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Research Article

Haematology of N’Dama and West African Short Horn cattle herds under natural Trypanosoma vivax challenge in Ghana

[version 1; peer review: 1 approved, 1 approved with reservations, 1 not approved]
PUBLISHED 13 Mar 2018
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This article is included in the Agriculture, Food and Nutrition gateway.

Abstract

Background: Animal trypanosomosis is a major cause of economic loss in livestock production in Africa. A suggested control measure is to use breeds with traits of trypanotolerance. The study examines the effect of natural Trypanosoma vivax challenge on haematological parameters in two trypanotolerant cattle [N’Dama and West African Short Horn (WASH)] herds.
Methods: T. vivax-specific primers were used to diagnose T. vivax infection in an N’Dama herd at Cape Coast in southern Ghana and a WASH herd at Chegbani in northern Ghana from May to July 2011 in a cross-sectional study. Levels of haematological parameters comprising packed cell volume (PCV), haemoglobin (Hb) concentration and total red blood cell (RBC) and white blood cell (WBC) counts; differential WBC counts (neutrophils, lymphocytes, eosinophils, monocytes and basophils); and RBC indices of mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were determined in blood samples and then compared between infected and uninfected cattle.
Results: We found that haematological indices for infected and uninfected animals in both breeds were within the normal range. However, the mean PCV values for T. vivax-infected WASH and N’Dama were lower in infected compared to uninfected animals. The difference was significant (p< 0.05) in N’Dama but not in WASH. The RBC indices were higher in infected N’Dama compared to infected WASH with a significant difference in total RBC (p < 0.05).
Conclusion: We conclude from our findings that despite the presence of infection by T. vivax, N’Dama and WASH cattle maintained their haematological parameters within acceptable normal ranges, and this underscores the need for routine diagnosis and treatment so that such trypanotolerant cattle do not serve as potential reservoirs of trypanosome parasites.

Keywords

Haematology, cattle, trypanotolerance, trypanosomosis, N’Dama, West African Short Horn

Introduction

Animal trypanosomosis, caused by trypanosomes mainly transmitted by tsetse flies results in annual economic losses in Africa in the range of US$ 1.0 - 1.2 billion in cattle production alone, and more than US$ 4.75 billion in terms of agricultural Gross Domestic Product (Enyaru et al., 2010). Among species of trypanosomes that cause nagana, Trypanosoma vivax is the predominant species in Ghana (Adam et al., 2012; Mahama et al., 2004; Turkson, 1993).

The usual consequence of trypanosome infection is anaemia, which is often accompanied by poor growth, weight loss, low milk yield, infertility, abortion and paralysis (Dagnachew et al., 2015; OIE, 2013; Steverding, 2008; Trail et al., 1984). Death may result within a few weeks to several months after infection. Past and current control methods are limited, and it is unlikely that a vaccine will become available in the foreseeable future (Vale, 2009).

Trypanotolerant breeds, although equally susceptible to initial infection by trypanosomes, possess the ability to survive, reproduce and remain productive in areas of high tsetse challenge without the need for the use of chemicals to control the vector or drugs to control the parasite (Dayo et al., 2009; Maganga et al., 2017; Rege et al., 1994; Yaro et al., 2016), where other breeds rapidly succumb to the disease (Murray & Dexter, 1988). The trypanotolerant trait is generally attributed to the taurine breeds of cattle in West and Central Africa, namely, the N'Dama and the West African Short Horn (WASH) (Roelants, 1986). Similar observations have been made for the Orma Boran X Maasai Zebu (Orma Zebu) crossbred cattle in East Africa (Maichomo et al., 2005; Mwangi et al., 1998a; Mwangi et al., 1998b). Studies have shown that the basis of this trait was associated with the capacity of these animals to develop less severe anaemia in the face of infection (Murray et al., 1982; Murray & Dexter, 1988).

We previously reported natural T. vivax challenge in N’Dama and WASH cattle herds in Ghana using a sensitive PCR approach (Ganyo, 2014). The current study being reported here examines the effect of natural T. vivax challenge on haematological parameters in these trypanotolerant cattle herds.

