Statistical Analysis and Comparison of Optical Classification of Atmospheric Aerosol Lidar Data

In this article, we present a new study for the analysis and classification of atmospheric aerosols in remote sensing LIDAR data. Information on particle size and associated properties are extracted from these remote sensing atmospheric data which are collected by a ground-based LIDAR system. This study first considers optical LIDAR parameter-based classification methods for clustering and classification of different types of harmful aerosol particles in the atmosphere. Since accurate methods for aerosol prediction behaviors are based upon observed data, computational approaches must overcome design limitations, and consider appropriate calibration and estimation accuracy. Consequently, two statistical methods based on generalized linear models (GLM) and regression tree techniques are used to further analyze the performance of the LIDAR parameter-based aerosol classification methods. The goal of GLM and regression tree analyses is to compare and contrast distinct classification data schemes, and compare the results with the measured aerosol reflection data in the atmosphere. The detailed statistical comparisons and analyses shows that the optical methods adopted in this study for classification and prediction of various harmful aerosol types such as soot, carbon monoxide (CO), sulfates (SOx), and nitrates (NOx) are efficient under appropriate functional distributions. The article offers a method for natural ordering of the aerosol types

Access and use of interventions to prevent and treat malaria among pregnant women in Kenya and Mali: a qualitative study.

BACKGROUND: Coverage of malaria in pregnancy interventions in sub-Saharan Africa is suboptimal. We undertook a systematic examination of the operational, socio-economic and cultural constraints to pregnant women's access to intermittent preventive treatment (IPTp), long-lasting insecticide-treated nets (LLINs) and case management in Kenya and Mali to provide empirical evidence for strategies to improve coverage. METHODS: Focus group discussions (FGDs) were held as part of a programme of research to explore the delivery, access and use of interventions to control malaria in pregnancy. FGDs were held with four sub-groups: non-pregnant women of child bearing age (aged 15-49 years), pregnant women or mothers of children aged <1 year, adolescent women, and men. Content analysis was used to develop themes and sub-themes from the data. RESULTS: Women and men's perceptions of the benefits of antenatal care were generally positive; motivation among women consisted of maintaining a healthy pregnancy, disease prevention in mother and foetus, checking the position of the baby in preparation for delivery, and ensuring admission to a facility in case of complications. Barriers to accessing care related to the quality of the health provider-client interaction, perceived health provider skills and malpractice, drug availability, and cost of services. Pregnant women perceived themselves and their babies at particular risk from malaria, and valued diagnosis and treatment from a health professional, but cost of treatment at health facilities drove women to use herbal remedies or drugs bought from shops. Women lacked information on the safety, efficacy and side effects of antimalarial use in pregnancy. CONCLUSION: Women in these settings appreciated the benefits of antenatal care and yet health services in both countries are losing women to follow-up due to factors that can be improved with greater political will. Antenatal services need to be patient-centred, free-of-charge or highly affordable and accountable to the women they serve

Infections bucco-dentaires en milieu psychiatrique de l’hôpital de Point-G : Observations de 130 cas.

Objectif : Analyser l’influence de la maladie mentale sur l’état de santé bucco-dentaire des patients psychiatriques. Matériels et méthode : Nous avons réalisé une étude prospective, transversale et descriptive basée sur l’observation des lésions bucco-dentaires chez les patients reçus en consultation psychiatrique. Elle s’est déroulée dans le service de Psychiatrie du Centre HospitaloUniversitaire du Point G pendant un mois (de juin à juillet 2014). La population cible était les patients psychiatriques connus suivis et/ou hospitalisés dans le service pendant la période de l'étude. Les données ont été recueillies à partir des dossiers médicaux et un questionnaire et saisies puis analysées avec le logiciel Epi info fr 6.0. Résultats : Pendant la période d’étude, 130 patients ont été retenus selon nos critères d’inclusion, dont 70,0% pour le sexe masculin avec un sex ratio de 2,3. La tranche d’âge 25- 34 ans était la plus représentée, soit 31,50%. . La majorité de nos patients présentaient une abrasion dentaire, soit 90,80% des cas. L’indice CAO/D de notre population était de 5,22. L’halitose et la sècheresse buccale étaient fréquentes chez les patients atteints de psychose chronique, soit respectivement 63,50% et 56,90% des cas. La gingivorragie a été observé chez 61,10% des patients atteints de psychose chronique.Conclusion : Cette étude montre la fréquence élevée de l’infection bucco-dentaire en milieu psychiatrique, d’où l’intérêt d’un partenariat entre professionnels de la santé mentale et ceux de la cavité buccal

