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Background: Over the last decade, artemisinin-based combination therapy (ACT) has contributed substantially to the decrease in malaria-related morbidity and mortality. The emergence of Plasmodium falciparum parasites resistant to artemisinin derivatives in Southeast Asia and the risk of their spread or of local emergence in sub-Saharan Africa are a major threat to public health. This study thus set out to estimate the proportion of P. falciparum isolates, with Pfkelch13 gene mutations associated with artemisinin resistance previously detected in Southeast Asia. Methods: Blood samples were collected in two sites of Bangui, the capital of the Central African Republic (CAR) from 2017 to 2019. DNA was extracted and nested PCR were carried out to detect Plasmodium species and mutations in the propeller domain of the Pfkelch13 gene for P. falciparum samples. Results: A total of 255 P. falciparum samples were analysed. Plasmodium ovale DNA was found in four samples (1.57%, 4/255). Among the 187 samples with interpretable Pfkelch13 sequences, four samples presented a mutation (2.1%, 4/187), including one non-synonymous mutation (Y653N) (0.5%, 1/187). This mutation has never been described as associated with artemisinin resistance in Southeast Asia and its in vitro phenotype is unknown. Conclusion: This preliminary study indicates the absence of Pfkelch13 mutant associated with artemisinin resistance in Bangui. However, this limited study needs to be extended by collecting samples across the whole country along with the evaluation of in vitro and in vivo phenotype profiles of Pfkelch13 mutant parasites to estimate the risk of artemisinin resistance in the CAR. [ABSTRACT FROM AUTHOR]

Sexual violence is commonly described as an epidemic in the Central African Republic (CAR) and other conflict settings. In response, the government and the international community have launched major efforts to combat sexual violence, including the investigation and prosecution of sexual crimes and offences by the ordinary justice system, the Special Criminal Court in the Central African Republic, and the International Criminal Court. Yet, little is known about how these efforts are perceived among the population and about their effectiveness at reducing exposure in a context of ongoing violence. This article builds on a unique series of four surveys conducted at six-month intervals between 2017 and 2018 with a total of 25,143 randomly selected adults. It assesses the magnitude of sexual violence and shows that respondents positively perceive efforts to combat sexual violence and increasingly understand and trust the justice system. Disclosure of sexual violence is increasing, but only one in five victims files a formal complaint with security and justice actors. Factors undermining disclosing or filing of complaints about these widespread events include fear of retaliation, re-traumatization, and stigmatization. Investigating sexual crimes in a context of insecurity is extremely challenging and the work of the various courts is hindered by practical, procedural, and social challenges detailed in this article, as well as the need to coordinate prosecutorial strategies. There is an urgent need to build capacity and to ensure appropriate and compassionate treatment towards those who have been assaulted. Monitoring perception of criminal justice efforts is an important step towards understanding their contribution to ending sexual violence and to peace. [ABSTRACT FROM AUTHOR]

When bringing armed conflicts to a peaceful end, the inclusion of civil society in peacemaking is a vital task. However, whereas previous research on civil society inclusion has made significant advancements, surprisingly little attention has been paid to analyzing how civil resistance and mass action may interact with more elite-driven approaches during peace processes. This study addresses this research gap by examining the interplay between elite and mass-based civil society approaches in three different peace processes in civil wars in Africa in the post-Cold War period: Liberia, the Central African Republic (CAR), and Burundi. We advance the literature by developing a framework that focuses on coordination of these different efforts and we explore this interplay empirically. With this study, we aim to broaden the research agenda, allowing for future synergies at the research frontier of mass action and the inclusion of civil society in peace processes. [ABSTRACT FROM AUTHOR]

Background: Infection by hepatitis E virus (HEV) can cause a high burden of morbidity and mortality in countries with poor access to clean water and sanitation. Our study aimed to investigate the situation of HEV infections in the Central African Republic (CAR).Methods: A retrospective analysis of the blood samples and notification forms collected through the national yellow fever (YF) surveillance program, but for which a diagnosis of YF was discarded, was carried out using an anti-HEV IgM ELISA and a HEV-specific RT-PCR.Results: Of 2883 YF-negative samples collected between January 2008 and December 2012, 745 (~ 26%) tested positive by at least either of the 2 tests used to confirm HEV cases. The results revealed that the CAR was hit by a large HEV outbreak in 2008 and 2009. The results also showed a clear seasonal pattern with correlation between HEV incidence and rainfall in Bangui. A phylogenetic analysis showed that the circulating strains belonged to genotypes 1e and 2b.Conclusions: Overall, this study provides further evidences that HEV can be a significant cause of acute febrile jaundice, particularly among adults during rainy season or flood, in a country from Sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Copyright of ZooKeys is the property of Pensoft Publishers 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 Journal of Ecology 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.)

