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PubMed2006

Beliefs and practices concerning twins, hermaphrodites, and albinos among the Bamana and Maninka of Mali.

The Bamana and Maninka of Mali greatly value twins, and have elaborated a range of cultural beliefs and practices to assure their survival. Rates of twinning among these two ethnic groups average from 15.2/1000 to 17.9/1000 births compared to 10.5/1000 births (without assisted reproduction) in the United States and Great Britain. Twins (flaniw) are regarded as extraordinary beings with unusual powers, and as a gift from the supreme deity. A small altar (sinzin) is maintained in the home of twins, and periodic sacrifices of chicken blood, kola nuts, millet paste and millet beer regularly made to assure their protection. Albinos (yéfeguéw) and true and pseudo-hermaphrodites (tyéténousotéw) are also considered twin beings. However, they are believed to be the result of aberrant parental social behavior. The Bamana and Maninka believe that all four groups (twins, albinos, hermaphrodites, and pseudo-harmaphrodites) are closely linked to Faro, an androgynous supernatural being who provides equilibrium in the world. Faro is the original albino and hermaphrodite who gave birth to the first pair of twins after self-impregnation. Whenever a twin dies, a small wooden statue is sculpted called a flanitokélé (twin that remains). This commemorative figure is kept close to the surviving twin, reflecting a belief in the inseparability of twins. Eventually, the surviving twin takes responsibility for the figure. When a surviving twin marries, another figure is often sculpted in the opposite sex from the deceased twin, and placed with the original sculpture. Such commemorative sculptures are not created upon the death of those who are albinos, hermaphrodites, or pseudo-hermaphrodites. In recent years, transformational belief patterns have evolved as increasing numbers of Bamana and Maninka embrace Islam. Traditional beliefs are often given Islamic myths of origin. However, even in this Islamic context, many practices that assure twin survival are maintained.

Albinism↗
PubMed1976

The prevalence of diabetes mellitus in three population groups in the Republic of Mali.

Three different adult population groups in Mali were screened for diabetes mellitus by means of a post-prandial blood glucose determination. The prevalence of diabetes for the entire population sampled was found to be 1-4%. Diabetes mellitus was strongly suspected in an additional 8-4%. The prevalence of elevated post-prandial blood glucose levels was found to be the lowest (5-1%) among a group of Bambara farmers who live an active rural life and whose total daily caloric intake is less than 1,000 on the average, only half of it provided by carbohydrates.

Diabetes Mellitus↗
PubMed1981

The role of women in traditional healing among the Bambara of Mali.

Although the Bambara of Mali are patrineal and patrilocal, women play important roles in the traditional healing system. These roles extend from the home, where women are often the household authorities on herbal remedies, to practitioner level as herbalists and to highly organized women's societies which focus on disease prevention and cure.

Female↗
PubMed1987

Breastfeeding and weaning in Mali: cultural context and hard data.

Patterns of infant feeding, based on cultural beliefs, affect the nutritional status, health, and growth of children. In order to understand malnutrition and infant health in a particular community, knowledge of both the beliefs and the practices associated with infant feeding in that community is essential. For this reason, it is critical that research strategies for collecting both traditional 'soft' data (the cultural context) and 'hard' data (observed patterns of infant feeding) be employed. A two-year study of infant feeding in Mali (1982-1983) provides detailed information about breastfeeding and weaning beliefs and practices. In this community, virtually all women breastfed their infants. Infants were nursed on demand, for comfort as well as nutrition. Weaning took place at an average age of 20.8 months, with a range of 6-32 months (N = 136). Bottle/formula use was very rare. Breastfeeding and weaning practices affected the growth and development of infants during the first two years of life. In contrast to many other populations, however, a number of infants in this community showed improved growth after weaning. Some traditional beliefs about infant feeding are changing under the pressure of urban norms, while others remain resistant to change, with varying effects on infant health.

Adult↗
PubMed1995

Child fostering and children's nutritional outcomes in rural Mali: the role of female status in directing child transfers.

