RÉSUMÉObjectifLa révélation d’une tuberculose par une localisation apparemment isolée dans le muscle sternocléidomastoïdien est exceptionnelle. Elle peut prêter à confusion avec une tumeur cervicale. Nous rapportons un cas avec ses particularités diagnostiques et thérapeutiques.ObservationPatient immunocompétent présentant une tuméfaction cervicale antérolatérale droite faisant suspecter une tumeur de la thyroïde. Les explorations paracliniques ont permis de découvrir une tuberculose du muscle sternocléidomastoïdien droit et un foyer pulmonaire latent homolatéral. L’évolution sous traitement médical a été favorable.ConclusionLa tuberculose musculaire au niveau cervical peut mimer une tumeur cervicale.
Microbiologie (bactériologie, virologie)ImmunologieMaladies infectieuses et tropicalesLicence : 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 ().
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.
Kaouther Ben Abdelghani, Kaouther Maatallah, Faida Ajili, Leila Souabni, Ahmed Laatar, Leith Zakraoui
La ténosynovite tuberculeuse est une localisation rare de la tuberculose. Le diagnostic en est souvent tardif en raison de manifestations cliniques souvent pauvres et chroniques. Nous rapportons une observation de ténosynovite tuberculeuse du 2ème rayon de la main droite d’évolution favorable sous traitement antituberculeux.
Microbiologie (bactériologie, virologie)Maladies infectieuses et tropicalesLicence : 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.
Ikram Boubess, Salma Ouassour, Mokha Tazi, Adib Filali, Mohammad Alami
La malakoplakie est une pathologie inflammatoire rare qui résulte d'un déficit de la fonction phagocytaire macrophagique. Il n'existe pas de symptomatologie spécifique de la maladie mais dépendante de l'organe touché. Nous rapportons un cas rare de malakoplakie annexielle chez une femme de 36 ans qui a été opérée pour suspicion de cancer ovarien et dont le diagnostic de malakoplakie ne s'est fait qu’à l'examen anatomopathologique. La malakoplakie touche essentiellement le tractus urogénital et le diagnostic positif repose seulement sur l'histologie. Le traitement est basé sur l'antibiothérapie et l'exérèse chirurgicale si mauvais état de l'organe atteint.
Microbiologie (bactériologie, virologie)PharmacologieLicence : 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.
Sanata Bamba, Fatou Barro-Traoré, Martine Liance, Cathy Chemla, Charles Sanou, Olo Da, Tinga Robert Guiguemdé
Mansonella perstans est une filaire dont les adultes sont à localisation péritonéale et les microfilaires à localisation sanguine, qui sévit principalement en Amérique Equatoriale et aux bords de rivières, de plages en Afrique tropicale humide. Sa transmission est assurée par la piqûre de culicoïdes. Nous rapportons le cas d’une patiente souffrant de prurit dans un contexte biologique d’hyperéosinophilie au cours d’un dépistage du cancer du col de l’utérus. Une microfilaire de Mansonella perstans a été observée sur son frottis cervico-vaginal mais aussi dans son sang. La patiente a été traitée avec succès par une prise unique combinée de 400 mg d’albendazole et d’ivermectine (150 µg/kg). La localisation cervico-vaginale de Mansonella perstans est atypique et exceptionnelle. Nous proposons une recherche systématique de microfilaires lors de frottis cervico-vaginaux des femmes souhaitant un dépistage du cancer du col de l’utérus au Centre Hospitalier de Bobo-Dioulasso pour déterminer la fréquence réelle de cette localisation atypique.
Santé publiqueLicence : 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.
Karima Atarraf, Lamiae Chater, Mounir Arroud, My Abderrahman Afifi
L'histiocytose X ou histiocytose de Langerhans est une maladie de l'enfant et de l'adulte jeune. Dont l'incidence est estimée à 1 cas sur 200 000 par an. C'est une maladie au spectre clinique très divers, allant du simple granulome éosinophile à la forme grave multiviscérale avec dysfonctionnement d'organe. Les auteurs rapportent deux observations concernant deux localisations assez rares de cette maladie, au niveau du pubis chez le premier enfant, et au niveau de la scapula chez le deuxième. Chez nos deux malades la localisation était focale, et l’évolution était favorable. A travers ces deux observations, nous allons essayer de décrire les différents aspects cliniques et radiologiques et discuter a travers une revue de littérature les démarches diagnostiques et thérapeutiques de cette maladie rare.
