Field evaluation of the intermittent preventive treatment of malaria during pregnancy (IPTp) in Benin: evolution of the coverage rate since its implementation

Background: Malaria is an important public health problem in Africa. Pregnant women are a vulnerable population and this disease can underlie an increased risk of low-birth weight newborns (< 2500 g); these women therefore need management during pregnancy. This was previously provided by chloroquine treatment, which, because of compliance problems and drug resistance, was replaced by intermittent preventive treatment with sulfadoxine-pyrimethamine (ITPp-SP) with two single doses taken after 16 weeks of amenorrhea, at least 4 weeks apart. This protocol was recommended by the World Health Organization (WHO) in 1998 and was initiated in Benin in 2006 after its political adoption in 2004. A retrospective longitudinal study was conducted in eight maternity hospitals in two geographical areas in Benin (in the south and north). The study investigated 2420 women who gave birth from 2005 to 2009. The antenatal cards of those women were randomly selected over 5 years with the aim of analyzing the IPT coverage in the study's maternity hospitals. Results: The rate of IPT-SP coverage evolved from 3.7% in 2005 to 87.8% in 2009 for women who had received at least one dose and from 2.7% to 68.4% from 2005 to 2009 for those who had received complete ITP (two doses). Variability in the results was observed depending on the geographical area (north/south) and the type of area (rural/urban). Conclusions: In total, application of IPT-SP 2-doses has rapidly evolved since 2005, but the objective of 80% IPT coverage has not yet been achieved throughout the country. Moreover, problems of drug shortage recurring in the field (reported by health staff) remain to be resolved

Hydrolyzed collagen interferes with in vitro photoprotective effectiveness of sunscreens

The chronological skin aging is a progressive and natural process with genetic and physiological changes. However, ultraviolet (UV) radiation may accelerate the oxidative stress, generating carcinogenesis and photoaging. Natural compounds and their applications are considered a trend in the cosmetic market. The protein-based film-forming compounds play an important role, once it collaborates for the better distribution of sunscreens on the skin. Here we investigated the in vitro photoprotective effectiveness of sunscreens containing the hydrolyzed collagen associated with UVA, UVB and/or inorganic filters. Sunscreens were developed with octocrylene (7.5%), butyl methoxydibenzoylmethane (avobenzone) (3.0%) and/or titanium dioxide (5.0%), associated or not with the hydrolyzed collagen (3.0%). In vitro photoprotective effectiveness was determined in a Labsphere(r) UV2000S by the establishment of the sun protection factor (SPF) and critical wavelength (nm) values. Physicochemical and organoleptic characteristics were also assayed. The hydrolyzed collagen subjectively improved the formulation sensory characteristics. However, this bioactive compound led to a decrease of the SPF values of the photoprotective formulations containing octocrylene alone and octocrylene + butyl methoxydibenzoylmethane + TiO2. This inadequate interaction may be considered during the development of new sunscreens intended to contain protein-based components

Pratos e mais pratos: louças domésticas, divisões culturais e limites sociais no Rio de Janeiro, século XIX

Reply to ten comments on a paper published in the last issue of this journal. The discussion follows along six main lines: History museums, identity, ideology and the category of nation; the need of material collections and their modalities: patrimonial, operational, virtual; theater versus laboratory; visitors and their ambiguities; Public History: the museum and the academy.Resposta aos comentários de dez especialistas que contribuíram no debate de texto publicado no último número desta revista. A discussão orientou-se segundo seis tópicos principais: museus históricos, identidade, ideologia e a categoria de nação; a necessidade de acervos materiais e suas modalidades: acervo patrimonial, operacional, virtual; teatro versus laboratório; o público e suas ambigüidades; História Pública: o museu e a Academia

Exemple du registre général du CHU de Limoges

International audienc

Antigen of major histocompatibility complex HLA-G : role in immune tolerance during malaria infection

Les femmes enceintes et les enfants sont les populations à haut risque pour le paludisme. Chez les premières, l'infection peut entraîner une infection placentaire (IP). Les enfants nés d'une mère ayant une IP seraient plus à risque de développer une infection palustre rapidement après la naissance. Un phénomène de tolérance immunitaire est évoqué mais aucune explication n'est émise. Nous proposons une explication basée sur l'implication de HLA-G, protéine de la tolérance immunitaire. Nous avons pu montrer que les niveaux élevés de HLA-G chez les enfants étaient associés à un risque élevé de paludisme et au faible poids de naissance. Il existe une très forte ressemblance mère-enfant au cours de la grossesse et durant les 2 premières années de vie de l’enfant avec une probabilité très élevé chez les enfants d’avoir le même profil que leur mère. Les femmes ayant une IP présentent un risque plus élevé d’avoir des enfants ayant des niveaux de HLA-G soluble élevé, et le délai de 1ère infection palustre est plus court pour les enfants nés de mères ayant un niveau de HLA-G élevé en début de grossesse. Ces résultats confirment que HLA-G est associée à l’infection palustre. Ils montrent que le rôle de HLA-G dans l’IP est très complexe. Face à la ressemblance mère-enfant et le délai de 1ère infection, il serait intéressant d’envisager le dosage de HLA-G maternel en début de grossesse afin de confirmer son rôle prédictif. HLA-G pourrait alors être un outil de santé publique intéressant pour identifier de potentiels futurs enfants à risque.Pregnant women and children are populations at high risk for malaria. Malaria infection in pregnancy can lead to placental malaria (PM). Children born to a mother with PM have an increased risk of malaria infection during the first years of life. To explain this phenomenon related to an immune tolerance, we suggest an explanation based on the implication of HLA-G, an immune tolerance protein. We show that high levels of soluble HLA-G in children were associated with malaria risk and low birth weight. There is a very strong mother/child resemblance during pregnancy and the first 2 years of life of the child with a very high probability in children of having the same profile as their mother. Women with PM have a higher risk to give birth to a child with high levels of soluble HLA-G, and children born to mothers with high HLA-G levels have an increased risk of malaria in early pregnancy. These results confirm that HLA-G is associated with malaria infection. They show that the role of HLA-G in PM is very complex. According to the maternal-child resemblance and the delay onset the first infection, it would be interesting to consider the dosage of maternal HLA-G in early pregnancy in order to confirm its predictive role. HLA-G could then be an interesting public health tool to identify potential children at risk

Étude de l'antigène du complexe majeur d'histocompatibilité HLA-G : rôle dans le phénomène de tolérance immunitaire au cours de l'infection palustre

Pregnant women and children are populations at high risk for malaria. Malaria infection in pregnancy can lead to placental malaria (PM). Children born to a mother with PM have an increased risk of malaria infection during the first years of life. To explain this phenomenon related to an immune tolerance, we suggest an explanation based on the implication of HLA-G, an immune tolerance protein. We show that high levels of soluble HLA-G in children were associated with malaria risk and low birth weight. There is a very strong mother/child resemblance during pregnancy and the first 2 years of life of the child with a very high probability in children of having the same profile as their mother. Women with PM have a higher risk to give birth to a child with high levels of soluble HLA-G, and children born to mothers with high HLA-G levels have an increased risk of malaria in early pregnancy. These results confirm that HLA-G is associated with malaria infection. They show that the role of HLA-G in PM is very complex. According to the maternal-child resemblance and the delay onset the first infection, it would be interesting to consider the dosage of maternal HLA-G in early pregnancy in order to confirm its predictive role. HLA-G could then be an interesting public health tool to identify potential children at risk.Les femmes enceintes et les enfants sont les populations à haut risque pour le paludisme. Chez les premières, l'infection peut entraîner une infection placentaire (IP). Les enfants nés d'une mère ayant une IP seraient plus à risque de développer une infection palustre rapidement après la naissance. Un phénomène de tolérance immunitaire est évoqué mais aucune explication n'est émise. Nous proposons une explication basée sur l'implication de HLA-G, protéine de la tolérance immunitaire. Nous avons pu montrer que les niveaux élevés de HLA-G chez les enfants étaient associés à un risque élevé de paludisme et au faible poids de naissance. Il existe une très forte ressemblance mère-enfant au cours de la grossesse et durant les 2 premières années de vie de l’enfant avec une probabilité très élevé chez les enfants d’avoir le même profil que leur mère. Les femmes ayant une IP présentent un risque plus élevé d’avoir des enfants ayant des niveaux de HLA-G soluble élevé, et le délai de 1ère infection palustre est plus court pour les enfants nés de mères ayant un niveau de HLA-G élevé en début de grossesse. Ces résultats confirment que HLA-G est associée à l’infection palustre. Ils montrent que le rôle de HLA-G dans l’IP est très complexe. Face à la ressemblance mère-enfant et le délai de 1ère infection, il serait intéressant d’envisager le dosage de HLA-G maternel en début de grossesse afin de confirmer son rôle prédictif. HLA-G pourrait alors être un outil de santé publique intéressant pour identifier de potentiels futurs enfants à risque

Modelling the number of avoidable new cancer cases in France attributable to alcohol consumption by following official recommendations: a simulation study

