Facteurs prédictifs de l’échec de traitement antituberculeux en Guinée Conakry

La tuberculose est un véritable problème de santé publique. C'est une maladie guérissable et cette  guérison passe par une bonne prise en charge thérapeutique. Il arrive parfois on assiste à l'échec thérapeutique, d'où l'intérêt de notre étude portant sur les facteurs prédictifs de ses échecs. Dans  l'espace d'une année sur 1300 cas de tuberculose toute forme confondue, 700 cas de tuberculose  pulmonaire à microscopie positive ont été répertorié dont 100 cas transférés. La tranche d'âge de 15-25  ans a été la plus touchée avec un sexe-ratio de 2 en faveur des hommes et 41,66% de nos malades ont été les ouvriers suivis de 20,83% des commerçants. La majorité de nos patients provenait de Conakry  soit 99, 5%. Sur 600 patients suivis les nouveaux cas  représentaient 83,33% et l'échec thérapeutique représentait 12 cas soit 2%. L'interruption du traitement  représente le principal facteur de l'échec. Les facteurs qui ont influencé la régularité des malades au  traitement ont été multiples. Des facteurs liés à l'organisation du système de santé, la rupture des  médicaments antituberculeux, l'éducation sanitaire insuffisante, les contraintes de la supervision du traitement, l'implication insuffisante et la vente des médicaments par le personnel de santé. Des facteurs liés aux patients euxmêmes, la crainte de perte d'emploi, les contraintes financières. Les renforcements de  l'organisation du système sanitaire et l'éducation thérapeutiques pourront réduire le taux d'échec du  traitement antituberculeux. L'amélioration de la qualité de la prise en charge des malades en situation d'échec devrait passer par une culture systématique des expectorations avec antibiogramme.Key words: Facteurs prédictifs, Echec, Antituberculeux, Tuberculose.

Effets du compost enrichi de l’urine humaine sur le rendement de la pomme de terre (MANDOLA) dans la Commune Urbaine de Faranah/République de Guinée

Le faible niveau d’apport des engrais minéraux par les producteurs dus son prix exorbitant est l’un des facteurs limitant la production de la pomme de terre. Le compost enrichi de l’urine constitue une alternative pour augmenter le rendement des cultures à faible coût. L’objectif principal de ce travail était d’évaluer l’effet des doses du compost enrichi de l’urine humaine sur le rendement de la pomme de terre (MANDOLA). Les doses du compost enrichi par l’urine humaine utilisées sont : D0=0t/ha (Témoin) ; D1=15t /ha (240g /poquet) ; D2=30t /ha (480g/poquet) ; D3= 45t /ha (720g/poquet). Les résultats de l’observation phénologique ont montré que les différentes doses appliquées ont eu un effet en réduisant le cycle végétatif de la culture D1 (72 jours), D2 et D3 (70 jours) contre D0 (74 jours). Au vu des résultats d’analyse de variance, le rendement total en tubercules la dose D3 (13,07 t /ha) a été meilleure, suivie de D2 (12,76 t/ha) et D1 (11,98 t/ha) ; le plus faible rendement a été obtenu au niveau du témoin D0 (10,16t/ha). Cela dénote que l’apport du compost enrichi de l’urine humaine contribue à l’augmentation du rendement de la pomme terre

Polygamy and family member relationship on Guinean family business succession planning

Purpose – The aim of the paper is to identify the key factors that affect Guinean family business (FB) succession planning. The study also evaluates the impact of these factors on the succession planning process to ensure business continuity. Design/methodology/approach – This descriptive quantitative research is based on a survey of 383 family businesses FBs in Conakry, the capital city of Guinea. The structural equation model (SEM) was used to analyze and validate the model featuring factors that influence family business FB succession planning (FBSP). The Theory of Stewardess and the Theory of FB Rivalry have been employed in the study. Findings – While the incumbent attributes, firm attributes, and estate tax were revealed to have no significant influence on succession planning, the successor attributes and the family relationship significantly affected succession planning. Besides, undesirable domestic relationships among children of different mothers from polygamous families had an indirect impact on business succession planning. Research limitations/implications – The limitations of the study include the population of the FBs being restricted only to those located in Conakry, the capital city. The study did not consider other regions and cities of Guinea. Besides, the grouping of attributes or characteristics was problematic, and studying each attribute separately as an independent variable would be much better. Finally, the limited literature and available data on Guinean FBs in general and succession planning generalize the findings to be done cautiously. Therefore, more studies are needed on FB succession in the country to further confirm these findings. Social implications – The study may help ensure social solidarity based on the findings of factors associated to polygamous families in relation to businesses. Originality/value – Few studies have been done on FBs in Conakry. Besides, putting attributes or characteristics into categories has been presented. Moreover, there is inadequate relevant literature and data on Guinean FBSP. Considering these limitations, the generalization of the findings should be done with caution. Therefore, this study touched on the issue of family business succession in Guinea which substantiates the findings

Community engagement for successful COVID-19 pandemic response: 10 lessons from Ebola outbreak responses in Africa

Publisher's version (útgefin grein)[No abstract available]The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.Peer Reviewe

Subsequent mortality in survivors of Ebola virus disease in Guinea: a nationwide retrospective cohort study.

BACKGROUND: A record number of people survived Ebola virus infection in the 2013-16 outbreak in west Africa, and the number of survivors has increased after subsequent outbreaks. A range of post-Ebola sequelae have been reported in survivors, but little is known about subsequent mortality. We aimed to investigate subsequent mortality among people discharged from Ebola treatment units. METHODS: From Dec 8, 2015, Surveillance Active en ceinture, the Guinean national survivors' monitoring programme, attempted to contact and follow-up all survivors of Ebola virus disease who were discharged from Ebola treatment units. Survivors were followed up until Sept 30, 2016, and deaths up to this timepoint were recorded. Verbal autopsies were done to gain information about survivors of Ebola virus disease who subsequently died from their closest family members. We calculated the age-standardised mortality ratio compared with the general Guinean population, and assessed risk factors for mortality using survival analysis and a Cox proportional hazards regression model. FINDINGS: Of the 1270 survivors of Ebola virus disease who were discharged from Ebola treatment units in Guinea, information was retrieved for 1130 (89%). Compared with the general Guinean population, survivors of Ebola virus disease had a more than five-times increased risk of mortality up to Dec 31, 2015 (age-standardised mortality ratio 5·2 [95% CI 4·0-6·8]), a mean of 1 year of follow-up after discharge. Thereafter (ie, from Jan 1-Sept 30, 2016), mortality did not differ between survivors of Ebola virus disease and the general population. (0·6 [95% CI 0·2-1·4]). Overall, 59 deaths were reported, and the cause of death was tentatively attributed to renal failure in 37 cases, mostly on the basis of reported anuria. Longer stays (ie, equal to or longer than the median stay) in Ebola treatment units were associated with an increased risk of late death compared with shorter stays (adjusted hazard ratio 2·62 [95% CI 1·43-4·79]). INTERPRETATION: Mortality was high in people who recovered from Ebola virus disease and were discharged from Ebola treatment units in Guinea. The finding that survivors who were hospitalised for longer during primary infection had an increased risk of death, could help to guide current and future survivors' programmes and in the prioritisation of funds in resource-constrained settings. The role of renal failure in late deaths after recovery from Ebola virus disease should be investigated. FUNDING: WHO, International Medical Corps, and the Guinean Red Cross

Framing the future of the COVID-19 response operations in 2022 in the WHO African region

