The household economic impact of Rheumatic Heart Disease (RHD) in South Africa

Background: Rheumatic heart disease (RHD) remains a major public health concern in African countries due to the high rates of complications such as atrial fibrillation, stroke, infective endocarditis, and heart failure, all of which can result in premature death. In 2015, RHD was estimated to affect 33 million people globally and resulted in at least 320,000 deaths, nearly all of which were in low and middle-income countries. Comparing to other non-communicable diseases (NCDs), RHD imposes economic burden on households that if measures are not in place to mitigate this, it can impoverish such household. However, there are several literatures on the intergenerational economic consequences of other chronic diseases. But, there is no study regarding the household economic of RHD. This mini-dissertation sets out to estimate the household economic impact of RHD. Methods: This study was a follow-on study from the Global Rheumatic Heart Disease Registry (REMEDY), which was a multi-center, international, hospital-based prospective registry of patients with RHD. It was designed as a cohort study to document the disease characteristics and outcomes of individuals with RHD across many countries. We recruited participants in the REMEDY study who were resident in Cape Town and received care at Groote Schuur Hospital (GSH). This study made use of patient and household member surveys to estimate the economic consequences of RHD among households in which REMEDY participants reside. REMEDY registry participants (index cases), their caregivers, and other household members were considered as respondents. 100 REMEDY participants receiving care at GSH was sampled. This sample size was chosen to balance feasibility and precision and to align with a parallel study of the cost of RHD to the health system that aimed to sample medical records from the same 100 REMEDY participants. Patient and household data collection was carried out between September 2017 to December 2017. Direct costs, indirect costs, and the downstream economic behaviors (coping strategies) that lead to medical impoverishment and other consequences were estimated. Cost of illness (COI) was used to assess the effect of ill-health and health-related expenditure on the consumption possibilities of households. Direct costs comprise both medical and nonmedical costs, which may include both the financial cost of resources as well as opportunity costs (e.g., of capital items). Human capital approach was used to calculate indirect cost. Implicit in the human capital approach is the assumption that changes in health status of household members can be reflected by losses in productivity, and losses in income generation. Productivity losses was estimated using the new South Africa minimum wage rate per month as proxy. Coping was estimated with the direct costs (e.g., borrowing from friends or relatives, or taking out formal loans) or indirect costs (e.g., intra-household labor substitution) and can be cost prevention strategies (e.g., ignoring illness, non-treatment) to cost management strategies (e.g., borrowing, selling assets, or labor substitution). Economic costs were valued in United State dollar (USD) converted from South African rand (ZAR) in 2017. Results: Direct medical cost was estimated to ZAR 0, because all patients were exempt from medical fees. Total direct non-medical cost for outpatient and inpatient visits was estimated to be ZAR 27,000 (USD 2000) and 29,000 (USD 2200) (respectively) over 302 and 74 encounters (respectively), an average of ZAR 270 (USD 20) and ZAR 290 (USD 22) per patient (respectively). Indirect costs incurred over the 302 outpatient encounters and 74 hospital admissions were estimated to be ZAR 41,000 (USD 3100) and ZAR 26,000 (USD 1900) (respectively), an average of ZAR 410 (USD 31) and ZAR 260 (USD 19) per patient. Direct cost had a very high impact on the household and they were compelled to adopt coping. Households observed in the study recorded that seventeen percent of households took out loans at an average of ZAR 1200 (USD 91) per loan (range ZAR 100 to ZAR 7000) (range USD 7 to 500). Fifteen percent received financial gifts at an average of ZAR 800 (USD 61) per gift. Two percent sold assets valued at ZAR 5600 (USD 120) on average. Five percent engaged in multiple coping strategies. Also, HH had to cope with indirect cost of illness as 15% of household caregivers changed jobs and 10% worked extra hours. About 4% of household members dropped out of school. Four percent adopted more than one coping strategy. A considerable share of participants reported that they had reduced education to take care of the affected patient. Most of the caregivers of patients with RHD were spouses and children, and 6 % were heads of household. The total cost of RHD to the average affected household is valued at about ZAR 1600 annually. In total, the overall annual economic impact of RHD in this sample of 100 households affected by RHD was estimated at ZAR 160,000 (USD 12200) (ZAR 1600 per household) (USD 120), representing 4.4% of annual household income or 4.9% of annual household expenditure patient spending that exceeded 10% threshold was estimated to be 8% and increasing the threshold to 40 % of non- food expenditure reduced the prevalence of catastrophic spending to 4%. Conclusions: The economic impact of RHD in South Africa is substantial despite government efforts to provide free care. The total cost of RHD to the average affected household is valued at about ZAR 1600 annually. A broader and more robust range of social policies will be required to mitigate non-medical and indirect costs and reduce distortions in household economic activity

