Erratic Supply Research Articles

Frozen landscapes: climate-adaptive design interventions in Ladakh and Zanskar

During the course of the past three decades, a number of subsistence agricultural villages in the Himalayan mountain range have witnessed ever-shrinking glaciers and an increasingly erratic supply of glacial meltwater. Having relied on these relatively stable reserves for crop irrigation for centuries, today’s high-Himalayan farmers must now contend with irregular weather patterns and events, such as drought, mudslides and cloudbursts. In the face of this shifting landscape, many farming villages have responded by altering long-standing agricultural practices in an effort to adapt to a changing climate. In this context, the incorporation of frozen landscape infrastructures can help to control the flow of surface meltwater, direct valuable water resources and stockpile irrigation reserves in the form of ice and snow. This article describes three types of frozen landscape design interventions currently employed in northern India: artificial glaciers, ice stupas and snow barrier bands. Although these constructs have been designed by engineers rather than landscape architects, they contribute to a larger body of climate-adaptive design solutions that suggest a way forward in the face of the unstable environmental pressures of the future. As landscape architects and designers look for opportunities to intervene in the climate crisis, the nascent frozen landscapes of northern India present ideas for climate change adaptive design work to build upon.

Erratic electricity supply (Dumsor) and anxiety disorders among university students in Ghana: a cross sectional study.

BackgroundGhana is currently experiencing electricity supply crisis that is believed to have some impact on the mental wellbeing of the population, especially among university students that have become increasingly dependent on uninterrupted electricity supply to fully function academically. There is no known study that explores the link between infrequent electricity supply and generalized anxiety disorders in sub-Saharan Africa. This study aimed to explore that link and determine the proportion of university students whose anxiety levels may be influenced by the electricity supply crisis that the country is experiencing at the moment.MethodsThis exploratory study used the Generalized Anxiety Disorder 7-item scale (GAD-7) to conduct the study on the University of Ghana campus. The likelihood ratio (LR) test and Fisher’s Exact tests were used to determine any association between the electricity supply crisis and anxiety levels among students. Unadjusted odds ratio and corresponding confidence intervals were estimated and ordinal logistic regression technique was used for the effect of covariates on anxiety.ResultsOverall, nearly 26 % of students interviewed felt nervous, anxious or on edge almost every day due to the erratic power supply. The proportion of students determined to be classified having minimal, mild, moderate and severe anxiety due to the erratic power supply was 24.2, 30.7, 22.1 and 23.1 % respectively. Students were significantly more likely to be anxious if the frequency of power outage increased (OR 1.36; CI 1.23–1.49).ConclusionsOur finding in this study suggests that although the erratic power supply does not allude to any clinical confirmation of the students having anxiety disorders, it does point to a fact that even in a resource-poor country like Ghana, where constant supply of electricity is not always guaranteed, students may not be entirely immune to the health and well-being implications of failures in some sectors of the economy such as power supply.

Rooftop Rainwater Harvesting as an Alternative Domestic Water Resource in Zambia

Within the last decade, substantial progress has been achieved in the management of centralized water reticulation in Zambia. Characterized by diversified fiscal resourcing, concurrent institutional restructuring and introduction of new players in water governance, the water sector is set to achieve improved reliability on sustainable grounds. However, the threat of underground water pollution resulting from increased urbanization besides the unreliable energy sector presents new challenges for the current urban water. In effect, urban areas are affected by chronic water rationing creating public stress and insecurity which impacts domestic development. While the course of development has meant investment in the extension and expansion of water infrastructure in Zambia, alternative urban water resources are being sought to address challenges of traditional water systems globally. This paper therefore attempts to make a case for the modernization of Rooftop Rainwater Harvesting (RRWH) as an augmenting water resource in the Zambian urban housing sector. Here—in, it is identified as a Low Impact Development technology within the Integrated Urban Water Management framework currently being forged by local water. Based on a desktop literature survey and online questionnaire survey, an argument to support the development of RRWH in Zambia was developed. While literature survey results revealed evidence of economic loss and a growing compromise to public health resulting from inconsistent water supply in the study area of Lusaka city, the online questionnaire survey depicted significant domestic stress due to erratic water supply. Results confirmed that at one time residents observed an average of eight hours of power blackouts which effectively induced water disruption forcing homeowners to engage in various water storage methods which in turn are costly on domestic time, health and finances. A retrospective discussion based on both survey results attempts to present benefits and opportunities of urban RRWH to water sector stakeholders providing recommendations towards the mainstreaming of the practice in Zambia.

