Showing papers by "University of Zimbabwe published in 2013"

Photosynthetic entrainment of the Arabidopsis thaliana circadian clock

Abstract: Circadian clocks provide a competitive advantage in an environment that is heavily influenced by the rotation of the Earth, by driving daily rhythms in behaviour, physiology and metabolism in bacteria, fungi, plants and animals. Circadian clocks comprise transcription-translation feedback loops, which are entrained by environmental signals such as light and temperature to adjust the phase of rhythms to match the local environment. The production of sugars by photosynthesis is a key metabolic output of the circadian clock in plants. Here we show that these rhythmic, endogenous sugar signals can entrain circadian rhythms in Arabidopsis thaliana by regulating the gene expression of circadian clock components early in the photoperiod, thus defining a 'metabolic dawn'. By inhibiting photosynthesis, we demonstrate that endogenous oscillations in sugar levels provide metabolic feedback to the circadian oscillator through the morning-expressed gene PSEUDO-RESPONSE REGULATOR 7 (PRR7), and we identify that prr7 mutants are insensitive to the effects of sucrose on the circadian period. Thus, photosynthesis has a marked effect on the entrainment and maintenance of robust circadian rhythms in A. thaliana, demonstrating that metabolism has a crucial role in regulation of the circadian clock.

A "One Health" surveillance and control of brucellosis in developing countries: moving away from improvisation.

Abstract: Although a "One Health" approach has been successfully implemented for emerging infectious zoonotic diseases with pandemic potential, we still lack a conceptual framework to address enzootic diseases like brucellosis. The vast majority of published brucellosis studies in the developing world rely solely on serology. An important shortcoming of brucellosis serology is the impossibility to infer which (smooth) Brucella spp. induced antibodies in the host. In this respect, mixed farming and especially raising small ruminants along with cattle, a common practice in the developing world, is reported to be a risk factor and a central question that has to be answered is whether cattle are infected with B. melitensis or with B. abortus or with both Brucella species. Therefore the isolation, identification and molecular characterization of Brucella spp. in human and the different livestock species needs to be undertaken to define a sound conceptual framework, identify the source of infection and plan appropriate control measures.

The Urban Crisis in Sub-Saharan Africa: A Threat to Human Security and Sustainable Development

Abstract: Urban centres have existed and have been evolving for many centuries across the world. However, the accelerated growth of urbanisation is a relatively recent phenomenon. The enormous size of urban populations and more significantly, the rapidity with which urban areas have been and are growing in many developing countries have severe social, economic and physical repercussions. This paper argues that the accelerated growth of urbanisation has amplified the demand for key services. However, the provision of shelter and basic services such as water and sanitation, education, public health, employment and transport has not kept pace with this increasing demand. Furthermore, accelerated and poorly managed urbanisation has resulted in various types of atmospheric, land and water pollution thereby jeopardising human security. This paper offers the conclusion that the increased environmental, social and economic problems associated with rapid urbanisation pose a threat to sustainable development, human security and, crucially, peace. stability

Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: a systematic review and meta-analysis

Abstract: Background Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations. Methods We conducted a systematic review and meta-analysis through MEDLINE and EMBASE (up to January 2012), as well as direct author contact. Eligible studies provided summary or individual-level data on one or more of the following traits in HIV+ and HIV-, or ART+ and ART- subgroups in SSA: body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TGs) and fasting blood glucose (FBG) or glycated hemoglobin (HbA1c). Information was synthesized under a random-effects model and the primary outcomes were the standardized mean differences (SMD) of the specified traits between subgroups of participants. Results Data were obtained from 49 published and 3 unpublished studies which reported on 29 755 individuals. HIV infection was associated with higher TGs [SMD, 0.26; 95% confidence interval (CI), 0.08 to 0.44] and lower HDL (SMD, −0.59; 95% CI, −0.86 to −0.31), BMI (SMD, −0.32; 95% CI, −0.45 to −0.18), SBP (SMD, −0.40; 95% CI, −0.55 to −0.25) and DBP (SMD, −0.34; 95% CI, −0.51 to −0.17). Among HIV+ individuals, ART use was associated with higher LDL (SMD, 0.43; 95% CI, 0.14 to 0.72) and HDL (SMD, 0.39; 95% CI, 0.11 to 0.66), and lower HbA1c (SMD, −0.34; 95% CI, −0.62 to −0.06). Fully adjusted estimates from analyses of individual participant data were consistent with meta-analysis of summary estimates for most traits. Conclusions Broadly consistent with results from populations of European descent, these results suggest differences in cardiometabolic traits between HIV-infected and uninfected individuals in SSA, which might be modified by ART use. In a region with the highest burden of HIV, it will be important to clarify these findings to reliably assess the need for monitoring and managing cardiometabolic risk in HIV-infected populations in SSA.

