Ring vaccination with rVSV-ZEBOV under expanded access in response to an outbreak of Ebola virus disease in Guinea, 2016: an operational and vaccine safety report.

BACKGROUND: In March, 2016, a flare-up of Ebola virus disease was reported in Guinea, and in response ring vaccination with the unlicensed rVSV-ZEBOV vaccine was introduced under expanded access, the first time that an Ebola vaccine has been used in an outbreak setting outside a clinical trial. Here we describe the safety of rVSV-ZEBOV candidate vaccine and operational feasibility of ring vaccination as a reactive strategy in a resource-limited rural setting. METHODS: Approval for expanded access and compassionate use was rapidly sought and obtained from relevant authorities. Vaccination teams and frozen vaccine were flown to the outbreak settings. Rings of contacts and contacts of contacts were defined and eligible individuals, who had given informed consent, were vaccinated and followed up for 21 days under good clinical practice conditions. FINDINGS: Between March 17 and April 21, 2016, 1510 individuals were vaccinated in four rings in Guinea, including 303 individuals aged between 6 years and 17 years and 307 front-line workers. It took 10 days to vaccinate the first participant following the confirmation of the first case of Ebola virus disease. No secondary cases of Ebola virus disease occurred among the vaccinees. Adverse events following vaccination were reported in 47 (17%) 6-17 year olds (all mild) and 412 (36%) adults (individuals older than 18 years; 98% were mild). Children reported fewer arthralgia events than adults (one [<1%] of 303 children vs 81 [7%] of 1207 adults). No severe vaccine-related adverse events were reported. INTERPRETATION: The results show that a ring vaccination strategy can be rapidly and safely implemented at scale in response to Ebola virus disease outbreaks in rural settings. FUNDING: WHO, Gavi, and the World Food Programme

Case Report: COVID-19 and Lassa Fever Coinfection in an Ebola Suspected Patient in Guinea

ABSTRACT. In this case report, we describe a clinical presentation and therapeutic history of a unique case diagnosed with Lassa fever and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a 23-year-old man from Yomou prefecture in southeast Guinea identified with suspected Ebola Virus Disease (EVD) in the midst of an ongoing outbreak of that disease in the same region. On May 3, 2021, he was admitted to the Nzérékoré Epidemic disease treatment center where his clinical condition deteriorated significantly. Laboratory testing performed on the same day reveals a negative EVD polymerase chain reaction (PCR). Three days later, the patient was tested positive for SARS-CoV-2 and Lassa fever by reverse transcriptase PCR (RT-PCR) assays. Laboratory examination also indicated severe hematological and biochemical deteriorations in the patient. This case substantiates the need for systematic differential diagnosis during epidemic-prone disease outbreaks to better manage severely unwell patients.</jats:p

Management Strategies for Avoiding Mining Land-use Conflicts in Developing Countries: A Case Study from the Côte d’Ivoire

