Prédiction de l’insulino-résistance par les ratios de lipoprotéines chez les adultes béninois

Des controverses subsistent sur force prédictive de l’insulino-résistance par les ratios de lipoprotéines chez les Afro-américains. L’objectif est de déterminer la force prédictive de l’insulino-résistance (IR) par les ratios triglycérides-par-HDL-cholestérol (TG/HDL-C) et cholestérol total-par-HDL-cholestérol (CT/HDL-C) chez des adultes béninois. L’étude est de type transversal, issue d’une enquête longitudinale sur le risque cardiométabolique et a inclut 416 sujets âgés de 29 à 69 ans. Les mesures anthropométriques et les dosages de la glycémie à jeun, de l’insulinémie, du CT, du HDL-C et des TG sont réalisés. L’IR est définie par le 75ème percentile des valeurs de « l’indice d’évaluation de modèle d'homéostasie pour l’insulino-résistance» (HOMA IR). Les valeurs prédictives de l’IR par les ratios TG/HDL-C et CT/HDL-C sont déterminées par les aires sous les courbes (AUC) de la « fonction d’efficacité du récepteur» (ROC). Les concentrations plasmatiques moyennes des lipides ont été en général plus élevées chez les IR que chez les non IR sauf pour les triglycérides : 0,9±0,5 mmol/L versus 0,8±0,4 mmol/L (p=0,138) chez les femmes, le cholestérol total : 4,7±1,7 mmol/L versus 4,3±1,2 mmol/L (p=0,161) et le HDL-Cholestérol : 1,2±0,5 mmol/L versus 1,34±0,5 mmol/L (p=0,105) chez les hommes. Les AUC ROC de prédiction de l’IR par le TG/HDL-C sont inférieures à 0,70 chez les femmes et les hommes, les obèses et les non obèses. L’AUC ROC de prédiction de l’IR par le CT/HDL-C est supérieure à 0,70 seulement chez les femmes : 0,71 (0,64-0,78). Le ratio TG/HDL-C n’est pas un prédicteur de l’IR dans la population d’étude alors que le ratio CT/HDL-C prédit l’IR chez les femmes seulement. Ces résultats contribueront au dépistage précoce de l’IR chez les femmes aux fins de la mise en place de mesures préventives.Mots clés : Prédiction, insulino-résistance, lipoprotéines, dyslipidémies, Bénin

Asymptomatic Carriage of Plasmodium in Urban Dakar: The Risk of Malaria Should Not Be Underestimated

Introduction: The objective of this study was to measure the rate of asymptomatic carriage of plasmodium in the Dakar region two years after the implementation of new strategies in clinical malaria management. Methodology: Between October and December 2008, 2952 households selected in 50 sites of Dakar area, were visited for interviews and blood sampling. Giemsa-stained thick blood smears (TBS) were performed for microscopy in asymptomatic adult women and children aged 2 to 10 years. To ensure the quality of the microscopy, we performed a polymerase chai

BMC Womens Health

BACKGROUND: Violence against women remains an important issue of inequality in African societies, with several consequences to health, social and economic status. This study aims to identify the factors related to the perception of intimate partner violence in Benin. METHODS: Data on intimate partner violence was collected by conducting live interviews, and from the Benin Demographic and Health Survey 2012. The dependent variable was acceptance of intimate partner violence. The independent variables were socio-demographic features such as age, level of education, matrimonial status, ethnicity, religion, place of residence and the index of economic well-being. Logistic regressions were performed and odds ratios (OR) with a confidence interval of 95% (CI95%) were estimated. RESULTS: Among the 21,574 people who answered the questions relating to violence against women by an intimate partner, the prevalence of acceptance of intimate partner violence was 15.77%. Ethnicity, level of education, administrative department of residence, religion, and socio-economic quintile were factors associated with the respondents' acceptance of violence against women by an intimate partner. CONCLUSION: Acceptance of intimate partner violence could be a major obstacle to the success of some health programs. There is a need to break the norms that support the vulnerability of women in Beninese society

Factorization of the solutions of the Fokker-Planck equation

Summary: "On the basis of Wiener integral, we study the relationship between the solution of the Fokker-Planck and Bloch equations. We established that the Bloch system of equation has the Hamilton structure. The factorization of the solution of the Fokker-Planck equation is illustrated on the examples of the harmonic oscillator and on the hydrogen atom.

