A systematic review of empirical evidence on migration influenced by environmental change in Africa

BACKGROUND Despite an increase in scholarly and policy interests in the impacts of environmental and climate change on migration, empirical knowledge in the field remains varied, patchy and limited. Generalized discourse on migration influenced by environmental change frequently leads to an oversimplification of the complex channels through which environmental change influences the migration process. The role of environmental and climate change in driving migration reported in existing studies seems to vary from one extreme to the other ‒ from limited and rather indirect role to significant impacts ‒ preventing us from drawing a conclusive evidence. OBJECTIVE This paper seeks to systematize the existing empirical evidence on migration influenced by environmental change with a focus on Africa, the continent most vulnerable to climate change. METHODS We combine elements of a systematic evidence assessment with a more reflexive form of evidence-focused literature review. 53 qualitative and quantitative studies selected from the comprehensive “Climig database” on the influence of environmental change on migration are systematically analyzed based on the framework of the multi-dimensional drivers of migration. RESULTS Environmental change influences migration in Africa in an indirect way i.e. through affecting other drivers of migration including sociodemographic, economic and political factors. How and in what direction environmental change influences migration depends on socioeconomic and geographical contexts, demographic characteristics and type and duration of migration. CONCLUSIONS It is not possible to draw a universal conclusion whether environmental change will increase or suppress migration in Africa since it is context-specific. CONTRIBUTION The review provides a first systematic and comprehensive summary of empirical evidence on environmental driver of migration in Africa considering direct and indirect pathways through which environmental change influence internal and international migration

Esophageal atresia: data from a national cohort

PURPOSE: A prospective national register was established in 2008 to record all new cases of live-birth newborns with esophageal atresia (EA). This epidemiological survey was recommended as part of a national rare diseases plan. METHODS: All 38 national centers treating EA participated by completing for each patient at first discharge a questionnaire validated by a national committee of experts. Data were centralized by the national reference center for esophageal anomalies. Quantitative and qualitative analyses were performed, with P-values of less than 0.05 considered statistically significant. Results of the 2008-2009 data collection are presented in this report. RESULTS: Three hundred seven new living cases of EA were recorded between January 1, 2008, and December 31, 2009. The male/female sex ratio was 1.3, and the live-birth prevalence of EA was 1.8 per 10,000 births. Major characteristics were comparable to those reported in the literature. Survival was 95%, and no correlation with caseload was noted. CONCLUSIONS: Epidemiologic surveys of congenital anomalies such as EA, which is a rare disease, provide valuable data for public health authorities and fulfill one important mission of reference centers. When compared with previous epidemiological data, this national population-based registry suggests that the incidence of EA remains stable

Le diagnostic anténatal modifie-t-il la prise en charge néonatale et le devenir à 1 an des enfants suivis pour atrésie de l’œsophage de type III ?

OBJECTIVE: Evaluate neonatal management and outcome of neonates with either a prenatal or a post-natal diagnosis of EA type III. STUDY DESIGN: Population-based study using data from the French National Register for EA from 2008 to 2010. We compared children with prenatal versus post-natal diagnosis in regards to prenatal, maternal and neonatal characteristics. We define a composite variable of morbidity (anastomotic esophageal leaks, recurrent fistula, stenosis) and mortality at 1 year. RESULTS: Four hundred and eight live births with EA type III were recorded with a prenatal diagnosis rate of 18.1%. Transfer after birth was lower in prenatal subset (32.4% versus 81.5%, P<0.001). Delay between birth and first intervention was not significantly different. Defect size (2cm vs 1.4cm, P<0.001), gastrostomy (21.6% versus 8.7%, P<0.001) and length in neonatal unit care were higher in prenatal subset (47.9 days versus 33.6 days, P<0.001). The composite variables were higher in prenatal diagnosis subset (38.7% vs 26.1%, P=0.044). CONCLUSION: Despite the excellent survival rate of EA, cases with antenatal detection have a higher morbidity related to the EA type (longer gap). Even if it does not modify neonatal management and 1-year outcome, prenatal diagnosis allows antenatal parental counseling and avoids post-natal transfer

Movable genetic elements and antibiotic resistance in enterococci

The enterococci possess genetic elements able to move from one strain to another via conjugation. Certain enterococcal plasmids exhibit a broad host range among gram-positive bacteria, but only when matings are performed on solid surfaces. Other plasmids are more specific to enterococci, transfer efficiently in broth, and encode a response to recipient-produced sex phermones. Transmissible non-plasmid elements, the conjugative transposons, are widespread among the enterococci and determine their own fertility properties. Drug resistance, hemolysin, and bacteriocin determinants are commonly found on the various transmissible enterococcal elements. Examples of the different systems are discussed in this review.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47900/1/10096_2005_Article_BF01963632.pd