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COVID-19: Are Africa’s diagnostic challenges blunting response effectiveness?
Get PDFSince its emergence in Wuhan, China in December 2019, novel Coronavirus disease - 2019 (COVID-19) has rapidly spread worldwide, achieving pandemic status on 11th March, 2020. As of 1st April 2020, COVID-19, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), had infected over 800,000 people and caused over 40,000 deaths in 205 countries and territories. COVID-19 has had its heaviest toll on Europe, United States and China. As of 1stof April 2020, the number of confirmed COVID-19 cases in Africa was relatively low, with the highest number registered by South Africa, which had reported 1,380 confirmed cases. On the same date (also the date of this review), Africa had reported 5,999 confirmed cases, of which 3,838 (almost 65%) occurred in South Africa, Algeria, Egypt, Morocco and Tunisia, with the remaining 2,071 cases distributed unevenly across the other African countries. We speculate that while African nations are currently experiencing much lower rates of COVID-19 relative to other continents, their significantly lower testing rates may grossly underestimate incidence rates. Failure to grasp the true picture may mean crucial windows of opportunity shut unutilized, while limited resources are not deployed to maximum effect. In the absence of extensive testing data, an overestimation of spread may lead to disproportionate measures being taken, causing avoidable strain on livelihoods and economies. Here, based on the African situation, we discuss COVID-19 diagnostic challenges and how they may blunt responses
Geographical accessibility in assessing bypassing behaviour for inpatient neonatal care, Bungoma County-Kenya
No full textNeonatal mortality rate in Kenya continues to be unacceptably high. In reducing newborn deaths, inequality in access to care and quality care have been identified as current barriers. Contributing to these barriers are the bypassing behaviour and geographical access which leads to delay in seeking newborn care. This study (i) measured geographical accessibility of inpatient newborn care, and (ii), characterized bypassing behaviour using the geographical accessibility of the inpatient newborn care seekers.The study is funded by the County Innovation Challenge Fund (CICF) grant number CICF-INN-R1-GA 004 to JG. The funder did not contribute to the design and decision to publish this protocol
Africa’s response to the COVID-19 pandemic: A review of the nature of the virus, impacts and implications for preparedness
No full textBackground: COVID-19 continues to wreak havoc in different countries across the world, claiming thousands of lives, increasing morbidity and disrupting lifestyles. The global scientific community is in urgent need of relevant evidence, to understand the challenges and knowledge gaps, as well as the opportunities to contain the spread of the virus. Considering the unique socio-economic, demographic, political, ecological and climatic contexts in Africa, the responses which may prove to be successful in other regions may not be appropriate on the continent. This paper aims to provide insight for scientists, policy makers and international agencies to contain the virus and to mitigate its impact at all levels.
Methods: The Affiliates of the African Academy of Sciences (AAS), came together to synthesize the current evidence, identify the challenges and opportunities to enhance the understanding of the disease. We assess the potential impact of this pandemic and the unique challenges of the disease on African nations. We examine the state of Africa’s preparedness and make recommendations for steps needed to win the war against this pandemic and combat potential resurgence.
Results: We identified gaps and opportunities among cross-cutting issues which is recommended to be addressed or harnessed in this pandemic. Factors such as the nature of the virus and the opportunities for drug targeting, point of care diagnostics, health surveillance systems, food security, mental health, xenophobia and gender-based violence, shelter for the homeless, water and sanitation, telecommunications challenges, domestic regional coordination and financing.
Conclusion: Based on our synthesis of the current evidence, while there are plans for preparedness in several African countries, there are significant limitations. Multi-sectoral efforts from the science, education, medical, technological, communication, business and industry sectors as well as local communities is required in order to win this fight
Family and provider perceptions of quality of care in the management of sick young infants in primary health care settings in four counties of Kenya.
No full textBackground Understanding the perceptions of quality of care given to sick young infants in primary health care settings is key for developing strategies for effective uptake and utilization of PSBI guidelines. The purpose of this study is to assess families’ and providers’ perceptions of care given to sick young infants at primary healthcare facilities in four diverse counties in Kenya.
Methods A cross-sectional qualitative design involving in-depth interviews (23) and focus group discussions (25) with very young (15-18 years), young (19-24 years) and older (25-45 years) caregivers of young infants 0-59 days; and key informant interviews with community- and facility-based frontline health providers (14) in primary health care facilities. Qualitative data were captured using audio tapes and field notes, transcribed, translated, and exported into QSR NVivo 12 for analysis. A thematic framework approach was adopted to classify and analyze data.
