Supporting sanitation and hygiene in prisons: WaterAid's support for Bolle detention centre in Mali

The Bolle detention centre in Bamako is a unique prison for women and girls in Mali with an average of 150 inmates. WaterAid’s intervention started in 2014 to improve the living conditions and health of women prisoners by providing water, hygiene and sanitation. The project involved constructing and rehabilitating sanitation facilities, and providing training and sensitisation for inmates and prison managers in improved hygiene behaviours and maintenance of the facilities. This is consistent with WaterAid’s principle of "equality, non-discrimination and inclusion" in the provision of WASH services. As a result of the intervention more than 130 women and girls now have access to improved toilets and live in a healthier environment. The Ministry of Justice as well as other stakeholders such as United Nations Mission for Mali inspired by the results, have committed themselves to extending the same action in other prisons in Mali

Production du fourrage de Mucuna pruriens pour l’alimentation des animaux et sa marge brute en zone cotonnière du Mali

En zone cotonnière du Mali, la situation d’affouragement des animaux est largement déficitaire. Pour améliorer la disponibilité des ressources fourragères, la recherche en partenariat avec les producteurs a introduit en milieu paysan la culture de Mucuna pruriens. Cette étude vise à évaluer les performances de M. pruriens dans la production du fourrage pour les animaux. Les essais ont été  conduits par 25 producteurs répartis dans 5 sites durant les campagnes agricoles 2015-2016, 2016-2017 et 2017-2018. Les essais étaient divisés en deux parcelles tests : culture pure de M. pruriens et association M. pruriens/maïs. La production moyenne en biomasse de  M. pruriens pur sur les 3 campagnes agricoles a été de 4 363±1 491kg MS/ha. Cette production couvre les besoins en matière sèche de 7,76±2,65 UBT durant 90 jours. Pour l’association, la production de biomasse a été de 5 449±1 766 kg MS/ha, elle couvre les besoins en matière sèche de 9,69±3,14 UBT pendant 90 jours. La marge brute de la culture pure de M. pruriens est de 786 060±298 140 FCFA/ha. Pour l’association, elle est de 850 917±36 1887 FCFA/ha. La culture de M. pruriens favorise l’intégration agriculture-élevage tout en  améliorant l’alimentation des animaux et les revenus des producteurs. Mots clés: Exploitation agricole, date de semis, Cultures fourragères, M. pruriens, zone cotonnière.   English Title: Production of Mucuna pruriens fodder for animal feed and its gross margin in the cotton-growing zone of Mali In Mali's cotton-growing zone, there is a large deficit in animal feed. To improve the availability of fodder resources, research in partnership with producers has introduced the cultivation of Mucuna pruriens into the farming environment. This study aims ed at evaluat’hg the performance of M. pruriens in the production of fodder for animals. The trials were conducted by 25 producers in 5 sites during the 2015-2016, 2016-2017 and  2017-2018 crop years. The trials were divided into two test plots: pure culture of M. pruriens and M. pruriens/corn combination. The average biomass production of pure M. pruriens over the 3 cropping seasons was 4363±1,491kg MS/ha. This production covers the dry matter requirement of  7.76±2.65 Btu for 90 days. For the association, the biomass production was 5449±1,766 kg DM/ha, covering the dry matter requirement  of 9.69±3.14 Btu for 90 days. The gross margin of the pure culture of M. pruriens is 786 060±298 140 FCFA/ha. For the association, it is 850 917±36 1887 FCFA/ha. The cultivation of M. pruriens promotes the integration of agriculture and livestock while improving animal  nutrition and the income of producers. Keywords: Farm, sowing date, fodder crops, M. pruriens, cotton ar

Characterization of element and mineral content in Artemisia annua and Camellia sinensis leaves by handheld X-ray fluorescence

Tea infusion is the most frequently worldwide consumed beverage next to water, with about 20 billion cups consumed daily. Artemisia annua leaves contain comparable levels of nutrients and mineral elements (dry matter basis) to many marketed tea (Camellia sinensis) leading us to suspect that this crop could also serve as an alternative source of nutrients for humans. Analyzer moveable X-ray fluorescence is used to evaluate the content of major, minor and toxic elements in A. annua from two different countries compared to six marketed tea in Senegal. To ensure qualified results, certified reference materials were used to perform the calibration. The very low and often negligible levels of inherent elements in the leaves, which are far below recommended toxic levels, establishes A. annua and selected marketed tea as a good reservoir of elements that might favour its use as a potential herbal tonic by humans. The mineral elements are present in different kinds of herbal leaves in various proportions depending on soil composition and the climate in which the plant grows.Keywords: X-ray fluorescence (XRF), Artemisia annua, Camellia sinensis, elements, leaves, medicinal plantAfrican Journal of Biotechnology Vol. 12(26), pp. 4179-418

