Characterization of maize producing households in the dry savanna of Mali

Maize is one of the three most important staple foods in Mali. Zones in the country with high potential for producing maize are limited to areas where the probability of drought risk is between 20 and 40%, meaning that recurring droughts have long handicapped maize production. In an attempt to alleviate drought stress on maize production, a household survey was conducted in the two Local Government Areas of Bougouni and Koutiala, both in the Sikasso Region, during the 2007/2008 production period. These two districts were selected following an environmental characterization of drought zones in Mali. The survey was mainly oriented towards maize based farming systems. Six sample villages were selected within each of the two districts. The sample population was defined as maize farming households. A total of 150 households were randomly selected and interviewed with structured questionnaires. Interviews were conducted by trained enumerators using a formal household survey. The purpose of the study is to provide both quantitative and qualitative feedback from farmers to researchers and to the B&MGF on the impact that improved maize varieties developed in the past have had upon the livelihoods of households and to provide a detailed database for the projection of expected outcomes with the deployment of new drought tolerant maize varieties under the B&MGF drought tolerant maize project. Both qualitative and quantitative analyses were used to extract from our set of variables those orthogonal linear combinations of the variables that best captured the common information. Most successful was the one proposed by Filmer and Pritchett (1998; 2001) called the Principal Component Analysis (PCA). To assess the variables affecting the adoption of improved maize varieties, the Tobit model was used. The results show that 99% of household heads are male. The size of a household is 22 persons, on average. About 47% of the household’s members are available for farm work. About 59% of household heads are illiterate, an important factor concerning the adoption of new technology. These household heads make decisions about 84% of farming activities; 86% of the households involved in the study belonged to at least one farmers’ organization in order to have easy access to inputs

Etude préliminaire portant sur le dépistage de la protéinurie à l’aide de bandelette urinaire chez les patients vivants avec le VIH au CHNU de Fann à Dakar.

Les glomérulopathies et autres affections rénales sont fréquentes au cours de l’histoire naturelle du VIH même si leur incidence a diminué avec la trithérapie. Elles sont pratiquement toujours responsables d’une protéinurie et/ou d’une hématurie. Nous avons fait une étude préliminaire portant sur la prévalence de la protéinurie dépistée à l’aide de bandelettes urinaires chez les PVVIH suivies à la clinique des maladies infectieuses du CHNU de Fann à Dakar. Il s’agissait d’une étude prospective allant du 1er Août au 30 Octobre 2008. Ont été inclus de façon exhaustive les patients séropositifs pour le VIH à la fois vus en ambulatoire et en hospitalisation présentant une protéinurie sans infection urinaire intercurrente. Nous avons recueilli leurs données sociodémographiques, les éléments de l’histoire naturelle, les facteurs en rapport avec la protéinurie et la néphropathie. La saisie et l’analyse des données ont été faites avec le logiciel Epi Info version 6.04. Nous avons utilisé le test de Chi2 pour comparer les variables qualitatives et p<0,05 a été retenu comme significative. Au total 100 patients ont été inclus, la moyenne d’âge était de 43± 9,8 ans chez les hommes et de 39± 10 ans pour les femmes. Les femmes étaient prédominantes (sex ratio H/F = 0,5). Tous les patients étaient infectés par le VIH1, ils avaient été dépistés à un stade tardif d’immunodépression, la moitié était sous ARV avec le plus souvent le protocole AZT +3TC+ EFV. La prévalence de la protéinurie était de 47,9%. Les facteurs significativement associés à la présence d’une protéinurie étaient : le sexe ; le taux de CD4<350/mm3 ; la charge virale > 100000copies/mm3 ; l’IMC <18,5 ; le taux d’hémoglobine<8,5 g/dl, la chimioprophylaxie au cotrimoxazole et les stades cliniques OMS 3 et 4. La fréquence de la néphropathie au cours du VIH au service des maladies infectieuses de Fann à Dakar suggère d’inclure son dépistage à la bandelette dans le bilan initial et de suivi de tout patient infecté par le VIH. Dans tous les cas il faudrait corriger tout facteur favorisant la survenue de cette néphropathie. La ponction biopsie rénale pourrait permettre des études plus approfondies

