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1.
Emerg Microbes Infect ; 9(1): 291-301, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32013784

RESUMO

The average time required to detect an Ebola virus disease (EVD) outbreak following spillover of Ebola virus (EBOV) to a primary human case has remained essentially unchanged for over 40 years, with some of the longest delays in detection occurring in recent decades. In this review, our aim was to examine the relationship between delays in detection of EVD and the duration and size of outbreaks, and we report that longer delays are associated with longer and larger EVD outbreaks. Historically, EVD outbreaks have typically been comprised of less than 100 cases (median = 60) and have lasted less than 4 months (median = 118 days). The ongoing outbreak in Democratic Republic of the Congo, together with the 2013-2016 west Africa outbreak, are stark outliers amidst these trends and had two of the longest delays in detection on record. While significant progress has been made in the development of EVD countermeasures, implementation during EVD outbreaks is problematic. Thus, EVD surveillance must be improved by the broad deployment of modern diagnostic tools, as prompt recognition of EVD has the potential to stem early transmission and ultimately limit the duration and size of outbreaks.


Assuntos
Surtos de Doenças , Ebolavirus , Doença pelo Vírus Ebola/epidemiologia , África Central/epidemiologia , África Ocidental/epidemiologia , Humanos , Fatores de Tempo
2.
Artigo em Inglês | MEDLINE | ID: mdl-31776599

RESUMO

Today's world is characterized by increasing population density, human mobility, urbanization, and climate and ecological change. This global dynamic has various effects, including the increased appearance of emerging infectious diseases (EIDs), which pose a growing threat to global health security.Outbreaks of EIDs, like the 2013-2016 Ebola outbreak in West Africa or the current Ebola outbreak in Democratic Republic of the Congo (DRC), have not only put populations in low- and middle-income countries (LMIC) at risk in terms of morbidity and mortality, but they also have had a significant impact on economic growth in affected regions and beyond.The Coalition for Epidemic Preparedness Innovation (CEPI) is an innovative global partnership between public, private, philanthropic, and civil society organizations that was launched as the result of a consensus that a coordinated, international, and intergovernmental plan was needed to develop and deploy new vaccines to prevent future epidemics.CEPI is focusing on supporting candidate vaccines against the World Health Organization (WHO) Blueprint priority pathogens MERS-CoV, Nipah virus, Lassa fever virus, and Rift Valley fever virus, as well as Chikungunya virus, which is on the WHO watch list. The current vaccine portfolio contains a wide variety of technologies, ranging across recombinant viral vectors, nucleic acids, and recombinant proteins. To support and accelerate vaccine development, CEPI will also support science projects related to the development of biological standards and assays, animal models, epidemiological studies, and diagnostics, as well as build capacities for future clinical trials in risk-prone contexts.


Assuntos
Doenças Transmissíveis Emergentes , Epidemias , Vacinas , África Ocidental , Animais , Surtos de Doenças , Alemanha , Humanos
3.
Hum Genet ; 139(1): 45-59, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31630246

RESUMO

Due to its long genetic evolutionary history, Africans exhibit more genetic variation than any other population in the world. Their genetic diversity further lends itself to subdivisions of Africans into groups of individuals with a genetic similarity of varying degrees of granularity. It remains challenging to detect fine-scale structure in a computationally efficient and meaningful way. In this paper, we present a proof-of-concept of a novel fine-scale population structure detection tool with Western African samples. These samples consist of 1396 individuals from 25 ethnic groups (two groups are African American descendants). The strategy is based on a recently developed tool called IPCAPS. IPCAPS, or Iterative Pruning to CApture Population Structure, is a genetic divisive clustering strategy that enhances iterative pruning PCA, is robust to outliers and does not require a priori computation of haplotypes. Our strategy identified in total 12 groups and 6 groups were revealed as fine-scale structure detected in the samples from Cameroon, Gambia, Mali, Southwest USA, and Barbados. Our finding helped to explain evolutionary processes in the analyzed West African samples and raise awareness for fine-scale structure resolution when conducting genome-wide association and interaction studies.


