A Dynamic 6,000-Year Genetic History of Eurasia's Eastern Steppe.

The Eastern Eurasian Steppe was home to historic empires of nomadic pastoralists, including the Xiongnu and the Mongols. However, little is known about the region's population history. Here, we reveal its dynamic genetic history by analyzing new genome-wide data for 214 ancient individuals spanning 6,000 years. We identify a pastoralist expansion into Mongolia ca. 3000 BCE, and by the Late Bronze Age, Mongolian populations were biogeographically structured into three distinct groups, all practicing dairy pastoralism regardless of ancestry. The Xiongnu emerged from the mixing of these populations and those from surrounding regions. By comparison, the Mongols exhibit much higher eastern Eurasian ancestry, resembling present-day Mongolic-speaking populations. Our results illuminate the complex interplay between genetic, sociopolitical, and cultural changes on the Eastern Steppe.

Understanding brucellosis: knowledge, perceptions, and self-reported prevalence among agro-pastoralists in Nakasongola, Uganda.

BACKGROUND: Brucellosis is an infectious zoonotic disease that poses serious health threats around the world including Uganda. Brucellosis is caused by Brucella spp., the bacteria being transmitted via contact through skin breaks, via inhalation, or orally through the consumption of raw milk and other dairy products. The aim of this study was to investigate self-reported prevalence, knowledge, and perceptions towards brucellosis transmission, within agro-pastoralist communities in the Nakasongola district, central Uganda. METHODS: This study employed a cross-sectional survey design. A semi-structured questionnaire was developed and administered to 398 participants selected through convenience sampling method. The survey gathered information on socio-demographic characteristics, knowledge of brucellosis transmission, symptoms, preventive measures, and self-reported prevalence of brucellosis. Qualitative data involved the use of six focus group discussions, identifying factors for transmission based on their perceived level of risk or impact using ranking by proportional piling. RESULTS: A majority (99.2%, n = 398) had heard about brucellosis and 71.2% were aware of the zoonotic nature of the disease. There were varied responses regarding transmission routes, symptoms, and preventive measures. Self-reported prevalence was relatively high (55.5%). Following adjusted analysis, factors such as subcounty, source of income, knowledge about symptoms of brucellosis, whether brucellosis is treatable, perception, and living close to animals were statistically significant. Participants from Wabinyonyi had 2.7 higher odds of reporting brucellosis than those from Nabiswera, aOR = 2.7, 95%CI 1.4-5.5. Crop farming and livestock had much higher odds of reporting brucellosis than those earning from casual sources, aOR = 8.5, 95%C 1.8-40.1 and aOR = 14.4, 95%CI 3.1-67.6, respectively. Those who had knowledge about symptoms had 6.9 higher odds of reporting brucellosis than who mentioned fever, aOR = 4.5, 95%CI 2.3-18.3. Likewise, living close with animals and handling aborted fetuses (aOR = 0.4, 95%CI: 0.17-0.86), (aOR = 0.2,95% CI: 0.07-0.0.42,) had significantly lower odds for self-reported prevalence compared to those who believed did not cause brucellosis. Risk factors identified included, handling of aborted fetuses and living in close proximity with animals. Overall, there was a moderate statistical agreement in the ranking across the focus groups discussion (Wc = 0.48, p < 0.01; n = 6). CONCLUSION: While awareness of brucellosis is high in the community, understanding of the transmission routes, clinical symptoms, and preventive measures varied. Investigating the understanding and assessing knowledge, perceptions and self-reported prevalence in this region indicated a necessity for risk communication strategies and community-based interventions to better control brucellosis transmission.

Recent Research on the Human Biology of Pastoralists.

Despite encroachment by agricultural systems and globalization, pastoral nomads maintain a robust presence in terms of numbers and subsistence activity. At the same time, increasing concern about climate change has promoted awareness that increased climatic fluctuation may push pastoral population past their capacity for resilience. The response of pastoralists to climate change has important implications for our evolutionary past and our increasingly problematic future. Yet, pastoralists have received less explicit attention than foragers as populations under consistent selective constraints including limited caloric intake, high levels of habitual activity, and high disease burdens. Additional factors include exposure to cold and high temperatures, as well as high altitude. Over the last 20 or so years, the use of new techniques for measuring energetics, including actigraphs and doubly labeled water have built on existing noninvasive sample collection for hormones, immune markers and genes to provide a more detailed picture of the human biology of pastoral populations. Here I consider recent work on pastoralists from Siberia and northern Europe, Africa, Asia, and South America. I survey what is known about maternal milk composition and infant health, childhood growth, lactase persistence, and adult energy expenditure and lactase persistence to build a picture of the pastoralist biological response to environmental conditions, including heat, cold, and high altitude. Where available I include information about population history because of its importance for selection. I end by outlining the impact of milk consumption and climate over the human life cycle and make suggestions for further research.

