Effets des demi-lunes associées au scarifiage sur les productions fourragères en région sahélienne du Burkina Faso

L’effet des demi-lunes associées au scarifiage sur la production fourragère a été étudié dans quatre terroirs sahéliens. Des parcelles d’observation de un ha sur terrain aménagé en demi-lune et un ha sur un témoin respectif ont été mises en place. Les observations ont concerné l’analyse de la composition floristique, la valeur fourragère et le recouvrement. Les résultats obtenus montrent une amélioration de la composition floristique et le recouvrement de la végétation. Les espèces fourragères telles Panicum laetum (+9,8%), Cassia obtusifolia (+17,1%) et Alysicarpus ovalifolius (+2,7%) ont connu une amélioration tandis que Schoenefeldiagracilis (-30%) et Eragrostis tenella (-1,1%) ont subit une régression. La production de fourrage a augmenté significativement (P < 0,05) entre les parcelles aménagées (2115,9 kg de MS.ha-1) et les témoins (463 kg deMS.ha-1). Cependant, l’apparition de Cassia obtusifolia en très forte contribution spécifique suggère que des essais d’alimentation soient menés sur cette espèce pour mieux valoriser l’impact des aménagements en demilune surtout qu’elle est bien appétée à l’état sec. Les demi-lunes + scarification sont rentables mais des recherches doivent cependant être menées pour trouver les modalités de gestion des espaces aménagés, afin d’éviter leur surexploitation et leur dégradation.Mots clés : Pâturage, fourrage, dégradation, Sahel, Burkina Faso

Expressions of psychological distress in Sierra Leone: Implications for community-based prevention and response

Alastair Ager - ORCID 0000-0002-9474-3563 https://orcid.org/0000-0002-9474-3563Replaced AM with VoR 2020-08-07Background Over recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced needs of the population and utilising relevant community-based resources to address them. This study took a grounded approach to identify the ways in which adults in Sierra Leone express psychological distress.Methods Rapid ethnographic methods deployed included 75 case study interviews with community members, 12 key informant pile sorts and 55 key informant interviews. Thematic analysis of data was supported by frequency analysis and multi-dimensional scaling.Results Thirty signs of distress were identified. The only consistent ‘syndrome’ identified with respect to these was a general concept of crase, which referred to psychosis-related presentation but also a wide range of other signs of distress. We did not find consensus on locally defined concepts for mild-moderate forms of mental disorder: people use multiple overlapping signs and terms indicating psychological distress.Conclusions Analysis supports calls to view mental health problems as a ‘continuum of distress’ rather than as discrete categories. This framing is coherent with opportunities for prevention and response in Sierra Leone which do not focus primarily on formal health care service providers but rather involve a range of community-based actors. It also enables attention to be paid to the identification of milder signs of distress with a view to early response and prevention of more severe mental health problems.This research was funded by NIHR Global Health Research Programme 16/136/100, Queen Margaret University.https://doi.org/10.1017/gmh.2020.127pubpu

'Once there is life, there is hope' Ebola survivors' experiences, behaviours and attitudes in Sierra Leone, 2015.

BACKGROUND: In Sierra Leone, over 4000 individuals survived Ebola since the outbreak began in 2014. Because Ebola survivorship was largely unprecedented prior to this outbreak, little is known about survivor experiences during and post illness. METHODS: To assess survivors' experiences and attitudes related to Ebola, 28 in-depth interviews and short quantitative surveys with survivors from all four geographic regions of Sierra Leone were conducted in May 2015. RESULTS: Survivor experiences, emotions and attitudes changed over time as they moved from disease onset to treatment, discharge and life post-discharge. Survivors mentioned experiencing acute fear and depression when they fell ill. Only half reported positive experiences in holding centres but nearly all were positive about their treatment centre experiences. Survivor euphoria on discharge was followed by concerns about their financial situation and future. While all reported supportive attitudes from family members, about a third described discrimination and stigma from their communities. Over a third became unemployed, especially those previously engaged in petty trade. Survivor knowledge about sexual transmission risk reflected counselling messages. Many expressed altruistic motivations for abstinence or condom use. In addition, survivors were strongly motivated to help end Ebola and to improve the healthcare system. Key recommendations from survivors included improved counselling in holding centres and long-term government support for survivors, including opportunities for participation in Ebola response efforts. CONCLUSIONS: Survivors face myriad economic, social and health challenges. Addressing survivor concerns, including the discrimination they face, could facilitate their reintegration into communities and their contributions to future Ebola responses

Deletion of Neurturin Impairs Development of Cholinergic Nerves and Heart Rate Control in Postnatal Mouse Hearts

