A bronchogenic cyst, presenting as a retroperitoneal cystic mass

Bronchogenic cysts are mostly benign, congenital abnormalities originating from the remnants of the primitive foregut. A retroperitoneal location is rare. Due to the mostly asymptomatic behavior and the historical confusion regarding histology, an exact prevalence is not known. We present here a case report of a retroperitoneal bronchogenic cyst. A literature review was performed for cases of retroperitoneal bronchogenic cysts written in English. Anatomopathological criteria for inclusion were pseudo stratified, ciliated, columnar epithelium together with the presence of at least one of the following: cartilage, smooth muscle or seromucous glands. In addition, the embryology, pathogenesis, radiological, clinical and suggested treatment modalities are reviewed. We report the surgical excision of a retroperitoneal bronchogenic cyst that presented as a non-functioning left adrenal mass. Our review of literature revealed only 62 potential cases of retroperitoneal bronchogenic cysts. After applying the strict anatomopathological criteria, only 30 cases of true retroperitoneal bronchogenic cysts could be identified. Retroperitoneal location of a bronchogenic cyst is rare. Despite the rarity of this pathologic entity, bronchogenic cysts should be considered in the differential diagnosis of retroperitoneal cystic lesions. Only histology can confirm definitive diagnosis. Surgery remains the recommended treatment of choice

Febrile illness diagnostics and the malaria-industrial complex: a socio-environmental perspective

Abstract Background Global prioritization of single-disease eradication programs over improvements to basic diagnostic capacity in the Global South have left the world unprepared for epidemics of chikungunya, Ebola, Zika, and whatever lies on the horizon. The medical establishment is slowly realizing that in many parts of sub-Saharan Africa (SSA), particularly urban areas, up to a third of patients suffering from acute fever do not receive a correct diagnosis of their infection. Main body Malaria is the most common diagnosis for febrile patients in low-resource health care settings, and malaria misdiagnosis has soared due to the institutionalization of malaria as the primary febrile illness of SSA by international development organizations and national malaria control programs. This has inadvertently created a “malaria-industrial complex” and historically obstructed our complete understanding of the continent’s complex communicable disease epidemiology, which is currently dominated by a mélange of undiagnosed febrile illnesses. We synthesize interdisciplinary literature from Ghana to highlight the complexity of communicable disease care in SSA from biomedical, social, and environmental perspectives, and suggest a way forward. Conclusion A socio-environmental approach to acute febrile illness etiology, diagnostics, and management would lead to substantial health gains in Africa, including more efficient malaria control. Such an approach would also improve global preparedness for future epidemics of emerging pathogens such as chikungunya, Ebola, and Zika, all of which originated in SSA with limited baseline understanding of their epidemiology despite clinical recognition of these viruses for many decades. Impending ACT resistance, new vaccine delays, and climate change all beckon our attention to proper diagnosis of fevers in order to maximize limited health care resources

Climate change and agricultural technology adoption: the case of drought tolerant maize in rural Nigeria

Climate change is a major problem undermining agricultural production in Africa. Consequently, efforts are being made to provide farmers with adaptation technologies, but little empirical research exists on the determinants of adopting such technologies. This article addresses this research gap, using the case of drought tolerant maize (DTM) technology in Nigeria. With survey data from 200 farm households and econometric techniques, we explore the determinants of whether to invest and how much to invest in adaptation technology by smallholder farmers. Results from the study indicate that among the key determinants of adoption are access to the technology, complementary inputs, extension services, and climate change information. We also show that off-farm income and wealth status of a household play a significant role in adoption, implying capital constraints; hence, it can be difficult for resource-poor farmers to adopt the technology. Moreover, the farmers identified cost of the technology and complementary inputs, particularly fertilizer as major constraints to adoption. We conclude that while the DTM technology is suitable and important in helping smallholder maize farmers to continue to produce under a changing climate, more support is needed for them to invest in the technology and overcome adoption constraints. Necessary interventions include improving access to information about climate change and the available adaptation technology, timely access to the technology and complementary inputs, and improving access to credit, particularly for the resource-poor farm households

Smallholder farmers perceptions of and adaptations to climate change in the Nigerian savanna

The savanna region of Africa is a potential breadbasket of the continent but is severely affected by climate change. Understanding farmers perceptions of climate change and the types of adjustments they have made in their farming practices in response to these changes will offer some insights into necessary interventions to ensure a successful adaptation in the region. This paper explores how smallholder farmers in the Nigerian savanna perceive and adapt to climate change. It is based on a field survey carried out among 200 smallholder farm households selected from two agro-ecological zones. The results show that most of the farmers have noticed changes in climate and have consequently adjusted their farming practices to adapt. There are no large differences in the adaptation practices across the region, but farmers in Sudan savanna agro-ecological zone are more likely to adapt to changes in temperature than those in northern Guinea savanna. The main adaptation methods include varying planting dates, use of drought tolerant and early maturing varieties and tree planting. Some of the farmers are facing limitations in adapting because of lack of information on climate change and the suitable adaptation measures and lack of credit. The study then concludes that to ensure successful adaptation to climate change in the region, concerted efforts are needed to design and promote planned adaptation measures that fit into the local context and also to educate farmers on climate change and appropriate adaptation measures