Central African Region Research Articles

Preliminary validation of the use of IgG antibody response to Anopheles gSG6-p1 salivary peptide to assess human exposure to malaria vector bites in two endemic areas of Cameroon in Central Africa.

The specific immune response to the Anopheles salivary peptide could be a pertinent and complementary tool to assess the risk of malaria transmission and the effectiveness of vector control strategies. This study aimed to obtain first reliable data on the current state of the Anopheles gSG6-P1 biomarker for assess the level of exposure to Anopheles bites in high malaria endemic areas in Cameroon. Blood smears were collected from people living in the neighborhoods of Youpwe (suburban area, continental) and Manoka (rural area, Island), both areas in the coastal region of Cameroon. Malaria infection was determined using thick blood smear microscopy, whereas the level of specific IgG response to gSG-P1 peptide was assessed by enzyme-linked immunosorbent assay from the dried blood spots. Of 266 (153 from Youpwe, 113 from Manoka) malaria endemic residents (mean age: 22.8±19.8 years, age range: 6 months–94 years, male/female sex ratio: 1/1.2, with Manoka mean age: 23.71±20.53, male/female sex ratio:1/1.13 and Youpwe mean age: 22.12±19.22, male/female sex ratio 1/0.67) randomly included in the study, Plasmodium infection prevalence was significantly higher in Manoka than in Youpwe (64.6% vs 12,4%, p = 0.0001). The anti-gSG6-P1 IgG response showed a high inter-individual heterogeneity and was significantly higher among individuals from Manoka than those from Youpwe (p = 0.023). Malaria infected individuals presented a higher anti-gSG6-P1 IgG antibody response than non-infected (p = 0.0004). No significant difference in the level of specific IgG response to gSG-P1 was observed according to long lasting insecticidal nets use. Taken together, the data revealed that human IgG antibody response to Anopheles gSG-P1 salivary peptide could be also used to assess human exposure to malaria vectors in Central African region. This finding strengthens the relevance of this candidate biomarker to be used for measuring human exposure to malaria vectors worldwide.

Increasing rabies data availability: The example of a One Health research project in Chad, Côte d'Ivoire and Mali

Rabies is a fatal but preventable disease that remains notoriously underreported. Weak data availability hampers advocacy, constitutes a barrier to resource allocation and inhibits effective prevention and control. To gain better insight into the global rabies burden and human vaccine demand several studies were funded through the Vaccine Alliance (GAVI) learning agenda. With the help of this funding, Swiss TPH and local in country partner organizations implemented a One Health research project in Chad, Côte d'Ivoire and Mali to collect data at household, public health facility and veterinary level. This paper describes the implementation of this research project and evaluates its success on amount of information gained, achieved capacity building, impact on knowledge creation and influence on national and international policies. The project was based on the One Health concept and guided by the principles of transboundary research partnerships formulated by the Swiss Academy of Sciences. Data was collected on bite incidents and health seeking from over 24’000 households, on access to treatment of over 8’800 bite cases registered in public health facilities and on the status of over 1’800 rabies suspect animals. Selected country specific datasets have contributed to more than 10 scientific articles so far. On the international level, the multi-level data collection provided a unique set of indicators to inform, along with results from other studies, new WHO rabies immunization recommendations and a vaccine investment case scenario to prevent human rabies. New rabies burden estimates based on the data gathered are published for Mali and will be modelled for the whole West and Central African region. On the national level, the project facilitated communication between animal health and human health workers catalyzing creation of local and national committees and formulation of national action plans for Mali and Côte D'Ivoire. Major challenges arose from lack of data collection and documentation experience of human health and veterinary workers and weak infrastructural capacities of the veterinary and human health systems of the project countries. Through adherence to the principles of transboundary research partnerships, project team members acquired valuable research and networking skills despite language barriers, enabling them to play key roles in the future agenda towards national, regional and global canine rabies elimination. Project external collaborations with local public institutions was facilitated through long-term local partnerships. Both factors enabled success in project implementation and outcomes by identifying and mitigating risks in advance, resolving challenges amiably and enabling mutual knowledge creation as a fructuous ground for sustained commitment. Lack of immediate follow-up funding did not allow to maintain activities beyond the project timeframe. However, the national and international policy changes triggered, as well as the strengthened local disease control and research capacities provides sustainable basis for the elimination of dog transmitted human rabies.

ENERGY EFFICIENCY IN OIC COUNTRIES: SDG 7 OUTPUT

Over the past few decades, countries in the Association of Islamic Cooperation Organizations (OIC) have reached various levels of economic development. At present, increasing energy access is one of the goals to be achieved by ensuring affordable, reliable, sustainable and modern energy access. This study aims to measure the effectiveness of energy access based on the indicators of the seventh sustainable developmet goals (SDGs) in 50 countries that are members of the OIC during the period 2010-2017. Efficiency measurements are carried out using the Data Envelopment Analysis (DEA) method. The productivity measurement is done by using the Malmquist Productivity Index (MPI). The results showed that Yemen was the country that had the highest rate of increase with a TFP value of 1.194. While the State of Egypt was the country that experienced the largest decline with a TFP value of 0.821. On the other hand, there are differences in the level of efficiency regionally, where Muslim countries in the European continent are then followed by the countries of the West Asian region in the second position and the third position is the central African region which is superior to the region Other Africa. Keywords: Sustainable Developmet Goals, Data Envelopment Analysis, Efficiency, Energy Access, Islamic Cooperation Organizations JEL Classifications: O1, 05, Q4 DOI: https://doi.org/10.32479/ijeep.10499

Investigating the dynamic relationships between credit supply, economic growth, and the environment: empirical evidence of sub-regional economies in Sub-Saharan Africa.

Sub-Saharan Africa (SSA) is considered the most vulnerable to challenges emanating from climate changes. A number of factors notably accelerated changes in growth influence SSA environment. Linking financial sector within growth and environmental outcomes has been the focus of policy makers and researchers. This study investigated the dynamic relationships between credit supply, economic growth, and the environment from the perspectives of the four sub-regional economies (Central, East, Southern, and West African regions) in SSA over the period 1990-2018. In addition, the study tested Environmental Kuznets Curve hypothesis across sub-regions. We employed panel vector autoregressive (panel VAR) model in a generalized method of moment framework to investigate the topic. The panel VAR results revealed that (i) economic growth negatively influence on carbon emissions of Central African countries but not in the East, Southern and West African sub-regions, (ii) credit supply had significantly positive influence on carbon emissions and economic growth of Central and East African sub-regions but negative influence on carbon emissions and economic growth West African sub-regions in SSA, and (iii) carbon emissions had significantly negatively influence on credit supply of East and West African sub-regions. The granger causality results revealed bidirectional causal links between credit supply and carbon emissions, economic growth, and credit supply in the Central and East African sub-regions, while most of the relationships were unidirectional. The impulse response function revealed that the impact of one variable on another vary throughout the periods and across sub-regions. Similarly, the elasticity of the variables to each other varies across sub-regions over the period studied. EKC hypothesis was validated in East African sub-region but was rejected in Central (u-shape relationship), Southern, and West African sub-regional economies indicating variations in growth and environmental outcomes among the sub-regional economies. Specific sub-regional policy recommendations are discussed.

Hypoglycaemic and anti-hyperglycaemic activity of Tabernanthe iboga aqueous extract in fructose-fed streptozotocin type 2 diabetic rats

Root bark preparations of the Gabonese plant Tabernanthe iboga (T. iboga) has long been used in traditional medicine in Central and West African regions for the management of type 2 diabetes (T2D). This study is the first investigation of in vivo hypoglycaemic activity in healthy rats and anti-hyperglycaemic activity of T. iboga in a 10% fructose-fed (40 mg/kg i.p.) streptozotocin (STZ) injected type 2 diabetic rat model. T. iboga at 50 to 200 mg/kg induced hypoglycaemia activity over 3 h fasted glucose tolerance in healthy Wistar rats and anti-hyperglycaemic effects on non-fasted and fasted blood glucose in fructose-fed STZ T2D rats with no toxicity. Fructose-fed STZ T2D rats developed characteristic type 2 diabetic complications over 6 weeks exhibiting significantly elevated fasting and non-fasting blood glucose, polydipsia, reduced body weight gain and glucose and insulin tolerance compared with STZ alone and normal control rats. T. iboga (50 mg/kg and 200 mg/kg bw) administered p.o. once daily for 4 weeks significantly improved diabetic symptoms of polydipsia, reduced body weight, hyperglycaemia, glucose and insulin tolerance (as AUC) compared with fructose-fed STZ T2D rats. T. iboga aqueous extract (50 mg/kg and 200 mg/kg) also significantly reversed altered actions of marker enzymes of liver including alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST), creatinine, HbA1c and elevated triglycerides in fructose-fed STZ type 2 diabetic rats. Our outcomes show that daily oral provision of T. iboga improves type 2 diabetes complications, superior to glibenclamide, in rat fructose-fed STZ model and offers the potential for safe clinical management of T2D in Gabon.