Assuntos
Grupo com Ancestrais do Continente Africano/genética , Grupos Étnicos/genética , Variação Genética , Genética Populacional , Estudo de Associação Genômica Ampla , Haplótipos , Software , África Ocidental/etnologia , Humanos
4.
J Ethnopharmacol ; 247: 112203, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31472271

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Combretum racemosum showed activity in previous ethnopharmacological investigations of some Combretum species used in malaria treatment in parts of West Africa. AIM OF THE STUDY: This study aimed at confirming the antimalarial potential of this plant by an activity-guided isolation of its active principles. MATERIALS AND METHODS: A crude methanolic leaf extract of Combretum racemosum and fractions thereof obtained by partition with chloroform and n-butanol were investigated for antiplasmodial activity against chloroquine-sensitive (D10) and chloroquine-resistant (W2) strains of Plasmodium falciparum. Repeated chromatographic separations were conducted on the chloroform fraction to isolate bioactive compounds for further tests on antiplasmodial activity. The characterization of the isolated substances was performed by applying NMR- and MS-techniques (ESI-MS, HR-ESIMS, 1D and 2D NMR). RESULTS: The chloroform fraction (D10: IC50 = 33.8 ±â€¯1.5 µg/mL and W2: IC50 = 27.8 ±â€¯2.9 µg/mL) exhibited better antiplasmodial activity than the n-butanol fraction (D10: IC50 = 78.1 ±â€¯7.3 µg/mL and W2: IC50 = 78 ±â€¯15 µg/mL) as well as the methanolic raw extract (D10: IC50 = 64.2 ±â€¯2.7 µg/mL and W2: IC50 = 65.8 ±â€¯14.9 µg/mL). Thus, the focus of the phytochemical investigation was laid on the chloroform fraction, which led to the identification of four ursane-type (19α-hydroxyasiatic acid (1), 6ß,23-dihydroxytormentic acid (4), madecassic acid (8), nigaichigoside F1 (10)) and four oleanane-type (arjungenin (2), combregenin (5), terminolic acid (7), arjunglucoside I (11)) triterpenes, as well as abscisic acid (9). Compounds 1 and 2, 4 and 5, 7 and 8 as well as 10 and 11 were isolated as isomeric mixtures in fractions CR-A, CR-C, CR-E and CR-H, respectively. All isolated compounds and mixtures exhibited moderate to low activity, with madecassic acid being most active (D10: IC50 = 28 ±â€¯12 µg/mL and W2: IC50 = 17.2 ±â€¯4.3 µg/mL). CONCLUSION: This paper reports for the first time antiplasmodial principles from C. racemosum and thereby gives reason to the traditional use of the plant.


Assuntos
Antimaláricos/farmacologia , Combretum/química , Extratos Vegetais/farmacologia , Plasmodium falciparum/efeitos dos fármacos , Triterpenos/farmacologia , África Ocidental , Animais , Antimaláricos/isolamento & purificação , Antimaláricos/uso terapêutico , Etnofarmacologia , Humanos , Malária/tratamento farmacológico , Malária/parasitologia , Medicina Tradicional Africana/métodos , Metanol/química , Testes de Sensibilidade Parasitária , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/uso terapêutico , Triterpenos/isolamento & purificação , Triterpenos/uso terapêutico
5.
Zootaxa ; 4567(2): zootaxa.4567.2.7, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-31715900

RESUMO

Bromeliads (Bromeliaceae) are an extremely diverse family of the angiosperms widely distributed in the tropical and subtropical regions of the Americas and West Africa. They often serve as phytotelmata, accumulating rainwater between leaves. Such water reservoirs can be inhabited by diverse organisms. But to date not much attention is paid to inventory of these organisms, with careful identification of each taxon. We found a microcrustacean Disparalona hamata (Birge, 1879) (Crustacea: Cladocera) in the bromeliad Tillandsia aguascalentensis Gardner, 1984 in Mexico. Investigated population included parthenogenetic females, gamogenetic females and males. Hereby the population apparently can pass the full life cycle under conditions of phytotelmata. Along with ecological observations, we provide additional taxonomic notes on the genus Disparalona Fryer, 1968 itself. Recently a series of morphological revisions was conducted for this genus. It was subdivided into two subgenera: Disparalona s.str. and Mixopleuroxus Hudec, 2010. But, in fact, the second taxon is a junior synonym of Leptorhynchus Daday, 1905. In this regard here we provide an updated list of taxonomic synonyms for the subgenus Leptorhynchus.