Different groups' grazing technique preferences in the Miombo woodlands of Eastern Tanzania.

Grazing in Miombo woodlands is essential for the livelihoods of the pastoral and agropastoral communities that live adjacent to these fragile ecosystems. However, Miombo woodlands offer not only fodder for livestock but also fertile land for crop farming; hence, they are equally important to the farmers residing in these areas. Due to the importance of the Miombo woodlands for the livelihoods of several groups, the consumption of and competition for Miombo resources has increased over time and now threatens the overall health of the ecosystem. This study aimed to identify the grazing techniques practiced by different livelihood groups in Miombo woodlands; their preferences for different practices, as well as the factors that influence these preferences, so as to understand how sustainable grazing can be achieved for better ecosystem health. The study was conducted in Handeni, Kilombero, and Kilosa districts and covered pastoralists, agropastoralists, and farmers. We carried out focus group discussions, key informant interviews, and a survey of 246 respondents. Un-patterned rotational grazing was the most preferred grazing technique by all three groups, and the only technique the three groups shared a preference for. All the groups took a neutral stance in relation to continuous grazing. Their preferences for other grazing techniques differ. The study highlights the need to raise awareness amongst pastoralists about land ownership and management and recommends enhancing land property rights for all groups in order to harmonize livestock keeping and other land uses for achieving sustainable grazing and overall ecosystem health in the fragile Miombo woodlands of Tanzania.

Demographic and Selection Histories of Populations Across the Sahel/Savannah Belt.

The Sahel/Savannah belt harbors diverse populations with different demographic histories and different subsistence patterns. However, populations from this large African region are notably under-represented in genomic research. To investigate the population structure and adaptation history of populations from the Sahel/Savannah space, we generated dense genome-wide genotype data of 327 individuals-comprising 14 ethnolinguistic groups, including 10 previously unsampled populations. Our results highlight fine-scale population structure and complex patterns of admixture, particularly in Fulani groups and Arabic-speaking populations. Among all studied Sahelian populations, only the Rashaayda Arabic-speaking population from eastern Sudan shows a lack of gene flow from African groups, which is consistent with the short history of this population in the African continent. They are recent migrants from Saudi Arabia with evidence of strong genetic isolation during the last few generations and a strong demographic bottleneck. This population also presents a strong selection signal in a genomic region around the CNR1 gene associated with substance dependence and chronic stress. In Western Sahelian populations, signatures of selection were detected in several other genetic regions, including pathways associated with lactase persistence, immune response, and malaria resistance. Taken together, these findings refine our current knowledge of genetic diversity, population structure, migration, admixture and adaptation of human populations in the Sahel/Savannah belt and contribute to our understanding of human history and health.

Only Death Will Separate Us: The Role of Extramarital Partnerships among Himba Pastoralists.

Extramarital partnerships are highly stigmatized in many societies and are typically excluded from studies of family dynamics and social support. Nevertheless, in many societies such relationships are common and can have important impacts on resource security and health outcomes. However, current studies of these relationships come mainly from ethnographic studies, with quantitative data extremely rare. Here we present data from a 10-year study of romantic partnerships among a community of Himba pastoralists in Namibia, where concurrency is common. The majority of married men (97%) and women (78%) currently reported having more than one partner (n = 122). Using multilevel models comparing marital and nonmarital relationships, we found that, contrary to conventional wisdom surrounding concurrency, Himba form enduring bonds with extramarital partners that often last decades and are very similar to marital ones in terms of length, emotional affect, reliability, and future prospects. Qualitative interview data showed that extramarital relationships were imbued with a set of rights and obligations that, while distinct from those of spouses, provide an important source of support. Greater inclusion of these relationships in studies of marriage and family would provide a clearer picture of social support and resource transfers in these communities and help to explain variation in the practice and acceptance of concurrency around the world.

Determinants of breast self-examination practice among women attending pastoralist health facilities, Southern Ethiopia: a cross-sectional study.

