Predictors of Abnormal Vaginal Discharge among Women of Reproductive Age in Southeast Nigeria

Background: An abnormal vaginal discharge is a common complaint among women of reproductive age, and it can indicate serious conditions like pelvic inflammatory disease and cervical cancer. This study aimed to assess the predictors of abnormal vaginal discharge in women of reproductive age group in Imo State, Southeast Nigeria. Methods: A cross-sectional study was conducted among 368 women of reproductive age group attending the clinic at Federal University Teaching Hospital Owerri, in Imo State, Nigeria. Respondents were recruited using a systematic sampling technique. Data were collected using a pre-tested interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of abnormal vaginal discharge. Statistical significance was set at p Results: The mean age of the respondents was 30 ± 4.5 years. Predictors of abnormal vaginal discharge were: age 36 - 45 years (OR: 4.5;95% C.I: 1.023 - 8.967, p = 0.041), being a student (OR: 2.4: 95% C.I: 1.496 - 7.336, p = 0.003), use of oral contraceptives (OR: 3.4;95% C.I: 1.068 - 6.932, p = 0.010), use of water cistern (OR: 4.7;C.I: 1.654 - 5.210, p = 0.028) anal hygiene practices (OR: 2.7;95% C.I: 1.142 - 4.809, p Conclusion: These findings suggest that targeted sexual and reproductive health interventions should be provided to reduce the risk of abnormal vaginal discharge in women of reproductive age group.

Customized Standalone GIS-Based Tool for Ground Water Quality Assessment: Gaza Strip as a Case Study

Employing the full versions of GIS software with its numerous functions to manage case-specific applications is becoming inconvenient for many reasons. A convenient solution that is spreading worldwide to solve this problem is to develop customized tools that use the same GIS concept to meet specific applications. The water resource department in Gaza strip has been facing technical and financial difficulties in using the full GIS versions in managing groundwater resources. Thus, the objective of this paper was to develop a customized standalone GIS-Based ground water quality assessment tool (GWQAT) to be used by the water resources management department in Gaza strip. GWQAT was developed using Microsoft visual basic programming language, a regression mathematical model, map objects, and map files generated from ESRI ARC Info. GWQAT was designed to achieve many functions such as mapping, map overlaying, buffering, charting, soil hydro-geological profiling, and predicting future groundwater quality parameters variations. The simplicity and validity of GWQAT was demonstrated by its application on the groundwater quality parameters in Gaza strip wells with emphasis on chloride concentration.

Assessment of Active Case Search of COVID-19 in Healthcare Facilities during the Third Wave of the Pandemic in Ekiti State, Nigeria

Early case detection and isolation of patients infected with highly infectious diseases through active case search (ACS) are important for early commencement of treatment and control of the disease within a population. This study aimed to assess the ACS of COVID-19 in healthcare facilities during the third wave of the pandemic in Ekiti State, Nigeria. This cross-sectional study was conducted in all healthcare facilities in Ekiti State. All cadres of local government primary healthcare workers were trained to carry out the ACS using semi-structured interviewer-administered questionnaire uploaded on android phone software open data kit (ODK). ACS was conducted between June and September (epidemiological week 23 to 36), 2021 and the collected data were analyzed using IBM SPSS version 23.0. P-value < 0.05 was taken as significant. The number of ACS visits for COVID-19 increases with epidemiological week progression, but the highest was in week 32 (9.9%). Cases of suspected COVID-19 in the healthcare facilities in the last one week were reported in more than half (58%) of the visits and 57.8% of those reported, documented between 1 - 4 cases. Also, out of those that were reported, 42% of them missed (not line listed) at least one suspected case of COVID-19. The private health facilities missed more cases of COVID-19 (54.3%) than other categories of health facilities (p < 0.001). The health educators and local government immunization officers (LIO) than other cadre of healthcare workers found most missed cases (57.1% and 51.4% respectively) in their visits (p < 0.001). The health educator as well as the LIO detected the highest proportion of missed suspected cases which shows that disease surveillance officers alone may not be adequate for ACS, there is a need to involve other local government team member.

