The carbon sink of secondary and degraded humid tropical forests.

The globally important carbon sink of intact, old-growth tropical humid forests is declining because of climate change, deforestation and degradation from fire and logging1-3. Recovering tropical secondary and degraded forests now cover about 10% of the tropical forest area4, but how much carbon they accumulate remains uncertain. Here we quantify the aboveground carbon (AGC) sink of recovering forests across three main continuous tropical humid regions: the Amazon, Borneo and Central Africa5,6. On the basis of satellite data products4,7, our analysis encompasses the heterogeneous spatial and temporal patterns of growth in degraded and secondary forests, influenced by key environmental and anthropogenic drivers. In the first 20 years of recovery, regrowth rates in Borneo were up to 45% and 58% higher than in Central Africa and the Amazon, respectively. This is due to variables such as temperature, water deficit and disturbance regimes. We find that regrowing degraded and secondary forests accumulated 107 Tg C year-1 (90-130 Tg C year-1) between 1984 and 2018, counterbalancing 26% (21-34%) of carbon emissions from humid tropical forest loss during the same period. Protecting old-growth forests is therefore a priority. Furthermore, we estimate that conserving recovering degraded and secondary forests can have a feasible future carbon sink potential of 53 Tg C year-1 (44-62 Tg C year-1) across the main tropical regions studied.

Unveiling African rainforest composition and vulnerability to global change.

Africa is forecasted to experience large and rapid climate change1 and population growth2 during the twenty-first century, which threatens the world's second largest rainforest. Protecting and sustainably managing these African forests requires an increased understanding of their compositional heterogeneity, the environmental drivers of forest composition and their vulnerability to ongoing changes. Here, using a very large dataset of 6 million trees in more than 180,000 field plots, we jointly model the distribution in abundance of the most dominant tree taxa in central Africa, and produce continuous maps of the floristic and functional composition of central African forests. Our results show that the uncertainty in taxon-specific distributions averages out at the community level, and reveal highly deterministic assemblages. We uncover contrasting floristic and functional compositions across climates, soil types and anthropogenic gradients, with functional convergence among types of forest that are floristically dissimilar. Combining these spatial predictions with scenarios of climatic and anthropogenic global change suggests a high vulnerability of the northern and southern forest margins, the Atlantic forests and most forests in the Democratic Republic of the Congo, where both climate and anthropogenic threats are expected to increase sharply by 2085. These results constitute key quantitative benchmarks for scientists and policymakers to shape transnational conservation and management strategies that aim to provide a sustainable future for central African forests.

A sensory appendage protein protects malaria vectors from pyrethroids.

Pyrethroid-impregnated bed nets have driven considerable reductions in malaria-associated morbidity and mortality in Africa since the beginning of the century1. The intense selection pressure exerted by bed nets has precipitated widespread and escalating resistance to pyrethroids in African Anopheles populations, threatening to reverse the gains that been made by malaria control2. Here we show that expression of a sensory appendage protein (SAP2), which is enriched in the legs, confers pyrethroid resistance to Anopheles gambiae. Expression of SAP2 is increased in insecticide-resistant populations and is further induced after the mosquito comes into contact with pyrethroids. SAP2 silencing fully restores mortality of the mosquitoes, whereas SAP2 overexpression results in increased resistance, probably owing to high-affinity binding of SAP2 to pyrethroid insecticides. Mining of genome sequence data reveals a selective sweep near the SAP2 locus in the mosquito populations of three West African countries (Cameroon, Guinea and Burkina Faso) with the observed increase in haplotype-associated single-nucleotide polymorphisms mirroring the increasing resistance of mosquitoes to pyrethroids reported in Burkina Faso. Our study identifies a previously undescribed mechanism of insecticide resistance that is likely to be highly relevant to malaria control efforts.

Phylogeographic analysis of the Bantu language expansion supports a rainforest route.

