This analysis of over a century of public health campaigns against human African trypanosomiasis ... more This analysis of over a century of public health campaigns against human African trypanosomiasis (sleeping sickness) in Angola aims to unravel the role of (utopian) dreams in global health. Attention to the emergence and use of concepts such as neglected tropical diseases (NTDs) and ideas about elimination or eradication highlights how these concepts and utopian dreams are instrumental for the advancement of particular agendas in an ever-shifting field of global health. The article shows how specific representations of the elimination and eradication of diseases, framed over a century ago, continue to push Western views and politics of care onto others. This analysis generates insight into how global health and its politics of power functioned in Angola during colonialism and post-independence.
Co-autors- Maria Joana Ferreira da Silva, Christina Paddock, Federica Gerini, Filipa Borges, Isa ... more Co-autors- Maria Joana Ferreira da Silva, Christina Paddock, Federica Gerini, Filipa Borges, Isa Aleixo-Pais, Mafalda Costa, Ivo Colmonero-Costeira, Catarina Casanova, Miguel Lecoq, Cristina Silva, Michael W. Bruford, Jorge Varanda & Tânia Minhós
The West-African sooty mangabey (Cercocebus atys) is threatened by habitat loss, hunting for meat consumption, and mortality during crop-foraging events. The species' overall demographic trend is unknown. Presence and distribution in Guinea-Bissau, a country neighbored by Senegal and Republic of Guinea, was confirmed in 1946 but the species was declared extinct in 1989 and not observed in subsequent countrywide expeditions. Narratives of its presence across southern Guinea-Bissau are scattered in reports and occurrence in the eastern part was reported in 2017, but the limits of its distribution are currently unknown. Here, we present recent geo-referenced visual and molecular-based records of the sooty mangabey for three protected areas in southern Guinea-Bissau collected as part of a region-wide survey. Individuals were observed in Cufada Lagoons Natural Park (2015) and Dulombi National Park (NP) (2016) and photographed in Boé NP (2007, 2015 and 2020). Thirty-six samples collected in Boé NP (2017) were identified as sooty mangabey using a 402 base pair fragment of the mitochondrial cytochrome b gene. Our work suggests a wider distribution in Guinea-Bissau than previously described, augments knowledge of the populations' current habitat use and threats, and has implications for efforts to conserve the species in West Africa. Considering the sooty mangabey as the reservoir of the simian immunodeficiency virus that led to the human variant, HIV-2, confirmation that the Guinea-Bissau population is not extinct may lead to a better understanding of early viral jump to humans and consequent epidemic spread, specifically of the HIV-2 Subgroup A. We highlight the need for extra conservation measures by Guinea-Bissau authorities.
This analysis of over a century of public health campaigns against human African trypanosomiasis... more This analysis of over a century of public health campaigns against human African trypanosomiasis (sleeping sickness) in Angola aims to unravel the role of (utopian) dreams in global health. Attention to the emergence and use of concepts such as neglected tropical diseases (NTDs) and ideas about elimination or eradication highlights how these concepts and utopian dreams are instrumental for the advancement of particular agendas in an ever-shifting field of global health. The article shows how specific representations of the elimination and eradication of diseases, framed over a century ago, continue to push Western views and politics of care onto others. This analysis generates insight into how global health and its politics of power functioned in Angola during colonialism and post-independence.
Se procurarmos uma entidade que marque, como nenhuma outra, a presença portuguesa no Ocidente de ... more Se procurarmos uma entidade que marque, como nenhuma outra, a presença portuguesa no Ocidente de África, ao longo do século XX, encontramo-la na Companhia de Diamantes de Angola – Diamang, que operou entre 1917 e 1975, sendo a maior contribuinte e a principal empregadora da Angola colonial nesse período. Rótulos que lhe eram apostos, como “um estado dentro do Estado” ou “a nona colónia”, são indícios claros da importância da Companhia no colonialismo português, mas também revelam desconhecimento da história desta gigantesca entidade. Comemorando-se este ano um século da criação da Diamang, justificasse a panorâmica que aqui traçaremos sobre a companhia. Do “Portugal melhorado” que a propaganda ali revelava à realidade escondida do trabalho forçado dos autóctones na mineração, da segregação entre europeus e africanos e, até, entre europeus de diferente estatuto, da profusão de eventos e atividades com que a Companhia garantia controlo e estabilidade. Tudo em nome de um objetivo essencial: produzir a maior quantidade possível de diamantes pelo menor custo.
