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Omuse ER, Tonnang HEZ, Yusuf AA, Machekano H, Egonyu JP, Kimathi E, Mohamed SF, Kassie M, Subramanian S, Onditi J, Mwangi S, Ekesi S, Niassy S. The global atlas of edible insects: analysis of diversity and commonality contributing to food systems and sustainability. Sci Rep 2024; 14:5045. [PMID: 38424443 PMCID: PMC10904393 DOI: 10.1038/s41598-024-55603-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024] Open
Abstract
The future of the food system on the planet is increasingly facing uncertainties that are attributable to population growth and a surge in demand for nutritious food. Traditional agricultural practices are poised to place strain on production, as well as natural resources and ecosystem services provided, particularly under a changing climate. Given their remarkable attributes, including a low environmental footprint, high food conversion ratio, rapid growth and nutritional values, edible insects can play a vital role in the global food system. Nonetheless, substantial knowledge gaps persist regarding their diversity, global distribution, and shared characteristics across regions, potentially impeding effective scaling and access to edible insects. Therefore, we compiled and analysed the fragmented database on edible insects and identified potential drivers that elucidate insect consumption, globally, focusing on promoting a sustainable food system. We collated data from various sources, including the literature for a list of edible insect species, the Global Biodiversity Information Facility and iNaturalist for the geographical presence of edible insects, the Copernicus Land Service library for Global Land Cover, and FAOSTAT for population, income, and nutritional security parameters. Subsequently, we performed a series of analytics at the country, regional and continental levels. Our study identifies 2205 insect species, consumed across 128 countries globally. Among continents, Asia has the highest number of edible insects (932 species), followed by North America (mainly Mexico) and Africa. The countries with the highest consumption of insects are Mexico (450 species), Thailand (272 species), India (262 species), DRC (255 species), China (235 species), Brazil (140 species), Japan (123 species), and Cameroon (100 species). Our study also revealed some common and specific practices related to edible insect access and utilisation among countries and regions. Although insect consumption is often rooted in cultural practices, it exhibits correlations with land cover, the geographical presence of potentially edible insects, the size of a country's population, and income levels. The practice of eating insects is linked to the culture of people in Africa, Asia, and Latin America, while increased consciousness and the need for food sustainability are driving most of the European countries to evaluate eating insects. Therefore, edible insects are becoming an increasingly significant part of the future of planetary food systems. Therefore, more proactive efforts are required to promote them for their effective contribution to achieving sustainable food production.
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Affiliation(s)
- Evanson R Omuse
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya
- Department of Zoology and Entomology, University of Pretoria, Private Bag X20, Hatfield, 0028, South Africa
| | - Henri E Z Tonnang
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya
| | - Abdullahi Ahmed Yusuf
- Department of Zoology and Entomology, University of Pretoria, Private Bag X20, Hatfield, 0028, South Africa
| | - Honest Machekano
- Department of Zoology and Entomology, University of Pretoria, Private Bag X20, Hatfield, 0028, South Africa
| | | | - Emily Kimathi
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya
| | - Samira Faris Mohamed
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya
| | - Menale Kassie
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya
| | - Sevgan Subramanian
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya
| | - Juliet Onditi
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya
| | - Serah Mwangi
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya
| | - Sunday Ekesi
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya
| | - Saliou Niassy
- International Centre of Insect Physiology and Ecology (icipe), P.O. Box 30772-00100, Nairobi, Kenya.
- Inter-African Phytosanitary Council of African Union (AU-IAPSC), P.O Box 4170, Yaoundé, Cameroon.
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Mitra S, Khan MA, Nielsen R, Kumar G, Rahman MT. Review of environmental challenges in the Bangladesh aquaculture industry. Environ Sci Pollut Res Int 2024; 31:8330-8340. [PMID: 38168855 DOI: 10.1007/s11356-023-31630-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024]
Abstract
The increasing population and plateaued capture fishery landings have led to increasing demand for aquaculture products. However, environmental challenges are critical barriers to the sustainable development of aquaculture in developing countries. This review critically evaluates the environmental barriers facing aquaculture development in Bangladesh while laying out a roadmap for future development and spatial planning. An increase in the area used for aquaculture most often results in increasing pressure on natural resources such as land, water, energy, and the sources used for feed. Some of the negative externalities that this review focuses on are effluent discharge, the spread of diseases, and conflicts over land use with other ecosystem users. A way forward is to internalize these negative externalities and their costs into production decisions by farmers. Formulation of incentive-based pragmatic regulations can pave a forward path to increased environmental sustainability.
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Affiliation(s)
- Sandip Mitra
- Department of Agricultural Finance and Cooperatives, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur City, Bangladesh.
