Adoption d’une culture contraceptive et maîtrise du projet familial. La contraception constitue-t-elle une Capabilité?

Nous examinons les facteurs d’adoption d’une « culture contraceptive », décrite par la connaissance, la pratique et les intentions, et ses liens avec l’espacement des naissances. L’analyse des enquêtes EDS Mali (2006) et Ghana (2008) montre la persistance du fossé entre connaissance et pratique - la connaissance de la contraception ne gomme pas les inégalités de pratique - et le rôle des « facteurs de conversion ». Ainsi l’avantage des habitants des grandes villes disparaît lorsque l’on contrôle pour les caractéristiques personnelles. Les comportements des femmes apparaissent influencés par la réalité de leur situation familiale, alors que ceux des hommes reposeraient plus sur des valeurs. Finalement, ce n’est pas l’adoption de la contraception qui importe pour l’espacement des naissances, mais le profil des femmes qui l’adoptent : la contraception ne constitue pas une Capabilité - une dimension de la liberté de planifier sa famille - mais un moyen parmi d’autres pour espacer les naissances

Evaluation de l’utilisation du protocole national de prise en charge du paludisme simple des enfants à Matam, Guinée Conakry

L'objectif était d'évaluer l'usage du nouveau protocole national de prise en charge du paludisme simple. Il s'agit d'une étude transversale de type descriptif menée du 01 octobre au 31 Décembre 2013. L'enquête a été faite dans les six services de santé de la commune de Matam et a intéressé tous les patients de 0-15 ans venant en consultation dans ces centres de santé d'une part et les prestataires de soins de ces dits centres d'autre part. Nous avons enregistré 545 patients dont 52,1% de sexe féminin, l'âge moyen était de 5,62±5. Plus de la moitié (60,2%) des prescriptions étaient conformes au protocole mais aucun prestataire ne s'en servait parce qu'inaccessible. Seulement 72% savaient de l'existence de ce protocole. La disponibilité et l'utilisation du protocole national de prise en charge du paludisme simple restent faibles. La formation continue du personnel semble nécessaire.Pan African Medical Journal 2016; 2

Variabilité morphologique du baobab (Adansonia digitata L.) au Mali

Introduction Le baobab (Adansonia digitata L.) est un arbre caractéristique du paysage agricole dans les zones semi-arides d’Afrique. Il est utilisé quotidiennement par la population locale africaine. La diversité des services et des produits du baobab suggère d’effectuer une évaluation de sa variabilité morphologique afin d’avoir une meilleure connaissance de son potentiel. Notre article a cherché à identifier des descripteurs morphologiques discriminants chez le baobab en relation avec la diversité agro-écologique du Mali. Matériel et méthodes Notre évaluation a concerné huit provenances de baobab reparties sur l’ensemble de son aire de distribution géographique au Mali. Elle a porté sur les caractères foliaires, fruitiers et sur ceux liés aux graines. Le coefficient de variation a été utilisé pour évaluer la variabilité. Les données ont été analysées par analyse de variance et analyse multi-variée. Résultats Une importante variabilité a été observée selon les provenances et les descripteurs utilisés. Les descripteurs morphologiques discriminants pour les baobabs que nous avons échantillonnés ont été la longueur et la largeur des fruits, la longueur du pédoncule des fruits, la longueur, la largeur et le nombre de lobes des feuilles

Common occurrence of Cryptosporidium hominis in asymptomatic and symptomatic calves in France

International audienceSymptomatic infection by the Apicomplexan Cryptosporidium spp. is presently considered the most frequent parasitic cause of acute diarrhea in both humans (especially severe in immunocompromised individuals and infants in both developed and developing countries) and cattle (calves), while asymptomatic infections are less often documented. Cryptosporidium (C.) hominis once considered to be restricted to humans accounts for the majority of pediatric cases in several countries. C. parvum can also infect cattle as well as C. bovis, C. andersoni, and C. ryanae. Recently, cattle C. hominis cryptosporidiosis has been reported, suggesting that the presence of C. hominis in calves was previously underestimated. The aim of this work was to characterize Cryptosporidium spp. infection in both asymptomatic and symptomatic dairy and beef calves from Metropolitan France. From February to November 2015, C. parvum or C. hominis infected calves were detected in farms from 5 geographic regions of France. Surprisingly, C. hominis was present in about one fifth of Cryptosporidium spp. infected calves, and exhibited genotypes which were previously reported in human and nonhuman primate. Further investigations are aimed at documenting direct or indirect C. hominis transmissions between and among livestock and humans

Etude Comparative Des Produits Issus De La Transformation En Filature Des Fibres De Trois Nouvelles Variétés De Cotonnier

