Banking and economic growth : case of the Gambia

This research advances four theoretical approaches in an attempt to relate the banking activities to the real economic activities. It starts with the Schumpeter’s circular flow of creditary production that argues that the banks start the production cycle for offering the credits that enable the entrepreneurs to purchase labor and capital. The banks increase the savings mobilization and allocate the scarce savings to the productive investments. Second, we develop a benchmark from the Broaddus’ competitive model to analyze the competitiveness and efficiency in the banking industry. The third theoretical approach incorporates a credit market in IS/LM analysis and discusses the credit constraint as an analogy to a quantity constraint of the neo-Keynesian theory. This approach also analyzes the impacts of the interaction between the monetary policy and the fiscal policy on the endogenous macroeconomic variables. We finally modify Tsurus’ model to show that banks’ mobilized savings could be spent on the maintenance of the banks rather than being channeled to the productive investments, and as a result a bank-based economy could perform worse than a nonbank-based economy. We then estimate and test the hypothetical relationships between the banking and the real economic activities, and estimate and analyze the banks’ credit market functions and the credit constraint hypothesis. We use Johansen Vector Error Correction Methods, VECM, for all the estimations, and hence the analysis is focused on the long run relationships and the adjustments towards the equilibrium. We also conduct an explorative survey into the public’s relationships with the banks. The research finds that the banks’ credit to the private sector is vital for the real economic activities of output and capital accumulation, it is found to be Granger causal for these activities, and it is a weakly exogenous variable in the equilibrium systems that do not include private sector investments; while, the bank liabilities are found to be an endogenous variable. The interest rate is found to slightly influence the decision of the public to save in the banks; the public see the credit facilities biased towards the consumption financing than investment financing. The lending interest rate has a small effect on the credit supply. The banks’ credit supply is inelastic with respect to the lending interest rate, and there is weak credit constraint in the credit market. The banking industry is found to be uncompetitive and inefficient; and the increased transaction costs of the bank credit market are associated with increased prices in the economy. These increased transaction costs are also found to cause the public to hold increased real money balances. The banks’ credit and lending capacity are found to depend on the private sector investments, increases in the private sector feed back onto both the banks’ credit and lending capacity. The banks lag behind the developments in the private sector; thus they are not promoters or engines of growth for the private sector

Food Security Monitoring and Evaluation in Rural Mali: Preliminary Findings

African Sky is a non-profit organization that has been continuously involved in community development efforts in the Sikasso, Koulikoro, and Segou regions of Mali since 2001. To inform these efforts, an assessment of survey and census data was conducted focusing on the rural village of Dissan, in the Sikasso region. During the evaluation period between 2001-2010 Dissan experienced highly variable rainfall. We hypothesized these conditions would negatively impact farming output, and as a result, nutritional status of the people living in Dissan. Our analysis shows that while land use did not change significantly, by household the variety of sorghum crops increased and non-sorghum food crops decreased. Farmers in Dissan are changing crop distribution due to an increased availability of new sorghum seed and in response to a variety of environmental factors

Assessment of the Therapeutic Efficacy of Two Artemisinin-Based Combinations in the Treatment of Uncomplicated Falciparum Malaria among Children Under 5 Years in Four District Hospitals in Sierra Leone

Plasmodium falciparum has developed resistance to almost every class of antimalarial compounds. As a result of this, the World Health Organization has recommended artemisinin-based combination therapy as first line treatment for P. falciparum malaria. There is however need for the continuous monitoring of the efficacy of these antimalarials in order to provide timely information on trends of the emergence of resistant strains. We assessed the therapeutic efficacy of oral artesunate – amodiaquine and artemether-lumefantrine combinations in the treatment of uncomplicated P. falciparum malaria in four District Hospitals in Sierra Leone. A total of 320 children under five years partiiccipated in the study sites (Kenema, Rokupa, Bo and Makeni). Oral Artesunate-amodiaquine combination was administered to participants in Kenema and Rokupa whilst Artemetherlumefantrine combination was administered to participants in Bo and Makeni. The new WHO Protocol for recruitment of participants in therapeutic efficacy trials in high transmission zones was adopted for the study with filter paper blood samples taken from each participant on days 0 and 28 to distinguish between treatment failure and new infection. When uncorrected for PCR analysis, 96% (95% CI: 902 – 989) and 100% (95% CI:63.1 – 100) responses were obtained in Kenema and Bo respectively with Artesunate-amodiaquine combination whilst 94.3% (CI 95 : 88.1 – 979) and 100% (95% CI: 96.5 – 100) were obtained with Artemether-lumefantrine combination in Bo and Makeni respectively. When corrected for PCR on the other hand, a 100% (95% CI) Adequate Clinical and Parasitological Response was obtained for the two drugs in all four study sites. Results from this study indicate that both Artesunate-amodiaquine and Artemether-lumefantrine combinations remain highly efficacious in Sierra Leone with presently no observed emergence of resistant strains to both drugs.Keywords: Artemisinin-based combination, uncomplicated falciparum malaria, children, Sierra Leon

