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  1. East African Medical Journal

    African Journals Online (AJOL)

    The East African Medical Journal is intended for publication of papers on ... research on problems relevant to East Africa and other African countries will receive special ... Analysis of survival patterns of TB‐HIV co‐infected patients in relation to ...

  2. EAST AFRICAN MEDICAL JOURNAL

    African Journals Online (AJOL)

    2003-11-11

    Nov 11, 2003 ... East African Medical Journal Vol. ... Lecturer/Consultant Surgeon, Paediatric Surgery Unit, Department of Surgery, College of Medical Sciences, University of Calabar, .... mind and the results obtained were however satisfying.

  3. East African Journal of Statistics: Journal Sponsorship

    African Journals Online (AJOL)

    East African Journal of Statistics: Journal Sponsorship. Journal Home > About the Journal > East African Journal of Statistics: Journal Sponsorship. Log in or Register to get access to full text downloads.

  4. East African Orthopaedic Journal: Submissions

    African Journals Online (AJOL)

    Author Guidelines. The East African Orthopaedic Journal is published biannually by the Kenya Orthopaedics Association. Its primary objective is to give researchers in orthopaedics and ... Format should be as follows; Details of authors as for original articles, summary of not more than 200 words, introduction, case report,

  5. East African Medical Journal

    African Journals Online (AJOL)

    Paris, France, K. C. Takarinda, BSc, MSc, International Union Against Tuberculosis and Lung ... Kenya and T. Galgalo, MSc, African Field Epidemiology Network. ... times more likely to develop active TB than those ... isoniazid preventive therapy (IPT), intensified TB case ... The capital city, where this study took place, had a.

  6. Scopus: Journal of East African Ornithology

    African Journals Online (AJOL)

    Scopus: Journal of East African Ornithology has been published since 1977 by the Bird Committee of the East Africa Natural History Society. Originally titled Scopus, the addition of Journal of East African Ornithology began with our January 2018 issue. The journal is published Open Access twice a year, typically in January ...

  7. East African Cenozoic vegetation history.

    Science.gov (United States)

    Linder, Hans Peter

    2017-11-01

    The modern vegetation of East Africa is a complex mosaic of rainforest patches; small islands of tropic-alpine vegetation; extensive savannas, ranging from almost pure grassland to wooded savannas; thickets; and montane grassland and forest. Here I trace the evolution of these vegetation types through the Cenozoic. Paleogene East Africa was most likely geomorphologically subdued and, as the few Eocene fossil sites suggest, a woodland in a seasonal climate. Woodland rather than rainforest may well have been the regional vegetation. Mountain building started with the Oligocene trap lava flows in Ethiopia, on which rainforest developed, with little evidence of grass and none of montane forests. The uplift of the East African Plateau took place during the middle Miocene. Fossil sites indicate the presence of rainforest, montane forest and thicket, and wooded grassland, often in close juxtaposition, from 17 to 10 Ma. By 10 Ma, marine deposits indicate extensive grassland in the region and isotope analysis indicates that this was a C 3 grassland. In the later Miocene rifting, first of the western Albertine Rift and then of the eastern Gregory Rift, added to the complexity of the environment. The building of the high strato-volcanos during the later Mio-Pliocene added environments suitable for tropic-alpine vegetation. During this time, the C 3 grassland was replaced by C 4 savannas, although overall the extent of grassland was reduced from the mid-Miocene high to the current low level. Lake-level fluctuations during the Quaternary indicate substantial variation in rainfall, presumably as a result of movements in the intertropical convergence zone and the Congo air boundary, but the impact of these fluctuations on the vegetation is still speculative. I argue that, overall, there was an increase in the complexity of East African vegetation complexity during the Neogene, largely as a result of orogeny. The impact of Quaternary climatic fluctuation is still poorly understood

  8. Journal of East African Natural History

    African Journals Online (AJOL)

    The Journal of East African Natural History is published jointly by the East Africa Natural History Society and the National Museums of Kenya. The Journal publishes papers and notes in the field of natural history, broadly defined as the study of organisms in their natural state, relevant to the eastern African region.

  9. Minority drug-resistant HIV-1 variants in treatment naïve East-African and Caucasian patients detected by allele-specific real-time PCR.

    Directory of Open Access Journals (Sweden)

    Halime Ekici

    Full Text Available To assess the presence of two major non-nucleoside reverse transcriptase inhibitors (NNRTI drug resistance mutations (DRMs, Y181C and K103N, in minor viral quasispecies of treatment naïve HIV-1 infected East-African and Swedish patients by allele-specific polymerase chain reaction (AS-PCR.Treatment naïve adults (n=191 with three epidemiological backgrounds were included: 92 Ethiopians living in Ethiopia; 55 East-Africans who had migrated to Sweden; and 44 Caucasians living in Sweden. The pol gene was analysed by standard population sequencing and by AS-PCR for the detection of Y181C and K103N.The Y181C was detected in the minority quasispecies of six Ethiopians (6.5%, in two Caucasians (4.5%, and in one East-African (1.8%. The K103N was detected in one East- African (1.8%, by both methods. The proportion of mutants ranged from 0.25% to 17.5%. Additional DRMs were found in all three treatment naïve patient groups by population sequencing.Major NNRTI mutations can be found by AS-PCR in minor quasispecies of treatment naïve HIV-1 infected Ethiopians living in Ethiopia, in East-African and Caucasian patients living in Sweden in whom population sequencing reveal wild-type virus only. Surveys with standard sequencing are likely to underestimate transmitted drug resistance and the presence of resistant minor quasispecies in treatment naïve patients should be topic for future large scale studies.

  10. East African Journal of Sciences: Submissions

    African Journals Online (AJOL)

    Aims The East African Journal of Sciences (EAJS) publishes original scientific ... of ideas among scientists engaged in research and development activities; and ... font size 12, Times New Roman), including tables, figures and illustrations.

  11. Scientific Communication | Okolo | East African Medical Journal

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 92, No 2 (2015) >. Log in or Register to get access to full text downloads.

  12. East African Agricultural and Forestry Journal

    African Journals Online (AJOL)

    East African Agricultural and Forestry Journal is published by the Kenya ... water resource base to meet the challenges of poverty alleviation and food security. ... on maize growth, nitrogen uptake and yield in a semi-arid Kenyan environment ...

  13. The East African rift system

    Science.gov (United States)

    Chorowicz, Jean

    2005-10-01

    This overview paper considers the East African rift system (EARS) as an intra-continental ridge system, comprising an axial rift. It describes the structural organization in three branches, the overall morphology, lithospheric cross-sections, the morphotectonics, the main tectonic features—with emphasis on the tension fractures—and volcanism in its relationships with the tectonics. The most characteristic features in the EARS are narrow elongate zones of thinned continental lithosphere related to asthenospheric intrusions in the upper mantle. This hidden part of the rift structure is expressed on the surface by thermal uplift of the rift shoulders. The graben valleys and basins are organized over a major failure in the lithospheric mantle, and in the crust comprise a major border fault, linked in depth to a low angle detachment fault, inducing asymmetric roll-over pattern, eventually accompanied by smaller normal faulting and tilted blocks. Considering the kinematics, divergent movements caused the continent to split along lines of preexisting lithospheric weaknesses marked by ancient tectonic patterns that focus the extensional strain. The hypothesis favored here is SE-ward relative divergent drifting of a not yet well individualized Somalian plate, a model in agreement with the existence of NW-striking transform and transfer zones. The East African rift system comprises a unique succession of graben basins linked and segmented by intracontinental transform, transfer and accommodation zones. In an attempt to make a point on the rift system evolution through time and space, it is clear that the role of plume impacts is determinant. The main phenomenon is formation of domes related to plume effect, weakening the lithosphere and, long after, failure inducing focused upper mantle thinning, asthenospheric intrusion and related thermal uplift of shoulders. The plume that had formed first at around 30 Ma was not in the Afar but likely in Lake Tana region (Ethiopia

  14. HPV infection and EGFR activation/alteration in HIV-infected East African patients with conjunctival carcinoma.

    Directory of Open Access Journals (Sweden)

    Jing Jie Yu

    2010-05-01

    Full Text Available There has been substantial growth in the numbers of patients with conjunctival squamous cell carcinoma infected with HIV in East Africa. The natural history of the conjunctival squamous cell carcinoma appears to be unique in this region of the world, but the etiologic mechanism unclear and therapeutic options limited. This research was carried out to determine if conjunctival squamous cell carcinoma harbors human papillomavirus DNA and is associated with activation of the EGFR signaling pathway. Positive findings would identify etiologic causes and provide clinical guidance to improve treatment.Expression of p-MAPK/MAPK, p-Akt/Akt and p-EGFR/EGFR in cell nuclei and cytoplasm of 38 FFPE specimens were assessed by immunohistochemistry; HPV genotype was detected by qPCR assay; EGFR mutation was assessed by DNA sequencing analysis; and EGFR mRNA expression was measured using relative qPCR. Statistical analyses included two-sided Fisher exact test or chi-square test, Spearman correlation coefficient and ANOVA. HPV 18 was found in 61% of samples, with HPV 16 double-genotype in 6 patients (16%. Immunohistochemistry and qPCR data suggest that activation and expression of the EGFR signaling pathway is related to disease progression of conjunctival cancer. The associations between cytoplasmic p-MAPK, cytoplasmic p-Akt and tumor invasiveness were significant (p = 0.05 or 0.028. Nuclear p-EGFR appeared only in invasive tumors. A significant positive association between EGFR expression and disease invasiveness was observed (p = 0.01. A SNP in 10 patients and one missense mutation were found within EGFR tyrosine kinase domain. Statistical analysis indicates that patients with measurable EGFR expression more likely harbor EGFR mutations, compared to those with negative EGFR expression (35.3% vs. 0%.We conclude that HPV types 16/18 infection is frequent in East African patients with AIDS-associated squamous cell carcinoma of the conjunctiva. EGFR activation

  15. Portulacaria afra in East AFrica | Newton | Journal of East African ...

    African Journals Online (AJOL)

    No Abstract. East African Journal of Natural History Vol. 96 (1) 2007: pp. 107-108. http://dx.doi.org/10.2982/0012-8317(2007)96[107:PAIEA]2.0.CO;2 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

  16. East African Journal of Public Health: Journal Sponsorship

    African Journals Online (AJOL)

    East African Journal of Public Health: Journal Sponsorship. Journal Home > About the Journal > East African Journal of Public Health: Journal Sponsorship. Log in or Register to get access to full text downloads.

  17. Scopus: Journal of East African Ornithology: Journal Sponsorship

    African Journals Online (AJOL)

    Scopus: Journal of East African Ornithology: Journal Sponsorship. Journal Home > About the Journal > Scopus: Journal of East African Ornithology: Journal Sponsorship. Log in or Register to get access to full text downloads.

  18. East and Central African Journal of Surgery: About this journal

    African Journals Online (AJOL)

    East and Central African Journal of Surgery: About this journal. Journal Home > East and Central African Journal of Surgery: About this journal. Log in or Register to get access to full text downloads.

  19. Archives: East and Central African Journal of Surgery

    African Journals Online (AJOL)

    Items 1 - 40 of 40 ... Archives: East and Central African Journal of Surgery. Journal Home > Archives: East and Central African Journal of Surgery. Log in or Register to get access to full text downloads.

  20. East African Journal of Statistics

    African Journals Online (AJOL)

    AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING ... EASJOSTA publishes the latest findings in applied and theoretical statistics. ... mathematics and acturial sciences, all considered as part of applied statistics.

  1. East African rarities committee report | Fisher | Scopus: Journal of ...

    African Journals Online (AJOL)

    East African Rarities Committee (EARC) Special Report Species included for East African countries in Britton (1980) which have since been considered unacceptable. East African Rarities Committee Report 2013–2015. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD ...

  2. Journal of East African Natural History: Submissions

    African Journals Online (AJOL)

    2017-11-01

    Nov 1, 2017 ... Author Guidelines. Submission: manuscripts should be submitted as a Word document in an email attachment, to the Editor-in-Chief, Journal of East African Natural History at office@naturekenya.org. The manuscript should be accompanied by a covering letter from the author, or in the case of multiple ...

  3. East African Journal of Sciences: Editorial Policies

    African Journals Online (AJOL)

    Open Access Policy. This journal provides immediate open access to its content, upon registration, on the principle that making research freely available to the public supports a greater global exchange of knowledge. Creative Commons License East African Journal of Sciences by Haramaya University is licensed under a ...

  4. East African Journal of Public Health

    African Journals Online (AJOL)

    The East African Journal of Public Health is a multi-disciplinary journal publishing scientific research work from a range of public health related disciplines including community medicine, epidemiology, nutrition, behavioural sciences, health promotion, health education, communicable and non-communicable disease.

  5. Assessing sanitary mixtures in East African cities

    NARCIS (Netherlands)

    Letema, S.C.

    2012-01-01

    The urbanisation of poverty and informality in East African cities poses a threat to environmental
    health, perpetuates social exclusion and inequalities, and creates service gaps (UN-Habitat, 2008).
    This makes conventional sanitation provision untenable citywide, giving rise to the

  6. Regional Integration: A Political Federation of the East African ...

    African Journals Online (AJOL)

    The aim of this paper is to explore the possibility and viability of an East African political federation project. Since the late 1800s under the then British East Africa, the countries of East Africa have been searching for ways to integrate. The search led to the establishment of the East African Community (EAC) in December ...

  7. Archives: East African Medical Journal

    African Journals Online (AJOL)

    Items 1 - 50 of 228 ... AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL · News. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers · about Open Access ...

  8. African Muslim Youth and the Middle East

    DEFF Research Database (Denmark)

    Ihle, Annette Haaber

    this African tradition of religious scholarship in the Middle East. The paper will, with the help of Pierre Bourdieu's notion of forms of capital related to various fields, analyse the challenges which Muslim students encounter during their stay in the Middle East and the forms of capital they bring back......, marked by economic decline and political instability. In Africa a weak or even failed state often means that young people have in reality no access to political, educational or economic positions and resources. In some countries like Nigeria, Ghana and the Ivory Coast the marginalisation of the youth...

  9. Collaboration with East African security organisations

    DEFF Research Database (Denmark)

    Nordby, Johannes Riber; Jacobsen, Katja L.

    2012-01-01

    of the concept. At the same time the three organisations represent different constellations of member nations and thus different national interests, and locally they have different legitimacy and political strength. Thus, when choosing collaboration partners for a security project it is not simply a question......When it comes to understanding the concept of security and the way fragile security situations should be solved, the difference is big. While EASF – the East African Standby Force – is a regular military force with a rather traditional, military perception of the concept of security, EAC (East...... African Community) and IGAD (Intergovernmental Authority on Development) have broader perceptions of the concept. According to EAC, security also concerns matters such as policy reform, legislation, education and infrastructure. IGAD considers food security and environmental and economic issues as part...

  10. Cerebral cortices of East african early hominids.

    Science.gov (United States)

    Falk, D

    1983-09-09

    An endocast of the frontal lobe of a reconstructed skull, which is approximately 2 million years old, from the Koobi Fora region of Kenya appears to represent the oldest human-like cortical sulcal pattern in the fossil record, while the endocast from another skull from the same region produces an endocast that appears apelike in its frontal lobe and similar to endocasts from earlier South African australopithecines. New analysis of paleoanatomical evidence thus indicates that at least two taxa of early hominids coexisted in East Africa.

  11. Crowdfunding in Emerging Markets : Lessons from East African Startups

    OpenAIRE

    World Bank Group

    2015-01-01

    The purpose of this paper is to capture lessons learned from East African entrepreneurs who were some of crowdfunding’s first adopters. Their experiences can serve as a practical guide for entrepreneurs looking to more effectively utilize crowdfunding across all emerging markets. In order to gather this data, the World Bank conducted interviews with a number of East African technology entr...

  12. Journal of East African Natural History: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. The Journal of East African Natural History is published jointly by the East Africa Natural History Society and the National Museums of Kenya. The Journal publishes papers and notes in the field of natural history, broadly defined as the study of organisms in their natural state, relevant to the eastern African ...

  13. East and Central African Journal of Surgery

    African Journals Online (AJOL)

    health institutions. Thus many patients present with advanced malignancies when surgery for cure is impossible and only palliative care can be offered. Unfortunately many African countries lack both facilities and specialists in palliative care. Until recently palliative care was not even included in the curriculum for medical.

  14. Tobacco smoking in black and white South Africans | Peltzer | East ...

    African Journals Online (AJOL)

    Tobacco smoking in black and white South Africans. K. Peltzer. Abstract. (East African Medical Journal: 2001 78(3): 115-118). Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/eamj.v78i3.9074 · AJOL African Journals Online.

  15. Records: East African Rarities Committee report and change of remit ...

    African Journals Online (AJOL)

    Scopus: Journal of East African Ornithology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 29 (2009) >. Log in or Register to get access to full text downloads.

  16. Short communications | Mockler | Scopus: Journal of East African ...

    African Journals Online (AJOL)

    Scopus: Journal of East African Ornithology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 36, No 1 (2016) >. Log in or Register to get access to full text downloads.

  17. Systematic and taxonomic issues concerning some East African bird ...

    African Journals Online (AJOL)

    Scopus: Journal of East African Ornithology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 34 (2015) >. Log in or Register to get access to full text downloads.

  18. General practitioners and clinical guidelines | Bhagat | East African ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 78, No 1 (2001) >. Log in or Register to get access to full text downloads.

  19. Stable isotopic composition of East African lake waters

    International Nuclear Information System (INIS)

    Odada, E.O.

    2001-01-01

    The investigation of stable isotopic composition of East African lake waters was conducted by scientists from the Department of Geology, University of Nairobi, as part of the International Decade for the East African Lakes (IDEAL) project and in close collaboration with the scientists from Large Lakes Observatory of the University of Minnesota and the Isotope Hydrology Laboratory of the IAEA in Vienna. The Research Contract was part of the IAEA Co-ordinated Research Programme on Isotope Techniques in Lake Dynamics Investigations, and was sponsored by the Agency. Water and grab sediment samples were obtained from East African Lakes during the month of January and February 1994 and July/August 1995. Water samples were analysed for oxygen and deuterium isotopic composition at the IAEA Laboratories in Vienna, Austria. In this final paper we report the results of the study of oxygen and deuterium isotopic composition from the East African lake waters. (author)

  20. Climate variability and impacts on east African livestock herders: the ...

    African Journals Online (AJOL)

    Climate variability and impacts on east African livestock herders: the Maasai of ... and vulnerability to climate variability and climate change is assessed, using data ... Model results suggest that the ecosystem is quite resilient and suggests that ...

  1. East African discourses on khat and sex.

    Science.gov (United States)

    Beckerleg, Susan

    2010-12-01

    The study aims to review and analyse the varied East African discourses on the effects of khat use on libido, fertility, transmission of HIV, prostitution and rape. The data were gathered between 2004 and 2009 in Kenya and Uganda. Between 2004 and 2005 across Kenya and Uganda a broad survey approach was adopted, involving identification of and travel to production areas, interviews with producers and consumers in rural and urban settings. In addition, a survey of 300 Ugandan consumers was carried out in late 2004. Between 2007 and 2009, an in-depth study of khat production, trade and consumption was conducted in Uganda. This study also employed a mixture of methods, including key informant interviews participant-observation and a questionnaire survey administered to 210 khat consumers. Khat is associated, by consumers and its detractors alike, with changes in libido and sexual performance. Although there is no evidence to support their claims, detractors of khat use argue that khat causes sexual violence, causes women to enter sex work, and that chewing causes the spread of sexually transmitted diseases, including the HIV virus. In East Africa the discourse on khat and sex has led to consumption of the substances being associated by many people with uncontrolled sexual behaviour. There is no evidence that khat use fuels promiscuity, commercial sex, sexually transmitted diseases or rape. The current discourse on khat and sex touches on all these topics. Local religious and political leaders invoke khat use as a cause of what they argue is a breakdown of morals and social order. In Kenya and Uganda it is women khat consumers who are seen as sexually uncontrolled. In Uganda, the argument is extended even to men: with male khat chewers labelled as prone to commit rape. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  2. General practitioners and clinical guidelines | Bhagat | East African ...

    African Journals Online (AJOL)

    East African Medical Journal: 2001 78(1): 30-34). Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/eamj.v78i1.9109 · AJOL African Journals Online.

  3. Acute appendicitis in a Kenya rural hospital | Willmore | East African ...

    African Journals Online (AJOL)

    East African Medical Journal: 2001 78(7): 355-357). Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/eamj.v78i7.9007 · AJOL African Journals Online.

  4. East and Central African Journal of Surgery: Contact

    African Journals Online (AJOL)

    Principal Contact. Prof. Ignatius Kakande Editor-in-Chief Association of Surgeons of East Africa. East and Central African Journal of Surgery. P.O. Box 7051. Kampala. Uganda. Alternative email: igkakande@gmail.com. Phone: +256 772 501 745. Email: ecajs@gmail.com ...

  5. Middle East and North African Oil.

    Science.gov (United States)

    Al-Quazzaz, Ayad

    1981-01-01

    Traces the history of oil and natural gas in the Middle East and relates the importance of the Middle East's current stores of oil to economic development. Information is presented on the relationship of major oil companies and local governments, OPEC, rate of production, and the impact of oil on the societies of the Middle East and North Africa.…

  6. Phytogeography of the tropical north-east African mountains

    Directory of Open Access Journals (Sweden)

    I. Friis

    1983-11-01

    Full Text Available The tropical north-east African mountains are tentatively divided into four phytochoria, the formal rank of which is not defined. The division is based on patterns of distribution and endemism in the region. The recognition of a distinct Afromontane phytochorion is now well established (Chapman & White, 1970; Werger, 1978; White, 1978. However, there is still very little information on the phytogeography of the individual mountains or mountain systems. This study hopes to fill a little of the gap by analysing distribution patterns and patterns of endemism in the flora of the tropical north-east African mountains. The north-east African mountain system is the largest in tropical Africa (see e.g. map in White, 1978. At the core of this system is the large Ethiopian massif, around which are located various mountains and mountain chains. These include the Red Sea Hills in the Sudan, the mountain chain in northern Somalia, the south-west Arabian mountains, and the Imatong mountains of south-east Sudan. The latter are often referred to the East African mountain system (White, 1978 but. as I will point out later, they also have a close connection with the south-west highlands of Ethiopia. The paper presents some results of my study of the mountain flora of tropical north-east Africa, particularly the forest species. Where no source is indicated, the data are from my own unpublished studies.

  7. Scopus: Journal of East African Ornithology: Contact

    African Journals Online (AJOL)

    Principal Contact. Darcy Ogada Dr Bird Committee of the East Africa Natural History Society. Editors,. Scopus,. c/o Nature Kenya,. P.O. Box 44486,. G.P.O. 00100,. Nairobi, Kenya. Email: scopus@naturekenya.org ...

  8. Bandwidth selection in smoothing functions | Kibua | East African ...

    African Journals Online (AJOL)

    ... inexpensive and, hence, worth adopting. We argue that the bandwidth parameter is determined by two factors: the kernel function and the length of the smoothing region. We give an illustrative example of its application using real data. Keywords: Kernel, Smoothing functions, Bandwidth > East African Journal of Statistics ...

  9. Genetic structure and diversity of East African taro [ Colocasia ...

    African Journals Online (AJOL)

    Taro [Colocasia esculenta (L) Schott] is mainly produced in Africa by small holder farmers and plays an important role in the livelihood of millions of poor people in less developed countries. The genetic diversity of East African taro has not been determined. This study utilizes six microsatellite primers to analyze five ...

  10. East African Journal of Public Health: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. The East African Journal of Public Health is a multi-disciplinary journal publishing scientific research work from a range of public health related disciplines including community medicine, epidemiology, nutrition, behavioural sciences, health promotion, health education, communicable and ...

  11. Adhesive intestinal obstruction | Kuremu | East African Medical Journal

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 83, No 6 (2006) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  12. Panmixia in east African Platgyra daedalea | Macdonald | Western ...

    African Journals Online (AJOL)

    Reef coral populations in the western Indian Ocean are neglected in terms of research and management. Very little is known about coral population connectivity and dynamics at regional scales. Platygyra daedalea was collected from Indian Ocean coral reefs, mainly from the east African coast between Mombasa Marine ...

  13. Proliferation and Shoot Recovery among the East African Highland ...

    African Journals Online (AJOL)

    Production of East African highland banana (EA-AAA banana) (Musa spp.) is limited by scarcity of planting materials, attributable to their low natural proliferation ability. Under natural field conditions, the EA-AAA bananas greatly differ in suckering ability. In vitro micropropagation has been adopted as an alternative means ...

  14. East African governments' responses to high cereal prices

    NARCIS (Netherlands)

    Meijerink, G.W.; Roza, P.; Berkum, van S.

    2009-01-01

    This study analyses the responses of governments in four East African countries (Kenya, Tanzania, Uganda and Ethiopia) with respect to price formation and price transmission in the cereal sector. All four countries were confronted with high cereal prices in 2008. Government policies applied largely

  15. Editorial : Clinical drug interactions | Kokwaro | East African Medical ...

    African Journals Online (AJOL)

    Journal Home > Vol 78, No 10 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Editorial: Clinical drug interactions. G. O. Kokwaro. Abstract. (East African Medical Journal 2001 78 (10): 505-506). Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  16. Alcoholism and diabetes mellitus: Case report | Otieno | East African ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 79, No 2 (2002) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  17. Anorexia nervosa in Kenya | Njenga | East African Medical Journal

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 81, No 4 (2004) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  18. Acute appendicitis in a Kenya rural hospital | Willmore | East African ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 78, No 7 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  19. Post-traumatic stress disorder: Case report | Nyamai | East African ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 77, No 4 (2000) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  20. Over grafting donor site | Rogers | East and Central African Journal ...

    African Journals Online (AJOL)

    East and Central African Journal of Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 14, No 2 (2009) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Over grafting donor site. AD Rogers, AK ...

  1. East and Central African Journal of Pharmaceutical Sciences ...

    African Journals Online (AJOL)

    East and Central African Journal of Pharmaceutical Sciences. 1. Vol. 8(2) 40 - 42. Constituents of the Stem Bark of Dombeya Rotundifolia Hochst. S.N. NDWIGAH*', G.N. THOITHI', J.W. MWANGI~ AND 1.0. KIBWAGE'. 'Department of Pharmaceutical Chemistry, School of Pharmacy, University of Nairobi,. P. 0.

  2. Maritime Security Concerns of the East African Community (EAC ...

    African Journals Online (AJOL)

    The maritime domain of the East African Community (EAC) is affected by a number of maritime security threats, including piracy, armed robbery against ships and an ongoing maritime border dispute between Kenya and Somalia. Neither the EAC nor its member States have long-term and holistic maritime security policies.

  3. 59 East and Central African Journal of Pharmaceutical Sciences Vol ...

    African Journals Online (AJOL)

    pharm-chem

    East and Central African Journal of Pharmaceutical Sciences. Vol. 16 (2013). There is a misconception that traditional medicine is unique to developing countries of Africa, Asia and. South America. This is certainly not true. Traditional medicine, often referred to as "alternative medicine", is widely used in developed countries ...

  4. East African Community Law : Institutional, Substantive and Comparative EU Aspects

    NARCIS (Netherlands)

    Ugirashebuja, E.; Ruhangisa, J.E.; Ottervanger, T.R.; Cuyvers, A.

    2017-01-01

    The East African Community (EAC) is a regional intergovernmental and supranational organization currently comprising the Republics of Burundi, Kenya, Rwanda, South Sudan, the United Republic of Tanzania, and the Republic of Uganda. Established in 2000, the EAC aims at widening and deepening

  5. Comparison of East African and Iran natural feeding condition based ...

    African Journals Online (AJOL)

    In this scientific work, we used soils from Zanzibar (Tansania region east African), Guilan (north of Iran), Tehran (center of Iran) and two type of soils from Zabol and Saravan regions (southeastern of Iran) in a condition simulated like atmospheric ones. The amounts of reduced Fe, Mn, Cu, Zn, pH, Ec, carbohydrate and lipid ...

  6. Looking forward to the East African Countries' Collaboration in ...

    African Journals Online (AJOL)

    of harmonizing nursing and midwifery education, practice and legislation. A study to ... opportunity for University Deans in the East African region to dialogue and examine possible areas .... essentials for a productive collaboration including; ... and 4 students graduated in mental health programs. ... such as e-learning.

  7. Primary breast sarcoma: case report | Hassan | East African Medical ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 81, No 7 (2004) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  8. Kaposis sarcoma in a Nairobi Hospital | Onyango | East African ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 81, No 3 (2004) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  9. Human Cryptosporidiosis: A Review | Ayuo | East African Medical ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 86, No 2 (2009) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  10. Editorial : Emerging issues of measles | Obimbo | East African ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 78, No 1 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  11. Task Shifting in HIV Clinics, Western Kenya | Kosgei | East African ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 87, No 7 (2010) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  12. Primary cerebral angitis of the central nervous | Das | East African ...

    African Journals Online (AJOL)

    Various medications like intravenous immunoglobulin, antibiotics, acyclovir, methyl prednisolone and management for raised intracranial pressure were instituted. She rapidly deteroriated and died on tenth hospital day. Only at autopsy was the diagnosis of primary angitis of central nervous system established. East African ...

  13. Scopus: Journal of East African Ornithology - Vol 32 (2012)

    African Journals Online (AJOL)

    Remarks concerning the East African coastal form of the Tropical Boubou Laniarius aethiopicus sublacteus (Cassin 1851), and its supposed black morph · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. DA Turner, BW Finch, ND Hunter, 47-49 ...

  14. East and Central African Journal of Pharmaceutical Sciences

    African Journals Online (AJOL)

    The East and Central African Journal of Pharmaceutical Sciences is dedicated to all aspects of Pharmaceutical Sciences research and is published in English. The scientific papers published in the Journal fall into three main categories: review papers, original research papers and short communications. Review papers in ...

  15. Agricultural Trade and Economic Growth in East African Community ...

    African Journals Online (AJOL)

    East African Community states, as many other states in the region, depend largely on agricultural activities to boost their economic growth and create employment. Up to 80 per cent of the populace depends on agriculture directly and indirectly for food, employment and income, while about 40 million people in EAC suffer ...

  16. East and Central African Journal of Surgery

    African Journals Online (AJOL)

    cough, diphtheria and measles. These no longer reach epidemic proportions in Africa as they did 30 years ago. But against a background of over- population, war and malnutrition, malaria and the diarrhoea1 diseases take an increasing toll of African children. In the cities, the diseases associated with affluence and gluttony ...

  17. Seismicity of the Earth 1900-2013 East African Rift

    Science.gov (United States)

    Hayes, Gavin P.; Jones, Eric S.; Stadler, Timothy J.; Barnhart, William D.; McNamara, Daniel E.; Benz, Harley M.; Furlong, Kevin P.; Villaseñor, Antonio; Hayes, Gavin P.; Jones, Eric S.; Stadler, Timothy J.; Barnhart, William D.; McNamara, Daniel E.; Benz, Harley M.; Furlong, Kevin P.; Villaseñor, Antonio

    2014-01-01

    The East African Rift system (EARS) is a 3,000-km-long Cenozoic age continental rift extending from the Afar triple junction, between the horn of Africa and the Middle East, to western Mozambique. Sectors of active extension occur from the Indian Ocean, west to Botswana and the Democratic Republic of the Congo (DRC). It is the only rift system in the world that is active on a continent-wide scale, providing geologists with a view of how continental rifts develop over time into oceanic spreading centers like the Mid-Atlantic Ridge.

  18. Hybridization in East African swarm-raiding army ants

    DEFF Research Database (Denmark)

    Kronauer, Daniel Jc; Peters, Marcell K; Schöning, Caspar

    2011-01-01

    Hybridization can have complex effects on evolutionary dynamics in ants because of the combination of haplodiploid sex-determination and eusociality. While hybrid non-reproductive workers have been found in a range of species, examples of gene-flow via hybrid queens and males are rare. We studied...... hybridization in East African army ants (Dorylus subgenus Anomma) using morphology, mitochondrial DNA sequences, and nuclear microsatellites....

  19. Emerging landscape degradation trends in the East African Horn

    Science.gov (United States)

    Pricope, N. G.; Michaelsen, J.; Husak, G. J.; Funk, C. C.; Lopez-Carr, D.

    2012-12-01

    Increasing climate variability along with declining trends in rainfall represent major risk factors affecting food security in many regions of the world. We identify Africa-wide regions where significant rainfall decreases from 1979-2011 are coupled with significant human population density increases. The rangelands of the East African Horn remain one of the world's most food insecure regions with significantly increasing human populations predominantly dependent on pastoralist and agro-pastoralist livelihoods. Widespread vegetation degradation is occurring, adversely impacting fragile ecosystems and human livelihoods. Using MODIS land cover and normalized difference vegetation index (NDVI) data collected since 2000, we observe significant changes in vegetation patterns and productivity over the last decade across the East African Horn and demonstrate that these two products can be used concurrently at large spatial scales to monitor vegetation dynamics at decadal time scales. Results demonstrate that a near doubling of the population in pastoral regions is linked with hotspots of degradation in vegetation condition. The most significant land cover change and browning trends are observed in areas experiencing drying precipitation trends in addition to increasing population pressures. These findings have serious implications for current and future regional food security monitoring and forecasting and for mitigation and adaptation strategies in a region where population is expected to continue increasing against a backdrop of drying climate trends.Fig.1(a)Change in standardized precipitation index in Africa between 1979-2010 (b)Change in population density at continental scale using the GRUMPv1 1990 and 2000 and AfriPop 2010 population density datasets Fig.2 Land cover change trajectories based on 2001-2009 MOD12Q1 Land Cover product for the East African Horn overlaid over aggregated FEWS Net Livelihoods Zones.

  20. Yellow fever, Asia and the East African slave trade.

    Science.gov (United States)

    Cathey, John T; Marr, John S

    2014-05-01

    Yellow fever is endemic in parts of sub-Saharan Africa and South America, yet its principal vectors--species of mosquito of the genus Aedes--are found throughout tropical and subtropical latitudes. Phylogenetic analyses indicate that yellow fever originated in Africa and that its spread to the New World coincided with the slave trade, but why yellow fever has never appeared in Asia remains a mystery. None of several previously proposed explanations for its absence there is considered satisfactory. We contrast the trans-Atlantic slave trade, and trade across the Sahara and to the Arabian Peninsula and Mesopotamia, with that to Far East and Southeast Asian ports before abolition of the African slave trade, and before the scientific community understood the transmission vector of yellow fever and the viral life cycle, and the need for shipboard mosquito control. We propose that these differences in slave trading had a primary role in the avoidance of yellow fever transmission into Asia in the centuries before the 20(th) century. The relatively small volume of the Black African slave trade between Africa and East and Southeast Asia has heretofore been largely ignored. Although focal epidemics may have occurred, the volume was insufficient to reach the threshold for endemicity.

  1. The biggest fish in the sea? Dynamic Kenyan labour migration in the East African community

    NARCIS (Netherlands)

    Ong'ayo, A.O.O.; Oucho, J.O.; Oucho, L.A.

    2013-01-01

    This study assesses the Kenyan policy and institutional framework concerning South–South labour migration with particular focus on the East African Community (EAC) countries. It focuses mainly on one particular policy instrument, the East African Community Common Market framework. The research

  2. Relapsing fever causative agent in Southern Iran is a closely related species to East African borreliae.

    Science.gov (United States)

    Naddaf, Saied Reza; Ghazinezhad, Behnaz; Kazemirad, Elham; Cutler, Sally Jane

    2017-10-01

    We obtained two blood samples from relapsing fever patients residing in Jask County, Hormozgan Province, southern Iran in 2013. Sequencing of a partial fragment of glpQ from two samples, and further characterization of one of them by analyzing flaB gene, and 16S-23S spacer (IGS) revealed the greatest sequence identity with East African borreliae, Borrelia recurrentis, and Borrelia duttonii, and Borrelia microti from Iran. Phylogenetic analyses of glpQ, flaB, and concatenated sequences (glpQ, flab, and IGS) clustered these sequences amongst East African Relapsing fever borreliae and B. microti from Iran. However, the more discriminatory IGS disclosed a unique 8-bp signature (CAGCCTAA) separating these from B. microti and indeed other relapsing fever borreliae. In southern Iran, relapsing fever cases are mostly from localities in which O. erraticus ticks, the notorious vector of B. microti, prevail. There are chances that this argasid tick serves as a host and vector of several closely related species or ecotypes including the one we identified in the present study. The distribution of this Borrelia species remains to be elucidated, but it is assumed to be endemic to lowland areas of the Hormozgan Province, as well as Sistan va Baluchistan in the southeast and South Khorasan (in Persian: Khorasan-e Jonobi) in the east of Iran. Copyright © 2017 Elsevier GmbH. All rights reserved.

  3. East African Journal of Sciences (2015) Volume 9 (1) 41-48 Effect of ...

    African Journals Online (AJOL)

    tosheba

    East African Journal of Sciences (2015). Volume 9 (1) 41-48 ... but no significant difference was observed amongst them. Queen .... used method of termite management in western. Ethiopia ..... Ethiopia. Working Document Series 68, ICRA,.

  4. East and Central African Journal of Surgery http://www.bioline.org.br ...

    African Journals Online (AJOL)

    Patrick

    East and Central African Journal of Surgery ... Investigations and intra-operative findings were suggestive of testicular torsion. We report this case because of its unusual ... The diagnosis is made mainly through clinical examination and signs.

  5. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    East and central African Journal of Surgery. Page 122 ... curriculum by integrating the basic and clinical sciences focusing on organ system and featuring early .... 5. identify the different radiological and imaging investigations. 6. know how to ...

  6. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    East and central African Journal of Surgery. Page 136 ... at school. Early presentation, immediate intervention and treatment can prevent grave .... Bank DE, Diaz L, Behrman DA, Delaney J, Bizzocco S. Tongue entrapment in an aluminum.

  7. Kinematics of the entire East African Rift from GPS velocities

    Science.gov (United States)

    Floyd, M.; King, R. W.

    2017-12-01

    Through a collaborative effort of the GeoPRISMS East Africa Rift GPS Working Group, we have collected and collated all of the publicly available continuous and survey-mode data for the entire rift system between 1994 and 2017 and processed these data as part of a larger velocity solution for Africa, Arabia and western Eurasia. We present here our velocity solution encompassing the major bounding plates and intervening terranes along the East African Rift from the Red Sea to the Malawi Rift and adjacent regions for GPS sites with data spans of at least 2.4 years, and north and east velocity uncertainties less than 1.5 mm/yr. To obtain realistic uncertainties for the velocity estimates, we attempted at each stage of the analysis to account for the character of the noise: During phase processing, we used an elevation-dependent weighting based on the phase residuals for each station; we then examined each position time series, removing outliers and reweighting appropriately to account for the white noise component of the errors; and e accounted for temporal correlations by estimating an equivalent random-walk magnitude for each continuous site and applying the median value (0.5 mm/√yr) to all survey-mode sites. We rigorously estimate relative rotation rates of Nubia, by choosing subset of well-determined sites such that the effective weights of western, northeastern and southern Africa were roughly equivalent, and Somalia, for which the estimate is dominated by three sites (MALI, RCMN, SEY1) whose uncertainties are a factor of 2-3 smaller than those of the other sites. For both plates, the weighted root-mean-square of the velocity residuals is 0.5 mm/yr. Our unified velocity solution provides a geodetic framework and constraints on the continental-scale kinematics of surface motions as well as more local effects both within and outside of the rift structures. Specific focus areas with denser coverage than previous fields include the Danakil block, the Afar Rift, the

  8. Model, Proxy and Isotopic Perspectives on the East African Humid Period

    Science.gov (United States)

    Tierney, Jessica E.; Lewis, Sophie C.; Cook, Benjamin I.; LeGrande, Allegra N.; Schmidt, Gavin A.

    2011-01-01

    Both North and East Africa experienced more humid conditions during the early and mid-Holocene epoch (11,000-5000yr BP; 11-5 ka) relative to today. The North African Humid Period has been a major focus of paleoclimatic study, and represents a response of the hydrological cycle to the increase in boreal summer insolation and associated ocean, atmosphere and land surface feedbacks. Meanwhile, the mechanisms that caused the coeval East African Humid Period are poorly understood. Here, we use results from isotopeenabled coupled climate modeling experiments to investigate the cause of the East African Humid Period. The modeling results are interpreted alongside proxy records of both water balance and the isotopic composition of rainfall. Our simulations show that the orbitally-induced increase in dry season precipitation and the subsequent reduction in precipitation seasonality can explain the East African Humid Period, and this scenario agrees well with regional lake level and pollen paleoclimate data. Changes in zonal moisture flux from both the Atlantic and Indian Ocean account for the simulated increase in precipitation from June through November. Isotopic paleoclimate data and simulated changes in moisture source demonstrate that the western East African Rift Valley in particular experienced more humid conditions due to the influx of Atlantic moisture and enhanced convergence along the Congo Air Boundary. Our study demonstrates that zonal changes in moisture advection are an important determinant of climate variability in the East African region.

  9. African Postal Heritage : Tanzania 1885-1920s : part I : German East Africa, 1885-1914

    NARCIS (Netherlands)

    Dietz, A.J.

    2016-01-01

    An earlier version of this African Postal Heritage Paper was published as African Studies Centre Leiden Working Paper 119 / 2015: "A postal history of the First World War in Africa and its aftermath - German colonies; III Deutsch Ostafrika / German East Africa", written by Ton Dietz.

  10. Ky'osimba Onaanya: Understanding Productivity of East African Highland Banana

    NARCIS (Netherlands)

    Taulya, G.

    2016-01-01

    Drought stress, potassium (K) and nitrogen (N) deficiencies are major constraints to East African highland banana (Musa spp. AAA-EA; hereafter referred to as ‘highland banana’), a primary staple food crop for over 30 million people in East Africa. This study explored the main and interactive effects

  11. Ky’osimba Onaanya: understanding productivity of East African Highland banana

    NARCIS (Netherlands)

    Taulya, G.

    2015-01-01

    Over 30 million people in East Africa depend on East African highland bananas for food and income. The bananas are grown with limited additions of nutrients and no irrigation, despite widespread poor soil fertility and regular dry seasons. This thesis describes the effect of increasing rainfall

  12. Anorexia nervosa in Kenya | Njenga | East African Medical Journal

    African Journals Online (AJOL)

    Background: Anorexia nervosa is a rare disorder in Africans, inspite of posing a serious public health hazard in the West. Whereas it is possible that African psychiatrists lack the skills to diagnose the disorder, other possible explanations for its apparent rarity must be sought in view of emerging evidence, which suggests a ...

  13. Applying East Asian Media Diplomacy Models to African Media: A ...

    African Journals Online (AJOL)

    The last two decades have seen the extensive expansion of South African and Nigerian media on the African continent. However, while the link between media and diplomacy, and the role of media in visualising the state for foreign audiences have received a lot of scholarly attention internationally, relatively little work has ...

  14. Use of Machine Learning Techniques for Identification of Robust Teleconnections to East African Rainfall Variability

    Science.gov (United States)

    Roberts, J. Brent; Robertson, F. R.; Funk, C.

    2014-01-01

    Hidden Markov models can be used to investigate structure of subseasonal variability. East African short rain variability has connections to large-scale tropical variability. MJO - Intraseasonal variations connected with appearance of "wet" and "dry" states. ENSO/IOZM SST and circulation anomalies are apparent during years of anomalous residence time in the subseasonal "wet" state. Similar results found in previous studies, but we can interpret this with respect to variations of subseasonal wet and dry modes. Reveal underlying connections between MJO/IOZM/ENSO with respect to East African rainfall.

  15. Ky'osimba Onaanya: Understanding Productivity of East African Highland Banana

    OpenAIRE

    Taulya, G.

    2016-01-01

    Over 30 million people in East Africa depend on East African highland bananas for food and income. The bananas are grown with limited additions of nutrients and no irrigation, despite widespread poor soil fertility and regular dry seasons. This thesis describes the effect of increasing rainfall and application of potassium and nitrogen fertilizers on banana growth and yields. In areas that receive less than 1100 mm of rainfall per year, additional rainfall increases yields by 65%. Application...

  16. THE IDIOSYNCRASY OF EAST AFRICAN ENGLISH Maria Tsilimos ...

    African Journals Online (AJOL)

    maria tsilimos

    officer of the Consortium for Independent Education Providers in Sub-Saharan Africa, ... African English has to be studied systematically in order that its unique characteristics can be ..... the contextualisation of the event that is narrated. Also ...

  17. Household Density and Infant Care in an East African Society

    Science.gov (United States)

    Munroe, Ruth H.; Munroe, Robert L.

    1971-01-01

    A cross-cultural relationship between household density and infant indulgence was investigated among Logoli infants in East Africa. Findings were taken as supportive of the view that socialization practices are influenced by ecological variables. (Author/JB)

  18. Regional Integration: A Political Federation of the East African ...

    African Journals Online (AJOL)

    sulaiman.adebowale

    2006-06-13

    Jun 13, 2006 ... He suggested that the countries of the East Africa Community (EAC) together with .... tries engaged in free trade for local produce. This was .... First, he averred that economic integration is not enough because of political ...

  19. Is the Proposed East African Monetary Union an Optimal Currency Area? A Structural Vector Autoregression Analysis

    OpenAIRE

    Steven K. Buigut; Neven Valev

    2004-01-01

    The treaty of 1999 to revive the defunct East African Community (EAC) ratified by Kenya, Uganda, and Tanzania came into force on July 2000 with the objective of fostering a closer co-operation in political, economic, social, and cultural fields. To achieve this, an East Africa Customs Union protocol was signed in March 2004. A Common Market, a Monetary Union, and ultimately a Political Federation of East Africa states is planned. Though the question of a monetary union has been discussed in t...

  20. Signatures of selection for environmental adaptation and zebu × taurine hybrid fitness in East African shorthorn zebu

    Science.gov (United States)

    The East African Shorthorn Zebu (EASZ) cattle are ancient hybrid between Asian zebu × African taurine cattle preferred by local farmers due to their adaptability to the African environment. The genetic controls of these adaptabilities are not clearly understood yet. Here, we genotyped 92 EASZ sample...

  1. Use and misuse of aspirin in rural Ethiopia | Duncan | East African ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 83, No 1 (2006) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should ...

  2. East African Journal of Public Health - Vol 7, No 1 (2010)

    African Journals Online (AJOL)

    East African Journal of Public Health. ... DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. E Mutabaruka, C Dochez, D Nshimirimana, A Meheus ... Prevalence of cigarette smoking and knowledge of its health implications among Nigerian soldiers · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT ...

  3. Drought is a major yield loss factor for rainfed East African highland banana

    NARCIS (Netherlands)

    Asten, van P.; Asten-Fermont, van A.M.; Taulya, G.

    2011-01-01

    Although drought stress has been identified among the production constraints of East African highland bananas (Musa spp., AAA-EA genome), no quantitative data were available to support this assumption. This study uses data from three on-station fertilizer trials (5–6 cycles) in Central and Southwest

  4. Characteristics of soils in selected maize growing sites along altitudinal gradients in East African highlands

    Directory of Open Access Journals (Sweden)

    Elijah Njuguna

    2015-12-01

    Full Text Available Maize is the main staple crop in the East African Mountains. Understanding how the edaphic characteristics change along altitudinal gradients is important for maximizing maize production in East African Highlands, which are the key maize production areas in the region. This study evaluated and compared the levels of some macro and micro-elements (Al, Ca, Fe, K, Mg, Mn, Na and P and other soil parameters (pH, organic carbon content, soil texture [i.e. % Sand, % Clay and % Silt], cation exchange capacity [CEC], electric conductivity [EC], and water holding capacity [HC]. Soil samples were taken from maize plots along three altitudinal gradients in East African highlands (namely Machakos Hills, Taita Hills and Mount Kilimanjaro characterized by graded changes in climatic conditions. For all transects, pH, Ca, K and Mg decreased with the increase in altitude. In contrast, % Silt, organic carbon content, Al and water holding capacity (HC increased with increasing altitude. The research provides information on the status of the physical–chemical characteristics of soils along three altitudinal ranges of East African Highlands and includes data available for further research.

  5. Louse-borne relapsing fever among East African refugees in Europe.

    Science.gov (United States)

    Antinori, Spinello; Mediannikov, Oleg; Corbellino, Mario; Raoult, Didier

    2016-01-01

    Louse-borne relapsing fever a neglected and forgotten disease by western physicians has recently re-emerged among East African migrants seeking asylum in Europe. We review here the cases observed so far together with a critical reappraisal of several issues regarding clinical presentation, diagnosis and treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. African mutinies in the Netherlands East Indies : a nineteenth-century colonial paradox

    NARCIS (Netherlands)

    Kessel, van W.M.J.; Abbink, J.; Bruijn, de M.E.; Walraven, van K.

    2003-01-01

    Between 1831 and 1872, the Dutch government recruited 3,000 Africans from the Gold Coast and Ashanti (Ghana) for service in the colonial army in the Netherlands East Indies. The majority of them were ex-slaves but were promised that their conditions of service would be the same as those of

  7. Simulating sanitation and waste flows and their environmental impacts in East African urban centres

    NARCIS (Netherlands)

    Oyoo, R.

    2014-01-01

    Simulating Sanitation and Waste Flows and their Environmental Impacts in East African Urban Centres

    Abstract

    If improperly managed, urban waste flows can pose a significant threat to the quality of both the natural environment and public health.

  8. Tectonic inheritance and continental rift architecture: Numerical and analogue models of the East African Rift System.

    NARCIS (Netherlands)

    Corti, G.; van Wijk, J.W.; Cloetingh, S.A.P.L.; Morley, C.

    2007-01-01

    The western branch of the East African Rift is composed of an arcuate succession of elongate asymmetric basins, which differ in terms of interaction geometry, fault architecture and kinematics, and patterns of uplift/subsidence and erosion/sedimentation. The basins are located within Proterozoic

  9. Contrasted continental rifting via plume-craton interaction : Applications to Central East African Rift

    NARCIS (Netherlands)

    Koptev, Alexander; Burov, Evgueni; Calais, Eric; Leroy, Sylvie; Gerya, Taras; Guillou-Frottier, Laurent; Cloetingh, Sierd

    The East African Rift system (EARS) provides a unique system with the juxtaposition of two contrasting yet simultaneously formed rift branches, the eastern, magma-rich, and the western, magma-poor, on either sides of the old thick Tanzanian craton embedded in a younger lithosphere. Data on the

  10. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    East and Central African Journal of Surgery Volume 15 Number 2. ... Makerere University,School of Biomedical sciences Department of Anatomy, P.O Box 7072, ..... should be borne in mind when locating the nerve for a regional block in the ...

  11. Evaluation of the LISEM soil erosion model in two catchments in the East African Highlands

    NARCIS (Netherlands)

    Hessel, R.; Bosch, van den R.; Vigiak, O.

    2006-01-01

    Under increasing population pressure, soil erosion has become a threat in the East African Highlands, and erosion modelling can be useful to quantify this threat. To test its applicability for this region, the LISEM soil erosion model was applied to two small catchments, one in the Usumbara

  12. Managing scalp defects in sub-Saharan Africa | Legbo | East African ...

    African Journals Online (AJOL)

    Conclusions: Management of scalp defects remains a major challenge in our environment. The importance of continuing education of colleagues and other health workers in peripheral health units on the importance of proper initial wound debridement and early referral cannot be overemphasised. East African Medical ...

  13. The role of households in solid waste management in East African capital cities

    NARCIS (Netherlands)

    Solomon, A.O.

    2011-01-01

    Solid Management is a concern in East African capital cities. The absence of managing solid waste is a serious problem. An ever bigger concern is the growing quantities of waste that are generatedat households level in informal settlements. In most cases proper safeguard measures are largely

  14. Social Realism in the African Novel: The South African and East ...

    African Journals Online (AJOL)

    Although the African novel arose from Europe, the African has used it to explore a different world view; a world where gods and men hold a place together in the affairs of men. But more importantly, the African novel has followed the peculiar history of colonization and decolonization. While the earlier novels depicted the ...

  15. Maintainability in a manpower system | Owino | East African Journal ...

    African Journals Online (AJOL)

    : EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/eajosta.v1i1.39173 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

  16. East African Medical Journal - Vol 83, No 9 (2006)

    African Journals Online (AJOL)

    An overview of health financing patterns and the way forward in the who african region · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. JM Kirigia, A Preker, G Carrin, C Mwikisa, AJ Diarra-Nama, S1-S28. http://dx.doi.org/10.4314/eamj.v83i9.9492 ...

  17. East African Medical Journal - Vol 87, No 8 (2010)

    African Journals Online (AJOL)

    Association of the ENPP1 rs997509 polymorphism with obesity in South African mixed ancestry learners · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. T Matsha, B Fanampe, Y Yako, S Hassan, M Hoffmann, L Van der Merwe, RT Erasmus ...

  18. Hantavirus strains in East Africa related to Western African hantaviruses

    Czech Academy of Sciences Publication Activity Database

    Těšíková, Jana; Bryjová, Anna; Bryja, Josef; Lavrenchenko, L. A.; Goüy de Bellocq, Joëlle

    2017-01-01

    Roč. 17, č. 4 (2017), s. 278-280 ISSN 1530-3667 R&D Projects: GA ČR GCP502/11/J070 Institutional support: RVO:68081766 Keywords : bats * East Africa * hantavirus * phylogeny * rodents Subject RIV: EE - Microbiology, Virology OBOR OECD: Infectious Diseases Impact factor: 2.045, year: 2016

  19. Journal of East African Natural History - Vol 89 (2000)

    African Journals Online (AJOL)

    10.2982/0012-8317(2000)89[73:ASOTSM]2.0.CO;2 · Status of the cheetah in Tanzania in the mid 1990's · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. PM Gros, 85-100. Germination of important East ...

  20. East African refugees adapting to life in the UK

    Directory of Open Access Journals (Sweden)

    Samuel Bekalo

    2012-12-01

    Full Text Available This article reflects on the first-hand life experiences of refugees ofEast/Horn of Africa origin on arrival in the UK. The experiences – someof which could be seen as humorous or sad – may be informative andrelevant for other practitioners.

  1. Editorial : Emerging issues of measles | Obimbo | East African ...

    African Journals Online (AJOL)

    Metrics powered by PLOS ALM · http://dx.doi.org/10.4314/eamj.v78i1.9102 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors. OTHER RESOURCES... for Researchers · for Journals · for Authors · for Policy Makers · about Open Access · FAQ's · News · AJOL jobs · More about ...

  2. Forecasting The Onset Of The East African Rains

    Science.gov (United States)

    MacLeod, D.; Palmer, T.

    2017-12-01

    The timing of the rainy seasons is critical for East Africa, where many livelihoods depend on rain-fed agriculture. The exact onset date of the rains varies from year to year and a delayed start has significant implications for food security. Early warning of anomalous onset can help mitigate risks by informing farmer decisions on crop choice and timing of planting. Onset forecasts may also pre-warn governments and NGOs of upcoming need for financial support and humanitarian intervention. Here we assess the potential to forecast the onset of both the short and long rains over East Africa at subseasonal to seasonal timescales. Based on operational reforecasts from ECMWF, we will demonstrate skilful prediction of onset anomalies. An investigation to determine potential sources of this forecast skill will also be presented. This work has been carried out as part of the project ForPAc: "Towards forecast-based preparedness action".

  3. Geodynamics of the East African Rift System ∼30 Ma ago: A stress field model

    Science.gov (United States)

    Min, Ge; Hou, Guiting

    2018-06-01

    The East African Rift System (EARS) is thought to be an intra-continental ridge that meets the Red Sea and the Gulf of Aden at the Ethiopian Afar as the failed arm of the Afar triple junction. The geodynamics of EARS is still unclear even though several models have been proposed. One model proposes that the EARS developed in a local tensile stress field derived from far-field loads because of the pushing of oceanic ridges. Alternatively, some scientists suggest that the formation of the EARS can be explained by upwelling mantle plumes beneath the lithospheric weak zone (e.g., the Pan-African suture zone). In our study, a shell model is established to consider the Earth's spherical curvature, the lithospheric heterogeneity of the African continent, and the coupling between the mantle plumes and the mid-ocean ridge. The results are calculated via the finite element method using ANSYS software and fit the geological evidence well. To discuss the effects of the different rock mechanical parameters and the boundary conditions, four comparative models are established with different parameters or boundary conditions. Model I ignores the heterogeneity of the African continent, Model II ignores mid-ocean spreading, Model III ignores the upwelling mantle plumes, and Model IV ignores both the heterogeneity of the African continent and the upwelling mantle plumes. Compared to these models is the original model that shows the best-fit results; this model indicates that the coupling of the upwelling mantle plumes and the mid-ocean ridge spreading causes the initial lithospheric breakup in Afar and East Africa. The extension direction and the separation of the EARS around the Tanzanian craton are attributed to the heterogeneity of the East African basement.

  4. Attitudes, perceptions and behaviours towards HIV testing among African-American and East African immigrant women in Washington, DC: implications for targeted HIV testing promotion and communication strategies.

    Science.gov (United States)

    De Jesus, Maria; Carrete, Claudia; Maine, Cathleen; Nalls, Patricia

    2015-12-01

    The objective of the study was to examine and compare the HIV testing attitudes, perceptions and behaviours between African-American and East African immigrant women in the Washington, DC metropolitan area. Adopting an inductive, qualitative methodological approach, we conducted a total of 40 in-depth, semistructured interviews between October 2012 and March 2013. Qualitative thematic analysis was used to analyse the data. Overall, African-American women held more favourable views towards HIV testing than East African immigrant women. Very few East African immigrant women sought HIV testing intentionally. The majority of East African participants were tested inadvertently, while others tested for immigration-related or employment-related purposes. There were many barriers that impede women from seeking an HIV test including negative assumptions (eg, "Getting an HIV test implies that I am HIV positive"), negative emotions (eg, "Fear of being diagnosed with HIV and what this will mean for me") and potential negative reactions from partner or others (eg, "Getting an HIV test can signal distrust, disrespect, or infidelity"). There were nuances in how each group articulated some of these barriers and East African women expressed unique concerns that originated from experiences in their home countries. The study shed light into the complexity of factors that constrain women from presenting themselves voluntarily for an HIV test and highlighted the nuances between African-American and East African perceptions. Implications of findings for effective targeted HIV screening promotion and communication strategies among these groups of women are discussed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. A new brachypterous scarab species, Orphnus longicornis (Coleoptera: Scarabaeidae: Orphninae), from the East African Rift.

    Science.gov (United States)

    Frolov, Andrey; Akhmetova, Lilia

    2015-11-05

    The Afrotropical Region is the center of the diversity of the scarab beetle genus Orphnus MacLeay, 1819 (Coleoptera: Scarabaeidae: Orphninae), with 94 species occurring from Sahel in the north to Little Karoo in the south (Paulian, 1948; Petrovitz, 1971; Frolov, 2008). The East African Rift is one of the richest regions of the Afrotropics housing more than 20 species of Orphnus (Paulian, 1948; Frolov, 2013), most of which are endemic to this region. Yet the scarab beetle fauna of the East African Rift, and especially the Eastern Arc Mountains, is still inadequately studied. Examination of the material housed in the Museum of Natural History of Humboldt-Universität, Berlin, Germany (ZMHUB), revealed a series of brachypterous Orphnus beetles belonging to an undescribed species. The new species is described and illustrated below.

  6. East African wetland-catchment data base for sustainable wetland management

    Science.gov (United States)

    Leemhuis, Constanze; Amler, Esther; Diekkrüger, Bernd; Gabiri, Geofrey; Näschen, Kristian

    2016-10-01

    Wetlands cover an area of approx. 18 Mio ha in the East African countries of Kenya, Rwanda, Uganda and Tanzania, with still a relative small share being used for food production. Current upland agricultural use intensification in these countries due to demographic growth, climate change and globalization effects are leading to an over-exploitation of the resource base, followed by an intensification of agricultural wetland use. We aim on translating, transferring and upscaling knowledge on experimental test-site wetland properties, small-scale hydrological processes, and water related ecosystem services under different types of management from local to national scale. This information gained at the experimental wetland/catchment scale will be embedded as reference data within an East African wetland-catchment data base including catchment physical properties and a regional wetland inventory serving as a base for policy advice and the development of sustainable wetland management strategies.

  7. East African wetland-catchment data base for sustainable wetland management

    Directory of Open Access Journals (Sweden)

    C. Leemhuis

    2016-10-01

    Full Text Available Wetlands cover an area of approx. 18 Mio ha in the East African countries of Kenya, Rwanda, Uganda and Tanzania, with still a relative small share being used for food production. Current upland agricultural use intensification in these countries due to demographic growth, climate change and globalization effects are leading to an over-exploitation of the resource base, followed by an intensification of agricultural wetland use. We aim on translating, transferring and upscaling knowledge on experimental test-site wetland properties, small-scale hydrological processes, and water related ecosystem services under different types of management from local to national scale. This information gained at the experimental wetland/catchment scale will be embedded as reference data within an East African wetland-catchment data base including catchment physical properties and a regional wetland inventory serving as a base for policy advice and the development of sustainable wetland management strategies.

