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Abstract Microplastics persist as a challenging pollutant in agroecosystems, posing potential risks to soil health and crop productivity. Root growth, elongation and expansion may significantly influence the vertical transport and infiltration of microplastics into the soil profile. Wheat plants (Triticum aestivum) grown in 70 cm deep rhizotrons were investigated for their influence on the vertical movement of two prevalent microplastic shapes, polyester fibres and polyvinyl chloride (PVC) fragments. Wheat was chosen for its dense and extensive fibrous and fine root system, which is a robust model for studying root-soil-microplastic interactions. Microplastics at a 0.24% w/w dry soil weight concentration were homogeneously distributed in the topsoil (0–20 cm). Infiltration of polyester fibres up to 50 cm into the soil profile was discerned as strong adherence to plant roots. PVC fragments exhibited greater mobility, reaching depths of 70 cm in the presence and absence of wheat plants. Plant growth response on exposure to microplastics appeared in the form of increased root branching and decreased shoot biomass, indicating a stress response in wheat plants. The results prove the vertical movement of microplastics, while the infiltration depth was influenced by microplastic shape. Movement was detected as either strong adherence of polyester fibres to plant roots or infiltration of PVC fragments. PVC fragments may have infiltrated through preferential flow paths in soil pores and the fissures created by root elongation and water movement.

Introduction The complex, multifaceted nature of oropharyngeal dysphagia calls for all health professionals to be aware and involved in its management. Drawing on the WHO’s Interprofessional Collaboration model, this study assessed the implications of health professionals’ awareness and involvement in the management of oropharyngeal dysphagia among inpatients in the acute care facility of a national (level-six) hospital in Kenya. The research questions were (1) what roles do health professionals play in the management of oropharyngeal dysphagia among adult inpatients in the acute care facility of a Kenyan national hospital? (2) what implications do health professionals’ awareness and involvement in oropharyngeal dysphagia management have on the outcomes of inpatients in the acute care facility of a Kenyan national hospital diagnosed with this condition?Methods This study adopted a cross-sectional, descriptive design. Data collection involved semistructured interviews with 15 health professionals handling dysphagia inpatients in the facility. The resulting data were transcribed verbatim, analysed thematically and presented through narrations.Results The analysis revealed that health professionals perform several oropharyngeal dysphagia management roles that fall into two broad complementary categories: those contributing directly to oropharyngeal dysphagia management and those supporting patients with the condition. However, some participants were uncertain of their roles in dysphagia management. The analysis also identified several potential implications of health professionals’ awareness/non-awareness and involvement/non-involvement in oropharyngeal dysphagia management. The implications were grouped into three themes: patient outcomes, professionalism and the healthcare system.Conclusions Increased involvement of all health professionals in the facility in oropharyngeal dysphagia management may result in improved patient outcomes and professionalism. As a recommendation, the hospital’s management should implement programmes emphasising holistic collaboration among health professionals working in its acute care facility to facilitate oropharyngeal dysphagia management and enhance patient outcomes.

Some Old Testament texts suggest that a man’s principal heirs were the sons from ‘legitimate’ wife/wives (Genesis 15:4, Deuteronomy 25:5-10, Judges 11:2, 1Kgs 21:3, and Ruth 4). Yet in Numbers 27:1-11 and the book of Ruth, one encounters the voices and actions of daughters and women who challenged the status quo on matters inheritance. Just like the Jewish religion in the Old Testament, in patriarchal, societies like Kenya, religious beliefs and negative cultural ideologies highly inform matters law and inheritance in ways that are disadvantaging to women and girls. In the African traditional society, polygamy and mistresses here referred to as slay-queens in the Kenyan contemporary street language netted together the family institution. The wives and ‘slay-queens’ indirectly benefit from property inheritance through the children. The Kenyan law of Succession (Amendment) Bill 2019, which is the primal law on inheritance, was reviewed for three years to lock out “illegitimate” children and slay-queens from inheriting the property of a deceased person. In a Kenyan context where women have no say over matters property inheritance and are seen as a man’s property; the bill fails to deliver an equitable approach. From a Post-Colonial and an Afro-Feminist approach, it is proposed that there is need to critique the Kenyan Law of Succession (Amendment) Bill 2019, challenge female experts in law to steer dignity conversations targeting a complete overhaul of all the discriminatory sections, interrogate religious and cultural foundations on which patriarchy finds ways of legalizing the discrimination of women and girls.

