Non-typhoidal Salmonella among slaughterhouse workers and in the pork value chain in selected districts of Uganda.

Introduction: Non-typhoidal Salmonella (NTS) is a major cause of gastroenteritis worldwide, often associated with meat consumption and meat processing. Research on NTS infection and circulating serovars in meat value chains in Uganda is limited. We aimed to establish NTS prevalence, antimicrobial resistance, and risk factors among slaughterhouse workers, and to identify potentially zoonotic serovars in the pork value chain. Material and methods: We conducted a nationwide cross-sectional survey, collecting 364 stool samples from livestock slaughterhouse workers and 1,535 samples from the pork value chain: mesenteric lymph nodes, fecal samples, swabs of carcass splitting floor, cleaning water, meat handlers hand swabs, carcass swabs, raw pork, cooked pork, and mixed raw vegetables. Samples were cultured for isolation of NTS, and subsequently serotyped according to White-Kauffmann-Le Minor scheme. Antimicrobial resistance profiles were determined using tube microdilution and Sensititre® EUVSEC3® plates. Semi- structured questionnaires with 35 questions were used to collect data on demographics, work related risk factors and activities outside the slaughterhouse. Results and discussion: Overall NTS prevalence was 19.2% (365/1899). Proportions at slaughter were; 46.7% in floor swabs, 30.5% in carcass swabs, 20.5% in pig faeces,19.2% in mesenteric lymph nodes,18.4% in hand swabs, 9.5% in water and 5.2% in slaughterhouse workers. At retail, proportions were 33.8% in pork chopping surface, 33.1% in raw pork, 18.9% in hand swabs, 4.0% in cooked pork and 0.7% in vegetables. Sixty-one serovars were identified, with significant overlap between humans and the pork value chain. Overall, zoonotic S. Zanzibar, monophasic serovars of S. subspecies salamae (II) and subspecies enterica (I), S. Typhimurium and S. Newport, were the most prevalent. S. Typhimurium was predominant in humans and exhibited multi-drug resistance. NTS infection was significantly associated with eating, drinking, or smoking while working (OR = 1.95, 95% CI: 0.67-2.90%, p = 0.004). The detected NTS serovars in slaughterhouse workers could be a potential indicator of circulating serovars in the general population. The persistent presence of NTS along the pork value chain highlights occurrence of cross-contamination and the potential for transmission to consumers and slaughterhouse workers. This emphasizes the need to reduce Salmonella prevalence on pig farms and improve hygiene and pork handling practices at slaughter and retail points.

Epidemiology of human and animal leptospirosis in Kenya: A systematic review and meta-analysis of disease occurrence, serogroup diversity and risk factors.

BACKGROUND: Leptospirosis is a priority zoonotic disease in Kenya, but an in-depth review of its presence in humans, animals and the environment is lacking. Therefore, we conducted this systematic review and meta-analysis to understand the epidemiological situation to date. METHODOLOGY: We searched for literature in African journals online, AGRIS, Embase, the Leptospira WOAH reference laboratory library, ProMED-mail, PubMed, Scopus, Web of Science, and the institutional repositories of 33 academic institutions and included 66 publications on leptospirosis in Kenya which spanned from 1951 to 2022. The review was registered on the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY). FINDINGS: Most investigations were done in rural and urban areas in western, southern, central, and coastal areas in Kenya and the largely pastoral eastern and northern areas were under-represented. A wide host range of domestic animals and wildlife was revealed, and occupational exposure was an important risk factor for humans. The microscopic agglutination test (MAT) was the most frequent test, particularly common in studies conducted during the 1980s and 1990s. However, varying MAT panels and cut-off titres were observed. The overall seroprevalence in cattle was 28.2% (95% confidence intervals [CI]: 12.0-53.0; heterogeneity: I2 = 96.7%, τ2 = 1.4), and 11.0% in goats (95% CI: 5.4-21.2; heterogeneity: I2 = 78.8%, τ2 = 0.4). Molecular tests were seldom used to determine species and illustrate strain diversity. There was a lack of awareness of leptospirosis among farmers and health practitioners. CONCLUSION: The widespread presence of leptospires and inadequate diagnostic capacity demonstrate that leptospirosis is a common but underreported disease in Kenya. Raising awareness and boosting the country's diagnostic capacity is crucial to timely detection and disease control.

Brucella Species Circulating in Smallholder Dairy Cattle in Tanzania.

