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Background: With the primary objective of addressing the disparity in global surgical care access, the College of Surgeons of East, Central, and Southern Africa (COSECSA) trains surgeons. While sufficient operative experience is crucial for surgical training, the extent of utilization of minimally invasive techniques during COSECSA training remains understudied. Methods: We conducted an extensive review of COSECSA general surgery trainees' operative case logs from January 1, 2015, to December 31, 2020, focusing on the utilization of minimally invasive surgical procedures. Our primary objective was to determine the prevalence of laparoscopic procedures and compare this to open procedures. We analyzed the distribution of laparoscopic cases across common indications such as cholecystectomy, appendicitis, and hernia operations. Additionally, we examined the impact of trainee autonomy, country development index, and hospital type on laparoscopy utilization. Results: Among 68,659 total cases, only 616 (0.9%) were laparoscopic procedures. Notably, 34 cases were conducted during trainee external rotations in countries like the United Kingdom, Germany, and India. Gallbladder and appendix pathologies were most frequent among the 582 recorded laparoscopic cases performed in Africa. Laparoscopic cholecystectomy accounted for 29% (276 of 975 cases), laparoscopic appendectomy for 3% (76 of 2548 cases), and laparoscopic hernia repairs for 0.5% (26 of 5620 cases). Trainees self-reported lower autonomy for laparoscopic (22.5%) than open cases (61.5%). Laparoscopy usage was more prevalent in upper-middle-income (2.7%) and lower-middle-income countries (0.8%) compared with lower-income countries (0.5%) (p < 0.001). Private (1.6%) and faith-based hospitals (1.5%) showed greater laparoscopy utilization than public hospitals (0.5%) (p < 0.001). Conclusions: The study highlights the relatively low utilization of minimally invasive techniques in surgical training within the ECSA region. Laparoscopic cases remain a minority, with variations observed based on specific diagnoses. The findings suggest a need to enhance exposure to minimally invasive procedures to ensure well-rounded training and proficiency in these techniques. [ABSTRACT FROM AUTHOR]

Purpose: Open repair of groin hernia is an essential skill for the general surgeon. This study aimed to develop a low-cost hernia model based on a validated high-fidelity model and assess its effectiveness in teaching inguinal hernia repair to surgical trainees from many institutions throughout Africa. Methods: Using inexpensive, locally available materials, a low-cost hernia model was created. Six models were constructed, and a workshop was conducted for surgical residents. Pre- and post-workshop surveys were administered to assess knowledge, confidence, and understanding. Statistical analyses were performed using paired t tests and the Wilcoxon signed-rank test. Results: The low-cost hernia model consisted of various readily available materials and cost an average of $5.07. Sixty-eight trainees participated in the workshop, and 59 completed the post-workshop survey. Participants reported a significant increase in confidence for both mesh and non-mesh repairs and an improved understanding of hernia anatomy after the workshop. Trainees scored an average of 5.6 (SD 1.9) out of 10 questions on the pre-workshop quiz and 7.9 (SD 1.4) out of 10 on the post-workshop quiz (p < 0.001), indicating improved knowledge. All trainees supported the use of the model for education. Conclusion: The low-cost hernia model demonstrated its effectiveness in enhancing trainees' understanding of hernia anatomy and increasing their confidence in hernia repair. Integrating low-cost hernia models into training programs can help improve trainees' knowledge and confidence in a safe and affordable environment. [ABSTRACT FROM AUTHOR]

Sustainability of African weather and climate information can only be ensured by investing in improved scientific understanding, observational data, and model capability. These requirements must be underpinned by capacity development, knowledge management; and partnerships of co-production, communication and coordination. [ABSTRACT FROM AUTHOR]

Protected areas are becoming increasingly isolated refugia for large carnivores but remain critical for their survival. Spotted hyaenas (Crocuta crocuta) are important members of the African large carnivore guild but, like other members of the guild, routinely come into conflict with people because of their large home ranges that are not always confined to protected areas. To effectively conserve spotted hyaena populations, it is paramount to monitor their abundance through reliable and cost-effective techniques. We estimated the density of spotted hyaenas in Hluhluwe–iMfolozi Park (HiP), South Africa using camera trap images and a spatially explicit capture-recapture (SECR) framework between 2013 and 2018. We estimated an average of 18.29 ± 3.27 spotted hyaenas per 100 km2 between 2013 and 2018, with an annual estimated high of 20.83/100 km2 in 2014 and a low of 11.98/100 km2 in 2015. Our results demonstrate that camera trap by-catch data can be used for estimating spotted hyaena densities over time. We believe that given the widespread use and deployment of camera traps across Africa, collaborative efforts to use existing data to improve regional and continental estimates and population trends for spotted hyaenas should be a priority. [ABSTRACT FROM AUTHOR]

The size of the home range of a mammal is affected by numerous factors. However, in the normally solitary, but polygynous, Leopard (Panthera pardus), home range size and maintenance is complicated by their transitory social grouping behavior, which is dependent on life history stage and/or reproductive status. In addition, the necessity to avoid competition with conspecifics and other large predators (including humans) also impacts upon home range size. We used movement data from 31 sites across Africa, comprising 147 individuals (67 males and 80 females) to estimate the home range sizes of leopards. We found that leopards with larger home ranges, and in areas with more vegetation, spent longer being active and generally traveled faster, and in straighter lines, than leopards with smaller home ranges. We suggest that a combination of bottom-up (i.e. preferred prey availability), top-down (i.e. competition with conspecifics), and reproductive (i.e. access to mates) factors likely drive the variability in Leopard home range sizes across Africa. However, the maintenance of a large home range is energetically expensive for leopards, likely resulting in a complex evolutionary trade-off between the satisfaction of basic requirements and preventing potentially dangerous encounters with conspecifics, other predators, and people. [ABSTRACT FROM AUTHOR]

As HIV unfolded in the 1980s, HIV and AIDS were heard and seen through the lives of those whom it touched directly. Personal histories were foregrounded, centred by the inevitable mortality attached to HIV infection, the courage of circumstance in the face of illness, and the activism necessary to make a difference. In the later part of the decade, the impacts of HIV were most apparent in East Africa, where community responses and political leadership coalesced to reduce new HIV infections. The 1990s marked a turn towards centralised policy, funding, and the reification of biomedically oriented approaches and systems that are intrinsically top-down. This biomedical turn centred on foregrounding the widespread availability of low-cost antiretroviral therapy and was articulated in the 90-90-90 and subsequent targets. Biomedicalisation reinforces individualised approaches to health primarily focused on biomedical technologies and health service provision that do not rely on community or social organisation formats. Emphasis on HIV treatment, along with the promise of reduced HIV transmission through viral load suppression, contributed to limiting socio-behavioural approaches to HIV prevention. While the importance of community-led response was highlighted in the 2016 United Nations Political Declaration on Ending AIDS, community-led response has devolved towards concepts such as community-led monitoring and community-led response that frame responses in direct relation to the dominant biomedical paradigm. There are lessons in the history of the AIDS response that demonstrate that communities formulate responses to AIDS differently when there have been opportunities for community members to determine the pathways for action to address HIV independently. Older research studies offer retrospective insights into moments in the history of HIV when communities were foregrounded and highlighted the need to reconsider the current trajectory of the HIV response. Not only for history's sake but to acknowledge that community leadership remains overwhelmed by elites. While lofty targets and goals drive the contemporary HIV response, the way forward is mired by uncertainty. HIV prevention efforts remain uneven, and millions of people living with HIV depend on access to treatment for decades to come in the context of budgetary uncertainties. Changing the course of AIDS will not be achieved if we fail to ensure that communities occupy a genuine and unambiguous place in shaping HIV response. [ABSTRACT FROM AUTHOR]

