Region Of Mali Research Articles

Challenges to the implementation and adoption of physical distancing measures against COVID-19 by internally displaced people in Mali: a qualitative study

BackgroundFor almost a decade now, Mali has been facing a security crisis that led to the displacement of thousands of people within the country. Since March 2020, a health crisis linked to the COVID-19 pandemic also surfaced. To overcome this health crisis, the government implemented some physical distancing measures but their adoption proved difficult, particularly among internally displaced people (IDPs). The objective of this study is to identify the challenges relating to the implementation and adoption of physical distancing measures and to determine the main mitigation measures taken by IDPs to adjust to these new policies.MethodsAn exploratory qualitative research was conducted in Bamako and Ségou, two of the ten regions of Mali. The study counted 68 participants including 50 IDPs, seven administrative and health authorities, and 11 humanitarian actors. Sampling was guided by the principle of saturation and diversification, and data was collected through semi-structured individual interviews (n = 36) and focus groups (n = eight). Analysis was based on thematic content analysis through NVivo software.ResultsThe main challenges identified concerning the implementation and adoption of physical distancing measures include the proximity in which IDPs live, their beliefs and values, the lack of toilets and safe water on sites, IDPs habits and economic situation, humanitarian actors’ lack of financial resources and authority, and social pressure from religious leaders. Implemented mitigation measures include the building of new shelters or their compartmentalization, the creation of income-generating activities and food banks, psychosocial support, promoting awareness of IDPs, and nightly police patrols and surveillance to discourage IDPs from going out. Finally, a call for action is suggested for the actors involved in IDPs support and management.ConclusionsThe study demonstrates the difficulty for IDPs to follow most of the physical distancing measures and informs about the risk of disease spreading among IDPs with its potential consequences. It also shows the inability of mitigation measures to control the outbreak and suggests actions to be considered.

Impacts of rainfall and temperature on photoperiod insensitive sorghum cultivar : model evaluation and sensitivity analysis

A combination of local-scale climate and crop simulation model were used to investigate the impacts of change in temperature and rainfall on photoperiod insensitive sorghum in the Sudanian zone of Mali. In this study, the response of temperature and rainfall to yield patterns of photoperiod insensitive sorghum (Sorghum bicolor L. Moench) using the Agricultural Production Systems Simulator (APSIM) model was evaluated. Following model calibration of the cultivar at varying sowing dates over two growing seasons (2013 and 2014), a long-term simulation was run using historical weather data (1981-2010) to determine the impacts of temperature and rainfall on grain yield, total biomass and water use efficiency at varying nitrogen fertilizer applications. The results showed that model performance was excellent with the lowest mean bias error (MBE) of -2.2 days for flowering and 1.4 days for physiological maturity. Total biomass and grain yield were satisfactorily reproduced, indicating fairly low RMSE values of 21.3% for total biomass and very low RMSE of 11.2 % for grain yield of the observed mean. Simulations at varying Nfertilizer application rate with increased temperature of 2 °C, 4 °C and 6 °C and decreased rainfall by 25 and 50 % (W-25% and W-50%) posed a highly significant risk to low yield compared to increase in rainfall. However, the magnitude of temperature changes showed a decline in grain yield by 10%, while a decrease in rainfall by W-25% and W-50% resulted in yield decline between 5% and 37%, respectively. Thus, climate-smart site-specific utilization of the photoperiod insensitive sorghum cultivar suggests more resilient and productive farming systems for sorghum in semi-arid regions of Mali.

Effect of mobile application user interface improvements on minimum expected home visit coverage by community health workers in Mali: a randomised controlled trial

BackgroundProactive community case management (ProCCM) has shown promise to advance goals of universal health coverage (UHC). ProCCM community health workers (CHWs) face operational challenges when pursuing their goal of visiting...

Functional human IgA targets a conserved site on malaria sporozoites.

Immunoglobulin (Ig)A antibodies play a critical role in protection against mucosal pathogens. However, the role of serum IgA in immunity to non-mucosal pathogens, such as Plasmodium falciparum, is poorly characterized, despite being the second most abundant isotype in blood after IgG. Here, we investigated the circulating IgA response in humans to Plasmodium falciparum sporozoites that are injected into the skin by mosquitoes and migrate to the liver via the bloodstream to initiate malaria infection. We found that circulating IgA was induced in three independent sporozoite-exposed cohorts: individuals living in an endemic region in Mali, malaria-naïve individuals immunized intravenously with three large doses of irradiated sporozoites, and malaria-naïve individuals exposed to a single controlled mosquito bite infection. Mechanistically, we found evidence in an animal model that IgA responses were induced by sporozoites at dermal inoculation sites. From malaria-resistant individuals, we isolated several IgA monoclonal antibodies that reduced liver parasite burden in mice. One antibody, MAD2-6, bound to a conserved epitope in the N-terminus of the P. falciparum circumsporozoite protein, the dominant protein on the sporozoite surface. Crystal structures of this antibody revealed a unique mode of binding whereby two Fabs simultaneously bound either side of the target peptide. This study reveals a role for circulating IgA in malaria and identifies the N-terminus of the circumsporozoite protein as a target of functional antibodies.

Persistence of the historical lineage I of West Africa against the ongoing spread of the Asian lineage of peste des petits ruminants virus.

Peste des petits ruminants (PPR) is a highly contagious disease of small ruminants. The causal agent, PPR virus (PPRV), is classified into four genetically distinct lineages. Lineage IV, originally from Asia, has shown a unique capacity to spread across Asia, the Middle East and Africa. Recent studies have reported its presence in two West African countries: Nigeria and Niger. Animals are frequently exchanged between Mali and Niger, which could allow the virus to enter and progress in Mali and to other West African countries. Here, PPRV samples were collected from sick goats between 2014 and 2017 in both Mali and in Senegal, on the border with Mali. Partial PPRV nucleoprotein gene was sequenced to identify the genetic lineage of the strains. Our results showed that lineage IV was present in south‐eastern Mali in 2017. This is currently the furthest West the lineage has been detected in West Africa. Surprisingly, we identified the persistence at least until 2014 of the supposedly extinct lineage I in two regions of Mali, Segou and Sikasso. Most PPRV sequences obtained in this study belonged to lineage II, which is dominant in West Africa. Phylogenetic analyses showed a close relationship between sequences obtained at the border between Senegal and Mali, supporting the hypothesis of an important movement of the virus between the two countries. Understanding the movement of animals between these countries, where the livestock trade is not fully controlled, is very important in the design of efficient control strategies to combat this devastating disease.

Are perception and adaptation to climate variability and change of cowpea growers in Mali gender differentiated?

Understanding the gender dimension of climate change perception and choice of adaptation strategies is crucial for policy recommendations that foster the development and integration of gender-responsive climate-smart agricultural interventions into agricultural development programs. This study determined the differences in the perception and choice of adaptation strategies between men and women farmers in Cinzana in the Segou region of Mali. The study used questionnaire interviews involving 260 farmers (49% women) and focus group discussions for data collection. Data were analyzed using descriptive statistics and multinomial logit model to understand the determinants of the level of adoption of adaptation strategies. The results showed that, irrespective of gender, majority of farmers perceived climate change as extended period of droughts, shortened duration of rains, increased frequency of strong winds and increased day and night temperatures. While climate change perception was similar between men and women, choice of adaptation strategies differed significantly in most instances. Women farmers were generally low adopters of crop and varieties-related strategies, soil and water conservation technics (contour farming, use of organic manure), etc., compare to men. Notably, being the household head, age and the availability of free labor were found to positively increased farmers’ probability of adopting many adaptation strategies. The study recommends improving women’s access and control of production resources (land, labor) as means to improving their adoption of adaptation strategies.

Seroprevalence of brucellosis in small ruminants and related risk behaviours among humans in different husbandry systems in Mali

Mali has a high pastoral potential with diverse coexisting production systems ranging from traditional (nomadic, transhumant, sedentary) to commercial (fattening and dairy production) production systems. Each of those systems is characterised by close interactions between animals and humans, increasing the potential risk of transmission of zoonotic diseases. The nature of contact network suggests that the risks may vary according to species, production systems and behaviors. However, the study of the link between small ruminants and zoonotic diseases has received limited attention in Mali. The objective of this study was to assess brucellosis seroprevalence and determine how the husbandry systems and human behaviour expose animal and human to infection risk. A cross-sectional study using cluster sampling was conducted in three regions in Mali. Blood was collected from 860 small ruminants. The sera obtained were analysed using both Rose Bengal and cELISA tests. In addition, 119 farmers were interviewed using a structured questionnaire in order to identify the characteristics of farms as well as the risk behaviors of respondents. Husbandry systems were dominated by agro-pastoral systems followed by pastoral systems. The commercial farms (peri-urban and urban) represent a small proportion. Small ruminant individual seroprevalence was 4.1% [2.8-5.6% (95% CI)]. Herd seroprevalence was estimated at 25.2% [17.7-33.9% (95% CI)]. Peri-urban farming system was more affected with seroprevalence of 38.1% [18.1-61.5 (95% CI)], followed by pastoral farming system (24.3% [11.7-41.2 (95% CI)]). Identified risk behaviors of brucellosis transmission to animals were: exchange of reproductive males (30.2%); improper disposal of placentas in the farms (31.1%); and keeping aborted females in the herd (69.7%). For humans, risk factors were: close and prolonged contact with animals (51.2%); consumption of unpasteurized dairy products (26.9%); and assisting female animals during delivery without any protection (40.3%). This study observed a high seroprevalence of brucellosis in small ruminants and also identified risky practices that allow cross transmission between the two populations. This calls for control strategy using a multi-sectoral and multidimensional approach.

Identification and characterization of Ralstonia spp. causing bacterial wilt disease of vegetables in Mali

Ralstonia solanacearum species complex is the most destructive and economically important bacterial pathogen of many plant species around the world. It is a particular constraint to the production of the solanaceous vegetables such as tomato, chilli pepper and African eggplant in West Africa. Its broad host range, ability to survive in the soil for long periods and ability to sustain latent infection, make it difficult to control. Identification, characterization and mapping the distribution of the causal Ralstonia spp. strains are necessary to help design effective control strategies. Wilted tomato, African eggplant and pepper plant samples were collected from fields in different regions of Mali. The causal bacterial strains were isolated from the samples and all were identified as Ralstonia pseudosolanacearum. Multiplex PCR using four phylotype specific primer pairs identified the presence of phylotype I strains distributed across all the vegetable production areas whereas phylotype III strains were limited to areas of Sikasso, Koulikoro and Segou to the south and east of Bamako city. Phylogenetic analysis of part of the conserved endoglucanase virulence gene sequences revealed four sequevars with most phylotype I strains identified as sequevars 46 and 31 with only a few as sequevar 14 and one sequevar 18. The phylotype III strains were all in the sequevar 23–48 group. Pathogenicity testing of a selected subset of the strains isolated in Mali showed them all to be pathogenic to the susceptible tomato cultivar Roma. To our knowledge, this is the first study on the molecular diversity within the Ralstonia spp. complex in Mali. This information is important for developing wilt management strategies including breeding for resistance and specifying quarantine restrictions.

Factors explaining the shortage and poor retention of qualified health workers in rural and remote areas of the Kayes, region of Mali: a qualitative study.

Shortage of health workers is a worldwide problem but is particularly critical in sub-Saharan Africa. In Mali, the number of health workers is insufficient and their retention is low, particularly in rural and remote areas. Rural postings are unattractive to health workers. Very few studies have examined the factors contributing to the shortage and poor retention of health workers in Mali. The objective of this study is to identify and understand these factors with regards to skilled health workers in two rural health districts (Yélimané and Bafoulabé) in the region of Kayes, Mali. This qualitative study is based on the conceptual framework of Lehman, Dieleman and Martineau. Data were collected through 46 in-depth interviews with health workers and decision-makers. A thematic content analysis was conducted with the support of QDA Miner software. The study identified factors contributing to the insufficient allocation and poor retention of rural health workers in these districts. They are individual-level factors (gender, family situation, age), unattractive living and working conditions, community recognition and participation, quality of leadership, an unfavourable recruitment/assignment process and insufficient financial incentives. It shows that female staff have specific constraints that prevent them from deploying to or staying in rural areas for long periods. In addition, the number of staff recruited at the national level is unpredictable and insufficient, while their recruitment and assignment process is perceived to be inequitable and not very transparent, disadvantaging rural health structures. Some strategies were identified to improve the availability and retention of health workers in these areas. They take into account certain social norms, notably gender roles, and include the improvement of living and working conditions, as well as the strengthening of health workforce management. This study's findings highlight the multifaceted nature of factors contributing to the availability and retention of health workers in rural and remote areas of sub-Saharan Africa and the challenges associated with them. This study identifies some strategies that can be combined to facilitate the retention and availability of health workers in these areas. Some strategies involve actors outside the health sector, requiring joint efforts for their implementation. This research provides decision-makers with evidence to support informed decision making with regards to the retention of health workers in rural areas.

