Rodent control strategies and Lassa virus: some unexpected effects in Guinea, West Africa.

The Natal multimammate mouse (Mastomys natalensis) is the host of Lassa mammarenavirus, causing Lassa haemorrhagic fever in West Africa. As there is currently no operational vaccine and therapeutic drugs are limited, we explored rodent control as an alternative to prevent Lassa virus spillover in Upper Guinea, where the disease is highly endemic in rural areas. In a seven-year experiment, we distributed rodenticides for 10-30 days once a year and, in the last year, added intensive snap trapping for three months in all the houses of one village. We also captured rodents both before and after the intervention period to assess their effectiveness by examining alterations in trapping success and infection rates (Lassa virus RNA and IgG antibodies). We found that both interventions reduced the rodent population by 74-92% but swiftly rebounded to pre-treatment levels, even already six months after the last snap-trapping control. Furthermore, while we observed that chemical control modestly decreased Lassa virus infection rates annually (a reduction of 5% in seroprevalence per year), the intensive trapping unexpectedly led to a significantly higher infection rate (from a seroprevalence of 28% before to 67% after snap trapping control). After seven years, we conclude that annual chemical control, alone or with intensive trapping, is ineffective and sometimes counterproductive in preventing Lassa virus spillover in rural villages. These unexpected findings may result from density-dependent breeding compensation following culling and the survival of a small percentage of chronically infected rodents that may spread the virus to a new susceptible generation of mice.

Evaluating the risk of conflict on recent Ebola outbreaks in Guinea and the Democratic Republic of the Congo.

BACKGROUND: Reducing Ebola virus transmission relies on the ability to identify cases and limit contact with infected bodily fluids through biosecurity, safe sex practices, safe burial and vaccination. Armed conflicts can complicate outbreak detection and interventions due to widespread disruption to governments and populations. Guinea and the Democratic Republic of the Congo (DRC) have historically reported the largest and the most recent Ebola virus outbreaks. Understanding if conflict played a role in these outbreaks may help in identifying key risks factors to improve disease control. METHODS: We used data from a range of publicly available data sources for both Ebola virus cases and conflict events from 2018 to 2021 in Guinea and the DRC. We fitted these data to conditional logistic regression models using the Self-Controlled Case Series methodology to evaluate the magnitude in which conflict increased the risk of reported Ebola virus cases in terms of incidence rate ratio. We re-ran the analysis sub-nationally, by conflict sub-event type and tested any lagged effects. RESULTS: Conflict was significantly associated with an increased risk of reported Ebola virus cases in both the DRC and Guinea in recent outbreaks. The effect was of a similar magnitude at 1.88- and 1.98-times increased risk for the DRC and Guinea, respectively. The greatest effects (often higher than the national values) were found in many conflict prone areas and during protest/riot-related conflict events. Conflict was influential in terms of Ebola virus risk from 1 week following the event and remained important by 10 weeks. CONCLUSION: Extra vigilance is needed following protests and riot-related conflict events in terms of Ebola virus transmission. These events are highly disruptive, in terms of access to transportation and healthcare and are often in urban areas with high population densities. Additional public health messaging around these types of conflict events, relating to the risks and clinical symptoms may be helpful in reducing transmission. Future work should aim to further understand and quantify conflict severity and intensity, to evaluate dose-response relationships in terms of disease risk.

Synthesis, optimization, and characterization of precipitation derived starch nanoparticles from guinea seeds.

Guinea starch nanoparticles (GS-SNP) were developed using ultrasound and nanoprecipitation techniques. The physicochemical, thermal, structural, morphological, pasting, and rheological properties of GS-SNP were examined and compared with native starch. The particle size of GS-SNP was 391.50-206.00 nm, with a PDI of 0.35-0.23 and a zeta potential of -37.5 to -13 mV. The amylose content of GS-SNP increased with a decrease in relative crystallinity, and a VH-type crystalline structure was observed. The GS-SNP were in round shape with some self-aggregated granules. The water and oil absorption capacity, solubility, and gelatinization temperature of GS-SNP increased, but the swelling power was restricted. The viscosity of the GS-SNP dispersion remained almost constant throughout the heating but slightly increased after cooling. A higher degree of shear thinning was observed due to a fluid-like gel network and weak gel structure. The optimum conditions were: 50 % amplitude, 30 min time, and a starch to ethanol ratio (1:4) with 85 % maximum desirability. Overall, the findings suggest that GS-SNP have promising potential for application in a liquid system where viscosity of the system cannot be significantly influenced by temperature.

