Malaria control and elimination in sub-Saharan Africa: data from antenatal care centres.

Although the burden of malaria is progressively declining in most of sub-Saharan Africa, it remains a huge public health issue with complex challenges, such as the rise of drug and insecticide resistance, low coverage of existing preventive strategies, scarcity of safe and effective vaccines, and weakness of public health systems.1 Malaria prevalence surveillance is one of the key cornerstones for achieving malaria control and elimination. WHO’s Global Technical Strategy for malaria has highlighted the importance of malaria surveillance as the third pillar for moving closer to malaria elimination

Antipyretic effect of ibuprofen in Gabonese children with uncomplicated falciparum malaria: a randomized, double-blind, placebo-controlled trial

<p>Abstract</p> <p>Background</p> <p>Antipyretic drugs are widely used in children with fever, though there is a controversy about the benefit of reducing fever in children with malaria. In order to assess the effect of ibuprofen on fever compared to placebo in children with uncomplicated <it>Plasmodium falciparum </it>malaria in Gabon, a randomized double blind placebo controlled trial, was designed.</p> <p>Methods</p> <p>Fifty children between two and seven years of age with uncomplicated malaria were included in the study. For the treatment of fever, all patients "received" mechanical treatment when the temperature rose above 37.5°C. In addition to the mechanical treatment, continuous fanning and cooling blanket, patients were assigned randomly to receive ibuprofen (7 mg/kg body weight, every eight hours) or placebo.</p> <p>Results</p> <p>The fever clearance time using a fever threshold of 37.5°C was similar in children receiving ibuprofen compared to those receiving placebo. The difference was also not statistically significant using a fever threshold of 37.8°C or 38.0°C. However, the fever time and the area under the fever curve were significantly smaller in the ibuprofen group compared to the placebo group.</p> <p>Conclusion</p> <p>Ibuprofen is effective in reducing the time with fever. The effect on fever clearance is less obvious and depends on definition of the fever threshold.</p> <p>Trial registration</p> <p>The trial registration number is: NCT00167713</p

Haplotype specific-sequencing reveals MBL2 association with asymptomatic Plasmodium falciparum infection

<p>Abstract</p> <p>Background</p> <p>Mannose binding lectin (MBL) has an important role in the activation of the complement system and opsonization of pathogenic microorganisms. Frequent polymorphisms found in the <it>MBL2 </it>gene affect the concentration and functionality of the protein and are associated with enhanced susceptibility to severe malaria in African children. Most <it>MBL2 </it>typing strategies were designed to the analysis of selected variants, the significance of whole haplotypes is poorly known. In this work, a new typing strategy was developed and validated in an association analysis of <it>MBL2 </it>with adult asymptomatic infection.</p> <p>Methods</p> <p><it>MBL2 </it>allele-specific fragments of 144 healthy Gabonese adults were amplified by using haplotype-specific sequencing (HSS), a new strategy that combines sequence-specific PCR and sequence-based typing. The Gabonese were investigated for the presence of <it>Plasmodium falciparum </it>parasitaemia by the amplification of parasite genes, immunochromatographic antigen detection and microscopic analysis. HSS results were also compared with a previously used real-time PCR (RT-PCR) method in 72 Euro-Brazilians.</p> <p>Results</p> <p>Fourteen polymorphisms were identified beside the commonly investigated promoter (<it>H, L</it>; <it>X, Y</it>; <it>P, Q</it>) and exon 1 (<it>A, O</it>; <it>O </it>= <it>B</it>, <it>C </it>or <it>D</it>) variants. The <it>MBL2*LYPA/LYPA </it>genotype was associated with the absence of asymptomatic infection (P = 0.017), whereas the <it>MBL2*LYQC </it>haplotype and <it>YA/YO </it>+ <it>YO/YO </it>genotypes were associated with positive parasite counts in asymptomatic adults (P = 0.033 and 0.018, respectively). The associations were specific to <it>LYPA </it>(identical to the reference sequence Y16577) and <it>LYQC </it>(Y16578) and would not have been revealed by standard genotyping, as there was no association with <it>LYPA </it>and <it>LYQC </it>haplotypes carrying new polymorphisms defined by sequence-based typing. In contrast, HSS and RT-PCR produced very similar results in the less diverse European-derived population.</p> <p>Conclusion</p> <p>In this work, a new typing strategy for a highly polymorphic gene was developed and validated focusing on the asymptomatic status of <it>P. falciparum-</it>infected adults. In populations with high nucleotide diversity, it allowed for the identification of associations with fine-scaled haplotypes that would not have been found using common typing techniques. In this preliminary study, <it>MBL2 </it>haplotypes or SNPs linked to them were found associated with susceptibility to infection and parasitaemia control of asymptomatic adults.</p

Assessment of the anti-HBs antibody response in Beninese infants following 4 doses of HBV vaccine, including administration at birth, compared to the standard 3 doses regime; a cross-sectional survey.