| | - Md Akhtaruzzaman Khan
- Department of Agricultural Finance and Banking, Bangladesh Agricultural University, Mymensingh, 2202, Bangladesh
| | - Rasmus Nielsen
- Institute of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
- Institute of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, Frederiksberg C, 1958, Denmark
| | - Ganesh Kumar
- Delta Research and Extension Center, Thad Cochran National Warmwater Aquaculture Center, Mississippi State University, Stoneville, MS, USA
| | - Md Takibur Rahman
- Department of Accounting and Information Systems, Patuakhali Science and Technology University, Dumki, Patuakhali-8602, Bangladesh
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Dang NAT, Phong Vu T, M. Gammeltoft T, Christian Bygbjerg I, W. Meyrowitsch D, Søndergaard J. Pre-/-post-analyses of a feasibility study of a peer-based club intervention among people living with type 2 diabetes in Vietnam's rural communities. PLoS One 2023; 18:e0290355. [PMID: 38015901 PMCID: PMC10684024 DOI: 10.1371/journal.pone.0290355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/05/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES Insufficient self-management is a significant barrier for people with type 2 diabetes (T2D) to achieve glycemic control and consequently reduce the risk of acute and long-term diabetes complications, negatively affecting their quality of life and increasing their risk of diabetes-related death. This pre-post study aimed to evaluate whether a peer-based club intervention might reduce glycated hemoglobin from baseline to post-intervention and enhance self-management among people living with T2D in two rural communities in Vietnam. METHODS A pre-post study was implemented with 222 adults with T2D residing in two rural communities in Vietnam. We used a structured questionnaire, clinical examination, and glycated hemoglobin to evaluate the possible effects of a diabetes club intervention by comparing Glycated Hemoglobin (HbA1c), Body Mass Index (BMI), Blood Pressure (BP), and diabetes-related self-management behaviors at baseline and post-intervention. The data were analyzed using SPSS 20, applying two related sample tests (Wilcoxon and McNemar test) and a paired-sample t-test at a significance level of less than 0.05. RESULTS The findings indicated that after implementation of the intervention, there were no significant statistical differences when comparing pre-and post-intervention levels of the primary outcome HbA1c, but some components of diabetes self-management showed statistically significant improvement. CONCLUSIONS After the peer support intervention in a Vietnamese rural community, there was no significant reduction in the primary outcome proportion of patients having an HbA1c less than 7%, but foot care knowledge and practice had improved. TRIAL REGISTRATION ClinicalTrials.gov NCT05602441.
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Affiliation(s)
- Ngoc-Anh Thi Dang
- Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Tuc Phong Vu
- Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Tine M. Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen K, Denmark
| | - Ib Christian Bygbjerg
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Dan W. Meyrowitsch
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | - Jens Søndergaard
- The Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
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Osei FA, Newton SKT, Nyanor I, Osei-Yeboah E, Amuzu EX, Mensah NK, Nyarko OO, Amanor E, Odoom SF, Abubakar SY, Dongyele M, Mohammed A, Asare O, Boadi S, Furu P, Meyrowitsch DW, Owusu-Dabo E. Awareness of and participation in mass drug administration programs used for onchocerciasis control in the Atwima Nwabiagya North District, Ghana. Glob Health Res Policy 2023; 8:47. [PMID: 37964321 PMCID: PMC10644529 DOI: 10.1186/s41256-023-00331-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 11/04/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Studies on Mass drug administration (MDA) in Ghana targeting various diseases, have mostly focused on factors that affect coverage and compliance to MDA with limited focus on evidence regarding awareness and community perception of the program. Therefore, this study sought to provide empirical evidence on the knowledge of onchocerciasis, and awareness of and participation in the MDA among community members. METHODS A community-based cross-sectional survey was conducted from August to October 2019 in communities within the Atwima Nwabiagya North District, Ghana. Data was collected from 2,008 respondents. Bivariate and multivariate logistic regression analyses were performed to measure the associations between socio-demographics, having heard of onchocerciasis and its prevention, and levels of awareness of the MDA program. RESULTS A total of 1268 respondents (63.2%) were aware of the MDA program. The majority ofMost respondents (74.4%) were of the view that the information given about the program was not enough and 45.4% of the respondents had no idea about the relevance of the MDA program. Respondents who had ever heard about onchocerciasis prevention and persons who had previously participated in the MDA program were more likely to be aware of the MDA program during implementation (AOR = 2.32; 95% CI 1.79-3.01 and AOR = 9.31; 95% CI 7.06-12.26, respectively). CONCLUSIONS We observed a significant association between being aware of MDA campaigns and knowledge of onchocerciasis and its preventive methods, and participation in previous MDA campaigns. We recommend intensification and improvement of prevention campaigns regarding the onchocerciasis MDA program as key to ensuring increased MDA program participation.
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Affiliation(s)
- Francis Adjei Osei
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Sam Kofi Tekyi Newton
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | | | | | | | | | | | | | - Mathias Dongyele
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Aliyu Mohammed
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ofeibea Asare
- Career Development Centre, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Peter Furu
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Dan Wolf Meyrowitsch
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Ellis Owusu-Dabo
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Tong S, Kjær JE, Peralta Ogorek LL, Pellegrini E, Song Z, Pedersen O, Herzog M. Responses of key root traits in the genus Oryza to soil flooding mimicked by stagnant, deoxygenated nutrient solution. J Exp Bot 2023; 74:2112-2126. [PMID: 36629284 PMCID: PMC10049916 DOI: 10.1093/jxb/erad014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/09/2023] [Indexed: 05/25/2023]
Abstract
Excess water can induce flooding stress resulting in yield loss, even in wetland crops such as rice (Oryza). However, traits from species of wild Oryza have already been used to improve tolerance to abiotic stress in cultivated rice. This study aimed to establish root responses to sudden soil flooding among eight wild relatives of rice with different habitat preferences benchmarked against three genotypes of O. sativa. Plants were raised hydroponically, mimicking drained or flooded soils, to assess the plasticity of adventitious roots. Traits included were apparent permeance (PA) to O2 of the outer part of the roots, radial water loss, tissue porosity, apoplastic barriers in the exodermis, and root anatomical traits. These were analysed using a plasticity index and hierarchical clustering based on principal component analysis. For example, O. brachyantha, a wetland species, possessed very low tissue porosity compared with other wetland species, whereas dryland species O. latifolia and O. granulata exhibited significantly lower plasticity compared with wetland species and clustered in their own group. Most species clustered according to growing conditions based on PA, radial water loss, root porosity, and key anatomical traits, indicating strong anatomical and physiological responses to sudden soil flooding.
