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Fishing catch is often used as a cost in marine conservation planning to avoid areas of high fishing activity when identifying potential marine reserve locations. However, the theory of marine reserves indicates that reserves are more likely to benefit fisheries in areas of heavy fishing activity that would otherwise be overfished. Whether or not fishing catch is calculated as a cost depends on the balance of conservation and fisheries goals for a reserve, and thus is critical for policymakers to consider when designing marine reserve networks. This research shows the utility of running an inverted cost model of fishery catches during marine reserve spatial prioritization as a first step in a marine planning process oriented towards stabilizing local fisheries. This technique serves as a heuristic tool that may help conservation planners explore regions that would otherwise be overlooked if fisheries data were absent or integrated purely as a cost in the planning process. Drawing on data from Madagascar to illustrate our approach, this research demonstrates that the regions most frequently selected using the inverted cost model not only meet conservation targets, but are also those most accessible to community-based resource managers, the dominant management paradigm in Madagascar as well as in many developing countries.

Urbanization degrades natural habitats and creates new urban ecosystems like domestic gardens. The plant composition of these gardens varies with socio-economic factors and urban planning levels. However, the diversity and impact of introduced species are often poorly assessed, causing potential ecological imbalances (disruptions in the natural functioning and stability of ecosystems), particularly in Lubumbashi (DR Congo). The objective was to analyze the spatial structure, plant diversity, propagation strategies, and ecological functions of domestic gardens. Three distinct neighborhoods were selected: a planned, unplanned, and residential neighborhood. Twenty avenues (with five plots per avenue) were chosen to represent the diversity within each neighborhood, and stratified random sampling of plots was conducted to analyze gardening practices. Gardens were classified into types, and their vegetation was evaluated based on species origin and ecological impact. The analysis of domestic gardens in Lubumbashi reveals significant variations across different neighborhood types. Residential neighborhoods exhibit larger average garden sizes (315.1 m2), higher species richness (22 species), and larger plot sizes (1032 m2) compared to unplanned and planned neighborhoods, where garden areas and species richness are notably lower. Rectangular gardens dominate in unplanned areas, while planned neighborhoods feature more intentional landscaping elements, such as flowerbeds and hedges. The use of gardens for food production is prominent in planned areas (40.7%), whereas residential neighborhoods prioritize ornamentation (51.4%). The study identified 232 taxa across 68 families, with a predominance of exotic species (80%) in all neighborhoods, particularly in unplanned areas (82.25%). The data revealed that Mangifera indica and Persea americana are abundant in all neighborhoods, illustrating their adaptability to different urban contexts. Herbaceous species are most common, followed by woody plants, with vines being sparse. Species dispersal is primarily driven by human activities (anthropochory), accounting for over 85% in all neighborhoods. These findings highlight the strong human influence on the composition and structure of domestic gardens in Lubumbashi, emphasizing the dominance of exotic species and the importance of anthropogenic factors in shaping urban green spaces. Urban policies should incorporate strategies to minimize the negative impacts of exotic species on native flora.

The study examines the spatiotemporal dynamics of landscape anthropization in the Kiziba-Baluba Hunting Domain (KBHD), near Lubumbashi in southeastern Democratic Republic of Congo, facing increasing human threats. It assesses these dynamics from 1989 to 2023 using remote sensing, Geographic Information Systems (GIS), and landscape ecology principles. The results reveal a significant decrease in forest cover, declining from 70.33 % in 1989 to 26.22 % in 2023, with an annual deforestation rate of -1.84 %. This deforestation has led to the expansion of savannas (63.93 %), agriculture (5.76 %), and built-up and bare soil (0.93 %) through patch creation and aggregation. The level of landscape disturbance has increased sixfold over 34 years, from 0.42 in 1989 to 2.81 in 2023. The reduction in the size of the largest forest patch and increased spatial isolation show rising fragmentation and dissection, often followed by the attrition of residual patches. These findings highlight the inefficiency of current conservation measures in KBHD, indicating a need for restructuring management, redefining protected area boundaries, developing a suitable management plan, implementing reforestation programs, strengthening enforcement of environmental laws, and actively involving local communities.

This study examines the spatio-temporal dynamics of Acacia auriculiformis in Lubumbashi city, southeastern Democratic Republic of Congo, in the context of rapid urbanization following the liberalization of the mining sector. The city has experienced significant demographic growth and unplanned spatial expansion, resulting in a decrease in vegetation cover. The introduction and proliferation of A. auriculiformis, an exotic tree species, have occurred without strategic planning or monitoring. Utilizing digitized remote sensing imagery from 2006, 2014, and 2021, we quantified the expansion of A. auriculiformis along the urban–rural gradient. Additionally, a floristic inventory conducted in 2021 provided insights into tree diversity within A. auriculiformis plantations. Our findings indicate a substantial increase in the number and area of A. auriculiformis patches, predominantly in urban zones. However, the patch values, highest in 2006, were shown to decline by 2021, especially in urban areas. The floristic inventory identified 39 tree species within A. auriculiformis plantations, including predominant species such as Albizia lebbeck, Albizia alba, and Leucaena leucocephala. Notably, 20 of these species are exotic, with half being invasive. In contrast, the 19 indigenous species were primarily found in peri-urban areas. While a greater number of tree species were observed in urban zones, larger average diameters were recorded in peri-urban zones. The persistence and expansion of A. auriculiformis in a landscape characterized by declining tree cover suggest its potential sustainability in this setting. However, A. auriculiformis plantations have facilitated the establishment of predominantly exotic and potentially invasive species. These findings highlight the need for the strategic management of A. auriculiformis and associated exotic flora to mitigate their spread and to consider their role in the restoration of degraded lands.

Lualaba Province, located in the southeastern Democratic Republic of the Congo (DRC), consists of five territories with varied dominant land uses: agriculture (Dilolo, Kapanga, and Musumba in the west) and mining (Mutshatsha and Lubudi in the east). The province also includes protected areas with significant governance challenges. The tropical dry forests that cover the unique Miombo woodland of Lualaba are threatened by deforestation, which poses risks to biodiversity and local livelihoods that depend on these forests for agriculture and forestry. To quantify the spatio-temporal dynamics of Lualaba’s landscape, we utilized Landsat images from 1990 to 2024, supported by a Random Forest Classifier. Landscape metrics were calculated at multiple hierarchical levels: province, territory, and protected areas. A key contribution of this work is its identification of pronounced deforestation trends in the unique Miombo woodlands, where the overall woodland cover has declined dramatically from 62.9% to less than 25%. This is coupled with a marked increase in landscape fragmentation, isolation of remaining woodland patches, and a shift toward more heterogeneous land use patterns, as evidenced by the Shannon diversity index. Unlike previous research, our study distinguishes between the dynamics in agricultural territories—which are particularly vulnerable to deforestation—and those in mining areas, where Miombo forest cover remains more intact but is still under threat. This nuanced distinction between land use types offers critical insights into the differential impacts of economic activities on the landscape. Our study also uncovers significant deforestation within protected areas, underscoring the failure of current governance structures to safeguard these critical ecosystems. This comprehensive analysis offers a novel contribution to the literature by linking the spatial patterns of deforestation to both agricultural and mining pressures while simultaneously highlighting the governance challenges that exacerbate landscape transformation. Lualaba’s Miombo woodlands are at a critical juncture, and without urgent, coordinated intervention from local and international stakeholders, the ecological and socio-economic foundations of the region will be irreversibly compromised. Urgent action is needed to implement land conservation policies, promote sustainable agricultural practices, strengthen Miombo woodland regulation enforcement, and actively support protected areas.

In the context of the Lubumbashi Charcoal Production Basin (LCPB), the socio-economic repercussions of the COVID-19 pandemic have exacerbated pressures on populations dependent on forest resources for their subsistence. This study employs a comprehensive methodological approach, integrating advanced remote sensing techniques, including image classification, mapping, and detailed landscape analysis, to quantify alterations in forest cover within the LCPB during the pandemic period. Our findings reveal a consistent trend of declining forested area, characterized by processes of attrition and dissection observed throughout various study phases, spanning from May 2019 to November 2023. This reduction in forest cover, notably more pronounced in the vicinity of Lubumbashi city and the northern zone of the LCPB, proved to be less pronounced between November 2019 and September 2020, underscoring the influence of COVID-19 pandemic-induced confinement measures on forest management practices in the region. However, subsequent to this period of restriction, deforestation activity intensified, leading to significant landscape transformations within the LCPB, primarily attributable to expanded human activities, consequently resulting in a notable decrease in the proportion of land occupied by these natural ecosystems. Consequently, the size of the largest forest patch declined substantially, decreasing from 14.62% to 8.20% between May 2019 and November 2023, thereby fostering a heightened density of forest edges over time. Our findings provide a significant contribution to understanding the complex interactions between the COVID-19 pandemic and deforestation phenomena, emphasizing the urgent need to adopt adaptive management strategies and appropriate conservation measures in response to current economic challenges.

This study investigates the spatial urban growth patterns of cities along the Democratic Republic of the Congo (DRC) and Zambia border, a region of significant economic importance characterized by cross-border trade. This activity has led to rapid but unplanned urban growth. The objective is to quantify the spatial expansion of Congolese cities (Kipushi, Kasumbalesa, Mokambo, and Sakania) bordering Zambia and to evaluate associated landscape changes. The methodology of this study includes the supervised classification of Landsat images with a spatial resolution of 30 m for the years 1990, 2000, 2010, and 2023. This classification was validated using field data. Subsequently, landscape metrics such as class area, patch number, Shannon diversity index, disturbance index, urban expansion intensity index, largest patch index, and mean Euclidean distance were calculated for each city and each date. The results reveal substantial landscape transformations in the border cities between 1990 and 2023. These changes are primarily driven by rapid urban expansion, particularly pronounced in Kasumbalesa. Between 1990 and 2023, forest cover declined from 70% to less than 15% in Kipushi, from 80% to 10% in Kasumbalesa, from 90% to 30% in Mokambo, and from 80% to 15% in Sakania. This forest cover loss is accompanied by an increase in landscape element diversity, as indicated by the Shannon diversity index, except in Kipushi, suggesting a transition towards more heterogeneous landscapes. In these border cities, landscape dynamics are also characterized by the expansion of agriculture and savannas, highlighted by an increase in the disturbance index. Analysis of spatial pattern changes shows that built-up areas, agriculture, and savannas exhibit trends of patch creation or aggregation, whereas forests are undergoing processes of dissection and patch attrition. Congolese cities bordering Zambia are undergoing substantial spatial changes propelled by intricate interactions between economic, demographic, and infrastructural factors. Our results underscore the need for sustainable development strategies to address urban sprawl through smart growth policies and mixed-use developments, mitigate deforestation via stricter land use regulations and reforestation projects, and enhance cross-border cooperation through joint environmental management and collaborative research initiatives.

In the Lubumbashi charcoal production basin (LCPB) in Southeastern DR Congo, agricultural and charcoal production activities regularly give rise to fires that lead to considerable degradation of the miombo open forest. This study analyzes the drivers of the spatiotemporal distribution of active fires and burnt areas in the LCPB by processing MODIS and Landsat data. In addition, a kernel density analysis method (KDE) was used to estimate fire risk, while the effect of the road network and dwellings on vegetation fires was highlighted in areas between a 0 and 3000 m radius. The obtained results revealed that fires in the LCPB generally occur between April and November, mainly during the day, between 11 a.m. and 12 p.m. These fires are concentrated in the central and southwestern part of the LCPB, more specifically in the savannahs and near roads. From 2002 to 2022, an average of 11,237 active fires and an average of 6337 km2 of burnt areas were recorded in the LCPB. Each year, these fires peak in August, and despite their steady decline, the few fires that have affected the forests have caused more devastation (more than 2790 km2/year) than those observed in the fields and savannah. These figures highlight the imperative need to put in place fire prevention and management measures in the LCPB, with particular emphasis on awareness, monitoring, and fire-fighting measures.

In the Kundelungu National Park (KNP), southeast of the Democratic Republic of Congo, illicit human activities including recurrent bushfires contribute to constant regression of forest cover. This study quantifies the landscape dynamics and analyses the spatio-temporal distribution of bushfire occurrence within KNP. Based on classified Landsat images from 2001, 2008, 2015 and 2022, the evolutionary trend of land cover was mapped and quantified through landscape metrics. The spatial transformation processes underlying the observed landscape dynamics were identified based on a decision tree. Finally, the spatio-temporal fire risk assessment was carried out after defining the burnt areas for each year between 2001 and 2022. The obtained results, expressed by the process of dissection and attrition of patches, show that the forest cover has regressed from 2339 km2 to 1596 km2 within the PNK, with an annual deforestation rate varying from 0.8% to 3.4% between 2001 and 2022. Over the same period, the average distance between forest patches has increased significantly, indicating fragmentation and spatial isolation. On the other hand, savannahs as well as field and fallow mosaics have expanded within KNP through the creation of new patches. In addition, several active fires affected more savannahs between 2001 (70 km2 in Integral Zone, 239 km2 in Annex Zone and 309 km2 in KNP) and 2022 (76 km2 in Integral Zone, 744 km2 in Annex Zone and 819 km2 in KNP), limiting their capacity to evolve into forests. Overall, anthropogenic pressure is higher in the Annex Zone of the KNP. Illegal agricultural development and vegetation fires have thus doubled the level of landscape disturbance in 21 years. Our observations justify the need to strengthen protection measures for KNP by limiting repeated human intrusions.

The paper presents the methodology behind the statistical selection of input parameters using the example of spraying two cold-sprayed coatings. The Ti and Cr3C2-25(Ni20Cr)-Gr coatings were tested. Despite the large difference in the structure of these coatings, nanoindentation studies were carried out focusing on the nano hardness H and elastic modulus E. Based on the four input parameters and two output parameters, a 2-level factorial 2(k-p) experimental design was performed. The conducted analysis showed the significant influence of the spray distance on the H and E values in the case of the Ti coating. The input parameters of the spray distance and the type of carrier gas used turned out to be statistically significant in the case of the cermet coating. Taking into account the statistical analysis, the coatings were sprayed with modified values of the input parameters.

The uncontrolled logging of Pterocarpus tinctorius Welw. in the Kasenga territory in the southeast of the Democratic Republic of the Congo is of significant socioeconomic benefit, but above all, it is a threat to the stability of forest ecosystems. Based on Landsat images from 2009, 2013, 2017 and 2021, the landscape dynamics of the Kasomeno region in the Kasenga territory, a P. tinctorius exploitation area, was quantified using a mapping approach coupled with landscape ecology analysis tools. The results reveal a continuous loss of forest cover over all the periods studied, mostly between 2013 and 2017, primarily through the dissection of patches. Also, through the spatial process of attrition, the fields recorded a regressive dynamic between 2013–2017, a sign of abandonment of agricultural activity in favour of P. tinctorius illegal logging. These landscape dynamics are the consequences of strong anthropic activities in the study area, leading to an important spatial expansion of the savannah. Consequently, the level of landscape disturbance doubled from 0.8 to 1.7 between 2009 and 2021. Our results suggest that, without regulatory enforcement, illegal logging of P. tinctorius seriously compromises forest ecosystem health and household food security in the region.

Background: The number of human African trypanosomiasis (HAT) cases in the Democratic Republic of Congo (DRC) has significantly reduced, thanks to more effective drugs and screening tools and regular mass screening. However, this potentially jeopardizes HAT control activities, especially community engagement. Methods: We used an ecological model framework to understand how various factors shape communities’ knowledge, perceptions, and behavior in this low endemicity context. Community members, frontline health providers, and policymakers were consulted using an ethnographic approach. Results: Communities in endemic areas are knowledgeable about causes, symptoms, and treatment of HAT, but this was more limited among young people. Few are aware of new HAT treatment or screening techniques. Participation in mass screening has declined due to many factors including fear and a lack of urgency, given the low numbers of cases. Delays in seeking medical care are due to confusion of HAT symptoms with those of other diseases and belief that HAT is caused by witchcraft. Conclusions: Community members see their role more in terms of vector control than participation in screening, referral, or accepting treatment. We propose recommendations for achieving sustainable community engagement, including development of an information and communication strategy and empowerment of communities to take greater ownership of HAT control activities.