  8. Estimates of interhemispheric transport of radioactive debris by the east African low-level jet stream

    International Nuclear Information System (INIS)

    Rangarajan, C.; Eapen, C.D.

    1981-01-01

    The movement of air masses across the equator by way of the east African low-level jet stream has been studied using fission products from the French nuclear tests of the South Pacific as tracers. The studies show that the transit time of air masses from Malagasy to India is 3--6 days and about 75% of the air mass on the west coast of India is from the southern hemisphere

  9. Immigrant Entrepreneurship in United Arab Emirates: An exploratory study on East African Asian Immigrant Businesses

    OpenAIRE

    Khakoo, Mohamed Hussein Turabali

    2008-01-01

    Immigrant entrepreneurship has always existed and has developed remarkably. It is related to migration flows over time and has brought increasing attention from researchers and management practitioners in recent years. The research sets out to investigate the process by which immigrants enter into entrepreneurship. The idea of starting a small business and the internationalization strategies they follow. A homogeneous ethnic minority is researched upon, the East African Asians who had migrate...

  10. Climate variability and impacts on east African livestock herders: The Maasai of Ngorongoro Conservation Area, Tanzania

    OpenAIRE

    Galvin, K.A.; Thornton, P.K.; Boone, R.B.; Sunderland, J.

    2004-01-01

    Metadata only record East African pastoral adaptation and vulnerability to climate variability and climate change is assessed, using data from decision-making processes and ecological data of the Maasai of Ngorongoro Conservation Area as an example. The paper uses integrated modeling, linking PHEWS, a household model, to SAVANNA, an ecosystem model to look at the effects of drought and a series of wet years on the well-being of Maasai pastoralists. Model results suggest that the ecosystem ...

  11. Alienation and Revolutionary Vision in East African Post-Colonial Dramatic Literature

    OpenAIRE

    Fashina, Nelson O.

    2009-01-01

    This paper is a trans-disciplinary inquiry into the principles of alienation and revolutionary ethos in two East African plays of postcolonial society. It engages literary-textual exegesis and sociological theories to unravel the multi-dimensional forms of alienation as an interrogation of contemporary postcolonial history. The writers, though somewhat in throes and dilemma of exilic consciousness, ‘commodify’ and appropriate the literary enterprise as weapon of active physical revolt and tex...

  12. Haemorheological Changes in African Breast Cancer Patients

    African Journals Online (AJOL)

    elearning

    complications, African patients with breast cancer may well be predisposed to thrombotic complications during illness. ... having breast cancer were studied. The patients were diagnosed by one of the authors from histological biopsy from the lump removed from the breast. None of ... statistics (Student's t-test for paired data.

  13. East African Medical Journal - Vol 78, No 3 (2001)

    African Journals Online (AJOL)

    HIV infection in elderly medical patients · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... Dental caries and periodontal conditions among primary school children in ... Epidemiology of injury patients at Bugando Medical centre, Tanzania ...

  14. Urolithiasis in Nairobi, Kenya | Ngugi | East African Medical Journal

    African Journals Online (AJOL)

    patients had PCNL; 18 as the first procedure and 5 after failed ESWL. Fifty-one patients had ureteroscopic. Management: Fourty seven had laser or pneumatic lithotripsy while four had stone removal by Dormia basket. Seven patients had bladder calculi managed by either cystolitholapaxy or forceps retrieval. Conclusions: ...

  15. Ideological trends in initial teacher education curricula: the case of East African universities

    Directory of Open Access Journals (Sweden)

    Proscovia Namubiru Ssentamu

    2014-12-01

    Full Text Available This paper reviews the ideological trends in initial teacher education curricula in East African universities during the post-independent and contemporary times. From the mid-1960s and mid-1980s, initial teacher education curricula were integrated and harmonised with support from the East African Community whose efforts were coordinated by the Inter-University Council for East Africa. With the breakup of the Community in 1977, each independent state pursued its own educational strategy. However, underfunding of the public sector by governments, introduction of market-friendly reforms under the World Bank Structural Adjustment Programme in 1987 and the de-regularisation policies led to the liberalisation of public services, including education. Liberalisation affected among others, the quality of the initial teacher education curricula. Consequently, national councils and commissions for higher education were established to control standards in higher education, and the Inter-University Council for East Africa was revived to standardise and harmonise educational standards at regional level. The review shows that over the past five decades, the structure and organisation of initial teacher education curricula has continuously adjusted itself and been adjusted to a hybrid culture blending classical humanism, utilitarianism, social re-constructionism, market and global ideologies. Comparable ideological inclinations at socio-economic and political levels have influenced this trend in the region. The paper highlights the implications of such trends on the future of initial teacher education in the region.

  16. East-African Social Sciences and Humanities Publishing: A Handmade Bibliometrics Approach

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, N

    2016-07-01

    For Eastern Africa, very little information about the SSH knowledge production can be found from a European perspective. Adequate indicators like information-rich bibliographic databases that cover East-Africa-based journals and book publishers are lacking. This research in progress explores their indexing situation in detail, their development, which is closely connected to political history, their (non-)usage, and affiliations as well as careerstages of their authors. Furthermore, it also pays attention to East-Africa-based SSH researchers who use other publication venues. Any bibliometric analysis in this field needs to rely on manual data collection, otherwise it would be heavily biased. This study lays out the foundation for citation analyses, qualitative research on the publications' content and the self-description of East-African scholars against the background of an academic environment that is often described as “international”. (Author)

  17. Post-Pan-African tectonic evolution of South Malawi in relation to the Karroo and recent East African rift systems

    Science.gov (United States)

    Castaing, C.

    1991-05-01

    Structural studies conducted in the Lengwe and Mwabvi Karroo basins and in the basement in South Malawi, using regional maps and published data extended to cover Southeast Africa, serve to propose a series of geodynamic reconstructions which reveal the persistence of an extensional tectonic regime, the minimum stress σ3 of which has varied through time. The period of Karroo rifting and the tholeiitic and alkaline magmatism which terminated it, were controlled by NW-SE extension, which resulted in the creation of roughly NE-SW troughs articulated by the Tanganyika-Malawi and Zambesi pre-transform systems. These were NW-SE sinistral-slip systems with directions of movement dipping slightly to the Southeast, which enabled the Mwanza fault to play an important role in the evolution of the Karroo basins of the Shire Valley. The Cretaceous was a transition period between the Karroo rifting and the formation of the Recent East African Rift System. Extension was NE-SW, with some evidence for a local compressional episode in the Lengwe basin. Beginning in the Cenozoic, the extension once more became NW-SE and controlled the evolution in transtension of the Recent East African Rift System. This history highlights the major role of transverse faults systems dominated by strike-slip motion in the evolution and perpetuation of the continental rift systems. These faults are of a greater geological persistence than the normal faults bounding the grabens, especially when they are located on major basement anisotropies.

  18. Informed consent in oral health care | Tsotsi | East African Medical ...

    African Journals Online (AJOL)

    Background: Informed consent and autonomy are the major ethical principles that define the relationship between health workers and the patient. ... Objectives: To investigate what and how much information dental patients perceived to had been given by oral health workers about treatment, benefits, risks and management ...

  19. Correlates of complete childhood vaccination in East African countries.

    Directory of Open Access Journals (Sweden)

    Maureen E Canavan

    Full Text Available BACKGROUND: Despite the benefits of childhood vaccinations, vaccination rates in low-income countries (LICs vary widely. Increasing coverage of vaccines to 90% in the poorest countries over the next 10 years has been estimated to prevent 426 million cases of illness and avert nearly 6.4 million childhood deaths worldwide. Consequently, we sought to provide a comprehensive examination of contemporary vaccination patterns in East Africa and to identify common and country-specific barriers to complete childhood vaccination. METHODS: Using data from the Demographic and Health Surveys (DHS for Burundi, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda, we looked at the prevalence of complete vaccination for polio, measles, Bacillus Calmette-Guérin (BCG and DTwPHibHep (DTP as recommended by the WHO among children ages 12 to 23 months. We conducted multivariable logistic regression within each country to estimate associations between complete vaccination status and health care access and sociodemographic variables using backwards stepwise regression. RESULTS: Vaccination varied significantly by country. In all countries, the majority of children received at least one dose of a WHO recommended vaccine; however, in Ethiopia, Tanzania, and Uganda less than 50% of children received a complete schedule of recommended vaccines. Being delivered in a public or private institution compared with being delivered at home was associated with increased odds of complete vaccination status. Sociodemographic covariates were not consistently associated with complete vaccination status across countries. CONCLUSIONS: Although no consistent set of predictors accounted for complete vaccination status, we observed differences based on region and the location of delivery. These differences point to the need to examine the historical, political, and economic context of each country in order to maximize vaccination coverage. Vaccination against these childhood diseases is a

  20. Genetic diversity of the Mycobacterium tuberculosis East African–Indian family in three tropical Asian countries

    Directory of Open Access Journals (Sweden)

    Yih-Yuan Chen

    2017-12-01

    Full Text Available Background: The Beijing lineage of Mycobacterium tuberculosis (MTB is the most predominant MTB strain in Asian countries and is spreading worldwide, however, the East African–Indian (EAI lineage is also particularly prevalent in many tropical Asian countries. The evolutionary relationships among MTB EAI isolates from Taiwan and those of tropical Asian countries remain unknown. Methods: The EAI strains collected from patients in Taiwan were analyzed using spacer oligonucleotide typing and mycobacterial interspersed repetitive unit–variable number of tandem repeats (MIRU-VNTR typing, and compared with published profiles from Cambodia and Singapore to investigate potential epidemiological linkages. Results: Among the three countries, the EAI lineage was most prevalent in Cambodia (60%; Singapore, 25.62%; and Taiwan, 21.85%, having also the highest rates of multidrug resistance and lowest rates of clustering of MTB isolates. We describe a convenient method using seven selected MIRU-VNTR loci for first-line typing to discriminate Beijing and EAI lineages. A potential epidemiological linkage in these tropical Asian countries is also discussed based on a minimum-spanning tree constructed using 24 MIRU-VNTR loci of MTB EAI strains. Conclusion: This study identified evolutionary relationships among MTB EAI isolates from Taiwan and those of two other tropical Asian countries, Cambodia and Singapore. Keywords: East African–Indian family, Mycobacterium tuberculosis, tropical Asian countries

  1. East African Journal of Public Health - Vol 6 (2009)

    African Journals Online (AJOL)

    Statistical Measure Of Association Between Smoking And Lung Cancer In Abakaliki, ... For Tracing Successful Factors Associated With Livestock Projects For Nutrition ... Survival In Gastric Cancer Patients: Univariate And Multivariate Analysis ...

  2. An aberrant uterus: Case report | Ondieki | East African Medical ...

    African Journals Online (AJOL)

    A case of an aberrant uterus is presented and literature reviewed. The patient presented with abnormal uterine bleeding, left iliac fossa pain and was managed by excising the aberrant uterus. This case was an enigma as it didn't present in the classical way one with anomalies of the uterus would present. Despite ...

  3. Alcoholism and diabetes mellitus: Case report | Otieno | East African ...

    African Journals Online (AJOL)

    He was an alcoholic receiving psychiatric care for alcoholism. They both presented separately at different hospitals with decompensated diabetes following heavy alcohol consumption. The history and clinico-laboratory picture of both patients are presented and brief management programme and outcome are also given.

  4. Lingual Thyrod: Case Report | Sonigra | East African Medical Journal

    African Journals Online (AJOL)

    A sixteen year old male presented with progressive dysphagia, dysphonia and haemoptysis over eight months. Radionuclide studies and computed tomographic scans confirmed an only functional thyroid gland at the base of tongue which was excised wholly via mandibular split transoral route and patient put on thyroxin ...

  5. East African Medical Journal - Vol 93, No 4 (2016)

    African Journals Online (AJOL)

    Occurence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in subgingival plaque among patients with periodontal disease at the University of Nairobi Dental Hospital · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. JJC Wambugu, NK Matu, TK Mulli, ...

  6. East African Medical Journal - Vol 94, No 4 (2017)

    African Journals Online (AJOL)

    Sero prevalence of hepatitis B and C viruses among HIV infected patients in a HIV care program in Kenya: a cross sectional study · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. S.B. Okoth, O.F. Rehmani, M.J. Karoney, L Diero, P.O. Ayuo, 266-273 ...

  7. Giant urinary bladder calculus: Case report | Otieno | East African ...

    African Journals Online (AJOL)

    A vertical calculus weighing more than 100 g is categorised as a giant urinary bladder stone. Giant urinary bladder stones are very rare and very few cases have been reported in English literature and only one case from Africa. This is a case report of a patient with a giant urinary bladder calculus presenting as a rectal ...

  8. East African Medical Journal - Vol 93, No 12 (2016)

    African Journals Online (AJOL)

    Evaluating engrailed-2 and cytokines in urine with serum PSA as potential biomarkers in patients with prostatism at Moi Teaching and Referral Hospital, Eldoret, Kenya · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. B Donald-Buri, K Patel, P Musau, E.N. Fish, 678-683 ...

  9. 16 East and Central African Journal of Pharmaceutical Sciences Vol ...

    African Journals Online (AJOL)

    admin

    An increase in the incidence of tuberculosis has been observed in prison populations. A descriptive cross sectional study was designed to assess the knowledge of tuberculosis among sick prisoners. Patients were interviewed using a questionnaire. Sixty per cent of those interviewed had been in prison for periods ranging ...

  10. Compilation of an informative microsatellite set for genetic characterisation of East African finger millet (Eleusine coracana

    Directory of Open Access Journals (Sweden)

    Santie M. De Villiers

    2015-03-01

    Discussion: Five individual samples from an accession captured the largest number of alleles per locus compared to the four different bulked sampling strategies but this difference was not significant. The identified set comprised 20 markers: UGEP24, UGEP53, UGEP84, UGEP27, UGEP98, UGEP95, UGEP64, UGEP33, UGEP67, UGEP106, UGEP110, UGEP57, UGEP96, UGEP66, UGEP46, UGEP79, UGEP20, UGEP12, UGEP73 and UGEP5 and was since used to assess East African finger millet genetic diversity in two separate studies.

  11. Simultaneous determination of seven informative Y chromosome SNPs to differentiate East Asian, European, and African populations.

    Science.gov (United States)

    Muro, Tomonori; Iida, Reiko; Fujihara, Junko; Yasuda, Toshihiro; Watanabe, Yukina; Imamura, Shinji; Nakamura, Hiroaki; Kimura-Kataoka, Kaori; Yuasa, Isao; Toga, Tomoko; Takeshita, Haruo

    2011-05-01

    Identification of the population origin of an individual is very useful for crime investigators who need to narrow down a suspect based on specimens left at a crime scene. Single nucleotide polymorphisms of the Y chromosome (Y-SNPs) are a class of markers of interest to forensic investigators because many of the markers indicate regional specificity, thus providing useful information about the geographic origin of a subject. We selected seven informative Y-SNPs (M168, M130, JST021355, M96, P126, P196, and P234) to differentiate the three major population groups (East Asian, European, and African) and used them to develop forensic application. SNP genotyping was carried out by multiplex PCR reaction and multiplex single base extension (MSBE) reaction followed by capillary electrophoresis of extension products. This method can be used to assign a haplogroup from both degraded male DNA samples and DNA samples containing a mixture of female and male DNA through PCR primers that generate small amplicons (less than about 150 bp) and are highly specific for targets on the Y chromosome. The allelic state of each marker was definitively determined from a total of 791 males from the three major population groups. As expected, samples from the three major population groups showed Y-haplogroups common in the region of provenance: Y haplogroups C, D, and O for East Asians; IJ and R1 for Europeans; and AB and E for Africans. Published by Elsevier Ireland Ltd.

  12. Field Plot Techniques for Black Sigatoka Evaluation in East African Highland Bananas

    Directory of Open Access Journals (Sweden)

    Okoro, JU.

    1997-01-01

    Full Text Available Number of plants per experimental unit and number of replications for the efficient and precise assessment of black sigatoka leaf spot disease caused by Mycosphaerella fijiensis in East African Highland bananas were determined. Two representative cultivars were used. Host response to black sigatoka infection was measured by recording the youngest leaf with necrotic spots. The number of plants per experimental unit was determined, using the methods of maximum curvature and comparison of variances, while the number of replications was estimated by Hatheway's method. The optimum experimental plot size was 3 plants (18 m2 for the beer banana cultivar 'Igitsiri', and 30 plants (180 m2 for the cooking banana cultivar 'Igisahira Gisanzwe', using the comparison of variances method. However, the optimum plot size was 15 plants (90 m2 for both cultivars using the method of maximum curvature. The latter statistical method was preferred because of the low precision of the estimates in the former method. Unreplicated trials with plots of 15 plants could be adequate to assess black sigatoka response in East African bananas if uniform disease pressure exists.

  13. Post-collisional magmatism in the central East African Orogen: The Maevarano Suite of north Madagascar

    Science.gov (United States)

    Goodenough, K.M.; Thomas, Ronald J.; De Waele, B.; Key, R.M.; Schofield, D.I.; Bauer, W.; Tucker, R.D.; Rafahatelo, J.-M.; Rabarimanana, M.; Ralison, A.V.; Randriamananjara, T.

    2010-01-01

    Late tectonic, post-collisional granite suites are a feature of many parts of the Late Neoproterozoic to Cambrian East African Orogen (EAO), where they are generally attributed to late extensional collapse of the orogen, accompanied by high heat flow and asthenospheric uprise. The Maevarano Suite comprises voluminous plutons which were emplaced in some of the tectonostratigraphic terranes of northern Madagascar, in the central part of the EAO, following collision and assembly during a major orogeny at ca. 550 Ma. The suite comprises three main magmatic phases: a minor early phase of foliated gabbros, quartz diorites, and granodiorites; a main phase of large batholiths of porphyritic granitoids and charnockites; and a late phase of small-scale plutons and sheets of monzonite, syenite, leucogranite and microgranite. The main phase intrusions tend to be massive, but with variably foliated margins. New U-Pb SHRIMP zircon data show that the whole suite was emplaced between ca. 537 and 522 Ma. Geochemically, all the rocks of the suite are enriched in the LILE, especially K, and the LREE, but are relatively depleted in Nb, Ta and the HREE. These characteristics are typical of post-collisional granitoids in the EAO and many other orogenic belts. It is proposed that the Maevarano Suite magmas were derived by melting of sub-continental lithospheric mantle that had been enriched in the LILE during earlier subduction events. The melting occurred during lithospheric delamination, which was associated with extensional collapse of the East African Orogen. ?? 2009 Natural Environment Research Council.

  14. Phylogenetic relationships among East African haplochromine fish as revealed by short interspersed elements (SINEs).

    Science.gov (United States)

    Terai, Yohey; Takezaki, Naoko; Mayer, Werner E; Tichy, Herbert; Takahata, Naoyuki; Klein, Jan; Okada, Norihiro

    2004-01-01

    Genomic DNA libraries were prepared from two endemic species of Lake Victoria haplochromine (cichlid) fish and used to isolate and characterize a set of short interspersed elements (SINEs). The distribution and sequences of the SINEs were used to infer phylogenetic relationships among East African haplochromines. The SINE-based classification divides the fish into four groups, which, in order of their divergence from a stem lineage, are the endemic Lake Tanganyika flock (group 1); fish of the nonendemic, monotypic, widely distributed genus Astatoreochromis (group 2); the endemic Lake Malawi flock (group 3); and group 4, which contains fish from widely dispersed East African localities including Lakes Victoria, Edward, George, Albert, and Rukwa, as well as many rivers. The group 4 haplochromines are characterized by a subset of polymorphic SINEs, each of which is present in some individuals and absent in others of the same population at a given locality, the same morphologically defined species, and the same mtDNA-defined haplogroup. SINE-defined group 4 contains six of the seven previously described mtDNA haplogroups. One of the polymorphic SINEs appears to be fixed in the endemic Lake Victoria flock; four others display the presence-or-absence polymorphism within the species of this flock. These findings have implications for the origin of Lake Victoria cichlids and for their founding population sizes.

  15. Middle East and North African Health Informatics Association (MENAHIA): Building Sustainable Collaboration.

    Science.gov (United States)

    Al-Shorbaji, Najeeb; Househ, Mowafa; Taweel, Adel; Alanizi, Abdullah; Mohammed, Bennani Othmani; Abaza, Haitham; Bawadi, Hala; Rasuly, Hamayon; Alyafei, Khalid; Fernandez-Luque, Luis; Shouman, Mohamed; El-Hassan, Osama; Hussein, Rada; Alshammari, Riyad; Mandil, Salah; Shouman, Sarah; Taheri, Shahrad; Emara, Tamer; Dalhem, Wasmiya; Al-Hamdan, Zaid; Serhier, Zineb

    2018-04-22

    There has been a growing interest in Health Informatics applications, research, and education within the Middle East and North African Region over the past twenty years. People of this region share similar cultural and religious values, primarily speak the Arabic language, and have similar health care related issues, which are in dire need of being addressed. Health Informatics efforts, organizations, and initiatives within the region have been largely under-represented within, but not ignored by, the International Medical Informatics Association (IMIA). Attempts to create bonds and collaboration between the different organizations of the region have remained scattered, and often, resulted in failure despite the fact that the need for a united health informatics collaborative within the region has never been more crucial than today. During the 2017 MEDINFO, held in Hangzhou, China, a new organization, the Middle East and North African Health Informatics Association (MENAHIA) was conceived as a regional non-governmental organization to promote and facilitate health informatics uptake within the region endorsing health informatics research and educational initiatives of the 22 countries represented within the region. This paper provides an overview of the collaboration and efforts to date in forming MENAHIA and displays the variety of initiatives that are already occurring within the MENAHIA region, which MENAHIA will help, endorse, support, share, and improve within the international forum of health informatics. Georg Thieme Verlag KG Stuttgart.

  16. Influence of Mascarene High and Indian Ocean dipole on East African extreme weather events

    Directory of Open Access Journals (Sweden)

    Ogwang Bob Alex

    2015-01-01

    Full Text Available Extreme weather and climate events such as floods and droughts are common in East Africa, causing huge socio-economic losses. This study links the east African October-December (OND rainfall, Indian Ocean Dipole (IOD and Mascarene High (MH.Correlation analysis is applied to quantify the relationship between the index of IOD (Dipole Mode Index (DMI and OND rainfall. Results show that there exists a significant correlation between OND rainfall and DMI, with a correlation coefficient of 0.6. During dry years, MH is observed to intensify and align itself in the southeast-northwest orientation, stretching up to the continent, which in turn inhibits the influx of moisture from Indian Ocean into East Africa. During wet years, MH weakens, shifts to the east and aligns itself in the zonal orientation. Moisture from Indian Ocean is freely transported into east Africa during wet years. Analysis of the drought and flood years with respect to the different variables including wind, velocity potential and divergence/ convergence revealed that the drought (flood years were characterized by divergence (convergence in the lower troposphere and convergence (divergence at the upper level, implying sinking (rising motion, especially over the western Indian Ocean and the study area. Convergence at low level gives rise to vertical stretching, whereas divergence results in vertical shrinking, which suppresses convection due to subsidence. Positive IOD (Negative IOD event results into flood (drought in the region. The evolution of these phenomena can thus be keenly observed for utilization in the update of seasonal forecasts.

  17. Isolation and molecular characterization of Chikungunya virus from the Andaman and Nicobar archipelago, India: evidence of an East, Central, and South African genotype.

    Science.gov (United States)

    Muruganandam, N; Chaaithanya, I K; Senthil, G S; Shriram, A N; Bhattacharya, D; Jeevabharathi, G S; Sudeep, A B; Pradeepkumar, N; Vijayachari, P

    2011-12-01

    Chikungunya virus (CHIKV) is an Alphavirus belonging to the family Togaviridae. In 2006, CHIKV infection struck the Andaman and Nicobar archipelago, with an attack rate of 60%. There were more than 10 cases with acute flaccid paralysis simulating the Guillian Barre Syndrome. The majority of the patients presented severe joint pain. The cause for such an explosive nature of the outbreak with increased morbidity was not known. The isolation of CHIKV was attempted and succeeded from nine subjects presenting clinical symptoms of Chikungunya fever. The cDNA of all the isolates was sequenced for partial E1 and nsP1 genes. Sequences were aligned based on the double locus sequence typing concept. The phylogenetic analysis shows that sequences of Andaman isolates grouped with the East, Central, and South African genotype of virus isolates from India, Sri Lanka, and Réunion. The genetic distance between Andaman isolates and the Réunion isolates was very small. The phylogenetic analysis confirmed the origin of the isolates responsible for the first ever confirmed CHIKV outbreak in these islands to be the East, Central, and South African genotype. In this manuscript, we discuss the involvement of the East, Central, and South African strain with the Chikungunya fever outbreak in this archipelago and double locus sequence typing as a first time approach.

  18. What do bodily symptoms in African psychiatric patients mean ...

    African Journals Online (AJOL)

    Objective: To review the various bodily symptoms presented by African psychiatric patients and attempt to understand them. Method: The literature on bodily (somatic) symptoms is surveyed with special reference to Africans and examples are drawn from a focused group discussion in one African rural community.

  19. Gene-centric meta-analysis of lipid traits in African, East Asian and Hispanic populations.

    Directory of Open Access Journals (Sweden)

    Clara C Elbers

    Full Text Available Meta-analyses of European populations has successfully identified genetic variants in over 100 loci associated with lipid levels, but our knowledge in other ethnicities remains limited. To address this, we performed dense genotyping of ∼2,000 candidate genes in 7,657 African Americans, 1,315 Hispanics and 841 East Asians, using the IBC array, a custom ∼50,000 SNP genotyping array. Meta-analyses confirmed 16 lipid loci previously established in European populations at genome-wide significance level, and found multiple independent association signals within these lipid loci. Initial discovery and in silico follow-up in 7,000 additional African American samples, confirmed two novel loci: rs5030359 within ICAM1 is associated with total cholesterol (TC and low-density lipoprotein cholesterol (LDL-C (p = 8.8×10(-7 and p = 1.5×10(-6 respectively and a nonsense mutation rs3211938 within CD36 is associated with high-density lipoprotein cholesterol (HDL-C levels (p = 13.5×10(-12. The rs3211938-G allele, which is nearly absent in European and Asian populations, has been previously found to be associated with CD36 deficiency and shows a signature of selection in Africans and African Americans. Finally, we have evaluated the effect of SNPs established in European populations on lipid levels in multi-ethnic populations and show that most known lipid association signals span across ethnicities. However, differences between populations, especially differences in allele frequency, can be leveraged to identify novel signals, as shown by the discovery of ICAM1 and CD36 in the current report.

  20. Blood vitamins and trace elements in Northern-East African cheetahs (Acinonyx jubatus soemmeringii) in captivity in the Middle East.

    Science.gov (United States)

    Beckmann, Katie M; O'Donovan, Declan; McKeown, Sean; Wernery, Ulli; Basu, Puja; Bailey, Tom A

    2013-09-01

    There are few published data regarding the endangered Northern-East African cheetah (Acinonyx jubatus soemmeringii), held in captivity in the Middle East and Europe. Studies have demonstrated a high incidence of disease in captive cheetahs, in which vitamin and trace element imbalances have often been implicated. Blood vitamin and trace element reference values in cheetahs merit further investigation. In this study, blood samples were opportunistically collected from apparently healthy A. j. soemmeringii from two collections (A and B) with successful breeding programs in the United Arab Emirates. The cheetahs were fed whole prey of mixed species (and, in Collection B, goat muscle and bone as well) dusted with vitamin and mineral supplements. Mean serum vitamin and trace element values (for cheetahs > 4 mo in age) were as follows: vitamin A (retinol), 2.20 microM/L (n = 27); vitamin B1, 0.0818 microM/L (n = 45); vitamin C, 28.6 microM/L (n=10); vitamin E (alpha-tocopherol), 35.6 microM/L (n = 27); copper (Cu), 12.53 microM/L (n = 27); selenium (Se), 3.10 microM/L (n = 27); and zinc (Zn), 10.87 microM/L (n = 27). Mean values of vitamin A, vitamin E, Cu, and Zn fell within ranges of published cheetah mean values, and mean Se was lower than range values for cheetahs presented in one previous study; blood vitamin B1 and vitamin C values of cheetahs have not previously been published. The values were taken to indicate that the cheetahs' nutritional status was adequate with regard to those nutrients analyzed. Serum vitamin E was particularly high in cheetahs fed fresh whole prey, and on this basis vitamin E supplementation of fresh whole prey appeared to have been unnecessary. There were differences (P < 0.05) between collections in serum vitamin B1, vitamin E, Cu, and 10 other hematologic and biochemical parameters. Nine hematologic and blood biochemical parameters differed among age categories.

  1. Mineral fertilizer response and nutrient use efficiencies of East African highland banana (Musa spp., AAA-EAHB, cv. Kisansa)

    NARCIS (Netherlands)

    Nyombi, K.; Asten, van P.J.A.; Corbeels, M.; Taulya, G.; Leffelaar, P.A.; Giller, K.E.

    2010-01-01

    Poor yields of East African highland bananas (Musa spp., AAA-EAHB) on smallholder farms have often been attributed to problems of poor soil fertility. We measured the effects of mineral fertilizers on crop performance at two sites over two to three crop cycles; Kawanda in central Uganda and Ntungamo

  2. East African highland bananas (Musa spp. AAA-EA) 'worry' more about potassium deficiency than drought stress

    NARCIS (Netherlands)

    Taulya, G.

    2013-01-01

    Drought stress, potassium (K) and nitrogen (N) deficiencies are major constraints to rain-fed East African highland banana (EAHB) production in Uganda. It was hypothesised that the reduction in fresh bunch mass and increase in dry matter (DM) allocation to corms with drought stress, K and N

  3. Norms for multivariate diagnosis of nutrient imbalance in the East African highland bananas (musa spp.aaa)

    NARCIS (Netherlands)

    Wairegi, L.; Asten, van P.

    2011-01-01

    Despite low yields and soil fertility problems, fertilizer use in the East African Highland banana (AAA-EA) production is absent. High fertilizer costs increase the need for site-specific fertilizer recommendations that address deficiencies. This study aimed to derive and compare norms for AAA-EA

  4. Good Governance and Foreign Direct Investment : A Legal Contribution to a Balanced Economic Development in the East African Community (EAC)

    NARCIS (Netherlands)

    Mbembe, Binda

    2015-01-01

    One of the objectives of the East African Community (EAC) is the promotion of a balanced economic development between its Partner States: Burundi, Kenya, Rwanda, Tanzania, and Uganda. And one of the ways to reach this economic development is the attraction of investment, especially Foreign Direct

  5. Fertility of the Small East African goat following pre-pubertal infection with Trypanosoma congolense

    International Nuclear Information System (INIS)

    O'Hara, H.B.; Gombe, S.

    1991-01-01

    Pre-pubertal male and female Small East African goats were infected with Trypanosoma congolense at 4-5 months of age. Changes in body weight and haemogram were monitored weekly. Progesterone and testosterone measurements were made three times weekly until the goats either reached puberty or 18 months of age. Onset of puberty was determined from observation of oestrus behaviour, mating or increase in libidio; this was confirmed by elevation in plasma progesterone or testosterone levels. Trypanosomiasis affected pre-pubertal goats by reducing body weight gain and delaying onset of puberty. Histological examination of the gonads showed pronounced pathological changes. These effects were reversed by treatment with isometamidium chloride (Samorin, May and Baker). It was concluded that early treatment of infected goats before serious gonadal damage could occur allowed full restoration of reproductive function. (author). 6 refs, 4 figs, 1 tab

  6. The influence of inherited structures on magmatic and amagmatic processes in the East African Rift.

    Science.gov (United States)

    Biggs, J.; Lloyd, R.; Hodge, M.; Robertson, E.; Wilks, M.; Fagereng, A.; Kendall, J. M.; Mdala, H. S.; Lewi, E.; Ayele, A.

    2017-12-01

    The idea that crustal heterogeneities, particularly inherited structures, influence the initiation and evolution of continental rifts is not new, but now modern techniques allow us to explore these controls from a fresh perspective, over a range of lengthscales, timescales and depths. In amagmatic rifts, I will demonstrate that deep fault structure is controlled by the stress orientation during the earliest phase of rifting, while the surface expression exploits near-surface weaknesses. I will show that pre-existing structures control the storage and orientation of deeper magma reservoirs in magmatic rifts, while the tectonic stress regime controls intra-rift faulting and shallow magmatism and stresses related to surface loading and cycles of inflation and deflation dominate at volcanic edifices. Finally, I will show how cross-rift structures influence short-term processes such as deformation and seismicity. I will illustrate the talk throughout using examples from along the East African Rift, including Malawi, Tanzania, Kenya and Ethiopia.

  7. Predicting East African spring droughts using Pacific and Indian Ocean sea surface temperature indices

    Science.gov (United States)

    Funk, Christopher C.; Hoell, Andrew; Shukla, Shraddhanand; Blade, Ileana; Liebmann, Brant; Roberts, Jason B.; Robertson, Franklin R.

    2014-01-01

    In southern Ethiopia, Eastern Kenya, and southern Somalia poor boreal spring rains in 1999, 2000, 2004, 2007, 2008, 2009 and 2011 contributed to severe food insecurity and high levels of malnutrition. Predicting rainfall deficits in this region on seasonal and decadal time frames can help decision makers support disaster risk reduction while guiding climate-smart adaptation and agricultural development. Building on recent research that links more frequent droughts to a stronger Walker Circulation, warming in the Indo-Pacific warm pool, and an increased western Pacific sea surface temperature (SST) gradient, we explore the dominant modes of East African rainfall variability, links between these modes and sea surface temperatures, and a simple index-based monitoring-prediction system suitable for drought early warning.

  8. Seasonal patterns of mixed species groups in large East African mammals.

    Science.gov (United States)

    Kiffner, Christian; Kioko, John; Leweri, Cecilia; Krause, Stefan

    2014-01-01

    Mixed mammal species groups are common in East African savannah ecosystems. Yet, it is largely unknown if co-occurrences of large mammals result from random processes or social preferences and if interspecific associations are consistent across ecosystems and seasons. Because species may exchange important information and services, understanding patterns and drivers of heterospecific interactions is crucial for advancing animal and community ecology. We recorded 5403 single and multi-species clusters in the Serengeti-Ngorongoro and Tarangire-Manyara ecosystems during dry and wet seasons and used social network analyses to detect patterns of species associations. We found statistically significant associations between multiple species and association patterns differed spatially and seasonally. Consistently, wildebeest and zebras preferred being associated with other species, whereas carnivores, African elephants, Maasai giraffes and Kirk's dik-diks avoided being in mixed groups. During the dry season, we found that the betweenness (a measure of importance in the flow of information or disease) of species did not differ from a random expectation based on species abundance. In contrast, in the wet season, we found that these patterns were not simply explained by variations in abundances, suggesting that heterospecific associations were actively formed. These seasonal differences in observed patterns suggest that interspecific associations may be driven by resource overlap when resources are limited and by resource partitioning or anti-predator advantages when resources are abundant. We discuss potential mechanisms that could drive seasonal variation in the cost-benefit tradeoffs that underpin the formation of mixed-species groups.

  9. Khat chewing and acculturation in East-African migrants living in Frankfurt am Main/Germany.

    Science.gov (United States)

    Bongard, Stephan; Nakajima, Motohiro; al'Absi, Mustafa

    2015-04-22

    Khat (Catha edulis, Forsk) is a drug widely used in countries around the Red Sea (East-Africa and Arabian Peninsula). In Germany khat chewing is illegal but nevertheless an often observed habit in immigrants from this region. This study investigates the interrelation between immigrants acculturation processes and traditional khat chewing habits. Sixty-one khat chewers (14 female) from East-African countries were interviewed about their khat chewing habits and acculturation strategy using standardized questionnaires. Results indicate that immigrants׳ khat chewing behaviors are similar to what is common in countries with traditional khat use. But khat chewing tended to be less among immigrants who were relatively more oriented towards their cultures of origin. Chewing khat was subjectively considered to help coping with problems, to forget bad memories and to concentrate better. It was concluded that khat chewing serves a functional use of coping with stressful events in the present or in the past within this sample. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Extremes in East African hydroclimate and links to Indo-Pacific variability on interannual to decadal timescales

    Science.gov (United States)

    Ummenhofer, Caroline C.; Kulüke, Marco; Tierney, Jessica E.

    2018-04-01

    East African hydroclimate exhibits considerable variability across a range of timescales, with implications for its population that depends on the region's two rainy seasons. Recent work demonstrated that current state-of-the-art climate models consistently underestimate the long rains in boreal spring over the Horn of Africa while overestimating the short rains in autumn. This inability to represent the seasonal cycle makes it problematic for climate models to project changes in East African precipitation. Here we consider whether this bias also has implications for understanding interannual and decadal variability in the East African long and short rains. Using a consistent framework with an unforced multi-century global coupled climate model simulation, the role of Indo-Pacific variability for East African rainfall is compared across timescales and related to observations. The dominant driver of East African rainfall anomalies critically depends on the timescale under consideration: Interannual variations in East African hydroclimate coincide with significant sea surface temperature (SST) anomalies across the Indo-Pacific, including those associated with the El Niño-Southern Oscillation (ENSO) in the eastern Pacific, and are linked to changes in the Walker circulation, regional winds and vertical velocities over East Africa. Prolonged drought/pluvial periods in contrast exhibit anomalous SST predominantly in the Indian Ocean and Indo-Pacific warm pool (IPWP) region, while eastern Pacific anomalies are insignificant. We assessed dominant frequencies in Indo-Pacific SST and found the eastern equatorial Pacific dominated by higher-frequency variability in the ENSO band, while the tropical Indian Ocean and IPWP exhibit lower-frequency variability beyond 10 years. This is consistent with the different contribution to regional precipitation anomalies for the eastern Pacific versus Indian Ocean and IPWP on interannual and decadal timescales, respectively. In the model

  11. Exploring Pacific Climate Variability and Its Impacts on East African Water Resources and Food Security

    Science.gov (United States)

    Funk, C. C.; Hoerling, M. P.; Hoell, A.; Liebmann, B.; Verdin, J. P.; Eilerts, G.

    2014-12-01

    In 8 out the past 15 boreal springs (1999, 2000, 2004, 2008, 2009, 2011, 2012, and 2013), substantial parts of eastern East Africa experienced very low boreal spring rains. These rainfall deficits have triggered widespread food insecurity, and even contributed to the outbreak of famine conditions in Somalia in 2011. At both seasonal and decadal time scales, new science supported by the USAID Famine Early Warning Systems Network seeks to understand the mechanisms producing these droughts. We present research suggesting that the ultimate and proximate causes of these increases in aridity are i) stronger equatorial Pacific SST gradients and ii) associated increases in the strength of the Indo-Pacific Walker circulation. Using observations and new modeling ensembles, we explore the relative contributions of Pacific Decadal Variability (PDV) and global warming under warm and cold east Pacific Ocean states. This question is addressed in two ways: by using atmospheric GCMs forced with full and ENSO-only SSTs, and ii) by decomposing coupled ocean-atmosphere climate simulations into PDV and non-PDV components. These analyses allow us to explore the Walker circulation's sensitivity to climate change under various PDV states, and inform a tentative bracketing of 2030 climate conditions. We conclude by discussing links to East African development. Regions of high rainfall sensitivity are delineated and intersected with recent changes in population and land cover/land use. The interaction of elevation and climate is shown to create climatically secure regions that are likely to remain viable even under drier and warmer conditions; such regions may be logical targets for agricultural intensification. Conversely, arid low elevation regions are likely to experience substantial temperature impacts. Continued expansion into these areas may effectively create more 'drought' even if rainfall increases.

  12. Bioenergy from agro-industrial residues in the East African region. Summary report

    Energy Technology Data Exchange (ETDEWEB)

    Jungersen, G. [Dansk Teknologisk Inst. (Denmark); Kivaisi, A.; Rubindamayugi, M. [Univ. of Dar es Salaam (Tanzania, United Republic of)

    1998-05-01

    Tanzania has recently developed a comprehensive environmental policy which has put high priority on several specific environmental issues. One of the issues is the quality of waste water. A special priority is given to the pollution from the sisal industry. The East-African agro-industries generate very large quantities of organic residues from production and processing of different crops. These residues form a major contribution to the pollution of air, soil and waterways, but, at the same time they constitute a large potential for production of bioenergy through anaerobic digestion as well as potential substrate for other biological fermentation processes. Generally, these residues are regarded as having no or very little value and the different disposal methods are mainly a matter of getting rid of the waste. The generation of residues are very often concentrated on few large units, which makes the exploitation of these resources feasible in large scale biogas systems. Typically the units will have a potential of a daily methane generation of 1,000-20,000 m{sup 3} CH{sub 4}, equivalent to a potential electricity production of 0.2-3.2 MW. The future utilization of these resources for production of valuable products is described in this report. This report consists of 3 volumes. This summary report including the main objectives and findings from the different project report: Mapping and Quantification of Organic Agro-Industrial Residues in East Africa; Biogas - Bioenergy Potential in East Africa, Seminar Proceedings, Siler Sands, Dar es Salaam 22-23 September 1997; Bioenergy from Sisal residues - Experimental results and Capacity Building Activities. (EG)

  13. Mainstreaming biodiversity and wildlife management into climate change policy frameworks in selected east and southern African countries

    Directory of Open Access Journals (Sweden)

    Olga L. Kupika

    2016-04-01

    Full Text Available The Rio+20 outcomes document, the Future We Want, enshrines green economy as one of the platforms to attain sustainable development and calls for measures that seek to address climate change and biodiversity management. This paper audits climate change policies from selected east and southern African countries to determine the extent to which climate change legislation mainstreams biodiversity and wildlife management. A scan of international, continental, regional and national climate change policies was conducted to assess whether they include biodiversity and/or wildlife management issues. The key finding is that many climate change policy–related documents, particularly the National Adaptation Programme of Actions (NAPAs, address threats to biodiversity and wildlife resources. However, international policies like the United Nations Framework Convention on Climate Change and Kyoto Protocol do not address the matter under deliberation. Regional climate change policies such as the East African Community, Common Market for Eastern and Southern Africa and African Union address biodiversity and/or wildlife issues whilst the Southern African Development Community region does not have a stand-alone policy for climate change. Progressive countries like Rwanda, Uganda, Tanzania and Zambia have recently put in place detailed NAPAs which are mainstream responsive strategies intended to address climate change adaptation in the wildlife sector. Keywords: mainstreaming, biodiversity, wildlife, climate change policy, east and southern Africa

  14. Traditional medicine use in surgical patients in a South African ...

    African Journals Online (AJOL)

    drug interactions and adverse effects with this medication.3,7–10. Very few studies if any have looked at the use of African TM in a. South African patient population booked for elective surgery. The concern in this patient population using TM is potential pharmacokinetic and pharmacodynamic interactions with drugs.

  15. An interdisciplinary approach for groundwater management in area contaminated by fluoride in East African Rift System

    Science.gov (United States)

    Da Pelo, Stefania; Melis, M. Teresa; Dessì, Francesco; Pistis, Marco; Funedda, Antonio; Oggiano, Giacomo; Carletti, Alberto; Soler Gil, Albert; Barbieri, Manuela; Pittalis, Daniele; Ghiglieri, Giorgio

    2017-04-01

    Groundwater is the main source of fresh water supply for most of the rural communities in Africa (approximately 75% of Africans has confidence in groundwater as their major source of drinking water). Many African countries has affected by high fluoride concentration in groundwater (up to 90 mg/L), generating the contamination of waters, soils and food, in particular in the eastern part of the continent. It seems that fluoride concentration is linked to geology of the Rift Valley: geogenic occurrence of fluoride is often connected to supergenic enrichment due to the weathering of alkaline volcanic rocks, fumaric gases and presence of thermal waters. The H2020 project FLOWERED (de-FLuoridation technologies for imprOving quality of WatEr and agRo-animal products along the East African Rift Valley in the context of aDaptation to climate change) wish to address environmental and health (human and animal) issues associated to the fluoride contamination in the African Rift Valley, in particular in three case study area located in Ethiopia, Tanzania and Kenya. FLOWERED aims to develop an integrated, sustainable and participative water and agriculture management at a cross-boundary catchment scale through a strong interdisciplinary research approach. It implies knowledge of geology, hydrogeology, mineralogy, geochemistry, agronomy, crop and animal sciences, engineering, technological sciences, data management and software design, economics and communication. The proposed approach is based on a detailed knowledge of the hydrogeological setting, with the identification and mapping of the specific geological conditions of water contamination and its relation with the different land uses. The East African Rift System (EARS) groundwater circulation and storage, today already poorly understood, is characterized by a complex arrangement of aquifers. It depends on the type of porosity and permeability created during and after the rock formation, and is strongly conditioned by the

  16. Genetic diversity and connectivity in the East African giant mud crab Scylla serrata: Implications for fisheries management.

    Directory of Open Access Journals (Sweden)

    Cyrus Rumisha

    Full Text Available The giant mud crab Scylla serrata provides an important source of income and food to coastal communities in East Africa. However, increasing demand and exploitation due to the growing coastal population, export trade, and tourism industry are threatening the sustainability of the wild stock of this species. Because effective management requires a clear understanding of the connectivity among populations, this study was conducted to assess the genetic diversity and connectivity in the East African mangrove crab S. serrata. A section of 535 base pairs of the cytochrome oxidase subunit I (COI gene and eight microsatellite loci were analysed from 230 tissue samples of giant mud crabs collected from Kenya, Tanzania, Mozambique, Madagascar, and South Africa. Microsatellite genetic diversity (He ranged between 0.56 and 0.6. The COI sequences showed 57 different haplotypes associated with low nucleotide diversity (current nucleotide diversity = 0.29%. In addition, the current nucleotide diversity was lower than the historical nucleotide diversity, indicating overexploitation or historical bottlenecks in the recent history of the studied population. Considering that the coastal population is growing rapidly, East African countries should promote sustainable fishing practices and sustainable use of mangrove resources to protect mud crabs and other marine fauna from the increasing pressure of exploitation. While microsatellite loci did not show significant genetic differentiation (p > 0.05, COI sequences revealed significant genetic divergence between sites on the East coast of Madagascar (ECM and sites on the West coast of Madagascar, mainland East Africa, as well as the Seychelles. Since East African countries agreed to achieve the Convention on Biological Diversity (CBD target to protect over 10% of their marine areas by 2020, the observed pattern of connectivity and the measured genetic diversity can serve to provide useful information for designing

  17. Spatial patterns of sea surface temperature influences on East African precipitation as revealed by empirical orthogonal teleconnections

    Directory of Open Access Journals (Sweden)

    Tim eAppelhans

    2016-02-01

    Full Text Available East Africa is characterized by a rather dry annual precipitation climatology with two distinct rainy seasons. In order to investigate sea surface temperature driven precipitation anomalies for the region we use the algorithm of empirical orthogonal teleconnection analysis as a data mining tool. We investigate the entire East African domain as well as 5 smaller sub-regions mainly located in areas of mountainous terrain. In searching for influential sea surface temperature patterns we do not focus any particular season or oceanic region. Furthermore, we investigate different time lags from zero to twelve months. The strongest influence is identified for the immediate (i.e. non-lagged influences of the Indian Ocean in close vicinity to the East African coast. None of the most important modes are located in the tropical Pacific Ocean, though the region is sometimes coupled with the Indian Ocean basin. Furthermore, we identify a region in the southern Indian Ocean around the Kerguelen Plateau which has not yet been reported in the literature with regard to precipitation modulation in East Africa. Finally, it is observed that not all regions in East Africa are equally influenced by the identified patterns.

  18. East African Crisis Response: Shaping Ethiopian Peace Force for Better Participation in Future Peace Operations

    National Research Council Canada - National Science Library

    Amdemichael, Haile A

    2006-01-01

    .... This thesis analyzes the Organization of African Unity/African Union (OAU/AU) efforts after the Cold War to restore security and ensure stability in the region and outlines the process of creating African Standby Forces (ASF...

  19. Grenvillian vs Pan-African tectonic evolution in the Gamburtsev Province of East Antarctica

    Science.gov (United States)

    Ferraccioli, F.; Guochao, W.; Finn, C.; Bell, R. E.

    2017-12-01

    The Gamburtsev Subglacial Mountains in interior East Antarctica are underlain by 50-60 km thick crust. In contrast, the Archean to Mesoproterozoic Mawson craton that occupies the Wilkes and Terre Adelie region features only 40-45 km thick crust. The Gamburtsev Province is underlain by 200 km thick lithoshere, as typically observed over Precambrian lithosphere that has not been substantially reworked during Phanerozoic subduction or collision. Ferraccioli et al., (2011) proposed that a segment of a stalled orogen (i.e. an orogen where widespread orogenic collapse and root delamination has not occurred) is preserved in the Gamburtsev Province and hypothesised that its origin relates to accretionary and subsequent collisional events at ca 1 Ga, linked to the assembly of Rodinia. However, passive seismic interpretations indicate that crustal thickening may relate instead to Pan-African age assembly of Gondwana (at ca 550 Ma). Here we interpret a set of enhanced magnetic and gravity images, depth to magnetic and gravity sources and 2D and forward and inverse models to characterise the crustal architecture of the Gamburtsev Province. Enhanced aeromagnetic images reveal a system of subglacial faults that segment the Gamburtsev Province into three distinct geophysical domains, the northern, central and southern domains. Apparent offsets in high-frequency magnetic anomalies within the central domain are interpreted as revealing a transpressional fault system parallel to the previously proposed Gamburtsev Suture. Our magnetic and gravity model, combined with independent constraints from sediment provenance ages, is interpreted as revealing arc and back arc terranes of inferred Grenvillian age in the northern and Central domains of the Gambrurtsev Province. Distinct magnetic anomalies correspond to inferred Paleoproterozoic crust that may have affinities with the Lambert Terrane and the South Pole Province, an inferred Mesoproterozoic (1.6-1.4 Ga?) igneous province. We

  20. Seasonal patterns of mixed species groups in large East African mammals.

    Directory of Open Access Journals (Sweden)

    Christian Kiffner

    Full Text Available Mixed mammal species groups are common in East African savannah ecosystems. Yet, it is largely unknown if co-occurrences of large mammals result from random processes or social preferences and if interspecific associations are consistent across ecosystems and seasons. Because species may exchange important information and services, understanding patterns and drivers of heterospecific interactions is crucial for advancing animal and community ecology. We recorded 5403 single and multi-species clusters in the Serengeti-Ngorongoro and Tarangire-Manyara ecosystems during dry and wet seasons and used social network analyses to detect patterns of species associations. We found statistically significant associations between multiple species and association patterns differed spatially and seasonally. Consistently, wildebeest and zebras preferred being associated with other species, whereas carnivores, African elephants, Maasai giraffes and Kirk's dik-diks avoided being in mixed groups. During the dry season, we found that the betweenness (a measure of importance in the flow of information or disease of species did not differ from a random expectation based on species abundance. In contrast, in the wet season, we found that these patterns were not simply explained by variations in abundances, suggesting that heterospecific associations were actively formed. These seasonal differences in observed patterns suggest that interspecific associations may be driven by resource overlap when resources are limited and by resource partitioning or anti-predator advantages when resources are abundant. We discuss potential mechanisms that could drive seasonal variation in the cost-benefit tradeoffs that underpin the formation of mixed-species groups.

  1. Development of catchment research, with particular attention to Plynlimon and its forerunner, the East African catchments

    Science.gov (United States)

    Blackie, J. R.; Robinson, M.

    2007-01-01

    Dr J.S.G. McCulloch was deeply involved in the establishment of research catchments in East Africa and subsequently in the UK to investigate the hydrological consequences of changes in land use. Comparison of these studies provides an insight into how influential his inputs and direction have been in the progressive development of the philosophy, the instrumentation and the analytical techniques now employed in catchment research. There were great contrasts in the environments: tropical highland (high radiation, intense rainfall) vs. temperate maritime (low radiation and frontal storms), contrasting soils and vegetation types, as well as the differing social and economic pressures in developing and developed nations. Nevertheless, the underlying scientific philosophy was common to both, although techniques had to be modified according to local conditions. As specialised instrumentation and analytical techniques were developed for the UK catchments many were also integrated into the East African studies. Many lessons were learned in the course of these studies and from the experiences of other studies around the world. Overall, a rigorous scientific approach was developed with widespread applicability. Beyond the basics of catchment selection and the quantification of the main components of the catchment water balance, this involved initiating parallel process studies to provide information on specific aspects of catchment behaviour. This information could then form the basis for models capable of extrapolation from the observed time series to other periods/hydrological events and, ultimately, the capability of predicting the consequences of changes in catchment land management to other areas in a range of climates.

  2. Malaria in east African highlands during the past 30 years: impact of environmental changes

    Directory of Open Access Journals (Sweden)

    Yousif El - Safi Himeidan

    2012-08-01

    Full Text Available East African highlands are one of the most populated regions in Africa. The population densities in the highlands ranged between 158 persons/km2 in Ethiopia to 410 persons/km2 in Rwanda. According to the United Nations Population Fund, the region has the world's highest population growth rate. These factors are likely behind the high rates of poverty among the populations. As there were no employment opportunities other than agricultural, this demographic pressure of poor populations have included in an extensive unprecedented land use and land cover changes such as modification of bushland, woodland, and grassland on hillsides to farmland and transformation of papyrus swamps in valley bottoms to dairy pastures and cropland and changing of fallows on hillsides from short or seasonal to longer or perennial. Areas harvested for food crops were therefore increased by more than 100% in most of the highlands. The lost of forest areas, mainly due to subsistence agriculture, between 1990 - 2010 ranged between 8000 ha in Rwanda to 2838000 ha in Ethiopia. These unmitigated environmental changes in the highlands led to rise temperature and optimizing the spread and survival of malaria vectors and development of malaria parasites. Malaria in highlands was initially governed by low ambient temperature, trend of malaria transmission was therefore increased and several epidemics were observed in late 1980s and early 2000s. Although, malaria is decreasing through intensified interventions since mid 2000s onwards, these environmental changes might expose population in the highlands of east Africa to an increase risk of malaria and its epidemic particularly if the current interventions are not sustained.

  3. The lithosphere of the East African Rift and Plateau (Afar-Ethiopia-Turkana) : insights from Integrated 3-D density modelling

    OpenAIRE

    Woldetinsae, Girma

    2005-01-01

    The area encompassing the Eastern branch of the East African Rift System (EARS: Afar-Ethiopia-Turkana) and associated plateaux is an ideal region to investigate extension and magmatism associated with rupturing continental lithosphere. Ethiopia covers an important part of the EARS. It contains the major section of the ca. 5000 km Afro-Arabian rift and includes the transition between the Arabo-Nubian-Shield and the Mozambique Belt. A compilation of over 45000 onshore and offshore gravity stati...

  4. The episode of genetic drift defining the migration of humans out of Africa is derived from a large east African population size.

    Directory of Open Access Journals (Sweden)

    Nuha Elhassan

    Full Text Available Human genetic variation particularly in Africa is still poorly understood. This is despite a consensus on the large African effective population size compared to populations from other continents. Based on sequencing of the mitochondrial Cytochrome C Oxidase subunit II (MT-CO2, and genome wide microsatellite data we observe evidence suggesting the effective size (Ne of humans to be larger than the current estimates, with a foci of increased genetic diversity in east Africa, and a population size of east Africans being at least 2-6 fold larger than other populations. Both phylogenetic and network analysis indicate that east Africans possess more ancestral lineages in comparison to various continental populations placing them at the root of the human evolutionary tree. Our results also affirm east Africa as the likely spot from which migration towards Asia has taken place. The study reflects the spectacular level of sequence variation within east Africans in comparison to the global sample, and appeals for further studies that may contribute towards filling the existing gaps in the database. The implication of these data to current genomic research, as well as the need to carry out defined studies of human genetic variation that includes more African populations; particularly east Africans is paramount.

  5. Giant seismites and megablock uplift in the East African Rift: evidence for Late Pleistocene large magnitude earthquakes.

    Science.gov (United States)

    Hilbert-Wolf, Hannah Louise; Roberts, Eric M

    2015-01-01

    In lieu of comprehensive instrumental seismic monitoring, short historical records, and limited fault trench investigations for many seismically active areas, the sedimentary record provides important archives of seismicity in the form of preserved horizons of soft-sediment deformation features, termed seismites. Here we report on extensive seismites in the Late Quaternary-Recent (≤ ~ 28,000 years BP) alluvial and lacustrine strata of the Rukwa Rift Basin, a segment of the Western Branch of the East African Rift System. We document examples of the most highly deformed sediments in shallow, subsurface strata close to the regional capital of Mbeya, Tanzania. This includes a remarkable, clastic 'megablock complex' that preserves remobilized sediment below vertically displaced blocks of intact strata (megablocks), some in excess of 20 m-wide. Documentation of these seismites expands the database of seismogenic sedimentary structures, and attests to large magnitude, Late Pleistocene-Recent earthquakes along the Western Branch of the East African Rift System. Understanding how seismicity deforms near-surface sediments is critical for predicting and preparing for modern seismic hazards, especially along the East African Rift and other tectonically active, developing regions.

  6. Use of Machine Learning Techniques for Iidentification of Robust Teleconnections to East African Rainfall Variability in Observations and Models

    Science.gov (United States)

    Roberts, J. Brent; Robertson, Franklin R.; Funk, Chris

    2014-01-01

    Providing advance warning of East African rainfall variations is a particular focus of several groups including those participating in the Famine Early Warming Systems Network. Both seasonal and long-term model projections of climate variability are being used to examine the societal impacts of hydrometeorological variability on seasonal to interannual and longer time scales. The NASA / USAID SERVIR project, which leverages satellite and modeling-based resources for environmental decision making in developing nations, is focusing on the evaluation of both seasonal and climate model projections to develop downscaled scenarios for using in impact modeling. The utility of these projections is reliant on the ability of current models to capture the embedded relationships between East African rainfall and evolving forcing within the coupled ocean-atmosphere-land climate system. Previous studies have posited relationships between variations in El Niño, the Walker circulation, Pacific decadal variability (PDV), and anthropogenic forcing. This study applies machine learning methods (e.g. clustering, probabilistic graphical model, nonlinear PCA) to observational datasets in an attempt to expose the importance of local and remote forcing mechanisms of East African rainfall variability. The ability of the NASA Goddard Earth Observing System (GEOS5) coupled model to capture the associated relationships will be evaluated using Coupled Model Intercomparison Project Phase 5 (CMIP5) simulations.

  7. Spatial vegetation patterns and neighborhood competition among woody plants in an East African savanna.

    Science.gov (United States)

    Dohn, Justin; Augustine, David J; Hanan, Niall P; Ratnam, Jayashree; Sankaran, Mahesh

    2017-02-01

    The majority of research on savanna vegetation dynamics has focused on the coexistence of woody and herbaceous vegetation. Interactions among woody plants in savannas are relatively poorly understood. We present data from a 10-yr longitudinal study of spatially explicit growth patterns of woody vegetation in an East African savanna following exclusion of large herbivores and in the absence of fire. We examined plant spatial patterns and quantified the degree of competition among woody individuals. Woody plants in this semiarid savanna exhibit strongly clumped spatial distributions at scales of 1-5 m. However, analysis of woody plant growth rates relative to their conspecific and heterospecific neighbors revealed evidence for strong competitive interactions at neighborhood scales of up to 5 m for most woody plant species. Thus, woody plants were aggregated in clumps despite significantly decreased growth rates in close proximity to neighbors, indicating that the spatial distribution of woody plants in this region depends on dispersal and establishment processes rather than on competitive, density-dependent mortality. However, our documentation of suppressive effects of woody plants on neighbors also suggests a potentially important role for tree-tree competition in controlling vegetation structure and indicates that the balanced-competition hypothesis may contribute to well-known patterns in maximum tree cover across rainfall gradients in Africa. © 2016 by the Ecological Society of America.

  8. A One-Size-Fits-All HIV Prevention and Education Approach?: Interpreting Divergent HIV Risk Perceptions Between African American and East African Immigrant Women in Washington, DC Using the Proximate-Determinants Conceptual Framework.

    Science.gov (United States)

    De Jesus, Maria; Taylor, Juanita; Maine, Cathleen; Nalls, Patricia

    2016-02-01

    To date, there are very few comparative US studies and none in DC that distinguish between US-born and foreign-born black women to examine and compare their perceptions of HIV risk. This qualitative study, therefore, analyzes African American and East African women's perceptions of HIV risk in the Washington DC Metropolitan area, which has the highest AIDS rate in the United States. Forty in-depth, semistructured interviews and 10 cognitive interviews were conducted among a sample of 25 African American women and 25 East African born women between October 2012 and March 2013 to examine perceptions regarding HIV risk. The in-depth semistructured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board. Adopting Boerma and Weir's Proximate Determinants conceptual framework to interpret the data, the results of the study demonstrate that African American and East African immigrant women have divergent perceptions of HIV risk. Although African American women ascribe HIV risk to individual-level behaviors and choices such as unprotected sex, East African women attribute HIV risk to conditions of poverty and survival. Study findings suggest that addressing HIV prevention and education among black women in DC will require distinct and targeted strategies that are culturally and community-centered to resonate with these different audiences.

