Results-based monitoring and evaluation for organizations working in agricultural development: a guide for practitioners

The purpose of this guide for practitioners is to contribute to the development of RBM&E capacity and to facilitate its institutionalization in organizations dealing with agricultural development. The target audiences of the guide include the staff in planning, monitoring and evaluation departments/units of public organizations and non-governmental organizations dealing with agricultural development at federal, regional, zonal or district levels. Staff of the agricultural research and higher learning institutes may also find the guide useful. It is assumed that users of the guide would have some basic knowledge of project/program/policy planning and implementation. The guide is based on an extensive review of M&E literature and the experiences of the RBM&E activities of the IPMS (Improving Productivity and Market Success) of Ethiopian farmers project.1 As part of its overall approach to market-oriented agricultural development, the IPMS project is working to facilitate the use and institutionalization of RBM&E system. The guide is organized as follows. Section two deals with basic concepts of RBM&E. Section three presents the relationships between the concepts and practices of M&E. Section four deals with the concepts and applications of participatory monitoring and evaluation. Sections five and six present the practices and processes of the selection of results to monitor and evaluate, and the selection of key performance indicators, respectively. Section seven discusses the methods of setting baseline data and targets, and section eight deals with data collection and analysis. While section nine deals with reporting and using M&E information, section ten discusses issues, approaches and requirements for institutionalizing and sustaining the RBM&E system

Outcomes of TB/HIV co-infected patients presenting with antituberculosis drug-induced liver injury

Background. South Africa has a significant burden of tuberculosis (TB). Anti-TB drug-induced liver injury (TB DILI) is one of the most serious adverse events that can arise from TB treatment (TBT). There are  limited data on TB DILI among HIV-infected patients and those on antiretroviral therapy (ART).Objective. To describe characteristics of HIV-infected patients presenting with TB DILI and the  proportion reintroduced on standard or modified TBT after DILI.Methods. This was a retrospective study of TB/HIV co-infected patients with DILI between 1 July 2009  and 30 September 2012. The primary focus of interest was HIV-infected patients with TB DILI on ART (ART/TB DILI) v. not on ART (TB DILI).Results. A total of 94 patients were included, 41 with TB DILI and 53 with ART/TB DILI. Compared with  patients with TB DILI, patients with ART/TB DILI were more likely to present with symptomatic DILI  (71.2% v. 51.2%; p=0.03) and had a lower median alanine aminotransferase level at diagnosis (89 IU/L v. 118 IU/L; p=0.008), a lower rate of ALT decline (–23 IU/L v. –76 IU/L; p=0.047) and longer duration of TBT at DILI diagnosis (53 days v. 11 days; p<0.001). In 71.8% of patients, standard TBT was reintroduced. More patients with ART/TB DILI than TB DILI required modified TBT (37.2% v.17.1%; p=0.05; crude odds ratio 2.17; 95% confidence interval 0.95 - 4.96). The rate of death/loss to follow-up was higher in the ART/TB DILI group (18.9% v. 14.5%).Conclusion. A significant number of TB/HIV co-infected patients were not able to tolerate standard TBT. Furthermore, ART appears to complicate TBT, with relatively fewer patients reintroduced on standard TBT

Missed appointments among rifampicin-resistant tuberculosis (RR-TB) patients at a decentralised RRTB outpatient clinic in Johannesburg, South Africa

Background. With the implementation of outpatient (ambulatory) decentralised rifampicin-resistant tuberculosis (RR-TB) treatment in South Africa (SA) since late 2011, the high rates of loss from treatment are a significant concern. Missed appointments lead to treatment interruptions and may contribute to amplification of resistance, ongoing transmission of RR-TB and an increased risk of morbidity and mortality to the patient.Objective. To describe characteristics of patients who missed scheduled appointments during ambulatory RR-TB treatment.Methods. The study was a retrospective, deidentified electronic medical record review of RR-TB patients at an outpatient clinic in Johannesburg, SA, from March 2013 to December 2014. Associations between missed appointments and clinical and demographic characteristics were analysed using time-to-event Cox proportional hazards regression.Results. Of 172 patients who met the eligibility criteria, 53.5% missed at least one appointment and 39.5% missed three or more. More than half (59.8%) of first missed appointments occurred within the first 3 months after treatment initiation. The median number of days from initiation until the first missed appointment was 82 (interquartile range 52 - 260.5). HIV-infected patients with a CD4 count of ≤100 cells/ μL (adjusted hazard ratio (aHR) 4.25, 95% confidence interval (CI) 1.49 - 12.18), patients referred from an inpatient facility (aHR 1.96, 95% CI 1.18 - 3.25) and patients aged 18 - 24 years as opposed to those aged 35 - 44 years (aHR 3.26, 95% CI 1.20 - 8.84) were all more likely to miss one or more appointments.Conclusion. HIV-infected patients with a low CD4 count, patients referred from inpatient care and young patients are at high risk of missing appointments and should receive interventions targeted at improving retention

