South District Research Articles

Response of Onion (Allium cepa L.) Bulb to the Combined Effect of Vermicompost and Mineral Fertilizer under Irrigated Soil Condition in Raya Azobo and Kilte-Awulaelo Districts South and Eastern Tigray, Ethiopia

Background: In Ethiopia, onion (Allium Cepa L.) is a major vegetable crop. However, due to erratic cultivation, rising mineral fertilizer prices and inadequate soil fertility management, its productivity is declining. Integrated nutrient management is a cost-effective approach to fertilizing soil. If used properly, the combination of vermicomposting with mineral fertilizers is one of the most promising options. Nonetheless, in the study areas, the appropriate application rate of vermicompost and NPSZn fertilizer on onion production has not been well examined. Methods: A field experiment was conducted in the irrigated soil conditions of Kilte-Awulaelo and Raya Azobo districts. The study used a randomized complete block design with three replications and twelve experimental treatments (4.5, 3 and 1.5 t ha-1 vermicompost rates combined with NPSZn 75, 50 and 25 kg ha-1). Full recommended 6 t ha-1 vermicompost, 100 kg ha-1 NPSZn fertilizer and absolute control were used. The collected agronomic data were subjected to ANOVA using SAS statistical software (SAS 9.0) and mean separation was done using LSD. Result: Most of the measured onion growth and yield parameters were significantly affected by the joint application of vermicompost and NPSZn. It varies among districts. Maximum bulb yields of 51.2 t ha-1 in Kilte-Awulaelo and 42.5 t ha-1 in Raya Azobo district were obtained from the application of 4.5 t ha-1 vermicompost with 50 kg ha-1 NPSZn and 4.5 t ha-1 vermicompost with 75 kg ha-1 NPSZn respectively. The combined application of vermicompost with NPSZn fertilizer enhanced onion growth and yield.

Stakeholder Views on Harmful Effects of Herbicides in Four Communities in Birim South District, Ghana

The study investigated stakeholder perceptions of the harmful effects of herbicides in four communities within the Birim South District of Ghana. It seeks to understand the views of Junior High School students, their teachers, and local farmers concerning the health and environmental risks posed by herbicides. A cross-sectional survey involving 90 students, 30 teachers, and 60 farmers was conducted using a structured questionnaire with close-ended items. Descriptive analysis showed that all respondent groups agreed on the harmful effects of herbicides, particularly on water contamination, soil fertility, and health. The study highlighted a strong consensus among respondents regarding the adverse impacts of herbicides on plant biodiversity, wildlife, and air quality. However, discrepancies emerged concerning knowledge of air pollution and specific health risks like endocrine disruption. Farmers exhibited the highest awareness of herbicide-related risks compared to teachers and students. Concerns were also raised about the involvement of children in herbicide application, with evidence suggesting potential negative impacts on their academic performance and health. The findings call for enhanced educational programs targeting all stakeholders to correct misconceptions and promote safer herbicide practices.

The provenance and provenience of photographs: Reconnecting serial images in the Umzimkhulu district, South Africa, 1899–2023

ABSTRACT This article introduces the ideas of provenance and provenience as a methodological approach to the study of photography from and in colonial contexts. It argues that rendering visible in this way the complex microhistories and photographic occasions of colonization, is an essential precondition to considering what a decolonization of photography could actually look like. Retracing a photograph’s trajectory back in time as image, object, and practice at times not only allows it to be reconnected to the exact place and moment in which it has been produced, but also shows its entanglement with other objects and actors as a lived experience. While this approach has value for studying photography at large, it is developed here through a series of 17 photographs showing a so-called first-fruits ceremony (ingcubhe), all taken on the same photographic occasion in the South African Umzimkhulu district in March 1899. Only by matching historical and present photographic frames and framings are descendants of the photographed and other stakeholders able to engage collectively with the photographs and their histories. It follows that it is more appropriate to the medium’s nature to think through the process of returning such photographs to their place of origin, not as a visual repatriation, but first of all as a visual reconnection. Reconnecting historical photographs to the exact space and time of their production through the research method repeat photography eventually creates new photographic occasions, which in turn are able to socially reanimate old ones.