  9. A one-size-fits-all HIV prevention and education approach?: Analyzing and interpreting divergent HIV risk perceptions between African American and East African immigrant women in Washington, DC

    Science.gov (United States)

    De Jesus, Maria; Taylor, Juanita; Maine, Cathleen; Nalls, Patricia

    2015-01-01

    Background To date, there are very few comparative US studies and none in DC that distinguish between US-born and foreign-born Black women to examine and compare their perceptions of HIV risk. This qualitative study, therefore, analyzes African American and East African women’s perceptions of HIV risk in the Washington DC Metropolitan area, which has the highest AIDS rate in the US. Methods Forty in-depth, semi-structured interviews and 10 cognitive interviews were conducted among a sample of 25 African American women and 25 East African born women between October 2012 and March 2013 to examine perceptions regarding HIV risk. The in-depth semi-structured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board. Results Adopting Boerma and Weir’s Proximate Determinants conceptual framework to interpret the data, the results of the study demonstrate that African American and East African immigrant women have divergent perceptions of HIV risk. While African American women ascribe HIV risk to individual-level behaviors and choices such as unprotected sex, East African women attribute HIV risk to conditions of poverty and survival. Conclusions Study findings suggest that addressing HIV prevention and education among Black women in DC will require distinct and targeted strategies that are culturally and community-centered in order to resonate with these different audiences. PMID:26766523

  10. Attitudes, perceptions, and behaviors toward HIV testing among African American and East African immigrant women in Washington, D.C.: Implications for targeted HIV testing promotion and communication strategies

    Science.gov (United States)

    De Jesus, Maria; Carrete, Claudia; Maine, Cathleen; Nalls, Patricia

    2015-01-01

    Objectives The objective of the study was to examine and compare the HIV testing attitudes, perceptions, and behaviors between African American and East African immigrant women in the Washington, D.C. Metropolitan area. Methods Adopting an inductive, qualitative methodological approach, we conducted a total of 40 in-depth, semi-structured interviews between October 2012 and March 2013. Qualitative thematic analysis was used to analyze the data. Results Overall, African American women held more favorable views toward HIV testing than East African immigrant women. Very few East African immigrant women sought HIV testing intentionally. The majority of East African participants were tested inadvertently, while others tested for immigration- or employment-related purposes. There were many barriers that impede women from seeking an HIV test including: negative assumptions (e.g., ‘Getting an HIV test implies that I am HIV positive’); negative emotions (e.g., ‘Fear of being diagnosed with HIV and what this will mean for me’); and potential negative reactions from partner or others (e.g., ‘Getting an HIV test can signal distrust, disrespect, or infidelity’). There were nuances in how each group articulated some of these barriers and East African women expressed unique concerns that originated from experiences in their home countries. Conclusions The study shed light into the complexity of factors that constrain women from presenting themselves voluntarily for an HIV test and highlighted the nuances between African American and East African perceptions. Implications of findings for effective targeted HIV screening promotion and communication strategies among these groups of women are discussed. PMID:25897146

  11. Relevance of East African Drill Cores to Human Evolution: the Case of the Olorgesailie Drilling Project

    Science.gov (United States)

    Potts, R.

    2016-12-01

    Drill cores reaching the local basement of the East African Rift were obtained in 2012 south of the Olorgesailie Basin, Kenya, 20 km from excavations that document key benchmarks in the origin of Homo sapiens. Sediments totaling 216 m were obtained from two drilling locations representing the past 1 million years. The cores were acquired to build a detailed environmental record spatially associated with the transition from Acheulean to Middle Stone Age technology and extensive turnover in mammalian species. The project seeks precise tests of how climate dynamics and tectonic events were linked with these transitions. Core lithology (A.K. Behrensmeyer), geochronology (A. Deino), diatoms (R.B. Owen), phytoliths (R. Kinyanjui), geochemistry (N. Rabideaux, D. Deocampo), among other indicators, show evidence of strong environmental variability in agreement with predicted high-eccentricity modulation of climate during the evolutionary transitions. Increase in hominin mobility, elaboration of symbolic behavior, and concurrent turnover in mammalian species indicating heightened adaptability to unpredictable ecosystems, point to a direct link between the evolutionary transitions and the landscape dynamics reflected in the Olorgesailie drill cores. For paleoanthropologists and Earth scientists, any link between evolutionary transitions and environmental dynamics requires robust evolutionary datasets pertinent to how selection, extinction, population divergence, and other evolutionary processes were impacted by the dynamics uncovered in drill core studies. Fossil and archeological data offer a rich source of data and of robust environment-evolution explanations that must be integrated into efforts by Earth scientists who seek to examine high-resolution climate records of human evolution. Paleoanthropological examples will illustrate the opportunities that exist for connecting evolutionary benchmarks to the data obtained from drilled African muds. Project members: R. Potts, A

  12. Trading or coercion? Variation in male mating strategies between two communities of East African chimpanzees.

    Science.gov (United States)

    Kaburu, Stefano S K; Newton-Fisher, Nicholas E

    2015-06-01

    Across taxa, males employ a variety of mating strategies, including sexual coercion and the provision, or trading, of resources. Biological market theory (BMT) predicts that trading of commodities for mating opportunities should exist only when males cannot monopolize access to females and/or obtain mating by force, in situations where power differentials between males are low; both coercion and trading have been reported for chimpanzees ( Pan troglodytes ). Here, we investigate whether the choice of strategy depends on the variation in male power differentials, using data from two wild communities of East African chimpanzees ( Pan troglodytes schweinfurthii ): the structurally despotic Sonso community (Budongo, Uganda) and the structurally egalitarian M-group (Mahale, Tanzania). We found evidence of sexual coercion by male Sonso chimpanzees, and of trading-of grooming for mating-by M-group males; females traded sex for neither meat nor protection from male aggression. Our results suggest that the despotism-egalitarian axis influences strategy choice: male chimpanzees appear to pursue sexual coercion when power differentials are large and trading when power differentials are small and coercion consequently ineffective. Our findings demonstrate that trading and coercive strategies are not restricted to particular chimpanzee subspecies; instead, their occurrence is consistent with BMT predictions. Our study raises interesting, and as yet unanswered, questions regarding female chimpanzees' willingness to trade sex for grooming, if doing so represents a compromise to their fundamentally promiscuous mating strategy. It highlights the importance of within-species cross-group comparisons and the need for further study of the relationship between mating strategy and dominance steepness.

  13. Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

    Science.gov (United States)

    Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

    2015-07-01

    Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.

  14. Energy consumption, economic growth and CO2 emissions in Middle East and North African countries

    International Nuclear Information System (INIS)

    Arouri, Mohamed El Hedi; Ben Youssef, Adel; M'henni, Hatem; Rault, Christophe

    2012-01-01

    This article extends the recent findings of , , and by implementing recent bootstrap panel unit root tests and cointegration techniques to investigate the relationship between carbon dioxide emissions, energy consumption, and real GDP for 12 Middle East and North African Countries (MENA) over the period 1981–2005. Our results show that in the long-run energy consumption has a positive significant impact on CO 2 emissions. More interestingly, we show that real GDP exhibits a quadratic relationship with CO 2 emissions for the region as a whole. However, although the estimated long-run coefficients of income and its square satisfy the EKC hypothesis in most studied countries, the turning points are very low in some cases and very high in other cases, hence providing poor evidence in support of the EKC hypothesis. CO 2 emission reductions per capita have been achieved in the MENA region, even while the region exhibited economic growth over the period 1981–2005. The econometric relationships derived in this paper suggest that future reductions in CO 2 emissions per capita might be achieved at the same time as GDP per capita in the MENA region continues to grow. - Highlights: ► We study the links between CO 2 emissions, energy consumption and GDP in MENA region. ► Energy consumption has a positive correlation with CO 2 emissions. ► GDP exhibits a quadratic relationship with CO 2 emissions for the region as a whole. ► However, the turning points are low in some cases and high in other cases. ► Thus, not all countries need to sacrifice economic growth to decrease CO 2 emissions.

  15. Reassessment of source parameters for three major earthquakes in the East African rift system from historical seismograms and bulletins

    Directory of Open Access Journals (Sweden)

    O. Kulhánek

    2000-06-01

    Full Text Available Source parameters for three majo earthquakes in the East African rift are re-computed from historical seismograms and bulletins. The main shock and the largest foreshock of the August 25, 1906 earthquake sequence in the main Ethiopian rift are re-located on the eastern shoulder of the rift segment.The magnitude of the main shock is estimated to be 6.5 (Mw from spectral analysis. The December 13, 1910 earthquake in the Rukwa rift (Western Tanzania indicated a significant strike-slip component from teleseismcs body-waveform inversion for fault mechanism and seismic moment. The January 6, 1928 earthquake in the Gregory rift (Kenya showed a multiple rupture process and unusually long duration for a size of 6.6(Mw. The May 20, 1990 earthquake in Southern Sudan, mentioned merely for the sake of comparison, is the largest of all instrumentally recorded events in the East African rift system. Despite the fact that the mode of deformation in the continental rift is predominantly of extensional nature, the three largest earthquakes known to occur in the circum-Tanzanian craton have shallow focal depths and significant strike-slip component in their fault mechanisms. This and similar works will enrich the database for seismic hazard assessment in East Africa.

  16. INSIDE THE NUMBERS: USING PRIVATE COMMERCIAL DATA TO ANALYZE EAST AFRICAN IMPORTED SOAP CONSUMPTION, 1870-1914

    Directory of Open Access Journals (Sweden)

    Laird Jones

    2015-06-01

    Full Text Available Social historians identify soap as a “new need,” and argue its consumption indicates changing notions of bodily cleanliness, beauty and status. Relying largely on qualitative evidence such as traveler and missionary accounts, print advertising and oral interviews, they contend African soap use was influenced by Christian missions, colonial education and branding in the marketplace. Quantitative evidence – limited customs data – neither confirms nor challenges this position. More detailed commercial records, however, paint a somewhat different picture. The East African correspondence of William O’Swald & Co. indicates that soap marketing predated both Christian missions and colonial influence. Further, general purpose laundry soap was the overwhelming best seller. Personal toilette soaps lagged far behind. Laundering imported cotton textiles appeared the motive for initial soap purchases, and perhaps also the first step toward later personal soap use.

  17. Ages of tuff beds at East African early hominid sites and sediments in the Gulf of Aden

    Science.gov (United States)

    Sarna-Wojcicki, A. M.; Meyer, C.E.; Roth, P.H.; Brown, F.H.

    1985-01-01

    The early hominids of East Africa were dated by determining the ages of tuff beds at the sites. Despite much research using palaeomagnetic and K/Ar-dating techniques, some of those ages are still controversial 1,2. To obtain independent age estimates for these tephra layers, we have examined cores from DSDP Sites 231 and 232 in the Gulf of Aden (Fig. 1a) which consist mainly of calcareous nannofossil ooze, but also contain rare tephra horizons3 dated by interpolation from the established nannofossil stratigraphy (Fig. 1b). Chemical analysis confirms that the identity and sequence of these horizons is the same as that at the East African sites. We conclude that the age of the Tulu Bor Tuff is <3.4 Myr and hence that the Hadar hominid specimens are also

  18. Reassessment of source parameters for three major earthquakes in the East African rift system from historical seismograms and bulletins

    OpenAIRE

    Ayele, A.; Kulhánek, O.

    2000-01-01

    Source parameters for three majo earthquakes in the East African rift are re-computed from historical seismograms and bulletins. The main shock and the largest foreshock of the August 25, 1906 earthquake sequence in the main Ethiopian rift are re-located on the eastern shoulder of the rift segment.The magnitude of the main shock is estimated to be 6.5 (Mw) from spectral analysis. The December 13, 1910 earthquake in the Rukwa rift (Western Tanzania) indicated a significant strike-slip componen...

  19. The strange case of East African annual fishes: aridification correlates with diversification for a savannah aquatic group?

    Science.gov (United States)

    Dorn, Alexander; Musilová, Zuzana; Platzer, Matthias; Reichwald, Kathrin; Cellerino, Alessandro

    2014-10-14

    Annual Nothobranchius fishes are distributed in East and Southern Africa and inhabit ephemeral pools filled during the monsoon season. Nothobranchius show extreme life-history adaptations: embryos survive by entering diapause and they are the vertebrates with the fastest maturation and the shortest lifespan. The distribution of Nothobranchius overlaps with the East Africa Rift System. The geological and paleoclimatic history of this region is known in detail: in particular, aridification of East Africa and expansion of grassland habitats started 8 Mya and three humid periods between 3 and 1 Mya are superimposed on the longer-term aridification. These climatic oscillations are thought to have shaped evolution of savannah African mammals. We reconstructed the phylogeny of Nothobranchius and dated the different stages of diversification in relation to these paleoclimatic events. We sequenced one mitochondrial locus and five nuclear loci in 63 specimens and obtained a robust phylogeny. Nothobranchius can be divided in four geographically separated clades whose boundaries largely correspond to the East Africa Rift system. Statistical analysis of dispersal and vicariance identifies a Nilo-Sudan origin with southwards dispersion and confirmed that these four clades are the result of vicariance events In the absence of fossil Nothobranchius, molecular clock was calibrated using more distant outgroups (secondary calibration). This method estimates the age of the Nothobranchius genus to be 8.3 (6.0 - 10.7) My and the separation of the four clades 4.8 (2.7-7.0) Mya. Diversification within the clades was estimated to have started ~3 Mya and most species pairs were estimated to have an age of 0.5-1 My. The mechanism of Nothobranchius diversification was allopatric and driven by geographic isolation. We propose a scenario where diversification of Nothobranchius started in rough coincidence with aridification of East Africa, establishment of grassland habitats and the appearance

  20. Xenoliths from Bunyaruguru volcanic field: Some insights into lithology of East African Rift upper mantle

    Science.gov (United States)

    Muravyeva, N. S.; Senin, V. G.

    2018-01-01

    The mineral composition of mantle xenoliths from kamafugites of the Bunyaruguru volcanic field has been determined. The major and some trace elements (Si, Ti, Al, Fe, Mn, Mg, Ca, Na, K, Cr, Ni, Ba, Sr, La, Ce, Nd, Nb) has been analyzed in olivine, clinopyroxene, phlogopite, Cr-spinel, titanomagnetite, perovskite and carbonates of xenoliths and their host lavas. Bunyaruguru is one of three (Katwe-Kikorongo, Fort Portal and Bunyaruguru) volcanic fields included in the Toro-Ankole province located on the North end of the West Branch of the East African Rift. The xenoliths from three craters within the Bunyaruguru volcanic field revealed the different character of metasomatic alteration, reflecting the heterogeneity of the mantle on the kilometer scale. The most unusual finding was composite glimmerite-wehrlite xenolith from the crater Kazimiro, which contains the fresh primary high-Mg olivine with inclusions of Cr-spinel that had not been previously identified in this area. The different composition of phenocryst and xenolith minerals indicates that the studied xenoliths are not cumulus of enclosing magma, but the composition of xenoliths characterizes the lithology of the upper mantle of the area. The carbonate melt inclusions in olivine Fo90 demonstrate the existence of primary carbonatitic magmas in Bunyaruguru upper mantle. The results of texture and chemical investigation of the xenolith minerals indicate the time sequence of metasomatic alteration of Bunyaruguru upper mantle: MARID metasomatism at the first stage followed by carbonate metasomatism. The abundances of REE in perovskites from kamafugite are 2-4 times higher than similar values for xenolith. Therefore the kamafugite magma was been generated from a more enriched mantle source than the source of the xenoliths. The evaluation of P-T conditions formation of clinopyroxene xenolith revealed the range of pressure 20-65 kbar and the temperatures range 830-1040 °C. The pressure of clinopyroxene phenocryst

  1. Contrasted continental rifting via plume-craton interaction: Applications to Central East African Rift

    Directory of Open Access Journals (Sweden)

    Alexander Koptev

    2016-03-01

    Full Text Available The East African Rift system (EARS provides a unique system with the juxtaposition of two contrasting yet simultaneously formed rift branches, the eastern, magma-rich, and the western, magma-poor, on either sides of the old thick Tanzanian craton embedded in a younger lithosphere. Data on the pre-rift, syn-rift and post-rift far-field volcanic and tectonic activity show that the EARS formed in the context of the interaction between a deep mantle plume and a horizontally and vertically heterogeneous lithosphere under far-field tectonic extension. We bring quantitative insights into this evolution by implementing high-resolution 3D thermo-mechanical numerical deformation models of a lithosphere of realistic rheology. The models focus on the central part of the EARS. We explore scenarios of plume-lithosphere interaction with plumes of various size and initial position rising beneath a tectonically pre-stretched lithosphere. We test the impact of the inherited rheological discontinuities (suture zones along the craton borders, of the rheological structure, of lithosphere plate thickness variations, and of physical and mechanical contrasts between the craton and the embedding lithosphere. Our experiments indicate that the ascending plume material is deflected by the cratonic keel and preferentially channeled along one of its sides, leading to the formation of a large rift zone along the eastern side of the craton, with significant magmatic activity and substantial melt amount derived from the mantle plume material. We show that the observed asymmetry of the central EARS, with coeval amagmatic (western and magmatic (eastern branches, can be explained by the splitting of warm material rising from a broad plume head whose initial position is slightly shifted to the eastern side of the craton. In that case, neither a mechanical weakness of the contact between the craton and the embedding lithosphere nor the presence of second plume are required to

  2. 3D Numerical Rift Modeling with Application to the East African Rift System

    Science.gov (United States)

    Glerum, A.; Brune, S.; Naliboff, J.

    2017-12-01

    As key components of plate tectonics, continental rifting and the formation of passive margins have been extensively studied with both analogue models and numerical techniques. Only recently however, technical advances have enabled numerical investigations into rift evolution in three dimensions, as is actually required for including those processes that cause rift-parallel variability, such as structural inheritance and oblique extension (Brune 2016). We use the massively parallel finite element code ASPECT (Kronbichler et al. 2012; Heister et al. 2017) to investigate rift evolution. ASPECT's adaptive mesh refinement enables us to focus resolution on the regions of interest (i.e. the rift center), while leaving other areas such as the asthenospheric mantle at coarse resolution, leading to kilometer-scale local mesh resolution in 3D. Furthermore, we implemented plastic and viscous strain weakening of the nonlinear viscoplastic rheology required to develop asymmetric rift geometries (e.g. Huismans and Beaumont 2003). Additionally created plugins to ASPECT allow us to specify initial temperature and composition conditions based on geophysical data (e.g. LITHO1.0, Pasyanos et al. 2014) or to prescribe more general along-strike variation in the initial strain seeding the rift. Employing the above functionality, we construct regional models of the East African Rift System (EARS), the world's largest currently active rift. As the EARS is characterized by both orthogonal and oblique rift sections, multi-phase extension histories as well as magmatic and a-magmatic branches (e.g. Chorowicz 2005; Ebinger and Scholz 2011), it constitutes an extensive natural laboratory for our research into the 3D nature of continental rifting. References:Brune, S. (2016), in Plate boundaries and natural hazards, AGU Geophysical Monograph 219, J. C. Duarte and W. P. Schellart (Eds.). Chorowicz, J. (2005). J. Afr. Earth Sci., 43, 379-410. Ebinger, C. and Scholz, C. A. (2011), in Tectonics of

  3. Rayleigh Wave Phase Velocities Beneath the Central and Southern East African Rift System

    Science.gov (United States)

    Adams, A. N.; Miller, J. C.

    2017-12-01

    This study uses the Automated Generalized Seismological Data Function (AGSDF) method to develop a model of Rayleigh wave phase velocities in the central and southern portions of the East African Rift System (EARS). These phase velocity models at periods of 20-100s lend insight into the lithospheric structures associated with surficial rifting and volcanism, as well as basement structures that pre-date and affect the course of rifting. A large dataset of >700 earthquakes is used, comprised of Mw=6.0+ events that occurred between the years 1995 and 2016. These events were recorded by a composite array of 176 stations from twelve non-contemporaneous seismic networks, each with a distinctive array geometry and station spacing. Several first-order features are resolved in this phase velocity model, confirming findings from previous studies. (1) Low velocities are observed in isolated regions along the Western Rift Branch and across the Eastern Rift Branch, corresponding to areas of active volcanism. (2) Two linear low velocity zones are imaged trending southeast and southwest from the Eastern Rift Branch in Tanzania, corresponding with areas of seismic activity and indicating possible incipient rifting. (3) High velocity regions are observed beneath both the Tanzania Craton and the Bangweulu Block. Furthermore, this model indicates several new findings. (1) High velocities beneath the Bangweulu Block extend to longer periods than those found beneath the Tanzania Craton, perhaps indicating that rifting processes have not altered the Bangweulu Block as extensively as the Tanzania Craton. (2) At long periods, the fast velocities beneath the Bangweulu Block extend eastwards beyond the surficial boundaries, to and possibly across the Malawi Rift. This may suggest the presence of older, thick blocks of lithosphere in regions where they are not exposed at the surface. (3) Finally, while the findings of this study correspond well with previous studies in regions of overlapping

  4. Historical volcanism and the state of stress in the East African Rift System

    Directory of Open Access Journals (Sweden)

    Geoffrey Wadge

    2016-09-01

    Full Text Available Crustal extension at the East African Rift System (EARS should, as a tectonic ideal, involve a stress field in which the direction of minimum horizontal stress is perpendicular to the rift. A volcano in such a setting should produce dykes and fissures parallel to the rift. How closely do the volcanoes of the EARS follow this? We answer this question by studying the 21 volcanoes that have erupted historically (since about 1800 and find that 7 match the (approximate geometrical ideal. At the other 14 volcanoes the orientation of the eruptive fissures/dykes and/or the axes of the host rift segments are oblique to the ideal values. To explain the eruptions at these volcanoes we invoke local (non-plate tectonic variations of the stress field caused by: crustal heterogeneities and anisotropies (dominated by NW structures in the Protoerozoic basement, transfer zone tectonics at the ends of offset rift segments, gravitational loading by the volcanic edifice (typically those with 1-2 km relief and magmatic pressure in central reservoirs. We find that the more oblique volcanoes tend to have large edifices, large eruptive volumes and evolved and mixed magmas capable of explosive behaviour. Nine of the volcanoes have calderas of varying ellipticity, 6 of which are large, reservoir-collapse types mainly elongated across rift (e.g. Kone and 3 are smaller, elongated parallel to the rift and contain active lava lakes (e.g. Erta Ale, suggesting different mechanisms of formation and stress fields. Nyamuragira is the only EARS volcano with enough sufficiently well-documented eruptions to infer its long-term dynamic behaviour. Eruptions within 7 km of the volcano are of relatively short duration (<100 days, but eruptions with more distal fissures tend to have greater obliquity and longer durations, indicating a changing stress field away from the volcano. There were major changes in long-term magma extrusion rates in 1977 (and perhaps in 2002 due to major along

  5. Constraints to estimating the prevalence of trypanosome infections in East African zebu cattle

    Directory of Open Access Journals (Sweden)

    Cox Andrew P

    2010-09-01

    Full Text Available Abstract Background In East Africa, animal trypanosomiasis is caused by many tsetse transmitted protozoan parasites including Trypanosoma vivax, T. congolense and subspecies of T. brucei s.l. (T. b. brucei and zoonotic human infective T. b. rhodesiense that may co-circulate in domestic and wild animals. Accurate species-specific prevalence measurements of these parasites in animal populations are complicated by mixed infections of trypanosomes within individual hosts, low parasite densities and difficulties in conducting field studies. Many Polymerase Chain Reaction (PCR based diagnostic tools are available to characterise and quantify infection in animals. These are important for assessing the contribution of infections in animal reservoirs and the risk posed to humans from zoonotic trypanosome species. New matrices for DNA capture have simplified large scale field PCR analyses but few studies have examined the impact of these techniques on prevalence estimations. Results The Whatman FTA matrix has been evaluated using a random sample of 35 village zebu cattle from a population naturally exposed to trypanosome infection. Using a generic trypanosome-specific PCR, prevalence was systematically evaluated. Multiple PCR samples taken from single FTA cards demonstrated that a single punch from an FTA card is not sufficient to confirm the infectivity status of an individual animal as parasite DNA is unevenly distributed across the card. At low parasite densities in the host, this stochastic sampling effect results in underestimation of prevalence based on single punch PCR testing. Repeated testing increased the estimated prevalence of all Trypanosoma spp. from 9.7% to 86%. Using repeat testing, a very high prevalence of pathogenic trypanosomes was detected in these local village cattle: T. brucei (34.3%, T. congolense (42.9% and T. vivax (22.9%. Conclusions These results show that, despite the convenience of Whatman FTA cards and specific PCR based

  6. Constraints to estimating the prevalence of trypanosome infections in East African zebu cattle.

    Science.gov (United States)

    Cox, Andrew P; Tosas, Olga; Tilley, Aimee; Picozzi, Kim; Coleman, Paul; Hide, Geoff; Welburn, Susan C

    2010-09-06

    In East Africa, animal trypanosomiasis is caused by many tsetse transmitted protozoan parasites including Trypanosoma vivax, T. congolense and subspecies of T. brucei s.l. (T. b. brucei and zoonotic human infective T. b. rhodesiense) that may co-circulate in domestic and wild animals. Accurate species-specific prevalence measurements of these parasites in animal populations are complicated by mixed infections of trypanosomes within individual hosts, low parasite densities and difficulties in conducting field studies. Many Polymerase Chain Reaction (PCR) based diagnostic tools are available to characterise and quantify infection in animals. These are important for assessing the contribution of infections in animal reservoirs and the risk posed to humans from zoonotic trypanosome species. New matrices for DNA capture have simplified large scale field PCR analyses but few studies have examined the impact of these techniques on prevalence estimations. The Whatman FTA matrix has been evaluated using a random sample of 35 village zebu cattle from a population naturally exposed to trypanosome infection. Using a generic trypanosome-specific PCR, prevalence was systematically evaluated. Multiple PCR samples taken from single FTA cards demonstrated that a single punch from an FTA card is not sufficient to confirm the infectivity status of an individual animal as parasite DNA is unevenly distributed across the card. At low parasite densities in the host, this stochastic sampling effect results in underestimation of prevalence based on single punch PCR testing. Repeated testing increased the estimated prevalence of all Trypanosoma spp. from 9.7% to 86%. Using repeat testing, a very high prevalence of pathogenic trypanosomes was detected in these local village cattle: T. brucei (34.3%), T. congolense (42.9%) and T. vivax (22.9%). These results show that, despite the convenience of Whatman FTA cards and specific PCR based detection tools, the chronically low parasitaemias in

  7. Thrombocyte counts in malaria patients at East Kalimantan

    Science.gov (United States)

    Siagian, L. R. D.; Asfirizal, V.; Toruan, V. D. L.; Hasanah, N.

    2018-04-01

    Malaria still becoming a serious health problem in Indonesia. Beside disorders of erythrocytes, there are some data that Plasmodium caused the other blood cells like leukocyte and thrombocyte. In malaria, changes of thrombocyte is thrombocytopenia that would be a complication from malaria vivax or malaria falciparum. The aim of this study is to know the thrombocyte count of malaria patients in East Kalimantan. Design of this study is descriptic retrospective from medical record’s data from 2011-2016 in 7 hospitals (AW Syahranie at Samarinda, Kanudjoso at Balikpapan, Penajam Paser Utara at Panajam, AM Parikesit at Tenggarong, Taman Husada at Bontang, Kudungga at Sangata and Abdul Rivai at Tanjung Redeb. We collected the data from June-August 2017. There are 1041 malaria patients with male and female respectively 88.2% and 11.2%. The etiology of malaria were Plasmodium falciparum, Plasmodium vivax and mixed infection (P.f and P.v) respectively 62.6%, 38% and 6.1%. We found thrombocyte count was normal, decrease and increase respectively 11%, 85% and 1.7%. The degree of thrombocytopenia in malaria patients were mild (100.000-150.000/µl) 31.8%, moderate (50.000-100.000/µL) 45.6% and severe (malaria patients at East Kalimantan was thrombocytopenia with moderate degree of thrombocytopenia.

  8. Isotopic signature of Pan-African rejuvenation in the Kerala Khondalite belt, southern India: implications for east Gondwana reassembly

    International Nuclear Information System (INIS)

    Unnikrishnan Warrier, C.

    1997-01-01

    Sm-Nd isotope systematics on mineral separates from sillimanite-and cordierite-bearing metapelite (khondalite), and garnet-and biotite-bearing gneiss (leptynite) from the Kerala Khondalite Belt (KKB), southern India, yielded mineral isochron ages (wr-feld-bio-gar) of 537±27 Ma (MSWD=0.9) and 534±26 Ma (MSWD=1.23) respectively. Rb-Sr systematics in the same samples gave wr-feld-bio mineral isochron ages of 437±9 Ma (MSWD=0.67) and 467±9 Ma (MSWD=0.76). These results provide the first mineral isochron ages for the regional metasedimentaries in the KKB. The ε (Nd T) values at 550 Ma for khondalite and leptynite are -22.7 and -21.8 respectively. These results demonstrate a complete rejuvenation of the crust during Pan-African times. Coeval alkaline plutons emplaced along fault-lineaments in this area suggest an extensional tectonic regime. Geochronologic correlations with the Lutzow-Holm bay complexes in east Antarctica, and the highland and southwestern complex of Sri Lanka show that a similar Pan-African tectono-thermal event manifested in all the east Gondwana crustal fragments. (author)

  9. Differential decay of the East-African Antarctic Orogen : an integrated examination of Northeastern Mozambique

    Science.gov (United States)

    Ueda, K.; Jacobs, J.; Emmel, B.; Thomas, R. J.; Matola, R.

    2009-04-01

    In Northeastern Mozambique, the late Proterozoic - early Paleozoic East African-Antarctic Orogen can be subdivided into two major blocks that exhibit some relevant differences. The line of divide is represented by the Lurio Belt, a kinematically poorly constrained shear zone that also marks the conceptual northern limit of frequent late-tectonic granitoid intrusions. Moreover, far-travelled granulite-facies nappes cover a much larger area north of this belt (Viola et. al, 2008), giving rise to the assumption of different exhumation and present exposure levels. U/Pb data from previous surveys (e.g., Norconsult consortium, 2007) show coeval high-grade metamorphism in the whole region between c. 610 - 550 Ma, while the block south of the Lurio Belt also shows continuing metamorphism until c. 490 Ma that can be related to extension. Geothermobarometry for samples from within the Lurio Belt (Engvik et. al, 2007) indicates rapid exhumation after high-pressure granulite facies metamorphism and is consistant with the assumption of long tectonic activity. A possible model for the outlined pattern is the delamination of the orogenic root only in the southern part, followed by rapid mechanical thinning as well as by isostatic accommodation along the Lurio Belt. A valuable marker was identified in the metasedimentary Mecuburi group that overlies the southern basement. U/Pb analysis of detrital zircons have yielded a maximum deposition age of c. 600 Ma, while metamorphism is recorded until c. 505 Ma. Investigations of the relationship between metasediments and older basement show that the basal contact is a fairly preserved depositional contact, allowing to suppose a conjoint post-depositional evolution. It is notable that the timing of deposition shortly follows the onset of the main, widespread high-grade metamorphism. Relatively high but variable degrees of migmatisation in the Mecuburi Group require a phase of burial from surface to deep levels after 600 Ma, followed by

  10. A Comparative Analysis of Institutional Capacities for Implementing Disability Policies in East African Countries: Functions of National Councils for Disability

    Directory of Open Access Journals (Sweden)

    Akiko Yokoyama

    2012-08-01

    Full Text Available During the “African Decade of Persons with Disabilities (2000-2009”, East African countries witnessed significant achievements, especially in the development of law, collection of statistics and in funding. However, many persons with disability are still marginalised from opportunities in education, healthcare and employment.Purpose: With the pre-supposition that the lack of institutional capacities for implementing disability policies is the one major stumbling-block which hinders widespread delivery of social services to persons with disabilities in low-income countries, this study makes a comparative analysis of institutional capacities in the disability sectors of Uganda, Kenya and Tanzania.Method: The research methods adopted were a literature survey and a field survey. The framework for analysis consists of: 1 capacities and functions of disability units in central governments, 2 relationships between central and local governments in the disability sector, and 3 relationships between governments and organisations of persons with disability (DPOs. Special attention is paid to the status, roles and functions of national councils for disability (NCDs, the independent statutory bodies recently established in each of the three countries, with clear authority and duties for the implementation of disability policies. The NCDs enable multi-sectoral stakeholders to be involved in the implementation of disability policies; therefore, positive relationships between the governments and DPOs are essential for the smooth functioning of the NCDs.Results: While the result of the field survey in Tanzania reveals several effective approaches for the smooth operation of the NCD, further study is needed to verify whether these approaches would be applicable to other East African countries such as Kenya and Uganda.doi 10.5463/DCID.v23i2.106

  11. The Ngorongoro Volcanic Highland and its relationships to volcanic deposits at Olduvai Gorge and East African Rift volcanism.

    Science.gov (United States)

    Mollel, Godwin F; Swisher, Carl C

    2012-08-01

    The Ngorongoro Volcanic Highland (NVH), situated adjacent and to the east of Olduvai Gorge in northern Tanzania, is the source of the immense quantities of lava, ignimbrite, air fall ash, and volcaniclastic debris that occur interbedded in the Plio-Pleistocene sedimentary deposits in the Laetoli and Olduvai areas. These volcanics have proven crucial to unraveling stratigraphic correlations, the age of these successions, the archaeological and paleontological remains, as well as the source materials from which the bulk of the stone tools were manufactured. The NVH towers some 2,000 m above the Olduvai and Laetoli landscapes, affecting local climate, run-off, and providing varying elevation - climate controlled ecosystem, habitats, and riparian corridors extending into the Olduvai and Laetoli lowlands. The NVH also plays a crucial role in addressing the genesis and history of East African Rift (EAR) magmatism in northern Tanzania. In this contribution, we provide age and petrochemical compositions of the major NVH centers: Lemagurut, basalt to benmorite, 2.4-2.2 Ma; Satiman, tephrite to phonolite, 4.6-3.5 Ma; Oldeani, basalt to trachyandesite, 1.6-1.5 Ma; Ngorongoro, basalt to rhyolite, 2.3-2.0 Ma; Olmoti, basalt to trachyte, 2.0-1.8 Ma; Embagai, nephelinite to phonolite, 1.2-0.6 Ma; and Engelosin, phonolite, 3-2.7 Ma. We then discuss how these correlate in time and composition with volcanics preserved at Olduvai Gorge. Finally, we place this into context with our current understanding as to the eruptive history of the NVH and relationship to East African Rift volcanism. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Analysis of the genetic diversity of selected East African sweet potato

    African Journals Online (AJOL)

    Aghomotsegin

    Taiwan. Orange. 65. Mugande x New kawogo 2. Uganda. Cream. 66. Bungoma. Uganda .... African countries is still very slow due to financial and technical .... IPGRI, Rome,. Italy and Institute for Genetic Diversity, Ithaca, New York, USA. ISBN:.

  13. East and Central African Journal of Surgery http://www.bioline.org.br ...

    African Journals Online (AJOL)

    Patrick

    populations in Asia, far-east, and North America. By far reported cases ... Zomba Central hospital with long standing history of a giant scalp cutenous horn for about 28 years .Excision ... educative pathologies goes under reported. Case Report.

  14. Patient dose measurement and dose reduction in East Anglia (UK)

    International Nuclear Information System (INIS)

    Wade, J.P.; Goldstone, K.E.; Dendy, P.P.

    1995-01-01

    At the end of 1990 a programme of patient dose measurements was introduced as part of the quality assurance service already provided for X ray departments throughout the East Anglian Health Region (UK). Thermoluminescence dosemeters (TLDs) were used to measure over 1200 skin entrance surface doses for four common radiographic views in 33 hospitals in both the NHS and private sector. The four views were chosen to cover a wide range of equipment and techniques. The data collected have enabled Regional reference doses to be set which, for all views considered, fall below the National Radiological Protection Board (NRPB) Reference levels. In departments which exceeded reference levels, techniques were reviewed, improvements suggested and doses re-measured, in accordance with the recommended procedure for patient dose audit. A significant finding was that, given appropriate controls, X ray departments in the private sector could achieve the same acceptably low doses as NHS departments. (Author)

  15. Quantification of African cassava mosaic virus (ACMV) and East African cassava mosaic virus (EACMV-UG) in single and mixed infected Cassava (Manihot esculenta Crantz) using quantitative PCR.

    Science.gov (United States)

    Naseem, Saadia; Winter, Stephan

    2016-01-01

    The quantity of genomic DNA-A and DNA-B of African cassava mosaic virus (ACMV) and East African cassava mosaic virus Uganda (Uganda variant, EACMV-UG) was analysed using quantitative PCR to assess virus concentrations in plants from susceptible and tolerant cultivars. The concentrations of genome components in absolute and relative quantification experiments in single and mixed viral infections were determined. Virus concentration was much higher in symptomatic leaf tissues compared to non-symptomatic leaves and corresponded with the severity of disease symptoms. In general, higher titres were recorded for EACMV-UG Ca055 compared to ACMV DRC6. The quantitative assessment also showed that the distribution of both viruses in the moderately resistant cassava cv. TMS 30572 was not different from the highly susceptible cv. TME 117. Natural mixed infections with both viruses gave severe disease symptoms. Relative quantification of virus genomes in mixed infections showed higher concentrations of EACMV-UG DNA-A compared to ACMV DNA-A, but a marked reduction of EACMV-UG DNA-B. The higher concentrations of EACMV-UG DNA-B compared to EACMV DNA-A accumulation in single infections were consistent. Since DNA-B is implicated in virus cell-to-cell spread and systemic movement, the abundance of the EACMV-UG DNA-B may be an important factor driving cassava mosaic disease epidemic. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. The barriers preventing effective treatment of South African patients ...

    African Journals Online (AJOL)

    Background: Consumer research was last conducted among South African patients with mental health problems in 1997/8 by GAMAIN (The Global Alliance of Mental Health and Advocacy Networks). Respondents at the time suffered primarily from anxiety and/or unipolar depression.1 Updated consumer research was ...

  17. Prader-Willi syndrome in South African patients clinical and ...

    African Journals Online (AJOL)

    Prader-Willi syndrome in. South African patients clinical and molecular diagnosis. A L Christianson, 0 L Viljoen, W S Winship,. M de la Rey, E J van Rensburg. Study objective. ... This probe detects a parent-of-origin-specific methylation imprint at locus ... These studies were undertaken in the Molecular Genetic. Laboratory of ...

  18. High prevalence of abnormal liver enzymes in South African patients ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of liver function test abnormalities in South African black and Indian adult patients with type 2 diabetes mellitus attending a tertiary diabetes clinic. iabetes clinic. Recorded data included the past medical and drug history, history of alcohol abuse, anthropometry, lipid profile and liver ...

  19. Non-uniform splitting of a single mantle plume by double cratonic roots : Insight into the origin of the central and southern East African Rift System

    NARCIS (Netherlands)

    Koptev, Alexander; Cloetingh, Sierd; Gerya, Taras; Calais, Eric; Leroy, Sylvie

    Using numerical thermo-mechanical experiments we analyse the role of an active mantle plume and pre-existing lithospheric thickness differences in the structural development of the central and southern East African Rift system. The plume-lithosphere interaction model setup captures the essential

  20. Tiger, tiger, burning bright? industrial policy lessons from Ireland and East Asia for small African economies

    OpenAIRE

    Bailey, David; Lenihan, Helena; Singh, Ajit

    2008-01-01

    The African economies, particularly those in Sub-Saharan Africa (SSA) stand today at an important crossroads. During the 1980s, for the average African country, GDP per capita fell at a rate of 0.5 percent per annum; in the 1990s it rose slightly at a rate of 0.3 percent per annum. However, in the last four years, the average growth rate of this variable has been a respectable 3 percent per annum. In 2007, GDP growth rate in Africa was estimated to be 6 percent per annum, one of the highest r...

  1. Teachers’ Perceptions on the Use of African Languages in the Curriculum: A Case Study of Schools in Kenya, East Africa

    Directory of Open Access Journals (Sweden)

    Martin C. Njoroge

    2011-08-01

    Full Text Available In order to revitalize African languages and advocate for their use as media of instruction in Kenyan schools, it is important to investigate and document the teachers’ attitude towards the use of these languages in teaching. The research on which this paper is based set forth to explore teachers’ perceptions on the use of the mother tongue as the language of instruction in Kenya, East Africa. Six schools out of 54 public schools in the Gatundu district were randomly sampled. 32 teachers of Grades 1-3 were interviewed to find out the actual practices in their classrooms, the challenges they faced, and the perceptions they held in relation to the use of the mother tongue in their teaching. The data were qualitatively analyzed and the emergent findings support the claim that the use of learners’ mother tongue is beneficial to learners. In addition, the paper discusses the findings and proposes recommendations for pedagogy.

  2. Facility-Level Factors Influencing Retention of Patients in HIV Care in East Africa.

    Science.gov (United States)

    Rachlis, Beth; Bakoyannis, Giorgos; Easterbrook, Philippa; Genberg, Becky; Braithwaite, Ronald Scott; Cohen, Craig R; Bukusi, Elizabeth A; Kambugu, Andrew; Bwana, Mwebesa Bosco; Somi, Geoffrey R; Geng, Elvin H; Musick, Beverly; Yiannoutsos, Constantin T; Wools-Kaloustian, Kara; Braitstein, Paula

    2016-01-01

    Losses to follow-up (LTFU) remain an important programmatic challenge. While numerous patient-level factors have been associated with LTFU, less is known about facility-level factors. Data from the East African International epidemiologic Databases to Evaluate AIDS (EA-IeDEA) Consortium was used to identify facility-level factors associated with LTFU in Kenya, Tanzania and Uganda. Patients were defined as LTFU if they had no visit within 12 months of the study endpoint for pre-ART patients or 6 months for patients on ART. Adjusting for patient factors, shared frailty proportional hazard models were used to identify the facility-level factors associated with LTFU for the pre- and post-ART periods. Data from 77,362 patients and 29 facilities were analyzed. Median age at enrolment was 36.0 years (Interquartile Range: 30.1, 43.1), 63.9% were women and 58.3% initiated ART. Rates (95% Confidence Interval) of LTFU were 25.1 (24.7-25.6) and 16.7 (16.3-17.2) per 100 person-years in the pre-ART and post-ART periods, respectively. Facility-level factors associated with increased LTFU included secondary-level care, HIV RNA PCR turnaround time >14 days, and no onsite availability of CD4 testing. Increased LTFU was also observed when no nutritional supplements were provided (pre-ART only), when TB patients were treated within the HIV program (pre-ART only), and when the facility was open ≤4 mornings per week (ART only). Our findings suggest that facility-based strategies such as point of care laboratory testing and separate clinic spaces for TB patients may improve retention.

  3. Facility-Level Factors Influencing Retention of Patients in HIV Care in East Africa.

    Directory of Open Access Journals (Sweden)

    Beth Rachlis

    Full Text Available Losses to follow-up (LTFU remain an important programmatic challenge. While numerous patient-level factors have been associated with LTFU, less is known about facility-level factors. Data from the East African International epidemiologic Databases to Evaluate AIDS (EA-IeDEA Consortium was used to identify facility-level factors associated with LTFU in Kenya, Tanzania and Uganda. Patients were defined as LTFU if they had no visit within 12 months of the study endpoint for pre-ART patients or 6 months for patients on ART. Adjusting for patient factors, shared frailty proportional hazard models were used to identify the facility-level factors associated with LTFU for the pre- and post-ART periods. Data from 77,362 patients and 29 facilities were analyzed. Median age at enrolment was 36.0 years (Interquartile Range: 30.1, 43.1, 63.9% were women and 58.3% initiated ART. Rates (95% Confidence Interval of LTFU were 25.1 (24.7-25.6 and 16.7 (16.3-17.2 per 100 person-years in the pre-ART and post-ART periods, respectively. Facility-level factors associated with increased LTFU included secondary-level care, HIV RNA PCR turnaround time >14 days, and no onsite availability of CD4 testing. Increased LTFU was also observed when no nutritional supplements were provided (pre-ART only, when TB patients were treated within the HIV program (pre-ART only, and when the facility was open ≤4 mornings per week (ART only. Our findings suggest that facility-based strategies such as point of care laboratory testing and separate clinic spaces for TB patients may improve retention.

  4. The Climate-Population Nexus in the East African Horn: Emerging Degradation Trends in Rangeland and Pastoral Livelihood Zones

    Science.gov (United States)

    Pricope, N. G.; Husak, G. J.; Funk, C. C.; Lopez-Carr, D.

    2014-12-01

    Increasing climate variability and extreme weather conditions along with declining trends in both rainfall and temperature represent major risk factors affecting agricultural production and food security in many regions of the world. We identify regions where significant rainfall decrease from 1979-2011 over the entire continent of Africa couples with significant human population density increase. The rangelands of Ethiopia, Kenya, and Somalia in the East African Horn remain one of the world's most food insecure regions, yet have significantly increasing human populations predominantly dependent on pastoralist and agro-pastoralist livelihoods. Vegetation in this region is characterized by a variable mosaic of land covers, generally dominated by grasslands necessary for agro-pastoralism, interspersed by woody vegetation. Recent assessments indicate that widespread degradation is occurring, adversely impacting fragile ecosystems and human livelihoods. Using two underutilized MODIS products, we observe significant changes in vegetation patterns and productivity over the last decade all across the East African Horn. We observe significant vegetation browning trends in areas experiencing drying precipitation trends in addition to increasing population pressures. We also found that the drying precipitation trends only partially statistically explain the vegetation browning trends, further indicating that other factors such as population pressures and land use changes are responsible for the observed declining vegetation health. Furthermore, we show that the general vegetation browning trends persist even during years with normal rainfall conditions such as 2012, indicating potential long-term degradation of rangelands on which approximately 10 million people depend. These findings have serious implications for current and future regional food security monitoring and forecasting as well as for mitigation and adaptation strategies in a region where population is expected

  5. Imaging rifting at the lithospheric scale in the northern East African Rift using S-to-P receiver functions

    Science.gov (United States)

    Lavayssiere, A.; Rychert, C.; Harmon, N.; Keir, D.; Hammond, J. O. S.; Kendall, J. M.; Leroy, S. D.; Doubre, C.

    2017-12-01

    The lithosphere is modified during rifting by a combination of mechanical stretching, heating and potentially partial melt. We image the crust and upper mantle discontinuity structure beneath the northern East African Rift System (EARS), a unique tectonically active continental rift exposing along strike the transition from continental rifting in the Main Ethiopian rift (MER) to incipient seafloor spreading in Afar and the Red Sea. S-to-P receiver functions from 182 stations across the northern EARS were generated from 3688 high quality waveforms using a multitaper technique and then migrated to depth using a regional velocity model. Waveform modelling of data stacked in large conversion point bins confirms the depth and strength of imaged discontinuities. We image the Moho at 29.6±4.7 km depth beneath the Ethiopian plateaux with a variability in depth that is possibly due to lower crustal intrusions. The crust is 27.3±3.9 km thick in the MER and thinner in northern Afar, 17.5±0.7 km. The model requires a 3±1.2% reduction in shear velocity with increasing depth at 68.5±1.5 km beneath the Ethiopian plateaux, consistent with the lithosphere-asthenosphere boundary (LAB). We do not resolve a LAB beneath Afar and the MER. This is likely associated with partial melt near the base of the lithosphere, reducing the velocity contrast between the melt-intruded lithosphere and the partially molten asthenosphere. We identify a 4.5±0.7% increase in velocity with depth at 91±3 km beneath the MER. This change in velocity is consistent with the onset of melting found by previous receiver functions and petrology studies. Our results provide independent constraints on the depth of melt production in the asthenosphere and suggest melt percolation through the base of the lithosphere beneath the northernmost East African rift.

  6. The Use Of Information And Communication Technology And Social Networking Sites In Political Governance Of East African Legislative Assembly Parliament

    Directory of Open Access Journals (Sweden)

    Ainebyona Robert

    2015-06-01

    Full Text Available Abstract This research project was carried out to ascertain the use of Information and Communication Technologies and Social Networking Sites in political governance of East African Legislative Assembly Parliament. The research project was based on the conviction that in this era of globalization use of ICTs and SNSs are fundamentally important and will have tremendous impact on governance leadership and legislation now and in the near future. The specific objective of this study was intended a To evaluate the use of Social Networking Sites in enhancing the political governance of East African Legislative assembly Parliament. The findings from the research showed that that all the respondents 100 were subscribed to social networking sites and used them from time to time. Additionally the EALA parliamentarians had a disparity when it came to use of SNSs to interact with constituents 73.3 of the respondents indicated that they have used SNSs to interact with constituents on matters affecting the community from time to time however 26.7 showed that they did not use Social Networking sites to interact with constituents. Lastly the use of ICTs and SNSs by EALA has also made it possible for citizens to view Assembly proceedings in real time and hence where able to view their representatives in the course of carrying out their duties in the political arena.Lastly the world is changing in a dynamic fashion SNSs are among the tools leading the transformation and it is about time Parliamentarians in Africa embrace SNSs as major tools in changing how leaders interact and remain accountable to their constituents a practice thats been a myth in Africa.

  7. Mapping International University Partnerships Identified by East African Universities as Strengthening Their Medicine, Nursing, and Public Health Programs.

    Science.gov (United States)

    Yarmoshuk, Aaron N; Guantai, Anastasia Nkatha; Mwangu, Mughwira; Cole, Donald C; Zarowsky, Christina

    International university partnerships are recommended for increasing the capacity of sub-Saharan African universities. Many publications describe individual partnerships and projects, and tools are available for guiding collaborations, but systematic mappings of the basic, common characteristics of partnerships are scarce. To document and categorize the international interuniversity partnerships deemed significant to building the capacity of medicine, nursing, and public health programs of 4 East African universities. Two universities in Kenya and 2 in Tanzania were purposefully selected. Key informant interviews, conducted with 42 senior representatives of the 4 universities, identified partnerships they considered significant for increasing the capacity of their institutions' medicine, nursing, and public health programs in education, research, or service. Interviews were transcribed and analyzed. Partners were classified by country of origin and corresponding international groupings, duration, programs, and academic health science components. One hundred twenty-nine university-to-university partnerships from 23 countries were identified. Each university reported between 25 and 36 international university partners. Seventy-four percent of partnerships were with universities in high-income countries, 15% in low- and middle-income countries, and 11% with consortia. Seventy percent included medicine, 37% nursing, and 45% public health; 15% included all 3 programs. Ninety-two percent included an education component, 47% research, and 24% service; 12% included all 3 components. This study confirms the rapid growth of interuniversity cross-border health partnerships this century. It also finds, however, that there is a pool of established international partnerships from numerous countries at each university. Most partnerships that seek to strengthen universities in East Africa should likely ensure they have a significant education component. Universities should make

  8. Eye Munchausen's Syndrome: Case Report | Atipo-Tsiba | East ...

    African Journals Online (AJOL)

    East African Medical Journal. Journal Home · ABOUT THIS ... Munchausen's syndrome is a psychiatric disorder characterised by a need to simulate a disease or trauma self-mutilation, in order to attract attention or sympathy. Patients with this ...

  9. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    population live10 and own about 20% of the world's vehicles. The WHO African ... used as a base line for future progression and comparison, these are Motorization index (Vehicle .... Motor vehicle crash. 782. 0. 0. 0 ... Electric accident. 36. 0. 0.

  10. Innovations in sanitation for sustainable urban growth; modernized mixtures in an east african context

    NARCIS (Netherlands)

    Letema, S.; Van Vliet, B.; Van Lier, J.B.

    2012-01-01

    Urbanisation of poverty and informality in East Africa poses a threat to public health and environmental protection, perpetuating social exclusion and inequalities, while it creates service gaps. Neither conventional on-site sanitation nor modern centralised off-site sanitation provisions are

  11. Epidemic malaria and warmer temperatures in recent decades in an East African highland

    NARCIS (Netherlands)

    Alonso, David; Bouma, Menno J.; Pascual, Mercedes

    2011-01-01

    Climate change impacts on malaria are typically assessed with scenarios for the long-term future. Here we focus instead on the recent past (1970-2003) to address whether warmer temperatures have already increased the incidence of malaria in a highland region of East Africa. Our analyses rely on a

  12. Prediction of East African Seasonal Rainfall Using Simplex Canonical Correlation Analysis.

    Science.gov (United States)

    Ntale, Henry K.; Yew Gan, Thian; Mwale, Davison

    2003-06-01

    A linear statistical model, canonical correlation analysis (CCA), was driven by the Nelder-Mead simplex optimization algorithm (called CCA-NMS) to predict the standardized seasonal rainfall totals of East Africa at 3-month lead time using SLP and SST anomaly fields of the Indian and Atlantic Oceans combined together by 24 simplex optimized weights, and then `reduced' by the principal component analysis. Applying the optimized weights to the predictor fields produced better March-April-May (MAM) and September-October-November (SON) seasonal rain forecasts than a direct application of the same, unweighted predictor fields to CCA at both calibration and validation stages. Northeastern Tanzania and south-central Kenya had the best SON prediction results with both validation correlation and Hanssen-Kuipers skill scores exceeding +0.3. The MAM season was better predicted in the western parts of East Africa. The CCA correlation maps showed that low SON rainfall in East Africa is associated with cold SSTs off the Somali coast and the Benguela (Angola) coast, and low MAM rainfall is associated with a buildup of low SSTs in the Indian Ocean adjacent to East Africa and the Gulf of Guinea.

  13. Fire and life in Tarangire : effects of burning and herbivory on an East African Savanna system

    NARCIS (Netherlands)

    Vijver, van de C.A.D.M.

    1999-01-01

    This thesis investigates the effects of fire on quality and quantity of forage for grazers in the savannas of East Africa where fire has been used as a tool in pasture management for centuries. Hereby the mechanisms that cause the effects, as well as the manner in which the effects are

  14. Journal of East African Natural History - Vol 88, No 1 (1999)

    African Journals Online (AJOL)

    Canthariphilous insects in east Africa · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. C Hemp, A Hemp, K Dettner, 1-15. http://dx.doi.org/10.2982/0012-8317(1999)88[1:CIIEA]2.0.CO;2 ...

  15. Journal of East African Natural History - Vol 86, No 1 (1997)

    African Journals Online (AJOL)

    1997)86[1:ACIT]2.0.CO;2 · New fern records for Kilimanjaro · EMAIL FULL TEXT EMAIL FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Andreas Hemp, 37-42. Zoogeography and biodiversity of syrphidae (Diptera) in East Africa ...

  16. A Scoring Tool to Identify East African HIV-1 Serodiscordant Partnerships with a High Likelihood of Pregnancy.

    Directory of Open Access Journals (Sweden)

    Renee Heffron

    Full Text Available HIV-1 prevention programs targeting HIV-1 serodiscordant couples need to identify couples that are likely to become pregnant to facilitate discussions about methods to minimize HIV-1 risk during pregnancy attempts (i.e. safer conception or effective contraception when pregnancy is unintended. A clinical prediction tool could be used to identify HIV-1 serodiscordant couples with a high likelihood of pregnancy within one year.Using standardized clinical prediction methods, we developed and validated a tool to identify heterosexual East African HIV-1 serodiscordant couples with an increased likelihood of becoming pregnant in the next year. Datasets were from three prospectively followed cohorts, including nearly 7,000 couples from Kenya and Uganda participating in HIV-1 prevention trials and delivery projects.The final score encompassed the age of the woman, woman's number of children living, partnership duration, having had condomless sex in the past month, and non-use of an effective contraceptive. The area under the curve (AUC for the probability of the score to correctly predict pregnancy was 0.74 (95% CI 0.72-0.76. Scores ≥ 7 predicted a pregnancy incidence of >17% per year and captured 78% of the pregnancies. Internal and external validation confirmed the predictive ability of the score.A pregnancy likelihood score encompassing basic demographic, clinical and behavioral factors defined African HIV-1 serodiscordant couples with high one-year pregnancy incidence rates. This tool could be used to engage African HIV-1 serodiscordant couples in counseling discussions about fertility intentions in order to offer services for safer conception or contraception that align with their reproductive goals.

  17. A Scoring Tool to Identify East African HIV-1 Serodiscordant Partnerships with a High Likelihood of Pregnancy.

    Science.gov (United States)

    Heffron, Renee; Cohen, Craig R; Ngure, Kenneth; Bukusi, Elizabeth; Were, Edwin; Kiarie, James; Mugo, Nelly; Celum, Connie; Baeten, Jared M

    2015-01-01

    HIV-1 prevention programs targeting HIV-1 serodiscordant couples need to identify couples that are likely to become pregnant to facilitate discussions about methods to minimize HIV-1 risk during pregnancy attempts (i.e. safer conception) or effective contraception when pregnancy is unintended. A clinical prediction tool could be used to identify HIV-1 serodiscordant couples with a high likelihood of pregnancy within one year. Using standardized clinical prediction methods, we developed and validated a tool to identify heterosexual East African HIV-1 serodiscordant couples with an increased likelihood of becoming pregnant in the next year. Datasets were from three prospectively followed cohorts, including nearly 7,000 couples from Kenya and Uganda participating in HIV-1 prevention trials and delivery projects. The final score encompassed the age of the woman, woman's number of children living, partnership duration, having had condomless sex in the past month, and non-use of an effective contraceptive. The area under the curve (AUC) for the probability of the score to correctly predict pregnancy was 0.74 (95% CI 0.72-0.76). Scores ≥ 7 predicted a pregnancy incidence of >17% per year and captured 78% of the pregnancies. Internal and external validation confirmed the predictive ability of the score. A pregnancy likelihood score encompassing basic demographic, clinical and behavioral factors defined African HIV-1 serodiscordant couples with high one-year pregnancy incidence rates. This tool could be used to engage African HIV-1 serodiscordant couples in counseling discussions about fertility intentions in order to offer services for safer conception or contraception that align with their reproductive goals.

  18. A review of visceral leishmaniasis during the conflict in South Sudan and the consequences for East African countries.

    Science.gov (United States)

    Al-Salem, Waleed; Herricks, Jennifer R; Hotez, Peter J

    2016-08-22

    Visceral leishmaniasis (VL), caused predominantly by Leishmania donovani and transmitted by both Phlebotomus orientalis and Phlebotomus martini, is highly endemic in East Africa where approximately 30 thousands VL cases are reported annually. The largest numbers of cases are found in Sudan - where Phlebotomus orientalis proliferate in Acacia forests especially on Sudan's eastern border with Ethiopia, followed by South Sudan, Ethiopia, Somalia, Kenya and Uganda. Long-standing civil war and unrest is a dominant determinant of VL in East African countries. Here we attempt to identify the correlation between VL epidemics and civil unrest. In this review, literature published between 1955 and 2016 have been gathered from MSF, UNICEF, OCHA, UNHCR, PubMed and Google Scholar to analyse the correlation between conflict and human suffering from VL, which is especially apparent in South Sudan. Waves of forced migration as a consequence of civil wars between 1983 and 2005 have resulted in massive and lethal epidemics in southern Sudan. Following a comprehensive peace agreement, but especially with increased allocation of resources for disease treatment and prevention in 2011, cases of VL declined reaching the lowest levels after South Sudan declared independence. However, in the latest epidemic that began in 2014 after the onset of a civil war in South Sudan, more than 1.5 million displaced refugees have migrated internally to states highly endemic for VL, while 800,000 have fled to neighboring countries. We find a strong relationship between civil unrest and VL epidemics which tend to occur among immunologically naïve migrants entering VL-endemic areas and when Leishmania-infected individuals migrate to new areas and establish additional foci of disease. Further complicating factors in East Africa's VL epidemics include severe lack of access to diagnosis and treatment, HIV/AIDS co-infection, food insecurity and malnutrition. Moreover, cases of post-kala-azar dermal

  19. The ‘complete gospel’ revisited: Middle East and African influences

    Directory of Open Access Journals (Sweden)

    Glenna S. Jackson

    2014-11-01

    Full Text Available The author focuses on the historically-reliable gospel pericopes in which a woman is the lead character. She argues that these women provide the complete gospel − Jesus teaches, heals, preaches and is anointed in the context of female-based stories and, of course, the women take him from conception to resurrection. Jackson argues, not only from an analysis of the texts themselves, but also from her personal experiences in the Middle East and Africa.

  20. Gender Equity in Mathematics Achievement in East African Primary Schools: Context Counts

    OpenAIRE

    Tia L. Zuze; Valerie E. Lee

    2007-01-01

    Although primary school enrollment is gradually on the increase in the developing world, differences in mathematics achievement between girls and boys persist. A complex combination of factors that is related to issues of the home environment, the school context, and national policy influences the performance of female students when compared to their male peers. We focus on three countries in East Africa with a female disadvantage in mathematics achievement and use data from 8,795 primary sch...