Hepatitis B virus (HBV) infection remains one of the major neglected health issues worldwide. In sub-Saharan Africa (SSA), HBV endemicity is high, with more than 8% of the population being chronic HBV carriers. Recently, WHO recommended that all infants should receive their first dose of the HBV vaccine as soon as possible after birth. Unfortunately, the incorporation of a birth dose of HBV in the expanded programme immunization (EPI) has not occurred in the majority of countries in SSA. From April to September 2017, a cross-sectional survey was conducted in two vaccine units located in southern Benin. We assessed the sustained anti-HBs antibody response in infants induced by a standard scheme of 3 doses of HBV vaccination (6, 10, 14 weeks) in comparison to a scheme of 4 doses with a birth dose included (0, 6, 10, 14 weeks). Blood samples were systematically collected in the first 140 children aged 9 months and their mothers who had consented to participate for the detection of HBs antigen and the quantification of anti-HBs antibodies. The prevalence of HBV infection among infants and mothers was 2.2% and 7.1%, respectively. Infants who received 4 doses of HBV vaccine had a significantly higher level of anti-HBs antibody than those who received 3 doses of vaccine (557.9 UI/L vs. 386.9 UI/L, respectively, P = 0.03). We also showed that the scheme of 4 doses was associated with a significantly higher sustained protective response in comparison to the scheme of 3 doses (aOR 2.49, 95% CI 1.03-6.03, P = 0.04). This result provides further evidence of the importance of administering HBV vaccine at birth, but also highlights the importance for the prevention of vertical transmissions. Additional studies are needed to better establish the cost-effectiveness of such a 4 doses immunization strategy before implementing the HBV vaccination at birth in the EPI

Findings of the Survey on Prevention of Plagiarism in Lithuanian Research Journals

AbstractAt the end of 2011, the Association of Lithuanian Serials initiated a survey, which aimed to ascertain whether Lithuanian journal editors, reviewers and authors encountered plagiarism, self-plagiarism and how they understood originality of a paper. Additionally, the survey looked at methods used for plagiarism prevention by editors and reviewers as well as ways, in which editors managed issues related to plagiarism. The survey suggests that no unanimous decision exists regarding the originality of a manuscript and that editors expect reviewers to identify plagiarism with little use of technologies. While answering to survey questions, respondents provided numerous comments. This demonstrates that plagiarism is a burning issue and scientific misconduct policy is needed in Lithuania. The survey was conducted during the period when the Lithuanian Research Council initiated the procedure for establishing the Ombudsman position. The Lithuanian Research Council funded several projects in 2012 and 2013, the aim of which was to familiarise the Lithuanian academic community with plagiarism prevention technologies and ethical aspects in academic publishing. The projects administrated by the Association of Lithuanian Serials provide research journal publishers and researchers related to journal publishing with a possibility of using CrossCheck system and discussing editorial policies

Retrospective analysis of antimicrobial resistance and bacterial spectrum of infection in Gabon, Central Africa

Background: Physicians depend on reliable information on the local epidemiology of infection and antibiotic resistance rates to guide empiric treatment in critically ill patients. As these data are scarce for Central Africa, we performed a retrospective analysis of microbiological findings from a secondary care hospital in Gabon. Methods: Microbiological reports from 2009 to 2012 were used to assess the non-susceptibility rates of the three most common isolates from six major types of infections (bloodstream, ear-eye-nose-throat, surgical site, skin and soft tissue, urinary tract and wound infection). Results: A high diversity of pathogens was found, but Staphylococcus aureus was predominant in the majority of infections. Overall, the three most prevalent pathogens in children were S. aureus (33.7%), Streptococcus pyogenes (8.1%) and Escherichia coli (4.5%) and in adults S. aureus (23.5%), E. coli (15.1%) and Klebsiella pneumoniae (7.4%). In total, 5.8% (n = 19) of all S. aureus isolates were methicillin resistant. The proportion of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae was 15.4% (n = 78), 49.4% of all K. pneumoniae were ESBL-producer (n = 42). Conclusion: The high diversity of potential pathogens and high resistance rates in Gram-negative bacteria challenge a rational empiric use of antibiotics. Countrywide continuous sentinel surveillance is therefore urgently needed.<br