Cervical cytology and HPV distribution in Cape Verde: A snapshot of a country taken during its first HPV nation-wide vaccination campaign.

Cervical cancer ranks as the third most common female cancer in Cape Verde and is the leading cause of cancer-related deaths among women in the country. While Human Papillomavirus (HPV) vaccination, which started in 2021, is anticipated to significantly reduce disease incidence, cervical screening remains crucial for non-vaccinated women. We retrospectively reviewed gynecologic cytology exams and HPV tests performed in Cape Verde between 2017 and April 2023 and processed at IMP Diagnostics. For this study, we considered 13035 women with cytology examinations performed and, 2013 of these, also with an HPV molecular test. Cytology diagnostics comprised 83 % NILM cases; 12 % ASC-US; 2.7 % LSIL; 1.2 % ASC-H; 0.5 % HSIL and 0.1 % SCC. In 505 (25.1 %) high-risk HPV infection was detected. Prevalence of HPV infection varied with age, peaking at young ages - ≤24 years old (55.5 %) and 25-35-year-old women (31.5 %) - and the lowest after 66 years old (9.7 %). Herein we present a comprehensive study regarding Cape Verde's cervical cytology and HPV distribution, aiming to provide a snapshot of the country's cervical cytology results and HPV distribution in recent years. Moreover, these data may contribute to establish a baseline to assess, in the future, the vaccination impact in the country.

Insights into the Geographical Origins of the Cabo Verde Green Monkey.

The green monkey Chlorocebus sabaeus, L. 1766, native to West Africa, was introduced to the Cabo Verde Archipelago in the 16th century. Historical sources suggest that, due to the importance of Cabo Verde as a commercial entrepôt in the Atlantic slave trade, establishing the precise place of origin of this introduced species is challenging. Non-invasive fecal samples were collected from feral and captive green monkey individuals in Cabo Verde. Two mitochondrial fragments, HVRI and cyt b, were used to confirm the taxonomic identification of the species and to tentatively determine the geographic origin of introduction to the archipelago from the African continent. By comparing the new sequences of this study to previously published ones, it was shown that Cabo Verde individuals have unique haplotypes in the HVRI, while also showing affinities to several populations from north-western coastal Africa in the cyt b, suggesting probable multiple sources of introduction and an undetermined most probable origin. The latter is consistent with historical information, but may also have resulted from solely using mtDNA as a genetic marker and the dispersal characteristics of the species. The limitations of the methodology are discussed and future directions of research are suggested.

A Rede Global de Bancos de Leite Humano realiza Missão de Cooperação Técnica em Cabo Verde

A Missão de Cooperação Técnica ocorreu no período de 22 de janeiro a 02 de fevereiro de 2024, em São Vicente -Cabo Verde. Com seu segundo Banco de Leite Humano inaugurado no dia 01 de setembro de 2022, no anfiteatro do Hospital Batista Sousa na cidade de Mindelo, Ilha de São Vicente em Cabo Verde, o BLH Dr. Batista de Sousa recebeu em janeiro deste ano a visita da equipe técnica dos profissionais da rBLH que teve como objetivo a Expansão e consolidação dos Bancos de Leite Humano em Cabo Verde com ênfase na Agenda 2030 para o Desenvolvimento Sustentável.

HIV-1 drug resistance and genetic diversity in people with HIV-1 in Cape Verde.

