Climate change to severely impact West African basin scale irrigation in 2 °C and 1.5 °C global warming scenarios

Abstract West Africa is in general limited to rainfed agriculture. It lacks irrigation opportunities and technologies that are applied in many economically developed nations. A warming climate along with an increasing population and wealth has the potential to further strain the region’s potential to meet future food needs. In this study, we investigate West Africa’s hydrological potential to increase agricultural productivity through the implementation of large-scale water storage and irrigation. A 23-member ensemble of Regional Climate Models is applied to assess changes in hydrologically relevant variables under 2 °C and 1.5 °C global warming scenarios according to the UNFCCC 2015 Conference of Parties (COP 21) agreement. Changes in crop water demand, irrigation water need, water availability and the difference between water availability and irrigation water needs, here referred as basin potential, are presented for ten major river basins covering entire West Africa. Under the 2 °C scenario, crop water demand and irrigation water needs are projected to substantially increase with the largest changes in the Sahel and Gulf of Guinea respectively. At the same time, irrigation potential, which is directly controlled by the climate, is projected to decrease even in regions where water availability increases. This indicates that West African river basins will likely face severe freshwater shortages thus limiting sustainable agriculture. We conclude a general decline in the basin-scale irrigation potential in the event of large-scale irrigation development under 2 °C global warming. Reducing the warming to 1.5 °C decreases these impacts by as much as 50%, suggesting that the region of West Africa clearly benefits from efforts of enhanced mitigation

Malaria Transmission Pattern in an Area Selected for Clinical Trials in the Sudanian Area of Senegal (West Africa)

Malaria transmission pattern was studied in 3 villages (Toubanding, Daga Ndoup, and Keur Samba Guèye) situated within an area selected for clinical trials. The study was conducted in the rainy season from July to December 2011. The main objective of this work was to gather baseline data on malaria transmission intensity and other entomological parameters before the advent of clinical trials. Mosquitoes were collected by Human-Landing Collections (HLCs) and by pyrethrum spray catches (PSCs). Five anopheline species were collected, namely, An. arabiensis, An. gambiae, An. funestus, An. pharoensis, and An. rufipes, giving a heterogeneous distribution within the study area. The populations dynamics of the vectors varied temporarily in each village depending on the pattern of the rainy season. Transmission intensity estimated by the entomological inoculation rate (EIR) was measured in each of the three villages with the variations linked to the microecological differences between the villages. Measurements were calculated for August, September, and October and were found to vary between 4 and 30 infected bites per person over the study period with a peak intensity observed in September. These results indicate that epidemiological field trials on malaria could be conducted in this area on the basis of the differences observed with transmission intensity, micro-ecological variations, and the objectives of the trials

Morbidity associated with sickle cell trait carriers

Background: Sickle cell trait carriers has long considered asymptomatic. This affirmation is now challenged because many patients complain of osteoarticular pain and several organic degenerative complications in particular; renal, eye and sudden death have been described. The objective of this study was to evaluate the morbidity of sickle cell trait and identify risk factors associated.Methods: This is a prospective study with duration of 16 months including 50 patients with sickle cell trait received regular visits (every 6 months) for painful events. Biological assessment was carried out systematically to eliminate rheumatic disease (CRP, ASLO, latex Waler Rose) or metabolic disorders (serum calcium, serum magnesium, and serum uric acid). A correlation between clinical and laboratory data was performed to study the relationship between morbidity observed and biological abnormalities.Results: Mean age of patients was 32 years (12-59) and mean age at diagnosis was 24 years (12-55 years). Sex ratio M/F was 0.16. Clinical symptoms were osteoarticular pain (88%), headache (86%), abdominal pain (76%), muscle cramps (70%), dizziness (56%), biliary lithiasis (6%), femoral head osteonecrosis (2%) and gross haematuria (2%). Seventeen patients (34%) had abnormal metabolic or rheumatic analysis. No risk factor associated with morbidity of patients was identified.Conclusions: This work has allowed us to find that the symptoms presented by sickle cell trait patients are dominated by painful events. This morbidity associated with porting sickle cell trait was not secondary to inflammatory or metabolic disorders or physical activity

Uterine ruptures during labor: a study of 26 cases at Nabil Choucair Medical Center, in the suburbs of Dakar

Background: This study aims to clarify the epidemiological profile of patients and describe the diagnostic, therapeutic and prognostic aspects of uterine ruptures at Nabil Choucair Health Center, in the suburbs of Dakar.Methods: This was a retrospective and prospective, descriptive and analytical study conducted over a period of 112 months, from July 31, 2005 and March 31, 2015; it concerned all diagnosed cases with uterine rupture, managed at Nabil Health Center Choucair Dakar. Data were collected from antenatal notebooks, delivery records, surgical reports and anesthetic records. The following parameters were studied: socio-demographic characteristics (frequency, chracteristics of patient), the course of pregnancy, diagnostic, prognostic, and therapeutic aspects. Data analysis was performed using SPSS software (version 11.0).Results: During the study period, we recorded 26 uterine ruptures from a total of 34,097 deliveries, that is a frequency of 8 out of 10,000 births. The epidemiological profile of the patients was that of a 30-year old woman, on average, few previous deliveries with an average parity of 3, who received on average 3 antenatal and evacuated in 50% of cases. Uterine rupture occurred in 17 patients on a new uterus (65, 4%) and in 9 patients on a scarred uterus (34.6%). Two patients (7%) were in hemorrhagic shock. A laparotomy aimed at specifying the place of rupture and making the treatment was performed in all patients. It was 18 uterine segmento-corporeal ruptures (69.2%), 5 segmental ruptures (19.2%) and 2 corporeal ruptures (7.6%). We recorded 9 uterine ruptures with living fetus (38.5%). Twenty-three patients (88.5%) underwent conservative suture against only 3 hemostasis hysterectomy (11.5%). The postoperative courses were uneventful in 57.7% of cases. Eleven patients (42.3%) had anemia and we recorded maternal deaths, which is a maternal mortality of 3.84%.Conclusions: Uterine rupture is a serious complication that is still responsible for significant maternal and fetal mortality. Prevention is based on careful monitoring of pregnancy and delivery