Background: Operative experience is a necessary part of surgical training. The College of Surgeons of East, Central, and Southern Africa (COSECSA), which oversees general surgery training programs in the region, has implemented guidelines for the minimum necessary case volumes upon completion of two (Membership) and five (Fellowship) years of surgical training. We aimed to review trainee experience to determine whether guidelines are being met and examine the variation of cases between countries. Methods: Operative procedures were categorized from a cohort of COSECSA general surgery trainees and compared to the guideline minimum case volumes for Membership and Fellowship levels. The primary and secondary outcomes were total observed case volumes and cases within defined categories. Variations by country and development indices were explored. Results: One hundred ninety-four trainees performed 69,283 unique procedures related to general surgery training. The review included 70 accredited hospitals and sixteen countries within Africa. Eighty percent of MCS trainees met the guideline minimum of 200 overall cases; however, numerous trainees did not meet the guideline minimum for each procedure. All FCS trainees met the volume target for total cases and orthopedics; however, many did not meet the guideline minimums for other categories, especially breast, head and neck, urology, and vascular surgery. The operative experience of trainees varied significantly by location and national income level. Conclusions: Surgical trainees in East, Central, and Southern Africa have diverse operative training experience. Most trainees fulfill the overall case volume requirements; however, further exploration of how to meet the demands of specific categories and procedures is necessary. [ABSTRACT FROM AUTHOR]

Anthracnose caused by Colletotrichum lindemuthianum is a major disease of common bean (Phaseolus vulgaris) worldwide. Yellow beans are a major market class of common bean especially in eastern and southern Africa. The Yellow Bean Collection (YBC), which is comprised of 255 genotypes, and has not been used previously in genetic studies on anthracnose, is an excellent genetic resource for understanding the extent of anthracnose resistance and its genetic architecture in the yellow bean market class. The objectives of this study were i) evaluate the YBC for resistance to races 5, 19, 39, 51, 81, 183, 1050 and 1105 of C. lindemuthianum. and ii) conduct genome-wide association analysis to identify genomic regions and candidate genes associated with resistance to C. lindemuthianum. The YBC was genotyped with 72,866 SNPs, and genome-wide association analysis was conducted using Mixed Linear Model in TASSEL. Andean and Middle American genotypes with superior levels of resistance to the eight races were identified. YBC278 was the only one among 255 genotypes that was highly resistant to all eight races. Resistance to anthracnose in the YBC was controlled by major-effect loci on chromosomes Pv01, Pv03, Pv04, Pv05 and Pv07. The genomic region on Pv01, which overlapped with the Andean locus Co-1 provided resistance to races 81, 1050 and 1105. Significant SNPs for resistance to race 39 were identified on Pv02. The genomic region on Pv04, which overlapped with known major-effect loci Co-3, Co-15, Co-16, Co-y and Co-z, provided resistance to races 5, 19, 51 and 183. Novel genomic regions for resistance to race 39 were identified on Pv05 and Pv07. Plant resistance genes (R genes) with NB-ARC and LRR domains, which occurred in clusters, were identified as positional candidate genes for genomic regions on Pv02 and Pv04. [ABSTRACT FROM AUTHOR]

Testbeds have become integral to advancing the transfer of knowledge and capabilities from research to operational weather forecasting in many parts of the world. The first high-impact weather testbed in tropical Africa was recently carried out through the African Science for Weather Information and Forecasting Techniques (SWIFT) program, with participation from researchers and forecasters from Senegal, Ghana, Nigeria, Kenya, the United Kingdom, and international and pan-African organizations. The testbed aims were to trial new forecasting and nowcasting products with operational forecasters, to inform future research, and to act as a template for future testbeds in the tropics. The African SWIFT testbed integrated users and researchers throughout the process to facilitate development of impact-based forecasting methods and new research ideas driven both by operations and user input. The new products are primarily satellite-based nowcasting systems and ensemble forecasts at global and regional convection-permitting scales. Neither of these was used operationally in the participating African countries prior to the testbed. The testbed received constructive, positive feedback via intense user interaction including fishery, agriculture, aviation, and electricity sectors. After the testbed, a final set of recommended standard operating procedures for satellite-based nowcasting in tropical Africa have been produced. The testbed brought the attention of funding agencies and organizational directors to the immediate benefit of improved forecasts. Delivering the testbed strengthened the partnership between each country's participating university and weather forecasting agency and internationally, which is key to ensuring the longevity of the testbed outcomes. [ABSTRACT FROM AUTHOR]

The HIV/AIDS pandemic in sub-Saharan Africa has brought renewed attention to the role of grandmothers as caregivers of children. Using 2004 Lesotho Demographic and Health Survey data, the authors examine the relationship between coresidence with a grandmother and child schooling in Lesotho, a country with one of the highest rates of HIV infection. Results confirm the critical role grandmothers play in the event of maternal death. Maternal orphans who live with a grandmother are just as likely to be in school as children living with a mother. The protective effect of living with a grandmother is also important for children whose mothers are alive but not affiliated with their households. The results of the analysis underscore the importance of attending to the simultaneous presence of mothers and grandmothers, as well as the circumstances associated with mother absence, when assessing the relationship between grandmother coresidence and child outcomes. (Contains 5 tables, 2 figures, and 11 notes.)

Spatial patterns of and competition for resources by territorial carnivores are typically explained by two hypotheses: 1) the territorial defence hypothesis and 2) the searching efficiency hypothesis.According to the territorial defence hypothesis, when food resources are abundant, carnivore densities will be high and home ranges small. In addition, carnivores can maximise their necessary energy intake with minimal territorial defence. At medium resource levels, larger ranges will be needed, and it will become more economically beneficial to defend resources against a lower density of competitors. At low resource levels, carnivore densities will be low and home ranges large, but resources will be too scarce to make it beneficial to defend such large territories. Thus, home range overlap will be minimal at intermediate carnivore densities.According to the searching efficiency hypothesis, there is a cost to knowing a home range. Larger areas are harder to learn and easier to forget, so carnivores constantly need to keep their cognitive map updated by regularly revisiting parts of their home ranges. Consequently, when resources are scarce, carnivores require larger home ranges to acquire sufficient food. These larger home ranges lead to more overlap among individuals' ranges, so that overlap in home ranges is largest when food availability is the lowest. Since conspecific density is low when food availability is low, this hypothesis predicts that overlap is largest when densities are the lowest.We measured home range overlap and used a novel method to compare intraspecific home range overlaps for lions Panthera leo (n = 149) and leopards Panthera pardus (n = 111) in Africa. We estimated home range sizes from telemetry location data and gathered carnivore density data from the literature.Our results did not support the territorial defence hypothesis for either species. Lion prides increased their home range overlap at conspecific lower densities whereas leopards did not. Lion pride changes in overlap were primarily due to increases in group size at lower densities. By contrast, the unique dispersal strategies of leopards led to reduced overlap at lower densities. However, when human‐caused mortality was higher, leopards increased their home range overlap. Although lions and leopards are territorial, their territorial behaviour was less important than the acquisition of food in determining their space use. Such information is crucial for the future conservation of these two iconic African carnivores. [ABSTRACT FROM AUTHOR]

