Variations in Elephant (Loxodanta africana) Diet Along a Rainfall Gradient: The Effect of Latitude, Grass Reserves, and Proximity to Water

Global climate change is predicted to bring longer dry seasons and changing rainfall patterns to equatorial Africa, causing range reductions for species such as elephants, whose diets are constrained by water availability. Elephants are facultative grazers whose diets are seasonal, with woody proportion of diet increasing in the dry season. In this study, we sought to identify the factors that predict woody percentage of elephant diet along a rainfall gradient at the Mpala Research Centre in central Kenya. We used elephant dung as a means to analyze the woody content of elephant diet. We found that grass biomass and distance to the nearest river explained the most variability in elephant diet, while latitude was a less influential predictor. Because these local factors were more important determinants of elephant diet differences than rainfall along a gradient, we conclude that climate change will likely affect elephant populations through elongated dry seasons, which may limit availability of nearby water sources

THE TRUE BURDEN OF MEASLES: THE ASSOCIATION BETWEEN MEASLES INCIDENCE AND NON-MEASLES INFECTIOUS MORTALITY IN CHILDREN IN BRAZIL, 1980-1995

Infectious disease is a major driver of global mortality, particularly in children. Despite the impact of vaccination campaigns, measles remains endemic in much of the developing world and recent outbreaks in the developed world ¿ due in part to the misconception that measles is a benign infection ¿ have raised concern of measles resurgence. In addition to being a primary cause of childhood mortality, measles also causes a profound immunosuppression that predisposes infected individuals to secondary infection, making measles an important underlying cause of non-measles infections as well; however, the extent and etiology of the contribution of measles to all non-measles infectious mortality has not been well-characterized. Here, epidemiological data for 1-9 year olds in Brazil is used to show that measles explains more than 60% of the decrease in childhood infectious mortality observed to coincide with the introduction of nationwide measles vaccination. These results suggest a much greater role for measles vaccination as a driver of reduced childhood mortality ¿ particularly respiratory and diarrheal mortality ¿ than had previously been described, and indicate that measles vaccination should continue to be emphasized in global health today

Colorectal cancer survival in sub‐Saharan Africa by age, stage at diagnosis and Human Development Index: A population‐based registry study

International audienceThere are limited population-based survival data for colorectal cancer (CRC) in sub-Saharan Africa. Here, 1707 persons diagnosed with CRC from 2005 to 2015 were randomly selected from 13 population-based cancer registries operating in 11 countries in sub-Saharan Africa. Vital status was ascertained from medical charts or through next of kin. 1-, 3- and 5-year overall and relative survival rates for all registries and for each registry were calculated using the Kaplan-Meier estimator. Multivariable analysis was used to examine the associations of 5-year relative survival with age at diagnosis, stage and country-level Human Development Index (HDI). Observed survival for 1448 patients with CRC across all registries combined was 72.0% (95% CI 69.5-74.4%) at 1 year, 50.4% (95% CI 47.6-53.2%) at 3 years and 43.5% (95% CI 40.6-46.3%) at 5 years. We estimate that relative survival at 5 years in these registry populations is 48.2%. Factors associated with poorer survival included living in a country with lower HDI, late stage at diagnosis and younger or older age at diagnosis (<50 or ≥70 years). For example, the risk of death was 1.6 (95% CI 1.2-2.1) times higher for patients residing in medium-HDI and 2.7 (95% CI 2.2-3.4) times higher for patients residing in low-HDI compared to those residing in high-HDI countries. Survival for CRC remains low in sub-Saharan African countries, though estimates vary considerably by HDI. Strengthening health systems to ensure access to prevention, early diagnosis and appropriate treatment is critical in improving outcomes of CRC in the region