Pano Kente: estrutura e estética africana

The fractal geometry of nature is seen in organizations and has set handcrafted artifacts, among them African Kente cloth traditionally produced by Ewe and Ashanti of West Africa. Incorporating parameters also classify products as carriers of fractal geometry, the Kente fabrics exhibit built from geometric shapes classified as seeds or unique architecture. This article aims to analyze examples of Kente cloths and establish the existence of geometric structures formed from a parent cell, exposing how this cell and how its architecture and formed patterns are maintained throughout the finished product.

Cytotoxicity of cashew flavonoids towards malignant cell lines

The leaves of the Cashew plant (Anacardium occidentale L.) are used by the folk medicine in South America and West Africa. This plant is rich in flavonoids, which are polyphenolic compounds widespread in plants, and that have diverse physiological effects. In a sub-acute toxicity assay it was found that an ethanolic extract of Cashew leaves elicited lymphopenia in rats. The extract was also found to be cytotoxic and to induce apoptosis in Jurkat (acute lymphoblastic leukemia) cells. The crude ethanolic extract was fractionated and resolved by HPLC. One of the four fractions obtained led to the isolation of the biflavonoid agasthisflavone. [H-3]-thymidine incorporation assays and flow cytometry analysis showed that the isolated compound displayed a high anti-proliferative effect in Jurkat cells with an IC50 of 2.4 mu g/ml (4.45 mu M). The effect of agathisflavone on the acute promyelocytic leukemia cell line HL60, Burkitt lymphoma Raji cells and Hep-2 laryngeal carcinoma cells was also tested. The two latter ones were only mildly affected by agathisflavone. It is also shown that agathisflavone induces apoptosis in Jurkat cells and it this proposed that this is the likely mechanism of agathisflavone specific cytotoxicity. (C) 2010 Elsevier GmbH. All rights reserved.

Serological detection of Plasmodium vivax malaria using recombinant proteins corresponding to the 19-kDa C-terminal region of the merozoite surface protein-1

Abstract Background Serological tests to detect antibodies specific to Plasmodium vivax could be a valuable tool for epidemiological studies, for screening blood donors in areas where the malaria is not endemic and for diagnosis of infected individuals. Because P. vivax cannot be easily obtained in vitro, ELISA assays using total or semi-purified antigens are rarely used. Based on this limitation, we tested whether recombinant proteins representing the 19 kDa C-terminal region of the merozoite surface protein-1 of P. vivax (MSP119) could be useful for serological detection of malaria infection. Methods Three purified recombinant proteins produced in Escherichia coli (GST-MSP119, His6-MSP119 and His6-MSP119-PADRE) and one in Pichia pastoris (yMSP119-PADRE) were compared for their ability to bind to IgG antibodies of individuals with patent P. vivax infection. The method was tested with 200 serum samples collected from individuals living in the north of Brazil in areas endemic for malaria, 53 serum samples from individuals exposed to Plasmodium falciparum infection and 177 serum samples from individuals never exposed to malaria. Results Overall, the sensitivity of the ELISA assessed with sera from naturally infected individuals was 95%. The proportion of serum samples that reacted with recombinant proteins GST-MSP119, His6-MSP119, His6-MSP119-PADRE and yMSP119-PADRE was 90%, 93.5%, 93.5% and 93.5%, respectively. The specificity values of the ELISA determined with sera from healthy individuals and from individuals with other infectious diseases were 98.3% (GST-MSP119), 97.7% (His6-MSP119 and His6-MSP119-PADRE) or 100% (yMSP119-PADRE). Conclusions Our study demonstrated that for the Brazilian population, an ELISA using a recombinant protein of the MSP119 can be used as the basis for the development of a valuable serological assay for the detection of P. vivax malaria.