Geographic Disparities in Domestic Pig Population Exposure to Ebola Viruses, Guinea, 2017-2019.

Although pigs are naturally susceptible to Reston virus and experimentally to Ebola virus (EBOV), their role in Orthoebolavirus ecology remains unknown. We tested 888 serum samples collected from pigs in Guinea during 2017-2019 (between the 2013-16 epidemic and its resurgence in 2021) by indirect ELISA against the EBOV nucleoprotein. We identified 2 hotspots of possible pig exposure by IgG titer levels: the northern coast had 48.7% of positive serum samples (37/76), and Forest Guinea, bordering Sierra Leone and Liberia, where the virus emerged and reemerged, had 50% of positive serum samples (98/196). The multitarget Luminex approach confirms ELISA results against Ebola nucleoprotein and highlights cross-reactivities to glycoprotein of EBOV, Reston virus, and Bundibugyo virus. Those results are consistent with previous observations of the circulation of Orthoebolavirus species in pig farming regions in Sierra Leone and Ghana, suggesting potential risk for Ebola virus disease in humans, especially in Forest Guinea.

Freshwater macroinvertebrates along the Nigeria-Cameroon border enhance the conservation value of the lower Guinea forest biodiversity hotspot.

In Nigeria and tropical Africa, the bias towards the protection of natural sites on account of terrestrial biodiversity or their resultant ecosystem services has led to a considerably low number of freshwater conservation studies in the region. To close this gap, six lotic freshwater systems in three different natural sites (Obudu Mountains, Agbokim Waterfalls, and Cross River National Park) along the Cameroon border of Nigeria were evaluated for the biodiversity of macroinvertebrates and some aspects of water quality in December 2021 and March 2022. Among other macroinvertebrate-related indices, the community conservation index (CCI), which considers the presence of threatened, rare, and notable species, was used for the conservation evaluation of the freshwater systems. The Ephemeroptera-Plecoptera-Trichoptera (EPT) species were notably rich at the sites, with over 12 species each at the Afundu Stream, Kwa River, Cataract Stream, and Agbokim River. All of the sites had a very high conservation value, according to the CCI, which was greater than 20. Some Obudu sites (Grotto and Becheve streams), despite having fewer EPT taxa, had higher CCI than the Kwa or Agbokim River. This was due to the presence of the endangered damselflies (Africocypha centripunctata and Allocnemis vicki) at the Obudu sites and a rare mayfly species in Nigeria (Tricorythus tinctus), which was reported at Agbokim and Kwa Rivers. The presence of a notable damselfly genus (Pentaphlebia) at the Afundu stream of the Obudu Mountains also raises some hope that the critically endangered damselfly (Pentaphlebia gamblesi), whose adult was last seen in 1973, could still be alive at the site. Canonical Correspondence Analysis revealed that the proportion of scrapers had a strong association with high BOD and EC in Agbokim River, while the Becheve and Grotto streams which had high vegetal cover was positively associated with shredders. Also, increasing DO in Afundu Stream, Kwa River and Cataract Stream was positively associated with EPT richness. This study revealed that more freshwater ecological studies need to be conducted at isolated natural sites and protected areas in Africa. Findings from such studies have implications for preserving freshwater ecosystems of high conservation value from the various threats that characterize the Anthropocene.

Genomic characterization of SARS-CoV-2 in Guinea, West Africa.

SARS-CoV-2 has claimed several million lives since its emergence in late 2019. The ongoing evolution of the virus has resulted in the periodic emergence of new viral variants with distinct fitness advantages, including enhanced transmission and immune escape. While several SARS-CoV-2 variants of concern trace their origins back to the African continent-including Beta, Eta, and Omicron-most countries in Africa remain under-sampled in global genomic surveillance efforts. In an effort to begin filling these knowledge gaps, we conducted retrospective viral genomic surveillance in Guinea from October 2020 to August 2021. We found that SARS-CoV-2 clades 20A, 20B, and 20C dominated throughout 2020 until the coincident emergence of the Alpha and Eta variants of concern in January 2021. The Alpha variant remained dominant throughout early 2021 until the arrival of the Delta variant in July. Surprisingly, despite the small sample size of our study, we also found the persistence of the early SARS-CoV-2 clade 19B as late as April 2021. Together, these data help fill in our understanding of the SARS-CoV-2 population dynamics in West Africa early in the COVID-19 pandemic.