The Bantu expansion transformed the linguistic, economic, and cultural composition of sub-Saharan Africa. However, the exact dates and routes taken by the ancestors of the speakers of the more than 500 current Bantu languages remain uncertain. Here, we use the recently developed "break-away" geographical diffusion model, specially designed for modeling migrations, with "augmented" geographic information, to reconstruct the Bantu language family expansion. This Bayesian phylogeographic approach with augmented geographical data provides a powerful way of linking linguistic, archaeological, and genetic data to test hypotheses about large language family expansions. We compare four hypotheses: an early major split north of the rainforest; a migration through the Sangha River Interval corridor around 2,500 BP; a coastal migration around 4,000 BP; and a migration through the rainforest before the corridor opening, at 4,000 BP. Our results produce a topology and timeline for the Bantu language family, which supports the hypothesis of an expansion through Central African tropical forests at 4,420 BP (4,040 to 5,000 95% highest posterior density interval), well before the Sangha River Interval was open.

Newly Identified Mycobacterium africanum Lineage 10, Central Africa.

Analysis of genome sequencing data from >100,000 genomes of Mycobacterium tuberculosis complex using TB-Annotator software revealed a previously unknown lineage, proposed name L10, in central Africa. Phylogenetic reconstruction suggests L10 could represent a missing link in the evolutionary and geographic migration histories of M. africanum.

Human monkeypox: A review of the literature.

Monkeypox (MPX) has recently made international headlines for the rapid and simultaneous progression of the disease across the world. This review aims at summarizing the literature available as well as describing the evolution of the disease as it pertains to the cases today along with potential treatments and infection control strategies. To date, more than 76 countries have reported cases in more than 12,261 people. Before this, MPX was a rare zoonotic disease confined to endemic areas in Western and Central Africa with sporadic outbreaks namely in the United States, associated with the import of wild animals from Ghana. However, during the current outbreak, human-to-human transmission has become the primary mode of transmission, raising concerns for unaccounted community spread. Most of these patients did not travel to the endemic areas of Africa, suggesting possible previously underdetected community transmission. Observations from emergent cases have reported that the manifestations of the disease were sometimes atypical from what has been previously described. Young men who have sex with men seem to be the population most vulnerable to infection. Though the disease is currently perceived to be mild in its clinical course, questions that remain unclear and warrant further investigation include potential of humans harboring a genital reservoir of the virus and the possibility of airborne transmission, which has implications for infection control and health of the community at large.

Genomic insights into Plasmodium vivax population structure and diversity in central Africa.

BACKGROUND: Though Plasmodium vivax is the second most common malaria species to infect humans, it has not traditionally been considered a major human health concern in central Africa given the high prevalence of the human Duffy-negative phenotype that is believed to prevent infection. Increasing reports of asymptomatic and symptomatic infections in Duffy-negative individuals throughout Africa raise the possibility that P. vivax is evolving to evade host resistance, but there are few parasite samples with genomic data available from this part of the world. METHODS: Whole genome sequencing of one new P. vivax isolate from the Democratic Republic of the Congo (DRC) was performed and used in population genomics analyses to assess how this central African isolate fits into the global context of this species. RESULTS: Plasmodium vivax from DRC is similar to other African populations and is not closely related to the non-human primate parasite P. vivax-like. Evidence is found for a duplication of the gene PvDBP and a single copy of PvDBP2. CONCLUSION: These results suggest an endemic P. vivax population is present in central Africa. Intentional sampling of P. vivax across Africa would further contextualize this sample within African P. vivax diversity and shed light on the mechanisms of infection in Duffy negative individuals. These results are limited by the uncertainty of how representative this single sample is of the larger population of P. vivax in central Africa.

The Anopheles coluzzii range extends into Kenya: detection, insecticide resistance profiles and population genetic structure in relation to conspecific populations in West and Central Africa.

