Vaccine coverage and determinants of incomplete vaccination in children aged 12-23 months in dschang, west region, cameroon: a cross-sectional survey during a polio outbreak

Inadequate immunization coverage with increased risk of vaccine preventable diseases outbreaksremains a problem in Africa. Moreover, different factors contribute to incomplete vaccination status. This study wasperformed in Dschang (West Region, Cameroon), during the polio outbreak occurred in October 2013, in order toestimate the immunization coverage among children aged 12–23 months, to identify determinants for incompletevaccination status and to assess the risk of poliovirus spread in the study population.Methods:A cross-sectional household survey was conducted in November-December 2013, using the WHOtwo-stage sampling design. An interviewer-administered questionnaire was used to obtain information fromconsenting parents of children aged 12–23 months. Vaccination coverage was assessed by vaccination card andparents’recall. Chi-square test and multilevel logistic regression model were used to identify the determinants ofincomplete immunization status. Statistical significance was set atp90 %, and 73.4 % children completedthe recommended vaccinations before 1-year of age. In the final multilevel logistic regression model, factorssignificantly associated with incomplete immunization status were: retention of immunization card (AOR: 7.89;95 % CI: 1.08–57.37), lower mothers’utilization of antenatal care (ANC) services (AOR:1.25; 95 % CI: 1.07–63.75),being the≥3rdborn child in the family (AOR: 425.4; 95 % CI: 9.6–18,808), younger mothers’age (AOR: 49.55;95 % CI: 1.59–1544), parents’negative attitude towards immunization (AOR: 20.2; 95 % CI: 1.46–278.9), and poorerparents’exposure to information on vaccination (AOR: 28.07; 95 % CI: 2.26–348.1). Longer distance from the vaccinationcenters was marginally significant (p=0.05).Conclusion:Vaccination coverage was high; however, 1 out of 7 children was partially vaccinated, and 1 out of 4 didnot complete timely the recommended vaccinations. In order to improve the immunization coverage, it is necessary tostrengthen ANC services, and to improve parents’information and attitude towards immunization, targeting youngerparents and families living far away from vaccination centers, using appropriate communication strategies. Finally, theestimated OPV-3 coverage is reassuring in relation to the ongoing polio outbrea

The Perversion of Dignity in Tsitsi Dangarembga’s Nervous Conditions

The goal of this thesis is to study Tsitsi Dangarembga’s allegory of aid which exploits the recipient’s precarity in her first novel Nervous Conditions. More specifically, I would like to explore how such aid dehumanizes the recipients it purports to help by imposing the giver’s goals and agenda on the recipient. I argue that because aid is after all underwritten by an ethics of power, the recipient’s helplessness in the acceptance of this gift, i.e., the precarious socioeconomic conditions which necessitate the acceptance of such aid, subject the recipient to the giver’s will, up to and even in the pursuit and realization of the giver’s goals and mission. Following Kant’s ideas on humanity and dignity, I argue that the recipients of such aid thus effectively become the means of attaining the giver’s goals. I discuss the novel’s portrayal of formal education, which is anchored to the mission; the missionaries select recipients who demonstrate academic potential, and a willingness to endure and obey their norms of success. He or she is consequently plucked out of the community, and fostered in the mission. And because the recipient is powerless in his or her choice to refuse the missionaries’ gift, he or she is inevitably tethered to the giver’s will and whims. By privileging education, the mission and its emissaries are portrayed as just another facet of social and hegemonic control posing as charity. The second part of my thesis explores some ways the recipients maintain their dignity in spite of such hegemonic control. I propose that Dangarembga’s novel humanizes her characters’ suffering, hence their humanity. In the voice of Tambu, the characters’ stories of survival elevate their humanity as they navigate their precarity, and negotiate the terms of a life worth living. Following Tambu’s journey from the village to Sacred Heart, which detours into the lives of the characters in the novel, Dangarembga invites us to envision the characters’ humanity as we engage in the novel’s politics. She does not allow her characters, and the reader, to lose sight of their worth as human beings. They live, in spite, or maybe because of the socioeconomic conditions which threaten to control them. Thrust in this limelight, the characters demonstrate their humanity in their continuous search for meaningful forms of self definition, and survival. And therein lies their dignity

Performance-based financing as a health system reform : mapping the key dimensions for monitoring and evaluation

Peer reviewedPublisher PD

COVID-19 Pandemic: The Origin, Transmission, Pathogenesis, and Therapeutic Application

