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An outbreak of suspected cutaneous leishmaniasis in Ghana: lessons learnt and preparation for future outbreaks  [cached]
Margaret A. Kweku,Shirley Odoom,Naiki Puplampu,Kwame Desewu
Global Health Action , 2011, DOI: 10.3402/gha.v4i0.5527
Abstract: Human cutaneous leishmaniasis (CL) has previously been reported in West Africa, but more recently, sporadic reports of CL have increased. Leishmania major has been identified from Mauritania, Senegal, Mali, and Burkina Faso. Three zymodemes (MON-26, MON-117, and MON-74, the most frequent) have been found. The geographic range of leishmaniasis is limited by the sand fly vector, its feeding preferences, and its capacity to support internal development of specific species of Leishmania. The risk of acquiring CL has been reported to increase considerably with human activity and epidemics of CL have been associated with deforestation, road construction, wars, or other activities where humans intrude the habitat of the vector. In the Ho Municipality in the Volta Region of Ghana, a localised outbreak of skin ulcers, possibly CL, was noted in 2003 without any such documented activity. This outbreak was consistent with CL as evidenced using various methods including parasite identification, albeit, in a small number of patients with ulcers.This paper reports the outbreak in Ghana. The report does not address a single planned study but rather a compilation of data from a number of ad-hoc investigations in response to the outbreak plus observations and findings made by the authors. It acknowledges that a number of the observations need to be further clarified. What is the detailed epidemiology of the disease? What sparked the epidemic? Can it happen again? What was the causative agent of the disease, L. major or some other Leishmania spp.? What were the main vectors and animal reservoirs? What are the consequences for surveillance of the disease and the prevention of its reoccurrence when the communities see a self-healing disease and may not think it is important?
Diagnosis of tuberculosis in Ghana: The role of laboratory training
KK Addo, D Yeboah-Manu, M Dan-Dzide, K Owusu-darko, P Caulley, GI Mensah, M Minamikawa, C Lienhardt, FA Bonsu, D Ofori-Adjei
Ghana Medical Journal , 2010,
Abstract: Objectives: The laboratory is considered the cornerstone of tuberculosis (TB) control programme. International review of Ghana’s programme in the late nineties identified the laboratory services as the weakest component. Sputum smear microscopy (SSM) being the main method of diagnosing pulmonary TB in Ghana, the training objectives were to: (i) strengthen the knowledge and skills of laboratory personnel on SSM (ii) impart necessary techniques in biosafety and (iii) introduce a Quality Assurance (QA) system in order to strengthen SSM services. Methods: Personnel were selected for training during a nationwide situation analysis of SSM centres in 2000/2001. Four training sessions on SSM/QA were held between 2001/2004. Results: A total of 80 personnel were trained: 10 regional TB coordinators and 70 laboratory personnel. The participants upon return to their respective regions also organized training within their districts. This approach resulted in another 100 district TB coordinators and 200 laboratory personnel being trained. Improvement in smear preparation, staining and reading ability of the participants were observed during the post-test and subsequent visit to their respective laboratories. The training has led to strengthening of TB laboratory services in the country and has contributed to increase in case detection from 10,745 in 2000 to 11,827 in 2004 and 14,022 in 2008. It was observed during the post-training follow-up and quarterly supervision visits that morale of the personnel was high. Conclusion: Continuous training and re-training of laboratory personnel on SSM and QA at regular intervals do play an important role for effective and efficient TB control programme.
Implementation of the Active TB Case Finding in Nigeria; Processes, Lessons Learnt and Recommendations  [PDF]
Oluremilekun Comfort Kusimo, Richard Olukolade, Queen Ogbuji, John Osho, Adeyinka Onikan, Abiodun Hassan, Oladapo Alabi Ladipo, Oladipo Owoyomi, Joseph Bakare, Simeon Onyemaechi, Adebola Lawanson
Journal of Tuberculosis Research (JTR) , 2018, DOI: 10.4236/jtr.2018.61002
Abstract: Introduction: Tuberculosis remains a major public health issue in Nigeria with the country ranking seventh among the 30 high TB burden countries. Nigeria is among the three countries that account for half of the 4.3 million “missing” TB cases globally. One untreated TB case is able to infect about 10 - 20 people annually. Hence, it is pertinent that TB is controlled effectively through the use of active case finding strategies to find the missing TB cases. Objective: This article highlights the best practices and key lessons learnt during the implementation of the active house to house TB case finding strategy in Nigeria. Lessons Learnt and Recommendations: Strategic community engagement, massive awareness creation using mass media and local means of communication, mapping of locations where registered TB cases live, to inform home visits for contact tracing and strengthening of laboratory systems, are viable mechanisms to improve TB case finding. Conclusion: Active TB case finding interventions should be implemented in the context of a strengthened diagnostics system, strategic community engagement and media involvement.
