Katima Mulilo has the highest burden of HIV/AIDS in Namibia. Due to several constraints of the antiretroviral therapy programme, HIV-infected persons still use ethnomedicines to manage AIDS-related ...opportunistic infections. Despite the reliance on plants to manage HIV/AIDS in Katima Mulilo, there have been no empirical studies to document the specific plant species used by traditional healers to treat AIDS-related opportunistic infections. In this study, an ethnobotanical survey was conducted to record the various plant families, species, and plant parts used to manage different HIV/AIDS-related opportunistic infections in Katima Mulilo, Caprivi region, Namibia. The results showed that a total of 71 plant species from 28 families, mostly the Combretaceae (14%), Anacardiaceae (8%), Mimosaceae (8%), and Ebanaceae (7%), were used to treat conditions such as herpes zoster, diarrhoea, coughing, malaria, meningitis, and tuberculosis. The most plant parts used were leaves (33%), bark (32%), and roots (28%) while the least used plant parts were fruits/seeds (4%). Further research is needed to isolate the plants' active chemical compounds and understand their modes of action.
To study the antibacterial efficacy of metallic Ag nanoparticle/titania (Ag‐NP)/TiO2 composite thin films against Escherichia coli (ATCC 25922), COMP‐Agn with various amounts of Ag (10 mol% ≤ n ≤ 80 ...mol%) are fabricated on a quartz glass substrate at 600 °C using the molecular precursor method. The films are characterized by X‐ray diffraction, X‐ray photoelectron, scanning electron microscopy, transmission electron microscopy, photoluminescence, and UVvis techniques. The analysis reveals that the films are composed of metallic Ag‐NPs embedded in a mixture of anatase and rutile matrix, with a volumetric fraction of Ag ranging from 0.18 to 0.68. The antibacterial activity of the TiO2 thin film and COMP‐Agn are determined by disk diffusion and viable cell count methods. Neither pure TiO2 nor pure Ag films exhibit any discernible antibacterial under dark and visible light. The antibacterial of Ag content in composite films is observed to persist for a maximum increase of 70%. The model is proposed on the basis of photoexcited electron transfer from Ag NPs to the TiO2 conduction band of COMP‐Agn, which clarifies the main factors affecting the photoresponse and the excellent response to visible light via surface plasmon resonance.
This manuscript presents an assessment of the antibacterial activities of titania combined with higher concentrations of metallic silver nanoparticles up to 80 mol%. The study evaluates the antibacterial properties of these composite thin films. Results show improved photoresponse thresholds with silver, and the plasmonic photocatalytic properties contribute to understanding bacteria growth inhibition mechanism.
Antimicrobial resistance (AMR) is a global concern among infectious diseases. Bloodstream infections can potentially become life-threatening if they become untreatable with conventional ...antimicrobials. This review aims to provide an understanding of the AMR prevalence and trends of common bacteremic pathogens, namely Escherichia coli and Staphylococcus aureus in the World Health Organization (WHO) Africa region.
PubMed and Google Scholar were searched using relevant keywords for published human studies (excluding case reports and reviews) reporting bacteremic AMR data on the pathogens of interest between 2008 and 2019. Two reviewers independently screened the articles against a pre-defined eligibility criterion. Data extraction and analysis were achieved with different platforms: Covidence, Excel, R version 3.6.3, and QGIS v3.4.5. The pooled prevalence, 95% confidence intervals, and I2 index (a measure of heterogeneity) were calculated for the various pathogen-antibiotic combinations.
Five hundred sixty-two papers were retrieved, with 27 papers included in the final analysis. Only 23.4% (11/47) of member states of the WHO African region had reports on AMR in bacteremia. The Clinical and Laboratory Standards Institute (CLSI) (78.5%) was the most common standard used in the region. For E. coli, the pooled resistance was: cefotaxime (42%), imipenem (4%), meropenem (0%), and colistin (0%). For S. aureus, the calculated pooled resistance was cloxacillin (34%), oxacillin (12%), and vancomycin (0%). There was a high degree of variation across studies (I2 > 90%).
The pooled resistance rates indicate a concerning degree of methicillin-resistant and Extended Spectrum-ß-lactamase–producing pathogens. The paucity of AMR data also presents challenges for a comprehensive understanding of the situation in the region. Continent-wide and standardized surveillance efforts therefore need strengthening.
