Central African Republic Research Articles

Reaching Forest Workers with Yellow Fever Vaccine Through Engagement of the Private Sector in Central African Republic

Background/Objectives: Yellow fever (YF) outbreaks continue to affect populations that are not reached by routine immunization services, such as workers at a high risk of occupational exposure to YF. In the Central African Republic (CAR), YF cases were detected in districts characterized by the presence of workers in forest areas. We developed an innovative approach based on a local partnership with private companies of the extractive industry to administer YF vaccine to workers in remote areas during the response to an outbreak. Methods: The planning stage of the campaign included the mapping of forestry and mining companies through the involvement of national and/or local representatives of companies from both the formal and informal sectors. Information sessions and mobilization targeted the heads of operating companies. Advanced and mobile strategies were used to target workers on their work site. Companies provided logistical support including transportation and communication and set up temporary vaccination posts. Results: Using this local partnership, it was possible to vaccinate over 70,000 workers (5.8% of the entire vaccinated population) in hard-to-reach areas, protecting them from YF. This represented around 47% of the estimated number of workers and dependents. The partnership with the private sector also contributed to increasing knowledge on the risk of YF and means of protection among a high-risk community. Conclusions: Private companies represent potentially useful actors that can contribute to the protection of high-risk workers and to the prevention and control YF outbreaks. The experience in the CAR has demonstrated that it is possible to obtain support from private companies, including informal ones, for a vaccination campaign.

Malaria parasite burden and heterogeneity of risk factors among Central African Republic refugees: a cross-sectional study in the Gado-Badzere refugee camp in Eastern Cameroon

BackgroundRefugees are vulnerable populations especially in malaria endemic areas where the disease claims many lives and constitutes an emerging challenge for humanitarian response. This study assessed how the influx and settlement of Central African Republic (CAR) refugees influences malaria burden in the Gado-Badzere refugee camp, Eastern Cameroon.MethodsA cross-sectional malariometric survey was conducted between November 2022 and October 2023 in 324 households comprising 1,304 individuals aged 1 month and above. Malaria parasite burden was determined using rapid diagnostic tests (RDTs) and Giemsa-stained microscopy. Demographic characteristics, malaria risk factors, treatment-seeking behaviors and costs to cure malaria were assessed using semi-structured questionnaires.ResultsOf the 1,304 participants, 525 (40.3%) were malaria parasite positive with moderate geometric mean parasite density (GMPD) of 1100 parasites/μl of blood. Plasmodium falciparum was the main species (99.8%), with mixed P. vivax infections (0.2%). Insecticide treated net (ITN) ownership was 53.7%, but its utilization was significantly low (22.4%) (P < 0.001). Reason for no ITN ownership was net damaged (74.7%). Net insufficiency (77.8%) accounted for non-frequent ITN use. Mean expenditure to treat malaria in the hospital was higher (USD 13.64 ± 8.67) than auto-medication (USD 1.13 ± 1.18). Significantly, malaria parasite prevalence and risk were higher for 0-5 years age (43.7%, OR = 1; P = 0.02), residents of sector 8 (49.2%, OR = 2.53; P < 0.001) of the camp, non-frequent ITN users (41.7%, OR = 2.08; P < 0.001), people living around stagnant water (44.4%, OR = 1.55; P < 0.001) and during the rainy season (43.5%, OR = 1.31; P = 0.02). The GMPD/µl was significantly higher in the 0-5 years age group (1456, P < 0.0001), inhabitants of sector 9 (1626, P = 0.04) and participants living around stagnant water (2097, P = 0.01).ConclusionThe malaria burden in CAR refugees may represent the reservoir for malaria transmission, especially with the circulation of P. vivax. The improper use of ITNs could be ameliorated through sensitization. Seasonal chemoprevention mainly during the rainy season and Indoor Residual Spraying (IRS) might be implemented for effective malaria control in refugee settings.

