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At the fringes of the unprecedented medication scale-up in the treatment of HIV, many African countries have experienced dramatic antiretroviral drug stock-outs. Usually considered the result of irrational decisions on behalf of local politicians, programme managers and even patients (who are stigmatised as immoral), these problems seem not to be so exceptional. However, ethnographic attention to the social consequences of the presence and absence of antiretroviral drugs in the Central African Republic (CAR) suggests that these stock-outs entail far more than logistical failures. In 2010 and 2011 in the CAR, major antiretroviral treatment (ARV) stock-outs resulted in the renewal of ‘therapeutic’ social ties and also significant social resistance and defiance. While this paper explores reasons for the shortage, its focus is on subsequent popular reactions to it, particularly among people who are HIV-positive and dependent on ARVs. The exceptional and ambiguous consequences of these drug stock-outs raise new concerns relevant to the politics of global public health. [ABSTRACT FROM AUTHOR]

This paper looks at the three-way relationship between the Government of Chad, humanitarians, and the United Nations Mission in the Central African Republic and Chad (MINURCAT) from 2004 until June 2011. Chad was never comfortable with the international presence of either humanitarians or peacekeepers and asserted its sovereignty increasingly during this period. MINURCAT was deployed in 2008 to protect humanitarian workers and to facilitate the provision of humanitarian assistance in eastern Chad. This association between the UN mission and humanitarian agencies contributed to making the latter the target of repressive practices by the government, such as the imposition of armed escorts. Facing a steep learning curve, Chad and its state officials gradually appropriated the discourse of the humanitarian and international community and ultimately, in 2010, requested the departure of MINURCAT, claiming that they could meet the protection needs of vulnerable populations in eastern Chad on their own. [ABSTRACT FROM AUTHOR]

Background: A randomized controlled trial in South Africa found a beneficial effect of acyclovir on genital ulcer healing, but no effect was seen in trials in Ghana, Central African Republic and Malawi. The aim of this paper is to assess whether the variation in impact of acyclovir on ulcer healing in these trials can be explained by differences in the characteristics of the study populations. Methodology/Principal Findings: Pooled data were analysed to estimate the impact of acyclovir on the proportion of ulcers healed seven days after randomisation by HIV/CD4 status, ulcer aetiology, size and duration before presentation; and impact on lesional HIV-1. Risk ratios (RR) were estimated using Poisson regression with robust standard errors. Of 1478 patients with genital ulcer, most (63%) had herpetic ulcers (16% first episode HSV-2 ulcers), and a further 3% chancroid, 2% syphilis, 0.7% lymphogranuloma venereum and 31% undetermined aetiology. Over half (58%) of patients were HIV-1 seropositive. The median duration of symptoms before presentation was 6 days. Patients on acyclovir were more likely to have a healed ulcer on day 7 (63% vs 57%, RR = 1.08, 95% CI 0.98-1.18), shorter time to healing (p = 0.04) and less lesional HIV-1 RNA (p = 0.03). Small ulcers (<50 mm2), HSV-2 ulcers, first episode HSV-2 ulcers, and ulcers in HIV-1 seropositive individuals responded best but the better effectiveness in South Africa was not explained by differences in these factors. Conclusions/Significance: There may be slight benefit in adding acyclovir to syndromic management in settings where most ulcers are genital herpes. The stronger effect among HIV-1 infected individuals suggests that acyclovir may be beneficial for GUD/HIV-1 co-infected patients. The high prevalence in this population highlights that genital ulceration in patients with unknown HIV status provides a potential entry point for provider-initiated HIV testing. [ABSTRACT FROM AUTHOR]

The article discusses the mapping of political economy of roadblocks in the Central African Republic. It mentions roadblocks as a manifestation of control over trade routes and a formidable source of funding for all parties. Information through a graph on concentration of roadblocks around distinct and overlapping trade circuits is also given.

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. Author Summary: Epilepsy is particularly common in tropical areas. One main reason is that many endemic infections have neurological consequences. In addition, the medical, social and demographic burden of epilepsy remains substantial in these countries where it is often seen as a contagious condition and where the aetiology is often undetermined. For several decades, field researchers had reported some overlapping between the geographical distributions of epilepsy and onchocerciasis, a parasitic disease caused by the filarial worm Onchocerca volvulus which afflicts some 40 million persons worldwide. Here, we conducted a statistical analysis of all the data available on the relationship between the two conditions to determine whether the proportion of people suffering from epilepsy in a community could be related to the frequency of onchocerciasis. The combined results of the eight studies carried out in west, central and east Africa indicate a close epidemiological association between the two diseases. Should a causative relationship be demonstrated, onchocerciasis, which is known as "river blindness" because of its most serious sequela and the distribution of its vectors, could thus also be called "river epilepsy". More research is needed to determine the mechanisms explaining this association and to assess the burden of onchocerciasis-associated epilepsy. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

In ratifying the ILO Convention 169 on Indigenous and Tribal Peoples Convention (ILO 169) in 2010, the Central African Republic (CAR) became the first African country to join the Convention. Following the ratification of the Convention, the CAR has engaged in a process of integration of the Convention within its national political and legal system. However, due to the widespread conflicts that has marked the country since 2013, the process of implementation of the Convention and the rights of indigenous peoples have greatly suffered. The conflict has had seriously impact on indigenous peoples of the country who have been severely affected by the violence. With this in mind, the aim of this article is to offer an overview on some of the main issues faced by indigenous peoples in the country and to offer some analysis on the potential impact that the ILO 169 has had and could have in the future. [ABSTRACT FROM AUTHOR]

