Investigating the Uptake of Hypofractionation for Breast and Prostate Cancer in Sub-Saharan Africa: A Qualitative Study of Physician and Medical Physicist Perspectives.

Purpose: In prostate and breast cancer, moderate hypofractionation (HF) has demonstrated comparable, if not greater, efficacy than conventional fractionation. There is a stark disparity in the uptake of HF between North America and Africa. Using the Consolidative Framework for Implementation Research, we evaluated barriers and facilitators for implementing HF in Sub-Saharan Africa (SSA).

Seasonal Variation in Home Range Sizes and Daily Distance to Ephemeral Surface Water for African Savannah Elephant () in Eastern Okavango Panhandle, Northern Botswana.

African elephants () are megaherbivores of the African savannas requiring extensive ranges that can provide critical resources for their survival and reproduction at different spatiotemporal scales. We studied seasonal differences in home range sizes and daily distance to the nearest surface water sources by five male and 10 female African elephants in the eastern Okavango Panhandle in northern Botswana between 2014 and 2017. We hypothesized that (i) elephant home ranges would be larger in the wet than in the dry season (because critical resources tend to be less localized in the wet than in the dry season), (ii) the daily distance of the elephants to the nearest ephemeral surface water sources would be larger in the dry than in the wet season because many of the ephemeral water sources would be dry in the dry season and elephants would start moving towards permanent water sources such as rivers, and lastly (iii) that the differences in elephant home ranges and daily distance to water would differ between sexes.

Knowledge, attitude, and practice of One Health and zoonotic diseases among multisectoral collaborators in Bhutan: Results from a nationwide survey.

The One Health concept is increasingly employed to combat zoonotic diseases. This study assessed the knowledge, attitudes, and practices regarding One Health and zoonotic diseases among key sector professionals to identify gaps and opportunities for enhancing One Health strategies in Bhutan. A cross-sectional, facility-based study was used to conduct a nationwide online questionnaire survey using a validated and pre-tested questionnaire among professionals from the Ministry of Health, the Ministry of Agriculture and Livestock, and universities.

Disparities in adult women's access to contraception during COVID-19: a multi-country cross-sectional survey.

During the COVID-19 pandemic, family planning services over the world have been disrupted. There are still uncertainties about the impact on access to contraception, particularly among marginalised populations. This study aimed to assess the effect of COVID-19 on women's access to contraception, focusing on those experiencing loss of income and self-isolation.

Molecular Testing of Zoonotic Bacteria in Cattle, Sheep, and Goat Abortion Cases in Botswana.

Abortion is one of the major causes of economic losses in livestock production worldwide. Because several factors can lead to abortion in cattle, sheep and goats, laboratory diagnosis, including the molecular detection of pathogens causing abortion, is often necessary. Bacterial zoonotic diseases such as brucellosis, coxiellosis, leptospirosis, and listeriosis have been implicated in livestock abortion, but they are under diagnosed and under-reported in most developing countries, including Botswana.

Evaluation of Hippocampal Microanatomy and Neuro-Biomarkers Following Administration of Silver Nanoparticles Conjugated with Tenofovir Disoproxil Fumarate in Experimental Diabetic Rats.

Adverse complications like metabolic disorders, neurotoxicity, and low central nervous system (CNS) penetration are associated with the long-term use of tenofovir disoproxil fumarate (TDF). Therefore, some modifications are required to enhance neurological functions using silver nanoparticles (AgNPs). This study aimed to evaluate the neuroprotective impact of silver nanoparticles (AgNPs)-conjugated TDF as AgNPs-TDF on the hippocampal microanatomy and some neuro-biomarkers of diabetic rats.

An Intelligent Approach for Early and Accurate Predication of Cardiac Disease Using Hybrid Artificial Intelligence Techniques.

