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This study explores the complex nature of female genital mutilation/cutting (FGM/C) by juxtaposing the mental and sexual health of women who had undergone FGM/C as part of initiation/membership into a traditional women's society (TWS) with those who were also cut but not initiated into a TWS. While considerable differences emerged between TWS members and nonmembers, there was no evidence that TWS membership was protective against the physical and psychological trauma typically ascribed to FGM/C. In fact, the pattern of results would tend to suggest the opposite. Possible explanations for and implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

This article explores the racial politics around African colonial subjects in Spain during the second half of the nineteenth century. Between the 1840s and the 1880s, colonial authorities brought to the metropole small groups of Africans from the Gulf of Guinea with the goal of turning them into hispanicized agents of colonization upon return to their communities. Drawing on official documents, newspapers and travel narratives I examine how the representations of the first groups reveal how Spain was moving from a model of social categorization based on monogenetic theories to a new paradigm influenced by the rise of scientific racism, albeit ideas from both would frequently converge. I will also argue that the mutable and unstable representations of African bodies correlate with the politicization of race, sometimes eluding depictions of physical features, while at other times showcasing them to construct an idea of racial difference. [ABSTRACT FROM AUTHOR]

Background: Pursuant to studies, receiving the three key maternal health services (Antenatal Care, Skilled Delivery Service, and Postnatal Care) in a continuum could prevent 71% of global maternal deaths. Despite the Western African region being known for its high maternal death and poor access to maternal health services, there is a dearth of studies that delve into the spectrum of maternal health services uptake. Hence, this study aimed to assess the level and predictors of partial and adequate utilization of health services in a single analytical model using the most recent Demographic and Health Survey (DHS) data (2013–2021). Methods: This study was based on the appended women's (IR) file of twelve West African countries. STATA software version 16 was used to analyze a weighted sample of 89,504 women aged 15–49 years. A composite index of maternal health service utilization has been created by combining three key health services and categorizing them into 'no', 'partial', or 'adequate' use. A multilevel multivariable multinomial logistic regression analysis was carried out to examine the effects of each predictor on the level of service utilization. The degree of association was reported using the adjusted relative risk ratio (aRRR) with a corresponding 95% confidence interval, and statistical significance was declared at p < 0.05. Results: 66.4% (95% CI: 64.9, 67.7) and 23.8% (95% CI: 23.3, 24.2) of women used maternal health services partially and adequately, respectively. Togo has the highest proportion of women getting adequate health care in the region, at 56.7%, while Nigeria has the lowest proportion, at 11%. Maternal education, residence, wealth index, parity, media exposure (to radio and television), enrolment in health insurance schemes, attitude towards wife beating, and autonomy in decision-making were identified as significant predictors of partial and adequate maternal health service uptake. Conclusion: The uptake of adequate maternal health services in the region was found to be low. Stakeholders should plan for and implement interventions that increase women's autonomy. Program planners and healthcare providers should give due emphasis to those women with no formal education and from low-income families. The government and the private sectors need to collaborate to improve media access and increase public enrolment in health insurance schemes. [ABSTRACT FROM AUTHOR]

In the intake records of the Foundling Hospital in Florence between 1445 and 1453, only two infants, out of almost three hundred, were marked as "ghezzo" and "nero," meaning dark-skinned and Black. At the same time, about fifty percent of the children left there were the children of enslaved women, who accounted for ninety-two percent of the enslaved population of Florence. While archival documents have not yet shown evidence of enslaved West Africans arriving in Florence before 1462, the Foundling Hospital records demonstrate the pervasiveness of Black and White boundaries as a site of difference. The use of epidermal descriptors, hereditary racialization, and gender division in a single archival record reveals the necessity of an intersectional approach to the study of enslavement. My article applies premodern critical race studies (PCRS) to archival documents by examining the language Florentines used for enslaved domestic servants in their sale, in their daily lives, and in describing their offspring. Through an examination of racialized terminology in the Florentine archives, I argue that considerations of race and race-thinking should now form a part of any scholarly analysis of this late medieval Tuscan city. The formulations of racial languages are found in the daily interactions and relationships of Florentines, especially women, with enslaved domestic laborers. I conclude that women, both enslaved and free, were instrumental to race-thinking in Florence. Since race in the late medieval Mediterranean was written on the canvas of female bodies and their productive capabilities, its study necessitates a close analysis of the words used about and by women. [ABSTRACT FROM AUTHOR]

We report midline impacts of a community-randomized cash transfer intervention to 1857 vulnerable mothers in 140 rural cocoa-farming communities of Côte d'Ivoire. Compared to mothers in the comparison group who participated in village savings and loan associations (VSLAs), treatment mothers participated in VSLAs and received 8 € each week for up to one year with no conditions attached (the midway point of a two-year program). We find small- to moderate-sized treatment effects on four of six indicators of economic well-being (d = 0.23–0.75), as well as small reductions in maternal stress (d = −0.27). We find no statistically detectable impacts on educational engagement, educational aspirations, or educational expectations for children. Results suggest that cash transfer programs in rural West African communities can improve economic well-being and reduce maternal stress. Implications for children and families and for future cash transfer evaluations are discussed. [ABSTRACT FROM AUTHOR]

Background: Female genital mutilation affects an estimated 200 million women and girls worldwide. This article examines a midwife-led service that integrates health advocates and counsellors into a model of holistic woman-centred care and was the blueprint for new national clinics opened in 2019. Methods: This retrospective case note review examined referral patterns, clinical findings and interventions over 11 years at a UK specialist clinic for non-pregnant women with female genital mutilation. Results: More than 2000 consultations were conducted. Two thirds of women had type 3 mutilation. Most were Somali (73.4%) with 18 other ethnic backgrounds represented. Women presented with dysuria, dyspareunia/apareunia, dysmenorrhea, recurrent infections, post-traumatic stress disorder, nightmares, flashbacks and psychosexual issues. Interventions included deinfibulation under local anaesthetic (many as same day walk-in cases), clinical reports for asylum applications and trauma counselling. One in 10 attendees were healthcare professionals/carers. Nearly 5% were refugees/asylum seekers. There were 12 safeguarding referrals, three cases of mandatory reporting duty and two protection orders. Intersectional violence was frequently reported among women of West African origin. Conclusions: Significant numbers of non-pregnant women require specialist help. Innovative means to publicise clinics and routine enquiry during gynaecological consultations and GP registration, could ensure earlier signposting to services. Deinfibulation can be safely performed by an expert midwife in a community or outpatient setting. [ABSTRACT FROM AUTHOR]

