On January 19th, 2022,  the Institut Pasteur de Dakar, member of the Pasteur Network and the Coalition for Epidemic Preparedness Innovations (CEPI) and announced a 10-year partnership in which CEPI will invest up to $50 million. This collaboration aims to advance equitable access to vaccines in Africa and contribute to the African Union’s goal of increasing African manufacturers’ share of vaccine supply to the continent to 60% by 2040.

CEPI’s investment will complement that of other major funders for the project MADIBA, including European Union, the European Investment Bank (EIB), the AFD – Agence Française de Développement, the Islamic Development Bank (IsDB), the IFC – International Finance Corporation, the U.S. International Development Finance Corporation, the German Government, and the Government of Senegal.

For more information:
CEPI’s news: https://cepi.net/news_cepi/cepi-and-institut-pasteur-de-dakar-announce-10-year-partnership-to-boost-manufacturing-of-affordable-vaccines-for-the-global-south/
Institut Pasteur de Dakar’s announcement: https://www.linkedin.com/feed/update/urn:li:activity:7021806481087811584/?updateEntityUrn=urn%3Ali%3Afs_feedUpdate%3A%28V2%2Curn%3Ali%3Aactivity%3A7021806481087811584%29

Due to globalization and the spread of vectors such as mosquitoes, dengue disease is an increasing burden on public health across the world. Rapid detection of vector species, and prevention of their establishment can be achieved by tracking vectors.  Scientists from the Pasteur Network, based at the Institut Pasteur de Nouvelle-Calédonie, the Institut Pasteur du Camboge, the Institut Pasteur du Laos and the Institut Pasteur de Madagascar, published an article in Plos One showing MALDI-TOF MS as a promising tool that could be used for an international surveillance of mosquito vectors of arbovirus.

A public health burden

Dengue virus is a pathogen transmitted to humans by vector mosquitoes. It causes mostly mild illness or flu-like syndromes. However, repeated infections are known to cause severe and potentially fatal clinical forms, called severe dengue.

Due to globalization, the geographical distribution of mosquitoes known to transmit the dengue virus is increasing, particularly in non-endemic regions. Dengue global incidence has increased eightfold in the last decades with an estimation of 390 million infected individuals per year across the world.[1] The dispersal risk highlights the need to improve vectors surveillance, ensuring rapid detection of introduced vector species and prevention of their establishment in new areas. The surveillance relies on accurate species identification of the vectors. Aedes aegypti and Aedes albopictus, as known as the tiger mosquito, which have a worldwide distribution, are the well-known vectors of dengue virus. However, in the Pacific region, at least 9 other species belonging to the Scutellaris Group mosquitoes are present and are confirmed or potential vectors of dengue virus.

MALDI-TOF MS for a global surveillance of mosquitoes

Mosquitoes of the Scutellaris Group are morphologically similar and pre-existing DNA sequence information is often unavailable. Therefore, scientists from the Pasteur Network, assessed the use of Matrix-Assisted Laser Desorption Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS) in identifying these dengue virus vector species.  MALDI-TOF MS is a method that generates protein spectra specific for each species.

Field-mosquitoes belonging to 8 species[2] from 6 countries in the Pacific, Asian and Madagascar, were included in this study carried out by the Institut Pasteur de Nouvelle-Calédonie, in collaboration with the Institut Pasteur du Cambodge, Institut Pasteur du Laos and the Institut Pasteur de Madagascar. Analysis provided evidence that a MALDI-TOF database created using mosquitoes from the Pacific region allowed suitable identification from the other regions. This technic was as efficient as the DNA sequencing method in identifying mosquito species. Indeed, for the most cases, an exact species identification was obtained for all individual mosquitoes even for morphologically and phylogenetically closely related species. Ultimately, these findings highlight that the MALDI-TOF MS is a promising tool that could be used for a global comprehensive arbovirus vectors surveillance.

