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Mahfoudhi Madiha, Khamassi Khaled
Rim Lahiani, Madiha Mahfoudhi
Dereje Dengela, Aklilu Seyoum, Bradford Lucas, Benjamin Johns, Kristen George, Allison Belemvire, Angela Caranci, Laura C. Norris, Christen M. Fornadel
BackgroundIndoor residual spraying (IRS) is the application of insecticide to the interior walls of household structures that often serve as resting sites for mosquito vectors of malaria. Human exposure to malaria vectors is reduced when IRS involves proper application of pre-determined concentrations of the active ingredient specific to the insecticide formulation of choice. The impact of IRS can be affected by the dosage of insecticide, spray coverage, vector behavior, vector susceptibility to insecticides, and the residual efficacy of the insecticide applied. This report compiles data on the residual efficacy of insecticides used in IRS campaigns implemented by the United States President’s Malaria Initiative (PMI)/United States Agency for International Development (USAID) in 17 African countries and compares observed length of efficacy to ranges proposed in World Health Organization (WHO) guidelines. Additionally, this study provides initial analysis on variation of mosquito mortality depending on the surface material of sprayed structures, country spray program, year of implementation, source of tested mosquitoes, and type of insecticide.MethodsResidual efficacy of the insecticides used for PMI/USAID-supported IRS campaigns was measured in Benin, Burkina Faso, Ethiopia, Ghana, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Nigeria, Rwanda, Senegal, Tanzania, Uganda, Zambia and Zimbabwe. The WHO cone bioassay tests were used to assess the mortality rate of mosquitoes exposed to insecticide-treated mud, wood, cement, and other commonly used housing materials. Baseline tests were performed within weeks of IRS application and follow-up tests were continued until the mortality of exposed mosquitoes dropped below 80% or the program monitoring period ended. Residual efficacy in months was then evaluated with respect to WHO guidelines that provide suggested ranges of residual efficacy for insecticide formulations recommended for use in IRS. Where the data allowe
The antimalarial drug piperaquine is associated with delayed ventricular depolarization, causing prolonged QT interval (time taken for ventricular de-polarisation and re-polarisation). There is a lack of safety data regarding dihydroartemisinin/piperaquine (DHA/PPQ) for the treatment of uncomplicated malaria, which has limited its use. We created a platform where electrocardiograms (ECG) were performed in public hospitals for the safety assessment of DHA/PPQ, at baseline before the use of dihydroartemisinin/piperaquine (Eurartesim®), and on day 3 (before and after administration of the final dose) and day 7 post-administration. Laboratory analyses included haematology and clinical chemistry. The main objective of the ECG assessment in this study was to evaluate the effect of administration of DHA/PPQ on QTc intervals and the association of QTc intervals with changes in blood biochemistry, full and differential blood count over time after the DHA/PPQ administration. A total of 1315 patients gave consent and were enrolled of which 1147 (87%) had complete information for analyses. Of the enrolled patients 488 (42%), 323 (28%), 213 (19%) and 123 (11%) were from Ghana, Burkina Faso, Tanzania and Mozambique, respectively. Median (lower—upper quartile) age was 8 (5–14) years and a quarter of the patients were children under five years of age (n = 287). Changes in blood biochemistry, full and differential blood count were temporal which remained within clinical thresholds and did not require any intervention. The mean QTcF values were significantly higher than on day 1 when measured on day 3 before and after administration of the treatment as well as on day 7, four days after completion of treatment (12, 22 and 4 higher, p < 0.001). In all age groups the values of QT, QTcF and QTcB were highest on day 3 after drug intake. The mean extreme QTcF prolongation from baseline was lowest on day 3 before drug intake (33 ms, SD = 19) and highest on day 3 after the last dose (60 ms,
