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Calls continue for the decolonisation of higher education (HE). Based on internationalisation debates, a research team from Africa, Europe and Latin America reviewed published decolonisation voices. Using bibliometric analysis and a conceptual review of abstracts, the authors examined the drivers framing decolonisation in HE and identified the voices in those debates which involved the historically oppressed and those wishing to elicit change in these debates. The paper recognises the importance for decolonisation in education as the tensions explored by the authors often intersect through HE into other domains of the political, social, economic and culturally important areas for replication and change in society.

Introduction: In the context of key population HIV testing programmes, identifying new HIV acquisitions, tracking incidence, and responding with prevention and treatment interventions will be critical for achieving HIV epidemic control. Laboratory tests for recently acquired HIV used as part of a "recent infection testing algorithm" (RITA), offer a potential tool to support this work. We implemented a RITA for female sex workers (FSWs) in Zimbabwe to explore opportunities and programmatic benefits. Methods: Between October 2021 and January 2023, recency testing was offered to FSWs attending the Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe's key populations programme. Dried blood spot (DBS) samples were taken at 86 clinic sites across 10 provinces and Laboratory LAg Avidity and viral load testing conducted. RITA results were analysed and linked to programme data to explore geographical differences and calculate HIV incidence. We describe concurrent efforts in HIV testing for social (social network testing [SNT]) and sexual (index case testing [ICT]) contacts of those testing HIV positive. Results: Among 24,976 FSWs tested at programme sites, 9.5% (2363/24,976) were confirmed HIV positive. We enrolled 55.5% (1311/2363) of eligible HIV‐positive FSWs to our study, of whom 11.7% (153/1311) were identified as having recently acquired HIV. It took a median of 37 days (IQR 20–67) for samples to be processed. Enrolment rates varied between provinces but the proportion of recently acquired HIV was similar (range: 18.4% to 4.0%). Overall HIV incidence was 3.4 (95% CI 2.7−4.0) per 100py. Where results could be linked to routinely collected data, we found no evidence of a difference in test‐positivity between the ICT and SNT contacts of those with recently acquired compared to those with long‐term HIV. Conclusions: Implementation of a RITA was possible within a nationally scaled sex worker programme, and while challenging to implement, can provide an understanding of transmission dynamics and HIV incidence in this context. Sub‐optimal recruitment and data linkage limited the interpretation of our findings and opportunities for strategic gains though focusing on HIV prevention efforts. [ABSTRACT FROM AUTHOR]

Introduction: Courier delivery has become a popular antiretroviral therapy (ART) distribution method in some HIV care settings, yet data on ART courier delivery and how it relates to ART outcomes are scarce. We studied the differences in viral suppression rates between individuals from a South African private sector HIV programme receiving ART by courier delivery and those receiving ART through traditional retail dispensing. Methods: Individuals aged 15 years or older who were actively enrolled in the Aid for AIDS programme between January 2011 and July 2022 were eligible for the analysis. The outcome of interest was viral suppression defined as a viral load (VL) <400 copies per ml. We calculated adjusted odds ratios (OR) for the association between the ART distribution method and viral suppression, comparing those receiving refills through courier pharmacies versus retail dispensing at the time of the VL testing. We used generalized estimating equations to account for repeated VL testing of the same individual. The models were adjusted for age, sex, calendar year, ART regimen, history of mental illness and medical insurance scheme. We computed adjusted ORs for the calendar periods 2011−2013, 2014−2016, 2017−2019, 2020−2022 and overall. Results: We extracted 442,619 VL measurements from 68,720 eligible individuals, 39,406 (57.3%) were women. The median number of VL measurements per individual was 6 (IQR 3−10). VL suppression was detected in 398,901 (90.1%) tests, and 185,701 (42.0%) of the tests were taken while the individual was receiving ART by courier delivery. Overall, courier delivery was associated with 5% higher odds of viral suppression than retail dispensing (adjusted OR 1.05, 95% CI 1.02−1.08). The strength and direction of this association varied by calendar period, with an adjusted OR of 1.37 (95% CI 1.27−1.48) in 2011−2013 and 1.02 (95% CI 0.97−1.07) in 2020−2022. Conclusions: Courier delivery of ART is a viable alternative to retail dispensing in the South African private sector, as it was associated with higher viral suppression until 2016 and similar suppression rates in recent years. Further research is needed to investigate the potential benefits and drawbacks of courier delivery of ART in both private and public healthcare settings. [ABSTRACT FROM AUTHOR]

Avian species diversity in Southern Africa is remarkably high, yet the mechanisms responsible for that diversity are poorly understood. While this is particularly true with respect to species endemic to the subregion, it is unclear as to how more broadly distributed African species may have colonized southern Africa. One process that may in part account for the high bird species diversity in southern Africa is a “species pump” model, wherein the region was repeatedly colonized by lineages from areas further north: a pattern related to climate cycling and the eastern African arid corridor. Once occupying southern Africa, with its many varied biomes, it is possible that climate cycling further affected lineages by generating genetic diversity in multiple refugia, a pattern recently shown for several southern African bird species. Here, we used mtDNA to address these questions in a widespread, sedentary habitat generalist bird species, the familiar chat (Oenanthe familiaris). The phylogenetic structure suggests a north‐to‐south colonization pattern, supporting the “species pump” model. Haplotype diversity was partitioned into two distinct clusters: southern Africa and Malawi (East Africa). Southern African haplotypes were not geographically partitioned, and we hypothesize that this pattern has arisen because this species is a habitat generalist, and as such resilient to habitat‐altering climate perturbations. Based on our phylogenetic results, we discuss the validity of currently recognized subspecies. [ABSTRACT FROM AUTHOR]

Despite their growing numbers and influence, there is limited research on African immigrant youth in the U.S. The purpose of this exploratory study is to examine the multiple identities that first and 1.5 generation African immigrant college students enact in their online worlds. By developing a deeper understanding of how these youths enact and perceive their online identities, educators and administrators may be better able to support their educational and professional goals. Open-ended questionnaires were administered and an analysis of social media accounts was conducted to understand the shifting identities that the participants performed in their online worlds. This nuanced understanding of the participants' online lives may enable educators and policy-makers to better design educational opportunities for first and 1.5 generation African immigrant youth.

Background: Identifying children at risk for severe COVID‐19 disease from severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) may guide future mitigation interventions. Using sentinel surveillance data, we aimed to identify risk factors for SARS‐CoV‐2–associated hospitalisation among patients aged ≤ 18 years with respiratory illness. Methods: From April 2020 to March 2022, patients meeting study case definitions were enrolled at four outpatient influenza‐like illness (ILI) and five inpatient severe respiratory infection (SRI) surveillance sites and tested for SARS‐CoV‐2 infection using polymerase chain reaction (PCR). Each ILI clinic shared a catchment area with its corresponding SRI hospital. Potential risk factors for SARS‐CoV‐2–associated hospitalisation were analysed using multivariable logistic regression by comparing inpatient versus outpatient SARS‐CoV‐2 cases. Results: Of 4688 participants aged ≤ 18 years, 4556 (97%) with complete PCR and HIV data were included in the analysis. Among patients with ILI and SRI, 92/1145 (8%) and 154/3411 (5%) tested SARS‐CoV‐2 positive, respectively. Compared to outpatients, hospitalised SARS‐CoV‐2 cases were associated with age < 6 months ([adjusted odds ratio (aOR) 8.0, 95% confidence interval (CI) 2.7–24.0] versus 1–4 years); underlying medical condition other than HIV [aOR 5.8, 95% CI 2.3–14.6]; laboratory‐confirmed Omicron BA.1/BA.2 or Delta variant ([aOR 4.9, 95% CI 1.7–14.2] or [aOR 2.8, 95% CI 1.1–7.3] compared to ancestral SARS‐CoV‐2); and respiratory syncytial virus coinfection [aOR 6.2, 95% CI 1.0–38.5]. Conclusion: Aligning with previous research, we identified age < 6 months or having an underlying condition as risk factors for SARS‐CoV‐2–associated SRI hospitalisation and demonstrated the potential of sentinel surveillance to monitor COVID‐19 in children. [ABSTRACT FROM AUTHOR]

