Indebtedness and macroeconomic imbalances in a monetary-union DSGE model

We build a two-country open-economy monetary union DSGE model in order to explain some macroeconomic imbalances in the euro area. We fo cus on the role of cyclic al behaviour of public spending and sovereign risk premium. Pro-cyclical primary public expenditures in one country do not lead to higher interest rates on domestic public bonds in the short term as long as output growth helps financing public debt. Spillover effects on th e other country can be positive on output as long as a real effective depreciation of the common currency leads to higher exports to the rest of the world

Surpoids et obésité dans la population au-dessus de 20 ans en milieu urbain bamakois (Mali)

Introduction: il est question dans notre travail d'étudier le SP et l'OB et les facteurs associés dans la population âgée de 20 ans ou plus. Méthodes: notre échantillon a été obtenu à partir d'une enquête sur les pathologies cardiovasculaires dans le District de Bamako et impliquant 2199 sujets de 5-104 ans, en sélectionnant tous les sujets âgés d'au moins 20 ans (1162). Pour chaque sujet, l'IMC, rapport taille / hanche et le tour de taille ont été déterminées. Les données ont été analysées avec SPSS 12. Résultats: l'âge moyen était de 36,86 années, 61,4% étaient des femmes, 49,7% dans le secteur informel et 38,0% avaient réalisé l'enseignement primaire. Facteurs de risque cardiovasculaires étaient l'inactivité physique (72,4%), le tabagisme (12,2%) et hypertension (26,7%). La prévalence de l'obésité était de 8,8 et 14,7% respectivement sur la base de l'indice de masse et le tour de taille. Conclusion: le SP et l'OB sont à prendre en compte dans les mesures de politique sanitaire que dans la pratique quotidienne des professionnels de santé, il est peut-être plus utile d'utiliser plusieurs paramètres pour être à même de bien stratifier nos patients par rapport à leur risque

Evolutionary profile of patients with hemoglobin SC disease regularly followed in Côte d'Ivoire

Background: West Africa is recognized as the elective focus of hemoglobin C. The S and C combination in the same patient gives a major sickle cell syndrome. In our country, very few series dealing with the evolutionary features of this SC form have been published contrary to the homozygous SS form. The aim of this study was to describe the evolutionary profile of double heterozygous SC sickle cell patients.Methods: This was a retrospective and prospective study with descriptive and analytical purpose of 174 SC sickle cell patients.Results: The median age was 26 years with extremes of 6 years and 57 years. 96% of patients had less than 4 vaso-occlusive seizures per year. The evolutionary complications were mainly ischemic (56.30%) and infectious (39.10%). Among ischemic complications, sickle cell retinopathies and aseptic osteonecrosis are the most common with 59.20% and 31.63% respectively. Infectious complications were dominated by ENT (36.76%) and osteoarticular (35.29%) infections. Only age had an influence on the occurrence of ischemic complications (p = 0.0001). The probability of survival at 5 years was 99.38% and that at 20 years was 91.57%. The overall survival was not influenced by evolutionary complications.Conclusions: Infectious and ischemic evolutionary complications show the importance of vaccination and an early screening program

Hypertension and Associated Factors in Rural and Urban Areas Mali: Data from the STEP 2013 Survey

Background. Our study aims to estimate hypertension (HTN) prevalence and its predictors in rural and urban area. Methods. We conducted a cross-sectional population-based study involving subjects aged 15 to 65 years. Collected data (sociodemographic, blood pressure, weight, height, and blood glucose) were analyzed using SPSS version 20. A logistic regression was conducted to look for factors associated with HTN. Results. Mean was 47 years. High blood pressure (HBP) prevalence was 21.1 and 24.7%, respectively, in rural and urban setting. In rural area age group significantly predicted hypertension with age of 60 years having more-than-4-times risk of hypertension, whereas, in urban area age group, sex and body mass index were predictors with OR: HTN raising from 2.06 [1.24–3.43] for 30–44 years old to 7.25 [4.00–13.13] for 60 years and more using <30 years as reference. Female sex was protective with OR of 0.45 [0.29–0.71] and using normal weight as reference OR for overweight was 1.54 [1.04–2.27] and 2.67 [1.64–4.36] for obesity. Conclusion. Hypertension prevalence is high and associated factors were age group in rural area and age group, female sex, and body mass index in urban area

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Urethrovaginal Fistula in a 5-Year-Old Girl

Urethral fistulas are rare in girls. They occur most of the time during trauma. The case presented here is an iatrogenic fistula. The treatment was simple and consisted of a simple dissection and suture of urethra and vagina