Facility and community results-based financing to improve maternal and child nutrition and health in The Gambia

In 2013, the Government of The Gambia implemented a novel results-based financing (RBF) intervention designed to improve maternal and child nutrition and health through a combination of community, facility and individual incentives. In a mixed-methods study, we used a randomized 2 x 2 study design to measure these interventions' impact on the uptake of priority maternal health services, hygiene and sanitation. Conditional cash transfers to individuals were bundled with facility results-based payments. Community groups received incentive payments conditional on completion of locally-designed health projects. Randomization occurred separately at health facility and community levels. Our model pools baseline, midline and endline exposure data to identify evidence of the interventions' impact in isolation or combination. Multivariable linear regression models were estimated. A qualitative study was embedded, with data thematically analyzed. We analyzed 5,927 household surveys: 1,939 baseline, 1,951 midline, and 2,037 endline. On average, community group interventions increased skilled deliveries by 11 percentage points, while the facility interventions package increased them by seven percentage points. No impact was found, either in the community group or facility intervention package arms on early ANC. The community group intervention led to 49, 43 and 48 percentage point increases in handwashing stations, soaps at station and water at station, respectively. No impact was found on improved sanitation facilities. The qualitative data help understand factors underlying these changes. No interaction was found between the community and facility interventions. Where demand-side barriers predominate and community governance structures exist, community group RBF interventions may be more effective than facility designs

Entomological investigations carried out from 2002 to 2010 into the involvement of water bugs (Heteroptera - Hemiptera) in transmission of Mycobacterium ulcerans to humans in Côte d’Ivoire (West Africa)

Ulcer is a disease caused by a mycobacterium present in the environment: Mycobacterium ulcerans.This communicable disease occurs essentially in wet tropical regions, and in particular in west Africa where it is endemic. It is the third most common mycobacterial disease affecting humans after leprosy and tuberculosis, although it is more prevalent than either leprosy or tuberculosis in some rural areas of several countries (Benin, Côte d’Ivoire and Ghana). This has led WHO to act, and in 1998 to declare Buruli ulcer an « emerging disease » and to recognize it as a neglected tropical disease. Its development is a source of concern in Côte d’Ivoire, the country most affected in the world, with an aggregate number of 30 000 cases and more than 2000 cases detected each year. It particularly affects children living in isolated rural areas around bodies of stagnant or slowly flowing water.  In order to control the disease, it is essential fully to understand its epidemiology. In this connection, there are several hypotheses on the mode of transmission of M. ulcerans to humans. Since 1999, the involvement of water bugs belonging to the order of the hemiptera has been invoked by Portaels. In 2002, this hypothesis was confirmed by Marsollier et al. for water bugs of the genus Naucoris taken from the region of Daloa in Côte d’Ivoire, where the disease is endemic. In 2008, Portaels also found M. ulcerans in samples taken from the environment (Gerridae) in Ghana. In 2007, studies began in Côte d’Ivoire into the specific diversity, biology, ecology, ethology and role of aquatic heteroptera in the transmission of M. ulcerans to humans. Samples of aquatic heteroptera were collected each month from different aquatic environments in endemic areas of Côte d’Ivoire. The insects were identified by family, genus and occasionally species. Their distribution, population dynamics and ecological distribution in the water points investigated were correlated with human activities. Monospecific batches of water bugs were regularly composed in order to identify the molecular signatures of M. ulcerans using PCR at the bacteriology laboratory of the Institut Pasteur in Côte d’Ivoire and at the bacteriology laboratory of the Groupe d’Etudes des Interactions Hôtes-Pathogènes (Host-Pathogen Study Group) at the University Teaching hospital in Angers, France. Eighteen (18) species belonging to 8 families were identified. After the aquatic insects collected had been identified, 283 monospecific batches were composed and sent to the Institut Pasteur in Côte d’Ivoire (IPCI) for PCR. Twenty four (24) of the 283 batches i.e. 8,5% containing the following, 14 Diplonychus sp, 2 Naucoris sp, 3 Micronecta sp, 2 Ranatra fusca, 2 Anisops sp and 1 Laccotrephes ater, respectively belonging to the families Belostomatidae, Naucoridae, Corixidae, Ranatridae and Nepidae tested positive under PCR. Thirty five (35) samples of saliva were collected from specimens of the genus Diplonychus. Six of the samples (i.e. 17%) tested positive under PCR. Out of 109 other monospecific batches sent to the laboratory in Angers, France, 33 (i.e. 30%) tested positive under PCR. They comprised 11 batches of Diplonychus sp (Belostomatidae), 8 batches of Micronecta sp (Corixidae), 2 batches of Laccocoris sp (Naucoridae), 4 batches of Ranatra fusca (Ranatridae), 3 batches of Anisops sp, 1 lot de Anisops sardea et 1 lot de Enithares sp (Notonectidae), 2 batches of Plea pullula (Pleidae) and 1 batch of de Laccotrephes sp (Nepidae). Clearly, not only is Diplonychus sp the genus most commonly found, it is also that most affected by M. ulcerans. This justifies the decision to breed this genus in the laboratory since 2008, in order to improve our understanding of its biology and ethology and to standardize physical and chemical parameters so as to determine the best conditions for breeding the insect which would provide an animal model for experimental infections. We have now bred six successive generations in the laboratory. To conclude, although some aquatic heteroptera that host M. ulcerans are strictly phytophagous, (e.g. the Corixidae), the great majority of water bugs are carnivorous predators that are hosts and vectors of M. ulcerans. The absence of a reliable key for determining the family, genus and species in central and west Africa has led us to draw up an iconographic catalogue to determine the taxonomy of these insects