An outbreak of atypical pneumonia reported in late December 2019, which subsequently progressed to global health crises of significant magnitude within the first three months after its appearance and the etiology was traced to a seafood wholesale market in the city of Wuhan, China. Where a large number of infected patients are presumed to have been exposed to the wet animal market and this was the first confirmed incident recorded. The genome sequence of this unknown pathogen was obtained and then through carefully genome sequence comparison with the already previously characterized corona viruses; SARS-CoV and MERS-CoV, it was found that a betacoronavirus belonging to subfamily orthocoronavirinie is responsible for the pneumonia cases. This suggested that Wuhan was the site where COVID-19 first started and the disease is zoonotic in origin. COVID-19 pandemic has presented considerable challenges to public health care systems at global scale and dictates almost every aspect of medical practice and policies across the world. Apparently, an effective treatment therapy against COVID-19 is the most urgently needed to curb the rapidly increasing incidence of SARS-CoV-2 infections. Unfortunately up to this moment there is no approved drug for the treatment of COVID-19 patients, although many reports are suggesting the drugs which were previously used against SARS-CoV and MERS-CoV such as remdesviri, lopinavir, ritonavir, interferon beta-1b, and ribavirin but these are being tested in randomized trials and again mostly showing less clinical benefits. Use of a triple combination of interferon beta-1b, lopinavir-ritonavir and ribavirin drugs were reported to be effective than when each drug is used separately, however, collaborative investigations are needed to ascertain the fidelity of these drugs. In this review, we summarize the latest research progress of the origin, pathogenesis, clinical characteristics of COVID-19, and discussed the current treatment regimens for combating the COVID-19 pandemic

Empowerment through friendship: A process view of community-based tourism

This paper explores the ‘alternative’ empowerment roles of catalyst, facilitator and advocate in community-based tourism in the context of community development practice, drawing on findings from four community-based tourism (CBT) ethnographic case studies in Kenya. The paper uncovers the ‘friend’ or ‘neighbour’ relationship as a possible combination of these roles, proposing that the various roles may be points or positions in a continuum, a relationship that develops over time. Arguably, these roles could be realized between a community and an individual from within or outside the community. It is further proposed that understanding the roles and the relationships provides possibilities for community empowerment and sustainable community development within CBT settings. The findings point towards opportunities for the enhancement of empowerment, either driven by deliberate efforts of development practitioners or brought about in non-deliberate, organic manner through collaborative work of a wide range of actors. Research in this area has the potential to contribute towards understanding the processes through which sustainable community development and public social policies affecting communities can achieve global agendas such as poverty alleviation, partnerships and sustainability in what are considered marginal areas

Initiation ceremonies as an entry point to HIV and AIDS prevention in Zambia: A study of traditional counsellors, Girls and young women in Lusaka Urban

HIV and AIDS is having a widespread impact on many parts of African society Zambia inclusive. Zambia, in southern Africa, has one of the world’s most devastating HIV and AIDS epidemics. More than one in every seven adults in the country is living with HIV and life expectancy has fallen to just 39 years. In 2009, nearly 83,000 adults were newly infected with HIV, which is about 200 new infections each day (UNAIDS 2008). In sub-Saharan Africa, the UNAIDS (2006)reports that around 59% of those living with HIV are females. This is attributed to the legal, social and economic disadvantage faced by women in most societies. The purpose of this study was therefore to determine the possibility of using initiation ceremonies as entry points in the fight against HIV and AIDS.The sample consisted of two groups of subjects. The first group comprised women who initiate girls (banacimbusa/Alangizi) and the second group was made up of girls/women who had undergone initiation rites in the recent five years. There were 100 respondents, 50 of whom were initiators or women who were involved in the initiation rites and the other 50 were women or girls who had gone through initiation.Purposeful sampling was initially used to identify girls and women (initiators and the initiates) who had experienced initiation. Then snowball sampling was used to indentify other participants with similar characteristics to the first group. Data was collected from the initiators and the initiated girls using two different questionnaires (see appendix I and II). Structured, semi structured and open ended interviews were used in order to cater for the diversity of participants. The researcher also spent time with the girls and women under study during initiation ceremonies and made observations of what was taught in initiation rites. Secondary data was collected from library materials such as text books, reports including journals on initiation ceremonies in traditional societies and even modern social set up. The results showed that initiation ceremonies are widely practiced in Zambia and they are used predominantly to teach about sex and sexuality to girls attaining puberty and young women about to enter marriage. Little or no information on HIV and AIDS is given during initiation rites. However there is a lot of potential for such messages to be passed on to the initiates because the curriculum of initiation rites can easily be adapted to include awareness and HIV prevention.There is a lot of potential inherent in initiation ceremonies and rites that can be tapped in the awareness campaign on HIV and AIDS. Initiation rites contain elements that can be used to empower and liberate women especially with regard to HIV and AIDS. They are the tools for acquisition, learning of habit, based on harmony with the spouse, parents, in-laws, and older people in general and mastering of conflict resolution mechanisms. Initiation rites equip maturing individuals with a vast body of special attributes that a woman is supposed to know and deal with through out her life. Therefore they can be adapted and should be incorporated in awareness and prevention programs for HIV and AIDS

