Healthy Aging: Comparative Analysis of Local Perception and Diet in Two Health Districts of Côte d'Ivoire and Japan.

Context: Good health and longevity depend on dynamic interactions between biological, social, psychological, and environmental factors. Aging is globally a big challenge, particularly with the demographic transition, including population growth, and an emerging burden to society. Knowledge, behavior, diet, and consumption of animal source food were related to aging and emerged as the key factors modulating healthy aging. Objective: The study was designed to understand the main healthy aging factors, such as knowledge, social network, and diet of elders, and to derive mutual learning from it for healthy aging. Methods: A qualitative approach has been applied to explore health-related knowledge, attitude, and diet of elders from Ebetsu (Japan) and Tiassalé (Côte d'Ivoire) health districts, using focus group discussions and comparative context analysis between high- and low-income countries. Results: The study shows that living longer is a common feature of people in Japan compared to Côte d'Ivoire, where the life expectancy is still low. Both groups of elders have social networks that support them, and both offer their gained experience to society. While Japanese elders depend on pension and insurance for income and medical treatments, Ivorians depend mostly on their children and social network in old age. The worries of elders differ between the two regions. In Ebetsu, elder members of the community are concerned about the future burden they pose for the younger generation if they develop ill-health, making them more resilient to aging. In Taabo, elders are considered to be culturally and socially useful to the society. Elders in Ebetsu pointed out that for healthy aging, education on diet at a younger age, physical activities, and access to basic social services are the key aspects. This was not observed in Taabo's context. Being inactive and dependent on others were described as the most worrying situations for elders in Ebetsu, as it is perceived to increase the risk of non-communicable diseases and anxiety. Elders in Ebetsu have good knowledge on what constitutes a healthy diet, and they believe that diversifying their diet, reducing portions, and substituting red meat with good animal and vegetable proteins are best eating practices to maintain good health. In Côte d'Ivoire, the diet is imbalanced and the whole family consumes the same meal made mainly with high-energy staples and little protein. However, it is observed in both societies that adopting a good diet is very expensive. Conclusion: The consciousness of aging is universal, but healthy aging varies according to the social systems, education, and knowledge on diet transition. Physical activities, protein-energy balance in diet, and social networks are the key for healthy aging in both contexts. The challenge is to find ways to increase knowledge regarding healthy aging and to strengthen the support system so that healthy aging becomes affordable.

Circulating Brucella species in wild animals of the Serengeti ecosystem, Tanzania.

BACKGROUND: Brucellosis is a bacterial zoonosis of public health and economic importance worldwide. It affects a number of domestic animals, wild animals and humans. Human brucellosis originates from either livestock or wildlife. The species of Brucella circulating in wild animals in Tanzania is largely unknown due to insufficient surveillance. This study was carried out to identify Brucella species found in selected wildlife hosts in the Serengeti ecosystem. METHODOLOGY: The study used a total of 189 archived samples that were obtained from cross-sectional studies previously conducted between 2000 and 2017 in the Serengeti ecosystem in Tanzania. Whole blood, serum and amniotic fluid collected from buffalos, lions, wildebeest, impala, zebra and hyena were available for DNA extraction. Multiplex polymerase chain reaction for B. abortus, B. melitensis, B. ovis and B. suis (AMOS PCR) and quantitative real-time PCR (qPCR) targeting the bcsp31 and IS711 genes for Brucella genus detection and the IS711 targets alkB for B. abortus and BMEI1162 for B. melitensis were used to detect Brucella strains. RESULTS: Out of the 189 samples tested, 12 (6.35 %) and 22 (11.6 %) were positive to AMOS-PCR and qPCR, respectively. Most of the positive samples were from lions (52.6 %) and buffaloes (19.6 %). Other animals that were positive included: wildebeest (13.6 %), impala (13.6 %), zebra (4.5 %) and hyena (4.5 %). Out of 22 positive samples, 16 (66.7 %) were identified as B. abortus and the other six samples did not amplify for neither B. abortus nor B. melitensis. CONCLUSIONS: The detection of Brucella DNA in archived wild animal samples shows testing potential of samples collected from this population. The zoonotic species B. abortus and B. melitensis detected in wild animals have previously been reported in livestock and humans in the region. The findings suggest that, due to the contact network, some of the identified wild animal hosts in this study could be reservoirs for infections in domestic animals and humans within the Serengeti ecosystem while others are likely dead-end hosts. One Health control strategies and continuous surveillance programs in other wildlife reserved areas should be implemented to help predicting transmission in livestock and humans in the region.

