Year-round longitudinal monitoring of a bushmeat market in central-western Côte d’Ivoire: Implication for wildlife conservation

Hunting for bushmeat in the tropics has become a major issue in terms of conservation and human health, especially in western and central Africa. In Côte d’Ivoire, despite a ban on hunting since 1974, the bushmeat trade is widespread. This situation has been exacerbated by the long-term socio-political unrest in Côte d’Ivoire, resulting in the lack of effective protection of protected areas (PAs). Our study was carried out in the central-west Department of Daloa. We conducted standard interviews with the six main traders of the markets to trace the geographical origin of the bushmeat, and quantify the number of animals sold by direct observations twice a week during 52 weeks. We used multiple regression analyses to identify combinations of variables (proportion of animals killed, mean body mass, total biomass, price of carcass, price per body mass) that influenced poaching pressure.A total of 955 carcasses were recorded in the central market of Daloa. This number includes 948 mammals (99 %), six reptiles (0.6 %), and one bird (0.1 %). Rodentia were the most frequently sold taxons by number of individuals (58 %), followed by Artiodactyla (35 %), Carnivora (4 %), and Primates (1 %). Almost half of the game originated from the Department of Zoukougbeu (42 %; N = 404), followed by the Departments of Daloa (29 %; N = 275) and Séguéla (13 %; N = 123). Over 75 % of all the carcasses appearing in the market consisted of greater cane rats and bushbuck. In contrast, over 68 % of the total biomass (23028.75 kg) entering the market was supplied by Bushbuck and Common warthog. Game diversity by catchment area was the highest in Séguéla and Grégbeu and the lowest in Guezon and Maminigui. Our data indicated that hunting was unequally distributed throughout the central-western region of Côte d’Ivoire or markets are unequally provisioned by hunters. Human population density of the catchment areas affected the quantity and the quality of bushmeat observed at the urban market. Increasing hunting pressure in the Departments of Zoukougbeu proximate to the Haut Sassandra forest reserve indicates that the local authority in charge of the surveillance of this reserve has to reinforce its protection to avoid further faunal depletion. Because most of the ungulates and rodents found on the market occur at high density in disturbed habitats, their relative frequencies in the carcasses provisioning the market could be used as indicators of site over-exploitation.     

Occurrence of ochratoxin A in spices commercialized in Abidjan (Côte d’Ivoire)

Ochratoxin A (OTA) is a mycotoxin produced mostly by several species of Aspergillus and Penicillium. OTA is nephrotoxic in all animal species in which it has been tested and is cancerogenic in rodents. It is associated with Balkan endemic nephropathy. It is naturally present in many crop products such as cereals (barley, wheat, maize) and dried fruits, spices, coffee, wine, olives, and cocoa. The aim of this study was to assess the contamination of three Ivoirian spices with OTA (ginger, chili, and pepper) widely consumed by the population. A total of 90 spice samples (ginger: n?=?30; chili: n?=?30; pepper n?=?30) was taken from various sales outlets of Abidjan. OTA was quantified using an HPLC apparatus coupled with a fluorimetric detector. The chili and ginger samples were contaminated with OTA at a mean concentration of 57.48?±?174 and 0.12?±?0.15 μg/kg, respectively. No contamination of the pepper samples was detected. Eight (26.67 %) of the chili samples exceeded the maximum limit of 15 μg/kg established by European regulation. These results should serve as an alert on the risk to the consumer population of these products that are highly contaminated with OTA.     

Census and distribution of chimpanzees in Côte D’Ivoire

Most methods of estimating chimpanzee population densities rely on nest counts. We tested the most frequently used techniques on a known chimpanzee community living in the rainforest of the Taï National Park, Côte d’Ivoire. The best density estimates are given by counts that assume groups of nests to be distributed randomly and that use the mean group size for homogenous habitat but the median for heterogenous habitats. Correction for real forest cover within the region should be made because chimpanzees make nests only in forested regions. This method gave the exact chimpanzee density for the Taï population, i.e. 1.7 nest builders/km². For the nationwide survey, we first estimated the chimpanzee density for different types of habitat (e.g. intact primary forest: 1.64 chimpanzees/km²; degraded forests: 0.4 chimpanzees/km²; human encroached forests and mosaic habitats: 0.09 chimpanzees/km²). Second, we estimated the total forest cover of the country with satellite pictures. This gave an estimated chimpanzee population in Côte d’Ivoire of about 11,676 ± 1,168 individuals, which equals the number of spectators at a soccer game in an average European town. Sadly, only three National Parks may have chimpanzee populations large enough to be viable, whereas the rest are scattered and isolated small populations that are already threatened in their survival.     