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Affiliation(s)
| | | | - Lucas León Peralta Ogorek
- Department of Biology, University of Copenhagen, Universitetsparken 4, 3rd floor, 2100 Copenhagen, Denmark
| | - Elisa Pellegrini
- Department of Biology, University of Copenhagen, Universitetsparken 4, 3rd floor, 2100 Copenhagen, Denmark
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, Via delle Scienze 206, 33100 Udine, Italy
| | - Zhiwei Song
- Department of Biology, University of Copenhagen, Universitetsparken 4, 3rd floor, 2100 Copenhagen, Denmark
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Tong S, Ashikari M, Nagai K, Pedersen O. Can the Wild Perennial, Rhizomatous Rice Species Oryza longistaminata be a Candidate for De Novo Domestication? Rice (N Y) 2023; 16:13. [PMID: 36928797 PMCID: PMC10020418 DOI: 10.1186/s12284-023-00630-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
As climate change intensifies, the development of resilient rice that can tolerate abiotic stresses is urgently needed. In nature, many wild plants have evolved a variety of mechanisms to protect themselves from environmental stresses. Wild relatives of rice may have abundant and virtually untapped genetic diversity and are an essential source of germplasm for the improvement of abiotic stress tolerance in cultivated rice. Unfortunately, the barriers of traditional breeding approaches, such as backcrossing and transgenesis, make it challenging and complex to transfer the underlying resilience traits between plants. However, de novo domestication via genome editing is a quick approach to produce rice with high yields from orphans or wild relatives. African wild rice, Oryza longistaminata, which is part of the AA-genome Oryza species has two types of propagation strategies viz. vegetative propagation via rhizome and seed propagation. It also shows tolerance to multiple types of abiotic stress, and therefore O. longistaminata is considered a key candidate of wild rice for heat, drought, and salinity tolerance, and it is also resistant to lodging. Importantly, O. longistaminata is perennial and propagates also via rhizomes both of which are traits that are highly valuable for the sustainable production of rice. Therefore, O. longistaminata may be a good candidate for de novo domestication through genome editing to obtain rice that is more climate resilient than modern elite cultivars of O. sativa.
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Affiliation(s)
- Shuai Tong
- Department of Biology, University of Copenhagen, Universitetsparken 4, 3Rd Floor, 2100, Copenhagen, Denmark
| | - Motoyuki Ashikari
- Bioscience and Biotechnology Center of Nagoya University, Furo-Cho, Chikusa, Nagoya, Aichi, 464-8602, Japan
| | - Keisuke Nagai
- Bioscience and Biotechnology Center of Nagoya University, Furo-Cho, Chikusa, Nagoya, Aichi, 464-8602, Japan.
| | - Ole Pedersen
- Department of Biology, University of Copenhagen, Universitetsparken 4, 3Rd Floor, 2100, Copenhagen, Denmark.
- School of Agriculture and Environment, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
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Nicolaisen MA, Hansen AS. Humor, transparency, and the management of distrust among business rivals: a case study of berthing meetings at the Port of Tema in Ghana. Marit Stud 2023; 22:9. [PMID: 36908279 PMCID: PMC9990062 DOI: 10.1007/s40152-023-00298-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
This article builds on rich empirical data following our unexpected discovery of a local practice to circumvent a stressful and counterproductive work environment due to distrust at the Port of Tema in Ghana. Using theoretical work on networks, trust, and humor, as well as extensive ethnographic fieldwork, we found that the humorous atmosphere at the regularly held physical berthing meetings fosters a sense of community, which enables competing professions, private companies, and public institutions to manage their mutual distrust. In an environment where trust among competitors is unrealistic, we argue that the objective of the performance of humor and transparency at the physical berthing meetings is the management of distrust rather than the creation of trust. The meetings have, gradually, grown to serve as a pragmatic local stakeholder adaptation to the challenges posed by universally perceived politicized, opaque, and corrupt business practices at the Port of Tema and beyond. In conclusion, we posit that our empirical findings allow us to identify the potential of and gaps in theories about trust and humor in understanding the dynamics of coping strategies among competitors in business settings that are characterized by unethical practices.