Dramatic declines in seropositivity as determined with crude extracts of Plasmodium falciparum schizonts between 2000 and 2010 in Dielmo and Ndiop, Senegal

BACKGROUND: Programmes of pre-elimination of malaria have been implemented in Senegal since 2010, and the burden of malaria has decreased substantially. These changes in the epidemiology should be monitored with effective tools that allow changes in patterns of transmission to be estimated. In Dielmo and Ndiop, two villages of Senegal with different malaria endemicity, infections have been followed longitudinally for 20 years, during which time there have been several control interventions leading to substantial decreases of transmission. This study aimed to compare malaria antibody responses of the inhabitants of these two villages, between 2000 and 2010, using schizont crude extracts of a local strain of P. falciparum (Pf Sch07/03). METHODS: Sera collected from inhabitants of the two villages (141 from Dielmo and 79 from Ndiop in 2000; 143 from Dielmo and 79 from Ndiop in 2010) were used to assess the prevalence of antibodies against crude schizont extracts of Pf Sch07/03. Three ages groups were defined: [5-9] yrs, [10-14] yrs and [15-19] yrs. Statistical comparisons were performed. Seroprevalence and the magnitude of antibody responses were compared between age groups, villages and periods. RESULTS: Overall seroprevalence to P.fSch07/03 decreased between 2000 and 2010 in both villages: from 94.4% to 44.4% in Dielmo and from 74.4% to 34.6% in Ndiop. The difference between Dielmo and Ndiop was highly significant in 2000 (p0.20). The decrease in seroprevalence was larger in younger (more than 40%) than older (less than 19%) inhabitants. Longitudinal monitoring of the younger group showed that seroprevalence decreased between 2000 and 2010 in Dielmo from 98.7 to 79.3, but not in Ndiop from 67.6 to 66.7. The magnitude of antibody responses in seropositive individuals was significantly higher in 2000 than 2010 for both villages. CONCLUSIONS: Crude extracts of P. falciparum are appropriate tools for evaluating malaria prevalence at different periods, and in both low and high endemic area. Using crude extracts from local strains to assess transmission may allow efficient evaluation of the consequences of control programs on malaria transmission

Use of HRP-2-based rapid diagnostic test for Plasmodium falciparum malaria: assessing accuracy and cost-effectiveness in the villages of Dielmo and Ndiop, Senegal

Background: In 2006, the Senegalese National Malaria Control Programme (NMCP) has recommended artemisinin-based combination therapy (ACT) as the first-line treatment for uncomplicated malaria and, in 2007, mandated testing for all suspected cases of malaria with a Plasmodium falciparum HRP-2-based rapid diagnostic test for malaria (RDT(Paracheck (R)). Given the higher cost of ACT compared to earlier anti-malarials, the objectives of the present study were i) to study the accuracy of Paracheck (R) compared to the thick blood smear (TBS) in two areas with different levels of malaria endemicity and ii) analyse the cost-effectiveness of the strategy of the parasitological confirmation of clinically suspected malaria cases management recommended by the NMCP. Methods: A cross-sectional study was undertaken in the villages of Dielmo and Ndiop (Senegal) nested in a cohort study of about 800 inhabitants. For all the individuals consulting between October 2008 and January 2009 with a clinical diagnosis of malaria, a questionnaire was filled and finger-prick blood samples were taken both for microscopic examination and RDT. The estimated costs and cost-effectiveness analysis were made considering five scenarios, the recommendations of the NMCP being the reference scenario. In addition, a sensitivity analysis was performed assuming that all the RDT-positive patients and 50% of RDT-negative patients were treated with ACT. Results: A total of 189 consultations for clinically suspected malaria occurred during the study period. The sensitivity, specificity, positive and negative predictive values were respectively 100%, 98.3%, 80.0% and 100%. The estimated cost of the reference scenario was close to 700(sic) per 1000 episodes of illness, approximately twice as expensive as most of the other scenarios. Nevertheless, it appeared to us cost-effective while ensuring the diagnosis and the treatment of 100% of malaria attacks and an adequate management of 98.4% of episodes of illness. The present study also demonstrated that full compliance of health care providers with RDT results was required in order to avoid severe incremental costs. Conclusions: A rational use of ACT requires laboratory testing of all patients presenting with presumed malaria. Use of RDTs inevitably has incremental costs, but the strategy associating RDT use for all clinically suspected malaria and prescribing ACT only to patients tested positive is cost-effective in areas where microscopy is unavailable

L’éléphantiasis vulvo-clitoridien: à propos d’un nouveau cas

L'éléphantiasis vulvo-clitoridien d'origine filarienne est une affection très rare. Nous rapportons un nouveau cas chez une femme de 33 ans suivie dans un service de Maladies Infectieuses pour filariose lymphatique. Elle avait une masse vulvo-clitoridienne qui évoluait depuis plus de 10 ans. Une résection clitoridienne et une plastie vulvaire a été réalisée. Les résultats fonctionnels et esthétiques étaient satisfaisants.Key words: Eléphantiasis, filariose, vulvo-clitoridie

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century