Habitat heterogeneity is a key driver of the diversity and distribution of species. African savannas are experiencing changes in their vegetation structure causing shifts towards increased woody plant cover, which results in vegetation structure homogenization. Given the impact that increasing woody plant cover has on patterns of animal use, resource managers across Africa are implementing habitat management practices that are intended to reduce woody plant cover. To understand the ecological implications of various habitat management practices on arthropod and bird communities, we leveraged large‐scale tree clearing and subsequent mowing in an African savanna to understand how changes in both the herbaceous layer and woody plant cover (i.e., structural heterogeneity) may shape arthropod and bird communities at the local scale. We focused on four replicated treatments: (1) annual summer mow, (2) annual winter mow, (3) >5 years since last mow (rest), and (4) an adjacent unmanipulated savanna to act as a control. We found that the mowing treatments significantly influenced vegetation structure both with respect to tree density and herbaceous layer. Both arthropod and bird community composition varied across treatments. Grass biomass was the best predictor of arthropod richness and abundance, with arthropods selecting for areas with high biomass. Insectivorous bird richness and abundance was driven by tree density (i.e., perching locations) and not arthropod abundance. Our results suggest that vegetation management practices contribute to habitat heterogeneity at the landscape scale and increase bird species richness through species turnover. However, we caution that if a single vegetation management practice dominates the landscape, it is plausible that it could lead to the simplification of the avian community. [ABSTRACT FROM AUTHOR]

In boreal winter, strong upper‐level midlatitude troughs across the Atlantic–Africa–southwestern Asia sector generate substantial tropical–extratropical interaction and have become recognized as important factors in some extreme weather events. As such, they represent important dynamic features to understand and capture in weather forecasts, as well as in climate models for projections on longer timescales. Here, we empirically study the 20% of winter days with strongest trough signatures during 1982–2020 at each longitude across the sector, and show that the trough impact over northern Africa, most notably in central parts, is particularly strong in magnitude, low‐latitude extent and persistence, leading to the characterization of a northern Africa mode of several‐days weather fluctuation. Weather conditions that follow strong troughs from the eastern Atlantic to the Central Mediterranean include: (i) a warming tendency across much of northern Africa, generally of several Celsius magnitude ahead of the trough, and >1°C even extending to the south of 10° N in central parts and continuing eastward until the Ethiopian Highlands; (ii) precipitation development further north than normal across northern tropical Africa, especially strong over longitudes corresponding to a northward extension of the main Congo rain belt. The intertropical discontinuity and low‐level heat low are also shifted significantly north, with the complex of anomalies persisting for several days, beyond the timescale of the trough. For context, at all other trough longitudes across the sector, a warming signal does emerge (statistically significant), but with much shorter persistence (2–3 days), smaller magnitude and extending southward clearly only to 15–20° N. Mid‐level tropical plumes of moisture are also typically present for strong troughs from the eastern Atlantic to southwestern Asia, and these alone can lead to weather extremes. However, low‐level warming and mid‐level moistening are uniquely juxtaposed at low latitudes over central Africa, where a near‐equatorial signature develops. [ABSTRACT FROM AUTHOR]

• A novel phylogeny for the daisy tribe Calenduleae is presented. • The phylogeny is based on nuclear and plastid DNA sequences, and morphology. • Dimorphotheca polyptera is not a Dimorphotheca , despite having dimorphic fruits. • D. polyptera is transferred to Osteospermum under O. polypterum. • the genus Osteospermum now has a member with dimorphic fruits. Generic circumscription in the small daisy tribe Calenduleae has been unstable, with various authors recognising between three and twelve genera. Evaluating alternative generic circumscriptions is difficult since existing phylogenetic hypotheses are poorly sampled. We assemble a preliminary phylogenetic hypothesis for the tribe based on nuclear ribosomal and plastid trn L- trn F DNA sequences. We recover a monophyletic Garuleum Cass. sister to the remaining species of Calenduleae. An expanded circumscription of Osteospermum L. is supported, including the former genera Calendula L., Chrysanthemoides Fabr., Monoculus B. Nord., and Tripteris Less., although sampling remains sparse. The genus Dimorphotheca Vaill. ex Moench is recovered in its current, enlarged circumscription including Castalis Cass. and O. sect. Blaxium (Cass.) Norl. However, our analysis identifies D. polyptera DC. as being distant from the rest of Dimorphotheca and embedded within an ' Osteospermum sensu amplo clade', a finding corroborated by the inclusion of additional accessions. We explore the morphological basis for this placement, and transfer D. polyptera to Osteospermum in order to maintain monophyly of Dimorphotheca. [ABSTRACT FROM AUTHOR]

Background: Datura stramonium L. (Solanaceae) is used traditionally in west Africa to treat asthma, epilepsy, rheumatoid arthritis, filariasis microbial infections and conjunctivitis. This study investigated the immunomodulatory effects of aqueous seed extract of D. stramonium L. (ASEDS) on Wistar rats. Methods: Thirty Wistar albino rats (180–200 g) were randomized into 6 groups (n = 5). Group 1 received distilled water only. Rats in groups 2–6 were pretreated with 10 mg/kg body weight (b.w.) Cyclophosphamide orally for 27-days to induce immunosuppression. Thereafter, they received treatment orally for 28 days as follows: Group 2 (distilled water), group 3 (5 mg/kg b.w. Levamisole), groups 4–6 (60, 90 and 120 mg/kg b.w. ASEDS, respectively). HPLC was used to determine major compounds in ASEDS. The effects of ASEDS on immune cells, immunoglobulins A, G and M levels, lipoproteins, and antioxidant status of rats were evaluated. Results: ASEDS indicated high content of Acutumine, Quinine, Catechin, Chlorogenic acid, Gallic acid, Quercetin, Vanillic acid, Luteolin, Formosanin C, Saponin, Cyanidin, Tannic acid, 3-Carene, Limonene and α-terpineol. Cyclophosphamide triggered significant (p < 0.05) reduction in total leucocyte count and differentials, IgA, IgG, high-density lipoproteins (HDL), catalase, superoxide dismutase, glutathione peroxidase, vitamins A, C and E levels of untreated rats. Administration of ASEDS led to significant (p < 0.05) improvement in immune cell counts, immunoglobulin synthesis, high-density lipoprotein concentration, and antioxidant status of rats in the treated groups. Conclusions: The results obtained from the study showed the immunomodulatory activity of ASEDS, thereby indicating its potential in immunostimulatory drug discovery. [ABSTRACT FROM AUTHOR]

There is a great demand to improve predictions of high‐impact weather across the African continent. This is because of the high frequency of intense convective storms that often produce severe flooding, strong winds and lightning, combined with the vulnerability of people, infrastructure and businesses to such hazards. The skill of numerical weather prediction over Africa is still low, even for lead times of less than 24 hours. Therefore, there is a particular need to deliver nowcasting of events as they occur. However, there remains a widespread lack of provision of nowcasting across Africa and virtually no use of automated nowcasting systems or tools. This limits the ability of national meteorological services to issue warnings and therefore potentially prevent the loss of life and significant financial losses. Coverage by meteorological radars is still very limited, but geostationary satellites provide regular high resolution data of the often large and long‐lived storms. As such, there is an opportunity to improve satellite‐based nowcasting capability in Africa. Work being undertaken as part of the Global Challenges Research Fund African SWIFT (Science for Weather Information and Forecasting Techniques) project is starting to improve the nowcasting of African convective systems and so the ability to provide timely warnings of extreme weather providing a wide range of benefits. [ABSTRACT FROM AUTHOR]

