Ostéo-arthrites tuberculeuses inhabituelles multifocales chez une patiente immunocompétente

Les formes multifocales de la tuberculose, surviennent habituellement chez des sujets immunodéprimés. Dans les formes multifocales, certaines localisations osseuses sont rares. Les auteurs rapportent le cas d'une patiente de 58 ans, immunocompétente qui présentait une tuberculose multifocale associant une atteinte pulmonaire et des localisations osseuses et articulaires inhabituelles (l'épaule, la cheville et le pied homolatéral, la branche illio-pubienne). Le diagnostic a été histologique (biopsie ostéo-articulaire) et bactériologique (mise en évidence des BAAR dans les crachats). Le traitement a été médico-chirurgical

Impact of fermentation and incorporation of cashew flour on the micronutrient and macronutrient contents of millet flour sold in the market: case of the city of Yamoussoukro

The weaning period of an infant, which should begin from 7 months, is characterized by the gradual change from a liquid to a solid diet. After 6 months, the nutrients contained in breast milk are no longer sufficient to meet the growing demands of the infant. This is the ideal period for the introduction of a complementary food to make up for any deficiencies. To contribute to this situation, two groups, each consisting of five combinations of millet flour, enriched with cashew flour were formulated. The samples M100A0 (Unenriched millet flour), M92,5A7,5, M85A15, M77, 5A22,5 and M70A30 were enriched with 7.5%, 15%, 22,5% and 30% downgraded cashew flour, respectively. The samples MF100A0 (Unenriched fermented millet flour), MF92, 5A7,5, MF85A15, MF77, 5A22,5 and MF70A30 were constructed in a corresponding manner, the only difference being that the millet flour was fermented. After analyses of the different formulations, the best proportions of proteins were observed in MF70A30, MF77, 5A22, 5 and M70A30, which were 13.13%, 12.25% and 12.25%, respectively. Samples M70A30 and M77,5A22,5 exhibited the best iron contents of 8.44 ppm and 8.12 ppm, respectively. The protein contents of the unfortified samples M100A0 and MF100A0 were 7.53% and 6.13% respectively. Formulations MF70A30, M77,5A2,5 and M70A30 with levels of 1.06 ppm, 0.98 ppm and 0.98 ppm, respectively, gave the best zinc contents. The moisture contents of the formulated samples had minimal changes. They varied between 6.16 ± 0.06% and 7.6 ± 0.99% for unfermented samples, and between 6.35 ± 0.32% and 7.0 ± 0.02% for fermented samples. The humidity values of the two groups of samples were not significantly different at P≤0.05. These low moisture contents in the flours are important for better preservation. At the end of this study, certain formulations were selected because of their good nutritional profile. Thus the formulations M70A30 composed of 70% millet flour and 30% cashew flour and MF70A30 composed of 70% fermented millet flour and 30% cashew flour present the best options and could be used as quality infant flours.&nbsp

Andean Pastures in the Fourth Region of Chile: Marginal Lands and Vital Spaces for a Transhumance System

In the fourth region of Chile, the high Andean pastures between Chile and Argentina are the summer destination for transhumant shepherds and sustain a part of the regional livestock. Since 2000, Chile has prohibited the passage of livestock to Argentina for animal health reasons in spite of official registers indicating that 60 to 75% of the summer transhumance livestock had an Argentine destination. Under those conditions it is questionable whether the Andean Chilean grasslands can absorb the increased pastoral demand without suffering damage. The objective is to provide elements of an answer to this question regarding the distribution and availability of the Andean forage resource and its modalities of explotation in the local transhumance system

Tuberculose ostéoarticulaire (mal de Pott exclu) : à propos de 120 cas à Abidjan

Introduction: La tuberculose ostéoarticulaire (TOA) représente 2 à 5 % de l'ensemble des tuberculoses .Elle demeure d'actualité surtout dans les pays à forte endémicité tuberculeuse. L'objectif était de déterminer la prévalence, les aspects topographiques, radiologiques de la TOA en milieu hospitalier ivoirien. Méthodes: Les auteurs rapportent une expérience de 11 ans, à travers une étude rétrospective de 120 dossiers de patientsatteints de la tuberculose ostéoarticulaire (le mal de Pott est exclu de cette étude).N'ont pas été inclus dans l'étude les dossiers ne comportant pas d'imagerie. Résultats: L'atteinte extra vertébrale représentait 09,2% de la tuberculose ostéoarticulaire. Il s'agissait de 54 hommes et 66 femmes, l'âge moyen était de 43,13 ans. On notait 123 cas d'ostéoarthrites, et 8 cas d'ostéites des os plats. L'atteinte des membres inférieurs prédominait dans 91,87% des cas. La hanche était la première localisation (45,04%), suivie du genou (25,19%). Les atteintes étaient multifocales dans 20% des cas. L'atteinte osseuse était associée à une tuberculose pulmonaire dans 05,83% des cas. Des localisations inhabituelles ont été rapportées : poignet (n=2), branches ischiopubiennes (n=4), atteinte sternoclaviculaire (n=4), médiopieds (n=2). Les lésions radiologiques étaient avancées (stades III et IV) dans 55,73% des cas. A la TDM, la prévalence des abcès était de 77%. Un geste chirurgical a été réalisé sur 16 articulations (2 épaules, 13 genoux, une cheville). Conclusion: La TOA des membres est peu fréquente contrairement à l'atteinte vertébrale. La hanche est la principale localisation. Le retard au diagnostic explique l'étendue des lésions anatomoradiologiques

