Date: Mon, 7 Apr 2014 05:36:29 +0200 (METDST)
by Tiphaine SAINT-CRIQ

LIBREVILLE, Gabon, April 07, 2014 (AFP) - Some in Gabon believe the bitter iboga root comes from the Tree of Knowledge in the Garden of Eden. Others elsewhere have derided it as a dangerous drug.   Today a growing number of Westerners are travelling to the central African country to sample it themselves as part of an ancestral rite called Bwiti, one of Gabon's official religions.   Among them is Remy Causse, who at 45 made the long journey from France in hopes that the ritual would help him to "see more clearly".

Bwiti combines worship of ancient forest spirits with elements of Christianity. It is practiced regularly and involves ingesting the powerful psychoactive root, iboga, which has effects similar to LSD, mescaline or amphetamines.   "Iboga cleans the insides," says Tatayo, a French-Gabonese spiritual guide who receives many of the Western "bandzi", or candidates for initiation.   "The bandzi empties himself of everything bad that is buried inside before coming face to face with himself."

But the deaths, deemed accidental, of two Western initiates saw the practice come under sharp scrutiny, notably in former colonial power France where health officials warned it was "hallucinogenic and highly toxic".   A report by the Mission of Vigilance against Sectarian Abuses (Miviludes) from 2007 called Bwiti a form of cult ritual that is dangerous "both physically and mentally".

Tatayo himself concedes that "you must be closely watched when you ingest iboga".   But Bwiti shamans like Tatayo believe that when they eat iboga, they are granted the power to see the future, heal the sick and speak with the dead.    Users say it helps them to break away from negative habits, and an extract from the root is now being used in Western medicine to treat drug addicts and alcoholics.    Like many foreigners before him, Causse turned to "Tatayo", who is originally from southwest France, at his beachside concession next to the president's quarters in Gabon's capital Libreville.
  
- By the torchlight -
==========================  
Under the light of the torches, initiates, their faces painted white, intone traditional chants over the music of the Ngombi, a form of sacred harp, or the Mogongo, an instrument made of a chord strung across an arc that the musician strums with a pulsating rhythm.   Causse starts to eat the iboga, crushed into powder, which Tatayo feeds him by the spoonful until he is overcome by visions amid the deafening noise of singing and dancing by "escorts". Lying on a mat, he seems to be sleeping as his spirit "roams".   Ingested in high doses, iboga causes anxiety, extreme apprehension and hallucinations, which are enhanced by the darkness and music. Sometimes Causse rouses and begins to vomit.

The visions last all night, and it's not until the early hours of the morning that Causse wakes up. Still groggy from the experience, he is unable to walk for several hours.    Despite being "a bit scared", he said he was happy two days after shaking off the lethargy caused by the iboga root. After this he will bear the name "Moukoukou", which means "spirits".   "The ritual has given me an understanding that cannot be explained in words; it has answered many of my questions," he says.
  
- Risks of initiation -
===========================  
Few people in Gabon doubt the effectiveness of the iboga root, which is considered an important part of the country's national heritage.  The country's first president was an initiate.   Outside the country, a dozen or so deaths have been reported in the United States and Europe among people who experimented with iboga, though the exact circumstances have not been clarified. Medical reports said the victims' nervous systems and hearts appear to have been affected and the deaths generally occurred more than 20 hours after taking the root.

In Gabon, neither the French embassy nor the Gabonese health ministry would comment on the bwiti ritual, given that it involves a recognised religious practice and use of a product authorised in the country.   Yet despite the dangers and the high price that Westerners must pay for their new experiences -- Causse paid 2,800 euros ($3,800) for his three-week journey -- more and more are coming.    Tatayo says that he now receives around 20 to 25 new foreign initiates -- mainly Europeans -- a year.
Date: Thu 6 Feb 2014
Source: PLoS Neglected Tropical Diseases [edited]
<http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0002681>

