Demographic profile of patients diagnosed with intracranial meningiomas in two academic hospitals in Johannesburg, South Africa: a 12-month prospective study

Background: Meningiomas are common brain tumours and display gender, racial and ethnic differences in their demographic profile. The demographic profile of our patients diagnosed with intracranial meningiomas is presented and compared with the literature.Objectives: To determine the age, gender, racial and ethnic distribution of our patients diagnosed with intracranial meningiomas.Methods: Consecutive patients (48 in number) seen at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and Chris Hani Baragwanath Academic Hospital (CHBAH), Johannesburg, with histologically proven meningiomas over a 12 month period were recruited for the study.Results: Meningiomas accounted for 33.8% of all primary brain tumours. The mean age of patients was 45.7 ± 10.5 years with a female-to-male ratio of 3.8:1. The mean age for male patients was 39.3 ± 13.5 years while that of female patients was 47.4 ± 9.0 years. The peak age range at presentation was in the fifth (41.7%) decade. The highest frequency was among Black Africans (75%) and Sotho ethnic nationality (27.1%).Conclusion: The study showed a female preponderance for intracranial meningiomas among our patients. Although intracranial meningiomas were more in frequency among Black Africans, the racial distribution mirrored our population distribution while the highest frequency was among Sotho ethnic nationality.Key words: intracranial meningioma, demographic profile, age, gender, race, ethni

Assessment of the Impact of Effluents Discharge from Murang’a Town and Its Environs on the Water Quality of River Mathioya, Murang’a County, Kenya

Effect of effluents into rivers is of great economic, environmental and health concern. Chemical fertilizers are used extensively in modern agriculture, in order to improve yield and productivity of agricultural products. However, nutrients, leaching through the soil from agricultural activities, sewerage effluents and runoff from residential areas reaching river water resources are causing serious pollution. The purpose of this study was to determine the impact of effluent discharges on water quality of River Mathioya in Murang’a County, Kenya. Samples were collected upstream and downstream of Murang’a town along the Mathioya River. The pH, dissolved oxygen, electrical conductivity, total dissolved solid, total suspended solids and temperature were determined using the respective meters. Heavy metals were determined using flame atomic absorption spectrometry while sodium and potassium were determined using flame photometry. Nitrates and phosphates were determined using UV/Visible spectrophotometry. Fluoride ion selective electrode was used to determine fluoride. The study has shown that there was considerable amount of heavy metals in the water samples of Mathioya River, though the levels were below WHO maximum permissible levels for zinc 0.05 - 0.08, chromium 0.02 - 0.03, lead was below the limit of detection and copper 0.03 - 0.04 while iron 0.73 - 1.16 and manganese 0.88-2.24 mg/L exceeded this limit. The concentrations of the physicochemical parameters pH 6.94 - 7.76, TDS (37.84 - 54.59 mg/L), TSS (42.78 - 53.84 mg/L), DO (4.75 - 8.27 mg/L) and EC 63.89 - 80.17, nitrates (6.40 - 13.66 mg/L), phosphates (0.29 - 0.91 mg/L) and fluoride (0.68 - 0.88 mg/L). Keywords: AAS, AES, UV/VIS, ISE, physico-chemical parameters, nutrients levels, heavy metals

Census and ear-notching of black rhinos (Diceros bicornis michaeli) in Tsavo East National Park, Kenya

This paper updates the status of the black rhino population in Tsavo East National Park (NP). Data were acquired through aerial counts of the black rhino between 3 and 9 October 2010 using three fixed-wing husky aircrafts and a Bell 206L helicopter in an area of about 3,300 km2. Based on previous sightings of rhinos, the area was divided into 14 blocks, with each block subdivided into 400 m transects. An aircraft flying at about 500 m above the ground was assigned to carry out the aerial survey following these transects within each block. Observers scanned for rhinos about 200 m on either sides of the flight paths. Intensive searches in areas with dense vegetation, especially along the Galana and Voi Rivers and other known rhino range areas was also carried out by both the huskies and the helicopter. The count resulted in sighting of 11 black rhinos. Seven of these individuals were ear notched and fitted with radio transmitters and the horns were tipped off to discourage poaching. Three of the seven captured rhinos were among the 49 animals translocated to Tsavo East between 1993 and 1999. The other four animals were born in Tsavo East. Two female rhinos and their calves were not ear-notched or fitted with transmitters. It is recommended that another count be carried out immediately after the wet season as the rhinos spend more time in the open areas while the vegetation is still green. The repeat aerail count is to include blocks north of River Galana