Effective Safety and Security Measures in the Prevention of Various Crimes in Selected Ordinary, Public Secondary Schools: A Participatory Framework Approach

Worldwide, various crimes have permeated schools, creating a major challenge when it comes to the maintenance of the safety and security of both educators and learners and, to a large extent, school infrastructure. It is surprising that South Africa is constantly grappling with a burgeoning wave of diverse crimes, a problem that is confined to the broader society but has infiltrated secondary schools. This study examined the types of crimes caused in secondary schools to establish effective safety and security measures for the prevention of those crimes. The study employed a qualitative approach in the form of an explanatory multi-case study of nine Tshwane South District (D4) public ordinary secondary schools in the province of Gauteng, South Africa, entrenched within Borda’s (1987) Participatory Theory. Data was collected through semi-structured interviews which were conducted with 30 purposively selected participants and analysed using thematic content analysis (TCA). The findings revealed the prevalence of various crimes in all the schools under study, and further exposed the lack of efficiency in the preservation of safety and security. To preserve safety and security, community involvement and participation are key because schools cannot rely only on technological advancement. Furthermore, all the stakeholders constituting a school community are urged to methodically consult and analyse all the existing policies for better and informed safety and security measures formulation. The study provides a unique opportunity for all stakeholders to assess strengths and weaknesses, thereby enabling the development of more effective measures to curtail and minimize the ongoing prevalence of such crimes. Keywords: Safety and Security, Various Crimes, Participatory Framework, South Africa, Ordinary, Public Secondary Schools

TB programme outcomes in South Fly District, Papua New Guinea, were maintained through COVID-19.

An established response to an outbreak of drug-resistant TB (DR-TB) on Daru Island, South Fly District (SFD), Western Province, Papua New Guinea (PNG). To describe and evaluate the trends in TB case notification disaggregated by demographic and clinical characteristics, programmatic interventions for TB and COVID-19 and treatment outcomes in 2017-2022. A cohort study of routinely collected programmatic data of all patients registered for TB treatment in SFD comparing pre-COVID (2017-2019) to COVID (2020-2022) periods. Of the 3,751 TB cases registered, 19.6% had DR-TB, and the case notification rate was 1,792/100,000 for Daru and 623/100,000 for SFD. There was a 29.2% reduction in case notifications from 2019 to 2021, with recovery in 2022. During COVID, the healthcare workforce was adversely impacted, and active TB case-finding was stopped. During COVID, compared to pre-COVID, bacteriological confirmation increased (62.3% to 71.9%), whereas rates of child TB notifications (11.6% to 9.1%), pulmonary TB (60.8% to 57.4%) and DR-TB (20.7% to 18.6%) decreased. High rates of treatment success were maintained for both drug-susceptible (86.5%) and DR-TB (83.6%). Health systems strengthening and community engagement before COVID likely contributed to resilience and mitigated potential impacts on TB in this remote and resource-limited setting. Case notifications remain very high, and additional interventions are needed to interrupt transmission.

Leaching profile of per- and polyfluoroalkyl substances (PFAS) from biosolids after thickening, anaerobic digestion, and dewatering processes, and significance of protein, phosphorus, and selected ions

Batch leaching experiments were conducted to evaluate the release of forty per- and polyfluoroalkyl substances (PFAS) from sludge samples collected after thickening, anaerobic digestion, and dewatering processes at two wastewater treatment plants. The South District wastewater treatment plant (SDWWTP), which receives domestic wastewater and landfill leachate from a nearby landfill, and the Central District wastewater treatment plant (CDWWTP), which receives only domestic wastewater, were selected for this study. PFAS released into the aqueous phase were analyzed by sacrificial sampling after 1, 3, 7, 14, and 30 days. Results demonstrated rapid PFAS leaching, with the highest levels detected in biosolid leachates after just one day. Distinct differences were observed in PFAS composition and concentrations between the two treatment plants. Of the forty PFAS measured, nineteen were detected, with higher concentrations identified at SDWWTP. The input of landfill leachate to SDWWTP appears to have significantly contributed to the elevated levels of specific PFAS, particularly long-chain compounds, compared to the emerging short-chain PFAS found in biosolids. In addition to PFAS analysis, the compositions of the sludge samples, including total and volatile solids, protein, phosphorus (P), iron, aluminum, calcium, and magnesium, were also assessed. Spearman correlation analyses revealed moderate to strong relationships between PFAS levels in leachate and certain sludge components. For instance, correlations between P content and PFCAs and FTCAs were moderate (R2 = 0.45–0.76). In thickener sludge leachate, strong correlations were observed for FPrPA (3:3 FTCA), PFDA, and PFTrDA with P, with R2 values of 0.60, 0.53, and 0.54, respectively. In the digested sludge, correlations were found for PFHpA, PFDA, and PFNA (R2 = 0.45–0.76). Also, for digested sludge leachate, strong correlations were found between the individual compounds PFHpA, PFHxA, PFNA, PFOA, and PFPeA (R2 = 0.60–0.88). Predominant PFAS in leachate from biosolids were identified, including PFOS, FPePA (5:3 FTCA), PFPeA, PFBA, PFHxA, N-EtFOSAA, and 6–2 FTS.

Parent-Child Communication Intentions and Adolescents’ Dating Behaviour in the Assin South District, Ghana

<i>Background</i>: Most parents conceive that discussion sexual related matters are a bad practice and does not need to occur. This study investigates the parent-child communication intentions and adolescents’ dating behaviour in the Assin South District, Ghana. <i>Methods</i>: A cross-sectional descriptive design was employed with 400 participants which comprised parents age 30-59 and older adolescents age 15-19 years. Data were analysed using frequency distribution, Pearson’s chi-squared test of independence and binary logistic regression. <i>Results</i>: Parent-child dyad communication easiness was statistically significant related to adolescents’ dating behaviour at p<0.05, (OR=2.504, 95%CI ([1.063-5.896]). Parent-child dyad do not discuss sexual health matters was statistically significant at P<0.05, (OR=0.429, 95%CI [0.187-0.985]). Parent-child dyad engage in talks for adolescents’ positive social conduct was statistically significant at P<0.05, (OR=0.211, 95%CI [0.046-0.972]). Parent-child dyad engage in communication for adolescents’ appropriate nurturing was also observed as statistically significant to adolescents’ dating behaviour at p<0.05, (OR=0.223, 95%CI [0.051-0.978]). Parent-child dyad engage in communication to share thoughts, feelings and ensure stable relations during adulthood among adolescents was also observed as statistically significant to adolescents’ dating behaviour at p<0.05, (OR=5.988, 95%CI [1.192-30.088]). <i>Conclusion</i>: Parents in Assin South District could guide adolescents to make informed decisions about dating if they (adolescents) choose to engage in or are already dating.

Diglossia in Ghanaian Society and Its Negative Influence on Students' Proficiency in English: A Case Study on Three Town Senior High School Students

This study investigates the phenomenon of diglossia in Ghanaian society, particularly in the Ketu South district. It focuses on Ghanaian Pidgin English (GPE), a variety of English that has gained widespread usage in various official and educational institutions across Ghana, transcending its traditional boundaries. The research examines GPE, exploring its emergence, development, varieties, and influence on the academic performance of Three Twon Senior High School (THREESEC) students in standard English. The study employs a descriptive-analytical research design to describe and analyze GPE within Ghanaian society. Additionally, it utilizes a quantitative approach to analyze results obtained from a series of questionnaires, aiming to understand the impact of GPE on THREESEC students' proficiency in English. The study reveals that most of the targeted students acknowledge that GPE has negatively affected their speaking skills. At the same time, a minority admit that it has adversely impacted their writing skills. Therefore, the study recommends that relevant stakeholders in Ghanaian society, particularly within the Ketu South community and school officials, implement necessary and stringent measures to limit the spread of this variety of English and discourage its use in educational institutions before it becomes too pervasive.

