Evaluating the sensitivity and specificity of Determine™ HIV-1/2 rapid test using a 0.01M phosphate-buffered saline produced at the Medical Research Council Unit The Gambia for the diagnosis of HIV.

BACKGROUND: Human immunodeficiency virus (HIV) rapid diagnostic tests (RDTs) are widely used. However, buffer stockouts commonly lead to utilising non-approved liquids, resulting in errors. Our aim was to evaluate the diagnostic accuracy of an alternative buffer. METHODS: Paired Determine HIV-1/2 rapid tests with commercial buffer and locally produced 0.01M phosphate-buffered saline (PBS) were performed on consecutive consenting individuals requiring HIV testing. Serum samples were sent for confirmation through the local gold-standard algorithm (Murex HIV Ag/Ab, Hexagon HIV with/without Geenius HIV 1/2). Test accuracy, κ and exact McNemar's test were also carried out. RESULTS: Of 167 participants, 137 had confirmatory testing. The sensitivity of the Determine HIV-1/2 test using PBS compared with the gold standard was 100% (95% confidence interval [CI] 90.5 to 100) with a specificity of 98% (95% CI 92.9 to 99.8). The κ value was 0.94 compared with the gold standard and 0.92 compared with the Determine HIV-1/2 test using the commercial buffer. McNemar's test showed no evidence of differing sensitivities. Due to operational constraints, the study included 37 of the 49 positive cases as determined by the sample size calculation, resulting in an attained power of 80% instead of the intended 90%. CONCLUSIONS: These results suggest that 0.01M PBS is an alternative solution for Determine HIV-1/2 when buffer stockouts occur.

The Influence of Parental Environmental Exposure and Nutrient Restriction on the Early Life of Offspring Growth in Gambia-A Pilot Study.

BACKGROUND: The role of the germline in epigenetic transgenerational inheritance starts with environmental factors, acting on the first generation of a gestating mother. These factors influence the developing second-generation fetus by altering gonadal development, thereby reprogramming the primordial germ cell DNA methylation and leading to consequences that might be seen along generations. OBJECTIVE: Despite these epigenetic factors now surfacing, the few available studies are on animal-based experiments, and conducting a follow-up on human intergenerational trials might take decades. To this response, this study aimed to determine the influence of parental energy, toxicant exposure, age, and nutrient restriction on the early life of offspring growth in Gambia. METHOD: This pilot study was based on population observation and combined both maternal and paternal factors across the country between August and October 2021. It captures the lifestyle and health detailed account of 339 reproductive parents and their last born (child under 5 years) using a structured interview questionnaire performed by nurses and public health officers. RESULTS: This study showed that parents who worked in industrial areas were more likely to have offspring with poor psychosocial skills. In addition, mothers who are exposed to oxidative stress and high temperatures are more likely to have offspring with poor psychosocial skills. Mothers who consume a high-protein diet were almost three times more likely to have infants with good psychosocial skills in their offspring. Furthermore, there was a negative correlation between maternal stress during pregnancy and the psychosocial skills of offspring. CONCLUSION: This study was able to ascertain if the maternal diet during gestation, toxicant exposure, maternal stress, and parental smoking habits have an influence on the early life of offspring. While the study recommends a large sample size study to eliminate selection bias, there should be an increased level of awareness of mothers of their offspring's health and their husbands' lifestyles that might influence the adulthood health of their offspring.

Bumsters, big black organs and old white gold: Embodied racial myths in sexual relationships of Gambian beach boys.

Sexuality is a platform upon which ideologies are enacted. Based on ethnographic fieldwork in The Gambia, this paper discusses the embodiment of racial myths about male Black bodies and Western affluence. Methods utilized included participant observation, focus group discussions and in-depth interviews. Beach-boys, locally called bumsters, are a common feature of the country's tourism. Societal attitudes to bumsters are ambivalent. Bumsters variously indulge in a complex web of sexual activity ranging from commercial to non-commercial, voluntary to socially-imposed, individual to peer-driven, heterosexual to homosexual, casual to regular, particularly with foreign tourists. Narratives about their sexuality reveal an enactment of myths about the male Black body and superior sexual performance on one hand, and images of plundered wealth sitting in 'the West'--a dream destination flowing with milk and honey, and physically represented by the toubab--a local label for White foreigners-on the other. This highly fantasized wealth forms the core of youth aspirations to travel abroad. Sexual activity with a toubab is the ticket out of Africa's inherent scarcity. Metaphors and idioms of unlimited virility and dynamic manhood are reinforced through sex tourism and form part of the identity of Gambian bumsters. These self-images reinstate and reinforce racial stereotypes.