  1. Critical care admission of South African (SA) surgical patients ...

    African Journals Online (AJOL)

    Critical care admission of South African (SA) surgical patients: Results of the SA Surgical Outcomes Study. D.L. Skinner, K de Vasconcellos, R Wise, T.M. Esterhuizen, C Fourie, A Goolam Mahomed, P.D. Gopalan, I Joubert, H Kluyts, L.R. Mathivha, B Mrara, J.P. Pretorius, G Richards, O Smith, M.G.L. Spruyt, R.M. Pearse, ...

  2. Haemorheological Changes in African Breast Cancer Patients ...

    African Journals Online (AJOL)

    Several Studies have indicated the existence of thrombo-embolic complications in cancer patients and that this could be associated with changes in heamorheological parameters. Packed cell volume (PCV), heamoglobin (Hb), relative plasma viscosity (RPV) and plasma Fibrinogen concentration (PFC) were measured in ...

  3. Acral peeling skin syndrome in two East-African siblings: case report

    Directory of Open Access Journals (Sweden)

    Kiprono Samson K

    2012-03-01

    Full Text Available Abstract Background Acral peeling skin syndrome is a rare autosomal recessive genodermatosis due to a missense mutation in transglutaminase 5. The skin peeling occurs at the separation of the stratum corneum from the stratum granulosum. Case presentation We present a case of two siblings who developed continuous peeling of the palms and soles from the first year of life. This peeling was more severe on the soles than palms and on younger sibling than elder sibling. Peeling is worsened by occlusion and sweating. Conclusions Sporadic cases of Acral Peeling Skin Syndrome occur in African population. There is variability in time of presentation and clinical severity even within families.

  4. Acral peeling skin syndrome in two East-African siblings: case report.

    Science.gov (United States)

    Kiprono, Samson K; Chaula, Baraka M; Naafs, Bernard; Masenga, John E

    2012-03-19

    Acral peeling skin syndrome is a rare autosomal recessive genodermatosis due to a missense mutation in transglutaminase 5. The skin peeling occurs at the separation of the stratum corneum from the stratum granulosum. We present a case of two siblings who developed continuous peeling of the palms and soles from the first year of life. This peeling was more severe on the soles than palms and on younger sibling than elder sibling. Peeling is worsened by occlusion and sweating. Sporadic cases of Acral Peeling Skin Syndrome occur in African population. There is variability in time of presentation and clinical severity even within families.

  5. Waardenburg syndrome type 2 in an african patient

    Directory of Open Access Journals (Sweden)

    H. Otman S

    2005-01-01

    Full Text Available A thirty six year-old African man, born in the Southern part of Libya, presented with congenital deafness and white forelock, variable-sized hypopigmented, depigmented patches and hyperpigmented islands within the areas of hypomelanosis affecting the upper parts of the trunk, both arms and forearms. The nasal root was hypertrophied, but there was a lack of lateral displacement of medial canthi. We report this case of Waardenburg syndrome type 2 (WS 2. As no treatment is available for patients with WS 2, prompt diagnosis and referral to a hearing specialist are crucial for the normal development of patients affected with this condition.

  6. Cardiovascular disease and diabetes in patients with African or Asian background.

    Science.gov (United States)

    Aambø, Arild; Klemsdal, Tor Ole

    2017-11-28

    Population groups of different ancestry appear to have varying prevalence of diabetes, different risks of developing cardiovascular disease and different responses to certain drugs that are used for these conditions. We wished to review the literature in this field. We have performed searches in several databases for systematic review articles published from the year 2000 onwards, and supplemented these with articles from reference lists, our own literature archives and a pyramid search in the Norwegian Electronic Health Library database. Altogether 37 articles were included. With regard to diagnosed diabetes, the prevalence of coronary heart disease and stroke varies among groups of South Asian, East Asian, African and European ancestry. In patients of South Asian ancestry, the risk of coronary heart disease appears to be twice that of Europeans, and the disease occurs 5–10 years earlier. The prevalence of stroke is especially high in persons of African ancestry. Risk factors such as dyslipidemia and hypertension are distributed differently among these groups. The therapeutic response to drugs such as beta blockers, ACE inhibitors and various statins differs; for example, statin doses in Asians may often be halved in relation to those used for Caucasians, and ACE inhibitors are not recommended as monotherapy for hypertension in persons of African ancestry. These differences are partly attributable to variations in genetic disposition. The findings are clinically significant – better insight in this field enables optimal tailoring of treatment for each patient, with more rapid achievement of goals and reduced risk of adverse effects. The recommendations given in this article are consistent with and complement the Directorate of Health’s revised guidelines for the treatment of diabetes.

  7. Pastoralism and wildlife: historical and current perspectives in the East African rangelands of Kenya and Tanzania.

    Science.gov (United States)

    Lankester, F; Davis, A

    2016-11-01

    The relationship between pastoralists, their livestock, wildlife and the rangelands of East Africa is multi-directional, complex and long-standing. The tumultuous events of the past century, however, have rewritten the nature of this relationship, reshaping the landscapes that were created, and relied upon, by both pastoralists and wildlife. Presently, much of the interaction between wildlife and pastoralists takes place in and around protected areas, the most contentious occurring in pastoral lands surrounding national parks. In conservation terminology these areas are called buffer zones. In the past century buffer zones have been shaped by, and contributed to, restrictive conservation policies, expropriation of land, efforts to include communities in conservation, both positive and negative wildlife/livestock interactions, and political tensions. In this review paper, the authors outline the history that shaped the current relationship between pastoralists, livestock and wildlife in buffer zones in East Africa and highlight some of the broader issues that pastoralists (and pastoralism as an effective livelihood strategy) now face. Finally, they consider some of the sustainable and equitable practices that could be implemented to improve livelihoods and benefit wildlife and pastoralism alike.

  8. A methodology to track temporal dynamics and rainfall thresholds of landslide processes in the East African Rift

    Science.gov (United States)

    Monsieurs, Elise; Jacobs, Liesbet; Kervyn, François; Kirschbaum, Dalia; d'Oreye, Nicolas; Derauw, Dominique; Kervyn, Matthieu; Nobile, Adriano; Trefois, Philippe; Dewitte, Olivier

    2015-04-01

    The East African rift valley is a major tectonic feature that shapes Central Africa and defines linear-shaped lowlands between highland ranges due to the action of geologic faults associated to earthquakes and volcanism. The region of interest, covering the Virunga Volcanic Province in eastern DRC, western Rwanda and Burundi, and southwest Uganda, is threatened by a rare combination of several types of geohazards, while it is also one of the most densely populated region of Africa. These geohazards can globally be classified as seismic, volcanic and landslide hazards. Landslides, include a wide range of ground movements, such as rock falls, deep failure of slopes and shallow debris flows. Landslides are possibly the most important geohazard in terms of recurring impact on the populations, causing fatalities every year and resulting in structural and functional damage to infrastructure and private properties, as well as serious disruptions of the organization of societies. Many landslides are observed each year in the whole region, and their occurrence is clearly linked to complex topographic, lithologic and vegetation signatures coupled with heavy rainfall events, which is the main triggering factor. The source mechanisms underlying landslide triggering and dynamics in the region of interest are still poorly understood, even though in recent years, some progress has been made towards appropriate data collection. Taking into account difficulties of field accessibility, we present a methodology to study landslide processes by multi-scale and multi-sensor remote sensing data from very high to low resolution (Pléiades, TRMM, CosmoSkyMed, Sentinel). The research will address the evolution over time of such data combined with other earth observations (seismic ground based networks, catalogues, rain gauge networks, GPS surveying, field observations) to detect and study landslide occurrence, dynamics and evolution. This research aims to get insights into the rainfall

  9. Advancing the Structural Use of Earth-based Bricks: Addressing Key Challenges in the East African Context

    Directory of Open Access Journals (Sweden)

    Mang Tia

    2010-11-01

    Full Text Available The research discussed in this paper is a subset of a bigger, NSF funded research project that is directed at investigating the use of sustainable building materials. The deployment context for the research is the hot and humid climate using selected cases from the East African region. The overarching goal for the research is advancing the structural use of earth-based technologies. Significant strides can be made through developing strategies for countering the adverse factors that affect the structural performance of the resulting wall, especially ones related to moisture dynamics. The research was executed in two phases. The first phase was a two-day NSF supported workshop which was held in Tanzania in July 2009. It provided a forum for sharing best practices in earth-based building technologies and developing a research and development roadmap. The priority research areas were broadly classified as optimizing the physio-mechanical properties of earth as a building material and managing socio-cultural impediments. In the second phase of the research, the authors collaborated with researchers from East Africa to conduct experimental work on the optimization of physio-mechanical properties. The specific research issues that have been addressed are: (1 characterizing the chemical reactions that can be linked to deterioration triggered by hygrothermal loads based on the hot and humid context, and; (2 developing a prototype for a simpler, portable, affordable and viable compressed brick production machine. The paper discusses the results from the characterization work that ultimately will be used to design bricks that have specific properties based on an understanding of how different stabilizers affect the hydration process. It also describes a cheaper, portable and more efficient prototype machine that has been developed as part of the follow-up research activities.

  10. Fundamental Flaws in the Architecture of the European Central Bank: The Possible End of the Euro Zone and its Effects to East African Community (EAC Countries

    Directory of Open Access Journals (Sweden)

    Nothando Moyo

    2014-09-01

    Full Text Available European countries embarked on a European integration programme that saw the formation of the Euro, which has emerged as a major currency (Blair, 1999 that was introduced in 1998. With the Euro, came the establishment of the European Central Bank. Thus this study seeks to investigate the flaws in the formation of the European Central Bank that surfaced during the major economic crisis in Europe. The crisis revealing the gaps in the formation and structure of the European central bank have created major challenges for the Economic and Monetary Union (EMU. Through an extant review of literature the study will examine the East African Community Countries, investigating the ties they have to the euro zone to analyse how the crisis has affected them. Furthermore, the study will analyse what would happen to the growth patterns of the East African Countries and the various prospects they may have should the Eurozone come to an end.

  11. Vitamin D intake, serum 25-hydroxyvitamin D status and response to moderate vitamin D3 supplementation: a randomised controlled trial in East African and Finnish women.

    Science.gov (United States)

    Adebayo, Folasade A; Itkonen, Suvi T; Öhman, Taina; Skaffari, Essi; Saarnio, Elisa M; Erkkola, Maijaliisa; Cashman, Kevin D; Lamberg-Allardt, Christel

    2018-02-01

    Insufficient vitamin D status (serum 25-hydroxyvitamin D (S-25(OH)D)0·05 for differences between ethnic groups). In conclusion, high prevalence of vitamin D insufficiency existed among East African women living in Finland, despite higher vitamin D intake than their Finnish peers. Moderate vitamin D3 supplementation was effective in increasing S-25(OH)D in both groups of women, and no ethnic differences existed in the response to supplementation.

  12. Littoral sedimentation of rift lakes: an illustrated overview from the modern to Pliocene Lake Turkana (East African Rift System, Kenya)

    Science.gov (United States)

    Schuster, Mathieu; Nutz, Alexis

    2015-04-01

    Existing depositional models for rift lakes can be summarized as clastics transported by axial and lateral rivers, then distributed by fan-deltas and/or deltas into a standing water body which is dominated by settling of fine particles, and experiencing occasional coarser underflows. Even if known from paleolakes and modern lakes, reworking of clastics by alongshore drift, waves and storms are rarely considered in depositional models. However, if we consider the lake Turkana Basin (East African Rift System, Kenya) it is obvious that this vision is incomplete. Three representative time slices are considered here: the modern Lake Turkana, the Megalake Turkana which developed thanks to the African Humid Period (Holocene), and the Plio-Pleistocene highstand episodes of paleolake Turkana (Nachukui, Shungura and Koobi Fora Formations, Omo Group). First, remarkable clastic morphosedimentary structures such as beach ridges, spits, washover fans, lagoons, or wave-dominated deltas are very well developed along the shoreline of modern lake Turkana, suggesting strong hydrodynamics responsible for a major reworking of the fluvial-derived clastics all along the littoral zone (longshore and cross-shore transport) of the lake. Similarly, past hydrodynamics are recorded from prominent raised beach ridges and spits, well-preserved all around the lake, above its present water-level (~360 m asl) and up to ~455 m. These large-scale clastic morphosedimentary structures also record the maximum extent of Megalake Turkana during the African Humid Period, as well as its subsequent regression forced by the end of the Holocene climatic optimum. Several hundreds of meters of fluvial-deltaic-lacustrine deposits spanning the Pliocene-Pleistocene are exposed in the Turkana basin thanks to tectonic faulting. These deposits are world famous for their paleontological and archeological content that documents the very early story of Mankind. They also preserve several paleolake highstand episodes with

  13. Contribution to the Investigation of Structure and Origin of the East African Graben by Gravimetry

    Institute of Scientific and Technical Information of China (English)

    Tondozi Keto; LIU Tianyou

    2005-01-01

    For our investigation we have 235 measurements done in the east part of Democratic Republic of Congo by P. Herrinck during a magnetic survey including the graben region from the parallel joining Goma city and Mahagi city, the region between Albert and Aka lakes, and the route from Aba to Kinsagani. During the surveys the density of recording points has been selected according to the importance of anomalies. In this way, the offset was 1 km where the disturbance was high in Goma city and 20 km have been sufficient along the route from Aba to Kinsagani. For the topographic and isostatic reductions only one cartographic document has been chosen that was the international map of the scale 1/1 000 000 which presents a certain characteristic of homogeneity.

  14. Genetic adaptation of giant lobelias (Lobelia aberdarica and Lobelia telekii to different altitudes in East African mountains

    Directory of Open Access Journals (Sweden)

    Shu-Ying eZhao

    2016-04-01

    Full Text Available The giant lobelias in East African mountains are good models for studying molecular mechanisms of adaptation to different altitudes. In this study, we generated RNA-seq data of a middle-altitude species Lobelia aberdarica and a high-altitude species L. telekii, followed by selective pressure estimation of their orthologous genes. Our aim was to explore the important genes potentially involved in adaptation to different altitudes. About 9.3 Gb of clean nucleotides, 167,929 – 170,534 unigenes with total lengths of 159,762,099 – 171,138,936 bp for each of the two species were generated. OrthoMCL method identified 3,049 1:1 orthologous genes (each species was represented by one ortholog. Estimations of non-synonymous to synonymous rate were performed using an approximate method and a maximum likelihood method in PAML. 85 orthologous genes were under positive selection. At least 8 of these genes are possibly involved in DNA repair, response to DNA damage and temperature stimulus, and regulation of gene expression, which hints on how giant lobelias adapt to high altitudinal environment that characterised by cold, low oxygen and strong ultraviolet radiation. The negatively selected genes are over-represented in Gene ontology terms of hydrolase, macromolecular complex assembly among others. This study sheds light on understanding the molecular mechanism of adaptation to different altitudes, and provides genomic resources for further studies of giant lobelias.

  15. East and Central African Journal of Surgery http://www.bioline.org.br ...

    African Journals Online (AJOL)

    Patrick

    The youth and young adults were the ... The time interval between the trauma and the patient arrival at the hospital and management ... findings and outcome of management of traumatic haemoperitoneum. Patients .... Sport (Football). 3. 1. 4.0.

  16. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    Results: 42/121 patients were bile culture positive (B+) while 79/121 patients were bile culture negative .... Table 2. Prevalence of risk factors for bactibilia. Parameter. Bile culture+(n. =42). Bile culture- ..... the European prospective study.

  17. East and Central African Journal of Surgery - Volume 14 Number 2 ...

    African Journals Online (AJOL)

    jen

    When more than two thirds of the dermis is taken there is a significantly higher incidence of delayed wound healing, hypertrophic scarring and deranged pigmentation. Patients and Methods. Fifteen adult patients and five children were recruited prospectively for overgrafting in a variety of settings. All patients had less than ...

  18. Mortality in East African shorthorn zebu cattle under one year: predictors of infectious-disease mortality.

    Science.gov (United States)

    Thumbi, Samuel M; Bronsvoort, Mark B M de C; Kiara, Henry; Toye, P G; Poole, Jane; Ndila, Mary; Conradie, Ilana; Jennings, Amy; Handel, Ian G; Coetzer, J A W; Steyl, Johan; Hanotte, Olivier; Woolhouse, Mark E J

    2013-09-08

    Infectious livestock diseases remain a major threat to attaining food security and are a source of economic and livelihood losses for people dependent on livestock for their livelihood. Knowledge of the vital infectious diseases that account for the majority of deaths is crucial in determining disease control strategies and in the allocation of limited funds available for disease control. Here we have estimated the mortality rates in zebu cattle raised in a smallholder mixed farming system during their first year of life, identified the periods of increased risk of death and the risk factors for calf mortality, and through analysis of post-mortem data, determined the aetiologies of calf mortality in this population. A longitudinal cohort study of 548 zebu cattle was conducted between 2007 and 2010. Each calf was followed during its first year of life or until lost from the study. Calves were randomly selected from 20 sub-locations and recruited within a week of birth from different farms over a 45 km radius area centered on Busia in the Western part of Kenya. The data comprised of 481.1 calf years of observation. Clinical examinations, sample collection and analysis were carried out at 5 week intervals, from birth until one year old. Cox proportional hazard models with frailty terms were used for the statistical analysis of risk factors. A standardized post-mortem examination was conducted on all animals that died during the study and appropriate samples collected. The all-cause mortality rate was estimated at 16.1 (13.0-19.2; 95% CI) per 100 calf years at risk. The Cox models identified high infection intensity with Theileria spp., the most lethal of which causes East Coast Fever disease, infection with Trypanosome spp., and helminth infections as measured by Strongyle spp. eggs per gram of faeces as the three important infections statistically associated with infectious disease mortality in these calves. Analysis of post-mortem data identified East Coast Fever as

  19. Middle east and North African oil in international relations (from 1970 to these days)

    International Nuclear Information System (INIS)

    Rafie, Hossein

    1999-01-01

    Petroleum is not purely an economical product, its main role in world economy and its concentration in Middle East and North Africa (two third of world reserves) made influence international politics. Knowing the nature of the region, petroleum and politics make one. The politicization of oil in the region starts, first of all, with the efforts of some powers, through their companies, to dominate oil countries, which by reaction incite these countries to eliminate foreign domination and establish their national control on oil matters. The situation is changing progressively. The position of productive states got stronger with the beginning of the 1970's which permitted the use of oil, in a way relatively efficient, as an instrument of power. Consequently, the balance of power shifted deeply in the favor of producers. On this basis, the argument consists of three parts: the first puts theoretic bases - theory of economical arm - and defines geographical and historical environment of the research. The second part studies the period of force of the oil countries, from the fourth Israel-Arab war and oil embargo that followed it, to the end of the second oil slump. The third part explains the shift of power on the international scene and the relative decline of oil power for the states of the region. The analysis of impact of the oil slump in 1986 and the mini impact of the second Persian Gulf war, quickly dominated, lead to clear the actual situation and outline the viewpoint of the future. (author)

  20. Otoliths of Five Extant Species of the Annual Killifish Nothobranchius from the East African Savannah

    Science.gov (United States)

    Reichenbacher, Bettina; Reichard, Martin

    2014-01-01

    This study presents, for the first time, a comprehensive dataset that documents the range of inter- and intraspecific otolith variation in aplocheiloid killifish, based on a total of 86 individuals representing five extant species of Nothobranchius PETERS, 1868, from East Africa: the sympatric pairs N. rubripinnis SEEGERS, 1986 and N. ruudwildekampi COSTA, 2009 (Eastern Tanzania), and N. orthonotus (PETERS, 1844) and N. furzeri JUBB, 1971 (Southern Mozambique), and two isolated populations of N. korthausae MEINKEN, 1973 (Eastern Tanzania). Otolith characters were analysed based on SEM images, and otolith morphometry was conducted using uni- and multivariate statistics. Two ancient clades of probably Early to Middle Miocene age in eastern Tanzania and southern Mozambique can be recognized based on otolith morphologies, which is consistent with previous work based on molecular data. The distinctive sulcus morphologies in the otoliths of sympatric species may be linked to species-specific hearing capabilities, perhaps constituting a case of character displacement in an area of secondary sympatry. The otoliths of the studied species of Nothobranchius are diagnostic at the species level, even in the case of closely related species diagnosable otherwise only by minor differences in coloration. The two populations of N. korthausae also displayed some differences in their otolith characters. The new data may facilitate future recognition of fossil species of Nothobranchius. As no fossil remains of extant aplocheiloid killifishes have yet been described, the discovery of fossil otoliths of Nothobranchius would significantly advance understanding of the evolutionary history of this interesting group of fishes. PMID:25383789

  1. Extent of East-African Nurse Leaders’ Participation in Health Policy Development

    Directory of Open Access Journals (Sweden)

    N. Shariff

    2012-01-01

    Full Text Available This paper reports part of a bigger study whose aim was to develop an empowerment model that could be used to enhance nurse leaders’ participation in health policy development. A Delphi survey was applied which included the following criteria: expert panelists, iterative rounds, statistical analysis, and consensus building. The expert panelists were purposively selected and included national nurse leaders in leadership positions at the nursing professional associations, nursing regulatory bodies, ministries of health, and universities in East Africa. The study was conducted in three iterative rounds. The results reported here were gathered as part of the first round of the study and that examined the extent of nurse leaders’ participation in health policy development. Seventy-eight (78 expert panelists were invited to participate in the study, and the response rate was 47%. Data collection was done with the use of a self-report questionnaire. Data analysis was done by use of SPSS and descriptive statistics were examined. The findings indicated that nurse leaders participate in health policy development though participation is limited and not consistent across all the stages of health policy development. The recommendations from the findings are that health policy development process needs to be pluralistic and inclusive of all nurse leaders practicing in positions related to policy development and the process must be open to their ideas and suggestions.

  2. Planation surfaces as a record of medium to large wavelength deformation: the example of the Lake Albert Rift (Uganda) on the East African Dome

    Science.gov (United States)

    Brendan, Simon; François, Guillocheau; Cécile, Robin; Jean, Braun; Olivier, Dauteuil; Massimo, Dall'Asta

    2016-04-01

    African relief is characterized by planation surfaces, some of them of continental scale. These surfaces are slightly deformed according to different wavelengths (x10 km; x100 km, x1000 km) which record both mantle dynamics (very long wavelength, x 1000 km) and lithosphere deformation (long wavelength deformation, x 100 km). Different types of these planation surfaces are recognized: - Etchplains capped by iron-duricrust which correspond to erosional nearly flat weathered surfaces resulting from the growth of laterites under warm and humid conditions. - Pediments which define mechanical erosional surfaces with concave or rectilinear profiles delimited by upslope scarps connected upstream with the upper landforms. We here focused on the Lake Albert Rift at the northern termination of the western branch of the East African Rift System of which the two branches are surimposed on the East-African Dome. Different wavelengths of deformation were characterized based on the 3D mapping of stepped planation surfaces: (1) very long wavelength deformations resulting from the uplift of the East African Dome; (2) long wavelength deformations resulting from the opening of the eastern branch and (3) medium wavelength deformations represented by the uplift of rift shoulders like the Rwenzori Mountains. The paleo-landscape reconstruction of Uganda shows the existence of four generations of landforms dated according to their geometrical relationships with volcanic rocks. A four stepped evolution of the Ugandan landforms is proposed: • 70 - 22 Ma: generation of two weathered planation surfaces (etchplain Uw and Iw). The upper one (Uw) records a very humid period culminating at time of the Early Eocene Climatic Optimum (70-45 Ma). It corresponds to the African Surface. A first uplift of the East African Dome generates a second lower planation surface (Iw) connected to the Atlantic Ocean base level; • 17-2.7 Ma: planation of large pediplains connected to the local base level induced

  3. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    Hence patients with risk factors for bactibilia should receive prophylactic ... long been known to be associated with biliary tract diseases and culturable bacteria in bile ... age>65 years, recent acute cholecystitis, recent acute pancreatitis, cholangitis, ..... patients undergoing cholecystectomy for acute and chronic cholecystitis.

  4. Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles.

    Science.gov (United States)

    Mayén, Ana-Lucia; Bovet, Pascal; Marti-Soler, Helena; Viswanathan, Bharathi; Gedeon, Jude; Paccaud, Fred; Marques-Vidal, Pedro; Stringhini, Silvia

    2016-01-01

    In high income countries, low socioeconomic status (SES) is related to unhealthier dietary patterns, while evidence on the social patterning of diet in low and middle income countries is scarce. In this study, we assess dietary patterns in the general population of a middle income country in the African region, the Republic of Seychelles, and examine their distribution according to educational level and income. Data was drawn from two independent national surveys conducted in the Seychelles among adults aged 25-64 years in 2004 (n = 1236) and 2013 (n = 1240). Dietary patterns were assessed by principal component analysis (PCA). Educational level and income were used as SES indicators. Data from both surveys were combined as no interaction was found between SES and year. Three dietary patterns were identified: "snacks and drinks", "fruit and vegetables" and "fish and rice". No significant associations were found between SES and the "snacks and drinks" pattern. Low vs. high SES individuals had lower adherence to the "fruit and vegetables" pattern [prevalence ratio (95% CI) 0.71 (0.60-0.83)] but a higher adherence to the traditional "fish and rice" pattern [1.58 (1.32-1.88)]. Income modified the association between education and the "fish and rice" pattern (p = 0.02), whereby low income individuals had a higher adherence to this pattern in both educational groups. Low SES individuals have a lower consumption of fruit and vegetables, but a higher consumption of traditional foods like fish and rice. The Seychelles may be at a degenerative diseases stage of the nutrition transition.

  5. Methods for sampling geographically mobile female traders in an East African market setting

    Science.gov (United States)

    Achiro, Lillian; Kwena, Zachary A.; McFarland, Willi; Neilands, Torsten B.; Cohen, Craig R.; Bukusi, Elizabeth A.; Camlin, Carol S.

    2018-01-01

    Background The role of migration in the spread of HIV in sub-Saharan Africa is well-documented. Yet migration and HIV research have often focused on HIV risks to male migrants and their partners, or migrants overall, often failing to measure the risks to women via their direct involvement in migration. Inconsistent measures of mobility, gender biases in those measures, and limited data sources for sex-specific population-based estimates of mobility have contributed to a paucity of research on the HIV prevention and care needs of migrant and highly mobile women. This study addresses an urgent need for novel methods for developing probability-based, systematic samples of highly mobile women, focusing on a population of female traders operating out of one of the largest open air markets in East Africa. Our method involves three stages: 1.) identification and mapping of all market stall locations using Global Positioning System (GPS) coordinates; 2.) using female market vendor stall GPS coordinates to build the sampling frame using replicates; and 3.) using maps and GPS data for recruitment of study participants. Results The location of 6,390 vendor stalls were mapped using GPS. Of these, 4,064 stalls occupied by women (63.6%) were used to draw four replicates of 128 stalls each, and a fifth replicate of 15 pre-selected random alternates for a total of 527 stalls assigned to one of five replicates. Staff visited 323 stalls from the first three replicates and from these successfully recruited 306 female vendors into the study for a participation rate of 94.7%. Mobilization strategies and involving traders association representatives in participant recruitment were critical to the study’s success. Conclusion The study’s high participation rate suggests that this geospatial sampling method holds promise for development of probability-based samples in other settings that serve as transport hubs for highly mobile populations. PMID:29324780

  6. East and Central African Journal of Surgery http://www.bioline.org.br ...

    African Journals Online (AJOL)

    Patrick

    Technology, Mbarara, Uganda .Correspondence to: ... of emergency department visits.4 Abdominal trauma is a leading cause of morbidity and mortality ... patient's medical records (i.e. referral form, if he had been referred) was done. For the ...

  7. 82 East and Central African Journal of Surgery Volume 12 Number 2 ...

    African Journals Online (AJOL)

    Josephine Nakato

    Background: Pressure ulcer management is difficult for the patient, relatives, doctor, and nursing staff ... school. Conclusion: Bilateral hip disarticulation with bilateral thigh flap utilization for the coverage ... (The classical incision goes below the.

  8. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    abroad of surgical patients at Addis Ababa University Medical Faculty, Tikur .... Easy access to health facilities ,investigations centers, better level of awareness ... 7. http://www.treatmentabroad.net/medical-tourism/medical-tourist-research/.

  9. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    characteristics, treatment outcome and prognostic factors for fistula closure and mortality in our local setting. Methods: ... The high rate of HIV infection in these patients needs further studies. ..... Campos ACL, Meguid MM, Coelho JCU. Factors ...

  10. East And Central African Journal of Surgery Volume 11 Number 2 ...

    African Journals Online (AJOL)

    user

    2006-12-02

    Dec 2, 2006 ... Radionuclide Scan and Other Diagnostic Studies in Goitre Patients in Tanzania ... When diagnosed by ultrasound the incidence raises to 30-50% 4,5. ..... breast cancer (unpublished) in Tanzania has been shown to be low.

  11. July/August 2010. East and central African Journal of Surger

    African Journals Online (AJOL)

    DELL

    tingling) in her left hand of three years duration. The patient ... sensation and strength of median- features secondary to autonomic nerve ... and) including sensitivity to changes in temperature (particularly cold), r or changes in sweating pattern of ...

  12. Genetic susceptibility to infectious disease in East African Shorthorn Zebu: a genome-wide analysis of the effect of heterozygosity and exotic introgression.

    Science.gov (United States)

    Murray, Gemma G R; Woolhouse, Mark E J; Tapio, Miika; Mbole-Kariuki, Mary N; Sonstegard, Tad S; Thumbi, Samuel M; Jennings, Amy E; van Wyk, Ilana Conradie; Chase-Topping, Margo; Kiara, Henry; Toye, Phil; Coetzer, Koos; deC Bronsvoort, Barend M; Hanotte, Olivier

    2013-11-09

    Positive multi-locus heterozygosity-fitness correlations have been observed in a number of natural populations. They have been explained by the correlation between heterozygosity and inbreeding, and the negative effect of inbreeding on fitness (inbreeding depression). Exotic introgression in a locally adapted population has also been found to reduce fitness (outbreeding depression) through the breaking-up of co-adapted genes, or the introduction of non-locally adapted gene variants. In this study we examined the inter-relationships between genome-wide heterozygosity, introgression, and death or illness as a result of infectious disease in a sample of calves from an indigenous population of East African Shorthorn Zebu (crossbred Bos taurus x Bos indicus) in western Kenya. These calves were observed from birth to one year of age as part of the Infectious Disease in East African Livestock (IDEAL) project. Some of the calves were found to be genetic hybrids, resulting from the recent introgression of European cattle breed(s) into the indigenous population. European cattle are known to be less well adapted to the infectious diseases present in East Africa. If death and illness as a result of infectious disease have a genetic basis within the population, we would expect both a negative association of these outcomes with introgression and a positive association with heterozygosity. In this indigenous livestock population we observed negative associations between heterozygosity and both death and illness as a result of infectious disease and a positive association between European taurine introgression and episodes of clinical illness. We observe the effects of both inbreeding and outbreeding depression in the East African Shorthorn Zebu, and therefore find evidence of a genetic component to vulnerability to infectious disease. These results indicate that the significant burden of infectious disease in this population could, in principle, be reduced by altered breeding

  13. Famine Early Warning Systems Network (FEWS NET) Contributions to Strengthening Resilience and Sustainability for the East African Community

    Science.gov (United States)

    Budde, M. E.; Galu, G.; Funk, C. C.; Verdin, J. P.; Rowland, J.

    2014-12-01

    The Planning for Resilience in East Africa through Policy, Adaptation, Research, and Economic Development (PREPARED) is a multi-organizational project aimed at mainstreaming climate-resilient development planning and program implementation into the East African Community (EAC). The Famine Early Warning Systems Network (FEWS NET) has partnered with the PREPARED project to address three key development challenges for the EAC; 1) increasing resiliency to climate change, 2) managing trans-boundary freshwater biodiversity and conservation and 3) improving access to drinking water supply and sanitation services. USGS FEWS NET has been instrumental in the development of gridded climate data sets that are the fundamental building blocks for climate change adaptation studies in the region. Tools such as the Geospatial Climate Tool (GeoCLIM) have been developed to interpolate time-series grids of precipitation and temperature values from station observations and associated satellite imagery, elevation data, and other spatially continuous fields. The GeoCLIM tool also allows the identification of anomalies and assessments of both their frequency of occurrence and directional trends. A major effort has been put forth to build the capacities of local and regional institutions to use GeoCLIM to integrate their station data (which is not typically available to the public) into improved national and regional gridded climate data sets. In addition to the improvements and capacity building activities related to geospatial analysis tools, FEWS NET will assist in two other areas; 1) downscaling of climate change scenarios and 2) vulnerability impact assessments. FEWS NET will provide expertise in statistical downscaling of Global Climate Model output fields and work with regional institutions to assess results of other downscaling methods. Completion of a vulnerability impact assessment (VIA) involves the examination of sectoral consequences in identified climate "hot spots". FEWS NET

  14. An MJO-Mediated Mechanism to Explain ENSO and IOD Impacts on East African Short Rains

    Science.gov (United States)

    Zaitchik, B. F.; Berhane, F.; Gnanadesikan, A.

    2015-12-01

    Previous studies have found that the El Nino Southern Oscillation (ENSO) and the Indian Ocean Dipole (IOD) have significant impacts on rainfall over East Africa (EA) during the short rains (Oct-Dec). However, not all ENSO and IOD events are associated with significant precipitation anomalies over EA. Our analysis shows that the IOD and ENSO influence EA rainfall by modifying the MJO. Composite analysis of rainfall and outgoing longwave radiation data show that the MJO over the Indian Ocean (phases 2 and 3 of the Wheeler and Hendon index) is associated with significant increase in precipitation over EA during El Niño. In La Niña and non-ENSO years, the MJO over the Indian Ocean has very weak impacts on EA convection and precipitation. Although previous studies have found that El Niño / La Niña events are associated with anomalous wetness/dryness over EA, the associations are not evident in the absence of the MJO. Similarly, the IOD exhibits strong associations with EA precipitation when there is MJO activity over the Indian Ocean. During the positive phase of the IOD, the MJO over the Indian Ocean has impacts that extend to EA. In the absence of the MJO, however, the IOD shows weak associations with EA precipitation. Furthermore, there are more MJO days in the Indian Ocean during El Niño and positive IOD events, which implies stronger impacts on EA. During La Niña events more MJO days are observed in the Pacific Ocean, favoring subsidence over the western Indian Ocean and dry anomalies over EA. These observations suggest two critical MJO-related questions that must be addressed in order to explain EA short rain variability typically attributed to ENSO or IOD: first, how do ENSO and IOD modify background conditions in a way that causes Indian Ocean MJO activity to be more strongly connected to EA under El Niño and IOD positive conditions, and second, why is it that El Niño and IOD positive states slow MJO propagation over the Indian Ocean and speed it over

  15. East African Soil Erosion Recorded in a 300 Year old Coral Colony From Kenya

    Science.gov (United States)

    Dunbar, R. B.; Fleitmann, D.; McCulloch, M.; Mudelsee, M.; Vuille, M.; McClanahan, T.; Cole, J.; Eggins, S.

    2006-12-01

    Soil erosion threatens the food security of 2.6 billion people worldwide. The situation is particularly dire in East and Sub-Saharan Africa where per capita food production has declined over the past 45 years. Erosion and the resultant loss of fertile soil is a key socio-economic and ecological problem in Kenya, affecting all sectors of its economy and damaging marine and terrestrial ecosystems. The temporal pattern of soil erosion is almost unknown and currently only sparse and rather anecdotal information exists. To aid in filling this gap of knowledge, we present a 300-year long Barium record from two Kenyan coral colonies (Porites sp., 3°15'S, 40°9' E; Malindi Marine National Park) that documents a dynamic history of soil erosion in the Sabaki river drainage basin. To reconstruct Sabaki River sediment flux to the Malindi coral reef Ba/Ca ratios were measured in the skeleton of two Porites colonies (Mal 96-1 and Mal 95-3). Well-developed annual bands allow us to develop annually precise chronologies. Ba/Ca ratios were measured in core Mal 96-1 at continuous 40 μm intervals (~400 to 500 samples yr-1) using laser-ablation inductively coupled plasma mass spectrometry (LA- ICP-MS). To test for reproducibility and accuracy of the Mal 96-1 Ba/Ca profile, coral core Mal 95-3 was analyzed at lower resolution (1 to 12 samples yr-1) using discrete micro-drill sampling and isotope dilution ICP-MS. The close similarity between both coral Ba/Ca profiles, in absolute values as well as general pattern, underscores the accuracy of the LA-ICP-MS technique and adds confidence to our interpretation of the 300 year long Mal 96-1 Ba/Ca profile. The Ba/Ca coral proxy record shows that while the sediment flux from the Sabaki River is nearly constant between 1700 and 1900, a continuous rise in sediment flux is observed since 1900, reflecting steadily increasing demographic pressure on land use. The peak in suspended sediment load and hence soil erosion recorded at the Malindi reef

  16. Fate of redox-sensitive elements in two different East-African wetland systems

    Science.gov (United States)

    Glasner, Björn; Fiedler, Sabine

    2017-04-01

    We expect that an intensified cropping alters soil pH and Eh, and negatively affects the production potential of wetlands. Therefore, we investigated the redox-conditions in combination with the fate of different redox-sensitive elements in two prototypical wetland systems that show a high potential for food production in East-Africa. While the floodplains (observed near Ifakara, Kilombero District/Tanzania) serve as major crop producing areas in the region, the Inland Valleys (observed in Namulonge, Central District/Uganda) show a high potential for future production. Both systems have been divided into three positions; the fringe near to the slope, the center near to the river and the middle in between these two positions. In order to get a better understanding of the two systems we installed continuously measuring redox-electrodes in three different positions within both systems. Additionally, the fate of mineral elements was measured using ion-exchange resins with an installation period of 3-4 months. At the Tanzanian field sites the Eh-potential shows one major dry period with moderately reducing to well drained conditions in all sampling depths (10, 30, and 50 cm below ground) in all three positions during the measuring period from March 2015 to Dec 2016. Starting with the rains the Eh-potential drops from 700 mV (in 10 and 30 cm depth) to reducing conditions at all three sites - with intermediate brakes in the middle and fringe positions, showing that there has been no rain during these periods. At the Ugandan field sites the Eh-potential shows more fluctuations during the measuring period, especially in the center position in 2015 ( 750 to -200 mV in 30 and 50 cm depth). Having just the Eh-potential from the first 30 cm below ground it is not really possible to differentiate between dry- and rainy-seasons at the sites. The fate of redox-sensitive elements (Fe, Mn, and P) does not always correlate with the overall Eh-conditions (median) of the installation

  17. Critically Ill Patients With the Middle East Respiratory Syndrome: A Multicenter Retrospective Cohort Study.

    Science.gov (United States)

    Arabi, Yaseen M; Al-Omari, Awad; Mandourah, Yasser; Al-Hameed, Fahad; Sindi, Anees A; Alraddadi, Basem; Shalhoub, Sarah; Almotairi, Abdullah; Al Khatib, Kasim; Abdulmomen, Ahmed; Qushmaq, Ismael; Mady, Ahmed; Solaiman, Othman; Al-Aithan, Abdulsalam M; Al-Raddadi, Rajaa; Ragab, Ahmed; Al Mekhlafi, Ghaleb A; Al Harthy, Abdulrahman; Kharaba, Ayman; Ahmadi, Mashael Al; Sadat, Musharaf; Mutairi, Hanan Al; Qasim, Eman Al; Jose, Jesna; Nasim, Maliha; Al-Dawood, Abdulaziz; Merson, Laura; Fowler, Robert; Hayden, Frederick G; Balkhy, Hanan H

    2017-10-01

    To describe patient characteristics, clinical manifestations, disease course including viral replication patterns, and outcomes of critically ill patients with severe acute respiratory infection from the Middle East respiratory syndrome and to compare these features with patients with severe acute respiratory infection due to other etiologies. Retrospective cohort study. Patients admitted to ICUs in 14 Saudi Arabian hospitals. Critically ill patients with laboratory-confirmed Middle East respiratory syndrome severe acute respiratory infection (n = 330) admitted between September 2012 and October 2015 were compared to consecutive critically ill patients with community-acquired severe acute respiratory infection of non-Middle East respiratory syndrome etiology (non-Middle East respiratory syndrome severe acute respiratory infection) (n = 222). None. Although Middle East respiratory syndrome severe acute respiratory infection patients were younger than those with non-Middle East respiratory syndrome severe acute respiratory infection (median [quartile 1, quartile 3] 58 yr [44, 69] vs 70 [52, 78]; p < 0.001), clinical presentations and comorbidities overlapped substantially. Patients with Middle East respiratory syndrome severe acute respiratory infection had more severe hypoxemic respiratory failure (PaO2/FIO2: 106 [66, 160] vs 176 [104, 252]; p < 0.001) and more frequent nonrespiratory organ failure (nonrespiratory Sequential Organ Failure Assessment score: 6 [4, 9] vs 5 [3, 7]; p = 0.002), thus required more frequently invasive mechanical ventilation (85.2% vs 73.0%; p < 0.001), oxygen rescue therapies (extracorporeal membrane oxygenation 5.8% vs 0.9%; p = 0.003), vasopressor support (79.4% vs 55.0%; p < 0.001), and renal replacement therapy (48.8% vs 22.1%; p < 0.001). After adjustment for potential confounding factors, Middle East respiratory syndrome was independently associated with death compared to non-Middle East respiratory syndrome severe acute respiratory

  18. Adapalene gel 0.1% for topical treatment of acne vulgaris in African patients.

    Science.gov (United States)

    Jacyk, W K; Mpofu, P

    2001-10-01

    Acne vulgaris is a common dermatologic disease in African patients, as well as in Caucasians. Our report evaluates the safety and efficacy of adapalene gel 0.1% in African patients with acne vulgaris. We used a 12-week, 2-center, open-label, noncomparative study of adapalene gel 0.1% in 65 African patients with acne vulgaris to assess the drug's effect on hyperpigmented lesions in people with dark skin. The study demonstrated that the progressive and significant improvements in lesion counts and global acne grades produced by adapalene in African patients were paralleled by significant improvements in the degree of hyperpigmentation of acne lesions. During treatment with adapalene, less than 5% of patients reported moderate or severe skin irritation at any time during the study, and the incidence of skin oiliness decreased markedly. We conclude that adapalene gel 0.1% was well tolerated and highly effective in African patients with acne vulgaris and was found to reduce hyperpigmentation.

  19. East and Central African Journal of Surgery Volume 10 Number 2 ...

    African Journals Online (AJOL)

    user

    2005-12-02

    Dec 2, 2005 ... Correspondences to: Dr Mchembe MD, Lecturer, Department of Surgery Muhimbili University College ... general or spinal anesthesia, patient was placed .... surgery textbook. J.B. Lippincott. Company Philadelphia 1984; 6-7. 2. Abrams JS: A hard look at colonoscopy. Am J Surg 1977; 133: 111-115. 3.

  20. East and Central African Journal of Surgery - Vol 21, No 1 (2016)

    African Journals Online (AJOL)

    Comparative analysis of one year outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in Primary Open Angle Glaucoma patients in Nigeria ... Epidemiology of low back pain among nurses working in public hospitals of Addis Ababa, Ethiopia · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  1. East and Central African Journal of Surgery http://www.bioline.org.br ...

    African Journals Online (AJOL)

    Patrick

    Cervical myelopathy from traditional bonesetters' treatment of spinal injury. O.E. Idowu1,2, O.C. ... patient management by this sect of health providers are still a burden in our society. ... rotation of the cervical spine takes place at this joint2.

  2. Cleft lip and palate: the Jos exprience | Orkar | East African Medical ...

    African Journals Online (AJOL)

    Objective: To determine the pattern of occurrence of cleft lip/palate and the factors that may have influenced treatment outcome. Design: Descriptive Study. Setting: Jos University Teaching Hospital, Jos, Nigeria. Subject: This study included 107 consecutive patients with cleft lip/palate managed between January 1991 and ...

  3. East and Central African Journal of Surgery Volume 11 Number 1 ...

    African Journals Online (AJOL)

    user

    back pain resolved completely in 5 of 7 patients with degenerative lumbar spine. ... Conclusion; TPF is the method of choice in fracture-dislocations and burst fractures ... The rib cage provides additional rigidity to the thoracic spine, at the same ...

  4. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    Audit of surgical mortality should be part of the health workers' general .... all surgical patients, adequate fluid resuscitation and recording on the daily fluid balance chart, timely ... Although physical access to health facilities in Uganda has improved with 82.5% ... population and the life expectancy is below sixty years19,26.

  5. East and Central African Journal of Surgery - Vol 19, No 1 (2014)

    African Journals Online (AJOL)

    The Cerebro-placental Ratio as a Prognostic Factor of Foetal Outcome in Patients with Third Trimester Hypertension · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. PL Parshuram, G Mwango, M Wambugu, J Ong'ech, P Mwachaka, 41-51 ...

  6. East African Journal of Public Health - Vol 11, No 4 (2014)

    African Journals Online (AJOL)

    Quality of life among dots (directly observed treatment short course) cured patients: a cross-sectional study · EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. B Nath, R Kumari, A Tripathi, A Shukla, T Midha, 853-861 ...

  7. 123 East and Central African Journal of Surgery Volume 12 Number ...

    African Journals Online (AJOL)

    Josephine Nakato

    limb associated with avascular necrosis of the head of femur. [Table 2]. Discussion. Our study involved 165 patients hospitalized in surgical ward of BUTH. Male were slightly more than female. The male predominance was previously reported by Boukinda et al2 in. Brazzaville and Cacala et al3 in South. Africa. In this study ...

  8. East and Central African Journal of Surgery http://www.bioline.org.br ...

    African Journals Online (AJOL)

    Patrick

    retrospective analysis of 95 patients and review of literature. Otolaryngol Pol. 1996;. 50(6): 567-78. 7. Lee JH, Smith RJ. Recurrent respiratory papillomatosis: pathogenesis to treatment. Curr. Opin Otolaryngol Head Neck Surg. 2005 Dec; 13(6): 354-9. 8. Rosen CA, Woodsen GE, Thompson JW, Hengesteg AP, Bradlow HL.

  9. 44 East and Central African Journal of Surgery Volume 12 Number 2 ...

    African Journals Online (AJOL)

    Josephine Nakato

    Methods: This was a retrospective review of record charts of patients' hearing status before surgery and between 18 – 24 months after surgery using the pure tone average derived according to the guidelines of the Committee on Hearing and Equilibrium of the American Academy of. Otolaryngology Head and Neck Surgery ...

  10. East and Central African Journal of Surgery Volume 15 Number 2 ...

    African Journals Online (AJOL)

    DELL

    Chemotherapy, and radiation therapy may be necessary in malignant disease. Long- term follow-up is essential ... from below the lower pole of the left kidney excised. Both kidneys were normal. Intraoperatively patient was stable. A yellowish brown tumor nodule measuring 7x4x4 cm, with histologically large tumor cells with ...

  11. East and Central African Journal of Surgery - Volume 14 Number 2 ...

    African Journals Online (AJOL)

    jen

    About 15 years ago caeco-colic intussusception was the leading cause of intestinal obstruction in adult patients seen at. Kibogora hospital1. The pattern of intestinal obstruction is an indirect indicator of how well surgical services are developed in a certain region. Holcombe2 compared the relative plethora of hernia and the.

  12. Low-intensity violence and the social determinants of adolescent health among three East African pastoralist communities.

    Science.gov (United States)

    Pike, Ivy L; Hilton, Charles; Österle, Matthias; Olungah, Owuor

    2018-04-01

    Recently, strong pleas have emerged to place the health of adolescents on the global health agenda. To reposition adolescence front and center, scholars argue that we must work toward a richly contextualized approach that considers the role that social environments play in shaping the final stages of growth and development. We aim to contribute to this deeper understanding of the social determinants of global adolescent health by offering a case study of three nomadic pastoralist communities from northern Kenya. In addition to noteworthy political and economic marginalization, East African pastoralist communities also contend with chronic, low intensity intercommunity conflict. Data collected over five extensive visits from 2008 to 2011, include the 10-19 year olds from 215 randomly sampled Pokot, Samburu, and Turkana households. Using a case/control design, we sampled two sites per ethnic community: one directly affected and one less affected by intercommunity violence. Our nutritional findings indicate that teens ages 15-19 years old had significantly higher anthropometric values compared to younger teens. Living in a wealthier household is associated with greater height, body mass indices, and summed skinfolds for boys but not for girls. Anthropometric measures were influenced by household and community variation in the mixed-effects, multi-level regression models. The Self-Report Questionnaire (SRQ-20) was used to assess psychosocial health, with higher scores associated with living in a community directly affected by violence and having lost a loved one due to violence. Our findings highlight the unique nature of adolescent health challenges but also the central role even subtle differences across communities and households play in shaping young people's experiences. With few studies to document the lived experience of pastoralist youth as they move toward adulthood, examining how such challenging socioeconomic environment shapes health seems long overdue

  13. Termites create spatial structure and govern ecosystem function by affecting N2 fixation in an East African savanna.

    Science.gov (United States)

    Fox-Dobbs, Kena; Doak, Daniel F; Brody, Alison K; Palmer, Todd M

    2010-05-01

    The mechanisms by which even the clearest of keystone or dominant species exert community-wide effects are only partially understood in most ecosystems. This is especially true when a species or guild influences community-wide interactions via changes in the abiotic landscape. Using stable isotope analyses, we show that subterranean termites in an East African savanna strongly influence a key ecosystem process: atmospheric nitrogen fixation by a monodominant tree species and its bacterial symbionts. Specifically, we applied the 15N natural abundance method in combination with other biogeochemical analyses to assess levels of nitrogen fixation by Acacia drepanolobium and its effects on co-occurring grasses and forbs in areas near and far from mounds and where ungulates were or were not excluded. We find that termites exert far stronger effects than do herbivores on nitrogen fixation. The percentage of nitrogen derived from fixation in Acacia drepanolobium trees is higher (55-80%) away from mounds vs. near mounds (40-50%). Mound soils have higher levels of plant available nitrogen, and Acacia drepanolobium may preferentially utilize soil-based nitrogen sources in lieu of fixed nitrogen when these sources are readily available near termite mounds. At the scale of the landscape, our models predict that termite/soil derived nitrogen sources influence >50% of the Acacia drepanolobium trees in our system. Further, the spatial extent of these effects combine with the spacing of termite mounds to create highly regular patterning in nitrogen fixation rates, resulting in marked habitat heterogeneity in an otherwise uniform landscape. In summary, we show that termite-associated effects on nitrogen processes are not only stronger than those of more apparent large herbivores in the same system, but also occur in a highly regular spatial pattern, potentially adding to their importance as drivers of community and ecosystem structure.

  14. ICDP project DeepCHALLA: reconstructing East African climate change and environmental history over the past 250,000 years

    Science.gov (United States)

    Verschuren, Dirk; Van Daele, Maarten; Wolff, Christian; Waldmann, Nicolas; Meyer, Inka; Ombori, Titus; Peterse, Francien; O'Grady, Ryan; Schnurrenberger, Doug; Olago, Daniel

    2017-04-01

    Sediments on the bottom of Lake Challa, a 92-meter deep crater lake on the border of Kenya and Tanzania near Mt. Kilimanjaro, contain a uniquely long and continuous record of past climate and environmental change. The near-equatorial location and exceptional quality of this natural archive provide great opportunities to study tropical climate variability at both short (inter-annual to decadal) and long (glacial-interglacial) time scales; and the influence of this climate variability on the region's freshwater resources, the functioning of terrestrial ecosystems, and the history of the East African landscape in which modern humans (our species, Homo sapiens) evolved and have lived ever since. Supported in part by the International Continental Scientific Drilling Programme (ICDP), the DeepCHALLA project has now recovered the sediment record of Lake Challa down to 214.8 meter below the lake floor, with almost certain 100% cover of the uppermost 121.3 meter (ca.150,000 year BP to present) and estimated 85% cover over the lower part of the sequence, down to the lowermost distinct reflector in the available seismic stratigraphy. This reflector represents a 2 meter thick layer of volcanic sand and silt deposited ca.250,000 years ago, and overlies still older silty lacustrine clays deposited during early lake development. Down-hole logging produced continuous profiles of in-situ sediment composition that confer an absolute depth scale to both the recovered cores and their three-dimensional representation in seismic stratigraphy. As readily observed through the transparent core liners, Lake Challa sediments are finely laminated throughout most of the recovered sequence. Combined with the great time span, the exquisite temporal resolution of these sediments promises to greatly increase our understanding of tropical climate and ecosystem dynamics, and create a long-awaited equatorial counterpart to the high-latitude climate records extracted from the ice sheets of Greenland

  15. Meat Quality Characteristics of Small East African Goats and Norwegian Crosses Finished under Small Scale Farming Conditions.

    Science.gov (United States)

    Hozza, W A; Mtenga, L A; Kifaro, G C; Shija, D S N; Mushi, D E; Safari, J G; Shirima, E J M

    2014-12-01

    The aim of the experiment was to study the effect of feeding system on meat quality characteristics of Small East African (SEA) goats and their crosses with Norwegian (SEA×N) goats finished under small scale farming conditions. Twenty four castrated goats at the age of 18 months with live body weight of 16.7±0.54 kg from each breed (SEA and SEA×N) were distributed in a completely randomized design in a 2×3 factorial arrangement (two breed, and three dietary treatments). The dietary treatments were; no access to concentrate (T0), 66% access to ad libitum concentrate allowance (T66) and 100% access to ad libitum concentrate allowance with 20% refusal (T100) and the experimental period was for 84 days. In addition, all goats were allowed to graze for 2 hours daily and later fed grass hay on ad libitum basis. Daily feed intakes were recorded for all 84-days of experiment after which the animals were slaughtered. Feed intake of T100 animals was 536 g/d, which was 183 g/d higher than that of T66 group. Supplemented goats had significantly (p0.05) for dressing percentage and carcass conformation among supplemented goats except fatness score, total fat depots and carcass fat which increased (pgoats fed concentrate declined rapidly and reached below 6 at 6 h post-mortem but temperature remained at 28°C. Cooking loss and meat tenderness improved (pgoats and their crosses with Norwegian breeds finished under small scale farming conditions in rural areas. Therefore, concentrate supplementation of goats of both breeds improves meat quality attributes.

  16. Introduction of East African cassava mosaic Zanzibar virus to Oman harks back to "Zanzibar, the capital of Oman".

    Science.gov (United States)

    Khan, Akhtar J; Akhtar, Sohail; Al-Matrushi, Abdulrahman M; Fauquet, Claude M; Briddon, Rob W

    2013-02-01

    Cassava mosaic disease (CMD) is the most devastating disease of the subsistence crop cassava (Manihot esculenta) across Africa and the Indian subcontinent. The disease is caused by viruses of the genus Begomovirus (family Geminiviridae)-seven species have been identified so far. The Sultanate of Oman is unusual among countries in Arabia in growing cassava on a small scale for local consumption. During a recent survey in A'Seeb wilayat of Muscat governorate, Oman, cassava plants were identified with symptoms typical of CMD. A begomovirus, East African cassava mosaic Zanzibar virus (EACMZV), was isolated from symptomatic plants. This virus was previously only known to occur in Zanzibar and Kenya. During the 19th Century, Zanzibar was governed by Oman and was so important that the Sultan of Oman moved his capital there from Muscat. After a period of colonial rule, the governing Arab elite was overthrown, following independence in the 1960s, and many expatriate Omanis returned to their homeland. Having gained a liking for the local Zanzibar cuisine, it appears that returning Omanis did not wish to do without dishes made from one particular favorite, cassava. Consequently, they carried planting material back to Oman for cultivation in their kitchen gardens. The evidence suggests that this material harbored EACMZV. Recently, Oman has been shown to be a nexus for geminiviruses and their associated satellites from diverse geographic origins. With their propensity to recombine, a major mechanism for evolution of geminiviruses, and the fact that Oman (and several other Arabian countries) is a major hub for trade and travel by air and sea, the possibility of onward spread is worrying.

  17. Sexual learning among East African adolescents in the context of generalized HIV epidemics: A systematic qualitative meta-synthesis.

    Directory of Open Access Journals (Sweden)

    Amelia S Knopf

    Full Text Available AIDS-related illness is the leading cause of mortality for adolescents in sub-Saharan Africa. Together, Kenya, Tanzania, and Uganda account for 21% of HIV-infected adolescents in sub-Saharan Africa. The United Nations framework for addressing the epidemic among adolescents calls for comprehensive sexual and reproductive health education. These HIV prevention efforts could be informed by a synthesis of existing research about the formal and informal sexual education of adolescents in countries experiencing generalized epidemics. The purpose of this study was to describe the process of sexual learning among East African adolescents living in the context of generalized HIV epidemics.Qualitative metasynthesis, a systematic procedure for integrating the results of multiple qualitative studies addressing a similar phenomenon, was used. Thirty-two research reports met study inclusion criteria. The reports were assessed in a four-step analytic process: appraisal, classification of findings, synthesis of findings, and construction of a framework depicting the process of sexual learning in this population.The framework includes three phases of sexual learning: 1 being primed for sex, 2 making sense of sex, and 3 having sexual experiences. Adolescents were primed for sex through gender norms, cultural practices, and economic structures as well as through conversations and formal instruction. They made sense of sex by acquiring information about sexual intercourse, reproduction and pregnancy, sexually transmitted infections, and relationships and by developing a variety of beliefs and attitudes about these topics. Some adolescents described having sexual experiences that met wants or needs, but many experienced sex that was coerced or violent. Whether sex was wanted, coerced, or violent, adolescents experienced worry about sexually transmitted infections or premarital pregnancy.The three phases of sexual learning interact to shape adolescents' sexual lives

  18. Content of a novel online collection of traditional east African food habits (1930s-1960s): data collected by the Max-Planck-Nutrition Research Unit, Bumbuli, Tanzania.

    Science.gov (United States)

    Raschke, Verena; Oltersdorf, Ulrich; Elmadfa, Ibrahim; Wahlqvist, Mark L; Cheema, Birinder Sb; Kouris-Blazos, Antigone

    2007-01-01

    Knowledge of traditional African foods and food habits has been, and continues to be, systematically extirpated. With the primary intent of collating data for our online collection documenting traditional African foods and food habits (available at: www.healthyeatingclub.com/Africa/), we reviewed the Oltersdorf Collection, 75 observational investigations conducted throughout East Africa (i.e. Tanzania, Kenya, and Uganda) between the 1930s and 1960s as compiled by the Max Planck Nutrition Research Unit, formerly located in Bumbuli, Tanzania. Data were categorized as follows: (1) food availability, (2) chemical composition, (3) staple foods (i.e. native crops, cereals, legumes, roots and tubers, vegetables, fruits, spices, oils and fats, beverages, and animal foods), (4) food preparation and culture, and (5) nutrient intake and health status indicators. Many of the traditional foods identified, including millet, sorghum, various legumes, root and tubers, green leafy vegetables, plant oils and wild meats have known health benefits. Food preparatory practices during this period, including boiling and occasional roasting are superior to current practices which favor frying and deep-frying. Overall, our review and data extraction provide reason to believe that a diversified diet was possible for the people of East Africa during this period (1930s-1960s). There is a wealth of knowledge pertaining to traditional East African foods and food habits within the Oltersdorf Collection. These data are currently available via our online collection. Future efforts should contribute to collating and honing knowledge of traditional foods and food habits within this region, and indeed throughout the rest of Africa. Preserving and disseminating this knowledge may be crucial for abating projected trends for non-communicable diseases and malnutrition in Africa and abroad.

  19. Alpha-thalassemia genetic testing: an important anemia diagnostic tool in patients of African heritage.

    Science.gov (United States)

    Dasanu, Constantin A

    2010-01-01

    Inherited alpha-thalassemia genotypes have been shown to have a rather high prevalence in some patient populations of African heritage. These genotypes lead to mild anemia with microcytic indices and a normal hemoglobin electrophoresis. In our outpatient department, we analyzed 54 consecutive patients of African descent with longstanding microcytic anemia, but no evidence of iron deficiency. We detected alpha-thalassemia gene deletions in 94 percent of these patients. Alpha-thalassemia genetic testing appears cost-effective in an otherwise unexplained, longstanding microcytic anemia in patients of African origin.

