Population-Level Determinants of Cholera Incidence in African countries

Cholera remains endemic in Africa, with limited access to safe drinking water and inadequate sanitation as 2 of the main drivers of its dissemination. Few studies have examined the impact of health system capacity, even though it plays an important role in prevention, early detection, and response to a cholera outbreak. Grounded in the ecosocial theory of infectious disease dissemination, this quantitative ecological study explored the effect of social vulnerability (as measured by access to safe drinking water and sanitation, rate of open defecation, poverty, income inequality, gender inequality, and adult literacy) and health system (as measured by health financing and density of human resources for health) capacity on incidence of cholera in the 47 countries of the African region of the World Health Organization. Logistic regression results showed that only access to improved sanitation [p \u3c .05; OR = .904; 95% CI: .823 – .992; N= 47], rate of open defecation [p \u3c .05; OR = .894; 95% CI: .822 – .973; N= 47], and health system capacity [p \u3c .05; OR = .792; 95% CI: .630 – .995; N=47] had a statistically significant association with incidence of cholera. The components of social vulnerability [p \u3c .05; OR = 1.080; 95% CI: 1.004 – 1.162; N=47] and the interaction between social vulnerability and health system capacity [p \u3c .05; OR = 1.004; 95% CI: 1.002 – 1.009; N= 47] were also significantly associated with the outcome. These findings can impact social change by guiding the development of effective multisectoral programs for cholera prevention and elimination

Effet de l'amendement organique sur les caractéristiques physicochimiques des rejets et le développement racinaire des espèces d'arbres, quinze ans après la plantation.

peer reviewedAmong mine wastes, tailings are known to have the largest environmental impact, as they have high concentrations of trace elements and are susceptible to wind dispersal and water erosion. A tree plantation trial was installed at Kipushi tailing (DR Congo) in order to mitigate the contaminant dispersal in the surrounding areas. Fifteen years later, the present study was conducted for the purpose of investigating the macronutrient and metal content in amended holes and assessing the performance of tree species through root behavior in the tailings dams. Results show elevated available P, K, Ca, and Mg concentration in the surface and amended layers, which is higher than the unpolluted soil of the miombo woodland. Trace metals were manifold higher compared to the pedo-geochemical background of the region, with Cu and Co concentration tending to increase in the organic matter-rich layers, while Zn, Cd, Pb, and As remained higher in tailings. Compared to the tailing layer, roots grew well in the amended layers, but few roots ranging from very fine to big from all the surviving species were able to grow beyond the amended layers, indicating the possibility of tree survival on the tailings dams over many years. Acacia polyacantha and Psidium guajava are species that showed a higher quantity of roots in the unamended tailing layers. Leaves should be avoided for human or animal consumption, but as the concentration of Cu, Zn, and Co in guava was lower, there is no indication of hazards in case of their consumption. Therefore, the use of well-adapted tree species on the mix-up of the organic amendments with the uncontaminated topsoil seemed to be a good technique for the reclamation of larger polluted areas.11. Sustainable cities and communitie

Coordination mechanisms for COVID-19 in the WHO Regional office for Africa

Aim: this study describes the coordination mechanisms that have been used for management of the COVID-19 pandemic in the WHO AFRO region; relate the patterns of the disease (length of time between onset of coordination and first case; length of the wave of the disease and peak attack rate) to coordination mechanisms established at the national level, and document best practices and lessons learned. Method: We did a retrospective policy tracing of the COVID-19 coordination mechanisms from March 2020 (when first cases of COVID-19 in the AFRO region were reported) to the end of the third wave in September 2021. Data sources were from document and Literature review of COVID-19 response strategies, plans, regulations, press releases, government websites, grey and peer-reviewed literature. The data was extracted to Excel file database and coded then analysed using Stata (version 15). Analysis was done through descriptive statistical analysis (using measures of central tendencies (Mean, DS, and median) and measures of central dispersion (range)), multiple linear regression, and thematic analysis of qualitative data. Results: There are three distinct layered coordination mechanisms (strategic, operational, and tactical) that were either implemented singularly or in tandem with another coordination mechanism. 87.23% (n=41) of the countries initiated strategic coordination, and 59.57% (n=28) initiated some form of operational coordination. Some of countries (n=26,55.32%) provided operational coordination using functional Public Health Emergency Operation Centres (PHEOCs) which were activated for the response. 31.91% (n=15) of the countries initiated some form of tactical coordination which involved the decentralisation of the operations at the local/grassroot level/district/ county levels. Decentralisation strategies played a key role in coordination, as was the innovative strategies by the countries; some coordination mechanisms built on already existing coordination systems and the heads of states were effective in the success of the coordination process. Financing posed challenge to majority of the countries in initiating coordination. Conclusion: Coordinating an emergency is a multidimensional process that includes having decision-makers and institutional agents define and prioritise policies and norms that contain the spread of the disease, regulate activities and behaviour and citizens, and respond to personnel who coordinate prevention

