Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

With reports of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) continuing to increase and therapeutic options decrease, infection control methods are of increasing importance. Here we investigate the relationship between surveillance and infection control. Surveillance plays two roles with respect to control: it allows detection of infected/colonized individuals necessary for their removal from the general population, and it allows quantification of control success. We develop a stochastic model of MRSA transmission dynamics exploring the effects of two screening strategies in an epidemic setting: random and on admission. We consider both hospital and community populations and include control and surveillance in a single framework. Random screening was more efficient at hospital surveillance and allowed nosocomial control, which also prevented epidemic behaviour in the community. Therefore, random screening was the more effective control strategy for both the hospital and community populations in this setting. Surveillance strategies have significant impact on both ascertainment of infection prevalence and its control

‘Wives of the Gods’: debating Fiasidi and the politics of meaning

In the south-eastern Volta Region of Ghana, a form of female religious affiliation to local shrines commonly known as trokosi, has been the subject of a campaign consisting of Christian-based NGOs and various government agencies that has successfully criminalised the practice and organised ‘liberations’ and rehabilitations of the initiates. Protagonists of the abolition campaign argue that trokosiwo are illegitimately initiated to specific shrines based on an offence committed by another lineage member, acting as a perpetual figure of restitution. They also argue that the practice constitutes a form of ‘female ritual slavery’ by translating the term trokosi as “slave of the gods” and arguing that the socio-economic status and social relations of the trokosiwo indicate their ‘slavery’. The highly publicised abolition campaign stimulated a counter-campaign, led by a neo-traditional organisation, that argued that the female shrine initiates are Queen-Mothers (rather than slaves), role-models to their lineage (rather than figures of restitution), and are socially privileged. Central to these contestations has been the figure of the fiasidi, particularly those initiated to shrines in one locality, Klikor. Abolitionists define fiasidiwo as being a variant of trokosi, despite some key differences. Those that contest this representation justified their position by highlighting the socio-economic position of fiasidiwo in Klikor's three shrines and pointing out the critical ways it differed from the representation of the Trokosi Slave. Members of the Klikor shrines also became political actors in the debates that ensued, by developing a close alliance to the neo-traditionalist organisation and creating their own organisation to network with similar shrines. This thesis considers the debates around trokosi and fiasidi at the national level and explores in detail the meaning attached to fiasidi and her position in the Klikor shrines and community. At its core, is an ethnography of the three shrines, their ritual specialists and initiates. I explore the way in which meaning is ascribed to the fiasidi, through narratives of the past, through the symbolism of key rituals and through the structured interactions between petitioners and ritual specialists. A concluding section then considers the intersection between these meanings and the contested terrains of religion in the debates about the Trokosi Slaves

Blessing the Rains: Fieldwork Meditations on ‘Africa’ by Toto

As an anthropologist who works in West Africa, I have ambivalent feelings towards the 1982 song ‘Africa’ by Toto. It is a song that lyrically does not make sense, although powerfully draws its audience into a romanticized mental imagery of the continent with “drums echoing,” “wild dogs crying,” and “old men” with “long forgotten words or ancient melodies.” Despite my annoyance at and critique of the lyrics and music video, I often found myself humming the lyrics “I bless the rains down in Africa” during my fifteen months fieldwork in the small town in south-eastern Ghana. This paper explores how the song came to signify for me a plea for disconnection from the relations I had worked to develop and a celebration when that disconnection was momentarily achieved during the downpours in the rainy seasons