For more information:
MALDI-TOF MS: An effective tool for a global surveillance of dengue vector species
Plos One, October 2022.
Antsa Rakotonirina*, Morgane Pol, Fara Nantenaina Raharimalala, Valentine Ballan, Malia Kainiu, Sébastien Boyer, Sosiasi Kilama, Sébastien Marcombe, Sylvie Russet, Emilie Barsac, Rama Vineshwaran, Malia Kaleméli Selemago, Vincent Jessop, Geneviève Robic, Romain Girod, Paul T. Brey, Julien Colot, Myrielle Dupont-Rouzeyrol, Vincent Richard, Nicolas Pocquet
*Corresponding author.
DOI: https://doi.org/10.1371/journal.pone.0276488

[1] https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue

[2] Ae. aegypti, Ae. albopictus, Ae. polynesiensis, Ae. scutellaris, Ae. pseudoscutellaris, Ae. malayensis, Ae. futunae and Culex quinquefasciatus

The Institut Pasteur de Madagascar in collaboration with the Institut Pasteur de Tunis and the Institut Pasteur, in Paris, all three members of the Pasteur Network, are organizing a course entitled “Les dimensions sociales des épidémies”. During 5 days, from April 17th to 21th, 2023, at the Institut Pasteur de Madagascar, the 25 participants will be able to strengthen their knowledge and capacities in Human and Social Sciences (HSS). HSS researchers of the Pasteur Network in Africa or involved in the Afroscreen project who speak French and are interested can apply until January 15th, 2023.

This course, carried out with the support of the Sonar Global and Afroscreen projects, is part of the capacity building process in Human and Social Sciences (HSS) at the level of the Pasteur Network and more broadly of African research and health institutes. 25 participants will be selected among the candidates who will have applied before January 15th, 2023 by filling the dedicated Google Form.

The courses will be given in person during 5 days by trainers from the Institute of Research in Health Sciences of Burkina Faso, the Social Sciences Pole of the Regional Center of Research and Training in Clinical Management of Fann in Dakar, Senegal, the Center of Research and Training in Infectiology of Guinea, the Higher Institute of Human Sciences of Tunis, the Institut Pasteur in Paris and the Institut Pasteur de Madagascar.

Applicant Profiles:
Researchers in SHS anthropologists, sociologists, specialists in education sciences, human geography, historians and data scientists applied to health who speak French.

Researchers from Pasteur Network members in Africa or researchers involved in the Afroscreen project (IRD, ANRS|MIE networks).


For more information:
Application area: https://forms.gle/sNcAVwcVycHrjLXM9
Article dedicated to the Institut Pasteur de Madagascar (in French): https://www.pasteur.mg/offres/appel-a-candidature-cours-du-pasteur-network-les-dimensions-sociales-des-epidemies-du-17-au-21-avril-2023-lieu-institut-pasteur-de-madagascar/

On December 09th, 2022 was held the 2021-2022 Institut Pasteur PhD Graduation Ceremony. Three graduates represented Pasteur Network: Dr Habib for the Institut Pasteur de Madagascar, Dr Lyu for the HKU-Pasteur Research Pole and Dr Modiyinji for the Pasteur Center in Cameroon. After the introductory speech of the guest of honor, Prof. Ugur Sahin, Professor of Translational Oncology and Immunology at the University of Mainz and CEO of BioNTech, all had a few minutes to present their background.

Dr. Azimdine Habib

Always have a goal in life and give yourself all the means to achieve it. Never be afraid of failure but learn from it to move forward”

Defended thesis

Relationship between gut microbiota composition and parasitic infestation in children in a malnutrition context

Dr. Azimdine Habib is originally from the Comoros Islands where he obtained his bachelor’s degree in Life Sciences in 2012. His master’s degree in Fundamental and Applied Biochemistry, option Biochemistry, Biodiversity and Health has brought him to Madagascar. He joined the Institut Pasteur de Madagascar during his second year in the bilharzia laboratory. In 2016, he was recruited as a laboratory technician in the experimental bacteriology unit. In 2017, he began his PhD under the supervision of Dr. Jean-Marc Collard. His thesis explores the link between the composition of the intestinal microbiota and intestinal parasites, especially in children with malnutrition. As part of the “My Thesis in 180 seconds” competition, organized by the Institut Pasteur de Madagascar, Azimdine Habib presented his thesis to a non-scientific audience and won first place in the 2nd edition. He then defended his thesis in December 2021. In October 2022, he joined the BIOMICS technology platform of the Institut Pasteur, also a member of the Pasteur Network, as a research engineer where he is interested in next generation sequencing.

