90 research outputs found
Utilisation des éléments nutritifs par deux arbres du Sahel: Acacia seyal et Sclerocarya birrea
Phylogeography of Rift Valley Fever Virus in Africa Reveals Multiple Introductions in Senegal and Mauritania
Rift Valley Fever (RVF) virus (Family Bunyaviridae) is an arthropod-borne RNA virus that infects primarily domestic ruminants and occasionally humans. RVF epizootics are characterized by numerous abortions and mortality among young animals. In humans, the illness is usually characterized by a mild self-limited febrile illness, which could progress to more serious complications. RVF virus is widespread and endemic in many regions of Africa. In Western Africa, several outbreaks have been reported since 1987 when the first major one occurred at the frontier of Senegal and Mauritania. Aiming to evaluate the spreading and molecular epidemiology in these countries, RVFV isolates from 1944 to 2008 obtained from 18 localities in Senegal and Mauritania and 15 other countries were investigated. Our results suggest that a more intense viral activity possibly took place during the last century compared to the recent past and that at least 5 introductions of RVFV took place in Senegal and Mauritania from distant African regions. Moreover, Barkedji in Senegal was possibly a hub associated with the three distinct entries of RVFV in West Africa
Etude prĂ©liminaire portant sur le dĂ©pistage de la protĂ©inurie Ă lâaide de bandelette urinaire chez les patients vivants avec le VIH au CHNU de Fann Ă Dakar.
Les glomĂ©rulopathies et autres affections rĂ©nales sont frĂ©quentes au cours de lâhistoire naturelle
du VIH mĂȘme si leur incidence a diminuĂ© avec la trithĂ©rapie. Elles sont pratiquement toujours
responsables dâune protĂ©inurie et/ou dâune hĂ©maturie. Nous avons fait une Ă©tude prĂ©liminaire
portant sur la prĂ©valence de la protĂ©inurie dĂ©pistĂ©e Ă lâaide de bandelettes urinaires chez les
PVVIH suivies Ă la clinique des maladies infectieuses du CHNU de Fann Ă Dakar. Il sâagissait
dâune Ă©tude prospective allant du 1er AoĂ»t au 30 Octobre 2008. Ont Ă©tĂ© inclus de façon
exhaustive les patients séropositifs pour le VIH à la fois vus en ambulatoire et en hospitalisation
présentant une protéinurie sans infection urinaire intercurrente. Nous avons recueilli leurs
donnĂ©es sociodĂ©mographiques, les Ă©lĂ©ments de lâhistoire naturelle, les facteurs en rapport avec la
protĂ©inurie et la nĂ©phropathie. La saisie et lâanalyse des donnĂ©es ont Ă©tĂ© faites avec le logiciel Epi
Info version 6.04. Nous avons utilisé le test de Chi2 pour comparer les variables qualitatives et
p<0,05 a Ă©tĂ© retenu comme significative. Au total 100 patients ont Ă©tĂ© inclus, la moyenne dâĂąge
était de 43± 9,8 ans chez les hommes et de 39± 10 ans pour les femmes. Les femmes étaient
prédominantes (sex ratio H/F = 0,5). Tous les patients étaient infectés par le VIH1, ils avaient été
dĂ©pistĂ©s Ă un stade tardif dâimmunodĂ©pression, la moitiĂ© Ă©tait sous ARV avec le plus souvent le
protocole AZT +3TC+ EFV. La prévalence de la protéinurie était de 47,9%. Les facteurs
significativement associĂ©s Ă la prĂ©sence dâune protĂ©inurie Ă©taient : le sexe ; le taux de
CD4<350/mm3
; la charge virale > 100000copies/mm3
; lâIMC <18,5 ; le taux dâhĂ©moglobine<8,5
g/dl, la chimioprophylaxie au cotrimoxazole et les stades cliniques OMS 3 et 4. La fréquence de
la néphropathie au cours du VIH au service des maladies infectieuses de Fann à Dakar suggÚre
dâinclure son dĂ©pistage Ă la bandelette dans le bilan initial et de suivi de tout patient infectĂ© par le
VIH. Dans tous les cas il faudrait corriger tout facteur favorisant la survenue de cette
néphropathie. La ponction biopsie rénale pourrait permettre des études plus approfondies
Causality between FDI and Financial Market Development: Evidence from Emerging Markets
Mortality from HIV-associated meningitis in sub-Saharan Africa: a systematic review and meta-analysis.