  20. Irritable Bowel Syndrome in a Population of African Patients

    Directory of Open Access Journals (Sweden)

    Sylvester Chuks Nwokediuko

    2012-01-01

    Full Text Available Background. Functional dyspepsia is the prototype functional gastrointestinal disorder. This study was designed to determine its prevalence, subtypes, and risk factors associated with the subtypes. Method. Patients with upper gastrointestinal symptoms who presented for endoscopy were administered a questionnaire containing the functional dyspepsia and irritable bowel syndrome modules of the Rome III diagnostic criteria. Results. Of 192 patients who had functional dyspepsia, epigastric pain syndrome, postprandial distress syndrome, and combination of the two subtypes accounted for 79.2%, 62.5%, and 50%, respectively. Multivariate analysis of the risk factors showed that independent predictors of postprandial distress syndrome were alcohol and irritable bowel syndrome while irritable bowel syndrome was independent predictor of epigastric pain syndrome. Alcohol, smoking, and use of nonsteroidal anti-inflammatory drugs were independent predictors of cooccurrence of postprandial distress syndrome and epigastric pain syndrome. Conclusion. Functional dyspepsia accounts for 62.5% of dyspepsia in a population of black African patients. Regarding symptomatology, epigastric pain syndrome, postprandial distress syndrome, and combination of the two subtypes account for 79.2%, 62.5%, and 50%, respectively. Risk factors for functional dyspepsia are irritable bowel syndrome, alcohol, smoking, and use of nonsteroidal anti-inflammatory drugs.

  1. Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries.

    Directory of Open Access Journals (Sweden)

    Corrine W Ruktanonchai

    Full Text Available Geographic accessibility to health facilities represents a fundamental barrier to utilisation of maternal and newborn health (MNH services, driving historically hidden spatial pockets of localized inequalities. Here, we examine utilisation of MNH care as an emergent property of accessibility, highlighting high-resolution spatial heterogeneity and sub-national inequalities in receiving care before, during, and after delivery throughout five East African countries.We calculated a geographic inaccessibility score to the nearest health facility at 300 x 300 m using a dataset of 9,314 facilities throughout Burundi, Kenya, Rwanda, Tanzania and Uganda. Using Demographic and Health Surveys data, we utilised hierarchical mixed effects logistic regression to examine the odds of: 1 skilled birth attendance, 2 receiving 4+ antenatal care visits at time of delivery, and 3 receiving a postnatal health check-up within 48 hours of delivery. We applied model results onto the accessibility surface to visualise the probabilities of obtaining MNH care at both high-resolution and sub-national levels after adjusting for live births in 2015.Across all outcomes, decreasing wealth and education levels were associated with lower odds of obtaining MNH care. Increasing geographic inaccessibility scores were associated with the strongest effect in lowering odds of obtaining care observed across outcomes, with the widest disparities observed among skilled birth attendance. Specifically, for each increase in the inaccessibility score to the nearest health facility, the odds of having skilled birth attendance at delivery was reduced by over 75% (0.24; CI: 0.19-0.3, while the odds of receiving antenatal care decreased by nearly 25% (0.74; CI: 0.61-0.89 and 40% for obtaining postnatal care (0.58; CI: 0.45-0.75.Overall, these results suggest decreasing accessibility to the nearest health facility significantly deterred utilisation of all maternal health care services. These

  2. Deriving spatial patterns from a novel database of volcanic rock geochemistry in the Virunga Volcanic Province, East African Rift

    Science.gov (United States)

    Poppe, Sam; Barette, Florian; Smets, Benoît; Benbakkar, Mhammed; Kervyn, Matthieu

    2016-04-01

    The Virunga Volcanic Province (VVP) is situated within the western branch of the East-African Rift. The geochemistry and petrology of its' volcanic products has been studied extensively in a fragmented manner. They represent a unique collection of silica-undersaturated, ultra-alkaline and ultra-potassic compositions, displaying marked geochemical variations over the area occupied by the VVP. We present a novel spatially-explicit database of existing whole-rock geochemical analyses of the VVP volcanics, compiled from international publications, (post-)colonial scientific reports and PhD theses. In the database, a total of 703 geochemical analyses of whole-rock samples collected from the 1950s until recently have been characterised with a geographical location, eruption source location, analytical results and uncertainty estimates for each of these categories. Comparative box plots and Kruskal-Wallis H tests on subsets of analyses with contrasting ages or analytical methods suggest that the overall database accuracy is consistent. We demonstrate how statistical techniques such as Principal Component Analysis (PCA) and subsequent cluster analysis allow the identification of clusters of samples with similar major-element compositions. The spatial patterns represented by the contrasting clusters show that both the historically active volcanoes represent compositional clusters which can be identified based on their contrasted silica and alkali contents. Furthermore, two sample clusters are interpreted to represent the most primitive, deep magma source within the VVP, different from the shallow magma reservoirs that feed the eight dominant large volcanoes. The samples from these two clusters systematically originate from locations which 1. are distal compared to the eight large volcanoes and 2. mostly coincide with the surface expressions of rift faults or NE-SW-oriented inherited Precambrian structures which were reactivated during rifting. The lava from the Mugogo

  3. Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries.

    Science.gov (United States)

    Ruktanonchai, Corrine W; Ruktanonchai, Nick W; Nove, Andrea; Lopes, Sofia; Pezzulo, Carla; Bosco, Claudio; Alegana, Victor A; Burgert, Clara R; Ayiko, Rogers; Charles, Andrew Sek; Lambert, Nkurunziza; Msechu, Esther; Kathini, Esther; Matthews, Zoë; Tatem, Andrew J

    2016-01-01

    Geographic accessibility to health facilities represents a fundamental barrier to utilisation of maternal and newborn health (MNH) services, driving historically hidden spatial pockets of localized inequalities. Here, we examine utilisation of MNH care as an emergent property of accessibility, highlighting high-resolution spatial heterogeneity and sub-national inequalities in receiving care before, during, and after delivery throughout five East African countries. We calculated a geographic inaccessibility score to the nearest health facility at 300 x 300 m using a dataset of 9,314 facilities throughout Burundi, Kenya, Rwanda, Tanzania and Uganda. Using Demographic and Health Surveys data, we utilised hierarchical mixed effects logistic regression to examine the odds of: 1) skilled birth attendance, 2) receiving 4+ antenatal care visits at time of delivery, and 3) receiving a postnatal health check-up within 48 hours of delivery. We applied model results onto the accessibility surface to visualise the probabilities of obtaining MNH care at both high-resolution and sub-national levels after adjusting for live births in 2015. Across all outcomes, decreasing wealth and education levels were associated with lower odds of obtaining MNH care. Increasing geographic inaccessibility scores were associated with the strongest effect in lowering odds of obtaining care observed across outcomes, with the widest disparities observed among skilled birth attendance. Specifically, for each increase in the inaccessibility score to the nearest health facility, the odds of having skilled birth attendance at delivery was reduced by over 75% (0.24; CI: 0.19-0.3), while the odds of receiving antenatal care decreased by nearly 25% (0.74; CI: 0.61-0.89) and 40% for obtaining postnatal care (0.58; CI: 0.45-0.75). Overall, these results suggest decreasing accessibility to the nearest health facility significantly deterred utilisation of all maternal health care services. These results

  4. GJB2 (Connexin-26) mutations are not frequent among hearing impaired patients in East Greenland

    DEFF Research Database (Denmark)

    Homoe, P.; Koch, A.; Rendtorff, Nanna Dahl

    2012-01-01

    Objective: Investigate genetic causes of HI among the Inuit populations in the Arctic with a high prevalence of hearing impairment (HI). Design: A cross-sectional survey with population-based controls. Study sample: Forty-five patients, with sensorineural or mixed HI and an available blood sample...... for GJB2 sequencing from DNA, were selected from 166 East Greenlanders by specialist audiology examination, including pure-tone air and bone conduction audiometry from 125 Hz to 8000 Hz. Controls were 108 East- and 109 West-Greenlanders. Results: Forty-five patients with HI were included, 24 males and 21...

  5. Conformity of package inserts information to regulatory requirements among selected branded and generic medicinal products circulating on the East African market.

    Science.gov (United States)

    Sillo, Hiiti B; Masota, Nelson E; Kisoma, Sunday; Rago, Lembit; Mgoyela, Veronica; Kaale, Eliangiringa A

    2018-01-01

    Availability of correct and adequate information about medicines is an important aspect in ensuring rational use of medicines and hence facilitating safety and expected efficacy of medicines during therapy. Package inserts have proven to be a good source of information to the prescribers and patients whereby they have been useful in highlighting important information pertaining proper use and handling of the medicines. The present study was aimed at establishing the extent to which package inserts of medicines circulating on the markets of the East African Community (EAC) Partner States conform to medicines information requirements as established in the harmonized guidelines as well as national guidelines. A total of 99 package inserts from six (6) types of medicines namely Albendazole, Artemether/Lumefantrine (ALu), Ciprofloxacin, Paracetamol, Amoxicillin and Metronidazole were purposefully collected from three EAC Partner States: Kenya, Tanzania and Uganda. The medicines were selected based on their indications as first line treatments, high rates of utilization within the medicines supply system and their positions in treatment of diseases of public importance across EAC Partner States. The inserts were evaluated on the availability of information regarding fifteen (15) parameters as extracted from the EAC harmonized guidelines for registration of medicines. Moreover, comparisons were made between the percentage conformity of the branded versus generic products, markets from which the samples were collected, origin of the manufacturer and type of medicine. Majority (93.9-100%) of the medicines' package inserts highly conformed to the inclusion of the information regarding the description and composition of the medications, indications, dosage and methods of administration, warnings and precautions, contraindications and storage conditions. However, the information on handling and disposal, container package description, excipients used, clinical pharmacology of

  6. East African Orthopaedic Journal

    African Journals Online (AJOL)

    Anthropometry of the distal femur in a Kenyan population and its correlation with total knee replacement implants · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. K.C. Lakati, B.M. Ndeleva, C.K. Kibet, S.M. Odhiambo, V.B. Sokobe, 67-72 ...

  7. East African Medical Journal

    African Journals Online (AJOL)

    REpORTINg ON MENTAl HEAlTH IllNESS (MHI) IN KENyA: HOw wEll ARE. wE dOINg? ... fundamental for evidence-based decision-making and improved service ... Owiti, MBChB, MSc, Academic Model for Prevention and Treatment of HIV ...

  8. East African Medical Journal

    African Journals Online (AJOL)

    2009-09-09

    Sep 9, 2009 ... PREGNANCY RATES AMONG FEMALE PARTICIPANTS IN PHASE I AND PHASE IIA AIDS VACCINE CLINICAL. TRIALS ..... for mothers, domestic workers and sex workers .... consultants of IAVI, the funding organisation and.

  9. East African Medical Journal

    African Journals Online (AJOL)

    F. M. Gakuya, BVM, MSc, M.N.Kyule, BVM, MSc, PhD, P.B. Gathura, BVM, MSc, PhD, Department of Public Health, Pharmacology and Toxicology, University of. Nairobi, P.O. Box 29053, Nairobi, Kenya and S. Kariuki, BVM, MSc, PhD, CentreforMicrobiology Research, Kenya Medical Research Institute, P.O. Box54840, ...

  10. East African Medical Journal

    African Journals Online (AJOL)

    (CHWs) to promote WASH practices and to collect household based data using a structured reporting tool. ... are encouraged to purchase from local shops. Hand washing ... Ethics Review Board of Médecins Sans Frontières,. Luxembourg.

  11. East African Medical Journal

    African Journals Online (AJOL)

    2002-07-01

    Jul 1, 2002 ... PREVALENCE OF VITAMIN A DEFICIENCY AMONG PRE-SCHOOL AND SCHOOL-AGED CHILDREN IN ARSSI ZONE. ETHIOPIA. YT Asrat, BSc. MSc ... in the “low” range (<20ttl/dl) in 51% of the children. Conclusion: The results ... of Arssi zone Dodotana Sire district was selected at random for this study.

  12. East African Medical Journal

    African Journals Online (AJOL)

    2007-11-11

    Nov 11, 2007 ... Kenyatta National Hospital, Nairobi Women's. Hospital, Coast ... standard Karl Storz tower consisting of two 15 inch flat ... The carbon dioxide insufflation pressure was ..... complications, took longer to perform and were offset.

  13. Psychosocial stress in South African patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Samantha Ramkisson

    2016-11-01

    Full Text Available Objective: Diabetes mellitus is considered an emotionally and behaviourally demanding condition which adds to the stress of a patient’s daily living. There is a paucity of literature in South Africa regarding stress and diabetes. This study therefore aims to identify the areas and contributory factors of psychosocial stress in South African patients with diabetes. Method: A cross-sectional study was conducted at two public facilities and five private medical practices on the north coast of KwaZulu-Natal, South Africa. The Questionnaire on Stress in Diabetes – Revised was administered to 401 participants. Results: Eighteen percent of the sample reported having extreme psychosocial stress. Depression, physical complaints and self-medication/diet were the main areas which contributed to high psychosocial stress. Factors that also contributed to high levels of psychosocial stress were low educational level, unemployment, female gender, attending the public sector and high HbA1c levels. Conclusion: Psychosocial stress affects metabolic control in patients with diabetes, thereby increasing the risks of long-term complications.

  14. The African Lupus Genetics Network (ALUGEN) registry: standardized, prospective follow-up studies in African patients with systemic lupus erythematosus.

    Science.gov (United States)

    Hodkinson, B; Mapiye, D; Jayne, D; Kalla, A; Tiffin, N; Okpechi, I

    2016-03-01

    The prevalence and severity of systemic lupus erythematosus (SLE) differs between ethnic groups and geographical regions. Although initially reported as rare, there is growing evidence that SLE is prevalent and runs a severe course in Africa. There is a paucity of prospective studies on African SLE patients. The African Lupus Genetics Network (ALUGEN) is a multicentred framework seeking to prospectively assess outcomes in SLE patients in Africa. Outcomes measured will be death, hospital admission, disease activity flares, and SLE-related damage. We will explore predictors for these outcomes including clinical, serological, socio-demographic, therapeutic and genetic factors. Further, we will investigate comorbidities and health-related quality of life amongst these patients. Data of patients recently (≤ 5 yrs) diagnosed with SLE will be collected at baseline and annual follow-up visits, and captured electronically. The ALUGEN project will facilitate standardized data capture for SLE cases in Africa, allowing participating centres to develop their own SLE registries, and enabling collaboration to enrich our understanding of inter-ethnic and regional variations in disease expression. Comprehensive, high-quality multi-ethnic data on African SLE patients will expand knowledge of the disease and inform clinical practice, in addition to augmenting research capacity and networking links and providing a platform for future biomarker and interventional studies. © The Author(s) 2015.

  15. East African cassava mosaic-like viruses from Africa to Indian ocean islands: molecular diversity, evolutionary history and geographical dissemination of a bipartite begomovirus

    Directory of Open Access Journals (Sweden)

    De Bruyn Alexandre

    2012-11-01

    Full Text Available Abstract Background Cassava (Manihot esculenta is a major food source for over 200 million sub-Saharan Africans. Unfortunately, its cultivation is severely hampered by cassava mosaic disease (CMD. Caused by a complex of bipartite cassava mosaic geminiviruses (CMG species (Family: Geminivirideae; Genus: Begomovirus CMD has been widely described throughout Africa and it is apparent that CMG's are expanding their geographical distribution. Determining where and when CMG movements have occurred could help curtail its spread and reveal the ecological and anthropic factors associated with similar viral invasions. We applied Bayesian phylogeographic inference and recombination analyses to available and newly described CMG sequences to reconstruct a plausible history of CMG diversification and migration between Africa and South West Indian Ocean (SWIO islands. Results The isolation and analysis of 114 DNA-A and 41 DNA-B sequences demonstrated the presence of three CMG species circulating in the Comoros and Seychelles archipelagos (East African cassava mosaic virus, EACMV; East African cassava mosaic Kenya virus, EACMKV; and East African cassava mosaic Cameroon virus, EACMCV. Phylogeographic analyses suggest that CMG’s presence on these SWIO islands is probably the result of at least four independent introduction events from mainland Africa occurring between 1988 and 2009. Amongst the islands of the Comoros archipelago, two major migration pathways were inferred: One from Grande Comore to Mohéli and the second from Mayotte to Anjouan. While only two recombination events characteristic of SWIO islands isolates were identified, numerous re-assortments events were detected between EACMV and EACMKV, which seem to almost freely interchange their genome components. Conclusions Rapid and extensive virus spread within the SWIO islands was demonstrated for three CMG complex species. Strong evolutionary or ecological interaction between CMG species may explain

  16. African Journals Online (AJOL)

    African Journals Online (AJOL)

    African Journals OnLine (AJOL) is the world's largest and pre-eminent collection of peer-reviewed, African-published scholarly journals. Historically, scholarly information has flowed from North to South and from West to East. It has also been difficult for African researchers to access the work of other African academics.

  17. African American Patients' Psychosocial Support Needs and Barriers to Treatment: Patient Needs Assessment.

    Science.gov (United States)

    Davey, Maureen P; Bilkins, Brianna; Diamond, Guy; Willis, Alliric I; Mitchell, Edith P; Davey, Adam; Young, Faith M

    2016-09-01

    This study assessed adult patient's psychosocial support needs and treatment barriers in an urban diverse cancer center. A needs assessment was conducted with a convenience sample of adult oncology patients (n = 113; 71.7 % African American). Most patients were parenting school-age children and worried about them (96 %); 86.7 % would attend a family support program. Among patients who were married or partnered (68 %), 63.7 % were concerned about communication, coping, and emotional support; 53.9 % would attend a couple support program. Patients identified similar treatment barriers: transportation, babysitting for younger children, convenience of time/place, and refreshments. Findings suggest that behavioral health care providers should be available to screen cancer patients and improve access to appropriate psychosocial oncology support programs.

  18. Tick infestation: a 200-patients' series | Guven | African Journal of ...

    African Journals Online (AJOL)

    African Journal of Infectious Diseases. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 11, No 2 (2017) >. Log in or Register to get access to full text downloads.

  19. Bacterial pneumonia in the AIDS patients | Salami | West African ...

    African Journals Online (AJOL)

    No Abstract. West African Journal of Medicine Vol. 25 (1) 2006: pp. 1-5. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/wajm.v25i1.28236 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  20. Genomic footprints of dryland stress adaptation in Egyptian fat-tail sheep and their divergence from East African and western Asia cohorts.

    Science.gov (United States)

    Mwacharo, Joram M; Kim, Eui-Soo; Elbeltagy, Ahmed R; Aboul-Naga, Adel M; Rischkowsky, Barbara A; Rothschild, Max F

    2017-12-15

    African indigenous sheep are classified as fat-tail, thin-tail and fat-rump hair sheep. The fat-tail are well adapted to dryland environments, but little is known on their genome profiles. We analyzed patterns of genomic variation by genotyping, with the Ovine SNP50K microarray, 394 individuals from five populations of fat-tail sheep from a desert environment in Egypt. Comparative inferences with other East African and western Asia fat-tail and European sheep, reveal at least two phylogeographically distinct genepools of fat-tail sheep in Africa that differ from the European genepool, suggesting separate evolutionary and breeding history. We identified 24 candidate selection sweep regions, spanning 172 potentially novel and known genes, which are enriched with genes underpinning dryland adaptation physiology. In particular, we found selection sweeps spanning genes and/or pathways associated with metabolism; response to stress, ultraviolet radiation, oxidative stress and DNA damage repair; activation of immune response; regulation of reproduction, organ function and development, body size and morphology, skin and hair pigmentation, and keratinization. Our findings provide insights on the complexity of genome architecture regarding dryland stress adaptation in the fat-tail sheep and showcase the indigenous stocks as appropriate genotypes for adaptation planning to sustain livestock production and human livelihoods, under future climates.

  1. Survival of patients with Kaposi's sarcoma in the South African ...

    African Journals Online (AJOL)

    When the South African (SA) antiretroviral therapy (ART) programme was rolled out in 2004, the treatment model for HIV- ... context of ART and affordable standard-of-care cancer regimens, KS ... for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, Faculty of Health Sciences,.

  2. CPD: The patient with daily headaches. | Maizels | South African ...

    African Journals Online (AJOL)

    South African Family Practice. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 47, No 10 (2005) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your ...

  3. Pressure Ulcers in Critically Ill Patients | Sanusi | African Journal of ...

    African Journals Online (AJOL)

    African Journal of Anaesthesia and Intensive Care. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 15, No 1 (2015) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. DOWNLOAD FULL TEXT Open Access ...

  4. Serum 25-hydroxyvitamin D in a West African population of tuberculosis patients and unmatched healthy controls

    DEFF Research Database (Denmark)

    Wejse, Christian; Olesen, Rikke; Rabna, Paulo

    2007-01-01

    BACKGROUND: Little is known regarding vitamin D deficiency (VDD) in African populations and in tuberculosis (TB) patients. VDD has been shown to be associated with TB. OBJECTIVE: We aimed to compare the degree of vitamin D insufficiency (VDI) and VDD in TB patients and healthy adult controls...... in a West African population. DESIGN: An unmatched case-control study was performed at a Demographic Surveillance Site in Guinea-Bissau. Serum 25-hydroxyvitamin D(3) [25(OH)D(3)] concentrations were measured in 362 TB patients and in 494 controls. RESULTS: Hypovitaminosis D [25(OH)D(3) Udgivelsesdato: 2007...

  5. Youth citizenship, national unity and poverty alleviation: East and West African approaches to the education of a new generation

    OpenAIRE

    Arnot, Madeleine; Casely-Hayford, Leslie; Wainaina, Paul K.; Chege, Fatuma; Dovie, Delali A.

    2009-01-01

    Youth citizenship is now on the international agenda. This paper explores what that concept might mean in the context of two African nations: Kenya and Ghana. Post independence, both countries focused on rethinking the colonial concept of citizenship in line with their political-cultural traditions, providing education for all youth and to encouraging new notions of national citizenship. Programmes for civic education were established that have been reshaped over the last fifty years. These c...

  6. African American women and prenatal care: perceptions of patient-provider interaction.

    Science.gov (United States)

    Dahlem, Chin Hwa Y; Villarruel, Antonia M; Ronis, David L

    2015-02-01

    Poor patient-provider interaction among racial/ethnic minorities is associated with disparities in health care. In this descriptive, cross-sectional study, we examine African American women's perspectives and experiences of patient-provider interaction (communication and perceived discrimination) during their initial prenatal visit and their influences on perceptions of care received and prenatal health behaviors. Pregnant African American women (n = 204) and their providers (n = 21) completed a pre- and postvisit questionnaire at the initial prenatal visit. Women were also interviewed face to face at the subsequent return visit. Women perceived high quality patient-provider communication (PPC) and perceived low discrimination in their interaction with providers. Multiple regression analyses showed that PPC had a positive effect on trust in provider (p prenatal care satisfaction (p prenatal health behaviors. Findings suggest that quality PPC improves the prenatal care experience for African American women. © The Author(s) 2014.

  7. GEOTHERM programme supports geothermal energy world-wide. Geothermal energy, a chance for East African countries; GEOTHERM: BGR foerdert weltweit Nutzung geothermischer Energie. Geothermie - eine Chance fuer ostafrikanische Laender

    Energy Technology Data Exchange (ETDEWEB)

    Kraml, M.; Kessels, K.; Kalberkamp, U.; Ochmann, N.; Stadtler, C. [Bundesanstalt fuer Geowissenschaften und Rohstoffe (BGR), Hannover (Germany)

    2007-02-15

    The high geothermal potential of East Africa, especially of the Eastern Rift, is known for a long time. Since these pioneer studies, geothermal plants have been constructed at three sites in East Africa. Nevertheless, up to now geothermal has been a success story only in Kenya. The steam power plant Olkaria I in Kenya is running reliability since 25 years. Today, the country produces more than 12% of its electricity from geothermal. Now, Eritrea, Djibouti, Uganda, Tanzania and Ethiopia which are also situated along the East African Rift, are planning similar projects. The countries need to develop new energy sources because oil prices have reached a critical level. In the past, hydro power was regarded to be a reliable source of energy, but increased droughts changed the situation. Thus, the african states are searching for alternatives to be able to stabilise their energy supply and to cover the growing energy demand. There is much hope that the success of the Kenyan geothermal power plants will be repeated in the neighbouring countries. The East African countries have joined their forces to give impetus to the use of the regional geothermal resources. On behalf of the Federal Ministry for Economic Cooperation and Development, the Federal Institute for Geosciences and Natural Resources supports the countries in realising their plans as part of the GEOTHERM Programme. Together with further donors (Iceland, France, USA, Global Environment Facility) the path will be paved for geothermal power plants in the above mentioned six East African countries. The following main steps are necessary: - Awareness raising of political decision makers about the advantages of including geothermal into the national power plans - Improvement of knowledge about potentials geothermal sites - Development of a regional equipment pool including the necessary geophysical equipment, laboratories, etc. - Training in geothermal exploration and plant maintenance, to minimise risks of site

  8. JUNCTOPHILIN 3 (JPH3) EXPANSION MUTATIONS CAUSING HUNTINGTON DISEASE LIKE 2 (HDL2) ARE COMMON IN SOUTH AFRICAN PATIENTS WITH AFRICAN ANCESTRY AND A HUNTINGTON DISEASE PHENOTYPE

    Science.gov (United States)

    Krause, A; Mitchell, CL; Essop, F; Tager, S; Temlett, J; Stevanin, G; Ross, CA; Rudnicki, DD; Margolis, RL

    2015-01-01

    Huntington disease (HD) is a progressive autosomal dominant neurodegenerative disorder, characterized by abnormal movements, cognitive decline and psychiatric symptoms, caused by a CAG repeat expansion in the huntingtin (HTT) gene on chromosome 4p. A CAG/CTG repeat expansion in the junctophilin-3 (JPH3) gene on chromosome 16q24.2 causes a Huntington disease-like phenotype (HDL2). All patients to date with HDL2 have some African ancestry. The present study aimed to characterize the genetic basis of the Huntington disease phenotype in South Africans and to investigate the possible origin of the JPH3 mutation. In a sample of unrelated South African individuals referred for diagnostic HD testing, 62% (106/171) of white patients compared to only 36% (47/130) of black patients had an expansion in HTT. However, 15% (20/130) of black South African patients and no white patients (0/171) had an expansion in JPH3, confirming the diagnosis of Huntington disease like 2 (HDL2). Individuals with HDL2 share many clinical features with individuals with HD and are clinically indistinguishable in many cases, although the average age of onset and diagnosis in HDL2 is 5 years later than HD and individual clinical features may be more prominent. HDL2 mutations contribute significantly to the HD phenotype in South Africans with African ancestry. JPH3 haplotype studies in 31 families, mainly from South Africa and North America, provide evidence for a founder mutation and support a common African origin for all HDL2 patients. Molecular testing in individuals with an HD phenotype and African ancestry should include testing routinely for JPH3 mutations. PMID:26079385

  9. African Journals Online (AJOL)

    African Journals Online (AJOL)

    reviewed, African-published scholarly journals. Historically, scholarly information has flowed from North to South and from West to East. It has also been difficult for African researchers to access the work of other African academics. In partnership with ...

  10. Palliative Care Physicians' Attitudes Toward Patient Autonomy and a Good Death in East Asian Countries.

    Science.gov (United States)

    Morita, Tatsuya; Oyama, Yasuhiro; Cheng, Shao-Yi; Suh, Sang-Yeon; Koh, Su Jin; Kim, Hyun Sook; Chiu, Tai-Yuan; Hwang, Shinn-Jang; Shirado, Akemi; Tsuneto, Satoru

    2015-08-01

    Clarification of the potential differences in end-of-life care among East Asian countries is necessary to provide palliative care that is individualized for each patient. The aim was to explore the differences in attitude toward patient autonomy and a good death among East Asian palliative care physicians. A cross-sectional survey was performed involving palliative care physicians in Japan, Taiwan, and Korea. Physicians' attitudes toward patient autonomy and physician-perceived good death were assessed. A total of 505, 207, and 211 responses were obtained from Japanese, Taiwanese, and Korean physicians, respectively. Japanese (82%) and Taiwanese (93%) physicians were significantly more likely to agree that the patient should be informed first of a serious medical condition than Korean physicians (74%). Moreover, 41% and 49% of Korean and Taiwanese physicians agreed that the family should be told first, respectively; whereas 7.4% of Japanese physicians agreed. Physicians' attitudes with respect to patient autonomy were significantly correlated with the country (Japan), male sex, physician specialties of surgery and oncology, longer clinical experience, and physicians having no religion but a specific philosophy. In all 12 components of a good death, there were significant differences by country. Japanese physicians regarded physical comfort and autonomy as significantly more important and regarded preparation, religion, not being a burden to others, receiving maximum treatment, and dying at home as less important. Taiwanese physicians regarded life completion and being free from tubes and machines as significantly more important. Korean physicians regarded being cognitively intact as significantly more important. There are considerable intercountry differences in physicians' attitudes toward autonomy and physician-perceived good death. East Asia is not culturally the same; thus, palliative care should be provided in a culturally acceptable manner for each country

  11. Molecular markers of anti-malarial drug resistance in Central, West and East African children with severe malaria

    OpenAIRE

    Nguetse, Christian N.; Adegnika, Ayola Akim; Agbenyega, Tsiri; Ogutu, Bernhards R.; Krishna, Sanjeev; Kremsner, Peter G.; Velavan, Thirumalaisamy P.

    2017-01-01

    BACKGROUND: The Plasmodium falciparum multidrug resistance 1 (PfMDR1), P. falciparum Ca(2+)-ATPase (PfATP6) and Kelch-13 propeller domain (PfK13) loci are molecular markers of parasite susceptibility to anti-malarial drugs. Their frequency distributions were determined in the isolates collected from children with severe malaria originating from three African countries. METHODS: Samples from 287 children with severe malaria [(Gabon: n = 114); (Ghana: n = 89); (Kenya: n = 84)] were genotyped fo...

  12. African migrant patients' trust in Chinese physicians: a social ecological approach to understanding patient-physician trust.

    Science.gov (United States)

    McLaughlin, Megan M; Simonson, Louis; Zou, Xia; Ling, Li; Tucker, Joseph D

    2015-01-01

    Patient trust in physicians is a critical determinant of health seeking behaviors, medication adherence, and health outcomes. A crisis of interpersonal trust exists in China, extending throughout multiple social spheres, including the healthcare system. At the same time, with increased migration from Africa to China in the last two decades, Chinese physicians must establish mutual trust with an increasingly diverse patient population. We undertook a qualitative study to identify factors affecting African migrants' trust in Chinese physicians and to identify potential mechanisms for promoting trust. We conducted semi-structured, in-depth interviews with 40 African migrants in Guangzhou, China. A modified version of the social ecological model was used as a theoretical framework. At the patient-physician level, interpersonal treatment, technical competence, perceived commitment and motive, and language concordance were associated with enhanced trust. At the health system level, two primary factors influenced African migrants' trust in their physicians: the fee-for-service payment system and lack of continuity with any one physician. Patients' social networks and the broader socio-cultural context of interactions between African migrants and Chinese locals also influenced patients' trust of their physicians. These findings demonstrate the importance of factors beyond the immediate patient-physician interaction and suggest opportunities to promote trust through health system interventions.

  13. African migrant patients' trust in Chinese physicians: a social ecological approach to understanding patient-physician trust.

    Directory of Open Access Journals (Sweden)

    Megan M McLaughlin

    Full Text Available Patient trust in physicians is a critical determinant of health seeking behaviors, medication adherence, and health outcomes. A crisis of interpersonal trust exists in China, extending throughout multiple social spheres, including the healthcare system. At the same time, with increased migration from Africa to China in the last two decades, Chinese physicians must establish mutual trust with an increasingly diverse patient population. We undertook a qualitative study to identify factors affecting African migrants' trust in Chinese physicians and to identify potential mechanisms for promoting trust.We conducted semi-structured, in-depth interviews with 40 African migrants in Guangzhou, China. A modified version of the social ecological model was used as a theoretical framework. At the patient-physician level, interpersonal treatment, technical competence, perceived commitment and motive, and language concordance were associated with enhanced trust. At the health system level, two primary factors influenced African migrants' trust in their physicians: the fee-for-service payment system and lack of continuity with any one physician. Patients' social networks and the broader socio-cultural context of interactions between African migrants and Chinese locals also influenced patients' trust of their physicians.These findings demonstrate the importance of factors beyond the immediate patient-physician interaction and suggest opportunities to promote trust through health system interventions.

  14. What role does African ancestry play in how hypertensive patients respond to certain antihypertensive drug therapy?

    Science.gov (United States)

    Seedat, Yackoob K; Brewster, Lizzy M

    2014-02-01

    This article is a summary of the response of the four commonly used antihypertensive agents in African ancestry patients. They are thiazide like diuretics or indapamide, calcium channel blockers (CCB), angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers, and β-adrenergic blockers (ARB). Response was superior in African ancestry patients on a thiazide like diuretic or indapamide and CCB, while the response to β-adrenergic blockers and ACEI are attenuated. Available data are very limited but self-defined ancestry seems to be the best predictor of individual responses to antihypertensive drugs. Knowledge of the factors like economic and social consideration affect the lower rate of detection, treatment and control of hypertension in the African ancestry population of the USA. For regions in which health care resources are particularly scarce, investment in population-based primary prevention strategies may yield the largest benefit.

  15. Geology and metallogeny of the Ar Rayn terrane, eastern Arabian shield: Evolution of a Neoproterozoic continental-margin arc during assembly of Gondwana within the East African orogen

    Science.gov (United States)

    Doebrich, J.L.; Al-Jehani, A. M.; Siddiqui, A.A.; Hayes, T.S.; Wooden, J.L.; Johnson, P.R.

    2007-01-01

    characteristics of the Ar Rayn terrane are analogous to the Andean continental margin of Chile, with opposite subduction polarity. The Ar Rayn terrane represents a continental margin arc that lay above a west-dipping subduction zone along a continental block represented by the Afif composite terrane. The concentration of epithermal, porphyry Cu and IOCG mineral systems, of central arc affiliation, along the AAF suggests that the AAF is not an ophiolitic suture zone, but originated as a major intra-arc fault that localized magmatism and mineralization. West-directed oblique subduction and ultimate collision with a land mass from the east (East Gondwana?) resulted in major transcurrent displacement along the AAF, bringing the eastern part of the arc terrane to its present exposed position, juxtaposed across the AAF against a back-arc basin assemblage represented by the Abt schist of the Ad Dawadimi terrane. Our findings indicate that arc formation and accretionary processes in the Arabian shield were still ongoing into the latest Neoproterozoic (Ediacaran), to about 620-600 Ma, and lead us to conclude that evolution of the Ar Rayn terrane (arc formation, accretion, syn- to postorogenic plutonism) defines a final stage of assembly of the Gondwana supercontinent along the northeastern margin of the East African orogen. ?? 2007 Elsevier B.V. All rights reserved.

  16. Land - Ocean Climate Linkages and the Human Evolution - New ICDP and IODP Drilling Initiatives in the East African Rift Valley and SW Indian Ocean

    Science.gov (United States)

    Zahn, R.; Feibel, C.; Co-Pis, Icdp/Iodp

    2009-04-01

    The past 5 Ma were marked by systematic shifts towards colder climates and concomitant reorganizations in ocean circulation and marine heat transports. Some of the changes involved plate-tectonic shifts such as the closure of the Panamanian Isthmus and restructuring of the Indonesian archipelago that affected inter-ocean communications and altered the world ocean circulation. These changes induced ocean-atmosphere feedbacks with consequences for climates globally and locally. Two new ICDP and IODP drilling initiatives target these developments from the perspectives of marine and terrestrial palaeoclimatology and the human evolution. The ICDP drilling initiative HSPDP ("Hominid Sites and Paleolakes Drilling Project"; ICDP ref. no. 10/07) targets lacustrine depocentres in Ethiopia (Hadar) and Kenya (West Turkana, Olorgesailie, Magadi) to retrieve sedimentary sequences close to the places and times where various species of hominins lived over currently available outcrop records. The records will provide a spatially resolved record of the East African environmental history in conjunction with climate variability at orbital (Milankovitch) and sub-orbital (ENSO decadal) time scales. HSPDP specifically aims at (1) compiling master chronologies for outcrops around each of the depocentres; (2) assessing which aspects of the paleoenvironmental records are a function of local origin (hydrology, hydrogeology) and which are linked with regional or larger-scale signals; (3) correlating broad-scale patterns of hominin phylogeny with the global beat of climate variability and (4) correlating regional shifts in the hominin fossil and archaeological record with more local patterns of paleoenvironmental change. Ultimately the aim is to test hypotheses that link physical and cultural adaptations in the course of the hominin evolution to local environmental change and variability. The IODP initiative SAFARI ("Southern African Climates, Agulhas Warm Water Transports and Retroflection

  17. Crustal and mantle structure and anisotropy beneath the incipient segments of the East African Rift System: Preliminary results from the ongoing SAFARI

    Science.gov (United States)

    Yu, Y.; Reed, C. A.; Gao, S. S.; Liu, K. H.; Massinque, B.; Mdala, H. S.; moidaki, M.; Mutamina, D. M.; Atekwana, E. A.; Ingate, S. F.; Reusch, A.; Barstow, N.

    2013-12-01

    Despite the vast wealth of research conducted toward understanding processes associated with continental rifting, the extent of our knowledge is derived primarily from studies focused on mature rift systems, such as the well-developed portions of the East African Rift System (EARS) north of Lake Malawi. To explore the dynamics of early rift evolution, the SAFARI (Seismic Arrays for African Rift Initiation) team deployed 50 PASSCAL broadband seismic stations across the Malawi, Luangwa, and Okavango rifts of the EARS during the summer of 2012. The cumulative length of the profiles is about 2500 km and the planned recording duration is 2 years. Here we present the preliminary results of systematic analyses of data obtained from the first year of acquisition for all 50 stations. A total of 446 high-quality shear-wave splitting measurements using PKS, SKKS, and SKS phases from 84 teleseismic events were used to constrain fast polarization directions and splitting times throughout the region. The Malawi and Okavango rifts are characterized by mostly NE trending fast directions with a mean splitting time of about 1 s. The fast directions on the west side of the Luangwa Rift Zone are parallel to the rift valley, and those on the east side are more N-S oriented. Stacking of approximately 1900 radial receiver functions reveals significant spatial variations of both crustal thickness and the ratio of crustal P and S wave velocities, as well as the thickness of the mantle transition zone. Stations situated within the Malawi rift demonstrate a southward increase in observed crustal thickness, which is consistent with the hypothesis that the Malawi rift originated at the northern end of the rift system and propagated southward. Both the Okavango and Luangwa rifts are associated with thinned crust and increased Vp/Vs, although additional data is required at some stations to enhance the reliability of the observations. Teleseismic P-wave travel-time residuals show a delay of about

  18. A new fossil cichlid from the Middle Miocene in the East African Rift Valley (Tugen Hills, Central Kenya: First record of a putative Ectodini

    Directory of Open Access Journals (Sweden)

    Melanie Altner

    2015-11-01

    Full Text Available Identification of fossil cichlids is difficult, because the currently used diagnostic morphological characters for living cichlids are mostly soft tissue based and such characters are hardly preserved in fossils. During our recent fieldwork in the Central Kenya Rift (E-Africa, we discovered several exceptionally well-preserved fossil cichlids, which can be assigned to different lineages among the African Pseudocrenilabrinae. Here we present one of those new specimens. Its most conspicuous character is a lateral line divided into three segments. This specimen was found in the lacustrine sediments of the Middle Miocene site Waril, Tugen Hills, Kenya. The site represents the deposits of an ancient freshwater lake ca. 9-10 million years ago. Previous work on fossil leaves from the same site allow for the reconstruction of open vegetation surrounding the lake and pronounced dry seasons. Among the main further characteristics of the new fossil cichlid is a lachrimal with six lateral line canals, big cycloid scales and a low number of dorsal fin spines (XIII. The latter two characters are traceable in several members of tribes within the Pseudocrenilabrinae. However, a lachrimal with six lateral line canals is exclusively found in certain tribes of the EAR (East African Radiation within the Pseudocrenilabrinae. Moreover, the unique lateral line pattern is solely present in two genera of the EAR tribe Ectodini. However, the fossil shows cycloid scales, while modern Ectodini have ctenoid scales. Taken all evidence together, this fossil may perhaps represent an ancient lineage related to the Ectodini. Up to date, there is no definite fossil record of the members of the EAR. Our fossil may represent the first reliable calibration point for this group, which would be consistent with the previously reconstructed diversification time of the H-lineage (EAR tribes, except Boulengerochromini, Bathybatini, Trematocarini and Lamprologini and the Lamprologini ca

  19. Influenza vaccination in patients with diabetes: disparities in prevalence between African Americans and Whites

    Directory of Open Access Journals (Sweden)

    Athamneh LN

    2014-06-01

    Full Text Available Background: Patients with diabetes who contract influenza are at higher risk of complications, such as hospitalization and death. Patients with diabetes are three times more likely to die from influenza complications than those without diabetes. Racial disparities among patients with diabetes in preventive health services have not been extensively studied. Objective: To compare influenza vaccination rates among African Americans and Whites patients with diabetes and investigate factors that might have an impact on racial disparities in the receipt of influenza vaccinations. Methods: A secondary data analysis of 47,283 (unweighted patients with diabetes from the 2011 Behavioral Risk Factor Surveillance System survey (BRFSS (15,902,478 weighted was performed. The survey respondents were asked whether they received an influenza vaccination in the last twelve months. We used logistic regression to estimate the odds of receiving the influenza vaccine based on race. Results: The results indicated a significantly lower proportion of African Americans respondents (50% reported receiving the influenza vaccination in the last year when compared with Whites respondents (61%. Age, gender, education, health care coverage, health care cost, and employment status were found to significantly modify the effect of race on receiving the influenza vaccination. Conclusions: This study found a significant racial disparity in influenza vaccination rates in adults with diabetes with higher rates in Whites compared to African Americans individuals. The public health policies that target diabetes patients in general and specifically African Americans in the 65+ age group, women, and homemakers, may be necessary to diminish the racial disparity in influenza vaccination rates between African Americans and Whites diabetics.

  20. EAST/SeSAME syndrome - review of the literature and introduction of four new Latvian patients.

    Science.gov (United States)

    Marta, C; Ieva, M; Inna, I; Mareta, A; Sandra, K; Pereca, J; Janis, S; Dita, P; Jurgis, S

    2018-05-03

    EAST (Epilepsy, Ataxia, Sensorineural deafness, Tubulopathy) or SeSAME (Seizures, Sensorineural deafness, Ataxia, Mental retardation, and Electrolyte imbalance) syndrome is a rare autosomal recessive syndrome first described in 2009 independently by Bockenhauer and Scholl. It is caused by mutations in KCNJ10, which encodes Kir4.1, an inwardly rectifying K + channel found in the brain, inner ear, kidney and eye. To date, 16 mutations in at least 28 patients have been reported. In this paper, we review mutations causing EAST/SeSAME syndrome, clinical manifestations in detail, and efficacy of treatment in previously reported patients. We also report a new Latvian kindred with four patients. In contrast to the majority of previous reports, we found a progressive course of the disorder in terms of hearing impairment and neurologic deficit. The treatment is based on antiepileptic drugs, electrolyte replacement, hearing aids and mobility devices. Future research should concentrate on recognizing the lesions in the central nervous system to evaluate new potential diagnostic criteria and on formally evaluating intellectual disability. This article is protected by copyright. All rights reserved.

  1. What role does African ancestry play in how hypertensive patients respond to certain antihypertensive drug therapy?

    NARCIS (Netherlands)

    Seedat, Yackoob K.; Brewster, Lizzy M.

    2014-01-01

    This article is a summary of the response of the four commonly used antihypertensive agents in African ancestry patients. They are thiazide like diuretics or indapamide, calcium channel blockers (CCB), angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers, and β-adrenergic

  2. Patient Characteristics and Treatment Outcomes for African American, Hispanic, and White Adolescents in DATOS-A.

    Science.gov (United States)

    Rounds-Bryant, Jennifer L.; Staab, Jennifer

    2001-01-01

    Compared background, pre-treatment characteristics, and post-treatment outcomes of African American, Hispanic, and white adolescent substance abusers participating in the Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A). Found that patients were similar with respect to basic pre-treatment demographics. Compared to white adolescents,…

  3. Is the Okavango Delta the terminus of the East African Rift System? Towards a new geodynamic model: Geodetic study and geophysical review

    Science.gov (United States)

    Pastier, Anne-Morwenn; Dauteuil, Olivier; Murray-Hudson, Michael; Moreau, Frédérique; Walpersdorf, Andrea; Makati, Kaelo

    2017-08-01

    The Okavango Graben (OG) has been considered as the terminus of the southwestern branch of the East African Rift System (EARS) since the 1970s based on fault morphology and early seismic and geophysical data. Thus it has been assumed to be an incipient rifting zone, analogous to the early stage of mature rifts in the EARS. Recent geodetic data and geophysical studies in the area bring new insights into the local crust and lithosphere, mantle activity and fault activity. In this study, we computed the velocities for three permanent GPS stations surrounding the graben and undertook a review of the new geophysical data available for the area. The northern and southern blocks of the graben show an exclusively low strike-slip displacement rate of about 1mm/year, revealing the transtensional nature of this basin. The seismic record of central and southern Africa was found to be instrumentally biased for the events recorded before 2004 and the OG may not represent the most seismically active area in Botswana anymore. Moreover, no significant lithosphere and crustal thinning is found in the tectonic structure nor any strong negative Bouguer anomaly and surface heat flux. Thus the OG does not match the classical model for a rifting zone. We propose a new geodynamic model for the deformation observed west of the EARS based on accommodation of far-field deformation due to the differential extension rates of the EARS and the displacement of the Kalahari craton relative to the Nubian plate.

  4. Fatty acid composition of minced meat, longissimus muscle and omental fat from Small East African goats finished on different levels of concentrate supplementation.

    Science.gov (United States)

    Mushi, D E; Thomassen, M S; Kifaro, G C; Eik, L O

    2010-10-01

    Effects of supplementing Small East African (SEA) goats with concentrate diets on fatty acids composition of minced meat, M. longissimus dorsi (LD) and omental fat were assessed using 23 animals (14.5 months old and 20.1 kg body weight). Goats were subjected to four levels of concentrate supplementation: ad libitum concentrate allowance (T100), 66% (T66), 33% (T33) and 0% (T0) of ad libitum concentrate allowance. All goats were slaughtered after 90 days of experimental period. Minced meat from concentrate-supplemented goats had higher (Pmeat from T00 and T66 goats had similar proportions of polyunsaturated fatty acids (PUFA) and n-6 PUFA that were higher (Pgoats whereas margaric and arachidonic acids were in higher (Pgoats. Overall, LD was associated with PUFA, omental fat with saturated fatty acids (SFA), minced meat with MUFA. It is concluded that finishing SEA goats on concentrate diets will increase the proportion of DFA in meat from them. In addition, the proportion of PUFA in meat from such goats will peak at concentrate supplementation equivalent to 66% of their ad libitum intake. Consumers should avoid high intake of internal fat due to their richness in SFA. Copyright (c) 2010 The American Meat Science Association. Published by Elsevier Ltd. All rights reserved.

  5. HLA-A29-POSITIVE BIRDSHOT CHORIORETINOPATHY IN AN AFRICAN AMERICAN PATIENT.

    Science.gov (United States)

    Knezevic, Alexander; Munk, Marion R; Pappas, Frankie; Merrill, Pauline T; Goldstein, Debra A

    2016-01-01

    To report the first documented case of HLA-A29-positive birdshot chorioretinopathy in an African American patient. A 51-year-old African American woman presented with a 10-year history of photopsia, progressive decrease in visual acuity, metamorphopsia, and new nyctalopia. Both fundi showed evidence of periphlebitis, arterial attenuation, macular edema, and diffuse chorioretinal atrophy. Fluorescein angiography revealed diffuse vascular leakage, and indocyanine green showed evenly distributed and symmetrical hypofluorescent spots, which were difficult to appreciate on fundoscopy. Workup revealed a positive HLA-A29 and was negative for sarcoid, tuberculosis, and syphilis. Birdshot chorioretinopathy overwhelmingly affects non-Hispanic Caucasians, but there have been rare reported cases in other ethnicities including Hispanics and African Americans. This patient's ethnicity may have contributed to the 10-year delay in diagnosis. To our knowledge, this is the first documented HLA-A29 positive case of birdshot chorioretinopathy in an African American. HLA-A29 may be a useful supportive test in cases with classic clinical presentation in non-Caucasian patients to enable the correct diagnose in a timely manner.

  6. African American patients' attitudes toward proactive health behaviors after exposure to direct-to-consumer advertising.

    Science.gov (United States)

    Yang, Yi; Gourley, Dick R; Gourley, Greta A; Faris, Richard J; Womeodu, Robin J; Yang, Jun; Likens, Carol C

    2010-05-01

    Previous research on direct-to-consumer advertising (DTCA) has not focused exclusively on the African American population. The purpose of this study was to explore African Americans' attitudes toward proactive health behaviors following exposure to DTCA of atorvastatin calcium (Lipitor, Pfizer Inc). One-hundred fifty African American patients participated in the study. Participants' functional health literacy and health locus of control were assessed. The participants were asked to view a DTCA of Lipitor, followed by face-to-face interviews. After watching the DTCA of Lipitor, 89.4% of participants agreed that they would talk to their physician about their cholesterol, 88.6% agreed that they would ask their physician to test their cholesterol level, and 47.3% agreed that they would ask their physician to write them a prescription for Lipitor. Those who had a history of high cholesterol were more likely to agree to ask their physician to test their cholesterol levels. Low household income, having public health insurance, and prior experience with taking Lipitor were significant positive predictors of patients agreeing to ask their physician to write a prescription of the advertised drug. African American patients showed favorable attitudes toward proactive health behaviors after exposure to DTCA of Lipitor.

  7. Serum lipid profile of newly diagnosed hypertensive patients in nnewi, South-East Nigeria.

    Science.gov (United States)

    Osuji, Charles U; Omejua, Emeka G; Onwubuya, Emmanuel I; Ahaneku, Gladys I

    2012-01-01

    Abnormalities in serum lipid and lipoprotein levels are recognized major modifiable cardiovascular disease and essential hypertension risk factors. The objective of this study was to examine the serum lipid patterns of newly diagnosed hypertensive patients attending a tertiary healthcare centre in South East Nigeria. Methods. Two hundred and fifty newly diagnosed adult hypertensive patients and an equal number of age- and sex-matched controls without hypertension were consecutively recruited from the Medical and General Outpatient Clinics of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Result. 126 males and 124 females were in each of the two groups. Mean age was comparable in both groups. Hypertensives had significantly higher mean systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, waist-hip ratio, and fasting blood sugar than the controls. The mean TC, TG, and LDL-C were significantly higher among the hypertensives. The mean HDL-C was comparable; P = 0.8. Among the hypertensive subjects, there was statistically significant positive correlation between BMI and TC; LDL-C and TG; WC and TG; FBS and TC; LDL-C and TG. HDL-C showed a statistically significant inverse correlation with WHR in hypertensives. Conclusion. This study showed that lipid abnormalities are highly prevalent among newly diagnosed hypertensives in South-East Nigeria.

  8. Hepatitis C virus Genotypes in Patients with End-Stage Renal Disease in East Azerbaijan, Iran

    Directory of Open Access Journals (Sweden)

    Somi Mohammad

    2008-01-01

    Full Text Available Information about the genotypes and associated risk factors in hepatitis C virus (HCV infected patients in Iran is limited. The aim of this study was to identify the HCV genotypes and associated risk factors in a group of HCV infected patients on dialysis therapy in Iran. The sera of 753 patients with chronic renal failure from fifteen dialysis units in East Azerbaijan Province were screened for anti-HCV antibodies as well as HCV RNA; viral RNA was extracted for the genotype specific primer approach. Patients were questioned concerning documented risk factors. Genotyping analysis was performed in 55 patients with positive anti-HCV and HCV-RNA. Genotypes 1 and 3 were found in 46 (83.7% and three (5.5% patients, respectively. The most frequent HCV subtype was 1a (76.4%, followed by 3a and 1b and 1b (5.5% each while one patient was infected with both 1a and 1b. There was no statistically significant difference between the risk factors analyzed and the acqui-sition of HCV infection. This study gives added evidence of the predominant HCV genotypes in Iran, which is different than reports from other Arab countries and similar with the pattern of genotype in both Europe and United States.

  9. Innovative solutions for intractable water problems in the face of climate change in southern and East African sub regions

    Science.gov (United States)

    Mapani, Benjamin; Makurira, Hodson; Magole, Lapologang; Meck, Maideyi; Mkandawire, Theresa; Mul, Marloes; Ngongondo, Cosmo

    2018-06-01

    This issue has a total of thirty-two (32) papers; and covers the IWRM sub themes of Hydrology, Land and People, Water Resources Management, Water and Environment and Wastewater and Sanitation. Water issues have become more and more complex as the supply side is affected by issues of quantity, availability and vulnerability due to natural factors such as climate change and urbanization. These challenges call for new management strategies and governance styles. Access to clean freshwater is a basic requirement for enhanced quality of life and development by all. However, this access has three main components that must be met adequately as this issue illustrates. These components are firstly, the quantity of water available; secondly, the quality and thirdly supply and appropriate delivery of this precious resource to domestic, commercial and industrial users. The demand side has also become more challenging, especially in urban areas as more and more people move from the rural areas to the cities. It has become a daily challenge in many African cities to supply water to these new urban dwellers and more so in unplanned settlements. These issues require a way and manner of delivering solutions and new innovative ideas. The topics in this issue vary from climate variability and how we are to improve our management strategies to mitigation, through to vulnerability of water resources and how to strengthen governance issues that plague some institutions in our region.

  10. The Integrated Genomic Architecture and Evolution of Dental Divergence in East African Cichlid Fishes (Haplochromis chilotes x H. nyererei

    Directory of Open Access Journals (Sweden)

    C. Darrin Hulsey

    2017-09-01

    Full Text Available The independent evolution of the two toothed jaws of cichlid fishes is thought to have promoted their unparalleled ecological divergence and species richness. However, dental divergence in cichlids could exhibit substantial genetic covariance and this could dictate how traits like tooth numbers evolve in different African Lakes and on their two jaws. To test this hypothesis, we used a hybrid mapping cross of two trophically divergent Lake Victoria species (Haplochromis chilotes × Haplochromis nyererei to examine genomic regions associated with cichlid tooth diversity. Surprisingly, a similar genomic region was found to be associated with oral jaw tooth numbers in cichlids from both Lake Malawi and Lake Victoria. Likewise, this same genomic location was associated with variation in pharyngeal jaw tooth numbers. Similar relationships between tooth numbers on the two jaws in both our Victoria hybrid population and across the phylogenetic diversity of Malawi cichlids additionally suggests that tooth numbers on the two jaws of haplochromine cichlids might generally coevolve owing to shared genetic underpinnings. Integrated, rather than independent, genomic architectures could be key to the incomparable evolutionary divergence and convergence in cichlid tooth numbers.

  11. Fertility Intentions, Pregnancy, and Use of PrEP and ART for Safer Conception Among East African HIV Serodiscordant Couples.

    Science.gov (United States)

    Heffron, Renee; Thomson, Kerry; Celum, Connie; Haberer, Jessica; Ngure, Kenneth; Mugo, Nelly; Bukusi, Elizabeth; Katabira, Elly; Odoyo, Josephine; Bulya, Nulu; Asiimwe, Stephen; Tindimwebwa, Edna; Baeten, Jared M

    2017-09-11

    African HIV serodiscordant couples often desire pregnancy, despite sexual HIV transmission risk during pregnancy attempts. Pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) reduce HIV risk and can be leveraged for safer conception but how well these strategies are used for safer conception is not known. We conducted an open-label demonstration project of the integrated delivery of PrEP and ART among 1013 HIV serodiscordant couples from Kenya and Uganda followed quarterly for 2 years. We evaluated fertility intentions, pregnancy incidence, the use of PrEP and ART during peri-conception, and peri-conception HIV incidence. At enrollment, 80% of couples indicated a desire for more children. Pregnancy incidence rates were 18.5 and 18.7 per 100 person years among HIV-uninfected and HIV-infected women, and higher among women who recently reported fertility intention (adjusted odds ratio 3.43, 95% CI 2.38-4.93) in multivariable GEE models. During the 6 months preceding pregnancy, 82.9% of couples used PrEP or ART and there were no HIV seroconversions. In this cohort with high pregnancy rates, integrated PrEP and ART was readily used by HIV serodiscordant couples, including during peri-conception periods. Widespread scale-up of safer conception counseling and services is warranted to respond to strong desires for pregnancy among HIV-affected men and women.

  12. Poaching and human encroachment reverse recovery of African savannah elephants in south-east Angola despite 14 years of peace

    Science.gov (United States)

    Chase, Michael J.; Griffin, Curtice R.

    2018-01-01

    With populations of African savannah elephants (Loxodonta africana) declining across the continent, assessing the status of individual elephant populations is important for conservation. Angola’s elephant population represents a key linkage between the larger populations of Namibia and Botswana. Elephants in Angola were decimated during the 1975–2002 Angolan civil war, but a 2005 survey showed that populations were recolonizing former habitats. Between 2005 and 2015, no research was permitted on elephants in Angola, but elsewhere in Africa many elephant populations experienced a poaching crisis. In 2015, we were able to resume elephant research in Angola. We used aerial surveys and satellite monitoring of collared elephants to determine the current status of elephant populations in Angola and to learn how human populations may be affecting elephant habitat usage. The aerial survey revealed a population of 3,395 ± SE of 797 elephants, but populations had declined 21% from the 2005 estimate. The high number of carcasses observed on the survey suggests that populations may have increased after the 2005 survey but were declining rapidly as of 2015. Satellite-collared elephants avoided areas elephants from preferred habitats near rivers. Taken together, these results suggest that Angola’s elephant population is experiencing intense poaching and may be losing habitat to human settlements. Without action to conserve their populations, Angola’s elephants face an uncertain future. PMID:29538387

  13. Comparison of the reorganisations of BP and Shell and possible opportunities for Middle East and North African Oil companies

    Energy Technology Data Exchange (ETDEWEB)

    Jenkins, Gilbert

    1999-07-01

    A critical analysis is provided of the recent reorganisations of the downstream and petrochemical activities of BP and Shell. BP (or BP Amoco including Arco) and Shell are preparing for the next decade anticipating the environment and changing the companies to maximise their profitability in that environment. For the oil producing countries of the Middle East and North Africa (MENA), there are lessons to be learned both from the forecasts which BP Amoco and Shell are making and from the way these companies intend to operate. BP Amoco's view of oil refining is that the surplus capacity is endemic; Shell's view is that it is transient. BP Amoco will market oil products selectively across the world; Shell is still intent on a global approach. Both BP Amoco and Shell will minimise their wholesaling activities in the retail market and expand their merchandising with ever better quality sites. In the petrochemicals sector, the companies are taking similar actions, ie concentrating on positions of strength and selling business activities with low market shares or poor profitability. Petrochemical sites will be favoured when they have access to company produced hydrocarbon feedstocks. From the analysis, it is suggested that MENA oil companies will need to consider carefully the timing of any new refinery building. The reorganisation of the major OECD-based oil companies should offer opportunities for MENA companies to secure outlets for LPG and condensates, to form marketing alliances in OECD markets and to become involved in OECD-based petrochemical businesses.

  14. Comparison of the reorganisations of BP and Shell and possible opportunities for Middle East and North African Oil companies

    International Nuclear Information System (INIS)

    Jenkins, Gilbert

    1999-01-01

    A critical analysis is provided of the recent reorganisations of the downstream and petrochemical activities of BP and Shell. BP (or BP Amoco including Arco) and Shell are preparing for the next decade anticipating the environment and changing the companies to maximise their profitability in that environment. For the oil producing countries of the Middle East and North Africa (MENA), there are lessons to be learned both from the forecasts which BP Amoco and Shell are making and from the way these companies intend to operate. BP Amoco's view of oil refining is that the surplus capacity is endemic; Shell's view is that it is transient. BP Amoco will market oil products selectively across the world; Shell is still intent on a global approach. Both BP Amoco and Shell will minimise their wholesaling activities in the retail market and expand their merchandising with ever better quality sites. In the petrochemicals sector, the companies are taking similar actions, ie concentrating on positions of strength and selling business activities with low market shares or poor profitability. Petrochemical sites will be favoured when they have access to company produced hydrocarbon feedstocks. From the analysis, it is suggested that MENA oil companies will need to consider carefully the timing of any new refinery building. The reorganisation of the major OECD-based oil companies should offer opportunities for MENA companies to secure outlets for LPG and condensates, to form marketing alliances in OECD markets and to become involved in OECD-based petrochemical businesses

  15. Geomorphic Response to Spatial and Temporal Tectonic uplift on the Kenya Rift of East African Rift System

    Science.gov (United States)

    Xue, L.; Abdelsalam, M. G.