PASQUALE - A long-term partnership to improve hand hygiene and capacity building in infection prevention and control in the Faranah region of Guinea.

Across the globe, hand hygiene (HH) is promoted to fight the spread of healthcare associated infections. Despite multiple ongoing HH campaigns and projects, the healthcare associated infection rates remain high especially in low- and middle-income countries. In the narrative overview presented here, we aim to share objectives, framework, successes and challenges of our long-term partnership in Guinea to offer guidance for other projects aiming to sustainably improve HH.

The economic burden of Ebola virus disease: a review and recommendations for analysis.

BACKGROUND: Ebola virus disease (EVD) continues to be a major public health threat globally, particularly in the low-and-middle-income countries (LMICs) of Africa. The social and economic burdens of EVD are substantial and have triggered extensive research into prevention and control. We aim to highlight the impact and economic implications, identify research gaps, and offer recommendations for future economic studies pertaining to EVD. METHOD: We conducted a comprehensive librarian-led search in PubMed/Medline, Embase, Google Scholar, EconLit and Scopus for economic evaluations of EVD. After study selection and data extraction, findings on the impact and economics of EVD were synthesized using a narrative approach, while identifying gaps, and recommending critical areas for future EVD economic studies. RESULTS: The economic evaluations focused on the burden of illness, vaccine cost-effectiveness, willingness-to-pay for a vaccine, EVD funding, and preparedness costs. The estimated economic impact of the 2014 EVD outbreak in Guinea, Liberia, and Sierra Leone across studies ranged from $30 billion to $50 billion. Facility construction and modification emerged as significant cost drivers for preparedness. The EVD vaccine demonstrated cost-effectiveness in a dynamic transmission model; resulting in an incremental cost-effectiveness ratio of about $96 per additional disability adjusted life year averted. Individuals exhibited greater willingness to be vaccinated if it incurred no personal cost, with a minority willing to pay about $1 for the vaccine. CONCLUSIONS: The severe impact of EVD puts pressure on governments and the international community for better resource utilization and re-allocation. Several technical and methodological issues related to economic evaluation of EVD remain to be addressed, especially for LMICs. We recommend conducting cost-of-sequelae and cost-of-distribution analyses in addition to adapting existing economic analytical methods to EVD. Characteristics of the affected regions should be considered to provide evidence-based economic plans and economic-evaluation of mitigations that enhance resource allocation for prevention and treatment.

Ebola virus disease (EVD) is a serious health problem, not only in Africa where there have been outbreaks but in other parts of the world as well. In addition to its severe health implications and resultant death, EVD also poses significant impact across several sectors, including food and agriculture, transportation, education, among others, ultimately impacting the economies of affected countries. While some studies have estimated the economic burden of EVD, there remains questions that need addressing. We conducted a review of published studies to estimate what is known about the economic burden of EVD, identified research gaps. Studies looked at how much money EVD costs in terms of prevention and treatment, while others reported on people's willingness to pay for a vaccine. The estimated economic impact of the 2014 EVD outbreak in Guinea, Liberia, and Sierra Leone ranged from approximately $30 billion to $50 billion across studies. Healthcare facility construction and modification were significant cost factors for response preparedness for EVD outbreaks. While the EVD vaccine showed cost-effectiveness, surveys of people across various regions revealed that more individuals were willing to get vaccinated if it was free, with a minority willing to pay a median of about $1 for the vaccine. The severe impact of EVD puts pressure on governments and the international community to use resources more efficiently. We recommend conducting analyses on the costs of long-term effects of EVD and costs of vaccine and treatment distribution, as well as adapting existing economic methods to the specific characteristics of affected regions. This would help create evidence-based economic plans and evaluations of strategies to enhance resource allocation for EVD prevention and treatment.

SARS-CoV-2 seroprevalence in vaccine-naïve participants from the Democratic Republic of Congo, Guinea, Liberia, and Mali.