Existing literary studies on migration and diaspora have mostly concentrated on issues affecting the homeland, questions of identity, memory, belonging and longing, and the politics of location across borders. Cross-sub continental comparison between south Asians and West African migrants' lived experiences seem to be less under the radar. However, since diaspora space represents an intersection of cultures, peoples, religions and psychic processes, this paper attempts to comparatively explore the processes that plunge migrants into an unsettling liminal space of unwelcome using Nadeem Aslam's Maps for Lost Lovers from South Asia and Chimamanda Ngozi Adichie's Americanah from West Africa. The engagement of these works from both divides is to explore the contours inherent when people are dislocated from their homeland attempting to navigate their ways in the new world. The impetus is to examine the geographical peculiarities that heighten the tension of migrants on one hand and the contest of cultural beliefs especially, religious practices that portend a distortion of identity, alienation and create tension between characters in the novels. The study divulges that the perception of the migrants about the flora and fauna from both subcontinents are similar and it heightens the feeling of alienation in diaspora on one hand and on the other, the differences in cultural systems create a tension especially among the characters of Islamic background. It is concluded that for Muslims living in the west, religio-cultural conflict is major signifier in the contests that are inherent in diaspora space. [ABSTRACT FROM AUTHOR]

Agricultural development projects increasingly aim to improve health and nutrition outcomes, often by engaging women. Although evidence shows such projects can improve women's and children's health and nutrition and empower women, little is known about their impacts on women's health- and nutrition-related agency and the extent to which impacts emerge through women's empowerment, largely due to a lack of instruments that measure the dimensions of women's agency that are directly relevant to health and nutrition outcomes. We developed an optional, complementary module for the project-level women's empowerment in agriculture index (pro- WEAI) to measure health- and nutrition-related agency (pro-WEAI + HN). Our method for developing related indicators used data collected from six agricultural development programmes implemented across Bangladesh, Burkina Faso and Mali (pooled sample = 12,114) and applied psychometric analysis (exploratory and confirmatory factor analysis) and the Alkire-Foster methodology. Results revealed seven indicators covering women's agency in the areas of her own health and diet; her health and diet during pregnancy; her child's diet; breastfeeding and weaning; purchasing food and health products; and acquiring food and health products. Multigroup confirmatory factor analysis revealed measurement invariance across contexts and samples. Tests of association (Cramer's V) and redundancy suggest that the pro-WEAI + HN indicators measured aspects of agency that are distinct from the core pro-WEAI. The uptake of these indicators in studies of nutrition-sensitive agricultural development projects may strengthen the evidence on how such programming can enhance women's empowerment to improve health and nutrition outcomes for themselves and their children. [ABSTRACT FROM AUTHOR]

Evidence from implementation research suggests that group-based behaviour change interventions (GBCIs) can encourage the development of peer support, promote psychosocial skills, and facilitate collaborative therapeutic relationships. However, although the mechanisms of action that mediate the behaviour change process have been extensively described in other settings, less is known about the implementation strategies and contextual factors that actuate the reported behaviour changes among programme participants in Ghana and sub-Saharan Africa, more generally. We draw on insights from the literature and field experiences from designing, implementing, and evaluating GBCIs across several rural and peri-urban communities in Ghana to discuss a range of theoretical, methodological, and contextual factors that facilitate the behaviour change process in programme participants. We offer suggestions to guide researchers to envision and manage potential challenges with the programme development and implementation processes. We propose that intervention programmes designed to facilitate health behaviour change in the defined context should (i) have a context-relevant focus, (ii) be coherent and well-structured, (iii) have explicit techniques to facilitate inter-personal and intra-personal change processes, (iv) include appropriate mechanisms to monitor and assess the progress of the interventional sessions; and (v) be implemented by trained facilitators with a deep knowledge of the sociocultural values and norms of the target group and of the principles and theories underlying the intervention programme. We envisage that these insights could serve to guide the design, implementation, and evaluation of contextually-tailored and potentially effective GBCIs that align with the needs, capacities, and circumstances of the local population. [ABSTRACT FROM AUTHOR]

Background: The relationship of diet with stroke risk among Africans is not well understood. Aim: The aim of this study was to investigate the association between dietary patterns and stroke risk among West Africans. Methods: In this multi-center case–control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Ghana. Food consumption was assessed using a food frequency questionnaire, and dietary patterns were summarized using principal component analysis. Stroke was defined using predefined criteria primarily on clinical evaluation following standard guidelines. Conditional logistic regression was applied to compute odds ratio (OR) and 95% confidence interval (CI) for stroke risk by tertiles of dietary patterns adjusting for relevant confounders. Results: Overall, mean age was 59.0 ± 13.9 years, and 3992 (54.2%) were males. Seven dietary patterns were identified. Multivariable-adjusted OR (95% CI) for risk of stroke by second and third tertiles (using the lowest and first tertile as reference) of dietary patterns was 1.65 (1.43, 1.90) and 1.74 (1.51, 2.02), for "poultry product and organ meat"; 1.69 (1.47, 1.96) and 1.51 (1.31, 1.75) for "red meat"; 1.07 (0.92, 1.23) and 1.21 (1.04, 1.40) for "fried foods and sweetened drinks"; 0.69 (0.60, 0.80) and 0.45 (0.39, 0.53) for "vegetables"; 0.84 (0.72, 0.97) and 0.81 (0.70, 0.93) for "whole-grain and fruit drinks"; and 0.97 (0.84, 1.12) and 0.85 (0.73, 0.98) for "fruits" respectively (p < 0.05). Conclusion: These data suggest that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke among Africans. Graphical abstract [ABSTRACT FROM AUTHOR]

The article presents a case study of a young 26-year-old Nigerian man who presented with a 3-year history of itchy skin lesions with centrifugal growth. The clinical diagnosis of tinea corporis was confirmed by direct microscopy and fungal culture of skin scrapings, with the identification of "Trichophyton rubrum." Treatment included terbinafine with the almost total disappearance of the lesions in three months leading to the replacement of terbinafine with fluconazole for an additional month.