Background The research involved the evaluation of physical and mechanical properties of hydroxyapatite (HAp) bio-ceramics sprayed on titanium substrate of the type Ti-grade 2 (CP-Ti) by means of the plasma method. An innovative method of coating is applied when using implantology for healing bone defects in the body. Material and Methods Hydroxyapatite coating was prepared in order to conduct research. The powder was made using wet-chemical technology consisting in separating the solids from the solution. Next, a titanium substrate was prepared, onto which hydroxyapatite was applied with a plasma technique. Results As a result of the research it has to be noted that the properties of the obtained coating may be used for covering large surfaces of implants of any shape. Conclusions During the research into the physical and mechanical properties of hydroxyapatite composites it has been observed that they show sufficient mechanical properties to be used in implantology. The further aim of the research will involve selecting technological parameters of spray coating in order to increase adhesion and cohesion of HAp coatings. Med Pr 2018;69(6):651–661

Background: Human African trypanosomiasis caused by Trypanosoma brucei gambiense (gambiense HAT) in patients with late-stage disease requires hospital admission to receive nifurtimox-eflornithine combination therapy (NECT). Fexinidazole, the latest treatment that has been recommended by WHO, also requires systematic admission to hospital, which is problematic in areas with few health-care resources. We aim to assess the safety and efficacy of acoziborole in adult and adolescent patients with gambiense HAT., Methods: This multicentre, prospective, open-label, single-arm, phase 2/3 study recruited patients aged 15 years or older with confirmed gambiense HAT infection from ten hospitals in the Democratic Republic of the Congo and Guinea. Inclusion criteria included a Karnofsky score greater than 50, ability to swallow tablets, a permanent address or traceability, ability to comply with follow-up visits and study requirements, and agreement to hospital admission during treatment. Oral acoziborole was administered as a single 960 mg dose (3 × 320 mg tablets) to fasted patients. Patients were observed in hospital until day 15 after treatment administration then for 18 months as outpatients with visits at 3, 6, 12, and 18 months. The primary efficacy endpoint was the success rate of acoziborole treatment at 18 months in patients with late-stage gambiense HAT (modified intention-to-treat [mITT] population), based on modified WHO criteria. A complementary post-hoc analysis comparing the 18-month success rates for acoziborole and NECT (using historical data) was performed. This study is registered at ClinicalTrials.gov, NCT03087955., Findings: Between Oct 11, 2016, and March 25, 2019, 260 patients were screened, of whom 52 were ineligible and 208 were enrolled (167 with late-stage and 41 with early-stage or intermediate-stage gambiense HAT; primary efficacy analysis set). All 41 (100%) patients with early-stage or intermediate-stage and 160 (96%) of 167 with late-stage disease completed the last 18-month follow-up visit. The mean age of participants was 34·0 years (SD 12·4), including 117 (56%) men and 91 (44%) women. Treatment success rate at 18 months was 95·2% (95% CI 91·2-97·7) reached in 159 of 167 patients with late-stage gambiense HAT (mITT population) and 98·1% (95·1-99·5) reached in 159 of 162 patients (evaluable population). Overall, 155 (75%) of 208 patients had 600 treatment-emergent adverse events. A total of 38 drug-related treatment-emergent adverse events occurred in 29 (14%) patients; all were mild or moderate and most common were pyrexia and asthenia. Four deaths occurred during the study; none were considered treatment related. The post-hoc analysis showed similar results to the estimated historical success rate for NECT of 94%., Interpretation: Given the high efficacy and favourable safety profile, acoziborole holds promise in the efforts to reach the WHO goal of interrupting HAT transmission by 2030., Funding: Bill & Melinda Gates Foundation, UK Aid, Federal Ministry of Education and Research, Swiss Agency for Development and Cooperation, Médecins Sans Frontières, Dutch Ministry of Foreign Affairs, Norwegian Agency for Development Cooperation, Norwegian Ministry of Foreign Affairs, the Stavros Niarchos Foundation, Spanish Agency for International Development Cooperation, and the Banco Bilbao Vizcaya Argentaria Foundation., Translation: For the French translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests BS reports fees from the Drugs for Neglected Diseases initiative (DNDi) for the statistical report and consulting fees from CEMAG, D&A Pharma, Inventiva, and OT4B Pharma. WMK, SR, AP, OVM, NS-W, DNT, and AT report employment at the DNDi. SS declares that Swiss Tropical and Public Health Institute acted as a service provider for the DNDi by monitoring the study sites. All other authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Detection of spliced leader (SL)-RNA allows sensitive diagnosis of gambiense human African trypanosomiasis (HAT). We investigated its diagnostic performance for treatment outcome assessment., Methods: Blood and cerebrospinal fluid (CSF) from a consecutive series of 97 HAT patients, originating from the Democratic Republic of the Congo, were prospectively collected before treatment with acoziborole, and during 18 months of longitudinal follow-up after treatment. For treatment outcome assessment, SL-RNA detection was compared with microscopic trypanosome detection and CSF white blood cell count. The trial was registered under NCT03112655 in clinicaltrials.gov., Findings: Before treatment, respectively 94.9% (92/97; CI 88.5-97.8%) and 67.7% (65/96; CI 57.8-76.2%) HAT patients were SL-RNA positive in blood or CSF. During follow-up, one patient relapsed with trypanosomes observed at 18 months, and was SL-RNA positive in blood and CSF at 12 months, and CSF positive at 18 months. Among cured patients, one individual tested SL-RNA positive in blood at month 12 (Specificity 98.9%; 90/91; CI 94.0-99.8%) and 18 (Specificity 98.9%; 88/89; CI 93.9-99.8%)., Interpretation: SL-RNA detection for HAT treatment outcome assessment shows ≥98.9% specificity in blood and 100% in CSF, and may detect relapses without lumbar puncture., Funding: The DiTECT-HAT project is part of the EDCTP2 programme, supported by Horizon 2020, the European Union Funding for Research and Innovation (grant number DRIA-2014-306-DiTECT-HAT)., Competing Interests: Declaration of interests The authors have declared that no competing interests exist., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Fexinidazole has been reported as an effective oral monotherapy against non-severe gambiense human African trypanosomiasis in a recent trial in adults. We aimed to assess the safety and efficacy of fexinidazole in children across all disease stages of gambiense human African trypanosomiasis., Methods: We did a multicentre, single-arm, open-label, phase 2-3 trial at eight district hospitals in the Democratic Republic of the Congo. We recruited children with a Karnofsky score of more than 50, those aged 6 years to younger than 15 years, weighing 20 kg or more, and with confirmed gambiense human African trypanosomiasis (any stage). Children weighing 20 kg or more and less than 35 kg received oral fexinidazole of 1200 mg (two × 600 mg tablets) once per day for 4 days (days 1-4) followed by 600 mg (one × 600 mg tablet) once per day for 6 days (days 5-10). Children weighing 35 kg or more received oral fexinidazole of 1800 mg (three × 600 mg tablets) once per day for 4 days (days 1-4), followed by 1200 mg (two × 600 mg tablets) once per day for 6 days (days 5-10). The primary endpoint was fexinidazole treatment success rate 12 months after end of treatment. A rate greater than 80% was deemed acceptable and a target value of 92% was aimed for. Safety was assessed through routine monitoring. This study is completed and registered with ClinicalTrials.gov, number NCT02184689., Findings: Between May 3, 2014, and Nov 22, 2016, we screened a total of 130 paediatric patients, of whom 125 (96%) received at least one dose of fexinidazole. All 125 patients (69 [55%] patients with stage 1, 19 [15%] with early stage 2, and 37 [30%] with late stage 2 gambiense human African trypanosomiasis) completed the 10-day treatment. Treatment success rate at 12 months was 97·6% (95% CI 93·1-99·5; 122 of 125 patients). The primary endpoint was met and the targeted value of 92% was exceeded. Treatment success at 12 months was elevated across all disease stages: 98·6% (95% CI 92·2-99·9; 68 of 69 patients) in stage 1, 94·7% (74·0-99·9; 18 of 19 patients) in early stage 2, and 97·3% (85·8-99·9; 36 of 37 patients) in late stage 2 gambiense human African trypanosomiasis. No new safety issues were observed beyond those found in adult trials. Overall, 116 (93%) of 125 patients reported 586 treatment-emergent adverse events, mainly mild or moderate. The most frequently reported treatment-emergent adverse events of interest during hospital admission were vomiting (86 [69%] of 125) and headache (41 [33%]). Seven (6%) of 125 patients had severe malaria, which was often accompanied by anaemia that was unrelated to fexinidazole. One patient died following dyspnoea and injury due to traumatic aggression 172 days after end of treatment, which was considered unrelated to fexinidazole or gambiense human African trypanosomiasis., Interpretation: Oral fexinidazole is a safe and effective first-line treatment option across all gambiense human African trypanosomiasis disease stages in paediatric patients., Funding: Through the Drugs for Neglected Diseases initiative: the Bill & Melinda Gates Foundation (USA), the Republic and Canton of Geneva (Switzerland), the Dutch Ministry of Foreign Affairs (Netherlands), the Norwegian Agency for Development Cooperation (Norway), the Federal Ministry of Education and Research through KfW (Germany), the Brian Mercer Charitable Trust (UK), and other private foundations and individuals from the human African trypanosomiasis campaign., Translation: For the French translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests BS reports personal fees from Drugs for Neglected Diseases initiative (DNDi) during the conduct of the study and personal fees from DNDi outside the submitted work. WMK, CB, OVM, SBl, FS, SD, NS-W, and AT report employment at DNDi. All other authors declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