It is still unclear to what extent animals possess knowledge of death. Primates display a large variety and often contradictory behaviors toward conspecific corpses, particularly those of infants (e.g., prolonged carrying and care). This study reports on reactions in a wild, habituated western gorilla group (Gorilla gorilla, 11–13 individuals) in the Central African Republic to an unanimated conspecific infant, and to an allospecific corpse. Individuals' reactions were compared to their usual behavior using both continuous focal animal sampling and 10-min instantaneous scan sampling. In the first observation, an infant gorilla fell out of a tree and looked dead. The mother retrieved it and remained unusually close to another adult female, until the infant started to move again, almost 1 h later. Cases of infants regaining consciousness after almost-fatal accidents may act as positive reinforcement for continued carrying by mothers, which might be socially learned. In the second case, three immature gorillas reacted to a dead red river hog. For 20 min they stared at the corpse from tree branches above, while chest beating, defecating, and urinating several times. They showed fear and did not approach the corpse. These observations show that non-predatory species, such as gorillas, may be able to acquire and develop some knowledge about death even though they do not kill other vertebrates. [ABSTRACT FROM AUTHOR]

Background: Repeated outbreaks of emerging pathogens underscore the need for preparedness plans to prevent, detect, and respond. As countries develop and improve National Action Plans for Health Security, addressing subnational variation in preparedness is increasingly important. One facet of preparedness and mitigating disease transmission is health facility accessibility, linking infected persons with health systems and vice versa. Where potential patients can access care, local facilities must ensure they can appropriately diagnose, treat, and contain disease spread to prevent secondary transmission; where patients cannot readily access facilities, alternate plans must be developed. Here, we use travel time to link facilities and populations at risk of viral hemorrhagic fevers (VHFs) and identify spatial variation in these respective preparedness demands.Methods and Findings: We used geospatial resources of travel friction, pathogen environmental suitability, and health facilities to determine facility accessibility of any at-risk location within a country. We considered in-country and cross-border movements of exposed populations and highlighted vulnerable populations where current facilities are inaccessible and new infrastructure would reduce travel times. We developed profiles for 43 African countries. Resulting maps demonstrate gaps in health facility accessibility and highlight facilities closest to areas at risk for VHF spillover. For instance, in the Central African Republic, we identified travel times of over 24 h to access a health facility. Some countries had more uniformly short travel times, such as Nigeria, although regional disparities exist. For some populations, including many in Botswana, access to areas at risk for VHF nationally was low but proximity to suitable spillover areas in bordering countries was high. Additional analyses provide insights for considering future resource allocation. We provide a contemporary use case for these analyses for the ongoing Ebola outbreak.Conclusions: These maps demonstrate the use of geospatial analytics for subnational preparedness, identifying facilities close to at-risk populations for prioritizing readiness to detect, treat, and respond to cases and highlighting where gaps in health facility accessibility exist. We identified cross-border threats for VHF exposure and demonstrate an opportunity to improve preparedness activities through the use of precision public health methods and data-driven insights for resource allocation as part of a country's preparedness plans. [ABSTRACT FROM AUTHOR]

Monkeypox is a vesicular-pustular illness that carries a secondary attack rate in the order of 10% in contacts unvaccinated against smallpox. Case fatality rates range from 1 to 11%, but scarring and other sequelae are common in survivors. It continues to cause outbreaks in remote populations in Central and West Africa, in areas with poor access and weakened or disrupted surveillance capacity and information networks. Recent outbreaks in Nigeria (2017-18) and Cameroon (2018) have occurred where monkeypox has not been reported for over 20 years. This has prompted concerns over whether there have been changes in the biology and epidemiology of the disease that may in turn have implications for how outbreaks and cases should best be managed. A systematic review was carried out to examine reported data on human monkeypox outbreaks over time, and to identify if and how epidemiology has changed. Published and grey literature were critically analysed, and data extracted to inform recommendations on outbreak response, use of case definitions and public health advice. The level of detail, validity of data, geographical coverage and consistency of reporting varied considerably across the 71 monkeypox outbreak documents obtained. An increase in cases reported over time was supported by literature from the Democratic Republic of Congo (DRC). Data were insufficient to measure trends in secondary attack rates and case fatality rates. Phylogenetic analyses consistently identify two strains of the virus without evidence of emergence of a new strain. Understanding of monkeypox virulence with regard to clinical presentation by strain is minimal, with infrequent sample collection and laboratory analysis. A variety of clinical and surveillance case definitions are described in the literature: two definitions have been formally evaluated and showed high sensitivity but low specificity. These were specific to a Congo-Basin (CB) strain–affected area of the DRC where they were used. Evidence on use of antibiotics for prophylaxis against secondary cutaneous infection is anecdotal and limited. Current evidence suggests there has been an increase in total monkeypox cases reported by year in the DRC irrespective of advancements in the national Integrated Disease Surveillance and Response (IDSR) system. There has been a marked increase in number of individual monkeypox outbreak reports, from outside the DRC in between 2010 and 2018, particularly in the Central African Republic (CAR) although this does not necessarily indicate an increase in annual cases over time in these areas. The geographical pattern reported in the Nigeria outbreak suggests a possible new and widespread zoonotic reservoir requiring further investigation and research. With regards to outbreak response, increased attention is warranted for high-risk patient groups, and nosocomial transmission risks. The animal reservoir remains unknown and there is a dearth of literature informing case management and successful outbreak response strategies. Up-to-date complete, consistent and longer-term research is sorely needed to inform and guide evidence-based response and management of monkeypox outbreaks. Monkeypox is a zoonotic infectious disease characterised by a pustular rash indistinguishable from smallpox, and systemic illness that can range from mild to fatal. Outbreaks predominantly affect remote populations in Central and West Africa. In 2017 and 2018, outbreaks were reported in Nigeria and Cameroon having been unreported for 20 years. We review monkeypox outbreak events occurring since 1970 to investigate if the pattern of outbreaks, person-to-person transmission and virus strain has changed and if so, whether this has implications for outbreak response strategies in low-resource settings. We found that recent literature continues to support an increase in reported outbreaks and number of cases by year in the Democratic Republic of Congo and number of outbreak reports per year in the Central African Republic. We highlight the importance of prioritising high-risk patient groups, remaining vigilant of nosocomial transmission and present that genetic strains remain unchanged. This study informs epidemiologists and outbreak response teams of the source and nature of the limited epidemiological data available on monkeypox outbreaks and may allow optimisation of public health advice and inform choice of suspected case definitions in field settings. Several recommendations are also made for further research efforts. [ABSTRACT FROM AUTHOR]