BACKGROUND: Breast cancer remains the most serious public health problem affecting millions of women worldwide. Despite various studies regarding breast self-examination practices conducted among health professionals and students in Ethiopia, limited information was found on women attending health care services in the pastoralist community. This study aimed to identify the determinants of breast self-examination practice (BSE) among women attending pastoralist health facilities in Southern Ethiopia. METHODS: An institutional-based cross-sectional study was conducted among 421 women who were attending family planning services in pastoralist health facilities in South Omo Zone, Southern Ethiopia from January to February 2022 using systematic random sampling to select a woman from each health facility in Jinka town. Data were collected using structured, pretested, and interviewer-administered questionnaires. Descriptive statistics such as proportions, means, and standard deviations were used to describe each relevant variable. Bivariate and multivariate logistic regression analyses were used to identify the determinants of BSE practices among women. RESULT: The mean age of the women was 25.43 ± 6.66 years. Fifty-four percent (n = 173) of the women had heard of BSE from health professionals. Eighty-nine (21.1%) women had undergone BSE. Women who resided in the urban areas (AOR = 6.79, CI: 3.40, 13.56), attained at least primary education and above (AOR = 8.96, CI: 4.14, 19.35), heard about BSE (AOR = 4.07, CI: 2.07, 7.98), and had a family history of breast cancer (AOR = 7.46, CI = 3.27, 17.00) were significantly associated with BSE practice. CONCLUSION AND RECOMMENDATION: Our study showed that women's practice of BSE was lower when compared with the local studies. We recommend health care professionals and others working in the area improve ways of increasing awareness about breast cancer, including its risk, and the need for BSE.

Global principles in local traditional knowledge: A review of forage plant-livestock-herder interactions.

An understanding of traditional ecological knowledge systems is increasingly acknowledged as a means of helping to develop global, regional and national, but locally relevant policies. Pastoralists often use lands that are unsuitable for crops due to biophysical and climatic extremities and variabilities. Forage plants of pastures are utilized by herding communities by applying locally relevant multigenerational knowledge. We analyzed the forage-related knowledge of pastoralists and herders by reviewing scientific papers and video documentaries on forage plants and indicators, their use in land management, and plant-livestock interactions. Semi-structured interviews were also conducted with key knowledge holders in Iran, Mongolia, Kenya, Poland and Hungary. We found 35 indicators used by herders to describe forage species. The indicators described botanical features, livestock behavior during grazing, and the impact of plants on livestock condition and health. The indicators were used in context-specific management decisions, with a variety of objectives to optimize grazing. We identified ten global principles, including, among others, a livestock-centered perspective, close monitoring and targeted pasturing of various (preferred or avoided) forages, and the use of different livestock types and well-planned spatial movements at multiple scales to optimize the utilization of available plant resources. Although pastoralists vary greatly across the globe, the character and use of their traditional forage-related knowledge do seem to follow strikingly similar principles. Understanding these may help the local-to-global-level understanding of these locally specific systems, support bottom-up pastoral initiatives and discussions on sustainable land management, and help to develop locally relevant global and national policies.

Water Insecurity, Water Borrowing, and Psychosocial Stress Among Daasanach Pastoralists in Northern Kenya.

This article quantifies Daasanach water insecurity experiences in Northern Kenya, examines how water insecurity is associated with water borrowing and psychosocial stress, and evaluates if water borrowing mitigates the stress from water insecurity. Of 133 households interviewed in 7 communities, 94% were water insecure and 74.4% borrowed water three or more times in the prior month. Regression analyses demonstrate water borrowing frequency moderates the relationship between water insecurity and psychosocial stress. Only those who rarely or never borrowed water reported greater stress with higher water insecurity. The coping mechanism of water borrowing may help blunt water insecurity-related stress.

Leaving no one behind: targeting mobile and migrant populations with health interventions for disease elimination-a descriptive systematic review.

BACKGROUND: Mobile and migrant populations (MMPs) pose a unique challenge to disease elimination campaigns as they are often hard to survey and reach with treatment. While some elimination efforts have had success reaching MMPs, other campaigns are struggling to do so, which may be affecting progress towards disease control and elimination. Therefore, this paper reviews the literature on elimination campaigns targeting MMPs across a selection of elimination diseases-neglected tropical diseases, malaria, trypanosomiasis, polio, smallpox, and rinderpest. METHODS: Through a systematic review process following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a three-person review team identified papers from databases, conference records, and citation searches using inclusion/exclusion criteria. Papers were divided into three key outcome domains during the synthetization process: (1) MMP movement patterns in East Africa including reasons for movement and consequences in terms of health outcomes and healthcare access; (2) MMP contribution to the transmission of disease across all geographies; (3) surveillance methods and treatment interventions used to implement programming in MMPs across all geographies. Experts in the field also provided supplemental information and gray literature to support this review. RESULTS: The review identified 103 records which were descriptively analyzed using the outcome domains. The results indicate that in East Africa, there are various motivations for migration from economic opportunity to political unrest to natural disasters. Regardless of motivation, mobile lifestyles affect health service access such that MMPs in East Africa report barriers in accessing healthcare and have limited health knowledge. Often lower service delivery to these populations has resulted in higher disease prevalence. A minority of articles suggest MMPs do not pose challenges to reaching disease control and elimination thresholds. Finally, the literature highlighted surveillance methods (e.g., using satellite imagery or mobile phone data to track movement, participatory mapping, snowball sampling) and intervention strategies (e.g., integration with animal health campaigns, cross-border coordination, alternative mass drug administration [MDA] methods) to implement health interventions in MMPs. CONCLUSIONS: Ultimately, the literature reviewed here can inform programmatic decisions as the community attempts to reach these never treated populations. SYSTEMATIC REVIEW REGISTRATION: The protocol for this manuscript was registered with the International Prospective Registry of Systematic Reviews (PROSPERO) (No. CRD42021214743).

