Rural West Africa Research Articles

Landscape and meteorological determinants of malaria vectors' presence and abundance in the rural health district of Korhogo, Côte d'Ivoire, 2016-2018, and comparison with the less anthropized area of Diébougou, Burkina Faso.

Understanding how weather and landscape shape the fine-scale distribution and diversity of malaria vectors is crucial for efficient and locally tailored vector control. This study examines the meteorological and landscape determinants of (i) the spatiotemporal distribution (presence and abundance) of the major malaria vectors in the rural region of Korhogo (northern Côte d'Ivoire) and (ii) the differences in vector probability of presence, abundance, and diversity observed between that area and another rural West African region located 300 km away in Diébougou, Burkina Faso. We monitored Anopheles human-biting activity in 28 villages of the Korhogo health district for 18 months (2016 to 2018), and extracted fine-scale environmental variables (meteorological and landscape) from high-resolution satellite imagery. We used a state-of-the-art statistical modeling framework to associate these data and identify environmental determinants of the presence and abundance of malaria vectors in the area. We then compared the results of this analysis with those of a similar, previously published study conducted in the Diébougou area. The spatiotemporal distribution of malaria vectors in the Korhogo area was highly heterogeneous and appeared to be strongly determined and constrained by meteorological conditions. Rice paddies, temporary sites filled by rainfall, rivers and riparian forests appeared to be the larval habitats of Anopheles mosquitoes. As in Diébougou, meteorological conditions (temperatures, rainfall) appeared to significantly affect all developmental stages of the mosquitoes. Additionally, ligneous savannas were associated with lower abundance of malaria vectors. Anopheles species diversity was lower in Korhogo compared to Diébougou, while biting rates were much higher. Our results suggest that these differences may be due to the more anthropized nature of the Korhogo region in comparison to Diébougou (less forested areas, more agricultural land), supporting the hypothesis of higher malaria vector densities and lower mosquito diversity in more anthropized landscapes in rural West Africa. This study offers valuable insights into the landscape and meteorological determinants of the spatiotemporal distribution of malaria vectors in the Korhogo region and, more broadly, in rural west-Africa. The results emphasize the adverse effects of the ongoing landscape anthropization process in the sub-region, including deforestation and agricultural development, on malaria vector control.

Use of native and human-modified habitats by different mammal guilds in West Africa

Over millennia, mammals have coexisted with humans across the forest-savannah mosaics characterising part of West Africa. While some savannahs have long been used for rice cultivation in Guinea-Bissau, savannas and forests are now being rapidly converted into cashew monocultures. To understand how species cope with such land-use changes, we investigated how mammals make use of forest patches, cashew orchards and rice paddies over two contrasting periods: early and late rainy season. Using camera-trapping, we examined mammal diversity and trophic guild activity across seven landscapes, each with one sampling site per habitat type in Northern Guinea-Bissau. Based on 937 records from 21 species, species richness and activity were similar across habitat types, but generally higher in the late-rainy season. In this season, species composition differed between the cashew orchards and rice paddies. At the guild-level, carnivore activity was lower in the rice paddies than in forests, while herbivore activity was lower in the cashew orchards in comparison to that in forests in the early-rainy season. The relatively similar assemblage-wide diversity across habitat types seems to be enabled by the high habitat heterogeneity, but likely offset by previous extinctions from the area. Yet, guild-level habitat use highlighted the fundamental role of forests to sustain functionally healthy mammal assemblages. Maintaining habitat heterogeneity, including patches of native forests, seems to be key in optimizing the long-term conservation of mammal diversity in rural West Africa.

Generation and gender: theorising social reproduction in rural West Africa

ABSTRACT This paper argues for generation to be incorporated into the analysis of social reproduction to open new ways of thinking about the significance of children's unpaid work in and for their families. This paper situates its argument in relation to social reproduction theory and the conceptualization of generation in childhood studies and development studies. It draws on a longitudinal study of girls growing up in contemporary Benin and Togo conducted by Plan Benin and Plan Togo. This paper shows how the work of social reproduction is distributed across the household with children, especially girls, playing a large part in these activities. Trading and farming are the main economic activities of women, and girls gradually extend their knowledge of how to farm and trade as they get older. This paper concludes that placing generation into the centre of social reproduction theory will not only make visible the work that children do in subsistence economies but is also important for answering the perennial question of social reproduction theory in capitalist economies: who pays for that ‘strange commodity’, ‘living labour’ to be reproduced.

