Diagnosis of \u3cem\u3eSchistosoma mansoni\u3c/em\u3e without the Stool: Comparison of Three Diagnostic Tests to Detect \u3cem\u3eSchiostosoma mansoni\u3c/em\u3e Infection from Filtered Urine in Zambia

Diagnosis for intestinal Schistosoma mansoni lacks sensitivity and is arduous to conduct. The standard diagnostic tests, Kato-Katz (KK) and circulating cathodic antigen (CCA) both lack sensitivity and with KK, require obtaining, transporting, and examining fresh stool. We compared diagnostic efficacy of KK, CCA, and polymerase chain reaction (PCR) to detect S. mansoni infection (species-specific DNA) from 89 filtered urine samples collected in Zambia. The PCR was the strongest indicator of positive cases with sensitivity and specificity of 100% in comparison to CCA (67% and 60%) and KK (50% and 100%). High positive and negative predictive values (100%) were also indicative of robustness of PCR. The same pattern was observed when stratified for sex and age group-specific analysis. Diagnosis of S. mansoni from filtered urine samples by PCR is an effective means to detect low intensity infection and would enhance the effectiveness of surveillance and control programs of schistosomiasis

Modelling and Predicting Energy Usage from Smart Meter Data and Consumer behaviours in Residential Houses.

Efforts of electrical utilities to respond to climate change requires the development of increasingly sophisticated, integrated electrical grids referred to as the smart grids. Much of the smart grid effort focuses on the integration of renewable generation into the electricity grid and on increased monitoring and automation of electrical transmission functions. However, a key component of smart grid development is the introduction of the smart electrical meter for all residential electrical customers. Smart meter deployment is the corner stone of the smart grid. In addition to adding new functionality to support system reliability, smart meters provide the technological means for utilities to institute new programs to allow their customers to better manage and reduce their electricity use and to support increased renewable generation to reduce greenhouse emissions from electricity use. As such, this thesis presents our research towards the study of how the data (energy usage profiles) produced by the smart meters within the smart grid system of residential homes is used to profile energy usage in homes and detect users with high fuel consumption levels. This project concerns the use of advanced machine learning algorithms to model and predict household behaviour patterns from smart meter readings. The aim is to learn and understand the behavioural trends in homes (as demonstrated in chapter 5). The thesis shows the trends of how energy is used in residential homes. By obtaining these behavioural trends, it is possible for utility companies to come up with incentives that can be beneficial to home users on changes that can be adopted to reduce their carbon emissions. For example consumers would be more likely prompted to turn of unusable appliances that are consuming high energy around the home e.g., lighting in rooms which are un occupied. The data used for the research is constructed from a digital simulation model of a smart home environment comprised of 5 residential houses. The model can capture data from this simulated network of houses, hence providing an abundance set of information for utility companies and data scientist to promote reductions in energy usage. The simulation model produces volumes of outliers such as high periods (peak hours) of energy usage and low periods (Off peak hours) of anomalous energy consumption within the residential setting of five homes. To achieve this, performance characteristics on a dataset comprised of wealthy data readings from 5 homes is analysed using Area under ROC Curve (AUC), Precision, F1 score, Accuracy and Recall. The highest result is achieved using the Two-Class Decision Forest classifier, which achieved 87.6% AUC

Financial decision-making gender and social norms in Zambia: report on the quantitative data generation, analysis and results and subsequent qualitative follow-up