Intensification of Sorghum Production in Flood Recession Agriculture in Yelimane, Western Mali

Flood recession farming is as an important supplement to rainfed agriculture in West Africa. Every year, large areas are flooded along riverbanks and temporary lakes. When water recedes from the flooded areas, farmers plant crops. This study describes the flood recession farming in the Yelimane district of Kayes region in Mali and assesses different ways to intensify the system. The use of external inputs in this system is minimal. Field experiments were undertaken over two years to test crop establishment methods, soil tillage, increasing plant density, use of organic and mineral fertilizer, and improved varieties. These technologies increased sorghum yield as compared to the control in the following descending order: Seed priming + fertilizer (77.1%), NPK + organic fertilizer (74%), seedling transplantation + micro fertilization (61.3%), improved varieties (49%), mounding (34%), and urea application (24.9%). The technology seed priming in combination with mineral fertilizers was promising because of the high yield and the low labor demand. Nitrogen fertilizer is needed in flood recession agriculture as the soils and the deposited sediments are low in nitrogen. Farmers’ choice of technology will depend on the yield level, net return per hectare, labor use, and access to inputs.

Bringing severe acute malnutrition treatment close to households through community health workers can lead to early admissions and improved discharge outcomes.

Severe acute malnutrition (SAM) affects over 16.6 million children worldwide. The integrated Community Case Management (iCCM) strategy seeks to improve essential health by means of nonmedical community health workers (CHWs) who treat the deadliest infectious diseases in remote rural areas where there is no nearby health center. The objective of this study was to assess whether SAM treatment delivered by CHWs close to families’ locations may improve the early identification of cases compared to outpatient treatment at health facilities (HFs), with a decreased number complicated cases referred to stabilization centers, increased anthropometric measurements at admission (closer to the admission threshold) and similarity in clinical outcomes (cure, death, and default). The study included 930 children aged 6 to 59 months suffering from SAM in the Kita district of the Kayes Region in Mali; 552 children were treated by trained CHWs. Anthropometric measurements, the presence of edema, and other medical signs were recorded at admission, and the length of stay and clinical outcomes were recorded at discharge. The results showed fewer children with edema at admission in the CHW group than in the HF group (0.4% vs. 3.7%; OR = 10.585 [2.222–50.416], p = 0.003). Anthropometric measurements at admission were higher in the CHW group, with fewer children falling into the lowest quartiles of both weight-for-height z-scores (20.2% vs. 31.5%; p = 0.002) and mid-upper arm circumference (18.0% vs. 32.4%; p<0.001), than in the HF group. There was no difference in the length of stay. More children in the CHW group were cured (95.9% vs. 88.7%; RR = 3.311 [1.772–6.185]; p<0.001), and there were fewer defaulters (3.7% vs. 9.8%; RR = 3.345 [1.702–6.577]; p<0.001) than in the HF group. Regression analyses demonstrated that less severe anthropometric measurements at admission resulted in an increased probability of cure at discharge. The study results also showed that CHWs provided more integrated care, as they diagnosed and treated significantly more cases of infectious diseases than HFs (diarrhea: 36.0% vs. 18.3%, p<0.001; malaria: 41.7% vs. 19.8%, p<0.001; acute respiratory infection: 34.8% vs. 25.2%, p = 0.007). The addition of SAM treatment in the curative tasks that the CHWs provided to the families resulted in earlier admission and more integrated care for children than those associated with HFs. CHW treatment also achieved better discharge outcomes than standard community treatment.

No effects of pilot performance-based intervention implementation and withdrawal on the coverage of maternal and child health services in the Koulikoro region, Mali: an interrupted time series analysis.

