Advances in the integration of microalgal communities for biomonitoring of metal pollution in aquatic ecosystems of sub-Saharan Africa.

This review elucidated the recent advances in integrating microalgal communities in monitoring metal pollution in aquatic ecosystems of sub-Saharan Africa (SSA). It also highlighted the potential of incorporating microalgae as bioindicators in emerging technologies, identified research gaps, and suggested directions for further research in biomonitoring of metal pollution. Reputable online scholarly databases were used to identify research articles published between January 2000 and June 2023 for synthesis. Results indicated that microalgae were integrated either individually or combined with other bioindicators, mainly macroinvertebrates, macrophytes, and fish, alongside physicochemical monitoring. There was a significantly low level of integration (< 1%) of microalgae for biomonitoring aquatic metal pollution in SSA compared to other geographical regions. Microalgal communities were employed to assess compliance (76%), in diagnosis (38%), and as early-warning systems (38%) of aquatic ecological health status. About 14% of biomonitoring studies integrated microalgal eDNA, while other technologies, such as remote sensing, artificial intelligence, and biosensors, are yet to be significantly incorporated. Nevertheless, there is potential for the aforementioned emerging technologies for monitoring aquatic metal pollution in SSA. Future monitoring in the region should also consider the standardisation and synchronisation of integrative biomonitoring and embrace the "Citizen Science" concept at national and regional scales.

Recent Advances in Biosorption of Copper and Cobalt by Filamentous Fungi.

Copper (Cu) and Cobalt (Co) are among the most toxic heavy metals from mining and other industrial activities. Both are known to pose serious environmental concerns, particularly to water resources, if not properly treated. In recent years several filamentous fungal strains have been isolated, identified and assessed for their heavy metal biosorption capacity for potential application in bioremediation of Cu and Co wastes. Despite the growing interest in heavy metal removal by filamentous fungi, their exploitation faces numerous challenges such as finding suitable candidates for biosorption. Based on current findings, various strains of filamentous fungi have high metal uptake capacity, particularly for Cu and Co. Several works indicate that Trichoderma, Penicillium, and Aspergillus species have higher Cu and Co biosorption capacity compared to other fungal species such as Geotrichum, Monilia, and Fusarium. It is believed that far more fungal species with even higher biosorption capability are yet to be isolated. Furthermore, the application of filamentous fungi for bioremediation is considered environmentally friendly, highly effective, reliable, and affordable, due to their low technology pre-requisites. In this review, we highlight the capacity of various identified filamentous fungal isolates for biosorption of copper and cobalt from various environments, as well as their future prospects.

Assessment of palliative care services in western Kenya.

BACKGROUND: The need for palliative care services is rapidly increasing due to the rising number of patients with non-communicable diseases. The objective of this study was to assess the current availability and barriers to palliative care and healthcare worker knowledge and perceptions on palliative pain control in western Kenya. METHODS: An evidence-based 40-question assessment tool was conducted between October 2015 and February 2016 in Siaya County, western Kenya. All level 4 and 5 facilities (e.g., regional and district hospitals) were assessed, as well as a selection of lower-level facilities chosen via convenience sampling, stratified by facility level (e.g., dispensaries, health centers, and health clinics). RESULTS: A key informant at each of 22 facilities was surveyed and included 1 medical officer (5%), 12 clinical officers (55%), and 9 nurses (41%). Key themes included training and education, awareness of palliative care and hospice, services provided, and pain control. All 22 providers had heard of palliative care and 4 (18%) had received formal training. Fourteen (64%) providers knew that morphine was on the World Health Organization (WHO) essential medication list, 8 (36%) had previously prescribed opioids, and 5 (23%) had prescribed them for palliation. Provider concerns for opioid use included its addictive properties (59%), appropriate dosing (9%), cost (5%), side effects (9%), and availability (5%). CONCLUSIONS: Palliative care and hospice services were identified by providers as important components in the management of chronic illnesses in western Kenya. Further provider education as well as increased access to pain medications including opioids is necessary to improve the care of patients in western Kenya.

Developing and Implementing a Pediatric Emergency Care Curriculum for Providers at District Level Hospitals in Sub-Saharan Africa: A Case Study in Kenya.

INTRODUCTION: Emergency medicine is a relatively new field in sub-Saharan Africa and dedicated training in pediatric emergency care is limited. While guidelines from the African Federation of Emergency Medicine (AFEM) regarding emergency training exist, a core curriculum in pediatric emergency care has not yet been established for providers at the district hospital level. METHODS: The objective of the project was to develop a curriculum for providers with limited training in pediatric emergencies, and contain didactic and simulation components with emphasis on treatment and resuscitation using available resources. A core curriculum for pediatric emergency care was developed using a validated model of medical education curriculum development and through review of existing guidelines and literature. Based on literature review, as well as a review of existent guidelines in pediatric and emergency care, 10 core topics were chosen and agreed upon by experts in the field, including pediatric and emergency care providers in Kenya and the United States. These topics were confirmed to be consistent with the principles of emergency care endorsed by AFEM as well as complimentary to existing Kenyan medical school syllabi. A curriculum based on these 10 core topics was created and subsequently piloted with a group of medical residents and clinical officers at a community hospital in western Kenya. RESULTS: The 10 core pediatric topics prioritized were airway management, respiratory distress, thoracic and abdominal trauma, head trauma and cervical spine management, sepsis and shock, endocrine emergencies, altered mental status/toxicology, orthopedic emergencies, burn and wound management, and pediatric advanced life support. The topics were incorporated into a curriculum comprised of ten 1.5-h combined didactic plus low-fidelity simulation modules. Feedback from trainers and participating providers gave high ratings to the ease of information delivery, relevance, and appropriateness of the curriculum. CONCLUSION: We present here a core curriculum in pediatric emergency care for district hospital level providers in Kenya which can be used as a framework for further development and implementation of training programs throughout sub-Saharan Africa.