Physiological and behavioural resistance of malaria vectors in rural West-Africa: a data mining study to address their fine-scale spatiotemporal heterogeneity, drivers, and predictability

Physiological and behavioural resistance of malaria vectors in rural West-Africa: a data mining study to address their fine-scale spatiotemporal heterogeneity, drivers, and predictability

Nudging parents and teachers to improve learning and reduce child labor in Cote d’Ivoire

Whether SMS-based nudge interventions can increase parent engagement and improve child learning outcomes across diverse contexts such as rural West Africa is unknown. We conducted a school-randomized trial to test the impacts of an audio or text-message intervention (two messages per week for one school year) to parents and teachers of second and fourth grade students (N = 100 schools, 2246 students) in Cote d’Ivoire. Schools were randomly assigned to have messages sent to (i) parents only, (ii) teachers only, (iii) parents and teachers together, or (iv) control. There were statistically non-significant impacts of the parents-only treatment on learning, although with typical effect sizes (d = 0.08, p = 0.158), and marginally statistically significant increases in child labor (d = 0.11, p < 0.10). We find no impacts of the other treatment conditions. Subgroup analyses based on pre-registered subgroups show significantly larger improvements in learning for children with below-median baseline learning levels for the parents-only arm and negative impacts on learning for girls for the teachers-only arm, suggesting different conclusions regarding impacts on equity for vulnerable children.

Skin wounds in a rural setting of Côte d'Ivoire: Population-based assessment of the burden and clinical epidemiology.

BackgroundData on the burden and clinical epidemiology of skin wounds in rural sub-Saharan Africa is scant. The scale of the problem including preventable progression to chronic wounds, disability and systemic complications is largely unaddressed.MethodsWe conducted a cross-sectional study combining active (household-based survey) and passive case finding (health services-based survey) to determine the burden and clinical epidemiology of wounds within the Taabo Health and Demographic Surveillance System (HDSS) in rural Côte d’Ivoire. Patients identified with wounds received free care and were invited to participate in the wound management study simultaneously carried out in the survey area. The data were analysed for wound prevalence, stratified by wound and patient characteristics.Results3842 HDSS-registered persons were surveyed. Overall wound prevalence derived from combined active and passive case finding was 13.0%. 74.1% (403/544) of patients were below the age of 15 years. Most frequent aetiologies were mechanical trauma (85.3%), furuncles (5.1%), burns (2.9%) and Buruli ulcer (2.2%). Most wounds were acute and smaller than 5 cm2 in size. 22.0% (176/799) of wounds showed evidence of secondary bacterial infection. 35.5% (22/62) of chronic wounds had persisted entirely neglected for years. Buruli ulcer prevalence was 2.3 per 1000 individuals and considerably higher than expected from an annual incidence of 0.01 per 1000 individuals as reported by WHO for Côte d’Ivoire at the time of the study.ConclusionsSkin wounds are highly prevalent in rural West Africa, where they represent a widely neglected problem. The HDSS-based survey with combined active and passive case finding adopted in this study provides a better estimate than school- and health institution-based surveys which underestimate the frequency of skin wounds and, particularly, of neglected tropical diseases of the skin, such as Buruli ulcer and yaws. A comparison with country-specific WHO data suggests underreporting of Buruli ulcer cases.Trial registrationRegistration at ClinicalTrials.gov NCT03957447.

Factors influencing hesitancy towards adult and child COVID-19 vaccines in rural and urban West Africa: a cross-sectional study

ObjectivesThis study aims: (1) to identify and describe similarities and differences in both adult and child COVID-19 vaccine hesitancy, and (2) to examine sociodemographic, perception-related and behavioural factors influencing vaccine...

