Mobile health service for HIV screening and care in resource-constrained setting

Objective: This review paper aims at demonstrating that mobile health services for HIV infection in resource-constrained countries may be particularly useful for HIV screening and treatment of HIV disease and associated co-morbidities, especially for people who have limited access to fixed health facilities, including remote or nomadic populations and socially marginalised people.Data source: PubMed database was used to retrieve appropriate literature related to the following MeSH terms: HIV, testing, counselling, mobile counselling and testing, routine offer of counselling and testing, provider-initiated testing and counselling,home-based counselling and testing, decentralisation.Study selection: All articles that met these inclusion criteria and described work conducted in sub-Saharan Africa were considered. Articles were reviewed for information pertaining to mobile health facilities in the field of HIV infection. Wealso reviewed available articles describing alternative approaches to HIV screening and care delivery in resource-limited settings without time period restrictions up to December 2015.Data synthesis: Data collected were analysed and the results related to the aim of the study.Conclusions: The development of mobile services has benefitted from the  simplification of laboratory tests, including reliable rapid diagnostic tests for HIV, and “point of care” (“POC”) tests for CD4 enumeration. The mobile strategy aims to reach more patients,particularly those living in remote areas, to reduce loss-to-follow-up, and to improve patient outcomes. With a reduction in HIV-related stigma and associated discrimination by using these services, the mobile strategy may assist decentralisation of programs devoted to HIV screening, anti-retroviral treatment and HIV care

Rapid susceptibility testing of Mycobacterium tuberculosis by the Mycobacteria Growth Indicator Tube (MGITAST SIRE)

ObjectiveTo evaluate the reliability of the Mycobacteria Growth Indicator Tube (MGITAST) for susceptibility testing of Mycobacterium tuberculosis.MethodsSeventy strains of M. tuberculosis were tested for susceptibility to streptomycin, isoniazid, rifampicin and ethambutol by comparing MGITAST results to those obtained by the method of proportion (MOP) on Lowenstein–Jensen (LJ) and Middlebrook 7H10 media. The 7H10 MOP was considered the method of reference.ResultsThe turnaround time for MGITAST was 6.2days (5–10days) and for MOP it was 18–21days. With rifampicin, MGITAST agreed for all isolates with both MOP. For streptomycin, MGITAST and 7H10 MOP agreed for 64 isolates (91.4%); 61 were susceptible and three resistant. LJ MOP and 7H10 MOP agreed for 64 isolates (92.2%); 62 were susceptible and three resistant. With isoniazid, both MOP agreed for all isolates, while MGITAST and 7H10 MOP had two discrepancies. For ethambutol, MGITAST and 7H10 MOP were concordant for 66 isolates; 65 were susceptible and one resistant. Both MOP were concordant for 67 isolates; 66 were susceptible and one resistant.ConclusionsBased on these results, MGITAST is a time-saving method and can be used as an alternative to the BACTEC System. MGITAST is reliable as far as rifampicin and isoniazid are concerned; however, additional studies are needed for streptomycin and ethambutol

Arbuscular mycorrhizal fungi associated with the rhizosphere of Piliostigma reticulatum and Guiera senegalensis shrubs in Senegal

Piliostima reticulatum and Guiera senegalensis shrubs constitute \u201cislands of soil fertility\u201d in the rhizosphere, with better availability of water and more intense biological activity in the Sudano-Sahelian agro-ecosystems. There is, however, paucity of information on diversity of arbuscular mycorrhizal fungi (AMF) fungi, which have a wide ecological range of associations with a variety of vegetation. The purpose of this study was to identify the types of AMF in the rhizospheres of P. reticulatum and G. senegalensis shrubs in Senegal. Soil samples were collected from around the shrubs in Keur Matar Arame and Keur Ndary Ndiaye in 2019 after a rainy season. Arbuscular mycorrhizae fungi spores were isolated by the wet sieving method and identified based on their morphological characteristics (shape, size, colour, attached hyphae, and spore ornamentation). Four types of AMF were identified, namely Glomus aggregatum, Sclerocystis rubiformis, Gigaspora margarita and Scutellospora gregaria. In addition, the density of spores was more abundant in the soil outside the shrub canopy compare to the soil beneath the shrub.Les arbustes Piliostima reticulatum et Guiera senegalensis constituent des \uab \ueelots de fertilit\ue9 \ubb dans la rhizosphere des sols, avec une meilleure disponibilit\ue9 en eau et une activit\ue9 biologique plus intense dans les agro-\ue9cosyst\ue8mes soudano-sah\ue9liens. Cependant, Il y a peu d\u2019informations sur la diversit\ue9 des champignons mycorhiziens arbusculaires (CMA) qui peuvent s\u2019associer avec une large vari\ue9t\ue9 de plantes. Le but de cette \ue9tude est d\u2019identifier les types de CMA dans les rhizosph\ue8res des arbustes P. reticulatum et G. senegalensis au S\ue9n\ue9gal. Des \ue9chantillons de sol ont \ue9t\ue9 collect\ue9s autour des arbustes \ue0 Keur Matar Arame et Keur Ndary Ndiaye en 2019 apr\ue8s la saison des pluies. Les spores de champignons mycorhiziens arbusculaires ont \ue9t\ue9 isol\ue9es par la m\ue9thode de tamisage humide et identifi\ue9es en fonction de leurs caract\ue9ristiques morphologiques (forme, taille, couleur, hyphes attach\ue9s et ornementation des spores). Quatre types de CMA ont \ue9t\ue9 identifi\ue9s, \ue0 savoir Glomus aggregatum, Sclerocystis rubiformis, Gigaspora margarita et Scutellospora gregaria. De plus, la densit\ue9 des spores \ue9tait plus abondante dans les sols hors couvert que dans les sols sous-couvert des arbustes

Delivering HIV treatment & care in resource limited settings - Therapeutic mobile units

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Bladder morbidity and hepatic fibrosis in mixed Schistosoma haematobium and S. mansoni Infections: a population-wide study in Northern Senegal.

