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MURIGA en Guinée: une expérience de mutualisation des risques liés à la grossesse et à l'accouchement
No full textActive transmission of Trypanosoma brucei gambiense Dutton, 1902 sleeping sickness in Abraka, Delta State, Nigeria
No full textOverview of the costs of obstetric care and the economic and social consequences for households
No full textNational fee exemption schemes for delivieries: comparing the recent experiences of Ghana and Senegal
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Postnatal and diet-dependent increases in enteric glial cells and VIP-containing neurones in preterm pigs
No full textA mature enteric nervous system (ENS) is required to ensure a normal pattern of intestinal motility in order to regulate digestion after birth. We hypothesized that neuronal and glial components of the ENS would mature during the first postnatal days in preterm pigs that are a sensitive animal model of food intolerance and necrotizing enterocolitis (NEC). Stereological volume densities of the general neuronal population [assessed by betaIII-tubulin immunoreactivity (IR)] and subsets of neuronal (VIP-IR and nitrergic IR) and glial cells (GFAP-IR and S100-IR) were determined in the small intestine of newborn preterm piglets (93% gestation), after 3 days of receiving total parenteral nutrition (TPN) and after 3 days of TPN plus 2 days of enteral feeding with sow's colostrum or milk formula. Following TPN, VIP in the myenteric and inner submucous plexus and GFAP in the inner submucous plexus increased, while the relative volume of the total neuronal population remained constant. Introduction of enteral food induced variable degrees of food intolerance and NEC, especially after formula feeding, a diet that gave rise to a higher myenteric VIP and GFAP content in the inner submucous plexus than colostrum feeding. However, the ENS seemed unaffected by the presence of NEC-like intestinal lesions. Nevertheless, this study shows that the ENS is highly plastic during the first days after premature birth and adapts in an age- and diet-dependent manner. The observed postnatal adaptation in enteric VIP and GFAP may help to maintain intestinal homeostasis during suboptimal feeding regimens in preterm neonates
Epidémiologie de la fièvre catarrhale ovine en Europe: situation actuelle et perspectives
No full textEn raison de son fort impact socio-économique et de son importance majeure pour le commerce international d'animaux et de produits animaux, la fièvre catarrhale ovine (FCO) est une maladie notifiable à l'Organisation mondiale de la Santé animale (OIE). Avant 1998, la FCO était considérée comme une maladie exotique en Europe. Entre 1998 et 2005, au moins 6 souches virales (bluetongue Virus, BTV) appartenant à cinq sérotypes (BTV 1, 2, 4, 9 et 16) ont été continuellement présentes dans le bassin méditerranéen. Depuis le mois d'août 2006, l'émergence inattendue du sérotype 8 (BTV-8) en Europe du Nord a été la cause d'une épizootie de FCO sans précédent, qui a affecté davantage les bovins qu'auparavant (virulence exacerbée s'exprimant par l'apparition de signes cliniques sévères et de troubles reproducteurs) et a fait intervenir des vecteurs très inféodés à nos régions (notamment le complexe Culicoides obsoletus, Culicoides dewulfi et Culicoides chiopterus). La recrudescence et l'extension de l'infection à BTV-8 en Europe durant l'année 2007 et l'année 2008 suggèrent que les critères pour l'établissement à l'état enzootique de la FCO semblent maintenant rencontrés dans cette région. En outre, l'extension radiale inexorable du BTV-8 à travers l'Europe, couplée à la récente progression du BTV-1 dans le sud-ouest de la France, augmente le risque de rencontre entre ces deux sérotypes mais également entre ces sérotypes et d'autres, en particulier ceux qui sévissent dans le bassin méditerranéen. Cette progression augmente aussi le risque que le BTV arrive dans une zone géographique où le vecteur Culicoides imicola est présent et actif plus longtemps dans l'année. Ces conditions augmentent le risque de réassortiment de différents segments génomiques individuels. Une possible émergence d'un réassortant pourrait s'accompagner d'une modification de la virulence de la souche virale incriminée. Face à une situation où la FCO devient enzootique, deux mesures sont à privilégier : la vaccination stratégique (basée sur les acquis scientifiques) à l'aide d'un vaccin à virus inactivé et la réduction du nombre de contacts entre les vecteurs et les animaux sensibles et/ou réceptifs. L'épidémiologie de la FCO est intimement liée à la compréhension détaillée de la virologie, de la pathogénie et de l'immunologie. Une veille scientifique est indispensable. En plus de la transmission vectorielle prédominante, des modes de transmission additionnels ont été récemment documentés chez les bovins pour le sérotype 8 tels qu'une transmission transplacentaire en l'absence d'activité vectorielle et, avec une moindre importance, une transmission horizontale (orale). Ces modes sont aussi à prendre en compte dans la stratégie de lutte à plus long terme, car ils favorisent l'endémicité de la maladie en Europe
