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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.
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Ebolavirus , Doença pelo Vírus Ebola , Humanos , Suínos , Animais , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/veterinária , Guiné/epidemiologia , Sus scrofa , Serra Leoa/epidemiologia , Nucleoproteínas/genéticaRESUMO
During 1979-2022, Cameroon recorded 32 laboratory-confirmed mpox cases among 137 suspected mpox cases identified by the national surveillance network. The highest positivity rate occurred in 2022, indicating potential mpox re-emergence in Cameroon. Both clade I (n = 12) and clade II (n = 18) monkeypox virus (MPXV) were reported, a unique feature of mpox in Cameroon. The overall case-fatality ratio of 2.2% was associated with clade II. We found mpox occurred only in the forested southern part of the country, and MPXV phylogeographic structure revealed a clear geographic separation among concurrent circulating clades. Clade I originated from eastern regions close to neighboring mpox-endemic countries in Central Africa; clade II was prevalent in western regions close to West Africa. Our findings suggest that MPXV re-emerged after a 30-year lapse and might arise from different viral reservoirs unique to ecosystems in eastern and western rainforests of Cameroon.
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Monkeypox virus , Mpox , Humanos , Camarões/epidemiologia , Monkeypox virus/genética , Ecossistema , Mpox/epidemiologia , África Ocidental/epidemiologiaRESUMO
Next-generation phenotyping (NGP) can be used to compute the similarity of dysmorphic patients to known syndromic diseases. So far, the technology has been evaluated in variant prioritization and classification, providing evidence for pathogenicity if the phenotype matched with other patients with a confirmed molecular diagnosis. In a Nigerian cohort of individuals with facial dysmorphism, we used the NGP tool GestaltMatcher to screen portraits prior to genetic testing and subjected individuals with high similarity scores to exome sequencing (ES). Here, we report on two individuals with global developmental delay, pulmonary artery stenosis, and genital and limb malformations for whom GestaltMatcher yielded Cornelia de Lange syndrome (CdLS) as the top hit. ES revealed a known pathogenic nonsense variant, NM_133433.4: c.598C>T; p.(Gln200*), as well as a novel frameshift variant c.7948dup; p.(Ile2650Asnfs*11) in NIPBL. Our results suggest that NGP can be used as a screening tool and thresholds could be defined for achieving high diagnostic yields in ES. Training the artificial intelligence (AI) with additional cases of the same ethnicity might further increase the positive predictive value of GestaltMatcher.
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Síndrome de Cornélia de Lange , Fenótipo , Humanos , Síndrome de Cornélia de Lange/genética , Síndrome de Cornélia de Lange/diagnóstico , Síndrome de Cornélia de Lange/patologia , Masculino , Feminino , Criança , Nigéria , Pré-Escolar , Proteínas de Ciclo Celular/genética , Sequenciamento do Exoma , Testes Genéticos/métodos , Sequenciamento de Nucleotídeos em Larga Escala , LactenteRESUMO
The magnitude of the HIV-1 epidemic in Nigeria is second only to the subtype C epidemic in South Africa, yet the subtypes prevalent in Nigeria require further characterization. A panel of 50 subtype G and 18 CRF02_AG Nigerian HIV-1 pseudoviruses (PSV) was developed and envelope coreceptor usage, neutralization sensitivity and cross-clade reactivity were characterized. These PSV were neutralized by some antibodies targeting major neutralizing determinants, but potentially important differences were observed in specific sensitivities (eg. to sCD4, MPER and V2/V3 monoclonal antibodies), as well as in properties such as variable loop lengths, number of potential N-linked glycans and charge, demonstrating distinct antigenic characteristics of CRF02_AG and subtype G. There was preferential neutralization of the matched CRF/subtype when PSV from subtype G or CRF02_AG were tested using pooled plasma. These novel Nigerian PSV will be useful to study HIV-1 CRF- or subtype-specific humoral immune responses for subtype G and CRF02_AG.