Angola borders and has long-term links with Democratic Republic of Congo (DRC) as well as high le... more Angola borders and has long-term links with Democratic Republic of Congo (DRC) as well as high levels of Human Immunodeficiency Virus (HIV) genetic diversity, indicating a potential role in the initial spread of the HIV-1 pandemic. Herein, we analyze 564 C2V3 and 354 pol publicly available sequences from DRC, Republic of Congo (RC) and Angola to better understand the initial spread of the virus in this region. Phylogeographic analyses were performed with the BEAST software. While our results pinpoint the origin of the pandemic to Kinshasa (DRC) around 1906, the introduction of HIV-1 to Angola could have occurred early between the 1910s and 1940s. Furthermore, most of the HIV-1 migrations out of Kinshasa were directed not only to Lubumbashi and Mbuji-Mayi (DRC), but also to Luanda and Brazzaville. Kinshasa census records corroborate these findings, indicating that the early exportation of the virus to Angola might be related to the high number of Angolans in Kinshasa at that time, originated mostly from the North of Angola. In summary, our results place Angola at the epicenter of the early HIV dissemination, together with DRC and RC.
Abstract
Background
The Dande Health and Demographic Surveillance System (HDSS) located in Bengo... more Abstract Background
The Dande Health and Demographic Surveillance System (HDSS) located in Bengo Province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I—Communicable diseases, maternal, perinatal and nutritional conditions; Group II—Non-communicable diseases; Group III—Injuries; IND—Indeterminate). Methods
Verbal Autopsies (VA) were performed after death identification during routine HDSS visits.
Associations between broad groups of CoD and sex, age, education, socioeconomic position, place of residence and place of death, were explored using chi-square tests and fitting logistic regression models. Results
From a total of 1488 deaths registered, 1009 verbal autopsies were performed and 798 of these were assigned a CoD based on the 10th revision of the International Classification of Diseases (ICD-10).
Mortality was led by CD (61.0 %), followed by IND (18.3 %), NCD (11.6 %) and INJ (9.1 %). Intestinal infectious diseases, malnutrition and acute respiratory infections were the main contributors to under-five mortality (44.2 %). Malaria was the most common CoD among children under 15 years old (38.6 %). Tuberculosis, traffic accidents and malaria led the CoD among adults aged 15–49 (13.5 %, 10.5 % and 8.0 % respectively). Among adults aged 50 or more, diseases of the circulatory system (23.2 %) were the major CoD, followed by tuberculosis (8.2 %) and malaria (7.7 %). CD were more frequent CoD among less educated people (adjusted odds ratio, 95 % confidence interval for none vs. 5 or more years of school: 1.68, 1.04–2.72). Conclusion
Infectious diseases were the leading CoD in this region. Verbal autopsies proved useful to identify the main CoD, being an important tool in settings where vital statistics are scarce and death registration systems have limitations.
This analysis of over a century of public health campaigns against human African trypanosomiasis ... more This analysis of over a century of public health campaigns against human African trypanosomiasis (sleeping sickness) in Angola aims to unravel the role of (utopian) dreams in global health. Attention to the emergence and use of concepts such as neglected tropical diseases (NTDs) and ideas about elimination or eradication highlights how these concepts and utopian dreams are instrumental for the advancement of particular agendas in an ever-shifting field of global health. The article shows how specific representations of the elimination and eradication of diseases, framed over a century ago, continue to push Western views and politics of care onto others. This analysis generates insight into how global health and its politics of power functioned in Angola during colonialism and post-independence.
