Lactic acid fermentation of sour porridge and mahewu, a non-alcoholic fermented cereal beverage

A research paper on lactic acid fermentation of nutritious cereals found in Zimbabwe.The microbiological and acidic changes during the natural fermentation of mahewu, a non-alcoholic cereal beverage, and sour porridge were investigated. The presence of pathogenic yeasts in both products was also investigated. The study was carried out over a period of six months in the year 2000. The pH and total acidity as well as microbiological analysis were carried out at intervals of time during the fermentation period. There was a sharp decrease in pH in the mahewu and sour porridge broths in the first 12 to 24 hours of fermentation. Very little titratable acids were produced in the first 6 to 12 hours which was followed by a steady increase during the rest of the fermentation period. Enteric bacteria increased slightly in the first 12 hours but decreased sharply afterwards and could not be detected when the pH was around 3.5 whereas lactic acid bacteria predominated during the fermentation period. Yeasts increased in numbers as the pH dropped and were detected in lower numbers than lactic acid bacteria throughout the fermentation period. The yeasts isolated in both mahewu and sour porridge broths were Saccharomyces cerevisiae, Candida species which included the pathogenic species, C.glabrata, C.kefyr, and Zygosaccharomyces species. The other pathogenic Candida species isolated in sour porridge broth only were C.inconspicua and C.guilliermondii. Klebsiella pneumoniae, Enterobacter species, Escherichia coli and Serratia ficaria were the enteric bacteria isolated in mahewu broth whereas Klebsiella and Enterobacter species were the enteric bacteria isolated in sour porridge. The lactic acid bacteria isolated in mahewu broth were Lactobacillus species, Pediococcus pentosaceus, Lactococcus lactis and Leuconostoc lactis whereas Lactobacillus coprophilus and Leuconostoc lactis were isolated in sour porridge broth

Cryptosporidiosis In Harare, Zimbabwe

A CAJM medical article.Objective: To determine the prevalence of Cryptosporidiumparvum in diarrhoeal patients. Design: This was a laboratory-based cross sectional study on cryptosporidiosis in diarrhoeal patients. Setting: Department of Medical Laboratory Sciences, College of Health Sciences in Harare, Zimbabwe. Subjects: People of all ages with diarrhoea presenting at primary level health centres in Harare. Main Outcome Measures: Patient’s age, laboratory results. Results: Cryptosporidium parvum was the commonest enteric pathogen and was detected in 5.8% of the 500 diarrhoeal patients of all ages followed by Shigella species (3.8%) and Salmonella species (2.0%). The highest detection rate of C.parvum oocysts was observed in children less than five years old (11.2%) followed by children between six and 10 years old (6.3%) and then the 31 to 40 year age group (5.9%). Conclusions: Cryptosporidiosis affects people of all ages in Harare but is more common in children, particularly those under five years. The Cparvum oocysts should be looked for routinely in diarrhoeal stool specimens particularly those from children less than five years since C.parvum may be one of the causative agents of diarrhoea in this age group

Changes in pain catastrophizing predict later changes in fibromyalgia clinical and experimental pain report: cross-lagged panel analyses of dispositional and situational catastrophizing

