Molecular detection of Imbrasia belina proteins associated with allergic reactions on harvesters and consumers from selected districts in Matabeleland: a comparative study.

BACKGROUND: Harvesting and consuming insects (entomophagy), particularly Imbrasia belina is widespread in developing countries like Zimbabwe. Due to their extraordinary nutritional content, tastiness, ease of processing and storage, Imbrasia belina has become a delicacy, reachable nutritious complement, and money source for some people in Zimbabwean communities. However, some harvesters and consumers have become allergic to the Imbrasia belina, popularly known as Mopani worms. This has been attributed or associated with the changes in the genetic structure of Imbrasia belina. Therefore, this research sought to compare the presence of the genes associated with allergic reactions to mopane worms from Gwanda and Umguza districts in Zimbabwe. METHODS: A lab-based observational study was conducted on collected Imbrasia belina samples from both districts. Fifteen samples of mopane worms were collected from each district, and DNA extraction was performed using DNeasy blood and tissue kit. The DNA extraction products were then amplified using a Polymerase chain reaction. The polymerase chain reaction products were run on agarose gel electrophoresis to determine the presence of the target genes. RESULTS: Three of the five samples from Gwanda district were positive for the tropomyosin gene, whereas two samples from Umguza district were positive. All the samples from the two districts were negative for arginine kinase genes. CONCLUSION: The study results highlighted that allergic reactions to Imbrasia belina reported in Gwanda district are associated with the presence of the tropomyosin gene, which has undergone polymorphism. Responsible authorities such as Gwanda local authority should develop bylaws that govern Imbrasia belina harvesting in the district.

Risk factors associated with a high incidence of sexually transmitted infections in Beitbridge, Zimbabwe.

BACKGROUND:  Sexually transmitted infections (STIs) are a major public health challenge, particularly in developing countries where the health infrastructure is often poor. Despite having a number of interventions in Beitbridge (such as the 24-h wellness centre), Zimbabwe, the incidence and prevalence of STIs is increasing. OBJECTIVES:  This study, therefore, aims to assess the risk factors associated with the high incidence of STIs in urban Beitbridge. METHOD:  A case-control study was conducted on 30 respondents who had suffered from STIs (selected from the registers at Beitbridge hospital and followed up) and 90 respondents who had not suffered from STIs (from the community) who resided in Beitbridge for at least 6 months and this excluded all those who were in transit. The factors contributing to the high incidence of STIs were identified using a pretested interviewer-administered semi-structured questionnaire in conjunction with a Likert scale to establish the attitudes and risk behaviours of the respondents on STIs. RESULTS:  A significant association was observed between high STI incidences and the nature of occupation (odds ration [OR]: 3.8), area of residence (OR: 2.78), number of sexual partners (OR: 7.56), payment demanded for sex (OR 22), condom use (OR: 3.7), alcohol use (OR: 2.86), and suspicion that partners had other sexual companions (OR: 15.5). Furthermore, a larger proportion of controls were knowledgeable on STIs as compared to the cases who participated in the study. CONCLUSION:  There is a need to develop awareness strategies that foster safe sexual practices, particularly among populations who do not choose abstinence or a single sexual partner lifestyle.

Sensitisation to Imbrasia belina (mopane worm) and other local allergens in rural Gwanda district of Zimbabwe.