Methods

Animals, sampling and blood collection

Fifty-five animals each were sampled from an N’Dama herd at Cape Coast in southern Ghana and a WASH herd at Chegbani in northern Ghana from May to July 2011 in a cross-sectional study. The herds were chosen purposively since these were herds with the breeds of interest. From each animal, about 4 ml of blood was collected from the jugular vein using standard operating procedure that required no sedation and transferred into vacutainer tubes containing EDTA as anticoagulant. The vacutainer tubes were then placed in a coolbox containing ice packs for transportation to the laboratory, where they were refrigerated the same day for subsequent analysis.

Trypanosome detection

DNA was extracted from 200 μl of blood of each animal according to the protocol of Bruford et al. (1998) following red blood cell (RBC) lysis (Biéler et al., 2012). The procedure for DNA amplification and diagnosis of T. vivax infection has been described elsewhere (Ganyo, 2014). Briefly, amplifications were carried out targeting the 170-base pairs (bp) satellite DNA monomer of T. vivax. The PCR was carried out in a total volume of 20 µl containing 10 pmoles of each primer i.e. TVW_A (5’-GTGCTCCATGTGCCACGTTG-3’) and TVW_B (5’-CATATGGTCTGGGAGCGGGT-3’) (Masiga et al., 1996), 4.0 μl 5X HF Buffer (Finnzymes), 10mM dNTPs, 1 unit Taq polymerase (Finnzymes) and 1 µl of DNA template. Cycling conditions for the PCR were accomplished in a 96-well thermocycler (PTC-100 Programmable Thermal Controller, MJ Research, Gaithersburg) as follows: initial denaturation at 98°C for 30 sec, followed by 35 cycles of denaturation at 98°C for 10 sec; annealing at 68°C for 30 sec, primer elongation at 72°C for 15 sec, and a final extension at 72°C for 7 min. PCR products were mixed with loading dye and samples were loaded alongside a molecular weight DNA marker as well as known positives and negatives into 1.5% agarose gel, stained with 50 mg/µl ethidium bromide. Electrophoresis was set at 75 volts for 1 hr 20 min, followed by visualization of the DNA under UV-illumination.

Determination of haematological parameters

Packed cell volume (PCV) was determined by the microhaematocrit centrifugation technique while haemoglobin (Hb) concentration was measured spectrophotometrically by the cyanmethaemoglobin method (Jain, 1986). Total RBC and white blood cell (WBC) counts were done manually using a haemocytometer, according to the procedure outlined in Merck Veterinary Manual (Merck Veterinary Manual, 1986). Differential WBC counts were obtained from air dried thin blood smears stained with Giemsa stain according to the battlement method (Merck Veterinary Manual, 1986). RBC indices of mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were calculated using standard formulae.

Statistical analysis

Data analysis was performed using the R statistical software version 2.3.7.1 (R Development Core Team, 2013). The one way analysis of variance (ANOVA) test was used to compare the means for haematological parameters in infected and uninfected cattle. Tests of significance were done at α = 0.05.

Results

Seven of the N’Dama samples (n=55) and 4 animals from the WASH samples (n=55) were positive for T. vivax infection. The mean haematological values for trypanosome-positive and negative cattle are shown in Table 1. For the N’Dama cattle, significant differences were observed in PCV (p < 0.05), total RBC count, MCV and MCH (p < 0.01) values between infected and uninfected cattle, with PCV, MCV and MCH values being significantly higher in uninfected compared to infected cattle. The other parameters were similar for both groups (Table 1). For the WASH cattle, the PCV, Hb and RBC values for uninfected cattle were higher than those for infected cattle (Table 1).

Table 1. Within-breed comparison of haematological parameters (mean ± SD) of Trypanosoma vivax infected and uninfected N’Dama cattle at Cape Coast and West African Short Horn cattle at Chegbani, Ghana.