Role of Social Capital on Uptake of Sustainable Agricultural Intensification Practices’ Combinations

Smallholder farmers in sub-Saharan Africa are faced with many challenges in the production of maize and legumes. Some of the challenges include soil mining, drought, soil erosion, input acquisition among others. These challenges cannot be alleviated with the adoption of a single agricultural practice but a bundle of combination. There was need, therefore, to evaluate if social capital among other factors influences adoption of the different combination of the six Sustainable Agricultural Intensification Practices among smallholder maize-legume systems in Kenya. The study used secondary data from Adoption Pathway project panel dataset collected from Bungoma, Siaya, Meru, Tharaka Nithi and Embu counties, in three waves:  covering 613 households in the baseline, 535 in the midline and 495 in the end line was used in the analysis. Eighteen possible combinations adopted by smallholder farmers, a Principal Component Analysis was used to reduces data dimensionality, such that Seven possible clusters were formed that were homogeneous within. An index of the different combinations in the cluster was then formed for each household. Using STATA software, a Seemingly Unrelated Regression model was used in the analysis of the seven equations against a set of dependent variables, among them social capital. The findings of the study showered that social capital is not significant in explaining adoption of different combinations of SAIPs that a household adopted except for cognitive social capital and participation level in group institutions where the household was a member. Other factors that influenced adoption of combination of SAIPs included age of the household head, received information about SAIP and input markets, amount of money that a household got as income and that which they saved. Additionally, the spatial distance of the farming plot measured as the number of walking minutes from the household homestead and the number of years one has been living in the village practicing maize-legume production also significantly influenced the combinations of the SAIPs that a household adopted. Policy interventions should encourage and promote better access to information and encourage participation in group institutions. Keywords: Principal Component Analysis, Clusters, Seemingly Unrelated Regressio

Saving biodiversity by fighting desertification in West and Central Africa

Environment and Developmen

A proximity biotinylation-based approach to identify protein-E3 ligase interactions induced by PROTACs and molecular glues

Proteolysis-targeting chimaeras (PROTACs) as well as molecular glues such as immunomodulatory drugs (IMiDs) and indisulam are drugs that induce interactions between substrate proteins and an E3 ubiquitin ligases for targeted protein degradation. Here, we develop a workflow based on proximity-dependent biotinylation by AirID to identify drug-induced neo-substrates of the E3 ligase cereblon (CRBN). Using AirID-CRBN, we detect IMiD-dependent biotinylation of CRBN neo-substrates in vitro and identify biotinylated peptides of well-known neo-substrates by mass spectrometry with high specificity and selectivity. Additional analyses reveal ZMYM2 and ZMYM2-FGFR1 fusion protein—responsible for the 8p11 syndrome involved in acute myeloid leukaemia—as CRBN neo-substrates. Furthermore, AirID-DCAF15 and AirID-CRBN biotinylate neo-substrates targeted by indisulam and PROTACs, respectively, suggesting that this approach has the potential to serve as a general strategy for characterizing drug-inducible protein–protein interactions in cells

Ekegusii Subject and Object Markers: Affixes or Clitics?

Bantu languages are known for their agglutinative nature and complex verbal morphology. A single verbal complex has several affixes including the subject markers (SMs) and object markers (OMs). The precise status of the SMs and OMs in Bantu remains unresolved. These markers have been analysed as agreement markers in some languages while in others, they are analysed as incorporated pronominals and in other languages as clitics. The objective of this paper is to determine whether these markers should be analysed as agreement markers, incorporated pronominals or clitics in EkeGusii. Findings reveal that the SM is an agreement marker when the overt lexical subject Determiner Phrase (DP) co-occurs with the SM and an incorporated pronoun in null subject constructions. Accordingly, the paper posits that the SM is both an agreeement marker and an incorporated pronominal in EkeGusii. The OM is an incorporated pronominal because the doubling of the OM and the corresponding lexical DP is not licensed in EkeGusii. In analysing the status of SMs and OMs, the morphological and syntactic evidence provided shows that these markers are more of affixes than clitics in this language