Caractérisation physico-chimique et bactériologique des eaux usées brutes du réseau d’égout de la ville d’Abidjan

La gestion des eaux résiduaires urbaines pose de nombreux problèmes environnementaux qui deviennent préoccupants pour la santé des populations d’Abidjan. Pour remédier à cela, il est souhaitable de mettre en place des stations d’épurations. Ainsi, notre étude se présente comme une étude préliminaire visant à caractériser sur le plan physico-chimique et bactériologique les effluents du réseau d’égout de la ville d’Abidjan. Pour ce faire, nous avons effectué six campagnes de  prélèvement d’eaux usées durant une  année (Décembre 2013-Novembre 2014) sur huit (8) sites spécifiques du réseau d’égout. Ces échantillons ont fait l’objet  d’analyses physico-chimiques et bactériologiques sur la base des normes Françaises, Canadiennes et celles décrites par Rodier. Les résultats obtenus indiquent qu’à l’exception du phosphore total (PT) dont les concentrations sont comprises entre 4,3±4 et 10,9±6,7mg/l, les autres principaux indicateurs de pollution que sont l’azote total (NTK, 73,3±32 à 118,2±37,6 mg/l), les matières en suspension (MES, 79±23,3 à325,2±270,3 mg/l), la demande biochimique en oxygène en 5 jours (DBO5, 127,3±87,7 à 863,7±262,2 mgO2/l) et la demande chimique en oxygène (DCO, 276,2±195,6 à 975,3±249,4 mgO2/l) sont au-delà des valeurs guidesrecommandées par l’Etat de Côte d’Ivoire à travers le service d’inspection des installations classées (SIIC) en matière de rejet des effluents en milieu récepteur. L’analyse de la flore bactérienne des effluents révèle que les concentrations de coliformes fécaux et les streptocoques fécaux excèdent les valeurs indicatives préconisées par l’OMS.Mots clés : Caractérisation, eaux usées, réseau d’égout, bactériologie, physico-chimie

A Trial of Early Antiretrovirals and Isoniazid Preventive Therapy in Africa

BACKGROUND: In sub-Saharan Africa, the burden of human immunodeficiency virus (HIV)-associated tuberculosis is high. We conducted a trial with a 2-by-2 factorial design to assess the benefits of early antiretroviral therapy (ART), 6-month isoniazid preventive therapy (IPT), or both among HIV-infected adults with high CD4+ cell counts in Ivory Coast. METHODS: We included participants who had HIV type 1 infection and a CD4+ count of less than 800 cells per cubic millimeter and who met no criteria for starting ART according to World Health Organization (WHO) guidelines. Participants were randomly assigned to one of four treatment groups: deferred ART (ART initiation according to WHO criteria), deferred ART plus IPT, early ART (immediate ART initiation), or early ART plus IPT. The primary end point was a composite of diseases included in the case definition of the acquired immunodeficiency syndrome (AIDS), non-AIDS-defining cancer, non-AIDS-defining invasive bacterial disease, or death from any cause at 30 months. We used Cox proportional models to compare outcomes between the deferred-ART and early-ART strategies and between the IPT and no-IPT strategies. RESULTS: A total of 2056 patients (41% with a baseline CD4+ count of ≥500 cells per cubic millimeter) were followed for 4757 patient-years. A total of 204 primary end-point events were observed (3.8 events per 100 person-years; 95% confidence interval [CI], 3.3 to 4.4), including 68 in patients with a baseline CD4+ count of at least 500 cells per cubic millimeter (3.2 events per 100 person-years; 95% CI, 2.4 to 4.0). Tuberculosis and invasive bacterial diseases accounted for 42% and 27% of primary end-point events, respectively. The risk of death or severe HIV-related illness was lower with early ART than with deferred ART (adjusted hazard ratio, 0.56; 95% CI, 0.41 to 0.76; adjusted hazard ratio among patients with a baseline CD4+ count of ≥500 cells per cubic millimeter, 0.56; 95% CI, 0.33 to 0.94) and lower with IPT than with no IPT (adjusted hazard ratio, 0.65; 95% CI, 0.48 to 0.88; adjusted hazard ratio among patients with a baseline CD4+ count of ≥500 cells per cubic millimeter, 0.61; 95% CI, 0.36 to 1.01). The 30-month probability of grade 3 or 4 adverse events did not differ significantly among the strategies. CONCLUSIONS: In this African country, immediate ART and 6 months of IPT independently led to lower rates of severe illness than did deferred ART and no IPT, both overall and among patients with CD4+ counts of at least 500 cells per cubic millimeter. (Funded by the French National Agency for Research on AIDS and Viral Hepatitis; TEMPRANO ANRS 12136 ClinicalTrials.gov number, NCT00495651.)