Operationalizing affordability criterion in energy justice: Evidence from rural West Africa

Affordability of energy is at the heart of the concept of energy poverty but also an important criterion for energy justice globally. Yet, in developing countries where households predominantly rely on traditional energy sources, measuring the cost of energy goes beyond the price of the fuel and includes other non-monetary costs, such as the time spent and the distance travelled for fuel collection. This paper thereby proposes a redefinition as well as an operationalization of the affordability criterion within the energy justice framework. The outcomes are applied to data obtained in rural Benin, Senegal and Togo. The results suggest that, on average, the opportunity costs related to energy collection represent between 29 and 35% of household income in rural areas. Additionally, failing to account for the non-monetary costs of energy consumption in rural locations may lead to categorizing at least 17% of households as having access to affordable energy, when in fact these households spend substantial amount of time in fuel collection. The study also suggests that reducing income poverty and promoting better access to modern energy sources, through rural electrification programs, are critical to ensure energy affordability in rural West Africa.

Productive uses of energy: A solution for promoting energy justice in rural areas in West Africa

The rural populations of West Africa are victims of energy injustice, for most of them do not have access to electricity and use very inefficient cooking systems that negatively impact their health and the environment. This study aims to investigate the status of access to energy in rural areas in three West African countries and to identify productive activities that could be developed based on available and accessible energy resources. Thus, surveys were conducted among 2291 rural households, including 640 in Benin, 1001 in Senegal and 650 in Togo. The information was collected using CSPro 6.3 software, cleaned with STATA software and analyzed using Microsoft Office EXCEL 2013 software. The analysis of the findings of the surveys was enriched by typical examples of rural energy enterprises in Mali, Senegal and Nigeria. The findings of the surveys showed that the main source of electricity in rural areas is the non-rechargeable dry cell battery for almost 50% of households and 25% are connected to the grid. The available energy resources reported are solar (89.3%), biomass (73.5%) and agricultural residues (39.5%). The economic activities carried out by households in rural West Africa are essentially agricultural, pastoralism (53.7%) and trade (18.0%). Typical examples of rural enterprises as part of electrification activities which integrate the development of productive activities are presented. This approach allows the populations to have income and cover their electricity consumption bills. This work will continue with the simulation of rural enterprises envisioned in the agriculture and livestock sector in West Africa.

Rainfall shocks and household welfare: Evidence from northern Ghana

CONTEXTRainfall shocks pose a threat to farmers in rural West Africa especially in the wake of the recurrent climate variability and its impacts on agricultural production. Despite the harm they pose, limited empirical studies exist on the welfare implications of rainfall shocks on farmers' welfare in West Africa. In addition, the potential impacts of rainfall induced commodity and labor market failures have not been given much attention in the empirical literature. OBJECTIVEOur study aimed to analyze the impact of negative rainfall shocks and commodity and labor market failures on farm households' welfare in northern Ghana. Examining the impact of commodity and labor market failures amidst the experience of a negative rainfall shock helps to identify the possible entry points through which the adverse impacts of rainfall deficits may be reduced. METHODSThe study is based on a household survey data from the Africa Rising program, historical daily climate data from the CCAFS-Climate data portal and random rainfall distributions from Monte Carlo simulation. A total of 1168 households were considered in the analysis. We analyze the impact of rainfall shocks and the above-mentioned entitlement failures using a static optimization model that incorporates a crop yield response function. RESULTS AND CONCLUSIONWe found that an increase in the frequency of negative rainfall shocks under a dry future with and without entitlement failures would impact negatively on the total income and consumption levels of both the asset non-poor and asset poor households in the study area. The asset poor households would however bear the brunt of the impact, and the anticipated impact would mostly be yielded through changes in agricultural incomes and expenditure on food purchases. With increasing risk of dry rainfall conditions, total incomes of farmers could decrease by 7.3% to 45.5%. It was found that ignoring potential failures in commodity and labor markets lead to over/underestimation of the impacts of major rainfall deficits on the different types of farmers. The impact of rainfall shocks on the welfare of farmers is scenario and cluster dependent. SIGNIFICANCEThe results have significance for policy formulation and future research. The findings from this study indicate a need for targeting and acknowledgement of the differential impacts of climate shocks on the different farmer groups. Efforts made in future research to incorporate entitlement failures in climate impact studies could produce more informative guide for effective policy formulation.

