Relationships between climate and year-to-year variability in meningitis outbreaks: A case study in Burkina Faso and Niger

<p>Abstract</p> <p>Background</p> <p>Every year, West Africa is afflicted with Meningococcal Meningitis (MCM) disease outbreaks. Although the seasonal and spatial patterns of disease cases have been shown to be linked to climate, the mechanisms responsible for these patterns are still not well identified.</p> <p>Results</p> <p>A statistical analysis of annual incidence of MCM and climatic variables has been performed to highlight the relationships between climate and MCM for two highly afflicted countries: Niger and Burkina Faso. We found that disease resurgence in Niger and in Burkina Faso is likely to be partly controlled by the winter climate through enhanced Harmattan winds. Statistical models based only on climate indexes work well in Niger showing that 25% of the disease variance from year-to-year in this country can be explained by the winter climate but fail to represent accurately the disease dynamics in Burkina Faso.</p> <p>Conclusion</p> <p>This study is an exploratory attempt to predict meningitis incidence by using only climate information. Although it points out significant statistical results it also stresses the difficulty of relating climate to interannual variability in meningitis outbreaks.</p

Ki-67: level of evidence and methodological considerations for its role in the clinical management of breast cancer: analytical and critical review

Clinicians can use biomarkers to guide therapeutic decisions in estrogen receptor positive (ER+) breast cancer. One such biomarker is cellular proliferation as evaluated by Ki-67. This biomarker has been extensively studied and is easily assayed by histopathologists but it is not currently accepted as a standard. This review focuses on its prognostic and predictive value, and on methodological considerations for its measurement and the cut-points used for treatment decision. Data describing study design, patients’ characteristics, methods used and results were extracted from papers published between January 1990 and July 2010. In addition, the studies were assessed using the REMARK tool. Ki-67 is an independent prognostic factor for disease-free survival (HR 1.05–1.72) in multivariate analyses studies using samples from randomized clinical trials with secondary central analysis of the biomarker. The level of evidence (LOE) was judged to be I-B with the recently revised definition of Simon. However, standardization of the techniques and scoring methods are needed for the integration of this biomarker in everyday practice. Ki-67 was not found to be predictive for long-term follow-up after chemotherapy. Nevertheless, high KI-67 was found to be associated with immediate pathological complete response in the neoadjuvant setting, with an LOE of II-B. The REMARK score improved over time (with a range of 6–13/20 vs. 10–18/20, before and after 2005, respectively). KI-67 could be considered as a prognostic biomarker for therapeutic decision. It is assessed with a simple assay that could be standardized. However, international guidelines are needed for routine clinical use

Relationships between climate and year-to-year variability in meningitis outbreaks: A case study in Burkina Faso and Niger-0

Ur clusters characterizing the intensity of the epidemic) of the contingency table (Tab.2) are projected.<p><b>Copyright information:</b></p><p>Taken from "Relationships between climate and year-to-year variability in meningitis outbreaks: A case study in Burkina Faso and Niger"</p><p>http://www.ij-healthgeographics.com/content/7/1/34</p><p>International Journal of Health Geographics 2008;7():34-34.</p><p>Published online 2 Jul 2008</p><p>PMCID:PMC2504476.</p><p></p

Meningococcal meningitis in Mali : long-term study of persistence and spread

International audienc