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Kassam NA, Laswai D, Kulaya N, Kaaya RD, Kajeguka DC, Schmiegelow C, Wang CW, Alifrangis M, Kavishe RA. Human IgG responses to Aedes mosquito salivary peptide Nterm-34kDa and its comparison to Anopheles salivary antigen (gSG6-P1) IgG responses measured among individuals living in Lower Moshi, Tanzania. PLoS One 2022; 17:e0276437. [PMID: 36301860 PMCID: PMC9612500 DOI: 10.1371/journal.pone.0276437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/13/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The level of human exposure to arbovirus vectors, the Aedes mosquitoes, is mainly assessed by entomological methods which are labour intensive, difficult to sustain at a large scale and are affected if transmission and exposure levels are low. Alternatively, serological biomarkers which detect levels of human exposure to mosquito bites may complement the existing epidemiologic tools as they seem cost-effective, simple, rapid, and sensitive. This study explored human IgG responses to an Aedes mosquito salivary gland peptide Nterm-34kDa in Lower Moshi, a highland area with evidence of circulating arboviruses and compared the Aedes IgG responses to Anopheles mosquitoes' salivary antigen (GSG6-P1) IgG responses. METHODS Three cross-sectional surveys were conducted in 2019: during the first dry season in March, at the end of the rainy season in June and during the second dry season in September in five villages located in Lower Moshi. Blood samples were collected from enrolled participants above six months of age (age span: 7 months to 94 years) and analysed for the presence of anti-Nterm-34kDa IgG antibodies. Possible associations between Nterm-34kDa seroprevalence and participants' characteristics were determined. Levels of IgG responses and seroprevalence were correlated and compared to the already measured IgG responses and seroprevalence of Anopheles mosquitoes' salivary antigen, GSG6-P1. RESULTS During the first dry season, Nterm-34kDa seroprevalence was 34.1% and significantly increased at the end of the rainy season to 45.3% (Chi square (χ2) = 6.42 p = 0.011). During the second dry season, the seroprevalence significantly declined to 26.5% (χ2 = 15.12 p<0.001). During the rainy season, seroprevalence was significantly higher among residents of Oria village (adjusted odds ratio (AOR) = 2.86; 95% CI = 1.0-7.8; p = 0.041) compared to Newland. Moreover, during the rainy season, the risk of exposure was significantly lower among individuals aged between 16 and 30 years (AOR = 0.25; 95% CI = 0.1 = 0.9; p = 0.036) compared to individuals aged between 0 and 5 years. There was weak to moderate negative correlation between N-term 34kDa IgG and gSG6-P1 antigens. N-term 34kDa seroprevalence were higher compared to gSG6-P1 seroprevalence. CONCLUSION The findings of this study support that IgG antibody responses towards the Aedes mosquito salivary peptide Nterm-34kDa are detectable among individuals living in lower Moshi and vary with season and geographical area. More individuals are exposed to Aedes mosquito bites than Anopheles mosquito and those exposed to Aedes bites are not necessarily exposed to Anopheles mosquitoes.
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Affiliation(s)
- Nancy A. Kassam
- Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
- * E-mail:
| | - Daniel Laswai
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Neema Kulaya
- Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Robert D. Kaaya
- Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
- Pan-African Malaria Vector Research Consortium, Moshi, Tanzania
| | - Debora C. Kajeguka
- Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Christentze Schmiegelow
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Christian W. Wang
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Michael Alifrangis
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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Lopez-Perez M, Viwami F, Seidu Z, Jensen ATR, Doritchamou J, Ndam NT, Hviid L. PfEMP1-Specific Immunoglobulin G Reactivity Among Beninese Pregnant Women With Sickle Cell Trait. Open Forum Infect Dis 2021; 8:ofab527. [PMID: 34909438 PMCID: PMC8664683 DOI: 10.1093/ofid/ofab527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sickle cell trait (HbAS) protects against severe Plasmodium falciparum malaria but not against placental malaria (PM). In this study, P falciparum erythrocyte membrane protein (PfEMP1)-specific antibodies were measured in HbAA and HbAS Beninese pregnant women as a proxy of exposure to specific PfEMP1 variants. METHODS Plasma samples collected at delivery from 338 HbAA and 63 HbAS women were used to measure immunoglobulin (Ig)G levels to 6 recombinant PfEMP1 proteins and 3 corresponding native proteins expressed on the infected erythrocyte (IE) surface. Immunoglobulin G-mediated inhibition of VAR2CSA+ IEs adhesion to chondroitin sulfate A (CSA) was also tested. RESULTS Levels of PfEMP1-specific IgG were similar in the 2 groups, except for native IT4VAR09 on IEs, where IgG levels were significantly higher in HbAS women. Adjusted odds ratios for women with positive IgG to HB3VAR06 and PFD1235w suggest a lower risk of infection with these virulent variants among HbAS individuals. The percentage of IEs binding to CSA did not differ between HbAA and HbAS women, but it correlated positively with levels of anti-VAR2CSA and parity. Women with PM had lower levels of anti-VAR2CSA-specific IgG and lower IgG-mediated inhibition of IE adhesion to CSA. CONCLUSIONS The findings support similar malaria exposure in HbAA and HbAS women and a lack of HbAS-dependent protection against placental infection among pregnant women.
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Affiliation(s)
- Mary Lopez-Perez
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Firmine Viwami
- UMR 261 MERIT, Université de Paris, Institut de Recherche pour le Développement, Paris, France
- Institut de Recherche Clinique du Benin, Abomey Calavi, Benin
| | - Zakaria Seidu
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West Africa Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Anja T R Jensen
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Nicaise Tuikue Ndam
- UMR 261 MERIT, Université de Paris, Institut de Recherche pour le Développement, Paris, France
- Institut de Recherche Clinique du Benin, Abomey Calavi, Benin
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Lars Hviid
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Centre for Medical Parasitology, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
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Midgley SJE, Esler KJ, Holden PB, Rebelo AJ, Stuart-Hill SI, Cullis JDS, Methner N. Typologies of collaborative governance for scaling nature-based solutions in two strategic South African river systems. Ambio 2021; 50:1587-1609. [PMID: 34061345 PMCID: PMC8249548 DOI: 10.1007/s13280-021-01531-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/29/2020] [Accepted: 01/28/2021] [Indexed: 05/28/2023]
Abstract
Scaled up planning and implementation of nature-based solutions requires better understanding of broad characteristics (typologies) of the current governance and financing landscape, collaborative approaches amidst local complexities, and factors of scalability. An inventory was compiled of water-related ecological infrastructure intervention projects in two river systems in South Africa, incorporating actor, environmental, social, and financial dimensions and benefits. Qualitative participatory analysis revealed eight typologies. Post-hoc classification analysis determined similarities and/or unique characteristics of seven quantitative typologies. Key characterising factors included the complexity/size of financial flows, complexity of partnership/governance arrangements, mandates/goals of actors, type of ecological infrastructure, trade-offs in investment in ecological/built infrastructure, and the model used for social benefits. Identified scalable typologies offer structures suited to increased investment, with other typologies offering specialised local value. A range of ecological infrastructure intervention typologies with differing biophysical and socioeconomic outcomes provide choices for investors with specific goals, and benefits to landscape actors.
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Affiliation(s)
- Stephanie J E Midgley
- African Climate & Development Initiative (ACDI), University of Cape Town, Private Bag X3, Rondebosch, 7701, South Africa.
| | - Karen J Esler
- Department of Conservation Ecology & Entomology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| | - Petra B Holden
- African Climate & Development Initiative (ACDI), University of Cape Town, Private Bag X3, Rondebosch, 7701, South Africa
| | - Alanna J Rebelo
- Department of Conservation Ecology & Entomology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| | | | - James D S Cullis
- Zutari (Pty) Ltd., 1 Century City Drive, Waterford Precinct, Century City, 7441, South Africa
| | - Nadine Methner
- African Climate & Development Initiative (ACDI), University of Cape Town, Private Bag X3, Rondebosch, 7701, South Africa
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Faurholt-Jepsen D, Friis H, Mwaniki DL, Boit MK, Kaduka LU, Tetens I, Christensen DL. Waist circumference and low high-density lipoprotein cholesterol as markers of cardiometabolic risk in Kenyan adults. PLoS One 2021; 16:e0247600. [PMID: 33630976 PMCID: PMC7906307 DOI: 10.1371/journal.pone.0247600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/09/2021] [Indexed: 11/18/2022] Open
Abstract
Background Abdominal obesity predict metabolic syndrome parameters at low levels of waist circumference (WC) in Africans. At the same time, the African lipid profile phenotype of low high-density lipoprotein (HDL) cholesterol without concomitant elevated triglyceride levels renders high triglyceride levels detrimental to cardiometabolic health unsuitable for identifying cardiometabolic risk in black African populations. Objectives We aimed to identify simple clinical measures for cardiometabolic risk based on WC and HDL in an adult Kenyan population in order to determine which of the two predictors had the strongest impact. Methods We used linear regression analyses to assess the association between the two exposure variables WC and HDL with cardiometabolic risk factors including ultrasound-derived visceral (VAT) and subcutaneous adipose tissue (SAT) accumulation, fasting and 2-h venous glucose, fasting insulin, fasting lipid profile, and blood pressure in adult Kenyans (n = 1 370), and a sub-population with hyperglycaemia (diabetes and pre-diabetes) (n = 196). The same analyses were performed with an interaction between WC and HDL to address potential effect modification. Ultrasound-based, semi-quantitative hepatic steatosis assessment was used as a high-risk measure of cardiometabolic disease. Results Mean age was 38.2 (SD 10.7) (range 17–68) years, mean body mass index was 22.3 (SD 4.5) (range 13.0–44.8) kg/m2, and 57.8% were women. Cardiometabolic risk was found in the association between both WC and HDL and all outcome variables (p<0.05) except for HDL and SAT, fasting and 2-h venous glucose. Additive cardiometabolic risk (WC and HDL interaction) was found for SAT, low-density lipoprotein cholesterol, and triglycerides. No differences in the association between WC and HDL and the outcome variables were found when comparing the full study population and the hyperglycaemia sub-population. Increase in WC and HDL were both associated with hepatic steatosis (OR 1.09, p<0.001, and OR 0.46, p = 0.031, respectively). Conclusion In adult Kenyans, increasing WC identified more cardiometabolic risk factors compared to HDL.
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Affiliation(s)
- Daniel Faurholt-Jepsen
- Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Michael K. Boit
- Department of recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya
| | | | - Inge Tetens
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Dirk L. Christensen
- Department of Public Health, Section of Global Health, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
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Bediako-Bowan AAA, Kurtzhals JAL, Mølbak K, Labi AK, Owusu E, Newman MJ. High rates of multi-drug resistant gram-negative organisms associated with surgical site infections in a teaching hospital in Ghana. BMC Infect Dis 2020; 20:890. [PMID: 33238903 PMCID: PMC7689982 DOI: 10.1186/s12879-020-05631-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/18/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is limited data to guide the prevention and management of surgical site infections (SSI) in low- and middle-income countries. We prospectively studied aetiological agents associated with SSI and their corresponding antibiotic susceptibility patterns in a tertiary hospital in Ghana. METHODS As part of a cohort study carried out at the surgical department of the Korle Bu Teaching Hospital (KBTH) from July 2017 to April 2019, wound swabs were collected from patients diagnosed with SSI. Isolates cultured from the wound swabs were identified by MALDI TOF and susceptibility testing was conducted according to EUCAST 2020 guidelines. Clinical data were monitored prospectively. RESULTS Of 4577 patients, 438 developed an SSI and 352 microbial isolates were cultured. Isolates were predominantly Gram negative (286, 81%), a pattern seen for all kinds of surgery and all wound classes. The most common species included Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Acinetobacter baumannii. The majority of organisms were multi-drug resistant including 86% of E. coli, 52% of A. baumannii and 86% of K. pneumoniae; and 65% (17/26) of the cefotaxime-resistant K. pneumoniae were extended spectrum β-lactamase producing. One of 139 E. coli, 15 of 49 P. aeruginosa, and 6 of 23 A. baumannii were meropenem resistant, but no clonal pattern was found. There was a 1% (5/428) prevalence of methicillin-resistant S. aureus. CONCLUSIONS The predominance of Gram-negative organisms and the high level of multi-drug resistance indicate a need to re-evaluate antibiotic prophylaxis and treatment protocols in surgical practice in low- and middle-income countries.