This study determines the prevalence of shea butter tree attack by the African mistletoe and stem borers, explores statistical relationship between prevalence, land use and tree morphological traits. In a the Bohicon shea parklands in Benin, a total of 258 shea butter trees was examined and measured in ten inventory plots in fallows, ten inventories plot in savannah, and ten inventory plots in cropped fields (Agroforestry systems). The classic inference was used to estimate the prevalence of shea trees attacks and Generalized Linear Models (GLMs) of the Binomial and Beta families were used, respectively, to model the relationship between the morphological traits and the attack risk, and the relationship between the land uses and the prevalence. The overall prevalence of pest attack in shea butter trees was 28.7% (CI = 23.3-34.7%), with a prevalence of African mistletoe of 24.8% (CI = 19.7-30.5%) and stem borers had attacked 6.2% (CI = 3.6-9.9%). These prevalence rates are lower than what has been reported from other sites before., Competing Interests: The authors declare no conflict of interest.

Background: Spliced Leader (SL) trypanosome RNA is detectable only in the presence of live trypanosomes, is abundant and the Trypanozoon subgenus has a unique sequence. As previously shown in blood from Guinean human African trypanosomiasis (HAT) patients, SL-RNA is an accurate target for diagnosis. Detection of SL-RNA in the cerebrospinal fluid (CSF) has never been attempted. In a large group of Congolese gambiense HAT patients, the present study aims i) to confirm the sensitivity of SL-RNA detection in the blood and; ii) to assess the diagnostic performance of SL-RNA compared to trypanosome detection in CSF., Methodology/principal Findings: Blood and CSF from 97 confirmed gambiense HAT patients from the Democratic Republic of Congo were collected using PAXgene blood RNA Tubes. Before RNA extraction, specimens were supplemented with internal extraction control RNA to monitor the extraction, which was performed with a PAXgene Blood RNA Kit. SL-RNA qPCR was carried out with and without reverse transcriptase to monitor DNA contamination. In blood, 92/97 (94.8%) HAT patients tested SL-RNA positive, which was significantly more than combined trypanosome detection in lymph and blood (78/97 positive, 80.4%, p = 0.001). Of 96 CSF RNA specimens, 65 (67.7%) were SL-RNA positive, but there was no significant difference between sensitivity of SL-RNA and trypanosome detection in CSF. The contribution of DNA to the Cq values was negligible. In CSF with normal cell counts, a fraction of SL-RNA might have been lost during extraction as indicated by higher internal extraction control Cq values., Conclusions/significance: Detection of SL-RNA in blood and CSF allows sensitive demonstration of active gambiense HAT infection, even if trypanosomes remain undetectable in blood or lymph. As this condition often occurs in treatment failures, SL-RNA detection in blood and CSF for early detection of relapses after treatment deserves further investigation., Trial Registration: This study was an integral part of the diagnostic trial "New Diagnostic Tools for Elimination of Sleeping Sickness and Clinical Trials: Early tests of Cure" (DiTECT-HAT-WP4, ClinicalTrials.gov Identifier: NCT03112655)., Competing Interests: The authors have declared that no competing interests exist.

Background: Epignathus is a rare, benign, congenital teratoma of the hard palate with an estimated incidence of 1 in 200,000 live births. Epignathus frequently leads to a high mortality (80-100%) due to airway obstruction in the neonatal period., Case Presentation: We report a case of successful management of a rare oropharyngeal teratoma in a African newborn girl who was referred to our institute with a large protruding intraoral mass, combined with cleft palate, causing some respiratory compromise. The palatal mass was removed on the fifth day after birth, and a palatoplasty performed on day 30., Conclusion: Epignathus is a life-threatening condition at the time of delivery. Appropriate management begins with securing the airway, followed by complete resection of the tumor., (© 2021. The Author(s).)

Introduction: Universal Health Coverage (UHC) has engaged attention of policy makers at both global and country levels. UHC is one of three strategic priorities of World Health Organization's (WHO) general program of work for 2019-2023, and it is then a global health priority. Rwanda Community-Based Health Insurance is considered the vehicle for UHC and Universal Health Insurance in Rwanda. CBHI was officially introduced in 1999/2000 and through 2011/2012 Rwanda was not far from effective UHC. However, since then, CBHI faced chronic financial deficit. This study aims to assess challenges facing Community-Based Health Insurance financial sustainability and to propose indicative solutions., Methods: quantitative, qualitative, analytical, longitudinal (2011-2018) and documentary mixed methods were applied. One National Pooling Risk (100%), 15 Community-Based Health Insurance districts (50%) and 60 Community Based Health Insurance sections (13.33%) were randomly selected and included in the study. To assess major challenges, "analyzing qualitative data G3658-6 approach" and "prioritization hanlon method" were used., Results: the study highlighted five major challenges: (i) disproportionate risk-equalization in the social health insurance contributory system; (ii) unit cost exceeding individual income (premium plus other revenues and subsidies); (iii) imperfection in funding mobilization and recovery; (iv) cost-escalation; (v) diseconomy of scale; and the study proposed indicative solutions including injection of additional funding and shifting from current fee-for-service payment to fully active strategic purchasing mechanisms as accompanying measures., Conclusion: CBHI financial sustainability is achievable, but this is contingent upon persistence of political commitment efforts to achieve UHC, correction of highlighted imperfections and injection of additional funding to allow Rwanda Community-Based Health Insurance to meet and/or exceed its cost in the long-term., Competing Interests: The authors declare no competing interests., (Copyright: Médard Nyandekwe et al.)

Cassava fields were prospected from two provinces of the Democratic Republic of Congo (Ituri and Haut Uélé) to evaluate the ampleness of Cassava brown streak disease (CBSD) infection. CBSD pressure was determined by assessing the incidence, severity, whitefly abundance and distribution of the disease viruses in the surveyed provinces. A duplex RT-PCR was performed for the simultaneous detection of Ugandan Cassava brown streak virus (UCBSV) and Cassava brown streak virus (CBSV) on 56 cassava leaves sampled in the study area. Our results show a high field CBSD incidence contrasted to a low severity in both provinces. CBSD severity was similar in both provinces (mean disease severity 2). High densities of whitefly were recorded in Ituri province (10 adult whiteflies plant -1 ) than in Haut Uélé where density was 5 adults plant -1 . However, no relation has been found between whitefly density and CBSD incidence and severity on cassava leaf, root and stems. Molecular analysis showed the incidence of single infections of UCBSV was greater than single infections of CBSV and mixed infections of UCBSV and CBSV. Disease incidence was greater in Ituri than in Haut Uélé; molecular incidence was lower than field incidence. Our results raise the need for appropriate CBSD control strategies in DRC., Competing Interests: Competing interestsThe authors declare no competing interests.The authors declare that they have no conflicts of interest with the contents of this article., (© 2020 The Author(s). This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.)

