Protective effect of a non-bacteriocinogenic Lactococcus piscium strain against Listeria monocytogenes in sterilised tropical cooked peeled shrimp

The protective activity of a non-bacteriocinogenic Lactococcus piscium CNCM I-4031 strain against Listeria monocytogenes was investigated in tropical cooked peeled shrimp stored at 8°C in modified atmosphere packaging (50% N2–50% CO2). When inoculated alone (L. piscium 107 CFU g-1 and L. monocytogenes 104 CFU g-1), protective culture and target strain grew very well on shrimp reaching a maximum cell number of 109 CFU g-1 after 7 and 14 days, respectively. In the presence of L. piscium, growth of L. monocytogenes was totally prevented after 3 days of storage. The count was 3.4 log CFU g-1 lower than in the control after 10 days and until the end of storage (31 days). Using the Seafood Spoilage and Safety Predictor Software (http://sssp.dtuaqua.dk), it was shown that pH decrease from 6.58 to 5.94 and lactic acid concentration of 89.65 mM measured in the co-inoculated batch did not fully explain the inhibition observed

Screening Questionnaires to Detect Neurological Disorders in Developing Countries: A Systematic Review

International audienceIntroduction: Neurological disorders are an important cause of disability and death worldwide. The distribution of these disorders differs significantly in developing countries. Screening questionnaires have been used as an important tool to detect neurological illnesses. This systematic literature review aimed to report the validity of screening questionnaires for neurological disorders in developing countries.Methods: The PubMed/MEDLINE, Scopus, ScienceDirect, and PASCAL databases were searched. All publishedstudies performed in developing countries were eligible.The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 tool. Summary measures of validity were reported (sensitivity and specificity).Results: Eight hundred and thirty-five records were identified, and 49 articles that met eligibility criteria were selected. The most frequently neurological disorders detected with a screening tool were epilepsy, stroke, and neuropathies (77, 53, and 40%, respectively). Ten screeningquestionnaires were accessible. Two questionnaires were mainly used to detect neurological disorders: the World Health Organization Protocol for Epidemiologic Studies of Neurologic Disorders and the Ten Questions Questionnaire. The sensitivity of the questionnaires was ranged from 84 to100% and 56 to 100%, respectively.Conclusion: This systematic review presents evidence that screening questionnaires are valid tools to detect neurological disorders in developing countries. Disease detection provides epidemiological data and the opportunity to implement secondaryand tertiary prevention strategies that will contribute to reduce the global burden of neurological disorders

Prevalence of chronic hepatitis B virus infection in Thailand : a systematic review and meta-analysis

Objective: To estimate the number of people living in Thailand with chronic hepatitis B (CHB), a major cause of liver cirrhosis and cancer, in view of the implementation of programs to prevent CHB complications. Methods: Using PubMed/Medline and ScienceDirect, all studies reporting hepatitis B surface antigen (HBsAg) seroprevalence estimates conducted in Thailand and published between 1975 and 2015 were reviewed systematically. Pooled prevalence estimates and their 95% confidence intervals (CIs) were calculated, and potential sources of heterogeneity investigated. Results: A high heterogeneity was observed between prevalence estimates. There was a significant decrease in the 150 estimates of HBsAg prevalence with more recent decades of birth (p < 0.001), even before the implementation of the national universal immunization program in 1992. When restricted to the general population, the pooled prevalence estimate was 5.1% (95% CI 4.3-6.0%), which would translate to an estimated number of individuals with CHB living in Thailand in 2015 as high as three million. Conclusions: The high burden of CHB in Asian countries is a major challenge for the incorporation of national programs to prevent CHB complications within health care systems

Incidence of Severe Neutropenia in HIV-Infected People Starting Antiretroviral Therapy in West Africa