OBJECTIVES: The InVITE study, starting in August 2021, was designed to examine the immunogenicity of different vaccine regimens in several countries including the Democratic Republic of Congo, Guinea, Liberia, and Mali. Prevaccination baseline samples were used to obtain estimates of previous SARS-CoV-2 infection in the study population. METHODS: Adult participants were enrolled upon receipt of their initial COVID-19 vaccine from August 2021 to June 2022. Demographic and comorbidity data were collected at the time of baseline sample collection. SARS-CoV-2 serum anti-Spike and anti-Nucleocapsid antibody levels were measured. RESULTS: Samples tested included 1016, 375, 663, and 776, from DRC, Guinea, Liberia, and Mali, respectively. Only 0.8% of participants reported a prior positive SARS-CoV-2 test, while 83% and 68% had anti-Spike and anti-Nucleocapsid antibodies, respectively. CONCLUSIONS: Overall SARS-CoV-2 seroprevalence was 86% over the accrual period, suggesting a high prevalence of SARS-CoV-2 infection. Low rates of prior positive test results may be explained by asymptomatic infections, limited access to SARS-CoV-2 test kits and health care, and inadequate surveillance. These seroprevalence rates are from a convenience sample and may not be representative of the population in general, underscoring the need for timely, well-conducted surveillance as part of global pandemic preparedness.

Valorization of guinea grass seed (Megathyrsus maximus): Synthesis and utilization of cellulose microfiber to reinforce esterified and cross-linked guinea starch films.

The present study extracts starch from guinea grass seed and fiber from the starch extraction residue. The fibrous residue was chemically converted into cellulose microfiber (CMF) and used to reinforce the native, esterified and crosslinked guinea starch films. The films were developed with 5 % starch, 40 % glycerol and 0, 2.5, 5, and 10 % CMF based on the dry matter of starch. SEM images of all film samples showed good compatibility of CMF with starch molecules, and no fractures or pores were observed. Adding filler materials to modified starch films slightly increased the film thickness (0.24 to 0.30 mm) due to the high dimensions of CMF, which comprise a significant amount of the composite's volume. A synergetic effect of starch modification and CMF in films decreased the moisture content (21.98 to 9.21 %), water solubility (25.65 to 15.47 %), water vapor permeability (6.96×10-7 to 1.65×10-7g∙mm2∙day∙Pa), and elongation at the break (33.51 to 16.79 %) while increasing the tensile strength (1.84 to 3.85 MPa) and Young's modulus (5.49 to 22.93 MPa). The L* and a* values of the films decreased, and the b* and opacity values of the films increased with the addition of CMF. The XRD graph showed that all films have semicrystalline structures with peaks at 18°, 20°, and 22°, and the degree of crystallinity increases (32.3 to 55.1 %) with CMF. All film samples showed good thermal stability up to 315 °C. In conclusion, esterified starch-based films exhibited superior barrier properties and flexibility. On the contrary, cross-linked starch films demonstrated higher tensile strength and lower water solubility.

Viral etiology of measles-like rash in Guinean children during the COVID epidemic in 2022.

Covid-19 in West Africa masked outbreaks of vaccine-preventable diseases such as the measles epidemic in children in Guinea in 2021-2022 characterized by a lack of confirmation of suspected clinical cases. During weeks 13-22 of 2022, saliva samples were collected from 213 children (3-60 months old) with measles-like symptoms within the St Gabriel dispensary in Conakry. Samples were processed in Virus Transport Medium (VTM) and tested on the same day by triplex reverse transcriptase -real-time polymerase chain reaction for Measles, Rubella and RNaseP. Samples were also tested for HHV6 and Parvovirus B19, viruses causing clinical signs similar to measles. We confirmed 146 (68.5%) measles cases, 27 (12.7%) rubella, 5 (2.3%) double-positive measles-rubella, 35 (16.4%) HHV-6 and 8 (3.75%) Parvovirus B19. To test the assay's robustness, 27 samples were kept at 26-30°C. Measles and rubella were still detected after 7 days at 26-30°C, and after 21 days measles and rubella were still detectable in all samples but one. Sequencing indicated the circulation of the B3 measles genotype, as expected in West Africa. This study highlights the robustness of the measles/rubella diagnostic test on saliva samples stored in VTM. The high level of rubella detection questioned the single valence measles vaccination strategy.