Performance-based financing (PBF) has been promoted and increasingly implemented across low- and middle-income countries to increase the utilization and quality of primary health care. However, the evidence of the impact of PBF is mixed and varies substantially across settings. Thus, further rigorous investigation is needed to be able to draw broader conclusions about the effects of this health financing reform. We examined the effects of the implementation and subsequent withdrawal of the PBF pilot programme in the Koulikoro region of Mali on a range of relevant maternal and child health indicators targeted by the programme. We relied on a control interrupted time series design to examine the trend in maternal and child health service utilization rates prior to the PBF intervention, during its implementation and after its withdrawal in 26 intervention health centres. The results for these 26 intervention centres were compared with those for 95 control health centres, with an observation window that covered 27 quarters. Using a mixed-effects negative binomial model combined with a linear spline regression model and covariates adjustment, we found that neither the introduction nor the withdrawal of the pilot PBF programme bore a significant impact in the trend of maternal and child health service use indicators in the Koulikoro region of Mali. The absence of significant effects in the health facilities could be explained by the context, by the weaknesses in the intervention design and by the causal hypothesis and implementation. Further inquiry is required in order to provide policymakers and practitioners with vital information about the lack of effects detected by our quantitative analysis.

Improving haemophilia diagnosis in developing countries: the Malian experience

Abstract Introduction Around 90% of all undiagnosed people with haemophilia (PWH) live in developing countries. In Mali, in sub-Saharan Africa, nearly 90% of potential PWH are not identified. We initiated a two-year study involving an integrated programme of training and awareness-raising with the aim of improving diagnosis and access to care for PWH, based on partnership with those who regularly interact with them. Methodology Our training programme focused on four regions of Mali and the district of Bamako, and included three types of health professionals from different districts and hospitals: medical doctor, nurse and laboratory technician. We also targeted traditional healers, who continue to be strongly involved in local healthcare, and provided training sessions for patients and their families on the symptoms, diagnosis, treatment and complications of haemophilia. A complementary programme of awareness-raising, including the national media, ran alongside the training sessions. Results Overall, the programme involved 495 participants: 213 health care professionals, 24 patients, 79 parents of patients, 126 traditional healers, and 53 media workers. A direct result was development of collaboration between these groups in identifying haemophilia, and the transfer of four patients from a traditional healer's office to hospital for diagnosis and treatment. The number of diagnosed PWH increased from 42 in 2016 to 126 in 2017. Conclusion The integrated haemophilia educational programme, which took into account the nature of the local environment and involved all relevant stakeholders, showed that taking a collaborative approach is a successful strategy for improving diagnosis and care for PWH in Mali. This approach could be relevant in other developing countries.

Agronomic Efficiency of Deep Urea Placement Technology in Lowland Rice Cultivation in the Ecological Conditions of the Sikasso Region in Mali: Case of the Village of Dalabani

In terms of human food consumption, rice is the world’s leading cereal and is nowadays the staple diet in the least developed countries. Current fertilization practice is based mainly on mineral fertilizers brought in on the fly which is inefficient because it leads to very high losses of nitrogen, and the increasing the productivity in lowland rice cultivation in Mali requires good soil fertilization management. The present study undertaken in lowland rice cultivation aims to improve fertilizer efficiency through deep placement of Urea (PPU) which envisages increasing the yields of lowland rice producers, reducing the amount of fertilizer used and decreasing environmental damage to the atmosphere and water. It was carried out in a farming environment following an experimental Split-plot system with four replications. The dose of organic manure and the form of mineral fertilizer taken at two and six levels of variation respectively were the factors studied. The combinations of factors resulted in twelve treatments. The results of the analysis show that organic fertilization only had a significant effect on tillering with the treatment without organic manure as the greatest number of tiller (16.41). On the other hand, the form of mineral fertilizer had significant and highly significant differences respectively on grain yield and number of tillers. The F4 (Granules (Urea + diammonium phosphate (DAP)) of 1.5 cm of diameter) treatment gave the maximum grain yield (2.68 t/ha) and number of tillers (17.45). The interaction of factors had a significant effect only on the number of tillers, with F0 without urea and DAP (control) having the highest performance with 22 of number of tillers. Maximum N uptake and N recovery were observed at the F1 (UG (Urea’s granule) + DAPS (DAP simple)) treatment level with values of 3455 kg/ha and 34% respectively.

