Amputations de la verge : circonstances de survenues et prise en charge en milieu hospitalier Sénégalais: Penis amputations: occurrence circumstances and management in Senegalese hospitals

Context and objectives. Penis amputations are rare emergencies which require microsurgical replantation. The objectives of this study were to analyze the occurrence circumstances, the anatomo-clinical and therapeutic characteristics of these traumas. Methods. This was a descriptive retrospective study involving patients admitted for total or partial penile amputations managed at the Louga Regional Hospital Center, Senegal, from January 2008 to December 2015. Results. Eight cases of penis amputations were recorded. They represented 0.6% of urological emergencies and 20.5% of external male genitalia traumas. Children were more affected (n = 5). There were more partial amputations (n = 7) than total one. The occurrence circumstances were: circumcision (n=3), assault (n=2), horse bite (n=2), and self-amputation (n=1). Three patients were admitted without the amputated stump, one patient was admitted in hemorrhagic shock. Surgical treatments encompass regularization of the remaining stump (n=6) and successful replantation (n=2). The replantations post-operative complications were skin necrosis. Conclusion. Penis amputations are mostly partial in our department and occur in children during circumcision. The poor preservation of the amputated stump and the lack of operating microscope lead rather to the regulation of the remaining stump or replantation without vasculo-nervous anastomosis. Contexte et objectifs. Les amputations traumatiques de verge sont des urgences rares dont la prise en charge exige une réimplantation microchirurgicale. La présente étude a pour objectif de décrire les circonstances de survenue et le profil anatomo-clinique et thérapeutique des amputations traumatiques de la verge. Méthodes. Etude documentaire descriptive portant sur les amputations totales ou partielles de verge prises en charge au Centre hospitalier de Louga, au Sénégal, entre janvier 2008 et décembre 2015. Résultats. Huit amputations de verge ont été enregistrées soit 0,6% des urgences urologiques et 20,5% des traumatismes des organes génitaux externes masculins. Les enfants étaient plus nombreux (n=5). Les amputations partielles majoritaires (n=7). Les circonstances de survenue étaient : circoncisions (n=3), agressions (n=2), morsures de cheval (n=2), et auto-amputation (n=1). Trois patients ont été admis sans le moignon amputé, un patient a été admis en état de choc hémorragique. Le traitement chirurgical sans recours à la microscopie a consisté en : régularisation du moignon (n=6), deux réimplantations réussies du moignon amputé (n=2) au prix de nécrose cutanée. Conclusion. Les amputations de la verge sont en majorité partielles dans notre service et surviennent particulièrement chez des enfants, pendant la circoncision. La mauvaise conservation du moignon amputé et le manque de microscope opératoire conduisent plutôt à la régulation du moignon ou à une réimplantation du moignon viable sans anastomose vasculo-nerveuse

Devenir des pathologies du canal péritonéo-vaginal et de la migration testiculaire chez l’enfant : prise en charge au centre hospitalier de Louga, Sénégal: Outcome of processus vaginalis and testicular migration related pathologies in children treated at Louga Hospital, Senegal

Contexte et objectifs. Le devenir des pathologies du canal péritonéo-vaginal (CPV) et de la migration testiculaire chez l’enfant est peu connu. L’objectif de ce travail était de décrire les aspects cliniques et le devenir de ces pathologies. Méthodes. Etude documentaire descriptive portant sur les hernies, hydrocèles, cryptorchidies et torsions du cordon spermatique opérées chez le garçon âgé de 0 à 16 ans, au Centre hospitalier de Louga, Sénégal, de janvier 2018 à décembre 2019. Résultats. 184 dossiers des patients ont été colligés, soit 32,5 % de patients opérés au cours de la période. Leur âge moyen était de 5,4 ± 4,3 ans. Ces pathologies englobaient : hernies inguinales (n=37 dont 3 étranglements), hydrocèles (n=113), cryptorchidies (n=27), testicules oscillants (n=2) et torsions du cordon spermatique (n=5). L’abord a été inguinal dans 96,1 %. Le traitement a consisté en : ligature du CPV, abaissement testiculaire, orchidopexie, orchidectomie. Aucune récidive, atrophie ou fonte testiculaire n’a été observée en trois mois de suivi. Conclusion. La prise en charge en urgence ou non des pathologies du CPV et de la migration testiculaire chez l’enfant est fréquente dans notre pratique, sans complication à courte terme. Le défi réside dans le suivi à long terme en raison des complications tardives. Context and objectives. Little is known about the outcome of patent processus vaginalis and testicular migration pathologies in children. The objectives of this study were to analyze clinical and therapeutic features of these pathologies. Methods. This was a descriptive retrospective study involving boys aged 0 to 16 years, operated for inguinal hernias, hydroceles, cryptorchidisms and testicular torsions, at the Louga Regional Hospital Center, Senegal, from January 2018 to December 2019. Results. 184 patients were recorded, which represented 32.5 % of all patients operated in the same period. Their average age was 5.4 ± 4.3 years. The managed pathologies were: inguinal hernias (n= 37 including 3 incarcerated hernias), hydroceles (n= 113), cryptorchidisms (n= 27), retractile testicles (n=2) and testicular torsions (n= 5). Inguinal approach was performed in 96,1 % of cases. Surgical managements were: ligature of the patent processus vaginalis, relocating the testicle within the scrotum, orchidopexy and orchidectomy. No recurrence, no purulent testicular discharge or testicular atrophy was encountered. Conclusion. Processus vaginalis and testicular migration pathologies are common in our practice. At 3 months of surgical operation, no complication was observed. However, the challenge is long-term follow-up due to late complications

Spatial swarm segregation and reproductive isolation between the molecular forms of Anopheles gambiae

Anopheles gambiae, the major malaria vector in Africa, can be divided into two subgroups based on genetic and ecological criteria. These two subgroups, termed the M and S molecular forms, are believed to be incipient species. Although they display differences in the ecological niches they occupy in the field, they are often sympatric and readily hybridize in the laboratory to produce viable and fertile offspring. Evidence for assortative mating in the field was recently reported, but the underlying mechanisms awaited discovery. We studied swarming behaviour of the molecular forms and investigated the role of swarm segregation in mediating assortative mating. Molecular identification of 1145 males collected from 68 swarms in Donéguébougou, Mali, over 2 years revealed a strict pattern of spatial segregation, resulting in almost exclusively monotypic swarms with respect to molecular form. We found evidence of clustering of swarms composed of individuals of a single molecular form within the village. Tethered M and S females were introduced into natural swarms of the M form to verify the existence of possible mate recognition operating within-swarm. Both M and S females were inseminated regardless of their form under these conditions, suggesting no within-mate recognition. We argue that our results provide evidence that swarm spatial segregation strongly contributes to reproductive isolation between the molecular forms in Mali. However this does not exclude the possibility of additional mate recognition operating across the range distribution of the forms. We discuss the importance of spatial segregation in the context of possible geographic variation in mechanisms of reproductive isolation

Evidence for divergent selection between the molecular forms of Anopheles gambiae: role of predation

The molecular forms of Anopheles gambiae are undergoing speciation. They are characterized by a strong assortative mating and they display partial habitat segregation. The M form is mostly found in flooded/irrigated areas whereas the S form dominates in the surrounding areas, but the ecological factors that shape this habitat segregation are not known. Resource competition has been demonstrated between species undergoing divergent selection, but resource competition is not the only factor that can lead to divergence. In a field experiment using transplantation of first instar larvae, we evaluated the role of larval predators in mediating habitat segregation between the forms. We found a significant difference in the ability of the molecular forms to exploit the different larval sites conditioned on the presence of predators. In absence of predation, the molecular forms outcompeted each other in their respective natural habitats however, the developmental success of the M form was significantly higher than that of the S form in both habitats under predator pressure. Our results provide the first empirical evidence for specific adaptive differences between the molecular forms and stress the role of larval predation as one of the mechanisms contributing to their divergence.https://doi.org/10.1186/1471-2148-8-

Personal protection of long lasting insecticide-treated nets in areas of Anopheles gambiae s.s. resistance to pyrethroids