The development of resources above and below ground simultaneously involves and impacts a variety of stakeholders worldwide, including states, corporations and local populations. Land use issues are important to investigate in developing countries, such as in sub-Saharan Africa where most nations have opted for either agriculture or mining to boost their economies in the aftermath of political independence in the 1960s. Company-community conflicts in mining have been widely researched, but mining land-use issues are still commonplace globally. There are limitations to the understanding about the broader issue because most studies have focused on conflicts that are not land related. This thesis focuses on a case study in Côte d’Ivoire, where coexistence between agriculture and mining is increasingly a challenge. Côte d’Ivoire is rich in both agricultural and mineral resources, but the country was predominantly reliant on an agricultural-based economy until 2010, when mine operators were invited to expand operations in order to diversify national development. However, this economic policy shift has been problematic, making land a central subject of stakeholder conflicts. This challenge is expected to continue into the future, with a continued expansion of mining in rural settings where land remains the most important economic asset, source of livelihoods, and also a cultural asset, for local populations. The aim of this research was to advance understanding of mining land-use conflicts in a developing nations context, using a case study site, Bonikro Gold Mine (BGM) from the Côte d’Ivoire. This single case study provided two rare opportunities to reflect critically on the broader phenomena. First was the fact that BGM’s operation is located in an area of higher agriculture value with a varying history of mining land-use issues. The other insight comes from the student’s position as an employee of BGM with professional position in Social Performance and working on Corporate Social Responsibility (CSR) in mining from the corporate perspective. The research is based on three main components including: a set of conceptual frameworks and theoretical perspectives; a desk review of specific available literature; and field investigations for qualitative and quantitative data collection. The conceptual frameworks identified for this study included a universal conceptual model developed to provide a comprehensive understanding of interaction between the causes and the effects of conflicts worldwide, and a specific contextual framework for the case study in the Côte d’Ivoire. The described theoretical approaches included social contract theory, legitimacy theory, stakeholder theory, theory of exchange, power dynamics and conflict resolution theory. Of these, stakeholder theory and the theory of conflict resolution were identified as being particularly valuable in understanding the challenges presented by mining land-use conflicts and what exactly the nature of the problems are. Additionally, a theoretical six-nine (69)-hypothesis was proposed as a new way to explain the power dynamism in mining stakeholder relationships, which is a novel contribution to extending power dynamics theory. The desktop study indicated that mining land-use conflicts exist because of a variety of root causes, involving different stakeholder perspectives across government, company and community. Primary and secondary data were collected from both participants and the case study site to populate the research with context-specific and nuanced information. The field survey reflects the responses of 511 participants from mining-affected community groups and government officials across the study scope region. The survey was conducted using interview questions and survey questionnaires, and a total of 411 interviews and 100 surveys were held in person. Fieldwork was completed between November 2016 and August 2017. The results enabled the identification of four primary conflict drivers: discrepancy between national land-mining laws and local contexts; benefit sharing issues that include local employment, lost asset compensation and social investment; challenges in relation to stakeholder engagement and consultation; and mining-induced changes such as disruption of local structures, economic displacement and human resettlement, environmental degradation and quality of life concerns. Bringing the theoretical and practical perspectives of the thesis together, the key finding of the study is that solutions to conflicts require a balanced resource governance system, an adapted industry driven approach and a good negotiation capacity of local communities. A balanced resource governance system should normally provide a strong platform for establishing good relationships between mining stakeholders via property rights, approvals process, operating conditions and closure planning. Furthermore, mine operators have the potential to reduce impact of mining on local communities with industry driven processes such as CSR and social license to operate (SLO). CSR approaches can be adapted to the needs of communities in terms of managing stakeholder engagement and environmental nuisances, sharing benefits and resolving conflicts once they occur. The SLO can be used to acknowledge social acceptance towards mining activities, and can be measured through community perception surveys, which can help to avoid or resolve problems. Moreover, effective community capacity to negotiate local level agreements can help generate more positive impacts and improve the quality of stakeholder relationships. These individual solutions can be applied in tandem, or in a sequence depending on specific challenges that stakeholders face, but the combination of the strengths of different solutions can provide a more successful outcome to reduce mining land-use conflicts. The thesis concludes with recommendations on practical strategies that could be adopted by different stakeholders to reduce and manage conflict, as well as suggestions for future research activity that could extend this work in terms of both theoretical and practice outcomes. Overall, this research focused on a single case study, but it was useful to build theory on and contribute to the understanding of mining land-use conflicts, and the insights derived hold relevance throughout Côte d’Ivoire as well as in other developing countries

My Research Data Management Plan-Diakite Mory

Primary and secondary data were collected from both participants and the case study site to populate the research with context-specific and nuanced information. The field survey reflects the responses of 511 participants from mining-affected community groups and government officials across the study scope region. The survey was conducted using interview questions and survey questionnaires, and a total of 411 interviews and 100 surveys were held in person. Fieldwork was completed between November 2016 and August 2017.</p

Acceptability of COVID-19 vaccination among health care workers: a cross-sectional survey in Morocco

Introduction This study aimed to evaluate the acceptability of COVID-19 vaccination among health care workers prior to the start of the COVID-19 vaccination campaign in Morocco. Methods This cross-sectional study was conducted in the Cheikh Khalifa University Hospital of Casablanca-Morocco. Utilizing a web-based platform surveys were distributed over a 3-week period via professional mailing list and social media. Odds ratios and 95% confidence intervals were estimated by using logistic regression models. Results A total of 303 health care workers participated in this study. The results showed a relatively high rate of vaccination acceptability (62.0%) among health care workers included in this study. Participants were more likely to accept the COVID-19 vaccine if they were physician, nurse, or technician (OR 1.79; 95% CI: 1.09–2.95), had high score of confidence in the information circulating about COVID-19 (OR 1.91; 95% CI: 1.36–2.69), or had high score of perceived severity of COVID-19 (OR 1.55; 95% CI: 1.11–2.15). Reasons of hesitation/or refusal of COVID-19 vaccine were fear of the likely side effects of the vaccine for 74.8% of participants, and concern about the effectiveness of the vaccine for 47.8%. Conclusion This study showed a relatively high rate of the COVID-19 vaccination acceptance among health care workers in Morocco. Willingness to be vaccinated was significantly associated with job category, confidence in the information circulating about COVID-19, and perceived severity of COVID-19. These results could be useful in the development of educational interventions to increase the acceptance of COVID-19 vaccine among health care workers in Morocco and similar settings