Research in West Africa has begun to document the phenomenon of child fostering although little attention has focussed on other types of non-maternal child care arrangements and their impact on child health. Evidence from a sample of 77 weaned children under five in rural Mali found that over one third (35%) of children were not the prime responsibility of both their biological parents. Nineteen per cent (N = 15) of the sample were formally fostered children, known as sukaabe bambaabe, who lived neither with their biological mothers nor with their biological fathers. Others lived under flexible or semi-permanent non-maternal care arrangements both within and outside the agnatic family. Factors precipitating fostering are outlined and are divided into: (i) those under which the child is fostered away from its biological family through force of circumstance; and (ii) those under which the child is actively requested by its foster mother. Rather than fostering providing a universal option for over-burdened mothers with too many or too closely-spaced children, the field evidence shows that the movement of children within and between households is rigorously controlled by the female social hierarchy. Children are transferred in a uni-directional fashion from the care of their low status biological mothers to high status foster mothers. Their transfer serves to visibly reinforce socio-political power differentials between these women who are at different stages of the female life-cycle and in different sets of household circumstances. Economic factors are not associated with the decision to keep the child or to foster it away, but do appear to determine whether the children living under non-maternal care are fostered out under a structured or unstructured fostering arrangement. Contrary to findings in other West African settings, fostering per se has little impact on children's nutritional outcomes as measured by their weight-for-age Z-Scores, probably because the use of surrogate or sibling caretakers is common in this environment even for children who are the full responsibility of their biological mothers. The context of the fostering, however, does influence fostered children's nutritional status. Those children who were requested by their foster mothers had better nutritional outcomes than those who were fostered in by force of circumstances. It is concluded that the concept of 'maternal and child health' and the 'maternal-child' dyad around which both health interventions and demographic evaluations are centred, may not always be appropriate in areas of high fostering prevalence.

Adolescent↗
PubMed1992

Preliminary observations on helminth parasite populations of the dromedary in northern Mali.

An abattoir survey on gastrointestinal parasites of the dromedary (Camelus dromedarius) was carried out in March/April 1987 in northern Mali. Parasitological examination of the digestive tract contents of 11 dromedaries revealed that Haemonchus longistipes was the predominant parasite with a prevalence as high as 85.7%. The genera Impalaia, Trichostrongylus, Cooperia, and Oesophagostomum were also recovered, but with a lower level of infection and frequency. The larval stage of the canine cestode Echinococcus granulosus was recorded in a single instance.

Abattoirs↗
PubMed2003

Risk factors for malaria infection and anemia for pregnant women in the Sahel area of Bandiagara, Mali.

Malaria infection and anemia during pregnancy are the primary causes of maternal and fetal morbidity and mortality. The aims of this study were to identify risk factors for malaria infection and to assess the relationship between malaria infection and anemia in pregnant women. Two cross-sectional surveys were conducted in September 1993 and then again in May 1994 (the end of the rainy and dry seasons respectively). A total of 235 pregnant women were randomly selected from both the rural and urban areas of Bandiagara, Mali. According to results from multivariate analysis, the risk of malaria infection was significantly higher during the rainy season (OR= 4.85, 95% CI 2.42-9.75) the first trimester of gestation (OR= 2.21, 95% CI 1.00-4.87, in younger women (OR= 2.48, 95% CI 1.19-5.16), and in women living in the rural area (2.49, 95% CI 0.99-6.27). The risk of anemia was also higher during the rainy season (OR= 1.93, 95% CI 1.10-3.39, in the rural area (OR= 3.55, 95% CI 1.46-8.62). The risk of anemia was lower during the first trimester of gestational age (OR= 0.45, 95% CI 0.22-0.92). The relationship between malaria infection and anemia also varied with season. During the rainy season, the risk for anemia was similar among malaria-infected and non-infected pregnant women. In contrast, the risk was higher among infected pregnant women during the dry season (OR= 3.43, 95% CI 1.09-10.07). In conclusion, the data suggest, that earlier gestation age, living in the rural area, and young age rather than parity are important risk factors for malaria infection in pregnant women. Further, malaria infection is strongly associated with anemia in pregnant women particularly during the dry season and is most likely the cause of anemia. Thus, control measures against malaria infection should target younger rural women in their first trimester of pregnancy.

Adult↗
PubMed2004

Malaria transmission in relation to rice cultivation in the irrigated Sahel of Mali.

Seven cross-sectional entomological surveys were carried out from September 1995 to February 1998 in three irrigated rice growing villages and three villages without irrigated agriculture in the area surrounding Niono, located 350km north-east of Bamako, Mali. The transmission pattern differed markedly between the two zones. In the irrigated zone, the transmission of malaria was fairly constant over the seasons at a low level. In the non-irrigated zone, transmission was mostly below detection level during the dry season, whereas it was high toward the end of the rainy season. In the irrigated zone, high densities of mosquitoes were correlated with low anthropophily, low sporozoite indices and probably low survival rates. In the non-irrigated zone, mosquito densities were lower and these relationships were less pronounced. Differential use of mosquito nets in the two zones may have been an important factor in the observed differences in transmission. The presence of cattle may also have played an important role. Two mosquito-catching methods (human landing catch and spray catch) were compared.

