Maternal HIV viral load testing during pregnancy and postpartum care in Gauteng Province, South Africa

Background. Pregnant and breastfeeding women living with HIV (WLHIV) are a target population for elimination of mother-to-child transmission of HIV (eMTCT). However, there are limited data on maternal virological responses during pregnancy and the postpartum period in South Africa (SA).Objectives. To review compliance of viral load (VL) testing with national guidelines and suppression rates during pregnancy and up to 9  months postpartum among WLHIV delivering in four tertiary hospitals in Gauteng Province, SA.Methods. All women who had a point-of-care HIV VL test using Xpert HIV-1 VL (Cepheid, USA) at delivery in four tertiary obstetric units in Gauteng between June 2018 and February 2020 were included. HIV VL tests of eligible women performed up to 9 months before and after delivery were extracted from the National Health Laboratory Service’s Corporate Data Warehouse. Proportions of women delivering who had antenatal and postpartum VL tests performed and their suppression rates were determined and expressed as percentages.Results. Of 4 989 eligible WLHIV (median age 31.1 years), 917 (18.4%) had a VL performed during the antenatal period; of these, 335 (36.5%) had a VL ≥50 copies/mL and 165 (18.0%) a VL ≥1 000 copies/mL. At delivery, 1 911 women (38.3%) had a VL ≥50 copies/mL and 1 028 (20.6%) a VL ≥1 000 copies/mL. Among 627 women (12.6%) with a VL test postpartum, 234 (37.3%) had a VL ≥50 copies/mL and 93 (14.8%) a VL ≥1 000 copies/mL. Overall, having a VL test performed during the antenatal period was associated with viral suppression at delivery and receiving a VL test postpartum (p<0.001). Women with a VL ≥50 copies/mL at delivery were more likely to be younger and to remain virally unsuppressed postpartum (p<0.001) compared with women with a VL <50 copies/mL.Conclusions. Fewer than 5% of WLHIV with a VL at the time of delivery received VL monitoring during the antenatal and postpartum periods in accordance with national guidelines. More than 80% of WLHIV delivering had no evidence of VL monitoring during the antenatal period, and they were more likely than women who received monitoring during the antenatal period to be virally unsuppressed at delivery and to receive no VL monitoring postpartum. Women with a high VL at delivery were likely to remain virally unsuppressed postpartum. These results emphasise the need for closer monitoring of and rapid reaction to high maternal VLs during pregnancy, at delivery and postpartum for attainment of eMTCT

Wet coffee processing discharges affecting quality of river water at Kayanza ecological zone, Burundi

Open Access Article; Published online: 29 Jun 2021Wet coffee processing leads to the generation of large volumes of wastewater, whose discharge to the environment leads to pollution of freshwater bodies. Kayanza is a major coffee growing area in Burundi with more than 40 wet coffee processing factories (WCPF) that discharge effluents directly to receiving water bodies without treatment. This study was carried out to assess the effect of coffee wastewater on the physicochemical properties of receiving waterbodies in Kayanza coffee growing ecological zone. Currently, no study has been done to analyze the effluent from the WCPF and assess the level of pollution. This study will therefore provide valuable data on the water pollution from coffee processing plants. Ten (10) rivers in the Kayanza coffee growing zone were studied during the months of April and June, 2020. Water samples were collected upstream (U) and downstream (D) of the effluent discharge points in triplicate. Samples were analyzed for pH, Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD5), Temperature, Salinity, Electrical Conductivity (EC), Total Dissolved Solids (TDS), Dissolved Oxygen (DO), Total Suspended Solids (TSS), Nitrates, Nitrites, Lead (Pb), Copper (Cu), Chlorides and Ammonium ions using standard methods. Physical parameters were analyzed in situ whereas chemical parameters were analyzed in the laboratories in Burundi Institute of Agricultural Sciences (ISABU) and University of Burundi. Data were analyzed using R-studio-1.0.153, GenStat 64-bit Release 14.1 and SSPS. Results on the physicochemical parameters indicated that coffee factory effluent has a polluting potential during coffee processing peak. The concentrations of the physicochemical parameters were significantly (p < 0.05) higher downstream (D) compared to upstream (U) of the river water sampling points. All downstream sites had COD, BOD5, TSS and pH values above allowable limits set by WHO and Burundi. The polluting impact of public wet coffee processing factories was significantly higher than that of private and cooperatives owned factories (p < 0.05). Measures should be taken in order to protect water bodies

Effluent quality of wet process coffee processing factories in coffee growing ecological zones in Burundi

Open Access Article; Published online: 30 Nov 2020Arabica coffee is cultivated by smallholders for commercial purposes, and it is commonly processed using wet Coffee Processing Technology. Burundi has more than 250 Coffee Processing factories which discharge their effluents to water bodies. The goal of this study was to determine the levels of physicochemical parameters in wastewater from Coffee Processing Technology factories in major coffee growing ecological zones in Burundi. Wastewater samples were collected from 19 sites representing private, public and cooperative owned coffee processing stations. Physicochemical analyses were determined in-situ field and laboratory conditions using standard procedures. Results indicate that the wastewater does not meet Burundi Effluent Discharge standards for Total Suspended solids, Chemical Oxygen Demand, Biochemical Oxygen Demand, pH. The data revealed that the wet coffee processing pollutes the environment in terms of pH, Total Suspended solids, Chemical Oxygen Demand, Biochemical Oxygen Demand. There is need to install quality polishing technologies to treat the water before disposal

