Fulfilling global marine commitments; lessons learned from Gabon

As part of the Post-2020 Biodiversity Framework, nations are assessing progress over the past decade in addressing the underlying drivers that influence direct pressures on biodiversity and formulating new policies and strategies for the decade to come. For marine conservation, global marine protected area (MPA) coverage is still falling short of the 10% target set in 2010. Here we show that while this reflects a lack of progress in many low- and middle-income countries, a few of these nations have met or exceeded international commitments. To provide an in-depth explanation of how this was achieved in Gabon, we summarize the lessons learnt by our consortium of policy makers and practitioners who helped implement a comprehensive and ecologically representative network of 20 MPAs. We show the importance of creating a national framework, building long-term stakeholder support, and focusing on research that guides implementation and policy; and outline a four-step approach that countries and donors could use as an example to help meet international commitments. By responding to calls to share lessons learned to inform future Convention on Biological Diversity targets, we show how Gabon's experiences could inform change elsewhere.Output Status: Forthcoming/Available Online Additional co-authors: Tim Collins, Philip D. Doherty, Angela Formia, Mark Gately, Micheline Schummer Gnandji, Innocent Ikoubou, Judicael Régis Kema Kema, Koumba Kombila, Pavlick Etoughe Kongo, Jean Churley Manfoumbi, Sara M. Maxwell, Georges H. Mba Asseko, Catherine M. McClellan, Gianna Minton, Samyra Orianne Ndjimbou, Guylène Nkoane Ndoutoume, Jean Noel Bibang Bi Nguema, Teddy Nkizogho, Jacob Nzegoue, Carmen Karen Kouerey Oliwina, Franck Mbeme Otsagha, Diane Savarit, Stephen K. Pikesley, Philippe du Plessis, Hugo Rainey, Lucienne Ariane Diapoma Kingbell Rockombeny, Howard C. Rosenbaum, Dan Segan, Guy-Philippe Sounguet, Emma J. Stokes, Dominic Tilley, Raul Vilela, Wynand Viljoen, Sam B. Weber, Matthew J. Witt, Brendan J. Godle

The critical need for pooled data on coronavirus disease 2019 in African children : an AFREhealth call for action through multicountry research collaboration

Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children and adolescents; and these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in improving knowledge on disease burden and manifestations of coronavirus disease 2019 (COVID-19) among children. Furthermore, it is essential to improve understanding of SARS-CoV-2 interactions with comorbidities and coinfections such as human immunodeficiency virus (HIV), tuberculosis, malaria, sickle cell disease, and malnutrition, which are highly prevalent among children in sub-Saharan Africa. The African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents is conducting studies across Western, Central, Eastern, and Southern Africa to address existing knowledge gaps. This consortium is expected to generate key evidence to inform clinical practice and public health policy-making for COVID-19 while concurrently addressing other major diseases affecting children in African countries.The US National Institutes of Health (NIH)/ Fogarty International Centre (FIC) to the African Forum for Research and Education in Health (AFREhealth).https://academic.oup.com/cidam2022Paediatrics and Child Healt

Assessment of the knowledge, attitudes, and practices toward human tuberculosis amongst rural communities in Chad.

INTRODUCTION Tuberculosis (TB) is an infectious zoonotic disease caused by bacteria belonging to the Mycobacterium tuberculosis complex. In sub-Saharan African countries such as Chad, TB is endemic and causes a high burden on humans and animals through morbidity, mortality, and reduced productivity in livestock. To effectively prevent and control the disease, strong coordination between policymakers, health and veterinary services, civil society organizations, and communities is needed. It also requires an understanding of the knowledge the communities have regarding TB. However, such knowledge is under-investigated, especially in rural areas. How knowledge affects people's attitudes and practices is also unclear. The main objective of this study was to investigate the knowledge, attitudes, and practices (KAP) of Chadian rural communities to better involve them in TB surveillance programs. METHODS A survey was conducted in 2021 in five rural health centers. Face-to-face interviews were conducted with persons suspected of having TB, and data on KAP were recorded and analyzed. RESULTS In total, 139 participants were enrolled. Overall, the knowledge and attitude of the participants were found to be good to moderate, with 126 (90.6%) and 97 (69.7%) having good knowledge and attitude, respectively. However, their practices were found to be rather weak, with only 40 (28.7%) participants having good practices. Men were found to have good knowledge about the disease significantly more often than women. Poor attitude was significantly associated with a mobile lifestyle compared to settled lifestyles and with farmers (mainly engaged in agriculture) compared to breeders (livestock keepers). Poor health practices were associated more with men than women and with settled lifestyles compared to a mobile lifestyle. Good practices were found to be in line with good knowledge and good attitudes; however, in the analyses, the association was not significant [OR knowledge = 5.83 (95% C.I. 0.6842.83), p = 0.112; OR attitude = 2.09 (95% C.I. 0.875.04), p = 0.100]. Furthermore, attitude was not associated with knowledge [OR = 1.03 (95% C.I. 0.303.55), p = 0.964]. DISCUSSION AND CONCLUSION Our study highlights the need for targeted sensitization and awareness campaigns for communities with poor knowledge and attitudes regarding TB. These campaigns should also include practical training to increase the level of good practice rather than simply providing knowledge