Ref: Grard G, Caron M, Mombo IM, et al: Zika Virus in Gabon (Central Africa) -- 2007: A New Threat from _Aedes albopictus_?PLoS Negl Trop Dis. 2014; 8(2): e2681. doi:10.1371/journal.pntd.0002681
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Background
--------------
Chikungunya [CHIKV] and dengue [DENV] viruses emerged in Gabon  in 2007, with large outbreaks primarily affecting the capital Libreville and several northern towns. Both viruses subsequently spread to the south-east of the country, with new outbreaks occurring in 2010. The mosquito species _Aedes albopictus_, that was known as a secondary vector for both viruses, recently invaded the country and was the primary vector involved in the Gabonese outbreaks. We conducted a retrospective study of human sera and mosquitoes collected in Gabon from 2007 to 2010, in order to identify other circulating arboviruses.
--------------
Not previously considered an important human arboviral pathogen, the epidemic capacity of Zika virus (ZIKV, a dengue-related flavivirus) was revealed by the Micronesia outbreak in 2007, which affected about 5000 persons. Widely distributed throughout tropical areas of Asia and Africa, ZIKV is transmitted by a broad range of mosquito species, most of which are sylvatic or rural, _Aedes aegypti_, an anthropophilic and urban species, being considered the main ZIKV epidemic vector.

In a context of emerging arbovirus infections (CHIKV and DENV) in Gabon since 2007, we conducted a retrospective study to detect other, related viruses. In samples collected during the concurrent CHIKV/DENV outbreaks that occurred in the capital city in 2007, we detected ZIKV in both humans and mosquitoes, and notably the Asian mosquito _Aedes albopictus_ that recently invaded the country and was the main vector responsible for these outbreaks. We found that the Gabonese ZIKV strain belonged to the African lineage, and phylogenetic analysis suggested ancestral diversification and spread rather than recent introduction.

These findings, showing for the 1st time epidemic ZIKV activity in an urban environment in Central Africa and the presence of ZIKV in the invasive mosquito _Aedes albopictus_, raise the possibility of a new emerging threat to human health.
---------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
roland.hubner@sante.belgique.be
====================
[This is the 1st report of an outbreak of Zika virus infections that ProMED-mail has posted for Gabon. It is interesting that an invasive mosquito vector, in this instance _Aedes albopictus_, increased an endemic virus, ZIKV, to an outbreak situation. This invasive mosquito is proving to be a public health problem in various parts of the world because of its capacity to transmit a variety of important arthropod-borne viruses. Zika virus has been spreading recently, with outbreaks in New Caledonia and French Polynesia [see ProMED archives].

A HealthMap/ProMED-mail interactive map of Gabon can be accessed at
<http://healthmap.org/r/ahG1>. - ProMed Mod.TY]
Date: Fri, 5 Jul 2013 16:51:45 +0200 (METDST)
by Celia LEBUR

LAMBARENE, Gabon, July 05, 2013 (AFP) - Deep in the African rainforest, the small town of Lambarene this weekend marks the arrival 100 years ago of Franco-German medical missionary Albert Schweitzer whose still existing hospital now struggles to survive in spite of its 20,000 patients annually.   Born in Alsace, then part of Germany, Schweitzer, a Lutheran, set foot on the mosquito-infested shores of the Ogooue river with his wife in 1913 in what was then one of the most isolated parts of France's colonial empire.

Today patients from all over Gabon are still being treated at the hospital he founded, a few metres (yards) away from the old corrugated structures where he practised for more than 50 years.   "I am proud to head this hospital," Antoine Nziengui told AFP. "We're among the few people in the world to work in a facility that is at the same time medical and humanitarian and also does research."

Schweitzer, who was awarded the Nobel Peace Prize in 1952, set up his first small hospital in an old corrugated henhouse, formerly owned by a nearby Protestant mission post.   Over the years the site developed into a proper hospital village where he worked until his death in 1965.   Schweitzer's belongings, including many letters and German-language bibles but also an organ which he played every day to be fit for fund-raising concerts in Europe, are kept at his former home, now a museum.  His tomb overlooks the river.

