Locations In sub-Saharan Africa Research Articles

Energy losses in crystalline silicon rooftop photovoltaic systems in selected site locations in Sub-Saharan Africa

Energy losses in crystalline silicon rooftop photovoltaic systems in selected site locations in Sub-Saharan Africa

Wi-Fi and the Wisdom Exchange: The Role of Lived Experience in the Age of AI

The ubiquitousness of Artificial intelligence (AI) now grows faster than a weed in a garden patch. This momentum frequently raises questions about how to implement inclusivity and ethical research standards. It also suggests the need to integrate lived experience rather than taking only the shortcut to AI's information highway. We wonder, Does the nature of technology present geographic bias? As we speed up the process of "knowing," do we lose a bank of knowledge based on natural observations and shared intentions? This paper examines the nature of AI's Socratic conversations compared with the communications invoked by global grassroots research study, to evaluate how each can contribute unique pathways linking science to social science. Pivoting around AI's summary of four water-conservation practices, survey questions were sent to seven locations in Sub-Saharan Africa where direct onsite farm research projects emphasized relationships between nature's processes and local quality of life. The results shed new perspectives on the value of supplementing formal online data with communications derived from grassroots sources – and the resulting implications for global knowledge and the sustainability of human systems.

Supervised Machine Learning and Bayesian Regression Kriging with Application to COVID-19 Incidences in Sub-Saharan Africa

Since COVID-19 invasion of the World, human life has been affected greatly. Several studies have shown a positive correlation between COVID-19 infections and pre-existing conditions such as Diabetes, Cancer, Tuberculosis, and Hypertension. In this study, we would like to determine whether demographic variables have a contribution to the spread of COVID-19 infections. We will apply a machine language method to select the demographic variables which are impactful in the spread of COVID-19 cases in Sub-Saharan Africa. Then we shall determine the nature of COVID-19 cases patterns applying the K-Nearest Neighbor (KNN) in calculating the neighborhood weights between locations/countries. The weights would then be tested for significance to conclude whether the cases patterns are either random, sparsely or clustered. We would then perform simulations to estimate the social demographic/covariates/fixed effects parameters and the random effects parameters. The Bayesian Kriging would be applied to predict Covid-19 cases based on the estimated social demographical variables coefficients/parameters and the random effects parameters in unknown/new locations in Sub Saharan Africa with a known uncertainty. The results showed that Children aged (0-14) years living with HIV AIDS, Prevalence of HIV Total (percentage of population ages 15-49) and Access to electricity (as a percentage of the population) was estimated to contribute to the increase of COVID-19 cases. Prediction of the COVID-19 cases in unknown locations showed that most of the cases were predicted in the elevated locations/areas than in the lower/flatter locations. This could mean that high elevated areas are associated with lower temperatures which increases the spread of COVID-19 cases as opposed to lower/flatter areas which are associated with higher temperatures which reduces the spread of COVID-19 cases.

Cardiometabolic disease risk factors in pre- and postmenopausal women from four sub-Saharan African countries: A cross-sectional study

ObjectiveTo compare the risk factors for cardiometabolic disease between pre- and postmenopausal women from four sub-Saharan African countries. Study designThis cross-sectional study included 3609 women (1740 premenopausal and 1869 postmenopausal) from sites in Ghana (Navrongo), Burkina Faso (Nanoro), Kenya (Nairobi), and South Africa (Soweto and Dikgale). Demographic, anthropometric and cardiometabolic variables were compared between pre- and postmenopausal women, within and across sites using multivariable regression analyses. The sites represent populations at different stages of the health transition, with those in Ghana and Burkina Faso being rural, whilst those in Kenya and South Africa are more urbanised. Main outcome measuresAnthropometric and cardiometabolic variables. ResultsThe prevalence rates of risk factors for cardiometabolic disease were higher in South (Soweto and Dikgale) and East (Nairobi) Africa than in West Africa (Nanoro and Navrongo), irrespective of menopausal status. Regression models in combined West African populations demonstrated that postmenopausal women had a larger waist circumference (β = 1.28 (95 % CI: 0.58; 1.98) cm), log subcutaneous fat (β =0.15 (0.10; 0.19)), diastolic (β = 3.04 (1.47; 4.62) mm Hg) and log systolic (β = 0.04 (0.02; 0.06)) blood pressure, log carotid intima media thickness (β = 0.03 (0.01; 0.06)), low-density lipoprotein cholesterol (β = 0.14 (0.04; 0.23) mmol/L) and log triglyceride (β= 0.10 (0.04; 0.16)) levels than premenopausal women. No such differences were observed in the South and East African women. ConclusionsMenopause-related differences in risk factors for cardiometabolic disease were prominent in West but not East or South African study sites. These novel findings should inform cardiometabolic disease prevention strategies in midlife women specific to rural and urban and peri-urban locations in sub-Saharan Africa.