Lymphœdème récurrent des membres inférieurs due à la station debout prolongée imposée par la machine déchiqueteuse : une observation clinique: Recurrent lower limbs edema induced by working in prolonged standing position: a clinical observation

Chronic venous insufficiency (CVI) is a major public health problem. The association of this disease with a type of profession is paradoxically rare. The authors report a case report of a woman suffering from recurrent lower limb edema due to a CVI caused by an extended standing station. The etiological investigation and management of CVI induced by working in prolonged standing position are discussed. L’insuffisance veineuse chronique (IVC) est un problème majeur de santé publique. L’association de cette maladie à un type de profession est paradoxalement rare. Les auteurs rapportent une observation clinique d’une femme souffrant des œdèmes des membres inférieurs récurrents dus à une IVC favorisée par la station débout prolongée. L’enquête étiologique et la prise en charge de cette IVC favorisée par une profession réalisée en orthostatisme sont discutées

Fulfilling global marine commitments; lessons learned from Gabon

As part of the Post-2020 Biodiversity Framework, nations are assessing progress over the past decade in addressing the underlying drivers that influence direct pressures on biodiversity and formulating new policies and strategies for the decade to come. For marine conservation, global marine protected area (MPA) coverage is still falling short of the 10% target set in 2010. Here we show that while this reflects a lack of progress in many low- and middle-income countries, a few of these nations have met or exceeded international commitments. To provide an in-depth explanation of how this was achieved in Gabon, we summarize the lessons learnt by our consortium of policy makers and practitioners who helped implement a comprehensive and ecologically representative network of 20 MPAs. We show the importance of creating a national framework, building long-term stakeholder support, and focusing on research that guides implementation and policy; and outline a four-step approach that countries and donors could use as an example to help meet international commitments. By responding to calls to share lessons learned to inform future Convention on Biological Diversity targets, we show how Gabon's experiences could inform change elsewhere

The Critical Need for Pooled Data on COVID-19 in African Children: An AFREhealth Call for Action through Multi-Country Research Collaboration.

Globally, there are prevailing knowledge gaps in the epidemiology, clinical manifestations, and outcomes of SARS-CoV-2 infection among children and adolescents; however, these gaps are especially wide in African countries. The availability of robust age-disaggregated data is a critical first step in improving knowledge on disease burden and manifestations of COVID-19 among children. Furthermore, it is essential to improve understanding of SARS-CoV-2 interactions with comorbidities and co-infections such as HIV, tuberculosis, malaria, sickle cell disease and malnutrition, which are highly prevalent among children in sub-Saharan Africa. The African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents is conducting studies across Western, Central, Eastern, and Southern Africa to address existing knowledge gaps. This consortium is expected to generate key evidence to inform clinical practice and public health policymaking for COVID-19, while concurrently addressing other major diseases affecting children in African countries

Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis.

Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice. We conducted a 6-country retrospective cohort study among hospitalized women of childbearing age between 1 March 2020 and 31 March 2021. Exposures were (1) pregnancy and (2) a positive SARS-CoV-2 RT-PCR test. The primary outcome for both analyses was intensive care unit (ICU) admission. Secondary outcomes included supplemental oxygen requirement, mechanical ventilation, adverse birth outcomes, and in-hospital mortality. We used log-binomial regression to estimate the effect between pregnancy and SARS-CoV-2 infection. Factors associated with mortality were evaluated using competing-risk proportional subdistribution hazards models. Our analyses included 1315 hospitalized women: 510 pregnant women with SARS-CoV-2, 403 nonpregnant women with SARS-CoV-2, and 402 pregnant women without SARS-CoV-2 infection. Among women with SARS-CoV-2 infection, pregnancy was associated with increased risk for ICU admission (adjusted risk ratio [aRR]: 2.38; 95% CI: 1.42-4.01), oxygen supplementation (aRR: 1.86; 95% CI: 1.44-2.42), and hazard of in-hospital death (adjusted sub-hazard ratio [aSHR]: 2.00; 95% CI: 1.08-3.70). Among pregnant women, SARS-CoV-2 infection increased the risk of ICU admission (aRR: 2.0; 95% CI: 1.20-3.35), oxygen supplementation (aRR: 1.57; 95% CI: 1.17-2.11), and hazard of in-hospital death (aSHR: 5.03; 95% CI: 1.79-14.13). Among hospitalized women in SSA, both SARS-CoV-2 infection and pregnancy independently increased risks of ICU admission, oxygen supplementation, and death. These data support international recommendations to prioritize COVID-19 vaccination among pregnant women