Perception of Youth in Selected Tertiary Institutions on Agricultural Education as a Means of Ensuring Food Security in Ogun State, Nigeria

Agriculture is central to improving food and nutrition security of any nation while this could be achieved through a better agricultural education and enlightenment of the youth. Thus, this study was carried out to assess perception of youth in Tertiary Institutions on Agricultural Education as a means of ensuring food security in Ogun State, Nigeria. Two hundred and fifty respondents were randomly selected as sample size for this study. Data collected were analyzed with descriptive statistics and chi-square. Results of the study showed that majority of the respondents were males (51.20%) with a mean age of 24.70 years and had a keen interest in acquiring knowledge and skills in Agriculture (71.20%). Furthermore, the results revealed that Agricultural Extension (100%), Crop Production and Protection (90.40%), Livestock Production (88.00%), Fishery and Aquaculture (87.20%), and Agricultural Economics (80.80%) were major scopes of Agricultural Education through which knowledge and skills were imparted on the Agricultural Students. However, effective Agricultural Education was hindered by inadequate resource personnel (71.20%), erratic electricity supply (66.40%), and poor financing of Agricultural Education (64.80%). Results of the study further indicated that a significant association existed between the scopes of agricultural education and perception of the respondents on agricultural education as a means of ensuring food security in the study area (χ2 = 8.98, df = 1). This study concluded that Agricultural Education contributed to skill acquisition in food production and nutritional security. Effective teaching and learning process should be supported by recruiting more resourceful personnel and providing essential Agricultural instructional materials to the institutions.

The Implications of Centre-local Relations on Service Delivery in Local Authorities in Zimbabwe: The Case of Chitungwiza

The area of centre-local relations in local government is a contemporary and topical debate in Zimbabwe. It was on this background that the research on centre-local relations was undertaken with a view to assessing the implications of service delivery in Chitungwiza Municipality (CM). The views of different authorities on centre-local relations were reviewed to further analyse the implications of centre-local relations on service delivery in municipalities. The study triangulated different data collection methods such as key informant interviews, documentary search, in-depth interviews, observation and survey to obtain detailed data on the state of centre-local relations and its implications on service delivery in CM. The findings of the study revealed that centre-local relations between the Ministry of Local Government and the CM are highly centralised. The parent ministry retains overall powers and control over the municipality. The Minister who is supposed to play a strategic role in policy formulation and implementation is involved in the day to day running of the municipality leaving little room for elected councillors and residents in general to determine their own destiny. It has been established that centre-local relations that are supposed to foster independence and autonomy of the municipality has turned into a master-subordinate relationship that has negatively affected service delivery. The study concluded that hyper-centralised governance relations are hindering effective service delivery in the municipality. This has been evidenced by erratic water supply, potholed roads, poor refuse collection and bursting of sewer pipes. The study recommends that the central government through the Ministry of Local Government must grant the municipality more autonomy as a measure of improving service delivery.

Implementation of the integrated management of childhood illness with parasitological diagnosis of malaria in rural Ghana: health worker perceptions