Résumé - Au Mali, comme ailleurs en Afrique, la sélection variétale est à la base du succès de la culture cotonnière. Le coton du Mali est presqu’entièrement exporté ; les fibres issues des variétés cultivées doivent répondre aux exigences du marché en termes de caractéristiques technologiques des fibres, facteurs clés du fonctionnement de la filature. Cette étude comparative a été réalisée sur trois nouvelles variétés de cotonniers A, B et C, issues d’un point d'expérimentation. L'objectif de l'étude est d’identifier les variétés ayant les meilleures performances variétales et industrielles pour la vulgarisation en production commerciale par les sociétés cotonnières. 1 échantillon représentatif de 100g de coton fibre, 20 échantillons de 5 m de rubans de carde, d’étirage et de 10 m de mèches, 30 échantillons de 100 m de fil et 40 échantillons de 500 mm de fil ont été respectivement prélevés par balle de chaque variété et à différentes étapes du processus de transformation par variété. Ces échantillons ont été testés sur des appareils de mesure dans les conditions requises au laboratoire de métrologie textile du CERFITEX, Ségou - Mali.L’analyse de variance (ANOVA) des données relatives aux fibres, rubans, mèches et fils et la comparaison de leurs principales caractéristiques de qualité à celle de la production mondiale avec l’application des USTER STATISTICS 2018 ont montré que les variétés de cotonnier A et B sont nettement meilleures que celle de C. Les performances variétales et industrielles de A et B, meilleures que celles de C sont recommandées à la vulgarisation Mots clés : Coton, caractéristiques technologiques, qualité, fibres, fils. [Comparative Study Of The Products Resulting From The Transformation Into Spinning Of The Fibers Of Three New Varieties Of Cotton]Abstract - In Mali, as elsewhere in Africa, varietal selection is the basis of the success of cotton growing. Cotton from Mali is almost entirely exported; fibers from cultivated varieties must meet market requirements in terms of the technological characteristics of fibers, key factors in the operation of the spinning mill. This comparative study was carried out on three new varieties of cotton A, B and C, from an experimental point. The objective of the study is to identify the varieties with the best varietal and industrial performance for popularization in commercial production by cotton companies. 1 representative sample of 100g of cotton fiber, 20 samples of 5m of carding and drawing slivers and 10m of rovings, 30 samples of 100m of yarn and 40 samples of 500mm of yarn were respectively taken per bale of each variety and at different stages of the transformation process by variety. These samples were tested on measuring devices under the required conditions at the CERFITEX textile metrology laboratory, Ségou - Mali.The analysis of variance (ANOVA) of fiber, sliver, roving and yarn data and the comparison of their main quality characteristics to that of world production with the application of USTER STATISTICS 2018 showed that cotton varieties A and B are clearly better than those of C. The varietal and industrial performances of A and B, better than that of C are recommended for popularisation Keywords : Cotton, technological characteristics, quality, fibres, yarns

Seasonality and shift in age-specific malaria prevalence and incidence in Binko and Carrière villages close to the lake in Selingué, Mali

BACKGROUND: Malaria transmission in Mali is seasonal and peaks at the end of the rainy season in October. This study assessed the seasonal variations in the epidemiology of malaria among children under 10 years of age living in two villages in Selingué: Carrière, located along the Sankarani River but distant from the hydroelectric dam, and Binko, near irrigated rice fields, close to the dam. The aim of this study was to provide baseline data, seasonal pattern and age distribution of malaria incidence in two sites situated close to a lake in Selingué. METHODS: Geographically, Selingué area is located in the basin of Sakanrani and belongs to the district of Yanfolila in the third administrative region of Mali, Sikasso. Two cross-sectional surveys were conducted in October 2010 (end of transmission season) and in July 2011 (beginning of transmission season) to determine the point prevalence of asymptomatic parasitaemia, and anaemia among the children. Cumulative incidence of malaria per month was determined in a cohort of 549 children through active and passive case detection from November 2010 through October 2011. The number of clinical episodes per year was determined among the children in the cohort. Logistic regression was used to determine risk factors for malaria. RESULTS: The prevalence of malaria parasitaemia varied significantly between villages with a strong seasonality in Carrière (52.0–18.9 % in October 2010 and July 2011, respectively) compared with Binko (29.8–23.8 % in October 2010 and July 2011, respectively). Children 6–9 years old were at least twice more likely to carry parasites than children up to 5 years old. For malaria incidence, 64.8–71.9 % of all children experienced at least one episode of clinical malaria in Binko and Carrière, respectively. The peak incidence was observed between August and October (end of the rainy season), but the incidence remained high until December. Surprisingly, the risk of clinical malaria was two- to nine-fold higher among children 5–9 years old compared to younger children. CONCLUSIONS: A shift in the peak of clinical episodes from children under 5–9 years of age calls for expanding control interventions, such as seasonal malaria chemoprophylaxis targeting the peak transmission months

Primaquine to reduce transmission of Plasmodium falciparum malaria in Mali : a single-blind, dose-ranging, adaptive randomised phase 2 trial

