Adoption of Free Open Source Geographic Information System Solution for Health Sector in Zanzibar Tanzania

\ud The study aims at developing in-depth understanding on how Open Source Geographic Information System technology is used to provide solutions for data visualization in the health sector of Zanzibar, Tanzania. The study focuses on implementing the health visualization solutions for the purpose of bridging the gap during the transition period from proprietary software to the Free Open-Source Software using Key Indicator Data System. The developed tool facilitates data integration between the two District Health Information Software versions and hence served as a gateway solution during the transition process. Implementation challenges that include outdated spatial data and the reluctance of the key users in coping with the new Geographical Information System technologies were also identified. Participatory action research and interviews were used in understanding the requirements for the new tool to facilitate the smooth system development for better health service delivery.\u

Uniting to end the TB epidemic: advances in disease control from prevention to better diagnosis and treatment.

Tuberculosis is a major global cause of morbidity and mortality. Despite recent advances in containing the epidemic, several challenges continue to slow progress towards elimination including the continuing impact of drug resistant disease, and the lack of appropriate tools. Curtailing the transmission of tuberculosis remains a challenge especially in high burden countries. New developments in measuring correlates of protection are urgently needed to support the evaluation of vaccines. Similarly, despite progress in molecular diagnostics, better tools are required to identify resistance to antibiotics in multi and extensively drug resistant tuberculosis. Whole Genome Sequencing may lead to the next generation of assays to rapidly detect resistance and evaluate transmission. Advances on shortening treatment are hampered by the lack of a biomarker of cure which obviates the current long wait for relapses in trials. New research is urgently needed to support development of new vaccines and better diagnostics tools and shorter treatment for drug sensitive and resistant tuberculosis

Effect of study design and setting on tuberculosis clustering estimates using Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR): a systematic review

Objectives: To systematically review the evidence for the impact of study design and setting on the interpretation of tuberculosis (TB) transmission using clustering derived from Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) strain typing. Data sources MEDLINE, EMBASE, CINHAL, Web of Science and Scopus were searched for articles published before 21st October 2014. Review methods Studies in humans that reported the proportion of clustering of TB isolates by MIRU-VNTR were included in the analysis. Univariable meta-regression analyses were conducted to assess the influence of study design and setting on the proportion of clustering. Results: The search identified 27 eligible articles reporting clustering between 0% and 63%. The number of MIRU-VNTR loci typed, requiring consent to type patient isolates (as a proxy for sampling fraction), the TB incidence and the maximum cluster size explained 14%, 14%, 27% and 48% of between-study variation, respectively, and had a significant association with the proportion of clustering. Conclusions: Although MIRU-VNTR typing is being adopted worldwide there is a paucity of data on how study design and setting may influence estimates of clustering. We have highlighted study design variables for consideration in the design and interpretation of future studies

Struktur, Perilaku dan Kinerja Pemasaran Biji Kakao di Kabupaten Parigi Moutong Provinsi Sulawesi Tengah

Parigi Moutong is one of cocoa production center in the Central Sulawesi province. The problem faced by cocoa farmers in Parigi Moutong is the weak bargaining position of farmers in the price determination. The purpose of this study is to analyze cocoa beans market structure, conduct and performance at Parigi Moutong district. The methods used are market concentration and exit barriers to analyze market structure; market conductand farmer share and marketing margin to analyze market performance. The results show that the market of cocoa beans has four marketing channels which the highest total margin is on 2nd channel (Rp 25 465 and oligopsony structure. The most efficient marketing channel is channel 3 with 58.01 percent of farmer share. One of alternatives to increase farmer's bargaining position in determining the cocoa price is by improving the cocoa quality through fermentation. This can be conducted by the farmer empowerment systematically and sustainably

Genetic Analisys of Cytochrome Oxidase Sub Unit 1 Gene Fragment From Cirrhilabrus Cf. Ryukyuensis (Labridae) From Cenderawasih Bay and Raja Ampat