With the evolving epidemiological parameters of COVID-19 in Africa, the response actions and lessons learnt during the pandemic's past two years, SARS-COV 2 will certainly continue to circulate in African countries in 2022 and beyond. As countries in the African continent need to be more prepared and plan to 'live with the virus' for the upcoming two years and after and at the same time mitigate risks by protecting the future most vulnerable and those responsible for maintaining essential services, WHO AFRO is anticipating four interim scenarios of the evolution of the pandemic in 2022 and beyond in the region. In preparation for the rollout of response actions given the predicted scenarios, WHO AFRO has identified ten strategic orientations and areas of focus for supporting member states and partners in responding to the COVID-19 pandemic in Africa in 2022 and beyond. WHO analysed trends of the transmissions since the first case in the African continent and reviewed lessons learnt over the past months. Establishing a core and agile team solely dedicated to the COVID-19 response at the WHO AFRO, the emergency hubs, and WCOs will improve the effectiveness of the response and address identified challenges. The team will collaborate with the various clusters of the regional office, and other units and subunits in the WCOs supported with good epidemics intelligence. COVID-19 pandemic has afflicted global humanity at unprecedented levels. Two years later and while starting the third year of the COVID-19 response, we now need to change and adapt our strategies, tools and approaches in responding timely and effectively to the pandemic in Africa and save more lives

The Recognition of and Care Seeking Behaviour for Childhood Illness in Developing Countries: A Systematic Review

Background: Pneumonia, diarrhoea, and malaria are among the leading causes of death in children. These deaths are largely preventable if appropriate care is sought early. This review aimed to determine the percentage of caregivers in low- and middle-income countries (LMICs) with a child less than 5 years who were able to recognise illness in their child and subsequently sought care from different types of healthcare providers. Methods and Findings: We conducted a systematic literature review of studies that reported recognition of, and/or care seeking for episodes of diarrhoea, pneumonia or malaria in LMICs. The review is registered with PROSPERO (registration number: CRD42011001654). Ninety-one studies met the inclusion criteria. Eighteen studies reported data on caregiver recognition of disease and seventy-seven studies on care seeking. The median sensitivity of recognition of diarrhoea, malaria and pneumonia was low (36.0%, 37.4%, and 45.8%, respectively). A median of 73.0% of caregivers sought care outside the home. Care seeking from community health workers (median: 5.4% for diarrhoea, 4.2% for pneumonia, and 1.3% for malaria) and the use of oral rehydration therapy (median: 34%) was low. Conclusions: Given the importance of this topic to child survival programmes there are few published studies. Recognition of diarrhoea, malaria and pneumonia by caregivers is generally poor and represents a key factor to address in attempts to improve health care utilisation. In addition, considering that oral rehydration therapy has been widely recommended for over forty years, its use remains disappointingly low. Similarly, the reported levels of care seeking from community health workers in the included studies are low even though global action plans to address these illnesses promote community case management. Giving greater priority to research on care seeking could provide crucial evidence to inform child mortality programmes

Meeting Records

The entire manuscript is available for download as a single PDF file. Because of the large size of this manuscript, it is also available in three PDF files. In addition, each page is available as a separate, larger, JPG file. If higher-resolution JP2 files are needed (WARNING: files average 15-20MB in size), please contact [email protected]. Fieldwork Team: Mouhamadou L. Diallo (Lecturer of Wolof & Pular Languages) and Ahmed Diallo (Research Assistant). Technical Team: Dr. Vika Zafrin (Digital Scholarship Librarian, BU Libraries), Professor Fallou Ngom (Professor of Anthropology), Dr. Peter Quella (Assistant Director, African Studies Center), and Sarah Davis Westwood (PhD Candidate, Department of History). This collection of Fuuta Jalon Pular Ajami materials is copied as part of the African Studies Center’s African Ajami Library. This project is funded by the BU African Studies Center. We thank Prof. Tim Longman, past Director of the African Studies Center, and the entire African Studies team for their support. For Inquiries: Please contact Professor Fallou Ngom ([email protected]).The material talks about the reports of meetings and timeline of different activities of a religious Pular organization in Dakar. It was written from 1980 up to now in Dakar, Senegal. The material was digitized in Dakar, Senegal. The video contains El hadj Mouhamadou Sall sharing biographical information and details related to the acquisition and contents of these Ajami materials.The contents of this collection were developed with support of the Title VI National Resource Center grant # P015A140088 from the U.S. Department of Education. However, those contents do not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the Federal Government