Participatory action research (PAR) as an entry point for supporting climate change adaptation by smallholder farmers in Africa

Abstract: Emerging trends of a changing and increasingly variable climate have introduced new livelihood challenges in rain-fed smallholder agricultural systems that predominate in Sub-Saharan Africa (SSA). The capacity of local farming communities and their institutions to respond to the new and emerging impacts of climate change is often constrained by lack of access to information and improved technologies, as well as poor support mechanisms to promote assimilation of new knowledge. This threatens to heighten vulnerability of the majority of SSA's rural communities who are already facing severe problems of food insecurity and a declining soil resource base. In this paper we use two case studies from Wenchi district in Ghana and Makoni in Zimbabwe to communicate how participatory action research (PAR) methodology, characterised by iterative planning–action–reflection cycles, was coupled with a new concept of field-based farmer learning centres to build adaptive capacity of smallholder farmers to climate change. The study was part of a University of Zimbabwe—led project supported under the Climate Change Adaptation in Africa (CCAA) programme to explore the state of resilience in African smallholder farming. The PAR and learning centre processes enabled communities, local leaders, and extension agents and researchers to establish the, hither to, imperceptible link between poor soil fertility and rising institutional challenges within communities. Institutional conflicts related to land tenure and sharecropping arrangements between migrant farmers and native landowners were addressed in Ghana, while local institutions supporting traditional social safety net mechanisms were revitalized in Zimbabwe. In both cases, it was apparent that farmers faced multiple stresses, at the core of which were poor and declining soil fertility and weakening local institutions. The worsening rainfall distribution and increasing cases of drought are broadening the scope for vulnerability, often driving competing claims and conflicts. PAR was successfully used as an entry point, empowering communities to self-mobilize and self-organize to co-learn and experiment with integrated soil fertility management (ISFM) technologies and other improved farming practices. They realised opportunities for achieving high crop yields and generate surpluses in good years. Strengthening local institutional capacity to revitalise community safety nets proved an essential ingredient for enhancing adaptive capacity of smallholders to climatic shocks. The PAR process was a major driver of effective partnerships among community members, extension, policy makers and researchers, but ensuing success generated a new set of social challenges that could not be addressed within the short timescale of the project. We conclude that PAR was a suitable mechanism for supporting self-organization and co-learning processes among smallholder farmers and their service providers, enabling them to use ISFM technologies and strengthen their local institutions around natural resource management. This revealed the scope for building adaptive capacity of these communities against climate change and variability.

Nitrous oxide emissions from European agriculture - an analysis of variability and drivers of emissions from field experiments

Abstract: Nitrous oxide emissions from a network of agri- cultural experiments in Europe were used to explore the rel- ative importance of site and management controls of emis- sions. At each site, a selection of management interventions were compared within replicated experimental designs in plot-based experiments. Arable experiments were conducted at Beano in Italy, El Encin in Spain, Foulum in Denmark, Log˚ arden in Sweden, Maulde in Belgium, Paulinenaue in Germany, and Tulloch in the UK. Grassland experiments were conducted at Crichton, Nafferton and Peaknaze in the UK, G¨¨ ¨ o in Hungary, Rzecin in Poland, Zarnekow in Germany and Theix in France. Nitrous oxide emissions were measured at each site over a period of at least two years us- ing static chambers. Emissions varied widely between sites

Postharvest agriculture in changing climates: its importance to African smallholder farmers