Juan Carlos Lol, Antonia L Böhmert, Juliane Hartke, Antoine Sanou, Jakob Kerbl-Knapp, Marion Morris, Julia B Mäurer, Patrick Hogan, Moussa Wamdaogo Guelbeogo, Eric R Lucas, Hilary Ranson, Victoria A Ingham
BackgroundThe Anopheles gambiae species complex comprises about nine sibling species, including An. gambiae, An. coluzzii, and An. arabiensis, three of the four major malaria vector species across Africa. Insecticide-based vector control remains the most critical tool in the fight against malaria, with a heavy reliance on pyrethroid insecticides. However, widespread pyrethroid resistance jeopardises the effectiveness of these methods. Currently, the number of diagnostic markers available to track pyrethroid resistance in endemic settings is limited, focusing mainly on changes at the insecticide target site.ResultsGenetic analysis of seven insecticide-resistant populations from West Africa, a region with intense insecticide resistance, reveals shared loci associated with pyrethroid resistance among the sister species An. gambiae, An. coluzzii, and An. arabiensis including kdr, GSTE1-8 and the CYP6P region. Notably, a mutation in the voltage-gated sodium channel, I1527T, previously identified in An. coluzzii and An. gambiae, was detected in wild-caught An. arabiensis from Burkina Faso. Additionally, a mutation, L207I, in GSTE7 common to An. coluzzii and An. arabiensis, significantly increases survivorship to deltamethrin. With the additional integration of RNAseq and data from the Anopheles gambiae 1000 genomes project, we were able to identify putative eQTLs associated with the expression of major insecticide resistance-related transcripts, such as CYP6P3, CYP9K1 and CYP6AA1.ConclusionThis study reveals several potential diagnostic markers of resistance that can be implemented in endemic settings and identifies putative introgression between An. arabiensis and An. coluzzii in Burkina Faso. Supplementary InformationThe online version contains supplementary material available at 10.1186/s12864-026-13109-8.
Craig W. Duffy, Alfred Amambua-Ngwa, Ambroise D. Ahouidi, Mahamadou Diakite, Gordon A. Awandare, Hampate Ba, Sarah J. Tarr, Lee Murray, Lindsay B. Stewart, Umberto D’Alessandro, Thomas D. Otto, Dominic P. Kwiatkowski, David J. Conway
Parasites infect hosts in widely varying environments, encountering diverse challenges for adaptation. To identify malaria parasite genes under locally divergent selection across a large endemic region with a wide spectrum of transmission intensity, genome sequences were obtained from 284 clinical Plasmodium falciparum infections from four newly sampled locations in Senegal, The Gambia, Mali and Guinea. Combining these with previous data from seven other sites in West Africa enabled a multi-population analysis to identify discrete loci under varying local selection. A genome-wide scan showed the most exceptional geographical divergence to be at the early gametocyte gene locus gdv1 which is essential for parasite sexual development and transmission. We identified a major structural dimorphism with alternative 1.5 kb and 1.0 kb sequence deletions at different positions of the 3′-intergenic region, in tight linkage disequilibrium with the most highly differentiated single nucleotide polymorphism, one of the alleles being very frequent in Senegal and The Gambia but rare in the other locations. Long non-coding RNA transcripts were previously shown to include the entire antisense of the gdv1 coding sequence and the portion of the intergenic region with allelic deletions, suggesting adaptive regulation of parasite sexual development and transmission in response to local conditions.
The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA) approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration.
