A geographical analysis of the role of water supply and sanitation in the risk of helminth infections of children in West Africa

Background We investigated the geographical variation of water supply and sanitation indicators (WS&S) and their role to the risk of schistosomiasis and hookworm infection in school age children in West Africa. The aim was to predict large-scale geographical variation in WS&S, quantify the attributable risk of S. haematobium, S. mansoni and hookworm infections due to WS&S and identify communities where sustainable transmission control could be targeted across the region. Methods National cross-sectional household-based demographic health surveys were conducted in 24,542 households in Burkina Faso, Ghana and Mali, in 2003–2006. We generated spatially-explicit predictions of areas without piped water, toilet facilities and finished floors in West Africa, adjusting for household covariates. Using recently published helminth prevalence data we developed Bayesian geostatistical models (MGB) of S. haematobium, S. mansoni and hookworm infection in West Africa including environmental and the mapped outputs for WS&S. Using these models we estimated the effect of WS&S on parasite risk, quantified their attributable fraction of infection, and mapped the risk of infection in West Africa. Findings Our maps show that most areas in West Africa are very poorly served by water supply except in major urban centers. There is a better geographical coverage for toilet availability and improved household flooring. We estimated smaller attributable risks for water supply in S. mansoni (47%) compared to S. haematobium (71%), and 5% of hookworm cases could be averted by improving sanitation. Greater levels of inadequate sanitation increased the risk of schistosomiasis, and increased levels of unsafe water supply increased the risk of hookworm. The role of floor type for S. haematobium infection (21%) was comparable to that of S. mansoni (16%), but was significantly higher for hookworm infection (86%). S. haematobium and hookworm maps accounting for WS&S show small clusters of maximal prevalence areas in areas bordering Burkina Faso and Mali smaller. The map of S. mansoni shows that this parasite is much more wide spread across the north of the Niger River basin than previously predicted. Interpretation Our maps identify areas where the Millennium Development Goal for water and sanitation is lagging behind. Our results show that WS&S are important contributors to the burden of major helminth infections of children in West Africa. Including information about WS&S as well as the “traditional” environmental risk factors in spatial models of helminth risk yielded a substantial gain both in model fit and at explaining the proportion of spatial variance in helminth risk. Mapping the distribution of infection risk adjusted for WS&S allowed the identification of communities in West Africa where integrative preventive chemotherapy and engineering interventions will yield the greatest public health benefits.

Herpes simplex 2 risk among women in a polygynous setting in rural West Africa

OBJECTIVES: To determine risk factors for herpes simplex 2 (HSV2) infection in women in a polygynous rural Gambian population. METHODS: Data from women who participated in a cross-sectional survey of reproductive health were matched to their own and, for women who had been or were married (ever-married), their spouses' data collected in a cross-sectional survey of fertility interests, including information on marital histories. RESULTS: Data were available on 150 never-married and 525 ever-married women. HSV2 prevalence was 16% amongst never-married women and 36% amongst ever-married women. For ever-married women, their own personal characteristics (age, ethnicity and genital cutting status) and events from their husbands' marriage history were important determinants of HSV2 infection. Women whose husbands married for the first time over age 35 were at greater risk than women whose husbands married by age 24 [odds ratio (OR) 2.72, 95% confidence interval (CI) 1.20-6.10]. Women whose husband reported interest in a new marriage were more likely to be HSV2 positive (OR 1.91, 95% CI 1.18-3.09). Women whose husbands were currently monogamous but had had previous marriages (OR 2.76, 95% CI 1.30-5.88) and women in currently polygynous marriages (OR 2.88, 95% CI 1.66-5.01) were three times as likely to be HSV2 positive as women who were their husband's only wife ever. CONCLUSION: Much transmission of HSV2 in this setting occurs within marriage where opportunity for personal protection is limited. High levels of transmission within marriage may undermine the impact of sexual behaviour change programmes aiming to reduce HSV2 and HIV incidence and complicate their evaluation.

Robust features of future climate change impacts on sorghum yields in West Africa

