Nurse educators’ experiences of case-based education in a South African nursing programme

BACKGROUND: A school of nursing at a university in the Western Cape experienced an increase in student enrolments from an intake of 150 students to 300 students in the space of one year. This required a review of the teaching and learning approach to ensure that it was appropriate for effective facilitation of large classes. The case-based education (CBE) approach was adopted for the delivery of the Bachelor of Nursing programme in 2005. AIM: The aim of the study was to explore nurse educators’ experiences, current practices and possible improvements to inform best practice of CBE at the nursing school in the Western Cape. METHODS: A participatory action research method was applied in a two day workshop conducted with nurse educators in the undergraduate nursing programme. The nominal group technique was used to collect the data. RESULTS: Three themes emerged from the final synthesis of the findings, namely: teaching and learning related issues, student issues and teacher issues. Amongst other aspects, theory and practice integration, as well as the need for peer support in facilitation of CBE, were identified as requiring strengthening. CONCLUSION: It was concluded that case-based education should continue to be used in the school, however, more workshops should be arranged to keep educators updated and new staff orientated in respect of this teaching and learning approach.Department of HE and Training approved lis

Food insecurity is associated with increased risk of non-adherence to antiretroviral therapy among HIV-infected adults in the Democratic Republic of Congo: a cross-sectional study.

BACKGROUND: Food insecurity is increasingly reported as an important barrier of patient adherence to antiretroviral therapy (ART) in both resource-poor and rich settings. However, unlike in resource rich-settings, very few quantitative studies to date have investigated the association of food insecurity with patient adherence to ART in Sub-Saharan Africa. The current study examines the association between food insecurity and adherence to ART among HIV-infected adults in the Democratic Republic of Congo (DRC). METHODS AND FINDINGS: This is a cross-sectional quantitative study of patients receiving ART at three private and one public health facilities in Kinshasa, DRC. Participants were consecutively recruited into the study between April and November 2012. Adherence was measured using a combined method coupling pharmacy refill and self-reported adherence. Food insecurity was the primary predictor, and was assessed using the Household Food Insecurity Access Scale (HFIAS). Of the 898 participants recruited into the study, 512 (57%) were food insecure, and 188 (20.9%) were not adherent to ART. Food insecurity was significantly associated with non-adherence to ART (AOR, 2.06; CI, 1.38-3.09). We also found that perceived harmfulness of ART and psychological distress were associated respectively with increased (AOR, 1.95; CI, 1.15-3.32) and decreased (AOR, 0.31; CI, 0.11-0.83) odds of non-adherence to ART. CONCLUSION: Food insecurity is prevalent and a significant risk factor for non-adherence to ART among HIV-infected individuals in the DRC. Our findings highlight the urgent need for strategies to improve food access among HIV-infected on ART in order to ensure patient adherence to ART and ultimately the long-term success of HIV treatment in Sub-Saharan Africa

Toward utilization of data for program management and evaluation: quality assessment of five years of health management information system data in Rwanda

Background: Health data can be useful for effective service delivery, decision making, and evaluating existing programs in order to maintain high quality of healthcare. Studies have shown variability in data quality from national health management information systems (HMISs) in sub-Saharan Africa which threatens utility of these data as a tool to improve health systems. The purpose of this study is to assess the quality of Rwanda's HMIS data over a 5-year period. Methods: The World Health Organization (WHO) data quality report card framework was used to assess the quality of HMIS data captured from 2008 to 2012 and is a census of all 495 publicly funded health facilities in Rwanda. Factors assessed included completeness and internal consistency of 10 indicators selected based on WHO recommendations and priority areas for the Rwanda national health sector. Completeness was measured as percentage of non-missing reports. Consistency was measured as the absence of extreme outliers, internal consistency between related indicators, and consistency of indicators over time. These assessments were done at the district and national level. Results: Nationally, the average monthly district reporting completeness rate was 98% across 10 key indicators from 2008 to 2012. Completeness of indicator data increased over time: 2008, 88%; 2009, 91%; 2010, 89%; 2011, 90%; and 2012, 95% (p<0.0001). Comparing 2011 and 2012 health events to the mean of the three preceding years, service output increased from 3% (2011) to 9% (2012). Eighty-three percent of districts reported ratios between related indicators (ANC/DTP1, DTP1/DTP3) consistent with HMIS national ratios. Conclusion and policy implications Our findings suggest that HMIS data quality in Rwanda has been improving over time. We recommend maintaining these assessments to identify remaining gaps in data quality and that results are shared publicly to support increased use of HMIS data