Implication du rythme circadien dans la réponse immunitaire de l’hôte

Le rythme circadien est un rythme biologique d'une durée d'environ 24 heures généré dans les noyaux suprachiasmatiques de l'hypothalamus. Plusieurs systèmes biologiques y compris le système immunitaire présentent une rythmicité circadienne. Ce travail a porté sur l'étude de la place du rythme circadien dans la réponse immune de l’hôte. Nous avons montré que les monocytes humains ont un rythme circadien qui est perdu lors de la différenciation en macrophages (MDM), mais peut être rétabli par un choc sérique. La phagocytose et la production de cytokines par les cellules avec rythme (monocytes et MDM synchronisés) étaient fonction du moment de l’interaction avec le stimulus infectieux. La délétion de Bmal1 supprime la rythmicité. Nous avons étendu ces observations à l’infection au SARS-CoV-2. Par ailleurs, nous avons montré un rythme circadien significatif chez E. coli. En second lieu, nous avons exploré le rythme circadien dans le placenta. Les macrophages et trophoblastes placentaires ont un rythme qui a été perdu après 4 jours de culture pour les macrophages. Une coculture des macrophages avec les trophoblastes a restauré le rythme. Les macrophages issus de placenta pré éclamptiques n'ont montré aucun rythme, même en coculture. Pour finir, nous avons décrit une perturbation du rythme circadien chez les patients polytraumatisés ainsi qu’une exacerbation des rythmes de la température dans le cadre du sepsis. Ces travaux ont permis d'apporter de nombreuses réponses quant au lien entre rythme circadien et réponse immune. Ainsi, le rythme circadien pourrait être une nouvelle cible thérapeutique dans la prise en charge de l’infection.Circadian rhythm is a biological rhythm of approximately 24 hours duration generated in the suprachiasmatic nuclei of the hypothalamus. Several biological systems, including the immune system, exhibit circadian rhythmicity. This work focused on the study of the place of circadian rhythm in the host immune response. We have shown that human monocytes have a circadian rhythm that is lost during differentiation into macrophages (MDM), but can be restored by serum shock. Phagocytosis and cytokine production by the rhythmic cells (monocytes and MDM synchronised) were dependent on the timing of the interaction with the infectious stimulus. The deletion of Bmal1 suppresses the rhythmicity. We extended these observations to SARS-CoV-2 infection. In addition, we showed a significant circadian rhythm in E. coli. Secondly, we explored the circadian rhythm in the placenta. Placental macrophages and trophoblasts have a circadian rhythm that was lost after 4 days of culture for macrophages. A co-culture of the macrophages with the trophoblasts restored the rhythm. Macrophages from pre-eclamptic placenta showed no rhythm, even in co-culture. Finally, we described a disruption of the circadian rhythm in polytrauma patients and an exacerbation of temperature rhythms in sepsis. This work has provided many answers as to the link between circadian rhythm and immune response. Thus, the circadian rhythm could be a new therapeutic target in the management of infection

For Whom the Clock Ticks: Clinical Chronobiology for Infectious Diseases

The host defense against pathogens varies among individuals. Among the factors influencing host response, those associated with circadian disruptions are emerging. These latter depend on molecular clocks, which control the two partners of host defense: microbes and immune system. There is some evidence that infections are closely related to circadian rhythms in terms of susceptibility, clinical presentation and severity. In this review, we overview what is known about circadian rhythms in infectious diseases and update the knowledge about circadian rhythms in immune system, pathogens and vectors. This heuristic approach opens a new fascinating field of time-based personalized treatment of infected patients