Immigration scholars and religious studies scholars have explored generational changes in religiosity. Less clear is the significance of religion in the lives of Black immigrant second-generation youth. Moreover, while there is research on intraracial boundary-negotiations between Black Americans and Black immigrants in the United States, it is rarely discussed in the context of religion. Drawing on interviews with seventy one second-generation West African teenagers in New York City, this paper explores the role of religion in the integration of Black immigrant second-generation youth. I find that religion is a primary tool through which ethnoracial boundaries are maintained between the children of West African immigrants and their Black American counterparts. I spotlight three means through which religion matters for ethnoracial boundaries: congregational demographics, religious codes of conduct and Islamophobia. Collectively, these findings demonstrate that religion is a key component of second-generation ethnoracial identity-formation. [ABSTRACT FROM AUTHOR]

Objectives: We report the association between pre‐antiretroviral therapy (pre‐ART) soluble vascular cell adhesion molecule‐1 (sVCAM‐1) levels and long‐term mortality in HIV‐infected West African adults participating in a trial of early ART in West Africa (Temprano ANRS 12136 trial). Methods: The ART‐naïve HIV‐infected adults were randomly assigned to start ART immediately or defer ART until the WHO criteria were met. Participants who completed the trial follow‐up were invited to participate in a post‐trial phase (PTP). The PTP end‐point was all‐cause death. We used multivariable Cox proportional models to analyse the association between baseline sVCAM‐1 and all‐cause death, adjusting for ART strategy, sex, CD4 count, plasma HIV‐1 RNA and peripheral blood mononuclear cell HIV‐1 DNA levels. Results: In all, 954 adults (77% women, median CD4 count of 387 cells/μL) were randomly assigned to start ART immediately (n = 477) or to defer initiation of ART (n = 477). They were followed for a median of 5.8 years [interquartile range (IQR): 5.2–6.3]. In multivariable analysis, the risk of death was significantly associated with baseline sVCAM‐1 [≥1458 vs. < 1458 ng/mL; adjusted hazard ratio = 2.86, 95% confidence interval (CI): 1.60–5.11]. The 6‐year probability of death rates were 14.4% (95%CI: 9.1–22.6) and 9.4% (5.4–16.1) in patients with baseline sVCAM‐1 ≥ 1458 ng/mL randomized to deferred and immediate ART, respectively, and 3.8% (2.2–6.5) and 3.5% (1.9–6.3) in patients with baseline sVCAM‐1 < 1458 ng/mL randomized to deferred and immediate ART. The median difference between pre‐ART and 12‐month sVCAM‐1 levels in patients randomized to immediate ART was −252 (IQR: −587 to −61). Conclusions: Pre‐ART sVCAM‐1 levels were significantly associated with mortality, independently of whether ART was started immediately or deferred, but they significantly decreased after 12 months of ART. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is becoming one of the leading causes of morbidity and mortality worldwide, including among Africans. Knowledge of the association between traditional risk factors and both diabetes and pre-diabetes, and whether these differ by age and sex, is important for designing targeted interventions. However, little is known about these associations for African populations.Methods: The study used data from WHO STEPS surveys, comprising 15,520 participants (6,774 men and 8,746 women) aged 25-64 years, from 5 different West African countries, namely Burkina Faso (4,711), Benin (3,816), Mali (1,772), Liberia (2,594), and Ghana (2,662). T-test and chi-square tests were used to compare differences in the prevalence of traditional risk factors for both sexes. Multinomial logistic regression was conducted to ascertain the relative risks (RR) and 95% confidence intervals (CI) for both T2DM and impaired fasting glucose (IFG) relating to each risk factor, including obesity [defined by BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)], high blood pressure (HBP), fruit and vegetable consumption, physical inactivity, alcohol consumption, and smoking. Models for each of these traditional risk factors and interactions with age and sex were fitted.Results: Factors associated with T2DM and IFG were age, obesity [defined by BMI, WC, WHtR, and WHR], HBP, smoking, physical inactivity, and fruit and vegetable consumption (p < 0.05). Analysis of interaction effects showed few significant differences in associations between risk factors and T2DM according to age or sex. Significant interaction with age was observed for HBP*age and T2DM [RR; 1.20, 95% CI: (1.01, 1.42)) (p = 0.04)], WHtR*age and T2DM [RR; 1.23, 95% CI: (1.06, 1.44) (p = 0.007)] and WHR*age and IFG [RR: 0.79, 95% CI: (0.67, 0.94) (p = 0.006)]. Some interactions with age and sex were observed for the association of alcohol consumption and both IFG and T2DM, but no clear patterns were observed.Conclusion: The study found that with very few exceptions, associations between traditional risk factors examined and both IFG and T2DM did not vary by age or sex among the West African population. Policies and public health intervention strategies for the prevention of T2DM and IFG should target adults of any age or sex in West Africa. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease (COVID-19) outbreak has caused a universal health crisis resulting in significant morbidities and mortalities particularly among high-risk groups. This study sought to determine regional factors associated with knowledge and attitude towards COVID-19 mitigation practices and risk perception of contracting the disease in Sub-Saharan African (SSA) countries. Methods: A cross-sectional anonymous online study was conducted among 1970 participants between April and May 2020, during the lockdown in many SSA countries. Recruitment of participants was via WhatsApp, Facebook and emails using authors' networks. The outcome variables were KAP (knowledge, attitudes and practice) of COVID-19 and analysis of variance (ANOVA) with post hoc test was run to assess the level of KAP by four regions in SSA. Simple and multiple linear regression (MLR) analyses were performed to examine factors associated with the outcome measures in the four SSA regions. Results: Mean knowledge (P = 0.707) and risk perception (P = 0.904) scores by four regions in SSA did not differ significantly. However, the mean attitude score was higher among West Africans compared with Southern (P = 0.019) and Central Africans (P = 0.003). MLR analysis revealed that among those living in West (adjusted coefficient β = -0.83 95% CI: -1.19, -0.48) and Southern Africa (β = -0.91 95% CI: -1.42, -0.40), having a primary or secondary education was associated with a decrease in knowledge scores while not being worried about COVID-19 decreased risk perception scores across the four SSA regions(West [β = -6.57, 95% CI: -7.53, -5.62], East [β = -6.24: 95% CI: -8.34,-4.15], Central [β = -6.51, 95% CI: -8.70, -4.31], and Southern Africa [β = -6.06: 95% CI: -7.51, -4.60]). Except among Southern Africans, participants who practiced self-isolation had positive attitude towards COVID-19. Conclusion: Future research on health education regarding COVID-19 or a future related pandemic in SSA should target people with lower education, those who do not self-isolate, those living in Southern and Western Africa and not worried about contracting COVID-19. [ABSTRACT FROM AUTHOR]