Abstract: Climate change and variability affect not only the field stages and yields of crops, but also what happens to them after harvest. There has been little discussion of the impacts of climate change on postharvest agriculture, and still less on these impacts in developing countries. Many studies have focused on potential crop yield and pre-harvest implications of different climatic projections, but have omitted an analysis of the need and ability to then protect this increasingly valuable harvest as a vital aspect of food security. Postharvest systems will be affected by changes in temperature, rainfall, humidity, extreme events and the natural and human responses to climate change and variability. This study describes typical grain postharvest systems in east and southern Africa and discusses the likely impacts of different climate change trends on postharvest activities, assets and human well-being outcomes. Adaptation opportunities for creating more climate resilient postharvest agricultural systems and associated livelihoods are identified. Many of these adaptation opportunities are already known and understood by postharvest service providers, highlighting the significant challenge of getting postharvest knowledge into use at a larger scale. A discussion is presented on the factors influencing attempts to strengthen the adaptive capacity of postharvest systems, such as its invisibility, its omission from training curricula, innovation system challenges, the policy bias towards pre-harvest agricultural spending, limited understanding of gender and diversity aspects of postharvest roles, and the dominance of maize in the food system. The study recognises the crucial role of postharvest agriculture in helping communities adapt and cope with change.

Relationship between burden of infection in ungulate populations and wildlife/livestock interfaces

Abstract: In southern African transfrontier conservation areas (TFCAs), people, livestock and wildlife share space and resources in semi-arid landscapes. One consequence of the coexistence of wild and domestic herbivores is the risk of pathogen transmission. This risk threatens local livelihoods relying on animal production, public health in the case of zoonoses, national economies in the context of transboundary animal diseases, and the success of integrated conservation and development initiatives. The level of interaction between sympatric wild and domestic hosts, defining different wildlife/livestock interfaces, characterizes opportunities of pathogen transmission between host populations. Exploring the relationship between infection burden and different types of wildlife/domestic interfaces is therefore necessary to manage the sanitary risk in animal populations through control options adapted to these multi-host systems. Here, we assessed the infection burdens of sympatric domestic cattle (Bos taurus/Bos indicus) and African buffalo (Syncerus caffer) at an unfenced interface and compared the infection burdens of cattle populations at different wildlife/livestock interfaces in the Great Limpopo TFCA. Patterns of infection in ungulate populations varied between wild and domestic hosts and between cattle populations at different wildlife/livestock interfaces. Foot-and-mouth disease, Rift Valley fever and theileriosis infections were detected in buffalo and cattle at unfenced interfaces; bovine tuberculosis was only present in buffalo; and brucellosis and lumpy skin disease only in cattle. At unfenced interfaces, cattle populations presented significantly higher Theileria parva and brucellosis prevalence. We hypothesize that cattle populations at wildlife/livestock interfaces face an increased risk of infection compared to those isolated from wildlife, and that the type of interface could influence the diversity and quantity of pathogens shared. Additional host behavioural and molecular epidemiological studies need to be conducted to support this hypothesis. If it is confirmed, the management of wildlife/livestock interfaces will need to be considered through the prism of livestock and public health.

Characterization of HIV-HBV coinfection in a multinational HIV-infected cohort.

