Abstract The East African Community (EAC) grapples with many challenges in tackling infectious disease threats and antimicrobial resistance (AMR), underscoring the importance of regional and robust ...pathogen genomics capacities. However, a significant disparity exists among EAC Partner States in harnessing bacterial pathogen sequencing and data analysis capabilities for effective AMR surveillance and outbreak response. This study assesses the current landscape and challenges associated with pathogen next-generation sequencing (NGS) within EAC, explicitly focusing on World Health Organization (WHO) AMR-priority pathogens. The assessment adopts a comprehensive approach, integrating a questionnaire-based survey amongst National Public Health Laboratories (NPHLs) with an analysis of publicly available metadata on bacterial pathogens isolated in the EAC countries. In addition to the heavy reliance on third-party organizations for bacterial NGS, the findings reveal a significant disparity among EAC member States in leveraging bacterial pathogen sequencing and data analysis. Approximately 97% ( n = 4,462) of publicly available high-quality bacterial genome assemblies of samples collected in the EAC were processed and analyzed by external organizations, mainly in Europe and North America. Tanzania led in-country sequencing efforts, followed by Kenya and Uganda. The other EAC countries had no publicly available samples or had all their samples sequenced and analyzed outside the region. Insufficient local NGS sequencing facilities, limited bioinformatics expertise, lack of adequate computing resources, and inadequate data-sharing mechanisms are among the most pressing challenges that hinder the EAC’s NPHLs from effectively leveraging pathogen genomics data. These insights emphasized the need to strengthen microbial pathogen sequencing and data analysis capabilities within the EAC to empower these laboratories to conduct pathogen sequencing and data analysis independently. Substantial investments in equipment, technology, and capacity-building initiatives are crucial for supporting regional preparedness against infectious disease outbreaks and mitigating the impact of AMR burden. In addition, collaborative efforts should be developed to narrow the gap, remedy regional imbalances, and harmonize NGS data standards. Supporting regional collaboration, strengthening in-country genomics capabilities, and investing in long-term training programs will ultimately improve pathogen data generation and foster a robust NGS-driven AMR surveillance and outbreak response in the EAC, thereby supporting global health initiatives.
Background East Africa is home to 170 million people and prone to frequent outbreaks of viral haemorrhagic fevers and various bacterial diseases. A major challenge is that epidemics mostly happen in ...remote areas, where infrastructure for Biosecurity Level (BSL) 3/4 laboratory capacity is not available. As samples have to be transported from the outbreak area to the National Public Health Laboratories (NPHL) in the capitals or even flown to international reference centres, diagnosis is significantly delayed and epidemics emerge. Main text The East African Community (EAC), an intergovernmental body of Burundi, Rwanda, Tanzania, Kenya, Uganda, and South Sudan, received 10 million euro funding from the German Development Bank (KfW) to establish BSL3/4 capacity in the region. Between 2017 and 2020, the EAC in collaboration with the Bernhard-Nocht-Institute for Tropical Medicine (Germany) and the Partner Countries' Ministries of Health and their respective NPHLs, established a regional network of nine mobile BSL3/4 laboratories. These rapidly deployable laboratories allowed the region to reduce sample turn-around-time (from days to an average of 8h) at the centre of the outbreak and rapidly respond to epidemics. In the present article, the approach for implementing such a regional project is outlined and five major aspects (including recommendations) are described: (i) the overall project coordination activities through the EAC Secretariat and the Partner States, (ii) procurement of equipment, (iii) the established laboratory setup and diagnostic panels, (iv) regional training activities and capacity building of various stakeholders and (v) completed and ongoing field missions. The latter includes an EAC/WHO field simulation exercise that was conducted on the border between Tanzania and Kenya in June 2019, the support in molecular diagnosis during the Tanzanian Dengue outbreak in 2019, the participation in the Ugandan National Ebola response activities in Kisoro district along the Uganda/DRC border in Oct/Nov 2019 and the deployments of the laboratories to assist in SARS-CoV-2 diagnostics throughout the region since early 2020. Conclusions The established EAC mobile laboratory network allows accurate and timely diagnosis of BSL3/4 pathogens in all East African countries, important for individual patient management and to effectively contain the spread of epidemic-prone diseases. Keywords: East African Community, Viral haemorrhagic fevers, Ebola virus disease, Dengue fever, Mobile laboratory, COVID-19, Outbreak response, BSL4, Capacity building
In response to the largest recorded monkeypox virus outbreak outside of endemic Central and Western Africa, the East African Community (EAC), in cooperation with the Bernhard-Nocht- Institute for ...Tropical Medicine (BNITM), coordinated an emergency monkeypox diagnostic training for the East African Region. As of June 2022, the Democratic Republic of Congo reported a steady increase of suspected monkeypox cases, increasing the risk of spill-over into the remaining six EAC Partner States. Within the existing EAC Mobile Laboratories project, laboratory experts of the National Public Health Laboratories of the remaining six EAC Partner States (Burundi, Rwanda, Tanzania, Kenya, Uganda and South Sudan) participated in the workshop and were trained in reception of suspect samples, DNA extraction and diagnosis using RT-PCR. The EAC region is now equipped with the tools to prepare and rapidly respond to any emerging monkeypox outbreak.