Sarah Kribi, Fidèle Touré, Adriano Mendes, Soufiane Sanou, Arsène Some, Abdoul M Aminou, Essia Belarbi, Rosemary Griessel, Arsène Hema, Firmin Kabore, Paul Pitzinger, Amy Strydom, Ann Christin Vietor, Korotimi Traoré, Arsène Zongo, Etilé A Anoh, Marica Grossegesse, Natalie Hofmann, Soumeya Ouangraoua, Armel Poda, Thérèse Kagone, Grit Schubert, Tim Eckmanns, Marietjie Venter, Fabian Leendertz, Chantal Akoua-Koffi, Sara Tomczyk
AbstractBackgroundReports on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread across Africa have varied, including among healthcare workers (HCWs). This study assessed the comparative SARS-CoV-2 burden and associated risk factors among HCWs in three African countries.MethodsA multicentre study was conducted at regional healthcare facilities in Côte d’Ivoire (CIV), Burkina Faso (BF) and South Africa (SA) from February to May 2021. HCWs provided blood samples for SARS-CoV-2 serology and nasopharyngeal/oropharyngeal swabs for testing of acute infection by polymerase chain reaction and completed a questionnaire. Factors associated with seropositivity were assessed with logistic regression.ResultsAmong 719 HCWs, SARS-CoV-2 seroprevalence was 34.6% (95% confidence interval 31.2 to 38.2), ranging from 19.2% in CIV to 45.7% in BF. A total of 20 of 523 (3.8%) were positive for acute SARS-CoV-2 infection. Female HCWs had higher odds of SARS-CoV-2 seropositivity compared with males, and nursing staff, allied health professionals, non-caregiver personnel and administration had higher odds compared with physicians. HCWs also reported infection prevention and control (IPC) gaps, including 38.7% and 29% having access to respirators and IPC training, respectively, in the last year.ConclusionsThis study was a unique comparative HCW SARS-CoV-2 investigation in Africa. Seroprevalence estimates varied, highlighting distinctive population/facility-level factors affecting COVID-19 burden and the importance of established IPC programmes to protect HCWs and patients.
Richard Oteng-Frimpong, Felix D. Dakora
Groundnut production constitutes an integral part of the livelihoods of the people in the Guinea savanna of West Africa. This region accounts for over 70% of the total groundnut production in Ghana, 90% in Nigeria, and 100% in Mali and Burkina Faso. However, harsh environmental conditions often result in drastic yield reductions. In this study, we identified groundnut genotypes with superior symbiotic efficiency, greater pod yield, and plant water-use efficiency from 21 advanced groundnut breeding lines from ICRISAT after testing them at three locations in the Guinea savanna of Ghana over two consecutive years. Average N contribution by the groundnut genotypes ranged from 48 to 108 kg N ha−1, and mean pod yield from 580 to 2,100 kg ha−1. Genotype 17 (ICGV-IS 08837) produced about 2.5-fold more pods than genotype 1 (Chinese), which was the most widely cultivated variety by farmers. Of the 21 genotypes studied, genotype 16 (ICGV 99247) recorded the highest shoot δ13C value and was superior in water-use efficiency, which was consistent with stability estimates and mean performance. We also measured the effects of G × E on pod yield, N2 fixation, shoot δ13C, and mega-environments for testing groundnut in the Guinea savanna, and these were all significant, although the effect was minimal on shoot δ13C values. Of the locations studied, Nyankpala and Damongo were more discriminating, and each constituted a mega-environment for conducting future groundnut trials in the Guinea savanna. Genotype 3 (ICG 6222) emerged as the best cultivar for the Damongo mega-environment, while genotype 17 was the best genotype for the Nyankpala mega-environment. The genotypes exhibiting the highest sensitivity of N2 fixation in the environment included genotype 3 (ICG 6222), genotype 4 (ICGV 00068), and genotype 10 (ICGV 03315) (bi > 1.3), while Pi estimates ranked genotypes 3, 10, and 17 as the best groundnut cultivars in terms of symbiotic N contribution. Based on the results of this study,
ObjectivesClinical breast examination (CBE) open the pathway to early detection and diagnosis of breast cancer. This study examined barriers to CBE uptake in seven sub-Saharan African (SSA) countries.MethodsData from the most current Demographic and Health Surveys of Burkina Faso, Cote d’Ivoire, Ghana, and Kenya Mozambique, Senegal and Tanzania was used. A weighted sample size of 65,486 women aged 25–49 years was used to estimate the pooled prevalence of CBE. We employed a multilevel logistic regression modelling technique, with results presented in adjusted odds ratios (aOR) along with a 95% confidence interval (CI).ResultsThe pooled prevalence of CBE uptake in the studied SSA countries is low at 19.2% [95%CI: 18.5–19.8]. Screening uptake was significantly low among women reporting difficulty in getting permission (aOR = 0.88, 95% CI: 0.82–0.95), and distance (aOR = 0.95, 95% CI: 0.89–0.99), as well as those who reported financial constraints (aOR = 0.92, 95% CI: 0.88–0.97), as barriers to access healthcare facilities. However, surprisingly, women who faced travel-alone barriers were 1.19 times (95%CI: 1.10–1.28) more likely to utilise CBE than those who did not face this barrier.ConclusionsWe conclude that barriers such as difficulties in obtaining permission, long distances to healthcare facilities, and financial constraints significantly reduce the likelihood of women undergoing CBE. The study underscores a need to improve access to healthcare facilities. Practically, this can be achieved by expanding mobile health services and integrating CBE into primary healthcare will help overcome distance-related challenges. Additionally, targeted outreach and transportation initiatives are necessary to support women facing travel barriers.
