Sequestration and Tissue Accumulation of Human Malaria Parasites: Can We Learn Anything from Rodent Models of Malaria?

The sequestration of Plasmodium falciparum–infected red blood cells (irbcs) in the microvasculature of organs is associated with severe disease; correspondingly, the molecular basis of irbc adherence is an active area of study. In contrast to P. falciparum, much less is known about sequestration in other Plasmodium parasites, including those species that are used as models to study severe malaria. Here, we review the cytoadherence properties of irbcs of the rodent parasite Plasmodium berghei ANKA, where schizonts demonstrate a clear sequestration phenotype. Real-time in vivo imaging of transgenic P. berghei parasites in rodents has revealed a CD36-dependent sequestration in lungs and adipose tissue. In the absence of direct orthologs of the P. falciparum proteins that mediate binding to human CD36, the P. berghei proteins and/or mechanisms of rodent CD36 binding are as yet unknown. In addition to CD36-dependent schizont sequestration, irbcs accumulate during severe disease in different tissues, including the brain. The role of sequestration is discussed in the context of disease as are the general (dis)similarities of P. berghei and P. falciparum sequestration

Annual cycle of the legume pod borer Maruca vitrata Fabricius (Lepidoptera: Crambidae) in southwestern Burkina Faso

Maruca vitrata is an economically significant insect pest of cowpea in sub-Saharan Africa. Understanding the seasonal population patterns of M. vitrata is essential for the establishment of effective pest management strategies. M. vitrata larval populations on cultivated cowpea and adult flying activities were monitored in addition to scouting for host plants and parasitoids during 2 consecutive years in 2010 and 2011 in southwestern Burkina Faso. Our data suggest that M. vitrata populations overlapped on cultivated cowpea and alternate host plants during the rainy season. During the cowpea off-season, M. vitrata maintained a permanent population on the wild host plants Mucuna poggei and Daniella oliveri. The parasitoid fauna include three species, Phanerotoma leucobasis Kri., Braunsia kriegeri End. and Bracon sp. Implications of these finding for pest management strategies are discussed

Malaria in Africa: Vector Species' Niche Models and Relative Risk Maps

A central theoretical goal of epidemiology is the construction of spatial models of disease prevalence and risk, including maps for the potential spread of infectious disease. We provide three continent-wide maps representing the relative risk of malaria in Africa based on ecological niche models of vector species and risk analysis at a spatial resolution of 1 arc-minute (9 185 275 cells of approximately 4 sq km). Using a maximum entropy method we construct niche models for 10 malaria vector species based on species occurrence records since 1980, 19 climatic variables, altitude, and land cover data (in 14 classes). For seven vectors (Anopheles coustani, A. funestus, A. melas, A. merus, A. moucheti, A. nili, and A. paludis) these are the first published niche models. We predict that Central Africa has poor habitat for both A. arabiensis and A. gambiae, and that A. quadriannulatus and A. arabiensis have restricted habitats in Southern Africa as claimed by field experts in criticism of previous models. The results of the niche models are incorporated into three relative risk models which assume different ecological interactions between vector species. The “additive” model assumes no interaction; the “minimax” model assumes maximum relative risk due to any vector in a cell; and the “competitive exclusion” model assumes the relative risk that arises from the most suitable vector for a cell. All models include variable anthrophilicity of vectors and spatial variation in human population density. Relative risk maps are produced from these models. All models predict that human population density is the critical factor determining malaria risk. Our method of constructing relative risk maps is equally general. We discuss the limits of the relative risk maps reported here, and the additional data that are required for their improvement. The protocol developed here can be used for any other vector-borne disease

Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review

BACKGROUND:Sub-Saharan African (SSA) countries are experiencing rapid transitions with increased life expectancy. As a result the burden of age-related conditions such as neurodegenerative diseases might be increasing. We conducted a systematic review of published studies on common neurodegenerative diseases, and HIV-related neurocognitive impairment in SSA, in order to identify research gaps and inform prevention and control solutions. METHODS: We searched MEDLINE via PubMed, 'Banque de Donnees de Sante Publique' and the database of the 'Institut d'Epidemiologie Neurologique et de Neurologie Tropicale' from inception to February 2013 for published original studies from SSA on neurodegenerative diseases and HIV-related neurocognitive impairment. Screening and data extraction were conducted by two investigators. Bibliographies and citations of eligible studies were investigated. RESULTS: In all 144 publications reporting on dementia (n=49 publications, mainly Alzheimer disease), Parkinsonism (PD, n=20), HIV-related neurocognitive impairment (n=47), Huntington disease (HD, n=19), amyotrophic lateral sclerosis (ALS, n=15), cerebellar degeneration (n=4) and Lewy body dementia (n=1). Of these studies, largely based on prevalent cases from retrospective data on urban populations, half originated from Nigeria and South Africa. The prevalence of dementia (Alzheimer disease) varied between <1% and 10.1% (0.7% and 5.6%) in population-based studies and from <1% to 47.8% in hospital-based studies. Incidence of dementia (Alzheimer disease) ranged from 8.7 to 21.8/1000/year (9.5 to 11.1), and major risk factors were advanced age and female sex. HIV-related neurocognitive impairment's prevalence (all from hospital-based studies) ranged from <1% to 80%. Population-based prevalence of PD and ALS varied from 10 to 235/100,000, and from 5 to 15/100,000 respectively while that for Huntington disease was 3.5/100,000. Equivalent figures for hospital based studies were the following: PD (0.41 to 7.2%), ALS (0.2 to 8.0/1000), and HD (0.2/100,000 to 46.0/100,000). CONCLUSIONS: The body of literature on neurodegenerative disorders in SSA is large with regard to dementia and HIV-related neurocognitive disorders but limited for other neurodegenerative disorders. Shortcomings include few population-based studies, heterogeneous diagnostic criteria and uneven representation of countries on the continent. There are important knowledge gaps that need urgent action, in order to prepare the sub-continent for the anticipated local surge in neurodegenerative diseases

Diversité des plantes mellifères de la zone soudano-guinéenne: cas de l’arrondissement de Manigri (Centre-Ouest du Bénin)

La flore mellifère environnant un rucher de l’arrondissement de Manigri a été étudiée à l’aide de relevés phénologiques et apicoles qui sont réalisés une fois par mois de janvier à décembre 2006. Ces relevés sont exécutés dans une aire d’observation de 1 km de rayon autour du rucher constitué de 10 ruches kenyanes. La flore mellifère est composée de 87 espèces, soit 32,7% des espèces en fleurs au nombre de 266. Elle comporte 75 genres et 34 familles. Les familles les plus riches en espèces mellifères sont les Leguminosae (16 espèces, soit 18,4%), les Combretaceae et les Rubiaceae (8 espèces chacune, soit 9,2%). Les plantes mellifères sont constituées de 60 espèces d’arbres et arbustes et de 27 espèces d’herbacées. Elles renferment 31% de plantes nectarifères, 33,3% de plantes pollinifères et 35,6% de plantes productrices de nectar et de pollens

Hepatite B et grossesse au centre de sante de reference de la commune II de Bamako, Mali : Hepatitis B and pregnancy at the reference health center of commune II of Bamako, Mali

L’hépatite B est un véritable enjeu de santé publique dans nos pays en développement. La prévention de la transmission mère-enfant constitue le principal défi de la prise en charge d’une femme enceinte ayant une hépatite B. But : Déterminer le pronostic materno-foetal de l’hépatite B associée à la grossesse. Matériels et Méthodes : Nous avons réalisé une étude descriptive transversale avec collecte prospective des données du 1er janvier au 31 décembre 2018 dans le service de gynécologie obstétrique du centre de santé de référence de la commune II de Bamako. Toutes les femmes enceintes ayant un antigène HBS positif ont été incluses. Résultats : La fréquence de l’hépatite B associée à la grossesse était de 1,14%. Il s’agissait de femmes au foyer (52,1%), âgées entre 21 et 29 ans (43,7%), paucigestes (50%). Le diagnostic de l’hépatite B a été fait au cours de cette grossesse dans 95,8% et dans 3% il s’agissait d’hépatite aigue. La sérovaccination a été effectuée chez 83,3% des nouveau-nés. Le pronostic materno-foetal a été bon car nous n’avons pas noté de complications maternelles telles que la cirrhose et le carcinome hépatocellulaire ni de décès maternel ou périnatal et le dépistage réalisé au 9èmois n’a pas mis en évidence d’hépatite B chez les nourrissons. Hepatitis B is a real public health issue in our developing countries. The main challenge in the management of a pregnant woman with hepatitis B is the prevention of mother-to-child transmission. Aim: To determine the maternal-fetal prognosis of hepatitis B associated with pregnancy. Materials and Methods: We carried out a cross-sectional descriptive study with prospective data collection from January 1 to December 31, 2018 in the obstetrical gynecology service of the reference health center of commune II of Bamako. All pregnant women with a positive HBS antigen were included. Results: The frequency of hepatitis B associated with pregnancy was 1.14%. These were housewives (52.1%), aged between 21 and 29 (43.7%), paucigest (50%). The diagnosis of hepatitis B was made during this pregnancy in 95.8% and in 3% it was acute hepatitis. Serovaccination was performed in 83.3% of newborns. The maternal-fetal prognosis was good because we didn’t note any maternal complications such as cirrhosis and hepatocellular carcinoma or maternal or perinatal death and the screening carried out in the 9th month didn’t show evidence of hepatitis B in infants

Single low-dose tafenoquine combined with dihydroartemisinin-piperaquine to reduce Plasmodium falciparum transmission in Ouelessebougou, Mali: a phase 2, single-blind, randomised clinical trial.

