Huambo Province Research Articles

The Role of Laboratory Supervision in Improving the Quality of Malaria Diagnosis: A Pilot Study in Huambo, Angola.

In 2006, the Angolan National Malaria Control Program introduced clinical guidelines for malaria case management, which included diagnostic confirmation of malaria before administration of treatment; however, diagnostic practices were inconsistent and of unknown quality. In 2009, a laboratory supervision program was implemented in Huambo Province, with the goal of assessing and improving diagnosis of malaria within the confines of available in-country resources. Supervisions were carried out from 2009 to 2014 using a standardized supervision tool by national laboratory trainers. Data from the first supervision were compared with that from the final supervision. Over the study period, the number and level of training of laboratory technicians increased, and there was a nonstatistically significant trend toward improved laboratory conditions. There was a significant reduction in false-positive microscopy slide reading (P = 0.0133). Laboratory infrastructural capacity to diagnose other communicable diseases, including syphilis, human immunodeficiency virus and hepatitis B virus infections (P = 0.0012, 0.0233 and 0.0026, respectively), also improved significantly. Laboratory supervision for malaria diagnosis found significant areas for improvement, and in combination with concurrent capacity-building activities, it improved the diagnostic capacity for malaria and other diseases. Importantly, this study demonstrates that locally available resources can be used to improve the accuracy of malaria diagnosis.

Soil mineralogical composition effects on the durability of adobe blocks from the Huambo region, Angola

After many years of war, great efforts have been made for the socio-economic development of Angola, particularly in the construction industry. Among the construction techniques, adobe is one of the most used in the province of Huambo, especially by low-income families, which constitute the majority. This technique was established as an intangible heritage in the culture of that population. Huambo province is located in the central region of Angola (Central Plateau). Adobe blocks are building elements with potential degradation by the action of water. Due to the subtropical climate, hot and humid, and geomorphology of the province, located at about 1000–2000 m of altitude and with an extensive river system, these buildings can be vulnerable and may present premature degradation, exacerbated by the lack of knowledge concerning the properties of the geomaterials used and techniques/solutions that allow their stabilization and conservation. This paper aims to present the main results of the study to investigate the influence on adobe performance in regard to the mineralogy and geochemistry of soils used in the production of adobes used in the construction of dwellings. The knowledge gained with this research can support the development of solutions for the common anomalies and problems in this construction, as well as to improve the strength and durability of the adobe units. For this purpose, soil samples were collected and mineralogical, geochemical, and physical tests were performed. Durability and erodibility tests were also performed on selected adobes, following the Geelong method. The results obtained with this research may contribute to the development of the knowledge concerning this sustainable building solution, which has a strong presence in the province of Huambo and neighbouring regions.

Critical period for weed control in potatoes in the Huambo Province (Angola)

The effects of different weed management periods on potatoes were studied in three areas (Bailundo, Chianga and Calenga) of the central highlands of Angola and in three cropping seasons, from June 2005 to May 2007. Six weed-management treatments were used to identify critical periods of competition and to allow the development of more precise management recommendations. Total potato yield ranged from about 22 t ha-1 in weed-free plots to about 3 t ha-1 with no weed control a yield loss of 86%. Major weed species Galinsoga parviflora, Cyperus esculentus, Bidens biternata, Amaranthus hybridus, Nicandra physaloides, Portulaca oleracea and Datura stramonium differed from area to area. The species G. parviflora dominated the weed flora in all three areas 73, 97 and 72 plants m² 50 days after crop emergence in Bailundo, Chianga and Calenga respectively, in dry season trials; while C. esculentus was also present in Chianga and Calenga, with an average density of ca 30 plants m-2 in dry season trials. Gompertz and logistic equations were fitted to data representing increasing periods of weed-free growth and weed interference, respectively. Critical periods for weed control, with a 95% weed-free total yield, were estimated from 26 to 66 and from 20 to 61 days after emergence for the rainy and dry seasons, respectively. Weed competition before or after these critical periods had negligible effects on crop yield.

Spatial dynamics and quantification of deforestation in the central-plateau woodlands of Angola (1990–2009)

Some authors argue that deforestation in Africa is one of the highest among the world’s continents. However, for several regions, historical data and observations obtained by remote sensing raise some controversy over the portrait accepted in international circles. This case study, located in the central plateau of Angola, highlights the importance of medium to high resolution multi-temporal observations of land cover by remote sensing as a means of obtaining objective information and illustrates the complexity of deforestation processes. Land cover change in the Huambo province (Angola) is analyzed using maps produced for three dates (in the period between 1990 and 2009) by classification of Landsat TM and ETM+ images. The results are a first stepping stone for the development of a forest monitoring baseline for REDD projects under the scope of post-Kioto agreements, and they indicate an overall recovery in the forest extent of Huambo (negative deforestation rate of −0.16%, contrasting with the +0.20% reported for the entire country). However, this apparent recovery hides an inversion in the dynamics of the more densely wooded vegetation types, the miombo woodlands, which show a very slight expansion in the first decade analyzed and a marked reduction in the second, while agriculture shows a consistent and constant expansion. The deforestation rate of 1.49% in miombo woodlands in the last decade is found to be seven times higher when compared with official figures reported for the entire country. These results are discussed in the context of the socio-economic factors that may have driven the observed dynamics.