This document presents the findings from quantitative and qualitative data generation and analysisconducted as part of the project “Financial decision-making, gender and social normsin Zambia”. Using a series of specially designed behavioural experiments and focus groupdiscussions, we generated an extensive set of insights into the normative environment withinwhich spouses in Eastern Province, Zambia, decide on individual money holding and saving.Here are some of those insights. Spouses in Eastern Province, Zambia, are willing to compromise household-level income to maintain individual control over money. Wives, but not husbands, are more likely to compromise household-level earnings to maintain individual control over money when theycan keep that money and their actions hidden from their spouses. Individually-held behaviouralprescriptions, i.e., the “shoulds” and “oughts” that individuals have in mind and reference asguides for their behaviour and benchmarks against which to evaluate others’ behaviour, informdecision-making about maintaining individual control over money at a cost to the household.Further, when individuals know that their spouses will find out about their decisions regardingmaintaining individual control over money (or not) at a cost to the household, the individualstake their spouses’ opinions about what they should do into account, i.e., they compromise. Inthe Focus Group Discussions (FGDs), wastefulness on the part of spouses was consistentlygiven as a reason for endeavouring to maintain individual control over money.There is strong but not unequivocal evidence pointing to the existence of a social norm, i.e., a“should” or “ought” that is collectively held and enforced by members of a community,forbidding saving in secret from one’s spouse, with the secrecy, not the saving being theproblem. Assuming it exists, this social norm forbidding saving in secret from one’s spouseapplies to both husbands and wives, and both husbands and wives acknowledge this. However,the extent to which violations of this norm are tolerated depends on who is doing the violatingand evaluating. In patrilineal communities (as compared to matrilineal communities), bothhusbands and wives are especially intolerant of secret saving by husbands, and in bothpatrilineal and matrilineal communities, wives are less tolerant than husbands of secret savingby husbands and more tolerant than husbands of secret saving by wives. This relative toleranceof secret saving by wives notwithstanding, just under one in three wives and one in sixhusbands think that a man is justified in beating his wife if he discovers that she is saving in ane-wallet or has joined a savings group without his knowledge and, as grounds for wife-beating,saving in secret is on a par with neglecting the children, visiting friends or family in secret andrefusing to have sex. When exploring the reasons for this strong norm against saving in secretin the FGDs, women express fear about the money going missing if the secret saver diesunexpectedly. Both men and women strongly believe that if a wife saves in secret, it raisessuspicions about where she is getting the money and that saving in secret can lead to maritaltension.ASC – Publicaties niet-programma gebonde

Financial decision-making, gender and social norms in Zambia: preliminary report on the quantitative data generation, analysis and results

This document presents the preliminary findings from the quantitative data generation and analysis conducted as part of the project “Financial decision-making, gender and social norms in Zambia”. Using a series of specially designed behavioural experiments, we generated an extensive set of insights into the normative environment within which spouses in Eastern Province, Zambia, make decisions about individual money holding and saving. Here are some of those insights. Spouses in Eastern Province, Zambia, are willing to compromise household-level earnings in order to maintain individual control over money. Wives, but not husbands, are more likely to compromise household-level earnings in order to maintain individual control over money, when they can keep that money and their actions hidden from their spouses. Individually-held behavioural prescriptions, i.e., the “shoulds” and “oughts” that individuals have in mind and reference as guides for their own behaviour and as benchmarks against which to evaluate others’ behaviour, inform decision-making about maintaining individual control over money at a cost to the household. Further, when individuals know that their spouses will find out about their descisions regarding maintaining individual control over money (or not) at a cost to the household, the individuals take their spouses’ opinions about what they should do into account, i.e., they compromise. There is strong but not unequivocal evidence pointing to the existence of a social norm, i.e., a “should” or “ought” that is collectively held and enforced by members of a community, forbidding saving in secret from one’s spouse, with the secrecy not the saving being the problem. Assuming it exists, this social norm forbidding saving in secret from one’s spouse applies to both husbands and wives, and this is acknowledged by both husbands and wives. However, the extent to which violations of this norm are tolerated depends on who is doing the violating and who the evaluating. In patrilineal communities (as compared to matrilineal communities), both husbands and wives are especially intolerant of secret saving by husbands and in both patrilineal and matrilineal communities, wives are less tolerant than husbands of secret saving by husbands and more tolerant than husbands of secret saving by wives. This relative tolerance of secret saving by wives notwithstanding, just under one in three wives and one in six husbands think that a man is justified in beating his wife if he discovers that she is saving in an e-wallet or has joined a savings group without his knowledge and, as grounds for wife beating, saving in secret is on a par with neglecting the children, visiting friends or family in secret and refusing to have sex. For further insights, see the main text of the report.ASC – Publicaties niet-programma gebonde