Plants from the Sceletium genus (Aizoaceae) have been traditionally used for millennia by the Khoe and Khoen people in southern Africa, as an appetite suppressant as well as a mood elevator. In more recent times, this mood-elevating activity has been commercialised in the South African natural products industry for the treatment of anxiety and depression, with several products available both locally and abroad. Research on this species has seen rapid growth with advancements in analytical and pharmacological tools, in an effort to understand the composition and biological activity. The Web of Science (WoS) database was searched for articles related to 'Sceletium' and 'Mesembrine'. These data were additionally analysed by bibliometric software (VOSviewer) to generate term maps and author associations. The thematic areas with the most citations were South African Traditional Medicine for mental health (110) and anxiolytic agents (75). Pioneer studies in the genus focused on chemical structural isolation, purification, and characterisation and techniques such as thin layer chromatography, liquid chromatography (HPLC, UPLC, and more recently, LC-MS), gas chromatography mass spectrometry (GC-MS), and nuclear magnetic resonance (NMR) to study mesembrine alkaloids. Different laboratories have used a diverse range of extraction and preanalytical methods that became routinely favoured in the analysis of the main metabolites (mesembrine, mesembranol, mesembranone, and Sceletium A4) in their respective experimental settings. In contrast with previous reviews, this paper identified gaps in the research field, being a lack of toxicology assays, a deficit of clinical assessments, too few bioavailability studies, and little to no investigation into the minor alkaloid groups found in Sceletium. Future studies are likely to see innovations in analytical techniques like leaf spray mass spectrometry and direct analysis in real-time ionisation coupled with high-resolution time-of-flight mass spectrometry (DART-HR-TOF-MS) for rapid alkaloid identification and quality control purposes. While S. tortuosum has been the primary focus, studying other Sceletium species may aid in establishing chemotaxonomic relationships and addressing challenges with species misidentification. This research can benefit the nutraceutical industry and conservation efforts for the entire genus. At present, little to no pharmacological information is available in terms of the molecular physiological effects of mesembrine alkaloids in medical clinical settings. Research in these fields is expected to increase due to the growing interest in S. tortuosum as a herbal supplement and the potential development of mesembrine alkaloids into pharmaceutical drugs. [ABSTRACT FROM AUTHOR]

A study was carried out to investigate the effects of wildfires on lake water quality using a source dataset of 2024 lakes worldwide, covering different lake types and ecological settings. Satellite-derived datasets (Lakes_cci and Fire_cci) were used and a Source Pathway Receptor approach applied which was conceptually represented by fires (burned area) as a source, precipitation/drought representing transport dynamics, and lakes as the ultimate receptor. This identified 106 lakes worldwide that are likely prone to be impacted by wildfires via a terrestrial pathway. Satellite-derived chlorophyll-a (Chl-a) and turbidity variables were used as indicators to detect changes in lake water quality potentially induced by wildfires over a four-year period. The lakes with the largest catchment areas burned and characterized by regular annual fires were located in Africa. Evidence for a strong influence of wildfires was not found across the dataset examined, although clearer responses were seen for some individual lakes. However, among the hydro-morphological characteristics examined, lake depth was found to be significant in determining Chl-a concentration peaks which were higher in shallow and lower in deep lakes. Lake turbidity responses indicated a dependence on lake catchment and weather conditions. While wildfires are likely to contribute to the nutrient load of lakes as found in previous studies, it is possible that in many cases it is not a dominant pressure and that its manifestation as a signal in lake Chl-a or turbidity values depends to a large part on lake typology and catchment characteristics. Assessment of lake water quality changes six months after a fire showed that Chl-a concentrations either increased, decreased, or showed no changes in a similar number of lakes, indicating that a lake specific ecological and hydro-morphological context is important for understanding lake responses to wildfires. [ABSTRACT FROM AUTHOR]

There have been few reports from Africa on the use and health effects of emollient therapy for newborn infants. We aimed to describe neonatal skin care practices in Africa, and to illuminate opportunities to introduce evidence-based interventions to improve these practices. We conducted a scoping review of the quantitative and qualitative published peer-reviewed and grey literature in English on emollient use in Africa. Outcomes of interest included neonatal skin care practices, with a focus on the application of oils and other products to infant skin, including in association with bathing and massage. We screened 5257 articles and summarised findings from 23 studies—13 qualitative, nine quantitative and one mixed methods—that met our study criteria. Seven studies reported the use of emollients for perceived benefits, including thermal care, treatment for illness, promotion of growth and development, infection reduction, skin condition improvement, spirituality and lubrication to aid massage. Four studies reported the quantitative health impact of skin care product applications, including improvements in skin condition, neurodevelopment and bone growth, as well as a reduction in nosocomial infections. This review highlights opportunities for skin care intervention and future research on neonatal skin care practices in Africa. [ABSTRACT FROM AUTHOR]

This article examines the relationship between inequality and education through the lens of colonial language education policies in African primary and secondary school curricula. The languages of former colonizers almost always occupy important places in society, yet they are not widely spoken as first languages, meaning that most people depend on formal education to learn them. The relationship between two related aspects of language education is tested with data on language education policies from 33 African states. Results show that the percent of teaching periods devoted to a colonial language as a subject of study has no association with income inequality. However, where colonial languages are the medium of instruction, income inequality is significantly higher even controlling for robust predictors of cross-national inequality. Results suggest that very heavy emphasis on such languages increases inequality by impeding progress through school, particularly for marginalized groups.

For over 25 years, new programs to attempt to stem the HIV epidemic have been developed in Africa by country governments as well as external donors. These programs and activities have built and operated facilities, trained clinicians, financed drugs and commodities, supported and helped finance government health planning and operations, and contributed in other ways. Who has benefited from this massive mobilization? While some single country and narrowly focused studies have been done, the issue of equity of HIV programs for vulnerable populations has not been examined in a large set of countries. Using Population-based HIV Impact Assessment (PHIA) data, we examine equity of the HIV programs in 13 African countries to determine if vulnerable groups (such as those with low wealth, rural populations, young adults, and females) have achieved comparable levels of access to HIV program services. In contrast, we also compare the equity of the HIV response to rural and low-wealth populations with the equity of corresponding domestic health systems using Demographic and Health Survey data. This study found that in over half of the countries, the HIV response indicators were equitable for vulnerable population segments including the low-wealth population (in seven countries) and rural population segment (in nine countries). In no country was the domestic health system equitable for these two groups. However, HIV programming does show some clear patterns of inequity for low-wealth and rural populations in some countries. For gender and young adults, the HIV response indicators show that in all 13 countries men and young adults are consistently underserved relative to their counterparts. [ABSTRACT FROM AUTHOR]

