Eff ectiveness of one dose of oral cholera vaccine in response to an outbreak: a case-cohort study

Background Oral cholera vaccines represent a new eff ective tool to fi ght cholera and are licensed as two-dose regimens with 2–4 weeks between doses. Evidence from previous studies suggests that a single dose of oral cholera vaccine might provide substantial direct protection against cholera. During a cholera outbreak in May, 2015, in Juba, South Sudan, the Ministry of Health, Médecins Sans Frontières, and partners engaged in the fi rst fi eld deployment of a single dose of oral cholera vaccine to enhance the outbreak response. We did a vaccine eff ectiveness study in conjunction with this large public health intervention. Methods We did a case-cohort study, combining information on the vaccination status and disease outcomes from a random cohort recruited from throughout the city of Juba with that from all the cases detected. Eligible cases were those aged 1 year or older on the fi rst day of the vaccination campaign who sought care for diarrhoea at all three cholera treatment centres and seven rehydration posts throughout Juba. Confi rmed cases were suspected cases who tested positive to PCR for Vibrio cholerae O1. We estimated the short-term protection (direct and indirect) conferred by one dose of cholera vaccine (Shanchol, Shantha Biotechnics, Hyderabad, India). Findings Between Aug 9, 2015, and Sept 29, 2015, we enrolled 87 individuals with suspected cholera, and an 898-person cohort from throughout Juba. Of the 87 individuals with suspected cholera, 34 were classifi ed as cholera positive, 52 as cholera negative, and one had indeterminate results. Of the 858 cohort members who completed a follow-up visit, none developed clinical cholera during follow-up. The unadjusted single-dose vaccine eff ectiveness was 80·2% (95% CI 61·5–100·0) and after adjusting for potential confounders was 87·3% (70·2–100·0). Interpretation One dose of Shanchol was eff ective in preventing medically attended cholera in this study. These results support the use of a single-dose strategy in outbreaks in similar epidemiological settings

Overweight and obesity in urban Africa: A problem of the rich or the poor?

BACKGROUND: Obesity is a well recognized risk factor for various chronic diseases such as cardiovascular diseases, hypertension, and type 2 diabetes mellitus. The aim of this study was to shed light on the patterns of overweight and obesity in sub-Saharan Africa, with special interest in differences between the urban poor and the urban non-poor. The specific goals were to describe trends in overweight and obesity among urban women; and examine how these trends vary by education and household wealth. METHODS: The paper used Demographic and Health Surveys data from seven African countries where two surveys had been carried out with an interval of at least 10 years between them. Among the countries studied, the earliest survey took place in 1992 and the latest in 2005. The dependent variable was body mass index coded as: Not overweight/obese; Overweight; Obese. The key covariates were time lapse between the two surveys; woman's education; and household wealth. Control variables included working status, age, marital status, parity, and country. Multivariate ordered logistic regression in the context of the partial proportional odds model was used. RESULTS: Descriptive results showed that the prevalence of urban overweight/obesity increased by nearly 35% during the period covered. The increase was higher among the poorest (+50%) than among the richest (+7%). Importantly, there was an increase of 45-50% among the non-educated and primary-educated women, compared to a drop of 10% among women with secondary education or higher. In the multivariate analysis, the odds ratio of the variable time lapse was 1.05 (p < 0.01), indicating that the prevalence of overweight/obesity increased by about 5% per year on average in the countries in the study. While the rate of change in urban overweight/obesity did not significantly differ between the poor and the rich, it was substantially higher among the non-educated women than among their educated counterparts. CONCLUSION: Overweight and obesity are on the rise in Africa and might take epidemic proportions in the near future. Like several other public health challenges, overweight and obesity should be tackled and prevented early as envisioned in the WHO Global strategy on diet, physical activity and health

Dietary patterns of adults living in Ouagadougou and their association with overweight

<p>Abstract</p> <p>Background</p> <p>Urbanization in developing countries comes along with changes in food habits and living conditions and with an increase in overweight and associated health risks. The objective of the study was to describe dietary patterns of adults in Ouagadougou and to study their relationship with anthropometric status of the subjects.</p> <p>Methods</p> <p>A qualitative food frequency questionnaire was administered to 1,072 adults living in two contrasted districts of Ouagadougou. Dietary patterns were defined by principal component analysis and described by multivariate analysis. Logistic regression was used to study their association with overweight.</p> <p>Results</p> <p>The diet was mainly made of cereals, vegetables and fats from vegetable sources. The two first components of the principal component analysis were interpreted respectively as a "snacking" score and as a "modern foods" score. Both scores were positively and independently associated with the economic level of households and with food expenditures (p ≤ 0.001 for both). The "snacking" score was higher for younger people (p = 0.004), for people having a formal occupation (p = 0.006), for those never married (p = 0.005), whereas the "modern foods" score was associated with ethnic group (p = 0.032) and district of residence (p < 0.001). Thirty-six percent of women and 14.5% of men were overweight (Body Mass Index > 25 kg/m²). A higher "modern foods" score was associated with a higher prevalence of overweight when confounding factors were accounted for (OR = 1.19 [95% CI 1.03-1.36]) but there was no relationship between overweight and the "snacking" score.</p> <p>Conclusions</p> <p>Modernisation of types of foods consumed was associated with the living conditions and the environment and with an increased risk of overweight. This should be accounted for to promote better nutrition and prevent non communicable diseases.</p