BACKGROUND: Anopheles coluzzii is a primary vector of malaria found in West and Central Africa, but its presence has hitherto never been documented in Kenya. A thorough understanding of vector bionomics is important as it enables the implementation of targeted and effective vector control interventions. Malaria vector surveillance efforts in the country have tended to focus on historically known primary vectors. The current study sought to determine the taxonomic status of samples collected from five different malaria epidemiological zones in Kenya as well as describe the population genetic structure and insecticide resistance profiles in relation to other An. coluzzii populations. METHODS: Mosquitoes were sampled as larvae from Busia, Kwale, Turkana, Kirinyaga and Kiambu counties, representing the range of malaria endemicities in Kenya, in 2019 and 2021 and emergent adults analysed using Whole Genome Sequencing (WGS) data processed in accordance with the Anopheles gambiae 1000 Genomes Project phase 3. Where available, historical samples from the same sites were included for WGS. Comparisons were made with An. coluzzii cohorts from West and Central Africa. RESULTS: This study reports the detection of An. coluzzii for the first time in Kenya. The species was detected in Turkana County across all three time points from which samples were analyzed and its presence confirmed through taxonomic analysis. Additionally, there was a lack of strong population genetic differentiation between An. coluzzii from Kenya and those from the more northerly regions of West and Central Africa, suggesting they represent a connected extension to the known species range. Mutations associated with target-site resistance to DDT and pyrethroids and metabolic resistance to DDT were found at high frequencies up to 64%. The profile and frequencies of the variants observed were similar to An. coluzzii from West and Central Africa but the ace-1 mutation linked to organophosphate and carbamate resistance present in An. coluzzii from coastal West Africa was absent in Kenya. CONCLUSIONS: These findings emphasize the need for the incorporation of genomics in comprehensive and routine vector surveillance to inform on the range of malaria vector species, and their insecticide resistance status to inform the choice of effective vector control approaches.

Trade and socioeconomic importance of an invasive giant snail in the endemic-rich island of São Tomé, Central Africa.

Managing invasive species is crucial to mitigate their negative impacts on ecosystems, yet conflicts may arise when their social benefits are disregarded. Human pressure on the endemic-rich forests of São Tomé has been high since the island was discovered by the Portuguese in the 15th century, and numerous species have been introduced. These include the invasive West African giant land snail (Archachatina marginata), which was introduced in the mid-20th century, is now widespread on the island, and is a potential threat to native flora and fauna. We assessed the frequency of consumption of this species and its socioeconomic importance to people across the island with household questionnaires, focus group discussions, and semistructured interviews. We explored the prevalence and potential drivers of use (e.g., wealth, household composition, and diversity of occupations) and characterized the commodity chain to identify demographic groups linked to the snail trade. We interviewed 672 people (1 person per household), conducted 6 focus groups, and interviewed 80 key actors belonging to 5 subcategories. The snail was the most widely consumed bushmeat and an important source of income, particularly for women and unemployed youth. Insecure and scarce livelihood alternatives, mostly in rural areas, were reported as drivers for trade involvement. Snail harvesting was more frequent in poorer households with low occupational diversity. Selling tended to occur in households that were well-established in the community and had a higher proportion of children. Both were stimulated by the proximity of communities to the native forest. Buying snails was common in all demographic groups, but it was linked to wealth and occupational diversity. Interventions to manage the impact of this introduced species on the valuable ecosystems of the island should involve multiple sectors of society to ensure societal support. This requires robust consideration of the welfare of vulnerable demographic groups that benefit from the species.