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Affiliation(s)
- Antoinette A A Bediako-Bowan
- Department of Surgery, University of Ghana Medical School, University of Ghana, P. O. Box 4356, Accra, Ghana.
- Department of Surgery, Korle Bu Teaching Hospital, Accra, Ghana.
- Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark.
- Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark.
| | - Jørgen A L Kurtzhals
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Kåre Mølbak
- Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark
- Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Appiah-Korang Labi
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- Department of Microbiology, Korle-Bu Teaching Hospital, P.O. Box 77, Accra, Ghana
| | - Enid Owusu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Science, University of Ghana, Legon, Accra, Ghana
| | - Mercy J Newman
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
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Kretchy JP, Dzodzomenyo M, Ayi I, Dwomoh D, Agyabeng K, Konradsen F, Dalsgaard A. Risk of faecal pollution among waste handlers in a resource-deprived coastal peri-urban settlement in Southern Ghana. PLoS One 2020; 15:e0239587. [PMID: 33006973 PMCID: PMC7531843 DOI: 10.1371/journal.pone.0239587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 09/10/2020] [Indexed: 11/19/2022] Open
Abstract
Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscriminate solid waste disposal and open defecation practices. Persons engaged in waste handling in such communities perform their activities with little or no personal protective equipment. They are thus confronted with the risk of faecal pollution of the hands and other bodily parts. A mixed method approach was used to investigate 280 waste handlers performing different activities to estimate recent faecal pollution of their hands and to observe the utilization of personal protective equipment and sanitation/hygiene facilities during work. The log concentration of E. coli on hands of waste handlers after work (8.60 ± 4.20 CFU/hand, mean ± standard deviation) was significantly higher compared with the E. coli log concentration before work (2.95 ± 1.89 CFU/hand, mean ± standard deviation) (p<0.001). The odds of faecal pollution was significantly higher (aOR 4.2; 95% CI: 1.9-9.1) for workers aged 35 years and above compared with those less than 35 years; and for workers at public toilet facilities (aOR 3.0; 95% CI: 1.0-8.4) compared with those who worked for private waste handling companies. Female workers were, however, 60% less likely (aOR 0.4; 95% CI: 0.2-0.8) to experience faecal pollution of their hands compared with males. The workers had limited access to water and sanitation and hygiene facilities, and about one-fifth (n = 59; 21.1%) did not use personal protective equipment during work. Waste handlers should be provided and instructed in proper use of personal protective equipment, have access to sanitation facilities and adopt improved hygiene behaviour to avoid the risk of faecal pollution and associated disease risk.
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Affiliation(s)
- James-Paul Kretchy
- Department of Physician Assistantship Studies, School of Medicine and Health Sciences, Central University, Miotso, Accra, Ghana
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- * E-mail: ,
| | - Mawuli Dzodzomenyo
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Irene Ayi
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Duah Dwomoh
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Kofi Agyabeng
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Flemming Konradsen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders Dalsgaard
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
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Smith-Togobo C, Pedersen MØ, Jensen SG, Duduyemi B, Gyasi RK, Ofori MF, Paintsil V, Renner L, Nørgaard P, Hviid L. Reliable cell and tissue morphology-based diagnosis of endemic Burkitt lymphoma in resource-constrained settings in Ghana. BMC Cancer 2019; 19:1270. [PMID: 31888714 PMCID: PMC6937736 DOI: 10.1186/s12885-019-6488-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 12/20/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Endemic Burkitt lymphoma (eBL) is an aggressive B-cell lymphoma, which is a common childhood cancer in areas with intense transmission of Plasmodium falciparum parasites. Early and accurate diagnosis is a prerequisite for successful therapy, but it optimally involves advanced laboratory investigations. These are technologically demanding, expensive, and often difficult to implement in settings where eBL is prevalent. Diagnosis is thus generally based on clinical assessment and morphological examination of tumour biopsies or fine-needle aspirates (FNAs). METHODS The purpose of the present study was to assess the accuracy of eBL diagnosis at two tertiary hospitals in Ghana. To that end, we studied FNAs from 29 eBL patients and 21 non-eBL lymphoma patients originally diagnosed in 2018. In addition, we examined 111 archival formalin-fixed and paraffin-embedded (FFPE) biopsies from Ghanaian patients originally diagnosed as eBL (N = 55) or non-eBL (N = 56) between 2010 and 2017. Availability-based subsets of samples were subjected to haematoxylin-eosin or Giemsa staining, C-MYC immunohistochemistry, and fluorescence in situ hybridisation (FISH) analysis of c-myc rearrangements. RESULTS We found a good correlation between original diagnosis and subsequent retrospective assessment, particularly for FNA samples. However, evidence of intact c-myc genes and normal C-MYC expression in samples from some patients originally diagnosed as eBL indicates that morphological assessment alone can lead to eBL over-diagnosis in our study area. In addition, several FFPE samples could not be assessed retrospectively, due to poor sample quality. Therefore, the simpler FNA method of obtaining tumour material is preferable, particularly when careful processing of biopsy specimens cannot be guaranteed. CONCLUSION We conclude that the accuracy of eBL diagnostic tools available in Ghana is generally adequate, but could be improved by implementation of additional pathology laboratory investigations. Improved attention to adequate preservation of archival samples is recommended.
