High blood viscosity is associated with high pulse wave velocity in African sickle cell trait carriers

Background: Sickle cell trait (SCT) is the benign condition of sickle cell disease. Often asymptomatic, the SCT carriers have hemorheological disturbances such as blood hyper-viscosity compared to healthy subjects. These disturbances could lead to structural and functional changes in large vessels. The aim of the study was to evaluate the association between blood viscosity (ηb) and pulse wave velocity (PWV) in SCT carriers.Methods: Thirteen SCT with high blood viscosity (SCT_hηb) aged 34±12 years (4 men) were compared to 13 SCT with low blood viscosity (SCT_lηb) aged 32±9 years (5 men) recruited from the National Blood Transfusion Center (CNTS) in Dakar (Senegal). Pulse wave velocity finger-toe (PWVft) was assessed using pOpmètre® (Axelife SAS-France). Cardiovascular risk (CVR) was assessed according to the Framingham Laurier score.Results: SCT_hηb had higher PWVft (m/s) than SCT_lηb respectively 8.98±1.98 and 7.11±1.18 (p = 0.004). CVR score (%) was higher in SCT_hηb than SCT_lηb, but this difference was not statistically significant (5.96±7.45 vs 2.09±2.15; p=0.31). Multivariate linear regression showed a positive correlation between PWVft and ηb and CVR score (r2=0.74, F=21.19, p˂0.001).Conclusions: Present results indicate that the SCT_hηb carriers have arteries stiffer than SCT_lηb and ηb and CVR could remain independent determinants of arterial stiffness in SCT carriers

Effects of lenten fasting on body composition and biochemical parameters

Background: The catholic lenten fasting is the period of 40 days of fasting that precedes Easter. It is one of religious fasting less documented in the scientific literature. Thus the aim of our study was to evaluate the evolution of anthropometric and body composition and biochemical profile during Catholic lenten fasting.Methods: We conducted a prospective study, which took place during the period between one week before at the end of lenten fasting. Eleven fasters (4 women and 7 men), aged between 18 and 59 years were included in present study. Anthropometric, body composition parameters and biochemical profile were evaluated one week before, at 15th day and at the end of Lenten fasting.Results: Weight, body mass index (BMI) and visceral fat decreased significantly at the end of Lenten fasting. Lipid profile changed significantly during this fasting period. Total cholesterol (TC), low density lipoprotein – cholesterol (LDL-C) and triglycerides decreased significantly with fasting. High density lipoprotein – cholesterol (HDL-C) was remained unchanged during this fasting period while TC/HDL ratio was significantly decreased at the end of Lent.Conclusions: Present study showed that the fasting of Lent seems to have beneficial effects on reducing cardiovascular risk factors. Further studies are required to better understand the physiological mechanisms involved for a therapeutic use

Evaluation of the pulse wave velocity in African rheumatoid arthritis subjects

Background: Rheumatoid arthritis is a systemic disease with often fatal vascular events. In addition to traditional cardiovascular risk factors, disease-specific elements contribute to this cardiovascular mortality. The aim of this study was to assess arterial stiffness in rheumatoid arthritis and to determine the factors involved.Methods: We have recruited the black African patients followed in rheumatology and had rheumatoid arthritis diagnosis. Only patients between 18 and 60 years and meeting the American College of Rheumatology criteria were included. All controls were healthy. We evaluated the propagation velocity of the pulse wave finger-toe (PWVft) measured by the pOpmètre®.Results: Present study shows that the PWVft was significantly elevated in over half of patients (55.10%). Besides, the mean patients PWVft was significantly higher than that of the control (respectively 9.40±0.51 and 7.22±0.33 p=0.001). In the patients, no factor was significantly involved in the arterial stiffness, but cons in the control group, the PWVft was significantly correlated with age (p=0.023 and r=0.55).Conclusions: Rheumatoid arthritis patients had higher PWVft compared to controls. Due to the importance of its cardiovascular morbidity and mortality, arthritis requires a regular monitoring element as arterial stiffness, which is currently a major vascular parameter monitoring

Widening the lens of population-based health research to climate change impacts and adaptation: the climate change and health evaluation and response system (CHEERS)