N’Dama (n=55)West African Short Horn (n=55)
ParameterInfected
n = 7
Uninfected
n = 48
F statisticp
value
Infected
n = 4
Uninfected
n = 51
F statisticp
value
PCV (%)30.7 ± 4.436.5 ± 4.05.500.023*28.3 ± 1.531.6 ± 5.11.560.218
Hb (g/dl)11.8 ± 1.913.1 ± 1.63.550.06511.5 ± 1.111.7 ± 2.00.050.834
RBC (×106mm3)9.1 ± 2.16.9 ± 1.97.180.010**5.5 ± 1.15.8 ± 1.30.180.671
MCV (fl)35.8 ± 11.053.1 ± 14.19.630.003**53.4 ± 12.856.6 ± 11.80.270.606
MCH (pg)13.8 ± 4.520.0 ± 5.28.820.004**21.5 ± 4.721.0 ± 4.70.050.821
MCHC (g/dl)38.6 ± 4.638.0 ± 4.40.140.71040.5 ± 2.037.3 ± 4.61.930.171
WBC (×103mm3)7.0 ± 2.98.6 ± 3.41.430.23811.5 ± 1.410.5 ± 2.20.830.367
Neutrophils (%)38.7 ± 12.839.1 ± 13.60.010.94347.5 ± 19.545.0 ± 12.40.140.715
Lymphocytes (%)39.6 ± 15.640.6 ± 12.00.040.84547.5 ± 18.542.1 ± 13.50.560.456
Eosinophils (%)21.4 ± 13.720.0 ± 11.50.090.7654.8 ± 1.79.6 ± 5.13.460.069
Monocytes (%)0.3 ± 0.80.2 ± 0.60.050.8290.3 ± 0.52.9 ± 3.62.130.151
Basophils (%)0.0 ± 0.00.0 ± 0.20.290.5900.0 ± 0.00.0 ± 0.30.080.782

n represents number of samples in each category

*Indicates level of significance at 5% level (p < 0.05)

**Indicates level of significance at 1% level (p < 0.01)

PCV, packed cell volume; Hb, haemoglobin; RBC, red blood cells; MCV, mean corpuscular volume; MCH, mean corpuscular haemoglobin; MCHC, mean corpuscular haemoglobin concentration; WBC, white blood cells.

When the mean haematological values for T. vivax-positive N’Dama and WASH cattle were compared (Table 2), significant differences were observed in the total RBC count (p = 0.01), MCV (p = 0.04), MCH (p = 0.02) and eosinophil values (p = 0.04). The RBC and eosinophil values were significantly (p < 0.05) higher in N’Dama compared to WASH, while the MCV, MCH and WBC values were significantly (p < 0.05) higher in WASH compared to N’Dama cattle.

Table 2. Across-breed comparison of haematological parameters (mean ± SD) of T. vivax infected N’Dama cattle at Cape Coast and WASH cattle at Chegbani, Ghana.

ParameterInfected N’Dama
n = 7
Infected WASH
n = 4
F statisticp
value
PCV (%)30.7 ± 4.428.3 ± 1.51.160.31
Hb (g/dl)11.8 ± 1.911.5 ± 1.10.130.727
RBC (×106mm3)9.1 ± 2.15.5 ± 1.19.480.013*
MCV (fl)35.8 ± 11.053.4 ± 12.85.800.039*
MCH (pg)13.8 ± 4.521.5 ± 4.77.320.024*
MCHC (g/dl)38.6 ± 4.640.5 ± 2.00.530.468
WBC (×103mm3)7.0 ± 2.911.5 ± 1.48.460.017*
Neutrophils (%)38.7 ± 12.847.5 ± 19.50.8340.385
Lymphocytes (%)39.6 ± 15.647.5 ± 18.50.580.466
Eosinophils (%)21.4 ± 13.74.8 ± 1.75.650.042*
Monocytes (%)0.3 ± 0.80.3 ± 0.50.0070.935
Basophils (%)0.0 ± 0.00.0 ± 0.0

n represents number of samples in each category

*Indicates level of significance at 5% level (p < 0.05)

WASH, West African Short Horn; PCV, packed cell volume; Hb, haemoglobin; RBC, red blood cells; MCV, mean corpuscular volume; MCH, mean corpuscular haemoglobin; MCHC, mean corpuscular haemoglobin concentration; WBC, white blood cells.

Dataset 1.Haematological parameters of T. vivax infected and uninfected WASH and N´Dama cattle at Chegbani and Cape Coast, respectively.

