L’hésitation à la vaccination COVID-19 dans les communes de Bamako au Mali

Bien que le développement de vaccins soit un exploit considérable, ce n'est que récemment qu'une attention considérable a été accordée à l'hésitation face au vaccin COVID-19. L'hésitation à la vaccination pourrait être un obstacle à l'optimisation de l'adoption et de l'acceptation des vaccins COVID-19. Cette étude voudrait déterminer les facteurs associés à l’hésitation à la vaccination COVID-19 dans les communes de Bamako au Mali. C’est une étude quantitative, descriptive et transversale utilisant un questionnaire pour déterminer les facteurs associés à l’hésitation à la vaccination COVID-19. La population de cette étude a concerné les adultes vivants dans les communes de Bamako au Mali. Au total 532 personnes vivants dans les communes de Bamako ont accepté de participer dont plus de la moitié étaient des femmes.  Environ 18,6 % avaient déjà reçu au moins une dose de vaccin contre la COVID-19. La peur des réactions secondaires (77 ,1%), était la principale raison de la réticence ou de l’hésitation à la vaccination COVID-19. Cette étude a rapporté une relation significative entre le statut vaccinal et les caractérisques socio-démographiques à savoir le sexe (p=0,01), l’âge (p=0,02), situation matrimoniale (p=0,04), le niveau d’éducation (p=0,01) et la connaissance sur la vaccination COVID-19 (p=0,002). L'hésitation à l'égard des vaccins est une menace imminente dans la bataille contre le COVID-19, car l'obtention d'une immunité collective dépend de l'efficacité du vaccin lui-même et de la volonté de la population à l’accepter

L’hésitation à la vaccination COVID-19 dans les communes de Bamako au Mali

Bien que le développement de vaccins soit un exploit considérable, ce n'est que récemment qu'une attention considérable a été accordée à l'hésitation face au vaccin COVID-19. L'hésitation à la vaccination pourrait être un obstacle à l'optimisation de l'adoption et de l'acceptation des vaccins COVID-19. Cette étude voudrait déterminer les facteurs associés à l’hésitation à la vaccination COVID-19 dans les communes de Bamako au Mali. C’est une étude quantitative, descriptive et transversale utilisant un questionnaire pour déterminer les facteurs associés à l’hésitation à la vaccination COVID-19. La population de cette étude a concerné les adultes vivants dans les communes de Bamako au Mali. Au total 532 personnes vivants dans les communes de Bamako ont accepté de participer dont plus de la moitié étaient des femmes.  Environ 18,6 % avaient déjà reçu au moins une dose de vaccin contre la COVID-19. La peur des réactions secondaires (77 ,1%), était la principale raison de la réticence ou de l’hésitation à la vaccination COVID-19. Cette étude a rapporté une relation significative entre le statut vaccinal et les caractérisques socio-démographiques à savoir le sexe (p=0,01), l’âge (p=0,02), situation matrimoniale (p=0,04), le niveau d’éducation (p=0,01) et la connaissance sur la vaccination COVID-19 (p=0,002). L'hésitation à l'égard des vaccins est une menace imminente dans la bataille contre le COVID-19, car l'obtention d'une immunité collective dépend de l'efficacité du vaccin lui-même et de la volonté de la population à l’accepter

Sahel terrorist crisis and development priorities: case of financial allocations for the control of non-communicable diseases in Burkina Faso

In Africa, nearly 46% of all mortality will be attributed to non-communicable diseases (NCDs) by 2030. While the cost of inaction far exceeds the cost of action against NCDs, global funding for the prevention and control of NCDs is minimal. The objective of this was to explore the Ministry of Health budget allocations for NCDs from 2010 to 2020 as well as the effect of the terrorism crisis on these allocations. The methodology was based on the budget tracking tool developed by the Scaling Up Nutrition Movement. Twenty-nine budget lines related to the prevention and/or control of NCDs have been identified. About 29.9 million USD were allocated to the fight against NCDs with an absorption rate of more than 98%.There is an upward trend of allocated budget characterized by an exponential increase from the development of the national integrated strategic plan for the fight against NCDs (2016–2020). In 2017, an increase of 184% compared to 2016 was observed. However, the efforts were challenged by the emergence of the terrorist threat which triggered in January 2016, leading to a drastic reduction in allocations for NCDs in favor likely of defense and security priorities as well as addressing the needs of internally displaced persons. A trend analysis suggests that the NCDs budget significantly decrease as the country global terrorist index increase. Further analysis is needed to better understand the implication on NCD incidence, and identify advocacy opportunities for mitigating the negative impact of the terrorist treat on NCDs and other development issues

Concordance of vaccination status and associated factors with incomplete vaccination: a household survey in the health district of Segou, Mali, 2019