The co-occurrence of water insecurity and food insecurity among Daasanach pastoralists in northern Kenya.

OBJECTIVE: Water plays a critical role in the production of food and preparation of nutritious meals, yet few studies have examined the relationship between water and food insecurity. The primary objective of this study, therefore, was to examine how experiences of household water insecurity (HWI) relate to experiences of household food insecurity (HFI) among a pastoralist population living in an arid, water-stressed region of northern Kenya. DESIGN: We implemented the twelve-item Household Water Insecurity Experiences (HWISE, range 0-36) Scale and the nine-item Household Food Insecurity Access Scale (HFIAS, range 0-27) in a cross-sectional survey to measure HWI and HFI, respectively. Data on socio-demographic characteristics and intake of meat and dairy in the prior week were collected as covariates of interest. SETTING: Northern Kenya, June-July 2019. PARTICIPANTS: Daasanach pastoralist households (n 136) from seven communities. RESULTS: In the prior 4 weeks, 93·4 % and 98·5 % of households had experienced moderate-to-severe HWI and HFI, respectively. Multiple linear regression analyses indicated a strong association between HWI and HFI. Each point higher HWISE score was associated with a 0·44-point (95 % CI: 0·22, 0·66, P = 0·003) higher HFIAS score adjusting for socio-economic status and other covariates. CONCLUSIONS: These findings demonstrate high prevalence and co-occurrence of HWI and HFI among Daasanach pastoralists in northern Kenya. This study highlights the need to address HWI and HFI simultaneously when developing policies and interventions to improve the nutritional well-being of populations whose subsistence is closely tied to water availability and access.

Contraceptive use among young women of pastoral communities of Karamoja sub-region in Uganda.

Sexual and reproductive health is an important part of general health globally recognised in Sustainable Development Goal (SDG) 3. Access to sexual and reproductive health services such as contraception provides young people with the opportunity to make informed choices regarding reproductive health. However, poor sexual and reproductive health is evident in numerous forms including sexually transmitted infections, unwanted pregnancies and unsafe abortion. In this paper, we examine the experiences of contraceptive use among young women living in pastoral communities. Findings derive from a qualitative contextual analysis of adolescent sexual and reproductive health conducted in the Karamoja sub-region of Uganda. Focus group discussions and in-depth interviews were conducted with married young women aged 15-19. Audio recordings and field notes were taken during interviews. Thematic data analysis was conducted aided by Atlas.ti software. Findings reveal that young women living in pastoralist communities experience challenges which deter their use of contraception. Contraceptive use experiences, socio-cultural values and practices, the attitudes of service providers, and livelihood necessities of pastoralism cause low uptake of contraception. Adequate understanding of the experiences and associated values encountered by such vulnerable and marginalised groups in the use of contraception is critical in addressing the challenge to achieving SDG targets.

Determinants of treatment-seeking behavior during self-reported febrile illness episodes using the socio-ecological model in Kilombero District, Tanzania.

BACKGROUND: Febrile diseases in Sub-Saharan Africa cause acute and chronic illness. Co-infections are common and these diseases have a complex etiology that includes zoonoses. For the implementation of appropriate treatment and control strategies, determinants of lay treatment-seeking behavior by the affected communities need to be understood. The objective of this study was to explore, using the socio-ecological model, the determinants of treatment-seeking actions among self-identified febrile illness cases in the Kilombero District of Tanzania. METHODS: Thirty-nine in-depth interviews were conducted with 28 men and 11 women in three villages in Kilombero district. These villages were purposively selected due to malaria endemicity in the area, animal husbandry practices, and proximity to livestock-wildlife interaction, all risk factors for contracting febrile zoonotic infections. Thematic analysis was conducted on the interviews to identify the key determinants of treatment-seeking actions. RESULTS: Study participants attributed febrile illnesses to malaria, typhoid and urinary tract infections. Treatment-seeking behavior was an iterative process, influenced by individual, socio-cultural, ecological and policy factors. Age, expendable income, previous history with a febrile illness, perceptions on disease severity, seasonal livelihood activities and access to timely healthcare were some of the determinants. Self-treatment with pharmaceutical drugs and herbs was usually the initial course of action. Formal healthcare was sought only when self-treatment failed and traditional healers were consulted after the perceived failure of conventional treatment. Delays in seeking appropriate health care and the consultation of medically unqualified individuals was very common. CONCLUSION: The results imply that treatment-seeking behavior is shaped by multiple factors across all levels of the socio-ecological model. Public policy efforts need to focus on facilitating prompt health care seeking through community education on the complicated etiology of febrile illnesses. Improved access to timely treatment and better differential diagnostics by health professionals are essential to ensure correct and appropriate treatment and to reduce reliance of patients on unqualified persons.

