Response of selected indigenous dryland agroforestry tree species to salinity and implications for soil fertility management

Salt tolerant plants are known to remove excess soluble salts from the soil and thus may be used in land reclamation. We studied the responses of the trees, Balinites aegyptiaca L. (Zygophyllaceae), as well as the Fabaceae, Acacia tortilis (Forssk) Hayne, and Tamarindus indica L. to salinity. Three experiments were conducted on: germination, in the laboratory; seedling performance in a lath house; and, the impact of the tree species on soil productivity in the field in Afar regional state along the Awash river, eastern Ethiopia. Mixtures of salts, composed of chlorides and sulfates were tested at different concentrations in both germination and lath house experiments in randomized complete block designs. Seedling root collar diameter and height were measured every two weeks. Soil samples were collected from randomly selected pots to examine the effect of salinity on soil properties. The effects of trees on in situ soil productivity was studied by collecting 72 soil samples at different distances from the tree and different soil depths. The soil productivity index was calculated. The study revealed that germination percentage and rate decreased significantly with increasing salt concentrations. The effects of the three tree species on soil properties were significantly different at 12.2 dS m -1 salinity level compared to the control. A. tortilis was the least salt-sensitive. Balancing the key requirements of adequate germination and growth and the ability to reduce the salt concentration of the soil solution, B. aegyptiaca is the species with the most potential. Therefore, the study suggests to use B. aegyptiaca as agroforestry trees in the form of parkland in arid and semi-arid areas where salinity problems are prominent

Prospective Study of Surgery for Traumatic Brain Injury in Addis Ababa, Ethiopia: Surgical Procedures, Complications, and Postoperative Outcomes

Under embargo until: 2022-06-02Background Traumatic brain injury (TBI) is an important cause of trauma-related mortality and morbidity in Ethiopia. There are significant resource limitations along the entire continuum of care, and little is known about the neurosurgical activity and patient outcomes. Methods All surgically treated TBI patients at the 4 teaching hospitals in Addis Ababa, Ethiopia were prospectively registered from October 2012 to December 2016. Data registration included surgical procedures, complications, reoperations, discharge outcomes, and mortality. Results A total of 1087 patients were included. The most common procedures were elevation of depressed skull fractures (49.5%) and craniotomies (47.9%). Epidural hematoma was the most frequent indication for a craniotomy (74.7%). Most (77.7%) patients were operated within 24 hours of admission. The median hospital stay for depressed skull fracture operations or craniotomies was 4 days. Decompressive craniectomy was only done in 10 patients. Postoperative complications were seen in 17% of patients, and only 3% were reoperated. Cerebrospinal fluid leak was the most common complication (7.9%). The overall mortality was 8.2%. Diagnosis, admission Glasgow Coma Scale (GCS) score, surgical procedure, and complications were significant predictors of discharge GCS score (P < 0.01). Age, admission GCS score, and length of hospital stay were significantly associated with mortality (P ≤ 0.005). Conclusions The injury panorama, surgical activity, and outcome are significantly influenced by patient selection due to deficits within both prehospital and hospital care. Still, the neurosurgical services benefit a large number of patients in the greater Addis region and are qualitatively comparable with reports from high-income countries.acceptedVersio

Prospective Study of Surgery for Traumatic Brain Injury in Addis Ababa, Ethiopia: Trauma Causes, Injury Types, and Clinical Presentation

Under embargo until: 2022-04-27Background Traumatic brain injury (TBI) is a public health problem in Ethiopia. More knowledge about the epidemiology and neurosurgical management of TBI patients is needed to identify possible focus areas for quality improvement and preventive efforts. Methods This prospective cross-sectional study (2012–2016) was performed at the 4 teaching hospitals in Addis Ababa, Ethiopia. All surgically treated TBI patients were included, and data on clinical presentation, injury types, and trauma causes were collected. Results We included 1087 patients (mean age 29 years; 8.7% females; 17.1% 50 km from the hospitals, whereas 46% of road traffic accident victims came from the urban area. Delayed admission was associated with higher Glasgow Coma Scale scores and nonsevere TBI (P < 0.01). Conclusions The injury panorama, delayed admission, and small number of operations performed for severe TBI are linked to a substantial patient selection bias both before and after hospital admission. Our results also suggest that there should be a geographical framework for tailored guidelines, preventive efforts, and development of prehospital and hospital services.acceptedVersio