Co-autors- Maria Joana Ferreira da Silva, Christina Paddock, Federica Gerini, Filipa Borges, Isa ... more Co-autors- Maria Joana Ferreira da Silva, Christina Paddock, Federica Gerini, Filipa Borges, Isa Aleixo-Pais, Mafalda Costa, Ivo Colmonero-Costeira, Catarina Casanova, Miguel Lecoq, Cristina Silva, Michael W. Bruford, Jorge Varanda & Tânia Minhós
The West-African sooty mangabey (Cercocebus atys) is threatened by habitat loss, hunting for meat consumption, and mortality during crop-foraging events. The species' overall demographic trend is unknown. Presence and distribution in Guinea-Bissau, a country neighbored by Senegal and Republic of Guinea, was confirmed in 1946 but the species was declared extinct in 1989 and not observed in subsequent countrywide expeditions. Narratives of its presence across southern Guinea-Bissau are scattered in reports and occurrence in the eastern part was reported in 2017, but the limits of its distribution are currently unknown. Here, we present recent geo-referenced visual and molecular-based records of the sooty mangabey for three protected areas in southern Guinea-Bissau collected as part of a region-wide survey. Individuals were observed in Cufada Lagoons Natural Park (2015) and Dulombi National Park (NP) (2016) and photographed in Boé NP (2007, 2015 and 2020). Thirty-six samples collected in Boé NP (2017) were identified as sooty mangabey using a 402 base pair fragment of the mitochondrial cytochrome b gene. Our work suggests a wider distribution in Guinea-Bissau than previously described, augments knowledge of the populations' current habitat use and threats, and has implications for efforts to conserve the species in West Africa. Considering the sooty mangabey as the reservoir of the simian immunodeficiency virus that led to the human variant, HIV-2, confirmation that the Guinea-Bissau population is not extinct may lead to a better understanding of early viral jump to humans and consequent epidemic spread, specifically of the HIV-2 Subgroup A. We highlight the need for extra conservation measures by Guinea-Bissau authorities.
This analysis of over a century of public health campaigns against human African trypanosomiasis... more This analysis of over a century of public health campaigns against human African trypanosomiasis (sleeping sickness) in Angola aims to unravel the role of (utopian) dreams in global health. Attention to the emergence and use of concepts such as neglected tropical diseases (NTDs) and ideas about elimination or eradication highlights how these concepts and utopian dreams are instrumental for the advancement of particular agendas in an ever-shifting field of global health. The article shows how specific representations of the elimination and eradication of diseases, framed over a century ago, continue to push Western views and politics of care onto others. This analysis generates insight into how global health and its politics of power functioned in Angola during colonialism and post-independence.
Se procurarmos uma entidade que marque, como nenhuma outra, a presença portuguesa no Ocidente de ... more Se procurarmos uma entidade que marque, como nenhuma outra, a presença portuguesa no Ocidente de África, ao longo do século XX, encontramo-la na Companhia de Diamantes de Angola – Diamang, que operou entre 1917 e 1975, sendo a maior contribuinte e a principal empregadora da Angola colonial nesse período. Rótulos que lhe eram apostos, como “um estado dentro do Estado” ou “a nona colónia”, são indícios claros da importância da Companhia no colonialismo português, mas também revelam desconhecimento da história desta gigantesca entidade. Comemorando-se este ano um século da criação da Diamang, justificasse a panorâmica que aqui traçaremos sobre a companhia. Do “Portugal melhorado” que a propaganda ali revelava à realidade escondida do trabalho forçado dos autóctones na mineração, da segregação entre europeus e africanos e, até, entre europeus de diferente estatuto, da profusão de eventos e atividades com que a Companhia garantia controlo e estabilidade. Tudo em nome de um objetivo essencial: produzir a maior quantidade possível de diamantes pelo menor custo.