OBJECTIVES: To characterize the genetic diversity and drug resistance profiles of people with HIV-1 failing ART in Cape Verde (CV). DESIGN: Cross-sectional study conducted between January 2019 and December 2021 in 24 health centres on the islands of Santiago and São Vicente. METHODS: The HIV-1 pol gene was sequenced in individuals with a detectable viral load. HIV-1 genetic diversity was determined by phylogenetic analysis. Drug resistance mutation patterns and resistance phenotypes were estimated using the Stanford algorithm. RESULTS: Viral load was detected in 73 of 252 (29%) enrolled participants and sequencing data were produced for 58 (79%) participants. CRF02 AG strains predominated (46.5%), followed by subtype G (22.4%). Most patients (80%) had mutations conferring resistance to nonnucleoside reverse transcriptase inhibitors (NNRTIs) (67%), nucleoside reverse transcriptase inhibitors (55%), integrase inhibitors (10%) and/or protease inhibitors (7%) used in Cape Verde, a significant increase compared with a study conducted in 2010-2011. The most common mutations were M184V/I (43%), K103N/S (36%) and G190A/S (19%). NNRTI resistance was associated with younger age and exposure to two or more drug regimens. CONCLUSION: The HIV-1 epidemic in Cape Verde is mainly driven by CRF02_AG and subtype G. Resistance to NNRTIs and/or NRTIs is highly prevalent and resistance to LPV/r and DTG is emerging. Our results support the use of DTG-based first-line ART and protease inhibitor-based regimens for patients with virological failure, but emerging resistance to LPV/r and DTG is a concern. Continued monitoring of drug resistance is essential to ensure adequate healthcare for PWH in Cape Verde.

Finding unveiled: Culex thalassius (Diptera: Culicidae), a new mosquito species emerges in the Cabo Verde archipelago.

Mosquito-borne diseases can pose significant burdens. In many countries, they pose a risk to national economies and the well-being of humans and animals. To mitigate this, mosquito surveillance is crucial to assess the real and potential transmission of mosquito-borne diseases. Between 2020 and 2023, mosquito larvae were collected from both indoor and outdoor breeding sites in urban and rural areas of 4 municipalities of Santiago and Boavista Islands in Cabo Verde. Mosquitoes were identified morphologically and by polymerase chain reaction-based techniques that targeted the mitochondrial cytochrome C oxidase subunit I sequence. During this period, 6,825 breeding sites were assessed, and of 8,094 mosquito specimens screened, 194 specimens of Culex thalassius were identified for the first time in the country in 4 municipalities of Santiago and Boavista Islands. This new finding highlights the importance of including entomological surveillance in health systems. Although this species has only been detected on a few islands, it is important to continuously monitor it to determine its distribution, spread/dispersal, density, and potential involvement in pathogen transmission.

Lost and found: Patterns of marine litter accumulation on the remote Island of Santa Luzia, Cabo Verde.

Santa Luzia, an uninhabited island in the archipelago of Cabo Verde, serves as a natural laboratory and important nesting site for loggerhead turtles Carettacaretta. The island constitutes an Integral Natural Reserve and a Marine Protected Area. We assessed marine litter accumulation on sandy beaches of the island and analysed their spatial patterns using two sampling methods: at a fine scale, sand samples from 1 × 1 m squares were collected, identifying debris larger than 1 mm; at a coarse scale, drone surveys were conducted to identify visible marine debris (>25 mm) in aerial images. We sampled six points on three beaches of the island: Achados (three points), Francisca (two points) and Palmo Tostão (one point). Then, we modelled the abundance of marine debris using topographical variables as explanatory factors, derived from digital surface models (DSM). Our findings reveal that the island is a significant repository for marine litter (>84% composed of plastics), with up to 917 plastic items per m2 in the sand samples and a maximum of 38 macro-debris items per m2 in the drone surveys. Plastic fragments dominate, followed by plastic pellets (at the fine-scale approach) and fishing materials (at the coarse-scale approach). We observed that north-facing, higher-elevation beaches accumulate more large marine litter, while slope and elevation affect their spatial distribution within the beach. Achados Beach faces severe marine debris pollution challenges, and the upcoming climate changes could exacerbate this problem.

Compulsory treatment in Portuguese-speaking countries: An analysis and comparison of the legal framework.