Methane (CH4) is a potent greenhouse gas with a warming potential 84 times that of carbon dioxide (CO2) over a 20‐year period. Atmospheric CH4 concentrations have been rising since the nineteenth century but the cause of large increases post‐2007 is disputed. Tropical wetlands are thought to account for ∼20% of global CH4 emissions, but African tropical wetlands are understudied and their contribution is uncertain. In this work, we use the first airborne measurements of CH4 sampled over three wetland areas in Zambia to derive emission fluxes. Three independent approaches to flux quantification from airborne measurements were used: Airborne mass balance, airborne eddy‐covariance, and an atmospheric inversion. Measured emissions (ranging from 5 to 28 mg m−2 hr−1) were found to be an order of magnitude greater than those simulated by land surface models (ranging from 0.6 to 3.9 mg m−2 hr−1), suggesting much greater emissions from tropical wetlands than currently accounted for. The prevalence of such underestimated CH4 sources may necessitate additional reductions in anthropogenic greenhouse gas emissions to keep global warming below a threshold of 2°C above preindustrial levels. Plain Language Summary: Methane (CH4) is a powerful greenhouse gas. The more CH4 in the atmosphere, the greater the amount of warming. CH4 is emitted naturally by many sources, such as wetlands, but is also emitted by many human activities, such as fossil fuel use, waste treatment, and farming. Tropical wetlands are thought to account for roughly one‐fifth of the global CH4 emissions, but studies on tropical wetlands in Africa are extremely rare. We measured CH4 emissions from three separate wetlands in Zambia (southern Africa) and found that models were estimating much lower CH4 emissions. If more CH4 is being emitted by the many other African wetlands than currently thought, then we may have overestimated the amount of CH4 that humans can yet emit before reaching 2°C of global warming, and failing the promises set out in the Paris Agreement. Key Points: Quantification of the first methane emission fluxes from Zambian wetlands using world‐first airborne survey data recorded over ZambiaIntercomparison of, and guidance on, the use of three independent approaches for flux quantification from aircraft surveysWetland methane fluxes were observed to be significantly greater than those simulated by Global Carbon Project land surface models [ABSTRACT FROM AUTHOR]

The ability to predict heavy rain and floods in Africa is urgently needed to reduce the socioeconomic costs of these events and increase resilience as climate changes. Numerical weather prediction in this region is challenging, and attention is being drawn to observationally based methods of providing short-term nowcasts (up to ∼6-h lead time). In this paper a freely available nowcasting package, pySTEPS, is used to assess the potential to provide nowcasts of satellite-derived convective rain rate for West Africa. By analyzing a large number of nowcasts, we demonstrate that a simple approach of "optical flow" can have useful skill at 2-h lead time on a 10-km scale and 4-h lead time at larger scales (200 km). A diurnal variation in nowcast skill is observed, with the worst-performing nowcasts being those that are initialized at 1500 UTC. Comparison with existing nowcasts is presented. Such nowcasts, if implemented operationally, would be expected to have significant benefits. Significance Statement: A freely available, easy-to-use nowcasting package has been applied to satellite-retrieved rainfall rates for West Africa, and extrapolations have useful skill at up to 4 h of lead time. [ABSTRACT FROM AUTHOR]

Large variations in the growth of atmospheric methane, a prominent greenhouse gas, are driven by a diverse range of anthropogenic and natural emissions and by loss from oxidation by the hydroxyl radical. We used a decade-long dataset (2010–2019) of satellite observations of methane to show that tropical terrestrial emissions explain more than 80% of the observed changes in the global atmospheric methane growth rate over this period. Using correlative meteorological analyses, we show strong seasonal correlations (r = 0.6–0.8) between large-scale changes in sea surface temperature over the tropical oceans and regional variations in methane emissions (via changes in rainfall and temperature) over tropical South America and tropical Africa. Existing predictive skill for sea surface temperature variations could therefore be used to help forecast variations in global atmospheric methane. Methane is a powerful greenhouse gas with emissions that are challenging to constrain. Here the authors use 10 years of satellite observations and show tropical terrestrial emissions account for 80% of observed global methane increases. [ABSTRACT FROM AUTHOR]

Background: Resident operative case volumes are an important aspect of surgical education, and minimums are required in Accreditation Council for Graduate Medical Education (ACGME) programs. Minimum operative case volumes for training do not exist in rural Africa. Our objective was to determine the optimal minimum operative case volume necessary for general surgery training in rural Africa. Methods: A cross-sectional census electronic survey was conducted among faculty (N = 24) and graduates (N = 56) of Pan-African Academy of Christian Surgeons training programs. Three equally weighted exposures (median minimum case volume suggested by participants, operative experience of prior graduates, and comparisons with ACGME minimums), adjusted from responses to targeted questions, were utilized to construct an optimal minimum operative case volume for training. Results: Sixty-four surgeons were contacted and 40 (13 faculty, 24 graduates, and 3 graduates who became faculty) participated. All participants thought operative case minimums were necessary, and the majority (98%) felt current training adequately prepared surgeons for their setting. Constructed optimal case volumes included 1000 major cases with fewer required cases than ACGME in abdomen, breast, thoracic, vascular, endoscopy, and laparoscopy and more required cases than ACGME for alimentary tract, endocrine, operative trauma, skin and soft tissue, pediatric, and plastic surgery. Other categories (gynecology, orthopedics, and urology) were deemed necessary for surgical training, with regional differences. Prior graduates satisfied the overall, but not category-specific, proposed minimums. Conclusions: The surveyed surgeons highlighted the need for diverse surgical training with minimum exposures. They described increased need for cases reflecting regional variations with a desire for more experience in categories less common at their institutions. [ABSTRACT FROM AUTHOR]

Africa is poised for a revolution in the quality and relevance of weather predictions, with potential for great benefits in terms of human and economic security. This revolution will be driven by recent international progress in nowcasting, numerical weather prediction, theoretical tropical dynamics, and forecast communication, but will depend on suitable scientific investment being made. The commercial sector has recognized this opportunity and new forecast products are being made available to African stakeholders. At this time, it is vital that robust scientific methods are used to develop and evaluate the new generation of forecasts. The Global Challenges Research Fund (GCRF) African Science for Weather Information and Forecasting Techniques (SWIFT) project represents an international effort to advance scientific solutions across the fields of nowcasting, synoptic and short-range severe weather prediction, subseasonal-to-seasonal (S2S) prediction, user engagement, and forecast evaluation. This paper describes the opportunities facing African meteorology and the ways in which SWIFT is meeting those opportunities and identifying priority next steps. Delivery and maintenance of weather forecasting systems exploiting these new solutions requires a trained body of scientists with skills in research and training, modeling and operational prediction, and communications and leadership. By supporting partnerships between academia and operational agencies in four African partner countries, the SWIFT project is helping to build capacity and capability in African forecasting science. A highlight of SWIFT is the coordination of three weather forecasting "Testbeds"—the first of their kind in Africa—which have been used to bring new evaluation tools, research insights, user perspectives, and communications pathways into a semioperational forecasting environment. [ABSTRACT FROM AUTHOR]

This article shares findings on COVID-19 in Africa across 2020 to examine concepts and practices of epidemic preparedness and response. Amidst uncertainties about the trajectory of COVID-19, the stages of emergency response emerge in practice as interconnected. We illustrate how complex dynamics manifest as diverse actors interpret and modify approaches according to contexts and experiences. We suggest that the concept of "intersecting precarities" best captures the temporalities at stake; that these precarities include the effects of epidemic control measures; and that people do not just accept but actively negotiate these intersections as they seek to sustain their lives and livelihoods. [ABSTRACT FROM AUTHOR]