Cirrhilabrus cf. ryukyuensis asal Teluk Cenderawasih dan Raja Ampat secara morfologi memiliki perbedaan warna dengan Cirrhilabrus ryukyuensis. Penelitian ini bertujuan menentukan hubungan filogenetik, evolusi, dan keragaman genetik Cirrhilabrus cf. ryukyuensis berdasarkan gen Sitokrom Oksidase sub Unit I (COI). Genom DNA mitokondria diekstrak menggunakan larutan chelex 10%. Primer FISH-BCH dan BCL digunakan untuk mengamplifikasi fragmen Gen COI dan sekuensing. Analisis data dilakukan dengan menggunakan perangkat lunak Sequencher 4.1 dan MEGA 5. Gen COI dari enam sampel C. cf. rykyuensis asal Teluk Cenderawasih dan Raja Ampat, memiliki panjang basa men-capai 613 bp. Komposisi rata-rata nukleotida T 32,8%, C 26,3%, A 23,2% dan G 17,7%. Terdapat enam posisi poli-morfisme yang kesemuanya disebabkan oleh mutasi transition. Hasil penerjemahan nukleotida, diperoleh asam amino dengan panjang 204 asam amino dengan urutan yang sama. Pohon filogenetik menunjukkan keenam sampel berada dalam satu clade yang sama dan berbeda dari clade Cirrhilabrus cyanopleura data Gene Bank

Drug-Resistant Tuberculosis--Current Dilemmas, Unanswered Questions, Challenges and Priority Needs

Tuberculosis was declared a global emergency by the World Health Organization (WHO) in 1993. Following the declaration and the promotion in 1995 of directly observed treatment short course (DOTS), a cost-effective strategy to contain the tuberculosis epidemic, nearly 7 million lives have been saved compared with the pre-DOTS era, high cure rates have been achieved in most countries worldwide, and the global incidence of tuberculosis has been in a slow decline since the early 2000s. However, the emergence and spread of multidrug-resistant (MDR) tuberculosis, extensively drug-resistant (XDR) tuberculosis, and more recently, totally drug-resistant tuberculosis pose a threat to global tuberculosis control. Multidrug-resistant tuberculosis is a man-made problem. Laboratory facilities for drug susceptibility testing are inadequate in most tuberculosis-endemic countries, especially in Africa; thus diagnosis is missed, routine surveillance is not implemented, and the actual numbers of global drug-resistant tuberculosis cases have yet to be estimated. This exposes an ominous situation and reveals an urgent need for commitment by national programs to health system improvement because the response to MDR tuberculosis requires strong health services in general. Multidrug-resistant tuberculosis and XDR tuberculosis greatly complicate patient management within resource-poor national tuberculosis programs, reducing treatment efficacy and increasing the cost of treatment to the extent that it could bankrupt healthcare financing in tuberculosis-endemic areas. Why, despite nearly 20 years of WHO-promoted activity and >12 years of MDR tuberculosis–specific activity, has the country response to the drug-resistant tuberculosis epidemic been so ineffectual? The current dilemmas, unanswered questions, operational issues, challenges, and priority needs for global drug resistance screening and surveillance, improved treatment regimens, and management of outcomes and prevention of DR tuberculosis are discussed

World TB Day 2016: an interview with leading experts in tuberculosis research.

In this interview, we talk to leading tuberculosis (TB) experts from University College London and the London School of Hygiene and Tropical Medicine about the current challenges in TB research. The video of this interview is available here: https://www.youtube.com/watch?v=75Die7MQBec&feature=youtu.be . The video can also be downloaded via Additional file 1

Insertion Element IS6110 based characterisation of Nepalese tuberculosis strains into different genetic lineages

Nepal is geographically located between India and China, a region containing significant Tuberculosis (TB) and Multi-Drug Resistance (MDR-TB) burdens. However, limited information is available on the phylogenetic diversity of Mycobacterium tuberculosis (Mtb) in Nepal. To gain further insight into the diversity of Mtb in Nepal, consecutive clinical samples from 176 newly diagnosed pulmonary tuberculosis patients were collected from two hospitals in Nepal. Insertion Site IS6110 Fluorescent Amplified Fragment Length Polymorphism (FAFLP) PCR and rpoB sequence analysis were carried out on genomic DNA extracts of cultured strains to assign them to accepted genetic lineages and identify MDR-TB. In this study, the IS6110 based characterisation showed a prevalence of 36.36% Central Asian Strain (CAS), 18.75% Beijing, 7.95 % Haarlem, 3.97% X, 2.2% each of Latin American Mediterranean (LAM), T-Uganda and T, 1.7% S and 24.4% were unassigned. Further, 3.9% of total M. tuberculosis isolates were of rifampicin resistant genotypes thus indicating that the prevalence of MDR could be higher than the country wide prevalence of MDR among new TB cases (2.2%) as reported by the national drug resistance survey carried out in 2011/2012