The role of emergency medical teams in Eswatini during the COVID-19 pandemic

The paper documents experiences and lesson learned in responding to COVID-19 pandemic in Eswatini with the support of the Emergency Medical Teams. WHO databases, operation reports and hospitalization records were reviewed. The WHO Emergency medical Teams built the capacity for the local response teams in Eswatini. The conclusion is that following the intervention of the WHO Emergency Response Teams, Eswatini is better prepared to respond to the ongoing COVID-19 pandemic and future outbreaks

Coordination and Management of COVID-19 in Africa through Health Operations and Technical Expertise Pillar: A Case Study from WHO AFRO One Year into Response

Abstract: Background: following the importation of the first Coronavirus disease 2019 (COVID-19) case into Africa on 14 February 2020 in Egypt, the World Health Organisation (WHO) regional office for Africa (AFRO) activated a three-level incident management support team (IMST), with technical pillars, to coordinate planning, implementing, supervision, and monitoring of the situation and progress of implementation as well as response to the pandemic in the region. At WHO AFRO, one of the pillars was the health operations and technical expertise (HOTE) pillar with five sub-pillars: case management, infection prevention and control, risk communication and community engagement, laboratory, and emergency medical team (EMT). This paper documents the learnings (both positive and negative for consideration of change) from the activities of the HOTE pillar and recommends future actions for improving its coordination for future emergencies, especially for multi-country outbreaks or pandemic emergency responses. Method: we conducted a document review of the HOTE pillar coordination meetings’ minutes, reports, policy and strategy documents of the activities, and outcomes and feedback on updates on the HOTE pillar given at regular intervals to the Regional IMST. In addition, key informant interviews were conducted with 14 members of the HOTE sub pillar. Key Learnings: the pandemic response revealed that shared decision making, collaborative coordination, and planning have been significant in the COVID-19 response in Africa. The HOTE pillar’s response structure contributed to attaining the IMST objectives in the African region and translated to timely support for the WHO AFRO and the member states. However, while the coordination mechanism appeared robust, some challenges included duplication of coordination efforts, communication, documentation, and information management. Recommendations: we recommend streamlining the flow of information to better understand the challenges that countries face. There is a need to define the role and responsibilities of sub-pillar team members and provide new team members with information briefs to guide them on where and how to access internal information and work under the pillar. A unified documentation system is important and could help to strengthen intra-pillar collaboration and communication. Various indicators should be developed to constantly monitor the HOTE team’s deliverables, performance and its members

Case Report: COVID-19 and Lassa Fever Coinfection in an Ebola Suspected Patient in Guinea

ABSTRACT. In this case report, we describe a clinical presentation and therapeutic history of a unique case diagnosed with Lassa fever and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a 23-year-old man from Yomou prefecture in southeast Guinea identified with suspected Ebola Virus Disease (EVD) in the midst of an ongoing outbreak of that disease in the same region. On May 3, 2021, he was admitted to the Nzérékoré Epidemic disease treatment center where his clinical condition deteriorated significantly. Laboratory testing performed on the same day reveals a negative EVD polymerase chain reaction (PCR). Three days later, the patient was tested positive for SARS-CoV-2 and Lassa fever by reverse transcriptase PCR (RT-PCR) assays. Laboratory examination also indicated severe hematological and biochemical deteriorations in the patient. This case substantiates the need for systematic differential diagnosis during epidemic-prone disease outbreaks to better manage severely unwell patients.</jats:p

A year of genomic surveillance reveals how the SARS-CoV-2 pandemic unfolded in Africa.