Assuntos
Bromeliaceae , Cladóceros , Tillandsia , África Ocidental , Animais , Feminino , Masculino , México
6.
Zootaxa ; 4679(3): zootaxa.4679.3.10, 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31715953

RESUMO

The small-sized genus Haroldius Boucomont, 1914 consists of 38 known species widely distributed in the Old World including South Asia, Southeast Asia and West Africa (Pereira 1954; Krikken Huijbregts 2006; Král Hájek 2012). Members of this genus are probably saprophagous or mycophagous (Scheuern 1995) and so far were collected by light traps, sifted from leaf litter or soil and captured by flight interception traps (Paulian 1939; Paulian Scheuern 1994; Krikken Huijbregts 2006). Some researches suggested that they could have precise ecological relationship with ants. Their myrmecophily habit was indicated mainly by the special morphological characters including smooth body and the characteristically broad-ened and flattened tibiae (Pereira 1954; Krell Philips 2010). However, their bi-ology are still rarely reported, and the larvae are still unknown (Pereira 1954; Krikken Huijbregts 2006).


Assuntos
Besouros , África Ocidental , Animais , Ásia , Ecologia , Ecossistema , Masculino
7.
Zootaxa ; 4563(1): zootaxa.4563.1.2, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-31716552

RESUMO

The state São Tomé and Príncipe consists of two separated oceanic archipelagos situated in the Gulf of Guinea (West Central Africa). Except of a first survey on São Tomé in the 19th century, its Orthoptera fauna has never been studied systematically. Here a list of all tettigonioid species which have been recorded from the islands is presented together with information about the bioacoustics and biology of some species. Each archipelago harbours nine species, but only two species are found in both parts of the country. Two species and one subgenus are described as new: Adapantus (Adapantus) excavatus sp. nov., Brachyamytta bombomensis sp. nov., Neoadapantus subg. nov. The following nomenclatural changes had to be done: Corycoides greeffi (Krauss, 1890) becomes new synonym of Corycoides paradoxus (Bolivar, 1890), Xiphidion guineensis Redtenbacher, 1891, Xiphidion africanum Redtenbacher, 1891 and Conocephalus inequalis Uvarov, 1928 become new synonyms of Conocephalus iris Serville, 1838. The species list of Conocephalus, subgenus Conocephalus, is revised. Additionally the known tettigonioids of Annobón (Equatorial Guinea) are listed (4 species).


Assuntos
Ortópteros , África Ocidental , Distribuição Animal , Animais , Guiné Equatorial , Guiné , Insetos , Ilhas , Oceanos e Mares
8.
PLoS Negl Trop Dis ; 13(11): e0007814, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31751337

RESUMO

Despite a very effective vaccine, active conflict and community distrust during the ongoing DRC Ebola epidemic are undermining control efforts, including a ring vaccination strategy that requires the prompt immunization of close contacts of infected individuals. However, in April 2019, it was reported 20% or more of close contacts cannot be reached or refuse vaccination, and it is predicted that the ring vaccination strategy would not be effective with such a high level of inaccessibility. The vaccination strategy is now incorporating a "third ring" community-level vaccination that targets members of communities even if they are not known contacts of Ebola cases. To assess the impact of vaccination strategies for controlling Ebola epidemics in the context of variable levels of community accessibility, we employed an individual-level stochastic transmission model that incorporates four sources of heterogeneity: a proportion of the population is inaccessible for contact tracing and vaccination due to lack of confidence in interventions or geographic inaccessibility, two levels of population mixing resembling household and community transmission, two types of vaccine doses with different time periods until immunity, and transmission rates that depend on spatial distance. Our results indicate that a ring vaccination strategy alone would not be effective for containing the epidemic in the context of significant delays to vaccinating contacts even for low levels of household inaccessibility and affirm the positive impact of a supplemental community vaccination strategy. Our key results are that as levels of inaccessibility increase, there is a qualitative change in the effectiveness of the vaccination strategy. For higher levels of vaccine access, the probability that the epidemic will end steadily increases over time, even if probabilities are lower than they would be otherwise with full community participation. For levels of vaccine access that are too low, however, the vaccination strategies are not expected to be successful in ending the epidemic even though they help lower incidence levels, which saves lives, and makes the epidemic easier to contain and reduces spread to other communities. This qualitative change occurs for both types of vaccination strategies: ring vaccination is effective for containing an outbreak until the levels of inaccessibility exceeds approximately 10% in the context of significant delays to vaccinating contacts, a combined ring and community vaccination strategy is effective until the levels of inaccessibility exceeds approximately 50%. More broadly, our results underscore the need to enhance community engagement to public health interventions in order to enhance the effectiveness of control interventions to ensure outbreak containment.