High genetic diversity of East Asian village dogs has recently been used to argue for an East Asian origin of the domestic dog. However, global village dog genetic diversity and the extent to which ...semiferal village dogs represent distinct, indigenous populations instead of admixtures of various dog breeds has not been quantified. Understanding these issues is critical to properly reconstructing the timing, number, and locations of dog domestication. To address these questions, we sampled 318 village dogs from 7 regions in Egypt, Uganda, and Namibia, measuring genetic diversity >680 bp of the mitochondrial D-loop, 300 SNPs, and 89 microsatellite markers. We also analyzed breed dogs, including putatively African breeds (Afghan hounds, Basenjis, Pharaoh hounds, Rhodesian ridgebacks, and Salukis), Puerto Rican street dogs, and mixed breed dogs from the United States. Village dogs from most African regions appear genetically distinct from non-native breed and mixed-breed dogs, although some individuals cluster genetically with Puerto Rican dogs or United States breed mixes instead of with neighboring village dogs. Thus, African village dogs are a mosaic of indigenous dogs descended from early migrants to Africa, and non-native, breed-admixed individuals. Among putatively African breeds, Pharaoh hounds, and Rhodesian ridgebacks clustered with non-native rather than indigenous African dogs, suggesting they have predominantly non-African origins. Surprisingly, we find similar mtDNA haplotype diversity in African and East Asian village dogs, potentially calling into question the hypothesis of an East Asian origin for dog domestication.
The emergence of antimicrobial resistance (AMR) among bacterial pathogens demands a local understanding of the epidemiological situation. This information is needed both for clinical treatment ...decision-making purposes as well as for the revision of current care guidelines. Clinical AMR data from Namibia is sparse, whilst urinary tract infections remain not only widespread but they disproportionally affect females. This paper aims to describe the national antimicrobial resistance situation of major bacterial uropathogens in females within the 14 Namibian regions.
Retrospective countrywide information on clinical urine cultures performed in females in Namibia in 2016-2017 was obtained from the national public health laboratory, Namibia Institute of Pathology (NIP). The data set included both microbiological findings as well as antimicrobial susceptibility test (AST) results. The AST was done as per the Clinical and Laboratory Standards Institute (CLSI) guidelines. Resistance to 3rd generation cephalosporins was indicative of Extended Spectrum-ß-lactamase (ESBL) production. Data analysis was done with WHONET using expert interpretation rules.
In total, 22,259 urinary cultures were performed, of which 13,673 (61.4%) were culture positive. Gram-negative bacterial species accounted for 72.6% of the findings. The most common pathogens identified were Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis. Most of these were from young females, with a median age ranging from 28 to 32 years for the various pathogens. Resistance to ampicillin was 77.7% in E. coli and 84.9% in K. pneumoniae. In E. coli, resistance to 1
line empiric therapy antibiotic, nitrofurantoin, was below 13%, except for one region that showed 59.2% resistance. Resistance to third generation cephalosporin (3GC) was used as a proxy for ESBL production. By year 2017, 3GC resistance was 22%, 31.4% and 8.3% for E. coli, K. pneumoniae and P. mirabilis, respectively.
We report high resistance to ampicillin, quinolones and sulfamethoxazole-trimethoprim amongst E. coli. Resistance rates to third-generation cephalosporins was also concerningly high at 22%. Resistance to carbapenems was low. However, superiority of nitrofurantoin was found, which provides rational support for the usefulness of nitrofurantoin as an empiric therapy regimen for the treatment of urinary tract infections in this setting.
Current competencies in global health education largely reflect perspectives from high-income countries (HICs). Consequently, there has been underrepresentation of the voices and perspectives of ...partners in low- and middle-income countries (LMICs) who supervise and mentor trainees engaged in short-term experiences in global health (STEGH).
The objective of this study was to better understand the competencies and learning objectives that are considered a priority from the perspective of partners in LMICs.
A review of current interprofessional global health competencies was performed to design a web-based survey instrument in English and Spanish. Survey data were collected from a global convenience sample. Data underwent descriptive statistical analysis and logistic regression.
The survey was completed by 170 individuals; 132 in English and 38 in Spanish. More than 85% of respondents rated cultural awareness and respectful conduct while on a STEGH as important. None of the respondents said trainees arrive as independent practitioners to fill health care gaps. Of 109 respondents, 65 (60%) reported that trainees gaining fluency in the local language was not important.
