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An award-winning genetic researcher and a tenacious journalist examine each phase of the Ebola epidemic in West Africa, the largest and deadliest of its kind. Their postmortem identifies factors that kept key information from reaching doctors, complicated the government's response to the crisis, and left responders unprepared for the next outbreak.-- Provided by publisher

In the 1980s, a research team led by Parisian scientists identified several unique DNA sequences, or haplotypes, linked to sickle cell anemia in African populations. After casual observations of how patients managed this painful blood disorder, the researchers in question postulated that the Senegalese type was less severe. The Enculturated Gene traces how this genetic discourse has blotted from view the roles that Senegalese patients and doctors have played in making sickle cell \"mild\" in a social setting where public health priorities and economic austerity programs have forced people to improvise informal strategies of care.

Antiblackness and Global Health offers a major new account of the 2014-2016 West African Ebola crisis and a radical perspective on the racial politics of global health. Lioba Hirsch traces the legacies of colonialism across the landscape of global health in Sierra Leone, showing how this history underpinned the international response to Ebola. The book moves from the material and atmospheric traces of colonialism and enslavement in Freetown, to the forms of knowledge presented in colonial archives and in contemporary expert accounts, to disease control and care practices. As the Covid-19 pandemic has revealed, health inequalities around the world disproportionately affect people of African descent. This book aims to equip critical scholars, medical and humanitarian practitioners, policy makers and health activists with the tools and knowledge to challenge antiblackness in global health practice and politics. The book argues that Black Studies can inform future research on medical interventions in Africa by unpacking postcolonial silences, centring Black perspectives and highlighting the endurance of colonial infrastructures in the present.

It is no exaggeration to say that theHankey, a small British ship that circled the Atlantic in 1792 and 1793, transformed the history of the Atlantic world. This extraordinary book uncovers the long-forgotten story of theHankey, from its altruistic beginnings to its disastrous end, and describes the ship's fateful impact upon people from West Africa to Philadelphia, Haiti to London. Billy G. Smith chased the story of theHankeyfrom archive to archive across several continents, and he now brings back to light a saga that continues to haunt the modern world. It began with a group of high-minded British colonists who planned to establish a colony free of slavery in West Africa. With the colony failing, the ship set sail for the Caribbean and then North America, carrying, as it turned out, mosquitoes infected with yellow fever. The resulting pandemic as theHankeytraveled from one port to the next was catastrophic. In the United States, tens of thousands died in Philadelphia, New York, Boston, and Charleston. The few survivors on theHankeyeventually limped back to London, hopes dashed and numbers decimated. Smith links the voyage and its deadly cargo to some of the most significant events of the era-the success of the Haitian slave revolution, Napoleon's decision to sell the Louisiana Territory, a change in the geopolitical situation of the new United States-and spins a riveting tale of unintended consequences and the legacy of slavery that will not die.

Strengthening Post-Ebola Health Systems addresses the challenge of enabling the development of viable, resilient, and fiscally sustainable health system in Guinea, Liberia, and Sierra Leone. Initiated while Ebola was still raging in all of the three most-affected countries in West Africa, it identifies the requirements for strengthening the health systems in these countries to go beyond just getting the number of Ebola cases to zero. The overall goal of this study is thus twofold: To assess the capacity of the health systems of the three most-affected countries in terms of their ability to deliver quality health services to their populations, perform core public health functions on a routine basis, and to respond to public health emergencies; and To identify the highest impact strategies to help these countries to strengthen their health systems to be more effective and resilient, drilling down into three key aspects of the health system--that is, fiscal space for universal health coverage (UHC), development and deployment of an effective health workforce, and continuous disease surveillance.

Background Hypertension remains a critical modifiable risk factor contributing to the global burden of cardiovascular disease. Despite its escalating prevalence in West Africa, comprehensive regional data on its epidemiological patterns and associated determinants remain sparse. This study addresses this gap through a systematic review and meta-analysis, synthesizing existing evidence on hypertension prevalence and its risk factors across West African populations. Methods A comprehensive search was conducted across multiple databases, including PubMed/MEDLINE, Web of Science, Scopus, Embase, CINAHL, and other sources to identify observational studies reporting hypertension prevalence or associated risk factors in adults aged ≥ 18 years in West Africa. Studies were included if they employed standardized diagnostic criteria (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or current antihypertensive medication use). Pooled prevalence estimates and odds ratios (ORs) for key risk factors were derived using random-effects meta-analysis. Heterogeneity was rigorously evaluated through prediction interval (PI), I² statistics, Q-tests, tau-squared, tau, and meta-regression analyses. Results The analysis included 30 studies comprising 70,212 participants from 10 West African nations. The pooled prevalence of hypertension was estimated at 33.8% (95% CI: 29.3, 38.7%), with substantial heterogeneity (I² = 99.4%; PI = 13 to 63%). Several factors were significantly associated with hypertension risk: overweight status (OR = 1.61; 95% CI: 1.40–1.85; I² = 88.4%; PI: 0.93–2.78), obesity (OR = 2.26; 95% CI: 2.02–2.53; I² = 75.2%; PI: 1.50–3.41), alcohol use (OR = 1.23; 95% CI: 1.05–1.44; I² = 79%; PI: 0.67–2.25), type 2 diabetes mellitus (OR = 1.98; 95% CI: 1.52–2.59; I² = 82.2%; PI: 0.81–4.84), reduced physical activity (OR = 1.46; 95% CI: 1.09–1.94; I² = 78.1%; PI: 0.57–3.70), and a family history of hypertension (OR = 1.74; 95% CI: 1.31–2.32; I² = 52.6%; PI: 0.59–5.18). Smoking showed a marginal association (OR = 1.03; 95% CI: 0.80–1.32; I² = 80.9%; PI: 0.42–2.51). Age demonstrated a strong positive association (β = 0.0537, p  < 0.001), explaining 67% of the variance in the meta-regression model. Heterogeneity remained high across all risk factor analyses (I² range: 52.6–88.4%), underscoring variability in regional epidemiological patterns. Conclusion Combating West Africa’s high hypertension burden requires integrated strategies focusing on lifestyle modification, early detection, and strengthened primary healthcare systems.