Efectos macroeconómicos de la mutualización de la deuda en una unión monetaria

Des propositions de mise en place d’euro-obligations ont émergé pendant la crise de la zone euro. Leurs avantages et inconvénients ont été présentés au Parlement européen. Cependant, il n’y a pas eu une évaluation des effets macro­économiques de la mutualisation du risque souverain. Cet article a pour objet d’y contribuer. Nous construisons un modèle DSGE d’union monétaire à deux pays et comparons les évolutions macroéconomiques dans trois scénarios de mutualisation de la dette souveraine par rapport à un scénario de référence où les pays émettent leurs propres obligations nationales : 1) une mutualisation totale de la dette avec des euro-obligations peu risquées ; 2) une mutualisation totale de la dette avec des euro-obligations risquées ; et 3) une mutualisation partielle de la dette dans laquelle les euro-obligations sont sans risque parce que leur émission est plafonnée à 60 % du PIB des pays. D’après nos résultats, un pays qui augmenterait ses dépenses publiques pourrait préférer le premier scénario parce que le multiplicateur budgétaire serait le plus élevé (1,9 contre 1,8 dans le scénario de référence). Mais pour l’autre pays, les effets de ce choc seraient négatifs. La mutualisation partielle serait préférable pour ce dernier (avec un multiplicateur de 2,2 contre – 1 dans le scénario de référence). Au total, une mutualisation même partielle des dettes souveraines pourrait permettre de rapprocher les intérêts divergents des pays de la zone euro.Proposals for implementing Eurobonds emerged during the Euro area crisis. Pros and cons have been presented to the European Parliament.However, there has not been any assessment of the macroeconomic effects of pooling sovereign risk.This paper aims at filling the gap. We build a DSGE model of a two-country currency union and compare macroeconomic outcomes under three scenarios of sovereign debt pooling relative to a baseline scenario where countries issue their own national sovereign bonds: 1) full pooling of debt with low-risk Eurobonds; 2) full pooling of debt with risky Eurobonds; and 3) partial pooling of debt with risk-free Eurobonds because issuance of such bonds is limited to 60% of each country’s GDP.According to our results, a country that would increase its public spending would prefer the first scenario because the fiscal multiplier would be the highest (1,9 against 1,8 in the baseline scenario).However, for the other country, the effects of the shock would be negative.A partial pooling of sovereign debt would be preferable for the latter (with a multiplier of 2,2 against – 1 in the baseline scenario).All in all, a partial pooling could help reconcile diverging national interests among member countries of the Euro area.Durante la crisis de la zona del euro surgieron propuestas para la introducción de eurobonos. Sus ventajas y desventajas se presentaron al Parlamento Europeo. Sin embargo, no se han evaluado los efectos macroeconómicos de la mutualización del riesgo soberano. Este artículo pretende contribuir a ello. Construimos un modelo DSGE de una unión monetaria de dos países y comparamos la evolución macroeconómica en tres escenarios de puesta en común de la deuda soberana frente a un escenario de referencia en el que los países emiten sus propios bonos nacionales: 1) mutualización total de la deuda con eurobonos de bajo riesgo; 2) mutualización total de la deuda con eurobonos de riesgo; y 3) mutualización parcial de la deuda, en la que los eurobonos están libres de riesgo porque su emisión está limitada al 60% del PIB de los países. De acuerdo con nuestros resultados, un país que aumentara el gasto público podría preferir el primer escenario porque el multiplicador fiscal sería el más alto (1,9 frente a 1,8 en el escenario de referencia). Sin embargo, para el otro país, los efectos de este choque serían negativos. La mutualización parcial sería preferible para este último (con un multiplicador de 2,2 frente a -1 en el escenario de referencia). En definitiva, incluso una mutualización parcial de las deudas soberanas podría permitir conciliar los intereses divergentes de los países de la zona del euro

Sovereign Risk Premium and Divergent Fiscal Policies in a Monetary Union

Prime de risque de défaut souverain et orientation divergente des politiques During the euro area (EA) sovereign debt crisis, lenders in financial markets raised default risk premiums on sovereign bonds issued by countries that were then considered too risky. Among some of these countries (especially Greece), fiscal policy had not been implemented according to good practices. In particular, the lack of fiscal discipline stemmed from pro-cyclical public spending. The (over-) reaction of financial markets translated into a sharp increase in the level of long-term interest rates in crisis-hit countries. Consequently, these countries were confronted with severe difficulties in trying to reduce public indebtedness. Moreover, the cost of borrowing for the private sector increased. In this article, we study the effects of asymmetric shocks causing a rise in the sovereign risk premium of one country of a monetary union. We analyze their effects on the domestic country (the one hit by the shock) and the spillovers on the rest of the union (RoU). To do so, we build an open monetary union DSGE model in which member countries are different from one another with regard to the degree of fiscal discipline (pro-cyclical versus counter-cyclical fiscal behaviour). We show that such a model is suitable to explain the mechanisms underlying divergent macroeconomic performance across EA countries after the Greek sovereign debt crisis

Indebtedness and macroeconomic imbalances in a monetary-union DSGE model

We build a two-country open-economy monetary union DSGE model in order to explain some macroeconomic imbalances in the euro area. We fo cus on the role of cyclic al behaviour of public spending and sovereign risk premium. Pro-cyclical primary public expenditures in one country do not lead to higher interest rates on domestic public bonds in the short term as long as output growth helps financing public debt. Spillover effects on th e other country can be positive on output as long as a real effective depreciation of the common currency leads to higher exports to the rest of the world

Leprosy persistence in the health district of Kenieba despite its elimination as a public health problem at the national level in Mali

WHO defined leprosy elimination as reaching a prevalence &lt; 1 case of leprosy per 10,000 inhabitants. Mali eliminated the disease since 2001 but in 2011, it recorded 226 new cases. This has a serious involvement in term of disease spreading. Therefore, we undertook a cross sectional study in Kenieba health district, still above the WHO recommended elimination threshold to better understand the disease epidemiology and its associated potential factors. The study took place from October 2013 to September 2014. All consenting villagers, living in one of the selected villages were included and clinically examined for leprosy signs