Model for Teaching the Helping Babies Survive Course Series and Advanced Life Support in Obstetrics Workshops to Rural Skilled Birth Attendants in Uganda

Background: Uganda, like much of Sub-Saharan Africa and other underserved regions continues to face the challenge of high neonatal and maternal mortality. The Helping Babies Survive (HBS) course and the Advanced Life Support in Obstetrics (ALSO) provide hands on education to train providers in key life-saving interventions. A uterine balloon tamponade (UBT) procedure can be life-saving in the event of uterine bleeding. The purpose of this implementation research is to gain more insight into the effectiveness of a tailored down 5-day combined HBS-ALSO-UBT course. In this study, we found that a tailored down 5-day combined HBS-ALSO-UBT could be performed with significantly improved self-assessment in diagnosing and managing a wide range of peripartum conditions.Keywords: Neonatal; Perinatal Care; Maternal Morbidity.

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The BabySaver: Design of a New Device for Neonatal Resuscitation at Birth with Intact Placental Circulation

Children ◽

10.3390/children8060526 ◽

2021 ◽

Vol 8 (6) ◽

pp. 526

Author(s):

James Ditai ◽

Aisling Barry ◽

Kathy Burgoine ◽

Anthony K. Mbonye ◽

Julius N. Wandabwa ◽

...

Keyword(s):

Low Cost ◽

Neonatal Resuscitation ◽

Sub Saharan Africa ◽

Skilled Birth Attendants ◽

New Device ◽

Birth Attendants ◽

Premature Babies ◽

Sub Saharan ◽

The Uk ◽

The University

The initial bedside care of premature babies with an intact cord has been shown to reduce mortality; there is evidence that resuscitation of term babies with an intact cord may also improve outcomes. This process has been facilitated by the development of bedside resuscitation surfaces. These new devices are unaffordable, however, in most of sub-Saharan Africa, where 42% of the world’s 2.4 million annual newborn deaths occur. This paper describes the rationale and design of BabySaver, an innovative low-cost mobile resuscitation unit, which was developed iteratively over five years in a collaboration between the Sanyu Africa Research Institute (SAfRI) in Uganda and the University of Liverpool in the UK. The final BabySaver design comprises two compartments; a tray to provide a firm resuscitation surface, and a base to store resuscitation equipment. The design was formed while considering contextual factors, using the views of individual women from the community served by the local hospitals, medical staff, and skilled birth attendants in both Uganda and the UK.

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Addressing Pediatric HIV Pretreatment Drug Resistance and Virologic Failure in Sub-Saharan Africa: A Cost-Effectiveness Analysis of Diagnostic-Based Strategies in Children ≥3 Years Old

Diagnostics ◽

10.3390/diagnostics11030567 ◽

2021 ◽

Vol 11 (3) ◽

pp. 567

Author(s):

Mutita Siriruchatanon ◽

Shan Liu ◽

James G. Carlucci ◽

Eva A. Enns ◽

Horacio A. Duarte

Keyword(s):

Drug Resistance ◽

Cost Effectiveness ◽

Virologic Failure ◽

Pediatric Hiv ◽

Sub Saharan Africa ◽

Financial Investment ◽

Switching Strategy ◽

Wide Range ◽

Sub Saharan ◽

Living With Hiv

Improvement of antiretroviral therapy (ART) regimen switching practices and implementation of pretreatment drug resistance (PDR) testing are two potential approaches to improve health outcomes for children living with HIV. We developed a microsimulation model of disease progression and treatment focused on children with perinatally acquired HIV in sub-Saharan Africa who initiate ART at 3 years of age. We evaluated the cost-effectiveness of diagnostic-based strategies (improved switching and PDR testing), over a 10-year time horizon, in settings without and with pediatric dolutegravir (DTG) availability as first-line ART. The improved switching strategy increases the probability of switching to second-line ART when virologic failure is diagnosed through viral load testing. The PDR testing strategy involves a one-time PDR test prior to ART initiation to guide choice of initial regimen. When DTG is not available, PDR testing is dominated by the improved switching strategy, which has an incremental cost-effectiveness ratio (ICER) of USD 579/life-year gained (LY), relative to the status quo. If DTG is available, improved switching has a similar ICER (USD 591/LY) relative to the DTGstatus quo. Even when substantial financial investment is needed to achieve improved regimen switching practices, the improved switching strategy still has the potential to be cost-effective in a wide range of sub-Saharan African countries. Our analysis highlights the importance of strengthening existing laboratory monitoring systems to improve the health of children living with HIV.

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Cassava Processing in Sub-Saharan Africa: the Implications for Expanding Cassava Production

Outlook on Agriculture ◽

10.1177/003072709402300307 ◽

1994 ◽

Vol 23 (3) ◽

pp. 197-205 ◽

Cited By ~ 10

Author(s):

Felix Izu Nweke

Keyword(s):

Food Security ◽

Water Supply ◽

Sub Saharan Africa ◽

Wide Range ◽

Intensive Use ◽

Cassava Production ◽

Sub Saharan ◽

Processing Techniques ◽

Technical Solutions ◽

Poor Soil

Cassava makes an important contribution to improving food security and rural incomes in sub-Saharan Africa, as it is tolerant of drought and poor soil and its cultivation does not require much labour. However, the fresh roots are bulky and perishable and need to be processed before they can be marketed; processing also removes the cyanogens which make many varieties poisonous in their raw form. Cassava roots are turned into granules, flours, pastes and chips, with a wide range of flavours and appearances for different areas and markets. Many different processing techniques are used, some of which make intensive use of fuelwood while others require a plentiful water supply. These requirements, as well as the need for a good transport and marketing infrastructure, limit the expansion of cassava production in sub-Saharan Africa, but technical solutions are being found.

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Comparative Area Studies and the Study of the Global South

Vestnik RUDN International Relations ◽

10.22363/2313-0660-2020-20-2-279-287 ◽

2020 ◽

Vol 20 (2) ◽

pp. 279-287

Author(s):

Rudra Sil ◽

Ariel I. Ahram

Keyword(s):

Social Science ◽

Science Inquiry ◽

Global South ◽

Sub Saharan Africa ◽

Theory Building ◽

Spatial And Temporal Variation ◽

Area Studies ◽

Wide Range ◽

Range Theory ◽

Sub Saharan

Comparative Area Studies (CAS) offers a template to bring the Global South back into the foreground of social science inquiry. CAS urges researchers to grapple directly with empirical variations derived from across the seemingly different global regions. CAS offers three comparative modes: intra-regional, cross-regional, and trans-regional. A number of scholars have used CAS’s comparative rubrics, even without knowing about the wider CAS agenda and program. CAS unsettles assumptions about discrete, fixed “regional” or civilizational blocks as well as about nomothetic theory-building aimed at universal or general laws. At the same time, CAS engages in the idea of medium-range theory-building, focusing empirical rigor and induction in order to create concepts and analyses that are portable yet contextualized. These macro-historical theories must be attentive to spatial and temporal variation in the social world. Claims of universalism are suspect. For the study of the Global South, in particular, CAS provides a path for aggregating and leveraging the wide range of observations and interpretations area specialists have to offer on regions as diverse as South Asia, the Middle East, Latin America, and sub-Saharan Africa. CAS thus changes the division of labor within social science to allow greater input for scholarship derived from and originating in the developing world.

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Pregnancy intention and gestational age at first antenatal care visit in Lesotho

African Journal of Midwifery and Women s Health ◽

10.12968/ajmw.2018.0034 ◽

2021 ◽

Vol 15 (1) ◽

pp. 1-11

Author(s):

Paul Mkandawire ◽

Joseph Kangmennaang ◽

Chad Walker ◽

Roger Antabe ◽

Kilian Atuoye ◽

...

Keyword(s):

Antenatal Care ◽

Gestational Age ◽

Secondary Data ◽

Universal Coverage ◽

Sub Saharan Africa ◽

World Health ◽

Antenatal Visit ◽

Life Saving ◽

Sub Saharan ◽

Health Organization

Background/aims With coverage of antenatal care in sub-Saharan Africa approaching a universal level, attention is now turning to maximising the life-saving potential of antenatal care. This study assessed the gestational age at which pregnant mothers make their first antenatal visit in the context of high antenatal coverage in Lesotho. Methods For the purposes of this study, secondary data from the Demographic and Health Survey of 2014 was analysed. These data were collected in 2014, via an interviewer administered questionnaire. Survival analysis was applied to the data, using Stata SE 15 to compute time ratios that estimate time to first antenatal visit in Lesotho. Results Despite near universal coverage, only 24% of mothers start antenatal care before 12 weeks of gestation, as recommended by the World Health Organization. In addition, mothers with unwanted pregnancies are most likely to delay antenatal care until later in gestation, followed by mothers with mistimed pregnancies. Education, but not wealth, correlates with the start of antenatal care. Conclusions Having achieved near universal coverage, emphasising a prompt start and adherence to recommended visits could optimise the life-saving potential of antenatal care in Lesotho.

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Molecular Diversity of Nematode Parasites in Afrotropical Reed Frogs (Hyperolius spp.)

Diversity ◽

10.3390/d12070265 ◽

2020 ◽

Vol 12 (7) ◽

pp. 265

Author(s):

Ulrich Sinsch ◽

J. Maximilian Dehling ◽

Patrick Scheid ◽

Carsten Balczun

Keyword(s):

Dna Sequences ◽

Nematode Species ◽

Sub Saharan Africa ◽

Parasitic Nematodes ◽

Marker Genes ◽

Nematode Parasites ◽

Diversity Assessment ◽

Wide Range ◽

Nematode Diversity ◽

Sub Saharan

The diversity of nematodes infecting amphibians is understudied in tropical Africa and unknown in Rwanda. Diversity assessment is hampered by the fact that species descriptions refer mostly to morphological features that are unlinked to DNA sequences of marker genes available in public databases. In this paper, we explore the abundance and diversity of parasitic nematodes in reed frogs Hyperolius kivuensis (n = 115), H. parallelus (n = 45) and H. viridiflavus (n = 100) collected in Rwanda. Five nematode species were identified morphologically as Orneoascaris chrysanthemoides, O. schoutedeni, Gendria leberrei, Aplectana chamaeleonis and Rhabdias collaris. Corresponding DNA sequences of 18S and COI genes were determined and subsequently deposited in GenBank. Aplectana chamaeleonis showed the highest prevalence (8.7%), but O. chrysanthemoides the highest mean intensity of infection (6.0) and largest number (24) of individuals in H. kivuensis. To the best of our knowledge, all amphibian hosts are new records for these nematode species, which are known to infect a wide range of amphibian and reptile species. Our findings suggest that nematode diversity is probably lower than previously assumed due to low host specificity. As morphological species identification is often challenging, our data facilitate molecular identification of adult and specifically larval nematodes found in amphibians of Sub-Saharan Africa.

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Student-perceived criteria for assessing university relevance in community development

South African Journal of Science ◽

10.17159/sajs.2016/20160071 ◽

2016 ◽

Vol Volume 112 (Number 11/12) ◽

Cited By ~ 1

Author(s):

Joseph Francis ◽

Beata Kilonzo ◽

Pertina Nyamukondiwa ◽

◽

...

