Impact of wastage on single and multi-dose vaccine vials: implications for introducing pneumococcal vaccines in developing countries

Introduction: Pneumococcal conjugate vaccines are expensive relative to those in the EPI systems of low-income countries. The current single-dose presentation costs more to store in the cold chain relative to multi-dose presentations but also has lower wastage rates. It is, therefore, important to determine the optimal balance of vial size and storage costs after adjusting for wastage. Objectives: To project the cost implications of wastage when vaccine wastage rates vary across vial sizes using country specific wastage data. Methods: For each potential vial size, we estimated cold chain costs and the cost of wasted vaccine doses using country level wastage data and projections of the price per dose of vaccine and cold chain storage. Results: Only 19 (26%) of 72 GAVI eligible countries had analyzable wastage data at WHO/HQ. The median wastage rates for single, 2- and 10-dose vials were 5%, 7% and 10% respectively. However wastage varied between 1%-10%, 1%-27% and 4%-44% for single, 2- and 10-dose vials respectively. The increased variance for multi-dose vial wastage implied wastage costs potentially greater than the savings realized from lower storage volumes. Conclusions: The optimal vial-size for PCV is dependent upon country specific wastage rates but few countries have these data. There may be a role for both single and multi-dose vials that is best determined by local management and storage capacities making local wastage data critical. Without effective wastage monitoring and control there is a risk that wastage costs will possibly exceed the savings from multi-dose vials? lower storage costs

Evaluation du cout economique de l’eau d’irrigation dans la zone office du Niger au Mali

L’objet de cet article est d’évaluer le coût économique de l’eau d’irrigation dans la zone Office du Niger (ON) au Mali. Pour l’atteinte des objectifs, deux types de coût ont été estimés (coût financier et coût économique de l’eau d’irrigation. Les données de l’enquête ont été combinées avec la revue de la littérature de l’ON et surtout avec des articles pertinents relatifs au coût économique de l’eau  d’irrigation dans des périmètres irrigués analogues dans d’autres pays africains afin d’alimenter utilement notre analyse critique etdiscussion. Les résultats ont montré que le coût financier est 63 474 FCFA, soit 97 €1 en moyenne et le coût économique est 185 446 FCFA/ha, soit 283 €/ha en moyenne. L’évaluation du coût de l’efficience donne 6 FCFA/m3 soit 0,009 €/m3 qui est supposé très faible. La redevance de l’eau contribue en moyenne 10% à l’entretien de l’ensemble des réseaux hydrauliques. En conclusion, la redevance payée par les producteurs est un coût social qui ne prend pas en compte le coût des aménagements hydro agricoles. Sans l’intervention de l’Etat, la production rizicole dans ce système allait connaitre d’énormes problèmes de rentabilité. Mots-clés : Evaluation-Coût économique-Eau d’irrigation - Office du Niger -Mali.   English title: Evaluation of the economic cost of irrigation water in the office du Niger in Mali The purpose of this article is to assess the economic cost of irrigation water in the Office du Niger area in Mali.To achieve the objectives, two types of cost were estimated (financial cost and economic cost of irrigation water. The data were combined with the review of the Office du Niger literature and especially with relevant articles relating to the economic cost of irrigation water in similar irrigated areas in other African countries to usefully contribute our critical analysis and discussion.The results showed that the average financial cost is about 63,474 FCFA/ha or 97 €/ha and the average economic cost is about 185,446 FCFA/ha or 283 €/ha. The cost of efficiency assessment gives 6 FCFA / m3 or 0.009 € / m3 which is assumed to be very low. Water charges contribute on average of 10% to the maintenance of all hydraulic networks. And the operators’ contribution represents only 4%.In conclusion, the royalty paid by the producers is a social cost which does not take into account the cost of hydro agricultural development. Without state intervention, rice production in this system would experience enormous problems and tertiary hydraulic networks. Keywords : Evaluation-Economic cost- Irrigation water- Office of Niger- Mali

Benchmark instance indicators and computational comparison of methods

chapter 7This chapter is devoted to extensive computational experiments on the resource-constrained project scheduling problem. Its objective is twofold. First, a selection of representative exact and heuristic methods among the ones presented in the previous chapters are tested and compared under a common experimental framework on four different instance sets. Second, classical and new instance difficulty indicators are evaluated through the experiments and their discriminating power is discussed

Caractérisation pathologique in vitro de deightoniella torulosa (Syd.) Ellis sur les cultivars de bananiers figue sucrée (musa AA), grande naine (musa AAA) et orishele (musa AAB)