Biodiversity and implication of waters bugs in transmission of Mycobacterium ulcerans, etiological agent of Buruli ulcer in Côte d’Ivoire (West Africa)

Date du colloque&nbsp;: 04/2009</p

A new panel of epitope mapped monoclonal antibodies recognising the prototypical tetraspanin CD81

Background: Tetraspanins are small transmembrane proteins, found in all higher eukaryotes, that compartmentalize cellular membranes through interactions with partner proteins. CD81 is a prototypical tetraspanin and contributes to numerous physiological and pathological processes, including acting as a critical entry receptor for hepatitis C virus (HCV). Antibody engagement of tetraspanins can induce a variety of effects, including actin cytoskeletal rearrangements, activation of MAPK-ERK signaling and cell migration. However, the epitope specificity of most anti-tetraspanin antibodies is not known, limiting mechanistic interpretation of these studies. Methods: We generated a panel of monoclonal antibodies (mAbs) specific for CD81 second extracellular domain (EC2) and performed detailed epitope mapping with a panel of CD81 mutants. All mAbs were screened for their ability to inhibit HCV infection and E2-CD81 association. Nanoscale distribution of cell surface CD81 was investigated by scanning electron microscopy. Results: The antibodies were classified in two epitope groups targeting opposing sides of EC2. We observed a wide range of anti-HCV potencies that were independent of their epitope grouping, but associated with their relative affinity for cell-surface expressed CD81. Scanning electron microscopy identified at least two populations of CD81; monodisperse and higher-order assemblies, consistent with tetraspanin-enriched microdomains. Conclusions: These novel antibodies provide well-characterised tools to investigate CD81 function, including HCV entry, and have the potential to provide insights into tetraspanin biology in general

Micronutrient Deficiencies, Nutritional Status and the Determinants of Anemia in Children 0-59 Months of Age and Non-Pregnant Women of Reproductive Age in The Gambia.