Intermittent preventive treatment of malaria provides substantial protection against malaria in children already protected by an insecticide-treated bednet in Mali: a randomised, double-blind, placebo-controlled trial.

BACKGROUND: Previous studies have shown that in areas of seasonal malaria transmission, intermittent preventive treatment of malaria in children (IPTc), targeting the transmission season, reduces the incidence of clinical malaria. However, these studies were conducted in communities with low coverage with insecticide-treated nets (ITNs). Whether IPTc provides additional protection to children sleeping under an ITN has not been established. METHODS AND FINDINGS: To assess whether IPTc provides additional protection to children sleeping under an ITN, we conducted a randomised, double-blind, placebo-controlled trial of IPTc with sulphadoxine pyrimethamine (SP) plus amodiaquine (AQ) in three localities in Kati, Mali. After screening, eligible children aged 3-59 mo were given a long-lasting insecticide-treated net (LLIN) and randomised to receive three rounds of active drugs or placebos. Treatments were administered under observation at monthly intervals during the high malaria transmission season in August, September, and October 2008. Adverse events were monitored immediately after the administration of each course of IPTc and throughout the follow-up period. The primary endpoint was clinical episodes of malaria recorded through passive surveillance by study clinicians available at all times during the follow-up. Cross-sectional surveys were conducted in 150 randomly selected children weekly and in all children at the end of the malaria transmission season to assess usage of ITNs and the impact of IPTc on the prevalence of malaria, anaemia, and malnutrition. Cox regression was used to compare incidence rates between intervention and control arms. The effects of IPTc on the prevalence of malaria infection and anaemia were estimated using logistic regression. 3,065 children were screened and 3,017 (1,508 in the control and 1,509 in the intervention arm) were enrolled in the study. 1,485 children (98.5%) in the control arm and 1,481 (98.1%) in the intervention arm completed follow-up. During the intervention period, the proportion of children reported to have slept under an ITN was 99.7% in the control and 99.3% in intervention arm (p = 0.45). A total of 672 episodes of clinical malaria defined as fever or a history of fever and the presence of at least 5,000 asexual forms of Plasmodium falciparum per microlitre (incidence rate of 1.90; 95% confidence interval [CI] 1.76-2.05 episodes per person year) were observed in the control arm versus 126 (incidence rate of 0.34; 95% CI 0.29-0.41 episodes per person year) in the intervention arm, indicating a protective effect (PE) of 82% (95% CI 78%-85%) (p<0.001) on the primary endpoint. There were 15 episodes of severe malaria in children in the control arm compared to two in children in the intervention group giving a PE of 87% (95% CI 42%-99%) (p = 0.001). IPTc reduced the prevalence of malaria infection by 85% (95% CI 73%-92%) (p<0.001) during the intervention period and by 46% (95% CI 31%-68%) (p<0.001) at the end of the intervention period. The prevalence of moderate anaemia (haemoglobin [Hb] <8 g/dl) was reduced by 47% (95% CI 15%-67%) (p<0.007) at the end of intervention period. The frequencies of adverse events were similar between the two arms. There was no drug-related serious adverse event. CONCLUSIONS: IPTc given during the malaria transmission season provided substantial protection against clinical episodes of malaria, malaria infection, and anaemia in children using an LLIN. SP+AQ was safe and well tolerated. These findings indicate that IPTc could make a valuable contribution to malaria control in areas of seasonal malaria transmission alongside other interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT00738946. Please see later in the article for the Editors' Summary