INVESTIGATION OF SPATIOTEMPORAL VARIABILITY AND CONTAMINATION OF PLASTIC MARINE DEBRIS IN QATAR’S COASTAL WATERS

There has been a tremendous proliferation in plastic production in the last five decades due to its low cost and versatile applications. Plastic debris dominates the marine litter globally and has been found in the most pristine environment including the abysmal region of the ocean. Studies show that over 8 million tons of plastics are dumped in the ocean annually. Plastics are persistent in the environment and take several decades to degrade especially in the ocean. Large plastic debris can destroy the coral reefs and may cause entanglement, choking, blockage of digestive tracts when ingested by turtles, whales, sharks etc, causing several thousand deaths annually among these organisms. Microplastics are tiny plastic particles that seldom originate from fragmentation of large plastic debris or are produced to serve some specific purposes. Microplastics pose greater threats as they can be mistaken for food by filter-feeders and planktivorous fish, and can also adsorb large quantities of recalcitrant organic pollutants (OPs) which biomagnify up the marine food web, hence, explains the need for their investigation. In the first phase of this study, the spatial and temporal distribution of microplastics was investigated in sediments and seawater respectively. Eight beaches across Qatar and four sea surface stations were surveyed between the months of December 2014 and March 2015. Microplastics were discovered in all samples and their abundance varied both in intertidal sandy beaches and sea surface. Since plastic debris are hydrophobic and easily adsorb organic pollutants the second phase of this study was targeted at investigating the concentration of PCBs and PAHs adsorbed on macroplastics in situ. Results showed that approximately all macroplastics analyzed were contaminated with PCBs and PAHs. Large piece-to-piece variations of contamination up to two orders of magnitude were discovered within sites (2 to 1,005 ng/g), although there was no significant difference in contaminant concentration among all sites for PCBs and PAHs respectively. Lastly, a field adsorption/desorption experiment was performed to investigate how pellets of different polymers and contaminated with POPs behave when placed in ambient seawater. Pellets were deployed and later retrieved at 48h, 96 h, 192 h, and 312 h respectively. The pellets were analyzed for PCBs and PAHs and undeployed pellets were also analyzed at time 0. Adsorbed PCBs and PAHs concentration showed a steady decrease with time, suggesting that contaminated pellets ending in the marine environment release their adsorbed contaminants in less contaminated seawaters revealing a complex OPs dynamic between plastics an seawater as a function of differential concentrations of pollutants. This study is the first of its kind in Qatar and seemingly in the entire Arabian Gulf region. Marine pollution is a growing concern in Qatar coastal and offshore environment. Marine debris is of major concern due to the fact that plastic can take several decades to be fully degraded. Results from this study indicate that microplastics are ubiquitous and the fact that they are easily mistaken for food and ingested by zooplankton and smaller fishes makes them a serious threat to the marine food web. Hence, a study on the spatiotemporal distribution of microplastics is crucial in investigating the size and polymeric properties of marine debris to give policy makers an insight of the sources of the debris and proffer suggestions on how to tackle the menace using a holistic approach

The influence of cultural coloration on conflict resolution by African Christian leaders : a study of Christian leaders and conflict resolution in Jos, Nigeria

https://place.asburyseminary.edu/ecommonsatsdissertations/1374/thumbnail.jp

Evaluation of Agroforestry Practices among Farmers of Kano State, Nigeria

Introduction: Integration of trees in agricultural land can certainly be complex and might be difficult to implement in various situations, and there is no one model that works for every region, but the benefits are significant. Trees are components of agroforestry system that contribute to food security, nutrition, medicine, income and environmental services. Aim: the study aimed to evaluate agroforestry practices among farmers of Kano State, Nigeria. Methodology: The study was conducted using multistage sampling procedure in which the state was characterized into three strata were selected from the three senatorial zone of the state making a selection of three (3) Local Government areas from each stratum and a total of  thirty six (36) villages. In each village, ten (10) interviewees were randomly selected for the structured questionnaire. Results: A total of three hundred and sixty (360) respondents were recruited in the study, of which, 137 majority (38 %) were between the ages of 30-39 years. 360 (100 %) males were the dominant sex, 271 (75 %) were married having at least the family size of 1-10 persons per household. 107, 97 and 45 had formal education (69 %) (primary 30 %, secondary 27 % and tertiary education 12 %). 234 (65 %) mainly engaged in farming, 176 (49 %) acquired their land through inheritance. Majority, 233 (65 %) of the farms size were between < 1-2 hectares. However, 143 (40 %) had average of 21-31 years of farming experience. The commonest predominant agroforestry practices are boundary markings 153 (43 %) and scattered trees on farmland 144 (40 %). Conclusion: the study shows that agroforestry practices are practiced among the farmers, though, more awareness will assist the farmers to enjoy all its benefits.   Keywords: Agroforestry; Practices; Trees; Farmers; Kano State; Nigeria. DOI: 10.7176/RHSS/12-17-02 Publication date:September 30th 202