Background This last decade's ongoing conflict in the Central African Republic (CAR) has led to gradual and continuous destruction of health services. With severe gaps in qualified health professionals, community health workers (CHWs) have become essential to ensuring health care access to the affected population. This article aims to evaluate the effectiveness of a 10-y CHW program in the CAR. Methods Routine case management data from CHWs were collected in the Paoua district from January 2012 to December 2017 and analysed. Structured interviews were conducted in the Paoua and Carnot health districts among individuals from three different groups (health service beneficiaries, CHWs and health facility managers). Results From 2012 to 2017, 353 948 people consulted for malaria suspicion with CHWs and 86% were found to be malaria positive after a rapid diagnostic test. Among those diagnosed patients, 98.5% received adequate treatment and nearly 1.5% were referred to health facilities. Also, 94.5% of respondents identified fever as the major malaria symptom. About 70% of the population could identify three malaria signs/symptoms and 84.4% accepted and used CHW services. Interviews with CHWs revealed that 45.8% of them received at least four training sessions per month as part of their capacity building. Conclusions CHWs can be a resourceful solution when other health professional are scarce. This study showed that CHWs are not only able to deliver curative and preventive health services, but they are also well accepted by the served communities. [ABSTRACT FROM AUTHOR]

A new species of the genus Setelacher Bouček, S. lasalleisp. nov. Gumovsky and van Noort, is described from the Afrotropical region (Central African Republic, Gabon and Uganda). It confirms the presence of the genus in the region. The only described species of the genus, S. fasciatus Bouček, is of Australasian and Indo-Malayan distribution, and one undescribed species was previously recorded from South Africa. All images presented here are available on [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]

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]

Copyright of African Journal of Ecology 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.)

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]

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]

People seeking to understand the scope and scale of violence in the Central African Republic over the past two years have cited a variety of social grievances centring on the political manipulation of religion, belonging, and access to opportunities. Without denying that these factors have played a role, this article argues that the violence must be understood in the context of social practices of violence that long predate the war, especially in light of the diffuse and non-centralized mode of organization through which the ongoing war has played out. The article focuses on the prevalence of popular punishment and vengeance, which have long histories as elements of statecraft in the CAR and have become even more widespread amid the generalized insecurity and anomie that have set in over the past few decades. The article presents evidence of the workings of popular punishment from the intra-family level to that of the crowd and quartier, in both rural and urban locales. Though people have important reservations about popular punishment, they also see vengeance as an important tool for enforcing a circumscribed mode of empathy and a minimum set of standards for social behaviour. These experiences in the CAR suggest that those wishing to understand how wartime mobilization happens must consider not just fighters' grievances but also people's conceptions of the practical and symbolic efficacy of vengeance and popular punishment as elements of politics and the management of threats. [ABSTRACT FROM PUBLISHER]

For the first fifty years of military peacekeeping, peacekeepers came far from the sites where they were deployed, the better to be impartial. That has changed dramatically over the last several decades, and nowhere is this clearer than in Africa, where the largest and longest-running United Nations peacekeeping missions are now staffed primarily by Africans, often from neighboring countries. Simultaneously, peacekeepers have been tasked with more-aggressive operations than was previously the case. This essay explores what these shifts look like on a human level, in terms of the interactions, relationships, and possibilities that emerge out of neighbor-peacekeepers. Drawing on ethnographic research with Rwandan soldiers deployed as UN peacekeepers in the Central African Republic (CAR), I argue that relationships between Rwandan peacekeepers and civilians are both familiar and awkward. Neighborliness can, however, be overturned when well-armed people — whether Central Africans or peacekeepers — act aggressively toward each other. This is the conflicted heart of the relationships that go into African peacekeeping in Africa: familiarity and friendliness can coexist with capacity to kill. [ABSTRACT FROM AUTHOR]