The neurotrophic factor neurturin is required for normal cholinergic innervation of adult mouse heart and bradycardic responses to vagal stimulation. Our goals were to determine effects of neurturin deletion on development of cardiac chronotropic and dromotropic functions, vagal baroreflex response, and cholinergic nerve density in nodal regions of postnatal mice. Experiments were performed on postnatal C57BL/6 wild-type (WT) and neurturin knockout (KO) mice. Serial electrocardiograms were recorded noninvasively from conscious pups using an ECGenie apparatus. Mice were treated with atenolol to evaluate and block sympathetic effects on heart rate (HR) and phenylephrine (PE) to stimulate the baroreflex. Immunohistochemistry was used to label cholinergic nerves in paraffin sections. WT and KO mice showed similar age-dependent increases in HR and decreases in PR interval between postnatal days (P) 2.5 and 21. Treatment with atenolol reduced HR significantly in WT and KO pups at P7.5. PE caused a reflex bradycardia that was significantly smaller in KO pups. Cholinergic nerve density was significantly less in nodal regions of P7.5 KO mice. We conclude that cholinergic nerves have minimal influence on developmental changes in HR and PR, QRS, and QTc intervals in mouse pups. However, cholinergic nerves mediate reflex bradycardia by 1 week postnatally. Deletion of neurturin impairs cholinergic innervation of the heart and the vagal efferent component of the baroreflex early during postnatal development

Establishing an antimicrobial stewardship program in Sierra Leone: a report of the experience of a low-income country in West Africa

Antimicrobial Resistance (AMR) is a growing global health challenge that threatens to undo gains in human and animal health. Prevention and control of AMR requires functional antimicrobial stewardship (AMS) program, which is complex and often difficult to implement in low- and middle-income countries. We aimed to describe the processes of establishing and implementing an AMS program at Connaught Hospital in Sierra Leone. The project involved the setting up of an AMS program, capacity building and performing a global point prevalence survey (GPPS) at Sierra Leone's national referral hospital. Connaught Hospital established a multidisciplinary AMS subcommittee in 2021 to provide AMS services such as awareness campaigns, education and training and review of guidelines. We performed a GPPS on 175 patients, of whom more than half (98, 56.0%) were prescribed an antibiotic: 63 (69.2%) in the surgical wards and 53 (51.2%) in the medical wards. Ceftriaxone (60, 34.3%) and metronidazole (53, 30.3%) were the most common antibiotics prescribed to patients. In conclusion, it is feasible to establish and implement an AMS program in low-income countries, where most hospitalized patients were prescribed an antibiotic

Contraception determinants in youths of Sierra Leone are largely behavioral

Background: Sexual initiation occurs early in Sierra Leone. This study aims to analyze the determinants of condom and/or contraceptive use among a representative sample of young persons (10 to 24 years) in Sierra Leone. Methods: This is a secondary analysis of data from a study conducted to monitor the implementation of a UNFPA package of interventions directed to improve SRH in young people of Sierra Leone. This assessment was conducted in 2016 at the end of the Ebola outbreak. In consequence, determinants linked to healthy lifestyle behaviors and UNFPA interventions were explored in addition to the usual determinants: socio demographic and sexual lifestyle. This study is a household quantitative survey with open ended questions used to illustrate and complete the analysis. Results: A total of 1409 young people were interviewed: of these, 216 boys and 381 girls were sexually active. Those who were pregnant or wished for pregnancy were excluded, leaving 194 boys and 268 girls for the analysis of determinants. The proportion of young people using neither condom nor other contraception at their last sexual intercourse in the whole sample was 40.5% and there was no statistically significant difference between boys and girls (42.3 vs 39.2; P = 0.504). Determinants were assessed and, after multivariable analysis, results differed between boys and girls and showed the importance of behavioral aspects. Four determinants were common to boys and girls: literacy, distance, negotiation capacity and hand washing. However, the distance factor for girls was to the health facility and for boys it was to school. Three more determinants remained in the boy's model: sleeping under a bednet, number of sexual partners and knowledge of contraceptive methods. Opinions about condoms and contraception revealed important barriers; opposition to contraceptive use was the main reason for non-use for both boys and girls, while lack of access was an important reason for boys. Conclusion: There is a need to reach out to the 40% of young people who are sexually active and neither pregnant nor with pregnancy desire, and are not using condom or contraception

Burkina Faso

Burkina Faso is a landlocked country in West Africa covering about 274,000 square kilometers. It is bordered by the Republic of Mali on the north and west; by Cote d’Ivoire on the Southwest; by Ghana, Togo, and Benin on the South; and by Niger on the east. The country has a dry tropical climate with two contrasting seasons. The rainy season generally lasts from May to October, but its duration decreases progressively from the southwest, amounting to only three months in the northern part of the country. Agriculture accounts for 40 percent of the gross domestic product (GDP) and 60 percent of the total exports of Burkina Faso. Its cropped area is 3.5– 4.0 million hectares, representing about 13 percent of the country’s total area and one-third of the arable land. Rainfed agriculture dominates, with largely rudimentary agricultural techniques prevailing among small-scale farmers. Crop production is more diversified in the Sudanian zone (in the southwest), with a variety of roots and tubers (yams, sweet potatoes, and cocoyams), fruits (mangoes, bananas, and citrus fruits), cashews, and sugarcane. The major cash crops are cotton, groundnuts, cowpeas, and sesame..