Human and animal health surveys among pastoralists.

Valid human and livestock health surveys, including longitudinal follow-up, are feasible among mobile pastoralists and provide fundamental information to agencies for interventions that are responsive to realities and effective in addressing the needs of pastoralists. However, pastoralists are often excluded from studies, surveillance systems and health programmes. The occurrence of preventable and treatable diseases such as perinatal tetanus, measles and tuberculosis are indicative of limited access to health providers and information. It is difficult for health services to include effective outreach with their available financial and human resources. One consequence is that maternal mortality rates among pastoralists are unacceptably high. Environmental determinants such as the quality of water and the pasture ecosystems further influence the morbidity of pastoralists. In the Sahel, the nutritional status of pastoralist children is seasonally better than that of settled children; but pastoralist women tend to have higher acute malnutrition rates. Pastoralist women are more vulnerable than men to exclusion from health services for different context-specific reasons. Evidence-based control measures can be assessed in cluster surveys with simultaneous assessments of health among people and livestock, where data on costs of disease and interventions are also collected. These provide important arguments for governmental and non-governmental agencies for intervention development. New, integrated One Health surveillance systems making use of mobile technology and taking into account local concepts and the experiences and priorities of pastoralist communities, combined with sound field data, are essential to develop and provide adapted human and animal health services that are inclusive for mobile pastoralist communities and allow them to maintain their mobile way of life.

Il est possible de réaliser auprès des populations de pasteurs nomades des enquêtes sérieuses sur la santé des personnes et des troupeaux assorties d'études de suivi longitudinales, et de fournir ainsi aux organisations pertinentes des informations fondamentales pour la conception d'interventions adaptées à la situation réelle des pasteurs et répondant à leurs besoins. Or, les populations pastorales sont fréquemment exclues des études, des systèmes de surveillance et des programmes sanitaires. L'incidence de maladies évitables et traitables, par exemple le tétanos néonatal, la rougeole et la tuberculose dénote un accès limité à l'information et aux prestations de santé. Avec les ressources financières et humaines dont ils disposent, les services de santé ne parviennent pas à assurer une couverture efficace de ces populations. L'une des conséquences de cet état de fait est le taux de mortalité maternelle intolérablement élevé enregistré dans les communautés pastorales. Certains déterminants environnementaux comme la qualité de l'eau et les écosystèmes des prairies affectent également l'état de santé des pasteurs. Au Sahel, les enfants des communautés pastorales ont un meilleur statut nutritionnel saisonnier que les enfants sédentaires ; en revanche, chez les femmes de ces communautés la malnutrition aiguë est plus fréquente. En outre, les femmes sont plus en risque que les hommes d'être exclues des services de santé, pour différentes raisons déterminées par le contexte. Des évaluations factuelles des mesures de prophylaxie peuvent être réalisées au moyen d'enquêtes agrégatives comprenant l'évaluation simultanée de l'état sanitaire des personnes et des troupeaux, ce qui permet également de réunir des informations sur les coûts des maladies et des interventions sanitaires. Ces informations sont importantes pour étayer l'argumentaire des organisations tant gouvernementales que non gouvernementales en faveur d'un renforcement des interventions. Il est essentiel de faire appel aux nouveaux systèmes de surveillance intégrés « Une seule santé ¼, en utilisant les technologies mobiles, en prenant en compte les concepts locaux ainsi que l'expérience et les priorités des communautés pastorales et en les complétant par des informations solides recueillies sur le terrain, afin de concevoir et d'assurer des prestations de santé humaine et animale adaptées et inclusives, destinées aux communautés pastorales nomades et leur permettant de conserver leur mode de vie nomade.