Importancia socioeconómica y comercial de un caracol invasor en la isla rica en endemismos de Santo Tomé, África Central Resumen La gestión de las especies invasoras es crucial para mitigar sus efectos negativos en los ecosistemas, aunque pueden surgir conflictos cuando no se tienen en cuenta sus beneficios sociales. La presión humana sobre los bosques de Santo Tomé, ricos en endemismos, ha sido alta desde que la isla fue colonizada por los portugueses en el siglo XV y desde entonces se han introducido numerosas especies. Una de ellas es el caracol terrestre gigante de África Occidental (Archachatina marginata), introducido a mediados del siglo XX y que ahora tiene una distribución amplia en la isla y es una amenaza potencial para la flora y la fauna autóctonas al ser invasor. Evaluamos la frecuencia de consumo de esta especie y su importancia socioeconómica para la población de toda la isla mediante encuestas en hogares, grupos de discusión y entrevistas semiestructuradas a actores clave de cinco categorías. Exploramos la prevalencia y los posibles factores impulsores del consumo (por ejemplo, la riqueza, la composición de los hogares y la diversidad de ocupaciones) y caracterizamos la cadena comercial para identificar los grupos demográficos vinculados al comercio de caracoles. Entrevistamos a 672 personas (una persona por hogar), realizamos seis grupos de discusión y entrevistamos a 80 actores clave. El caracol fue la carne de caza más consumida y una importante fuente de ingresos, sobre todo para las mujeres y los jóvenes desempleados. La inseguridad y la escasez de medios de subsistencia, sobre todo en las zonas rurales, fueron los factores que impulsaron la participación en el mercado. La colecta de caracoles fue más frecuente en los hogares más pobres y con escasa diversidad ocupacional. La venta tendía a producirse en hogares bien establecidos en la comunidad y con una mayor proporción de niños. Ambos factores se vieron estimulados por la proximidad de las comunidades al bosque nativo. La compra de caracoles fue común en todos los grupos demográficos, pero estuvo vinculada a la riqueza y a la diversidad ocupacional. Las intervenciones para gestionar el impacto de esta especie introducida en los valiosos ecosistemas de la isla deben implicar a múltiples sectores de la sociedad para garantizar su apoyo. Para ello es necesario tener muy en cuenta el bienestar de los grupos demográficos vulnerables que se benefician de la especie.

Laparoscopy experience in East, Central, and Southern Africa: insights from operative case volume analysis.

BACKGROUND: With the primary objective of addressing the disparity in global surgical care access, the College of Surgeons of East, Central, and Southern Africa (COSECSA) trains surgeons. While sufficient operative experience is crucial for surgical training, the extent of utilization of minimally invasive techniques during COSECSA training remains understudied. METHODS: We conducted an extensive review of COSECSA general surgery trainees' operative case logs from January 1, 2015, to December 31, 2020, focusing on the utilization of minimally invasive surgical procedures. Our primary objective was to determine the prevalence of laparoscopic procedures and compare this to open procedures. We analyzed the distribution of laparoscopic cases across common indications such as cholecystectomy, appendicitis, and hernia operations. Additionally, we examined the impact of trainee autonomy, country development index, and hospital type on laparoscopy utilization. RESULTS: Among 68,659 total cases, only 616 (0.9%) were laparoscopic procedures. Notably, 34 cases were conducted during trainee external rotations in countries like the United Kingdom, Germany, and India. Gallbladder and appendix pathologies were most frequent among the 582 recorded laparoscopic cases performed in Africa. Laparoscopic cholecystectomy accounted for 29% (276 of 975 cases), laparoscopic appendectomy for 3% (76 of 2548 cases), and laparoscopic hernia repairs for 0.5% (26 of 5620 cases). Trainees self-reported lower autonomy for laparoscopic (22.5%) than open cases (61.5%). Laparoscopy usage was more prevalent in upper-middle-income (2.7%) and lower-middle-income countries (0.8%) compared with lower-income countries (0.5%) (p < 0.001). Private (1.6%) and faith-based hospitals (1.5%) showed greater laparoscopy utilization than public hospitals (0.5%) (p < 0.001). CONCLUSIONS: The study highlights the relatively low utilization of minimally invasive techniques in surgical training within the ECSA region. Laparoscopic cases remain a minority, with variations observed based on specific diagnoses. The findings suggest a need to enhance exposure to minimally invasive procedures to ensure well-rounded training and proficiency in these techniques.