BACKGROUND: Compulsory treatment involves the hospital admission of individuals with mental disorders in appropriate facilities through judicial decisions. However, limited information is available regarding the similarities and differences in compulsory treatment legislation in Portuguese-speaking countries. AIMS: To analyse the commonalities and differences in compulsory treatment legislation in Portuguese-speaking countries, where Portuguese is the primary official language, including Angola, Brazil, Cape Verde, East Timor, Guinea-Bissau, Mozambique, Portugal, and São Tomé and Príncipe. METHODS: A comparative analysis of the specific legislation on compulsory treatment in Portuguese-speaking countries was conducted. National development plans were analysed in countries lacking legislation. A purposive sampling of mental health professionals was contacted to gather information on the countries under study. RESULTS: Among the eight Portuguese-speaking countries examined, specific legislation regarding compulsory treatment was found only in Brazil, Cape Verde, and Portugal. These countries, with the lowest poverty rates, exhibited a notable degree of homogeneity in the criteria supporting compulsory treatment, ensuring the protection of individual rights. In contrast, in Angola, East Timor, Guinea-Bissau, Mozambique, and São Tomé and Príncipe, compulsory treatment primarily relies on mental health development plans, resulting in significant variations in the presented criteria. CONCLUSIONS: The significant disparities in compulsory treatment policies among Portuguese-speaking countries, with only Brazil, Cape Verde, and Portugal having specific legislation, underscore the need for a collective effort to establish more consistent procedures and safeguard individual rights.

Suicidal behaviour among adults in Cabo Verde in 2020.

BACKGROUND: The aim of the investigation was to evaluate past 12-month suicidal behaviour (PSB) among adults in Cabo Verde. METHODS: Data from 4,563 adults (mean age 41.4 years) that participated in the 2020 Cabo Verde STEPS survey were analysed. RESULTS: Results indicate that the proportion of PSB (attempt 0.6%, plan 1.5% and ideation 3.3%) was 3.7% (2.4% men/5.0% women). In adjusted logistic regression analysis, younger age, female sex, unemployed, widowed or divorced, alcohol family problem, heart attack, angina or stroke, current smokeless tobacco use and low fruit/vegetable intake were associated with PSB. CONCLUSION: Almost 4% of participants had PSB and several associated factors were identified that can guide public health interventions.

Behavioural and biological risk factors of non-communicable diseases among adults in Cabo Verde: a repeated cross-sectional study of the 2007 and 2020 national community-based surveys.

OBJECTIVE: The aim of the study is to estimate trends in the prevalence and associated factors of non-communicable disease (NCD) risk factors in adults from 2007 to 2020 in Cabo Verde. DESIGN: Population-based cross-sectional study. SETTING: Nationally representative samples of adult population in Cabo Verde from the 2007 and 2020 STEPwise approach to NCD risk factor surveillance (STEPS) surveys. PARTICIPANTS: The sample included 1760 adults in 2007 and 3721 in 2020. OUTCOME MEASURES: Included fruit/vegetable consumption, low physical activity, sedentary behaviour, current tobacco use, hazardous alcohol use, diabetes, total elevated cholesterol, hypertension and overweight/obesity. Logistic regressions adjusted for sociodemographic factors were applied to estimate predictors of each of the nine NCD risk factors. RESULTS: Compared with participants in the study year 2007, participants in the study year 2020 had a significantly higher prevalence of low physical activity (adjusted OR (AOR): 2.21, 95% CI: 1.15 to 4.25) and overweight/obesity (AOR: 1.68, 95% CI: 1.26 to 2.23) and significantly lower rate of hypertension (AOR: 0.77, 95% CI: 0.64 to 0.93). Low physical activity (AOR: 1.61, 95% CI: 1.23 to 2.10), overweight/obesity (AOR: 2.59, 95% CI: 2.10 to 3.20), current tobacco use (AOR: 1.94, 95% CI: 1.36 to 2.75), hypertension (AOR: 5.45, 95% CI: 4.24 to 7.00), diabetes (AOR: 8.40, 95% CI: 4.65 to 15.18) and elevated total cholesterol (AOR: 4.58, 95% CI: 2.83 to 7.39) were more common among the 50-64-year-olds. Being male increased the odds of current tobacco use (AOR: 3.64, 95% CI: 2.75 to 4.81) and hazardous alcohol use (AOR: 4.79, 95% CI: 3.15 to 7.27), and decreased the odds of low physical activity (AOR: 0.48, 95% CI: 0.39 to 0.58) and overweight/obesity (AOR: 0.47, 95% CI: 0.40 to 0.56). CONCLUSIONS: Of the nine NCD risk factors evaluated from 2007 to 2020 in Cabo Verde, two increased (overweight/obesity and low physical activity) and one decreased (hypertension). Several associated variables were identified for each individual NCD risk factor that can help in guiding interventions.