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.
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.
Face au scepticisme grandissant des Français vis-à-vis de la vaccination, et en particulier à la suite de l'annonce de la nouvelle loi du 30.12.2017 relative au financement de la sécurité sociale pour 2018, nous avons voulu réaliser une étude de la littérature confrontant les arguments contre la vaccination, les plus répandus sur internet, et les données de la science. Les résultats de notre étude ne montrent aucun lien entre la vaccination et la sclérose en plaques, l'autisme ou la myofasciite à macrophages. Nous n'avons pu conclure sur l'effet de l'aluminium présent dans les vaccins du fait du faible nombre de publications et de leurs grandes hétérogénéités. L'immunité vaccinale a été jugée efficace et suffisante par les publications consultées. Aucune preuve n'a été trouvée pour incriminer les laboratoires pharmaceutiques. Notre étude révèle l'importance de la communication entre la population et les acteurs de la santé pour informer et rassurer les patients quant à la vaccination et ainsi éviter la propagation de fausses informations.
ImmunologieSémiologieMaladies infectieuses et tropicalesLicence : https://creativecommons.org/licenses/by/4.0/
Francis Deriennic, Annette Leclerc, Philippe Mairiaux, Jean-Pierre Meyer, Anna Ozguler
La lombalgie se définit par la présence de douleurs. Plus précisément, la lombalgie désigne toute manifestation douloureuse siégeant dans la partie basse de la colonne vertébrale, c’est-à-dire entre la charnière dorso-lombaire(D12-L1) et la charnière lombo-sacrée (L5-S1). En ce sens, la lombalgie commune n’est pas une entité pathologique : c’est un symptôme pouvant répondre à la souffrance mécanique de structures rachidiennes et péri rachidiennes diverses.(...)Dans l’affirmation « mal de dos, mal du siècle », il y a à la fois du vrai, du faux et de l’imprécis :• du vrai, en ce sens que la lombalgie est une affection très fréquente en population adulte puisque dans différentes enquêtes, environ 60 % des adultes,parfois plus, déclarent souffrir ou avoir souffert de lombalgie ;• du faux, en ce sens que la lombalgie est une affection bénigne dont l’évolution spontanée est favorable dans la majorité des cas. En effet, les enquêtes disponibles montrent que seulement une lombalgie sur cinq, en moyenne,entraîne un arrêt de travail. Parmi ces arrêts, la majorité sont des arrêts courts(55 % entre 1 et 7 jours dans l’enquête EDF-GDF) ;• de l’imprécis dans la mesure où dire : « 60 à 80 % des adultes souffrent ou ont souffert de lombalgie » signifie que 60 à 80 % des adultes répondraient ouià une question portant sur des douleurs, intenses ou légères, passagères oudurables, dans un passé lointain ou proche ou pour le présent. Avec unedéfinition beaucoup plus stricte, par exemple l’existence d’un arrêt de travailpour lombalgie dans les 12 derniers mois, on obtient une fréquence beaucoupplus faible (de l’ordre de 5 à 10 %).
Biostatistiques et épidémiologieSanté publiqueLicence : https://creativecommons.org/publicdomain/zero/1.0/
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.
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.
