A cost-effective scheme developed for studying human malaria caused by Plasmodium falciparum

Research in human malaria disease has consistently been hindered in developing countries where this disease is endemic, due to the prohibitive cost of constructing and maintaining currently available experimental mouse models. Our goal, therefore, was to develop a cost-effective mouse model that may be used as research tool for studying human malaria disease. Plasmodium falciparum-infected human blood samples were cultured invitro for 92 hours, and invivo malaria infection was induced by intraperitoneally injecting 0.5ml of the Plasmodium falciparum cultures into experimental mice, which were modified by the application of immunosuppressive and humanization protocols in which aspirin (4mg/kg), doxycycline (4mg/kg), and 0.5ml human blood that retained all of its cellular components (erythrocytes, leukocytes, and platelets) were repeatedly injected via the intraperitoneal route. Data obtained showed that the invitro-cultured Plasmodium falciparum significantly retained its infectivity and immunogenicity, since all the 20 mice inoculated exhibited peripheral blood parasitaemia. Quinine chemotherapy using standard antimalarial drug (73mg quinine/kg), however, induced significant suppression of the peripheral blood parasitaemia in the infected mice. Our results suggest that there is a substantial possibility of inducing and eradicating human malaria disease in our mouse model (humanized non-genetically manipulated mouse model) when used as a substitute for the conventional mouse models (humanized genetically manipulated mouse models). Keywords: Synchronized, Invitro, Invivo, Inocula, Immunosuppressed, Parasitaemia, Intraperitoneal,                Infectivity

Evaluation de la qualité sanitaire des poudres de feuilles de Moringa oleifera Lam. commercialisées au profit des Personnes Vivant avec le VIH à Cotonou (Bénin)

Face au péril des carences nutritionnelles, la promotion des compléments alimentaires prend de l’ampleur au Bénin. L’objectif de cette étude est d’évaluer la qualité hygiénique des poudres de feuilles de Moringa oleifera commercialisées à Cotonou. 24 échantillons ont été achetés dans 12 points de vente et soumis à des analyses de laboratoire. L’enquête a révélé que, 25% des échantillons ne sont pas scellés, 58% des emballages sont non opaques, les dates de conditionnement et dates limites d’utilisation ne figurent pas sur 50% des échantillons. 43% des poids marqués ne sont pas conformes aux poids nets réels. La concentration moyenne des germes aérobies mésophiles (1,4.106 à 3.106 UFC/g) dépasse significativement la limite maximale d’acceptation du produit au plan microbiologique. Cette insalubrité des échantillons se confirme par la forte présence de Staphylocoques à coagulase positive (3.104), Escherichia coli (1,5.103 à 30.103), levures (1,1.103 à 15.103) et moisissures (3,4.103 à 30.103) respectivement dans 100%, 92%, 50% et 17% des poudres analysées. Par ailleurs, les bactéries Anaérobies Sulfito-Réductrices sont dans les limites d’acceptation de l’aliment. Au total, l’innocuité des poudres de Moringa commercialisées n’est pas garantie et il importe que les fabricants corrigent les failles en matière d’hygiène dans le processus de fabrication.Mots clés : Moringa oleifera, Complément alimentaire, nutrition, qualité, hygiène

Comparative Study of Malaria Prevalence among Travellers in Nigeria (West Africa) Using Slide Microscopy and a Rapid Diagnosis Test

Malaria is a major disease in Africa and leads to various public health problems. A study was carried out at the Aviation Medical Clinic Laboratory, Murtala Mohammed Airport, Ikeja, Lagos State, Nigeria, in 2014. The work aimed to determine the prevalence of malaria among patients attending the laboratory. Blood samples were therefore collected from 51 patients and subjected to both blood smear microscopy and a rapid immunochromatographic diagnostic test (SD BIOLINE Malaria Ag) for detection of, respectively, malaria parasites and antigens. At the end of the study, 22% of the patients were detected positive by the microscopic examination while 9.8% were tested positive when using SD BIOLINE Malaria Ag. The outcomes of the study show a high prevalence of malaria at the airport. This represents a serious risk factor leading to a high likelihood of spread and occurrence of malaria in other countries including Western countries whereby the disease is nonendemic. It also pointed out that the blood smear microscopy seems to be better than Rapid Diagnosis Test (RDT) for malaria diagnosis

International Study of the Epidemiology of Paediatric Trauma : PAPSA Research Study

Objectives: Trauma is a significant cause of morbidity and mortality worldwide. The literature on paediatric trauma epidemiology in low- and middle-income countries (LMICs) is limited. This study aims to gather epidemiological data on paediatric trauma. Methods: This is a multicentre prospective cohort study of paediatric trauma admissions, over 1 month, from 15 paediatric surgery centres in 11 countries. Epidemiology, mechanism of injury, injuries sustained, management, morbidity and mortality data were recorded. Statistical analysis compared LMICs and high-income countries (HICs). Results: There were 1377 paediatric trauma admissions over 31 days; 1295 admissions across ten LMIC centres and 84 admissions across five HIC centres. Median number of admissions per centre was 15 in HICs and 43 in LMICs. Mean age was 7 years, and 62% were boys. Common mechanisms included road traffic accidents (41%), falls (41%) and interpersonal violence (11%). Frequent injuries were lacerations, fractures, head injuries and burns. Intra-abdominal and intra-thoracic injuries accounted for 3 and 2% of injuries. The mechanisms and injuries sustained differed significantly between HICs and LMICs. Median length of stay was 1 day and 19% required an operative intervention; this did not differ significantly between HICs and LMICs. No mortality and morbidity was reported from HICs. In LMICs, in-hospital morbidity was 4.0% and mortality was 0.8%. Conclusion: The spectrum of paediatric trauma varies significantly, with different injury mechanisms and patterns in LMICs. Healthcare structure, access to paediatric surgery and trauma prevention strategies may account for these differences. Trauma registries are needed in LMICs for future research and to inform local policy

The Potential of Medical Abortion to Reduce Maternal Mortality in Africa: What Benefits for Tanzania and Ethiopia?

BACKGROUND: Unsafe abortion is estimated to account for 13% of maternal mortality globally. Medical abortion is a safe alternative. METHODS: By estimating mortality risks for unsafe and medical abortion and childbirth for Tanzania and Ethiopia, we modelled changes in maternal mortality that are achievable if unsafe abortion were replaced by medical abortion. We selected Ethiopia and Tanzania because of their high maternal mortality ratios (MMRatios) and contrasting situations regarding health care provision and abortion legislation. We focused on misoprostol-only regimens due to the drug's low cost and accessibility. We included the impact of medical abortion on women who would otherwise choose unsafe abortion and on women with unwanted/mistimed pregnancies who would otherwise carry to term. RESULTS: Thousands of lives could be saved each year in each country by implementing medical abortion using misoprostol (2122 in Tanzania and 2551 in Ethiopia assuming coverage equals family planning services levels: 56% for Tanzania, 31% for Ethiopia). Changes in MMRatios would be less pronounced because the intervention would also affect national birth rates. CONCLUSIONS: This is the first analysis of impact of medical abortion provision which takes into account additional potential users other than those currently using unsafe abortion. Thousands of women's lives could be saved, but this may not be reflected in as substantial changes in MMRatios because of medical abortion's demographic impact. Therefore policy makers must be aware of the inability of some traditional measures of maternal mortality to detect the real benefits offered by such an intervention

Global Perspectives on Task Shifting and Task Sharing in Neurosurgery.

BACKGROUND: Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit. METHODS: The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018-January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores. RESULTS: Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine). CONCLUSIONS: Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs