Fréquence des néphropathies congénitales au Centre hospitalier universitaire de Donka à Conakry: Frequency of congenital nephropathies in the University Hospital of Donka in Conakry

Context and objective. The real extent of congenital nephropathies is little known in Africa and in particular in Guinea. The objective of this study was to determine the prevalence of congenital nephropathies in the University Hospital of Donka. Methods. This was a descriptive retrospective study enrolling patients admitted for congenital nephropathy at both pediatric and pediatric surgery departments of Donka, between January 1st, 2007 and June 30th, 2012. The parameters of the study were epidemiological, clinical and paraclinical data.  Results. Of 34,448 patients recorded during the period studied, 26 had congenital nephropathies. They encompassed nephroblastoma (n=17), SJPU (n=6), hydronephrosis on left multikystic kidney (n=1), multikystic kidney in ptosis (n=1) and renal ectopia (n=1). Male sex was preponderant (21/26) with a sex ratio of 4.2/1. The 29 day-old to 2 year-old children were more affected. Conclusion. Congenital nephropathies appear less frequently in this hospital probably due to the absence of optimal facilities. The early diagnosis of congenital nephropathies should be made during the antenatal time, which would be a key to a better management of these conditions in affected children. Contexte et objectif. L’ampleur réelle des néphropathies congénitales est peu connue en Afrique et notamment en Guinée. L’objectif de cette étude était de déterminer la fréquence des néphropathies congénitales rencontrées. Méthodes. Cette étude documentaire de type descriptif sur la néphropathie congénitale, a été conduite entre les 1er janvier 2007 et 30 juin 2012, dans les services de pédiatrie et de chirurgie pédiatrique de Donka. Les paramètres d’interet englobaient les données épidémiologiques, cliniques et paracliniques.  Résultats. Parmi les 34.448 dossiers colligés, 26 présentaient une néphropathie congénitale. Il s’agissait des néphroblastomes (n=17), des syndromes de jonction pyélo-urétérale (n=6), d’une hydronéphrose sur rein multikystique gauche (n=1), d’un rein multikystique en ptose (n=1) et d’une ectopie rénale (n=1). Le sexe masculin était prépondérant (21/26) avec un sexe ratio de 4,2/1. Les enfants de 29 jours à 2 ans étaient les plus touchés. Conclusion. Les néphropathies congénitales sont paraissent moins fréquentes dans cette institution hospitalière, à cause du manque d’un plateau technique diagnostique optimal. Le diagnostic précoce des néphropathies congénitales devrait être fait dans la période prénatale ce qui permettrait une meilleure prise en charge des enfants affectés

Évaluation du Risque Cardiovasculaire Absolu Chez les Patients Hémodialysés Diabétiques et Non diabétiques au Centre National d’Hémodialyse de Donka Conakry