Du Feu à l'Eau: Source and Flux of Dissolved Black Carbon From the Congo River

AbstractPyrogenic organic residues from wildfires and anthropogenic combustion are ubiquitous in the environment and susceptible to leaching from soils into rivers, where they are known as dissolved black carbon (DBC). Here we quantified and isotopically characterized DBC from the second largest river on Earth, the Congo, using 12 samples collected across three annual hydrographs from 2010 to 2012. We find that the Congo River exports an average of 803 ± 84 Gg‐C as DBC per year, comprising 7.5% of the river's average annual dissolved organic carbon (DOC) flux (10.7 ± 1.2 Tg‐C yr−1). Concentrations of DBC were strongly correlated with discharge and DOC concentration, indicating transport limitation for DBC flux from the Congo River Basin. Stable carbon isotopic signatures of DBC revealed a seasonal shift in pyrogenic source from forest dominant to an increasing contribution from savannah biomass, which derives from the North‐South bimodal hydrologic regime within the basin. Our results also indicate that black carbon produced within the Congo Basin is exported by the river on relatively short time scales and that total DBC export will increase with climate change predictions for the central African region.

Mapping lymphatic filariasis in Loa loa endemic health districts na\xefve for ivermectin mass administration and situated in the forested zone of Cameroon

BackgroundThe control of lymphatic filariasis (LF) caused by Wuchereria bancrofti in the Central African Region has been hampered by the presence of Loa loa due to severe adverse events that arise in the treatment with ivermectin. The immunochromatographic test (ICT) cards used for mapping LF demonstrated cross-reactivity with L. loa and posed the problem of delineating the LF map. To verify LF endemicity in forest areas of Cameroon where mass drug administration (MDA) has not been ongoing, we used the recently developed strategy that combined serology, microscopy and molecular techniques.MethodsThis study was carried out in 124 communities in 31 health districts (HDs) where L. loa is present. At least 125 persons per site were screened. Diurnal blood samples were investigated for circulating filarial antigen (CFA) by FTS and for L. loa microfilariae (mf) using TBF. FTS positive individuals were further subjected to night blood collection for detecting W. bancrofti. qPCR was used to detect DNA of the parasites.ResultsOverall, 14,446 individuals took part in this study, 233 participants tested positive with FTS in 29 HDs, with positivity rates ranging from 0.0 to 8.2%. No W. bancrofti mf was found in the night blood of any individuals but L. loa mf were found in both day and night blood of participants who were FTS positive. Also, qPCR revealed that no W. bancrofti but L.loa DNA was found with dry bloodspot. Positive FTS results were strongly associated with high L. loa mf load. Similarly, a strong positive association was observed between FTS positivity and L loa prevalence.ConclusionsUsing a combination of parasitological and molecular tools, we were unable to find evidence of W. bancrofti presence in the 31 HDs, but L. loa instead. Therefore, LF is not endemic and LF MDA is not required in these districts.

Uptake of cancer screenings among a multiethnic refugee population in North Texas, 2014-2018.