Discussion

The mean PCVs for infected N’Dama and WASH cattle in this study were lower than those for uninfected cattle, which support other findings (Waiswa & Katunguka-Rwakishaya, 2004), and are consistent with the pathological effect of anaemia in trypanosome infections. A survey conducted in cattle in Ethiopia (Bekele & Nasir, 2011) revealed that the mean PCV of trypanosome-infected animals was significantly lower (20.8 ± 3.2 %) compared to non-infected animals (24.9 ±3.8 %). A later study in Ethiopia (Dagnachew et al., 2015) in cattle experimentally infected with T. vivax isolates also showed that the mean PCV, Hb and total RBC count were lower (p < 0.001) in all infected groups than in non-infected control animals. In Nigeria, domestic ruminants that were naturally infected with trypanosomes had significantly lower (p < 0.05) PCV and RBC counts compared to uninfected animals (Ohaeri & Eluwa, 2011). Lower herd average PCVs for trypanosome-positive cattle compared to trypanosome-negative cattle have also been reported from Zambia (Marcotty et al., 2008), Cameroon (Achukwi & Musongong, 2009) and Gabon (Cossic et al., 2017).

The mean PCV, Hb and RBC values observed in both infected and uninfected N’Dama and WASH cattle studied were within the established normal reference values (Jain, 1993). The presence of T. vivax parasites is associated with a reduction in the mean RBC values below the normal range, an indication of anaemia (Murray & Dexter, 1988; Silva et al., 1999). However, infected cattle in the present study had mean RBC values within the normal range, which could be attributed to their trypanotolerant trait. In a typical trypanotolerance phenomenon, pathogenic Trypanosoma species infection does not usually result in anaemia (Murray et al., 1982; Murray & Dexter, 1988). Our findings compare favourably with the report that the mean RBC, Hb and PCV values in natural T. vivax-infected trypanotolerant Muturu cattle in Nigeria (Mbanasor et al., 2003) were well within accepted normal values for cattle. An earlier study (Adam et al., 2012) involving trypanotolerant WASH cattle in Ghana also reported normal PCV value despite the presence of trypanosome parasites.

The importance of keeping trypanotolerant cattle as a trypanosomosis control measure in Ghana has long been recognised (Mahama et al., 2003; Turkson, 1993). However, farmers are increasingly showing a preference for trypanosusceptible Zebu cattle and its Sanga crossbreed, which have a larger body size, higher milk yield and heavier live weight (World Bank, 1992). For example, the last Ghana Livestock Census published in 1997 indicated that the WASH constituted 70% of the cattle population in Ghana (Mahama et al., 2003), while a later study gave a reduced WASH population of 47.5% (Ahunu & Boa-Amponsem, 2001).

The larger bodied trypanosusceptible cattle breeds command higher prices compared to the smaller bodied trypanotolerant cattle, but unlike trypanotolerant cattle, trypanosusceptible cattle cannot survive in areas of high tsetse densities without veterinary intervention or other tsetse control strategies (Mahama et al., 2003; Turkson, 1993).

Although trypanotolerant breeds are equally susceptible to trypanosome infection, they possess the ability to survive, reproduce and remain productive in areas of high tsetse challenge without the need for the use of chemicals to control the vector or drugs to control the parasite (Dayo et al., 2009; Maganga et al., 2017; Rege et al., 1994; Yaro et al., 2016).

As was clearly demonstrated in this study, the infected trypanotolerant WASH and N’Dama maintained their mean RBC values in the normal range, which is an indication of good health. Further, in the present study, informal information revealed that none of the livestock keepers who keep such trypanotolerant breeds use trypanocidal drugs regularly or strategically to control the infection. Since trypanotolerant cattle could serve as potential reservoirs of trypanosome parasites, there is the need for owners of WASH and N’Dama herds in Ghana to incorporate routine diagnosis and treatment of trypanosome infections into their overall management strategy.

