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Power in Colonial Africa
Even in its heyday European rule of Africa had limits. Whether through complacency or denial, many colonial officials ignored the signs of African dissent. Displays of opposition by Africans, too indirect to counter or quash, percolated throughout the colonial era and kept alive a spirit of sovereignty that would find full expression only decades later. In
Power in Colonial Africa: Conflict and Discourse in Lesotho, 1870–1960 , Elizabeth A. Eldredge analyzes a panoply of archival and oral resources, visual signs and symbols, and public and private actions to show how power may be exercised not only by rulers but also by the ruled. The BaSotho—best known for their consolidation of a kingdom from the 1820s to 1850s through primarily peaceful means, and for bringing colonial forces to a standstill in the Gun War of 1880–1881—struggled to maintain sovereignty over their internal affairs during their years under the colonial rule of the Cape Colony (now part of South Africa) and Britain from 1868 to 1966. Eldredge explores instances of BaSotho resistance, resilience, and resourcefulness in forms of expression both verbal and non-verbal. Skillfully navigating episodes of conflict, the BaSotho matched wits with the British in diplomatic brinksmanship, negotiation, compromise, circumvention, and persuasion, revealing the capacity of a subordinate population to influence the course of events as it selectively absorbs, employs, and subverts elements of the colonial culture. “A refreshing, readable and lucid account of one in an array of compositions of power during colonialism in southern Africa.”—David Gordon,
Journal of African History “Elegantly written.”—Sean Redding,
Sub-Saharan Africa “Eldredge writes clearly and attractively, and her studies of the war between Lerotholi and Masupha and of the conflicts over the succession to the paramountcy are essential reading for anyone who wants to understand those crises.”—Peter Sanders,
Journal of Southern African Studies
eBook
The Rough Guide to South Africa, Lesotho & Swaziland
The Rough Guide to South Africa is the definitive guide to one of the world's most fascinating and varied countries. Discover the best the country has to offer with stunning photography, extensive maps, comprehensive listings and detailed practical information. With accommodation listings that range from the most sumptuous safari lodges to cheap and cheerful backpacker lodges in stunning coastal positions, there's something for every budget. In-depth coverage on South Africa's many nature reserves is complemented by an illustrated wildlife guide, to help you make the most of your time on safari. Whether you want to explore the country's big sights - from the wilds of Kruger National Park and the best spots for whale watching to Cape Town's vibrant dining scene - or to uncover its many hidden gems, such as the dramatic desert scenery of the Richtersveld, The Rough Guide to South Africa is your indispensible travelling companion. Make the most of your time on Earth[trademark] with The Rough Guide to South Africa.
Book
Switch to second-line versus continued first-line antiretroviral therapy for patients with low-level HIV-1 viremia: An open-label randomized controlled trial in Lesotho
Current World Health Organization (WHO) antiretroviral therapy (ART) guidelines define virologic failure as two consecutive viral load (VL) measurements ≥1,000 copies/mL, triggering empiric switch to next-line ART. This trial assessed if patients with sustained low-level HIV-1 viremia on first-line ART benefit from a switch to second-line treatment.
This multicenter, parallel-group, open-label, superiority, randomized controlled trial enrolled patients on first-line ART containing non-nucleoside reverse transcriptase inhibitors (NNRTI) with two consecutive VLs ≥100 copies/mL, with the second VL between 100-999 copies/mL, from eight clinics in Lesotho. Consenting participants were randomly assigned (1:1), stratified by facility, demographic group, and baseline VL, to either switch to second-line ART (switch group) or continued first-line ART (control group; WHO guidelines). The primary endpoint was viral suppression (<50 copies/mL) at 36 weeks. Analyses were by intention to treat, using logistic regression models, adjusted for demographic group and baseline VL. Between August 1, 2017, and August 7, 2019, 137 individuals were screened, of whom 80 were eligible and randomly assigned to switch (n = 40) or control group (n = 40). The majority of participants were female (54 [68%]) with a median age of 42 y (interquartile range [IQR] 35-51), taking tenofovir disoproxil fumarate/lamivudine/efavirenz (49 [61%]) and on ART for a median of 5.9 y (IQR 3.3-8.6). At 36 weeks, 22/40 (55%) participants in the switch versus 10/40 (25%) in the control group achieved viral suppression (adjusted difference 29%, 95% CI 8%-50%, p = 0.009). The switch group had significantly higher probability of viral suppression across different VL thresholds (<20, <100, <200, <400, and <600 copies/mL) but not for <1,000 copies/mL. Thirty-four (85%) participants in switch group and 21 (53%) in control group experienced at least one adverse event (AE) (p = 0.002). No hospitalization or death or other serious adverse events were observed. Study limitations include a follow-up period too short to observe differences in clinical outcomes, missing values in CD4 cell counts due to national stockout of reagents during the study, and limited generalizability of findings to other than NNRTI-based first-line ART regimens.