Quality of malaria case management at outpatient health facilities in Angola

BackgroundAngola's malaria case-management policy recommends treatment with artemether-lumefantrine (AL). In 2006, AL implementation began in Huambo Province, which involved training health workers (HWs), supervision, delivering AL to health facilities, and improving malaria testing with microscopy and rapid diagnostic tests (RDTs). Implementation was complicated by a policy that was sometimes ambiguous.MethodsFourteen months after implementation began, a cross-sectional survey was conducted in 33 outpatient facilities in Huambo Province to assess their readiness to manage malaria and the quality of malaria case-management for patients of all ages. Consultations were observed, patients were interviewed and re-examined, and HWs were interviewed.ResultsNinety-three HWs and 177 consultations were evaluated, although many sampled consultations were missed. All facilities had AL in-stock and at least one HW trained to use AL and RDTs. However, anti-malarial stock-outs in the previous three months were common, clinical supervision was infrequent, and HWs had important knowledge gaps. Except for fever history, clinical assessments were often incomplete. Although testing was recommended for all patients with suspected malaria, only 30.7% of such patients were tested. Correct testing was significantly associated with caseloads < 25 patients/day (odds ratio: 18.4; p < 0.0001) and elevated patient temperature (odds ratio: 2.5 per 1°C increase; p = 0.007). Testing was more common among AL-trained HWs, but the association was borderline significant (p = 0.072). When the malaria test was negative, HWs often diagnosed patients with malaria (57.8%) and prescribed anti-malarials (60.0%). Sixty-six percent of malaria-related diagnoses were correct, 20.1% were minor errors, and 13.9% were major (potentially life-threatening) errors. Only 49.0% of malaria treatments were correct, 5.4% were minor errors, and 45.6% were major errors. HWs almost always dosed AL correctly and gave accurate dosing instructions to patients; however, other aspects of counseling needed improvement.ConclusionBy late-2007, substantial progress had been made to implement the malaria case-management policy in a setting with weak infrastructure. However, policy ambiguities, under-use of malaria testing, and distrust of negative test results led to many incorrect malaria diagnoses and treatments. In 2009, Angola published a policy that clarified many issues. As problems identified in this survey are not unique to Angola, better strategies for improving HW performance are urgently needed.

Malaria vectors in Angola: distribution of species and molecular forms of the Anopheles gambiae complex, their pyrethroid insecticide knockdown resistance (kdr) status and Plasmodium falciparum sporozoite rates

BackgroundMalaria is by far the greatest cause of morbidity and mortality in Angola, being responsible for 50% of all outpatient attendance and around 22% of all hospital deaths, yet by 2003 only 2% of under-5s used insecticide-treated nets. Entomological studies are an essential foundation for rational malaria control using insecticide-treated nets and indoor residual spraying, but there have been no published studies of malaria vectors in Angola over the 27 years of the civil war, to its end in 2002. This paper describes studies arising from a WHO-sponsored visit in support of the National Malaria Control Programme.MethodsDuring April 2001, mosquitoes were sampled by indoor pyrethrum spray collection from four sites in the semi-arid coastal provinces of Luanda and Benguela and two sites in Huambo province, in the humid tropical highlands. Collections took place towards the end of the rainy season and were used to determine the Anopheles species present, their sporozoite rates and the frequency of a kdr allele conferring resistance to pyrethroid insecticides.ResultsA PCR test for the Anopheles gambiae complex showed a preponderance of An. gambiae, with indoor resting densities ranging from 0.9 to 23.5 per house. Of 403 An. gambiae identified to molecular form, 93.5% were M-form and 6.5% S-form. M and S were sympatric at 4 sites but no M/S hybrids were detected. The highest proportion of S-form (20%) was in samples from Huambo, in the humid highlands. Anopheles funestus was found at one site near Luanda. The sporozoite rate of mosquitoes, determined by an ELISA test, was 1.9% for An. gambiae (n = 580) and 0.7% for An. funestus (n = 140). Of 218 An. gambiae (195 M-form and 23 S-form) genotyped for the West African kdr-resistance allele, all were homozygous susceptible.ConclusionAn. gambiae M-form is the most important and widespread malaria vector in the areas studied but more extensive studies of malaria vectors are required to support the malaria control programme in Angola. These should include standard insecticide resistance biossays and molecular assays that can detect both metabolic resistance and target site insensitivity.

Forced migration and deslocados in the Huambo Province, Angola

Angola has three to four million internally displaced persons, one of the highest per capita figures in the world. Most of the displaced persons originate from Huambo and other parts of Planalto Central, where the Ovimbundu is the dominant ethnic group. Through the experiences of displaced people, this article discusses why people flee, and thus aims to provide better understanding of the causes of their displacement, the strategies they choose and apply during flight and settlement and their identity as deslocado. The displaced population in Huambo can be divided into two groups: new deslocados and old deslocados. There are several causes of displacement, such as civil war, degradation of the land resources and displacement during the colonial period (war, forced labour, expulsion from land, etc.). The data used in this article were collected in Huambo and Luanda from November 1998 to June 1999.

Africa — Latin America — Asia — Middle East — Europe

At the end of September new security problems arose, compelling the ICRC delegation in Angola temporarily to suspend its activities on the Planalto. In the night of 24 to 25 September the ICRC premises in Katchiungo (Huambo province), where fortunately no one was present at the time, were attacked and ransacked. After this incident the delegate general for Africa, Mr. J. M. Bornet, went to Angola from 29 September to 7 October to reexamine the situation with the delegation and to discuss with the authorities. At the end of October, the danger in the field had not diminished and continued to prevent a resumption of activities.