BackgroundPoint of care hemoglobin meters play key roles in increasing access to anemia screening in antenatal care especially in settings with limited access to laboratories. We aimed to determine the diagnostic accuracy of a non-invasive spot-check hemoglobin (SpHb) meter, Masimo Rad-67® Pulse CO-Oximeter®, in the diagnosis of anemia in pregnant women attending antenatal care clinics in Kilifi, Kenya.MethodsThis was a diagnostic accuracy study that retrospectively evaluated SpHb against a validated reference standard of laboratory assessed hemoglobin (Lab Hb) by a SYSMEX XN-330 automated hematology analyzer. The study was nested within a prospective pregnancy cohort study that recruited unselected pregnant women from antenatal care clinics in two public hospitals in Kilifi County, coastal Kenya. Records with both SpHb and Lab Hb were selected from pregnancy visits between May 2021 and December 2022. Linear regression and Bland-Altman analysis were performed to compare the two tests and diagnostic accuracy parameters obtained for the diagnosis of anemia.ResultsA total of 2,975 records (from 2,203 unique participants), with paired SpHb and Lab Hb were analyzed. Linear regression showed a significant but weak positive correlation, a proportional bias of 0.44 (95% CI 0.41–0.47) and a constant of 7.59 (95% CI 7.30–7.87, p

Abstract Background Over two million children and adolescents suffer from chronic kidney disease globally. Early childhood insults such as birth asphyxia could be risk factors for chronic kidney disease in later life. Our study aimed to assess renal function among children aged two to four years, born to women with obstructed labour. Methods We followed up 144 children aged two to four years, born to women with obstructed labor at Mbale regional referral hospital in Eastern Uganda. We used serum creatinine to calculate estimated glomerular filtration rate (eGFR) using the Schwartz formula. We defined decreased renal function as eGFR less than 90 ml/min/1.73m2. Results The mean age of the children was 2.8 years, standard deviation (SD) of 0.4 years. Majority of the children were male (96/144: 66.7%). The mean umbilical lactate level at birth among the study participants was 8.9 mmol/L with a standard deviation (SD) of 5.0. eGFR of the children ranged from 55 to 163 ml/min/1.73m2, mean 85.8 ± SD 15.9. Nearly one third of the children (45/144) had normal eGFR (> 90 ml/Min/1.73m2), two thirds (97/144) had a mild decrease of eGFR (60–89 ml/Min/1.73m2), and only two children had a moderate decrease of eGFR (

Abstract Background Globally, high systolic blood pressure accounts for 10.8 million deaths annually. The deaths are disproportionately higher among black people. The reasons for this disparity are poorly understood, but could include a high burden of perinatal insults such as birth asphyxia. Therefore, we aimed to assess the incidence of elevated blood pressure and to explore associated factors among children born to women with obstructed labour. Methods We followed up children born to women with obstructed labour aged 25 to 44 months at Mbale regional referral hospital that had participated in the sodium bicarbonate trial ( Trial registration number PACTR201805003364421) between October 2021 and April 2022. Our primary outcome was elevated blood pressure defined as blood pressure (either systolic or diastolic or both) ≥ the 90th percentile for age, height, and sex in the reference population based on the clinical practice guideline for screening and management of high blood pressure in children and adolescents. We used logistic regression to estimate odds ratios between selected exposures and elevated blood pressure. Results The incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.6–36.1)). Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (Adjusted odds ratio (AOR) 2.46: 95% CI (1.01–5.97). Female participants had 2.81 times the odds of elevated blood pressure as their male counterparts (AOR 2.81 95% CI (1.16–6.82). Participants with reduced estimated glomerular filtration rate had 2.85 times the odds of having elevated blood pressure as those with normal estimated glomerular filtration rate (AOR 2.85 95% CI (1.00–8.13). We found no association between arterial cord lactate, stunting, wealth index, exclusive breastfeeding, food diversity and elevated blood pressure. Conclusion Our findings show a high incidence of elevated blood pressure among children. We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors.

