Characterizing visual field loss from past mercury exposure in an Indigenous riverine community (Grassy Narrows First Nation, Canada): a cluster-based approach.

Background: Between 1962 and 1975, a chlor-alkali plant in Canada discharged approximately 9 metric tons of mercury (Hg) into the Wabigoon River. Over the following decades, biomarkers of Hg exposure of persons from Grassy Narrows First Nation (Asubpeeschoseewagong Anishinabek), located downriver from the discharge, reflected Hg concentrations in fish. Hg exposure is known to target the calcarine fissure, resulting in visual field (VF) loss.

The evolution of symptoms of nervous system dysfunction in a First Nation community with a history of mercury exposure: a longitudinal study.

Background: Since the 1960's, mercury (Hg) contamination of the aquatic environment of Asubpeeschoseewagong Anishinabek (Grassy Narrows First Nation) territories has impacted the community members' traditions, culture, livelihood, diet and health. Despite decreasing Hg exposure over time, a recent study suggested that long-term exposure contributed to later-life symptom clusters of nervous system dysfunction. Here, the objective was to evaluate, 5 years later, the prevalence and progression of these symptoms and examine the contribution of long-term, past Hg exposure.

Visual Characteristics of Adults with Long-Standing History of Dietary Exposure to Mercury in Grassy Narrows First Nation, Canada.

Since the 1960s, Grassy Narrows First Nation (Ontario, Canada) has been exposed to methyl mercury (Hg) through fish consumption, resulting from industrial pollution of their territorial waters. This cross-sectional study describes the visual characteristics of adults with documented Hg exposure between 1970 and 1997. Oculo-visual examinations of 80 community members included visual acuity, automated visual fields, optical coherence tomography [OCT], color vision and contrast sensitivity.

Past mercury exposure and current symptoms of nervous system dysfunction in adults of a First Nation community (Canada).

Background: The watershed in Asubpeeschoseewagong Netum Anishinabek (Grassy Narrows First Nation) territory has been contaminated by mercury (Hg) since 1962, resulting in very high Hg concentrations in fish, central to the community's culture, traditions, economy and diet. Biomarkers of Hg exposure (umbilical cord blood and hair/blood samples), monitored between 1970 and 1997, decreased over time. A recent Grassy Narrows Community Health Assessment (GN-CHA) survey included current symptoms of nervous system dysfunction.

Mercury exposure and premature mortality in the Grassy Narrows First Nation community: a retrospective longitudinal study.

Background: Little is known about the influence of toxic exposures on reduced life expectancy in First Nations people in Canada. The Grassy Narrows First Nation community have lived with the consequences of one of the worst environmental disasters in Canadian history. In the early 1960s, 10 000 kg of mercury (Hg) was released into their aquatic ecosystem.

SMS-based smartphone application for disease surveillance has doubled completeness and timeliness in a limited-resource setting - evaluation of a 15-week pilot program in Central African Republic (CAR).

Background: It is a challenge in low-resource settings to ensure the availability of complete, timely disease surveillance information. Smartphone applications (apps) have the potential to enhance surveillance data transmission.

Methods: The Central African Republic (CAR) Ministry of Health and Médecins Sans Frontières (MSF) conducted a 15-week pilot project to test a disease surveillance app, Argus, for 20 conditions in 21 health centers in Mambéré Kadéi district (MK 2016).

A multi-faceted pandemic: a review of the state of knowledge on the Zika virus.

While until recently the small and isolated Zika outbreaks in Eastern Asia and Pacific islands had been overlooked, the large-scale outbreak that started in Brazil in 2015 and the increase of microcephaly cases in the same place and time made media headlines. Considered as harmless until recently, Zika has given rise to an important global crisis that poses not only health challenges but also environmental, economical, social, and ethical challenges for states and people around the world. The main objective of this paper is to review the recent Zika outbreak by covering a broad range of disciplines and their interactions.

Using routine health data and intermittent community surveys to assess the impact of maternal and neonatal health interventions in low-income countries: A systematic review.

Background: There is a need to provide increased evidence on effective interventions to reduce maternal and neonatal mortality in low- and middle-income countries (LMICs).

Objectives: To summarize the breadth of knowledge on using routine data (Routine Health Information Systems [RHIS] and Intermittent Community Surveys [ICS]) for well-designed maternal and neonatal health evaluations in LMICs.

Search Strategy: We searched reports and articles published in Embase, Medline, and Google scholar.

The free caesareans policy in low-income settings: an interrupted time series analysis in Mali (2003-2012).

Introduction: Several countries have instituted fee exemptions for caesareans to reduce maternal and newborn mortality.

Objectives: To evaluate the effect of fee exemptions for caesareans on population caesarean rates taking into account different levels of accessibility.

Methods: The observation period was from January 2003 to May 2012 in one Region and covered 11.

No effect of user fee exemption on perceived quality of delivery care in Burkina Faso: a case-control study.

Background: Although many developing countries have developed user fee exemption policies to move towards universal health coverage as a priority, very few studies have attempted to measure the quality of care. The present paper aims at assessing whether women's satisfaction with delivery care is maintained with a total fee exemption in Burkina Faso.

Methods: A quasi-experimental design with both intervention and control groups was carried out.

Developing a tool to measure satisfaction among health professionals in sub-Saharan Africa.