Improving HIV Treatment Adherence through a Public Private Partnership in Zambia

Background: Effective ART with low viral loads and absence of STIs significantly reduce chances of sexual transmission of HIV. ART is therefore a key pillar in HIV prevention. Appropriate support is however essential for optimum treatment outcome, patient safety and HIV prevention benefit. The scale-up of ART continues to strain the already overstretched human resources in public facilities, impacts on the quality of care, and contributes to loss to follow-up. Task shifting is therefore a strategy to augment the limited human resources. Methodology: In partnership with the Livingstone General Hospital (LGH) and four private pharmacists, the COH III Project through Howard University is promoting quality HIV care by engaging the pharmacists in adherence counselling and treatment monitoring. The LGH ART pharmacist allocates consenting stable ART clients to pharmacies based on willingness to be referred and patient preference. Patients are given schedule of visits to pharmacies where the pharmacists provide medication/adherence counselling and monitor side effects. Patients with medication/treatment issues are referred back to the LGH ART clinic for follow-up. Results: Between October 2012 and August 2013, 280 patients were enrolled and followed up by the four pharmacists. 69% of patients visited the pharmacy at least once, 25% at least twice and 13% at least thrice. The 33 client referrals by pharmacists to LGH were related to adverse drug reactions, suspected treatment failure, pregnancy, and treatment monitoring. The intervention has reduced workload for the ART pharmacist;improved communication of treatment challenges and identification of patients with medication related problems, and reduced travel distances and waiting times. This has resulted in improved adherence and better patient outcomes. Conclusion: Private pharmacists present an opportunity to improve quality of HIV interventions in poor human resource capacity settings. The necessary legal and regulatory framework needs to however be developed to guide the process.

Baseline Survey on Coral Diseases, Stress Factors and New Threats in Coral Reefs of Gulf of Mannar Marine Biosphere, India

Gulf of Mannar Marine Biosphere Reserve (GOMMBRE) is the first marine biosphere reserve in India and Southeast Asia. It has a rich marine biodiversity including coral reefs, but now facing threats from different environmental factors and anthropogenic interferences. Particularly, coral reefs distributed in the 21 islands under the Gulf of Mannar (GoM) region are facing critical threats. Although several institutions and authors have studied various aspects on corals, direct and indirect influences of natural and anthropogenic catastrophes on corals have been poorly understood. Therefore, the main objective of this study was to identify the anthropogenic disturbances, biological stress factors and diseases on fringing reefs of GoM. The present study reveals that dead coral reefs are being replaced by assemblage of marine algae. Although several diseases were recorded during this study, pink line disease is wide spread in all the islands. Porites sp. and Acropora sp. were the more affected corals. This baseline data lays foundations to survey and to assess the rapid changes that occur over a period of time in coral reefs of GoM.

Assessing nest attentiveness of Common Terns via video cameras and temperature loggers

Background:While nest attentiveness plays a critical role in the reproductive success of avian species,nest attentiveness data with high temporal resolution is not available for many species.However,improvements in both video monitoring and temperature logging devices present an opportunity to increase our understanding of this aspect of avian behavior.Methods:To investigate nest attentiveness behaviors and evaluate these technologies,we monitored 13 nests across two Common Tern(Sterna hirundo)breeding colonies with a paired video camera-temperature logger approach,while monitoring 63 additional nests with temperature loggers alone.Observations occurred from May to August of 2017 on Poplar(Chesapeake Bay,Maryland,USA)and Skimmer Islands(Isle of Wight Bay,Maryland,USA).We examined data respective to four times of day:Morning(civil dawn‒11:59),Peak(12:00‒16:00),Cooling(16:01‒civil dusk),and Night(civil dusk‒civil dawn).Results:While successful nests had mostly short duration off-bouts and maintained consistent nest attentiveness throughout the day,failed nests had dramatic reductions in nest attentiveness during the Cooling and Night periods(p<0.05)with one colony experiencing repeated nocturnal abandonment due to predation pressure from a Great Horned Owl(Bubo virginianus).Incubation appeared to ameliorate ambient temperatures during Night,as nests were significantly warmer during Night when birds were on versus off the nest(p<0.05).Meanwhile,off-bouts during the Peak period occurred during higher ambient temperatures,perhaps due to adults leaving the nest during the hottest periods to perform belly soaking.Unfortunately,temperature logger data alone had limited ability to predict nest attentiveness status during shorter bouts,with results highly dependent on time of day and bout duration.While our methods did not affect hatching success(p>0.05),video-monitored nests did have significantly lower clutch sizes(p<0.05).Conclusions:The paired use of iButtons and video cameras enabled a detailed description of the incubation behavior of COTE.However,while promising for future research,the logistical and potential biological complications involved in the use of these methods suggest that careful planning is needed before these devices are utilized to ensure data is collected in a safe and successful manner.