Antibody responses in Plasmodium falciparum malaria and their relation to protection against the disease

Protective immunity against Plasmodium falciparum may be obtained after repeated exposure to infection. Several studies indicate that immunity against the blood stages of the P. Falciparum infection is mainly antibody mediated. Protective antibodies may act either on their own, mediate antibody-dependent phagocytosis and/or cell-mediated neutralization of parasites. This thesis describes several aspects of humoral immune responses to P. falciparum infection in individuals of different age groups, different genetic background and with different degrees of malaria exposure. Several target antigens for antibody-mediated inhibition of parasite growth or invasion have been identified. One such antigen is Pf332, which appears on the surface of parasitized erythrocytes at late trophozoite and schizont stage. This surface exposure makes the antigen a possible target for opsonizing antibodies. We optimized an in vitro assay for studying cellmediated parasite neutralization in the presence of Pf332-reactive antibodies. Our data demonstrate that, Pf332 specific antibodies are able to inhibit parasite growth on their own and in cooperation with human monocytes. The P. falciparum parasites have evolved several mechanisms to evade the host neutralizing immune responses. In this thesis, we show that freshly isolated P. falciparum parasites from children living in a malaria endemic area of Burkina Faso were less sensitive for growth inhibition in vitro by autologous immunoglobulins (Ig) compared with heterologous ones. Analyses of two consecutive isolates taken 14 days apart, with regard to genotypes and sensitivity to growth inhibition in vitro, did not give any clear-cut indications on possible mechanisms leading to a reduced inhibitory activity in autologous parasite/antibody combinations. The frequent presence of persisting parasite clones in asymptomatic children indicates that the parasite possesses as yet undefined mechanisms to evade neutralizing immune responses. Transmission reducing measures such insecticide treated nets (ITNs) have been shown to be effective in reducing morbidity and mortality from malaria. However, concerns have been raised that ITNs usage could affect the acquisition of malaria immunity. We studied the effect of the use of insecticide treated curtains (ITC) on anti-malarial immune responses of children living in villages with ITC since birth. The use of ITC did neither affect the levels of parasite neutralizing immune responses nor the multiplicity of infection. These results indicate that the use of ITC does not interfere with the acquisition of anti-malarial immunity in children living in a malaria hyperendemic area. There is substantial evidence that the African Fulani tribe is markedly less susceptible to malaria infection compared to other sympatrically living ethnic tribes. We investigated the isotypic humoral responses against P. falciparum asexual blood stages in different ethnic groups living in sympatry in two countries exhibiting different malaria transmission intensities, Burkina Faso and Mali. We observed higher levels of the total malaria-specific-IgG and its cytophilic subclasses in individuals of the Fulani tribe as compared to non-Fulani individuals. Fulani individuals also showed higher levels of antibodies to measles antigen, indicating that the intertribal differences are not specific for malaria and might reflect a generally activated immune system in the Fulani.

Heiltraditionen und Biodiversität: Die traditionelle Medizin der Baatombu Nordbenins

