Données préliminaires sur le paludisme humain en zones rurale et sémi-urbaine du département du Nkam (Littoral-Cameroun)

Objectif : Cette étude évalue les connaissances et les pratiques des populations sur le traitement et la prévention du paludisme et détermine la transmission du paludisme en zones rurale et sémi-urbaine du département du Nkam.Méthodologie et résultats : Un questionnaire a été administré aux populations de Bodiman et Yabassi, localités rurale et semi-urbaine, en mai 2015. Les captures de moustiques sur volontaires ont été effectuées à l’intérieur de 7 habitations par site, de juillet à septembre 2015, au rythme de 2 nuits consécutives par mois. L’infectivité des vecteurs a été déterminée par le test ELISA-CSP. 73,17% (n= 513) d’interviewés connaissaient les vecteurs du paludisme alors que seulement 9,46% (n= 63) connaissaient le germe. La moustiquaire était l’outil de prévention le plus utilisé à Bodiman (100%) et Yabassi (38,46%). Le montant mensuellement dépensé par les ménages contre le paludisme s’élevait à 2,31€ et 16,01€ en moyenne, respectivement à Bodiman et Yabassi. La majorité d’interviewés à Bodiman (n= 98 ; %=49,49) et Yabassi (n=198 ; %= 42,31) se rendaient à l’hôpital en cas de paludisme. En outre, 37 833 moustiques dont 35 961 à Bodiman et 1 872 à Yabassi ont été capturés. An. gambiae (81,82%) et An. coluzzii (18,18%) étaient les membres du complexe Gambiae identifiés ; An. coluzzii (59,26%) étant le plus représenté à Yabassi, et An. gambiae (81,82%) à Bodiman. Les indices sporozoïtiques d’An. gambiae s.l. étaient de 0% à Bodiman et de 2,15% à Yabassi.Conclusion et application : L’association de la lutte antilarvaire aux méthodes existantes de lutte antivectorielle par les pouvoirs publics contribuerait à baisser les fortes densités agressives observées à Bodiman de manière à réduire le budget alloué au paludisme par les ménages.Mots-clés : Connaissances, pratiques, transmission, paludisme, Bodiman, Yabassi

A co-designed mHealth programme to support healthy lifestyles in Māori and Pasifika peoples in New Zealand (OL@-OR@):A cluster-randomised controlled trial

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: The OL@-OR@ mobile health programme was co-designed with Māori and Pasifika communities in New Zealand, to support healthy lifestyle behaviours. We aimed to determine whether use of the programme improved adherence to health-related guidelines among Māori and Pasifika communities in New Zealand compared with a control group on a waiting list for the programme. Methods: The OL@-OR@ trial was a 12-week, two-arm, cluster-randomised controlled trial. A cluster was defined as any distinct location or setting in New Zealand where people with shared interests or contexts congregated, such as churches, sports clubs, and community groups. Members of a cluster were eligible to participate if they were aged 18 years or older, had regular access to a mobile device or computer, and had regular internet access. Clusters of Māori and of Pasifika (separately) were randomly assigned (1:1) to either the intervention or control condition. The intervention group received the OL@-OR@ mHealth programme (smartphone app and website). The control group received a control version of the app that only collected baseline and outcome data. The primary outcome was self-reported adherence to health-related guidelines, which were measured with a composite health behaviour score (of physical activity, smoking, alcohol intake, and fruit and vegetable intake) at 12 weeks. The secondary outcomes were self-reported adherence to health-related behaviour guidelines at 4 weeks; self-reported bodyweight at 12 weeks; and holistic health and wellbeing status at 12 weeks, in all enrolled individuals in eligible clusters; and user engagement with the app, in individuals allocated to the intervention. Adverse events were not collected. This study is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12617001484336. Findings: Between Jan 24 and Aug 14, 2018, we enrolled 337 Māori participants from 19 clusters and 389 Pasifika participants from 18 clusters (n=726 participants) in the intervention group and 320 Māori participants from 15 clusters and 405 Pasifika participants from 17 clusters (n=725 participants) in the control group. Of these participants, 227 (67%) Māori participants and 347 (89%) Pasifika participants (n=574 participants) in the intervention group and 281 (88%) Māori participants and 369 (91%) Pasifika participants (n=650 participants) in the control group completed the 12-week follow-up and were included in the final analysis. Relative to baseline, adherence to health-related behaviour guidelines increased at 12 weeks in both groups (315 [43%] of 726 participants at baseline to 329 [57%] of 574 participants in the intervention group; 331 [46%] of 725 participants to 369 [57%] of 650 participants in the control group); however, there was no significant difference between intervention and control groups in adherence at 12 weeks (odds ratio [OR] 1·13; 95% CI 0·84–1·52; p=0·42). Furthermore, the proportion of participants adhering to guidelines on physical activity (351 [61%] of 574 intervention group participants vs 407 [63%] of 650 control group participants; OR 1·03, 95% CI 0·73–1·45; p=0·88), smoking (434 [76%] participants vs 501 [77%] participants; 1·12, 0·67–1·87; p=0·66), alcohol consumption (518 [90%] participants vs 596 [92%] participants; 0·73, 0·37–1·44; p=0·36), and fruit and vegetable intake (194 [34%] participants vs 196 [30%] participants; 1·08, 0·79–1·49; p=0·64) did not differ between groups. We found no significant differences between the intervention and control groups in any secondary outcome. 147 (26%) intervention group participants engaged with the OL@-OR@ programme (ie, set at least one behaviour change goal online). Interpretation: The OL@-OR@ mobile health programme did not improve adherence to health-related behaviour guidelines amongst Māori and Pasifika individuals. Funding: Healthier Lives He Oranga Hauora National Science Challenge

