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Abstract: The Central African Republic (CAR) has been a theater of hostilities for decades, in- cluding the Seleka rebellion in December 2012, which caused religious-based discrimination, especially between the Muslim minority and Christian majority. Opportunistic political leaders and armed groups have misused religion for political and egocentric gains in the CAR. The pur- pose of this qualitative content analysis research is to investigate the use of religion for political motives in the CAR and how such actions impact conflict and sectarian divides in the so-called phantom state. The paper recommends ways to mitigate political influence and the misuse of religion by political and armed group actors in the CAR. Very little or no literature on conflict in the CAR has specifically addressed the influence of politics on religion and how it contributes to fueling conflict in the country. This study fills the gaps in the literature by investigating the historical narratives of the CAR conflict while highlighting instances of political abuse of religion. A review of existing literature on the political manipulation of religion establishes the basis for a critical analysis of the influence of politics on religion in the CAR and its impact on conflict. [ABSTRACT FROM AUTHOR]

Treatment of acute malnutrition requires novel approaches to improve coverage, reduce costs and improve the efficiency of standard protocols that separate the management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). The use of simplified, combined protocols to treat both MAM and SAM has drawn research and policy interest among global, regional and national stakeholders. However, the perspectives of local communities and health care workers regarding the use of protocols to treat acute malnutrition in a routine health care system are generally lacking. This was a cross‐sectional mixed‐methods study aimed at assessing the perceptions of different stakeholders on the use of a simplified, combined protocol in two districts in the Central African Republic. Most of the respondents preferred the simplified, combined protocol over the standard protocol. They generally agreed that the protocol was easy to understand, allowed more children to receive treatment and was effective in treating acute malnutrition. The protocol modifications were well received, including the expanded admission criteria, use of mid‐upper arm circumference (MUAC) only for admission and discharge criteria and reduced and simplified ready‐to‐use therapeutic food quantity to treat MAM and SAM. Some caregivers expressed concern with the use of MUAC only to declare recovery, flagging that underlying illnesses could still be present. The caregivers recommended the provision of other food basket interventions to improve the treatment. The support by caregivers and health care workers on the idea of training community health volunteers to treat acute malnutrition points to the potential of scaling up decentralized treatment to increase coverage in remote areas. Key messages: The use of the simplified, combined protocol to treat acute malnutrition received overwhelming support from most stakeholders involved in implementation.Stakeholders were supportive of the use of the protocol to provide care for both severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) children with a shorter length of stay in treatment.Most stakeholders supported the use of mid‐upper arm circumference only for the admission and discharge of children.The majority of stakeholders reported that the ready‐to‐use therapeutic food given for MAM and SAM was sufficient for the child's recovery.The idea of training and equipping community health volunteers to treat acute malnutrition was well supported by caregivers and health care workers and should be explored further. [ABSTRACT FROM AUTHOR]

Background: The use of medical abortion using either a combination of mifepristone and misoprostol, or misoprostol alone has contributed to increased safety and decreased mortality and morbidity. The availability of quality medical abortion medicines is an essential component in the provision of quality abortion care. Understanding the factors that influence the availability of medical abortion medicines is important to help in-country policymakers, program planners, and providers improve availability and use of medical abortion. Methods: Using a national assessment protocol and an availability framework, we assessed the availability of medical abortion medicines across five elements (Registration & Quality Assurance, Policy & Financing, Procurement & Distribution, Provider Knowledge, and End-user Knowledge) in eight countries: Botswana, Burkina Faso, Central African Republic, Democratic Republic of the Congo, Eswatini, Lesotho, Namibia and Uganda between November 2020 and November 2021. The assessment included an online desk review and virtual or telephone-based key informant interviews. Results: Registration of medical abortion medicines—misoprostol or co-packaged mifepristone and misoprostol products (combi-pack)—was established in all countries, except the Central African Republic. In Lesotho and Eswatini, the national regulatory agency is still in development and importation of Cytotec™ misoprostol is permitted for off-label use in obstetrics/gynecology. Misoprostol was included in all countries' essential medicines lists, except Botswana. Burkina Faso and Democratic Republic of the Congo also include mifepristone on their essential medicines list and medical abortion regimens in national abortion care service and delivery guidelines. Additionally, guidelines clarified health worker roles in the provision of abortion care specific to the legal context of each country and permitted task-shifting of abortion service provision. Where guidelines did not exist, medical abortion medicines and their use were not well integrated into the public health care system. Community awareness activities on abortion rights and services have been limited in scope across the countries assessed, however, end-users' awareness of misoprostol as a medical abortion medicine was reported. Conclusion: The national landscape assessments identified several cross-cutting opportunities to improve availability of medical abortion medicines, including importing quality-assured medical abortion medicines; developing nationally approved abortion service and delivery guidelines that optimize healthcare worker roles; and expanding communication strategies to reach end-users and pharmacists. [ABSTRACT FROM AUTHOR]

The paper analyses the normative and empirical capacity of elections to function as a peace mechanism in the early stages of the recovery period. Accordingly, the analysis is based on a theoretical framework that draws attention to the timing of elections in postconflict societies. Moreover, in order to operationalize such theoretical aspects, the paper focuses on two relevant case studies: the 1997 elections in Liberia (perceived as postconflict) and the 2020-2021 elections in The Central African Republic (early peace process - not void of conflict). Accordingly, the paper poses the following research questions: How was the prospect of organizing these rounds of election received by the parties involved in the conflict? How did these rounds of election relate to the peace process? Do elections represent an adequate mechanism to achieve positive peace in post-conflict societies. [ABSTRACT FROM AUTHOR]

Background: Mortality from physical inactivity-related non-communicable diseases (NCDs) is projected to surpass deaths from communicable diseases by 2030 in Africa. Monitoring physical activity (PA) is important for planning public health interventions addressing NCDS and planetary health, but there is a dearth of evidence on PA trends in Africa. This study explored the secular trends in overall and domains of PA (leisure, occupation, and transport), and examined the gender, age, and education disparities in PA trends across African countries. Methods: We utilized data from the STEPwise approach to NCDs risk factor surveillance in eleven African countries (Algeria, Benin, Botswana, Cabo Verde, Eritrea, Eswatini, Malawi, Mali, Central Africa Republic, Sao Tome and Principe, and Zambia) with at least two surveys conducted between 2003/2010 (first-wave) and 2010/2020 (second-waves). A total of 29,282 and 40,147 adults (18–69 years) in the first and second waves, respectively, completed PA interviews using the Global Physical Activity Questionnaire. Gender, age, and education status were self-reported. Weighted individual-country PA prevalence and 95% confidence interval (95%CI) were obtained. Random-effect meta-analysis was conducted to assess pooled estimates of PA trends across countries. Gender, age, and education disparities in PA trends were also investigated. Results: Country-specific results showed significant upward trends in total PA in eight countries. Seven countries showed significant increasing trends in some leisure-time PA (2.0% − 13.9% increase) and ≥ 150 min/week transport PA (4.0% − 24.5% increase), while five countries recorded significant increasing trends in occupational PA (6.6% − 56.9% increase). Gender, age and education disparities in meeting the WHO PA guidelines remained relatively stable over time, but disparities in leisure, transport and occupational PA increased in most countries. Conclusions: The prevalence of overall PA among African adults has marginally increased over 17 years. There are still many adults, especially women and people with lower education, not doing well in domain specific PA. Policy and environmental interventions are needed to improve PA and to reduce gender, age, and education disparities in leisure, transport, and occupational PA in African countries. [ABSTRACT FROM AUTHOR]