Sekou Samadoulougou, Mathieu Maheu-Giroux, Fati Kirakoya-Samadoulougou, Mathilde De Keukeleire, Marcia C Castro, Annie Robert
BackgroundPrevious research on determinants of malaria in Burkina Faso has largely focused on individual risk factors. Malaria risk, however, is also shaped by community, health system, and climatic/environmental characteristics. The aims of this study were: i) to identify such individual, household, community, and climatic/environmental risk factors for malaria in children under five years of age, and ii) to produce a parasitaemia risk map of Burkina Faso.MethodsThe 2010 Demographic and Health Survey (DHS) was the first in Burkina Faso that tested children for malaria parasitaemia. Multilevel and geo-statistical models were used to explore determinants of malaria using this nationally representative database.ResultsParasitaemia was collected from 6,102 children, of which 66.0% (95% confidence interval (CI): 64.0-68.0%) were positive for Plasmodium spp. Older children (>23 months) were more likely to be parasitaemic than younger ones, while children from wealthier households and whose mother had higher education were at a lower risk. At the community level, living in a district with a rate of attendance to health facilities lower than 2 visits per year was significantly associated with greater odds of being infected. Malaria prevalence was also associated with higher normalized difference vegetation index, lower average monthly rainfall, and lower population densities. Predicted malaria parasitaemia was spatially variable with locations falling within an 11%-92% prevalence range. The number of parasitaemic children was nonetheless concentrated in areas of high population density, albeit malaria risk was notably higher in the sparsely populated rural areas.ConclusionMalaria prevalence in Burkina Faso is considerably higher than in neighbouring countries. Our spatially-explicit population-based estimates of malaria risk and infected number of children could be used by local decision-makers to identify priority areas where control efforts should be enhanced.Electronic
Kathryn Batchelor, Lalbila Aristide Yoda, Féridjou Emilie Georgette Sanon Ouattara, Olivia Hellewell
Background: Many lower and middle income countries (LMICs) have high levels of linguistic diversity, meaning that health information and care is not available in the languages spoken by the majority of the population. This research investigates the extent to which language needs are taken into account in planning for HIV/AIDS-related health communication in development contexts. Methods: We analysed all HIV/AIDS-related policy documents and reports available via the websites of the Department for International Development UK, The Global Fund, and the Ministries of Health and National AIDS commissions of Burkina Faso, Ghana and Senegal. We used quantitative and qualitative analysis to assess the level of prominence given to language issues, ascertain the level at which mentions occur (donor/funder/national government or commission), and identify the concrete plans for interlingual communication cited in the documents. Results: Of the 314 documents analysed, 35 mention language or translation, but the majority of the mentions are made in passing or in the context of providing background socio-cultural information, the implications of which are not explored. At donor level (DFID), no mentions of language issues were found. Only eight of the documents (2.5%) outline concrete actions for addressing multilingualism in HIV/AIDS-related health communication. These are limited to staff training for sign language, and the production of multilingual resources for large-scale sensitization campaigns. Conclusions: The visibility of language needs in formal planning and reporting in the context of HIV/AIDS-related health care is extremely low. Whilst this low visibility should not be equated to a complete absence of translation or interpreting activity on the ground, it is likely to result in insufficient resources being dedicated to addressing language barriers. Further research is needed to fully understand the ramifications of the low prominence given to questions of language,
Floriane Gallais, Sylvie de Martino, Eric-André Sauleau, Yves Hansmann, Dan Lipsker, Cedric Lenormand, Emilie Talagrand-Reboul, Pierre H. Boyer, Nathalie Boulanger, Benoit Jaulhac, Frederic Schramm
