Association between genital tract infection and premature rupture of membranes: A retrospective case control study in Tunisia, North Africa

Premature Rupture of Membranes is responsible for most cases of neonatal death. In most of these cases, the causes of PROM havenot been established in Tunisia, although several risk factors have been described. Therefore, we set out to determine the presenceof an association between genital infections and PROM among Tunisian women. A case-control study was conducted among 251 womens to detect the presence of association between genital tract infection and Premature Rupture of Membranes.Cases had apremature membranes rupture and the controls had intact membranes or suffering from premature membrane rupture during thelatent phase of labour. Data were collected from the medical register including socio-demographic characteristics, obstetrics, andmedical history. Association between genital infections and premature rupture of membranes was estimated using the Odds Ratioand 95% CI. One risk factor was identified, including age. There is no association between the presence of Group B streptococcus (OR= 1.08; 95% CI 0.50-2.34), presence of Trichomonasvaginalis (OR= 2.45; 95% CI 0.15-39.83) and presence of Candidiasis (OR= 1.11; 95% CI 0.58-2.14) and premature rupture of membranes. Co-infection was not associated with premature rupture of membranes (OR= 0.43; 95% CI 0.45-6.07). There is no association between genital infections and PROM among pregnant Tunisian women. Keywords: Genital infections, premature rupture of membranes, risk factors, Monastir, TunisiaLa rupture prématurée des membranes est responsable de la plupart des cas de décès néonatal. Enn effet, les causes de la RPM n'ont pas été établies en Tunisie, bien que plusieurs facteurs de risque aient été décrits. Par conséquent, nous avons cherché à déterminer la présence d'une association entre les infections génitales et la RPM chez les femmes tunisiennes. Une étude castémoins a été menée auprès de 251 femmes pour détecter la présence d'une association entre l'infection des voies génitales et la rupture prématurée des membranes. Les cas avaient une rupture prématurée des membranes et les témoins avaient des membranes intactes ou souffraient d'une rupture prématurée de la membrane pendant la phase latente du travail. Les données ont été recueillies à partir du registre médical, y compris les caractéristiques sociodémographiques, l'obstétrique et les antécédents médicaux. L'association entre les infections génitales et la rupture prématurée des membranes a été estimée à l'aide du OR et de l'IC à 95%. Un facteur de risque a été identifié, incluant l'âge. Il n'y a pas d'association entre la présence de streptocoques du groupe B (OR = 1,08; IC à 95% 0,50-2,34), la présence de Trichomonasvaginalis (OR = 2,45; IC à 95% 0,15-39,83) et la présence de candidose (OR = 1,11; 95% CI 0,58-2,14) et rupture prématurée des membranes. La co-infection n'était pas associée aussi à la rupture prématurée des membranes (OR = 0,43; IC à 95% 0,45 à 6,07). Il n'y a pas d'association entre les infections génitales et la RPM chez les femmes tunisiennes. Mots-clés: Infections génitales, rupture prématurée des membranes, facteurs de risque, Monastir, Tunisi

Evaluation of pro-inflammatory cytokines in frail Tunisian older adults.

The present study was undertaken to evaluate serum levels of pro-inflammatory cytokines in Tunisian older adults and to examine the relationships between inflammatory marker levels, geriatric, and biochemical parameters. A cross-sectional study was conducted in a population of Tunisian older adults (N = 141, aged 65 and over). Patients were recruited from the Department of Internal Medicine, Fattouma Bourguiba University Hospital (Monastir, Tunisia) and from a nursing home (Sousse, Tunisia). Comprehensive geriatric assessment, history taking and examination including functional and nutritional assessment were done for each participant. Enzyme-linked immunosorbent assay (ELISA) test was used to measure serum cytokine (TNF-α, IL-8, IL-6) levels. The modified Short Emergency Geriatric Assessment score (SEGAm) were used to classify patients as 51 very-frail, 40 frail, and 50 non-frail. The age of the participants (80 men, 61 women) ranged from 65 to 97 years. Serum levels of TNF-α, IL-8 and C-reactive protein (CRP) were significantly higher in very-frail participants compared to frail and non-frail ones. However, no significant differences in IL-6 levels were detected among frailty groups. After adjustment for age, CRP and IL-8 levels remained significantly associated with frailty. Analysis of the receiver operating characteristic (ROC) curve corresponding to IL-8 showed an area under the curve of 0.7 (p = 0.003; 95% CI [0.58-0.81]) and a predictive threshold of 5.27 pg/ml. Positive correlations were found between frailty score, IL-6, and IL-8 levels. In addition, a significant positive correlation was observed between IL-8 levels and Timed Up and Go test results. However, a negative correlation was observed between Mini Nutritional Assessment Short-Form score, IL-6 and CRP levels, as well as between Activities of Daily Living score and serum levels of TNF-α, IL-6, and CRP. In conclusion, the key findings of this study collectively support a role of pro-inflammatory cytokines, TNF-α, CRP, and especially IL-8 in the development of frailty in older adults

Lessons about Causes and Management of an Ebola Outbreak

Ebola virus disease (EVD) is one of the deadliest viral diseases. It is characterized by a high mortality rate due to the lack of effective and safe treatments or vaccines and its ability to spread at an unstoppable pace. The West Africa outbreak ended but the disease may strike again at any time. The latest epidemic was, by far, the deadliest to date. The most concern was why this outbreak was so different from the previous ones. We proposed in this review firstly to summarize the principal causes of its unprecedented spread and secondly to identify the steps for an effective management approach of a future Ebola outbreak. Attributes of the affected populations and insufficient control efforts were the main reasons of its amplification. This was complicated by a delayed international response. The health crisis was ignored for months until it got out of control. The management of Ebola presents a multitude of challenges in terms of preparedness and capacity to face an outbreak. In addition to the need for adequate health care facilities, ongoing surveillance tools, appropriate training of health workers and raising population awareness, readiness requires a large scale and coordinated international intervention to support affected and at-risk nations, to intensify their response activities and to strengthen their capacities. Constant interventions after the outbreak are still needed to ensure that vital health and related service institutions in these countries are fully prepared to respond to an eminent epidemic

