Human papillomavirus Genotype Distribution and Co-infection with Sexually Transmitted Pathogens in Reproductive age Women in Urban Gambia

Cervical cancer is the second most common female cancer in The Gambia, and there have been few studies carried out on the causative agent, human papillomavirus (HPV) in this country. The Gambia introduced the quadrivalent HPV vaccine for girls between the ages of 9-13 years in the urban area in 2014; nationwide immunization will take place in 2019. This study determined the common circulating oncogenic HPV types in the urban region where most cervical cancer cases were reported. Two hundred and thirty-two women between 20 – 49 years of age from the urban region who attended a polyclinic were recruited for this work. Endocervical and high vaginal swabs were collected, and a socio-demographic questionnaire was administered to capture potential risk characteristics associated with HPV. Nucleic acid amplification techniques and DNA sequencing were carried out to determine the HPV genotype using PGMY09/11 consensus primers. Phylogenetic analysis was carried out on the Gambian HPV sequences to further confirm the identification of The Gambian HPV genotypes and its relatedness to sequences of the same types from other geographical locations. Microbiological and nucleic acid amplification analyses were used to determine the prevalence of other sexually transmitted pathogens in the participants. Blood samples, endocervical swab, and Pap smear were collected from HIV positive participants and these participants were followed up and re-examined every nine months for 24 months, to determine the persistence of cervical HPV infection, HPV antibodies, and cytological cervical changes. Pseudo-typed neutralisation assays were performed to characterise high-risk HPV antibodies in HIV positive women. Among the sample population studied, HPV prevalence was found to be 12% (28/232). HPV 52 was the most prevalent (17.9%) genotype detected in cervical samples. The Gambian high-risk HPV genotypes, except for a novel putative HPV 35 genotype, were 98 -100% identical to those submitted in the GenBank database. Prolonged (> 5 years) use of hormone contraceptive was the only variable found to associate statistically with HPV infection. Fifty percent (14/28) of participants infected with HPV were co-infected with Ureaplasma urealyticum/parvum and 25% (7/28) with HIV. HPV sero-prevalence was found to be 51.7% (15/29) in HIV positive participants. HIV positive women had been exposed to multiple HPV types and HPV 52 antibody was more prevalent 24% (7/29). Other high-risk HPV genotypes were found to cause high-grade cervical lesions and cancer in HIV positive women. Future studies to investigate oncogenic HPV genotypes in cervical cancer specimens will be useful in providing evidence for policies and future evaluation of the quadrivalent HPV vaccine in The Gambia

Human papilloma virus genotype distribution and risk factor analysis amongst reproductive aged women in urban Gambia

Purpose. Cervical cancer is the most frequently diagnosed female cancer in The Gambia, representing approximately 30% of cases. In 2014, the quadrivalent human papilloma virus (HPV) vaccine was introduced, which offers protection against HPV genotypes 6, 11, 16 and 18. To evaluate the potential effectiveness of this vaccine, genotype distribution and risk factor analysis were assessed. Methodology. Endocervical samples (n=232) were collected from women aged 20-49 years residing in urban Gambia. A questionnaire was administered to capture socio-demographic and cervical cancer risk factors. HPV detection and genotyping was performed by PCR amplification of the L1 major capsid gene and analysis of sequenced PCR products. Results/ Key Findings. The prevalence of HPV was 12% (28/232) and the high risk (HR) genotype HPV 52 (5/28) was the most prevalent genotype. HR-HPV sequences had high identity (≥ 90 %) to isolates which originated from America, Europe and Asia but not from Africa. Half (14/28) of participants were co-infected with Ureaplasma urealyticum/parvum, which increases the risk of progression to cervical cancer. Female genital mutilation and the use of hormone contraception for >5 years were identified as potential risk factors for HPV infection. Ethnicity-associated differences were also noted; participants of the Fula ethnic group had a higher prevalence of HR-HPV infection (31.3%) compared to the Mandinka (18.8%) and Wollof (12.5%) groups. Conclusion. These data may have a significant public health impact as the HPV quadrivalent vaccine may be of limited value if the circulating non-HPV 16/18 HR-genotypes are responsible for cytological abnormalities of the cervix

Maternal-fetal prognosis of obstetric emergencies at the maternity ward of the Mamou regional hospital

Background: Pregnant women may be at risk of unpredictable obstetric complications such as: bleeding, dystocia, acute fetal suffering, pre-eclampsia and eclampsia. This maternal-fetal prognosis of obstetric emergencies is influenced by factors that are most often related to complications that alter the course or outcome of a pregnancy and require prompt care. The objectives of this study are to analyze the factors that influence the maternal-fetal prognosis of obstetric emergencies; determine their frequency, describe the clinical profiles of patients and evaluate the maternal-fetal prognosis.Methods: The study was conducted at the Mamou Regional Hospital. It was a 6-month quantitative, descriptive and analytical study, from July 1st to December 31st, 2016, including all parturient women whose term is greater than or equal to 28 weeks of amenorrhoea.Results: The study covered 377 obstetric emergencies out of a total of 1273 deliveries, or 29.61%. Factors influencing the prognosis were: young age, parity, unfavorable socio-economic conditions and difficult baseline conditions. The main obstetric emergencies recorded were acute fetal suffering, disproportion and narrowed pelvis. The dominant mode of delivery was caesarean section with a frequency of 89.65%. Maternal lethality is 3.44% and fetal lethality is 5.14%.Conclusions: Obstetric emergency is a frequent situation where better management would improve the prognosis of the mother and fetus

Cancer in The Gambia: 1988–97

We describe the incidence of cancer in The Gambia over a 10-year period using data collected through the Gambian National Cancer Registry. Major problems involved with cancer registration in a developing country, specifically in Africa are discussed. The data accumulated show a low overall rate of cancer incidence compared to more developed parts of the world. The overall age standardized incidence rates (ASR) were 61.0 and 55.7 per 100 000 for males and females, respectively. In males, liver cancer was most frequent, comprising 58% of cases (ASR 35.7) followed by non-Hodgkin lymphoma, 5.4% (ASR 2.4), lung 4.0%, (ASR 2.8) and prostate 3.3% (ASR 2.5) cancers. The most frequent cancers in females were cervix uteri 34.0% (ASR 18.9), liver 19.4% (ASR 11.2), breast 9.2% (ASR 5.5) and ovary 3.2% (ASR 1.6). The data indicate that cancers of the liver and cervix are the most prevalent cancers, and are likely to be due to infectious agents. It is hoped that immunization of children under 1 year against hepatitis B will drastically reduce the incidence of liver cancer in The Gambia. © 2001 Cancer Research Campaign http://www.bjcancer.co

The gravity duals of SO/USp superconformal quivers

We study the gravity duals of SO/USp superconformal quiver gauge theories realized by M5-branes wrapping on a Riemann surface ("G-curve") together with a Z_2-quotient. When the G-curve has no punctures, the gravity solutions are classified by the genus g of the G-curve and the torsion part of the four-form flux G_4. We also find that there is an interesting relation between anomaly contributions from two mysterious theories: T_{SO(2N)} theory with SO(2N)^3 flavor symmetry and \tilde{T}_{SO(2N)} theory with SO(2N) x USp(2N-2)^2 flavor symmetry. The dual gravity solutions for various SO/USp-type tails are also studied.Comment: 27 pages, 13 figures; v2 minor corrections, typos corrected, Figure 13 replaced, references adde

Assessment of Post-abortion Care Services in Two Health Facilities in Conakry, Guinea