Income, Price, and Government Expenditure Elasticities of Oil in the Gulf Cooperation Council Countries

The analysis of the domestic oil consumption data in the six Gulf Cooperation Council (GCC) countries has reached five important findings. First, contemporaneously, no robust short run relationships are found in the data. Second, the international oil price increases tend to induce increased domestic oil consumptions in all member countries except in Oman. Third, three member countries, Bahrain, Kuwait and United Arab Emirates, are found to be oil conserving as their per capita GDP grow and expand; whereas, the other three countries, Oman, Qatar and Saudi Arabia, tend to drive up their domestic oil consumptions as their per capita GDP expand and grow. Fourth, the three oil-conserving countries also have higher income elasticity than the three non-oil conserving countries. Finally, the domestic oil markets are found to be immune to disturbances and shocks to the international oil prices. Therefore, in the face of rising oil prices, per capita oil consumptions are rapidly raising in the GCC countries, while they have taken downward trends in some developed countries such as the United States and Japan. Keywords: Income elasticity; Oil consumption; GCC JEL Classifications: C01; C3

Use of Lumbar Perforator Recipient Vessels for Salvage Chest Wall Reconstruction: A Case Report

Summary: Abdominal-based free flaps are commonly used for breast reconstruction, and the internal mammary or thoracodorsal vessels are typically used as recipient sites. Conversely, free tissue transfer is less commonly used for chest wall reconstruction in the setting of chest wall recurrence, in part, because of a paucity of recipient vessels. Here, we describe a case of a 68-year-old female smoker with metastatic breast cancer, who presented with a chest wall recurrence. There was a large area of chronic ulceration with foul smelling drainage, in addition to radiation-induced tissue injury, and palliative resection was performed. The area was reconstructed with a free transverse rectus abdominis myocutaneous flap using lumbar perforators as recipient vessels, because conventional recipient sites were unavailable because of scarring from radiation and residual tumor. This case demonstrates that uncommon recipient vessels such as lumbar perforators may allow for successful palliative chest wall reconstruction. We hypothesize that the tumor burden, previous surgeries, and radiation may have rendered the recipient field relatively ischemic, thereby inducing hypertrophy of the lumbar perforators, similar to a delay phenomenon

Non-participation during azithromycin mass treatment for trachoma in The Gambia: heterogeneity and risk factors.

BACKGROUND: There is concern that untreated individuals in mass drug administration (MDA) programs for neglected tropical diseases can reduce the impact of elimination efforts by maintaining a source of transmission and re-infection. METHODOLOGY/PRINCIPAL FINDINGS: Treatment receipt was recorded against the community census during three MDAs with azithromycin for trachoma in The Gambia, a hypo-endemic setting. Predictors of non-participation were investigated in 1-9 year olds using random effects logistic regression of cross-sectional data for each MDA. Two types of non-participators were identified: present during MDA but not treated (PNT) and eligible for treatment but absent during MDA (EBA). PNT and EBA children were compared to treated children separately. Multivariable models were developed using baseline data and validated using year one and two data, with a priori adjustment for previous treatment status. Analyses included approximately 10000 children at baseline and 5000 children subsequently. There was strong evidence of spatial heterogeneity, and persistent non-participation within households and individuals. By year two, non-participation increased significantly to 10.4% overall from 6.2% at baseline, with more, smaller geographical clusters of non-participating households. Multivariable models suggested household level predictors of non-participation (increased time to water and household head non-participation for both PNT and EBA; increased household size for PNT status only; non-inclusion in a previous trachoma examination survey and younger age for EBA only). Enhanced coverage efforts did not decrease non-participation. Few infected children were detected at year three and only one infected child was EBA previously. Infected children were in communities close to untreated endemic areas with higher rates of EBA non-participation during MDA. CONCLUSIONS/SIGNIFICANCE: In hypo-endemic settings, with good coverage and no association between non-participation and infection, efforts to improve participation during MDA may not be required. Further research could investigate spatial hotspots of infection and non-participation in other low and medium prevalence settings before allocating resources to increase participation

