Relatively Low Prevalence of Peripheral and Placental Plasmodium Infection at Delivery in Bangui, Central African Republic

Introduction. The aim of this study was to estimate the prevalence of malaria among women giving birth in Bangui. Association between sociodemographic characteristics of those women and malaria, as well as prevention compliance (use of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTsp) and insecticide-treated bed nets (ITNs)), was analyzed. Methods. During September 2009, a survey was conducted on 328 women who gave birth at two main maternities of Bangui. Information was obtained by standardized questionnaire about sociodemographic criteria, IPTsp, other antimalarial treatment, and use of bet nets. Smears prepared from peripheral and placental blood were analysed for malaria parasites. Findings and Discussion. Positive results were found in 2.8% of thick peripheral blood smears and in 4.0% of placental slides. A proportion of 30.5% of the women had received at least two doses of IPTsp during the current pregnancy. Only a proportion of 42.4% of this study population had ITNs. Multigravid women were less likely to use IPTsp and ITNs. However, use of IPTsp was associated with personal income and secondary or university educational status. Hence, although this relatively prevalence was observed, more efforts are needed to implement IPTsp and ITNs, taking into account sociodemographic criteria

Pattern of the Antimalarials Prescription during Pregnancy in Bangui, Central African Republic

Introduction. The aim of this study was to identify the antimalarials prescribed during the pregnancy and to document their timing. Method. From June to September 2009, a survey was conducted on 565 women who gave birth in the Castors maternity in Bangui. The antenatal clinics cards were checked in order to record the types of antimalarials prescribed during pregnancy according to gestational age. Results. A proportion of 28.8% ANC cards contained at least one antimalarial prescription. The commonest categories of antimalarials prescribed were: quinine (56.7%), artemisinin-based combinations (26.8%) and artemisinin monotherapy (14.4%). Among the prescriptions that occurred in the first trimester of pregnancy, artemisinin-based combinations and artemisinin monotherapies represented the proportions of (10.9%) and (13.3%). respectively. Conclusion. This study showed a relatively high rate (>80%) of the recommended antimalarials prescription regarding categories of indicated antimalarials from national guidelines. But, there is a concern about the prescription of the artemisinin derivatives in the first trimester of pregnancy, and the prescription of artemisinin monotherapy. Thus, the reinforcement of awareness activities of health care providers on the national malaria treatment during pregnancy is suggested

Evaluation of drug administration errors in a teaching hospital

<p>Abstract</p> <p>Background</p> <p>Medication errors can occur at any of the three steps of the medication use process: prescribing, dispensing and administration. We aimed to determine the incidence, type and clinical importance of drug administration errors and to identify risk factors.</p> <p>Methods</p> <p>Prospective study based on disguised observation technique in four wards in a teaching hospital in Paris, France (800 beds). A pharmacist accompanied nurses and witnessed the preparation and administration of drugs to all patients during the three drug rounds on each of six days per ward. Main outcomes were number, type and clinical importance of errors and associated risk factors. Drug administration error rate was calculated with and without wrong time errors. Relationship between the occurrence of errors and potential risk factors were investigated using logistic regression models with random effects.</p> <p>Results</p> <p>Twenty-eight nurses caring for 108 patients were observed. Among 1501 opportunities for error, 415 administrations (430 errors) with one or more errors were detected (27.6%). There were 312 wrong time errors, ten simultaneously with another type of error, resulting in an error rate without wrong time error of 7.5% (113/1501). The most frequently administered drugs were the cardiovascular drugs (425/1501, 28.3%). The highest risks of error in a drug administration were for dermatological drugs. No potentially life-threatening errors were witnessed and 6% of errors were classified as having a serious or significant impact on patients (mainly omission). In multivariate analysis, the occurrence of errors was associated with drug administration route, drug classification (ATC) and the number of patient under the nurse's care.</p> <p>Conclusion</p> <p>Medication administration errors are frequent. The identification of its determinants helps to undertake designed interventions.</p

Subduction or sagduction? Ambiguity in constraining the origin of ultramafic–mafic bodies in the Archean crust of NW Scotland

The Lewisian Complex of NW Scotland is a fragment of the North Atlantic Craton. It comprises mostly Archean tonalite–trondhjemite–granodiorite (TTG) orthogneisses that were variably metamorphosed and reworked in the late Neoarchean to Paleoproterozoic. Within the granulite facies central region of the mainland Lewisian Complex, discontinuous belts composed of ultramafic–mafic rocks and structurally overlying garnet–biotite gneiss (brown gneiss) are spatially associated with steeply-inclined amphibolite facies shear zones that have been interpreted as terrane boundaries. Interpretation of the primary chemical composition of these rocks is complicated by partial melting and melt loss during granulite facies metamorphism, and contamination with melts derived from the adjacent migmatitic TTG host rocks. Notwithstanding, the composition of the layered ultramafic–mafic rocks is suggestive of a protolith formed by differentiation of tholeiitic magma, where the ultramafic portions of these bodies represent the metamorphosed cumulates and the mafic portions the metamorphosed fractionated liquids. Although the composition of the brown gneiss does not clearly discriminate the protolith, it most likely represents a metamorphosed sedimentary or volcano-sedimentary sequence. For Archean rocks, particularly those metamorphosed to granulite facies, the geochemical characteristics typically used for discrimination of paleotectonic environments are neither strictly appropriate nor clearly diagnostic. Many of the rocks in the Lewisian Complex have ‘arc-like’ trace element signatures. These signatures are interpreted to reflect derivation from hydrated enriched mantle and, in the case of the TTG gneisses, partial melting of amphibolite source rocks containing garnet and a Ti-rich phase, probably rutile. However, it is becoming increasingly recognised that in Archean rocks such signatures may not be unique to a subduction environment but may relate to processes such as delamination and dripping. Consequently, it is unclear whether the Lewisian ultramafic–mafic rocks and brown gneisses represent products of plate margin or intraplate magmatism. Although a subduction-related origin is possible, we propose that an intraplate origin is equally plausible. If the second alternative is correct, the ultramafic–mafic rocks and brown gneisses may represent the remnants of intracratonic greenstone belts that sank into the deep crust due to their density contrast with the underlying partially molten low viscosity TTG orthogneisses

Unveiling ductile deformation during fast exhumation of a granitic pluton in a transfer zone

Exhumation and cooling of upper crustal plutons is generally assumed to develop in the brittle domain, thus determining an abrupt passage from crystallization to faulting. To challenge this general statement, we applied an integrated approach involving meso- and micro-structural studies, thermochronology, geochronology and rheological modelingto the Miocene syn-tectonic Porto Azzurro pluton on Elba (Tuscan archipelago – Italy). This pluton is emplaced in an extensional setting, and we have realized that its fast exhumation is accompanied by localized ductile shear zones, developing along dykes and veins, later affected by brittle deformation. This is unequivocally highlighted by field studies and EBSD-aided microstructural analysis. To constrain the emplacement and exhumation rate of the Porto Azzurro pluton we performed U-Pb zircon dating and (U+Th)/He apatite thermochronology, which resulted in a magma emplacement age of 6.4 ± 0.4 Ma and an exhumation rate of 3.4 to 3.9 mm/yr. Thermo-rheological modeling established that localized ductile deformation occurred at two different time steps: within felsic dykes when the pluton first entered into the brittle field at 380 kyr, and along quartz-rich hydrothermal veins at c. 550 kyr after pluton emplacement. Hence, the major conclusion of our data is that ductile deformation can affect a granitic intrusion even when it is entered into the brittle domain in a fast exhuming extensional regime