Background: Asymptomatic HIV-infected people who start ART early may feel less motivated and neglect compliance. This might promote the emergence of resistance.Methods: In the Temprano trial, ART-naive HIV-infected adults with high CD4 counts were randomly assigned to start ART immediately (immediate group) or defer ART until the WHO criteria were met (deferred group). All participants were monitored for 30 months. Those in the deferred group who started ART were monitored for longer, until they had completed 30 months on ART. We compared the rate of virological failure and drug resistance between the immediate and deferred groups 30 months after ART initiation.Results: Of the 2056 participants in Temprano, 1033 were assigned to start ART immediately and 1023 to defer ART. Of the latter, 488 started ART during trial follow-up. Patients in the deferred group who started ART had a lower median CD4 count (280 versus 465 cells/mm3) and a higher median plasma HIV-1 RNA (5.1 versus 4.7 log10 copies/mL) at baseline. During follow-up, participants in both groups had similar antiretroviral drug exposure. Thirty months after ART initiation, patients in the deferred group had a higher rate of virological failure (35.3% versus 29.9%, P = 0.04) and a lower genotypic susceptibility score (P = 0.04).Conclusions: Starting ART early decreases the risk of virological failure and drug resistance in the medium term. This benefit is of particular importance in countries where access to viral load monitoring and the number of antiretroviral drug lines is limited. [ABSTRACT FROM AUTHOR]

An in-depth understanding of the impact of aging, cognitive reserve, and HIV status on cognitive function is needed in older West African adults. Ninety-nine HIV-negative and 334 HIV-positive adults aged ≥ 50 years were enrolled in three clinics (Senegal and Côte d'Ivoire) participating in the IeDEA West Africa collaboration. All subjects underwent the Free and Cued Selective Reminding Test (FCSRT) and the Isaacs Set Test (IST). Age (both linear and quadratic), education level, and HIV status effects on Z-scores were assessed using multivariate linear regression models. Interactions between HIV status and age or educational level were tested. In the present cohort of older West African adults, the role of age and educational level on episodic memory and verbal fluency was observed without revealing an interaction between HIV status and age effect. As age had quadratic effects, older HIV-positive adults should not be considered as a unique group irrespective of their age. Low-educated HIV-positive patients had the lowest verbal fluency performance compared to others. Further studies are needed to duplicate these results. In clinical settings, screening and adapted programs focusing on improving cognition in those patients are needed. [ABSTRACT FROM AUTHOR]

This essay examines the histories of two enslaved Africans living in Cuba and sent to prison in the mid-nineteenth century, to consider the ways in which prison represented a path to freedom within and beyond slave societies. Formerly enslaved people in Cuba and Puerto Rico, released from bondage upon entering the carceral system, were often resold into slavery upon completion of their prison sentences – but not always. The essay focuses first on the case of Gregorio Lucumí, imprisoned in Cuba, whose civil status post-sentence was debated by authorities seeking to discourage crime as a means to secure prison sentences that might yield freedom from slavery. It then turns to the lengthier case of Isidoro Gangá, sent to prison in Melilla, North Africa, and who, post-sentence, appealed for freedom via free soil principles. [ABSTRACT FROM AUTHOR]

Public health professionals may be confronted with unique ethical challenges in outbreak response situations. We conducted interviews with twenty-two public health professionals involved in responses to the 2014–2015 Ebola epidemic in Sierra Leone and Liberia to explore how they understood and experienced the ethical challenges involved in this work. The concerns covered in these interviews ranged dramatically, but three themes emerged as unique contributions from a subset of individuals integrally involved with the frontline response, who framed concerns about representation as key ethical issues. These included concerns regarding misrepresentations of West Africans as 'resistant' to the epidemic response, failures in material and information resources provided in the response, and representations of 'rationality' between responders and publics. Such concerns suggest that perspectives advanced in the critical public health literature in recent decades are circulating amongst public health professionals involved in outbreak response, although discord amongst respondents suggests the need for more deliberate efforts to reframe thinking about resistance, resources, and rationality in future public health outbreak responses. [ABSTRACT FROM AUTHOR]

The outbreak of the novel coronavirus pandemic, otherwise known as COVID-19 brought about the use of new terminologies—new lexical items such as social distancing, self-isolation, and lockdown. In developed countries, basic social amenities to support these are taken for granted; this is not the case in West African countries. Instead, those suggested safeguards against contracting COVID-19 have exposed the infrastructural deficit in West African countries. In addition, and more profoundly, these safeguards against the disease have distorted the traditional community-individuality balance. The enforcement of social distancing, self-isolation, and lockdown has made it impossible for West Africans to drift to their ancestral homes and villages, as is usually the case in times of crisis, with attendant consequences for communal life and traditional burial rites. This could be one of the reasons why some COVID-19 patients are escaping from isolation centres, since to die in such centres violates their bodily integrity at an ontological level. [ABSTRACT FROM AUTHOR]

