Jean-Michel Mazaux, Bernard Claverie, Brigitte Deleplanque, Michel Barat
Les troubles cognitifs dans les accidents vasculaires cérébraux avec hémiplégie. - Les troubles cognitifs ne doivent pas être sous-estimés lors d'un accident vasculaire cérébral, car la plupart des techniques de rééducation dépendent des processus d'intégration et d'apprentissage. Ces troubles cognitifs sont principalement observés au cours des AVC ischémiques, et cet article décrit brièvement les tableaux cliniques les plus fréquents. Presque tous les patients souffrent de troubles de la mémoire et de l'attention. L'intelligence verbale est altérée chez les patients souffrant d'une lésion de l'hémisphère gauche et l'intelligence visuo-spatiale est altérée après une lésion de l'hémisphère droit. La psychologie cognitive a suggéré que les processus cognitifs pouvaient être organisés selon des systèmes modulaires interactifs, et cette théorie semble d'une importance majeure pour les progrès de la réadaptation.
PhysiologieSémiologieMaladies infectieuses et tropicalesLicence : https://creativecommons.org/licenses/by/4.0/
La spectrométrie de mobilité ionique est de plus en plus souvent couplée à des mesures de spectrométrie de masse, soit à des fins de séparation, soit pour faciliter l'identification des composés. Je présente ici les définitions et les concepts de base liés à la spectrométrie de mobilité ionique. La définition de "section efficaces de collision" telle qu’utilisée en spectrométrie de mobilité ionique est également abordée, avec une mise en garde sur le fait que la définition IUPAC n'est pas parfaitement adaptée à la description de la quantité physique dont dépend la mobilité ionique. Enfin, les types d'analyseurs de mobilité ionique les plus couramment rencontrés dans les spectromètres commerciaux contemporains sont présentés et comparés. Cet article est une traduction par l’auteur du chapitre 1 : Ion Mobility–Mass Spectrometry: an Overview, publié dans « Ion Mobility-Mass Spectrometry: Fundamentals and Applications, Editors: Alison E Ashcroft, Frank Sobott, 2022, Royal Society of Chemistry, https://doi.org/10.1039/9781839162886 », mise à disposition sur HAL avec l’aimable autorisation de la RSC.
BiochimieBiologie cellulaire et moléculaireLicence : https://creativecommons.org/licenses/by/4.0/
Mamoudou H. Djingarey, Fabien V. K. Diomandé, Rodrigue Barry, Denis Kandolo, Florence Shirehwa, Clement Lingani, Ryan T. Novak, Carol Tevi-Benissan, William Perea, Marie-Pierre Preziosi, F. Marc LaForce
Background. A group A meningococcal conjugate vaccine (PsA-TT) was developed specifically for the African “meningitis belt” and was prequalified by the World Health Organization (WHO) in June 2010. The vaccine was first used widely in Burkina Faso, Mali, and Niger in December 2010 with great success. The remaining 23 meningitis belt countries wished to use this new vaccine.Methods. With the help of African countries, WHO developed a prioritization scheme and used or adapted existing immunization guidelines to mount PsA-TT vaccination campaigns. Vaccine requirements were harmonized with the Serum Institute of India, Ltd.Results. Burkina Faso was the first country to fully immunize its 1- to 29-year-old population in December 2010. Over the next 4 years, vaccine coverage was extended to 217 million Africans living in 15 meningitis belt countries.Conclusions. The new group A meningococcal conjugate vaccine was well received, with country coverage rates ranging from 85% to 95%. The rollout proceeded smoothly because countries at highest risk were immunized first while attention was paid to geographic contiguity to maximize herd protection. Community participation was exemplary.
Microbiologie (bactériologie, virologie)ImmunologieMaladies infectieuses et tropicalesLicence : http://creativecommons.org/licenses/by/3.0/igo/legalcode This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any r
Statistiques de base : description des données, probabilités, lois normale et binomiale, intervalles de confiance, tests d'hypothèse, chi-deux, corrélation et régression linéaire.