High quality post-abortion care (PAC) is needed to curb maternal deaths by providing effective treatment and preventing future unintended pregnancies through PAC family planning. This study aimed at assessing PAC services with a focus on women‘s satisfaction with care they received in two health facilities in Conakry. We conducted a cross-sectional mixed method study with 426 PAC clients from March 1st to August 31st, 2014. Data analyses were performed using Stata software version 14 for quantitative data and using a thematic approach for qualitative data. Overall, 92.5% of women were satisfied with PAC services they received. The short waiting time (< 30 min), the appropriate management of pain during the treatment, the affordable cost of the treatment, the confidentiality of services, the good patient-provider interaction and the cleanliness of the premises were factors statistically significantly associated with the satisfaction of women (P-value ˂ 0.001). This study showed a high rate ofwomen‘s satisfaction. Nevertheless, health authorities should assure a regular follow-up on the application of official prices for the treatment of PAC patients; and providers should further consider aspects such as pain management during treatment, confidentiality of services, patient-provider interaction for optimal satisfaction of clients with PAC services. Keywords: Assessment, Post-abortion care, Health facilities, GuineaDes soins post-avortement (SAA) de haute qualité sont nécessaires pour réduire les décès maternels en fournissant un traitement efficace et en prévenant les futures grossesses non désirées grâce à la planification familiale après-avortement. Cette étude visait à évaluer les services de SAA en mettant l'accent sur la satisfaction des femmes à l'égard des soins qu'elles ont reçus dans deux établissements de santé à Conakry. Nous avons mené une étude transversale à méthodes mixtes auprès de 426 clientes de SAA du 1er mars au 31 août 2014. Les analyses de données ont été réalisées à l'aide du logiciel Stata version 14 pour les données quantitatives et en utilisant une approche thématique pour les données qualitatives. Dans l'ensemble, 92,5% des femmes étaient satisfaites des services de SAA qu'elles ont reçus. Le temps d'attente court (<30 min), la gestion appropriée de la douleur pendant le traitement, le coût abordable du traitement, la confidentialité des services, la bonne interaction patiente -prestataire et la propreté des locaux étaient des facteurs statistiquement significativement associés à la satisfaction des femmes (valeur P ˂0,001). Cette étude a montré un taux élevé de satisfaction des femmes. Néanmoins, les autorités sanitaires devraient assurer un suivi régulier de l'application des prix officiels pour le traitement des patientes de SAA; et les prestataires devraient en outre prendre en compte des aspects tels que la gestion de la douleur pendant le traitement, la confidentialité des services, l'interaction patiente-prestataire pour une satisfaction optimale des clientes à l‘égard des services de SAA. Mots-clés: Évaluation, Soins post-avortement, Établissements de santé, Guiné

The cetaceans of Guinea, a first check-list of documented species. Scientific Committee document SC/58/O15, International Whaling Commission, May-June 2006, St. Kitts

A CMS workshop on West African Cetacea (Conakry, May 2000), called for i.a. ‘carrying out .. inventory of cetacean species; collection, treatment and compilation of data for each state.’ The present paper is a preliminary faunal checklist of cetaceans occurring in Guinea’s EEZ. Information was gleaned from strandings, bycatches, scientific and opportunistic sightings and a literature review. Ten species are included for which supporting voucher material and data were available for examination. These are, three baleen whales: Balaenoptera brydei, Balaenoptera acutorostrata and Megaptera novaeangliae; and seven species of odontocetes: Kogia breviceps, Tursiops truncatus, Sousa teuszii, Stenella frontalis, Delphinus delphis, Steno bredanensis and Globicephala macrorhynchus. Another two species, Physeter macrocephalus and Stenella attenuate were sighted off Guinea but no photographic evidence was obtained. The current account is thought to reflect an incomplete picture of Guinea’s cetacean biodiversity. Future surveys are expected to update and investigate spatial and temporal distribution patterns for each species along Guinea’s coast. A few bycatches landed by artisanal fishers were utilised locally, but there are no signs of any substantial captures. Nonetheless, monitoring should be continued. The set-up of a national reference collection and database is recommended. The population identities of the encountered Atlantic humpback dolphin, minke whale and humpback whale are of particular interest

Beyond LLM in M-theory

The Lin, Lunin, Maldacena (LLM) ansatz in D = 11 supports two independent Killing directions when a general Killing spinor ansatz is considered. Here we show that these directions always commute, identify when the Killing spinors are charged, and show that both their inner product and resulting geometry are governed by two fundamental constants. In particular, setting one constant to zero leads to AdS7 x S4, setting the other to zero gives AdS4 x S7, while flat spacetime is recovered when both these constants are zero. Furthermore, when the constants are equal, the spacetime is either LLM, or it corresponds to the Kowalski-Glikman solution where the constants are simply the mass parameter.Comment: 1+30 pages, footnote adde

Dipole Coupling Effect of Holographic Fermion in the Background of Charged Gauss-Bonnet AdS Black Hole

We investigate the holographic fermions in the charged Gauss-Bonnet $AdS_{d}$ black hole background with the dipole coupling between fermion and gauge field in the bulk. We show that in addition to the strength of the dipole coupling, the spacetime dimension and the higher curvature correction in the gravity background also influence the onset of the Fermi gap and the gap distance. We find that the higher curvature effect modifies the fermion spectral density and influences the value of the Fermi momentum for the appearance of the Fermi surface. There are richer physics in the boundary fermion system due to the modification in the bulk gravity.Comment: 16 pages, accepted for publication in JHE