Animals↗
PubMed2004

Malaria incidence in relation to rice cultivation in the irrigated Sahel of Mali.

Seven repeated cross-sectional parasitological surveys, collecting a total of 13,912 blood samples, were carried out from September 1995 to February 1998 in three irrigated rice growing villages and three villages without irrigated agriculture in the area surrounding Niono, Mali. Parasite prevalence varied according to season and agricultural zone, but showed similar patterns for villages within the same zone. Overall, malaria prevalence was 47% in the villages without irrigated agriculture and 34% in the irrigated rice growing villages. In a village in the irrigated zone, and a village in the non-irrigated zone, 1067 and 608 children up to the age of 14 years, respectively, were followed in a passive malariological study for the period of 13 months. Fevers were attributed to malaria using a statistical method, taking into account the parasitaemia in afebrile controls from the cross-sectional surveys. The incidence of malaria fevers differed markedly between the two zones and over time. In the village in the irrigated zone, the incidence of malaria fevers was fairly constant over the year at 0.7 per 1000 children per day. In the village without irrigated agriculture, incidence was low during the dry season (at 0.6 per 1000 children per day), whereas it was high during the rainy season (at 3.2 per 1000 children per day). These results correspond well to the malaria transmission observed in a concurrent entomological survey. Rice cultivation in the semi-arid sub-Saharan environment altered the transmission pattern from seasonal to perennial, but reduced annual incidence more than two-fold.

Adolescent↗
PubMed2004

Comparison of schistosome transmission in a single- and a double-cropped area in the rice irrigation scheme, 'Office du Niger', Mali.

Rice is becoming increasingly important as a staple food in West Africa and there is a need to increase production to meet the demand and one way to achieve this is to harvest two annual crops. It is possible that such intensified irrigation could affect transmission of schistosomes and this study attempts to compare schistosome transmission in single and double-cropped areas of an irrigation scheme, 'Office du Niger', in Mali. Double cropping has been practised for some years in the Niono area while in the Kolongotomo area still only a single crop is grown. Parasitological surveys conducted in 10 villages (5 from each of these 2 areas) showed that Schistosoma haematobium was less prevalent in the area with single cropping than in the area with double cropping. In order to compare transmission patterns between the two areas, all human-water contact sites around four villages (two from each area) were identified and included in transmission studies. From August 1996 to June 1997, eight surveys were conducted, at intervals of approximately 45 days, in each of these sites to record density of the intermediate hosts, density of infected snails, environmental factors (especially density of aquatic macrophytes), and frequency of human-water contacts. Although the data provide useful information on transmission patterns in Niono and Kolongotomo areas, they fail to demonstrate clear-cut differences in snail population dynamics and transmission patterns between the two areas. A key element in snail habitats in both areas is the abundance of aquatic macrophytes, especially the submerged species. Snail control using environmental modification should focus on controlling these plants in human-water contact sites.

Adolescent↗
PubMed2004

An ethnopharmacological survey of plants used for wound healing in Dogonland, Mali, West Africa.

Traditional medicine, being a significant element in the cultural patrimony, still remains the main recourse for a large majority of people in Dogonland, Mali, for treating various diseases and ailments. This paper reports an ethnopharmacological study in Dogonland with the aim to identify medicinal plants used in the treatment of wounds. Information obtained from traditional healers revealed 73 plant species being used as wound healing remedies, according to the definitions of wounds given by the healers themselves. The plants, belonging to 34 plant families, are used as first aids, in the washing of wounds, extraction of pus, as coagulants, as well as for infected wounds. The most frequently used preparations are decoctions and powdered plant material.

Ethnopharmacology↗
PubMed2005

Medicinal use of Cochlospermum tinctorium in Mali Anti-ulcer-, radical scavenging- and immunomodulating activities of polymers in the aqueous extract of the roots.

Cochlospermum tinctorium A. Rich. (Cochlospermaceae) is a widely used medicinal plant in the West African country, Mali. An ethnopharmacological survey was conducted and 106 traditional practitioners interviewed. The roots were the part of the plant reported to be the most frequently used for medicinal purposes. The main indications were to treat jaundice (41), gastro intestinal diseases or ailments (28), malaria (12), schistosomiasis (10) and dysurea (6). A high-molecular weight water extract (25, 50 and 100 mg/kg, body weight) significantly inhibited HCl/ethanol-induced gastric lesions in mice. The extract showed DPPH-radical scavenging- and immunomodulating activities in vitro. The main components of the extract were identified as polysaccharides (59.3%) and polyphenols (9.3%). The polysaccharides were purified and characterised as highly complex pectic arabinogalactans type II. As parts of the polyphenol compounds gallotannins and ferulic acids were identified. This study shows that the polysaccharides are partly responsible for the bioactivities observed in vitro. Both polysaccharides and polyphenols may be responsible for the anti-ulcer activities observed.

