Amélioration de la surveillance de l’influenza aviaire de type H5N1 - Cartographie du risque d’influenza aviaire de type H5N1 en Afrique: Rapport final et cartes de risqué d’influenza aviaire

Plus de 85% des ménages ruraux en Afrique élèvent la volaille aux fins d’alimentation, de revenu ou les deux, et de nombreuses personnes vivent en contact étroit avec leurs oiseaux. La possibilité d’une épidémie de l’influenza aviaire hautement pathogène (IAHP) de type H5N1 est donc une grande préoccupation. Depuis 2006, la grippe aviaire est apparue dans au moins 11 pays africains et plus de 600 foyers d’épidémie ont été signalés. La vigilance est essentielle en vue de limiter la maladie mais le personnel de santé animale ne peut faire un suivi partout à la fois. Ce projet de cartographie de facteurs de risques a été conçu en vue d’aider à prioriser leurs efforts en indiquant les lieux où il existe un risque très élevé de flambées de la maladie. La cartographie des risques est une image complexe générée par ordinateur qui montre la répartition spatiale des facteurs de risques prévus d’une maladie. Elle est fondée sur la répartition spatiale des « facteurs de risques » associés au risque accru de maladie et à l’importance relative de chacun de ces facteurs. Dans le cas d’une grippe aviaire de type H5N1, les facteurs de risques sont les principales voies de transport, les marchés de volailles et les points d’eau avec possibilité de contact entre les oiseaux domestiques et sauvages. Pour ce projet, les chercheurs ont préparé des cartes de risques de grippe aviaire en Afrique en utilisant la modélisation de décision multicritères (MCDM). De cette façon, ils ont intégré les données et les informations de diverses sources telles que les publications scientifi ques, les cartes disponibles dans le domaine public, les études de terrain et les consultations d’expert

Risk mapping for HPAI H5N1 in Africa - Improving surveillance for virulent bird flu: Final report and maps

More than 85 percent of households in rural Africa raise poultry for food, income, or both, and many people live in close contact with their birds. The possibility of an epidemic of highly pathogenic avian influenza (HPAI) H5N1 is therefore a major concern. Since 2006 bird fl u has been introduced into at least 11 countries in Africa, and over 600 outbreaks reported. Vigilance is key to limiting the disease but animal health personnel cannot monitor everywhere at once. This risk-mapping project was designed to help prioritize their efforts by showing in which places outbreaks are more likely to occur. A risk map is a complex, computer-generated image that shows the spatial distribution of the predicted risk of a disease. It is based on the spatial distribution of “risk factors” associated with an increased risk of disease, and the relative importance of each of these factors. In the case of virulent bird fl u, risk factors include major transport routes, markets where poultry may be traded, and wetlands with the possibility of contact between poultry and wild birds. Researchers in this project have prepared risk maps for bird fl u in Africa using multi-criteria decision modeling (MCDM). In this way they have integrated data and information from such diverse sources as published scientific literature, maps available in the public domain, field surveys and expert consultations

Risk of suicidality in mental and neurological disorders in low and middle-income countries: A systematic review and meta-analysis

Background: Both fatal and nonfatal suicidal behaviours are important complications of mental, neurological, and substance use disorders (MNSDs) worldwide. We aimed at quantifying the association of suicidal behaviour with MNSDs in Low and Middle Income Countries (LMICs) where varying environmental and socio-cultural factors may impact outcome. Methods: We conducted a systematic review and meta-analysis to report the associations between MNSDs and suicidality in LMICs and the study-level factors of these associations. We searched the following electronic databases: PUBMED, PsycINFO, MEDLINE, CINAHL, World Cat, and Cochrane library for studies on suicide risk in MNSDs, with a comparison/control group of persons without MNSDs, published from January 1, 1995 to September 3, 2020. Median estimates were calculated for relative risks for suicide behaviour and MNSDs, and when appropriate, these were pooled using random effects metanalytic model. This study was registered with PROSPERO, CRD42020178772. Results: The search identified 73 eligible studies: 28 were used for quantitative synthesis of estimates and 45 for description of risk factors. Studies included came from low and upper middle-income countries with a majority of these from Asia and South America and none from a low-income country. The sample size was 13,759 for MNSD cases and 11,792 hospital or community controls without MNSD. The most common MNSD exposure for suicidal behaviour was depressive disorders (47 studies (64%)), followed by schizophrenia spectrum, and other psychotic disorders (28 studies (38%)). Pooled estimates from the meta-analysis were statistically significant for suicidal behaviour with any MNSDs (odds ratios (OR) = 1∙98 (95%CI = 1∙80–2∙16))) and depressive disorder (OR = 3∙26 (95%CI = 2∙88–3∙63))), with both remaining significant after inclusion of high-quality studies only. Meta-regression identified only hospital-based studies (ratio of OR = 2∙85, CI:1∙24–6∙55) and sample size (OR = 1∙00, CI:0∙99–1∙00) as possible sources of variability in estimates. Risk for suicidal behaviour in MNSDs was increased by demographic factors (e.g., male sex, and unemployment), family history, psychosocial context and physical illness. Interpretation: There is an association between suicidal behaviour and MNSDs in LMICs, the association is greater for depressive disorder in LMICs than what has been reported in High Income Countries (HICs). There is urgent need to improve access for MNSDs care in LMICs. Funding: None