Deightoniella torulosa est un champignon fréquemment associé aux attaques des cercosporioses sur les principaux cultivars de bananier en Côte-d\'Ivoire. Les symptômes qu\'il induit sont mal connus et les attaques occasionnées en plantation sont négligées. Le champignon a été isolé et son pouvoir pathogène a été mis en évidence sur des fragments de feuilles et des feuilles entières de différents cultivars de bananiers en utilisant différentes concentrations de spores : à 104, 5.104 et 105 spores / ml. Des coupes histologiques ont été aussi réalisées. Les résultats ont mis en évidence l\'activité parasitaire du champignon sur les fragments de feuilles et sur les feuilles entières. La période d\'incubation est de 3 à 5 jours. La germination des spores débute en moins d\'une heure et atteint 95 à 100 % au bout de 4 heures. L\'évolution des symptômes varie en fonction des cultivars. L\'ampleur des attaques s\'est révélée importante lorsque les concentrations de spores sont élevées. Le champignon provoque des attaques sévères pour des concentrations de 105 spores / ml. Ainsi, Deightoniella torulosa induit seul des attaques, colonise les tissus du limbe foliaire et contribue à la sénescence prématurée des feuilles de bananiers.Deightoniella torulosa is a fungus usually associated with symptoms of black sigatoka leaf streak in Côte-d\'Ivoire. The pathogenic activity of the fungus is not well known and its effect on field is neglected. The fungus has been isolated and its pathogenic activity has been determined on leaves of cultivated banana through the use of different concentrations of conidia: 104, 5.104 and 105 spores / ml. Inoculated samples have been fixed for histological observations. Results showed stomata penetration and pathogenic activity of fungus beginning from the third (3rd) to the fifth (5th) day after inoculation. We observed that conidia germination begins in less than 1 hour and reaches 95 to 100 % within 4 hours. The progress of the disease varies according to the according to the banana cultivars and the amount of conidia. 105 spores / ml have induced symptoms. Then, Deightoniella torulosa alone could induce symptoms and was involved in rapid necrosis of infected leaves in natural conditions. Keywords: Deightoniella torulosa, activité parasitaire, inoculations, cultivars de bananiers, sénescence, Côte-d\'Ivoire./Deightoniella torulosa, pathogenic activity, inoculations, cultivated banana, Côte-d\'Ivoire.Sciences & Nature Vol. 4 (2) 2007: pp. 179-18

Management of tuberculosis of the uterine cervix in the University Hospital Center of Treichville

Genital tuberculosis is a rare entity which is classically presented with nonspecific signs posing diagnostic problems. We report the case of a young patient in genital activity, supported in our hospital for tuberculosis of the uterine cervix. She initially consulted for contact metrorrhagia and speculum examination had found an ulcerative budding cervix making suggest a cervical cancer. Finally, the histology of cervical biopsy confirmed the diagnosis of cervical tuberculosis and the patient was treated with anti-bacillary antibiotics. The evolution was favourable marked by declared healing after 6 months of treatment. The objective of this observation is to discuss the epidemiological, clinical and therapeutic characteristics of this affection

Electrical resistivity and ultrasonic measurements during sequential fracture test of cementitious composite

Cracks in cover of reinforced and pre-stressed concrete structures significantly influence the ingress of deleterious species causing decrease in durability of these structures. The paper is focused on the effect of fracture process on two selected physical parameters of concrete – the electrical resistivity and the ultrasonic pulse passing time – which might be employed as the quality indicator of concrete cover within (nondestructive) procedure(s) of assessment of the structural durability. The concrete electrical resistivity and ultrasonic passing time were investigated here with respect to two variants of treatment of the test specimens’ surface (the pre-dried surface and the wet surface). Test configuration of three-point bending of notched beam was utilized to control the crack propagation; the fracture process passed through several loading–unloading sequences between which the electrical resistivity and ultrasonic passing time readings over the fractured region were performed. Equivalent elastic crack model was used for estimation of the fracture advance (described via the effective crack length) at the loading stages corresponding to the resistivity and ultrasonic measurements. Relationships between changes of both the concrete resistivity and ultrasonic pulse passing time and the effective crack length is determined and discussed

1-Benzoyl-3-methyl-2,6-diphenyl-4-piperidone

In the title moleclue, C25H23NO2, the 4-piperidone ring adopts a boat conformation. The mol­ecular conformation is stabilized by an intra­molecular C—H⋯O hydrogen bond. In the crystal, mol­ecules are connected through weak inter­molecular C—H⋯O hydrogen bonds

AF17 Competes With AF9 for Binding to DOT1A to up-Regulate Transcription of Epithelial NA\u3csup\u3e+\u3c/sup\u3e Channel α

We previously reported that Dot1a*AF9 complex represses transcription of the epithelial Na+ channel subunit α (α-ENaC) gene in mouse inner medullary collecting duct mIMCD3 cells and mouse kidney. Aldosterone relieves this repression by down-regulating the complex through various mechanisms. Whether these mechanisms are sufficient and conserved in human cells or can be applied to other aldosterone-regulated genes remains largely unknown. Here we demonstrate that human embryonic kidney 293T cells express the three ENaC subunits and all of the ENaC transcriptional regulators examined. These cells respond to aldosterone and display benzamil-sensitive Na+ currents, as measured by whole-cell patch clamping. We also show that AF17 and AF9 competitively bind to the same domain of Dot1a in multiple assays and have antagonistic effects on expression of an α-ENaC promoter-luciferase construct. Overexpression of Dot1a or AF9 decreased mRNA expression of the ENaC subunits and their transcriptional regulators and reduced benzamil-sensitive Na+ currents. AF17 over-expression caused the opposite effects, accompanied by redirection of Dot1a from the nucleus to the cytoplasm and reduction in histone H3 K79 methylation. The nuclear export inhibitor leptomycin B blocked the effect of AF17 overexpression on H3 K79 hypomethylation. RNAi-mediated knockdown of AF17 yielded nuclear enrichment of Dot1a and histone H3 K79 hypermethylation. As with AF9, AF17 displays nuclear and cytoplasmic co-localization with Sgk1. Therefore, AF17 competes with AF9 to bind Dot1a, decreases Dot1a nuclear expression by possibly facilitating its nuclear export, and relieves Dot1a*AF9-mediated repression of α-ENaC and other target genes

HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

This paper is part of the Special Issue : INDEPTH Network Cause-Specific MortalityAs the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data.To present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB) and pneumonia.Deaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population.The dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates.Measuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS.P. Kim Streatfield ... Yohannes A. Melaku ... et.al