Background: Gastrointestinal endoscopy (GIE) is not routinely accessible in many parts of rural Africa. As surgical training expands and technology progresses, the capacity to deliver endoscopic care to patients improves. We aimed to describe the current burden of gastrointestinal (GI) disease undergoing GIE by examining the experience of surgical training related to GIE. Methods: A retrospective review was conducted on GIE procedures performed by trainees with complete case logs during 5-year general surgery training at Pan-African Academy of Christian Surgeons (PAACS) sites. Cases were classified according to diagnosis and/or indication, anatomic location, intervention, adverse events, and outcomes. Comparisons were performed by institutional location and case volumes. Analysis was performed for trainee self-reported autonomy by post-graduate year and case volume experience. Results: Twenty trainees performed a total of 2181 endoscopic procedures. More upper endoscopies (N = 1,853) were performed than lower endoscopies (N = 325). Of all procedures, 546 (26.7%) involved a cancer or mass, 267 (12.2%) involved a report of blood loss, and 452 (20.7%) reported pain as a component of the diagnosis. Interventions beyond biopsy were reported in 555 (25%) procedures. Esophageal indications predominated the upper endoscopies, particularly esophageal cancer. Trainees in high-volume centers and in East Africa performed more interventional endoscopy and procedures focused on esophageal cancer. Procedure logs documented adverse events in 39 cases (1.8% of all procedures), including 16 patients (0.8%) who died within 30 days of the procedure. Self-reported autonomy improved with both increased endoscopy experience and post-graduate year. Conclusions: GIE is an appropriate component of general surgery residency training in Africa, and adequate training can be provided, particularly in upper GI endoscopy, and includes a wide variety of endoscopic therapeutic interventions. [ABSTRACT FROM AUTHOR]

The economic and humanistic impact of COVID-19 pandemic is enormous globally. No definitive treatment exists, hence accelerated development and approval of COVID-19 vaccines, offers a unique opportunity for COVID-19 prevention and control. Vaccine hesitancy may limit the success of vaccine distribution in Africa, therefore we assessed the potentials for coronavirus vaccine hesitancy and its determinants among Africans. An online cross-sectional African-wide survey was administered in Arabic, English, and French languages. Questions on demographics, self-reported health status, vaccine literacy, knowledge and perception on vaccines, past experience, behavior, infection risk, willingness to receive and affordability of the SARS-COV-2 vaccine were asked. Data were subjected to descriptive and inferential statistics. A total of 5,416 individuals completed the survey. Approximately, 94% were residents of 34 African countries while the other Africans live in the Diaspora. Only 63% of all participants surveyed were willing to receive the COVID-19 vaccination as soon as possible and 79% were worried about its side effects. Thirty-nine percent expressed concerns of vaccine-associated infection. The odds of vaccine hesitancy was 0.28 (95% CI: 0.22, 0.30) among those who believed their risk of infection was very high, compared to those who believed otherwise. The odds of vaccine hesitancy was one-fifth (OR = 0.21, 95% CI: 0.16, 0.28) among those who believed their risk of falling sick was very high, compared to those who believed their risk of falling very sick was very low. The OR of vaccine hesitancy was 2.72 (95% CI: 2.24, 3.31) among those who have previously refused a vaccine for themselves or their child compared to counterparts with no self-reported history of vaccine hesitancy. Participants want the vaccines to be mandatory (40%), provided free of charge (78%) and distributed in homes and offices (44%). COVID-19 vaccine hesitancy is substantial among Africans based on perceived risk of coronavirus infection and past experiences. [ABSTRACT FROM AUTHOR]

Background Globally, clinical training programmes have adopted several strategies in response to the evolving COVID-19 pandemic, including reorganizing the provision of care and safeguarding the well-being of trainees. This study aimed to describe the effects of the COVID-19 pandemic on surgical training programmes in Africa. Methods We conducted a cross-sectional survey through an online questionnaire distributed via email to all College of Surgeons of East, Central and Southern Africa (COSECSA) trainees and faculty. Input regarding experiences with the COVID-19 pandemic was sought, including perceptions about personal protective equipment (PPE), organizational changes impacting training, use of e-learning platforms, reactions to the pandemic, and measures taken by institutions to combat COVID-19. Descriptive statistics were utilized, along with comparisons between faculty and trainee experiences. P values =0.05 were considered statistically significant. Results Including 78 faculty members (31.6%), 247 participants completed the survey, and 175 believed they had been supplied with sufficient information regarding COVID-19 and the relevant PPE (71.7% of 244 who responded to this questionnaire item). The PPE components that were reported as most available were face masks (n=239, 96.8%), gloves (n=236, 95.5%), and body gowns (n=178, 72.1%). Most of the respondents (n=212, 85.8%) had learning reorganized at their centres due to the pandemic. Forty-two participants (17.0%) reported being exposed to COVID-19. Two respondents (0.8%) reported testing positive for COVID-19, but both were asymptomatic. About half of the respondents (n=122, 49.4%) used the existing COSECSA e-learning platform in the same manner as before the pandemic, and 174 participants (70.4%) suggested that COSECSA should implement a different examination format given the circumstances. Conclusions COSECSA training centres have adopted measures to combat the COVID-19 pandemic. Despite this, the pandemic has already adversely affected staff and patients. The centres should increase access to information about COVID-19 and enhance infection protection practices. Likewise, COSECSA should enrich online educational platforms and consider alternative examination formats. [ABSTRACT FROM AUTHOR]

The Hadley circulation and tropical rain belt are dominant features of African climate. Moist convection provides ascent within the rain belt, but must be parameterized in climate models, limiting predictions. Here, we use a pan-African convection-permitting model (CPM), alongside a parameterized convection model (PCM), to analyze how explicit convection affects the rain belt under climate change. Regarding changes in mean climate, both models project an increase in total column water (TCW), a widespread increase in rainfall, and slowdown of subtropical descent. Regional climate changes are similar for annual mean rainfall but regional changes of ascent typically strengthen less or weaken more in the CPM. Over a land-only meridional transect of the rain belt, the CPM mean rainfall increases less than in the PCM (5%vs 14%) but mean vertical velocity at 500 hPa weakens more (17% vs 10%). These changes mask more fundamental changes in underlying distributions. The decrease in 3-hourly rain frequency and shift from lighter to heavier rainfall are more pronounced in the CPM and accompanied by a shift from weak to strong updrafts with the enhancement of heavy rainfall largely due to these dynamic changes. The CPM has stronger coupling between intense rainfall and higher TCW. This yields a greater increase in rainfall contribution from events with greater TCW, with more rainfall for a given large-scale ascent, and so favors slowing of that ascent. These findings highlight connections between the convective-scale and larger-scale flows and emphasize that limitations of parameterized convection have major implications for planning adaptation to climate change. [ABSTRACT FROM AUTHOR]

Rapid urbanisation has led to major landscape alterations, affecting aquatic ecosystems' hydrological and biogeochemical cycles, and biodiversity. Thus, habitat alteration is considered a major driver of aquatic biodiversity loss and related aquatic ecosystem goods and services. This study aimed to investigate and compare aquatic macroinvertebrate richness, diversity and community structure between urban temporary wetlands, located within protected and un-protected areas. The latter were found within an open public space or park with no protection or conservation status, whereas the former were inaccessible to the public and had formal protected, conservation status. We hypothesised that; (1) protected urban wetlands will harbour higher aquatic macroinvertebrate biodiversity (both dry and wet) as compared to un-protected urban wetlands, and (2) that the community composition between the two urban wetlands types will be significantly different. Contrary to our hypothesis, our results revealed no major differences between protected and un-protected urban wetlands, based on the measures investigated (i.e. taxon richness, Shannon-Weiner diversity, Pielou's evenness and community composition) during the dry and wet phase. The only exception was community composition, which revealed significant differences between these urban wetland types. These results suggest that human activities (potential littering and polluting) in the un-protected urban wetlands have not yet resulted in drastic change in macroinvertebrate richness and composition, at least from the dry phase. This suggests a potential for un-protected urban wetlands suffering from minimal human impact to act as important reservoirs of biodiversity and ecosystem services. [ABSTRACT FROM AUTHOR]