Brucellosis is a zoonosis caused by bacteria of the genus Brucella, which results in economic losses relating to livestock and threatens public health. A cross-sectional study was conducted to determine the molecular prevalence of Brucella species in smallholder dairy cattle in six regions of Tanzania from July 2019 to October 2020. Dairy cattle (n = 2048) were sampled from 1371 farms. DNA extracted from blood and vaginal swabs was tested for Brucella using qPCR targeting the IS711 gene and positives were tested for the alkB marker for B. abortus and BMEI1172 marker for B. melitensis. The molecular prevalence was 3.5% (95% CI: 2.8-4.4) with the highest prevalence 8.1% (95% CI: 4.6-13.0) in Njombe region. B. melitensis was the predominant species detected (66.2%). Further studies are recommended to understand the source of B. melitensis and its implications for veterinary public health. Livestock keepers should be informed of the risks and biosecurity practices to reduce the introduction and control of Brucella. Cattle and small ruminant vaccination programs could be implemented to control brucellosis in high-risk populations in the country.

Indirect victims of violence: Mental health and the close relatives of serious assault victims in England.

An extensive body of evidence shows the impact of being the direct victim of a serious assault. However, much less is known about the impact on the family and close relatives of victims, who may be considered indirect victims. Based on analyses of the 2014 Adult Psychiatric Morbidity Survey, a face-to-face, cross-sectional probability-sample survey of 7519 adults aged 16 and over in England, this article estimates what proportion of the population was closely related to a victim of serious assault, and whether this experience was associated with a higher prevalence of feeling unsafe, depression and anxiety disorder, post-traumatic stress, self-harm, and suicidality. Descriptive and multivariable regression analyses were conducted, adjusting for complex survey design and potentially confounding factors. Results show that one in twenty adults (4.5%, n = 345) was closely related to a victim of serious assault (95% confidence interval (CI):4.0-5.2%). Close adult relatives of assault victims were more likely than the rest of the population to have been direct victims of violence and abuse themselves, to have experienced multiple other adversities, and to live in more deprived neighbourhoods. However, even when controlling for these experiences, relatives of victims had adjusted odds of feeling unsafe in the neighbourhood where they lived 2.36 times higher than the rest of the population (CI:1.26-4.44), and their odds of having a depressive or anxiety disorder were 1.37 times higher (0.99-1.90). These analyses indicate that relatives in England may already be vulnerable, with potential to also be further affected by the experiences of family members. To more fully account for the effects of violence in society, research with indirect victims of serious violence in the context of their own experiences of direct victimization and wider adversities is required. This could be factored into a broader remit for victim support services which includes support for victims' families.

Cost-effectiveness of a two-layer compression bandage versus standard bandage following total knee arthroplasty.

Aims: To assess the cost-effectiveness of a two-layer compression bandage versus a standard wool and crepe bandage following total knee arthroplasty, using patient-level data from the Knee Replacement Bandage Study (KReBS). Methods: A cost-utility analysis was undertaken alongside KReBS, a pragmatic, two-arm, open label, parallel-group, randomized controlled trial, in terms of the cost per quality-adjusted life year (QALY). Overall, 2,330 participants scheduled for total knee arthroplasty (TKA) were randomized to either a two-layer compression bandage or a standard wool and crepe bandage. Costs were estimated over a 12-month period from the UK NHS perspective, and health outcomes were reported as QALYs based on participants' EuroQol five-dimesion five-level questionnaire responses. Multiple imputation was used to deal with missing data and sensitivity analyses included a complete case analysis and testing of costing assumptions, with a secondary analysis exploring the inclusion of productivity losses. Results: The base case analysis found participants in the compression bandage group accrued marginally fewer QALYs, on average, compared with those in the standard bandage group (reduction of 0.0050 QALYs (95% confidence interval (CI) -0.0051 to -0.0049)), and accumulated additional mean costs (incremental cost of £52.68 per participant (95% CI 50.56 to 54.80)). Findings remained robust to assumptions tested in sensitivity analyses, although considerable uncertainty surrounded the outcome estimates. Conclusion: Use of a two-layer compression bandage is marginally less effective in terms of health-related quality of life, and more expensive when compared with a standard bandage following TKA, so therefore is unlikely to provide a cost-effective option.

Continent-wide genomic analysis of the African buffalo (Syncerus caffer).

