Mapping Digital Media: Poland

The Mapping Digital Media project examines the global opportunities and risks created by the transition from traditional to digital media. Covering 60 countries, the project examines how these changes affect the core democratic service that any media system should provide: news about political, economic, and social affairs.Digital switch-over of terrestrial broadcasting in Poland may still be almost a year away, but the lead-up and preparations to it have shed light on the most entrenched problems facing the country's public service broadcasters.This study of the impact of digitization on Polish media highlights the delays in digitization caused by political infighting; the lack of technical and financial assistance to ensure that the most vulnerable members of society benefit from digitization and new media; and the funding crisis afflicting public broadcasting. The political and economic position of the public broadcaster is critical in the digitization of broadcasting in Poland, both because of its continued—albeit diminishing—role in the media market, and because of its extensive involvement in the preparations for the switch-over.The authors of this report assess that the initiatives to inform the public about how digitization will affect them have been insufficient. Appropriate provisions should swiftly be put in place. Other major recommendations include a revision of spectrum allocation criteria to improve access for those "third way" broadcasters such as religious, educational, civil society or local government outlets, and the need for a durable solution to the public broadcasting funding crisis

α-Thalassemia Impairs the Cytoadherence of Plasmodium falciparum-Infected Erythrocytes

α-Thalassemia results from decreased production of α-globin chains that make up part of hemoglobin tetramers (Hb; α(2)β(2)) and affects up to 50% of individuals in some regions of sub-Saharan Africa. Heterozygous (-α/αα) and homozygous (-α/-α) genotypes are associated with reduced risk of severe Plasmodium falciparum malaria, but the mechanism of this protection remains obscure. We hypothesized that α-thalassemia impairs the adherence of parasitized red blood cells (RBCs) to microvascular endothelial cells (MVECs) and monocytes--two interactions that are centrally involved in the pathogenesis of severe disease.We obtained P. falciparum isolates directly from Malian children with malaria and used them to infect αα/αα (normal), -α/αα and -α/-α RBCs. We also used laboratory-adapted P. falciparum clones to infect -/-α RBCs obtained from patients with HbH disease. Following a single cycle of parasite invasion and maturation to the trophozoite stage, we tested the ability of parasitized RBCs to bind MVECs and monocytes. Compared to parasitized αα/αα RBCs, we found that parasitized -α/αα, -α/-α and -/-α RBCs showed, respectively, 22%, 43% and 63% reductions in binding to MVECs and 13%, 33% and 63% reductions in binding to monocytes. α-Thalassemia was associated with abnormal display of P. falciparum erythrocyte membrane protein 1 (PfEMP1), the parasite's main cytoadherence ligand and virulence factor, on the surface of parasitized RBCs.Parasitized α-thalassemic RBCs show PfEMP1 display abnormalities that are reminiscent of those on the surface of parasitized sickle HbS and HbC RBCs. Our data suggest a model of malaria protection in which α-thalassemia ameliorates the pro-inflammatory effects of cytoadherence. Our findings also raise the possibility that other unstable hemoglobins such as HbE and unpaired α-globin chains (in the case of β-thalassemia) protect against life-threatening malaria by a similar mechanism

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

CONTRAINTES DES MERES D’ENFANTS PIEDS BOTS AU CENTRE NATIONAL D’APPAREILLAGE ORTHOPEDIQUE DU MALI

L’étude intitulée « Les contraintes des mères d’enfants pieds bots du Centre National d’Appareillage Orthopédique du Mali », a été réalisée de juillet à septembre 2022 au CNAOM. Il s'agissait d'une étude rétrospective et descriptive portant sur 168 mères d'enfants pieds bots ayant bénéficié de la méthode Ponseti comme traitement. Sur les 168 mères d'enfants pieds bots reçues, 30 mères d'enfants pieds bots ont répondu aux critères d'inclusion. L'objectif général de l'étude était d'analyser les contraintes des mères d’enfants pieds bots pris en charge par la méthode Ponseti au CNAOM du 1er janvier 2012 au 31 décembre 2016.  Excel et World ont été utilisés. Les résultats obtenus sont : la majorité des enfants (83 %) avait un âge compris entre 0 et 6 mois, le sexe masculin représentait 57 % avec un sexe ratio de 1,30 ; la durée du traitement est perçue comme longue pour 70 % et très longue selon 30 % des participantes, la difficulté majeure rencontrée par les mères d’enfants pieds bots reste le problème d’ordre financier et la durée de l’attente soit respectivement 46,67% et 33,33%