Background Single low doses of primaquine, when added to artemisinin-based combination therapy, might prevent transmission of Plasmodium falciparum malaria to mosquitoes. We aimed to establish the activity and safety of four low doses of primaquine combined with dihydroartemisinin-piperaquine in male patients in Mali. Methods In this phase 2, single-blind, dose-ranging, adaptive randomised trial, we enrolled boys and men with uncomplicated P falciparum malaria at the Malaria Research and Training Centre (MRTC) field site in Ouelessebougou, Mali. All participants were confirmed positive carriers of gametocytes through microscopy and had normal function of glucose-6-phosphate dehydrogenase (G6PD) on colorimetric quantification In the first phase, participants were randomly assigned (1:1:1) to one of three primaquine doses: 0 mg/kg (control), 0.125 mg/kg, and 0.5 mg/kg. Randomisation was done with a computer-generated randomisation list (in block sizes of six) and concealed with sealed, opaque envelopes. In the second phase, different participants were sequentially assigned (1:1) to 0.25 mg/kg primaquine or 0.0625 mg/kg primaquine. Primaquine tablets were dissolved into a solution and administered orally in a single dose. Participants were also given a 3 day course of dihydroartemisinin-piperaquine, administered by weight (320 mg dihydroartemisinin and 40 mg piperaquine per tablet). Outcome assessors were masked to treatment allocation, but participants were permitted to find out group assignment. Infectivity was assessed through membrane feeding assays, which were optimised through the beginning part of phase one. The primary efficacy endpoint was the mean within-person percentage change in mosquito infectivity 2 days after primaquine treatment in participants who completed the study after optimisation of the infectivity assay, had both a pre-treatment infectivity measurement and at least one follow-up infectivity measurement, and who were given the correct primaquine dose. The safety endpoint was the mean within-person change in haemoglobin concentration during 28 days of study follow-up in participants with at least one follow-up visit. This study is registered with ClinicalTrials.gov, number NCT01743820. Findings Between Jan 2,2013, and Nov 27,2014, we enrolled 81 participants. In the primary analysis sample (n=71), participants in the 0.25 mg/kg primaquine dose group (n=15) and 0.5 mg/kg primaquine dose group (n=14) had significantly lower mean within-person reductions in infectivity at day 2-92.6% (95% CI 78.3-100; p=0.0014) for the 0.25 mg/kg group; and 75.0% (45.7-100; p=0.014) for the 0.5 mg/kg primaquine group compared with those in the control group (n=14; 11.3% [-27.4 to 50.0]). Reductions were not significantly different from control for participants assigned to the 0.0625 mg/kg dose group (n=16; 41.9% [1.4-82.5]; p=0.16) and the 0.125 mg/kg dose group (n=12; 54.9% [13.4-96.3]; p=0.096). No clinically meaningful or statistically significant drops in haemoglobin were recorded in any individual in the haemoglobin analysis (n=70) during follow-up. No serious adverse events were reported and adverse events did not differ between treatment groups. Interpretation A single dose of 0.25 mg/kg primaquine, given alongside dihydroartemisinin-piperaquine, was safe and efficacious for the prevention of P falciparum malaria transmission in boys and men who are not deficient in G6PD. Future studies should assess the safety of single-dose primaquine in G6PD-deficient individuals to define the therapeutic range of primaquine to enable the safe roll-out of community interventions with primaquine.Peer reviewe

Comparison of molecular quantification of Plasmodium falciparum gametocytes by Pfs25 qRT-PCR and QT-NASBA in relation to mosquito infectivity.

BACKGROUND: Quantifying gametocyte densities in natural malaria infections is important to estimate malaria transmission potential. Two molecular methods (Pfs25 mRNA quantitative reverse transcriptase PCR (qRT-PCR) and Pfs25 mRNA quantitative nucleic acid sequence based amplification (QT-NASBA)) are commonly used to determine gametocyte densities in clinical and epidemiological studies and allow gametocyte detection at densities below the microscopic threshold for detection. Here, reproducibility of these measurements and the association between estimated gametocyte densities and mosquito infection rates were compared. METHODS: To quantify intra- and inter-assay variation of QT-NASBA and qRT-PCR, a series of experiments was performed using culture-derived mature Plasmodium falciparum gametocytes from three different parasite isolates (NF54, NF135, NF166). Pfs25 mRNA levels were also determined in samples from clinical trials in Mali and Burkina Faso using both methods. Agreement between the two methods and association with mosquito infection rates in membrane feeding assays were assessed. RESULTS: Intra- and inter-assay variability was larger in QT-NASBA compared to qRT-PCR, particularly at low gametocyte densities (100 gametocyte per ?L). Samples collected in one of the two transmission studies had extremely low gametocyte densities by both molecular methods, which is suggestive of RNA degradation due to an unknown number of freeze-thaw cycles and illustrates the reliance of molecular gametocyte diagnostics on a reliable cold-chain. CONCLUSIONS: The experiments indicate that both qRT-PCR and QT-NASBA are of value for quantifying mature gametocytes in samples collected in field studies. For both assays, estimated gametocyte densities correlated well with mosquito infection rates. QT-NASBA is less reproducible than qRT-PCR, particularly for low gametocyte densities