La realización de estudios válidos de salud humana y animal, con seguimiento longitudinal de cohortes, no solo es un procedimiento factible entre los pastores nómadas, sino que además proporciona información básica a los organismos encargados de realizar intervenciones que se ajusten a la realidad sobre el terreno y respondan eficazmente a las necesidades de las sociedades pastorales. Estas, sin embargo, quedan con frecuencia excluidas de estudios, sistemas de vigilancia y programas sanitarios. La aparición de enfermedades que se pueden prevenir y tratar, como el tétanos perinatal, el sarampión o la tuberculosis, es indicativa de un acceso deficiente a los proveedores de asistencia sanitaria y a la información sobre cuestiones de salud. Con los recursos humanos y económicos de que disponen, a los servicios de salud les resulta difícil instaurar mecanismos para llegar eficazmente a esas poblaciones, lo que, entre otras consecuencias, se traduce en tasas de mortalidad materna inaceptablemente altas en las sociedades pastorales. En la morbilidad de esas poblaciones también influyen determinantes ambientales como la calidad del agua o los ecosistemas de pradera. En el Sahel, el estado de nutrición de los niños de las comunidades de pastores es mejor, según las estaciones, que el de los niños sedentarizados. Las mujeres de las sociedades pastorales, sin embargo, tienden a presentar índices más elevados de malnutrición aguda, y por diferentes razones ligadas al contexto, están más expuestas que los hombres a verse privadas de servicios de salud. Las medidas de control basadas en datos empíricos pueden ser evaluadas mediante estudios por conglomerados con valoración simultánea del estado de salud de las personas y el ganado, en los que también se obtienen datos sobre el costo de las enfermedades y las intervenciones sanitarias, datos que ofrecen a los organismos oficiales o no gubernamentales poderosos argumentos a la hora de definir intervenciones. Para concebir y dispensar servicios adaptados de salud humana y animal, que sin dejar de lado a las comunidades de pastores nómadas a la vez les permitan mantener su modo de vida itinerante, es esencial poner en solfa nuevos sistemas integrados de vigilancia, que se ajusten a los principios de «Una sola salud¼, aprovechen las tecnologías móviles y tengan en cuenta los conceptos y experiencias locales y las prioridades de las comunidades de pastores, combinándolos con la obtención de datos sólidos sobre el terreno.

Institutional development: from legal pluralism to institutional bricolage in West African pastoralism.

Pastoralists in Africa are increasingly vulnerable to the effects of globalisation, climate change and changes in land use. They are confronted with problems related to access to scarce natural resources and their regulation, the management of mobility, and too little investment in health systems, livestock production and social service delivery. However, this paper focuses on positive trends and vital innovations in pastoral societies. These rely on robust institutions and policy frameworks that contribute to economically secure, politically stable, and environmentally sustainable livelihoods for African pastoral societies. The authors analyse ways in which internal and external efforts can improve the economic viability and social aspects of pastoralism. The institutions that manage natural resources and their effects on livelihoods and access to social services must be critically reviewed. The authors suggest that a new model for the economic and social development of African pastoralism should be positioned between donor- or governmentdriven development (in other words, 'seeing like a state') and the autonomous development goals of pastoralists ('seeing like a pastoralist'). Pastoralists are resourceful, entrepreneurial and innovative people, fully able to support new institutional systems and services which recognise their way of life and production systems. It seems evident that African pastoralism will maintain its vitality and creativity through a process of 'bricolage', with institutional and policy innovations based on a constant renegotiation of norms, the reinvention or transformation of tradition, the importance of legitimate authority and the role of the people themselves in shaping such arrangements.

