Peasant farmer–raptor conflicts around Chembe Bird Sanctuary, Zambia, Central Africa: poultry predation, ethno–biology, land use practices and conservation

Los conflictos entre campesinos y rapaces alrededor del refugio de Chembe Bird, en Zambia, África central: depredación de aves de corral, etnobiología, prácticas de uso de la tierra y conservación Las rapaces prestan servicios ecosistémicos a las comunidades rurales de África: (1) depredando roedores, (2) regulando las poblaciones de serpientes dañinas, (3) configurando las creencias culturales y (4) formando parte de las atracciones turísticas. Sin embargo, los campesinos las relacionan con la disminución de las aves de corral, las profecías telepáticas y la brujería tradicional. En consecuencia, las rapaces son perseguidas por los humanos. Mediante una técnica de análisis cualitativo de contenido, analizamos la interacción entre los campesinos y las rapaces en zonas adyacentes al refugio de Chembe Bird. Nuestros resultados revelan las prácticas, actitudes y percepciones negativas que podrían poner en peligro de extinción a cinco rapaces en la zona de estudio. A fin de mejorar la coexistencia entre agricultores y rapaces, proponemos utilizar medidas transformadoras de carácter conceptual (por ejemplo, sensibilizar a las partes interesadas, garantizar el cumplimiento riguroso de la legislación relativa a las rapaces y proteger su hábitat, así como reforzar el capital social relacional) y medidas prácticas (como proporcionar cercados apropiados y aves de corral de fenotipos de alta resistencia).Los conflictos entre campesinos y rapaces alrededor del refugio de Chembe Bird, en Zambia, África central: depredación de aves de corral, etnobiología, prácticas de uso de la tierra y conservación Las rapaces prestan servicios ecosistémicos a las comunidades rurales de África: (1) depredando roedores, (2) regulando las poblaciones de serpientes dañinas, (3) configurando las creencias culturales y (4) formando parte de las atracciones turísticas. Sin embargo, los campesinos las relacionan con la disminución de las aves de corral, las profecías telepáticas y la brujería tradicional. En consecuencia, las rapaces son perseguidas por los humanos. Mediante una técnica de análisis cualitativo de contenido, analizamos la interacción entre los campesinos y las rapaces en zonas adyacentes al refugio de Chembe Bird. Nuestros resultados revelan las prácticas, actitudes y percepciones negativas que podrían poner en peligro de extinción a cinco rapaces en la zona de estudio. A fin de mejorar la coexistencia entre agricultores y rapaces, proponemos utilizar medidas transformadoras de carácter conceptual (por ejemplo, sensibilizar a las partes interesadas, garantizar el cumplimiento riguroso de la legislación relativa a las rapaces y proteger su hábitat, así como reforzar el capital social relacional) y medidas prácticas (como proporcionar cercados apropiados y aves de corral de fenotipos de alta resistencia).Raptors provide ecosystem services to African rural communities by: (1) preying on rodents, (2) regulating harmful snake populations, (3) shaping cultural beliefs, and (4) being part of tourist attractions. Peasant farmers, however, connect them with poultry depletion, telepathic omens, and traditional witchcraft. Consequently, raptors suffer human–induced persecution. Using a qualitative content analysis technique, we investigated the interaction between farmers and raptors in areas adjoining the Chembe Bird Sanctuary. Our results unravel negative perceptions, attitudes and practices that could threaten the extinction of five raptors in the study area. We propose the use of transformative cognitive measures (e.g., raising stakeholder awareness, ensuring stringent law enforcement for raptors and protecting their habitat, and strengthening relational social capital) and physical measures (e.g., providing appropriate fencing and poultry breeding of high resilient phenotypes) to improve the co–existence between farmers and raptors

Use of cotrimoxazole prophylaxis in HIV infected in patients at a referral hospital

A journal article on the administering of cotrimoxazole in HIV infected patients in Zimbabwe.The sub-Saharan region is the most affected by the HIV/AIDS pandemic with an average of 8% of the population being infected. Opportunistic infections have a major impact on the health and survival of HIV infected patients. The advent of highly active antiretroviral therapy has, however, significantly reduced the prevalence of opportunistic infections in HIV infected patients. Primary prophylaxis of opportunistic infections continues to be one of the most important strategies in the management of patients infected with HIV. In addition, primary prophylaxis against opportunistic infections including Pneumocystis carinni pneumonia (PCP) has already been shown to have an independent role in prolonging survival.Pneumocystis carinii remains an important pathogen for the broad spectrum of immunocompromised individuals, despite significant advances in antimicrobial therapy. Cotrimoxazole is recommended as the drug of choice for the prevention and treatment of PCP