Dr. Huibin Lyu

“Practice is the sole criterion for testing truth”

Defended thesis

Investigation of the cross-reactive humoral responses to SARS-CoV-2 in human and mice

Dr. Huibin Lyu, aka Tomas, has started his research journey at the Guangdong University of Technology in China, investigating the anti-bacterial and anti-tumor functions of Curcumin. This first encounter with research has spurred him to begin his second Master regarding virology and immunology at Guangzhou Medical University. Especially, he focused on cross-reactive monoclonal antibody screening against the influenza A virus. Under a Doctoral Grants Calmette & Yersin scholarship, he joined the HKU-Pasteur Research Pole, member of the Pasteur Network, to carry out his Ph. D. in Prof. Roberto Bruzzone and Dr. Chris Mok’s group. His initial Ph. D. research proposal was a continuation of his master’s degree and focused on the antibody response after the first influenza infection in the newborn and the specialization of the immune system in the mouse model. In response to the Covid-19 pandemic, Dr. Lyu shifted his focus to another virus, SARS-CoV-2, and contributed to a better understanding of the immune response to this virus. In September 2022, he defended his dissertation on the cross-reactions of the immune system to SARS-CoV-2 in humans and mice. Dr. Lyu is now a post-doctoral fellow at the University of Illinois Urbana-Champaign where he is working to identify signatures of human antibodies against different pathogens.

Dr. Abdou Fatawou Modiyinji

“Science has no homeland”

Defended thesis

Study of the prevalence and molecular characterization of hepatitis E virus among animal and human populations in Cameroon: Evaluation of interspecies transmission

Dr. Abdou Fatawou Modiyinji completed his studies at the Faculty of Sciences of the University of Yaoundé 1 in Cameroon. In 2012, he obtained his bachelor’s degree in Biology of Animal Organisms. He continued with a master’s degree in Parasitology and Ecology which he obtained in 2015. He then carried out a PhD at the Department of Animal Biology and Physiology and the Centre Pasteur du Cameroun, a member of the Pasteur Network. His thesis, the first study of its kind in Cameroon, focused on hepatitis E among human and animal populations in the country. In addition to characterizing the genotypes of the hepatitis E virus in humans, it highlighted a high seroprevalence of the virus in both populations suggesting an interspecies transmission of the hepatitis E virus in Cameroon. Abdou Fatawou Modiyinji, author of several publications during his thesis, defended his thesis in July 2022. He is now studying enteroviruses as a post-doctoral researcher at the Pasteur Center in Cameroon.

During the Pasteur Network Annual Meeting from November 28 to 30, 2022 in Rome, Dr. Norosoa Razanajatovo, from the Institut Pasteur de Madagascar received the Pasteur Network Talent Award 2022[1] issued by the President of the Institut Pasteur, Stewart Cole.

Dr Norosoa Razanajatovo joined the National Influenza Centre (NIC) of the Virology Unit of the Institut Pasteur of Madagascar in 2013 as a research engineer. She received her doctorate with an option of applied biochemistry in medical sciences, which she obtained in 2015. Carried out under the supervision of Dr. Jean-Michel Héraud, her thesis work, which focused on the identification and molecular characterization of respiratory viruses circulating in Madagascar, has helped to implement a better prevention strategy against respiratory diseases. Norosoa Razanajatovo has notably played a role for the implementation of the program to develop national surveillance of influenza in collaboration with the Ministries of Malagasy Public Health and Livestock.

From 2016, she became technical manager and deputy chief of the National Center for Influenza. The same year, she was also appointed WHO technical advisor. Over the years, she has acquired solid experience in the field of surveillance of respiratory viruses through the management of various epidemics such as H1N1 influenza, or more recently, COVID-19. In 2022, she was promoted researcher. She coordinates laboratory surveillance of viral respiratory infections and associated research programs.

A good surveillance system is important to master an epidemic, but an effective and up -to -date research strategy is the keystone to achieve this.”

She studies the viral causes of acute respiratory infections, the identification of a seasonal characteristics for common respiratory viruses, the development of predictive diagnostic tools and molecular biology of human and zoonotic viruses.

Her latest project focuses on the dynamics of the introduction and dissemination of respiratory viruses relevant for human and animal health for the country and worldwide. In parallel, Dr. Norosoa Razanajatovo is invested in the transmission of her knowledge by the supervision of different students, by holding training workshops for local and regional laboratories and by training the staff of regional institutions in the executive training program in field epidemiology. With regard to her commitment and her career, she received the Pasteur Network Talent Award 2022 at the Annual Meeting on November 28, 2022 in Rome.