Students’, Teachers’ and Farmers’ Mastery of Knowledge on the Use and Benefits of Herbicides in Four Communities in Birim South District, Ghana

Rampant farmer application of herbicides involving students in agriculture in Ghana, especially in Birim South District is a major concern for stakeholders. This problem can be reversed if stakeholder knowledge about appropriate ways of application and usefulness of herbicides is known. Hence, this study determined views of Junior High School students, their teachers and farmers in Birim South District of Ghana about the usefulness and appropriate application of herbicides. Ninety students, 30 teachers and 60 farmers randomly and conveniently selected participated in a cross-sectional survey in the District. Expert validated questionnaire with Cronbach alpha reliability coefficient of .0.75 was used. There were eight close-ended items. Questionnaires were personally administered and analysed descriptively. Students (mean =2.3), teachers (mean = 2.7) and farmers (mean = 3.6) were all familiar with herbicides but farmers were most familiar. All teachers and farmers and 93.33% of students agreed that herbicides are primarily used to control weeds. Opinions about cost-effectiveness of herbicides were highly varied. There were also varied opinions about practices farmers could adopt to minimize risks associated with herbicide application. All respondents had some misconceptions about usefulness and appropriate ways of herbicide application. The implication is that there should be education programmes to help stakeholders to consolidate the right information and empower them with more knowledge to do away with the misconceptions.

Lead (Pb) Exposure on Hemoglobin Levels and Decreasing Lung Function of Fuel Station Workers Banjarmasin

Introdution:Exposure to airborne pollutants such as lead (Pb) can cause health problems. Fuel stations are one of the places with a high risk of Pb exposure sourced from fuel or motor vehicle exhaust emissions. This research aims to know the effect of Pb exposure on hemoglobin levels and lung function in fuel station workers. Methods: This study was observational, analytical, and cross-sectional on 40 fuel station workers in South Banjarmasin District. Urinary Pb measurement was carried out by spectrophotometry, then the relationship to peripheral blood hemoglobin (Hb) levels and lung function was analyzed based on FEV1 (%), FVC (%), and FEV1/FVC ratio with a simple linear regression test. The data met the classical assumptions of normality, heteroscedasticity, and with no autocorrelation. If abnormal distribution was found, data transformation was carried out. Results: Study obtained urinary Pb levels below the normal threshold of 0.0356±0.0074 ppm. Respectively, urinary Pb levels did not have a significant effect on Hb levels (mean±SD:14.39±1.41, adjusted R2:6.2%, p=0.067), FEV1 (94.15±6.93, 5.8%, p=0.074) and FVC (89.68±6.24, 0.5%, p=0.380). However, urinary Pb significantly correlated with decreasing the FEV1/FVC ratio (90.87±3.36, 10%, p=0.026) with the equation y=96.550159.454x even without any obstruction value. Conclusion: This study showed that urinary Pb levels were normal. An increase in urinary Pb levels has a significant effect on decreasing the FEV1/FVC ratio. Prevention to reduce the health impacts of Pb needs to be taken. More research on at-risk populations with longer years of service needs to be done

Socio-demographic factors, housing characteristics, and clinical symptoms associated with falciparum malaria in two rapidly urbanizing areas in the Ashanti region of Ghana