Understanding the experiences of mothers with preterm babies admitted in a public hospital

Preterm delivery is a stressful and life threatening situation to both mothers and pre-term babies. This stress renders mothers unable to carry out their expectations such as caring for their preterm babies. Caring for the well-being of mother is essential for future development of the pre-term baby

Formulation of Functional Food Supplements: Case Study of Manufacturing Process Optimization at ‘Sarepta Production’, Burkina Faso

Introduction: In the context of promoting local resources and achieving food sovereignty, plant-based food supplements play a key role. However, their production often remains artisanal, making them prone to contamination and quality inconsistency. Objective: This study aimed to harmonize and standardize the manufacturing practices of four dietary supplements produced at the “Sarepta Production” unit in Ouagadougou, Burkina Faso, by integrating Good Manufacturing Practices (GMP) and Good Hygiene Practices (GHP). Methodology: Standard Operating Procedures (SOPs) were developed for each stage of the production process. Microbiological analyses were carried out on three successive batches at Agence Nationale pour la Sécurité Sanitaire de l’Environnement, de l’Alimentation, du Travail et des produits de santé (ANSSEAT) using standards established by the International Organization for Standardization (ISO standards) to assess sanitary quality. Results and Discussion: The results showed a progressive reduction in total aerobic mesophilic flora, yeasts, molds, and thermotolerant coliforms across the three production cycles. No pathogenic microorganisms like Salmonella, E. coli, or S. aureus were detected. The implementation of GMP, GHP, and Hazard Analysis and Critical Control Points (HACCP) principles enabled effective control of critical points, such as raw material reception, mixing, packaging, and storage. Conclusion: This study demonstrates that strict integration of hygiene and quality standards within small-scale food supplement manufacturing units significantly improves microbiological safety and consumer acceptability. It offers a reproducible model for other local food initiatives in sub-Saharan Africa in general and in Burkina Faso in particular. Keywords: Food Supplements, Good Manufacturing Practices, Microbiological Quality, Harmonization, Local Production, Critical Control Points

Emergence of begomoviruses and DNA satellites associated with weeds and intercrops: a potential threat to sustainable production of cassava in Côte d’Ivoire

Cassava (Manihot esculenta Crantz) plays a significant role in the livelihoods of people in Africa, particularly in Côte d’Ivoire. However, its production is threatened by begomoviruses which cause huge yield losses. Some weeds and food crops intercropped with cassava act as reservoirs, thereby facilitating the sustenance and propagation of Cassava mosaic begomoviruses (CMBs), along with other begomoviruses. To effectively manage these diseases, it is imperative to enhance our understanding of the various hosts of cassava viruses in Côte d’Ivoire. Thus, a comprehensive nationwide survey was conducted in 2017 in cassava fields across Côte d’Ivoire, and molecular analyses were performed on the samples collected. The results obtained from this survey indicated that 65 plant species belonging to 31 families were potential alternative hosts for CMBs in Côte d’Ivoire. The molecular analyses revealed that four species, Capsicum annuum, Solanum melongena, Centrosema pubescens, and Asystasia gangetica exhibited differential affinities for both African cassava mosaic virus and East African cassava mosaic Cameroon virus. Additionally, other begomoviruses and new alphasatellites were identified. Soybean chlorotic blotch virus was isolated from C. pubescens while West African Asystasia virus 1, West African Asystasia virus 2, and a new Asystasia yellow mosaic alphasatellite were isolated from A. gangetica which appears to be a plant species that could favor the emergence of new viral species harmful to cassava cultivation. This study offers insights that will inform the development of more effective control methods for sustainable cassava production in Côte d’Ivoire