Keyword(s):

Community Development ◽

Rural Area ◽

Undergraduate Students ◽

Rural Areas ◽

Sub Saharan Africa ◽

Community Members ◽

Sustainable Solutions ◽

Wide Range ◽

Perceptions Of Students ◽

Sub Saharan

Abstract In sub-Saharan Africa, universities are increasingly being called upon to contribute more towards combating poverty and promoting development in rural areas. Yet, it is still argued that universities are ivory towers, and as a result, their contribution to finding sustainable solutions to issues hampering the realisation of improved quality of life of people in rural areas remains unsatisfactory. This perception emanates from the universities’ apparent failure to articulate and demonstrate how they can achieve the desired goal stated above. Moreover, there are no universally embraced criteria for assessing the relevance of a rural area based university to the community it serves. This study was therefore carried out to determine the perceptions of University of Venda undergraduate students on what they believed were appropriate criteria for assessing the relevance of a rural area based university in community development in South Africa. Reflection circles, anchored on participatory research techniques, were used to engage the students. The results of the engagement were organised into sub-themes. The most prominent perceptions were: ‘A university has active long-term community-based development initiatives’; ‘A university is continuously addressing the real needs of the communities in question’; ‘University initiatives are creating jobs for its graduates and community members’; and ‘Continuous community requests for university assistance in solving the challenges militating against development’. The wide range of perceptions of students observed in this study is a useful input into initiatives seeking to develop an objective tool for assessing the relevance of a rural area based university in community development.

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Strategies for Representing Tone in African Writing Systems

Written Language & Literacy ◽

10.1075/wll.2.1.02bir ◽

1999 ◽

Vol 2 (1) ◽

pp. 1-44 ◽

Cited By ~ 19

Author(s):

Steven Bird

Keyword(s):

Practical Experience ◽

Sub Saharan Africa ◽

Writing Systems ◽

Tone Languages ◽

Wide Range ◽

Two Factors ◽

Sub Saharan ◽

Vernacular Literacy ◽

Methodological Principles ◽

As Stress

Tone languages provide some interesting challenges for the designers of new orthographies. One approach is to omit tone marks, just as stress is not marked in English (zero marking). Another approach is to do phonemic tone analysis, and then make heavy use of diacritic symbols to distinguish the "tonemes" (shallow marking). While orthographies based on either system have been successful, this may be thanks to our ability to manage inadequate orthographies, rather than to any intrinsic advantage which is afforded by one or the other approach. In many cases, practical experience with both kinds of orthography in sub-Saharan Africa has shown that people have not been able to attain the level of reading and writing fluency that we know to be possible for the orthographies of non-tonal languages. In some cases this can be attributed to a socio linguistic setting which does not favour vernacular literacy. In other cases, the orthography itself may be to blame. If the orthography of a tone language is difficult to use or to learn, then a good part of the reason may be that the designer either has not paid enough attention to the FUNCTION of tone in the language, or has not ensured that the information encoded in the orthography is ACCESSIBLE to the ordinary (non-linguist) user of the language. If the writing of tone is not going to continue to be a stumbling block to literacy efforts, then a fresh approach to tone orthography is required — one which assigns high priority to these two factors. This article describes the problems with orthographies that use too few or too many tone marks, and critically evaluates a wide range of creative intermediate solutions. I review the contributions made by phonology and reading theory, and provide some broad methodological principles to guide those who are seeking to represent tone in a writing system. The tone orthographies of several languages from sub-Saharan Africa are presented throughout the article, with particular emphasis on some tone languages of Cameroon.

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Place Names as an Historical Source: An Introduction with Examples from Southern Senegambia and Germany

History in Africa ◽

10.2307/3171995 ◽

1992 ◽

Vol 19 ◽

pp. 45-101 ◽

Cited By ~ 4

Author(s):

Stephan Bühnen

Keyword(s):