Emissions of methane (CH4) from tropical ecosystems, and how they respond to changes in climate, represent one of the biggest uncertainties associated with the global CH4 budget. Historically, this has been due to the dearth of pan-tropical in situ measurements, which is particularly acute in Africa. By virtue of their superior spatial coverage, satellite observations of atmospheric CH4 columns can help to narrow down some of the uncertainties in the tropical CH4 emission budget. We use proxy column retrievals of atmospheric CH4 (XCH4) from the Japanese Greenhouse gases Observing Satellite (GOSAT) and the nested version of the GEOS-Chem atmospheric chemistry and transport model (0.5∘×0.625∘) to infer emissions from tropical Africa between 2010 and 2016. Proxy retrievals of XCH4 are less sensitive to scattering due to clouds and aerosol than full physics retrievals, but the method assumes that the global distribution of carbon dioxide (CO2) is known. We explore the sensitivity of inferred a posteriori emissions to this source of systematic error by using two different XCH4 data products that are determined using different model CO2 fields. We infer monthly emissions from GOSAT XCH4 data using a hierarchical Bayesian framework, allowing us to report seasonal cycles and trends in annual mean values. We find mean tropical African emissions between 2010 and 2016 range from 76 (74–78) to 80 (78–82) Tg yr -1 , depending on the proxy XCH4 data used, with larger differences in Northern Hemisphere Africa than Southern Hemisphere Africa. We find a robust positive linear trend in tropical African CH4 emissions for our 7-year study period, with values of 1.5 (1.1–1.9) Tg yr -1 or 2.1 (1.7–2.5) Tg yr -1 , depending on the CO2 data product used in the proxy retrieval. This linear emissions trend accounts for around a third of the global emissions growth rate during this period. A substantial portion of this increase is due to a short-term increase in emissions of 3 Tg yr -1 between 2011 and 2015 from the Sudd in South Sudan. Using satellite land surface temperature anomalies and altimetry data, we find this increase in CH4 emissions is consistent with an increase in wetland extent due to increased inflow from the White Nile, although the data indicate that the Sudd was anomalously dry at the start of our inversion period. We find a strong seasonality in emissions across Northern Hemisphere Africa, with the timing of the seasonal emissions peak coincident with the seasonal peak in ground water storage. In contrast, we find that a posteriori CH4 emissions from the wetland area of the Congo Basin are approximately constant throughout the year, consistent with less temporal variability in wetland extent, and significantly smaller than a priori estimates. [ABSTRACT FROM AUTHOR]

The representation of convection remains one of the most important sources of bias in global models, and evaluation methods are needed that show that models provide the correct mean state and variability, both for the correct reasons. Here we develop a novel approach for evaluating rainfall variability due to convectively coupled Kelvin waves (CCKWs) in this region. A phase cycle was defined for the CCKW cycle in OLR and used to composite rainfall anomalies. We characterize the observed (TRMM) rainfall response to CCKWs over tropical Africa in April and evaluate the performance of regional climate model (RCM) simulations: a parameterized convection simulation (P25) and the first pan-Africa convection-permitting simulation (CP4). TRMM mean rainfall is enhanced and suppressed by CCKW activity, and the occurrence of extreme rainfall and dry days is coupled with CCKW activity. Focusing on regional differences, we show for the first time that there is a dipole between West Africa and the Gulf of Guinea involving onshore/offshore shifts in rainfall, and the transition to enhanced rainfall over west equatorial Africa occurs one phase before the transition over east equatorial Africa. The global model used to drive the RCMs simulated CCKWs with mean amplitudes of 75%-82% of observations. The RCMs simulated coherent responses to the CCKWs and captured the large-scale spatial patterns and phase relationships in rainfall although the simulated rainfall response is weaker than observations and there are regional biases that are bigger away from the equator. P25 produced a closer match to TRMM mean rainfall anomalies than CP4 although the response in dry days was more closely simulated by CP4. [ABSTRACT FROM AUTHOR]

Objective: Given the high post-stroke mortality and disability and paucity of data on the quality of stroke care in Sub-Saharan Africa, we sought to characterize the implementation of stroke-focused treatments and 90-day outcomes of neuroimaging-confirmed stroke patients at the largest referral hospital in Tanzania.Design: Prospective cohort study.Setting: Muhimbili National Hospital (MNH) in Dar es Salaam, July 2016-March 2017.Participants: Adults with new-onset stroke (<14 days), confirmed by head CT, admitted to MNH.Main Outcomes Measures: Modified Rankin scale (mRS) and vital status.Results: Of 149 subjects (mean age 57; 48% female; median NIH stroke scale (NIHSS) 19; 46% ischemic stroke; 54% hemorrhagic), implementation of treatments included: dysphagia screening (80%), deep venous thrombosis prophylaxis (0%), aspirin (83%), antihypertensives (89%) and statins (95%). There was limited ability to detect atrial fibrillation and carotid artery disease and no acute thrombolysis or thrombectomy. Of ischemic subjects, 19% died and 56% had severe disability (mRS 4-5) at discharge; 49% died by 90 days. Of hemorrhagic subjects, 33% died and 49% had severe disability at discharge; 50% died by 90 days. In a multivariable model, higher NIHSS score but not dysphagia, unconsciousness, or patient age was predictive of death by 90 days.Conclusions: The 90-day mortality of stroke presenting at MNH is 50%, much higher than in higher income settings. Although severe stroke presentations are a major factor, efforts to improve the quality of care and prevent complications of stroke are urgently needed. Acute stroke interventions with low number needed to treat represent challenging long-term goals. [ABSTRACT FROM AUTHOR]

The price of cobalt has increased by some 450% in the past two years, mainly due to increasing demand for lithium–ion batteries. With an official 2017 production of 64 kt, the Democratic Republic of Congo produces more than half of the world's cobalt. African Copperbelt operations have traditionally focused on copper production; however, it has now become imperative to also consider cobalt recovery from these ores. A plethora of processing routes is possible. Most hydrometallurgical flowsheets recover cobalt from the raffinate of the low-grade copper solvent-extraction circuit. Downstream purification processes include sequential precipitation with a variety of reagents, solvent extraction, and ion exchange. Product choices include hydroxide, carbonate, sulfate, and metal cathode. This study assesses technical and economic advantages and limitations of various approaches to the hydrometallurgical processing of cobalt in an African context. [ABSTRACT FROM AUTHOR]