The progression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Africa has so far been heterogeneous, and the full impact is not yet well understood. In this study, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations predominantly from Europe, which diminished after the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1, and C.1.1. Although distorted by low sampling numbers and blind spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a source for new variants

Medicinal Vitex species (Lamiaceae) occupy different niches in Haut-Katanga tropical dry woodlands

International audienceBackground and aims – Sustainable management of the medicinal plant resources provided by tropical forests is of utmost importance to human populations in developing countries. Trees and shrubs of the genus Vitex (Lamiaceae) are of great medicinal importance in Haut-Katanga (SE D.R. Congo), frequently used to treat tropical diseases. However, the security of supply is threatened, particularly by urban sprawl and mining. A conservation strategy for medicinal plants is urgently needed. In this context, we try to better understand the ecological factors (mostly soil) explaining the distribution of three medicinal species of Vitex (Lamiaceae) ( V. fischeri , V. madiensis , and V. mombassae ) that co-occur in the tropical dry woodlands in the region of Lubumbashi. Material and methods – In 114 plots (10 m radius), comprising at least one species of Vitex , all woody species with a DBH ≥ 10 cm were inventoried and soil samples were collected. Multivariate Regression Trees (MRT) combined with indicator species index IndVal and Redundancy analysis (RDA) were used to characterise habitats and woody plant communities associated to each Vitex species and to explain the variability of plant community composition. Key results – Four habitats were identified, and the three Vitex species differ significantly in ecological range. Vitex fischeri is a specialist of a most distinctive community on high Mg and low Al soil (termite mounds). Vitex mombassae is indicative of one habitat, corresponding to low altitude (&lt; 1230 m) plots. Vitex madiensis has a broader range, being a generalist of all habitats except termite mounds. Conclusion – These results emphasise the importance of a detailed knowledge of species ecology to design species-specific conservation strategies, even for congeneric species occurring in sympatry in the same landscape

Medicinal Vitex species (Lamiaceae) occupy different niches in Haut-Katanga tropical dry woodlands

International audienceBackground and aims – Sustainable management of the medicinal plant resources provided by tropical forests is of utmost importance to human populations in developing countries. Trees and shrubs of the genus Vitex (Lamiaceae) are of great medicinal importance in Haut-Katanga (SE D.R. Congo), frequently used to treat tropical diseases. However, the security of supply is threatened, particularly by urban sprawl and mining. A conservation strategy for medicinal plants is urgently needed. In this context, we try to better understand the ecological factors (mostly soil) explaining the distribution of three medicinal species of Vitex (Lamiaceae) ( V. fischeri , V. madiensis , and V. mombassae ) that co-occur in the tropical dry woodlands in the region of Lubumbashi. Material and methods – In 114 plots (10 m radius), comprising at least one species of Vitex , all woody species with a DBH ≥ 10 cm were inventoried and soil samples were collected. Multivariate Regression Trees (MRT) combined with indicator species index IndVal and Redundancy analysis (RDA) were used to characterise habitats and woody plant communities associated to each Vitex species and to explain the variability of plant community composition. Key results – Four habitats were identified, and the three Vitex species differ significantly in ecological range. Vitex fischeri is a specialist of a most distinctive community on high Mg and low Al soil (termite mounds). Vitex mombassae is indicative of one habitat, corresponding to low altitude (&lt; 1230 m) plots. Vitex madiensis has a broader range, being a generalist of all habitats except termite mounds. Conclusion – These results emphasise the importance of a detailed knowledge of species ecology to design species-specific conservation strategies, even for congeneric species occurring in sympatry in the same landscape