Fifteenth Century ◽

Oral Tradition ◽

Sub Saharan Africa ◽

Place Names ◽

Research Experience ◽

Wide Range ◽

History Of ◽

Egg Shells ◽

Sub Saharan ◽

Written Sources

Written sources for the history of sub-Saharan Africa (with the exception of East Africa) only begin to appear with the inception of Arabic records from the ninth century onwards, and these are restricted to the Sahel and the northern part of the savanna belt. European sources begin in the mid-fifteenth century, first for Senegambia. They, in turn, confine themselves to the coast and its immediate hinterland, as well as the navigable courses of rivers, with few, and often vague, references to the interior. For the time before the early written sources and for those extensive areas which only much later entered the horizon of writing witnesses, other sources illuminating the past have to be traced and tapped. Among such non-written sources are the findings of anthropology and archeology, of research in oral tradition and place names. Because of their interdependence, working with different source types contributes to the reliability of results.So far little systematic use has been made of place names as a source for African history. Houis' 1958 dictum, “la toponymie ouest-africaine n'est pas encore sortie de l'oeuf,” has not yet been proven obsolete. In this paper I hope to stimulate the process of shedding the egg shells. It is intended as a short introduction to the potential historical treasures place names may yield, into their characteristics, and into some principles guiding their interpretation. With the aim at illustrating my arguments, I add examples of place names. These I have chosen from two areas which, at first sight, seem to have been selected rather randomly; southern Senegambia and Germany. In fact both areas share few features, both geographically and historically. Two reasons have led me to select them. First, they simply are the regions I know best. Secondly, the recourse to German place names is instructive, as research on place names has been undertaken there for more than a century, leading to a wide range of data and to the accumulation of rich research experience.

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CLIPB10 is a Terminal Protease in the Regulatory Network That Controls Melanization in the African Malaria Mosquito Anopheles gambiae

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2020.585986 ◽

2021 ◽

Vol 10 ◽

Author(s):

Xin Zhang ◽

Miao Li ◽

Layla El Moussawi ◽

Sally Saab ◽

Shasha Zhang ◽

...

Keyword(s):

Anopheles Gambiae ◽

Serine Proteases ◽

Ex Vivo ◽

Protein A ◽

Tumor Formation ◽

Sub Saharan Africa ◽

Humoral Immune ◽

Wide Range ◽

Sub Saharan

Humoral immune responses in animals are often tightly controlled by regulated proteolysis. This proteolysis is exerted by extracellular protease cascades, whose activation culminates in the proteolytic cleavage of key immune proteins and enzymes. A model for such immune system regulation is the melanization reaction in insects, where the activation of prophenoxidase (proPO) leads to the rapid formation of eumelanin on the surface of foreign entities such as parasites, bacteria and fungi. ProPO activation is tightly regulated by a network of so-called clip domain serine proteases, their proteolytically inactive homologs, and their serpin inhibitors. In Anopheles gambiae, the major malaria vector in sub-Saharan Africa, manipulation of this protease network affects resistance to a wide range of microorganisms, as well as host survival. However, thus far, our understanding of the molecular make-up and regulation of the protease network in mosquitoes is limited. Here, we report the function of the clip domain serine protease CLIPB10 in this network, using a combination of genetic and biochemical assays. CLIPB10 knockdown partially reversed melanotic tumor formation induced by Serpin 2 silencing in the absence of infection. CLIPB10 was also partially required for the melanization of ookinete stages of the rodent malaria parasite Plasmodium berghei in a refractory mosquito genetic background. Recombinant serpin 2 protein, a key inhibitor of the proPO activation cascade in An. gambiae, formed a SDS-stable protein complex with activated recombinant CLIPB10, and efficiently inhibited CLIPB10 activity in vitro at a stoichiometry of 1.89:1. Recombinant activated CLIPB10 increased PO activity in Manduca sexta hemolymph ex vivo, and directly activated purified M. sexta proPO in vitro. Taken together, these data identify CLIPB10 as the second protease with prophenoloxidase-activating function in An. gambiae, in addition to the previously described CLIPB9, suggesting functional redundancy in the protease network that controls melanization. In addition, our data suggest that tissue melanization and humoral melanization of parasites are at least partially mediated by the same proteases.

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