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million 95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% 95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

Regeneration ecology of Jatropha curcas L. in Africa: implications for its biofuel production and invasiveness

Jatropha curcas L. is a tropical tree belonging to the Euphorbiaceae family. The high oil content and suitable fatty acid composition of the seeds are two arguments to promote J. curcas as a promising biodiesel crop. However, little information is available on the regeneration ecology and productivity of the species. In addition to this, the higher number of male flowers compared to female flowers results in a low yield. A better knowledge of the reproductive ecology of the species is imperative (e.g. pollination process, flowering, fruiting, seed yield, seed dispersal and establishment) for yield optimization and invasiveness risk assessment and management. Therefore this research first focused on the current discourse and it questions how to increase the seed and oil yield of J. curcas through agronomic approaches such as pollen manipulation, pruning, spacing and fertilization. The second question was the invasiveness issue of J. curcas. To answer both questions we formulated the following research objectives: (i) identify the possible potential arthropod pollinators of J. curcas, (ii) find out the best pollination method to increase seed yield, oil quantity and quality, (iii) identify the best agronomic management practices and timing to modify flower sex ratio and to increase seed and oil yield of J. curcas, and (iv) assess the invasiveness risk of J. curcas and seeding potential to adjacent land ecosystems. For seed yielding crops such as J. curcas it can be expected that successful pollination is a key process that affects seed yield, oil quantity and oil quality. Insight into the diversity and movement of potential pollinators forms an important aspect of the needed knowledge. In the first part of this dissertation we report on J. curcas flower visitors observed in two Southern African countries. Observations at two sites, each on 10 trees, during 10 days showed that 41 insects and 2 Arachnida in Zambia and 29 insect species in Malawi visited J. curcas flowers. Diptera and Hymenoptera were the largest group. The most abundant insect visitors were Apis mellifera and Chrysomya chloropyga. A. mellifera visits more inflorescences within shorter period than C. chloropyga and shows a frequent appearance in both sites.Floral phenology studies and pollination experiments (natural and artificial) in two sites in Zambia (2 year and 5 year old plantations) and one site in Malawi (5 year plantation) showed J. curcas is not only of protandrous nature, as previously reported. It can be both protandrous and protogynous and able to produce seeds through both self-and cross-pollination. The male to female flower sex ratios were 22:1, 17:1 and 10:1 respectively for 2 year and 5 year old plantation in Zambia and 5 years old plantation in Malawi. The flower longevity periods (mean&plusmn; SE) were 1.80&plusmn;0.07 days for male flowers and 4.5&plusmn;0.18 days for female flowers. Fewer fruit set and lower seed yield were recorded from autogamous pollination in Zambia sites. In the case of Malawi, more matured fruits resulted from autogamous pollination but the fruits contained fewer seeds. High fruit and seed yield were recorded for open pollination similar to pollen-supplemented pollination at Zambia sites, which indicates there was no pollen limitation in the study sites. In the Malawi site, there was no seed yield difference between pollination treatments. The natural fruit set and seed yield in Zambia indicates that conserving the natural pollination will improve J. curcas fruit set and seed yield, as a base for better oil production.The seed morphology, seed oil content (g), seed oil concentration (%) and oil fatty acid composition study after different pollination treatments in Zambia showed the effect of pollination more reflected in total oil yield per inflorescence and tree than in unit seed oil content and concentration. Up to 70% and 29% oil yield reduction was observed for autonomous autogamy and self-pollination treatments, respectively, compared to open pollination. Cross- and self-pollination resulted in longer seeds than open pollination but not in oil content and concentration differences. The oil has high unsaturated fatty acid content (80%) and is composed of 9 fatty acids. Pollination treatments had an effect on fatty acid composition of individual seed oil from mature trees (5 year old), but did not for 2 year old trees. The oleic acid content, a determinant fatty acid component for quality biodiesel production, was lower for artificial self-pollination (9% reduction) compared to open pollination. This research demonstrates overall oil yield and quality are the highest under natural pollination. This shows the importance of safeguarding the quality and effectiveness of open natural pollination. This can be done by enhancing the presence of insects identified as J. curcas pollinators, particularly those pollinators enhancing cross-pollination. Proper application of fertilizer and canopy management such as pruning and planting density are believed to increase J. curcas seed and oil yield. The 2009 to 2011 field experiments in Balaka, Malawi showed J. curcas yield can be best improved without pruning. Spacing and pruning did not show flower sex ratio differences among the treatments. We found up to 55% seed and final oil yield reduction after pruning, particularly for trees pruned in the dry cold season, and beginning of rainy season compared to non-pruned trees. It is claimed that J. curcas can be grown on soils with low nutrient content but this study revealed that yield was low for non-fertilized trees, even on good soils. Fertilizer application altered the flower sex ratio of J. curcas. Seed yield and oil yield increased at higher application rates of Phosphorus (at 200 % P level, relative to the recommended rate) and Nitrogen (at 143 % N level, relative to the recommended rate) with an increase of seed yield and oil yield (mean &plusmn; SE) to 217&plusmn;41% and 217&plusmn;38% and 203&plusmn;42% and 204&plusmn;45% respectively compared to non-fertilized trees. Based onthe integrated invasiveness research experiments (spontaneous occurrence of seedlings, seed dispersal mechanisms, seed predation by animals, and germination success of dispersed seeds) in Zambia, J. curcas is not an invasive species. No spontaneous regeneration was observed in land use systems adjacent to J. curcas plantations. Primary seed dispersal was limited, and predominantly under the canopy of the mother plant. Rodents and shrews dispersed and predated J. curcas seeds and fruits. They transported the seeds up to 23 m from the sources and repositioned them in their burrows up to 0.7 m deep, but none of these seeds could establish. Germination experiments in adjacent land use systems revealed 4% germination success at the soil surface, and 65% if buried artificially at 1-2 cm depth, yet the latter is unlikely to occur under natural conditions. These findings show that J. curcas seeds may be dispersed by animals to adjacent land use systems, but no natural recruitment was observed given low germination on the surface and none in burrows. All together these results suggest that the plant currently does not show an elevated risk of invasion to adjacent land use systems, at least not in the investigated case study. The overall study elucidates the importance of understanding the critical steps and processes of J. curcas regeneration ecology to optimize seed yield, oil yield and to avoid the invasiveness risk of the species in Africa. The research methodology can be also applied for other similar current tropical biofuel crops. As such, this study adds to the scientific knowledge of the regeneration ecology of tropical biofuel crops in tropical and sub tropical regions of the world.status: publishe