Perspectives and experiences of healthcare providers on the response to the COVID-19 pandemic in three maternal and neonatal referral hospitals in Guinea in 2020: a qualitative study.

BACKGROUND: The COVID-19 pandemic has adversely affected access to essential healthcare services. This study aimed to explore healthcare providers' perceptions and experiences of the response to the COVID-19 pandemic in three referral maternal and neonatal hospitals in Guinea. METHODS: We conducted a longitudinal qualitative study between June and December 2020 in two maternities and one neonatology referral ward in Conakry and Mamou. Participants were purposively recruited to capture diversity of professional cadres, seniority, and gender. Four rounds of in-depth interviews (46 in-depth interviews with 18 respondents) were conducted in each study site, using a semi-structured interview guide that was iteratively adapted. We used both deductive and inductive approaches and an iterative process for content analysis. RESULTS: We identified four themes and related sub-themes presented according to whether they were common or specific to the study sites, namely: 1) coping strategies & care reorganization, which include reducing staffing levels, maintaining essential healthcare services, suspension of staff daily meetings, insertion of a new information system for providers, and co-management with COVID-19 treatment center for caesarean section cases among women who tested positive for COVID-19; 2) healthcare providers' behavior adaptations during the response, including infection prevention and control measures on the wards and how COVID-19-related information influenced providers' daily work; 3) difficulties encountered by providers, in particular unavailability of personal protective equipment (PPE), lack of financial motivation, and difficulties reducing crowding in the wards; 4) providers perceptions of healthcare service use, for instance their fear during COVID-19 response and perceived increase in severity of complications received and COVID-19 cases among providers and parents of newborns. CONCLUSION: This study provides insights needed to be considered to improve the preparedness and response of healthcare facilities and care providers to future health emergencies in similar contexts.

Malaria trends in districts that were targeted and not-targeted for seasonal malaria chemoprevention in children under 5 years of age in Guinea, 2014-2021.

BACKGROUND: Seasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3-59 months (CU5) in districts with high and seasonal malaria transmission. OBJECTIVE: We assessed the programmatic impact of SMC in Guinea's context of scaled up malaria intervention programming by comparing malaria-related outcomes in 14 districts that had or had not been targeted for SMC. METHODS: Using routine health management information system data, we compared the district-level monthly test positivity rate (TPR) and monthly uncomplicated and severe malaria incidence for the whole population and disaggregated age groups (<5 years and ≥5 years of age). Changes in malaria indicators through time were analysed by calculating the district-level compound annual growth rate (CAGR) from 2014 to 2021; we used statistical analyses to describe trends in tested clinical cases, TPR, uncomplicated malaria incidence and severe malaria incidence. RESULTS: The CAGR of TPR of all age groups was statistically lower in SMC (median=-7.8%) compared with non-SMC (median=-3.0%) districts. Similarly, the CAGR in uncomplicated malaria incidence was significantly lower in SMC (median=1.8%) compared with non-SMC (median=11.5%) districts. For both TPR and uncomplicated malaria incidence, the observed difference was also significant when age disaggregated. The CAGR of severe malaria incidence showed that all age groups experienced a decline in severe malaria in both SMC and non-SMC districts. However, this decline was significantly higher in SMC (median=-22.3%) than in non-SMC (median=-5.1%) districts for the entire population, as well as both CU5 and people over 5 years of age. CONCLUSION: Even in an operational programming context, adding SMC to the malaria intervention package yields a positive epidemiological impact and results in a greater reduction in TPR, as well as the incidence of uncomplicated and severe malaria in CU5.