BACKGROUND: Lyme borreliosis in humans results in a range of clinical manifestations, thought to be partly due to differences in the pathogenicity of the infecting strain. This study compared European human clinical strains of Borreliella afzelii (previously named Borrelia afzelii) using multilocus sequence typing (MLST) to determine their spatial distribution across Europe and to establish whether there are associations between B. afzelii genotypes and specific clinical manifestations of Lyme borreliosis. For this purpose, typing was performed on 63 strains, and data on a further 245 strains were accessed from the literature. RESULTS: All 308 strains were categorized into 149 sequence types (STs), 27 of which are described here for the first time. Phylogenetic and goeBURST analyses showed short evolutionary distances between strains. Although the main STs differed among the countries with the largest number of strains of interest (Germany, the Netherlands, France and Slovenia), the B. afzelii clinical strains were less genetically structured than those previously observed in the European tick population. Two STs were found significantly more frequently in strains associated with clinical manifestations involving erythema migrans, whereas another ST was found significantly more frequently in strains associated with disseminated manifestations, especially neuroborreliosis. CONCLUSIONS: The MLST profiles showed low genetic differentiation between B. afzelii strains isolated from patients with Lyme borreliosis in Europe. Also, clinical data analysis suggests the existence of lineages with differential dissemination properties in humans.
Malaria control programs are being jeopardized by the spread of insecticide resistance in mosquito vector populations. The situation in Burkina Faso is emblematic with Anopheles gambiae populations showing high levels of resistance to most available compounds. Although the frequency of insecticide target-site mutations including knockdown resistance (kdr) and insensitive acetylcholinesterase (Ace-1 R) alleles has been regularly monitored in the area, it is not known whether detoxifying enzymes contribute to the diversity of resistance phenotypes observed in the field. Here, we propose an update on the phenotypic diversity of insecticide resistance in An. gambiae populations sampled from 10 sites in Burkina Faso in 2010. Susceptibility to deltamethrin, permethrin, DDT, bendiocarb and fenithrotion was assessed. Test specimens (N = 30 per locality) were identified to species and molecular form and their genotype at the kdr and Ace-1 loci was determined. Detoxifying enzymes activities including non-specific esterases (NSEs), oxydases (cytochrome P450) and Glutathione S-Transferases (GSTs) were measured on single mosquitoes (N = 50) from each test locality and compared with the An. gambiae Kisumu susceptible reference strain. In all sites, mosquitoes demonstrated multiple resistance phenotypes, showing reduced mortality to several insecticidal compounds at the same time, although with considerable site-to-site variation. Both the kdr 1014L and Ace-1 R 119S resistant alleles were detected in the M and the S forms of An. gambiae, and were found together in specimens of the S form. Variation in detoxifying enzyme activities was observed within and between vector populations. Elevated levels of NSEs and GSTs were widespread, suggesting multiple resistance mechanisms segregate within An. gambiae populations from this country. By documenting the extent and diversity of insecticide resistance phenotypes and the putative combination of their underlying mechanisms in An. gambiae
Sunny S. Kim, Césaire T. Ouédraogo, Rock R. Zagré, Rasmané Ganaba, Maurice G. Zafimanjaka, Manisha Tharaney, Purnima Menon
AbstractLow coverage of effective nutrition interventions in many high‐burden countries, due to service provision and demand factors, result in poor uptake of recommended practices and nutrition outcomes. We examined the factors that influence maternal nutrition and early breastfeeding practices and determined the extent that the key factors could improve these practices in two regions in Burkina Faso. We used household survey data among pregnant (n = 920) and recently delivered women (n = 1840). Multivariable regression analyses were conducted to identify the determinants of a diverse diet and iron‐folic acid (IFA) supplement consumption, weight monitoring during pregnancy and early initiation of breastfeeding (EIBF). Population attributable risk analysis was used to estimate how much the outcomes can be improved under optimal conditions of interventions that address the modifiable determinants. During pregnancy, 21% of women achieved minimum diet diversity (MDD‐W), 70% consumed 90+ IFA tablets and 65% were weighed 4+ times; EIBF was 