Soumaïla Pagabeleguem, Momar Talla Seck, Baba Sall, Marc JB Vreysen, Geoffrey Gimonneau, Assane Gueye Fall, Mireille Bassene, Issa Sidibé, Jean-Baptiste Rayaissé, Adrien MG Belem, Jérémy Bouyer
BackgroundThe application of the sterile insect technique (SIT) requires mass-production of sterile males of good biological quality. The size of the project area will in most cases determine whether it is more cost effective to produce the sterile flies locally (and invest in a mass-rearing facility) or import the sterile flies from a mass-rearing facility that is located in another country. This study aimed at assessing the effect of long distance transport of sterile male Glossina palpalis gambiensis pupae on adult male fly yield.MethodsThe male pupae were produced at the Centre International de Recherche-Développement sur l’Elevage en zone Subhumide (CIRDES), Bobo-Dioulasso, Burkina Faso, and shipped with a commercial courier service in insulated transport boxes at a temperature of ±10°C to Senegal (±36 h of transport). Upon arrival in the insectary in Dakar, the pupae were transferred to an emergence room and the flies monitored for 3–6 days.ResultsThe results showed that the used system of isothermal boxes that contained phase change material packs (S8) managed to keep the temperature at around 10°C which prevented male fly emergence during transport. The emergence rate was significantly higher for pupae from batch 2 (chilled at 4°C for one day in the source insectary before transport) than those from batch 1 (chilled at 4°C for two days in the source insectary before transport) i.e. an average (±sd) of 76.1 ± 13.2% and 72.2 ± 14.3%, respectively with a small proportion emerging during transport (0.7 ± 1.7% and 0.9 ± 2.9%, respectively). Among the emerged flies, the percentage with deformed (not fully expanded) wings was significantly higher for flies from batch 1 (12.0 ± 6.3%) than from batch 2 (10.7 ± 7.5%). The amount of sterile males available for release as a proportion of the total pupae shipped was 65.8 ± 13.3% and 61.7 ± 14.7% for batch 1 and 2 pupae, respectively.ConclusionsThe results also showed that the temperature inside the parcel must be control
Santé publiqueLicence : 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
Charlotte Huet, Abdoulaye Ouedraogo, Issouf Konaté, Isidore Traore, François Rouet, Antoinette Kaboré, Anselme Sanon, Philippe Mayaud, Philippe Van de Perre, Nicolas Nagot
BackgroundConcerns have been raised that marginalised populations may not achieve adequate compliance to antiretroviral therapy. Our objective was to describe the long-term virological, immunological and mortality outcomes of providing highly active antiretroviral therapy (HAART) with strong adherence support to HIV-infected female sex workers (FSWs) in Burkina Faso and contrast outcomes with those obtained in a cohort of regular HIV-infected women.MethodsProspective study of FSWs and non-FSWs initiated on HAART between August 2004 and October 2007. Patients were followed monthly for drug adherence (interview and pill count), and at 6-monthly intervals for monitoring CD4 counts and HIV-1 plasma viral loads (PVLs) and clinical events.Results95 women, including 47 FSWs, were followed for a median of 32 months (interquartile range [IQR], 20-41). At HAART initiation, the median CD4 count was 147 cells/μl (IQR, 79-183) and 144 cells/μl (100-197), and the mean PVLs were 4.94 log10copies/ml (95% confidence interval [CI], 4.70-5.18) and 5.15 log10 copies/ml (4.97-5.33), in FSWs and non-FSWs, respectively. Four FSWs died during follow-up (mortality rate: 1.7 per 100 person-years) and none among other women. At 36 months, the median CD4 count increase was 230 cells/μl (IQR, 90-400) in FSWs vs. 284 cells/μl (193-420) in non-FSWs; PVL was undetectable in 81.8% (95% CI, 59.7-94.8) of FSWs vs. 100% (83.9-100) of non-FSWs; and high adherence to HAART (> 95% pills taken) was reported by 83.3% (95% CI, 67.2-93.6), 92.1% (95% CI, 78.6-98.3), and 100% (95% CI, 54.1-100) of FSWs at 6, 12, and 36 months after HAART initiation, respectively, with no statistical difference compared to the pattern observed among non-FSWs.ConclusionsClinical and biological benefits of HAART can be maintained over the long term among FSWs in Africa and could also lead to important public health benefits.
Biostatistiques et épidémiologieImmunologiePharmacologieLicence : http://creativecommons.org/licenses/by/2.0 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 work is properly cited.