The factors associated with contraceptive use among young female students in rural Guinea / Facteurs associés à l'utilisation des méthodes contraceptives chez les jeunes filles élèves en milieu rural guinéen

Introduction: The low use of modern contraceptive methods by young girls is a real public health problem in sub-Saharan Africa, especially among young female students living in rural areas. The purpose of this study was to analyze the factors associated with contraceptive use among young female students in rural Guinea. Method: This was an analytical cross-sectional study including 607 students from 10 secondary schools in the rural district of Kankan, Guinea. Results: A total of 607 female students were interviewed and included in this study. They had an average age of 17.3 ± 1.7 years, 50.9% were in junior high school, and 49.1% were in high school. During our survey period, 67.7% of the girls reported being sexually active, while only 24.4% were on modern contraception. In the bivariate analysis, factors such as age, religion, school level, having heard of contraception, and having had sexual intercourse were statistically associated with contraceptive use. In the multivariate analysis, factors such as age (OR = 2.1; CI = 1.1­3.8), religion (OR = 5.1; CI = 2.8­9.5), and having had sexual intercourse (OR = 2.2; CI = 1.4­3.5) remained statistically associated with the use of contraceptive methods among young female students. Conclusion: Our study highlights the need to increase awareness of, and access to, contraceptive methods in schools in order to improve contraceptive practice and, in turn, to reduce the frequency of unwanted and early pregnancies among young female students in rural areas of Guinea.

Introduction: La faible utilisation des méthodes contraceptives modernes par les jeunes filles constitue un véritable problème de santé publique en Afrique subsaharienne, en particulier chez les jeunes filles élèves et résidant en milieu rural. Cette étude visait à analyser les facteurs associés à l'utilisation des méthodes contraceptives chez les jeunes filles élèves en milieu rural guinéen. Méthodes: Il s'agissait d'une étude transversale analytique incluant 607 élèves de 10 écoles secondaires du district rural de Kankan en Guinée. Résultats: Au total, 607 jeunes filles élèves ont été interrogées et incluses dans cette étude. Leur moyenne d'âge était de 17,3 ± 1,7 ans, 50,9 % d'entre elles fréquentaient le collège et 49,1 % le lycée. Pendant notre période d'enquête, 67,7 % des jeunes filles ont déclaré être sexuellement actives alors que seules 24,4 % étaient sous contraception moderne. En analyse bivariée, les facteurs comme l'âge, la religion, le niveau scolaire, avoir déjà entendu parler de contraception et avoir déjà eu un rapport sexuel étaient statistiquement associés à l'utilisation de méthodes contraceptives. En analyse multivariée, les facteurs comme l'âge (RCa = 2,1 ; IC = 1,1-3,8), la religion (RCa = 5,1 ; IC = 2,8-9,5) et avoir déjà eu un rapport sexuel (RCa = 2,2 ; IC = 1,4-3,5) restaient statistiquement associés à l'utilisation de méthodes contraceptives chez les jeunes filles en milieu scolaire. Conclusion: Notre étude souligne le besoin de renforcer la sensibilisation et l'accès aux méthodes contraceptives en milieu scolaire en vue d'améliorer la pratique contraceptive, et par ricochet réduire la fréquence des grossesses non désirées et précoces chez les jeunes filles élèves en milieu rural guinéen.

Prevalence and factors associated with intention to use contraceptives among women of reproductive age: a multilevel analysis of the 2018 Guinea demographic and health survey.

BACKGROUND: Contraceptive use is a key indicator of improving the health and well-being of women, mothers and their families, preventing unwanted pregnancies, and reducing maternal and child mortalities. Despite a lot of investments from the Government of Guinea to improve contraceptive use, studies reveal that contraceptive use still remains low in Guinea. However, the intention to use contraceptives in Guinea has not been well examined. Therefore, this study seeks to examine the factors associated with the intention to use contraceptives among women of reproductive age in Guinea. METHODS: The study made use of data from the Guinea Demographic and Health Survey (GNDHS) conducted in 2018. For this study, we included a weighted sample of 6,948 women who were either married or cohabiting and responded to all the variables of interest. The data were analyzed using Stata version 14.2. Descriptive and multilevel logistic regression were carried out to examine the factors associated with the intention to use contraceptives. The results of multilevel logistic regression were presented using adjusted odds ratios at 95% confidence intervals and p-value < 0.05 to determine the significant associations. RESULTS: The prevalence of intention-to-use contraceptives among women was 19.8% (95% CI18.3%-21.5%). Women with secondary/higher educational levels [aOR = 1.58, 95% CI = 1.26-1.99], women whose partners had secondary/higher educational level [aOR = 1.26, 95% CI = 1.04-1.52], women who were cohabiting [aOR = 1.74, 95% CI = 1.13-2.68] and were exposed to mass media [aOR = 1.60, 95% CI = 1.35-1.89] were likely to have higher intentions to use contraceptives. Additionally, women from the Kankan Region [aOR = 4.26, 95% CI = 2.77-6.54] and women who belong to the richer wealth quintile [aOR = 1.36, 95% CI = 0.91-1.89] were likely to have higher odds of intentions to use contraceptives. However, women aged 45-49 years, those from the Peulh ethnic group, and those who lack the competence to make healthcare decisions alone had lower odds of intention to use contraceptives. CONCLUSION: The study revealed a low prevalence of intention to use contraceptives among women of reproductive age in Guinea. The study has highlighted that both individual-level and household/community-level factors were significantly associated with the intention to use contraceptives. Therefore, policymakers and stakeholders need to consider these factors discussed in this paper when developing policies and interventions to promote and enhance intention-to-use contraceptives among women of reproductive age in Guinea. The findings call on the Government of Guinea and all stakeholders in Guinea to ensure that female education is promoted to help improve their social status, decision-making on fertility, and reduce fertility rates and maternal mortality.