BackgroundMalaria has been described as a disease of poverty, affecting the poorest populations typically living in rural areas. As hitherto rural areas transition into semi-urban environments, this study investigated the prevalence of falciparum malaria and associated risk factors in two rapidly urbanizing districts in the Ashanti Region of Ghana.MethodsA cross-sectional, hospital-based study was conducted at Agona and Mankranso Government Hospitals located within the Sekyere South and Ahafo Ano Southwest districts respectively, in the Ashanti Region of Ghana. Five µL of venous blood was obtained from suspected malaria patients and tested for malaria using rapid diagnostic test (RDT). Data on socio-demographic factors, clinical symptoms, and housing characteristics were collected using a structured questionnaire. Univariate and multivariate logistic regression analysis were performed to identify risk factors associated with malaria.ResultsA total of 1739 participants were enrolled in the study between January and June 2021 with median age of 22 years (IQR = 6–36). Overall malaria prevalence was 24.8%. Compared to > 30-year-olds, children between 0 and 5 years (aOR = 3.36) and those aged between 6 and 14 (aOR = 6.71) were three and six times more likely to test positive for malaria, respectively. Similarly, farming (aOR = 1.74), compared to other occupations, living close to stagnant water (aOR = 1.34), experiencing chills (aOR = 1.5), and vomiting (aOR = 1.93) were associated with increased odds of malaria infection. Having roofing ceiling (aOR = 0.66) and screened doors (aOR = 0.75) were associated with decreased risk of malaria. However, sleeping under insecticide-treated nets (ITNs), using mosquito coils/repellents, and indoor residual spraying (IRS) were not statistically significantly associated with infection.ConclusionChildren between 0 and 5 years and those aged between 6 and 14 years continue to shoulder the highest burden of malaria. Efforts to improve housing characteristics such as installation of roofing ceiling, screening doors, and clearing potential mosquito breeding sites should be encouraged in these rapidly urbanizing areas.

Magnitude of late presentation for induced abortion care services and the associated factors among reproductive-age women at selected hospitals in the South Gondar district of Northwest Ethiopia in 2023: a multicentred, cross-sectional study

ObjectiveThe objective of the study was to determine the magnitude of and the factors associated with late presentation for induced abortion care services at hospitals in the South Gondar district...

Application of Curriculum Mapping in Relation to Classroom Learning Outcomes of Public Elementary Schools

This study was conducted to determine the relationship between the application of curriculum mapping and classroom learning outcomes of public elementary schools in South District of Governor Generoso, Division of Davao Oriental. This utilized the non-experimental quantitative research design employing correlational method. The respondents were composed of teachers using universal sampling. The statistical tools used were Mean, Pearson Product Moment Coefficient Correlation (Pearson r) and Regression Analysis. The application of curriculum mapping and classroom learning outcomes in public elementary schools is oftentimes manifested by the teachers. There is a significant relationship between application of curriculum mapping and classroom learning outcomes in public elementary schools. The domains of analysis on the application of curriculum mapping indicators significantly influence classroom learning outcomes indicators. Thus, the application of curriculum mapping in relation to learning outcomes should be strengthened in school to help the teachers recognize the school vision, arm them with the motivation and tools to achieve it and compensate them appropriately for their efforts by being aware of teachers need and treating everyone fairly, to find that employees will be more motivated to do their work.

The transmission routes of African swine fever during an outbreak in Serbia July-August 2023: African swine fever virus detections in environmental samples and insects.

