Acetylcholinesterase (ace‑1R) target site mutation G119S and resistance to carbamates in Anopheles gambiae (sensu lato) populations from Mali

Open Access Journal; Published online: 05 Jun 2020Background The long-lasting insecticidal nets (LLINs) and indoor residual spraying of insecticide (IRS) are major malaria vector control strategies in Mali. The success of control strategies depends on a better understanding of the status of malaria vectors with respect to the insecticides used. In this study we evaluate the level of resistance of Anopheles gambiae (sensu lato) to bendiocarb and the molecular mechanism that underlies it. Methods Larvae of An. gambiae (s.l.) were collected from breeding habitats encountered in the three study sites and bioassayed with bendiocarb. The ace-1 target site substitution G119S was genotyped using a TaqMan assay. Results The three species of the An. gambiae complex in Mali, i.e. An. arabiensis, An. coluzzii and An. gambiae (s.s.) were found in sympatry in the three surveyed localities with different frequencies. We observed a resistance and suspicious resistance of the three species to bendiocarb with a mortality rate ranging from 37% to 86%. The allelic frequency of the G119S mutation was higher in An. gambiae (s.s.) compared to the other two species; 42.86%, 25.61% and 16.67% respectively in Dangassa, Koula, and Karadié. The allelic frequency of G119S in An. coluzzii ranged from 4.5% to 8.33% and from 1.43% to 21.15% for An. arabiensis. After exposure to bendiocarb, the G119S mutation was found only in survivors. The survival of Anopheles gambiae (s.l) populations from the three surveyed localities was associated with the presence of the mutation. Conclusions The study highlights the implication of G119S mutation in bendiocarb resistance in An. gambiae (s.s.), An. arabiensis and An. coluzzii populations from the three surveyed localities

Aspects diagnostiques et thérapeutiques des malformations pulmonaires congénitales symptomatiques de l’enfant au Mali

Symptomatic congenital pulmonary malformations (CPM) in child are rare. The diagnosis is based on clinical, radiological and histopathological confrontation. The aim of this study is to derterminate the diagnostic, therapeutic and evolutionary profile of CPM in a poor ressources country. This was a retrospective study over a period of 8 years (from January 2012 to March 2020), including 13 cases treated for CPM in the thoracic surgery department of a teaching hospital in Mali. Among patients, we found 5 cases of congenital lobar emphysema (38.8%), 4 cases of pulmoary cyst (30.8%), 3 cases of cystic adenomatoid malformation of the lung (23%) and 1 case of pulmonary sequestration(7,7%). The sex ratio was 2,2. All patients were symptomatic with an average age of 8,5 months. The symptoms were dominated by respiratory infection (38,4%), dyspnea (30,8%), dyspnea with cyanosis(7,7), dyspnea with thoracic pain (7,7%), respiratory distress (7,7%) and hemoptysis (7,7%). The chest X-ray has allowed to orient the diagnosis in most cases and the thoracic scan set it in 100% of the cases. All the patients underwent surgery by thoracotomy. Lobectomy was done for 53,8 % followed by cystectomy in 30,8%, segmentectomy (7,7%) and pneumonectomy (7,7%) of patients. Histopathological examination confirmed the diagnosis of malformation in all cases. The postoperative outcome was uneventful for all the patients. Clinical manifestations evoks the diagnosis of symptomatic CPM, the chest X-ray allowed to orient it and the thoracic scan set it in all cases. The treatment is mainly surgical. Keywords: Pulmonary malformation, diagnosis, treatment, child, Mali

Trends in malaria epidemiological factors following the implementation of current control strategies in Dangassa, Mali

