ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma a

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The phytochemical composition and <i>in vitro</i> antiviral activity of decoctions from galls of <i>Guiera senegalensis</i> J.F. Gmel. (<i>Combretaceae</i>) and their relative non-toxicity for chickens

Aqueous decoctions obtained from the galls of Guiera senegalensis were screened to determine their phytochemical composition and in vitro antiviral activity against fowlpox virus. In addition, we wanted to investigate the toxic effects, if any, of crude extracts in chickens. Steroids as well as cardiac glycosides not previously reported, an alkaloid, polyphenols and saponins were detected in the various fractions of organic solvents used for extracting the decoctions. Antiviral activity was determined by cytopathic effect inhibition assay in primary chicken embryo skin cells. The 50 % inhibitory concentration (EC50) was shown to be 15.6 µg/ml. Toxicity for cells was established by determining the 50 % cytotoxic concentration (CCy50). A value of 90 µg/ml and a selectivity index (CCy50/EC50) of 5.8 were obtained. In vivo studies of toxicity were performed in chickens that were dosed orally with decoctions of several concentrations for 2 weeks and then monitored for 3 months. No significant changes in several blood chemical parameters were obtained, except for a significant decline in SGOT levels in birds dosed with 100 mg/kg. These levels were nevertheless within the accepted normal range. The findings suggest that aqueous decoctions of galls from G. senegalensis are non-toxic for chickens when administered orally, even at a daily dose of 100 mg/kg for 14 days

Diplome d’etudes specialisees de pneumologie: appreciation de la formation par les candidats audit diplome a la faculte des Sciences de la Sante de Lome

Objectif: Recenser l’appréciation qu’ont les apprenants sur l’école de pneumologie de Lomé.Méthodologie: Un questionnaire anonyme a été adressé aux 13 médecins en spécialisation au cours du mois d’Août 2015. Les items portaient sur les cours théoriques et la formation pratique.Résultats: Le taux de réponse était de 92,3%. Les médecins, en moyenne âgés de 38,9±6,68 ans, étaient en deuxième (05), troisième (02) et quatrième (05) année de spécialisation. Trois quarts des enquêtés bénéficiaient d’une bourse. Tous les résidents connaissaient les objectifs assignés au D.E.S. Les connaissances théoriques étaient acquises au cours des staffs matinaux et des cours magistraux dans 91,66% des cas et par des recherches personnelles dans 53,4% des cas. Plus de la moitié (58,3%) des enquêtés avaient participé à au moins un congrès scientifique.L’apprentissage des différents gestes d’exploration en pneumologie avait fait l’objet d’un enseignement magistral dans la moitié des cas. Les premiers gestes techniques avaient été supervisés par un senior (55,6%) ou par un pneumologue (44,4%). Les principales recommandations faites par les apprenants à la coordination du D.E.S. de Pneumologie étaient le renforcement du plateau technique (5/12), le tutorat des D.E.S. par des pneumologues lors de la préparation des exposés (5/12) et la prise en compte du niveau d’étude lors de la composition des épreuves écrites. 83,33% des enquêtés recommanderaient l’école de Pneumologie de Lomé à un confrère désireux de se spécialiser dans le domaine.Conclusion: L’appréciation des D.E.S. de pneumologie sur l’école de Lomé souligne la nécessité d’un renforcement en encadreurs et en plateau technique.Mots clés: Appréciation, DES, pneumologie, LoméEnglish Title: Diploma study respiratory specialist: assessment of training by candidates said degree at the faculty of Health Sciences LomeEnglish AbstractObjective: Identify learners' appreciation of the Lome Pulmology School.Methods: An anonymous questionnaire was sent to 13 physicians in specialization during the month of August 2015. The items covered the theoretical courses and training convenient.Results: The response rate was 92.3%. Doctors, average age 38.9 ± 6.68 years, were second (05), third (02) and fourth (05) year of specialization. Three quarters of  respondents were receiving a scholarship. All residents were aware of the objectives assigned to D.E.S.Theoretical knowledge was acquired during the morning staff meetings and lectures in 91.66% of cases and by personal research in 53.4% of cases. More than half (58.3%) of respondents had participated in at least one scientific meeting. Learning the various exploration gestures pulmonology was the subject of a lecture in half the cases. The first technical movements were supervised by a senior (55.6%) or a pulmonologist (44.4%). The main recommendations made by learners coordination D.E.S. Pulmonary were the strengthening of the technical platform (5/12), tutoring D.E.S. by pulmonologists in preparing presentations (5/12) and taking into account the level of study when composing written tests. 83.33% of respondents would recommend the Lome Pneumology School to a colleague wishing to specialize in the field.Conclusion: The assessment of D.E.S. Respiratory on the Lome school emphasizes the need for supervisors in strengthening and technical platform.Keywords: Appreciation, DES, pulmonology, Lom

Seed ecology of the invasive tropical tree Parkinsonia aculeata

Parkinsonia aculeata is an invasive tree native to tropical America, but introduced to Australia. Propagation and stand regeneration is mainly by seed. To gain baseline knowledge for management decisions, seed bank dynamics were monitored for two months during the fruit dispersal period at a coastal wetland in Costa Rica (native habitat), and at a coastal wetland and two semi-arid rangeland sites in Northern Queensland, Australia (introduced habitats). Seed bank densities underneath dense, uniform Parkinsonia stands were found to be lowest in the Australian wetland but highest in the Costa Rican wetland. Post-dispersal seed losses were highest in the Australian wetland, primarily due to seed germination and/or death. At the other sites, seed losses were minor during the study period, and predation was the most important cause of losses. At the two rangeland sites bruchid beetles accounted for more than 95% of the seed losses by predation. Total predation was lowest in the Costa Rican wetland. In order to test for intrinsic differences of seed characteristics, germination trials were conducted using both canopy seeds and seeds from the soil seed bank. Dormancy release and germination rate were studied under four temperature treatments. In all populations, dormancy release increased with increasing temperature, but averaged responses were significantly different between Costa Rican and Australian seed populations, and between seeds collected from the soil and from trees. Germination rate of scarified seeds was fastest at 35°C in all tested seed populations. While high seed germination levels seem to explain low seed bank densities in the Australian wetland, the large seed banks at the rangeland sites reflect the lower incidence of favourable conditions for germination. In the Australian wetland biocontrol with bruchids is unlikely to be successful, while control by conventional methods, such as killing stands by basal bark spraying, seems feasible, due to a lower long-term risk of re-infestation from the soil seed bank. At the rangeland sites conventional control will be difficult and costly. Parkinsonia stands may be better left to their own, while bruchid populations are monitored and management efforts are concentrated on preventing further invasion

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis)

Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards