Jail fever (epidemic typhus) outbreak in Burundi.

PubMed

Raoult, D; Roux, V; Ndihokubwayo, J B; Bise, G; Baudon, D; Marte, G; Birtles, R

1997-01-01

We recently investigated a suspected outbreak of epidemic typhus in a jail in Burundi. We tested sera of nine patients by microimmunofluorescence for antibodies to Rickettsia prowazekii and Rickettsia typhi. We also amplified and sequenced from lice gene portions specific for two R. prowazekii proteins: the gene encoding for citrate synthase and the gene encoding for the rickettsial outer membrane protein. All patients exhibited antibodies specific for R. prowazekii. Specific gene sequences were amplified in two lice from one patient. The patients had typical clinical manifestations, and two died. Molecular techniques provided a convenient and reliable means of examining lice and confirming this outbreak. The jail-associated outbreak predates an extensive ongoing outbreak of louse-borne typhus in central eastern Africa after civil war and in refugee camps in Rwanda, Burundi (1), and Zaire.

Jail fever (epidemic typhus) outbreak in Burundi.

PubMed Central

Raoult, D.; Roux, V.; Ndihokubwayo, J. B.; Bise, G.; Baudon, D.; Marte, G.; Birtles, R.

1997-01-01

We recently investigated a suspected outbreak of epidemic typhus in a jail in Burundi. We tested sera of nine patients by microimmunofluorescence for antibodies to Rickettsia prowazekii and Rickettsia typhi. We also amplified and sequenced from lice gene portions specific for two R. prowazekii proteins: the gene encoding for citrate synthase and the gene encoding for the rickettsial outer membrane protein. All patients exhibited antibodies specific for R. prowazekii. Specific gene sequences were amplified in two lice from one patient. The patients had typical clinical manifestations, and two died. Molecular techniques provided a convenient and reliable means of examining lice and confirming this outbreak. The jail-associated outbreak predates an extensive ongoing outbreak of louse-borne typhus in central eastern Africa after civil war and in refugee camps in Rwanda, Burundi (1), and Zaire. PMID:9284381

Pregnancy history and current use of contraception among women of reproductive age in Burundi, Kenya, Rwanda, Tanzania and Uganda: analysis of demographic and health survey data.

PubMed

Bakibinga, Pauline; Matanda, Dennis J; Ayiko, Rogers; Rujumba, Joseph; Muiruri, Charles; Amendah, Djesika; Atela, Martin

2016-03-10

To examine the relationship between pregnancy history and the use of contraception among women of reproductive age (15-49 years) in East Africa. Demographic and Health Surveys data from Burundi (2010), Kenya (2008-2009), Rwanda (2010), Tanzania (2010) and Uganda (2011) were used in the analysis. Logistic regression was used to determine the effects of women's pregnancy history on their use of contraception. Burundi, Kenya, Rwanda, Tanzania and Uganda. 3226, 2377, 4396, 3250 and 2596 women of reproductive age (15-49 years) from Burundi, Kenya, Rwanda, Tanzania and Uganda, respectively, were included in the analysis. Women who had experienced a mistimed pregnancy were more likely to use a modern contraceptive method during their most recent sexual encounter in Kenya, Rwanda, Burundi and Uganda. Other significant correlates of women's contraceptive use were: desire for more children, parity, household wealth, maternal education and access information through radio. In-country regional differences on use of modern contraceptive methods were noted across five East African countries. Women's birth histories were significantly associated with their decision to adopt a modern contraceptive method. This highlights the importance of considering women's birth histories, especially women with mistimed births, in the promotion of contraceptive use in East Africa. Variations as a result of place of residency, educational attainment, access to family planning information and products, and wealth ought to be addressed in efforts to increase use of modern contraceptive methods in the East African region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Conflict, Reconciliation and Peace Education: Moving Burundi toward a Sustainable Future. Routledge Research in International and Comparative Education

ERIC Educational Resources Information Center

Timpson, William; Ndura, Elavie; Bangayimbaga, Apollinaire

2014-01-01

When the September 11, 2001 attacks in the United States occurred--causing that nation to wage wars of revenge in Afghanistan and Iraq--the people of Burundi were recovering from nearly forty years of violence, genocide and civil wars that had killed nearly one million and produced another million refugees. Here in this small East African nation,…

Translations on North Korea No. 624

DTIC Science & Technology

1978-10-23

Gymnasts in Burundi 27 GDR Anniversary 27 DPRK-Africa Association Greets Guinean 27 Women’s Group 28 Romanian Ambassador 28 ’ Polish Army Day 28...opera "The Flower Girl" firmly gripped the hearts of the audience and was warmly acclaimed by them for its high ideological content and artistic ...English 1034 GMT 8 Oct 78 SK] GYMNASTS IN BURUNDI—Pyongyang, 8 Oct—Jean-Baptiste Bagaza, president of the Republic of Burundi, received the mass

Democratic Republic of Congo A Fertile Ground for Instability in the Great Lakes Region States

DTIC Science & Technology

2017-06-09

International 2007, 3). Non-state Armed Groups Involved in the Congo Conflict There have been a number of non-state actors from the four countries herein...insurgent groups from neighboring countries: Uganda, Rwanda, and Burundi. These non-state actors have their own interests and goals; namely, wrestling...chaos in the Great Lakes Region. These are insurgent groups from neighboring countries: Uganda, Rwanda, and Burundi. These non-state actors have

Burundi: country profile.

PubMed

Hilsum, L

1988-10-01

One of Africa's most rural and densely populated countries, Burundi is a landlocked nation in Central Africa. The 4.9 million people are 85% Hutus, agricultural people of Bantu origin. However, the Hutus are excluded from power by the minority Tutsis, and the 2 groups have engaged in violent conflict. After a military coup in 1987, a new president, Major Pierre Buyoya, was installed, but restrictions on the Hutus continue. The major difference in Burundi has been a relaxation of restrictions on the Catholic church, which were severe under the former President Bagaza. Most Hutus are Catholic, with a minority of Muslims. For the peasant farmer, faced with diminishing arable land and reliance on 1 export crop (coffee), life is becoming more difficult. An expansion of sugar production was planned to reduce reliance on coffee, although the government has a rather ambivalent approach to development. While promoting private sector development with the help of the World Bank and the U.S. government, the Burundi government maintains a rigid 1-party system with strict control over the lives of the people. Infant mortality stands at 196/1,000 live births and life expectancy is low--43 years for women and 40 years for men. The literacy rate is low (39% for men, 15% for women), and the GNP per capita is low ($230). Most land is used for subsistence crops such as cassava, bananas, sweet potatoes, maize, pulses, and sorghum.

Maternal and reproductive health financing in Burundi: public-sector contribution levels and trends from 2010 to 2012.

PubMed

Chaumont, Claire; Muhorane, Carmen; Moreira-Burgos, Isabelle; Juma, Ndereye; Avila-Burgos, Leticia

2015-10-01

An understanding of public financial flows to reproductive health (RH) at the country level is key to assessing the extent to which they correspond to political commitments. This is especially relevant for low-income countries facing important challenges in the area of RH. To this end, the present study analyzes public expenditure levels and trends with regards to RH in Burundi between the years 2010 to 2012, looking specifically at financing agents, health providers, and health functions. The analysis was performed using standard RH sub-account methodology. Information regarding public expenditures was gathered from national budgets, the Burundi Ministry of Public Health information system, and from other relevant public institutions. Public RH expenditures in Burundi accounted for $41.163 million international dollars in 2012, which represents an increase of 16 % from 2010. In 2012, this sum represented 0.57 % of the national GDP. The share of total public health spending allocated to RH increased from 15 % in 2010 to 19 % in 2012. In terms of public agents involved in RH financing, the Ministry of Public Health proved to play the most important role. Half of all public RH spending went to primary health care clinics, while more than 70 % of this money was used for maternal health; average public RH spending per woman of childbearing age stagnated during the study period. The flow patterns and levels of public funds to RH in Burundi suggest that RH funding correctly reflects governmental priorities for the period between 2010 and 2012. In a context of general shrinking donor commitment, local governments have come to play a key role in ensuring the efficient use of available resources and the mobilizing of additional domestic funding. A strong and transparent financial tracking system is key to carrying out this role and making progress towards the MDG Goals and development beyond 2015.

Evaluation of a social marketing intervention promoting oral rehydration salts in Burundi.

PubMed

Kassegne, Sethson; Kays, Megan B; Nzohabonayo, Jerome

2011-03-08

Diarrhea is the second leading cause of death for children under five in Burundi; however, use of oral rehydration salts (ORS), the recommended first-line treatment, remains low. In 2004, PSI/Burundi launched a social marketing intervention to promote ORASEL among caregivers of children under five; the product was relaunched in 2006 with a new flavor. This study evaluates the intervention after the ORASEL relaunch, which included mass media and interpersonal communication activities. The study looks at trends in ORASEL use in Burundi and in behavioral determinants that may be related to its use. In 2006 and 2007, PSI conducted household surveys among Burundian females of reproductive age (15-49). Both surveys used a two-stage sampling process to select 30 households in each of 115 rural and urban collines throughout the nation. Survey respondents were asked about diarrhea treatment-related behavior; key behavioral determinants; and exposure to the ORASEL intervention. Data were analyzed to identify trends over time, characteristics of ORASEL users, and associations between exposure to the intervention and changes in ORASEL use and related behavioral determinants. ORASEL use among caregivers at their children's last diarrheal episode increased significantly from 20% in 2006 to 30% in 2007, and there were also desirable changes in several behavioral determinants associated with ORASEL use. Evaluation analysis showed that a higher level of exposure to the social marketing campaign was associated with greater use of ORASEL and with significant improvements in perceived availability, knowledge of the signs of diarrhea and dehydration, social support, and self-efficacy. ORS use can be improved through social marketing and educational campaigns that make the public aware of the availability of the product, encourage dialogue about its use, and increase skills and confidence relating to correct product preparation and administration. Further interventions in Burundi and elsewhere should promote ORS through a variety of mass media and interpersonal communication channels, and should be rigorously evaluated in the context of the total market for diarrhea treatment products.

Selected French Speaking Sub-Saharan African Countries: Burundi, Cameroon (Eastern), Chad, Congo (Brazzaville), Dahomey, Gabon, Ivory Coast, Mali, Mauritania, Niger, Rwanda, Senegal, Togo, Upper Volta, Zaire. A Guide to the Academic Placement of Students from These Countries in Academic Institutions of the United States.

ERIC Educational Resources Information Center

Trudeau, Edouard J. C.

The educational systems of 15 Sub-Saharan African countries are described, and guidelines concerning the academic placement of students who wish to study in U.S. institutions are provided. Tables indicate the grades covered by primary education and secondary education (academic and technical). Burundi, Rwanda, and Zaire have followed the Belgian…

Leadership and Innovation-Listening to and Learning From Young People in Burundi.

PubMed

Nininahazwe, Cédric; Alesi, Jacquelyne; Caswell, Georgina; Lumumba, Musah; Mellin, Julie; Ndayizeye, Nicholas-Monalisa; Orza, Luisa; Rahimi, Michaela; Westerhof, Nienke

2017-02-01

This commentary describes young people's leadership from the perspective of a youth-led organization in the Link Up project in Burundi, Réseau National des Jeunes vivant avec le VIH. It describes processes that enable young people to guide, influence, deliver, and improve health service provision; the challenges faced by Réseau National des Jeunes vivant avec le VIH and how they are addressing these challenges. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Ageism in Belgium and Burundi: a comparative analysis

PubMed Central

Marquet, Manon; Missotten, Pierre; Schroyen, Sarah; Nindaba, Desiderate; Adam, Stéphane

2016-01-01

Background Recent cross-cultural comparisons between Asian and Western cultures have shown that ageism arises more from the lack of availability of social and economic resources for older adults than from the culture itself. We tested this assumption by conducting a survey among people living in a least developed country compared with those living in a developed country. Participants and methods Twenty-seven Belgians living in Belgium, 29 Burundians living in Belgium, and 32 Burundians living in Burundi were included in this study. Their attitudes toward older adults were assessed using several self-reported measures. Results Statistical analyses confirmed that older people are more negatively perceived by Burundians living in Burundi than by Burundians and Belgians living in Belgium, whose attitudes did not differ from each other. Conclusion Consistent with our hypothesis, our results suggest that the level of development of a country and more particularly the lack of government spending on older people (pension and health care systems) may contribute to their younger counterparts perceiving them more negatively. PMID:27601889

Identifying behavioural determinants for interventions to increase handwashing practices among primary school children in rural Burundi and urban Zimbabwe.

PubMed

Seimetz, Elisabeth; Slekiene, Jurgita; Friedrich, Max N D; Mosler, Hans-Joachim

2017-07-14

This article presents the development of a school handwashing programme in two different sub-Saharan countries that applies the RANAS (risk, attitudes, norms, ability, and self-regulation) systematic approach to behaviour change. Interviews were conducted with 669 children enrolled in 20 primary schools in Burundi and 524 children in 20 primary schools in Zimbabwe. Regression analyses were used to assess the influence of the RANAS behavioural determinants on reported handwashing frequencies. The results revealed that, in both countries, a programme targeting social norms and self-efficacy would be most effective. In Burundi, raising the children's perceived severity of the consequences of contracting diarrhoea, and in Zimbabwe, increasing the children's health knowledge should be part of the programme. The school handwashing programme should create awareness of the benefits of handwashing through educational activities, raise the children's ability and confidence in washing hands at school through infrastructural improvements, and highlight the normality of washing hands at school through events and poster creation.

Blindness and Severe Visual Impairment in Pupils at Schools for the Blind in Burundi

PubMed Central

Ruhagaze, Patrick; Njuguna, Kahaki Kimani Margaret; Kandeke, Lévi; Courtright, Paul

2013-01-01

Purpose: To determine the causes of childhood blindness and severe visual impairment in pupils attending schools for the blind in Burundi in order to assist planning for services in the country. Materials and Methods: All pupils attending three schools for the blind in Burundi were examined. A modified WHO/PBL eye examination record form for children with blindness and low vision was used to record the findings. Data was analyzed for those who became blind or severely visually impaired before the age of 16 years. Results: Overall, 117 pupils who became visually impaired before 16 years of age were examined. Of these, 109 (93.2%) were blind or severely visually impaired. The major anatomical cause of blindness or severe visual impairment was cornea pathology/phthisis (23.9%), followed by lens pathology (18.3%), uveal lesions (14.7%) and optic nerve lesions (11.9%). In the majority of pupils with blindness or severe visual impairment, the underlying etiology of visual loss was unknown (74.3%). More than half of the pupils with lens related blindness had not had surgery; among those who had surgery, outcomes were generally poor. Conclusion: The causes identified indicate the importance of continuing preventive public health strategies, as well as the development of specialist pediatric ophthalmic services in the management of childhood blindness in Burundi. The geographic distribution of pupils at the schools for the blind indicates a need for community-based programs to identify and refer children in need of services. PMID:23580854

Blindness and severe visual impairment in pupils at schools for the blind in Burundi.

PubMed

Ruhagaze, Patrick; Njuguna, Kahaki Kimani Margaret; Kandeke, Lévi; Courtright, Paul

2013-01-01

To determine the causes of childhood blindness and severe visual impairment in pupils attending schools for the blind in Burundi in order to assist planning for services in the country. All pupils attending three schools for the blind in Burundi were examined. A modified WHO/PBL eye examination record form for children with blindness and low vision was used to record the findings. Data was analyzed for those who became blind or severely visually impaired before the age of 16 years. Overall, 117 pupils who became visually impaired before 16 years of age were examined. Of these, 109 (93.2%) were blind or severely visually impaired. The major anatomical cause of blindness or severe visual impairment was cornea pathology/phthisis (23.9%), followed by lens pathology (18.3%), uveal lesions (14.7%) and optic nerve lesions (11.9%). In the majority of pupils with blindness or severe visual impairment, the underlying etiology of visual loss was unknown (74.3%). More than half of the pupils with lens related blindness had not had surgery; among those who had surgery, outcomes were generally poor. The causes identified indicate the importance of continuing preventive public health strategies, as well as the development of specialist pediatric ophthalmic services in the management of childhood blindness in Burundi. The geographic distribution of pupils at the schools for the blind indicates a need for community-based programs to identify and refer children in need of services.

Latent class analysis to evaluate performance of point-of-care CCA for low-intensity Schistosoma mansoni infections in Burundi.

PubMed

Clements, Michelle N; Corstjens, Paul L A M; Binder, Sue; Campbell, Carl H; de Dood, Claudia J; Fenwick, Alan; Harrison, Wendy; Kayugi, Donatien; King, Charles H; Kornelis, Dieuwke; Ndayishimiye, Onesime; Ortu, Giuseppina; Lamine, Mariama Sani; Zivieri, Antonio; Colley, Daniel G; van Dam, Govert J

2018-02-23

Kato-Katz examination of stool smears is the field-standard method for detecting Schistosoma mansoni infection. However, Kato-Katz misses many active infections, especially of light intensity. Point-of-care circulating cathodic antigen (CCA) is an alternative field diagnostic that is more sensitive than Kato-Katz when intensity is low, but interpretation of CCA-trace results is unclear. To evaluate trace results, we tested urine and stool specimens from 398 pupils from eight schools in Burundi using four approaches: two in Burundi and two in a laboratory in Leiden, the Netherlands. In Burundi, we used Kato-Katz and point-of-care CCA (CCAB). In Leiden, we repeated the CCA (CCAL) and also used Up-Converting Phosphor Circulating Anodic Antigen (CAA). We applied Bayesian latent class analyses (LCA), first considering CCA traces as negative and then as positive. We used the LCA output to estimate validity of the prevalence estimates of each test in comparison to the population-level infection prevalence and estimated the proportion of trace results that were likely true positives. Kato-Katz yielded the lowest prevalence (6.8%), and CCAB with trace considered positive yielded the highest (53.5%). There were many more trace results recorded by CCA in Burundi (32.4%) than in Leiden (2.3%). Estimated prevalence with CAA was 46.5%. LCA indicated that Kato-Katz had the lowest sensitivity: 15.9% [Bayesian Credible Interval (BCI): 9.2-23.5%] with CCA-trace considered negative and 15.0% with trace as positive (BCI: 9.6-21.4%), implying that Kato-Katz missed approximately 85% of infections. CCAB underestimated disease prevalence when trace was considered negative and overestimated disease prevalence when trace was considered positive, by approximately 12 percentage points each way, and CAA overestimated prevalence in both models. Our results suggest that approximately 52.2% (BCI: 37.8-5.8%) of the CCAB trace readings were true infections. Whether measured in the laboratory or the field, CCA outperformed Kato-Katz at the low infection intensities in Burundi. CCA with trace as negative likely missed many infections, whereas CCA with trace as positive overestimated prevalence. In the absence of a field-friendly gold standard diagnostic, the use of a variety of diagnostics with differing properties will become increasingly important as programs move towards elimination of schistosomiasis. It is clear that CCA is a valuable tool for the detection and mapping of S. mansoni infection in the field and CAA may be a valuable field tool in the future.

Evaluation of a social marketing intervention promoting oral rehydration salts in Burundi

PubMed Central

2011-01-01

Background Diarrhea is the second leading cause of death for children under five in Burundi; however, use of oral rehydration salts (ORS), the recommended first-line treatment, remains low. In 2004, PSI/Burundi launched a social marketing intervention to promote ORASEL among caregivers of children under five; the product was relaunched in 2006 with a new flavor. This study evaluates the intervention after the ORASEL relaunch, which included mass media and interpersonal communication activities. The study looks at trends in ORASEL use in Burundi and in behavioral determinants that may be related to its use. Methods In 2006 and 2007, PSI conducted household surveys among Burundian females of reproductive age (15-49). Both surveys used a two-stage sampling process to select 30 households in each of 115 rural and urban collines throughout the nation. Survey respondents were asked about diarrhea treatment-related behavior; key behavioral determinants; and exposure to the ORASEL intervention. Data were analyzed to identify trends over time, characteristics of ORASEL users, and associations between exposure to the intervention and changes in ORASEL use and related behavioral determinants. Results ORASEL use among caregivers at their children's last diarrheal episode increased significantly from 20% in 2006 to 30% in 2007, and there were also desirable changes in several behavioral determinants associated with ORASEL use. Evaluation analysis showed that a higher level of exposure to the social marketing campaign was associated with greater use of ORASEL and with significant improvements in perceived availability, knowledge of the signs of diarrhea and dehydration, social support, and self-efficacy. Conclusions ORS use can be improved through social marketing and educational campaigns that make the public aware of the availability of the product, encourage dialogue about its use, and increase skills and confidence relating to correct product preparation and administration. Further interventions in Burundi and elsewhere should promote ORS through a variety of mass media and interpersonal communication channels, and should be rigorously evaluated in the context of the total market for diarrhea treatment products. PMID:21385460

[Epidemic typhus in Africa].

PubMed

Ndihokubwayo, J B; Raoult, D

1999-01-01

Epidemic typhus is caused by a small strictly intracellular virus named Rickettsia prowazekii, a member of the Rickettsial family. It is transmitted to man by the body louse, Pediculus humanus. Although now rare in Western countries, exanthematic typhus remains common in the Southern hemisphere due to poverty, inadequate clothing hygiene, and poor socioeconomic conditions. In Africa, outbreaks have historically occurred in Burundi, Rwanda, southwest Ouganda, and Ethiopia. The largest outbreak of epidemic typhus since the World War II was reported in Burundi where ongoing civil war since October 1993 has forced 10 p. 100 of the population of Burundi to live in cold, promiscuity, and malnutrition of makeshift refugee camps. The purpose of this report based on our two-year experience working with this unfortunate population is to describe the characteristics of this disease in Africa where the epidemic form had become rare until recently. Indeed political unrest as well as numerous civil wars are now epidmiological factors favorizing outbreaks of epidemic typhus at any time. This overview also provides an opportunity to recall epidemiological, bacteriological, and clinical aspects of typhus as well as diagnosis and treatment of the disease in the context of Africa.

Assessing the factor structure of the Childhood Trauma Questionnaire, and cumulative effect of abuse and neglect on mental health among adolescents in conflict-affected Burundi.

PubMed

Charak, Ruby; de Jong, J T V M; Berckmoes, Lidewyde H; Ndayisaba, Herman; Reis, Ria

2017-10-01

The present study aimed to examine the factor structure of the Childhood Trauma Questionnaire (CTQ; Bernstein & Fink, 1998), highlight rates of abuse and neglect among Burundian adolescents, compare these rates with those found in high-income nations, and examine the cumulative effect of multiple types of abuse and neglect on depression and PTSD symptoms. Participants were 231 adolescents and youth (M=14.9, SD=1.99, 58.4% female) from five provinces of Burundi, a country in Central Africa affected by war and political violence. Translation and back-translation of the CTQ was carried out to obtain an adaptation of CTQ in Kirundi, the native language of Burundi. With the exception of one item on 'molestation' in the factor of sexual abuse, the five-factor structure of CTQ was obtained comprising latent factors, namely emotional, physical, and sexual abuse, and emotional and physical neglect. The rate of abuse and neglect ranged from 14.7-93.5% with more than 37% reporting 4 or more types of abuse and neglect experiences. Emotional abuse and neglect, and physical neglect were 2-3 times higher among Burundian adolescents when compared with studies from high-income countries using the CTQ. A cumulative effect of multiple types of abuse and neglect was found, such that, those with 4 or more types of maltreatment were higher on symptoms of depression and posttraumatic stress. Findings highlight the need for culturally sensitive, standardized, and validated measures and norms for gauging childhood maltreatment in Burundi and related need for preventative interventions on childhood maltreatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Community perceptions of mental distress in a post-conflict setting: a qualitative study in Burundi.

PubMed

Familiar, Itziar; Sharma, Sonali; Ndayisaba, Herman; Munyentwari, Norbert; Sibomana, Seleus; Bass, Judith K

2013-01-01

There is scant documentation of the mental health characteristics of low-income communities recovering from armed conflict. To prepare for quantitative health surveys and health service planning in Burundi, we implemented a qualitative study to explore concepts related to mental distress and coping among adults. Mental distress was defined as problems related to feelings, thinking, behaviour and physical stress. Using free listing and key informant interviews with a range of community members, we triangulated data to identify salient issues. Thirty-eight free list respondents and 23 key informants were interviewed in 5 rural communities in Burundi using 2 interview guides from the WHO Toolkit for Mental Health Assessment in Humanitarian Settings. Based on these interviews, we identified four locally defined idioms/terms relating to mental distress: ihahamuka (anxiety spectrum illnesses), ukutiyemera (a mix of depression and anxiety-like syndrome), akabonge (depression/grief-like syndrome) and kwamana ubwoba burengeje (anxiety-like syndrome). Mental distress terms were perceived as important problems impacting community development. Affected individuals sought help from several sources within the community, including community leaders and traditional healers. We discuss how local expressions of distress can be used to tailor health research and service integration from the bottom up.

Training in youth-friendly service provision improves nurses' competency level in the Great Lakes Region.

PubMed

Weiss, Carine; Elouard, Yajna; Gerold, Jana; Merten, Sonja

2018-05-05

This survey investigates whether relevant training and availability of guidelines improve self-reported competencies of nurses in the provision of youth-friendly sexual and reproductive health services in South-Kivu Province in the Democratic Republic of the Congo, Burundi, and Rwanda. A quantitative baseline survey was conducted among nurses in randomly selected health facilities. Nurses providing youth-friendly sexual and reproductive health services were asked to self-rate their competencies with regards to technical knowledge, clinical, and communication skills. In South-Kivu, Burundi, and Rwanda, 135, 131, and 99 nurses were interviewed, respectively. Overall differences of service and guideline availability and self-rated competencies can be observed between the three countries. In two countries, more than one in five nurses considered themselves to be only somewhat or not confident to counsel young people. Nurses from Rwanda showed the highest level of competencies followed by Burundi and South-Kivu. Lack of training in youth-friendly health services or family planning showed significant associations with reporting feeling somehow or not competent. The lack of training, supervision, and guidelines expressed by the nurses is of great concern. Competency-based training in youth-friendly health services is an important approach in improving nurses' competency level.

Geo-additive modelling of malaria in Burundi

PubMed Central

2011-01-01

Background Malaria is a major public health issue in Burundi in terms of both morbidity and mortality, with around 2.5 million clinical cases and more than 15,000 deaths each year. It is still the single main cause of mortality in pregnant women and children below five years of age. Because of the severe health and economic burden of malaria, there is still a growing need for methods that will help to understand the influencing factors. Several studies/researches have been done on the subject yielding different results as which factors are most responsible for the increase in malaria transmission. This paper considers the modelling of the dependence of malaria cases on spatial determinants and climatic covariates including rainfall, temperature and humidity in Burundi. Methods The analysis carried out in this work exploits real monthly data collected in the area of Burundi over 12 years (1996-2007). Semi-parametric regression models are used. The spatial analysis is based on a geo-additive model using provinces as the geographic units of study. The spatial effect is split into structured (correlated) and unstructured (uncorrelated) components. Inference is fully Bayesian and uses Markov chain Monte Carlo techniques. The effects of the continuous covariates are modelled by cubic p-splines with 20 equidistant knots and second order random walk penalty. For the spatially correlated effect, Markov random field prior is chosen. The spatially uncorrelated effects are assumed to be i.i.d. Gaussian. The effects of climatic covariates and the effects of other spatial determinants are estimated simultaneously in a unified regression framework. Results The results obtained from the proposed model suggest that although malaria incidence in a given month is strongly positively associated with the minimum temperature of the previous months, regional patterns of malaria that are related to factors other than climatic variables have been identified, without being able to explain them. Conclusions In this paper, semiparametric models are used to model the effects of both climatic covariates and spatial effects on malaria distribution in Burundi. The results obtained from the proposed models suggest a strong positive association between malaria incidence in a given month and the minimum temperature of the previous month. From the spatial effects, important spatial patterns of malaria that are related to factors other than climatic variables are identified. Potential explanations (factors) could be related to socio-economic conditions, food shortage, limited access to health care service, precarious housing, promiscuity, poor hygienic conditions, limited access to drinking water, land use (rice paddies for example), displacement of the population (due to armed conflicts). PMID:21835010

Potential of household environmental resources and practices in eliminating residual malaria transmission: a case study of Tanzania, Burundi, Malawi and Liberia.

PubMed

Semakula, Henry M; Song, Guobao; Zhang, Shushen; Achuu, Simon P

2015-09-01

The increasing protection gaps of insecticide-treated nets and indoor-residual spraying methods against malaria have led to an emergence of residual transmission in sub-Saharan Africa and thus, supplementary strategies to control mosquitoes are urgently required. To assess household environmental resources and practices that increase or reduce malaria risk among children under-five years of age in order to identify those aspects that can be adopted to control residual transmission. Household environmental resources, practices and malaria test results were extracted from Malaria Indicators Survey datasets for Tanzania, Burundi, Malawi and Liberia with 16,747 children from 11,469 households utilised in the analysis. Logistic regressions were performed to quantify the contribution of each factor to malaria occurrence. Cattle rearing reduced malaria risk between 26%-49% while rearing goats increased the risk between 26%-32%. All piped-water systems reduced malaria risk between 30%-87% (Tanzania), 48%-95% (Burundi), 67%-77% (Malawi) and 58%-73 (Liberia). Flush toilets reduced malaria risk between 47%-96%. Protected-wells increased malaria risk between 19%-44%. Interestingly, boreholes increased malaria risk between 19%-75%. Charcoal use reduced malaria risk between 11%-49%. Vector control options for tackling mosquitoes were revealed based on their risk levels. These included cattle rearing, installation of piped-water systems and flush toilets as well as use of smokeless fuels.

Intergenerational transmission of violence and resilience in conflict-affected Burundi: a qualitative study of why some children thrive despite duress.

PubMed

Berckmoes, L H; de Jong, J T V M; Reis, R

2017-01-01

Research suggests that in environments where community conflict and violence are chronic or cyclical, caregiving can impact how children may begin to reproduce violence throughout the various stages of their lives. The aim of this study is to understand how caregiving affects processes of reproducing violence and resilience among children in conflict-affected Burundi. We combined a socio-ecological model of child development with a child-actor perspective. We operationalized the core concepts 'vulnerable household', 'resilience', and 'caregiving' iteratively in culturally relevant ways, and put children's experiences at the center of the inquiry. We carried out a comparative case study among 74 purposively sampled vulnerable households in six collines in three communes in three provinces in the interior of Burundi. Burundian field researchers conducted three consecutive interviews; with the head of the household, the main caregiver, and a child. Our findings reveal a strong congruence between positive caregiving and resilience among children. Negative caregiving was related to negative social behavior among children. Other resources for resilience appeared to be limited. The overall level of household conditions and embedment in communities attested to a generalized fragile ecological environment. In conflict-affected socio-ecological environments, caregiving can impact children's functioning and their role in reproducing violence. Interventions that support caregivers in positive caregiving are promising for breaking cyclical violence.

Measuring and understanding the effects of a performance based financing scheme applied to nutrition services in Burundi-a mixed method impact evaluation design.

PubMed

Nimpagaritse, Manassé; Korachais, Catherine; Roberfroid, Dominique; Kolsteren, Patrick; Zine Eddine El Idrissi, Moulay Driss; Meessen, Bruno

2016-06-14

Malnutrition is a huge problem in Burundi. In order to improve the provision of services at hospital, health centre and community levels, the Ministry of Health is piloting the introduction of malnutrition prevention and care indicators within its performance based financing (PBF) scheme. Paying for units of services and for qualitative indicators is expected to enhance provision and quality of these nutrition services, as PBF has done, in Burundi and elsewhere, for several other services. This paper presents the protocol for the impact evaluation of the PBF scheme applied to malnutrition. The research design consists in a mixed methods model adopting a sequential explanatory design. The quantitative component is a cluster-randomized controlled evaluation design: among the 90 health centres selected for the study, half receive payment related to their results in malnutrition activities, while the other half get a budget allocation. Qualitative research will be carried out both during the intervention period and at the end of the quantitative evaluation. Data are collected from 1) baseline and follow-up surveys of 90 health centres and 6,480 households with children aged 6 to 23 months, 2) logbooks filled in weekly in health centres, and 3) in-depth interviews and focus group discussions. The evaluation aims to provide the best estimate of the impact of the project on malnutrition outcomes in the community as well as outputs at the health centre level (malnutrition care outputs) and to describe quantitatively and qualitatively the changes that took place (or did not take place) within health centres as a result of the program. Although PBF schemes are blooming in low in-come countries, there is still a need for evidence, especially on the impact of revising the list of remunerated indicators. It is expected that this impact evaluation will be helpful for the national policy dialogue in Burundi, but it will also provide key evidence for countries with an existing PBF scheme and confronted with malnutrition problems on the appropriateness to extend the strategy to nutrition services. ClinicalTrials.gov PRS Identifier: NCT02721160; registered March 2016.

Soil fertility status and challenges in Burundi: an overview

NASA Astrophysics Data System (ADS)

Kaboneka, Salvator

2015-04-01

Landlocked and thousands miles away from international sea ports, Burundi is one of the poorest country in the world. 58% of the population suffers chronic malnutrition, 67% live in absolute poverty (MDG report 2012). 90% of the estimated 10 million people depends on subsistence agriculture, on about 3 million ha of cultivable land. The average size of a family farm is less than 0.5 ha which has to support a family of typically 7 people . As a consequence, fallow practices are no longer possible and continuous land cultivation leads to enormous soil losses by erosion. As much as 100-200 metric tons per hectare of soil losses have been reported on the hill sides of the Mumirwa region, whose landscape is currently so degraded that the local community now say that "stones grow" in the zone. In medium to high altitude areas, about 1 million of ha are acidic (pH < 5) with a high risk of Al toxicity and deficiencies in major (P, Ca, Mg, K) and micro-nutrients (Cu, Zn). Some parts of the low land of the Imbo zone, dedicated to rice cultivation, manifest indications of salinity. A recent survey showed that 14% of the 2.800 ha of land committed to rice production is affected by rising salinity. Although soil salinity constitutes a challenge to rice producers in that region, soil acidity, often combined with Al toxicity, is the major limitation to soil productivity throughout Burundi. Almuminum saturation up to 60% and pH as low as 4.5 are observed. As elsewhere, technical solutions do exist, but the level of poverty of the population is such that access to fertilizers and adoption of sustainable practices is very weak. We believe that the main challenge to soil productivity in Burundi is more socio-economic than technical, and farmers should be helped with simple tools that should be linked to their indigenous knowledge about soil fertility. Sustainable management of soil fertility is the key challenge for farmers to optimize a sustainable yield. Key words: micro nutrient, soil fertility, nutrient depletion, soil acidity.

Reintegration of child soldiers in Burundi: a tracer study

PubMed Central

2012-01-01

Background Substantial attention and resources are aimed at the reintegration of child soldiers, yet rigorous evaluations are rare. Methods This tracer study was conducted among former child soldiers (N=452) and never-recruited peers (N=191) who participated in an economic support program in Burundi. Socio-economic outcome indicators were measured retrospectively for the period before receiving support (T1; 2005–06); immediately afterwards (T2; 2006–07); and at present (T3; 2010). Participants also rated present functional impairment and mental health indicators. Results Participants reported improvement on all indicators, especially economic opportunity and social integration. At present no difference existed between both groups on any of the outcome indicators. Socio-economic functioning was negatively related with depression- and, health complaints and positively with intervention satisfaction. Conclusion The present study demonstrates promising reintegration trajectories of former child soldiers after participating in a support program. PMID:23095403

The sudden removal of user fees: the perspective of a frontline manager in Burundi.

PubMed

Nimpagaritse, Manassé; Bertone, Maria Paola

2011-11-01

In May 2006, the President of Burundi announced the removal of user fees in all health centres and hospitals for children under 5 and women giving birth. As other studies also point out, the policy was adopted extremely suddenly, without much reflection on its ultimate aims and on the operational dimension of its implementation. From the perspective of a frontline manager, this paper provides a descriptive case study of the abolition of user fees in the Muramvya District and a first-hand account of the effects of the sudden reform in the management of a district and a district hospital. The analysis highlights the challenges that the district and hospital teams faced. The main issues were: the reduction of financial flows, which prevented the possibility of investments and caused frequent drugs stock-outs; the reduced quality of the services and the disruption of the referral system; the motivation of the health staff who saw the administrative workload increase (not necessarily because of increased utilization) and faced 'ethical dilemmas' caused by the imprecise targeting of the reform. Undoubtedly, the removal of user fees for certain groups was an equitable and necessary measure in an extremely poor country such as Burundi. However, the suddenness of the decision and the lack of preparation had critical and long-lasting consequences for the entire health system. This analysis, performed from the frontline perspective, clarifies the importance of a rigorous planning of any reform, as well as of involving peripheral actors and understanding the complex challenges that they face.

78 FR 41972 - Determination Under Section 107(a) of the William Wilberforce Trafficking Victims Protection...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

...-457) and Delegation of Waiver Authority Pursuant to Section 107(a) of Public Law 110-457, I hereby..., Barbados, Belarus, Burundi, Chad, Comoros, The Gambia, Liberia, Malaysia, Maldives, and Thailand. This...

Assembly of Associations: Communique, 2002.

ERIC Educational Resources Information Center

Barrett, Helle, Comp.; Brown, Gerald R., Comp.

This document reports developments in school librarianship from around the world. Reports from the following countries, regions, and organizations are included: Austria; the Australian School Library Association; the Botswana Secondary School Librarians Association; Burundi; the Association for Teacher-Librarianship in Canada; the Canadian School…

Africa, Asia, Europe, and Latin America.

ERIC Educational Resources Information Center

Loh, Eudora I.

1992-01-01

This annotated bibliography lists 30 government documents published between 1988 and 1991 by Argentina, Bolivia, Brazil, Burundi, Chile, China, Columbia, Denmark, France, Gambia, Guinea Bissau, Hong Kong, India, Italy, Luxembourg, Mexico, Nepal, Nigeria, Portugal, Rwanda, South Africa, and Thailand. Topics addressed include the environment,…

Food for Survival: Diagnosing Crop Patterns to Secure Lower Threshold Food Security Levels in Farm Households of Burundi.

PubMed

Niragira, Sanctus; D'Haese, Marijke; D'Haese, Luc; Ndimubandi, Jean; Desiere, Sam; Buysse, Jeroen

2015-06-01

Burundi is one of the world's poorest countries, coming last in the Global Food Index (2013). Yet, a large majority of its population depends on agriculture. Most smallholder families do not produce enough to support their own families. To estimate the optimal crop mix and resources needed to provide the family with food containing sufficient energy, fat, and protein. This study uses mathematical programming to obtain the optimal crop mix that could maximize output given the constraints on production factor endowments and the need to feed the household. The model is calibrated with household-level data collected in 2010 in Ngozi Province in northern Burundi. Four models are developed, each representing a different farm type. The typology is based on 2007 data. Model predictions are compared with data collected during a revisit of the area in 2012. By producing a smaller number of crops and concentrating on those in which they have a comparative advantage, and trading produce and input with other farms, large and medium-sized farms can improve their productivity and hire extra workers to supplement family labor. Predictions of crops to be planted coincided to a high degree with those that farmers planted 2 years after our survey on newly acquired plots. Despite land scarcity, it is still possible for households that own land to find optimal crop combinations that can meet their minimal food security requirements while generating a certain level of income. Nearly landless households would benefit from the increased off-farm employment opportunities. With only 0.05 ha of land per capita, the annotation Nearly Landless is used to highlight the limited access to land observed in this farm category. © The Author(s) 2015.