Higher local Ebola incidence causes lower child vaccination rates.

Ebola is a highly infectious and often fatal zoonotic disease endemic to West and Central Africa. Local outbreaks of the disease are common, but the largest recorded Ebola epidemic originated in Guinea in December 2013, spreading to Liberia, and Sierra Leone in the following year and lasting until April 2016. The epidemic presented a serious challenge to local healthcare systems and foreign aid agencies: it degraded services, caused the loss of healthcare professionals, disrupted the economy, and reduced trust in modern healthcare. This study aims to estimate the extent to which variation in one long-term measure of the quality of local healthcare (the child vaccination rate) is a consequence of local variation in the intensity of the epidemic. Applying a "difference-in-differences" model to household survey data from before and after the epidemic, we show that in 2018-2019, overall rates of vaccination for BCG, DPT, measles, and polio are lower in Guinean and Sierra Leonean districts that had a relatively high incidence of Ebola; statistical analysis indicates that this is a causal effect. The effects of the epidemic on access to healthcare have been local effects, at least in part.

Nitrate fertilization enhances manganese phytoextraction in Tanzania guinea grass: a novel hyperaccumulator plant?

Manganese (Mn) is essential for plants but very toxic at high rates. However, hyperaccumulators can tolerate high Mn concentrations in plant tissue, especially when properly fertilized with N. Tanzania guinea grass (Megathyrsus maximus Jacq.) has been indicated as metal tolerant and a good candidate for Mn phytoextraction due to its fast growth and high biomass. The objective was to evaluate the Mn hyperaccumulator potential of Tanzania guinea grass grown as affected by proportions of nitrate/ammonium (NO3-/NH4+). An experiment in a growth chamber with nutrient solution, combining NO3-/NH4+ proportions (100/0 and 70/30) and Mn rates (10, 500, 1500, and 3000 µmol L-1), was carried out. The highest Mn concentration was verified in plants grown with 100/0 NO3-/NH4+ and Mn at 3000 µmol L-1, reaching up to 5500 and 21,187 mg kg-1 in shoots and roots, respectively, an overall concentration of 13,345 mg kg-1. These numbers are typically seen in hyperaccumulators. At that combination, Mn accumulation in shoots was also the highest, reaching up to 76.2 mg per pot, a phytoextraction rate of 23.1%. Excess Mn increased both H2O2 concentration in roots and non-photochemical quenching and therefore decreased net photosynthesis, stomatal conductance, electron transport rate, and photochemical quenching. Nevertheless, proline concentration in roots affected by excess Mn was high and indicates its important role for mitigating stress since Mn rates did not even affect the dry biomass. Tanzania guinea grass is highly tolerant to excess Mn as much as a hyperaccumulator. However, to show all its potential, the grass needs to be supplied with N as NO3-. We indicate Tanzania guinea grass as a Mn hyperaccumulator plant.

A study of land use changes and its impacts on flood inundation in the Konkoure River Basin, Republic of Guinea.