A frequent sight along many roads, roadblocks form a banal yet persistent element across the margins of contemporary global logistical landscapes. How, this article asks, can we come to terms with roadblocks as a logistical form of power? Based on an ongoing mapping of roadblocks in the Democratic Republic of Congo and the Central African Republic, it sketches a political geography of "roadblock politics": a spatial pattern of control concentrated around trade routes, where the capacity to disrupt logistical aspirations is translated into other forms of power, financial and political. While today's roadblocks are tied up with the ongoing conflict in both countries, the article shows, roadblock politics has a much deeper history. Before colonization, African rulers manufactured powerful polities out of control over points of passage along long-distance trade routes crisscrossing the continent. The article traces how since precolonial times control over long-distance trade routes was turned into a source of political power, how these routes were forcefully appropriated through colonial occupation, how after the crumbling of the colonial order new connections were engineered between political power and the circulation of goods in Central Africa, and how control over these flows ultimately became a key stake in ongoing civil wars in the region. [ABSTRACT FROM AUTHOR]

Objective: Where human African trypanosomiasis (HAT) patients are seen, failure to microscopically diagnose infections by Trypanosoma brucei gambiense in blood smears and/or cerebrospinal fluid (CSF) in the critical early stages of the disease is the single most important factor in treatment failure, a result of delayed treatment onset or its absence. We hypothesized that the enhanced sensitivity of detergent-enhanced loop-mediated isothermal amplification (LAMP) will allow for point of care (POC) detection of African trypanosomes in the CSF of HAT patients where the probability for detecting a single parasite or parasite DNA molecule in 1 μL of CSF sample is negligible by current methods. Methodology: We used LAMP targeting the multicopy pan-T. brucei repetitive insertion mobile element (RIME LAMP) and the Trypanosoma brucei gambiense 5.8S rRNA-internal transcribed spacer 2 gene (TBG1 LAMP). We tested 1 μL out of 20 μL sham or Triton X-100 treated CSFs from 73 stage-1 and 77 stage-2 HAT patients from the Central African Republic and 100 CSF negative controls. Results: Under sham conditions, parasite DNA was detected by RIME and TBG1 LAMP in 1.4% of the stage-1 and stage-2 gambiense HAT CSF samples tested. After sample incubation with detergent, the number of LAMP parasite positive stage-2 CSF’s increased to 26%, a value which included the 2 of the 4 CSF samples where trypanosomes were identified microscopically. Unexpected was the 41% increase in parasite positive stage-1 CSF’s detected by LAMP. Cohen’s kappa coefficients for RIME versus TBG1 LAMP of 0.92 (95%CI: 0.82–1.00) for stage-1 and 0.90 (95%CI: 0.80–1.00) for stage-2 reflected a high level of agreement between the data sets indicating that the results were not due to amplicon contamination, data confirmed in χ2 tests (p<0.001) and Fisher’s exact probability test (p = 4.7e-13). Conclusion: This study detected genomic trypanosome DNA in the CSF independent of the HAT stage and may be consistent with early CNS entry and other scenarios that identify critical knowledge gaps for future studies. Detergent-enhanced LAMP could be applicable for non-invasive African trypanosome detection in human skin and saliva or as an epidemiologic tool for the determination of human (or animal) African trypanosome prevalence in areas where chronically low parasitemias are present. [ABSTRACT FROM AUTHOR]