An Overview of Energy Access Solutions for Rural Healthcare Facilities

Quality in healthcare service is essential in giving rural dwellers a good standard of living. It has been established that many rural locations in Sub-Saharan Africa away from the grid connection have difficulty accessing electricity. The inaccessibility of reliable energy and essential medical equipment was the leading barrier to improved healthcare delivery in these rural locations. The deficiency of basic medical equipment to power essential services due to limited or unreliable electricity access has reduced rural healthcare workers’ care capabilities, resulting in higher mortality rates. This paper, therefore, reviews the existing energy solutions for rural healthcare facilities, thereby analysing different approaches and the geographical energy mix and ascertaining the effectiveness of various techniques and energy mix as solutions to effective healthcare delivery in healthcare centres. Hybrid Renewable Energy Sources (HRES) microsystems, like microgrids incorporated with solar panels and battery, is identified to ensure higher and more reliable energy access in rural healthcare centres. At the same time, the adoption of Demand Side Management (DSM) in the HRES deployment in countryside healthcare facilities is reported to decrease the initial cost of installation and improve efficiency. Lastly, in improving energy access, rural electrification planning is achieved through modelling tools related to energy access modelling.

Genome-Wide Screening for Pathogenic Proteins and microRNAs Associated with Parasite-Host Interactions in Trypanosoma brucei.

Tsetse flies are a type of blood-sucking insect living in diverse locations in sub-Saharan Africa. These insects can transmit the unicellular parasite Trypanosoma brucei (T. brucei) which causes African trypanosomiasis in mammals. There remain huge unmet needs for prevention, early detection, and effective treatments for this disease. Currently, few studies have investigated the molecular mechanisms of parasite-host interactions underlying African trypanosomiasis, mainly due to a lack of understanding of the T. brucei genome. In this study, we dissected the genomic and transcriptomic profiles of T. brucei by annotating the genome and analyzing the gene expression. We found about 5% of T. brucei proteins in the human proteome, while more than 80% of T. brucei protein in other trypanosomes. Sequence alignment analysis showed that 142 protein homologs were shared among T. brucei and mammalian genomes. We identified several novel proteins with pathogenic potential supported by their molecular functions in T. brucei, including 24 RNA-binding proteins and six variant surface glycoproteins. In addition, 26 novel microRNAs were characterized, among which five miRNAs were not found in the mammalian genomes. Topology analysis of the miRNA-gene network revealed three genes (RPS27A, UBA52 and GAPDH) involved in the regulation of critical pathways related to the development of African trypanosomiasis. In conclusion, our work opens a new door to understanding the parasite-host interaction mechanisms by resolving the genome and transcriptome of T. brucei.

Patterns of fuel use, cooking practices and factors associated with the use of LPG for cooking in peri-urban Cameroon

Background/Aim: Over three billion people, mostly living in low and middle income countries (LMICs), are exposed to household air pollution from reliance on polluting fuels (e.g. wood, charcoal). There is a dearth of information on barriers to adoption and sustained use of clean cooking fuels, (e.g. liquefied petroleum gas (LPG)) in remote locations in sub-Saharan Africa. Methods: A cross-sectional demographic and fuel use survey was completed by approximately 1500 household cooks from peri-urban Mbalmayo in Central Cameroon. Stratified random sampling was conducted to identify approximately 200 clean (LPG) and 200 polluting (e.g. wood) cooking fuel users who completed in-depth surveys on individual and household characteristics that were potentially associated with cooking behavior and fuel choice. Results: Among households using solid fuels (n=196), the main reported barrier to LPG adoption included the initial cost of LPG equipment (n=87; 59%). Concerns over LPG safety were a significant concern in both users and non-users of LPG (n=366; 83.6% perceived LPG to be dangerous). Decision making over choice of cooking fuel was approximately equally split between the main cook (typically women) and the head of household (usually men); men were in charge of decision making regarding cooking fuel adoption among 41.4% (n=121) LPG users and 56.2% (n=82) of biomass users. Stacking was universal (100%) amongst LPG users, with 70% LPG use. Free secondary fuel and a distance 20-30minutes from retail point reduced LPG use by 20% and 10% respectively. Household head unemployed (O.R 2,057, p-value .000), No formal education (O.R 15.200,p-value .006), and Cost (O.R 2.489, p-value 0.000) were all associated with the non-adoption of LPG. Conclusions: Addressing safety concerns through education, and financially supporting households (e.g. through microfinance) will considerably scale LPG adoption in peri-urban Cameroon. Policies to facilitate LPG adoption should be targeted to both genders. Key words: LPG, clean cooking, adoption