Tuberculosis, HIV/AIDS and Malaria Health Services in sub-Saharan Africa – A Situation Analysis of the Disruptions and Impact of the COVID-19 Pandemic

Background: The unprecedented and ongoing COVID-19 pandemic has exposed weaknesses in African countries’ health systems. The impact of shifted focus on COVID-19 for the past 2 years on routine health services, especially those for the epidemics of Tuberculosis, HIV/AIDS and Malaria, have been dramatic in both quantity and quality. Methods: In this article, we reflect on the COVID-19 related disruptions on the Tuberculosis, HIV/AIDS and Malaria routine health services across Africa. Results: The COVID-19 pandemic resulted in disruptions of routine health services and diversion of already limited available resources in sub-Saharan Africa. As a result, disease programs like TB, malaria and HIV have recorded gaps in prevention and treatment with the prospects of reversing gains made towards meeting global targets. The extent of the disruption is yet to be fully quantified at country level as most data available is from modelling estimates before and during the pandemic. Conclusions: Accurate country-level data is required to convince donors and governments to invest more into revamping these health services and help prepare for managing future pandemics without disruption of routine services. Increasing government expenditure on health is a critical part of Africa's economic policy. Strengthening health systems at various levels to overcome the negative impacts of COVID-19, and preparing for future epidemics will require strong visionary political leadership. Innovations in service delivery and technological adaptations are required as countries aim to limit disruptions to routine services

Prevalence of Malaria and Anaemia among HIV Infected Pregnant women Receiving Co-trimoxazole Prophylaxis in Tanzania: A Cross Sectional Study in Kinondoni Municipality.

HIV-infected pregnant women are particularly more susceptible to the deleterious effects of malaria infection particularly anaemia. In order to prevent opportunistic infections and malaria, a policy of daily co-trimoxazole prophylaxis without the standard Suphadoxine-Pyrimethamine intermittent preventive treatment (SP-IPT) was introduced to all HIV infected pregnant women in the year 2011. However, there is limited information about the effectiveness of this policy. This was a cross sectional study conducted among HIV-infected pregnant women receiving co-trimoxazole prophylaxis in eight public health facilities in Kinondoni Municipality from February to April 2013. Blood was tested for malaria infection and anaemia (haemoglobin <11 g/dl). Data were collected on the adherence to co-trimoxazole prophylaxis and other risk factors for malaria infection and anaemia. Pearson chi-square test, Fischer's exact test and multivariate logistic regression were used in the statistical analysis. This study enrolled 420 HIV infected pregnant women. The prevalence of malaria infection was 4.5%, while that of anaemia was 54%. The proportion of subjects with poor adherence to co-trimoxazole was 50.5%. As compared to HIV infected pregnant women with good adherence to co-trimoxazole prophylaxis, the poor adherents were more likely to have a malaria infection (Adjusted Odds Ratio, AOR = 6.81, 95%CI = 1.35-34.43, P = 0.02) or anaemia (AOR = 1.75, 95%CI = 1.03-2.98, P = 0.039). Other risk factors associated with anaemia were advanced WHO clinical stages, current malaria infection and history of episodes of malaria illness during the index pregnancy. The prevalence of malaria was low; however, a significant proportion of subjects had anaemia. Good adherence to co-trimoxazole prophylaxis was associated with reduction of both malaria infection and anaemia among HIV infected pregnant women

Impact of improved maize varieties on food security in Eastern Zambia : A doubly robust analysis

This study investigates the impact of improved maize varieties on household food security in eastern Zambia using household survey data from a sample of over 800 rural households. Since treatment effect estimates are often prone to misspecification in either the treatment or outcome equation, we use the doubly robust inverse probability weighted regression adjustment method, complemented with propensity score matching on six different food security measures to obtain reliable impact estimates. Generally, we find a positive impact of improved maize adoption on food security across the two econometric approaches. Maize being the most important food staple in Zambia has a great bearing on the food security status of farm households. It is therefore imperative that a conducive environment is created that promotes the adoption of maize yield improving technologies.</p

Planned delivery or expectant management for late preterm pre-eclampsia in low-income and middle-income countries (CRADLE-4): a multicentre, open-label, randomised controlled trial

