From current vaccine recommendations to everyday practices: An analysis in five sub-Saharan African countries

AbstractBackgroundEstimates of WHO and UNICEF vaccination coverage may provide little insight into the extent to which vaccinations are administered on time. Yet, lack of adherence to the recommended age to receive a specific vaccination may have detrimental health consequences. For example, delays in receiving vaccination will prolong the risk of lack of protection, often when disease risk is highest, such as during early infancy. We estimated the reported age at vaccination, and vaccine coverage at different ages in children from five sub-Saharan African countries.MethodsWe analyzed data from the latest Demographic and Health Programme databases available for Burkina Faso 2010 (n=15,044 observations), Ghana 2008 (n=2992), Kenya 2008–9 (n=6079), Senegal 2010–11 (n=12,326), and Tanzania 2010 (n=8023). We assessed, amongst vaccinees, the exact age when vaccine was administered for the three infant doses of pentavalent vaccine (DTP) and the first dose of measles-containing-vaccine (MCV), as well as the proportion of children immunized with these antigens by a certain age. Vitamin A supplementation (VAS) coverage was evaluated as a potential contact visit for vaccine introduction.ResultsFor all DTP doses, the median intervals between recommended and actual ages of receiving vaccination ranged from 12, 17 and 23 days in Kenya, to 22, 33 and 45 days in Senegal. MCV was mostly given during the recommended age of 9 months. In each country, there was a large discrepancy in the median age at DTP vaccination between regions. VAS coverage in young children ranged from 30.3% in Kenya to 78.4% in Senegal, with large variations observed between areas within each study country.ConclusionIn the context of new vaccine introduction, age of children at vaccination should be monitored to interpret data on vaccine-preventable disease burden, vaccine effectiveness, and vaccine safety, and to adapt targeted interventions and messages

Social and Hydrological Responses to Extreme Precipitations: An Interdisciplinary Strategy for Postflood Investigation

International audienceThis paper describes and illustrates a methodology to conduct postflood investigations based on interdisciplinary collaboration between social and physical scientists. The method, designed to explore the link between crisis behavioral response and hydrometeorological dynamics, aims at understanding the spatial and temporal capacities and constraints on human behaviors in fast-evolving hydrometeorological conditions. It builds on methods coming from both geosciences and transportations studies to complement existing post-flood field investigation methodology used by hydrometeorologists. The authors propose an interview framework, structured around a chronological guideline to allow people who experienced the flood firsthand to tell the stories of the circumstances in which their activities were affected during the flash flood. This paper applies the data collection method to the case of the 15 June 2010 flash flood event that killed 26 people in the Draguignan area (Var, France). As a first step, based on the collected narratives, an abductive approach allowed the identification of the possible factors influencing individual responses to flash floods. As a second step, behavioral responses were classified into categories of activities based on the respondents' narratives. Then, aspatial and temporal analysis of the sequences made of the categories of action to contextualize the set of coping responses with respect to local hydrometeorological conditions is proposed. During this event, the respondents mostly follow the pace of change in their local environmental conditions as the flash flood occurs, official flood anticipation being rather limited and based on a large-scale weather watch. Therefore, contextual factors appear as strongly influencing the individual's ability to cope with the event in such a situation

A bloodâ based nutritional risk index explains cognitive enhancement and decline in the multidomain Alzheimer prevention trial

IntroductionMultinutrient approaches may produce more robust effects on brain health through interactive qualities. We hypothesized that a bloodâ based nutritional risk index (NRI) including three biomarkers of diet quality can explain cognitive trajectories in the multidomain Alzheimer prevention trial (MAPT) over 3â years.MethodsThe NRI included erythrocyte nâ 3 polyunsaturated fatty acids (nâ 3 PUFA 22:6nâ 3 and 20:5nâ 3), serum 25â hydroxyvitamin D, and plasma homocysteine. The NRI scores reflect the number of nutritional risk factors (0â 3). The primary outcome in MAPT was a cognitive composite Z score within each participant that was fit with linear mixedâ effects models.ResultsEighty percent had at lease one nutritional risk factor for cognitive decline (NRI â ¥1: 573 of 712). Participants presenting without nutritional risk factors (NRI=0) exhibited cognitive enhancement (β = 0.03 standard units [SU]/y), whereas each NRI point increase corresponded to an incremental acceleration in rates of cognitive decline (NRIâ 1: β = â 0.04 SU/y, P = .03; NRIâ 2: β = â 0.08 SU/y, P < .0001; and NRIâ 3: β = â 0.11 SU/y, P = .0008).DiscussionIdentifying and addressing these wellâ established nutritional risk factors may reduce ageâ related cognitive decline in older adults; an observation that warrants further study.Highlightsâ ¢Multiâ nutrient approaches may produce more robust effects through interactive propertiesâ ¢Nutritional risk index can objectively quantify nutritionâ related cognitive changesâ ¢Optimum nutritional status associated with cognitive enhancement over 3â yearsâ ¢Suboptimum nutritional status associated with cognitive decline over 3â yearsâ ¢Optimizing this nutritional risk index may promote cognitive health in older adultsPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152935/1/trc2jtrci201911004.pd

