Southern Africa Nazarene University

SUMMARYBACKGROUNDIn 2017, WHO endorsed digital adherence technologies, including video-observed treatment (VOT), to support TB treatment adherence. In 2021, Eswatini implemented VOT to support adherence for drug-resistant TB (DR-TB) patients nationwide, although limited evidence exists regarding its feasibility and acceptability in low-resource settings.METHODSWe conducted 33 in-depth interviews with DR-TB patients and health care providers (HCPs), across all four regions of Eswatini to explore their experiences with VOT.RESULTSThe findings indicated broad acceptance of VOT among both HCPs and patients. HCPs reported that VOT strengthened their connection with patients, facilitated adherence, and increased their confidence in treatment outcomes. While most patients found VOT user-friendly and appreciated the independence and privacy it offered, elderly patients faced challenges using smartphones, which sometimes resulted in poor-quality video submissions.CONCLUSIONVOT is feasible and acceptable among HCPs and patients in Eswatini. Further research is needed to evaluate the impact of VOT on treatment outcomes in high-burden and low-resource settings to inform the scale-up of similar digital health interventions in comparable contexts. Strengthening digital infrastructure and providing tailored support for elderly patients could further enhance VOT effectiveness and equity.

Communities relying on drinking-water storage routinely document containers as a reservoir for pathogens when they are not properly cleaned. Although lab-based research provides guidance on cleaning protocols, gaps remain in understanding: 1) what methods are practiced, and 2) method effectiveness at reducing biofilm growth. In partnership with AFMAC, this pilot explored biofilm contamination in household water storage containers of four Zambian communities engaged in WASH promoting community health clubs and health promoters. A mixed-methods design was used: 15 to 20 households per community completed a knowledge, attitudes, and practices survey and provided whole-container biofilm samples. Four focus group discussions with program members and four interviews with AFMAC staff explored container cleaning sensitizations. Findings revealed household awareness of container cleaning, inconsistent cleaning practices, and high levels of biofilm in 100% of storage containers. The absence of a standardized container cleaning module, reliance on visual cues as a proxy for microbial safety, and disproportionate burden placed on women underscore critical gaps in current programming and highlight container cleaning as a critical pathway to interrupt recontamination. This pilot highlights the need for locally adapted, practical protocols using accessible materials. Advancing container hygiene through integrated, adaptive, and scalable approaches is essential for reducing public health risks from unsafe water storage and improving point-of-use water quality.

Interactions between microbial communities and the host can modulate mosquito biology, including vector competence. Therefore, future vector biocontrol measures will utilize these interactions and require extensive monitoring of the mosquito microbiome. Metabarcoding strategies will be useful for conducting vector monitoring on a large scale. We used 16S and 18S rRNA gene metabarcoding through iSeq100 sequencing to characterize the microbiome and eukaryome of Aedes albopictus (Skuse 1894) and Culex pipiens (Linnaeus 1758), two globally important vectors present in South Korea. Mosquitoes were collected from an urban and a semi-urban location in South Korea. Bacterial alpha and beta diversities varied by population. Pseudomonadota dominated the microbiomes of both species. The microbiome composition varied by population and was dominated by different taxa. At the genus level, Wolbachia sp. was the most enriched genus in Cx. pipiens, followed by Aeromonas sp. In Ae. Albopictus, the most abundant group was Enterococcus sp. The gregarine parasite Ascogregarina taiwanensis was highly prevalent in Ae. Albopictus and its absence was marked by the presence of seven bacterial taxa. To our knowledge, this is the first characterization of the microbiome of Ae. albopictus and Cx. pipiens in these regions of South Korea and contributes to the current information on the microbiome of mosquito species, which can be used in further studies to assess pathogen-microbiome and microbiome-microbiome interactions.

ABSTRACT Voluntary medical male circumcision (VMMC) was identified as an effective strategy in HIV prevention. Although circumcision reduces heterosexual acquisition of HIV by 60%, there is low uptake of VMMC services in Eswatini. This study applies the health belief model (HBM) in understanding perceptions of young men in Eswatini towards VMMC for HIV prevention to upscale its adoption. A qualitative design was followed. Uncircumcised males aged 20–29 years were recruited among university students. In-depth interviews were conducted, transcribed verbatim, and transcripts imported into NVivo12 for line-by-line analysis. Emerging codes were categorized under major constructs of the HBM. Condomless sex, having multiple sex partners, genital caressing and being uncircumcised were seen as susceptible exposure. Taking life-long treatment and stigma were perceived as severity. However, participants had no intent to circumcise in the near future even after acknowledging the severity. Hygiene, prevention of sexually transmitted infections including HIV were perceived as main benefits. Fear of pain was perceived as key barrier impeding adopting circumcision and seemed to outweigh the benefits for some participants. These findings will assist programme planners to review and promote VMMC services that will improve good health and well-being of young men to avert HIV new infections in Eswatini.

The zeitgeist of childhood is characterized by ebullience, which requires creative imaginations to accommodate and express emotional ideas, the power of arts is germane in making this happen at this epoch. Eswatini elementary curriculum formally boarded the creative artistic train in 2018, the competency-based expressive arts as a core subject started as a pilot research, implemented in the precocious stage of grade one to advance skill and aptitude at an early age; and then progressed to upper grades. This is to challenge learners to meet high but realistic expectations geared toward articulate competencies to meet sustainable development goals. National Curriculum reviews investigated outcomes and experiences of the refined subject, as reported by Mamba and Zulu in Times of Eswatini, they stressed the need for the country to embrace the arts with all serosity as it is quintessential in bridging the gap in joblessness in the country, a national focus [1,2]. Jedishkem and co-authors concurred, that regardless of a college qualification, the arts are dependent variables needed for success in the current world economy [3]. Recognizing and nurturing creative growth aesthetically is relevant to skill development and enhances holistic education. The study was conducted over the course of over fourteen thirty-minute periods in mid-2023, detailed research was carried out in a singular subject area by datum recording first-hand data on classroom phenomena on the outcomes of Expressive Arts from seven elementary public schoolrooms involving over 350 learners and 7 pre-service educators in Eswatini. Instructors’ training and knowledge of the arts were probed, besides reflections on art pedagogy. Adept educators communicated their pleasure in teaching the subject, unfortunately, the inept deemed it a fifth wheel. They neither take it seriously nor look forward to artsy sessions since there is a wide knowledge skill gap and social competencies. Introduction to the art variants of dance, drama, music, and visual art enabled learners to be inspired to perform before audiences or even be part of an audience having the chance to exhibit their creative abilities. Guided by the textbooks they were exposed to techniques relevant to specific art trajectories that deepened their understanding of themselves, others, and the world at large fostering imagination despite the extrapolated demerits of inexpert instructors amidst unresourceful dire straits.

The study aims to investigate the appropriateness of teacher education provided by teacher training institutions to teachers for an inclusive set-up in primary schools, Eswatini. Learners with disabilities in Eswatini are usually found in special schools; however, the government of Eswatini advises parents to send these children to nearby community schools. The study investigated whether the teachers in public primary schools were appropriately trained by the teacher training institutions for inclusive classrooms. A qualitative approach was used in the study, employing the multiple case study design. Semi-structured interviews were used to collect data from Eswatini senior inspector of inclusive education, a parent of an out-of-school child with a disability, two teachers and a school principal from each of the four schools involved in the study. The recommendations would assist teacher training institutions in Eswatini to improve inclusiveness in their courses. The study revealed that teachers were not competent to teach learners with disabilities in an inclusive classroom. Some primary schools did not admit children with disabilities due to their pre-service training. The study recommended that the pre-service training should be aligned with the situations in schools. Through the study, a model ensuring teachers' competence in inclusive education was produced.

Objective: This study describes the availability of basic services, equipment, and commodities for integrated DM-TB services, best practices by healthcare workers, and opportunities for better integration of DM-TB care in Eswatini. Methods: A qualitative design was used. Twenty-three healthcare workers participated in a survey and key informant interview. Results: Most respondents indicated DM and TB care are integrated and clients access blood pressure and fasting/random blood glucose assessment. Few respondents indicated they provide visual assessment, hearing assessment, and HbA1c testing. Respondents experienced stockouts of urinalysis strips, antihypertensive drugs, insulin, glucometer strips, and DM drugs in the previous 6months before the interview. Four main themes emerged from the qualitative interviews-quality and current standards of care, best practices, opportunities, and recommendations to improve integrated services delivery. Conclusion: While DM care is provided for TB patients, the implementation of integrated DM-TB services is suboptimal as the quality and current standards of care vary across health facilities due to different patient-level and health system challenges. Some identified opportunities must be utilized for a successful DM-TB integration.