BACKGROUND: The prevalence of allergic diseases is increasing in Zimbabwe and the data relate to local as well as exotic allergen sources. As entomophagy, the practice of eating insects, is a recognised source of local allergens, we sought to measure the prevalence of and risk factors for sensitisation to Imbrasia belina (mopane worm), a popular edible insect. This was investigated alongside other locally relevant allergens in a rural community in Gwanda district, south of Zimbabwe. METHODS: A cross sectional study was conducted among 496 adults and children aged 10 years and above in Gwanda district, a mopane worm harvesting area in Zimbabwe. Data on individual characteristics and mopane worm exposure factors were collected using questionnaires. Sensitivity to allergens was assessed by performing skin prick tests at a local clinic using 10 different commercial allergen extracts (Stallergenes, France) and in-house extracts of mopane worm (Imbrasia belina) and mopane leaves (Colophospermum mopane). Data were analysed using Stata version 13 software. RESULTS: The prevalence of sensitisation to at least one allergen was 31.17% (n = 144). The prevalence of atopy was higher in adults (33.33%) than in children (23.53%) (p = 0.059). The commonest inhalant allergen sources were mopane worm (14.29%), Tyrophagus putrescentiae (14.29%), mopane leaves (13.42%), Alternaria alternata (6.49%) and Dermatophagoides pteronyssinus (6.49%). Polysensitisation was demonstrated in the study population and of the 108 participants (75%) who were sensitised to two or more allergens, 66 (61%) were women. Sensitisation to mopane worm and mopane leaves often clustered with Tyrophagus putrescentiae amongst adults. Adjusted logistic regression analyses between mopane worm sensitisation and self-reported exposure variables showed that sensitisation was more likely amongst mopane worm harvesters (OR = 1.92, 95%CI = 0.77-4.79), those who cooked or roasted mopane worms during harvesting (OR = 2.69, 95%CI = 0.78-9.31) and harvesting without personal protective equipment (PPE) (OR = 2.12, 95%CI = 0.83-5.44) compared to non-harvesters. CONCLUSION: Atopic sensitization was common in this mopane worm harvesting community in Gwanda district of Zimbabwe. There was frequent co-sensitisation of mopane worm and mopane leaves with Tyrophagus putrescentiae in children and adults. It is important to determine the clinical relevance of our findings, particularly relating to mopane worm sensitisation.

A feasibility study to assess Imbrasia belina (mopane worm) sensitisation and related respiratory health outcomes in a rural community in Gwanda district, Zimbabwe.

BACKGROUND: Allergic diseases are considered to be some of the fastest growing chronic conditions in Africa. Of concern is the paucity of knowledge about the local environment and its role in allergic disease development. In response to this, we explored whether Imbrasia belina, a popular indigenous edible insect commonly known as mopane worm, is a potential allergen of clinical and public health significance in Zimbabwe. This study was intended to assess the plausibility and feasibility of this hypothesis with a view to evaluate the insect's health impact in a larger study. METHODS: The study participants included male and female villagers aged 10 years and above in Gwanda district, Zimbabwe. Eligible participants who completed the household questionnaire were referred to the local clinic for skin prick tests and to measure lung function and allergic airway inflammation. Allergen sensitisation patterns were evaluated using 10 different inhalant allergen extracts including an in-house preparation of mopane worm. Lung function was measured with a Koko Legend spirometer, and fractional exhaled nitric oxide levels (FeNO) (NIOX VERO) were measured in participants with at least one abnormal spirometric parameter. Data was analysed using Stata version 13 software. RESULTS: Of the 46 eligible participants that completed the household questionnaire, 17 went to the clinic giving a response rate of 37%. The majority who completed the questionnaire were adults (91%) and the children (9%) were all female. The prevalence of sensitisation to Imbrasia belina was 50%, and the prevalence ranged from 22 to 72% for the other allergens including cockroach, mosquito and house dust mites. The data collection tools were safe and well tolerated by participants with no adverse events reported. Self-reported respiratory symptoms, abnormal lung function and elevated FeNO were recorded amongst participants sensitised to mopane worm. CONCLUSION: Pre-defined feasibility criteria were met with the exception of a lower than expected response rate for clinic data collection in this pilot study. For the main study, modifying the sampling strategy and applying more consistent community engagement will improve the response rates.

Assessing the nature of asthma in African epidemiological studies: a scoping review protocol.