Smart Armyworm Surveillance: Project Technical Report

This project was designed to test three different technologies for monitoring the fall armyworm, a highly migratory moth pest of maize in Kenya. This insect is invasive and is estimated to have caused between US$200 and US$600 million dollars’ worth of crop damage in Africa since it was first observed in western Africa in 2016. The three technologies we piloted were entomological radar, digital pheromone traps and an image identification app. The hypothesis we set out to test was that high-altitude moth migrations are linked to pest incidence at ground level and the later impacts of feeding damage. Our objective was to install and launch all three technologies in the space of a year, with the aim of developing an integrated dataset that would provide an overview of near-ground and upper-atmospheric movements of fall armyworm. This data would be shared with multiple different stakeholders in real-time. Over a 12-month period between March 2019 and February 2020, we installed the entomological radar, 20 digital pheromone traps and launched the Nondo app to test this hypothesis. Although there were several challenges, the outcomes after one year include: 1. Preliminary radar data. We were able to detect insects at heights up to 800m and the preliminary data would suggest these are targets of the appropriate mass to be classed as noctuid moths 2. A network of digital pheromone traps. We observed fall armyworm in almost all of the locations where the traps were installed and received daily automated updates, despite the traps being hosted in very rural parts of Kenya. 3. An image detection algorithm for the fall armyworm and other maize pests. This provided a very high level of accuracy for species where we were able to provide more than 100 images (>90% in some cases). This project has profound potential for impact as it demonstrates the successful implementation of an “internet of things” approach to biological monitoring in very rural parts of Kenya. Indeed, one of the highlights of this project is the deployment of the digital trap network beyond the end of the project. This is the first time such an ambitious, multi-layered monitoring network comprising radar, pheromone traps, machine learning and decision support apps has been established in Sub-Saharan Africa. This project is a proof-of-concept that clearly demonstrates the potential of digital monitoring to deliver major impacts for farmers in Sub-Saharan Africa

Putting the C Back into the ABCs: A Multi-Year, Multi-Region Investigation of Condom Use by Ugandan Youths 2003-2010

A major strategy for preventing transmission of HIV and other STIs is the consistent use of condoms during sexual intercourse. Condom use among youths is particularly important to reduce the number of new cases and the national prevalence. Condom use has been often promoted by the Uganda National AIDS Commission. Although a number of studies have established an association between condom use at one's sexual debut and future condom use, few studies have explored this association over time, and whether the results are generalizable across multiple locations. This multi time point, multi district study assesses the relationship between sexual debut and condom use and consistent use of condoms thereafter. Uganda has used Lot Quality Assurance Sampling surveys since 2003 to monitor district level HIV programs and improve access to HIV health services. This study includes 4518 sexually active youths interviewed at five time points (2003-2010) in up to 23 districts located across Uganda. Using logistic regression, we measured the association of condom use at first sexual intercourse on recent condom usage, controlling for several factors including: age, sex, education, marital status, age at first intercourse, geographical location, and survey year. The odds of condom use at last intercourse, using a condom at last intercourse with a non-regular partner, and consistently using a condom are, respectively, 9.63 (95%WaldCI = 8.03-11.56), 3.48 (95%WaldCI = 2.27-5.33), and 11.12 (95%WaldCI = 8.95-13.81) times more likely for those individuals using condoms during their sexual debut. These values did not decrease by more than 20% when controlling for potential confounders. The results suggest that HIV prevention programs should encourage condom use among youth during sexual debut. Success with this outcome may have a lasting influence on preventing HIV and other STIs later in life

The psychological and social impacts of curfew during the covid-19 outbreak in Kuwait: a cross-sectional study

The Coronavirus (COVID-19) pandemic in Kuwait led to a nationwide curfew between 22 March and August 2020. The purpose of this study was to evaluate the impact of the COVID-19 curfew during the pandemic on Kuwaiti citizens and residents. A cross-sectional survey was used to collect data from Kuwaiti residents over the age of 21 through an online questionnaire shared via social media, including WhatsApp and Facebook. Data collection occurred between 18 June and 15 July 2020. Data from 679 respondents (57.9% females and 42.1% males; 67.7% Kuwaiti nationals and 32.3% non-Kuwaiti nationals) were analyzed. Symptoms of depression were reported among 59.8% of females and 51.0% of males, and extremely severe depression among 20.4% of females and 13.6% of males. Approximately 42.0% of females and 37.8% of males were under psychological distress, with 15.1% of females and 9.1% of males experiencing severe or extremely severe psychological distress. Over a third of females (34.9%) reported experiencing tensions or violent behaviors from family members, and 22.1% reported verbal or physical abuse. Among males, 26.4% reported experiencing tensions or violent behaviors, and 12.2% reported verbal or physical abuse. Extremely severe depression was associated with being female (2.00 times), aged 21–29 (4.56 times), experiencing tensions or violent behaviors from family members (4.56 times), being physically inactive (1.64 times), smoking cigarettes (3.02 times), and having poor or very poor quality of sleep (1.75 times). Severe or extremely severe psychological distress was associated with being female (3.09 times), aged 21–49 (3.68 times), having ill-health conditions or diseases (1.83 times), experiencing tension or violent behaviors from family members (3.56 times), smoking cigarettes (3.06 times), and having poor or very poor quality of sleep (2.20 times). Findings indicate that people living in Kuwait experienced negative psychological impacts, such as depression and psychological distress, attributable to the pandemic-related restrictions. Unpartnered females aged 21–49 are more mentally vulnerable than partnered males over the age of 50. Findings support an urgent need for targeted interventions to improve health behaviors and social support, including coping mechanisms specific to COVID-19 related stress, family counseling systems, and the provision of accessible and acceptable services using telehealth

Access and use of interventions to prevent and treat malaria among pregnant women in Kenya and Mali: a qualitative study.