Retention on antiretroviral therapy and drivers of lost-to-follow up in the Central African Republic: a longitudinal analysis.

The retention in care of patients undergoing antiretroviral therapy (ART) is a cornerstone for preventing AIDS-associated morbidity and mortality, as well as further transmission of HIV. Adherence to ART poses particular challenges in conflict-affected settings like the Central African Republic (CAR). The study objective was to estimate the rate of lost-to-follow-up (LTFU) and determine factors associated with LTFU among patients living with HIV under ART in CAR. A retrospective cohort analysis was conducted using data from patients being managed at 42 representative ART dispensing sites (i.e. management of ≥200 patients) in the seven health regions of CAR which started ART between January 2019 to September 2021 and followed up to December 2021. The outcome of LTFU was defined as a failure of a patient to attend a scheduled ART refill appointment for at least 90 days from the last appointment. Patients were censored at the first LTFU event. A total of 6844 patients enrolled in ART care were included in the analysis, of whom 67.5% were females. The mean age (standard deviation) was 35.3 years (10.5). Forty-two per cent (n = 2874/6844) had an LTFU event during the follow-up period. However, 23.2% (n = 666/2874) returned to care after LTFU. Overall retention in antiretroviral care at 12 months was 64.2% (CI 63.0-65.5), which ranged from 76.1% in the capital to 48.2% in the inner country region. Risk factors related to LTFU were being male (adjusted hazard ratio [aHR] 1.33; CI 1.1-1.5), age < 25 (aHR 1.46; CI 1.1-1.9), living in regions outside the capital (aHR 1.83; CI 1.6-2.3) and undernutrition (aHR 1.13; CI 1.0-1.3). Retention to care in CAR is suboptimal, especially in the inner country. Our results underline the difficulties involved in retaining patients in ART in complex settings, the interplay between poor retention, social unrest, stigma, food insecurity and HIV epidemic control, and the need for tailored programming and interventions like differentiated treatment strategies and complementary food provision.

Global Genepool Conservation and use Strategy for Dioscorea (YAM)

The global genepool conservation and use strategy for yam were developed in this study. Diversity analysis, and in situ and ex situ conservation gap analyses were carried out for the 27 global priority yam crop wild relatives (CWR) at taxon and ecogeographic levels to determine their representativeness in conservation actions. Hotspots were found in Nzerekore region of Guinea, Nimba and Grand Gedeh regions of Liberia, Montagnes, Sassandra- Marahouse, and Bas – Sassandra regions of Cote d’Ivoire, Volta, Greater Accra and Eastern regions of Ghana, Centrale and Plateau regions of Togo, Donga, Oueme, Atlantique, Littoral and Plateau provinces of Benin, Southwest zone of Nigeria, Es region of Cameroon, Sangha- Mbaere region of Central Africa Republic. Likouala and Sangha regions of the Republic of the Congo, Northeast of India, Northern, Central, Western, Eastern and Northeast regions of Thailand, West of Cambodia, South Central Coast, Central Highlands, Southeast and Makong River Delta regions of Vietnam, Xaisomboun, Bolikhamxai, and Viangchan prefecture provinces of Lao People’s Democratic Republic. A total of 13 potential reserve sites were identified in 13 countries, with four locations in the network of protected area (PA). 22 priority CWR (81%) were conserved ex situ, but only 15.38% of the taxa had at least 50 accessions in genebanks, and 65.38% of the priority CWR are underrepresented in genebanks, and 19.23% of the species are not represented in ex situ collections. The findings and recommendations of this study will guide the production and implementation of effective long-term conservation action and sustainable utilization of global priority yam CWR. The active conservation of the global yam priority species will underpin food security and mitigate climate change.