A simplified, combined protocol admitting children with a mid‐upper‐arm circumference (MUAC) of <125 mm or oedema to malnutrition treatment with ready‐to‐use therapeutic food (RUTF) uses two sachets of RUTF per day of those with MUAC < 115 mm and/or oedema and one sachet of RUTF per day for those with MUAC 115–<125 mm. This treatment previously demonstrated noninferior programmatic outcomes compared with standard treatment and high recovery in a routine setting. We aimed to observe the protocol's effectiveness in a routine setting at scale, in two health districts of the Central African Republic through an observational cohort study. The pilot enrolled children for 1 year in consortium by the Ministry of Health and nongovernmental partners. A total of 7909 children were admitted to the simplified, combined treatment. Treatment resulted in an 81.2% overall recovery, with a mean length of stay (LOS) of 38.7 days and a mean RUTF consumption of 43.4 sachets per child treated. Among children admitted with MUAC < 115 mm or oedema, 67.9% recovered with a mean LOS of 48.1 days and consumed an average of 70.9 RUTF sachets. Programme performance differed between the two districts, with an overall defaulting rate of 31.1% in the Kouango‐Grimari health district, compared to 8.2% in Kemo. Response to treatment by children admitted with severe acute malnutrition (SAM) by MUAC and SAM by oedema was similar. The simplified, combined protocol resulted in a satisfactory overall recovery and low RUTF consumption per child treated, with further need to understand defaulting in the context. Key messages: The simplified, combined protocol with a mid‐upper‐arm circumference (MUAC)‐based ready‐to‐use therapeutic food (RUTF) resulted in a recovery rate that reached SPHERE standards, low length of stay and low RUTF consumption per child among all children treated.Response to treatment was similar among children admitted with severe acute malnutrition (SAM) by oedema and those admitted SAM by MUAC.Contextual factors such as insecurity and stockouts in treatment products affect programme outcomes by increasing defaulting and decreasing recovery rates.The simplified, combined protocol might present an opportunity to treat more children with less product; decentralised delivery should continue to be explored. [ABSTRACT FROM AUTHOR]

Background: Ongoing conflict between multiple armed groups, including pastoralist herders in the Central African Republic (CAR) causes frequent population displacements, food insecurity and scarcity of healthcare services. The inaccessibility and insecurity of many areas of CAR limit data collection and assessments from national nutritional surveys. Community health workers (CHWs) trained by an international non-governmental organisation, The MENTOR Initiative, deliver basic healthcare to children under 5 years old living in hard-to-reach and conflict-affected areas in eight subprefectures of north-west CAR. Their nutritional status and its associations with geography, malaria, season and conflict are unknown. Methods: CHW monthly records (October 2015–August 2021), Armed Conflict Location and Event Data project conflict data and The World Bank Group meteorological data for eight subprefectures of north-west CAR were analysed. Associations between counts of global acute malnutrition (GAM) assessed by mid-upper arm circumference and malaria, season and conflict were investigated using negative binomial regression. Results: Of the 457,325 consultations with children aged 6–59 months, 6.2% and 0.4% were classified as moderately or severely malnourished, respectively. The negative binomial model demonstrated differences in counts of GAM by subprefecture. Counts of GAM were positively associated with the case rate of severe malaria (IRR = 1.045; 95% CI: 1.04–1.06) and the rainy season (July–September) (IRR = 1.10; 95% CI: 1.03–1.17). Conflict events coded as Battles in ACLED were associated with lower counts of GAM (IRR = 0.78; 95% CI: 0.62–0.97). Conclusions: This analysis shows geographical differences in levels of malnutrition in north-west CAR and demonstrates clear associations between malnutrition, season and malaria. It provides evidence that levels of GAM may be underestimated in north-west CAR in areas experiencing conflict. These findings highlight the need for targeted nutritional support to reach children most at risk of malnutrition. CHWs are a proven effective means of delivering essential primary healthcare services in hard-to-reach, conflict-affected areas. [ABSTRACT FROM AUTHOR]

Considering the uneven geography of foreign direct investment in Africa, this article examines political, demographic and infrastructural factors that have led six countries – Burundi, Central African Republic, Comoros, the Gambia, Guinea Bissau and São Tomé and Príncipe – to be the least attractive territories to the external capital. This paper investigates the extent to which political stability, qualification of labor, potential consumer market, regional integration, and infrastructure play a central role in attracting investments. It also debates Geography's role in investigating African countries' particularities to avoid common generalizations, which are still disseminated by Afro-Optimism and Afro-Pessimist perspectives. [ABSTRACT FROM AUTHOR]

Youth as a category that informs international interventions in conflict-affected settings has gained currency in the past decade. This article traces the rising rhetoric of youth in UN Disarmament, Demobilization and Reintegration (DDR) discourse and demonstrates how changes in its dominant representations have implications beyond the matter of semantics. Drawing on post-structuralist traditions, the article highlights how the DDR discourse delineates problems through particular framings that call forth certain solutions, which in turn reinforce the very (mis)understandings that underlie the interventions. A case study from the Central African Republic illustrates how the hegemonic representation of youth-as-troublemakers in UN documents, together with a compelling narrative that naturalized the link between youth, unemployment and violence, made possible and conferred legitimacy to the proliferation of projects with an overwhelming economic focus. The article discusses how the resource landscape, such as opportunities to unlock earmarked funding, incentivizes the reproduction of certain constructions of youth that align with today's policy panic around violent extremism. In so doing, it puts into question the instrumental approach towards discourse by pointing to surprising ways in which discourses become appropriated by both international peacebuilders and the 'subjects' of these interventions. [ABSTRACT FROM AUTHOR]

Background: In 2020, during the COVID-19 pandemic, Médecins Sans Frontières (MSF) initiated three cycles of dihydroartemisin-piperaquine (DHA-PQ) mass drug administration (MDA) for children aged three months to 15 years within Bossangoa sub-prefecture, Central African Republic. Coverage, clinical impact, and community members perspectives were evaluated to inform the use of MDAs in humanitarian emergencies. Methods: A household survey was undertaken after the MDA focusing on participation, recent illness among eligible children, and household satisfaction. Using routine surveillance data, the reduction during the MDA period compared to the same period of preceding two years in consultations, malaria diagnoses, malaria rapid diagnostic test (RDT) positivity in three MSF community healthcare facilities (HFs), and the reduction in severe malaria admissions at the regional hospital were estimated. Twenty-seven focus groups discussions (FGDs) with community members were conducted. Results: Overall coverage based on the MDA card or verbal report was 94.3% (95% confidence interval (CI): 86.3–97.8%). Among participants of the household survey, 2.6% (95% CI 1.6–40.3%) of round 3 MDA participants experienced illness in the preceding four weeks compared to 30.6% (95% CI 22.1–40.8%) of MDA non-participants. One community HF experienced a 54.5% (95% CI 50.8–57.9) reduction in consultations, a 73.7% (95% CI 70.5–76.5) reduction in malaria diagnoses, and 42.9% (95% CI 36.0–49.0) reduction in the proportion of positive RDTs among children under five. A second community HF experienced an increase in consultations (+ 15.1% (− 23.3 to 7.5)) and stable malaria diagnoses (4.2% (3.9–11.6)). A third community HF experienced an increase in consultations (+ 41.1% (95% CI 51.2–31.8) and malaria diagnoses (+ 37.3% (95% CI 47.4–27.9)). There were a 25.2% (95% CI 2.0–42.8) reduction in hospital admissions with severe malaria among children under five from the MDA area. FGDs revealed community members perceived less illness among children because of the MDA, as well as fewer hospitalizations. Other indirect benefits such as reduced household expenditure on healthcare were also described. Conclusion: The MDA achieved high coverage and community acceptance. While some positive health impact was observed, it was resource intensive, particularly in this rural context. The priority for malaria control in humanitarian contexts should remain diagnosis and treatment. MDA may be additional tool where the context supports its implementation. [ABSTRACT FROM AUTHOR]