Effect of isoniazid preventive therapy on risk of death in west African, HIV-infected adults with high CD4 cell counts: long-term follow-up of the Temprano ANRS 12136 trial.

BACKGROUND: Temprano ANRS 12136 was a factorial 2 × 2 trial that assessed the benefits of early antiretroviral therapy (ART; ie, in patients who had not reached the CD4 cell count threshold used to recommend starting ART, as per the WHO guidelines that were the standard during the study period) and 6-month isoniazid preventive therapy (IPT) in HIV-infected adults in Côte d'Ivoire. Early ART and IPT were shown to independently reduce the risk of severe morbidity at 30 months. Here, we present the efficacy of IPT in reducing mortality from the long-term follow-up of Temprano. METHODS: For Temprano, participants were randomly assigned to four groups (deferred ART, deferred ART plus IPT, early ART, or early ART plus IPT). Participants who completed the trial follow-up were invited to participate in a post-trial phase. The primary post-trial phase endpoint was death, as analysed by the intention-to-treat principle. We used Cox proportional models to compare all-cause mortality between the IPT and no IPT strategies from inclusion in Temprano to the end of the follow-up period. FINDINGS: Between March 18, 2008, and Jan 5, 2015, 2056 patients (mean baseline CD4 count 477 cells per μL) were followed up for 9404 patient-years (Temprano 4757; post-trial phase 4647). The median follow-up time was 4·9 years (IQR 3·3-5·8). 86 deaths were recorded (Temprano 47 deaths; post-trial phase 39 deaths), of which 34 were in patients randomly assigned IPT (6-year probability 4·1%, 95% CI 2·9-5·7) and 52 were in those randomly assigned no IPT (6·9%, 5·1-9·2). The hazard ratio of death in patients who had IPT compared with those who did not have IPT was 0·63 (95% CI, 0·41 to 0·97) after adjusting for the ART strategy (early vs deferred), and 0·61 (0·39-0·94) after adjustment for the ART strategy, baseline CD4 cell count, and other key characteristics. There was no evidence for statistical interaction between IPT and ART (pinteraction=0·77) or between IPT and time (pinteraction=0·94) on mortality. INTERPRETATION: In Côte d'Ivoire, where the incidence of tuberculosis was last reported as 159 per 100 000 people, 6 months of IPT has a durable protective effect in reducing mortality in HIV-infected people, even in people with high CD4 cell counts and who have started ART. FUNDING: National Research Agency on AIDS and Viral Hepatitis (ANRS)

The impact of tubal ectopic pregnancy in Papua New Guinea - a retrospective case review

BACKGROUND: Ectopic pregnancy (EP) is an important cause of morbidity and mortality amongst women of reproductive age. Tubal EP is well described in industrialised countries, but less is known about its impact in low-resource countries, in particular in the South Pacific Region. METHODS: We undertook a retrospective review of women with tubal EP treated at a provincial referral hospital in coastal Papua New Guinea over a period of 56 months. Demographic and clinical variables were obtained from patients’ medical records and analysed. The institutional rate of tubal EP was calculated, and diagnosis and management reviewed. Potential risk factors for tubal EP were identified, and delays contributing to increased morbidity described. RESULTS: A total of 73 women had tubal EP. The institutional rate of tubal EP over the study period was 6.3 per 1,000 deliveries. There were no maternal deaths due to EP. The mean age of women was 31.5+/−5.7 years, 85% were parous, 67% were rural dwellers and 62% had a history of sub-fertility. The most commonly used diagnostic aid was culdocentesis. One third of women had clinical evidence of shock on arrival. All women with tubal EP were managed by open salpingectomy. Tubal rupture was confirmed for 48% of patients and was more common amongst rural dwellers. Forty-three percent of women had macroscopic evidence of pelvic infection. Two-thirds of patients received blood transfusions, and post-operative recovery lasted six days on average. Late presentation, lack of clinical suspicion, and delays with receiving appropriate treatments were observed. CONCLUSIONS: Tubal EP is a common gynaecological emergency in a referral hospital in coastal PNG, and causes significant morbidity, in particular amongst women residing in rural areas. Sexually transmitted infections are likely to represent the most important risk factor for tubal EP in PNG. Interventions to reduce the morbidity due to tubal EP include the prevention, detection and treatment of sexually transmitted infections, identification and reduction of barriers to prompt presentation, increasing health workers’ awareness of ectopic pregnancy, providing pregnancy test kits to rural health centres, and strengthening hospital blood transfusion services, including facilities for autotransfusion