BackgroundTimely and appropriate management of febrile illness among children under five years of age will contribute to achieving Millennium Development Goal-4. The revised World Health Organization-Global Malaria Programme’s policy on test-based management of malaria must integrate effectively into the Integrated Management of Childhood Illness (IMCI). This study reports on perceptions of health workers on the health system factors influencing effective delivery of test-based diagnosis of malaria with IMCI.MethodsA qualitative study was conducted among a range of health workers at different levels of the health system in the Brong Ahafo Region of Ghana. Interview transcripts were transferred into Nvivo 8 software for data management and analysis. A frame-work approach at two levels was used in the analysis, which included the processes required for implementation of test-based management of malaria and the health systems context.ResultsForty-nine in-depth interviews were conducted. The National Health Insurance Scheme (NHIS) was perceived to have led to an increase in health facility attendance, thereby increasing the workload of health workers. Workload was reported as the main reason that health workers were not able to complete all of the examinations included in the IMCI algorithm. The NHIS financing guidelines were seen to be determining diagnosis and treatment practices by health-care givers. Concern was expressed about the erratic supply of malaria rapid diagnostic test kits (RDTs), the quality of RDTs related to potential false negative results when clinical symptoms were consistent with malaria. IMCI was seen as important but practically impossible to fully implement due to workload.ConclusionsImplementation of the WHO-revised IMCI guideline is confronted with a myriad of health systems challenges. The perceptions of front-line health workers on the accuracy and need for RDTs together with the capacity of health systems to support implementation plays a crucial role. The NHIS financing guidelines of diagnostics and treatments are influencing clinical decision-making in this setting. Further study is needed to understand the impact of the NHIS on the feasibility of integrating test-based management for malaria into the IMCI guidelines.

AB0456 Combination Leflunomide and Methotreaxate in Refractory RA: A Biologic-Sparing Approach

BackgroundIn resource-constrained settings where biologic agents are not widely available, there are limited therapeutic option for patients with rheumatoid arthritis (RA) refractory to triple disease modifying antirheumatic (DMARD) combination therapyObjectivesTo...

Tuberculosis in tropical areas and immigrants.

About 95% of cases and 98% of deaths due to tuberculosis (TB) occur in tropical countries while, in temperate low incidence countries, a disproportionate portion of TB cases is diagnosed in immigrants.Urbanization, poverty, poor housing conditions and ventilation, poor nutritional status, low education level, the HIV co-epidemic, the growing impact of chronic conditions such as diabetes are the main determinants of the current TB epidemiology in tropical areas. TB care in these contests is complicated by several barriers such as geographical accessibility, educational, cultural, sociopsychological and gender issues. High quality microbiological and radiological facilities are not widely available, and erratic supply of anti-TB drugs may affect tropical areas from time to time. Nevertheless in recent years, TB control programs reached major achievements in tropical countries as demonstrated by several indicators.Migrants have a high risk of acquire TB before migration. Moreover, after migration, they are exposed to additional risk factors for acquiring or reactivating TB infection, such as poverty, stressful living conditions, social inequalities, overcrowded housing, malnutrition, substance abuse, and limited access to health care. TB mass screening programs for migrants have been implemented in low endemic countries but present several limitations. Screening programs should not represent a stand-alone intervention, but a component of a wider approach integrated with other healthcare activities to ensure the health of migrants.

ON DEMAND WATER SUPPLY AND WATER USE EFFICIENCY THROUGH BURRIED PIPE SYSTEM- A CASE STUDY

Land and water are the two basic needs of agricultural and economic development of any country. According to FAO, about 60 percent of water supplied in surface irrigation course goes unused. Majority of irrigation projects undertaken worldwide indicated that generally low irrigation efficiencies. The main component of water losses in irrigation system may be attributed to water losses in storage, losses in conveyance system, losses in operations and losses in application. Indiscriminate use of water indirectly affects the normal growth and yield of the crop. To strengthen the sustainable agriculture in Karnataka, tank irrigation system was established centuries ago. During the past few decades, due to erratic rainfall and distribution pattern during kharif, the tank filling status was not consistent and probability of available water for irrigation purposes was also not certain. In order to minimize the losses in conveyance of water from the source to the target site, the buried pipe Distributary systems have been designed and developed, which is the first of its kind for tank command irrigation with the adoption of solar pump to lift water from the jack well in order to reduce the dependence on the erratic electric supply at village level. The effect of on-demand water supply on different crops yield during Kharif and rabi/summer 2003 to 2008 indicated that there was a significant change in the yield of crops and cropping pattern in command area due to intervention of on demand water supply.

