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Background Human landing catches (HLCs) are required to collect blackflies for entomological evaluation to verify onchocerciasis elimination. However, there are ethical concerns regarding exposure of vector collectors to infectious blackflies and safer alternative methods are needed. This study evaluated a modified HLC technique where collectors wore coloured trousers (blue, black or blue-black), protecting them from bites during fly collection, and their performance was compared with the standard. Methods The study was conducted in Makouopsap, Cameroon, in the Massangam health district for 4 months. Four collector pairs—one 'standard' (bare-legged) and three modified—were placed 50 m apart along known breeding sites on the Mbam and Nja Rivers. Collections were performed from 07:00 to 17:00 h, 4 d/month. Hourly rates of flies caught were analysed using a negative binomial generalised linear model to explore associations between flies caught and collection techniques and seasons. Results Overall, 17 246 blackflies were caught. There was no significant statistical difference in the number of blackflies and parous flies caught between black trousers and the standard. Thus there is a strong indication that wearing black trousers is a viable non-inferior alternative to the standard HLC. Conclusions Further studies are needed to confirm generalisability in different ecozones and transmission environments and among different blackfly species. [ABSTRACT FROM AUTHOR]

We trialed strategies to reach semi-nomadic population with interventions targeting onchocerciasis including a combination of community knowledge and Geographical Information System (GIS) technology; nomad-specific sensitization; and mobile outreach. The interventions included ivermectin (ivm) mass drug administration (MDA) and treating infected individuals (found upon skin snip microscopy test) with doxycycline for 35 days. Microscopy-negative snips were further tested by Polymerase Chain Reaction (PCR). After 8 months, individuals immigrating or emigrating constituted 47% of the initial population; 59% of individuals not born in the area have immigrated during the last five years; 28% (age>9) reportedly never taken ivm; 72% (compared to 51% previously) of eligible population (age ≥ 5 years) took ivm; and 47% (age > 8, not pregnant, not breastfeeding, not severely ill,) participated in the test. A high prevalence of onchocerciasis,15.1%, was found upon microscopy & PCR test; 9/10 tested by skin snip microscopy and PCR at follow-up were all negative. Microfilaria prevalence and intensity upon skin snip microscopy reduced significantly from baseline following the intervention (8.9% to 4.1%, p = 0.032; 0.18 to 0.16, p = 0.013, respectively). The strategies considerably increased reach to nomadic camps. Treating with doxycycline in combination with ivm is feasible and has led to a significant reduction in infection level within one year among the semi-nomads. Being potentially curative in one intervention round, this combination should be considered for population group faced with challenges of achieving adequate coverage and adhesion to ivm MDA over prolonged period (>10 years). Author summary: Community knowledge, satellite imagery, semi-nomadic sensitization and outreach strategies were employed to deliver ivermectin and doxycycline treatments against onchocerciasis in semi-nomadic population. Doxycycline was offered only when skin snip examination revealed infection. We found that about 50% of the population has either left or joined the community within 8 months; 59% of people not born in the area arrived during the last 5 years; 28% of those older than 9 years reported never taking ivermectin; 72% (compared to 51% previously) of eligible population (≥5 years) took ivermectin; and 47% participated in skin snip test. A high proportion of participants– 15% were infected. All the infected individuals were treated, and no infection was found in almost all those retested (9/10). This study highlights high rate of onchocerciasis and the challenges of offering continuous treatment for a prolonged period (>10 years) to a mobile population. It further demonstrates that combining ivermectin and doxycycline is preferrable in mobile population as it is curative and can be given only one time. [ABSTRACT FROM AUTHOR]

This paper explores functional and structural resilience in outcomes-based public service partnerships. Using a theoretical framework informed by socio-ecological and health fields, and data from all thirty-one social impact bonds (SIBs) funded through the UK government's Life Chances Fund, we explore how SIBs adapted service delivery and funding mechanisms in response to Covid-19. Human factors supported service continuity and adaptation, indicating the presence of functional resilience. Evidence of structural resilience was mixed, highlighting the importance of clear governance roles for determining structural changes during a crisis. Implications for an increasingly networked and partnership-based public service sector are discussed. [ABSTRACT FROM AUTHOR]

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Aflatoxins are naturally occurring food toxins known to contaminate cereals with a carry-over effect in milk and meat products from farm animals raised on contaminated feed. In children, continuous consumption of aflatoxin-contaminated food is linked to immune suppression, vaccine interference and growth faltering while in adult populations, carcinogenesis in the liver has been established. We evaluate the main determinants of aflatoxin exposures among children recruited from primary schools in Makueni and Siaya Counties. A five-part questionnaire was administered to collect information from randomly selected participants. AflatoxinB1-lysine adducts in children's sera and total aflatoxins in food samples were analyzed by High-Performance Liquid Chromatography with Fluorescence detection. Using Chi-squared tests and Kruskal–Wallis tests, children from low-income households had the highest aflatoxin exposure, p-value = 0.0029. Smaller family size, greater food diversity, and good farming practices were associated with low aflatoxin exposures p < 0.001. Individual households living under severe levels of poverty were evidently exposed to higher levels of aflatoxins. [ABSTRACT FROM AUTHOR]