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• Survival analysis was conducted for 131 patients with coronavirus disease 2019 (COVID-19) in Somalia. • Interventions to improve outcomes in this low-resource and fragile setting were examined. • Risk factors for deaths included age ≥60 years, cardiovascular disease and use of non-invasive ventilation. • Patients who received oxygen alone were more likely to survive than patients who were ventilated. • Optimizing critical care for patients with COVID-19 in fragile states requires policy discourse. To determine risk factors for death in patients with coronavirus disease 2019 (COVID-19) admitted to the main hospital in Somalia, and identify interventions contributing to improved clinical outcome in a low-resource and fragile setting. A survival analysis was conducted of all patients with COVID-19 admitted to the main hospital in Somalia from 30 March to 12 June 2020. Of the 131 patients admitted to the hospital with COVID-19, 52 (40%) died and 79 (60%) survived. The main factors associated with the risk of in-hospital death were age ≥60 years {survival probability on day 21 was 0.789 [95% confidence interval (CI) 0.658–0.874] in patients aged <60 years vs 0.339 (95% CI 0.205–0.478) in patients aged ≥60 years}, cardiovascular disease [survival probability 0.478 (95% CI 0.332–0.610) in patients with cardiovascular disease vs 0.719 (95% CI 0.601–0.807) in patients without cardiovascular disease] and non-invasive ventilation on admission (patients who were not ventilated but received oxygen were significantly more likely to survive than patients who were ventilated; P <0.001). Considering the risk factors (age ≥60 years, presence of cardiovascular disease and use of non-invasive ventilation) is critical when managing patients with severe COVID-19, especially in low-resource settings where availability of skilled healthcare workers for critical care units is limited. These findings also highlight the importance of use of medical oxygen for severely ill patients, and the critical aspect of deciding whether or not to ventilate critical patients with COVID-19 in order to improve clinical outcome. [ABSTRACT FROM AUTHOR]

Despite the remarkable potential for biogas production from livestock and organic wastes, the number of constructed biogas digesters for the continent is in the order of thousands and in case of Mauritania is lower than the number of the provinces. While majority of the existing digesters left far behind the expected efficiency, lack of a comprehensive economic assessment along with an efficient design questions their practical application. The present study introduced the first assessment to evaluate the biogas potential from livestock manures and waste from slaughterhouses in Northwest Africa (a case of Mauritania). Using ArcGIS® software, a database was conducted to build maps that show the amount of waste products, the potential of biogas, and equivalent amounts of energy. These were used to assess the potential of biogas and the corresponding potential energy for each geographical department in Mauritania. The results indicated that the southern provinces had the highest biogas potential with the maximum and the average values of 520 and 258.7 (±125.8) × 106 m3/year. On the other hand, the lowest biogas production potential (27.7 × 106 m3/year) was recorded for northern provinces with the maximum and the average values of 135 and 76.4 (±39.7) × 106 m3/year. The results showed that 63,579 × 106 kg of waste associated with livestock (cattle) and slaughterhouse applications were annually produced in the country. It was determined that this quantity could generate 2451 × 106 m3 of biogas per year, corresponding to an energy potential of 52,704 × 106 MJ/year. Considering the rapid depletion of conventional energy sources and the significance of biogas as a renewable fuel, a detailed feasibility analysis (for the biogas production in each province of Mauritania by means of community type fixed-dome digesters) was also performed in the scope of this study. The results of the comprehensive cost breakdown analysis revealed that the revenues obtained from sale of biogas-generated electricity and digested slurry (as fertilizer) could able to pay the initial investment within approximately 6.5 years without subsidy. The findings of this study, as the first of its own, could be used to comprehend how utilization of information such as slaughterhouse and livestock population, nutrition habitats, land-usage maps and geographic information system (GIS) can be employed to germinate a model for more comprehensive assessment of biogas production potential from livestock manure and slaughterhouse wastes, specifically in case of northern African countries. Moreover, in case of biogas plant, this model could be employed as a decision-making tool to identify the highly qualified location for construction of the biogas plant. • Mapping of biogas production potential is conducted in Mauritania for the first time. • 63,579 × 106 kg of waste can generate 2451 × 106 m3 of biogas per year in the country. • The southern provinces are found to have approximately 4 times more biogas potential. • Energy production in Mauritania heavily depends on oil, natural gas, and wood fuels. • A nationwide biogas digester project can pay for itself in 6.5 years without subsidy. [ABSTRACT FROM AUTHOR]

[Display omitted] • Electricity consumption is mapped using a combined cartographic methodology. • State of the sky impact is explored for the first time on energy management strategies. • LF strategy provides the best load monitoring by minimizing the generator uptime. • Energy management strategies play a pivotal role as hybrid solar system control tools. A novel optimized sizing and management strategy of a grid-connected hybrid photovoltaic (PV)-solar-battery-group system were proposed for the electrification of residential consumers in Northwest Africa (a case of Mauritania), and the influence of the state of the sky (clear, moderately overcast, and overcast) was analyzed according to the load flowing (LF) and the cycle charging (CC) strategies. In order to mitigate the pressure on the national grid, consolidate the consumer autonomy, minimize the cost of medium- and long-term consumption bills, and CO 2 -related emissions, a cartographic approach was conducted as the first attempt to map the electricity consumption potential for buildings in the city of Nouakchott (Mauritania) using a geo-referenced database. ArcGIS®, HOMER Pro®, and MATLAB® softwares were used for the establishment of the load profile, optimized sizing of the PV-batteries-group-grid system, and calculation of the lightness index, respectively. The LF strategy provided the best monitoring of the load throughout the day by minimizing the generator uptime. The techno-economic analysis revealed the values of cost of energy (COE) and net present cost (NPC) as follows: COE = $0.0549/kWh and NPC = $24,796 for the LF PV-batteries-grid strategy, COE = 0.0646 $/kWh and NPC = $23,380 for the CC PV-batteries-grid strategy, and COE = $0.17/kWh and NPC = $23,262 for the case of the grid on its own. [ABSTRACT FROM AUTHOR]