BACKGROUND: Asthma is one of the most common chronic respiratory conditions in the world and is increasing in prevalence, particularly in Africa and other low-income countries. The disproportionately high numbers of premature deaths and severe or uncontrolled cases in many African countries are indicative of their inability to cope with a costly disease like asthma. Progress has, however, been made in understanding the complex and heterogeneous nature of the disease. The objective of this study will be to summarise the epidemiological literature on the nature of asthma in African countries. METHODS: We registered a study protocol for a scoping review. The review was designed following the Arksey and O'Malley framework. We will search PubMed/MEDLINE, African Journals Online (AJOL) and relevant grey literature (e.g. Google Scholar, EBSCOhost) from January 1990 onwards. Only primary epidemiological studies of asthma (e.g. frequency, disease mechanisms, associated risk factors and comorbidities) written in English and conducted in Africa will be included. Two reviewers will independently screen all citations, full-text articles and abstract data. Potential conflicts will be resolved through discussion. Findings will be reported using narrative synthesis and tabulation of the summaries. DISCUSSION: This scoping review will capture the state of the current epidemiological literature on asthma in African countries. Results will be published in a peer-reviewed journal. We anticipate this review will identify gaps and make recommendations for future areas of study. SCOPING REVIEW REGISTRATION: Open Science Framework http://osf.io/n2p87/.

Factors associated with home births in a selected ward in Mberengwa District, Zimbabwe.

OBJECTIVE: Despite many efforts put by the Government to ensure that women give birth in health facilities under trained personnel supervision; statistics suggest that ward 2 in Mberengwa District in Zimbabwe has the highest home births. This study sought to assess factors that are associated with home births in ward 2 of Mberengwa District in Zimbabwe. DESIGN: Case- control. SETTING: Ward 2 in Mberengwa District in Zimbabwe. PARTICIPANTS: 35 and 105 women who gave birth at home and facilities, respectively. METHODS: A piloted researcher administered questionnaire was used to collect data from systematically selected respondents on factors leading to their choice of place to give birth. The home and facility births were geocoded using a Garmin etrex-30 Global Positioning System receiver and exported to Quantum Geographic Information System software for spatial analysis and mapping. RESULTS: Factors associated with home births were; being uneducated (2.90, CI 1.08-7.57), unemployed (2.56, CI 1.08-6.23), could not afford facility bills (20.92, 3.19-160.31), and lack of access to Ante Natal Care (23.8, 7.04-90). 69% (24) of cases and 30% (32) of resided within the 5 km radius of health facilities. There was significant difference in levels of knowledge between cases and controls about benefits of giving birth in facilities. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: It is acknowledged that costs are a huge barrier in accessing antenatal care services. These factors together with others need to be addressed so as to improve access by pregnant women to health facilities.

Asthma associated with pesticide exposure among women in rural Western Cape of South Africa.

BACKGROUND: Few studies have investigated asthma and pesticides among women farm workers in developing countries. METHODS: A cross-sectional study was conducted to investigate the association between pesticides and asthma among rural women (n = 211). Outcome measurements included respiratory symptoms (European Community Respiratory Health Survey questionnaire), immunological status (Phadiatop, serum IgE to mite allergens) and lower airway inflammation (fractional exhaled nitric oxide (FeNO) levels). Exposure variables included self-reported pesticide exposure and whole blood cholinesterase (ChE). RESULTS: The prevalence of ocular-nasal symptoms (ONS), doctor-diagnosed asthma and current asthma was 24%, 11%, and 6% respectively. ONS was positively associated with re-entering a sprayed field (OR = 2.97; CI: 0.93-9.50). Asthma symptom score was associated with low ChE (OR = 1.93; CI: 1.09-3.44). Participants with high FeNO (>50 ppb) also had an elevated odds of having low ChE (OR = 4.8; CI: 0.80-28.00). CONCLUSION: Pesticide exposure among women farm workers is associated with increased risk of ocular nasal symptoms and an elevated asthma symptom score.