Background Headache is a public health problem in Africa and is a significant cause of neurological consultations, imposing a heavy burden. Data on its actual economic burden are scarce in Africa. This study aims to evaluate the direct cost of headache management in 2023 and to identify factors associated with the high direct cost of headache management. Methods This cohort study with descriptive and analytical aims was conducted from June 15 to October 15, 2023, in the neurology unit of the teaching hospital of Borgou in Parakou, on 91 subjects with headaches, including migraine, tension type headache, trigeminal neuralgia, cluster headache, paroxysmal hemicrania and secondary headache. Any patient who had experienced headaches in the past 12 months, who was aged at least 18 years and who provided informed consent was included. The direct cost of headache management was defined as the sum of costs by consumption level category (consultation, diagnostic tests, treatments, transport, hospitalization costs, other nonmedical costs) and the monetary value of the main companion. This cost was expressed in Benin’s local currency (West African francs XOF), with a corresponding amount in euros. The direct cost of headache care was considered high when the mean monthly direct cost was more than 10% of the guaranteed minimum wage in Benin. Consumption level data were collected through an individual interview, supplemented by a review of medical records, notebooks, and receipts for headache management. Data entry was carried out via the KoboCollect application. Data analysis was performed using EpiInfo 7.2 software. Results A total of 91 participants were included, with 51 women (56.04%). The mean age was 38.91 ± 14.52 years. The monthly direct cost estimated one month after inclusion was high, calculated at XOF1,599,400 (€2,438.26), with an average of XOF17,575.82 ± 10,290.68 (€26.79 ± 15.69), representing 33.80% of the minimum wage in Benin. The global annual direct cost of headaches was XOF15,537,875 (€23,687.23) with a higher cost for tension type headaches at XOF6,077,530 (€9,265.09), whereas that of migraine was calculated at XOF4,603,970 (€7,018.67). The factors associated with high costs of headache management were a history of anxiety ( p  = 0.02), the presence of comorbidities ( p  = 0.005), the frequency of attacks ( p  = 0.048), and consumption related to psychiatric consultation ( p  = 0.02). Conclusion The direct cost of managing headaches is high, with multiple associated factors. Strategies aimed at reducing this cost are urgently needed to optimize management and influence national public health policy for headache patients in Benin.

In West Africa, Schistosoma spp. are capable of infecting multiple definitive hosts, a lifecycle feature that may complicate schistosomiasis control. We characterized the evolutionary relationships among multiple Schistosoma mansoni isolates collected from snails (intermediate hosts), humans (definitive hosts), and rodents (definitive hosts) in Senegal. On a local scale, diagnosis of S. mansoni infection ranged 3.8%-44.8% in school-aged children, 1.7%-52.6% in Mastomys huberti mice, and 1.8%-7.1% in Biomphalaria pfeifferi snails. Our phylogenetic framework confirmed the presence of multiple S. mansoni lineages that could infect both humans and rodents; divergence times of these lineages varied (0.13-0.02 million years ago). We propose that extensive movement of persons across West Africa might have contributed to the establishment of these various multihost S. mansoni clades. High S. mansoni prevalence in rodents at transmission sites frequented by humans further highlights the implications that alternative hosts could have on future public health interventions.

Climate change is a major source of concern in the Middle East and North Africa (MENA) region, and migration is often understood as one of several strategies used by households to respond to changes in climate and environmental conditions, including extreme weather events. This study focuses on the link between climate change and migration. Most micro-level studies measure climate change either by the incidences of extreme weather events or by variation in temperature or rainfall. A few studies have found that formal and informal institutions as well as policies also affect migration. Institutions that make government more responsive to households (for example through public spending) discourage both international and domestic migration in the aftermath of extreme weather events. Migration is often an option of last resort after vulnerable rural populations attempting to cope with new and challenging circumstances have exhausted other options such as eating less, selling assets, or removing children from school. This study is based in large part on new data collected in 2011 in Algeria, Egypt, Morocco, Syria, and the Republic of Yemen. The surveys were administered by in-country partners to a randomly selected set of 800 households per country. It is also important to emphasize that neither the household survey results nor the findings from the qualitative focus groups are meant to be representative of the five countries in which the work was carried, since only a few areas were surveyed in each country. This report is organized as follows: section one gives synthesis. Section two discusses household perceptions about climate change and extreme weather events. Section three focuses on migration as a coping mechanisms and income diversification strategy. Section four examines other coping and adaptation strategies. Section five discusses perceptions about government and community programs.