The African buffalo (Syncerus caffer) is a wild bovid with a historical distribution across much of sub-Saharan Africa. Genomic analysis can provide insights into the evolutionary history of the species, and the key selective pressures shaping populations, including assessment of population level differentiation, population fragmentation, and population genetic structure. In this study we generated the highest quality de novo genome assembly (2.65 Gb, scaffold N50 69.17 Mb) of African buffalo to date, and sequenced a further 195 genomes from across the species distribution. Principal component and admixture analyses provided little support for the currently described four subspecies. Estimating Effective Migration Surfaces analysis suggested that geographical barriers have played a significant role in shaping gene flow and the population structure. Estimated effective population sizes indicated a substantial drop occurring in all populations 5-10,000 years ago, coinciding with the increase in human populations. Finally, signatures of selection were enriched for key genes associated with the immune response, suggesting infectious disease exert a substantial selective pressure upon the African buffalo. These findings have important implications for understanding bovid evolution, buffalo conservation and population management.

Large-scale determinants of street tree growth rates across an urban environment.

Urban street trees offer cities critical environmental and social benefits. In New York City (NYC), a decadal census of every street tree is conducted to help understand and manage the urban forest. However, it has previously been impossible to analyze growth of an individual tree because of uncertainty in tree location. This study overcomes this limitation using a three-step alignment process for identifying individual trees with ZIP Codes, address, and species instead of map coordinates. We estimated individual growth rates for 126,362 street trees (59 species and 19% of 2015 trees) using the difference between diameter at breast height (DBH) from the 2005 and 2015 tree censuses. The tree identification method was verified by locating and measuring the DBH of select trees and measuring a set of trees annually for over 5 years. We examined determinants of tree growth rates and explored their spatial distribution. In our newly created NYC tree growth database, fourteen species have over 1000 unique trees. The three most abundant tree species vary in growth rates; London Planetree (n = 32,056, 0.163 in/yr) grew the slowest compared to Honeylocust (n = 15,967, 0.356 in/yr), and Callery Pear (n = 15,902, 0.334 in/yr). Overall, Silver Linden was the fastest growing species (n = 1,149, 0.510 in/yr). Ordinary least squares regression that incorporated biological factors including size and the local urban form indicated that species was the major factor controlling growth rates, and tree stewardship had only a small effect. Furthermore, tree measurements by volunteer community scientists were as accurate as those made by NYC staff. Examining city wide patterns of tree growth indicates that areas with a higher Social Vulnerability Index have higher than expected growth rates. Continued efforts in street tree planting should utilize known growth rates while incorporating community voices to better provide long-term ecosystem services across NYC.

NPCC4: Concepts and tools for envisioning New York City's futures.

This chapter of the New York City Panel on Climate Change 4 (NPCC4) report discusses the many intersecting social, ecological, and technological-infrastructure dimensions of New York City (NYC) and their interactions that are critical to address in order to transition to and secure a climate-adapted future for all New Yorkers. The authors provide an assessment of current approaches to "future visioning and scenarios" across community and city-level initiatives and examine diverse dimensions of the NYC urban system to reduce risk and vulnerability and enable a future-adapted NYC. Methods for the integration of community and stakeholder ideas about what would make NYC thrive with scientific and technical information on the possibilities presented by different policies and actions are discussed. This chapter synthesizes the state of knowledge on how different communities of scholarship or practice envision futures and provides brief descriptions of the social-demographic and housing, transportation, energy, nature-based, and health futures and many other subsystems of the complex system of NYC that will all interact to determine NYC futures.

Emerging data on diagnosis and management of uterine isthmoceles: a rapid review.

PURPOSE OF REVIEW: With a rising number of cesarean sections, the prevalence of uterine isthmoceles is increasing. We performed a rapid review to assess the most recent data on the diagnosis and management of uterine isthmoceles over the past 18 months to identify current trends and directions for continued research. RECENT FINDINGS: A comprehensive search was conducted in PubMed (NLM), Embase (Ovid), CINAHL (EBSCOhost) to find English written articles discussing the diagnosis or management of uterine isthmoceles published in the previous 18 months. Data extraction was performed on one hundred articles that met inclusion criteria. SUMMARY: This rapid review highlights agreement regarding diagnostic methods, symptoms, and recommended treatment paths for patients with symptomatic uterine niches. However, the diversity in definitions hampers the capacity to formulate detailed conclusions regarding the features of uterine niches and their impact on women's health.

Urbanization exacerbates climate sensitivity of eastern United States broadleaf trees.