Detection of mutations associated with resistance to rifampicin and isoniazid in <italic>Mycobacterium tuberculosis</italic> by polymerase chain reaction-ligase detection reaction

Mycobacterium tuberculosis (MTB) infection remains a serious infectious disease worldwide, causing 8.8 million new infections and 1.45 million deaths in 2010 [1]. The emergence of drug-resistant strains of MTB poses a significant threat to the control of the disease globally. Multidrugresistant MTB (MDR-TB), defined as being resistant to at least rifampicin (RMP) and isoniazid (INH), and extensively drug-resistant TB (XDR-TB), defined as being additionally resistant to any fluoroquinolone and one injectable secondline drug, are associated with higher treatment failure rates. China is the second largest nation in terms of the number of the MTB infection, and 9.3% of the cases are MDR-TB [2]. MDR-TB arises from spontaneous chromosomal mutations at low frequency, but clinical MDR-TB largely occurs as a result of man-made selection during disease treatment of these genetic alterations through erratic drug supply, suboptimal physician prescription, and poor patient adherence [3]. S315T/M mutation in katG and mutations in the promoter region of inhA operon are the main mechanisms of INH resistance [4,5]. Mutations at positions 516, 526, and 531 in rpoB are the most frequent mutations in RMP-resistant MTB strains [6]. Since the transmission of the selected MDR-TB strains causes a large number of MDR-TB cases [7,8], the need for rapid, reliable, and cost-effective drug susceptibility testing (DST) is urgent. Polymerase chain reaction (PCR) followed by ligase detection reaction (LDR) method has been widely used to detect various single nucleotide polymorphisms and drug-resistant mutations with high sensitivity and low cost [9–12]. In the present study, we established a PCR-LDR assay for the simultaneous detection of the mutations related to MDR-TB, and evaluated its performance using isolates and clinical samples. Here, a total of 120 MTB isolates obtained from pulmonary TB patients at The Third Hospital of Changzhou, during July, 2011 and March, 2012 were collected and subjected to DST for RMP and INH in the BACTEC MGIT 960 instrument with medium, and DST supplement (Becton Dickinson and Company, Sparks, USA) as recommended by the manufacturer. All the 120 MTB isolates were detected by phenotypic DST, PCR-LDR, and DNA sequencing. The specific primers and probes (Supplementary Tables S1 and S2) for both wild type and mutant type targeting codon 315 of the katG gene, codon 15 of the inhA promoter region, codons 516, 526, and 531 of rpoB. All the primers and probes were synthesized by Invitrogen (Shanghai, China). Genome DNA of MTB was extracted by a commercial kit (Fosun Diagnostics, Shanghai, China) according to manufacturer’s instruction. All isolates were detected by both the PCR-LDR assay and sequencing. The multiplex PCR-LDR method was the same as described in previous studies [11,12]. The amplifications and LDR were performed in a PE 9600 thermal cycler (Life Technology, Foster City, USA). The LDR products were electrophoresed on an ABI 377 DNA Sequencer (Life Technology) for 30 min. Results were analyzed using the GeneMapper software (Life Technology). Meanwhile, the PCR products of rpoB and inhA promoter region were purified and sequenced by Life Technology. The results of phenotypic DST, PCR-LDR, and DNA sequencing were summarized in Table 1. Phenotypic DST of MTB isolates indicated that 26 (21.7%) at low level (1 mg/ ml) and 11 (9.2%) at high level (10 mg/ml) resistance to INH, while 17 (14.2%) at low-level and 9 (7.5%) at highlevel resistance to RMP. Among them, 13 (10.8%) were resistant to both INH and RMP at low level, or MDR. PCR-LDR assays for the detection of MDR-TB were carried out on 120 isolates. The S315M in katG was detected in 16 (13.3%) of 120 isolates. No S315T mutation in katG and G15T mutation in the promoter region of inhAwas detected. The D516V/G, H526Y/D, S531/L/W mutations in rpoB were detected in 1 (0.8%), 3 (2.5%), and 8 (6.7%) of 120 isolates, respectively. The typical results of PCR-LDR were shown in Fig. 1 and Supplementary Fig. S1. Acta Biochim Biophys Sin 2014, 46: 78–81 |a The Author 2013. Published by ABBS Editorial Office in association with Oxford University Press on behalf of the Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences. DOI: 10.1093/abbs/gmt119. Advance Access Publication 11 November 2013

Serving Nigerian Law Students: E-readiness and Utilization of University E-Information Facilities