West Africa is highly vulnerable to climate hazards and better quantification and understanding of the impact of climate change on crop yields are urgently needed. Here we provide an assessment of near-term climate change impacts on sorghum yields in West Africa and account for uncertainties both in future climate scenarios and in crop models. Towards this goal, we use simulations of nine bias-corrected CMIP5 climate models and two crop models (SARRA-H and APSIM) to evaluate the robustness of projected crop yield impacts in this area. In broad agreement with the full CMIP5 ensemble, our subset of bias-corrected climate models projects a mean warming of +2.8 °C in the decades of 2031–2060 compared to a baseline of 1961–1990 and a robust change in rainfall in West Africa with less rain in the Western part of the Sahel (Senegal, South-West Mali) and more rain in Central Sahel (Burkina Faso, South-West Niger). Projected rainfall deficits are concentrated in early monsoon season in the Western part of the Sahel while positive rainfall changes are found in late monsoon season all over the Sahel, suggesting a shift in the seasonality of the monsoon. In response to such climate change, but without accounting for direct crop responses to CO2, mean crop yield decreases by about 16–20% and year-to-year variability increases in the Western part of the Sahel, while the eastern domain sees much milder impacts. Such differences in climate and impacts projections between the Western and Eastern parts of the Sahel are highly consistent across the climate and crop models used in this study. We investigate the robustness of impacts for different choices of cultivars, nutrient treatments, and crop responses to CO2. Adverse impacts on mean yield and yield variability are lowest for modern cultivars, as their short and nearly fixed growth cycle appears to be more resilient to the seasonality shift of the monsoon, thus suggesting shorter season varieties could be considered a potential adaptation to ongoing climate changes. Easing nitrogen stress via increasing fertilizer inputs would increase absolute yields, but also make the crops more responsive to climate stresses, thus enhancing the negative impacts of climate change in a relative sense. Finally, CO2 fertilization would significantly offset the negative climate

Producing tilapia in small cage in West Africa

This document is part of a series of 5 technical manuals produced by the Challenge Program Project CP34 “Improved fisheries productivity and management in tropical reservoirs”. The Water Research Institute (WRI) in Akosombo, Ghana, is working to bring cage aquaculture technology to smallholder farmers. The stocking, feeding and cage-construction technology piloted by WRI is now being widely adopted in the Lower Volta basin in Ghana. The results of WRI research over the period 2005-2009 are presented here as a guide to potential investors. (PDF contains 19 pages)

Envisioning 2050: climate change, aquaculture and fisheries in West Africa. Dakar, Senegal 14-16 April 2010

This report presents the activities and results of the workshop Envisioning 2050: Climate Change, Aquaculture and Fisheries in West Africa. The objectives of the workshop were to discuss critical issues and uncertainties faced by the fisheries and aquaculture sector in Ghana, Senegal and Mauritania, build sectoral scenarios for 2050 and discuss the implication of these scenarios in the context of climate change for the countries and the region.

Review of the crevalle jacks, Caranx hippos complex (Teleostei: Carangidae), with a description of a new species from West Africa

The Caranx hippos species complex comprises three extant species: crevalle jack (Caranx hippos) (Linnaeus, 1766) from both the western and eastern Atlantic oceans; Pacific crevalle jack (Caranx caninus) Günther, 1868 from the eastern Pacific Ocean; and longfin crevalle jack (Caranx fischeri) new species, from the eastern Atlantic, including the Mediterranean Sea and Ascension Island. Adults of all three species are superficially similar with a black blotch on the lower half of the pectoral fin, a black spot on the upper margin of opercle, one or two pairs of enlarged symphyseal canines on the lower jaw, and a similar pattern of breast squamation. Each species has a different pattern of hyperostotic bone development and anal-fin color. The two sympatric eastern Atlantic species also differ from each other in number of dorsal-and anal-fin rays, and in large adults of C. fischeri the lobes of these fins are longer and the body is deeper. Caranx hippos from opposite sides of the Atlantic are virtually indistinguishable externally but differ consistently in the expression of hyperostosis of the first dorsalfin pterygiophore. The fossil species Caranx carangopsis Steindachner 1859 appears to have been based on composite material of Trachurus sp. and a fourth species of the Caranx hippos complex. Patterns of hyperostotic bone development are compared in the nine (of 15 total) species of Caranx sensu stricto that exhibit hyperostosis.

Biodiversity of estuarine fish faunas in West Africa

In West Africa (between Ivory Coast and Sénégal), estuarine environments vary from lagoons to high discharge rivers to inverse hypersaline estuaries. This results in a high diversity of estuarine fish species, with an important turnover and a core of ubiquitous species. The species richness of a given estuary depends on the combination of hydrological factors (marine or freshwater dominance) and biogeography (continental biogeographic regions). The catch rate is higher in lagoons and inverse estuaries than in normal estuaries, which can be explained by the predominance of small juveniles in the latter. Clupeids are the most abundant fishes all over the region, but different systems have different dominant species. Assessing the functioning of West-African estuaries provides useful comparisons to Asian estuarine systems.