Introduction: the region of Segou recorded 36.8% of children were incompletely vaccinated in 2018. In 2019, the district of Segou was one of the districts with the lowest vaccination coverage in the region, with 85.1% coverage for the three doses of the pentavalent vaccine and 85.4% for the measles vaccine. This study was initiated to better understand this low vaccination coverage, in the absence of specific studies on vaccination coverage in the district of Segou. Methods: a prospective cross-sectional study was conducted from May to August 2020 with 30 clusters. We performed Kappa coefficient, bivariate, and multiple logistic regression analysis. Results: findings showed that 18.46% (101/547) [15.44-21.93] of children were incompletely vaccinated. Mothers correctly reported the vaccination status of their children in 67.30% of cases (Kappa coefficient). Uneducated (OR[IC95%]=2.13[1.30-3.50]), living in rural area (OR[IC95%]=2.07[1.23-3.47]), lack of knowledge of Expanded Program on Immunization (EPI) target diseases (OR[IC95%]=2.37[1.52-3.68]), lack of knowledge of vaccination schedule (OR[IC95%]=3.33[1.90-5.81]) and lack of knowledge of the importance of vaccination (OR[IC95%]=3.6[2.35-6.32]) were associated with incomplete vaccination. In multivariate analysis, uneducated (ORa[IC95%>]=1.68[1.004-2.810]) and lack of knowledge of the importance of vaccination were associated with incomplete vaccination (ORa[IC95%]=3.40[2.049-5.649]). Conclusion: findings showed a good concordance of the vaccination status. Living in a rural area, no education, lack of the knowledge of EPI target diseases, lack of the knowledge of vaccination schedule and lack of knowledge of the importance of vaccination were associated with incomplete vaccination

Stakeholder engagement in the development of genetically modified mosquitoes for malaria control in West Africa: lessons learned from 10 years of Target Malaria’s work in Mali

From 2012 to 2023, the Malaria Research and Training Center (MRTC), based out of the University of Sciences, Techniques and Technologies of Bamako (USTTB), was part of the Target Malaria research consortium working towards developing novel gene drive-based tools for controlling populations of malaria vector mosquitoes. As part of this work, Target Malaria Mali has undertaken a range of in-depth engagement activities with the communities where their research is conducted and with other stakeholders nationally. These activities were meant to ensure that the project’s activities took place with the agreement of those communities, and that those communities were able to play a role in shaping the project’s approach to ensure that its eventual outcomes were in line with their needs and concerns. This paper aims to conduct a critical assessment of those 10 years of stakeholder engagement in order to identify good practices which can inform future engagement work on gene drive research in West Africa. It sets out a range of approaches and practices that enabled the Target Malaria Mali team to engage a variety of stakeholders, to share information, collect feedback, and determine community agreement, in a manner that was inclusive, effective, and culturally appropriate. These can be useful tools for those working on gene drive research and other area-wide vector control methods in West African contexts to ensure that their research is aligned with the interests of the communities who are intended to be its ultimate beneficiaries, and to allow those communities to play a meaningful role in the research process

Use of ChAd3-EBO-Z Ebola virus vaccine in Malian and US adults, and boosting of Malian adults with MVA-BN-Filo: a phase 1, single-blind, randomised trial, a phase 1b, open-label and double-blind, dose-escalation trial, and a nested, randomised, double-blind, placebo-controlled trial