Reductions in NO2 burden over north equatorial Africa from decline in biomass burning in spite of growing fossil fuel use, 2005 to 2017.

Socioeconomic development in low- and middle-income countries has been accompanied by increased emissions of air pollutants, such as nitrogen oxides [NOx: nitrogen dioxide (NO2) + nitric oxide (NO)], which affect human health. In sub-Saharan Africa, fossil fuel combustion has nearly doubled since 2000. At the same time, landscape biomass burning-another important NOx source-has declined in north equatorial Africa, attributed to changes in climate and anthropogenic fire management. Here, we use satellite observations of tropospheric NO2 vertical column densities (VCDs) and burned area to identify NO2 trends and drivers over Africa. Across the northern ecosystems where biomass burning occurs-home to hundreds of millions of people-mean annual tropospheric NO2 VCDs decreased by 4.5% from 2005 through 2017 during the dry season of November through February. Reductions in burned area explained the majority of variation in NO2 VCDs, though changes in fossil fuel emissions also explained some variation. Over Africa's biomass burning regions, raising mean GDP density (USD⋅km-2) above its lowest levels is associated with lower NO2 VCDs during the dry season, suggesting that economic development mitigates net NO2 emissions during these highly polluted months. In contrast to the traditional notion that socioeconomic development increases air pollutant concentrations in low- and middle-income nations, our results suggest that countries in Africa's northern biomass-burning region are following a different pathway during the fire season, resulting in potential air quality benefits. However, these benefits may be lost with increasing fossil fuel use and are absent during the rainy season.

An overview of artemisinin-resistant malaria and associated Pfk13 gene mutations in Central Africa.

Malaria caused by Plasmodium falciparum is one of the deadliest and most common tropical infectious diseases. However, the emergence of artemisinin drug resistance associated with the parasite's Pfk13 gene, threatens the public health of individual countries as well as current efforts to reduce malaria burdens globally. It is of concern that artemisinin-resistant parasites may be selected or have already emerged in Africa. This narrative review aims to evaluate the published evidence concerning validated, candidate, and novel Pfk13 polymorphisms in ten Central African countries. Results show that four validated non-synonymous polymorphisms (M476I, R539T, P553L, and P574L), directly associated with a delayed therapy response, have been reported in the region. Also, two Pfk13 polymorphisms associated to artemisinin resistance but not validated (C469F and P527H) have been reported. Furthermore, several non-validated mutations have been observed in Central Africa, and one allele A578S, is commonly found in different countries, although additional molecular and biochemical studies are needed to investigate whether those mutations alter artemisinin effects. This information is discussed in the context of biochemical and genetic aspects of Pfk13, and related to the regional malaria epidemiology of Central African countries.

Gender and adolescent sexual and reproductive health and rights in West and Central Africa: New evidence and emerging gaps.

The West and Central Africa (WCA) region is a natural resource-rich, 24-country, contiguous area with a population of nearly 500 million people. The median age for the region is currently 18 years and approximately one-third of its population is aged between 10 and 24 years. If current demographic trends in the region persist, its population will reach 1.5 billion by 2050. At that time, WCA will not only have the largest number of young people globally, but it will also be the only part of the world whose population of young people will continue to increase1. Many countries in the region are also or have recently been involved in armed conflicts, which have devastated infrastructure, displaced people, stifled development, and more importantly, resulted in myriad deaths and morbidities.