BACKGROUND: The global distribution map of schistosomiasis shows a large overlap of Schistosoma haematobium- and S. mansoni-endemic areas in Africa. Yet, little is known about the consequences of mixed Schistosoma infections for the human host. A recent study in two neighboring co-endemic communities in Senegal indicated that infection intensities of both species were higher in mixed than in single infections. Here, we investigated the relationship between mixed Schistosoma infections and morbidity in the same population. So far, this has only been studied in children. METHODS: Schistosoma infection was assessed by microscopy. Schistosoma-specific morbidity was assessed by ultrasound according to WHO guidelines. Multivariable logistic regression models were used to identify independent risk factors for morbidity. PRINCIPAL FINDINGS: Complete parasitological and morbidity data were obtained from 403 individuals. Schistosoma haematobium-specific bladder morbidity was observed in 83% and S. mansoni-specific hepatic fibrosis in 27% of the participants. Bladder morbidity was positively associated with S. haematobium infection intensity (OR = 1.9 (95% CI 1.3-2.9) for a 10-fold increase in intensity). Moreover, people with mixed infections tended to have less bladder morbidity than those with single S. haematobium infections (OR = 0.3 (95% CI 0.1-1.1)). This effect appeared to be related to ectopic S. mansoni egg elimination in urine. Hepatic fibrosis on the other hand was not related to S. mansoni infection intensity (OR = 0.9 (95% CI 0.6-1.3)), nor to mixed infections (OR = 1.0 (95% CI 0.7-1.7)). CONCLUSIONS/SIGNIFICANCE: This is the first population-wide study on the relationship between mixed Schistosoma infections and morbidity. Mixed infections did not increase the risk of S. mansoni-associated morbidity. They even tended to reduce the risk of S. haematobium-associated morbidity, suggesting a protective effect of S. mansoni infection on bladder morbidity. These unexpected results may have important consequences for schistosomiasis control in co-endemic areas and warrant further investigation

Genomic Sites of Human Immunodeficiency Virus Type 2 (HIV-2) Integration: Similarities to HIV-1 In Vitro and Possible Differences In Vivo

Retroviruses have distinct preferences in integration site selection in the host cell genome during in vitro infection, with human immunodeficiency virus type 1 (HIV-1) integration strongly favoring transcriptional units. Additionally, studies with HIV-1 have shown that the genomic site of proviral integration may impact viral replication, with integration in heterochromatin associated with a block in viral transcription. HIV-2 is less pathogenic than HIV-1 and is believed to have a lower replication rate in vivo. Although differences in integration site selection between HIV-2 and HIV-1 could potentially explain the attenuated pathogenicity of HIV-2, no studies have characterized integration site selection by HIV-2. In this study, we mapped 202 HIV-2 integration sites during in vitro infection of peripheral blood mononuclear cells with a primary HIV-2 isolate. In addition, we assayed for in vivo proviral integration within heterochromatin in 21 HIV-1-infected subjects and 23 HIV-2-infected subjects, using an alphoid repeat PCR assay. During in vitro infection, HIV-2 displayed integration site preferences similar to those previously reported for HIV-1. Notably, 82% of HIV-2 integrations mapped to Refseq genes, and integration strongly favored regions of the genome with high gene density and high GC content. Though rare, the proportion of HIV-2 subjects with evidence of proviral integration within heterochromatin in vivo was higher than that of HIV-1-infected subjects. It is therefore possible that integration site selection may play a role in the differences in HIV-1 and HIV-2 in vivo pathogenesis

Inhibitory humoral responses to the Plasmodium falciparum vaccine candidate EBA-175 are independent of the erythrocyte invasion pathway

Plasmodium falciparum utilizes multiple ligand-receptor interactions for invasion. The invasion ligand EBA-175 is being developed as a major blood-stage vaccine candidate. EBA-175 mediates parasite invasion of host erythrocytes in a sialic acid-dependent manner through its binding to the erythrocyte receptor glycophorin A. In this study, we addressed the ability of naturally acquired human antibodies against the EBA-175 RII erythrocyte-binding domain to inhibit parasite invasion of ex vivo isolates, in relationship to the sialic acid dependence of these parasites. We have determined the presence of antibodies to the EBA-175 RII domain by enzyme-linked immunosorbent assay (ELISA) in individuals from areas of Senegal where malaria is endemic with high and low transmission. Using affinity-purified human antibodies to the EBA-175 RII domain from pooled patient plasma, we have measured the invasion pathway as well as the invasion inhibition of clinical isolates from Senegalese patients in ex vivo assays. Our results suggest that naturally acquired anti-EBA-175 RII antibodies significantly inhibit invasion of Senegalese parasites and that these responses can be significantly enhanced through limiting other ligand-receptor interactions. However, the extent of this functional inhibition by EBA-175 antibodies is not associated with the sialic acid dependence of the parasite strain, suggesting that erythrocyte invasion pathway usage by parasite strains is not driven by antibodies targeting the EBA-175/glycophorin A interaction. This work has implications for vaccine design based on the RII domain of EBA-175 in the context of alternative invasion pathways