SummaryBackgroundThe 2014 west African Zaire Ebola virus epidemic prompted worldwide partners to accelerate clinical development of replication-defective chimpanzee adenovirus 3 vector vaccine expressing Zaire Ebola virus glycoprotein (ChAd3-EBO-Z). We aimed to investigate the safety, tolerability, and immunogenicity of ChAd3-EBO-Z in Malian and US adults, and assess the effect of boosting of Malians with modified vaccinia Ankara expressing Zaire Ebola virus glycoprotein and other filovirus antigens (MVA-BN-Filo).MethodsIn the phase 1, single-blind, randomised trial of ChAd3-EBO-Z in the USA, we recruited adults aged 18–65 years from the University of Maryland medical community and the Baltimore community. In the phase 1b, open-label and double-blind, dose-escalation trial of ChAd3-EBO-Z in Mali, we recruited adults 18–50 years of age from six hospitals and health centres in Bamako (Mali), some of whom were also eligible for a nested, randomised, double-blind, placebo-controlled trial of MVA-BN-Filo. For randomised segments of the Malian trial and for the US trial, we randomly allocated participants (1:1; block size of six [Malian] or four [US]; ARB produced computer-generated randomisation lists; clinical staff did randomisation) to different single doses of intramuscular immunisation with ChAd3-EBO-Z: Malians received 1 × 1010 viral particle units (pu), 2·5 × 1010 pu, 5 × 1010 pu, or 1 × 1011 pu; US participants received 1 × 1010 pu or 1 × 1011 pu. We randomly allocated Malians in the nested trial (1:1) to receive a single dose of 2 × 108 plaque-forming units of MVA-BN-Filo or saline placebo. In the double-blind segments of the Malian trial, investigators, clinical staff, participants, and immunology laboratory staff were masked, but the study pharmacist (MK), vaccine administrator, and study statistician (ARB) were unmasked. In the US trial, investigators were not masked, but participants were. Analyses were per protocol. The primary outcome was safety, measured with occurrence of adverse events for 7 days after vaccination. Both trials are registered with ClinicalTrials.gov, numbers NCT02231866 (US) and NCT02267109 (Malian).FindingsBetween Oct 8, 2014, and Feb 16, 2015, we randomly allocated 91 participants in Mali (ten [11%] to 1 × 1010 pu, 35 [38%] to 2·5 × 1010 pu, 35 [38%] to 5 × 1010 pu, and 11 [12%] to 1 × 1011 pu) and 20 in the USA (ten [50%] to 1 × 1010 pu and ten [50%] to 1 × 1011 pu), and boosted 52 Malians with MVA-BN-Filo (27 [52%]) or saline (25 [48%]). We identified no safety concerns with either vaccine: seven (8%) of 91 participants in Mali (five [5%] received 5 × 1010 and two [2%] received 1 × 1011 pu) and four (20%) of 20 in the USA (all received 1 × 1011 pu) given ChAd3-EBO-Z had fever lasting for less than 24 h, and 15 (56%) of 27 Malians boosted with MVA-BN-Filo had injection-site pain or tenderness.Interpretation1 × 1011 pu single-dose ChAd3-EBO-Z could suffice for phase 3 efficacy trials of ring-vaccination containment needing short-term, high-level protection to interrupt transmission. MVA-BN-Filo boosting, although a complex regimen, could confer long-lived protection if needed (eg, for health-care workers).FundingWellcome Trust, Medical Research Council UK, Department for International Development UK, National Cancer Institute, Frederick National Laboratory for Cancer Research, Federal Funds from National Institute of Allergy and Infectious Diseases

Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys

PURPOSE: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys. METHODS: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported. RESULTS: Between 29th February 2016 and 24th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma. CONCLUSION: This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets

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

RECOMPOSITION DES TERRITOIRES POLITIQUES ET GOUVERNANCE URBAINE : LE CAS DE LA VILLE DE BAMAKO (MALI)

Is the city of Bamako producing a political change? The present thesis aims at giving an answer to this seemingly common question of political sciences. Based on a survey conducted during the elections of 2007, I intend to approach the theoretical and methodological aspects of a study which attempts to explain the low electoral turnout in Bamako. Considering the territory first as an aggregate of quantitative data (objective territory) and then as a social construction shaped by individuals (subjective territory), I intend to get back to the inputs of a socio-geographical approach, for a clear understanding of the reasons of the low voter turnout. "Politics" appears both as the result of an identification of territorial issues as well as a series of defined themes (e.g. voting at elections; globalization; etc.) showing some distinct aspects of the territory's influence over the politicization of individuals. Throughout the thesis, I shall draw from directive and semi-directive interviews so as to figure out the Bamakois' sense of democracy.La ville de Bamako produit-elle du changement politique ? C'est à cette question, en apparence classique que cette thèse entend répondre. A partir d'une enquête menée dans le contexte des échéances électorales de 2007, nous proposons d'aborder les voies théoriques et méthodologiques d'une étude qui tente d'expliquer la faible participation électorale des bamakois. En prenant successivement en compte le territoire comme agrégat de données quantitatives (territoire objectif) puis comme construction sociale opérée par les individus (territoire subjectif), nous proposons de revenir sur les apports d'une approche " sociogéographique ", permettant de comprendre les raisons de la faible participation électorale des individus. La " politique " apparaît à la fois comme le résultat d'un repérage des problèmes territoriaux et comme une série de thèmes définis (le vote aux élections, la mondialisation, etc) donnant à voir quelques aspects distincts de l'influence du territoire sur la politisation des individus. Il conviendra dans cette thèse de mobiliser des entretiens directifs et semi-directifs afin de connaître le sentiment démocratique des bamakois

Femmes et citoyenneté : des modes de constructions sociales. Journée scientifique Mali-Genre

L'article porte sur la construction du politique avec un éclairage sur le genre au Mali. Dans ce pays d’Afrique subsaharienne, la femme s’impose au cours de ces dix dernières années comme un acteur majeur de la construction du politique. L'article revient sur les enseignements d'une journée scientifique organisée au sein d'ESO et qui interroge les relations étroites, mais pas forcément explicites que les femmes maliennes entretiennent avec le religieux et le pouvoir. C'est finalement un état des lieux des nouvelles formes d’enjeux territoriaux de la démocratie politique et de ses diverses formes de régulation auxquels les rapports genrés participent pleinement