Abstract: Objective: To understand the HIV–hepatitis B virus (HBV) epidemic from a global perspective by clinically and virologically characterizing these viruses at the time of antiretroviral therapy (ART) initiation in a multinational cohort. Methods and design: HIV-infected patients enrolled in two international studies were classified as HIV–HBV coinfected or HIV monoinfected prior to ART. HIV–HBV coinfected patients were tested for HBV characteristics, hepatitis D virus (HDV), a novel noninvasive marker of liver disease, and drug-resistant HBV. Comparisons between discrete covariates used x 2 or Fisher’s exact tests (and Jonchkheere–Terpstra for trend tests), whereas continuous covariates were compared using Wilcoxon RankSum Test. Results: Of the 2105 HIV-infected patients from 11 countries, the median age was 34 years and 63% were black. The 115 HIV–HBV coinfected patients had significantly higher alanine aminotransferase and aspartate aminotransferase values, lower BMI, and lower CD4 þ T-cell counts than HIV monoinfected patients (median 159 and 137 cells/ml, respectively, P ¼ 0.04). In the coinfected patients, 49.6% had HBeAgnegative HBV, 60.2% had genotype A HBV, and 13% were HDV positive. Of the HBeAg-negative patients, 66% had HBV DNA 2000 IU/ml or less compared to 5.2% of the HBeAg-positive individuals. Drug-resistant HBV was not detected. Conclusion: Screening for HBV in HIV-infected patients in resource-limited settings is important because it is associated with lower CD4 þ T-cell counts. In settings in which HBV DNA is not available, HBeAg may be useful to assess the need for HBV treatment. Screening for drug-resistant HBV is not needed prior to starting ART in settings in which this study was conducted. 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins AIDS 2013, 27:191–201

Predicting Patterns of Long-Term CD4 Reconstitution in HIV-Infected Children Starting Antiretroviral Therapy in Sub-Saharan Africa: A Cohort-Based Modelling Study

Abstract: Background: Long-term immune reconstitution on antiretroviral therapy (ART) has important implications for HIV-infected children, who increasingly survive into adulthood. Children’s response to ART differs from adults’, and better descriptive and predictive models of reconstitution are needed to guide policy and direct research. We present statistical models characterising, qualitatively and quantitatively, patterns of long-term CD4 recovery. Methods and Findings: CD4 counts every 12 wk over a median (interquartile range) of 4.0 (3.7, 4.4) y in 1,206 HIV-infected children, aged 0.4–17.6 y, starting ART in the Antiretroviral Research for Watoto trial (ISRCTN 24791884) were analysed in an exploratory analysis supplementary to the trial’s pre-specified outcomes. Most (n = 914; 76%) children’s CD4 counts rose quickly on ART to a constant agecorrected level. Using nonlinear mixed-effects models, higher long-term CD4 counts were predicted for children starting ART younger, and with higher CD4 counts (p,0.001). These results suggest that current World Health Organization–recommended CD4 thresholds for starting ART in children $5 y will result in lower CD4 counts in older children when they become adults, such that vertically infected children who remain ART-nao¨ve beyond 10 y of age are unlikely ever to normalise CD4 count, regardless of CD4 count at ART initiation. CD4 profiles with four qualitatively distinct r econstitution patterns were seen in the remaining 292 (24%) children. Study limitations included incomplete viral load data, and that the uncertainty in allocating children to distinct reconstitution groups was not modelled. Conclusions: Although younger ART-nao ¨ve children are at high risk of disease progression, they have good potential for achieving high CD4 counts on ART in later life provided ART is initiated following current World Health Organization (WHO), Paediatric European Network for Treatment of AIDS, or US Centers for Disease Control and Prevention guidelines. In contrast, to maximise CD4 reconstitution in treatment-nao ¨ve children .10 y, ART should ideally be considered even if there is a low risk of immediate disease progression. Further exploration of the immunological mechanisms for these CD4 recovery profiles should help guide management of paediatric HIV infection and optimise children’s immunological development. Please see later in the article for the Editors’ Summary.

Effects of the Synthetic Inertia from wind power on the total system inertia after a frequency disturbance

Abstract: The future power systems face several challenges; one of them is the use of high power converters that virtually decouple primary energy source from the AC power grid. An important consequence of this situation is their effect on total system inertia and the ability to overcome the system's frequency disturbances. The wind power industry has created a controller to enable inertial response on wind turbines generators: Synthetic Inertial. This paper evaluates the effects of the inertia emulation of wind turbines based on full-converters and their effect on total system inertia after frequency disturbances happen. The main contribution of this paper is to demonstrate (based on simulations) that during an under-frequency transients on future power systems, synthetic inertia does not completely avoid worse scenarios in terms of under-frequency load shedding. The extra power delivered from a wind turbine during frequency disturbances can increase “momentary” the total system inertia and substantially reduce the rate of change of frequency providing time for the active governors to respond. However, synthetic inertia might not completely avoid under-frequency load shedding.