Effects of lime and phosphorus rates on growth of hybrid Arabica coffee seedlings at Jimma, southwest Ethiopia

Open Access ArticleCoffee growing soil of southwestern region parts of Ethiopia are classified as Nitisols with having a low pH and highly deficient in phosphorus. A nursery experiment was conducted at Jimma Agricultural Research Center, southwestern Ethiopia to evaluate the effects of lime and phosphorus rates on coffee seedling growth under nursery conditions. The experiment was laid out in a randomized complete block design with 3 replications. The treatments were arranged in factorial combinations of five levels of lime (0, 5, 10, 15 and 20 g) and four levels of phosphorus (0, 400, 600 and 800 mg) 2.5 kg-1top soil. The statical data was analyzed through SAS software and treatment means were compared at 5% probability using Duncan Multiple Range Test. The results revealed that the interactions of lime and P rates significantly increased the growth of both non-destructive parameters (plant height, girth, number of nods, interned length, leaf number and leaf area) and Root growth parameters (taproot length, lateral root length, lateral root number, root volume, leaf stem and root fresh weight, of coffee seedlings. The maximum shoot and root extensions were obtained from the interaction of 10 g lime and 800 mg P rates 2.5 kg-1top soil. On the other hand, applications of P significantly (P≤ 0.01) affected soil and plant growth parameters. As P rate increased availability P boosted and plant growth were enhanced. Similarly, an application of lime significantly affected (P≤ 0.01) plant growth and enhance nutrient availability up to 10 g, though further applications adversely affect seedling growth and nutrient availability. Hence, combined application of 10 g lime and 800 mg P rate 2.5 kg-1top enhances the optimum growth of coffee seedlings under nursery conditions

Leaf traits variation of arabica coffee cultivars in response to population density and mineral nutrient

Open Access ArticleLeaf trait is good predictors of plant performance. It is closely associated with light requirement, growth and survival of the plant. This study was designed to evaluate the effect of seedling planting density and fertilizer rate on leaf traits variation of two Arabica coffee cultivars under nursery conditions. It was conducted at Jimma Agricultural Research Center from (February 29 to October 29), 2018. A factorial experiment was used and treatments were arranged using completely randomized design with three replications. Treatments consisted of combinations of two Arabica coffee cultivars (74110 and 75227), four population densities (one, two, three and four plants per polythene tube) and three compound NPK (22:6:12 + Te) rates (control, 5g and 10g). The results showed that interaction between cultivar, population density and fertilizer was significantly (P ≤ 0.05) influenced LN, LPR and LAI, and highly significantly (P ≤ 0.01) influenced LWR and SLA. High planting density (PD2) with 5g of NPK enhanced LN and LPR in cultivar-74110 while conventional (PD1) with 5g of NPK enhanced LN and LPR in cultivar-75227. Highest value of LWR was recorded from high planting density (PD2) with 5g of NPK while maximum value of LAI and SLA was recorded from high planting density (PD3) with 5g of NPK for both cultivars. At early field planting time, coffee seedling with higher LAI and SLA are very important for efficiently capture and better utilization of solar energy or light as well as increase seedling growth. In general, planting high population density (PD3) and fertilized with 5 g of NPK seems sufficient to improve LAI and SLA of coffee seedlings. Therefore, the future research direction should be focused on the management for increase leaf traits under field conditions

Factors associated with repeat genital symptoms among sexually transmitted infection service attendees in South Africa, 2015 - 2016

Background. South African guidelines recommend a syndromic approach for the management of sexually transmitted infections (STIs), based on the presence of genital symptoms. However, the guidelines do not prescribe specific indications for microbiology testing for patients presenting with or without repeat genital symptoms.Objectives. To describe the prevalence of and factors associated with repeat genital symptoms among STI service attendees at primary care facilities.Methods. This was a cross-sectional study at 7 STI primary care facilities participating in the aetiological surveillance of STIs between January 2015 and December 2016. Demographic and clinical information and appropriate genital specimens were collected from participants presenting with vaginal discharge syndrome (VDS), male urethral syndrome (MUS) and/or genital ulcer syndrome (GUS). Repeat genital symptoms were defined as self-reported history of the same STI-related genital symptoms in the preceding 12 months. Multivariable logistic regression identified factors associated with repeat genital symptoms.Results. Of 1 822 eligible participants, 480 (30%) had repeat genital symptoms (25% and 75% in the preceding 3 months and 12 months, respectively). Of those with repeat genital symptoms, the median age was 28 (interquartile range (IQR) 24 - 32) years, and 54% were females. The most common aetiological agents among participants with VDS, MUS and GUS were bacterial vaginosis (n=132; 55%), Neisseria gonorrhoeae (n=172; 81%) and ulcers (n=67; 63%), respectively. One hundred and seven (20%) participants had no detectable common STI aetiology. In the multivariable analysis, repeat genital symptoms were associated with HIV co-infection (adjusted odds ratio (aOR) 1.43; 95% confidence interval (CI) 1.14 - 1.78), VDS diagnosis (aOR 1.39; 95% CI 1.10 - 1.76), self-reported condom use (aOR 1.56; 95% CI 1.20 - 2.03) and age 25 - 34 years (aOR 1.33; 95% CI 1.03 - 1.71).Conclusions. Our study found a high prevalence of repeat genital symptoms ‒ a significant proportion without STI aetiology. Identified factors of repeat genital symptoms highlight the need for improved integration of HIV and STI prevention and management. Further research is needed to determine the aetiology of repeat genital symptoms and the contribution of non-STI causes