African swine fever (ASF) is a highly contagious viral disease of domestic pigs and wild boar (Sus scrofa) caused by an arbovirus- African swine fever virus (ASFV), which is classified into the family Asfarviridae. Even though the main transmission route of ASFV is direct contact between animals and carcasses releasing ASFV into the environment, the role of other transmission routes such as via environmental contamination or insects remains in great part unclear. During an epidemic f ASF in Serbia in 2023, environmental samples (soil, feed, water and swabs from the pig barns), and insects [resulting in collection of adult and/or larval stages of non-biting flies (Diptera: Calliphoridae and Muscidae)] were collected in four locations in South Banat district of Serbia. To assess the possibility that insects carry the ASFV in infected courtyards, sticky fly traps and open Petri dishes containing meat mixed with humid cotton wads were offered in three locations during the five days of the experiment in the Belgrade area. Furthermore, to confirm the role of flies in ASF in mechanical transmission pathway in Serbia, L2 and L3 larvae of flies (Lucilia sericata Meigan, 1826; Stomoxys calcitrans Linnaeus, 1758) were collected from the pig carcasses from infected farms, bred to adults in the Laboratory and an ASFV spiked meat meal was placed into cages with three-day-old flies (n = 52) to estimate positivity of flies and duration of mechanical transmission of ASFV. The results from the environmental samples showed no positive ASFV DNA detection, the same was true for the samples from meat-based traps and sticky fly traps, while ASFV DNA was detected in three samples containing eggs, L1 and L3 fly larvae collected from carcasses and adult flies (L. sericata). In experimental conditions, only one S. calcitrans fly tested positive on day 1 post-infection. The results implicate the possible role of Lucilia sp. flies in the mechanical transmission of ASFV as well as S. calcitrans in Serbia during an outbreak, while ASFV DNA was not detected in environmental samples in this study.

What is the state of play? A nursing and midwifery workplace satisfaction survey across five local health districts

Background The COVID-19 pandemic and recovery period have exacerbated workforce challenges for nurses and midwives. The increasingly complex nature of healthcare, combined with rising workloads and staff attrition highlights the need for initiatives that improve workplace satisfaction and retention. In response, mentoring programs aimed at enhancing job satisfaction and retention are being increasingly implemented. Aims This study sought to measure the workplace satisfaction of nurses and midwives across five New South Wales local health districts, utilising data captured from a wider study investigating the implementation of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring program. Design An exploratory, mixed methods study using purposive sampling was employed. Methods A secondary analysis of a modified version of the Nursing Workplace Satisfaction Questionnaire, was used to quantify intrinsic, extrinsic, and relational workplace satisfaction constructs among nursing and midwifery staff. Open ended questions included in the survey were thematically analysed using methods developed by Braun and Clarke (2022). Results Between June–October 2023, n = 106 participants returned the survey. Differences between intrinsic (items 2 & 5), extrinsic (item 9) relational (items 13-15) constructs were observed for health districts, Aboriginality, age, and professional role characteristics (P < 0.05). Five qualitative themes emerged from the data: Helping people is the priority; Teams make a difference to my workplace satisfaction; Managers impact my satisfaction; Scope and recognition; and Organisational factors. Conclusions Overall, our findings indicate noticeable differences in workforce satisfaction and retention across various factors, including workforce areas, Aboriginality, age, and professional roles. For these groups, initiatives aimed at improving satisfaction and retention should prioritise fostering teamwork and a sense of belonging, as these elements have significant impact on job satisfaction for nurses and midwives and provide valuable guidance for nursing leaders. Impact statement This study identifies that teamwork and belongingness impact workplace satisfaction for nurses and midwives.

Noticing Students’ Geometry Learning Using Van Hiele’s Geometry Thinking Model at the Senior High School level in Builsa South District of Upper East Region

Noticing Students’ Geometry Learning Using Van Hiele’s Geometry Thinking Model at the Senior High School level in Builsa South District of Upper East Region

Implementasi Teknik Sambung Pucuk untuk Meningkatkan Produktivitas dan Keberlanjutan Tanaman Buah Lokal Duku (Lansium domesticum) di Desa Arisan Buntal, Sumatera Selatan