    2017-12-01

    Tectonic uplifts of the shoulders of the East Africa Rift System (EARS) have significant impact on the geological record by reorganizing drainage systems, increasing sediment supply, and changing climate and biogeography. Recent studies in geochronology, geomorphology and geophysics have provided some understanding of the timing of tectonic uplift and its distribution pattern of the (EARS). We do not know how the vertical motion is localized along the rift axis and the relative roles of upwelling of magma and rift extensional processes play in tectonic uplift history. This work presents detailed morphometric study of the fluvial landscape response to the tectonic uplift and climate shifting of the Kenya Rift shoulders in order to reconstruct their incision history, with special attention to timing, location, and intensity of uplift episodes. This work compiles the Shuttle Radar Topography Mission (SRTM) Digital Elevation Model (DEM) and Sentinel-2A data, summarized previous 39Ar-40Ar and thermochronology data, and calculates long-term incision rate and geomorphic proxies (normalized steepness and chi-integral) along the Kenya Rift. It also models the age of tectonic/climatic events by using knickpoint celerity model and R/SR integrative approach. It found that the maximum long-term incision rates of 300 mm/kyr to be at the central Kenya Rift, possibly related to the mantle-driven process and rapid tectonic uplift. The geomorphic proxies indicate southward decreasing pattern of the short-term incision rate, possibly related to the migration of the mantle plume.

  16. Adult non Hodgkin's lymphoma patients: experience from a tertiary care cancer centre in north east India.

    Science.gov (United States)

    Hazarika, Munlima; Iqbal, Asif; Krishnatreya, Manigreeva; Sharma, Jagannath Dev; Bhuyan, Chidananda; Saikia, Bhargab Jyoti; Roy, Partha Sarathi; Das, Rashmi; Nandy, Pintu; Kataki, Amal Chandra

    2015-01-01

    There is paucity of data on non Hodgkin's lymphoma (NHL) from our population in North-East India. In this retrospective study, patients were consecutively followed-up to see the clinic-pathological pattern of NHL, various responses, and pattern of relapses to first line treatment with chemotherapy. All patients in the present study received standard regimen of cyclophosphamde, doxorubicin, vincristine, prednisolone (CHOP) with or without rituximab (R-CHOP) as per our institutional protocol as first line therapy. Our study has shown that, in our adult population, the majority of NHL cases present with stage II and stage III disease and extra nodal involvement, B-cell lymphomas and diffuse large cell lymphomas being the most common subtypes. International prognostic index was a significant factor for varied responses to treatment. The majority of relapses after complete remission occurred in the first year.

  17. Institutional capacity for health systems research in East and Central African schools of public health: knowledge translation and effective communication.

    Science.gov (United States)

    Ayah, Richard; Jessani, Nasreen; Mafuta, Eric M

    2014-06-02

    Local health systems research (HSR) provides policymakers and practitioners with contextual, evidence-based solutions to health problems. However, producers and users of HSR rarely understand the complexities of the context within which each operates, leading to the "know-do" gap. Universities are well placed to conduct knowledge translation (KT) integrating research production with uptake. The HEALTH Alliance Africa Hub, a consortium of seven schools of public health (SPHs) in East and Central Africa, was formed to build capacity in HSR. This paper presents information on the capacity of the various SPHs to conduct KT activities. In 2011, each member of the Africa Hub undertook an institutional HSR capacity assessment using a context-adapted and modified self-assessment tool. KT capacity was measured by several indicators including the presence of a KT strategy, an organizational structure to support KT activities, KT skills, and institutional links with stakeholders and media. Respondents rated their opinions on the various indicators using a 5-point Likert scale. Averages across all respondents for each school were calculated. Thereafter, each school held a results validation workshop. A total of 123 respondents from all seven SPHs participated. Only one school had a clear KT strategy; more commonly, research was disseminated at scientific conferences and workshops. While most respondents perceived their SPH as having strong institutional ties with organizations interested in HSR as well as strong institutional leadership, the organizational structures required to support KT activities were absent. Furthermore, individual researchers indicated that they had little time or skills to conduct KT. Additionally, institutional and individual links with policymakers and media were reported as weak. Few SPHs in Africa have a clear KT strategy. Strengthening the weak KT capacity of the SPHs requires working with institutional leadership to develop KT strategies designed

  18. Estimating seroprevalence of herpes simplex virus type 1 among different Middle East and North African male populations residing in Qatar

    Science.gov (United States)

    Nasrallah, Gheyath K.; Dargham, Soha R.; Mohammed, Layla I.

    2017-01-01

    HSV‐1 epidemiology in the Middle East and North Africa (MENA) remains poorly understood. Our study aimed to measure HSV‐1 antibody prevalence (seroprevalence) and its age‐distribution among select MENA populations residing in Qatar. Sera were collected from male blood donors attending Hamad Medical Corporation 2013‐2015. A total of 2,077 sera were tested for anti‐HSV‐1 antibodies using HerpeSelect® 1 ELISA IgG kits (Focus Diagnostics, Cypress, CA). Robust Poisson regression was conducted to estimate adjusted infection prevalence ratios. Country‐specific HSV‐1 seroprevalence was estimated for 10 national populations: 97.5% among Egyptians, 92.6% among Yemenis, 90.7% among Sudanese, 88.5% among Syrians, 86.5% among Jordanians, 82.3% among Qataris, 81.4% among Iranians, 81.4% among Lebanese, 80.5% among Palestinians, and 77.0% among Pakistanis. Age‐specific HSV‐1 seroprevalence was estimated for Egypt, the Fertile Crescent (Iraq, Jordan, Lebanon, Palestine, and Syria), and Qatar. Seroprevalence increased with age among Fertile Crescent and Qatari nationals. Seroprevalence increased from 70.0% among those aged ≤ 24 years up to 98.0% among those aged ≥55 years among Fertile Crescent nationals. Seroprevalence was consistently above 90% for all ages among Egyptians. HSV‐1 seroprevalence is high in MENA, though with some variation across countries. The seroprevalence appears to have declined among current young age cohorts compared to its levels a few decades ago. PMID:28817197

  19. Continuous 1.3-million-year record of East African hydroclimate, and implications for patterns of evolution and biodiversity.

    Science.gov (United States)

    Lyons, Robert P; Scholz, Christopher A; Cohen, Andrew S; King, John W; Brown, Erik T; Ivory, Sarah J; Johnson, Thomas C; Deino, Alan L; Reinthal, Peter N; McGlue, Michael M; Blome, Margaret W

    2015-12-22

    The transport of moisture in the tropics is a critical process for the global energy budget and on geologic timescales, has markedly influenced continental landscapes, migratory pathways, and biological evolution. Here we present a continuous, first-of-its-kind 1.3-My record of continental hydroclimate and lake-level variability derived from drill core data from Lake Malawi, East Africa (9-15° S). Over the Quaternary, we observe dramatic shifts in effective moisture, resulting in large-scale changes in one of the world's largest lakes and most diverse freshwater ecosystems. Results show evidence for 24 lake level drops of more than 200 m during the Late Quaternary, including 15 lowstands when water levels were more than 400 m lower than modern. A dramatic shift is observed at the Mid-Pleistocene Transition (MPT), consistent with far-field climate forcing, which separates vastly different hydroclimate regimes before and after ∼800,000 years ago. Before 800 ka, lake levels were lower, indicating a climate drier than today, and water levels changed frequently. Following the MPT high-amplitude lake level variations dominate the record. From 800 to 100 ka, a deep, often overfilled lake occupied the basin, indicating a wetter climate, but these highstands were interrupted by prolonged intervals of extreme drought. Periods of high lake level are observed during times of high eccentricity. The extreme hydroclimate variability exerted a profound influence on the Lake Malawi endemic cichlid fish species flock; the geographically extensive habitat reconfiguration provided novel ecological opportunities, enabling new populations to differentiate rapidly to distinct species.

  20. Institutional capacity for health systems research in East and Central African Schools of Public Health: strengthening human and financial resources

    Science.gov (United States)

    2014-01-01

    Background Despite its importance in providing evidence for health-related policy and decision-making, an insufficient amount of health systems research (HSR) is conducted in low-income countries (LICs). Schools of public health (SPHs) are key stakeholders in HSR. This paper, one in a series of four, examines human and financial resources capacities, policies and organizational support for HSR in seven Africa Hub SPHs in East and Central Africa. Methods Capacity assessment done included document analysis to establish staff numbers, qualifications and publications; self-assessment using a tool developed to capture individual perceptions on the capacity for HSR and institutional dialogues. Key informant interviews (KIIs) were held with Deans from each SPH and Ministry of Health and non-governmental officials, focusing on perceptions on capacity of SPHs to engage in HSR, access to funding, and organizational support for HSR. Results A total of 123 people participated in the self-assessment and 73 KIIs were conducted. Except for the National University of Rwanda and the University of Nairobi SPH, most respondents expressed confidence in the adequacy of staffing levels and HSR-related skills at their SPH. However, most of the researchers operate at individual level with low outputs. The average number of HSR-related publications was only capacity. This study underscores the need to form effective multidisciplinary teams to enhance research of immediate and local relevance. Capacity strengthening in the SPH needs to focus on knowledge translation and communication of findings to relevant audiences. Advocacy is needed to influence respective governments to allocate adequate funding for HSR to avoid donor dependency that distorts local research agenda. PMID:24888371

  1. Two extended haplotype blocks are associated with adaptation to high altitude habitats in East African honey bees.

    Directory of Open Access Journals (Sweden)

    Andreas Wallberg

    2017-05-01

    Full Text Available Understanding the genetic basis of adaption is a central task in biology. Populations of the honey bee Apis mellifera that inhabit the mountain forests of East Africa differ in behavior and morphology from those inhabiting the surrounding lowland savannahs, which likely reflects adaptation to these habitats. We performed whole genome sequencing on 39 samples of highland and lowland bees from two pairs of populations to determine their evolutionary affinities and identify the genetic basis of these putative adaptations. We find that in general, levels of genetic differentiation between highland and lowland populations are very low, consistent with them being a single panmictic population. However, we identify two loci on chromosomes 7 and 9, each several hundred kilobases in length, which exhibit near fixation for different haplotypes between highland and lowland populations. The highland haplotypes at these loci are extremely rare in samples from the rest of the world. Patterns of segregation of genetic variants suggest that recombination between haplotypes at each locus is suppressed, indicating that they comprise independent structural variants. The haplotype on chromosome 7 harbors nearly all octopamine receptor genes in the honey bee genome. These have a role in learning and foraging behavior in honey bees and are strong candidates for adaptation to highland habitats. Molecular analysis of a putative breakpoint indicates that it may disrupt the coding sequence of one of these genes. Divergence between the highland and lowland haplotypes at both loci is extremely high suggesting that they are ancient balanced polymorphisms that greatly predate divergence between the extant honey bee subspecies.

  2. Using High-Resolution Data to Assess Land Use Impact on Nitrate Dynamics in East African Tropical Montane Catchments

    Science.gov (United States)

    Jacobs, Suzanne R.; Weeser, Björn; Guzha, Alphonce C.; Rufino, Mariana C.; Butterbach-Bahl, Klaus; Windhorst, David; Breuer, Lutz

    2018-03-01

    Land use change alters nitrate (NO3-N) dynamics in stream water by changing nitrogen cycling, nutrient inputs, uptake and hydrological flow paths. There is little empirical evidence of these processes for East Africa. We collected a unique 2 year high-resolution data set to assess the effects of land use (i.e., natural forest, smallholder agriculture and commercial tea plantations) on NO3-N dynamics in three subcatchments within a headwater catchment in the Mau Forest Complex, Kenya's largest tropical montane forest. The natural forest subcatchment had the lowest NO3-N concentrations (0.44 ± 0.043 mg N L-1) with no seasonal variation. NO3-N concentrations in the smallholder agriculture (1.09 ± 0.11 mg N L-1) and tea plantation (2.13 ± 0.19 mg N L-1) subcatchments closely followed discharge patterns, indicating mobilization of NO3-N during the rainy seasons. Hysteresis patterns of rainfall events indicate a shift from subsurface flow in the natural forest to surface runoff in agricultural subcatchments. Distinct peaks in NO3-N concentrations were observed during rainfall events after a longer dry period in the forest and tea subcatchments. The high-resolution data set enabled us to identify differences in NO3-N transport of catchments under different land use, such as enhanced NO3-N inputs to the stream during the rainy season and higher annual export in agricultural subcatchments (4.9 ± 0.3 to 12.0 ± 0.8 kg N ha-1 yr-1) than in natural forest (2.6 ± 0.2 kg N ha-1 yr-1). This emphasizes the usefulness of our monitoring approach to improve the understanding of land use effects on riverine N exports in tropical landscapes, but also the need to apply such methods in other regions.

  3. Two extended haplotype blocks are associated with adaptation to high altitude habitats in East African honey bees

    Science.gov (United States)

    Schöning, Caspar

    2017-01-01

    Understanding the genetic basis of adaption is a central task in biology. Populations of the honey bee Apis mellifera that inhabit the mountain forests of East Africa differ in behavior and morphology from those inhabiting the surrounding lowland savannahs, which likely reflects adaptation to these habitats. We performed whole genome sequencing on 39 samples of highland and lowland bees from two pairs of populations to determine their evolutionary affinities and identify the genetic basis of these putative adaptations. We find that in general, levels of genetic differentiation between highland and lowland populations are very low, consistent with them being a single panmictic population. However, we identify two loci on chromosomes 7 and 9, each several hundred kilobases in length, which exhibit near fixation for different haplotypes between highland and lowland populations. The highland haplotypes at these loci are extremely rare in samples from the rest of the world. Patterns of segregation of genetic variants suggest that recombination between haplotypes at each locus is suppressed, indicating that they comprise independent structural variants. The haplotype on chromosome 7 harbors nearly all octopamine receptor genes in the honey bee genome. These have a role in learning and foraging behavior in honey bees and are strong candidates for adaptation to highland habitats. Molecular analysis of a putative breakpoint indicates that it may disrupt the coding sequence of one of these genes. Divergence between the highland and lowland haplotypes at both loci is extremely high suggesting that they are ancient balanced polymorphisms that greatly predate divergence between the extant honey bee subspecies. PMID:28542163

  4. The clinical characteristics and new classification of sticky eyelid syndrome in East Asian patients.

    Science.gov (United States)

    Chang, Minwook; Lee, Hwa; Park, Min Soo; Baek, Sehyun

    2014-12-01

    The aim of this study was to demonstrate the characteristics of sticky eyelid syndrome (SES) and to suggest a modified definition and new classification of the disease in relation to the severity of the syndrome in East Asian patients. Forty-four eyes of 31 patients with sticky eyelid syndrome were included in this study. The medical records of patients who were diagnosed with sticky eyelid syndrome were retrospectively reviewed. Sticky eyelid syndrome was defined as an abnormal adhesion between the upper and lower eyelids during blinking. We divided the subjects into four grades according to the severity of the disease. Among 31 patients, there were 10 men and 21 women. The mean age of patients was 62.5 years. A total of 13 patients had SES bilaterally. All patients had meibomian gland dysfunction (MGD). Thirty-three eyes had dermatochalasis, and 30 eyes had involutional ptosis. Horizontal lower lid laxity was observed in 23 eyes, and reverse ptosis found in 15 eyes. Patients were classified into four groups as follows: G1: 11 (25%), G2: 24 (54.5%), G3: 6 (13.6%) and G4: 3 eyes (6.8%). Patients in Grade 1 tended to improve only with medical treatment for MGD. However, surgical management was necessary for patients in Grades 3 and 4. Meibomian gland dysfunction is a fundamental risk factor for developing sticky eyelid syndrome. Further, combined upper lid ptosis or lower lid laxity may be aggravating factors. According to the grading, medical or surgical management can be chosen. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  5. Metabolic syndrome in Tunisian bipolar I patients | Ezzaher | African ...

    African Journals Online (AJOL)

    Gender, age, illness episode and treatment were not significantly associated with metabolic syndrome, while patients under lithium had higher prevalence of metabolic syndrome than those under valproic acid, carbamazepine or antipsychotics. Patients with metabolic syndrome had significant higher levels of HOMA-IR and ...

  6. "Getting tested is almost like going to the Salem witch trials": discordant discourses between Western public health messages and sociocultural expectations surrounding HIV testing among East African immigrant women.

    Science.gov (United States)

    De Jesus, Maria; Carrete, Claudia; Maine, Cathleen; Nalls, Patricia

    2015-01-01

    Washington, DC, has the highest AIDS diagnosis rate in the USA, and Black women are disproportionately affected. Although HIV testing is the first entryway into vital treatment services, evidence reveals that foreign-born blacks have a lower rate of recent HIV testing than US-born blacks. To date, however, there are no studies that examine the culture-specific perceptions of HIV testing among East African immigrant women (who comprise a large share of Black Africans in DC) to better understand their potential barriers to testing. Adopting the PEN-3 cultural model as our theoretical framework, the main objective of this study was to examine East African women's HIV testing perceptions and partner communication norms. Between October 2012 and March 2013, trained interviewers conducted a total of 25 interviews with East African women in the Washington, DC, metropolitan area. For triangulation purposes, data collection consisted of both in-depth, semi-structured interviews and cognitive interviews, in which participants were administered a quantitative survey and assessed on how they interpreted items. Qualitative thematic analysis revealed a systematic pattern of discordant responses across participants. While they were aware of messages related to Western public health discourse surrounding HIV testing (e.g., Everyone should get tested for HIV; One should talk to one's spouse about HIV testing), divergent sociocultural expectations rooted in cultural and religious beliefs prevailed (e.g., Getting an HIV test brings shame to the person who got tested and to one's family; it implies one is engaging in immoral behavior; One should not talk with one's spouse about HIV testing; doing so breaks cultural norms). Implications of using a culture-centered model to examine the role of sociocultural expectations in HIV prevention research and to develop culturally responsive prevention strategies are discussed.

  7. ‘Getting tested is almost like going to the Salem witch trials’: Discordant discourses between western public health messages and sociocultural expectations surrounding HIV testing among East African immigrant women

    Science.gov (United States)

    DE JESUS, Maria; CARRETE, Claudia; MAINE, Cathleen; NALLS, Patricia

    2015-01-01

    Washington, DC has the highest AIDS diagnosis rate in the United States and Black women are disproportionately affected. Although HIV testing is the first entryway into vital treatment services, evidence reveals that foreign-born blacks have a lower rate of recent HIV testing than U.S.-born blacks. To date, however, there are no studies that examine the culture-specific perceptions of HIV testing among East African immigrant women (who comprise a large share of Black Africans in DC) to better understand their potential barriers to testing. Adopting the PEN-3 cultural model as our theoretical framework, the main objective of this study was to examine East African women’s HIV testing perceptions and partner communication norms. Between October 2012 and March 2013, trained interviewers conducted a total of 25 interviews with East African women in the Washington DC Metropolitan area. For triangulation purposes, data collection consisted of both in-depth, semi-structured interviews and cognitive interviews, in which participants were administered a quantitative survey and assessed on how they interpreted items. Qualitative thematic analysis revealed a systematic pattern of discordant responses across participants. While they were aware of messages related to western public health discourse surrounding HIV testing (e.g., Everyone should get tested for HIV; One should talk to one’s spouse about HIV testing), divergent sociocultural expectations rooted in cultural and religious beliefs prevailed (e.g., Getting an HIV test brings shame to the person who got tested and to one’s family; it implies one is engaging in immoral behavior; One should not talk with one’s spouse about HIV testing; doing so breaks cultural norms). Implications of using a culture-centered model to examine the role of sociocultural expectations in HIV prevention research and to develop culturally responsive prevention strategies are discussed. PMID:25616443

  8. Prevalence of Substance Use Among Patients of Community Health Centers in East Los Angeles and Tijuana.

    Science.gov (United States)

    Gelberg, Lillian; Natera Rey, Guillermina; Andersen, Ronald M; Arroyo, Miriam; Bojorquez-Chapela, Ietza; Rico, Melvin W; Vahidi, Mani; Yacenda-Murphy, Julia; Arangua, Lisa; Serota, Martin

    2017-02-23

    Given the increased use of psychoactive substances on the United States-Mexico border, a binational study (Tijuana, Mexico-Los Angeles, USA) was conducted to identify the prevalence of substance use in primary care settings. To compare the prevalence and characteristics of patients at risk for substance use disorders in Tijuana and East Los Angeles (LA) community clinics with special attention paid to drug use. This was an observational, cross-sectional, analytical study, comparing substance use screening results from patients in Tijuana and LA. The settings were 2 community clinics in LA and 6 in Tijuana. Participants were 2,507 adult patients in LA and 2,890 in Tijuana eligible for WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) screening during March-October 2013. Patients anonymously self-administered the WHO ASSIST on a tablet PC in the clinic waiting rooms. Of eligible patients, 96.4% completed the ASSIST in Tijuana and 88.7% in LA (mean 1.34 minutes and 4.20 minutes, respectively). The prevalence of patients with moderate-to-high substance use was higher in LA than Tijuana for each substance: drugs 19.4% vs. 5.7%, alcohol 15.2% vs. 6.5%, tobacco 20.4% vs. 16.2%. LA patients born in Mexico had 2x the odds and LA patients born in the United States had 6x the odds of being a moderate-to-high drug user compared to Tijuana patients born in Mexico. Moderate-to-high drug use is higher in LA than in Tijuana but rates are sufficiently high in both to suggest that screening for drug use (along with alcohol and tobacco use) should be integrated into routine primary care of community clinics in both cities.

  9. Fault kinematics and tectonic stress in the seismically active Manyara Dodoma Rift segment in Central Tanzania Implications for the East African Rift

    Science.gov (United States)

    Macheyeki, Athanas S.; Delvaux, Damien; De Batist, Marc; Mruma, Abdulkarim

    2008-07-01

    The Eastern Branch of the East African Rift System is well known in Ethiopia (Main Ethiopian Rift) and Kenya (Kenya or Gregory Rift) and is usually considered to fade away southwards in the North Tanzanian Divergence, where it splits into the Eyasi, Manyara and Pangani segments. Further towards the south, rift structures are more weakly expressed and this area has not attracted much attention since the mapping and exploratory works of the 1950s. In November 4, 2002, an earthquake of magnitude Mb = 5.5 struck Dodoma, the capital city of Tanzania. Analysis of modern digital relief, seismological and geological data reveals that ongoing tectonic deformation is presently affecting a broad N-S trending belt, extending southward from the North Tanzanian Divergence to the region of Dodoma, forming the proposed "Manyara-Dodoma Rift segment". North of Arusha-Ngorongoro line, the rift is confined to a narrow belt (Natron graben in Tanzania) and south of it, it broadens into a wide deformation zone which includes both the Eyasi and Manyara grabens. The two-stage rifting model proposed for Kenya and North Tanzania also applies to the Manyara-Dodoma Rift segment. In a first stage, large, well-expressed topographic and volcanogenic structures were initiated in the Natron, Eyasi and Manyara grabens during the Late Miocene to Pliocene. From the Middle Pleistocene onwards, deformations related to the second rifting stage propagated southwards to the Dodoma region. These young structures have still limited morphological expressions compared to the structures formed during the first stage. However, they appear to be tectonically active as shown by the high concentration of moderate earthquakes into earthquake swarms, the distribution of He-bearing thermal springs, the morphological freshness of the fault scarps, and the presence of open surface fractures. Fault kinematic and paleostress analysis of geological fault data in basement rocks along the active fault lines show that recent

  10. Clinical phenotype of South-East Asian temporomandibular disorder patients with upper airway resistance syndrome.

    Science.gov (United States)

    Tay, D K L; Pang, K P

    2018-01-01

    Clinical and radiographic characteristics of a subset of South East Asian temporomandibular disorder (TMD) patients with comorbid upper airway resistance syndrome (UARS) were documented in a multi-center prospective series of 86 patients (26 men and 60 women / mean age 35.7 years). All had excessive daytime sleepiness, high arousal index and Apnoea-Hypopnoea Index (AHI) temporomandibular joint (TMJ) arthralgia while 90·7% reported sleep bruxism (SB). Unlike patients with obstructive sleep apnoea (OSA), hypertension was uncommon (4·7%) while depression was prevalent at 68·6% with short REM latency of 25% documented in 79·6% and 57·6% of these depressed patients, respectively. 65·1% displayed a posteriorly displaced condyle at maximum intercuspation with or without TMJ clicking. Most exhibited a forward head posture (FHP) characterised by loss of normal cervical lordosis (80·2%), C0-C1 narrowing (38·4%) or an elevated hyoid position (50%), and 91·9% had nasal congestion. We postulate the TMD-UARS phenotype may have originally developed as an adaptive response to 'awake' disordered breathing during growth. Patients with persistent TMD and/or reporting SB should be screened for UARS and chronic nasal obstruction, especially when they also present with FHP. The lateral cephalogram is a useful tool in the differentiation of UARS from other OSA phenotypes. © 2017 John Wiley & Sons Ltd.

  11. Oxidative Stress Indicators in Patients with Prostate Disorders in Enugu, South-East Nigeria

    Directory of Open Access Journals (Sweden)

    Romanda Duru

    2014-01-01

    Full Text Available Depletion of cellular antioxidants can result from free radical formation due to normal endogenous reactions and the ingestion of exogenous substances and environmental factors. The levels of reactive oxygen species-(ROS- scavenging enzymes such as SOD and glutathione peroxidase have been shown to be significantly altered in malignant cells and in primary cancer tissues. The aim of this study was to determine the antioxidant status of patients with prostate disorders in South-East Nigeria to ascertain the possible role of depletion of antioxidants in prostatic degeneration. 104 subjects made up of 40 PCa patients, 32 with BPH, and 32 controls participated in this study. The levels of superoxide dismutase, glutathione peroxidase, vitamin C, and vitamin E were estimated using standard procedures. The results show that both the BPH and PCa patients had a significant decrease (P<0.05 in GPX, SOD, vitamin C, and vitamin E levels compared to the control subjects. However, there was also a significant decrease (P<0.05 in SOD and vitamin C levels in PCa patients when compared with the BPH group. This indicates that patients with BPH and prostate cancer have decreased antioxidant status and may benefit from micronutrient supplementation.

  12. Renal dysfunction in African patients with acute heart failure

    NARCIS (Netherlands)

    Sani, Mahmoud U.; Davison, Beth A.; Cotter, Gad; Sliwa, Karen; Edwards, Christopher; Liu, Licette; Damasceno, Albertino; Mayosi, Bongani M.; Ogah, Okechukwu S.; Mondo, Charles; Dzudie, Anastase; Ojji, Dike B.; Voors, Adrian A.

    Aims In Western countries with typically elderly ischaemic acute heart failure patients, predictors and clinical outcome of renal dysfunction and worsening renal function are well described. However, the prevalence, predictors and clinical outcome of renal dysfunction in younger, mainly hypertensive

  13. Fanconi anaemia in South African patients with Afrikaner ancestry

    African Journals Online (AJOL)

    Fanconi anaemia (FA) is a rare genetic condition of impaired DNA ... An earlier age of diagnosis of FA in Afrikaner patients, a high frequency of somatic anomalies and a ... median current age and median age of presentation with symptoms in.

  14. Fanconi Anaemia in South African Patients with Afrikaner Ancestry

    Directory of Open Access Journals (Sweden)

    C Feben

    2017-10-01

    Full Text Available Background. Fanconi anaemia (FA is a rare genetic disorder of impaired DNA repair that results in physical and haematological consequences in affected individuals. In South Africa (SA, individuals with Afrikaner ancestry are at an increased risk of inheriting disease-causing FA mutations, owing to the three common FANCA (FA, complementation group A founder mutations present in this population subgroup. Objectives. To describe the physical phenotype of SA patients with FANCA mutations for the purpose of recommending appropriate care for affected individuals. Methods. A structured clinical examination and file-based review were used to evaluate the physical phenotype of 7 patients with compound heterozygous and homozygous FANCA founder mutations, and 1 patient with confirmed FANCA complementation analysis. Descriptive statistical analysis was used to determine the frequency of physical anomalies in Afrikaner patients and to compare the described phenotype to other FA cohorts, including a previously clinically characterised black SA FA cohort. Results. An earlier age of diagnosis of FA in Afrikaner patients, a high frequency of somatic anomalies and a higher-than-expected incidence of the VACTERL/H phenotype were noted. Conclusions. Based on our findings, recommendations for the care of FA patients with Afrikaner ancestry are made, including renal ultrasound evaluation at diagnosis and hearing screening

  15. The African oil industry

    International Nuclear Information System (INIS)

    Ford, Mark; Griffiths, Thalia

    1999-10-01

    Contains Executive Summary and Chapters on: Adding value to African hydrocarbons in a global energy market; North Africa; East Africa; West Africa; Central Africa; Southern Africa; Strategies for Africa; Outlook. (Author)

  16. African Journals Online (AJOL)

    African Journals Online (AJOL)

    reviewed, African-published scholarly journals. Historically, scholarly information has flowed from North to South and from West to East. It has also been difficult ... Featured Country: Egypt, Arab Rep. Featured Journal: Alexandria Journal of Medicine ...

  17. Validation of a dietary intake tool for african-american dialysis patients with low literacy.

    Science.gov (United States)

    Duffrin, Christopher; Carraway-Stage, Virginia G; Briley, Alexis; Christiano, Cynthia

    2015-06-01

    This study analysed the validity and reliability of a food frequency questionnaire designed for African-American patients with low literacy. This instrument was designed specifically to meet the need for a tool that was short, easy to understand, and met clinical reliability and validity standards. Assessing patient nutritional status and dietary intake is crucial to the care of patients in end stage kidney disease. The development of a quick and reliable nutritional assessment tool for patients with low literacy could increase nutritional counselling effectiveness and improve patient outcomes. The renal food frequency questionnaire (RFF) and a standard 24-hour recall were administered to a general population of African-American patients undergoing dialysis. Registered Dieticians and statistical analyses were used to validate the content and structural validity and reliability of the RFF to adequately measure dietary intake. The study sample consisted of 30 African-American patients who received dialysis treatment at a regional teaching hospital facility. The RFF was found to be a simple, easy to understand instrument with low reading complexity (grade level 4.4). Inter-rater reliability was found to be high (.81-1.00), and statistical analysis determined a high level of clinical validity. The RFF was found to be a valid dietary recall tool that is appropriate for patients with limited literacy. It was found to have acceptable reliability and validity when compared with a standard 24-hour recall and has potential for use as a dietary intake and monitoring tool in patients undergoing dialysis. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  18. Why is patient safety so hard in low-income countries? A qualitative study of healthcare workers' views in two African hospitals.

    Science.gov (United States)

    Aveling, Emma-Louise; Kayonga, Yvette; Nega, Ansha; Dixon-Woods, Mary

    2015-02-25

    The views of practitioners at the sharp end of health care provision are now recognised as a valuable source of intelligence that can inform efforts to improve patient safety in high-income countries. Yet despite growing policy emphasis on patient safety in low-income countries, little research examines the views of practitioners in these settings. We aimed to give voice to how healthcare workers in two East African hospitals identify and explain the major obstacles to ensuring the safety of patients in their care. We conducted in-depth, face to face interviews with healthcare workers in two East African hospitals. Our sample included a total of 57 hospital staff, including nurses, physicians, technicians, clinical services staff, administrative staff and hospital managers. Hospital staff in low-income settings offered broadly encompassing and aspirational definitions of patient safety. They identified obstacles to patient safety across three major themes: material context, staffing issues and inter-professional working relationships. Participants distinguished between the proximal influences on patient safety that posed an immediate threat to patient care, and the distal influences that generated the contexts for such hazards. These included contexts of severe material deprivation, but also the impact of relational factors such as teamwork and professional hierarchies. Structures of authority, governance and control that were not optimally aligned with achieving patient safety were widely reported. As in high-income countries, the accounts of healthcare workers in low-income countries provide sophisticated and valuable insights into the challenges of patient safety. Though the impact of resource constraints and weak governance structures are particularly marked in low-income countries, the congruence between accounts of health workers in diverse settings suggest that the origins and solutions to patient safety problems are likely to be similar everywhere and are

  19. Hepatic gene expression of Caucasian and African-American patients with obesity-related non-alcoholic fatty liver disease.

    Science.gov (United States)

    Stepanova, Maria; Hossain, Noreen; Afendy, Arian; Perry, Kellie; Goodman, Zachary D; Baranova, Ancha; Younossi, Zobair

    2010-05-01

    There is increasing data suggesting that African Americans with NAFLD tend to have less progressive liver disease. The aim of this study is to assess differences in the hepatic gene expression of African-American and Caucasian patients with NAFLD who had undergone bariatric surgery. A total of 94 patients (81 NAFLD and 13 weight-matched controls with normal liver biopsy) were included. Of the entire cohort, 73 were Caucasians and 21 were African Americans. All patients were undergoing bariatric surgery. Two liver biopsies were obtained at the time of surgery. One biopsy was snap-frozen for gene expression and the other biopsy was stained for pathologic assessment. Liver biopsy confirmed that 24 patients from our cohort had NASH while 57 had only simple steatosis. Snap-frozen liver biopsy specimens of these patients were then used for the RNA extraction. cDNA probes were hybridized with customized microarray gene chips containing 5,220 relevant genes. Gene expression profiles were compared between groups using significance analysis of microarrays algorithm. In comparison to all Caucasian patients, African-American patients had over-expression of EPB41L1, IGF2, FAH, ACSL4, FUT4, CYP3A (q values < 10(-4)). In comparison to Caucasian NAFLD patients, African-American NAFLD patients showed over-expression of EPB41L1 and ACSL4 genes. Finally, in comparison to Caucasian NASH patients, African-American NASH patients showed over-expression of GSTM 2, GSTM4 and GSTM5 as well as FH and ASCL4 genes. Some genes highlighted by this analysis, particularly cytochrome CYP3A and glutathione transferases GSTM2, 4, 5, were previously implicated in the pathogenesis of NASH. African-American patients with biopsy-proven obesity-related NAFLD and NASH have a specific hepatic gene expression pattern that may explain their differences from Caucasian patients with NAFLD in developing progressive liver disease.

  20. Cardiovascular risk factors in patients with Addison's disease: a comparative study of South African and Swedish patients.

    Directory of Open Access Journals (Sweden)

    Ian Louis Ross

    Full Text Available BACKGROUND: Patients with Addison's disease (AD in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD. Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. METHODS: In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP and adiponectin were studied. RESULTS: All patients were Caucasian and the majority were women N = 36 (65.5%. Mean (standard deviation; SD ages of the Swedish and South African patients were 52.9 (13.0 and 52.6 (14.4 years and BMI 25.3 (3.2 and 25.8 (4.1 kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1 versus 24.3 (8.0 mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR triglycerides (TG [1.59 (1.1-2.46 versus 0.96 (0.74-1.6 mmol/l; p<0.001], total cholesterol (TC [6.02(1.50 versus 5.13 (0.87 mmol/l; p<0.001], LDL-C [4.43 (1.44 versus 2.75 (0.80 mmol/l; p<0.001] and median hs-CRP [2.15 (0.93-5.45 versus 0.99 (0.57-2.10 mg/L; p<0.003] and lower HDL-C [0.80 (0.40 versus 1.86 (0.46 mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. CONCLUSIONS: South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors.

  1. Cardiovascular Risk Factors in Patients with Addison's Disease: A Comparative Study of South African and Swedish Patients

    Science.gov (United States)

    Ross, Ian Louis; Bergthorsdottir, Ragnhildur; Levitt, Naomi; Dave, Joel Alex; Schatz, Desmond; Marais, David; Johannsson, Gudmundur

    2014-01-01

    Background Patients with Addison's disease (AD) in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD). Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. Methods In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden) matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP) and adiponectin were studied. Results All patients were Caucasian and the majority were women N = 36 (65.5%). Mean (standard deviation; SD) ages of the Swedish and South African patients were 52.9 (13.0) and 52.6 (14.4) years and BMI 25.3 (3.2) and 25.8 (4.1) kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1) versus 24.3 (8.0) mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR) triglycerides (TG) [1.59 (1.1–2.46) versus 0.96 (0.74–1.6) mmol/l; p<0.001], total cholesterol (TC) [6.02(1.50) versus 5.13 (0.87) mmol/l; p<0.001], LDL-C [4.43 (1.44) versus 2.75 (0.80) mmol/l; p<0.001] and median hs-CRP [2.15 (0.93–5.45) versus 0.99 (0.57–2.10) mg/L; p<0.003] and lower HDL-C [0.80 (0.40) versus 1.86 (0.46) mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. Conclusions South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors. PMID:24603607

  2. Typhoid fever in a South African in-patient population

    NARCIS (Netherlands)

    Khan, Mohammad Enayet Hossain

    2004-01-01

    In conclusion, the data presented herein show that no single clinical or paraclinical parameter is reliable in arriving at a correct clinical diagnosis of typhoid fever and that bacteriologic confirmation is necessary for the diagnosis of typhoid fever. Patients ’ age and sex influence the clinical

  3. Huntington\\'s disease: Genetic heterogeneity in black African patients

    African Journals Online (AJOL)

    Objective. Huntington's disease (HD) has been reported to occur rarely in black patients. A new genetic variant– Huntington's disease-like 2 (HDL2) – occurring more frequently in blacks, has recently been described. The absence of an expanded trinucleotide repeat at the chromosome 4 HD locus was previously regarded ...

  4. A patient with multiple iris | Asselman | Southern African Journal of ...

    African Journals Online (AJOL)

    IRIS results from a pathological inflammatory response to pre-existing infective, host or other antigens, alive or dead, causing clinical deterioration in HIV-infected patients after initiating ART.1 A case definition for IRIS is shown in Table I. The most common forms of IRIS described occur in association with mycobacterial and ...

  5. Tick infestation: a 200-patients' series | Guven | African Journal of ...

    African Journals Online (AJOL)

    Conclusions: Although non-of the patients of our study has been diagnosed with Crimean-Congo hemorrhagic fever we informed all of them for the incubation period and call for observation during the time. Tick borne infections may present with vary of symptoms, the most sever of which is hemorrhagic diathesis and ...

  6. Microvascular complications in South African patients with long ...

    African Journals Online (AJOL)

    The prevalence of complications and the clinical and biochemical parameters were evaluated for type 1 and type 2 diabetes and for each ethnic group. Results. Of the 219 patients, 47 had type 1 DM (36 blacks, 11 Indians) and 172 were classilied a type 2 DM (96 blacks, 76 Indians). The mean age of onset of DM was later ...

  7. Endocrine dysfunction among adult patients with tuberculosis: An African experience

    Directory of Open Access Journals (Sweden)

    Davis Kibirige

    2014-01-01

    Full Text Available A broad spectrum of endocrine conditions has been reported among adult patients with tuberculosis in Africa. This review aims to describe the magnitude and pathogenesis of the following endocrinopathies among patients with tuberculosis in Africa: adrenal insufficiency, diabetes mellitus, disorders of calcium and vitamin D metabolism, thyroid dysfunction and hypogonadism. PubMed database and Google scholar were used to search for the relevant published English language studies and case reports relating to endocrine abnormalities and tuberculosis in Africa up to July 2013. The search terms used were endocrine dysfunction, endocrine abnormalities, adrenal insufficiency, diabetes mellitus, thyroid dysfunction, hypogonadism, disorders of calcium and vitamin D metabolism, tuberculosis, Africa. Reference lists of the identified articles were further used to identify other studies. Adrenal insufficiency, diabetes mellitus and calcium-vitamin D abnormalities were the most prevalent and frequently reported endocrine disorders among adult patients with tuberculosis in Africa. A meticulous endocrine evaluation among tuberculosis patients with suspected endocrine abnormalities should be encouraged in Africa and other high TB endemic regions. Treatment of these endocrine disorders has generally been shown to improve quality of life and reduce mortality.

  8. Ventilator-associated pneumonia in critically ill African patients on ...

    African Journals Online (AJOL)

    Background: Stress ulcer prophylaxis is an integral part of the care of the critically ill. Agents that alter gastric pH may predispose these patients to gastric colonisation, with subsequent pneumonia and/or sepsis. Cytoprotective agents such as sucralfate preserve gastric acidity and may be protective. Objective: To determine ...

  9. Prescribing patterns of methylphenidate in a South African patient ...

    African Journals Online (AJOL)

    ADHD) in children. The primary aim of the study was to investigate the prescribing patterns of methylphenidate of a medical aid patient population in a private sector and to compare the results with previous studies. An exposure cohort drug ...

  10. ISSN 2073 ISSN 2073-9990 East Cent. East Cent. East Cent. Afr. J.

    African Journals Online (AJOL)

    DELL

    East and Central African Journal of Surgery. ... collaboration in the writing and editing of Surgical Care at the District Hospital, ... increasing availability of computers and huge developments in software technology such ... Emergency Surgery ...

  11. Gastric cancers of Western European and African patients show different patterns of genomic instability

    Directory of Open Access Journals (Sweden)

    Mulder Chris JJ

    2011-01-01

    Full Text Available Abstract Background Infection with H. pylori is important in the etiology of gastric cancer. Gastric cancer is infrequent in Africa, despite high frequencies of H. pylori infection, referred to as the African enigma. Variation in environmental and host factors influencing gastric cancer risk between different populations have been reported but little is known about the biological differences between gastric cancers from different geographic locations. We aim to study genomic instability patterns of gastric cancers obtained from patients from United Kingdom (UK and South Africa (SA, in an attempt to support the African enigma hypothesis at the biological level. Methods DNA was isolated from 67 gastric adenocarcinomas, 33 UK patients, 9 Caucasian SA patients and 25 native SA patients. Microsatellite instability and chromosomal instability were analyzed by PCR and microarray comparative genomic hybridization, respectively. Data was analyzed by supervised univariate and multivariate analyses as well as unsupervised hierarchical cluster analysis. Results Tumors from Caucasian and native SA patients showed significantly more microsatellite instable tumors (p Conclusions Gastric cancers from SA and UK patients show differences in genetic instability patterns, indicating possible different biological mechanisms in patients from different geographical origin. This is of future clinical relevance for stratification of gastric cancer therapy.

  12. Hematological consequences of a FANCG founder mutation in Black South African patients with Fanconi anemia.

    Science.gov (United States)

    Feben, Candice; Kromberg, Jennifer; Wainwright, Rosalind; Stones, David; Poole, Janet; Haw, Tabitha; Krause, Amanda

    2015-03-01

    Fanconi anemia (FA) is a rare disorder of DNA repair, associated with various somatic abnormalities but characterized by hematological disease that manifests as bone marrow aplasia and malignancy. The mainstay of treatment, in developed nations, is hematopoietic stem cell transplantation (HSCT) with subsequent surveillance for solid organ and non-hematological malignancies. In South Africa, FA in the Black population is caused by a homozygous deletion mutation in the FANCG gene in more than 80% of cases. Many affected patients are not diagnosed until late in the disease course when severe cytopenia and bone marrow aplasia are already present. Most patients are not eligible for HSCT at this late stage of the disease, even when it is available in the state health care system. In this study, the hematological presentation and disease progression in 30 Black South African patients with FA, confirmed to have the FANCG founder mutation, were evaluated and compared to those described in other FA cohorts. Our results showed that patients, homozygous for the FANCG founder mutation, present with severe cytopenia but progress to bone marrow failure at similar ages to other individuals affected with FA of heterogeneous genotype. Further, the incidence of myelodysplastic syndrome is similar to that which has been previously described in other FA cohorts. Although severe cytopenia at presentation may be predicted by a higher number of somatic anomalies, the recognition of the physical FA phenotype in Black South African patients is challenging and may not be useful in expediting referral of suspected FA patients for tertiary level investigations and care. Given the late but severe hematological presentation of FA in Black South African patients, an investigative strategy is needed for earlier recognition of affected individuals to allow for possible HSCT and management of bone marrow disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Two deletion variants of Middle East respiratory syndrome coronavirus found in a patient with characteristic symptoms.

    Science.gov (United States)

    Xie, Qian; Cao, Yujuan; Su, Juan; Wu, Jie; Wu, Xianbo; Wan, Chengsong; He, Mingliang; Ke, Changwen; Zhang, Bao; Zhao, Wei

    2017-08-01

    Significant sequence variation of Middle East respiratory syndrome coronavirus (MERS CoV) has never been detected since it was first reported in 2012. A MERS patient came from Korea to China in late May 2015. The patient was 44 years old and had symptoms including high fever, dry cough with a little phlegm, and shortness of breath, which are roughly consistent with those associated with MERS, and had had close contact with individuals with confirmed cases of MERS.After one month of therapy with antiviral, anti-infection, and immune-enhancing agents, the patient recovered in the hospital and was discharged. A nasopharyngeal swab sample was collected for direct sequencing, which revealed two deletion variants of MERS CoV. Deletions of 414 and 419 nt occurred between ORF5 and the E protein, resulting in a partial protein fusion or truncation of ORF5 and the E protein. Functional analysis by bioinformatics and comparison to previous studies implied that the two variants might be defective in their ability to package MERS CoV. However, the mechanism of how these deletions occurred and what effects they have need to be further investigated.

  14. Certified causes of death in patients with mesothelioma in South East England

    Directory of Open Access Journals (Sweden)

    Peto Julian

    2009-01-01

    Full Text Available Abstract Background Mesothelioma is a highly fatal cancer that is caused by exposure to asbestos fibres. In many populations, the occurrence of mesothelioma is monitored with the use of mortality data from death certification. We examine certified causes of death of patients who have been diagnosed with mesothelioma, and assess the validity of death certification data as a proxy for mesothelioma incidence. Methods We extracted mesothelioma registrations in the South East of England area between 2000 and 2004 from the Thames Cancer Registry database. We retained for analysis 2200 patients who had died at the time of analysis, after having excluded seven dead cases where the causes of death were not known to the cancer registry. The 2200 deaths were classified hierarchically to identify (1 mesothelioma deaths, (2 deaths certified as lung cancer deaths or (3 deaths from unspecified cancer, and (4 deaths from other causes. Results 87% of the patients had mesothelioma mentioned on the death certificate. 6% had no mention of mesothelioma but included lung cancer as a cause of death. Another 6% had no mention of mesothelioma or lung cancer, but included an unspecified cancer as a cause of death. Lastly, 2% had other causes of death specified on the death certificate. Conclusion This analysis suggests that official mortality data may underestimate the true occurrence of mesothelioma by around 10%.

  15. An observational study of acarbose treatment in patients with type 2 diabetes from the Middle East and Morocco

    Directory of Open Access Journals (Sweden)

    Shihabi AR

    2013-04-01

    Full Text Available Abdul R Shihabi,1 Essam M Moussa,2 Hania Sobierajska,3 Birgit Schmidt4 1Al Ain Centre, Dubai, United Arab Emirates; 2New Jeddah Hospital, Jeddah, Saudi Arabia; 3Etihad Airways Medical Centre, Abu Dhabi, United Arab Emirates; 4Bayer Schering Pharma AG, Leverkusen, Germany Background: The prevalence of type 2 diabetes is increasing dramatically in the Middle East and North Africa region. However, there are few trials that have determined the effect of antidiabetic treatment in an observational setting in these countries. Methods: This was a noninterventional study performed in Morocco in 2006–2007 and in the Middle East in 2005–2006 to observe the efficacy and safety of acarbose in patients with pretreated or untreated type 2 diabetes. Glycemic parameters (fasting blood glucose, one-hour postprandial blood glucose, and HbA1c were recorded within a 3-month period. The observation period included an initial visit at the start of acarbose therapy and up to three follow-ups. Results: Acarbose was effective in reducing glycemic parameters in patients from Morocco (n = 1082 and the Middle East (n = 1737. The mean one-hour postprandial blood glucose decreased by 35.5% to 165.4 ± 47.9 mg/dL in the Middle East and by 35.5% to 179.0 ± 49.9 mg/dL in Morocco. Mean fasting blood glucose decreased by 30.8% to 126.6 ± 34.2 mg/dL (Middle East and by 34.5% to 150.6 ± 47.1 mg/dL (Morocco. The absolute reduction in HbA1c was 1.3% in the Middle East (final value 7.4% and 1.0% in Morocco (final value 7.5%. Overall, 107 patients (Middle East and 26 patients (Morocco experienced minor drug-related adverse events, which were mainly gastrointestinal. The tolerability of acarbose was rated as very good/good by 80.8% in the Middle East and by 68.6% in Morocco. Conclusion: This study illustrates the efficacy and safety of acarbose in the treatment of type 2 diabetic patients in an observational setting. Keywords: type 2 diabetes, acarbose, Glucobay®, Glucor

  16. Do Asian renal transplant patients need another mycophenolate mofetil dose compared with Caucasian or African American patients?

    Science.gov (United States)

    Li, Pengmei; Shuker, Nauras; Hesselink, Dennis A; van Schaik, Ron H N; Zhang, Xianglin; van Gelder, Teun

    2014-10-01

    Mycophenolate mofetil (MMF) is used to prevent acute rejection following solid organ transplantation in transplant centers all over the world. Patients from different ethnic backgrounds are treated with this drug, for which therapeutic drug monitoring (TDM) has not become the standard of practice in most centers. Whether or not some ethnic groups require a different MMF dose has been a topic of debate in recent years. In this review, it is shown that Asian patients, compared with Caucasian patients, with a comparable MMF dose reach higher mycophenolic acid (MPA) exposure. Also clinical experience points toward more adverse events in case of treatment with 1 g MMF bid in Asian patients, and therefore, for this ethnic group, a lower maintenance dose seems justified. In contrast, African American patients reach similar drug concentrations as Caucasians patients receiving the same MMF dose, but due to immunological reasons, they require a higher MMF dose to reach comparable acute rejection incidences. When TDM is performed, clinicians can correct the dose and compensate for interethnic differences in drug exposure. Otherwise, it is important to choose the right dose. This optimal dose is 20-46% lower in Asian transplant recipients than in Caucasian or African American patients. © 2014 Steunstichting ESOT.

  17. Psychosocial predictors of depression among older African American patients with cancer.

    Science.gov (United States)

    Hamilton, Jill B; Deal, Allison M; Moore, Angelo D; Best, Nakia C; Galbraith, Kayoll V; Muss, Hyman

    2013-07-01

    To determine whether psychosocial factors predict depression among older African American patients with cancer. A descriptive correlational study. Outpatient oncology clinic of a National Cancer Institute-designated cancer center in the southeastern United States. African American patients with cancer aged 50-88 years. Fisher's exact and Wilcoxon rank-sum tests were used to evaluate differences between patients who were possibly depressed (Geriatric Depression Scale) or not. Multivariate linear regression statistics were used to identify the psychosocial factors that predicted higher depression scores. Education and gender were included as covariates. Religiosity, emotional support, collectivism, perceived stigma, and depression. Participants (N = 77) had a mean age of 61 years (SD = 8.4), and a majority were well-educated, insured, religiously affiliated, and currently in treatment. Participants who were in the lowest income category, not married, or male had higher depression scores. The multivariable model consisting of organized religion, emotional support, collectivism, education, and gender explained 52% (adjusted R2) of the variation in depression scores. Stigma became insignificant in the multivariable model. Psychosocial factors are important predictors of depression. Emotional support and organized religious activities may represent protective factors against depression, whereas collectivism may increase their risk. Nurses need to be particularly aware of the potential psychological strain for patients with collectivist values, experienced stigma, disruptions in church attendance, and lack of emotional support. In addition, the treatment plans for these patients should ensure that family members are knowledgeable about cancer, its treatment, and side effects so they are empowered to meet support needs. Among older African American patients with cancer, emotional support and reassurance from family and friends that they will not abandon them decreases the

  18. African Journals Online (AJOL)

    African Journals Online (AJOL)

    Historically, scholarly information has flowed from North to South and from West to East. It has also been difficult for African researchers to access the work of other African academics. In partnership with hundreds of journals from all ... Featured Country: Nigeria, Featured Journal: Nigeria Journal of Business Administration ...

  19. A delayed presentation of ameloblastic fibrosarcoma in an African patient.

    Science.gov (United States)

    Chauke, Nkhensani Yvonne; Sofianos, Chrysis; Liakos, Dimitri; Ndobe, Elias

    2017-08-01

    A 24-year-old womanpresented with ameloblastic fibrosarcoma arising from ameloblastic fibroma. The delayed presentation accounted for the extensive destruction of the mandible and complete occlusion of her oral cavity. This resulted in an inability to eat and maintain oral hygiene. A multidisciplinary team management approach involved nutritional optimisation, segmental mandibulectomy, reconstruction with a reconstructive plate and a free anterolateral thigh flap to line the the floor of mouth. Functional and aesthetic outcome was acceptable, and the patient is planned for secondary free fibular flap bony reconstruction. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Modeling the Sedimentary Infill of Lakes in the East African Rift: A Case Study of Multiple versus Single Rift Basin Segments

    Science.gov (United States)

    Zhang, C.; Scholz, C. A.

    2016-12-01

    The sedimentary basins in the East African Rift are considered excellent modern examples for investigating sedimentary infilling and evolution of extensional systems. Some lakes in the western branch of the rift have formed within single-segment systems, and include Lake Albert and Lake Edward. The largest and oldest lakes developed within multi-segment systems, and these include Lake Tanganyika and Lake Malawi. This research aims to explore processes of erosion and sedimentary infilling of the catchment area in single-segment rift (SSR) and multi-segment rift (MSR) systems. We consider different conditions of regional precipitation and evaporation, and assess the resulting facies architecture through forward modeling, using state-of-the-art commercial basin modeling software. Dionisos is a three-dimensional numerical stratigraphic forward modeling software program, which simulates basin-scale sediment transport based on empirical water- and gravity-driven diffusion equations. It was classically used to quantify the sedimentary architecture and basin infilling of both marine siliciclastic and carbonate environments. However, we apply this approach to continental rift basin environments. In this research, two scenarios are developed, one for a MSR and the other for a SSR. The modeled systems simulate the ratio of drainage area and lake surface area observed in modern Lake Tanganyika and Lake Albert, which are examples of MSRs and SSRs, respectively. The main parameters, such as maximum subsidence rate, water- and gravity-driven diffusion coefficients, rainfall, and evaporation, are approximated using these real-world examples. The results of 5 million year model runs with 50,000 year time steps show that MSRs are characterized by a deep water lake with relatively modest sediment accumulation, while the SSRs are characterized by a nearly overfilled lake with shallow water depths and thick sediment accumulation. The preliminary modeling results conform to the features

  1. Geomorphometric reconstruction of post-eruptive surfaces of the Virunga Volcanic Province (East African Rift), constraint of erosion ratio and relative chronology

    Science.gov (United States)

    Lahitte, Pierre; Poppe, Sam; Kervyn, Matthieu

    2016-04-01

    Quaternary volcanic landforms result from a complex evolution, involving volcanic constructional events and destructive ones by collapses and long-term erosion. Quantification, by morphometric approaches, of the evolution through time of the volcano shape allows the estimation of relative ages between volcanoes sharing the same climate and eruptive conditions. We apply such method to six volcanoes of the Virunga Volcanic Province in the western branch of the East African Rift Valley that still has rare geochronological constraints. As they have comparable sizes, volcanic history and erupted products, these edifices may have undergone comparable conditions of erosion which justify the deduction of relative chronology from their erosion pattern. Our GIS-based geomorphometric approach, the SHAPEVOLC algorithm, quantifies erupted or dismantled volumes by numerically modeling topographies resulting from the eruptive construction of each volcano. Constraining points are selected by analyses of morphometric properties of each cell of the current DEM, as the loci where the altitude is still representative of the un-eroded volcanic surfaces. A primary elevation surface is firstly adjusted to these constraining points by modeling a first-order pseudo-radial surface defined by: 1. the curve best fitting the concave-upwards volcano profile; 2. the location and elevation of the volcano summit; and 3. the possible eccentricity and azimuth parameters that allow to stretch and contract contours to adjust the shape of the model to the elliptically-shaped surface of the volcano. A second-order surface is next computed by local adjustment of the first-order surface to the constraining points to obtain the definitive primary elevation surface of the considered volcanic construct. Amount of erosion is obtained by summing the difference in elevation between reconstructed surfaces and current ones that allows to establish relative ages of volcanoes. For the 6 studied Virunga volcanoes

  2. Spatio-temporal characteristics of the Equatorial Ionization Anomaly (EIA) in the East African region via ionospheric tomography during the year 2012

    Science.gov (United States)

    Kassa, T.; Damtie, B.; Bires, A.; Yizengaw, E.; Cilliers, P.

    2015-01-01

    We present the characteristics of the EIA in the East African sector inferred from ground-based GPS receivers via ionospheric tomography during the year 2012. For the analysis, we developed and used a 2D ionospheric tomography imaging software based on Bayesian inversion approach. To reconstruct ionospheric electron density form slant Total Electron Content (sTEC) measurements, we selected a chain of ten ground-based GPS receivers with stations' codes and geomagnetic coordinates: ARMI (3.03 °S, 109.29 °E), DEBK (4.32 °N, 109.48 °E), ASOS (1.14 °N, 106.16 °E), NEGE (3.60 °S, 111.35 °E), SHIS (3.26 °N, 110.62 °E), ASAB (4.91 °N, 114.34 °E), SHEB (7.36 °N, 110.60 °E), EBBE (9.54 °S, 104.10 °E), DODM (16.03 °S, 109.04 °E) & NAMA (11.49 °N, 113.60 °E). The temporal, spatial and storm-time characteristics of the EIA and the hourly, day-to-day and seasonal variations of the maximum electron density of F2 region (NmF2) at 15.29°S geomagnetic latitude are presented. We found that the magnitude of the peak and the width/thickness of the EIA pronounced during the equinox and weakened during the solstice seasons at 2100 LT. It is also observed that the EIA persisted for longer time in equinox season than the solstice season. The spatial appearance of the northern and southern anomalies are observed starting from 6.12 ° N and 10 ° S respectively along geomagnetic latitude during equinox season. The EIA is localized between 180 km and 450 km along the altitude during December solstice. The analysis on the NmF2 demonstrated a significant dependence on local time, day and season of the year. We also investigated the storm response of the EIA for the magnetic storm of Day Of the Year (DOY) 274-276. It is observed that the disturbance dynamo related composition change (O/N2 ratio) resulted in a well-developed EIA with an increase in the peak and the width of the EIA at 2100 LT on DOY 275 (main phase of the storm) compared to 274 (initial phase of the storm

  3. Identification of patient-centered outcomes among African American women with type 2 diabetes.

    Science.gov (United States)

    Miller, Stephania T; Akohoue, Sylvie A; Brooks, Malinda A

    2014-12-01

    African American women carry a disproportionate diabetes burden, yet there is limited information on strategies to identify outcomes women perceive as important intervention outcomes (patient-centered outcomes). This study presents a brief strategy to solicit these outcomes and to describe outcomes identified using the highlighted strategy. Thirty-four African-American women with type 2 diabetes were enrolled in group-based, diabetes/weight management interventions. A diabetes educator asked participants to write down their intervention expectations followed by verbal sharing of responses. Expectation-related themes were identified using an iterative, qualitative, team analytic approach based on audio-recorded responses. The majority of the expectation-related themes (6 of 10) were reflective of self-care education/management and weight loss-related patient-centered outcomes. The remaining themes were associated with desires to help others prevent or manage diabetes, reduce negative diabetes-related emotions, get rid of diabetes, and stop taking diabetes medications. This study adds to a limited body of knowledge regarding patient-centered outcomes among a group that experiences a disproportionate diabetes burden. Future work could include integrating outcomes that are less commonly addressed in diabetes-related lifestyle interventions (e.g., diabetes-related negative emotions), along with more commonly addressed outcomes (e.g., weight loss), to increase the patient-centeredness of the interventions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. East African Journal of Sciences

    African Journals Online (AJOL)

    ... resources, education, natural sciences, human and animal health sciences. ... Grain Yield and Economic Benefit of Intercropping Barley and Faba Bean in the ... Growth of Botrytis fabae and Manage Chocolate Spot Severity on Faba Bean ...

  5. East African Medical Journal: Submissions

    African Journals Online (AJOL)

    Communications should be addressed to the Editor-in-Chief, P.O. Box 41632, ... and the identity of any individual concealed according to ethical requirements. ... not wish to publish materials that has appeared beforehand in public media.

  6. Investigation of Caucasian rheumatoid arthritis susceptibility loci in African patients with the same disease

    Science.gov (United States)

    2012-01-01

    Introduction The largest genetic risk to develop rheumatoid arthritis (RA) arises from a group of alleles of the HLA DRB1 locus ('shared epitope', SE). Over 30 non-HLA single nucleotide polymorphisms (SNPs) predisposing to disease have been identified in Caucasians, but they have never been investigated in West/Central Africa. We previously reported a lower prevalence of the SE in RA patients in Cameroon compared to European patients and aimed in the present study to investigate the contribution of Caucasian non-HLA RA SNPs to disease susceptibility in Black Africans. Methods RA cases and controls from Cameroon were genotyped for Caucasian RA susceptibility SNPs using Sequenom MassArray technology. Genotype data were also available for 5024 UK cases and 4281 UK controls and for 119 Yoruba individuals in Ibadan, Nigeria (YRI, HapMap). A Caucasian aggregate genetic-risk score (GRS) was calculated as the sum of the weighted risk-allele counts. Results After genotyping quality control procedures were performed, data on 28 Caucasian non-HLA susceptibility SNPs were available in 43 Cameroonian RA cases and 44 controls. The minor allele frequencies (MAF) were tightly correlated between Cameroonian controls and YRI individuals (correlation coefficient 93.8%, p = 1.7E-13), and they were pooled together. There was no correlation between MAF of UK and African controls; 13 markers differed by more than 20%. The MAF for markers at PTPN22, IL2RA, FCGR2A and IL2/IL21 was below 2% in Africans. The GRS showed a strong association with RA in the UK. However, the GRS did not predict RA in Africans (OR = 0.71, 95% CI 0.29 - 1.74, p = 0.456). Random sampling from the UK cohort showed that this difference in association is unlikely to be explained by small sample size or chance, but is statistically significant with p<0.001. Conclusions The MAFs of non-HLA Caucasian RA susceptibility SNPs are different between Caucasians and Africans, and several polymorphisms are barely detectable in

  7. Development of a Conceptual Framework for Understanding Shared Decision making Among African-American LGBT Patients and their Clinicians.