Evaluating the performance of the GeneXpert HIV‑1 qualitative assay as a consecutive test for a new early infant diagnosis algorithm in South Africa

Background. The proportion of HIV-exposed infants and young children infected with HIV in South Africa (SA) has declined markedly over the past decade as a result of the country’s comprehensive prevention of mother-to-child transmission programme. This decrease has in turn reduced the positive predictive value (PPV) of diagnostic assays, necessitating review of early infant diagnosis (EID) algorithms to ensure improved accuracy. Objectives. To evaluate the performance of the GeneXpert HIV-1 qualitative assay (Xpert EID) as a consecutive test for infants with an ‘HIV-detected’ polymerase chain reaction screening test at birth. Methods. We retrospectively analysed a longitudinal cohort of HIV-exposed infants on whom birth testing was performed, using whole-blood ethylenediaminetetra-acetic acid samples, from four tertiary sites in Gauteng Province between June 2014 and December 2019. Birth samples from all infants with a Cobas AmpliPrep/Cobas TaqMan HIV-1 Qualitative Test v2.0 (CAP/CTM v2.0) HIV-detected screening test, a concurrent Xpert EID test and a subsequent confirmatory CAP/CTM v2.0 test on a separate specimen were included. Performance of the Xpert EID in predicting final HIV status was determined as proportions with 95% confidence intervals (CIs). A comparison of indeterminate CAP/CTM v2.0 results, as per National Health Laboratory Service resulting practice, with discordant CAP/CTM v2.0 v. Xpert EID results was performed. Results. Of 150 infants who met the inclusion criteria, 6 (3.9%) had an Xpert EID result discordant with final HIV status: 5 (3.3%) were false negatives and 1 (0.7%) was false positive. As a consecutive test, the Xpert EID yielded a sensitivity of 96.5% (95% CI 92 - 98.9), specificity of 85.7% (95% CI 42.1 - 99.6), PPV of 99.3% (95% CI 95.7 - 99.9), negative predictive value of 54.5% (95% CI 32.5 - 74.9) and overall accuracy of 96.1% (95% CI 91.5 - 98.5). Using discordant CAP/CTM v2.0/Xpert EID results as criteria to verify indeterminate results instead of current practice would have reduced the number of indeterminate screening results by 42.1%, from 18 (12.6%) to 11 (7.2%), without increasing the false-positive rate. Conclusions. Addition of the Xpert EID as a consecutive test for specimens with an HIV-detected PCR screening result has the potential to improve the PPV and reduce the indeterminate rate, thereby reducing diagnostic challenges and time to final status, in SA’s EID programme

Agro-morphological characterization of Arabica coffee cultivars in Burundi

Open Access JournalBackground and Objective: Arabica coffee is an important beverage crop in world trade. The crop is gaining increasing importance in Burundi as an export crop. This study aimed to evaluate diversity among coffee cultivars based on quantitative agro-morphological traits for developing superior cultivars in Burundi. Materials and Methods: Fifteen coffee accessions including five commercial cultivars) were used in the study. From each accession, data were collected from three randomly selected trees on 17 quantitative agro-morphological traits and subjected to various statistical analyses including, analysis of variance (ANOVA), PCA biplot and cluster analysis. Results: The analysis of variance showed significant differences (p<0.05) among the accessions for most of the quantitative traits studied. Considering the number of fruits per internode and percentage of fruit-bearing primary branches, the highest yielding accessions were SL28, Mysore and S795. PCA showed that four principal components namely, PC1(33.70), PC2(30.57), PC3(10.21) and PC4(9.15) explained about 83.63% of the total variation. Cluster and distance analysis of quantitative traits revealed the existence of three different groups. The number of accessions in each group was 3, 3 and 9 for clusters I, II and III respectively. The maximum distance was seen between clusters I and II (88) while the minimum was seen between I and III (23). Conclusion: The results show wide diversity among the 15 coffee genotypes grown in Burundi concerning most quantitative morphological traits studied. The genotypes were grouped into three clusters where, Cluster II and III contained genotypes with valuable quantitative agronomic traits, while most of the accessions in cluster I exhibited poor agronomic performance