Biostatistiques et épidémiologieMéthodologie de la recherche et thèseLicence : CC-BY-4.0
Mark J. Hanemaaijer, Hannah Higgins, Ipek Eralp, Youki Yamasaki, Norbert Becker, Oscar D. Kirstein, Gregory C. Lanzaro, Yoosook Lee
BackgroundInsecticide resistance in Anopheles coluzzii mosquitoes has become widespread throughout West Africa including in Burkina Faso. The insecticide resistance allele (kdr or L1014F) is a prime indicator that is highly correlated with phenotypic resistance in West Africa. Studies from Benin, Ghana and Mali have suggested that the source of the L1014F is introgression of the 2L divergence island via interspecific hybridization with Anopheles gambiae. The goal of this study was to characterize local mosquito populations in the Nouna Department, Burkina Faso with respect to: (i) the extent of introgression between An. coluzzii and An. gambiae, (ii) the frequency of the L1014F mutation and (iii) Plasmodium infection rates.MethodsA total of 95 mosquitoes were collected from ten sites surrounding Nouna town in Kossi Province, Burkina Faso in 2012. The species composition, the extent of introgression in An. coluzzii mosquitoes and their Plasmodium infection rates were identified with a modified version of the “Divergence Island SNP” (DIS) genotyping assay.ResultsThe mosquito collection contained 70.5% An. coluzzii, 89.3% of which carried a 3 Mb genomic region on the 2L chromosome with L1014F insecticide resistance mutation that was introgressed from An. gambiae. In addition, 22.4% in the introgressed An. coluzzii specimens were infected with Plasmodium falciparum, whereas none of the non-introgressed (“pure”) An. coluzzii were infected.ConclusionThis paper is the first report providing divergence island SNP genotypes for natural population of Burkina Faso and corresponding Plasmodium infection rates. These observations warrant further study and could have a major impact on future malaria control strategies in Burkina Faso.Electronic supplementary materialThe online version of this article (10.1186/s12936-019-2759-1) contains supplementary material, which is available to authorized users.
Biologie cellulaire et moléculaireGénétiqueMicrobiologie (bactériologie, virologie)Licence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (), which permits unrestricted use, distribution, and reproduction in any medium, provid
Paola Pollegioni, Tania Persampieri, Roxana L. Minuz, Alessandro Bucci, Alessandro Trusso, Salvatore Di Martino, Chiara Leo, Marco Bruttini, Marco Ciolfi, Ann‐Marie Waldvogel, Frédéric Tripet, Alekos Simoni, Andrea Crisanti, Ruth Müller
AbstractThe development of genetically modified mosquitoes (GMM) and their subsequent field release offers innovative approaches for vector control of malaria. A non‐gene drive self‐limiting male‐bias Ag(PMB)1 strain has been developed in a 47‐year‐old laboratory G3 strain of Anopheles gambiae s.l. When Ag(PMB)1 males are crossed to wild‐type females, expression of the endonuclease I‐PpoI during spermatogenesis causes the meiotic cleavage of the X chromosome in sperm cells, leading to fertile offspring with a 95% male bias. However, World Health Organization states that the functionality of the transgene could differ when inserted in different genetic backgrounds of Anopheles coluzzii which is currently a predominant species in several West‐African countries and thus a likely recipient for a potential release of self‐limiting GMMs. In this study, we introgressed the transgene from the donor Ag(PMB)1 by six serial backcrosses into two recipient colonies of An. coluzzii that had been isolated in Mali and Burkina Faso. Scans of informative Single Nucleotide Polymorphism (SNP) markers and whole‐genome sequencing analysis revealed a nearly complete introgression of chromosomes 3 and X, but a remarkable genomic divergence in a large region of chromosome 2 between the later backcrossed (BC6) transgenic offspring and the recipient paternal strains. These findings suggested to extend the backcrossing breeding strategy beyond BC6 generation and increasing the introgression efficiency of critical regions that have ecological and epidemiological implications through the targeted selection of specific markers. Disregarding differential introgression efficiency, we concluded that the phenotype of the sex ratio distorter is stable in the BC6 introgressed An. coluzzii strains. The introgression of a synthetic sex ratio distortion transgene into two different genetic backgrounds of Anopheles coluzzii by six backcrosses. We showed that the phenotype of the sex ratio distorter is stab
Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : http://creativecommons.org/licenses/by/4.0/ This is an open access article under the terms of theLicense, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Kamal Bentama, Iliass Chemlal, Mohamed Benabbou, Mohamed El Abssi, Meouhamed El Ouananni, Mouhamed Cherrab, Alami Faricha, Abdelkader Errougani, Mohamed Amraoui, Rachid Chekoff
L'invagination intestinale aiguë est une pathologie du nourrisson et du petit enfant. Sa survenue chez l'adulte est très inhabituelle. Elle est d’étiologie diverse. Dans l'immense majorité des cas, elle est secondaire à une tumeur qui peut être bénigne ou maligne. L'invagination intestinale sur lipome est exceptionnelle. Nous rapportons un cas d'invagination intestinale grêlo-grêlique sur lipome.
PédiatrieLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hamza Hasnaoui, Hicham El Bouhaddouti, Ouadii Mouaqit, El Bachir Benjelloun, Abdelmalek Ousadden, Khalid Ait Taleb
L'invagination intestinale aiguë est une pathologie du nourrisson et du petit enfant. Sa survenue chez l'adulte est très inhabituelle. Elle est d'étiologie diverse. Dans l'immense majorité des cas, elle est secondaire à une tumeur qui peut être bénigne ou maligne. Un lymphome T digestif révélé par invagination intestinale est une entité très rare. Nous rapportons le cas d'un patient de 43 ans, admis aux urgences du centre hospitalier universitaire Hassan II de Fès, Maroc pour une occlusion intestinale. Le scanner abdominal a montré une invagination intestinale aiguë grêlo-grêlique sur un épaississement pariétal digestif de l'anse incarcérée. Le traitement était une résection chirurgicale carcinologique à ciel ouvert. L'étude anatomopathologique et immunohistochimique de la pièce opératoire a conclu à un lymphome anaplasique à grandes cellules de type T. Après la chirurgie, une chimiothérapie est indiquée dans le but d'améliorer le pronostic et d'éviter une éventuelle rechute. L'invagination intestinale est une affection rare chez l'adulte. Elle conduit le plus souvent à la découverte d'une cause organique pouvant être tumorale. A partir de ce nouveau cas et après analyse de la littérature, nous discutons les caractéristiques cliniques, diagnostiques et les possibilités thérapeutiques de cette pathologie rare.
ImmunologiePédiatrieLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Khalid El Haoudi, Said Ait Laalim, Karim Ibn Majdoub Hassani, Imane Toughrai, Khalid Mazaz
L'invagination intestinale aiguë (IIA) secondaire à une cause inhabituelle est une complication rare et une urgence abdominale. Elle pose un problème diagnostique et thérapeutique. Nous rapportons le cas d'un patient âgé de 45 ans, qui présentait une sténose bulbaire peptique résistante au traitement médical. Le patient a été opéré avec présence en per opératoire d'un estomac de stase, en amont d'une sténose bulbaire infranchissable. Une jéjunostomie d'alimentation à la Witzel a été réalisée vu l’état général très altéré du patient. L’évolution était marquée par l'installation d'une invagination sur sonde de jéjunostomie ayant nécessité une intervention chirurgicale avec des suites simples. L'amélioration de la prise en charge et du pronostic de l'IIA secondaire à une cause inhabituelle nécessitant un diagnostic précoce. Le traitement de cette forme particulière d'invagination est presque exclusivement basé sur la chirurgie.
Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abdelali Guellil, Rachid Jabi, Laila Bouzayan, Mohammed Boudou, Soumia Elarabi, Brahim Zeriouh, Mohammed Bouziane
Le diverticule de Meckel reste l´anomalie congénitale la plus courante affectant le tractus gastro-intestinale, correspondant au défaut d´involution du canal omphalo-mésentérique. Cette anomalie est le plus souvent asymptomatique, et peut-être révélé lors d´une complication tel que l´invagination intestinale. Cet article présente le diagnostic et la prise en charge d´une patiente de 18 ans admise en urgence pour invagination iléo-iléale sur diverticule de Meckel compliqué d´occlusion. Le report de cette observation est intéressant, car elle met en lumière une pathologie rare dont le diagnostic doit être précoce par scanner abdominal, qui permet d´éviter la perforation ou la nécrose grêlique. La résection intestinale sans désinvagination est le traitement de référence.
Licence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p
AbstractThere is relatively little data on the etiology of bacterial infections in patients with sickle cell anemia (SCA) in West Africa, and no data from countries that have implemented conjugate vaccines against both Streptococcus pneumoniae and Haemophilus influenzae type b (Hib).We conducted a retrospective analysis of SCA patients admitted to the Medical Research Council Unit, The Gambia, during a 5-year period when there was high coverage of Hib and Pneumococcal conjugate vaccination. We evaluated 161 admissions of 126 patients between April 2010 and April 2015.Pathogenic bacteria were identified in blood cultures from 11 of the 131 admissions that had cultures taken (8.4%, 95% CI 4.5–14.1%). The most frequent isolate was Salmonella Typhimurium (6/11; 54.5%), followed by Staphylococcus aureus (2/11; 18.2%) and other enteric Gram-negative pathogens (2/11; 18.2%) and there was 1 case of H influenzae non-type b bacteremia (1/11; 9.1%). There were no episodes of bacteremia caused by S pneumoniae or Hib.The low prevalence of S pneumoniae and Hib and the predominance of nontyphoidal Salmonella as a cause of bacteremia suggest the need to reconsider optimal antimicrobial prophylaxis and the empirical treatment regimens for patients with SCA.
Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)ImmunologieLicence : http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Seah H. Lim, Barbara A. Methé, Bettina M. Knoll, Alison Morris, Stephen K. Obaro
Non-typhoidal Salmonella usually induces self-limiting gastroenteritis. However, in many parts of Africa, especially in individuals who are malnourished, infected with malaria, or have sickle cell disease, the organism causes serious and potentially fatal systemic infections. Since the portal of entry of non-typhoidal Salmonella into the systemic circulation is by way of the intestine, we argue that an increased gut permeability plays a vital role in the initiation of invasive non-typhoidal Salmonella in these patients. Here, we will appraise the evidence supporting a breach in the intestinal barrier and propose the mechanisms for the increased risks for invasive non-typhoidal Salmonella infections in these individuals.
Parasitologie et mycologieHématologieMaladies infectieuses et tropicalesLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (), which permits unrestricted use, distribution, and reproduction in any medium, provid
R. Rebecca Love, Marco Pombi, Moussa W. Guelbeogo, Nathan R. Campbell, Melissa T. Stephens, Roch K. Dabire, Carlo Costantini, Alessandra della Torre, Nora J. Besansky
Chromosomal inversion polymorphisms have special importance in the Anopheles gambiae complex of malaria vector mosquitoes, due to their role in local adaptation and range expansion. The study of inversions in natural populations is reliant on polytene chromosome analysis by expert cytogeneticists, a process that is limited by the rarity of trained specialists, low throughput, and restrictive sampling requirements. To overcome this barrier, we ascertained tag single nucleotide polymorphisms (SNPs) that are highly correlated with inversion status (inverted or standard orientation). We compared the performance of the tag SNPs using two alternative high throughput molecular genotyping approaches vs. traditional cytogenetic karyotyping of the same 960 individual An. gambiae and An. coluzzii mosquitoes sampled from Burkina Faso, West Africa. We show that both molecular approaches yield comparable results, and that either one performs as well or better than cytogenetics in terms of genotyping accuracy. Given the ability of molecular genotyping approaches to be conducted at scale and at relatively low cost without restriction on mosquito sex or developmental stage, molecular genotyping via tag SNPs has the potential to revitalize research into the role of chromosomal inversions in the behavior and ongoing adaptation of An. gambiae and An. coluzzii to environmental heterogeneities.