40%. Nutrition knowledge was associated with MDD‐W (odds ratio [OR]: 3.2), 90+ IFA (OR: 1.5) and EIBF (OR: 1.9). Positive social norms and family support were associated with 90+ IFA (OR: 1.5). Early and 4+ ANC visits were associated with 90+ IFA (OR: 1.5 and 10) and 4+ weight monitoring (OR: 6.2). Nutrition counselling was associated with 90+ IFA (OR: 2.5) and EIBF (OR: 1.5). Under optimal programme conditions, 41% of women would achieve MDD‐W, 93% would consume 90+ IFA, 93% would be weighed 4+ times and 57% would practice EIBF. Strengthening the delivery and uptake of interventions targeted at these modifiable factors has the potential to improve maternal nutrition practices. We examined the factors that influence maternal nutrition and early breastfeeding practices and determined the extent that the key factors could improve these practices in two regions in Burkina Faso. Strengthening the delivery and uptake of interventions target
Cally Roper and colleagues analyze the distribution of sulfadoxine resistance mutations and flanking microsatellite loci to trace the emergence and dispersal of drug-resistant Plasmodium falciparum malaria in Africa. BackgroundAlthough the molecular basis of resistance to a number of common antimalarial drugs is well known, a geographic description of the emergence and dispersal of resistance mutations across Africa has not been attempted. To that end we have characterised the evolutionary origins of antifolate resistance mutations in the dihydropteroate synthase (dhps) gene and mapped their contemporary distribution.Methods and FindingsWe used microsatellite polymorphism flanking the dhps gene to determine which resistance alleles shared common ancestry and found five major lineages each of which had a unique geographical distribution. The extent to which allelic lineages were shared among 20 African Plasmodium falciparum populations revealed five major geographical groupings. Resistance lineages were common to all sites within these regions. The most marked differentiation was between east and west African P. falciparum, in which resistance alleles were not only of different ancestry but also carried different resistance mutations.ConclusionsResistant dhps has emerged independently in multiple sites in Africa during the past 10–20 years. Our data show the molecular basis of resistance differs between east and west Africa, which is likely to translate into differing antifolate sensitivity. We have also demonstrated that the dispersal patterns of resistance lineages give unique insights into recent parasite migration patterns. Editors' SummaryBackground Plasmodium falciparum, a mosquito-borne parasite that causes malaria, kills nearly one million people every year, mostly in sub-Saharan Africa. People become infected with P. falciparum when they are bitten by a mosquito that has acquired the parasite in a blood meal taken from an infected person. P. falciparum malar
Mary Aigbiremo Oboh, Fatou Faal, Oluwagbemisola Elizabeth Adeniji, Simon Correa, Anthony Uyimulam Amawu, Ekon Ogban, Eva Heinz, Grant Hughes, Martin M. Meremikwu, Alfred Amambua-Ngwa
BackgroundThe development of resistance by Plasmodium falciparum to anti-malarial drugs impedes any benefits of the drug. In addition, absence or delayed availability of current anti-malarial drugs in remote areas has the potential to results to parasite escape and continuous transmission.Case presentationThe case of a 29-year old pregnant woman from Biase Local Government Area in Cross River State Nigeria presenting with febrile illness and high body temperature of 38.7 °C was reported. She looked pale and vomited twice on arrival at the health facility. Her blood smear on the first day of hospitalization was positive for P. falciparum by RDT, microscopy (21,960 parasite/µl) and real-time PCR, with a PCV of 18%. She was treated with 600 mg intravenous quinine in 500 ml of 5% Dextrose/0.9% Saline 8-hourly for 24 h. On the second day of hospitalization, she complained of weakness, persistent high-grade fever and vaginal bleeding. A bulging amnion from an extended cervix was observed. Following venous blood collection for laboratory investigations, 600 µg of misoprostol was inserted into the posterior fornix of her vagina as part of her obstetric care. Parenteral quinine was discontinued, and she was given full therapeutic regimen of artemether-lumefantrine 80/480 mg tablets to be taken for 3 days beginning from the second day. Her blood samples on the second and third day of hospitalization remained positive for P. falciparum by all three diagnostic methods. Single nucleotide polymorphism (SNP) assay on all three P. falciparum isolates revealed the presence of variants associated with multiple drug resistant markers.DiscussionInfecting P. falciparum isolates may have been resistant to initial quinine treatment resulting from parasite cross-resistance with other quinoline associated resistant markers such as 86Y and 184 F.ConclusionsTherefore, the likely transmission of similarly resistant parasites in the study area calls for reinforcement of interventions and adhere