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Anticorpos Neutralizantes , Anticorpos Anti-HIV , Infecções por HIV , HIV-1 , Testes de Neutralização , HIV-1/imunologia , HIV-1/genética , HIV-1/classificação , Nigéria , Anticorpos Neutralizantes/imunologia , Anticorpos Neutralizantes/sangue , Humanos , Anticorpos Anti-HIV/imunologia , Anticorpos Anti-HIV/sangue , Infecções por HIV/imunologia , Infecções por HIV/virologia , Produtos do Gene env do Vírus da Imunodeficiência Humana/imunologia , Produtos do Gene env do Vírus da Imunodeficiência Humana/genética , Reações Cruzadas/imunologiaRESUMO
Seabirds interact with fishing vessels to consume fishing discards and baits, sometimes resulting in incidental capture (bycatch) and the death of the bird, which has clear conservation implications. To understand seabird-fishery interactions at large spatiotemporal scales, researchers are increasing their use of simultaneous seabird and fishing vessel tracking. However, vessel tracking data can contain gaps due to technical problems, illicit manipulation, or lack of adoption of tracking monitoring systems. These gaps might lead to underestimating the fishing effort and bycatch rates and jeopardize the effectiveness of marine conservation. We deployed bird-borne radar detector tags capable of recording radar signals from vessels. We placed tags on 88 shearwaters (Calonectris diomedea, Calonectris borealis, and Calonectris edwardsii) that forage in the northwestern Mediterranean Sea and the Canary Current Large Marine Ecosystem. We modeled vessel radar detections registered by the tags in relation to gridded automatic identification system (AIS) vessel tracking data to examine the spatiotemporal dynamics of seabird-vessel interactions and identify unreported fishing activity areas. Our models showed a moderate fit (area under the curve >0.7) to vessel tracking data, indicating a strong association of shearwaters to fishing vessels in major fishing grounds. Although in high-marine-traffic regions, radar detections were also driven by nonfishing vessels. The tags registered the presence of potential unregulated and unreported fishing vessels in West African waters, where merchant shipping is unusual but fishing activity is intense. Overall, bird-borne radar detectors showed areas and periods when the association of seabirds with legal and illegal fishing vessels was high. Bird-borne radar detectors could improve the focus of conservation efforts.
Uso de radares en aves para analizar las interacciones de las pardelas con las pesquerías legales e ilegales Resumen Las aves marinas interactúan con los barcos pesqueros para consumir los cebos y lo que descartan, lo que a veces resulta en la captura accesoria y la muerte del ave, por lo que esto tiene implicaciones claras para la conservación. Los investigadores cada vez usan más el rastreo simultáneo de las aves marinas y los barcos pesqueros para comprender las interacciones aves marinas pesquerías a gran escala espaciotemporal. Sin embargo, los datos del rastreo de barcos pueden incluir vacíos por problemas técnicos, manipulación ilícita o porque no adoptan sistemas para monitorear el rastreo. Estos vacíos pueden llevar a subestimar el esfuerzo de pesca y las tasas de captura accesoria y a comprometer la efectividad de la conservación marina. Desplegamos marcas detectoras de radar encima de aves capaces de registrar las señales de radar de los barcos. Colocamos estas marcas en 88 pardelas (Calonectris diomedea, C. borealis, y C. edwardsii) que forrajean en el noroeste del Mar Mediterráneo y el Gran Ecosistema Marino de Canarias. Modelamos las detecciones del radar de los barcos registradas por las marcas en relación con los datos reticulados de rastreo de barcos del sistema de identificación automático (AIS) para analizar las dinámicas espaciotemporales de las interacciones aves marinasbarcos e identificar áreas con actividad pesquera no reportada. Nuestros modelos mostraron un ajuste moderado (área bajo la curva > 0.7) a los datos de rastreo de barcos, lo que indica una fuerte asociación entre las pardelas y los barcos en los principales sitios de pesca, aunque en las regiones con alto tránsito de barcos las detecciones por radar también fueron causadas por barcos no pesqueros. Las marcas registraron la presencia del potencial de barcos pesqueros sin regular y sin reportar en aguas del oeste de África, en donde los buques mercantes son poco comunes pero la actividad pesquera es intensa. En general, los detectores por radar en las aves mostraron áreas y periodos en donde la asociación entre las aves marinas y los barcos pesqueros legales e ilegales es alta. Estos detectores por radar podrían mejorar el enfoque de los esfuerzos de conservación.