Due to rising land development, mitigating the negative effects of land use change is becoming a problem. Understanding how land development affects flood inundation is critical for long-term water resource management. This study evaluates the land use change in the Konkoure River Basin and its impact on flood inundation. The land use changes were assessed using Landsat image (level 1) in August 2006 and August 2021. In addition, we used GIS and remote sensing applications to assess the degree of changes that took place in the Konkoure watershed. According to the findings, 32.16% of the total area became built-up areas, and 35.51% was converted to other land uses in Konkoure watershed. Konkoure's most significant change is that 29.50% of forest area transformed into built-up areas and other land uses. The rainfall-runoff-inundation model (RRI) based inundation of the Konkoure River Basin was compared to the MODIS extent between 31 August 2006 and 30 August 2021 flood events. Flood inundation variations in the Konkoure watershed were studied in terms of inundation area, peak inundation depth, runoff volume, and the infiltration rate. As a result, the flood inundation area increased from 139.98 to 198.72 km2 and the infiltration rate decrease from 7 to 5 mm/h. Moreover, we used flow duration curves (FDCs) to fully comprehend the streamflow processes. The result indicates that the Konkoure watershed has experienced flooding partly due to land use change.

Analysis of cardiovascular risk factors: a retrospective epidemiological study in Guinea in 2022.

OBJECTIVE: This study presents a comprehensive descriptive and comparative analysis of a Guinean cohort, focusing on geographical variables and medical histories in relation to family backgrounds and cardiovascular risk scores. The primary goal is to enhance understanding of cardiovascular risk factor distribution within the Guinean population and identify significant correlations among the investigated variables. PATIENTS & METHODS: In this retrospective study, data from 2435 Guinean patients in 2022 were analyzed based on demographic and medical variables. Cardiovascular risk scores were calculated following Guinea's national program guidelines for non-communicable disease prevention and control. Rigorous data collection, including retrospective analyses and screening campaigns, was conducted in collaboration with the Fondation pour le Diabète et les Maladies Non Transmissibles de Conakry. Statistical tests, including one-way ANOVA, Kruskal-Wallis, Pearson Chi², V Cramer, Fisher exact, and Mann-Whitney U, were applied for a comprehensive comparative analysis. RESULTS: Analysis across five cardiovascular risk score levels revealed significant variations in gender, region, and tuberculosis prevalence. Gender differences were notable, with a female predominance in both groups, slightly higher in the 10 % or more risk group. The higher-risk group exhibited a greater proportion of fasting blood glucose measurements. CONCLUSIONS: Effectively assessing and managing hypertension, diabetes, and other pathologies requires considering factors such as geographic area, family history, cardiovascular risk score, and gender for accurate evaluation. These factors influence pathology prevalence and should be considered in individualized prevention and management strategies. The study underscores the importance of tailored measures to enhance disease management and reduce associated risks.

Predictors of Death in Rifampicin Resistant Tuberculosis Patients Treated with the Short Course in Conakry, Guinea.

The emergence of rifampicin-resistant tuberculosis (RR-TB) is a major issue for TB control programs due to high risk of treatment failure and death. The objective of this study was to describe survival and to determine predictors of death in RR-TB patients treated with the short regimen (9-11 months) in the Conakry TB treatment centers. Sociodemographic, clinical, and survival data were collected prospectively between 2016 and 2021 on RR-TB patients in the Department of Pneumo-Phtisiology, the Carrière and the Tombolia TB centers. The Kaplan-Meier method was used to estimate the cumulative incidence of death of patients. The Cox regression model was used to identify the predictors independently associated with death. Of 869 patients, 164 (18.9%) patients died during treatment, 126 of them within 120 days of treatment initiation. The factors associated with death during treatment were as follows: patients treated in the Carrière TB center (adjusted hazard ratio [aHR] = 1.65; 95% CI: 1.06-2.59) and in the Department of Pneumo-Phtisiology (aHR = 3.26; 95% CI: 2.10-5.07), patients ≥ 55 years old (aHR = 4.80; 95% CI: 2.81-8.19), patients with no history of first-line TB treatment (aHR = 1.51; 95% CI: 1.05-2.16), and patients living with HIV (aHR = 2.81; 95% CI: 1.94-4.07). The results of this study can help the national TB control program to reconsider its therapeutic strategy to improve patient care in case of RR-TB. Large prospective clinical studies should be conducted to provide evidence of the impact of such factors like previous history of TB treatment and HIV infection on survival of RR-TB patients.