Characterization of the exopolysaccharide produced by a whey utilizing strain of Klebsiella oxytoca

Physical, chemical and rheological properties of a polysaccharide produced by an isolate of Klebsiella oxytoca were characterized. Freeze dried samples of the polysaccharide were neutral and werecompletely soluble in water. Samples did not form gels even in the presence of salt treatments. The major monosaccharide constituents of the polysaccharide were rhamnose (37%, w/w) and glucose(34%, w/w). Residues of cellobiose were detected, suggesting that the polysaccharide had a cellulose backbone. The gum was more comparable to broth apparent viscosities of xanthan gum than to gellangum. The K. oxytoca polysaccharide (KOP) produced high solution viscosity at low concentrations. At a gum concentration 0.5% (w/v), an apparent viscosity of 400 cP at 24 s-1 was obtained. Rheologicalbehavior showed that the KOP formed non newtonian fluids, indicating that it is a pseudoplastic biopolymer. Although the KOP solutions displayed pseudoplastic behavior, increases in shearing timedid not result in significant changes on the apparent viscosity. This indicated that the gum is neither thixotropic nor rheopectic. The conclusion reached about the potential application of the gum was thatit could be suitable for use as a stabilizing or suspending agent rather than a gelling agent

Some Swazi phytomedicines and their constituents

Ethnobotanical surveys of Manzini and Shiselweni regions of Swaziland were conducted to document new phytomedicines used in Swaziland and to determine their chemical constituents with a view toprovide the scientific basis of the use of the remedies in traditional medical practice and as a guide to bioprospecting for drugs. The plants collected in the surveys were extracted with suitable solvents andanalysed for secondary metabolites. Sixty one medicinal plants from thirty five families used for treating thirty one diseases were analysed. The medicinal uses of these plants had never been documentedin the pharmacopoeia of Swaziland. Different classes of secondary metabolites were found in the plants, namely alkaloids, anthranoids, flavonoids, glycosides, polyphenols, saponins, steroids andtannins. Some of the diseases the plants were used to treat are back ache, cardiac problems, chest pain, cough, diabetes, diarrhoea, headache, menorrhagia, snake bite, stomach ache and urino-genitalproblems. The presence of these secondary metabolites in the plants was of great importance in the understanding of the basis of the use of the plants in traditional medical practice and may provide alead in bioprospecting for new pharmaceutical products of herbal origin

Measuring HIV stigma for PLHAs and nurses over time in five African countries

The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho, Malawi, South Africa, Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69), and 67.1% (N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63), and 88.6% (N=784) were females. Eighty-four per cent of all PLHAs reported one or more HIV-stigma events at baseline. This declined, but was still significant 1 year later, when 64.9% reported experiencing at least one HIV-stigma event. At baseline, 80.3% of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.7% 1 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions, particularly focused at health care providers who experience HIV stigma by association

Prejudice and misconceptions about tuberculosis and HIV in rural and urban communities in Ethiopia: a challenge for the TB/HIV control program

<p>Abstract</p> <p>Background</p> <p>In Ethiopia, where HIV and tuberculosis (TB) are very common, little is known about the prejudice and misconceptions of rural communities towards People living with HIV/AIDS (PLHA) and TB.</p> <p>Methods</p> <p>We conducted a cross sectional study in Gilgel Gibe Field Research area (GGFRA) in southwest Ethiopia to assess the prejudice and misconceptions of rural and urban communities towards PLHA and TB. The study population consisted of 862 randomly selected adults in GGFRA. Data were collected by trained personnel using a pretested structured questionnaire. To triangulate the findings, 8 focus group discussions among women and men were done.</p> <p>Results</p> <p>Of the 862 selected study participants, 750(87%) accepted to be interviewed. The mean age of the respondents was 31.2 (SD ± 11.0). Of the total interviewed individuals, 58% of them were females. More than half of the respondents did not know the possibility of transmission of HIV from a mother to a child or by breast feeding. For fear of contagion of HIV, most people do not want to eat, drink, and share utensils or clothes with a person living with HIV/AIDS. A higher proportion of females [OR = 1.5, (95% CI: 1.0, 2.2)], non-literate individuals [OR = 2.3, (95%CI: 1.4, 3.6)], rural residents [OR = 3.8, (95%CI: 2.2, 6.6)], and individuals who had poor knowledge of HIV/AIDS [OR = 2.8, (95%CI: 1.8, 2.2)] were more likely to have high prejudice towards PLHA than respectively males, literates, urban residents and individuals with good knowledge. Exposure to cold air was implicated as a major cause of TB. Literates had a much better knowledge about the cause and methods of transmission and prevention of TB than non-literates. More than half of the individuals (56%) had high prejudice towards a patient with TB. A larger proportion of females [OR = 1.3, (95% CI: 1.0, 1.9)] and non-literate individuals [OR = 1.4, (95% CI: 1.1, 2.0)] had high prejudice towards patients with TB than males and literate individuals.</p> <p>Conclusion</p> <p>TB/HIV control programs in collaboration with other partners should invest more in social mobilization and education of the communities to rectify the widespread prejudice and misconceptions.</p