Oxygyne Schltr. (Thismiaceae) is a rare and little-known genus of achlorophyllous mycoheterotrophic perennial herbs with one of the most remarkable distributions of all angiosperm plant genera globally, being disjunct between Japan and West–Central Africa. Each species is known only from a single location, and in most cases from a single specimen. This monographic study names, describes and maps two new species, Oxygyne duncanii Cheek from cloud forest in SW Region Cameroon and O. frankei Cheek from gallery forest in the Central African Republic, representing the first new Oxygyne species described from Africa in 112 years, and raising the number of described Oxygyne species from four to six. Oxygyne duncanii is remarkable for sharing more morphological characters with two of the three Japanese species (O. hyodoi C.Abe & Akasawa, O. shinzatoi (H. Ohashi) Tsukaya) than with the geographically much closer type species of the genus, O. triandra from Mt Cameroon. Based mainly on herbarium specimens and field observations made in Cameroon and Japan during a series of botanical surveys, we provide descriptions, synonymy, mapping and extinction risk assessments for each species of Oxygyne, together with keys to the genera of Thismiaceae and the species of Oxygyne. The subterranean structures of African Oxygyne are described for the first time, and found to be consistent with those of the Japanese species. We review and reject an earlier proposal that the Japanese species should be segregated from the African species as a separate genus, Saionia Hatus. The only character that separates the two disjunct species groups is now flower colour: blue or partly-blue in the Japanese species compared with orange-brown in the African species. Studies of the pollination biology and mycorrhizal partners of Oxygyne are still lacking. Two of the six species, O. triandra Schltr. and O. hyodoi, appear to be extinct, and the remaining four are assessed as Critically Endangered using the IUCN 2012 criteria. To avoid further extinction, an urgent requirement is for conservation management of the surviving species in the wild. Since few achlorophyllous mycoheterotrophs have been successfully cultivated from seed to maturity, ex situ conservation will not be viable for these species and protection in the wild is the only viable option. While natural habitat survives, further botanical surveys could yet reveal additional new species between Central Africa and Japan. [ABSTRACT FROM AUTHOR]

While the ridde constitutes a game that challenges the intellectual adroitness of the riddler's peers, it is a metaphor that confronts the apparently impossible with what is. If Harold Scheub is correct in affirming in his book The Poem in the Story (Madison: U of Wisconsin P, 2002) that the riddle is ‘a model for all oral art,’ then the dynamics of riddle change are significant for the entire gamut of literary art. This paper presents the Gbaya riddle of Cameroon and the Central African Republic in its historical context with mutation, replacement, and creation of new riddles. By remembering and retaining from the past, borrowing from the present, and creating anew in the midst of constant change, the Gbaya riddle maintains its life of entertainment and instruction. The vicissitudes of change are made friendly through the metaphor of the riddle. [ABSTRACT FROM AUTHOR]

While “Pygmy” hunter-gatherers have generally been assumed to be the original inhabitants of the central African rainforest, recent studies dispute the viability of subsistence in tropical rainforests through foraging alone. There are, however, few studies that are based on sound data of actual long-term foraging. This paper examines the viability of “pure” foraging in tropical rainforests, based on data from participant observation of a long-term foraging expedition among the Baka in the northwestern Congo Basin. The group was observed to subsist solely on wild food resources, particularly wild yams, for two-and-half months. The study was carried out during the dry season when food resources are generally thought to be scarce in tropical rainforests. [ABSTRACT FROM AUTHOR]

This paper presents the analyses of data obtained from eight permanent 20 km transects to determine the relative effect of local human populations and ecological factors on the distribution of large mammals within the Dzanga sector of the Dzanga-Ndoki National Park and the adjacent area of the Dzanga-Sangha Dense Forest Special Reserve in south-west Central African Republic. Principal component analysis indicated that human activities significantly influence the distribution of large mammals, even within this protected area. Distance from the village and the main road as well as the distance from secondary roads appeared to have the greatest influence. Elephants in particular were significantly less common in areas related to human use. Our study showed that poachers use roads, both primary and secondary, to penetrate into the National Park. Thus increasing anti-poaching efforts along these roads could be an effective protection measure. [ABSTRACT FROM AUTHOR]

This paper examines the intracultural variability of parental and alloparental caregiving among the Aka foragers of the Central African Republic. It has been suggested that maternal kin offer higher frequencies of allocare than paternal kin and that maternal investment in infants will decrease when alloparental assistance is provided. Behavioral observations were conducted on 15 eight- to twelve-month-old infants. The practice of brideservice and the flexibility of Aka residence patterns offered a means to test the effect of maternal residence on parental and alloparental investment. There was a significant variation in the frequency of investment and who supplied care to infants depending on whether mothers resided with their kin or their husbands' kin. However, in spite of the variation in allocare, when all categories of caregivers were examined collectively, infants received similar overall levels of care.

The Central African Republic experienced unprecedented violence between 2012 and 2014. We analyse three recent ruptures that developed as a result of this crisis, suggesting a break with the country's past. First, the Séléka rebellion that started in 2012; second, the establishment of a robust UN Peacekeeping mission in 2014; and finally, the democratic election of a civilian president in 2016. However, three deep-rooted patterns of governance have in each case transformed these ruptures. A history of outsourced politics, a plurality of violence and peripheral neglect push actors to perpetuate the violent past rather than breaking with it. We conclude that after an initial attempt to break with the CAR's long-term political economic trends, rebel groups, the UN mission and the democratic government have backtracked and now risk reinforcing the violence that mark politics and everyday life in the country. [ABSTRACT FROM AUTHOR]

