Existence of traveling wave solutions of a deterministic vector-host epidemic model with direct transmission

We consider an epidemic model with direct transmission given by a system of nonlinear partial differential equations and study the existence of traveling wave solutions. When the basic reproductive number of the considered model is less than one, we show that there is no nontrivial traveling wave solution. On the other hand, when the basic reproductive number is greater than one, we prove that there is a minimum wave speed $c^*$ such that the system has a traveling wave solution with speed $c$ connecting both equilibrium points for any $c\ge c^*$. Moreover, under suitable assumption on the diffusion rates, we show that there is no traveling wave solution with speed less than $c^*$. We conclude with numerical simulations to illustrate our findings. The numerical experiments supports the validity of our theoretical results

Stigma, identity and resistance among people living with HIV in South Africa

AIDS-related stigma can cause delays in testing, poor treatment adherence, and greater numbers of new infections. Existing studies from low- and middle-income countries focus on the negative experiences of stigma, and few document resistance strategies. In this article we document the diverse journeys of people living with HIV in South Africa, through ill health, testing, disclosure, and treatment, and their responses to stigma. The research questions of focus are: Why are some able to resist stigma despite poverty and gendered oppression, whereas others are not? Why are some people able to reach closure, adapting to diagnosis, prognosis and finding a social context within which they resist stigma and can live with their illness? The illness narratives reported here show that the ability to resist stigma derives from a new role or identity with social value or meaning. Generation of a new role requires resources that are limited due to poverty, and exacerbated by unstable family relations. People who are socially marginalised have fewer opportunities to demonstrate their social value, face the greatest risk of transmission, re-infection and failure to adhere to medication, and require particular support from the health sector or community groups

Determinants of Acceptance of Cervical Cancer Screening in Dar es Salaam, Tanzania.

To describe how demographic characteristics and knowledge of cervical cancer influence screening acceptance among women living in Dar es Salaam, Tanzania. Multistage cluster sampling was carried out in 45 randomly selected streets in Dar es Salaam. Women between the ages of 25-59 who lived in the sampled streets were invited to a cervical cancer screening; 804 women accepted and 313 rejected the invitation. Information on demographic characteristics and knowledge of cervical cancer were obtained through structured questionnaire interviews. Women aged 35-44 and women aged 45-59 had increased ORs of 3.52 and 7.09, respectively, for accepting screening. Increased accepting rates were also found among single women (OR 2.43) and among women who had attended primary or secondary school (ORs of 1.81 and 1.94). Women who had 0-2 children were also more prone to accept screening in comparison with women who had five or more children (OR 3.21). Finally, knowledge of cervical cancer and awareness of the existing screening program were also associated with increased acceptance rates (ORs of 5.90 and 4.20). There are identifiable subgroups where cervical cancer screening can be increased in Dar es Salaam. Special attention should be paid to women of low education and women of high parity. In addition, knowledge and awareness raising campaigns that goes hand in hand with culturally acceptable screening services will likely lead to an increased uptake of cervical cancer screening

A qualitative assessment of community acceptability and use of a locally developed children's book to increase shared reading and parent-child interactions in rural Zambia