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Aves , Conservação dos Recursos Naturais , Pesqueiros , Radar , Animais , Aves/fisiologia , Conservação dos Recursos Naturais/métodos , Mar Mediterrâneo , Navios , EspanhaRESUMO
BACKGROUND: Lassa fever is a hemorrhagic disease caused by Lassa virus (LASV), which has been classified by the World Health Organization as one of the top infectious diseases requiring prioritized research. Previous studies have provided insights into the classification and geographic characteristics of LASV lineages. However, the factor of the distribution and evolution characteristics and phylodynamics of the virus was still limited. METHODS: To enhance comprehensive understanding of LASV, we employed phylogenetic analysis, reassortment and recombination detection, and variation evaluation utilizing publicly available viral genome sequences. RESULTS: The results showed the estimated the root of time of the most recent common ancestor (TMRCA) for large (L) segment was approximately 634 (95% HPD: [385879]), whereas the TMRCA for small (S) segment was around 1224 (95% HPD: [10301401]). LASV primarily spread from east to west in West Africa through two routes, and in route 2, the virus independently spread to surrounding countries through Liberia, resulting in a wider spread of LASV. From 1969 to 2018, the effective population size experienced two significant increased, indicating the enhanced genetic diversity of LASV. We also found the evolution rate of L segment was faster than S segment, further results showed zinc-binding protein had the fastest evolution rate. Reassortment events were detected in multiple lineages including sub-lineage IIg, while recombination events were observed within lineage V. Significant amino acid changes in the glycoprotein precursor of LASV were identified, demonstrating sequence diversity among lineages in LASV. CONCLUSION: This study comprehensively elucidated the transmission and evolution of LASV in West Africa, providing detailed insights into reassortment events, recombination events, and amino acid variations.
Assuntos
Febre Lassa , Vírus Lassa , Humanos , Vírus Lassa/genética , Filogenia , Febre Lassa/epidemiologia , Aminoácidos , LibériaRESUMO
BACKGROUND: Imported cerebral malaria (CM) cases in non-endemic areas are often misdiagnosed, which delays treatment. Post-malaria neurological syndrome (PMNS) after recovery from severe malaria can also complicate diagnosis. CASE: We report an imported malaria case from West Africa with two sequential episodes with neurological syndromes within about a month. The first episode was diagnosed as CM with microscopy-positive Plasmodium falciparum infection. The second episode, occurring a month after the recovery from the first CM episode, was consistent with PMNS, since malaria parasites were not detected by microscopy in peripheral blood smears. However, this diagnosis was complicated by the detection of Plasmodium vivax in peripheral blood by PCR, suggesting a potential cause of the second episode by P. vivax. CONCLUSION: This study suggests that PMNS often occurs after severe falciparum malaria. Concurrent P. vivax infection with pathogenic biomass being predominantly extravascular further complicates accurate diagnosis.
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Malária Cerebral , Malária Falciparum , Malária Vivax , Plasmodium , Humanos , Plasmodium falciparum , Malária Falciparum/complicações , Malária Falciparum/diagnóstico , Malária Falciparum/parasitologia , Malária Vivax/complicações , Malária Vivax/diagnóstico , Malária Vivax/parasitologia , Plasmodium vivax/genética , Malária Cerebral/complicações , Malária Cerebral/diagnósticoRESUMO
In sub-Saharan Africa, sexually transmitted infections (STIs) are a public health concern. The impact of STIs are exacerbated in post-conflict low- and middle-income countries, such as Liberia, where exposure to traumatic events is prevalent and access to mental health services are limited. Following a syndemics framework, this study used regression analyses to explore the independent, additive, and multiplicative effects of four psychosocial conditions (exposure to war-related traumatic events, intimate partner violence [IPV], stressful life events, and depressive symptoms) on self-reported STIs. Data were collected from 379 youth aged 18-30 years (n = 170 women; n = 179 men) in Montserrado County, Liberia. Results revealed that psychosocial variables correlated with each other and STI risk. In multivariable analysis, stressful life events, depressive symptoms, and IPV were statistically significant predictors of STI risk. We found support for an additive effect between the number of psychosocial conditions reported and STI risk, as well as a multiplicative effect (interaction) between IPV and depressive symptoms on STI risk. Our results suggest a synergy between experiencing psychosocial conditions and STI risk and point to the potential benefit of multi-level sexual health approaches that simultaneously address mental health and IPV among youth in Liberia.