Sulphadoxine/pyrimethamine versus amodiaquine for treating uncomplicated childhood malaria in Gabon: A randomized trial to guide national policy

<p>Abstract</p> <p>Background</p> <p>In Gabon, following the adoption of amodiaquine/artesunate combination (AQ/AS) as first-line treatment of malaria and of sulphadoxine/pyrimethamine (SP) for preventive intermittent treatment of pregnant women, a clinical trial of SP versus AQ was conducted in a sub-urban area. This is the first study carried out in Gabon following the WHO guidelines.</p> <p>Methods</p> <p>A random comparison of the efficacy of AQ (10 mg/kg/day × 3 d) and a single dose of SP (25 mg/kg of sulphadoxine/1.25 mg/kg of pyrimethamine) was performed in children under five years of age, with uncomplicated falciparum malaria, using the 28-day WHO therapeutic efficacy test. In addition, molecular genotyping was performed to distinguish recrudescence from reinfection and to determine the frequency of the <it>dhps </it>K540E mutation, as a molecular marker to predict SP-treatment failure.</p> <p>Results</p> <p>The day-28 PCR-adjusted treatment failures for SP and AQ were 11.6% (8/69; 95% IC: 5.5–22.1) and 28.2% (20/71; 95% CI: 17.7–38.7), respectively This indicated that SP was significantly superior to AQ (<it>P </it>= 0.019) in the treatment of uncomplicated childhood malaria and for preventing recurrent infections. Both treatments were safe and well-tolerated, with no serious adverse reactions recorded. The <it>dhps </it>K540E mutation was not found among the 76 parasite isolates tested.</p> <p>Conclusion</p> <p>The level of AQ-resistance observed in the present study may compromise efficacy and duration of use of the AQ/AS combination, the new first-line malaria treatment. Gabonese policy-makers need to plan country-wide and close surveillance of AQ/AS efficacy to determine whether, and for how long, these new recommendations for the treatment of uncomplicated malaria remain valid.</p

Bridging the gap: Multi‐omics profiling of brain tissue in Alzheimer's disease and older controls in multi‐ethnic populations

IntroductionMulti-omics studies in Alzheimer's disease (AD) revealed many potential disease pathways and therapeutic targets. Despite their promise of precision medicine, these studies lacked Black Americans (BA) and Latin Americans (LA), who are disproportionately affected by AD.MethodsTo bridge this gap, Accelerating Medicines Partnership in Alzheimer's Disease (AMP-AD) expanded brain multi-omics profiling to multi-ethnic donors.ResultsWe generated multi-omics data and curated and harmonized phenotypic data from BA (n&nbsp;=&nbsp;306), LA (n&nbsp;=&nbsp;326), or BA and LA (n&nbsp;=&nbsp;4) brain donors plus non-Hispanic White (n&nbsp;=&nbsp;252) and other (n&nbsp;=&nbsp;20) ethnic groups, to establish a foundational dataset enriched for BA and LA participants. This study describes the data available to the research community, including&nbsp;transcriptome from three brain regions, whole genome sequence, and proteome measures.DiscussionThe inclusion of traditionally underrepresented groups in multi-omics studies is essential to discovering the full spectrum of precision medicine targets that will be pertinent to all populations affected with AD.HighlightsAccelerating Medicines Partnership in Alzheimer's Disease Diversity Initiative led brain tissue profiling in multi-ethnic populations. Brain multi-omics data is generated from Black American, Latin American, and non-Hispanic White donors. RNA, whole genome sequencing and tandem mass tag proteomicsis completed and shared. Multiple brain regions including caudate, temporal and dorsolateral prefrontal cortex were profiled