Defining malaria burden from morbidity and mortality records, self treatment practices and serological data in Magugu, Babati District, northern Tanzania

Malaria morbidity and mortality data from clinical records provide essential information towards defining disease burden in the area and for planning control strategies, but should be augmented with data on transmission intensity and serological data as measures for exposure to malaria. The objective of this study was to estimate the malaria burden based on serological data and prevalence of malaria, and compare it with existing self-treatment practices in Magugu in Babati District of northern Tanzania. Prospectively, 470 individuals were selected for the study. Both microscopy and Rapid Diagnostic Test (RDT) were used for malaria diagnosis. Seroprevalence of antibodies to merozoite surface proteins (MSP-119) and apical membrane antigen (AMA-1) was performed and the entomological inoculation rate (EIR) was estimated. To complement this information, retrospective data on treatment history, prescriptions by physicians and use of bed nets were collected. Malaria prevalence in the area was 6.8% (32/470). Of 130 individuals treated with artemisinin combination therapy (ACT), 22.3 % (29/130) were slide confirmed while 75.3% (98/130) of them were blood smear negative. Three of the slides confirmed individuals were not treated with ACT. Fever was reported in 38.2% of individuals, of whom 48.8 % (88/180) were given ACT. Forty-two (32.3%) of those who received ACT had no history of fever. About half (51.1%) of those treated with ACT were childre

Essential Emergency and Critical Care: a consensus among global clinical experts.

BACKGROUND: Globally, critical illness results in millions of deaths every year. Although many of these deaths are potentially preventable, the basic, life-saving care of critically ill patients are often overlooked in health systems. Essential Emergency and Critical Care (EECC) has been devised as the care that should be provided to all critically ill patients in all hospitals in the world. EECC includes the effective care of low cost and low complexity for the identification and treatment of critically ill patients across all medical specialties. This study aimed to specify the content of EECC and additionally, given the surge of critical illness in the ongoing pandemic, the essential diagnosis-specific care for critically ill patients with COVID-19. METHODS: In a Delphi process, consensus (>90% agreement) was sought from a diverse panel of global clinical experts. The panel iteratively rated proposed treatments and actions based on previous guidelines and the WHO/ICRC's Basic Emergency Care. The output from the Delphi was adapted iteratively with specialist reviewers into a coherent and feasible package of clinical processes plus a list of hospital readiness requirements. RESULTS: The 269 experts in the Delphi panel had clinical experience in different acute medical specialties from 59 countries and from all resource settings. The agreed EECC package contains 40 clinical processes and 67 requirements, plus additions specific for COVID-19. CONCLUSION: The study has specified the content of care that should be provided to all critically ill patients. Implementing EECC could be an effective strategy for policy makers to reduce preventable deaths worldwide

The use of participatory approaches in developing ICT-based systems for disseminating agricultural knowledge and information for farmers in developing countries: the case of Tanzania

The Electronic Journal of Information Systems in Developing Countries- EJISDC (2017) 78, 8, 1-23This paper provides an insight on the use of various participatory approaches to develop ICTs to the rural farming communities. The paper shows how collective groups of farmers can be empowered through involvement of different stakeholders in a participatory action research. The paper also discusses how participatory action research will help the farming community in adopting ICT-based solutions for agriculture. This in turn will contribute in solving problems as well as assisting decision making in identifying technological and agricultural needs. In this study, a total of 64 researchers and extension workers and 320 rural farmers were involved. Primary data were collected using a self-administered questionnaire and interviews. Data were analyzed using descriptive statistics tool. The results indicate that many ICT- based solutions for agriculture are not adopted by farmers and other stakeholders in various agricultural value chains because those ICTs were developed without using participatory approaches. Moreover, the results from study indicate that participatory action research approaches such as Participatory Communication (PV), Participatory Video (PV), Participatory Learning and Action Research (PLAR), Farmer Participatory Research (FPR), Informal-Mobile Learning Research (IMLR) have a significant impact on the effective use of ICTs in rural farming community and the agricultural domain in general. Among of these participatory approaches, the IMLR and PLAR have shown to be more effective because of availability and interactive mobile learning environments that excite interests, commitments and encourages participatory attitudes among famers and researchers. This study provides an evident that ICTs has a dominant position to alleviate rural poverty and strengthen the agriculture productivity through participatory approaches. We recommend that a strong commitment of all actors in agriculture value chain is needed so that they can collaborate to identify the problem, analysis and design possible solutions and finally, implement and later on use those developed ICTs to increase agriculture productivity

The use of participatory approaches in developing ICT-based systems for disseminating agricultural knowledge and information for farmers in developing countries: the case of Tanzania

The Electronic Journal of Information Systems in Developing Countries- EJISDC (2017) 78, 8, 1-23This paper provides an insight on the use of various participatory approaches to develop ICTs to the rural farming communities. The paper shows how collective groups of farmers can be empowered through involvement of different stakeholders in a participatory action research. The paper also discusses how participatory action research will help the farming community in adopting ICT-based solutions for agriculture. This in turn will contribute in solving problems as well as assisting decision making in identifying technological and agricultural needs. In this study, a total of 64 researchers and extension workers and 320 rural farmers were involved. Primary data were collected using a self-administered questionnaire and interviews. Data were analyzed using descriptive statistics tool. The results indicate that many ICT- based solutions for agriculture are not adopted by farmers and other stakeholders in various agricultural value chains because those ICTs were developed without using participatory approaches. Moreover, the results from study indicate that participatory action research approaches such as Participatory Communication (PV), Participatory Video (PV), Participatory Learning and Action Research (PLAR), Farmer Participatory Research (FPR), Informal-Mobile Learning Research (IMLR) have a significant impact on the effective use of ICTs in rural farming community and the agricultural domain in general. Among of these participatory approaches, the IMLR and PLAR have shown to be more effective because of availability and interactive mobile learning environments that excite interests, commitments and encourages participatory attitudes among famers and researchers. This study provides an evident that ICTs has a dominant position to alleviate rural poverty and strengthen the agriculture productivity through participatory approaches. We recommend that a strong commitment of all actors in agriculture value chain is needed so that they can collaborate to identify the problem, analysis and design possible solutions and finally, implement and later on use those developed ICTs to increase agriculture productivity