Russia’s Wagner Group/Africa Corps: an authoritarian conflict management examination

ABSTRACT The article examines Russia’s Wagner Group and its successor, Africa Corps, through the lens of Authoritarian Conflict Management (ACM) with its three levels of discourse, space, and economy. To set the analysis, the article first identifies ACM’s rationales and components in contradistinction to liberal peacebuilding. The article then interrogates Wagner Group’s activities in the Central African Republic (CAR) and Mali. It closes with a scrutiny of Wagner Group’s impact and limitations with ACM in mind and investigates the degree to which Africa Corps can be framed in the same manner. Collectively, these parts reveal that Wagner Group’s presence supported democratic erosion and authoritarian entrenchment in CAR and Mali. Yet human rights transgressions against civilians and particular attention to mining and economic activities spurred grievances amongst non-fighters, rebel groups, and jihadists alike in CAR and Mali. Quantitative personnel limitations of Wagner Group/Africa Corps both inform the stance taken and limit the ability to respond and assert dominance as per ACM considerations.

Psychological Impact of Covid-19 Pandemic on Health Care Workers of a Field Hospital in UN Peacekeeping Mission

Background: The Covid-19 pandemic has significantly affected the healthcare system worldwide as well as the psychological state of all. The objective of the current study was to assess the psychological conditions of the healthcare workers in Enhanced Level 1+ Hospital, Bouar, Central African Republic (CAR). This assessment can help in the guideline development and implication psychological interventions which in turn can improve the quality of life, working environment and decision-making capabilities of health care workers during widespread pandemic. Methods: This descriptive cross-sectional study was conducted on 40 medical personnel working in Enhanced Level 1+ Hospital, Bouar, Central African Republic. The study was performed from June 2022 to August 2022. Assessment of psychological status of military healthcare providers was done by analyzing the results derived from the Mental health survey, Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder scale (GAD-7) and Patient Health Questionnaire (PHQ-9). Hospital records were analyzed to assess the changes in workload. Results: The working hour increased significantly from Pre Covid to Post Covid period (1920±34.1 hours/week to 2120±67.3 hours/week) although the number of weekly patients in OPD and Emergency decreased slightly from 51.9 to 40.6. Elevated mental stress was observed during outbreak (average PSS-10 score in June 22 was 20.4 which reduced to 9.7 in August). The same pattern was observed in case of GAD-7 score (15.6 to 10.8) and PHQ-9 score (12.4 to 6.1). The percentage of concerns regarding Covid19 was high during the outbreak, 37/40 (92.5%), which decreased after wards to 18/40 (45%). Conclusion: The UN field hospitals are inadequate to support mass outbreak like COVID 19 in the context of both staff and medical supplies. During Covid 19 outbreak, sharp rise of workload and difficulties in restocking of essential medical items played a vital role in the mental state of the medical professionals. The field hospitals in UN peacekeeping missions require intensive effort especially on disaster and epidemic management during pre-deployment training. Moreover, reconsidering distribution of human resources in field hospitals is also required. Bangladesh Armed Forces Med J Vol 57 No (1) June 2024, pp 35-42

Detection and characterization of HIV-1 group O and HIV-2 in the Central African Republic.

The Central African Republic (CAR) is characterized by widespread HIV epidemic with notable prevalence and genetic diversity. We herein analysed the genetic diversity of atypical non-M HIV-1 strains. In-house serotyping assays for variants of HIV-1 (M, N, O, P) and HIV-2 were used to test a biological collection of 6092 HIV-seropositive blood samples collected between 2003 and 2014 at the Institut Pasteur de Bangui. Samples indicative of recombinant M/O groups, HIV-2, or those that yield doubtful/negative results underwent further PCR tests and sequencing. We found six atypical HIV strains: specifically, three (0.05%) HIV-1 group O strains (subtype H) detected in samples from 2005, 2008 and 2009, alongside three (0.05%) HIV-2 strains (two group A and one group B) identified in samples from 2007 and 2009. HIV-1/O strains showed a genetic link to Cameroon and Gabon strains. This study highlights the dominance of HIV-1/M in the CAR's HIV epidemic over time and underscores the infrequent occurrence of HIV-1 group O and HIV-2 strains. These findings validate the efficacy of WHO-recommended HIV testing protocols and emphasize the need for adaptive surveillance and management strategies to confront the complexities introduced by the genetic diversity of HIV strains.

