Safety of Single-Dose Primaquine in G6PD-Deficient and G6PD-Normal Males in Mali Without Malaria : An Open-Label, Phase 1, Dose-Adjustment Trial

Erratum: The Journal of Infectious Diseases, Volume 217, Issue 7, 1 April 2018, Page 1171, https://doi.org/10.1093/infdis/jiy074Methods: We conducted an open-label, nonrandomized, dose-adjustment trial of the safety of 3 single doses of primaquine in glucose-6-phosphate dehydrogenase (G6PD)-deficient adult males in Mali, followed by an assessment of safety in G6PD-deficient boys aged 11–17 years and those aged 5–10 years, including G6PD-normal control groups. The primary outcome was the greatest within-person percentage drop in hemoglobin concentration within 10 days after treatment. Results: Fifty-one participants were included in analysis. G6PD-deficient adult males received 0.40, 0.45, or 0.50 mg/kg of SLD-PQ. G6PD-deficient boys received 0.40 mg/kg of SLD-PQ. There was no evidence of symptomatic hemolysis, and adverse events considered related to study drug (n = 4) were mild. The mean largest within-person percentage change in hemoglobin level between days 0 and 10 was −9.7% (95% confidence interval [CI], −13.5% to −5.90%) in G6PD-deficient adults receiving 0.50 mg/kg of SLD-PQ, −11.5% (95% CI, −16.1% to −6.96%) in G6PD-deficient boys aged 11–17 years, and −9.61% (95% CI, −7.59% to −13.9%) in G6PD-deficient boys aged 5–10 years. The lowest hemoglobin concentration at any point during the study was 92 g/L. Conclusion: SLD-PQ doses between 0.40 and 0.50 mg/kg were well tolerated in G6PD-deficient males in Mali.Methods: We conducted an open-label, nonrandomized, dose-adjustment trial of the safety of 3 single doses of primaquine in glucose-6-phosphate dehydrogenase (G6PD)-deficient adult males in Mali, followed by an assessment of safety in G6PD-deficient boys aged 11–17 years and those aged 5–10 years, including G6PD-normal control groups. The primary outcome was the greatest within-person percentage drop in hemoglobin concentration within 10 days after treatment. Results: Fifty-one participants were included in analysis. G6PD-deficient adult males received 0.40, 0.45, or 0.50 mg/kg of SLD-PQ. G6PD-deficient boys received 0.40 mg/kg of SLD-PQ. There was no evidence of symptomatic hemolysis, and adverse events considered related to study drug (n = 4) were mild. The mean largest within-person percentage change in hemoglobin level between days 0 and 10 was −9.7% (95% confidence interval [CI], −13.5% to −5.90%) in G6PD-deficient adults receiving 0.50 mg/kg of SLD-PQ, −11.5% (95% CI, −16.1% to −6.96%) in G6PD-deficient boys aged 11–17 years, and −9.61% (95% CI, −7.59% to −13.9%) in G6PD-deficient boys aged 5–10 years. The lowest hemoglobin concentration at any point during the study was 92 g/L. Conclusion: SLD-PQ doses between 0.40 and 0.50 mg/kg were well tolerated in G6PD-deficient males in Mali.Peer reviewe

High doses of favipiravir in two men survivors of Ebola virus disease carrying Ebola virus in semen in Guinea

BACKGROUND: Persistence of Ebola virus (EBOV) in semen remains of deep concern, as sexual transmission of EBOV seems plausible up to 6 months after acute phase of Ebola virus disease (EVD). Favipiravir, a broad spectrum antiviral product, has been evaluated in reducing EVD mortality in Guinea in 2014-2015 in the JIKI trial, the pharmacokinetic results of which suggest that an increase of dose might be necessary to achieve a therapeutically relevant exposure. In FORCE trial, we aimed at evaluating the tolerance and activity of high doses of favipiravir in male EVD survivors with EBOV RNA detection in semen in Guinea. CASE: In 2016, we launched a phase IIa open-labeled multicenter dose escalation study. Male survivors of EVD with EBOV RT-PCR positive on semen received a loading dose of 2400 mg BID of favipiravir on day 1 then a maintenance dose of 1800 mg BID from day 2-14. The primary outcome was the tolerance, assessed daily during period treatment and up to day 90. Unfortunately only two participants were included and the trial was stopped for lack of recruitment. No clinical adverse event of grade 3/4 was reported for both patients. One patient experienced a grade 3 hypocalcemia at day 10 and 14. CONCLUSIONS: High doses of favipiravir were well tolerated in these two participants. Better characterized tolerance and pharmacokinetics of high doses of favipiravir are of utmost importance considering that favipiravir is a candidate treatment for a variety of emerging severe viral diseases with poor prognosis

Efficacy and safety of primaquine and methylene blue for prevention of Plasmodium falciparum transmission in Mali: a phase 2, single-blind, randomised controlled trial.

