5 research outputs found
Aspects échographiques du coeur chez des drépanocytaires majeurs suivis au CRLD de Bamako, Mali
No full textLe dysfonctionnement cardiaque est l'un des facteurs pronostiques de la drépanocytose. Très peu d'études ont été réalisées sur les manifestations cardiaques chez le drépanocytaire au Mali. Ce travail a été fait, dans le but d'étudier les aspects écho cardiographiques chez des drépanocytaires majeurs (formes SS, SC, Sbeta-thalassémie) âgés de 18 ans et plus. Il s'agissait d'une étude transversale descriptive prospective qui s'est déroulée de Mai 2016 en Avril 2017, réalisée au sein de trois Centres du district de Bamako: le Centre de Recherche et de Lutte contre la Drépanocytose, le service de cardiologie du CHU Luxembourg et le laboratoire d'analyses médicales Mérieux. L'échographie cardiaque a été réalisée à l'aide de l'échographe GE (VIVID 7 Pro) et par le même opérateur. Nous avons inclus une population de 120 patients, constituée de 41 hommes (34,17 p.100 ) et de 79 femmes (65,83 p.100 ) d'âge moyen égal à 37,26 plus ou moins 11 ans. Soixante-deux patients étaient homozygotes SS (51,67 p.100 ), 46 étaient doubles hétérozygotes SC (38,33 p.100 ) et 12 étaient Sbéta thalassémiques (10 p.100 ); dont 6 S-béta-zéro et 6 S-béta-plus thalassémiques. Le taux d'hémoglobine de base moyen était de 9,77 plus ou moins 1,69 g/dL et celui des lactates déshydrogénases était en moyenne de 859,6 plus ou moins 430,8 UI/L. Le temps de décélération moyen était de 210,20 plus ou moins 54,23 ms, la FEVG moyenne était de 73,07 plus ou moins 8,87. La dysfonction diastolique, l'hyperdébit et l'hyperkinésie étaient retrouvées respectivement chez: 45 (35,5 p.100 ), 35 (29,17 p.100 ) et 29 patients (24,17 p.100 ). L'hypertension artérielle pulmonaire échographiques a été retrouvée chez 24 patients soit 20 p.100 . Les hémoglobinoses SS et S/beta0 thalassémies s'étaient avérées les plus sévères. Ces résultats dicteraient une échographie cardiaque syst Le dysfonctionnement cardiaque est l'un des facteurs pronostiques de la drépanocytose. Très peu d'études ont été réalisées sur les manifestations cardiaques chez le drépanocytaire au Mali. Ce travail a été fait, dans le but d'étudier les aspects écho cardiographiques chez des drépanocytaires majeurs (formes SS, SC, Sbeta-thalassémie) âgés de 18 ans et plus. Il s'agissait d'une étude transversale descriptive prospective qui s'est déroulée de Mai 2016 en Avril 2017, réalisée au sein de trois Centres du district de Bamako: le Centre de Recherche et de Lutte contre la Drépanocytose, le service de cardiologie du CHU Luxembourg et le laboratoire d'analyses médicales Mérieux. L'échographie cardiaque a été réalisée à l'aide de l'échographe GE (VIVID 7 Pro) et par le même opérateur. Nous avons inclus une population de 120 patients, constituée de 41 hommes (34,17 p.100 ) et de 79 femmes (65,83 p.100 ) d'âge moyen égal à 37,26 plus ou moins 11 ans. Soixante-deux patients étaient homozygotes SS (51,67 p.100 ), 46 étaient doubles hétérozygotes SC (38,33 p.100 ) et 12 étaient Sbéta thalassémiques (10 p.100 ); dont 6 S-béta-zéro et 6 S-béta-plus thalassémiques. Le taux d'hémoglobine de base moyen était de 9,77 plus ou moins 1,69 g/dL et celui des lactates déshydrogénases était en moyenne de 859,6 plus ou moins 430,8 UI/L. Le temps de décélération moyen était de 210,20 plus ou moins 54,23 ms, la FEVG moyenne était de 73,07 plus ou moins 8,87. La dysfonction diastolique, l'hyperdébit et l'hyperkinésie étaient retrouvées respectivement chez: 45 (35,5 p.100 ), 35 (29,17 p.100 ) et 29 patients (24,17 p.100 ). L'hypertension artérielle pulmonaire échographiques a été retrouvée chez 24 patients soit 20 p.100 . Les hémoglobinoses SS et S/beta0 thalassémies s'étaient avérées les plus sévères. Ces résultats dicteraient une échographie cardiaque systématique chez tous les drépanocytaires majeurs qu'il y ait signes d'appel ou pas
Evaluation of Attractive Targeted Sugar Baits, a new outdoor vector control strategy against malaria: results from a cluster randomised open-label parallel arm controlled trial in Southwestern Mali