Circulation of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli of Pandemic Sequence Types 131, 648, and 410 Among Hospitalized Patients, Caregivers, and the Community in Rwanda.

Multi-drug resistant (MDR), gram-negative Enterobacteriaceae, such as Escherichia coli (E. coli) limit therapeutic options and increase morbidity, mortality, and treatment costs worldwide. They pose a serious burden on healthcare systems, especially in developing countries like Rwanda. Several studies have shown the effects caused by the global spread of extended-spectrum beta-lactamase (ESBL)-producing E. coli. However, limited data is available on transmission dynamics of these pathogens and the mobile elements they carry in the context of clinical and community locations in Sub-Saharan Africa. Here, we examined 120 ESBL-producing E. coli strains from patients hospitalized in the University Teaching Hospital of Butare (Rwanda), their attending caregivers as well as associated community members and livestock. Based on whole-genome analysis, the genetic diversification and phylogenetics were assessed. Moreover, the content of carried plasmids was characterized and investigated for putative transmission among strains, and for their potential role as drivers for the spread of antibiotic resistance. We show that among the 30 different sequence types (ST) detected were the pandemic clonal lineages ST131, ST648 and ST410, which combine high-level antimicrobial resistance with virulence. In addition to the frequently found resistance genes blaCTX–M–15, tet(34), and aph(6)-Id, we identified csg genes, which are required for curli fiber synthesis and thus biofilm formation. Numerous strains harbored multiple virulence-associated genes (VAGs) including pap (P fimbriae adhesion cluster), fim (type I fimbriae) and chu (Chu heme uptake system). Furthermore, we found phylogenetic relationships among strains from patients and their caregivers or related community members and animals, which indicates transmission of pathogens. Also, we demonstrated the presence and potential transfer of identical/similar ESBL-plasmids in different strains from the Rwandan setting and when compared to an external plasmid. This study highlights the circulation of clinically relevant, pathogenic ESBL-producing E. coli among patients, caregivers and the community in Rwanda. Combining antimicrobial resistance with virulence in addition to the putative exchange of mobile genetic elements among bacterial pathogens poses a significant risk around the world.

LOW AWARENESS, TARGET ORGAN DAMAGE AND CARDIOVASCULAR COMPLICATIONS OF HYPERTENSION IN LOW RESOURCE SETTING

Objective: This paper reviews the current picture of low awareness, target organ damage, and cardiovascular complications in Africa using available literature as well as meta-analyses. Sub-Saharan Africa typically consists mostly of a low resource setting. Design and method: Meta-analyses of publications on hypertension and related cardiovascular complications in Africa were carried out. An extensive literature search was carried out. Publications were mainly from various locations in Sub-Saharan Africa (SSA). Results: A meta-analysis of 37 publications showed the prevalence of hypertension varied extensively between and within studies. Prevalence was higher in urban than in rural populations; it was also higher with increasing age in most studies. Less than 40% were previously diagnosed. Of these less than 30% were on drug treatment, and less than 20% had blood pressure within the defined normal range. Ogah and Rayner identified 38 publications from Sub-Saharan Africa mostly conducted in urban areas: two national surveys (Malawi and Mozambique), 14 in rural settings, 16 in urban communities, one each in semi-urban and semi-urban/rural settings, and four in both rural and urban communities (figure 1) The treatment status for South African black males with hypertension showed that 20% were aware of their condition, 14% of them were on treatment and only 7% were controlled. ; these figures were respectively 47%, 29%, and 15% for women (Steyn et al) Of 219 hypertensives, in a population in Ghana 104 (47.5%) had evidence of target organ damage. Other studies from Tanzania, Sudan, South Africa, and Nigeria showed a significantly low level of Awareness, significant Target Organ Damage mostly at the time of diagnosis. Generally in Nigeria and most, some other African countries, complications of hypertension contributes significantly to Hospital admissions (Onwubere et al) Conclusions: It is observed that in most parts of Africa, hypertension presents with earlier and more severe target organ damage compared to developed country settings. This results from the late presentation, ignorance of the need for regular medical checks, paucity of adequate medical facilities, poverty, sub-standard drugs, and ethnic and genetic factors.

Investigating the Feasibility of Child Mortality Surveillance With Postmortem Tissue Sampling: Generating Constructs and Variables to Strengthen Validity and Reliability in Qualitative Research.

BackgroundThe Child Health and Mortality Prevention Surveillance (CHAMPS) network aims to generate reliable data on the causes of death among children aged <5 years using all available information, including minimally invasive tissue sampling (MITS). The sensitive nature of MITS inevitably evokes religious, cultural, and ethical questions influencing the feasibility and sustainability of CHAMPS.MethodsDue to limited behavioral studies related to child MITS, we developed an innovative qualitative methodology to determine the barriers, facilitators, and other factors that affect the implementation and sustainability of CHAMPS surveillance across 7 diverse locations in sub-Saharan Africa and South Asia. We employed a multimethod grounded theory approach and analytical structure based on culturally specific conceptual frameworks. The methodology guided data interpretation and collective analyses confirming how to define dimensions of CHAMPS feasibility within the cultural context of each site while reducing subjectivity and bias in the process of interpretation and reporting.ResultsFindings showed that the approach to gain consent to conduct the MITS procedure involves religious factors associated with timing of burial, use of certain terminology, and methods of transporting the body. Community misperceptions and uncertainties resulted in rumor surveillance and consistency in information sharing. Religious pronouncements, recognition of health priorities, attention to pregnancy, and advancement of child health facilitated community acceptability. ConclusionsThese findings helped formulate program priorities, guided site-specific adaptations in surveillance procedures, and verified inferences drawn from CHAMPS epidemiological and formative research data. Results informed appropriate community sensitization and engagement activities for introducing and sustaining mortality surveillance, including MITS.

Impacts of intensifying or expanding cereal cropping in sub-Saharan Africa on greenhouse gas emissions and food security.

Cropping is responsible for substantial emissions of greenhouse gasses (GHGs) worldwide through the use of fertilizers and through expansion of agricultural land and associated carbon losses. Especially in sub-Saharan Africa (SSA), GHG emissions from these processes might increase steeply in coming decades, due to tripling demand for food until 2050 to match the steep population growth. This study assesses the impact of achieving cereal self-sufficiency by the year 2050 for 10 SSA countries on GHG emissions related to different scenarios of increasing cereal production, ranging from intensifying production to agricultural area expansion. We also assessed different nutrient management variants in the intensification. Our analysis revealed that irrespective of intensification or extensification, GHG emissions of the 10 countries jointly are at least 50% higher in 2050 than in 2015. Intensification will come, depending on the nutrient use efficiency achieved, with large increases in nutrient inputs and associated GHG emissions. However, matching food demand through conversion of forest and grasslands to cereal area likely results in much higher GHG emissions. Moreover, many countries lack enough suitable land for cereal expansion to match food demand. In addition, we analysed the uncertainty in our GHG estimates and found that it is caused primarily by uncertainty in the IPCC Tier 1 coefficient for direct N2 O emissions, and by the agronomic nitrogen use efficiency (N-AE). In conclusion, intensification scenarios are clearly superior to expansion scenarios in terms of climate change mitigation, but only if current N-AE is increased to levels commonly achieved in, for example, the United States, and which have been demonstrated to be feasible in some locations in SSA. As such, intensifying cereal production with good agronomy and nutrient management is essential to moderate inevitable increases in GHG emissions. Sustainably increasing crop production in SSA is therefore a daunting challenge in the coming decades.

First Record of Quill Mites (Acariformes: Syringophilidae: Picobiinae) Living in the Quill Walls of Parrots.

Quill mites (Acariformes: Prostigmata: Syringophilidae) are a family of about 400 ectoparasite species known to infest birds for over 140 yr. All previously identified quill mites occur in the calamus, a cavity of the bird feather, where they spent their entire life except for a short dispersion period. In this study, we report the first record of quill mites dwelling in the quill walls during their entire life cycle. In short, we found all of the different life stages of the species Lawrencipicobia poicephali (Skoracki & Dabert 2002) (Acariformes: Syringophilidae) in the quill wall in 33 host individuals of six different host species from many different locations in Sub-Saharan Africa. Hosts were collected over a time period spanning more than 70 yr. Lastly, we report six new avian hosts for this ectoparasite species.