INTRODUCTION: Early reading interventions hold promise for increasing language and literacy development in young children and improving caregiver-child interactions. To engage rural caregivers and young children in home reading, Zambian child psychologists and education specialists developed a culturally representative, local language children's book targeted at pre-grade 1 children. OBJECTIVES: We qualitatively assessed community acceptability and use of the book distributed to households with young children in two provinces of Zambia. METHODS: We conducted 15 focus group discussions (FGDs) with women (n=117) who received the "Zambian folktales adapted stories for young children" book. A codebook was created a priori, based on established themes in the guide; content analysis was conducted in Nvivo v12. Data were interpreted against the Theoretical Framework on Acceptability. FINDINGS: Respondents described wide acceptability of the children's book across multiple framework constructs. Respondents believed the book was culturally appropriate for its folktale structure and appreciated the morals and lessons provided by the stories. Respondents described using the book in multiple ways including reading in one-on-one or group settings, asking the child questions about the narrative or pictures, and providing additional commentary on the actions or figures in the pictures. Respondents believed the books were helping children grow their vocabulary and early literacy skills. The book's simple vocabulary facilitated use by less educated caregivers. The primary concern voiced was the ability of low literacy caregivers to utilize the book for reading. DISCUSSION: The children's book was widely considered acceptable by rural Zambian communities. It provided a platform for an additional method of caregiver-child interactions in these households for reading, dialogue, and oral storytelling. Shared reading experiences have potentially substantial benefits for the language development and emergent literacy of young children. Programs to develop and deliver culturally acceptable books to households with limited access should be considered by governments and funders

Aspects épidémio-clinique et évolutif de la Cirrhose du foie à Kinshasa : Etude Multicentrique: Multicentric study on epidemiological, clinical and progressive aspects of liver cirrhosis in Kinshasa

Context and objectives. Liver cirrhosis is relatively common and leads to multiple complications in developing countries where management is often late. However, data on this disease are paradoxically scarce in DR Congo. The present study was designed to describe epidemiological, clinical, therapeutic aspects as well as outcome of cirrhosis in the city of Kinshasa. Methods. In a retrospective study, 1,056 records of patients having liver cirrhosis and attending 8 hospitals over 11 years (2001-2011) in the city of Kinshasa were analyzed. The parameters of interest included sociodemographic, clinical and disease progression data. Results. Their mean age was 51 ± 16 years with a male predominance (68.8%). The etiologies of cirrhosis were dominated by alcoholism (49.6%) and viral hepatitis (22.4%). Among patients with viral hepatitis, 11.3 % were seropositive for HBsAg, 34.0% for anti-HCV and 54.7% for HBV-HCV. Almost half of the patients presented with abdominal pain (45%), physical asthenia (43%) and abdominal bloating (42%). The most common clinical signs found were ascites, hepatomegaly and lower limb edema. The outcome was marked by ascites in 64.7%, jaundice in 42.3%, malignant degeneration in 33% and digestive hemorrhage in 32%. Beside the symptomatic treatment, an etiological treatment was rarely tempted. No patient benefited from hepatic transplantation and 44.2% of patients died. Conclusion. Almost half of cirrhotic patients studied were alcoholic and the treatment still symptomatic. This study argues for a national policy for the management of liver cirrhosis and especially prevention through the fight against chronic alcoholism and vaccination campaigns against viral hepatitis B and C. Contexte et objectifs. La cirrhose est relativement fréquente et occasionne des multiples complications dans les pays en voie de développement où la prise en charge est souvent tardive. Cependant, les données y relatives sont fragmentaires en RD Congo. Les objectifs de la présente étude étaient de décrire les aspects épidémiologiques, cliniques, et évolutifs de la cirrhose hépatique dans la ville de Kinshasa. Méthodes. Il s’agissait d’une étude documentaire ayant colligé les dossiers médicaux de 1056 patients ayant présenté une cirrhose du foie dans 8 centres hospitaliers de la ville de Kinshasa entre 2001 et 2011. Les paramètres d’intérêt comprenaient les données sociodémographiques, cliniques, ainsi que l’évolution des patients sous l’attitude thérapeutique. Résultats. Leur âge moyen était de 51ans (ET=16) avec une prédominance masculine (68,8%). Les étiologies de la cirrhose étaient dominées par l’alcoolisme (49,6%) et l’hépatite virale (22,4%). Parmi les patients avec hépatite virale (22,4%), 11,3% de l’Ag HBs, 34% de l’Ac anti VHC et 54,7% de co-infection VHB-VHC étaient rencontrés. Près de la moitié des patients ont présenté à l’admission des douleurs abdominales (45%), de l’asthénie physique (43%) et un ballonnement abdominal (42%). L’ascite, l’hépatomégalie et les œdèmes des membres inférieurs étaient les signes physiques fréquemment rencontrés. L’évolution était marquée par une ascite chez 64,7%, un ictère chez 42,3%, une dégénérescence maligne chez 33% et une HD chez 32%. En dehors du traitement symptomatique, le traitement étiologique était rarement tenté. Aucun patient n’a bénéficié d’une transplantation hépatique et 44,2% des patients étaient  décédés. Conclusion. Près de la moitié des patients étudiés avait une cirrhose alcoolique dont la prise en charge reste très délicate expliquant la surmortalité. Cette étude plaide pour une politique nationale de prise en charge de la cirrhose du foie et surtout de prévention par la lutte contre l’alcoolisme chronique et les campagnes de vaccination contre l’hépatite virale B et C