Using pastoralist community knowledge to locate and treat dry-season mosquito breeding habitats with pyriproxyfen to control Anopheles gambiae s.l. and Anopheles funestus s.l. in rural Tanzania.

Fundamentally, larviciding with pyriproxyfen (PPF) has potential to complement Long Lasting Insecticide Nets (LLINs) and indoor residual sprays (IRS) in settings where resistance to pyrethroids and residual malaria transmission exist. In this study, we evaluated the field effectiveness of larviciding using PPF to reduce dry season productivity of mosquito breeding habitats that were located by pastoralists within the study area. Using pastoralist knowledge, dry season breeding habitats in Mofu village rural Tanzania were located and monitored for larval productivity for a period of 8 months before PPF intervention. During the intervention, six out of twelve breeding habitats were treated with Sumilarv 0.5G PPF granules. The impact of deposited PPF was monitored by recording emergence inhibition of larvae collected from treated habitats compared to the appropriate control group for a period of three months and half post-intervention. During baseline, the average proportion (+SD) of adult emerged was similar between two clusters, with (0.89 + 0.22) for the control cluster and (0.93 + 0.16) for the treatment cluster of breeding habitats. Following treatment with PPF, the average proportion (+SD) of adult emerged in the treated breeding habitats was significantly low (0.096 + 0.22) compared to adults that emerged from larvae in the untreated habitats (0.99 + 0.22) (p < 0.0001). Of all emerged adults, approximately 94% were An. gambiae s.l. and the remaining 6% were An. funestus s.l. This is the first study demonstrating the usefulness of engaging pastoralist community to locate and identify hard to find mosquito breeding habitats. Reduced productivity of the targeted habitats with PPF offers prospect of implementing PPF larviciding in dry season when habitats are few and permanent to control mosquito population in rural settings.

Evaluation of the feasibility and sustainability of the joint human and animal vaccination and its integration to the public health system in the Danamadji health district, Chad.

BACKGROUND: One Health approaches such as the Joint human and animal vaccination programmes (JHAVP) are shown to be feasible and to increase health care access to hard-to-reach communities such as mobile pastoralists. However, the financial sustainability and the integration into the public health systems at the district level of such programmes are still challenging. The main objective of the present study was to give insight to the feasibility and financial sustainability of JHAVP integrated as part of the public health system in Chad. METHODS: We conducted a mixed methods study using semi-structured key informant interviews, focus group discussions and budget impact analysis. Strengths, weaknesses, opportunities, and threats were analysed regarding the feasibility and sustainability of the implementation of JHAVP in Danamadji health district in Chad. Feasibility was further analysed using three dimensions: acceptability, implementation, and adaptation. Financial sustainability of JHAVP was analysed through budget impact analysis of implementation of the programme at district level. RESULTS: The acceptability of this approach was regularly assessed by immunization campaign teams through evaluation meetings which included pastoralists. The presence of authorities in the meetings and workshops of the programme had an incentive effect since they represent a mark of consideration these populations generally declared to be lacking. The coordination between the public health and veterinary services at central and decentralized level seemed to be a key element in the success of the implementation of the programme. Regarding financial sustainability, the total incremental budget impact was 27% slightly decreasing to 26% after five years, which accounts for up to one third of the total budget of the district health office. Also, given that most of the costs for each round are recurrent costs, efficiency gains from scale effects over time are limited. CONCLUSION: Based on these findings, we conclude that for JHAVP to be routinely delivered at the district health level, a considerable increase in financial resources would be required. The district could benefit from joint immunization to maintain contact with mobile pastoralists to promote the use of available immunization services at district level.

Health interventions among mobile pastoralists: a systematic review to guide health service design.