Primary culture of Mycobacterium ulcerans from human tissue specimens after storage in semisolid transport medium
No full textTissue specimens collected from patients with clinically suspected Buruli ulcer treated in two Buruli ulcer treatment centers in Benin between 1998 and 2004 were placed in semisolid transport medium and transported at ambient temperature for microbiological analysis at the Institute of Tropical Medicine in Antwerp, Belgium. The impact of the delay before microbiological analysis on primary culture of Mycobacterium ulcerans was investigated. The length of storage in semisolid transport medium varied from 6 days to 26 weeks. Of the 1,273 tissue fragments positive for M. ulcerans DNA by an IS2404-specific PCR, 576 (45.2%) yielded positive culture results. The sensitivity of direct smear examination was 64.6% (822/1,273 tissue fragments). The median time required to obtain a positive culture result was 11 weeks. Positive cultures were obtained even from samples kept for more than 2 months at ambient temperatures. Moreover, there was no reduction in the viability of M. ulcerans, as detected by culture, when specimens remained in semisolid transport medium for long periods of time (up to 26 weeks). We can conclude that the method with semisolid transport medium is very robust for clinical specimens from patients with Buruli ulcer that, due to circumstances, cannot be analyzed in a timely manner. This transport medium is thus very useful for the confirmation of a diagnosis of Buruli ulcer with specimens collected in the field
Effects of grinding surgical tissue specimens and smear staining methods on Buruli ulcer microscopic diagnosis
No full textThe definitive version is available at www3.interscience.wiley.comTo optimize Buruli ulcer (BU) microscopic diagnosis, we compared two smear preparation methods from tissue specimens: smears made with tissue suspension after grinding and smears made directly with unground tissue. We also compared two smear staining methods: auramine and Ziehl-Neelsen (ZN). IS 2404-PCR was used as reference method. One hundred and thirty-one surgical tissue specimens from patients suspected of having BU were analyzed. Both smear preparation methods and both staining methods were equivalent in any combination. Thus we recommend ZN stained smears of unground tissue for peripheral treatment centres
Malaria in central Vietnam: analysis of risk factors by multivariate analysis and classification tree models
No full textBACKGROUND: In Central Vietnam, forest malaria remains difficult to control due to the complex interactions between human, vector and environmental factors. METHODS: Prior to a community-based intervention to assess the efficacy of long-lasting insecticidal hammocks, a complete census (18,646 individuals) and a baseline cross-sectional survey for determining malaria prevalence and related risk factors were carried out. Multivariate analysis using survey logistic regression was combined to a classification tree model (CART) to better define the relative importance and inter-relations between the different risk factors. RESULTS: The study population was mostly from the Ra-glai ethnic group (88%), with both low education and socio-economic status and engaged mainly in forest activities (58%). The multivariate analysis confirmed forest activity, bed net use, ethnicity, age and education as risk factors for malaria infections, but could not handle multiple interactions. The CART analysis showed that the most important risk factor for malaria was the wealth category, the wealthiest group being much less infected (8.9%) than the lower and medium wealth category (16.6%). In the former, forest activity and bed net use were the most determinant risk factors for malaria, while in the lower and medium wealth category, insecticide treated nets were most important, although the latter were less protective among Ra-glai people. CONCLUSION: The combination of CART and multivariate analysis constitute a novel analytical approach, providing an accurate and dynamic picture of the main risk factors for malaria infection. Results show that the control of forest malaria remains an extremely complex task that has to address poverty-related risk factors such as education, ethnicity and housing conditions