Background: Monkeypox is a viral zoonotic disease commonly reported in humans in parts of Central and West Africa. This protocol is for an Expanded Access Programme (EAP) to be implemented in the Central African Republic, where Clade I monkeypox virus diseases is primarily responsible for most monkeypox infections. The objective of the programme is to provide patients with confirmed monkeypox with access to tecovirimat, a novel antiviral targeting orthopoxviruses, and collect data on clinical and virological outcomes of patients to inform future research. Methods: The study will be conducted at participating hospitals in the Central African Republic. All patients who provide informed consent to enrol in the programme will receive tecovirimat. Patients will remain in hospital for the duration of treatment. Data on clinical signs and symptoms will be collected every day while the patient is hospitalised. Blood, throat and lesion samples will be collected at baseline and then on days 4, 8, 14 and 28. Patient outcomes will be assessed on Day 14 –end of treatment–and at Day 28. Adverse event and serious adverse event data will be collected from the point of consent until Day 28. Discussion: This EAP is the first protocolised treatment programme in Clade I MPXV. The data generated under this protocol aims to describe the use of tecovirimat for Clade I disease in a monkeypox endemic region of Central Africa. It is hoped that this data can inform the definition of outcome measures used in future research and contribute to the academic literature around the use of tecovirimat for the treatment of monkeypox. The EAP also aims to bolster research capacity in the region in order for robust randomised controlled trials to take place for monkeypox and other diseases. Trial registration: {2a & 2b}: ISRCTN43307947. [ABSTRACT FROM AUTHOR]

Copyright of Cameroon Academy of Sciences Journal is the property of Cameroon Academy of Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

"What explains the feeling of being disempowered? The literature on aspirations suggests subjectively deprived people may feel disempowered because they consider that any improvement to their lot is simply out of their reach. The present paper provides original and robust evidence that, alongside the well-known objective capabilities related to skills, assets and opportunities, psychological capabilities linked to aspirations also matter. Based on a Central African household survey and tackling endogeneity issues, we show that: (i) feeling subjectively more deprived decreases the probability of reporting a high level of empowerment, defined as power from within, that is the power to change one's life; (ii) the probability of reporting empowerment decreases with the size of the aspirations gap, defined as the negative gap between one's level of subjective wealth and the locality's mean level; (iii) the capability framework is a relevant one to address the complex links between aspirations and empowerment." [ABSTRACT FROM AUTHOR]

This present research explores a progressive repurposing of Virtual Reality technology, Virtual Immersive Contact (VIC), in a real-world setting to; explore viability to reduce prejudice and investigate the role of empathy in motivating prosocial behavior. The study employed a between-subjects repeated-measures experimental design of a randomized sample (n = 113) split into two conditions to reduce prejudice and discrimination in the active conflict area of the Central African Republic (CAR). In line with the study's hypotheses, VIC produced a significant increase in empathic concern for the Muslim outgroup and intentions to donate to a Muslim family, while also showing that the relationship between empathy and helping behaviours was mostly explained by confounding variables. This research provides both the first evidence of its kind that VIC could be a new form of fostering positive intergroup contact in an active conflict setting, crating a new facet of intergroup contact theory, and further evolving the literature on the empathy, prosocial behaviour relationship. [ABSTRACT FROM AUTHOR]

While United Nations (UN) peacekeeping operations are increasingly deployed during ongoing violent conflict, they are also increasingly staffed with civilian personnel tasked with peacebuilding at the local level. How does violent conflict affect civilian peacekeepers' peacebuilding efforts locally? Shifting the research focus from military to civilian peacekeepers, we argue that the latter have various incentives and the capacity to concentrate their local-level peacebuilding efforts in violence-affected areas. We test our argument using novel, georeferenced data on peacebuilding by "Civil Affairs" personnel of the peacekeeping operation in the Central African Republic. Consistent with our expectation, violence positively correlates with civilian peacekeepers' peacebuilding interventions both within and across localities. Furthermore, mediation analyses suggest that this correlation is not merely due to greater UN military deployments in violence-affected areas. Instrumental variable regression supports a causal interpretation: violence leads to more efforts by civilian peacekeepers. These findings inform expectations and assessments of peacekeeping effectiveness. [ABSTRACT FROM AUTHOR]

This paper investigates the geochemistry of bulk rock and infers the petrogenesis of ultramafic rocks in the Boali Precambrian terrane in Mbi Valley, in the North of the Central African Republic (CAR). The studied rocks comprise coarse primary olivine and orthopyroxene relics (dominant phase), magnesio-hornblende, magnetite, and antigorite. Whole-rock analysis indicates low SiO2 (average of 43.14 wt%) and high MgO (19.84–26.98 wt%) contents and their Mg number (Mg#) ranges from 74 to 82. They display high Ni (526–865 ppm), Cr (1500–3680 ppm) contents. AFM (Na2O-K2O)-FeO-MgO) and ACM (Al2O3-CaO-MgO) ternary diagrams have revealed that the studied samples correspond to arc-related ultramafic cumulates. Chondrite-normalized REE plots display an increasing trend from La to Sm (CeN/SmN: 0.74–1.81), weak negative to no Eu (Eu/Eu* = 0.72–1.05) and strong negative Ce (Ce/Ce* = 0.33–0.98) anomalies. Primitive mantle normalized of multi-element diagrams exhibit LREE enrichment and large ion lithophile elements (LILE) relative to high field strength elements (HFSE), and notable negative anomalies in Nb. This suggests the generation of the parent melt by slab dehydration and wedge melting processes. In addition, incompatible trace element composition and ratios assumed that the source magma had an enhanced mantle source associated with a prominent influence of continental crust. Metasomatism of mantle wedge by plate-dehydrated, LILE-rich fluids and the incorporation of sediments derived from subduction explain the enhancement of the source. Integrated major and trace element compositions jointly with the tectonic reconstruction of this region and LA-ICP-MS U–Pb data on zircon constrain the emplacement age at ca. 2099 Ma in a continental margin arc setting involving subduction of an oceanic plate beneath the continental lithosphere, dehydration of the slab and mantle wedge melting. This result intimate that the remnants of Paleoproterozoic oceanic crust or subduction event and subsequent basins closure extended from the Congo craton in Cameroon to CAR and NE Brazil. [ABSTRACT FROM AUTHOR]

