Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening.

BACKGROUND: A well-established antimicrobial resistance (AMR) laboratory-based surveillance (LBS) is of utmost importance in a country like Zambia which bears a significant proportion of the world's communicable disease burden. This study assessed the capacity of laboratories in selected hospitals to conduct AMR surveillance in Zambia. METHODS: This cross-sectional exploratory study was conducted among eight purposively selected hospitals in Zambia between August 2023 and December 2023. Data were collected using the self-scoring Laboratory Assessment of Antibiotic Resistance Testing Capacity (LAARC) tool. FINDINGS: Of the assessed facilities, none had full capacity to conduct AMR surveillance with varying capacities ranging from moderate (63% (5/8)) to low (38% (3/8)). Some of the barriers of AMR-LBS were the lack of an electronic laboratory information system (63% (5/8)) and the lack of locally generated antibiograms (75% (6/8)). Quality control for antimicrobial susceptibility testing (AST), pathogen identification and media preparation had the lowest overall score among all of the facilities with a score of 14%, 20% and 44%, respectively. The highest overall scores were in specimen processing (79%), data management (78%), specimen collection, transport and management (71%), and safety (70%). Most facilities had standard operating procedures in place but lacked specimen-specific standard operating procedures. CONCLUSION: The absence of laboratories with full capacity to conduct AMR surveillance hinders efforts to combat AMR and further complicates the treatment outcomes of infectious diseases. Establishing and strengthening LBS systems are essential in quantifying the burden of AMR and supporting the development of local antibiograms and treatment guidelines.

Optimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settings.

The World Health Organization's 2035 vision is to reduce tuberculosis (TB) associated mortality by 95%. While low-burden, well-equipped industrialised economies can expect to see this goal achieved, it is challenging in the low- and middle-income countries that bear the highest burden of TB. Inadequate diagnosis leads to inappropriate treatment and poor clinical outcomes. The roll-out of the Xpert(®) MTB/RIF assay has demonstrated that molecular diagnostics can produce rapid diagnosis and treatment initiation. Strong molecular services are still limited to regional or national centres. The delay in implementation is due partly to resources, and partly to the suggestion that such techniques are too challenging for widespread implementation. We have successfully implemented a molecular tool for rapid monitoring of patient treatment response to anti-tuberculosis treatment in three high TB burden countries in Africa. We discuss here the challenges facing TB diagnosis and treatment monitoring, and draw from our experience in establishing molecular treatment monitoring platforms to provide practical insights into successful optimisation of molecular diagnostic capacity in resource-constrained, high TB burden settings. We recommend a holistic health system-wide approach for molecular diagnostic capacity development, addressing human resource training, institutional capacity development, streamlined procurement systems, and engagement with the public, policy makers and implementers of TB control programmes.

Equine piroplasmosis in Kelantan, Malaysia: Clinicohemato-biochemical alterations in subclinically and clinically infected equids.

Equine piroplasmosis (EP) is global disease of equids affect the international movement of horses and their industry. This work was conducted on a random collection of blood samples from a total of 306 equids (horses and ponies) comprising both clinically healthy (n=276) and clinically suspected animals (n=30) for EP from 53 stables in eight districts at Kelantan, Malaysia. Competitive-inhibition enzyme linked immunosorbent test (cELISA) was applied to detect the antibodies for Theileria equi and Babesia caballi and their titers in the serum. Hemato-biochemical parameters were analyzed from blood and serum samples from clinical and subclinical cases in comparison to healthy animals (n=25) a control group. The overall prevalence of EP infections (T. equi, B. caballi and both infections) in subclinical and clinical infected equids was 70.26 and 9.80 per cent, respectively. The subclinical infection in equids was statistically higher than that of clinical infection (P<0.05). Higher titration of T. equi antibodies in clinical infected cases ranged from 1/160 to 1/1280 in (n=27), whereas in B. caballi the titres ranged from 1/160 to 1/640 (n=26). Manifestation in clinical cases was the acute onset of the disease, with significant Hemato-biochemical changes. Whereas, equids with subclinical infection appeared healthy with absence of clinical signs and non-significant Hemato-biochemical alterations were seen as compared to clinical cases and healthy control groups.

The effect of noise on human performance: a clinical trial.

BACKGROUND: Noise is defined as unwanted or meaningless sound that apart from auditory adverse health effects may distract attention from cues that are important for task performance. Human performance is influenced by many job-related factors and workplace conditions including noise level. OBJECTIVE: To study the effect of noise on human performance. METHODS: The participants included 40 healthy male university students. The experimental design consisted of 3 (sound pressure level) × 3 (noise schedule) × 2 (noise type) factors. To investigate occupational skill performance, some specific test batteries were used: 1) steadiness test, 2) Minnesota manual dexterity test, 3) hand tool dexterity test, and 4) two-arm coordination test. Time duration of test completion was measured as speed response; to determine error response, the time taken during committing an error by participants while performing a task was measured. RESULTS: Speed response obtained from the 4 tests in combined conditions of noise schedule, harmonic index, and sound pressure level was highest for (intermittent, treble, 95 dB), (continuous, treble, 95 dB), (continuous, treble, 85 dB) and (intermittent, treble, 95 dB), respectively. CONCLUSION: Treble noise was found significant in reducing human performance; also, intermittent noise, especially at high pressure levels, was responsible for worsening environmental conditions during performing a task.

The development of manualised cognitive behaviour treatment for adults with mild intellectual disability and common mental disorders.

People with intellectual disability are at a greater risk of developing common mental disorders. In the United Kingdom, the National Institute for Health and Clinical Excellence guidelines recommend cognitive behavioural therapy (CBT) as the treatment of choice for such problems. Even though there is growing evidence that people with mild intellectual disability can benefit from CBT, there are no manuals to assist in the delivery of the treatment. Previously published material from journals and books describing both CBT in people with intellectual disability and the general population was reviewed to create the first draft. Further consultations with professionals and service users with intellectual disability on the content, accessibility and language that was used in the manual were carried out. Specific materials were developed for use in the therapy sessions and for homework. The manual, written for trained therapists, provides generic information about communication and thinking styles in people with mild intellectual disability and describes in detail how to conduct each session. It contains also contains the materials and a leaflet to help carers support the treatment. Manualised treatments are helpful in maintaining a consistent approach to treatment and may be more beneficial for hard to reach population groups.

Effect of sugars on characteristics of Boer goat semen after cryopreservation.

In order to improve Boer goat semen quality during cryopreservation process, the influence of sugar supplementation on semen characteristics of sperm were investigated. Three experiments were carried out to investigate the effect of (a) addition of two monosaccharides (fructose and glucose) and two disaccharides sugars (trehalose and sucrose) (b) sugar combination (fructose and trehalose, sucrose and trehalose, glucose and trehalose), and control (glucose without trehalose) (c) different concentrations of trehalose on cryopreservation using Tris based extender. The total motility, forward motility, viability, normal spermatozoa, acrosome integrity and membrane integrity were assessed subjectively. Differences were not detected among monosaccharides, but glucose increased (P<0.05) sperm forward motility in post-thaw goat semen compared to trehalose or sucrose supplementation. Semen quality did not differ (P>0.05) among disaccharide sugar supplementation. Combination of glucose and trehalose significantly improved the characteristics of Boer spermatozoa after cryopreservation (P<0.05). Supplementation of trehalose (198.24mM) into the glucose extender significantly increased total motility, forward motility, live spermatozoa, acrosome integrity and membrane integrity following cryopreservation (P<0.05). In conclusion, glucose had the better ability to support Boer sperm motility and movement patterns. Combination of monosaccharide (glucose) and disaccharide (trehalose) improved semen quality following cryopreservation. Trehalose supplementation at the concentration of 198.24mM to the glucose extender conferred the greater improvement of semen quality for Boer semen cryopreservation.

Application of acoustical processor reactors for degradation of diazinon from surface water.

BACKGROUND: Since organophosphorus pesticides are widely used for industry and insect control in agricultural crops, their fate in the environment is very important. Pesticide contamination of surface water has been recognized as a major contaminant in world because of their potential toxicity towards human and animals. The objective of this research was to investigate the influence of various parameters including the influence of time, power, and initial concentration on degradation of diazinon pesticide. METHODS: The sonochemical degradation of diazinon was investigated using acoustical processor reactor. Acoustical processor reactor with 130 kHz was used to study the degradation of pesticide solution. Samples were analyzed using HPLC at different time intervals. Effectiveness of APR at different times (20, 40, 60, 80, 100, and 120 min), concentrations (2, 4 and 8 mg/L) and powers (300W, 400W, 500W) were compared. RESULTS: The degradation of the diazinon at lower concentrations was greater in comparison to higher concentrations. There was also direct correlation between power and diazinon degradation. In addition, when the power increased, the ability to degraded diazinon increased. CONCLUSION: The sonodegradation of diazinon pesticide at different concentrations and powers was successfully provided. It has been shown that APR can be used to reduce the concentration of dissolved pesticide using high frequency.

First Report of Alfalfa Witches Broom Disease in Oman Caused by a Phytoplasma of the 16Sr II Group.

Alfalfa (Medicago sativa L.) is a primary forage crop in the Sultanate of Oman. A new disease of alfalfa in Oman is characterized by proliferation of shoots and yellowing of leaves in 1- to 2-year-old plants and tillering of stems in 4- to 5-year-old plants. Annual losses due to this disease are estimated at more than US$ 23 million. Samples of healthy and infected alfalfa plants were collected from different regions. Total DNA was extracted according to Khadhair et al. (1), with minor modifications. Amplification of 16S rDNA was done using a nested polymerase chain reaction (PCR) approach with primers P1/P7 and R16F2n/R16R2. DNA from healthy leaves and sterile water was used as a negative control, while DNA from periwinkle infected with faba bean phyllody (16SrII-C), aster yellows (16SrI), tomato big bud (16SrII-D), sweet potato little leaf (16SrII-D), catharanthus phyllody (16SrVI), and sesame phyllody (16SrII-A) were used as positive controls and for restriction fragment length polymorphism (RFLP) comparisons. Nested 1.25-kb PCR products from infected plant samples were subjected to RFLP analysis with restriction endonucleases RsaI, AluI, HaeIII, HhaI, EcoRI, TaqI, Tru9I, and Sau3AI. The analysis showed that the alfalfa witches' broom phytoplasma (AWBP) belonged to the 16SrII group (peanut witches' broom) and that the AWBP was most similar to sweet potato little leaf (16SrII-D) but distinct from "Candidatus Phytoplasma aurantifolia," the cause of lime witches' broom in Oman. Other phytoplasmas infecting alfalfa have been reported from Europe and North America (1,3), but they belong to the 16SrVI (clover phyllody) and 16SrI (aster yellows) groups. An alfalfa witches' broom reported from Italy (2) forms a separate grouping (4). To our knowledge, this is the first report of a phytoplasma from the peanut witches' broom group infecting alfalfa in the Sultanate of Oman. References: (1) A. H. Khadhair et al. Microbiol. Res. 152:259, 1997. (2) C. Marcone et al. J. Plant Pathol. 79:211, 1997. (3) R. D. Peters et al. Plant Dis. 83:488, 1999. (4) E. Seemuller et al. J. Plant Pathol. 80:3, 1998.