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Violência por Parceiro Íntimo , Infecções Sexualmente Transmissíveis , Masculino , Adolescente , Feminino , Humanos , Depressão/epidemiologia , Libéria/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Violência por Parceiro Íntimo/psicologia , Estresse Psicológico , Parceiros Sexuais/psicologiaRESUMO
BACKGROUND: Successful efforts to encourage uptake of subdermal contraceptive implants, with a lifespan of three to five years, necessitate planning to ensure that quality removal services are available when desired. In Burkina Faso, implant use has tripled over the past 8 years and now comprises almost half of the contraceptive method mix. Population Monitoring for Action (PMA) surveys identified barriers to obtaining quality removal when desired, particularly when the implant is not palpable, or providers lack needed skills or supplies. The Expanding Family Planning Choices (EFPC) project supported ministries of health in four countries with evaluation and strengthening of implant removal services. METHODS: An implant removal landscape assessment was conducted at 24 health facilities in three regions of Burkina Faso with high implant use that included provider observations of implant removal, interviews with providers and health facility managers, and facility readiness surveys. The project used landscape data to mobilize stakeholders through a series of participatory workshops to develop a collaborative roadmap and commit to actions supporting quality implant removals. RESULTS: Landscape findings revealed key gaps in provision of quality removal services, including high levels of provider confidence for implant insertion and removal (82% and 71%, respectively), low competence performing simple and difficult removals (19.2% and 11.1%, respectively), inadequate supplies and equipment (no facilities had all necessary materials for removal), lack of difficult removal management systems, and a lack of standard data collection tools for removal. Exposure to the data convinced stakeholders to focus on removals rather than expanding insertion services. While not all roadmap commitments were achieved, the process led to critical investments in quality implant removals. CONCLUSION: Landscape data revealed that facilities lack needed supplies and equipment, and providers lack skills needed to perform quality implant removals, limiting client reproductive choice. Disseminating this data enabled stakeholders to identify and commit to evidence-based priority actions. Stakeholders have since capitalized on program learnings and the roadmap, including following MOH guidance for implant removal supplies and health provider training. Our experience in Burkina Faso offers a replicable model of how data can direct collective action to improve quality of contraceptive implant removals.
Assuntos
Remoção de Dispositivo , Burkina Faso , Humanos , Feminino , Remoção de Dispositivo/métodos , Implantes de Medicamento , Serviços de Planejamento Familiar/métodos , Participação dos Interessados , Anticoncepcionais Femininos , Instalações de Saúde/estatística & dados numéricosRESUMO
BACKGROUND: Globally, close to one-third of all workplace violence (WV) occurs in the health sector. Exposure to WV among healthcare professionals in Ghana has been widely speculated, but there is limited evidence on the problem. This study therefore investigated WV, its risk factors, and the psychological consequences experienced by health workers in Ghana. METHODS: An analytic cross-sectional study was conducted in the Greater Accra region from January 30 to May 31, 2023, involving selected health facilities. The participants for the study were selected using a simple random sampling technique based on probability proportional-to-size. The data analyses were performed using STATA 15 software. Logistic regression analyses were employed to identify the factors associated with WV, considering a significance level of p-value < 0.05. RESULTS: The study was conducted among 607 healthcare providers and support personnel across 10 public and private hospitals. The lifetime career, and one-year exposure to any form of WV was 414 (68.2%) [95% CI: (64.3-71.9%)] and 363 (59.8%) [95% CI: (55.8-63.7%)], respectively. Compared to other forms of WV, the majority of healthcare workers, 324 (53.4%) experienced verbal abuse within the past year, and a greater proportion, 85 (26.2%) became 'super alert' or vigilant and watchful following incidents of verbal abuse. Factors significantly linked to experiencing any form of WV in the previous 12 months were identified as follows: older age [AOR = 1.11 (1.06, 1.17)], working experience [AOR = 0.91 (0.86, 0.96)], having on-call responsibilities [AOR = 1.75 (1.17, 2.61)], and feeling adequately secure within health facility [AOR = 0.45 (0.26, 0.76)]. CONCLUSION: There was high occurrence of WV, and verbal abuse was the most experienced form of WV. Age, work experience, on-call duties, and security within workplace were associated with exposure to WV. Facility-based interventions are urgently needed to curb the incidence of WV, especially verbal abuse.