Molecular Diagnostics for Lassa Fever at Irrua Specialist Teaching Hospital, Nigeria: Lessons Learnt from Two Years of Laboratory Operation  [PDF]
Danny A. Asogun equal contributor ,Donatus I. Adomeh equal contributor,Jacqueline Ehimuan equal contributor,Ikponmwonsa Odia equal contributor,Meike Hass,Martin Gabriel,Stephan ?lschl?ger,Beate Becker-Ziaja,Onikepe Folarin,Eric Phelan,Philomena E. Ehiane,Veritas E. Ifeh,Eghosasere A. Uyigue,Yemisi T. Oladapo,Ekene B. Muoebonam,Osagie Osunde,Andrew Dongo,Peter O. Okokhere,Sylvanus A. Okogbenin,Mojeed Momoh,Sylvester O. Alikah,Odigie C. Akhuemokhan,Peter Imomeh,Maxy A. C. Odike,Stephen Gire,Kristian Andersen,Pardis C. Sabeti,Christian T. Happi,George O. Akpede,Stephan Günther
PLOS Neglected Tropical Diseases , 2012, DOI: 10.1371/journal.pntd.0001839
Abstract: Background Lassa fever is a viral hemorrhagic fever endemic in West Africa. However, none of the hospitals in the endemic areas of Nigeria has the capacity to perform Lassa virus diagnostics. Case identification and management solely relies on non-specific clinical criteria. The Irrua Specialist Teaching Hospital (ISTH) in the central senatorial district of Edo State struggled with this challenge for many years. Methodology/Principal Findings A laboratory for molecular diagnosis of Lassa fever, complying with basic standards of diagnostic PCR facilities, was established at ISTH in 2008. During 2009 through 2010, samples of 1,650 suspected cases were processed, of which 198 (12%) tested positive by Lassa virus RT-PCR. No remarkable demographic differences were observed between PCR-positive and negative patients. The case fatality rate for Lassa fever was 31%. Nearly two thirds of confirmed cases attended the emergency departments of ISTH. The time window for therapeutic intervention was extremely short, as 50% of the fatal cases died within 2 days of hospitalization—often before ribavirin treatment could be commenced. Fatal Lassa fever cases were older (p = 0.005), had lower body temperature (p<0.0001), and had higher creatinine (p<0.0001) and blood urea levels (p<0.0001) than survivors. Lassa fever incidence in the hospital followed a seasonal pattern with a peak between November and March. Lassa virus sequences obtained from the patients originating from Edo State formed—within lineage II—a separate clade that could be further subdivided into three clusters. Conclusions/Significance Lassa fever case management was improved at a tertiary health institution in Nigeria through establishment of a laboratory for routine diagnostics of Lassa virus. Data collected in two years of operation demonstrate that Lassa fever is a serious public health problem in Edo State and reveal new insights into the disease in hospitalized patients.
The management of a coronary cameral fistula: lessons learnt
GT Mokgwathi
Southern African Journal of Anaesthesia and Analgesia , 2012,
Abstract: Coronary arteriovenous fistula (CAVF) is a rare congenital anomaly. Literature on CAVF perioperative anaesthetic management is limited, but the consequences of mismanaging symptomatic CAVF are dire, with the potential risk of perioperative myocardial infarction, and even death. We present a 48-year-old male with symptomatic congenital coronary cameral fistulae, who underwent a successful surgical repair of the fistulae. This case study describes this very rare phenomenon, and its perioperative anaesthetic management, including the lessons learnt.
Sweetpotato selection releases: Lessons learnt from Uganda
ROM Mwanga, B Odongo, C Niringiye, R Kapinga, S Tumwegamire, PE Abidin, EE Carey, B Lemaga, J Nsumba, D Zhang
African Crop Science Journal , 2007,
Abstract: The National Sweetpotato Programme of the National Agricultural Research Organisation (NARO) in Uganda released 14 sweetpotato cultivars between 1994 and 2005. Of the released cultivars, six have gained importance in local Ugandan markets and in export trade to Europe and two are being used as parental sources for high dry matter (>30%), sweetpotato virus disease (SPVD) and nematode resistance in hybridization schemes, and in the genetic mapping work in joint international collaborative research. Two orange-fleshed sweetpotato (OFSP) cultivars, namely, Ejumula, and SPK004 (Kakamega), high in beta-carotene (the precursor for vitamin A) are spreading rapidly for combating widespread vitamin A deficiency in Uganda. The major steps leading to the release of Kakemega and Ejumula are used to illustrate the experience of the Ugandan sweetpotato breeding programme sustained activities for a decade, and lessons learnt are highlighted. The sustained breeding activities have led to a vibrant and robust program, increased international and south to south collaboration, increased partnership and alliances; shifted research focus from production to production per se and quality (nutrition), resulting into significant and relevant agricultural research. The lesson here is that it takes a long time to develop technologies, disseminate and commercialize them. It also requires commitment by the donor, government, scientists, farmers and other stakeholders for effective commercialization of the developed technologies.