Outcomes of TB/HIV co-infected patients presenting with antituberculosis drug-induced liver injury

Background. South Africa has a significant burden of tuberculosis (TB). Anti-TB drug-induced liver injury (TB DILI) is one of the most serious adverse events that can arise from TB treatment (TBT). There are limited data on TB DILI among HIV-infected patients and those on antiretroviral therapy (ART).Objective. To describe characteristics of HIV-infected patients presenting with TB DILI and the proportion reintroduced on standard or modified TBT after DILI.Methods. This was a retrospective study of TB/HIV co-infected patients with DILI between 1 July 2009 and 30 September 2012. The primary focus of interest was HIV-infected patients with TB DILI on ART (ART/TB DILI) v. not on ART (TB DILI).Results. A total of 94 patients were included, 41 with TB DILI and 53 with ART/TB DILI. Compared with patients with TB DILI, patients with ART/TB DILI were more likely to present with symptomatic DILI (71.2% v. 51.2%; p=0.03) and had a lower median alanine aminotransferase level at diagnosis (89 IU/L v. 118 IU/L; p=0.008), a lower rate of ALT decline (–23 IU/L v. –76 IU/L; p=0.047) and longer duration of TBT at DILI diagnosis (53 days v. 11 days; p<0.001). In 71.8% of patients, standard TBT was reintroduced. More patients with ART/TB DILI than TB DILI required modified TBT (37.2% v.17.1%; p=0.05; crude odds ratio 2.17; 95% confidence interval 0.95 - 4.96). The rate of death/loss to follow-up was higher in the ART/TB DILI group (18.9% v. 14.5%).Conclusion. A significant number of TB/HIV co-infected patients were not able to tolerate standard TBT. Furthermore, ART appears to complicate TBT, with relatively fewer patients reintroduced on standard TBT

Magnetic field reversals in an experimental turbulent dynamo

We report the first experimental observation of reversals of a dynamo field generated in a laboratory experiment based on a turbulent flow of liquid sodium. The magnetic field randomly switches between two symmetric solutions B and -B. We observe a hierarchy of time scales similar to the Earth's magnetic field: the duration of the steady phases is widely distributed, but is always much longer than the time needed to switch polarity. In addition to reversals we report excursions. Both coincide with minima of the mechanical power driving the flow. Small changes in the flow driving parameters also reveal a large variety of dynamo regimes.Comment: 5 pages, 4 figure

Dynamo Transition in Low-dimensional Models

Two low-dimensional magnetohydrodynamic models containing three velocity and three magnetic modes are described. One of them (nonhelical model) has zero kinetic and current helicity, while the other model (helical) has nonzero kinetic and current helicity. The velocity modes are forced in both these models. These low-dimensional models exhibit a dynamo transition at a critical forcing amplitude that depends on the Prandtl number. In the nonhelical model, dynamo exists only for magnetic Prandtl number beyond 1, while the helical model exhibits dynamo for all magnetic Prandtl number. Although the model is far from reproducing all the possible features of dynamo mechanisms, its simplicity allows a very detailed study and the observed dynamo transition is shown to bear similarities with recent numerical and experimental results.Comment: 7 page

A call to action: Addressing the reproductive health needs of women with drug-resistant tuberculosis

Although there is substantial risk to maternal and neonatal health in the situation of pregnancy during treatment for rifampicin-resistant tuberculosis (RR-TB), there is little evidence to guide clinicians as to how to manage this complexity. Of the 49 680 patients initiated on RR-TB treatment from 2009 to 2014 in South Africa, 47% were women and 80% of them were in their reproductive years (15 - 44). There is an urgent need for increased evidence of the safety of RR-TB treatment during pregnancy, increased access to contraception during RR-TB treatment, and inclusion of reproductive health in research on the prevention and treatment of TB

Transport of magnetic field by a turbulent flow of liquid sodium

We study the effect of a turbulent flow of liquid sodium generated in the von K\'arm\'an geometry, on the localized field of a magnet placed close to the frontier of the flow. We observe that the field can be transported by the flow on distances larger than its integral length scale. In the most turbulent configurations, the mean value of the field advected at large distance vanishes. However, the rms value of the fluctuations increases linearly with the magnetic Reynolds number. The advected field is strongly intermittent.Comment: 4 pages, 6 figure