Arisan Buntal Village is a small village in South Sumatra's Ogan Komering Ilir district. Duku (Lansium domesticum Corr) is a highly valued commodity in Arisan Buntal. The most significant barrier to straw development in Arisan Buntal is a need for high-quality seeds. Duku are traditionally grown; therefore, they take a long time to produce fruit. As a result, more advanced stitching techniques, such as the grafting technique, are required. However, because the youth of Arisan Buntal knew nothing about it and did not practice it, they tended to abandon the attempt down the business. This activity seeks to provide instruction in the Samsung puck technique production to the Arisan Buntal youth, allowing them to get superior duke crops and encouraging the sustainability of duke crops at the activity site. The evaluation of the activities revealed that the training participants improved their knowledge of duku-related commodities and grafting techniques. The post-test findings showed that 100% of the participants were aware of Arisan Buntal Village's potential as a hub for the growth of duku farming and the clamping method for duku crops. Furthermore, as many as 94% of participants had already tried the procedure with the assistance of specialists. Furthermore, the percentage of participants who prefer to apply the grafting method to the front has increased from 76.5% to 91.7%. The observation shows that the success rate of this technique reached 80%.

Initiating systemic capacity development for leadership from the bottom-up: a realist evaluation of a leadership innovation in a South African health district.

The need for leadership in and of district health systems is critical for the effective delivery of services and for inter-sectoral collaboration for health. Leadership capacity development has not, however, been prioritised within health systems and the systemic capacity (i.e. roles, structures, and processes) that is needed to develop managers who can lead is not always in place. This paper aims to contribute to understanding how to build such capacity, considering a relevant bottom-up innovation. We observed, in the period 2013 - 2015, the emergent implementation of this innovation (a 'Leadership Commission') in a South African health district. What started out as an effort to train individual leaders evolved into the development of systemic capacity for leadership capacity development (LCD). We adopted realist evaluation as the main methodological approach, as well as case study design; and we first developed a programme theory of the internally driven LCD initiative, through a round of interviews with senior managers. We then tested the programme theory drawing on fourteen in-depth interviews and field notes of meetings and processes. Our analysis suggests that building systemic capacity for LCD requires leadership to be expressed as a strategic priority by those with positional authority; and that bottom-up LCD requires institutional commitment through strengthening routine structures or creating new ones. The ability to leverage existing resources is another key element of systemic capacity. The mechanisms that enable bottom-up capacity development include tacit and experiential knowledge, sensemaking, systems thinking, and trust between, and motivation of, those tasked with leading LCD. Leadership development is constrained by increased workloads for those involved if the prioritisation of leadership becomes simply an additional task, and sustainability challenges are likely in the absence of additional resources for bottom-up innovation.

A retrospective study of Quality Control of Fresh Frozen Plasma (FFP) using Factor VIII levels in Central Blood Transfusion Services Indonesian Red Cross