Assessing the impact of mass rape on the incidence of HIV in conflict-affected countries

PubMed Central

Virginie, Supervie; Yasmin, Halima; Sally, Blower

2010-01-01

Objectives To quantify the potential impact of mass rape on HIV incidence in seven conflict-afflicted-countries (CACs), with severe HIV epidemics, in Sub-Saharan Africa. Design Uncertainty analysis of a risk equation model. Methods A mathematical model was used to evaluate the potential impact of mass rape on increasing HIV incidence in women and girls in: Burundi, Democratic Republic of Congo (DRC), Rwanda, Sierra Leone, Somalia, southern Sudan and Uganda. The model was parameterized with data from UNAIDS/WHO and the US Census Bureau’s International Data Base. Incidence data from UNAIDS/WHO were used for calibration. Results Mass rape could cause ~five HIV infections per 100,000 females per year in the DRC, Sudan, Somalia and Sierra Leone, double that in Burundi and Rwanda, and quadruple that in Uganda. The number of females infected per year due to mass rape is likely to be relatively low in Somalia and Sierra Leone, 127 (median: Inter-Quartile-Range (IQR) 55–254) and 156 (median: IQR 69–305), respectively. Numbers could be high in the DRC and Uganda: 1,120 (median: IQR 527–2,360) and 2,172 (median: IQR 1,031–4,668), respectively. In Burundi, Rwanda and Sudan numbers are likely to be intermediate. Under extreme conditions 10,000 women and girls could be infected per year in the DRC, and 20,000 women and girls in Uganda. Mass rape could increase annual incidence by ~ 7% (median: IQR 3–15). Conclusions Interventions and treatment targeted to rape survivors during armed conflicts could reduce HIV incidence. Support should be provided both on the basis of human rights and public health. PMID:20859191

Countrywide Reassessment of Schistosoma mansoni Infection in Burundi Using a Urine-Circulating Cathodic Antigen Rapid Test: Informing the National Control Program

PubMed Central

Ortu, Giuseppina; Ndayishimiye, Onésime; Clements, Michelle; Kayugi, Donatien; Campbell, Carl H.; Lamine, Mariama Sani; Zivieri, Antonio; Magalhaes, Ricardo Soares; Binder, Sue; King, Charles H.; Fenwick, Alan; Colley, Daniel G.; Jourdan, Peter Mark

2017-01-01

Following implementation of the national control program, a reassessment of Schistosoma mansoni prevalence was conducted in Burundi to determine the feasibility of moving toward elimination. A countrywide cluster-randomized cross-sectional study was performed in May 2014. At least 25 schools were sampled from each of five eco-epidemiological risk zones for schistosomiasis. Fifty randomly selected children 13–14 years of age per school were included for a single urine-circulating cathodic antigen (CCA) rapid test and, in a subset of schools, for duplicate Kato-Katz slide preparation from a single stool sample. A total of 17,331 children from 347 schools were tested using CCA. The overall prevalence of S. mansoni infection, when CCA trace results were considered negative, was 13.5% (zone range [zr] = 4.6–17.8%), and when CCA trace results were considered positive, it was 42.8% (zr = 34.3–49.9%). In 170 schools, prevalence of this infection determined using Kato-Katz method was 1.5% (zr ==0–2.7%). The overall mean intensity of S. mansoni infection determined using Kato-Katz was 0.85 eggs per gram (standard deviation = 10.86). A majority of schools (84%) were classified as non-endemic (prevalence = 0) using Kato-Katz; however, a similar proportion of schools were classified as endemic when CCA trace results were considered negative (85%) and nearly all (98%) were endemic when CCA trace results were considered positive. The findings of this nationwide reassessment using a CCA rapid test indicate that Schistosoma infection is still widespread in Burundi, although its average intensity is probably low. Further evidence is now needed to determine the association between CCA rapid test positivity and low-intensity disease transmission. PMID:28115675

Obstetric Fistula in Burundi: a comprehensive approach to managing women with this neglected disease

PubMed Central

2013-01-01

Background In Burundi, the annual incidence of obstetric fistula is estimated to be 0.2-0.5% of all deliveries, with 1000–2000 new cases per year. Despite this relatively high incidence, national capacity for identifying and managing obstetric fistula is very limited. Thus, in July 2010, Medecins Sans Frontieres (MSF) set up a specialised Obstetric Fistula Centre in Gitega (Gitega Fistula Centre, GFC), the only permanent referral centre for obstetric fistula in Burundi. A comprehensive model of care is offered including psychosocial support, conservative and surgical management, post-operative care and follow-up. We describe this model of care, patient outcomes and the operational challenges. Methods Descriptive study using routine programme data. Results Between July 2010 and December 2011, 470 women with obstetric fistula presented for the first time at GFC, of whom 458 (98%) received treatment. Early urinary catheterization (conservative management) was successful in four out of 35 (11%) women. Of 454 (99%) women requiring surgical management, 394 (87%) were discharged with a closed fistula, of whom 301 (76%) were continent of urine and/or faeces, while 93 (24%) remained incontinent of urine and/or faeces. In 59 (13%) cases, the fistula was complex and could not be closed. Outcome status was unknown for one woman. Median duration of stay at GFC was 39 days (Interquartile range IQR, 31–51 days). The main operational challenges included: i) early case finding and recruitment for conservative management, ii) national capacity building in obstetric fistula surgical repair, and iii) assessing the psychosocial impact of this model. Conclusion In a rural African setting, it is feasible to implement a comprehensive package of fistula care using a dedicated fistula facility, and satisfactory surgical repair outcomes can be achieved. Several operational challenges are discussed. PMID:23965150

Rural Development and Labour-Intensive Schemes. Impact Studies of Some Pilot Programmes.

ERIC Educational Resources Information Center

Gaude, J.; And Others

1987-01-01

Examines case studies of special public works programs in five countries (Burkina Faso, Burundi, Rwanda, Nepal, and United Republic of Tanzania) that included afforestation projects, anti-erosion works, and the building of reservoirs. Discusses program design, implementation, and impact. (CH)

Maritime vessels carry more than half of growing U.S.-East Africa trade

DOT National Transportation Integrated Search

2009-03-01

Trade between the United States and East African countries : (defi ned in this special report as Burundi, Kenya, : Rwanda, Tanzania, and Uganda) has grown substantially : in recent years, reaching $1.3 billion in value in 2007. : Between 1997 and 200...

A potato model intercomparison across varying climates and productivity levels

USDA-ARS?s Scientific Manuscript database

A potato crop multi-model assessment was conducted to quantify variation among models and evaluate responses to climate change. Nine modeling groups simulated agronomic and climatic responses at low- (Chinoli, Bolivia and Gisozi, Burundi) and high- (Jyndevad, Denmark and Washington, United States) ...

Peace-building and reconciliation dividends of integrated health services delivery in post-conflict Burundi: qualitative assessments of providers and community members.

PubMed

Christensen, Cathryn; Edward, Anbrasi

2015-01-01

While demonstrating causality remains challenging, several 'health-peace' mechanisms have been proposed to describe how health systems contribute to peace-building and stability in post-conflict settings. A qualitative study was undertaken in southern Burundi to identify drivers of social tension and reconciliation in the catchment area of Village Health Works, a health services organisation. Key informant interviews and focus group discussions were conducted in early 2014 with a total of one hundred and twenty community members and staff representing a range of conflict and recovery experience. Themes emerging from these interviews indicated mechanisms at the individual, household, community, and regional levels through which health provision mitigates tensions and promotes social cohesion. This peace dividend was amplified by the clinic's integrated model, which facilitates further community interaction through economic, agricultural and education programmes. Land pressure and the marginalisation of repatriated refugees were cited as drivers of local tension.

Measuring Hope Among Children Affected by Armed Conflict: Cross-Cultural Construct Validity of the Children's Hope Scale.

PubMed

Haroz, Emily E; Jordans, Mark; de Jong, Joop; Gross, Alden; Bass, Judith; Tol, Wietse

2017-06-01

We investigated the cross-cultural construct validity of hope, a factor associated with mental health protection and promotion, using the Children's Hope Scale (CHS). The sample ( n = 1,057; 48% girls) included baseline data from three cluster-randomized controlled trials with children affected by armed conflict ( n = 329 Burundi; n = 403 Indonesia; n = 325 Nepal). The confirmatory factor analysis in each country indicated good fit for the hypothesized two-factor model. Analysis by gender indicated that configural invariance was supported and that scalar invariance was demonstrated in Indonesia. However, metric and scalar invariance were not supported in Burundi and Nepal. In country comparisons, configural and metric invariance were met, but scalar invariance was not supported. Evidence from this study supports the use of the CHS within various sociocultural settings and across genders, but direct comparisons of CHS scores across groups should be done with caution. Rigorous evaluations of the measurement properties of mental health protective and promotive factors are necessary to inform both research and practice.

Forecasting malaria incidence based on monthly case reports and environmental factors in Karuzi, Burundi, 1997–2003

PubMed Central

Gomez-Elipe, Alberto; Otero, Angel; van Herp, Michel; Aguirre-Jaime, Armando

2007-01-01

Background The objective of this work was to develop a model to predict malaria incidence in an area of unstable transmission by studying the association between environmental variables and disease dynamics. Methods The study was carried out in Karuzi, a province in the Burundi highlands, using time series of monthly notifications of malaria cases from local health facilities, data from rain and temperature records, and the normalized difference vegetation index (NDVI). Using autoregressive integrated moving average (ARIMA) methodology, a model showing the relation between monthly notifications of malaria cases and the environmental variables was developed. Results The best forecasting model (R2adj = 82%, p < 0.0001 and 93% forecasting accuracy in the range ± 4 cases per 100 inhabitants) included the NDVI, mean maximum temperature, rainfall and number of malaria cases in the preceding month. Conclusion This model is a simple and useful tool for producing reasonably reliable forecasts of the malaria incidence rate in the study area. PMID:17892540

Reconciling reintegration: the complexity of economic and social reintegration of ex-combatants in Burundi.

PubMed

Willems, Rens; van Leeuwen, Mathijs

2015-04-01

The extent to which disarmament, demobilisation and reintegration (DDR) programmes initiated by state or multilateral agencies can realise the reintegration of ex-combatants remains debated. While some consider that DDR should have the ambition to result in long-term reintegration, others argue that DDR should focus on short-term goals. This paper explores experiences with the reintegration of ex-combatants in Burundi. It shows the interconnectedness of economic and social reintegration processes, and demonstrates that the reintegration of ex-combatants cannot be seen in isolation from the wider recovery and development context in which DDR is taking place. Moreover, the case demonstrates that reconciliation and social reintegration are deeply interconnected, to the extent that social reintegration may fail if reconciliation is not taken into account. Rather than a debate between long- and short-term goals, the focus should therefore be on increasing the understanding of reintegration processes and finding ways in which programmes can contribute to those. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

Quality Is Culture-Bound.

ERIC Educational Resources Information Center

Ebbeck, Fred

Presenting a case study of the African nation of Burundi to illustrate the great variation in the environment in which children are raised in developing and developed nations, this paper focuses on the importance of considering the context of a particular culture and society when educators talk about the quality of early childhood services.…

Determinants of stunting and severe stunting among Burundian children aged 6-23 months: evidence from a national cross-sectional household survey, 2014.

PubMed

Nkurunziza, Sandra; Meessen, Bruno; Van Geertruyden, Jean-Pierre; Korachais, Catherine

2017-07-25

Burundi is one of the poorest countries and is among the four countries with the highest prevalence of stunting (58%) among children aged less than 5 years. This situation undermines the economic growth of the country as undernutrition is strongly associated with less schooling and reduced economic productivity. Identifying the determinants of stunting and severe stunting may help policy-makers to direct the limited Burundian resources to the most vulnerable segments of the population, and thus make it more cost effective. This study aimed to identify predictors of stunting and severe stunting among children aged less than two years in Burundi. The sample is made up of 6199 children aged 6 to 23 months with complete anthropometric measurements from the baseline survey of an impact evaluation study of the Performance-Based financing (PBF) scheme applied to nutrition services in Burundi from 2015 to 2017. Binary and multivariable logistic regression analyses were used to examine stunting and severe stunting against a set of child, parental and household variables such as child's age or breastfeeding pattern, mother's age or knowledge of malnutrition, household size or socio-economic status. The prevalence of stunting and severe stunting were 53% [95%CI: 51.8-54.3] and 20.9% [95%CI: 19.9-22.0] respectively. Compared to children from 6-11 months, children of 12-17 months and 18-23 months had a higher risk of stunting (AdjOR:2.1; 95% CI: 1.8-2.4 and 3.2; 95% CI: 2.8-3.7). Other predictors for stunting were small babies (AdjOR=1.5; 95% CI: 1.3-1.7 for medium-size babies at birth and AdjOR=2.9; 95% CI: 2.4-3.6 for small-size babies at birth) and male children (AdjOR=1.5, 95% CI: 1.4-1.8). In addition, having no education for mothers (AdjOR=1.6; 95% CI: 1.2-2.1), incorrect mothers' child nutrition status assessment (AdjOR=3.3; 95% CI: 2.8-4), delivering at home (AdjOR=1.4; 95% CI: 1.2-1.6) were found to be predictors for stunting. More than to 2 under five children in the household (AdjOR=1.45; 95% CI: 1.1-1.9 for stunting and AdjOR= 1.5; 95% CI: 1.2-1.9 for severe stunting) and wealth were found to be predictors for both stunting and severe stunting. The factors associated with stunting were found to be applicable for severe stunting as well. Mother's education level, mother's knowledge about child nutrition status assessment and health facility delivery were predictors of child stunting. Our study confirms that stunting and severe stunting is in Burundi, as elsewhere, a multi-sectorial problem. Some determinants relate to the general development of Burundi: education of girls, poverty, and food security; will be addressed by a large array of actions. Some others relate to the health sector and its performance - we think in particular of the number of children under five in the household (birth spacing), the relationship with the health center and the knowledge of the mother on malnutrition. Our findings confirm that the Ministry of Health and its partners should strive for better performing and holistic nutrition services: they can contribute to better nutrition outcomes.

Redescription of Helorus ruficornis Förster (Hymenoptera: Heloridae), with a new synonymy and new Afrotropical specimen records

USDA-ARS?s Scientific Manuscript database

Research up to this point has recorded two species of Afrotropical Heloridae: Helorus ruficornis Foerster and H. elgoni Risbec. After examining recently collected specimens from Kenya and Burundi, we have been able to better understand intraspecific variation with H. ruficornis, and as a result, we...

Survey of Basic Education in Eastern Africa. UNESCO/UNICEF Co-Operation Programme.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Nairobi (Kenya). Regional Office of Science and Technology for Africa.

A survey of basic education in 13 Eastern African countries (Madagascar, Burundi, Comores, Ethiopia, Mauritius, Botswana, Kenya, Lesotho, Swaziland, Tanzania, Zambia, Malawi, and Somalia) covers basic education programs and UNICEF's supporting role. Basic education is seen as a concept evolved in the region, involving formal school systems and…

Africa: A Survey of Distance Education 1991. New Papers on Higher Education: Studies and Research 4.

ERIC Educational Resources Information Center

John, Magnus

Country profiles compiled through a survey of distance education in Africa form the contents of this document. International organizations and 35 countries were surveyed: Algeria; Benin; Botswana; Burkina Faso; Burundi; Cameroon; Central African Republic; Chad; Congo (Brazzaville); Djibouti; Ethiopia; Gambia; Ghana; Guinea; Ivory Coast; Kenya;…

The Role of Education in Peace-Building in the African Great Lakes Region: Educators' Perspectives

ERIC Educational Resources Information Center

Ndura-Ouedraogo, Elavie

2009-01-01

This article discusses the findings from a qualitative study which examined educators' perceptions of their contributions to the quest for sustainable peace in Burundi and the African Great Lakes region. The study looked at how educators representing different ethnic backgrounds, academic preparation, and currently employed at different levels…

Learning about War and Peace in the Great Lakes Region of Africa

ERIC Educational Resources Information Center

Bird, Lyndsay

2007-01-01

Two-thirds of the world's conflicts are in Africa. In particular, the Great Lakes region (Rwanda, Burundi, Democratic Republic of Congo, Uganda and Tanzania) continues to see conflicts that are complex, extreme and seemingly intractable. By exploring the narrative experiences of those most affected by the conflicts in the region--specifically…

[Sociocultural aspects of albinism in Sub-Saharan Africa: mutilations and ritual murders committed in east Africa (Burundi and Tanzania)].

PubMed

Aquaron, R; Djatou, M; Kamdem, L

2009-10-01

This report presents an overview of the many sociocultural prejudices confronting albinos and their parents in Sub-Saharan Africa at each stage of life (infancy, adolescence, and adulthood). The birth of an albino child to two black parents has always been an enigma for African peoples. French-speaking and English-speaking populations in Central, East and South African countries have invented numerous myths to account for this event. Albinos are believed to possess good and evil magical powers. On the white magic side, some organs are believed to confer luck, health, and prosperity. For this reason albinos in Tanzania and Burundi are still in 2008 prey to ritual murders and mutilations to obtain various body parts such as arms, legs, and genitals for preparation of amulets. This barbaric and iniquitous practice has been severely condemned by authorities in both countries as well as by the European Parliament. To end these atrocities disseminating accurate medical information explaining the genetic basis of albinism will be necessary to eliminate ignorance and superstition.

Livelihoods, power, and food insecurity: adaptation of social capital portfolios in protracted crises--case study Burundi.

PubMed

Vervisch, Thomas G A; Vlassenroot, Koen; Braeckman, Johan

2013-04-01

The failure of food security and livelihood interventions to adapt to conflict settings remains a key challenge in humanitarian responses to protracted crises. This paper proposes a social capital analysis to address this policy gap, adding a political economy dimension on food security and conflict to the actor-based livelihood framework. A case study of three hillsides in north Burundi provides an ethnographic basis for this hypothesis. While relying on a theoretical framework in which different combinations of social capital (bonding, bridging, and linking) account for a diverse range of outcomes, the findings offer empirical insights into how social capital portfolios adapt to a protracted crisis. It is argued that these social capital adaptations have the effect of changing livelihood policies, institutions, and processes (PIPs), and clarify the impact of the distribution of power and powerlessness on food security issues. In addition, they represent a solid way of integrating political economy concerns into the livelihood framework. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Measuring Hope Among Children Affected by Armed Conflict: Cross-Cultural Construct Validity of the Children’s Hope Scale

PubMed Central

Haroz, Emily E.; Jordans, Mark; de Jong, Joop; Gross, Alden; Bass, Judith; Tol, Wietse

2018-01-01

We investigated the cross-cultural construct validity of hope, a factor associated with mental health protection and promotion, using the Children’s Hope Scale (CHS). The sample (n = 1,057; 48% girls) included baseline data from three cluster-randomized controlled trials with children affected by armed conflict (n = 329 Burundi; n = 403 Indonesia; n = 325 Nepal). The confirmatory factor analysis in each country indicated good fit for the hypothesized two-factor model. Analysis by gender indicated that configural invariance was supported and that scalar invariance was demonstrated in Indonesia. However, metric and scalar invariance were not supported in Burundi and Nepal. In country comparisons, configural and metric invariance were met, but scalar invariance was not supported. Evidence from this study supports the use of the CHS within various sociocultural settings and across genders, but direct comparisons of CHS scores across groups should be done with caution. Rigorous evaluations of the measurement properties of mental health protective and promotive factors are necessary to inform both research and practice. PMID:26508802

Ranking malaria risk factors to guide malaria control efforts in African highlands.

PubMed

Protopopoff, Natacha; Van Bortel, Wim; Speybroeck, Niko; Van Geertruyden, Jean-Pierre; Baza, Dismas; D'Alessandro, Umberto; Coosemans, Marc

2009-11-25

Malaria is re-emerging in most of the African highlands exposing the non immune population to deadly epidemics. A better understanding of the factors impacting transmission in the highlands is crucial to improve well targeted malaria control strategies. A conceptual model of potential malaria risk factors in the highlands was built based on the available literature. Furthermore, the relative importance of these factors on malaria can be estimated through "classification and regression trees", an unexploited statistical method in the malaria field. This CART method was used to analyse the malaria risk factors in the Burundi highlands. The results showed that Anopheles density was the best predictor for high malaria prevalence. Then lower rainfall, no vector control, higher minimum temperature and houses near breeding sites were associated by order of importance to higher Anopheles density. In Burundi highlands monitoring Anopheles densities when rainfall is low may be able to predict epidemics. The conceptual model combined with the CART analysis is a decision support tool that could provide an important contribution toward the prevention and control of malaria by identifying major risk factors.

Genetic and morphological characterisation of the Ankole Longhorn cattle in the African Great Lakes region.

PubMed

Ndumu, Deo B; Baumung, Roswitha; Hanotte, Olivier; Wurzinger, Maria; Okeyo, Mwai A; Jianlin, Han; Kibogo, Harrison; Sölkner, Johann

2008-01-01

The study investigated the population structure, diversity and differentiation of almost all of the ecotypes representing the African Ankole Longhorn cattle breed on the basis of morphometric (shape and size), genotypic and spatial distance data. Twentyone morphometric measurements were used to describe the morphology of 439 individuals from 11 sub-populations located in five countries around the Great Lakes region of central and eastern Africa. Additionally, 472 individuals were genotyped using 15 DNA microsatellites. Femoral length, horn length, horn circumference, rump height, body length and fore-limb circumference showed the largest differences between regions. An overall FST index indicated that 2.7% of the total genetic variation was present among sub-populations. The least differentiation was observed between the two sub-populations of Mbarara south and Luwero in Uganda, while the highest level of differentiation was observed between the Mugamba in Burundi and Malagarasi in Tanzania. An estimated membership of four for the inferred clusters from a model-based Bayesian approach was obtained. Both analyses on distance-based and model-based methods consistently isolated the Mugamba sub-population in Burundi from the others.

The East African monsoon system: Seasonal climatologies and recent variations: Chapter 10

USGS Publications Warehouse

Funk, Christopher C.; Hoell, Andrew; Shukla, Shraddhanand; Husak, Gregory J.; Michaelsen, J.

2016-01-01

This chapter briefly reviews the complex climatological cycle of the East African monsoon system, paying special attention to its connection to the larger Indo-Pacific-Asian monsoon cycle. We examine the seasonal monsoon cycle, and briefly explore recent circulation changes. The spatial footprint of our analysis corresponds with the “Greater Horn of Africa” (GHA) region, extending from Tanzania in the south to Yemen and Sudan in the north. During boreal winter, when northeast trade winds flow across the northwest Indian Ocean and the equatorial moisture transports over the Indian Ocean exhibit strong westerly mean flows over the equatorial Indian Ocean, East African precipitation is limited to a few highland areas. As the Indian monsoon circulation transitions during boreal spring, the trade winds over the northwest Indian Ocean reverse, and East African moisture convergence supports the “long” rains. In boreal summer, the southwesterly Somali Jet intensifies over eastern Africa. Subsidence forms along the westward flank of this jet, shutting down precipitation over eastern portions of East Africa. In boreal fall, the Jet subsides, but easterly moisture transports support rainfall in limited regions of the eastern Horn of Africa. We use regressions with the trend mode of global sea surface temperatures to explore potential changes in the seasonal monsoon circulations. Significant reductions in total precipitable water are indicated in Kenya, Tanzania, Rwanda, Burundi, Uganda, Ethiopia, South Sudan, Sudan, and Yemen, with moisture transports broadly responding in ways that reinforce the climatological moisture transports over the Indian Ocean. Over Kenya, southern Ethiopia and Somalia, regressions with velocity potential indicate increased convergence aloft. Near the surface, this convergence appears to manifest as a surface high pressure system that modifies moisture transports in these countries as well as Uganda, Tanzania, Rwanda, and Burundi. An analysis of rainfall changes indicates significant declines in parts of Tanzania, Rwanda, Burundi, Uganda, Kenya, Somalia, Ethiopia, and Yemen.

A Comparative Survey of Seven Adult Functional Literacy Programs in Sub-Saharan Africa.

ERIC Educational Resources Information Center

Richmond, Edmun B.

A study compares the adult functional literacy campaigns and programs developed in seven African nations: the Gambia, Liberia, Mali, Burundi, Rwanda, Kenya, and Seychelles. After an introductory chapter outlining the background of African adult functional literacy efforts and some of the constraints on them, the second chapter gives an overview of…

Life in the Shadow: An Examination of the Minor Foreign Relations of the DPRK

DTIC Science & Technology

2014-03-01

27 a. Cuba ...Relations Established Country Relations Established Algeria 9/25/1958 Tanzania 1/13/1965 Guinea 10/8/1958 Syria 7/25/1966 Cuba 8/29/1960 Burundi 3...using this author’s previously outlined methods. 0 500 1000 1500 2000 2500 Congo Cuba Germany India Iran Italy Mongolia Syria Number of Times

Undernutrition, subsequent risk of mortality and civil war in Burundi.

PubMed

Verwimp, Philip

2012-07-01

The paper investigates the effect of child undernutrition on the risk of mortality in Burundi. Using anthropometric data from a longitudinal survey (1998-2007) we find that undernourished children, measured by the height-for-age z-scores (HAZ) in 1998 had a higher probability to die during subsequent years. In order to address the problem of omitted variables correlated with both nutritional status and the risk of mortality, we use the length of exposure to civil war prior to 1998 as a source of exogenous variation in a child's nutritional status. Children exposed to civil war in their area of residence have worse nutritional status. The results indicate that one year of exposure translates into a 0.15 decrease in the HAZ, resulting in a 10% increase in the probability to die. For boys, we find a 0.34 decrease in HAZ per year of exposure, resulting in 25% increase in the probability to die. For girls, the results are statistically not significant at the usual thresholds. We show the robustness of our results and we derive policy conclusion for a nutrition intervention in times of conflict. Copyright © 2011 Elsevier B.V. All rights reserved.

Genetic and morphological characterisation of the Ankole Longhorn cattle in the African Great Lakes region

PubMed Central

Ndumu, Deo B; Baumung, Roswitha; Hanotte, Olivier; Wurzinger, Maria; Okeyo, Mwai A; Jianlin, Han; Kibogo, Harrison; Sölkner, Johann

2008-01-01

The study investigated the population structure, diversity and differentiation of almost all of the ecotypes representing the African Ankole Longhorn cattle breed on the basis of morphometric (shape and size), genotypic and spatial distance data. Twentyone morphometric measurements were used to describe the morphology of 439 individuals from 11 sub-populations located in five countries around the Great Lakes region of central and eastern Africa. Additionally, 472 individuals were genotyped using 15 DNA microsatellites. Femoral length, horn length, horn circumference, rump height, body length and fore-limb circumference showed the largest differences between regions. An overall FST index indicated that 2.7% of the total genetic variation was present among sub-populations. The least differentiation was observed between the two sub-populations of Mbarara south and Luwero in Uganda, while the highest level of differentiation was observed between the Mugamba in Burundi and Malagarasi in Tanzania. An estimated membership of four for the inferred clusters from a model-based Bayesian approach was obtained. Both analyses on distance-based and model-based methods consistently isolated the Mugamba sub-population in Burundi from the others. PMID:18694545

Educating Culturally Displaced Students with Truncated Formal Education (CDS-TFE): The Case of Refugee Students and Challenges for Administrators, Teachers, and Counselors

ERIC Educational Resources Information Center

Gahungu, Athanase; Gahungu, Olive; Luseno, Florah

2011-01-01

From 2006 to 2008, refugee resettlement agencies brought 4018 refugees to Chicago, Illinois. Using the example of the challenges faced by 14 refugee students from Burundi in adjusting to the U.S. school system, the authors call the attention of schools to the distinction between educating English Language Learners (ELL) and Educating Culturally…

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda

PubMed Central

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Objectives Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. Methods This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. Results The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Conclusions Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services. PMID:26405800

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda.

PubMed

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services.

Performance-based financing in the context of selective free health-care: an evaluation of its effects on the use of primary health-care services in Burundi using routine data.

PubMed

Falisse, Jean-Benoît; Ndayishimiye, Juvenal; Kamenyero, Vincent; Bossuyt, Michel

2015-12-01

Performance-based financing (PBF) is an increasingly adopted strategy in low- and middle-income countries. PBF pilot projects started in Burundi in 2006, at the same time when a national policy removed user fees for pregnant women and children below 5 years old. PBF was gradually extended to the 17 provinces of the country. This roll-out and data from the national health information system are exploited to assess the impact of PBF on the use of health-care services. PBF is associated with an increase in the number of anti-tetanus vaccination of pregnant women (around +20 percentage points in target population, P < 0.10). Non-robust positive effects are also found on institutional deliveries and prenatal consultations. Changes in outpatient visits, postnatal visits and children vaccinations are not significantly correlated with PBF. It is also found that more qualified nurses headed to PBF-supported provinces. The limited quality of the data and the restricted size of the sample have to be taken into account when interpreting these results. Health facility-level figures from PBF-supported provinces show that most indicators but those relative to preventive care are growing through time. The dataset does not include indicators of the quality of care and does not allow to assess whether changes associated with PBF are resource-driven or due to the incentive mechanism itself. The results are largely consistent with other impact evaluations conducted in Burundi and Rwanda. The fact that PBF is mostly associated with positive changes in the use of services that became free suggests an important interaction effect between the two strategies. A possible explanation is that the removal of user fees increases accessibility to health care and acts on the demand side while PBF gives medical staffs incentives for improving the provision of services. More empirical research is needed to understand the sustainability of (the incentive mechanism of) PBF and the interaction between PBF and other health policies. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Preparing Peacekeepers: An Analysis of the African Contingency Operations, Training, and Assistance Program Command and Staff Operational Skills Course

ERIC Educational Resources Information Center

Karis, Daniel Gerald

2010-01-01

The United States (U.S.) response to events in Africa in the 1990s--warlords in Somalia, the genocide in Rwanda, the crisis in Burundi, and the destruction of the U.S. embassies in Kenya and Tanzania--was the development of the African Crisis Response Initiative (ACRI) followed by the African Contingency Operations Training and Assistance (ACOTA)…

Location Optimization of Mobile Cold-Formed Steel Systems to Provide Humanitarian Relief After Natural Disasters

DTIC Science & Technology

2015-12-01

Verde 6 7 9 119 3 5 6 4 7 9 Cameroon 16 13 13...232 500 Cambodia 3 1 550 000 Cameroon 2 0 Canada 5 1 800 Cape Verde 1 30 000 Central African Republic 1 0 Chad 1...0 Brazil 1 280 Bulgaria 1 525 Burundi 1 0 Cameroon 0 0 Cape Verde 0 0 Chile 4 60 463

South Africa: Current Issues and U.S. Relations

DTIC Science & Technology

2009-05-20

almost 900 soldiers to the U.N. Operation in Burundi (ONUB), where former President Nelson Mandela played a leading role in brokering a peace...racial segregation, won control of the National Assembly. The Assembly chose as President Nelson Mandela , the ANC leader who had been released from...reportedly improving. South Africa has taken a critical stance toward the war in Iraq, and former President Nelson Mandela has been vocal in his

Community participation and voice mechanisms under performance-based financing schemes in Burundi.

PubMed

Falisse, Jean-Benoît; Meessen, Bruno; Ndayishimiye, Juvénal; Bossuyt, Michel

2012-05-01

Community participation is often described as a key for primary health care in low-income countries. Recent performance-based financing (PBF) initiatives have renewed the interest in this strategy by questioning the accountability of those in charge at the health centre (HC) level. We analyse the place of two downward accountability mechanisms in a PBF scheme: health committees elected among the communities and community-based organizations (CBOs) contracted as verifiers of health facilities' performance. We evaluated 100 health committees and 79 CBOs using original data collected in six Burundi provinces (2009-2010) and a framework based on the literature on community participation in health and New Institutional Economics. Health committees appear to be rather ineffective, focusing on supporting the medical staff and not on representing the population. CBOs do convey information about the concerns of the population to the health authorities; yet, they represent only a few users and lack the ability to force changes. PBF does not automatically imply more 'voice' from the population, but introduces an interesting complement to health committees with CBOs. However, important efforts remain necessary to make both mechanisms work. More experiments and analysis are needed to develop truly efficient 'downward' mechanisms of accountability at the HC level. © 2012 Blackwell Publishing Ltd.

Regional Engagement in Africa: Closing the Gap Between Strategic Ends and Ways

DTIC Science & Technology

2011-09-01

Power Sharing in Rwanda to Successful Top-Down Military Integration,” 11. 41 Stephen D. Biddle, “Military Effectiveness,” in The International...in Rwanda ,” 11. 50 Mukhopadhyay, 558, 560. MARTEN The East African Standby Force (EASF) is East Africa’s contribution to the African Union’s African...efficient than dealing directly with the EASF. Sometimes this causes difficulties in conducting combined activities. In 2009, Burundi, Kenya, Rwanda

Trafficking in Persons: U.S. Policy and Issues for Congress

DTIC Science & Technology

2008-08-14

pairs, models, dancers, domestic workers, etc. Traffickers advertise these “jobs” as well as marriage opportunities abroad in local newspapers and on...is no single victim stereotype , a majority of trafficked women are under the age of 25, with many in their mid- to late teens. In Latin America, for...Emirates, Uruguay, Vietnam, and Yemen. 32 The Tier 2 Watch List of countries include Argentina , Armenia, Azerbaijan, Albania, Bahrain, Burundi, Cameroon

Lessons from Burundi’s Security Sector Reform Process

DTIC Science & Technology

2014-11-01

Defense University,Africa Center for Strategic Studies,300 Fifth Avenue, Building 20 Fort McNair,Washington ,DC,20319-5066 8. PERFORMING ORGANIZATION...Fifth Avenue, Building 20 Fort McNair Washington, D.C. 20319-5066 Phone: + 1 202-685-7300 Website: www.africacenter.org AfricA Security briefS Director...Official Complicity and Impunity (New York: Human Rights Watch, March 2010). 4 Louis- Alexandre Berg, “Security Governance and the Recurrence of

Tubaramure, a Food-Assisted Integrated Health and Nutrition Program, Reduces Child Stunting in Burundi: A Cluster-Randomized Controlled Intervention Trial.

PubMed

Leroy, Jef L; Olney, Deanna; Ruel, Marie

2018-03-01

Food-assisted maternal and child health and nutrition (FA-MCHN) programs are widely used to address undernutrition, but little is known about their effectiveness in improving child linear growth. We assessed the impact of Burundi's Tubaramure FA-MCHN program on linear growth. The program targeted women and their children during the first 1000 d and included 1) food rations, 2) strengthening of health services and promotion of their use, and 3) behavior change communication (BCC). A second objective was to assess the differential effect when varying the timing and duration of receiving food rations. We used a 4-arm, cluster-randomized controlled study to assess program impact with the use of cluster fixed-effects double-difference models with repeated cross-sectional data (baseline and follow-up 4 y later with ∼3550 children in each round). Treatment arms received food rations (corn-soy blend and micronutrient-fortified vegetable oil) for the first 1000 d (T24), from pregnancy through the child reaching 18 mo (T18), or from birth through the child reaching 24 mo ["no food during pregnancy" (TNFP)]. All treatment arms received BCC for the first 1000 d. The control arm received no food rations or BCC. Stunting (height-for-age z score <2 SDs) increased markedly from baseline to follow-up, but Tubaramure had a significant (P < 0.05) beneficial effect in the T24 [7.4 percentage points (pp); P < 0.05], T18 (5.7 pp; P < 0.05), and TNFP (4.6; P = 0.09) arms; the differences in effect across arms were not significant (P > 0.01). Secondary analyses showed that the effect was limited to children whose mother and head of household had some primary education and who lived in households with above-median assets. FA-MCHN programs are an effective development tool to improve child linear growth and can protect children from political and economic shocks in vulnerable countries such as Burundi. A better understanding of how to improve the nutritional status of children in the worst-off households is needed. This trial was registered at www.clinicaltrials.gov as NCT01072279.

Could the Outcome of the Genocide in Rwanda be Different with an Operational Planning Cell in the United Nations?

DTIC Science & Technology

2012-06-08

best. The government must work with mainly with them.”11 Belgium developed the Rwandans’ population to be individualist , by introducing taxation...monopoly is turned into an economic and social monopoly…selection in school, the political, economic, and social monopoly turn into a cultural ...Rwanda-Burundi disapproved all political meetings. Because of the creation of all the new political parties, the cultural tension was at its maximum

Review and three new species of the flat bug genus Neochelonoderus Hoberlandt, 1967 from East Africa (Hemiptera: Heteroptera: Aradidae).

PubMed

Heiss, Ernst; Grebennikov, Vasily

2015-04-17

The apterous East African Mezirinae flat bug genus Neochelonoderus Hoberlandt 1967 is revised. In addition to known species from Burundi (N. basilewskyi) and Democratic Republic of the Congo (N. straeleni), two new species from Tanzania (N. talaus n. sp. and N. areius n. sp.) and one from Zambia (N. hoberlandti n. sp.) are described and illustrated. A key to the species of Neochelonoderus is presented.

USSR Report, International Affairs, Speeches by Foreign Delegates 27th CPSU Conference.

DTIC Science & Technology

1986-06-03

Burkina Faso Minister of National Defense Jean -Baptiste Lingani (PRAVDA, 5 Mar 86) .... .’•.’ . ■.". 33 Burundi Party of Unity and National...PRAVDA, 7 Mar 86) • • 195 Secretary of Progressive Front of People of the Seychelles Jacques Hodoul ( Jacques Hodoul; PRAVDA, 6 Mar 86) 197 Sierra...war and insure the bright future of mankind. (Prolonged applause). 12^24 CSO: 1807/201 32 BURKINA FASO MINISTER OF NATIONAL DEFENSE JEAN -BAPTISTE

Hope in Africa?: social representations of world history and the future in six African countries.

PubMed

Cabecinhas, Rosa; Liu, James H; Licata, Laurent; Klein, Olivier; Mendes, Júlio; Feijó, João; Niyubahwe, Aline

2011-10-01

Data on social representations of world history have been collected everywhere in the world except sub-Saharan Africa. Two studies using open-ended data involving university students from six African countries fill this gap. In Study 1, nominations from Cape Verde and Mozambique for the most important events in world history in the past 1000 years were dominated by war and politics, recency effects, and Western-centrism tempered by African sociocentrism on colonization and independence. The first three findings replicated previous research conducted in other parts of the world, but the last pattern contrasted sharply with European data. Study 2 employed a novel method asking participants how they would begin the narration of world history, and then to describe a major transition to the present. Participants most frequently wrote about the evolution of humanity out of Africa, followed by war and then colonization as a beginning, and then replicated previous findings with war, colonization, and technology as major transitions to the present. Finally, when asked about how they foresaw the future, many participants expressed hope for peace and cooperation, especially those facing more risk of collective violence (Burundi and Congo). A colonial/liberation narrative was more predominant in the data from former Portuguese colonies (Angola, Cape Verde, and Guinea-Bissau) than from former Belgian colonies (Burundi and Congo).

Introduction of performance-based financing in burundi was associated with improvements in care and quality.

PubMed

Bonfrer, Igna; Soeters, Robert; Van de Poel, Ellen; Basenya, Olivier; Longin, Gashubije; van de Looij, Frank; van Doorslaer, Eddy

2014-12-01

Several governments in low- and middle-income countries have adopted performance-based financing to increase health care use and improve the quality of health services. We evaluated the effects of performance-based financing in the central African nation of Burundi by exploiting the staggered rollout of this financing across provinces during 2006-10. We found that performance-based financing increased the share of women delivering their babies in an institution by 22 percentage points, which reflects a relative increase of 36 percent, and the share of women using modern family planning services by 5 percentage points, a relative change of 55 percent. The overall quality score for health care facilities increased by 45 percent during the study period, but performance-based financing was found to have no effect on the quality of care as reported by patients. We did not find strong evidence of differential effects of performance-based financing across socioeconomic groups. The performance-based financing effects on the probability of using care when ill were found to be even smaller for the poor. Our findings suggest that a supply-side intervention such as performance-based financing without accompanying access incentives for poor people is unlikely to improve equity. More research into the cost-effectiveness of performance-based financing and how best to target vulnerable populations is warranted. Project HOPE—The People-to-People Health Foundation, Inc.

Prevalence of disease and non-battle injury, anxiety and depression in the Royal Thai Armed Forces during the operation of the United Nations in Burundi.

PubMed

Saraithong, Surakarn; Aimpun, Pote; Rangsin, Ram; Areekul, Wirote; Mungthin, Mathirut; Panichkul, Suthee

2009-02-01

To determine the prevalence and impact of common disease and non-battle injuries (DNBI) among the military personnel deployed to the operations of the United Nations (UN) in Burundi from June to December 2005. The study population consisted of 175 Thai military personnel. A pre- and post deployment questionnaire assessing demographic data, general health, dental problems, underlying disease and health risk behaviors was performed. The information of DNBI was collected weekly. Data on initial visits for 27 DNBI categories were complied at the unit and event data on morbidity measures for each DNBI category were aggregated for all reporting units on a weekly basis. Anxiety and depression were assessed using the Hospital Anxiety and Depression (HAD) scale. The majority of the troops was in good health at pre- and post deployment. The total weekly initial visit DNBI rate was 337.6 visits per 1,000 persons, which was rather high compared to the Joint Chiefs of Staff (JCS) reference rate. The most common DNBI categories were respiratory illnesses (21.9%), medical/surgical injuries (19.8%) and recreational injuries (15.5%). The present data indicated that despite modern preventive medicine measures, illnesses and non-battle injuries were still common, which had a significant impact on military readiness and operational efficiency.

Paleolimnological investigations of anthropogenic environmental change in Lake Tanganyika: I. An introduction to the project

USGS Publications Warehouse

Cohen, A.S.; Palacios-Fest, M. R.; McGill, J.; Swarzenski, P.W.; Verschuren, D.; Sinyinza, R.; Songori, T.; Kakagozo, B.; Syampila, M.; O'Reilly, C. M.; Alin, S.R.

2005-01-01

We investigated paleolimnological records from a series of river deltas around the northeastern rim of Lake Tanganyika, East Africa (Tanzania and Burundi) in order to understand the history of anthropogenic activity in the lake's catchment over the last several centuries, and to determine the impact of these activities on the biodiversity of littoral and sublittoral lake communities. Sediment pollution caused by increased rates of soil erosion in deforested watersheds has caused significant changes in aquatic communities along much of the lake's shoreline. We analyzed the effects of sediment discharge on biodiversity around six deltas or delta complexes on the east coast of Lake Tanganyika: the Lubulungu River delta, Kabesi River delta, Nyasanga/Kahama River deltas, and Mwamgongo River delta in Tanzania; and the Nyamuseni River delta and Karonge/Kirasa River deltas in Burundi. Collectively, these deltas and their associated rivers were chosen to represent a spectrum of drainage-basin sizes and disturbance levels. By comparing deltas that are similar in watershed attributes (other than disturbance levels), our goal was to explore a series of historical "experiments" at the watershed scale, with which we could more clearly evaluate hypotheses of land use or other effects on nearshore ecosystems. Here we discuss these deltas, their geologic and physiographic characteristics, and the field procedures used for coring and sampling the deltas, and various indicators of anthropogenic impact. ?? Springer 2005.

Body Lice as Tools for Diagnosis and Surveillance of Reemerging Diseases

PubMed Central

Roux, Veronique; Raoult, Didier

1999-01-01

Body lice are vectors of three bacteria which cause human disease: Rickettsia prowazekii, the agent of epidemic typhus; Bartonella quintana, the agent of trench fever; and Borrelia recurrentis, the agent of relapsing fever. A recrudescence of body lice is being observed as the numbers of individuals living under social conditions which predispose individuals to infestation have increased. Because this phenomenon may lead to the reemergence of infections transmitted by body lice, we aimed to assess the occurrence and prevalence of the three agents described above in more than 600 body lice collected from infested individuals in the African countries of Congo, Zimbabwe, and Burundi, in France, in Russia, and in Peru. The presence of the three bacteria in each louse was determined by specific PCR amplification, and the identities of the organisms detected were confirmed by determination of the nucleotide base sequences of the amplification products. Using this approach, we were able to confirm the presence of R. prowazekii in lice collected from refugees in Burundi, among whom typhus was epidemic, and the presence of B. quintana in lice collected from all locations except the Congo. B. recurrentis was never found. Molecular approaches are convenient tools for the detection and identification of bacterial DNA in body lice and for the epidemiological study of louse-borne bacteria from countries where no medical and biological laboratory facilities are available. PMID:9986818

Body lice as tools for diagnosis and surveillance of reemerging diseases.