Epidemiological Pattern of Lassa Fever Outbreak in Ondo State, Southwest Nigeria, 2014 to 2019

Introduction: Annual outbreak of Lassa Fever (LF) has been reported in Ondo State over the years. We analyzed LF surveillance data from January 2014 to December 2019 to describe the epidemiological pattern of the outbreak. Method: Lassa fever dataset from January 2014 to December 2019 was obtained from the State Ministry of Health. Variables analyzed include date of onset of symptom, age, gender, place (Local Government Area, LGA) and outcome of laboratory test. Data were summarized using frequencies, proportions, chart and maps. Results: From January 2014 and December 2019, 2141 suspected LF cases were reported. Of these, 551 cases were laboratory confirmed with 134 deaths recorded. The LF cases (suspected vs. confirmed) reported increased in 2016 (73 vs. 19), 2017 (207 vs. 76), 2018 (452 vs. 159) and 2019 (856 vs. 285) respectively. Most of the confirmed cases (89.5%) were ≥15 years while more than half (53.7%) were males. Prior to 2016, only two LGAs (Owo and Ose) recorded continued transmission of the disease. However, between 2016 and 2019, the disease had spread to 8 neighboring LGAs (P < 0.001) with the CFR declining from 67% in 2015 to 20% in 2019. Conclusion: We found an unusual increase in the suspected LF cases reported between January 2016 and December 2019 with a corresponding increase in the confirmed cases and high annual case fatality rates. Hence, we recommend intensified surveillance activities to enhance timely reporting of cases and laboratory confirmation to ensure early commencement of treatment to reduce the case fatality rate.

Exhibition of Bleaching Resistance Via Adaptive Bleaching Pattern by Coral Reefs of the Gulf of Mannar during Massive Bleaching Event 2019

Coral reefs in the Gulf of Mannar(GoM)and Palk Bay regions are facing potential threats from climate change,sedimentation and anthropogenic activities.Considerably,coral reefs in these two regions are highly damaged due to frequent bleaching events caused by increased sea surface temperature(SST)recorded over the past two decades.Recently,during February to May 2019,mass bleaching event of corals was documented again in GoM and Palk Bay regions due to increased sea surface temperatures ranged between 32°C to 36°C.Despite of completely bleached corals,some coral colonies of the same bleached coral species have displayed adaptive bleaching pattern(ABP)for survival.This incidence is displayed by the symbiotic zooxanthellae to protect coral polyps from environmental stress such as elevated temperatures.These observations infer that coral colonies with preferential bleaching pattern ability would serve as environmental stress resisting coral colonies which can be used for restoration activities and cryopreservation.Further studies are needed to explain the potential mechanisms or specific environmental drivers responsible for ABP.