Background: According to a report from the Ministry of Health of the Republic of Indonesia, there are 470 blood transfusion units in Indonesia (235 units managed by PMI, 220 units managed by the government, four units of health services provinces, nine units of vertical hospital BTUs, two unit’s Indonesian police and army hospital) distributed in 38 provinces. With so many BTUs spread throughout Indonesia, each BTU must have the same quality standards to maintain and improve blood services. Therefore, it is necessary to carry out Quality Control of the blood component products produced. Quality control is critical in safely and effectively processing blood and other components. A quality concept comprises quality control, assurance, and management. The laboratory service should have a quality control system. Quality testing and monitoring of blood components for transfusion have led to manufacturing or development. Factor VIII levels are internal quality control parameters required for quality analysis of Fresh Frozen plasma (FFP). As per international standard guidelines and government national regulations (PMK 91/2015) for quality assurance of FFP, 1% of all the units prepared, or four units per month, are tested for stable coagulation factors, including Factor VIII levels. Objective: This study aims to evaluate factor VIII levels in each units FFP to ensure the availability of high-quality products with maximum therapeutic and minimal risk to recipients. Methods: The retrospective data were collected from Research and Development CBTS Indonesian Red Cross archives from 1 January 2019 to 30 April 2023. Out of total 284 units FFP collected from Blood Transfusion Unit Indonesian Red Cross from Sumatera Island (Lampung Province, Palembang City, Pekanbaru City), DKI Jakarta Province (CBTS IRC), Jawa Barat Province (Depok City, District of Bekasi City, District of Bogor City), Banten Province (Tangerang City, District South of Tangerang City), Government Hospital (Fatmawati Hospital BTU), Army Hospital (RSPAD Gatot Soebroto BTU) were tested Quality Control with semi-automated Sysmex CA50 and automated Sysmex CA620 to determine of factor VIII levels in each unit FFP. Results: A total of 284 units of FFP were tested, and mean factor VIII levels were 1,2 IU/mL with a range of 0,3 IU/mL-5,3 IU/mL, the normal range measure being &gt; 0,7 IU/mL. Only 4,9 % (14/284) FFP units were inappropriate from the standard, while 95,1 % (270/284) FFP units could be accepted criteria standard. Conclusion: We conclude that there are still those below-standard Quality FFP products from blood transfusion units; it is necessary to increase the processing of blood components so that the coagulation factors are maintained. From taking blood collecting, transporting, and shipping, it is required to carry out quality control to produce products that meet national and international standards.

Rheumatic heart disease: an ongoing public health concern in vulnerable communities

Abstract Background Acute rheumatic fever (ARF) results from an autoimmune response triggered by group A streptococcus (GAS) infection (1). Severe or recurrent ARF episodes can cause permanent heart valve damage, leading to complications including heart failure, stroke, arrhythmias, carditis, and decompensation during pregnancy (2). Purpose Rheumatic fever (RF) remains a public health concern in Australia, particularly among Indigenous, migrant populations and socioeconomically disadvantaged communities. Europe and various regions worldwide have experienced significant migration from areas with a high prevalence of RHD (3). Amongst the more than 1 million asylum seekers who arrived in Europe in 2015, an estimated 1% could potentially be affected by RHD (3). This migration influx underscores the pressing need for the implementation of strategies in health policy and practice. We aimed to outline the attributes of our RF-RHD cohort to aid in the formulation of a Model of Care (MoC). Methods Cases were identified on a quarterly basis either through the NSW Public Health Rapid, Emergency, Disease, and Syndromic Surveillance (PHREDSS) system or via clinical diagnoses reported to the Public Health Unit (PHU) from January 2015 to June 2023. Demographic profiles, clinical particulars, and patient outcomes were collected from patients in the South Western Sydney Local Health District (SWSLHD), NSW, Australia. Results A total of 45 cases were reported (Table 1). This consisted predominantly of females with an average age at diagnosis of 14 years. A majority were obese (69%). Most were in the Maori and Pacific Islander populations (62%), while a smaller portion of patients were of Aboriginal or Torres Strait Islander descent (9%) (Australian Indigenous community). Notably, 84% of patients diagnosed with ARF subsequently progressed to RHD. Among the reported cases, 16 patients underwent valvular surgery, 2 patients progressed to end-stage heart failure, and there was 1 mortality. 39% (11) of female patients were pregnant during the study period, with 6 (55%) of these patients decompensating during their pregnancy (Table 2). Conclusion Rheumatic fever persists as a public health concern on a global scale. Our findings emphasize the need for a high index of clinical awareness in considering RF/RHD in socioeconomically disadvantaged communities. In our setting, there is a disproportionate burden of disease among the Pacific Islander population. The high occurrence of cardiac decompensation during pregnancy, underscores the need for close monitoring in this demographic. Despite the prevalence of rheumatic fever predominantly affecting young patients in vulnerable groups, we found a significant proportion of individuals lost to follow-up or not connected with Cardiology services. Addressing rheumatic fever requires a comprehensive approach that encompasses improved healthcare accessibility, targeted health education initiatives, and socioeconomic interventions.