Global acute malnutrition is associated with geography, season and malaria incidence in the conflict-affected regions of Ouham and Ouham Pendé prefectures, Central African Republic

BackgroundOngoing conflict between multiple armed groups, including pastoralist herders in the Central African Republic (CAR) causes frequent population displacements, food insecurity and scarcity of healthcare services. The inaccessibility and insecurity of many areas of CAR limit data collection and assessments from national nutritional surveys. Community health workers (CHWs) trained by an international non-governmental organisation, The MENTOR Initiative, deliver basic healthcare to children under 5 years old living in hard-to-reach and conflict-affected areas in eight subprefectures of north-west CAR. Their nutritional status and its associations with geography, malaria, season and conflict are unknown.MethodsCHW monthly records (October 2015–August 2021), Armed Conflict Location and Event Data project conflict data and The World Bank Group meteorological data for eight subprefectures of north-west CAR were analysed. Associations between counts of global acute malnutrition (GAM) assessed by mid-upper arm circumference and malaria, season and conflict were investigated using negative binomial regression.ResultsOf the 457,325 consultations with children aged 6–59 months, 6.2% and 0.4% were classified as moderately or severely malnourished, respectively. The negative binomial model demonstrated differences in counts of GAM by subprefecture. Counts of GAM were positively associated with the case rate of severe malaria (IRR = 1.045; 95% CI: 1.04–1.06) and the rainy season (July–September) (IRR = 1.10; 95% CI: 1.03–1.17). Conflict events coded as Battles in ACLED were associated with lower counts of GAM (IRR = 0.78; 95% CI: 0.62–0.97).ConclusionsThis analysis shows geographical differences in levels of malnutrition in north-west CAR and demonstrates clear associations between malnutrition, season and malaria. It provides evidence that levels of GAM may be underestimated in north-west CAR in areas experiencing conflict. These findings highlight the need for targeted nutritional support to reach children most at risk of malnutrition. CHWs are a proven effective means of delivering essential primary healthcare services in hard-to-reach, conflict-affected areas.

Asymptomatic Malaria Cases and Plasmodium Species among BaAka Pygmies in Central Africa.

Malaria is a significant health problem in Africa, primarily due to the Plasmodium falciparum species, but this is not the only etiological factor responsible for malaria on the continent. The goal of the present research was to describe asymptomatic malaria cases and to identify Plasmodium species responsible for malaria in the BaAka Pygmies, inhabitants of the Central African Republic (CAR). Screening was realised in the period of August-September 2021 among 308 people, including 74 children and 234 adults reporting to a healthcare facility in Monasao (southwest CAR), an area inhabited by a semi-nomadic tribe of BaAka Pygmies. The study consisted of two phases. Phase I, which was conducted in Africa, consisted of performing malaria rapid diagnostic tests (mRDTs), taking haemoglobin measurements and collecting blood samples onto Whatman FTA cards for molecular diagnostics. Phase II, which was conducted in Poland, involved molecular tests (RT-PCR) to confirm or rule out malaria infections and to identify Plasmodium species responsible for the infections. mRDTs detected Plasmodium infections in 50.3% of children and 17.1% of adults participating in the study, whereas RT-PCR assays yielded positive results for 59.5% children and 28.6% adults. Molecular tests detected multiple Plasmodium falciparum infections but also three infections with P. malariae, three with P. ovale and one with P. vivax. The obtained results have confirmed numerous asymptomatic Plasmodium infections among the BaAka Pygmies. The rates of asymptomatic malaria cases in adults were twice as high as those in children, which may be indicative of the gradual acquisition of protective immunity with age. The study findings have also demonstrated that although most cases of malaria in Africa are caused by P. falciparum, three other species are also present in the region.