Abstract Vitamin A deficiency and soil‐transmitted helminth infection are serious public health problems in Kenya. The coverage of vitamin A supplementation and deworming medication (VASD) provided through mass campaigns is generally high, yet with a cost that is not sustainable, while coverage offered through routine health services is low. Alternative strategies are needed that achieve the recommended coverage of >80% of children twice annually and can be managed by health systems with limited resources. We undertook a study from September to December 2021 to compare the feasibility and coverage of VASD locally delivered by community health volunteers (CHV) (“intervention arm”) to that achieved by the bi‐annual Malezi Bora campaign event (“control arm”). This comparative cross‐sectional study was conducted in sub‐counties of Siaya County using both qualitative and quantitative methods. VASD were offered through the CHS in Alego Usonga and through Malezi Bora in Bondo Sub‐County. Coverage was assessed by a post‐event coverage survey among caregivers of children aged 6–59 months (n = 307 intervention; n = 318 control). Key informant interviews were conducted with n = 43 personnel across both modalities, and 10 focus group discussions were conducted with caregivers of children aged 6–59 months to explore knowledge, attitudes and perceptions of the two strategies. VAS coverage by CHV was 90.6% [95% CI: 87.3–93.9] compared to 70.4% [95% CI: 65.4–75.4] through the Malezi Bora, while deworming coverage was 73.9% [95% CI: 69.0–78.7] and 54.7% [95% CI: 49.2–60.2], respectively. With sufficient training and oversight, CHV can achieve superior coverage to campaigns.

Abstract Background Cardiovascular disease (CVD) is increasing in Sub-Saharan Africa (SSA). Overweight/obesity and tobacco use are modifiable CVD risk factors, however literature about the spatiotemporal dynamics of these risk factors in the region at subnational or local scales is lacking. We describe the spatiotemporal trends of overweight/obesity and tobacco use at subnational levels over a 13-year period (2003 to 2016) in five East African nations. Methods Cross-sectional, nationally representative Demographic and Health Surveys (DHS) were used to explore the subnational spatiotemporal patterns of overweight/obesity and tobacco use in Burundi, Kenya, Rwanda, Tanzania, and Uganda, five East African Community (EAC) nations with unique cultural landscapes influencing CVD risk factors. Adaptive kernel density estimation and logistic regression were used to determine the spatial distribution and change over time of CVD risk factors on a subnational and subpopulation (rural/urban) scale. Results Subnational analysis shows that regional and national level analysis masks important trends in CVD risk factor prevalence. Overweight/obesity and tobacco use trends were not similar: overweight/obesity prevalence increased across most nations included in the study and the inverse was true for tobacco use prevalence. Urban populations in each nation were more likely to be overweight/obese than rural populations, but the magnitude of difference varied widely between nations. Spatial analysis revealed that although the prevalence of overweight/obesity increased over time in both urban and rural populations, the rate of change differed between urban and rural areas. Rural populations were more likely to use tobacco than urban populations, though the likelihood of use varied substantially between nations. Additionally, spatial analysis showed that tobacco use was not evenly distributed across the landscape: tobacco use increased in and around major cities and urban centers but declined in rural areas. Conclusions We highlight the importance of de-homogenizing CVD risk factor research in SSA. Studies of national or regional prevalence trends mask important information about subpopulation and place-specific behavior and drivers of risk factor prevalence. Spatially explicit studies should be considered as a vital tool to understand local drivers of health, disease, and associated risk factor trends, especially in highly diverse yet low-resourced, marginalized, and often homogenized regions.