Although there are now approved treatments and vaccines for Ebola virus disease, the case fatality rate remains unacceptably high even when patients are treated with the newly approved therapeutics. Furthermore, these countermeasures are not expected to be effective against disease caused by other filoviruses. A meeting of subject-matter experts was held during the 10th International Filovirus Symposium to discuss strategies to address these gaps. Several investigational therapeutics, vaccine candidates, and combination strategies were presented. The greatest challenge was identified to be the implementation of well-designed clinical trials of safety and efficacy during filovirus disease outbreaks. Preparing for this will require agreed-upon common protocols for trials intended to bridge multiple outbreaks across all at-risk countries. A multinational research consortium including at-risk countries would be an ideal mechanism to negotiate agreement on protocol design and coordinate preparation. Discussion participants recommended a follow-up meeting be held in Africa to establish such a consortium. [ABSTRACT FROM AUTHOR]

In an effort to address migration of talent from sub-Saharan Africa, a number of higher education institutions are attempting to strengthen or develop graduate programs in several areas. These institutions see the potential for emerging digital technologies to provide new and exciting opportunities for collaboration with Western institutions. Examples of these institutions include University of Stellenbosch in South Africa and Iowa State University, which collaborated on a needs assessment for collaborative action to build faculty capacity through the development of shared Internet-based courses. This article describes this initiative. (Contains a list of 3 resources.)

This paper describes weathering modifications to elephant bones in Zimbabwe, southern Africa, and discusses possible implications about conditions of deposition and the time elapsed since death or skeletonization. The observed patterns of proboscidean bone weathering, the times elapsed since death, and burial times may not be same as for bones of smaller terrestrial mammals typically found in fossil assemblages. A system of weathering stages is proposed for proboscidean long bones, flat bones, mandibles, and ribs. Special attention is given to drying cracks that affect breakage patterns when weathered bones are trampled or impacted. Weathering effects on elephant bones vary for several reasons, such as differences between juvenile and adult cortical bone and frequency of wet/dry cycling. Also briefly discussed are the observed or possible effects of burning, dissolution, organic erosion such as root etching, and inorganic carbonate (calcite) encrustation. Comparable weathering effects are also reported on bones of Mammuthus spp., supporting the probability that (1) bone weathering in fossil proboscidean assemblages can be described in corresponding terms, and (2) implications about assemblage origins may be similar, although this inference must be cautiously drawn. The data reported here will allow analysts to describe assemblage materials in consistent terms. [ABSTRACT FROM AUTHOR]

Tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) are prodrugs of the nucleotide analogue tenofovir, which acts intracellularly to inhibit HIV replication. Whereas TDF converts to tenofovir in plasma and may cause kidney and bone toxicity, TAF mostly converts to tenofovir intracellularly, so it can be administered at lower doses. TAF leads to lower tenofovir plasma concentrations and lower toxicity, but there are limited data on its use in Africa. We used data from 41 South African adults living with HIV from the ADVANCE trial and described, with a joint model, the population pharmacokinetics of tenofovir given as TAF or TDF. The TDF was modeled to appear in plasma as tenofovir with a simple first‐order process. Instead, two parallel pathways were used for a TAF dose: an estimated 32.4% quickly appeared as tenofovir into the systemic circulation with first‐order absorption, whereas the rest was sequestered intracellularly and released into the systemic circulation as tenofovir slowly. Once in plasma (from either TAF or TDF), tenofovir disposition followed two‐compartment kinetics and had a clearance of 44.7 L/h (40.2–49.5), for a typical 70‐kg individual. This semimechanistic model describes the population pharmacokinetics of tenofovir when dosed as either TDF or TAF in an African population living with HIV and can be used as a tool for exposure prediction in patients, and to simulate alternative regimes to inform further clinical trials. [ABSTRACT FROM AUTHOR]

An interview with Tanzanian researcher Julie Makani is presented. Among the issues she discussed include her thoughts on the estimated 80% of worldwide cases of sickle cell disease that occur in the African region despite advances in research and treatment, how hydroxyurea is used as a sickle cell disease treatment, and the factors that drives stigmatization in relation to the disease.

Background Alzheimer's disease (AD) is the most common cause of dementia and this progressive neurological disorder is associated with substantial mortality and morbidity. We aimed to report the burden of AD and other types of dementia in the Middle East and North Africa (MENA) region, by age, sex and sociodemographic index (SDI), for the period 1990–2019. Methods publicly accessible data on the prevalence, death and disability-adjusted life years (DALYs) because of AD, and other types of dementia, were retrieved from the global burden of disease 2019 project for all MENA countries from 1990 to 2019. Results in 2019, the age-standardised point prevalence of dementia was 777.6 per 100,000 populations in MENA, which was 3.0% higher than in 1990. The age-standardised death and DALY rates of dementia were 25.5 and 387.0 per 100,000, respectively. In 2019, the highest DALY rate was observed in Afghanistan and the lowest rate was in Egypt. That same year, the age-standardised point prevalence, death and DALY rates increased with advancing age and were higher for females of all age groups. From 1990 to 2019, the DALY rate of dementia decreased with increasing SDI up to 0.4, then slightly increased up to an SDI of 0.75, followed by a decrease for the remaining SDI levels. Conclusions the point prevalence of AD and other types of dementia has increased over the past three decades, and in 2019, the corresponding regional burden was higher than the global average. [ABSTRACT FROM AUTHOR]

Objective: We aimed to report the burden of bulimia nervosa (BN) in the Middle East and North Africa (MENA) region by age, sex, and sociodemographic index (SDI), for the period 1990–2019. Methods: Estimates of the prevalence, incidence, and disability‐adjusted life‐years (DALYs) attributable to BN were retrieved from the Global Burden of Disease study 2019, between 1990 and 2019, for the 21 countries in the MENA region. The counts and age‐standardized rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. Results: In 2019, the estimated regional age‐standardized point prevalence and incidence rates of BN were 168.3 (115.0–229.6) and 178.6 (117.0–255.6) per 100,000, which represented 22.0% (17.5–27.2) and 10.4% (7.1–14.7) increases, respectively, since 1990. Moreover, in 2019 the regional age‐standardized DALY rate was 35.5 (20.6–55.5) per 100,000, which was 22.2% (16.7–28.2) higher than in 1990. In 2019, Qatar (58.6 [34.3–92.5]) and Afghanistan (18.4 [10.6–29.2]) had the highest and lowest age‐standardized DALY rates, respectively. Regionally, the age‐standardized point prevalence of BN peaked in the 30–34 age group and was more prevalent among women. In addition, there was a generally positive association between SDI and the burden of BN across the measurement period. Discussion: In the MENA region, the burden of BN has increased over the last three decades. Cost‐effective preventive measures are needed in the region, especially in the high SDI countries. Public Significance: This study reports the estimated burden of BN in the MENA region and shows that its burden has increased over the last three decades. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma of the anus (SCCA) is caused by HPV, and is elevated in persons living with HIV (PLWHIV). We aimed to estimate sex‐ and HIV‐stratified SCCA burden at a country, regional and global level. Using anal cancer incidence estimates from 185 countries available through GLOBOCAN 2020, and region/country‐specific proportions of SCCA vs non‐SCCA from the Cancer Incidence in Five Continents (CI5) Volume XI database, we estimated country‐ and sex‐specific SCCA incidence. Proportions of SCCA diagnosed in PLWHIV, and attributable to HIV, were calculated using estimates of HIV prevalence (UNAIDS 2019) and relative risk applied to SCCA incidence. Of 30 416 SCCA estimated globally in 2020, two‐thirds occurred in women (19 792) and one‐third among men (10 624). Fifty‐three percent of male SCCA and 65% of female SCCA occurred in countries with a very high Human Development Index (HDI). Twenty‐one percent of the global male SCCA burden occurred in PLWHIV (n = 2203), largely concentrated in North America, Europe and Africa. While, only 3% of global female SCCA burden (n = 561) occurred in PLWHIV, mainly in Africa. The global age‐standardized incidence rate of HIV‐negative SCCA was higher in women (0.55 cases per 100 000) than men (0.28), whereas HIV‐positive SCCA was higher in men (0.07) than women (0.02). HIV prevalence reached >40% in 22 countries for male SCCA and in 10 countries for female SCCA, mostly in Africa. Understanding global SCCA burden by HIV status can inform SCCA prevention programs (through HPV vaccination, screening and HIV control) and help raise awareness to combat the disease. [ABSTRACT FROM AUTHOR]