Insufficient evidence of Jatropha curcas L. invasiveness: experimental observations in Burkina Faso, West Africa

Biofuel plants such as Jatropha curcas L. have potential to support the livelihoods of rural communities and contribute to sustainable rural development in Africa, if risks and uncertainties are minimized. Yet recent papers have warned of the risk of biological invasions in such tropical regions as a consequence of the introduction of exotic biofuel crops. We investigated the seed dispersal risk and invasiveness potential of both J. curcas monoculture plantations and live fences into adjacent cultivated and uncultivated land use systems in Sissili province, Burkina Faso. Invasiveness potential was assessed through (i) detecting evidence of natural regeneration in perimeters around J. curcas plantations and live fences, (ii) assessing seed dispersal mechanisms and (iii) assessing seedling establishment potential through in situ direct seed sowing. Spontaneous regeneration around the plantation perimeters of the three sites was very low. Individual seedling density around J. curcas live fences was less than 0.01 m-2 in all sites. Seventy percent of the seedlings were found close to the live fence and most of them derived from the same year (96%), which indicates low seed-bank longevity and seedling survival. Jatropha curcas can be dispersed by small mammals and arthropods, particularly rodents and ants. In some sites, such as in Onliassan, high secondary seed dispersal by animals (up to 98%) was recorded. There were highly significant differences in germination rates between seeds at the soil surface (11%) and those buried artificially at 1-2 cm depth (64%). In conclusion, we failed to find convincing evidence of the spreading of J. curcas or any significant impact on the surrounding environment