West County Research Articles

Determinants of Community HIV Index Testing among HIV Index Clients in Yirol West County, South Sudan

Background: Index case HIV/AIDS testing is a useful approach for addressing and enhancing the efficiency and yield of testing in high-risk populations among the high-risk groups for contracting HIV/AIDS partners and relatives of those existing with the disease.
 Objective: The research aimed to establish the determinants of community HIV index testing among HIV index clients in Yirol West County, South Sudan.
 Methods: The research employed an analytical cross-sectional research strategy, where a mixed approach entailing both questionnaire guides and interview guides were utilized. The sample size was premeditated using Fischer's formula where 252 study respondents were recruited in this study. The chi-square test and regression (logistic analysis) were applied to identify the determinants of community HIV clients index testing. For qualitative data, thematic analysis was carried out. While data collection took one month, the entire study consumed one year to be completed.
 Results: The utilization of community HIV index testing services was low in this study with only 24.2 % of the study respondents reporting utilizing these health services. Discussing HIV testing and counseling services (OR=3.3,95%CI=0.11-0.84),counseling to bring family members for HIV testing(OR=1.9,95%CI=0.29-0.97), and education level(OR=6.1,95%CI=0.04-0.65) was found to increase the odds of utilizing community HIV index testing. The presence of stigma (OR=8.3,95% CI=0.05-0.24) and lack of trust (OR=2,95%CI=0.27-0.96) among healthcare providers reduced the odds of utilizing community HIV index testing.
 Conclusion: The utilization of community HIV index testing services was low. Discussing HIV testing and counseling services, the status of marriage, gender, age, counseling to bring family members for HIV testing .and education level were found to increase the odds of utilizing community HIV index testing while the presence of stigma and discrimination, and duration lived with a partner lack of trust among health care providers reduced the odds of utilizing community HIV index testing. There is a need to put the necessary measures to enhance the increased uptake of community HIV index testing services.

In Memoriam: Mats Morell

In Memoriam: Mats Morell

Status of Teacher Turnover in Selected Secondary Schools in Bugangaizi County West, Kakumiro District, Uganda

Teacher turnover could have a negative effect on students’ academic achievement, and teaching workload. The aim of this paper was to investigate the status teacher turnover in selected secondary schools in Bugangaizi County West, Kakumiro District, Uganda. The target population was 19 secondary school headteachers while 14 headteachers was used as the sample size. Data was collected using document analysis and interview guides. The instruments were tested to see if the questions were relevant, clear and unambiguous. Research experts who had content in the area under investigation were consulted and their comments used to improve the questions in the interview guide as a way of ensuring face validity. For quantitative data obtained, they were first edited for completeness, coded and entered into the Statistical Package for Social Scientists (SPSS) version 20.1. The data was tabulated to generate descriptive statistics. Qualitative data was organized, interpreted, patterns in the data identified, data patterns related to research themes. Some important prepositions from the participants was quoted verbatim in the appropriate sections of the discussion. The data was finally used as a basis for informed and verifiable conclusions. The paper found out that teacher turnover was an issue in many schools. Majority of head teachers openly reported that some teachers quit teaching from their schools either for green pastures or to other professions. The study concluded that there was low teacher turnover of 4.7% that is approximately 11 teachers per year. The paper recommended that Ministry of Education and Sports in Uganda should put in place a system that captures the statistics of teacher turnover and make right decision through replacements. Keywords: Teachers; Turnover; Status; Secondary; Schools DOI: 10.7176/JEP/13-33-09 Publication date: November 30 th 2022

Relationship between Teacher Turnover and Students’ Academic Performance at Uganda Certificate of Education Level in Bugangaizi County West, Kakumiro District, Uganda