PubMed

Roux, V; Raoult, D

1999-03-01

Body lice are vectors of three bacteria which cause human disease: Rickettsia prowazekii, the agent of epidemic typhus; Bartonella quintana, the agent of trench fever; and Borrelia recurrentis, the agent of relapsing fever. A recrudescence of body lice is being observed as the numbers of individuals living under social conditions which predispose individuals to infestation have increased. Because this phenomenon may lead to the reemergence of infections transmitted by body lice, we aimed to assess the occurrence and prevalence of the three agents described above in more than 600 body lice collected from infested individuals in the African countries of Congo, Zimbabwe, and Burundi, in France, in Russia, and in Peru. The presence of the three bacteria in each louse was determined by specific PCR amplification, and the identities of the organisms detected were confirmed by determination of the nucleotide base sequences of the amplification products. Using this approach, we were able to confirm the presence of R. prowazekii in lice collected from refugees in Burundi, among whom typhus was epidemic, and the presence of B. quintana in lice collected from all locations except the Congo. B. recurrentis was never found. Molecular approaches are convenient tools for the detection and identification of bacterial DNA in body lice and for the epidemiological study of louse-borne bacteria from countries where no medical and biological laboratory facilities are available.

[Government policies and actions in Burundi in the area of rural development].

PubMed

Mworoha, E

1986-01-01

This article discusses policies and actions designed by the government of Burundi to assure food self-sufficiency and to improve living conditions in rural areas. Burundi has had a long history of food self-sufficiency due to good soils, adequate rainfall, and hard work by the rural population. In the past 3 decades, however, the food supply has been threatened by various factors including soil erosion and rapid population increase. The government has undertaken a reforestation program which covered 51,050 hectares in the past 7 years with plans to cover 20% of the national territory by the year 2000. Work has also been done to contain rivers within their courses and to popularize antierosion techniques such as terracing and proper use of pastures. Partly because the population is growing at a rate of 2.7% per year, the average plot available per household is estimated at only 1.3 hectare, rendering efforts to improve productivity imperative. The high cost of chemical fertilizers has forced reliance on compost, and some 6 million compost heaps are now in existence. Agropastoral integration projects are seeking to improve yields through better combinations of livestock and land use. Research to improve the seed supply has already resulted in improved strains of rice, maize, wheat, kidney beans, manioc, sweet potatoes, cotton, tea and coffee. Regional seed production centers are planned to facilitate distribution and adaptation of seeds to each ecological zone. Research is underway to identify appropriate new crops and to extend the ranges of existing crops. To encourage participation of the rural population in agricultural improvement efforts, the government is financing schools and institutions which will train local level agricultural promoters and extension agents. Local governments at all levels, regional development societies, cooperatives and other structures are also being organized to assist farmers. In order to restructure and modernize the rural environment, the government has invested heavily in agricultural development and the prices of agricultural products have been raised repeatedly since 1976. Improved road networks and other infrastructure, provision of credit for agricultural improvements, and provision of affordable building materials and housing credits are among related efforts. Health interventions such as an immunization program which has achieved 50% coverage through 17 medical centers have caused some decline in the infant mortality rate. By the year 2000 according to current plans there will be 300 health centers or 1/10,000 population, and 35 hospitals compared to the 29 currently operating. The number of physicians has increased from 111 in 1980 to 216 in 1984 following addition of a medical school to the University of Burundi. The number of medical technicians has increased from 450 to 555, of auxiliary nurses from 453 to 575, of sanitary technicians from 11 to 28. In pursuit of the government objective of basic education for all children by 1987, the number of students increased from 159,729 in 1979-80 to 296,672 in 1983-84. Practical work in agriculture, artisanry, and other areas is to be introduced, and classes will be conducted in local language rather than French. Centers for nonformal education are also being introduced. Attempts are being made to assure that rural development efforts are in harmony with the culture and social aspects of life in the countryside.

Turning the ECOWAS Standby Force in a More Proactive Force: An Analysis of Past Interventions to Assess Key Deployment Hindrances

DTIC Science & Technology

2015-06-12

collective security mechanisms, almost from nothing, in less than 20 years. Since 2003, the AU has deployed missions to Burundi (AMIB), Sudan/ Darfur (AMIS...deployment of AU missions in Somalia, Darfur and in the CAR. ECOWAS, despite the absence of a formalized MOU between its member states, is...proven somewhat effective in eastern Africa where the AU deployed a mission first in Darfur and then in Somalia, which the UN later undertook. However

The Separation of Southern Sudan: A Possible American Response

DTIC Science & Technology

2011-03-11

missions/unmis/facts.shtml. 40 48 Erin Weir and Vanessa Parra,_ "Sudan: UNMIS Must be More Proactive in Protecting Civilians," Refugees International...December 13,2010, http://uk.reuters.com/article/idUKTRE6BC4EE20101213 (accessed December 28, 2010). 52 J air van der Lijn, "To Paint the Nile Blue...has had to be replaced by the UN in two of its first three attempts. (Burundi and Sudan) Weir, Erin and Parra, Vanessa . "Sudan: Ul\\TMIS Must be

Mental health treatment outcome expectancies in Burundi.

PubMed

Irankunda, Pacifique; Heatherington, Laurie

2017-02-01

Best practices in global mental health stress the importance of understanding local values and beliefs. Research demonstrates that expectancies about the effectiveness of a given treatment significantly predicts outcome, beyond the treatment effect itself. To help inform the development of mental health interventions in Burundi, we studied expectancies about the effectiveness of four treatments: spiritual healing, traditional healing, medication, and selected evidence-based psychosocial treatments widely used in the US. Treatment expectancies were assessed for each of three key syndromes identified by previous research: akabonge (a set of depression-like symptoms), guhahamuka (a set of trauma-related symptoms), and ibisigo (a set of psychosis-like symptoms) . In individual interviews or written surveys in French or Kirundi with patients ( N = 198) awaiting treatment at the clinic, we described each disorder and the treatments in everyday language, asking standard efficacy expectations questions about each ("Would it work?" "Why or why not?"). Findings indicated uniformly high expectancies about the efficacy of spiritual treatment, relatively high expectancies for western evidence-based treatments (especially cognitive behavior therapy [CBT] for depression-like symptoms), lower expectancies for medicine, and especially low expectancies for traditional healing (except for traditional healing for psychosis-like symptoms). There were significant effects of gender but not of education level. Qualitative analyses of explanations provide insight into the basis of people's beliefs, their explanations about why a given treatment would or would not work varied by type of disorder, and reflected beliefs about underlying causes. Implications for program development and future research are discussed.

Fostering food security in areas of extreme poverty through Integrated Farm Management: the case of Burundi

NASA Astrophysics Data System (ADS)

Kessler, Aad; van Duivenbooden, Niek; van Beek, Christy

2014-05-01

Extreme poverty in Burundi's rural area and tensions between families with limited access to arable land hinder development towards a more stable and peaceful society. Due to these tensions and a rapid population growth, agricultural land is currently subject to increased degradation and low agricultural productivity. A whole range of other limiting factors contributes to this, such as: poor seed quality, poor nutrient management combined with low soil fertility, inadequate agronomic practices, pests and crop diseases, poorly developed supply chains, health problems, difficult access to credit, and insecurity. Solving one of these problems will not solve the chain that eventually leads to low food production; it will simply move the emphasis to the next constraining factor. An integrated rural development approach is therefore required to break this vicious circle. The project Fanning the Spark, a Public-Private-Partnership between Achmea Foundation, Alterra of Wageningen University and Research Centre, and HealthNet-TPO in Burundi started in September 2013 with an intervention in several rural villages in Gitega. The project's objective is to increase food production at village level, by means of investments in crop production, a family (income) insurance package that protects rural families against the financial consequences of catastrophic events (natural and health) and making micro-credits available. This will enhance farmers' workability and generate income from agricultural activities in order to break the poverty cycle and enhance food security. The insurance package comprises agricultural and health insurances, and will be jointly implemented with the sustainable agriculture component. The latter component focuses on Integrated Farm Management and the use of innovative soil management practices. Farmer-to-farmer training and scaling-up are crucial components, and in the first phase of the project "innovative farmer groups" have a central role in the project. Each innovative farmer formulates and implements an Integrated Farm Management plan. This is a tool for farmers to plan, reflect and learn about sustainable land management, and particularly about the integration of all farm activities and how these contribute together to enhanced food security. Activities considered in these Integrated Farm Management plans are related to agriculture, livestock, infrastructure, agroforestry, soil conservation and training. The first results of the acceptance and impact of the strategy are now available, and in the next phase all innovative farmers will implement their plans and train fellow farmers to start planning their own Integrated Farm Management.

Democratic Republic of Congo: Background and U.S. Policy

DTIC Science & Technology

2014-02-24

U.S. Policy” below). See also reports by the U.N. Group of Experts, e.g., U.N. doc. S /2012/348/Add.1, June 27, 2012; U.N. doc. S /2012/843, November...15, 2012; and U.N. doc. S /AC.43/2012/NOTE.26, November 26, 2012. 30 The original signatories to the Framework Agreement are Angola, Burundi, Central...in the FARDC’s command structure following the M23’ s seizure of Goma; support provided to the FARDC by the Intervention Brigade; and an apparent

Toward policies for climate change mitigation: "Barriers for family-sized biogas in the District of Gihanga, Burundi"

NASA Astrophysics Data System (ADS)

Nkunzimana, Leonard; Huart, Michel; Zaccai, Edwin

2014-05-01

In the context of climate change mitigation and poverty reduction, it has been argued that biogas energy is relevant, as it is economically and ecologically useful. In the 1980s, biogas use played an important role in the development of Burundi. Many schools and public institutions had implemented such installations. Unfortunately, many biogas infrastructures were destroyed in the civil war of the 1990s. This study analyzes what could be done, after a decade of crisis, to develop that sector. It aims to assess how and to what extent the inhabitants of villages are willing to contribute to the development of biogas technologies. We interviewed 150 farmers in order to assess their perception on the ecologic and economic features of biogas plants if implemented in their villages. The influence of socioeconomic, cultural, and demographic factors of households was assessed in this study. Results suggest that the maximum amount that a household is willing to pay each month for biogas use at a family level is positive for large-size households, households that are aware of climate change, consumers of candles, households with high income, households with an educated head, women, and breeders. However, the willingness decreases for households with older head of families. The study concludes that awareness campaigns on biogas benefits and financial and nonfinancial incentives are necessary. This policy should probably and primarily be oriented toward some more receptive categories of the population. Women should be fully involved, considering their positive motivation toward sustaining this sector.

Tuberculose chez le personnel de santé du secteur public au Burundi: fréquence et facteurs de risque

PubMed Central

Mukuku, Olivier; Ruhindiza, Bienvenu Mukuku; Mupepe, Alexis Kumba; Sawadogo, Michel

2013-01-01

Introduction Le but de cette étude était de déterminer la fréquence de la tuberculose (TB) chez le personnel de santé du secteur public en charge des patients tuberculeux et d’évaluer les facteurs de risque de contracter la tuberculose chez ce personnel au Burundi. Méthodes Il s’agit d’une étude transversale à visée analytique réalisée auprès de 300 travailleurs prestant dans 30 centres de dépistage et de traitement de la TB (CDT) au Burundi du 16 octobre au 15 novembre 2012. Les paramètres sociodémographiques et professionnels ainsi que l’antécédent de vaccination BCG de travailleurs ayant été touché par la TB ont été analysé et comparé à ceux de travailleurs qui ne l’ont pas été. Le seuil de signification a été fixé à p < 0,05. Résultats La fréquence de la TB chez le personnel de santé est de 15%. Le risque de souffrir de la TB est de près de 4 fois chez les travailleurs âgés d’au moins 50 ans (OR=3,73; 1,53-9,08), chez ceux qui n’ont jamais reçu de vaccin de BCG (OR=3,73; 1,24-11,03), chez ceux qui n’ont pas de cicatrice vaccinale de BCG (OR=3,80; 1,67-8,62) et chez ceux qui travaillent depuis au moins 6 ans dans un CDT (OR=3,79; 1,44-9,96); ce risque est de 9 fois chez ceux qui sont mariés (OR=9,42; 1,26-70,23), de 8 fois chez ceux qui n’aèrent pas leurs salles de travail (OR=8,20; 1,48-48,23) et de 6 fois chez ceux qui ont comme profession nettoyeur ou aide-soignant (OR=6,12; 2,92-12,82). Par contre, aucune corrélation statistiquement significative n’a été observée entre le fait de souffrir de la TB et le sexe mais aussi le nombre d’heures de contact d’un travailleur avec un patient tuberculeux (p>0,05). Conclusion L’âge, l’antécédent de vaccination de BCG ainsi que la majorité de paramètres professionnels sont en association avec la maladie TB des travailleurs de CDT. D’où, la maîtrise de certains facteurs de risque s’avère important pour faire face au fardeau de la TB parmi le personnel hospitalier. PMID:24847402

How do low-birthweight neonates fare 2 years after discharge from a low-technology neonatal care unit in a rural district hospital in Burundi?

PubMed

van den Boogaard, W; Zuniga, I; Manzi, M; Van den Bergh, R; Lefevre, A; Nanan-N'zeth, K; Duchenne, B; Etienne, W; Juma, N; Ndelema, B; Zachariah, R; Reid, A

2017-04-01

As neonatal care is being scaled up in economically poor settings, there is a need to know more on post-hospital discharge and longer-term outcomes. Of particular interest are mortality, prevalence of developmental impairments and malnutrition, all known to be worse in low-birthweight neonates (LBW, <2500 g). Getting a better handle on these parameters might justify and guide support interventions. Two years after hospital discharge, we thus assessed: mortality, developmental impairments and nutritional status of LBW children. Household survey of LBW neonates discharged from a neonatal special care unit in Rural Burundi between January and December 2012. Of 146 LBW neonates, 23% could not be traced and 4% had died. Of the remaining 107 children (median age = 27 months), at least one developmental impairment was found in 27%, with 8% having at least five impairments. Main impairments included delays in motor development (17%) and in learning and speech (12%). Compared to LBW children (n = 100), very-low-birthweight (VLBW, <1500 g, n = 7) children had a significantly higher risk of impairments (intellectual - P = 0.001), needing constant supervision and creating a household burden (P = 0.009). Of all children (n-107), 18% were acutely malnourished, with a 3½ times higher risk in VLBWs (P = 0.02). Reassuringly, most children were thriving 2 years after discharge. However, malnutrition was prevalent and one in three manifested developmental impairments (particularly VLBWs) echoing the need for support programmes. A considerable proportion of children could not be traced, and this emphasises the need for follow-up systems post-discharge. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Weathering and evaporation controls on dissolved uranium concentrations in groundwater - A case study from northern Burundi.

PubMed

Post, V E A; Vassolo, S I; Tiberghien, C; Baranyikwa, D; Miburo, D

2017-12-31

The potential use of groundwater for potable water supply can be severely compromised by natural contaminants such as uranium. The environmental mobility of uranium depends on a suite of factors including aquifer lithology, redox conditions, complexing agents, and hydrological processes. Uranium concentrations of up to 734μg/L are found in groundwater in northern Burundi, and the objective of the present study was to identify the causes for these elevated concentrations. Based on a comprehensive data set of groundwater chemistry, geology, and hydrological measurements, it was found that the highest dissolved uranium concentrations in groundwater occur near the shores of Lake Tshohoha South and other smaller lakes nearby. A model is proposed in which weathering and evapotranspiration during groundwater recharge, flow and discharge exert the dominant controls on the groundwater chemical composition. Results of PHREEQC simulations quantitatively confirm this conceptual model and show that uranium mobilization followed by evapo-concentration is the most likely explanation for the high dissolved uranium concentrations observed. The uranium source is the granitic sand, which was found to have a mean elemental uranium content of 14ppm, but the exact mobilization process could not be established. Uranium concentrations may further be controlled by adsorption, especially where calcium-uranyl‑carbonate complexes are present. Water and uranium mass balance calculations for Lake Tshohoha South are consistent with the inferred fluxes and show that high‑uranium groundwater represents only a minor fraction of the overall water input to the lake. These findings highlight that the evaporation effects that cause radionuclide concentrations to rise to harmful levels in groundwater discharge areas are not only confined to arid regions, and that this should be considered when selecting suitable locations for water supply wells. Copyright © 2017 Elsevier B.V. All rights reserved.

The Effect of Performance-Based Financial Incentives on Improving Health Care Provision in Burundi: A Controlled Cohort Study

PubMed Central

Rudasingwa, Martin; Soeters, Robert; Bossuyt, Michel

2015-01-01

To strengthen the health care delivery, the Burundian Government in collaboration with international NGOs piloted performance-based financing (PBF) in 2006. The health facilities were assigned - by using a simple matching method - to begin PBF scheme or to continue with the traditional input-based funding. Our objective was to analyse the effect of that PBF scheme on the quality of health services between 2006 and 2008. We conducted the analysis in 16 health facilities with PBF scheme and 13 health facilities without PBF scheme. We analysed the PBF effect by using 58 composite quality indicators of eight health services: Care management, outpatient care, maternity care, prenatal care, family planning, laboratory services, medicines management and materials management. The differences in quality improvement in the two groups of health facilities were performed applying descriptive statistics, a paired non-parametric Wilcoxon Signed Ranks test and a simple difference-in-difference approach at a significance level of 5%. We found an improvement of the quality of care in the PBF group and a significant deterioration in the non-PBF group in the same four health services: care management, outpatient care, maternity care, and prenatal care. The findings suggest a PBF effect of between 38 and 66 percentage points (p<0.001) in the quality scores of care management, outpatient care, prenatal care, and maternal care. We found no PBF effect on clinical support services: laboratory services, medicines management, and material management. The PBF scheme in Burundi contributed to the improvement of the health services that were strongly under the control of medical personnel (physicians and nurses) in a short time of two years. The clinical support services that did not significantly improved were strongly under the control of laboratory technicians, pharmacists and non-medical personnel. PMID:25948432

Physicians' and nurses' attitudes towards performance-based financial incentives in Burundi: a qualitative study in the province of Gitega.

PubMed

Rudasingwa, Martin; Uwizeye, Marie Rose

2017-01-01

Performance-based financing (PBF) was first implemented in Burundi in 2006 as a pilot programme in three provinces and was rolled out nationwide in 2010. PBF is a reform approach to improve the quality, quantity, and equity of health services and aims at achieving universal health coverage. It focuses on how to best motivate health practitioners. To elicit physicians' and nurses' experiences and views on how PBF influenced and helped them in healthcare delivery. A qualitative cross-sectional study was carried out among frontline health workers such as physicians and nurses. The data was gathered through individual face-to-face, in-depth, semi-structured interviews with 6 physicians and 30 nurses from February to March 2011 in three hospitals in Gitega Province. A simple framework approach and thematic analysis using a combination of manual technique and MAXQDA software guided the analysis of the interview data. Overall, the interviewees felt that the PBF scheme had provided positive motivation to improve the quality of care, mainly in the structures and process of care. The utilization of health services and the relationship between health practitioners and patients also improved. The salary top-ups were recognized as the most significant impetus to increase effort in improving the quality of care. The small and sometimes delayed financial incentives paid to physicians and nurses were criticized. The findings of this study also indicate that the positive interaction between performance-based incentive schemes and other health policies is crucial in achieving comprehensive improvement in healthcare delivery. PBF has the potential to motivate medical staff to improve healthcare provision. The views of medical staff and the context of the area of implementation have to be taken into consideration when designing and implementing PBF schemes.

[Osteogenesis imperfecta in monozygotic twins in Burundi].

PubMed

Armstrong, O; Karayuba, R; Ngendahayo, L; Habonimana, E

1994-01-01

Little data is available about osteogenesis imperfecta in Black African children. This defect was diagnosed in monozygotic twins from Rwanda who presented multiple fractures, in particular of the femur, when they began to walk. Osteogenesis imperfecta was confirmed by lower limb deformity, presence of wormian bones in the skull, blue sclera, and tooth defects. In addition to the fact that it is uncommon to encounter this condition in monozygotic twins, this case is interesting for several reasons. Was osteogenesis imperfecta in these patients type I, frequent, or type III, exceptional? More importantly, this case stresses the high prevalence of type III in Black Africa which could constitute a hot-bed in the world.

Exploring the potential offered by legacy soil databases for ecosystem services mapping of Central African soils

NASA Astrophysics Data System (ADS)

Verdoodt, Ann; Baert, Geert; Van Ranst, Eric

2014-05-01

Central African soil resources are characterised by a large variability, ranging from stony, shallow or sandy soils with poor life-sustaining capabilities to highly weathered soils that recycle and support large amounts of biomass. Socio-economic drivers within this largely rural region foster inappropriate land use and management, threaten soil quality and finally culminate into a declining soil productivity and increasing food insecurity. For the development of sustainable land use strategies targeting development planning and natural hazard mitigation, decision makers often rely on legacy soil maps and soil profile databases. Recent development cooperation financed projects led to the design of soil information systems for Rwanda, D.R. Congo, and (ongoing) Burundi. A major challenge is to exploit these existing soil databases and convert them into soil inference systems through an optimal combination of digital soil mapping techniques, land evaluation tools, and biogeochemical models. This presentation aims at (1) highlighting some key characteristics of typical Central African soils, (2) assessing the positional, geographic and semantic quality of the soil information systems, and (3) revealing its potential impacts on the use of these datasets for thematic mapping of soil ecosystem services (e.g. organic carbon storage, pH buffering capacity). Soil map quality is assessed considering positional and semantic quality, as well as geographic completeness. Descriptive statistics, decision tree classification and linear regression techniques are used to mine the soil profile databases. Geo-matching as well as class-matching approaches are considered when developing thematic maps. Variability in inherent as well as dynamic soil properties within the soil taxonomic units is highlighted. It is hypothesized that within-unit variation in soil properties highly affects the use and interpretation of thematic maps for ecosystem services mapping. Results will mainly be based on analyses done in Rwanda, but can be complemented with ongoing research results or prospects for Burundi.

Shifting management of a community volunteer system for improved child health outcomes: results from an operations research study in Burundi.

PubMed

Weiss, Jennifer; Makonnen, Raphael; Sula, Delphin

2015-01-01

Community-based strategies that foster frequent contact between caregivers of children under five and provide credible sources of health information are essential to improve child survival. Care Groups are a community-based implementation strategy for the delivery of social and behavior change interventions. This study assessed if supervision of Care Group activities by Ministry of Health (MOH) personnel could achieve the same child health outcomes as supervision provided by specialized non-governmental organization (NGO) staff. The study was a pretest-posttest quasi-experimental design implemented in Burundi. A total of 45 MOH-led Care Groups with 478 Care Group Volunteers (CGVs) were established in the intervention area; and 50 NGO-led Care Groups with 509 CGVs were formed in the comparison area. Data were collected from 593 and 700 mothers of children 0-23 months at baseline and endline, respectively. Pearson's chi-squared test and difference-in-difference analysis assessed changes in 40 child health and nutrition outcomes. A qualitative process evaluation was also conducted midway through the study. The MOH-led Care Group model performed at least as well as the NGO-led model in achieving specific child health and nutrition outcomes. Mothers of children 0-23 months in the intervention and comparison sites reported similar levels of knowledge and practices for 38 of 40 dependent variables measured in the study, and these results remained unchanged after accounting for differences in the indicator values at baseline. Process monitoring data confirmed that the MOH-led Care Group model and the NGO-led Care Group model were implemented with similar intervention strength. The study demonstrated that behavior change interventions traditionally led by NGOs can be implemented through the existing MOH systems and achieve similar results, thereby increasing the potential for sustainable child health outcomes. Future research on the MOH-led Care Group model is required to systematically document all inputs and monetary costs borne by the MOH to implement the model.

School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial.

PubMed

Tol, Wietse A; Komproe, Ivan H; Jordans, Mark J D; Ndayisaba, Aline; Ntamutumba, Prudence; Sipsma, Heather; Smallegange, Eva S; Macy, Robert D; de Jong, Joop T V M

2014-04-01

Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim). We conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention. No main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes. Given inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are contingent upon individual (for example, age, gender) and contextual (for example, family functioning, state of conflict, displacement) variables. Results suggest the potential benefit of school-based preventive interventions particularly in post-conflict settings. The study was registered as ISRCTN42284825.

Knowledge and practices of general practitioners at district hospitals towards cervical cancer prevention in Burundi, 2015: a cross-sectional study.

PubMed

Ndizeye, Zacharie; Vanden Broeck, Davy; Vermandere, Heleen; Bogers, John Paul; Van Geertruyden, Jean-Pierre

2018-01-16

Well-organized screening and treatment programmes are effective to prevent Invasive Cervical Cancer (ICC) in LMICs. To achieve this, the World Health Organization (WHO) recommends the involvement of existing health personnel in casu doctors, nurses, midwives in ICC prevention. A necessary precondition is that health personnel have appropriate knowledge about ICC. Therefore, to inform policy makers and training institutions in Burundi, we documented the knowledge and practices of general practitioners (GPs) at district hospital level towards ICC control. A descriptive cross-sectional survey was conducted from February to April, 2015 among all GPs working in government district hospitals. A structured questionnaire and a scoring system were used to assess knowledge and practices of GPs. The participation rate was 58.2%. Majority of GPs (76.3%) had appropriate knowledge (score > 70%) on cervical cancer disease; but some risk factors were less well known as smoking and the 2 most important oncogenic HPV. Only 8.4% of the participants had appropriate knowledge on ICC prevention: 55% of the participants were aware that HPV vaccination exists and 48.1% knew cryotherapy as a treatment method for CIN. Further, 15.3% was aware of VIA as a screening method. The majority of the participants (87%) never or rarely propose screening tests to their clients. Only 2 participants (1.5%) have already performed VIA/VILI. Wrong thoughts were also reported: 39.7% thought that CIN could be treated with radiotherapy; 3.1% thought that X-ray is a screening method. In this comprehensive assessment, we observed that Burundian GPs have a very low knowledge level about ICC prevention, screening and treatment. Suboptimal practices and wrong thoughts related to ICC screening and treatments have also been documented. We therefore recommend an adequate pre- and in-service training of GPs and most probably nurses on ICC control before setting up any public health intervention on ICC control.

Physicians’ and nurses’ attitudes towards performance-based financial incentives in Burundi: a qualitative study in the province of Gitega

PubMed Central

Rudasingwa, Martin; Uwizeye, Marie Rose

2017-01-01

ABSTRACT Background: Performance-based financing (PBF) was first implemented in Burundi in 2006 as a pilot programme in three provinces and was rolled out nationwide in 2010. PBF is a reform approach to improve the quality, quantity, and equity of health services and aims at achieving universal health coverage. It focuses on how to best motivate health practitioners. Objective: To elicit physicians’ and nurses’ experiences and views on how PBF influenced and helped them in healthcare delivery. Methods: A qualitative cross-sectional study was carried out among frontline health workers such as physicians and nurses. The data was gathered through individual face-to-face, in-depth, semi-structured interviews with 6 physicians and 30 nurses from February to March 2011 in three hospitals in Gitega Province. A simple framework approach and thematic analysis using a combination of manual technique and MAXQDA software guided the analysis of the interview data. Results: Overall, the interviewees felt that the PBF scheme had provided positive motivation to improve the quality of care, mainly in the structures and process of care. The utilization of health services and the relationship between health practitioners and patients also improved. The salary top-ups were recognized as the most significant impetus to increase effort in improving the quality of care. The small and sometimes delayed financial incentives paid to physicians and nurses were criticized. The findings of this study also indicate that the positive interaction between performance-based incentive schemes and other health policies is crucial in achieving comprehensive improvement in healthcare delivery. Conclusions: PBF has the potential to motivate medical staff to improve healthcare provision. The views of medical staff and the context of the area of implementation have to be taken into consideration when designing and implementing PBF schemes. PMID:28452651

Mobile technologies for disease surveillance in humans and animals.

PubMed

Mwabukusi, Mpoki; Karimuribo, Esron D; Rweyemamu, Mark M; Beda, Eric

2014-04-23

A paper-based disease reporting system has been associated with a number of challenges. These include difficulties to submit hard copies of the disease surveillance forms because of poor road infrastructure, weather conditions or challenging terrain, particularly in the developing countries. The system demands re-entry of the data at data processing and analysis points, thus making it prone to introduction of errors during this process. All these challenges contribute to delayed acquisition, processing and response to disease events occurring in remote hard to reach areas. Our study piloted the use of mobile phones in order to transmit near to real-time data from remote districts in Tanzania (Ngorongoro and Ngara), Burundi (Muyinga) and Zambia (Kazungula and Sesheke). Two technologies namely, digital and short messaging services were used to capture and transmit disease event data in the animal and human health sectors in the study areas based on a server-client model. Smart phones running the Android operating system (minimum required version: Android 1.6), and which supported open source application, Epicollect, as well as the Open Data Kit application, were used in the study. These phones allowed collection of geo-tagged data, with the opportunity of including static and moving images related to disease events. The project supported routine disease surveillance systems in the ministries responsible for animal and human health in Burundi, Tanzania and Zambia, as well as data collection for researchers at the Sokoine University of Agriculture, Tanzania. During the project implementation period between 2011 and 2013, a total number of 1651 diseases event-related forms were submitted, which allowed reporters to include GPS coordinates and photographs related to the events captured. It was concluded that the new technology-based surveillance system is useful in providing near to real-time data, with potential for enhancing timely response in rural remote areas of Africa. We recommended adoption of the proven technologies to improve disease surveillance, particularly in the developing countries.

Tectonic significance of Kibaran structures in Central and Eastern Africa

NASA Astrophysics Data System (ADS)

Rumvegeri, B. T.

Tectonical movements of the Kibaran belt (1400-950 Ma) can be subdivided into two major deformation events, corresponding to tight, upright or recumbent folds, thrust faults, nappes and stretching lineation with a general plunging southwards. At the regional scale, the stretching lineation, associated with thrust faults and nappes is interpreted as an indication of a northwards moving direction. The shear zone with mafic-ultramafic rocks across Burundi, MW-Tanzania, SW-Uganda and NE-Zaïre is the suture zone of the Kibaran belt. Kibaran metamorphism is plurifacial and has four epizodes. The second, syn-D2, is the most important and constitutes the climax; it reached the granulite facies. The succession of tectonic, metamorphic and magmatic features suggests geotectonic evolution by subduction-collision.

[Burundi, a new beginning? The burden of the past].

PubMed

Kaidi, H

1988-03-09

Burundi, unlike most Central African nations, had a relatively rich precolonial history. A well-structured monarchy reigned from the beginning of the 16th century, according to some historians. A strong monarch of the early 19th century extended the borders of the country to approximately their current limits. In 1903, the country was conquered by the Germans, to be ceded to Belgium after Germany's defeat in World War I. After World War II, political parties seeking independence began to form. The UPRONA (Union for National Progress) party was founded by Prince Louis Rwagasore, and became the most active and best organized, attracting mass support. The party was banned by the colonial authorities on the grounds that the family of the king could not participate in elections or political activities. Nevertheless, the party triumphed in legislative elections in September 1961. Rwagasore was assassinated in October 1961. Independence was declared in July 1962. Successional struggles and tribal rivalries blocked efforts at reform of the government and economy. Civil war in 1972 saw the slaughter of between 100,000 and 300,000 citizens before order was restored with the aid of the Zairean army. The Second Republic was declared in a bloodless coup in 1976 by Colonel Bagaza. In the 1st years of his rule production increased, tentative efforts at industrialization were made, and schools and roads were constructed. Toward the end of his reign, however, he became increasingly jealous of his prerogatives and expelled, fired, or imprisoned members of government and high functionaries, and curbed the activities of the Catholic Church to which 65% of the population belonged. Relations with neighboring countries deteriorated while the nation's economic situation worsened. A coup in 1987 led by Major Buyoya was rapidly followed by release of political prisoners and improved relations with the Church and neighboring countries. Nevertheless, the country had a huge debt, prices for its principal export, coffee, were declining, and international assistance was slow to reappear. The new government made respect for human rights one of its principal tenets.

School-based mental health intervention for children in war-affected Burundi: a cluster randomized trial

PubMed Central

2014-01-01

Background Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim). Methods We conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention. Results No main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes. Conclusions Given inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are contingent upon individual (for example, age, gender) and contextual (for example, family functioning, state of conflict, displacement) variables. Results suggest the potential benefit of school-based preventive interventions particularly in post-conflict settings. Trial registration The study was registered as ISRCTN42284825 PMID:24690470

Extent and drainage status of organic soils in the Lake Victoria catchment

NASA Astrophysics Data System (ADS)

Barthelmes, Reni; Barthelmes, Alexandra; Joosten, Hans

2016-04-01

When considering peatlands and organic soils in the tropics, the huge areas in SE Asia prevail in public and scientific perception, whereas Africa has largely been out of focus. However, East Africa contains large areas of organic soils as well. They basically occur in the high altitudes of the uplifted flanks of the East African Rift System, isolated volcanoes and the Ethiopian highlands, in the Zambezian floodplains (e.g. Zambia), and in coastal environments (e.g. Mozambique and Madagascar). We used a mapping approach that integrates old field data and maps, specialized landscape and peatland-related knowledge, and modern RS and GIS techniques to elaborate a comprehensive and rather reliable overview of organic soils (incl. peatlands) in the Lake Victoria catchment. Maps at a scale of 1:25,000 have been prepared for Burundi, Kenya, Rwanda, Tanzania and Uganda. The land use intensity has been estimated for all organic soil areas based on satellite and aerial imagery. Feeding the Nile River, sustaining a fast growing and widely poor population and already facing climatic changes, organic soils of the Lake Victoria neighbouring countries are partially under heavy threat. We mapped 10,645 km2 of organic soils for the entire area of which 8,860 km2 (83.2%) seem to be in near natural condition. We assume slightly drainage and low degradation for 564 km2 (5.3%) and intensive drainage and heavy degradation for 1,222 km2 (11.5%). Degradation hotspot is Burundi with 522 km2 (79.5%) of heavily drained and degrading organic soils. This area assessment has been quite conservative to not overestimate the extent of organic soils. A reserve of 5-7,000 km2 of wetlands in the Lake Victoria catchment may include peatlands too, which needs to be confirmed in field surveys. Considering the key role of peatlands and organic soils for water provision and regulation and their rapid degradation due to drainage and inappropriate use, this inventory might be a step towards organic soil protection, and the development (or rediscovery) of sustainable land use options for undrained or future rewetted areas.

Tubaramure, a Food-Assisted Integrated Health and Nutrition Program in Burundi, Increases Maternal and Child Hemoglobin Concentrations and Reduces Anemia: A Theory-Based Cluster-Randomized Controlled Intervention Trial.

PubMed

Leroy, Jef L; Olney, Deanna; Ruel, Marie

2016-08-01

Despite their popularity, food-assisted maternal and child health and nutrition (MCHN) programs have not been evaluated rigorously, and evidence of their impacts on maternal and child outcomes is scant. This study estimated the impact of Tubaramure, a food-assisted MCHN program implemented by Catholic Relief Services and partners in eastern Burundi, on hemoglobin and anemia (primary outcome) in children aged 0-23.9 mo and their mothers and explored the impact pathways. The program targeted women and their children during their first 1000 d of life and included 1) food rations, 2) strengthening and promotion of the use of health services, and 3) behavior change communication. This was a cluster-randomized controlled study to assess program impact by using cluster fixed-effects double-difference models with repeated cross-sectional data (baseline and follow-up 2 y later). We explored impact pathways by estimating impact on intermediary factors addressed by Tubaramure that are known determinants of hemoglobin and anemia and by regressing hemoglobin and anemia on each determinant to assess the plausibility that the effect operated through each determinant. Hemoglobin decreased and anemia increased markedly from baseline to follow-up, but Tubaramure had a significant (P < 0.05) beneficial effect on both children [6.1 percentage points (pps)] and mothers who had given birth in the previous 3 mo (34.9 pps). The program also had significant (P < 0.05) impacts on factors along the hypothesized impact pathways: dietary diversity, consumption of iron-rich foods, morbidity, and fever for child hemoglobin and dietary diversity, consumption of iron-rich foods, and current bed-net use for maternal anemia. We showed, for the first time to our knowledge, that a food-assisted MCHN program had a positive impact on anemia and hemoglobin in both mothers and children. The plausible pathways identified highlight the importance of addressing multiple determinants of anemia. This trial was registered at clinicaltrials.gov as NCT01072279. © 2016 American Society for Nutrition.

Understanding resilience in armed conflict: Social resources and mental health of children in Burundi

PubMed Central

Hall, Brian J.; Tol, Wietse A.; Jordans, Mark J.D.; Bass, Judith; de Jong, Joop T.V.M.

2014-01-01

Little is known about the role of cognitive social capital among war-affected youth in low- and middle-income countries. We examined the longitudinal association between cognitive social capital and mental health (depression and posttraumatic stress disorder (PTSD) symptoms), functioning, and received social support of children in Burundi. Data were obtained from face-to-face interviews with 176 children over three measurement occasions over the span of 4-months. Cognitive social capital measured the degree to which children believed their community was trustworthy and cohesive. Mental health measures included the Depression Self-Rating Scale (DSRS) (Birleson, 1981), the Child Posttraumatic Symptom Scale (Foa, Johnson, & Feeny, 2001), and a locally constructed scale of functional impairment. Children reported received social support by listing whether they received different types of social support from self-selected key individuals. Cross-lagged path analytic modeling evaluated relationships between cognitive social capital, symptoms and received support separately over baseline (T1), 6-week follow-up (T2), and 4-month follow-up (T3). Each concept was treated and analyzed as a continuous score using manifest indicators. Significant associations between study variables were unidirectional. Cognitive social capital was associated with decreased depression between T1 and T2 (B=−0.22, p<.001) and T2 and T3 (β=−0.25, p<.001), and with functional impairment between T1 and T2 (β=−0.15, p=.005) and T2 and T3 (β=−0.14, p=.005); no association was found for PTSD symptoms at either time point. Cognitive social capital was associated with increased social support between T1 and T2 (β=0.16, p=.002) and T2 and T3 (β=0.16, p=.002). In this longitudinal study, cognitive social capital was related to a declining trajectory of children’s mental health problems and increases in social support. Interventions that improve community relations in war-affected communities may alter the trajectories of resource loss and gain with conflict-affected children. PMID:24922609

Women's empowerment and male involvement in antenatal care: analyses of Demographic and Health Surveys (DHS) in selected African countries.

PubMed

Jennings, Larissa; Na, Muzi; Cherewick, Megan; Hindin, Michelle; Mullany, Britta; Ahmed, Saifuddin

2014-08-30

Increasing women's status and male involvement are important strategies in reducing preventable maternal morbidity and mortality. While efforts to both empower women and engage men in maternal health care-seeking can work synergistically, in practice they may result in opposing processes and outcomes. This study examines whether a woman's empowerment status, in sum and across economic, socio-familial, and legal dimensions, is associated with male partner accompaniment to antenatal care (ANC). Women's empowerment was measured based on the sum of nine empowerment items in the 2010-2011 Demographic and Health Surveys in eight sub-Saharan African countries: Burkina Faso (n = 2,490), Burundi (n = 1,042), Malawi (n = 1,353), Mozambique (n = 414), Rwanda (n = 1,211), Senegal (n = 505), Uganda (n = 428) and Zimbabwe (n = 459). In cross-sectional analyses, bivariate and multivariable logistic regressions models were used to examine the odds of male partner accompaniment to ANC between women with above-average versus below-average composite and dimensional empowerment scores. In the majority of countries, male accompaniment to ANC was not uncommon. However, findings were mixed. Positive associations in women's composite empowerment and male involvement were observed in Burkina Faso (OR = 1.27, 95% CI: 1.08, 1.50) and Uganda (OR = 1.53, 95% CI: 1.00-2.35), and in the economic empowerment dimension in Burkina Faso (OR = 1.24, 95% CI: 1.05-1.47). In Malawi, significant negative associations were observed in the odds of male accompaniment to ANC and women's composite (OR = 0.77, 95% CI: 0.62-0.97) and economic empowerment scores (OR = 0.75, 95% CI: 0.59-0.94). No significant differences were observed in Burundi, Mozambique, Rwanda, Senegal, or Zimbabwe. Women's empowerment can be positively or negatively associated with male antenatal accompaniment. Male involvement efforts may benefit from empowerment initiatives that promote women's participation in social and economic spheres, provided that antenatal participation does not undermine women's preferences or autonomy. The observation of mixed and null findings suggests that additional qualitative and longitudinal research may enhance understanding of women's empowerment in sub-Saharan African settings.

Cost of epilepsy: a systematic review.

PubMed

Strzelczyk, Adam; Reese, Jens Peter; Dodel, Richard; Hamer, Hajo M

2008-01-01

The objective of this review was to overview published cost-of-illness (COI) studies of epilepsy and their methodological approaches. Epilepsy imposes a substantial burden on individuals and society as a whole. The mean prevalence of epilepsy is estimated at 0.52% in Europe, 0.68% in the US, and peaks up to 1.5% in developing countries. Estimation of the economic burden of epilepsy is of pivotal relevance to enable a rational distribution of healthcare resources. This is especially so with the introduction of the newer antiepileptic drugs (AEDs), the marketing of vagal-nerve stimulators and the resurgence of new surgical treatment options, which have the potential to considerably increase the costs of treating epilepsy.A systematic literature review was performed to identify studies that evaluated direct and indirect costs of epilepsy. Using a standardized assessment form, information on the study design, methodological framework and data sources were extracted from each publication and systematically reported. We identified 22 studies worldwide on costs of epilepsy. The majority of the studies reflected the costs of epilepsy in Europe (three studies each for the UK and Italy, one study each for Germany, the Netherlands, Switzerland, France and the EU) and the US (four studies), but studies were also available from India (two), Hong Kong, Oman, Burundi, Chile and Mexico. The studies utilized different frameworks to evaluate costs. All used a bottom-up approach; however, only 12 studies (55%) evaluated direct as well as indirect costs. The range for the mean annual direct costs lay between 40 International Dollar purchasing power parities (PPP-$) in rural Burundi and PPP-$4748 (adjusted to 2006 values) in a German epilepsy centre. Recent studies suggest AEDs are becoming the main contributor to direct costs. The mean indirect costs ranged between 12% and 85% of the total annual costs. Epilepsy is a cost-intensive disorder. A reliable comparison of the different COI studies in epilepsy is not easily feasible, as the evaluated studies show substantial methodological differences with respect to their patient selection criteria, diagnostic stratifications and evaluated costs. Therefore, there is an urgent need for studies that evaluate direct and indirect costs in a standardized fashion.

Dynamics of Cholera Outbreaks in Great Lakes Region of Africa, 1978–2008

PubMed Central

Nkoko, Didier Bompangue; Giraudoux, Patrick; Plisnier, Pierre-Denis; Tinda, Annie Mutombo; Piarroux, Martine; Sudre, Bertrand; Horion, Stephanie; Tamfum, Jean-Jacques Muyembe; Ilunga, Benoît Kebela

2011-01-01

Cholera outbreaks have occurred in Burundi, Rwanda, Democratic Republic of Congo, Tanzania, Uganda, and Kenya almost every year since 1977–1978, when the disease emerged in these countries. We used a multiscale, geographic information system–based approach to assess the link between cholera outbreaks, climate, and environmental variables. We performed time-series analyses and field investigations in the main affected areas. Results showed that cholera greatly increased during El Niño warm events (abnormally warm El Niños) but decreased or remained stable between these events. Most epidemics occurred in a few hotspots in lakeside areas, where the weekly incidence of cholera varied by season, rainfall, fluctuations of plankton, and fishing activities. During lull periods, persistence of cholera was explained by outbreak dynamics, which suggested a metapopulation pattern, and by endemic foci around the lakes. These links between cholera outbreaks, climate, and lake environments need additional, multidisciplinary study. PMID:22099090

A survey of the praying mantises of Rwanda, including new records (Insecta, Mantodea).

PubMed

Tedrow, Riley; Nathan, Kabanguka; Richard, Nasasira; Svenson, Gavin J

2015-10-01

We report the results of two surveys targeting praying mantises in four localities in Rwanda, specifically Akagera National Park, Nyungwe National Park, Volcanoes National Park, and the Arboretum de Ruhande at the National University of Rwanda. Using an assortment of collecting techniques, including metal halide light traps, sweep netting vegetation and general searching, we obtained 387 adult and 352 juvenile specimens, representing 41 species. A total of 28 novel species records for Rwanda are added to the 18 previously recorded species for the country, in addition to 20 novel species records for the broader region, including neighbouring Uganda and Burundi. This study provides high resolution images of the dorsal habitus of both sexes of representative species, both pinned and living. Species distribution records are presented and discussed. With a 155% increase in species recorded from Rwanda, this survey illustrates the need for further taxonomic work in the region.

The body louse as a vector of reemerging human diseases.

PubMed

Raoult, D; Roux, V

1999-10-01

The body louse, Pediculus humanus humanus, is a strict human parasite, living and multiplying in clothing. Louse infestation is associated with cold weather and a lack of hygiene. Three pathogenic bacteria are transmitted by the body louse. Borrelia recurrentis is a spirochete, the agent of relapsing fever, recently cultured on axenic medium. Historically, massive outbreaks have occurred in Eurasia and Africa, but currently the disease is found only in Ethiopia and neighboring countries. Bartonella quintana is now recognized as an agent of bacillary angiomatosis bacteremia, trench fever, endocarditis, and chronic lymphadenopathy among the homeless. Rickettsia prowazekii is the agent of epidemic typhus. The most recent outbreak (and the largest since World War II) was observed in Burundi. A small outbreak was also reported in Russia in 1997. Louse infestation appears to become more prevalent worldwide, associated with a decline in social and hygienic conditions provoked by civil unrest and economic instability.

[Lice and lice-borne diseases in humans].

PubMed

Houhamdi, L; Parola, P; Raoult, D

2005-01-01

Among the three lice which parasite the human being, the human body louse, Pediculus humanus humanus, is a vector of infectious diseases. It lives and multiplies in clothes and human infestation is associated with cold weather and a lack of hygiene. Three pathogenic bacteria are transmitted by the body louse: 1) Rickettsia prowazekii, the agent of epidemic typhus of which the most recent outbreak (and the largest since World War II) was observed during the civil war in Burundi; 2) Borrelia recurrentis, the agent of relapsing fever, historically responsible of massive outbreaks in Eurasia and Africa, which prevails currently in Ethiopia and neighboring countries; 3) Bartonella quintana, the agent of trench fever, bacillary angiomatosis, chronic bacteremia, endocarditis, and lymphadenopathy. Body louse infestation, associated with a decline in social and hygienic conditions provoked by civil unrest and economic instability, is reemergent worldwide. Recently, a forth human pathogen, Acinetobacter baumannii, has been associated to the body louse.

Fission-track ages of apatites from the Precambrian of Rwanda and Burundi - Relationship to East African rift tectonics

NASA Astrophysics Data System (ADS)

van den Haute, P.

1984-11-01

Fission-track method dating of 27 apatite samples recovered from Precambrian intrusive rocks has yielded ages in the 75-423 million year range, which is noted to be younger than the ages of emplacement or metamorphism for these rocks according to other radiometric methods. On the basis of the regional geology and the length ratios of spontaneous-to-induced tracks for 18 of the 27 samples, it can be inferred that the fission-track ages are not mixed ages due to a recent thermal event, but rather that they date the last cooling history of the studied massifs. This last cooling is interpreted as primarily the result of a slow, epirogenetic uplift which affected the area during the major part of the Phanerozoic. In this way, the large age variations can be ascribed to differential cooling caused by regional epirogenetic uplift rate differences.

Spot-checks to measure general hygiene practice.

PubMed

Sonego, Ina L; Mosler, Hans-Joachim

2016-01-01

A variety of hygiene behaviors are fundamental to the prevention of diarrhea. We used spot-checks in a survey of 761 households in Burundi to examine whether something we could call general hygiene practice is responsible for more specific hygiene behaviors, ranging from handwashing to sweeping the floor. Using structural equation modeling, we showed that clusters of hygiene behavior, such as primary caregivers' cleanliness and household cleanliness, explained the spot-check findings well. Within our model, general hygiene practice as overall concept explained the more specific clusters of hygiene behavior well. Furthermore, the higher general hygiene practice, the more likely children were to be categorized healthy (r = 0.46). General hygiene practice was correlated with commitment to hygiene (r = 0.52), indicating a strong association to psychosocial determinants. The results show that different hygiene behaviors co-occur regularly. Using spot-checks, the general hygiene practice of a household can be rated quickly and easily.

Characterisation of Central-African emissions based on MAX-DOAS measurements, satellite observations and model simulations over Bujumbura, Burundi.

NASA Astrophysics Data System (ADS)

Gielen, Clio; Hendrick, Francois; Pinardi, Gaia; De Smedt, Isabelle; Stavrakou, Trissevgeni; Yu, Huan; Fayt, Caroline; Hermans, Christian; Bauwens, Maité; Ndenzako, Eugene; Nzohabonayo, Pierre; Akimana, Rachel; Niyonzima, Sébastien; Müller, Jean-Francois; Van Roozendael, Michel

2016-04-01

Central Africa is known for its strong biogenic, pyrogenic, and to a lesser extent anthropogenic emissions. Satellite observations of species like nitrogen dioxide (NO2) and formaldehyde (HCHO), as well as inverse modelling results have shown that there are large uncertainties associated with the emissions in this region. There is thus a need for additional measurements, especially from the ground, in order to better characterise the biomass-burning and biogenic products emitted in this area. We present MAX-DOAS measurements of NO2, HCHO, and aerosols performed in Central Africa, in the city of Bujumbura, Burundi (3°S, 29°E, 850m). A MAX-DOAS instrument has been operating at this location by BIRA-IASB since late 2013. Aerosol-extinction and trace-gases vertical profiles are retrieved by applying the optimal-estimation-based profiling tool bePRO to the measured O4, NO2 and HCHO slant-column densities. The MAX-DOAS vertical columns and profiles are used for investigating the diurnal and seasonal cycles of NO2, HCHO, and aerosols. Regarding the aerosols, the retrieved AODs are compared to co-located AERONET sun photometer measurements for verification purpose, while in the case of NO2 and HCHO, the MAX-DOAS vertical columns and profiles are used for validating GOME-2 and OMI satellite observations. To characterise the biomass-burning and biogenic emissions in the Bujumbura region, the trace gases and aerosol MAX-DOAS retrievals are used in combination to MODIS fire counts/radiative-power and GOME-2/OMI NO2 and HCHO satellite data, as well as simulations from the NOAA backward trajectory model HYSPLIT. First results show that HCHO seasonal variation around local noon is driven by the alternation of rain and dry periods, the latter being associated with intense biomass-burning agricultural activities and forest fires in the south/south-east and transport from this region to Bujumbura. In contrast, NO2 is seen to depend mainly on local emissions close to the city, due to the short lifetime of this species (typically 1-2 hours). Regarding the biogenic emissions, it is found that they play only a minor role in the observed HCHO seasonality. These results are further assessed using the tropospheric 3D-CTM IMAGES.

Using organic matter to increase soil fertility in Burundi: potentials and limitations

NASA Astrophysics Data System (ADS)

Kaboneka, Salvator

2015-04-01

Agriculture production in Burundi is dominated by small scale farmers (0.5 ha/household) who have only very limited access to mineral inputs. In the past, farmers have relied on fallow practices combined with farm yard manures to maintain and improve soil fertility. However, due to the high population growth and high population density (370/km²), fallow practices are nowadays no longer feasible, animal manures cannot be produced in sufficient quantities to maintain soil productivity and food insecurity has become a quasi permanent reality. Most Burundian soils are characterized by 1:1 types of clay minerals (kaolinite) and are acidic in nature. Such soils are of very low cation exchange capacity (CEC). To compare the effect of % clays and % organic matter (% C), correlations tests have been conducted between the two parameters and the CEC. It was found that in high altitude kaolinitic and acidic soils, CEC was highly correlated to % C and less correlated to % clay, suggesting that organic matter could play an important role in improving fertility and productivity of these soils. Based on these findings, additional studies have been conducted to evaluate the fertilizer and soil amendment values of animal manures (cattle, goat, chicken), and leguminous (Calliandra calothyrsus, Gliricidia sepium, Senna simea, Senna spectabilis) and non-leguminous (Tithonia diversifolia) foliar biomass. It was observed that chicken manure significantly reduces Al3+ levels in acidic soils, while Tithonia diversifolia outperforms in nutrient releases compared to the commonly known leguminous agroforestry shrubs and trees indicated above. Although the above mentioned organic sources can contribute to the soil nutrients supply, the quantities potentially available on farm are generally small. The only solution is to supplement these organic sources with other organic sources (compost, organic household waste), chemical fertilizers and mineral amendments (lime) to achieve Integrated Soil Fertility Management. The amendments with inorganic minerals must be on the one hand as specific as possible to function as a real site-specific fertilizer, on the other hand it should be a generic blend to make it less expensive. This is a dilemma, and requires new ways of balancing organic matter and nutrients in the soils. Key words: Kaolinitic and acidic soils, CEC, Organic matter, animal manures, foliar biomass.

A qualitative study exploring the determinants of maternal health service uptake in post-conflict Burundi and Northern Uganda.

PubMed

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-02-05

Armed conflict has been described as an important contributor to the social determinants of health and a driver of health inequity, including maternal health. These conflicts may severely reduce access to maternal health services and, as a consequence, lead to poor maternal health outcomes for a period extending beyond the conflict itself. As such, understanding how maternal health-seeking behaviour and utilisation of maternal health services can be improved in post-conflict societies is of crucial importance. This study aims to explore the determinants (barriers and facilitators) of women's uptake of maternal, sexual and reproductive health services (MSRHS) in two post-conflict settings in sub-Saharan Africa; Burundi and Northern Uganda, and how uptake is affected by exposure to armed conflict. This is a qualitative study that utilised in-depth interviews and focus group discussions (FGDs) for data collection. One hundred and fifteen participants took part in the interviews and FGDs across the two study settings. Participants were women of reproductive age, local health providers and staff of non-governmental organizations. Issues explored included the factors affecting women's utilisation of a range of MSRHS vis-à-vis conflict exposure. The framework method, making use of both inductive and deductive approaches, was used for analyzing the data. A complex and inter-related set of factors affect women's utilisation of MSRHS in post-conflict settings. Exposure to armed conflict affects women's utilisation of these services mainly through impeding women's health seeking behaviour and community perception of health services. The factors identified cut across the individual, socio-cultural, and political and health system spheres, and the main determinants include women's fear of developing pregnancy-related complications, status of women empowerment and support at the household and community levels, removal of user-fees, proximity to the health facility, and attitude of health providers. Improving women's uptake of MSRHS in post-conflict settings requires health system strengthening initiatives that address the barriers across the individual, socio-cultural, and political and health system spheres. While addressing financial barriers to access is crucial, attention should be paid to non-financial barriers as well. The goal should be to develop an equitable and sustainable health system.

Multispacer Typing of Rickettsia prowazekii Enabling Epidemiological Studies of Epidemic Typhus†

PubMed Central

Zhu, Yong; Fournier, Pierre-Edouard; Ogata, Hiroyuki; Raoult, Didier

2005-01-01

Currently, there is no tool for typing Rickettsia prowazekii, the causative agent of epidemic typhus, currently considered a potential bioterrorism agent, at the strain level. To test if the multispacer typing (MST) method could differentiate strains of R. prowazekii, we amplified and sequenced the 25 most variable intergenic spacers between the R. prowazekii and R. conorii genomes in five strains and 10 body louse amplicons of R. prowazekii from various geographic origins. Two intergenic spacers, i.e., rpmE/tRNAfMet and serS/virB4, were variable among tested R. prowazekii isolates and allowed identification of three and two genotypes, respectively. When the genotypes obtained from the two spacers were combined, we identified four different genotypes. MST demonstrated that several R. prowazekii strains circulated in human body lice during an outbreak of epidemic typhus in Burundi. This may help to discriminate between natural and intentional outbreaks. Our study supports the usefulness of MST as a versatile method for rickettsial strain genotyping. PMID:16145131

Circulation of two Enterovirus C105 (EV-C105) lineages in Europe and Africa.

PubMed

Piralla, A; Daleno, C; Girello, A; Esposito, S; Baldanti, F

2015-06-01

The coding sequences of five human enterovirus (HEV)-C genotype 105 strains recovered in Italy, Romania and Burundi from patients with upper and lower respiratory tract infections were analysed and phylogenetically compared with other circulating HEV-C strains. The EV-C105 was closely related to EV-C109 and EV-C118 strains. The European strains were similar to other circulating EV-C105 strains, while the two African EV-C105 clustered in separate bootstrap-supported (>0.90) branches of the P2 and P3 region trees. Minor inconsistencies in the clustering pattern of EV-C105 in the capsid region (P1) and non-capsid region (P3) suggest that recombination may have occurred in EV-C105 group B viruses. In conclusion, phylogenetic analysis revealed the circulation of two distinct EV-C105 lineages in Europe and Africa. A different pattern of evolution could be hypothesized for the two EV-C105 lineages. © 2015 The Authors.

Practice-driven evaluation of a multi-layered psychosocial care package for children in areas of armed conflict.

PubMed

Jordans, M J D; Komproe, I H; Tol, W A; Susanty, D; Vallipuram, A; Ntamatumba, P; Lasuba, A C; De Jong, J T V M

2011-06-01

Psychosocial and mental health service delivery frameworks for children in low-income countries are scarce. This paper presents a practice-driven evaluation of a multi-layered community-based care package in Burundi, Indonesia, Sri Lanka and Sudan, through a set of indicators; (a) perceived treatment gains; (b) treatment satisfaction; (c) therapist burden; (d) access to care; (e) care package costs. Across four settings (n = 29,292 children), beneficiaries reported high levels of client satisfaction and moderate post-treatment problem reductions. Service providers reported significant levels of distress related to service delivery. Cost analyses demonstrated mean cost per service user to vary from 3.46 to 17.32 depending on country and specification of costs. The results suggest a multi-layered psychosocial care package appears feasible and satisfactory in reaching out to substantial populations of distressed children through different levels of care. Future replication should address therapist burden, cost reductions to increase sustainability and increase evidence for treatment efficacy.

Improved latrine cleanliness through behaviour change and changes in quality of latrine construction: a longitudinal intervention study in rural Burundi.

PubMed

Mosler, Hans-Joachim; Sonego, Ina Lucia

2017-10-01

Latrine cleanliness increased in the intervention group compared to the control group (increase from 21 to 31 % of latrines classified as clean in intervention [N = 198] and decrease from 37 to 27 % in control [N = 91]). Improved habitual latrine cleaning lead to latrines being 3.5 times more likely to improve in observed latrine cleanliness (χ 2  = 16.36, p < .001) and so did improvements in quality of latrine construction, eg households that had installed a lid were 7.39 times more likely to have a cleaner latrine (χ 2  = 4.46, p < .05). Changes in psychosocial factors, namely forgetting, personal norm, satisfaction with cleanliness, explained much of the change in habitual latrine cleaning (adj. r 2  = .46). Behaviour change interventions targeting psychosocial factors and quality of latrine construction seem promising to ensure clean and hygienic latrines.

Multispacer typing of Rickettsia prowazekii enabling epidemiological studies of epidemic typhus.

PubMed

Zhu, Yong; Fournier, Pierre-Edouard; Ogata, Hiroyuki; Raoult, Didier

2005-09-01

Currently, there is no tool for typing Rickettsia prowazekii, the causative agent of epidemic typhus, currently considered a potential bioterrorism agent, at the strain level. To test if the multispacer typing (MST) method could differentiate strains of R. prowazekii, we amplified and sequenced the 25 most variable intergenic spacers between the R. prowazekii and R. conorii genomes in five strains and 10 body louse amplicons of R. prowazekii from various geographic origins. Two intergenic spacers, i.e., rpmE/tRNA(fMet) and serS/virB4, were variable among tested R. prowazekii isolates and allowed identification of three and two genotypes, respectively. When the genotypes obtained from the two spacers were combined, we identified four different genotypes. MST demonstrated that several R. prowazekii strains circulated in human body lice during an outbreak of epidemic typhus in Burundi. This may help to discriminate between natural and intentional outbreaks. Our study supports the usefulness of MST as a versatile method for rickettsial strain genotyping.

40Ar/ 39Ar dating of micas from granites of NE Kibaran Belt (Karagwe-Ankolean), NW Tanzania

NASA Astrophysics Data System (ADS)

Ikingura, J. R.; Reynolds, P. H.; Watkinson, D. H.; Bell, K.

1992-11-01

40Ar/ 39Ar total gas ages of muscovites and biotites from granites associated with NE Kibaran belt (Karagwe-Ankolean) in NW Tanzanian are in the range of about 945-700 Ma, much less than the estimated age of the granites. Age gradients in the muscovite spectra are indicative of partial gas loss as a result of thermal overprinting. Evidence for at least two tectonothermal events, at ca. 950 Ma and ca. 700 Ma, is noted. The older of these correlates with the formation of tin-bearing pegmatites and hydrothermal veins in the Kibaran belt; the younger with vein emplacements in the Burundian and/or a deformational episode. Correlation of 40Ar/ 39Ar age data with K-Ar and Rb-Sr data from other parts of the Kibaran belt in Burundi, Rwanda and Zaire indicates that the NE Kibaran belt, east of the Western Rift, experienced a tectonothermal history similar to that of the western part of the during the late-Proterozoic.

Renewable Energy Zones for the Africa Clean Energy Corridor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, Grace C.; Deshmukh, Ranjit; Ndhlukula, Kudakwashe

Multi-criteria Analysis for Planning Renewable Energy (MapRE) is a study approach developed by the Lawrence Berkeley National Laboratory with the support of the International Renewable Energy Agency (IRENA). The approach combines geospatial, statistical, energy engineering, and economic methods to comprehensively identify and value high-quality wind, solar PV, and solar CSP resources for grid integration based on techno-economic criteria, generation profiles (for wind), and socio-environmental impacts. The Renewable Energy Zones for the Africa Clean Energy Corridor study sought to identify and comprehensively value high-quality wind, solar photovoltaic (PV), and concentrating solar power (CSP) resources in 21 countries in the East andmore » Southern Africa Power Pools to support the prioritization of areas for development through a multi-criteria planning process. These countries include Angola, Botswana, Burundi, Djibouti, Democratic Republic of Congo, Egypt, Ethiopia, Kenya, Lesotho, Libya, Malawi, Mozambique, Namibia, Rwanda, South Africa, Sudan, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. The study includes the methodology and the key results including renewable energy potential for each region.« less

Children's height and weight in rural and urban populations in low-income and middle-income countries: a systematic analysis of population-representative data

PubMed Central

Paciorek, Christopher J; Stevens, Gretchen A; Finucane, Mariel M; Ezzati, Majid

2013-01-01

Summary Background Urban living affects children's nutrition and growth, which are determinants of their survival, cognitive development, and lifelong health. Little is known about urban–rural differences in children's height and weight, and how these differences have changed over time. We aimed to investigate trends in children's height and weight in rural and urban settings in low-income and middle-income countries, and to assess changes in the urban–rural differentials in height and weight over time. Methods We used comprehensive population-based data and a Bayesian hierarchical mixture model to estimate trends in children's height-for-age and weight-for-age Z scores by rural and urban place of residence, and changes in urban–rural differentials in height and weight Z scores, for 141 low-income and middle-income countries between 1985 and 2011. We also estimated the contribution of changes in rural and urban height and weight, and that of urbanisation, to the regional trends in these outcomes. Findings Urban children are taller and heavier than their rural counterparts in almost all low-income and middle-income countries. The urban–rural differential is largest in Andean and central Latin America (eg, Peru, Honduras, Bolivia, and Guatemala); in some African countries such as Niger, Burundi, and Burkina Faso; and in Vietnam and China. It is smallest in southern and tropical Latin America (eg, Chile and Brazil). Urban children in China, Chile, and Jamaica are the tallest in low-income and middle-income countries, and children in rural areas of Burundi, Guatemala, and Niger the shortest, with the tallest and shortest more than 10 cm apart at age 5 years. The heaviest children live in cities in Georgia, Chile, and China, and the most underweight in rural areas of Timor-Leste, India, Niger, and Bangladesh. Between 1985 and 2011, the urban advantage in height fell in southern and tropical Latin America and south Asia, but changed little or not at all in most other regions. The urban–rural weight differential also decreased in southern and tropical Latin America, but increased in east and southeast Asia and worldwide, because weight gain of urban children outpaced that of rural children. Interpretation Further improvement of child nutrition will require improved access to a stable and affordable food supply and health care for both rural and urban children, and closing of the the urban–rural gap in nutritional status. Funding Bill & Melinda Gates Foundation, Grand Challenges Canada, UK Medical Research Council. PMID:25104494

Pre-instrumental seismicity in Central Africa using felt seisms recorded mainly at the meteorological stations of DRC, Rwanda and Burundi during the colonial period

NASA Astrophysics Data System (ADS)

Mulumba, J.-L.; Delvaux, D.

2012-04-01

Seismic hazard assessment and mitigation of catastrophes are primarily based on the identification and characterization of seismically active zones. These tasks still rely heavily on the existing knowledge of the seismic activity over the longest possible time period. The first seismic network in Equatorial Africa (IRSAC network) was operated from the Lwiro scientific base on the western shores of Lake Kivu between 1953 and 1963. Before this installation, the historical record of seismic activity in Central Africa is sparse. Even for the relatively short period concerned, spanning only 50-60 years, the historical record is far from being complete. A first attempt has been made by Herrinckx (1959) who compiled a list 960 felt seisms recorded at the meteorological stations between 1915 and 1954 in Congo, Rwanda and Burundi. They were used to draw a density map of felt seisms per square degree. We completed this data base by exploiting the meteorological archives and any available historical report to enlarge the database which now reaches 1513 entries between 1900 and 1959. These entries have been exanimate in order to identify possible historical seismic events. Those are defined by 3 or more quasi-simultaneous records observed over a relatively short distance (a few degrees of latitude/longitude) within a short time difference (few hours). A preliminary list of 115 possible historical seisms has been obtained, identified by 3 to 15 different stations. The proposed location is taken as the average latitude and longitude of the stations where the felt seisms were recorded. Some of the most important ones are associated to aftershocks that have been felt at some stations after the main shocks. The most recent felt seisms have been also recorded instrumentally, which helps to validate the procedure followed. The main difficulties are the magnitude estimation and the possible spatial incompleteness of the recording of felt seism evidence at the margin of the observation network. The distribution of these historical felt seisms mach the distribution of the instrumental epicenters. The results obtained may be used to complete the existing catalogues of historical seismicity. Herrinckx, P. (1959). Séismicité du Congo belge. Compilation des seismes observés aux stations climatologiques entre 1909 et 1954. Académie royale des Sciences coloniales. Classe des Sciences naturelles et médicales. Mémoire in8°. Nouvelle série, 11(5), 1-55

Sexual violence as a risk factor for family planning-related outcomes among young Burundian women.

PubMed

Elouard, Yajna; Weiss, Carine; Martin-Hilber, Adriane; Merten, Sonja

2018-01-01

The study aimed to examine associations between experience of sexual violence and family planning-related outcomes. A multi-stage cluster survey was conducted among a representative sample of 744 young women aged 15-24 in eight provinces in Burundi. The prevalence of young women who reported having ever been physically forced to have sexual intercourse was 26.1%. Young women who had experienced sexual violence (ever) were 2.5 times more likely not to have used any modern contraceptives in the 12 months preceding the survey. They were also 2.3 times more likely to report that their last pregnancy was unplanned. Higher odds of not being able to negotiate contraceptive use with their partners were only reported by young women having experienced sexual violence in the 12 months prior to the survey when adjusted for confounders. Sexual violence was found to be significantly associated with contraceptive negotiation and use as well as unplanned pregnancy. Weak perceived ability to negotiate contraceptive use highlights gender inequalities leaving young women vulnerable to unprotected sex and thus unplanned pregnancies.

[Epidemic typhus in tropical Africa. A reemerging disease that is severe but curable].

PubMed

Zoguéreh, D D; Ndihokubwayo, J B; Simboyinuma, A

2000-01-01

In tropical regions of Africa, frequently subject to social and political upheavals, there is an ever-present threat of typhus epidemics, as shown by the recent typhus outbreak in Burundi in 1997. Epidemic typhus should be systematically suspected in certain epidemiological conditions: famine, war, high-density populations (refugee camps, prisons), the presence of body louse in the clothing, and in the presence of certain clinical findings: severe infectious syndrome (temperature above 38 C), severe pain and muscle weakness, with coughing and severe neurological signs. The rapid diagnosis and treatment of typhus are essential. The prognosis has improved, thanks to the specific antibiotics that are currently available, particularly doxycycline, prescribed as a single oral dose of 200 mg for adults or of 100 mg for children. However, the prognosis still depends to a large extent on the speed of diagnosis. Typhus epidemics could be effectively predicted and limited if the measures for control of the body louse recommended by the World Health Organization were applied in the areas with the most favorable epidemiological conditions.

Petrography, geochemistry and U-Pb zircon age of the Matongo carbonatite Massif (Burundi): Implication for the Neoproterozoic geodynamic evolution of Central Africa

NASA Astrophysics Data System (ADS)

Midende, Gilbert; Boulvais, Philippe; Tack, Luc; Melcher, Frank; Gerdes, Axel; Dewaele, Stijn; Demaiffe, Daniel; Decrée, Sophie

2014-12-01

The Matongo carbonatite intrusion belongs to the Neoproterozoic Upper Ruvubu alkaline plutonic complex (URAPC), that is located in Burundi along the western branch of the East African Rift. Beside the Matongo carbonatite, the URAPC alkaline complex comprises feldspathoidal syenites, diorites, quartz-bearing syenites and granites. Three main facies have been recognized in the Matongo carbonatite: (1) Sövites represent the dominant facies. Two varieties have been recognized. A scarce coarse-grained sövite (sövite I), which is altered and poorly enriched in REE (4 < ΣREE < 8 ppm), is encountered in highly fractured zones. A fine-grained sövite (sövite II), which is made of saccharoidal calcite, commonly associated with apatite, aegirine and amphibole, is abundant in the intrusion. Sövite II is enriched in LREE (442 < ΣREE < 1550 ppm, 49 < LaN/YbN < 175). (2) Ferrocarbonatites, that form decimeter-wide veins crosscutting the sövites, are characterized by a LREE enriched patterns (225 < ΣREE < 1048 ppm, 17 < LaN/YbN < 64). (3) K-feldspar and biotite-rich fenite facies (silicocarbonatites) have been recognized at the contact between the carbonatites and the country rock. They are likewise LREE-enriched (134 < ΣREE < 681 ppm, 25 < LaN/YbN < 46). Additionaly, "late" hydrothermal MREE-rich carbonatite veinlets can be found in sövite I. They are characterized by moderate enrichment in REE (ΣREE = 397 ppm), with a MREE-humped pattern (LaN/YbN = 3.7). The different facies represent the typical magmatic evolution of a carbonatite, while the silicocarbonatites are interpreted as resulting from the fenitisation of the country host-rocks. In addition, the most REE-depleted and fractionated facies, i.e. the coarse-grained sövite facies and the "late" calcite veinlets testify for hydrothermal processes that occurred after carbonatite emplacement and result from REE mobilization and redistribution. Large idiomorphic zircon crystals (megacrysts), found in the vicinity of the carbonatite can directly be related to the carbonatite evolution. They have been dated at 705.5 ± 4.5 Ma (U-Pb concordant age, LA-ICP-MS). Similar zircon megacrysts of the Lueshe carbonatite (DRCongo) have been dated and give a concordant age at 798.5 ± 4.9 Ma (U-Pb, LA-ICP-MS). Considering that an extensional tectonic regime occured at that time in Central Africa - what remains debated - both ages could relate to different stages of Rodinia breakup, with uprise of mantle-derived magmas along Palaeoproterozoic lithospheric zones of weakness.

Children's height and weight in rural and urban populations in low-income and middle-income countries: a systematic analysis of population-representative data.

PubMed

Paciorek, Christopher J; Stevens, Gretchen A; Finucane, Mariel M; Ezzati, Majid

2013-11-01

Urban living affects children's nutrition and growth, which are determinants of their survival, cognitive development, and lifelong health. Little is known about urban-rural differences in children's height and weight, and how these differences have changed over time. We aimed to investigate trends in children's height and weight in rural and urban settings in low-income and middle-income countries, and to assess changes in the urban-rural differentials in height and weight over time. We used comprehensive population-based data and a Bayesian hierarchical mixture model to estimate trends in children's height-for-age and weight-for-age Z scores by rural and urban place of residence, and changes in urban-rural differentials in height and weight Z scores, for 141 low-income and middle-income countries between 1985 and 2011. We also estimated the contribution of changes in rural and urban height and weight, and that of urbanisation, to the regional trends in these outcomes. Urban children are taller and heavier than their rural counterparts in almost all low-income and middle-income countries. The urban-rural differential is largest in Andean and central Latin America (eg, Peru, Honduras, Bolivia, and Guatemala); in some African countries such as Niger, Burundi, and Burkina Faso; and in Vietnam and China. It is smallest in southern and tropical Latin America (eg, Chile and Brazil). Urban children in China, Chile, and Jamaica are the tallest in low-income and middle-income countries, and children in rural areas of Burundi, Guatemala, and Niger the shortest, with the tallest and shortest more than 10 cm apart at age 5 years. The heaviest children live in cities in Georgia, Chile, and China, and the most underweight in rural areas of Timor-Leste, India, Niger, and Bangladesh. Between 1985 and 2011, the urban advantage in height fell in southern and tropical Latin America and south Asia, but changed little or not at all in most other regions. The urban-rural weight differential also decreased in southern and tropical Latin America, but increased in east and southeast Asia and worldwide, because weight gain of urban children outpaced that of rural children. Further improvement of child nutrition will require improved access to a stable and affordable food supply and health care for both rural and urban children, and closing of the the urban-rural gap in nutritional status. Bill & Melinda Gates Foundation, Grand Challenges Canada, UK Medical Research Council. Copyright © 2013 Paciorek et al. Open Access article distributed under the terms of CC BY. Published by .. All rights reserved.

Assessment of the vulnerability and the resilience of the population at risk of multi-hazard: a support to geo-risk management in Central Africa

NASA Astrophysics Data System (ADS)

Michellier, Caroline; Kervyn, François; Tréfon, Théodore; Wolff, Eléonore

2013-04-01

GeoRisCA is a project which aims at studying the geo-risk in the Kivu region (DRC, Rwanda, Burundi), in order to support risk management. The approach developed in GeoRisCA combines methodologies from various disciplines, which will allow the analyses of seismic, volcanic and mass-movement hazards and the vulnerability assessment of the threatened elements. Vulnerability is a complex concept which is commonly defined as the susceptibility of the population, the infrastructures and the natural ecosystems to suffer from damages if a hazard occurs. The densely populated area extended from the North Kivu province in Democratic Republic of the Congo (DRC) to North Burundi and East Rwanda is vulnerable to several geohazards, such as landslides triggered by geodynamical processes (climate, seismicity, volcanism) and possibly worsen by anthropic actions. Located in the East African rift valley, the region is also characterized by a strong seismicity, with increasing people and infrastructure exposed. In addition, east DRC hosts the two most active African volcanoes: Nyiragongo and Nyamulagira. Their activity can have serious impacts, as in 2002 when Nyiragongo directly endangers the ~800.000 inhabitants of Goma city, located ~15 km to the south. Linked to passive volcanic degassing, SO2 and CO2 discharge may also increase the population vulnerability(morbidity, mortality). Focusing specifically on this region, the vulnerability assessment methodology developed in GeoRisCA takes into account "exposure to perturbations" and "adaptive capacity or resilience" of the vulnerable systems. On one hand, the exposure is identified as the potential degree of loss of a given element or set of elements at risk; i.e., the susceptibility of people, infrastructures and buildings with respect to a hazard (social vulnerability). It focuses mainly on land use, and on demographic and socio-economic factors that increase or attenuate the impacts of hazards events on local populations. On the other hand, the resilience of the individual, the household, the community, is its adaptive capacity to absorb disturbance and reorganize into a fully functioning system by anticipation, response, adaptation and recovery. A key contribution of GeoRisCA project is to assess the vulnerability to different geohazards by integrating geographic and time variability. This methodology takes into account the specificities highlighted at the regional and the local scale (urban sites). And it also considers that the vulnerability evolves with time, e.g. due to improved education, increased income, denser social networks and evolution of coping mechanisms. Using the above described methodology, one of the main objective of GeoRisCA is to developed vulnerability maps that, once associated with geohazards data, will provide decision making tools for existing preparedness and mitigation institutions.

Process for protein enrichment of cassava by solid substrate fermentation in rural conditions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Daubresse, P.; Ntibashirwa, S.; Gheysen, A.

1987-06-01

An artisanal static process for protein enrichment of cassava by solid-state fermentation, developed in laboratory and tested on pilot units in Burundi (Central Africa), provides enriched cassava containing 10.7% of dry matter protein versus 1% before fermentation. Cassava chips, processed into granules of 2-4-mm diameter, are moistened (40% water content) and steamed. After cooling to 40 degrees C, cassava is mixed with a nutritive solution containing the inoculum (Rhizopus oryzae, strain MUCL 28627) and providing the following per 100 g dry matter: 3.4 g urea, 1.5 g KH/sub 2/PO/sub 4/, O.8 g MgSO/sub 4/.7H/sub 2/O, and 22.7 g citric acid.more » For the fermentation, cassava, with circa 60% moisture content, is spread in a thin layer (2-3 cm thick) on perforated trays and slid into an aerated humidified enclosure. The incubation lasts more or less 65 hours. The production of protein enriched cassava is 3.26 kg dry matter/square m tray. The effects of the variation of the nutritive solution composition and the inoculum conservation period on the protein production are equally discussed. (Refs. 37).« less

Secondary Migration and Relocation Among African Refugee Families in the United States

PubMed Central

Weine, Stevan Merrill; Hoffman, Yael; Ware, Norma; Tugenberg, Toni; Hakizimana, Leonce; Dahnweigh, Gonwo; Currie, Madeleine; Wagner, Maureen

2014-01-01

The purpose of this study was to understand the secondary migration and relocation of African refugees resettled in the United States. Secondary migration refers to moves out of state, while relocation refers to moves within state. Of 73 recently resettled refugee families from Burundi and Liberia followed for 1 year through ethnographic interviews and observations, 13 instances of secondary migration and 9 instances of relocation were identified. A family ecodevelopmental framework was applied to address: Who moved again, why, and with what consequences? How did moving again impact family risk and protective factors? How might policies, researchers, and practitioners better manage refugees moving again? Findings indicated that families undertook secondary migration principally for employment, affordable housing, family reunification, and to feel more at home. Families relocated primarily for affordable housing. Parents reported that secondary migration and relocation enhanced family stability. Youth reported disruption to both schooling and attachments with peers and community. In conclusion, secondary migration and relocation were family efforts to enhance family and community protective resources and to mitigate shortcomings in resettlement conditions. Policymakers could provide newly resettled refugees jobs, better housing and family reunification. Practitioners could devise ways to better engage and support those families who consider moving. PMID:21361922

Have wet and dry Precambrian crust largely governed Cenozoic intraplate magmatism from Arabia to East Africa?

NASA Astrophysics Data System (ADS)

Bonavia, Franco F.; Chorowicz, Jean; Collet, Bernard

To explain Cenozoic continental volcanism between Arabia and East Africa, the existing model infers that a plume impinged beneath Ethiopia, between 30 Ma and 20 Ma, and volcanism extruded within a 1000 km radius. Because relative motion of the Afro-Arabian plate was about northeast in the last 120 Ma, we infer that at 84 Ma a plume, originated from the core-mantle boundary, impinged beneath Nubia-Arabia and is now under the Tanzania craton. This plume caused uplift (Afro-Arabian swell) and magma under-plating. After Fyfe's idea (1992), the conceptual model proposed herein suggests that, following plume impact, there was in Nubia-Arabia only intrusion of mafic dykes because the crust was largely unprocessed (wet). At about 50 Ma the plume was under Ethiopia, and coeval volcanism extruded because the crust was highly recycled (dry). In Zaire-Burundi and Tanzania, volcanism is explained to be coeval with the arrival of the plume because there also the crust is recycled. In Arabia and Yemen-Ethiopia continental-flood basalts younger than 30 Ma formed because lithospheric extension along the Red Sea-Gulf of Aden was the cause of (or the result of) plume(s), probably originated from the upper mantle.

A gender-based approach to developing a healthy lifestyle and healthy weight intervention for diverse Utah women.

PubMed

Simonsen, Sara E; Digre, Kathleen B; Ralls, Brenda; Mukundente, Valentine; Davis, France A; Rickard, Sylvia; Tavake-Pasi, Fahina; Napia, Eru Ed; Aiono, Heather; Chirpich, Meghan; Stark, Louisa A; Sunada, Grant; Keen, Kassy; Johnston, Leanne; Frost, Caren J; Varner, Michael W; Alder, Stephen C

2015-08-01

Utah women from some cultural minority groups have higher overweight/obesity rates than the overall population. We utilized a gender-based mixed methods approach to learn about the underlying social, cultural and gender issues that contribute to the increased obesity risk among these women and to inform intervention development. A literature review and analysis of Utah's Behavioral Risk Factor Surveillance System data informed the development of a focus group guide. Focus groups were conducted with five groups of women: African immigrants from Burundi and Rwanda, African Americans, American Indians/Alaskan Natives, Hispanics/Latinas, and Pacific Islanders. Six common themes emerged: (1) health is multidimensional and interventions must address health in this manner; (2) limited resources and time influence health behaviors; (3) norms about healthy weight vary, with certain communities showing more preference to heavier women; (4) women and men have important but different influences on healthy lifestyle practices within households; (5) women have an influential role on the health of families; and (6) opportunities exist within each group to improve health. Seeking insights from these five groups of women helped to identify common and distinct cultural and gender themes related to obesity, which can be used to help elucidate core obesity determinants. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ring complexes and related rocks in Africa

NASA Astrophysics Data System (ADS)

Vail, J. R.

Over 625 igneous complexes throughout Africa and Arabia have been selected and classified on the basis of petrographic association and chronology into six broad age groups forming 29 provinces. The groups range from Mid-Proterozoic to Tertiary and include gabbro, granite, syenite, foid syenite and carbonatite plutonic rocks, the majority in the form of ring-dykes, cone-sheets, plugs, circular intrusions, and their associated extrusive phases. Pan-African late or post-orogenic complexes (720-490 Ma) are common in the Arabian-Nubian and Tuareg shields of north Africa originating from subduction zone derived magmatism. Anorogenic complexes in Egypt, NE and central Sudan, Niger, Nigeria, Cameroon, Zaïre-Burundi, Malawi, Mozambique, Zimbabwe, Namibia and Angola span 550 to 50 Ma and are dominantly alkali granites and foid syenites. Many groups occur as en-echelon bands within linear arrays, and show migrating centres of intrusion in variable directions. In W. Africa there was a progressive shift of emplacement southwards during early Ordovician to Mid-Cretaceous times. Distribution patterns suggest thatdeep seated features, such as shear zones associated with lithospheric plate movements,controlled melting, and the resultant location of the complexes. Economic mineralization is not widespread in the rocks of the African ring complexes and is mainly restricted to small deposits of Sn, W, F, U and Nb.

The global distribution of Banana bunchy top virus reveals little evidence for frequent recent, human-mediated long distance dispersal events

PubMed Central

Stainton, Daisy; Martin, Darren P.; Muhire, Brejnev M.; Lolohea, Samiuela; Halafihi, Mana’ia; Lepoint, Pascale; Blomme, Guy; Crew, Kathleen S.; Sharman, Murray; Kraberger, Simona; Dayaram, Anisha; Walters, Matthew; Collings, David A.; Mabvakure, Batsirai; Lemey, Philippe; Harkins, Gordon W.; Thomas, John E.; Varsani, Arvind

2015-01-01

Banana bunchy top virus (BBTV; family Nanoviridae, genus Babuvirus) is a multi-component single-stranded DNA virus, which infects banana plants in many regions of the world, often resulting in large-scale crop losses. We analyzed 171 banana leaf samples from fourteen countries and recovered, cloned, and sequenced 855 complete BBTV components including ninety-four full genomes. Importantly, full genomes were determined from eight countries, where previously no full genomes were available (Samoa, Burundi, Republic of Congo, Democratic Republic of Congo, Egypt, Indonesia, the Philippines, and the USA [HI]). Accounting for recombination and genome component reassortment, we examined the geographic structuring of global BBTV populations to reveal that BBTV likely originated in Southeast Asia, that the current global hotspots of BBTV diversity are Southeast Asia/Far East and India, and that BBTV populations circulating elsewhere in the world have all potentially originated from infrequent introductions. Most importantly, we find that rather than the current global BBTV distribution being due to increases in human-mediated movements of bananas over the past few decades, it is more consistent with a pattern of infrequent introductions of the virus to different parts of the world over the past 1,000 years. PMID:27774281

Evidence for an African cluster of human head and body lice with variable colors and interbreeding of lice between continents.

