Genotypes of Helicobacter pylori isolates in Gambian children and adults

Helicobacter pylori is a globally important and genetically diverse gastric pathogen that infects most people in developing countries. Earlier reports indicated high prevalence of H. pylori colonization, but a low frequency of H. pylori-associated diseases in Africa but recent reviews have shown that gastroduodenal disease is actually common in Africa. Most detailed analyses of H. pylori have used strains from non-African countries, despite the high importance of Africa in the emergence and evolution of humans and their pathogens. There have been far fewer critical studies such as genotypes in association with gastric disease, population genetics and antimicrobial resistance and susceptibility of H. pylori strains from Africa. It is with this background that the genotypes of H. pylori in association with gastroduodenal diseases, antibiotic susceptibility to commonly used drugs and population genetics from ethnic African adults and children in The Gambia were investigated. In this study, it was found that the prevalence of H. pylori is high in dyspeptic patients in The Gambia and that many strains were of the putatively more virulent cagA+, vacAs1 and vacAm1 genotypes. There was a high prevalence of cagA positive strains in patients with overt gastric diseases than those with non-ulcerative dyspepsia; conversely, the co-existence of both cagA+ and cagA- was found to be protective against the development of gastroduodenal disease. Analyses of the sequenced data with the STRUCTURE software indicated that Gambian H. pylori strains were closely related to hspWAfrica than to strains from more distant African regions (hspSAfrica and hpNEAfrica) indicating common ancestral origin. Essentially no traces of European or North African ancestry were found despite Gambia's history of invasion and colonisation by peoples from these regions during the last millennium. Antibiotic susceptibility tests have shown that Gambian strains were found to be highly sensitive to clarithromycin, erythromycin, tetracycline and amoxicillin but found that more than two-thirds of Gambian H. pylori strains were metronidazole resistant. These data indicate caution in use of metronidazole-based therapies in The Gambia. This thesis provides a detailed initial description of a set of H. pylori isolates directly related to a geographically defined West African population. The data presented has answered some relevant questions on H. pylori virulent genes in association with gastro-duodenal diseases and antibiotic susceptibility providing a comprehensive basis for future studies

Effectiveness of maternity waiting homes in increasing utilization of facility-based delivery: A systematic review

To reduce the second delay contributing to maternal mortality, maternity waiting homes have been recommended for implementation especially in remote areas to help improve access to facility-based skilled delivery. Evidence of its effectiveness, however, is limited. This systematic review, therefore, aims to assess the effectiveness of the Maternity waiting home strategy in increasing utilization of facility delivery. Search for relevant articles was conducted on PubMed, Scopus, Google Scholar, Ebscohost, and Science Direct from database inception to March 30, 2021. Two reviewers independently screened the articles and assessed the quality of the studies. The identified maternity waiting home interventions and their effectiveness in improving facility-based delivery uptake were narratively synthesized and reported following the preferred reporting items for systematic reviews and meta-analysis reporting guidelines. The search yielded 670 articles of which five studies fulfilled the inclusion criteria. The three of five studies revealed that there is a significant association between Maternity waiting home use and utilization of facility-based delivery. The quality of the Maternity waiting homes significantly improved facility-based delivery uptake. Maternity Waiting Homes appear to be promising in decreasing barriers to skilled delivery attendance however the quality of evidence is low. More interventional studies of robust design are needed to clearly demonstrate its effectiveness

L’esthétique du vulgarisme dans le polar francophone négro-africain

Résumé : Cet article a choisi le roman policier africain comme objet privilégié d’étude. Il s’agit de montrer en quoi le discours dans le polar africain est un nouveau prisme de perception de la crise des sociétés industrielles. En fait, les caractéristiques de notre analyse s’éloignent des artifices de l’intrigue pour s’intéresser de manière singulière aux ressorts du langage dans le récit. Les antagonismes dans le polar organisent le récit policier de sorte qu’on a un discours qui se construit selon une esthétique du vulgarisme : le langage populaire et l’introduction des traits de l’intime. C’est ce tandem dans l’approche discursive qu’explore ce travail. Le genre policier raconte la relation à la loi dans un contexte de modernité. Entre désordre et transgression, les personnages se cherchent une identité à travers le discours que chacun semble porter pour échapper à l’enfermement et au silence qui sont les vrais handicaps de la civilisation industrielle

