Are pit latrines in urban areas of Sub-Saharan Africa performing? A review of usage, filling, insects and odour nuisances.

BACKGROUND: A pit latrine is the most basic form of improved sanitation which is currently used by a number of people around the globe. In spite of the wide spread use, known successes and advantages associated with pit latrines, they have received little attention in form of research and development. This review focuses on the usage and performance (filling, smell and insect nuisance) of pit latrines in urban areas of sub-Saharan Africa (SSA) and proposes approaches for their improvements and sustainability. METHODS: Current pit latrine usage within urban SSA was calculated from Joint Monitoring Programme (JMP) water and sanitation country-files. We conducted a literature search and review of documents on pit latrine usage, filling, smell and insect nuisances in urban areas of SSA. Findings of the review are presented and discussed in this paper. RESULTS AND DISCUSSION: Pit latrines are in use by more than half the urban population in SSA and especially among low income earners. An additional 36 million people in urban areas of SSA have adopted the pit latrine since 2007. However, their performance is unsatisfactory. Available literature shows that contributions have been made to address shortfalls related to pit latrine use in terms of science and technological innovations. However, further research is still needed. CONCLUSION: Any technology and process management innovations to pit latrines should involve scientifically guided approaches. In addition, development, dissemination and enforcement of minimum pit latrine design standards are important while the importance of hygienic latrines should also be emphasized.

Electronic Antiretroviral Therapy Adherence Monitors and Associated Interventions Improve Adolescent-Caregiver Relationships and Self-Efficacy Among Adolescents and Young Adults with HIV in Uganda.

Many adolescents and young adults with HIV (AYWH) struggle with antiretroviral therapy (ART) adherence and experience poorer outcomes than adults. Relevant factors include forgetfulness and poor self-efficacy related to their evolving neurobiology. We qualitatively explored experiences of AYWH-caregivers dyads using real-time ART adherence monitors and associated reminder functions in the home setting. As part of an implementation science-oriented study, AYWH used the Wisepill adherence monitor for 3 months. AYWH could also opt for short message service (SMS) self-reminders, a self-selected social supporter for delayed or missed doses, or an alarm reminder. We conducted in-depth interviews with randomly selected AYWH-caregiver dyads regarding their experience using the monitor. Qualitative data were analyzed using inductive content analysis. We completed 15 AYWH-caregiver dyad interviews. Of the AYWH, 67% were female, mean age was 16 years, 56% lived with their biological mother, and 86% were virologically suppressed. AYWH and their caregivers generally found the adherence monitors acceptable, though some had privacy concerns. AYWH felt the monitors helped them take charge of their medication, largely through the real-time alarm and SMS reminders; this took the burden of adherence reminders away from the caregivers, improving strained AYWH-caregiver relationships. Two adolescents reported rebound poor adherence after monitor withdrawal. ART adherence monitors and associated tools were largely acceptable to AYWH and their caregivers in home settings. The intervention helped improve AYWH self-efficacy and alleviated burden from some AYWH-caregiver relationships. Rebound poor adherence suggests the need for on-going support and/or other means to achieve intrinsic mechanisms for sustained adherence. Clinical Trial Registration number: NCT03825952.

Combined Application of Biofertilizers and Inorganic Nutrients Improves Sweet Potato Yields.

Sweet potato [Ipomoea batatas (L) Lam] yields currently stand at 4.5 t ha-1 on smallholder farms in Uganda, despite the attainable yield (45-48 t ha-1) of NASPOT 11 cultivar comparable to the potential yield (45 t ha-1) in sub-Saharan Africa (SSA). On-farm field experiments were conducted for two seasons in the Mt Elgon High Farmlands and Lake Victoria Crescent agro-ecological zones in Uganda to determine the potential of biofertilizers, specifically arbuscular mycorrhizal fungi (AMF), to increase sweet potato yields (NASPOT 11 cultivar). Two kinds of biofertilizers were compared to different rates of phosphorus (P) fertilizer when applied with or without nitrogen (N) and potassium (K). The sweet potato response to treatments was variable across sites (soil types) and seasons, and significant tuber yield increase (p < 0.05) was promoted by biofertilizer and NPK treatments during the short-rain season in the Ferralsol. Tuber yields ranged from 12.8 to 20.1 t ha-1 in the Rhodic Nitisol (sandy-clay) compared to 7.6 to 14.9 t ha-1 in the Ferralsol (sandy-loam) during the same season. Root colonization was greater in the short-rain season compared to the long-rain season. Biofertilizers combined with N and K realized higher biomass and tuber yield than biofertilizers alone during the short-rain season indicating the need for starter nutrients for hyphal growth and root colonization of AMF. In this study, N0.25PK (34.6 t ha-1) and N0.5PK (32.9 t ha-1) resulted in the highest yield during the long and the short-rain season, respectively, but there was still a yield gap of 11.9 and 13.6 t ha-1 for the cultivar. Therefore, a combination of 90 kg N ha-1 and 100 kg K ha-1 with either 15 or 30 kg P ha-1 can increase sweet potato yield from 4.5 to >30 t ha-1. The results also show that to realize significance of AMF in nutrient depleted soils, starter nutrients should be included.