Adjuvants, Immunologic↗
PubMed2005

Evaluation of medicinal plants from Mali for their in vitro and in vivo trypanocidal activity.

Water, methanol and dichloromethane extracts prepared from various parts of 40 medicinal plant species from Mali were investigated for their trypanocidal activity against Trypanosoma brucei brucei. Of a total of 165 extracts tested in vitro in the Low Inoculation Long Incubation Test (LILIT), 24 extracts showed a high trypanocidal activity. Using the Long-Term Viability Assay (LtVA) for corroboration of the results of the 24 extracts, it was found that 15 samples had minimum inhibitory concentration (MIC) values > 10 microg/ml, eight MIC values of 100 microg/ml and one MIC values of 50-100 microg/ml. So far, four extracts with MIC values < or = 100 microg/ml were tested for antitrypanosomal activity in mice, experimentally infected with Trypanosoma brucei brucei. Only, the aqueous extracts of the leaves of Terminalia avicennioides Guill. and Perr. (Combretaceae) and the stem bark of Ceiba pentandra (L.) Gaertn. (Bombacaceae) were able to reduce the parasitaemia in animals treated at the dose of 100 mg/kg b.w. (intraperitoneally, two times daily for 3 days) and of 150 mg/kg b.w. (per os, two times daily for 3 days), respectively. The reduction of parasitaemia was, however, statistically significant (p=0.002) only in case of treatment with Terminalia avicennioides.

Animals↗
PubMed2006

Antiplasmodial and GABA(A)-benzodiazepine receptor binding activities of five plants used in traditional medicine in Mali, West Africa.

Extracts of five medicinal plants: Boscia angustifolia, Cissus quadrangularis, Securidaca longipedunculata, Stylosanthes erecta and Trichilia emetica, used traditionally in Malian traditional medicine were screened for in vitro antiplasmodial activity and GABA(A)-benzodiazepine receptor binding activity. Four extracts showed significant antiplasmodial activities, with the dichloromethane extract of leaf of Securidaca longipedunculata being the most active (IC(50) of 7 microg/ml [95% CI: 5-9]). The dichloromethane extract of leaf of Trichilia emetica, in addition to its antiplasmodial activity (IC(50): 12 microg/ml [95% CI: 12-14]), exhibited a good binding activity to the GABA(A)-benzodiazepine receptor, while water and methanol extracts of the same plant did not show any activity. A strong GABA(A)-receptor complex binding activity was observed in the methanol extract of aerial part of Stylosanthes erecta. The results in this study justify some of the traditional indications of the plants investigated and may thus be candidates for Improved Traditional Medicines in Mali.

Animals↗
PubMed2004

Different antibody- and cytokine-mediated responses to Plasmodium falciparum parasite in two sympatric ethnic tribes living in Mali.

The Fulani are known to be less susceptible to Plasmodium falciparum malaria infections and to have lower parasitaemia despite living under similar malaria transmission intensity compared with other ethnic tribes. The aim of the present study was to examine whether the Fulani were more polarised towards Th2 as reflected by higher numbers of malaria-specific IL-4- and IL-10-producing cells and lower numbers of IFN-gamma- and IL-12-producing cells as compared to their neighbour ethnic tribe, the Dogon of Mali. Total IgE and both anti-malaria IgE and IgG antibodies were measured by ELISA and the numbers of IL-4-, IFN-gamma-, IL-10- and IL-12-producing cells were enumerated using enzyme-linked ImmunoSpot assay (ELISPOT). Numbers of parasite clones were detected by polymerase chain reaction (PCR). The study was performed outside the transmission period and all individuals included were asymptomatic. The results revealed that the Fulani were less parasitised, had fewer circulating parasite clones in their blood, had significantly higher anti-malaria IgG and IgE antibodies and higher proportions of malaria-specific IL-4- and IFN-gamma-producing cells compared to the Dogon. The higher antigen-specific production of IL-4 among the Fulani was statistically significant both before and after adjustment for level of spontaneous cytokine production, while greater IFN-gamma production only attained statistical significance after adjustment for spontaneous levels. Taken together, the association of higher anti-malarial IgE and IgG antibodies and increased numbers of specific IL-4- and IFN-gamma-producing cells compared to the ethnic sympatric tribe, the Dogon, may assist in explaining the lower susceptibility to malaria observed in the Fulani.