PubMed

Veracx, Aurélie; Boutellis, Amina; Merhej, Vicky; Diatta, Georges; Raoult, Didier

2012-01-01

Human head lice and body lice have been classified based on phenotypic characteristics, including geographical source, ecotype (preferred egg laying site hair or clothes), shape and color. More recently, genotypic studies have been based on mitochondrial genes, nuclear genes and intergenic spacers. Mitochondrial genetic analysis reclassified lice into three genotypes (A, B and C). However, no previous study has attempted to correlate both genotypic and phenotypic data. Lice were collected in four African countries: Senegal, Burundi, Rwanda and Ethiopia and were photographed to compare their colors. The Multi-Spacer-Typing (MST) method was used to genotype lice belonging to the worldwide Clade A, allowing a comparison of phenotypic and genotypic data. No congruence between louse color and genotype has been identified. Phylogenetic analysis of the spacer PM2, performed including lice from other sources, showed the existence of an African cluster of human lice. However, the analysis of other spacers suggested that lice from different areas are interbreeding. We identified two geotypes of Clade A head and body lice including one that is specifically African, that can be either black or grey and can live on the head or in clothing. We also hypothesized that lice from different areas are interbreeding.

Spatial co-distribution of neglected tropical diseases in the East African Great Lakes region: revisiting the justification for integrated control

PubMed Central

Clements, Archie C. A.; Deville, Marie-Alice; Ndayishimiye, Onésime; Brooker, Simon; Fenwick, Alan

2010-01-01

Summary OBJECTIVE To determine spatial patterns of co-endemicity of schistosomiasis mansoni and the soil-transmitted helminths (STHs) Ascaris lumbricoides, Trichuris trichiura and hookworm in the Great Lakes region of East Africa, to help plan integrated neglected tropical disease programmes in this region. METHOD Parasitological surveys were conducted in Uganda, Tanzania, Kenya and Burundi in 28 213 children in 404 schools. Bayesian geostatistical models were used to interpolate prevalence of these infections across the study area. Interpolated prevalence maps were overlaid to determine areas of co-endemicity. RESULTS In the Great Lakes region, prevalence was 18.1% for Schistosoma mansoni, 50.0% for hookworm, 6.8% for A. lumbricoides and 6.8% for T. trichiura. Hookworm infection was ubiquitous, whereas S. mansoni, A. lumbricoides and T. trichiura were highly focal. Most areas were endemic (prevalence ≥10%) or hyperendemic (prevalence ≥50%) for one or more STHs, whereas endemic areas for schistosomiasis mansoni were restricted to foci adjacent large perennial water bodies. CONCLUSION Because of the ubiquity of hookworm, treatment programmes are required for STH throughout the region but efficient schistosomiasis control should only be targeted at limited high-risk areas. Therefore, integration of schistosomiasis with STH control is only indicated in limited foci in East Africa. PMID:20409287

The global distribution of Banana bunchy top virus reveals little evidence for frequent recent, human-mediated long distance dispersal events.

PubMed

Stainton, Daisy; Martin, Darren P; Muhire, Brejnev M; Lolohea, Samiuela; Halafihi, Mana'ia; Lepoint, Pascale; Blomme, Guy; Crew, Kathleen S; Sharman, Murray; Kraberger, Simona; Dayaram, Anisha; Walters, Matthew; Collings, David A; Mabvakure, Batsirai; Lemey, Philippe; Harkins, Gordon W; Thomas, John E; Varsani, Arvind

2015-01-01

Banana bunchy top virus (BBTV; family Nanoviridae, genus Babuvirus ) is a multi-component single-stranded DNA virus, which infects banana plants in many regions of the world, often resulting in large-scale crop losses. We analyzed 171 banana leaf samples from fourteen countries and recovered, cloned, and sequenced 855 complete BBTV components including ninety-four full genomes. Importantly, full genomes were determined from eight countries, where previously no full genomes were available (Samoa, Burundi, Republic of Congo, Democratic Republic of Congo, Egypt, Indonesia, the Philippines, and the USA [HI]). Accounting for recombination and genome component reassortment, we examined the geographic structuring of global BBTV populations to reveal that BBTV likely originated in Southeast Asia, that the current global hotspots of BBTV diversity are Southeast Asia/Far East and India, and that BBTV populations circulating elsewhere in the world have all potentially originated from infrequent introductions. Most importantly, we find that rather than the current global BBTV distribution being due to increases in human-mediated movements of bananas over the past few decades, it is more consistent with a pattern of infrequent introductions of the virus to different parts of the world over the past 1,000 years.

Power, policy and the Prunus africana bark trade, 1972-2015.

PubMed

Cunningham, A; Anoncho, V F; Sunderland, T

2016-02-03

After almost 50 years of international trade in wild harvested medicinal bark from Africa and Madagascar, the example of Prunus africana holds several lessons for both policy and practice in the fields of forestry, conservation and rural development. Due to recent CITES restrictions on P. africana exports from Burundi, Kenya and Madagascar, coupled with the lifting of the 2007 European Union (EU) ban in 2011, Cameroon's share of the global P. africana bark trade has risen from an average of 38% between 1995 and 2004, to 72.6% (658.6 metric tons) in 2012. Cameroon is therefore at the center of this international policy arena. This paper draws upon several approaches, combining knowledge in working with P. africana over a 30-year period with a thorough literature review and updated trade data with "ground-truthing" in the field in 2013 and 2014. This enabled the construction of a good perspective on trade volumes (1991-2012), bark prices (and value-chain data) and the gaps between research reports and practice. Two approaches provided excellent lenses for a deeper understanding of policy failure and the "knowing-doing gap" in the P. africana case. A similar approach to Médard's (1992) analyses of power, politics and African development was taken and secondly, studies of commodity chains that assess the power relations that coalesce around different commodities (Ribot, 1998; Ribot and Peluso, 2003). Despite the need to conserve genetically and chemically diverse P. africana, wild populations are vulnerable, even in several "protected areas" in Burundi, Cameroon, the Democratic Republic of Congo and in the forest reserves of Madagascar. Secondly, hopes of decentralized governance of this forest product are misplaced due to elite capture, market monopolies and subsidized management regimes. At the current European price, for P. africana bark (US$6 per kg) for example, the 2012 bark quota (658.675t) from Cameroon alone was worth over US$3.9 million, with the majority of this accruing to a single company. In contrast to lucrative bark exports, the livelihood benefits and financial returns to local harvesters from wild harvest are extremely low. For example, in 2012, the 48 active harvesters working within Mount Cameroon National Park (MCNP) received less than 1US$ per day from bark harvests, due to a net bark price of 0.33 US$ per kg (or 43% of the farm gate price for wild harvested bark). In addition, the costs of inventory, monitoring and managing sustainable wild harvests are far greater than the benefits to harvesters. Without the current substantial international donor subsidies, sustainable harvest cannot be sustained. What is required to supply the current and future market is to develop separate, traceable P. africana bark supply chains based on cultivated stocks. On-farm production would benefit thousands of small-scale farmers cultivating P. africana, including local women, for whom wild harvesting is too onerous. This change requires CITES and EU support and would catalyze P. africana cultivation in across several montane African countries and Madagascar, increasing farm-gate prices to harvesters compared to economic returns from wild harvest. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

La formation a Bukavu au Zaire: une course entre l'education et la catastrophe

NASA Astrophysics Data System (ADS)

Balegamire, Bazilashe Juvénal

1996-11-01

A description of the socio-educational situation in Bukavu since the colonial era clearly shows why the population has sought means of overcoming the gradual abandonment by the Zairean State of its responsibilities, which has been aggravated by the large-scale influx into Kivu, in Eastern Zaire, of refugees from Rwanda and Burundi and of Zaireans who has been living in those countries for some years. These means are principally trade occupations, small-time selling, short-term vocational training and higher and university education at private institutions which are financed locally and/or by funds from the North. A new approach has been deveoped, that of training the trainers working for non-governmental development organisations. Trainers of trainers have been recruited locally among the many graduates of the Higher Institutes of Education and Rural Development, which have been affected by unemployment and the miserable salaries which the State offers to its employees. The trainers of trainers could be trained by the Higher Institute of Rural Development, making the largest possible use of local skills. However, such training should be one of a set of reforms of the Zairean education system. All of this only makes sense if Zaire and its neighbours urgently defuse present socio-political tensions so that all of our populations can peacefully and resolutely engage in the healthy transformation of our societies.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, S.

This document describes the contents of a digital database containing maximum potential aboveground biomass, land use, and estimated biomass and carbon data for 1980. The biomass data and carbon estimates are associated with woody vegetation in Tropical Africa. These data were collected to reduce the uncertainty associated with estimating historical releases of carbon from land use change. Tropical Africa is defined here as encompassing 22.7 x 10{sup 6} km{sup 2} of the earth's land surface and is comprised of countries that are located in tropical Africa (Angola, Botswana, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Congo, Benin, Equatorial Guinea,more » Ethiopia, Djibouti, Gabon, Gambia, Ghana, Guinea, Ivory Coast, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Namibia, Niger, Nigeria, Guinea-Bissau, Zimbabwe (Rhodesia), Rwanda, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo, Uganda, Burkina Faso (Upper Volta), Zaire, and Zambia). The database was developed using the GRID module in the ARC/INFO{trademark} geographic information system. Source data were obtained from the Food and Agriculture Organization (FAO), the U.S. National Geophysical Data Center, and a limited number of biomass-carbon density case studies. These data were used to derive the maximum potential and actual (ca. 1980) aboveground biomass values at regional and country levels. The land-use data provided were derived from a vegetation map originally produced for the FAO by the International Institute of Vegetation Mapping, Toulouse, France.« less

Condoms and Coca-Cola.

PubMed

Townsend, S

1992-01-01

Social marketing entails promoting the appropriate and quality product to be sold in the right places at the right price. Even though mass media advertisement of condoms is forbid in Zaire, condoms have been effectively promoted and sold in the country using alternate approaches. 8 million units of the condom, Prudence, were sold in 1990, and Prudence has become the generic name for condoms in the Zaire. Noting that Coca-Cola, beer, and cigarettes may be purchased virtually ubiquitously, commercial outlets and local traders were enlisted to sell condoms at reduced prices on the market. Reduced price sales are possible since donor and government agencies provide the condoms to wholesalers and merchants free of charge. The successful social marketing of condoms expands condom availability to a greater segment of a country's population while recovering some public sector costs and shifting health care away from the public sector. Condoms are especially promoted to high risk groups such as commercial sex workers and their clients in Zaire. Similar programs have been inspired in 10 African countries including Cameroon and Burundi, as well as in Brazil, Haiti, and India. Prevention programs in Latin America and Asia will benefit from these program experiences in Africa. In closing, the article notes the need for an adequate and predictable commodity supply in attaining effective social marketing. Marked program success may, however, lead to sustainability problems.

Social marketing of condoms: selling protection and changing behavior.

PubMed

Townsend, S

1991-06-01

Social marketing of condoms in Zaire began in 1987 and sales rose to 8 million in 1990, a notable change from the previous situation where about half a million condoms were distributed by government health clinics only. Social marketing is the use of for-profit sales and marketing techniques for public health problem.s When the Zaire National AIDS Committee initiated social marketing of condoms, with the assistance of Population Services International, they had the experience of successful Asian programs of the 1970s, and the political sanction resulting from the AIDS threat to back them up. Efforts were made to find just the right product name, "Prudence," logo, package, color and slogan by consumer research. Prudence implies responsible behavior, capturing both the AIDS and STD prevention and the family planning markets. Consumers like the package and associate it with quality, since most condoms sold before in Zaire had no special packaging. Distribution outlets include 7000 retail shops, groceries, pharmacies, hotel, social clubs, 300 bars and even Congo River barges which sex workers frequent. The price was set close to that of a pack of gum for 3, or that of a bottle of beer for a dozen. Promotion is limited by a government ban of advertising in mass media, so point of purchase materials, special offers and promotional items are being used. Prudence condoms are now being marketed in Cameroon and Burundi.

Removing user fees in the health sector: a review of policy processes in six sub-Saharan African countries.

PubMed

Meessen, Bruno; Hercot, David; Noirhomme, Mathieu; Ridde, Valéry; Tibouti, Abdelmajid; Tashobya, Christine Kirunga; Gilson, Lucy

2011-11-01

In recent years, governments of several low-income countries have taken decisive action by removing fully or partially user fees in the health sector. In this study, we review recent reforms in six sub-Saharan African countries: Burkina Faso, Burundi, Ghana, Liberia, Senegal and Uganda. The review describes the processes and strategies through which user fee removal reforms have been implemented and tries to assess them by referring to a good practice hypotheses framework. The analysis shows that African leaders are willing to take strong action to remove financial barriers met by vulnerable groups, especially pregnant women and children. However, due to a lack of consultation and the often unexpected timing of the decision taken by the political authorities, there was insufficient preparation for user fee removal in several countries. This lack of preparation resulted in poor design of the reform and weaknesses in the processes of policy formulation and implementation. Our assessment is that there is now a window of opportunity in many African countries for policy action to address barriers to accessing health care. Mobilizing sufficient financial resources and obtaining long-term commitment are obviously crucial requirements, but design details, the formulation process and implementation plan also need careful thought. We contend that national policy-makers and international agencies could better collaborate in this respect.

The Influence of Contextual and Psychosocial Factors on Handwashing.

PubMed

Seimetz, Elisabeth; Boyayo, Anne-Marie; Mosler, Hans-Joachim

2016-06-01

Even though washing hands with soap is among the most effective measures to reduce the risk of infection, handwashing rates in infrastructure-restricted settings remain seriously low. Little is known about how context alone and in interaction with psychosocial factors influence hand hygiene behavior. The aim of this article was to explore how both contextual and psychosocial factors affect handwashing practices. A cross-sectional survey was conducted with 660 caregivers of primary school children in rural Burundi. Hierarchical regression analyses revealed that household wealth, the amount of water per person, and having a designated place for washing hands were contextual factors significantly predicting handwashing frequency, whereas the contextual factors, time spent collecting water and amount of money spent on soap, were not significant predictors. The contextual factors explained about 13% of the variance of reported handwashing frequency. The addition of the psychosocial factors to the regression model resulted in a significant 41% increase of explained variation in handwashing frequency. In this final model, the amount of water was the only contextual factor that remained a significant predictor. The most important predictors were a belief of self-efficacy, planning how, when, and where to wash hands, and always remembering to do so. The findings suggest that contextual constraints might be perceived rather than actual barriers and highlight the role of psychosocial factors in understanding hygiene behaviors. © The American Society of Tropical Medicine and Hygiene.

Parker's sneak-guard model revisited: why do reproductively parasitic males heavily invest in testes?

PubMed

Ota, Kazutaka; Kohda, Masanori; Hori, Michio; Sato, Tetsu

2011-10-01

Alternative reproductive tactics are widespread in males and may cause intraspecific differences in testes investment. Parker's sneak-guard model predicts that sneaker males, who mate under sperm competition risk, invest in testes relatively more than bourgeois conspecifics that have lower risk. Given that sneakers are much smaller than bourgeois males, sneakers may increase testes investment to overcome their limited sperm productivity because of their small body sizes. In this study, we examined the mechanism that mediates differential testes investment across tactics in the Lake Tanganyika cichlid fish Lamprologus callipterus. In the Rumonge population of Burundi, bourgeois males are small compared with those in other populations and have a body size close to sneaky dwarf males. Therefore, if differences in relative testis investment depend on sperm competition, the rank order of relative testis investment should be dwarf males > bourgeois males in Rumonge = bourgeois males in the other populations. If differences in relative testis investment depend on body size, the rank order of relative testes investment should be dwarf males > bourgeois males in Rumonge > bourgeois males in the other populations. Comparisons of relative testis investment among the three male groups supported the role of sperm competition, as predicted by the sneak-guard model. Nevertheless, the effects of absolute body size on testes investment should be considered to understand the mechanisms underlying intraspecific variation in testes investment caused by alternative reproductive tactics.

Parker's sneak-guard model revisited: why do reproductively parasitic males heavily invest in testes?

NASA Astrophysics Data System (ADS)

Ota, Kazutaka; Kohda, Masanori; Hori, Michio; Sato, Tetsu

2011-10-01

Alternative reproductive tactics are widespread in males and may cause intraspecific differences in testes investment. Parker's sneak-guard model predicts that sneaker males, who mate under sperm competition risk, invest in testes relatively more than bourgeois conspecifics that have lower risk. Given that sneakers are much smaller than bourgeois males, sneakers may increase testes investment to overcome their limited sperm productivity because of their small body sizes. In this study, we examined the mechanism that mediates differential testes investment across tactics in the Lake Tanganyika cichlid fish Lamprologus callipterus. In the Rumonge population of Burundi, bourgeois males are small compared with those in other populations and have a body size close to sneaky dwarf males. Therefore, if differences in relative testis investment depend on sperm competition, the rank order of relative testis investment should be dwarf males > bourgeois males in Rumonge = bourgeois males in the other populations. If differences in relative testis investment depend on body size, the rank order of relative testes investment should be dwarf males > bourgeois males in Rumonge > bourgeois males in the other populations. Comparisons of relative testis investment among the three male groups supported the role of sperm competition, as predicted by the sneak-guard model. Nevertheless, the effects of absolute body size on testes investment should be considered to understand the mechanisms underlying intraspecific variation in testes investment caused by alternative reproductive tactics.

Tropical Africa: Land Use, Biomass, and Carbon Estimates for 1980 (and updated for the year 2000) (NDP-055)

DOE Data Explorer

Brown, Sandra [University of Illinois, Urbana, IL (USA); Winrock International, Arlington, Virginia (USA); Gaston, Greg [University of Illinois, Urbana, IL (USA); Oregon State University; Beaty, T. W. [Carbon Dioxide Information Analysis Center (CDIAC), Oak Ridge National Laboratory, Oak Ridge, TN (USA); Olsen, L. M. [Carbon Dioxide Information Analysis Center (CDIAC), Oak Ridge National Laboratory, Oak Ridge, TN (USA)

2001-01-01

This document describes the contents of a digital database containing maximum potential aboveground biomass, land use, and estimated biomass and carbon data for 1980. The biomass data and carbon estimates are associated with woody vegetation in Tropical Africa. These data were collected to reduce the uncertainty associated with estimating historical releases of carbon from land use change. Tropical Africa is defined here as encompassing 22.7 x 10E6 km² of the earth's land surface and is comprised of countries that are located in tropical Africa (Angola, Botswana, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Congo, Benin, Equatorial Guinea, Ethiopia, Djibouti, Gabon, Gambia, Ghana, Guinea, Ivory Coast, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Namibia, Niger, Nigeria, Guinea-Bissau, Zimbabwe (Rhodesia), Rwanda, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo,Uganda, Burkina Faso (Upper Volta), Zaire, and Zambia). The database was developed using the GRID module in the ARC/INFO (TM geographic information system. Source data were obtained from the Food and Agriculture Organization (FAO), the U.S. National Geophysical Data Center, and a limited number of biomass-carbon density case studies. These data were used to derive the maximum potential and actual (ca. 1980) aboveground biomass values at regional and country levels. The land-use data provided were derived from a vegetation map originally produced for the FAO by the International Institute of Vegetation Mapping, Toulouse, France.

Epilepsy in Onchocerciasis Endemic Areas: Systematic Review and Meta-analysis of Population-Based Surveys

PubMed Central

Pion, Sébastien D. S.; Kaiser, Christoph; Boutros-Toni, Fernand; Cournil, Amandine; Taylor, Melanie M.; Meredith, Stefanie E. O.; Stufe, Ansgar; Bertocchi, Ione; Kipp, Walter; Preux, Pierre-Marie; Boussinesq, Michel

2009-01-01

Objective We sought to evaluate the relationship between onchocerciasis prevalence and that of epilepsy using available data collected at community level. Design We conducted a systematic review and meta-regression of available data. Data Sources Electronic and paper records on subject area ever produced up to February 2008. Review Methods We searched for population-based studies reporting on the prevalence of epilepsy in communities for which onchocerciasis prevalence was available or could be estimated. Two authors independently assessed eligibility and study quality and extracted data. The estimation of point prevalence of onchocerciasis was standardized across studies using appropriate correction factors. Variation in epilepsy prevalence was then analyzed as a function of onchocerciasis endemicity using random-effect logistic models. Results Eight studies from west (Benin and Nigeria), central (Cameroon and Central African Republic) and east Africa (Uganda, Tanzania and Burundi) met the criteria for inclusion and analysis. Ninety-one communities with a total population of 79,270 individuals screened for epilepsy were included in the analysis. The prevalence of epilepsy ranged from 0 to 8.7% whereas that of onchocerciasis ranged from 5.2 to 100%. Variation in epilepsy prevalence was consistent with a logistic function of onchocerciasis prevalence, with epilepsy prevalence being increased, on average, by 0.4% for each 10% increase in onchocerciasis prevalence. Conclusion These results give further evidence that onchocerciasis is associated with epilepsy and that the disease burden of onchocerciasis might have to be re-estimated by taking into account this relationship. PMID:19529767

Girls and war: an extra vulnerability.

PubMed

Black, M

1998-01-01

It is no longer possible to consider the raping of girls as an isolated atrocity of war. In Uganda, guerrilla forces have kidnapped 6000-10,000 children and have forced the "most desirable" girls to become "wives" of warlords. Girls who manage to escape are deeply traumatized and suffer ill health as well as possible social ostracism. In refugee camps, recognition that adolescent girls face special risks of rape and of engaging in the informal prostitution that may expose them to HIV/AIDS has led to the introduction of new measures to increase female security. Families in refugee camps in Burundi and Somalia protect female honor by submitting their daughters to very early marriage, which also abuses the girls' rights. Girls conscripted to military groups are forced to transport materials, cook, or help loot villages. In conditions of war, even girls who remain at home protected by their families must assume extra responsibilities, especially if men go off to fight leaving women with the agricultural and livestock burdens. Girls will be the first children withdrawn from school to help keep the household afloat. Girls and women are also expected to tend those wounded by the very war that destroys the health care services that are vital to meet women's reproductive needs. Efforts are being made to identify rape as a specific war crime, and these efforts should be extended to the kidnapping and forced recruitment of children into combat roles. Moral codes must be reestablished, even if they are only nominal at present.

Description de Nosopsyllus (N.) Atsbi n. sp. (Siphonaptera : Ceratophyllidae) d’Éthiopie et révision de l’espèce affine N. (N.) Incisus (Jordan & Rothschild, 1913) ; discussion biogéographique

PubMed Central

Beaucournu, J.-C.; Meheretu, Y.; Welegerima, K.; Mergey, T.; Laudisoit, A.

2012-01-01

Nous décrivons un Nosopsyllus s. sto. nouveau du nord de l’Éthiopie, N. atsbi, montrant des ressemblances phylétiques avec N. incisus (Jordan & Rothschild, 1913), espèce cantonnée à la partie orientale de la région afrotropicale. Ceci nous conduit à revoir les populations classées comme incisus sur l’unique critère de la sétation du télomère (trois fortes soies marginales, au lieu des deux classiquement observées dans ces genre et sous-genre). Il apparaît que N. incisus s. sto. est connu au nord-est de la République Démocratique du Congo, au Kenya, au Burundi et en Tanzanie. Au nord et au sud de cette région (centre de l’Éthiopie, d’une part, Zambie et Malawi, d’autre part), deux taxa sont morphologiquement à part et nous les érigeons au rang de sous-espèces : Nosopsyllus (N.) incisus traubi n. ssp. et N. (N.) incisus lewisi n. ssp. À l’heure actuelle, le “complexe incisus” est riche de quatre taxa, à savoir, du nord au sud, N. atsbi n. sp., N. incisus traubi n. ssp., N. incisus incisus (Jordan & Rothschild, 1913) et N. incisus lewisi n. ssp. PMID:22314238

Appetitive Aggression and Adverse Childhood Experiences Shape Violent Behavior in Females Formerly Associated with Combat

PubMed Central

Augsburger, Mareike; Meyer-Parlapanis, Danie; Bambonye, Manassé; Elbert, Thomas; Crombach, Anselm

2015-01-01

This study investigated the impact of violent experiences during childhood, posttraumatic stress disorder (PTSD) and appetitive aggression on everyday violent behavior in Burundian females with varying participation in war. Moreover, group differences in trauma-related and aggression variables were expected. Appetitive aggression describes the perception of violence perpetration as fascinating and appealing and is a common phenomenon in former combatants. Semi-structured interviews were conducted with 158 females, either former combatants, supporters of armed forces or civilians during the civil war in Burundi. The PTSD Symptom Scale Interview was used to assess PTSD symptom severity, the Appetitive Aggression Scale to measure appetitive aggression and the Domestic and Community Violence Checklist to assess both childhood maltreatment and recent aggressive behavior. Former combatants had experienced more traumatic events, perpetrated more violence and reported higher levels of appetitive aggression than supporters and civilians. They also suffered more severely from PTSD symptoms than civilians but not than supporters. The groups did not differ regarding childhood maltreatment. Both appetitive aggression and childhood violence predicted ongoing aggressive behavior, whereas the latter outperformed PTSD symptom severity. These findings support current research showing that adverse childhood experiences and a positive attitude toward aggression serve as the basis for aggressive behavior and promote an ongoing cycle of violence in post-conflict regions. Female members of armed groups are in need of demobilization procedures including trauma-related care and interventions addressing appetitive aggression. PMID:26635666

Effects of multi-stakeholder platforms on multi-stakeholder innovation networks: Implications for research for development interventions targeting innovations at scale

PubMed Central

Schut, Marc; Hermans, Frans; van Asten, Piet; Leeuwis, Cees

2018-01-01

Multi-stakeholder platforms (MSPs) have been playing an increasing role in interventions aiming to generate and scale innovations in agricultural systems. However, the contribution of MSPs in achieving innovations and scaling has been varied, and many factors have been reported to be important for their performance. This paper aims to provide evidence on the contribution of MSPs to innovation and scaling by focusing on three developing country cases in Burundi, Democratic Republic of Congo, and Rwanda. Through social network analysis and logistic models, the paper studies the changes in the characteristics of multi-stakeholder innovation networks targeted by MSPs and identifies factors that play significant roles in triggering these changes. The results demonstrate that MSPs do not necessarily expand and decentralize innovation networks but can lead to contraction and centralization in the initial years of implementation. They show that some of the intended next users of interventions with MSPs–local-level actors–left the innovation networks, whereas the lead organization controlling resource allocation in the MSPs substantially increased its centrality. They also indicate that not all the factors of change in innovation networks are country specific. Initial conditions of innovation networks and funding provided by the MSPs are common factors explaining changes in innovation networks across countries and across different network functions. The study argues that investigating multi-stakeholder innovation network characteristics targeted by the MSP using a network approach in early implementation can contribute to better performance in generating and scaling innovations, and that funding can be an effective implementation tool in developing country contexts. PMID:29870559

Impact of Urbanization on Precipitation Distribution and Intensity over Lake Victoria Basin

NASA Astrophysics Data System (ADS)

Gudoshava, M.; Semazzi, F. H. M.

2014-12-01

In this study, sensitivity simulations on the impact of rapid urbanization over Lake Victoria Basin in East Africa were done using a Regional Climate Model (RegCM4.4-rc29) with the Hostetler lake model activated. The simulations were done for the rainy seasons that is the long rains (March-April-May) and short rains (October-November-December). Africa is projected to have a surge in urbanization with an approximate rate of 590% in 2030 over their 2000 levels. The Northern part of Lake Victoria Basin and some parts of Rwanda and Burundi are amongst the regions with high urbanization projections. Simulations were done with the land cover for 2000 and the projected 2030 urbanization levels. The results showed that increasing the urban fraction over the northern part of the basin modified the physical parameters such as albedo, moisture and surface energy fluxes, aerodynamic roughness and surface emissivity, thereby altering the precipitation distribution, intensity and frequency in the region. The change in the physical parameters gave a response of an average increase in temperature of approximately 2oC over the urbanized region. A strong convergence zone was formed over the urbanized region and thereby accelerating the lake-breeze front towards the urbanized region center. Precipitation in the urbanized region and regions immediate to the area increased by approximately 4mm/day, while drying up the southern (non-urbanized) side of the basin. The drying up of the southern side of the basin could be a result of divergent flow and subsidence that suppresses vertical development of storms.

Molecular and Phylogeographic Analysis of Human Immuno-deficiency Virus Type 1 Strains Infecting Treatment-naive Patients from Kigali, Rwanda

PubMed Central

Rusine, John; Jurriaans, Suzanne; van de Wijgert, Janneke; Cornelissen, Marion; Kateera, Brenda; Boer, Kimberly; Karita, Etienne; Mukabayire, Odette; de Jong, Menno; Ondoa, Pascale

2012-01-01

This study aimed at describing the genetic subtype distribution of HIV-1 strains circulating in Kigali and their epidemiological link with the HIV-1 strains from the five countries surrounding Rwanda. One hundred and thirty eight pol (RT and PR) sequences from 116 chronically- and 22 recently-infected antiretroviral therapy (ART)-naïve patients from Kigali were generated and subjected to HIV drug resistance (HIV-DR), phylogenetic and recombinant analyses in connection with 366 reference pol sequences from Rwanda, Burundi, Kenya, Democratic Republic of Congo, Tanzania and Uganda (Los Alamos database). Among the Rwandan samples, subtype A1 predominated (71.7%), followed by A1/C recombinants (18.1%), subtype C (5.8%), subtype D (2.9%), one A1/D recombinant (0.7%) and one unknown subtype (0.7%). Thirteen unique and three multiple A1/C recombinant forms were identified. No evidence for direct transmission events was found within the Rwandan strains. Molecular characteristics of HIV-1 were similar between chronically and recently-infected individuals and were not significantly associated with demographic or social factors. Our report suggests that the HIV-1 epidemic in Kigali is characterized by the emergence of A1/C recombinants and is not phylogenetically connected with the HIV-1 epidemic in the five neighboring countries. The relatively low level of transmitted HIV-DR mutations (2.9%) reported here indicates the good performance of the ART programme in Rwanda. However, the importance of promoting couples' counseling, testing and disclosure during HIV prevention strategies is highlighted. PMID:22905148

A spatially explicit assessment of current and future hotspots of hunger in Sub-Saharan Africa in the context of global change

NASA Astrophysics Data System (ADS)

Liu, Junguo; Fritz, Steffen; van Wesenbeeck, C. F. A.; Fuchs, Michael; You, Liangzhi; Obersteiner, Michael; Yang, Hong

2008-12-01

Hunger knows no boundaries or borders. While much research has focused on undernutrition on a national scale, this report evaluates it at subnational levels for Sub-Saharan Africa (SSA) to pinpoint hotspots where the greatest challenges exist. Undernutrition is assessed with a spatial resolution of 30 arc-minutes by investigating anthropometric data on weight and length of individuals. The impact of climate change on production of six major crops (cassava, maize, wheat, sorghum, rice and millet) is analyzed with a GIS-based Environmental Policy Integrated Climate (GEPIC) model with the same spatial resolution. Future hotspots of hunger are projected in the context of the anticipated climate, social, economic, and bio-physical changes. The results show that some regions in northern and southwestern Nigeria, Sudan and Angola with a currently high number of people with undernutrition might be able to improve their food security situation mainly through increasing purchasing power. In the near future, regions located in Ethiopia, Uganda, Rwanda and Burundi, southwestern Niger, and Madagascar are likely to remain hotspots of food insecurity, while regions located in Tanzania, Mozambique and the Democratic Republic of Congo might face more serious undernutrition. It is likely that both the groups of regions will suffer from lower capacity of importing food as well as lower per capita calorie availability, while the latter group will probably have sharper reduction in per capita calorie availability. Special attention must be paid to the hotspot areas in order to meet the hunger alleviation goals in SSA.

Effects of multi-stakeholder platforms on multi-stakeholder innovation networks: Implications for research for development interventions targeting innovations at scale.

PubMed

Sartas, Murat; Schut, Marc; Hermans, Frans; Asten, Piet van; Leeuwis, Cees

2018-01-01

Multi-stakeholder platforms (MSPs) have been playing an increasing role in interventions aiming to generate and scale innovations in agricultural systems. However, the contribution of MSPs in achieving innovations and scaling has been varied, and many factors have been reported to be important for their performance. This paper aims to provide evidence on the contribution of MSPs to innovation and scaling by focusing on three developing country cases in Burundi, Democratic Republic of Congo, and Rwanda. Through social network analysis and logistic models, the paper studies the changes in the characteristics of multi-stakeholder innovation networks targeted by MSPs and identifies factors that play significant roles in triggering these changes. The results demonstrate that MSPs do not necessarily expand and decentralize innovation networks but can lead to contraction and centralization in the initial years of implementation. They show that some of the intended next users of interventions with MSPs-local-level actors-left the innovation networks, whereas the lead organization controlling resource allocation in the MSPs substantially increased its centrality. They also indicate that not all the factors of change in innovation networks are country specific. Initial conditions of innovation networks and funding provided by the MSPs are common factors explaining changes in innovation networks across countries and across different network functions. The study argues that investigating multi-stakeholder innovation network characteristics targeted by the MSP using a network approach in early implementation can contribute to better performance in generating and scaling innovations, and that funding can be an effective implementation tool in developing country contexts.

Social network analysis of multi-stakeholder platforms in agricultural research for development: Opportunities and constraints for innovation and scaling.

PubMed

Hermans, Frans; Sartas, Murat; van Schagen, Boudy; van Asten, Piet; Schut, Marc

2017-01-01

Multi-stakeholder platforms (MSPs) are seen as a promising vehicle to achieve agricultural development impacts. By increasing collaboration, exchange of knowledge and influence mediation among farmers, researchers and other stakeholders, MSPs supposedly enhance their 'capacity to innovate' and contribute to the 'scaling of innovations'. The objective of this paper is to explore the capacity to innovate and scaling potential of three MSPs in Burundi, Rwanda and the South Kivu province located in the eastern part of Democratic Republic of Congo (DRC). In order to do this, we apply Social Network Analysis and Exponential Random Graph Modelling (ERGM) to investigate the structural properties of the collaborative, knowledge exchange and influence networks of these MSPs and compared them against value propositions derived from the innovation network literature. Results demonstrate a number of mismatches between collaboration, knowledge exchange and influence networks for effective innovation and scaling processes in all three countries: NGOs and private sector are respectively over- and under-represented in the MSP networks. Linkages between local and higher levels are weak, and influential organisations (e.g., high-level government actors) are often not part of the MSP or are not actively linked to by other organisations. Organisations with a central position in the knowledge network are more sought out for collaboration. The scaling of innovations is primarily between the same type of organisations across different administrative levels, but not between different types of organisations. The results illustrate the potential of Social Network Analysis and ERGMs to identify the strengths and limitations of MSPs in terms of achieving development impacts.

Terpenoids from Platostoma rotundifolium (Briq.) A. J. Paton Alter the Expression of Quorum Sensing-Related Virulence Factors and the Formation of Biofilm in Pseudomonas aeruginosa PAO1

PubMed Central

Rasamiravaka, Tsiry; Ngezahayo, Jérémie; Pottier, Laurent; Oliveira Ribeiro, Sofia; Souard, Florence; Hari, Léonard; Stévigny, Caroline; El Jaziri, Mondher; Duez, Pierre

2017-01-01

Platostoma rotundifolium (Briq.) A. J. Paton aerial parts are widely used in Burundi traditional medicine to treat infectious diseases. In order to investigate their probable antibacterial activities, crude extracts from P. rotundifolium were assessed for their bactericidal and anti-virulence properties against an opportunistic bacterial model, Pseudomonas aeruginosa PAO1. Whereas none of the tested extracts exert bacteriostatic and/or bactericidal proprieties, the ethyl acetate and dichloromethane extracts exhibit anti-virulence properties against Pseudomonas aeruginosa PAO1 characterized by an alteration in quorum sensing gene expression and biofilm formation without affecting bacterial viability. Bioguided fractionation of the ethyl acetate extract led to the isolation of major anti-virulence compounds that were identified from nuclear magnetic resonance and high-resolution molecular spectroscopy spectra as cassipourol, β-sitosterol and α-amyrin. Globally, cassipourol and β-sitosterol inhibit quorum sensing-regulated and -regulatory genes expression in las and rhl systems without affecting the global regulators gacA and vfr, whereas α-amyrin had no effect on the expression of these genes. These terpenoids disrupt the formation of biofilms at concentrations down to 12.5, 50 and 50 µM for cassipourol, β-sitosterol and α-amyrin, respectively. Moreover, these terpenoids reduce the production of total exopolysaccharides and promote flagella-dependent motilities (swimming and swarming). The isolated terpenoids exert a wide range of inhibition processes, suggesting a complex mechanism of action targeting P. aeruginosa virulence mechanisms which support the wide anti-infectious use of this plant species in traditional Burundian medicine. PMID:28613253

Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective.

PubMed

Epping-Jordan, JoAnne E; van Ommeren, Mark; Ashour, Hazem Nayef; Maramis, Albert; Marini, Anita; Mohanraj, Andrew; Noori, Aqila; Rizwan, Humayun; Saeed, Khalid; Silove, Derrick; Suveendran, T; Urbina, Liliana; Ventevogel, Peter; Saxena, Shekhar

2015-01-01

Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development. Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste. These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders. Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.

A study on reintegration of street children in Burundi: experienced violence and maltreatment are associated with mental health impairments and impeded educational progress

PubMed Central

Crombach, Anselm; Bambonyé, Manassé; Elbert, Thomas

2014-01-01

Street children are exposed to violence, and subsist in poor and generally precarious conditions. In conflict regions, institutional care facilities are often the only well established way to care for vulnerable children. Providing access to school education is considered to be key to allow successful integration into society. However, adverse effects of psychological disorders may pose another serious obstacle. In semi-structured interviews in a sample of 112 Burundian male youths (mean age = 15.9 years), we assessed exposure to traumatic stressors, regularly and recently occurring violence as well as prevalence of posttraumatic stress disorder (PTSD), depression, substance dependence, suicidal risk, and progress in school. Former street children (n = 32) and other vulnerable children (n = 50) in a residential center were compared to children living in the streets (n = 15) or with families (n = 15). While the children living in the center were less regularly exposed to violence and reported less substance dependence than street children, PTSD symptoms were common among the former street children. Furthermore, we provided empirical evidence that for the children living in the center, recently experienced violence – mostly minor physical conflicts, psychological violence and neglect – was associated with increased PTSD symptomatology and impeded progress in school. In a population of children who experienced many traumatic incidences and a lot of violence, even minor violent events may trigger and reinforce PTSD symptoms. Hence controlling exposure to violence and addressing mental ill-health in vulnerable children is mandatory for reintegration. PMID:25566123

Dermatophytes and dermatophytosis in the eastern and southern parts of Africa.

PubMed

Nweze, E I; Eke, I E

2018-01-01

Dermatophytosis is currently a disease of global importance and a public health burden. It is caused by dermatophytes, which attack and grow on dead animal keratin. Dermatophytes belong to three genera, namely, Epidermophyton, Microsporum, and Trichophyton. The predominant clinical forms and causative agents vary from one region of the world to another. Poor socioeconomic status, high population densities, and poor sanitary conditions are some of the factors responsible for the high prevalence of dermatophytosis in many developing countries, which include countries in southern and eastern Africa, the focus of this review. To the best of our knowledge, there is currently no review article on published findings on dermatophytosis in the eastern and southern parts of Africa. This information will be of interest to the medical and research community since the world has become a global village. This review covers published research findings in eastern and southern regions of Africa until this date. The countries covered in the current review include Kenya, Ethiopia, Tanzania, South Africa, Mozambique, Madagascar, Malawi, Rwanda, Burundi, Uganda, Zambia, Zimbabwe, and Botswana. T. violaceum is the most common human etiological agent in all the countries under review with prevalence ranging from 56.7% to 95%, except for Madagascar (M. langeronii, reclassified as M. audouinii), Uganda (M. gypseum) and Malawi (M. audouinii). Tinea capitis was the most clinical type, followed by tinea corporis. Etiological agents of animal dermatophytoses were variable in the countries where they were reported. Major risk factors for dermatophytoses are age, climatic, and socioeconomic factors. © The Author 2017. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The politics of AIDS.

PubMed

1990-02-01

The are political and religious attitudes toward acquired immunodeficiency syndrome (AIDS) that should be prohibited from effecting policies to prevent and combat it. Some governments do not wish to admit the presence of AIDS which reflects the type of society there, and some churches oppose the use of condoms. There is also an argument about whether AIDS originated in East Africa or in California, where it appeared and spread at about the same time. Zaire does not monitor or report AIDS although, with 300 cases, it is probably the most affected country in Africa, followed by Uganda, Tanzania, Zambia, Rwanda, Burundi, Kenya, Zimbabwe, and Malawi. Most African medical services don't have adequate personnel. Many African doctors leave their countries for better opportunities elsewhere. These problems lead the outside world to think governments are attempting cover up or withhold information on AIDS cases. In Zambia it is estimated that 7 % of rural and 10% of urban adult males are HIV positive. Numbers in the army could be as high as 20%. There have been efforts to control or withhold this information, although, the president has led an open policy approach since his son's death from AIDS. Mozambique and Angola are at war: statistics on AIDS are not being gathered there while conditions encouraging the spread of AIDS proceed unchecked. In Namibia, there have been only 6 confirmed cases of AIDS but doctors estimate at least 50-100 persons are infected. These cases are located in Caprivi which is close to the Zambian and Zimbabwean borders. It is evident that political views should not divert attention from the medical treatment of AIDS, and the public must insist on safe methods such as condom use, to prevent its spread.

Some like it hot: the influence and implications of climate change on coffee berry borer (Hypothenemus hampei) and coffee production in East Africa.