Prevalence and Modes of Transmission of Hepatitis C Virus Infection: A Historical Worldwide Review.

Hepatitis C virus infection affects over 58 million individuals and is responsible for 290,000 annual deaths. The infection spread in the past via blood transfusion and iatrogenic transmission due to the use of non-sterilized glass syringes mostly in developing countries (Cameroon, Central Africa Republic, Egypt) but even in Italy. High-income countries have achieved successful results in preventing certain modes of transmission, particularly in ensuring the safety of blood and blood products, and to a lesser extent, reducing iatrogenic exposure. Conversely, in low-income countries, unscreened blood transfusions and non-sterile injection practices continue to play major roles, highlighting the stark inequalities between these regions. Currently, injection drug use is a major worldwide risk factor, with a growing trend even in low- and middle-income countries (LMICs). Emerging high-risk groups include men who have sex with men (MSM), individuals exposed to tattoo practices, and newborns of HCV-infected pregnant women. The World Health Organization (WHO) has proposed direct-acting antiviral (DAA) therapy as a tool to eliminate infection by interrupting viral transmission from infected to susceptible individuals. However, the feasibility of this ambitious and overly optimistic program generates concern about the need for universal screening, diagnosis, linkage to care, and access to affordable DAA regimens. These goals are very hard to reach, especially in LMICs, due to the cost and availability of drugs, as well as the logistical complexities involved. Globally, only a small proportion of individuals infected with HCV have been tested, and an even smaller fraction of those have initiated DAA therapy. The absence of an effective vaccine is a major barrier to controlling HCV infection. Without a vaccine, the WHO project may remain merely an illusion.

Potential climate change effects on the distribution of urban and sylvatic dengue and yellow fever vectors

ABSTRACT Climate change may increase the risk of dengue and yellow fever transmission by urban and sylvatic mosquito vectors. Previous research primarily focused on Aedes aegypti and Aedes albopictus. However, dengue and yellow fever have a complex transmission cycle involving sylvatic vectors. Our aim was to analyze how the distribution of areas favorable to both urban and sylvatic vectors could be modified as a consequence of climate change. We projected, to future scenarios, baseline distribution models already published for these vectors based on the favorability function, and mapped the areas where mosquitoes’ favorability could increase, decrease or remain stable in the near (2041–2060) and distant (2061–2080) future. Favorable areas for the presence of dengue and yellow fever vectors show little differences in the future compared to the baseline models, with changes being perceptible only at regional scales. The model projections predict dengue vectors expanding in West and Central Africa and in South-East Asia, reaching Borneo. Yellow fever vectors could spread in West and Central Africa and in the Amazon. In some locations of Europe, the models suggest a reestablishment of Ae. aegypti, while Ae. albopictus will continue to find new favorable areas. The results underline the need to focus more on vectors Ae. vittatus, Ae. luteocephalus and Ae. africanus in West and Central sub-Saharan Africa, especially Cameroon, Central Africa Republic, and northern Democratic Republic of Congo; and underscore the importance of enhancing entomological monitoring in areas where populations of often overlooked vectors may thrive as a result of climate changes.

The Implications of Autochthony-Based Victimization for Reparative Justice in Africa