Angola borders and has long-term links with Democratic Republic of Congo (DRC) as well as high le... more Angola borders and has long-term links with Democratic Republic of Congo (DRC) as well as high levels of Human Immunodeficiency Virus (HIV) genetic diversity, indicating a potential role in the initial spread of the HIV-1 pandemic. Herein, we analyze 564 C2V3 and 354 pol publicly available sequences from DRC, Republic of Congo (RC) and Angola to better understand the initial spread of the virus in this region. Phylogeographic analyses were performed with the BEAST software. While our results pinpoint the origin of the pandemic to Kinshasa (DRC) around 1906, the introduction of HIV-1 to Angola could have occurred early between the 1910s and 1940s. Furthermore, most of the HIV-1 migrations out of Kinshasa were directed not only to Lubumbashi and Mbuji-Mayi (DRC), but also to Luanda and Brazzaville. Kinshasa census records corroborate these findings, indicating that the early exportation of the virus to Angola might be related to the high number of Angolans in Kinshasa at that time, originated mostly from the North of Angola. In summary, our results place Angola at the epicenter of the early HIV dissemination, together with DRC and RC.
Abstract
Background
The Dande Health and Demographic Surveillance System (HDSS) located in Bengo... more Abstract Background
The Dande Health and Demographic Surveillance System (HDSS) located in Bengo Province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I—Communicable diseases, maternal, perinatal and nutritional conditions; Group II—Non-communicable diseases; Group III—Injuries; IND—Indeterminate). Methods
Verbal Autopsies (VA) were performed after death identification during routine HDSS visits.
Associations between broad groups of CoD and sex, age, education, socioeconomic position, place of residence and place of death, were explored using chi-square tests and fitting logistic regression models. Results
From a total of 1488 deaths registered, 1009 verbal autopsies were performed and 798 of these were assigned a CoD based on the 10th revision of the International Classification of Diseases (ICD-10).
Mortality was led by CD (61.0 %), followed by IND (18.3 %), NCD (11.6 %) and INJ (9.1 %). Intestinal infectious diseases, malnutrition and acute respiratory infections were the main contributors to under-five mortality (44.2 %). Malaria was the most common CoD among children under 15 years old (38.6 %). Tuberculosis, traffic accidents and malaria led the CoD among adults aged 15–49 (13.5 %, 10.5 % and 8.0 % respectively). Among adults aged 50 or more, diseases of the circulatory system (23.2 %) were the major CoD, followed by tuberculosis (8.2 %) and malaria (7.7 %). CD were more frequent CoD among less educated people (adjusted odds ratio, 95 % confidence interval for none vs. 5 or more years of school: 1.68, 1.04–2.72). Conclusion
Infectious diseases were the leading CoD in this region. Verbal autopsies proved useful to identify the main CoD, being an important tool in settings where vital statistics are scarce and death registration systems have limitations.
Drawing on rich ethnographic and historical intertwinements, Making and Unmaking Public Health in... more Drawing on rich ethnographic and historical intertwinements, Making and Unmaking Public Health in Africa maps the ongoing construction of Global Public Health, while simultaneously debating the Public in public health and pinpointing the spread of new global health landscapes. The introduction by Ruth Prince excels in mapping the complex history of health actions in Africa and the links between local and transnational settings. It brings to the fore the role of political contexts and economic changes, from imperial blueprints to the centralised socialist plans of the early post-independence period, and the role of the 1980s Structural Adjustment Programmes that paved the way for present-day neoliberal approaches to views of health programmes.
Most explanations for the epidemic spread of HIV-2 (the lesser known AIDS virus affecting 1.5 mil... more Most explanations for the epidemic spread of HIV-2 (the lesser known AIDS virus affecting 1.5 million) casually suggest migrations, urbanization, war, commercial sex, STDs and biomedicine as underlying reasons, but present little or no evidence to substantiate or differentiate them.