Assuntos
Vacinas contra Ebola/administração & dosagem , Ebolavirus/imunologia , Doença pelo Vírus Ebola/prevenção & controle , Vacinação/métodos , África Ocidental/epidemiologia , Ebolavirus/genética , Epidemias , Características da Família , Feminino , Doença pelo Vírus Ebola/imunologia , Doença pelo Vírus Ebola/transmissão , Doença pelo Vírus Ebola/virologia , Humanos , Masculino
9.
Rev Sci Tech ; 38(1): 113-122, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31564736

RESUMO

The natural ecology of Ebola virus infection remains enigmatic. No clear reservoir species has been confirmed but there is evidence of infection in a wide spectrum of mammals, including humans, non-human primates, domestic and wild ungulates and a variety of bat species, both frugivorous and insectivorous. Humans and most other species examined appear to be spillover hosts and suffer disease. Bats are the exception and are tolerant to infection in some laboratory studies. Some surveys show a low prevalence of antibodies against Zaire Ebola virus (ZEBOV) strains in bats during human outbreaks and inter-epidemic periods, and this order of mammals is considered to be the likely reservoir for the virus. Other putative sources include insects but this hypothesis is unproven in the field or laboratory. Moreover, some potential sources, such as aquatic species, have yet to be investigated. There are a number of environmental, human behavioural and ecological risk factors proposed with respect to spillover and spread. In the West African outbreak, which was unprecedented in scale and geographic spread, the source of the spillover remains unproven, although an association exists between the proposed index case and a colony of insectivorous bats. In all but a few Ebola virus disease events, spillover has only been superficially investigated and this was also the case in the West African epidemic. The authors suggest that, to address risks at the human-animal-environmental interface, using a One Health approach, more effort is needed to investigate spillover factors at the time of a ZEBOV epidemic, in addition to conducting inter-epidemic surveys in peridomestic environments. The true prevalence of ZEBOV infection in any species of bats remains unknown. Large-scale, expensive, non-randomised surveys, with low sampling numbers per species, are unlikely to provide evidence for Ebola virus reservoirs or to improve our epidemiological understanding.


Assuntos
Ebolavirus , Doença pelo Vírus Ebola , África Ocidental/epidemiologia , Animais , Quirópteros/virologia , Surtos de Doenças/prevenção & controle , Reservatórios de Doenças , Ebolavirus/fisiologia , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/virologia , Humanos
10.
Public Health Rep ; 134(6): 592-598, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31600452

RESUMO

The 2014-2016 Ebola epidemic in West Africa influenced how public health officials considered migration and emerging infectious diseases. Responding to the public's concerns, the US government introduced enhanced entry screening and post-arrival monitoring by public health authorities to reduce the risk of importation and domestic transmission of Ebola while continuing to allow travel from West Africa. This case study describes a new initiative, the Check and Report Ebola (CARE+) program that engaged travelers arriving to the United States from countries with Ebola outbreaks. The Centers for Disease Control and Prevention employed CARE ambassadors, who quickly communicated with incoming travelers and gave them practical resources to boost their participation in monitoring for Ebola. The program aimed to increase travelers' knowledge of Ebola symptoms and how to seek medical care safely, increase travelers' awareness of monitoring requirements, reduce barriers to monitoring, and increase trust in the US public health system. This program could be adapted for use in future outbreaks that involve the potential importation of disease and require the education and active engagement of travelers to participate in post-arrival monitoring.