The concept of autochthony or ‘indigeneity’ has been employed in multiple contexts across Africa and refers to people with historical connections to particular territories. It can be manipulated by political elites who demonize perceived ‘allochthonous’ minorities or ‘outsiders’. Though autochthony-related violence is often considered to constitute or resemble genocide or ‘ethnic cleansing’, the contested nature of these concepts necessitates further consideration of the impact of such violence beyond the genocide lens. This essay explores the potential implications of such hostilities and violence for ‘restorative’ or ‘reparative’ justice. It focuses on the examples of the protracted violence in Democratic Republic of Congo (DRC) and Central African Republic (CAR), where both peace and justice seem elusive for many communities, and the missed opportunities to foster reparative justice for victims of the last major conflict in Côte d’Ivoire (2010–11). In focusing on victims of autochthony-related violence, this essay considers the potential specific, multilayered, and intersecting needs of such victims and the challenges they may face within the context of any broader, comprehensive processes of reparative justice. Given the challenges that this essay highlights, it concludes by recommending that scholars further consider a conceptualization of reparative justice encompassing the multilayered experiences of autochthony-based victimization.

Characterization of enteroviruses circulating among farm animals and children in Central African Republic

ABSTRACT To characterize enteroviruses (EVs) circulating in farm animals in Central African Republic (CAR), we screened 192 stools of animals under 12 months belonging to family farms located in or near Bangui. To assess whether EV exchanges exist between these animals and humans, we also screened 195 stools of children who lived in contact with farm animals, as well as control stools of 358 children with no contact with farm animals. EVs were typed based on their capsid sequences. In children, all EVs belonged to species A, B and C, with EV-Cs accounting for 60%. Some EV-Cs shared recent common ancestors with lineages of vaccine-derived poliovirus that emerged in the country in 2019–2020. In animals, we identified EV-Gs that belonged to 10 different types, including a previously unknown one that we named EV-G28, while no EV-E or EV-F were observed. The CAR EV-Gs were genetically closely related to specimens sampled in other continents and some of them harboured the torovirus-derived insertion already reported in some EV-Gs. The worldwide circulation of EV-Gs is likely due the massive international trade of live animals. Besides, two human EV-Cs (coxsackievirus A17 and coxsackievirus A24) were detected in pigs, suggesting that these viruses could cross the species barrier. Our work provides original data on the epidemiology and ecology of EVs circulating among herd animals in Africa.

Religious Conflict in Central African Republic

One of the challenges facing the world today is the issue of religious conflict. The consequences of the above are unimaginable for a land-locked country like Central African Republic (CAR). Conflicts there have led to the destruction of lives and properties in the last decades of the country's nationhood. There is a strong link between religion and violence, and this link has a long genealogy in Western scholarship. It is against this background that this research addresses the political and economic effects of the religious conflict in CAR. More than half of the respondents in this study agreed that the use of religion as an instrument to acquire political power led to the conflict in CAR. Since religion is a major source of soft power, it is used and misused by religious and governmental organizations to pursue their interests. Religion is not inherently violent; instead, it is how people choose to interpret religion that provides justification for violent actions. The study recommends that the government should emphasize the secularity and supremacy of the constitution and religious leaders should establish inter-faith platforms to curb religious crises.

Seroprevalence and molecular characterization of viral hepatitis and HIV co-infection in the Central African Republic.

The Central African Republic (CAR) is one of the countries with the highest prevalence of viral hepatitis infection in the world. Coinfection with HIV increases the morbidity and mortality beyond that of mono-infection with either hepatitis or HIV. The present study describes the geographic distribution of viral hepatitis infections and molecular characterization of these viruses in the CAR. Out of 12,599 persons enrolled during the fourth Multiple Indicator Cluster Survey of 2010 in the CAR, 10,621 Dried Blood Spot (DBS) samples were obtained and stored at -20°C. Of these DBS, 4,317 samples were randomly selected to represent all regions of the CAR. Serological tests for hepatitis B, D, and C viruses were performed using the ELISA technique. Molecular characterization was performed to identify strains. Of the 4,317 samples included, 53.2% were from men and 46.8% from women. The HBsAg prevalence among participants was 12.9% and that HBc-Ab was 19.7%. The overall prevalence of HCV was 0.6%. Co-infection of HIV/HBV was 1.1% and that of HBV/HDV was 16.6%. A total of 77 HBV, 6 HIV, and 6 HDV strains were successfully sequenced, with 72 HBV (93.5%) strains belonging to genotype E and 5 (6.5%) strains belonging to genotype D. The 6 HDV strains all belonged to clade 1, while 4 recombinants subtype were identified among the 6 strains of HIV. Our study found a high prevalence of HBV, HBV/HDV and HBV/HIV co-infection, but a low prevalence of HCV. CAR remains an area of high HBV endemicity. This study's data and analyses would be useful for establishing an integrated viral hepatitis and HIV surveillance program in the CAR.