No full textThe Attractive Targeted Sugar Bait (ATSB) is a new malaria outdoor vector control tool targeting sugar-feeding behaviours of vector mosquitoes. In Mali, a two-year open-label two-arm cluster randomised controlled trial compared the efficacy and safety of ATSB plus insecticide treated mosquito nets (ITN) versus ITN alone on malaria burden.76 clusters were formed, of which 38 were randomly allocated to the intervention. Cohort studies and household surveys were performed to assess clinical malaria incidence (primary outcome) in children aged 5 to 14 years and malaria infection prevalence in individuals aged 6 months or older respectively. Primary analyses were performed as intention-to-treat basis. The trial was designed to detect a minimum 30% reduction in the two outcomes over a two-year period with a power of at least 80%. The trial is registered at ClinicalTrial.gov (NCT04149119).The proportion of sleeping buildings with at least 2 ATSB ranged between 70% and 80%. Coverage of ATSB in good condition was lower (50% or less). Over the two years trial period, the clinical malaria incidence rate in the control and intervention arm was 0.726 and 0.660 cases per person-year respectively, with no statistical evidence for an intervention effect (Incidence Rate Ratio (IRR)=0.90; 95%CI 0.77, 1.05; p=0.188). Malaria infection prevalence was approximately 37% in both arms (Odds Ratio (OR)=0.96; 95%CI 0.76, 1.21; p=0.729). In clusters with coverage of stations in good condition above 80%, there was evidence for a 26% reduction in malaria incidence compared to control clusters after controlling for confounders (adjusted IRR=0.74; 95%CI 0.61, 0.90; p=0.002).Overall the trial did not demonstrate evidence of additional protection against malaria of ATSB compared to using ITN alone. Suboptimal coverage and maintenance of ATSB in good condition in the field may explain the lack of an intervention effect
High exposure to malaria vector bites despite high use of bednets in a setting of seasonal malaria in southwestern Mali: the urgent need for outdoor vector control strategies.
No full textBACKGROUND: Early evening and outdoor biting by vector mosquitoes undermines the effectiveness of insecticide-treated nets (ITNs), as users of nets are exposed to vector biting whilst not under a net, both outdoors and indoors. This study assessed exposure to malaria vector bites amongst users and non-users of ITNs in southwestern Mali. METHODS: Using cross-sectional household survey data of human behaviour and malaria infection prevalence, along with mosquito human landing catch (HLC) data collected in 30 separate communities, the average number of Anopheles gambiae sensu lato (s.l.) mosquito bites per person per night (bppn) received outdoors and indoors were estimated for each survey respondent. The proportion of bites that were not preventable by using a net, the relative contributions of outdoor and indoor residual biting, and the risk factors for exposure to vector bites were estimated. RESULTS: Despite very high use of nets (93.2%), malaria infection prevalence was 34% overall. A large proportion of respondents (78%) reported being outdoors at 8 pm, but by midnight, 98% were indoors. Net users were exposed to indoor biting for 1 h, on average, between going indoors and going to bed. For 91%, the net used was an ITN. Human biting rates peaked between 2 and 4 am, when most people (90%) were in bed. Individuals using a net received 11.2 bppn in total, of which 7.1 bppn (63%) occurred outdoors. Those not using a net received almost 10 times the number of bites indoors as net users (38.4 bppn versus 4.0 bppn). The total number of bites received by net users was about one third the total number of bites received by non-net users, indicating the proportion of bites not preventable by use of a net alone. Risk factors for biting exposure included not using a net, going indoors late, location near the river and age over 15 years. CONCLUSIONS: ITNs substantially reduce exposure to indoor biting, but in this setting, net users still received a large number of Anopheles mosquito bites, giving rise to high malaria infection prevalence despite near-universal net use. Most residual biting occurred outdoors, but about a third still occurred with individuals indoors before going under a net. Effective interventions that reduce residual outdoor and indoor biting are necessary to reduce the high malaria burden in settings like southwestern Mali