The Programme for Integrated Development of Artisanal Fisheries in West Africa

The Programme for Integrated Development of Artisanal Fisheries in West Africa (IDAF) was initiated in 1983 to help some 20 coastal states from Mauritiana to Angola which wished to develop and manage their artisanal fisheries through participatory and integrated approaches. IDAF was initially financed by Denmark and Norway. The second phase of the programme which started in January 1989 and its third phase, July 1984 are entirely financed by Denmark through the Danish International Development Assistance (DANIDA). IDAF objectives and activities to meet its goals are briefly discussed together with its beneficiaries and accomplishments.

Swimming crab Callinectes amnicola (Decapoda-Portunidae) capture analysis of a lagoon with high continental influence (Aby Lagoon, Cote d'Ivoire, West Africa)

The study describes the main causes of captures and productions decreasing of swimming crab Callinectes amnicola (Decapoda Portunidae) in Aby lagoon complex. For that, docks of two Sub Prefectures of Adiaké and Assini-Mafia respectively including the villages of Adiaké, Anga, Assomlan, Epleman, Aby and Man-Man, M'Bratty, Assini-Ngouankro and Assini-Mafia were studied from 2006 to 2009 and completed with previous results obtained from 1988 to 2005. Field investigators were identified by site/village and they recorded daily activities of fishermen (number of effective fishermen, number of gears and area of fishing, duration of fishing, types and quantity of bait) and landing of swimming crabs. During recent period of the study, total production decreased from 3742 tons in 2006 to 1500 tons in 2009. Matrix correlations and correlation analysis indicated that this downward trend was due to the increase of the number of fishermen, number of fishing gear, the decrease in female crabs capture and degradation of the environment related to gradual closure of the Assini-Mafia channel. Despite this decline, total production in Aby lagoon remained high compared to the productions of some lagoons of the country and the region. Given the importance of fishing swimming crabs in Aby lagoon, since it concerns many young people and it is a source of income, stringent measures for sustainable and responsible management must be taken and implemented as part of a co-management plan involving all stakeholders to sustainably manage the resource

Composition of waters of lakes and rivers in east and west Africa

Thirty-three groups of geochemically related natural lake and river waters collected from 368 sites scattered over East and West Africa, were investigated to determine correlations between their various ions and the patterns of change in their ionic composition across the African continent. The following nine significant correlations were found to exist in the entire area or in a major part of it: sodium and potassium; sodium and chloride; sodium and sulphate; potassium and ammonium; potassium and chloride; ammonium and nitrate; calcium and magnesium; magnesium and chloride; sulphate and chloride. When compared with the world average composition. The concentration of potassium in these waters was found to be high, that of calcium and nitrate was low. With respect to the area of East Africa only, trends in the pattern of change involving the ionic composition of the lake and river water and the longitude at which the sites were present, were found to exist for the ratio of sodium: conductivity (which showed an increase in the direction of West to East), magnesium: conductivity, and for the sum of calcium and magnesium: phosphate was generally found to increase in East Africa in the direction of west to East.

Dietary exposure to aflatoxin from maize and groundnut in young children from Benin and Togo, West Africa

Aflatoxins are a family of fungal toxins that are carcinogenic to man and cause immunosuppression, cancer and growth reduction in animals. We conducted a cross-sectional study among 480 children (age 9 months to 5 years) across 4 agroecological zones (SS, NGS, SGS and CS) in Benin and Togo to identify the effect of aflatoxin exposure on child growth and assess the pattern of exposure. Prior reports on this study [Gong, Y.Y., Cardwell, K., Hounsa, A., Egal, S., Turner, Hall, A.J., Wild, C.P., 2002. Dietary aflatoxin exposure and impaired growth in young children from Benin and Togo: cross sectional study. British Medical Journal 325, 20-21, Gong, Y.Y., Egal, S., Hounsa, A., Turner, P.C., Hall, A.J., Cardwell, K., Wild, C.P., 2003. Determinants of aflatoxin exposure in young children from Benin and Togo, West Africa: the critical role of weaning and weaning foods. International Journal of Epidemiology, 32, 556-562] showed that aflatoxin exposure among these children is widespread (99%) and that growth faltering is associated with high blood aflatoxinalbumin adducts (AF-alb adducts), a measure of recent past exposure. The present report demonstrates that consumption of maize is an important source of aflatoxin exposure for the survey population. Higher AF-alb adducts were correlated with higher A. flavus (CFU) infestation of maize (p=0.006), higher aflatoxin contamination (ppb) of maize (p<0.0001) and higher consumption frequencies of maize (p=0.053). The likelihood of aflatoxin exposure from maize was particularly high in agro-ecological zones where the frequency of maize consumption (SGS and CS), the presence of allatoxin in maize (SGS) or the presence of A. flavus on maize (NGS and SGS) was relatively high. Socio-economic background did not affect the presence of A. flavus and aflatoxin in maize, but better maternal education was associated with lower frequencies of maize consumption among children from the northernmost agro-ecological zone (SS) (p=0.001). The impact of groundinit consumption on aflatoxin exposure was limited in this population. High AF-alb adduct levels were correlated with high prevalence of A. flavus and aflatoxin in groundinit, but significance was weak after adjustment for weaning status, agro-ecological zone and maternal socio-economic status (resp. p = 0.091 and p = 0.083). Ingestion of A. flavus and aflatoxin was high in certain agro-ecological zones (SS and SGS) and among the higher socio-economic strata due to higher frequencies of groundnut consumption. Contamination of groundnuts was similar across socio-economic and agroecological boundaries.