Improving coverage of antenatal iron and folic acid supplementation and malaria prophylaxis through targeted information and home deliveries in Côte d'Ivoire: a cluster randomised controlled trial

INTRODUCTION: Coverage of antenatal iron and folic acid (IFA) supplementation and malaria chemoprophylaxis remains low in many low-income and middle-income settings. We assessed the effectiveness of personal information (INFO) sessions and personal information session plus home deliveries (INFO+DELIV) to increase coverage of IFA supplementation and intermittent preventive treatment in pregnancy (IPTp), and their effectiveness on postpartum anaemia and malaria infection. METHODS: We included 118 clusters randomised to a control (39), INFO (39) and INFO+DELIV (40) arm, in a trial conducted between 2020 and 2021 with pregnant women (age >/=15 years) in their first or second trimester of pregnancy in Taabo, Cote d'Ivoire. We used generalised linear regression models to assess intervention impact in postpartum anaemia and malaria parasitaemia, and displayed resulting estimates as prevalence ratios. RESULTS: Overall, 767 pregnant women were enrolled and 716 (93.3%) were followed up after delivery. Neither intervention had an impact on postpartum anaemia, with estimated adjusted prevalence ratios (aPRs) of 0.97 (95% CI 0.79 to 1.19, p=0.770) for INFO and 0.87 (95% CI 0.70 to 1.09, p=0.235) for INFO+DELIV. While INFO had no effect on malaria parasitaemia (aPR=0.95, 95% CI 0.39 to 2.31, p=0.915), INFO+DELIV reduced malaria parasitaemia by 83% (aPR=0.17, 95% CI 0.04 to 0.75, p=0.019). No improvements in antenatal care (ANC) coverage (aPR=1.05, 95% CI 0.81 to 1.36, p=0.692), IFA (aPR=2.00, 95% CI 0.89 to 4.46, p=0.093) and IPTp (aPR=1.03, 95% CI 0.87 to 1.21, p=0.728) compliance were found for INFO. INFO+DELIV increased ANC attendance (aPR=1.35, 95% CI 1.02 to 1.78, p=0.037) and compliance with IPTp (aPR=1.60, 95% CI 1.41 to 1.80, p<0.001) and IFA recommendations (aPR=7.06, 95% CI 3.68 to 13.51, p<0.001). CONCLUSIONS: INFO+DELIV can substantially increase compliance with IFA supplementation and improve malaria prevention. However, the increases in IFA supplementation are likely insufficient to address the prevalence of often severe anaemia in this population. TRIAL REGISTRATION NUMBER: NCT04250428

Study protocol of a cluster randomized controlled trial of strategies to increase antenatal iron and folic acid supplementation and malaria prophylaxis in rural south-central Côte d'Ivoire

BACKGROUND: Coverage of antenatal iron and folic acid supplementation (IFAS) and intermittent preventive treatment of malaria in pregnancy (IPTp) remains low in many countries. Evidence on the most effective ways to increase both IFASIPTp is mixed overall, with only few studies directly identifying cost-effective ways to increase coverage of both interventions. The proposed study aims to assess the cost, impact and relative cost-effectiveness of two complementary strategies of increasing IFAS and malaria chemoprophylaxis coverage among pregnant women relative to the current default system in a rural low-income setting of sub-Saharan Africa. METHODS/DESIGN: This study will be carried out in the Taabo health and demographic surveillance system (HDSS) in south-central Cote d'Ivoire. This is a cluster-randomized trial targeting 720 consenting pregnant women aged >/=15 years. The 118 clusters constituting the Taabo HDSS monitoring area will be randomly allocated to one of the following three groups with equal probability: a control group, an information only group, and an information plus home delivery group. To assess the relative effectiveness of each strategy, we will conduct an endline survey within the first 2 weeks after delivery. The primary outcomes of the trial will be maternal post-partum anaemia and malaria infection. Anaemia will be assessed using HEMOCUE devices; malaria infections will be assessed using standard rapid diagnostic tests named CareStart Malaria Pf (HRP2) Ag RDT (Multi Kit with capped lancet and inverted cup specimen transfer device). Other outcomes will include self-reported adherence to supplementation and malaria chemoprophylaxis, as well as miscarriages, stillbirths and low birth weight deliveries. DISCUSSION: This study will assess the cost-effectiveness of two alternative strategies to increase antenatal IFAS and malaria chemoprophylaxis coverage among pregnant women in rural Cote d'Ivoire and similar settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT04250428 ; Registered 31 January 2020