Harnessing the potential of African youth for transforming health research in Africa

Africa faces a significant burden of infectious diseases, including Malaria and HIV/AIDS, along with an increasing prevalence of non-infectious diseases such as diabetes and cancer. This dual health challenge is amplified by socioeconomic difficulties, restricted access to healthcare, and lifestyle changes, thus present unique scientific needs. Effectively addressing these issues requires a skilled scientific workforce adept in comprehensive healthcare strategies. This analysis explores the critical landscape of health research in Africa, emphasizing the unique opportunity presented by the continent’s youthful population, projected to reach almost 1 billion by 2050. The youth’s innovative potential and fresh perspectives offer a chance to overcome development barriers in health research. Nevertheless, challenges such as under-resourced education, limited research training, inadequate mentorship, and funding difficulties persist. This paper urgently calls upon African leaders, international partners, and stakeholders to prioritize health research, mobilize funding, forge strategic partnerships, and empower the youth as essential steps to capitalize on the continent’s dynamic youth for breakthrough health outcomes. Such investments are vital not just for health but for the overall economic, social, and strategic growth of the continent. Through shared responsibility and a united effort, the potential of African youth can be harnessed, leading to transformative research, improved health outcomes, and a prosperous future. This perspective represents the collective voice of passionate young researchers and advocates across Africa, calling for a new era of health research on the continent

A cross-country review of strategies of the German development cooperation to strengthen human resources

ABSTRACT: BACKGROUND: Recent years have seen growing awareness of the importance of human resources for health in health systems and with it an intensifying of the international and national policies in place to steer a response. This paper looks at how governments and donors in five countries - Cameroon, Indonesia, Malawi, Rwanda and Tanzania - have translated such policies into action. More detailed information with regard to initiatives of German development cooperation brings additional depth to the range and entry doors of human resources for health initiatives from the perspective of donor cooperation. METHODS: This qualitative study systematically presents different approaches and stages to human resources for health development in a cross-country comparison. An important reference to capture implementation at country level was grey literature such as policy documents and programme reports. In-depth interviews along a predefined grid with national and international stakeholders in the five countries provided information on issues related to human resources for health policy processes and implementation. RESULTS: All five countries have institutional entities in place and have drawn up national policies to address human resources for health. Only some of the countries have translated policies into strategies with defined targets and national programmes with budgets and operational plans. Traditional approaches of supporting training for individual health professionals continue to dominate. In some cases partners have played an advocacy and technical role to promote human resources for health development at the highest political levels, but usually they still focus on the provision of ad hoc training within their programmes, which may not be in line with national human resources for health development efforts or may even be counterproductive to them. Countries that face an emergency, such as Malawi, have intensified their efforts within a relatively short time and by using donor funding support also through new initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. CONCLUSIONS: The country case studies illustrate the range of initiatives that have surged in recent years and some main trends in terms of donor initiatives. Though attention and priority attributed to human resources for health is increasing, there is still a focus on single initiatives and programmes. This can be explained in part by the complexity of the issue, and in part by its need to be addressed through a long-term approach including public sector and salary reforms that go beyond the health secto