Im Zentrum der vorliegenden Untersuchung steht die Nutzung von Medizinalpflanzen vor dem Hintergrund einer zurückgehenden Phytodiversität in Nordbenin. Die Dissertation ba-siert auf ethnologischen Forschungen, die in das interdisziplinäre Forschungsprojekt BIOTA (Biodiversity Monitoring Transect Analysis in Africa) eingebunden sind. Das BIOTA-Projekt untersucht die Wirkung menschlichen Handelns (insbesondere Nutzung) auf die Biodiversi-tät und versucht aus diesen Erkenntnissen Maßnahmen zum Erhalt der biologischen Vielfalt abzuleiten. Die vorliegende Studie basiert auf einem 13-monatigen Feldforschungsaufenthalt im Zeitraum von April 2004 bis August 2006 in der nordbeninischen Gemeinde Ouassa-Pehunco. Meine Informanten sind überwiegend traditionelle Heiler, mit denen ich standardi-sierte und offene Interviews durchführte, deren Behandlungsverfahren und Heilzeremonien ich teilnehmend beobachtete sowie dokumentierte und auf deren Initiative hin ich mich bei dem Aufbau eines Medizinalpflanzengartens einbrachte (cf. Kap. 1). In diesem Forschungsfeld situiere ich mich mit der Frage nach dem Einfluss einer verän-derten Pflanzenvielfalt auf die traditionelle medizinische Versorgung der Baatombu Nordbe-nins. Die Beantwortung dieser Frage erfolgt in mehreren Schritten. 1. Die Phytodiversität nimmt, wie von naturwissenschaftlicher Seite bestätigt, in der Region ab. 2. Lokale Heilkun-dige nehmen diesen Rückgang an verfügbaren Heilpflanzen ebenso wahr. 3. Die Abnahme der Pflanzenbestände führen die Heiler vor allem auf den Baumwollanbau und die demogra-fischen Entwicklungen der Region zurück - dies entspricht ebenfalls den Auffassungen von Naturwissenschaftlern, die eine Verdichtung der landwirtschaftlichen Bodennutzung fest-stellten. 4. Heilkundige und Heilpflanzenverkäuferinnen vermerken eine zunehmende Nach-frage nach lokaler Pflanzenmedizin aufgrund der steigenden Bevölkerungszahlen. 5. Die pflanzenbasierte Gesundheitsversorgung der lokalen Bevölkerung ist jedoch relativ gesi-chert, da die Heiler sich alternativ wirkender Medizinalpflanzen bedienen, ihre Therapiefor-men der veränderten Lage anpassen (z.B. geringere Dosierungen) und sie regelmäßig genutz-te Pflanzen im Medizinalpflanzengarten Guson wieder anpflanzen. Ein wichtiger Aspekt der Arbeit ist, dass die Heilpraktiken der Baatombu nicht allein auf naturheilkundlichem Erfahrungswissen beruhen, sondern in magisch-religiöse Vorstellungen eingebettet sind (cf. Kap. 2). Demzufolge untersuche ich die lokalen Krankheits- und Ge-sundheitsvorstellungen und die symbolischen Klassifikationen von Heilpflanzen und Krank-heiten (cf. Kap. 3). Ich stellte fest, dass nach Auffassung von Heilkundigen soziokulturelle Faktoren wie der Zeitpunkt und der Ort einer Sammlung sowie entsprechende Ernte-Rituale die medizinische Wirksamkeit von Pflanzen maßgeblich bedingen (cf. Kap. 5). Die Umwelt-klassifikation der Heiler (Landschafts- und Vegetationstypen) richtet sich demzufolge nach dem medizinischen Wert, den sie einer Heilpflanze zuschreiben (cf. Kap.4). Basierend auf diesen Erkenntnissen wurde von einigen engagierten Heilern und mit Un-terstützung von BIOTA, der GTZ und der Deutschen Botschaft der Medizinalpflanzengarten Guson eingerichtet, der eine Antwort auf die regionale Ressourcenverknappung darstellt und in seiner Anlage dem lokalen ökologischen und heilkundlichen Wissen der Heiler entspricht (cf. Kap. 6). Den Anwendungsbezug der Forschung nutzten die Heiler, um sich als Interes-sensgemeinschaft für den Erhalt der benötigten pflanzlichen Ressourcen einzusetzen.

Identification of an African Bacillus anthracis Lineage That Lacks Expression of the Spore Surface-Associated Anthrose-Containing Oligosaccharide

The surfaces of Bacillus anthracis endospores expose a pentasaccharide containing the monosaccharide anthrose, which has been considered for use as a vaccine or target for specific detection of the spores. In this study B. anthracis strains isolated from cattle carcasses in African countries where anthrax is endemic were tested for their cross-reactivity with monoclonal antibodies (MAbs) specific for anthrose-containing oligosaccharides. Unexpectedly, none of the isolates collected in Chad, Cameroon, and Mali were recognized by the MAbs. Sequencing of the four-gene operon encoding anthrose biosynthetic enzymes revealed the presence of premature stop codons in the aminotransferase and glycosyltransferase genes in all isolates from Chad, Cameroon, and Mali. Both immunological and genetic findings suggest that the West African isolates are unable to produce anthrose. The anthrose-deficient strains from West Africa belong to a particular genetic lineage. Immunization of cattle in Chad with a locally produced vaccine based on anthrose-positive spores of the B. anthracis strain Sterne elicited an anti-carbohydrate IgG response specific for a synthetic anthrose-containing tetrasaccharide as demonstrated by glycan microarray analysis. Competition immunoblots with synthetic pentasaccharide derivatives suggested an immunodominant role of the anthrose-containing carbohydrate in cattle. In West Africa anthrax is highly endemic. Massive vaccination of livestock in this area has taken place over long periods of time using spores of the anthrose-positive vaccine strain Sterne. The spread of anthrose-deficient strains in this region may represent an escape strategy of B. anthracis.