Biologie cellulaire et moléculaireGénétiqueParasitologie et mycologieLicence : http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ahmed Touimi Benjelloun, Assia Makayssi, Simohamed Ennachit, Mohamed Elkarroumi
L'inversion utérine non puerpérale chronique est une situation clinique extrêmement rare, 85% des inversions sont puerpérales exposant l'accouchée au risque d'hémorragie de la délivrance cataclysmique. Nous rapportons le cas d'une patiente de 70 ans qui s'est présentée en consultation pour prolapsus uro-génital du 3ème degré, une hystérectomie totale sans conservation annexielle a été réalisée par un double abord: voie vaginale complétée par une laparotomie mettant en évidence une inversion utérine à contenu annexielle bilatérale. La voie abdominale a permis en plus d'une bonne exposition chirurgicale, l'exclusion d'un contenu digestif ou urinaire pris dans l'inversion avant la réalisation de l'hystérectomie. Bien que rare et de diagnostic difficile, l'inversion utérine non puerpérale aiguë est une urgence médico-chirurgicale.
Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Chimae Eddaoudi, Mohammed Achraf Grohs, Abdilhay Filali
Une inversion utérine est une complication rare de l’accouchement potentiellement grave, dans laquelle le corps utérin se retourne en doigt de gant et fait saillie dans le vagin ou hors de la vulve. Cette pathologie se manifeste en général juste après l’accouchement, par une douleur importante dans un tableau de choc hémorragique. Le diagnostic est essentiellement clinique et impose d’être immédiat afin de permettre une réinversion rapide avant la formation d’un anneau de striction. En effet, la mortalité est aujourd’hui faible si le diagnostic et la prise en charge sont précoces. L’inversion utérine ne semble pas non plus grever le pronostic obstétrical. Parmi les facteurs favorisants, on retrouve avant tout une hypotonie utérine associée à une insertion fundique du placenta, ce qui provoque une dépression du fond utérin en cas de manoeuvres intempestives (traction sur le cordon, expression utérine). La réinversion doit être rapide, menée de façon conjointe aux mesures de réanimation (traitement du choc). Elle fait appel à plusieurs méthodes manuelles consistant à retourner l’utérus après éventuelle utilisation de procédés myorelaxants (dérivés nitrés, bêtamimétiques, anesthésie générale). L’échec conduit à un traitement chirurgical par voie haute ou voie basse. Nous rapportons le cas d’une inversion utérine totale qui s’est produite avant la délivrance, lors d’un accouchement par voie haute.
Gynécologie-obstétriqueLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
BackgroundThis paper provides an insightful quantitative ethnoecological analysis and affirms that agro-pastoralists have a multiplicity of criteria for valuating their natural forage resources. Rural households in West Africa are not only confronted with water resource scarcity but also have to cope with limited forage resources to feed livestock in both wet and dry seasons based on local knowledge. Local agro-pastoral social-ecological systems (SESs) in the study areas stem from the daily utilization of available forage resources by dominant domestic livestock (cattle, goats, and sheep) over the years. However, there is very little systematic knowledge documentation on forage-related valuation criteria in this part of the world. Hence, this study aimed at examining (1) forage resources used for different seasons and livestock types, (2) explicit forage-related valuation criteria and associated salience, and (3) effects of socio-demographic and climatic aridity on local valuation criteria.MethodsTo address these aims, a total of 526 individual ethnoecological interviews (encompassing Dagbani, Gurunsi, and Mossi ethnic groups) were conducted in 16 villages coupled with vegetation sampling of 144 plots in Ghana and Burkina Faso. Rigorous model selection, generalized linear mixed-effects models, cognitive salience indices, and descriptive statistics were applied.ResultsThe results revealed that majority (73%) of the agro-pastoralists regarded herbaceous forage plants to be very palatable for livestock consumption in the rainy season and for cattle while woody vegetation and crop-related forage plants were rather perceived to be more important in the dry season and for goats and sheep. The findings also indicated that climatic aridity significantly influenced the number of forage-related valuation criteria cited by agro-pastoralists for different seasonal and livestock types (p < 0.001). It was also found out that agro-pastoralists did not only judge forage plants base