Mapping malaria risk among children in Côte d’Ivoire using Bayesian geo-statistical models

ABSTRACT: BACKGROUND: In Cote d'Ivoire, an estimated 767,000 disability-adjusted life years are due to malaria, placing the country at position number 14 with regard to the global burden of malaria. Risk maps are important to guide control interventions, and hence, the aim of this study was to predict the geographical distribution of malaria infection risk in children aged <16 years in Cote d'Ivoire at high spatial resolution. METHODS: Using different data sources, a systematic review was carried out to compile and georeference survey data on Plasmodium spp. infection prevalence in Cote d'Ivoire, focusing on children aged <16 years. The period from 1988 to 2007 was covered. A suite of Bayesian geo-statistical logistic regression models was fitted to analyse malaria risk. Non-spatial models with and without exchangeable random effect parameters were compared to stationary and non-stationary spatial models. Non-stationarity was modelled assuming that the underlying spatial process is a mixture of separate stationary processes in each ecological zone. The best fitting model based on the deviance information criterion was used to predict Plasmodium spp. infection risk for entire Cote d'Ivoire, including uncertainty. RESULTS: Overall, 235 data points at 170 unique survey locations with malaria prevalence data for individuals aged <16 years were extracted. Most data points (n = 182, 77.4%) were collected between 2000 and 2007. A Bayesian non-stationary regression model showed the best fit with annualized rainfall and maximum land surface temperature identified as significant environmental covariates. This model was used to predict malaria infection risk at nonsampled locations. High-risk areas were mainly found in the north-central and western area, while relatively low-risk areas were located in the north at the country border, in the northeast, in the south-east around Abidjan, and in the central-west between two high prevalence areas. CONCLUSION: The malaria risk map at high spatial resolution gives an important overview of the geographical distribution of the disease in Cote d'Ivoire. It is a useful tool for the national malaria control programme and can be utilized for spatial targeting of control interventions and rational resource allocation.     

Changes in the termite assemblage across a sequence of land-use systems in the rural area around Lamto Reserve in central Côte d’Ivoire

Termites are major decomposers in tropical regions and play an important role in soil processes. This study investigated the termite assemblage structure across a sequence of differing land-use systems. With a standardized method, data were collected on termites from the following habitats: semi-deciduous forest, teak plantation, cocoa plantation, Jatropha plantation, food crop field and 4-years old fallow. Termite species richness declined from the semi-deciduous forest to 4-years old fallow through teak plantation, food crop field, cocoa plantation and Jatropha plantation. The relative abundance of fungus-growers was the highest in all land-use types while that of soil-feeders steeply declined in all man-modified sites. The wood-feeding species showed clear responses to disturbance, with low abundances in monospecific- and modified sites without high trees. Comparisons with other studies suggest that changes in the termite assemblage structure result from forest conversion to agricultural systems. To help mitigate the loss of termites when forests are disturbed or cleared, we recommend to: (1) promote the association of cropping and silvicultural systems that reduces changes in microclimate and maintains the original termite assemblage with the associated ecosystem services; (2) leave dead wood on the ground after forest disturbance to accelerate the recovery of the termite assemblage; and (3) increase forest and silvicultural patch size and reduce length of forest edges to sustain the survival of forest-dependent species.     