Les pasteurs africains sont en situation de vulnérabilité accrue face aux effets de la mondialisation, du changement climatique et de la transformation de l'utilisation des terres. Ils sont confrontés à des problèmes liés à l'accès et à la réglementation des ressources naturelles qui se raréfient sans cesse, à la gestion de la mobilité et au manque d'investissements dédiés aux systèmes de santé, à la production animale et à la fourniture de services sociaux. Néanmoins, dans cet article l'accent est mis sur les tendances positives et sur les innovations vitales actuellement à l'oeuvre dans les sociétés pastorales. Celles-ci reposent sur des institutions robustes et des cadres d'élaboration de politiques qui contribuent à garantir aux sociétés pastorales africaines une source de revenus économiquement intéressants, politiquement stables, et durables au plan écologique. Les auteurs analysent les possibilités d'améliorer au moyen d'initiatives internes et extérieures la viabilité économique et les aspects sociaux du pastoralisme. Il est indispensable de procéder à une évaluation critique des institutions chargées de la gestion des ressources naturelles et d'analyser leurs effets sur les moyens d'existence des pasteurs et sur leur accès aux services sociaux. Les auteurs considèrent qu'un nouveau modèle de développement économique et social du pastoralisme africain devrait trouver sa place entre le développement impulsé par les donateurs ou par les gouvernements (autrement dit, le point de vue étatique) et les objectifs autonomes de développement des pasteurs eux-mêmes (le point de vue du pasteur). Les pasteurs sont des individus pleins de ressources et animés par l'esprit d'entreprise et d'innovation, ce qui les rend parfaitement capables de soutenir de nouveaux systèmes et services institutionnels dès lors que ceux-ci prennent en compte leur mode de vie et leurs systèmes de production. Il semble clair que le pastoralisme africain préservera sa vitalité et sa créativité tout au long d'un processus de bricolage, ce qui se traduira par des innovations institutionnelles et politiques fondées sur une renégociation permanente des normes, sur la réinvention ou la transformation des traditions, sur l'impératif de légitimer l'autorité et sur la participation des populations à la conception des dispositifs mis en place.

Las sociedades pastorales africanas son cada vez más vulnerables a los efectos de la mundialización, el cambio climático y la transformación de los usos del suelo. Afrontan problemas relacionados con el acceso a recursos naturales escasos y su regulación, con la gestión de la movilidad y con la insuficiencia de las inversiones en sistemas de salud, producción ganadera y prestación de servicios sociales. Los autores, sin embargo, se centran en las tendencias positivas y las innovaciones esenciales que tienen lugar en las sociedades pastorales, fruto de instituciones robustas y de conjuntos de políticas que favorecen medios de sustento económicamente seguros, políticamente estables y ambientalmente sostenibles en las sociedades pastorales africanas. Los autores se detienen a analizar el modo en que las iniciativas internas y externas pueden mejorar tanto la viabilidad económica como una serie de aspectos sociales del pastoreo. Es preciso someter a un examen crítico las instituciones que gestionan los recursos naturales, así como los efectos de esa gestión en los medios de sustento y el acceso a los servicios sociales. Los autores abogan por un nuevo modelo de desarrollo económico y social del pastoreo africano que convendría posicionar a medio camino entre el desarrollo impulsado por donantes o administraciones públicas (o dicho de otro modo, visto «desde la óptica del estado¼) y los objetivos de desarrollo fijados por las propias sociedades de pastores (esto es, «desde la óptica del pastoreo¼). Las sociedades pastorales están formadas por gente ingeniosa, emprendedora e innovadora, perfectamente capaz de secundar nuevos servicios y sistemas institucionales que tengan en cuenta sus modos de vida y sistemas de producción. Parece evidente que el mantenimiento de la vitalidad y creatividad del pastoreo africano habrá de pasar por un proceso de «bricolaje¼ que traiga consigo innovaciones institucionales y políticas basadas en la renegociación constante de las normas, la reinvención o transformación de la tradición, la importancia de la autoridad legítima y la intervención de la propia población en el proceso de configurar toda esta nueva organización.