Assuntos
Educação em Saúde , Doença pelo Vírus Ebola/epidemiologia , Programas de Rastreamento , Vigilância da População , Saúde Pública/tendências , Viagem , África Ocidental , Epidemias/prevenção & controle , Comunicação em Saúde , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Estados Unidos/epidemiologia
11.
PLoS Negl Trop Dis ; 13(10): e0007791, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31618206

RESUMO

Monkeypox is a vesicular-pustular illness that carries a secondary attack rate in the order of 10% in contacts unvaccinated against smallpox. Case fatality rates range from 1 to 11%, but scarring and other sequelae are common in survivors. It continues to cause outbreaks in remote populations in Central and West Africa, in areas with poor access and weakened or disrupted surveillance capacity and information networks. Recent outbreaks in Nigeria (2017-18) and Cameroon (2018) have occurred where monkeypox has not been reported for over 20 years. This has prompted concerns over whether there have been changes in the biology and epidemiology of the disease that may in turn have implications for how outbreaks and cases should best be managed. A systematic review was carried out to examine reported data on human monkeypox outbreaks over time, and to identify if and how epidemiology has changed. Published and grey literature were critically analysed, and data extracted to inform recommendations on outbreak response, use of case definitions and public health advice. The level of detail, validity of data, geographical coverage and consistency of reporting varied considerably across the 71 monkeypox outbreak documents obtained. An increase in cases reported over time was supported by literature from the Democratic Republic of Congo (DRC). Data were insufficient to measure trends in secondary attack rates and case fatality rates. Phylogenetic analyses consistently identify two strains of the virus without evidence of emergence of a new strain. Understanding of monkeypox virulence with regard to clinical presentation by strain is minimal, with infrequent sample collection and laboratory analysis. A variety of clinical and surveillance case definitions are described in the literature: two definitions have been formally evaluated and showed high sensitivity but low specificity. These were specific to a Congo-Basin (CB) strain-affected area of the DRC where they were used. Evidence on use of antibiotics for prophylaxis against secondary cutaneous infection is anecdotal and limited. Current evidence suggests there has been an increase in total monkeypox cases reported by year in the DRC irrespective of advancements in the national Integrated Disease Surveillance and Response (IDSR) system. There has been a marked increase in number of individual monkeypox outbreak reports, from outside the DRC in between 2010 and 2018, particularly in the Central African Republic (CAR) although this does not necessarily indicate an increase in annual cases over time in these areas. The geographical pattern reported in the Nigeria outbreak suggests a possible new and widespread zoonotic reservoir requiring further investigation and research. With regards to outbreak response, increased attention is warranted for high-risk patient groups, and nosocomial transmission risks. The animal reservoir remains unknown and there is a dearth of literature informing case management and successful outbreak response strategies. Up-to-date complete, consistent and longer-term research is sorely needed to inform and guide evidence-based response and management of monkeypox outbreaks.


Assuntos
Surtos de Doenças , Monkeypox/epidemiologia , Monkeypox/virologia , África Ocidental/epidemiologia , Animais , República Centro-Africana/epidemiologia , Bases de Dados Factuais , Humanos , Monkeypox/transmissão , Vírus da Varíola dos Macacos/classificação , Filogenia , Saúde Pública , Virulência
12.
BMC Infect Dis ; 19(1): 810, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533659

RESUMO

BACKGROUND: The 2014-2016 Ebola epidemic in West Africa was the largest Ebola epidemic to date. Contact tracing was a core surveillance activity. Challenges with paper-based contact tracing systems include incomplete identification of contacts, delays in communication and response, loss of contact lists, inadequate data collection and transcription errors. The aim of this study was to design and evaluate an electronic system for tracing contacts of Ebola cases in Port Loko District, Sierra Leone, and to compare this with the existing paper-based system. The electronic system featured data capture using a smartphone application, linked to an alert system to notify the District Ebola Response Centre of symptomatic contacts. METHODS: The intervention was a customised three-tier smartphone application developed using Dimagi's CommCare platform known as the Ebola Contact Tracing application (ECT app). Eligible study participants were all 26 Contact Tracing Coordinators (CTCs) and 86 Contact Tracers (CTs) working in the 11 Chiefdoms of Port Loko District during the study period (April-August 2015). Case detection was from 13th April to 17th July 2015. The CTCs and their CTs were provided with smartphones installed with the ECT app which was used to conduct contact tracing activities. Completeness and timeliness of contact tracing using the app were compared with data from April 13th-June 7th 2015, when the standard paper-based system was used. RESULTS: For 25 laboratory-confirmed cases for whom paper-based contact tracing was conducted, data for only 39% of 408 contacts were returned to the District, and data were often incomplete. For 16 cases for whom app-based contact tracing was conducted, 63% of 556 contacts were recorded as having been visited on the app, and the median recorded duration from case confirmation to first contact visit was 70 h. CONCLUSION: There were considerable challenges to conducting high-quality contact tracing in this setting using either the paper-based or the app-based system. However, the study demonstrated that it was possible to implement mobile health (mHealth) in this emergency setting. The app had the benefits of improved data completeness, storage and accuracy, but the challenges of using an app in this setting and epidemic context were substantial.