Characterization of New Races of Xanthomonas oryzae pv. oryzae in Mali Informs Resistance Gene Deployment.

Bacterial leaf blight caused by Xanthomonas oryzae pv. oryzae represents a severe threat to rice cultivation in Mali. Characterizing the pathotypic diversity of bacterial populations is key to the management of pathogen-resistant varieties. Forty-one X. oryzae pv. oryzae isolates were collected between 2010 and 2013 in the major rice growing regions in Mali. All isolates were virulent on the susceptible rice variety Azucena; evaluation of the isolates on 12 near isogenic rice lines, each carrying a single resistance gene, identified six new races (A4 to A9) and confirmed race A3 that was previously reported in Mali. Races A5 and A6, isolated in Office du Niger and Sélingué, were the most prevalent races in Mali. Race A9 was the most virulent, circumventing all of the resistance genes tested. Xa3 controlled six of seven races (i.e., 89% of the isolates tested). The expansion of race A9 represents a major risk to rice cultivation and highlights the urgent need to identify a local source of resistance. We selected 14 isolates of X. oryzae pv. oryzae representative of the most prevalent races to evaluate 29 rice varieties grown by farmers in Mali. Six isolates showed a high level of resistance to X. oryzae pv. oryzae and were then screened with a larger collection of isolates. Based on the interactions among the six varieties and the X. oryzae pv. oryzae isolates, we characterized eight different pathotypes (P1 to P8). Two rice varieties, SK20-28 and Gigante, effectively controlled all of the isolates tested. The low association observed among races and pathotypes of X. oryzae pv. oryzae suggests that the resistance observed in the local rice varieties does not simply rely on single known Xa genes. X. oryzae pv. oryzae is pathogenically and geographically diverse. Both the races of X. oryzae pv. oryzae characterized in this study and the identification of sources of resistance in local rice varieties provide useful information to inform the design of effective breeding programs for resistance to bacterial leaf blight in Mali.

Apiculture and Poverty Reduction Nexus: Evidence From Rural Households in Sikasso Region of Mali

Beekeeping is traditionally an age-long and environmentally friendly agricultural activity. Beekeeping can provide economic and social benefits through the provision of employment opportunities and...

Sociodemographic Characteristics of Traditional Healers and Their Knowledge of Noma: A Descriptive Survey in Three Regions of Mali.

Background: Noma can be a lethal disease and causes disfigurement in young children in low-resource countries, particularly in Africa. In these settings, 80% of the population mainly consult traditional healers for healthcare problems. Our study aimed to describe the sociodemographic characteristics of traditional healers and to assess their knowledge of noma. Methods: We conducted a survey among traditional healers in three Malian regions from May 2015 to January 2016 and collected data on sociodemographic characteristics, professional activity, knowledge, and experience of noma and collaboration with modern medicine. Results: Among 770 traditional healers invited to participate, 732 responded (95%) (mean age, 54.5 years). Most were illiterate (66.3%), which was associated with older age (p < 0.001). Although they treated all types of disease, only 10.5% had some knowledge of noma, with regional differences (p < 0.001). Conclusion: Noma is poorly known among traditional healers, especially in remote areas. Our findings suggest a lack of interest among young people for traditional medicine, implying an imminent decrease of healers, and thus the need for national health systems to strengthen and promote access to modern health care. Training programmes to improve the early diagnosis referral of noma patients should include all types of primary health workers.

The association between child Schistosoma spp. infections and morbidity in an irrigated rice region in Mali: A localized study