Le risque cardiovasculaire chez les hémodialysés semble varier en fonction du statut diabétique ainsi que d’autres facteurs associés et constitue un problème de santé publique en Afrique en général et particulièrement en Guinée. Dans ce sens, l’objectif de cette étude était d’évaluer le risque de survenue d’une pathologie cardiovasculaire absolu chez les patients hémodialysés diabétiques, par rapport aux patients hémodialysés non diabétiques. La présente, étude transversale, descriptive et analytique a été réalisée entre le 1 ier avril et le 30 juin 2019 au Centre National d’Hémodialyse de Donka. L’étude a inclus les 140 patients hémodialysés durant la période. Le recrutement était exhaustif et concernait tous les patients hémodialysés répondant aux critères de sélection. Les données ont été recueillies prospectivement chez les patients hémodialysés puis compilées et traitées dans Epi info. 7.2.2.6. Un questionnaire semi-administré a été utilisé à ce fin. Pour évaluer le risque cardiovasculaire chez les patients le FRAMINGHAM RISK SCORE (FRS) a été aussi utilisé. L’enquête a concerné 140 individus dont 91 (65,00%) étaient des hommes, contre 49 (35,00%) de femmes, soit un sex- ratio de 1,86 soit 2 hommes pour une femme. L’âge moyen était de 41 ± 4,1 ans avec des extrêmes de (30 ; 74) ans. On notait une prédominance chez les hommes des facteurs de risque, pour le tabagisme. L’étude a trouvé 39 diabétiques contre 101 non diabétiques. Le risque était élevé chez 23 diabétiquessur 39 ; et 25 sur 101 des patients non diabétiques. L’étude montre qu’un patient sur quatre aurait un risque absolu élevé chez les patients non diabétiques et un patient sur deux chez les patients diabétiques. Ce risque est majoré par d’autres facteurs associés. Introduction: Cardiovascular risk in hemodialysis appears to vary depending on diabetic status and other associated factors and is a public health problem in Africa in general and particularly in Guinea. The objective of this study was to assess the risk of absolute cardiovascular disease in diabetic hemodialysis patients, compared to non-diabetic hemodialysis patients. Methods: Between April 1 and June 30, 2019, a descriptive and analytical cross-sectional study was conducted at the National Hemodialysis Centre in Donka. The study included 140 hemodialysis patients during the period. Recruitment was comprehensive and involved all hemodialysis patients meeting the selection criteria. The data were collected prospectively in hemodialysis patients and then compiled and processed in Epi info. 7.2.2.6. A semi-administered questionnaire had been used. To assess cardiovascular risk in patients, FRAMINGHAM RISK SCORE (FRS) was used. Results: The survey involved 140 individuals, 91 of whom (65.00%) 49 (35.00%) were men. sex ratio of 1.86 or 2 men per woman. The average age was 41-4.1 years with extremes of (30; 74) years. There was a predominance among men of risk factors for smoking. The study found 39 diabetics versus 101 non-diabetics. The risk was high in 23 out of 39 diabetics; and 25 out of 101 non-diabetic patients. Conclusion: The study shows that one in four patients would have a high absolute risk in diabetic and non-diabetic patients and also confirms the association of other factors that increase this risk. The survey involved 140 individuals, 91 of whom (65.00%) 49 (35.00%) were men. sex ratio of 1.86 or 2 men per woman. The average age was 41-4.1 years with extremes of (30; 74) years. There was a predominance among men of risk factors for smoking and diabetes. In our series, most of our patients had a low risk level of 56 (40%). Conclusion: This survey finds a low risk in this hemodialysis population. This should lead to strengthening strategies for preventing cardiovascular disease in this at-risk population

R ES EA R CH Open Access Phenetic and genetic structure of tsetse fly populations (Glossina palpalis palpalis) in southern Ivory Coast

Abstract Background: Sleeping sickness, transmitted by G. p. palpalis, is known to be present in the Ivory Coast. G. p. palpalis has recently been reported to occur in several places within the town of Abidjan, including: (i) the Banco forest, (ii) the Abobo Adjamé University campus and (iii) the zoological park. Could these three places be treated sequentially, as separate tsetse populations, or should they be taken as one area comprising a single, panmictic population? Methods: The amount of gene flow between these places provides strategic information for vector control. It was estimated by the use of both microsatellite DNA and morphometric markers. The idea was to assess the interest of the faster and much less expensive morphometric approach in providing relevant information about population structure. Thus, to detect possible lack of insect exchange between these neighbouring areas of Abidjan, we used both genetic (microsatellite DNA) and phenetic (geometric morphometrics) markers on the same specimens. Using these same markers, we also compared these samples with specimens from a more distant area of south Ivory Coast, the region of Aniassué (186 km north from Abidjan). Results: Neither genetic nor phenetic markers detected significant differentiation between the three Abidjan G. p. palpalis samples. Thus, the null hypothesis of a single panmictic population within the city of Abidjan could not be rejected, suggesting the control strategy should not consider them separately. The markers were also in agreement when comparing G. p. palpalis from Abidjan with those of Aniassué, showing significant divergence between the two sites. Conclusions: Both markers suggested that a successful control of tsetse in Abidjan would require the three Abidjan sites to be considered together, either by deploying control measures simultaneously in all three sites, or by a continuous progression of interventions following for instance the "rolling carpet" principle. To compare the geometry of wing venation of tsetse flies is a cheap and fast technique. Agreement with the microsatellite approach highlights its potential for rapid assessment of population structure