Expanding Research Capacity in Sub-Saharan Africa Through Informatics, Bioinformatics, and Data Science Training Programs in Mali
No full textBioinformatics and data science research have boundless potential across Africa due to its high levels of genetic diversity and disproportionate burden of infectious diseases, including malaria, tuberculosis, HIV and AIDS, Ebola virus disease, and Lassa fever. This work lays out an incremental approach for reaching underserved countries in bioinformatics and data science research through a progression of capacity building, training, and research efforts. Two global health informatics training programs sponsored by the Fogarty International Center (FIC) were carried out at the University of Sciences, Techniques and Technologies of Bamako, Mali (USTTB) between 1999 and 2011. Together with capacity building efforts through the West Africa International Centers of Excellence in Malaria Research (ICEMR), this progress laid the groundwork for a bioinformatics and data science training program launched at USTTB as part of the Human Heredity and Health in Africa (H3Africa) initiative. Prior to the global health informatics training, its trainees published first or second authorship and third or higher authorship manuscripts at rates of 0.40 and 0.10 per year, respectively. Following the training, these rates increased to 0.70 and 1.23 per year, respectively, which was a statistically significant increase (p < 0.001). The bioinformatics and data science training program at USTTB commenced in 2017 focusing on student, faculty, and curriculum tiers of enhancement. The program’s sustainable measures included institutional support for core elements, university tuition and fees, resource sharing and coordination with local research projects and companion training programs, increased student and faculty publication rates, and increased research proposal submissions. Challenges reliance of high-speed bandwidth availability on short-term funding, lack of a discounted software portal for basic software applications, protracted application processes for United States visas, lack of industry job positions, and low publication rates in the areas of bioinformatics and data science. Long-term, incremental processes are necessary for engaging historically underserved countries in bioinformatics and data science research. The multi-tiered enhancement approach laid out here provides a platform for generating bioinformatics and data science technicians, teachers, researchers, and program managers. Increased literature on bioinformatics and data science training approaches and progress is needed to provide a framework for establishing benchmarks on the topics
Long-term cellular immunity of vaccines for Zaire Ebola Virus Diseases
No full textInternational audienceRecent Ebola outbreaks underscore the importance of continuous prevention and disease control efforts. Authorized vaccines include Merck’s Ervebo (rVSV-ZEBOV) and Johnson & Johnson’s two-dose combination (Ad26.ZEBOV/MVA-BN-Filo). Here, in a five-year follow-up of the PREVAC randomized trial (NCT02876328), we report the results of the immunology ancillary study of the trial. The primary endpoint is to evaluate long-term memory T-cell responses induced by three vaccine regimens: Ad26–MVA, rVSV, and rVSV–booster. Polyfunctional EBOV-specific CD4+ T-cell responses increase after Ad26 priming and are further boosted by MVA, whereas minimal responses are observed in the rVSV groups, declining after one year. In-vitro expansion for eight days show sustained EBOV-specific T-cell responses for up to 60 months post-prime vaccination with both Ad26-MVA and rVSV, with no decline. Cytokine production analysis identify shared biomarkers between the Ad26-MVA and rVSV groups. In secondary endpoint, we observed an elevation of pro-inflammatory cytokines at Day 7 in the rVSV group. Finally, we establish a correlation between EBOV-specific T-cell responses and anti-EBOV IgG responses. Our findings can guide booster vaccination recommendations and help identify populations likely to benefit from revaccination