Santé publiqueLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (), which permits unrestricted use, distribution, and reproduction in any medium, provid
BackgroundNatural resource extraction projects offer both opportunities and risks for sustainable development and health in host communities. Often, however, the health of the community suffers. Health impact assessment (HIA) can mitigate the risks and promote the benefits of development but is not routinely done in the developing regions that could benefit the most.ObjectiveOur study aims to investigate health and health determinants in regions affected by extractive industries in Burkina Faso, Ghana, Mozambique, and Tanzania. The evidence generated in our study will inform a policy dialogue on how HIA can be promoted as a regulatory approach as part of the larger research initiative called the HIA4SD (Health impact assessment for sustainable development) project.MethodsThe study is a concurrent triangulation, mixed methods, multi-stage, multi-focus project that specifically addresses the topics of governance and policy, social determinants of health, health economics, health systems, maternal and child health, morbidity and mortality, and environmental determinants, as well as the associated health outcomes in natural resource extraction project settings across four countries. To investigate each of these health topics, the project will (1) use existing population-level databases to quantify incidence of disease and other health outcomes and determinants over time using time series analysis; (2) conduct two quantitative surveys on mortality and cost of disease in producer regions; and (3) collect primary qualitative data using focus groups and key informant interviews describing community perceptions of the impacts of extraction projects on health and partnership arrangements between the projects and local and national governance. Differences in health outcomes and health determinants between districts with and without an extraction project will be analyzed using matched geographical analyses in quasi-Poisson regression models and binomial regression models. Costs
Biostatistiques et épidémiologiePédiatrieGynécologie-obstétriqueLicence : https://creativecommons.org/licenses/by/4.0/ http://www.researchprotocols.org This is an open-access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first pub
Fabrice A. Somé, Thomas Bazié, Hanna Y. Ehrlich, Justin Goodwin, Aine Lehane, Catherine Neya, Kabré Zachari, Martina Wade, Jean-Marie Ouattara, Brian D. Foy, Roch K. Dabiré, Sunil Parikh, Jean-Bosco Ouédraogo
BackgroundSince 2014, seasonal malaria chemoprevention (SMC) with amodiaquine–sulfadoxine–pyrimethamine (AQ–SP) has been implemented on a large scale during the high malaria transmission season in Burkina Faso. This paper reports the prevalence of microscopic and submicroscopic malaria infection at the outset and after the first round of SMC in children under 5 years old in Bama, Burkina Faso, as well as host and parasite factors involved in mediating the efficacy and tolerability of SMC.MethodsTwo sequential cross-sectional surveys were conducted in late July and August 2017 during the first month of SMC in a rural area in southwest Burkina Faso. Blood smears and dried blood spots were collected from 106 to 93 children under five, respectively, at the start of SMC and again 3 weeks later. Malaria infection was detected by microscopy and by PCR from dried blood spots. For all children, day 7 plasma concentrations of desethylamodiaquine (DEAQ) were measured and CYP2C8 genetic variants influencing AQ metabolism were genotyped. Samples were additionally genotyped for pfcrt K76T and pfmdr1 N86Y, molecular markers associated with reduced amodiaquine susceptibility.Results2.8% (3/106) of children were positive for Plasmodium falciparum infection by microscopy and 13.2% (14/106) by nested PCR within 2 days of SMC administration. Three weeks after SMC administration, in the same households, 4.3% (4/93) of samples were positive by microscopy and 14.0% (13/93) by PCR (p = 0.0007). CYP2C8*2, associated with impaired amodiaquine metabolism, was common with an allelic frequency of 17.1% (95% CI 10.0–24.2). Day 7 concentration of DEAQ ranged from 0.48 to 362.80 ng/mL with a median concentration of 56.34 ng/mL. Pfmdr1 N86 predominated at both time points, whilst a non-significant trend towards a higher prevalence of pfcrt 76T was seen at week 3.ConclusionThis study showed a moderate prevalence of low-level malaria parasitaemia in children 3 weeks following SMC during the first mon
Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as
BackgroundMost of the evidence on antimicrobial stewardship programmes (ASP) to help sustain the effectiveness of antimicrobials is generated in high income countries. We report a study investigating implementation of ASP in secondary care across low-, middle- and high-income countries. The objective of this study was to map the key contextual, including cultural, drivers of the development and implementation of ASP across different resource settings.Materials and methodsHealthcare professionals responsible for implementing ASP in hospitals in England, France, Norway, India, and Burkina Faso were invited to participate in face-to face interviews. Field notes from observations, documentary evidence, and interview transcripts were analysed using grounded theory approach. The key emerging categories were analysed iteratively using constant comparison, initial coding, going back the field for further data collection, and focused coding. Theoretical sampling was applied until the categories were saturated. Cross-validation and triangulation of the findings were achieved through the multiple data sources.Results54 participants from 24 hospitals (England 9 participants/4 hospitals; Norway 13 participants/4 hospitals; France 9 participants/7 hospitals; India 13 participants/ 7 hospitals; Burkina Faso 8 participants/2 hospitals) were interviewed. Across Norway, France and England there was consistency in ASP structures. In India and Burkina Faso there were country level heterogeneity in ASP. State support for ASP was perceived as essential in countries where it is lacking (India, Burkina Faso), and where it was present, it was perceived as a barrier (England, France). Professional boundaries are one of the key cultural determinants dictating involvement in initiatives with doctors recognised as leaders in ASP. Nurse and pharmacist involvement was limited to England. The surgical specialty was identified as most difficult to engage with in each country. Despite challenges, on
Microbiologie (bactériologie, virologie)PharmacologieSanté publiqueLicence : Creative Commons Attribution License This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Paul Lokubal, Clara Calvert, Simon Cousens, Marina Daniele, Rasmané Ganaba, Veronique Filippi
IntroductionThe period following childbirth poses physiological, physical, social and psychological challenges to women that may affect their quality of life. Few studies in Africa have explored women’s health-related quality of life (HrQoL) and its determinants in postpartum populations, including the quality of women’s relationships with their male partners. We investigated whether relationship satisfaction was associated with better HrQoL among postpartum women in Burkina Faso, 8 months after childbirth.MethodsWe analysed data from 547 women from the control arm of a randomised controlled trial in Burkina Faso. The study outcome was a woman’s HrQoL, assessed using the cross-culturally validated WHOQOL-BREF tool, with response categories adapted for Burkina Faso. The exposure was relationship satisfaction measured using questions adapted from the Dyadic Adjustment Scale and Marital Assessment Test tools. We calculated the median HrQOL scores for the study sample, overall and for each domain of HrQOL (physical, psychological, social and environmental). The association between relationship satisfaction and HrQoL was examined using multiple linear regression models with robust SEs.ResultsPostpartum women had high median HrQoL scores in the physical (88.1), psychological (93.1), social (86.1) and environmental (74.0) domains and overall HrQoL (84.0). We found that higher relationship satisfaction is associated with increased HrQoL. After adjusting for potential confounders, we found that for each point increase in relationship satisfaction score, the increase in HrQoL was 0.39 (p<0.001) for the overall HrQoL; 0.32 (p=0.013) for the physical domain; 0.25 (p=0.037) for the psychological domain; 0.46 (p<0.001) for the social domain and 0.49 (p<0.001) for the environmental domain.ConclusionHigher relationship satisfaction is associated with higher HrQoL scores. Policies should aim to support women to cope with the challenges of childbirth and childcare in the postpartum p