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Violência no Trabalho , Humanos , Violência no Trabalho/psicologia , Estudos Transversais , Gana/epidemiologia , Prevalência , Inquéritos e Questionários , Pessoal de Saúde/psicologia , Local de Trabalho/psicologia , Fatores de RiscoRESUMO
BACKGROUND: This article gives the pediatric anesthesia perspective from Cameroon, Nigeria, Ghana, Liberia, and Gambia, five out of six countries in Anglophone West Africa. Over 40% of the population of most of these countries are younger than 14 years and there is an increasing need for paediatric anesthesia services. FINDINGS: Workforce density ranges from 0.08 to 0.58 physician anesthesia providers per 100,000 population. There are only 13 trained pediatric anesthetists; ratios range from 0 to 0.4 per 100,000 children, thus pediatric anesthesia services are provided by various cadres of physician and non-physician anesthesia providers. Physician anesthesia training is mostly carried out by the West African College of Surgeons as well as national postgraduate colleges. Pediatric anesthesia services are provided in tertiary (teaching), secondary (general), district, faith-based, military, private hospitals and through surgical missions. Challenges include lack of trained personnel, high morbidity from late presentation to health facilities and financial constraints, lack of health insurance for pediatric anesthesia services, unavailability of appropriate equipment and consumables, a narrow range of medications, very few pediatric-specific operating theaters, and inadequate critical care services. SOLUTIONS: The lack of opportunities for sub-specialty training in pediatric anesthesia in West Africa is currently being addressed in Nigeria and Ghana. Non-governmental agencies fund programs and courses related to pediatric anesthesia and have also provided fully equipped operating theaters. Advocacy for pediatric anesthesia can be achieved through the National Surgical Obstetric Anesthesia and Nursing Plans Implementation Committee of the various countries. There is an urgent need for prioritization of health in the budgets of Anglophone West African countries and governments must deliberately provide support for anesthesia and surgical services. More international collaborations towards workforce training and creation of children's hospitals are needed.
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Anestesia , Anestesiologia , Pediatria , Humanos , África Ocidental , Criança , Anestesiologia/educação , Anestesia PediátricaRESUMO
BACKGROUND: Pursuant to studies, receiving the three key maternal health services (Antenatal Care, Skilled Delivery Service, and Postnatal Care) in a continuum could prevent 71% of global maternal deaths. Despite the Western African region being known for its high maternal death and poor access to maternal health services, there is a dearth of studies that delve into the spectrum of maternal health services uptake. Hence, this study aimed to assess the level and predictors of partial and adequate utilization of health services in a single analytical model using the most recent Demographic and Health Survey (DHS) data (2013-2021). METHODS: This study was based on the appended women's (IR) file of twelve West African countries. STATA software version 16 was used to analyze a weighted sample of 89,504 women aged 15-49 years. A composite index of maternal health service utilization has been created by combining three key health services and categorizing them into 'no', 'partial', or 'adequate' use. A multilevel multivariable multinomial logistic regression analysis was carried out to examine the effects of each predictor on the level of service utilization. The degree of association was reported using the adjusted relative risk ratio (aRRR) with a corresponding 95% confidence interval, and statistical significance was declared at p < 0.05. RESULTS: 66.4% (95% CI: 64.9, 67.7) and 23.8% (95% CI: 23.3, 24.2) of women used maternal health services partially and adequately, respectively. Togo has the highest proportion of women getting adequate health care in the region, at 56.7%, while Nigeria has the lowest proportion, at 11%. Maternal education, residence, wealth index, parity, media exposure (to radio and television), enrolment in health insurance schemes, attitude towards wife beating, and autonomy in decision-making were identified as significant predictors of partial and adequate maternal health service uptake. CONCLUSION: The uptake of adequate maternal health services in the region was found to be low. Stakeholders should plan for and implement interventions that increase women's autonomy. Program planners and healthcare providers should give due emphasis to those women with no formal education and from low-income families. The government and the private sectors need to collaborate to improve media access and increase public enrolment in health insurance schemes.