2013 WSES guidelines for management of intra-abdominal infections

Peer reviewe

CARI'96 : actes du 3ème colloque africain sur la recherche en informatique = CARI'96 : proceedings of the 3rd African conference on research in computer science

L'imagerie médicale apporte une aide précieuse au pronostic et au diagnostic d'un grand nombre de pathologies. Elle est aujourd'hui un domaine d'application clé du traitement numérique d'images. Cependant le coût d'une station de traitement numérique d'images reste assez onéreux. Nous avons développé à partir de la carte graphique VGA des ordinateurs PC, un logiciel d'analyse d'images dénommé IMAGE_M. Ce logiciel est utilisable sur la plupart des ordinateurs et constitue un support appréciable pour l'enseignement du traitement numérique d'images. La plupart des outils de base du traitement numérique d'images sont disponibles et l'utilisateur peut y intégrer facilement ses propres outils développés en langage C. Le logiciel IMAGE_M est également un outil de recherche. Nous nous en servons pour l'analyse des images de radiographie dentaire acquises au format bitmap (bmp) à l'aide d'un scanner. En effet, en odonto-stomatologie, la constatation est faite des cas de plus en plus fréquents d'accidents d'évolution de la dent de sagesse inférieure. Elle est soit enclavée soit incluse et déjà des lésions sur la face distale de la dent de 12 ans sont observables. Les difficultés opératoires sont souvent quasi permanentes. Les résultats de cette étude sur la situation intra-osseuse de la dent de sagesse nous permettront de donner le pronostic évolutif de la dent de sagesse chez le négro-africain et de déterminer l'attitude thérapeutique. Au total les clichés radiographiques de 100 enfants (9 à 16 ans) et de 100 adultes (17 à 35 ans) sont analysés dans cette étude. Ces clichés sont des panoramiques (200 clichés) et des téléradiographies de profil (200 clichés). L'intérêt de l'analyse numérique d'images ici sera aussi de pouvoir approcher les résultats obtenus à l'aide du scanner médical qui reste très onéreux pour nos pays sous développés. (Résumé d'auteur

Physicochemical Changes in Bulbils of Two Cultivars of Dioscorea bulbifera During the Ripening Period

Abstract: This study was carried out in order to determine and compare changes in physicochemical properties of bulbils from two cultivars (yellow and mauve) of Dioscorea bulbifera at different periods during the growth. The tests were performed on the bulbils from one to six months of age. The results showed that the weight of bulbils of both cultivars increased. They were ranged on fresh weight basis, from 31.88±13.1 g to 314.93±16.87 g for yellow cultivar and from 10.26±5.17 to 61±14.17 g for mauve cultivar. Starch content, like lipids, total and reducing sugars, cellulose and ash increased also. Starch was the most abundant chemical component with values ranged from 62.09±5.45 to 78.5±5.2% and from 60.56±3.05 to 70.57±6.87%, (on dry weight basis) for yellow and mauve cultivar respectively. Potassium is the most abundant mineral. It value increased during the growth time and ranged (in mg per 100 g dry weight) from 109.2±0.30 to 451.9±0.41 and from 89.66±0,5 to 403.45±0.6 for yellow and mauve cultivar respectively. Bulbils physiological maturity might be set at sixth month during the growth time as some components like Zn, Mg and protein reached a critical level after six months

Nutrition des veaux au cours du sevrage. I. - Evolution de la consommation d'aliments et des concentrations sanguines de divers métabolites énergétiques

International audienc