By complementing historical epidemiology and virology with history and anthropology this talk shows that disease and epidemics do not occur in a void or play out in independent computer models. The messy world of society, with its socio-cultural, economic and political influences, is thus central to understanding HIV epidemics. A thorough examination of historical developments and their link to virological research provides new evidence for understanding the emergence of HIV-2 and its role in the AIDS epidemic.
"Although several colonial powers declared the reduction in Human African Trypanosomiasis (sleepi... more "Although several colonial powers declared the reduction in Human African Trypanosomiasis (sleeping sickness) its most profound public health success, by the 1990s sleeping sickness was the epitome of a Neglected Tropical Disease.
A social science/humanities perspective emphasizes the relevance of social, cultural, economic and political factors that set the Angolan canvas, where anti-sleeping sickness programs with its diagnosis, treatments and follow-ups occur often in contrast with peoples’ worldviews and practices.
This study results from an almost 3-year research carried out by a multidisciplinary team of anthropologists, historians and physicians. Qualitative and quantitative methodologies were used to thoroughly characterize the public health approaches used over the past century: chemotherapeutical, preventive or vector control actions, modifications of programs due to local responses, macro political shifts or the emergence of new international stakeholders.
Non-biological issues such as variable “community” responses to either active prospecting (diagnosis) or anti-vector actions, the hyper-vertical nature of programs, the hegemonic weight of local representations of biomedical treatments, relevance of therapeutical management group in molding people’s healing itineraries prior to their arrival to treatment centers, due in part, to a growing and diverse ‘health market’, are key to grasp the situation on the ground, the poor rates of follow-up or the persistence of historical foci.
Present application of global health concepts will profits greatly from critical historical and cultural examination of past endeavors, which is what this presentation attempts to provide with its multidisciplinary approach brought forward in historical and ethnographic forms.
The diachronic perspective on disease control in Angola contributes to a better understanding of the characteristics and factors shaping the nature of the programs developed under the aegis of colonial medicine and/or presently of global health."
This dissertation deals with the implementation of a Diamang’s sanitary occupation via a Trypanos... more This dissertation deals with the implementation of a Diamang’s sanitary occupation via a Trypanosimiasis campaign. This application was an important step in the production of local knowledge regarding the human resources available within the company’s concessionary region. It was also important means in analysing the processes of objectification and creation of subjectivities using the contemporary medical discourse related to African populations. The classification of ethnic groups provided the company with a pseudo-scientific tool subsequently used to more effectively and actively manage the available workforce.
This thesis examines the provision of biomedicine by a colonial diamond
company, Diamang, in twen... more This thesis examines the provision of biomedicine by a colonial diamond company, Diamang, in twentieth-century Portuguese Angola. It attempts to better understand the functioning and complexities of Portuguese Imperialism. It argues that Diamang healthcare services were central in the Portuguese state efforts to respond to international pressures against colonialism and central for the understanding of the empire. The company’s health services were autonomous from the state ones and for most of the colonial period provided better healthcare. Diamang’s argument that it provided similar healthcare for Westerners and Africans is contradicted by a closer and critical reading of the records. In place was a racial-hierarchical system of care with westerners and their families on top, followed by workers, whilst the bottom position was occupied by the general population. Its mobile campaigns were key elements for the company’s health efforts and allow a more intricate understanding of the dynamics and fragmented nature of the Portuguese empire. The use by health-services of anthropometrics for labour recruitment reveals a complex exercise where the result was an increased number of workers, and a constant intake of men unfit for mine work. Closer attention to living and working conditions informs that production costs and labour concerns fashioned mining. It is revealed that diseases killed more workers than accidents and that Diamang did little to prevent these. The role of mine managers in these, and consequently in the workers’ health, is also emphasised. The political character of medical studies of workers’ health at mines and its value as a negotiation card with the government is also stressed, again reinforcing the political character of healthcare and the colonialism by proxy nature of Diamang.