Background: Pre-eclampsia is a leading cause of maternal and perinatal mortality. Evidence regarding interventions in a low-income or middle-income setting is scarce. We aimed to evaluate whether planned delivery between 34+ 0 and 36+ 6 weeks’ gestation can reduce maternal mortality and morbidity without increasing perinatal complications in India and Zambia. / Methods: In this parallel-group, multicentre, open-label, randomised controlled trial, we compared planned delivery versus expectant management in women with pre-eclampsia from 34+ 0 to 36+ 6 weeks’ gestation. Participants were recruited from nine hospitals and referral facilities in India and Zambia and randomly assigned to planned delivery or expectant management in a 1:1 ratio by a secure web-based randomisation facility hosted by MedSciNet. Randomisation was stratified by centre and minimised by parity, single-fetus pregnancy or multi-fetal pregnancy, and gestational age. The primary maternal outcome was a composite of maternal mortality or morbidity with a superiority hypothesis. The primary perinatal outcome was a composite of one or more of: stillbirth, neonatal death, or neonatal unit admission of more than 48 h with a non-inferiority hypothesis (margin of 10% difference). Analyses were by intention to treat, with an additional per-protocol analysis for the perinatal outcome. The trial was prospectively registered with ISRCTN, 10672137. The trial is closed to recruitment and all follow-up has been completed. / Findings: Between Dec 19, 2019, and March 31, 2022, 565 women were enrolled. 284 women (282 women and 301 babies analysed) were allocated to planned delivery and 281 women (280 women and 300 babies analysed) were allocated to expectant management. The incidence of the primary maternal outcome was not significantly different in the planned delivery group (154 [55%]) compared with the expectant management group (168 [60%]; adjusted risk ratio [RR] 0·91, 95% CI 0·79 to 1·05). The incidence of the primary perinatal outcome by intention to treat was non-inferior in the planned delivery group (58 [19%]) compared with the expectant management group (67 [22%]; adjusted risk difference –3·39%, 90% CI –8·67 to 1·90; non-inferiority p<0·0001). The results from the per-protocol analysis were similar. There was a significant reduction in severe maternal hypertension (adjusted RR 0·83, 95% CI 0·70 to 0·99) and stillbirth (0·25, 0·07 to 0·87) associated with planned delivery. There were 12 serious adverse events in the planned delivery group and 21 in the expectant management group. / Interpretation: Clinicians can safely offer planned delivery to women with late preterm pre-eclampsia, in a low-income or middle-income country. Planned delivery reduces stillbirth, with no increase in neonatal unit admissions or neonatal morbidity and reduces the risk of severe maternal hypertension. Planned delivery from 34 weeks’ gestation should therefore be considered as an intervention to reduce pre-eclampsia associated mortality and morbidity in these settings. / Funding: UK Medical Research Council and Indian Department of Biotechnology

AstraZeneca COVID-19 vaccine induces robust broadly cross-reactive antibody responses in Malawian adults previously infected with SARS-CoV-2

Background: Binding and neutralising anti-Spike antibodies play a key role in immune defence against SARS-CoV-2 infection. Since it is known that antibodies wane with time and new immune-evasive variants are emerging, we aimed to assess the dynamics of anti-Spike antibodies in an African adult population with prior SARS-CoV-2 infection and to determine the effect of subsequent COVID-19 vaccination. Methods: Using a prospective cohort design, we recruited adults with prior laboratory-confirmed mild/moderate COVID-19 in Blantyre, Malawi, and followed them up for 270 days (n = 52). A subset of whom subsequently received a single dose of the AstraZeneca COVID-19 vaccine (ChAdOx nCov-19) (n = 12). We measured the serum concentrations of anti-Spike and receptor-binding domain (RBD) IgG antibodies using a Luminex-based assay. Anti-RBD antibody cross-reactivity across SARS-CoV-2 variants of concern (VOC) was measured using a haemagglutination test. A pseudovirus neutralisation assay was used to measure neutralisation titres across VOCs. Ordinary or repeated measures one-way ANOVA was used to compare log10 transformed data, with p value adjusted for multiple comparison using Šídák's or Holm-Šídák's test. Results: We show that neutralising antibodies wane within 6 months post mild/moderate SARS-CoV-2 infection (30–60 days vs. 210–270 days; Log ID50 6.8 vs. 5.3, p = 0.0093). High levels of binding anti-Spike or anti-RBD antibodies in convalescent serum were associated with potent neutralisation activity against the homologous infecting strain (p < 0.0001). A single dose of the AstraZeneca COVID-19 vaccine following mild/moderate SARS-CoV-2 infection induced a 2 to 3-fold increase in anti-Spike and -RBD IgG levels 30 days post-vaccination (both, p < 0.0001). The anti-RBD IgG antibodies from these vaccinated individuals were broadly cross-reactive against multiple VOCs and had neutralisation potency against original D614G, beta, and delta variants. Conclusions: These findings show that the AstraZeneca COVID-19 vaccine is an effective booster for waning cross-variant antibody immunity after initial priming with SARS-CoV-2 infection. The potency of hybrid immunity and its potential to maximise the benefits of COVID-19 vaccines needs to be taken into consideration when formulating vaccination policies in sub-Saharan Africa, where there is still limited access to vaccine doses

A multi-stakeholder situation assessment of COVID-19 disease preparedness and mitigation measures in a large prison complex in Malawi.