Sedimentary provenance and maximum depositional age analysis of the Cretaceous? Lapur and Muruanachok sandstones (Turkana Grits), Turkana Basin, Kenya

AbstractThe Turkana Basin of northwestern Kenya is well known for its rich Neogene–Quaternary vertebrate fossil record; however, it also represents one of the few locations in sub-Saharan Africa where Cretaceous vertebrate fossils, including dinosaurs and other archosaurs, are preserved. These Cretaceous deposits are colloquially referred to as the ‘Turkana Grits’, and assumed to be Cretaceous in age based on their limited biostratigraphy. The ‘Turkana Grits’ are overlain by Palaeogene volcanic rocks (&amp;lt;35 Ma), which are widely considered to record the earliest evidence of plume-related volcanism in the East African Rift System. In this study, we present the results of an integrated sedimentary provenance investigation of two units within the ‘Turkana Grits’ called the Lapur and Muruanachok sandstones. Analysis of U–Pb ages and Lu–Hf initial ɛHf(t) values from 1106 detrital zircons demonstrate that sediments are primarily derived from Neoarchaean and Neoproterozoic basement sources, except for six Palaeogene grains from the upper Lapur Sandstone, which are of unknown provenance. Considered together, these data point to the Mozambique Belt, which makes up the nearby rift flanks, as the primary provenance source. This is consistent with palaeocurrent data, and suggests localized sediment input by alluvial fans, which fed into NNW-directed fluvial systems. Perhaps the most surprising finding is the identification of the late Paleocene detrital zircons, which not only demonstrate that the depositional age for the top of the formation is Paleocene rather than Cretaceous, but also provides possible evidence for the oldest Palaeogene volcanic activity within the East African Rift System.

Knowledge of intrapartum care among obstetric care providers in rural Kenya

Kenya did not meet its maternal mortality ratio (MMR) target under the Millennium Development Goals. The aim of this study was to examine the gaps in knowledge of intrapartum care among obstetric care providers (OCPs) in rural Nandi County, Kenya. This cross-sectional study in 2015 surveyed 326 nurses, midwives, clinical officers and physicians about their knowledge, attitudes and practices related to normal labor and childbirth, immediate newborn care and management of obstetric complications. Self-reported intrapartum knowledge among OCPs was insufficient according to accepted international standards. The mean total knowledge score for all OCPs based on a validated 30-question inventory was 62% (range 23-90%). Only 14 providers (4%) scored as 'competent' (a score ≥80%). Scores were higher for OCPs who had received pre- and postemployment emergency obstetric care training and those with higher levels of confidence in their skills. Survey respondents identified a lack of knowledge as one of the greatest barriers to high-quality patient care. Increasing training opportunities for OCPs may improve the quality of obstetric care provided to women in Kenya and other high-MMR locations in sub-Saharan Africa and enable progress toward achieving the ambitious Sustainable Development Goals target for maternal survival.

Development of next-generation sequencing (NGS)-based SSRs in African nightshades: Tools for analyzing genetic diversity for conservation and breeding

Abstract African nightshade is an indigenous leafy vegetable in Eastern and Western Africa that is valued for its high nutrient content and potential to generate income. Efforts to improve this crop have been hampered by limited information available on intra- and interspecific genetic diversity. Here, we present data on the development and application of polymorphic simple sequence repeat (SSR) markers in a broad collection of entries (gene bank accessions, landraces from farmers, breeding lines and commercial cultivars) from two species of African nightshades, Solanum scabrum (Mill.) and S. villosum (Mill.). Next generation sequencing information was used to develop 16 polymorphic SSR markers that revealed genetic diversity within and between the 54 entries collected from various geographic locations in Sub-Saharan Africa. High levels of polymorphism were detected within entries, indicating gene flow between entries and/or a low intensity of selection during development of breeding lines and improved cultivars. As a consequence, they have retained sufficient variation for further selection within the improved germplasm. The two species were clearly distinct, and S. scabrum was found to be less diverse compared to S. villosum. Furthermore, some entries were identified as probably misclassified based on morphological markers as they can clearly be placed within the gene pool of either S. scabrum or S. villosum using the SSR data. In addition to the diversity studies, we determined the genome size and ploidy of a selection of 29 entries helpful for the design of future NGS-based marker projects. All entries of S. scabrum were found to be hexaploid, whereas entries of S. villosum were tetraploid with a haploid genome size of all samples slightly varying by approximately 1 pg. Finally, we also determined pollen viability parameters, which differed significantly between the two species but did not correlate to any of the other parameters measured.