Assuntos
Busca de Comunicante/métodos , Doença pelo Vírus Ebola/diagnóstico , Adolescente , Adulto , África Ocidental , Criança , Pré-Escolar , Surtos de Doenças , Feminino , Doença pelo Vírus Ebola/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis , Serra Leoa/epidemiologia , Telemedicina , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-31547169

RESUMO

The increasing prevalence and poorer management of Type 2 diabetes among West African immigrants in the UK is a public health concern. This research explored the experiences of West African immigrants in the management of Type 2 diabetes in the UK using a constructivist grounded theory approach. In-depth individual interviews were conducted with thirty-four West African immigrants living with Type 2 diabetes in the London area. Fifteen male and nineteen female adult West African immigrants with age range from 33-82 years participated in the study. Participants were recruited from five diabetes support groups and community settings. Initial, focused and theoretical coding, constant comparison and memos were used to analyse collected data. Three concepts emerged: Changing dietary habits composed of participants' experiences in meeting dietary recommendations, improving physical activity concerned with the experience of reduced physical activity since moving to the UK and striving to adapt which focus on the impact of migration changes in living with Type 2 diabetes in the UK. These address challenges that West African immigrants experience in the management of Type 2 diabetes in the UK. The findings of this research provide a better understanding of the influencing factors and can be used to improve the support provided for West Africans living with Type 2 diabetes in the UK, presenting a deeper understanding of socio-cultural factors that contribute to supporting individuals from this population.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Diabetes Mellitus Tipo 2/etnologia , Dieta/etnologia , Emigrantes e Imigrantes/psicologia , Adulto , África Ocidental/etnologia , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus Tipo 2/dietoterapia , Exercício , Comportamento Alimentar , Feminino , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Reino Unido
14.
Int Health ; 11(5): 334-337, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31385587

RESUMO

Recent disease outbreaks have demonstrated the severe health, economic and political crises that epidemics can trigger. The rate of emergence of infectious diseases is accelerating and, with deepening globalisation, pathogens are increasingly mobile. Yet the 2014-2015 West African Ebola epidemic exposed major gaps in the world's capacity to prevent and respond to epidemics. In the midst of the world's second largest ever recorded Ebola outbreak in the Democratic Republic of the Congo, we reflect on six of the many lessons learnt from the epidemic in West Africa, focusing on progress made and the challenges ahead in preparing for future threats. While Ebola and other emerging epidemics will remain a challenge in the years to come, by working in partnership with affected communities and across sectors, and by investing in robust health systems, it is within our power to be better prepared when they strike.


Assuntos
Surtos de Doenças/prevenção & controle , Epidemias/prevenção & controle , Saúde Global , Doença pelo Vírus Ebola/epidemiologia , África Ocidental/epidemiologia , República Democrática do Congo/epidemiologia , Humanos
15.
Health Policy Plan ; 34(7): 529-543, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31377775

RESUMO

West African countries are ranked especially low in global corruption perception indexes. The health sector is often singled out for particular concern given the role of corruption in hampering access to, and utilization of health services, representing a major barrier to progress to universal health coverage and to achieving the health-related Sustainable Development Goals. The first step in tackling corruption systematically is to understand its scale and nature. We present a systematic review of literature that explores corruption involving front-line healthcare providers, their managers and other stakeholders in health sectors in the five Anglophone West African (AWA) countries: Gambia, Ghana, Liberia, Nigeria and Sierra Leone, identifying motivators and drivers of corrupt practices and interventions that have been adopted or proposed. Boolean operators were adopted to optimize search outputs and identify relevant studies. Both grey and published literature were identified from Research Gate, Yahoo, Google Scholar, Google and PubMed, and reviewed and synthesized around key domains, with 61 publications meeting our inclusion criteria. The top five most prevalent/frequently reported corrupt practices were (1) absenteeism; (2) diversion of patients to private facilities; (3) inappropriate procurement; (4) informal payments; and (5) theft of drugs and supplies. Incentives for corrupt practices and other manifestations of corruption in the AWA health sector were also highlighted, while poor working conditions and low wages fuel malpractice. Primary research on anti-corruption strategies in health sectors in AWA remains scarce, with recommendations to curb corrupt practices often drawn from personal views and experience rather that of rigorous studies. We argue that a nuanced understanding of all types of corruption and their impacts is an important precondition to designing viable contextually appropriate anti-corruption strategies. It is a particular challenge to identify and tackle corruption in settings where formal rules are fluid or insufficiently enforced.


