Anti-inflammatory, anthropometric and lipomodulatory effects Dyglomera® (aqueous extract of Dichrostachys glomerata) in obese patients with metabolic syndrome

Background: Increased visceral fat, dyslipidemia and increased markers of inflammation and coagulation are cardiovascular risk factors commonly encountered in obese people with metabolic syndrome. Previous studies have shown that ground Dichrostachys glomerata (DG), a spice used in Western Cameroon, can have beneficial effects on inflammation and various other cardiovascular disease risk factors. The purpose of the present study was to evaluate the effects of Dyglomera®, an aqueous extract of DG (standardized to NLT 10% polyphenols) on certain anthropometric, biochemical (including pro-inflammatory and pro-thrombotic states) and hemodynamic parameters in obese patients with metabolic syndrome. Methods: The study was an 8-week randomized, double-blind, placebo-controlled trial involving 116 males and 202 females aged between 24 and 58 years. Participants were randomly divided into two groups: treatment and placebo. Capsules containing the active treatment (200 mg Dyglomera®) or placebo (200 mg maize powder) were administered 30–60 minutes before lunch and dinner throughout the study period. Various biochemical (namely, blood glucose, lipid profile, pro-inflammatory and pro-thrombotic markers), anthropometric and hemodynamic parameters were measured at baseline and after 4 and 8 weeks of treatment.Results: At the end of the study, the Dyglomera® group showed statistically significant differences in all 16 parameters compared to baseline values. Changes in BMI and waist circumference were accompanied by changes in biochemical parameters, with the exception of adiponectin levels which were not correlated to waist circumference and PAI-1 values. The results confirm the hypothesis that Dyglomera®, the aqueous extract of DG, has anti-inflammatory properties, and is effective in reducing cardiovascular disease risk factors associated with metabolic syndrome in obese human subjects

0541: Management of heart failure: experiences in African patients

AimTo determine clinical characteristics and mode of treatment of patients with heart failure in Yaounde military hospital (YMH).MethodsData of patients with heart failure (HF) followed on a period of 6 months in YMH were used to determine clinical characteristics and mode of treatment.ResultsA total of 72 patients were consecutively studied comprising 45 men (62.5%) and 27 women (37.5%) aged 62.8±16.5 and 61.1±19.4 years, respectively. All the patients presented with NYHA functional class III or IV. Alcohol was the most common etiological factor of HF (66.7%) hypertension was the most common risk factor for HF (37.5%) while only 16.7% of the patients were smokers. Global heart failure was the common presentation (60.9%). Left bundle branch was present in 47% of electrocardiograms while 8.7% of the patients were in atrial fibrillation. Dilated cardiomyopathy was the common lesion (80%). Most patients presented with severe left ventricular (LV) systolic dysfunction (66.6%). Male subjects had worse LV systolic dys-function compare to women without significant difference (56.3% vs 43.8% p=0.8). Diabete was not associated with severe LV dysfunction (78.9% on non diabetic vs 6.3% of diabetic patients). Current recommended pharmacology therapies were used in most of the cases. Diuretics were used in 100% while ACE inhibitors were in 91.3% of cases. 52.4% of patients had beta blockers.ConclusionMost heart failure patients in Cameroon present in the sixth decade with severe heart failure. All the recommended therapies are not available in our country

Human Immunodeficiency Virus and Hepatitis C Virus Co-infection in Cameroon: Investigation of the Genetic Diversity and Virulent Circulating Strains

Background: RNA virus infections represent a significant cause of illness and death in vertebrates. Specifically in humans, RNA viruses are responsible for a wide range of acute, chronic, emerging and re-emerging infections. HIV and HCV rank as some of the most severe RNA viruse infections facing Africa. Methods: To determine genotypes and subtypes of HIV and HCV among co-infected patients in Cameroon, viral RNA was isolated from HIV/HCV co-infected individuals, in Douala, Cameroon. A total of 36 HIV/HCV co-infected isolates (22 from volunteer blood donors and 14 from people living with HIV/AIDS not yet on antiretroviral treatment) were analyzed using molecular biology techniques that involved RT-PCR, gene/TOPO cloning, DNA sequencing, and bioinformatics tools for sequence management and analysis. Epidemiological data were examined as well.Results: Results show that HIV strains isolated belong to the circulating recombinant forms CRF02_AG, whereas HCV isolates from Cameroon belong to genotypes 1, 2, and 4. The corresponding HCV subtypes investigated were 1a, 1b, 1c, 2a, 2c, 2k, and 4a. Subtypes 1a and 1b, most frequently found in developed countries, also circulate in Cameroon. Epidemiologic data show that HIV/HCV co-infected patients are older than HIVmono-infected patients.Conclusions: These results indicate that HIV/HCV co-infection represent a significant threat in Cameroon. There is evidence of genetic diversity of HIV and HCV; virulent hepatitis C virus subtypes 1a and 1b circulate in Cameroon. An epidemiological and molecular database on HIV and HCV is necessary for the development of further intervention in Cameroon as an imperative for monitoring disease progression.Key words: HIV; HCV; Co-infection ; Genotypes ; Virulent