Background The objectives of this study were to determine the association between the vulnerability factors linked to human immunodeficiency virus (HIV) and other sexually transmitted infection among the young women who sell sex (YWSS) group (15–24 years) and adult sex workers, engaged in consensual sex for money (AFSW). Methods A cross-sectional study was conducted among AFSW involved in commercial sex transactions. Prevalence ratios (PR) analysis was carried out using log-binomial regression model. Results The prevalence of HIV-1 was 29.4% among YWSS compared to 19.6% among female sex worker (PR = 1.43 [1.07–1.91]). Consistent condoms use last 3 months were very low at 22.3% and 41.2%, respectively (PR = 0.52 [0.37–0.74]), the low education level among YWSS versus AFSW (PR = 0.55 [0.40–0.76]); YWSS having been a victim of sexual violence in the last 12 months (PR = 2.00 [1.52–2.63]), were also more likely to be HIV positive. Conclusions The YWSS had a high prevalence of HIV, experienced other socioeconomic vulnerabilities and remain a key population for comprehensive HIV programs. To reach all YWSS, programs need to consider many outreach programs and address the shared determinants of HIV risk. [ABSTRACT FROM AUTHOR]

The majority of the world's ultra-poor live in conflict-affected environments. Poverty reduction efforts are increasingly attempting to target the most vulnerable inhabitants of these settings. Few studies have so far examined their impacts. Against the backdrop of one of the largest humanitarian crises in recent years, survey data from the Central African Republic demonstrates that a year after the conclusion of a large social safety net program, the poorest female participants did not benefit proportionately to other women and men. We draw on 257 in-depth qualitative interviews in extremely difficult-to-access conflict-affected sites across the country to explore the puzzle of why the most vulnerable inhabitants of conflict-affected settings may fail to benefit equally from poverty reduction programs. We demonstrate that conditions of social isolation—rather than poverty itself—create two specific barriers to long-term benefits. First, social isolation means that the poorest women recipients lack the social support networks that permit others to respond to conflict-related shocks without draining all their new income on emergency spending. Second, small social networks create a shortage of labor and higher start-up costs for new revenue-generating activities, thereby preventing spending on investment opportunities. These factors highlight the social barriers to poverty reduction, which are often intensified by shocks born from war, that material aid alone fails to redress. [ABSTRACT FROM AUTHOR]

Copyright of Annales UMCS, Sectio K (Politologia) is the property of Maria Curie-Sklodowska University in Lublin and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Politique Africaine is the property of Karthala Editions Diffusion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

While preventive maintenance services have emerged as promising interventions to improve the continuity of water service delivery, the operational and contextual requirements for sustained functionality within maintenance models are not well understood. This paper uses data analysis to better understand factors influencing the success of rural water service delivery within the circuit rider maintenance model in fragile contexts. Incorporating operational data from a large scale circuit rider hand-pump maintenance program in the Central African Republic, mixed-effect logistic regression models were used to identify determinants of water point functionality and payment compliance. Models were informed by data from over 16,000 maintenance visits across nine years. Faster response time, proximity to urban centers, and proximity to other hand-pumps emerged as significant factors for improving water point functionality, while proximity to maintenance program headquarters, pump functionality, and frequency of maintenance visits significantly influenced payment compliance. The observed high functionality rates of hand-pumps serviced by the maintenance program indicates the potential benefits of professionalized maintenance through the circuit rider model at promoting water system reliability in fragile contexts. Despite adaptability and resilience in implementation of the circuit rider model, insecurity and conflict remain barriers to sustaining service delivery in the Central African Republic. [ABSTRACT FROM AUTHOR]

This research paper is based on living material belonging to the genus Euphaedra, collected over the last 10 years in Bangui, as well as a neighbouring South West area in Central African Republic (CAR). There are four rare species of Euphaedra confirmed in CAR, and three others are reported for the first time in this country. Some comments are included relating to species abundance and distribution. [ABSTRACT FROM AUTHOR]

How do public procurement practices influence effective public financial management (PFM) in Africa? Notwithstanding the several public procurement reforms to improve PFM in Africa, outcomes have not been sustainable. Prior studies have failed to explain this phenomenon. With a descriptive case study design based on comprehensive datasets, this paper explains this situation with three key factors underlying the public procurement environment in three African countries: Ethiopia, Central African Republic, and Ghana. From the agency theory lenses, these factors affect the agency cost in public administrative systems necessary for addressing the agency problems in public procurement management towards desired PFM outcomes. [ABSTRACT FROM AUTHOR]

Objectives: With a fourth of all under-five children affected, stunting remains one of the biggest health challenges worldwide. Even though the main underlying factors are known, the exact pathways to stunting varying in affected regions, and interventions thus need to be tailored to the local contexts. This study aimed assessing and comparing factors associated with stunting in two understudied sub-Saharan urban contexts with some of the highest stunting prevalence globally: Bangui, Central African Republic (~ 36%) and Antananarivo, Madagascar (42%). Methods: We performed a case–control study on 175 + 194 stunted and 237 + 230 non-stunted control children aged 2–5 years and matched for age, gender and district of residency. Factors associated with stunting were identified using a standardized, paper questionnaire delivered by trained interviewers. Statistical analysis was done using logistic regression modelling. Results: In both sites, formal maternal education lowered the risk of being stunted and restricted access to soap, suffering of anaemia and low birth weight were associated with higher risk of stunting. Short maternal stature, household head different from parents, diarrhoea and coughing were associated with an increased risk and continuing breastfeeding was associated with a lower risk of stunting in Antananarivo. Previous severe undernutrition and dermatitis/ fungal skin infections were associated with higher and changes in diet during pregnancy with lower risk of stunting in Bangui. Conclusions: Our results suggest maternal education, antenatal care, iron supplementation and simple WASH interventions such as using soap and infection control as general and breastfeeding (Antananarivo) or better nutrition (Bangui) as area-specified interventions. [ABSTRACT FROM AUTHOR]

The recurrence of conflict and violence in the CAR in the 1990s and early 2000s underpinned the movement of people from this country to Cameroon. The avalanche of people fleeing war, atrocities perpetrated by politico-military groups and highwaymen along the eastern borders, constitutes a serious security threat. This threat can be understood in terms of its immediate effects and long-term impacts on East Cameroon. The dynamics of these cross-border migratory movements have had direct repercussions on the political, economic, social and physical life of the populations of Cameroon's eastern fringe. Based on empirical documentation in the form of books, articles, press clippings and newspapers, directive and semi-directive interviews, and field observations of various actors and protagonists, this article aims, in short, to show and highlight the impacts of cross-border mobility on security in East Cameroon, a geographical entity contiguous with the Central African Republic. [ABSTRACT FROM AUTHOR]