Within the first 14 days after outbreak confirmation, the East African Community Mobile laboratory network was actively involved in providing Sudan virus disease and differential diagnostics in the ...epicentre at Mubende Regional Referral Hospital (and neighbouring districts), as well as in coordination of mobile laboratory preparedness activities in five other East African countries. Introduction On 20 September 2022, the Ugandan Ministry of Health declared an Ebola Sudan virus disease (SVD) outbreak in the Mubende District of the country, with one confirmed SVD death and six probable deaths reported in the region since 1 September 2022.1 Since 2017, and with funding from the German Federal Ministry for Economic Cooperation and Development through the KfW Development Bank, the East African Community (EAC) together with the Bernhard-Nocht-Institute for Tropical Medicine established a network of nine mobile EAC laboratories embedded within the National Public Health Laboratories (NPHLs) of six EAC Partner States (Tanzania, Kenya, Burundi, Rwanda, South Sudan and Uganda).2 3 These field-deployable mobile laboratories have the capacity to diagnose risk group four pathogens, such as SVD. On the same day of the SVD outbreak announcement (20 September 2022) by the Ugandan government, the EAC Health Department initiated their regional pandemic preparedness and response activities, which consisted of a two-pronged approach: while the mobilisation of the EAC mobile laboratory network commenced, the regional procurement of diagnostic kits for SVD and differential diagnosis was immediately initiated (for a detailed timeline of events, see table 1).Table 1 Timeline of regional SVD outbreak response and preparedness activities in six East African countries Days following outbreak announcement 1 2 3 4 5 6 7 8 9 10 11 12 13 14 SVD outbreak declared by Uganda MoH EAC secretariat Emergency pandemic preparedness meetings Emergency procurement initiated Logistical support (kit delivery) Technical country support Press Release No of SVD kits ordered/expected 1×96 tests (arrival day 20) Uganda SVD outbreak response Request for support to EAC Lab deployment from Kampala to Mubende Start of testing No of SVD kits ordered/received 4×96 tests No. Diagnostic workflows, standard operating procedures and supply of diagnostics kits The EAC Mobile laboratories consist of negative pressure gloveboxes (Könnecke, Germany) (see figure 2) for sample inactivation and Bio-Rad CFX96 RT-PCR platforms for molecular SVD diagnosis (for further details on the laboratory setup, see Affara et al2).