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Serviços de Saúde Materna , Feminino , Gravidez , Humanos , Cuidado Pré-Natal , Análise de Regressão , Inquéritos Epidemiológicos , Demografia , Aceitação pelo Paciente de Cuidados de Saúde , Análise MultinívelRESUMO
OBJECTIVES: Disease progression, loss to follow-up, and mortality of HIV-2 compared with HIV-1 in children is not well understood. This is the first nationwide study reporting outcomes in children with the two HIV types in Guinea-Bissau. STUDY DESIGN: Nationwide retrospective follow-up study. METHODS: This is a retrospective follow-up study among HIV-infected children <15 years at nine ART centers from 2006 to 2021. Baseline parameters and disease outcomes for children with HIV-2 and HIV-1 were compared. RESULTS: The annual number of children diagnosed with HIV peaked in 2017. HIV-2 (n = 64) and HIV-1 (n = 1945) infected children were different concerning baseline median age (6.5 vs 3.1 years, P < 0.01), but had similar levels of severe immunodeficiency (P = 0.58) and severe anemia (P = 0.26). Within the first year of follow-up, 36.3% were lost, 5.9% died, 2.7% had transferred clinic, and 55.2% remained for follow-up. Mortality (HR = 1.05 95% CI: 0.53-2.08 for HIV-2) and attrition (HR = 0.86 95% CI: 0.62-1.19 for HIV-2) rates were similar for HIV types. CONCLUSIONS: The decline in children diagnosed per year since 2017 is possibly due to lower HIV prevalence, lack of HIV tests, and the SARS-CoV-2 epidemic. Children with HIV-2 were twice as old as HIV-1 infected when diagnosed, which suggests a slower disease progression. However, once they develop immunosuppression mortality is similar.
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Infecções por HIV , Soropositividade para HIV , HIV-1 , Criança , Humanos , Pré-Escolar , Seguimentos , Estudos Retrospectivos , Infecções por HIV/epidemiologia , HIV-2 , Guiné-Bissau/epidemiologia , Progressão da DoençaRESUMO
The detrimental effects of antimicrobial resistance (AMR) have called for several approaches in the fight against it in West Africa, where telemedicine is still in its infancy. In West Africa, self-medication is prevalent because the majority of these medications are easily accessible due to insufficient regulatory structures that control their production, distribution, and consumption. Also, access to healthcare facilities and professionals is limited. All of these and other inadequacies consequently result in the emergence of antimicrobial-resistant organisms. AMR, which is now a major global health crisis according to the WHO, may cause the deaths of about 10 million people before 2050, and Africa may make up 41% of these deaths, with the Western part of this continent affected the most. While several approaches have been adopted, unlike in other regions of the world, the use of telemedicine in West Africa to fight AMR has rarely been studied or considered and where it is now in partial use, its efficacy is constrained by several factors. This paper discusses the roles of telemedicine, the limitations to its application in the fight against AMR, and suggests remedies for these limitations.
RESUMO
This study explored the enablers and obstacles to the integration of traditional medicine and mainstream medicine in mental health services in West Africa. This study is a systematic review conducted in accordance with the relevant parts of the Preferred Reporting Items for Systematic reviews and Meta-analyses. Keywords searches were done in databases, and other reference lists were also searched. The Rainbow model of integrated care and a thematic analysis framework were used to account for the factors influencing the integration of traditional medicine and mainstream medicine in mental health services in West Africa. A total of 12 studies met the eligibility criteria after the evaluation of 6413 articles from databases and reference lists. The themes of: policy and implementation; different conceptualisation of mental health/referrals; trust issues, and education and training, were enablers or obstacles of integration depending on how they worked to facilitate or hinder integration. There was an indication of little integration of TM and MM at the macro, meso and micro levels in mental health services in West Africa. Though the study does cover all the West African states evenly, it is recommended that policy-makers and stakeholders interested in integration should ensure integration activities, especially policies, cut across all the levels of the rainbow model of integrated care and are planned and aligned at the macro, meso and micro levels instead of using ad hoc measures, informal initiatives or placing TM services in MM mental health services, which do not amount to integration.
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Prestação Integrada de Cuidados de Saúde , Serviços de Saúde Mental , Humanos , Serviços de Saúde Mental/organização & administração , África Ocidental , Prestação Integrada de Cuidados de Saúde/organização & administração , Medicina Tradicional , Medicinas Tradicionais Africanas , Transtornos Mentais/terapiaRESUMO
INTRODUCTION: Nowadays, Internet addiction is a major concern due to the growing number of Internet users and the consequences associated with this addiction. PURPOSE OF THE RESEARCH: In this study, we aimed to determine the prevalence of and factors associated with Internet addiction among health sciences students at the University of Abomey-Calavi. METHODS: A cross-sectional study was conducted among 346 students from the Faculty of Health Sciences and the National Institute of Medical and Health Sciences at the University of Abomey-Calavi. Participants were selected using simple random sampling. Internet addiction was assessed using K. Young's "Internet Addiction Test." Logistic regression modeling was employed to explore factors associated with Internet addiction. The strength of the association was assessed using odds ratios; the confidence interval (CI) was 95%; and a p-value < 0.05 in the final model was considered significant. RESULTS: The prevalence of Internet addiction was 31.8% (95% CI: [23.26% - 41.38%]). Factors associated with Internet addiction were the participant's field of study, poor relationships with friends and family, communication difficulties, depression, and psychoactive substance consumption. CONCLUSIONS: Evidence of Internet addiction exists among students in health sciences institutions in Benin. These findings can support the development of prevention and intervention strategies centered on addressing a public health issue that is still insufficiently recognized.