Mbororo nomadic pastoralists have fled the Central African Republic (CAR) since 2003 because of atrocities perpetrated against them. Conflict has, in fact, always been a major motor behind nomadism for the Mbororo, along with the quest for pasture. The "normal" severity of Mbororo life, however, has been compounded by the "exceptional" severity caused by the situation in the CAR. This article analyzes the way in which the Mbororo distinguish between the two types of severity, and how these different forms of experienced hardship are accommodated in the pastoralists' way of life. I show how historical trajectories with conflict and nomadic hardship allow refugee Mbororo to adjust to recurrent hardship by adapting their pathways and livelihood strategies. This illustrates the way in which duress is central in nomadic society. [ABSTRACT FROM AUTHOR]

Oxygyne Schltr. (Thismiaceae) is a rare and little-known genus of achlorophyllous mycoheterotrophic perennial herbs with one of the most remarkable distributions of all angiosperm plant genera globally, being disjunct between Japan and West–Central Africa. Each species is known only from a single location, and in most cases from a single specimen. This monographic study names, describes and maps two new species, Oxygyne duncanii Cheek from cloud forest in SW Region Cameroon and O. frankei Cheek from gallery forest in the Central African Republic, representing the first new Oxygyne species described from Africa in 112 years, and raising the number of described Oxygyne species from four to six. Oxygyne duncanii is remarkable for sharing more morphological characters with two of the three Japanese species (O. hyodoi C.Abe & Akasawa, O. shinzatoi (H. Ohashi) Tsukaya) than with the geographically much closer type species of the genus, O. triandra from Mt Cameroon. Based mainly on herbarium specimens and field observations made in Cameroon and Japan during a series of botanical surveys, we provide descriptions, synonymy, mapping and extinction risk assessments for each species of Oxygyne, together with keys to the genera of Thismiaceae and the species of Oxygyne. The subterranean structures of African Oxygyne are described for the first time, and found to be consistent with those of the Japanese species. We review and reject an earlier proposal that the Japanese species should be segregated from the African species as a separate genus, Saionia Hatus. The only character that separates the two disjunct species groups is now flower colour: blue or partly-blue in the Japanese species compared with orange-brown in the African species. Studies of the pollination biology and mycorrhizal partners of Oxygyne are still lacking. Two of the six species, O. triandra Schltr. and O. hyodoi, appear to be extinct, and the remaining four are assessed as Critically Endangered using the IUCN 2012 criteria. To avoid further extinction, an urgent requirement is for conservation management of the surviving species in the wild. Since few achlorophyllous mycoheterotrophs have been successfully cultivated from seed to maturity, ex situ conservation will not be viable for these species and protection in the wild is the only viable option. While natural habitat survives, further botanical surveys could yet reveal additional new species between Central Africa and Japan. [ABSTRACT FROM AUTHOR]

This article evaluates the military operation of the European Union in Chad and the Central African Republic in 2008-09. Despite a promising conceptual approach and close cooperation with the United Nations (UN), the operation created significant political problems between member states. It led to a split - France arguing that it carried too much of the burden and Germany and the United Kingdom sensing that they were sponsoring a pet project. When the UN failed to achieve its ambitious promises to establish a parallel presence and follow-on force, tensions arose with the UN as well. This type of operation is therefore unlikely to be repeated in the near future. [ABSTRACT FROM AUTHOR]

This article covers the past two years of the activity of the International Criminal Court. Ten years after the signature of the Rome Statute, the Court has continued investigating situations in four countries (Democratic Republic of Congo, Uganda, the Sudan and the Central African Republic). The activity of the Court has accelerated, with four indictees in custody in the DRC situation, one public arrest warrant in the CAR situation and two in the Sudan situation. The Court has developed its case law on victim participation and refined its procedural framework, through constant debate between the Prosecutor and the pre-trial chambers. It has also pursued its goal of increasing cooperation with State parties, and raising awareness of the Court through outreach programs. The Court faces difficult challenges in establishing itself as a credible court, balancing the necessary requirements of fairness in a criminal trial and the high expectations of victims and the international community. The recent stay of proceedings and granting of release in the Lubanga case, which is supposed to be the first trial of the Court, is an illustration of this challenge and the difficulty in finding this balance. [ABSTRACT FROM AUTHOR]

The article discusses the establishment of the General Agreement on Trade in Services (GATS) to be administered by the World Trade Organization. The objective of GATS is to ensure that key parts of the audiovisual service sector are progressively liberalized and privatized. The United States and the Central African Republic have made preliminary commitments in all subcategories of the audiovisual sector. A major criticism of the GATS is the secrecy and lack of transparency of the process.

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Fragile states have been raising increasing concern among donors since the mid-2000s. The policies of the Global Fund to fight HIV/AIDS, Malaria, and Tuberculosis (GF) have not excluded fragile states, and this source has provided financing for these countries according to standardized procedures. They represent interesting cases for exploring the meaning and role of measurement in a globalized context. Measurement in the field of HIV/AIDS and its treatment has given rise to a private outsourcing of expertise and auditing, thereby creating a new form of value based on the social process of registration and the creation of realities produced by the intervention itself. These "scriptural economies" must be questioned in terms of the production of knowledge, but also in terms of social justice. Governing HIV/AIDS treatments by numbers in a fragile state is explored in this article through the experience of the Central African Republic (CAR) in terms of epidemiology and access to antiretroviral drugs. The unexpected effects of performance-based programs in this context underline the need for global health governance to be re-embedded into a social justice framework. [ABSTRACT FROM AUTHOR]

