A WISE STRATEGIC DECISION——Written in Celebration of Establishment of China-South Africa Diplomatic Ties

South Africa is to establish diplomatic relations with the People’s Republic ofChina by the end of this year while cutting off its official ties with Taiwan.This will be a major event worthy of warm celebrations. It will usher in a newstage in the annals of bilateral relations of friendship and cooperation. The decisionfor the changeover in diplomatic recognition by the new South Africa Governmentis a wise, crucial strategic action taken after all-round deliberations on its long-termstate interests and carried out in accordance with diplomatic norms accepted in theinternational community. No doubt, it will exert positive impact worldwide.

Extension of Chemoprevention of Seasonal Malaria to Five Cycles and to Children from the Age of 6 to 9 Years in Africa: Analysis of Its Acceptability, Feasibility, Cost and Impact A Systematic Review

Introduction: Seasonal Malaria Chemoprevention (SMC) aims at preventing malaria in children during the high transmission season. It has been recommended by the WHO since 2013 for children from the age of 3-59 months. However, despite the impact of this intervention, a peak in the prevalence and incidence of malaria is observed in children from the age of 5-9 years. The aim of this study is to determine from the current literature the feasibility, impact and cost-effectiveness of extending SMC to five cycles and to older children. Methods: A litterature search of PubMed/Medline, NCBI and Google scholar identified 1333 articles. After reading the titles and abstracts by two authors, 24 articles were selected and submitted for full reading. Random control studies on the extension of SMC, malaria, feasibility of SMC, impact of SMC and cost-effectiveness of SMC were selected. A total of 16 articles were included for the qualitative synthesis after excluding 8 studies. Results: Following the summary of the evidence, we conclude that the extension is feasible but will be confronted with the unavailability of older children. The intervention period coincides with field work. SMC is effective in reducing the prevalence and incidence of malaria and the parasite density in children. The financial cost of administering SMC is lower than that of treating a child suffering from malaria. Conclusion: After analysing the information, it was found that the majority of the African population supports the extension of the SMC to the number of cycles and the age group in order to alleviate the high mortality and morbidity rates among children due to malaria.

COVID-19 Vaccination Status and Severe Outcomes among Patients Hospitalized for COVID-19 in West Africa, Togo, 2021

Objectives: More than a year after its introduction, COVID-19 vaccination coverage was low in the Togolese population and little data were available on its benefits for hospitalized patients. This study aimed to describe the impact of COVID-19 vaccination on the prognosis of hospitalized patients. Methods: This was a retrospective cohort study of patients admitted to the Centre Hospitalier Régional Lomé Commune (Togo) between June 1, 2021 and May 31, 2022. Primary outcomes (admission to the intensive care unit and death) were presented with frequency and proportion. Mortality rates were presented by sociodemographic and clinical characteristics and compared by appropriate statistical tests. Factors associated with inpatient death were described by performing a Cox proportional hazard regression. Results: A total of 604 patients were hospitalized (50.0% women). The mean age was 54.03 ±17.1 years. Only 55 patients were fully vaccinated (9.1%). ICU admission was significantly more frequent in unvaccinated patients than in vaccinated ones (63.0% vs. 38.2%;p Conclusion: COVID-19 vaccination had a significant benefit for patients with COVID-19 infection in terms of reducing the risk of death. Based on real-world data from sub-Saharan Africa, this information can help optimize the benefit of COVID-19 vaccination by raising community awareness and increasing vaccine coverage while reducing hesitancy.

Assessment of the Physical Capabilities of Heart Failure Patients before and after Cardiovascular Rehabilitation: A Study of 125 Patients from West Africa, Dakar, Senegal