Hydraulic Characteristics and Suspended Sediment Loads during Spring Breakup in Several Streams Located on the National Petroleum Reserve in Alaska, USA

This article presents results from a broad field campaign involving discharge and surface-water slope measurements, water sampling, and longitudinal river-bed profile surveys. During the spring breakup of 2011, fieldwork was carried out in several pristine streams located in the National Petroleum Reserve in Alaska;the studied streams cover two main regions: 1) foothills (Ikpikpuk River, Seabee Creek, Prince Creek, and Otuk Creek);2) coastal plain (Fish Creek, Judy Creek, and Ublutuoch River). Reported data includes basic geometric and hydraulic characteristics such as channel width and depth, cross-sectional area, average velocity, friction factor, shear stress, suspended sediment concentrations from autosamplers and grab samples, and dune dimensions and steepness ratios. The measured discharge in different streams ranged from 2 to 853 m3/s, which corresponded to post-breakup and near peak conditions, respectively. The temporal variation of Manning’s n was in phase with measured discharge, with high values of n associated with the presence of floating ice during the measurements. Calculations indicate that sediment particle sizes ≤2 mmmoved during the measurements. In general, variations in discharge were accompanied by changes in suspended sediment concentrations.

Geo-Spatial Mapping of Tuberculosis Burden in Anambra State, South-East Nigeria

Background: Anambra state in south-east Nigeria is one of the high TB burden states in the country. Despite recent improvements in TB case notification, estimates from the National Prevalence survey suggest that there is still a significant pool of missed TB cases in the state. Although active TB case finding interventions are needed at community level, information on local TB transmission hotspots is lacking. The objective of this study was to map the geo-spatial location of all TB cases detected in the state in 2019. Findings from this secondary data analysis will help to target interventions appropriately with a view to achieving better program efficiency. Method: A de-identified dataset containing descriptive physical addresses of registered TB cases in 2019 was developed. The dataset was then deconstructed and restructured using Structured Query Language in a relational data base environment. The validated dataset was geocoded using ArcGIS server geocode service and validated using python geocoding toolbox, and Google geocoding API. The resultant geocoded dataset was subjected to geo-spatial analysis and the magnitude-per-unit area of the TB cases was calculated using the Kernel Density function. TB case notification rates were also calculated and Choropleth maps were plotted to portray the TB burden as contained in the dataset. Results: Five local government areas (LGAs) (Onitsha North, Onitsha South, Idemili North, Nnewi North, Ogbaru) had spots with “Extremely high” burden with two LGAs (Onitsha North and South) accounting for the largest spots. Eight LGAs had spots with “Very high” TB burden. Also, 24 hotspots across the state had “High” TB burden and two LGAs (Orumba North, Orumba South) had only “Low” TB burden areas. Conclusion: Visualizing the heat map of TB patients has helped to identify transmission hotspots that will be targeted for case finding interventions and effort should be made to increase sensitization of the people on certain behavioural attributes that may contribute to contracting Tuberculosis.

Exploring Gaps in Healthcare Workers Knowledge, Attitude, Perception and Practice of COVID-19 Prevention and Control in Rivers State Nigeria

Background Knowledge, attitude, perception, and practice of Covid-19 prevention affect the effectiveness of healthcare workers in the pandemic response. This study assessed gaps in awareness, knowledge, attitude, perception, and practice of Covid-19 prevention among healthcare workers in Rivers State, Nigeria. Methods This was a descriptive cross-sectional survey carried out six weeks into Rivers State response that commenced on February 20, 2020, in the 23 Local Government Areas (LGAs). State Disease Surveillance and Notification Officers used multistage sampling to recruit 555 healthcare workers for the survey. A self-designed structured interviewer-administered questionnaire built into the Open Data Kit application for android phones was used for data collection. Descriptive data analysis was done, and outputs presented as frequency and percentages. Results There was a total of 372 (67.0%) female respondents. Majority of study participants had tertiary education 453 (81.6%). The mean age of study participants was 40.6 years (Standard Deviation = 7.8 years). Furthermore, 285 (51.4%) were Community Health Workers, and had over ten years practicing experience 393 (70.8%). Most healthcare workers 554 (99.8%) had heard about Covid-19, through radio 539 (97.1%), and television 445 (80.2%) yet 213 (38.4%) respondents did not know that it is caused by a virus. Most respondents 415 (74.8%) had good knowledge about Covid-19. However, only 148 (26.7%) would refer suspected cases to a facility and only 365 (65.8%) respondents demonstrated the correct hand washing technique. Conclusion There are some gaps in health worker knowledge, attitude, perception, and practice of Covid-19 prevention. Interventions to bridge these gaps are needed for effective containment of this pandemic.