Change in termite communities along a chronosequence of mango tree orchards in the north of Côte d’Ivoire

Termites constitute the major component of the macrofauna of the soil, and influence the structure of the soil, in tropical regions. This study aimed to estimate their assemblages in a chronosequence of mango tree orchards in the north of Côte d’Ivoire and compare them with those in unmanaged savanna. Using a standardized method of rapid biodiversity estimation, termites were collected in seven age classes of mango tree orchards (class 1: <5 years; class 2: 5–9 years; class 3: 10–14 years; class 4: 15–19 years; class 5: 20–24 years; class 6: 25–29 years; class 7: 30 years and over) and compared with termites collected from the savanna. Results show that the species richness was lowest in the young orchards of class 1 (9 species), and increased with the age of the orchards to reach its maximum in the old orchards of class 7 (28 species); these latter were comparable in richness with the savanna (26 species). The Shannon index (H’) and the evenness (E) follow the same trend as the species richness. The orchards of classes 1 and 2 were more dissimilar to the savanna. In contrast, termites were well represented in the savanna and in the old orchard of classes 6 and 7. Rhinotermitinae and Cubitermitinae subfamilies, absent in the young orchards of classes 1 and 2, were very abundant in the old orchards (classes 6 and 7). Overall, the findings of this study show that only the old mango orchards sustain termite diversity that comes close to that of the savanna. In this region, the cessation of agricultural activities in mango orchards favors the reconstitution of termite communities and presumably the restoration of the ecosystem services provided by termites. Thus it would be possible to combine agriculture and the conservation soil biodiversity.     

Ecosystem services for conservation finance: applying the TEEB stepwise approach in Côte d’Ivoire

Ecosystem service (ES) evidence and arguments can mobilize support for biodiversity conservation. However, the ES concept’s impact on the ground seems unclear: It is reliant upon a range of pre-requisites at the science-policy nexus and it tends to be science-driven and demanding in terms of data and required capacity. The TEEB stepwise approach (The Economics of Ecosystems and Biodiversity for Local and Regional Policy Makers, Earthscan, London, 2012) guides purpose-driven ES assessments and seeks to enhance the usefulness of the ES concept in difficult real-world settings. An application of this approach has not yet been appraised. Also, beyond the instrumental use of ES data (e.g. for the design of payment schemes for ES), there is little documented experience with strategically using ES arguments for mobilizing financial resources for conservation. As many other countries, Côte d’Ivoire does not have a strong knowledge base on ecosystem services (ES). Such circumstances can preclude the use of the ES concept for convincing potential donors to co-finance conservation. We examine the recent ES assessment for the Parc national de Taï (PNT), Côte d’Ivoire, which followed the TEEB stepwise approach. We look at process, results and outcomes to address three questions: (i) How did study results contribute to mobilizing funds for the PNT? (ii) In which ways was the TEEB stepwise approach useful in practice? (iii) What lessons can be drawn for ES assessments geared to conservation finance?     

Plant Species Diversity in the Southern Part of the Taï National Park (Côte d’Ivoire)

Plant species diversity is surveyed in the southern part of the Taï National Park (TNP), Côte d’Ivoire. This park is the largest remaining tract of pristine forest in the West African rainforest biodiversity hotspot. Plant assemblages and environment factors were surveyed in 39 temporary 625-m² plots within three areas. The species list was completed thanks to itinerant prospections. TWINSPAN classification and detrended correspondence analysis were applied to the 39 relevés. We recorded a total of 916 plant species, including 169 West African endemics, that rises the floristic richness of TNP in 1233 species. Most plant species recorded were Guineo-Congolian species (90.9%) among which 8% were ‘Sassandrian species’, i.e. endemics of the extreme southwest Côte d’Ivoire. Eight of these endemics were exclusive of the southern part of TNP. The forest is very species-rich, particularly in Rubiaceae, Leguminosae and Euphorbiaceae. Most of the sampled species (59.5%) were erect phanerophytes with a dbh≤10 cm. We distinguished 7 plant community types, mainly determined by geomorphology and disturbance history. Lowland forests were typical dense evergreen forests with different degrees of maturity related to historical human impact. Inselbergs and swampy depressions provide an original azonal vegetation. We conclude that the southern part of TNP contributes significantly to the regional biodiversity hotspot since it includes the last remnants of primary evergreen rainforest and contains species assemblages from both higher rainfall biomes on moist soils derived from schist parent material and lower rainfall biomes on inselberg slopes and top. As anthropogenic disturbance clearly reduces biodiversity, these last remnants should be integrally protected.     