In sub-Saharan Africa, despite the implementation of multiple control interventions, the prevalence of malaria infection and clinical cases remains high. The primary tool for vector control against malaria in this region is the use of long-lasting insecticide-treated nets (LLINs) combined or not with indoor residual spraying (IRS) to achieve a synergistic effect in protection. The objective of this study was to assess the effectiveness of LLINs, with or without IRS, protected against Plasmodium falciparum infection and uncomplicated clinical cases (UCC) of malaria in Benin. A case-control study was conducted, encompassing all age groups, in the urban area of Djougou and the rural area of Cobly. A cross-sectional survey was conducted that included 2080 individuals in the urban area and 2770 individuals in the rural area. In the urban area, sleeping under LLINs did not confer significant protection against malaria infection and UCC when compared to no intervention. However, certain neighbourhoods benefited from a notable reduction in infection rates ranging from 65% to 85%. In the rural area, the use of LLINs alone, IRS alone, or their combination did not provide additional protection compared to no intervention. IRS alone and LLINs combined with IRS provided 61% and 65% protection against malaria infection, respectively, compared to LLINs alone. The effectiveness of IRS alone and LLINs combined with IRS against UCC was 52% and 54%, respectively, when compared to LLINs alone. In both urban and rural areas, the use of LLINs alone, IRS alone, and their combination did not demonstrate significant individual protection against malaria infection and clinical cases when compared to no intervention. In the conditions of this study, LLINs combined or not with IRS are not effective enough to eliminate malaria. In addition to the interventions, this study identified factors associated with malaria in Benin as housing design, neglected social groups like gender-marginalised indi
Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : https://creativecommons.org/licenses/by/4.0/ Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ().
BackgroundThe WHO Global Malaria Programme advocates for a comprehensive, strategic approach to managing insecticide resistance, highlighting the importance of using multiple insecticides with different modes of action through rotations and combinations. To slow the spread of resistance, it is essential to develop and evaluate new formulations that feature unique modes of action and extended residual effects. Addressing this need, Mitsui Chemicals Crop & Life Solutions, Inc., developed VECTRON™ T500, a new indoor residual spraying (IRS) formulation using broflanilide, applied at a dosage of 100 mg AI/m2. This formulation was tested in a Phase III community trial, alongside Actellic® 300CS, a commonly used IRS product containing pirimiphos-methyl, applied at the recommended dosage of 1000 mg AI/m2.MethodsMonthly WHO wall cone bioassays were performed to assess the efficacy of the interventions using three mosquito strains: the laboratory-bred, insecticide-susceptible Anopheles gambiae s.s. Kisumu strain, the insecticide-resistant Anopheles coluzzii VKPer strain, and wild Anopheles gambiae s.l. mosquitoes from the Vallée du Kou, where the study was conducted. Vector surveillance was carried out to compare the results between sites treated with VECTRON™ T500, Actellic® 300CS, and an untreated control site. In addition, any reported adverse effects were closely monitored to evaluate the community’s acceptance of VECTRON™ T500.ResultsVECTRON™ T500 consistently achieved 100% mortality across all wall types for both susceptible and resistant mosquito strains over the 12-month period. In comparison, Actellic® 300CS induced < 80% mortality for both strains, irrespective of the wall substrate. When assessing delayed mortality in An. gambiae s.l. mosquitoes collected from sites treated with Actellic® 300CS (VK1) and VECTRON™ T500 (VK3), a statistically significant difference was noted after a 72-h holding period compared to the control site (RR = 0.51, CI95% = [0.31–0.6], P =
Microbiologie (bactériologie, virologie)Parasitologie et mycologiePharmacologieLicence : 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
In this prospective, observational study (ClinicalTrials.gov Identifier: NCT02661464), long-term safety information was collected from participants previously exposed to the Ebola vaccines Ad26.ZEBOV and/or MVA-BN-Filo while enrolled in phase 1, 2, or 3 clinical studies. The study was conducted at 15 sites in seven countries (Burkina Faso, France, Kenya, Tanzania, Uganda, the United Kingdom, and the United States). Adult participants and offspring from vaccinated female participants who became pregnant (estimated conception ≤28 days after vaccination with MVA-BN-Filo or ≤3 months after vaccination with Ad26.ZEBOV) were enrolled. Adults were followed for 60 months after their first vaccination, and children born to female participants were followed for 60 months after birth. In the full analysis set (n = 614 adults; median age [range]: 32.0 [18–65] years), 49 (8.0%) had ≥1 serious adverse event (SAE); the incidence rate of any SAE was 27.4 per 1000 person-years (95% confidence interval: 21.0, 35.2). The unrelated SAEs of malaria were reported in the two infants in the full analysis set, aged 11 and 18 months; both episodes were resolved. No deaths or life-threatening SAEs occurred during the study. Overall, no major safety issues were identified; one related SAE was reported. These findings support the long-term clinical safety of the Ad26.ZEBOV and MVA-BN-Filo vaccines.