Teacher turnover could have a negative effect on students’ academic achievement, and teaching workload. The aim of this paper was to investigate the relationship between teacher turnover and students’ academic achievement in selected secondary schools in Bugangaizi County West, Kakumiro District, Uganda. The target population was 19 secondary school head teachers while 14 head teachers were used as the sample size. Data was collected using document analysis and interview guide. The instruments were tested to see if the questions were relevant, clear and unambiguous. Research experts who had content in the area under investigation were consulted and their comments used to improve the questions in the interview guide as a way of ensuring face validity. For quantitative data obtained, they were first edited for completeness, coded and entered into the Statistical Package for Social Scientists (SPSS) version 20.1. The data was tabulated to generate descriptive statistics in addition, Pearson Correlation analysis was used to test the relationship between independent and dependent variables. Qualitative data was organized, interpreted, patterns in the data identified, data patterns related to research themes. Some important prepositions from the participants was quoted verbatim in the appropriate sections of the discussion. The data was finally used as a basis for informed and verifiable conclusions. The paper found out that there was a significant negative correlation between teacher turnover and students’ performance (r = -.729 ; p = .007). The paper concluded that high teacher turnover affects students’ academic performance negative. The paper recommended that Ministry of Education and Sports in Uganda should put in place a system that captures the statistics of teacher turnover and make right decision through replacements. Keywords: Relationship; Teachers; Turnover; Academic Performance DOI: 10.7176/JEP/13-33-10 Publication date: November 30 th 2022

New West and Old West in the Twenty-First Century: The Rich Get Richer

The rural U.S. West is increasingly valued for its unique natural beauty, tourism potential, and the outdoor recreational activities it provides rather than for its grazing potential, lumber mills, or extraction of valuable minerals. With this transition in mind, we examine demographic changes in the region within the context of selective migration. We build on research conducted in the late 1990s that studied the changing spatial patterns of migration and income migration within the rural Mountain West. We update the current economic and demographic structure of the region and then document how 1990s patterns have persisted through an analysis of population concentration and income migration using U.S. Census and Internal Revenue Service data. Positive net migration and income migration have focused on New West (high amenity) counties, whereas the Old West, comprised of government, mining and manufacturing, farming, and other (diversified) counties, has fallen farther behind in income migration. Consequently, selective migration to areas of natural beauty and recreation potential has increasingly transformed the rural New West into its own peculiar geography, distinct in demographics as well as environment from the Old West, revealing a growing spatial inequality between these two areas, especially in income and housing.

Contribution of Auto-Visual AFP Detection and Reporting (AVADAR) on polio surveillance in South Sudan.

Introductionthe last wild polio virus in South Sudan was documented in 2009. Nonetheless, it was one of the last four countries in the WHO African region to be accepted as a polio-free country in June 2020. In line with this, to accelerate the polio-free documentation process, the country has piloted Auto Visual AFP Detection and Reporting (AVADAR) in three counties. This study examined the contribution of the AVADAR surveillance system to the traditional Acute Flaccid Paralysis (AFP) surveillance system to document lessons learnt and best practices.Methodswe performed a retrospective descriptive quantitative study design to analyze secondary AVADAR surveillance data collected from June 2018 to December 2019 and stored at the WHO AVADAR server.Resultsthe AVADAR community surveillance system has improved the two main AFP surveillance indicators in the piloted counties and made up 86% of the total number of true AFP cases detected in these counties. The completeness and timeliness of weekly zero reporting were 97% and 94%, respectively and maintained above the standard throughout the study, while the two main surveillance indicators in the project area were improved progressively except for the Gogrial West County. In contrast, main surveillance indicators declined in some of the none-AVADAR implementing counties.Conclusionthe AVADAR surveillance system can overcome the logistical and remoteness barriers that can hinder the early detection and reporting of cases due to insecurity, topographical, and communication barrier in rural and hard-to-reach areas to accomplish and sustain the two main surveillance indicators, along with the completeness and timeliness of weekly zero reporting. We recommend extending this application-based surveillance system to other areas with limited resources and similar challenges by incorporating other diseases of public health concern.

An Interethnic Paradox: Chicago's Irish and Everyone Else

An Interethnic Paradox: Chicago's Irish and Everyone Else

Factors affecting male involvement in the uptake of maternal and child health services in Ndorwa County West, Kabale district