Niger : Quand la France instrumentalise « AQMI » pour imposer la « stratégie du choc »

En septembre 2010, sept employés d’Areva dont cinq français sont enlevés sur le site d’Arlit au Niger par AQMI. Immédiatement, la France procède à un important déploiement de militaires au Niger et au Burkina Faso pour combattre les ravisseurs. Toutefois, l’observation du cadre constitué par les objectifs manifestes, le comportement,les ressources et contraintes qu’affronte la France permet de déceler l’existence d’autres enjeux se nouant autour de la participation française à la lutte contre AQMI. Cet article se propose de démontrer comment la France mobilise AQMI comme ressource en vue d’imposer « choc » et « effroi » au Niger. // Niger, France, Al-Qaida au Maghreb islamique, Terrorisme

Performance characteristics and design recommendations for biomass-burning stoves using earthen construction materials

This report provides an analysis of the thermal performance and emissions characteristics of improved biomass stoves constructed using earthen materials. Commonly referred to as mud stoves, this type of improved stove incorporates high clay content soil with an organic binder in the construction of its combustion chamber and body. When large quantities of the mud material are used to construct the stove body, the stove does not offer significant improvements in fuel economy or air quality relative to traditional open fire cooking. This is partly because a significant amount of heat is absorbed by the mass of the stove reducing combustion efficiency and heat transfer to the cook pot. An analysis of the thermal and mechanical properties of stove materials was also performed. A material mixture containing a one‐to‐one ratio by volume of high content clay soil and straw was found to have thermal properties comparable to fired ceramics used in more advanced improved stove designs. Feedback from mud stove users in Mauritania and Mali, West Africa was also collected during implementation. Suggestions for stove design improvements were developed based on this information and the data collected in the performance, emissions, and material properties analysis. Design suggestions include reducing stove height to accommodate user cooking preferences and limiting overall stove mass to reduce heat loss to the stove body.

The causative pathogen determines the inflammatory profile in cerebrospinal fluid and outcome in patients with bacterial meningitis

BACKGROUND The brain's inflammatory response to the infecting pathogen determines the outcome of bacterial meningitis (BM), for example, the associated mortality and the extent of brain injury. The inflammatory cascade is initiated by the presence of bacteria in the cerebrospinal fluid (CSF) activating resident immune cells and leading to the influx of blood derived leukocytes. To elucidate the pathomechanisms behind the observed difference in outcome between different pathogens, we compared the inflammatory profile in the CSF of patients with BM caused by Streptococcus pneumonia (n = 14), Neisseria meningitidis (n = 22), and Haemophilus influenza (n = 9). METHODS CSF inflammatory parameters, including cytokines and chemokines, MMP-9, and nitric oxide synthase activity, were assessed in a cohort of patients with BM from Burkina Faso. RESULTS Pneumococcal meningitis was associated with significantly higher CSF concentrations of IFN-γ , MCP-1, and the matrix-metalloproteinase (MMP-) 9. In patients with a fatal outcome, levels of TNF-α, IL-1 β, IL-1RA, IL-6, and TGF-α were significantly higher. CONCLUSION The signature of pro- and anti-inflammatory mediators and the intensity of inflammatory processes in CSF are determined by the bacterial pathogen causing bacterial meningitis with pneumococcal meningitis being associated with a higher case fatality rate than meningitis caused by N. meningitidis or H. influenzae.

Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries.

SETTING Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons. OBJECTIVE To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries. DESIGN We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n = 14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n = 6 programs) in 2012. Patient-level data were collected on 1002 adult TB patients seen at 40 of the participating ART programs. RESULTS Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the entire course of treatment, 16 (34%) during the intensive phase only, and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line anti-tuberculosis regimens; 18 (38%) reported TB drug shortages. CONCLUSIONS Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower-income countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance.