Workshop on Malaria transmission: current challenges and new tools in the elimination context- Lisbon 2017, 2017
Introduction: In 2015 half of the world’s population was at risk of malaria. However, it is Sub-S... more Introduction: In 2015 half of the world’s population was at risk of malaria. However, it is Sub-Saharan Africa that bares the brunt of deaths (1) . Angola is no exception. The country’s population is considered at risk, but the most affected groups are children under five years old and pregnant women. The disease is caused by the transmission of Plasmodium sp. through the bite of the Anopheles mosquito. In Angola the main parasite is Plasmodium falciparum. The country presents three main areas of incidence of the disease: Mesoendemic stable, Mesoendemic unstable and Hyperendemic, with transmission being acute during the rainy season, from January to May. ... This research is but an exploratory first step in characterizing malaria in Angola. From mid-2000s onwards the national government successively piggy-banked on several global actors to combat malaria. But, despite signs of rapid progress recent data shows there is still room for improvement (3, 9, 10). Malaria is a disease of poverty, attention should not focus only on health policies or systems. The umbrella-project sheltering this research aims to bring forward an integrate outlook with data from distinct approaches: epidemiological, health policies, socioeconomic conditions, urbanization, with geographic information analysis and mosquito genetic data. Such interdisciplinary perspective will surely contribute to grasp the complexity, challenges, but also avenues of possibilities, of the goal the Angolan government agreed to: the elimination of Malaria by 2030.
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Papers by jorge varanda
The West-African sooty mangabey (Cercocebus atys) is threatened by habitat loss, hunting for meat consumption, and mortality during crop-foraging events. The species' overall demographic trend is unknown. Presence and distribution in Guinea-Bissau, a country neighbored by Senegal and Republic of Guinea, was confirmed in 1946 but the species was declared extinct in 1989 and not observed in subsequent countrywide expeditions. Narratives of its presence across southern Guinea-Bissau are scattered in reports and occurrence in the eastern part was reported in 2017, but the limits of its distribution are currently unknown. Here, we present recent geo-referenced visual and molecular-based records of the sooty mangabey for three protected areas in southern Guinea-Bissau collected as part of a region-wide survey. Individuals were observed in Cufada Lagoons Natural Park (2015) and Dulombi National Park (NP) (2016) and photographed in Boé NP (2007, 2015 and 2020). Thirty-six samples collected in Boé NP (2017) were identified as sooty mangabey using a 402 base pair fragment of the mitochondrial cytochrome b gene. Our work suggests a wider distribution in Guinea-Bissau than previously described, augments knowledge of the populations' current habitat use and threats, and has implications for efforts to conserve the species in West Africa. Considering the sooty mangabey as the reservoir of the simian immunodeficiency virus that led to the human variant, HIV-2, confirmation that the Guinea-Bissau population is not extinct may lead to a better understanding of early viral jump to humans and consequent epidemic spread, specifically of the HIV-2 Subgroup A. We highlight the need for extra conservation measures by Guinea-Bissau authorities.
Comemorando-se este ano um século da criação da Diamang, justificasse a panorâmica que aqui traçaremos sobre a companhia. Do “Portugal melhorado” que a propaganda ali revelava à realidade escondida do trabalho forçado dos autóctones na mineração, da segregação entre europeus e africanos e, até, entre europeus de diferente estatuto, da profusão de eventos e atividades com que a Companhia garantia controlo e estabilidade. Tudo em nome de um objetivo essencial: produzir a maior quantidade possível de diamantes pelo menor custo.
Background
The Dande Health and Demographic Surveillance System (HDSS) located in Bengo Province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I—Communicable diseases, maternal, perinatal and nutritional conditions; Group II—Non-communicable diseases; Group III—Injuries; IND—Indeterminate).
Methods
Verbal Autopsies (VA) were performed after death identification during routine HDSS visits.
Associations between broad groups of CoD and sex, age, education, socioeconomic position, place of residence and place of death, were explored using chi-square tests and fitting logistic regression models.
Results
From a total of 1488 deaths registered, 1009 verbal autopsies were performed and 798 of these were assigned a CoD based on the 10th revision of the International Classification of Diseases (ICD-10).
