Health facility-based prevalence and potential risk factors of autism spectrum disorders in Mali

Background: The prevalence of autism spectrum disorders (ASD) is 1-2% worldwide, 1 in 68 in the U.S, and unknown in Africa. ASD is under-diagnosed in Mali due to stigma and the lack of appropriate human resources and infrastructure.Objective: To determine the ASD frequency and potential risk factors in Mali.Methods: We identified all the health facilities and community-based organizations involved in the ASD diagnosis and management in Bamako. We established an ASD research and awareness platform in Mali, which encompasses community-based organizations and a multidisciplinary team including psychiatrists, psychologists, pediatricians, geneticists, and public health and social science specialists. Through this platform, we performed a survey in health facilities and organizations where patients with ASD are likely to seek care in Bamako. We reviewed the psychiatric patient registry to obtain basic epidemiological profiles of children with ASD, epilepsy and other psychiatric disorders.Results: We found a health facility-based prevalence of ASD of 4.5% (105/2,343) in Bamako. The mean age at the first outpatient visit was 7.64 ± 3.85 years old. First degree consanguinity of 29.5% (31/105) was more frequent in parents of ASD children versus age and sex matched controls OR= 4.37 [1.96-9.76] p=0.0001.Conclusion: Our data suggest that ASD is more common than expected in Mali. The established ASD awareness and research platform may improve the diagnosis and management of ASD by raising ASD awareness, training of Malian clinicians and researchers in early ASD screening and diagnosis, and strengthening research capacity in genomics of ASD and other mental disorders.Keywords: ASD, prevalence, consanguinity, health facilit

Synthetic SARS-CoV-2 (2019-nCoV), MERS-CoV and SARSr-CoV vaccine : A comparative computational analysis to propose candidate epitopes

Background: Coronaviruses are normally specific to an animal taxon as host, mammals or birds depending on their species; however, these viruses can sometimes change host as a result of mutation. The HCoV-229E is one of six human coronaviruses that include HCoV-NL63, HCoV-OC43, HCoV-HKU1, MERS-CoV and SARSr-CoV (SARSr-CoV-1 and SARS-CoV2) and is distributed globally. MERS-CoV and SARS-CoV-2 could persist on inanimate surface like (metal, glass or plastic for up to nine days) (Huang, C.-L, 2020). Preventive measures and drug treatment with hydrochloroquine are useful, but a good effective vaccine may be needed to stop propagation of the covid-19 pandemic. The aim of our study was to identifiy vaccine candidate epitopes by bioinformatics approaches. Materials and Method: The complete genomic sequences of SARS-CoV-2 were obtained from 2019 Novel Coronavirus Resource (2019nCoVR) and two databases, including the National Center for Biotechnology Information (NCBI) Global Initiative on Sharing All Influenza Data (GISAID) and TAURAU/T-bio-infoserver for online bioinformatics. we will provide a brief review of viral origin, compare the sequencing data for conserved region identification, his commonest protein domain( target binding site) and consensus motif design for an potential candidate molecule (epitope) prurposition for treatment strategies for the newly identified 2019-nCoV , SARSr-CoV strain and MERS-CoV. Results: Interestingly, sequence comparison between SARS-CoV-2 and another strain revealed that the residues present in the receptor-interacting motive are highly conserved with 70 % identity. we funded five important amino acids ( L455, Y473, N479, F486, Q493) on the receptor binding domain from spike proteins responsible of contact between virus and horst . In the SARS-CoV_ RBD are present residues (D480, and T487) that allowed the interspecies infection. However, in SARS-CoV-2, slight modification of some residues could improve the interaction with the human cellular receptor: L455, F486, Q493, and N501. In SARS-CoV, two main residues (479 and 487) have been associated to the recognition of the human ACE2 receptor. In the SARS-CoV-2, the residues corresponding to N479 correspond to Q493 and T487 to N501. These changes in the SARS-CoV-2 represent energetically favorable changes for the interaction with the receptor. we identified the sequences of amino acids that are well conserved across many coronaviruses including 2019nCoV and other strains, the motif KRSFIEDLLFNKVTLADAGF was found to be particularly well-conserved in this study and corresponds to the region around one of the known cleavage sites of the SARS virus that are believed to be required for virus activation for cell entry. This sequence motif and surrounding variations formed the basis for proposing a specific synthetic vaccine epitope this finding can make related likely rigid small molecule candidates and binding targets. Conclusion: This study provides information and opportunities for biological confirmation. The work can nevertheless be described in bioinformatics terms, and easily replicated by others, although new data and research on Covid-19 are emerging and evolving at an explosive rythm.</p