Household diversification and market dependence: understanding vulnerability in rural West Africa

ABSTRACT Understanding the empirical relationships among three parameters is necessary to reduce household vulnerability: diversification, market dependence and economic security. A cross-sectional study of these relationships was conducted in five areas with histories of cash cropping in Mali, Burkina Faso, Niger, and northern Nigeria. Household diversification was found to be positively associated with economic security while negatively associated with household dependence on markets. Moreover, individuals in market oriented households are more likely to adopt individualistic orientations. These findings confirm a positive role of diversification but raise concerns about how markets affect the prospects for maintaining or reducing household vulnerability.

A Fix for Fixtures: Addressing Lead Contamination in West African Drinking Water.

A Fix for Fixtures: Addressing Lead Contamination in West African Drinking Water.

Energy poverty in rural West Africa and its determinants: Evidence from Senegal and Togo

This research evaluates the levels and the determinants of energy poverty in rural West Africa using countrywide primary data for Senegal and Togo. The study estimates and compares various indicators for measuring energy poverty and a newly proposed multidimensional measure. The results suggest that rural energy poverty levels vary from 31.2 to 98.5 percent in Senegal and 53.5 to 98.8 percent in Togo. Measures that are based on per capita energy consumption generate higher energy poverty rates in rural Senegal than Togo due to the relative scarcity of fire wood and the relatively larger household size in Senegal. Multidimensional and expenditure-based energy measures generate higher energy poverty in rural Togo than Senegal, reflecting the higher per capita income and greater access to modern energy sources in Senegal compared to Togo. Household income, fertility and the type of fuel used are the main drivers of household energy poverty in both countries. Furthermore, rural households tend to have greater energy consumption when the decisions about energy purchase are made jointly by male and female household members. Thus, public policies that improve rural households' income, foster women's participation in decision-making, and provide affordable energy would help reduce energy poverty in both countries.

Responses to chemical cross-talk between the Mycobacterium ulcerans toxin, mycolactone, and Staphylococcus aureus

Buruli ulcer is a neglected tropical disease caused by the environmental pathogen, Mycobacterium ulcerans whose major virulence factor is mycolactone, a lipid cytotoxic molecule. Buruli ulcer has high morbidity, particularly in rural West Africa where the disease is endemic. Data have shown that infected lesions of Buruli ulcer patients can be colonized by quorum sensing bacteria such as Staphylococcus aureus, S. epidermidis, and Pseudomonas aeruginosa, but without typical pathology associated with those pathogens’ colonization. M. ulcerans pathogenesis may not only be an individual act but may also be dependent on synergistic or antagonistic mechanisms within a polymicrobial network. Furthermore, co-colonization by these pathogens may promote delayed wound healing, especially after the initiation of antibiotic therapy. Hence, it is important to understand the interaction of M. ulcerans with other bacteria encountered during skin infection. We added mycolactone to S. aureus and incubated for 3, 6 and 24 h. At each timepoint, S. aureus growth and hemolytic activity was measured, and RNA was isolated to measure virulence gene expression through qPCR and RNASeq analyses. Results showed that mycolactone reduced S. aureus hemolytic activity, suppressed hla promoter activity, and attenuated virulence genes, but did not affect S. aureus growth. RNASeq data showed mycolactone greatly impacted S. aureus metabolism. These data are relevant and significant as mycolactone and S. aureus sensing and response at the transcriptional, translational and regulation levels will provide insight into biological mechanisms of interspecific interactions that may play a role in regulation of responses such as effects between M. ulcerans, mycolactone, and S. aureus virulence that will be useful for treatment and prevention.