OBJECTIVE: Mobile pastoralists are one of the last populations to be reached by health services and are frequently missed by health campaigns. Since health interventions among pastoralists have been staged across a range of disciplines but have not yet been systematically characterised, we set out to fill this gap. METHODS: We conducted a systematic search in PubMed/MEDLINE, Scopus, Embase, CINAL, Web of Science, WHO Catalog, AGRICOLA, CABI, ScIELO, Google Scholar and grey literature repositories to identify records that described health interventions, facilitators and barriers to intervention success, and factors influencing healthcare utilisation among mobile pastoralists. No date restrictions were applied. Due to the heterogeneity of reports captured in this review, data were primarily synthesised through narrative analysis. Descriptive statistical analysis was performed for data elements presented by a majority of records. RESULTS: Our search yielded 4884 non-duplicate records, of which 140 eligible reports were included in analysis. 89.3% of reports presented data from sub-Saharan Africa, predominantly in East Africa (e.g. Ethiopia, 30.0%; Kenya, 17.1%). Only 24.3% of reports described an interventional study, while the remaining 75.7% described secondary data of interest on healthcare utilisation. Only two randomised controlled trials were present in our analysis, and only five reports presented data on cost. The most common facilitators of intervention success were cultural sensitivity (n = 16), community engagement (n = 12) and service mobility (n = 11). CONCLUSION: Without adaptations to account for mobile pastoralists' unique subsistence patterns and cultural context, formal health services leave pastoralists behind. Research gaps, including neglect of certain geographic regions, lack of both interventional studies and diversity of study design, and limited data on economic feasibility of interventions must be addressed to inform the design of health services capable of reaching mobile pastoralists. Pastoralist-specific delivery strategies, such as combinations of mobile and 'temporary fixed' services informed by transhumance patterns, culturally acceptable waiting homes, community-directed interventions and combined joint human-animal One Health design as well as the bundling of other health services, have shown initial promise upon which future work should build.

OBJECTIF: Les éleveurs nomades sont l'une des dernières populations à être touchées par les services de santé et sont souvent ratés par les campagnes de santé. Etant donné que les interventions de santé parmi ces éleveurs ont été programmées dans une gamme de disciplines mais n'ont pas encore été systématiquement caractérisées, nous avons entrepris de combler cette lacune. MÉTHODES: Nous avons effectué une recherche systématique dans les répertoires PubMed/MEDLINE, Scopus, EMBASE, CINAL, Web of Science, WHO Catalog, AGRICOLA, CABI, ScIELO, Google Scholar et de la littérature grise pour identifier les reports décrivant les interventions de santé, les facilitateurs et les obstacles au succès de l'intervention ainsi que les facteurs influençant l'utilisation des soins de santé chez les éleveurs nomades. Aucune restriction de date n'a été appliquée. En raison de l'hétérogénéité des rapports capturés dans cette revue, les données ont été principalement synthétisées au moyen d'une analyse narrative. Une analyse statistique descriptive a été effectuée pour les éléments de données présentés par une majorité des reports. RÉSULTATS: Notre recherche a révélé 4.884 rapports non dupliqués, dont 140 éligibles ont été inclus dans l'analyse. 89,3% des rapports présentaient des données d'Afrique subsaharienne, principalement en Afrique de l'Est (ex: Ethiopie, 30,0%; Kenya, 17,1%). Seuls 24,3% des rapports décrivaient une étude interventionnelle, tandis que les 75,7% restants décrivaient des données d'intérêt secondaires sur l'utilisation des soins de santé. Seuls deux essais contrôlés randomisés étaient présents dans notre analyse, et seuls cinq rapports présentaient des données sur le coût. Les facilitateurs les plus courants du succès des interventions étaient la sensibilité culturelle (n=16), l'engagement communautaire (n=12) et la mobilité des services (n=11). CONCLUSION: Sans adaptations pour tenir compte des modèles de subsistance et du contexte culturel uniques des éleveurs nomades, les services de santé formels les laissent de côté. Les lacunes de la recherche, y compris la négligence de certaines régions géographiques, le manque d'études interventionnelles et la diversité de la conception des études, et les données limitées sur la faisabilité économique des interventions doivent être comblées pour éclairer la conception de services de santé capables d'atteindre les éleveurs nomades. Des stratégies de prestation spécifiques aux éleveurs nomades, telles que des combinaisons de services mobiles et «fixes temporaires¼ éclairés par des schémas de transhumance, des maisons d'attente culturellement acceptables, des interventions dirigées par la communauté et une conception conjointe d'une seule santé homme-animal ainsi que le regroupement d'autres services de santé, ont montré une promesse initiale sur laquelle les travaux futurs devraient s'appuyer.

Seropositivity and associated intrinsic and extrinsic factors for Rift Valley fever virus occurrence in pastoral herds of Nigeria: a cross sectional survey.

