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The marketing of sweetened and flavoured tobacco in the early 1990s resulted in an upsurge in waterpipe smoking (WPS), mainly among young people and women. Here, we estimate prevalence rates among school-attending adolescents aged 14–19 (girls 52%) for a lifetime experience of WPS and within the last 30 days (WPS < 30 days) and identify influential factors for such smoking in Bissau, Guinea-Bissau. A random sample (N = 2039) was drawn from a class-based register created for 16 schools in Bissau; attending students in June 2017 were invited to respond to a locally adapted Planet Youth questionnaire. Descriptive statistics, odds ratio with 95% confidence interval, and multinomial logistic regression analysis were used to identify influential factors for WPS. The prevalence rates for a lifetime experience of WPS and within < 30 days were high, 17.7% and 15.0%, respectively, with no significant gender difference. For both groups, a multinomial logistic regression analysis identified attending higher grades in school, use of alcohol and being a victim of sexual violence as significant, influential factors. The overlapping of influential factors suggests preventive work against substance abuse should focus on less stigmatising behaviour, such as WPS and firmer implementation of the Framework Convention of Tobacco Control (FCTC).

Diverse actors, including foreign and national states, international agencies, donors, non-governmental organisations (NGOs), and private ventures, demand, fund, and implement anti-trafficking activities worldwide. Bissau-Guinean Quran schoolboys begging in Senegalese cities are defined as victims of child trafficking, and their teachers as traffickers. This article aims to explore the Quran teachers’ understanding of begging and their response to being accused of child trafficking. It rests on data collected during anthropological fieldwork in Guinea-Bissau and Senegal since 2009, including interviews and participation in religious events. The Quran teachers, some of whom admit colleagues might exploit their students, highlight four aspects of begging: allowing poor populations economically to study the Quran; contributing to humbleness, humility, and empathy with underprivileged groups; redistributing resources across generations; and allowing the acquisition of knowledge, liberation, and power. They maintain that the NGOs are profiting from funds provided to “rescue” the students and act as real traffickers, and together with funders, they aim to eliminate Islam. Embedded in layers of coloniality, the Quran teachers keep their position as community leaders. Banning begging is bound to fail if the anti-trafficking NGOs ignore their understanding of meaningful suffering and begging, including the economic and religious aspects of alms-seeking and its reciprocal nature.

Introduction Despite tremendous progress in the development of diagnostics, vaccines and therapeutics for Ebola virus disease (EVD), challenges remain in the implementation of holistic strategies to rapidly curtail outbreaks. We investigated the effectiveness of a community-based contact isolation strategy to limit the spread of the disease in the Democratic Republic of Congo (DRC).Methods We did a quasi-experimental comparison study. Eligible participants were EVD contacts registered from 12 June 2019 to 18 May 2020 in Beni and Mabalako Health Zones. Intervention group participants were isolated to specific community sites for the duration of their follow-up. Comparison group participants underwent contact tracing without isolation. The primary outcome was measured as the reproduction number (R) in the two groups. Secondary outcomes were the delay from symptom onset to isolation and case management, case fatality rate (CFR) and vaccination uptake.Results 27 324 EVD contacts were included in the study; 585 in the intervention group and 26 739 in the comparison group. The intervention group generated 32 confirmed cases (5.5%) in the first generation, while the comparison group generated 87 (0.3%). However, the 32 confirmed cases arising from the intervention contacts did not generate any additional transmission (R=0.00), whereas the 87 confirmed cases arising from the comparison group generated 99 secondary cases (R=1.14). The average delay between symptom onset and case isolation was shorter (1.3 vs 4.8 days; p

Balanced medical and criminal justice approaches addressing determinants of alcohol and other drugs (AOD) use are central to achieving the United Nations Sustainable Development Goals 3 and 16. However, data on AOD use in resource-poor settings are characterised by relative paucity and anecdote. This study aimed to describe and analyse AOD use susceptibility and its determinants among school-attending adolescents in the capital Bissau, Guinea-Bissau. Survey data were collected through a locally adapted Planet Youth questionnaire in June 2017 across 16 schools in Bissau. The 2039-strong sample was selected through a multi-stage, random cluster process. Participants’ lifetime alcohol use was 27.3%, smoking 10.8%, and cannabis use 3.6%. In each instance, the ‘15 years and above’ age bracket was the most common initiation period, signifying increased instigation in later adolescence. Subsequent Varimax Principal Component Analysis (PCA) of 312 variables captured data-driven models of AOD use susceptibility, implying imitated, polydrug use among initiates. Linear regression analysis revealed drinking, group violence, male gender, school dismissal and relationship breakdown as explanatory variables. Overlapping predictive variables suggest singular interventions may pre-empt myriad antisocial behaviours. PCA offers alternatives to singular, potentially myopic quantifications of drug use. PCA facilitates the creation of context-sensitive composite variables, enabling the identification of related outcome behaviours relevant to studies’ sociocultural settings.

Background COVID-19 is mainly a disease of adults but can affect vulnerable children indirectly through social containment measures. The study aimed to explore the impact of the pandemic on the lives of Quranic schoolboys, almudos, who beg on behalf of their teachers, chernos, in Guinea-Bissau.Methods Data were collected in July 2020 during a state of emergency. Data rest on semistructured interviews with 14 almudos and observations. The almudos, aged 12–16 years, were identified in the capital Bissau and the regional centre Gabú.Results Four interconnected themes were found. The first, hardship, was brought by the COVID-19 pandemic and caused by lockdown and police threats, resulting in a decrease in alms and hunger. The second, circumvention of calamity, included preventive measures the boys undertook and concerns with crowdedness impeding social distancing. Relations with others is the third theme. These had changed with sharply reduced contacts with neighbours and other providers of alms. The parents had more frequent telephone contact with their sons, and encouraged them to continue their studies. At the same time, the chernos and almudos passed more time together, and they dedicated more time than earlier to the studies and prayers. The fourth theme has to do with the boys’ concerns about their long-term aspirations—to complete their studies and become respected chernos, for which begging was seen as an integral part.Conclusion The almudos suffered from decreased alms, resulting in hunger. COVID-19 was only an additional burden to the boys, who are used to facing challenges while begging to complete their religious education. According to the Convention on the Rights of the Child, children have a right to develop their capabilities in line with their future aspirations. Governments and child rights organisations need to address the specific needs of almudos in respectful collaboration with them, their parents, the chernos and their communities.