BACKGROUND: The development of mosquito nets pre-treated with insecticide, Long Lasting Impregnated Nets (LLINs) that last the life span of the net, is a solution to the difficulty of the re-impregnation of conventional nets. Even if they showed a good efficacy in control conditions, their efficacy in the field, particularly in areas with resistance of Anopheles gambiae to pyrethroids, is not well documented. This study compares wide (Olyset(®)) and small (Permanet(®)) mesh LLINs in field conditions, using entomological parameters. METHODS: The two LLINs were tested in a rice-growing area of south-western Burkina Faso (West Africa) with year around high density of the main malaria vector An. gambiae s.s. In the study village (VK6), there is a mixed population of two molecular forms of An. gambiae, the S-form which dominates during the rainy season and the M-form which dominates the rest of the year. The two LLINs Olyset(® )and Permanet(® )were distributed in the village and 20 matched houses were selected for comparison with four houses without treated nets. RESULTS: Mosquito entrance rate was ten fold higher in control houses than in houses with LLINs and there was no difference between the two net types. Among mosquitoes found in the houses, 36 % were dead in LLIN houses compared to 0% in control houses. Blood feeding rate was 80 % in control houses compared to 43 % in LLIN houses. The type of net did not significantly impact any of these parameters. No mosquitoes were found inside Permanet(®), whereas dead or dying mosquitoes were collected inside the Olyset(®). More than 60% of mosquitoes found on top or inside the nets had had blood meals from cattle, as shown by ELISA analysis. CONCLUSION: The percentage of blood-fed mosquitoes in a bed net study does not necessarily determine net success. The efficacy of the two types of LLINs was comparable, during a period when the S-form of An. gambiae was carrying the kdr gene. Significantly higher numbers of mosquitoes were collected in control houses compared to intervention houses, indicating that the LLINs provided an additional deterrent effect, which enhanced their expected prevention capacity

Native entomopathogenic Metarhizium spp. from Burkina Faso and their virulence against the malaria vector Anopheles coluzzii and non-target insects

Genetically enhanced Metarhizium pingshaense are being developed for malaria vector control in Burkina Faso. However, not much is known about the local prevalence and pathogenicity of this fungus, so we prospected mosquitoes and plant roots (a common habitat for Metarhizium spp.) for entomopathogenic fungi. Our investigations showed that Metarhizium spp. represented between 29–74% of fungi isolated from plant root rhizospheres in diverse collection sites. At low spore dosages (1 × 106 conidia/ml), two mosquito-derived M. pingshaense isolates (Met_S26 and Met_S10) showed greater virulence against Anopheles coluzzii (LT80 of ~7 days) than isolates tested in previous studies (LT80 of ~10 days). In addition, the local isolates did not cause disease in non-target insects (honeybees and cockroaches). Our work provides promising findings for isolating local Metarhizium strains for application in mosquito biological control and for future transgenic biocontrol strategies in Burkina Faso.https://doi.org/10.1186/s13071-018-2796-

Prediction of mosquito species and population age structure using mid-infrared spectroscopy and supervised machine learning

Despite the global efforts made in the fight against malaria, the disease is resurging. One of the main causes is the resistance that Anopheles mosquitoes, vectors of the disease, have developed to insecticides. Anopheles must survive for at least 10 days to possibly transmit malaria. Therefore, to evaluate and improve malaria vector control interventions, it is imperative to monitor and accurately estimate the age distribution of mosquito populations as well as their population sizes. Here, we demonstrate a machine-learning based approach that uses mid-infrared spectra of mosquitoes to characterise simultaneously both age and species identity of females of the African malaria vector species Anopheles gambiae and An. arabiensis. mid-infrared spectroscopy-based prediction of mosquito age structures was statistically indistinguishable from true modelled distributions. The accuracy of classifying mosquitoes by species was 82.6%. The method has a negligible cost per mosquito, does not require highly trained personnel, is rapid, and so can be easily applied in both laboratory and field settings. Our results indicate this method is a promising alternative to current mosquito species and age-grading approaches, with further improvements to accuracy and expansion for use with other mosquito vectors possible through collection of larger mid-infrared spectroscopy data sets