Birgok calsma, dogrudan yabanci yatrimin (DYY) diényadaki biydmeye etkisini tahmin etmeye calsmugnr, ancak gok az: Sahra alt. Afrika'ya odaklannushir. Bana gére, bu tez, Térkiye ve Almanya'nm ...Dogrudan Yabanci Yaturimenmn, Tirkiye ve Almaaya’nin Merkez Bankas: ve Afrika ilkelerinden ikincil verileri kullanarak Sahra ali Afrika itketerinin ekonomik biyimesine etkisini arashrmaktadir.ARDL modeli yaklagom kullaniarak, bu calgmada degisken Ekonomik bdydme ve bajumsiz ise Toplam DYY, Tarkiye'nin DYY, Almanya'mn DYY, Ticaret ve finansin degiskenler olarak kullanmaktadir. E-views 10.0 yazlim program kullanilarak, Tarkiye ve Almanya'nn DYY‘lannin SAA dlkeleri ckonomik biydme dzerinde uzun dinemli etkisi clup olmadigime eg bitinlesme iliskisini araghrip sir testi ele almmighr. ARDL modelden elde edilen sonuglar, Tarkiye DYV'nin katsay: uzun ddnemde istatistiki olarak anlamh bulunamamistir. Bu sonucu teorik acismndan ters olup teorik bulgularina gore Tark sirketlerinin genis yayibm ve fark sahra alt. Afrika iiikelerindeki yatuumlardaa kaynaklanmaktadiy ve = ayrica altyapidaki Taérk yatrim bilydmeyi artrmaktadir. Dogal kaynaklara daha fazta yofuniasan diter bircok dlkenin yatnmeiariain aksine, Tark yatmnmelar ekonomik bilydme icin etkili olan ve ev sahibi dlkelere yeni teknoloji veya bilgi getirecek daha fazla akyaps sektdraine yogualasmaktadir. Ote yandan, Danya‘daki DYY, Ticaret, Finans ve Almanya'nm DYY uzun déinemde ekonomik biydme dzerindeki etkisiain pozitif ve istatistiksel olarak anlamh bulunmustur. Bu sonuc¢ dnceki Mteratdrie uyumlu oldugunu gésterip Alman DYY'lerinin ise nedeni belirli ilkelerdeki Alman girketlerinin yozunlagmasi ve ayni zamanda SAA dilkeleri ve Almanya arasindaki ticaretin tiv degerini Térkiye'’nin kargdlagt{s zaman farkh ve bdyik olduguau ifade edilmistir.
Abstract Introduction Intimate partner violence is defined as any behavior by a current or past male intimate partner during marriage, cohabitation, or any other formal or informal union that causes ...physical, sexual, or psychological harm. Men are the most common perpetrators of this against women. It affects almost one-third of all women worldwide. Objective This study aimed to assess the prevalence, consequences, and factors associated with intimate partner violence among partnered women in Gambella town. Methods A community-based, cross-sectional study design was employed. A systematic random sampling technique was used to select the study participants. Data was collected using a pretested, structured questionnaire. The data were entered and analyzed using SPSS software version 25. The bivariate and multivariate logistic regression method was used to identify factors associated with intimate partner violence. Variables with a p -value <0.05 were considered significantly associated with intimate partner violence. Results The overall prevalence of intimate partner violence in the lifetime and the last 12 months was 58.8, 95% CI (54.0, 63.6), and 51.8, 95% CI (46.7, 56.8), respectively. More than half (53.3%) of the violence resulted in physical injury, while 32.9% were separated from their partners whereas, mother’s history of exposure to IPV AOR: 1.8, 95% CI (1.03–3.27), p < 0.05, respondent’s age AOR: 3.4, 95% CI (1.8, 6.5), p < 0.001, substance use AOR:2.5, 95% CI (1.5–4.1), p < 0.001, disagreement on sexual intercourse AOR:3.2, 95% CI (1.8–5.7), p < 0.01, monthly family income AOR:0.32, 95% CI: (0.16–0.63), p < 0.01 and family size AOR:2.8, 95% CI: (1.6–4.8), p < 0.01 were significantly associated with IPV. Conclusion The study indicated that the prevalence of intimate partner violence was very high. Age of the woman, family size, substance use, economic status, were among factors significantly associated with intimate partner violence. Therefore, responsible stakeholders should respond to the deep-rooted and highly complicated gender inequality by implementing preventive measures.
Background:
The use of psychoactive substances is one of the main public health issues worldwide. However, there is a lack of evidence on the magnitude of current substance use among students in ...Ethiopia. Therefore, this study aimed to provide comprehensive views of the current prevalence of substance use among students in Ethiopia.
Methods:
We searched PubMed/Medline, Health InterNetwork Access to Research Initiative (HINARI), Google Scholar, and gray literature sources between 2000 and 2019. The prevalence of current substances with a 95% confidence interval (CI) was estimated using the random-effects model. The results were presented using forest plots, and Cochrane Q-test and I2 were used to measure the extents of between-study variations.
