“Shaping the family”: Individual’s capabilities to exercise reproductive rights seen through a qualitative survey

We analyze here the outcome of focus group discussions and individual interviews conducted in Mali and Ghana. The aim is to identify collective images about family norms and emergence of alternative values, and to examine people’s degree of ambivalence towards norms and their ability to conceive and realize their own family plans. Discourses show that family life plans should not be seen as pre-established. Ability to shape the family appears conjectural both as regards current resources and the position in the family trajectory. In both countries, two types of resources play a key role: schooling and influence/support from the family and network. Results highlight that the least individual freedom is to be found at the start of family life and in gender power relationships; some freedom appears in the timing of fertility; while more room for individual agency characterizes youth and individuals with more personal resources and supportive surroundings

Enhanced Access to Climate-Smart Agriculture and Climate Information Services by Farmers in Mali

Mali is a rice basket in West Africa, providing a substantial amount of the region's rice supply, but is also highly vulnerable to climate variability and change. AICCRA-Mali aims to strengthen the technical, institutional, and human capacity required to accelerate the wide-scale adoption of climate-smart agriculture and climate information services packages by hundreds of thousands of men and women farmers in Mali. The project focuses on rice and associated speculations (legume, vegetable, tuber, fish, and tree) value chains and pursues to enhance resilience to drought and flooding in rainfed systems and cold and water scarcity in irrigated systems. In 2022, 111,064 farmers including 49% women were supported in the use of CSA and CIS interventions by AfricaRice and the national partners (Syngenta Foundation, Niger office, Mali-Meteo and IER). The focused CSA and CIS interventions were RiceAdvice, drought-tolerant rice varieties, alternate wetting and drying, mechanization services, solar-powered irrigation, GEM parboiling, direct seeding, and information about weather forecasts. The mechanisms used included service provision business models, technologies demonstration followed by farmers' exchange days, save-for-change financing mechanism, Pay-As-You-Go business model, multi-stakeholders’ platforms, and Local Groups for Meteorological Assistance. Application of RiceAdvice recommendations improved rice yield by 0.9 t/ha and farmers’ income by 320 USD/ha. The yield increase was higher in women’s fields (+1.0 t/ha) compared to men’s fields (+0.8 t/ha), which was attributed to the fact that women have culturally access to soils with lower fertility than men’s in Mali, and consequently, the soil responses to applied fertilizers were better in women’s than in men’s fields. When the benefits of the use of RiceAdvice were aggregated over the total area cultivated by the 53,045 farmers, the rice production increase was estimated to be 42966 tones and the farmers’ income increase was estimated to be 15.3 million USD. Farmers who used the solar-powered irrigation pumps increased their income by USD 5,262 per hectare, and improved their food consumption score by 3.1. The food consumption score is the frequency of consumption of different food groups consumed by a household during the 7 days before the survey. The use of solar-powered irrigation technologies enabled farmers to produce cash crops such as onion, tomato, cabbage, and potato during the dry season when fields had previously been abandoned due to water scarcity. Thanks to these additional crops, the increase in their incomes mean they are investing more in quality seeds, and fertilizers

AICCRA Scaling Vision: Mali

AICCRA-Mali scaling vision is to ensure that by 2030, 1,000,000 farmers, including 35% women use the CSA and CIS interventions developed, validated, or scaled by the project to enhance the security of income, employment and food including nutrition in the face of climate change. The short-term objective is to enhance the yield income, food, and nutrition security of 250,000 farmers including 35% women in the face of climate variability and climate change by December 2023 by adopting innovative partnerships and inclusive business models to ensure sustainability