During the last few years Nigeria invested substantially in their ICT infrastructure. Nigerian university libraries have acknowledged the need for the introduction of ICTs and e-resources for information retrieval. For a law faculty to exist a law library with e-resources is a requirement. The study aimed to determine the current position concerning the ability of the university and academic law libraries to provide access to ICTs and e-resources as part of their information service delivery. A secondary aim was to determine the e-readiness of the law students to search, retrieve and utilize eresources. Twelve universities offering law were targeted. Interviews were held with the librarians from both the university and law libraries and student opinions were sought through questionnaires and observation. One thousand two hundred and sixty students responded to the questionnaires. Observations of the available ICT facilities were also made. It was found that ICTs are available, but that the infrastructure is insufficient in most of the libraries. It was found that the university libraries were better resourced with ICTs than the academic law libraries. E-resources were also available in some of the law libraries, but not in all. Inaccessibility to ICTs was a major challenge. Many other challenges were identified impacting on service delivery and information seeking. Students were mostly e-ready but lacked general awareness of and easy access to e-resources. It was recommended that all law libraries improve on their ICT facilities and provision of e-resources. Also that the university managers actively search for ways to minimize disruptions such as erratic power supplies, low bandwidth, lack of computers, and payment of fees for Internet access.

HIV Prevention, Treatment, and Care for People Who Inject Drugs

HIV Prevention, Treatment, and Care for People Who Inject Drugs

Physico-chemical and Escherichia coli assessment of selected sachet water produced in some areas of Minna, Niger State, Nigeria

Access to good quality drinking water in Minna and, indeed, other parts of Niger State is one of the biggest challenges to many households which have, for years, depended on other sources of water to augment the erratic supply made by the government. In an effort to ensure adequate supply, packaged water has been introduced to provide safe, hygienic and affordable drinking water. However, trends have implicated some packaged water as agents of disease transmission. In this work, the physicochemical and coliform analyses of selected packaged water, otherwise called “pure water” were carried out. Ten brands were collected from the packaging factories (5 samples per brand) and were analysed weekly for four weeks. Results obtained were compared with WHO and EPA standards for drinking and recreational water. Their pH values, except for Sabo Best (6.26 ± 0.02), were within the stated WHO/EPA standards (6.50 - 8.50). The coliform levels of FUTMin (75.00 ± 2.00), Happy Days (75.00 ± 2.00) and Carry More (23.33 ± 0.33), based on the most probable number (MPN), were unfit for potability since they could also contain other microorganisms implicated in gastro-intestinal water borne diseases. The respective 1.63 ± 0.10 and 1.54 ± 0.10 mg/dm3 for Evershine and Supreme waters were above the 0.3 mg/dm3 iron standard just as the respective copper and nitrate values of 1.19 ± 0.14, 1.27 ± 0.10, 1.48 ± 0.10 and 86.81 ± 0.62, 124.47 ± 1.36, 141.70 ± 0.00 mg/dm3 for Golden Age, Supreme and Sabo Best were higher than the respective 1 and 50 mg/dm3 standards for copper and nitrates. All other parameters were within the EPA and WHO values. Key words: Packaged water, coliform, Escherichia coli, most probable number (MPN), potability, gastro-intestinal.

Adopting environment responsive strategies for existing buildings: a prescriptive study

Buildings around the world are known to be highly energy intensive through their life cycle consuming about 40% of the world’s primary energy supply. This is especially true for hospitality buildings, since they cannot compromise on the comfort conditions for the guests and have to ensure 24 h continuous energy and water supply. In urban areas, particularly with high-end tourist facilities, energy effi ciency measures are widely used. However, in case of remote natural areas with erratic supply of grid electricity, use of fossil fuels for backup power supply is common. Energy effi ciency measures are rare when the facility caters to budget tourists. In such cases, it is important to adopt environment-sensitive measures for the buildings so that their negative impact on nature and surrounding environment can be minimized. This paper discusses some of the strategies that can be easily integrated with existing buildings and also evaluates their economic feasibility for successful adoption. The case studies selected are typical two tourist lodges located in the coastal belt of West Bengal in India, popular for its beach tourism. Data collected on their energy and water consumption pattern have been recorded and case-specifi c adoption and integration of environmentally appropriate measures into the existing building forms have been identifi ed. While further evaluation of these has shown favorable environmental impact, the cost payback analysis had different results to share. It was found that fi nancial viability of some of