Factors associated with HIV testing among youth in a generalised hyperendemic setting: findings from a national survey in Eswatini

Aim: Even though Eswatini was the first country in Africa to achieve the UNAIDS 95-95-95 targets among people living with HIV nationally, youth aged 15–24 years lag behind in HIV testing. This study determined the overall prevalence of HIV testing among the youth and the factors associated with HIV testing.Methods: Data were analysed for 1 834 young people from the 2016–2017 Swaziland HIV Incidence Measurement Survey (SHIMS2) using multivariable logistic regression.Results: Overall, 66% of the young people had tested for HIV in the past 12 months before SHIMS2. Lower odds of HIV testing were observed among males, among those aged 15–17 years, the never married/cohabited, those with primary and secondary education, and among those who had high perceived stigma towards people living with HIV and AIDS. Youth from households classified in the poor and middle quintiles had higher odds of testing for HIV compared to those from rich households.Conclusion: Efforts to increase HIV testing should consider the sociodemographic and behavioural factors identified as determinants of HIV non-testing in this age group

Evaluation of a Health Setting-Based Stigma Intervention in Five African Countries

The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and 10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses (n = 134) completed a demographic questionnaire, the HIV/AIDS Stigma Instrument-Nurses (HASI-N), a self-efficacy scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set of instruments before and after the intervention, with the PLHA completing the HIV/AIDS Stigma Instrument for PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well received. It led to understanding and mutual support between nurses and PLHA and created some momentum in all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to change. Further evaluation research with control groups and larger samples and measuring change over longer periods of time is indicated

"You are wasting our drugs": health service barriers to HIV treatment for sex workers in Zimbabwe.

BACKGROUND: Although disproportionately affected by HIV, sex workers (SWs) remain neglected by efforts to expand access to antiretroviral treatment (ART). In Zimbabwe, despite the existence of well-attended services targeted to female SWs, fewer than half of women diagnosed with HIV took up referrals for assessment and ART initiation; just 14% attended more than one appointment. We conducted a qualitative study to explore the reasons for non-attendance and the high rate of attrition. METHODS: Three focus group discussions (FGD) were conducted in Harare with HIV-positive SWs referred from the 'Sisters with a Voice' programme to a public HIV clinic for ART eligibility screening and enrolment. Focus groups explored SWs' experiences and perceptions of seeking care, with a focus on how managing HIV interacted with challenges specific to being a sex worker. FGD transcripts were analyzed by identifying emerging and recurring themes that were specifically related to interactions with health services and how these affected decision-making around HIV treatment uptake and retention in care. RESULTS: SWs emphasised supply-side barriers, such as being demeaned and humiliated by health workers, reflecting broader social stigma surrounding their work. Sex workers were particularly sensitive to being identified and belittled within the health care environment. Demand-side barriers also featured, including competing time commitments and costs of transport and some treatment, reflecting SWs' marginalised socio-economic position. CONCLUSION: Improving treatment access for SWs is critical for their own health, programme equity, and public health benefit. Programmes working to reduce SW attrition from HIV care need to proactively address the quality and environment of public services. Sensitising health workers through specialised training, refining referral systems from sex-worker friendly clinics into the national system, and providing opportunities for SW to collectively organise for improved treatment and rights might help alleviate the barriers to treatment initiation and attention currently faced by SW

'My dreams are shuttered down and it hurts lots'-a qualitative study of palliative care needs and their management by HIV outpatient services in Kenya and Uganda.

BACKGROUND: Despite the huge burden of HIV in sub-Saharan Africa, there is little evidence of the multidimensional needs of patients with HIV infection to inform the person-centred care across physical, psychological, social and spiritual domains stipulated in policy guidance. We aimed to describe the problems experienced by people with HIV in Kenya and Uganda and the management of these problems by HIV outpatient services. METHODS: Local researchers conducted in depth qualitative interviews with HIV patients, caregivers and service staff at 12 HIV outpatient facilities (6 in Kenya, 6 in Uganda). Interview data were analysed thematically. RESULTS: 189 people were interviewed (83 patients, 47 caregivers, 59 staff). The impact of pain and symptoms and their causes (HIV, comorbidities, treatment side-effects) were described. Staff reported that effective pain relief was not always available, particularly in Kenya. Psychosocial distress (isolation, loneliness, worry) was exacerbated by stigma and poverty, and detrimentally affected adherence. Illness led to despair and hopelessness. Provision of counselling was reported, but spiritual support appeared to be less common. Neither pain nor psychosocial problems were routinely reported to service staff. Collaboration with local hospices and income-generation activities for patients were highlighted as useful. CONCLUSIONS: The findings demonstrate the multiple and interrelated problems associated with living with HIV and how psychosocial and spiritual distress can contribute to 'total pain' in this population. In line with the palliative care approach, HIV care requires holistic care and assessment that take into account psychological, socioeconomic and spiritual distress alongside improved access to pain-relieving drugs, including opioids