Results Perceived care given to SYIs was described around six domains of WHO’s framework for the quality of maternal and newborn health care: evidence-based practices for routine and emergency care; functional referral systems; effective communication; respect and preservation of dignity; availability of competent, motivated human resources; and availability of physical resources. Views of caregivers and providers regarding SYIs care at PHCs were similar across the four sites. Main hindrance to SYI care includes stockout of essential drugs, limited infrastructure, lack of functional referral system, inadequate providers which led to delays in receiving treatment, inadequate provider skills and poor provider attitudes. Despite these challenges, motivation and teamwork of health providers were key tenets in care provision.
Conclusion The findings underscore the need to prioritize improving quality of SYIs services at PHCs by building capacity of providers through training, ensuring continuous supply of essential medicines and equipment, improving infrastructure including referral.This work is part of a 3-year project funded by USAID on Scaling up PSBI Guidelines in Kenya through building confidence in the management of sepsis in young infants
Improve Supply Chains for Economic Recovery
No full textDuring this period of COVID – 2019 all industries that contribute to the country economic growth e.g manufacturing sector, agricultural sector, health sector is experiencing supply chain vulnerability. In the health sector for instance we have seen the government move swiftly to source for health care equipment e.g PPEs, Ventilators, testing reagents and testing apparatus. The horticulture industry has not been left behind since no much business is going on in our export countries such as Europe due to the lockdown to contain the spread of COVID – 19. Still there is no inter - county trading in Kenya because of partial lockdown as one of the major mitigating measures to contain the COVID – 19 in the country. This also has led to many job losses in the countr
A kinetic and mechanistic study of analogous bifunctional dialkylamine platinum(ii) complexes
No full textThis study was aimed at investigating the comparative substitution behaviour of analogous cis/trans-Pt(II) complexes with inert dialkylamine ligands. The rate of substitution of the aqua ligands by three nucleophiles, viz. thiourea (TU), 1,3-dimethylthiourea (DMTU) and 1,1,3,3-tetramethylthiourea (TMTU), for the complexes: [cis-Pt(OH2)2(NH3)2](ClO4)2 (cPt), [cis-Pt(OH2)2(NH2CH3)2](ClO4)2 (cPtM), [cis-Pt(OH2)2{NH2CH(CH3)2}2](ClO4)2 (cPtR), [trans-Pt(OH2)2(NH3)2](ClO4)2 (tPt), [trans-Pt(OH2)2(NH2CH3)2](ClO4)2 (tPtM) and [trans-Pt(OH2)2{NH2CH(CH3)2}2](ClO4)2 (tPtR) was investigated under pseudo first-order conditions as a function of concentration and temperature by stopped-flow and UV/visible spectrophotometry. The reactions of the cis-complexes proceed in two concerted steps whereas those of the trans-complexes followed a stepwise mechanism involving rate determining substitution of the first chloride followed by a fast second substitution step, with no intermediates being detected. The pseudo first-order rate constants, kobs obeyed the rate law: kobs = k2[nucleophile]. The trans-complexes were observed to be approximately 103 times more reactive than their corresponding cis-analogues. The electronic and the steric hindrance due to the geometries of the complexes controlled the overall reaction pattern. The order of reactivity of the complexes is tPt > tPtM > tPtR > cPt > cPtM > cPtR. The reactivity of the nucleophiles with the complexes decreases with an increase in steric demand in the order: TU > DMTU > TMTU. The trans-dialkylamine complexes formed distinctly different kinetic products relative to their cis-analogues. 195Pt NMR spectroscopic results confirmed the final kinetic products of each of the cis- and trans-complexes. The negative entropy of activation (ΔS≠) values in all the complexes investigated assert an associative substitution mechanism, with the mechanism being more pronounced in the cis-complexes than in their trans-analogues
Review of comparative studies of cytotoxic activities of Pt(II), Pd(II), Ru(II)/(III) and Au(III) complexes, their kinetics of ligand substitution reactions and DNA/BSA interactions
No full textNew concepts and various strategies are being explored to improve the cytotoxicity of metal-based complexes. One of those strategies is to fine-tune the substitution kinetics of metallo-drugs to limit competive substitution, and hence maximise delivery to the cellular targets, DNA or proteins. To date, it appears there is a missing link in understanding the correlation between kinetics of ligand substitution reactions, biomolecule interactions and their respective cytotoxicity. While there are a number of orginal and review articles reporting the kinetics of ligand substitution reaactions, DNA/BSA interactions and cytotoxicity of metal compelxes, independently, very few papers report these three studies simultaneously. In fact, there is no single review that has attempted to capture the link between kinetics of ligand subsititution reactions and biomolecule interactions on cytotoxicity of metal complexes. In this current review, we examine the correlations between the kinetics of ligand substitution reactions and DNA interactions, protein binding (BSA) and cytotoxicity activities of some Pt(II)/(IV), Pd(II), Ru(II)/Ru(III) and Au(III) metallo-based drugs reported in literature. While limited data is available, it is envisaged that this review shall in part motivate and stimulate more comparative studies
Evaluation of the ant-inflammatory and anti-nociceptive activities of methanolic stem bark extract of lochocarpus eriocaxylx (harms.)