For more information:
Article from the Institut Pasteur de Madagascar: https://www.pasteur.mg/dr-norosoa-harline-razanajatovo-laureate-du-prix-pasteur-network-talent-award-2022/

[1] Each year, the Pasteur Network Talent Award recognizes one or two Pasteur Network researchers who are the future leaders of the network.

Following the recent outbreak of monkeypox, researchers from the Pasteur Network and ANRS | Emerging Infectious Diseases have published a complete portrait of the disease in the New England Journal of Medicine. This is an opportunity to review the signs of the disease, its origin, and also the projects undertaken by the Pasteur Network, such as AFRIPOX, supported by the Institut Pasteur and in collaboration with the Institut Pasteur de Bangui.

All information on this publication can be found in the dedicated article on the Institut Pasteur website.

For more information:
Article from the Institut Pasteur: Monkeypox: a detailed profile of the disease
Review article: Monkeypox
New England Journal of Medicine, 26 octobre 2022.
Antoine Gessain, M.D., Emmanuel Nakoune, Ph.D., and Yazdan Yazdanpanah, M.D.
DOI: 10.1056/NEJMra2208860

During an epidemic, it can happen that no diagnostic test is perfectly adapted to the pathogen. In order to contain the epidemic as quickly as possible, screening is done using several tests. The interpretation of the results of the different tests becomes more complex, which can make individual diagnosis difficult and lead to an underestimation of the disease’s prevalence. Using the plague outbreak that affected Madagascar in 2017 as a case study, researchers from the Institut Pasteur and the Institut Pasteur de Madagascar propose an analytical framework to characterize the performance of different tests and estimate the true prevalence of the outbreak. Published in the journal Plos Biology, these results will help improve the quality of diagnosis during future epidemics.

Between August and November 2017, 2,414 cases clinically suspected of carrying Yersinia pestis, the plague bacillus, were reported, with a large proportion of pulmonary plague. The samples were analyzed using three types of diagnostic tests: bacterial culture, rapid plague test, and molecular biology or qPCR. Significant discrepancies were observed between the different tests, making interpretation of the results complex. The greatest uncertainty related to the extent of the pneumonic plague outbreak, with positive cases ranging from 1% to 18%. The analytical framework used in this study estimated that 7-15% of suspected cases were carriers of Yersinia pestis for this outbreak.  

Estimating the performance of a diagnostic test

Two parameters, specificity and sensitivity, determine the performance of a test. Specificity is the probability of being found negative when uninfected while sensitivity is the probability of being found positive when infected. When there is a reference test with perfect sensitivity and specificity, it is easy to estimate the sensitivity and specificity of other tests by comparing them to the reference test. In the absence of a reference test, as was the case for this plague epidemic, the authors had to estimate the performance of each test and then the prevalence of the epidemic. To do this, they used the latent class method, which is based on the comparison of the results of different imperfect tests. This analysis revealed that molecular biology had the best performance; and that the rapid detection test had limited specificity during the 2017 plague outbreak. Its performance was better the following year, 2018, suggesting that the context of response to a large epidemic can impact diagnostic quality.

Combining results to reconstruct an epidemic

Once the performance of the different tests was known, the researchers determined how to improve case classification algorithms to minimize the risk of false positives and false negatives. They were also able to reconstruct, in a more refined way, the epidemiological trends of the epidemic in space and time. Better classification of cases is particularly important for the allocation of scarce resources, for example by accurately targeting contact tracing efforts where incidence is highest. This avoids deploying resources to false positives and maximizes the impact of mobile testing facilities.

While the development and availability of high quality diagnostics remains a priority, this analytical framework could be a valuable tool to reduce uncertainty for other infectious diseases that lack reference diagnostics. For example, it is already used by the Institut Pasteur de Madagascar to diagnose tuberculosis.