Adult↗
PubMed2006

Home management of childhood diarrhoea in southern Mali--implications for the introduction of zinc treatment.

Diarrhoea remains one of the leading killers of young children. A recent meta-analysis demonstrated that a two-week course of zinc tablets once daily significantly reduces the severity and duration of diarrhoea and mortality in young children (Bhutta et al., 2000. Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: Pooled analysis of randomized controlled trials. American Journal of Clinical Nutrition, 72(6), 1516-1522). Formative research is being conducted in a number of countries to prepare for the large-scale promotion of this new treatment. In-depth and semi-structured interviews with parents, community health workers, and traditional healers were conducted to examine the household management of diarrhoea in the Sikasso region of southern Mali in preparation for the introduction of a short-course of daily zinc for childhood diarrhoea at the community level. Supporting data from a subsequent household survey are also presented. Although nearly all parents knew oral rehydration solution (ORS) could replace lost fluids, its inability to stop diarrhoea caused parents to seek antibiotics from local markets, traditional medicines or anti-malarials to cure the illness. The notion of combining multiple treatments to ensure the greatest therapeutic benefit was prevalent, and modern medicines were often administered simultaneously with traditional therapies. As parents often deem ORS insufficient and judge that an additional treatment should be combined with ORS to cure diarrhoea, the concept of joint therapy of zinc and ORS should be well accepted in the community. Mothers-in-law and fathers, who play a significant role in decisions to seek treatment for sick children, as well as traditional healers, should also be considered when designing new programs to promote zinc. Similarities with formative research conducted for a previous generation of diarrhoea control programmes are discussed.

Child Welfare↗
PubMed2006

Knowledge, attitudes and practices of expatriates towards malaria chemoprophylaxis and personal protection measures on a mine in Mali.

A questionnaire survey of malaria chemoprophylaxis knowledge, attitudes, and practices of 90 expatriates on a Mali mine yielded 68 (75.5%) responses. A total of 49 (72%) subjects took perennial chemoprophylaxis, 6 (9%) were children <5 years. Out of 68, 13 (19%) took chemoprophylaxis during the high transmission season only and 10 (15%) never took chemoprophylaxis. Reasons advanced for not taking chemoprophylaxis were concern over adverse effects, presumed immunity from long term residence in Africa, and on site access to quality medical care. Chemoprophylactics used were: atovaquone-proguanil 1 (2%); chloroquine and proguanil 15 (30%); doxycycline 16 (33%); mefloquine 17 (35%). Thirteen out of 49 (27%) subjects admitted to missing chemoprophylaxis doses and 15/68 (22%) had suffered malaria while on chemoprophylaxis. Fifteen out of 49 (31%) low season chemoprophylaxis users and 4/19 (21%) non-users contracted low season malaria (chi(2), p=0.63). A total of 46 (68%) used insect repellants, 50 (74%) used insecticide sprays or coils in rooms, 9 (13%) slept under insecticide treated nets. Malaria control in expatriates requires improvement; additional strategies for consideration that require reduced compliance requirements by expatriates are suggested, including residual spraying, seasonal chemoprophylaxis use, and emergency stand by medication.

Age Factors↗
PubMed2005

Spleen enlargement and genetic diversity of Plasmodium falciparum infection in two ethnic groups with different malaria susceptibility in Mali, West Africa.

The high resistance to malaria in the nomadic Fulani population needs further understanding. The ability to cope with multiclonal Plasmodium falciparum infections was assessed in a cross-sectional survey in the Fulani and the Dogon, their sympatric ethnic group in Mali. The Fulani had lower parasite prevalence and densities and more prominent spleen enlargement. Spleen rates in children aged 2-9 years were 75% in the Fulani and 44% in the Dogon (P<0.001). There was no difference in number of P. falciparum genotypes, defined by merozoite surface protein 2 polymorphism, with mean values of 2.25 and 2.11 (P=0.503) in the Dogon and Fulani, respectively. Spleen rate increased with parasite prevalence, density and number of co-infecting clones in asymptomatic Dogon. Moreover, splenomegaly was increased in individuals with clinical malaria in the Dogon, odds ratio 3.67 (95% CI 1.65-8.15, P=0.003), but not found in the Fulani, 1.36 (95% CI 0.53-3.48, P=0.633). The more susceptible Dogon population thus appear to respond with pronounced spleen enlargement to asymptomatic multiclonal infections and acute disease whereas the Fulani have generally enlarged spleens already functional for protection. The results emphasize the importance of spleen function in protective immunity to the polymorphic malaria parasite.

Adolescent↗