BACKGROUND: Coverage of malaria in pregnancy interventions in sub-Saharan Africa is suboptimal. We undertook a systematic examination of the operational, socio-economic and cultural constraints to pregnant women's access to intermittent preventive treatment (IPTp), long-lasting insecticide-treated nets (LLINs) and case management in Kenya and Mali to provide empirical evidence for strategies to improve coverage. METHODS: Focus group discussions (FGDs) were held as part of a programme of research to explore the delivery, access and use of interventions to control malaria in pregnancy. FGDs were held with four sub-groups: non-pregnant women of child bearing age (aged 15-49 years), pregnant women or mothers of children aged <1 year, adolescent women, and men. Content analysis was used to develop themes and sub-themes from the data. RESULTS: Women and men's perceptions of the benefits of antenatal care were generally positive; motivation among women consisted of maintaining a healthy pregnancy, disease prevention in mother and foetus, checking the position of the baby in preparation for delivery, and ensuring admission to a facility in case of complications. Barriers to accessing care related to the quality of the health provider-client interaction, perceived health provider skills and malpractice, drug availability, and cost of services. Pregnant women perceived themselves and their babies at particular risk from malaria, and valued diagnosis and treatment from a health professional, but cost of treatment at health facilities drove women to use herbal remedies or drugs bought from shops. Women lacked information on the safety, efficacy and side effects of antimalarial use in pregnancy. CONCLUSION: Women in these settings appreciated the benefits of antenatal care and yet health services in both countries are losing women to follow-up due to factors that can be improved with greater political will. Antenatal services need to be patient-centred, free-of-charge or highly affordable and accountable to the women they serve

Combining national survey with facility-based HIV testing data to obtain more accurate estimate of HIV prevalence in districts in Uganda.

BACKGROUND: National or regional population-based HIV prevalence surveys have small sample sizes at district or sub-district levels; this leads to wide confidence intervals when estimating HIV prevalence at district level for programme monitoring and decision making. Health facility programme data, collected during service delivery is widely available, but since people self-select for HIV testing, HIV prevalence estimates based on it, is subject to selection bias. We present a statistical annealing technique, Hybrid Prevalence Estimation (HPE), that combines a small population-based survey sample with a facility-based sample to generate district level HIV prevalence estimates with associated confidence intervals. METHODS: We apply the HPE methodology to combine the 2011 Uganda AIDS indicator survey with the 2011 health facility HIV testing data to obtain HIV prevalence estimates for districts in Uganda. Multilevel logistic regression was used to obtain the propensity of testing for HIV in a health facility, and the propensity to test was used to combine the population survey and health facility HIV testing data to obtain the HPEs. We assessed comparability of the HPEs and survey-based estimates using Bland Altman analysis. RESULTS: The estimates ranged from 0.012 to 0.178 and had narrower confidence intervals compared to survey-based estimates. The average difference between HPEs and population survey estimates was 0.00 (95% CI: - 0.04, 0.04). The HPE standard errors were 28.9% (95% CI: 23.4-34.4) reduced, compared to survey-based standard errors. Overall reduction in HPE standard errors compared survey-based standard errors ranged from 5.4 to 95%. CONCLUSIONS: Facility data can be combined with population survey data to obtain more accurate HIV prevalence estimates for geographical areas with small population survey sample sizes. We recommend use of the methodology by district level managers to obtain more accurate HIV prevalence estimates to guide decision making without incurring additional data collection costs

An assessment of facility-based care of diabetes, hypertension, and heart failure across western Kenya

Background: Low- and middle- income countries account for three-fourths of the global non- communicable disease related mortality. In response to the increasing number of non- communicable disease diagnoses in Kenya, the government released a national strategy for non- communicable disease in 2015. The purpose of this study was to assess facility-based care of diabetes, hypertension, and heart failure across western Kenya.Methods: A 71-question cross-sectional survey was administered among facility-based healthcare workers in Siaya County, western Kenya, between October 2015 and January 2016. All Level 4 and 5 facilities, as well as a cohort of lower-level facilities were surveyed.Results: Of the 21 health facilities surveyed, six (31.6%) had specific non-communicable disease clinics. Eleven of the 21 (52.4%) facilities had glucometers, and providers indicated that even these glucometers were often not functional. Three of the 21 facilities (14.3%) had a diabetic registry, one a functioning electrocardiogram machine, and one other a congestive heart failure registry.Conclusions: Facilities at every level were lacking equipment and medications expected by the Kenya’s Essential Package of Health Services. Improvement for follow up and referral services could be achieved through the development of comprehensive non-communicable disease registries