For more information:
Evaluating and optimizing the use of diagnostics during epidemics: Application to the 2017 plague outbreak in Madagascar
Plos Biology, August 15th, 2022.
Quirine ten Bosch†*, Voahangy Andrianaivoarimanana, Beza Ramasindrazana, Guillain Mikaty, Rado JL Rakotonanahary, Birgit Nikolay, Soloandry Rahajandraibe, Maxence Feher, Quentin Grassin, Juliette Paireau, Soanandrasana Rahelinirina, Rindra Randremanana, Feno Rakotoarimanana, Marie Melocco,Voahangy Rasolofo, Javier Pizarro-Cerda, Anne-Sophie Le Guern, Eric Bertherat, Maherisoa Ratsitorahina, André Spiegel, Laurence Baril, Minoarisoa Rajerison, Simon Cauchemez
† These authors contributed equally to this work.
* Corresponding author.

A study conducted as part of the Afriobiota project involving several members of the Pasteur Network, in collaboration with the University of Lausanne, unravels the link between the gut ecosystem and stunting that affects undernourished children. The results of this research that included nearly 1,000 children aged 2 to 5 years between 2016 and 2018 are published in the journal PNAS.

In children, undernutrition – the consumption and/or assimilation of insufficient food to cover the body’s needs – manifests itself mainly through stunted growth. According to the Food and Agriculture Organization of the United Nations, 22% of children under 5 years of age worldwide will be affected by stunting (estimate for the year 2020).

This study focuses on the role of gut microbial communities (microbiota) in undernutrition. This research was coordinated by Prof. Philippe Sansonetti and conducted within the Pasteur Network. It was conducted over a period of six years by the Institut Pasteur in collaboration with the Institut Pasteur de Madagascar and the Institut Pasteur de Bangui as part of the Afriobiota project supported by the Total Foundation.

The work, carried out in Madagascar and the Central African Republic on 1,000 children aged 2 to 5 years, showed that more than 80% of stunted children have an abnormal bacterial overgrowth in the small intestine (SIBO). More specifically, these are bacteria initially present in the mouth that proliferate in the small intestine. Using experimental models (cell cultures and mice), researchers have shown that this phenomenon slows down the assimilation of lipids. This malabsorption of fats could partly explain the growth retardation suffered by children.

For more information:
Stunted children display ectopic small intestinal colonization by oral bacteria, which cause lipid malabsorption in experimental models
PNAS, October 05th, 2022.
Pascale Vonaesch*, João R. Araújo, Jean-Chrysostome Gody, Jean-Robert Mbecko, Hugues Sanke, Lova Andrianonimiadana, Tanteliniaina Naharimanananirina, Synthia Nazita Ningatoloum, Sonia Sandrine Vondo, Privat Bolmbaye Gondje, Andre Rodriguez-Pozo, Maheninasy Rakotondrainipiana, Kaleb Jephté Estimé Kandou, Alison Nestoret, Nathalie Kapel, Serge Ghislain Djorie, B. Brett Finlay, Laura Wegener Parfrey, Jean-Marc Collard, Rindra Vatosoa Randremanana, Philippe J. Sansonetti* and The Afribiota Investigators
* Corresponding authors.
Flash Research of the University of Lausanne

Monkeypox virus (MPXV) is a neglected tropical pathogen whose recent emergence has accelerated its study. In this context, Pasteur Network researchers have developed rapid MPXV diagnostic tests that can be viewed by the naked eye in less than 30 minutes, and are as consistent as the current PCR-based nucleic acid test used for MPXV diagnostics. This new diagnostic tool will contribute to the control and prevention of MPXV epidemics.

In May 2022, outbreaks of monkeypox virus (MPXV) were reported simultaneously in Europe, North America and South America, outside the virus-endemic regions of Africa. Pasteur Network researchers collaborated to develop and validate tests for the rapid detection of MPXV. These newly designed tests can produce reliable fluorescence or lateral flow results on a strip in 20 to 30 minutes. Led by the teams of Emmanuel Nakouné (Institut Pasteur de Bangui) and Nicolas Berthet and Gary Wong (Institut Pasteur de Shanghai), the study presenting the results of these rapid diagnostic tests was published in the journal Viruses.

The tests are based on isothermal amplification of a targeted region of the virus genome, and are based on recombinase with or without CRISPR/Cas12. The tests gave consistent results with the reference molecular test, PCR in real time, for the 19 clinical samples used to validate the assay. In addition, the tests were specific and did not cross-react with other pox viruses, such as vaccinia.