Abstract Background Pre-Exposure Prophylaxis (PrEP) has demonstrated clinical efficacy in preventing HIV infection, yet its uptake remains low. This study, conducted in five PrEP implementing districts in Lesotho, examined factors motivating persons at risk of HIV infection to adopt or reject PrEP when offered freely. Methods In-depth interviews were undertaken with stakeholders directly engaged with PrEP policy (n = 5), program implementation (n = 4), and use (current PrEP users = 55, former PrEP users = 36, and PrEP decliners (n = 6)). Focus group discussions (n = 11, 105 total participants) were conducted with health staff directly providing HIV and PrEP services. Results Demand for PrEP was reported highest among those at greatest risk for HIV acquisition: those in serodiscordant relationships and/or engaged in sex work. Culturally sensitive PrEP counseling was described as an opportunity to transfer knowledge, build trust, and address user concerns. Conversely, top-down counseling resulted in PrEP distrust and confusion about HIV status. Key motivations for PrEP uptake revolved around sustaining core social relationships, desire for safer conception, and caring for ailing relatives. The decline of PrEP initiation was driven by a combination of individual-level factors (risk perception, perceived side effects, disbelief of the drug’s efficacy and PrEP’s daily pill regimen), societal factors (lack of social support and HIV-related stigma), and structural factors related to PrEP access. Conclusions Our findings suggest strategies for effective national PrEP rollout and implementation include: (1) demand creation campaigns which highlight positive aspects of PrEP, while simultaneously addressing apprehensions for uptake; (2) strengthening health provider counseling capacity; and (3) addressing societal and structural HIV-related stigma.

According to the Ministry of Health in Kenya, tuberculosis (TB) is the fifth greatest cause of death and the main infectious disease killer in Kenya and across the world. In Kenya and throughout Africa, TB continues to wreak havoc on many vulnerable populations, homes, and communities despite being preventable and treatable. Common TB diagnostics, like blood and skin tests, frequently fail to identify the precise kind of TB. As a result, the World Health Organization (WHO) advises expanding the use of X-rays, for screening. In TB-prevalent regions of Kenya, a shortage of radiologists hampers effective screening and diagnosis, highlighting the need for scalable solutions for accurate X-ray analysis.Recent advancements in deep learning techniques have shown promise in the healthcare sector, particularly in radiology. However, many deep convolutional neural network (CNN) architectures are computationally intensive due to their size and resource requirements. This study designed and developed a Pruned CNN to address this issue by applying pruning techniques to baseline architectures. This approach significantly reduced model sizes while maintaining accuracy levels. Specifically, the pruned version of the DenseNet model achieved an impressive 99 % accuracy with a reduction rate of 65.8 %. These results highlight the potential of this pruned CNN as an effective and efficient tool for TB detection, particularly in resource-constrained environments. This study addresses the shortage of radiological expertise in many regions by providing a tool that can assist in the interpretation of X-ray images. This capability can help healthcare providers deliver timely and accurate diagnoses, thereby improving patient care.

BackgroundPre-Exposure Prophylaxis (PrEP) has demonstrated efficacy in preventing HIV infection. Female Bar Workers (FBWs) often act as informal sex workers, placing them at risk of HIV infection. Despite expressing interest in PrEP, FBWs face barriers to accessing public-sector clinics where PrEP is delivered. We developed a study to compare the effectiveness of workplace-based PrEP provision to standard-of-care facility-based provision for PrEP initiation, retention and adherence among FBWs.MethodsIn this double-randomized intervention study, FBWs aged 15 years and above will be screened, consented and initiated on PrEP (emtricitabine/tenofovir disoproxil), and followed for six months. Participants will be randomized at the bar level and offered PrEP at their workplace or at a health facility. Those who are initiated will be independently individually randomized to either receive or not receive an omni-channel PrEP champion intervention (support from an experienced PrEP user) to improve PrEP adherence. We expect to screen 1,205 FBWs to enroll at least 160 HIV negative women in the study. Follow-up visits will be scheduled monthly. HIV testing will be performed at baseline, month 1, 4 and 6; and TDF testing at months 2 and 6. Primary outcomes for this trial are: (1) initiation on PrEP (proportion of those offered PrEP directly observed to initiate PrEP); and (2) adherence to PrEP (detectable urine TDF drug level at 6-months post-enrollment). The primary outcomes will be analyzed using Intention-to-Treat (ITT) analyses.DiscussionUsing a randomized trial design, we will evaluate two interventions aiming to reduce barriers to uptake and retention on PrEP among FBWs, a vulnerable population at risk of HIV acquisition and onward transmission. If these interventions prove effective in promoting PrEP among FBWs, they could assist in abating the HIV epidemic in Africa.Trial registrationRegistered with German Clinical Trials Register (www.drks.de) on 29 April 2020; Registration number DRKS00018101.