Apartheid's Black Soldiers: Un-National Wars and Militaries in Southern Africa, by Lennart Bolliger Lennart Bolliger, I Apartheid's Black Soldiers: Un-National Wars and Militaries in Southern Africa i . Bolliger points out that most of these former soldiers had little formal education and nothing but military skills to sell. [Extracted from the article]

Background: Mass drug administration (MDA) is the main strategy towards lymphatic filariasis (LF) elimination. Progress is monitored by assessing microfilaraemia (Mf) or circulating filarial antigenaemia (CFA) prevalence, the latter being more practical for field surveys. The current criterion for stopping MDA requires <2% CFA prevalence in 6- to 7-year olds, but this criterion is not evidence-based. We used mathematical modelling to investigate the validity of different thresholds regarding testing method and age group for African MDA programmes using ivermectin plus albendazole. Methodolgy/Principal findings: We verified that our model captures observed patterns in Mf and CFA prevalence during annual MDA, assuming that CFA tests are positive if at least one adult worm is present. We then assessed how well elimination can be predicted from CFA prevalence in 6-7-year-old children or from Mf or CFA prevalence in the 5+ or 15+ population, and determined safe (>95% positive predictive value) thresholds for stopping MDA. The model captured trends in Mf and CFA prevalences reasonably well. Elimination cannot be predicted with sufficient certainty from CFA prevalence in 6-7-year olds. Resurgence may still occur if all children are antigen-negative, irrespective of the number tested. Mf-based criteria also show unfavourable results (PPV <95% or unpractically low threshold). CFA prevalences in the 5+ or 15+ population are the best predictors, and post-MDA threshold values for stopping MDA can be as high as 10% for 15+. These thresholds are robust for various alternative assumptions regarding baseline endemicity, biological parameters and sampling strategies. Conclusions/Significance: For African areas with moderate to high pre-treatment Mf prevalence that have had 6 or more rounds of annual ivermectin/albendazole MDA with adequate coverage, we recommend to adopt a CFA threshold prevalence of 10% in adults (15+) for stopping MDA. This could be combined with Mf testing of CFA positives to ensure absence of a significant Mf reservoir for transmission. Author summary: Mass drug administration (MDA) of antifilarial drugs is the main strategy towards the elimination of lymphatic filariasis (LF), but defining when MDA can safely be stopped is challenging. Current stopping guidelines require that the prevalence of microfilaraemia (Mf) in the population falls below 1% or the prevalence of circulating filarial antigenaemia (CFA) in 6-and-7-year-old children falls below 2%. The evidence base underlying this threshold is limited. The accuracy of this threshold is hard to assess in field studies due to the long timespan between stopping MDA and the occurrence of either elimination or resurgence. We used mathematical modelling to assess how well elimination can be predicted at community-level from the Mf or CFA prevalence observed 1-year after the last MDA round and we determined safe stopping thresholds (>95% certainty that elimination is achieved). We found that the currently used CFA prevalence in 6–7 year-old children is a poor indicator for stopping decisions in LF elimination programmes implementing MDA with ivermectin plus albendazole, and that CFA prevalence among people aged 5 or 15 years and older is a much more reliable and practical indicator of elimination outcomes. Lymphatic filariasis elimination programmes should reconsider guidelines for stopping MDA. [ABSTRACT FROM AUTHOR]

Background Optimized laboratory services are recognized as an integral part of high-quality healthcare delivery. However, these services are often unavailable or substandard in resource-limited countries. The implementation of quality management systems (QMSs) in the laboratory can transform laboratory services and ultimately improve patient care in these settings. Methods The Clinical and Laboratory Standards Institute, through its Global Health Partnerships (GHP) program, has intervened in 32 laboratories to implement QMSs and improve performance. Standardized checklists were used before and after the structured intervention to quantify the impact of this program. Results QMS implementation resulted in a statistically significant improvement in overall mean checklist scores. All participating laboratories demonstrated improvement in their quality and performance, with 13 laboratories achieving national accreditation within the time frame of this study. Conclusion A structured program that utilizes well-recognized, standardized checklists and has leadership and laboratory team support, professional training with onsite guidance (i.e. train the trainer) and access to professionals experienced with QMS implementation and maintenance can lead to significant improvements in quality in resource-limited countries. [ABSTRACT FROM AUTHOR]

Viviparity has evolved independently multiple times within squamate reptiles. In the Lacertidae, two genera and several species from the Northern Hemisphere are known to be viviparous. However, although viviparity is present in many African reptiles, all African lacertids were considered exclusively oviparous. The lacertid genus Tropidosaura is restricted to mountainous grassland habitats across central and southern South Africa. Prompted by the dissection of a gravid T. essexi specimen containing well-developed embryos, we dissected additional gravid females from two museum collections to assess parity mode in the four Tropidosaura species. Gravid females of three species contained developing eggs, but all gravid Tropidosaura essexi specimens examined exhibited simple placental development or contained well-developed embryos with the presence of a simple placenta and an absence of any eggshell. The large yolks and simple placentae suggest that viviparity in T. essexi is lecithotrophic. T. essexi thus represents the only known viviparous species of lacertid in Africa and therefore, the first known viviparous lacertid in the Southern Hemisphere, revealing yet another independent case of the evolution of viviparity within the squamates. T. essexi occurs at higher maximum elevations than any of its oviparous congeners, and the recorded litter size in T. essexi was slightly higher than the clutch sizes of other members of the genus. Previously reported oviparity in T. essexi may either be the result of specimen misidentification or potential bimodal reproductive in this species, but this latter explanation is unlikely, given that none of the T. essexi examined in this study showed evidence of oviparity. [ABSTRACT FROM AUTHOR]

