Acceptabilite´ du test VIH propose´ aux nourrissons dans les services pe´ diatriques, en Coˆ te d’Ivoire, Significations pour la couverture du diagnostic pe´diatrique

Proble`me: Le de´pistage VIH chez les enfants a rarement e´te´ au centre des pre´occupations des chercheurs. Quand le de´pistage pe´diatrique a retenu l’attention, cela a e´te´ pour e´clairer seulement sur les performances diagnostiques en ignorant meˆme que le test pe´diatrique comme bien d’autres peut s’accepter ou se refuser. Cet article met au coeur de son analyse les raisons qui peuvent expliquer qu’on accepte ou qu’on refuse de faire de´pister son enfant.Objectif: Etudier chez les parents, les me`res, les facteurs explicatifs de l’acceptabilite´ du test VIH des  nourrissons de moins de six mois.Me´thodes: Entretien semi-directif a` passages re´pe´te´s avec les parents de nourrissons de moins de six mois dans les formations sanitaires pour la pese´e/vaccination et les consultations pe´diatriques avec proposition syste´matique d’un test VIH pour leur nourrisson.Re´sultats: Nous retenons que la re´alisation effective du test pe´diatrique du VIH chez le nourrisson repose sur trois e´le´ments. Primo, le personnel de sante´ par son discours (qui de´note de ses connaissances et  perceptions meˆme sur l’infection) oriente´ vers les me`res influence leur acceptation ou non du test. Secundo, la me`re qui par ses connaissances et perceptions meˆme sur le VIH, dont le statut particulier, l’impression de bien-eˆtre chez elle et son enfant influence toute re´alisation du test pe´diatrique VIH. Tertio, l’environnement conjugal de la me`re, particulie`rement caracte´rise´ par les rapports au sein du couple, sur la facilite´ de parler du test VIH et sa re´alisation chez les deux parents ou chez la me`re seulement sont autant de facteurs qui influencent la re´alisation effective du de´pistage du VIH chez l’enfant. Le principe pre´ventif du VIH, et le de´sir de faire tester l’enfant ne suffisent pas a` eux seuls pour aboutir a` sa re´alisation effective, selon certaines me`res confronte´es au refus du conjoint. A l’oppose´, les autres me`res refusant la re´alisation du test  pe´diatrique disent s’y opposer ; bien entendu, meˆme dans le cas ou` le conjoint l’accepterait.Discussion: Les me`res sont les principales mises en cause et craignent les re´primandes et la stigmatisation. Le pe`re, le conjoint peut eˆtre un obstacle, quand il s’oppose au test VIH du nourrisson, ou devenir le facilitateur de sa re´alisation s’il est convaincu. Le positionnement du pe`re demeure donc essentiel dans la question de l’acceptabilite´ du VIH pe´diatrique. Les me`res en ont conscience et pre´sagent des difficulte´s a` faire  de´pister ou non les enfants sans avis pre´alable du conjoint a` la fois pe`re, et chef de famille.Conclusion: La question du de´pistage pe´diatrique du VIH, au terme de notre analyse, met en face trois e´le´ments qui exigent une gestion globale pour assurer une couverture effective. Ces trois e´le´ments n’existeraient pas sans s’influencer, donc ils sont constamment en interaction et empeˆchent ou favorisent la re´alisation ou non du test pe´diatrique. Aussi, dans une intention d’aboutir a` une couverture effective du de´pistage VIH des nourrissons, faut-il tenir compte d’une gestion harmonieuse de ces trois e´le´ments: La premie`re, la me`re seule (avec ses connaissances, ses perceptions), son environnement conjugal (de  proposition du test inte´grant 1- l’e´poux et / ou pe`re de l’enfant avec ses perceptions et connaissances sur l’infection 2- la facilite´ de parler du test et sa re´alisation chez les deux ou un des parents, la me`re) et les connaissances, attitudes et pratiques du personnel de l’e´tablissement sanitaire sur l’infection du VIH.Recommandations: Nos recommandations proposent une rede´finition de l’approche du VIH/sida vers des familles expose´es au VIH et une inte´gration plus accentue´e du pe`re facilitant leur propre acceptation du test VIH et celle de leur enfant.Mots cle´s: Acceptabilite´, Test VIH, Enfants, Nourrissons Problem: HIV testing in children had rarely been a central concern for researchers. When pediatric tracking retained the attention, it was more to inform on the diagnosis tools performances rather than the fact the pediatric test can be accepted or refused. This article highlights the parent’s reasons which explain why pediatric HIV test is accepted or refused.Objective: To study among parents, the explanatory factors of the acceptability of pediatric HIV testing among infant less than six months.Methods: Semi-structured interview with repeated passages in the parents of infants less than six months attending in health care facilities for the pediatric weighing/vaccination and consultations.Results: We highlight that the parent’s acceptance of the pediatric HIV screening is based on three elements.Firstly, the health care workers by his speech (which indicates its own knowledge and perceptions on the infection) directed towards mothers’ influences their acceptance or not of the HIV test. Secondly, the mother who by her knowledge and perceptions on HIV, whose particular status, give an impression of her own wellbeing for her and her child influences any acceptance of the pediatric HIV test. Thirdly, the marital environment of the mother, particularly characterized by the ease of communication within the couple, to speak about the HIV test and its realization for the parents or the mother only are many factors which influence the effective realization of the pediatric HIV testing. The preventive principle of HIV transmission and the desire to realize the test in the  newborn are not enough alone to lead to its effective realization, according to certain mothers confronted with the father’s refusal. On the other hand, the other mothers refusing the realization of the pediatric test told to be opposed to it; of course, even if their partner would accept it.Discussion: The mothers are the principal facing the pediatric HIV question and fear the reprimands and stigma. The father, the partner could be an obstacle, when he is opposed to the infant HIV testing, or also the facilitator with his realization if he is convinced. The father position thus remains essential face to the question of pediatric HIV testing acceptability. The mothers are aware of this and predict the difficulties of achieving their infant to be tested without the preliminary opinion of their partner at the same time father, and head of the family.Conclusion: The issue of pediatric HIV testing, at the end of our analysis, highlights three elements which require a comprehensive management to improve the coverage of pediatric HIV test. These three elements would not exist without being influenced; therefore they are constantly in interaction and prevent or support the realization or not pediatric test. Also, with the aim to improve the pediatric HIV test coverage, it is necessary to take into account the harmonious management of these elements. Firstly, the mother alone (with her knowledge, and perceptions), its marital environment (with the proposal of the HIV test integrating (1) the partner and/or father with his perceptions and knowledge on HIV infection and (2) facility of speaking about the test and its realization at both or one about the parents, the mother) and of the knowledge, attitudes and practices about the infection of health care workers of the sanitary institution.Recommendations: Our recommendations proposed taking into account a redefinition of the HIV/AIDS approach towards the families exposed to HIV and a more accentuated integration of the father facilitating their own HIV test acceptation and that of his child.Keywords: acceptability, HIV testing, children, infantsArticle in French