Xi He, Maohua Pan, Weilin Zeng, Chunyan Zou, Liang Pi, Yucheng Qin, Luyi Zhao, Pien Qin, Yuxin Lu, J. Kevin Baird, Yaming Huang, Liwang Cui, Zhaoqing Yang
BackgroundPlasmodium vivax transmission in West Africa, dominant for the Duffy-negative blood group, has been increasingly recognized from both local residents as well as international travelers who contracted P. vivax malaria there. However, the relapsing pattern and sensitivity to antimalarial treatment of P. vivax strains originated from this region are largely unknown. There is evidence that the efficacy of primaquine for radical cure of relapsing malaria depends on host factors such as the hepatic enzyme cytochrome P450 (CYP) 2D6.Case presentationA 49-year-old Chinese man was admitted to the Shanglin County Hospital in Guangxi Province, China, on December 19, 2016, 39 days after he returned from Ghana, where he stayed for one and a half years. He was diagnosed by microscopy as having uncomplicated P. vivax malaria. Treatment included 3 days of intravenous artesunate (420 mg total), and 3 days of chloroquine (1550 mg total), and 8 days of primaquine (180 mg total). Although parasites and symptoms were cleared rapidly and he was malaria-negative for almost two months, he suffered four relapses with relapse intervals ranging from 58 to 232 days. The last relapse occurred at 491 days from his first vivax attack. For the first three relapses, he was treated similarly with chloroquine and primaquine, sometimes supplemented with additional artemisinin combination therapies (ACTs). For the last relapse, he was treated with intravenous artesunate, 3 days of an ACT, and 7 days of azithromycin, and had remained healthy for 330 days. Molecular studies confirmed P. vivax infections for all the episodes. Although this patient was diagnosed to have normal glucose-6-phosphate dehydrogenase (G6PD) activity, his CYP2D6 genotype corresponded to a 2A/36 allele variant suggesting of an impaired primaquine metabolizer phenotype.ConclusionsThis clinical case suggests that P. vivax malaria originating from West Africa may produce multiple relapses extending beyond one year. The fail
Hyacinthe K. Toe, Soumanaba Zongo, Florence Kabore, Inoussa Toe, Antoine Sanou, Siaka Debe, Moussa W. Guelbeogo, Moussa Namountougou, Olivier Gnankine
BackgroundAedes aegypti, the primary vector of Dengue fever in Burkina Faso, breeds in a variety of domestic and peri-domestic water holding containers. The influence of these water containers on the mosquitoes’ ability to survive exposure to chemical insecticides remains unclear. This study investigated the insecticide susceptibility profile of Aedes aegypti in relation to larval habitat types in three districts of Ouagadougou.MethodsAdult females reared from larvae collected in “domestic containers” and “car tires” were exposed separately to papers impregnated with deltamethrin, pirimiphos-methyl, and bendiocarb to determine their susceptibility profiles. A subsample of mosquitoes per locality and container type was screened for the F1534C, V1016I and V410L kdr mutations involved in pyrethroid resistance.ResultsMosquito population from the three localities showed high resistance to deltamethrin and pirimiphos-methyl and moderate resistance to bendiocarbe, with mortality rates ranging from 15% to 27%, 21% to 33% and 67% to 86%, respectively. Mosquitoes from the "domestic containers" were significantly more resistant to deltamethrin than those from tires (10% vs. 22%, p < 0.002). The frequency of the 1534C mutation was also significantly higher in the "domestic containers" compared to those from tires (0.88 vs. 0.76, p = 0.013).The other mutations 1016I and 410L, were reported with an overall frequency of 0.51 and 0.36, respectively.ConclusionsThese findings suggest that larval habitat type may influence both the level and mechanisms of resistance in Aedes aegypti. This has important implications for the design of targeted vector control strategies in dengue-endemic settings.Supplementary InformationThe online version contains supplementary material available at 10.1186/s41182-025-00888-1.