Institutional development and policy frameworks for pastoralism: from local to regional perspectives.

Pastoralists are among the most politically and economically marginalised communities in the world. They have less and less access to the natural resources on which their livelihoods depend and very limited access to basic socio-economic services and infrastructure. This paper builds on a number of studies carried out in the Sahel, the Horn of Africa, Central Asia and the Swiss Alps to address the institutional dynamics required for sustainable pastoralism. Specifically, the authors question the way in which institutions and policies are currently shaped and suggest that reforming these could contribute to new avenues for pastoralism. Among the main drivers of pastoralist marginalisation are poor public and private institutional arrangements. The consequences are violent conflict and increased mobility and relocation. Responses to the current weaknesses of pastoralism must encompass inclusive, comprehensive institutions which allow access to resources, economic viability and integration in the new socio-ecological space. The authors argue that those involved in pastoral development in national as well as international arenas, including pastoralist groups, states and agencies, are creatively engaged in a process of innovation for pastoralism, and this will contribute towards new forms of governance and improved institutional and policy frameworks.

Les communautés pastorales comptent parmi les plus marginalisées au plan politique et économique. Les pasteurs peuvent de moins en moins accéder aux ressources naturelles dont ils tirent leur subsistance ; leur accès aux services et aux infrastructures socio-économiques de base est également très limité. À partir d'une série d'études conduites au Sahel, dans la Corne de l'Afrique, en Asie centrale et dans les Alpes suisses, les auteurs cherchent à déterminer la dynamique institutionnelle nécessaire à la pérennisation du pastoralisme. En particulier, ils remettent en cause la manière dont les institutions et les politiques sont conçues à l'heure actuelle, estimant que leur réforme permettrait d'ouvrir de nouvelles perspectives pour le pastoralisme. La médiocrité des dispositifs institutionnels tant publics que privés compte parmi les principaux facteurs de la marginalisation des pasteurs. Celle-ci entraîne des conflits violents et une mobilité et relocalisation accrues. Les réponses aux faiblesses actuelles du pastoralisme passent nécessairement par des institutions à l'action inclusive et exhaustive, garantissant l'accés aux ressources, la viabilité économique et l'intégration dans le nouvel espace socio-écologique. Les auteurs estiment que les acteurs du développement du pastoralisme sur la scène nationale autant qu'internationale, y compris les groupes de pasteurs, les états et les agences de développement sont engagés de manière créative dans un processus d'innovation en faveur du pastoralisme, ce qui contribuera à créer de nouvelles formes de gouvernance et de meilleurs cadres institutionnels et d'élaboration des politiques.

Las comunidades que viven del pastoreo están entre las más marginadas tanto política como económicamente. Cada vez les resulta más difícil acceder a los recursos naturales de los que dependen para vivir y disponen de un acceso muy deficiente a la infraestructura y los servicios socioeconómicos básicos. Los autores, partiendo de una serie de estudios realizados en el Sahel, el Cuerno de África, Asia Central y los Alpes suizos, examinan la dinámica institucional necesaria para que el pastoreo llegue a ser sostenible. En concreto, tras cuestionar los procedimientos por los que actualmente se forjan instituciones y se formulan políticas, sugieren que la reforma de estos mecanismos podría ser útil para abrir nuevos horizontes al pastoreo. Entre los principales factores que determinan la marginación de las sociedades pastorales figuran las carencias de los dispositivos institucionales públicos y privados, lo que tiene por consecuencia conflictos violentos y un mayor grado de movilidad y relocalizaciones. Toda respuesta a la actual situación de fragilidad del pastoreo debe acompañarse de instituciones integradoras y completas, que hagan posible el acceso a los recursos, la viabilidad económica y la integración en el nuevo espacio socioecológico. Los autores postulan que todas aquellas instancias que intervienen en las cuestiones de desarrollo pastoral en foros tanto nacionales como internacionales, en particular los propios grupos de pastores, amén de los Estados y organismos, son componentes creativos de un proceso de innovación al servicio del pastoreo, proceso que ayudará a alumbrar nuevas formas de gobernanza, así como regímenes institucionales y parámetros normativos más eficaces.