Commercialisation des escargots geants africains (achatines) dans les departements de l’atlantique et du littoral au sud-benin

L'objectif de cet article est d’analyser le système de commercialisation des escargots géants africains (achatines) afin de faire des recommandations pour leur  exploitation rationnelle et durable. Trois marchés ruraux (Houègbo, Zinvié et Avakpa) et un marché urbain (Dantokpa dans Cotonou) ont été étudiés. Dans ces marchés, 53 acteurs du système de commercialisation des achatines ont été sélectionnés. Les analyses ont été effectuées suivant l’approche Structure - Conduite - Performance. Les résultats obtenus indiquent que le système de commercialisation des achatines est dominé essentiellement par les femmes. Le circuit commercial est relativement simple avec trois principaux acteurs, à savoir les collecteurs, les grossistes et les négociantes. Les marchés étudiés sont intégrés hormis Avakpa, ce qui peut se justifier par son enclavement par rapport aux autres. La marge de commercialisation est relativement faible pour les collecteurs et les grossistes, alors qu’elle est élevée pour les négociantes et très élevée pour les cueilleurs, ce qui encourage la cueillette et peut conduire à la disparition des escargots géants africains. D’où la nécessité de mettre sur pied des programmes d’élevage. The objective of this paper is to analyze the African giant snails marketing system study in order to make recommendations for their rational and sustainable exploitation. Three rural markets (Houègbo, Zinvié and Avakpa) and one urban market (Dantokpa in Cotonou) have been studied. In these markets, 53 actors of African giant snails marketing system have been selected. Analyses have been done according to “Structure–Behavior–Performance” approach. The results obtained indicate that women essentially dominate the African giant snails marketing. The marketing network is relatively simple with three main actors namely collectors, wholesalers and dealers. The studied markets are integrated except Avakpa. The gross margin is relatively weak for collectors and wholesalers, whereas it is high for dealers and very high for gatherers, what encourages the gathering that can drive to the African giant snails extinction. From which it is necessary to get African giant snails raising programs off the ground.

Mise a jour taxonomique et nomenclaturale des asteraceae du Togo

La flore du Togo éditée depuis 1984 n’a suivi à ce jour aucune mise à jour mais depuis lors, de nouvelles investigations et récoltes lui ont été ajoutées. L’actualisation de cette flore passe par la mise à jour nomenclaturale et taxonomique des spécimens d’herbier du Togo. L’objectif de cette étude est de mettre à jour la liste des Asteraceae du Togo à travers les échantillons d’herbier. Ce travail s’inscrit dans celui plus global de réaliser une mise à jour taxonomique et nomenclaturale de la flore du Togo. Cette mise à jour actuellement est facilitée par l’informatisation de l’herbier et de l’exploitation de sa base de données qui est le RIHA (Réseau Informatique des Herbiers d’Afrique). Le matériel utilisé relève des étiquettes d’herbier et de la base de données RIHA de l’Herbier de l’Université de Lomé. Plusieurs extraits issus des requêtes ont permis de dresser les listes des Asteraceae du Togo. Une comparaison avec la flore du Togo a permis de confirmer ladite liste. La consultation de plusieurs bases de données botaniques ont permis de faire le parallèle entre les noms d’étiquettes et les noms valides en cours d’usage actuellement. Les résultats montrent que la flore du Togo est riche de 110 espèces réparties en 48 genres. Sur le nombre total d’espèces, 31 espèces portent encore sur les étiquettes, des noms invalides. Les usages relevés sur les étiquettes sont d’ordre médicinal et alimentaire. Mots clés: Flore du Togo, mise à jour, Asteraceae, base de données, RIHA English Title: Taxonomic and nomenclatural revision of asteraceae of Togo&nbsp; English Abstract The flora of Togo published since 1984 has not been updated to date but since then, new investigations and harvests have been added. The updating of this flora requires the nomenclatural and taxonomic updating of the herbarium specimens. The objective of this study is to update the list of Asteraceae of Togo through herbarium sheets. This work is part of the more global task of carrying out a taxonomic and nomenclatural update of the Togo’s flora. This updating is currently facilitated by the computerization of the herbarium and the exploitation of its database which is the RIHA (Réseau Informatique des Herbiers d'Afrique). The equipment used is from the herbarium labels and the RIHA database of the Herbarium of the University of Lomé. Several extracts from the queries made it possible to draw up lists of Asteraceae from Togo. A comparison with the flora of Togo made it possible to confirm the said list. Consultation of several&nbsp; botanical databases made it possible to draw a parallel between the label names and the valid names currently in use. The results show that the flora of Togo is rich with 110 species of Asteraceae divided into 48 genera. Out of the total number of species, 31 species still have invalid names on labels. The uses noted on the labels are medicinal and food uses. Keywords: Togo's Flora, updating, Asteraceae family, computerizatio