International audienceAimsTo predict the effects of perfect adherence to the French alcohol consumption guidelines, a maximum of 10 standard alcoholic drinks per week with no more than two standard alcoholic drinks per day, during a 36-year period (2014–50).DesignThis simulation study is an adaption of the Sheffield Alcohol Policy Model. The dose–response relationship between alcohol consumption and alcohol-attributable cancer risks was defined by cancer site-specific risk functions, each modelled as a continuous risk. These estimates were used to compute the potential impact fraction (PIF) associated with alcohol consumption by cancer site.SettingThe French general adult population during a 36-year period (2014–50).ParticipantsFor the baseline scenario, the current distribution of consumption levels, the counterfactual scenario and perfect adherence to the French alcohol consumption guidelines, we generated for each gender and age group 1000 randomly distributed alcohol consumption values from calibrated group-specific gamma distribution.MeasurementsThe predicted number of new cancer cases among men and women in France between 2015 and 2050 that could have been prevented by following the French government's alcohol consumption guidelines.FindingsThe simulation predicted that perfect adherence to the French government's alcohol consumption guidelines would prevent, on average, an estimated 15 952 cancer cases per year after the PIF reached its full effect, which would have represented 4.5% of new cancer cases in 2015. The number of averted cancer cases over the study period were highest for oral cavity, oropharynx and hypopharynx cancer (respectively, 118 462, 95% CI = 113 803–123 022 and 11 167, 95% CI = 10 149–12 229] for men and women; liver and intrahepatic bile ducts cancer (123 447, 95% CI = 112 581–133 404 and 2825, 95% CI = 2208,4095); colorectal cancer (89 859, 95% CI = 84 651–95 355 and 12 847, 95% CI = 11 545–14 245); and female breast cancer (61 649, 95% CI = 56 330–67 452).ConclusionThis simulation study of the French general population predicted that perfect adherence to the French government's alcohol consumption guidelines (no more than 10 standard alcoholic drinks per week and two per day) would prevent almost 16 000 cancer cases per year

High plasma levels of HLA-G are associated with low birth weight and with an increased risk of malaria in infancy

Background: The immunosuppressive properties of HLA-G protein can create a tolerogenic environment that may allow Plasmodium falciparum to avoid host immune responses. There are known associations between high levels of circulating soluble HLA-G (sHLA-G) and either parasite or viral infections and it has been suggested that the induction of sHLA-G expression could be a mechanism via which infectious agents subvert host immune defence. The study presented here is the first to investigate the possible association between sHLA-G and malaria or malaria related risk factors in Benin. Methods: A parasitological and clinical follow-up of 165 mothers and their newborns from delivery through to one year of age was conducted in the Tori Bossito area of southern Benin. Plasma levels of sHLA-G were determined by ELISA in maternal peripheral and cord blood and again in infants' peripheral blood at 3, 6, 9 and 12 months of age. The associations between the levels of sHLA-G and malaria risk factors were investigated through multivariate mixed models. Results: Strong correlations were observed between the maternal and cord plasma concentrations of sHLA-G. In multivariate analyses, high cord plasma levels of sHLA-G were independently associated with (i) low birth weight and (ii) an increased risk of P. falciparum infection in infancy. Conclusion: These results show for the first time the possible involvement of sHLA-G in generating immune tolerance during pregnancy-associated malaria. Soluble HLA-G may represent a useful marker of susceptibility to malaria in infants and be associated with the higher susceptibility to infection observed for LBW children

Incidence des principaux cancers en France métropolitaine en 2023 et tendances depuis 1990

International audienceLes cancers constituent un ensemble de pathologies dont la fréquence, le pronostic et l’évolution sont trèsvariables. Dans le cadre d’une collaboration partenariale pour la surveillance des cancers, des indicateursd’incidence et de mortalité sont produits régulièrement. La dernière étude publiée portait sur la période 1990-2018.L’objectif de celle-ci est d’estimer l’incidence des 19 cancers les plus fréquents, celle de l’ensemble descancers en France métropolitaine pour l’année 2023 et d’actualiser l’analyse des évolutions depuis 1990,en particulier pour les années récentes. Des projections ont été réalisées à partir des données des registresde cancers observées de 1985 jusqu’en 2018.En 2023, le nombre de nouveaux cancers, toutes localisations confondues, est estimé à 433 136 cas. Les tauxd’incidence standardisés monde sont de 355 et 274 cas pour 100 000 personnes-années chez l’homme et lafemme respectivement. Depuis 1990, chez la femme, le taux d’incidence « tous cancers » augmente de façoncontinue de +0,9% par an. Chez l’homme, ce taux a augmenté en moyenne de +0,3% par an de 1990 à 2023 :après une augmentation jusqu’en 2005, le taux d’incidence a diminué et semble se stabiliser depuis 2012.Deux cancers ont vu leurs tendances récentes modifiées : le cancer de la prostate, avec depuis 2015 une nouvelleaugmentation de l’incidence, et le cancer de la thyroïde, avec depuis 2014 une diminution de l’incidence. Pources deux cancers, les projections de l’incidence de 2019 à 2023 étaient incertaines et n’ont pas été réalisées.Tous cancers confondus, ces évolutions du taux d’incidence combinées aux évolutions démographiques ontconduit à un doublement du nombre de nouveaux cas de cancers depuis 1990 chez l’homme et la femme