Control of schistosomiasis in sub-Saharan Africa: progress made, new opportunities and remaining challenges

Several other journal supplements have documented progress made in the control of schistosomiasis in Egypt, China and Brazil, however, with more than 97% of the schistosome infections now estimated to occur in Africa, the relevance of this special issue in Parasitology cannot be overemphasized. In total, 18 articles are presented, inclusive of a lead-editorial from the WHO highlighting a seminal resolution at the 54th World Health Assembly in 2001 that advocated de-worming. Facilitated by a US$ 30 million grant from the Bill and Melinda Gates Foundation in 2002, the Schistosomiasis Control Initiative subsequently fostered implementation of large-scale schistosomiasis (and soil-transmitted helminthiasis) control programmes in six selected African countries. From 2005, CONTRAST, a European union-funded consortium, was formed to conduct multi-disciplinary research pertaining to optimisation of schistosomiasis control. Progress made in schistosomiasis control across sub-Saharan Africa since the turn of the new millennium is reviewed, shedding light on the latest findings stemming from clinical, epidemiological, molecular and social sciences research, inclusive of public health interventions with monitoring and evaluation activities. New opportunities for integrating the control of schistosomiasis and other so-called neglected tropical diseases are highlighted, but more importantly, several opportune questions that arise from it frame the remaining challenges ahead for an enduring solutio

Journalists as watchdogs of good governance: Challenges and some ways forward5

No Abstrac

‘I really appreciate you saying that’: the challenges of developing a partnership

Teacher Education in Sub-Saharan Africa (TESSA) is a community of teacher-educators in HEIs across Africa, led by the Open University UK. FAWEMA is the Malawian chapter of FAWE, the Forum for African Women Educationalists, committed to girls’ and women’s education in Malawi. TESSA/OU and FAWEMA have been working together since 2010, and in 2013 are beginning a new 4 year project, funded by DFID Malawi. The project is to facilitate rural women’s access to teacher education, by means of a 2 year ‘school experience programme’ where the women work as Teaching Assistants in local rural schools; and a programme of supported self-study, where the women take the secondary exams which could give them entry to teacher training college. The new project has provided a context for TESSA/OU and FAWEMA to interrogate how each constructs the partnership: the opportunity to look back and look forward. Negotiating the shape of the project, the share of the budget, and the parameters of responsibilities has allowed a much wider reflection on our relationship. The perspective of DfID Malawi has been key: their oversight is both of our project and of the ‘Keeping Girls in School’ programme, of which this project is one strand. This reflection by TESSA/OU and FAWEMA on our partnership has not been a particularly comfortable process, and this paper focuses on what continue to be some of the challenges ahead, as well as the opportunities

Differential spatial repositioning of activated genes in Biomphalaria glabrata snails infected with Schistosoma mansoni

Copyright @ 2014 Arican-Goktas et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.This article has been made available through the Brunel Open Access Publishing Fund.Schistosomiasis is an infectious disease infecting mammals as the definitive host and fresh water snails as the intermediate host. Understanding the molecular and biochemical relationship between the causative schistosome parasite and its hosts will be key to understanding and ultimately treating and/or eradicating the disease. There is increasing evidence that pathogens that have co-evolved with their hosts can manipulate their hosts' behaviour at various levels to augment an infection. Bacteria, for example, can induce beneficial chromatin remodelling of the host genome. We have previously shown in vitro that Biomphalaria glabrata embryonic cells co-cultured with schistosome miracidia display genes changing their nuclear location and becoming up-regulated. This also happens in vivo in live intact snails, where early exposure to miracidia also elicits non-random repositioning of genes. We reveal differences in the nuclear repositioning between the response of parasite susceptible snails as compared to resistant snails and with normal or live, attenuated parasites. Interestingly, the stress response gene heat shock protein (Hsp) 70 is only repositioned and then up-regulated in susceptible snails with the normal parasite. This movement and change in gene expression seems to be controlled by the parasite. Other differences in the behaviour of genes support the view that some genes are responding to tissue damage, for example the ferritin genes move and are up-regulated whether the snails are either susceptible or resistant and upon exposure to either normal or attenuated parasite. This is the first time host genome reorganisation has been seen in a parasitic host and only the second time for any pathogen. We believe that the parasite elicits a spatio-epigenetic reorganisation of the host genome to induce favourable gene expression for itself and this might represent a fundamental mechanism present in the human host infected with schistosome cercariae as well as in other host-pathogen relationships.NIH and Sandler Borroughs Wellcome Travel Fellowshi