Parasitologie et mycologieImmunologieMaladies infectieuses et tropicalesLicence : https://creativecommons.org/licenses/by/4.0/ Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ().
Artemisinin combination therapies (ACTs) are the WHO-recommended first-line therapies for uncomplicated Plasmodium falciparum malaria. The emergence and spread of artemisinin-resistant genotypes is a major global public health concern due to the increased rate of treatment failures that result. This is particularly germane for WHO designated ‘high burden to high impact’ (HBHI) countries, such as Burkina Faso, where there is increased emphasis on improving guidance, strategy, and coordination of local malaria response in an effort to reduce the prevalence of P. falciparum malaria. To explore how the increased adoption of ACTs may affect the HBHI malaria setting of Burkina Faso, we added spatial structure to a validated individual-based stochastic model of P. falciparum transmission and evaluated the long-term effects of increased ACT use. We explored how de novo emergence of artemisinin-resistant genotypes, such as pfkelch13 580Y, may occur under scenarios in which private-market drugs are eliminated or multiple first-line therapies (MFT) are deployed. We found that elimination of private market drugs would result in lower treatment failures rates (between 11.98% and 12.90%) when compared to the status quo (13.11%). However, scenarios incorporating MFT with equal deployment of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DHA-PPQ) may accelerate near-term drug resistance (580Y frequency ranging between 0.62 to 0.84 in model year 2038) and treatment failure rates (26.69% to 34.00% in 2038), due to early failure and substantially reduced treatment efficacy resulting from piperaquine-resistant genotypes. A rebalanced MFT approach (90% AL, 10% DHA-PPQ) results in approximately equal long-term outcomes to using AL alone but may be difficult to implement in practice.
Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)Parasitologie et mycologieLicence : 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.
Jessica Julie Chantal Samba, Yacouba Sawadogo, Herman Karim Sombie, Hervé Kafando, Wendinmi Arnaud Marie Joseph Zougmore, Maxime Damolga, Cheick Ahmed Ouattara, Armel Poda, Abdoul-Salam Ouedraogo
Introductionantiretroviral therapy enables the suppression of the plasma viral load and the restoration of immune responses. Therapeutic failures are still observed in patients living with HIV despite the considerable benefits of antiretroviral therapy. This study aimed to describe the long-term evolution of immunological and virological parameters in patients undergoing treatments for HIV-1 at the Day Hospital of Bobo-Dioulasso in Burkina Faso.Methodsa retrospective descriptive and analytical study covering 10 years from 2009 was conducted at the Sourô Sanou University Hospital Center (CHUSS) in Bobo-Dioulasso. HIV-1-positive patients with at least two viral load measurements and two CD4 T cell counts were included in this study. Excel 2019 and RStudio were used to analyze the data.Resultsa total of 265 patients were included in this study. The mean age of the patients was 48 ± 8.98 years and women accounted for 77.7% of the study population. A considerable decrease in the number of patients with TCD4 lymphocytes below 200 cells/μl from year 2 of treatment and a progressive increase in those with TCD4 lymphocytes above 500 cells/μl were observed in the study. Regarding the evolution of viral load, an increase in the proportions of patients with an undetectable viral load and a decrease in those with a viral load greater than 1000 copies/ml were noticed in years 2, 5, 6, and 8 of the follow-up. However, a decrease in the proportions of patients with undetectable viral load and an increase in those with viral load above 1000 copies/ml were observed in the years 4, 7, and 10 of follow-up.Conclusionthis study highlighted the different trends of viral load and LTCD4 evolution over 10 years of antiretroviral treatment. It showed a good immunovirological response was shown at the beginning of antiretroviral therapy, and then, a poor evolution of these markers at certain periods during the follow-up of HIV-positive patients.