Tree growth is a key mechanism driving carbon sequestration in forest ecosystems. Environmental conditions are important regulators of tree growth that can vary considerably between nearby urban and rural forests. For example, trees growing in cities often experience hotter and drier conditions than their rural counterparts while also being exposed to higher levels of light, pollution, and nutrient inputs. However, the extent to which these intrinsic differences in the growing conditions of trees in urban versus rural forests influence tree growth response to climate is not well known. In this study, we tested for differences in the climate sensitivity of tree growth between urban and rural forests along a latitudinal transect in the eastern United States that included Boston, Massachusetts, New York City, New York, and Baltimore, Maryland. Using dendrochronology analyses of tree cores from 55 white oak trees (Quercus alba), 55 red maple trees (Acer rubrum), and 41 red oak trees (Quercus rubra) we investigated the impacts of heat stress and water stress on the radial growth of individual trees. Across our three-city study, we found that tree growth was more closely correlated with climate stress in the cooler climate cities of Boston and New York than in Baltimore. Furthermore, heat stress was a significant hindrance to tree growth in higher latitudes while the impacts of water stress appeared to be more evenly distributed across latitudes. We also found that the growth of oak trees, but not red maple trees, in the urban sites of Boston and New York City was more adversely impacted by heat stress than their rural counterparts, but we did not see these urban-rural differences in Maryland. Trees provide a wide range of important ecosystem services and increasing tree canopy cover was typically an important component of urban sustainability strategies. In light of our findings that urbanization can influence how tree growth responds to a warming climate, we suggest that municipalities consider these interactions when developing their tree-planting palettes and when estimating the capacity of urban forests to contribute to broader sustainability goals in the future.

Strategies to develop an LGBTQIA+-inclusive adolescent sexual health program evaluation.

Introduction: Adolescent sexual health interventions are increasingly incorporating content that is inclusive of LGBTQIA+ youth (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other marginalized sexualities and genders). Evaluations of such programs must also be inclusive to enhance the validity of evaluation results and avoid further marginalization. We present strategies for increasing LGBTQIA+-inclusivity based on our evaluation of SafeSpace, a sexual health curriculum. Methods: To design an LGBTQIA+-inclusive program evaluation, we leveraged LGBTQIA+ research staff's insights, pursued a parental consent waiver, developed an inclusive recruitment plan, and crafted demographic and sexual behavior survey measures with input from youth and equity experts. We conducted a pilot study with 42 youth ages 14-17 to assess the feasibility and efficacy of our strategies. Results: We obtained a parental consent waiver and recruited a majority LGBTQIA+ pilot study sample (62%). Using themes from cognitive interviews with youth and experts regarding inclusive framing and use of plain language, we refined demographic measures and expanded sexual behavior measures. Conclusion: Findings suggest that the strategies used to enhance LGBTQIA+-inclusivity in our evaluation of SafeSpace were effective in respectfully and more accurately capturing a fuller range of experiences and identities of LGBTQIA+ and cis-straight youth. The strategies and survey measures developed for this study can be applied to increase LGBTQIA+-inclusivity in other adolescent sexual health program evaluations.

Trends in outcomes used to measure the effectiveness of UK-based support interventions and services targeted at adults with experience of domestic and sexual violence and abuse: a scoping review.

OBJECTIVES: In the UK, a range of support services and interventions are available to people who have experienced or perpetrated domestic and sexual violence and abuse (DSVA). However, it is currently not clear which outcomes and outcome measures are used to assess their effectiveness. The objective of this review is to summarise, map and identify trends in outcome measures in evaluations of DSVA services and interventions in the UK. DESIGN: Scoping review. DATA SOURCES: MEDLINE, EMBASE, PsycINFO, Social Policy and Practice, ASSIA, IBSS, Sociological abstracts and SSCI electronic databases were searched from inception until 21 June 2022. Grey literature sources were identified and searched. ELIGIBILITY: We included randomised controlled trials, non-randomised comparative studies, pre-post studies and service evaluations, with at least one outcome relating to the effectiveness of the support intervention or service for people who have experienced and/or perpetrated DSVA. Outcomes had to be assessed at baseline and at least one more time point, or compared with a comparison group. CHARTING METHODS: Outcome measures were extracted, iteratively thematically grouped into categories, domains and subdomains, and trends were explored. RESULTS: 80 studies reporting 87 DSVA interventions or services were included. A total of 426 outcome measures were extracted, of which 200 were used more than once. The most commonly reported outcome subdomain was DSVA perpetration. Cessation of abuse according to the Severity of Abuse Grid was the most common individual outcome. Analysis of temporal trends showed that the number of studies and outcomes used has increased since the 1990s. CONCLUSIONS: Our findings highlight inconsistencies between studies in outcome measurement. The increase in the number of studies and variety of measures suggests that as evaluation of DSVA services and interventions matures, there is an increased need for a core of common, reliable metrics to aid comparability. PROTOCOL REGISTRATION: https://osf.io/frh2e.