Assuntos
Fraude/estatística & dados numéricos , Setor de Assistência à Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Absenteísmo , África Ocidental , Fraude/economia , Setor de Assistência à Saúde/economia , Setor de Assistência à Saúde/ética , Pessoal de Saúde/economia , Humanos , Roubo/estatística & dados numéricos
16.
J Ethnobiol Ethnomed ; 15(1): 37, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409403

RESUMO

BACKGROUND: An ethnobotanical study was conducted in the eight regions of Niger to identify local knowledge variation of millet (Pennisetum glaucum (L.) R. Br) uses. In fact, the level of individual knowledge can be affected by many factors such as gender, age, ethnicity, occupation, religious and cultural beliefs, etc. This study documented indigenous knowledge of millet uses in Niger and aimed specifically to (i) identify the different types of millet organ uses and (ii) assess the variation of local knowledge of millet uses along with ethnicity, occupation, and age. METHODS: The data were collected in 32 major millet-producing villages in Niger through individual semi-structured interviews and focus group discussions. About 508 individuals from 5 ethnic groups were interviewed. The assessment of the knowledge was performed by calculating five ethnobotanical indices such as the number of reported uses by parts of the plant (RU), the use-value of the parts of the plant (PPV), the specific use-value (SU), the intraspecific use-value (IUV), and the relative frequency of citations (FRC). Data were analyzed using descriptive, univariate, and multivariate statistical analyses. RESULTS: The results indicated a significant variation in uses across ethnic groups (H = 38.14, P = 0.000) and socio-occupational categories (H = 6.80, P = 0.033). The Hausa, Kanuri, and Zarma-Sonhrai ethnic groups, farmers were the largest users of the species. Dietary (51.40%) and forage (40.35%) were the most reported uses. The most commonly used parts of the plant were the stubble (74.92%) and grains (73.68%). CONCLUSIONS: The study showed the importance of P. glaucum in the daily life of local people. It also confirmed the uneven distribution of indigenous knowledge of millet uses in Niger due to social factors. Now, the challenge is how to incorporate these social differences in knowledge of millet uses in view to sustainable management and conservation of local genetic resources of millet. Finally, this work could be an important decision-making tool for future millet valuing.


Assuntos
Comparação Transcultural , Etnobotânica/métodos , Conhecimento , Pennisetum/classificação , África Ocidental , Características Culturais , Países em Desenvolvimento , Feminino , Humanos , Entrevistas como Assunto , Masculino , Milhetes/classificação , Níger , Plantas Comestíveis , Fatores Socioeconômicos
17.
Artigo em Inglês | MEDLINE | ID: mdl-31438546

RESUMO

The Ebola epidemic in West Africa between 2014 and 2015 was the deadliest since the discovery of the virus four decades ago. With the second-largest outbreak of Ebola virus disease currently raging in the Democratic Republic of the Congo, (DRC) it is clear that lessons from the past can be quickly forgotten-or be incomplete in the first instance. In this article, we seek to understand the health challenges facing marginalised people by elaborating on the multiple dimensions of marginalisation in the case of the West Africa Ebola epidemic. We trace and unpack modes of marginalisation, beginning with the "outbreak narrative" and its main components and go on to examine other framings, including the prioritisation of the present over the past, the positioning of 'Us versus Them'; and the marginalisation-in responses to the outbreak-of traditional medicine, cultural practices and other practices around farming and hunting. Finally, we reflect on the 'lessons learned' framing, highlighting what is included and what is left out. In conclusion, we stress the need to acknowledge-and be responsive to-the ethical, normative framings of such marginalisation.