Background: Major chikungunya outbreaks have affected several Central African countries during the past decade. The chikungunya virus (CHIKV) was isolated from humans and sylvan mosquitoes in the Central African Republic (CAR) during the 1970 and 1980s but has not been found recently, despite the presence of Aedes albopictus since 2010. The risk of a massive chikungunya epidemic is therefore potentially high, as the human populations are immunologically naïve and because of the presence of the mosquito vector. In order to estimate the risk of a large outbreak, we assessed the vector competence of local Ae. aegypti and Ae. albopictus populations for ancient local strains of CHIKV in CAR. Mosquitoes were orally infected with the virus, and its presence in mosquito saliva was analysed 7 and 14 days post-infection (dpi) by quantitative reverse transcriptase polymerase chain reaction. Results: The two species had similar infection rates at 7 and 14 days, and the dissemination rate of both vectors was = 80% at 14 dpi. Only females followed up to 14 dpi had CHKV in their saliva. Conclusion: These results confirm the risk of transmission of enzootic CHIKV by anthropophilic vectors such as Ae. aegypti and Ae. albopictus. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (breast Ca) is recognised as a major public health problem in the world. Data on reproductive factors associated with breast Ca in the Central African Republic (CAR) is very limited. This study aimed to identify reproductive variables as risk factors for breast Ca in CAR women.Methods: A case-control study was conducted among 174 cases of breast Ca confirmed at the Pathology Unit of the National Laboratory in Bangui between 2003 and 2015 and 348 age-matched controls. Data collection tools included a questionnaire, interviews and a review of medical records of patients. Data were analysed using SPSS software version 20. Odd ratios and 95% confidence intervals (CI) for the likelihood of developing breast Ca were obtained using unconditional logistic regression.Results: In total, 522 women with a mean age of 45.8 (SD = 13.4) years were enrolled. Women with breast Ca were more likely to have attained little or no education (AOR = 11.23, CI: 4.65-27.14 and AOR = 2.40, CI: 1.15-4.99), to be married (AOR = 2.09, CI: 1.18-3.71), to have had an abortion (AOR = 5.41, CI: 3.47-8.44), and to be nulliparous (AOR = 1.98, CI: 1.12-3.49). Decreased odds of breast Ca were associated with being employed (AOR = 0.32, CI: 0.19-0.56), living in urban areas (AOR = 0.16, CI: 0.07-0.37), late menarche (AOR = 0.18, CI: 0.07-0.44), regular menstrual cycles (AOR = 0.44, CI: 0.23-0.81), term pregnancy (AOR = 0.26, CI: 0.13-0.50) and hormonal contraceptive use (AOR = 0.62, CI: 0.41-0.93).Conclusion: Breast Ca risk factors in CAR did not appear to be significantly different from that observed in other populations. This study highlighted the risk factors of breast Ca in women living in Bangui to inform appropriate control measures. [ABSTRACT FROM AUTHOR]

The Special Criminal Court in the Central African Republic can be viewed in two ways. The optimistic view is that it is a vindication of the idea that the international community should complement the efforts of states in the fight against impunity. The pessimistic view is that its establishment represents the International Criminal Court (ICC)'s failure to catalyze accountability at the national level. Against the backdrop of these two opposing narratives, this article examines the main legal features of this new 'hybrid' court and its relationship to the principle of complementarity enshrined in the ICC Statute. It addresses the following questions: the hybrid court's legal basis under Central African law, its jurisdictional mandate, the mixed composition of its staff, immunities and amnesties, and the Special Criminal Court's concurrent jurisdiction with the ICC. The article suggests that, although it is a promising example of international - national cooperation, the Special Criminal Court calls into question legal and systemic assumptions underpinning complementarity, the principle that gives states priority in prosecuting international crimes, which in turn raises questions about the relevance of complementarity in analogous conflict and post-conflict situations. [ABSTRACT FROM AUTHOR]

Eleven cassava genotypes were tested against cassava mosaic disease ( CMD) and compared to a local susceptible cultivar in field conditions from June 2011 to July 2012 in Central African Republic ( CAR) at two sites representative of the savanna (Damara) and forest (Pissa) zones of the country. The mean number of whiteflies observed on plants varied among genotypes within each site, but was found nearly three times higher at Damara than at Pissa, resulting in a CMD incidence nearly five times higher at Damara than at Pissa. However, no relation was observed between the number of insect on the plants and the level of susceptibility/resistance of the genotypes. The difference of disease pressure between the two sites revealed high level of resistance in several genotypes, while some other ones indicated rather only a partial resistance. Nevertheless, none of the genotypes tested was found immune, in the end, the virus being detected at least in one site in every genotype, including those ones presenting no symptoms in both sites. The impact of CMD on yield components was assessed on the local susceptible check and three partially resistant genotypes, showing that the disease has no significant effect on the tuberous roots number as well as their weight in both sites. The yield potential varied among different genotypes and between the two sites, the mean number of tuberous roots as well as their mean weight being higher in Damara than in Pissa. This study identified highly resistant genotypes such as 'Gabon' that performed well in both sites, and '91/02322' that was symptomless and presented a yield potential equivalent to the local check. These genotypes could be distributed to growers with the main advantage to be resistant to CMD and, therefore, reducing the risk to spread sources of inoculum all over the cassava cropping areas in the country. [ABSTRACT FROM AUTHOR]