This article reports findings of a research study that examined how black Muslim women seek help for domestic violence. A sample comprised of six black Muslim women, four African American and two West African, completed a series of in-depth interviews about their experiences. Data was analyzed using grounded theory methodology. Four overarching help-seeking strategies emerged: family and/or friends, religion and/or spirituality, services, legal system. Participants revealed what initiated or prevented their use of these strategies, as well as the outcome of strategy utilization. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Systolic (SBP) and diastolic blood pressure (DBP) are commonly used for cardiovascular disease (CVD) risk prediction, and pulse pressure (PP) and mean arterial blood pressure (MAP) can provide additional information. It is therefore important to understand the factors associated with these cardiovascular risk markers. This cross-sectional study involved 1839 men and women aged 40–60 years. Data on SBP, DBP, MAP, PP, sociodemography, lifestyle, anthropometry, and lipids were collected. Gender-stratified linear regression analyses were performed to determine the association between log-transformed blood pressure indices and the study variables. Age was associated with all measured blood pressure indices (p < 0.001) among men and women. Men had higher SBP (p = 0.007) and PP (p < 0.001) than women. Nankana ethnicity was associated with higher PP levels (p < 0.005) in the total population. Vendor meal consumption among women was associated with higher PP levels (p < 0.05). Fruit intake among men was associated with lower PP levels (p < 0.05). Currently unmarried women had higher SBP (p < 0.005), DBP (p < 0.05), MAP (p < 0.005), and PP (p < 0.005) than currently married women. Pesticide exposure was negatively associated with SBP (p < 0.005), DBP (p < 0.005), MAP (p < 0.005), and PP (p < 0.05) among women. Increased subcutaneous fat was associated with DBP (p < 0.005) and MAP (p < 0.05) among women. Among men, hip circumference was associated with higher DBP and MAP (p < 0.05 for both associations), subcutaneous fat associated with higher SBP (p < 0.005), DBP (p < 0.001), and MAP (p < 0.001) and visceral fat was associated with higher PP (p < 0.05). In the total population, visceral fat was associated with higher DBP (p < 0.05) and MAP (p < 0.001). High-density lipoprotein cholesterol was positively associated with SBP (p < 0.005), DBP (p < 0.005), and MAP (p < 0.001) for women and positively associated with SBP, DBP, and MAP (p < 0.001 for all three) and PP (p < 0.05) for men. The association of blood pressure indices with modifiable risk factors suggests that targeted health interventions may reduce CVD risk in this population. [ABSTRACT FROM AUTHOR]

African Americans have a wide range of continental genetic ancestry. It is unclear whether racial differences in blood pressure (BP) control are related to ancestral background. The authors analyzed data from the Jackson Heart Study, a cohort exclusively comprised of self-identified African Americans, to assess the association between estimated West African ancestry (WAA) and BP control (systolic and diastolic BP < 140/90 mm Hg). Three nested modified Poisson regression models were used to calculate prevalence ratios for BP control associated with the three upper quartiles, separately, vs the lowest quartile of West African ancestry. The authors analyzed data from 1658 participants with hypertension who reported taking all of their antihypertensive medications in the previous 24 hours. WAA was estimated using 389 ancestry informative markers and categorized into quartiles (Q1: <73.7%, Q2: >73.7%-81.0%, Q3: >81.0%-86.3%, and Q4: >86.3%). The proportion of participants with controlled BP in the lowest-to-highest WAA quartile was 75.2%, 76.1%, 76.6%, and 74.4%. The prevalence ratios (95% CI) for controlled BP comparing Q2, Q3, and Q4 to Q1 of WAA were 1.00 (0.93-1.08), 1.02 (0.94-1.10), and 0.99 (0.91-1.07), respectively. Among African Americans in the Jackson Heart Study taking antihypertensive medication, BP control rates did not differ across quartiles of WAA. [ABSTRACT FROM AUTHOR]

Purpose: African Americans, especially men, have a higher incidence of lung cancer compared with all other racial and ethnic groups in the US. Self-reported race is frequently used in genomic research studies to capture an individual's race or ethnicity. However, it is clear from studies of genetic admixture that human genetic variation does not segregate into the same biologically discrete categories as socially defined categories of race. Previous studies have suggested that the degree of West African ancestry among African Americans can contribute to cancer risk in this population, though few studies have addressed this question in lung cancer.Methods: Using a genetic ancestry panel of 100 SNPs, we estimated West African, European, and Native American ancestry in 1,407 self-described African Americans and 2,413 European Americans.Results: We found that increasing West African ancestry was associated with increased risk of lung cancer among African American men (ORQ5 vs Q1 = 2.55 (1.45-4.48), p = 0.001), while no association was observed in African American women (ORQ5 vs Q1 = 0.90 (0.51-1.59), p = 0.56). This relationship diminished following adjustment for income and education.Conclusions: Genetic ancestry is not a major contributor to lung cancer risk or survival disparities. [ABSTRACT FROM AUTHOR]

Prior research on Black immigrants in the US has almost exclusively focused on those from the Caribbean. Yet African immigrants are poised to become the largest Black immigrant group in the US. This article addresses this issue by exploring the ethnoracial identity-work central to the processes by which the children of African immigrants integrate into American. I draw upon interviews of 36 West African and Black American high school students in the Bronx, New York. The findings reveal an identificational convergence where African and Black American youth identify similarly (i.e. as 'Black' and 'African-American') yet make different meanings of behind these terms. I examined three prominent domains (e.g. physical appearances, parenting and cultural stereotypes) that shape these varied articulations and intraracial boundaries. [ABSTRACT FROM AUTHOR]

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The African Movement of Working Children and Youth aims to empower and support young people, who otherwise would be excluded from educational and socioeconomic chances, to 'prepare their future'. In so doing, they re-interpret and re-combine transnational and local frames of reference in order to legitimize and materialize their ideas. I conceptualize this commitment as promoting a democratization of the future because they broaden the meaning of the (good) future as well as the means of access to it. [ABSTRACT FROM AUTHOR]