Plasma Biomarkers to Detect Prevalent or Predict Progressive Tuberculosis Associated With Human Immunodeficiency Virus–1

Background The risk of HIV-1 infected individuals developing TB is high while both prognostic and diagnostic tools remain insensitive. The predictive performance of plasma biomarkers to identify HIV-1 infected individuals likely to progress to active disease is unknown. Methods Thirteen preselected analytes were determined from QuantiFERON® Gold in-tube (QFT) plasma samples in 421 HIV-1 infected persons recruited within the screening and enrolment phases of a randomised controlled trial of isoniazid preventive therapy. Blood for QFT was obtained pre-randomisation. Individuals were classified into prevalent TB, incident TB and controls. Comparisons between groups, supervised learning methods and weighted correlation network analyses were applied utilising the unstimulated and background-corrected plasma analyte concentrations. Results Unstimulated samples showed higher analyte concentrations in prevalent and incident TB compared to controls. The largest differences were seen for CXCL10, IL-2, IL-1 and TGF-. Predictive model analysis using unstimulated analytes discriminated better between controls and prevalent TB (Area Under the Curve AUC= 0·9), reasonably between incident and prevalent TB (AUC > 0·8), but poorly between controls and incident TB. Unstimulated IL-2 and IFN-γ were ranked at or near the top for all comparisons except the comparison between controls vs incident TB. Models using background adjusted values performed poorly. Conclusions Single plasma biomarkers are unlikely to distinguish between disease states in HIV-1 co-infected individuals and combinations of biomarkers are required. The ability to detect prevalent TB is potentially important, as no blood test hitherto has suggested utility to detect prevalent TB amongst HIV-1 co-infected persons

Using Open Public Meetings and Elections to Promote Inward Transparency and Accountability: Lessons from Zambia

BackgroundCommunity-led governance can ensure that leaders are accountable to the populations they serve and strengthen health systems for maternal care. A key aspect of democratic accountability is electing respective governance bodies, in this case community boards, and holding public meetings to inform community members about actions taken on their behalf. After helping build and open 10 maternity waiting homes (MWHs) in rural Zambia as part of a randomized controlled trial, we assisted community governance committees to plan and execute annual meetings to present performance results and, where needed, to elect new board members. MethodsWe applied a principally qualitative design using observation and analysis of written documentation of public meetings to answer our research question: how do governance committees enact inward transparency and demonstrate accountability to their communities. The analysis measured participation and stakeholder representation at public meetings, the types and purposes of accountability sought by community members as evidenced by questions asked of the governance committee, and responsiveness of the governance committee to issues raised at public meetings. ResultsPublic meetings were attended by 6 out of 7 possible stakeholder groups, and reports were generally transparent. Stakeholders asked probing questions focused mainly on financial performance. Governance committee members were responsive to questions raised by participants, with 59% of answers rated as fully or mostly responsive (showing understanding of and answering the question). Six of the 10 sites held elections to re-elect or replace governance committee members. Only 2 sites reached the target set by local stakeholder committees of 50% female membership, down from 3 at formation. To further improve transparency and accountability, community governance committees need to engage in advance preparation of reports, and should consult with stakeholders on broader measures for performance assessment. Despite receiving training, community-level governance committees lacked understanding of the strategic purpose of open public meetings and elections, and how these relate to democratic accountability. They were therefore not motivated to engage in tactics to manage stakeholders effectively. ConclusionWhile open meetings and elections have potential to enhance good governance at the community level, continuous training and mentoring are needed to build capacity and enhance sustainability

Plasma Biomarkers to Detect Prevalent or Predict Progressive Tuberculosis Associated With Human Immunodeficiency Virus-1