Introduction: COVID‐19 stretched healthcare systems to their limits, particularly in settings with a pre‐existing high burden of infectious diseases, including HIV and tuberculosis (TB). We studied the impact of COVID‐19 on TB services at antiretroviral therapy (ART) clinics in low‐ and middle‐income countries. Methods: We surveyed ART clinics providing TB services in the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium in Africa and the Asia‐Pacific until July 2021 (TB diagnoses until the end of 2021). We collected site‐level data using standardized questionnaires. Results: Of 46 participating ART clinics, 32 (70%) were in Africa and 14 (30%) in the Asia‐Pacific; 52% provided tertiary care. Most clinics (85%) reported disrupted routine HIV care services during the pandemic, both in Africa (84%) and the Asia‐Pacific (86%). The most frequently reported impacts were on staff (52%) and resource shortages (37%; protective clothing, face masks and disinfectants). Restrictions in TB health services were observed in 12 clinics (26%), mainly reduced access to TB diagnosis and postponed follow‐up visits (6/12, 50% each), and restrictions in TB laboratory services (22%). Restrictions of TB services were addressed by dispensing TB drugs for longer periods than usual (7/12, 58%), providing telehealth services (3/12, 25%) and with changes in directly observed therapy (DOT) (e.g. virtual DOT, 3/12). The number of TB diagnoses at participating clinics decreased by 21% in 2020 compared to 2019; the decline was more pronounced in tertiary than primary/secondary clinics (24% vs. 12%) and in sites from the Asia‐Pacific compared to Africa (46% vs. 14%). In 2021, TB diagnoses continued to decline in Africa (–8%) but not in the Asia‐Pacific (+62%) compared to 2020. During the pandemic, new infection control measures were introduced or intensified at the clinics, including wearing face masks, hand sanitation and patient triage. Conclusions: The COVID‐19 pandemic led to staff shortages, reduced access to TB care and delays in follow‐up visits for people with TB across IeDEA sites in Africa and the Asia‐Pacific. Increased efforts are needed to restore and secure ongoing access to essential TB services in these contexts. [ABSTRACT FROM AUTHOR]

Monkeypox is a zoonotic disease caused by monkeypox virus (MPXV), in which outbreaks mainly occurred in West and Central Africa, with only sporadic spillovers to countries outside Africa due to international travel or close contact with wildlife. During May 2022, multiple countries in Europe, North and South America, Australia, Asia, and Africa reported near-simultaneous outbreaks of MPXV, the first time that patient clusters were reported over such a large geographical area. Cases have no known epidemiological links to MPXV-endemic countries in West or Central Africa. Real-time PCR is currently the gold standard for MPXV diagnostics, but it requires trained laboratory personnel and specialized equipment, and results can only be obtained after several hours. A rapid and simple-to-operate point-of-care diagnostic test for MPXV is crucial for limiting its spread and controlling outbreaks. Here, three recombinase-based isothermal amplification assays (RPA/RAA) for the rapid detection of MPXV isolates were developed. These three assays target the MPXV G2R gene, and the limit of detection for these systems is approximately 100 copies of DNA per reaction. The assays were found to be specific and non-cross reactive against other pox viruses, such as vaccinia virus, and the results can be visualized within 20–30 min. The assays were validated with DNA extracted from 19 clinical samples from suspected or confirmed MPXV patients from Central Africa, and found to be consistent with findings from traditional qPCR. These results provide a solid platform for the early diagnosis of potential MPXV cases, and will help with the control and prevention of current and future outbreaks. [ABSTRACT FROM AUTHOR]

Scholars have long debated whether international organizations (IO) matter in international politics. Skeptics argue that power politics determine outcomes while champions see IOs as important, independently shaping outcomes and reshaping the structure of politics. Between these extremes, scholars have made numerous theoretical and empirical contributions to understanding under what conditions IOs make a difference. Yet, the fundamental question remains: when IOs identify a significant problem, can they solve it? We identify an underutilized analytical approach to understanding this broad debate. Specifically, we suggest scholars analyze this question by focusing on an IOs response to given crises to provide internal validity to claims throughout this debate. Furthermore, we encourage scholars to move beyond the oft-cited global or European cases to better incorporate insights from IOs in various parts of the world. Here, we explore the Southern African Development Community's attempt to coordinate member states' maritime strategy to solve the emergent piracy problem caused by the Somali civil war. In identifying these new directions for research, we demonstrate that IOs, even under difficult circumstances, are effective actors in international politics. [ABSTRACT FROM AUTHOR]

The Critically Endangered Chapman's pygmy chameleon Rhampholeon chapmanorum is endemic to the low elevation rainforest of the Malawi Hills in southern Malawi. Much of this forest has been converted to agriculture and it was uncertain whether chameleon populations have persisted. We used current and historical satellite imagery to identify remaining forest patches and assess deforestation. We then surveyed forest patches for the presence of this chameleon, and assessed its genetic diversity and structure. We estimated that 80% of the forest has been destroyed since 1984, although we found extant populations of the chameleon in each of the patches surveyed. Differentiation of genetic structure was strong between populations, suggesting that gene flow has been impaired. Genetic diversity was not low, but this could be the result of a temporal lag as well as lack of sensitivity in the mitochondrial marker used. Overall, the impact of forest loss is assumed to have led to a large demographic decline, with forest fragmentation preventing gene flow. [ABSTRACT FROM AUTHOR]

African American (AA) and European American (EA) women often exhibit differences in hemoglobin (Hb) and 25-hydroxyvitamin D [25(OH)D], both of which can be altered by calorie restriction leading to weight loss. Given these known differences, it is of clinical interest to examine the potential for race-specific, adverse responses to weight loss. Sixty-four overweight (BMI 27-29.9 kg/²), premenopausal women consumed a standardized, very-low calorie diet to reduce BMI < 25 kg/². Ancestry informative markers provided estimates of African admixture, an objective mean of expressing race. Blood sampling and anthropometric measures were performed at baseline and upon meeting target BMI. At baseline, in the overweight state, Hb (g/dL) (AA, 11.7 ± 0.9 vs. EA, 12.5 ± 0.8; p < .01) and 25(OH)D (nmol/L) (AA, 35.7 ± 12.9 vs. EA, 57.0 ± 20.0; p < .01) were lower in AAs. After weight loss, Hb decreased (AA, -0.5 ± 0.7 vs. EA, -0.4 ± 0.6; p = .48) to a similar extent among races. Conversely, 25(OH)D increased (AA, 43.4 ± 14.0 vs. EA 68.2 ± 24.3; p < .01) though the magnitude of change (Δ) was not different (AA, +7.8 ± 13.5 vs. EA,+11.2 ± 16.7;p = .37) between races. Multiple linear regression revealed a positive association between ΔHb and Δ25(OH)D (r = .386; p < .01) adjusted for African admixture, Δtestosterone, and Δbody fat%. Path analyses revealed a significant indirect effect of Δbody fat% on ΔHb through Δ25(OH)D, β =-0.023, CI [-0.06, -0.004]. Following 15% weight loss, participants with the largest increase in serum 25(OH)D exhibited the smallest decrease in Hb. Future research should clarify the optimal degree of calorie restriction to stimulate weight loss while mitigating the potential risk of anemia associated with dieting efforts. [ABSTRACT FROM AUTHOR]

Firms must estimate expected credit losses (EL) to comply with accounting standards and unexpected credit losses (UL) to determine regulatory credit risk capital. Both rely on estimates of obligor probabilities of default (PD). Investors also pay close attention to credit ratings—derived from inter alia default rates. Changes in climate will increase firm default rates. Studies investigating the impact of climate change on PDs are limited because this is a novel field and data are still relatively scarce. Africa will be most severely impacted by climate change: default rates will deteriorate leading to increased PDs, LGDs, provision requirements (through increased expected losses) and regulatory credit risk capital (through increased unexpected losses). Corporate equity prices are simulated using Geometric Brownian motion (GBM) and shocks brought about by climate events of differing frequency and severity are applied to these simulated prices. Post shock prices and return volatilities are differentially affected depending on the nature of the applied shock. These constitute inputs into a well-known model of corporate default form which resultant PDs may be extracted. A possible calibration approach is developed for climate event-based impacts on corporate default rates. A scaling factor matrix (an amount by which the unaffected default rate increases after a specified climate event type occurs) can help market participants forecast default rate changes. Climate related impacts have been quantified, calibrated, and used to assess credit quality degradation. [ABSTRACT FROM AUTHOR]