BACKGROUND: Primaquine and methylene blue are gametocytocidal compounds that could prevent Plasmodium falciparum transmission to mosquitoes. We aimed to assess the efficacy and safety of primaquine and methylene blue in preventing human to mosquito transmission of P falciparum among glucose-6-phosphate dehydrogenase (G6PD)-normal, gametocytaemic male participants. METHODS: This was a phase 2, single-blind, randomised controlled trial done at the Clinical Research Centre of the Malaria Research and Training Centre (MRTC) of the University of Bamako (Bamako, Mali). We enrolled male participants aged 5-50 years with asymptomatic P falciparum malaria. G6PD-normal participants with gametocytes detected by blood smear were randomised 1:1:1:1 in block sizes of eight, using a sealed-envelope design, to receive either sulfadoxine-pyrimethamine and amodiaquine, sulfadoxine-pyrimethamine and amodiaquine plus a single dose of 0·25 mg/kg primaquine, dihydroartemisinin-piperaquine, or dihydroartemisinin-piperaquine plus 15 mg/kg per day methylene blue for 3 days. Laboratory staff, investigators, and insectary technicians were masked to the treatment group and gametocyte density of study participants. The study pharmacist and treating physician were not masked. Participants could request unmasking. The primary efficacy endpoint, analysed in all infected patients with at least one infectivity measure before and after treatment, was median within-person percentage change in mosquito infectivity 2 and 7 days after treatment, assessed by membrane feeding. This study is registered with ClinicalTrials.gov, number NCT02831023. FINDINGS: Between June 27, 2016, and Nov 1, 2016, 80 participants were enrolled and assigned to the sulfadoxine-pyrimethamine and amodiaquine (n=20), sulfadoxine-pyrimethamine and amodiaquine plus primaquine (n=20), dihydroartemisinin-piperaquine (n=20), or dihydroartemisinin-piperaquine plus methylene blue (n=20) groups. Among participants infectious at baseline (54 [68%] of 80), those in the sulfadoxine-pyrimethamine and amodiaquine plus primaquine group (n=19) had a median 100% (IQR 100 to 100) within-person reduction in mosquito infectivity on day 2, a larger reduction than was noted with sulfadoxine-pyrimethamine and amodiaquine alone (n=12; -10·2%, IQR -143·9 to 56·6; p<0·0001). The dihydroartemisinin-piperaquine plus methylene blue (n=11) group had a median 100% (IQR 100 to 100) within-person reduction in mosquito infectivity on day 2, a larger reduction than was noted with dihydroartemisinin-piperaquine alone (n=12; -6·0%, IQR -126·1 to 86·9; p<0·0001). Haemoglobin changes were similar between gametocytocidal arms and their respective controls. After exclusion of blue urine, adverse events were similar across all groups (59 [74%] of 80 participants had 162 adverse events overall, 145 [90%] of which were mild). INTERPRETATION: Adding a single dose of 0·25 mg/kg primaquine to sulfadoxine-pyrimethamine and amodiaquine or 3 days of 15 mg/kg per day methylene blue to dihydroartemisinin-piperaquine was highly efficacious for preventing P falciparum transmission. Both primaquine and methylene blue were well tolerated. FUNDING: Bill & Melinda Gates Foundation, European Research Council

Discrepant Prevalence and Incidence of Leishmania Infection between Two Neighboring Villages in Central Mali Based on Leishmanin Skin Test Surveys

