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Barriers to effective patient care as experienced by nurses in primary healthcare clinics in African countries : a systematic review of qualitative studies
(BioMed Central, 2025-02) Nesengani, Tintswalo Victoria; Downing, Charlene; Ten Ham-Baloyi, Wilma
BACKGROUND : The essence of adopting the Alma-Ata Declaration (1978) was to ensure that essential and acceptable healthcare services are accessible to individuals and families in the community. However, existing literature points that various factors pose as barriers towards effective caring for patients by nurses in primary healthcare clinics. Identifying factors that pose as barriers in effective caring for patients can assist in using strategies that can help in improving the provision of healthcare services.
METHODS : A qualitative systematic review was conducted in accordance with the Joanna Briggs Institute’s approach, including the search and selection, critical appraisal, data extraction and synthesis. An extensive literature search was undertaken to identify relevant qualitative research studies research with substantive findings that reflected nurses’ challenges in PHC clinics, conducted in African countries from 2010 to 2024, in the following databases: CINAHL and Medline (through EBSCOhost), BioMed Central, ScienceDirect and Scopus (Elsevier), followed by a manual search in Google Scholar, and a citation search.
RESULTS : Following the data extraction and analysis of nine articles, three themes were identified: (1) Shortage of nurses; (2) High workloads for nurses; and (3) Shortage of medicines. A majority of articles were from South Africa (n = 7).
CONCLUSIONS :
The identified barriers may be addressed at different healthcare system levels in various African countries to improve the provision of healthcare services.
Behaviour of commercial layer hens in enriched cages and floor systems examined using human and video-based observations
(South African Society for Animal Science, 2025-06) Chilemba, Timothy.; Van Marle-Koster, Este; Masenge, Andries; Cromhout, M.; Nkukwana, Thobela T.; evm.koster@up.ac.za
There is considerable pressure to eliminate the use of conventional cages in commercial layer hen production systems. However, the assessment of alternative systems that can ensure the hen's ability to perform natural behaviours, while simultaneously enhancing farm productivity and economic efficiency, remains incomplete. This study assessed layer behaviour in a floor system and in enriched cages on a commercial layer farm using human and video-based observations. The study focused on dust bathing, nesting, feather pecking, and perching behaviours, and on the formation of mud balls on the feet. A large proportion (72.9%) of the hens exhibited dust-bathing behaviour, with an average duration of 22.63 minutes. Feather pecking was exhibited by 35.4% of layers in the enriched cages, compared to 58.3% of layers in the floor system. Overall, feather pecking was the least observed behaviour. Layers in enriched cages used perches more (47%) than layers in the floor system (27%), and a negative association was found between body weight and perching in layers in the floor system. At the end of the six-week trial period, 41.67% of the hens had developed mud balls on their toes that exceeded 3 cm in length. The results of this study provide evidence of the relationships between poultry behaviour, welfare, and production. Video-based observations confirmed that farm managers may not be able to identify certain welfare-related behavioural aspects unless they are closely monitored. The results of this study may be used to inform stakeholders about behaviour and welfare considerations in the management of commercial layers.
Benthic macroinvertebrates as bioindicators of stream health within the Central African Copperbelt
(Springer, 2025-07) Ouma, Kennedy O.; Shane, Agabu; Monde, Concillia; Syampungani, Stephen
Globally, stream ecosystem health in mining regions, including the Central African Copperbelt (CACB), is threatened by increased aquatic metal pollution. Stream biomonitoring and bioassessment offers an eco-friendly nature-based approach to determine the aquatic ecological conditions and inform management interventions in mining landscapes. This study conducted monthly between May 2022 and April 2023, explored the taxonomic and functional responses of macroinvertebrates as bioindicators of the ecological condition of four streams in the north-western Zambian Copperbelt of the CACB. 252 sediment samples were collected and analysed for metals. 144 macroinvertebrate samples were collected to determine their taxonomic and functional traits. ANOVA (analysis-of-variance), SIMPER (similarity-percentage), ANOSIM (analysis-of-similarities), CCA (canonical correspondence analysis) and multidimensional biotic index analyses were conducted to correlate environmental and biotic variables. Metal concentrations (mg/kg) in sediments followed the order As (5.27) < Pb (5.75) < Zn (44.6) < Ni (89.3) < Cu (187.5). From ANOVA, the macroinvertebrate community was significantly dominated by Insecta families, mostly Diptera (23.3%) and Coleoptera (16.7%). Trophically, predators significantly dominated in the order Odonata (34.7%) > Hemiptera (31.8%) > Diptera (18.9%). SIMPER depicted a strong influence of Cu, EC, velocity, sediment texture and organic matter on macroinvertebrate diversity and spatial distribution. ANOSIM indicated the highest community dissimilarity at the most impacted stream (KYABR). Habitat assessment metrics, including ZISS-1, ASPT, and EPT/Chironomidae ratio, registered a “good ecological status” with the presence of pollution-sensitive taxa (Helodidae and Perlidae), in concordance with environmental variables, confirming the suitability of macroinvertebrates as proxy bioindicators of stream health in mining landscapes. The study confirms the potential of macroinvertebrates, as potential bioindicators of stream health in mining landscapes. Their diversity and distribution is strongly influenced by Cu, EC, velocity, and sediment characteristics while habitat assessment metrics indicate a "good ecological status" despite moderate metal contamination.