The mean WBC counts for the N’Dama and WASH in the present study were within the normal values reported by Jain (Jain, 1993) but were lower than those reported for T. vivax-infected and uninfected Muturu cattle in Nigeria (Mbanasor et al., 2003). The total RBC count for infected N’Dama was significantly (p < 0.05) higher than that for infected WASH suggesting that the N’Dama may be better at controlling anaemia compared to WASH.

Conclusion

In conclusion, the study found that in spite of the presence of natural T. vivax infection, the haematological parameters of N’Dama and WASH cattle herds were within acceptable normal ranges. Since such healthy cattle could serve as a potential source of infection for trypanosusceptible cattle and other domestic animals, the study underscores the need to incorporate routine diagnosis and treatment for trypanosome parasites in the management of trypanotolerant cattle herds.

Statement of animal welfare and ethics

Collection of blood was done as per standard operating procedures to ensure animal welfare (https://www.dpi.nsw.gov.au/animals-and-livestock/animal-welfare/general/general-welfare-of-livestock/sop/pigs/health/blood-collection). These are standard operating procedures used in veterinary medicine internationally.

Owners of animals gave their consent before the animals were bled. Prior to jugular venipuncture, the body of the animal was manually restrained by assistants to avoid injury to the animal. Further, the head of the animal was turned by another assistant at a 30-degree angle to the side by holding the animal under its jaw; this is to allow for easy access to the vein, and, to ensure quick, easy and safe collection of the sample causing minimal distress to the animal. To avoid repeated puncturing, time was taken to locate the vein accurately and it was distended by gentle pressure with the fingers before the needle was inserted. After the vein was located, the area was properly cleaned by alcohol to keep bacteria out of the needle insertion site. To ensure that sampling did not result in hypovolemic shock, physiological stress, anaemia and possibly death, only a minimal amount of 4ml of blood was drawn from each animal. To prevent needle-stick injury, a new needle was used for each venipuncture. As soon as blood was removed from the animal, the insertion site was swabbed with alcohol to remove any bacteria that might have entered the area during the drawing of blood. Pressure was applied for 30–60 seconds immediately following withdrawal of the needle; the pressure caused blood to clot, thereby preventing bleeding.

At the time this work was conducted (2011) there was no requirement by the University of Cape Coast for ethical clearance for work with animals. Therefore, we followed internationally accepted procedures such as those outlined in "Guidelines for the Welfare of Livestock from which Blood is Harvested for Commercial and Research Purposes” published by the New Zealand National Animal Ethics Advisory Committee in 2009 (https://www.mpi.govt.nz/dmsdocument/1475-guidelines-for-the-welfare-of-livestock-from-which-blood-is-harvested-for-commercial-and-research-purposes).

Data availability

Dataset 1: Haematological parameters of T. vivax infected and uninfected WASH and N'Dama cattle at Chegbani and Cape Coast, respectively. 10.5256/f1000research.14032.d197325 (Ganyo et al., 2018)

Author information

EYG holds a PhD in Parasitology. JNB is an Associate Professor in the Department of Biomedical and Forensic Sciences, and the Dean of the School of Biological Sciences. JV is a scientist and head of the Molecular Biology and Bioinformatics Unit, International Centre of Insect Physiology and Ecology Nairobi, Kenya. DKM is the head of Animal Health, International Centre of Insect Physiology and Ecology, Nairobi, Kenya. PKT is a Professor of Veterinary Epidemiology and Dean, School of Veterinary Medicine, University of Ghana, Legon, Accra, Ghana.

Comments on this article Comments (1)