Competing Interests: The authors declare no competing interests.

The 'Plantain-Optim' dataset (came from the 'Plantain-Optim' experiment conducted from 2009 to 2011 at CARBAP experimental station in Cameroon. The main objective was to describe agronomic potential of nine plantain varieties, including five natural plantains commonly cropped in Cameroon, and four plantain-like hybrids. A completely randomized bloc permitted to compare growth, development and yield of 45 plants per variety split between five replicates. Cropping practices guarantied non-limiting and homogenous conditions. Each plant was measured every 15 days. Data described aerial organ sizes, foliar structure and bunch characteristics of the mother plant. The 'Plantain-Optim' dataset includes the complete individual growth of each studied plantain of the 'Plantain-Optim' experiment with a 15-day accuracy. It is a useful standard of plantain varietal diversity for comparison with others datasets. Varietal growth and development homogeneity, biomass production or foliar and bunch structures could be further investigated. Moreover, these accurate data on plantain growth could be valuable for plantain 3D modelling.

Background: Few therapeutic options are available to treat the late-stage of human African trypanosomiasis, a neglected tropical disease, caused by Trypanosoma brucei gambiense (g-HAT). The firstline treatment is a combination therapy of oral nifurtimox and intravenous eflornithine that needs to be administered in a hospital setting by trained personnel, which is not optimal given that patients often live in remote areas with few health resources. Therefore, we aimed to assess the safety and efficacy of an oral regimen of fexinidazole (a 2-substituted 5-nitroimidazole with proven trypanocidal activity) versus nifurtimox eflornithine combination therapy in patients with late-stage g-HAT., Methods: In this randomised, phase 2/3, open-label, non-inferiority trial, we recruited patients aged 15 years and older with late-stage g-HAT from g-HAT treatment centres in the Democratic Republic of the Congo (n=9) and the Central African Republic (n=1). Patients were randomly assigned (2:1) to receive either fexinidazole or nifurtimox eflornithine combination therapy according to a predefined randomisation list (block size six). The funder, data management personnel, and study statisticians were masked to treatment. Oral fexinidazole was given once a day (days 1-4: 1800 mg, days 5-10: 1200 mg). Oral nifurtimox was given three times a day (days 1-10: 15 mg/kg per day) with eflornithine twice a day as 2 h infusions (days 1-7: 400 mg/kg per day). The primary endpoint was success at 18 months (ie, deemed as patients being alive, having no evidence of trypanosomes in any body fluid, not requiring rescue medication, and having a cerebrospinal fluid white blood cell count ≤20 cells per μL). Safety was assessed through routine monitoring. Primary efficacy analysis was done in the modified intention-to-treat population and safety analyses in the intention-to-treat population. The acceptable margin for the difference in success rates was defined as 13%. This study has been completed and is registered with ClinicalTrials.gov, number NCT01685827., Findings: Between October, 2012, and November, 2016, 419 patients were pre-screened. Of the 409 eligible patients, 14 were not included because they did not meet all inclusion criteria (n=12) or for another reason (n=2). Therefore, 394 patients were randomly assigned, 264 to receive fexinidazole and 130 to receive nifurtimox eflornithine combination therapy. Success at 18 months was recorded in 239 (91%) patients given fexinidazole and 124 (98%) patients given nifurtimox eflornithine combination therapy, within the margin of acceptable difference of -6·4% (97·06% CI -11·2 to -1·6; p=0·0029). We noted no difference in the proportion of patients who experienced treatment-related adverse events (215 [81%] in the fexinidazole group vs 102 [79%] in the nifurtimox eflornithine combination therapy group). Treatment discontinuations were unrelated to treatment (n=2 [1%] in the fexinidazole group). Temporary nifurtimox eflornithine combination therapy interruption occurred in three (2%) patients. 11 patients died during the study (nine [3%] in the fexinidazole group vs two [2%] in the nifurtimox eflornithine combination therapy group)., Interpretation: Our findings show that oral fexinidazole is effective and safe for the treatment of T b gambiense infection compared with nifurtimox eflornithine combination therapy in late-stage HAT patients. Fexinidazole could be a key asset in the elimination of this fatal neglected disease., Funding: Drugs for Neglected Diseases initiative., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Discharge of wastewater leading to notable soil surface contamination is widely reported. But few works highlight the fast dynamics of soils and their morphological transformations that may result from such anthropogenic activities. Near Paris (France), sandy Luvisols were irrigated with urban wastewater since the 1890s. Within and outside the discharge area, the soil cover presents decameter-sized cryogenic structures. We studied macro morphological soil characteristics, soil chemistry and clay mineralogy on selected bulk samples, as well as contemporary pedofeatures and related metal pollutant distribution patterns in soil thin sections from subsurface horizons. Annual repetitive waterlogging and drying cycles initiated a hydromorphic soil forming process: ferrolysis, based on iron reduction producing alkalinity under anaerobic conditions, and iron oxidation producing acidity in aerobic conditions. Its intensity was enhanced at the top of thick clay-rich B-horizons in the center of cryogenic structures. The polygonal soil structure favored the evacuating of soil water and alkalinity. Within one century, such recurrent alternating redox conditions have led to clay destruction, removal of iron, strong bleaching of the E horizon and formation of abiotic Fe-rich pedofeatures at depth. In addition, between anaerobic clay-rich B and aerated E or C horizons, the contrasting hydrodynamic conditions enhanced manganese (Mn) oxidizing fungal activity and the formation of biotic Mn-rich pedofeatures. Both types of pedofeatures trapped metal pollutants in deep soil horizons. In our work, the impacts of centenary anthropogenic activity were amplified by millenary cryogenic structures, acting together to promote fast soil dynamics, within a few decades., (Copyright © 2017 Elsevier B.V. All rights reserved.)