Background: Cardiac rehabilitation represents a critical therapeutic strategy for patients suffering from chronic heart failure. The physical capacity of patients with heart failure, assessed using the exercise test and the 6-minute walk test, is the measure of the patient’s overall functional ability to perform physical activities and tolerate exercise loads. The objective of this study was to assess the impact of cardiac rehabilitation on patients’ physical capabilities and to conduct a thorough comparison of data obtained via exercise testing and the 6-minute walk test before and after the rehabilitation programme. Methods: This was a descriptive and analytical cross-sectional study, conducted from 1 February 2021 to 31 June 2022. Included were heart failure patients who had participated in an outpatient cardiovascular rehabilitation programme. The collected data included anamnestic, clinical, paraclinical data, and the 6-minute walk test. Informed consent was obtained. Data analysis, word processing, and charting were performed using Microsoft Word 2016, Excel 2013, and Sphinx version 5.1.0.2. Data analysis was performed using SPSS (Statistical Package for Social Sciences) version 24.0. Any difference less than 0.05 was considered statistically significant. Results: In a Senegalese study, heart failure patients undergoing rehabilitation in a cardiac unit represented 45.59% of all cases, with a prevalence rate of 3.21%. The average participant was 57.97 years old, with those aged 61 to 70 forming the largest group (35.5%). The study noted a male predominance (sex ratio of 2.1) and identified dyslipidaemia (80.6%) and sedentarism (71%), as prevalent cardiovascular risk factors. All participants initially suffered from NYHA stage 2 or 3 dyspnoea, yet 80.65% showed no symptoms following rehabilitation. Significant improvements were recorded in resting heart rate (from 79 to 67 bpm), and the 6-minute walk test distance (from 328 m to 470 m). Enhanced exercise tolerance and walking test outcomes were particularly notable in patients with LVEF ≥ 50%, women, non-obese individuals, those initially walking less than 300 m, achieving more than 3 METs, and non-smokers. Conclusion: The findings underscore the effectiveness of cardiovascular rehabilitation in improving symptoms, physical capability, and overall quality of life for heart failure patients in Senegal.

The Effects of Age and Ejaculatory Abstinence on Semen Quality and Reproductive Hormones in Africa and the Middle East

The aim of this study was to retrospectively evaluate the effects of male age and ejaculatory abstinence on semen parameters and reproductive hormones among men residing in Africa and the Middle East. A total of 70,142 semen analysis results were analysed and grouped according to the age intervals (16 - 20, 21 - 30, 31 - 40, 41 - 50, 51 - 60, >60) and ejaculatory abstinence (<2 days, 2 - 5 days and >5 days). Semen parameters i.e. volume, concentration, progressive motility, total progressively motile count, morphology, total normal sperm count, DNA fragmentation, viability, sORP, normed sORP were specifically evaluated. Additionally, for each age interval, reproductive hormones i.e. estradiol, luteinizing hormone, follicle stimulating hormone, testosterone and prolactin were evaluated. Semen volume, total progressively motile count, sperm morphology and total normal sperm count constantly decrease significantly after the age of 30 years. Sperm concentration started declining significantly after the age of 50 years. There was a constant age- related increase in number of spermatozoa with damaged DNA. sORP constantly increased up to 60 years. Furthermore, constantage-related decreases in FSH, serum testosterone and prolact in were observed from patients aged between 16 years and 60 years. Semen volume, sperm concentration, progressive motility and normal morphology were significantly higher in patients having > 5 days of abstinence. Patients having > 5 days of abstinence had the lowest normed sORP. Male age significantly affects sperm parameters and reproductive hormones in fertile and infertile men residing in Africa and the Middle East. Prolonged abstinence days provides better semen quality.

Hepatitis B Vaccination Coverage among University Students in Sub-Saharan Africa: Systematic Review and Meta Analysis

Introduction: Hepatitis B is an infectious disease that remains a real public health problem in Africa. Students represent a group at risk for this disease. The objective of this study was to estimate the hepatitis B vaccination coverage rate among students in sub-Saharan Africa. Methods: A systematic search of databases (PubMed, AJOL) and a manual search of Google Scholar was conducted to retrieve all published studies reporting hepatitis B vaccination coverage among students in sub-Saharan Africa. The pooled coverage rate was estimated with a 95% confidence interval (CI) in a random-effects meta-analysis. Results: A total of 35 studies were included and included 20,520 students. The mean age was 22.1 ± 5.1 years with a predominance of female sex (sex ratio F/M = 1.05). The vaccination coverage rate was 28.8% [95% CI: 22.9% - 34.7%]. Disaggregation allowed to estimate coverage rates of 29.8% [95% CI: 22.9% - 36.7%], 23.4% [95% CI: 9.4% - 37.4%] and 17.0% [95% CI: 14.4% - 19.5%] respectively in West Africa, East Africa and Central Africa. Conclusion: Less than a third of students in sub-Saharan Africa are protected against hepatitis B. However, the majority of this target group is at risk of infection. It would be relevant to screen and, if necessary, vaccinate all new students.

