Caregiver Recognition of Childhood Diarrhea, Care Seeking Behaviors and Home Treatment Practices in Rural Burkina Faso: A Cross-Sectional Survey

Introduction: To design effective national diarrhea control programs, including oral rehydration solution (ORS) and therapeutic zinc supplementation, information is needed on local perceptions of illness, external care seeking behaviors, and home treatment practices. Methods: A cross-sectional, community-based household survey was conducted in the Orodara Health District, Burkina Faso. Caregivers of 10,490 children,27 months were interviewed to assess child diarrhea prevalence and related car

A whole-plant functional scheme predicting the early growth of tropical tree species: evidence from 15 tree species in Central Africa

Key message: This study highlighted the consistency of a functional scheme integrating leaf, stem and root traits, biomass allocation and stem anatomy for 15 tropical tree species at the seedling stage. This functional scheme was shaped by the trade-offs for resource use and the hydraulics of the plants and was found to determine seedling growth. Abstract: Functional traits determine plant functioning, performance and response to the environment and define species functional strategy. The functional strategy of 15 African tree species was assessed by (1) highlighting the structure of traits covariance and the underlying functional trade-offs, (2) inferring a whole-plant functional scheme and (3) testing the correlation of the functional scheme with plant performance for two early developmental stages (seedlings and saplings). We selected 10 seedlings for each of the 15 species studied from a nursery in south-eastern Cameroon and measured 18 functional traits, including leaf, stem and root traits, biomass allocation and stem anatomy. We assessed the height and diameter growth of the seedlings and the DBH growth and survival for the saplings of nearby plantations. Multivariate analyses highlighted the covariations among the functional traits of the leaf/stem/root, biomass allocation ratios and stem anatomy. The major trait covariation axes were driven by two trade-offs, first between resource acquisition and conservation and second between hydraulic safety and efficiency. The axes were integrated into a Bayesian network inferring a functional scheme at the whole-plant scale, which was found to predict the growth of the seedlings but not the performance of the saplings. The functional strategies of the seedlings were determined by an integrated whole-plant scheme reflecting the trade-offs for resource use and plant hydraulics. The scheme predicted the growth of the seedlings through mechanistic pathways from the wood stem to all the plant traits, but it appeared to shift at the stage of the saplings. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature

Improving statistical inference on pathogen densities estimated by quantitative molecular methods: malaria gametocytaemia as a case study

BACKGROUND: Quantitative molecular methods (QMMs) such as quantitative real-time polymerase chain reaction (q-PCR), reverse-transcriptase PCR (qRT-PCR) and quantitative nucleic acid sequence-based amplification (QT-NASBA) are increasingly used to estimate pathogen density in a variety of clinical and epidemiological contexts. These methods are often classified as semi-quantitative, yet estimates of reliability or sensitivity are seldom reported. Here, a statistical framework is developed for assessing the reliability (uncertainty) of pathogen densities estimated using QMMs and the associated diagnostic sensitivity. The method is illustrated with quantification of Plasmodium falciparum gametocytaemia by QT-NASBA. RESULTS: The reliability of pathogen (e.g. gametocyte) densities, and the accompanying diagnostic sensitivity, estimated by two contrasting statistical calibration techniques, are compared; a traditional method and a mixed model Bayesian approach. The latter accounts for statistical dependence of QMM assays run under identical laboratory protocols and permits structural modelling of experimental measurements, allowing precision to vary with pathogen density. Traditional calibration cannot account for inter-assay variability arising from imperfect QMMs and generates estimates of pathogen density that have poor reliability, are variable among assays and inaccurately reflect diagnostic sensitivity. The Bayesian mixed model approach assimilates information from replica QMM assays, improving reliability and inter-assay homogeneity, providing an accurate appraisal of quantitative and diagnostic performance. CONCLUSIONS: Bayesian mixed model statistical calibration supersedes traditional techniques in the context of QMM-derived estimates of pathogen density, offering the potential to improve substantially the depth and quality of clinical and epidemiological inference for a wide variety of pathogens

Highly seasonal climate and reproductive phenology in the Mayombe forest: contribution of historical data from the Luki Reserve in the Democratic Republic of Congo

