Safe Food, Fair Food: Participatory risk analysis for improving the safety of informally produced and marketed food in sub-Saharan Africa

Millions of small-scale farmers efficiently supply the great majority of the meat and milk market in Africa. Surging demand for livestock products (the “livestock revolution”) is an unprecedented opportunity for setting poor farmers on pathways out of poverty, but to gain maximum benefit they must be able to produce safe food of acceptable quality. Currently, most smallholder livestock products are sold in informal markets where conventional regulation and inspection methods have failed and where private or civil sector alternatives have not emerged: as a consequence, most livestock-derived food products contain high levels of hazards. Quantitative risk-based approaches for assessing and managing food safety offer a powerful new method for reducing the enormous health burden imposed by food borne disease, while taking into account other societal goals such as pro-poor growth. However, application to food safety problems in Africa has been limited. We discuss some of the constraints and a new approach which can help overcome these: Participatory Risk Analysis, and give examples of its current application in west, east and south Africa

Research productivity and main publishing institutions in Côte d'Ivoire, 2000-2016

The research productivity of countries commonly grouped within sub-Saharan Africa is as diverse as their cultural, economic, linguistic, political, and social profiles. While South Africa has been the science hub on the subcontinent for decades, publishing original research articles in the thousands, Mauritania struggles to have a single publication in international indexed journals in any given year. Detailed country-specific accounts on the co-evolution of research productivity and demographic and economic indicators from sub-Saharan Africa are lacking and render an accurate evaluation and cross-country comparison of internal research progress challenging.; We assessed the research productivity of Côte d'Ivoire, a francophone West African country that has gone through considerable socio-political unrest, for the period 2000-2016, and determined the main publishing institutions. We considered original research articles extracted from PubMed and Web of Science Core Collection, emphasizing life sciences and biomedical sciences.; We found the quantity of publications doubling from 4.1 to 8.5 per million population and the 'total product' - a measure for quantity and quality of published articles - rising from 0.8 to 22.1 per million population between 2000 and 2016. Since 2010 there was a marked increase in the proportion of English publications and a concomitant drop in the proportion of articles with Ivorian first and last authors. The percentage of foreign author contribution increased from 38.7% in 2000 to 71.6% in 2016, suggesting an 'internationalization' of the country's research production and output. Mixed authorship compared with 'Ivorian only' showed higher representation in journals with an official impact factor by Web of Science with proportions of 73% versus 28% for 2008 and 91% versus 45% for 2016. Two universities and university hospitals and three autonomous research institutions were consistently among the top 10 institutions publishing peer-reviewed material in three selected years (2000, 2008, and 2016). The main features of the most successful publishing institutions were research staff size, diversification of research portfolio and funding, multiple research bases across the country, and established and productive partnerships with foreign institutions.; Since the turn of the millennium, research productivity in Côte d'Ivoire has steadily grown at an above regional and global rate despite recurring economic pressures and sociopolitical unrest. We have observed benefits of internationalization throughout this current analysis reaching from improved publishing standards to increasing resilience of research institutions in times of crisis

Potential risk of regional disease spread in west Africa through cross-border cattle trade

Transboundary animal movements facilitate the spread of pathogens across large distances. Cross-border cattle trade is of economic and cultural importance in West Africa. This study explores the potential disease risk resulting from large-scale, cross-border cattle trade between Togo, Burkina Faso, Ghana, Benin, and Nigeria for the first time.; A questionnaire-based survey of livestock movements of 226 cattle traders was conducted in the 9 biggest cattle markets of northern Togo in February-March 2012. More than half of the traders (53.5%) operated in at least one other country. Animal flows were stochastically simulated based on reported movements and the risk of regional disease spread assessed. More than three quarters (79.2%, range: 78.1-80.0%) of cattle flowing into the market system originated from other countries. Through the cattle market system of northern Togo, non-neighbouring countries were connected via potential routes for disease spread. Even for diseases with low transmissibility and low prevalence in a given country, there was a high risk of disease introduction into other countries.; By stochastically simulating data collected by interviewing cattle traders in northern Togo, this study identifies potential risks for regional disease spread in West Africa through cross-border cattle trade. The findings highlight that surveillance for emerging infectious diseases as well as control activities targeting endemic diseases in West Africa are likely to be ineffective if only conducted at a national level. A regional approach to disease surveillance, prevention and control is essential

Heckman-type selection models to obtain unbiased estimates with missing measures outcome: theoretical considerations and an application to missing birth weight data

In low-income settings, key outcomes such as biomarkers or clinical assessments are often missing for a substantial proportion of the study population. The aim of this study was to assess the extent to which Heckman-type selection models can create unbiased estimates in such settings.; We introduce the basic Heckman model in a first stage, and then use simulation models to compare the performance of the model to alternative approaches used in the literature for missing outcome data, including complete case analysis (CCA), multiple imputations by chained equations (MICE) and pattern imputation with delta adjustment (PIDA). Last, we use a large population-representative data set on antenatal supplementation (AS) and birth outcomes from Côte d'Ivoire to illustrate the empirical relevance of this method.; All models performed well when data were missing at random. When missingness in the outcome data was related to unobserved determinants of the outcome, large and systematic biases were found for CCA and MICE, while Heckman-style selection models yielded unbiased estimates. Using Heckman-type selection models to correct for missingness in our empirical application, we found supplementation effect sizes that were very close to those reported in the most recent systematic review of clinical AS trials.; Missingness in health outcome can lead to substantial bias. Heckman-selection models can correct for this selection bias and yield unbiased estimates, even when the proportion of missing data is substantial