PubMed

Jaramillo, Juliana; Muchugu, Eric; Vega, Fernando E; Davis, Aaron; Borgemeister, Christian; Chabi-Olaye, Adenirin

2011-01-01

The negative effects of climate change are already evident for many of the 25 million coffee farmers across the tropics and the 90 billion dollar (US) coffee industry. The coffee berry borer (Hypothenemus hampei), the most important pest of coffee worldwide, has already benefited from the temperature rise in East Africa: increased damage to coffee crops and expansion in its distribution range have been reported. In order to anticipate threats and prioritize management actions for H. hampei we present here, maps on future distributions of H. hampei in coffee producing areas of East Africa. Using the CLIMEX model we relate present-day insect distributions to current climate and then project the fitted climatic envelopes under future scenarios A2A and B2B (for HADCM3 model). In both scenarios, the situation with H. hampei is forecasted to worsen in the current Coffea arabica producing areas of Ethiopia, the Ugandan part of the Lake Victoria and Mt. Elgon regions, Mt. Kenya and the Kenyan side of Mt. Elgon, and most of Rwanda and Burundi. The calculated hypothetical number of generations per year of H. hampei is predicted to increase in all C. arabica-producing areas from five to ten. These outcomes will have serious implications for C. arabica production and livelihoods in East Africa. We suggest that the best way to adapt to a rise of temperatures in coffee plantations could be via the introduction of shade trees in sun grown plantations. The aims of this study are to fill knowledge gaps existing in the coffee industry, and to draft an outline for the development of an adaptation strategy package for climate change on coffee production. An abstract in Spanish is provided as Abstract S1.

Effect of pay for performance to improve quality of maternal and child care in low- and middle-income countries: a systematic review.

PubMed

Das, Ashis; Gopalan, Saji S; Chandramohan, Daniel

2016-04-14

Pay for Performance (P4P) mechanisms to health facilities and providers are currently being tested in several low- and middle-income countries (LMIC) to improve maternal and child health (MCH). This paper reviews the existing evidence on the effect of P4P program on quality of MCH care in LMICs. A systematic review of literature was conducted according to a registered protocol. MEDLINE, Web of Science, and Embase were searched using the key words maternal care, quality of care, ante natal care, emergency obstetric and neonatal care (EmONC) and child care. Of 4535 records retrieved, only eight papers met the inclusion criteria. Primary outcome of interest was quality of MCH disaggregated into structural quality, process quality and outcomes. Risk of bias across studies was assessed through a customized quality checklist. There were four controlled before after intervention studies, three cluster randomized controlled trials and one case control with post-intervention comparison of P4P programs for MCH care in Burundi, Democratic Republic of Congo, Egypt, the Philippines, and Rwanda. There is some evidence of positive effect of P4P only on process quality of MCH. The effect of P4P on delivery, EmONC, post natal care and under-five child care were not evaluated in these studies. There is weak evidence for P4P's positive effect on maternal and neonatal health outcomes and out-of-pocket expenses. P4P program had a few negative effects on structural quality. P4P is effective to improve process quality of ante natal care. However, further research is needed to understand P4P's impact on MCH and their causal pathways in LMICs. PROSPERO registration number CRD42014013077 .

Social network analysis of multi-stakeholder platforms in agricultural research for development: Opportunities and constraints for innovation and scaling

PubMed Central

Hermans, Frans; Sartas, Murat; van Schagen, Boudy; van Asten, Piet

2017-01-01

Multi-stakeholder platforms (MSPs) are seen as a promising vehicle to achieve agricultural development impacts. By increasing collaboration, exchange of knowledge and influence mediation among farmers, researchers and other stakeholders, MSPs supposedly enhance their ‘capacity to innovate’ and contribute to the ‘scaling of innovations’. The objective of this paper is to explore the capacity to innovate and scaling potential of three MSPs in Burundi, Rwanda and the South Kivu province located in the eastern part of Democratic Republic of Congo (DRC). In order to do this, we apply Social Network Analysis and Exponential Random Graph Modelling (ERGM) to investigate the structural properties of the collaborative, knowledge exchange and influence networks of these MSPs and compared them against value propositions derived from the innovation network literature. Results demonstrate a number of mismatches between collaboration, knowledge exchange and influence networks for effective innovation and scaling processes in all three countries: NGOs and private sector are respectively over- and under-represented in the MSP networks. Linkages between local and higher levels are weak, and influential organisations (e.g., high-level government actors) are often not part of the MSP or are not actively linked to by other organisations. Organisations with a central position in the knowledge network are more sought out for collaboration. The scaling of innovations is primarily between the same type of organisations across different administrative levels, but not between different types of organisations. The results illustrate the potential of Social Network Analysis and ERGMs to identify the strengths and limitations of MSPs in terms of achieving development impacts. PMID:28166226

Local discrepancies in measles vaccination opportunities: results of population-based surveys in Sub-Saharan Africa

PubMed Central

2014-01-01

Background The World Health Organization recommends African children receive two doses of measles containing vaccine (MCV) through routine programs or supplemental immunization activities (SIA). Moreover, children have an additional opportunity to receive MCV through outbreak response immunization (ORI) mass campaigns in certain contexts. Here, we present the results of MCV coverage by dose estimated through surveys conducted after outbreak response in diverse settings in Sub-Saharan Africa. Methods We included 24 household-based surveys conducted in six countries after a non-selective mass vaccination campaign. In the majority (22/24), the survey sample was selected using probability proportional to size cluster-based sampling. Others used Lot Quality Assurance Sampling. Results In total, data were collected on 60,895 children from 2005 to 2011. Routine coverage varied between countries (>95% in Malawi and Kirundo province (Burundi) while <35% in N’Djamena (Chad) in 2005), within a country and over time. SIA coverage was <75% in most settings. ORI coverage ranged from >95% in Malawi to 71.4% [95% CI: 68.9-73.8] in N’Djamena (Chad) in 2005. In five sites, >5% of children remained unvaccinated after several opportunities. Conversely, in Malawi and DRC, over half of the children eligible for the last SIA received a third dose of MCV. Conclusions Control pre-elimination targets were still not reached, contributing to the occurrence of repeated measles outbreak in the Sub-Saharan African countries reported here. Although children receiving a dose of MCV through outbreak response benefit from the intervention, ensuring that programs effectively target hard to reach children remains the cornerstone of measles control. PMID:24559281

The present-day epidemiological situation in the Horn of Africa on the example of Somalia.

PubMed

Korzeniewski, Krzysztof

2012-01-01

This article presents information on the environmental hazards prevailing in Somalia and recommends a health prophylaxis in connection with a potential deployment of Polish Military Contingent to this part of the world. Somalia is a country located in the eastern part of Africa, in the so-called Horn of Africa. The country has been continuously at war for over two decades. Because of its much-devastated municipal and industrial infrastructure, widespread famine and limited access of the local people to healthcare it is considered one of the countries where living conditions are extremely difficult. Epidemiological indexes in Somalia are the worst in the world, and the Somali citizens are entirely dependent on foreign humanitarian assistance. At present, three different military operations, under the auspices of international organizations, have been carried out on the soil and the territorial waters: the European Union Naval Force Somalia--Operation Atlanta, the NATO Operation Ocean Shield, and the biggest of the three--the UN peacekeeping mission AMISOM with 9,5 thousand African troops, mainly from Uganda and Burundi). Despite their presence, the situation of the civilian population is critical. If the number ofpeacekeeping and stabilization troops deployed to the Horn of Africa is increased, it is very likely that Polish soldiers will also get involved in the military operations in Somalia. because of a strong possibility that following European military contingents are going to be relocated to East Africa to carry out the mandatory tasks, in relation to the occurrence of difficult climatic conditions and low sanitary standards, it is necessary to undertake appropriate preventive measures before the departure (compulsory/recommended vaccinations, antimalarial chemoprophylaxis, stocks of medicines to be taken by soldiers for an extended period of time, prevention and treatment kits), throughout the deployment (acclimatization, avoiding alcohol, water and electrolytes replenishment, using antimalarial chemoprophylaxis and repellents), and after returning from the area of operation (terminal chemoprophylaxis of malaria, reporting any health problem to health care facilities).

Some Like It Hot: The Influence and Implications of Climate Change on Coffee Berry Borer (Hypothenemus hampei) and Coffee Production in East Africa

PubMed Central

Vega, Fernando E.; Davis, Aaron; Borgemeister, Christian; Chabi-Olaye, Adenirin

2011-01-01

The negative effects of climate change are already evident for many of the 25 million coffee farmers across the tropics and the 90 billion dollar (US) coffee industry. The coffee berry borer (Hypothenemus hampei), the most important pest of coffee worldwide, has already benefited from the temperature rise in East Africa: increased damage to coffee crops and expansion in its distribution range have been reported. In order to anticipate threats and prioritize management actions for H. hampei we present here, maps on future distributions of H. hampei in coffee producing areas of East Africa. Using the CLIMEX model we relate present-day insect distributions to current climate and then project the fitted climatic envelopes under future scenarios A2A and B2B (for HADCM3 model). In both scenarios, the situation with H. hampei is forecasted to worsen in the current Coffea arabica producing areas of Ethiopia, the Ugandan part of the Lake Victoria and Mt. Elgon regions, Mt. Kenya and the Kenyan side of Mt. Elgon, and most of Rwanda and Burundi. The calculated hypothetical number of generations per year of H. hampei is predicted to increase in all C. arabica-producing areas from five to ten. These outcomes will have serious implications for C. arabica production and livelihoods in East Africa. We suggest that the best way to adapt to a rise of temperatures in coffee plantations could be via the introduction of shade trees in sun grown plantations. The aims of this study are to fill knowledge gaps existing in the coffee industry, and to draft an outline for the development of an adaptation strategy package for climate change on coffee production. An abstract in Spanish is provided as Abstract S1. PMID:21935419

Perspectives of resettled African refugees on accessing medicines and pharmacy services in Queensland, Australia.

PubMed

Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

2017-10-01

The aim of this study was to explore the barriers to accessing medicines and pharmacy services among refugees in Queensland, Australia, from the perspectives of resettled African refugees. A generic qualitative approach was used in this study. Resettled African refugees were recruited via a purposive snowball sampling method. The researcher collected data from different African refugee communities, specifically those from Sudanese, Congolese and Somalian communities. Participants were invited by a community health leader to participate in the study; a community health leader is a trained member of the refugee community who acts as a 'health information conduit' between refugees and the health system. Invitations were done either face-to-face, telephonically or by email. The focus groups were digitally recorded in English and transcribed verbatim by the researcher. Transcripts were entered into NVIVO© 11 and the data were analysed using inductive thematic analysis. Four focus groups were conducted between October and November 2014 in the city of Brisbane with African refugees, one with five Somali refugees, one with five Congolese refugees, one with three refugee community health leaders from South Sudan, Liberia and Eritrea and one with three refugee community health leaders from Uganda, Burundi and South Sudan. Eleven sub-themes emerged through the coding process, which resulted in four overarching themes: health system differences, navigating the Australian health system, communication barriers and health care-seeking behaviour. With regard to accessing medicines and pharmacy services, this study has shown that there is a gap between resettled refugees' expectations of health services and the reality of the Australian health system. Access barriers identified included language barriers, issues with the Translating and Interpreter Service, a lack of professional communication and cultural beliefs affecting health care-seeking behaviour. This exploratory study has established a foundation for further research into the barriers to accessing medicines and pharmacy services for resettled refugees. The findings are likely to be applicable to a wider population. © 2016 Royal Pharmaceutical Society.

Identifying Water Insecurity Hotspots in the Lake Victoria Basin of Eastern Africa

NASA Astrophysics Data System (ADS)

Pricope, N. G.; Shukla, S.; Linard, C.; Gaughan, A.

2014-12-01

The Lake Victoria Basin (LVB), one of Africa's most populated transboundary watersheds and home to more than 30 million inhabitants, is increasingly challenged by both water quality problems and water quantity shortages against a backdrop of climate variability and change; and other environmental challenges. As a result of pollution, droughts, more erratic rainfall, heightened demand for water for both consumption and agricultural needs as well as differences in water allocation among the riverine countries of Uganda, Tanzania, Kenya, Rwanda and Burundi, many parts of this region are already experiencing water scarcity on a recurrent basis. Furthermore, given projected annual population growth rates of 2.5 to 3.5% for the next 20 years, water shortages are likely to be exacerbated in the future. Analyzing historical changes in the water resources of this region is hence important to identify "hot spots" that might be most sensitive to future changes in climate and demography. In this presentation, we report the findings of a comprehensive analysis performed to (i) examine changes in water resources of LVB in recent decades and (ii) identify overlap between regions of significant changes in water resources with land cover changes and high population centers that are also projected to grow the fastest over the coming decades. We first utilize several satellite, stations and model(s) based climatic and hydrologic datasets to assess changes in water resources in this region. We then use a quality-controlled Moderate Resolution Imaging Spectroradiometer (MODIS) land cover product to identify areas of significant land cover changes. Simultaneously we use projections of gridded population density based on differential growth rates for rural and urban population to estimate fastest projected human population growth for 2030 and 2050 relative to 2010 data. Using the outcomes of these change analysis we identify water insecurity hotspots in the LVB.

A potato model intercomparison across varying climates and productivity levels.

PubMed

Fleisher, David H; Condori, Bruno; Quiroz, Roberto; Alva, Ashok; Asseng, Senthold; Barreda, Carolina; Bindi, Marco; Boote, Kenneth J; Ferrise, Roberto; Franke, Angelinus C; Govindakrishnan, Panamanna M; Harahagazwe, Dieudonne; Hoogenboom, Gerrit; Naresh Kumar, Soora; Merante, Paolo; Nendel, Claas; Olesen, Jorgen E; Parker, Phillip S; Raes, Dirk; Raymundo, Rubi; Ruane, Alex C; Stockle, Claudio; Supit, Iwan; Vanuytrecht, Eline; Wolf, Joost; Woli, Prem

2017-03-01

A potato crop multimodel assessment was conducted to quantify variation among models and evaluate responses to climate change. Nine modeling groups simulated agronomic and climatic responses at low-input (Chinoli, Bolivia and Gisozi, Burundi)- and high-input (Jyndevad, Denmark and Washington, United States) management sites. Two calibration stages were explored, partial (P1), where experimental dry matter data were not provided, and full (P2). The median model ensemble response outperformed any single model in terms of replicating observed yield across all locations. Uncertainty in simulated yield decreased from 38% to 20% between P1 and P2. Model uncertainty increased with interannual variability, and predictions for all agronomic variables were significantly different from one model to another (P < 0.001). Uncertainty averaged 15% higher for low- vs. high-input sites, with larger differences observed for evapotranspiration (ET), nitrogen uptake, and water use efficiency as compared to dry matter. A minimum of five partial, or three full, calibrated models was required for an ensemble approach to keep variability below that of common field variation. Model variation was not influenced by change in carbon dioxide (C), but increased as much as 41% and 23% for yield and ET, respectively, as temperature (T) or rainfall (W) moved away from historical levels. Increases in T accounted for the highest amount of uncertainty, suggesting that methods and parameters for T sensitivity represent a considerable unknown among models. Using median model ensemble values, yield increased on average 6% per 100-ppm C, declined 4.6% per °C, and declined 2% for every 10% decrease in rainfall (for nonirrigated sites). Differences in predictions due to model representation of light utilization were significant (P < 0.01). These are the first reported results quantifying uncertainty for tuber/root crops and suggest modeling assessments of climate change impact on potato may be improved using an ensemble approach. © 2016 John Wiley & Sons Ltd.

Half of rifampicin-resistant Mycobacterium tuberculosis complex isolated from tuberculosis patients in Sub-Saharan Africa have concomitant resistance to pyrazinamide

PubMed Central

Diallo, Awa Ba; Tagliani, Elisa; Diarra, Bassirou; Kadanga, Abalo Essosimna; Togo, Antieme Combo George; Thiam, Aliou; de Rijk, Willem Bram; Alagna, Riccardo; Houeto, Sabine; Ba, Fatoumata; Dagnra, Anoumou Yaotsè; Ivan, Emil; Affolabi, Dissou; Schwoebel, Valérie; Trebucq, Arnaud; de Jong, Bouke Catherine; Rigouts, Leen; Daneau, Géraldine

2017-01-01

Background Besides inclusion in 1st line regimens against tuberculosis (TB), pyrazinamide (PZA) is used in 2nd line anti-TB regimens, including in the short regimen for multidrug-resistant TB (MDR-TB) patients. Guidelines and expert opinions are contradictory about inclusion of PZA in case of resistance. Moreover, drug susceptibility testing (DST) for PZA is not often applied in routine testing, and the prevalence of resistance is unknown in several regions, including in most African countries. Methods Six hundred and twenty-three culture isolates from rifampicin-resistant (RR) patients were collected in twelve Sub-Saharan African countries. Among those isolates, 71% were from patients included in the study on the Union short-course regimen for MDR-TB in Benin, Burkina Faso, Burundi, Cameroon, Central Africa Republic, the Democratic Republic of the Congo, Ivory Coast, Niger, and Rwanda PZA resistance, and the rest (29%) were consecutive isolates systematically stored from 2014–2015 in Mali, Rwanda, Senegal, and Togo. Besides national guidelines, the isolates were tested for PZA resistance through pncA gene sequencing. Results Over half of these RR-TB isolates (54%) showed a mutation in the pncA gene, with a significant heterogeneity between countries. Isolates with fluoroquinolone resistance (but not with injectable resistance or XDR) were more likely to have concurrent PZA resistance. The pattern of mutations in the pncA gene was quite diverse, although some isolates with an identical pattern of mutations in pncA and other drug-related genes were isolated from the same reference center, suggesting possible transmission of these strains. Conclusion Similar to findings in other regions, more than half of the patients having RR-TB in West and Central Africa present concomitant resistance to PZA. Further investigations are needed to understand the relation between resistance to PZA and resistance to fluoroquinolones, and whether continued use of PZA in the face of PZA resistance provides clinical benefit to the patients. PMID:29088294

HIV spreading among women and children in Asia and Eastern Europe.

PubMed

1996-12-16

This December 16, 1996, article gives some statistics published in "HIV/AIDS: The Global Epidemic," recently released by the United Nations Agency on AIDS (UNAIDS). 25% of all deaths (6.4 million total) due to acquired immunodeficiency syndrome (AIDS) occurred within the last year. 3.1 million persons were infected with human immunodeficiency virus (HIV) in 1996; the total number of HIV/AIDS cases is 22.6 million. About 90% of HIV/AIDS cases live in developing countries. Most of the newly infected adults (2.7 million total) are younger than 25; 50% are women. In 1996, 400,000 children were infected with HIV; the total number of cases in children is 830,000. Drug abuse and sexually transmitted diseases (STDs) are responsible for the rapid spread of HIV in central and eastern Europe. In Nikolayev (Ukraine), the proportion of HIV cases among injecting drug users rose from 1.7% in January 1995 to 56.5% 11 months later. In Kaliningrad (Russia), the number of reported cases increased from 21 to 387 since January 1996. These countries do not have the infrastructure to provide programs. Figures cited from the Chinese Academy of Preventive Medicine show that the number of cases of HIV in China rose from 10,000 at the end of 1993 to 100,000 by the end of 1995. In Vietnam, HIV rates among prostitutes increased from 9% in 1992 to 38% in 1994. Sub-Saharan Africa has 14 million cases (63% of the world total). Refugees in Rwanda and Burundi come from areas where over 20% of pregnant women, and 50% of those with other STDs, have HIV. In South Africa's Free State, HIV rates among pregnant women grew from 1/25 to greater than 1/10, in 2 years. In El Salvador, according to one study of female sex workers, the HIV rate among 15- to 19-year-olds was 3.1%, as opposed to 2.2% overall. Dr. Peter Piot, of UNAIDS, urges promotion of safe sex programs for women and development of a vaccine.

Encouraging self-development. Profile: Louise Lassonde.

PubMed

Rowley, J

1992-01-01

A profile of Louise Lassonde, population advisor to the UN Conference on Environment and Development (UNCED) portrays her ethnic and educational background, her interests, and achievements. She was born a French Canadian near Montreal and earned a degree in anthropology with an emphasis on the ancient cultures of Peru. A second degree was earned in sociology and a Ph.D. in demography. In her investigations, it was discovered that there were few remnants of the old Indian culture remaining in the Andean highlands; Quechua and Spanish languages were learned in the process. Her professional responsibilities have included university teaching in development and demography in Montreal, development assistance work in Burundi, Rwanda, and eastern Zaire as regional director for a Canadian nongovernmental organization, and consultancy activities for UNICEF and UNFPA. As a consultant, she was engaged in studying women and their ways of generating income and improving the quality of their lives. In 1989, her position was as country director to Togo and Benin within the UN Population Fund followed by a position in the UNCED secretariat in Geneva. Her field experience has contributed to a view that time is precious and that there is accountability for action or inaction. A little bit of effort can go a long way, i.e., improved management and information and good will. The assumption is that people have the will and desire to improve their own and their families as long as there is hope and freedom from a discouraging atmosphere. Lack of understanding can create tremendous barriers. The example is given of a man presenting with malaria at an African health center and not being treated because of his tribal affiliation; he died when medicine was within reach. Support must be provided in terms of health and education so that people can set the targets for themselves and develop creative solutions compatible with their own cultures. Her positive approach is visible in her insistence that population issues be included in preparatory documents. She helped prepare a chapter in Agenda 21, the draft action plan for the Earth Summit in Rio de Janeiro which established the principle of stabilization of world population.

The modern Nile sediment system: Processes and products

NASA Astrophysics Data System (ADS)

Garzanti, Eduardo; Andò, Sergio; Padoan, Marta; Vezzoli, Giovanni; El Kammar, Ahmed

2015-12-01

We trace compositional changes of Nile sediments for 7400 km, from their sources in equatorial rift highlands of Burundi and Rwanda to their sink in the Mediterranean Sea. All chemical and physical controls on sediment petrography, mineralogy and geochemistry, including weathering, grain-size, hydraulic sorting, mechanical breakdown, anthropic impact, mixing and recycling are investigated in detail. The Nile course is controlled along its entire length by the East African-Red Sea Rift. In this anorogenic setting, detritus is derived in various proportions from volcanic fields associated with tectonic extension (Anorogenic Volcanic provenance) and from igneous, metamorphic and sedimentary rocks uplifted on the rift shoulders or exposed on the craton (Continental Block provenance). The entire spectrum of such detrital signatures is displayed in the Nile catchment. Volcaniclastic Atbara sand is generated by focused erosion of the Ethiopian basaltic plateau in semiarid climate, whereas quartzose White Nile sand reflects low erosion rates, extensive weathering and sediment trapping in lakes and swamps at equatorial to subequatorial latitudes. In the main Nile, as in its main tributary the Blue Nile, suspended load is volcaniclastic, whereas feldspatho-quartzose bedload is derived largely from basement sources, with fine to medium-grained eolian sand added along the lower course. Mixing of detrital populations with different provenance and grain size is reflected in diverse violations of settling-equivalence relationships in fluvial and deltaic sediments. Sediment delivery from Sudan has been cut off after closure of the Aswan High Dam and accelerated erosion of deltaic cusps is leading to local formation of placer lags dominated by ultradense Fe-Ti-Cr oxides, but mineralogical changes caused by man's radical modification of fluvial regimes have been minor so far. In beaches of Sinai, Gaza and Israel, the Nile volcaniclastic trace gets progressively diluted by quartzose sand recycled from eolian coastal deposits and carbonaticlastic detritus eroded from the Levant rift shoulder. Studying the compositional variability of modern sediments in big-river systems allows us to appreciate the richness of natural processes occurring in the vast drainage basin, and provides us with a key to understand the information stored in sedimentary archives and to reconstruct the evolution of the Earth's surface from the recent to the less recent past.

State-building and human resources for health in fragile and conflict-affected states: exploring the linkages.

PubMed

Witter, Sophie; Falisse, Jean-Benoit; Bertone, Maria Paola; Alonso-Garbayo, Alvaro; Martins, João S; Salehi, Ahmad Shah; Pavignani, Enrico; Martineau, Tim

2015-05-15

Human resources for health are self-evidently critical to running a health service and system. There is, however, a wider set of social issues which is more rarely considered. One area which is hinted at in literature, particularly on fragile and conflict-affected states, but rarely examined in detail, is the contribution which health staff may or do play in relation to the wider state-building processes. This article aims to explore that relationship, developing a conceptual framework to understand what linkages might exist and looking for empirical evidence in the literature to support, refute or adapt those linkages. An open call for contributions to the article was launched through an online community. The group then developed a conceptual framework and explored a variety of literatures (political, economic, historical, public administration, conflict and health-related) to find theoretical and empirical evidence related to the linkages outlined in the framework. Three country case reports were also developed for Afghanistan, Burundi and Timor-Leste, using secondary sources and the knowledge of the group. We find that the empirical evidence for most of the linkages is not strong, which is not surprising, given the complexity of the relationships. Nevertheless, some of the posited relationships are plausible, especially between development of health cadres and a strengthened public administration, which in the long run underlies a number of state-building features. The reintegration of factional health staff post-conflict is also plausibly linked to reconciliation and peace-building. The role of medical staff as part of national elites may also be important. The concept of state-building itself is highly contested, with a rich vein of scepticism about the wisdom or feasibility of this as an external project. While recognizing the inherently political nature of these processes, systems and sub-systems, it remains the case that state-building does occur over time, driven by a combination of internal and external forces and that understanding the role played in it by the health system and health staff, particularly after conflicts and in fragile settings, is an area worth further investigation. This review and framework contribute to that debate.

Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries.

PubMed

Ruktanonchai, Corrine W; Ruktanonchai, Nick W; Nove, Andrea; Lopes, Sofia; Pezzulo, Carla; Bosco, Claudio; Alegana, Victor A; Burgert, Clara R; Ayiko, Rogers; Charles, Andrew Sek; Lambert, Nkurunziza; Msechu, Esther; Kathini, Esther; Matthews, Zoë; Tatem, Andrew J

2016-01-01

Geographic accessibility to health facilities represents a fundamental barrier to utilisation of maternal and newborn health (MNH) services, driving historically hidden spatial pockets of localized inequalities. Here, we examine utilisation of MNH care as an emergent property of accessibility, highlighting high-resolution spatial heterogeneity and sub-national inequalities in receiving care before, during, and after delivery throughout five East African countries. We calculated a geographic inaccessibility score to the nearest health facility at 300 x 300 m using a dataset of 9,314 facilities throughout Burundi, Kenya, Rwanda, Tanzania and Uganda. Using Demographic and Health Surveys data, we utilised hierarchical mixed effects logistic regression to examine the odds of: 1) skilled birth attendance, 2) receiving 4+ antenatal care visits at time of delivery, and 3) receiving a postnatal health check-up within 48 hours of delivery. We applied model results onto the accessibility surface to visualise the probabilities of obtaining MNH care at both high-resolution and sub-national levels after adjusting for live births in 2015. Across all outcomes, decreasing wealth and education levels were associated with lower odds of obtaining MNH care. Increasing geographic inaccessibility scores were associated with the strongest effect in lowering odds of obtaining care observed across outcomes, with the widest disparities observed among skilled birth attendance. Specifically, for each increase in the inaccessibility score to the nearest health facility, the odds of having skilled birth attendance at delivery was reduced by over 75% (0.24; CI: 0.19-0.3), while the odds of receiving antenatal care decreased by nearly 25% (0.74; CI: 0.61-0.89) and 40% for obtaining postnatal care (0.58; CI: 0.45-0.75). Overall, these results suggest decreasing accessibility to the nearest health facility significantly deterred utilisation of all maternal health care services. These results demonstrate how spatial approaches can inform policy efforts and promote evidence-based decision-making, and are particularly pertinent as the world shifts into the Sustainable Goals Development era, where sub-national applications will become increasingly useful in identifying and reducing persistent inequalities.

Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries

PubMed Central

Ruktanonchai, Nick W.; Nove, Andrea; Lopes, Sofia; Pezzulo, Carla; Bosco, Claudio; Alegana, Victor A.; Burgert, Clara R.; Ayiko, Rogers; Charles, Andrew SEK; Lambert, Nkurunziza; Msechu, Esther; Kathini, Esther; Matthews, Zoë; Tatem, Andrew J.

2016-01-01

Background Geographic accessibility to health facilities represents a fundamental barrier to utilisation of maternal and newborn health (MNH) services, driving historically hidden spatial pockets of localized inequalities. Here, we examine utilisation of MNH care as an emergent property of accessibility, highlighting high-resolution spatial heterogeneity and sub-national inequalities in receiving care before, during, and after delivery throughout five East African countries. Methods We calculated a geographic inaccessibility score to the nearest health facility at 300 x 300 m using a dataset of 9,314 facilities throughout Burundi, Kenya, Rwanda, Tanzania and Uganda. Using Demographic and Health Surveys data, we utilised hierarchical mixed effects logistic regression to examine the odds of: 1) skilled birth attendance, 2) receiving 4+ antenatal care visits at time of delivery, and 3) receiving a postnatal health check-up within 48 hours of delivery. We applied model results onto the accessibility surface to visualise the probabilities of obtaining MNH care at both high-resolution and sub-national levels after adjusting for live births in 2015. Results Across all outcomes, decreasing wealth and education levels were associated with lower odds of obtaining MNH care. Increasing geographic inaccessibility scores were associated with the strongest effect in lowering odds of obtaining care observed across outcomes, with the widest disparities observed among skilled birth attendance. Specifically, for each increase in the inaccessibility score to the nearest health facility, the odds of having skilled birth attendance at delivery was reduced by over 75% (0.24; CI: 0.19–0.3), while the odds of receiving antenatal care decreased by nearly 25% (0.74; CI: 0.61–0.89) and 40% for obtaining postnatal care (0.58; CI: 0.45–0.75). Conclusions Overall, these results suggest decreasing accessibility to the nearest health facility significantly deterred utilisation of all maternal health care services. These results demonstrate how spatial approaches can inform policy efforts and promote evidence-based decision-making, and are particularly pertinent as the world shifts into the Sustainable Goals Development era, where sub-national applications will become increasingly useful in identifying and reducing persistent inequalities. PMID:27561009

Prevalence, distribution, and social determinants of tobacco use in 30 sub-Saharan African countries.

PubMed

Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Mansingh; Sin, Shwe

2014-12-18

Although the Framework Convention on Tobacco Control prioritizes monitoring of tobacco use by population-based surveys, information about the prevalence and patterns of tobacco use in sub-Saharan Africa is limited. We provide country-level prevalence estimates for smoking and smokeless tobacco (SLT) use and assess their social determinants. We analyzed population-based data of the most recent Demographic Health Surveys performed between 2006 and 2013 involving men and women in 30 sub-Saharan African countries. Weighted country-level prevalence rates were estimated for 'current smoking' (cigarettes, pipe, cigars, etc.) and 'current SLT use' (chewing, snuff, etc.). From the pooled datasets for men and women, social determinants of smoking and SLT use were assessed through multivariate analyses using a dummy country variable as a control and by including a within-country sample weight for each country. Among men, smoking prevalence rates were high in Sierra Leone (37.7%), Lesotho (34.1%), and Madagascar (28.5%); low (<10%) in Ethiopia, Benin, Ghana, Nigeria, and Sao Tome & Principe; the prevalence of SLT use was <10% in all countries except for Madagascar (24.7%) and Mozambique (10.9%). Among women, smoking and SLT prevalence rates were <5% in most countries except for Burundi (9.9%), Sierra Leone (6%), and Namibia (5.9%) (smoking), and Madagascar (19.6%) and Lesotho (9.1%) (SLT use). The proportion of females who smoked was lower than SLT users in most countries. Older age was strongly associated with both smoking and SLT use among men and women. Smoking among both men and women was weakly associated, but SLT use was strongly associated, with education. Similarly, smoking among men and women was weakly associated, but SLT use was strongly associated, with the wealth index. Smoking and SLT use were also associated with marital status among both men and women, as well as with occupation (agriculturists and unskilled workers). Prevalence of smoking among women was much lower than in men, although the social patterns of tobacco use were similar to those in men. Tobacco control strategies should target the poor, not/least educated, and agricultural and unskilled workers, who are the most vulnerable social groups in sub-Saharan Africa.

Drought vulnerability assessment for prioritising drought warning implementation

NASA Astrophysics Data System (ADS)

Naumann, Gustavo; Faneca Sànchez, Marta; Mwangi, Emmah; Barbosa, Paulo; Iglesias, Ana; Garrote, Luis; Werner, Micha

2014-05-01

Drought warning provides a potentially efficient approach to mitigation of drought impacts, and should be targeted at areas most vulnerable to being adversely impacted. Assessing drought vulnerability is, however, complex and needs to consider susceptibility to drought impact as well as the capacity to cope with drought. In this paper a Drought Vulnerability Index (DVI) is proposed that considers four primary components that reflect the capacity of society to adapt to drought; the renewable natural capital, the economic capacity, the human and civic resources, and the available infrastructure and technology. The DVI is established as a weighted combination of these four components, each a composite of selected indicators. Constituent indicators are calculated based on national and/or regional census data and statistics, and while the resulting DVI should not be considered an absolute measure of drought vulnerability it does provide for a prioritisation of areas that can be used to target drought warning efforts. Sensitivity analysis of weights applied show the established DVI to be robust. Through the DVI the development of drought forecasting and warning can be targeted at the most vulnerable areas. The proposed DVI is applied at both the continental scale in Africa to assess drought vulnerability of the different nations across Africa, and at the national level in Kenya, allowing for prioritisation of the counties within Kenya to drought vulnerability. Results show the relative vulnerability of countries and counties vulnerable to drought. At the continental scale, Somalia, Burundi, Niger, Ethiopia, Mali and Chad are found to be the countries most vulnerable to drought. At the national level, the relative vulnerability of the counties across Kenya is found, with counties in the North-East of Kenya having the highest values of DVI. At the country level results were compared with drought disaster information from the EM-DAT disaster database, showing a good agreement between recorded drought impact and the established DVI classes. Kenya counties most vulnerable to drought are primarily located in the North-East of the country, showing a reasonable agreement with the spatial distribution of impacts of the 2010/2011 drought, despite the drought itself being more widespread.

A methodology to track temporal dynamics and rainfall thresholds of landslide processes in the East African Rift

NASA Astrophysics Data System (ADS)

Monsieurs, Elise; Jacobs, Liesbet; Kervyn, François; Kirschbaum, Dalia; d'Oreye, Nicolas; Derauw, Dominique; Kervyn, Matthieu; Nobile, Adriano; Trefois, Philippe; Dewitte, Olivier

2015-04-01

The East African rift valley is a major tectonic feature that shapes Central Africa and defines linear-shaped lowlands between highland ranges due to the action of geologic faults associated to earthquakes and volcanism. The region of interest, covering the Virunga Volcanic Province in eastern DRC, western Rwanda and Burundi, and southwest Uganda, is threatened by a rare combination of several types of geohazards, while it is also one of the most densely populated region of Africa. These geohazards can globally be classified as seismic, volcanic and landslide hazards. Landslides, include a wide range of ground movements, such as rock falls, deep failure of slopes and shallow debris flows. Landslides are possibly the most important geohazard in terms of recurring impact on the populations, causing fatalities every year and resulting in structural and functional damage to infrastructure and private properties, as well as serious disruptions of the organization of societies. Many landslides are observed each year in the whole region, and their occurrence is clearly linked to complex topographic, lithologic and vegetation signatures coupled with heavy rainfall events, which is the main triggering factor. The source mechanisms underlying landslide triggering and dynamics in the region of interest are still poorly understood, even though in recent years, some progress has been made towards appropriate data collection. Taking into account difficulties of field accessibility, we present a methodology to study landslide processes by multi-scale and multi-sensor remote sensing data from very high to low resolution (Pléiades, TRMM, CosmoSkyMed, Sentinel). The research will address the evolution over time of such data combined with other earth observations (seismic ground based networks, catalogues, rain gauge networks, GPS surveying, field observations) to detect and study landslide occurrence, dynamics and evolution. This research aims to get insights into the rainfall thresholds that trigger and control the different types of landslide in this region of the East African Rift. A specific attention will be given to the landslide processes in relation to volcanic activity and earthquakes.

Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activities.

PubMed

Cailhol, Johann; Craveiro, Isabel; Madede, Tavares; Makoa, Elsie; Mathole, Thubelihle; Parsons, Ann Neo; Van Leemput, Luc; Biesma, Regien; Brugha, Ruairi; Chilundo, Baltazar; Lehmann, Uta; Dussault, Gilles; Van Damme, Wim; Sanders, David

2013-10-25

Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries' responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation of internal migration of HRH, sometimes in collaboration with GHIs. Sustainable HRH strengthening is a complex process, depending mostly on HRH production and retention factors, these factors being country-specific. GHIs could assist in these strategies, provided that they are flexible enough to incorporate country-specific needs in terms of funding, that they coordinate at global-level and minimise conditionality for countries.

Adult HIV care resources, management practices and patient characteristics in the Phase 1 IeDEA Central Africa cohort

PubMed Central

Divaris, Kimon; Newman, Jamie; Hemingway-Foday, Jennifer; Akam, Wilfred; Balimba, Ashu; Dusengamungu, Cyrille; Kalenga, Lucien; Mbaya, Marcel; Molu, Brigitte Mfangam; Mugisha, Veronicah; Mukumbi, Henri; Mushingantahe, Jules; Nash, Denis; Niyongabo, Théodore; Atibu, Joseph; Azinyue, Innocent; Kiumbu, Modeste; Woelk, Godfrey

2012-01-01

Introduction Despite recent advances in the management of HIV infection and increased access to treatment, prevention, care and support, the HIV/AIDS epidemic continues to be a major global health problem, with sub-Saharan Africa suffering by far the greatest humanitarian, demographic and socio-economic burden of the epidemic. Information on HIV/AIDS clinical care and established cohorts’ characteristics in the Central Africa region are sparse. Methods A survey of clinical care resources, management practices and patient characteristics was undertaken among 12 adult HIV care sites in four countries of the International Epidemiologic Databases to Evaluate AIDS Central Africa (IeDEA-CA) Phase 1 regional network in October 2009. These facilities served predominantly urban populations and offered primary care in the Democratic Republic of Congo (DRC; six sites), secondary care in Rwanda (two sites) and tertiary care in Cameroon (three sites) and Burundi (one site). Results Despite some variation in facility characteristics, sites reported high levels of monitoring resources, including electronic databases, as well as linkages to prevention of mother-to-child HIV transmission programs. At the time of the survey, there were 21,599 HIV-positive adults (median age=37 years) enrolled in the clinical cohort. Though two-thirds were women, few adults (6.5%) entered HIV care through prevention of mother-to-child transmission services, whereas 55% of the cohort entered care through voluntary counselling and testing. Two-thirds of patients at sites in Cameroon and DRC were in WHO Stage III and IV at baseline, whereas nearly all patients in the Rwanda facilities with clinical stage information available were in Stage I and II. WHO criteria were used for antiretroviral therapy initiation. The most common treatment regimen was stavudine/lamivudine/nevirapine (64%), followed by zidovudine/lamivudine/nevirapine (19%). Conclusions Our findings demonstrate the feasibility of establishing large clinical cohorts of HIV-positive individuals in a relatively short amount of time in spite of challenges experienced by clinics in resource-limited settings such as those in this region. Country differences in the cohort's site and patient characteristics were noted. This information sets the stage for the development of research initiatives and additional programs to enhance adult HIV care and treatment in Central Africa. PMID:23199800

Widespread rape does not directly appear to increase the overall HIV prevalence in conflict-affected countries: so now what?

PubMed Central

Anema, Aranka; Joffres, Michel R; Mills, Edward; Spiegel, Paul B

2008-01-01

Background Sub-Saharan Africa (SSA) is severely affected by HIV/AIDS and conflict. Sexual violence as a weapon of war has been associated with concerns about heightened HIV incidence among women. Widespread rape by combatants has been documented in Burundi, Sierra Leone, Rwanda, Democratic Republic of Congo, Liberia, Sudan and Uganda. To examine the assertion that widespread rape may not directly increase HIV prevalence at the population level, we built a model to determine the potential impact of varying scenarios of widespread rape on HIV prevalence in the above seven African countries. Discussion Our findings show that even in the most extreme situations, where 15% of the female population was raped, where HIV prevalence among assailants was 8 times the country population prevalence, and where the HIV transmission rate was highest at 4 times the average high rate, widespread rape increased the absolute HIV prevalence of these countries by only 0.023%. These projections support the finding that widespread rape in conflict-affected countries in SSA has not incurred a major direct population-level change in HIV prevalence. However, this must not be interpreted to say that widespread rape does not pose serious problems to women's acquisition of HIV on an individual basis or in specific settings. Furthermore, direct and indirect consequences of sexual violence, such as physical and psychosocial trauma, unwanted pregnancies, and stigma and discrimination cannot be understated. Summary The conclusions of this article do not significantly change current practices in the field from an operational perspective. Proper care and treatment must be provided to every survivor of rape regardless of the epidemiological effects of HIV transmission at the population level. Sexual violence must be treated as a protection issue and not solely a reproductive health and psychosocial issue. It is worth publishing data and conclusions that could be misconstrued and may not make much of a programmatic difference in the field. Data, if collected, analysed and interpreted carefully, help to improve our understanding of complicated and nuanced situations. Ultimately, our understanding of what the outcomes of such interventions can achieve will be more realistic. It also helps decision-makers prioritise their funding and interventions. PMID:18664265

Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activities

PubMed Central

2013-01-01

Background Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. Methods A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries’ responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. Results In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation of internal migration of HRH, sometimes in collaboration with GHIs. Conclusion Sustainable HRH strengthening is a complex process, depending mostly on HRH production and retention factors, these factors being country-specific. GHIs could assist in these strategies, provided that they are flexible enough to incorporate country-specific needs in terms of funding, that they coordinate at global-level and minimise conditionality for countries. PMID:24160182

Exploring drought vulnerability in Africa: an indicator based analysis to be used in early warning systems

NASA Astrophysics Data System (ADS)

Naumann, G.; Barbosa, P.; Garrote, L.; Iglesias, A.; Vogt, J.