Background: Maternal and Child Health care involves reproductive goals of; preventing unwanted pregnancies, decreasing high risk pregnancies, reducing morbidity and mortality and increasing accessibility to family planning servicesMethods: It was cross-sectional study employing both qualitative and quantitative approaches. Information was captured from 288 men and women aged 18-45 involved in maternal and child health services.Results: Data was analysed using SPSS version 21 to generate both descriptive and regression statistics. The study found out prevalence of male involvement in MCH services low at only 35.8%. Factors such as; level of education [AOR=2.331; (95% CI: 1.011–5.376); p=0.047], marital status [AOR=1.999; (95% CI: 1.026–3.893); p=0.042], cultural beliefs [AOR=0.561; (95% CI: 0.316–0.998); p=0.049], distance to the facility [AOR=0.416; (95% CI: 0.205–0.841); p=0.015] and rudeness of the health workers [AOR=1.942; (95% CI: 0.231–0.955); p=0.037] were significantly associated with low male involvement in MCH services. Shortage of financial resources, poor communication, and harassment by health workers were some of the challenges faced by men who accompanied their spouses for MCH services.Conclusions: The study confirmed the prevalence of male involvement in MCH services low due to various factors such as cultural beliefs, shortage of finance and poor perceptions.

Parental Views on the Acceptability and Feasibility of Measurement Tools Used to Assess Movement Behaviour of Pre-School Children: A Qualitative Study.

Movement behaviours (physical activity, sedentary behaviour, and sleep) are important for the health and development of pre-school children (aged 3–4 years). There is limited qualitative research examining the acceptability and feasibility of tools used to assess movement behaviours in pre-schoolers. This study explored parental views on various measurement tools in three deprived areas in England, UK (West Yorkshire, County Durham and Northumberland). The study consisted of a demonstration of the different tools (accelerometers, a diary and a questionnaire), directly followed by focus group discussions. Three focus group discussions with a total of eleven parents and carers were transcribed verbatim and analysed using thematic analysis. Findings revealed four main themes: (1) importance of contextual information when using any measurement tool (e.g., child illness, capturing different routines); (2) practical issues associated with devices (e.g., aversion to devices being attached directly to the skin of their child; concern of larger devices during sleep time); (3) encouraging children to wear a device (e.g., making devices attractive to children—‘superpowers’); and (4) presentation of diaries and questionnaires (e.g., age-appropriate movement activities, preference for real-time recording over recall). Practical recommendations for the use of the tools to measure movement behaviours of pre-school children are provided.

A perspective of a woman on strength from support and mentorship

aAssistant Professor of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri bDepartment of Orthopaedic Surgery Barnes-Jewish Hospital and Barnes-Jewish West County Hospital, St. Louis, Missouri Financial Disclosure: The author reports no conflicts of interest. Correspondence to Kimberly Ann Bartosiak, MD, Department of Orthopaedic Surgery, Washington University School of Medicine, 660 South Euclid Avenue, MSC, 8233-04-5505, Saint Louis, Missouri 63110 Tel: (+314) 362-0255; fax: (+314) 300-0835; e-mail: [email protected].

Divergent Rhabdovirus Discovered in a Patient with New-Onset Nodding Syndrome.

A divergent rhabdovirus was discovered in the bloodstream of a 15-year-old girl with Nodding syndrome from Mundri West County in South Sudan. Nodding syndrome is a progressive degenerative neuropathy of unknown cause affecting thousands of individuals in Sub-Saharan Africa. The index case was previously healthy until she developed head-nodding seizures four months prior to presentation. Virus discovery by VIDISCA-NGS on the patient’s plasma detected multiple sequence reads belonging to a divergent rhabdovirus. The viral load was 3.85 × 103 copies/mL in the patient’s plasma and undetectable in her cerebrospinal fluid. Further genome walking allowed for the characterization of full coding sequences of all the viral proteins (N, P, M, U1, U2, G, U3, and L). We tentatively named the virus “Mundri virus” (MUNV) and classified it as a novel virus species based on the high divergence from other known viruses (all proteins had less than 43% amino acid identity). Phylogenetic analysis revealed that MUNV forms a monophyletic clade with several human-infecting tibroviruses prevalent in Central Africa. A bioinformatic machine-learning algorithm predicted MUNV to be an arbovirus (bagged prediction strength (BPS) of 0.9) transmitted by midges (BPS 0.4) with an artiodactyl host reservoir (BPS 0.9). An association between MUNV infection and Nodding syndrome was evaluated in a case–control study of 72 patients with Nodding syndrome (including the index case) matched to 65 healthy households and 48 community controls. No subject, besides the index case, was positive for MUNV RNA in their plasma. A serological assay detecting MUNV anti-nucleocapsid found, respectively, in 28%, 22%, and 16% of cases, household controls and community controls to be seropositive with no significant differences between cases and either control group. This suggests that MUNV commonly infects children in South Sudan yet may not be causally associated with Nodding syndrome.