La région de l'Afrique de l'Ouest et du Centre (AOC) est une zone contiguë de 24 pays riches en ressources naturelles et comptant près de 500 millions d'habitants. L'âge médian de la région est actuellement de 18 ans et environ un tiers de sa population est âgée de 10 à 24 ans. Si les tendances démographiques actuelles de la région persistent, la population de la région atteindra 1,5 milliard d'habitants d'ici 2050. À cette époque, l'AOC comptera non seulement le plus grand nombre de jeunes au monde, mais elle sera également la seule partie du monde dont la population de le nombre de jeunes va continuer à augmenter1. De nombreux pays de la région sont également ou ont été récemment impliqués dans des conflits armés, qui ont dévasté les infrastructures, déplacé les populations, étouffé le développement et, plus important encore, entraîné une myriade de morts et de morbidités.

Mapping of schistosome hybrids of the haematobium group in West and Central Africa.

Hybridization of parasitic species is an emerging health problem in the evolutionary profile of infectious disease, particularly within trematodes of the genus Schistosoma. Because the consequences of this hybridization are still relatively unknown, further studies are needed to clarify the epidemiology of the disease and the biology of hybrid schistosomes. In this article, we provide a detailed review of published results on schistosome hybrids of the haematobium group. Using a mapping approach, this review describes studies that have investigated hybridization in human (S. haematobium, S. guineensis, and S. intercalatum) and animal (S. bovis and S. curassoni) schistosome species in West Africa (Niger, Mali, Senegal, Côte d'Ivoire, Benin, Nigeria) and in Central Africa (Cameroon, Gabon, Democratic Republic of Congo), as well as their limitations linked to the underestimation of their distribution in Africa. This review provides information on studies that have highlighted hybrid species of the haematobium group and the regions where they have been found, notably in West and Central Africa.

Monkeypox Virus Infections in Humans.

Human monkeypox is a viral zoonosis endemic to West and Central Africa that has recently generated increased interest and concern on a global scale as an emerging infectious disease threat in the midst of the slowly relenting COVID-2019 disease pandemic. The hallmark of infection is the development of a flu-like prodrome followed by the appearance of a smallpox-like exanthem. Precipitous person-to-person transmission of the virus among residents of 100 countries where it is nonendemic has motivated the immediate and widespread implementation of public health countermeasures. In this review, we discuss the origins and virology of monkeypox virus, its link with smallpox eradication, its record of causing outbreaks of human disease in regions where it is endemic in wildlife, its association with outbreaks in areas where it is nonendemic, the clinical manifestations of disease, laboratory diagnostic methods, case management, public health interventions, and future directions.

New evidence on adolescent sexual and reproductive health and rights from the West and Central African region.

The African Journal of Reproductive Health is pleased to publish these compendiums of original research in this special edition that document new findings in adolescent sexual and reproductive health and rights from the West and Central African region (WCA). While sub-Saharan Africa has some of the worst indicators of sexual and reproductive health and rights (SRHR) in the world, the indicators are more daunting in the WCA region. To date, the WCA is recognized to have the highest rates of unwanted pregnancy, unsafe abortion, and human immunodeficiency virus (HIV) and other sexually transmissible infections, as well as the lowest contraceptive prevalence rates among adolescents worldwide.1 Despite the high rate of adverse adolescent reproductive health outcomes in WCA, there has been limited documentations of the socio-cultural and economic circumstances that perpetuate these adverse consequences. There have also been no purposefully designed interventions that provide strong scientific evidence for developing strategies to reverse the trend.

Le Journal africain de la santé reproductive est heureux de publier ces recueils de recherches originales dans cette édition spéciale qui documentent les nouvelles découvertes sur la santé et les droits sexuels et reproductifs des adolescents de la région de l'Afrique de l'Ouest et du Centre (WCA). Alors que l'Afrique subsaharienne possède certains des pires indicateurs au monde en matière de santé et de droits sexuels et reproductifs (SDSR), les indicateurs sont plus intimidants dans la région AOC. À ce jour, l'AOC est reconnue pour avoir les taux les plus élevés de grossesses non désirées, d'avortements à risque, de virus de l'immunodéficience humaine (VIH) et d'autres infections sexuellement transmissibles, ainsi que les taux de prévalence contraceptive les plus faibles parmi les adolescents dans le monde.1 Malgré le taux élevé de En dépit des résultats négatifs en matière de santé reproductive des adolescents en AOC, il existe peu de documentation sur les circonstances socioculturelles et économiques qui perpétuent ces conséquences néfastes. Il n'y a pas non plus d'interventions spécialement conçues qui fournissent des preuves scientifiques solides pour élaborer des stratégies visant à inverser la tendance.