Investigating the zoonotic origin of the West African Ebola epidemic

The severe Ebola virus disease epidemic occurring in West Africa stems from a single zoonotic transmission event to a 2‐year‐old boy in Meliandou, Guinea. We investigated the zoonotic origins of the epidemic using wildlife surveys, interviews, and molecular analyses of bat and environmental samples. We found no evidence for a concurrent outbreak in larger wildlife. Exposure to fruit bats is common in the region, but the index case may have been infected by playing in a hollow tree housing a colony of insectivorous free‐tailed bats (Mops condylurus). Bats in this family have previously been discussed as potential sources for Ebola virus outbreaks, and experimental data have shown that this species can survive experimental infection. These analyses expand the range of possible Ebola virus sources to include insectivorous bats and reiterate the importance of broader sampling efforts for understanding Ebola virus ecology

Lessons learned for surveillance system strengthening through capacity building and partnership engagement in post-Ebola Guinea, 2015–2019

The 2014–2016 Ebola outbreak in Guinea revealed systematic weaknesses in the existing disease surveillance system, which contributed to delayed detection, underreporting of cases, widespread transmission in Guinea and cross-border transmission to neighboring Sierra Leone and Liberia, leading to the largest Ebola epidemic ever recorded. Efforts to understand the epidemic's scale and distribution were hindered by problems with data completeness, accuracy, and reliability. In 2017, recognizing the importance and usefulness of surveillance data in making evidence-based decisions for the control of epidemic-prone diseases, the Guinean Ministry of Health (MoH) included surveillance strengthening as a priority activity in their post-Ebola transition plan and requested the support of partners to attain its objectives. The U.S. Centers for Disease Control and Prevention (US CDC) and four of its implementing partners—International Medical Corps, the International Organization for Migration, RTI International, and the World Health Organization—worked in collaboration with the Government of Guinea to strengthen the country's surveillance capacity, in alignment with the Global Health Security Agenda and International Health Regulations 2005 objectives for surveillance and reporting. This paper describes the main surveillance activities supported by US CDC and its partners between 2015 and 2019 and provides information on the strategies used and the impact of activities. It also discusses lessons learned for building sustainable capacity and infrastructure for disease surveillance and reporting in similar resource-limited settings

Long-term cellular immunity of vaccines for Zaire Ebola Virus Diseases

Recent Ebola outbreaks underscore the importance of continuous prevention and disease control efforts. Authorized vaccines include Merck’s Ervebo (rVSV-ZEBOV) and Johnson & Johnson’s two-dose combination (Ad26.ZEBOV/MVA-BN-Filo). Here, in a five-year follow-up of the PREVAC randomized trial (NCT02876328), we report the results of the immunology ancillary study of the trial. The primary endpoint is to evaluate long-term memory T-cell responses induced by three vaccine regimens: Ad26–MVA, rVSV, and rVSV–booster. Polyfunctional EBOV-specific CD4+ T-cell responses increase after Ad26 priming and are further boosted by MVA, whereas minimal responses are observed in the rVSV groups, declining after one year. In-vitro expansion for eight days show sustained EBOV-specific T-cell responses for up to 60 months post-prime vaccination with both Ad26-MVA and rVSV, with no decline. Cytokine production analysis identify shared biomarkers between the Ad26-MVA and rVSV groups. In secondary endpoint, we observed an elevation of pro-inflammatory cytokines at Day 7 in the rVSV group. Finally, we establish a correlation between EBOV-specific T-cell responses and anti-EBOV IgG responses. Our findings can guide booster vaccination recommendations and help identify populations likely to benefit from revaccination