During an Ebola outbreak, the WHO recommends that health professionals consider people as suspect cases (SCs) when they show key signs such as the sudden onset of high fever or specific symptoms after having had contact with a suspect or confirmed Ebola case. SCs should then get care, be isolated and be reported to health authorities until the Ebola virus disease is confirmed through a lab test. This exploratory study aims to understand this identification process in the field based on a qualitative analysis of the diagnosis and therapeutic itineraries of 19 SCs in Cote d'Ivoire and Senegal (2014-2015). Results indicate that the main criteria for SC identification at the field level were fever (understood broadly) and provenance from a highly affected country (applied indiscriminately). WHO criteria were not followed in at least 9 of the 19 cases. Several medical, social and cultural factors favour over-identification of people as SCs, including relativism in defining 'high fever', placism, humanitarian or securitarian bias, issues in categorising SC's contact cases, and the context of fear. To avoid undue categorisation and its possible harmful social effects, the WHO definition should be implemented more carefully in various contexts and with greater consideration for ethical issues, while prioritising diagnosis strategies with higher specificity. [ABSTRACT FROM AUTHOR]

Reducing potential dangers by changing routine behavior to avoid certain people, places, or technologies can be prudent, but reporting avoidance also can be symbolic. This study probed Americans' reactions to Ebola from December 2014 to May 2015 with a longitudinal study (final n = 625), plus a representative sample in May: How much did they claim to avoid West Africans, commercial flights, Ebola-associated cities, and four other targets? What factors affected self-reported avoidance? Did people with opportunities to implement avoidance report more (e.g. frequent flyers can change their routine behavior more to avoid commercial flights than can infrequent flyers)? The December 2014 survey found most people never considered avoidance, but substantial minorities claimed acting or intending to avoid each target; substantial majorities of May 2015 respondents reported avoidance intentions if a new Ebola outbreak occurred in Africa or the United States. Perceptions of personal risk, concern about infection, and following Ebola news were primary factors in reported avoidance, with temporal reversals (e.g. news following increased avoidance in December but decreased it in May). Opportunity enhanced reported avoidance in December 2014 by indirect effects through personal risk, concern, and news following, but decreased avoidance intentions in May 2015 through direct effects of opportunity on avoidance. Temporal shifts in avoidance reports and associations seem consistent with objective declines in Ebola cases, perhaps mediated by changes in news coverage. Further consideration of avoidance behavior and the role of opportunity could enhance hazard management. [ABSTRACT FROM AUTHOR]

We conducted an observational cohort study of end-stage kidney disease (ESKD) in >7000 African and Caribbean people with HIV in the UK. Using Poisson regression and East Africans as the reference group, the adjusted incidence rate ratio (95% confidence interval) of ESKD was 3.14 (1.26-7.84) in Southern Africans, 6.35 (2.53-15.96) in West Africans, and 5.26 (1.91-14.43) in Caribbeans. Higher CD4 cell count and suppressed HIV replication were associated with reduced risk of ESKD. The risk of ESKD varied among HIV-positive people of African heritage, with the highest rates observed in those of West African descent. [ABSTRACT FROM AUTHOR]

Chapter Seven of a book by Heather Salazar and Roderick Nicholls is presented which explores the philosophy of spirituality. Topics discussed include the spirituality of post-1965 West African immigrants in the West, the relationships that exist between everyday aesthetics and everyday religion, West African diaspora in the U.S., and symbolism and spirituality.

Abstract: Immigrants make up large proportions of many low‐income neighborhoods, but have been largely ignored in the neighborhood safety literature. We examined perceived safety's association with migration using a six‐item, child‐specific measure of parents’ perceptions of school‐aged (5–12 years of age) children's safety in a sample of 93 West African immigrant parents in New York City. Aims of the study were (a) to identify pre‐migration correlates (e.g., trauma in home countries), (b) to identify migration‐related correlates (e.g., immigration status, time spent separated from children during migration), and (c) to identify pre‐migration and migration correlates that accounted for variance after controlling for non‐migration‐related correlates (e.g., neighborhood crime, parents’ psychological distress). In a linear regression model, children's safety was associated with borough of residence, greater English ability, less emotional distress, less parenting difficulty, and a history of child separation. Parents’ and children's gender, parents’ immigration status, and the number of contacts in the U.S. pre‐migration and pre‐migration trauma were not associated with children's safety. That child separation was positively associated with safety perceptions suggests that the processes that facilitate parent–child separation might be reconceptualized as strengths for transnational families. Integrating migration‐related factors into the discussion of neighborhood safety for immigrant populations allows for more nuanced views of immigrant families’ well‐being in host countries. [ABSTRACT FROM AUTHOR]

Aims and objectives: This paper reports on women's experiences of weight gain and obesity as they became acculturated to the Australian diet and lifestyle. Background: Migrants from sub-Saharan Africa have a much higher risk of obesity than the native population when settling in industrialised countries. Method: Qualitative. Results: Women in this study reported weight gain post-migration. This was attributed to increased access to a wide variety of food including takeaway food and more sedentary lifestyles. Conclusions: Obesity has long-term consequences for health and well-being. Further research is needed to support a healthy transition to life in Australia. Relevance to clinical practice: Gaining insight into the underlying reasons that West African immigrants to Australia become obese could contribute to assisting health professionals design culturally appropriate interventions and health education programmes to support new arrivals. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to report the safety and efficacy of the membrane-tube (MT)-type glaucoma shunt device (Finetube MT) in the management of refractory glaucoma in indigenous West Africans. Methods: The Finetube MT was implanted into 25 eyes of 25 West African patients with refractory glaucoma. These patients had inadequate intraocular pressure (IOP) control despite maximum tolerable IOP-lowering medications with or without previous ocular surgeries. IOP, postoperative complications, interventions, visual acuities, and the number of IOP-lowering medications were analyzed preoperatively and postoperatively. Results: The mean (standard deviation [SD]) age of the patients was 49.7 (20.9) years. The mean (SD) follow-up duration was 21.0 (10.6) months. Postoperatively, the mean (SD) IOP reduced from a preoperative value of 38.1 (10.3) mmHg to 14.5 (4.6), 16.1 (7.8), and 14.7 (3.0) mmHg at 1, 2, and 3 years postoperatively, respectively, representing 61.9%, 57.7%, and 61.4% reduction from baseline (P<0.01). The mean (SD) number of IOP-lowering medications reduced from 4.1 (1.0) to 0.6 (0.9) at 1 year and 0.9 (1.1) at 2 years after the operation (P<0.01). Using an IOP level between 6 and 21 mmHg and reduced by $20% from baseline, the cumulative survival rate (standard error) was 96.0% (3.9%) at 6 months, 89.0% (6.0%) at 18 months, and 81.3% (10.6%) at 3 years after the operation. There was no postoperative ocular hypotony, tube occlusion, or device exposure. Conclusion: The Finetube MT may effectively control IOP with minimal risk of postoperative complications in indigenous West Africans. [ABSTRACT FROM AUTHOR]