2014-05-01

We propose a composite drought vulnerability indicator (DVI) that reflects different aspects of drought vulnerability evaluated at Pan-African level for four components: the renewable natural capital, the economic capacity, the human and civic resources, and the infrastructure and technology. The selection of variables and weights reflects the assumption that a society with institutional capacity and coordination, as well as with mechanisms for public participation, is less vulnerable to drought; furthermore, we consider that agriculture is only one of the many sectors affected by drought. The quality and accuracy of a composite indicator depends on the theoretical framework, on the data collection and quality, and on how the different components are aggregated. This kind of approach can lead to some degree of scepticism; to overcome this problem a sensitivity analysis was done in order to measure the degree of uncertainty associated with the construction of the composite indicator. Although the proposed drought vulnerability indicator relies on a number of theoretical assumptions and some degree of subjectivity, the sensitivity analysis showed that it is a robust indicator and hence able of representing the complex processes that lead to drought vulnerability. According to the DVI computed at country level, the African countries classified with higher relative vulnerability are Somalia, Burundi, Niger, Ethiopia, Mali and Chad. The analysis of the renewable natural capital component at sub-basin level shows that the basins with high to moderate drought vulnerability can be subdivided into the following geographical regions: the Mediterranean coast of Africa; the Sahel region and the Horn of Africa; the Serengeti and the Eastern Miombo woodlands in eastern Africa; the western part of the Zambezi Basin, the southeastern border of the Congo Basin, and the belt of Fynbos in the Western Cape province of South Africa. The results of the DVI at the country level were compared with drought disaster information from the EM-DAT disaster database. Even if a cause-effect relationship cannot be established between the DVI and the drought disaster database, a good agreement is observed between the drought vulnerability maps and the number of persons affected by droughts. These results are expected to contribute to the discussion on how to assess drought vulnerability and hopefully contribute to the development of drought early warning systems in Africa.

Anti-malarial market and policy surveys in sub-Saharan Africa.

PubMed

Diap, Graciela; Amuasi, John; Boakye, Isaac; Sevcsik, Ann-Marie; Pecoul, Bernard

2010-04-23

At a recent meeting (Sept 18, 2009) in which reasons for the limited access to artemisinin-based combination therapy (ACT) in sub-Saharan Africa were discussed, policy and market surveys on anti-malarial drug availability and accessibility in Burundi and Sierra Leone were presented in a highly interactive brainstorming session among key stakeholders across private, public, and not-for-profit sectors. The surveys, the conduct of which directly involved the national malaria control programme managers of the two countries, provides the groundwork for evidence-based policy implementation. The results of the surveys could be extrapolated to other countries with similar socio-demographic and malaria profiles. The meeting resulted in recommendations on key actions to be taken at the global, national, and community level for better ACT accessibility. At the global level, both public and private sectors have actions to take to strengthen policies that lead to the replacement of loose blister packs with fixed-dose ACT products, develop strategies to ban inappropriate anti-malarials and regulate those bans, and facilitate technology and knowledge transfer to scale up production of fixed-dose ACT products, which should be readily available and affordable to those patients who are in the greatest need of these medicines. At the national level, policies that regulate the anti-malarial medicines market should be enacted and enforced. The public sector, including funding donors, should participate in ensuring that the private sector is engaged in the ACT implementation process. Research similar to the surveys discussed is important for other countries to develop and evaluate the right incentives at a local level. At the community level, community outreach and education about appropriate preventive and treatment measures must continue and be strengthened, with service delivery systems developed within both public and private sectors, among other measures, to decrease access to ineffective and inappropriate anti-malarial medicines. What was clear during the meeting is that continuing commitment, strengthened interaction and transparency among various stakeholders, with focus on communities, national governments, and evidence-based policy and action are the only way to sustainably address the control of malaria, a disease which continues to have a significant health and socio-economic impact worldwide, particularly in sub-Saharan Africa. Details on the methodology employed in carrying out the studies discussed at this meeting, as well as more detailed results, data analysis and discussion of the studies are soon to be published.

Mitochondrial phylogeography and population structure of the cattle tick Rhipicephalus appendiculatus in the African Great Lakes region.

PubMed

Amzati, Gaston S; Pelle, Roger; Muhigwa, Jean-Berckmans B; Kanduma, Esther G; Djikeng, Appolinaire; Madder, Maxime; Kirschvink, Nathalie; Marcotty, Tanguy

2018-05-31

The ixodid tick Rhipicephalus appendiculatus is the main vector of Theileria parva, wich causes the highly fatal cattle disease East Coast fever (ECF) in sub-Saharan Africa. Rhipicephalus appendiculatus populations differ in their ecology, diapause behaviour and vector competence. Thus, their expansion in new areas may change the genetic structure and consequently affect the vector-pathogen system and disease outcomes. In this study we investigated the genetic distribution of R. appendiculatus across agro-ecological zones (AEZs) in the African Great Lakes region to better understand the epidemiology of ECF and elucidate R. appendiculatus evolutionary history and biogeographical colonization in Africa. Sequencing was performed on two mitochondrial genes (cox1 and 12S rRNA) of 218 ticks collected from cattle across six AEZs along an altitudinal gradient in the Democratic Republic of Congo, Rwanda, Burundi and Tanzania. Phylogenetic relationships between tick populations were determined and evolutionary population dynamics models were assessed by mismach distribution. Population genetic analysis yielded 22 cox1 and 9 12S haplotypes in a total of 209 and 126 nucleotide sequences, respectively. Phylogenetic algorithms grouped these haplotypes for both genes into two major clades (lineages A and B). We observed significant genetic variation segregating the two lineages and low structure among populations with high degree of migration. The observed high gene flow indicates population admixture between AEZs. However, reduced number of migrants was observed between lowlands and highlands. Mismatch analysis detected a signature of rapid demographic and range expansion of lineage A. The star-like pattern of isolated and published haplotypes indicates that the two lineages evolve independently and have been subjected to expansion across Africa. Two sympatric R. appendiculatus lineages occur in the Great Lakes region. Lineage A, the most diverse and ubiquitous, has experienced rapid population growth and range expansion in all AEZs probably through cattle movement, whereas lineage B, the less abundant, has probably established a founder population from recent colonization events and its occurrence decreases with altitude. These two lineages are sympatric in central and eastern Africa and allopatric in southern Africa. The observed colonization pattern may strongly affect the transmission system and may explain ECF endemic instability in the tick distribution fringes.

Improving estimates of insecticide-treated mosquito net coverage from household surveys: using geographic coordinates to account for endemicity

PubMed Central

2014-01-01

Background Coverage estimates of insecticide-treated nets (ITNs) are often calculated at the national level, but are intended to be a proxy for coverage among the population at risk of malaria. The analysis uses data for surveyed households, linking survey enumeration areas (clusters) with levels of malaria endemicity and adjusting coverage estimates based on the population at risk. This analysis proposes an approach that is not dependent on being able to identify malaria risk in a location during the survey design (since survey samples are typically selected on the basis of census sampling frames that do not include information on malaria zones), but rather being able to assign risk zones after a survey has already been completed. Methods The analysis uses data from 20 recent nationally representative Demographic and Health Survey (DHS), Malaria Indicator Surveys (MIS), an AIDS Indicator Survey (AIS), and an Anemia and Malaria Prevalence Survey (AMP). The malaria endemicity classification was assigned from the Malaria Atlas Project (MAP) 2010 interpolated data layers, using the Geographic Positioning System (GPS) location of the survey clusters. National ITN coverage estimates were compared with coverage estimates in intermediate/high endemicity zones (i.e., the population at risk of malaria) to determine whether the difference between estimates was statistically different from zero (p-value <0.5). Results Endemicity varies substantially in eight of the 20 studied countries. In these countries with heterogeneous transmission of malaria, stratification of households by endemicity zones shows that ITN coverage in intermediate/high endemicity zones is significantly higher than ITN coverage at the national level (Burundi, Kenya, Namibia, Rwanda, Tanzania, Senegal, Zambia, and Zimbabwe.). For example in Zimbabwe, the national ownership of ITNs is 28%, but ownership in the intermediate/high endemicity zone is 46%. Conclusion Incorporating this study’s basic and easily reproducible approach into estimates of ITN coverage is applicable and even preferable in countries with areas at no/low risk of malaria and will help ensure that the highest-quality data are available to inform programmatic decisions in countries affected by malaria. The extension of this type of analysis to other malaria interventions can provide further valuable information to support evidence-based decision-making. PMID:24993082

Geological setting and timing of the cassiterite vein type mineralization of the Kalima area (Maniema, Democratic Republic of Congo)

NASA Astrophysics Data System (ADS)

Dewaele, S.; Muchez, Ph; Burgess, R.; Boyce, A.

2015-12-01

The Central African Mesoproterozoic Karagwe-Ankole belt in the Great Lakes area (DRCongo, Rwanda, Burundi, Uganda and Tanzania) forms a metallogenic province that hosts a variety of granite-related mineralization, which contains cassiterite, columbite-tantalite, wolframite/ferberite, spodumene and beryl. The Kalima area in the Maniema province of the DRCongo forms one of the most important areas for cassiterite mineralization in the eastern part of the DRCongo, even after many decades of exploitation. The mineralization dominantly consists of quartz veins that are hosted in Mesoproterozoic metasediments at the contact with granitic rocks of the Kalima granite (Avuanga and Yubuli) or directly crosscutting these granitic rocks (Atondo). Only limited - and mainly unmineralized pegmatites - have been described in the Lutshurukuru area. Mineralized quartz veins - and some granite bodies - intruded following the regional tectonic foliation or existing fracture zones, confirming the late-to post-tectonic origin of the fertile granite system. The emplacement of the quartz veins resulted in an alteration of the metasedimentary and granitic host-rocks, mainly resulting in muscovitization, tourmalinization and silicification. Cassiterite itself formed relatively late during vein formation and is associated with muscovite in fractures in or along the margins of the quartz veins. 40Ar-39Ar age dating of muscovite of an unmineralized pegmatite from the Lutshurukuru area gave an excellent plateau age of 1024 ± 5.5 Ma, while the muscovite associated with mineralization gave plateau ages of 986 ± 5.3 Ma for the Atondo deposit and 992.4 ± 5.4 Ma for the Yubuli deposit. The rather large spread in ages between the supposed parental granite/pegmatite and quartz veins is interpreted to reflect different magmatic events in the evolution of a composite granite system, starting at ∼1020 Ma and ending with mineralized quartz vein formation at ∼990 Ma. The latter age corresponds with the U-Pb age reported for columbite-tantalite in the area (993 ± 1 Ma at Kamisuku), which could be interpreted as the primary formation age of a new generation of mineralized pegmatites in the Kalima area, or as the resetting age of the U-Pb system during the ∼990 Ma mineralizing event. Muscovite of a mineralized greisen sample of Avuanga gave a plateau age with relaxed constraints of 1010.3 ± 5.9 Ma, which has been interpreted as a partially resetting of muscovite formed at ∼1020 Ma age, during the ∼990 Ma event.

Tectono-metamorphic evolution of the Kibuye-Gitarama-Gatumba area (Rwanda): using petrochronology to unravel the geodynamic framework of the Karagwe-Ankole Belt

NASA Astrophysics Data System (ADS)

Van Daele, Johanna; Jacques, Dominique; Hulsbosch, Niels; Dewaele, Stijn; Muchez, Philippe

2017-04-01

The Mesoproterozoic Karagwe-Ankole Belt (KAB) extends from Burundi over Rwanda and NW-Tanzania to S-Uganda (Central Africa). The integration of the metamorphic and magmatic evolution of this orogenic belt in a consistent geodynamic framework is still controversial. Additionally, geochronological information on the deformation phases is limited. This tectono-metamorphic model is, however, a crucial component in the understanding of the Meso- to Early Neoproterozoic mineralization processes. A detailed structural mapping of road and river transects was performed in the Kibuye-Gitarama-Gatumba area (West Rwanda) to determine the deformation history of the KAB. Structural analyses and petrographic studies identified two main compressive deformation phases. A locally observed foliation with a N45W-N50W orientation is interpreted as the consequence of a first compressional phase (D1, shortening direction N40E-N45E). Additionally, a well-developed crenulation cleavage and a regionally pervasive foliation were found. The cleavage and foliation have an orientation of N20W-N30W (exceptionally N20E) and are indicative of a second compressional phase (D2) with an EW shortening direction. Final extension (D3) along a N30W-N10E direction resulted in boudinage and joint development. Fieldwork observations combined with known ages of the granites in the KAB indicate that D1 and D2 took place prior to 986 Ma while D3 is younger than 986 Ma. Based on thin section petrography, a petrochronological strategy was outlined to fill in the gaps of the currently broadly defined timeframe. The regional metamorphic grade of the study area is upper greenschist, with the formation of muscovite, biotite, chlorite, garnet, staurolite and cordierite. The main penetrative tectonic foliations (D1 and D2) are expressed by the preferential orientation of muscovite or biotite. In some cases, muscovite growing along the crenulation cleavage (syn-D2) was observed. Furthermore, pre- and syn-D2 garnets were identified. Different generations of quartz veins (post-dating D3) contain muscovite, garnet and/or biotite. These minerals provide excellent dating possibilities (Ar-Ar, in-situ Rb-Sr and Sm-Nd). The obtained results will be used to refine the chronological aspects of the deformation history of the KAB. Furthermore, these data will be combined with regional structural data, petrographic and geothermobarometric analyses to reconstruct the tectono-metamorphic evolution of the Karagwe-Ankole Belt, which will allow to obtain a better insight in the geodynamic evolution and the ore-forming processes.

Petrology, geochronology and emplacement model of the giant 1.37 Ga arcuate Lake Victoria Dyke Swarm on the margin of a large igneous province in eastern Africa

NASA Astrophysics Data System (ADS)

Mäkitie, Hannu; Data, Gabriel; Isabirye, Edward; Mänttäri, Irmeli; Huhma, Hannu; Klausen, Martin B.; Pakkanen, Lassi; Virransalo, Petri

2014-09-01

A comprehensive description of the petrography, geochemical composition, Sm-Nd data and intrinsic field relationships of a giant arcuate Mesoproterozoic mafic dyke swarm in SW Uganda is presented for the first time. The swarm is ∼100 km wide and mainly hosted in the Palaeoproterozoic Rwenzori Belt between the Mesoproterozoic Karagwe-Ankole Belt and the Archaean Uganda Block. The dykes trend NW-SE across Uganda, but can be correlated across Lake Victoria to another set of arcuate aeromagnetic anomalies that continue southwards into Tanzania, resulting in a remarkably large semi-circular swarm with an outer diameter of ∼500 km. We propose that this unique giant dyke structure be named the Lake Victoria Dyke Swarm (LVDS). The dykes are tholeiites with Mg numbers between 0.69 and 0.44, and with inherited marked negative Nb and P anomalies in spider diagrams. Two dykes provide Sm-Nd mineral ages of 1368 ± 41 Ma and 1374 ± 42 Ma, with initial εNd values of -2.3 and -3.2, and 87Sr/86Sr ratios of ∼0.706-0.709. Geotectonic discrimination diagrams for the swarm exhibit more arc type than within-plate tectonic signatures, but this is in accordance with systematic enrichments in LREE, U and Th in the dolerites, more likely due to the involvement of the continental lithosphere during their petrogenesis. The LVDS is coeval with a regional ∼1375 Ma bimodal magmatic event across nearby Burundi, Rwanda and NW Tanzania, which can collectively be viewed as a large igneous province (LIP). It also indicates that the nearby Karagwe-Ankole Belt sequences - bracketed between 1.78 and 1.37 Ga and assumed by some to have been deposited within intracratonic basins - were capped by flood basalts that have subsequently been removed by erosion. Different geochemical signatures (e.g. LaN/SmN) suggest that most of the arcuate swarm was derived from an enriched SCLM, whereas related intrusions in the centre of this semi-circular segment have more or less enriched asthenospheric mantle source signatures. A model of how the LIP configuration formed, and especially its giant arcuate swarm, requires fortuitous pre-existing structures, an unusually large sub-crustal magma chamber, and/or some very intrinsic rift process. The LIP is apparently related to a global 1.4-1.2 Ga rifting event that led to the break-up of the Columbia/Nuna supercontinent.

Holocene Millennial Time Scale Hydrological Changes In Central-east Africa

NASA Astrophysics Data System (ADS)

Jolly, D.; Bonnefille, R.; Beaufort, L.

The Holocene hydrological changes of a tropical swamp is reconstructed using a high resolution pollen record (ca 50 yrs) from the Kuruyange valley (Burundi, Africa, 3°35'S, 29°41'E), at 2000 m elevation. The sequence was dated by 10 radiocarbon dates, allowing reconstruction between ca 12 500 and 1000 cal yr B.P. In the Kuruyange swamp, peat accumulated rapidly at a sedimentation rate varying from 0.73 (prior to 6200 cal yr B.P.) to 1.51 mm/yr (during the late Holocene). A pollen index of water table, based on a ratio of aquatic versus non-aquatic plants has been used in order to test the hypothesis of hydrological constraints on the swampy ecosystem. Eight arid phases are evidenced by the index minima at 12 200, 11 200, 9900, 8600, 6500, 5000, 3400, 1600 cal yr B.P. The good agreement existing between this index and independent data such as (i) low-resolution East-African lake level reconstruct ions (Gillespie et al., 1983) and (ii) ?18O analyses from Arabian Sea (Sirocko et al., 1993) suggests the water table level responds to the monsoon dynamic. The Index varies periodically with a combination of 1/1515, 1/880 and 1/431 years-1 frequencies, revealed by time series analyses (Blackman-Tukey and Maximum Entropy). The extrapolation of the composite curve based on these 3 periodicities show that two major climatic events defined in the high latitudes between 1000 and 660 cal yr B.P. (Medieval Warm Period) and between 500 and 100 cal yr B.P. (Little Ice Age) are recorded in our data and show respectively high and low stands of the water table. Our results support some previous pollen-derived climate estimates in Ethiopia done by Bonnefille and Umer (1994). Moreover, the "1500 year" cycle registered in our data from the tropics, already evidenced in higher latitudes (Wijmstra et al., 1984; Bondet al., 1997; Schulz et al., 1999; Bond et al., 2001) support the hypothesis of strong teleconnections between tropical/subtropical and polar climates during the deglaciation (Sirocko et al., 1996) and the Holocene. References Bond et al., Science,278, 1257 (1997) Bond et al., Science,294, 2130 (2001) Bonnefille &Umer, Palaeogeography, Palaeoclimatology, Palaeoecology, 109, 331 (1994) Gillespie et al., Nature, 306, 680 (1983) Schulz et al., Geophysical Research Letters, 26, 3385 (1999) Sirocko et al., Nature, 364, 322 (1993) Sirocko et al., Science, 272, 526 (1996) Wijmstra et al., Acta Botanica Neerlandica, 33, 547 (1984)

Religious and cultural traits in HIV/AIDS epidemics in sub-Saharan Africa.

PubMed

Velayati, Ali-Akbar; Bakayev, Valerii; Bahadori, Moslem; Tabatabaei, Seyed-Javad; Alaei, Arash; Farahbood, Amir; Masjedi, Mohammad-Reza

2007-10-01

The pandemic of HIV/AIDS in sub-Saharan Africa and the rise of epidemics in Asia to the previously unforeseen level are likely to have global social, economic, and political impacts. In this emergency, it is vital to reappraise the weight of powerful religious and cultural factors in spreading the disease. The role of Islam in shaping values, norms, and public policies in North African states is to be appreciated for the lowest HIV prevalence in their populations. Yet, the place of religion in prevention of the disease diffusion is not fully understood nor worldwide acknowledged by the primary decision makers. Another topic, which has received little attention to date, despite the abundance of literature concerning the unfortunate Africa's anti-AIDS campaign, is an issue of colonial past. To better comprehend the share of both traits in diverse spread of HIV in sub-Saharan Africa, we studied the correlation between Muslim and Christian proportions in the state's population and HIV rate. By this method, Muslim percentage came out as a potential predictor of HIV prevalence in a given state. In another approach, most subcontinental countries were clustered by colocalization and similarity in their leading religion, colonial past, and HIV seroprevalence starting from barely noticeable (0.6 - 1.2%, for Mauritania, Senegal, Somalia, and Niger) and low levels (1.9 - 4.8%, for Mali, Eritrea, Djibouti, Guinea, Guinea-Bissau, Burkina-Faso, and Chad) for Muslim populated past possessions of France and Italy, in the northern part of the subcontinent. Former territories of France, Belgium, Portugal, and the UK formed two other groups of the countries nearing the equator with Catholic prevailing (Democratic Republic of Congo, Republic of Congo, Rwanda, Gabon, and Burundi) or mixed populations comprising Christian, Muslim, and indigenous believers (Benin, Ghana, Uganda, Togo, Angola, Nigeria, Liberia, Kenya, Cameroon, Côte d'Ivoire, and Sierra-Leone), which covered the HIV prevalence range from 1.9% to 7%. Albeit being traced by origin to the central part of the continent, HIV has reached the highest rates in the South, particularly Malawi (14.2%), Zambia (16.5%), South Africa (21.5%), Zimbabwe (24.6%), Lesotho (28.9%), Botswana (37.3%), and Swaziland (38.8%)-all former British colonies with dominating Christian population. In the group ranking list, a distinct North to South oriented incline in HIV rates related to prevailing religion and previous colonial history of the country was found, endorsing the preventive role of the Islam against rising HIV and the increased vulnerability to menace in states with particular colonial record.

Prevalence of malnutrition among HIV-infected children in Central and West-African HIV-care programmes supported by the Growing Up Programme in 2011: a cross-sectional study.

PubMed

Jesson, Julie; Masson, David; Adonon, Arsène; Tran, Caroline; Habarugira, Capitoline; Zio, Réjane; Nicimpaye, Léoncie; Desmonde, Sophie; Serurakuba, Goreth; Kwayep, Rosine; Sare, Edith; Konate, Tiefing; Nimaga, Abdoulaye; Saina, Philemon; Kpade, Akossiwa; Bassuka, Andrée; Gougouyor, Gustave; Leroy, Valériane

2015-05-26

The burden of malnutrition among HIV-infected children is not well described in sub-Saharan Africa, even though it is an important problem to take into account to guarantee appropriate healthcare for these children. We assessed the prevalence of malnutrition and its associated factors among HIV-infected children in HIV care programmes in Central and West-Africa. A cross-sectional study was conducted from September to December 2011 among the active files of HIV-infected children aged 2-19 years old, enrolled in HIV-care programmes supported by the Sidaction Growing Up Programme in Benin, Burundi, Cameroon, Côte d'Ivoire, Mali, Chad and Togo. Socio-demographics characteristics, anthropometric, clinical data, and nutritional support were collected. Anthropometric indicators, expressed in Z-scores, were used to define malnutrition: Height-for-age (HAZ), Weight-for-Height (WHZ) for children < 5 years and BMI-for-age (BAZ) for children ≥5 years. Three types of malnutrition were defined: acute malnutrition (WHZ/BAZ < -2 SD and HAZ ≥ -2 SD), chronic malnutrition (HAZ < -2 SD and WHZ/BAZ ≥ -2 SD) and mixed malnutrition (WHZ/BAZ < -2 SD and HAZ < -2 SD). A multinomial logistic regression model explored associated factors with each type of malnutrition. Overall, 1350 HIV-infected children were included; their median age was 10 years (interquartile range [IQR]: 7-13 years), 49 % were girls. 80 % were on antiretroviral treatment (ART), for a median time of 36 months. The prevalence of malnutrition was 42 % (95 % confidence interval [95% CI]: 40-44 %) with acute, chronic and mixed malnutrition at 9 % (95% CI: 6-12 %), 26 % (95% CI: 23-28 %), and 7 % (95% CI: 5-10 %), respectively. Among those malnourished, more than half of children didn't receive any nutritional support at the time of the survey. Acute malnutrition was associated with male gender, severe immunodeficiency, and the absence of ART; chronic malnutrition with male gender and age (<5 years); and mixed malnutrition with male gender, age (<5 years), severe immunodeficiency and recent ART initiation (<6 months). Orphanhood and Cotrimoxazole prophylaxis were not associated with any type of malnutrition. The prevalence of malnutrition in HIV-infected children even on ART remains high in HIV care programmes. Anthropometric measurements and appropriate nutritional care of malnourished HIV-infected children remain insufficient and a priority to improve health care of HIV-infected children in Africa.

Variability of the recent climate of eastern Africa

NASA Astrophysics Data System (ADS)

Schreck, Carl J., III; Semazzi, Fredrick H. M.

2004-05-01

The primary objective of this study is to investigate the recent variability of the eastern African climate. The region of interest is also known as the Greater Horn of Africa (GHA), and comprises the countries of Burundi, Djibouti, Eritrea, Ethiopia, Kenya, Rwanda, Somalia, Sudan, Uganda, and Tanzania.The analysis was based primarily on the construction of empirical orthogonal functions (EOFs) of gauge rainfall data and on CPC Merged Analysis of Precipitation (CMAP) data, derived from a combination of rain-gauge observations and satellite estimates. The investigation is based on the period 1961-2001 for the short rains season of eastern Africa of October through to December. The EOF analysis was supplemented by projection of National Centers for Environmental Prediction wind data onto the rainfall eigenmodes to understand the rainfall-circulation relationships. Furthermore, correlation and composite analyses have been performed with the Climatic Research Unit globally averaged surface-temperature time series to explore the potential relationship between the climate of eastern Africa and global warming.The most dominant mode of variability (EOF1) based on CMAP data over eastern Africa corresponds to El Niño-southern oscillation (ENSO) climate variability. It is associated with above-normal rainfall amounts during the short rains throughout the entire region, except for Sudan. The corresponding anomalous low-level circulation is dominated by easterly inflow from the Indian Ocean, and to a lesser extent the Congo tropical rain forest, into the positive rainfall anomaly region that extends across most of eastern Africa. The easterly inflow into eastern Africa is part of diffluent outflow from the maritime continent during the warm ENSO events. The second eastern African EOF (trend mode) is associated with decadal variability. In distinct contrast from the ENSO mode pattern, the trend mode is characterized by positive rainfall anomalies over the northern sector of eastern Africa and opposite conditions over the southern sector. This rainfall trend mode eluded detection in previous studies that did not include recent decades of data, because the signal was still relatively weak. The wind projection onto this mode indicates that the primary flow that feeds the positive anomaly region over the northern part of eastern Africa emanates primarily from the rainfall-deficient southern region of eastern Africa and Sudan. Although we do not assign attribution of the trend mode to global warming (in part because of the relatively short period of analysis), the evidence, based on our results and previous studies, strongly suggests a potential connection.

Medicinal plants used by Burundian traditional healers for the treatment of microbial diseases.

PubMed

Ngezahayo, Jérémie; Havyarimana, François; Hari, Léonard; Stévigny, Caroline; Duez, Pierre

2015-09-15

Infectious diseases represent a serious and worldwide public health problem. They lead to high mortality, especially in non-developed countries. In Burundi, the most frequent infectious diseases are skin and respiratory (mainly in children) infections, diarrhea, added to malaria, HIV/AIDS and tuberculosis. Local population used mostly traditional herbal medicines, sometimes animal and mineral substances, to fight against these plagues. To survey in different markets and herbal shops in Bujumbura city, medicinal plants sold to treat microbial infections, with particular emphasis on the different practices of traditional healers (THs) regarding plant parts used, methods of preparation and administration, dosage and treatment duration. The ethnobotanical survey was conducted by interviewing, using a pre-set questionnaire, sixty representative healers, belonging to different associations of THs approved and recognised by the Ministry of Health. Each interviewed herbalist also participated in the collection of samples and the determination of the common names of plants. The plausibility of recorded uses has been verified through an extensive literature search. Our informants enabled us to collect 155 different plant species, distributed in 51 families and 139 genera. The most represented families were Asteraceae (20 genera and 25 species), Fabaceae (14 genera and 16 species), Lamiaceae (12 genera and 15 species), Rubiaceae (9 genera and 9 species), Solanaceae (6 genera and 6 species) and Euphorbiaceae (5 genera and 6 families). These plants have been cited to treat 25 different alleged symptoms of microbial diseases through 271 multi-herbal recipes (MUHRs) and 60 mono-herbal recipes (MOHRs). Platostoma rotundifolium (Briq.) A. J. Paton (Lamiaceae), the most cited species, has been reported in the composition of 41 MUHRs, followed by Virectaria major (Schum.) Verdc (Rubiaceae, 39 recipes), Kalanchoe crenata (Andrews) Haw. (Crassulaceae, 37 recipes), Stomatanthes africanus (Oliv. & Hiern) R. M. King & H. Rob. (35 recipes), and Helichrysum congolanum Schltr. & O. Hoffm. (Asteraceae, 33 recipes). Regarding MOHRs, Pentas longiflora Oliv. (Rubiaceae) is the most important species with 19 recipes, followed by Kalanchoe crenata (Andrews) Haw. (Crassulaceae, 10 recipes), Gymnosporia senegalensis (Lam.) Loes. (Celastraceae, 9 recipes), Tetradenia riparia (Hochst.) Codd (Lamiaceae, 8 recipes) and Cardiospermum halicacabum L. (Sapindaceae, 6 recipes). Concerning the preparation and administration of recipes, our informants state to be able to adjust the doses based on the patient's age (child or adult) and/or his/her physiology (e.g. pregnancy). This study indicates that medicinal plants are still widely used for the treatment of microbial diseases in Bujumbura city. However, there is much to do in this area, especially in the assessment and monitoring of the quality, effectiveness and safety of the different recipes preconised by Burundian traditional healers. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Seismic hazard of the Kivu rift (western branch, East African Rift system): new neotectonic map and seismotectonic zonation model

NASA Astrophysics Data System (ADS)

Delvaux, Damien; Mulumba, Jean-Luc; Sebagenzi Mwene Ntabwoba, Stanislas; Fiama Bondo, Silvanos; Kervyn, François; Havenith, Hans-Balder

2017-04-01

The first detailed probabilistic seismic hazard assessment has been performed for the Kivu and northern Tanganyika rift region in Central Africa. This region, which forms the central part of the Western Rift Branch, is one of the most seismically active part of the East African rift system. It was already integrated in large scale seismic hazard assessments, but here we defined a finer zonation model with 7 different zones representing the lateral variation of the geological and geophysical setting across the region. In order to build the new zonation model, we compiled homogeneous cross-border geological, neotectonic and sismotectonic maps over the central part of East D.R. Congo, SW Uganda, Rwanda, Burundi and NW Tanzania and defined a new neotectonic sheme. The seismic risk assessment is based on a new earthquake catalogue, compiled on the basis of various local and global earthquake catalogues. The use of macroseismic epicenters determined from felt earthquakes allowed to extend the time-range back to the beginning of the 20th century, spanning 126 years, with 1068 events. The magnitudes have been homogenized to Mw and aftershocks removed. From this initial catalogue, a catalogue of 359 events from 1956 to 2015 and with M > 4.4 has been extracted for the seismic hazard assessment. The seismotectonic zonation includes 7 seismic source areas that have been defined on the basis of the regional geological structure, neotectonic fault systems, basin architecture and distribution of thermal springs and earthquake epicenters. The Gutenberg-Richter seismic hazard parameters were determined using both the least square linear fit and the maximum likelihood method (Kijko & Smit aue program). Seismic hazard maps have been computed with the Crisis 2012 software using 3 different attenuation laws. We obtained higher PGA values (475 years return period) for the Kivu rift region than the previous estimates (Delvaux et al., 2016). They vary laterally in function of the tectonic setting, with the lowest value in the volcanically active Virunga - Rutshuru zone, highest in the currently non-volcanic parts of Lake Kivu, Rusizi valley and North Tanganyika rift zone, and intermediate in the regions flanking the axial rift zone. Those are to be considered as preliminary values, as there are a number of important uncertainties such as the heterogeneity and relatively short duration of the instrumental seismic catalogue used (60 years), the absence of locally derived attenuation laws and thus the choice of the attenuation laws used, and the seismic zonation scheme. Delvaux, D. et al., 2016. Journal of African Earth Sciences, doi: 10.1016/j.jafrearsci.2016.10.004.

Synonymy of Reikosiella Yoshimoto under Merostenus Walker (Hymenoptera: Chalcidoidea: Eupelmidae), with a checklist of world species and a revision of those species with brachypterous females.

PubMed

Gibson, Gary A P

2017-04-21

Reikosiella Yoshimoto, 1969 is synonymized under Merostenus Walker, 1837 n. syn. and treated as M. (Reikosiella), one of four subgenera recognized in the genus. Hirticauda Bouček, 1988, previously treated as a subgenus of Reikosiella, is synonymized under M. (Merostenus) n. syn., and two subgenera established in Reikosiella by Gibson (1995) are synonymized under Merostenus and treated as the subgenera M. (Capreocauda) and M. (Incohata) n. syns. The new generic synonymy is proposed after morphological comparison of females and males of Merostenus and Reikosiella sensu Gibson (1995), including reanalysis of features possessed by a basal group of genera of Eupelminae whose females share two hypothesized symplesiomorphies-a medially divided mesotrochantinal plate and lack of a mesotibial apical groove. A checklist of the 51 world species assigned to Merostenus is given, with 1 described species in M. (Incohata), 6 in M. (Capreocauda), 6 in M. (Reikosiella) and 38 in M. (Merostenus). All but one, the type species of Merostenus, represent new combinations. The species of Merostenus with brachypterous females are revised, with 8 of 10 species described as new. In addition to M. (Merostenus) excavatus (Dalman) (♀, ♂) from the Palaearctic, described in the same subgenus are one new species from Mexico, M. (Merostenus) mexicanus n. sp. (♀), and seven from the Afrotropical region, M. (Merostenus) distigma n. sp. (♀: Kenya, Tanzania), M. (Merostenus) micropterus n. sp. (♀: Democratic Republic of the Congo), M. (Merostenus) platyscapus n. sp. (♀: South Africa), M. (Merostenus) reticulatus n. sp. (♀, ♂: Kenya), M. (Merostenus) speculum n. sp. (♀: Burundi), M. (Merostenus) congoensis (♀: Democratic Republic of the Congo), and M. (Merostenus) longistylus n. sp. (♀, ♂: South Africa). The first seven species are assigned to the excavatus species-group of M. (Merostenus) based on females sharing a completely sclerotized pronotum and apically truncate syntergum. Also treated is M. (Reikosiella) melinus (Yoshimoto) n. comb. (♀: Argentina, Brazil, Hawaii), the only species known with macropterous to variably strongly brachypterous females. Six species are transferred to other genera. Merostenus ferrugineus Yoshimoto & Ishii is transferred to Anastatus Motschulsky as A. ferrugineus (Yoshimoto & Ishii) n. comb., Merostenus guamensis Yoshimoto & Ishii and Merostenus palauensis Yoshimoto & Ishii are transferred to Eupelmus Dalman and provisionally classified in E. (Eupelmus) as E. (Eupelmus) guamensis (Yoshimoto & Ishii) n. comb. and E. (Eupelmus) palauensis (Yoshimoto & Ishii) n. comb., Eupelminus subapterus Ashmead is transferred to E. (Eupelmus) as E. (Eupelmus) subapterus (Ashmead) n. comb., and Eupelminus robustus Brues and Eupelminus tarsatus Waterston are transferred to Arachnophaga (Parasolindenia Brues) as Arachnophaga (Parasolindenia) robusta (Brues) n. comb. and Arachnophaga (Parasolindenia) tarsata (Waterston) n. comb. The character-state analysis and treated species are illustrated through macrophotography and, except for A. robusta, notes and illustrations provided for the excluded species to assist their future recognition.

Rwanda.

PubMed

1985-09-01

Rwanda's population characteristics, history, government, political situation, economy, and foreign relations were briefly discribed. Rwanda, a small African country, covers an area of 10,160 square miles and is situated between Zaire, Uganda, Burundi, and Tanzania. During the 1400s, Tutsi cattle breeders moved into the region and turned the Hutu farmers, the original occupants of the region, into serfs. The Tutsi maintained their dominant position until 1959. Rwanda was a German protectorate between 1899-1916 and a territory under the administration of Belgium following World War I. During the 1950s, the Tutsi resisted efforts by the Belgians to democratize the country, and in 1959, the Party of the Hutu Emancipation Movement (PARMEHUTU) overthrew the Tutsi monarchy. The PARMEHUTU leader, Gregoire Kayibanda was selected by the elected unicameral National Assembly to head the government following the granting of independence to Rwanda in 1962. In 1973 growing government inefficiency and corruption led to the takeover of the country by the military leader, Major General Juvenal Habyarimana, who in 1975 formed the National Revolutionary Movement for Development. Although civilian rule is being gradually restored, Habyarimana, who is now the elected president of the country, retains considerable power. In addition to the president, the country is run by a 17-member cabinet and a 70-member elected legislative body, the National Development Council. The current goverment is strongly committed to the developing the country's economy. Rwanda is a poor and overpopulated country, and its economy is based mainly on subsistence level farming. 93% of the work force is engaged in agriculture. 35% of the gross national product (GNP) is derived from agriculture, and the main agricultural products are tea, pyrethrum, and cinchona. Small-scale industries account for another 21.6% of the GNP. The government is working to increase the country's energy sources and to attract foreign investments. The country has some mineral desposits which contribute toward the country's foreign exchange. In 1984, the GNP was US$1.7 billion, the annual economic growth rate was 2.9%, the per capita GNP was US$270, and exports and imports were US$147.9 million and US$204.9 million respectively. Rwanda's population size is 6.3 million, and 85% of the population is Hutu and 14% is Tutsi. The annual population growth rate is 3.7%. The dominant religion is Christianity. The literacy rate is 37%, schooling is compulsory for 8 years, the infant mortality rate is 102/1000 live births, and life expectancy is 48 years. In 1981, the government established the National Population Office to develop and implement a national family planning policy. Rwanda follows a moderate and nonaligned course in foreign matters and maintains friendly relations with the US. In 1984 the US provided Rwanda with US$6.2 million in development assistance and US$1.5 million in food assistance. Most US aid is directed toward agricultural and health development.

The Nyanza Project: Interdisciplinary Research Training In Tropical Lakes

NASA Astrophysics Data System (ADS)

Cohen, A. S.; Lezzar, K. E.; Michel, E.; O'Reilly, C. M.; Russell, J. M.; Nkotagu, H.; Kimirei, I.

2005-12-01

The Nyanza Project is a research training program for American and African students, run annually at Lake Tanganyika (LT), Tanzania. The Project`s objective is to provide undergraduates, graduate students and secondary school teachers with the skills to plan and conduct interdisciplinary research on various aspects of tropical lake studiees. At a time of rapid global change there is a pressing need for young scientists trained to investigate environmental processes in an interdisciplinary framework. Training students to understand long-term changes in water availability, water quality and the relationship of aquatic ecosystems to rapid climate change represents a critical element of this societal need. Waterbodies in the tropics are particularly useful proving grounds for training future researchers on the impacts of global change on natural waters, as they are very sensitive to environmental and climatic change. Moreover, they are likely to provide instructive bellwethers of changes to come in U.S. inland waters. Each year 17-22 undergraduates, 3-4 graduate students and one secondary school teacher are selected for the program from the US and Africa. To date (1998-2005), 89 undergraduate students, 24 graduate students, and 8 secondary school teachers from the US have participated through the Project`s NSF support and 58 African students (from Tanzania, Burundi, Zambia, Congo, Kenya, and Burkina Faso) have been funded to participate in the Nyanza Project through supporting grants from our non-NSF funding sources. The 7-week program comprises an initial two week intensive short course on all aspects of the LT system and project preparation period, followed by 5 weeks of directed research, written report preparation, and scientific meeting-styled presentations. Focal topics for Nyanza Project research include: 1) investigating East African paleoclimates using sediment cores and reflection seismic profiling, 2) mapping & interpreting the geologic structure and depositional processes on the lake`s floor and watersheds 3) studying the extremely diverse and largely endemic fish and invertebrate fauna found in the littoral zone of LT to understand species interactions, environmental controls on species distribution, and factors regulating species diversification, 4) understanding the linkages between short-term climate variability, internal circulation in the lake, nutrient availability, and productivity in the open water (pelagic) portion of LT, and 5) investigating the impacts of deforestation and soil erosion in the LT basin on lake and stream ecosystems. Given that the Nyanza Project primarily serves undergraduates it has been extremely productive in terms of research output, with 27 articles published/in press in peer reviewed journals/edited volumes, 73 presentations given at national or international scientific meetings (59% by student first authors) and 16 theses based on Nyanza work. Extended abstracts for all 100 student projects from 1998-2004 are available at our website. Alumni surveys indicate that the Nyanza Project has significantly changed past student`s approach to science and/or career directions.

Towards a Global High Resolution Peatland Map in 2020

NASA Astrophysics Data System (ADS)

Barthelmes, Alexandra; Barthelmes, Karen-Doreen; Joosten, Hans; Dommain, Rene; Margalef, Olga

2015-04-01

Some 3% of land area on planet Earth (approx. 4 million km2) is covered by peatlands. About 10% (~ 0.3 % of the land area) are drained and responsible for a disproportional 5 % of the global anthropogenic CO2 emissions (Victoria et al., 2012). Additionally, peatland drainage and degradation lead to land subsidence, soil degradation, water pollution, and enhanced susceptibility to fire (Holden et al., 2004; Joosten et al., 2012). The global importance of peatlands for carbon storage and climate change mitigation has currently been recognized in international policy - since 2008 organic soils are subject of discussion in the UN Framework Convention on Climate Change (UNFCCC) (Joosten, 2011). In May 2013 the European Parliament decided that the global post 2020 climate agreement should include the obligation to report emissions and removals from peatland drainage and rewetting. Implementation of such program, however, necessitates the rapid availability of reliable, comprehensive, high resolution, spatially explicit data on the extent and status of peatlands. For many reporting countries this requires an innovation in peatland mapping, i.e. the better and integrative use of novel, but already available methods and technologies. We developed an approach that links various science networks, methodologies and data bases, including those of peatland/landscape ecology for understanding where and how peatlands may occur, those of remote sensing for identifying possible locations, and those of pedology (legacy soil maps) and (palaeo-)ecology for ground truthing. Such integration of old field data, specialized knowledge, and modern RS and GIS technologies enables acquiring a rapid, comprehensive, detailed and rather reliable overview, even on a continental scale. We illustrate this approach with a high resolution overview of peatland distribution, area, status and greenhouse gas fluxes e.g. for the East African countries Rwanda, Burundi, Uganda and Zambia. Furthermore, we discuss the perspectives and opportunities to complete a global map by collaborative action by 2020. References: Holden J., Chapman P.J., Labadz J.C. 2004 Artificial drainage of peatlands: hydrological and hydrochemical process and wetland restoration. Prog. Phys. Geogr, 28, 95-123. Joosten H. 2011. Sensitising global conventions for climate change mitigation by peatlands. In: Tanneberger F., Wichtmann W. (eds.) 2011. Carbon credits from peatland rewetting. Climate - biodiversity - land use. Science, policy, implementation and recommendations of a pilot project in Belarus. Schweizerbart, Stuttgart, p. 90-94. Joosten H., Tapio-Biström M.-L., Tol S. (eds.) 2012. Peatlands - guidance for climate change mitigation by conservation, rehabilitation and sustainable use. Mitigation of Climate Change in Agriculture Series 5. FAO, Rome, L + 96 p. http://www.fao.org/docrep/015/an762e/an762e.pdf. Victoria R., Banwart S., Black H., Ingram J., Joosten H., Milne E., Noellemeyer E. 2012. The benefits of soil carbon. Managing soils for multiple economic, societal, and environmental benefits. UNEP Yearbook 2012, UNEP, Nairobi, pp. 18-33.

Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis.

PubMed

Ouma, Paul O; Maina, Joseph; Thuranira, Pamela N; Macharia, Peter M; Alegana, Victor A; English, Mike; Okiro, Emelda A; Snow, Robert W

2018-03-01

Timely access to emergency care can substantially reduce mortality. International benchmarks for access to emergency hospital care have been established to guide ambitions for universal health care by 2030. However, no Pan-African database of where hospitals are located exists; therefore, we aimed to complete a geocoded inventory of hospital services in Africa in relation to how populations might access these services in 2015, with focus on women of child bearing age. We assembled a geocoded inventory of public hospitals across 48 countries and islands of sub-Saharan Africa, including Zanzibar, using data from various sources. We only included public hospitals with emergency services that were managed by governments at national or local levels and faith-based or non-governmental organisations. For hospital listings without geographical coordinates, we geocoded each facility using Microsoft Encarta (version 2009), Google Earth (version 7.3), Geonames, Fallingrain, OpenStreetMap, and other national digital gazetteers. We obtained estimates for total population and women of child bearing age (15-49 years) at a 1 km 2 spatial resolution from the WorldPop database for 2015. Additionally, we assembled road network data from Google Map Maker Project and OpenStreetMap using ArcMap (version 10.5). We then combined the road network and the population locations to form a travel impedance surface. Subsequently, we formulated a cost distance algorithm based on the location of public hospitals and the travel impedance surface in AccessMod (version 5) to compute the proportion of populations living within a combined walking and motorised travel time of 2 h to emergency hospital services. We consulted 100 databases from 48 sub-Saharan countries and islands, including Zanzibar, and identified 4908 public hospitals. 2701 hospitals had either full or partial information about their geographical coordinates. We estimated that 287 282 013 (29·0%) people and 64 495 526 (28·2%) women of child bearing age are located more than 2-h travel time from the nearest hospital. Marked differences were observed within and between countries, ranging from less than 25% of the population within 2-h travel time of a public hospital in South Sudan to more than 90% in Nigeria, Kenya, Cape Verde, Swaziland, South Africa, Burundi, Comoros, São Tomé and Príncipe, and Zanzibar. Only 16 countries reached the international benchmark of more than 80% of their populations living within a 2-h travel time of the nearest hospital. Physical access to emergency hospital care provided by the public sector in Africa remains poor and varies substantially within and between countries. Innovative targeting of emergency care services is necessary to reduce these inequities. This study provides the first spatial census of public hospital services in Africa. Wellcome Trust and the UK Department for International Development. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

An adjusted bed net coverage indicator with estimations for 23 African countries

PubMed Central

2013-01-01

Background Many studies have assessed the level of bed net coverage in populations at risk of malaria infection. These revealed large variations in bed net use across countries, regions and social strata. Such studies are often aimed at identifying populations with low access to bed nets that should be prioritized in future interventions. However, often spatial differences in malaria endemicity are not taken into account. By ignoring variability in malaria endemicity, these studies prioritize populations with little access to bed nets, even if these happen to live in low endemicity areas. Conversely, populations living in regions with high malaria endemicity will receive a lower priority once a seizable proportion is protected by bed nets. Adequately assigning priorities requires accounting for both the current level of bed net coverage and the local malaria endemicity. Indeed, as shown here for 23 African countries, there is no correlation between the level of bed net coverage and the level of malaria endemicity in a region. Therefore, the need for future interventions can not be assessed based on current bed net coverage alone. This paper proposes the Adjusted Bed net Coverage (ABC) statistic as a measure taking into account both local malaria endemicity and the level of bed net coverage. The measure allows setting priorities for future interventions taking into account both local malaria endemicity and bed net coverage. Methods A mathematical formulation of the ABC as a weighted difference of bed net coverage and malaria endemicity is presented. The formulation is parameterized based on a model of malaria epidemiology (Smith et al. Trends Parasitol 25:511-516, 2009). By parameterizing the ABC based on this model, the ABC as used in this paper is proxy for the steady-state malaria burden given the current level of bed net coverage. Data on the bed net coverage in under five year olds and malaria endemicity in 23 Sub-Saharan countries is used to show that the ABC prioritizes different populations than the level of bed net coverage by itself. Data from the following countries was used: Angola, Burkina Faso, Burundi, Cameroon, Congo Democratic Republic, Ethiopia, Ghana, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Namibia, Nigeria, Rwanda, Senegal, Sierra Leone, Tanzania, Uganda, Zambia and Zimbabwe. The priority order given by the ABC and the bed net coverage are compared at the countries’ level, the first level administrative divisions and for five different wealth quintiles. Results Both at national level and at the level of the administrative divisions the ABC suggests a different priority order for selecting countries and divisions for future interventions. When taking into account malaria endemicity, measures assessing equality in access to bed nets across wealth quintiles, such as slopes of inequality, are prone to change. This suggests that when assessing inequality in access to bed nets one should take into account the local malaria endemicity for populations from different wealth quintiles. Conclusion Accounting for malaria endemicity highlights different countries, regions and socio-economic strata for future intervention than the bed net coverage by itself. Therefore, care should be taken to factor out any effects of local malaria endemicity in assessing bed net coverage and in prioritizing populations for further scale-up of bed net coverage. The ABC is proposed as a simple means to do this that is derived from an existing model of malaria epidemiology. PMID:24359227

The White Nile sedimentary system

NASA Astrophysics Data System (ADS)

Garzanti, Eduardo; Andò, Sergio; Padoan, Marta; Resentini, Alberto; Vezzoli, Giovanni; Villa, Igor

2014-05-01

The Nile River flows for ~6700 km from south of the Equator to finally reach the Mediterranean Sea at northern subtropical latitudes (Woodward et al. 2007). This is the longest sedimentological laboratory on Earth, a unique setting in which we are investigating changes in sediment composition associated with diverse chemical and physical processes, including weathering and hydraulic sorting. The present study focuses on the southern branch of the Nile across 20° of latitude, from hyperhumid Burundi and Rwanda highlands in central Africa to Khartoum, the capital city of Sudan at the southern edge of the Sahara. Our study of the Kagera basin emphasizes the importance of weathering in soils at the source rather than during stepwise transport, and shows that the transformation of parent rocks into quartzose sand may be completed in one sedimentary cycle (Garzanti et al. 2013a). Micas and heavy minerals, less effectively diluted by recycling than main framework components, offer the best key to identify the original source-rock imprint. The different behaviour of chemical indices such as the CIA (a truer indicator of weathering) and the WIP (markedly affected by quartz dilution) helps us to distinguish strongly weathered first-cycle versus polycyclic quartz sands (Garzanti et al. 2013b). Because sediment is efficiently trapped in East African Rift lakes, the composition of Nile sediments changes repeatedly northwards across Uganda. Downstream of both Lake Kyoga and Lake Albert, quartzose sands are progressively enriched in metamorphiclastic detritus supplied from tributaries draining amphibolite-facies basements. The evolution of White Nile sediments across South Sudan, a scarcely accessible region that suffered decades of civil war, was inferred from the available information (Shukri 1950), integrated by original petrographic, heavy-mineral and geochemical data (Padoan et al. 2011). Mineralogical and isotopic signatures of Bahr-el-Jebel and Sobat sediments, derived respectively from Archean gneisses of Uganda and Neoproterozoic basements of Ethiopia, become gradually homogenized and enriched in quartz, and remain finally unchanged down to Khartoum. This suggests massive sediment dumping in the Sudd and Machar Marshes, and explains why White Nile sediment contribution to the main Nile is negligible (Garzanti et al. 2006). REFERENCES Garzanti E., Andò S., Vezzoli G., Megid A.A.A., El Kammar A., 2006. Petrology of Nile River sands (Ethiopian and Sudan): sediment budgets and erosion patterns. EPSL 252:327-341. Garzanti E., Padoan M., Setti M., Peruta L., Najman Y., Villa I.M., 2013. Weathering geochemistry and Sr-Nd fingerprints of equatorial upper Nile and Congo muds. Geochem. Geophys. Geosyst. 14:292-316. Garzanti E., Padoan M., Andò S., Resentini A., Vezzoli G., Lustrino M., 2013. Weathering and relative durability of detrital minerals in equatorial climate: sand petrology and geochemistry in the East African Rift. J.Geol. 121:547-580. Padoan M., Garzanti E., Harlavan Y., Villa I.M., 2011. Tracing Nile sediment sources by Sr and Nd isotope signatures (Uganda, Ethiopia, Sudan). Geochim. Cosmochim. Acta 75:3627-3644. Shukri N.M., 1950. The mineralogy of some Nile sediments. Quart. J. Geol. Soc. London 105:511-534. Woodward J.C., Macklin M.G., Krom M.D., Williams M.A.J. 2007. The Nile: Evolution, quaternary river environments and material fluxes. In: Large Rivers, Avijit Gupta (Ed.), Wiley, 261-292.

An Integrated Hydrological and Water Management Study of the Entire Nile River System - Lake Victoria to Nile Delta

NASA Technical Reports Server (NTRS)

Habib, Shahid; Zaitchik, Benjamin; Alo, Clement; Ozdogan, Mutlu; Anderson, Martha; Policelli, Fritz

2011-01-01

The Nile basin River system spans 3 million km(exp 2) distributed over ten nations. The eight upstream riparian nations, Ethiopia, Eretria, Uganda, Rwanda, Burundi, Congo, Tanzania and Kenya are the source of approximately 86% of the water inputs to the Nile, while the two downstream riparian countries Sudan and Egypt, presently rely on the river's flow for most of the their needs. Both climate and agriculture contribute to the complicated nature of Nile River management: precipitation in the headwaters regions of Ethiopia and Lake Victoria is variable on a seasonal and inter-annual basis, while demand for irrigation water in the arid downstream region is consistently high. The Nile is, perhaps, one of the most difficult trans-boundary water issue in the world, and this study would be the first initiative to combine NASA satellite observations with the hydrologic models study the overall water balance in a to comprehensive manner. The cornerstone application of NASA's Earth Science Research Results under this project are the NASA Land Data Assimilation System (LDAS) and the USDA Atmosphere-land Exchange Inverse (ALEXI) model. These two complementary research results are methodologically independent methods for using NASA observations to support water resource analysis in data poor regions. Where an LDAS uses multiple sources of satellite data to inform prognostic simulations of hydrological process, ALEXI diagnoses evapotranspiration and water stress on the basis of thermal infrared satellite imagery. Specifically, this work integrates NASA Land Data Assimilation systems into the water management decision support systems that member countries of the Nile Basin Initiative (NBI) and Regional Center for Mapping of Resources for Development (RCMRD, located in Nairobi, Kenya) use in water resource analysis, agricultural planning, and acute drought response to support sustainable development of Nile Basin water resources. The project is motivated by the recognition that accurate, frequent, and spatially distributed estimates of the water balance are necessary for effective water management. This creates a challenge for watersheds that are large, include data poor regions, and/or span multiple nations. All of these descriptors apply to the Nile River basin, yet successful management of the Nile is critical for development and political stability in the region. For this reason, improved hydrological data to support cooperative water management in the Nile basin is a priority for USAID, the US State Department, the World Bank and other international organizations. In this project, the U.S. based research team is working with partners at RCMRD, Nile Basin Initiative (NBI), and their member national-level agencies to develop satellite-based land cover maps, satellite-derived evapotranspiration estimates (using the ALEXI algorithm), and NASA's Land Data Assimilation System (LDAS) customized to match identified information needs. The cornerstone applied sciences product of the project is the development of a customized "Nile LDAS" that will produce optimal estimates of hydrological states and fluxes, as vetted against the in situ observations of NBI and RCMRD member organizations and independent satellite-derived hydrological estimates. Nile LDAS will be applied to improve the reliability of emerging Decision Support Systems in applications that include drought monitoring, reservoir management, and irrigation planning. The end-users such as RCMRD, NBI, Ethiopian and Kenya Meteorological and Famine Early Warning System Network (FEWSNet) will be the eventual benefactors of this work. There will be a capacity building process involving the above end-user organizations and transfer the models and the results for these organizations to execute for future use. The team has already initiated this study and the early results of first years' work are shown. The plan is to complete this work by late 2013.

Natural equilibria and anthropic effects on sediment transport in big river systems: The Nile case

NASA Astrophysics Data System (ADS)

Garzanti, Eduardo; Andò, Sergio; Padoan, Marta; Vezzoli, Giovanni; Villa, Igor

2014-05-01

The Nile River flows for ~ 6700 km, from Burundi and Rwanda highlands south of the Equator to the Mediterranean Sea at northern subtropical latitudes. It is thus the longest natural laboratory on Earth, a unique setting in which we are carrying out a continuing research project to investigate changes in sediment composition associated with a variety of chemical and physical processes, including weathering in equatorial climate and hydraulic sorting during transport and deposition. Petrographic, mineralogical, chemical, and isotopic fingerprints of sand and mud have been monitored along all Nile branches, from the Kagera and White Nile draining Archean, Paleoproterozoic and Mesoproterozoic basements uplifted along the western branch of the East African rift, to the Blue Nile and Atbara Rivers sourced in Ethiopian volcanic highlands made of Oligocene basalt. Downstream of the Atbara confluence, the Nile receives no significant tributary water and hardly any rainfall across the Sahara. After construction of the Aswan High Dam in 1964, the Nile ceased to be an active conveyor-belt in Egypt, where the mighty river has been tamed to a water canal; transported sediments are thus chiefly reworked from older bed and levee deposits, with minor contributions from widyan sourced in the Red Sea Hills and wind-blown desert sand and dust. Extensive dam construction has determined a dramatic sediment deficit at the mouth, where deltaic cusps are undergoing ravaging erosion. Nile delta sediments are thus recycled under the effect of dominant waves from the northwest, the longest Mediterranean fetch direction. Nile sands, progressively enriched in more stable minerals such as quartz and amphiboles relative to volcanic rock fragments and pyroxene, thus undergo multistep transport by E- and NE-directed longshore currents all along the coast of Egypt and Palestine, and are carried as far as Akko Bay in northern Israel. Nile mud reaches the Iskenderun Gulf in southern Turkey. A full knowledge of the Nile sediment system not only has wide paleoclimatic, paleoceanographic and archaeological implications, including a better understanding of Quaternary environmental changes in northern Africa, water circulation and sapropel development in the Mediterranean Sea, and impact on the Egyptian civilization by natural phenomena, but is also strongly needed to mitigate undesirable impacts of human activities on natural equilibria and to improve watershed, reservoir and coastal management. Mineralogical data (Shukri, 1950) integrated by new petrographic, heavy-mineral and geochemical analyses (Padoan et al., 2011) show how sediments derived from Archean gneisses exposed through northern Uganda and from Panafrican basements drained by Ethiopian tributaries of River Sobat become progressively enriched in quartz at the expense of unstable components across the Sudd and Machar Marshes (grey shaded area). Petrographic, mineralogical, and isotopic signatures are gradually homogenized along both the Bahr el Jebel/Bahr ez Zeraf and the Sobat and remain finally unchanged down to Khartoum, which suggests massive sediment dumping in the marshes. This explains why White Nile sediment contribution to the main Nile downstream Khartoum is virtually negligible (Garzanti et al., 2006). Garzanti, E., Andò, S., Vezzoli, G., Abdel Megid, A.A., El Kammar, A., 2006. Petrology of Nile River sands (Ethiopian and Sudan): sediment budgets and erosion patterns. Earth Planet. Sci. Lett., 252, 327-341. Padoan, M., Garzanti, E., Harlavan, Y., Villa, I.M., 2011. Tracing Nile sediment sources by Sr and Nd isotope signatures (Uganda, Ethiopia, Sudan). Geochim. Cosmochim. Acta, 75, 3627-3644. Said, R., 1993. The River Nile, Oxford, Pergamon, 1993, 320 p. Shukri, N.M., 1950. The mineralogy of some Nile sediments. Quart. J. Geol. Soc. London, 105, 511-534. Williams, M.A.J., Faure, H., 1980. The Sahara and the Nile. Balkema, Rotterdam. Woodward, J.C., Macklin, M.G., Krom, M.D., Williams, M.A.J., 2007. The Nile: Evolution, quaternary river environments and material fluxes. In: Large Rivers: Geomorphology and Management, Avijit Gupta (Ed.), John Wiley and Sons, ch. 13, 261-292.

Impact of Air Temperature and SST Variability on Cholera Incidence in Southeastern Africa, 1971-2006

NASA Astrophysics Data System (ADS)

Paz, Shlomit

2010-05-01

The most important climatic parameter related to cholera outbreaks is the temperature, especially of the water bodies and the aquatic environment. This factor governs the survival and growth of V. cholerae, since it has a direct influence on its abundance in the environment, or alternatively, through its indirect influence on other aquatic organisms to which the pathogen is found to attach. Thus, the potential for cholera outbreaks may rise, parallel to the increase in ocean surface temperature. Indeed, recent studies indicate that global warming might create a favorable environment for V. cholerae and increase its incidence in vulnerable areas. Africa is vulnerable to climate variability. According to the recent IPCC report on Africa, the air temperature has indicated a significant warming trend since the 1960s. In recent years, most of the research into disease vectors in Africa related to climate variability has focused on malaria. The IPCC indicated that the need exists to examine the vulnerabilities and impacts of climatic factors on cholera in Africa. In light of this, the study uses a Poisson Regression Model to analyze the possible association between the cholera rates in southeastern Africa and the annual variability of air temperature and sea surface temperature (SST) at regional and hemispheric scales, for the period 1971-2006. Data description is as follows: Number of cholera cases per year in Uganda, Kenya, Rwanda, Burundi, Tanzania, Malawi, Zambia and Mozambique. Source: WHO Global Health Atlas - cholera. Seasonal and annual temperature time series: Regional scale: a) Air temperature for southeastern Africa (30° E-36° E, 5° S-17° S), source: NOAA NCEP-NCAR; b) Sea surface temperature, for the western Indian Ocean (0-20° S, 40° E-45° E), source: NOAA, Kaplan SST dataset. Hemispheric scale (for the whole Southern Hemisphere): a) Air temperature anomaly; b) Sea surface temperature anomaly. Source: CRU, University of East Anglia. The following Poisson regression model is suggested: log{E(CHOLt)} = b0+b1×Xt+b2×Xt-1 where: CHOLt = the number of new cases of cholera in year t Xt / Xt-1 = the climate covariate measured in year t/t-1. (b0,b1) = the coefficients. A first order autocorrelation, AR1 = cor(Yt, Yt-1) is taken into account in the estimation using Generalized Estimating Equations. b1 and b2 quantify the association of CHOL and X, i.e. if Xt or Xt-1 increase by one unit, the mean of Yt is expected to increase in exp{b1} or exp{b2} times, respectively (multiplicative model). The results showed a significant exponential increase of cholera rates in humans during the study period, with an estimate of exp(b1)=1.08 (p-value = 0.02). Associations have been found between the annual increase of the air temperature in southeastern Africa and the cholera incidence in the same area. Linkages were found also for a wider scale, with the air temperature anomaly of the Southern Hemisphere, with an estimate of exp(b1)=1.18 (p-value = 0.04) and exp(b1)=1.26 (p-value = 0.006) for the previous year. Significant linkages were detected between the annual cholera rate and the annual western Indian Ocean' SST , with exp(b1) = 1.31 (p-value = 0.01) for the current year and exp(b1) = 1.23 (p-value = 0.05) for the previous year. Linkages were found also for the hemispheric scale, with the SST anomaly. The increase of global temperature may influence the temporal fluctuations of cholera, as well as potentially increasing the frequency and duration of its outbreaks. Despite future uncertainty, the climate variability has to be considered in predicting further cholera outbreaks in Africa. This may help to promote better, more efficient preparedness. For more details: Paz, S. 2010. Impact of Temperature Variability on Cholera Incidence in Southeastern Africa, 1971-2006. EcoHealth, in press.

Payment methods for outpatient care facilities

PubMed Central

Yuan, Beibei; He, Li; Meng, Qingyue; Jia, Liying

2017-01-01

Background Outpatient care facilities provide a variety of basic healthcare services to individuals who do not require hospitalisation or institutionalisation, and are usually the patient's first contact. The provision of outpatient care contributes to immediate and large gains in health status, and a large portion of total health expenditure goes to outpatient healthcare services. Payment method is one of the most important incentive methods applied by purchasers to guide the performance of outpatient care providers. Objectives To assess the impact of different payment methods on the performance of outpatient care facilities and to analyse the differences in impact of payment methods in different settings. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), 2016, Issue 3, part of the Cochrane Library (searched 8 March 2016); MEDLINE, OvidSP (searched 8 March 2016); Embase, OvidSP (searched 24 April 2014); PubMed (NCBI) (searched 8 March 2016); Dissertations and Theses Database, ProQuest (searched 8 March 2016); Conference Proceedings Citation Index (ISI Web of Science) (searched 8 March 2016); IDEAS (searched 8 March 2016); EconLit, ProQuest (searched 8 March 2016); POPLINE, K4Health (searched 8 March 2016); China National Knowledge Infrastructure (searched 8 March 2016); Chinese Medicine Premier (searched 8 March 2016); OpenGrey (searched 8 March 2016); ClinicalTrials.gov, US National Institutes of Health (NIH) (searched 8 March 2016); World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (searched 8 March 2016); and the website of the World Bank (searched 8 March 2016). In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via ISI Web of Science to find other potentially relevant studies. We also contacted authors of the main included studies regarding any further published or unpublished work. Selection criteria Randomised trials, non-randomised trials, controlled before-after studies, interrupted time series, and repeated measures studies that compared different payment methods for outpatient health facilities. We defined outpatient care facilities in this review as facilities that provide health services to individuals who do not require hospitalisation or institutionalisation. We only included methods used to transfer funds from the purchaser of healthcare services to health facilities (including groups of individual professionals). These include global budgets, line-item budgets, capitation, fee-for-service (fixed and unconstrained), pay for performance, and mixed payment. The primary outcomes were service provision outcomes, patient outcomes, healthcare provider outcomes, costs for providers, and any adverse effects. Data collection and analysis At least two review authors independently extracted data and assessed the risk of bias. We conducted a structured synthesis. We first categorised the comparisons and outcomes and then described the effects of different types of payment methods on different categories of outcomes. We used a fixed-effect model for meta-analysis within a study if a study included more than one indicator in the same category of outcomes. We used a random-effects model for meta-analysis across studies. If the data for meta-analysis were not available in some studies, we calculated the median and interquartile range. We reported the risk ratio (RR) for dichotomous outcomes and the relative change for continuous outcomes. Main results We included 21 studies from Afghanistan, Burundi, China, Democratic Republic of Congo, Rwanda, Tanzania, the United Kingdom, and the United States of health facilities providing primary health care and mental health care. There were three kinds of payment comparisons. 1) Pay for performance (P4P) combined with some existing payment method (capitation or different kinds of input-based payment) compared to the existing payment method We included 18 studies in this comparison, however we did not include five studies in the effects analysis due to high risk of bias. From the 13 studies, we found that the extra P4P incentives probably slightly improved the health professionals' use of some tests and treatments (adjusted RR median = 1.095, range 1.01 to 1.17; moderate-certainty evidence), and probably led to little or no difference in adherence to quality assurance criteria (adjusted percentage change median = -1.345%, range -8.49% to 5.8%; moderate-certainty evidence). We also found that P4P incentives may have led to little or no difference in patients' utilisation of health services (adjusted RR median = 1.01, range 0.96 to 1.15; low-certainty evidence) and may have led to little or no difference in the control of blood pressure or cholesterol (adjusted RR = 1.01, range 0.98 to 1.04; low-certainty evidence). 2) Capitation combined with P4P compared to fee-for-service (FFS) One study found that compared with FFS, a capitated budget combined with payment based on providers' performance on antibiotic prescriptions and patient satisfaction probably slightly reduced antibiotic prescriptions in primary health facilities (adjusted RR 0.84, 95% confidence interval 0.74 to 0.96; moderate-certainty evidence). 3) Capitation compared to FFS Two studies compared capitation to FFS in mental health centres in the United States. Based on these studies, the effects of capitation compared to FFS on the utilisation and costs of services were uncertain (very low-certainty evidence). Authors' conclusions Our review found that if policymakers intend to apply P4P incentives to pay health facilities providing outpatient services, this intervention will probably lead to a slight improvement in health professionals' use of tests or treatments, particularly for chronic diseases. However, it may lead to little or no improvement in patients' utilisation of health services or health outcomes. When considering using P4P to improve the performance of health facilities, policymakers should carefully consider each component of their P4P design, including the choice of performance measures, the performance target, payment frequency, if there will be additional funding, whether the payment level is sufficient to change the behaviours of health providers, and whether the payment to facilities will be allocated to individual professionals. Unfortunately, the studies included in this review did not help to inform those considerations. Well-designed comparisons of different payment methods for outpatient health facilities in low- and middle-income countries and studies directly comparing different designs (e.g. different payment levels) of the same payment method (e.g. P4P or FFS) are needed. Payment methods for outpatient care facilities Review aim The aim of this Cochrane review was to assess the effect of different payment systems for outpatient care facilities. We collected and analysed all relevant studies to answer this question and included 21 studies. Key messages Pay-for-performance systems probably have only small benefits or make little or no difference to healthcare provider behaviour or patients' use of healthcare services. We are uncertain whether they cause harm. We are uncertain about the benefits and harms of other payments systems because the research is lacking or of very low certainty. What was studied in the review? Many healthcare services are offered to patients through outpatient facilities rather than to inpatients in hospitals. Outpatient facilities are also known as ambulatory care facilities, and include primary healthcare centres, outpatient clinics, urgent care centres, family planning centres, mental health centres, and dental clinics. Different systems to reimburse outpatient (ambulatory) care facilities for their services are available to governments and health insurers. These systems include: • budget systems, where the facility is given a fixed amount of money in advance to cover expenses for a fixed period; • capitation payment systems, where the facility is paid a fixed amount of money in advance to provide specific services to each enrolled patient for a fixed period; • fee-for-service systems, where payment is based on the specific services that the healthcare facility provides; • pay-for-performance systems, where payment is partly based on the performance of the facility's healthcare providers. Different payment systems can have different effects on how healthcare facilities deliver care. These changes can be intentional or unintentional and can lead to both benefits and harms. At best, a payment system can encourage healthcare providers to offer the right healthcare services to the right patients in the best and most cost-efficient way. However, payment systems can also lead providers to offer poor-quality, expensive, and unnecessary care, which can ultimately have a negative impact on patients' health. This Cochrane review assessed the effect of different payment systems for outpatient care facilities. Other Cochrane reviews have assessed the effect of different payment systems for individual healthcare professionals and for inpatient facilities. Main results We found 21 relevant studies from the United Kingdom, the United States, Rwanda, Burundi, Tanzania, Afghanistan, China, and Democratic Republic of Congo. Most of the studies were from primary healthcare facilities. The studies assessed capitation systems, fee-for-service systems, and different types of pay-for-performance systems. Pay-for-performance systems: • probably slightly improve providers' use of some tests and treatments; • probably lead to little or no difference in providers' compliance with quality assurance criteria; • may lead to little or no difference in patients' use of health services; • may lead to little or no difference in patients' health status. Capitation combined with a pay-for-performance system targeted at reducing antibiotic use probably slightly reduces antibiotic prescriptions when compared to a fee-for-service system. Two studies compared capitation with fee-for-service systems, however, we assessed the certainty of the evidence as very low. We did not find any relevant studies that assessed budget systems. How up-to-date is this review? We searched for studies that had been published up to March 2016. PMID:28253540

Niobium and tantalum

USGS Publications Warehouse

Schulz, Klaus J.; Piatak, Nadine M.; Papp, John F.; Schulz, Klaus J.; DeYoung,, John H.; Seal, Robert R.; Bradley, Dwight C.

2017-12-19

Niobium and tantalum are transition metals that are almost always found together in nature because they have very similar physical and chemical properties. Their properties of hardness, conductivity, and resistance to corrosion largely determine their primary uses today. The leading use of niobium (about 75 percent) is in the production of high-strength steel alloys used in pipelines, transportation infrastructure, and structural applications. Electronic capacitors are the leading use of tantalum for high-end applications, including cell phones, computer hard drives, and such implantable medical devices as pacemakers. Niobium and tantalum are considered critical and strategic metals based on the potential risks to their supply (because current production is restricted to only a few countries) and the significant effects that a restriction in supply would have on the defense, energy, high-tech industrial, and medical sectors.The average abundance of niobium and tantalum in bulk continental crust is relatively low—8.0 parts per million (ppm) niobium and 0.7 ppm tantalum. Their chemical characteristics, such as small ionic size and high electronic field strength, significantly reduce the potential for these elements to substitute for more common elements in rock-forming minerals and make niobium and tantalum essentially immobile in most aqueous solutions. Niobium and tantalum do not occur naturally as pure metals but are concentrated in a variety of relatively rare oxide and hydroxide minerals, as well as in a few rare silicate minerals. Niobium is primarily derived from the complex oxide minerals of the pyrochlore group ((Na,Ca,Ce)2(Nb,Ti,Ta)2(O,OH,F)7), which are found in some alkaline granite-syenite complexes (that is, igneous rocks containing sodium- or potassium-rich minerals and little or no quartz) and carbonatites (that is, igneous rocks that are more than 50 percent composed of primary carbonate minerals, by volume). Tantalum is derived mostly from the mineral tantalite ((Fe,Mn)(Ta,Nb)2O6), which is found as an accessory mineral in rare-metal granites and pegmatites that are also enriched in lithium and cesium (termed lithium-cesium-tantalum (LCT)-type pegmatites).Brazil and Canada are the leading nations that produce niobium mineral concentrates, but Brazil is by far the leading producer, accounting for about 90 percent of production, which comes mostly from weathered material derived from carbonatites. Brazil and Canada also have the largest identified niobium resources; additional resources, although they are less well reported, occur in Angola, Australia, China, Greenland, Malawi, Russia, and South Africa. Australia and Brazil have been the leading producers of tantalum mineral concentrates, although recently Ethiopia and Mozambique have also been significant suppliers of tantalum. Artisanal mining of columbite-tantalite (also called coltan) is practiced in many countries, particularly Burundi, the Democratic Republic of the Congo (Congo [Kinshasa]), Nigeria, Rwanda, and Uganda. Brazil has about 40 percent of the identified tantalum resources; other countries and regions with identified tantalum resources include, in decreasing order of resources, Australia, Asia, Russia and the Middle East, Africa, North America, and Europe. Identified niobium and tantalum resources in the United States are small, low grade, and difficult to recover and process, and are thus not commercially recoverable at current prices. Consequently, the United States meets its current and expected future needs for niobium and tantalum through imports of primary mineral concentrates and alloys and through recovery from foreign and domestic alloy scrap that contain the metals.Environmentally, the main issues related to niobium and tantalum mining are land disruptions, the volume of waste materials and their disposal, and the radioactivity of some tailings and waste materials that contain thorium and uranium. Because of the relative biological inertness of niobium and tantalum, human and ecological health concerns are generally minimal under most natural conditions.Demand for both niobium and tantalum is expected to increase as the world economy continues to recover from the downturn that began in 2008. Increased demand for niobium is linked to increased consumption of microalloyed steel, which is used in the manufacture of cars, buildings, ships, and refinery equipment. Demand for these steels will likely increase with continued economic development in such countries as Brazil, China, and India. In addition, increased global demand for cars, cell phones, computers, superconducting magnets, and other high-tech devices will likely spur increased demand for both niobium and tantalum. The estimated global reserves and resources of niobium and tantalum are large and appear more than sufficient to meet global demand for the foreseeable future, possibly the next 500 years. The sale of “conflict coltan” attributed to rebel forces waging a civil war in Congo (Kinshasa) has been of recent concern and has highlighted the need for a transparent and traceable global supply chain that can exclude illegal columbite-tantalite from the conventional market while discerning legitimate artisanal mine production in central Africa.

Paying for performance to improve the delivery of health interventions in low- and middle-income countries .

PubMed

Witter, Sophie; Fretheim, Atle; Kessy, Flora L; Lindahl, Anne Karin

2012-02-15

There is a growing interest in paying for performance as a means to align the incentives of health workers and health providers with public health goals. However, there is currently a lack of rigorous evidence on the effectiveness of these strategies in improving health care and health, particularly in low- and middle-income countries. Moreover, paying for performance is a complex intervention with uncertain benefits and potential harms. A review of evidence on effectiveness is therefore timely, especially as this is an area of growing interest for funders and governments. To assess the current evidence for the effects of paying for performance on the provision of health care and health outcomes in low- and middle-income countries. We searched more than 15 databases in 2009, including the Cochrane Effective Practice and Organisation of Care Group Specialised Register (searched 3 March 2009), CENTRAL (2009, Issue 1) (searched 3 March 2009), MEDLINE, Ovid (1948 to present) (searched 24 June 2011), EMBASE, Ovid (1980 to 2009 Week 09) (searched 2 March 2009), EconLit, Ovid (1969 to February 2009) (searched 5 March 2009), as well as the Social Sciences Citation Index, ISI Web of Science (1975 to present) (searched 8 September 2010). We also searched the websites and online resources of numerous international agencies, organisations and universities to find relevant grey literature and contacted experts in the field. We carried out an updated search on the Results-Based Financing website in April 2011, and re-ran the MEDLINE search in June 2011. Pay for performance refers to the transfer of money or material goods conditional on taking a measurable action or achieving a predetermined performance target. To be included, a study had to report at least one of the following outcomes: changes in targeted measures of provider performance, such as the delivery or utilisation of healthcare services, or patient outcomes, unintended effects and/or changes in resource use. Studies also needed to use one of the following study designs: randomised trial, non-randomised trial, controlled before-after study or interrupted time series study, and had to have been conducted in low- or middle-income countries (as defined by the World Bank). We aimed to present a meta-analysis of results. However, due to the limited number of studies in each category, the diversity of intervention designs and study methods, as well as important contextual differences, we present a narrative synthesis with separate results from each study. Nine studies were included in the review: one randomised trial, six controlled before-after studies and two interrupted time series studies (or studies which could be re-analysed as such). The interventions were varied: one used target payments linked to quality of care (in the Philippines). Two used target payments linked to coverage indicators (in Tanzania and Zambia). Three used conditional cash transfers, modified by quality measurements (in Rwanda, Burundi and the Democratic Republic of Congo). Two used conditional cash transfers without quality measures (in Rwanda and Vietnam). One used a mix of conditional cash transfers and target payments (China). Targeted services also varied. Most of the interventions used a wide range of targets covering inpatient, outpatient and preventive care, including a strong emphasis on services for women and children. However, one focused specifically on tuberculosis (the main outcome measure was cases detected); one on hospital revenues; and one on improved treatment of common illnesses in under-sixes. Participants were in most cases in a mix of public and faith-based facilities (dispensaries, health posts, health centres and hospitals), though districts were also involved and in one case payments were made direct to individual private practitioners.One study was considered to have low risk of bias and one a moderate risk of bias. The other seven studies had a high risk of bias. Only one study included any patient health indicators. Of the four outcome measures, two showed significant improvement for the intervention group (wasting and self reported health by parents of the under-fives), while two showed no significant difference (being C-reactive protein (CRP)-negative and not anaemic). The two more robust studies both found mixed results - gains for some indicators but no improvement for others. Almost all dimensions of potential impact remain under-studied, including intended and unintended impact on health outcomes, equity, organisational change, user payments and satisfaction, resource use and staff satisfaction. The current evidence base is too weak to draw general conclusions; more robust and also comprehensive studies are needed. Performance-based funding is not a uniform intervention, but rather a range of approaches. Its effects depend on the interaction of several variables, including the design of the intervention (e.g. who receives payments, the magnitude of the incentives, the targets and how they are measured), the amount of additional funding, other ancillary components such as technical support, and contextual factors, including the organisational context in which it is implemented.

Payment methods for outpatient care facilities.

PubMed

Yuan, Beibei; He, Li; Meng, Qingyue; Jia, Liying

2017-03-03

Outpatient care facilities provide a variety of basic healthcare services to individuals who do not require hospitalisation or institutionalisation, and are usually the patient's first contact. The provision of outpatient care contributes to immediate and large gains in health status, and a large portion of total health expenditure goes to outpatient healthcare services. Payment method is one of the most important incentive methods applied by purchasers to guide the performance of outpatient care providers. To assess the impact of different payment methods on the performance of outpatient care facilities and to analyse the differences in impact of payment methods in different settings. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), 2016, Issue 3, part of the Cochrane Library (searched 8 March 2016); MEDLINE, OvidSP (searched 8 March 2016); Embase, OvidSP (searched 24 April 2014); PubMed (NCBI) (searched 8 March 2016); Dissertations and Theses Database, ProQuest (searched 8 March 2016); Conference Proceedings Citation Index (ISI Web of Science) (searched 8 March 2016); IDEAS (searched 8 March 2016); EconLit, ProQuest (searched 8 March 2016); POPLINE, K4Health (searched 8 March 2016); China National Knowledge Infrastructure (searched 8 March 2016); Chinese Medicine Premier (searched 8 March 2016); OpenGrey (searched 8 March 2016); ClinicalTrials.gov, US National Institutes of Health (NIH) (searched 8 March 2016); World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (searched 8 March 2016); and the website of the World Bank (searched 8 March 2016).In addition, we searched the reference lists of included studies and carried out a citation search for the included studies via ISI Web of Science to find other potentially relevant studies. We also contacted authors of the main included studies regarding any further published or unpublished work. Randomised trials, non-randomised trials, controlled before-after studies, interrupted time series, and repeated measures studies that compared different payment methods for outpatient health facilities. We defined outpatient care facilities in this review as facilities that provide health services to individuals who do not require hospitalisation or institutionalisation. We only included methods used to transfer funds from the purchaser of healthcare services to health facilities (including groups of individual professionals). These include global budgets, line-item budgets, capitation, fee-for-service (fixed and unconstrained), pay for performance, and mixed payment. The primary outcomes were service provision outcomes, patient outcomes, healthcare provider outcomes, costs for providers, and any adverse effects. At least two review authors independently extracted data and assessed the risk of bias. We conducted a structured synthesis. We first categorised the comparisons and outcomes and then described the effects of different types of payment methods on different categories of outcomes. We used a fixed-effect model for meta-analysis within a study if a study included more than one indicator in the same category of outcomes. We used a random-effects model for meta-analysis across studies. If the data for meta-analysis were not available in some studies, we calculated the median and interquartile range. We reported the risk ratio (RR) for dichotomous outcomes and the relative change for continuous outcomes. We included 21 studies from Afghanistan, Burundi, China, Democratic Republic of Congo, Rwanda, Tanzania, the United Kingdom, and the United States of health facilities providing primary health care and mental health care. There were three kinds of payment comparisons. 1) Pay for performance (P4P) combined with some existing payment method (capitation or different kinds of input-based payment) compared to the existing payment methodWe included 18 studies in this comparison, however we did not include five studies in the effects analysis due to high risk of bias. From the 13 studies, we found that the extra P4P incentives probably slightly improved the health professionals' use of some tests and treatments (adjusted RR median = 1.095, range 1.01 to 1.17; moderate-certainty evidence), and probably led to little or no difference in adherence to quality assurance criteria (adjusted percentage change median = -1.345%, range -8.49% to 5.8%; moderate-certainty evidence). We also found that P4P incentives may have led to little or no difference in patients' utilisation of health services (adjusted RR median = 1.01, range 0.96 to 1.15; low-certainty evidence) and may have led to little or no difference in the control of blood pressure or cholesterol (adjusted RR = 1.01, range 0.98 to 1.04; low-certainty evidence). 2) Capitation combined with P4P compared to fee-for-service (FFS)One study found that compared with FFS, a capitated budget combined with payment based on providers' performance on antibiotic prescriptions and patient satisfaction probably slightly reduced antibiotic prescriptions in primary health facilities (adjusted RR 0.84, 95% confidence interval 0.74 to 0.96; moderate-certainty evidence). 3) Capitation compared to FFSTwo studies compared capitation to FFS in mental health centres in the United States. Based on these studies, the effects of capitation compared to FFS on the utilisation and costs of services were uncertain (very low-certainty evidence). Our review found that if policymakers intend to apply P4P incentives to pay health facilities providing outpatient services, this intervention will probably lead to a slight improvement in health professionals' use of tests or treatments, particularly for chronic diseases. However, it may lead to little or no improvement in patients' utilisation of health services or health outcomes. When considering using P4P to improve the performance of health facilities, policymakers should carefully consider each component of their P4P design, including the choice of performance measures, the performance target, payment frequency, if there will be additional funding, whether the payment level is sufficient to change the behaviours of health providers, and whether the payment to facilities will be allocated to individual professionals. Unfortunately, the studies included in this review did not help to inform those considerations.Well-designed comparisons of different payment methods for outpatient health facilities in low- and middle-income countries and studies directly comparing different designs (e.g. different payment levels) of the same payment method (e.g. P4P or FFS) are needed.