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

A generic learning simulation framework to assess security strategies in cyber-physical production systems

Connected systems through computerized networks are at the heart of the Industry of the future. As they merge physical entities with cyber spaces, they fall under the paradigm of cyber-physical production systems. Cybersecurity is a key challenge for such systems, as they are subject to daily attempts of intruders to gain unauthorized access to their internal resources or to compromise their integrity. The fast increase of new attack strategies requires the rapid design and assessment of new defense strategies. It entails a complex, error-prone and time-consuming process, including the clear specification of the attack and defense strategies involved, and the design and implementation of the simulation model allowing to evaluate the performances of the defense strategy. This work intends to make such a process transparent to cybersecurity managers by limiting their workload to the sole specification of the characteristics of the system and the logic of the attack and the defense. It provides a generic hybrid simulation framework for flexible evaluation of cybersecurity policies, which is demonstrated on a SYN flooding application. Therefore, the contribution is twofold: (1) The proposed framework offers a high-level environment allowing various experts to collaborate by graphically modeling a given attack strategy and the envisioned defense strategy, without engaging in heavy implementation efforts. Then the framework's executable infrastructure, which combines simulation with machine learning to understanding the interactions between the attackers & the defender, will allow them assessing the performances of these strategies. The proposed framework differs from state-of-the-art cybersecurity simulation environments in its uniqueness to combining the expressive power of a universal simulation modeling formalism with the user-friendliness of a visual simulation tool. Therefore, it offers at one side, a very high modeling flexibility for easy exploration of various cybersecurity strategies, and at the other side, integrated learning capabilities for allowing self-adaptive user-based cybersecurity strategy design. (2) The application demonstrating the framework focuses on the most encountered and still uncontrolled threats in cybersecurity, i.e. the SYN-Flooding based Denial of Service (DoS) attack. The application targeted is not meant to propose yet another SYN flood detection algorithm or to improve the state-of-the-art in that domain, but to prove the framework operationality. The experimental results obtained showcase the ability of the framework to support learning simulation-based SYN flood defense algorithm design and validation

Polyarthrite Rhumatoïde en Consultation Rhumatologique à Maradi, Niger

Rheumatoid arthritis (RA) is the most common auto-immune disease. Rarely described in Niger, we reported its epidemiological, clinical, paraclinical, therapeutic, and evolutionary aspects in hospitals environments. In order to analyze these aspects in detail, a prospective study has been realized over a period of one (1) year in the Rheumatology Department of the Regional Hospital Center of Maradi. We have included all RA cases in accordance with the ACR/EULAR classification criteria of 2010. The data was entered and analyzed on SPSS 20.0 software. After collecting and studying 32 AR observations from among 846 rheumatologic consultations, the results have demonstrated different points: the average patient’s age is 38,9 years, the delay for the diagnosis was 6 years, and in some cases extraarticular manifestations have been observed. The results show that the inflammatory syndrome was constant and that the treatment remains classic with non-pharmacologic means, analgesics, NSAID (non-steroidal antiinflammatory agent), infiltrations and DMARDs (disease-modifying anti- rheumatic drug). The evolution is positive in all the cases. Thanksto thisstudy it is possible to affirm that rheumatoid arthritis is a reality in Niger and it has been better described. The diagnosis is late, the articular and systemic manifestations are the same as in Caucasians, but the autoimmunity seems less. The disease is very active, altering the quality of life. As for itstreatment, conventional background therapy still remains effective.La polyarthrite rhumatoïde (PR) est la plus fréquente des maladies auto-immunes. Rarement décrite au Niger, nous rapportons ses aspects épidémiologiques, cliniques, paracliniques, thérapeutiques et évolutifs en milieu hospitalier. Afin d’analyser ces aspects avec plus de détail une étude prospective a été réalisée sur une période d’un (01) an dans le service de rhumatologie du Centre Hospitalier Régional de Maradi. Nous avons inclus tous les cas de PR en accord avec les critères de classifications de l’ACR/EULAR de 2010. Les données ont été saisies et analysées sur le logiciel SPSS 20.0. Après avoir colligé et étudié 32 observations de PR parmi 846 consultations rhumatologiques, les résultats ont démontré des points divers : l’âge moyen des patients était 38,9 ans, le délai diagnostique était de 6 ans et dans quelques cas il y a eu la présence de manifestations extraarticulaires. Les résultats ont également montré que le syndrome inflammatoire était constant et que la prise en charge reste classique avec des moyens non pharmacologiques, des antalgiques, AINS (agent antiinflammatoire non stéroïdien),, infiltrations, et des DMARDs (diseasemodifying anti-rheumatic drug) . L’évolution est favorable dans tous les cas. En bref, la polyarthrite rhumatoïde est une réalité au Niger, de mieux en mieux décrite. Le diagnostic est tardif, les manifestations articulaires et systémiques sont les mêmes que chez les caucasiens mais l’auto-immunité semble moindre. La maladie est très active, altérant la qualité de vie. En ce qui concerne le traitement, le traitement de fond classique reste efficace