Essai préliminaire de mise en oeuvre de culture de cyanobactérie en Côte d’Ivoire

Les cyanobactéries sont des bactéries photosynthétiques capable produire des métabolites secondaires dont les cyanotoxines. Les blooms à  cyanobactérie toxiques représentent des menaces aussi bien pour l’environnement que l’homme et les animaux. L’étude des toxines et autres métabolites nécessitent des cultures viables de cyanobactérie. Cependant, la culture in vitro de cyanobactérie en Côte d’Ivoire est peu développée. Cette étude s’est donnée pour objectif d’expérimenter la culture in vitro de cyanobactérie à partir d’échantillon de phytoplankton récolté dans la nature. Une revue de la littérature a servi de base à cette étude. Elle a permis d'identifier un site de prélèvement, des techniques et des clés d'identification des cyanobactéries. Elle a également permis la sélection de milieux de culture à utiliser. Un « incubateur artisanal » a été développé pour la culture de cyanobactéries. Le milieu Bold modifié (M1) était statistiquement le plus adapté à la culture des cyanobactéries en général. La composition de ce milieu pourrait avoir favorisé le  développement de certains genres aux détriments d’autres. La culture de cyanobactéries a été mise en oeuvre. Il reste cependant à améliorer la technique à poursuivre vers la purification des cultures et l’étude des  métabolites secondaires. Keywords : Cyanobacterie, Culture, Environnement, Identification, Côte d’Ivoire