Field Emission SEM (FESEM) textural observations, crystal size distribution (CSD) analyses, UV-excited luminescence imaging, and photoluminescence (PL) microspectroscopy excited by 488 nm laser were conducted on two texturally contrasting samples of carbonado, a kind of natural polycrystalline diamond from the Central African Republic (CAR). The investigated carbonado samples A and B show extremely different textures: sample A is made up of faceted crystals accompanied by abundant, small rectangular pores, whereas sample B has a granular texture with coarser crystals and scarce, large pores. Diamond crystals smaller than 2-3 µm are enriched in sample A but depleted in sample B. These textural features indicate that sample B diamonds were annealed under thermodynamically stable P-T conditions. The pore characteristics indicate that fluid permeability was higher for sample A than sample B. Photoluminescence (PL) spectra indicate that samples A and B correspond to Group A and B carbonados in the classification of Kagi et al. (1994), respectively, so that sample A reveals emissions from the H3 center without any N-V derived emission at 575 nm, whereas sample B shows emissions from the 3H center and the N-V defect. In addition, UV-excited luminescence images and photoluminescence spectra for sample B indicate that the rims of diamond crystals within several microns of a pore show luminescence features similar to those of Group AB carbonados (Kagi et al., 1994), indicating that this Group AB material was formed from Group B by irradiation from pore-filling, radioactive-element-bearing materials at a low temperature. The extent of the low-temperature irradiation is considered to depend on fluid permeability, and the Group A material was strongly irradiated due to its permeable texture whereas the Group B material was not significantly irradiated due to its less permeable granular texture. These results indicate that Group B carbonados have retained their original PL spectral features produced under high pressures and temperatures at mantle depths. [ABSTRACT FROM AUTHOR]

The article offers information on the visit of Pope Francis to the Central African Republic (CAR) in November 2015 to help prevent and respond to gender-based violence (GBV) in the country. Topics mentioned include the visit shows the power and influence of faith leaders, the willingness of the government to partner with faith-based initiatives, and the effort of faith communities to prevent and respond to GBV.

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Multi-actor peace operations have become the dominant mode of peace operations since the end of the cold war. This article uses the literature on institutional linkages and inter-organizational relations, thus far developed independently from the literature on such operations, to shed light on the relations between the organizations involved in them. The analysis of one specific case – the interactions between the United Nations, the African Union, the Economic Community of Central African States and the European Union in the Central African Republic – shows the usefulness of merging this body of theory with the primarily empirically driven research on peace operations and UN–regional collaboration. The findings of this study are meant to facilitate further research on multi-actor peace operations and serve as a building block for a theory explaining the emergence and configuration of such operations. [ABSTRACT FROM PUBLISHER]

The use of child soldiers in conflicts has received increasing academic attention in recent years. This article examines post-conflict periods to see whether the use of child soldiers mobilizes United Nations peacekeeping operations (UN PKO) in the aftermath of a conflict. Taking into consideration how child soldiers affect conflict and how important their reintegration is to sustainable peace and post-conflict development, we analyse whether the presence of child soldiers in a civil war increases the likelihood of the presence of a PKO. We argue that the UN deems a conflict with child soldiers as a difficult case for conflict resolution, necessitating a response from the international community. This is in line with our empirical results confirming that the use of child soldiers significantly increases the likelihood of peacekeeping. [ABSTRACT FROM PUBLISHER]

An updated checklist of Dryinidae, Embolemidae and Sclerogibbidae from Central African Republic and Uganda is presented. The following new species of Dryinidae are described: from Central African Republic: Anteon dzanganum sp. n. (Anteoninae); from Uganda: Anteon granulatum sp. n., A. kibalense sp. n., A. makererense sp. n., A. mubfs sp. n. (Anteoninae); Bocchus kibalensis sp. n. (Bocchinae); Dryinus kibalus sp. n. (Dryininae); Gonatopus kanyawarus sp. n. (Gonatopodinae). The following species have been recorded for the first time from Central African Republic: Embolemidae: Ampulicomorpha madecassa Olmi, 1999a; Embolemus capensis Olmi, 1997; Dryinidae: Aphelopus mediocarinatus (Benoit, 1951d), A. testaceus Olmi, 1991, A. wittei Benoit, 1951c (Aphelopinae); Anteon cautum Olmi, 1994a, A. evertsi Olmi, 1989, A. gutturnium (Benoit, 1951b), A. inflatrix Benoit, 1951b, A. kivuanum (Benoit, 1951c), A. semajanna Olmi, Copeland & Guglielmino, 2015, A. zairense Benoit, 1951d (Anteoninae); Pseudodryinus townesi (Olmi, 1984) (Dryininae); Echthrodelphax tauricus Ponomarenko, 1970, Gonatopus camerounensis Olmi, 2011, G. kolyadai Olmi, 2007b, Neodryinus antiquus Benoit, 1954, N. tussaci Olmi, 2004b (Gonatopodinae); Sclerogibbidae: Probethylus callani Richards, 1939b; Sclerogibba algerica Benoit, 1963, S. rapax Olmi, 2005a. The following species have been recorded for the first time from Uganda: Embolemidae: Ampulicomorpha magna Olmi, 1996; Dryinidae: Anteon cautum Olmi, 1994a, A. fisheri Olmi, 2003, A. hoyoi Olmi, 1984, A. kivuanum (Benoit, 1951c), A. townesi Olmi, 1984, A. zairense Benoit, 1951d (Anteoninae); Bocchus bini Olmi, 1984 (Bocchinae); Dryinus saussurei (Ceballos, 1936) (Dryininae); Echthrodelphax migratorius Benoit, 1954, Neodryinus tussaci Olmi, 2004b (Gonatopodinae). The following further species has been recorded for the first time from Mali: Sclerogibba algerica Benoit, 1963 (Sclerogibbidae); from Ivory Coast: Adryinus oweni Olmi, 1984 (Gonatopodinae); from Cameroon and South Africa: Gonatopus operosus Olmi, 1993 (Gonatopodinae); from Democratic Republic of the Congo and Zambia: Neodryinus antiquus Benoit, 1954 (Gonatopodinae); from South Africa: Anteon striatum Olmi, 2005b (Anteoninae). Including the above new records, 23 species of Dryinidae (previously six), two species of Embolemidae (previously none) and three species of Sclerogibbidae (previously two) are now known from Central African Republic. For Uganda, 39 species of Dryinidae (previously 23), one species of Embolemidae (previously none) and four species of Sclerogibbidae (previously four) are now known. Additional new faunistic records are provided for Cameroon, Democratic Republic of the Congo, Ivory Coast, Mali, South Africa and Zambia. [ABSTRACT FROM AUTHOR]