Objective Worldwide, the highest frequencies of APOL1-associated kidney variants are found in indigenous West Africans among whom small vessel disease ( SVD) ischemic stroke is the most common stroke phenotype. The objective of this study was to investigate the association and effect sizes of 23 selected SNPs in 14 genes of relevance, including the APOL1 G1 variants, with the occurrence of SVD ischemic stroke among indigenous West African participants in the Stroke Investigative Research and Education Network ( SIREN) Study. Materials and Methods Cases were consecutively recruited consenting adults (aged 18 years or older) with neuroimaging-confirmed first clinical stroke. Stroke-free controls were ascertained using a locally validated version of the Questionnaire for Verifying Stroke-Free Status ( QVSFS). Logistic regression models adjusting for known vascular risk factors were fitted to assess the associations of the 23 SNPs in rigorously phenotyped cases (N = 154) of SVD ischemic stroke and stroke-free (N = 483) controls. Results Apolipoprotein L1 ( APOL1) rs73885319 ( OR = 1.52; CI: 1.09-2.13, P-value = .013), rs2383207 in CDKN2A/ CDKN2B ( OR = 3.08; CI: 1.15-8.26, P -value = .026) and rs2107595 ( OR = 1.70; CI: 1.12-2.60, P-value = .014) and rs28688791 ( OR = 1.52; CI: 1.03-2.26, P-value = .036) in HDAC9 gene were associated with SVD stroke at 0.05 significance level. Polymorphisms in other genes did not show significant associations. Conclusion This is the first report of a specific association of APOL1 with a stroke subtype. Further research is needed to confirm these initial findings and deepen understanding of the genetics of stroke in people of African ancestry with possible implications for other ancestries as all humans originated from Africa. [ABSTRACT FROM AUTHOR]

This article contributes to the study of migrant ‘illegality’ and deportability by focusing on informal regimes of citizenship and regulation between state and society. It sheds light, in particular, on the interactions between West African migrant traders and immigration officers in Angola. Although Angola deports thousands of ‘illegal’ West African and other migrants every year, during everyday checks police officers often extort money from, rather than expel, undocumented migrants. Far from jeopardizing immigration enforcement, this kind of predatory policing is sustained by the deportation apparatus. The article demonstrates that illegalization and the threat of deportation spread discretionary power and authoritarianism down the state hierarchy, resulting in more intense and frequent street-level predation. What deportability downgrades is therefore not only migrants’ formal rights, but also the more informal rules of corruption through which migrants negotiate their inclusion in the state. [ABSTRACT FROM PUBLISHER]

Nicolas Klotz's and Élisabeth Perceval‘s filmLa Blessure(2004) problematizes the political visibility and artistic representation of undocumented African immigrants in Paris by deliberately parsing sound and sight and imixing fiction with reality. Opening with a scene at the detention center at Orly airport,La Blessuretracks the sites and spaces accessible to undocumented immigrants. According to Élisabeth Perceval, screenwriter ofLa Blessure, the film is not about contemporary demands for asylum, with its ‘lot of statistics and proofs’ but about following alongside the experiences or sensations of refugees, combining the real and the fictional into a particular ‘carnal’ relationship. Similarly filmmaker Nicolas Klotz remarked thatLa Blessurewas filmed ‘next to [à coté de] those who have lost everything. In the space where they dare to still exist'. This language of proximity, of touching on the subject and spaces of asylum seekers, resists the logic of rendering visible, in order to remediate, the painful experiences of West Africans in Paris in many recent films. Films, such as Djib (Jean Odoutan 2000), according to film historian Carrie Tarr, forge ‘rewarding, if transient, cross-cultural relationships and … collective political action’ through an aesthetics of humanitarian individualizing joined with identity politics.La Blessure, on the other hand, takes a different approach – a complete spectorial disidentification with the main character, Blandine. Through a noncontiguous use of sound and image as well as fragmented narration,La Blessurefragments the spectator's sensorium to problematize the relation of individual bodies to the social whole, and the relation of the spectator to the nonsites inhabited by refugees in Paris – the detention center and slums of the periphery. [ABSTRACT FROM PUBLISHER]

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell 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.)

This paper contextualizes racial and ethnic identities in shaping African women’s work lives in the USA. While the literature on black immigrant groups has posited that ethnic identities are often deployed to shield black immigrants from racism, my findings indicate that for a group of African women, their racial and ethnic identities are viewed as potential sources of discrimination. As black immigrant women from middle-class backgrounds in their home countries, they also articulate experiences with racism and downward social and occupational mobility. Accounting for how race and ethnicity intersect in the lives of black immigrant groups can nuance our understanding of racial identities and highlight diversity in experiences among national and regional groups. Focusing on particular health-care settings further suggests the importance of professional contexts in shaping the identity formations of recent black immigrants. [ABSTRACT FROM PUBLISHER]

French colonialism resulted in the inclusion of large numbers of West Africans into French educational institutions. Furthermore, the Senegambian region has a long history of intermarriage with French citizens. This paper draws on this history to explore the interplay between migration, education and binational marriage over several generations of West African students, with a particular focus on Senegal. Students from Francophone countries continue to seek educational opportunities in France, but in recent years they have been increasingly affected by the tightening up of immigration policies. In this context, this paper suggests that marriage to a French spouse often plays an important role in the fulfilment of educational projects, and that this role is contingent on issues of gender and class. At times, however, tensions between marriage in France and social expectations back home end up compromising education altogether. [ABSTRACT FROM PUBLISHER]