Prevalence of physical violence against people in insecure migration status: A systematic review and meta-analysis.

OBJECTIVES: This study summarised evidence on the prevalence of interpersonal, community and state physical violence against people in insecure migration status. METHODS: We conducted a systematic review and meta-analysis of primary studies that estimated prevalence of physical violence against a population in insecure migration status. We searched Embase, Social Policy and Practice, Political Science Complete, SocINDEX and Web of Science Social Sciences Citation Index for reports published from January 2000 until 31 May 2023. Study quality was assessed using an adapted version of the Joanna Briggs assessment tool for cross-sectional studies. Two reviewers carried out screening, data extraction, quality assessment and analysis. Meta-analysis was conducted in Stata 17, using a random effects model and several exploratory subgroup analyses. RESULTS: We retrieved 999 reports and included 31 retrospective cross-sectional studies with 25,997 migrants in insecure status. The prevalence estimate of physical violence was 31.16% (95% CI 25.62-36.70, p < .00). There was no statistically significant difference in the estimates for prevalence of violence for men (35.30%, 95% CI 18.45-52.15, p < .00) and for women (27.78%, 95% CI 21.42-34.15, p < .00). The highest point estimate of prevalence of violence was where insecure status was related to employment (44.40%, 95% CI 18.24-70.57, p < .00), although there were no statistically significant difference in the subgroup analysis. The prevalence of violence for people in undocumented status was not significantly different (29.13%, 95% CI 19.86-38.41, p < .00) than that for refugees and asylum seekers (33.29%, 95% CI 20.99-45.59, p < .00). The prevalence of violence in Asia was 56.01% (95% CI 22.47-89.55, p < .00). Europe had the lowest point prevalence estimate (17.98%, 95% CI 7.36-28.61, p < .00), although the difference was not statistically significant. The prevalence estimate during the migration journey was 32.93% (95% CI 24.98-40.88, p < .00). Intimate partner violence attached to insecure status was estimated at 29.10%, (95% CI 8.37-49.84, p = .01), and state violence at 9.19% (95% CI 6.71-11.68, p < .00). CONCLUSIONS: The prevalence of physical violence is a concern among people in a range of insecure migration statuses. Prevalence of violence is not meaningfully higher for people in undocumented status than for people in other types of insecure status. REVIEW REGISTRATION: PROSPERO (CRD42021268772).

Surgical versus non-surgical management of lateral compression type-1 pelvic fracture in adults 60 years and older: the L1FE RCT.