A qualitative inquiry of access to and quality of primary healthcare in seven communities in East and West Africa (SevenCEWA): perspectives of stakeholders, healthcare providers and users

BackgroundUniversal health coverage is one of the Sustainable Development Goal targets known to improve population health and reduce financial burden. There is little qualitative data on access to and quality of primary healthcare in East and West Africa. The aim of this study was to describe the viewpoints of healthcare users, healthcare providers and other stakeholders on health-seeking behaviour, access to and quality of healthcare in seven communities in East and West Africa.MethodsA qualitative study was conducted in four communities in Nigeria and one community each in Kenya, Uganda and Tanzania in 2018. Purposive sampling was used to recruit: 155 respondents (mostly healthcare users) for 24 focus group discussions, 25 healthcare users, healthcare providers and stakeholders for in-depth interviews and 11 healthcare providers and stakeholders for key informant interviews. The conceptual framework in this study combined elements of the Health Belief Model, Health Care Utilisation Model, four ‘As’ of access to care, and pathway model to better understand the a priori themes on access to and quality of primary healthcare as well as health-seeking behaviours of the study respondents. A content analysis of the data was done using MAXQDA 2018 qualitative software to identify these a priori themes and emerging themes.ResultsAccess to primary healthcare in the seven communities was limited, especially use of health insurance. Quality of care was perceived to be unacceptable in public facilities whereas cost of care was unaffordable in private facilities. Health providers and users as well as stakeholders highlighted shortage of equipment, frequent drug stock-outs and long waiting times as major issues, but had varying opinions on satisfaction with care. Use of herbal medicines and other traditional treatments delayed or deterred seeking modern healthcare in the Nigerian sites.ConclusionsThere was a substantial gap in primary healthcare coverage and quality in the selected communities in rural and urban East and West Africa. Alternative models of healthcare delivery that address social and health inequities, through affordable health insurance, can be used to fill this gap and facilitate achieving universal health coverage.

Identification of nutritionally modifiable hormonal and epigenetic drivers of positive and negative growth deviance in rural African fetuses and infants: Project protocol and cohort description

Growth retardation (stunting, wasting and poor organ development) among children in low-income countries has major short and long-term health consequences yet very little is known about the nutritional and environmental influences on the key hormonal axes regulating child growth in these settings, nor the tempo and timing of faltering episodes. Here we describe the study protocol and provide a cohort description of the Hormonal and Epigenetic Regulators of Growth (HERO-G) study. This prospective cohort study from rural Gambia, West Africa, followed mothers and children longitudinally from pre-conception, through pregnancy, delivery, and to two years of child age A total of 251 eligible mother-infant pairs were recruited into the HERO-G study, with 206 (82%) followed up until two years of age. Women were seen at scheduled antenatal appointments at 20, 28 and 36 weeks of gestation, and at delivery, where possible. Between one week and 12 months of age, infants were visited every second day for collection of detailed anthropometry and morbidity data. Infants identified as about to enter a growth faltering episode at these visits entered a more detailed 20-day protocol, with the collection of dried blood spots, anthropometry and body composition. All infants were seen for scheduled clinic visits at 3, 6, 9, 12, 18 and 24 months of age for clinical examination and venous blood draw. Data from the HERO-G study is being used to explore three major mechanistic pathways influencing growth: 1) genome-wide investigations for signatures of epigenetic effects on any loci that might affect growth; 2) frequent anthropometric measurement coupled with non-invasive monitoring for rapid identification and interrogation of real-time faltering patterns and aetiology; 3) focused measurement of hormones and cytokines that act together in an integrated manner, both in utero and after birth, to coordinate patterns of growth with immune activation, inflammation, and nutritional status.

English

The incidence of snake bite in rural West Africa is reportedly high with an 11&ndash;17% mortality rate. Nigeria has one third of the cases for snake bite cases in this region.Thus, most tribes in North-western part of Nigeria depend on medicinal plants for snakebites. However, it appears that a gap exists on documentation of these plants especially tropical flora used in the management of snake bite. This led to increase depletion of medicinal plant resources and knowledge of their traditional use. Consequently, this survey provided knowledge and data on medicinal plants use in management of snake bite which will help retard the current rate of extinction and decimation of the medicinal plants in these areas and then provide need to conserve what is left as medicinal plants for posterity sake. The study was carried in three northwestern states of Nigeria namely Sokoto, Kebbi and Zamfara for three months. A semi-structured questionnaire was administered and fourteen respondents made up of herb sellers (7%), traditional medical practitioners (93%). The majority of the respondents were male (100%) and 34% were above 50 years of age.&nbsp; From the study, the data collected shows 25 medicinal plants were in use by different categories of practitioners. Botanical names, local names, family names, plant part (s) use and number of citations were also obtained and documented. Key words: North-western Nigeria, snakebites, medicinal plants. &nbsp