Data on micronutrient deficiency prevalence, nutrition status, and risk factors of anemia in The Gambia is scanty. To fill this data gap, a nationally representative cross-sectional survey was conducted on 1354 children (0-59 months), 1703 non-pregnant women (NPW; 15-49 years), and 158 pregnant women (PW). The survey assessed the prevalence of under and overnutrition, anemia, iron deficiency (ID), iron deficiency anemia (IDA), vitamin A deficiency (VAD), and urinary iodine concentration (UIC). Multivariate analysis was used to assess risk factors of anemia. Among children, prevalence of anemia, ID, IDA, and VAD was 50.4%, 59.0%, 38.2%, and 18.3%, respectively. Nearly 40% of anemia was attributable to ID. Prevalence of stunting, underweight, wasting, and small head circumference was 15.7%, 10.6%, 5.8%, and 7.4%, respectively. Among NPW, prevalence of anemia, ID, IDA and VAD was 50.9%, 41.4%, 28.0% and 1.8%, respectively. Anemia was significantly associated with ID and vitamin A insufficiency. Median UIC in NPW and PW was 143.1 µg/L and 113.5 ug/L, respectively. Overall, 18.3% of NPW were overweight, 11.1% obese, and 15.4% underweight. Anemia is mainly caused by ID and poses a severe public health problem. To tackle both anemia and ID, programs such as fortification or supplementation should be intensified

Prevalence and co-existence of cardiometabolic risk factors and associations with nutrition-related and socioeconomic indicators in a national sample of Gambian women.

Cardiovascular diseases (CVD) are on the rise in Sub-Saharan Africa, and a large proportion of the adult population is thought to suffer from at least one cardiometabolic risk factor. This study assessed cardiometabolic risk factors and the contribution of nutrition-related indicators in Gambian women. The prevalence and co-existence of diabetes (elevated glycated hemoglobin (HbA1c ≥ 6.5%) or prediabetes (HbA1c ≥ 5.7% to  3 mg/L or alpha-1-acid glycoprotein (AGP) > 1 g/L) and the contribution of nutrition related and socioeconomic indicators were measured in non-pregnant women 15-49 years of age in the Gambia using data from a nationally representative cross-sectional stratified survey. Nationally, 54.5% (95% CI: 47.4, 61.4) of 1407 women had elevated HbA1c. Of these, 14.9% were diabetic and 85.1% were prediabetic. Moreover, 20.8% (95% CI 17.8, 20.0) of 1685 women had hypertension, 11.1% (95% CI 9.0, 13.7) of 1651 were obese and 17.2% (95% CI 5.1, 19.6) of 1401 had inflammation. At least one of the aforementioned cardiometabolic risk factor was present in 68.3% (95% CI 63.0, 73.1) of women. Obesity increased the risk of hypertension (aRR 1.84; 95% CI 1.40, 2.41), diabetes (aRR 1.91; 95% CI 1.29, 2.84), elevated HbA1c (aRR 1.31; 95% CI 1.14, 1.51) and inflammation (aRR 3.47; 95% CI 2.61, 4.61). Inflammation increased the risk of hypertension (aRR 1.42; 95% CI 1.14, 1.78). Aging increased the risk of hypertension, obesity and inflammation. Further, inadequate sanitation increased the risk for diabetes (aRR 1.65; 95% CI 1.17, 2.34) and iron deficiency increased the risk of elevated HbA1c (aRR 1.21; 95% CI 1.09, 1.33). The high prevalence of cardiometabolic risk factors and their co-existence in Gambian women is concerning. Although controlling obesity seems to be key, multifaceted strategies to tackle the risk factors separately are warranted to reduce the prevalence or minimize the risk of CVD

Species-Specific Activity of SIV Nef and HIV-1 Vpu in Overcoming Restriction by Tetherin/BST2