Introduction: Fibromyalgia (FM), characterized by wide-spread diffuse pain and sensory abnormalities, is associated with elevated indices of distress and pain-related catastrophizing compared to both pain-free samples and those with chronic pain conditions. Catastrophizing is a pervasive negative mental set, and is a strong predictor of negative pain-related outcomes such as clinical pain intensity, and physical disability. Situational catastrophizing, measured in the context of experimentally-induced pain, is strongly related to enhanced pain sensitivity, a core aspect of the pathophysiology of fibromyalgia. However, little is known regarding the temporal course of the association between catastrophizing and pain-related "outcomes". Most studies involve only static assessments of pain and catastrophizing at a single time point, which provides little insight into the direction of the observed associations. We sought to investigate the temporal relationships between catastrophizing and indices of both clinical pain (substudy 1) and experimentally-induced pain (substudy 2) in a larger randomized controlled longitudinal trial. Methods: Fifty-seven patients with FM completed catastrophizing, depression, and pain questionnaires as well as laboratory cold pressor pain testing at baseline, post-intervention and three month follow-up during a lifestyle physical activity study. Cross-lagged panel analyses were used to address these temporal relationships. Results: In substudy 1, analyses revealed that pre-to-post changes in dispositional catastrophizing ratings prospectively accounted for unique variance in subsequent post-to-follow-up changes in clinical pain ratings (p = 0.005), while pre-to-post changes in pain ratings did not account for unique variance in post-to-follow-up changes in catastrophizing ratings. An identical pattern was observed experimentally in substudy 2, with pre-to-post changes in situational catastrophizing ratings prospectively accounting for unique variance in subsequent post-to-follow-up changes in experimental pain ratings (p = 0.014), while pre-to-post changes in pain ratings did not account for unique variance in post-to-follow-up changes in catastrophizing ratings. Specifically, initial alterations in catastrophizing were associated with subsequent alterations in clinical and experimentally induced pain. Controlling for levels of depression did not affect the results. Conclusions: These findings provide empirical evidence that catastrophizing processes might precede and contribute to subsequent alterations in the pain experience for FM patients. Trial Registration clinicaltrials.gov: NCT00383084

Bacterial contamination of food and household stored drinking water in a farmworker community in Zimbabwe

A clinical study on bacterial contamination of household stored food and water in a plantation community in Zimbabwe.Diarrhoeal disease is one of the major problems affecting young children in the tropics. Standards of personal hygiene and public sanitation are low in many communities in developing countries and contamination of foods and drinking water with pathogenic micro-organisms may be an important source of infectious diarrhoea. Not much work has been conducted on the role of contaminated foods and household stored drinking water in the transmission of childhood diarrhoea in developing countries. In a study which was carried out in Gambia,1 it was observed that a very high proportion of food consumed by infants and young children was overgrown with bacteria to a hazardous degree

Nursing and midwifery students\u27 experiences and perception of their clinical learning environment in Malawi: A mixed-method study

© 2020 The Author(s). Background: The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. This study aimed to assess the student nurses and midwives\u27 experiences and perception of the clinical learning environment in Malawi. Methods: A concurrent triangulation mixed methods research design was used to collect data from nursing and midwifery students. Quantitative data were collected using a Clinical Learning Environment Inventory, while qualitative data were collected using focus group discussions. The Clinical Learning Environment Inventory has six subscales of satisfaction, involvement, individualisation, innovation, task orientation and personalisation. The focus group interview guide had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression and qualitative data were thematically analysed. Results: A total of 126 participants completed the questionnaire and 30 students participated in three focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed a statistically significant association between satisfaction with clinical learning environment and personalization (β = 0.50, p = \u3c 0.001), and task orientation (β =0.16 p = \u3c 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment. Conclusion: Although satisfaction with clinical learning environment subscale had the highest mean score, nursing and midwifery students encountered multifaceted challenges such as lack of resources, poor relationship with staff and a lack of support from clinical teachers that negatively impacted on their clinical learning experiences. Training institutions and hospitals need to work together to find means of addressing the challenges by among others providing resources to students during clinical placement

Change-of-state Paradigms and the middle in Kinyarwanda

This paper investigates the derivational relationships among members of verbal paradigms in Kinyarwanda (Bantu JD.61; Rwanda) by pursuing two interrelated goals. First, I describe a variety of derivational strategies for marking transitive and intransitive variants in change-of-state verb paradigms. Second, I focus on the detransitivizing morpheme –ik which serves as one possible marking for intransitive members of these paradigms. Ultimately, I argue that this morpheme is a marker of middle voice, and the variety of readings which appear with this form can be subsumed under a single operation of argument suppression. Finally, I provide a discussion of reflexives and the apparent lack of a reflexive reading with –ik by arguing that this reading is blocked by either lexical reflexives or the reflexive prefix i–

Independent and combined effects of improved water, sanitation, and hygiene, and improved complementary feeding, on child stunting and anaemia in rural Zimbabwe: a cluster-randomised trial.