Lessons from the past:isotopes of an endangered rail as indicators of underlying change to tidal marsh habitats

Introduction:Tidal marsh systems along the Pacific coast of the United States have experienced substantial stress and loss of area and ecosystem function,which we examined by using the endangered California Ridgway’s Rail,Rallus obsoletus obsoletus(‘rail’)as an indicator of its tidal marsh habitat in the San Francisco Estuary.We organized a collection of historical(1885-1940)and modern(2005-2014)rail feathers and analyzed the feather isotope means for delta carbon(δ^(13)C),sulfur(δ^(34)S),and nitrogen(δ^(15)N)by region and time period.Outcomes:Feather isotopes represented the primary foraging habitat during historical then modern time periods.Neither individual nor regional rail feather isotopes suggested freshwater or terrestrial foraging by the rail.Three regions with both historic and modern feather isotopes revealed non-uniform spatial shifts in isotope levels consistent with a marine based food web and significantδ^(15)N enrichment.Discussion:Our results supported the rail’s status as a generalist forager and obligate tidal marsh species throughout the historic record.The variable isoscape trends generated from feather isotope means illustrated a modern loss of the isotopic homogeneity between regions of historical tidal marsh,which correlated with spatially-explicit habitat alterations such as increasing biological invasions and sewage effluent over time.Conclusion:These findings have reinforced the importance of tidal marsh conservation in the face of ongoing underlying changes to these important ecosystems.

Towards a downstream passage solution for out-migrating American eel (Anguilla rostrata) on the St. Lawrence River

There is a need to develop safe and effective downstream passage for diadromous anguillid eels on large rivers,where the combination of physical screening and bypass structures that is used to protect eel on smaller rivers is infeasible.The Eel Passage Research Center was established in 2013 to address the challenge of providing safe passage for out-migrating silver-stage American eel(Anguilla rostrata)on the St.Lawrence River,the outflow of the Laurentian Great Lakes,which is spanned by two large,mainstem hydroelectric generating stations.The Center’s goal is to develop the technology to behaviorally guide eel to a collection point for capture and transfer around the two generating stations.To achieve this goal,three parallel initiatives were undertaken;1)research into behavioral guidance techniques suitable for guiding out-migrating eel on large,high flow rivers,2)the evaluation of sonar technologies for detection of eel,necessary for assessing in situ guidance,and 3)the commissioning of literature reviews for the most promising guidance technologies.A number of behavioral guidance stimuli,including electricity,flow,sound and electromagnetic fields were examined in laboratory and flume settings for their utility in guiding out-migrating silver-stage eel.Of the techniques examined,only sound showed any promise for guidance.Three sonar technologies(Simrad 120 kHz EK60 echosounder,Sound Metrics ARIS Explorer 1800 sonar,and the Kongsberg Mesotech 500 kHz M3 multi-mode multibeam sonar)were evaluated to determine if existing acoustic technologies could be used to estimate the relative abundance and distribution of out-migrating silver-phase American eel in the St.Lawrence River.Only the ARIS unit could successfully identify eel targets,and only over a short(<15 m)range.The immense volume of sonar data accumulated over a portion of a single outmigration season contributed to the successful development of machine learning tools to automate the identification of American eel targets.Based on previous research on the St.Lawrence River identifying light as a promising deterrent,and the potential for sound as a deterrent in this study,full literature reviews were commissioned for these two stimuli.Lessons learned to date have resulted in the design of a subscale,prototype guidance structure that is expected to be deployed in 2022.