Tetherin, also known as BST2, CD317 or HM1.24, was recently identified as an interferon-inducible host–cell factor that interferes with the detachment of virus particles from infected cells. HIV-1 overcomes this restriction by expressing an accessory protein, Vpu, which counteracts tetherin. Since lentiviruses of the SIVsmm/mac/HIV-2 lineage do not have a vpu gene, this activity has likely been assumed by other viral gene products. We found that deletion of the SIVmac239 nef gene significantly impaired virus release in cells expressing rhesus macaque tetherin. Virus release could be restored by expressing Nef in trans. However, Nef was unable to facilitate virus release in the presence of human tetherin. Conversely, Vpu enhanced virus release in the presence of human tetherin, but not in the presence of rhesus tetherin. In accordance with the species-specificity of Nef in mediating virus release, SIV Nef downregulated cell-surface expression of rhesus tetherin, but did not downregulate human tetherin. The specificity of SIV Nef for rhesus tetherin mapped to four amino acids in the cytoplasmic domain of the molecule that are missing from human tetherin, whereas the specificity of Vpu for human tetherin mapped to amino acid differences in the transmembrane domain. Nef alleles of SIVsmm, HIV-2 and HIV-1 were also able to rescue virus release in the presence of both rhesus macaque and sooty mangabey tetherin, but were generally ineffective against human tetherin. Thus, the ability of Nef to antagonize tetherin from these Old World primates appears to be conserved among the primate lentiviruses. These results identify Nef as the viral gene product of SIV that opposes restriction by tetherin in rhesus macaques and sooty mangabeys, and reveal species-specificity in the activities of both Nef and Vpu in overcoming tetherin in their respective hosts

Gametocyte carriage in uncomplicated Plasmodium falciparum malaria following treatment with artemisinin combination therapy: a systematic review and meta-analysis of individual patient data

BACKGROUND: Gametocytes are responsible for transmission of malaria from human to mosquito. Artemisinin combination therapy (ACT) reduces post-treatment gametocyte carriage, dependent upon host, parasite and pharmacodynamic factors. The gametocytocidal properties of antimalarial drugs are important for malaria elimination efforts. An individual patient clinical data meta-analysis was undertaken to identify the determinants of gametocyte carriage and the comparative effects of four ACTs: artemether-lumefantrine (AL), artesunate/amodiaquine (AS-AQ), artesunate/mefloquine (AS-MQ), and dihydroartemisinin-piperaquine (DP). METHODS: Factors associated with gametocytaemia prior to, and following, ACT treatment were identified in multivariable logistic or Cox regression analysis with random effects. All relevant studies were identified through a systematic review of PubMed. Risk of bias was evaluated based on study design, methodology, and missing data. RESULTS: The systematic review identified 169 published and 9 unpublished studies, 126 of which were shared with the WorldWide Antimalarial Resistance Network (WWARN) and 121 trials including 48,840 patients were included in the analysis. Prevalence of gametocytaemia by microscopy at enrolment was 12.1 % (5887/48,589), and increased with decreasing age, decreasing asexual parasite density and decreasing haemoglobin concentration, and was higher in patients without fever at presentation. After ACT treatment, gametocytaemia appeared in 1.9 % (95 % CI, 1.7–2.1) of patients. The appearance of gametocytaemia was lowest after AS-MQ and AL and significantly higher after DP (adjusted hazard ratio (AHR), 2.03; 95 % CI, 1.24–3.12; P = 0.005 compared to AL) and AS-AQ fixed dose combination (FDC) (AHR, 4.01; 95 % CI, 2.40–6.72; P < 0.001 compared to AL). Among individuals who had gametocytaemia before treatment, gametocytaemia clearance was significantly faster with AS-MQ (AHR, 1.26; 95 % CI, 1.00–1.60; P = 0.054) and slower with DP (AHR, 0.74; 95 % CI, 0.63–0.88; P = 0.001) compared to AL. Both recrudescent (adjusted odds ratio (AOR), 9.05; 95 % CI, 3.74–21.90; P < 0.001) and new (AOR, 3.03; 95 % CI, 1.66–5.54; P < 0.001) infections with asexual-stage parasites were strongly associated with development of gametocytaemia after day 7. CONCLUSIONS: AS-MQ and AL are more effective than DP and AS-AQ FDC in preventing gametocytaemia shortly after treatment, suggesting that the non-artemisinin partner drug or the timing of artemisinin dosing are important determinants of post-treatment gametocyte dynamics