Abstract Background In sub-Saharan Africa (SSA), malaria remains a public health problem despite recent reports of declining incidence. Severe malaria is a multiorgan disease with wide-ranging clinical spectra and outcomes that have been reported to vary by age, geographical location, transmission intensity over time. There are reports of recent malaria epidemics or resurgences, but few data, if any, focus on the clinical spectrum of severe malaria during epidemics. This describes the clinical spectrum and outcomes of childhood severe malaria during the disease epidemic in Eastern Uganda. Methods This prospective cohort study from October 1, 2021, to September 7, 2022, was nested within the ‘Malaria Epidemiological, Pathophysiological and Intervention studies in Highly Endemic Eastern Uganda’ (TMA2016SF-1514-MEPIE Study) at Mbale Regional Referral Hospital, Uganda. Children aged 60 days to 12 years who at admission tested positive for malaria and fulfilled the clinical WHO criteria for surveillance of severe malaria were enrolled on the study. Follow-up was performed until day 28. Data were collected using a customized proforma on social demographic characteristics, clinical presentation, treatment, and outcomes. Laboratory analyses included complete blood counts, malaria RDT (SD BIOLINE Malaria Ag P.f/Pan, Ref. 05FK60-40-1) and blood slide, lactate, glucose, blood gases and electrolytes. In addition, urinalysis using dipsticks (Multistix® 10 SG, SIEMENS, Ref.2300) at the bedside was done. Data were analysed using STATA V15.0. The study had prior ethical approval. Results A total of 300 participants were recruited. The median age was 4.6 years, mean of 57.2 months and IQR of 44.5 months. Many children, 164/300 (54.7%) were under 5 years, and 171/300 (57.0%) were males. The common clinical features were prostration 236/300 (78.7%), jaundice in 205/300 (68.3%), severe malarial anaemia in 158/300 (52.7%), black water fever 158/300 (52.7%) and multiple convulsions 51/300 (17.0%), impaired consciousness 50/300(16.0%), acidosis 41/300(13.7%), respiratory distress 26/300(6.7%) and coma in 18/300(6.0%). Prolonged hospitalization was found in 56/251 (22.3%) and was associated with acidosis, P = 0.041. The overall mortality was 19/300 (6.3%). Day 28 follow-up was achieved in 247/300 (82.3%). Conclusion During the malaria epidemic in Eastern Uganda, severe malaria affected much older children and the spectrum had more of prostration, jaundice severe malarial anaemia, black water fever and multiple convulsions with less of earlier reported respiratory distress and cerebral malaria.

Abstract Background Infections are one of the leading causes of death in the neonatal period. This trial aims to evaluate if the provision of alcohol-based hand rub (ABHR) to pregnant women for postnatal household use prevents severe infections (including sepsis, diarrhoea, pneumonia, or death) among infants during the first three postnatal months. Methods Through a cluster-randomised trial in eastern Uganda, 72 clusters are randomised in a 2-arm design with rural villages as units of randomisation. We estimate to include a total of 5932 pregnant women at 34 weeks of gestation. All women and infants in the study are receiving standard antenatal and postnatal care. Women in the intervention group additionally receive six litres of ABHR and training on its use. Research midwives conduct follow-up visits at participants’ homes on days 1, 7, 28, 42, and 90 after birth and telephone calls on days 14, 48, and 60 to assess the mother and infant for study outcomes. Primary analyses will be by intention to treat. Discussion This study will provide evidence on the effectiveness of a locally available and low-cost intervention in preventing neonatal sepsis and early infant infections. If ABHR is found effective, it could be implemented by adding it to birthing kits. Trial registration Pan African Clinical Trial Registry, PACTR202004705649428. Registered 1 April 2020, https://pactr.samrc.ac.za/ .

Mentorship is an important contributor to strengthening research capacity among health researchers. Formal mentorship programmes, targeting women mentees can help mitigate some of the gendered power dynamics and can also help early career researchers learn from others’ experiences of navigating these challenges. In 2020, the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction at the World Health Organization launched a mentorship programme geared towards early career women researchers. This paper describes the process of designing and implementing a mentorship programme for early career women sexual and reproductive health and rights researchers from low- and middle-income countries including valuable lessons learned vis-à-vis existing evidence. Some of these findings have been incorporated into iterations of the programme launched in 2022. Critical points include: ensuring considerations for language and geographical distribution; allowing mentees to participate in the matching process; providing training and opportunities to network and learn from other participants; offering the support and structure for developing these relationships. Providing women researchers with the tools – through mentorship – to navigate the unique challenges they face in their career journeys, can have a lasting impact on research capacity. Countries and institutions committed to strengthening research capacity need to focus on the holistic growth and motivation of individuals in a way that ensures gender equality.

