Low antiretroviral therapy uptake and low early retention among pregnant women who tested positive for human immunodeficiency virus in informal health centers in urban and semi-rural settings in Cameroon: a prospective cohort study

IntroductionDespite the efforts of Cameroon’s Ministry of Public Health against informal health centers (IHCs) because of their illegitimacy, the number of IHCs is increasing in Cameroon. Most of these IHCs have antenatal care services and screen pregnant women for HIV. However, nothing is known about the subsequent outcomes of those who tested positive for HIV. This study aimed to assess the initiation of antiretroviral therapy (ART) in ART-naïve pregnant women screened HIV positive in IHCs within three months of diagnosis and their ART retention at three months post-initiation. In addition, we sought to identify the factors associated with ART non-initiation in this population.MethodsMay 01, 2019 to August 31, 2020, we carried out a prospective cohort study of ART-naïve pregnant women who attended their first antenatal care visit and screened HIV positive at IHCs in the cities of Douala and Ebolowa in Cameroon. Standardized questionnaires were used to interview consenting participants at three points: the day of the delivery of the antenatal HIV test result, three months later, and three months after ART initiation. The data collected were entered into KoboCollect and analyzed using SPSS V23.0 software. The Chi-square test was used to compare proportions, Kaplan Meier techniques and Cox proportional hazards regression was used to estimate retention in ART and identify factors associated with ART non-retention, respectively.Results and discussionA total of 85 ART-naïve pregnant women living with HIV were enrolled in the study. The median age and gestational age at the first antenatal care visit were 29 years (interquartile range (IQR), 2333.5) and 28weeks of amenorrhea (IQR, 2032), respectively. Only 34% (29/85) initiated ART, and 65.5% (19/29) of the initiators were retained in ART three months later. Lack of perceived self-efficacy to initiate ART (adjust Hazard Ratio = 5.57, 90% CI: 1.29 to 24.06), increased the probability of not be retaining in ART by any time during three months post initiation. Given the low ART uptake and the low retention in care among pregnant women living with HIV screened in IHCs, PMTCT policies in Cameroon should pay greater attention to this population, to facilitate their continuum of PMTCT care

In situ estimation of ice crystal properties at the South Pole using LED calibration data from the IceCube Neutrino Observatory

The IceCube Neutrino Observatory instruments about 1 km3 of deep, glacial ice at the geographic South Pole. It uses 5160 photomultipliers to detect Cherenkov light emitted by charged relativistic particles. An unexpected light propagation effect observed by the experiment is an anisotropic attenuation, which is aligned with the local flow direction of the ice. We examine birefringent light propaga- tion through the polycrystalline ice microstructure as a pos- sible explanation for this effect. The predictions of a first- principles model developed for this purpose, in particular curved light trajectories resulting from asymmetric diffusion, provide a qualitatively good match to the main features of the data. This in turn allows us to deduce ice crystal properties. Since the wavelength of the detected light is short compared to the crystal size, these crystal properties include not only the crystal orientation fabric, but also the average crystal size and shape, as a function of depth. By adding small empiri- cal corrections to this first-principles model, a quantitatively accurate description of the optical properties of the IceCube glacial ice is obtained. In this paper, we present the exper- imental signature of ice optical anisotropy observed in Ice- Cube light-emitting diode (LED) calibration data, the theory and parameterization of the birefringence effect, the fitting procedures of these parameterizations to experimental data, and the inferred crystal propertie

Three-year performance of the IceAct telescopes at the IceCube Neutrino Observatory

IceAct is an array of compact Imaging Air Cherenkov Telescopes at the ice surface as part of the IceCube Neutrino Observatory. The telescopes, featuring a camera of 61 silicon photomultipliers and fresnel-lens-based optics, are optimized to be operated in harsh environmental conditions, such as at the South Pole. Since 2019, the first two telescopes have been operating in a stereoscopic configuration in the center of IceCube\u27s surface detector IceTop. With an energy threshold of about 10 TeV and a wide field-of-view, the IceAct telescopes show promising capabilities of improving current cosmic-ray composition studies: measuring the Cherenkov light emissions in the atmosphere adds new information about the shower development not accessible with the current detectors. First simulations indicate that the added information of a single telescope leads, e.g., to an improved discrimination between flux contributions from different primary particle species in the sensitive energy range. We review the performance and detector operations of the telescopes during the past 3 years (2020-2022) and give an outlook on the future of IceAct

Highlights from the IceCube Neutrino Observatory

As IceCube surpasses a decade of operation in the full detector configuration, results that drive forward the fields of neutrino astronomy, cosmic ray physics, multi-messenger astronomy, particle physics, and beyond continue to emerge at an accelerated pace. IceCube data is dominated by background events, and thus teasing out the signal is the common challenge to most analyses. Statistical accumulation of data, along with better understanding of the background fluxes, the detector, and continued development of our analysis tools have produced many profound results that were presented at ICRC2023. Highlights covered here include the first neutrino observation of the Galactic Plane, the first observation of a steady emission neutrino point source NGC1068, new characterizations of the cosmic ray flux and its secondary particles, and a possible new era in measuring the energy spectrum of the diffuse astrophysical flux. IceCube is poised to make more discoveries and drive fields forward in the near future with many novel analyses coming online

Search for the rare interactions of neutrinos from distant point sources with the IceCube Neutrino Telescope

