2 research outputs found

    Spatio Temporal Land Use Land Cover Change Mapping of Malete Elemere: Implication on Development Planning of Emerging Communities

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    The use of Ecosystem and Biodiversity mapping, land use land cover change detection has been advocated in preparation of developmental master plan in towns and cities. Noticeable changes have been observed within Malete Elemere community since the establishment of Kwara State University Malete, yet its spatial pattern and socio ecological implication have not been investigated. This work seek to determine and produce land cover land use change map of Malete Elemere over the last 10 years and post 15 year periods through change detection techniques so as to evaluate the impact of the establishment of Kwara State university on the settlement spatial development. Landsat 7 Enhanced Thematic Mapper Plus (ETM+) satellite images of 2005, 2010 and 2015 of the study area were acquired from USGS at spatial resolution of 30 m. Radiometric correction were applied to all the images using radiance modules in Idrisi32 with radiance spectral value set at DN 0 (Lmin) and 255 (Lmax). An unsupervised classification was carried out on the composite images of bands 4,3,2,1 for all the selected years to identify possible maximum spectral reflectance classes, this was followed by supervised classification using training sample from the field survey from which image to image spatio-temporal changes statistics were extracted. To generate a prediction of LULC changes for 2025, Cellular Automata-Markovian transition estimator (CA-Markov) in Idrisi32 was used. Various Kappa statistics was used to evaluate the performance of prediction with an average K statistics of above 0.83 recorded. The result shows that built up area gained an astronomical increase (180%) between 2005 and 2015 while forest lost significantly (34%) within the same periods, with most of the gains occurring in 2010 and 2015 after the establishment of KWASU. By 2025, two Major growth pole centres will emerge along Malete Elemere Axis and one minor in Jenkunu Omoni Axis which will exert a great stress on infrastructural facilities and may create a chaotic condition if left unattended to

    Enhanced infection prophylaxis reduces mortality in severely immunosuppressed HIV-infected adults and older children initiating antiretroviral therapy in Kenya, Malawi, Uganda and Zimbabwe: the REALITY trial

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    Meeting abstract FRAB0101LB from 21st International AIDS Conference 18–22 July 2016, Durban, South Africa. Introduction: Mortality from infections is high in the first 6 months of antiretroviral therapy (ART) among HIV‐infected adults and children with advanced disease in sub‐Saharan Africa. Whether an enhanced package of infection prophylaxis at ART initiation would reduce mortality is unknown. Methods: The REALITY 2×2×2 factorial open‐label trial (ISRCTN43622374) randomized ART‐naïve HIV‐infected adults and children >5 years with CD4 <100 cells/mm3. This randomization compared initiating ART with enhanced prophylaxis (continuous cotrimoxazole plus 12 weeks isoniazid/pyridoxine (anti‐tuberculosis) and fluconazole (anti‐cryptococcal/candida), 5 days azithromycin (anti‐bacterial/protozoal) and single‐dose albendazole (anti‐helminth)), versus standard‐of‐care cotrimoxazole. Isoniazid/pyridoxine/cotrimoxazole was formulated as a scored fixed‐dose combination. Two other randomizations investigated 12‐week adjunctive raltegravir or supplementary food. The primary endpoint was 24‐week mortality. Results: 1805 eligible adults (n = 1733; 96.0%) and children/adolescents (n = 72; 4.0%) (median 36 years; 53.2% male) were randomized to enhanced (n = 906) or standard prophylaxis (n = 899) and followed for 48 weeks (3.8% loss‐to‐follow‐up). Median baseline CD4 was 36 cells/mm3 (IQR: 16–62) but 47.3% were WHO Stage 1/2. 80 (8.9%) enhanced versus 108(12.2%) standard prophylaxis died before 24 weeks (adjusted hazard ratio (aHR) = 0.73 (95% CI: 0.54–0.97) p = 0.03; Figure 1) and 98(11.0%) versus 127(14.4%) respectively died before 48 weeks (aHR = 0.75 (0.58–0.98) p = 0.04), with no evidence of interaction with the two other randomizations (p > 0.8). Enhanced prophylaxis significantly reduced incidence of tuberculosis (p = 0.02), cryptococcal disease (p = 0.01), oral/oesophageal candidiasis (p = 0.02), deaths of unknown cause (p = 0.02) and (marginally) hospitalisations (p = 0.06) but not presumed severe bacterial infections (p = 0.38). Serious and grade 4 adverse events were marginally less common with enhanced prophylaxis (p = 0.06). CD4 increases and VL suppression were similar between groups (p > 0.2). Conclusions: Enhanced infection prophylaxis at ART initiation reduces early mortality by 25% among HIV‐infected adults and children with advanced disease. The pill burden did not adversely affect VL suppression. Policy makers should consider adopting and implementing this low‐cost broad infection prevention package which could save 3.3 lives for every 100 individuals treated
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