A comparative assessment of selected raw water intake systems in Rwanda

After the genocide of 1994, Rwanda has been struggling to contain urban migration and its pressures on existing facilities. Water supply coverage is low at 76% in urban areas and 68% in rural areas. This implies that huge investments are required to meet the Millennium Development Goals on water supply and sanitation. This study was conducted to assess the existing problems of raw water intake systems at Yanze and Nyabarongo intakes in Kigali; Shyogwe intake in Ruhango District; and Kadahokwa intake in Huye District. The study was in response to high amounts of sediments in raw water which literally clogged the intake systems for a number of days, resulting in erratic water supplies to the residents in the rainy season. The study focused on performance problems of the intake systems, raw water turbidity variations and the assessment of how environmental concerns could be addressed in the design of intake systems in areas of high soil erosion activities. Data was collected through interviews and physical measurements. The study revealed that flooding, intake site selection, erosion, screen clogging, intake protection, high raw water turbidity, inadequacy of raw water supplied to the water treatment plants, and low downstream environmental flows were the main intake problems. The Yanze intake had worst problems with high levels of flooding, erosion, sedimentation, and high raw water turbidity levels. The bank filtration system at Nyabarongo gave the least problems of raw water turbidity. Yanze and Nyabugogo river intakes systems were found to be threatened by decreasing water levels attributed to surrounding upstream landuse activities. It was recommended that proper maintenance of existing structures, landuse management around river intakes, use of well-designed reservoir abstraction systems, increased groundwater abstraction systems (including bank filtration), would greatly improve the performance of intake systems in Rwanda.

Managment of diabetic ketoacidosis in children and adolescents in sub-Saharan Africa: A review

Diabetic ketoacidosis (DKA) is a complex metabolic state of hyperglycaemia, ketosis, and acidosis. Diabetes in sub-Saharan Africa is, in many patients a serious disease with a poor prognosis. Most deaths, however, are due to preventable causes. To improve knowledge on the management of DKA in sub-Saharan Africa. Literature review from different published sources. Health systems in sub-Saharan Africa are currently organised for the treatment of episodes of illness and not long-term conditions like diabetes. Therefore the high rates of DKA is essentially due to lack of training of health professionals, lack of facilities in most hospitals, lack of public awareness as well as lack of health education to individual patients/families. In addition erratic insulin supply coupling with infections, low parental education, poor insulin storage and lack of facilities for self monitoring of blood glucose. A complex unfavourable social and economic environment is the basis of the high prevalence of DKA in sub-Saharan Africa. Several episodes of DKA can be prevented by effective public awareness programmes and education to healthcare providers.

Fairness and legitimacy of decisions during delivery of malaria services and ITN interventions in zambia

BackgroundMalaria is the leading cause of morbidity and the second leading cause of mortality in Zambia. Perceptions of fairness and legitimacy of decisions relating to treatment of malaria cases within public health facilities and distribution of ITNs were assessed in a district in Zambia. The study was conducted within the framework of REsponse to ACcountable priority setting for Trust in health systems (REACT), a north-south collaborative action research study, which evaluates the Accountability for Reasonableness (AFR) approach to priority setting in Zambia, Tanzania and Kenya.MethodsThis paper is based on baseline in-depth interviews (IDIs) conducted with 38 decision-makers, who were involved in prioritization of malaria services and ITN distribution at district, facility and community levels in Zambia, one Focus Group Discussion (FGD) with District Health Management Team managers and eight FGDs with outpatients' attendees. Perceptions and attitudes of providers and users and practices of providers were systematized according to the four AFR conditions relevance, publicity, appeals and leadership.ResultsConflicting criteria for judging fairness were used by decision-makers and patients. Decision-makers argued that there was fairness in delivery of malaria treatment and distribution of ITNs based on alleged excessive supply of free malaria medicines, subsidized ITNs, and presence of a qualified health-provider in every facility. Patients argued that there was unfairness due to differences in waiting time, distances to health facilities, erratic supply of ITNs, no responsive appeal mechanisms, inadequate access to malaria medicines, ITNs and health providers, and uncaring providers. Decision-makers only perceived government bodies and donors/NGOs to be legitimate stakeholders to involve during delivery. Patients found government bodies, patients, indigenous healers, chiefs and politicians to be legitimate stakeholders during both planning and delivery.ConclusionPoor status of the AFR conditions of relevance, publicity, appeals and leadership corresponds well to the differing perceptions of fairness and unfairness among outpatient attendees and decision-makers. This may have been re-enforced by existing disagreements between the two groups regarding who the legitimate stakeholders to involve during service delivery were. Conflicts identified in this study could be resolved by promoting application of approaches such as AFR during priority setting in the district.