Statistical Emulation for Environmental Sustainability Analysis

The potential effects of climate change on the environment and society are many. In order to effectively quantify the uncertainty associated with these effects, highly complex simulation models are run with detailed representations of ecosystem processes. These models are computationally expensive and can involve computer runs of several days for their outputs. Computationally cheaper models can be obtained from large ensembles of simulations using a statistical emulation. The purpose of this thesis is to construct cheaper computational models (emulators) from simulation outputs of Lund-Potsdam-Jena-managed Land (LPJmL) which is a dynamic global vegetation and crop model. This research work is part of a project called ERMITAGE. The project links together several key component models into a common framework to better understand how the management and interaction of land, water and the earth’s climate system could be improved. The thesis focuses specifically on emulation of major outputs from the LPJmL model; carbon fluxes (NPP, carbon loss due to heterotrophic respiration and fire carbon) and potential crop yields (cereal, rice, maize and oil crops). Future decadal changes in carbon fluxes and crop yields are modelled as linear functions of climate change and other relevant variables. The emulators are constructed using a combination of statistical techniques of stepwise least squares regression, principal component analysis, weighted least squares regression, censored regression and Gaussian process regression. Further modelling involves sensitivity analyses to identify the relative contribution of each input variable to the total output variance. This used the Sobol global sensitivity method. The data cover the period 2001-2100 and comprise climate scenarios of several GCMs and RCPs. Under cross validation the percentage of variance explained ranges from 52-96% for carbon fluxes, 60-88% for the rainfed crops and 62-93% for the irrigated crops, averaged over climate scenarios

Formation Evaluation of ‘J Field’, Niger Delta Using Well Log Data

Wireline logs from three (3) wells, 1, 2 and 3 were used to quantitatively evaluate the ‘J field’ of the Niger Delta area. The wells had been evaluated using a combination of Gamma-ray log, Resistivity logs and Neutron – Density logs. Wireline log analysis was used in the reservoir evaluation of the ‘J field’; the hydrocarbon sands were delineated by the use of gamma ray, resistivity and density/neutron from which the reservoir prospectivity were determined. Well 1 has 4 reservoirs, well 2 has 4 reservoirs and well 3 has 4 reservoirs, the reservoirs are namely (A, B, C, D) .This investigation helps to identify the lithologies and recognize the hydrocarbon bearing intervals as – well as to quantify the amount/type of hydrocarbon in the reservoirs contained in wells 1, 2, 3) for further exploration and exploitation in the ‘J field’ of the Niger Delta. The petrophysical properties of the reservoirs analyzed include: water saturation for wells 1, 2 and 3 ranging from (0.13– 0.26) %, (0.16 – 0.37) % and (0 – 0.41) %, porosity values; (18 –23) %, (14 – 20) % and (18 – 23) %, hydrocarbon saturation for the wells are; (0.74 – 0.86) %, (0.63 – 0.84) % and (0 – 0.59) % respectively. The net pay thickness for well 1 is 39.88 metres, well 2 is 53.4 metres and well 3 is 53.9 metres. The analysis of the wells depict the presence of hydrocarbons in well 1 and well 2, with only one reservoir (D) in well 3 indicating the presence of hydrocarbon. Keywords: (Hydrocarbon, Well logs, Reservoir and Volumetric Analysis) DOI: 10.7176/JEES/10-2-05 Publication date: February 29th 202

Influence of leafy biomass transfer of agroforestry trees with nitrogen fertilizer on maize stover yield in Makera, Nigeria