BackgroundSchistosomiasis is one of the neglected tropical diseases endemic to Mali. There has been insufficient investigation of the morbidity burden in highly endemic irrigated rice areas with the ongoing mass drug administration with praziquantel. In February 2005, a year after an initial mass drug administration in 2004, we performed the first cross-sectional survey of schistosomiasis in the Kokry-Bozo village in the Office du Niger rice irrigation region. In the fourteen years since this survey, there has been almost no research into schistosomiasis morbidity in Mali due to lack of funding. Therefore, the 2005 survey supplies near-baseline data for any future research into the treatment impacts in the area. MethodsOne hundred and ninety-four children aged 6–14 years from two schools were assessed for bladder pathology by ultrasound, and for anaemia and micro-haematuria by laboratory tests. Schistosoma eggs were examined microscopically in fresh stool and urine samples. Multivariate logistic regression analysis quantified the association of Schistosoma infections with anaemia, bladder pathology and micro-haematuria. Akaike’s information criterion was used to test the assumption of linear effects of infection intensity classes and used to compare across models. ResultsThe overall prevalence of schistosomiasis in 189 school children was 97%; 17% (33/189) had a single infection (S. mansoni,13%, or S. haematobium, 4%) and 80% (156/189) were co-infected with S. mansoni and S. haematobium. The overall prevalence of S. mansoni with light infection was 27% (53/194), moderate infection was 24% (47/194) and heavy infection was 42% (81/194). Of the 194 of children investigated for S. haematobium 59% (114/194) had light infection and 26% (50/194) had heavy infection. No hookworm eggs were detected.The level of abnormal bladder pathology was 18% (35/189) with the highest found in 10–14 year old children. The prevalence of anaemia was 91% (172/189) and was twice as likely to be associated (OR 2.0, 95% CI 1.1–3.9) with S. mansoni infections than in children without infection. As infection intensity with S. mansoni increased the risk of anaemia (OR 2.0, 95% CI 1.1–3.9) also increased. As infection intensity with S. haematobium increased bladder pathology (OR 2.4, 95%CI 1.3–4.5), haematuria (OR 6.7, 95%CI 3.3–13.6) and micro-haematuria increased (OR 2.4, 95%CI 1.3–4.5). ConclusionOur research contributes an important micro-geographical assessment of the heavy burden of schistosomiasis and associated morbidity in children who live in the rice irrigation regions. Our literature review found that there has been very limited research conducted on the impact of the treatment to control morbidity in the ON. Therefore, there is a need to do a comparable, but more extensive, study to identify any changes in morbidity and to indicate current requirements for the control programme. Our results from 2005 called for routine integration of iron supplementation, food fortification and diet diversification into the deworming program.

Predictors of poor nutritional status among children aged 6\u201324\xa0months in agricultural regions of Mali: a cross-sectional study

BackgroundThe right nutrition during the first 2 years of life can positively impact a child’s ability to develop, grow, and learn. Malnutrition remains a public health problem in Mali and little is known about the factors affecting the nutritional status of children. This study aims to assess the magnitude and the predictors of undernutrition in children aged 6–24 months in the poor rural regions of Mali.MethodsA community-based cross-sectional study was conducted in the villages in the Sikasso and Mopti regions in Mali from January to March 2016, comprising of 959 boys and 856 girls aged 6–24 months. A structured interviewer administered a questionnaire that was used to collect data from the mothers living in 1764 households. Anthropometric measurements were performed using standardized methods in order to identify the factors associated with children suffering from undernutrition (stunting and wasting). Bivariate and multivariate logistic regression analyses were conducted.ResultsThe results of our study indicated that 23.9 and 28.4% children were underweight and stunted; the prevalence of wasting was 13.9% using the W/H measurement and 16.5% with the MUAC. Overall, the presence of diarrhea in the past 2 weeks (p < 0.001), higher child age (p < 0.001), male sex (p < 0.001), households with the lowest household amenity score (p < 0.002), and households with a low dietary diversity score (p < 001) were significantly associated with chronic malnutrition. The factors significantly associated with acute malnutrition were male sex (p < 0.01), preterm birth (p < 0.03), lower child age (0.001), a high number of siblings (p < 0.03), and living in a household with more months of inadequate food provisioning (p < 0.03).ConclusionChild undernutrition is a critical public health problem in the agricultural regions of Mali. Future efforts should be directed at addressing the food insecurity and at improving the yearlong household availability and accessibility of nutritious food, as well as taking diseases prevention into account.

Seroprevalence of Rift Valley Fever Virus Antibodies in Cattle in Mali, 2005-2014.

Rift Valley fever virus (RVFV) outbreaks have considerable impact on human and animal health. Here, we are reporting a serosurvey of cattle from all regions of Mali. These demonstrated that few had been exposed to RVFV from 2005 to 2014. Recent outbreaks of RVF in Niger and a single human case in Mali provide justification for further entomological and ecological studies of this virus.