Dynamics of maternal lymphocyte subsets from 3rd trimester to postpartum and their impact on mother-to-child HIV-1 transmission

MSc (Med), Faculty of Health Sciences, University ofthe Witwatersrand, 2007Background Mother-to-child transmission of HIV infection is the primary cause of paediatric HIV infections worldwide. High HIV infection rates in women of childbearing age (15-49 years) and efficiency of PMTCT have resulted in the high rate of HIV incidence and prevalence in children of sub-Saharan Africa. The stark contrast in the success of PMTCT interventions between the western countries and less developed countries indicates the need for further research to develop alternative, easier, and more effective population-based interventions. Methodology This was a retrospective cohort study of the medical records of approximately 300 HIV infected women enrolled in the Nevirapine Resistance study between May 2002 and February 2003. An assessment of the significance of changes in immunological parameters (CD4 counts, CD4 percentages, CD4/CD8 ratios) and HIV RNA from 3rd trimester to 6 weeks postpartum and causal associations vi between these changes and increased risk of PMTCT was then conducted using logistic regression models. Results Mothers with CD4 counts above 200cells/μL were approximately exhibited onethird the likelihood of transmitting HIV-1 to their infants than mothers with CD4 counts below 200 cells/μL [OR 0.35 (0.13, 0.95)]. High maternal HIV RNA levels demonstrated a stronger association with increased risk of PMTCT with women with postpartum viral loads greater than 100 000 copies/μL exhibiting ten times the likelihood [OR 10.15 (2.17-47.55)]. Statistically significant mean increases in CD4 and CD8 cell counts from 3rd trimester to postpartum were observed. Mean increases in CD4 and CD8 counts demonstrated no association with PMTCT. Conclusion CD4 cell counts and CD8 cell counts underwent statistically significant changes from 3rd trimester to postpartum. These changes seem not to represent any clinically significant change in maternal disease progression during this time period and were found not to be associated with PMTCT

The nuclear receptors of Biomphalaria glabrata and Lottia gigantea: Implications for developing new model organisms

© 2015 Kaur et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedNuclear receptors (NRs) are transcription regulators involved in an array of diverse physiological functions including key roles in endocrine and metabolic function. The aim of this study was to identify nuclear receptors in the fully sequenced genome of the gastropod snail, Biomphalaria glabrata, intermediate host for Schistosoma mansoni and compare these to known vertebrate NRs, with a view to assessing the snail's potential as a invertebrate model organism for endocrine function, both as a prospective new test organism and to elucidate the fundamental genetic and mechanistic causes of disease. For comparative purposes, the genome of a second gastropod, the owl limpet, Lottia gigantea was also investigated for nuclear receptors. Thirty-nine and thirty-three putative NRs were identified from the B. glabrata and L. gigantea genomes respectively, based on the presence of a conserved DNA-binding domain and/or ligand-binding domain. Nuclear receptor transcript expression was confirmed and sequences were subjected to a comparative phylogenetic analysis, which demonstrated that these molluscs have representatives of all the major NR subfamilies (1-6). Many of the identified NRs are conserved between vertebrates and invertebrates, however differences exist, most notably, the absence of receptors of Group 3C, which includes some of the vertebrate endocrine hormone targets. The mollusc genomes also contain NR homologues that are present in insects and nematodes but not in vertebrates, such as Group 1J (HR48/DAF12/HR96). The identification of many shared receptors between humans and molluscs indicates the potential for molluscs as model organisms; however the absence of several steroid hormone receptors indicates snail endocrine systems are fundamentally different.The National Centre for the Replacement, Refinement and Reduction of Animals in Research, Grant Ref:G0900802 to CSJ, LRN, SJ & EJR [www.nc3rs.org.uk]

Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection : Systematic review and meta-analysis

Objective To assess the accuracy of point-of-care testing for circulatory cathodic antigen in the diagnosis of schistosome infection. Methods We searched MEDLINE, EMBASE, LILACS and other bibliographic databases for studies published until 30 September 2015 that described circulatory cathodic antigen testing compared against one to three Kato–Katz tests per subject – for Schistosoma mansoni – or the filtration of one 10-ml urine sample per subject – for S. haematobium. We extracted the numbers of true positives, false positives, true negatives and false negatives for the antigen testing and performed meta-analyses using a bivariate hierarchical regression model. Findings Twenty-six studies published between 1994 and 2014 met the inclusion criteria. In the detection of S. mansoni, a single antigen test gave a pooled sensitivity of 0.90 (95% confidence interval, CI: 0.84–0.94) and a pooled specificity of 0.56 (95% CI: 0.39–0.71; n = 7) when compared against a single Kato–Katz test. The corresponding values from comparisons with two to three Kato–Katz tests per subject were 0.85 (95% CI: 0.80–0.88) and 0.66 (95% CI: 0.53–0.76; n = 14), respectively. There appeared to be no advantage in using three antigen tests per subject instead of one. When compared against the results of urine filtration, antigen testing for S. haematobium showed poor sensitivity and poor specificity. The performance of antigen testing was better in areas of high endemicity than in settings with low endemicity. Conclusion Antigen testing may represent an effective tool for monitoring programmes for the control of S. mansoni

Internal and external imperial dynamics in Habakkuk : a contextual study of the Book of Habakkuk from a Malawian socio-economic and political viewpoint.

Doctor of Philosophy in Theology.This study is an economic reading of the book of Habakkuk from Malawian socio-economic and political viewpoint. It is a good example of scholarly study of Scripture not done as „art for art‟s sake,‟ but undertaken because of the recognition that the Bible has something essential to say to a critical human situation. Designed as a dialogue between an ancient biblical text of Habakkuk and a modern context of Malawi, the study examines the internal and the external imperial dynamics in effort to better appreciate the shared relevance of these two chronologically disparate contexts. The two contexts share the common reality that both are socially, economically and politically shaped by the challenges of devastating imperialism. The dialogue is facilitated through a contextual biblical studies framework – using the tri-polar model or the African contextual biblical hermeneutics model – that recognizes the importance of our contexts in the interpretation of the biblical text. Since we cannot measure the people‟s well-being through the eyes of the elite but of those who suffer and struggle in life, this study deliberately chose the context of the poor and marginalized to be the subject of interpretation. To truly understand the Bible is to read it through the eyes of the oppressed, since the God who speaks in the Bible is the God of the oppressed (Fiorenza, 1981:100). The study will use liberation and postcolonial biblical hermeneutics belonging to the wider context of biblical interpretation in theology of liberation as sub-theoretical frameworks. The two frameworks are ideo-theological orientations where potential lines of connection between the biblical text with its contexts and today‟s readers and their contexts are drawn. This study is concerned with why Malawi is still rated among the ten poorest countries in the world with over half of its populace still living below the poverty line despite having been independent for fifty-one years? Malawi continues to face many socio-economic and political problems, which are caused by economies of extraction – a particular form of capitalism that African states inherited upon gaining independence from colonial masters. It is exploitive as it involves those who do not labour gaining from those who labour. In this study, economies of extraction are a useful link between economic dimensions of Habakkuk and those of Malawi. The study therefore aims at exploring what is contained in both Habakkuk and Malawi that assists us to understand and value both contexts. Such an interpretation within the context of a critical situation, theology of liberation offers a message that has as its aim emancipatory effects on the poor and marginalized (Fiorenza, 1981:109)