Epidemiology, Clinical Features and Antifungal Resistance Profile of Candida auris in Africa: Systematic Review

Candida auris since it discovery in 2009 is becoming a severe threat to human health due to its very quickly spread, its worldwide high resistance to systemic antifungal drugs. In resource-constrained settings where several conditions are met for its emergence and spread, this worrisome fungus could cause large hospital and/or community-based outbreaks. This review aimed to summarize the available data on C. auris in Africa focusing on its epidemiology and antifungal resistance profile. Major databases were searched for articles on the epidemiology and antifungal resistance profile of C. auris in Africa. Out of 2,521 articles identified 22 met the inclusion criteria. In Africa, nearly 89% of African countries have no published data on C. auris. The prevalence of C. auris in Africa was 8.74%. The case fatality rate of C. auris infection in Africa was 39.46%. The main C. auris risk factors reported in Africa were cardiovascular disease, renal failure, diabetes, HIV, recent intake of antimicrobial drugs, ICU admissions, surgery, hemodialysis, parenteral nutrition and indwelling devices. Four phylogenetic clades were reported in Africa, namely clades I, II, III and IV. Candida auris showed a pan-African very high resistance rate to fluconazole, moderate resistance to amphotericin B, and high susceptibility to echinocandins. Finally, C. auris clade-specific mutations were observed within the ERG2, ERG3, ERG9, ERG11, FKS1, TAC1b and MRR1 genes in Africa. This systematic review showed the presence of C. auris in the African continent and a worrying unavailability of data on this resilient fungus in most African countries.

Systematic Analysis of Factors Associated with Late Breast Cancer Screening in Women in Sub-Saharan Africa from 2014 to 2020

Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to 2020.Setting: This systematic review focuses on sub-Saharan Africa. Methods: We searched for articles in four databases (PubMed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.

Ambulatory Radio Iodine Therapy in the Management of Hyperthyroidism in Africa: African Systematic Review and Perspectives in Burkina Faso

Introduction: In hyperthyroidism, selective irradiation of the thyroid gland with radioactive iodine is a radical treatment and an alternative to surgery. The aim of this review is to assess the medium-term efficacy of outpatient treatment of hyperthyroidism with iodine-131 in Africa. Methods: We identified the studies carried out in Africa on outpatient radiation therapy between 2016 and 2020. For each article included, we noted the country concerned and the year of publication, the numbers studied, the socio-demographic characteristics of the patients, the indications for radio iodine therapy, the dose administered, the results of the hormonal dosage 6 months after radiation. Results: 13 retrospective studies were included to constitute a total population of 925 patients. The average age was 40.77 years, the sex ratio of 1/5.4 with a clear female predominance. The 3 main etiologies of hyperthyroidism justifying outpatient radio iodine therapy were Graves’ disease (55.89%), toxic multinodular goiter (22.70%) and toxic adenoma (21.40%). The average dose of iodine 131 administered per course is 13.7 mCi. No short-and medium-term complications were reported. The radio iodine therapy was effective in 86.08% (n = 796) of the patients with extremes of 72% and 100%. Conclusion: Radio iodine therapy is effective in Africa. It is simple, inexpensive on an outpatient basis and well tolerated. The introduction of outpatient radio iodine therapy could improve the management of patients with hyperthyroidism in Burkina Faso.

Projected impacts of climate change on the habitat of Xerophyta species in Africa

Climate change poses a serious long-term threat to biodiversity.To effectively reduce biodiversity loss,conservationists need to have a thorough understanding of the preferred habitats of species and the variables that affect their distribution.Therefore,predicting the impact of climate change on speciesappropriate habitats may help mitigate the potential threats to biodiversity distribution.Xerophyta,a monocotyledonous genus of the family Velloziaceae is native to mainland Africa,Madagascar,and the Arabian Peninsula.The key drivers of Xerophyta habitat distribution and preference are unknown.Using 308 species occurrence data and eight environmental variables,the MaxEnt model was used to determine the potential distribution of six Xerophyta species in Africa under past,current and future climate change scenarios.The results showed that the models had a good predictive ability(Area Under the Curve and True Skill Statistics values for all SDMs were more than 0.902),indicating high accuracy in forecasting the potential geographic distribution of Xerophyta species.The main bioclimatic variables that impacted potential distributions of most Xerophyta species were mean temperature of the driest quarter(Bio9)and precipitation of the warmest quarter(Bio18).According to our models,tropical Africa has zones of moderate and high suitability for Xerophyta taxa,which is consistent with the majority of documented species localities.The habitat suitability of the existing range of the Xerophyta species varied based on the climate scenario,with most species experiencing a range loss greater than the range gain regardless of the climate scenario.The projected spatiotemporal patterns of Xerophyta species help guide recommendations for conservation efforts.

