Intermittent preventive treatment of malaria provides substantial protection against malaria in children already protected by an insecticide-treated bednet in Burkina Faso: a randomised, double-blind, placebo-controlled trial.

BACKGROUND: Intermittent preventive treatment of malaria in children (IPTc) is a promising new approach to the control of malaria in areas of seasonal malaria transmission but it is not known if IPTc adds to the protection provided by an insecticide-treated net (ITN). METHODS AND FINDINGS: An individually randomised, double-blind, placebo-controlled trial of seasonal IPTc was conducted in Burkina Faso in children aged 3 to 59 months who were provided with a long-lasting insecticide-treated bednet (LLIN). Three rounds of treatment with sulphadoxine pyrimethamine plus amodiaquine or placebos were given at monthly intervals during the malaria transmission season. Passive surveillance for malaria episodes was established, a cross-sectional survey was conducted at the end of the malaria transmission season, and use of ITNs was monitored during the intervention period. Incidence rates of malaria were compared using a Cox regression model and generalized linear models were fitted to examine the effect of IPTc on the prevalence of malaria infection, anaemia, and on anthropometric indicators. 3,052 children were screened and 3,014 were enrolled in the trial; 1,505 in the control arm and 1,509 in the intervention arm. Similar proportions of children in the two treatment arms were reported to sleep under an LLIN during the intervention period (93%). The incidence of malaria, defined as fever or history of fever with parasitaemia ≥ 5,000/µl, was 2.88 (95% confidence interval [CI] 2.70-3.06) per child during the intervention period in the control arm versus 0.87 (95% CI 0.78-0.97) in the intervention arm, a protective efficacy (PE) of 70% (95% CI 66%-74%) (p<0.001). There was a 69% (95% CI 6%-90%) reduction in incidence of severe malaria (p = 0.04) and a 46% (95% CI 7%-69%) (p = 0.03) reduction in the incidence of all-cause hospital admissions. IPTc reduced the prevalence of malaria infection at the end of the malaria transmission season by 73% (95% CI 68%-77%) (p<0.001) and that of moderately severe anaemia by 56% (95% CI 36%-70%) (p<0.001). IPTc reduced the risks of wasting (risk ratio [RR] = 0.79; 95% CI 0.65-1.00) (p = 0.05) and of being underweight (RR = 0.84; 95% CI 0.72-0.99) (p = 0.03). Children who received IPTc were 2.8 (95% CI 2.3-3.5) (p<0.001) times more likely to vomit than children who received placebo but no drug-related serious adverse event was recorded. CONCLUSIONS: IPT of malaria provides substantial protection against malaria in children who sleep under an ITN. There is now strong evidence to support the integration of IPTc into malaria control strategies in areas of seasonal malaria transmission. TRIAL REGISTRATION: ClinicalTrials.govNCT00738946. Please see later in the article for the Editors' Summary

Hepatoprotective activity of aqueous extract of Balanites aegyptiaca L. Delile (Balanitaceae) roots bark

Balanites aegyptiaca (L.) Del (Balanitaceae) is traditionally used for the treatment of various ailments such as syphilis, jaundice and liver disorders, epilepsy, ... This study was designed to evaluate acute toxicity and hepatoprotective effect of aqueous extract of Balanites aegyptiaca on CCl4 induced hepatotoxicity in rats.Methods: Acute toxicity was assessed with the extract at a dose of 2000 mg / kg bw. The extract at doses of 25, 50 and 100 mg / kg b.w. was orally administered respectively to CC14-induced hepatotoxicity (0.5 ml / kg) animals. Silymarin (100 mg / kg) was given as a reference. Biochemical parameters such as ALT, AST, PT, ALB and ALP were assayed as well as enzymatic antioxidant activities SOD, CAT and MDA. Nitrogen monoxide (NO) involved in inflammation was also measured.Results: Activities of liver marker enzymes, ALT, AST and ALP, total protein, albumin and showed a significant hepatoprotective effect. Regarding antioxidant enzymatic activities in vivo (SOD, CAT and MDA) of aqueous extract exhibited a significant effect showing increasing levels of SOD, CAT and reducing malondialdehyde (MDA) levels. The production of NO is significantly reduced compared to the batch intoxicated by CCl4.Conclusion: Balanites aegyptiaca is endowed with hepatoprotective properties that can be attributed to antioxidant potential which could justify its use in traditional medicine in liver disorders

Livestock keepers’ attitudes: Keystone of effective community-based breeding programs

Livestock keepers in southwestern Burkina Faso hold the local Lobi taurine breed, local Zebu cattle, and their crosses. Some communities in the region have begun to implement community-based cattle breeding programs (CBBPs), which involve animal tagging and recording and, potentially, also bull sharing. Based on the hypothesis that the participation of livestock keepers in CBBPs depends on their attitudes towards these programs, we used questionnaires to survey the attitudes of 125 farmers towards cattle breeding strategies and tools. Results were analyzed using principal component analysis. Farmers showed a highly positive attitude towards maintaining the features of their preferred cattle breed, but their attitudes varied substantially towards crossbreeding for breed improvement. Farmers generally agreed that performance was more important than animal appearance, and most of them were willing to cooperate with breeders’ associations but were skeptical about sharing their bulls with other farmers. The majority was reluctant to record performance data, which may be due to a capacity deficit and their confidence in being able to select the best animals based purely on phenotype. Our analysis suggests that breeders’ associations, as a key component of CBBPs, should lay down clear rules and obligations for their members from the outset. Timely consideration of farmers’ attitudes towards different breeding tools may improve their uptake and guarantee the sustainability of CBBPs