Assuntos
Doença pelo Vírus Ebola/epidemiologia , África Ocidental/epidemiologia , Surtos de Doenças , Humanos , Marginalização Social
18.
Artigo em Alemão | MEDLINE | ID: mdl-31420718

RESUMO

In 2014/2015 West Africa suffered an Ebola virus disease (EVD) outbreak of unprecedented unknown severity. The outbreak affected mostly Liberia, Sierra Leone and Guinea, and for the first time spread to major cities, some of which have international airports. Worldwide, 28,652 cases were registered, 11,325 of which were fatal. A few cases were confirmed outside the main outbreak countries. Three EVD patients and one person with a needle-stick injury were evacuated to Germany and treated or kept under observation there. One of the patients died.In this article, the course of the outbreak and the international response are addressed. Epidemiological data and important political developments in connection with the EVD outbreak are summarized.The outbreak started in December 2013 in Guinea. It reached its peak from September to December 2014. On 8 August 2014, the World Health Organization (WHO) declared a public health emergency of international concern (PHEIC). The General Assembly of the United Nations (UN) established on 19 September 2014 the UN Mission for Ebola Emergency Response (UNMEER). On the same day, the German government pledged more financial aid and other support, such as the establishment of an air bridge, the construction of treatment centres and training.Up until April 2016, there were repeated local outbreaks. On 29 March 2016 WHO declared that the PHEIC had ended. On 28 April 2016 the outbreak was finally over.


Assuntos
Surtos de Doenças , Doença pelo Vírus Ebola/terapia , África Ocidental/epidemiologia , Surtos de Doenças/prevenção & controle , Alemanha , Guiné/epidemiologia , Doença pelo Vírus Ebola/epidemiologia , Humanos , Internacionalidade , Serra Leoa/epidemiologia
19.
Dev Psychol ; 55(9): 1850-1867, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31464490

RESUMO

Studies conducted in Western countries document the special role of mother-infant face-to-face exchanges for early emotional development including social smiling. A few cross-cultural studies have shown that the Western pattern of face-to-face communication is absent in traditional rural cultures, without identifying other processes that promote emotional Co-regulation. The present study compared three different samples: Western middle-class families in Italy, rural traditional Nso farmer families in Cameroon, and West African sub-Saharan immigrant families in Italy using biweekly observations of 20 mother-infant dyads from each cultural context from age 4 to 12 weeks. Longitudinal sequential analysis of maternal and infant behaviors showed that from as early as 4 weeks, in Italian dyads maternal affectionate talking is linked with infant active attention to mother in sequences of face-to-face contact; this link fosters the subsequent emergence of infant smiling/cooing, and then sequences of positive feedback between infant and maternal emotional expressions that, by the 3rd month, dynamically stabilize. In contrast, for Cameroonian/Nso dyads over the 2nd and 3rd month, maternal motor stimulation marked by rhythmic vocalizing is linked with infant active attention to surroundings. The relatively few smiling/cooing actions of Nso babies at their mothers were answered mainly with tactile stimulation that did not foster the maintenance of face-to-face visual contact. Finally, West African immigrant dyads showed a combination of both face-to-face and sensorimotor coregulated exchanges observed in their new and native cultures. These findings suggest that emotional Co-regulation in early infancy can occur via multiple, culture-specific pathways that may be substantially different from the western pattern of face-to-face communication. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Desenvolvimento Infantil/fisiologia , Comparação Transcultural , Emoções/fisiologia , Comportamento do Lactente/fisiologia , Relações Mãe-Filho/etnologia , Sorriso , Adulto , África Ocidental/etnologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Camarões , Emigrantes e Imigrantes/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Lactente , Itália , Estudos Longitudinais , Masculino , Tato
20.
Artigo em Alemão | MEDLINE | ID: mdl-31428830

RESUMO

The Ebola virus disease outbreak in West Africa in 2014/2015 was by far the biggest, most prolonged, and geographically most widespread outbreak of this disease since the discovery of the Ebola virus in 1976. Although no cases of Ebola virus disease were confirmed in Germany, a number of crisis management activities were initiated.Based on a combination of local, national, and international lessons learned, literature research, and a large number of discussions among German colleagues as well as German and foreign colleagues, the experiences of selected German public health actors as well as implications for health protection activities in Germany are presented.On the one hand, preparedness for managing unusual high consequence health events-caused by rare, highly pathogenic biological agents-including the provision of adequate material and personnel resources remains important in Germany. On the other hand, more German engagement in global health is necessary, because the dividing line between global health and local health is increasingly disappearing.


Assuntos
Surtos de Doenças , Doença pelo Vírus Ebola , Saúde Pública , África Ocidental , Alemanha , Humanos
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