Purpose: Prisons in the sub-Saharan African region face unprecedented challenges during the COVID19 pandemic. In Malawi, the first prison system case of COVID-19 was notified in July 2020. While, prison settings were included in the 2nd domestic COVID-19 response plan within the Law Enforcement cluster (National COVID-19 preparedness and response plan, July-December 2020), they were initially not included in the K157 billion (USD 210 million) COVID-19 fund. Design/methodology/approach: A multi-method situation assessment of the COVID-19 response and human rights assurance of prisoners and staff was conducted in a large prison complex in Malawi. Qualitative research underpinned by the Empirical Phenomenological Psychological (EPP) framework consisted of interviews with key informants such as prison health personnel, senior prison staff, penal and judicial policymakers, government and civil society organisations (n = 14) and focus group discussions with consenting male (n = 48) and female prisoners (n = 48), and prison wardens (n = 24). Prison site visits were supported by detailed observations based on the WHO Checklist for COVID-19 in prisons (n = 9). Data were collected and analysed thematically using the EPP stepwise approach and triangulated based on Bronfenbrenner’s model conceptualising COVID-19 as a multi-level event disrupting the prison eco-system. Findings: The results are presented as MICRO-MESO level individual and community experiences of incarceration during COVID-19 spanning several themes: Awareness raising and knowledge of COVID-19 in prisons; Prison congestion and the impossibility of social distancing; Lack of adequate ventilation, hygiene and sanitation and Provisions and correct use of personal protective equipment (PPE); MESO-MACRO level interplay between the prison community of prisoners and staff and judicial policy impacts; Medical system COVID-19 response, infrastructure and access to healthcare; COVID19 detection and quarantine measures and Prisoner access to the outside world. Originality: This unique situation assessment of the Malawian prison system response to mitigate COVID-19 illustrates the dynamics at the micro-level whereby prisoners rely on the State and have restricted agency in protecting themselves from disease. This is due to severe structural inadequacies based on low resource allocation to prisons leading to a compromised ability to prevent and treat disease; an infirm and congested infrastructure and bottlenecks in the judicial system fueling a continued influx of remand detainees leading to high over capacity. Multi-pronged interventions involving key stakeholders, with prison management and line Ministry as coordinators are warranted to optimise COVID-19 interventions and future disease outbreaks in the Malawian prison system

The association between levels of alcohol consumption and mental health problems and academic performance among young university students

Purpose: Mental health problems and harmful alcohol consumption have been found to be high among young university students compared to the general population in Australia. This research aimed to investigate the association between levels of drinking and mental health problems and academic performance among university students aged 18 to 24 years. Methods: This study used a quantitative cross-sectional design using data that were collected in 2014 as part of the Youth Alcohol Project (YAP). Participants were randomly drawn from a cross sectional sample of 6000 undergraduate students. Included in the study were only students who were within the age of 18-24, undergraduate, and internally enrolled at the main campus. A total of 2518 undergraduate students aged 18 to 24 years who were enrolled internally at Curtin University Bentley campus were randomly recruited. Data were collected through an online survey. Students were invited to participate in the study through their student email address. The email invitations coincided with the release of semester results to increase the likelihood of students accessing their emails. A further 628 students were randomly recruited through face to face intercept survey during the campus market days. Data were collected by trained research assistants. Validated instruments were used to collected data on levels of alcohol consumption, mental health, and academic performance. Results: A considerable proportion of participants (44%) reported consuming alcohol at hazardous or harmful levels. Multiple logistic regression analysis showed that students who were consuming alcohol at hazardous levels were 1.2 times more likely to report psychological distress than those with lower levels of alcohol consumption (aOR 1.2, 95% CI: 1.1-1.5). In addition, being late for class (aOR 1.7, 95% CI:1.1-2.4), missing classes (aOR = 2.6, 95% CI: 1.9-2.6), inability to concentrate in class (aOR = 2.6, 95% CI: 1.9-3.4), and inability to complete assignments (aOR = 3.5, 95% CI 2.0-6.0) independently predicted for moderate or hazardous alcohol consumption. Conclusion: The study shows that a considerable proportion of undergraduate students at university consume alcohol at hazardous or harmful levels. In addition, high levels of alcohol consumption are associated with poor academic performance and mental health outcomes among students. The results of the study warrant multi-strategy interventions that focus on policy, organisational, educational, environmental and economic strategies that will help to reduce alcohol related harms among university students