    Science.gov (United States)

    Peek, Monica E; Lopez, Fanny Y; Williams, H Sharif; Xu, Lucy J; McNulty, Moira C; Acree, M Ellen; Schneider, John A

    2016-06-01

    Enhancing patient-centered care and shared decision making (SDM) has become a national priority as a means of engaging patients in their care, improving treatment adherence, and enhancing health outcomes. Relatively little is known about the healthcare experiences or shared decision making among racial/ethnic minorities who also identify as being LGBT. The purpose of this paper is to understand how race, sexual orientation and gender identity can simultaneously influence SDM among African-American LGBT persons, and to propose a model of SDM between such patients and their healthcare providers. We reviewed key constructs necessary for understanding SDM among African-American LGBT persons, which guided our systematic literature review. Eligible studies for the review included English-language studies of adults (≥ 19 y/o) in North America, with a focus on LGBT persons who were African-American/black (i.e., > 50 % of the study population) or included sub-analyses by sexual orientation/gender identity and race. We searched PubMed, CINAHL, ProQuest Dissertations & Theses, PsycINFO, and Scopus databases using MESH terms and keywords related to shared decision making, communication quality (e.g., trust, bias), African-Americans, and LGBT persons. Additional references were identified by manual reviews of peer-reviewed journals' tables of contents and key papers' references. We identified 2298 abstracts, three of which met the inclusion criteria. Of the included studies, one was cross-sectional and two were qualitative; one study involved transgender women (91 % minorities, 65 % of whom were African-Americans), and two involved African-American men who have sex with men (MSM). All of the studies focused on HIV infection. Sexual orientation and gender identity were patient-reported factors that negatively impacted patient/provider relationships and SDM. Engaging in SDM helped some patients overcome normative beliefs about clinical encounters. In this paper, we present a

  8. ISSN 2073-9990 East Cent. Afr. J. surg. (Online) 89

    African Journals Online (AJOL)

    Hp 630 Dual Core

    (Online). Publication COSECSA/ASEA -East and Central African Journal of Surgery. ... Vein Thrombosis – a Management ilemma – a Case Report. S G Mungazi, D .... A 67 year old hypertensive female patient initially presented to the Physicians with a history of .... survival in the absence of an IVC catheter. Whilst no major ...

  9. Giant fat containing breast masses: report of six cases | Hanna | East ...

    African Journals Online (AJOL)

    Six patients with giant fat containing breast masses encountered over a 20 year period are presented including a brief review of the literature. These benign tumours especially the giant varieties are rare but are likely to be increasingly diagnosed because of the widespread use of mammography. (East African Medical ...

  10. Identification of four novel HLA-B alleles, B*1590, B*1591, B*2726, and B*4705, from an East African population by high-resolution sequence-based typing.

    Science.gov (United States)

    Luo, M; Mao, X; Plummer, F A

    2005-02-01

    We report here four novel HLA-B alleles, B*1590, B*1591, B*2726, and B*4705, identified from an East African population during sequence-based HLA-B typing. The novel alleles were confirmed by sequencing two separate polymerase chain reaction products, and by molecular cloning and sequencing multiple clones. B*1590 is identical to B*1510 at exon 2 and exon 3, except for a difference (GCCGTC) at codon 158. Sequence differences at codon 152 (GAGGTG) and codon 167 (TGGTCG) differentiate B*1591 from B*1503 at exon 3. B*2726 is identical to B*2708 at exon 2 and exon 3, except for a difference (AAGCAG) at codon 70. B*4705 was identified in three Kenyan women. The allele is identical to B*47010101/02 at exon 2 and exon 3, except for differences at codon 97 (AGGAAT) and codon 99 (TTTTAT). These new alleles have been named by the WHO Nomenclature Committee. Identification of these novel HLA-B alleles reflects the genetic diversity of this East African population.

  11. Cardiac involvement in a patient with clinical and serological evidence of African tick-bite fever

    Directory of Open Access Journals (Sweden)

    Ave Anne

    2005-10-01

    Full Text Available Abstract Background Myocarditis and pericarditis are rare complications of rickettsiosis, usually associated with Rickettsia rickettsii and R. conorii. African tick-bite fever (ATBF is generally considered as a benign disease and no cases of myocardial involvement due to Rickettsia africae, the agent of ATBF, have yet been described. Case presentation The patient, that travelled in an endemic area, presented typical inoculation eschars, and a seroconversion against R. africae, was admitted for chest pains and increased cardiac enzymes in the context of an acute myocarditis. Conclusion Our findings suggest that ATBF, that usually presents a benign course, may be complicated by an acute myocarditis.

  12. The Design and Evaluation of African Language Learning Materials. Proceedings of the Spring 1984 Conference on Developing Guidelines for the Evaluation of African Language Learning Materials (East Lansing, Michigan, April 13-14, 1984).

    Science.gov (United States)

    Dwyer, David J., Ed.

    Representatives from major institutions teaching African languages convened to discuss the design of African language textbooks and to propose guidelines for the writing of new textbooks and evaluation of existing ones. Conference papers include: "Language Acquisition Theory and Materials Construction" (Stephen Krashen); "The Structures of Verbal…

  13. Risk factors for death in HIV-infected adult African patients receiving anti-retroviral therapy.

    Science.gov (United States)

    Siika, A M; Wools-Kaloustian, K; Mwangi, A W; Kimaiyo, S N; Diero, L O; Ayuo, P O; Owino-Ong'or, W D; Sidle, J E; Einterz, R M; Yiannoutsos, C T; Musick, B; Tierney, W M

    2010-11-01

    To determine risk factors for death in HIV-infected African patients on anti-retroviral therapy (ART). Retrospective Case-control study. The MOH-USAID-AMPATH Partnership ambulatory HIV-care clinics in western Kenya. Between November 2001 and December 2005 demographic, clinical and laboratory data from 527 deceased and 1054 living patients receiving ART were compared to determine independent risk factors for death. Median age at ART initiation was 38 versus 36 years for the deceased and living patients respectively (p100/mm3 (HR=1.553. 95% CI (1.156, 2.087), p<0.003). Patients attending rural clinics had threefold higher risk of dying compared to patients attending clinic at a tertiary referral hospital (p<0.0001). Two years after initiating treatment fifty percent of non-adherent patients were alive compared to 75% of adherent patients. Male gender, WHO Stage and haemoglobin level <10 grams% were associated with time to death while age, marital status, educational level, employment status and weight were not. Profoundly immunosuppressed patients were more likely to die early in the course of treatment. Also, patients receiving care in rural clinics were at greater risk of dying than those receiving care in the tertiary referral hospital.

  14. Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria

    DEFF Research Database (Denmark)

    Abdulla, S.; Adam, I.; Adjei, G. O.

    2015-01-01

    values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs). Methods: A literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled...... trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting...... early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data. Results: In total, 29,493 patients from 84 clinical trials were included...

  15. Patient satisfaction, preventive services, and emergency room use among African-Americans with type 2 diabetes.

    Science.gov (United States)

    Gary, Tiffany L; Maiese, Eric M; Batts-Turner, Marian; Wang, Nae-Yuh; Brancati, Fredrick L

    2005-12-01

    The aim of this study was to determine the relationship between patient satisfaction and diabetes- related preventive health care and emergency room (ER) use. We studied 542 urban African-Americans with type 2 diabetes aged > or =25 years who were enrolled in a primary carebased intervention trial to improve diabetes control and reduce adverse health events; 73% female, mean age 58 years, 35% had yearly household incomes of Consumer Assessment of Health Plans Survey (CAHPS) and use of diabetes-related preventive health care and ER were assessed by self-report. We then followed participants for 12 months to determine ER use prospectively. In general, participants gave favorable ratings of their care; over 70% reported that they had no problem getting care, over 60% reported the highest ratings on the communication and courtesy domains, and mean ratings (0-10 scale) for personal doctor and overall health care were high (8.8 and 8.4, respectively). Using poisson regression models adjusted for age, education, and self-reported rating of health, several aspects of patient satisfaction were associated with subsequent ER use. Participants who reported that medical staff were usually helpful or that doctors and nurses usually spent enough time were 0.49 and 0.37 times, respectively, less likely to use the ER (all p < 0.05). However, few aspects of patient satisfaction were associated with better preventive services. These data suggest that greater patient satisfaction was associated with lower ER use in urban African-Americans. Whether measures to improve patient satisfaction would reduce ER use requires further prospective study.

  16. Warfarin maintenance dose in older patients: higher average dose and wider dose frequency distribution in patients of African ancestry than those of European ancestry.

    Science.gov (United States)

    Garwood, Candice L; Clemente, Jennifer L; Ibe, George N; Kandula, Vijay A; Curtis, Kristy D; Whittaker, Peter

    2010-06-15

    Studies report that warfarin doses required to maintain therapeutic anticoagulation decrease with age; however, these studies almost exclusively enrolled patients of European ancestry. Consequently, universal application of dosing paradigms based on such evidence may be confounded because ethnicity also influences dose. Therefore, we determined if warfarin dose decreased with age in Americans of African ancestry, if older African and European ancestry patients required different doses, and if their daily dose frequency distributions differed. Our chart review examined 170 patients of African ancestry and 49 patients of European ancestry cared for in our anticoagulation clinic. We calculated the average weekly dose required for each stable, anticoagulated patient to maintain an international normalized ratio of 2.0 to 3.0, determined dose averages for groups 80 years of age and plotted dose as a function of age. The maintenance dose in patients of African ancestry decreased with age (PAfrican ancestry required higher average weekly doses than patients of European ancestry: 33% higher in the 70- to 79-year-old group (38.2+/-1.9 vs. 28.8+/-1.7 mg; P=0.006) and 52% in the >80-year-old group (33.2+/-1.7 vs. 21.8+/-3.8 mg; P=0.011). Therefore, 43% of older patients of African ancestry required daily doses >5mg and hence would have been under-dosed using current starting-dose guidelines. The dose frequency distribution was wider for older patients of African ancestry compared to those of European ancestry (PAfrican ancestry indicate that strategies for initiating warfarin therapy based on studies of patients of European ancestry could result in insufficient anticoagulation and thereby potentially increase their thromboembolism risk. Copyright 2010 Elsevier Inc. All rights reserved.

  17. CLINICAL PROFILE OF PATIENTS WITH ALCOHOLIC LIVER DISEASE IN UPPER ASSAM OF NORTH EAST INDIA

    Directory of Open Access Journals (Sweden)

    Ardhendu Kumar Sen

    2017-05-01

    Full Text Available BACKGROUND Alcohol is the most commonly abused drug worldwide causing liver injury with respect to dose, duration, type of alcohol consumption and drinking patterns and gender with diverse ethnicity and social customs. There is high prevalence of alcohol use in the society without much social taboo in the North Eastern States of India and also there is a high prevalence of different ethnic tribes with the custom of taking country made alcohol casually as a part of their tradition. The aim of this study is to study the clinical profile of patients with alcoholic liver disease in upper Assam of north east India. MATERIALS AND METHODS The study was a hospital-based observational study in which patients of 18 years and older and diagnosed to have alcoholic liver disease were included. Cases excluded were patients of NASH, viral hepatitis, drug-induced hepatitis, haemochromatosis, alcoholic liver disease with diabetes and kidney disease. Informed written consent was taken from the patients or their attendants. Ethical clearance was taken from the Institutional Ethical Committee. A total of 138 cases were selected for the study. A detailed evaluation of clinical history, examination and investigations and the results were recorded in a predesigned proforma. RESULTS Out of 138 patients, 113 were males and 25 were females with male:female ratio of 4.5:1. Majority of cases (34.78% were in the age group of (41-50 years. It was observed that 98 patients (71.01% belonged to the lower socioeconomic status group. The average duration of alcohol intake was 18.39 ± 6.24 years for males and 16.76 ± 6.59 years for females. The overall average duration of alcohol intake was 18.09 ± 6.29 years. The majority of the patients (104 cases, 75.36% took both foreign and country-made liquors. The most common clinical presentation was abdominal distension and swelling of feet (71 cases, 51.45% followed by jaundice (68 cases, 49.28% and anorexia (56 cases, 40.58%. The

  18. Nutrient intake and nutritional status of newly diagnosed patients with cancer from the East Coast of Peninsular Malaysia.

    Science.gov (United States)

    Menon, Kavitha; Razak, Shariza Abdul; Ismail, Karami A; Krishna, Bhavaraju Venkata Murali

    2014-09-30

    Cancer therapy in Malaysia primarily focuses on the clinical management of patients with cancer and malnutrition continues to be one of the major causes of death in these patients. There is a dearth of information on the nutrient intake and status of newly diagnosed patients with cancer prior to the initiation of treatment. The present study aims to assess the nutrient intake and status of newly diagnosed patients with cancer from the East Coast of Peninsular Malaysia. A cross-sectional study was conducted using a convenient sample of newly diagnosed adult patients with cancer (n = 70) attending the Oncology clinic, Hospital Universiti Sains Malaysia in the East Coast of Peninsular Malaysia. Information on socio-demographic characteristics, clinical status, anthropometry, dietary intake and biochemical data including blood samples was obtained. The mean (SD) age, triceps skin fold (TSF), mid upper arm circumference (MUAC) and body mass index (BMI) of participants was 21.1(3.9) years, 17.6(7.9) mm, 24.1(5.5) cm, and 21.1(3.9) Kg/m(2), respectively; 39% participants had BMI cancer were undernourished (i.e. women: MUAC cancer from the East Coast of Peninsular Malaysia were underweight and undernourished. The majority of patients with cancer had poor micronutrient intakes; the older women had a poor macro and micronutrient intakes. Before the initiation of rigorous clinical management of patients with cancer, screening for nutritional status, subsequent nutrition counseling, and interventions are essential to improve their nutritional status; consequently, response to cancer therapy, survival and quality of life.

  19. Development of an evaluation framework for African-European hospital patient safety partnerships.

    Science.gov (United States)

    Rutter, Paul; Syed, Shamsuzzoha B; Storr, Julie; Hightower, Joyce D; Bagheri-Nejad, Sepideh; Kelley, Edward; Pittet, Didier

    2014-04-01

    Patient safety is recognised as a significant healthcare problem worldwide, and healthcare-associated infections are an important aspect. African Partnerships for Patient Safety is a WHO programme that pairs hospitals in Africa with hospitals in Europe with the objective to work together to improve patient safety. To describe the development of an evaluation framework for hospital-to-hospital partnerships participating in the programme. The framework was structured around the programme's three core objectives: facilitate strong interhospital partnerships, improve in-hospital patient safety and spread best practices nationally. Africa-based clinicians, their European partners and experts in patient safety were closely involved in developing the evaluation framework in an iterative process. The process defined six domains of partnership strength, each with measurable subdomains. We developed a questionnaire to measure these subdomains. Participants selected six indicators of hospital patient safety improvement from a short-list of 22 based on their relevance, sensitivity to intervention and measurement feasibility. Participants proposed 20 measures of spread, which were refined into a two-part conceptual framework, and a data capture tool created. Taking a highly participatory approach that closely involved its end users, we developed an evaluation framework and tools to measure partnership strength, patient safety improvements and the spread of best practice.

  20. High Mortality in Severe Sepsis and Septic Shock Patients with Do-Not-Resuscitate Orders in East Asia.

    Science.gov (United States)

    Huang, Chun-Ta; Chuang, Yu-Chung; Tsai, Yi-Ju; Ko, Wen-Je; Yu, Chong-Jen

    2016-01-01

    Severe sepsis is a potentially deadly illness and always requires intensive care. Do-not-resuscitate (DNR) orders remain a debated issue in critical care and limited data exist about its impact on care of septic patients, particularly in East Asia. We sought to assess outcome of severe sepsis patients with regard to DNR status in Taiwan. A retrospective cohort study was conducted in intensive care units (ICUs) between 2008 and 2010. All severe sepsis patients were included for analysis. Primary outcome was association between DNR orders and ICU mortality. Volume of interventions was used as proxy indicator to indicate aggressiveness of care. Sixty-seven (9.4%) of 712 patients had DNR orders on ICU admission, and these patients were older and had higher disease severity compared with patients without DNR orders. Notably, DNR patients experienced high ICU mortality (90%). Multivariate analysis revealed that the presence of DNR orders was independently associated with ICU mortality (odds ratio: 6.13; 95% confidence interval: 2.66-14.10). In propensity score-matched cohort, ICU mortality rate (91%) in the DNR group was statistically higher than that (62%) in the non-DNR group (p central venous catheterization were more commonly used in DNR patients than in non-DNR patients. From the Asian perspective, septic patients placed on DNR orders on ICU admission had exceptionally high mortality. In contrast to Western reports, DNR patients received more ICU interventions, reflecting more aggressive approach to dealing with this patient population. The findings in some ways reflect differences between East and West cultures and suggest that DNR status is an important confounder in ICU studies involving severely septic patients.

  1. Impact of Renal Failure on Survival of African Patients with Cirrhosis

    Directory of Open Access Journals (Sweden)

    Attia K

    2008-01-01

    Full Text Available To assess the effect of renal failure on the survival of black African patients with cirrhosis, we studied 132 (82 males, 50 females cirrhotic black African patients with mean age of 47.5 ±14.4 years and mean follow-up period of 373 ± 194 days. The edema and ascitis were the main reasons for admission to hospital. Renal failure was present in 30 (22.7% patients, and it was positively correlated to the severity of the stage of the liver disease, and associated with severe hyponatremia. Survival at 1 year was 60.1% and 37.6% in the absence or presence of renal failure, respectively (p< 0.001. The stage of the liver disease was significantly inversely corre-lated with survival, which was further diminished in the presence of renal failure:23.7% versus 12.5% for Child-Pugh-Turcote (CPT A-B in the absence or presence of renal failure, respectively (p= 0.67, 30.2% versus 81.8% for CPT C in the absence or the presence of renal failure respectively (p< 0.001. Hyponatremia has also appeared detrimental to survival, since mortality was 38.4% versus 81.8% in the absence or the presence of hyponatremia respectively (p< 0.001. By multivariate analysis, renal failure, CPT stage C, and hyponatremia independently significantly correlated to mortality in patients with cirrhosis. We conclude that renal failure is frequently associated with decompensated cirrhosis. The presence of renal failure in this setting often results in high mortality. Renal failure that occurs in the setting of a severe liver disease and hyponatremia may be part of hepatorenal syndrome.

  2. Quantification and comparison of psychiatric distress in African patients with albinism and vitiligo: a 5-year prospective study.

    Science.gov (United States)

    Ajose, F O A; Parker, R A; Merrall, E L C; Adewuya, A O; Zachariah, M P

    2014-07-01

    Vitiligo and albinism are two disorders of pigmentation that make the affected African highly visible and strikingly different from their peers. Both pose considerable management challenges, attract significant stigma and profound impairment of quality of life. To determine and compare psychiatric distress in vitiligo and albinism using the Hospital Anxiety and Depression Scale (HADS). Participants were 87 albinos and 102 vitiligo adult patients seen at an urban tertiary hospital in Nigeria between 2004 and 2009. Prevalence of psycho morbidity was 59% (60/102) in vitiligo compared with 26% (23/87) in the albinos. The mean anxiety score was estimated to be 2.55 points lower for albino patients (95% CI: 1.47 to 3.64), and the mean depression score 2.76 points lower (95% CI: 1.84 to 3.68), after adjustment for age, sex and marital status. However, significant differences were not observed when comparing the vitiligo patients with the subset of albino patients with skin cancer. Older patients had significantly higher anxiety and depression scores. Females had significantly higher anxiety scores (but not depression scores) compared to males. Genital involvement in vitiligo was significantly associated with anxiety but not depression. We found that the African with vitiligo suffers significantly higher psychiatric distress than the African albino on average. Clinical evaluation of these patients would be incomplete without assessment of their psycho morbidity. There is need for increased focus on cancer prevention strategies in the African albino. © 2013 European Academy of Dermatology and Venereology.

  3. Research on stored biological samples: views of African American and White American cancer patients.

    Science.gov (United States)

    Pentz, Rebecca D; Billot, Laurent; Wendler, David

    2006-04-01

    Proposals on consent for research with biological samples should be informed by empirical studies of individuals' views. Studies to date queried mostly white research subjects. The aim of this study was to compare the views of two groups of patients: cancer patients at a university clinic (Winship Cancer Institute at Emory Healthcare) and cancer patients at an inner city county hospital (Grady) who were given the option of tissue banking. Overall, 315/452 (70%) patients completed the survey. The Grady cohort was 86% African American; the Winship cohort was 82% White. The vast majority (95%) of individuals in both cohorts agreed to provide a biological sample for future research. Both cohorts were willing for their samples to be used to study cancer and other diseases, including Alzheimer disease. Few participants preferred to control the disease to be studied (10%) or wished to be contacted again for consent for each future research project (11%). In our sample, almost all clinical patients, regardless of site of care, ethnicity or socioeconomic status, were willing to provide a biological sample for research purposes and allow investigators to determine the research to be done without contacting the patients again. These findings support the recommendation to offer individuals a simplified consent with a one-time binary choice whether to provide biological samples for future research. Copyright 2006 Wiley-Liss, Inc.

  4. Metabolic Syndrome in South African Patients with Severe Mental Illness: Prevalence and Associated Risk Factors.

    Directory of Open Access Journals (Sweden)

    Shamima Saloojee

    Full Text Available There is a surge of cardiovascular disease (CVD in Africa. CVD is the leading cause of mortality among patients with severe mental illness (SMI in developed countries, with little evidence from the African context.To determine the prevalence and risk factors for MetS among South African patients with SMI.In a cross sectional study, individuals with SMI treated with antipsychotics and a control group without a mental illness, matched for age, gender and ethnicity were evaluated for MetS using the 2009 Joint Interim statement (JIS criteria.Of the 276 study group subjects, 65.9% were male, 84.1% black African, 9.1% white, 5.4% of Indian descent and 1.5% coloured (mixed race with a mean age of 34.7 years (±12.5. Schizophrenia was the most common diagnosis (73.2% and 40% were taking first generation antipsychotics. The prevalence of MetS was 23.2% (M: 15.4%, F: 38.3% in the study group and 19.9% (M: 11.9%, F: 36.3% in the control group (p = 0.4. MetS prevalence was significantly higher in study subjects over 55 years compared to controls (p = 0.03. Increased waist circumference (p< 0.001 and low high density lipoprotein (HDL cholesterol (p = 0.003 were significantly more prevalent in study subjects compared to controls. In study subjects, risk factors associated with MetS included age (OR: 1.09, 95% CI 1.06-1.12, p < 0.001, female gender (OR: 2.19, 95% CI 1.06-4.55, p = 0.035 and Indian descent (OR: 5.84, 95% CI 1.66-20.52, p = 0.006 but not class of antipsychotic (p = 0.26.The overall MetS prevalence was not increased in patients with SMI compared to controls; however, the higher prevalence of the individual components (HDL cholesterol and waist circumference suggests an increased risk for CVD, especially in patients over 55 years.

  5. On being African and Reformed? Towards an African Reformed ...

    African Journals Online (AJOL)

    2014-06-17

    Jun 17, 2014 ... It is furthermore our contention that the notion of culture and African worldviews was always perceived negatively ..... dean of the South East Asia Graduate School of Theology. He later .... Another Reformed church for Indian.

  6. "The Service I Rendered Was Just as True": African American Soldiers and Veterans as Activist Patients.

    Science.gov (United States)

    Adler, Jessica L

    2017-05-01

    In this article, I examine how African American soldiers and veterans experienced and shaped federally sponsored health care during and after World War I. Building on studies of the struggles of Black leaders and health care providers to win professional and public health advancement in the 1920s and 1930s, and of advocates to mobilize for health care rights in the mid-20th century, I focus primarily on the experiences and activism of patients in the interwar years. Private and government correspondence, congressional testimony, and reports from Black newspapers reveal that African American soldiers and veterans communicated directly with policymakers and bureaucrats regarding unequal treatment, assuming roles as "policy actors" who viewed health and medical care as "politics by other means." In the process, they drew attention to the paradoxes inherent in expanding government entitlements in the era of Jim Crow, and helped shape a veterans' health system that emerged in the 1920s and remained in place for the following century. They also laid the groundwork for the system's precedent-setting desegregation, referred to by advocates of the time as "a shining example to the rest of the country."

  7. How Ghanaian, African-Surinamese and Dutch patients perceive and manage antihypertensive drug treatment: a qualitative study

    OpenAIRE

    Beune, E.J.A.J.; Haafkens, J.A.; Agyemang, C.; Schuster, J.S.; Willems, D.L.

    2008-01-01

    OBJECTIVES: To explore and compare how Ghanaian, African-Surinamese (Surinamese), and White-Dutch patients perceive and manage antihypertensive drug treatment in Amsterdam, the Netherlands. METHODS: Qualitative study was conducted using detailed interviews with a purposive sample of 46 hypertensive patients without comorbidity who were prescribed antihypertensives. RESULTS: Patients in all the ethnic groups actively decided how to manage their prescribed antihypertensive regimens. In all the ...

  8. Intimate partner violence and mental health symptoms in African American female ED patients.

    Science.gov (United States)

    Houry, Debra; Kemball, Robin; Rhodes, Karin V; Kaslow, Nadine J

    2006-07-01

    Intimate partner violence (IPV) victims often seek care in the ED, whether for an injury from abuse or other sequelae such as mental health symptoms. The objective of the study was to assess whether depressive symptoms, posttraumatic stress disorder (PTSD), and suicidality were associated with physical, sexual, or emotional IPV in African American female ED patients and to determine if experiencing multiple types of abuse was associated with increased mental health symptoms. All eligible African American female patients were approached in the ED waiting room during study periods. Patients participated in the screening process via a computer kiosk. Questions regarding IPV and mental health symptoms were asked using validated tools. In this prospective cohort, 569 participated and 36% of those in a relationship in the past year (n=461) disclosed that there were victims of IPV in the past year. In the past year, 22% experienced recent physical abuse, 9% recent sexual abuse, and 32% recent emotional abuse. A Pearson correlation was conducted and showed that all mental health symptoms were positively correlated with each type of IPV and each type of mental health symptom category. Mental health symptoms increased significantly with amount of abuse: depression (odds ratio [OR], 5.9 for 3 types of abuse), PTSD (OR, 9.4 for 3), and suicidality (OR, 17.5 for 3). Emotional, sexual, and physical IPV were significantly associated with mental health symptoms. Each type of abuse was independently associated with depression, suicidality, and PTSD. Experiencing more than 1 type of abuse was also correlated with increased mental health symptoms.

  9. Association between African American race and outcomes in patients with nonmetastatic triple-negative breast cancer: a retrospective analysis by using results from the Georgia Cancer Specialist Database.

    Science.gov (United States)

    Christiansen, Neal; Chen, Lei; Gilmore, James; Pechar, David; Szabo, Stephen

    2012-08-01

    The objective of this study was to evaluate, in a real-world context, the impact of race on disease recurrence and survival in patients with nonmetastatic triple-negative breast cancer (TNBC) treated with adjuvant chemotherapy. The study selected patients from the 2003-2008 Georgia Cancer Specialist Database with stage I-III confirmed TNBC who had received adjuvant chemotherapy. These patients were followed-up from initial diagnosis to death, cancer recurrence, or loss to follow-up. The primary outcome was disease-free survival (DFS). Kaplan-Meier curves compared DFS and recurrence between African American and non-African American groups. The impact of African American status was examined further through multivariate Cox models by adjusting for age, comorbidity, body mass index (BMI), smoking status, initial TNBC stage, surgery, and radiation therapy. Among 209 patients with TNBC, 89 (42.6%) were African American. The 2 groups (African American vs. non-African American) were similar in mean age at diagnosis (53.2 vs. 54.4 years; P =.487) and with surgery and radiation rates (98.9% vs. 100%; P = .244; 68.5% vs. 62.5%; P = .365, respectively). Compared with non-African Americans, African American patients had a higher BMI (30.4 vs. 28.6 kg/m(2); P = .0477) and were less likely to be diagnosed at stage I (31.5% vs. 51.7%; P = .0107). The African American patients had a lower 5-year DFS rate (45.2% vs. 79.7%; P = .0005) and a higher 5-year recurrence rate (42.5% vs. 7.0%; P = .0005) compared with the non-African American patients. Among patients with TNBC treated with adjuvant chemotherapy, African American race was associated with a worse outcome irrespective of later stage at presentation or higher BMI. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Use of endoscopy in diagnosis and management of patients with dysphagia in an African setting.

    Science.gov (United States)

    Mudawi, H M Y; Mahmoud, A O A; El Tahir, M A; Suliman, S H; Ibrahim, S Z

    2010-04-01

    The objectives of this study were to define the utility of esophagogastroduodenoscopy in the diagnosis and management of patients presenting with dysphagia and to determine the relative incidence of the various causes of dysphagia in Sudan. This is a prospective, cross-sectional, descriptive, hospital-based study carried out at the endoscopy unit of Soba University Hospital, Khartoum, Sudan. All patients complaining of dysphagia underwent upper gastrointestinal endoscopy with therapeutic intervention when necessary. A total of 114 patients were enrolled in the study, with a mean age of 47 years SD +/- 19 and a male to female ratio of 1 : 1.04. A benign condition was diagnosed in 56% of the cases; this included esophageal strictures in 21% of the cases and achalasia in 14%. Malignant causes were mainly due to esophageal cancer (40.4%) and cancer of the stomach cardia (3.5%). Therapeutic intervention was attempted in 83% of the cases. Risk factors predictive of a malignant etiology were age over 40 years (P dysphagia lasting between 1 month and 1 year (P endoscopy in our African setting is an accurate and useful investigation in the diagnosis and management of patients presenting with dysphagia. Patients over the age of 40 years presenting with dysphagia and weight loss are more likely to have a neoplastic disease and should be referred for urgent endoscopy.

  11. Mitochondrial impairment observed in fibroblasts from South African Parkinson’s disease patients with parkin mutations

    Energy Technology Data Exchange (ETDEWEB)

    Merwe, Celia van der, E-mail: celiavdm@sun.ac.za [Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town (South Africa); Loos, Ben [Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch (South Africa); Swart, Chrisna [Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town (South Africa); Kinnear, Craig [Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town (South Africa); MRC Centre for Molecular and Cellular Biology and the DST/NRF Centre of Excellence for Biomedical TB Research, Stellenbosch University, Cape Town (South Africa); Henning, Franclo [Division of Neurology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town (South Africa); Merwe, Lize van der [Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town (South Africa); Department of Statistics, University of the Western Cape, Cape Town (South Africa); Pillay, Komala [National Health Laboratory Services (NHLS) Histopathology Laboratory, Red Cross Children’s Hospital, Cape Town (South Africa); Muller, Nolan [Division of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town (South Africa); Zaharie, Dan [Neuropathology Unit, Division of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town (South Africa); Engelbrecht, Lize [Cell Imaging Unit, Central Analytical Facility, Stellenbosch University, Cape Town (South Africa); Carr, Jonathan [Division of Neurology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town (South Africa); and others

    2014-05-02

    Highlights: • Mitochondrial dysfunction observed in patients with parkin-null mutations. • Mitochondrial ATP levels were decreased. • Electron-dense vacuoles were observed in the patients. • Mitochondria from muscle biopsies appeared within normal limits. • One patient did not show these defects possibly due to compensatory mechanisms. - Abstract: Parkinson’s disease (PD), defined as a neurodegenerative disorder, is characterized by the loss of dopaminergic neurons in the substantia nigra in the midbrain. Loss-of-function mutations in the parkin gene are a major cause of autosomal recessive, early-onset PD. Parkin has been implicated in the maintenance of healthy mitochondria, although previous studies show conflicting findings regarding mitochondrial abnormalities in fibroblasts from patients harboring parkin-null mutations. The aim of the present study was to determine whether South African PD patients with parkin mutations exhibit evidence for mitochondrial dysfunction. Fibroblasts were cultured from skin biopsies obtained from three patients with homozygous parkin-null mutations, two heterozygous mutation carriers and two wild-type controls. Muscle biopsies were obtained from two of the patients. The muscle fibers showed subtle abnormalities such as slightly swollen mitochondria in focal areas of the fibers and some folding of the sarcolemma. Although no differences in the degree of mitochondrial network branching were found in the fibroblasts, ultrastructural abnormalities were observed including the presence of electron-dense vacuoles. Moreover, decreased ATP levels which are consistent with mitochondrial dysfunction were observed in the patients’ fibroblasts compared to controls. Remarkably, these defects did not manifest in one patient, which may be due to possible compensatory mechanisms. These results suggest that parkin-null patients exhibit features of mitochondrial dysfunction. Involvement of mitochondria as a key role player in PD

  12. Mitochondrial impairment observed in fibroblasts from South African Parkinson’s disease patients with parkin mutations

    International Nuclear Information System (INIS)

    Merwe, Celia van der; Loos, Ben; Swart, Chrisna; Kinnear, Craig; Henning, Franclo; Merwe, Lize van der; Pillay, Komala; Muller, Nolan; Zaharie, Dan; Engelbrecht, Lize; Carr, Jonathan

    2014-01-01

    Highlights: • Mitochondrial dysfunction observed in patients with parkin-null mutations. • Mitochondrial ATP levels were decreased. • Electron-dense vacuoles were observed in the patients. • Mitochondria from muscle biopsies appeared within normal limits. • One patient did not show these defects possibly due to compensatory mechanisms. - Abstract: Parkinson’s disease (PD), defined as a neurodegenerative disorder, is characterized by the loss of dopaminergic neurons in the substantia nigra in the midbrain. Loss-of-function mutations in the parkin gene are a major cause of autosomal recessive, early-onset PD. Parkin has been implicated in the maintenance of healthy mitochondria, although previous studies show conflicting findings regarding mitochondrial abnormalities in fibroblasts from patients harboring parkin-null mutations. The aim of the present study was to determine whether South African PD patients with parkin mutations exhibit evidence for mitochondrial dysfunction. Fibroblasts were cultured from skin biopsies obtained from three patients with homozygous parkin-null mutations, two heterozygous mutation carriers and two wild-type controls. Muscle biopsies were obtained from two of the patients. The muscle fibers showed subtle abnormalities such as slightly swollen mitochondria in focal areas of the fibers and some folding of the sarcolemma. Although no differences in the degree of mitochondrial network branching were found in the fibroblasts, ultrastructural abnormalities were observed including the presence of electron-dense vacuoles. Moreover, decreased ATP levels which are consistent with mitochondrial dysfunction were observed in the patients’ fibroblasts compared to controls. Remarkably, these defects did not manifest in one patient, which may be due to possible compensatory mechanisms. These results suggest that parkin-null patients exhibit features of mitochondrial dysfunction. Involvement of mitochondria as a key role player in PD

  13. How Ghanaian, African-Surinamese and Dutch patients perceive and manage antihypertensive drug treatment: a qualitative study

    NARCIS (Netherlands)

    Beune, Erik J. A. J.; Haafkens, Joke A.; Agyemang, Charles; Schuster, John S.; Willems, Dick L.

    2008-01-01

    OBJECTIVES: To explore and compare how Ghanaian, African-Surinamese (Surinamese), and White-Dutch patients perceive and manage antihypertensive drug treatment in Amsterdam, the Netherlands. METHODS: Qualitative study was conducted using detailed interviews with a purposive sample of 46 hypertensive

  14. How Ghanaian, African-Surinamese and Dutch patients percieve and manage antihypertensive drug treatment: A qualitive study

    NARCIS (Netherlands)

    Beune, E.J.; Haafkens, J.; Agyeman, Ch.; Schuster, J.; Willems, D.

    2008-01-01

    OBJECTIVES: To explore and compare how Ghanaian, African-Surinamese (Surinamese), and White-Dutch patients perceive and manage antihypertensive drug treatment in Amsterdam, the Netherlands. METHODS: Qualitative study was conducted using detailed interviews with a purposive sample of 46 hypertensive

  15. Developmental issues in chiropractic: a South African practitioner and patient perspective

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Mouton, Johan

    2007-01-01

    OBJECTIVE: This study explores pertinent aspects of chiropractic practice in contemporary South Africa in terms of the domains of beliefs, philosophy, professional matters, and education. METHODS: Ten practitioners were purposively sampled. From these, 3 were used as gatekeepers to access 6...... in the chiropractor's office. However, some patients seem confused by the lack of health care system integration and consequently display uncertainty of the status the chiropractor can claim professionally and educationally. Practitioners portrayed a view, indicating that chiropractic cannot claim coherence in any...... health care practices as part of the education process and the concomitant perceived lack of exposure especially to black South Africans emerged as interesting and pertinent developmental themes in the local context. CONCLUSIONS: The international discourse related to issues in the domains of philosophy...

  16. Des-A-lupane in an East African lake sedimentary record as a new proxy for the stable carbon isotopic composition of C3 plants

    NARCIS (Netherlands)

    van Bree, Loes G.J.; Rijpstra, W. Irene C; Al-Dhabi, N.A.; Verschuren, D.; Sinninghe Damste, J.S.; de Leeuw, J.W.

    2016-01-01

    We studied the high-resolution and well-dated 25,000 year sedimentary record of Lake Challa, a deep tropical crater lake in equatorial East Africa, to explore new proxies for paleoenvironmental and paleohydrological change. Sedimentary biomarker analysis revealed the presence of des-A-triterpenoids

  17. Quality of life in South East Asian patients who consult for dyspepsia: Validation of the short form Nepean Dyspepsia Index

    OpenAIRE

    Mahadeva, Sanjiv; Wee, Hwee-Lin; Goh, Khean-Lee; Thumboo, Julian

    2009-01-01

    Abstract Background Treatment objectives for dyspepsia include improvements in both symptoms and health-related quality of life (HRQoL). There is a lack of disease-specific instruments measuring HRQoL in South East Asian dyspeptics. Objectives To validate English and locally translated version of the Short-Form Nepean Dyspepsia Index (SF-NDI) in Malaysian patients who consult for dyspepsia. Methods The English version of the SF-NDI was culturally adapted locally and a Malay translation was de...

  18. The Internet as an emerging patient education tool among African American men with prostate cancer: an exploratory study.

    Science.gov (United States)

    Wallington, Sherrie Flynt

    2008-06-01

    The lives of African American men with prostate cancer are greatly influenced by the information available to them, some of which is accessed on the Internet. Research indicates that the Internet can enhance consumer health knowledge but has not reached socioeconomic groups at highest risk for health disparities, such as African American men with prostate cancer. In this study, focus groups were used to explore the perceptions and uses of the Internet as a patient education tool among 39 African American men aged 39 years and older with diverse socioeconomic backgrounds. Nineteen (49%) participants reported using the Internet, 15 (38%) reported no use but indicated it was used on their behalf, and 5 (13%) reported no use and no use on their behalf. The findings revealed varying degrees of Internet use for information and social support. Prostate cancer diagnosis, poor patient-doctor communications, and accessibility influenced Internet use. Accessibility related more to lack of ease and familiarity with Internet use than lack of computer access. With training and awareness, the Internet has potential as a patient education tool among African American men with prostate cancer.

  19. Impact of Middle East respiratory syndrome outbreak on the use of emergency medical resources in febrile patients.

    Science.gov (United States)

    Jeong, Hyunho; Jeong, Sikyoung; Oh, Juseok; Woo, Seon Hee; So, Byung Hak; Wee, Jeong Hee; Kim, Ji Hoon; Im, Ji Yong; Choi, Seung Pill; Park, Kyoungnam; Cho, Byul Nim Hee; Hong, Sungyoup

    2017-06-01

    Outbreaks of transmissible respiratory infection are suspected to have significant effects on the health of pediatric and geriatric patients. The objective was to assess the impact of the Middle East respiratory syndrome (MERS) outbreak on the use of emergency resources. An ecologic analysis of emergency department (ED) records between September and December 2015, was performed. Data was obtained from the National Emergency Department Information System database for Korea. All demographic and diagnostic data from patients presenting with febrile symptoms as a main complaint were collected. The data were compared to the equivalent period in the three years preceding the MERS outbreak in Korea. Following the MERS outbreak, there was an increase in overall ED visits by febrile patients and the proportion of visits by febrile patients, relative to total ED attendances. This effect was more prominent in the children under five years. The duration of the chief complaint before ED arrival and the length of ED stay were significantly increased among younger pediatric patients. Decreased body temperature on arrival was observed in younger pediatric patients. MERS outbreak appears to have had a significant effects on ED use by febrile patients. The use of emergency care services by pediatric patients makes them more vulnerable to an outbreak of a transmissable disease. An effective strategy to control emergency center visits by non-urgent febrile patients and provide proper medical services is urgently needed.

  20. Informed and patient-centered decision-making in the primary care visits of African Americans with depression.

    Science.gov (United States)

    Hines, Anika L; Roter, Debra; Ghods Dinoso, Bri K; Carson, Kathryn A; Daumit, Gail L; Cooper, Lisa A

    2018-02-01

    We examined the prevalence and extent of informed decision-making (IDM) and patient-centered decision-making (PCDM) in primary care visits of African Americans with depression. We performed a cross-sectional analysis of audiotaped clinical encounters and post-visit surveys of 76 patients and their clinicians. We used RIAS to characterize patient-centeredness of visit dialogue. IDM entailed discussion of 3 components: the nature of the decision, alternatives, and pros/cons. PCDM entailed discussion of: lifestyle/coping strategies, knowledge/beliefs, or treatment concerns. We examined the association of IDM and PCDM with visit duration, overall patient-centeredness, and patient/clinician interpersonal ratings. Approximately one-quarter of medication and counseling decisions included essential IDM elements and 40% included at least one PCDM element. In high patient-centered visits, IDM was associated with patients feeling respected in counseling and liking clinicians in medication decisions. IDM was not related to clinician ratings. In low patient-centered visits, PCDM in counseling decisions was positively associated with patients feeling respected and clinicians respecting patients. The associations between IDM and PCDM with interpersonal ratings was moderated by overall patient-centeredness of the visit, which may be indicative of broader cross-cultural communication issues. Strengthening partnerships between depressed African Americans and their clinicians may improve patient-engaged decision-making. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Pharmacokinetics of Antibiotics in Sub-Saharan African Patient Populations: A Systematic Review.

    Science.gov (United States)

    Bos, Jeannet C; van Hest, Reinier M; Prins, Jan M

    2017-08-01

    In sub-Saharan Africa (SSA), severe febrile illness accounts for a large majority of medical admissions. SSA patients may also suffer from cachexia and organ dysfunction resulting from tuberculosis, hepatitis B, and hypertension. It is hard to tell how these conditions influence the pharmacokinetics (PK) of antibiotics in this population. The aim of this systematic review was to summarize antibiotic PK data of SSA adult patient populations to clarify whether inappropriate drug concentrations that may also lead to antimicrobial resistance are likely to occur. An electronic search was conducted in Ovid MEDLINE, Embase, and the African Index Medicus collecting studies from 1946 to May 2016. Reviewers independently selected studies reporting outcome data on volume of distribution (V), clearance, and half-life. Relevant information was abstracted and quality assessed. Twelve studies were selected, addressing 6 antibiotic classes. There were 6 studies on fluoroquinolones and 1 on β-lactam antibiotics. Nine out of 12 originated from South Africa and 6 of those dealt with intensive care unit (ICU) populations. The quality of most studies was low. Studies on amikacin, teicoplanin, and ertapenem (n = 4) displayed a pattern of a large V with low drug concentrations. Fluoroquinolone PK changes were less prominent and more diverse whereas the probability of pharmacodynamic target attainment was low for the treatment of tuberculosis in South Africa. Interindividual variability of V was high for 10/12 studies. Antibiotic PK data of SSA adult patient populations are scarce, but disease-induced inappropriate drug concentrations do occur. Data from non-ICU, severely ill patients, and β-lactam data are particularly lacking, whereas β-lactam antibiotics are commonly used, and typically vulnerable to disease-induced PK changes. Studies investigating the PK and pharmacodynamics of β-lactam antibiotics in severely ill, adult SSA patient populations are needed to improve local

  2. Serum Lipoprotein (a Levels in Black South African Type 2 Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Jim Joseph

    2016-01-01

    Full Text Available Lipoprotein (a (Lp(a which is a low-density lipoprotein-like particle containing apo(a is considered as an emergent cardiovascular risk factor. Type 2 diabetes mellitus (T2DM is associated with a two- to threefold increase in the risk of cardiovascular disease (CVD. The aim of this study was to investigate the levels of Lp(a in Black South African T2DM patients and its association with other metabolic factors. 67 T2DM patients and 48 healthy control participants were recruited for the cross-sectional study. The Lp(a level was determined by ELISA and the result was analyzed using SPSS. The Lp(a level in diabetics was found to be significantly increased (P=0.001 when compared to the normal healthy group. In the diabetic group, the Lp(a levels correlated significantly with the duration of diabetes (P=0.008 and oxidized LDL (ox-LDL levels (P=0.03 and decreased total antioxidant capacity (P=0.001. The third tertile of Lp(a was significantly correlated with increased ox-LDL, C-reactive protein, and triglycerides and decreased total antioxidant capacity.

  3. Complications of Transfusion-Dependent β-Thalassemia Patients in Sistan and Baluchistan, South-East of Iran

    Science.gov (United States)

    Yaghobi, Maryam; Miri-Moghaddam, Ebrahim; Majid, Naderi; Bazi, Ali; Navidian, Ali; Kalkali, Asiyeh

    2017-01-01

    Background: Thalassemia syndromes are among prevalent hereditary disorders imposing high expenses on health-care system worldwide and in Iran. Organ failure represents a life-threatening challenge in transfusion- dependent β-thalassemia (TDT) patients. The purpose of the present study was to determine the frequency of organ dysfunctions among TDT patients in Sistan and Baluchistan province in South-East of Iran. Materials and Methods: Laboratory and clinical data were extracted from medical records as well as by interviews. Standard criteria were applied to recognize cardiac, gonadal, endocrine and renal dysfunctions. The collected data were analyzed using the SPSS statistics software (Ver.19). Results: A total of 613 TDT patients (54.3% males and 45.7% females) were included in this study. The mean age of patients was 13.3 ±7.7 years old. Cardiac events comprised the most encountered complications (76.4%), following by hypogonadism (46.8%), parathyroid dysfunction (22%), thyroid abnormalities (8.3%), diabetes (7.8%) and renal disease (1.8%). Hypogonadism comprised the most identified complication in patient 15 years old (P<0.01). Conclusion: As cardiac events are significantly more common among TDT patients, close monitoring of the heart function is recommended for identifying patients with cardiac problems. PMID:29340121

  4. Lung function and long-term safety of tiotropium/olodaterol in East Asian patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Bai C

    2017-11-01

    Full Text Available Chunxue Bai,1 Masakazu Ichinose,2 Sang Haak Lee,3 Kwan Ho Lee,4 Olaf Jöns,5 Ulrich Bothner,6 Yihua Zhao,7 Roland Buhl8 1Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China; 2Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; 3Department of Internal Medicine, St Paul’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea; 4Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea; 5Department of Medicine TA Respiratory Diseases, 6Department of Pharmacovigilance, Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany; 7Department of Biostatistics and Data Sciences, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA; 8Pulmonary Department, Mainz University Hospital, Mainz, Germany Background and purpose: While the efficacy and safety of combined tiotropium and olodaterol in patients with COPD was established in a large clinical trial program, it is important to assess whether clinical data can be applied to geographic patient groups, particularly for East Asian patients who may have a different phenotypic profile to the global trial population. This study aimed to compare the lung function and safety profiles of tiotropium/olodaterol and monocomponents in East Asian and global populations from the TONADO® trials.Materials and methods: In the replicate, double-blind, parallel-group, active-controlled, randomized, 52-week, Phase III TONADO studies, patients received tiotropium/olodaterol, tiotropium, or olodaterol. We assessed the forced expiratory volume in 1 second (FEV1 area under the curve from 0 to 3 hours (AUC0–3 response and trough FEV1 response at 24 weeks for the approved doses, tiotropium/olodaterol 5/5 µg, tiotropium 5 µg, and olodaterol 5 µg. Treatment-emergent adverse events were recorded throughout treatment and ≤21 days

  5. Differential gene expression between African American and European American colorectal cancer patients.

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    Biljana Jovov

    Full Text Available The incidence and mortality of colorectal cancer (CRC is higher in African Americans (AAs than other ethnic groups in the U. S., but reasons for the disparities are unknown. We performed gene expression profiling of sporadic CRCs from AAs vs. European Americans (EAs to assess the contribution to CRC disparities. We evaluated the gene expression of 43 AA and 43 EA CRC tumors matched by stage and 40 matching normal colorectal tissues using the Agilent human whole genome 4x44K cDNA arrays. Gene and pathway analyses were performed using Significance Analysis of Microarrays (SAM, Ten-fold cross validation, and Ingenuity Pathway Analysis (IPA. SAM revealed that 95 genes were differentially expressed between AA and EA patients at a false discovery rate of ≤5%. Using IPA we determined that most prominent disease and pathway associations of differentially expressed genes were related to inflammation and immune response. Ten-fold cross validation demonstrated that following 10 genes can predict ethnicity with an accuracy of 94%: CRYBB2, PSPH, ADAL, VSIG10L, C17orf81, ANKRD36B, ZNF835, ARHGAP6, TRNT1 and WDR8. Expression of these 10 genes was validated by qRT-PCR in an independent test set of 28 patients (10 AA, 18 EA. Our results are the first to implicate differential gene expression in CRC racial disparities and indicate prominent difference in CRC inflammation between AA and EA patients. Differences in susceptibility to inflammation support the existence of distinct tumor microenvironments in these two patient populations.

  6. Safety and effectiveness of the new P2Y12r inhibitor agents vs clopidogrel in ACS patients according to the geographic area: East Asia vs Europe

    NARCIS (Netherlands)

    Giordana, Francesca; Montefusco, Antonio; D'Ascenzo, Fabrizio; Moretti, Claudio; Scarano, Silvia; Abu-Assi, Emad; Raposeiras-Roubín, Sergio; Henriques, Jose Paulo Simao; Saucedo, Jorge; González-Juanatey, José Ramón; Wilton, Stephen B.; Kikkert, Wouter J.; Nuñez-Gil, Iván; Ariza-Sole, Albert; Song, Xiantao; Alexopoulos, Dimitrios; Liebetrau, Christoph; Kawaji, Tetsuma; Huczek, Zenon; Nie, Shao-Ping; Fujii, Toshiharu; Correia, Luis; Kawashiri, Masa-Aki; García-Acuña, José María; Southern, Danielle; Alfonso, Emilio; Terol, Belén; Garay, Alberto; Zhang, Dongfeng; Chen, Yalei; Xanthopoulou, Ioanna; Osman, Neriman; Möllmann, Helge; Shiomi, Hiroki; Kowara, Michal; Filipiak, Krzysztof; Wang, Xiao; Yan, Yan; Fan, Jing-Yao; Ikari, Yuji; Nakahayshi, Takuya; Sakata, Kenji; Yamagishi, Masakazu; Kalpak, Oliver; Kedev, Sasko; Gaita, F.

    2016-01-01

    Background: In the setting of the Acute Coronary Syndrome (ACS), differences in response to prasugrel and ticagrelor between East Asian and European patients have not been investigated yet. Methods: This is a sub-analysis of the "BleeMACS registry". Patients admitted for ACS and underwent PCI from

  7. Phase 1 study of the investigational Aurora A kinase inhibitor alisertib (MLN8237) in East Asian cancer patients: pharmacokinetics and recommended phase 2 dose.

    Science.gov (United States)

    Venkatakrishnan, Karthik; Kim, Tae Min; Lin, Chia-Chi; Thye, Lim Soon; Chng, Wee Joo; Ma, Brigette; Chen, Ming Huang; Zhou, Xiaofei; Liu, Hua; Kelly, Virginia; Kim, Won Seog

    2015-08-01

    This phase 1 study assessed the pharmacokinetics (PK), maximum tolerated dose (MTD)/recommended phase 2 dose (RP2D), safety, and preliminary efficacy of the investigational Aurora A kinase inhibitor, alisertib, in East Asian patients with advanced solid tumors or lymphomas. Patients received alisertib twice-daily (BID) for 7 days in 21-day cycles. Doses were escalated (3 + 3) from 30 mg BID based on cycle 1 dose-limiting toxicities (DLTs) until the MTD, followed by expansion for PK/safety characterization. Thirty-six patients (61 % Chinese, 36 % Korean, 3 % Malay) received alisertib (30 mg BID, n = 30; 40 mg BID, n = 6; median, 2.5 cycles). Alisertib exposures increased approximately dose proportionally, and mean half-life was 16 h. Geometric mean apparent oral clearance (2.65 L/h) was 40 % lower than previous estimates in Western patients, resulting in approximately 70 % higher mean dose-normalized, steady-state exposures (735 nM*h/mg) in East Asian patients. Two patients experienced DLTs at 40 mg BID (grade 3 stomatitis; grade 4 neutropenia); the MTD/RP2D was 30 mg BID. Common toxicities (grade ≥3 at RP2D) were neutropenia (50 %), diarrhea (13 %), and stomatitis (10 %). One patient with extranodal T-/NK-cell lymphoma (nasal type) achieved a partial response and 18 (51 %) had stable disease. The MTD/RP2D of alisertib in East Asian patients (30 mg BID) was lower than in Western patients (50 mg BID), consistent with higher systemic exposures in the East Asian population. Alisertib was generally well tolerated and showed signs of antitumor activity in East Asian cancer patients.

  8. Surgical outcomes of the Ex-PRESS glaucoma filtration device in African American and white glaucoma patients

    Directory of Open Access Journals (Sweden)

    Salim S

    2012-06-01

    Full Text Available Sarwat Salim, Haiming Du, Sumalee Boonyaleephan, Jim WanUniversity of Tennessee Health Science Center, Memphis, TN, USAPurpose: To compare the surgical outcomes of the Ex-PRESS glaucoma filtration device in African American and white glaucoma patients.Design: Retrospective comparative case series.Methods: This was a comparative case series of 36 eyes of 36 African Americans and 43 eyes of 43 whites that underwent placement of the Ex-PRESS glaucoma filtration device under a partial-thickness scleral flap for uncontrolled glaucoma. All eyes received intraoperative mitomycin C. The primary outcome measures were intraocular pressure (IOP, number of postoperative glaucoma medications, and surgical success. Surgical success was defined as IOP between 5 and 18 mm Hg, with or without glaucoma medications, without further glaucoma surgery, or loss of light perception vision. Results: Average follow-up was 31.9 ± 9.8 (range, 14.6–47 months for African Americans and 30.7 ± 8.6 (range, 14.3–47 months for whites. At 33 months, surgical success was 80.0% in the African American group and 83.3% in the white group (P = 1.00. Reasons for surgical failure included increased IOP (3 eyes, 3.8%, persistent hypotony with maculopathy (1 eye, 1.3%, and further surgery (4 eyes, 5.06%. Compared with preoperative values, the mean postoperative IOP and number of glaucoma medications were significantly reduced in both groups, and no statistical difference was observed between the two groups at 33 months. Postoperative complications were similar in the two groups.Conclusions: Similar surgical outcomes were observed in African American and white glaucoma patients after implantation of the Ex-PRESS glaucoma filtration device. This latest modification of glaucoma filtration surgery may be a better surgical option for African Americans given its potential advantages of no tissue removal, predictable outcomes related to consistent lumen size and controlled flow, fewer

  9. ISSN 2073 ISSN 2073 9990 East Cent. Afr. J. 9990 East Cent. Afr. J ...

    African Journals Online (AJOL)

    Hp 630 Dual Core

    COSECSA/ASEA Publication East and Central African ... the one hand on medical technology and equipment and on the other hand on the medical .... traumatic brain injury was the main cause of death amongst emergency admissions at the.

  10. Effects of patient-provider race concordance and smoking status on lung cancer risk perception accuracy among African-Americans.

    Science.gov (United States)

    Persky, Susan; Kaphingst, Kimberly A; Allen, Vincent C; Senay, Ibrahim

    2013-06-01

    Communication of lung cancer risk information between providers and African-American patients occurs in a context marked by race-based health disparities. A controlled experiment assessed whether perceived physician race influenced African-American patients' (n = 127) risk perception accuracy following the provision of objective lung cancer risk information. Participants interacted with a virtual reality-based, simulated physician who provided personalized cancer risk information. Participants who interacted with a racially discordant virtual doctor were less accurate in their risk perceptions at post-test than those who interacted with a concordant virtual doctor, F(1,94) = 4.02, p = .048. This effect was amplified among current smokers. Effects were not mediated by trust in the provider, engagement with the health care system, or attention during the encounter. The current study demonstrates that African-American patients' perceptions of a doctor's race are sufficient to independently impact their processing of lung cancer risk information.

  11. Spatial co-distribution of neglected tropical diseases in the East African Great Lakes region: revisiting the justification for integrated control

    Science.gov (United States)

    Clements, Archie C. A.; Deville, Marie-Alice; Ndayishimiye, Onésime; Brooker, Simon; Fenwick, Alan

    2010-01-01

    Summary OBJECTIVE To determine spatial patterns of co-endemicity of schistosomiasis mansoni and the soil-transmitted helminths (STHs) Ascaris lumbricoides, Trichuris trichiura and hookworm in the Great Lakes region of East Africa, to help plan integrated neglected tropical disease programmes in this region. METHOD Parasitological surveys were conducted in Uganda, Tanzania, Kenya and Burundi in 28 213 children in 404 schools. Bayesian geostatistical models were used to interpolate prevalence of these infections across the study area. Interpolated prevalence maps were overlaid to determine areas of co-endemicity. RESULTS In the Great Lakes region, prevalence was 18.1% for Schistosoma mansoni, 50.0% for hookworm, 6.8% for A. lumbricoides and 6.8% for T. trichiura. Hookworm infection was ubiquitous, whereas S. mansoni, A. lumbricoides and T. trichiura were highly focal. Most areas were endemic (prevalence ≥10%) or hyperendemic (prevalence ≥50%) for one or more STHs, whereas endemic areas for schistosomiasis mansoni were restricted to foci adjacent large perennial water bodies. CONCLUSION Because of the ubiquity of hookworm, treatment programmes are required for STH throughout the region but efficient schistosomiasis control should only be targeted at limited high-risk areas. Therefore, integration of schistosomiasis with STH control is only indicated in limited foci in East Africa. PMID:20409287

  12. Work-family and family-work conflicts amongst African nurses caring for patients with AIDS.

    Science.gov (United States)

    Makola, Lehlogonolo; Mashegoane, Solomon; Debusho, Legesse K

    2015-12-14

    South African nursing environments are marked by various incapacitating stressors. This study explores work-family (W-F) and family-work (F-W) conflicts as aspects of stress amongst nurses working with patients who have AIDS. The study sought to determine the value of W-F and F-W conflicts as predictors of work and family satisfaction, as well as turnover intentions and the moderating role of supervisor and significant other support, amongst nurses caring for patients with AIDS in public hospitals within the Capricorn and Mopani districts, Limpopo Province. The study used a cross-sectional design, with data collected at one point only. Ninety-one nursing staff provided the data for the study by completing structured, self-administered surveys. Analysis involved computing correlations of all study variables. Thereafter, associated variables were used as predictors. In each predictive analysis, the nurses' stress served as a control variable, W-F and F-W conflicts were the independent variables and significant others and supervisor supports were moderators. Interaction terms were derived from independent and moderator variables. Although the findings of the study were not generally supportive of the hypotheses advanced, they nevertheless showed, amongst other findings, that F-W conflict predicted work satisfaction whilst W-F conflict predicted turnover intentions. Moreover, significant other support had a direct effect on family satisfaction whilst supervisor support moderated reports of W-F conflict and experiences of work satisfaction. The study showed that inter-role models that appear to be established in the context of developed societies require some further investigations in South Africa.