Leishmaniasis is a vector-borne disease transmitted to humans by the bite of an infected sand fly. Leishmaniasis is present in more than 88 countries and affects more than 12 million people. Depending on the species of Leishmania, the host can develop cutaneous leishmaniasis (CL), which is characterized by skin ulcers in uncovered parts of the body or a more severe form, visceral leishmaniasis, which affects the liver and spleen and is fatal if not treated. This study aims to establish the past and present infection with Leishmania parasites in two villages where recent cases have been diagnosed by the dermatology center (CNAM) in Bamako. This was achieved using a Leishmania-specific skin test that was administered annually to permanent residents of Kemena and Sougoula villages from 2006 to 2008. The results show that transmission of Leishmania is active and stable in these two villages. Moreover, despite sharing similar cultural and environmental features, the individuals from Kemena presented three times the risk of Leishmania infection compared with those from Sougoula. Our findings raise awareness of the continued presence of CL in Mali

The population of the eastern margin of the Inland Niger Delta in the first millenium AD

L’histoire du peuplement demeure une question fondamentale en archéologie. Dans cette étude, nous nous sommes proposé de retracer l’histoire du peuplement de la marge orientale du delta intérieur du Niger en examinant des macro-traces de montage identifiées sur la céramique des sites archéologiques de l’Âge du Fer et localisés dans les trois sous-régions (le delta intérieur du Niger, le Gourma-des-Mont et le Pays dogon), qui composent la zone. Il vise à comprendre les mécanismes de peuplement de chaque sous-région, appréhender les relations entre les sous-régions et établir une dynamique relationnelle entre les traditions céramiques et les communautés de la région. Grâce à une approche pluridisciplinaire associant à la fois les informations historiques, ethnoarchéologiques et archéologiques, nous avons pu établir que le peuplement et les traditions céramiques observées s’intègrent dans une dynamique historique et sociale commune à la marge orientale du delta intérieur du Niger.The history of the population remains a key issue in archaeology. In this study, we proposed to trace the migratory history of the eastern margin of the Inner Niger Delta by examining macro-traces of assemblage identified on the ceramic from the Iron Age archaeological sites and located within three sub-regions (the Inner Niger Delta, the Gourma and the Dogon Country), which are part of the study area. It aims to understand the mechanisms of population of each sub-region, comprehend the relationship between the sub-regions and establish a dynamic relationship between ceramic traditions and communities in the region. Through a multidisciplinary approach involving both historical, ethno- archaeological and archaeological information, we have shown that settlement and ceramic traditions found in each sub-region and traditions are part of a historical and social dynamics common to the eastern margin of the inner Niger Delta

Synthèse par pulvérisation magnétron et caractérisation de couches minces photochromes