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Affiliation(s)
- Cecilia Smith-Togobo
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Ghana
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Ø Pedersen
- Department of Pathology, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Steffen G Jensen
- Department of Pathology, Herlev and Gentofte Hospital, Herlev, Denmark
| | | | - Richard K Gyasi
- Department of Pathology, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Michael F Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Vivian Paintsil
- Department of Child Health, Komfo Anokye Hospital, Kumasi, Ghana
| | - Lorna Renner
- Department of Child Health, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Peter Nørgaard
- Department of Pathology, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Lars Hviid
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
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Hounmanou YMG, Leekitcharoenphon P, Kudirkiene E, Mdegela RH, Hendriksen RS, Olsen JE, Dalsgaard A. Genomic insights into Vibrio cholerae O1 responsible for cholera epidemics in Tanzania between 1993 and 2017. PLoS Negl Trop Dis 2019; 13:e0007934. [PMID: 31869327 PMCID: PMC6927581 DOI: 10.1371/journal.pntd.0007934] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 11/18/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Tanzania is one of seven countries with the highest disease burden caused by cholera in Africa. We studied the evolution of Vibrio cholerae O1 isolated in Tanzania during the past three decades. METHODOLOGY/PRINCIPAL FINDINGS Genome-wide analysis was performed to characterize V. cholerae O1 responsible for the Tanzanian 2015-2017 outbreak along with strains causing outbreaks in the country for the past three decades. The genomes were further analyzed in a global context of 590 strains of the seventh cholera pandemic (7PET), as well as environmental isolates from Lake Victoria. All Tanzanian cholera outbreaks were caused by the 7PET lineage. The T5 sub-lineage (ctxB3) dominated outbreaks until 1997, followed by the T10 atypical El Tor (ctxB1) up to 2015, which were replaced by the T13 atypical El Tor of the current third wave (ctxB7) causing most cholera outbreaks until 2017 with T13 being phylogenetically related to strains from East African countries, Yemen and Lake Victoria. The strains were less drug resistant with approximate 10-kb deletions found in the SXT element, which encodes resistance to sulfamethoxazole and trimethoprim. Nucleotide deletions were observed in the CTX prophage of some strains, which warrants further virulence studies. Outbreak strains share 90% of core genes with V. cholerae O1 from Lake Victoria with as low as three SNPs difference and a significantly similar accessory genome, composed of genomic islands namely the CTX prophage, Vibrio Pathogenicity Islands; toxin co-regulated pilus biosynthesis proteins and the SXT-ICE element. CONCLUSION/SIGNIFICANCE Characterization of V. cholerae O1 from Tanzania reveals genetic diversity of the 7PET lineage composed of T5, T10 and T13 sub-lineages with introductions of new sequence types from neighboring countries. The presence of these sub-lineages in environmental isolates suggests that the African Great Lakes may serve as aquatic reservoirs for survival of V. cholerae O1 favoring continuous human exposure.
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Affiliation(s)
| | | | - Egle Kudirkiene
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Robinson H. Mdegela
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Rene S. Hendriksen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - John Elmerdahl Olsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anders Dalsgaard
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore city, Singapore
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Sonda TB, Horumpende PG, Kumburu HH, van Zwetselaar M, Mshana SE, Alifrangis M, Lund O, Aarestrup FM, Chilongola JO, Mmbaga BT, Kibiki GS. Ceftriaxone use in a tertiary care hospital in Kilimanjaro, Tanzania: A need for a hospital antibiotic stewardship programme. PLoS One 2019; 14:e0220261. [PMID: 31381579 PMCID: PMC6681960 DOI: 10.1371/journal.pone.0220261] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/11/2019] [Indexed: 12/12/2022] Open
Abstract
Excessive use of antibiotics, especially watch group antibiotics such as ceftriaxone leads to emergence and spread of antimicrobial resistance (AMR). In low and middle-income countries (LMICs), antibiotics are overused but data on consumption is scarcely available. We aimed at determining the extent and predictors of ceftriaxone use in a tertiary care university teaching hospital in Kilimanjaro, Tanzania. A hospital-based cross-sectional study was conducted from August 2013 through August 2015. Patients admitted in the medical, surgical wards and their respective intensive care units, receiving antimicrobials and other medications for various ailments were enrolled. Socio-demographic and clinical data were recorded in a structured questionnaire from patients' files and logistic regression was performed to determine the predictors for ceftriaxone use. Out of the 630 patients included in this study, 322 (51.1%) patients were on ceftriaxone during their time of hospitalization. Twenty-two patients out of 320 (6.9%) had been on ceftriaxone treatment without evidence of infection. Ceftriaxone use for surgical prophylaxis was 44 (40.7%), of which 32 (72.7%) and 9 (20.5%) received ceftriaxone prophylaxis before and after surgery, respectively. Three (6.8%) received ceftriaxone prophylaxis during surgery. Predicting factors for that the health facility administered ceftriaxone were identified as history of any medication use before referral to hospital [OR = 3.4, 95% CI (1.0-11.4), p = 0.047], bacterial infection [OR = 18.0, 95% CI (1.4-225.7, p = 0.025)], surgical ward [OR = 2.9, 95% CI (0.9-9.4), p = 0.078] and medical wards [OR = 5.0, 95% CI (0.9-28.3), p = 0.070]. Overall, a high ceftriaxone use at KCMC hospital was observed. Antimicrobial stewardship programs are highly needed to monitor and regulate hospital antimicrobial consumption, which in turn could help in halting the rising crisis of antimicrobial resistance.