MPXV, a neglected tropical pathogen, is closely related to smallpox, a disease that has been eradicated in humans since the 1980s. Although MPXV epidemics are regularly reported in Africa among the poorest communities, it remains understudied, even after the first MPXV epidemic was reported outside the endemic areain the USA during 2003. Rapid, sensitive and specific detection of MPXV is essential to inform health authorities of suspected cases as soon as possible, in order to monitor epidemic developments. These results therefore provide a point-of-care platform for the early diagnosis of potential MPXV cases, and will contribute to the prevention and control of current and future MPXV epidemics.

For more information:
Article from the Institut Pasteur de Bangui (in French)
Development and Characterization of Recombinase-Based Iso-thermal Amplification Assays (RPA/RAA) for the Rapid Detection of Monkeypox virus
Viruses, September 2022.
Lingjing Mao, Jiaxu Ying, Benjamin Selekon, Ella Gonofio, Xiaoxia Wang, Emmanuel Nakoune, Gary Wong*, Nicolas Berthet*
* Corresponding authors.

The first conference of French-speaking science journalists was held in Dakar from October 10th to 16th, 2022. It was attended by nearly 60 journalists from more than 20 countries[1]. The Pasteur Network partnered with the event with the aim of sharing the scientific knowledge of its members, all of which are experts in global health. The idea was to bring scientists and journalists together to ensure that only factually verified scientific information reaches the public. Several scientists from the Institut Pasteur de Dakar spoke at the event, demonstrating this commitment to delivering quality scientific information.

The conference was organized by the French-speaking Africa Science Journalists’ Network (RJSAF) with the French Association of Science Journalists (AJSPI), the Quebec Association of Science Communication (ACS) and the Swiss Association of Science Journalism (SASJ). It was held at the Center for Studies in Information Science and Technology (CESTI) at Cheikh Anta Diop University (UCAD).

The main theme of the conference was journalism and the climate crisis. Several of the topics proposed by the organizers were related to health, an area of expertise for Pasteur Network members like the Institut Pasteur de Dakar.

Neglected and emerging diseases in Africa 

Dr. Xavier Berthet, the Institut Pasteur de Dakar’s, Scientific Director, spoke alongside Dr. Digas Ngolo Tete from DNDi during an expert panel discussion on “Neglected and emerging diseases in Africa” on Monday October 10th, the opening day of the conference. Their presentation was an opportunity to take a closer look at these diseases, caused mostly by parasites (sleeping sickness and schistosomiasis) or bacteria (trachoma and Buruli ulcer), that can be very debilitating for those affected. Dr. Xavier Berthet explained how problems affecting populations can be tackled via the initiatives implemented at the Institut Pasteur de Dakar, like the manufacture of biological products at its future vaccine facility, currently under construction in Diamniadio, and infectious disease surveillance.

Zoonoses: situation and challenges in the age of climate change 

A panel of virology experts from the Institut Pasteur de Dakar addressed the question “Zoonoses: situation and challenges in the age of climate change” on Wednesday October 12th. Dr. Jean-Michel Héraud pointed out that 75% of the diseases that have emerged recently are of zoonotic origin. Out of the total estimated number of viruses on the planet, known as the “virome,” few are as yet known to infect humans. Factors contributing to emergence, like demographics, uncontrolled urbanization, human-induced environmental changes and climate change, were explained to the journalists in attendance. Dr. Oumar Faye, winner of the 2019 Pasteur Network Talent Award, reiterated the role of WHO Collaborating Centers in identifying viruses. He shared his experiences of the Ebola outbreak and more recently the Zika outbreak in Brazil, which helped him to anticipate and prepare for future outbreaks, for example with a mobile laboratory facilitating access to samples and speeding up virus identification. The scientists emphasized the value of One Health approaches, methods to identify viral reservoirs and the use of genomic surveillance to rapidly detect new threats to human and animal health and better anticipate their emergence.

The conference continued for a further four days, covering other scientific fields such as agricultural models in a +1.5°C climate scenario, with events including workshops for journalists. A visit to a virology laboratory at the Institut Pasteur de Dakar and to the Diamniadio manufacturing site brought the week to a close.

Full program: https://www.cmjsf.org/programme/

[1] Countries represented: Benin, Burkina Faso, Burundi, Cameroon, Canada, Central African Republic, Côte d’Ivoire, Democratic Republic of the Congo, Egypt, France, Guinea, Haiti, Madagascar, Mali, Morocco, Niger, Rwanda, Senegal, Switzerland, Togo, Tunisia