Background: Lateral compression type-1 pelvic fractures are a common fragility fracture in older adults. Patients who do not mobilise due to ongoing pain are at greater risk of immobility-related complications. Standard treatment in the United Kingdom is provision of pain relief and early mobilisation, unlike fragility hip fractures, which are usually treated surgically based on evidence that early surgery is associated with better outcomes. Currently there is no evidence on whether patients with lateral compression type-1 fragility fractures would have a better recovery with surgery than non-surgical management. Objectives: To assess the clinical and cost effectiveness of surgical fixation with internal fixation device compared to non-surgical management of lateral compression type-1 fragility fractures in older adults. Design: Pragmatic, randomised controlled superiority trial, with 12-month internal pilot; target sample size was 600 participants. Participants were randomised between surgical and non-surgical management (1 : 1 allocation ratio). An economic evaluation was planned. Setting: UK Major Trauma Centres. Participants: Patients aged 60 years or older with a lateral compression type-1 pelvic fracture, arising from a low-energy fall and unable to mobilise independently to a distance of 3 m and back due to pelvic pain 72 hours after injury. Interventions: Internal fixation device surgical fixation and non-surgical management. Participants, surgeons and outcome assessors were not blinded to treatment allocation. Main outcome measures: Primary outcome - average patient health-related quality of life, over 6 months, assessed by the EuroQol-5 Dimensions, five-level version utility score. Secondary outcomes (over the 6 months following injury) - self-rated health, physical function, mental health, pain, delirium, displacement of pelvis, mortality, complications and adverse events, and resource use data for the economic evaluation. Results: The trial closed early, at the end of the internal pilot, due to low recruitment. The internal pilot was undertaken in two separate phases because of a pause in recruitment due to the coronavirus disease 2019 pandemic. The planned statistical and health economic analyses were not conducted. Outcome data were summarised descriptively. Eleven sites opened for recruitment for a combined total of 92 months. Three-hundred and sixteen patients were assessed for eligibility, of whom 43 were eligible (13.6%). The main reason for ineligibility was that the patient was able to mobilise independently to 3 m and back (n = 161). Of the 43 eligible participants, 36 (83.7%) were approached for consent, of whom 11 (30.6%) provided consent. The most common reason for eligible patients not consenting to take part was that they were unwilling to be randomised to a treatment (n = 10). There were 11 participants, 5 randomised to surgical management with internal fixation device and 6 to non-surgical management. The average age of participants was 83.0 years (interquartile range 76.0, 89.0) and the EuroQol-5 Dimensions, five-level version utility score at 6 months post randomisation (n = 8) was 0.32 (standard deviation 0.37). A limitation of the trial was that study objectives were not addressed due to poor recruitment. Conclusions: It was not feasible to recruit to this trial in the current context. Further research to understand the treatment and recovery pathways of this group of patients, along with their outcomes, would be needed prior to undertaking a future trial. Future work: Exploration of equipoise across different healthcare professional groups. Investigate longer-term patient outcomes. Trial registration: This trial is registered as ISRCTN16478561. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/167/57) and is published in full in Health Technology Assessment; Vol. 28, No. 15. See the NIHR Funding and Awards website for further award information.

When older adults with weak bones fall onto their side, they can fracture the pelvis in a certain way known as a 'lateral compression type-1 fracture'; this summary will use 'pelvic fracture'. Pelvic fractures can heal without surgery; patients are offered pain relief and encouraged to move as much as they can after the injury. Pelvic fractures can be painful, and some people are not able to get up and walk for weeks. These fractures can cause health problems such as chest infections, urinary tract infections, pressure sores and blood clots. To avoid these problems, we are trying to find treatments to help people recover sooner. Pelvic surgeons think patients may benefit from surgery with an internal fixation device (a bar and screws) to stabilise the pelvis; however, there can be risks and complications with any surgery. This study aimed to find out which treatment is better for patients and better value for money for the National Health Service. This required 600 people aged over 60, in hospital with a pelvic fracture and having difficulty walking to take part. Three hundred would receive surgery and 300 would receive non-surgical treatment. Over 6 months, participants would complete questionnaires, a walking assessment and have X-rays to check healing. The trial had a 12-month run-in period to see if enough people would take part. The trial closed early as we were unable to recruit sufficient people into the study. Fewer older patients with pelvic fractures were identified than expected, 51% were able to walk after a few days and therefore were not eligible to be included in the study. Of the patients, 13.6% were eligible and 30.6% of those consented to take part. Restrictions on visitors during the coronavirus disease 2019 pandemic made it difficult to discuss the study with patients' families and fewer patients were admitted to hospital where the study was taking place. The research question could not be answered by this study at the present time.

Cross-sectional serosurvey of Leptospira species among slaughter pigs, goats, and sheep in Uganda.

INTRODUCTION: Leptospira are a group of bacteria, including pathogenic types that cause leptospirosis. In Uganda, Leptospira exposure has been reported in humans, with domesticated animals being speculated as the source. However, comparable evidence of Leptospira prevalence and circulating serovars/serogroups in animals is only documented for cattle, and dogs. Our study determined Leptospira seroprevalence, associated risk factors and serogroups circulating among slaughtered pigs, goats, and sheep in Uganda. METHODS: During an 11-month cross-sectional survey in selected slaughter facilities in three regions of Uganda, we collected blood from 926 pigs, 347 goats, and 116 sheep. The age, sex, breed, and origin of each sampled animal were noted. The samples were tested for anti-Leptospira antibodies using the microscopic agglutination test, based on a panel of 12 serovars belonging to 12 serogroups. RESULTS: Leptospira seroprevalence was 26.67% (247/926, 95%CI 23.92-29.61) among pigs, and 21.81% (101/463, 95%CI 18.29-25.80) in goats and sheep (small ruminants). L. interrogans Australis and L. kirschneri Grippotyphosa were the commonest serovars among pigs, as was L. borgpetersenii Tarassovi in small ruminants. Pigs sourced from the Eastern (Odds Ratio [OR] = 2.82, 95%CI 1.84-4.30) and Northern (OR = 3.56, 95%CI 2.52-5.02) regions were more likely to be seropositive, compared to those from the Central region. For small ruminants, being female (OR 2.74, 95% CI 1.69-4.57) and adult (OR 4.47, 95% CI 1.57-18.80) was significantly more associated with Leptospira seropositivity. Conclusion/significance: Detection of a moderate seroprevalence, and several Leptospira serogroups among pigs, sheep, and goats from all regions of Uganda, supports existing reports in cattle and dogs, and implies widespread Leptospira exposure in domestic animals in Uganda. These findings may inform future programs for the control of leptospirosis in livestock in Uganda.