Background: In sub-Saharan Africa, lack of motivation and job dissatisfaction have been cited as causes of poor healthcare quality and outcomes. Measurement of health workers' satisfaction adapted to sub-Saharan African working conditions and cultures is a challenge. The objective of this study was to develop a valid and reliable instrument to measure satisfaction among health professionals in the sub-Saharan African context.

Toxic risks and nutritional benefits of traditional diet on near visual contrast sensitivity and color vision in the Brazilian Amazon.

Background: Visual functions are known to be sensitive to toxins such as mercury (Hg) and lead (Pb), while omega-3 fatty acids (FA) and selenium (Se) may be protective. In the Tapajós region of the Brazilian Amazon, all of these elements are present in the local diet.

Objective: Examine how near visual contrast sensitivity and acquired color vision loss vary with biomarkers of toxic exposures (Hg and Pb) and the nutrients Se and omega-3 FA in riverside communities of the Tapajós.

Emergency obstetric care in Mali: catastrophic spending and its impoverishing effects on households.

Objective: To investigate the frequency of catastrophic expenditures for emergency obstetric care, explore its risk factors, and assess the effect of these expenditures on households in the Kayes region, Mali.

Methods: Data on 484 obstetric emergencies (242 deaths and 242 near-misses) were collected in 2008-2011. Catastrophic expenditure for emergency obstetric care was assessed at different thresholds and its associated factors were explored through logistic regression.

Birth seasonality as a response to a changing rural environment (Kayes region, Mali).

Birth seasonality responds to a variety of environmental and socio-cultural factors. The present study was carried out to quantify the trends in seasonal variation in birth rate in seven districts in the Kayes region of Mali between 2007 and 2010 and to attempt to link climatic- and agricultural-cycle-dependent factors with birth seasonality. Lagged regression analysis based on time series analysis techniques was used to investigate seasonality of births registered in health facilities and its association with climate, labour migration, agriculture workload, malaria infection and food supply.

The effects of midwives' job satisfaction on burnout, intention to quit and turnover: a longitudinal study in Senegal.

Background: Despite working in a challenging environment plagued by persistent personnel shortages, public sector midwives in Senegal play a key role in tackling maternal mortality. A better understanding of how they are experiencing their work and how it is affecting them is needed in order to better address their needs and incite them to remain in their posts. This study aims to explore their job satisfaction and its effects on their burnout, intention to quit and professional mobility.

Neurotoxic sequelae of mercury exposure: an intervention and follow-up study in the Brazilian Amazon.

Since 1995, the Caruso Project used an Ecosystem Approach to Human Health to examine mercury (Hg) exposure in fish-eating communities in the Brazilian Amazon and develop interventions to maximise nutrition from traditional diet and minimise toxic risk. In 1995, 2000 and 2006, this study followed fish consumption, Hg levels, and visual and motor functions in 31 villagers. Questionnaires gathered information on socio-demographics and diet.

Visual acuity in fish consumers of the Brazilian Amazon: risks and benefits from local diet.

Objective: To examine the associations between near and distant visual acuity and biomarkers of Hg, Pb, n-3 fatty acids and Se from the local diet of fish-eating communities of the Tapajós River in the Brazilian Amazon.

Design: Visuo-ocular health and biomarkers of Hg (hair, whole blood, plasma), Pb (whole blood), Se (whole blood and plasma) and n-3 fatty acids (plasma total phospholipids) were assessed in a cross-sectional study.

Setting: Lower Tapajós River Basin (State of Pará, Brazil), May to July 2006.

No evidence of selenosis from a selenium-rich diet in the Brazilian Amazon.

Selenium (Se) is an essential element and a well-known anti-oxidant. In the Lower Tapajós River region of the Brazilian Amazon, biomarkers of Se range from normal to very high. The local traditional diet includes important Se sources such as Brazil nuts, chicken, game meat and certain fish species.

Selenium and mercury in the Brazilian Amazon: opposing influences on age-related cataracts.

Background: Age-related cataracts (ARCs) are an important cause of blindness in developing countries. Although antioxidants may be part of the body's defense to prevent ARC, environmental contaminants may contribute to cataractogenesis. In fish-eating populations of the lower Tapajós region, elevated exposure to mercury (Hg) has been reported, and blood levels of selenium (Se) range from normal to very high (> 1,000 microg/L).

An exploratory study of diabetes in a First Nation community with respect to serum concentrations of p,p'-DDE and PCBs and fish consumption.

This study examined the association between self-reported diabetes, fish consumption and serum levels of organochlorines in a First Nation community. One quarter of the 101 participants reported diabetes. Serum PCBs, but not p,p'-DDE, were positively correlated to consumption frequency of total fish, walleye and pike, but not trout.

Elevated blood lead levels in a riverside population in the Brazilian Amazon.

Lead (Pb) is recognized as one of the most toxic metals. Sources of Pb exposure have been widely documented in North America, and the removal of Pb additives from gasoline was reflected in a dramatic lowering of blood Pb concentration. In Latin America, the removal of Pb from gasoline resulted in decreased exposure, but Pb levels in many areas remain high due to occupational and environmental sources of exposure.

Neuropsychiatric symptoms, omega-3, and mercury exposure in freshwater fish-eaters.

Mercury is a neurotoxin, absorbed primarily through fish consumption. However, the nutritional benefit from omega-3 fatty acids (n-3 FA) may offset the deleterious effects of mercury. Increased n-3 FA have been associated with lower rates of mood disorders.