Central African Republic (CAR) is one of the poorest and most unstable countries in the world and has occupied the top place in all possible rankings of failed states, instability, poverty, corruption etc. for many years. However, although the CAR has experienced almost constant instability for the last few decades it was only in recent years that it has received the media attention which was unseen before. Such an unusual interest has resulted from two successive internal conflicts: first, in 2012 the anti‑ government rebellion drawing together the alliance of rebel militia factions, the Séléka, and a year later the insurrection of the opposing Anti‑Balaka forces. The article is an attempt to analyse the causes of the instability of the CAR and the current political and security situation in the country, taking into account, among other things, the results of the fieldwork conducted by the author in the Central African Republic, as well as his long‑time research on the phenomenon of dysfunctional states. [ABSTRACT FROM AUTHOR]

Yellow fever still causes high burden in several areas of sub-Saharan Africa and Latin America. There are few well-designed epidemiological studies and limited data about yellow fever in Africa. Staples et al., in a recently published paper in Transactions of the Royal Society of Tropical Medicine & Hygiene, performed a nationwide study in the Central African Republic (CAR) assessing infection risk and the operational impact of preventive measures. The rapid assessment of human, non-human and mosquito data call attention to the potential risk of future yellow fever outbreaks in the CAR and elsewhere. The study reinforces the need for intensified applied and operational research to address problems and human capacity needs in the realm of neglected tropical diseases in the post-2015 agenda. [ABSTRACT FROM AUTHOR]

Background: Although rabies represents an important public health threat, it is still a neglected disease in Asia and Africa where it causes tens of thousands of deaths annually despite available human and animal vaccines. In the Central African Republic (CAR), an endemic country for rabies, this disease remains poorly investigated. Methods: To evaluate the extent of the threat that rabies poses in the CAR, we analyzed data for 2012 from the National Reference Laboratory for Rabies, where laboratory confirmation was performed by immunofluorescence and PCR for both animal and human suspected cases, and data from the only anti-rabies dispensary of the country and only place where post-exposure prophylaxis (PEP) is available. Both are located in Bangui, the capital of the CAR. For positive samples, a portion of the N gene was amplified and sequenced to determine the molecular epidemiology of circulating strains. Results: In 2012, 966 exposed persons visited the anti-rabies dispensary and 632 received a post-exposure rabies vaccination. More than 90% of the exposed persons were from Bangui and its suburbs and almost 60% of them were under 15-years of age. No rabies-related human death was confirmed. Of the 82 samples from suspected rabid dogs tested, 69 were confirmed positive. Most of the rabid dogs were owned although unvaccinated. There was a strong spatiotemporal correlation within Bangui and within the country between reported human exposures and detection of rabid dogs (P<0.001). Phylogenetic analysis indicated that three variants belonging to Africa I and II lineages actively circulated in 2012. Conclusions: These data indicate that canine rabies was endemic in the CAR in 2012 and had a detrimental impact on human health as shown by the hundreds of exposed persons who received PEP. Implementation of effective public health interventions including mass dog vaccination and improvement of the surveillance and the access to PEP are urgently needed in this country. [ABSTRACT FROM AUTHOR]

In April 2014, the European Union (EU) launched EUFOR RCA, a military bridging operation that provided temporary support to the United Nations (UN) in achieving a safe and secure environment in Bangui, the capital of the Central African Republic (CAR), until March 2015. After EUFOR's mandate concluded, the union launched a follow up military advisory mission, EUMAM RCA, to improve the CAR armed forces' capacities and solidify EUFOR's achievements. However, the deployment processes of both EUFOR and EUMAM were characterized by a paradox: on the one hand, their planning processes were quick and effective; on the other hand, their force generation processes were prolonged and difficult. What explains this paradox? This article argues that, in the case of both missions, there was a mismatch between EU Member States' desire to act and their willingness to invest resources in those actions, that is, an intentions-reality gap. Due to the CAR's humanitarian emergency and France's appeal for burden-sharing, a sense of 'collective obligation' drove EU Member States to approve the deployment of EUFOR and EUMAM politically. However, since most Member States had no direct interests at stake in the CAR, they felt no equal sense of obligation to contribute to these efforts. [ABSTRACT FROM AUTHOR]