Comparing climate change perceptions and meteorological data in rural West Africa to improve the understanding of household decisions to migrate

Largely dependent on rain-fed agriculture, the West African populations could be severely impacted by climate change and variability. In this paper, we performed a literature review relating to perceptions of climate change and variability in West Africa, followed by an in-depth comparison between perceptions by rural dwellers of Burkina Faso and trends in meteorological data to discuss the importance of perceptions vis-a-vis climate trends in migration decision. Results showed that respondents perceived increasing temperature and worsening rainfall conditions over 1988–2007 matching with findings of previous studies but inconsistent with the trends observed in rainfall data. Given that climate change is recognized as a key driver of mobility on the one hand and the fact that climate change perceptions influence decision to migrate on the other hand, our results suggest to jointly include perceptions and climate data in future research on environmental migration in order to improve the understanding of household’s decision in response to climate change.

High crossreactivity of human T cell responses between Lassa virus lineages.

Lassa virus infects hundreds of thousands of people each year across rural West Africa, resulting in a high number of cases of Lassa fever (LF), a febrile disease associated with high morbidity and significant mortality. The lack of approved treatments or interventions underscores the need for an effective vaccine. At least four viral lineages circulate in defined regions throughout West Africa with substantial interlineage nucleotide and amino acid diversity. An effective vaccine should be designed to elicit Lassa virus specific humoral and cell mediated immunity across all lineages. Most current vaccine candidates use only lineage IV antigens encoded by Lassa viruses circulating around Sierra Leone, Liberia, and Guinea but not Nigeria where lineages I-III are found. As previous infection is known to protect against disease from subsequent exposure, we sought to determine whether LF survivors from Nigeria and Sierra Leone harbor memory T cells that respond to lineage IV antigens. Our results indicate a high degree of cross-reactivity of CD8+ T cells from Nigerian LF survivors to lineage IV antigens. In addition, we identified regions within the Lassa virus glycoprotein complex and nucleoprotein that contributed to these responses while T cell epitopes were not widely conserved across our study group. These data are important for current efforts to design effective and efficient vaccine candidates that can elicit protective immunity across all Lassa virus lineages.

Identification of nutritionally modifiable hormonal and epigenetic drivers of positive and negative growth deviance in rural African fetuses and infants: Project protocol and cohort description.

Growth retardation (stunting, wasting and poor organ development) among children in low-income countries has major short and long-term health consequences yet very little is known about the nutritional and environmental influences on the key hormonal axes regulating child growth in these settings, nor the tempo and timing of faltering episodes. Here we describe the study protocol and provide a cohort description of the Hormonal and Epigenetic Regulators of Growth (HERO-G) study. This prospective cohort study from rural Gambia, West Africa, followed mothers and children longitudinally from pre-conception, through pregnancy, delivery, and to two years of child age A total of 251 eligible mother-infant pairs were recruited into the HERO-G study, with 206 (82%) followed up until two years of age. Women were seen at scheduled antenatal appointments at 20, 28 and 36 weeks of gestation, and at delivery, where possible. Between one week and 12 months of age, infants were visited every second day for collection of detailed anthropometry and morbidity data. Infants identified as about to enter a growth faltering episode at these visits entered a more detailed 20-day protocol, with the collection of dried blood spots, anthropometry and body composition. All infants were seen for scheduled clinic visits at 3, 6, 9, 12, 18 and 24 months of age for clinical examination and venous blood draw. Data from the HERO-G study is being used to explore three major mechanistic pathways influencing growth: 1) genome-wide investigations for signatures of epigenetic effects on any loci that might affect growth; 2) frequent anthropometric measurement coupled with non-invasive monitoring for rapid identification and interrogation of real-time faltering patterns and aetiology; 3) focused measurement of hormones and cytokines that act together in an integrated manner, both in utero and after birth, to coordinate patterns of growth with immune activation, inflammation, and nutritional status.