The Liverpool fish market in Lagos State, Nigeria

A survey of the Liverpool Fish Market in Lagos State, Nigeria was carried out to assess the market structure, the socio- economic characteristics of the fish marketers and the nature of fish sold. The Liverpool fish market was headed by a woman, Alhaja Aminat Abdukalim, the Iyalode of Sanni Market Apapa who co-coordinated the activities in the market. The market was dominated mostly by women and only few men were found in a ratio 1:4 (male: female). Eighty-six percent of the respondents were within 21 – 50 years age bracket which fell within the active age in human beings while only 2% of them were above 60 years. Majority of the marketers (70%) had only primary school education while only 5% had tertiary education. Smoked fish (65%) constituted a majority of the fish marketed while the remaining 35% were fresh and live fish. Liverpool market was identified as an important secondary fish market in Lagos State which played critical role in channeling fishery products to the citizens of Lagos Metropolis. Major problems faced by the marketers were erratic supply of electricity, inadequate cold storage facilities and stalls to display the fish products. Key words: Fish market structure, fish marketers, socio-economic characteristics, fish sold.

Nosocomial infections and the challenges of control in developing countries.

Nosocomial infection is a recognized public health problem world-wide with a prevalence rate of 3.0-20.7% and an incidence rate of 5-10%. It has become increasingly obvious that infections acquired in the hospital lead to increased morbidity and mortality which has added noticeably to economic burden. However, after about three decades of nosocomial infection surveillance and control world-wide, it still remains an important problem for hospitals today. Studies have shown that most hospitals in developing countries especially Africa, have no effective infection control programme due to lack of awareness of the problem, lack of personnel, poor water supply, erratic electricity supply, ineffective antibiotic policies with emergence of multiply antibiotic resistant microbes, poor laboratory backup, poor funding and non-adherence to safe practices by health workers. It is recommended that the cost of hospital infection control programme should be included in the health budget of the country and fund allocated for the infection control committee for routine control purposes and to bear the cost of outbreaks. There is need for adequate staffing and continuous education of staff on the principles of infection control, especially hand washing which is the single most important effective measure to reduce the risks of cross infection.

Le diabète et l’obésité, réellement des maladies héritées d’un passé de chasseurs-cueilleurs ?

According to the thrifty genotype hypothesis, the high prevalence of type 2 diabetes and obesity is a consequence of genetic variants that have undergone positive selection during historical periods of erratic food supply. The recent expansion in the number of validated type 2 diabetes- and obesity-susceptibility loci, coupled with access to empirical data, enables us to look for evidence in support (or otherwise) of the thrifty genotype hypothesis using proven loci. We employed a range of tests to obtain complementary views of the evidence for selection: we determined whether the risk allele at associated “index” sing-lenucleotide polymorphisms is derived or ancestral, calculated the integrated haplotype score (iHS) and assessed the population differentiation statistic fixation index (FST) for 17 type 2 diabetes and 13 obesity loci. We found no evidence for significant differences for the derived-ancestral allele test. None of the studied loci showed strong evidence for selection based on the iHS score. We find a high FST for rs7901695 at TCF7L2, the largest type 2 diabetes effect size found to date. Our results provide some evidence for selection at specific loci, but there are no consistent patterns of selection that provide conclusive confirmation of the thrifty genotype hypothesis. Discovery of more signals and more causal variants for type 2 diabetes and obesity is likely to allow more detailed examination of these issues.