Introduction: De nos jours, l'addiction à Internet est une préoccupation majeure en raison de l'évolution croissante du nombre d'internautes mais aussi de ses conséquences. But de l'étude: Dans cette étude, nous avons déterminé la prévalence et les facteurs associés à l'addiction à Internet chez les étudiants des sciences de la santé de l'Université d'Abomey-Calavi. Méthodes: Il s'agit d'une étude transversale menée auprès de 346 étudiants de la Faculté des sciences de la santé et de l'Institut national médico-sanitaire de l'Université d'Abomey-Calavi. Ces derniers ont été sélectionnés par échantillonnage aléatoire simple. L'addiction à Internet a été mesurée grâce à l'outil « Internet addiction test de Young ¼. Une modélisation par régression logistique a été utilisée pour explorer les facteurs associés à l'addiction à Internet. La force de l'association a été évaluée avec un rapport de cotes et son intervalle de confiance (IC) à 95 % ; une valeur p <0,05 dans le modèle final a été considérée comme significative. Résultats: La prévalence de l'addiction à Internet était de 31,8 % (IC95 % : [23,26 % - 41,38 %]). La filière d'études, les mauvaises relations avec les proches, les difficultés de communication, la dépression et la consommation de substances psychoactives étaient associées à l'addiction à Internet. Conclusions: Il existe des évidences qui montrent l'addiction à Internet des étudiants des institutions universitaires de santé au Benin. Ces évidences peuvent soutenir la mise en place de stratégies de prévention et de prise en charge axées sur la communication autour d'un phénomène encore insuffisamment perçu comme le problème de santé publique qu'il constitue.
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Comportamento Aditivo , Estudantes de Medicina , Humanos , Estudos Transversais , Benin , Transtorno de Adição à Internet , Estudantes , Comportamento Aditivo/epidemiologia , InternetRESUMO
This study focuses on assessing coastal vulnerability and habitat sensitivity along the West African coast by delineating hotspots based on surface temperature, pH, chlorophyll-a, particulate organic carbon, and carbonate concentrations between 2018 and 2023 depending on data availability. Initial exploration of these variables revealed two distinct focal points i.e., the Togo-Nigerian coastal stretch and the stretch from Sierra Leone to Mauritania. Lower pH trends (acidification) in surface waters were observed off the West African coast, particularly in areas around the south-south Niger Delta in Nigeria and the coastal regions of Guinea and Guinea Bissau. Sea surface temperature analysis revealed highest temperatures (27-30°C) within Nigeria to Guinea coastal stretch, intermediate temperatures (24-27°C) within the Guinea Bissau and Senegal coastal stretch, and the lowest temperatures off the coast of Mauritania. Furthermore, correlation analysis between sea surface temperature and calcite concentration in the Mauritania-Senegal hotspot, as well as between overland runoff and particulate organic carbon in the Togo-Nigeria hotspot, revealed strong positive associations (r>0.60) and considerable predictive variability (R2 ≈ 0.40). From the habitat sensitivity analysis, certain regions, including Cape Verde, Côte d'Ivoire, Nigeria, Senegal, and Sierra Leone, exhibited high sensitivity due to environmental challenges and strong human dependence on coastal resources. Conversely, Gambia, Guinea, Guinea-Bissau, Liberia, and Togo displayed lower sensitivity, influenced by geographical-related factors (e.g. coastal layout, topography, etc.) and current levels of economic development (relatively lower industrialization levels). Regional pH variations in West African coastal waters have profound implications for ecosystems, fisheries, and communities. Addressing these challenges requires collaborative regional policies to safeguard shared marine resources. These findings underscore the link between ecosystem health, socioeconomics, and the need for integrated coastal management and ongoing research to support effective conservation.