Health risk and pollution associated with trace metals in the waters of the Ebolowa municipal lake basin (Central Africa): evidence from hydrochemistry, quality indices, and statistical analyses.

The aim of this study was to investigate the status of trace metals (As, Cr, Cu, Ni, Pb, Fe, and Zn) and health and carcinogenic risk associated then in the Ebolowa Municipal Lake (EML) basin. To this end, 21 water samples were collected from the EML and its two tributaries, Mfoumou and Bengo'o, and analyzed by Quantofix method (nanocolors and visiocolor ECO) by using the MACHEREY-NAGEL photometer. The data were processed using multivariate statistics. The results showed that all the physicochemical parameters (pH, EC, and TDS), with the exception of TDS, comply with were within WHO limits. The distribution of trace metals at the three sites investigated was as follows: Zn (80-400 ± 1.58 µg/L) > Cu (50-150 ± 9.38 µg/L) > Fe (10-40 ± 0.71 µg/L) > Pb (1-20 ± 3.02 µg/L) > As (1-9 ± 0.44 µg/L) > Ni (1-9 ± 1.48 µg/L). However, the highest values were observed in the EML and the Mfoumou River, where Pb pollution was noted. Statistical analysis showed that anthropogenic inputs increase the presence of Cr, Cu, Pb, and Zn. Trace Metal Pollution Index values were below 15 at all sites, illustrating low levels of pollution. The trace metal evaluation index values for the Bengo'o stream are pure (mean = 0.6), slightly affected in the Mfoumou stream (mean = 2.0), and moderately affected in the EML (mean = 2.2). The toxicity load index values illustrate that the waters studied are toxic. The non-carcinogenic (HI) and carcinogenic (CR) health risk index values suggest a risk linked to oral ingestion in the LME and Mfoumou watercourses. The latter appears to be the main source of allochthonous pollutant input to the EML.

Epidemiological Evidence of Nosocomial and Zoonotic Transmission of Human T-Cell Leukemia Virus-1 in a Large Survey in a Rural Population of Central Africa.

BACKGROUND: Central Africa is one of the largest areas of high endemicity for human T-cell leukemia virus-1 (HTLV-1). However, no preventive measures are yet implemented to reduce its transmission, which can be sexual, from mother-to-child, or through contaminated blood products. Rare zoonotic transmissions from nonhuman primates (NHPs) have also been reported in this region. Here we investigated the HTLV-1 prevalence and associated risk factors in a rural population in Cameroon. METHODS: From 2019 to 2021, we performed a cross-sectional survey in the eastern region of Cameroon. HTLV-1 infection was first screened by ELISA, then tested by western blot and envelope gene targeted polymerase chain reaction. Risk factors associated with HTLV-1 infection were identified by logistic regression in univariable and multivariable analyses. RESULTS: Among 3400 participants, HTLV-1 prevalence was 1.1% (95% confidence interval [CI], .7-1.5). Factors independently associated with HTLV-1 infection were Pygmy ethnicity (adjusted odd ratio [aOR], 2.9; 95% CI, 1.3-6.2), history of surgery (aOR, 6.3; 95% CI, 2.2-17.8), and NHP bite (aOR, 6.6; 95% CI, 2.2-19.8). CONCLUSIONS: These results suggest both iatrogenic and zoonotic transmission of HTLV-1 in Cameroon. Further studies are needed to assess the risk of nosocomial transmission of HTLV-1, to guide public health authorities in implementing preventive measures to control HTLV-1 transmission.