BACKGROUND: The risk of individuals infected with human immunodeficiency virus (HIV)-1 developing tuberculosis (TB) is high, while both prognostic and diagnostic tools remain insensitive. The potential for plasma biomarkers to predict which HIV-1-infected individuals are likely to progress to active disease is unknown. METHODS: Thirteen analytes were measured from QuantiFERON Gold in-tube (QFT) plasma samples in 421 HIV-1-infected persons recruited within the screening and enrollment phases of a randomized, controlled trial of isoniazid preventive therapy. Blood for QFT was obtained pre-randomization. Individuals were classified into prevalent TB, incident TB, and control groups. Comparisons between groups, supervised learning methods, and weighted correlation network analyses were applied utilizing the unstimulated and background-corrected plasma analyte concentrations. RESULTS: Unstimulated samples showed higher analyte concentrations in the prevalent and incident TB groups compared to the control group. The largest differences were seen for C-X-C motif chemokine 10 (CXCL10), interleukin-2 (IL-2), IL-1α, transforming growth factor-α (TGF-α). A predictive model analysis using unstimulated analytes discriminated best between the control and prevalent TB groups (area under the curve [AUC] = 0.9), reasonably well between the incident and prevalent TB groups (AUC > 0.8), and poorly between the control and incident TB groups. Unstimulated IL-2 and IFN-γ were ranked at or near the top for all comparisons, except the comparison between the control vs incident TB groups. Models using background-adjusted values performed poorly. CONCLUSIONS: Single plasma biomarkers are unlikely to distinguish between disease states in HIV-1 co-infected individuals, and combinations of biomarkers are required. The ability to detect prevalent TB is potentially important, as no blood test hitherto has been suggested as having the utility to detect prevalent TB amongst HIV-1 co-infected persons

Data Analysis Techniques to Visualise Accesses to Patient Records in Healthcare Infrastructures

Access to Electronic Patient Record (EPR) data is audited heavily within healthcare infrastructures. However, it is often left untouched in a data silo and only accessed on an ad hoc basis. Users with access to the EPR infrastructure are able to access the data of almost any patient without reprimand. Very Important Patients (VIPs) are an exception, for which the audit logs are regularly monitored. Otherwise, only if an official complaint is logged by a patient are audit logs reviewed. Data behaviour within healthcare infrastructures needs proactive monitoring for malicious, erratic or unusual activity. In addition, external threats, such as phishing or social engineering techniques to acquire a clinician’s logon credentials, need to be identified. This paper presents research towards a system which uses data analysis and visualisation techniques deployed in a cloud setting. The system adds to the defence-in-depth of the healthcare infrastructures by understanding patterns of data for profiling users’ behaviour to enable the detection and visualisation of anomalous activities. The results demonstrate the potential of visualising accesses to patient records for the situational awareness of patient privacy officers within healthcare infrastructures

A Study into Smart Grid Consumer-User Profiling for Security Applications

A smart meter measures energy consumption with more granular detail than conventional analogue meters. The Advanced Metering Infrastructure (AMI) facilitates real-time two-way communication between the consumer and the rest of the energy grid. Information concerning electricity consumption, demand and response and home energy generation is communicated back to the local utility for monitoring and billing purposes. However, the detailed electricity usage patterns and trends can also be used to understand daily consumer habits and their routines. The collection and analysis of such data raises significant security and ethical concerns which must be adequately addressed. This paper focuses on the data collected from the residential smart grid using its default reading frequency of 30 minutes. The research demonstrates how the information can be exploited to remotely profile users and detect abnormal user behaviours using cloud-based analytics. Security implications are outlined and a case study is put forward as a demonstration of information that can be obtained through consumer profiling

‘Languages don’t have bones, so you can just break them’: rethinking multilingualism in education policy and practice in Africa

Multilingualism is widespread amongst individuals and communities in African countries. However, language-in-education policies across the continent continue to privilege monolingual approaches to language use in the classroom. In this paper we highlight the colonial origins of these monolingual ideologies and discuss the detrimental effects which arise when learners’ linguistic repertoires are not welcomed within the education system. We draw attention to major themes within education across a range of contexts: policy vagueness, teachers as policy implementers, and the creation and imposition of boundaries. We advocate for a language-in-education approach which brings the outside in, which welcomes individuals’ lived multilingual realities and which values these as resources for learning. We highlight the ways in which translanguaging could represent a positive shift to the way in which multilingual language practices are talked about, and can contribute to decolonising language policy in African contexts. We conclude by calling to action those working on education and policy to ensure that learners and teachers are better supported. We call ultimately for a rethinking of multilingualism