ImmunologieMaladies infectieuses et tropicalesSanté publiqueLicence : 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
Abel Bicaba, Luc Serme, Gaël Chetaille, Gountante Kombate, Alice Bila, Slim Haddad
BackgroundSeasonal malaria chemoprevention (SMC) relies on community health workers to distribute drugs. This study assessed: (1) the capacity of community-based distributors (CBDs) at the start and end of a campaign and from one campaign to another after training or refresher courses before each round; (2) to what extent CBDs’ experience over several campaigns contributed to measurable increase in their capacities; and (3) to what extent the training and experience of committed CBDs helped the less productive to catch up.MethodsA longitudinal analysis was conducted in one Burkina Faso health district during the 2017 and 2018 campaigns. A panel including all CBDs was created. Their capacities were observed after: (1) initial training for the 2017 season; (2) refresher training for that year’s fourth round; and (3) initial training for the 2018 season. All were invited to complete a questionnaire at the end of training with 27 multiple-choice questions on their main tasks. Observers noted content coverage and conditions under which training sessions were conducted.ResultsThe 612 CBDs showed, on average, high understanding of their tasks from the start of the annual campaigns. Tasks related to communicating with parents and reporting were best mastered. Their capacities grew from round to round and campaign to campaign, after most had undergone training and been supervised by head nurses. The greatest progress was in the technical components, considered more complex, which involved selecting eligible children, choosing the correct drug packet, and referring children to health professionals. Retaining CBDs from one round to the next benefited everyone, whatever their starting level. Groups that initially obtained the lowest scores (women, illiterates, youngest/oldest) progressed the most.ConclusionThese results confirm the potential of using CBDs under routine programme implementation. Mandating CBDs with targeted tasks is a functional model, as they achieve mastery in
Biologie cellulaire et moléculaireGénétiqueParasitologie et mycologieLicence : 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
Brianna Frangione, Ying Jiang, Margaret de Groh, Esme Fuller-Thomson, Ian Colman, Paul J. Villeneuve
AbstractIntroduction:The COVID-19 pandemic caused unprecedented and inequitably distributed adverse health impacts, which varied across socioeconomic circumstances. We investigated differences in incident depression among individuals aged 50 years and older according to various employment factors during the early stages of the pandemic. Methods:We included 16 719 Canadian Longitudinal Study on Aging participants who provided data at Follow-up one (2015–2018) (FUP1) and twice during the pandemic (Spring and Autumn 2020). The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to classify individuals with depression (CESD-10 score≥10). Logistic regression, adjusted for possible confounders, estimated the odds of incident depression in Autumn 2020.Results:We found depression scores worsened from pre-pandemic (FUP1) to Autumn 2020; this pattern was evident across different employment features. Individuals who were newly unemployed in Spring 2020 had over double the odds of depression in Autumn 2020 (odds ratio [OR]=2.22; 95% confidence interval [CI]: 1.51–3.28) compared to those who remained retired. Higher odds of depression were also observed among those with employment disruptions in Spring 2020 relative to those who did not (OR=1.65; 95% CI: 1.28–2.12), and individuals primarily working in non-home-based settings in Autumn 2020 had 21% lower odds of depression (OR=0.79; 95% CI: 0.63–0.98) than those who worked remotely. Conclusion:Our findings suggest that employment status was an important predictor of depression among Canadians during the early phases of the pandemic.
Biostatistiques et épidémiologieSanté publiqueLicence : This work is licensed under a Creative Commons Attribution 4.0 International License
Chris Drakeley, Salim Abdulla, Selidji Todagbe Agnandji, José Francisco Fernandes, Peter Kremsner, Bertrand Lell, Ludovic Mewono, Bache Emmanuel Bache, Michael Gabriel Mihayo, Omar Juma, Marcel Tanner, Marc Christian Tahita, Halidou Tinto, Salou Diallo, Palpouguini Lompo, Umberto D’Alessandro, Bernhards Ogutu, Lucas Otieno, Solomon Otieno, Walter Otieno, Janet Oyieko, Kwaku Poku Asante, Dominic Bon-Ereme Dery, George Adjei, Elisha Adeniji, Dorcas Atibilla, Seth Owusu-Agyei, Brian Greenwood, Samwel Gesase, John Lusingu, Coline Mahende, Robert Mongi, Method Segeja, Samuel Adjei, Tsiri Agbenyega, Alex Agyekum, Daniel Ansong, John Tanko Bawa, Harry Owusu Boateng, Léonard Dandalo, Veronica Escamilla, Irving Hoffman, Peter Maenje, Francis Martinson, Terrell Carter, Didier Leboulleux, David C. Kaslow, Effua Usuf, Jean-Yves Pirçon, Edith Roset Bahmanyar