Phytotherapy against buruli ulcer in the Health District of Yamoussoukro (Cote d'Ivoire) : Identification, description, and symbolic functions of the plants and recipes used.

This study aims to describe the plants and recipes proposed by traditional healers against Buruli ulcer in Côte d'Ivoire and to analyze their symbolic aspects. Buruli ulcer is an increasingly serious health problem in Côte d'Ivoire. The ivorian state through the National Buruli Ulcer Control Programme and its partners, has developed various actions to fight that disease. Medical and surgical treatments are offered free of charge to patients. Hundreds of health centers in different health districts have been converted into Buruli ulcer management centers. Despite these actions, traditional treatment continues to dominate the treatment journey. In rural areas, traditional healers provide management for Buruli ulcer. This qualitative and descriptive study studied 4 traditional healers and 37 patients at the Kongouanou care center. The traditional healers offer patients products that are disinfectants and ointments prepared from leaves, bark, roots, and fruits of different plants. The modes of treatment are supported by both dietary restrictions and a set of symbolic elements. Several reasons explain the predominance of traditional medicine in patients' treatment routes, although none of the patients interviewed was cured. It is, however, appropriate to establish collaboration with traditional healers to promote early detection and immediate recourse to specialized treatment centers.

[Indentification of institutional factors affecting the well-being of sedentary and nomadic populations living in the Waza-Logone flood plain along the border between Cameroon and Chad]. / A la recherche des déterminants institutionnels du bien-être des populations sédentaires et nomades dans la plaine du Waza-Logone de la frontière camerounaise et tchadienne.

This article describes an ongoing research project designed to compile a database to promote pastoral development in the lowlands along the Logone and Chari Rivers in Cameroon. A number of sedentary and nomadic populations depend on these flood plains south of Lake Chad for their livelihood. However the natural resources of the area undergo sharp seasonal variations and sometimes become the property of sedentary groups. As a result nomadic communities experience difficulty not only in gaining access to grazing lands and water but also to quality health care (hospital centers, effective medication). The purpose of this study was to define institutional requirements necessary to ensure access to health care resources for both nomadic and sedentary groups. The main problem for the nomadic population is that, unlike the now defunct pre-colonial structures, today's institutions are not compatible with the subsistence strategies of rural populations. These findings suggest that new institutional frameworks for natural resource management could indirectly improve the health status of nomadic pastoralist.

A la recherche des determinants institutionnels du bien-etre des populations sedentaires et nomades dans la plaine du Waza-Logone de la frontiere camerounaise et tchadienne

This article describes an ongoing research project designed to compile a database to promote pastoral development in the lowlands along the Logone and Chari Rivers in Cameroon. A number of sedentary and nomadic populations depend on these flood plains south of Lake Chad for their livelihood. However the natural resources of the area undergo sharp seasonal variations and sometimes become the property of sedentary groups. As a result nomadic communities experience difficulty not only in gaining access to grazing lands and water but also to quality health care (hospital centers; effective medication). The purpose of this study was to define institutional requirements necessary to ensure access to health care resources for both nomadic and sedentary groups. The main problem for the nomadic population is that; unlike the now defunct precolonial structures; today's institutions are not compatible with the subsistence strategies of rural populations. These findingss u ggest that new institutional framewo rks for nat u ral resource management could indirectly improve the health status of nomadic pastoralist