Nécrolyse épidermique liée à l’application cutanée d’une solution d’hydroxyde de potassium

Dans nos régions, une solution d'hydroxyde de potassium est régulièrement utilisée en application sur la peau comme traitement traditionnel dans le but de traiter un prurit ou une éruption cutanée. Dans notre pratique quotidienne, nous observons de plus en plus de réactions cutanées à ce type de traitement. Nous rapportons un cas de nécrolyse épidermique généralisée suite à l'application d'une solution concentrée d'hydroxyde de potassium. Il s'agissait d'une patiente de 51 ans, séropositive au VIH2, et au virus de l'hépatite virale C, mais non éligible au traitement antirétroviral. Elle était hospitalisée pour des décollements épidermiques nécrolytiques quasi-généralisés survenue le lendemain de l'application une solution de concentré de potasse sur tout le tégument. Cette solution avait été appliquée dans le but de traiter une éruption micropapuleuse prurigineuse généralisée (exanthème maculo-papuleux) survenue suite à a prise de cotrimoxazole. La réépidermisation était totale sans séquelle après un mois de suivi. Le diagnostic nécrolyse épidermique toxique ou syndrome de Lyell qui met souvent en jeu le pronostic vital avait été écarté devant la conservation de l'état général, l'absence d'atteinte muqueuse et la rapide cicatrisation. Certains traitements traditionnels ont fait la preuve au cours du temps de leur efficacité, mais un mésusage peut être à l'origine d'effets secondaires graves

Eplucher l'Oignon : Pour une filière oignon nigérienne compétitive et inclusive

Perceptual learning is associated with experience-based changes in stimulus salience. Here, we use a novel procedure to show that learning a new association between a self-label and a neutral stimulus produces fast alterations in social salience measured by interference when targets associated with other people have to be selected in the presence of self-associated distractors. Participants associated neutral shapes with either themselves or a friend, over a short run of training trials. Subsequently, the shapes had to be identified in hierarchical (global-local) forms. The data show that giving a shape greater personal significance by associating it with the self had effects on visual selection equivalent to altering perceptual salience. Similar to previously observed effects linked to when perceptually salient distractors are ignored, effects of a self-associated distractor also increased activation in the left intraparietal cortex sulcus. The results show that self-associations to sensory stimuli rapidly modulate neural responses in a manner similar to changes in perceptual saliency. The self-association procedure provides a new way to understand how personal significance affects behavior

A mode-of-action ontology model for safety evaluation of chemicals: outcome of a series of workshops on repeated dose toxicity

Repeated dose toxicity evaluation aims at assessing the occurrence of adverse effects following chronic or repeated exposure to chemicals. Non-animal approaches have gained importance in the last decades because of ethical considerations as well as due to scientific reasons calling for more human-based strategies. A critical aspect of this challenge is linked to the capacity to cover a comprehensive set of interdependent mechanisms of action, link them to adverse effects and interpret their probability to be triggered in the light of the exposure at the (sub)cellular level. Inherent to its structured nature, an ontology addressing repeated dose toxicity could be a scientific and transparent way to achieve this goal. Additionally, repeated dose toxicity evaluation through the use of a harmonized ontology should be performed in a reproducible and consistent manner, while mimicking as accurately as possible human physiology and adaptivity. In this paper, the outcome of a series of workshops organized by Cosmetics Europe on this topic is reported. As such, this manuscript shows how experts set critical elements and ways of establishing a mode-of-action ontology model as a support to risk assessors aiming to perform animal-free safety evaluation of chemicals based on repeated dose toxicity data

Polymorphisms in Plasmodium falciparum chloroquine resistance transporter and multidrug resistance 1 genes: parasite risk factors that affect treatment outcomes for P. falciparum malaria after artemether-lumefantrine and artesunate-amodiaquine.

Adequate clinical and parasitologic cure by artemisinin combination therapies relies on the artemisinin component and the partner drug. Polymorphisms in the Plasmodium falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance 1 (pfmdr1) genes are associated with decreased sensitivity to amodiaquine and lumefantrine, but effects of these polymorphisms on therapeutic responses to artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL) have not been clearly defined. Individual patient data from 31 clinical trials were harmonized and pooled by using standardized methods from the WorldWide Antimalarial Resistance Network. Data for more than 7,000 patients were analyzed to assess relationships between parasite polymorphisms in pfcrt and pfmdr1 and clinically relevant outcomes after treatment with AL or ASAQ. Presence of the pfmdr1 gene N86 (adjusted hazards ratio = 4.74, 95% confidence interval = 2.29 - 9.78, P < 0.001) and increased pfmdr1 copy number (adjusted hazards ratio = 6.52, 95% confidence interval = 2.36-17.97, P < 0.001 : were significant independent risk factors for recrudescence in patients treated with AL. AL and ASAQ exerted opposing selective effects on single-nucleotide polymorphisms in pfcrt and pfmdr1. Monitoring selection and responding to emerging signs of drug resistance are critical tools for preserving efficacy of artemisinin combination therapies; determination of the prevalence of at least pfcrt K76T and pfmdr1 N86Y should now be routine