BackgroundRefugees are less likely than US born populations to receive cancer screenings. Building Bridges is a community health worker prevention program designed to increase refugee’s cancer screening uptake. The purpose of this cross sectional analysis was to assess differences in uptake of cervical, breast, liver, and colorectal screens across six cultural groups.MethodsData was abstracted in 2018 for this analysis. Participants were categorized into six cultural groups (Myanmar, Central Africa, Bhutan, Somalia, Arabic Speaking Countries, and Other) to assess differences in sociodemographic measures and screening uptake. Uptake proportions were calculated for each cancer type (cervical, breast, liver, and colon) among eligible participants, by gender and cultural group. Differences in uptake across groups were assessed using stratified analysis and logistic regression. Prevalence odds ratios (POR) and 95% confidence intervals (CIs) were calculated for each group to assess the association between screening completion and cultural group.Findings874 refugees were asked about cancer screening history. The majority of participants were either ‘never had been screened’ or ‘not up-to-date’ for every cancer screening. Among age eligible, 82% had no prior pap exam within the past 3 years, 81% had no prior mammogram within the past year, 69% didn’t know their Hepatitis B status and 87% never had a colon cancer screening. Overall, higher uptake of all types of cancer screenings was observed in Myanmar and Bhutanese groups, except colon cancer screening which was higher among Central African Region and Arabic Speaking participants.ConclusionScreening uptake varied by ethnic group and screening type. The program reached an under and never screened population, however, the proportion of refugees who received a cancer screening remained low compared to the US population. Diversity within refugee communities requires adaptation to specific cultural and linguistic needs to include new Americans in cancer elimination efforts.

China Sneezes the World Catches a Cold-CEMAC

When China sneezes the world catches a cold is a statement that is true today more than ever before. The outbreak of the COVID-19 has had far reaching consequences around the world as almost every component of society is greatly affected in one way or the other. The impact transcends through culture, politics, history, economic, health and even the distortion of the historical landscape. If anyone doubted the super power position of China, COVID-19 has given us the opportunity to rethink. Economically, the ban of flights and limited movements in and out of the country has impaired the positive evolution of the financial markets naturally tilting the growth curve towards continues low. Food supplies, medication, importation and most especially commodity prices are on their all-time low. On the health side with extraverted African economies is meting towards short falls, at the central African sub region, rating institutions are projecting a 4.1% drop in consumer goods as import is greatly affected. The United Nations said it now estimates Africa's GDP rate will fall from 3.2 percent to 1.8 percent this year. In order for Africa to meet its global targets under the UN’s Sustainable Development Goals, economists say Africa must grow at a minimum of 8 percent. The novel COVID-19 has infected more than 94,800 people in at least 77 countries (see chart), bringing global manufacturing supply chains to a grinding halt and causing a slowdown in key service sectors such as tourism, transport, and recreation. While the virus will cause exports from Cameroon to China and Italy to fall, policymakers must see the negative implications of the virus as a trigger to incentivise higher value-added products such as components for computers and solar panels, consumer products such as cornflakes, packaged salmon, potatoes and cornflower, which are all appropriate for an increasingly climate-centric global consumer.

Supergene manganese ore records 75 Myr-long Campanian to Pleistocene geodynamic evolution and weathering history of the Central African Great Lakes Region – Tectonics drives, climate assists

The southeastern part of the Democratic Republic of the Congo locally hosts Proterozoic manganese deposits. The deposits of Kisenge-Kamata are the most significant, but manganese ores are also known to occur at Kasekelesa (former Katanga Province) and Mwene-Ditu (former Kasai Province). For the present study, cryptomelane-rich samples from these two localities were dated, using the 40Ar/39Ar step-heating method with a CO2 laser probe. The ages obtained are within a range of c. 77 Myr to c. 2 Myr. Cryptomelane formation took place at c. 76.4 Ma, c. 59.6 Ma, c. 45 Ma, c. 35 Ma, c. 23.8 Ma, c. 15.4 Ma, and c. 13.3 Ma at Kasekelesa, and it occurred at c. 35 Ma, c. 22.4 Ma, c. 15 Ma, c. 5.5–7.2 Ma, c. 3.6 Ma, and c. 2.1–2.3 Ma at Mwene-Ditu. The Campanian age (c. 76.4 Ma) recorded at Kasekelesa is the oldest 40Ar/39Ar age that has up to now been recorded for Mn ores from Africa. It documents the formation of oxidized ore along a Campanian or older erosion surface, which could be part of the ‘African Erosion Surface’. The complete age record suggests that continent-wide tectonics accounts for most of the recognized supergene ore formation episodes, controlled by vertical lithospheric movements that are ultimately responsible for alternating stages of landscape stability and erosion. Tectonics is thus regarded as the first-order control for secondary ore formation in Central Africa, over the last 80 Myr. Climate is a second-order control, because sufficient water supply is needed for supergene enrichment, whereby climatic conditions are recognized to have been favourable during some relatively cold Late Mesozoic and Paleogene periods, as well as during some humid and warm Neogene stages.