Mass drug administration with azithromycin for trachoma elimination and the population structure of Streptococcus pneumoniae in the nasopharynx

ABSTRACTBackgroundMass drug administration (MDA) with azithromycin for trachoma elimination reduces nasopharyngeal carriage of Streptococcus pneumoniae in the short term. We evaluated S. pneumoniae carried in the nasopharynx before and after a round of azithromycin MDA to determine whether MDA was associated with changes in pneumococcal population structure.MethodsWe analysed 514 pneumococcal isolates cultured from nasopharyngeal samples collected in Gambian villages that received MDA for trachoma elimination. The samples were collected during three cross-sectional surveys conducted before the third round of MDA (CSS-1) and at one (CSS-2) and six (CSS-3) months after MDA. Whole genome sequencing was conducted on randomly selected isolates. Bayesian Analysis of Population Structure (BAPS) was used to cluster related isolates by capturing variation in the core genome. Serotype and multi-locus sequence type were inferred from the genotype. The Antimicrobial Resistance Identification by Assembly (ARIBA) tool was used to identify macrolide resistance genes.ResultsTwenty-seven BAPS clusters were assigned. These consisted of 81 sequence types (STs), 15 of which were novel additions to pubMLST. Two BAPS clusters, BAPS20 (p-value&lt;=0.016) and BAPS22 (p-value&lt;=0.032) showed an increase in frequency at CSS-3 not associated with antimicrobial resistance. Macrolide resistance within BASP17 increased after treatment (p&lt;0.05) and was carried on a mobile transposable element that also conferred resistance to tetracycline.ConclusionsLimited changes in pneumococcal population structure were observed after the third round of MDA suggesting treatment had little effect on the circulating lineages. An increase in macrolide resistance within one BAPS highlights the need for antimicrobial resistance surveillance in treated villages.</jats:sec

Mass administration of azithromycin and Streptococcus pneumoniae carriage: cross-sectional surveys in the Gambia.

OBJECTIVE: To evaluate the effect of repeated mass drug administration (MDA) of azithromycin in the Gambia on the nasopharyngeal carriage of Streptococcus pneumoniae and on the emergence of antibiotic-resistant strains. METHODS: This study involved villages that participated in a cluster randomized trial comparing the effect of one versus three azithromycin MDA rounds on the prevalence of trachoma. Only villages in which most children received 7-valent pneumococcal conjugate vaccine were included. Three cross-sectional surveys were performed in two villages that received three annual MDA rounds: the first immediately before the third MDA round and the second and third, 1 and 6 months, respectively, after the third MDA round. The third survey also covered six villages that had received one MDA round 30 months previously. Pneumococcal carriage was assessed using nasopharyngeal swabs and azithromycin resistance was detected using the Etest. FINDINGS: The prevalence of pneumococcal carriage decreased from 43.4% to 19.2% between the first and second surveys (P < 0.001) but rebounded by the third survey (45.8%; P = 0.591). Being a carrier at the first survey was a risk factor for being a carrier at the second (odds ratio: 3.71; P <  0.001). At the third survey, the prevalence of carriage was similar after one and three MDA rounds (50.3% versus 45.8%, respectively; P = 0.170), as was the prevalence of azithromycin resistance (0.3% versus 0.9%, respectively; P = 0.340). CONCLUSION: Three azithromycin MDA rounds did not increase the prevalence of nasopharyngeal carriage of azithromycin-resistant S. pneumoniae strains compared with one round