Le kawal, un condiment a base de feuilles fermentees de senna obtusifolia: technologies et valeurs nutritionnelles

De nombreux aliments fermentés à base de légumes-feuilles sont consommés dans le monde, particulièrement en Afrique et en Asie. Ces aliments très répandus, représentent le régime de base en plus de leurs matières premières disponibles et constituent une part importante dans l’alimentation des populations locales. Le kawal obtenu par fermentation naturelle et alcaline des feuilles de Senna obtusifolia encore appelé Cassia obtusifolia, est un aliment très apprécié et largement consommé par les populations au Tchad et au Soudan. Les feuilles de S. obtusifolia occupent une place importante dans le système alimentaire de nombreuses communautés en Afrique. Elles sont riches en acides aminés essentiels et peuvent être considérées comme des produits d’intérêt nutritionnel de par leur valeur protéique. Le kawal contient des quantités appréciables de protéines et est utilisé comme substitut de viande et ou de poisson. Il est également riche en hydrates de carbone et en sels minéraux. La technologie de production du kawal reste traditionnelle avec des équipements rudimentaires et une fermentation incontrôlée. Cependant, cette technique de fermentation bien que traditionnelle permet l’élimination des facteurs antinutritionnels contenus dans les feuilles. Elle contribue aussi à l’amélioration de la valeur nutritionnelle et au développement de composés aromatiques tout en permettant d’augmenter la biodisponibilité des minéraux aboutissant ainsi à un produit qui permet de réduire les problèmes de carences en minéraux chez l’Homme. Les bactéries fermentaires du kawal, principalement celles des genres Bacillus et Lactobacillus du fait de leurs aptitudes probiotiques sont bénéfiques pour la santé humaine. La transformation de ce produit constitue un enjeu économique important en raison des revenus générés et contribue ainsi à la valorisation des ressources végétales et à la sécurité alimentaire des populations. Les technologies de la transformation du kawal n’étant pas bien maitrisées et variant d’une région à l’autre et ou d’une productrice à une autre il est donc indispensable de faire une synthèse sur les technologies de sa transformation et sa valeur nutritionnelle en vue de son amélioration.Mots clés: Kawal, feuilles fermentées, Senna obtusifolia, technologies, valeursnutritionnelle

Prevalence of metabolic syndrome among HIV-positive and HIV-negative populations in sub-Saharan Africa-a systematic review and meta-analysis

BACKGROUND: Metabolic syndrome (MetS) is a constellation of conditions that increase the risk of cardiovascular diseases. It is an emerging concern in sub-Saharan African (SSA) countries, particularly because of an increasingly aging population and lifestyle changes. There is an increased risk of MetS and its components among people living with Human immune deficiency syndrome (HIV) individuals; however, the prevalence of metabolic syndrome in the SSA population and its differential contribution by HIV status is not yet established. This systematic review and meta-analysis were conducted to estimate the pooled prevalence of metabolic syndrome in people living with HIV and uninfected populations, its variation by sub-components. METHODS: We performed a comprehensive search on major databases-MEDLINE (PubMed), EBSCOhost, and Cochrane Database of Systematic Reviews and Web of sciences for original epidemiological research articles that compared proportions of the MetS and its subcomponents between people living with HIV and uninfected patients and published between January 1990-December 2017. The inclusion criteria were adults aged ≥ 18 years, with confirmed HIV status. We assessed the risk of bias using a prevalence studies tool, and random effect meta-analyses were used to compute the pooled overall prevalence. RESULTS: A total of four cross-sectional studies comprising 496 HIV uninfected and 731 infected participants were included in the meta-analysis. The overall prevalence of MetS among people living with HIV was 21.5% (95% CI 15.09-26.86) versus uninfected 12.0% (95% CI 5.00-21.00%), with substantial heterogeneity. The reported relative risk estimate for MetS among the two groups was twofold (RR 1.83, 95% CI 0.98-3.41), with an estimated predictive interval of 0.15 to 22.43 and P = 0.055 higher for the infected population. Hypertension was the most prevalent MetS sub-components, with diverse proportions of people living with HIV (5.2-50.0%) and uninfected (10.0-59.0%) populations. CONCLUSIONS: The high range of MetS prevalence in the HIV-infected population compared to the uninfected population highlights the possible presence of HIV related drivers of MetS. Also, the reported high rate of MetS, irrespective of HIV status, indicates a major metabolic disorder epidemic that requires urgent prevention and management programs in SSA. Similarly, in the era of universal test and treat strategy among people living with HIV cohorts, routine check-up of MetS sub-components is required in HIV management as biomarkers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016045727

Prévalence de la dépression et influence sur la sexualité dans les couples serodiscordants à Ouagadougou (Burkina Faso)

English Title:  Prevalence of depression and his influence on sexuality in serodiscordant couples in Ouagadougou (Burkina Faso)English AbstractDepression is often associated with risky sexual behaviors. The aim of the study was to assess the prevalence of depression and his influence on unprotected sex and sexual dysfunction in HIV discordant couples in Ouagadougou. This was a cross-sectional study from January 1st to June 31, 2010. Serodiscordant couples whom were following in the University Hospital Yalgado Ouedraogo and agreed to participate were included.Eighty heterosexual couples were studied. Thirty-one (38.7%) seropositive and 23 (28.7%) seronegative partners suffered from depression (p = 0.18).The mean score of depression was 3.5 ± 2.1 in HIV-positive and 3.3 ± 1.6 in HIV-negative partners (p = 0.85). Depression affected both partners in 13 couples (16.2%) and only one in 28 couples (35%). The unprotected sex were reported in 5 (38.5%) couples where both partners were depressed, 13 (46.4%) where only one was depressed and 26 (66.7%) where neither partner was depressed (p = 0.11). Depression was notified at least for one partner in 40 (51, 3%) couples where partner (s) reported dysfunction and 1 (50%) couple where no partner reported this. Effective medical and psychological care of partners is needed to promote a beaming and safety sex in serodiscordant couples.Keywords: depression, sexuality, serodiscordant couples, Burkina Fas