Human biomonitoring of inorganic elements in a representative sample of the general population from Cape Verde: Results from the PERVEMAC-II study.

Inorganic elements such as heavy metals and other potentially toxic elements are frequently detected in humans. The aim of the present study was to analyze the blood concentrations of 49 inorganic elements in a cohort of 401 subjects from Cape Verde. The study was performed in the frame of the Pesticide Residues in Vegetables of the Macaronesia project (PERVEMAC-II). Concentration of inorganic elements, including elements in the ATSDR's priority pollutant list and rare earth elements (RREs) were measured by ICP-MS in the whole blood of participants. A total of 20 out of 49 elements (40.8%) were detected in ≥20% of participants. Arsenic, copper, mercury, lead, selenium, strontium and zinc were detected in ≥99% of samples. Among the REEs, 7 showed detection frequencies above 20%. The median number of different elements detected was 15. In the present series, 77.0, 99.2 and 33.4% of the participants showed values of arsenic, mercury and lead higher than Reference Values 95%. These percentages were much higher than those reported in similar studies. Niobium and tantalum showed the highest median concentrations: 1.35 and 1.34 ng/mL, suggesting an environmental source of these valuable REEs in Cape Verde. Age appeared as the most important factor influencing the blood levels of inorganic elements. Lifestyle had an effect on the concentration of some of these elements. Those subjects whose water source was pond water had significantly higher arsenic levels. The concentration of ∑REEs was significantly higher among individuals who purchase their food in supermarkets (P = 0.013). These variables are of relevance since they can be controlled individually to reduce exposure to these contaminants. Our results may be useful for the implementation of public health measures by the competent authorities.

Naegleria australiensis isolated from a wastewater treatment station in Santiago Island, Cape Verde.

Despite the Naegleria genus being isolated from different natural environments such as water, soil, and air, not all Naegleria species are capable of causing infections in humans, and they are capable of completing their life cycle in environmental niches. However, the presence of this genus may suggest the existence of one of the highly pathogenic free-living amoeba (FLA) species: Naegleria fowleri or the brain-eating amoeba. This facultative parasitic protozoon represents a risk to public health, mainly related to domestic and agricultural waters. In this research, our main objective was to determine the existence of pathogenic protozoa in the Santa Cruz wastewater treatment plant, Santiago Island. Using 5 L of water we confirmed the presence of potentially pathogenic Naegleria australiensis, being the first report on Naegleria species in Cape Verde. This fact demonstrates the low efficiency in the treatment of wastewater and, consequently, a potential threat to public health. Nevertheless, more studies will be needed for the prevention and control of possible infections in this Macaronesian country.

Increase in Cape Verde hurricanes during Atlantic Niño.

At seasonal-to-interannual timescales, Atlantic hurricane activity is greatly modulated by El Niño-Southern Oscillation and the Atlantic Meridional Mode. However, those climate modes develop predominantly in boreal winter or spring and are weaker during the Atlantic hurricane season (June-November). The leading mode of tropical Atlantic sea surface temperature (SST) variability during the Atlantic hurricane season is Atlantic Niño/Niña, which is characterized by warm/cold SST anomalies in the eastern equatorial Atlantic. However, the linkage between Atlantic Niño/Niña and hurricane activity has not been examined. Here, we use observations to show that Atlantic Niño, by strengthening the Atlantic inter-tropical convergence zone rainband, enhances African easterly wave activity and low-level cyclonic vorticity across the deep tropical eastern North Atlantic. We show that such conditions increase the likelihood of powerful hurricanes developing in the deep tropics near the Cape Verde islands, elevating the risk of major hurricanes impacting the Caribbean islands and the U.S.

The economic impact of premature mortality in Cabo Verde: 2016-2020.