The Impact of Sharing a Shisha (Hookah) Mouthpiece during Smoking: Case of Tuberculosis and Hepatitis in South Saharan Africa

This study investigates the health implications of sharing a shisha (hookah) mouthpiece during smoking, with a focus on tuberculosis (TB) and hepatitis prevalence in Sub Saharan Africa. It examines shisha smoking behavior patterns and associated risks of disease transmission among those sharing a common mouthpiece. Through literature review and empirical data analysis, the research highlights epidemiological factors driving TB and hepatitis transmission within the context of shisha smoking in Sub Saharan Africa. Exploring cultural, social, and behavioral determinants influencing shisha mouthpiece sharing, the study offers insights into interventions and public health strategies. It emphasizes the need for targeted health education campaigns, policy interventions, and community-based initiatives to promote safer smoking practices. Immediate coordinated public health interventions, including educational campaigns and regulatory measures, are recommended. Collaboration among healthcare professionals, policymakers, and communities is essential. These insights deepen the understanding of challenges posed by communal shisha smoking in Sub Saharan Africa, laying the groundwork for evidence-based interventions to reduce TB and hepatitis transmission and enhance overall health outcomes in the region. This research underscores the urgency of addressing the risks associated with shisha smoking, aiming to mitigate disease transmission and improve population health in Sub Saharan Africa.

Interleukin 6 and Bone Erosions in Rheumatoid Arthritis in an African Hospital

Introduction: Rheumatoid arthritis (RA) is a chronic, erosive and deforming inflammatory rheumatic disease. In the era of biotherapies and the arrival of biosimilars in sub-Saharan Africa, the objective of this study was to describe plasma IL-6 variations in RA patients at Cité Verte District Hospital (Cameroon). Material and Methods: Descriptive and analytical cross-sectional study from December 1, 2021 to May 31, 2022. We included patients over 18 years old suffering from RA (ACR/EULAR 2010). Patients with an infection were not included. The data collected were age, sex, smoking status, family history, disease duration, disease activity by DAS28, CRP, rheumatoid factor, and plasma level of IL-6. Bone erosion was sought on radiography and ultrasound. Result: We included 31 patients, 25 of whom were women (80.6%). The mean age was 47.27 ± 17.97 years. Disease activity was predominantly moderate (32.3%) and severe (32.3%). Mean IL-6 level was 15.29 ± 2.36 pg/ml (extremes: 11.26 pg/ml and 20.15 pg/ml). IL-6 levels were higher in patients with a history of smoking. Similarly, IL-6 levels were higher in patients with mildly active RA in remission than in moderately and severely active RA. Mean IL-6 levels were significantly higher in patients with erosive RA (16.3 pg/ml VS 14.6 pg/ml). Conclusion: IL-6 levels were significantly elevated in men, weaned smokers and patients with bone erosions.

Socioenvironmental Drivers of Farmers’ Perceptions of Climate Change Risk in Agroforestry Parklands of West Atacora in Benin (West Africa)

Throughout the world, climate change is threatening the human population. In West Africa, smallholder farmers in indigenous agricultural societies typically hold considerable knowledge. Therefore, this study was conducted in West Atacora of Benin Republic to assess the drivers of farmers’ perceptions of climate change risk. We used a random sampling technique to select 360 households’ heads who were interviewed regarding different climate change risks perception. Binomial logistic regression was used to assess the drivers of farmers’ perceptions of climate change risks. The results showed that the farmers in drier areas had a higher perception of the global risk of climate change than those in humid areas. The same trend was observed for the seven different individual’s climate change risk investigated. The study identified also membership of farm organizations as main sociodemographic characteristic that explains farmers’ perception of climate change risk perception. These findings are helpful tools to sensitize the local people on climate change risk and cope with the risk in agricultural lands.