The recent discovery and evidence of neutrino signals from distant sources, TXS 0506+056 and NGC 1068 respectively, provide opportunities to search for rare interactions of neutrinos that they might encounter on their paths. One potential scenario of interest is the interaction between neutrinos and dark matter, which is invisible and expected to be abundantly spread over the Universe. Various astrophysical observations have implied the existence of dark matter. When high-energy neutrinos from extragalactic sources interact with dark matter during their propagation, their spectra might show suppressions at specific energy ranges, where such interactions occur. These attenuation signatures from the interaction might be measurable on Earth with large neutrino telescopes such as the IceCube Neutrino Observatory. This analysis is focused on the search for rare interactions of high-energy neutrinos from the IceCube-identified astrophysical neutrino sources with dark matter in sub-GeV masses and several benchmark mediator cases using the upgoing track-like events. In this poster, sensitivity studies about the interaction of neutrinos and dark matter are presented

A new simulation framework for IceCube Upgrade calibration using IceCube Upgrade Camera system

Currently, an upgrade consisting of seven densely instrumented strings in the center of the volume of the IceCube detector with new digital optical modules (DOMs) is being built. On each string, DOMs will be regularly spaced with a vertical separation of 3 m between depths of 2160 m and 2430 m below the surface of the ice, which is a denser configuration compared to the existing DOMs of IceCube detector. For a precise calibration of the IceCube Upgrade it is important to understand the properties of the ice, both inside and surrounding the deployment holes.LEDs and Camera systems, which are developed and produced at Sungkyunkwan university, are installed in every single DOM to measure these properties. For these calibration measurements, a new simulation framework, which produces expected images from various geometric and optical variables has been developed and images produced from the simulation are expected to be used to develop an analysis framework for the IceCube Upgrade camera calibration system and for the design of the IceCube Gen2 camera system

Dynamic factors associated with COVID-19 vaccine uptake in Cameroon between 2021 and 2022

Background: Little is known about attitudes towards COVID-19 vaccination in sub-Saharan Africa, where immunisation coverage is the lowest in the world. Aim: The study aimed to identify factors associated with COVID-19 vaccine hesitancy and uptake in Cameroon, and assess changes in these factors over a period of time. Setting: The study was conducted in the ten regions of Cameroon. Methods: The authors conducted a two-phase cross-sectional survey in the 10 regions of Cameroon, from July 2021 to August 2021 (Phase one) and from August 2022 to September 2022 (Phase two). We analysed reasons for vaccine hesitancy descriptively and used logistic regression to assess factors associated with hesitancy. Results: Overall, we enrolled 12 109 participants: 6567 (54.23%) in Phase one and 5542 (45.77%) in Phase two. Of these, 8009 (66.14%) were not interested in receiving the COVID-19 vaccine (n = 4176 in Phase one, n = 3833 in Phase two). The refusal rate increased significantly in the northern region from 27.00% in Phase 1 to 60.00% in Phase two. The leading contributor to COVID-19 vaccine hesitancy was fear that the vaccine was dangerous, which was significantly associated (95% confidence interval [CI], p  0.05%) with vaccine refusal in both phases. Overall, 32.90% of participants (n = 2578) perceived the COVID-19 vaccine to be dangerous. Advanced age, male gender, Muslim religion and low level of education were associated with vaccine acceptance. Participants reported that healthcare workers were the most trusted source of information about the COVID-19 vaccine by 5005 (42.84%) participants. Conclusion: Despite the investment of the Ministry of Health and its partners in community engagement, focussing on communication about the vaccine efficacy, tolerance and potential adverse events, fear of the vaccine remains high, likely leading to vaccine hesitancy in Cameroon between 2021 and 2022. Contribution: The study highlight regional variations in COVID-19 vaccine acceptance in Cameroon, with factors age, gender, religion and education influencing willingness to vaccine. Trust in health workers was high, indicating that, tailored, community-led vaccination strategies are key for improving vaccine uptake, not only for COVID-19 but also for future epidemics

Towards a cosmic ray composition measurement with the IceAct telescopes at the IceCube Neutrino Observatory

The IceCube Neutrino Observatory is equipped with the unique possibility to measure cosmic ray induced air showers simultaneously by their particle footprint on the surface with the IceTop detector and by the high-energy muonic shower component at a depth of more than 1.5 km. Since 2019 additionally, two Imaging Air Cherenkov Telescopes, called IceAct, measure the electromagnetic component of air showers in the atmosphere above the IceCube detector. This opens the possibility to measure air shower parameters in three independent detectors and allows to improve mass composition studies with the IceCube data. One IceAct camera consists of 61 SiPM pixels in a hexagonal grid. Each pixel has a field of view of 1.5 degree resulting in an approximately 12-degree field of view per camera. A single telescope tube has a diameter of 50 cm, is built robust enough to withstand the harsh Antarctic conditions, and is able to detect cosmic ray particles with energies above approximately 10 TeV. A Graph Neural Network (GNN) is trained to determine the air shower properties from IceAct data. The composition analysis is then performed using Random Forest Regression (RF). Since all three detectors have a different energy threshold, we train several RFs with different inputs, combining the different detectors and taking advantage of the lower energy threshold of the IceAct telescopes. This will result in composition measurements for different detector combinations and enables cross-checks of the results in overlapping energy bands. We present the method, parameters for data selection, and the status of this analysis

Sensitivity of the IceCube-Gen2 Surface Array for Cosmic-Ray Anisotropy Studies

The energy of the transition from Galactic to extra-galactic origin of cosmic rays is one of the major unresolved issues of cosmic-ray physics. However, strong constraints can be obtained from studying the anisotropy in the arrival directions of cosmic rays. The sensitivity to cosmic-ray anisotropy is, in particular, a matter of statistics. Recently, the cosmic ray anisotropy measurements in the TeV to PeV energy range were updated from IceCube using 11 years of data. The IceCube-Gen2 surface array will cover an area about 8 times larger than the existing IceTop surface array with a corresponding increase in statistics and capability to investigate cosmic-ray anisotropy with higher sensitivity. In this contribution, we present details on the performed simulation studies and sensitivity to the cosmic-ray anisotropy signal for the IceCube-Gen2 surface array