Market Hunting in the Taï Region,Côte d’Ivoire and Implications for Monkey Populations

We studied the effect of market hunting on primate species in the Taï National Park and adjacent forests in Côte d’Ivoire. We assessed the impact of hunting by comparing the calculated maximal reproduction rate with the current off-take rate. We assessed the average bushmeat consumption per capita/per year from weekly investigations on bushmeat available in 88 bushmeat restaurants and markets over a 12-mo period in 1999. We derived data on preferences for particular game species from interviews of 162 bushmeat consumers, 25 subsistence hunters and 3 groups of professional hunters. Hunting pressure was highest on the larger primate species such red colobus (Procolobus badius), black- and- white colobus (Colobus polykomos) and sooty mangabeys (Cercocebus atys). The amount of primate bushmeat extracted from the Taï National Park and surrounding forests was 249,229 kg in 1999. We estimated population densities using line transect surveys. By referring to current population densities we calculated the maximum production of each species using the Robinson Redford model (2001) and assuming unhunted conditions. A comparison of current harvest levels with maximum production suggests that harvest of Procolobus badius is sustainable, whereas current off-take of Colobus polykomos, Cercocebus atys, Cercopithecus diana (diana monkey) and C. campbelli (Campbell’s monkeys) exceeds sustainability by ≤3 times. We recommend that wildlife managers promote programs that encourage the production of domestic animals as a substitute for wild meat.     

Effects of management intensity on ant diversity in cocoa plantation (Oume,centre west Côte d’Ivoire)

Anthropogenic habitat modifications, including conversion of forest to agricultural production cause losses of native species. In this study we examined the losses suffered by ant communities in relation to the intensity of management in cocoa plantations established in former tropical forest. An extensive sampling protocol consisting of pitfall trapping, leaf litter sampling, soil sampling and hand sampling was used to characterize ant species richness and composition in the native forest and compare it with three cocoa farms differing in their management intensity. Species richness was negatively correlated with management intensity and differed greatly between management practices and the forest. Two subfamilies (Myrmicinae and Amblyoponinae) showed a significant negative correlation with agricultural intensification probably because their species are constrained to living in forest like habitat. The species composition differed greatly between management practices and the forest. Intensively and moderately managed cocoa plantations were most dissimilar to the forest. In contrast, forest ants were well represented in the least intensively managed plantation. Overall, the findings of this study show that only slightly managed cocoa plantations sustain an ant diversity that comes close to that of the forest. This also holds true for cocoa plantations on former agricultural, and thus previously heavily used, land. The findings may help in the conservation of biodiversity as management practices most likely to sustain forest like ant communities have been identified.     

Multiple Pathogens Including Potential New Species in Tick Vectors in C?te d’Ivoire

BackgroundOur study aimed to assess the presence of different pathogens in ticks collected in two regions in Côte d’Ivoire.Conclusions/SignificanceFor the first time, we demonstrate the presence of different pathogens such as R. aeschlimannii, C. burnetii, Borrelia sp., A. centrale, A. marginale, and E. ruminantium in ticks in Côte d’Ivoire as well as potential new species of unknown pathogenicity.     

Update of ichthyofauna diversity and ecological status of a coastal River Nero (Côte d’Ivoire – West Africa)