Mortality analysis studies in Cabo Verde are scarce and those available are limited to short periods of analysis and to specific population groups. National mortality data reports do not quantify the burden of disease associated with premature mortality. This study estimated the years of potential life lost (YPLL), years of potential productive life lost (YPPLL) and the costs associated with them in Cabo Verde from 2016 to 2020 and aimed to determine trends of early mortality due to all causes of death. Mortality data were obtained from the Ministry of Health, Cabo Verde. Deaths that occurred from 2016 to 2020, in individuals aged between one (1) and 73 years old were analyzed by sex, age group, municipality and cause of death. YPLL, YPPLL and cost of productivity lost (CPL) were estimated using life expectancy and the human capital approach methods, respectively. There were 6100 deaths recorded in the sample population and males represented 68.1% (n = 4,154) of the reported deaths. The number of deaths verified corresponded to 145,544 YPLL, of which 69.0% (n = 100,389) were attributed to males. There were 4,634 deaths among individuals of working age, which resulted in 80 965 YPPLL, with males contributing 72.1% (n = 58,403) of the total YPPLL. The estimated CPL due to premature death was 98,659,153.23 USD. Injuries and external causes together accounted for 21,580,954.42 USD (21.9%) of CPL, while diseases of the circulatory system 18,843,260.42 USD (19.1%) and certain infectious and parasitic diseases accounted for 16,633,842.70 USD (16.9%). The study demonstrated the social and economic burden of premature mortality. The YPLL, YPPLL and CPL measures can be used to complement measures traditionally used to demonstrate the burden and loss of productivity due to premature mortality and to support resource allocation and public health decision making in Cabo Verde.

First isolation of Echinococcus granulosus sensu lato genotype 7 in the archipelago of Cape Verde.

There are no scientific data available on the occurrence of the Echinococcus granulosus sensu lato (s.l.) cluster in definitive hosts (domestic dogs), intermediate hosts (domestic livestock) nor humans in Cape Verde. In this pilot study, environmental dog fecal samples (n = 369) were collected around food markets, official slaughterhouses, as well as home and small business slaughter spots in 8 of the 9 inhabited islands from the Cape Verde archipelago, between June 2021 and March 2022. Additionally, during the same period, 40 cysts and tissue lesions were opportunistically collected from 5 islands, from locally slaughtered cattle (n = 7), goats (n = 2), sheep (n = 1) and pigs (n = 26). Genetic characterization by a multiplex polymerase chain reaction assay targeting the 12S rRNA gene confirmed the presence of E. granulosus s.l. in fecal and tissue material. In total, 17 cyst samples from Santiago (n = 9), Sal (n = 7) and São Vicente (n = 1) and 8 G6/G7-positive dog fecal samples from Santiago (n = 4) and Sal (n = 4) were identified as E. granulosus s.l. G7 by sequence analysis (nad2, nad5 and nad1 genes). This study discloses the transmission of E. granulosus s.l. G7, in pig, cattle and dog in Cape Verde.

A genetic and linguistic analysis of the admixture histories of the islands of Cabo Verde.

From the 15th to the 19th century, the Trans-Atlantic Slave-Trade (TAST) influenced the genetic and cultural diversity of numerous populations. We explore genomic and linguistic data from the nine islands of Cabo Verde, the earliest European colony of the era in Africa, a major Slave-Trade platform between the 16th and 19th centuries, and a previously uninhabited location ideal for investigating early admixture events between Europeans and Africans. Using local-ancestry inference approaches, we find that genetic admixture in Cabo Verde occurred primarily between Iberian and certain Senegambian populations, although forced and voluntary migrations to the archipelago involved numerous other populations. Inter-individual genetic and linguistic variation recapitulates the geographic distribution of individuals' birth-places across Cabo Verdean islands, following an isolation-by-distance model with reduced genetic and linguistic effective dispersals within the archipelago, and suggesting that Kriolu language variants have developed together with genetic divergences at very reduced geographical scales. Furthermore, based on approximate bayesian computation inferences of highly complex admixture histories, we find that admixture occurred early on each island, long before the 18th-century massive TAST deportations triggered by the expansion of the plantation economy in Africa and the Americas, and after this era mostly during the abolition of the TAST and of slavery in European colonial empires. Our results illustrate how shifting socio-cultural relationships between enslaved and non-enslaved communities during and after the TAST, shaped enslaved-African descendants' genomic diversity and structure on both sides of the Atlantic.