"We did not know what was wrong"-Barriers along the care cascade among hospitalized adolescents with HIV in Gaborone, Botswana

High mortality among adolescents with HIV reflects delays and failures in the care cascade. We sought to elucidate critical missed opportunities and barriers to care among adolescents hospitalized with HIV at Botswana's tertiary referral hospital. We enrolled all HIV-infected adolescents (aged 10-19 years) hospitalized with any diagnosis other than pregnancy from July 2015 to January 2016. Medical records were reviewed for clinical variables and past engagement in care. Semi-structured interviews of the adolescents (when feasible) and their caregivers explored delays and barriers to care. Twenty-one eligible adolescents were identified and 15 were enrolled. All but one were WHO Clinical Stage 3 or 4. Barriers to diagnosis included lack of awareness about perinatal HIV infection, illness or death of the mother, and fear of discrimination. Barriers to adherence to antiretroviral therapy included nondisclosure, isolation, and mental health concerns. The number of hospitalized HIV-infected adolescents was lower than expected. However, among those hospitalized, the lack of timely diagnosis and subsequent gaps in the care cascade elucidated opportunities to improve outcomes and quality of life for this vulnerable group

Seed-borne fungi of cowpea [Vigna unguiculata (L.) Walp] and their possible control in vitro using locally available fungicides in Botswana.

Seeds of three cowpea cultivars namely Black eye, ER 7 and Tswana obtained from the Department of Agriculture Research, Gaborone were tested for the presence of seed-borne fungi, and their possible control in vitro using locally available fungicides. Four hundred fifty seeds of each cultivar of cowpea were disinfected with 2% sodium hypochlorite solution for 10 min and washed three times with sterile distilled water before placing them in PDA plates (5 seeds/9 cm Petri plate), incubated at 22±2o C for 12 hour each under continuous light and dark. A total of eight fungi were detected from seeds of cowpea. These were Aspergillus flavus, A. niger, Cylindrocarpon sp., Fusarium equisiti, F. oxyaporum, Penicillium chyrosogenum, Rhizopus oligosporus and R. stolonifer. Rhizopus spp. were dominant fungi recovered from seeds, followed by Penicillium, Aspergillus, Fusarium and Cylindrocarpon. The fungi detected resulted in decay and rotting of seeds, and thereby reducing percentage germination of seeds (22%, 37% and 63 % seed germination in Black eye, ER7 and Tswana varieties of cowpea respectively). Out of four fungicides tested, benlate, captan, dithane M 45 and chlorothalanil. Dithane M45 effectively controlled seed-borne fungi, and enhanced seed germination to an average of 86% (93% germination with no fungi detected in Tswana variety) as compared to chlorothalonile (79%), benlate and captan (77%) and un-treated seeds (45%). The fungal incidence was reduced to 2.3%, 4.3%, 5.3% and 5.3% when seeds were treated with dithane M-45, chlorothalonil, benlate and captan respectively as compared to 62% in non-treated seeds.</jats:p

Methicillin-Resistant Staphylococcus aureus

Prior to the 1990s, most methicillin-resistant Staphylococcus aureus (MRSA) was hospital-associated (HA-MRSA); community-associated MRSA (CA-MRSA) then began to cause infections outside the health-care environment. The third significant emergence of MRSA has been in livestock animals [livestock-associated MRSA (LA-MRSA)]. The widespread and rapid growth in CA-MRSA and LA-MRSA has raised the question as to whether MRSA is indeed a food-borne pathogen. The observations on animal-to-animal and animal-to-human transfer of LA-MRSA have prompted research examining the origin of LA-MRSA and its capacity to cause zoonotic disease in humans. This review summarizes the current knowledge about MRSA from foodproducing animals and foods with respect to the role of these organisms to act as food-borne pathogens and considers the available tools to track the spread of these organisms. It is clear thatLA-MRSAandCA-MRSAand even HA-MRSA can be present in/on food intended for human consumption, but we conclude on the basis of the published literature that this does not equate to MRSA being considered a food-borne pathogen. Expected final online publication date for the Annual Review of Food Science and Technology Volume 4 is February 28, 2013. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates

Diagnoses given on admission or during hospitalization per medical team^a.

<p>Diagnoses given on admission or during hospitalization per medical team<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0195372#t002fn001" target="_blank">^a</a>.</p

Characteristics of enrolled adolescents.

<p>Characteristics of enrolled adolescents.</p