The general aim of this study is to update the inventory of the fish species and to specify distribution patterns in the Nero River ichthyofauna in order to establish some basis for the conservation of these fish communities and their habitat. From February 2009 to January 2010, thirty-three sites were sampled monthly with gill nets and a backpack electrofisher, and environmental variables were recorded. Overall, 46 species included in 33 genuses, 24 families and 9 orders were collected. Eleven families and 30 species were the first records for the Nero River. Including all species previously listed in the literature, the number of species presently known in the Nero River and its tributaries is revised to 59. Four families, Alestidae (21%), Schilbeidae (19%), Cyprinidae (17%) and Cichlidae (16%) that made up 73% of the total number of the catches, were the most dominant. The most dominant numerical species were Schilbe mandibularis and Brycinus longipinnis. Fish species and sampling sites along with eight environmental variables were ordinated with canonical correspondence analysis (CCA) coupled to the Monte Carlo test. Ecological status based on fish assemblage according to environmental variables and anthropogenic pressures showed that miss dead wood leaves and roots, electrical conductivity, total dissolved solids, mud, nitrite, basin width, dissolved oxygen and pH, were the primary factors influencing fish distribution. The environmental tolerance index (ETI), ecological tolerance (t_k) and optima (u_k) values of 10 species to 8 different environmental variables were analyzed. Six species (Hemichromis fasciatus, Epiplatys chaperi, Barbus ablabes, B. longipinnis, Hemichromis bimaculatus and Chromidotilapia guntheri) have high ETI and a cosmopolitan distribution in the Nero River. In the tributaries of the middle course, high concentrations of nitrite in the water, added to the presence of a lot of tolerant species in the ichthyofauna are indications of disturbance of these areas. Subsequent recommendations were formulated for efficient restoration and conservation management of this River.     

Spatio-temporal variations of the zooplankton abundance and composition in a West African tropical coastal lagoon (Grand-Lahou,Côte d’Ivoire)

Zooplankton constitutes a sensitive tool for monitoring environmental changes in coastal lagoons; however, the available information on zooplankton communities is not sufficient to optimize their rational management. The relationships between zooplankton distribution and environmental factors were studied in a tropical lagoon to test whether the indicator properties of zooplankton assemblages could be used to monitor water quality, in a context of expected eutrophication provoked by an increasing anthropogenic activity. Twenty-one (21) stations were sampled monthly from January to December 2004. The community was composed of 65 taxa including Copepoda, Rotifera, and Cladocera. Copepoda was the most abundant group (81% of total numbers). The main zooplankton species were Oithona brevicornis, Acartia clausi, and Brachionus plicatilis. The highest zooplankton abundance (171–175 ind. l⁻¹) was recorded during the long, dry season (February–April) and the lowest (40–45 ind. l⁻¹) during the rainy and the flood periods (June–July). At a spatial level, the lowest abundance was observed in the estuarine zone. During the dry seasons (December–April and August–September), marine zooplankton taxa were abundant near the channel of Grand-Lahou, and brackish water taxa dominated in the other sites. Multivariate analyses (Co-inertia) showed that the composition of zooplanktonic communities and their spatio-temporal variations were mainly controlled by salinity variations closely linked to the climatic and hydrological context. The role of the trophic state on zooplankton communities could not be clearly evidenced. Our results and a comparison with previous studies in the neighboring, highly polluted Ebrié Lagoon suggest that the ratio between Oithona and Acartia abundance could be used as biological indicator for the water quality. Handling editor: S. I. Dodson     

Scope and Limits of an Anamnestic Questionnaire in a Control-Induced Low-Endemicity Helminthiasis Setting in South-Central C?te d’Ivoire

Background

Schistosomiasis and soil-transmitted helminthiasis are two high-burden neglected tropical diseases. In highly endemic areas, control efforts emphasize preventive chemotherapy. However, as morbidity, infection, and transmission begin to decrease, more targeted treatment is likely to become more cost-effective, provided that comparatively cheap diagnostic methods with reasonable accuracy are available.

Methodology

Adults were administered an anamnestic questionnaire in mid-2010 during a cross-sectional epidemiological survey in the Taabo health demographic surveillance system in south-central Côte d’Ivoire. Questions pertaining to risk factors and signs and symptoms for schistosomiasis and soil-transmitted helminthiasis were included. The individuals’ helminth infection status and their belonging to three different anthelmintic treatment groups were compared with the questionnaire results (i) to inform the local health authorities about the epidemiological and clinical footprint of locally prevailing helminthiases, and (ii) to explore the scope and limits of an anamnestic questionnaire as monitoring tool, which eventually could help guiding the control of neglected tropical diseases in control-induced low-endemicity settings.