In conclusion, dietary exposure to aflatoxin from groundnut was less than from maize in young children from Benin and Togo. Intervention strategies that aim to reduce dietary exposure in this population need to focus on maize consumption in particular, but they should not ignore consumption of groundnuts. (c) 2005 Elsevier B.V. All rights reserved.

Reduction in exposure to carcinogenic aflatoxins by postharvest intervention measures in west Africa: a community-based intervention study

Background Aflatoxins are fungal metabolites that frequently contaminate staple foods in much of sub-Saharan Africa, and are associated with increased risk of liver cancer and impaired growth in young children. We aimed to assess whether postharvest measures to restrict aflatoxin contamination of groundnut crops could reduce exposure in west African villages.

Methods We undertook an intervention study at subsistence farms in the lower Kindia region of Guinea. Farms from 20 villages were included, ten of which implemented a package of postharvest measures to restrict aflatoxin contamination of the groundnut crop; ten controls followed usual postharvest practices. We measured the concentrations of blood aflatoxin-albumin adducts from 600 people immediately after harvest and at 3 months and 5 months postharvest to monitor the effectiveness of the intervention.

Findings In control villages mean aflatoxin-albumin concentration increased postharvest (from 5.5 pg/mg [95% CI 4.7-6.1] immediately after harvest to 18.7 pg/mg [17.0-20.6] 5 months later). By contrast, mean aflatoxin-albumin concentration in intervention villages after 5 months of groundnut storage was much the same as that immediately postharvest (7.2 pg/mg [6.2-8.4] vs 8.0 pg/mg [7.0-9.2]). At 5 months, mean adduct concentration in intervention villages was less than 50% of that in control villages (8.0 pg/mg [7.2-9.2] vs 18.7 pg/mg [17.0-20.6], p<0.0001). About a third of the number of people had non-detectable aflatoxin-albumin concentrations at harvest. At 5 months, five (2%) people in the control villages had non-detectable adduct concentrations compared with 47 (20%) of those in the intervention group (p<0.0001). Mean concentrations of aflatoxin B1 in groundnuts in household stores in intervention and control villages were consistent with measurements of aflatoxin-albumin adducts.

Interpretation Use of low-technology approaches at the subsistence-farm level in sub-Saharan Africa could substantially reduce the disease burden caused by aflatoxin exposure.

Postweaning exposure to aflatoxin results in impaired child growth: A longitudinal study in Benin, west Africa

Aflatoxins are dietary contaminants that are hepatocarcinogenic and immunotoxic and cause growth retardation in animals, but there is little evidence concerning the latter two parameters in exposed human populations. Aflatoxin exposure of West African children is known to be high, so we conducted a longitudinal study over an 8-month period in Benin to assess the effects of exposure on growth. Two hundred children 16-37 months of age were recruited from four villages, two with high and two with low aflatoxin exposure (50 children per village). Serum aflatoxin-albumin (AF-alb) adducts, anthropometric parameters, information on food consumption, and various demographic data were measured at recruitment (February) and at two subsequent time points (June and October). Plasma levels of vitamin A and zinc were also measured. AF-alb adducts increased markedly between February and October in three of the four villages, with the largest increases in the villages with higher exposures. Children who were fully weaned at recruitment had higher AF-alb than did those still partially breast-fed (p < 0.0001); the major weaning food was a maize-based porridge. There was no association between AF-alb and micronutrient levels, suggesting that aflatoxin exposure was not accompanied by a general nutritional deficiency. There was, however, a strong negative correlation (p < 0.0001) between AF-alb and height increase over the 8-month follow-up after adjustment for age, sex, height at recruitment, socioeconomic status, village, and weaning status; the highest quartile of AF-alb was associated with a mean 1.7 cm reduction in growth over 8 months compared with the lowest quartile. This study emphasizes the association between aflatoxin and stunting, although the underlying mechanisms remain unclear. Aflatoxin exposure during the weaning period may be critical in terms of adverse health effects in West African children, and intervention measures to reduce exposure merit investigation.