This study examined migration narratives of West African immigrants for the connections between experiences of loss and educational aspirations for their children. The qualitative design consisted of three interviews per family in which parents (N = 20, 12 families) were asked to narrate their families’ migration histories. Transcripts were analyzed using grounded theory followed by thematic coding. Discussions of loss were markedly proximal to discussions of children’s education. Schooling was described as providing upward mobility but conflicting with education at home, which was seen as fostering traditional values. Discussion contextualizes findings using Hobfoll’s conservation of resources theory and Kagitçibasi’s family change theory. Implications include salience of loss to educational aspirations and school-family partnerships for immigrants. [ABSTRACT FROM PUBLISHER]

The association between the football industry and the trafficking of West African youth has captivated academic, media and political interest. This article uses football trafficking as a case study to think through the broader conception of mobile African male bodies in football migration and trafficking discourses. I contribute to and move beyond existing literature on African football migration by stepping away from structural approaches currently used to conceptualise this migratory process. This is achieved by bringing migrants' subjectivities to the fore, and in doing so I also provide a novel critique of policy responses to irregular football migration. The article draws on data obtained from migrants who left West Africa for Europe, exploring the journeys these would-be footballers took, and their trajectories and circumstances after arrival. The central argument is that existing policy responses frame irregular football migrants as being ‘better off at home’. Problematically this creates a tension as for many of these migrants their country of origin is precisely where they do not want to be. Consequently, many remain in destination countries illegally without any means of subsistence. [ABSTRACT FROM PUBLISHER]

The knowledge, attitudes, and practices surrounding bushmeat consumption and importation in the United States are not well described. Focus groups of West African persons living in Minnesota, USA, found that perceived risks are low and unlikely to deter consumers. Incentives for importation and consumption were multifactorial in this community. [ABSTRACT FROM AUTHOR]

Copyright of HAU: Journal of Ethnographic Theory is the property of University of Chicago Press 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 History in Africa: A Journal of Method is the property of Cambridge University Press 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.)

Age-adjusted mortality rates for prostate cancer are higher for African-American men compared with those of European ancestry. Recent data suggest that West African men also have elevated risk for prostate cancer relative to European men. Genetic susceptibility to prostate cancer could account for part of this difference. We conducted a genome-wide association study (GWAS) of prostate cancer in West African men in the Ghana Prostate Study. Association testing was performed using multivariable logistic regression adjusted for age and genetic ancestry for 474 prostate cancer cases and 458 population-based controls on the Illumina HumanOmni-5 Quad BeadChip. The most promising association was at 10p14 within an intron of a long non-coding RNA (lncRNA RP11-543F8.2) 360 kb centromeric of GATA3 ( p = 1.29E−7). In sub-analyses, SNPs at 5q31.3 were associated with high Gleason score (≥7) cancers, the strongest of which was a missense SNP in PCDHA1 (rs34575154, p = 3.66E−8), and SNPs at Xq28 (rs985081, p = 8.66E−9) and 6q21 (rs2185710, p = 5.95E−8) were associated with low Gleason score (<7) cancers. We sought to validate our findings in silico in the African Ancestry Prostate Cancer GWAS Consortium, but only one SNP, at 10p14, replicated at p < 0.05. Of the 90 prostate cancer loci reported from studies of men of European, Asian or African-American ancestry, we were able to test 81 in the Ghana Prostate Study, and 10 of these replicated at p < 0.05. Further genetic studies of prostate cancer in West African men are needed to confirm our promising susceptibility loci. [ABSTRACT FROM AUTHOR]

Non-nucleoside reverse transcriptase inhibitor (NNRTI) associated rash is common and frequently leads to discontinuation of NNRTIs. This study assessed the risk of developing rashes and discontinuing NNRTIs and associated factors in a large clinic in central Ghana. In this retrospective cohort study, clinical data were obtained in patients starting efavirenz or nevirapine between 2004–2010. Factors associated with rashes were explored using a multivariate Cox proportional hazards regression model. Of 3,999 patients who started NNRTI-based ART, 281 (7.0%) experienced at least one episode of NNRTI-related rash with an incidence of 2.63 events/100 person-years, occurring in 10.2% and 5.6% of patients taking nevirapine and efavirenz respectively. Most rashes (94%) were grade 1 or 2 and were reported a median of 2 months following initiation of ART. In multivariate analysis developing a rash was associated with nevirapine use (aHR 1.67, 95% CI 1.28–2.10), female gender (aHR of 1.39, 95% CI 1.01–1.92) and lower baseline CD4 counts (aHR 0.88, 95% CI 0.82–0.95 per 50 cells/mm3 increment). Patients with nevirapine-associated rash were 11 times more likely to discontinue treatment as patients with efavirenz-associated rash. In contrast to findings in other studies, NNRTI-associated rashes in Ghanaians appear more common in patients with lower baseline CD4 counts. Given the increased frequency of rashes with nevirapine and subsequent discontinuations in many patients, along with other treatment-limiting toxicities, this provides further impetus for the replacement of nevirapine by efavirenz as the first-line NNRTI treatment of choice in Africa. [ABSTRACT FROM AUTHOR]

Background: Plasmodium ovale and Plasmodium malariae have long been reported to be widely distributed in tropical Africa and in other major malaria-endemic areas of the world. However, little is known about the burden caused by these two malaria species. Methods and Findings: We did a longitudinal study of the inhabitants of Dielmo village, Senegal, between June, 1990, and December, 2010. We monitored the inhabitants for fever during this period and performed quarterly measurements of parasitemia. We analyzed parasitological and clinical data in a random-effect logistic regression model to investigate the relationship between the level of parasitemia and the risk of fever and to establish diagnostic criteria for P. ovale and P. malariae clinical attacks. The prevalence of P. ovale and P. malariae infections in asymptomatic individuals were high during the first years of the project but decreased after 2004 and almost disappeared in 2010 in relation to changes in malaria control policies. The average incidence densities of P. ovale and P. malariae clinical attacks were 0.053 and 0.093 attacks per person per year in children <15 years and 0.024 and 0.009 attacks per person per year in adults ≥15 years, respectively. These two malaria species represented together 5.9% of the malaria burden. Conclusions: P. ovale and P. malariae were a common cause of morbidity in Dielmo villagers until the recent dramatic decrease of malaria that followed the introduction of new malaria control policies. P. ovale and P. malariae may constitute an important cause of morbidity in many areas of tropical Africa. [ABSTRACT FROM AUTHOR]