Cultivation of leguminous tree crops and biomass transfer is the main possibility for soil enrichment with nutrients, especially with nitrogen and play alternative role as source of organic fertilizer. This study investigated the influence of leafy biomass transfer of Albizia lebbeck and Parkia biglobosa leguminous agroforestry trees with urea on maize stover yield. A 3 x 4 x 2 factorial design in a split-split plot design was used for this experiment in three replicates for two years. The considered factors were; biomass species (Albizia lebbeck and Parkia biglobosa, and control) as main plots, four rates of nitrogen (0, 40, 80, 120 kg N ha-1) as sub-plots, and two maize varieties (DMR-ESR-7 and 2009 EVAT) as sub-sub plots. Data were statistically analysed using (ANOVA) at p =.05. Albizia lebbeck decomposed (38.2 g) faster than Parkia biglobosa (28.16 g). Decomposition rate constant (KD) and nitrogen release rate constant (KN) was higher in Albizia with the mean values of 15.04 week-1 and 10.74 week-1 than in Parkia (9.94 week-1, 7.89 week-1) in both seasons respectively; and this enhanced maize crop to promptly utilise the nutrient release in Albizia lebbeck. The result revealed that Albizia lebbeck leafy biomass alone brought about increase in stover yield. Nevertheless, addition of 120 kg N ha-1 urea produced higher stover yield in 2009 EVAT. Therefore, amendment of soil with Albizia lebbeck biomass and up to 40 kg N ha-1 urea improved soil quality and enhanced better stover yield production.Keywords: leafy biomass, transfer, agroforestry trees, urea, nutrient release, maize stover yiel

Temporal Water Balance Analysis in Different Climatic Scenarios in Oyo State, Nigeria

The study was conducted to examine water availability in different climatic scenarios in Oyo State. The data used comprised of rainfall and temperature records. The spans of the data used vary from one station to the other: 38-year data for Ibadan and 37-year for Ogbomoso stations, both collected from NIMET Office, Ilorin while 11-year also collected from the Office of Oyo State Agricultural Development Programme (OYSADEP) Headquarters at Shaki were available for Shaki Station. Evapotranspiration data for the three stations were empirically generated while water balance model was computed using MATLAB R2007a version in order to determine the respective water availability and the regression analysis was used to determine rainfall trends. The results showed that rainfall amounts vary from year to year and also increasing trends in the three stations over the period examined. It was also discovered that in all the periods investigated across the stations, Ibadan has 81.58%, Shaki, 81.81% and Ogbomoso, 56.80% as wet years indicating that there is abundant water resources in Oyo State. It is recommended that strategies  be put in place to exploit excess rainwater for various purposes especially by increasing the capacity of water reservoirs and dams across the State for development of pipe borne water network and also, for irrigation farming during dry spells. Further investigation is recommended on water balance and its implications for agricultural practice in the study area

A Prefeasibility Economic Evaluation and Geochemical Characteristics of Abuja Leather Mining District Pegmatites, Southwestern Nigeria

The Abuja leather mining district located in southwestern Nigeria is one of the productive pegmatite field in Nigeria and is known to bear valuable economic minerals and associated with granite gneiss were studied with a view to evaluate their petrogenetic characteristics and economic evaluation of the rare metal Ta-Nb mineralization in the area. A systematic geological survey, pitting, geochemical analysis and economic evaluation were carried out. Petrological studies were carried out on some selected representative rock samples were prepared and studied for petrographic analysis. Mineralization is limited to the pegmatites which are moderately weathered in the prospect zones and these streams of pegmatitic veins are semi discordant and they contain mainly quartz, muscovite, mica-plagioclase (albite), and microcline as the main minerals while tourmaline and beryl occur in subordinate amounts.Geochemical analysis revealed that the pegmatites are siliceous and of rare – metal type. The host rocks are peraluminous and of S – type. Albite, lepidolite and muscovites (extracted from the pegmatites) are significantly enriched in Li, Rb Cs, Nb and Ta compared to the granite gneiss. The whole rock samples showed strong affinity to the syn-collisional and volcanic arc granites with an enrichment LREE and a depletion in HREE with a strong negative Eu anomaly. the rare-metal pegmatites exhibit pronounced negative Eu and slightly positive Ce anomalies. The low K/Rb ratio of the pegmatites indicates fraction accompanied by Rb enrichment and Ba depletion. Probable reserves of Ta2O5, Nb2O5 and SnO2 for prospect 1 up to 20m assuming grade constancy is 131.00tons, 396.11tons and 306.96tons respectively, for prospect 2 is 279.05 tons, 858.913 tons and 783.08 tons respectively, for prospect 3 is 60.58 tons, 822.16 tons and 697.96tons respectively, for prospect 4 is 3.59 tons, 8.72 tons and 32.55 tons and for prospect 5 is 255.52 tons, 616.98 tons and 441.41 tons respectively. Proper process method to maximize recovery is suggested to make the venture profitable as enumerated in this research. The present system of recovery using simple planning method can only guarantee 11% recovery, which will not be economical considering the size of the deposit. Keywords: pegmatite, economic evaluation, geochemistry, recovery, Nigeria