Termite mounds as islands: woody plant assemblages relative to termitarium size and soil properties

Abstract: Questions: We investigated whether soils of small mounds resembled large mound or matrix soils, whether changes in plant composition reflected changes in soils, and the sequence in which plants colonize and disappear from mounds of increasing size. Location: Miombo woodland in northwest Zimbabwe. Methods: Macrotermitinae termitaria vary in size and soil nutrient concentrations, harbouring distinct woody plant assemblages, making them foci for plant and animal diversity, and also influencing primary, secondary and tertiary productivity. In spite of the importance of termitaria to heterogeneity and diversity, no studies have investigated changes in plant species assemblages as mound surface area increases to the point where mound vegetation is distinct from that of the matrix. We compared woody plant assemblages on 43 matrix plots with 95 Macrotermes termitaria across a range of surface areas, using ANOSIM, cluster analysis and MDS ordination. We compared soil nutrients, pH and clay, from ten large and ten small termitaria, and ten matrix sites. We also assessed how relative representation of large mound or matrix indicator species changed with mound area. Results: Change was apparent even at mound sizes of >10 m2, where both soils and plant assemblages on mounds were significantly different to those of the matrix. Plant assemblages fell into two main groups at 20% similarity; the first comprised of matrix plots, mounds 30 m2. At 40% similarity, four groups emerged: matrix, mounds 30 m2. Woody plant composition changed gradually as mound area increased. On termitaria 30 m2 in surface area, only mound indicator species were found. Conclusions: Through termite activities in concentrating nutrients and clay, termitaria provide habitat for species usually excluded from the matrix. The process of mound building and the nature of the plants that establish on them seem to establish a positive feedback for establishment of other non-woodland matrix species.

Undisclosed Antiretroviral Drug Use in a Multinational Clinical Trial (HIV Prevention Trials Network 052)

Abstract: The HIV Prevention Trials Network 052 study enrolled serodiscordant couples. Index participants infected with human immunodeficiency virus reported no prior antiretroviral (ARV) treatment at enrollment. ARV drug testing was performed retrospectively using enrollment samples from a subset of index participants. ARV drugs were detected in 45 of 96 participants (46.9%) with an undetectable viral load, 2 of 48 (4.2%) with a low viral load, and 1 of 65 (1.5%) with a high viral load (P < .0001); they were also detected in follow-up samples from participants who were not receiving study-administered treatment. ARV drug testing may be useful in addition to self-report of ARV drug use in some clinical trial settings.

Opportunities for optimization of in-field water harvesting to cope with changing climate in semi-arid smallholder farming areas of Zimbabwe

Abstract: Climate change has resulted in increased vulnerability of smallholder farmers in marginal areas of Zimbabwe where there is limited capacity to adapt to changing climate. One approach that has been used to adapt to changing climate is in-field water harvesting for improved crop yields in the semi- arid regions of Zimbabwe. This review analyses the history of soil and water conservation in Zimbabwe, efforts of improving water harvesting in the post independence era, farmer driven innovations, water harvesting technologies from other regions, and future directions of water harvesting in semi arid marginal areas. From this review it was observed that the blanket recommendations that were made on the early conservation method were not suitable for marginal areas as they resulted in increased losses of the much needed water. In the late 1960 and 70s’, soil and water conservation efforts was a victim of the political environment and this resulted in poor uptake. Most of the water harvesting innovations which were promoted in the 1990s’ and some farmer driven innovations improved crop yields in marginal areas but were poorly taken up by farmers because they are labour intensive as the structures should be made annually. To address the challenges of labour shortages, the use of permanent in-field water harvesting technologies are an option. There is also need to identify ways for promoting water harvesting techniques that have been proven to work and to explore farmer-led knowledge sharing platforms for scaling up proven technologies.

