Recent Budget of Hydroclimatology and Hydrosedimentology of the Congo River in Central Africa

Although the Congo Basin is still one of the least studied river basins in the world, this paper attempts to provide a multidisciplinary but non-exhaustive synthesis on the general hydrology of the Congo River by highlighting some points of interest and some particular results obtained over a century of surveys and scientific studies. The Congo River is especially marked by its hydrological regularity only interrupted by the wet decade of 1960, which is its major anomaly over nearly 120 years of daily observations. Its interannual flow is 40,500 m3 s−1. This great flow regularity should not hide important spatial variations. As an example, we can cite the Ubangi basin, which is the most northern and the most affected by a reduction in flow, which has been a cause for concern since 1970 and constitutes a serious hindrance for river navigation. With regard to material fluxes, nearly 88 × 106 tonnes of material are exported annually from the Congo Basin to the Atlantic Ocean, composed of 33.6 × 106 tonnes of TSS, 38.1 × 106 tonnes of TDS and 16.2 × 106 tonnes of DOC. In this ancient flat basin, the absence of mountains chains and the extent of its coverage by dense rainforest explains that chemical weathering (10.6 t km−2 year−1 of TDS) slightly predominates physical erosion (9.3 t km−2 year−1 of TSS), followed by organic production (4.5 t km−2 year−1 of DOC). As the interannual mean discharges are similar, it can be assumed that these interannual averages of material fluxes, calculated over the longest period (2006–2017) of monthly monitoring of its sedimentology and bio-physical-chemistry, are therefore representative of the flow record available since 1902 (with the exception of the wet decade of 1960). Spatial heterogeneity within the Congo Basin has made it possible to establish an original hydrological classification of right bank tributaries, which takes into account vegetation cover and lithology to explain their hydrological regimes. Those of the Batéké plateau present a hydroclimatic paradox with hydrological regimes that are among the most stable on the planet, but also with some of the most pristine waters as a result of the intense drainage of an immense sandy-sandstone aquifer. This aquifer contributes to the regularity of the Congo River flows, as does the buffer role of the mysterious “Cuvette Centrale”. As the study of this last one sector can only be done indirectly, this paper presents its first hydrological regime calculated by inter-gauging station water balance. Without neglecting the indispensable in situ work, the contributions of remote sensing and numerical modelling should be increasingly used to try to circumvent the dramatic lack of field data that persists in this basin

Signatures of malaria-associated pathology revealed by high-resolution whole-blood transcriptomics in a rodent model of malaria.

The influence of parasite genetic factors on immune responses and development of severe pathology of malaria is largely unknown. In this study, we performed genome-wide transcriptomic profiling of mouse whole blood during blood-stage infections of two strains of the rodent malaria parasite Plasmodium chabaudi that differ in virulence. We identified several transcriptomic signatures associated with the virulent infection, including signatures for platelet aggregation, stronger and prolonged anemia and lung inflammation. The first two signatures were detected prior to pathology. The anemia signature indicated deregulation of host erythropoiesis, and the lung inflammation signature was linked to increased neutrophil infiltration, more cell death and greater parasite sequestration in the lungs. This comparative whole-blood transcriptomics profiling of virulent and avirulent malaria shows the validity of this approach to inform severity of the infection and provide insight into pathogenic mechanisms

A survey of risk factors associated with hypertension in the adult population of Kang, Kgalagadi North, Botswana

Background: Sustainable and aggressive population-based programmes on hypertension awareness, prevention, treatment and control are key to the successful control of this epidemic. The objective of the study was to determine to what extent hypertension and risk factors for its development were prevalent in the Kang village community in Botswana, and specifically to assess its prevalence in the adult population and its relationship with high blood pressure, anthropometric measures and lifestyle factors, i.e. diet and the use of tobacco products and alcohol.Method: A population-based cross-sectional study was conducted on 161 adult residents of Kang aged 18 years and older from November to December 2008. A questionnaire adapted from the World Health Organization stepwise approach to the surveillance of chronic disease was used for the data collection. Results: The prevalence of hypertension in the adult population of Kang was found to be 32% (95% confidence interval: 25-40). There was no significant sex difference in the prevalence rate in men (28%) versus women (34%), (p  = 0.59). Hypertension was more prevalent in the overweight group than in the normal-weight group (p  = 0.3), in the obese group than in the normal-weight group (p  = 0.002), and in the obese group than in the overweight group (p  = 0.04). Conclusion: This study showed that hypertension affected almost a third of the adult population of Kang, and was significantly associated with overweight and obesity

Knowledge, attitudes and practice of healthcare providers regarding contraceptive use in adolescence in Mahalapye, Botswana

Introduction: Adolescent pregnancy is a global public health problem, for which healthcare providers (HCPs) play a critical role to prevent unintended pregnancy. This study investigated the knowledge, attitude and practice (KAP) of HCPs towards the use of contraceptives in adolescents.Results: Of the 101 eligible for the study, 79.2% HCPs from the selected clinics and hospital responded. The majority (91.2%) of respondents felt confident to explain to adolescents how to use old contraceptive methods such as oral contraceptives or IUCD, less than half of the respondents (41.3%) were confident to explain how to use new contraceptive methods such as transdermal contraceptive patches or vaginal rings. Medical doctors felt more confident to prescribe new contraceptive methods compared with nurses, both vaginal rings (p-value = 0.0006) and transdermal contraceptive patches (p-value = 0.0003). More than two-thirds of the respondents disagreed that beliefs influenced their ability to offer contraceptive services to adolescents, half of the respondents strongly disagreed that it was morally wrong for adolescents to use contraceptives. Although three-quarters of respondents strongly agreed (median = 5, [IQR 5–6]) that they were comfortable with prescribing contraceptives to adolescents, only 23% of the respondents very much prescribed or always prescribed contraceptives to adolescents.Conclusion: Most of the HCPs prescribed contraceptives irregularly, and had limited knowledge about newer methods. To change HCPs’ KAP, in addition to continuing medical education (CME), the establishment of family planning clinics for adolescents and more undergraduate contraceptive teaching for medical and nursing students could result in the increased utilisation of contraceptive services by adolescents.</jats:p

Knowledge, attitudes and practice of healthcare providers regarding contraceptive use in adolescence in Mahalapye, Botswana

Introduction: Adolescent pregnancy is a global public health problem, for which healthcare providers (HCPs) play a critical role to prevent unintended pregnancy. This study investigated the knowledge, attitude and practice (KAP) of HCPs towards the use of contraceptives in adolescents.Results: Of the 101 eligible for the study, 79.2% HCPs from the selected clinics and hospital responded. The majority (91.2%) of respondents felt confident to explain to adolescents how to use old contraceptive methods such as oral contraceptives or IUCD, less than half of the respondents (41.3%) were confident to explain how to use new contraceptive methods such as transdermal contraceptive patches or vaginal rings. Medical doctors felt more confident to prescribe new contraceptive methods compared with nurses, both vaginal rings (p-value = 0.0006) and transdermal contraceptive patches (p-value = 0.0003). More than two-thirds of the respondents disagreed that beliefs influenced their ability to offer contraceptive services to adolescents, half of the respondents strongly disagreed that it was morally wrong for adolescents to use contraceptives. Although three-quarters of respondents strongly agreed (median = 5, [IQR 5–6]) that they were comfortable with prescribing contraceptives to adolescents, only 23% of the respondents very much prescribed or always prescribed contraceptives to adolescents.Conclusion: Most of the HCPs prescribed contraceptives irregularly, and had limited knowledge about newer methods. To change HCPs’ KAP, in addition to continuing medical education (CME), the establishment of family planning clinics for adolescents and more undergraduate contraceptive teaching for medical and nursing students could result in the increased utilisation of contraceptive services by adolescents

Knowledge, attitudes, and practices of clerkship supervisors regarding the biopsychosocial approach at the University of Botswana’s Faculty of Medicine

Abstract Background The biopsychosocial and spiritual model (BPSM), commonly referred to as body-mind unity, complements the biological model by expanding health professionals’ understanding through the integration of psychological and eco-social elements as influential factors in health and disease. Clerkships are a phase of medical education where students transition from theoretical learning to practical application under the supervision of experienced health practitioners. This study investigates the knowledge, attitudes, and practices (KAP) of clerkship supervisors at the University of Botswana’s Faculty of Medicine (UB-FOM) regarding the BPSM. Methods We conducted a quantitative cross-sectional survey, distributing online (via Microsoft 365 Forms) and self-administered paper-based questionnaires to clerkship supervisors. KAP information was gathered using a five-point Likert scale and an open-ended question section that asked respondents to elaborate on factors they perceived as limitations to applying the BPSM. Results Only 34.3% of approximately 140 clerkship supervisors invited to participate in the study responded. Forty-eight supervisors completed the questionnaire. Most participants (n = 38, 79.2%) reported receiving training on the BPSM during their undergraduate or postgraduate education. Most UB-FOM clerkship supervisors appreciated the importance of considering all four dimensions of health in healthcare activities (mean score = 4.14 > weighted mean score of 4.04). They felt less comfortable instructing medical students on the model during clinical rotations (mean score = 3.98 < weighted mean score of 4.04), and they expressed less agreement about the ability of psychosocial processes and treatments to alter medical illnesses. Additionally, they less recognised the importance of incorporating spiritual evaluation into medical practice (mean score = 3.82 < weighted mean score of 4.04). Obstacles to implementing the BPSM included time constraints during consultations, a negative attitude towards the BPSM, a lack of updated training, and an absence of defined guidelines for the BPSM. Conclusion While most UB-FOM clerkship supervisors who participated to the study acknowledged the importance of considering all four dimensions of health in healthcare activities, they felt less comfortable instructing medical students on the BPSM during clinical rotations and expressed less agreement about the efficacy of psychosocial processes in medical treatment. We recommend implementing research that specifically targets the beliefs and attitudes of clerkship supervisors