Buccal soft tissue lipoma in an adult Nigerian: a case report and literature review

<p>Abstract</p> <p>Introduction</p> <p>Lipomas are benign mesenchymal neoplasms composed of mature adipocytes, usually surrounded by a thin fibrous capsule. They are uncommon intra-oral tumors with 1% to 4% occurring in this region. The literature is scanty on lipomas occurring in the buccal soft tissue, especially in our environment.</p> <p>Case presentation</p> <p>We present a case of a 35-year-old woman of the Tiv ethnic group of Nigeria who presented with a slow growing left cheek swelling that was treated by intra-oral local excision.</p> <p>Conclusion</p> <p>The purpose of this report is to highlight the existence of this rare but not uncommon disease even in our environment and to emphasize that a high index of suspicion is needed in making a diagnosis. Surgical excision as treatment is associated with an excellent outcome.</p

Public Debt Sustainability in Developing Asia: An Update

Our previous assessment of debt sustainability in developing Asia, conducted in 2011, found that the region's fiscal outlook was mostly benign. In this study we update the debt sustainability assessment, taking stock of the latest data and including a larger number of countries. With the benefit of hindsight, we assess the accuracy of our earlier debt ratio forecasts and the underlying macroeconomic assumptions. By and large, we find that standard debt sustainability analysis (DSA) represents a valid forecasting tool, able to predict debt ratios fairly accurately under reasonable assumptions and circumstances. Further, our fan chart analysis confirms the importance for stochastic analysis to integrate standard DSA, in order to capture heightened macroeconomic volatility, which we observe for some countries in the region. Looking forward to 2020, debt ratio projections confirm that the outlook remains benign for the region as a whole, country heterogeneity notwithstanding. On the issue of DSA methods and implementation, we emphasize the importance of macroeconomic forecast accuracy and suggest that volatility be captured by risk analysis tools that would optimally flank the standard DSA framework

Using models to inform policies to meet multiple objectives. Sustainable development, climate change mitigation and biodiversity conservation in Central Africa

Land-use change models can help in developing a holistic understanding of the range of potential impacts of different land-use related policy options, and so strengthen the development and implementation of policies to meet a range of objectives; including sustainable development, climate change mitigation, food security and biodiversity conservation. Member countries of the Central Africa Forest Commission (COMIFAC) have committed to sustainable management of the region’s forests, including under the COMIFAC “Convergence Plan”, and to achieving the Sustainable Development Goals (SDGs). Achieving these objectives is dependent on the development, and implementation, of new and existing national policies and approaches. Projections from land-use modelling identify potential trade-offs and synergies in the achievement of the SDGs under different macro-economic and land-use policy related scenarios. In particular they highlight the importance of effective protected areas and forest concessions for the conservation of Great Apes and other threatened species, and show that maintaining these areas has negligible impact on agricultural production in the region. As development continues in the region, further increasing the extent of protected areas could play a role in greatly reducing the number of species losing a large proportion of their habitat. However, protected area expansion needs to be well planned to avoid adverse impacts on particular species and societal challenges such as food security

Application of isothermal titration calorimetry in evaluation of protein–nanoparticle interactions

Nanoparticles (NPs) offer a number of advantages over small organic molecules for controlling protein behaviour inside the cell. Protein binding to the surface of NPs depends on their surface characteristics, composition and method of preparation (Mandal et al. in J Hazard Mater 248–249:238–245, 2013). It is important to understand the binding affinities, stoichiometries and thermodynamical parameters of NP–protein interactions in order to see which interaction will have toxic and hazardous consequences and thus to prevent it. On the other side, because proteins are on the brink of stability, they may experience interactions with some types of NPs that are strong enough to cause denaturation or significantly change their conformations with concomitant loss of their biological function. Structural changes in the protein may cause exposure of new antigenic sites, “cryptic” peptide epitopes, potentially triggering an immune response which can promote autoimmune disease (Treuel et al. in ACS Nano 8(1):503–513, 2014). Mechanistic details of protein structural changes at NP surface have still remained elusive. Understanding the formation and persistence of the protein corona is critical issue; however, there are no many analytical methods which could provide detailed information about the NP–protein interaction characteristics and about protein structural changes caused by interactions with nanoparticles. The article reviews recent studies in NP–protein interactions research and application of isothermal titration calorimetry (ITC) in this research. The study of protein structural changes upon adsorption on nanoparticle surface and application of ITC in these studies is emphasized. The data illustrate that ITC is a versatile tool for evaluation of interactions between NPs and proteins. When coupled with other analytical methods, it is important analytical tool for monitoring conformational changes in proteins