Submicroscopic Plasmodium falciparum infections are associated with maternal anemia, premature births, and low birth weight

Background. Molecular, as opposed to microscopic, detection measures the real prevalence of Plasmodium falciparum infections. Such occult infections are common during pregnancy but their impact on pregnancy outcomes is unclear. We performed a longitudinal study to describe that impact. Methods. In a cohort of 1037 Beninese pregnant women, we used ultrasound to accurately estimate gestational ages. Infection with P. falciparum, hemoglobin concentration, use of intermittent preventive treatment during pregnancy (IPTp) for malaria, and other parameters were recorded during pregnancy. Using multivariate analyses, we evaluated the impact of submicroscopic infections on maternal anemia, premature birth, and low birth weight. Results. At inclusion, polymerase chain reaction (PCR) and microscopy detected infection in 40% and 16% of women, respectively. The proportion infected declined markedly after 2 doses of IPTp but rebounded to 34% (by PCR) at delivery. Submicroscopic infections during pregnancy were associated with lower mean hemoglobin irrespective of gravidity, and with increased anemia risk in primigravidae (odds ratio [OR], 2.23; 95% confidence interval [CI], .98-5.07). Prospectively, submicroscopic infections at inclusion were associated with significantly increased risks of low birth weight in primigravidae (OR, 6.09; 95% CI, 1.16-31.95) and premature births in multigravidae (OR, 2.25; 95% CI, 1.13-4.46). Conclusions. In this detailed longitudinal study, we document the deleterious impact of submicroscopic P. falciparum parasitemia during pregnancy on multiple pregnancy outcomes. Parasitemia occurs frequently during pregnancy, but routine microscopic and rapid diagnostic tests fail to detect the vast majority of episodes. Our findings imply caution in any revision of the current strategies for prevention of pregnancy-associated malaria

Submicroscopic placental infection by non-falciparum Plasmodium spp.

Background Among the Plasmodium species that infect humans, adverse effects of P. falciparum and P. vivax have been extensively studied and reported with respect to poor outcomes particularly in first time mothers and in pregnant women living in areas with unstable malaria transmission. Although, other non-falciparum malaria infections during pregnancy have sometimes been reported, little is known about the dynamics of these infections during pregnancy. Methods and findings Using a quantitative PCR approach, blood samples collected from Beninese pregnant women during the first antenatal visit (ANV) and at delivery including placental blood were screened for Plasmodium spp. Risk factors associated with Plasmodium spp. infection during pregnancy were assessed as well as the relationships with pregnancy outcomes. P. falciparum was the most prevalent Plasmodium species detected during pregnancy, irrespective either of parity, of age or of season during which the infection occurred. Although no P. vivax infections were detected in this cohort, P. malariae (9.2%) and P. ovale (5.8%) infections were observed in samples collected during the first ANV. These non-falciparum infections were also detected in maternal peripheral blood (1.3% for P. malariae and 1.2% for P. ovale) at delivery. Importantly, higher prevalence of P. malariae (5.5%) was observed in placental than peripheral blood while that of P. ovale was similar (1.8% in placental blood). Among the non-falciparum infected pregnant women with paired peripheral and placental samples, P. malariae infections in the placental blood was significantly higher than in the peripheral blood, suggesting a possible affinity of P. malariae for the placenta. However, no assoctiation of non-falciparum infections and the pregnancy outcomes was observed Conclusions Overall this study provided insights into the molecular epidemiology of Plasmodium spp. infection during pregnancy, indicating placental infection by non-falciparum Plasmodium and the lack of association of these infections with adverse pregnancy outcomes

Optimized pan-species and speciation duplex real-time pcr assays for Plasmodium parasites detection in malaria vectors

Background: An accurate method for detecting malaria parasites in the mosquito's vector remains an essential component in the vector control. The Enzyme linked immunosorbent assay specific for circumsporozoite protein (ELISA-CSP) is the gold standard method for the detection of malaria parasites in the vector even if it presents some limitations. Here, we optimized multiplex real-time PCR assays to accurately detect minor populations in mixed infection with multiple Plasmodium species in the African malaria vectors Anopheles gambiae and Anopheles funestus. Methods: Complementary TaqMan-based real-time PCR assays that detect Plasmodium species using specific primers and probes were first evaluated on artificial mixtures of different targets inserted in plasmid constructs. The assays were further validated in comparison with the ELISA-CSP on 200 field caught Anopheles gambiae and Anopheles funestus mosquitoes collected in two localities in southern Benin. Results: The validation of the duplex real-time PCR assays on the plasmid mixtures demonstrated robust specificity and sensitivity for detecting distinct targets. Using a panel of mosquito specimen, the real-time PCR showed a relatively high sensitivity (88.6%) and specificity (98%), compared to ELISA-CSP as the referent standard. The agreement between both methods was "excellent' (k = 0.8, P < 0.05). The relative quantification of Plasmodium DNA between the two Anopheles species analyzed showed no significant difference (P = 0, 2). All infected mosquito samples contained Plasmodium falciparum DNA and mixed infections with P. malariae and/or P. ovale were observed in 18.6% and 13.6% of An. gambiae and An. funestus respectively. Plasmodium vivax was found in none of the mosquito samples analyzed. Conclusion: This study presents an optimized method for detecting the four Plasmodium species in the African malaria vectors. The study highlights substantial discordance with traditional ELISA-CSP pointing out the utility of employing an accurate molecular diagnostic tool for detecting malaria parasites in field mosquito populations