This study proposes a new hybrid machine learning (ML) model for the early and accurate diagnosis of heart disease. The proposed model is a combination of two powerful ensemble ML models, namely ExtraTreeClassifier (ETC) and XGBoost (XGB), resulting in a hybrid model named ETCXGB. At first, all the features of the utilized heart disease dataset were given as input to the ETC model, which processed it by extracting the predicted probabilities and produced an output.

Scoping Review of Climate Change Adaptation Interventions for Health: Implications for Policy and Practice.

Climate change is among the greatest threats to health in the 21st century, requiring the urgent scaling-up of adaptation interventions. We aim to summarise adaptation interventions that were funded by the Belmont Forum and the European Union, the largest global funders of climate change and health research. A systematic search was conducted (updated February 2023) to identify articles on adaptation interventions for health within this funding network.

Neurodevelopmental outcomes in children exposed in utero to dolutegravir- or efavirenz-based ART.

Objective: To examine the impact of in utero exposure to dolutegravir (DTG)- or efavirenz (EFV)-based antiretroviral treatment (ART) on child neurodevelopmental (ND) outcomes.

Design: Prospective cohort design, enrolling 3 cohorts of 2-year-olds: children HIV-negative born to mothers with HIV (CHEU) receiving either DTG-based or EFV-based 3-drug ART during pregnancy, and children born to mothers without HIV (CHUU).

Methods: Primary child ND outcomes were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) and compared between cohorts using generalized estimating equation models adjusted for confounders.

High prevalence of reverse transcriptase inhibitors associated resistance mutations among people living with HIV on dolutegravir-based antiretroviral therapy in Francistown, Botswana.

Objectives: We assessed HIV-1 drug resistance profiles among people living with HIV (PLWH) with detectable viral load (VL) and on dolutegravir-based antiretroviral therapy (ART) in Botswana.

Methods: The study utilised available 100 residual HIV-1 VL samples from unique PLWH in Francistown who had viraemia at-least 6 months after initiating ART in Botswana's national ART program from November 2023 to January 2024. Viraemia was categorized as low-level viraemia (LLV) (VL: 200-999 copies/mL) or virologic failure (VF) (VL ≥1000 copies/mL).

Physical activity and anxiety during the COVID-19 pandemic in Tanzania: insights for public health policy in low-income contexts.

Background: The COVID-19 pandemic heightened anxiety levels globally, disproportionately affecting low-and middle-income countries (LMICs). Physical activity (PA) has shown potential to alleviate mental health challenges, including anxiety. This study explores the relationship between PA and anxiety among Tanzanian adults during the pandemic, examining whether self-reported health status moderates this relationship and identifying demographic variations.

Phylodynamic analysis reveals disparate transmission dynamics of -complex lineages in Botswana.

Tuberculosis epidemics have traditionally been conceptualized as arising from a single uniform pathogen. However, -complex (Mtbc), the pathogen causing tuberculosis in humans, encompasses multiple lineages exhibiting genetic and phenotypic diversity that may be responsible for heterogeneity in TB transmission. We analysed a population-based dataset of 1,354 Mtbc whole-genome sequences collected over four years in Botswana, a country with high HIV and tuberculosis burden.

Subsequent pregnancies in the IMPAACT 2010/VESTED Trial: high rate of adverse outcomes in women living with HIV.

Introduction: Women with HIV (WHIV) have higher risks of adverse pregnancy outcomes, particularly in the absence of antiretroviral treatment(ART), and timing of ART may impact risk.

Methods: In IMPAACT 2010 (VESTED), 643 pregnant WHIV in 9 countries were randomized 1:1:1 to initiate ART: dolutegravir (DTG)+emtricitabine(FTC)/tenofovir alafenamide(TAF); DTG+FTC/tenofovir disoproxil fumarate (TDF) or efavirenz (EFV)/FTC/TDF. We describe adverse pregnancy outcomes in women with a subsequent pregnancy during 50 weeks of postpartum follow-up: spontaneous abortion (<20 weeks), stillbirth (≥20 weeks), preterm delivery (<37 weeks) and small-for-gestational-age (SGA).