This study found different levels of agreement between partners across economic regions of the world when compared with existing global health competencies. By gaining insight into host partners' perceptions of desired competencies, global health education programs in LMICs can be more collaboratively and ethically designed to meet the priorities, needs, and expectations of those stakeholders. This study begins to shift the paradigm of global health education program design by encouraging North–South/East–West shared agenda setting, mutual respect, empowerment, and true collaboration.
Abstract Background Competencies developed for global health education programmes that take place in low-income and middle-income countries have largely reflected the perspectives of educators and ...organisations in high-income countries. Consequently, there has been under-representation of voices and perspectives of host communities, where practical, experience-based global-health education occurs. In this study, we aimed to understand what global-health competencies are important in trainees who travel to work in other countries, seeking opinions from host community members and colleagues in low-income and middle-income countries. Methods We performed a literature review of current interprofessional global health competencies to inform our survey design. We used a web-based survey, available in English and Spanish, to collect data through Likert-scale and written questions. We piloted the survey in a diverse group of 14 respondents from high-income, middle-income, and low-income countries and subsequently refined the survey for greater clarity. We used convenience sampling to recruit participants from around the world and included a broad range of coauthors. A website was constructed in English and Spanish and the survey link added. This website and link were distributed as broadly as possible. It was mandatory for survey participants to list their country of birth and current work in order to confirm representation. Findings We received 274 responses: 227 in English and 47 in Spanish between Sept 1, 2015, and Dec 31, 2015. Respondents were from 38 countries across all economic regions. After data cleaning, we included 170 responses (132 in English and 38 in Spanish): 44 (26%) from high-income countries, 74 (44%) from upper-middle income countries, 31 (18%) from lower-middle income countries, and 21 (12%) from low-income countries. Respondents spoke 22 distinct primary languages. In terms of pre-departure competencies, 111 respondents rated cultural awareness and respectful conduct while on rotations as important. For intra-experience competencies, 88 of 112 respondents (79%) thought that it was equally as important for trainees to learn about the local culture as it was to learn about medical conditions. 65 of 109 (60%) respondents reported trainees gaining fluency in the local language as being not important. In terms of post-experience competencies, none of the respondents reported that trainees arrive as independent practitioners to fill health-care gaps. Interpretation Most hosts and partners across economic regions appreciate having trainees from other countries in their institutions and communities. There was a strong emphasis from respondents on the importance of a greater focus on cultural learning and building respect over medical knowledge and clinical practice. Additionally, respondents did not believe that trainees fill important human resource gaps, but are instead being provided with a beneficial learning experience. By gaining insight into host perceptions on desired competencies, global health education programmes in low-income and middle-income countries can be collaboratively and ethically designed and implemented to meet the priorities, needs, and expectations of host communities. Our findings could change how global health education programmes are structured, by encouraging North-South/East-West shared agenda setting, mutual respect, empowerment, and collaboration. Funding Child Family Health International.
Thousands of students travel yearly from high-income countries (HICs) to low-income and middle-income countries (LMICs) for short-term experiences in global health, with much less travel by LMIC ...students to HICs. Little structured research has been done to seek host perspectives, particularly from LMICs, on what they would like to teach learners. By seeking LMIC host perspectives, we aimed to improve global health pedagogy, curriculum design, assessment, and experiential learning, better meeting host goals and expectations. Our additional aim was to improve mutual respect and trust, share power honestly and ethically, and facilitate more genuinely collaborative agenda setting between LMIC and HIC partners.
We previously did a hybrid quantitative and qualitative web-based survey from Sept 1, 2015, to Dec 31, 2015, exploring global health competencies with particular attention to LMIC hosts supervising and housing trainees in short-term experiences in global health. 274 host perspectives were gleaned from 38 countries speaking 22 languages. In this qualitative study, we analysed open-ended questions and responses not previously covered from the same survey data. 97 of 274 responses were selected for qualitative analysis, conducted via content analysis and coding, ensuring inter-rater reliability, and comparing HIC and LMIC responses.
Four core themes emerged in our content analysis regarding desired global health core competencies: most important global health core competencies; biggest mistakes students make; biggest challenges students face; and what students should remember most in experiential global health education.
Our qualitative study revealed intriguing comparative results addressing core controversies in global health, such as who “does global health” and where one must be to “do global health”. Moving forward we hope this initial survey research will facilitate more genuinely collaborative agenda setting between North–South and East–West partners.
Child Family Health International.
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