Host age and Plasmodium falciparum multiclonality are associated with gametocyte prevalence: a 1-year prospective cohort study

Abstract Background Since Plasmodium falciparum transmission relies exclusively on sexual-stage parasites, several malaria control strategies aim to disrupt this step of the life cycle. Thus, a better understanding of which individuals constitute the primary gametocyte reservoir within an endemic population, and the temporal dynamics of gametocyte carriage, especially in seasonal transmission settings, will not only support the effective implementation of current transmission control programmes, but also inform the design of more targeted strategies. Methods A 1-year prospective cohort study was initiated in June 2013 with the goal of assessing the longitudinal dynamics of P. falciparum gametocyte carriage in a village in Mali with intense seasonal malaria transmission. A cohort of 500 individuals aged 1–65 years was recruited for this study. Gametocyte prevalence was measured monthly using Pfs25-specific RT-PCR, and analysed for the effects of host age and gender, seasonality, and multiclonality of P. falciparum infection over 1 year. Results Most P. falciparum infections (51–89%) in this population were accompanied by gametocytaemia throughout the 1-year period. Gametocyte prevalence among P. falciparum-positive individuals (proportion of gametocyte positive infections) was associated with age (p = 0.003) but not with seasonality (wet vs. dry) or gender. The proportion of gametocyte positive infections were similarly high in children aged 1–17 years (74–82% on median among 5 age groups), while older individuals had relatively lower proportion, and those aged > 35 years (median of 43%) had significantly lower than those aged 1–17 years (p < 0.05). Plasmodium falciparum-positive individuals with gametocytaemia were found to have significantly higher P. falciparum multiclonality than those without gametocytaemia (p < 0.033 in two different analyses). Conclusions Taken together, these results suggest that a substantial proportion of Pf-positive individuals carries gametocytes throughout the year, and that age is a significant determinant of gametocyte prevalence among these P. falciparum-positive individuals. Furthermore, the presence of multiple P. falciparum genotypes in an infection, a common feature of P. falciparum infections in high transmission areas, is associated with gametocyte prevalence

L'Auto-vélo : automobilisme, cyclisme, athlétisme, yachting, aérostation, escrime, hippisme / dir. Henri Desgranges

14 septembre 19181918/09/14 (A19,N6445)

A potential role for plasma uric acid in the endothelial pathology of Plasmodium falciparum malaria.

BACKGROUND: Inflammatory cytokinemia and systemic activation of the microvascular endothelium are central to the pathogenesis of Plasmodium falciparum malaria. Recently, 'parasite-derived' uric acid (UA) was shown to activate human immune cells in vitro, and plasma UA levels were associated with inflammatory cytokine levels and disease severity in Malian children with malaria. Since UA is associated with endothelial inflammation in non-malaria diseases, we hypothesized that elevated UA levels contribute to the endothelial pathology of P. falciparum malaria. METHODOLOGY/PRINCIPAL FINDINGS: We measured levels of UA and soluble forms of intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-Selectin), thrombomodulin (sTM), tissue factor (sTF) and vascular endothelial growth factor (VEGF) in the plasma of Malian children aged 0.5-17 years with uncomplicated malaria (UM, n = 487) and non-cerebral severe malaria (NCSM, n = 68). In 69 of these children, we measured these same factors once when they experienced a malaria episode and twice when they were healthy (i.e., before and after the malaria transmission season). We found that levels of UA, sICAM-1, sVCAM-1, sE-Selectin and sTM increase during a malaria episode and return to basal levels at the end of the transmission season (p<0.0001). Plasma levels of UA and these four endothelial biomarkers correlate with parasite density and disease severity. In children with UM, UA levels correlate with parasite density (r = 0.092, p = 0.043), sICAM-1 (r = 0.255, p<0.0001) and sTM (r = 0.175, p = 0.0001) levels. After adjusting for parasite density, UA levels predict sTM levels. CONCLUSIONS/SIGNIFICANCE: Elevated UA levels may contribute to malaria pathogenesis by damaging endothelium and promoting a procoagulant state. The correlation between UA levels and parasite densities suggests that parasitized erythrocytes are one possible source of excess UA. UA-induced shedding of endothelial TM may represent a novel mechanism of malaria pathogenesis, in which activated thrombin induces fibrin deposition and platelet aggregation in microvessels. This protocol is registered at clinicaltrials.gov (NCT00669084)