Integrated Analysis of Innate, Th1, Th2, Th17, and Regulatory Cytokines Identifies Changes in Immune Polarisation Following Treatment of Human Schistosomiasis

Abstract: Urogenital schistosomiasis is a debilitating disease caused by the parasitic trematode Schistosoma haematobium, which currently infects >100 million people [1]. Humans are exposed to infective larvae (cercariae), which invade via percutaneous penetration; adult male and female worms, which mate in the urogenital tract; and eggs, which are transmitted to the environment in urine. Repeated passage of eggs across the bladder and urogenital tract leads to characteristic immune-mediated morbidities [2, 3]. The World Health Organization advocates schistosomiasis control via treatment with the antihelminthic drug praziquantel (PZQ) [4] due to its efficacy at clearing infection [5, 6] and reducing the prevalence of schistosome-associated morbidities [7]. Praziquantel treatment also alters schistosome-specific immune responses, and removal of infection and/or exposure to antigens released from parasites damaged by treatment may influence responses to subsequent infection [8–10]. Studies showing a decline in the proportion of circulating T regulatory (Treg) cells [11] and increased effector responses to parasite [12, 13] and nonparasite antigens [14, 15] post-treatment indicate that immunoregulatory mechanisms established during infection are alleviated when infection is removed. Furthermore, PZQ-induced changes in antibody levels, CD23+ B cells [16], and cellular proliferation [13] have been associated with reduced Schistosoma mansoni reinfection rates, suggesting that treatment may have longer-term benefits in addition to transient infection clearance. Taken together, these observations suggest that treatment alters not only the magnitude of the host immune response but also the phenotype of schistosome-specific responses. However, although previous human studies have inferred relative changes in the phenotype of the schistosome-specific cytokine response from changes in individual responses [12, 17], this hypothesis has not been directly assessed. Importantly, experimental models of helminth infection suggest that innate cells and CD4+ T helper (Th) cells (Th1, Th2, Treg, and Th17) cross-regulate one another during infection [18, 19], and the interaction between these responses rather than levels of individual cytokines alone may influence resistance to reinfection [20]. No studies to date have investigated schistosome-specific, Th17-associated cytokine responses in humans despite the role of Th17 in schistosome egg-mediated immunopathologies in mice [21–23] and detectable levels of Th17-type cytokines in plasma samples from S. haematobium–exposed humans [24]. This study addresses 4 key hypotheses relating to the effect of PZQ on schistosome-specific immune responses: (1) treatment influences levels of schistosome-specific, Th17-associated cytokines in addition to the previously assayed cytokines; (2) the cytokine environment (comprising markers associated with innate inflammatory, Th1, Th2, Th17, and regulatory responses) of treated individuals is fundamentally altered relative to pretreatment responses; (3) the effects of treatment on schistosome-specific cytokines differ between responses to cercariae, adult worms and eggs; and (4) cytokine responses elicited 6 weeks post-treatment influence reinfection rates. Our results yield insights into the immunological effects of antihelminthic treatment and how these relate to parasite life history and the development of protective immunity.

Translating Coverage Gains into Health Gains for All Women and Children: The Quality Care Opportunity

Abstract: The proportion of women and childrenreceiving health care in the poorest coun-tries is increasing [1]. Unfortunately, mark-ers of improved health outcomes, such asfalling maternalornewbornmortality,havenot matched expectations from the gains inthe coverage of care.Robust evidenceexistsfor one explanatory factor: the poor–richgaps in coverage found along the continu-um of care for women and children, andparticularly for the crucial period aroundchildbirth [2]. The more-neglected expla-nation for the mismatch between coverageand health outcomes is the quality of thecare provided to women and children,which isthefocus of Year 1 of the MaternalHealth Task Force (MHTF)-PLOS Collec-tion on Maternal Health (http://www.ploscollections.org/maternalhealth_year1)and our short commentary.Although inadequacies in care havelong been noted across the world and formany health problems [3], a focus on themagnitude, costs, and consequences spe-cifically for women and children in low-income countries is relatively new, and stillhas not achieved the status of a politicalpriority [4]. This contrasts markedly withthe attention paid to the coverage of care.Here we seek to highlight the synergiesbetween inequalities in coverage andquality. The inverse care law [5] proposesthat quality of care varies inversely withneed, and we extend this to emphasizethat poor quality care is disproportionatelyborne by the poorest groups of womenand children. Our commentary is struc-tured around a key cause and a conse-quence of the neglect of quality—weakmeasurement and poor evidence foraction—and concludes with priorities forseizing the quality care opportunity.

Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health.

Abstract: The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs. This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed. However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose.

Remote sensing based water quality monitoring in Chivero and Manyame lakes of Zimbabwe

Abstract: Lakes Chivero and Manyame are amongst Zimbabwe’s most polluted inland water bodies. MEdium Resolution Imaging Spectrometry level 1b full resolution imagery for 2011 and 2012 were used to derive chlorophyll-a (chl_a) and phycocyanin (blue-green algae) concentrations using a semi-empirical band ratio model; total suspended matter (TSM) concentrations were derived from the MERIS processor. In-situ measured chl_a was used to validate the remotely sensed values. Results indicate that remote sensing measurements are comparable with in situ measurements. A strong positive correlation ( R 2 = 0.91; MAE = 2.75 mg/m 3 (8.5%)) and p R 2 = 0.9458; p R 2 = 0.7344; p R 2 = 9047; p

The role of community conversations in facilitating local HIV competence: case study from rural Zimbabwe

Abstract: This paper examines the potential for community conversations to strengthen positive responses to HIV in resource-poor environments. Community conversations are an intervention method through which local people work with a facilitator to collectively identify local strengths and challenges and brainstorm potential strategies for solving local problems. We conducted 18 community conversations (with six groups at three points in time) with a total of 77 participants in rural Zimbabwe (20% HIV positive). Participants were invited to reflect on how they were responding to the challenges of HIV, both as individuals and in community groups, and to think of ways to better support openness about HIV, kindness towards people living with HIV and greater community uptake of HIV prevention and treatment. Community conversations contributed to local HIV competence through (1) enabling participants to brainstorm concrete action plans for responding to HIV, (2) providing a forum to develop a sense of common purpose in relation to implementing these, (3) encouraging and challenging participants to overcome fear, denial and passivity, (4) providing an opportunity for participants to move from seeing themselves as passive recipients of information to active problem solvers, and (5) reducing silence and stigma surrounding HIV. Our discussion cautions that community conversations, while holding great potential to help communities recognize their potential strengths and capacities for responding more effectively to HIV, are not a magic bullet. Poverty, poor harvests and political instability frustrated and limited many participants’ efforts to put their plans into action. On the other hand, support from outside the community, in this case the increasing availability of antiretroviral treatment, played a vital role in enabling communities to challenge stigma and envision new, more positive, ways of responding to the epidemic.

Geographical distribution and oncogenic risk association of human papillomavirus type 58 E6 and E7 sequence variations

Abstract: Human papillomavirus (HPV) 58 accounts for a notable proportion of cervical cancers in East Asia and parts of Latin America, but it is uncommon elsewhere. The reason for such ethnogeographical predilection is unknown. In our study, nucleotide sequences of E6 and E7 genes of 401 HPV58 isolates collected from 15 countries/cities across four continents were examined. Phylogenetic relationship, geographical distribution and risk association of nucleotide sequence variations were analyzed. We found that the E6 genes of HPV58 variants were more conserved than E7. Thus, E6 is a more appropriate target for type-specific detection, whereas E7 is more appropriate for strain differentiation. The frequency of sequence variation varied geographically. Africa had significantly more isolates with E6-367A (D86E) but significantly less isolates with E6-203G, -245G, -367C (prototype-like) than other regions (p ≤ 0.003). E7-632T, -760A (T20I, G63S) was more frequently found in Asia, and E7-793G (T74A) was more frequent in Africa (p < 0.001). Variants with T20I and G63S substitutions at E7 conferred a significantly higher risk for cervical intraepithelial neoplasia grade III and invasive cervical cancer compared to other HPV58 variants (odds ratio = 4.44, p = 0.007). In conclusion, T20I and/or G63S substitution(s) at E7 of HPV58 is/are associated with a higher risk for cervical neoplasia. These substitutions are more commonly found in Asia and the Americas, which may account for the higher disease attribution of HPV58 in these areas.