Einfluss von Kommunikationsmaßnahmen mit CSR-Bezug auf die Einstellung zur Marke

Entscheidet sich ein Unternehmen Nachhaltigkeitsmaßnahmen zu kommunizieren, stellt sich die Frage, wie dies am effizientesten geschehen soll, um das Markenimage dauerhaft zu stärken. Die Kommunikation von Corporate Social Responsibility (CSR) ist eng mit dem Thema der Glaubwürdigkeit verknüpft. Jene in der CSR-Literatur noch wenig behandelten Fragen, wie z.B. die Frage nach dem Einfluss der CSR-Kommunikation auf die Einstellung zu Marken, greift diese Arbeit durch ein konzeptionelles Modell auf, das den Einfluss des Mediums auf die Wirkung zwischen CSR-Kommunikation und der Einstellung zur Marke überprüft. Im Anschluss daran wird das Modell mittels eines Experiments für zwei Dienstleistungsbranchen mit jeweils zwei verschiedenen Marken empirisch überprüft. Dies erbrachte den Nachweis, dass sich emotionale Werbegestaltung auf die emotionale Imagekomponente positiv auswirkt. Auch kann ein Einfluss der «nachhaltigen» Werbegestaltung auf die emotionale Imagekomponente gezeigt werden

An Education Change Project to improve Pharmacy and Nursing Collaboration

Nursing and the pharmacy department play a significant role in the delivery of quality health care. The relationship between nursing and the pharmacy staff is interdependence, making it extremely important for these two departments to communicate. In the absence of effective communication, misunderstanding between nurses and pharmacists could lead to unnecessary delays in the quality of service that the patients receive. The Veterans Affairs North Texas Health Care Systems (VANTHCS) devised a Drug Policy and Procedure (DPAP) on August 14th, 2013, governing the control and utilization of drugs for both inpatients and outpatients (North Texas Health Care Systems Memorandum No. 119-01, 2013). North Texas Health Care System drug policy and procedures established that the pharmacy should provide stat medication orders within 30 minutes, now dose medications within 60 minutes, and routine medications within two hours (North Texas Health Care System, 2013). The purpose of the PICOT question In acute care nurses and pharmacy department personnel (P) how does an educational program to facilitate effective communication (I) as compared to no educational program (C) affect nurse pharmacy communication (O) within three months (T) ? is to improve communication and collaboration between nursing and pharmacy personnel, which facilitates better understanding between these two departments and enhance the quality patient care delivery. Poor collaboration and communication among health care professionals could lead to dire consequences, including disrupted and delayed care (Celio et al., 2018). Professionally, it only makes sense that nurses and the pharmacy personnel establish and maintain an open level of communication, understanding, and collaboration to improve the quality of service provided to our veterans

IP Multicasting in Hybrid Networks

The asymmetric nature of traffic in most networks, as evident in the Internet, is shifting current networking technology trends more towards the development of hybrid networks. Multimedia traffic with its inherent variability in Quality of Service (QoS) requirements further reinforces this trend. Technologies such as DirecPC which allow users to send traffic terrestrially and receive traffic through satellite have demonstrated the efficiency of the broadcast nature of satellite communications as a means of delivering high bandwidth traffic to end users. Even though the majority of Internet applications rely on point-to- point transmission (unicast), emerging applications such as teleconferencing and information distribution have necessitated the development of an overlay multicast backbone network in the Internet (MBONE) for point/multipoint-to-multipoint data transmission. A major hurdle in multicasting over the Internet is the potential for high bandwidth traffic to cause congestion in the terrestrial backbone. Introducing hybrid terminals within corporate LANs for incoming multicast streams thus would provide an effective means of preserving gateway bandwidth for other outgoing traffic

Assessment of the Level of Mercury Present in Soaps by the Use of Cold Vapour Atomic Fluorescence Spectrometric Analysis – A Gambian Case Study

Sixteen brands of soap were analysed for their total mercury content using cold vapour atomic fluorescence spectrometry. The aim was to find out if the soaps contained mercury and if so, what quantity. In addition, are the quantities acceptable for health purposes. Mercury was found to be present in some soaps which did not indicate it on their labels, as required by law. The amounts of mercury found in the soaps were generally low, and may not lead to any short term mercury-linked health problems. A very low limit of detection was obtained.Keywords: Mercury, The Gambia, Soaps, Indigenous industry, Fluorescenc

Outbreak of serotype W135 Neisseria meningitidis in central river region of the Gambia between February and June 2012: A hospital-based review of Paediatric cases