No full textInflammation and pain are characteristic conditions of many diseases. These conditions range
From the mild known as acute to the severe one known as chronic. The management of the
Disorders related to pain and inflammation has been through the use of the conventional drugs
Such as the nsaids, corticosteroids and opioids. Even though they have successfully resulted
In the management of the conditions, they have not been devoid of side effects. Additionally,
They have been found to be inaccessible and unfordable to the majority of the population that
Lives below the economic levels. This has triggered the search of the alternatives from the
Natural sources such as plants, micro-organisms and minerals. Medicinal plants have gained
Favor among many people due to the low cost, high efficacy and lower side effects associated
With them Medicinal plants have as well reported to contain various phytochemicals that have
Various pharmacological properties such as anti-inflammatory and antinociceptive. The use of
Plants by man in the management of many ailment dates back many years long ago. Despite of
The many years of their usage and efficacy very little information is available that support their
Therapeutic value scientifically. Lochocarpus eriocaxylx has been used traditionally in the
Management of various diseases such as. However, its analgesic and anti-inflammatory activity
Of the stem bark remains unexplored. In this study the analgesic and anti-inflammatory activity
Of the methanolic stem bark extract of Lochocarpus eriocaxylx was investigated. The analgesic
Activity was assessed by the acetic acid writhing test while the anti-inflammatory activity was
Evaluated using the xylene induced ear edema in the swiss albino mice. Etanercept was used
As the positive analgesic and anti-inflammatory drug. The analgesic activity results showed that
The positive control recorded significantly higher inhibition of the writhing in the swiss albino
Mic as compared to the methanolic stem bark extract of the Lochocarpus eriocaxylx at all doses
(p<0.05). However, the administration of the methanolic stem extract of Lochocarpus
Eriocaxylx reduced the effects of the acetic acid in the swiss albino mice in a dose dependent
Manner. The higher dose and the lower dose recorded significantly higher and lower writhe
Inhibition respectively (p<0.05). The anti-inflammatory results showed that the administration
Of the methanolic stem bark extract of Lochocarpus eriocaxylx inhibited the effects of the
Xylene by significantly reducing the formation of edema on the left ear. However, etanercept,
The positive control drug significantly inhibited the formation of edema more as compared to
All the other groups (p<0.05). In conclusion, the stem bark of Lochocarpus eriocaxylx can be a
Potential source of natural analgesic and anti-inflammatory agent that is characterized by
Reduced side effects and with the ability to inhibit the tumor necrosis factor
Antibodies against a short region of PfRipr inhibit Plasmodium falciparum merozoite invasion and PfRipr interaction with Rh5 and SEMA7A
No full textPlasmodium falciparum merozoite invasion into erythrocytes is an essential step of the blood-stage cycle, survival of parasites, and malaria pathogenesis. P. falciparum merozoite Rh5 interacting protein (PfRipr) forms a complex with Rh5 and CyRPA in sequential molecular events leading to erythrocyte invasion. Recently we described PfRipr as a conserved protein that induces strain-transcending growth inhibitory antibodies in in vitro assays. However, being a large and complex protein of 1086 amino acids (aa) with 87 cysteine residues, PfRipr is difficult to express in conventional expression systems towards vaccine development. In this study we sought to identify the most potent region of PfRipr that could be developed to overcome difficulties related to protein expression, as well as to elucidate the invasion inhibitory mechanism of anti-PfRipr antibodies. Using the wheat germ cell-free system, Ecto- PfRipr and truncates of approximately 200 aa were expressed as soluble proteins. We demonstrate that antibodies against PfRipr truncate 5 (PfRipr_5: C720-D934), a region within the PfRipr C-terminal EGF-like domains, potently inhibit merozoite invasion. Furthermore, the antibodies strongly block PfRipr/Rh5 interaction, as well as that between PfRipr and its erythrocyte-surface receptor, SEMA7A. Taken together, PfRipr_5 is a potential candidate for further development as a blood-stage malaria vaccine
Computer-Supported Collaborative Learning and Assessment: A Strategy for Developing Online Learning Communities in Continuing Education
No full textThis chapter focuses on re-interpreting the findings of a recent study based on collaborative learning perspectives. The study utilized a case study design in which two online postgraduate courses were investigated as a collective case study. Online observations, analysis of the archived course content and interview transcripts were used as data collection techniques. The data from multiple sources were triangulated. Qualitative techniques were used in data analysis and descriptive statistics were integrated to extend the meaning of qualitative data. The findings of the study suggest that social interactivity is pivotal to facilitating meaningful learning in formal online education. The findings further illustrate that development of productive communities in continuing (in-service) education is a gradual process that evolves through four stages starting from community of interest to community of practic