Abstract 13107: Effectiveness Of The Outpatient Pritikin Intensive Cardiac Rehabilitation Program In Patients With Heart Failure

Introduction: The Pritikin intensive cardiac rehabilitation (ICR) program includes structured exercise sessions augmented by heart health education sessions for patients recovering from myocardial infarction, cardiac surgery, PCI, and stable angina. Medicare coverage for ICR expanded to include patients with heart failure (HF) with reduced ejection fraction (HFrEF, EF <35%). However, the efficacy of outpatient ICR on improvement of cardiovascular disease (CVD) risk factors in all patients with HF, regardless of EF, is unknown. Hypothesis: Patients with HF who participate in the outpatient Pritikin ICR program will have improvements in several clinically significant CVD risk factors, including cardiorespiratory fitness, strength, body composition, and lipid profiles. Methods: We performed a prospective cohort study of patients with HF enrolled in the outpatient Pritikin ICR program at Barnes Jewish West County Hospital in St. Louis, MO. Patients referred for ICR since 1/1/2017 were invited to participate in assessments at baseline (BL) and after completing 24 ICR visits. Each visit included a monitored exercise session plus a Pritikin education session focusing on dietary changes (low-fat, low-sodium, high-fiber foods) and stress management through a series of videos, cooking classes, and workshops. We measured body composition using bioelectrical impedance, cardiorespiratory fitness using a 6-min walk test, hand grip strength by dynamometry, and lipids by venipuncture. Values are presented as median difference, and interquartile range (IQR) from BL to visit 24. Results: 84 patients with HF (68% HfrEF, 32% HfpEF; 70.2% also diagnosed with MI, CABG, or PCI; 40% women; mean age 69.9 [SD 9.6] y), completed BL and visit 24 assessments over an average of 9.9 weeks. Significant improvements (all P <0.01) were observed for whole-body fat (-1.2%, IQR -2.4, 0.8), trunk fat (-1.3%, -3.2, 0.5), fat free mass (+0.6 kg, -0.3, 1.7), 6-min walk distance (+45.7 m, 17.9, 68.9), hand grip strength (+1.0 kg, -0.4, 2.9), and LDL cholesterol (-3 mg/dL, -14, 6). Conclusion: Outpatient Pritikin ICR results in significant cardiovascular benefits in patients with HF by enhancing exercise capacity and strength, reducing adiposity, and improving lipid profiles.

S3400 Knowledge and Practices on the Diagnosis and Treatment of Non-Alcoholic Steatohepatitis: A Survey of Non-Gastroenterology Physicians in a West Texas County

S3400 Knowledge and Practices on the Diagnosis and Treatment of Non-Alcoholic Steatohepatitis: A Survey of Non-Gastroenterology Physicians in a West Texas County

A Checklist of the Mosquito Species in 13 Counties West of San Antonio, Texas.

The aim of this study was to consolidate mosquito information for 13 counties west of San Antonio, Bexar County, Texas, and to create a species checklist for future regional studies. The resulting checklist established a baseline for local mosquito-borne disease surveillance and can serve as a resource for public health officials. The 13 counties in this region were Bandera, Edwards, Kendall, Kerr, Kimble, Kinney, Maverick, Medina, Real, Sutton, Uvalde, Val Verde, and Zavala counties. To develop the checklist, county-level mosquito species data were extracted from 38 peer-reviewed publications and government documents, university reference collections, private collections, and the Texas Department of State Health Services' historical collection data. These data were combined with author field collections to create a comprehensive species list. Overall, 339 county-level records were documented through field studies with a total of 36 species representing 8 genera confirmed as being present in this region. An additional 14 species listed in historical surveillance records were not collected during this study.

A West Texas County Food Insecurity Survey Findings

Despite living in the world’s largest food-producing nation, children and adults face poverty and hunger in every county across America. According to Feeding America [1], more than 38 million Americans are living in poverty. More than 37 million people struggle with hunger in this country, including more than 11 million children. 1 in every 9 Americans are food insecure. The situation is even worse in the state of Texas where 1 in every 7 Texans are food insecure. This makes Texas one of just 15 states with higher food insecurity than the national average [2]. In 2018, The Tom Green County Hunger Coalition (TGCHC) conducted a Food Access Survey (FAS) to help determine areas of need regarding food assistance in the city of San Angelo, Texas. The 328 respondents were divided into two groups (Food Secure and Food Insecure) based on their responses and compared. There were significant differences found between the two groups in regards to their age, household size, housing tenure, access, and assistance.