Principal Findings

Our study sample consisted of 195 adults (101 males, 94 females). We found prevalences of hookworm, Trichuris trichiura, Schistosoma haematobium, and Schistosoma mansoni of 39.0%, 2.7%, 2.1%, and 2.1%, respectively. No Ascaris lumbricoides infection was found. Helminth infection intensities were generally very low. Seven, 74 and 79 participants belonged to three different treatment groups. Multivariable logistic regression models revealed statistically significant (p<0.05) associations between some risk factors, signs, and symptoms, and the different helminth infections and treatment groups. However, the risk factors, signs, and symptoms showed weak diagnostic properties.

Conclusions/Significance

The generally low prevalence and intensity of helminth infection in this part of south-central Côte d’Ivoire indicates that recent control efforts have turned our study area into a low endemicity setting. Our anamnestic questionnaire had low sensitivity and specificity to identify infected individuals or treatment groups.     

Pattern of the evolution of HIV-1 enν gene in C?te d?Ivoire

Cête d׳Ivoire continues to have the highest HIV-1 prevalence rate in West Africa, although the infection number is in constant decline. The external envelope protein of the viruses is a likely site of selection, and responsible for receptor binding and entry into host cells, and therefore constitutes an ideal region with which to investigate the evolutionary processes acting on HIV-1. In this study, we analyse 189 envelope glycoprotein V3 loop region sequences of viruse isolates from 1995 to 2009, from HIV-1 untreated patients living in Cête d׳Ivoire, to decipher the temporal relationship between disease diversity, divergence and selection. Our analyses show that the nonsynonymous and synonymous ratio (dN/dS) was lower than 1 for viral populations analysed within 15 years, which showed the sequences did not undergo adequate immune pressure. The phylogenetic tree of the sequences analysed demonstrated distinctly long internal branches and short external branches, suggesting that only a small number of viruses infected the new host cell at each transmission. In addition to identifying sites under purifying selection, we also identified neutral sites that can cause false positive inference of selection. These sites presented form a resource for future studies of selection pressures acting on HIV-1 enν gene in Cête d׳Ivoire and other West African countries.     

Monitoring tropical forest fragmentation in the Zagné-Taï area (west of Taï National Park,Côte d’Ivoire)

Deforestation west of the Tai National Park over the last 3 decades has been dramatic, with forest cover of rural areas decreasing from 89.6% in 1974 to 6.7% in 2003. The process comprised 3 major steps. During the 10 first years, deforestation was limited to a ca. 5 km band each side of the main north–south track. From 1984 to 1990 there was a massive increase in deforestation whose front met the limits of the protected areas, leaving many forest fragments of various sizes forming a mosaic in the landscape. From 1990 to 2003 these fragments were further deforested by being either totally destroyed or reduced in size, or further split into smaller units. During these latter 13 years their number was halved, their average area was reduced by an 8th, and their total area reduced by an 11th. In addition, a moving cost analysis has indicated that most of the area could now be out of reach for forest species dispersion. This critical situation may be explained by the increase of population pressure (due to internal increment as well as massive immigration) causing increased land cultivation and a growing trend to permanent cash crop cultivation, which removed important surfaces from the traditional shifting cultivation cycle. Without the implementation of a forest fragment protection policy local population demands for wood and non-timber forest products would likely be entirely dependant on protected areas in the future. Furthermore, deforestation pressure is likely to reach the protected areas which had, until recently, remained relatively untouched (despite a minor deforestation peak between 1984 and 1990).     

Effects of Hygiene and Defecation Behavior on Helminths and Intestinal Protozoa Infections in Taabo,C?te d’Ivoire

Background

More than 1 billion people are currently infected with soil-transmitted helminths and schistosomes. The global strategy to control helminthiases is the regular administration of anthelmintic drugs to at-risk populations. However, rapid re-infection occurs in areas where hygiene, access to clean water, and sanitation are inadequate.

