Protocol, rationale and design of PEOPLE (Post ExpOsure Prophylaxis for LEprosy in the Comoros and Madagascar): A cluster randomized trial on effectiveness of different modalities of implementation of post-exposure prophylaxis of leprosy contacts

Background: Leprosy is an ancient infectious disease with a global annual incidence that has plateaued above 200,000 new cases since over a decade. New strategies are required to overcome this stalemate. Post-exposure prophylaxis (PEP) with a single dose of Rifampicin (SDR) has conditionally been recommended by the World Health Organization (WHO), based on a randomized-controlled-Trial in Bangladesh. More evidence is required. The Post ExpOsure Prophylaxis for Leprosy (PEOPLE) trial will assess effectiveness of different modalities of PEP on the Comoros and Madagascar. Methods: PEOPLE is a cluster-randomized trial with villages selected on previous leprosy-incidence and randomly allocated to four arms. Four annual door-To-door surveys will be performed in all arms. All consenting permanent residents will be screened for leprosy. Leprosy patients will be treated according to international guidelines and eligible contacts will be provided with SDR-PEP. Arm-1 is the comparator in which no PEP will be provided. In arms 2, 3 and 4, SDR-PEP will be provided at double the regular dose (20 mg/kg) to eligible contacts aged two years and above. In arm 2 all household-members of incident leprosy patients are eligible. In arm 3 not only household-members but also neighbourhood contacts living within 100-m of an incident case are eligible. In arm 4 such neighbourhood contacts are only eligible if they test positive to anti-PGL-I, a serological marker. Incidence rate ratios calculated between the comparator arm 1 and each of the intervention arms will constitute the primary outcome. Discussion: Different trials on PEP have yielded varying results. The pivotal COLEP trial in Bangladesh showed a 57% reduction in incidence over a two-year period post-intervention without any rebound in the following years. A study in a high-incidence setting in Indonesia showed no effect of PEP provided to close contacts but a major effect of PEP provided as a blanket measure to an entire island population. High background incidence could be the reason of the lack of effect of PEP provided to individual contacts. The PEOPLE trial will assess effectiveness of PEP in a high incidence setting and will compare three different approaches, to identify who benefits most from PEP. Trial registration: Clinicaltrials.Gov. NCT03662022. Initial Protocol Version 1.2, 27-Aug-2018

Prediction of the accumulation behavior of pesticides in PDMS-coated stir bars used as passive samplers in freshwaters

International audiencePassive samplers accumulate organic contaminants at rates that depend on in-field exposure conditions such as freshwater flow velocity, water temperature and water quality. Time-weighted average concentrations can be determined by using a correction process such as the performance reference compound (PRC) method. This study presented a new approach to predict the accumulation behavior of pesticides in polydimethylsiloxane-coated stir bars under different exposure conditions and assign a specific PRC to each pesticide for quantitative purposes. We used an experimental design with eight simultaneous accumulation kinetics of 13 pesticides and elimination kinetics of three PRC candidates run in a flow-through system to determine the effects of flow velocity, water temperature and dissolved organic matter on the kinetic constants. We identified the parameters that had a significant effect on the accumulation of each pesticide and assigned a PRC candidate to each pesticide. We then used a discriminant function analysis to find the parameters that had a significant effect on accumulation of the 13 pesticides via their physical-chemical properties and to predict through a stochastic approach the parameters for seven other pesticides. This approach provides a better framework for identifying a PRC than conventional methods to determine unbiased concentrations in future monitoring efforts

Monitoring of 53 contaminants of emergent concern: occurrence in effluents, sludges, and surface waters upstream and downstream of 7 wastewater treatment plants

International audienc

A nation-wide monitoring campaign of 53 contaminants of emergent concern in surface waters and sediments (EMNAT 2018): occurrence and PNEC exceedance evaluation

International audienc

Nation-wide monitoring of 53 contaminants of emergent concern in surface waters and sediment (EMNAT 2018): occurrence and PNEC exceedance evaluation

International audienc

Uso da alga Lithothamnium calcareum como fonte alternativa de cálcio nas rações de frangos de corte Use of algae Lithothamnium calcareum as alternative source of calcium in diets for broiler chickens

Objetivou-se, com este trabalho, avaliar o uso da alga Lithothamnium calcareum (Pallas) Areschoug nas rações para frangos de corte de 1 a 21 e 21 a 42 dias de idade, em substituição à fonte de cálcio tradicional (calcário calcítico). Para isso, foram utilizados 300 pintos machos, da linhagem Cobb®, que receberam rações contendo o calcário calcítico e a alga Lithothamnium calcareum (colhida de inteira e na forma de areia biodentrítica) como fontes de cálcio. O delineamento experimental utilizado foi o inteiramente casualizado, com três tratamentos e cinco repetições de 20 aves cada. As variáveis analisadas foram: ganho de peso (g/ave), consumo de ração (g/ave) e conversão alimentar (g/g). No final do experimento foram avaliados os parâmetros ósseos: peso da tíbia (g), comprimento da tíbia (mm), diâmetro da tíbia (mm) e teor de cinzas na tíbia (%). Na fase inicial (1 a 21 dias) houve efeito (P<0,05) entre os tratamentos para o ganho de peso e conversão alimentar, sendo que o tratamento controle apresentou melhores resultados. Para a fase de crescimento (21 a 42 dias) e período total (1 a 42 dias) não houve efeito entre os tratamentos estudados. A utilização da alga Lithothamnium calcareum (independente da forma de colheita) em substituição à fonte de cálcio tradicional (calcário calcítico) pode ser recomendada para as rações de frangos de corte, sem prejudicar o desempenho zootécnico. Porém, deve-se levar em consideração a viabilidade econômica do uso dessa fonte alternativa nas rações.<br>The objective of this study was to evaluate the use of the algae Lithothamnium calcareum (Pallas) Areschoug in diets for broiler chickens from 1 to 21 and 21 to 42 days, to replace the traditional source of calcium (limestone). 300 male chicks from Cobb® strain, which received diets containing limestone and Lithothamnium calcareum algae (as a whole and as sand biodentritic) were used as sources of calcium. The experimental design was completely randomized, with three treatments and five replicates of 20 birds each. The variables analyzed were: weight gain (g / bird), feed intake (g / bird), feed per again (g / g). At the end of the experiment the bone parameters: weight of the tibia (g), tibia length (mm), diameter of the tibia (mm) and ash content in the tibia (%). Were evaluated in the initial phase (1 to 21 days) there was an effect (P <0.05) between treatments for weight gain and feed per again, and the control treatment showed better results. For the growing phase (21 to 42 days) and total period (1 to 42 days) there was no effect among the treatments studied. The use of the algae Lithothamnium calcareum (independently of the harvest) to replace the traditional source of calcium (limestone) can be recommended for diets of broilers without affecting the growth performance. However, one should take into consideration the economic feasibility of using this alternative source in the diets