Electrochemical monitoring of Chlorhexidine Digluconate effect on polyelectrolyte immobilized bacteria and kinetic cell adhesion

International audienceThe electrochemical impedance spectroscopy (EIS) technique has been used as a sensitive method to explore the effect of antibacterial molecules on immobilized bacteria and biofilm formation. In this work, we describe the electrochemical spectroscopy as a powerful method to monitor the effect of Chlorhexidine Digluconate (CHX-Dg) on polyelectrolyte immobilized Escherichia coli K12 MG1655 and the kinetics of cell adhesion on gold electrodes. The experimental impedance data were modelised with a Zview program to find the best equivalent electrical circuit and analyse its parameter's properties. Polyelectrolyte multilayer formation on the electrode surface and bacteria immobilization greatly increased the electron-transfer resistance (Ret) and reduced the constant phase element (CPEdl). The effect of CHX-Dg was studied in a 0.5 × 10−4 mmol l−1 to 0.5 mmol l−1 range. The relation between the evolution of Ret and CHX-Dg concentration was found to be negatively correlated. When CHX-Dg was added, the electrochemical monitoring of the bacterial kinetic adhesion showed that the electrode's capacity (CP) variation remained stable, demonstrating that the addition of CHX-Dg in the broth inhibited bacterial adhesion

The association between functional HLA-G 14 bp insertion/deletion and +3142 C > G polymorphisms and susceptibility to multiple sclerosis

We aimed to investigate two main polymorphisms in the 3' untranslated region (3'UTR) of the HLA-G gene [14 bp insertion/deletion (INS/DEL) and +3142 C > G] and to assess their impact on the soluble HLA-G (sHLA-G) production in patients with multiple sclerosis (MS). This study included 60 patients with relasping-remitting (RR) MS and 112 healthy donors (HD). Mutations were identified by PCR and PCR–RFLP, and serum sHLA-G quantification was performed by ELISA. For the 14 bp INS/DEL polymorphism, variants frequencies were similar in patients and controls, whereas a significant increased frequency of the +3142 G allele was found in MS patients compared to HD (63.4% vs 52.3%, p = 0.04; OR = 1.58, 95%CI = 1.003–2.48). In addition, an association was found between MS susceptibility and the haplotypes regrouping both studied polymorphisms. Indeed, the 14 bp DEL/ + 3142 G haplotype frequency was significantly increased in MS patients compared to HD (20.8% vs 12.5%, p = 0.04, OR = 1.84). On the other hand, no associations were detected between both polymorphisms and clinical parameters, except the lower age of disease onset (ADO) in patients with the +3142 C/C genotype. Moreover, our study doesn't show any significant variation of sHLA-G serum levels between patients and controls. Our findings showed that the +3142 C > G, but not the 14 bp INS/DEL, polymorphism may constitute a genetic susceptibility factor to MS in the Tunisian population. However, no association was found between the two polymorphisms and sHLA-G serum levels

Monitoring of E. coli immobilization on modified gold electrode: A new bacteria-based glucose sensor

International audienc

Detection and Genomic Characterization of Aichi Viruses in Stool Samples from Children in Monastir, Tunisia▿

Aichi virus has been associated with acute gastroenteritis in adults and children. Stool samples were collected from 788 Tunisian children suffering from diarrhea. Aichi virus was found in 4.1% of the cases. The high proportion of monoinfections and the high frequency of hospitalizations support the role of Aichi virus in pediatric gastroenteritis

Molecular Epidemiology of Norovirus Gastroenteritis Investigated Using Samples Collected from Children in Tunisia during a Four-Year Period: Detection of the Norovirus Variant GGII.4 Hunter as Early as January 2003 ▿

Human noroviruses (NoVs) cause epidemic and endemic acute gastroenteritis in children and adults. To study the prevalence and genetic diversity of NoV in children in Tunisia, a total of 788 fecal samples were collected during a 4-year period in the region of Monastir, from children 12 years of age or younger, hospitalized or presenting in dispensaries with symptoms of acute gastroenteritis. NoV was detected by reverse transcription-PCR and confirmed by sequence analysis. This is the first report that describes the molecular epidemiology of NoV in Tunisian children: NoVs were characterized as the causative agent in 128 (16.2%) of the samples. Fourteen samples contained a mixture of two NoVs, and 33 samples were coinfected with additional enteric viruses. Eight distinct NoV genotypes were detected (GGI.2, GGI.4, GGII.1, GGII.4, GGII.8, GGII.14, GGIIb/GGII.2, and GGIIb/GGII.3). GGII.4 was the most prevalent genotype, accounting for 83 (64.8%) cases. Interestingly the GGII.4 variant Hunter, described as spreading all over the world in 2004, was found in Tunisia as early as January 2003. The delay of 1 year between the isolation in Tunisia and the worldwide emergence is somewhat surprising, considering the importance of the contacts between North Africa and Europe particularly. Nevertheless, this illustrates the idea that sporadic gastroenteritis cases may be a reservoir for emerging epidemic NoV strains