Results:
A total of 1543 study articles were identified from electronic databases, and 32 cross-sectional studies were included in the meta-analysis. The prevalence of current use of at least 1 substance was 37.63% (95% CI: 33.66, 41.69), alcohol 27.61% (95% CI: 22.10, 33.48), khat 17.20% (95% CI: 14.03, 20.62), and smoking 9.74% (95% CI: 7.17, 12.64). The prevalence of any substance use in high school students versus university/college students was 41.55% (95% CI: 38.83, 44.29) versus 36.24% (95% CI: 32.37, 40.20), alcohol 24.21% (95% CI: 14.05, 36.11) versus 25.27% (95% CI: 19.76, 31.20), khat 13.82% (95% CI: 8.61, 20.02) versus 17.30% (95% CI:13.75, 21.16), and cigarette 8.30% (95% CI: 1.89, 18.60) versus 9.80% (95% CI: 7.32, 12.58). Meta-regression analysis revealed publication year, sample size, female proportion, and age were not significantly associated with the current use of substances.
Conclusion:
Overall, the current substance use of any substance, alcohol, chewing khat, and smoking cigarettes was relatively high. A significant proportion of high school students were already using substances at an early age. Policymakers should formulate and implement regulations to control the pervasive use of substances by young people around educational institutions at all levels.
Protocol Registration:
The protocol has been registered on 19 August 2019 on the International Prospective Register of Systematic Reviews (PROSPERO) with ID: CDR42019130560.
Abstract The Turkana low-level jet (LLJ) is an intrinsic part of the African climate system. It is the principle conduit for water vapor transport to the African interior from the Indian Ocean, and ...droughts in East Africa tend to occur when the jet is strong. The only direct observations of the Turkana jet come from manual tracking of pilot balloons in the 1980s. Now, modern reanalysis datasets disagree with one another over the strength of jet winds and underestimate the strength of the jet by 25%–75% compared to the pilot balloon data. This article gives an overview of a field campaign based in northwest Kenya—the Radiosonde Investigation for the Turkana Jet (RIFTJet)—which measured the Turkana jet for the first time in 40 years using modern technologies. Radiosonde data reveal a persistent low-level jet, which formed on every night of the campaign, with an average low-level maximum wind speed of 16.8 m s −1 at 0300 LT. One of the latest reanalysis datasets (ERA5) underestimates low-level wind speeds by an average of 24% (4.1 m s −1 ) at 0300 LT and by 33% (3.6 m s −1 ) at 1500 LT. The measurements confirm the role of the Turkana LLJ in water vapor transport: mean water vapor transport at Marsabit is 172 kg m s −1 . The dataset provides new opportunities to understand regional dynamics, and to evaluate models in one of the most data-sparse regions in the world.
Background:
Self-care practice is the activity that a hypertensive patient undertakes intending to improve their health. Poor self-care practice leads to uncontrolled hypertension. Therefore, ...strategies designed to prevent and control hypertension-related death, disability, and morbidity should consider the level of the patient’s self-care practice and risk factors. This study assessed self-care practice and associated factors among hypertensive patients in public health facilities of Harar Town in eastern Ethiopia.
Method:
An institution-based cross-sectional study was conducted among 398 randomly selected hypertensive patients from 25 March 2019 to 16 April 2019. Pretested structured questionnaires adapted from validated tools were used to collect data from participants using electronic Open Data Kit software through face-to-face exit interview. Data were analyzed by SPSS version 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with self-care practice. Adjusted odds ratio with 95% confidence interval was used to report association and the significance was declared at p-value < 0.05.
Results:
Level of good self-care practice was 29.9% (95% confidence interval: 25.3% and 34.7%). Age ⩾ 60 years (adjusted odds ratio = 3.4, 95% confidence interval: 1.2 and 9.3), formal education (adjusted odds ratio = 2.3, 95% confidence interval: 1.3 and 4.2), absence of comorbidities (adjusted odds ratio = 1.8, 95% confidence interval: 1.1 and 3.1), adequate knowledge about hypertension (adjusted odds ratio = 4.7, 95% confidence interval: 2.5 and 8.8), good social support (adjusted odds ratio = 2.7, 95% confidence interval: 1.6 and 4.7), and being khat abstainer (adjusted odds ratio = 1.9, 95% confidence interval: 1.1 and 3.5) were significantly associated with good self-care practice.
Conclusion:
The prevalence of good self-care practice was low. In this study, good self-care practice was significantly associated with age, formal education, comorbidities, knowledge about hypertension, social support, and current khat chewing condition. Regular check-up and follow-up of patients’ compliance with self-management protocol, and more emphasis should be given to identify factors that potentially impeding patients’ adherence to hypertension self-management protocol.
PDF