Fragmentation du paysage naturel au Mali: cas des sites d'orpaillage de la préfecture de Kangaba

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Responding to the changing WASH needs in Mali

The political unrest that started in Mali on the 21st of March 2012 has had a significant impact on access to safe water and sanitation for an estimated 1.9 million people. Like most development or non-humanitarian organisations, WaterAid Mali was forced to stop their water and sanitation interventions in northern target communities due to insecurity. In the south, water, sanitation and hygiene needs changed quickly, as a result of the large number of people migrating from the north. WaterAid Mali has adapted to these changes through reallocating resources, implementing new activities and internal capacity building. This paper will discuss the experiences of WaterAid Mali as well as the lessons learnt

Delivery strategies for malaria vaccination in areas with seasonal malaria transmission

BACKGROUND: Seasonal vaccination with the RTS,S/AS01E malaria vaccine given alongside seasonal malaria chemoprevention (SMC) substantially reduces malaria in young children. The WHO has recommended the use of RTS,S/AS01E, including seasonal vaccination, in areas with seasonal malaria transmission. This study aimed to identify potential strategies to deliver RTS,S/AS01E, and assess the considerations and recommendations for delivery of seasonal malaria vaccination in Mali, a country with highly seasonal malaria. METHODS: Potential delivery strategies for RTS,S/AS01E in areas with seasonal malaria were identified through a series of high level discussions with the RTS,S/AS01E plus SMC trial investigators, international and national immunisation and malaria experts, and through the development of a theory of change. These were explored through qualitative in-depth interviews with 108 participants, including national-level, regional-level and district-level malaria and immunisation programme managers, health workers, caregivers of children under 5 years of age, and community stakeholders. A national-level workshop was held to confirm the qualitative findings and work towards consensus on an appropriate strategy. RESULTS: Four delivery strategies were identified: age-based vaccination delivered via the Essential Programme on Immunisation (EPI); seasonal vaccination via EPI mass vaccination campaigns (MVCs); a combination of age-based priming vaccination doses delivered via the EPI clinics and seasonal booster doses delivered via MVCs; and a combination of age-based priming vaccination doses and seasonal booster doses, all delivered via the EPI clinics, which was the preferred strategy for delivery of RTS,S/AS01E in Mali identified during the national workshop. Participants recommended that supportive interventions, including communications and mobilisation, would be needed for this strategy to achieve required coverage. CONCLUSIONS: Four delivery strategies were identified for administration of RTS,S/AS01E alongside SMC in countries with seasonal malaria transmission. Components of these delivery strategies were defined as the vaccination schedule, and the delivery system(s) plus the supportive interventions needed for the strategies to be effective. Further implementation research and evaluation is needed to explore how, where, when and what effective coverage is achievable via these new strategies and their supportive interventions

Comparison of molecular quantification of Plasmodium falciparum gametocytes by Pfs25 qRT-PCR and QT-NASBA in relation to mosquito infectivity.

BACKGROUND: Quantifying gametocyte densities in natural malaria infections is important to estimate malaria transmission potential. Two molecular methods (Pfs25 mRNA quantitative reverse transcriptase PCR (qRT-PCR) and Pfs25 mRNA quantitative nucleic acid sequence based amplification (QT-NASBA)) are commonly used to determine gametocyte densities in clinical and epidemiological studies and allow gametocyte detection at densities below the microscopic threshold for detection. Here, reproducibility of these measurements and the association between estimated gametocyte densities and mosquito infection rates were compared. METHODS: To quantify intra- and inter-assay variation of QT-NASBA and qRT-PCR, a series of experiments was performed using culture-derived mature Plasmodium falciparum gametocytes from three different parasite isolates (NF54, NF135, NF166). Pfs25 mRNA levels were also determined in samples from clinical trials in Mali and Burkina Faso using both methods. Agreement between the two methods and association with mosquito infection rates in membrane feeding assays were assessed. RESULTS: Intra- and inter-assay variability was larger in QT-NASBA compared to qRT-PCR, particularly at low gametocyte densities (100 gametocyte per ?L). Samples collected in one of the two transmission studies had extremely low gametocyte densities by both molecular methods, which is suggestive of RNA degradation due to an unknown number of freeze-thaw cycles and illustrates the reliance of molecular gametocyte diagnostics on a reliable cold-chain. CONCLUSIONS: The experiments indicate that both qRT-PCR and QT-NASBA are of value for quantifying mature gametocytes in samples collected in field studies. For both assays, estimated gametocyte densities correlated well with mosquito infection rates. QT-NASBA is less reproducible than qRT-PCR, particularly for low gametocyte densities