Background Plasmodium falciparum prevalence (PfPR) is a widely used metric for assessing malaria transmission intensity. This study was carried out concurrently with the RTS,S/AS01 candidate malaria vaccine Phase III trial and estimated PfPR over ≤ 4 standardized cross-sectional surveys.MethodsThis epidemiology study (NCT01190202) was conducted in 8 sites from 6 countries (Burkina Faso, Gabon, Ghana, Kenya, Malawi, and Tanzania), between March 2011 and December 2013. Participants were enrolled in a 2:1:1 ratio according to age category: 6 months–4 years, 5–19 years, and ≥ 20 years, respectively, per year and per centre. All sites carried out surveys 1–3 while survey 4 was conducted only in 3 sites. Surveys were usually performed during the peak malaria parasite transmission season, in one home visit, when medical history and malaria risk factors/prevention measures were collected, and a blood sample taken for rapid diagnostic test, microscopy, and haemoglobin measurement. PfPR was estimated by site and age category.ResultsOverall, 6401 (survey 1), 6411 (survey 2), 6400 (survey 3), and 2399 (survey 4) individuals were included in the analyses. In the 6 months–4 years age group, the lowest prevalence (assessed using microscopy) was observed in 2 Tanzanian centres (4.6% for Korogwe and 9.95% for Bagamoyo) and Lambaréné, Gabon (6.0%), while the highest PfPR was recorded for Nanoro, Burkina Faso (52.5%). PfPR significantly decreased over the 3 years in Agogo (Ghana), Kombewa (Kenya), Lilongwe (Malawi), and Bagamoyo (Tanzania), and a trend for increased PfPR was observed over the 4 surveys for Kintampo, Ghana. Over the 4 surveys, for all sites, PfPR was predominantly higher in the 5–19 years group than in the other age categories. Occurrence of fever and anaemia was associated with high P. falciparum parasitaemia. Univariate analyses showed a significant association of anti-malarial treatment in 4 surveys (odds ratios [ORs]: 0.52, 0.52, 0.68, 0.41) and bed net use in 2 su
Biostatistiques et épidémiologieParasitologie et mycologieImmunologieLicence : 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
Shannon N. Wood, Haley L. Thomas, Georges Guiella, Rosine Mosso, Peter Gichangi, Simon P.S. Kibira, Fredrick Makumbi, Pierre Z. Akilimali, Funmilola M. OlaOlorun, Elizabeth Omoluabi, Michele R. Decker
SummaryBackgroundReproductive coercion (RC) is a type of abuse where a partner intentionally attempts to interfere with fertility through deception or violence, often by manipulating one’s contraceptive use or reproductive decision-making. Cross-sectional studies on the magnitude of RC across sub-Saharan Africa have noted associations with contraceptive use. No studies have longitudinally examined RC experiences as related to future contraceptive dynamics, including discontinuation or forgoing use altogether.MethodsTwo rounds of longitudinal population-based cohorts across eight sites in sub-Saharan Africa, from November 2020 to January 2023, were used to prospectively examine past-year RC’s impact on future contraceptive dynamics (discontinuation and switching vs. continuation for contraceptive users at baseline; adoption vs. continued non-use for contraceptive non-users at baseline) using bivariate and multivariable multinomial and logistic regression.FindingsMinimal differences in women’s past-year RC experiences were observed over a two-year period. In many settings, RC prevalence decreased. Only in Uganda did past-year RC increase between rounds (15.8% to 17.8%). RC’s impact on contraceptive dynamics over one year differed by setting. In Burkina Faso, women with past-year RC had a three-fold increased risk of discontinuing contraception, as compared to continuing (RRR = 2.63; 95% CI = 1.28–5.42; p<0.01). In Uganda, past-year RC was marginally associated with reduced odds of contraceptive adoption, compared to continued non-use (p<0.1).InterpretationIn this first longitudinal study of RC, trajectories varied across settings, as did RC’s impact on contraception, affirming the importance of context. Future work should clarify RC trajectories and drivers thereof. Providers must be aware of RC leading to potential discontinuation. Contraceptive provision must be flexible and reflect women’s life circumstances, including partner dynamics.FundingThis work was supporte
Biostatistiques et épidémiologieSanté publiqueLicence : This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Nchangwi Syntia Munung, Obiageli E. Nnodu, Patrick Ohiani Moru, Akpaka A. Kalu, Benido Impouma, Marsha J. Treadwell, Ambroise Wonkam
Somatic gene therapy will be one of the most exciting practices of genetic medicine in Africa and is primed to offer a “new life” for persons living with sickle cell disease (SCD). Recently, successful gene therapy trials for SCD in the USA have sparked a ray of hope within the SCD community in Africa. However, the high cost, estimated to exceed 1.5 million USD, continues to be a major concern for many stakeholders. While affordability is a key global health equity consideration, it is equally important to reflect on other ethical, legal and social issues (ELSIs) that may impact the responsible implementation of gene therapy for SCD in Africa. These include informed consent comprehension, risk of therapeutic misestimation and optimistic bias; priorities for SCD therapy trials; dearth of ethical and regulatory oversight for gene therapy in many African countries; identifying a favourable risk-benefit ratio; criteria for the selection of trial participants; decisional conflict in consent; standards of care; bounded justice; and genetic tourism. Given these ELSIs, we suggest that researchers, pharma, funders, global health agencies, ethics committees, science councils and SCD patient support/advocacy groups should work together to co-develop: (1) patient-centric governance for gene therapy in Africa, (2) public engagement and education materials, and (3) decision making toolkits for trial participants. It is also critical to establish harmonised ethical and regulatory frameworks for gene therapy in Africa, and for global health agencies to accelerate access to basic care for SCD in Africa, while simultaneously strengthening capacity for gene therapy.
Biologie cellulaire et moléculaireGénétiqueHématologieLicence : Open Access http://creativecommons.org/licenses/by/4.0/ 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 you give appropriate credit to the original autho
Nicolas Nagot, Chipepo Kankasa, Nicolas Meda, Justus Hofmeyr, Cheryl Nikodem, James K Tumwine, Charles Karamagi, Halvor Sommerfelt, Dorine Neveu, Thorkild Tylleskär, Philippe Van de Perre
BackgroundPostnatal transmission of HIV-1 through breast milk remains an unsolved challenge in many resource-poor settings where replacement feeding is not a safe alternative. WHO now recommends breastfeeding of infants born to HIV-infected mothers until 12 months of age, with either maternal highly active antiretroviral therapy (HAART) or peri-exposure prophylaxis (PEP) in infants using nevirapine. As PEP, lamivudine showed a similar efficacy and safety as nevirapine, but with an expected lower rate of resistant HIV strains emerging in infants who fail PEP, and lower restrictions for future HIV treatment. Lopinavir/ritonavir (LPV/r) is an attractive PEP candidate with presumably higher efficacy against HIV than nevirapine or lamivudine, and a higher genetic barrier to resistance selection. It showed an acceptable safety profile for the treatment of very young HIV-infected infants. The ANRS 12174 study aims to compare the risk of HIV-1 transmission during and safety of prolonged infant PEP with LPV/r (40/10 mg twice daily if 2-4 kg and 80/20 mg twice daily if >4 kg) versus Lamivudine (7,5 mg twice daily if 2-4 kg, 25 mg twice daily if 4-8 kg and 50 mg twice daily if >8 kg) from day 7 until one week after cessation of BF (maximum 50 weeks of prophylaxis) to prevent postnatal HIV-1 acquisition between 7 days and 50 weeks of age.MethodsThe ANRS 12174 study is a multinational, randomised controlled clinical trial conducted on 1,500 mother-infant pairs in Burkina Faso, South Africa, Uganda and Zambia. We will recommend exclusive breastfeeding (EBF) until 26th week of life and cessation of breastfeeding at a maximum of 49 weeks in both trial arms.HIV-uninfected infants at day 7 (± 2 days) born to HIV-1 infected mothers not eligible for HAART who choose to breastfeed their infants.The primary endpoint is the acquisition of HIV-1 (as assessed by HIV-1 DNA PCR) between day 7 and 50 weeks of age. Secondary endpoints are safety (including resistance, adverse events and growth)
Biologie cellulaire et moléculaireGénétiqueMicrobiologie (bactériologie, virologie)Licence : http://creativecommons.org/licenses/by/2.0 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 work is properly cited.