A generic system for critiquing physicians' prescriptions: usability, satisfaction and lessons learnt  [PDF]
Jean-Baptiste Lamy,Vahid Ebrahiminia,Brigitte Seroussi,Jacques Bouaud,Christian Simon,Madeleine Favre,Hector Falcoff,Alain Venot
Computer Science , 2013,
Abstract: Clinical decision support systems have been developed to help physicians to take clinical guidelines into account during consultations. The ASTI critiquing module is one such systems; it provides the physician with automatic criticisms when a drug prescription does not follow the guidelines. It was initially developed for hypertension and type 2 diabetes, but is designed to be generic enough for application to all chronic diseases. We present here the results of usability and satisfaction evaluations for the ASTI critiquing module, obtained with GPs for a newly implemented guideline concerning dyslipaemia, and we discuss the lessons learnt and the difficulties encountered when building a generic DSS for critiquing physicians' prescriptions.
Macroseismology: the lessons learnt from the 1997/98 Colfiorito seismic sequence  [cached]
R. Camassi,R. Azzaro,A. Tertulliani
Annals of Geophysics , 2008, DOI: 10.4401/ag-4453
Abstract: The seismic sequence of the Umbria-Marche Apennines was a dramatic moment for the population involved; at the same time, it provided a unique occasion for the Italian scientific community and for the national civil protection to assess their respective abilities in understanding and managing the event. Furthermore, macroseismology (including historical seismology) has knowingly confronted important methodological problems, such as the procedures for assigning macroseismic intensity, the use of the macroseismic scale, the impossibility of distinguishing the effects of earthquakes following closely in both space and time, within such a complex sequence. Starting from the analysis of the problems that were faced after the 1997/98 Umbria- Marche earthquakes, as during the following seismic crises over the last 10 years, we propose some considerations on the lessons we have learnt from that seismic sequence.
Practical experiences of, and lessons learnt from, Internet technologies in higher education
Stephen Shaw,Simon Polovina
Educational Technology & Society , 1999,
Abstract: The paper addresses how the Internet as computer-mediated communication is affecting teaching and learning in higher education institutions, particularly as these institutions face increasing competition due to the emergence of Web-based collaboration and assessment technologies. London s South Bank University (SBU), a typical modern-day higher education institution is thereby in the process of integrating Internet technologies into its conventional and distance learning programmes. From its practical experiences so far SBU has learnt a variety of valuable lessons. In particular the technical and social aspects that determine the choice and use of the most appropriate software tools were identified, as well as a new approach towards online (Internet / Web) subject reference sources was outlined. From SBU s anecdotal experiences, useful recommendations are made for the effective use of Internet technologies that applies to many higher educational institutions.
The Development of Computational Biology in South Africa: Successes Achieved and Lessons Learnt  [PDF]
Nicola J. Mulder?,Alan Christoffels?,Tulio de Oliveira?,Junaid Gamieldien?,Scott Hazelhurst?,Fourie Joubert?,Judit Kumuthini?,Ché S. Pillay?,Jacky L. Snoep?,?zlem Tastan Bishop
PLOS Computational Biology , 2016, DOI: 10.1371/journal.pcbi.1004395
Abstract: Bioinformatics is now a critical skill in many research and commercial environments as biological data are increasing in both size and complexity. South African researchers recognized this need in the mid-1990s and responded by working with the government as well as international bodies to develop initiatives to build bioinformatics capacity in the country. Significant injections of support from these bodies provided a springboard for the establishment of computational biology units at multiple universities throughout the country, which took on teaching, basic research and support roles. Several challenges were encountered, for example with unreliability of funding, lack of skills, and lack of infrastructure. However, the bioinformatics community worked together to overcome these, and South Africa is now arguably the leading country in bioinformatics on the African continent. Here we discuss how the discipline developed in the country, highlighting the challenges, successes, and lessons learnt.
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