<div><p>Background</p><p>In sub-Saharan Africa, antiretroviral therapy (ART) including drugs with potential toxicity such as Zidovudine (ZDV) are routinely prescribed. This study aimed at estimating the incidence of severe neutropenia and associated factors after ART initiation in five West African countries.</p><p>Methods</p><p>A retrospective cohort analysis was conducted within the international epidemiologic database to evaluate AIDS (IeDEA) collaboration in West Africa. All HIV-infected adults, initiating ART between 2002 and 2014, with a baseline and at least one follow-up absolute neutrophil count (ANC) measurement were eligible. Incidence of severe neutropenia (ANC <750 cells/mm³) was estimated with 95% confidence interval (CI) according to age, gender, HIV clinic, hemoglobin, CD4 count, clinical stage, and ART duration. A Cox proportional hazard model was used to identify factors associated with severe neutropenia, expressed with their adjusted hazard ratios (aHR).</p><p>Results</p><p>Between 2002 and 2014, 9,426 HIV-infected adults were enrolled. The crude incidence rate of a first severe neutropenia was 9.1 per 100 person-years (95% CI: 8.6–9.8). Factors associated with severe neutropenia were exposure to ZDV <6 months (aHR = 2.2; 95% CI: 1.8–2.6), ≥6–12 months (aHR = 2.1; 95% CI: 1.6–2.8) and ≥12 months (aHR = 1.6; 95% CI: 1.2–2.2) [Ref. no ZDV exposure], CD4 count <350 cells/mm³ (aHR = 1.3; 95% CI: 1.1–1.5) and advanced clinical stage at ART initiation (aHR = 1.2; 95% CI: 1.0–1.4).</p><p>Conclusion</p><p>The incidence of severe neutropenia after ART initiation in West Africa is high and associated with ZDV exposure and advanced HIV disease. In this context, efforts are needed to scale-up access to less toxic first-line ART drugs and to promote early ART initiation.</p></div

Incidence and risk factors of loss to follow-up among HIV-infected children in an antiretroviral treatment program

International audienceIntroductio: The success of antiretroviral treatment (ART) programs can be compromised by high rates of patient loss to follow-up (LTFU). We assessed the incidence and risk factors of LTFU in a large cohort of HIV-infected children receiving ART in Thailand.Methods: All children participating in a multicenter cohort (NCT00433030) between 1999 and 2014 were included. The date of LTFU was 9 months after the last contact date. ART interruption was defined as ART discontinuation for more than 7 days followed by resumption of treatment. Baseline and time-dependent risk factors associated with LTFU were identified using Fine and Gray competing risk regression models with death or referral to another hospital as competing events.Results: Of 873 children who were followed during a median of 8.6 years (interquartile range 4.5–10.6), 196 were LTFU, 73 died, and 195 referred. The cumulative incidence of LTFU was 2.9% at 1 year, 7.3% at 5 years and 22.2% at 10 years. Children aged 13 years and more had a 3-fold higher risk (95% confidence interval 2.06–4.78) of LTFU than those younger. Children who had interrupted ART within the previous year had a 2.5-fold higher risk (1.12–5.91) than those who had not. The risk of LTFU was lower in children stunted (height-for-age Z-scores <-2 SD) (0.42–0.96) or underweight (weight-for-age Z-scores <-2 SD) (0.24–0.97).Conclusion: Adolescence, ART interruption and absence of growth deficit were associated with LTFU. These may be warnings that should draw clinicians’ attention and possibly trigger specific interventions. Children with no significant growth retardation may also be at risk of LTFU

Cox regression univariate and multivariate models estimating risk of severe neutropenia within two years after ART initiation.

<p>IeDEA West Africa collaboration, 2002–2014 (N = 9,426).</p

Study population flow chart.

<p>ANC, absolute neutrophil count; ART, antiretroviral therapy.</p

Patient’s characteristics at ART initiation.

<p>IeDEA West Africa collaboration, 2002–2015 (N = 9,426).</p

Incidence of severe neutropenia among 9,426 HIV-infected patients over a two-year period after ART initiation.

<p>IeDEA West Africa collaboration, 2002–2015.</p

Distribution of antiretroviral modifications in HIV-infected patients with a first severe episode of neutropenia (n = 134).

<p>Distribution of antiretroviral modifications in HIV-infected patients with a first severe episode of neutropenia (n = 134).</p