Sero-prevalence and risk factors associated with occurrence of anti-Brucella antibodies among slaughterhouse workers in Uganda.

INTRODUCTION: Brucellosis is a febrile zoonosis occurring among high-risk groups such as livestock keepers and abattoir workers and is a public health priority in Uganda. The technical complexities of bacteriological and molecular methods make serological approaches the cornerstone of diagnosis of human brucellosis in resource limited settings. Therefore, proper application and interpretation of serological tests is central to achieve a correct diagnosis. MATERIALS AND METHODS: We conducted a cross-sectional study to estimate the seroprevalence and factors associated with anti-Brucella antibodies among slaughterhouse workers processing ruminants and pigs in three regions of the country with serial testing using a combination of the Rose Bengal Test (RBT) and the BrucellaCapt test. An authorized clinician collected 543 blood samples from consenting abattoir workers as well as attribute medical and social demographic data. Univariable and multivariable logistic regression were used to determine factors associated with anti-Brucella sero-positivity. RESULTS AND DISCUSSION: The sero-prevalence among ruminant slaughterhouse workers ranged from 7.3% (95% CI: 4.8-10.7) using BrucellaCapt to 9.0% (95% CI: 6.3-12.7) using RBT. Slaughterhouse workers from the Eastern regions (AOR = 9.84, 95%CI 2.27-69.2, p = 0.006) and those who graze animals for alternative income (AOR = 2.36, 95% CI: 1.91-6.63, p = 0.040) were at a higher risk of exposure to Brucella. Similarly, those who wore Personal Protective Equipment (AOR = 4.83, 95%CI:1.63-18.0, p = 0.009) and those who slaughter cattle (AOR = 2.12, 95%CI: 1.25-6.0, p = 0.006) were at a higher risk of exposure to Brucella. Those who slaughter small ruminants (AOR = 1.54, 95%CI: 1.32-4.01, p = 0.048) were also at a higher risk of exposure to Brucella. CONCLUSIONS AND RECOMMENDATIONS: Our study demonstrates the combined practical application of the RBT and BrucellaCapt in the diagnosis of human brucellosis in endemic settings. Both pharmaceutical (e.g., routine testing and timely therapeutic intervention), and non-pharmaceutical (e.g., higher index of suspicion of brucellosis when investigating fevers of unknown origin and observation of strict abattoir hygiene) countermeasures should be considered for control of the disease in high-risk groups.

Horizon scanning of potential threats to high-Arctic biodiversity, human health and the economy from marine invasive alien species: A Svalbard case study.

The high Arctic is considered a pristine environment compared with many other regions in the northern hemisphere. It is becoming increasingly vulnerable to invasion by invasive alien species (IAS), however, as climate change leads to rapid loss of sea ice, changes in ocean temperature and salinity, and enhanced human activities. These changes are likely to increase the incidence of arrival and the potential for establishment of IAS in the region. To predict the impact of IAS, a group of experts in taxonomy, invasion biology and Arctic ecology carried out a horizon scanning exercise using the Svalbard archipelago as a case study, to identify the species that present the highest risk to biodiversity, human health and the economy within the next 10 years. A total of 114 species, currently absent from Svalbard, recorded once and/or identified only from environmental DNA samples, were initially identified as relevant for review. Seven species were found to present a high invasion risk and to potentially cause a significant negative impact on biodiversity and five species had the potential to have an economic impact on Svalbard. Decapod crabs, ascidians and barnacles dominated the list of highest risk marine IAS. Potential pathways of invasion were also researched, the most common were found associated with vessel traffic. We recommend (i) use of this approach as a key tool within the application of biosecurity measures in the wider high Arctic, (ii) the addition of this tool to early warning systems for strengthening existing surveillance measures; and (iii) that this approach is used to identify high-risk terrestrial and freshwater IAS to understand the overall threat facing the high Arctic. Without the application of biosecurity measures, including horizon scanning, there is a greater risk that marine IAS invasions will increase, leading to unforeseen changes in the environment and economy of the high Arctic.