Methodology

In July 2011, inhabitants from two villages and seven hamlets of the Taabo health demographic surveillance system in south-central Côte d’Ivoire provided stool and urine samples. Kato-Katz and ether-concentration methods were used for the diagnosis of Schistosoma mansoni, soil-transmitted helminths (Ascaris lumbricoides, Trichuris trichiura, and hookworm), and intestinal protozoa. Urine samples were subjected to a filtration method for the diagnosis of Schistosoma haematobium. A questionnaire was administered to households to obtain information on knowledge, attitude, practice, and beliefs in relation to hygiene, sanitation, and defecation behavior. Logistic regression models were employed to assess for associations between questionnaire data and parasitic infections.

Principal Findings

A total of 1,894 participants had complete data records. Parasitological examinations revealed prevalences of hookworm, S. haematobium, T. trichiura, S. mansoni, and A. lumbricoides of 33.5%, 7.0%, 1.6%, 1.3% and 0.8%, respectively. Giardia intestinalis and Entamoeba histolytica/E. dispar were detected in 15.0% and 14.4% of the participants, respectively. Only one out of five households reported the presence of a latrine, and hence, open defecation was common. Logistic regression analysis revealed that age, sex, socioeconomic status, hygiene, and defecation behavior are determinants for helminths and intestinal protozoa infections.

Conclusions/Significance

We found that inadequate sanitation and hygiene behavior are associated with soil-transmitted helminths and intestinal protozoa infections in the Taabo area of south-central Côte d’Ivoire. Our data will serve as a benchmark to monitor the effect of community-led total sanitation and hygiene education to reduce the transmission of helminthiases and intestinal protozoa infections.     

The Dispute Concerning the Delimitation of the Maritime Boundary Between Ghana and Côte d’Ivoire: Implications for the Law of the Sea

The final judgment in the maritime boundary delimitation case between Ghana and Côte d’Ivoire was delivered by an ad hoc special chamber (the Chamber) of the International Tribunal for the Law of the Sea (ITLOS) on 23 September 2017. The decision addressed important legal questions relating not only to maritime boundary delimitation but also to the balancing of various rights and interests at the provisional measures stage and international responsibility for unilateral resource exploitation activities in disputed zones pending delimitation. This article analyzes the decision of the Chamber with respect to its findings on tacit boundary agreements, delimitation methodology, and international responsibility.     

Evaluation of Cervical Cancer Screening Programs in C?te d’Ivoire,Guyana, and Tanzania: Effect of HIV Status

Background

HIV infection increases a woman’s risk for cervical cancer, and cervical cancer incidence and mortality rates are higher in countries with high HIV prevalence and limited resources for screening. Visual inspection with acetic acid (VIA) allows screening and treatment of cervical lesions in a single-visit approach (SVA), but data on its performance in HIV-infected women are limited. This study’s objective was to examine cervical cancer screening using VIA/SVA in programs serving HIV-infected women.

Methods

A VIA/SVA program with cryotherapy for VIA-positive lesions was implemented in Côte d’Ivoire, Guyana, and Tanzania from 2009 to 2012. The effect of HIV status on VIA positivity and on presence of cryotherapy-eligible lesions was examined using a cross-sectional study design, with Chi-square tests for comparisons and constructed multivariate logistic regression models. A P-value of < 0.05 was significant.

Findings

VIA was performed on 34,921 women, 10% (3,580) were VIA positive; 2,508 (85%) eligible women received cryotherapy during the same visit; only 234 (52%) of those who postponed returned for treatment; 622 (17%) VIA-positive women had lesions too large to be treated with cryotherapy and were referred for excisional treatment. In multivariate analysis—controlling for HIV status, location of the screening clinic, facility location, facility type, and country—compared to HIV-uninfected/unknown women, HIV-infected women had higher odds of being VIA positive (OR 1.95, 95% CI 1.76, 2.16, P<0.0001) and of having large lesions requiring referral (OR 1.93, 95% CI 1.49, 2.51, P< 0.0001). Minor treatment complications occurred in 19 of 3,032 (0.63%) women; none required further intervention.

Conclusions

This study found that compared to HIV-uninfected/unknown women, HIV-infected women had nearly twice the odds of being VIA-positive and to require referral for large lesions. SVA was safe and resulted in significant reductions in loss to follow-up. There is increased need for excisional treatment in countries with high HIV prevalence.