INTRODUCTION: HIV-associated cryptococcal, TB and pneumococcal meningitis are the leading causes of adult meningitis in sub-Saharan Africa (SSA). We performed a systematic review and meta-analysis with the primary aim of estimating mortality from major causes of adult meningitis in routine care settings, and to contrast this with outcomes from clinical trial settings. METHODS: We searched PubMed, EMBASE and the Cochrane Library for published clinical trials (defined as randomized-controlled trials (RCTs) or investigator-managed prospective cohorts) and observational studies that evaluated outcomes of adult meningitis in SSA from 1 January 1990 through 15 September 2019. We performed random effects modelling to estimate pooled mortality, both in clinical trial and routine care settings. Outcomes were stratified as short-term (in-hospital or two weeks), medium-term (up to 10 weeks) and long-term (up to six months). RESULTS AND DISCUSSION: Seventy-nine studies met inclusion criteria. In routine care settings, pooled short-term mortality from cryptococcal meningitis was 44% (95% confidence interval (95% CI):39% to 49%, 40 studies), which did not differ between amphotericin (either alone or with fluconazole) and fluconazole-based induction regimens, and was twofold higher than pooled mortality in clinical trials using amphotericin based treatment (21% (95% CI:17% to 25%), 17 studies). Pooled short-term mortality of TB meningitis was 46% (95% CI: 33% to 59%, 11 studies, all routine care). For pneumococcal meningitis, pooled short-term mortality was 54% in routine care settings (95% CI:44% to 64%, nine studies), with similar mortality reported in two included randomized-controlled trials. Few studies evaluated long-term outcomes. CONCLUSIONS: Mortality rates from HIV-associated meningitis in SSA are very high under routine care conditions. Better strategies are needed to reduce mortality from HIV-associated meningitis in the region
A development study and randomised feasibility trial of a tailored intervention to improve activity and reduce falls in older adults with mild cognitive impairment and mild dementia
Background:
People with dementia progressively lose abilities and are prone to falling. Exercise- and activity-based interventions hold the prospect of increasing abilities, reducing falls, and slowing decline in cognition. Current falls prevention approaches are poorly suited to people with dementia, however, and are of uncertain effectiveness. We used multiple sources, and a co-production approach, to develop a new intervention, which we will evaluate in a feasibility randomised controlled trial (RCT), with embedded adherence, process and economic analyses.
Methods:
We will recruit people with mild cognitive impairment or mild dementia from memory assessment clinics, and a family member or carer. We will randomise participants between a therapy programme with high intensity supervision over 12 months, a therapy programme with moderate intensity supervision over 3 months, and brief falls assessment and advice as a control intervention. The therapy programmes will be delivered at home by mental health specialist therapists and therapy assistants. We will measure activities of daily living, falls and a battery of intermediate and distal health status outcomes, including activity, balance, cognition, mood and quality of life. The main aim is to test recruitment and retention, intervention delivery, data collection and other trial processes in advance of a planned definitive RCT. We will also study motivation and adherence, and conduct a process evaluation to help understand why results occurred using mixed methods, including a qualitative interview study and scales measuring psychological, motivation and communication variables. We will undertake an economic study, including modelling of future impact and cost to end-of-life, and a social return on investment analysis.