Mortality was led by CD (61.0 %), followed by IND (18.3 %), NCD (11.6 %) and INJ (9.1 %). Intestinal infectious diseases, malnutrition and acute respiratory infections were the main contributors to under-five mortality (44.2 %). Malaria was the most common CoD among children under 15 years old (38.6 %). Tuberculosis, traffic accidents and malaria led the CoD among adults aged 15–49 (13.5 %, 10.5 % and 8.0 % respectively). Among adults aged 50 or more, diseases of the circulatory system (23.2 %) were the major CoD, followed by tuberculosis (8.2 %) and malaria (7.7 %). CD were more frequent CoD among less educated people (adjusted odds ratio, 95 % confidence interval for none vs. 5 or more years of school: 1.68, 1.04–2.72).
Conclusion
Infectious diseases were the leading CoD in this region. Verbal autopsies proved useful to identify the main CoD, being an important tool in settings where vital statistics are scarce and death registration systems have limitations.
The West-African sooty mangabey (Cercocebus atys) is threatened by habitat loss, hunting for meat consumption, and mortality during crop-foraging events. The species' overall demographic trend is unknown. Presence and distribution in Guinea-Bissau, a country neighbored by Senegal and Republic of Guinea, was confirmed in 1946 but the species was declared extinct in 1989 and not observed in subsequent countrywide expeditions. Narratives of its presence across southern Guinea-Bissau are scattered in reports and occurrence in the eastern part was reported in 2017, but the limits of its distribution are currently unknown. Here, we present recent geo-referenced visual and molecular-based records of the sooty mangabey for three protected areas in southern Guinea-Bissau collected as part of a region-wide survey. Individuals were observed in Cufada Lagoons Natural Park (2015) and Dulombi National Park (NP) (2016) and photographed in Boé NP (2007, 2015 and 2020). Thirty-six samples collected in Boé NP (2017) were identified as sooty mangabey using a 402 base pair fragment of the mitochondrial cytochrome b gene. Our work suggests a wider distribution in Guinea-Bissau than previously described, augments knowledge of the populations' current habitat use and threats, and has implications for efforts to conserve the species in West Africa. Considering the sooty mangabey as the reservoir of the simian immunodeficiency virus that led to the human variant, HIV-2, confirmation that the Guinea-Bissau population is not extinct may lead to a better understanding of early viral jump to humans and consequent epidemic spread, specifically of the HIV-2 Subgroup A. We highlight the need for extra conservation measures by Guinea-Bissau authorities.
Comemorando-se este ano um século da criação da Diamang, justificasse a panorâmica que aqui traçaremos sobre a companhia. Do “Portugal melhorado” que a propaganda ali revelava à realidade escondida do trabalho forçado dos autóctones na mineração, da segregação entre europeus e africanos e, até, entre europeus de diferente estatuto, da profusão de eventos e atividades com que a Companhia garantia controlo e estabilidade. Tudo em nome de um objetivo essencial: produzir a maior quantidade possível de diamantes pelo menor custo.
Background
The Dande Health and Demographic Surveillance System (HDSS) located in Bengo Province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I—Communicable diseases, maternal, perinatal and nutritional conditions; Group II—Non-communicable diseases; Group III—Injuries; IND—Indeterminate).
Methods
Verbal Autopsies (VA) were performed after death identification during routine HDSS visits.
Associations between broad groups of CoD and sex, age, education, socioeconomic position, place of residence and place of death, were explored using chi-square tests and fitting logistic regression models.
Results
From a total of 1488 deaths registered, 1009 verbal autopsies were performed and 798 of these were assigned a CoD based on the 10th revision of the International Classification of Diseases (ICD-10).