Identifying and quantifying factors that influence tree growth are crucial issues to ensure sustainable forest management, particularly in moist tropical forests. Tree growth depends on several factors comprising ontogenic stage, competition by neighbours and environmental conditions. Several studies have focused on one or two of them, but very few have considered all three, especially in Central Africa. We investigated the effects of diameter and competition on tree growth, in four Central African sites characterized by their soil physicochemical properties, at both tree community and population levels.We calibrated growth models using diameter data collected on 29,741 trees between 2015 and 2018, on twelve 4 or 9‐ha plots spread over the four sites. These models included diameter, wood density, competition indices and site effect as explainable variables at the community level and excluded wood density at the population level.At the community level, the best models explained 11% of growth variability with a decreasing effect of species wood density, diameter, site and competition. Our results show that even if low, site effect can result from different soil nutrients depending on both tree size and species wood density. We observed higher tree growth on sites with (i) high exchangeable K, organic C, total N and total P for low wood density species; (ii) high available P and C:N for small trees, high exchangeable Ca and Mg for medium to large trees, all belonging to medium and hard wood density species. At the population level, the best models explained between 0 to 43% of growth variability, with significant competition effect (resp. site effect) for 21 (resp. 9) of the 43 species studied. Site ranking varied greatly between the 9 species concerned, probably reflecting different sensitivities to the scarcity of particular soil nutrients.Synthesis. Our study provides original results on the factors influencing tree growth in Central Africa, showing that the potential effect of soil nutrients depends on tree size and species wood density. Remaining highly unpredictable at the population level, this effect makes it essential to increase the number of dynamics monitoring systems in logging concessions. [ABSTRACT FROM AUTHOR]

Qualitative empirical enquiries into dynamics of security and insecurity often include a blind spot that bear theoretical ramifications because only those areas and respondents that allow for relatively safe fieldwork are studied. To transparently articulate the spheres of projection that creep into our knowledge production, we propose a distinction between inner and outer circles as highly fluid but separate geographical, socio-political and methodological spaces. Drawing on fieldwork in the Central African Republic and South Sudan, we discuss the risks posed by incomplete data and subsequently flawed inferences. We argue that the perceptions of fear projected onto the outer circle shape people's behaviour more than measurable insecurity incidents and that increased interaction between actors in both circles reduces the perceived threats coming from the outer circles. We demonstrate how studying insecurity from inner circles risks securitizing outer circles while further centralizing the inner ones. We thus urge transparency in data collection and the related inferences that underpin our knowledge production. [ABSTRACT FROM AUTHOR]

(1) Background: Bacillus cereus biovar anthracis (Bcbva) was the causative agent of an anthrax-like fatal disease among wild chimpanzees in 2001 in Côte d'Ivoire. Before this, there had not been any description of an anthrax-like disease caused by typically avirulent Bacillus cereus. Genetic analysis found that B. cereus had acquired two anthrax-like plasmids, one a pXO1-like toxin producing plasmid and the other a pXO2-like plasmid encoding capsule. Bcbva caused animal fatalities in Cameroon, Democratic Republic of Congo, and the Central African Republic between 2004 and 2012. (2) Methods: The pathogen had acquired plasmids in the wild and that was discovered as the cause of widespread animal fatalities in the early 2000s. Primate bones had been shipped out of the endemic zone for anthropological studies prior to the realized danger of contamination with Bcbva. Spores were isolated from the bone fragments and positively identified as Bcbva. Strains were characterized by classical microbiological methods and qPCR. Four new Bcbva isolates were whole-genome sequenced. Chromosomal and plasmid phylogenomic analysis was performed to provide temporal and spatial context to these new strains and previously sequenced Bcbva. Tau and principal component analyses were utilized to identify genetic and spatial case patterns in the Taï National Park anthrax zone. (3) Results: Preliminary studies positively identified Bcbva presence in several archival bone fragments. The animals in question died between 1994 and 2010. Previously, the earliest archival strains of Bcbva were identified in 1996. Though the pathogen has a homogeneous genome, spatial analyses of a subset of mappable isolates from Taï National Park revealed strains found closer together were generally more similar, with strains from chimpanzees and duikers having the widest distribution. Ancestral strains were located mostly in the west of the park and had lower spatial clustering compared to more recent isolates, indicating a local increase in genetic diversity of Bcbva in the park over space and time. Global clustering analysis indicates patterns of genetic diversity and distance are shared between the ancestral and more recently isolated type strains. (4) Conclusions: Our strains have the potential to unveil historical genomic information not available elsewhere. This information sheds light on the evolution and emergence of a dangerous anthrax-causing pathogen. [ABSTRACT FROM AUTHOR]

A new Afrotropical genus (Ifrika gen. n.) and three new species (Ifrika mnyamasp. n., Ifrika nyigusp. n. and Ifrika wadudusp. n.) are described and illustrated. A fourth species, Ifrika pauculihirtacomb. n., is transferred from Dissomphalus. The males of this genus are easily recognised among the other genera of Pristocerinae by having the following combination of characteristics: the median clypeal lobe indistinct from the lateral ones, the dorsal pronotal area very short, the hypopygium with an inner membrane and a posterior margin deeply excavated, the genitalia with the harpe strongly incurved, almost fully divided, the aedeagus with a basal cover plate, the mediodorsal fold, and the median projection ventrally curved and apodeme dorsally curved. A key to all species and some comments on the Afrotropical Bethylidae fauna are also provided. [ABSTRACT FROM AUTHOR]

This paper examines how innovative skills and knowledge are transmitted and acquired among adolescents in two hunter-gatherer communities, the Aka of southern Central African Republic and the Chabu of southwestern Ethiopia. Modes of transmission and processes of social learning are addressed. Innovation as well as social learning have been hypothesized to be key features of human cumulative culture, enhancing the fitness and survival of individuals in diverse environments. The innovation literature indicates adult males are more innovative than children and female adults and therefore predicts that adolescents will seek out adult males. Further, the mode of transmission should be oblique (i.e., learning from adults other than parents). Thus, learning of innovations should be oblique or horizontal rather than vertical, with adolescents paying particular attention to "successful" innovative individuals (prestige bias). The social learning literature indicates that complex skills or knowledge is likely to be learned through teaching, and therefore that teaching will be an important process in the transmission of innovations. In-depth and semi-structured interviews, informal observations, and systematic free-listing were used to evaluate these hypotheses. The study found that (1) cultural context patterned whether or not adolescents sought out adult male or female innovators; (2) oblique modes of transmission were mentioned with greater frequency than horizontal or vertical modes; (3) knowledge and skill bias was notable and explicitly linked by the adolescents to reproductive effort; and (4) teaching was biased toward same-sex individuals and was an important but not an exclusive means of transmitting complex skills and social knowledge. [ABSTRACT FROM AUTHOR]

Heavy episodic drinking (HED) is associated with negative health consequences. The goal of the study was to assess HED among the general adult population in Central African Republic (CAR). In a cross-sectional survey in CAR (Bangui city and Ombella M'Poko region), 3 301 people (range = 25 - 64 years) completed structured interview questions, including on alcohol use, and anthropometric and blood pressure measurements were taken. Logistic regression was used to assess associations between sociodemographic indicators, health factors, and past-month HED. Results indicated that 33.0% of participants reported HED (26.4% in women and 44.4% in men), and among past 12-month drinkers 63.1% reported HED. In the final logistic regression model, male sex, aged 35 to 44 years, ten or more years of education, current tobacco smoking, current smokeless tobacco use, second-hand smoke exposure, and having four or more meals outside the home in the past week increased the odds of HED. One-third of the study population reported HED, suggesting a need for population-level interventions to reduce HED. [ABSTRACT FROM AUTHOR]