PédiatrieGynécologie-obstétriqueSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original w
Katharine A Collins, Alphonse Ouedraogo, Wamdaogo Moussa Guelbeogo, Shehu S Awandu, Will Stone, Issiaka Soulama, Maurice S Ouattara, Apollinaire Nombre, Amidou Diarra, John Bradley, Prashanth Selvaraj, Jaline Gerardin, Chris Drakeley, Teun Bousema, Alfred Tiono
IntroductionA large proportion of malaria-infected individuals in endemic areas do not experience symptoms that prompt treatment-seeking. These asymptomatically infected individuals may retain their infections for many months during which sexual-stage parasites (gametocytes) are produced that may be transmissible to mosquitoes. Reductions in malaria transmission could be achieved by detecting and treating these infections early. This study assesses the impact of enhanced community case management (CCM) and monthly screening and treatment (MSAT) on the prevalence and transmissibility of malaria infections.Methods and analysisThis cluster-randomised trial will take place in Sapone, an area of intense, highly seasonal malaria in Burkina Faso. In total, 180 compounds will be randomised to one of three interventions: arm 1 - current standard of care with passively monitored malaria infections; arm 2 - standard of care plus enhanced CCM, comprising active weekly screening for fever, and detection and treatment of infections in fever positive individuals using conventional rapid diagnostic tests (RDTs); or arm 3 - standard of care and enhanced CCM, plus MSAT using RDTs. The study will be conducted over approximately 18 months covering two high-transmission seasons and the intervening dry season. The recruitment strategy aims to ensure that overall transmission and force of infection is not affected so we are able to continuously evaluate the impact of interventions in the context of ongoing intense malaria transmission. The main objectives of the study are to determine the impact of enhanced CCM and MSAT on the prevalence and density of parasitaemia and gametocytaemia and the transmissibility of infections. This will be achieved by molecular detection of infections in all study participants during start and end season cross-sectional surveys and routine sampling of malaria-positive individuals to assess their infectiousness to mosquitoes.Ethics and disseminationThe study h
Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original w
Parasitologie et mycologieMaladies infectieuses et tropicalesLicence : http://creativecommons.org/licenses/by/4.0 http://creativecommons.org/publicdomain/zero/1.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original
RÉSUMÉObservationLe but de lenquête était d'identifier les vecteurs de chikungunya et d’étudier leur bioécologie afin de contribuer aux activités de riposte contre l’épidémie de 2020 dans les villes d’Abéché et de Biltine à l’Est du Tchad.Matériel et méthodesLes stades immatures des moustiques Aedes ont été collectés et les indices de risque épidémique (indices Récipient, Maison et de Breteau) ont été calculés et comparés par le test du Khi carré. Les larves et nymphes collectées ont été mises en élevage et les adultes qui en sont issus ont été identifiés morphologiquement à l'aide d'une clé dichotomique. La faune résiduelle endophile a été échantillonnée par pulvérisation matinale d'insecticide dans les chambres où seules les femelles étaient collectées.RésultatsAu total, 2 039 spécimens de moustiques appartenant à trois genres ont été collectés : 470 (23%) ont été identifiés comme Aedes aegypti, 731 Anopheles spp (36%) et 838 Culex spp (41%). Les pots de fleurs étaient les gîtes les plus représentés (69%) suivis des jarres/fûts d'eau (17%) et des pneus/récipients abandonnés (14%). Partout, les indices de risque étaient largement au-dessus des seuils épidémiques définis par l’OMS. Entre les deux villes, seul l'indice Maison a présenté une différence significative (p=0,004) : il était plus élevé à Abéché qu’à Biltine.ConclusionL'enquête a permis d'identifier A. aegypti comme vecteur probable de chikungunya présent dans les deux villes. Il importe de chercher à comprendre ses comportements de piqûre et de repos ainsi que sa sensibilité aux différentes classes d'insecticides afin d'organiser une lutte antivectorielle efficace.
Biostatistiques et épidémiologieSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/ Cet article en libre accès est distribué selon les termes de la licence Creative Commons CC BY 4.0 ().