Mortality was led by CD (61.0 %), followed by IND (18.3 %), NCD (11.6 %) and INJ (9.1 %). Intestinal infectious diseases, malnutrition and acute respiratory infections were the main contributors to under-five mortality (44.2 %). Malaria was the most common CoD among children under 15 years old (38.6 %). Tuberculosis, traffic accidents and malaria led the CoD among adults aged 15–49 (13.5 %, 10.5 % and 8.0 % respectively). Among adults aged 50 or more, diseases of the circulatory system (23.2 %) were the major CoD, followed by tuberculosis (8.2 %) and malaria (7.7 %). CD were more frequent CoD among less educated people (adjusted odds ratio, 95 % confidence interval for none vs. 5 or more years of school: 1.68, 1.04–2.72).
Conclusion
Infectious diseases were the leading CoD in this region. Verbal autopsies proved useful to identify the main CoD, being an important tool in settings where vital statistics are scarce and death registration systems have limitations.
The introduction by Ruth Prince excels in mapping the complex history of health actions in Africa and the links between local and transnational settings. It brings to the
fore the role of political contexts and economic changes, from imperial blueprints to the centralised socialist plans of the early post-independence period, and the role of the
1980s Structural Adjustment Programmes that paved the way for present-day neoliberal approaches to views of health programmes.
By complementing historical epidemiology and virology with history and anthropology this talk shows that disease and epidemics do not occur in a void or play out in independent computer models. The messy world of society, with its socio-cultural, economic and political influences, is thus central to understanding HIV epidemics. A thorough examination of historical developments and their link to virological research provides new evidence for understanding the emergence of HIV-2 and its role in the AIDS epidemic.
A social science/humanities perspective emphasizes the relevance of social, cultural, economic and political factors that set the Angolan canvas, where anti-sleeping sickness programs with its diagnosis, treatments and follow-ups occur often in contrast with peoples’ worldviews and practices.
This study results from an almost 3-year research carried out by a multidisciplinary team of anthropologists, historians and physicians. Qualitative and quantitative methodologies were used to thoroughly characterize the public health approaches used over the past century: chemotherapeutical, preventive or vector control actions, modifications of programs due to local responses, macro political shifts or the emergence of new international stakeholders.
Non-biological issues such as variable “community” responses to either active prospecting (diagnosis) or anti-vector actions, the hyper-vertical nature of programs, the hegemonic weight of local representations of biomedical treatments, relevance of therapeutical management group in molding people’s healing itineraries prior to their arrival to treatment centers, due in part, to a growing and diverse ‘health market’, are key to grasp the situation on the ground, the poor rates of follow-up or the persistence of historical foci.
Present application of global health concepts will profits greatly from critical historical and cultural examination of past endeavors, which is what this presentation attempts to provide with its multidisciplinary approach brought forward in historical and ethnographic forms.
The diachronic perspective on disease control in Angola contributes to a better understanding of the characteristics and factors shaping the nature of the programs developed under the aegis of colonial medicine and/or presently of global health."
company, Diamang, in twentieth-century Portuguese Angola. It attempts to better understand the functioning and complexities of Portuguese Imperialism. It argues that Diamang healthcare services were central in the Portuguese state efforts to respond to international pressures against colonialism and central for the understanding of the empire.
The company’s health services were autonomous from the state ones and for most of the colonial period provided better healthcare. Diamang’s argument that it provided similar healthcare for Westerners and Africans is contradicted by a closer and critical reading of the records. In place was a racial-hierarchical system of care with westerners and their families on top, followed by workers, whilst the bottom position was occupied by the general population. Its mobile campaigns were key elements for the company’s health efforts and allow a more intricate understanding of the dynamics and fragmented nature of the Portuguese empire.
The use by health-services of anthropometrics for labour recruitment reveals a complex exercise where the result was an increased number of workers, and a constant intake of men unfit for mine work.
Closer attention to living and working conditions informs that production
costs and labour concerns fashioned mining. It is revealed that diseases killed more workers than accidents and that Diamang did little to prevent these. The role of mine managers in these, and consequently in the workers’ health, is also emphasised. The political character of medical studies of workers’ health at mines and its value as a negotiation card with the government is also stressed, again reinforcing the political
character of healthcare and the colonialism by proxy nature of Diamang.