Background: Despite increasing evidence on COVID-19, few studies have been conducted in humanitarian settings and none have investigated the direct and indirect effects of the pandemic in the Central African Republic. We studied the COVID-19 epidemiology, health service utilization, and health care seeking behavior in the first year of the pandemic in Bangui and surrounding areas. Methods: This mixed-methods study encompasses four components: descriptive epidemiological analysis of reported COVID-19 cases data; interrupted time series analysis of health service utilization using routine health service data; qualitative analysis of health care workers' perceptions of how health services were affected; and health care seeking behavior of community members with a household survey and focus group discussions. Results: The COVID-19 epidemiology in CAR aligns with that of most other countries with males representing most of the tested people and positive cases. Testing capacity was mainly concentrated in Bangui and skewed towards symptomatic cases, travelers, and certain professions. Test positivity was high, and many cases went undiagnosed. Decreases in outpatient department consultations, consultations for respiratory tract infections, and antenatal care were found in most study districts. Cumulative differences in districts ranged from − 46,000 outpatient department consultations in Begoua to + 7000 in Bangui 3; − 9337 respiratory tract infections consultations in Begoua to + 301 in Bangui 1; and from − 2895 antenatal care consultations in Bimbo to + 702 in Bangui 2. Consultations for suspected malaria showed mixed results while delivery of BCG vaccine doses increased. Fewer community members reported seeking care at the beginning of the pandemic compared to summer 2021, especially in urban areas. The fear of testing positive and complying with related restrictions were the main obstacles to seeking care. Conclusions: A large underestimation of infections and decreased health care utilization characterized the first year of the COVID-19 pandemic in Bangui and surrounding area. Improved decentralized testing capacity and enhanced efforts to maintain health service utilization will be crucial for future epidemics. A better understanding of health care access is needed, which will require strengthening the national health information system to ensure reliable and complete data. Further research on how public health measures interact with security constraints is needed. [ABSTRACT FROM AUTHOR]

The interactions between the geophysical processes and geodynamics of the lithosphere play a crucial role in the geologic structure of the Earth's crust. The Bangui magnetic anomaly is a notable feature in the lithospheric structure of the Central African Republic (CAR) resulting from a complex tectonic evolution. This study reports on the coherence in the geophysical data and magnetic anomaly field analysed from a series of maps. The data used here include raster grids on free-air altimetric gravity, magnetic EMAG2 maps, geoid EGM2008 model and topographic SRTM/ETOPO1 relief. The data were processed to analyse the correspondence between the geophysical and geologic setting in the CAR region. Histogram equalization of the topographic grids was implemented by partition of the raster grids into equal-area patches of data ranged by the segments with relative highs and lows of the relief. The original data were compared with the equalized, normalized and quadratic models. The scripts used for cartographic data processing are presented and commented. The consistency and equalization of topography, gravity and geoid data were based using GMT modules 'grdfft' and 'grdhisteq' modules. Using GMT scripts for mapping the geophysical and gravity data over CAR shows an advanced approach to multi-source data visualization to reveal the relationships in the geophysical and topographic processes in central Africa. The results highlighted the correlation between the distribution of rocks with high magnetism in the central part of the Bangui anomaly, and distribution of granites, greenstone belts, and metamorphosed basalts as rock exposure. The correspondence between the negative Bouguer anomaly (<−80 mGal), low geoid values (<−12 m) and the extent of the magnetic anomaly with extreme negative values ranging from −1000 to −200 nT is identified. The integration of the multi-source data provides new insights into the analysis of crustal thicknesses and the average density of the Earth in CAR, as well as the magnitude of the magnetic fields with notable deviations caused by the magnetic flux density in the Bangui area related to the distribution of mineral resources in CAR. [ABSTRACT FROM AUTHOR]

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The purpose of this paper is to examine the relationship between capital flight, diamond exports and political governance crisis in the Central African Republic. To achieve this, use is made of multiple correspondence analysis to construct a political governance crisis index, and the Autoregressive Distributed Lag Model and Bound test for co‐integration are employed to establish short‐run and long‐run relationships. The short‐run results show political governance crisis and diamond exports have a significant and negative effect on capital flight. The interaction term between diamonds exports and political governance crisis is found to be positively related to capital flight in the short run. The long‐run equilibrium shows a significant and negative relationship between political governance crisis, diamond exports, and gross domestic product growth even though the interaction between political governance crisis and diamond exports show a positive and significant relationship. The total natural resource rent is found to be positively related to capital flight but not statistically significant. It is then recommended that a combination of stable political governance associated with reducing corruption in public affairs and promoting transparency in the management of the diamond sector be strengthened to effectively reduce the flight of capital. [ABSTRACT FROM AUTHOR]

Never has the doctrine of command responsibility been shaken as when the Appeal Chamber of the International Criminal Court issued the Bemba Appeal Judgment. The latter solely addresses whether the defendant – Jean-Pierre Bemba, former Commander-in-chief of the Mouvement de libération du Congo – took reasonable and necessary measures to prevent or punish his subordinates' crimes perpetrated in the Central African Republic. Yet, the various dissenting, separate and concurring opinions advocate opposing positions on the scope, elements and nature of this notorious doctrine. This paper relocates the 'sharp disagreements' that surfaced during the Bemba Appeal Judgment within the broader phenomena of the individualisation of war. Through an in-depth examination of the interpretation offered by the appellate judges, it designs a model of command responsibility that properly individualises Article 28 Rome Statute, and, by the same token, respect the fundamental rights of military commanders. [ABSTRACT FROM AUTHOR]

This paper postulates that highly educated leaders matter in economic growth and development and that this is one of the fundamental causes of the differences in income between countries. To verify this assertion, we examine Central African Republic and Singapore within the neoclassical growth model that incorporates educational attainments of leaders as the functionally relevant explanatory variable. We found the mean years of schooling of educated leaders to be statistically and significantly different in both countries, but more importantly, educational attainments of leaders have a positive and statistically significant effect on economic growth in Singapore, but negative in Central African Republic. [ABSTRACT FROM AUTHOR]

Background: CAR is one of the poorest countries in the world. While UN statistics suggest that there is no health emergency in the country, two recently published mortality surveys contradict this. Moreover, recent accusations of massive scale human rights abuses by mercenaries suggested the need for a nationwide mortality survey. Methods: Two stage cluster surveys were conducted in two different strata: one in the roughly half of the country within the Government's control, and one in the areas mostly outside of the Government's control. We randomly selected 40 clusters of 10 households in each stratum. The survey included questions on vital events with open-ended questions about health and household challenges at the beginning and end of each interview. Results: 70 of 80 selected clusters were successfully visited. We interviewed 699 households, containing 5070 people. 11 households (1.6%) refused to be interviewed and approximately 18.3% of households were absent at the time of visitation, mainly in the safer Government controlled areas. Interviewed households had a birth rate of 42.6 /1000 / year (95%CI 35.4–59.7) and a crude mortality rate (CMR) of 1.57 /10,000/day (95%CI: 1.36–1.78). The birth rate was lower and the death rate markedly higher in the strata outside of Government control. Families described malaria or fever, and diarrhea as the primary reported causes of death with violence accounting for 6% of all deaths. Conclusions: CAR is experiencing a severe health emergency, with the highest measured nationwide mortality in the world to our knowledge. UN published death rate estimates appear to be less than one fourth of reality. There is a desperate need for food aid in the form of general distributions in CAR, along with the accompanying work programs, seed and tool distributions needed to restart local economies. This is of particular importance in rural areas outside of the Government control. While some humanitarian actors are doing their best to respond, the crisis level mortality rate suggests that the needs in CAR are being largely unmet. [ABSTRACT FROM AUTHOR]