Objectives: Gullah African Americans are descendants of formerly enslaved Africans living in the Sea Islands along the coast of the southeastern U.S., from North Carolina to Florida. Their relatively high numbers and geographic isolation were conducive to the development and preservation of a unique culture that retains deep African features. Although historical evidence supports a West‐Central African ancestry for the Gullah, linguistic and cultural evidence of a connection to Sierra Leone has led to the suggestion of this country/region as their ancestral home. This study sought to elucidate the genetic structure and ancestry of the Gullah. Materials and Methods: We leveraged whole‐genome genotype data from Gullah, African Americans from Jackson, Mississippi, African populations from Sierra Leone, and population reference panels from Africa and Europe to infer population structure, ancestry proportions, and global estimates of admixture. Results: Relative to non‐Gullah African Americans from the Southeast US, the Gullah exhibited higher mean African ancestry, lower European admixture, a similarly small Native American contribution, and increased male‐biased European admixture. A slightly tighter bottleneck in the Gullah 13 generations ago suggests a largely shared demographic history with non‐Gullah African Americans. Despite a slightly higher relatedness to populations from Sierra Leone, our data demonstrate that the Gullah are genetically related to many West African populations. Discussion: This study confirms that subtle differences in African American population structure exist at finer regional levels. Such observations can help to inform medical genetics research in African Americans, and guide the interpretation of genetic data used by African Americans seeking to explore ancestral identities. [ABSTRACT FROM AUTHOR]

A few months before immigrating to New Zealand, an Afrikaans‐English bilingual woman was interviewed in South Africa about her expectations of her sociolinguistic life in her new country. Fifteen years later she was interviewed again, in New Zealand. This article tells the story of her pre‐departure expectations and desires, and her retrospective meaning making of the experiences she had lived since her arrival in New Zealand. This longitudinal narrative study focuses on her use of South African English in the host country, particularly in the community and the workplace, and pays attention to its reception by others in these contexts. The study draws on a cognitive‐developmental model of identity integration to frame the analysis of interview data from a narrative perspective. It does so by using short story analysis (Barkhuizen, 2016). Short stories are extracts of interview data in story form and are analyzed for their content and varying scales of context. Three short stories are analyzed in this article. They show how the participant's English is used and received in New Zealand and what effect this has on her life and identity as an immigrant in the country over time. [ABSTRACT FROM AUTHOR]

To study the interaction between HIV and other carcinogenic infections in conjunctival squamous cell carcinoma (SCC), we evaluated the presence of a broad spectrum of human viruses in conjunctiva specimens. Beta Human papillomavirus (HPV; n = 46), gamma HPV (n = 52), polyomaviruses (n = 12) and herpes viruses (n = 3) was determined in DNA extracted from 67 neoplastic and 55 non‐neoplastic conjunctival tissues of HIV‐positive and HIV negative subjects by Luminex‐based assays. Next‐generation sequencing (NGS) was also used to further characterize the presence of cutaneous HPVs. Detection of beta‐2 HPV infections was associated with the risk of neoplasia (adjusted odds ratio [aOR] 3.0; 95% confidence interval [CI] 1.3‐6.8), regardless of HIV status (HIV positive, aOR 2.6, 95% CI 0.9‐7.7; HIV negative, aOR 3.5, 95% CI 0.9‐14.4). EBV was strongly associated with the risk of neoplasia (aOR 12.0, 95% CI 4.3‐33.5; P <.01) mainly in HIV individuals (HIV positive, aOR 57.5; 95% CI: 10.1‐327.1; HIV negative aOR 2.6; 95% CI: 0.2‐34.7). NGS allowed to identify 13 putative novel HPVs in cases and controls. Our findings suggest a role of beta HPV types and EBV, in conjunctival SCC. However, additional studies of viral expression in tumor tissue are required to confirm the causal association. What's new? Risk of conjunctival squamous cell carcinoma (SCC) is strongly associated with ultraviolet radiation exposure and immune suppression. In Africa, SCC incidence has also been affected by the spread of HIV and may be impacted by other viral infections. Here, analyses of a large number of viruses in conjunctival non‐malignant and malignant tissues from patients in Southern Uganda reveal associations between conjunctival SCC and cutaneous beta human papillomavirus (HPV) and Epstein‐Barr virus (EBV) infection. Beta‐2 HPV infection was linked to neoplasia risk regardless of HIV status, whereas EBV was associated with neoplasia primarily in HIV‐infected individuals. [ABSTRACT FROM AUTHOR]

HPV35 has been found in only ∼2% of invasive cervical cancers (ICC) worldwide but up to 10% in Sub‐Saharan Africa, warranting further investigation and consideration of impact on preventive strategies. We studied HPV35 and ethnicity, in relation to the known steps in cervical carcinogenesis, using multiple large epidemiologic studies in the U.S. and internationally. Combining five U.S. studies, we measured HPV35 positivity and, in Northern California, observed HPV35 type‐specific population prevalence and estimated 5‐year risk of developing precancer when HPV35‐positive. HPV35 genetic variation was examined for differences in carcinogenicity in 1053 HPV35+ cervical specimens from a U.S. cohort and an international collection. African‐American women had more HPV35 (12.1% vs 5.1%, P <.001) and more HPV35‐associated precancers (7.4% vs 2.1%, P <.001) compared to other ethnicities. Precancer risks after HPV35 infection did not vary by ethnicity (global P =.52). The HPV35 A2 sublineage showed an increased association with precancer/cancer in African‐Americans (OR = 5.6 vs A1, 95% CI = 1.3‐24.8) and A2 was more prevalent among ICC in Africa than other world regions (41.9% vs 10.4%, P <.01). Our analyses support a strong link between HPV35 and cervical carcinogenesis in women of African ancestry. Current HPV vaccines cover the majority of cervical precancer/cancer across all ethnic groups; additional analyses are required to determine whether the addition of HPV35 to the already highly effective nine‐valent HPV vaccine would provide better protection for women in Africa or of African ancestry. What's new? HPV35 accounts for 2% of invasive cervical cancers worldwide, but possibly as much as 10% in sub‐Saharan Africa. These authors found that African‐American women had higher rates of HPV35 infection, and more precancers associated with HPV35, than women of other ethnicities. However, precancer risk by HPV35 status did not vary by ethnicity. Genetic testing uncovered an association between precancer and the A2 sublineage of HPV35 within Africa and among African‐American women in the US. Additionally, particular HPV35 SNPs, including one in the E7 oncogene, were associated with precancer or cancer. Recognizing the importance of HPV35 in women of African ancestry could help improve HPV screening tests or vaccines. [ABSTRACT FROM AUTHOR]