Version 2
VERSION 2 PUBLISHED 10 Aug 2018
Revised
Version 1
VERSION 1 PUBLISHED 13 Mar 2018
Discussion is closed on this version, please comment on the latest version above.
  • Author Response 10 Aug 2018
    Paa Kobina, Department of Animal Science, School of Agriculture, University of Cape Coast, Ghana
    10 Aug 2018
    Author Response
    Responses to Second Reviewer’s comments
    1. Actual concentration of ethidium bromide and volumes of the PCR components have been provided in the methods section of the revised text, under the ‘Trypanosome ... Continue reading
  • Discussion is closed on this version, please comment on the latest version above.
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Ganyo EY, Boampong JN, Masiga DK et al. Haematology of N’Dama and West African Short Horn cattle herds under natural Trypanosoma vivax challenge in Ghana [version 1; peer review: 1 approved, 1 approved with reservations, 1 not approved]. F1000Research 2018, 7:314 (https://doi.org/10.12688/f1000research.14032.1)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
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ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions
Version 1
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PUBLISHED 13 Mar 2018
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Reviewer Report 01 Jun 2018
Sophie Thévenon, UMR INTERTRYP, French Agricultural Research Centre for International Development (CIRAD) , Montpellier, France 
Not Approved
VIEWS 18
The manuscript aims at assessing the effect of infections by Trypanosoma vivax on the hematological parameters of N’dama and WASH (West African Short-horn) cattle, raised in two natural environments in Ghana. The purpose is to highlight the trypanotolerant character of ... Continue reading
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Thévenon S. Reviewer Report For: Haematology of N’Dama and West African Short Horn cattle herds under natural Trypanosoma vivax challenge in Ghana [version 1; peer review: 1 approved, 1 approved with reservations, 1 not approved]. F1000Research 2018, 7:314 (https://doi.org/10.5256/f1000research.15253.r33786)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Reviewer Report 18 May 2018
David M Groth, School of Biomedical Sciences, Curtin University, Bentley, WA, Australia 
Approved with Reservations
VIEWS 19
Animal trypanosomosis is an important disease in both animals and humans and understanding the host’s response to such infection is important scientific endeavor. The manuscript describes some basic hematological parameters in these two breeds of animals, which may have some ... Continue reading
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HOW TO CITE THIS REPORT
Groth DM. Reviewer Report For: Haematology of N’Dama and West African Short Horn cattle herds under natural Trypanosoma vivax challenge in Ghana [version 1; peer review: 1 approved, 1 approved with reservations, 1 not approved]. F1000Research 2018, 7:314 (https://doi.org/10.5256/f1000research.15253.r33583)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Reviewer Report 25 Apr 2018
Yahaya Adam, Tsetse and Trypanosomiasis Control Unit/PATTEC, Ministry of Food and Agriculture, Pong-Tamale, Ghana 
Approved
VIEWS 13
Animal trypanosomosis, as reported in the paper, is indeed a major constraint to livestock production systems in Ghana. The theme for the paper is therefore very appropriate. The study design and methods as presented appear to satisfy the standard requirements for a scientific study. The ... Continue reading
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Adam Y. Reviewer Report For: Haematology of N’Dama and West African Short Horn cattle herds under natural Trypanosoma vivax challenge in Ghana [version 1; peer review: 1 approved, 1 approved with reservations, 1 not approved]. F1000Research 2018, 7:314 (https://doi.org/10.5256/f1000research.15253.r33102)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
  • Author Response 27 Apr 2018
    Paa Kobina, Department of Animal Science, School of Agriculture, University of Cape Coast, Ghana
    27 Apr 2018
    Author Response
    We accept the comments of the Referee. We agree that the two breeds are not as productive as other breeds but having them deal better with trypanosomosis is considered by ... Continue reading
COMMENTS ON THIS REPORT
  • Author Response 27 Apr 2018
    Paa Kobina, Department of Animal Science, School of Agriculture, University of Cape Coast, Ghana
    27 Apr 2018
    Author Response
    We accept the comments of the Referee. We agree that the two breeds are not as productive as other breeds but having them deal better with trypanosomosis is considered by ... Continue reading

Comments on this article Comments (1)

Version 2
VERSION 2 PUBLISHED 10 Aug 2018
Revised
Version 1
VERSION 1 PUBLISHED 13 Mar 2018
Discussion is closed on this version, please comment on the latest version above.
  • Author Response 10 Aug 2018
    Paa Kobina, Department of Animal Science, School of Agriculture, University of Cape Coast, Ghana
    10 Aug 2018
    Author Response
    Responses to Second Reviewer’s comments
    1. Actual concentration of ethidium bromide and volumes of the PCR components have been provided in the methods section of the revised text, under the ‘Trypanosome ... Continue reading
  • Discussion is closed on this version, please comment on the latest version above.
Alongside their report, reviewers assign a status to the article:
Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions
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