BACKGROUND: Child stunting reduces survival and impairs neurodevelopment. We tested the independent and combined effects of improved water, sanitation, and hygiene (WASH), and improved infant and young child feeding (IYCF) on stunting and anaemia in in Zimbabwe. METHODS: We did a cluster-randomised, community-based, 2 × 2 factorial trial in two rural districts in Zimbabwe. Clusters were defined as the catchment area of between one and four village health workers employed by the Zimbabwe Ministry of Health and Child Care. Women were eligible for inclusion if they permanently lived in clusters and were confirmed pregnant. Clusters were randomly assigned (1:1:1:1) to standard of care (52 clusters), IYCF (20 g of a small-quantity lipid-based nutrient supplement per day from age 6 to 18 months plus complementary feeding counselling; 53 clusters), WASH (construction of a ventilated improved pit latrine, provision of two handwashing stations, liquid soap, chlorine, and play space plus hygiene counselling; 53 clusters), or IYCF plus WASH (53 clusters). A constrained randomisation technique was used to achieve balance across the groups for 14 variables related to geography, demography, water access, and community-level sanitation coverage. Masking of participants and fieldworkers was not possible. The primary outcomes were infant length-for-age Z score and haemoglobin concentrations at 18 months of age among children born to mothers who were HIV negative during pregnancy. These outcomes were analysed in the intention-to-treat population. We estimated the effects of the interventions by comparing the two IYCF groups with the two non-IYCF groups and the two WASH groups with the two non-WASH groups, except for outcomes that had an important statistical interaction between the interventions. This trial is registered with ClinicalTrials.gov, number NCT01824940. FINDINGS: Between Nov 22, 2012, and March 27, 2015, 5280 pregnant women were enrolled from 211 clusters. 3686 children born to HIV-negative mothers were assessed at age 18 months (884 in the standard of care group from 52 clusters, 893 in the IYCF group from 53 clusters, 918 in the WASH group from 53 clusters, and 991 in the IYCF plus WASH group from 51 clusters). In the IYCF intervention groups, the mean length-for-age Z score was 0·16 (95% CI 0·08-0·23) higher and the mean haemoglobin concentration was 2·03 g/L (1·28-2·79) higher than those in the non-IYCF intervention groups. The IYCF intervention reduced the number of stunted children from 620 (35%) of 1792 to 514 (27%) of 1879, and the number of children with anaemia from 245 (13·9%) of 1759 to 193 (10·5%) of 1845. The WASH intervention had no effect on either primary outcome. Neither intervention reduced the prevalence of diarrhoea at 12 or 18 months. No trial-related serious adverse events, and only three trial-related adverse events, were reported. INTERPRETATION: Household-level elementary WASH interventions implemented in rural areas in low-income countries are unlikely to reduce stunting or anaemia and might not reduce diarrhoea. Implementation of these WASH interventions in combination with IYCF interventions is unlikely to reduce stunting or anaemia more than implementation of IYCF alone. FUNDING: Bill & Melinda Gates Foundation, UK Department for International Development, Wellcome Trust, Swiss Development Cooperation, UNICEF, and US National Institutes of Health.The SHINE trial is funded by the Bill & Melinda Gates Foundation (OPP1021542 and OPP113707); UK Department for International Development; Wellcome Trust, UK (093768/Z/10/Z, 108065/Z/15/Z and 203905/Z/16/Z); Swiss Agency for Development and Cooperation; US National Institutes of Health (2R01HD060338-06); and UNICEF (PCA-2017-0002)