Background: Meningitis still accounts for many deaths in children especially during epidemics in countries within the African meningitis belt. Between February and May 2012, the Gambia witnessed an outbreak of meningitis in two of its six regions. This study presents a clinical perspective of this outbreak in central river region of the Gambia. It evaluated the outbreak pattern, clinical features, and mortality among suspected cases that presented to the hospital during the outbreak. Methodology: This is a prospective observational study of suspected cases of meningitis that presented to the pediatric ward of the Bansang Hospital during the outbreak period. Confirmed cases of meningitis were consecutively  enrolled, and those with negative blood cultures presenting during the same period were employed as controls.Result: Two hundred and four suspected cases of meningitis presented to the pediatric ward during the outbreak. Ninety were confirmed as meningitis cases. The W135 strain of Neisseria meningitidis was responsible for 89 (98.9%) of meningitis cases seen with an incidence rate of 74.9/100,000 in children (0-14 years) and in.hospital case fatality rate of 7.9%. Highest attack rate was among the 12-49 months age group. Clinical features such as meningeal signs (neck stiffness), conjunctivitis, and joint swelling were seen more in cases than controls. Contact history with relatives, who had fever in previous 2 weeks prior to illness was significantly seen more in cases. Adjusted regression analysis showed 7.5 more likelihood of infection with positive contact history (odds ratio [OR]: 7.2 confidence interval [CI]: [3.39-15.73]). There was no significant difference in death outcome between cases and controls (OR: 0.78 CI: [0.29-2.13]). The double peak wave-like pattern of the epidemic curve noted during this outbreak suggests a disseminated outbreak originating from an index case with propagated spread.Conclusion: There is need for more effective surveillance and incorporation of vaccine against meningitis into the expanded program on immunization schedule of the Gambia and other countries within the meningitic epidemic belt.Key words: Neisseria meningitis, W135 strain, Outbreak, Children, Central River Regio

High Performance IP Multicasting Over Wireless Satellite- Terrestrial Networks

We describe our recent work on the design and implementation of high performance Internet services over networks consisting of interconnected high data rate satellites including Direct Broadcast Satellite hosts and terrestrial wireless LANs with various capabilities (with rates from 16 kbps to 10Mbps, including LMDS and MMDS systems). The network can use either bi- directional or receive-only satellite links for downstream data delivery and wireless and wireline terrestrial or satellite links for the upstream path. A key concept in our work is that of a hybrid terminal, which is a PC connected to a satellite antenna (including just DBS antennas) and to the wireless LAN. The hybrid terminal uses a modem connection for outgoing traffic while receiving incoming information through the VSAT. The hybrid terminal is attached to the Internet through any Internet service provider who supports Serial Line Internet Protocol (SLIP). The traffic from the hybrid terminal is transmitted to the hybrid gateway through IP-within-IP encapsulation, to accomplish asymmetric routing. The hybrid gateway is responsible for decapsulation of traffic from hybrid terminals. It is also responsible for formatting data to suit the satellite transmission. The asymmetric nature of traffic in most networks, as evident in the Internet, is shifting current networking technology trends more towards the development of hybrid networks. Multimedia traffic, with its inherent variability in Quality of Service (QoS) requirements, further reinforces this trend. Technologies such as DirecPC, which allow users to send traffic terrestrially and receive traffic through satellite have demonstrated the efficiency of the broadcast nature of satellite communications as a means of delivering high bandwidth traffic to end users. Even though the majority of Internet applications rely on point-to-point transmission (unicast), emerging applications such as teleconferencing and information distribution have necessitated the development of an overlay multicast backbone network in the Internet (MBONE) for point/multipoint-to- multipoint data transmission. A major hurdle in multicasting over the Internet is the potential for high bandwidth traffic to cause congestion in the terrestrial backbone. Introducing hybrid terminals within corporate LANs for incoming multicast streams thus would provide an effective means of preserving gateway bandwidth for other outgoing traffic. We describe our work on IP multicast extensions to the wireless hybrid network described. We describe effective extensions of IGMP, and asymmetric multicast algorithms that exploit the asymmetry to increase the number of users, scale-up and improve the loading of the terrestrial components. This requires an asymmetric multicast routing mechanism. We describe enhancements to existing multicast routing protocols such as CBT to the hybrid environment described here. We provide results on performance of our proposed hybrid multicast algorithms with respect to the following performance metrics: time to join a group; time for a packet to reach every member of the multicast group; performance with large multicast groups

Porcine Cysticercosis and Risk Factors in The Gambia and Senegal

During a stratified cross-sectional survey, 1705 pigs were sampled from 279 randomly selected households, 63 randomly selected communities and villages, from four study areas in The Gambia and Senegal during the period October 2007 to January 2008. Porcine cysticercosis prevalence detected by tongue inspection at animal level per study area ranged from 0.1% to 1.0%. Using an antigen-detection ELISA the seroprevalence of cysticercosis at both community/village and animal levels for the four selected study areas is: Western region 80.0% (95%CI: 52.4%–93.6%) and 4.8% (95%CI: 3.4%–6.5%), Bignona 86.7% (95%CI: 59.8%–96.6%) and 8.9% (95%CI: 5.0%–15.5%), Kolda 82.4% (95%CI: 46.8%–96.1%) and 13.2% (95%CI: 10.8%–16.0%), and Ziguinchor 81.3% (95%CI: 43.5%–96.1%) and 6.4% (95%CI: 4.0%–10.1%), respectively. No risk factors for cysticercosis were found significant in this study. This study proved that porcine cysticercosis is endemic and distributed widely in the study areas though its incidence might be suppressed by the generalised use of toilets and latrines in the study areas