CENTRAL AFRICAN REPUBLIC: THE POLITICIZATION OF RELIGION AND CONFLICT

The Central African Republic (CAR) has been a theater of hostilities for decades, in cluding the Seleka rebellion in December 2012, which caused religious-based discrimination, especially between the Muslim minority and Christian majority. Opportunistic political leaders and armed groups have misused religion for political and egocentric gains in the CAR. The pur pose of this qualitative content analysis research is to investigate the use of religion for political motives in the CAR and how such actions impact conflict and sectarian divides in the so-called phantom state. The paper recommends ways to mitigate political influence and the misuse of religion by political and armed group actors in the CAR. Very little or no literature on conflict in the CAR has specifically addressed the influence of politics on religion and how it contributes to fueling conflict in the country. This study fills the gaps in the literature by investigating the historical narratives of the CAR conflict while highlighting instances of political abuse of religion. A review of existing literature on the political manipulation of religion establishes the basis for a critical analysis of the influence of politics on religion in the CAR and its impact on conflict. Keywords: Politics, religious identities, conflict, Central African Republic, anti-Balaka, Seleka.

SARS-CoV-2 Neutralizing Antibodies in Three African Countries Following Multiple Distinct Immune Challenges.

The COVID-19 pandemic has affected Madagascar, Cameroon, and the Central African Republic (CAR), with each experiencing multiple waves by mid-2022. This study aimed to evaluate immunity against SARS-CoV-2 strains Wuhan (W) and BA.2 (BA.2) among healthcare workers (HCWs) in these countries, focusing on vaccination and natural infection effects. HCWs' serum samples were analyzed for neutralizing antibodies (nAbs) against W and BA.2 variants, with statistical analyses comparing responses between countries and vaccination statuses. Madagascar showed significantly higher nAb titers against both strains compared to CAR and Cameroon. Vaccination notably increased nAb levels against W by 2.6-fold in CAR and 1.8-fold in Madagascar, and against BA.2 by 1.6-fold in Madagascar and 1.5-fold in CAR. However, in Cameroon, there was no significant difference in nAb levels between vaccinated and unvaccinated groups. This study highlights the complex relationship between natural and vaccine-induced immunity, emphasizing the importance of assessing immunity in regions with varied epidemic experiences and low vaccination rates.

A time of decline: An eco-anthropological and ethnohistorical investigation of mpox in the Central African Republic.

The Central African Republic (CAR) has experienced repeated mpox outbreaks since 2001. Although several mpox epidemiological risk factors for zoonotic and interhuman transmission have been documented, the reasons for more frequent epidemic outbreaks are less well understood, relying on vague explanatory categories, including deforestation, hunting, and civil unrest. To gain insight into increasingly frequent outbreaks, we undertook an ethnohistorical, eco-anthropological analysis in two CAR regions: the Lobaye prefecture, experiencing one or more annual outbreaks in the past decade, and the Sangha-Mbaere prefecture, with a longer history of mpox but less frequent outbreaks. We comparatively examined changing political economies, forest use practices, and understandings of mpox. In 2022, we conducted 40 qualitative ethnohistorical, anthropological interviews and participant-observation of forest activities in two languages (Sango and French). We compared contemporary practices with hunting, trapping, and meet consumption practices, documented through quantitative and qualitative observation in one research site, over 6 months in 1993. We find increased rodent capture and consumption in both sites in the past 30 years and expanded practices of other potentially risky activities. Simultaneously, we also identify important differences in risky practices between our Lobaye and Sangha-Mbaere participants. In addition, Lobaye and Sangha participants underscored historical processes of decline producing mpox among other emergences, but they framed these declension processes diversely as economic, political, nutritional, and moral. Our findings are important because they mobilize new types of evidence to shed light on the processual dynamics of mpox outbreaks in the CAR. This study also reveals variability across two sites within the same country, highlighting the importance of comparative, fine-grained anthropological and historical research to identify underlying dynamics of mpox outbreaks. Finally, our study points to the need for mpox interventions and risk communication accounting for these regional differences, even within a single country.

Copaifera mildbraedii Desf.: Phytochemical Composition of Extracts, Essential Oil, and In Vitro Biological Activities of Bark

Copaifera mildbraedii Desf. is an evergreen tree with an umbrella-like crown. It is distributed from south-eastern Nigeria eastward to the Central African Republic (CAR). The aim of this study was to assess the chemical composition and biological activities of C. mildbraedii bark, as well as the chemical composition of the essential oil. Ethyl acetate (EtOAc) and methanol (MeOH) extracts showed a high total phenolic content (TPC) (149.9 and 148.8 mg GAE/g dry residue (dr), respectively), which was related to good antioxidant activity (DPPH) with an IC50 of 21.2 and 12.9 µg/mL, respectively. High-performance liquid chromatography coupled with diode array detector (HPLC-DAD) analysis revealed seven phenolic compounds with myricitrin (13.3 mg/g dr) and 2,4-dihydroxy-3,6-dimethyl benzoic acid (30.7 mg/g dr) as major compounds, while gas chromatography-mass spectrometry (GC-MS) analysis enabled detection of 13 volatile compounds (3 before and 10 after derivatization). Thirty compounds were identified in the essential oil, which corresponds to 65% of all identified compounds. Among the latter, E,E-farnesylacetone and γ-gurjunene were considered as major compounds (8.08 and 10.43%, respectively). The EtOAc extract showed a potent potential, simultaneously, against anti-acetylcholinesterase (AChE), anti-15-lipoxygenase (15-LOX), anti-xanthine oxidase (XOD), and cytotoxic (OVCAR) activities, whereas cyclohexane (CYHA) and dichloromethane (DCM) extracts showed a cytotoxic effect with high percentages of inhibition (95.2%).

Investigating animal reservoirs for hepatitis E virus in Bangui, Central African Republic.

Hepatitis E virus (HEV) is a major cause of enterotropic viral hepatitis, a major public health problem in many developing countries. In Central African Republic (CAR), HEV genotypes 1, 2, and 3 have been found to have an impact on human health. However, data on HEV in animal reservoirs are still lacking for CAR. Here, we investigated the presence of HEV in farmed pigs and goats in Bangui, the capital city of CAR, using molecular methods. In a prospective study, fecal samples from 61 pigs and 39 goats from farms in five districts (2nd, 4th, 6th, 7th, 8th) of Bangui were collected and tested for HEV RNA by real-time RT-PCR. The samples were further analyzed by nested-PCR and sequenced to determine the genotype and subtype to which the virus belong. In total, 22/100 (22.0%) feces samples were successfully amplified for HEV RNA by real time RT-PCR. All positive samples were from pigs (22/61; 36.1%), while all goat samples were negative (0/39). Twelve HEV RNA samples (12/22 or 54.5%) were successfully amplified by nested RT-PCR, and subsequently sequenced. Phylogenetic analysis revealed that the obtained sequences clustered with subtype 3h and were genetically related to the human HEV sequences from CAR. This study confirms that pigs constitute an HEV reservoir, with genotype 3 being the major circulating strain. Further studies are needed to investigate other local reservoirs and to improve knowledge of the molecular epidemiology of HEV in CAR.