First detection of Theileria parva in cattle from Cameroon in the absence of the main tick vector Rhipicephalus appendiculatus.

A major risk factor for the spread of livestock diseases and their vectors is the uncontrolled transboundary movement of live animals for trade and grazing. Such movements constrain effective control of tick‐transmitted pathogens, including Theileria parva. Only limited studies have been undertaken to identify ticks and tick‐borne diseases (TTBDs) affecting cattle in central African countries, including Cameroon. We hereby report the collection of baseline data on the prevalence of T. parva in Cameroon through a countrywide cross‐sectional survey, conducted in 2016, involving collection of blood samples from cattle from 63 sites across the five agro‐ecological zones (AEZs) of the country. ELISA‐based surveillance of infected cattle was performed on 479 randomly selected samples and revealed specific antibodies to T. parva in 22.7% and T. mutans in 41.1% of cattle. Screening of 1,340 representative DNA samples for the presence of T. parva identified 25 (1.86%) positives using a p104 antigen gene‐based nested PCR assay. The positives were distributed across agro‐ecological zones I, II, III and V. None of the p104 positive cattle exhibited clinical symptoms of East Coast fever (ECF). Using reverse line blot (RLB), 58 (4.3%) and 1,139 (85%) of the samples reacted with the T. parva and T. mutans oligonucleotide probes, respectively. This represents the first report of T. parva from Cameroon. Surprisingly, no Rhipicephalus appendiculatus ticks, the main vector of T. parva, were identified in a parallel study involving comprehensive morphological and molecular survey of tick species present in the country. Only two of the 25 p104 positive cattle were PCR‐positive for the CD8+ T‐cell target schizont‐expressed antigen gene Tp1. Cloning and sequencing of Tp1 amplicons revealed sequence identity with the reference T. parva Muguga. This new finding raises serious concerns of a potential spread of ECF into the central African region.

Optimized rain drop size distribution model for microwave propagation for equatorial Africa

In radio propagation, modelling of rainfall rate, rain attenuation and drop size distribution is highly location-dependent and thus requires availability of reliable data from various locations. Models and mathematical predictions obtained based on data from one location often prove inadequate when applied to another location with either slightly or radically different rainfall pattern. In this paper, the focus is to develop a new rainfall drop size distribution model for equatorial Africa using disdrometer data obtained in Butare, Rwanda (2°35’53.88”S and 29° 44’ 31.5” E). Rainfall data was classified into annual, monthly and rainfall regimes which are drizzle, widespread, shower and thunderstorm, based on their rainfall rates. The maximum likelihood estimation technique was applied to construct estimates of input Drop Size Distribution (DSD) fit parameters of the developed statistical distribution for rainfall DSD in Butare. The newly obtained distribution was compared to the existing rainfall DSD models, namely, Lognormal, Gamma, Marshall-Palmer and Weibull distributions, and found to be an improvement over the existing ones. The Mie Scattering technique is employed to derive the scattering parameters. Thereafter, the derived scattering parameters with DSD models are used for the estimation of rainfall attenuation for the Central African region.

HIV self-testing: The key to unlock the first 90 in West and Central Africa

The West and Central African region (WCAR) still registers some of the highest rates of new HIV infections worldwide (16%) despite a low prevalence of HIV (1.9%). In this region, only 48% of people living with HIV are aware of their HIV status. To fill this gap, HIV Self testing (HIVST) could potentially be an additional approach to overcome the barriers to diagnose HIV infected patients, therefore being one of the keys to unlock the first 90 as recommended by the World Health Organization (WHO) since 2016. However, many challenges remain for the adoption of HIVST in routine clinical practice in low prevalence settings and need to be contextualized to WCAR settings. We report in this paper some of the challenges and discuss opportunities for a successful implementation of HIVST in the WCAR.

Impact of weather conditions on incidence and mortality of COVID-19 pandemic in Africa.

The weather-related conditions change the ecosystem and pose a threat to social, economic and environmental development. It creates unprecedented or unanticipated human health problems in various places or times of the year. Africa is the world's second largest and most populous continent and has relatively changeable weather conditions. The present study aims to investigate the impact of weather conditions, heat and humidity on the incidence and mortality of COVID-19 pandemic in various regions of Africa. In this study, 16 highly populated countries from North, South, East, West, and Central African regions were selected. The data on COVID-19 pandemic including daily new cases and new deaths were recorded from World Health Organization. The daily temperature and humidity figures were obtained from the weather web "Time and Date". The daily cases, deaths, temperature and humidity were recorded from the date of appearance of first case of "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" in the African region, from Feb 14 to August 2, 2020. In African countries, the daily basis mean temperature from Feb 14, 2020 to August 2, 2020 was 26.16±0.12°C, and humidity was 57.41±0.38%. The overall results revealed a significant inverse correlation between humidity and the number of cases (r= -0.192, p<0.001) and deaths (r= -0.213, p<0.001). Similarly, a significant inverse correlation was found between temperature and the number of cases (r= -0.25, p<0.001) and deaths (r=-0.18, p<0.001). Furthermore, the regression results showed that with 1% increase in humidity the number of cases and deaths was significantly reduced by 3.6% and 3.7% respectively. Congruently, with 1°C increase in temperature, the number of cases and deaths was also significantly reduced by 15.1% and 10.5%, respectively. Increase in relative humidity and temperature was associated with a decrease in the number of daily cases and deaths due to COVID-19 pandemic in various African countries. The study findings on weather events and COVID-19 pandemic have an impact at African regional levels to project the incidence and mortality trends with regional weather events which will enhance public health readiness and assist in planning to fight against this pandemic.

ANALYSIS AND INTERPRETATION OF REGIONAL-SCALED GRAVITY MEASUREMENTS IN THE CENTRAL EQUATORIAL ATLANTIC REGION OF AFRICA

Regional-scaled gravity data was interpreted for the Central Equatorial Atlantic African region, a region comprising of both oceanic and continental areas, with a view to understanding more about its complex geological settings and the processes of tectonic evolution. The methods adopted involved the generation of topography/bathymetry, free-air and Bouguer anomaly grids from topography, free-air anomaly and Bouguer anomaly datasets; regional-residual gravity field separation, lineament mapping from the Horizontal Derivative and 2-D modelling of the sub-surface. Within the study area, the elevation ranged from -4,200 to 3,840 m. The free-air anomaly map showed a combination of elongated and circular positive free-air anomalies and elongated, negative free-air anomalies whose values varied between -40 mGal and 70 mGal. The Bouguer anomaly values ranged from -121 to +229 mGal. The Bouguer anomaly map also showed both elongated and circular positive and negative Bouguer anomalies. The dominant orientations of the elongated Bouguer anomalies were the NE-SW, the E-W and the ESE-WNW orientations. Gravity modelling within the oceanic region re- vealed the presence of a basaltic cover whose thickness varied between 1,330 m to 7,700 m in the oceanic and continental margin regions. Associated with the occurrence of this basaltic cover were kinks interpreted as eruption fissures from which the basaltic cover was ejected. It was discovered that the African West Coast Atlantic margin consisted of a trench around the continental margin region adjoined just to the north by some high density basalt, and also that the West African Coastline is heavily laced with magmatism and must have therefore been an active magmatic region in the past. Based on the interpreted data, the study concluded that the Equatorial Atlantic Ocean might have opened on a frame- work of rifts which extended into the inland regions to form the present day sedimentary basins and from the Bouguer anomaly profile along latitude 10oN that it is possible that both the Minna batholith and the Jos Plateau exploited the Proterozoic basement weaknesses for their emplacement.

Prevalence and Associated Factors of Teenage Pregnancy among Secondary and High School Students in the Tiko Health District, South West Region, Cameroon