Introduction Predictors of neurodevelopment among children who are HIV‐exposed uninfected (CHEU) are poorly understood. Methods Mothers with and without HIV and their children were enrolled during 6‐week postnatal care visits across seven sites in Kenya between March 2021 and June 2022. Infant neurodevelopment was assessed using the Malawi Developmental Assessment Tool, including social, language, fine motor and gross motor domains. We used multivariate linear mixed effects models to identify associations between 1‐year neurodevelopment scores, HIV and antiretroviral therapy (ART) exposures, and household factors, adjusted for potential confounders and clustered by the site. Results At 1‐year evaluation, CHEU (n = 709) and children who are HIV‐unexposed uninfected (CHUU) (n = 715) had comparable median age (52 weeks) and sex distribution (49% vs. 52% female). Mothers living with HIV were older (31 vs. 27 years), had lower education (50% vs. 26% primary) and were more likely to be report moderate‐to‐severe food insecurity (26% vs. 9%) (p < 0.01 for all). Compared to CHUU, CHEU had higher language scores (adjusted coeff: 0.23, 95% CI: 0.06, 0.39) and comparable social, fine and gross motor scores. Among all children, preterm birth was associated with lower gross motor scores (adjusted coeff: −1.38, 95% CI: −2.05, −0.71), food insecurity was associated with lower social scores (adjusted coeff: −0.37, 95% CI: −0.73, −0.01) and maternal report of intimate partner violence (IPV) was associated with lower fine motor (adjusted coeff: −0.76, 95% CI: −1.40, −0.13) and gross motor scores (adjusted coeff: −1.07, 95% CI: −1.81, −0.33). Among CHEU, in utero efavirenz (EFV) exposure during pregnancy was associated with lower gross motor scores compared to dolutegravir (DTG) exposure (adjusted coeff: −0.51, 95% CI: −1.01, −0.03). Lower fine and gross motor scores were also associated with having a single or widowed mother (adjusted coeff: −0.45, 95% CI: −0.87, −0.03) or a deceased or absent father (adjusted coeff: −0.81, 95% CI: −1.58, −0.05), respectively. Conclusions Biologic and social factors were associated with child neurodevelopment. Despite socio‐demographic differences between CHEU and CHUU, 1‐year neurodevelopment was similar. Addressing IPV and food insecurity may provide benefits regardless of maternal HIV status. DTG use was associated with higher neurodevelopmental scores in CHEU, compared to EFV regimens, potentially contributing to a lack of neurodevelopmental difference between CHEU and CHUU.

Converting arable land to semi-natural grassland has the potential to restore soil structural stability (SSS) and increase soil organic carbon (SOC) storage. However, the effect of the initial soil C level and conditions on the changes following introduction of grassland is poorly understood. We quantified changes in SSS and SOC in topsoil from the Askov straw disposal and cover cropping experiment initiated in 1981 in Denmark before and after its conversion to semi-natural grassland in 2020. Due to different straw input and cover crop use in the arable phase, the grass was established on soils with different initial conditions (11.9–17.9 g C kg−1 oven-dry soil). Soils sampled in 2019 and 2021 from plots subjected to different treatments in the arable phase were analyzed for clay dispersibility measured on two macro-aggregate sizes (ClayDis 1–2 mm and ClayDis 8–16 mm), wet stability of aggregates (WSA) and SOC. Irrespective of initial soil conditions, introduction of semi-natural grassland resulted in a rapid increase in SOC, a decline in ClayDis 1–2 mm and no change in WSA. The relative change in ClayDis 1–2 mm was larger than the change in SOC, and the slope for the relationship between SOC and ClayDis 1–2 mm decreased after conversion to grassland. Based on these observations, we suggest that the additional driver in play was aggregate-binding and -bonding agents being persistent due to the absence of tillage following the conversion to grassland. Notably, changes in SOC and SSS were similar regardless of initial soil conditions, which may be related to a similar productivity in the semi-natural grassland and soil C saturation.

Introduction: Predictors of neurodevelopment among children who are HIV‐exposed uninfected (CHEU) are poorly understood. Methods: Mothers with and without HIV and their children were enrolled during 6‐week postnatal care visits across seven sites in Kenya between March 2021 and June 2022. Infant neurodevelopment was assessed using the Malawi Developmental Assessment Tool, including social, language, fine motor and gross motor domains. We used multivariate linear mixed effects models to identify associations between 1‐year neurodevelopment scores, HIV and antiretroviral therapy (ART) exposures, and household factors, adjusted for potential confounders and clustered by the site. Results: At 1‐year evaluation, CHEU (n = 709) and children who are HIV‐unexposed uninfected (CHUU) (n = 715) had comparable median age (52 weeks) and sex distribution (49% vs. 52% female). Mothers living with HIV were older (31 vs. 27 years), had lower education (50% vs. 26% primary) and were more likely to be report moderate‐to‐severe food insecurity (26% vs. 9%) (p < 0.01 for all). Compared to CHUU, CHEU had higher language scores (adjusted coeff: 0.23, 95% CI: 0.06, 0.39) and comparable social, fine and gross motor scores. Among all children, preterm birth was associated with lower gross motor scores (adjusted coeff: −1.38, 95% CI: −2.05, −0.71), food insecurity was associated with lower social scores (adjusted coeff: −0.37, 95% CI: −0.73, −0.01) and maternal report of intimate partner violence (IPV) was associated with lower fine motor (adjusted coeff: −0.76, 95% CI: −1.40, −0.13) and gross motor scores (adjusted coeff: −1.07, 95% CI: −1.81, −0.33). Among CHEU, in utero efavirenz (EFV) exposure during pregnancy was associated with lower gross motor scores compared to dolutegravir (DTG) exposure (adjusted coeff: −0.51, 95% CI: −1.01, −0.03). Lower fine and gross motor scores were also associated with having a single or widowed mother (adjusted coeff: −0.45, 95% CI: −0.87, −0.03) or a deceased or absent father (adjusted coeff: −0.81, 95% CI: −1.58, −0.05), respectively. Conclusions: Biologic and social factors were associated with child neurodevelopment. Despite socio‐demographic differences between CHEU and CHUU, 1‐year neurodevelopment was similar. Addressing IPV and food insecurity may provide benefits regardless of maternal HIV status. DTG use was associated with higher neurodevelopmental scores in CHEU, compared to EFV regimens, potentially contributing to a lack of neurodevelopmental difference between CHEU and CHUU., INTRODUCTION Successful prevention of vertical transmission programmes over the last decade has contributed to a rapidly growing population of almost 16 million children who are HIV‐exposed uninfected (CHEU) around the [...]

Introduction Diseases addressed by surgical, obstetric, trauma and anaesthesia (SOTA) care are rising globally due to an anticipated rise in the burden of non-communicable diseases and road traffic accidents. Low- and middle-income countries (LMICs) disproportionately bear the brunt. Evidence-based policies and political commitment are required to reverse this trend. The Lancet Commission of Global Surgery proposed National Surgical and Obstetric and Anaesthesia Plans (NSOAPs) to alleviate the respective SOTA burdens in LMICs. NSOAPs success leverages comprehensive stakeholder engagement and appropriate health policy analyses and recommendations. As Uganda embarks on its NSOAP development, policy prioritisation in Uganda remains unexplored. We, therefore, seek to determine the priority given to SOTA care in Uganda’s healthcare policy and systems-relevant documents.Methods and analysis We will conduct a scoping review of SOTA health policy and system-relevant documents produced between 2000 and 2022 using the Arksey and O’Malley methodological framework and additional guidance from the Joanna Briggs Institute Reviewer’s manual. These documents will be sought from the websites of SOTA stakeholders by hand searching. We shall also search from Google Scholar and PubMed using well-defined search strategies. The Knowledge Management Portal for the Ugandan Ministry of Health, which was created to provide evidence-based decision-making data, is the primary source. The rest of the sources will include the following: other repositories like websites of relevant government institutions, international and national non-governmental organisations, professional associations and councils, and religious and medical bureaus. Data retrieved from the eligible policy and decision-making documents will include the year of publication, the global surgery specialty mentioned, the NSOAP surgical system domain, the national priority area involved and funding. The data will be collected in a preformed extraction sheet. Two independent reviewers will screen the collected data, and results will be presented as counts and their respective proportions. The findings will be reported narratively using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews.Ethics and dissemination This study will generate evidence-based information on the state of SOTA care in Uganda’s health policy, which will inform NSOAP development in this nation. The review’s findings will be presented to the Ministry of Health planning task force. The study will also be disseminated through a peer-reviewed publication; oral and poster presentations at local, regional, national and international conferences and over social media.