There are three dominant contributing factors that distort short tandem repeat profile measurements, two of which, stutter and variations in the allelic peak heights, have been described extensively. Here we characterise the remaining component, baseline noise. A probabilistic characterisation of the non-allelic noise peaks is not only inherently useful for statistical inference but is also significant for establishing a detection threshold. We do this by analysing the data from 643 single person profiles for the Identifiler Plus kit and 303 for the PowerPlex 16 HS kit. This investigation reveals that although the dye colour is a significant factor, it is not sufficient to have a per-dye colour description of the noise. Furthermore, we show that at a per-locus basis, out of the Gaussian, log-normal, and gamma distribution classes, baseline noise is best described by log-normal distributions and provide a methodology for setting an analytical threshold based on that deduction. In the PowerPlex 16 HS kit, we observe evidence of significant stutter at two repeat units shorter than the allelic peak, which has implications for the definition of baseline noise and signal interpretation. In general, the DNA input mass has an influence on the noise distribution. Thus, it is advisable to study noise and, consequently, to infer quantities like the analytical threshold from data with a DNA input mass comparable to the DNA input mass of the samples to be analysed., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Background: The present study is one of the first to provide a picture of antimicrobial resistance for a range of bacteria and antimicrobial classes in Gabon, Central Africa., Methods: During the year 2010, 146 urine cytology, 143 blood cultures, 107 vaginal swabs, 23 urethral swabs, and 18 other culture examinations were positives. All isolates were tested for antibiotic sensitivity., Results: Four hundred thirty-seven microorganisms were isolated: 210 enterobacteria, 166 staphylococci, 38 streptococci, 14 Acinetobacter, and nine Stenotrophomonas. Of the Klebsiella isolates, 18% and 30% were found to be resistant to selected third-generation cephalosporins (3CG) and fourth-generation cephalosporins (4CG), respectively. Sixty-seven percent of Escherichia coli isolates were resistant to amoxicillin with clavulanic acid. Between 3% and 30% of E. coli isolates were resistant to selected 3CG. All Enterobacter cloacae isolates were sensitive to imipenem. Resistance to quinolones/fluoroquinolones was seen in 21-50% of E. coli isolates. Twenty-six percent of E. cloacae showed resistance to ceftazidime and 37% to cefotaxime. The resistance rate to quinolones ranged between 58% and 78%. Thirty-two percent of Staphylococcus isolates were resistant to gentamicin. Low resistance rates to teicoplanin (2-4%) were observed. Thirty-seven percent of isolated Staphylococcus aureus and 61% of isolated Staphylococcus saprophyticus were resistant to both penicillin G and oxacillin. Streptococcus isolates had low resistance rates to erythromycin, ceftriaxone, and ciprofloxacin (5%, 7%, and 14%, respectively) and were highly resistant to tetracycline, gentamicin, and sulfamethoxazole-trimethoprim (92%, 91%, and 62%, respectively)., Conclusions: The antimicrobial resistance profiles seen here are of concern. To control the spread of drug-resistant bacteria, clinicians should be cognizant of their local antimicrobial resistance patterns., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Universal Health Coverage (UHC) has been a global concern for a long time and even more nowadays. While a number of publications are almost unanimous that Rwanda is not far from UHC, very few have focused on its financial sustainability and on its extreme external financial dependency. The objectives of this study are: (i) To assess Rwanda UHC based mainly on Community-Based Health Insurance (CBHI) from 2000 to 2012; (ii) to inform policy makers about observed gaps for a better way forward., Methods: A retrospective (2000-2012) SWOT analysis was applied to six metrics as key indicators of UHC achievement related to WHO definition, i.e. (i) health insurance and access to care, (ii) equity, (iii) package of services, (iv) rights-based approach, (v) quality of health care, (vi) financial-risk protection, and (vii) CBHI self-financing capacity (SFC) was added by the authors., Results: The first metric with 96,15% of overall health insurance coverage and 1.07 visit per capita per year versus 1 visit recommended by WHO, the second with 24,8% indigent people subsidized versus 24,1% living in extreme poverty, the third, the fourth, and the fifth metrics excellently performing, the sixth with 10.80% versus ≤40% as limit acceptable of catastrophic health spending level and lastly the CBHI SFC i.e. proper cost recovery estimated at 82.55% in 2011/2012, Rwanda UHC achievements are objectively convincing., Conclusion: Rwanda UHC is not a dream but a reality if we consider all convincing results issued of the seven metrics.

Recognizing direct relationships between variables connected in a network is a pervasive problem in biological, social and information sciences as correlation-based networks contain numerous indirect relationships. Here we present a general method for inferring direct effects from an observed correlation matrix containing both direct and indirect effects. We formulate the problem as the inverse of network convolution, and introduce an algorithm that removes the combined effect of all indirect paths of arbitrary length in a closed-form solution by exploiting eigen-decomposition and infinite-series sums. We demonstrate the effectiveness of our approach in several network applications: distinguishing direct targets in gene expression regulatory networks; recognizing directly interacting amino-acid residues for protein structure prediction from sequence alignments; and distinguishing strong collaborations in co-authorship social networks using connectivity information alone. In addition to its theoretical impact as a foundational graph theoretic tool, our results suggest network deconvolution is widely applicable for computing direct dependencies in network science across diverse disciplines.