Introduction: Teenage pregnancy is a common public health problem with global estimates of 16 million teenage births yearly. It is one of the major causes of maternal and neonatal mortality worldwide with the majority of the cases seen in the low and middle-income countries. Cameroon has recorded the highest fertility rate among teenagers in the entire Central African region as of 2017. Notably, there are limited data available on assessing the awareness and prevention of teenage pregnancies among secondary and high school students in Cameroon. Thus, this study aimed at assessing the prevalence and associated factors of teenage pregnancy among secondary and high school students in the Tiko Health District, South West Region, Cameroon. Methods: A cross-sectional descriptive study was conducted whereby data was collected using self-administered questionnaires from 250 systematically sampled participants from five teaching institutions in the Tiko Health District. Data was analysed using the EPI Info software, version 7.0. The study was carried out from the 15th November 2018 to the 20th of May 2019. Results: We had a total of 250 participants. The prevalence of teenage pregnancy was 5.20% (95% CI 3.34 - 9.1). A total of 47.20% (95% CI: 37.56 - 53.6) of participants were sexually active. Having multiple partners was a major risk factor for teenage pregnancy (AOR: 3.2, 95%CI: 1.75 - 4.03, P-value: 0.03). After adjusting for confounders educational level was a risk factor for the awareness of teenage pregnancy (AOR: 0.54, 95%CI: 0.30 - 0.92, P-value: 0.04). Poor communication skills, social shyness, and lack of knowledge were potential barriers to contraceptive use. Conclusion: Having multiple sexual partners was a risk factor to the prevalence of teenage pregnancy. The majority of adolescents had considerate ideas of teenage pregnancy, its prevention, and its consequences. However, a good number of them lack adequate knowledge of a comprehensive sexuality education. Thus, measures have to be put in place to provide better sex education to adolescents.

Survey of ophthalmologists-in-training in Eastern, Central and Southern Africa: A regional focus on ophthalmic surgical education

Background: There are 2.7 ophthalmologists per million population in sub-Saharan Africa, and a need to train more. We sought to analyse current surgical training practice and experience of ophthalmologists to inform planning of training in Eastern, Central and Southern Africa. Methods: This was a cross-sectional survey. Potential participants included all current trainee and recent graduate ophthalmologists in the Eastern, Central and Southern African region. A link to a web-based questionnaire was sent to all heads of eye departments and training programme directors of ophthalmology training institutions in Eastern, Central and Southern Africa, who forwarded to all their trainees and recent graduates. Main outcome measures were quantitative and qualitative survey responses. Results: Responses were obtained from 124 (52%) trainees in the region. Overall level of satisfaction with ophthalmology training programmes was rated as ‘somewhat satisfied’ or ‘very satisfied’ by 72%. Most frequent intended career choice was general ophthalmology, with >75% planning to work in their home country post-graduation. A quarter stated a desire to mainly work in private practice. Only 28% of junior (first and second year) trainees felt surgically confident in manual small incision cataract surgery (SICS); this increased to 84% among senior trainees and recent graduates. The median number of cataract surgeries performed by junior trainees was zero. 57% of senior trainees were confident in performing an anterior vitrectomy. Only 29% of senior trainees and 64% of recent graduates were confident in trabeculectomy. The mean number of cataract procedures performed by senior trainees was 84 SICS (median 58) and 101 phacoemulsification (median 0). Conclusion: Satisfaction with post-graduate ophthalmology training in the region was fair. Most junior trainees experience limited cataract surgical training in the first two years. Focused efforts on certain aspects of surgical education should be made to ensure adequate opportunities are offered earlier on in ophthalmology training.

Survey of ophthalmologists-in-training in Eastern, Central and Southern Africa: A regional focus on ophthalmic surgical education.

Background: There are 2.7 ophthalmologists per million population in sub-Saharan Africa, and a need to train more. We sought to analyse current surgical training practice and experience of ophthalmologists to inform planning of training in Eastern, Central and Southern Africa. Methods: This was a cross-sectional survey. Potential participants included all current trainee and recent graduate ophthalmologists in the Eastern, Central and Southern African region. A link to a web-based questionnaire was sent to all heads of eye departments and training programme directors of ophthalmology training institutions in Eastern, Central and Southern Africa, who forwarded to all their trainees and recent graduates. Main outcome measures were quantitative and qualitative survey responses. Results: Responses were obtained from 124 (52%) trainees in the region. Overall level of satisfaction with ophthalmology training programmes was rated as 'somewhat satisfied' or 'very satisfied' by 72%. Most frequent intended career choice was general ophthalmology, with >75% planning to work in their home country post-graduation. A quarter stated a desire to mainly work in private practice. Only 28% of junior (first and second year) trainees felt surgically confident in manual small incision cataract surgery (SICS); this increased to 84% among senior trainees and recent graduates. The median number of cataract surgeries performed by junior trainees was zero. 57% of senior trainees were confident in performing an anterior vitrectomy. Only 29% of senior trainees and 64% of recent graduates were confident in trabeculectomy. The mean number of cataract procedures performed by senior trainees was 84 SICS (median 58) and 101 phacoemulsification (median 0). Conclusion: Satisfaction with post-graduate ophthalmology training in the region was fair. Most junior trainees experience limited cataract surgical training in the first two years. Focused efforts on certain aspects of surgical education should be made to ensure adequate opportunities are offered earlier on in ophthalmology training.