Clinical Variation of Plasmodium falciparum eba-175

The association between P. falciparum eba-175, ama-1, and msp-3 polymorphism in the pathogenicity of malaria disease was investigated. We therefore compared the prevalence of different alleles between symptomatic and asymptomatic malarial children under five years of age living in Burkina Faso. Blood filter papers were collected during the 2008 malaria transmission season from 228 symptomatic and 199 asymptomatic children under five years of age. All patients were living in the rural area of Saponé at about 50 km from Ouagadougou, the capital city of Burkina Faso. P. falciparum parasite DNA was extracted using QIAGEN kits and the alleles diversity was assessed by a nested PCR. PCR products were then digested by restriction enzymes based on already described polymorphic regions of the eba-175, ama-1, and msp-3 genes. The individual alleles eba-175_FCR3 and msp-3_K1 frequencies were statistically higher (p<0.0001) in the asymptomatic group compared to the symptomatic ones. No statistically significant difference was noted in the prevalence of ama-1-3D7, ama-1-K1, and ama-1-HB3 genotypes between the two groups (p>0.05). The comparative analysis of P. falciparum genotypes indicated that the polymorphism in eba-175 and msp-3 genotypes varied between asymptomatic and symptomatic clinical groups and may contribute to the pathogenesis of malaria

Protocol for a parallel group, two-arm, superiority cluster randomised trial to evaluate a community-level complementary-food safety and hygiene and nutrition intervention in Mali:the MaaCiwara study (version 1.3; 10 November 2022)

BACKGROUND: Diarrhoeal disease remains a significant cause of morbidity and mortality among the under-fives in many low- and middle-income countries. Changes to food safety practices and feeding methods around the weaning period, alongside improved nutrition, may significantly reduce the risk of disease and improve development for infants. We describe a protocol for a cluster randomised trial to evaluate the effectiveness of a multi-faceted community-based educational intervention that aims to improve food safety and hygiene behaviours and enhance child nutrition. METHODS: We describe a mixed-methods, parallel group, two-arm, superiority cluster randomised controlled trial with baseline measures. One hundred twenty clusters comprising small urban and rural communities will be recruited in equal numbers and randomly allocated in a 1:1 ratio to either treatment or control arms. The community intervention will be focussed around an ideal mother concept involving all community members during campaign days with dramatic arts and pledging, and follow-up home visits. Participants will be mother–child dyads (27 per cluster period) with children aged 6 to 36 months. Data collection will comprise a day of observation and interviews with each participating mother–child pair and will take place at baseline and 4 and 15 months post-intervention. The primary analysis will estimate the effectiveness of the intervention on changes to complementary-food safety and preparation behaviours, food and water contamination, and diarrhoea. Secondary outcomes include maternal autonomy, enteric infection, nutrition, child anthropometry, and development scores. A additional structural equation analysis will be conducted to examine the causal relationships between the different outcomes. Qualitative and health economic analyses including process evaluation will be done. CONCLUSIONS: The trial will provide evidence on the effectiveness of community-based behavioural change interventions designed to reduce the burden of diarrhoeal disease in the under-fives and how effectiveness varies across different contexts. TRIAL REGISTRATION: ISRCTN14390796. Registration date December 13, 2021 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-022-06984-5

Prevalence of P. falciparum Gametocyte Carrying between Two Sympatric Ethnic Groups Living in Seasonal Malaria Transmission Setting of Burkina Faso after Universal Bed Nets Coverage Campaigns

Aims: This study aimed to compare the prevalence of P. falciparum gametocyte carriage in two sympatric ethnic groups living in seasonal malaria transmission setting in Burkina Faso. Study Design: A cross-sectional survey was conducted from September to November 2017 in children aged from 2 to 12 years and living in Barkoundouba, avillage located at the Northeast part of Ouagadougou, capital city of Burkina Faso. The study participants were subject to clinical examination including axillary temperature. Blood samples were collected from finger pricks to performed RDT and blood smears for malaria diagnosis and on filter paper for molecular detection of the parasite. Any case of fever (temperature ≥ 37.5°C) with RDT positive was treated according to national guideline. Methodology: We included 461 patients in this study. P. falciparum presence and densities were determined by microscopy using Giemsa-stained thick blood smears. The nested PCR was used to confirm the presence of the asexual parasites assessed by the microscopy. Results: P. falciparum prevalence assessed by microscopy was 83 (32.55%) and 103 (50%) for Fulani and Mossi respectively, whereas the prevalence by nested PCR was 88 (39.11%) for Fulani and 121 (68.75%) for Mossi. The gametocyte carriage in the two ethnic groups was: 3.53% for Fulani and 11.65% for Mossi. The prevalence ratio for P. falciparum asymptomatic and gametocyte carriers was 1.5 and 3 in favor of Mossi group respectively. Conclusion: This study showed that the Fulani have a lower prevalence of P. falciparum compared to the Mossi group despite the decrease of parasitemia and prevalence in both groups compared to previous studies