Transforming African Education Systems in Science, Technology, Engineering, and Mathematics (STEM) Using ICTs: Challenges and Opportunities

This paper presents the role of ICTs in transforming Africa’s Education Systems (AES) in science, technology, engineering, and mathematics (STEM) subjects/courses. The paper highlights on a positive shift across Africa in using ICT to improve the quality of teaching and learning through activities such as intensive ICT skills training to teachers, increase in ICT equipments and applications in schools, and emergence of living labs (LLs) and innovation spaces/centres (InnoSpace). We first provide some of the challenges of integrating ICTs in education followed by a description of key past and current ICT initiatives supporting the adoption of ICTs in schools using a number of case studies in sub-Saharan Africa. We further present various ICT-based models for education, as a transformational approach towards integrating ICTs in AES. Moreover, we provide various ICT platforms deployed for education service delivery in disadvantaged African society (e.g., rural areas) including LLs and InnoSpace across the continent. Finally, we highlight our main findings and observations in terms of opportunities and future ICT for education research directions in Africa. Our aim is to provide some guidelines and ensure that Africa uniformly meet the 2030 United Nations Sustainable Development Goal number 4, which is to ensure inclusive and quality education for all and promote lifelong learning, particularly using ICTs

Defining malaria burden from morbidity and mortality records, self treatment practices and serological data in Magugu, Babati District, northern Tanzania

Malaria morbidity and mortality data from clinical records provide essential information towards defining disease burden in the area and for planning control strategies, but should be augmented with data on transmission intensity and serological data as measures for exposure to malaria. The objective of this study was to estimate the malaria burden based on serological data and prevalence of malaria, and compare it with existing self-treatment practices in Magugu in Babati District of northern Tanzania. Prospectively, 470 individuals were selected for the study. Both microscopy and Rapid Diagnostic Test (RDT) were used for malaria diagnosis. Seroprevalence of antibodies to merozoite surface proteins (MSP- 119) and apical membrane antigen (AMA-1) was performed and the entomological inoculation rate (EIR) was estimated. To complement this information, retrospective data on treatment history, prescriptions by physicians and use of bed nets were collected. Malaria prevalence in the area was 6.8% (32/470). Of 130 individuals treated with artemisinin combination therapy (ACT), 22.3 % (29/130) were slide confirmed while 75.3% (98/130) of them were blood smear negative. Three of the slides confirmed individuals were not treated with ACT. Fever was reported in 38.2% of individuals, of whom 48.8 % (88/180) were given ACT. Forty-two (32.3%) of those who received ACT had no history of fever. About half (51.1%) of those treated with ACT were children <10 years old. Immunoglobulin against MSP-119 was positive in 16.9% (74/437) while against AMA-1 was positive in 29.8 % (130/436). Transmission intensity was estimated at <0.2 infectious bites per person per year. The RDT was highly specific (96.3%) but with low sensitivity (15.6%). In conclusion, Magugu is a low endemic area. There is substantial over diagnosis, over treatment and self treatment in the community. The burden of malaria based on medical records is over estimated as was mostly presumptive. The low sensitivity of RDT reflects the low number of immune individuals as well as the low parasite density

Transmission intensity and malaria vector population structure in Magugu, Babati District in northern Tanzania

A 1-year longitudinal study was conducted in Magugu in Babati district, northern Tanzania to determine malaria vector population structure and malaria transmission indices. Mosquitoes were sampled using the Centre for Disease Control (CDC) light traps. A total of 110,357 adult female mosquitoes were collected. Anopheles gambiae s.l. accounted 25% of the total female mosquito collected. Relatively fewer An. funestus were collected. Other mosquito species collected were An. pharoensis, An. coustani, An. maculipalpis, An. marshallii, Culex quinquefasciatus , Cx unnivittatus, Mansonia uniformis and Ma. africana. An analysis by Polymerase Chain Reaction revealed that An. arabiensis was the only member of the An. gambiae complex in the collected samples. The number of mosquito collected correlated with the increasing mean rainfall. Blood meal analysis showed a higher human enzymatic reaction among An. gambiae s.l. (63.5%) followed by An. funestus (42.9%). Bovine enzymatic reaction was higher among An. coustani (73.7%) followed by the An. pharoensis (66.7%). The Enzyme Linked Immunosorbent Assay (ELISA) was used to detect Plasmodium falciparum circumsporozoites proteins in 10,000 female Anopheles mosquitoes. Only two An. arabiensis were found to be infected. The entomological inoculation rate (EIR) was estimated at 0.51 infectious bites per person per year. This EIR was considered to be relatively low, indicating that malaria transmission in this area is low. Variability in mosquito blood meal shows availability of variety of preferred blood meal choices and impact of other factors inhibiting mosquito-human host contact.The study has provided information considered useful in the mapping of the vector distribution and population structure in the country. Such information is considered to be among the essential tools for planning malaria control interventions