First Detection of Mycobacterium ulcerans DNA in Environmental Samples from South America

The occurrences of many environmentally-persistent and zoonotic infections are driven by ecosystem changes, which in turn are underpinned by land-use modifications that alter the governance of pathogen, biodiversity and human interactions. Our current understanding of these ecological changes on disease emergence however remains limited. Buruli ulcer is an emerging human skin disease caused by the mycobacterium, Mycobacterium ulcerans, for which the exact route of infection remains unclear. It can have a devastating impact on its human host, causing extensive necrosis of the skin and underlying tissue, often leading to permanent disability. The mycobacterium is associated with tropical aquatic environments and incidences of the disease are significantly higher on floodplains and where there is an increase of human aquatic activities. Although the disease has been previously diagnosed in South America, until now the presence of M. ulcerans DNA in the wild has only been identified in Australia where there have been significant outbreaks and in western and central regions of Africa where the disease is persistent. Here for the first time, we have identified the presence of the aetiological agent's DNA in environmental samples from South America. The DNA was positively identified using Real-time Polymerase Chain Reaction (PCR) on 163 environmental samples, taken from 23 freshwater bodies in French Guiana (Southern America), using primers for both IS2404 and for the ketoreductase-B domain of the M. ulcerans mycolactone polyketide synthase genes (KR). Five samples out of 163 were positive for both primers from three different water bodies. A further nine sites had low levels of IS2404 close to a standard CT of 35 and could potentially harbour M. ulcerans. The majority of our positive samples (8/14) came from filtered water. These results also reveal the Sinnamary River as a potential source of infection to humans. © 2014 Morris et al

Landscape Diversity Related to Buruli Ulcer Disease in Côte d'Ivoire

Buruli ulcer (BU) is one of the most neglected but treatable tropical diseases. The causative organism, Mycobacterium ulcerans, is from the family of bacteria that causes tuberculosis and leprosy. This severe skin disease leads to long-term functional disability if not treated. BU has been reported in over 30 countries mainly with tropical and subtropical climates, but Côte d'Ivoire is one of the most affected countries. M. ulcerans is an environmental bacterium and its mode of transmission to humans is still unclear, such that the disease is often referred to as the “mysterious disease” or the “new leprosy”. Here, we explored the relationship between environmental and socioeconomic factors and BU cases on a nationwide scale. We found that irrigated rice field cultures areas, and, to a lesser extent, banana fields as well as areas in the vicinity of dams used for irrigation and aquaculture purposes, represent high risk zones for the human population to contract BU in Côte d'Ivoire. This work identifies high-risk areas for BU in Côte d'Ivoire and deserves to be extended to different countries. We need now to obtain a global vision and understanding of the route of transmission of M. ulcerans to humans in order to better implement control strategies

Evidence for Spinodal Decomposition in Nuclear Multifragmentation

Multifragmentation of a ``fused system'' was observed for central collisions between 32 MeV/nucleon 129Xe and natSn. Most of the resulting charged products were well identified thanks to the high performances of the INDRA 4pi array. Experimental higher-order charge correlations for fragments show a weak but non ambiguous enhancement of events with nearly equal-sized fragments. Supported by dynamical calculations in which spinodal decomposition is simulated, this observed enhancement is interpreted as a ``fossil'' signal of spinodal instabilities in finite nuclear systems.Comment: 4 pages, 4 figures, to be published in Phys. Rev. Letter

ICBP90 belongs to a new family of proteins with an expression that is deregulated in cancer cells