Long Range Sequencing Shows Improved Resolution in the Detection of Beta Globin Cluster Variants

Introduction: Globin gene sequencing has long been impeded by repetitive regions, homology and structural variation. Currently, long-read sequencing technology has been limited by high cost and error rate. These challenges can be mitigated by sample multiplexing of targeted capture sequencing and the use of consensus reads, respectively. This ongoing study analyzes the utility of long range sequencing technology in identifying historically problematic beta globin cluster mutations. Materials and methods: Long range sequencing was performed on complex beta globin gene cluster cases utilizing the Sequel platform (Pacific Biosciences, Menlo Park, California, United States). Sample input was 1 microgram of DNA extracted from whole blood. Circular Consensus Sequence (CCS) FASTQ sequences files were mapped to reference genome (GRCh37/hg19) using NGMLR, followed by annotation of variants using a custom bioinformatics workflow. Comparison to multiplex ligation-dependent probe amplification (MLPA), Sanger sequencing, array CGH, short-range NGS (300 bp), hemoglobin protein, and clinical data was performed. Results: CCS read length varied from 1 to 10 kb, average 3.5. Analysis of the beta globin cluster region showed impressive superiority and comprehensiveness to Sanger, MLPA, array CGH and short range sequencing technology: 1) single nucleotide variants (SNVs) were identified to a sensitivity and specificity of 99.5%; 2) large structural variants (SVs) such as large deletions, duplications, insertions, crossovers and fusions spanning many kilobases were characterized in the heterozygous, homozygous and compound heterozygous state to a precise genomic coordinate (table 1); 3) phasing SNVs identified Hb S haplotypes (Central African region (CAR), Benin, Senegal, Arab-Indian and Cameroon). Conclusion: 1) Long range sequencing holds significant promise in genotyping hemoglobin disorders. This method improves efficiency with potential for a single test offering with increased resolution, particularly in large deletion analysis. Complex cases greatly benefited from improved range and resolution. 2) The decreased requirement of blood volume for extensive testing is of particular interest for the pediatric population. 3) Genotyping of Hb S patients detected by positive newborn screening will help predict need for prophylaxis or therapy by assessing variant zygosity, phasing and haplotypes. In conclusion, we believe that long range sequencing has immense potential to contribute extensively to thalassemia and hemoglobinopathy diagnostics and is far superior to the currently available technologies for beta globin cluster analysis. Disclosures Jen: Celgene: Employment.

An evaluation of COSMO‐CLM regional climate model in simulating precipitation over Central Africa

AbstractIn this study, an analysis of present day climate simulation (1998–2008) is presented for the Central African (CA) region with the COnsortium for Small‐scale MOdelling in CLimate Mode (CCLM) regional climate model, forced by the ERA‐Interim (ERAINT) reanalysis data. The ability of the CCLM to simulate the observed precipitation with particular focus on the mean spatial pattern, low‐level circulation, seasonal cycles, and daily characteristics is evaluated. Likewise, the added value of the regional model CCLM compared to the driving ERAINT reanalysis is also investigated. It is shown that ERAINT and CCLM exhibit quite different sign of bias, which is an indication of the importance of internal variability and fine scale processes representation for the simulation of surface climate. Despite the CCLM is constantly dry over southern CA, the model succeeds to reproduce reasonably the mean spatial patterns of precipitation and low‐level circulation features, along with the associated seasonal cycles over the whole CA and majority of the five selected analysis sub‐regions. Results also show that daily precipitation indices are well represented, although the better performance greatly depends on the considered seasons. Nevertheless, CCLM substantially outperforms the ERAINT daily precipitation characteristics, thus highlighting the added value of the downscaling exercise over the region. The analysis of daily precipitation indices also reveals that the dry character of the model could probably be connected to the underestimation of the simulated less intense events, which in turn result to an overestimation of the simulated dry spell duration.