The Impacts and Causes of Land Fragmentation on Farm Productivity: Case Review of East African Countries

This report provides an overall assessment of land fragmentation problems in East Africa. Many parts of East Africa have become highly fragmented, putting development systems and activities in these areas at risk of complete collapse. Land fragmentation occurs when land gets converted for agriculture, industrialization, or urbanization, invaded by non-local plants, or enclosed for individual use and by subdividing farmlands into subsequent smaller units called parcels with varying average farm sizes. Fragmentation results from inappropriate agricultural development processes and ineffective land use planning that fails to recognize how farmland is used, and the importance of its interconnected areas. Insecurity of tenure and resource rights are key factors in making this possible. Land fragmentation is one of the key reasons why the ability of most resources in East Africa becomes scarcer, and those remaining become “privatized” by more powerful community members—keen to maintain their access to them. Such individualistic attitudes are new and disadvantage the poorest even further by affecting the traditional customary safety nets and agricultural outputs. Neither the government nor customary governance systems effectively protect resource access for the poorest. This review summary report identifies the key causes, measures, and implications, government interventions, and the common remedies to land fragmentation problems in the East African Countries of Kenya, Uganda, Rwanda, and Tanzania including neighboring Ethiopia, and the Sudan. The findings indicated from 2005 to 2015, the population kept increasing for all the named countries in East Africa with Rwanda and Uganda having a substantial increase in population density. The study review further explores the trend in the performance of agriculture by average farm sizes within the intervals of five years by highlighting their strong linkages and found that the average farm size has declined drastically, especially for Kenya. This can only mean that small farms kept becoming smaller and smaller and that there were more small-scale farmers. The results further depicted that the major and commonly cultivated food crops among the East African countries include maize, sorghum, rice, cassava, sweet potatoes, bananas, Irish potatoes, beans, peas, etc., with maize yields (Mt/ha) in 2003 for Uganda being the highest (1.79 Mt/ha) and the lowest in Rwanda (0.77 Mt/ha) respectively. Therefore, from the review results, recommendations are being made as to how the negative impacts of land fragmentation on agricultural productivity can be reduced or mitigated. One way is by community sensitization and awareness about the importance of land consolidation and its proposition on farm productivity.

Development of Digital Economy in Africa and the Prospects of China-Africa Cooperation in Digital Economy

Entering the 21st century,with the rapid development and popular use of mobile Internet and the accelerated innovation in such technologies as big data,artificial intelligence(AI),the Internet of Things,cloud computing and blockchain,digitalization has been increasingly integrated into the whole process of economic and social development on all fronts and the digital economy has ushered in a stage of rapid growth.Despite of a slow start,Africa’s digital economy,driven by the wave of digital globalization,has entered the fast lane in recent years and successfully transcended the personal computer Internet era to directly enter the mobile Internet era.During the COVID pandemic,digital economy served as a new engine in pandemic response and recovery.

"China and Africa Can Create Amazing Value"——Interview with Mehdi Laraki,President of the Morocco Chinese Business Council

"hina and Africa can create amazing value,because Africa or Morocco and China have a lot of common points,and the 2024Summit of the Forum on China-Africa Cooperation (FOCAC) can make the relationship between Africa or Morocco and China even stronger."In an interview with China's Foreign Trade,Mehdi Laraki,President of the Morocco-China Business Council said,"I've been here (China)more than 65 times,but I always feel like a child every time,it's just like a miracle.

Epidemiological Profile of Men Who Have Sex with Men: First Data about Male Sex Workers in Central African Republic (CAR)

Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.

China-Africa Economic and Trade Cooperation is Full of Vitality

China is the largest developing country,and Africa is the continent with the highest concentration of developing countries.Similar historical experiences and common historical missions have long linked China and Africa so closely.From September 4 to 6,the 2024 Forum on China-Africa Cooperation(FOCAC)Summit will be held in Beijing.The theme this year is“Joining Hands to Promote Modernization and Build a High-Level China-Africa Community with a Shared Future”.Leaders of FOCAC’s African members will be invited to attend,and representatives from relevant African regional organizations and international organizations will participate in the related activities.

China-Africa University Cooperation: Its Practical Relevance, Conceptual Trend and Innovative Mode

Since the Forum on China-Africa Cooperation(FOCAC)was held in 2000,China and Africa have both advocated the expansion of cooperation in the field of education and human resources development,and China-Africa exchanges and cooperation on education have thus ushered in a historical process of fast development.

EV Market in the Middle East and Africa Requires New Business Approach

The Middle East and Africa(MEA) appears to be a future crucial destination for China's carmakers as more than 10 Chinese EV brands have entered the market there.Changing geopolitics is not the only reason for this decision,nor is the potential profit,although the latter is a consideration for many Chinese investors.More broadly,the ongoing revolution in the automotive industry is leading to a global restructuring of markets and a consequent change in the game.Preemptive efforts to enhance strategic advantages are now a must for all stakeholders.In this context,the Middle East and Africa are a natural alternative for participants to maintain their resilience,given Africa's huge market,abundant raw materials for electric vehicles,and comfortable position in global power struggles.