Emergence of Epidemic Neisseria meningitidis Serogroup X Meningitis in Togo and Burkina Faso

Serogroup X meningococci (NmX) historically have caused sporadic and clustered meningitis cases in sub-Saharan Africa. To study recent NmX epidemiology, we analyzed data from population-based, sentinel and passive surveillance, and outbreak investigations of bacterial meningitis in Togo and Burkina Faso during 2006–2010. Cerebrospinal fluid specimens were analyzed by PCR. In Togo during 2006–2009, NmX accounted for 16% of the 702 confirmed bacterial meningitis cases. Kozah district experienced an NmX outbreak in March 2007 with an NmX seasonal cumulative incidence of 33/100,000. In Burkina Faso during 2007–2010, NmX accounted for 7% of the 778 confirmed bacterial meningitis cases, with an increase from 2009 to 2010 (4% to 35% of all confirmed cases, respectively). In 2010, NmX epidemics occurred in northern and central regions of Burkina Faso; the highest district cumulative incidence of NmX was estimated as 130/100,000 during March–April. Although limited to a few districts, we have documented NmX meningitis epidemics occurring with a seasonal incidence previously only reported in the meningitis belt for NmW135 and NmA, which argues for development of an NmX vaccine

Prescreening for European Prevention of Alzheimer Dementia (EPAD) trial-ready cohort: impact of AD risk factors and recruitment settings

Abstract: Background: Recruitment is often a bottleneck in secondary prevention trials in Alzheimer disease (AD). Furthermore, screen-failure rates in these trials are typically high due to relatively low prevalence of AD pathology in individuals without dementia, especially among cognitively unimpaired. Prescreening on AD risk factors may facilitate recruitment, but the efficiency will depend on how these factors link to participation rates and AD pathology. We investigated whether common AD-related factors predict trial-ready cohort participation and amyloid status across different prescreen settings. Methods: We monitored the prescreening in four cohorts linked to the European Prevention of Alzheimer Dementia (EPAD) Registry (n = 16,877; mean ± SD age = 64 ± 8 years). These included a clinical cohort, a research in-person cohort, a research online cohort, and a population-based cohort. Individuals were asked to participate in the EPAD longitudinal cohort study (EPAD-LCS), which serves as a trial-ready cohort for secondary prevention trials. Amyloid positivity was measured in cerebrospinal fluid as part of the EPAD-LCS assessment. We calculated participation rates and numbers needed to prescreen (NNPS) per participant that was amyloid-positive. We tested if age, sex, education level, APOE status, family history for dementia, memory complaints or memory scores, previously collected in these cohorts, could predict participation and amyloid status. Results: A total of 2595 participants were contacted for participation in the EPAD-LCS. Participation rates varied by setting between 3 and 59%. The NNPS were 6.9 (clinical cohort), 7.5 (research in-person cohort), 8.4 (research online cohort), and 88.5 (population-based cohort). Participation in the EPAD-LCS (n = 413 (16%)) was associated with lower age (odds ratio (OR) age = 0.97 [0.95–0.99]), high education (OR = 1.64 [1.23–2.17]), male sex (OR = 1.56 [1.19–2.04]), and positive family history of dementia (OR = 1.66 [1.19–2.31]). Among participants in the EPAD-LCS, amyloid positivity (33%) was associated with higher age (OR = 1.06 [1.02–1.10]) and APOE ɛ4 allele carriership (OR = 2.99 [1.81–4.94]). These results were similar across prescreen settings. Conclusions: Numbers needed to prescreen varied greatly between settings. Understanding how common AD risk factors link to study participation and amyloid positivity is informative for recruitment strategy of studies on secondary prevention of AD