VECUS PSYCHOSOCIAUX DES MERES D’ENFANTS PIEDS BOTS AU CENTRE NATIONAL D’APPAREILLAGE ORTHOPEDIQUE DU MALI

L’étude traite les « vécus psychosociaux des mères d’enfants pieds bots au Centre National d’Appareillage Orthopédique du Mali ». Il s'agissait d'une étude rétrospective et descriptive portant sur une cible exhaustive prévisionnelle de 168 mères d'enfants pieds bots ayant bénéficié de la méthode Ponseti comme traitement au CNAOM. Sur les 168 mères d'enfants pieds bots reçues, 30 mères d'enfants pieds bots ont répondu aux critères d'inclusion. L'objectif général de l'étude était d'analyser les vécus psychosociaux du pied bot sur les mères par la méthode Ponseti. Au terme des travaux, les résultats ont révélé que les mères venaient de toutes les communes de Bamako, principalement de la commune VI, I, V, respectivement 26 %, 24 % et 21 %. Toutes les mères (100 %) d'enfants pieds bots ont eu une hantise et la majeure partie des mères (93 %) des enfants pieds bots ne dormait pas la nuit. La moitié des mères (50 %) se culpabilisaient de la venue de l'enfant pied bot, tandis que 70 % ont eu une vie conjugale affectée ; 93,3 % des mères ont été victimes de mauvaises attitudes des membres de la famille ou des voisins face au pied bot de leurs enfants

Distribution and morphology of knobs on the surface of parasitized RBCs.

<p>Atomic force micrographs (AFMs) of parasitized −α/αα (HE) (<b>a,d</b>) and −α/−α (HO) (<b>b,e</b>) RBCs obtained from naturally-parasitized Malian children with malaria and −/−α (HH) (<b>c,f</b>) RBCs infected with a laboratory-adapted <i>P. falciparum</i> clone showing normal (<b>a,b</b>) or abnormal (<b>c–f</b>) knob distributions and morphologies. AFM images are representative of 32, 10 and 18 images of parasites in −α/αα, −/−αα and −/−α RBCs. Inlays show YOYO-1-stained parasites that correspond to those imaged by AFM. Comparison AFMs of parasitized HbA, HbC and HbS RBCs have been reported previously <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0037214#pone.0037214-Arie1" target="_blank">[22]</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0037214#pone.0037214-Cholera1" target="_blank">[37]</a>.</p

Relative cytoadherence and surface PfEMP1 levels of parasitized RBCs. a,

<p>Adherence of parasitized RBCs to MVECs. The numbers of parasitized −α/αα (HE), −α/−α (HO) and −/−α (HH) RBCs adhering to MVECs were normalized to those of parasitized αα/αα RBCs tested in parallel. The mean (± SEM) number of parasitized αα/αα RBCs per 100 MVECs was 260±40, <i>N</i> = 19. Results were obtained from 19 naturally-circulating parasite isolates and 2 laboratory-adapted parasite clones (A4tres and FCR-3), multiple blood donors (5 αα/αα, 2−α/αα, 2 −α/−α and 2−/−α), and 4 MVEC donors (not all combinations tested). This resulted in −α/αα, −α/−α and −/−α samples being compared to αα/αα samples 12, 5 and 4 times. <b>b,</b> Adherence of parasitized RBCs to monocytes. The numbers of parasitized −α/αα, −α/−α and −/−α RBCs adhering to monocytes were normalized to those of αα/αα RBCs tested in parallel. The mean (± SEM) number of parasitized αα/αα RBCs per 100 monocytes was 136±10, <i>N</i> = 12. Results were obtained from 3 naturally-circulating parasite isolates and 3 laboratory-adapted parasite clones (3D7, A4tres and FCR-3), multiple blood donors (5 αα/αα, 3 −α/αα, 2 −α/−α and 2−/−α) and 4 monocyte donors (not all combinations tested). This resulted in −α/αα, −α/−α and −/−α samples being compared to αα/αα samples 20, 3 and 4 times. The αα/αα and −α/αα RBCs were different from those used in endothelial cell adherence assays. <b>c,</b> PfEMP1 expression levels (median fluorescence intensities, MFI) on the surface of parasitized RBCs. The mean (± SEM) MFI of parasitized αα/αα RBCs was 556±153, <i>N</i> = 6. Results were obtained from 2 laboratory-adapted parasite clones (A4tres, FVO and FCR3^CSA), multiple blood donors (4 αα/αα, 6 −α/αα and 2−/−α), and various concentrations of 2 antisera (not all combinations tested). This resulted in −α/αα, and −/−α samples being compared to αα/αα samples 10 and 6 times. The αα/αα and −α/αα RBCs were different from those used in endothelial cell and monocyte adherence assays.</p

Effect of a fifth round of seasonal malaria chemoprevention in children aged 5–14&nbsp;years in Dangassa, an area of long transmission in Mali

Despite a significant reduction in the burden of malaria in children under five years-old, the efficient implementation of seasonal malaria chemoprevention (SMC) at large scale remains a major concern in areas with long malaria transmission. Low coverage rate in the unattainable areas during the rainy season, a shift in the risk of malaria to older children and the rebound in malaria incidence after stopping drug administration are mainly reported in these areas. These gaps represent a major challenge in the efficient implementation of SMC measures. An open randomized study was conducted to assess the effect of a fifth additional round to current regime of SMC in older children living in Dangassa, a rural malaria endemic area. Poisson regression Model was used to estimate the reduction in malaria incidence in the intervention group compared to the control group including age groups (5-9 and 10-14&nbsp;years) and the use of long-lasting insecticidal nets (LLINs; Yes or No) with a threshold at 5%. Overall, a downward trend in participation rate was observed from August (94.3%) to November (87.2%). In November (round 4), the risk of malaria incidence was similar in both groups (IRR&nbsp;=&nbsp;0.66, 95%CI [0.35-1.22]). In December (round 5), a decrease of 51% in malaria incidence was observed in intervention group compared to control group adjusted for age groups and the use of LLINs (IRR&nbsp;=&nbsp;0.49, 95%CI [0.26-0.94]), of which 17% of reduction is attributable to the 5th round in the intervention group. An additional fifth round of SMC resulted in a significant reduction of malaria incidence in the intervention group. The number of SMC rounds could be adapted to the local condition of malaria transmission

A Decade of Progress Accelerating Malaria Control in Mali: Evidence from the West Africa International Center of Excellence for Malaria Research

This article highlights over a decade of signature achievements by the West Africa International Centers for Excellence in Malaria Research (WA-ICEMR) and its partners toward guiding malaria prevention and control strategies. Since 2010, the WA-ICEMR has performed longitudinal studies to monitor and assess malaria control interventions with respect to space-time patterns, vector transmission indicators, and drug resistance markers. These activities were facilitated and supported by the Mali National Malaria Control Program. Research activities included large-scale active and passive surveillance and expanded coverage of universal long-lasting insecticide-treated bed nets and seasonal malaria chemopre-vention (SMC). The findings revealed substantial declines in malaria occurrence after the scale-up of control interventions in WA-ICEMR study sites. WA-ICEMR studies showed that SMC using sulfadoxine-pyrimethamine plus amodiaquine was highly effective in preventing malaria among children under 5 years of age. An alternative SMC regimen (dihydroartemisinin plus piperaquine) was shown to be potentially more effective and provided advantages for acceptability and compliance over the standard SMC regimen. Other findings discussed in this article include higher observed multiplicity of infection rates for malaria in historically high-endemic areas, continued antimalarial drug sensitivity to Plasmodium falciparum, high outdoor malaria transmission rates, and increased insecticide resistance over the past decade. The progress achieved by the WA-ICEMR and its partners highlights the critical need for maintaining current malaria control interventions while developing novel strategies to disrupt malaria transmission. Enhanced evaluation of these strategies through research partnerships is particularly needed in the wake of reported artemisinin resistance in Southeast Asia and East Africa