Melorheostosis with bilateral involvement in a black African patient

Melorheostosis is a rare chronic bone disease of unknown etiology that often affects a single limb. Onset usually occurs in childhood or early adolescence. A flowing wax appearance along the surface of the bone and multiple areas of bone sclerosis produce a typical radiographic picture. We describe the first case reported in a black African, in whom an exceedingly rare feature was a bilateral distribution of the lesions. (C) 2003 Elsevier SAS. All rights reserved

Technologies, qualité et importance socioéconomique du poisson séché en Afrique

Les pertes post-captures constituent un problème reconnu dans la sous-région. En Afrique subsaharienne, environ 25 % du poisson sont perdus par manque de moyens efficaces de conservation et de transformation. Lestechniques traditionnelles (le salage, le séchage et le fumage) sont des moyens utilisés pour conserver et améliorer la disponibilité du poisson.  Dans les pays en développement comme le Tchad, la majeure partie desproduits transformés ne sont pas pris en compte par les différentes  structures gouvernementales. En effet, les diverses régions productrices ne bénéficient pas d’assistance et de conseils. La production et la  consommation des poissons fumés et séchés sont de plus en plus  courantes dans la zone sahélienne. Certaines techniques de séchage et de fumage traditionnelles ne respectent pas les bonnes pratiques d’hygiène et de fabrication et affectent la qualité hygiénique ainsi que les  caractéristiques texturales et organoleptiques du produit fini.L’utilisation de produits chimiques non homologués lors du séchage et du stockage constitue un sérieux problème de santé publique. Il est donc important de recenser les technologies de séchage pratiquées en Afrique.Cette présente revue montre que pour obtenir des produits de bonne  qualité hygiénique et nutritionnelle, l’utilisation des séchoirs améliorés et la sensibilisation des producteurs sur le respect des bonnes pratiques d’hygiène et de fabrication sont importantes.Mots clés : Poissons séchés-diagrammes- technologies de séchage-AfriqueTechnologies, Quality and socioeconomic importance of dried fish in AfricaThe losses post-captures constitute a problem recognized in the under-area. In sub-Saharan Africa, 25 % of fish are lost approximately for lack of effective means of conservation and transformation. The traditional  techniques (salting, drying and the manuring) are means used to preserve and improve the fish availability. In the developing countries like Republic of Chad, the major part of the processed products are not taken into  account by the various governmental structures. Indeed, the various  producing areas don’t have any assistance and councils. The production and the consumption of smoked and dried fish are increasingly in the sahelian zone. Certain techniques of traditional drying and manuring don’t respect the good practices of hygiene and manufacture and affect hygienic quality as well as the organoleptic characteristics and of the finished product. The use of unauthorized chemicals during drying and storage constitutes a serious problem of public health. It is thus significant to draw up the technologies of drying used in Africa. This present review shows that to obtain products of good quality hygienic and nutritional, the use of the improved driers and the sensitizing of the producers on the respect of the good practices of hygiene and manufacture are important.Key words: Dried fish-diagrams-technologies of drying-Afric

Aortic dissection progressing to intramural hematoma: A multiple case study

Advances in tomographic imaging have made aortic dissection, known as intramural hematoma (IMH), more common in acute aortic syndrome. Unpredictable IMH development to dissection or rupture, or acute aortic (pain) syndrome, may indicate underlying illness. Independent observational data show that after 30 days in the hospital, the IMH either fades or progresses to a dissection, restricted rupture, or aneurysm. Type A ascending aortic IMH has a significant risk of early development and requires prompt surgery. Recurrent pain or pleural effusion indicate disease progression. Large PAU may be a common denominator of development and bad outcome, but no PAU does not suggest stable IMH. 75% of individuals with proximal IMH died or had surgery. Validating an earlier concept, IMH of the descending aorta may demand careful waiting. A recent meta-analysis explains IMH and aortic ulcers. Natural course of 168 cases of typical IMH led to overt aortic dissection in 25% of ascending aortic IMH and in 13% of descending IMH, aortic rupture in 28% and 9%, or stabilization in 28% and 76%; 30-day mortality was 18% with surgical repair of proximal IMH and 33% with surgery to distal IMH compared to 60% and 8% with medical treatment of proximal and distal IMH. Aortic rupture, imminent aortic rupture, or clinical deterioration suggest TEVAR is needed. Type B IMH treatment involves monitoring vital signs (systolic 120) and treating pain. They have CT scans often (repeated with worsening or new-onset pain or concerns about end-organ ischemia). TEVAR may be an option for people who haven\u27t responded to hypertension medicines, have persistent pain, or have IMA enlargement (IMH). In type B IMH patients, beta-blockers lower heart rate and blood pressure. Calcium channel blockers and sodium nitroprusside are options. To avoid reflex tachycardia, use these drugs alongside beta-blockers. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may assist aortic remodeling and blood pressure regulation. Ascending aortic IMH has a bad short-term prognosis, although surgery improves outcomes. When IMH of the descending aorta is restricted or the aortic diameter is less than 50 mm, the prognosis is better. Location, aortic width, and risk variables are inconsistent predictors of late progression for IMH. Good blocking may improve prognosis even if surgery fails