Messaging Circumstances and Economic Pressures as Influences on Linkage to Medical Male Circumcision following Community-Based HIV Testing for Men in Rural Southwest Uganda: A Qualitative Study.

Voluntary medical male circumcision (MMC) reduces risk of HIV infection, but uptake remains suboptimal among certain age groups and locations in sub-Saharan Africa. We analysed qualitative data as part of the Linkages Study, a randomized controlled trial to evaluate community-based HIV testing and follow-up as interventions promoting linkage to HIV treatment and prevention in Uganda and South Africa. Fifty-two HIV-negative uncircumcised men participated in the qualitative study. They participated in semistructured individual interviews exploring (a) home HTC experience; (b) responses to test results; (c) efforts to access circumcision services; (d) outcomes of efforts; (e) experiences of follow-up support; and (f) local HIV education and support. Interviews were audio-recorded, translated, transcribed, and summarized into “linkage summaries.” Summaries were analysed inductively to identify the following three thematic experiences shaping men's circumcision choices: (1) intense relief upon receipt of an unanticipated seronegative diagnosis, (2) the role of peer support in overcoming fear, and (3) anticipation of missed economic productivity. Increased attention to the timing of demand creation activities, to who delivers information about the HIV prevention benefits of MMC, and to the importance of missed income during recovery as a barrier to uptake promises to strengthen and sharpen future MMC demand creation strategies.

THE INTERNATIONAL GOOD CLINICAL PRACTICES GUIDELINES: TIME FOR A REVISION?

BackgroundThe Good Clinical Practices (GCP) codes of the World Health Organization and the International Conference of Harmonization set international standards for clinical research. But critics argue that they were written...

Identification of advantageous electricity generation options in sub-Saharan Africa integrating existing resources

Pioneering approaches are needed to accelerate universal access to electricity while simultaneously transitioning to reliable, sustainable and affordable energy systems. In sub-Saharan Africa (SSA), the challenges lie in attracting the private sector to complement public investments. Here, we present an integrated ‘low-hanging-fruit’ approach aimed at boosting private investment and speeding up the deployment of renewable energy systems in SSA. We analyse the potential of existing energy infrastructure, where a significant upfront investment has already been made, to be exploited for electricity generation. We develop a comprehensive methodology to identify and select suitable locations in SSA and estimate their potential for exploitation. These locations have been further analysed in terms of power capacity potential, electricity output, investments needed and population to be benefited. This strategy to attract additional finance can easily be reproduced, engaging private investors while simultaneously helping to achieve the United Nations (UN) Sustainable Development Goals on energy. Strategies to improve energy access in developing countries are urgently needed. Szabo et al. propose an approach to achieve wider access to electricity in sub-Saharan Africa that depends on existing under-utilized energy infrastructure such as dams, non-hybridized gensets and biomass cofiring.

Effect of geographical variation of Echis ocellatus, Naja nigricollis and Bitis arietans venoms on their neutralization by homologous and heterologous antivenoms

Two antivenoms prepared by using Echis ocellatus, Bitis arietans and Naja nigricollis venoms from different locations in sub-Saharan Africa were compared for their neutralizing ability. Both antivenoms were similarly effective in the neutralization of the venoms of the three species from different locations. However in the case of E. ocellatus venom, antivenom prepared using venom from Nigerian specimens was more effective than antivenom prepared with venom from Cameroon specimens in the neutralization of coagulant activity.

A Systematic Review of Innovative Diabetes Care Models in Low-and Middle-Income Countries (LMICs)

Over 70% of the world's patients with diabetes reside in low-and middle-income countries (LMICs), where adequate infrastructure and resources for diabetes care are often lacking. Therefore, academic institutions, health care organizations, and governments from Western nations and LMICs have worked together to develop a variety of effective diabetes care models for resource-poor settings. A focused search of PubMed was conducted with the goal of identifying reports that addressed the implementation of diabetes care models or initiatives to improve clinical and/or biochemical outcomes in patients with diabetes mellitus. A total of 15 published manuscripts comprising nine diabetes care models in 16 locations in sub-Saharan Africa, Latin America, and Asia identified by the above approach were systematically reviewed. The reviewed models shared a number of principles including collaboration, education, standardization, resource optimization, and technological innovation. The most comprehensive models used a number of these principles, which contributed to their success. Reviewing the principles shared by these successful programs may help guide the development of effective future models for diabetes care in low-income settings.