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana

Background: Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. Objective: To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. Methods: The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. Results: The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. Conclusion: The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people

Varietal impact on women's labour, workload and related drudgery in processing root, tuber and banana crops. Focus on cassava in sub-Saharan Africa

Open Access ArticleRoots, tubers and cooking bananas are bulky and highly perishable. In Africa, except for yams, their consumption is mainly after transport, peeling and cooking in the form of boiled pieces or dough, a few days after harvest. To stabilize, better preserve the products and, in the case of cassava, release toxic cyanogenic glucosides, a range of intermediate products have been developed, mainly for cassava, related to fermentation and drying after numerous processing operations. This review highlights, for the first time, the impact of genotypes on labour requirements, productivity, and the associated drudgery in processing operations primarily carried out by women processors. Peeling, soaking/grinding/fermentation, dewatering, sieving, and toasting steps were evaluated on a wide range of new hybrids and traditional landraces. The review highlights case studies of gari production from cassava. Results show that, depending on the genotypes used, women's required labour can be more than doubled and even the sum of the weights transported along the process can be up to four times higher for the same quantity of end product. Productivity and loads carried between each processing operation are highly influenced by root shape, ease of peeling, dry matter content and/or fiber content. Productivity and the often related experienced drudgery are key factors to be considered for a better acceptance of new genotypes by actors in the value-addition chain, leading to enhanced adoption, and ultimately to improved livelihoods for women processors

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Immunization with Single-Cycle SIV Significantly Reduces Viral Loads After an Intravenous Challenge with SIVmac239

Strains of simian immunodeficiency virus (SIV) that are limited to a single cycle of infection were evaluated for the ability to elicit protective immunity against wild-type SIVmac239 infection of rhesus macaques by two different vaccine regimens. Six animals were inoculated at 8-week intervals with 6 identical doses consisting of a mixture of three different envelope variants of single-cycle SIV (scSIV). Six additional animals were primed with a mixture of cytoplasmic domain-truncated envelope variants of scSIV and boosted with two doses of vesicular stomatitis virus glycoprotein (VSV G) trans-complemented scSIV. While both regimens elicited detectable virus-specific T cell responses, SIV-specific T cell frequencies were more than 10-fold higher after boosting with VSV G trans-complemented scSIV (VSV G scSIV). Broad T cell recognition of multiple viral antigens and Gag-specific CD4+ T cell responses were also observed after boosting with VSV G scSIV. With the exception of a single animal in the repeated immunization group, all of the animals became infected following an intravenous challenge with SIVmac239. However, significantly lower viral loads and higher memory CD4+ T cell counts were observed in both immunized groups relative to an unvaccinated control group. Indeed, both scSIV immunization regimens resulted in containment of SIVmac239 replication after challenge that was as good as, if not better than, what has been achieved by other non-persisting vaccine vectors that have been evaluated in this challenge model. Nevertheless, the extent of protection afforded by scSIV was not as good as typically conferred by persistent infection with live, attenuated SIV. These observations have potentially important implications to the design of an effective AIDS vaccine, since they suggest that ongoing stimulation of virus-specific immune responses may be essential to achieving the degree of protection afforded by live, attenuated SIV

A preliminary analysis on the effect of copper on Anopheles coluzzii insecticide resistance in vegetable farms in Benin.

The use of agrochemicals in vegetable production could influence the selection for insecticide resistance in malaria vectors. Unfortunately, there is a dearth of information on the potential contribution of agrochemicals to insecticide resistance in Anopheles mosquitoes breeding on vegetable farms in southern Benin. A Knowledge, Attitudes and Practices study was conducted with 75 vegetable farmers from Houeyiho and Seme to determine the main agrochemicals used in vegetable production, and the concentration and frequency of application, among other details. Mosquitoes and breeding water were sampled from the farms for analysis. Bioassays were conducted on mosquitoes, while breeding water was screened for heavy metal and pesticide residue contamination. Lambda-cyhalothrin was the main insecticide (97.5%) used by farmers, and Anopheles coluzzii was the main mosquito identified. This mosquito species was resistant (30-63% mortality rate) to λ-cyhalothrin. It was also observed that 16.7% of the examined breeding sites were contaminated with λ-cyhalothrin residues. Furthermore, copper contamination detected in mosquito breeding sites showed a positive correlation (r = 0.81; P = 0.0017) with mosquito resistance to λ-cyhalothrin. The presence of copper in λ-cyhalothrin-free breeding sites, where mosquitoes have developed resistance to λ-cyhalothrin, suggests the involvement of copper in the insecticide resistance of malaria vectors; this, however, needs further investigation