BACKGROUND: Rift Valley fever (RVF) is a vector-borne emerging zoonotic disease of animals and humans, characterized by socioeconomic losses to livestock farmers and global public health threat. The study determined RVFV seroprevalence in cattle, assessed pastoralists' knowledge about RVF, and factors that influence its occurrence in pastoral cattle herds of Nigeria. A cross-sectional study was conducted in pastoral herds of North-central Nigeria from 2017 to 2018. Data were collected using serology and questionnaire tools. Descriptive statistics were used to analyze the obtained data. Categorical variables were presented as proportions and their associations determined by Chi-square tests. Associations of risk factors were analyzed by univariable and multivariable logistic regressions analyses at 95% confidence level. RESULTS: The overall IgM seropositivity of RVFV in pastoral cattle herds was 5.6%. This was higher in nomadic herds (7.4%) than in agro-pastoral herds (3.8%). All animal demographic characteristics of age, sex and breeds were not significantly (p > 0.05) associated with RVFV occurrence in pastoral herds. All the 403 pastoralists selected participated in the study, with the majorities of them being male, married and have no formal education. Majority of the pastoralists had low knowledge levels about zoonotic RVFV infection. All identified socio-ecological factors significantly (p < 0.05) influenced RVFV occurrence in herds. Mosquitoes availability in cattle environment (OR = 7.81; 95% CI: 4.85, 12.37), presence of rivers and streams at grazing fields (OR = 10.80; 95% CI: 6.77, 17.34), high rainfall (OR = 4.30; 95% CI: 2.74, 6.59), irrigated rice fields (OR = 5.14; 95% CI: 3.21, 7.79), bushy vegetation (OR = 6.11; 95% CI: 3.96, 9.43), animal movement (OR = 2.2; 95% CI: 1.45, 3.25), and seasons (OR = 2.34; 95% CI: 1.55, 3.51) were more likely to influenced RVFV occurrence in cattle herds. CONCLUSIONS: Results of this study had illustrated recent circulation of RVFV in pastoral cattle herds in Nigeria and needs urgent interventions. The surveyed pastoralists had low knowledge level about RVF while the socio-ecological factors significantly influenced RVFV occurrence in herds. To address these gaps, pastoralists should be educated on clinical manifestations and modes of transmission of the disease in animals and humans, and mitigation measures. Adequate knowledge about RVF epidemiology will assure food security and public health.

Managing complex emergencies.

Complex emergencies, also known as major humanitarian emergencies, differ from emergencies related to natural disasters or major disease outbreaks, in that they are essentially political in nature and will, in most cases, erode the cultural, civil, political and economic stability of societies. They can be exacerbated by natural disasters and eventually require external interventions. National Veterinary Services are usually weakened or partially or totally disrupted. Interventions to support livestock-dependent communities should build on local capacity. Multisector, integrated disaster management plans should be in place and should include not only preparedness and response, but also mitigation, prevention and recovery strategies. National Veterinary Services and their partners should work in close collaboration and are encouraged to look beyond animal-health-related interventions, also addressing access to feed and water, and keeping marketing chains for livestock open. This paper also touches on the specific needs of displaced people, host communities, and pastoralists, as well as addressing disease eradication programmes in the context of complex emergencies.

Les situations d'urgence complexes (également appelées «urgences humanitaires majeures ¼) se distinguent des situations d'urgence dues à des catastrophes naturelles ou à des foyers majeurs de maladie par leur nature essentiellement politique et par le fait qu'elles nuisent généralement à la stabilité culturelle, civile, politique et économique des sociétés affectées. Elles sont parfois exacerbées par des catastrophes naturelles et peuvent nécessiter à terme une intervention extérieure. Les Services vétérinaires nationaux sont généralement affaiblis, voire partiellement ou totalement suspendus. Les interventions visant à soutenir les communautés qui vivent de l'élevage doivent s'appuyer sur les capacités locales. Il convient d'avoir établi des plans de gestion des catastrophes multisectoriels et intégrés comportant des stratégies non seulement de préparation et d'intervention mais aussi d'atténuation, de prévention et de rétablissement. Il est recommandé aux Services vétérinaires nationaux et à leurs partenaires de travailler en étroite collaboration et d'avoir une vision allant au-delà des interventions strictement liées à la santé animale afin de traiter également le problème de l'accès des animaux aux aliments et à l'eau et de faire en sorte que les filières de commercialisation du bétail demeurent ouvertes. Outre la problématique des programmes d'éradication des maladies dans le contexte des situations d'urgence complexes, les auteurs abordent également les besoins spécifiques des personnes déplacées, des communautés d'accueil et des populations pastorales.