Étude du niveau de production larvaire d’Anopheles gambiae s.l. (Diptera: Culicidae) dans différents types de gîtes à Oussou-yaokro au Centre-Ouest et à Korhogo, au Nord (Côte d’Ivoire).

Objectif : Le paludisme est un problème de santé publique en Côte d’Ivoire. La lutte contre les vecteurs de cette affection nécessite la connaissance de leur lieu de reproduction. Cette étude se propose d’identifier les gîtes habituels et éventuellement les gîtes inhabituels (ou atypiques) d’An. gambiae s.l. en milieu rurale et en milieu urbain.Méthodologie et résultats : Des prospections larvaires dans divers points d’eau et la mesure des paramètres physico-chimiques ont été menées à Oussou-yaokro (milieu rural) pendant 4 mois et de manière transversale à Korhogo (milieu urbain). A Oussou-yaokro, 41 gîtes ont été recensés contre 44 à Korhogo et repartis en gîtes classiques et en gîtes atypiques (non habituels) d’An. gambiae s.l. Les gîtes atypiques sont par ordre d’importance les citernes ou jarres de conservation domestique d’eau, les abreuvoirs d’animaux, les eaux usées de fabrication de beurre de Karité, fosses septiques et des pneus usagés. La majorité des gîtes positifs se trouvent dans l’environnement immédiat des populations locales. A Oussou-yaokro, les gîtes atypiques produisent de manière similaire les larves que les gîtes classiques contrairement à Korhogo où les gîtes habituels sont plus productifs que les gîtes atypiques. La dynamique des gîtes a montré que les jarres ont une production larvaire régulière sur toute l’étude aussi bien en saison sèche qu’en saison des pluies en milieu rural. Quant à la productivité des gîtes, elle est liée à la pluviométrie en saison des pluies, mais aussi aux habitudes et à la durée de conservation d’eau dans les récipients en saison sècheConclusion et application des résultats : La présente étude indique qu’An. gambiae s.l. se développe aussi dans des gîtes atypiques, tels que les jarres, les abreuvoirs d’animaux, les eaux des fosses septiques, les eaux résiduelles de beurre de karité, initialement propices à la reproduction d’Aedes aegypti et de Culex quinquefasciatus. Au regard de nos résultats, la lutte antivectorielle contre les vecteurs du paludisme doit prendre en compte tous les points d’eau sans exclusive en raison de l’ubiquité d’An. gambiae s.l.Mots-clefs : An. gambiae s.l., production larvaire, type de gîtes, milieu rural, milieu urbain, Oussou-yaokro, Korhogo, Côte d’Ivoir