Editorial review: Male circumcision, gender and HIV prevention in sub-Saharan Africa: a (social science) research agenda

No Abstract.SAHARA J Vol. 4 (3) 2007: pp. 658-66

Investigating the zoonotic origin of the West African Ebola epidemic

The severe Ebola virus disease epidemic occurring in West Africa stems from a single zoonotic transmission event to a 2‐year‐old boy in Meliandou, Guinea. We investigated the zoonotic origins of the epidemic using wildlife surveys, interviews, and molecular analyses of bat and environmental samples. We found no evidence for a concurrent outbreak in larger wildlife. Exposure to fruit bats is common in the region, but the index case may have been infected by playing in a hollow tree housing a colony of insectivorous free‐tailed bats (Mops condylurus). Bats in this family have previously been discussed as potential sources for Ebola virus outbreaks, and experimental data have shown that this species can survive experimental infection. These analyses expand the range of possible Ebola virus sources to include insectivorous bats and reiterate the importance of broader sampling efforts for understanding Ebola virus ecology

Editorial review: male circumcision, gender and HIV prevention in sub-Saharan Africa: a (social science) research agenda

Sub-Saharan Africa is the part of the world which is the most affected by the HIV and AIDS pandemic, with 24.5 million people infected by the virus that causes AIDS. Adult HIV prevalence in southern Africa is estimated at 16%, at 6% in East Africa and at 4.5% in West and Central Africa (UNAIDS, 2006). Ecological studies in sub-Saharan Africa have suggested a geographical association between areas of higher prevalence of HIV and lower prevalence of male circumcision (MC) (Drain, Halperin, Hughes, Klausner & Bailey, 2006). An initial short-term randomised controlled study on male circumcision led by the Agence nationale de recherche sur le sida (ANRS) at Orange Farm in South Africa revealed a reduction of 60%-75% in the risk of female to male transmission of HIV-1 in circumcised men (Auvert et al., 2005).These studies, which were supported by the National Institutes of Health (NIH), were conducted in Kisumu in Kenya (Bailey et al., 2007) and in Rakai in Uganda (Gray et al., 2007).They demonstrated a risk reduction of around 58% and 53% respectively.On the 28th of March 2007 based on these studies, the WHO and UNAIDS issued a statement endorsing male circumcision (MC) as an additional strategy in HIV prevention, particularly in high HIV prevalence and low male circumcision countries (WHO/UNAIDS, 2007).

Asthme aigu grave de l’enfant : caractéristiques épidémiologiques, cliniques, thérapeutiques et évolutifs au Sénégal : Severe acute asthma of the child: epidemiological, clinical, therapeutic and evolutive characteristics in Senegal

Context and objective. The lethality of asthma is related to the occurrence of severe acute asthma which is a crisis that does not yield under initial bronchodilator therapy. The objective of this study was to describe the epidemiological, diagnostic, therapeutic and evolutionary characteristics of children hospitalized for a severe acute asthma attack. Methods. We conducted a retrospective study of 11 years (from January 1st, 2005 and December 31st, 2015) at the Pediatric Emergency and Respiratory Department of the Albert Royer Children's Hospital (CHNEAR). 89 Children aged 0 to 15 years hospitalized for severe asthma or severe acute asthma were included. Results. The hospital prevalence of severe asthma attacks was 0.18%. The average age of the children was 44.21 months and the sex ratio was 1.69. The hospitalizations peaks have been registered during the months of July and December. 6.6% of patients were undergoing treatment and 17.9% had already been hospitalized for severe asthma attacks. The main biological abnormalities were: hypoxemia (79.7%), anemia (66.29%) and leukocytosis (44.9%). Radiological abnormalities were dominated by pulmonary over distension (60.7%) and bronchial syndrome (36%). All patients were under oxygen, salbutamol and corticosteroids. One death was encountered. The average hospital length of stay was 3.75 days. The complications were pneumo-mediastinum / cervico-mediastinal emphysema in 4 cases, pneumothorax in 2 cases and atelectasis in 1 case. Conclusion. Severe acute asthma is a relatively rare condition, but it is always associated with a significant morbidity. Contexte et objectif. La létalité de l’asthme est liée à la survenue d’asthme aigu grave qui est une crise qui ne cède pas sous traitement bronchodilatateur initial. L’objectif de cette étude était de décrire les caractéristiques épidémiologiques, diagnostiques, thérapeutiques et évolutives des enfants hospitalisés pour une crise d’asthme aigu grave. Méthodes. Nous avons conduit une étude documentaire portant sur une période de 11 ans (1 janvier 2005-31 décembre 2015) et réalisée aux services des urgences pédiatriques et de pneumologie du centre hospitalier national d’enfants Albert Royer (CHNEAR). Etaient inclus, 89 enfants de 0 à 15ans hospitalisés pour crise d’asthme sévère ou asthme aigu grave. Résultats. La prévalence hospitalière des crises d’asthmes sévère était de 0,18%. Leur âge moyen était de 44,2 mois et le sexe ratio 1,6. Les pics d’hospitalisations ont été enregistrés durant les mois de Juillet et Décembre. 6,6% des patients étaient sous traitement de fond et 17,9% avaient déjà été hospitalisés pour crises d’asthmes sévères. L’hypoxémie (79,7%), l’anémie (66,2%) et l’hyperleucocytose (44,9%) étaient les principales anomalies biologiques. Les signes radiologiques étaient dominés par l’hyperinflation pulmonaire (60,7%) et le syndrome bronchique (36%). Tous les patients étaient ont bénéficié de l’oxygène, le salbutamol et les corticoïdes. Sous cette attitude thérapeutique, un décès avait été déploré. La durée moyenne de l’hospitalisation était de 3,75 jours. Les complications enregistrées étaient le pneumo-médiastin/emphysème cervico-médiastinal dans 4 cas, le pneumothorax dans 2 cas, la rupture trachéale dans 1 cas et l’atélectasie dans 1 cas. Conclusion. L’asthme aigu grave semble peu fréquent mais reste toujours associée à une morbidité non négligeable