BACKGROUND: Over the past decade, three strategies have reduced severe malaria cases and deaths in endemic regions of Africa, Asia and the Americas, specifically: (1) artemisinin-based combination therapy (ACT); (2) insecticide-treated bed nets (ITNs); and, (3) intermittent preventive treatment with sulfadoxine-pyrimethamine in pregnancy (IPTp). The rationale for this study was to examine communities in Dangassa, Mali where, in 2015, two additional control strategies were implemented: ITN universal coverage and seasonal malaria chemoprevention (SMC) among children under 5 years old. METHODS: This was a prospective study based on a rolling longitudinal cohort of 1401 subjects participating in bi-annual smear surveys for the prevalence of asymptomatic Plasmodium falciparum infection and continuous surveillance for the incidence of human disease (uncomplicated malaria), performed in the years from 2012 to 2020. Entomological collections were performed to examine the intensity of transmission based on pyrethroid spray catches, human landing catches and enzyme-linked immunosorbent assay (ELISA) testing for circumsporozoite antigen. RESULTS: A total of 1401 participants of all ages were enrolled in the study in 2012 after random sampling of households from the community census list. Prevalence of infection was extremely high in Dangassa, varying from 9.5 to 62.8% at the start of the rainy season and from 15.1 to 66.7% at the end of the rainy season. Likewise, the number of vectors per house, biting rates, sporozoites rates, and entomological inoculation rates (EIRs) were substantially greater in Dangassa. DISCUSSION: The findings for this study are consistent with the progressive implementation of effective malaria control strategies in Dangassa. At baseline (2012–2014), prevalence of P. falciparum was above 60% followed by a significant year-to-year decease starting in 2015. Incidence of uncomplicated infection was greater among children  < 5 years old, while asymptomatic infection was more frequent among the 5–14 years old. A significant decrease in EIR was also observed from 2015 to 2020. Likewise, vector density, sporozoite rates, and EIRs decreased substantially during the study period. CONCLUSION: Efficient implementation of two main malaria prevention strategies in Dangassa substantially contribute to a reduction of both asymptomatic and symptomatic malaria from 2015 to 2020

Complications macro-angiopathiques du diabete a l’hopital du Mali de Bamako

Introduction-objectif: Le diabète est un facteur de risque cardiovasculaire (FRCV) majeur, responsable de complications cardiovasculaires dont la  prise en charge est complexe. L’objectif de l’étude est d’évaluer les  complications macro-angiopathiques du diabète.Patients et Méthodes: Etude transversale, descriptive et analytique de 18 mois, concernant les patients diabétiques (type 1 avec 5 ans d’évolution et type 2).Résultats: Nous avons colligé 275 patients diabétiques. L’âge moyen de nos patients était de 59 ans. Le sex ratio était de 0,82. Le diabète était de type 2 chez 93,09% des patients. La durée moyenne d’évolution du diabète était de 6 ans. L’HbA1c était supérieure à 7% chez 51,64% des patients. 77,46% avaient au minimum 2 FRCV associés au diabète. La dyslipidémie était le FRCV le plus fréquent associé au diabète (51,27%). Quatre-vingt-trois (83) patients sur 275 avaient au moins une  macroangiopathie (fréquence hospitalière de 30,18%). L’artériopathie oblitérante des membres inférieurs (AOMI) était présente chez 49 patients, l’accident vasculaire cérébral (AVC) chez 28 patients et la coronaropathie chez 17 patients. Nous avons noté un lien statistiquement significatif entre durée d’évolution du diabète, et deux complications macro-angiopathiques (AOMI p:0,001 et AVC p:0,05). Le mauvais équilibre glycémique et le nombre de FRCV étaient corrélés aux complications macroangiopathiques (AOMI, AVC, coronaropathie) de façon significative avec p&lt;0,05.Conclusion: Le diabète est une maladie métabolique responsable de complications macro-angiopathiques. Sa prise en charge précoce ainsi qu’une correction des autres FRCV permettent d’éviter ou de ralentir ces complications.Mots clés : Diabète, Macro-angiopathies, Hôpital Du Mali.  Macrovascular complications of diabetes at the hôpital du Mali of Bamako Introduction-Aim: Diabete is a major risk cardiovascular factor (FRCV). It is a chronic disease responsible of cardiovascular complications with a complex management. The objective of the study is to evaluate the macrovascular complications of diabetes.Patients and methods: It is a cross-sectional, descriptive and analytical study of 18 months, concerning diabetic patients (type 1 with 5 years of evolution and type 2).Results: We collected 275 diabetics patients. Mean age of our patients was 59 years. Sex ratio was 0.82. Diabetes was type 2 in 93.09%. Mean duration of diabetes was 6 years. HBA1C was greater than 7% in 51.64%. 77.46% had at least 2 cardiovascular risk factors associated with diabetes. Dyslipidemia was the most common cardiovascular risk factors associated with diabetes (51.27%). 83 of 275 patients had at least one macrovascular complication (hospital frequency of 30.18%). Peripheral artery disease (PAD) was present in 49 patients, stroke in 28 patients, and coronary artery disease in 17 patients. We noted a statistically significant link between the duration of diabetes, and two macrovascular complications (PAD p: 0.001 and stroke p: 0.05). The poor glycemic balance and number of  cardiovascular risk factors were correlated with macrovascular complications (AOMI, stroke, coronary artery disease) significantly with p &lt; 0.05.Conclusion: Diabetes is a metabolic disease responsible of macrovascular complications. Early care and correction of other cardiovascular risk factors can prevent or slow these complications.Keywords: Diabetes, Macrovascular complications, Hôpital Du Mal