Esophageal squamous cell carcinoma (ESCC) has a high prevalence in several countries in Africa and Asia. Previous genome-wide association studies (GWAS) in Chinese populations have identified several ESCC susceptibility loci, including variants on chromosome 2q33 and 6p21, but the contribution of these loci to risk in African populations is unknown. In this study we tested the association of 10 genetic variants at these two risk loci on susceptibility to ESCC in two South African ethnic groups. Variants at 2q33 (rs3769823, rs10931936, rs13016963, rs7578456, rs2244438) and 6p21 (rs911178, rs3763338, rs2844695, rs17533090, rs1536501) were genotyped in a set of Black Xhosa (463 cases and 480 controls) and Mixed Ancestry (269 cases and 288 controls) individuals. Genotyping was performed using TaqMan allelic discrimination assays. The Pearson's chi-squared test was used to compare the allele frequency between cases and controls. Gene-environment interactions with tobacco smoking and alcohol consumption were investigated in a case-control analysis. A logistic regression analysis was further performed to elucidate the independent effect of each association signal on the risk of ESCC. The 2q33 variants rs10931936, rs7578456, and rs2244438 were marginally associated with higher risk of ESCC in the Mixed Ancestry population (ORs = 1.39–1.58, p ≤ 0.035), of which rs7578456 and rs2244438 remained significant after multiple correction (p < 0.005). The associations with rs7578456 and rs2244438 were also observed across strata of tobacco smoking (ORs = 1.47–2.75, p ≤ 0.035) and alcohol consumption (ORs = 1.45–2.06, p ≤ 0.085) status. However, only the association with rs2244438, which lies within an exon of TRAK2 , remained significant after adjustment for the other variants in the region. Interestingly, none of the variants tested were significantly associated with ESCC in the Black South African population. These finding implicate TRAK2 as a casual gene for ESCC risk in the Mixed Ancestry population of South Africa and confirm prior evidence of population-specific differences in the genetic contribution to ESCC, which may reflect differences in genetic architecture and environmental exposure across ethnic groups. [ABSTRACT FROM AUTHOR]

Introduction: An estimated 3.8 billion passengers traveled on commercial aircraft in 2016, of whom close to 1.5 billion crossed international boundaries. Modern commercial aircrafts can carry up to 800 passengers and can fly more than 18 hours. Although not very common, in-flight medical incidents can result in flight diversions that are costly and extremely inconvenient. The aim of the current study was to review in-flight medical incidents on a commercial African carrier between 2009 and 2011. Methods: A secondary analysis of data collected by air stewards during in-flight medical events that were recorded in a register were retrieved for the 3-year period 2009-2011. All medical documented data was evaluated. Results: A total of 3306 medical events equating to an average of 155 cases per million passengers per year were documented over the 3-year study period, of which 3279 were specified into medical categories. Cardiovascular cases (1124; 34.0%) gastrointestinal (727; 22.0%), muscular-skeletal (302; 9%), and respiratory (202; 6%) were the most common cases. Most incidents (74%) were managed by the cabin crew. Five of the medical incidents led to diversions. There were 9 deaths on board over the 3-year period. Conclusion: In-flight medical incidents are rare events. Comparisons with other airlines is difficult due to the non-standardization of recording methods. A global uniform reporting format across all airlines is necessary. Further research is required to determine the factors associated with medical incidents so that pre-emergency preparedness plans can be strengthened. [ABSTRACT FROM AUTHOR]

Background:  Diagnosis of human immunodeficiency virus (HIV) infection during early infancy (commonly known as "early infant HIV diagnosis" [EID]) followed by prompt initiation of antiretroviral therapy dramatically reduces mortality. EID testing is recommended at 6 weeks of age, but many infant infections are missed.Design/methods:  We simulated 4 EID testing strategies for HIV-exposed infants in South Africa: no EID (diagnosis only after illness; hereafter, "no EID"), testing once (at birth alone or at 6 weeks of age alone; hereafter, "birth alone" and "6 weeks alone," respectively), and testing twice (at birth and 6 weeks of age; hereafter "birth and 6 weeks"). We calculated incremental cost-effectiveness ratios (ICERs), using discounted costs and life expectancies for all HIV-exposed (infected and uninfected) infants.Results:  In the base case (guideline-concordant care), the no EID strategy produced a life expectancy of 21.1 years (in the HIV-infected group) and 61.1 years (in the HIV-exposed group); lifetime cost averaged $1430/HIV-exposed infant. The birth and 6 weeks strategy maximized life expectancy (26.5 years in the HIV-infected group and 61.4 years in the HIV-exposed group), costing $1840/infant tested. The ICER of the 6 weeks alone strategy versus the no EID strategy was $1250/year of life saved (19% of South Africa's per capita gross domestic product); the ICER for the birth and 6 weeks strategy versus the 6 weeks alone strategy was $2900/year of life saved (45% of South Africa's per capita gross domestic product). Increasing the proportion of caregivers who receive test results and the linkage of HIV-positive infants to antiretroviral therapy with the 6 weeks alone strategy improved survival more than adding a second test.Conclusions:  EID at birth and 6 weeks improves outcomes and is cost-effective, compared with EID at 6 weeks alone. If scale-up costs are comparable, programs should add birth testing after strengthening 6-week testing programs. [ABSTRACT FROM AUTHOR]

Over 90% of deaths attributable to malaria are in African children under 5 years old. Yet, new treatments are often tested primarily in adult patients and extrapolations have proven to be sometimes invalid, especially in dosing regimens. For studies in severe malaria an additional complication is that the decline in severe malaria in adult patients precludes sufficiently powered trials in adults, before the intervention can be tested in the ultimate target group, paediatric severe malaria. In this paper we propose an alternative pathway to the development of drugs for use in paediatric severe malaria. We argue that following the classical phase I and II studies, small safety and efficacy studies using well-chosen surrogate endpoints in adult severe malaria be conducted, instead of larger mortality endpoint trials. If the drug appears safe and promising small pilot studies in paediatric severe malaria using the same endpoints can follow. Finally, with carefully observed safeguards in place to ensure high ethical standards, promising candidate interventions can be taken forward into mortality endpoint, well-powered, large paediatric studies in African children with severe malaria. Given the available research capacity, limited numbers of prudently selected interventions can be studied in phase III trials, and adaptive designs should be considered. [ABSTRACT FROM AUTHOR]

Planned changes to land use in West Africa have been proposed to both combat desertification and to preserve biodiversity in the region, however, there is an urgent need for tools to assess the effects of these proposed changes on local and regional scale precipitation. We use a high-resolution, convection-permitting numerical weather prediction (NWP) model to study how the initiation and propagation of mesoscale convective systems (MCS) depends on the surface vegetation cover. The simulations covered a 4-day period during the West African monsoon in August 2006. In many aspects of the simulations, there was evidence of vegetation type exerting a significant influence on the location of precipitation where the influence of orography and coastal water was minimal. In this study, vegetation was classified according to the fractional coverage of tree (>30%) and grass (>30%) plant functional types. Tree-grass boundary cover was defined where more than 3 grid cells of both tree and grass occurred in a moving 3 × 3 window, which was further enlarged using a 3 grid cell (∼12 km) buffer. We found that over the whole study region (5N to 17N and 11W to 9E) 33.8% of convective initiations occur over tree-grass boundaries that cover only 28.4% of the land surface. This is significantly more than would be expected by chance (p = 0.0483), providing support to the hypothesis that vegetation gradients provide heat and moisture gradients, of a similar magnitude to that of soil moisture. Additionally, we found that on average, more time under an MCS occurred over boundary cover and orography, followed by tree cover, during the afternoon and evening period, thus supporting the hypothesis that land cover type influences the location of larger propagating systems. Contrasting patterns were found in the quantity of precipitation between small-scale convective cells and larger scale MCS. More small-scale precipitation accumulated, on average, over grass cover during the afternoon period, indicating a tendency for small-scale convection, initiated over boundaries, to prefer the drier and warmer grass side of vegetation boundaries in the afternoon period. However, once these smaller scale convective cells merge together to form larger MCS, a tendency for the most intense precipitation to fall over tree cover was observed. When intense precipitation (>10 mm per hour) occurred simultaneously over tree, boundary and grass cover, we found the highest precipitation rate to be most frequently over tree cover (48.4%), and least frequently over boundary cover (19.9%), indicating a preference of MCS for cooler, more moist forest cover. These results show for the first time that convection-permitting NWP models do exhibit responses to vegetation similar to those observed in the real world, and therefore are useful tools to assess the impacts of proposed future land use changes. [ABSTRACT FROM AUTHOR]