International audienceICBP90 (Inverted CCAAT box Binding Protein of 90 kDa) is a recently identified nuclear protein that binds to one of the inverted CCAAT boxes of the topoisomerase IIalpha (TopoIIalpha) gene promoter. Here, we show that ICBP90 shares structural homology with several other proteins, including Np95, the human and mouse NIRF, suggesting the emergence of a new family of nuclear proteins. Towards elucidating the functions of this family, we analysed the expression of ICBP90 in various cancer or noncancer cell lines and in normal or breast carcinoma tissues. We found that cancer cell lines express higher levels of ICBP90 and TopoIIalpha than noncancer cell lines. By using cell-cycle phase-blocking drugs, we show that in primary cultured human lung fibroblasts, ICBP90 expression peaks at late G1 and during G2/M phases. In contrast, cancer cell lines such as HeLa, Jurkat and A549 show constant ICBP90 expression throughout the entire cell cycle. The effect of overexpression of E2F-1 is more efficient on ICBP90 and TopoIIalpha expression in noncancer cells (IMR90, WI38) than in cancer cells (U2OS, SaOs). Together, these results show that ICBP90 expression is altered in cancer cell lines and is upregulated by E2F-1 overexpression with an efficiency depending on the cancer status of the cell line

Measurements of sideward flow around the balance energy

Sideward flow values have been determined with the INDRA multidetector for Ar+Ni, Ni+Ni and Xe+Sn systems studied at GANIL in the 30 to 100 A.MeV incident energy range. The balance energies found for Ar+Ni and Ni+Ni systems are in agreement with previous experimental results and theoretical calculations. Negative sideward flow values have been measured. The possible origins of such negative values are discussed. They could result from a more important contribution of evaporated particles with respect to the contribution of promptly emitted particles at mid-rapidity. But effects induced by the methods used to reconstruct the reaction plane cannot be totally excluded. Complete tests of these methods are presented and the origins of the ``auto-correlation'' effect have been traced back. For heavy fragments, the observed negative flow values seem to be mainly due to the reaction plane reconstruction methods. For light charged particles, these negative values could result from the dynamics of the collisions and from the reaction plane reconstruction methods as well. These effects have to be taken into account when comparisons with theoretical calculations are done.Comment: 27 pages, 15 figure

Identification of a Small TAF Complex and Its Role in the Assembly of TAF-Containing Complexes

TFIID plays a role in nucleating RNA polymerase II preinitiation complex assembly on protein-coding genes. TFIID is a multisubunit complex comprised of the TATA box binding protein (TBP) and 14 TBP-associated factors (TAFs). Another class of multiprotein transcriptional regulatory complexes having histone acetyl transferase (HAT) activity, and containing TAFs, includes TFTC, STAGA and the PCAF/GCN5 complex. Looking for as yet undiscovered subunits by a proteomic approach, we had identified TAF8 and SPT7L in human TFTC preparations. Subsequently, however, we demonstrated that TAF8 was not a stable component of TFTC, but that it is present in a small TAF complex (SMAT), containing TAF8, TAF10 and SPT7L, that co-purified with TFTC. Thus, TAF8 is a subunit of both TFIID and SMAT. The latter has to be involved in a pathway of complex formation distinct from the other known TAF complexes, since these three histone fold (HF)-containing proteins (TAF8, TAF10 and SPT7L) can never be found together either in TFIID or in STAGA/TFTC HAT complexes. Here we show that TAF8 is absolutely necessary for the integration of TAF10 in a higher order TFIID core complex containing seven TAFs. TAF8 forms a heterodimer with TAF10 through its HF and proline rich domains, and also interacts with SPT7L through its C-terminal region, and the three proteins form a complex in vitro and in vivo. Thus, the TAF8-TAF10 and TAF10-SPT7L HF pairs, and also the SMAT complex, seem to be important regulators of the composition of different TFIID and/or STAGA/TFTC complexes in the nucleus and consequently may play a role in gene regulation