Effectiveness of physiotherapist-led exercise interventions for burn rehabilitation: A systematic review and meta-analysis.

Background: Exercise is utilised by physiotherapists to prevent complications and improve overall function and quality of life post-burn. However, the effect of physiotherapist-led exercise has not been comprehensively reviewed. Consequently, this study aimed to investigate the effectiveness of physiotherapy exercises for persons' post-burn.

Developing an evaluation approach for the in-depth review of a new undergraduate medical programme as a complex system.

Background: A new undergraduate medical programme was instituted at the University of Botswana in 2009. In 2016, the Faculty of Medicine decided to conduct a comprehensive review of the programme. Participants at a planning workshop decided the review had to lead to an in-depth understanding of the programme.

Extensive cervical lesion and treatment outcomes in women with HIV/HPV co-infection.

Background: Cervical cancer is a common cancer worldwide, with > 85% of deaths occurring in Lower- and Middle-Income Countries where resources for screening programs are limited. Women living with HIV (WLHIV) are at increased risk. HPV test-and-treat is a screening strategy where women with HPV are offered ablative treatment of the cervix to reduce the risk of invasive cancer.

Dynamical modeling of Salmonellosis in humans and dairy cattle with temperature and pH effects.

Approximately 20 million cases and 0.15 million human fatalities worldwide each year are caused by Salmonellosis. A mechanistic compartmental model based on ordinary differential equations is proposed to evaluate the effects of temperature and pH on the transmission dynamics of Salmonellosis.

Conceptualizing patient-level adverse effects in implementation trials.

Background: Identifying and monitoring adverse effects (AEs) are integral to ensuring patient safety in clinical trials. Research sponsors and regulatory bodies have put into place a variety of policies and procedures to guide researchers in protecting patient safety during clinical trials. However, it remains unclear how these policies and procedures should be adapted for trials in implementation science.

A descriptive summary of the WHO availability assessments of medical abortion medicines in eight African countries.

Background: The use of medical abortion using either a combination of mifepristone and misoprostol, or misoprostol alone has contributed to increased safety and decreased mortality and morbidity. The availability of quality medical abortion medicines is an essential component in the provision of quality abortion care. Understanding the factors that influence the availability of medical abortion medicines is important to help in-country policymakers, program planners, and providers improve availability and use of medical abortion.

Fish handling and postharvest losses around the Fincha'a, Amarti, and Nashe reservoirs in Oromiya, Ethiopia.

This study assessed the factors contributing to postharvest loss of fish around the Fincha'a, Amarti, and Nashe reservoirs in Horro Guduru Wollega, Oromia, Western Ethiopia, using semi-structured questionnaires from January, 2022 GC onward. The aim of the finding was to know the fish handling and post-harvest preservation of fish around the reservoirs. In the study area, 320 respondents were selected using a random sampling system.

Pan African Vivax and Ovale Network (PAVON) Malaria Diagnostic Competency Training: Offering Training Opportunities to Impact Malaria Elimination Strategies in Sub-Saharan Africa.

PAVON has developed a malaria microscopy competency training scheme to augment competency in malaria microscopy. Here, data accrued from training activities between 2020 and 2023 in Botswana are presented. Three trainings were done for 37 central and peripheral level technicians for a two-week period.

Emergence of Omicron FN.1 a descendent of BQ.1.1 in Botswana.

Botswana, like the rest of the world, has been significantly impacted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In December 2022, we detected a monophyletic cluster of genomes comprising a sublineage of the Omicron variant of concern (VOC) designated as B.1.

Trends and Outcomes of Laparoscopic Surgery in Low-Resource Settings: Lessons From Two African Healthcare Systems-A Narrative Review.

Introduction: Laparoscopic surgery (LS) has been a promising development in surgical practice globally ever since its introduction. LS has exhibited many an advantage, including bettering patient outcomes, lowering the risk of postoperative infection, and displaying economical affluence. However, its implementation in the African continent still faces various challenges.