Primaquine to reduce transmission of Plasmodium falciparum malaria in Mali : a single-blind, dose-ranging, adaptive randomised phase 2 trial

Background Single low doses of primaquine, when added to artemisinin-based combination therapy, might prevent transmission of Plasmodium falciparum malaria to mosquitoes. We aimed to establish the activity and safety of four low doses of primaquine combined with dihydroartemisinin-piperaquine in male patients in Mali. Methods In this phase 2, single-blind, dose-ranging, adaptive randomised trial, we enrolled boys and men with uncomplicated P falciparum malaria at the Malaria Research and Training Centre (MRTC) field site in Ouelessebougou, Mali. All participants were confirmed positive carriers of gametocytes through microscopy and had normal function of glucose-6-phosphate dehydrogenase (G6PD) on colorimetric quantification In the first phase, participants were randomly assigned (1:1:1) to one of three primaquine doses: 0 mg/kg (control), 0.125 mg/kg, and 0.5 mg/kg. Randomisation was done with a computer-generated randomisation list (in block sizes of six) and concealed with sealed, opaque envelopes. In the second phase, different participants were sequentially assigned (1:1) to 0.25 mg/kg primaquine or 0.0625 mg/kg primaquine. Primaquine tablets were dissolved into a solution and administered orally in a single dose. Participants were also given a 3 day course of dihydroartemisinin-piperaquine, administered by weight (320 mg dihydroartemisinin and 40 mg piperaquine per tablet). Outcome assessors were masked to treatment allocation, but participants were permitted to find out group assignment. Infectivity was assessed through membrane feeding assays, which were optimised through the beginning part of phase one. The primary efficacy endpoint was the mean within-person percentage change in mosquito infectivity 2 days after primaquine treatment in participants who completed the study after optimisation of the infectivity assay, had both a pre-treatment infectivity measurement and at least one follow-up infectivity measurement, and who were given the correct primaquine dose. The safety endpoint was the mean within-person change in haemoglobin concentration during 28 days of study follow-up in participants with at least one follow-up visit. This study is registered with ClinicalTrials.gov, number NCT01743820. Findings Between Jan 2,2013, and Nov 27,2014, we enrolled 81 participants. In the primary analysis sample (n=71), participants in the 0.25 mg/kg primaquine dose group (n=15) and 0.5 mg/kg primaquine dose group (n=14) had significantly lower mean within-person reductions in infectivity at day 2-92.6% (95% CI 78.3-100; p=0.0014) for the 0.25 mg/kg group; and 75.0% (45.7-100; p=0.014) for the 0.5 mg/kg primaquine group compared with those in the control group (n=14; 11.3% [-27.4 to 50.0]). Reductions were not significantly different from control for participants assigned to the 0.0625 mg/kg dose group (n=16; 41.9% [1.4-82.5]; p=0.16) and the 0.125 mg/kg dose group (n=12; 54.9% [13.4-96.3]; p=0.096). No clinically meaningful or statistically significant drops in haemoglobin were recorded in any individual in the haemoglobin analysis (n=70) during follow-up. No serious adverse events were reported and adverse events did not differ between treatment groups. Interpretation A single dose of 0.25 mg/kg primaquine, given alongside dihydroartemisinin-piperaquine, was safe and efficacious for the prevention of P falciparum malaria transmission in boys and men who are not deficient in G6PD. Future studies should assess the safety of single-dose primaquine in G6PD-deficient individuals to define the therapeutic range of primaquine to enable the safe roll-out of community interventions with primaquine.Peer reviewe