In this study, switching to second-line ART among patients with sustained low-level HIV-1 viremia resulted in a higher proportion of participants with viral suppression. These results endorse lowering the threshold for virologic failure in future WHO guidelines.
The trial is registered at ClinicalTrials.gov, NCT03088241.
Journal Article
Recent HIV infections among newly diagnosed individuals living with HIV in rural Lesotho: Secondary data from the VIBRA cluster-randomized trial
HIV recency assays are used to distinguish recently acquired infection from long-term infection among individuals newly diagnosed with HIV. Since 2015, the World Health Organisation recommends the use of an algorithm to assess recency of infections which is based on an HIV recency assay and viral load (VL) quantification. We determined the proportion of recent HIV infections among participants of the VIBRA (Village-Based Refill of Antiretroviral therapy) cluster-randomized trial in Lesotho and assessed risk factors for these recent infections.
The VIBRA trial recruited individuals living with HIV and not taking antiretroviral therapy during a door-to-door HIV testing campaign in two rural districts (Butha-Buthe and Mokhotlong). Samples were collected from participants newly diagnosed and tested for HIV recency using the Asanté HIV-1 Rapid Recency Assay and VL using the Roche Cobas System. Clinical and socio-demographic data were extracted from the trial database. Univariate analysis was conducted to determine factors associated with recent compared to long-term infection.
Participants were recruited from August 2018 to May 2019 and 184 patient-samples included in this study. The majority were female (108 [59%]) with a median age of 36 years (interquartile range 30-50 years). We found 13 (7.0%) recent infections, while 171 (93.0%) were classified as long-term HIV infections. No conclusive evidence for risk factors of recent infection was found.
During door-to-door testing among a general population sample in rural Lesotho, 7% of those who were newly diagnosed had acquired HIV in the preceding 6 months. More efforts and research are needed to curb ongoing transmissions in these rural communities.
Journal Article
South Africa, Lesotho & Swaziland
The only guide to include coverage of Lesotho and Swaziland. South Africa is a growing tourist destination. Includes detailed full-color maps.
Book
Private solutions for infrastructure in Lesotho
Infrastructure in Lesotho is relatively undeveloped with poor coverage and low-quality services common to many African countries that have low per capita incomes and government fiscal limitations that constrain infrastructure investment. This report finds that private participation in infrastructure could offer Lesotho three key advantages: (1) augmenting budget resources in cases where the private sector undertakes to finance projects or services that would not otherwise be funded, (2) improving the quality and efficiency of service delivery, and (3) accelerating investments in infrastructure. By the same token, the report makes clear that private participation in infrastructure carries significant down-side risks that, despite the best of intentions, could lead to negative fiscal impacts, lower than expected service quality, disruptions to service, or more dire consequences. Accordingly, the need to establish private participation in infrastructure implementation and post-transaction oversight capacity is deemed to be of paramount importance if the Lesotho Government is to embrace an overall strategy for private participation in infrastructure.
eBook
Extensively Drug-Resistant Tuberculosis with Conflicting Resistance Testing Results, Lesotho
A patient with extensively drug-resistant tuberculosis in Lesotho recovered successfully after failed treatment with bedaquiline, delamanid, linezolid, and clofazimine. Whole-genome sequencing and broth microdilution testing results were not in agreement, illustrating the urgent need for studies that correlate phenotypic and genotypic resistance testing with clinical response.
Journal Article
Description of the female of Atherimorphalatipennis Stuckenberg (Diptera, Rhagionidae): the first record of brachyptery in Rhagionidae
The genus Atherimorpha White, 1915 is a Gondwanan relic, occurring in South America, Southern Africa and Australia. Females are rarely collected, and are not described for more than half of the known species. The female of Atherimorphalatipennis Stuckenberg, 1956 was collected for the first time in 2021 and is described here, along with a redescription of the male. We describe the differences from the male, with the reduced wings and poorly defined scutellum the most noteworthy. The female of A.latipennis represents the first recorded case of brachyptery in the family Rhagionidae. Possible drivers of brachyptery in Afrotropical Diptera are briefly discussed.The genus Atherimorpha White, 1915 is a Gondwanan relic, occurring in South America, Southern Africa and Australia. Females are rarely collected, and are not described for more than half of the known species. The female of Atherimorphalatipennis Stuckenberg, 1956 was collected for the first time in 2021 and is described here, along with a redescription of the male. We describe the differences from the male, with the reduced wings and poorly defined scutellum the most noteworthy. The female of A.latipennis represents the first recorded case of brachyptery in the family Rhagionidae. Possible drivers of brachyptery in Afrotropical Diptera are briefly discussed.
Journal Article