Serological evidence of Flavivirus circulation in human populations in Northern Kenya: an assessment of disease risk 2016\u20132017

BackgroundYellow fever, Dengue, West Nile and Zika viruses are re-emerging mosquito-borne Flaviviruses of public health concern. However, the extent of human exposure to these viruses and associated disease burden in Kenya and Africa at large remains unknown. We assessed the seroprevalence of Yellow fever and other Flaviviruses in human populations in West Pokot and Turkana Counties of Kenya. These areas border Uganda, South Sudan and Ethiopia where recent outbreaks of Yellow fever and Dengue have been reported, with possibility of spillover to Kenya.MethodologyHuman serum samples collected through a cross-sectional survey in West Pokot and Turkana Counties were screened for neutralizing antibodies to Yellow fever, Dengue-2, West Nile and Zika virus using the Plaque Reduction Neutralization Test (PRNT). Seroprevalence was compared by county, site and important human demographic characteristics. Adjusted odds ratios (aOR) were estimated using Firth logistic regression model.ResultsOf 877 samples tested, 127 neutralized with at least one of the four flaviviruses (14.5, 95% CI 12.3–17.0%), with a higher proportion in Turkana (21.1%, n = 87/413) than in West Pokot (8.6%, n = 40/464). Zika virus seroprevalence was significantly higher in West Pokot (7.11%) than in Turkana County (0.24%; χ2P < 0.0001). A significantly higher Yellow fever virus seroprevalence was also observed in Turkana (10.7%) compared to West Pokot (1.29%; χ2 P < 0.0001). A high prevalence of West Nile virus was detected in Turkana County only (10.2%) while Dengue was only detected in one sample, from West Pokot. The odds of infection with West Nile virus was significantly higher in males than in females (aOR = 2.55, 95% CI 1.22–5.34). Similarly, the risk of Zika virus infection in West Pokot was twice higher in males than females (aOR = 2.01, 95% CI 0.91–4.41).ConclusionEvidence of neutralizing antibodies to West Nile and Zika viruses indicates that they have been circulating undetected in human populations in these areas. While the observed Yellow Fever prevalence in Turkana and West Pokot Counties may imply virus activity, we speculate that this could also be as a result of vaccination following the Yellow Fever outbreak in the Omo river valley, South Sudan and Uganda across the border.

