Baseline Trachoma Surveys in Kaskazini A and Micheweni Districts of Zanzibar: Results of Two Population-Based Prevalence Surveys Conducted with the Global Trachoma Mapping Project.

PURPOSE: Based on health care records and trachoma rapid assessments, trachoma was suspected to be endemic in Kaskazini A and Micheweni districts of Zanzibar. This study aimed to investigate the prevalence of trachomatous inflammation-follicular (TF), and trachomatous trichiasis (TT) in each of those districts. METHODS: The survey was undertaken in Kaskazini A and Micheweni districts on Unguja and Pemba Islands, respectively. A multi-stage cluster random sampling design was applied, whereby 25 census enumeration areas (clusters) and 30 households per cluster were included. Consenting eligible participants (children aged 1-9 years and people aged 15 years and older) were examined for trachoma using the World Health Organization simplified grading system. RESULTS: A total of 1673 households were surveyed and 6407 participants (98.0% of those enumerated) were examined for trachoma. Examinees included a total of 2825 children aged 1-9 years and 3582 people aged 15 years and older. TF prevalence in 1-9-year-olds was 2.7% (95% confidence interval, CI, 2.7-4.1%) in Kazkazini A and 11.4% (95% CI 6.6-16.5%) in Micheweni. Among people aged 15 years and older, TT prevalence was 0.01% (95% CI 0.00-0.04%) in Kazkazini A and 0.21% (95% CI 0.08-0.39%) in Micheweni. CONCLUSION: Trachoma is a public health problem in Micheweni district, where implementation of all four components of the SAFE strategy (surgery, antibiotics, facial cleanliness, and environmental improvement), including mass drug administration with azithromycin, is required. These findings will facilitate planning for trachoma elimination

Perinatal outcomes following Helping Babies Breathe training and regular peer-peer skills practice among village midwives in Sudan.

Over 80% of deliveries in Sudan occur in rural areas, attended by village midwives (VMWs). To determine the impact of Helping Babies Breathe training and regular peer-peer skills practice (HBBT(+RPPSP)) on VMW resuscitation practices and outcomes. In a prospective community-based intervention study, 71/82 VMWs, reporting to six East Nile rural medical centres, with previous experience in community health research, consented to HBBT(+RPPSP). Outcomes included changes in the resuscitation practices, fresh stillbirths (FSB) and early neonatal deaths <1 week (ENND). There were 1350 and 3040 deliveries before and after HBBT(+RPPSP), respectively, with no significant differences between the two cohorts regarding maternal age, education or area of birth. Drying of the newborn increased almost tenfold (8.4%, n=113 to 74.9%, n=1011) while suctioning of the mouth/nose decreased fivefold (80.3%, n=2442 to 14.4%, n=437) following HBBT(+RPPSP). Pre-HBBT(+RPPSP)9/18 (50%) newborns who had mouth-to-mouth ventilation died, compared with 13/119 (11%) who received bag-mask ventilation post-HBBT(+RPPSP). Excluding 11 macerated fetuses, there were 55 perinatal deaths: 14 FSB/18 ENND (6 months pre-HBBT(+RPPSP)) and 10 FSB/13 ENND (18 months post-HBBT(+RPPSP)). FSB rates decreased from 10.5 to 3.3 per 1000 births ((χ(2))=8.6209, p=0.003), while ENND rates decreased from 13.5 to 4.3 per 1000 live births ((χ(2))=10.9369, p=0.001) pre-HBBT(+RPPSP) and post-HBBT(+RPPSP), respectively. In a selected group of VMWs, HBBT(+RPPSP) was associated with improvements in newborn resuscitation and perinatal outcomes. HBBT(+RPPSP) could have immense benefits if propagated nationally to all 17 000 VMWs in Sudan.This study was funded by the Irish Aid Civil Society Grant scheme

The current state of natural ponds of North Unguja, Zanzibar: The alteration due to climate change and anthropogenic events

Natural ponds are a biologically important habitat type for their specialized collection and the considerable numbers of rare and endemic species they support and play critical role in maintaining biodiversity. Continued increases in anthropogenic behavior and climate change, act in concert to cause alteration to pond and pond perimeter. In Zanzibar, there are several ponds that impound rainfall runoff; however, there is slight concern in conservation in spite of it great support to ecosystem and livelihood. This paper aimed to determine the current changes within the natural pond perimeter of both natural and anthropogenic events, in north region of Unguja, Zanzibar. A mixed method approach was employed to collect data from 113 respondents that are community members around the six ponds (Vuga, Kichungwani, Mbiji, Muwanda, Kinyasini, and Ketwa) were involved in the study. The qualitative data collected through observations based on checklist made around the ponds was analyzed using atlas Ti software, whereas quantitative data collected through questionnaires and measurement were analyzed using SPSS software version 20. The study findings revealed that in the northern Unguja ponds, there is a greater decrease in Area size, changing in condition of water, settlement encroachment and change in vegetation cover which alter the ecosystem composition and human livelihood. These findings highlight the fundamental importance to raise awareness of the alteration trend of the northern Unguja pond and Zanzibar in general. Keywords: Natural ponds, climate, changes (alteration), anthropogenic, freshwater.</jats:p

A TP-LPV-LMI Approach to Control of Tumor Growth

By using advanced control techniques to control physiological systems sophisticated control regimes can be realized. There are several challenges need to be solved in these approaches, however. Most of the time, the lack of information of the internal dynamics, the nonlinear behavior of the system to be controlled and the variabilities coming from that simple fact that people are different and their specifics vary in time makes the control design difficult. Nevertheless, the use of appropriate methodologies can facilitate to find solutions to them. In this study, our aim is to introduce different techniques and by combining them we show an effective way for control design with respect to physiological systems. Our solution stands on four pillars: transformation of the formulated model into control oriented model (COM) form; use the COM for linear parameter varying (LPV) kind modeling to handle unfavorable dynamics as linear dependencies; tensor product modeling (TPM) to downsize the computational costs both from modeling and control design viewpoint; and finally, using linear matrix inequalities (LMI) based controller design to satisfy predefined requirements. The occurring TP-LPV-LMI controller is able to enforce a given, nonlinear system to behave as a selected reference system. In this study, the detailed control solution is applied for tumor growth control to maintain the volume of the tumor

Functionalized Cyclodextrins and Their Applications in Biodelivery

International audienc