Cancer survival in Africa, central and south America, and Asia (SURVCAN-3): a population-based benchmarking study in 32 countries.

BACKGROUND: Population-based cancer survival is a key measurement of cancer control performance linked to diagnosis and treatment, but benchmarking studies that include lower-income settings and that link results to health systems and human development are scarce. SURVCAN-3 is an international collaboration of population-based cancer registries that aims to benchmark timely and comparable cancer survival estimates in Africa, central and south America, and Asia. METHODS: In SURVCAN-3, population-based cancer registries from Africa, central and south America, and Asia were invited to contribute data. Quality control and data checks were carried out in collaboration with population-based cancer registries and, where applicable, active follow-up was performed at the registry. Patient-level data (sex, age at diagnosis, date of diagnosis, morphology and topography, stage, vital status, and date of death or last contact) were included, comprising patients diagnosed between Jan 1, 2008, and Dec 31, 2012, and followed up for at least 2 years (until Dec 31, 2014). Age-standardised net survival (survival where cancer was the only possible cause of death), with 95% CIs, at 1 year, 3 years, and 5 years after diagnosis were calculated using Pohar-Perme estimators for 15 major cancers. 1-year, 3-year, and 5-year net survival estimates were stratified by countries within continents (Africa, central and south America, and Asia), and countries according to the four-tier Human Development Index (HDI; low, medium, high, and very high). FINDINGS: 1 400 435 cancer cases from 68 population-based cancer registries in 32 countries were included. Net survival varied substantially between countries and world regions, with estimates steadily rising with increasing levels of the HDI. Across the included cancer types, countries within the lowest HDI category (eg, CÔte d'Ivoire) had a maximum 3-year net survival of 54·6% (95% CI 33·3-71·6; prostate cancer), whereas those within the highest HDI categories (eg, Israel) had a maximum survival of 96·8% (96·1-97·3; prostate cancer). Three distinct groups with varying outcomes by country and HDI dependant on cancer type were identified: cancers with low median 3-year net survival (<30%) and small differences by HDI category (eg, lung and stomach), cancers with intermediate median 3-year net survival (30-79%) and moderate difference by HDI (eg, cervix and colorectum), and cancers with high median 3-year net survival (≥80%) and large difference by HDI (eg, breast and prostate). INTERPRETATION: Disparities in cancer survival across countries were linked to a country's developmental position, and the availability and efficiency of health services. These data can inform policy makers on priorities in cancer control to reduce apparent inequality in cancer outcome. FUNDING: Tata Memorial Hospital, the Martin-Luther-University Halle-Wittenberg, and the International Agency for Research on Cancer.

Atmospheric phosphorus deposition amplifies carbon sinks in simulations of a tropical forest in Central Africa.

Spatial redistribution of nutrients by atmospheric transport and deposition could theoretically act as a continental-scale mechanism which counteracts declines in soil fertility caused by nutrient lock-up in accumulating biomass in tropical forests in Central Africa. However, to what extent it affects carbon sinks in forests remains elusive. Here we use a terrestrial biosphere model to quantify the impact of changes in atmospheric nitrogen and phosphorus deposition on plant nutrition and biomass carbon sink at a typical lowland forest site in Central Africa. We find that the increase in nutrient deposition since the 1980s could have contributed to the carbon sink over the past four decades up to an extent which is similar to that from the combined effects of increasing atmospheric carbon dioxide and climate change. Furthermore, we find that the modelled carbon sink responds to changes in phosphorus deposition, but less so to nitrogen deposition. The pronounced response of ecosystem productivity to changes in nutrient deposition illustrates a potential mechanism that could control carbon sinks in Central Africa. Monitoring the quantity and quality of nutrient deposition is needed in this region, given the changes in nutrient deposition due to human land use.