Addressing poor seed quality is pivotal for increased potato yields in Kenya. For this to be realized there is a need for nutrient optimization in the hydroponic system. The objective of this study was to examine the effects of nutrient stock solution concentrations on the quality of minitubers produced under a hydroponic system. Two greenhouse experiments were set up at Egerton University, Kenya in 2022. The treatments included three nutrient solution concentrations: 75% (N75), 100% (N100) and 125% (N125) and four potato varieties (Wanjiku, Unica, Shangi and Nyota) grown in a cocopeat substrate hydroponic system. The results indicated that the application of N125 produced minitubers that had significantly higher specific gravity, dry matter, starch, ash and sugar content. Crude protein and phosphorus did not differ significantly with the application of varying nutrient concentrations. The varieties did not differ significantly in the quality parameters except for total sugars where Unica was significantly different from Nyota and Wanjiku while Shangi did not differ from all varieties. Therefore, it will be advisable to apply 125% of the ADC-Molo recommended nutrient stock formulation which should be considered as an effective method of increasing minitubers quality under a hydroponic system.

Abstract Growing high-yielding varieties is crucial for successful crop production and maximizing farmers’ net returns. One such example is IR05N221, locally referred to as Komboka rice variety, which was released in Kenya in 2013. On the one hand, Komboka can bridge the gap in rice imports since yields of existing rice varieties do not meet the increasing rice consumption levels of the Kenyan population. On the other hand, it has taken about seven years for Komboka to be appreciated by farmers, necessitating the need to understand farmer preferences when it comes to adopting a new improved variety. We used a mixed-method study approach by combining quantitative and qualitative data collected regionally and locally in both rainfed and irrigated ecologies. When compared to most of the other rice varieties under evaluation, Komboka was high-yielding, early-maturing, and had moderate tolerance to diseases in both rainfed and irrigated ecologies. However, farmers at the regional level ranked Komboka either at the same or lower rank in terms of sensory attributes. At the local level, farmers predominantly grew older and more aromatic Basmati 370 rice variety for sale, as it fetched them more money, with preferences for both men and women rice farmers being the same. Despite Komboka being a high-yielding variety, Mwea rice farmers’ perceptions and preferences for this improved variety were low. While Komboka was equally aromatic, the lack of a ready market dissuaded these farmers from widely preferring the new Komboka variety. We provide prerequisite information that can support the commercialization and promotion of the Komboka variety. We also show that widespread favourable perception of new varieties hinges on matching preferences between breeders’ efforts for improved rice productivity with farmers’ needs for market competitiveness in these new varieties.

The decolourisation of Bismarck Brown dye by the newly isolated bacterial strain, Pseudomonas aeruginosa (JKAK), was studied at various parameters. Additionally, decolourisation of Bismarck Brown was studied using previously isolated strains; Bacillus sp. (AK1), Lysinibacillus sp. (AK2) and Kerstersia sp. (VKY1). The studies were carried out at temperature (35–50°C), dye concentration (200–800 mg/L), pH (5.5–10.5), metal ions (200–1000 mg/L) and NaCl (5–30 g/L). The optimum pH and temperature were 8.5 and 40°C, respectively. The strains decolourised over 53.75% of 800 mg/L Bismarck Brown after 24 h of incubation. The JKAK strain showed significant halotolerance and decolourised over 90% of the dye in the presence of 30 g/L NaCl. Further, JKAK decolourised over 86.4% of the dye in the presence of 1000 mg/L of Pb2+ and Zn2+ ions. The products of decolourisation were identified as aromatic amines and showed decreased phytotoxicity when compared to the untreated dye. [ABSTRACT FROM AUTHOR]