Bacterial Isolation from natural grassland on nitrogen-free agar yields many strains without nitrogenase
(MDPI, 2025-01) Koirala, Amrit; Alshibli, Nabilah Ali; Das, Bikram K.; Brözel, Volker Siegfried
Nitrogen inputs for sustainable crop production for a growing population require the enhancement of biological nitrogen fixation. Efforts to increase biological nitrogen fixation include bioprospecting for more effective nitrogen-fixing bacteria. As bacterial nitrogenases are extremely sensitive to oxygen, most primary isolation methods rely on the use of semisolid agar or broth to limit oxygen exposure. Without physical separation, only the most competitive strains are obtained. The distance between strains provided by plating on solid media in reduced oxygen environments has been found to increase the diversity of culturable potential diazotrophic bacteria. To obtain diverse nitrogen-fixing isolates from natural grasslands, we plated soil suspensions from 27 samples onto solid nitrogen-free agar and incubated them under atmospheric and oxygen-reducing conditions. Putative nitrogen fixers were confirmed by subculturing in liquid nitrogen-free media and PCR amplification of the nifH genes. Streaking of the 432 isolates on nitrogen-rich R2A revealed many cocultures. In most cases, only one community member then grew on NFA, indicating the coexistence of nonfixers in coculture with fixers when growing under nitrogen-limited conditions. To exclude isolates able to scavenge residual nitrogen, such as that from vitamins, we used a stringent nitrogen-free medium containing only 6.42 μmol/L total nitrogen and recultured them in a nitrogen-depleted atmosphere. Surprisingly, PCR amplification of nifH using various primer pairs yielded amplicons from only 17% of the 442 isolates. The majority of the nifH PCR-negative isolates were Bacillus and Streptomyces. It is unclear whether these isolates have highly effective uptake systems or nitrogen reduction systems that are not closely aligned with known nitrogenase families. We advise caution in determining the nitrogen fixation ability of plants from growth on nitrogen-free media, even where the total nitrogen is very limited.
Bacterial blood microbiome of Mastomys rodents : implications for disease spill-over at the animal-human interface within the Bushbuckridge-East community, South Africa
(Frontiers Media, 2025-02) Kolo, Agatha Onyemowo; Brayton, Kelly A.; Collins, Nicola E.; Bastos, Armanda D.S.; Matthee, Sonja; Gall, Cory A.; Wentzel, Jeanette Maria; Neves, L.C.B.G.D. (Luís); Oosthuizen, Marinda C.
The Bushbuckridge-East community in Mpumalanga Province, South Africa is bordered by nature reserves, including the Manyeleti Game Reserve. Murid rodents are prevalent in both Manyeleti and communal rangelands adjoining the community households. Although rodents are reservoir hosts for a broad range of viral, bacterial and parasitic pathogens, the rodent microbial diversity and transmission of zoonotic agents to humans in the community is understudied. In this study we investigated bacterial diversity in wild and commensal rodents sampled from different habitats. The 16S rRNA gene was amplified from DNA extracted from the blood of 24 wild Mastomys and one Steatomys sp. and subjected to PacBio circular consensus sequencing. As Bartonella species were dominant in the blood microbiome, gltA gene characterization was performed to delineate species. Rodents sampled from peri-urban and communal rangelands had higher proportions of Bartonella spp. [Hlalakahle (77.7%), Gottenburg (47.8%), Tlhavekisa (83.8%)] compared to those from the protected habitat (43.8%). Ehrlichia spp., Anaplasma spp., and Coxiella burnetii were detected at <1% of the sequence reads. Conventional PCR and sequencing validated the detection of Bartonella spp. with the first confirmation of Bartonella mastomydis infection in Mastomys in South Africa. Additionally, 317 mites, 90 fleas, 10 ticks and eight lice were collected from the rodents, providing evidence of possible vectors of the organisms detected. The detection of zoonotic agents in rodents in Bushbuckridge-East community, together with prior serological confirmation of Bartonella and Coxiella in non-malarial acute febrile patients from this community, highlights the possible risks that commensal rodents pose to human health.