Las emergencias complejas, también denominadas «grandes emergencias humanitarias¼, difieren de las emergencias causadas por desastres naturales o grandes brotes infecciosos en que son de carácter eminentemente político y en que casi siempre acaban erosionando la estabilidad cultural, civil, política y económica de la sociedad afectada. A veces se ven agravadas por desastres naturales y a la postre requieren intervenciones externas. Los Servicios Veterinarios nacionales suelen verse fragilizados o parcial o completamente desarticulados. Toda intervención de apoyo a poblaciones dependientes del ganado debería partir de los medios de acción existentes a escala local. Es preciso tener instituidos planes integrados y multisectoriales de gestión de desastres, que incluyan no solo mecanismos de preparación y respuesta, sino también dispositivos de mitigación, prevención y recuperación. Los Servicios Veterinarios nacionales y sus asociados deben trabajar en estrecha colaboración. A todos ellos se los alienta a que, lejos de limitarse a las intervenciones de salud animal, se ocupen también del acceso a los piensos y el agua y de mantener abiertos los circuitos de comercialización de ganado. Los autores abordan también aquí las necesidades específicas de las personas desplazadas, las comunidades de acogida y las poblaciones pastorales, así como los programas de erradicación de enfermedades en el contexto de emergencias complejas.

Diet and adult age-at-death among mobile foragers: A synthesis of bioarcheological methods.

OBJECTIVES: The research explores whether the combined study of cortical bone histology, bone morphology, and dietary stable isotopes can expand insights into past human health and adaptations, particularly dietary sufficiency and life span. MATERIALS AND METHODS: Midthoracic rib cortices from 54 South African Late Holocene adult skeletons (28 M, 24 F, two sex undetermined) are assessed by transmitted-light microscopy for cross-sectional area measurements, osteon area (On.Ar), osteon population density, and presence/absence of secondary osteon variants. Values for δ13 Cbone collagen , δ15 Nbone collagen , 14 C dates, Southwestern and Southern Cape geographic regions, body size measures, estimated ages-at-death from both morphological and histological methods are integrated into analyses, which include Spearman correlations, χ2 tests and Kruskal-Wallis ANOVAs. RESULTS: There is reduced On.Ar variability with higher δ15 N (r = -.41, p = .005); rib %cortical area and δ15 N are negatively correlated in the Southern Cape group (r = -.60, p = .03). Osteon variants are more common in older adults; histological ages at death are significantly older than those determined from gross morphology. DISCUSSION: We found bone tissue relationships with measures of diet composition, but indicators of dietary adequacy remain elusive. Relationships of tissue quality and isotopes suggest that some Southern Cape adults lived long lives. Osteon variants are associated with age-at-death; some association with diet remains possible. Gross morphological methods appear to underestimate adult ages-at-death, at least among small-bodied adults.

Traditional healers' role in the detection of active tuberculosis cases in a pastoralist community in Ethiopia: a pilot interventional study.

BACKGROUND: Pastoralists rely on traditional healers (THs) for general health problems. However, some studies indicate that such practices result in delays in the diagnosis and treatment of tuberculosis (TB) cases. This study aims to assess the role of traditional healers in the detection and referral of active TB cases in a pastoralist community. METHODS: We identified 22 traditional healers from 7 villages of Kereyu pastoralist community in the Fentale district in Ethiopia in January 2015. We trained these THs in identifying presumptive TB symptoms and early referral to the nearby healthcare facilities. The training was held during a 1 week period that included a visit to their villages and follow-up. A 1 day meeting was held with the traditional healers, the district TB care and prevention coordinator and health extension workers from the selected sub-district to discuss the referral link between THs and the nearby healthcare facilities. Health providers working at the TB units in the selected healthcare facilities were oriented about the training given and planned involvement of THs in referring presumptive TB case. In addition, documentation of the presumptive TB cases was discussed. RESULTS: We succeeded in tracing and interviewing 8 of the 22 THs. The rest were on seasonal migration. According to the THs report for the 1 year period, these 8 THs had referred 24 TB suspects to the healthcare facilities. Sputum smear microscopy confirmed 13 of the 24 suspects as having TB cases. Among those confirmed, 10 completed treatment and three were on treatment. Five presumptive TB cases were confirmed non TB cases through further evaluation at the healthcare facilities and six of the presumptive TB cases were lost to follow up by the THs. Whereas, four of the presumptive TB cases were lost to follow up to the healthcare facility. CONCLUSIONS: Results of the present study indicate that THs can contribute to the detection of undiagnosed active TB cases in a pastoralist community, provided they are given appropriate training and support.