La classification : entre savoir de référence et objet documentaire. : Contextes, langues et cultures dans l’organisation des connaissances. IXe Colloque ISKO – France 2013

Fonds audiovisuel issu d'une collaboration entre ISKO (France) et le programme ESCoM-AAR (Equipe Sémiotique Cognitive et nouveaux Médias - Archives Audiovisuelles de la Recherche. Paris, France, 2014).Le chapitre français de l'ISKO a comme préoccupation majeure, depuis sa création en 1996, la question de l'organisation des connaissances. Cette thématique a été traitée sous l’angle des structures d’organisation, des outils techniques de médiation mais aussi des formes et mécanismes de partage des connaissances. Ces questions sont au cœur des processus de production, de structuration et d’accès à l’information. Dans la continuité de ces réflexions, la 9ème édition du colloque ISKO-France vise à répondre aux problématiques liées à la pertinence de l’information par la contextualisation dans les différentes phases de ces processus. La démocratisation des technologies de l’information et de la communication, en particulier avec Internet, permet à un plus grand nombre de producteurs et diffuseurs de mettre à disposition des informations, comme elle offre à un plus grand nombre d’utilisateurs d’y avoir accès. Or, la production, la mise à disposition et l’accès à l’information sont liés à l’utilisation de ces informations, rendant les problématiques liées à la pertinence de l’information primordiales

Le projet FloodScale: Multi-scale hydrometeorological observation and modelling for flash floods understanding and simulation

[Departement_IRSTEA]Eaux [TR1_IRSTEA]ARCEAUInternational audienceThe FloodScale project is a contribution of the French hydrological community to the HyMeX program. Its general objective is to improve the understanding and simulation of the hydrological processes leading to flash floods. To reach these goals, a combined multi-scale observation and modelling effort is proposed, relying on nested-catchments instrumentation covering the following scales: (i) the hillslope scale, where process understanding on runoff generation and concentration can be tackled; (ii) the small to medium catchment scale (1-100 km2) where the impact of network structure, rainfall, landscape, initial soil moisture variability can be quantified; (iii) the larger scale (100-1000 km2) where transfer phenomena in rivers and flooding become important. The potential of innovative observations at various scales, complementing traditional measurements will also be assessed. FloodScale focuses on the Gard and Ardèche catchments of the Cévennes-Vivarais Hydrometeorological Observatory (OHM-CV). It builds on existing observation networks to propose (i) an harmonization of existing instrumentations; (ii) an enhancement of the measurements to better understand active hydrological processes during and between flash floods; (iii) innovative approaches for the documentation of ephemeral flash floods events; (iv) the evaluation of new data analysis and modelling approaches at various scales. The presentation will give an overview of the experimental set up and associated modelling approaches which will be deployed in FloodScale during the HyMeX EOP 2012-2015. http://www.mf-congress.com/hymex2012/abstracts/abstracts_print.ph

Le projet FloodScale: Multi-scale hydrometeorological observation and modelling for flash floods understanding and simulation

International audienceThe FloodScale project is a contribution of the French hydrological community to the HyMeX program. Its general objective is to improve the understanding and simulation of the hydrological processes leading to flash floods. To reach these goals, a combined multi-scale observation and modelling effort is proposed, relying on nested-catchments instrumentation covering the following scales: (i) the hillslope scale, where process understanding on runoff generation and concentration can be tackled; (ii) the small to medium catchment scale (1-100 km2) where the impact of network structure, rainfall, landscape, initial soil moisture variability can be quantified; (iii) the larger scale (100-1000 km2) where transfer phenomena in rivers and flooding become important. The potential of innovative observations at various scales, complementing traditional measurements will also be assessed. FloodScale focuses on the Gard and Ardèche catchments of the Cévennes-Vivarais Hydrometeorological Observatory (OHM-CV). It builds on existing observation networks to propose (i) an harmonization of existing instrumentations; (ii) an enhancement of the measurements to better understand active hydrological processes during and between flash floods; (iii) innovative approaches for the documentation of ephemeral flash floods events; (iv) the evaluation of new data analysis and modelling approaches at various scales. The presentation will give an overview of the experimental set up and associated modelling approaches which will be deployed in FloodScale during the HyMeX EOP 2012-2015. http://www.mf-congress.com/hymex2012/abstracts/abstracts_print.ph