Background: Community engagement, incorporating elements of the broader concepts of public and stakeholder engagement, is increasingly promoted globally, including for health research conducted in developing countries. In sub-Saharan Africa, community engagement needs and challenges are arguably intensified for studies involving gay, bisexual and other men who have sex with men, where male same-sex sexual interactions are often highly stigmatised and even illegal. This paper contextualises, describes and interprets the discussions and outcomes of an international meeting held at the Kenya Medical Research Institute-Wellcome Trust in Kilifi, Kenya, in November 2013, to critically examine the experiences with community engagement for studies involving men who have sex with men.Discussion: We discuss the ethically charged nature of the language used for men who have sex with men, and of working with 'representatives' of these communities, as well as the complementarity and tensions between a broadly public health approach to community engagement, and a more rights based approach. We highlight the importance of researchers carefully considering which communities to engage with, and the goals, activities, and indicators of success and potential challenges for each. We suggest that, given the unintended harms that can emerge from community engagement (including through labelling, breaches in confidentiality, increased visibility and stigma, and threats to safety), representatives of same-sex populations should be consulted from the earliest possible stage, and that engagement activities should be continuously revised in response to unfolding realities. Engagement should also include less vocal and visible men who have sex with men, and members of other communities with influence on the research, and on research participants and their families and friends. Broader ethics support, advice and research into studies involving men who have sex with men is needed to ensure that ethical challenges - including but not limited to those related to community engagement - are identified and addressed. Underlying challenges and dilemmas linked to stigma and discrimination of men who have sex with men in Africa raise special responsibilities for researchers. Community engagement is an important way of identifying responses to these challenges and responsibilities but itself presents important ethical challenges. [ABSTRACT FROM AUTHOR]

The article examines the practice of paying Lobola for a wife in contemporary South Africa. Topics covered include analysis of some of the problems associated with Lobola including the replacement of cattle with money which lead to the perception that the bride is the groom's property which makes the wives subject to abuse by her husband and in-laws, the connection between Lobola and the spread of sexually transmitted diseases, analysis of the place of traditions in South Africa and the opinion that Lobola as an African tradition should be respected and used as a means of uplifting women and helping them to build their self-esteem and self-worth.

Increased global sharing of public health research data has potential to advance scientific progress but may present challenges to the interests of research stakeholders, particularly in low-to-middle income countries. Policies for data sharing should be responsive to public views, but there is little evidence of the systematic study of these from low-income countries. This qualitative study explored views on fair data-sharing processes among 60 stakeholders in Kenya with varying research experience, using a deliberative approach. Stakeholders’ attitudes were informed by perceptions of benefit and concerns for research data sharing, including risks of stigmatization, loss of privacy, and undermining scientific careers and validity, reported in detail elsewhere. In this article, we discuss institutional trust-building processes seen as central to perceptions of fairness in sharing research data in this setting, including forms of community involvement, individual prior awareness and agreement to data sharing, independence and accountability of governance mechanisms, and operating under a national framework. [ABSTRACT FROM AUTHOR]

Monkeypox virus (MPXV) is the etiological agent of human (MPX). It is an emerging orthopoxvirus zoonosis in the tropical rain forest of Africa and is endemic in the Congo-basin and sporadic in West Africa; it remains a tropical neglected disease of persons in impoverished rural areas. Interaction of the human population with wildlife increases human infection with MPX virus (MPXV), and infection from human to human is possible. Smallpox vaccination provides good cross-protection against MPX; however, the vaccination campaign ended in Africa in 1980, meaning that a large proportion of the population is currently unprotected against MPXV infection. Disease control hinges on deterring zoonotic exposure to the virus and, barring that, interrupting person-to-person spread. However, there are no FDA-approved therapies against MPX, and current vaccines are limited due to safety concerns. For this reason, new studies on pathogenesis, prophylaxis and therapeutics are still of great interest, not only for the scientific community but also for the governments concerned that MPXV could be used as a bioterror agent. In the present study, a new vaccination strategy approach based on three recombinant bovine herpesvirus 4 (BoHV-4) vectors, each expressing different MPXV glycoproteins, A29L, M1R and B6R were investigated in terms of protection from a lethal MPXV challenge in STAT1 knockout mice. BoHV-4-A-CMV-A29LgD106ΔTK, BoHV-4-A-EF1α-M1RgD106ΔTK and BoHV-4-A-EF1α-B6RgD106ΔTK were successfully constructed by recombineering, and their capacity to express their transgene was demonstrated. A small challenge study was performed, and all three recombinant BoHV-4 appeared safe (no weight-loss or obvious adverse events) following intraperitoneal administration. Further, BoHV-4-A-EF1α-M1RgD106ΔTK alone or in combination with BoHV-4-A-CMV-A29LgD106ΔTK and BoHV-4-A-EF1α-B6RgD106ΔTK, was shown to be able to protect, 100% alone and 80% in combination, STAT1(-/-) mice against mortality and morbidity. This work demonstrated the efficacy of BoHV-4 based vectors and the use of BoHV-4 as a vaccine-vector platform. Author Summary: Human Monkeypox is a zoonotic neglected tropical disease, and the majority of human infections occur in the poor rural areas of central Africa. Human Monkeypox was discovered when the Smallpox vaccination campaign stopped, exposing the immunologically unprotected population to the risk of Monkeypoxvirus infection. Currently, no safe and efficacious vaccines for prevention of Monkeypox are available for an epidemic setting, and further studies are needed for the development of a safe and efficacious vaccine. In this study, safety and protection of three recombinant Bovine Herpesvirus 4-based vectors, each delivering a Monkeypox glycoprotein, was evaluated in a suitable mouse model. All three recombinants appeared safe, and one of them, delivering a single dose of Monkeypox M1R glycoprotein, protected 60% of mice against a lethal dose of Monkeypoxvirus; when given as a prime/boost, it afforded 100% protection. Although further investigation into other Monkeypox models, including non-human primate, is needed to assess bovine herpesvirus 4-based vector delivering M1R safety and protection, the findings of this work pave the way for the potential use of Bovine Herpesvirus 4-based vectors for other category A agents. [ABSTRACT FROM AUTHOR]

Background: Community engagement has been recognised as an important aspect of the ethical conduct of biomedical research, especially when research is focused on ethnically or culturally distinct populations. While this is a generally accepted tenet of biomedical research, it is unclear what components are necessary for effective community engagement, particularly in the context of genomic research in Africa. Methods: We conducted a review of the published literature to identify the community engagement strategies that can support the successful implementation of genomic studies in Africa. Our search strategy involved using online databases, Pubmed (National Library of Medicine), Medline and Google scholar. Search terms included a combination of the following: community engagement, community advisory boards, community consultation, community participation, effectiveness, genetic and genomic research, Africa, developing countries. Results: A total of 44 articles and 1 thesis were retrieved of which 38 met the selection criteria. Of these, 21 were primary studies on community engagement, while the rest were secondary reports on community engagement efforts in biomedical research studies. 34 related to biomedical research generally, while 4 were specific to genetic and genomic research in Africa. Conclusion: We concluded that there were several community engagement strategies that could support genomic studies in Africa. While many of the strategies could support the early stages of a research project such as the recruitment of research participants, further research is needed to identify effective strategies to engage research participants and their communities beyond the participant recruitment stage. Research is also needed to address how the views of local communities should be incorporated into future uses of human biological samples. Finally, studies evaluating the impact of CE on genetic research are lacking. Systematic evaluation of CE strategies is essential to determine the most effective models of CE for genetic and genomic research conducted in African settings. [ABSTRACT FROM AUTHOR]