University of Juba

Background: Malaria is a leading cause of illness and death in under five and pregnant women. Despite insecticide-treated nets' mass distribution, their utilization is low. ITNs persisted in a preventive intervention and a physical barrier to mosquitoes. We explore fever prevalence, health-seeking, knowledge, attitudes, practices, and ITN ownership and utilization among mothers/caregivers of U-5 children in South Sudan. Methods: A community-based descriptive cross-sectional survey was implemented in 23 counties with high malaria incidences. Mothers/caregivers of U-5 were recruited. A multi-stage cluster random sampling technique was used. Trained enumerators were employed to administer a questionnaire adopted from the malaria indicator survey. Kobo collects v.2022.2 was used, and SPSSTM 27 was used for analysis. Results: A total of 466 interviews were completed, bypassing 460 sample size estimates. Of 466, 89.3% (n=416) were mothers/caregivers of U-5. 73% were females. The majority is 25-34 years old, with 34.3% (95% CI 30 - 39). 60.1% had no formal education, 91.8% (89.5 - 94.2) were employed in the private sector, and Fever prevalence in U-5 was 56.1%. Treatment was sought for 59.2% of U-5 with fever, and 25.1% received timely care. 46% received treatment from a government hospital, 9% from private, and 44.9% received ACT. Utilization of any nets and ITNs was 72% and 69.4%. Overall ownership and usage were 72.3% and 71.9%; 73.1% of females used ITNs, and 72.2% were religious believers. 94% U-5 with at least one ITN slept under an ITN last night. Conclusion: The majority of respondents had a better understanding of malaria prevention but poor seeking behavior. Low ownership and utilization of ITNs were revealed. Thus, improvement in community education towards early treatment-seeking and ITN usage is required. Our findings would be useful for effective treatment, response to control, and prevention in highly endemic zones of South Sudan.

The effectiveness of inclusive leadership has been examined in stable Western contexts, but not in fragile states. This study investigates its impact on Subordinates' job performance in the South Sudan public sector. A cross-sectional quantitative design was employed, collecting data from 370 civil servants across various ministries in Juba, South Sudan. Data analysis utilized SPSS and SmartPLS employing structural equation modeling (SEM) to test direct, mediating, and moderating effects. Results indicate that inclusive leadership is significantly associated with public employees' job performance, with motivation and engagement partially mediating this relationship. Organizational culture, particularly the dimensions of involvement and adaptability, significantly moderated these effects. These findings demonstrate that inclusive leadership can significantly improve job performance, even in fragile state contexts, by repairing social exchange, redefining motivation, and serving as a vital resource, challenging the universal applicability of Western theories. Practical implications and future research direction are discussed.

Diabetes, a prevalent metabolic disorder, has prompted extensive research into natural remedies with hypoglycemic potential and minimal side effects. The aim of this study was to examine phenolic compounds using high-performance liquid chromatography (HPLC). Acute toxicity was assessed in mice following OECD 423 criteria, and anti-diabetic potential was tested by intraperitoneal injection of alloxan (150 mg/kg) to induce experimental diabetes. Acute toxicity assessment found no adverse effects, while chemical analysis revealed various phenolic compounds like rutin, quercetin, and gallic acid, known for their therapeutic properties. In vitro experiments with the aqueous extract showed significant inhibition of pancreatic α-amylase enzyme activity (IC50 value: 119.813 ± 3.827 μg/mL). In vivo studies demonstrated the extract's efficacy in mitigating body weight loss, promoting hypoglycemic effects, and improving oral glucose tolerance. Additionally, the extract regulated biochemical parameters including total cholesterol, triglycerides, liver enzymes, and renal markers. These findings suggest that Cistus albidus leaf polyphenols possess anti-hyperglycemic and α-amylase inhibitory properties, supporting its traditional use in diabetes treatment and potential incorporation into future antidiabetic medications. Molecular docking analysis further supported the interaction of extract constituents with relevant target proteins, offering insights into potential therapeutic interventions.

OBJECTIVE:South Sudan's maternal and neonatal indicators remain among the lowest in the world. This is attributable to limits in health-care infrastructure, inadequate funding, a lack of skilled birth attendants, and insufficient adherence to evidence-based labor monitoring systems. The WHO's Labor Care Guide (LCG) was created to promote respectful, safe, and high-quality intrapartum care. Recognizing the need to improve labor management and improvement of maternal and newborn indicators, the Association of Gynecologists and Obstetricians of South Sudan (AGOSS) conducted a feasibility study to evaluate the LCG's implementation at selected health facilities around the country. The present study was conducted to assess feasibility of replacing partograph with the LCG, facilities readiness and success of its implementation in a low health setting such as a fragile health system in South Sudan. METHODS:This was a descriptive study conducted in seven public selected health facilities across five geographical states in South Sudan, from March to August, 2024, utilizing the lottery methods. The study was done in two phases; Phase 1 to survey the facilities which met the assessment, and Phase 2 for carrying out the study. A convenience sampling technique was used to recruit 105 healthcare workers serving in the maternity department. Data were selected and entered into SPSS 27 for descriptive analysis. RESULTS:The study involved 105 participants from labor ward health workers, predominantly female (68.6%) and mainly midwives (50.5%), with smaller proportions of doctors, nurses, and clinical officers. Although most respondents (92%) had received training on the LCG, many learned through on-the-job mentorship, and a notable proportion still found the tool challenging. Only one-third rated LCG as easy to use, while 40% reported difficulties, particularly with the fetal monitoring section. Across seven health facilities, LCG utilization was low: only 41% of the 2645 women who delivered during the study period were monitored using LCG. Despite this, acceptance of the tool was high, with over 90% of respondents recommending its use over the traditional partograph, either outright or with additional training. Major barriers to effective LCG implementation included lack of basic equipment in 63% of facilities, high workload, shortages of healthcare staff and supplies, inadequate patient records, language barriers, illiteracy among traditional birth attendants, and weak health information systems. Overall, while LCG was viewed positively and widely supported, significant training, resource, and system constraints limited its practical use. CONCLUSION:There are possibilities for the labor care guide adaption in South Sudan. The study advises that healthcare providers be trained on LCG, that facilities be equipped with appropriate equipment and supplies, that skilled health professionals be deployed, and that working circumstances be improved so that healthcare workers can use the LCG effectively.

Aquaponics integrates aquaculture and hydroponics into a recirculating system where fish-derived nutrients sustain plant growth. The efficiency of this process relies heavily on the biofilm support media that facilitate microbial activity and nutrient transformation. This study evaluated the performance of biochar and clay pebbles as biofilm substrates in a Nutrient Film Technique (NFT) aquaponic system cultivating rocket (Eruca vesicaria subsp. sativa) with tilapia (Oreochromis niloticus). Over a two-month trial, biochar significantly enhanced nitrogen mineralization, increasing nitrate concentrations from 0.24 to 0.34 mg·L⁻¹. Microbiological assessments confirmed the absence of pathogenic bacteria in both systems, while biochar promoted higher populations of nitrifying microorganisms. Plant physiological and biochemical traits were strongly influenced by the substrate type: biochar increased dry biomass, nitrogen content, photosynthetic pigments, soluble proteins, and sugars, whereas clay pebbles favored the accumulation of carotenoids and secondary metabolites including phenolics, flavonoids, and tannins. Overall, biochar improved water quality and nutrient availability, resulting in enhanced rocket productivity, while clay pebbles contributed to superior nutritional and antioxidant properties. These findings highlight the importance of biofilter media selection for optimizing both yield and nutritional quality in aquaponic production systems.