Introduction: In the Central African Republic (CAR), HIV/AIDS is the main cause of death in women aged 15–49 years. Increased testing coverage is essential in prevention of HIV/AIDS, especially in areas where conflict hinders access to health care. Socio-economic status (SES) has been shown to be associated with HIV testing uptake. We investigated whether "Provider-initiated HIV testing and counselling" (PITC) could be implemented in a family planning clinic in an active conflict zone in the Central African Republic to reach women of reproductive age and assessed whether socioeconomic status was associated with testing uptake. Methods: Women aged 15–49 years were recruited from a free family planning clinic run by Médecins Sans Frontières in the capital Bangui. An asset-based measurement tool was created based on analysis of qualitative in-depth interviews. Measures of socioeconomic status were constructed from the tool, also by using factor analysis. Logistic regression was used to quantify the association between SES and HIV testing uptake (yes/no), while controlling for potential confounders: age, marital status, number of children, education level and head of household. Results: A total of 1419 women were recruited during the study period, where 87.7% consented to HIV testing, and 95.5% consented to contraception use. A total of 11.9% had never been tested for HIV previously. Factors negatively associated with HIV testing uptake were: being married (OR = 0.4, 95% CI 0.3–0.5); living in a household headed by the husband as opposed to by another person (OR = 0.4, 95% CI 0.3–0.6), and lower age (OR = 0.96, 95% CI 0.93–0.99). Higher level of education (OR = 1.0, 95% CI 0.97–1.1) and having more children aged under 15 (OR = 0.92, 95% CI 0.81–1.1) was not associated with testing uptake. In multivariable regression, testing uptake was lower in the higher SES groups, but the differences were not significant (OR = 0.80, 95% CI 0.55–1.18). Conclusions: The findings show that PITC can be successfully implemented in the patient flow in a family planning clinic, without compromising contraception uptake. Within the PITC framework in a conflict setting, socioeconomic status was not found to be associated with testing uptake in women of reproductive age. [ABSTRACT FROM AUTHOR]

Background: Abortion-related complications are one of the five main causes of maternal mortality. However, research about abortion is very limited in fragile and conflict-affected settings. Our study aims to describe the magnitude and severity of abortion-related complications in two referral hospitals supported by Médecins Sans Frontières and located in such settings in northern Nigeria and Central African Republic (CAR). Methods: We used a methodology similar to the World Health Organization (WHO) near-miss approach adapted in the WHO multi-country study on abortion (WHO-MCS-A). We conducted a cross-sectional study in the two hospitals providing comprehensive emergency obstetric care. We used prospective medical records' reviews of women presenting with abortion-related complications between November 2019 and July 2021. We used descriptive analysis and categorized complications into four mutually exclusive categories of increasing severity. Results: We analyzed data from 520 and 548 women respectively in Nigerian and CAR hospitals. Abortion complications represented 4.2% (Nigerian hospital) and 19.9% (CAR hospital) of all pregnancy-related admissions. The severity of abortion complications was high: 103 (19.8%) and 34 (6.2%) women were classified as having severe maternal outcomes (near-miss cases and deaths), 245 (47.1%) and 244 (44.5%) potentially life-threatening, 39 (7.5%) and 93 (17.0%) moderate, and 133 (25.6%) and 177 (32.3%) mild complications, respectively in Nigerian and CAR hospitals. Severe bleeding/hemorrhage was the main type of complication in both settings (71.9% in the Nigerian hospital, 57.8% in the CAR hospital), followed by infection (18.7% in the Nigerian hospital, 27.0% in the CAR hospital). Among the 146 women (Nigerian hospital) and 231 women (CAR hospital) who did not report severe bleeding or hemorrhage before or during admission, anemia was more frequent in the Nigerian hospital (66.7%) compared to the CAR hospital (37.6%). Conclusion: Our data suggests high severity of abortion-related complications in these two referral facilities of fragile and conflict-affected settings. Factors that could contribute to this high severity in these contexts include greater delays in accessing post-abortion care, decreased access to contraceptive and safe abortion care that result in increased unsafe abortions; as well as increased food insecurity leading to iron-deficiencies and chronic anaemia. The results highlight the need for better access to safe abortion care, contraception, and high quality postabortion care to prevent and manage complications of abortion in fragile and conflict-affected settings. [ABSTRACT FROM AUTHOR]

Diamond and gold mining has been practiced by artisanal miners in the Central African Republic (CAR) for decades. The recent introduction of riverine dredges indicates a transition from artisanal/manual digging and sorting techniques to small-scale mining methods. This study implements a remote sensing analysis of Synthetic Aperture Radar (SAR) data to map gold and diamond dredges operating on the Kadéï (Sangha) river in the CAR. Riverine vessels are identified in Sentinel-1 SAR data between 2015 and 2019, and their activity levels are mapped over time. The number of active dredges identified on the river increased over the five years studied, with the largest increase occurring between 2016 and 2017. Detailing a method for mapping and monitoring riverine diamond and gold dredge mining is an important step in keeping up with evolving technologies and new areas of mineral exploitation and in helping address concerns over resource governance in remote and conflict-prone terrain. The use of SAR technology, with its weather-independence, broad coverage, and available wavelength combinations, allows for higher temporal resolution and improved vessel detection in the monitoring of small-scale mining (SSM) dredges. [ABSTRACT FROM AUTHOR]

"Leaving no one behind" (LNOB) constitutes one of the core principles underpinning the 2030 Agenda for Sustainable Development. We propose a complementary fuzzy logic approach to identify countries left behind in human development and each of its dimensions. We find that the countries left furthest behind at the beginning of the century were those that most reduced gaps with respect to better performing countries after two decades. Nevertheless, we cannot clearly speak of convergence in human development. There are notable exceptions, such as the Central African Republic, Liberia, Yemen, Haiti or Venezuela, which despite the improvement in their Human Development Index worryingly increased their gaps in human development dimensions relative to the rest of the world. Our analysis highlights significant advantages of using the proposed fuzzy-based LNOB approach to incorporate the moral imperative of leaving no country behind in the measurement of human development. [ABSTRACT FROM AUTHOR]

Beginning in 2013, the Central African Republic has been engulfed in a civil war pitting successive governments against a substantial number of armed groups who also compete against each other for control over territory, population and resources. Some of these groups are claiming to be defenders of religious groups in the country, with the Séléka militias fighting for the Muslim communities and the anti-Balaka groups claiming Christian roots and inclinations. Other religiously inspired armed groups such as the Lord's Resistance Army are also present in the country. The following study is an attempt to understand how the "religious" label can be applied to such armed groups and whether it can influence their behavior, thus bringing into light a valuable, albeit lesser known example on how AGs and religion are connected in contemporary Africa. [ABSTRACT FROM AUTHOR]