The intensification of thermal extremes in west Africa

International audienceThis study aims in filling the gap in understanding the relationship between trend and extreme in diurnal and nocturnal temperatures (Tx and Tn) over the Gulf of Guinea area and the Sahel. Time-evolution and trend of Tx and Tn anomalies, extreme temperatures and heat waves are examined using regional and station-based indices over the 1900–2012 and 1950–2012 periods respectively. In investigating extreme temperature anomalies and heat waves, a percentile method is used. At the regional and local scales, rising trends in Tx and Tn anomalies, which appear more pronounced over the past 60 years, are identified over the two regions. The trends are characterized by an intensification of: i) nocturnal/Tn warming over the second half of the 20th century; and ii) diurnal/Tx warming over the post-1980s. This is the same scheme with extreme warm days and warm nights. Finally annual number of diurnal and nocturnal heat waves has increase over the Gulf of Guinea coastal regions over the second half of the 20th century, and even more substantially over the post-1980s period. Although this trend in extreme warm days and nights is always overestimated in the simulations, from the Coupled Model Intercomparison Project Phase 5 (CMIP5), those models display rising trends whatever the scenario, which are likely to be more and more pronounced over the two regions in the next 50 years

A Comparison of the Sensitivity and Fecal Egg Counts of the McMaster Egg Counting and Kato-Katz Thick Smear Methods for Soil-Transmitted Helminths

Currently, in public health, the reduction in the number of eggs excreted in stools after drug administration is used to monitor the efficacy of drugs against parasitic worms. Yet, studies comparing diagnostic methods for the enumeration of eggs in stool are few. We compared the Kato-Katz thick smear (Kato-Katz) and McMaster egg counting (McMaster) methods, which are commonly used diagnostic methods in public and animal health, respectively, for the diagnosis and enumeration of eggs of roundworms, whipworms and hookworms in 1,536 stool samples from children in five trials across Africa, Asia and South America. The Kato-Katz method was the most sensitive for the detection of roundworms, but there was no significant difference in sensitivity between the methods for hookworms and whipworms. The sensitivity of the methods differed across the trials and magnitude of egg counts. The Kato-Katz method resulted in significantly higher egg counts, but these were subject to lack of accuracy caused by intrinsic properties of this method. McMaster provided more reliable estimates of drug efficacies. We conclude that the McMaster is an alternative method for monitoring large-scale treatment programs. It allows accurate monitoring of drug efficacy and can be easily performed under field conditions

A Research Agenda for Helminth Diseases of Humans: Intervention for Control and Elimination

Recognising the burden helminth infections impose on human populations, and particularly the poor, major intervention programmes have been launched to control onchocerciasis, lymphatic filariasis, soil-transmitted helminthiases, schistosomiasis, and cysticercosis. The Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), was given the mandate to review helminthiases research and identify research priorities and gaps. A summary of current helminth control initiatives is presented and available tools are described. Most of these programmes are highly dependent on mass drug administration (MDA) of anthelmintic drugs (donated or available at low cost) and require annual or biannual treatment of large numbers of at-risk populations, over prolonged periods of time. The continuation of prolonged MDA with a limited number of anthelmintics greatly increases the probability that drug resistance will develop, which would raise serious problems for continuation of control and the achievement of elimination. Most initiatives have focussed on a single type of helminth infection, but recognition of co-endemicity and polyparasitism is leading to more integration of control. An understanding of the implications of control integration for implementation, treatment coverage, combination of pharmaceuticals, and monitoring is needed. To achieve the goals of morbidity reduction or elimination of infection, novel tools need to be developed, including more efficacious drugs, vaccines, and/or antivectorial agents, new diagnostics for infection and assessment of drug efficacy, and markers for possible anthelmintic resistance. In addition, there is a need for the development of new formulations of some existing anthelmintics (e.g., paediatric formulations). To achieve ultimate elimination of helminth parasites, treatments for the above mentioned helminthiases, and for taeniasis and food-borne trematodiases, will need to be integrated with monitoring, education, sanitation, access to health services, and where appropriate, vector control or reduction of the parasite reservoir in alternative hosts. Based on an analysis of current knowledge gaps and identification of priorities, a research and development agenda for intervention tools considered necessary for control and elimination of human helminthiases is presented, and the challenges to be confronted are discussed