Healthcare seeking for diarrhoea, malaria and pneumonia among children in four poor rural districts in Sierra Leone in the context of free health care: results of a cross-sectional survey

BACKGROUND: To plan for a community case management (CCM) program after the implementation of the Free Health Care Initiative (FHCI), we assessed health care seeking for children with diarrhoea, malaria and pneumonia in 4 poor rural districts in Sierra Leone. METHODS: In July 2010 we undertook a cross-sectional household cluster survey and qualitative research. Caregivers of children under five years of age were interviewed about healthcare seeking. We evaluated the association of various factors with not seeking health care by obtaining adjusted odds ratios and 95% confidence limits using a multivariable logistic regression model. Focus groups and in-depth interviews of young mothers, fathers and older caregivers in 12 villages explored household recognition and response to child morbidity. RESULTS: The response rate was 93% (n=5951). Over 85% of children were brought for care for all conditions. However, 10.8% of those with diarrhoea, 36.5% of those with presumed pneumonia and 41.0% of those with fever did not receive recommended treatment. In the multivariable models, use of traditional treatments was significantly associated with not seeking outside care for all three conditions. Qualitative data showed that traditional treatments were used due to preferences for locally available treatments and barriers to facility care that remain even after FHCI. CONCLUSION: We found high healthcare seeking rates soon after the FHCI; however, many children do not receive recommended treatment, and some are given traditional treatment instead of seeking outside care. Facility care needs to be improved and the CCM program should target those few children still not accessing care

Dispersal and reproductive careers of male mountain gorillas in Bwindi Impenetrable National Park, Uganda

Dispersal is a key event in the life of an animal and it influences individual reproductive success. Male mountain gorillas exhibit both philopatry and dispersal, resulting in a mixed one-male and multimale social organization. However, little is known about the relationship between male dispersal or philopatry and reproductive careers in Bwindi mountain gorillas. Here we analyze data spanning from 1993 to 2017 on social groups in Bwindi Impenetrable National Park, Uganda to examine the proportion of males that disperse, age of dispersal, pathways to attaining alpha status, fate of dispersing males and philopatric males, and male tenure length as well as make comparisons of these variables to the Virunga mountain gorilla population. We report previously undocumented cases of dispersal by immature males and old males and we also observed the only known case of a fully mature male immigrating into a breeding group. We used genetic tracking of known individuals to estimate that a minimum of 25% of males that disperse to become solitary males eventually form new groups. No differences were found between the Bwindi and Virunga population in the age of male dispersal, the proportion of males that disperse, the age of alpha male acquisition, and dominance tenure length. The lack of differences may be due to small sample sizes or because the observed ecological variability does not lead to life history differences between the populations. Males in both populations follow variable strategies to attain alpha status leading to the variable one-male and multimale social organization, including dispersal to become solitary and eventually form a group, via group fissioning, usurping another alpha male, or inheriting the alpha position when a previous group leader dies

Spatiotemporal dynamics of urban climate during the wet-dry season transition in a tropical African city

The Urban Heat Island effect has been the focus of several studies concerned with the effects of urbanisation on human and ecosystem health. Humidity, however, remains much less studied, although it is useful for characterising human thermal comfort, the Urban Dryness Island effect and vegetation development. Furthermore, variability in microscale climate due to differences in land cover is increasingly crucial for understanding urbanisation effects on the health and wellbeing of living organisms. We used regression analysis to investigate the spatial and temporal dynamics of temperature, humidity and heat index in the tropical African city of Kampala, Uganda. We gathered data during the wet to dry season transition from 22 locations that represent the wide range of urban morphological differences in Kampala. Our analysis showed that the advancement of the dry season increased variability of climate in Kampala and that the most built-up locations experienced the most profound seasonal changes in climate. This work stresses the need to account for water availability and humidity to improve our understanding of human and ecosystem health in cities

Evidence of urban heat island impacts on the vegetation growing season length in a tropical city

Knowledge about the impacts of urban heat islands (UHI) and associated thermal gradients on vegetation seasonality (i.e. phenology) is vital for understanding spatial patterns in vegetation ecosystem functions. However, in contrast to temperate cites, there is little evidence to show how UHI influences landscape phenological processes in the tropics. In this study, we examined vegetation phenological responses to urban form, distance from the city centre and surface temperatures, in the tropical city of Kampala, Uganda. Estimates of vegetation growing season length and land surface temperature were derived from MODIS satellite imagery for multiple years (2013–2015) and urban form was characterised using the Local Climate Zone (LCZ) classification. We showed that growing season length increased along the urban–rural gradient (p < 0.001) and was longest in the least built-up LCZ class (p < 0.001). Growing season length was significantly reduced as land surface temperature increased (p < 0.001). These findings contrast with results reported for temperate cities, where higher temperatures are often associated with longer vegetation growing seasons. Our findings suggest that enhanced surface temperatures associated with UHI are a limiting factor to season length in the urban tropics. Urban planners in tropical cities should therefore account for vegetation sensitivity to UHI when developing targeted management strategies aiming to optimise the benefits accrued from vegetation

Technological opportunities for sensing of the health effects of weather and climate change: a state-of-the-art-review

Sensing and measuring meteorological and physiological parameters of humans, animals, and plants are necessary to understand the complex interactions that occur between atmospheric processes and the health of the living organisms. Advanced sensing technologies have provided both meteorological and biological data across increasingly vast spatial, spectral, temporal, and thematic scales. Information and communication technologies have reduced barriers to data dissemination, enabling the circulation of information across different jurisdictions and disciplines. Due to the advancement and rapid dissemination of these technologies, a review of the opportunities for sensing the health effects of weather and climate change is necessary. This paper provides such an overview by focusing on existing and emerging technologies and their opportunities and challenges for studying the health effects of weather and climate change on humans, animals, and plants