Unmet needs and behaviour during the Ebola response in Sierra Leone: a retrospective, mixed-methods analysis of community feedback from the Social Mobilization Action Consortium

Background: The west African Ebola epidemic (2014–15) necessitated behaviour change in settings with prevalent and pre-existing unmet needs as well as extensive mechanisms for local community action. We aimed to assess spatial and temporal trends in community-reported needs and associations with behaviour change, community engagement, and the overall outbreak situation in Sierra Leone. Methods: We did a retrospective, mixed-methods study. Post-hoc analyses of data from 12 096 mobiliser visits as part of the Social Mobilization Action Consortium were used to describe the evolution of satisfied and unsatisfied needs (basic, security, autonomy, respect, and social support) between Nov 12, 2014, and Dec 18, 2015, and across 14 districts. Via Bayesian hierarchical regression modelling, we investigated associations between needs categories and behaviours (numbers of individuals referred to treatment within 24 h of symptom onset or deaths responded to with safe and dignified burials) and the role of community engagement programme status (initial vs follow-up visit) in the association between satisfied versus unsatisfied needs and behaviours. Findings: In general, significant associations were observed between unsatisfied needs categories and both prompt referrals to treatment and safe burials. Most notably, communities expressing unsatisfied capacity needs reported fewer safe burials (relative risk [RR] 0·86, 95% credible interval [CrI] 0·82–0·91) and fewer prompt referrals to treatment (RR 0·76, 0·70–0·83) than did those without unsatisfied capacity needs. The exception was expression of unsatisfied basic needs, which was associated with significantly fewer prompt referrals only (RR 0·86, 95% CrI 0·79–0·93). Compared with triggering visits by community mobilisers, follow-up visits were associated with higher numbers of prompt referrals (RR 1·40, 95% CrI 1·30–1·50) and safe burials (RR 1·08, 1·02–1·14). Interpretation: Community-based development of locally feasible, locally owned action plans, with the support of community mobilisers, has potential to address unmet needs for more sustained behaviour change in outbreak settings

Advanced magnetic resonance imaging and neuropsychological assessment for detecting brain injury in a prospective cohort of university amateur boxers

$\textbf{Background/aim:}$ The safety of amateur and professional boxing is a contentious issue. We hypothesised that advanced magnetic resonance imaging and neuropsychological testing could provide evidence of acute and early brain injury in amateur boxers. $\textbf{Methods:}$ We recruited 30 participants from a university amateur boxing club in a prospective cohort study. Magnetic resonance imaging (MRI) and neuropsychological testing was performed at three time points: prior to starting training; within 48 hours following a first major competition to detect acute brain injury; and one year follow-up. A single MRI acquisition was made from control participants. Imaging analysis included cortical thickness measurements with Advanced Normalization Tools (ANTS) and FreeSurfer, voxel based morphometry (VBM), and Tract Based Spatial Statistics (TBSS). A computerized battery of neuropsychological tests was performed assessing attention, learning, memory and impulsivity. $\textbf{Results:}$ During the study period, one boxer developed seizures controlled with medication while another developed a chronic subdural hematoma requiring neurosurgical drainage. A total of 10 boxers contributed data at to the longitudinal assessment protocol. Reasons for withdrawal were: logistics (10), stopping boxing (7), withdrawal of consent (2), and development of a chronic subdural hematoma (1). No significant changes were detected using VBM, TBSS, cortical thickness measured with FreeSurfer or ANTS, either cross-sectionally at baseline, or longitudinally. Neuropsychological assessment of boxers found attention/concentration improved over time while planning and problem solving ability latency decreased after a bout but recovered after one year. $\textbf{Conclusion:}$ While this neuroimaging and neuropsychological assessment protocol could not detect any evidence of brain injury, one boxer developed seizures and another developed a chronic sub-dural haematoma.PJH is supported by a NIHR Research Professorship. VFJN is supported by a Health Foundation / Academy of Medical Sciences Clinician Scientist Fellowship. BJS holds a grant from the NIHR Brain Injury Healthcare Technology Co-operative. This study was supported through the Cambridge National Institute for Health Research (NIHR) Biomedical Research Centre (BRC). Control data were acquired with the support of the Medical Research Council as part of their Addiction Initiative (grant number G1000018), and a Pathfinder award from Medical Research Council (G0401099)

Niger

Niger is a landlocked country in West Africa located between 11°37´ and 23°23´ north latitude and between 00°10´ and 16°00´ east longitude, with an area of 1,267,000 square kilometers. Niger shares borders with Algeria and Libya in the north, Chad in the east, Nigeria and Benin in the south, and Burkina Faso and Mali in the west. Three-fourths of Niger is covered by the Sahara Desert. The southern part of the country is in the Sahelian climate zone, with Sudan savannah vegetation. The rainy season lasts for only three months, with total rainfall ranging from 150 to 600 millimeters per year in the Sudan savannah; maximum temperatures are high (45°C in the shade in April–May). The vegetation cover is sparse, and nomadic agriculture is dominant..