The function of the law in shaping social values is exposed in the article. Thispaper considers whether certain practices penalised in the surveyed countries (carrying our rituals with the use of human remains) could be classified as intangible cultural heritage and, thus, whether these practices should be legally protected. The main conclusion of the analysis is the statement that criminal law as a response to shamanism is inconsistent with the basic principles of a democratic state oflaw, including the right to expression and self-determination. Assuming that described social phenomenon exists in a society, and at the same time, this practice does not threaten other members of this society and is commonly accepted, the legislator should avoid creating regulations that are inconsistent with the current axiological system in a given community. The elimination of certain practices should take place by creating civilisation awareness inside a community. Criminal law does not fulfil this function. On the contrary, it contributes to the deepening and consolidation of the existence of certain pathological phenomena, as well as to the disappearance of indigenous cultures. [ABSTRACT FROM AUTHOR]

Rebel governance assumes a symbiotic relationship between coercion and public goods provision. However, in the rebel-held town of Ndélé, Central African Republic, we find that governance happens in rebel-held territory, but rarely by rebels. Rebels allowed other actors to provide services for the people only when this did not hinder rebels extracting political clout and economic benefit from the people and their lands. We show how rebels' extractive ambitions and governance discourses evolved during successive stages of rebellion through a diachronic comparison rooted in multimethod fieldwork from 2018 to 2022. We ask, why were rebel groups able to set up their rule, then rule for seven years, before ultimately losing power? Rebels evoked public goods at the onset of rebellion to justify the use of coercive means. After rebel rule was established, rebels outsourced public goods to international and state actors allowing for governance in rebel-held territory while focussing their own efforts on extraction. When their rule was challenged, rebels targeted governance actors and spaces in their territory in pursuit of economic gain and political dominance. Our findings call for a re-evaluation of existing rebel governance studies and the ways in which rebel groups are engaged with. [ABSTRACT FROM AUTHOR]

The study aimed to estimate the prevalence and associated factors of undiagnosed hypertension (HTN) among adults in the Central African Republic (CAR). In the cross-sectional 2017 CAR (Bangui and Ombella M'Poko) STEPS survey, 3265 persons aged 25 to 64 years (non-pregnant and with complete blood pressure measurement), responded to an interview, biomedical and physical, including blood pressure, measurements. Undiagnosed HTN was classified as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg among adults who had never been told by a doctor or other health worker that they had raised blood pressure or hypertension and had not been taking antihypertensive medication. Binary logistic regressions are used to estimate factors associated with undiagnosed HTN. Among those with HTN (N = 1373), the proportion of undiagnosed HTN was 69.8% and 30.2% diagnosed HTN. In the adjusted logistic regression analysis, male sex (AOR: 2.12, 95% CI 1.39–3.23), current tobacco use (AOR: 1.58, 95% CI 1.03–2.42), and high physical activity (AOR: 1.93, 95% CI 1.00–3.71) were positively associated, and age (AOR: 0.75, 95% CI 0.59–0.96), and underweight (AOR: 0.58, 95% CI 0.37–0.90) were inversely associated with undiagnosed HTN. In addition, among men, ever screened for glucose (AOR: 0.07, 95% CI 0.02–0.27) was negatively associated with undiagnosed HTN, and among women, married or cohabiting (AOR: 1.20, 95% CI 1.00–1.44), current heavy drinking (AOR: 1.41, 95% CI 1.04–1.91) were positively associated with undiagnosed HTN. Seven in ten of the adult population with HTN had undiagnosed HTN in CAR. Efforts should be reinforced to screen for HTN in the general population. [ABSTRACT FROM AUTHOR]

The notion of 'stability' and the practice of 'stability operations' experienced a revival in the last decade. The paper shows how different actors (UN, NATO, US and European countries) have been using the concept 'stability' in their recent doctrines. It then shows how as a multi-faceted notion stability can benefit from methodological pluralism, how actors adopt different and even conflicting meanings across a range of different cases and stability operations seem to carry troubling political and normative implications. In sum, this introductory essay specifies how the present collection contributes to the literature and the ongoing policy debate by dissecting the notions of stability and stability operations. [ABSTRACT FROM AUTHOR]

The Central African Republic, located in the central part of Africa, has been known for decades of conflict between the communities. Citizens of local communities first influenced the solution to the conflict. However, the mentioned country cannot solve it, and external actors must contribute to these processes. International organisations (United Nations, European Union, and African Union) and the powered world countries (the United States of America, China, and France) were also significant, active, and influential in this process. Russia obtained a unique position in the process. The present study attempted to critically evaluate this country's historical background, current conflict situation, and perspectives. The study aimed to answer the essential question of the external players, activities, and roles in the Central African Republic and asserted their interests in the mentioned region by the complex of general theoretical methods. Special attention was paid to Russian activities in this country. It is obvious that the mutual relations of external actors fundamentally influence the situation in the mentioned country. The conflict situation in the country was affected, is affected, and will be affected not only by inside processes but also by outside processes. [ABSTRACT FROM AUTHOR]

Introduction: the Exacto® Triplex HIV/HCV/HBsAg (Biosynex, Strasbourg, France) consists in lateral flow, immunochromatographic rapid diagnostic test simultaneously detecting human immunodeficiency virus (HIV)-1 and HIV-2 and hepatitis C virus (HCV)- specific antibodies (IgG and IgM) and hepatitis B virus (HBV) surface antigen (HBsAg) in serum, plasma and whole blood. We herein evaluated its diagnostic performances in the Central African Republic (CAR). Methods: crosssectional study was conducted on prospectively collected panel of 550 sera from adult inpatients living in Bangui, including 200 HIV-positive, 100 HBsAg-positive, 50 HCV-positive, 200 negatives to three viruses according to reference immunoenzymatic serological tests including Murex HCV (Diasorin, Saluggia, Italy) for HCV, Murex HBsAg (Diasorin) for HBV, Genscreen ULTRA HIV Ag-Ab HIV-1/2 Version 2 (Bio-Rad, Marnes-la-Coquette, France) and Murex HIV 1.2.0 Ag/Ab Combination (Diasorin), the 2 tests associated in the parallel algorithm for the reference strategy for the diagnosis of HIV in CAR. Serum samples were tested blindly in duplicate. The findings are reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: the Exacto® Triplex showed 99.5% (95% CI; 98.5-100.0), 96.0% [90.6-100.0] and 99.0% [97.1-100.0] sensitivities for HIV, HCV and HBsAg, respectively. The specificity, positive and negative predictive values (PPV and NPV) were 100.0% for all three viruses. The Youden's J index and Cohen's κ coefficient were 0.99 for HIV and HBsAg. For HCV, Youden's J and Cohen's κ coefficient were 0.96 and 0.98, respectively. In the epidemiological context of the CAR, the PPV and NPV for all three viral infections were high (≥99.0% to 100%). Conclusion: taken together, our STROBEcompliant study demonstrates that the Exacto® Triplex HIV/HCV/HBsAg showed high sensitivity and specificity for HIV and HBsAg (≥99.0%), and relatively high sensitivity (96.0%) and high specificity (100%) for HCV. These analytical performances are within the limits required by the WHO (i.e. sensitivity ≥99.0% and specificity ≥98.0%) for HIV and HBV. The Exacto® Triplex HIV/HCV/HBsAg is user-friendly at low cost, and appears highly desirable for routine use in the CAR, and likely other Central African countries. [ABSTRACT FROM AUTHOR]