Gabon has asked the United Nations Organization for Education, Science and Culture (UNESCO) to include the site in its World Heritage List, but some wonder what will become of the hospital which has become run-down and is lacking 21st-century equipment.   Funds raised by the hospital foundation and Gabon's annual subsidies of about 1.5 million euros are far from sufficient to run the hospital properly.    It does not provide magnetic resonance imaging (MRI) and in spite of a high birth rate in the region has only four incubators that according to Doctor Nziengui "do not really work" as they should.   "The hospital should be run like a company... We're treating patients even if they can't pay," said Nziengui.   "It's good to have a social sensibility but it comes with a price."

In 2009 a new hospital with state-of-the-art equipment opened on the other side of town, after President Ali Bongo Ondimba pushed for Lambarene to become a major medical centre so that Schweitzer's legacy "will continue to shine".   By the end of the year authorities also hope to open an international clinical centre that will carry Schweitzer's name and also do research into tropical diseases.   On Saturday and Sunday, Lambarene will host dozens of renowned scientists and doctors, heads of state and humanitarian workers who will pay homage to Schweitzer's work.   An international conference will also discuss the three epidemics that continue to leave a heavy toll among Africans: malaria, tuberculosis and HIV/AIDS.
Date: Thu 13 Dec 2012
Source: Xinhua News Agency [in French, machine trans. ProMed Corr.SB, edited]
<http://french.news.cn/afrique/2012-12/13/c_132039369.htm>

The Gabonese Ministry of Health announced on Wednesday [12 Dec 2012] that 150 suspected cases of chikungunya, a [virus] disease spread by mosquitoes that causes severe pain, had been recorded at the Melen regional hospital in the eastern outskirts of Libreville.

"From the clinical point of view, this strongly suggests an outbreak of chikungunya," said the statement read out on television by the Gabonese media adviser to the Ministry of Health, Marie Josee Ndombi. According to the text, samples are being examined to ascertain the origin of the epidemic of "fever, headache, muscle and joint pain raging in Libreville."

In late November, the Ministry of Health recognized the existence of an outbreak of chikungunya in the city of Mouila, 444 km [275 mi] south of Libreville.

At Mouila, as in Libreville, patients complained of the same symptoms -- partial paralysis of the lower limbs, abdominal pain, fever, flu, and headaches.

This is the 2nd time chikungunya has been reported in Gabon. The 1st outbreak took place in 2007. More than 21 000 Gabonese were infected. Crisis committees were set up at airports and in health centers, the latter against resurgence. Unlike malaria, chikungunya [virus], also transmitted by mosquitoes, is not as deadly. The disease is cured without complications.

The government recommends wearing long clothes at night, sleeping under an impregnated mosquito net from a health center, and destroying all mosquito breeding centers such as stagnant water.
======================
[This is the 3rd time that chikungunya virus outbreaks in Gabon have been reported by ProMED-mail, the 1st in 2007 and the 2nd in 2010. The partial paralysis reported in the cases above may be a reluctance by infected individuals to move due to intense joint and muscle pain that is characteristic of chikungunya virus infections. ProMED-mail would appreciate receiving results of laboratory tests on samples sent in to confirm (or refute) the clinical diagnosis.

A HealthMap/ProMED-mail map of Gabon can be accessed at
<http://healthmap.org/r/1zl4>. - ProMed Mod.TY]
Date: Fri, 15 Jun 2012 14:45:16 +0200 (METDST)

Libreville, June 15, 2012 (AFP) - Nineteen students who tried to halt courses at the Omar Bongo University (UOB) in Gabon have been released after being held in police cells, student and legal sources said Friday.  "We're released on bail," Firmin Ollo, one of the leaders of the detained students told AFP. Each of the students is to appear before a judge next week.

Four students were freed during the day on Thursday and the others were released at the end of the evening. "They are accused of disturbing the peace and are called before the judge next week, some on Monday and others on Tuesday and Wednesday," the lawyer for the students, Gisele Eyue Bekale, said.

The students were arrested on Monday while trying to disrupt teaching at the university in Libreville, where many students have been on strike since January to back calls for grants and an end to the age limit of 27 for eligibility for funds. The strike action has led to several clashes with the security forces. One student witness, Celestin Mito-Mito, said that "some of the arrested students turned themselves in". The detention conditions of the 19 drew the attention of opposition figures and human rights activists in the central African country, who published photos of 12 students held in a single small cell on social networking websites.
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