Objectives: To report the level and trends of prevalence, incidence and years lived with disability (YLDs) for osteoarthritis (OA) in 195 countries and territories from 1990 to 2017 by age, sex and Socio-demographic index (SDI; a composite of sociodemographic factors).Methods: Publicly available modelled data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 were used. The burden of OA was estimated for 195 countries and territories from 1990 to 2017, through a systematic analysis of prevalence and incidence modelled data using the methods reported in the GBD 2017 Study. All estimates were presented as counts and age-standardised rates per 100 000 population, with uncertainty intervals (UIs).Results: Globally, the age-standardised point prevalence and annual incidence rate of OA in 2017 were 3754.2 (95% UI 3389.4 to 4187.6) and 181.2 (95% UI 162.6 to 202.4) per 100 000, an increase of 9.3% (95% UI 8% to 10.7%) and 8.2% (95% UI 7.1% to 9.4%) from 1990, respectively. In addition, global age-standardised YLD rate in 2017 was 118.8 (95% UI 59.5 to 236.2), an increase of 9.6% (95% UI 8.3% to 11.1%) from 1990. The global prevalence was higher in women and increased with age, peaking at the >95 age group among women and men in 2017. Generally, a positive association was found between the age-standardised YLD rate and SDI at the regional and national levels. Age-standardised prevalence of OA in 2017 ranged from 2090.3 to 6128.1 cases per 100 000 population. United States (6128.1 (95% UI 5729.3 to 6582.9)), American Samoa (5281 (95% UI 4688 to 5965.9)) and Kuwait (5234.6 (95% UI 4643.2 to 5953.6)) had the three highest levels of age-standardised prevalence. Oman (29.6% (95% UI 24.8% to 34.9%)), Equatorial Guinea (28.6% (95% UI 24.4% to 33.7%)) and the United States 23.2% (95% UI 16.4% to 30.5%)) showed the highest increase in the age-standardised prevalence during 1990-2017.Conclusions: OA is a major public health challenge. While there is remarkable international variation in the prevalence, incidence and YLDs due to OA, the burden is increasing in most countries. It is expected to continue with increased life expectancy and ageing of the global population. Improving population and policy maker awareness of risk factors, including overweight and injury, and the importance and benefits of management of OA, together with providing health services for an increasing number of people living with OA, are recommended for management of the future burden of this condition. [ABSTRACT FROM AUTHOR]

Environments are heterogeneous in space and time, and the permeability of landscape and climatic barriers to gene flow may change over time. When barriers are present, they may start populations down the path toward speciation, but if they become permeable before the process of speciation is complete, populations may once more merge. In Southern Africa, aridland biomes play a central role in structuring the organization of biodiversity. These biomes were subject to substantial restructuring during Plio‐Pleistocene climatic fluctuations, and the imprint of this changing environment should leave genetic signatures on the species living there. Here, we investigate the role of adjacent aridland biome boundaries in structuring the genetic diversity within a widespread generalist bird, the Cape Robin‐chat (Cossypha caffra). We find evidence supporting a central role for aridland biomes in structuring populations across Southern Africa. Our findings support a scenario wherein populations were isolated in different biome refugia, due to separation by the exceptionally arid Nama Karoo biome. This biome barrier may have arisen through a combination of habitat instability and environmental unsuitability, and was highly unstable throughout the Plio‐Pleistocene. However, we also recovered a pattern of extensive contemporary gene flow and admixture across the Nama Karoo, potentially driven by the establishment of homesteads over the past 200 years. Thus, the barrier has become permeable, and populations are currently merging. This represents an instance where initial formation of a barrier to gene flow enabled population differentiation, with subsequent gene flow and the merging of populations after the barrier became permeable. [ABSTRACT FROM AUTHOR]

An approach to reduce forecast data to coastal waveguide coordinates is described and demonstrated, informed by the literature on coastally trapped waves (CTWs). All discussion is limited to the Australian mainland but the approach is generally relevant to regions where CTWs influence sea level, including the Americas and Africa. The approach does not produce new forecasts, but aims to focus forecaster attention on aspects of sea level forecasts prominent on the long Australian coast. The approach also explicitly addresses spatial issues associated with measuring coastal paths. Coastal paths are scale dependent and forecast models discretize the coastal boundary differently. A well-defined coastal path is required for the quantitative application of CTW concepts such as propagation distance and offshore direction. The relevance of coastally trapped signals and remote forcing is documented in the oceanographic literature, but is effectively unknown to the general public and rarely mentioned in press reports of sea level events such as nuisance flooding. Routine presentation of forecast guidance in waveguide coordinates could contribute to the transfer of oceanographic research understanding into forecast narratives. In addition, the approach can facilitate quantitative forecast evaluations that target CTW properties. Two ocean forecast systems are contrasted in this framework for the Australian mainland. One year of daily forecasts are compared, with indications that model baroclinicity is of practical relevance. [ABSTRACT FROM AUTHOR]

Botulinum neurotoxin-producing clostridia are diverse in the types of toxins they produce as well as in their overall genomic composition. They are globally distributed, with prevalent species and toxin types found within distinct geographic regions, but related strains containing the same toxin types may also be located on distinct continents. The mechanisms behind the spread of these bacteria and the independent movements of their bont genes may be understood through examination of their genetic backgrounds. The generation of 15 complete genomic sequences from bacteria isolated in Argentina, Australia, and Africa allows for a thorough examination of genome features, including overall relationships, bont gene cluster locations and arrangements, and plasmid comparisons, in bacteria isolated from various areas in the southern hemisphere. Insights gained from these examinations provide an understanding of the mechanisms behind the independent movements of these elements among distinct species. [ABSTRACT FROM AUTHOR]

Researchers have found consistently that religion reduces criminal behavior. Yet rising levels of political violence are frequently attributed to a new wave of religious terrorism. Our study seeks to reconcile this apparent discrepancy by studying the attitudes of people living in 34 African nations. Using data from the Afrobarometer survey and mixed modeling, we examine the influence of individual and collective religiosity for shaping civic engagement and willingness to engage in political violence. While individual religiosity decreases support for violent political action, collective religiosity increases it. The effects of religiosity are the same for Muslims and Christians and the country religious context minimally affects residents' civic engagement and interest in violent political behavior. Our study underscores the importance of the theoretical and empirical distinction between individual and collective religiosity and offers insight into how civic engagement can be a pathway through which religion shapes support for political violence. [ABSTRACT FROM AUTHOR]

Summary: Cassava brown streak disease (CBSD) is a leading cause of cassava losses in East and Central Africa, and is currently having a severe impact on food security. The disease is caused by two viruses within the Potyviridae family: Cassava brown streak virus (CBSV) and Ugandan cassava brown streak virus (UCBSV), which both encode atypical Ham1 proteins with highly conserved inosine triphosphate (ITP) pyrophosphohydrolase (ITPase) domains. ITPase proteins are widely encoded by plant, animal, and archaea. They selectively hydrolyse mutagenic nucleotide triphosphates to prevent their incorporation into nucleic acid and thereby function to reduce mutation rates. It has previously been hypothesized that U/CBSVs encode Ham1 proteins with ITPase activity to reduce viral mutation rates during infection. In this study, we investigate the potential roles of U/CBSV Ham1 proteins. We show that both CBSV and UCBSV Ham1 proteins have ITPase activities through in vitro enzyme assays. Deep‐sequencing experiments found no evidence of the U/CBSV Ham1 proteins providing mutagenic protection during infections of Nicotiana hosts. Manipulations of the CBSV_Tanza infectious clone were performed, including a Ham1 deletion, ITPase point mutations, and UCBSV Ham1 chimera. Unlike severely necrotic wild‐type CBSV_Tanza infections, infections of Nicotiana benthamiana with the manipulated CBSV infectious clones do not develop necrosis, indicating that that the CBSV Ham1 is a necrosis determinant. We propose that the presence of U/CBSV Ham1 proteins with highly conserved ITPase motifs indicates that they serve highly selectable functions during infections of cassava and may represent a euphorbia host adaptation that could be targeted in antiviral strategies. [ABSTRACT FROM AUTHOR]

Background: A single co-administered dose of ivermectin (IVM) plus diethylcarbamazine (DEC) plus albendazole (ALB), or triple-drug therapy, was recently found to be more effective for clearing microfilariae (Mf) than standard DEC plus ALB currently used for mass drug administration programs for lymphatic filariasis (LF) outside of sub-Saharan Africa. Triple-drug therapy has not been previously tested in LF-uninfected individuals from Africa. This study evaluated the pharmacokinetics (PK), safety, and efficacy of triple-drug therapy in people with and without Wuchereria bancrofti infection in West Africa. Methods: In this open-label cohort study, treatment-naïve microfilaremic (>50 mf/mL, n = 32) and uninfected (circulating filarial antigen negative, n = 24) adults residing in Agboville district, Côte d’Ivoire, were treated with a single dose of IVM plus DEC plus ALB, and evaluated for adverse events (AEs) until 7 days post treatment. Drug levels were assessed by liquid chromatography and mass spectrometry. Persons responsible for assessing AEs were blinded to participants’ infection status. Findings: There was no difference in AUC0-inf or Cmax between LF-infected and uninfected participants (P>0.05 for all comparisons). All subjects experienced mild AEs; 28% and 25% of infected and uninfected participants experienced grade 2 AEs, respectively. There were no severe or serious adverse events. Only fever (16 of 32 versus 4 of 24, P<0.001) and scrotal pain/swelling in males (6 of 20 versus 0 of 12, P = 0.025) were more frequent in infected than uninfected participants. All LF positive participants were amicrofilaremic at 7 days post-treatment and 27 of 31 (87%) remained amicrofilaremic 12 months after treatment. Conclusions: Moderate to heavy W. bancrofti infection did not affect PK parameters for IVM, DEC or ALB following a single co-administered dose of these drugs compared to uninfected individuals. The drugs were well tolerated. This study confirmed the efficacy of the triple-drug therapy for clearing W. bancrofti Mf and has added important information to support the use of this regimen in LF elimination programs in areas of Africa without co-endemic onchocerciasis or loiasis. Trial registration: ClinicalTrials.gov . [ABSTRACT FROM AUTHOR]

The purpose of this research was to determine the extent to which women of African ancestry manifested power in their relationships regarding sexual activities and to examine the influence that specific variables had on their sexual partnerships. A sample (N = 200) of midlife women aged 40–65, who lived in the Midwest participated in this research. The Sexual Relationship Power Scale was used to examine these relationships. Face-to-face interviews occurred in community settings. Multiple regression equations were used to examine the potential impact of specific variables on sexual functioning. Results of the analysis revealed that variables such as mental quality of life, decision-making, and health promotion were positively associated with sexual relationships. Conversely, depression and life stress scores were negatively linked to sexual relationships. Knowledge gained from this research could be used to explore the phenomena of power as expressed in the daily lives of women of African descent. The research can also be discussed from the perspective of a "Black tax," that has burdened Black women for centuries and is manifested through years of discrimination, bias, and the lack of equity in most domains of American institutions. [ABSTRACT FROM AUTHOR]

Long maligned as the largest threat to democratization, recent studies have suggested that military coups can act as important windows of opportunity for democratization in authoritarian regimes. It is argued that even failed coup attempts can roughly double the probability that an authoritarian regime democratizes in the next three years. We revisit these findings by assessing each case of a democratic transition occurring in a failed coup spell in Africa, using the standards of prior work. Our analysis points to a more pessimistic view of the influence of failed coups. Specifically, we find that the nature of these transitions, often being drawn out over several years, and the nature of the data previously utilized to test the association undermine the ability to observe a democratizing effect. Instead of failed coups providing a significant boost to democratization, we find they are more likely to reinforce the country's previous political trajectory. Failed coups serve incumbents with the dual benefit of both outing their opponents and providing a pretext for their removal, ultimately providing a policy boost for both democrats and autocrats. [ABSTRACT FROM AUTHOR]

Spodoptera exempta nucleopolyhedrovirus (SpexNPV) is a viral pathogen of the African armyworm, Spodoptera exempta (Lepidoptera: Noctuidae), a significant agricultural pest of cereal crops in Africa. SpexNPV has been evaluated as a potential insecticide for control of this pest and has served as the subject of research on baculovirus pathology and transmission. Occlusion bodies (OBs) of SpexNPV isolate 244.1 were examined, and the nucleotide sequence of the genome was determined and characterized. SpexNPV-244.1 OBs consisted of irregular polyhedra with a size and appearance typical for alphabaculoviruses. Virions within the polyhedra contained 1–8 nucleocapsids per unit envelope. The SpexNPV-244.1 genome was comprised of a 129,528 bp circular sequence, in which 139 ORFs were annotated. Five homologous regions (hrs) consisting of a variable number of 28-bp imperfect palindromes were identified in the genome. The genome sequence contained the 38 core genes of family Baculoviridae, as well as three ORFs unique to the SpexNPV sequence and one ORF that was apparently acquired by horizontal gene transfer with a betabaculovirus ancestor. Phylogenetic inference with core gene amino acid sequence alignments placed SpexNPV-244.1 in a lineage containing alphabaculoviruses of Spodoptera frugiperda and Spodopotera exigua which in turn is part of a larger group of alphabaculoviruses from the subfamily Noctuinae in the lepidopteran family Noctuidae. Kimura-2-parameter pairwise nucleotide distances indicated that SpexNPV-244.1 represented a different and previously unlisted species in the genus Alphabaculovirus. Gene parity plots indicated that the gene order of SpexNPV-244.l was extensively collinear with that of Spodoptera exigua NPV (SeMNPV). These plots also revealed a group of 17 core genes whose order was conserved in other alpha- and betabaculoviruses. [ABSTRACT FROM AUTHOR]

Purpose: The 2014 outbreak of Ebola virus disease (EVD) in West Africa was the largest in history. Starting in September 2014, International Medical Corps (IMC) operated five Ebola treatment units (ETUs) in Sierra Leone and Liberia. This paper explores how future infectious disease outbreak facilities in resource-limited settings can be planned, organized, and managed by analyzing data collected on water, sanitation, and hygiene (WASH) and infection prevention control (IPC) protocols. Design/Methodology/Approach: We conducted a retrospective cohort study by analyzing WASH/IPC activity data routinely recorded on paper forms or white boards at ETUs during the outbreak and later merged into a database from two IMC-run ETUs in Sierra Leone between December 2014 and December 2015. Findings: The IMC WASH/IPC database contains data from over 369 days. Our results highlight parameters key to designing and maintaining an ETU. High concentration chlorine solution usage was highly correlated with both daily patient occupancy and high-risk zone staff entries; low concentration chlorine usage was less well explained by these measures. There is high demand for laundering and disinfecting of personal protective equipment (PPE) on a daily basis and approximately 1 (0–4) piece of PPE is damaged each day. Research limitations/Implications: Lack of standardization in the type and format of data collected at ETUs made constructing the WASH/IPC database difficult. However, the data presented here may help inform humanitarian response operations in future epidemics. [ABSTRACT FROM AUTHOR]