Change of urban park usage as a response to the COVID-19 global pandemic.

Urban parks became critical for maintaining the well-being of urban residents during the COVID-19 global pandemic. To examine the impact of COVID-19 on urban park usage, we selected New York City (NYC) and used SafeGraph mobility data, which was collected from a large sample of mobile phone users, to assess the change in park visits and travel distance to a park based on 1) park type, 2) the income level of the visitor census block group (visitor CBG) and 3) that of the park census block group (park CBG). All analyses were adjusted for the impact of temperature on park visitation, and we focused primarily on visits made by NYC residents. Overall, for the eight most popular park types in NYC, visits dropped by 49.2% from 2019 to 2020. The peak reduction in visits occurred in April 2020. Visits to all park types, excluding Nature Areas, decreased from March to December 2020 as compared to 2019. Parks located in higher-income CBGs tended to have lower reductions in visits, with this pattern being primarily driven by large parks, including Flagship Parks, Community Parks and Nature Areas. All types of parks saw significant decreases in distance traveled to visit them, with the exception of the Jointly Operated Playground, Playground, and Nature Area park types. Visitors originating from lower-income CBGs traveled shorter distances to parks and had less reduction in travel distances compared to those from higher-income CBGs. Furthermore, both before and during the pandemic, people tended to travel a greater distance to parks located in high-income CBGs compared to those in low-income CBGs. Finally, multiple types of parks proved crucial destinations for NYC residents during the pandemic. This included Nature Areas to which the visits remained stable, along with Recreation Field/Courts which had relatively small decreases in visits, especially for lower-income communities. Results from this study can support future park planning by shedding light on the different uses of certain park types before and during a global crisis, when access to these facilities can help alleviate the human well-being consequences of "lockdown" policies.

Risk factors for diarrheagenic Escherichia coli infection in children aged 6-24 months in peri-urban community, Nairobi, Kenya.

Escherichia coli commonly inhabits the gut of humans and animals as part of their microbiota. Though mostly innocuous, some strains have virulence markers that make them pathogenic. This paper presents results of a cross-sectional epidemiological study examining prevalence of diarrheagenic E. coli (DEC) pathotypes in stool samples of asymptomatic healthy children (n = 540) in Dagoretti South subcounty, Nairobi, Kenya. E. coli was cultured and pathotyped using PCR to target specific virulence markers associated with Shiga-toxin, enteropathogenic, enterotoxigenic, enteroaggregative, entero-invasive and diffusely adherent E. coli. Overall prevalence of DEC pathotypes was 20.9% (113/540) with enteropathogenic E. coli being the most prevalent (34.1%), followed by enteroaggregative E. coli (23.5%) and Shiga-toxin producing E. coli (22.0%) among positive samples. We found evidence of co-infection with multiple pathotypes in 15% of the positive samples. Our models indicated that at the household level, carriage of DEC pathotypes in children was associated with age group [12-18 months] (OR 1.78; 95%CI 1.03-3.07; p = 0.04), eating matoke (mashed bananas) (OR 2.32; 95%CI 1.44-3.73; p = 0.001) and pulses/legumes (OR 1.74; 95%CI 1.01-2.99; p = 0.046) while livestock ownership or contact showed no significant association with DEC carriage (p>0.05). Our findings revealed significant prevalence of pathogenic DEC circulating among presumptive healthy children in the community. Since there has been no previous evidence of an association between any food type and DEC carriage, unhygienic handling, and preparation of matoke and pulses/legumes could be the reason for significant association with DEC carriage. Children 12-18 months old are more prone to DEC infections due to exploration and hand-to-mouth behavior. A detailed understanding is required on what proportion of positive cases developed severe symptomatology as well as fatal outcomes. The co-infection of pathotypes in the rapidly urbanizing environment needs to be investigated for hybrid or hetero-pathotype circulation that have been implicated in previous infection outbreaks.