peer reviewedEn Afrique, la phénologie reproductive des arbres tropicaux, majoritairement annuelle, semble présenter une certaine régularité. Cette étude documente les variations intra- et interannuelles de la phénologie reproductive des arbres de la forêt du Mayombe à partir des données historiques de la Réserve de Luki (République démocratique du Congo). Le diamètre de reproduction des espèces exploitées pour le bois, encore largement méconnu, a été également examiné pour les espèces suffisamment représentées dans les données. Le suivi phénologique de 3 642 arbres appartenant à 158 espèces et 39 familles a été réalisé tous les 10 jours de 1948 à 1957. Les statistiques circulaires ont été utilisées pour tester le synchronisme de la phénologie entre arbres, à l’échelle de la communauté, pour la forêt dans son ensemble, et individuellement pour 87 espèces, dont 35 espèces bien représentées (n ≥ 20 arbres), 16 espèces commerciales et 36 autres espèces. Des régressions logistiques ont permis de déterminer le diamètre de fructification (minimum et régulier) de ces espèces. Pour la majorité des espèces, la floraison était régulière, annuelle et largement saisonnière (81,6 %, 71 espèces). Les pics étaient plus marqués pour la floraison que pour la fructification, plus étalée dans le temps, bien que significativement agrégée temporellement. La majorité des arbres et des espèces fleurissaient entre décembre et février, pendant la petite saison sèche, bien que des fleurs et des fruits étaient observables toute l’année à l’échelle de la communauté. Seules 13 espèces ont montré une relation significative entre le diamètre et la reproduction, parmi lesquelles sept espèces de canopée, cinq de sous-bois et une héliophile. Pour ces espèces, la moyenne du diamètre minimum de reproduction était de 17,3 cm

Systems of Differential Algebraic Equations in Computational Electromagnetics

Starting from space-discretisation of Maxwell's equations, various classical formulations are proposed for the simulation of electromagnetic fields. They differ in the phenomena considered as well as in the variables chosen for discretisation. This contribution presents a literature survey of the most common approximations and formulations with a focus on their structural properties. The differential-algebraic character is discussed and quantified by the differential index concept

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air (R) App

Background In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. Methods All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. Results A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. Conclusions VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.Peer reviewe

Micronutrient fortification of food and its impact on woman and child health: A systematic review

Background: Vitamins and minerals are essential for growth and metabolism. The World Health Organization estimates that more than 2 billion people are deficient in key vitamins and minerals. Groups most vulnerable to these micronutrient deficiencies are pregnant and lactating women and young children, given their increased demands. Food fortification is one of the strategies that has been used safely and effectively to prevent vitamin and mineral deficiencies.Methods: A comprehensive search was done to identify all available evidence for the impact of fortification interventions. Studies were included if food was fortified with a single, dual or multiple micronutrients and impact of fortification was analyzed on the health outcomes and relevant biochemical indicators of women and children. We performed a meta-analysis of outcomes using Review Manager Software version 5.1.Results: Our systematic review identified 201 studies that we reviewed for outcomes of relevance. Fortification for children showed significant impacts on increasing serum micronutrient concentrations. Hematologic markers also improved, including hemoglobin concentrations, which showed a significant rise when food was fortified with vitamin A, iron and multiple micronutrients. Fortification with zinc had no significant adverse impact on hemoglobin levels. Multiple micronutrient fortification showed non-significant impacts on height for age, weight for age and weight for height Z-scores, although they showed positive trends. The results for fortification in women showed that calcium and vitamin D fortification had significant impacts in the post-menopausal age group. Iron fortification led to a significant increase in serum ferritin and hemoglobin levels in women of reproductive age and pregnant women. Folate fortification significantly reduced the incidence of congenital abnormalities like neural tube defects without increasing the incidence of twinning. The number of studies pooled for zinc and multiple micronutrients for women were few, though the evidence suggested benefit. There was a dearth of evidence for the impact of fortification strategies on morbidity and mortality outcomes in women and children.Conclusion: Fortification is potentially an effective strategy but evidence from the developing world is scarce. Programs need to assess the direct impact of fortification on morbidity and mortality

The response of tropical rainforests to drought : lessons from recent research and future prospects

Key message: we review the recent findings on the influence of drought on tree mortality, growth or ecosystem functioning in tropical rainforests. Drought plays a major role in shaping tropical rainforests and the response mechanisms are highly diverse and complex. The numerous gaps identified here require the international scientific community to combine efforts in order to conduct comprehensive studies in tropical rainforests on the three continents. These results are essential to simulate the future of these ecosystems under diverse climate scenarios and to predict the future of the global earth carbon balance. - Context: tropical rainforest ecosystems are characterized by high annual rainfall. Nevertheless, rainfall regularly fluctuates during the year and seasonal soil droughts do occur. Over the past decades, a number of extreme droughts have hit tropical rainforests, not only in Amazonia but also in Asia and Africa. The influence of drought events on tree mortality and growth or on ecosystem functioning (carbon and water fluxes) in tropical rainforest ecosystems has been studied intensively, but the response mechanisms are complex.- Aims: herein, we review the recent findings related to the response of tropical forest ecosystems to seasonal and extreme droughts and the current knowledge about the future of these ecosystems. - Results: this review emphasizes the progress made over recent years and the importance of the studies conducted under extreme drought conditions or in through-fall exclusion experiments in understanding the response of these ecosystems. It also points to the great diversity and complexity of the response of tropical rainforest ecosystems to drought. - Conclusion: the numerous gaps identified here require the international scientific community to combine efforts in order to conduct comprehensive studies in tropical forest regions. These results are essential to simulate the future of these ecosystems under diverse climate scenarios and to predict the future of the global earth carbon balance