These thesis works are within the framework of the ANR Photoflex (2013-2016), which aims to develop a contactless laser printing technology, in order to create updatable or permanent patterns of unique character on any types of supports, especially flexible supports. We report on a reactive magnetron sputtering-based deposition method to synthesize, at room temperature, photochromic nanocomposite thin films consisting of Ag nanoparticles sandwiched between nanoporous TiO2 layers. These films are deposited on flexible substrates such as a transparent plastic (PET) and a diffusing paper. We show that when the TiO2 is elaborated in the metallic sputtering mode, the nanocomposite film is colored due to the formation of metal Ag nanoparticles inducing a localized surface plasmon resonance in the visible range. In contrast, in the compound sputtering mode, the nanocomposite film is colorless because the Ag nanoparticles are oxidized during their capping by the TiO2. We have demonstrated that the colorless samples can be colored under UV laser irradiation (244 nm) due to the reduction of oxidized silver, followed by the growth of metallic Ag nanoparticles by coalescence or Ostwald ripening. Moreover, visible laser irradiation at low irradiances (few W.cm-2) of the colored films gives rise to changes in the particle morphology that modifies the absorbance of the films and results in sample color changes. We have investigated the influence of the deposition conditions (capping layer thickness of nanoparticles, TiO2 buffer layer thickness, Ag amount, holding time after Ag deposition, plasma annealing of Ag nanoparticles, multilayer) in order to optimize the photochromic effects in amplitude and in speed. All the mechanisms are repeatable during UV/Visible irradiation cyclic processes. For strong visible laser irradiances (several tens of kW.cm-2), we observed on nanocomposite films deposited on glass, color changes dependent on the polarization direction of the probe beam, related to the thermal growth and to the self-organization of Ag according to a periodic grating of nanoparticle chains. Contrary to low irradiances, the photo-induced colors are permanent and have a dichroic character. This study opens up interesting possibilities in terms of applications, including authentication and traceability of manufactured products, data storage, the new generation of datamatrix, etc.Ces travaux de thèse rentrent dans le cadre de l’ANR Photoflex (2013-2016) qui vise à mettre au point une technologie d’impression laser sans contact, pour créer des motifs actualisables ou permanents à caractère unique sur tout type de support, en particuliers des supports souples. Nous rapportons la synthèse par technique de pulvérisation magnétron en mode réactif et à température ambiante de films minces nanocomposites photochromes constitués de nanoparticules d’Ag entre deux couches nanoporeuses de TiO2. Ces films sont déposés sur des substrats souples tels qu’un plastique transparent (PET) et un papier diffusant. Nous montrons que lorsque le TiO2 est élaboré en régime de pulvérisation élémentaire, le film nanocomposite est coloré en raison de la présence de nanoparticules d’Ag métalliques induisant une résonance de plasmons de surface localisés dans le visible. En revanche, en régime de pulvérisation composite, le film nanocomposite est incolore car l’Ag s’oxyde lors de son recouvrement par le TiO2. Nous avons démontré que les échantillons incolores peuvent se colorer sous insolation laser UV (244 nm) dû à la réduction de l’Ag oxydé puis à la croissance de nanoparticules d’Ag métalliques par coalescence ou par mûrissement d’Ostwald. De plus, l’insolationlaser visible (647 nm) à de faibles éclairements (quelques W.cm-2) de ce type de film ou des films initialement colorés donne lieu à des changements morphologiques des nanoparticules d’Ag qui modifient l’absorbance du film et entraînent une modification de la coloration de l’échantillon. Nous avons étudié l’influence des conditions de dépôt (épaisseur de la couche de recouvrement des nanoparticules, épaisseur de la sous-couche de TiO2, quantité d’Ag, temporisation après dépôt d’Ag, traitement plasma des nanoparticules d’Ag, multicouches) afin d’optimiser les effets de photochromisme en amplitude et en vitesse. Tous les mécanismes de photochromisme sont répétables durant des processus cycliques d’insolation UV/Visible. Pour de forts éclairements en laser visible (plusieurs dizaines de kW.cm-2), nous avons observé sur des films nanocomposites déposés sur verre, des changements de couleurs dépendants de la direction de polarisation du faisceau sonde, liés à la croissance thermique et à l’auto-organisation de l’Ag selon un réseau périodique de chaînes de nanoparticules. Contrairement aux faibles éclairements, les couleurs photo-induites sont permanentes et présentent un caractère dichroïque. Cette étude ouvre des perspectives intéressantes en termes d’applications, notamment pour l’authentification et la traçabilité de produits manufacturés, le stockage de données, les nouvelles générations de datamatrix, etc

Le peuplement de la marge orientale du delta intérieur du Niger au premier millénaire après Jésus Christ

L histoire du peuplement demeure une question fondamentale en archéologie. Dans cette étude, nous nous sommes proposé de retracer l histoire du peuplement de la marge orientale du delta intérieur du Niger en examinant des macro-traces de montage identifiées sur la céramique des sites archéologiques de l Âge du Fer et localisés dans les trois sous-régions (le delta intérieur du Niger, le Gourma-des-Mont et le Pays dogon), qui composent la zone. Il vise à comprendre les mécanismes de peuplement de chaque sous-région, appréhender les relations entre les sous-régions et établir une dynamique relationnelle entre les traditions céramiques et les communautés de la région. Grâce à une approche pluridisciplinaire associant à la fois les informations historiques, ethnoarchéologiques et archéologiques, nous avons pu établir que le peuplement et les traditions céramiques observées s intègrent dans une dynamique historique et sociale commune à la marge orientale du delta intérieur du Niger.The history of the population remains a key issue in archaeology. In this study, we proposed to trace the migratory history of the eastern margin of the Inner Niger Delta by examining macro-traces of assemblage identified on the ceramic from the Iron Age archaeological sites and located within three sub-regions (the Inner Niger Delta, the Gourma and the Dogon Country), which are part of the study area. It aims to understand the mechanisms of population of each sub-region, comprehend the relationship between the sub-regions and establish a dynamic relationship between ceramic traditions and communities in the region. Through a multidisciplinary approach involving both historical, ethno- archaeological and archaeological information, we have shown that settlement and ceramic traditions found in each sub-region and traditions are part of a historical and social dynamics common to the eastern margin of the inner Niger Delta.NANTERRE-PARIS10-Bib. élec. (920509901) / SudocSudocFranceF