Energy security is an international concern for all countries in the world, particularly, for the policymakers looking for the wellbeing of citizens. While proper methods to measure energy security without ignoring the different aspects and multidimensional interplay is necessary, the need for an objective evaluation with numerical indicators is of utmost importance. This research covers these gaps by providing a detailed numerical method to formulate an energy security index that is globally comprehensive, but also nationally applicable to all countries in the world. This implies to include all needed aspects and dimensions of energy security. Results of this research show the global performance of all countries in the world in energy security and the performance of these countries in each of the 15 dimensions that articulate energy security. Germany and the United States performed best in the world, when it comes to overall energy security levels, whereas the Central African Republic and Turkmenistan are on the lowest end of performance. Conclusions show that there is not a single way for development and enhancing energy security but rather different alternatives and options. Countries need to learn from each other to identify what works best for their context and implement these strategies in order to enhance energy security. [ABSTRACT FROM AUTHOR]

Recently, there were anecdotal reports of a high number of persons with epilepsy, including children with nodding seizures in the Landja Mboko area located about 9 km from the capital city Bangui, Central African Republic. We suspected the area to be endemic for onchocerciasis, and that the alleged increase in the number of epilepsy cases was due to ongoing Onchocerca volvulus transmission. However, ivermectin mass drug distribution (MDA) had never been implemented in the area. Therefore we performed an Ov16 antibody prevalence study among children, aged 6–9 years, using the biplex rapid diagnostic test (SD Bioline Oncho/LF biplex IgG4 RDT). The overall Ov16 seroprevalence was 8.9%, and that of lymphatic filariasis (LF) was 1.9%. Ov16 seropositivity was highest in Kodjo (20.0%), a village close to rapids on the river. Our study shows that there is ongoing O. volvulus transmission in the Landja Mboko area. We recommend that the extent of this onchocerciasis focus should be mapped, and the introduction of ivermectin MDA should be considered in these communities. [ABSTRACT FROM AUTHOR]

Background: In high syphilis prevalence settings, the syphilis testing and treatment strategy for mothers and newborns must be tailored to balance the risk of over treatment against the risk of missing infants at high-risk for congenital syphilis. Adding a non-treponemal test (Rapid Plasma Reagin - RPR) to a routine rapid treponemal test (SD Bioline Syphilis 3.0) for women giving birth can help distinguish between neonates at high and low-risk for congenital syphilis to tailor their treatment. Treatment for neonates born to RPR-reactive mothers (high-risk) is 10 days of intravenous penicillin, while one dose of intramuscular penicillin is sufficient for those born to RPR non-reactive mothers (low-risk). This strategy was adopted in March 2017 in a Médecins Sans Frontières supported hospital in Bangui, Central African Republic. This study examined the operational consequences of this algorithm on the treatment of newborns.Methods: The study was a retrospective cohort study. Routine programmatic data were analysed. Descriptive statistical analysis was done. Total antibiotic days, hospitalization days and estimated costs were compared to scenarios without RPR testing and another where syphilis treatment was the sole reason for hospitalization.Results: Of 202 babies born to SD Bioline positive mothers 89 (44%) and 111(55%) were RPR-reactive and non-reactive respectively (2 were unrecorded) of whom 80% and 88% of the neonates received appropriate antibiotic treatment respectively. Neonates born to RPR non-reactive mothers were 80% less likely to have sepsis [Relative risk (RR) = 0.20; 95% Confidence interval (CI) = 0.04-0.92] and 9% more likely to be discharged [RR = 1.09; 95% CI = 1.00-1.18] compared to those of RPR-reactive mothers. There was a 52%, and 49% reduction in antibiotic and hospitalization days respectively compared to a scenario with SD-Bioline testing only. Total hospitalization costs were also 52% lower compared to a scenario without RPR testing.Conclusions: This testing strategy can help identify infants at high and low risk for congenital syphilis and treat them accordingly at substantial cost savings. It is especially appropriate for settings with high syphilis endemicity, limited resources and overcrowded maternities. The babies additionally benefit from lower risks of exposure to unnecessary antibiotics and nosocomial infections. [ABSTRACT FROM AUTHOR]