Assuntos
Mudança Climática , Ecossistema , Humanos , Acidificação dos Oceanos , Concentração de Íons de Hidrogênio , Monitoramento Ambiental , Água do Mar , CarbonoRESUMO
Background: Hepatitis B (HBV) and hypertension (HTN) are prevalent in West Africa (WA). Inadequate control is common, and evaluation and management are challenging among immigrants due to unfamiliarity with the United States (US) healthcare system. While HBV is stigmatised, HTN is recognised as an important condition. We describe how a HTN screening program can facilitate HBV screening in the Bronx WA community. Methods: Thirty-minute HTN educational programs were delivered in collaboration with faith-based organisations, and 5-min presentations were presented upon request at community gatherings. Arrangements were made for those interested in a clinic visit where a questionnaire was completed, blood pressure (BP) measured, a free BP cuff provided, HBV testing performed, and referrals made. For those without ongoing care, insurance was arranged, and linkage to care provided. Findings: Seven 30-min and five 5-min presentations were conducted. After the 30-min presentation, 204 of 445 attendees (45.8%) requested a visit, and 68 (33.3%) attended the visit. After the 5-min presentation, 80 requested a visit and 51 (63.8%) attended the visit. A BP >140/90 mmHg was present in 122 individuals (48.4%), including 43 (17.1%) without a history of HTN and 39 (15.5%) with BP >160/90 mmHg. All except two who reported previous testing agreed to HBV testing. 19 (7.5%) were hepatitis B surface antigen positive. Transition into ongoing care was provided for 60 (33.9%) with HTN who were not integrated into the US healthcare system. Interpretation: HTN screening with a free BP cuff promotes HBV screening and US healthcare integration. Funding: No funding.
RESUMO
Pharmaceutical and Personal Care Products (PPCPs) are widely used to prevent or treat human and animal diseases, thereby improving the quality of daily life. Poor management of post-consumer products is recognized worldwide, as they negatively affect the ecosystems where they are discharged. The first action to prevent negative impacts is the state of knowledge regarding their occurrence. This paper critically reports the panorama of West Africa in terms of PPCPs occurrence in different water sources. To achieve this objective, a systematic review was conducted on PPCPs in West Africa following the PRISMA guidelines. Databases, including African Journals Online, PubMed, Google Scholar, Scopus, and Dimensions, were used for this search. Thirty-five articles, representing 58 % of West African countries, were selected according to the inclusion and exclusion criteria. Of these articles, one included data from multiple West African countries, while the remaining 34 exclusively focused on Benin, Cameroon, Ghana, and Nigeria. The results revealed a variety of PPCPs investigated, about 27 groups and 112 compounds, with greater emphasis on antibiotics, analgesics and PSHXEs. HPLC was the predominant analytical method used, resulting in total concentrations of PPCPs in the range of 200,000 to 3,200,000 ng/L in drinking water, 12 to 700,000 ng/L in groundwater, 0.42 to 107,800,000 ng/L in surface water, 8.5 to 121,310,000 ng/L in wastewater, and 440 to 421,700 ng/L in tap water. Ghana, Nigeria and Cameroon reported the highest number of PPCPs investigated and consequently the highest concentration of cases. These compounds present a high potential ecological risk, with >50 % exceeding the risk quotient limit. Therefore, West Africa as a community needs integrated approaches and strategies to monitor water, especially transboundary resources. This review is timely and provides pertinent information to policymakers and researchers on PPCPs in water.
Assuntos
Cosméticos , Água Potável , Poluentes Químicos da Água , Humanos , Cosméticos/análise , Ecossistema , Monitoramento Ambiental/métodos , Gana , Preparações Farmacêuticas , Poluentes Químicos da Água/análiseRESUMO
Background: Huntington's disease like 2 (HDL2) has been reported exclusively in patients with African ancestry, mostly originating from South Africa. Case report: We report three patients in Mali including a proband and his two children who have been examined by neurologists and psychiatrists after giving consent. They were aged between 28 and 56 years old. Psychiatric symptoms were predominant in the two younger patients while the father presented mainly with motor symptoms. Genetic testing identified a heterozygous 40 CTG repeat expansion in the Junctophilin-3 (JPH3) gene in all three patients. Discussion: This study supports the hypothesis that HDL2 may be widely spread across Africa. Highlights: We report here the first case of HDL2 in West Africa, suggesting that HDL2 is widely spread across African continent, and increasing access to genetic testing could uncover other cases.