3 research outputs found
Spatio-temporal Change in Land Use and Land Cover: Implications for Conservation of Fina Faunal Reserve in Mali
The natural resources in FINA reserve of Mali are undergoing intense degradation coupled with increased human pressure on the reserve. Vegetation in this reserve is severely threatened. Existing inventories regarding such threats are currently out dated. There is, therefore, a crucial need to assess land use and land cover change in the reserve. The methodological approach in this study has combined LULC change detection with LULC intensity analysis. Using Landsat images, intensity analysis model was utilised in detecting changes in land use and land cover in the reserve, and the changes were evaluated in relation to agricultural activities in the reserve. The results revealed an increase in agricultural land by 2-4% per annum and a decrease in savannah wood land by 2% per year from 1985 to 2013. Bare land and Savannah woodland were found to be gradually replaced by agricultural land. The observed transition of vegetation cover to agricultural land indicates the extent of human pressure on the reserve. Consequently, to preserve these ecosystems, there is the need to initiate and implement measures aimed at limiting cultivation and other human activities in the reserve. These measures should integrate food production and forestry, as well as involve rural community participation through appropriate incentives.Keywords: Land Use and Land Cover Change, Category Level Analysis, Vegetation Dynamics, Fina faunal reserve
Seasonal Malaria Chemoprevention Therapy in Children Up To 9 Years of Age: Protocol for a Cluster-Randomized Trial Study
BackgroundSeasonal malaria chemoprevention (SMC) is recommended by the World Health Organization for the sub-Sahel region in sub-Saharan Africa for preventing malaria in children 3 months old to younger than 5 years. Since 2016, the Malian National Malaria Control Program has deployed SMC countrywide during its high malaria transmission season at a rate of 4 monthly cycles annually. The standard SMC regimen includes sulfadoxine-pyrimethamine (SP) plus amodiaquine (AQ). Resistance against SP is suspected to be rising across West Africa; therefore, assessing the effectiveness of an alternative antimalarial drug for SMC is needed to provide a second-line regimen when it is ultimately needed. It is not well understood whether SMC effectively prevents malaria in children aged 5 years or older.
ObjectiveThe primary goal of the study is to compare 2 SMC regimens (SP-AQ and dihydroartemisinin-piperaquine [DHA-PQ]) in preventing uncomplicated Plasmodium falciparum malaria in children 3 months to 9 years old. Secondly, we will assess the possible use of DHA-PQ as an alternative SMC drug in areas where resistance to SP or AQ may increase following intensive use.
MethodsThe study design is a 3-arm cluster-randomized design comparing the SP-AQ and DHA-PQ arms in 2 age groups (younger than 5 years and 5-9 years) and a control group for children aged 5-9 years. Standard SMC (SP-AQ) for children younger than 5 years was provided to the control arm, while SMC with SP-AQ was delivered to children aged 3 months to 9 years (arm 2), and SMC with DHA-PQ will be implemented in study arm 3 for children up to 9 years of age. The study was performed in Mali’s Koulikoro District, a rural area in southwest Mali with historically high malaria transmission rates. The study’s primary outcome is P falciparum incidence for 2 SMC regimens in children up to 9 years of age. Should DHA-PQ provide an acceptable alternative to SP-AQ, a plausible second-line prevention option would be available in the event of SP resistance or drug supply shortages. A significant byproduct of this effort included bolstering district health information systems for rapid identification of severe malaria cases.
ResultsThe study began on July 1, 2019. Through November 2022, a total of 4556 children 3 months old to younger than 5 years were enrolled. Data collection ended in spring 2023, and the findings are expected to be published later in early 2024.
ConclusionsRoutine evaluation of antimalarial drugs is needed to establish appropriate SMC age targets. The study goals here may impact public health policy and provide alternative therapies in the event of drug shortages or resistance.
Trial RegistrationClinicalTrials.gov NCT04149106, https://clinicaltrials.gov/ct2/show/NCT04149106
International Registered Report Identifier (IRRID)DERR1-10.2196/5166
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Validation of two parent-reported autism spectrum disorders screening tools M-CHAT-R and SCQ in Bamako, Mali.
BackgroundEarly screening is crucial for early autism spectrum disorders (ASD) diagnosis and intervention. ASD screening tools have mostly been constructed based on the Western cultural context. We hypothesized that their use in Mali may require a prior validation.ObjectiveTo validate the modified checklist for autism in toddlers-Revised (M-CHAT-R) and the social communication questionnaire (SCQ) in the Malian sociocultural context for ASD screening.Study designWe administered M-CHAT-R and SCQ in 947 toddlers aged 16-30 months old at the district and community health centers in Bamako and 120 patients (60 autistic and 60 age and sex matched controls) aged ≥4 years old at the psychiatry department in Bamako. Toddlers at moderate to high risk of ASD underwent M-CHAT-R/F and clinical evaluation by an ASD multidisciplinary team. M-CHAT-R and SCQ were evaluated for cultural appropriateness by Malian anthropologists. The sensitivity, specificity, PPV, NPV were determined for both M-CHAT-R and SCQ. Health professionals have been trained during ASD seminary on how to use M-CHAT-R and SCQ for ASD screening in Bamako.ResultsWe found for the M-CHAT-R a sensitivity of 50%, a specificity of 100%, a PPV of 100% and a NPV of 87%. The SCQ had a sensitivity of 71%, a specificity of 72%, a PPV of 73% and a NPV of 70%. We have found four out of 20 items on the M-CHAT-R that were culturally inappropriate in the Malian context.DiscussionM-CHAT-R and SCQ can be used for early autism screening in Mali. In the future, we plan to train a descent number of Malian physicians in chief and pediatricians at the district hospitals across the country to integrate the early ASD screening into the national health system.ConclusionM-CHAT-R has a perfect specificity and SCQ a fair diagnostic accuracy for ASD in Mali