Eliminating lead exposure from drinking water—A global call to action

Each year, approximately 900,000 people die from exposure to lead [1]. But the full impacts of lead exposure are far more insidious. Lead is a potent neurotoxin that impairs brain function and irreversibly harms children’s cognitive development. Any exposure to lead can be damaging. Recent studies estimate that 800 million children globally (approximately 1 in 3) have blood lead concentrations above 5 micrograms per deciliter and that lead exposure may be responsible for 30% of all intellectual disabilities of unknown origin [2, 3]. Lead exposure increases disease burden, estimated at over 21 million disability-adjusted life years (DALYs) yearly, primarily due to cardiovascular diseases and mental disorders. This disease burden attributed to lead has increased globally since 1990, because of population growth and aging [4]. Additional research has shown evidence of a direct dose-response relationship between children’s blood lead levels and reductions in IQ which decreases lifetime earnings [5, 6]. This makes lead a public health threat and a key environmental risk factor that exacerbates long-term inequalities affecting especially marginalized groups. Important sources of exposure include batteries, paint, food containers, drinking water systems, and leaded gasoline (now banned in all countries)

Subclinical Cardiac Dysfunction Is Associated With Extracardiac Organ Damages

Background: Several studies conducted in America or Europe have described major cardiac remodeling and diastolic dysfunction in patients with sickle cell disease (SCD). We aimed at assessing cardiac involvement in SCD in sub-Saharan Africa where SCD is the most prevalent.Methods: In Cameroon, Mali and Senegal, SCD patients and healthy controls of the CADRE study underwent transthoracic echocardiography if aged ≥10 years. The comparison of clinical and echocardiographic features between patients and controls, and the associations between echocardiographic features and the vascular complications of SCD were assessed.Results: 612 SCD patients (483 SS or Sβ0, 99 SC, and 19 Sβ+) and 149 controls were included. The prevalence of dyspnea and congestive heart failure was low and did not differ significantly between patients and controls. While left ventricular ejection fraction did not differ between controls and patients, left and right cardiac chambers were homogeneously more dilated and hypertrophic in patients compared to controls and systemic vascular resistances were lower (p &lt; 0.001 for all comparisons). Three hundred and forty nine SCD patients had extra-cardiac organ damages (stroke, leg ulcer, priapism, microalbuminuria or osteonecrosis). Increased left ventricular mass index, cardiac dilatation, cardiac output, and decreased systemic vascular resistances were associated with a history of at least one SCD-related organ damage after adjustment for confounders.Conclusions: Cardiac dilatation, cardiac output, left ventricular hypertrophy, and systemic vascular resistance are associated with extracardiac SCD complications in patients from sub-Saharan Africa despite a low prevalence of clinical heart failure. The prognostic value of cardiac subclinical involvement in SCD patients deserves further studies

Resurgence of Ebola Virus Disease in Guinea Linked to a Survivor With Virus Persistence in Seminal Fluid for More Than 500 Days.

We report on an Ebola virus disease (EVD) survivor who showed Ebola virus in seminal fluid 531 days after onset of disease. The persisting virus was sexually transmitted in February 2016, about 470 days after onset of symptoms, and caused a new cluster of EVD in Guinea and Liberia