Synthetic SARS-CoV-2 (2019-nCoV), MERS-CoV and SARSr-CoV vaccine : A comparative computational analysis to propose candidate epitopes

Background: Coronaviruses are normally specific to an animal taxon as host, mammals or birds depending on their species; however, these viruses can sometimes change host as a result of mutation. The HCoV-229E is one of six human coronaviruses that include HCoV-NL63, HCoV-OC43, HCoV-HKU1, MERS-CoV and SARSr-CoV (SARSr-CoV-1 and SARS-CoV2) and is distributed globally. MERS-CoV and SARS-CoV-2 could persist on inanimate surface like (metal, glass or plastic for up to nine days) (Huang, C.-L, 2020). Preventive measures and drug treatment with hydrochloroquine are useful, but a good effective vaccine may be needed to stop propagation of the covid-19 pandemic. The aim of our study was to identifiy vaccine candidate epitopes by bioinformatics approaches. Materials and Method: The complete genomic sequences of SARS-CoV-2 were obtained from 2019 Novel Coronavirus Resource (2019nCoVR) and two databases, including the National Center for Biotechnology Information (NCBI) Global Initiative on Sharing All Influenza Data (GISAID) and TAURAU/T-bio-infoserver for online bioinformatics. we will provide a brief review of viral origin, compare the sequencing data for conserved region identification, his commonest protein domain( target binding site) and consensus motif design for an potential candidate molecule (epitope) prurposition for treatment strategies for the newly identified 2019-nCoV , SARSr-CoV strain and MERS-CoV. Results: Interestingly, sequence comparison between SARS-CoV-2 and another strain revealed that the residues present in the receptor-interacting motive are highly conserved with 70 % identity. we funded five important amino acids ( L455, Y473, N479, F486, Q493) on the receptor binding domain from spike proteins responsible of contact between virus and horst . In the SARS-CoV_ RBD are present residues (D480, and T487) that allowed the interspecies infection. However, in SARS-CoV-2, slight modification of some residues could improve the interaction with the human cellular receptor: L455, F486, Q493, and N501. In SARS-CoV, two main residues (479 and 487) have been associated to the recognition of the human ACE2 receptor. In the SARS-CoV-2, the residues corresponding to N479 correspond to Q493 and T487 to N501. These changes in the SARS-CoV-2 represent energetically favorable changes for the interaction with the receptor. we identified the sequences of amino acids that are well conserved across many coronaviruses including 2019nCoV and other strains, the motif KRSFIEDLLFNKVTLADAGF was found to be particularly well-conserved in this study and corresponds to the region around one of the known cleavage sites of the SARS virus that are believed to be required for virus activation for cell entry. This sequence motif and surrounding variations formed the basis for proposing a specific synthetic vaccine epitope this finding can make related likely rigid small molecule candidates and binding targets. Conclusion: This study provides information and opportunities for biological confirmation. The work can nevertheless be described in bioinformatics terms, and easily replicated by others, although new data and research on Covid-19 are emerging and evolving at an explosive rythm

Autism seminary for public engagement: evaluation of knowledge and attitudes of traditional medical practitioners in Mali

Background: Autism spectrum disorders (ASD) are stigmatizing in Africa and traditional medical practitioners occupy the first line of diagnosis and treatment due to the cultural perception of ASD, and the scarcity of conventional health services in Mali. We aimed to assess the knowledge, attitudes, and practices (KAP) concerning autism among traditional medical practitioners in Bamako, Mali. Methods: We conducted a 6-week cross-sectional survey following a 1-day autism awareness seminary on September 9th, 2017 in Bamako. A questionnaire was designed to assess the KAP regarding autism. To assess their practices, parents of autistic children were asked about their experiences with traditional medical practitioners. Results: Of the 37 study participants 67.60% were males and 56.8% had not heard about autism before the seminary. After the seminary, 73% claimed to understand the diagnosis criteria of autism, but only 16.2% could recall symptoms from all the three domains (reciprocal social interaction, verbal and nonverbal communication, and stereotyped behaviors/restricted interests) of a child development impaired by autism. Of traditional medical practitioners, 73% believed autism was caused by devils, God’s will, bad luck and divine punishment of maternal misbehavior; 65% were used to treating mental illness, and 78.4% felt traditional healing was the only treatment option in autism. Negative attitudes towards autistic children were present in 18.9%, suggesting a very strong cultural mindset on autism. Conclusion: Knowledge on autism was poor among traditional medical practitioners. A culturally tailored autism public engagement strategy is necessary to positively change the mindset of Malian traditional medical practitioners.</ns4:p

Autism Spectrum Disorders in Mali: Parental concerns about child developmental milestones and late diagnostic age

Abstract Background In Mali, the health facility-based prevalence of autism spectrum disorders (ASD) was 4.5% (105/2,343) and the age of first medical visit for autistic children was around 7 years old in 2018. Parental recognition of developmental abnormalities initiates the early autism detection and diagnosis. Our aim was to investigate if parental concerns were associated with early first medical visits and subsequent ASD diagnostic in Mali. Methods We conducted a pilot study from November 2017 to July 2019. We surveyed parents of 57 autistic children aged 3-14 years old. Results Parents were concerned over verbal communication in 54.1% and reciprocal social interaction in 43.8%. Children with ASD had their first medical visit after 18 months old in 66.7%, ≥ two medical visits in 87.7%, and were identified after 36 months old in 76.8%.Conclusion: Parental concerns were not significantly associated with early first medical visit and ASD identification. A full scale study will be conducted for more consistent results.</jats:p

Autism Spectrum Disorders in Mali: Parental concerns about child developmental milestones and late diagnostic age

Abstract Background: In Mali, the national health facility-based prevalence of autism spectrum disorders (ASD) was 4.5% (105/2,343) and the age of first medical visit for autistic children was around 7 years old in 2018. Parental recognition of developmental abnormalities initiates the early autism detection and diagnosis. Our aim was to investigate if parental concerns were associated with early first medical visits and subsequent ASD diagnostic in Mali. Methods: We conducted a pilot study from November 2017 to July 2019. We surveyed parents of 57 out of 60 available autistic children aged 3-14 years old. Results: Parents were concerned over verbal communication in 54.1% and reciprocal social interaction in 43.8%. Children with ASD had their first medical visit after 18 months old in 66.7%, ≥ two medical visits in 87.7%, and were identified after 36 months old in 76.8%. Conclusion: Parental concerns were not significantly associated with early first medical visit and ASD identification. Our results will guide future full scale studies on parental concerns in ASD in Mali.</jats:p

A Pilot Study on&amp;nbsp;Autism Spectrum Disorders&amp;nbsp;in Mali: Parental Concerns About Child Developmental Milestones and Late Diagnostic Age

Abstract BackgroundIn Mali, the health facility-based prevalence of autism spectrum disorders (ASD) in Mali was 4.5% (105/2,343) and the age of first medical visit for autistic children was around 7 years old in 2018. Parental recognition of developmental abnormalities initiates the early autism detection and diagnosis. We aimed to assess the feasibility of a main study to associate parental concerns with early first medical visits and subsequent ASD diagnostic in Mali.MethodsWe conducted a pilot study from November 2017 to July 2019. We surveyed 57 parents of autistic children aged 3-14 years old.ResultsParents were concerned over verbal communication in 54.1% and reciprocal social interaction in 43.8%. Children with ASD had their first medical visit after 18 months old in 66.7%, ≥ two medical visits in 87.7%, and were identified after 36 months old in 76.8%.ConclusionParental concerns were not significantly associated with early first medical visit and ASD identification. This pilot study will help in the design of larger studies on the same topic in Mali.</jats:p

A Pilot Study on Autism Spectrum Disorders in Mali: Parental concerns about child developmental milestones and late diagnostic age

Abstract Background: In Mali, the health facility-based prevalence of autism spectrum disorders (ASD) in Mali was 4.5% (105/2,343) and the age of first medical visit for autistic children was around 7 years old in 2018. Parental recognition of developmental abnormalities initiates the early autism detection and diagnosis. In this pilot study, our aim was to investigate if parental concerns were associated with early first medical visits and subsequent ASD diagnostic in Mali. Methods: We conducted a pilot study from November 2017 to July 2019. We surveyed 57 parents of autistic children aged 3-14 years old. Results: Parents were concerned over verbal communication in 54.1% and reciprocal social interaction in 43.8%. Children with ASD had their first medical visit after 18 months old in 66.7%, ≥ two medical visits in 87.7%, and were identified after 36 months old in 76.8%. Conclusion: Parental concerns were not significantly associated with early first medical visit and ASD identification. This pilot study will help in the design of larger studies on the same topic in Mali.</jats:p