Discussion:
In this study, we aim to better understand the practicalities of both intervention and research delivery, and to generate substantial new knowledge on motivation, adherence and the approach to economic analysis. This will enable us to refine a novel intervention to promote activity and safety after a diagnosis of dementia, which will be evaluated in a definitive randomised controlled trial.\ud
Trial registration:
ClinicalTrials.gov: NCT02874300; ISRCTN 10550694
Study of 300,486 individuals identifies 148 independent genetic loci influencing general cognitive function
Correction Volume: 10, Article Number: 2068 DOI: 10.1038/s41467-019-10160-w WOS:000466339700001General cognitive function is a prominent and relatively stable human trait that is associated with many important life outcomes. We combine cognitive and genetic data from the CHARGE and COGENT consortia, and UK Biobank (total N = 300,486; age 16-102) and find 148 genome-wide significant independent loci (P <5 x 10(-8)) associated with general cognitive function. Within the novel genetic loci are variants associated with neurodegenerative and neurodevelopmental disorders, physical and psychiatric illnesses, and brain structure. Gene-based analyses find 709 genes associated with general cognitive function. Expression levels across the cortex are associated with general cognitive function. Using polygenic scores, up to 4.3% of variance in general cognitive function is predicted in independent samples. We detect significant genetic overlap between general cognitive function, reaction time, and many health variables including eyesight, hypertension, and longevity. In conclusion we identify novel genetic loci and pathways contributing to the heritability of general cognitive function.Peer reviewe
Cerebral small vessel disease genomics and its implications across the lifespan
White matter hyperintensities (WMH) are the most common brain-imaging feature of cerebral small vessel disease (SVD), hypertension being the main known risk factor. Here, we identify 27 genome-wide loci for WMH-volume in a cohort of 50,970 older individuals, accounting for modification/confounding by hypertension. Aggregated WMH risk variants were associated with altered white matter integrity (pâ=â2.5Ă10-7) in brain images from 1,738 young healthy adults, providing insight into the lifetime impact of SVD genetic risk. Mendelian randomization suggested causal association of increasing WMH-volume with stroke, Alzheimer-type dementia, and of increasing blood pressure (BP) with larger WMH-volume, notably also in persons without clinical hypertension. Transcriptome-wide colocalization analyses showed association of WMH-volume with expression of 39 genes, of which four encode known drug targets. Finally, we provide insight into BP-independent biological pathways underlying SVD and suggest potential for genetic stratification of high-risk individuals and for genetically-informed prioritization of drug targets for prevention trials.Peer reviewe
Autoantibodies against type I IFNs in patients with critical influenza pneumonia
In an international cohort of 279 patients with hypoxemic influenza pneumonia, we identified 13 patients (4.6%) with autoantibodies neutralizing IFN-alpha and/or -omega, which were previously reported to underlie 15% cases of life-threatening COVID-19 pneumonia and one third of severe adverse reactions to live-attenuated yellow fever vaccine. Autoantibodies neutralizing type I interferons (IFNs) can underlie critical COVID-19 pneumonia and yellow fever vaccine disease. We report here on 13 patients harboring autoantibodies neutralizing IFN-alpha 2 alone (five patients) or with IFN-omega (eight patients) from a cohort of 279 patients (4.7%) aged 6-73 yr with critical influenza pneumonia. Nine and four patients had antibodies neutralizing high and low concentrations, respectively, of IFN-alpha 2, and six and two patients had antibodies neutralizing high and low concentrations, respectively, of IFN-omega. The patients' autoantibodies increased influenza A virus replication in both A549 cells and reconstituted human airway epithelia. The prevalence of these antibodies was significantly higher than that in the general population for patients 70 yr of age (3.1 vs. 4.4%, P = 0.68). The risk of critical influenza was highest in patients with antibodies neutralizing high concentrations of both IFN-alpha 2 and IFN-omega (OR = 11.7, P = 1.3 x 10(-5)), especially those <70 yr old (OR = 139.9, P = 3.1 x 10(-10)). We also identified 10 patients in additional influenza patient cohorts. Autoantibodies neutralizing type I IFNs account for similar to 5% of cases of life-threatening influenza pneumonia in patients <70 yr old
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