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Affiliation(s)
- Tolbert B. Sonda
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Pius G. Horumpende
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Department of Biochemistry and Molecular Biology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Lugalo General Military Hospital, Military College of Medical Sciences, Dar es Salaam, Tanzania
| | - Happiness H. Kumburu
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Marco van Zwetselaar
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | | | - Michael Alifrangis
- Centre for Medical Parasitology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ole Lund
- Centre for Biological Sequence Analysis, Technical University of Denmark; Copenhagen, Denmark
| | - Frank M. Aarestrup
- Centre for Genomic Epidemiology, Technical University of Denmark; Copenhagen, Denmark
| | - Jaffu O. Chilongola
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Department of Biochemistry and Molecular Biology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Blandina T. Mmbaga
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Department of Biochemistry and Molecular Biology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
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Katanga J, Kjaer SK, Manongi R, Wu CS, Iftner T, Waldstrom M, Pembe AB, Mwaiselage J, Rasch V. Performance of careHPV, hybrid capture 2 and visual inspection with acetic acid for detection of high-grade cervical lesion in Tanzania: A cross-sectional study. PLoS One 2019; 14:e0218559. [PMID: 31216333 PMCID: PMC6583973 DOI: 10.1371/journal.pone.0218559] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/04/2019] [Indexed: 01/02/2023] Open
Abstract
Objective To examine the test performance of careHPV, Hybrid Capture2 (HC2) and visual inspection with acetic acid (VIA) for detection of cytologically diagnosed high-grade cervical lesions or cancer (HSIL+). Design Cross-sectional study. Setting Ocean Road Cancer Institute (ORCI) and Kilimanjaro Christian Medical Center (KCMC), Tanzania. Population Women attending routine cervical cancer screening. Method We enrolled 4080 women (25–60 years) in the study. The women were interviewed on lifestyle habits, and tested for HIV. A cervical specimen for careHPV testing (performed at ORCI and KCMC), and a liquid-based cytology sample for HPV DNA detection using HC2 (performed at Tuebingen University Hospital, Germany) and for cytology assessment (performed at Vejle Hospital, Denmark) were obtained at a gynecological examination. Subsequently, VIA was performed. With cytology as gold standard, the sensitivity and specificity of careHPV, HC2, and VIA for detection of HSIL+ were calculated. Results Altogether, 23.6% had a positive careHPV test, 19.1% had positive HC2 test, and 6.3% had a positive VIA test. The sensitivity/specificity was 88.9%/78.9% for careHPV and 91.1%/83.7%, for HC2. VIA showed a low sensitivity of 31.1% but a high specificity (94.6%) for detection of HSIL+. The sensitivity of careHPV, HC2 and VIA was higher among younger women, and among HIV positive women. VIA triage of careHPV positive women improved specificity, but sensitivity dropped to 27%. Conclusion Our results confirm the low sensitivity of VIA for detection of HSIL+ and further document that careHPV test is promising as a primary screening method for cervical-cancer prevention in low-resource regions. A suitable triage test has to be identified.
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Affiliation(s)
- Johnson Katanga
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- * E-mail:
| | - Susanne K. Kjaer
- Danish Cancer Society Research Center, Unit of Virus, Lifestyle and Genes, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Rachel Manongi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - Chun Sen Wu
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Thomas Iftner
- Department of Virologi, Tuebingen University Hospital, Tuebingen, Germany
| | | | - Andrea B. Pembe
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Vibeke Rasch
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
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Sigalla GN, Mushi D, Meyrowitsch DW, Manongi R, Rogathi JJ, Gammeltoft T, Rasch V. Intimate partner violence during pregnancy and its association with preterm birth and low birth weight in Tanzania: A prospective cohort study. PLoS One 2017; 12:e0172540. [PMID: 28235031 PMCID: PMC5325295 DOI: 10.1371/journal.pone.0172540] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 02/05/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Intimate partner violence (IPV) is a public health problem that affects millions of women worldwide. The role of violence as an underlying factor in poor birth outcomes remains an area where strong evidence is lacking. The aim of this study was to determine the association between intimate partner violence (IPV) and preterm delivery (PTB) and low birth weight (LBW). Materials and methods A prospective cohort study was conducted among 1112 pregnant women attending antenatal care in Moshi–Tanzania. The women were enrolled before 24 weeks gestation, followed-up at week 34 to determine exposure to violence during pregnancy, and after delivery to estimate gestation age at delivery and birth weight. Logistic regression analysis was performed to assess the association between exposure to IPV during pregnancy and PTB and LBW while adjusting for possible confounders. In addition, stratified analysis based on previous history of adverse pregnancy outcome was performed. Results One-third of the women experienced IPV during pregnancy, 22.3% reported emotional, 15.4% sexual and 6.3% physical violence. Women exposed to physical IPV were three times more likely to experience PTB (AOR = 2.9; CI 95%: 1.3–6.5) and LBW (AOR = 3.2; CI 95%: 1.3–7.7). Women with previous adverse pregnancy outcomes and exposure to physical IPV had a further increased risk of PTB (AOR = 4.5; CI 95%: 1.5–13.7) and LBW (AOR = 4.8; CI 95%: 1.6–14.8) compared to those without previous history of adverse outcome. Conclusion Women who are exposed to IPV during pregnancy are at increased risk of PTB and LBW. The risk is even stronger if the women additionally have suffered a previous adverse pregnancy outcome. Interventions addressing IPV are urgently needed to prevent occurrence and reoccurrence of PTB and LBW.
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Affiliation(s)
- Geofrey Nimrod Sigalla
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Health, Evangelical Lutheran Church in Tanzania, Arusha, Tanzania
- * E-mail:
| | - Declare Mushi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | - Rachel Manongi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Jane Januarius Rogathi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Tine Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke Rasch
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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