The Antebellum Kanawha Salt Business and Western Markets by John E. Stealey III

Reviewed by: The Antebellum Kanawha Salt Business and Western Markets by John E. Stealey III Billy Joe Peyton The Antebellum Kanawha Salt Business and Western Markets. By John E. Stealey III. (Morgantown: West Virginia University Press, 2016. Pp. x xiii, 280.) At the dawn of Kanawha salt’s rise to prominence during the War of 1812, two principal sources of domestic salt existed in the interior United States—Onondaga County, New York, and Gallatin County, Illinois. Wartime embargoes on British salt, coupled with increased demand for the mineral as a meat preservative, created a substantial Western market for Kanawha salt. Area producers developed innovative drilling techniques to tap an ancient subterranean ocean, and shortly thereafter fifty-two furnace operations produced over one million bushels of salt annually. Owing to a shortage of free labor, enslaved African Americans provided the primary workforce that enabled many salt makers to amass great wealth and local power. The slave population of Kanawha County peaked at 3,140 persons in 1850, the highest total of any Virginia county west of the Shenandoah Valley. (Only Jefferson County, with 4,341 slaves, had a higher total than Kanawha County in 1850; see US Bureau of the Census, Seventh Census of the United States, https://www2.census.gov/library/publications/decennial/1850/1850a/1850a-14.pdf.) As the author states, the resultant slave society created a unique situation whereby Southern Appalachian bondsmen produced an extractive product for interstate commerce (133). [End Page 110] Stealey originally published this detailed study of the antebellum Kanawha salt industry in 1993. Time has not diminished the relevance of his work, which remains the sole scholarly monograph focused exclusively on the history of Kanawha salt. The new edition features an updated introduction by the author, but no new primary sources or manuscript collections have been located to alter the original narrative (xi). Stealey utilizes an impressive array of previously unharvested manuscript collections and other primary source documents to tell the Kanawha salt story. Among the most relevant are the Dickinson and Shrewsbury salt company papers, death registers for the 1849 and 1850 cholera outbreak at Kanawha Salines (present-day Malden), and an obscure Virginia court case in the Library of Congress that details a previously unknown association arrangement of antebellum Kanawha salt makers between 1817 and 1851. (Stealey has published all Kanawha salt makers’ agreements of concert and combination in a separate but related work; see John E. Stealey, III. Kanawhan Prelude to Nineteenth-Century Monopoly in the United States: The Virginia Salt Combinations (Richmond: Virginia Historical Society, 2000)). The book engages readers in timely historical inquiry on the business, economic, labor, and legal history of this important industry. In so doing, it has altered existing knowledge about the application of nineteenth-century associative and contract law in the United States. In a broader context, the work is reminiscent of recent studies on the rise of the market economy, the culture of new capitalism, and slavery’s profitability and adaptability. One avenue of exploration is the influence of outside market forces on Kanawha producers, especially the importance of genealogical influences among salt makers and slave owners in the Piedmont region of Virginia. Stealey heaps praise on the “entrepreneurial acumen” of area salt manufacturers, along with their technological innovation and amazingly sophisticated worldview. Students of West Virginia history have long been aware of the claim that the Kanawha Salt Association, created in 1817, constituted the nation’s first business trust. In his updated work, Stealey reiterates the fact that “So far, no earlier examples of output pools or proposals for a trust arrangement than those on the Great Kanawha have surfaced in the legal literature” (John E. Stealey III, Kanawhan Prelude to Nineteenth-Century Monopoly in the United States, xvi). Indeed, his compelling research and analysis support this assertion, which elevates the monograph to a work of national significance on the evolution of US business organization within a legal history context. In summary, The Antebellum Kanawha Salt Business and Western Markets by John E. Stealey III is a first-rate scholarly work about an essential, but inexplicably neglected, aspect of West Virginia’s industrial past. The book [End Page 111] expertly details myriad elements...

Belgian Refugees in Cheshire: ‘Place’ and the Invisibility of the Displaced

ABSTRACTThe First World War centenary has invigorated research into the Belgian refugee presence, especially at the local level. However, as this article argues, the responses which Belgians elicited locally, as well as the ‘quality’ and longevity of the memory culture surrounding them, were intimately tethered to ideas about and experiences of ‘place’ during the war and after. Exiled Belgians were almost uniquely positioned to communicate the totality of war as well as stand as silent representatives of the trauma of displacement. Yet, this case study of the North West county of Cheshire demonstrates how wartime tragedy with regional consequences, as well as a preoccupation with combatant internees and casualties, eclipsed the everyday reality and the post-war memory of the Belgians.

Analaysis of the Changing Role of Traditional Birth Attendants in Yirol West County, South Sudan

Analaysis of the Changing Role of Traditional Birth Attendants in Yirol West County, South Sudan

Effect of Virulence of Root Rot Pathogens and Cultivar Resistance on Disease Occurrence in Dry Beans

Dry bean samples with root rot symptoms were collected in a Z pattern from field locations representing the 11 production counties in west and central Nebraska from 2015 to 2017. Recovered isolates were identified using primers for the β-tubulin gene and internal transcribed spacer region. Among the 132 isolates obtained including, Fusarium (44%), Rhizoctonia (30.3%), and other fungal genera (25.7%), the top 17 pathogenic strains were selected through rolled towel assay and used in a greenhouse study to challenge seven dry bean cultivars in six market classes commonly produced in Nebraska, namely, great northern, pinto, navy, kidney, small red, and black bean. Destructive sampling and disease rating of dry bean plants was conducted to evaluate cultivar resistance, compare virulence among strains, and assess the effect on disease severity. Strains of R. solani AG-5, R. solani AG-2-2 IIIB, R. solani AG-4, F. cuneirostrum, and F. sporotrichioides were the most virulent. None of the tested dry bean cultivars had durable resistance; however, there were significant differences in cultivar susceptibility. The Medalist dry bean cultivar was the least susceptible, and Merlot was the most susceptible. The virulence of the pathogens was more important than the cultivar resistance and should be considered in dry bean production decisions.