Cheick Rachid BARGO, Wendbénédo Habacuc SARE, Mohamed Karfalla KABA, Modibo Abdoulaye NANA
RÉSUMÉIntroductionLe mal de Pott cervical est une localisation très rare de la tuberculose osseuse. Son association à des abcès froids cercico-thoraciques est également exceptionnelle.ObservationPatient de 36 ans, noir africain, d'origine burkinabè, avec notion de contage tuberculeux (mère atteinte de tuberculose pulmonaire), sans autre antécédent pathologique, reçu pour une cervicalgie chronique évoluant depuis six mois dans un contexte non fébrile et d'altération de l’état général. L'examen montrait des tuméfactions fluctuantes latéro-cervicale gauche et basithoracique gauche. L'examen pleuropulmonaire et neurologique était normal. La sérologie VIH et l'intradermoréaction à la tuberculine étaient négatives. La tomodensitométrie cervico thoracique a mis en évidence de multiples abcès. Il a été réalisé une incision drainage des abcès. L'analyse du prélèvement a montré la présence de bacille acido-alcoolo-résistant à l'examen direct, et de Mycobacterium tuberculosis au test Xpert avec une sensibilité à la rifampicine. Le diagnostic d'abcès froids tuberculeux multiples associé à un mal de Pott cervical a été posé. Le patient a été mis sous antalgique usuel et sous antituberculeux pendant 12 mois. L’évolution a été favorable avec un recul d'une année au-delà du traitement.ConclusionL'abcès cervical froid compliquant un mal de Pott cervical est exceptionnel. L'imagerie et la technique d'étude geneXpert sont aujourd'hui des outils de diagnostic rapides et efficaces de la tuberculose. Cette forme particulière doit toujours être suspectée dans les zones endémiques.
Johnny Cizemba, Kevin Ndangi, Pistis Zamba, Raymond Minkutu, Chris Muteba, Doudou Diumu
Nous présentons le cas d'un patient de 70 ans, opéré pour une fracture du col du fémur gauche Garden 4. Le traitement avait consisté en une prothèse totale de hanche (PTH) primaire dont l'évolution à court terme était marquée par 6 complications, ayant nécessité 3 reprises chirurgicales. La disponibilité des moyens logistiques, la rapidité dans les gestes ont permis d'obtenir une issue acceptable.
Hakima Elmahi, Fatima Zahra Mernissi
Ahlam Abdou, Badreddine Hassam
Mustapha Ahsaini, Adil Mellouki, Soufiane Mellas, Jalaleddine El Ammari, Mohammed Fadl Tazi, Mohammed Jamal El Fassi, Moulay Hassan Farih
Le dysraphisme spinal (ou spina bifida) est une pathologie neurologique qui représente la première cause de handicap urologique congénital. Il peut avoir des expressions cliniques très variables, les troubles vésico-sphinctériens et sexuels sont fréquents et rarement isolés, noyés au sein des troubles moteurs, orthopédiques, sensitifs, digestifs voire cognitifs. Le syndrome de la moelle bas attachée est une complication du dysraphisme spinal. Affection est souvent découverte chez l'enfant. Elle peut être asymptomatique et rencontrée chez l'adulte. Les troubles vésico-sphinctériens constituent la principale cause de morbi-mortalité par les complications uro-nephrologiques qu'ils entrainent avec une altération significative de la qualité de vie de ces patients, justifiant ainsi une prise en charge spécifique, multidisciplinaire et un suivi strict. Nous présentons un cas exceptionnel de dysraphisme spinale type syndrome de la moelle bas attachée de découverte fortuite à l'âge adulte à l'occasion du bilan étiologique de lithiases de l'urètre prostatique associées à une anéjaculation.