BACKGROUND: Tafenoquine was recently approved as a prophylaxis and radical cure for Plasmodium vivax infection, but its Plasmodium falciparum transmission-blocking efficacy is unclear. We aimed to establish the efficacy and safety of three single low doses of tafenoquine in combination with dihydroartemisinin-piperaquine for reducing gametocyte density and transmission to mosquitoes. METHODS: In this four-arm, single-blind, phase 2, randomised controlled trial, participants were recruited at the Clinical Research Unit of the Malaria Research and Training Centre of the University of Bamako in Mali. Eligible participants were aged 12-50 years, with asymptomatic P falciparum microscopy-detected gametocyte carriage, had a bodyweight of 80 kg or less, and had no clinical signs of malaria defined by fever. Participants were randomly assigned (1:1:1:1) to standard treatment with dihydroartemisinin-piperaquine, or dihydroartemisinin-piperaquine plus a single dose of tafenoquine (in solution) at a final dosage of 0·42 mg/kg, 0·83 mg/kg, or 1·66 mg/kg. Randomisation was done with a computer-generated randomisation list and concealed with sealed, opaque envelopes. Dihydroartemisinin-piperaquine was administered as oral tablets over 3 days (day 0, 1, and 2), as per manufacturer instructions. A single dose of tafenoquine was administered as oral solution on day 0 in parallel with the first dose of dihydroartemisinin-piperaquine. Tafenoquine dosing was based on bodyweight to standardise efficacy and risk variance. The primary endpoint, assessed in the per-protocol population, was median percentage change in mosquito infection rate 7 days after treatment compared with baseline. Safety endpoints included frequency and incidence of adverse events. The final follow-up visit was on Dec 23, 2021; the trial is registered with ClinicalTrials.gov, NCT04609098. FINDINGS: From Oct 29 to Nov 25, 2020, 1091 individuals were screened for eligibility, 80 of whom were enrolled and randomly assigned (20 per treatment group). Before treatment, 53 (66%) individuals were infectious to mosquitoes, infecting median 12·50% of mosquitoes (IQR 3·64-35·00). Within-group reduction in mosquito infection rate on day 7 was 79·95% (IQR 57·15-100; p=0·0005 for difference from baseline) following dihydroartemisinin-piperaquine only, 100% (98·36-100; p=0·0005) following dihydroartemisinin-piperaquine plus tafenoquine 0·42 mg/kg, 100% (100-100; p=0·0001) following dihydroartemisinin-piperaquine plus tafenoquine 0·83 mg/kg, and 100% (100-100; p=0·0001) following dihydroartemisinin-piperaquine plus tafenoquine 1·66 mg/kg. 55 (69%) of 80 participants had a total of 94 adverse events over the course of the trial; 86 (92%) adverse events were categorised as mild, seven (7%) as moderate, and one (1%) as severe. The most common treatment-related adverse event was mild or moderate headache, which occurred in 15 (19%) participants (dihydroartemisinin-piperaquine n=2; dihydroartemisinin-piperaquine plus tafenoquine 0·42 mg/kg n=6; dihydroartemisinin-piperaquine plus tafenoquine 0·83 mg/kg n=3; and dihydroartemisinin-piperaquine plus tafenoquine 1·66 mg/kg n=4). No serious adverse events occurred. No significant differences in the incidence of all adverse events (p=0·73) or treatment-related adverse events (p=0·62) were observed between treatment groups. INTERPRETATION: Tafenoquine was well tolerated at all doses and accelerated P falciparum gametocyte clearance. All tafenoquine doses showed improved transmission reduction at day 7 compared with dihydroartemisinin-piperaquine alone. These data support the case for further research on tafenoquine as a transmission-blocking supplement to standard antimalarials. FUNDING: Bill & Melinda Gates Foundation. TRANSLATIONS: For the French, Portuguese, Spanish and Swahili translations of the abstract see Supplementary Materials section