Promoting Local Innovations: A tool for adaptation to climate change and sustainable development in Mountains

Throughout their history mountain communities have had to adapt to changing environmental and socio-economic conditions. They have developed strategies and specialized knowledge to sustain their livelihoods in a context of adverse climatic events and constant change. As negotiations and discussions on climate change emphasize the critical need for locally relevant and community owned adaptation strategies, there is a need for new tools to capitalize on this local knowledge and endogenous potential for innovation. The toolkit Promoting Local Innovation (PLI) was designed by the Centre for Development and Environment (CDE) of the University of Bern, Switzerland, to facilitate a participatory social learning process which identifies locally available innovations that can be implemented for community development. It is based on interactive pedagogy and joint learning among different stakeholders in the local context. The tried-and-tested tool was developed in the Andean region in 2004, and then used in International Union for Conservation of Nature (IUCN) climate change adaptation projects in Thailand, Burkina Faso, Senegal, and Chile. These experiences showed that PLI can be used to involve all relevant stakeholders in establishing strategies and actions needed for rural communities to adapt to climate change impacts, while building on local innovation potential and promoting local ownership

Scientists’ situated knowledge: Strong objectivity in transdisciplinarity

Although transdisciplinary research has started addressing important epistemological challenges, as evidenced by the discussion about ‘mode 2’ knowledge production, its relation with postulations of ‘scientific objectivity’ is not yet well clarified. A common way of dealing with the epistemological challenge of situated knowledge production, as proposed by transdisciplinarity, is to point to the fundamental aspect of reflexivity. But reflexivity also includes being aware that power and control over the object is derived from the social position of researchers, an issue not often explicitly discussed in transdisciplinary research. Reflexivity thus represents an important but insufficient principle for guaranteeing appropriate levels of self-reflection within a process of knowledge coproduction. We therefore hypothesize that transdisciplinary research could greatly benefit from feminist scientific tradition, in particular the insights of standpoint theory and the concept of ‘strong objectivity’. We analyse, and reflect upon, how a recent transdisciplinary research initiative – conducted together with civil society organizations in (CSOs) in six countries: Bangladesh, Bolivia, Brazil, Burkina Faso, Ecuador and India – has benefited from the use of ‘strong objectivity’. We analyse how the social position of all stakeholders, including ourselves as the scientific actors in this initiative, influence the process and conditions of transdisciplinary knowledge co-production, and we discuss how power and control by scientists affects the process and conditions of interaction. Thereby we argue for the necessity of explicitly assuming sides in contested contexts for reaching objectivity in transdisciplinary research.

The ring vaccination trial: a novel cluster randomised controlled trial design to evaluate vaccine efficacy and effectiveness during outbreaks, with special reference to Ebola

A World Health Organization expert meeting on Ebola vaccines proposed urgent safety and efficacy studies in response to the outbreak in West Africa. One approach to communicable disease control is ring vaccination of individuals at high risk of infection due to their social or geographical connection to a known case. This paper describes the protocol for a novel cluster randomised controlled trial design which uses ring vaccination.In the Ebola ça suffit ring vaccination trial, rings are randomised 1:1 to (a) immediate vaccination of eligible adults with single dose vaccination or (b) vaccination delayed by 21 days. Vaccine efficacy against disease is assessed in participants over equivalent periods from the day of randomisation. Secondary objectives include vaccine effectiveness at the level of the ring, and incidence of serious adverse events.Ring vaccination trials are adaptive, can be run until disease elimination, allow interim analysis, and can go dormant during inter-epidemic periods.

Efficacy and effectiveness of an rVSV-vectored vaccine expressing Ebola surface glycoprotein: interim results from the Guinea ring vaccination cluster-randomised trial.

BACKGROUND A recombinant, replication-competent vesicular stomatitis virus-based vaccine expressing a surface glycoprotein of Zaire Ebolavirus (rVSV-ZEBOV) is a promising Ebola vaccine candidate. We report the results of an interim analysis of a trial of rVSV-ZEBOV in Guinea, west Africa. METHODS For this open-label, cluster-randomised ring vaccination trial, suspected cases of Ebola virus disease in Basse-Guinée (Guinea, west Africa) were independently ascertained by Ebola response teams as part of a national surveillance system. After laboratory confirmation of a new case, clusters of all contacts and contacts of contacts were defined and randomly allocated 1:1 to immediate vaccination or delayed (21 days later) vaccination with rVSV-ZEBOV (one dose of 2 × 10(7) plaque-forming units, administered intramuscularly in the deltoid muscle). Adults (age ≥18 years) who were not pregnant or breastfeeding were eligible for vaccination. Block randomisation was used, with randomly varying blocks, stratified by location (urban vs rural) and size of rings (≤20 vs >20 individuals). The study is open label and masking of participants and field teams to the time of vaccination is not possible, but Ebola response teams and laboratory workers were unaware of allocation to immediate or delayed vaccination. Taking into account the incubation period of the virus of about 10 days, the prespecified primary outcome was laboratory-confirmed Ebola virus disease with onset of symptoms at least 10 days after randomisation. The primary analysis was per protocol and compared the incidence of Ebola virus disease in eligible and vaccinated individuals in immediate vaccination clusters with the incidence in eligible individuals in delayed vaccination clusters. This trial is registered with the Pan African Clinical Trials Registry, number PACTR201503001057193. FINDINGS Between April 1, 2015, and July 20, 2015, 90 clusters, with a total population of 7651 people were included in the planned interim analysis. 48 of these clusters (4123 people) were randomly assigned to immediate vaccination with rVSV-ZEBOV, and 42 clusters (3528 people) were randomly assigned to delayed vaccination with rVSV-ZEBOV. In the immediate vaccination group, there were no cases of Ebola virus disease with symptom onset at least 10 days after randomisation, whereas in the delayed vaccination group there were 16 cases of Ebola virus disease from seven clusters, showing a vaccine efficacy of 100% (95% CI 74·7-100·0; p=0·0036). No new cases of Ebola virus disease were diagnosed in vaccinees from the immediate or delayed groups from 6 days post-vaccination. At the cluster level, with the inclusion of all eligible adults, vaccine effectiveness was 75·1% (95% CI -7·1 to 94·2; p=0·1791), and 76·3% (95% CI -15·5 to 95·1; p=0·3351) with the inclusion of everyone (eligible or not eligible for vaccination). 43 serious adverse events were reported; one serious adverse event was judged to be causally related to vaccination (a febrile episode in a vaccinated participant, which resolved without sequelae). Assessment of serious adverse events is ongoing. INTERPRETATION The results of this interim analysis indicate that rVSV-ZEBOV might be highly efficacious and safe in preventing Ebola virus disease, and is most likely effective at the population level when delivered during an Ebola virus disease outbreak via a ring vaccination strategy. FUNDING WHO, with support from the Wellcome Trust (UK); Médecins Sans Frontières; the Norwegian Ministry of Foreign Affairs through the Research Council of Norway; and the Canadian Government through the Public Health Agency of Canada, Canadian Institutes of Health Research, International Development Research Centre, and Department of Foreign Affairs, Trade and Development.

Potential Impact of Sexual Transmission on Ebola Virus Epidemiology: Sierra Leone as a Case Study.

BACKGROUND Sexual transmission of Ebola virus disease (EVD) 6 months after onset of symptoms has been recently documented, and Ebola virus RNA has been detected in semen of survivors up to 9 months after onset of symptoms. As countries affected by the 2013-2015 epidemic in West Africa, by far the largest to date, are declared free of Ebola virus disease (EVD), it remains unclear what threat is posed by rare sexual transmission events that could arise from survivors. METHODOLOGY/PRINCIPAL FINDINGS We devised a compartmental mathematical model that includes sexual transmission from convalescent survivors: a SEICR (susceptible-exposed-infectious-convalescent-recovered) transmission model. We fitted the model to weekly incidence of EVD cases from the 2014-2015 epidemic in Sierra Leone. Sensitivity analyses and Monte Carlo simulations showed that a 0.1% per sex act transmission probability and a 3-month convalescent period (the two key unknown parameters of sexual transmission) create very few additional cases, but would extend the epidemic by 83 days [95% CI: 68-98 days] (p < 0.0001) on average. Strikingly, a 6-month convalescent period extended the average epidemic by 540 days (95% CI: 508-572 days), doubling the current length, despite an insignificant rise in the number of new cases generated. CONCLUSIONS/SIGNIFICANCE Our results show that reductions in the per sex act transmission probability via abstinence and condom use should reduce the number of sporadic sexual transmission events, but will not significantly reduce the epidemic size and may only minimally shorten the length of time the public health community must maintain response preparedness. While the number of infectious survivors is expected to greatly decline over the coming months, our results show that transmission events may still be expected for quite some time as each event results in a new potential cluster of non-sexual transmission. Precise measurement of the convalescent period is thus important for planning ongoing surveillance efforts.