  13. Work-family and family-work conflicts amongst African nurses caring for patients with AIDS

    Directory of Open Access Journals (Sweden)

    Lehlogonolo Makola

    2015-12-01

    Full Text Available Background: South African nursing environments are marked by various incapacitating stressors. This study explores work-family (W-F and family-work (F-W conflicts as aspects of stress amongst nurses working with patients who have AIDS. Objectives: The study sought to determine the value of W-F and F-W conflicts as predictors of work and family satisfaction, as well as turnover intentions and the moderating role of supervisor and significant other support, amongst nurses caring for patients with AIDS in public hospitals within the Capricorn and Mopani districts, Limpopo Province. Methods: The study used a cross-sectional design, with data collected at one point only. Ninety-one nursing staff provided the data for the study by completing structured, self-administered surveys. Analysis involved computing correlations of all study variables. Thereafter, associated variables were used as predictors. In each predictive analysis, the nurses’ stress served as a control variable, W-F and F-W conflicts were the independent variables and significant others and supervisor supports were moderators. Interaction terms were derived from independent and moderator variables. Results: Although the findings of the study were not generally supportive of the hypotheses advanced, they nevertheless showed, amongst other findings, that F-W conflict predicted work satisfaction whilst W-F conflict predicted turnover intentions. Moreover, significant other support had a direct effect on family satisfaction whilst supervisor support moderated reports of W-F conflict and experiences of work satisfaction. Conclusions: The study showed that inter-role models that appear to be established in the context of developed societies require some further investigations in South Africa.

  14. Gout Self-Management in African American Veterans: A Qualitative Exploration of Challenges and Solutions From Patients' Perspectives.

    Science.gov (United States)

    Singh, Jasvinder A; Herbey, Ivan; Bharat, Aseem; Dinnella, Janet E; Pullman-Mooar, Sally; Eisen, Seth; Ivankova, Nataliya

    2017-11-01

    To explore gout self-management and associated challenges and solutions in African Americans. We conducted semistructured interviews with 35 African American veterans with gout, who received health care at Birmingham or Philadelphia Veterans Affairs (VA) medical centers, had filled urate-lowering therapy (ULT; most commonly allopurinol) for at least 6 months, and had a ULT medication possession ratio ≥80%. The interview protocol was constructed to explore key concepts related to gout self-management, including initial diagnosis of gout, beginning medical care for gout, the course of the gout, ULT medication adherence, dietary strategies, comorbidity and side effects, and social support. Thirty-five African American male veterans with gout who had ≥80% ULT adherence (most commonly, allopurinol) were interviewed at Birmingham (n = 18) or Philadelphia (n = 17) VA medical centers. Mean age was 65 years, mean body mass index was 31.9 kg/m 2 , 97% had hypertension, 23% had coronary artery disease, and 31% had renal failure. The main themes motivating African American veterans to better gout self-management were fear of pain, adherence to medications, self-discipline, lifestyle changes, information gathering, and developing a positive outlook. Birmingham participants more frequently revealed skipping gout medications. More Philadelphia participants discussed lifestyle/diet changes to prevent gout flares, indicated limiting social activities that involved drinking, and sought more information about gout self-management from health care providers and internet sources. Identified themes, including cultural differences by site, led to the development of a patient-centered intervention to improve gout self-management in African American men with gout. © 2017, American College of Rheumatology.

  15. Why are some patients with Duchenne muscular dystrophy dying young: An analysis of causes of death in North East England.

    Science.gov (United States)

    Van Ruiten, H J A; Marini Bettolo, C; Cheetham, T; Eagle, M; Lochmuller, H; Straub, V; Bushby, K; Guglieri, M

    2016-11-01

    Duchenne muscular dystrophy (DMD) is the most common inherited muscle disease in children. Recent years have seen an increase in age of survival into adulthood following the introduction of proactive standards of care. We reviewed mortality in DMD in our population in order to identify potential underlying risk factors for premature death and improve clinical care. A retrospective case note review of all deaths in the DMD population over the last 10 years in North East England. We identified 2 groups of patients: patients who died from underlying cardiac and/or respiratory failure (group 1) and patients who died unexpectedly in the absence of underlying cardio-respiratory failure (group 2). Detailed information was available on 21 patients. Mean age of death in group 1 (17 patients) was 23.9 (14.4-39.5) years, in group 2 (4 patients) 14 (12.7-14.9) years. Causes of death in group 2 were acute pneumonia, cardiac arrest, acute respiratory distress and multi-organ failure. Across both groups we identified concerns regarding respiratory failure, inadequate nutrition, non-attendance at appointments, suboptimal coordination of care and decreased psychological wellbeing. In group 2, fat embolism, cardiac arrhythmia and adrenal insufficiency were also potential contributing factors. The main cause of death in DMD in our population remains cardio-respiratory failure. Four patients (19%) died in their teenage years in the absence of severe cardiorespiratory failure. A more thorough understanding of the impact of DMD and its treatment on all organs systems is required to minimise the risk of an untimely death. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  16. Results of a real-world study on vortioxetine in patients with major depressive disorder in South East Asia (REVIDA).

    Science.gov (United States)

    Chin, Cheuk Ngen; Zain, Azhar; Hemrungrojn, Solaphat; Ung, Eng Khean; Kwansanit, Patanon; Au Yong, Koon Choong; Chong, Marvin Swee Woon; Inpa, Chalowat; Yen, Teck Hoe; Yeoh, Boon Beng David; Tay, Liam Kai; Bernardo, Carmina; Lim, Lionel Chee-Chong; Yap, Chin Hong; Fones, Calvin; Nayak, Ashwini; Nelleman, Lars

    2018-05-17

    The REVIDA study aimed to assess the evolution of major depression symptoms in South East Asian (SEA) patients treated with vortioxetine for major depression in real-world clinical practice. This non-interventional study was conducted from Aug 2016 to Apr 2017. A total of 138 patients (aged 18-65 years) with an active episode of major depression were recruited from Malaysia, Philippines, Singapore, and Thailand. Vortioxetine was initiated on the first visit and patients were followed for 3 months. Depression severity was assessed using the PHQ-9 questionnaire (patient-assessed) and CGI-S scale (physician-assessed); cognitive function was assessed with the PDQ-D questionnaire; work productivity and activity impairment (WPAI) was assessed with the WPAI questionnaire. At baseline, 89.9% of patients were moderately to severely depressed (PHQ-9 score ≥ 10). During the 3-month treatment period, mean±SD PHQ-9 score decreased from 18.7±5.7 to 5.0±5.3, mean±SD CGI-S score decreased from 4.4±0.7 to 2.2±1.1, and mean±SD PDQ-D score decreased from 42.1±18.8 to 13.4±13.0. By month 3, response and remission rates reached 80.8% and 59.0%, respectively. Work productivity loss decreased from 73.6% to 30.5%, while activity impairment decreased from 71.5% to 24.6%. Positive correlations were observed between PHQ-9, PDQ-D, and WPAI work productivity loss and activity impairment. By month 3, 82.0% of patients were either not depressed or only mildly depressed (PHQ-9 score ≤ 9). In real-world clinical settings, vortioxetine was effective in reducing depression severity and improving cognitive function and work productivity in SEA patients with major depression.

  17. Tectonic inheritance in the development of the Kivu - north Tanganyika rift segment of the East African Rift System: role of pre-existing structures of Precambrian to early Palaeozoic origin.

    Science.gov (United States)

    Delvaux, Damien; Fiama Bondo, Silvanos; Ganza Bamulezi, Gloire

    2017-04-01

    The present architecture of the junction between the Kivu rift basin and the north Tanganyika rift basin is that of a typical accommodation zone trough the Ruzizi depression. However, this structure appeared only late in the development of the Western branch of the East African Rift System and is the result of a strong control by pre-existing structures of Precambrian to early Palaeozoic origin. In the frame of a seismic hazard assessment of the Kivu rift region, we (Delvaux et al., 2016) constructed homogeneous geological, structural and neotectonic maps cross the five countries of this region, mapped the pre-rift, early rift and Late Quaternary faults and compiled the existing knowledge on thermal springs (assumed to be diagnostic of current tectonic activity along faults). We also produced also a new catalogue of historical and instrumental seismicity and defined the seismotectonic characteristics (stress field, depth of faulting) using published focal mechanism data. Rifting in this region started at about 11 Ma by initial doming and extensive fissural basaltic volcanism along normal faults sub-parallel to the axis of the future rift valley, as a consequence of the divergence between the Nubia and the Victoria plate. In a later stage, starting around 8-7 Ma, extension localized along a series of major border faults individualizing the subsiding tectonic basins from the uplifting rift shoulders, while lava evolved towards alkali basaltic composition until 2.6 Ma. During this stage, initial Kivu rift valley was extending linearly in a SSW direction, much further than its the actual termination at Bukavu, into the Mwenga-Kamituga graben, up to Namoya. The SW extremity of this graben was linked via a long oblique transfer zone to the central part of Lake Tanganyika, itself reactivating an older ductile-brittle shear zone. In the late Quaternary-early Holocene, volcanism migrated towards the center of the basin, with the development of the Virunga volcanic massif

  18. An analysis of the economic and patient outcome impact of an integrated COPD service in east London.

    Science.gov (United States)

    Garner, Anna; Hodson, Matthew; Ketsetzis, Georgios; Pulle, Laurence; Yorke, Janelle; Bhowmik, Angshu

    2017-01-01

    Exacerbations of COPD carry a huge burden of morbidity and a significant economic impact. It has been shown that home care may be useful for exacerbations of COPD. This article presents a review of an integrated COPD service in east London. Hospital Episode Statistics, Public Health Mortality Files and clinical data were used to analyze differences in health care usage and COPD patient outcomes, including COPD assessment test (CAT) scores for a subsample, before and after the introduction of the integrated service. There was a significant (30%) reduction in the number of hospital bed days for COPD patients ( P economic model shows that the economic benefits of the service (via impact on place of death and reduction in length of hospital stay) were almost equal to the cost of the service. The increase in proportion of short-stay admissions and the reduction in bed days suggest an impact of the service on early supported discharge and that this along with an improvement in patient clinical outcomes and in quality of end-of-life care shows that an exemplar integrated COPD service can provide benefits that equate to a nearly cost-neutral service.

  19. Cognitive Function Among Obstructive Sleep Apnea Patients in North East Malaysia.

    Science.gov (United States)

    Yusop, Che Yusfarina Che; Mohamad, Irfan; Mohammad, Wan Mohd Zahiruddin Wan; Abdullah, Baharudin

    2017-01-01

    Obstructive sleep apnea patients may develop deficits in the cognitive domains of attention, concentration, executive function, verbal and visuospatial memory, constructional abilities, and psychomotor functioning. As cognitive performance will improve with the treatment, early screening for cognitive dysfunction should be done to prevent further deterioration. We aim to evaluate the cognitive function of obstructive sleep apnea patients by using the 'Mini Mental State Examination'. This was a cross sectional study to evaluate the cognitive function of moderate and severe obstructive sleep apnea patients with age ranged from 18 to 60 old who attended our sleep clinic. These patients were confirmed to have moderate and severe obstructive sleep apnea by Type 1 polysomnography (attended full overnight study). The age, gender and ethnicity were noted and other relevant data such as weight, height, body mass index and apnea and hypopnoea index were recorded accordingly. The cognitive function was evaluated using validated Malay version of Mini Mental State Examination which measured 5 areas of cognitive functions comprising orientation, registration, attention and calculation, word recall and language abilities, and visuospatial. A total of 38 patients participated in this study. All 19 patients of moderate group and 14 patients of severe group had normal cognitive function while only 5 patients in severe group had mild cognitive function impairment. There was a statistically significant difference between the moderate group and severe group on cognitive performance (p value = 0.042). Severe obstructive sleep apnea patients may have impaired cognitive function. Mini Mental State Examination is useful in the screening of cognitive function of obstructive sleep apnea patients but in normal score, more sophisticated test batteries are required as it is unable to identify in 'very minimal' or 'extremely severe' cognitive dysfunction. Copyright © 2017 National Medical

  20. Universal Screening for Intimate Partner and Sexual Violence in Trauma Patients - What About the Men? An EAST Multicenter Trial.

    Science.gov (United States)

    Zakrison, Tanya L; Rattan, Rishi; Milian Valdés, Davel; Ruiz, Xiomara; Gelbard, Rondi; Cline, John; Turay, David; Luo-Owen, Xian; Namias, Nicholas; George, Jessica; Yeh, Dante; Pust, Daniel; Williams, Brian H

    2018-02-14

    A recent EAST-supported, multicenter trial demonstrated a similar rate of intimate partner and sexual violence (IPSV) between male and female trauma patients, regardless of mechanism. Our objective was to perform a subgroup analysis of our affected male cohort as this remains an understudied group in the trauma literature. We conducted a recent EAST-supported, cross-sectional, multicenter trial over one year (03/15-04/16) involving four Level I trauma centers throughout the United States. We performed universal screening of adult trauma patients using the validated HITS (Hurt, Insult, Threaten, Scream) and SAVE (sexual violence) screening surveys. Risk factors for male patients were identified. Chi-squared test compared categorical variables with significance at p<0.05. Parametric data is presented as mean +/-standard deviation. A total of 2,034 trauma patients were screened, of which 1,281 (63%) were men. Of this cohort, 119 men (9.3%) screened positive for intimate partner violence, 14.1% for IPSV and 6.5% for sexual violence. On categorical analysis of the HITS screen, the proportion of men that were physically hurt was 4.8% compared to 4.3% for women (p = 0.896). A total of 4.8% of men screened positive for both intimate partner and sexual violence. The total proportion of men who presented with any history of intimate partner violence, sexual violence or both (IPSV) was 15.8%. More men affected by penetrating trauma screened positive for IPSV (p < 0.00001). IPSV positivity in men was associated with mental illness, substance abuse, and trauma recidivism. One out of every twenty men that present to trauma centers is a survivor of both intimate partner and sexual violence, with one out of every six men experiencing some form of violence. Men are at similar risk for physical abuse as women when this intimate partner violence occurs. IPSV is associated with penetrating trauma in men. Support programs for this population may potentially impact associated mental

  1. Functioning in patients with major depression treated with duloxetine or a selective serotonin reuptake inhibitor in East Asia

    Directory of Open Access Journals (Sweden)

    Novick D

    2016-02-01

    Full Text Available Diego Novick,1 William Montgomery,2 Josep Maria Haro,3 Maria Victoria Moneta,3 Gang Zhu,4 Li Yue,5 Jihyung Hong,6 Héctor Dueñas,7 Roberto Brugnoli8 1Eli Lilly and Company, Windlesham, Surrey, UK; 2Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 3Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; 4Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, 5Lilly Suzhou Pharmaceutical Company, Ltd, Shanghai, People’s Republic of China; 6Department of Healthcare Management, Gachon University, Seongnam, South Korea; 7Eli Lilly de Mexico, Mexico City, Mexico; 8School of Medicine, Sapienza University of Rome, Rome, ItalyPurpose: To assess and compare the levels of functioning in patients with major depressive disorder treated with either duloxetine with a daily dose of ≤60 mg or a selective serotonin reuptake inhibitor (SSRI as monotherapy for up to 6 months in a naturalistic setting in East Asia. In addition, this study examined the impact of painful physical symptoms (PPS on the effects of these treatments.Patients and methods: Data for this post hoc analysis were taken from a 6-month prospective observational study involving 1,549 patients with major depressive disorder without sexual dysfunction. The present analysis focused on a subgroup of patients from East Asia (n=587. Functioning was measured using the Sheehan Disability Scale (SDS. Depression severity was assessed using the 16-item Quick Inventory of Depressive Symptomatology-Self Report. PPS were rated using the modified Somatic Symptom Inventory. A mixed model with repeated measures was fitted to compare the levels of functioning between duloxetine-treated (n=227 and SSRI-treated (n=225 patients, adjusting for baseline patient characteristics.Results: The mean SDS total score was similar between the two treatment cohorts (15.46 [standard deviation =6.11] in the duloxetine

  2. Performance of MIDAS Over East African Longitude Sector: Case Study During 4-14 March 2012 Quiet to Disturbed Geomagnetic Conditions

    Science.gov (United States)

    Giday, Nigussie M.; Katamzi-Joseph, Zama T.

    2018-02-01

    This study investigates the performance of a tomographic algorithm, Multi-Instrument and Data Analysis System (MIDAS), during an extended period of 4-14 March 2012, containing moderate and strong geomagnetic storms conditions, over an understudied and data scarce Eastern African longitude sector. Nonetheless, a relatively better distribution of Global Navigation Satellite Systems stations exists along a narrow longitude sector between 30°E and 44°E and latitude range of 30°S and 36°N that spans the equatorial, middle-, and low-latitude ionosphere. Then results are compared with independent global models such as International Reference Ionosphere 2012 (IRI-2012) and global ionosphere map (GIM). MIDAS performance was better than that of the IRI-2012 and GIM models in terms of capturing the diurnal trends as well as the short temporal total electron content (TEC) structures, with least root-mean-square errors (RMSEs). Overall, MIDAS results showed better agreement with the observation vertical TEC (VTEC) with computed maximum correlation coefficient (r) of 0.99 and minimum root-mean-square error (RMSE) of 2.91 TEC unit (1 TECU = 1,016 el m-2 over all the test stations and the validation days. Conversely, for the IRI-2012 and GIM TEC estimates, the corresponding maximum computed r values were 0.93 and 0.99, respectively, while the minimum RMSEs were 13.03 TECU and 6.52 TECU, respectively, for all the test stations and the validation days.

  3. Dyslipidemias in type 2 diabetes mellitus patients in Nnewi South-East Nigeria.

    Science.gov (United States)

    Jisieike-Onuigbo, N N; Unuigbe, E I; Oguejiofor, C O

    2011-01-01

    Dyslipidemia has been noted to play an integral role in the pathogenesis and progression of micro and macrovascular complications in diabetes mellitus patients. The complications exemplified by renal vascular and cardiovascular disease cause the most morbidity and mortality in this group of patients. This study is aimed at understanding the pattern of dyslipidemia among type 2 diabetic patients. A total of 108 consenting adult type 2 diabetic patients seen in the medical unit of the Nnamdi Azikiwe University Teaching Hospital Nnewi were evaluated in this crosssectional study. Their fasting lipid profile, fasting blood glucose, weight, height and blood pressure were evaluated. The prevalence of dyslipidemia (at least one abnormal lipid profile) was 90.7%. The 24.1% had single dyslipidemia while 66.6% had combined dyslipidemia. Reduced HDL constituted the highest single abnormality (62%) followed by hypertriglyceridemia (56.5%), hypercholesterolemia (53.7%) and high LDL in (44.4%). The duration of DM was not significantly associated with dyslipidemia (P > 0.05). Dyslipidemia is highly prevalent among type 2 diabetic patients in Nigeria with the majority of the patients having combined dyslipidemia. We recommend that aggressive treatment of lipidemia and hyperglycemia can be instituted to reduce the risk of macro and microvascular complications.

  4. Clinical, immunologic and insulin secretory characteristics of young black South African patients with diabetes: Hospital based single centre study.

    Science.gov (United States)

    Ekpebegh, C O; Longo-Mbenza, B

    2013-03-01

    To classify and characterize the clinical features of various diabetes classes among young black South Africans. Cross sectional study of 60 black patients with diabetes, all less than 30 years of age and attending Nelson Mandela Academic Hospital, Mthatha, South Africa. Diabetes was classified as Types 1A, 1B and 2 based on the anti-glutamic acid decarboxylase status and serum C-peptide response to intravenous injection of glucagon. Mean age was 19.6±4.8 years (n=60) with similar gender distribution. The mean duration of diabetes was 24.2±45.1 months. Type 1A was the class of diabetes in 55% (n=33/60) of patients. Type 1B and 2 accounted for 30% (n=18/60) and 15% (n=9/60) of patients respectively. Patients classified as Type 2 had higher waist circumference and higher prevalence of acanthosis nigricans than Types 1A and 1B groups. History of diabetes in a first degree relative and hypertension were found in similar proportions of patients with Types 1A, 1B and 2 diabetes. Five Type 1A diabetes patients had body mass index of 26.2-41kg/m(2) and this included two newly diagnosed patients with body mass index of 26.7kg/m(2) and 33.2kg/m(2). The majority of our young black South Africans with diabetes are of the Type 1A class. Acanthosis nigricans was not found in any patient with Type 1 A diabetes. A minority of Type 1 A diabetes patients were obese at initial diagnosis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Quality of warfarin control in atrial fibrillation patients in South East Queensland, Australia.

    Science.gov (United States)

    Bernaitis, N; Badrick, T; Davey, A K; Anoopkumar-Dukie, S

    2016-08-01

    Warfarin is widely prescribed to decrease the risk of stroke in atrial fibrillation (AF) patients. Due to patient variability in response, regular monitoring is required, and time in therapeutic range (TTR) used to indicate quality of warfarin control with a TTR>60% is recommended. Recently, an Australian Government review of anticoagulants identified the need to establish current warfarin control and determine the potential place of the newer oral anticoagulants. To determine warfarin control by a pathology practice in Queensland, Australia and identify factors influencing TTR. Retrospective data were collected from Sullivan Nicolaides Pathology, a major pathology practice offering a warfarin care programme in Australia. Patients enrolled in their programme as of September 2014 were included in the study. TTR was calculated using INR test results, and test dates using the Rosendaal method with mean patient TTR were used for analysis and comparison. Exclusions were target therapeutic range outside 2.0-3.0, less than two INR tests and programme treatment time of less than 30 days. The eligible 3692 AF patients had 73.6% of INR tests within the therapeutic range. The mean TTR was 81%, with 97% of patients above a TTR of 60%. TTR was not significantly influenced by age, gender or socioeconomic factors. The observed mean TTR of over 80% is superior to the minimum recommended threshold of 60%. The TTR achieved by the Queensland pathology practice demonstrates that dedicated warfarin programmes can produce high-quality warfarin care, ensuring the full benefit of warfarin for Australian patients. © 2016 Royal Australasian College of Physicians.

  6. The survival analysis of beta thalassemia major patients in South East of Iran

    International Nuclear Information System (INIS)

    Roudbari, M.; Soltani-Rad, M.; Roudbari, S.

    2008-01-01

    The objective was to determine the survival of beta-thalassemia major patients with transfusion, and its related factors in Southeast of Iran. This cross-sectional study was performed in Zahedan, Iran in 2007. The sample included patients who were referred from all over the Zahedan Thalassemia Center from 1998 to 2006. The data were collected using the patient's records, which were recorded by the staff during transfusion. The data included demographic and medical information blood group, blood RH, the kind of transfused blood [KTB], annual number of transfusions [ANOT], accompanied disease [AD], Hemoglobin [Hb] and ferritin level. For data analysis, the Kaplan-Meyer method, and Long Rank test together with Cox Regression were used. Forty-six of 578 patients died and 99% survived for the first year. The ages survival proportions were 5 (97.9%), 10 (97%), 15 (92.1%), and 20 (81.2%) years. The survival time showed significant relationships with the ANOT p=0.0053, KTB p=0.003, Hb=0.002 and ferritin level p=0.0087, and AD p=0.00. Using regular transfusion, paying attention to screening of transfused blood, increasing the families knowledge on the disease to prevent the bearing of thalassemia fetus, are recommended; finally, the detection and treating of the AD, are of great importance to extend the lifetime of the patients. (author)

  7. Effects of Patient-Provider Race Concordance and Smoking Status on Lung Cancer Risk Perception Accuracy among African Americans

    Science.gov (United States)

    Persky, Susan; Kaphingst, Kimberly A.; Allen, Vincent C.; Senay, Ibrahim

    2013-01-01

    Background Communication of lung cancer risk information between providers and African-American patients occurs in a context marked by race-based health disparities. Purpose A controlled experiment assessed whether perceived physician race influenced African-American patients’ (n=127) risk perception accuracy following the provision of objective lung cancer risk information. Methods Participants interacted with a virtual reality-based, simulated physician who provided personalized cancer risk information. Results Participants who interacted with a racially discordant virtual doctor were less accurate in their risk perceptions at post-test than those who interacted with a concordant virtual doctor, F(1,94)=4.02, p=.048. This effect was amplified among current smokers. Effects were not mediated by trust in the provider, engagement with the health care system, or attention during the encounter. Conclusions The current study demonstrates that African-American patients’ perceptions of a doctor’s race are sufficient to independently impact their processing of lung cancer risk information. PMID:23389688

  8. Usability evaluation of the interactive Personal Patient Profile-Prostate decision support system with African American men.

    Science.gov (United States)

    Jaja, Cheedy; Pares-Avila, Jose; Wolpin, Seth; Berry, Donna

    2010-04-01

    The Personal Patient Profile-Prostate (P4) program is an interactive Web-based decision support system that provides men with localized prostate cancer customized education and coaching with which to make the best personal treatment decision. This study assessed functionality and usability of the P4 program and identified problems in user-computer interaction in a sample of African American men. Usability testing was conducted with 12 community-dwelling African American adult men. The health status of participants was not known or collected by the research team. Each participant worked with the P4 program and provided simultaneous feedback using the "think aloud" technique. Handwritten field notes were collated and assigned to 3 standard coded categories. Aspects of P4 program usability was made based on common issues in the assigned categories. Summary statistics were derived for types and frequency of usability issues noted in the coded data. Twelve participants reported a total of 122 usability comments, with a mean of 9 usability comments. The most common usability issue by participant was completeness of information content, which comprised 53 (43%) of the total issues. Comprehensibility of text and graphics was second, comprising 51 (42%) of the total issues. This study provided initial inventory of usability issues for community African American men that may potentially interfere with application of the P4 system in the community setting and overall system usability, confirming the need for usability testing of a culturally appropriate Internet-based decision support system before community application.

  9. Evaluation of Modified Patient Health Questionnaire-9 Teen in South African Adolescents

    OpenAIRE

    Aggarwal, Shilpa; Taljard, Lian; Wilson, Zane; Berk, Michael

    2017-01-01

    Background: This report describes the findings of the survey conducted by South African Depression and Anxiety Group (SADAG) in a cohort of disadvantaged South African adolescent scholars in which PHQ-9 teen version was modified and adapted (PHQ-9M) to improve the response rate. Method: PHQ-9M was administered to 2025 secondary students of 35 schools over 2 years in Gauteng Province, South Africa. Results: The mean age was 15.8 years. 23% of respondents scored 9 or above, 26.7% reported suici...

  10. PXR and CAR single nucleotide polymorphisms influence plasma efavirenz levels in South African HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Swart Marelize

    2012-11-01

    Full Text Available Abstract Background This study investigated variation in NR1I2 and NR1I3 and its effect on plasma efavirenz levels in HIV/AIDS patients. Variability in plasma drug levels has largely led research on identifying causative variants in drug metabolising enzyme (DME genes, with little focus on the nuclear receptor genes NR1I2 and NR1I3, coding for PXR and CAR, respectively, that are involved in regulating DMEs. Methods 464 Bantu-speaking South Africans comprising of HIV/AIDS patients on efavirenz-based treatment (n=301 and 163 healthy subjects were genotyped for 6 SNPs in NR1I2 and NR1I3. 32 of the 301 patients had their DNA binding domains (DBDs in NR1I2 and NR1I3 sequenced. Results Significantly decreased efavirenz plasma concentrations were observed in patients carrying the NR1I3 rs3003596C/C and T/C genotypes (P=0.015 and P=0.010, respectively. Sequencing resulted in the discovery of a further 13 SNPs, 3 of which are novel variants in the DBD of NR1I2. There were significant differences in the distribution of NR1I2 and NR1I3 SNPs between South Africans when compared to Caucasian, Asian and Yoruba population groups. Conclusion For the realisation of personalised medicine, PXR and CAR genetic variation should be taken into consideration because of their involvement in the regulation of DMEs.

  11. Psychological distress and psychiatric disorders in primary health care patients in East and West Germany 1 year after the fall of the Berlin Wall.

    Science.gov (United States)

    Achberger, M; Linden, M; Benkert, O

    1999-04-01

    The reunification of Germany confronted citizens in East and West Germany with many changes in their lives. These changes may be considered as critical life events. Especially for those in East Germany, life circumstances drastically changed, and individuals were increasingly required to adopt and develop coping capabilities. In addition to new opportunities and freedom, there was threatening uncertainty about the future. Theories of life events and stress postulate that threat events have an impact on human well-being. It was expected that there would be an increased rate of psychiatric morbidity after unification, especially in the eastern part of Germany. An international study by the WHO on psychiatric disorders in general health care was carried out in 1990, 1 year after the opening of the Berlin Wall, in both parts of Berlin and in Mainz, West Germany. This allowed for a comparison of the prevalence rates of psychiatric disorders among general health care patients in the East and West, after the euphoria immediately following unification had subsided. The prevalence rates of current ICD-10 diagnoses and of subthreshold disorders in East Berlin were similar to the rates in West Berlin and Mainz. The recognition rate of psychiatric disorders by physicians did not differ in East Berlin as compared to West Berlin and Mainz. Contrary to the prediction expected from the literature on individual negative life events, major changes in life circumstances and stressful life events on a societal level within 1 year did not have a major impact on psychological function.

  12. Oral manifestations and related factors of HIV positive patients in south-east of Iran

    Directory of Open Access Journals (Sweden)

    Shirin Saravani

    2017-03-01

    Full Text Available Introduction: Oral manifestations can be the first signs of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS and a useful marker for the progression of this disease. The present study aimed to determine the prevalence of oral manifestations and examine their relationship with socio-demographic factors in HIV-positive patients in the health centers affiliated to Zahedan University of Medical Sciences (Southeast Iran. Methods: In this cross-sectional study in addition to determining oral manifestations based on the classification of EC-clearing house (European Commission clearing house, information such as age, gender, marital status, residence, education, occupation, habits, oral hygiene, loss of weight in the last six months. Body Mass Index (BMI, mode of HIV transmission, stage of disease, anti-retroviral therapy (ART, and duration of HIV were gathered through direct question from the patients or the information contained in their records. Then the relationship between various factors and oral manifestations was analyzed using Chi-square, Fisher’s Exact Test, Student T Test, Mann- Whitney tests and logistic regression. Results: Oral examination was performed on 119 HIV-positive patients who were 69.7% male and 30.3% female and had a mean age of 35.4±12.7 years. Oral manifestations were found in 57.1% of the patients. Pseudomembranous candidiasis (34.1% and linear gingival erythema (33% were the most common lesions in these patients. The probability of oral manifestations occurrence increased with age and duration of smoking in smokers with HIV (P=0.036 and P=0.012, respectively. Conclusion: Most oral manifestations were those strongly associated with HIV infection (91%. Timely diagnosis and treatment of oral manifestations in HIV patients should be considered in conjunction with other treatments.

  13. Early identification of pneumonia patients at increased risk of Middle East respiratory syndrome coronavirus infection in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Anwar E. Ahmed

    2018-05-01

    Full Text Available Background: The rapid and accurate identification of individuals who are at high risk of Middle East respiratory syndrome coronavirus (MERS-CoV infection remains a major challenge for the medical and scientific communities. The aim of this study was to develop and validate a risk prediction model for the screening of suspected cases of MERS-CoV infection in patients who have developed pneumonia. Methods: A two-center, retrospective case–control study was performed. A total of 360 patients with confirmed pneumonia who were evaluated for MERS-CoV infection by real-time reverse transcription polymerase chain reaction (rRT-PCR between September 1, 2012 and June 1, 2016 at King Abdulaziz Medical City in Riyadh and King Fahad General Hospital in Jeddah, were included. According to the rRT-PCR results, 135 patients were positive for MERS-CoV and 225 were negative. Demographic characteristics, clinical presentations, and radiological and laboratory findings were collected for each subject. Results: A risk prediction model to identify pneumonia patients at increased risk of MERS-CoV was developed. The model included male sex, contact with a sick patient or camel, diabetes, severe illness, low white blood cell (WBC count, low alanine aminotransferase (ALT, and high aspartate aminotransferase (AST. The model performed well in predicting MERS-CoV infection (area under the receiver operating characteristics curves (AUC 0.8162, on internal validation (AUC 0.8037, and on a goodness-of-fit test (p = 0.592. The risk prediction model, which produced an optimal probability cut-off of 0.33, had a sensitivity of 0.716 and specificity of 0.783. Conclusions: This study provides a simple, practical, and valid algorithm to identify pneumonia patients at increased risk of MERS-CoV infection. This risk prediction model could be useful for the early identification of patients at the highest risk of MERS-CoV infection. Further validation of the prediction model on a

  14. Self-Care Management among Patients with Type 2 Diabetes in East Jerusalem

    Science.gov (United States)

    Daoud, Nihaya; Osman, Amira; Hart, Trevor A.; Berry, Elliott M.; Adler, Bella

    2015-01-01

    Objective: Little research exists on diabetes self-care management (DSCM) in Arab populations. We examined the contribution of health belief constructs, socioeconomic position (SEP) and clinical factors (glycated haemoglobin [HbA1C] level, type of diabetes treatments, and receiving professional guidance) to DSCM among Arab patients in East…

  15. The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States, part 1: African-American patients.

    Science.gov (United States)

    McClelland, Shearwood; Page, Brandi R; Jaboin, Jerry J; Chapman, Christina H; Deville, Curtiland; Thomas, Charles R

    2017-01-01

    African Americans experience the highest burden of cancer incidence and mortality in the United States and have been persistently less likely to receive interventional care, even when such care has been proven superior to conservative management by randomized controlled trials. The presence of disparities in access to radiation therapy (RT) for African American cancer patients has rarely been examined in an expansive fashion. An extensive literature search was performed using the PubMed database to examine studies investigating disparities in RT access for African Americans. A total of 55 studies were found, spanning 11 organ systems. Disparities in access to RT for African Americans were most prominently study in cancers of the breast (23 studies), prostate (7 studies), gynecologic system (5 studies), and hematologic system (5 studies). Disparities in RT access for African Americans were prevalent regardless of organ system studied and often occurred independently of socioeconomic status. Fifty of 55 studies (91%) involved analysis of a population-based database such as Surveillance, Epidemiology and End Result (SEER; 26 studies), SEER-Medicare (5 studies), National Cancer Database (3 studies), or a state tumor registry (13 studies). African Americans in the United States have diminished access to RT compared with Caucasian patients, independent of but often in concert with low socioeconomic status. These findings underscore the importance of finding systemic and systematic solutions to address these inequalities to reduce the barriers that patient race provides in receipt of optimal cancer care.

  16. Institutional capacity for health systems research in East and Central African schools of public health: experiences with a capacity assessment tool.

    Science.gov (United States)

    Jessani, Nasreen; Lewy, Daniela; Ekirapa-Kiracho, Elizabeth; Bennett, Sara

    2014-06-02

    Despite significant investments in health systems research (HSR) capacity development, there is a dearth of information regarding how to assess HSR capacity. An alliance of schools of public health (SPHs) in East and Central Africa developed a tool for the self-assessment of HSR capacity with the aim of producing institutional capacity development plans. Between June and November 2011, seven SPHs across the Democratic Republic of Congo, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda implemented this co-created tool. The objectives of the institutional assessments were to assess existing capacities for HSR and to develop capacity development plans to address prioritized gaps. A mixed-method approach was employed consisting of document analysis, self-assessment questionnaires, in-depth interviews, and institutional dialogues aimed at capturing individual perceptions of institutional leadership, collective HSR skills, knowledge translation, and faculty incentives to engage in HSR. Implementation strategies for the capacity assessment varied across the SPHs. This paper reports findings from semi-structured interviews with focal persons from each SPH, to reflect on the process used at each SPH to execute the institutional assessments as well as the perceived strengths and weaknesses of the assessment process. The assessment tool was robust enough to be utilized in its entirety across all seven SPHs resulting in a thorough HSR capacity assessment and a capacity development plan for each SPH. Successful implementation of the capacity assessment exercises depended on four factors: (i) support from senior leadership and collaborators, (ii) a common understanding of HSR, (iii) adequate human and financial resources for the exercise, and (iv) availability of data. Methods of extracting information from the results of the assessments, however, were tailored to the unique objectives of each SPH. This institutional HSR capacity assessment tool and the process for its utilization

  17. Novel engineered HIV-1 East African Clade-A gp160 plasmid construct induces strong humoral and cell-mediated immune responses in vivo

    International Nuclear Information System (INIS)

    Muthumani, Karuppiah; Zhang Donghui; Dayes, Nathanael S.; Hwang, Daniel S.; Calarota, Sandra A.; Choo, Andrew Y.; Boyer, Jean D.; Weiner, David B.

    2003-01-01

    HIV-1 sequences are highly diverse due to the inaccuracy of the viral reverse transcriptase. This diversity has been studied and used to categorize HIV isolates into subtypes or clades, which are geographically distinct. To develop effective vaccines against HIV-1, immunogens representing different subtypes may be important for induction of cross-protective immunity, but little data exist describing and comparing the immunogenicity induced by different subtype-based vaccines. This issue is further complicated by poor expression of HIV structural antigens due to rev dependence. One costly approach is to codon optimize each subtype construct to be examined. Interestingly, cis-acting transcriptional elements (CTE) can also by pass rev restriction by a rev independent export pathway. We reasoned that rev+CTE constructs might have advantages for such expression studies. A subtype A envelope sequence from a viral isolate from east Africa was cloned into a eukaryotic expression vector under the control of the CMV-IE promoter. The utility of inclusion of the Mason-Pfizer monkey virus (MPV)-CTE with/without rev for driving envelope expression and immunogenicity was examined. Expression of envelope (gp120) was confirmed by immunoblot analysis and by pseudotype virus infectivity assays. The presence of rev and the CTE together increased envelope expression and viral infection. Furthermore the CTE+rev construct was significantly more immunogenic then CTE alone vector. Isotype analysis and cytokine profiles showed strong Th1 response in plasmid-immunized mice, which also demonstrated the superior nature of the rev+CTE construct. These responses were of similar or greater magnitude to a codon-optimized construct. The resulting cellular immune responses were highly cross-reactive with a HIV-1 envelope subtype B antigen. This study suggests a simple strategy for improving the expression and immunogenicity of HIV subtype-specific envelope antigens as plasmid or vector

  18. Causes of unrest at silicic calderas in the East African Rift: New constraints from InSAR and soil-gas chemistry at Aluto volcano, Ethiopia

    Science.gov (United States)

    Hutchison, William; Biggs, Juliet; Mather, Tamsin A.; Pyle, David M.; Lewi, Elias; Yirgu, Gezahegn; Caliro, Stefano; Chiodini, Giovanni; Clor, Laura E.; Fischer, Tobias P.

    2016-08-01

    Restless silicic calderas present major geological hazards, and yet many also host significant untapped geothermal resources. In East Africa, this poses a major challenge, although the calderas are largely unmonitored their geothermal resources could provide substantial economic benefits to the region. Understanding what causes unrest at these volcanoes is vital for weighing up the opportunities against the potential risks. Here we bring together new field and remote sensing observations to evaluate causes of ground deformation at Aluto, a restless silicic volcano located in the Main Ethiopian Rift (MER). Interferometric Synthetic Aperture Radar (InSAR) data reveal the temporal and spatial characteristics of a ground deformation episode that took place between 2008 and 2010. Deformation time series reveal pulses of accelerating uplift that transition to gradual long-term subsidence, and analytical models support inflation source depths of ˜5 km. Gases escaping along the major fault zone of Aluto show high CO2 flux, and a clear magmatic carbon signature (CO2-δ13C of -4.2‰ to -4.5‰). This provides compelling evidence that the magmatic and hydrothermal reservoirs of the complex are physically connected. We suggest that a coupled magmatic-hydrothermal system can explain the uplift-subsidence signals. We hypothesize that magmatic fluid injection and/or intrusion in the cap of the magmatic reservoir drives edifice-wide inflation while subsequent deflation is related to magmatic degassing and depressurization of the hydrothermal system. These new constraints on the plumbing of Aluto yield important insights into the behavior of rift volcanic systems and will be crucial for interpreting future patterns of unrest.

  19. African Journals Online: Browse Alphabetically -- letter E

    African Journals Online (AJOL)

    Items 1 - 39 of 39 ... The East African Journal of Sciences (EAJS) publishes original ... The objects of the Association journal shall be the advancement of the science and art of ..... Economics, Business Management, and Public Administration and ...

  20. African Journal of Clinical and Experimental Microbiology

    African Journals Online (AJOL)

    African Journal of Clinical and Experimental Microbiology. ... of edible locally produced dry season leafy vegetables cultivated in south east Enugu, Nigeria ... Cross-seasonal analysis of bacteriological profile of water sources as a disease risk ...

  1. Why do hypertensive patients of African ancestry respond better to calcium blockers and diuretics than to ACE inhibitors and β-adrenergic blockers? A systematic review

    Science.gov (United States)

    2013-01-01

    Background Clinicians are encouraged to take an individualized approach when treating hypertension in patients of African ancestry, but little is known about why the individual patient may respond well to calcium blockers and diuretics, but generally has an attenuated response to drugs inhibiting the renin-angiotensin system and to β-adrenergic blockers. Therefore, we systematically reviewed the factors associated with the differential drug response of patients of African ancestry to antihypertensive drug therapy. Methods Using the methodology of the systematic reviews narrative synthesis approach, we sought for published or unpublished studies that could explain the differential clinical efficacy of antihypertensive drugs in patients of African ancestry. PUBMED, EMBASE, LILACS, African Index Medicus and the Food and Drug Administration and European Medicines Agency databases were searched without language restriction from their inception through June 2012. Results We retrieved 3,763 papers, and included 72 reports that mainly considered the 4 major classes of antihypertensive drugs, calcium blockers, diuretics, drugs that interfere with the renin-angiotensin system and β-adrenergic blockers. Pharmacokinetics, plasma renin and genetic polymorphisms did not well predict the response of patients of African ancestry to antihypertensive drugs. An emerging view that low nitric oxide and high creatine kinase may explain individual responses to antihypertensive drugs unites previous observations, but currently clinical data are very limited. Conclusion Available data are inconclusive regarding why patients of African ancestry display the typical response to antihypertensive drugs. In lieu of biochemical or pharmacogenomic parameters, self-defined African ancestry seems the best available predictor of individual responses to antihypertensive drugs. PMID:23721258

  2. Mobile communication tools for a South African deaf patient in a pharmacy context

    NARCIS (Netherlands)

    Chininthorn, P.; Glaser, M.; Freudenthal, A.; Tucker, W.D.

    2012-01-01

    This paper presents a case of iterative community-based co-design to facilitate the emergence of an innovative mobile system to address a potentially life-threatening scenario for Deaf people in South Africa. For Deaf people who communicate in South African Sign Language, miscommunication due to

  3. 'Under pressure': How Ghanaian, African-Surinamese and Dutch patients explain hypertension

    NARCIS (Netherlands)

    Beune, E. J. A. J.; Haafkens, J. A.; Schuster, J. S.; Bindels, P. J. E.

    2006-01-01

    The aim of this study was to explore and compare explanatory models (EMs) of hypertension in native-Dutch, first-generation Ghanaian and African-Surinamese (Surinamese) hypertensives in Amsterdam, the Netherlands. Through semi-structured interviews, we elicited accounts of the nature, causes and

  4. 'Under pressure': how Ghanaian, African-Surinamese and Dutch patients explain hypertension

    NARCIS (Netherlands)

    Beune, E.J.A.J.; Haafkens, J.; Schuster, J.S.; Bindels, P.J.E.

    2006-01-01

    The aim of this study was to explore and compare explanatory models (EMs) of hypertension in native-Dutch, first-generation Ghanaian and African-Surinamese (Surinamese) hypertensives in Amsterdam, the Netherlands. Through semi-structured interviews, we elicited accounts of the nature, causes and

  5. Comparison of FOLFOX and DOF regimens as first-line treatment in East Asian patients with advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Liu M

    2018-01-01

    manageable. The combination of docetaxel/oxaliplatin/fluorouracil was active and well tolerated in AGC patients and deserves further evaluation. However, for elderly patients with AGC, the DOF regimen was associated with worse toxicities; therefore, the FOLFOX regimen might be a more suitable option. Keywords: East Asian AGC patients, chemotherapy, safety, efficacy

  6. ICDP Project DeepCHALLA: Reconstructing 250,000 Years of Climate Change and Environmental History on the East African Equator

    Science.gov (United States)

    Wolff, C.; Verschuren, D.; Van Daele, M. E.; Waldmann, N.; Meyer, I.; Lane, C. S.; Van der Meeren, T.; Ombori, T.; Kasanzu, C.; Olago, D.

    2017-12-01

    (inter-annual to decadal) and long (glacial-interglacial) time scales; and to assess the multi-faceted impact of this climate change on the region's freshwater resources, the functioning of terrestrial ecosystems, and the history of the African landscape in which modern humans (our species, Homo sapiens) originally evolved and have lived ever since.

  7. A community-based oral health promotion model for HIV patients in Nairobi, East District in Kenya: a study protocol

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    Lucina N. Koyio

    2013-06-01

    Full Text Available Background: General HIV-related orofacial lesions, most commonly oropharyngeal candidiasis, have a typical clinical appearance and can be recognised by members of the community. Although affected patients often experience pain leading to compromised eating and swallowing, barriers such as social stigma and lack of knowledge regarding available services may prevent them from seeking early care. Educating the community about these lesions through community health workers (CHWs who are democratically elected community members may encourage individuals affected to seek early oral health-care in the health facilities. A health facility (HF is a health centre mainly run by clinical officers (CO, i.e. personnel with a 3-year medical training, and nurses. This study aims to evaluate the effect of a CHW training programme on: i their knowledge and recognition of HIV-related oral-facial lesions at a community level; and ii referral of affected patients from the community to the HFs. Design and Methods: All 800 CHWs in 2 administrative divisions of Nairobi East District (test group n=400; control group n=400 will be selected. The test group will receive training. CHWs in both groups will be assessed at 4 time points: −3, 0, +3 and +6 months with reference to the training on: i their knowledge of HIV-related orofacial lesions (using a written questionnaire; and ii their performance in referring affected patients to the HFs (using clinical data. Expected Impact: Early recognition of HIV-related orofacial lesions at a community level will prompt community members to seek early oral care, leading to early HIV testing and counselling regarding failure of antiretroviral therapy, while treatment outcomes are still favourable.

  8. Physician assessment of stroke risk in hypertensive patients in the Middle East and Africa: results of the action survey.

    Science.gov (United States)

    Badr, Kamal F; Boudia, Khereddine M Merad; Alami, Mohamed; Khoja, Waleed A; Belhani, Ali B; Nawar, Moustafa; Ragy, Hany; Ishaq, Mohammad; Baron, J M Muscat; Hammoudeh, Ayman J; De Mar Youssef, Suzan S; Nakhle, Reine M; Chalfoun, Amale G

    2007-01-01

    In the absence of reliable, contemporary national data, the ACTION survey was designed to: a) provide preliminary data on stroke risk in the MEA (Middle East and Africa); b) describe the contribution of specific cardiovascular risk factors; 3) assess blood pressure (BP) control. This was a multi-center observational study in nine countries in the MEA region. From 2003 to 2005, 562 physicians from a variety of specialties recorded observations of cardiovascular risk factors in 4,747 hypertensive patients, aged 54-80 years. The 10-year absolute stroke risk was calculated using a scoring system based on the Framingham Heart Study observations, and comparisons made with an age-matched cohort. The mean 10-year stroke risk was estimated at 22.7% and was significantly higher for men (25.4%) than for women (19.5%) (P age-matched Framingham cohort, the estimated stroke risk in our population was almost double, and was significantly higher for females (212%) than for males (192%) (P < .001). Hypertension, diabetes, left ventricular hypertrophy, and smoking were major contributing risk factors, as were physical inactivity and elevated cholesterol. Blood pressure was controlled in only 18% of the population and in 12% of diabetics. Physicians of all specialties were willing to participate in stroke risk assessment. The risk of stroke in hypertensive patients in the MEA region is high, and is higher than would be predicted using Framingham data, particularly for females. Hypertension appears to be poorly controlled in more than 80% of hypertensive patients in the MEA region.

  9. Frequency of epidermal growth factor receptor mutations in Jordanian lung adenocarcinoma patients at diagnosis

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    Natheir Obeidat

    2016-01-01

    Conclusion: The present study revealed that the EGFR mutations rate in Jordanian patients with adenocarcinoma of the lung was higher than in African-American, and some white Caucasian patients, and was lower than in patients in East Asia, and other countries of South Asia.

  10. Development of a risk-prediction model for Middle East respiratory syndrome coronavirus infection in dialysis patients.

    Science.gov (United States)

    Ahmed, Anwar E; Alshukairi, Abeer N; Al-Jahdali, Hamdan; Alaqeel, Mody; Siddiq, Salma S; Alsaab, Hanan A; Sakr, Ezzeldin A; Alyahya, Hamed A; Alandonisi, Munzir M; Subedar, Alaa T; Aloudah, Nouf M; Baharoon, Salim; Alsalamah, Majid A; Al Johani, Sameera; Alghamdi, Mohammed G

    2018-04-14

    Introduction The Middle East respiratory syndrome coronavirus (MERS-CoV) infection can cause transmission clusters and high mortality in hemodialysis facilities. We attempted to develop a risk-prediction model to assess the early risk of MERS-CoV infection in dialysis patients. Methods This two-center retrospective cohort study included 104 dialysis patients who were suspected of MERS-CoV infection and diagnosed with rRT-PCR between September 2012 and June 2016 at King Fahd General Hospital in Jeddah and King Abdulaziz Medical City in Riyadh. We retrieved data on demographic, clinical, and radiological findings, and laboratory indices of each patient. Findings A risk-prediction model to assess early risk for MERS-CoV in dialysis patients has been developed. Independent predictors of MERS-CoV infection were identified, including chest pain (OR = 24.194; P = 0.011), leukopenia (OR = 6.080; P = 0.049), and elevated aspartate aminotransferase (AST) (OR = 11.179; P = 0.013). The adequacy of this prediction model was good (P = 0.728), with a high predictive utility (area under curve [AUC] = 76.99%; 95% CI: 67.05% to 86.38%). The prediction of the model had optimism-corrected bootstrap resampling AUC of 71.79%. The Youden index yielded a value of 0.439 or greater as the best cut-off for high risk of MERS infection. Discussion This risk-prediction model in dialysis patients appears to depend markedly on chest pain, leukopenia, and elevated AST. The model accurately predicts the high risk of MERS-CoV infection in dialysis patients. This could be clinically useful in applying timely intervention and control measures to prevent clusters of infections in dialysis facilities or other health care settings. The predictive utility of the model warrants further validation in external samples and prospective studies. © 2018 International Society for Hemodialysis.

  11. The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

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    Susan J. Armstrong

    2015-05-01

    Full Text Available Background: Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective: This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods: During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36. Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semi-structured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. Results: The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers’ recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. Conclusion: The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision

  12. Why do hypertensive patients of African ancestry respond better to calcium blockers and diuretics than to ACE inhibitors and β-adrenergic blockers? A systematic review

    NARCIS (Netherlands)

    Brewster, Lizzy M.; Seedat, Yackoob K.

    2013-01-01

    Clinicians are encouraged to take an individualized approach when treating hypertension in patients of African ancestry, but little is known about why the individual patient may respond well to calcium blockers and diuretics, but generally has an attenuated response to drugs inhibiting the

  13. The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States, part 1: African-American patients

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    Shearwood McClelland, III, MD

    2017-10-01

    Conclusions: African Americans in the United States have diminished access to RT compared with Caucasian patients, independent of but often in concert with low socioeconomic status. These findings underscore the importance of finding systemic and systematic solutions to address these inequalities to reduce the barriers that patient race provides in receipt of optimal cancer care.

  14. Matrix-assisted laser desorption/ionization time of flight mass spectrometry for comprehensive indexing of East African ixodid tick species.

    Science.gov (United States)

    Rothen, Julian; Githaka, Naftaly; Kanduma, Esther G; Olds, Cassandra; Pflüger, Valentin; Mwaura, Stephen; Bishop, Richard P; Daubenberger, Claudia

    2016-03-15

    The tick population of Africa includes several important genera belonging to the family Ixodidae. Many of these ticks are vectors of protozoan and rickettsial pathogens including Theileria parva that causes East Coast fever, a debilitating cattle disease endemic to eastern, central and southern Africa. Effective surveillance of tick-borne pathogens depends on accurate identification and mapping of their tick vectors. A simple and reproducible technique for rapid and reliable differentiation of large numbers of closely related field-collected ticks, which are often difficult and tedious to discriminate purely by morphology, will be an essential component of this strategy. Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) is increasingly becoming a useful tool in arthropod identification and has the potential to overcome the limitations of classical morphology-based species identification. In this study, we applied MALDI-TOF MS to a collection of laboratory and field ticks found in Eastern Africa. The objective was to determine the utility of this proteomic tool for reliable species identification of closely related afrotropical ticks. A total of 398 ixodid ticks from laboratory maintained colonies, extracted from the hides of animals or systematically collected from vegetation in Kenya, Sudan and Zimbabwe were analyzed in the present investigation. The cytochrome c oxidase I (COI) genes from 33 specimens were sequenced to confirm the tentatively assigned specimen taxa identity on the basis of morphological analyses. Subsequently, the legs of ticks were homogenized and analyzed by MALDI-TOF MS. A collection of reference mass spectra, based on the mass profiles of four individual ticks per species, was developed and deposited in the spectral database SARAMIS™. The ability of these superspectra (SSp.) to identify and reliably validate a set of ticks was demonstrated using the remaining individual 333 ticks. Ultimately, ten

  15. Quality of life in South East Asian patients who consult for dyspepsia: Validation of the short form Nepean Dyspepsia Index

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    Goh Khean-Lee

    2009-05-01

    Full Text Available Abstract Background Treatment objectives for dyspepsia include improvements in both symptoms and health-related quality of life (HRQoL. There is a lack of disease-specific instruments measuring HRQoL in South East Asian dyspeptics. Objectives To validate English and locally translated version of the Short-Form Nepean Dyspepsia Index (SF-NDI in Malaysian patients who consult for dyspepsia. Methods The English version of the SF-NDI was culturally adapted locally and a Malay translation was developed using standard procedures. English and Malay versions of the SF-NDI were assessed against the SF-36 and the Leeds Dyspepsia Questionnaire (LDQ, examining internal consistency, test-retest reliability and construct validity. Results Pilot testing of the translated Malay and original English versions of the SF-NDI in twenty subjects did not identify any cross-cultural adaptation problems. 143 patients (86 English-speaking and 57 Malay speaking with dyspepsia were interviewed and the overall response rate was 100% with nil missing data. The median total SF-NDI score for both languages were 72.5 and 60.0 respectively. Test-retest reliability was good with intraclass correlation coefficients of 0.90 (English and 0.83 (Malay, while internal consistency of SF-NDI subscales revealed α values ranging from 0.83 – 0.88 (English and 0.83 – 0.90 (Malay. In both languages, SF-NDI sub-scales and total score demonstrated lower values in patients with more severe symptoms and in patients with functional vs organic dyspepsia (known groups validity, although these were less marked in the Malay language version. There was moderate to good correlation (r = 0.3 – 0.6 between all SF-NDI sub-scales and various domains of the SF-36 (convergent validity. Conclusion This study demonstrates that both English and Malay versions of the SF-NDI are reliable and probably valid instruments for measuring HRQoL in Malaysian patients with dyspepsia.

  16. Prevalence of hepatitis C virus infection among hemodialysis patients in the Middle-East: A systematic review and meta-analysis.

    Science.gov (United States)

    Ashkani-Esfahani, Soheil; Alavian, Seyed Moayed; Salehi-Marzijarani, Mohammad

    2017-01-07

    To determine hepatitis C virus (HCV) infection prevalence in each country of the Middle-East and the overall prevalence of the region. In this systematic review, we gathered all documents related to HCV infection prevalence among hemodialysis patients in 17 middle-east countries from April 2006 to March 2016. We selected only cross-sectional studies that had proper sampling and measurement methods as well as a valid statistical analysis. After screening of 7311 documents, 56 studies were selected reporting the prevalence of HCV infection among hemodialysis patients from 10 countries of the region. Seven countries including United Arab Emirates, Afghanistan, Qatar, Bahrain, Kuwait, Oman, Israel, and Cyprus did not have any relevant document; thus, their latest reports were just mentioned. We performed the meta-analysis and determined the prevalence rates for each country as well as the whole region. The overall HCV infection prevalence among hemodialysis patients in the region was reported to be 25.3%; Egypt and Syria had the highest reported rates while Iran and Lebanon had the lowest. Further investigations are still needed to provide more reliable databases, find main risk factors, and to improve diagnosis and treatment plans, particularly in higher prevalent countries. Controlling the prevalence and improving the management methods of HCV infection among hemodialysis patients are of a great concern in the Middle-East region.

  17. Mobile communication tools for a South African deaf patient in a pharmacy context

    OpenAIRE

    Chininthorn, P.; Glaser, M.; Freudenthal, A.; Tucker, W.D.

    2012-01-01

    This paper presents a case of iterative community-based co-design to facilitate the emergence of an innovative mobile system to address a potentially life-threatening scenario for Deaf people in South Africa. For Deaf people who communicate in South African Sign Language, miscommunication due to language barriers, under-education and under-employment can lead to a potentially dangerous therapeutic outcome when Deaf people misunderstand a pharmacist's instructions on how to take prescribed med...

  18. Perceived social support in African American breast cancer patients: Predictors and effects.

    Science.gov (United States)

    Thompson, Tess; Pérez, Maria; Kreuter, Matthew; Margenthaler, Julie; Colditz, Graham; Jeffe, Donna B

    2017-11-01

    Social support plays an important role in quality of life and health outcomes after breast cancer diagnosis and treatment. To examine changes in perceived social support in African American women during the two years following a new breast cancer diagnosis. This secondary analysis uses data collected from 2009 to 2015 from 227 newly diagnosed, African American women with breast cancer (mean age 56 [SD = 10], 59% household income social support (measured by the Medical Outcomes Study Social Support Survey) as well as correlates of baseline levels of social support and predictors of change in individuals' social support. Additional analyses examined whether change in social support over the first year affected depressive symptoms (Center for Epidemiologic Studies Depression Scale) and general health perceptions (RAND SF-36 subscale) at two years. Being married, reporting greater spirituality, and reporting fewer depressive symptoms at baseline were significantly associated with higher initial levels of perceived social support. Women whose social support declined during the first year after diagnosis reported more severe depressive symptoms and worse general health perceptions at two years. Clinicians should periodically assess perceived social support among African American women with breast cancer to help find support resources for those who have low initial social support and for those whose support declines in the first year after diagnosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Determinants of the accuracy of rapid diagnostic tests in malaria case management: evidence from low and moderate transmission settings in the East African highlands

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    Rapuoda Beth

    2008-10-01

    Full Text Available Abstract Background The accuracy of malaria diagnosis has received renewed interest in recent years due to changes in treatment policies in favour of relatively high-cost artemisinin-based combination therapies. The use of rapid diagnostic tests (RDTs based on histidine-rich protein 2 (HRP2 synthesized by Plasmodium falciparum has been widely advocated to save costs and to minimize inappropriate treatment of non-malarial febrile illnesses. HRP2-based RDTs are highly sensitive and stable; however, their specificity is a cause for concern, particularly in areas of intense malaria transmission due to persistence of HRP2 antigens from previous infections. Methods In this study, 78,454 clinically diagnosed malaria patients were tested using HRP2-based RDTs over a period of approximately four years in four highland sites in Kenya and Uganda representing hypoendemic to mesoendemic settings. In addition, the utility of the tests was evaluated in comparison with expert microscopy for disease management in 2,241 subjects in two sites with different endemicity levels over four months. Results RDT positivity rates varied by season and year, indicating temporal changes in accuracy of clinical diagnosis. Compared to expert microscopy, the sensitivity, specificity, positive predictive value and negative predictive value of the RDTs in a hypoendemic site were 90.0%, 99.9%, 90.0% and 99.9%, respectively. Corresponding measures at a mesoendemic site were 91.0%, 65.0%, 71.6% and 88.1%. Although sensitivities at the two sites were broadly comparable, levels of specificity varied considerably between the sites as well as according to month of test, age of patient, and presence or absence of fever during consultation. Specificity was relatively high in older age groups and increased towards the end of the transmission season, indicating the role played by anti-HRP2 antibodies. Patients with high parasite densities were more likely to test positive with RDTs than

  20. The Sarawak lupus cohort: clinical features and disease patterns of 633 SLE patients in a single tertiary centre from East Malaysia.

    Science.gov (United States)

    Teh, C L; Ling, G R; Aishah, Wan Sharifah

    2015-01-01

    Systemic lupus erythematosus (SLE) has been well studied in West Malaysian populations but lacking in East Malaysian populations. The aim of this study was to examine the clinical features and disease patterns of patients with SLE in a multiethnic East Malaysian population in Sarawak. All SLE patients who were treated in Sarawak General Hospital were reviewed in a retrospective longitudinal study using a standard protocol from 1 January 2006 to 31 December 2013. There were a total of 633 patients in our study with the female to male ratio of 12:1. Our study patients were of multiethnic origins with predominant Chinese ethnic group. They had a mean age of 36.9 ± 13.2 years and a mean duration of illness of 7.2 ± 6.0 years. The main involvements were haematological (74.2 %), malar rash (64.0 %) and renal (58.6 %). Chinese patients were less likely to have discoid lupus, pleuritis and pericarditis, while Malay patients were more likely to have arthritis. Bidayuh patients were more likely to have oral ulcer. Secondary antiphospholipid syndrome was more common in Chinese. The majority of patients were in clinical remission with low SDI. There were 58 deaths (9.2 %) during 2006-2013 with the main causes of death being flare of disease and infection.