BackgroundClimate change significantly impacts health in low-and middle-income countries (LMICs), exacerbating vulnerabilities. Comprehensive data for evidence-based research and decision-making is crucial but scarce. Health and Demographic Surveillance Sites (HDSSs) in Africa and Asia provide a robust infrastructure with longitudinal population cohort data, yet they lack climate-health specific data. Acquiring this information is essential for understanding the burden of climate-sensitive diseases on populations and guiding targeted policies and interventions in LMICs to enhance mitigation and adaptation capacities.ObjectiveThe objective of this research is to develop and implement the Change and Health Evaluation and Response System (CHEERS) as a methodological framework, designed to facilitate the generation and ongoing monitoring of climate change and health-related data within existing Health and Demographic Surveillance Sites (HDSSs) and comparable research infrastructures.MethodsCHEERS uses a multi-tiered approach to assess health and environmental exposures at the individual, household, and community levels, utilizing digital tools such as wearable devices, indoor temperature and humidity measurements, remotely sensed satellite data, and 3D-printed weather stations. The CHEERS framework utilizes a graph database to efficiently manage and analyze diverse data types, leveraging graph algorithms to understand the complex interplay between health and environmental exposures.ResultsThe Nouna CHEERS site, established in 2022, has yielded significant preliminary findings. By using remotely-sensed data, the site has been able to predict crop yield at a household level in Nouna and explore the relationships between yield, socioeconomic factors, and health outcomes. The feasibility and acceptability of wearable technology have been confirmed in rural Burkina Faso for obtaining individual-level data, despite the presence of technical challenges. The use of wearables to study the impact of extreme weather on health has shown significant effects of heat exposure on sleep and daily activity, highlighting the urgent need for interventions to mitigate adverse health consequences.ConclusionImplementing the CHEERS in research infrastructures can advance climate change and health research, as large and longitudinal datasets have been scarce for LMICs. This data can inform health priorities, guide resource allocation to address climate change and health exposures, and protect vulnerable communities in LMICs from these exposures

High blood viscosity is associated with high pulse wave velocity in African sickle cell trait carriers

Background: Sickle cell trait (SCT) is the benign condition of sickle cell disease. Often asymptomatic, the SCT carriers have hemorheological disturbances such as blood hyper-viscosity compared to healthy subjects. These disturbances could lead to structural and functional changes in large vessels. The aim of the study was to evaluate the association between blood viscosity (ηb) and pulse wave velocity (PWV) in SCT carriers.Methods: Thirteen SCT with high blood viscosity (SCT_hηb) aged 34±12 years (4 men) were compared to 13 SCT with low blood viscosity (SCT_lηb) aged 32±9 years (5 men) recruited from the National Blood Transfusion Center (CNTS) in Dakar (Senegal). Pulse wave velocity finger-toe (PWVft) was assessed using pOpmètre® (Axelife SAS-France). Cardiovascular risk (CVR) was assessed according to the Framingham Laurier score.Results: SCT_hηb had higher PWVft (m/s) than SCT_lηb respectively 8.98±1.98 and 7.11±1.18 (p = 0.004). CVR score (%) was higher in SCT_hηb than SCT_lηb, but this difference was not statistically significant (5.96±7.45 vs 2.09±2.15; p=0.31). Multivariate linear regression showed a positive correlation between PWVft and ηb and CVR score (r2=0.74, F=21.19, p˂0.001).Conclusions: Present results indicate that the SCT_hηb carriers have arteries stiffer than SCT_lηb and ηb and CVR could remain independent determinants of arterial stiffness in SCT carriers

How does baseline anthropometry affect anthropometric outcomes in children receiving treatment for severe acute malnutrition? A secondary analysis of a randomized controlled trial.

Mid-upper arm circumference (MUAC) < 11.5 cm and weight-for-height Z-score (WHZ) < -3 are used for screening for severe acute malnutrition (SAM). Underweight and concurrent wasting and stunting may better target those at the highest risk of mortality. We compared anthropometric outcomes in children enrolled in a trial of antibiotics for SAM based on categories of baseline anthropometry, including indicators for programme admission (WHZ < -3, MUAC < 11.5) and alternative indicators (weight-for-age Z-score [WAZ] < -3, concurrent wasting and stunting [WHZ < -3 and height-for-age Z-score < -3]). Participants were followed weekly until nutritional recovery and at 8 weeks. We evaluated changes in weight gain (g/kg/day), MUAC, and WHZ in children admitted by admissions criteria (MUAC only, WHZ only, or MUAC and WHZ) and by underweight or concurrent wasting and stunting. Of 301 admitted children, 100 (33%) were admitted based on MUAC only, 41 (14%) WHZ only, and 160 (53%) both MUAC and WHZ, 210 (68%) were underweight and 67 (22%) were concurrently wasted/stunted. Low MUAC and low WHZ children had the lowest probability of nutritional recovery (17% vs. 50% for MUAC-only and 34% for WHZ-only). There was no difference in weight gain velocity or WHZ by admissions criteria (WHZ and/or MUAC). Underweight and concurrently wasted/stunted children had lower MUAC and WHZ at 8 weeks compared with those who were not underweight or concurrently wasted and stunted. Children with both low MUAC and low WHZ had the worst outcomes. Relying on MUAC alone may miss children who have poor outcomes. Other indicators, such as WAZ, may be useful for identifying vulnerable children

Azithromycin versus Amoxicillin and Malarial Parasitemia among Children with Uncomplicated Severe Acute Malnutrition: A Randomized Controlled Trial.

Antibiotics are recommended by the WHO as part of the management of uncomplicated severe acute malnutrition in children. We evaluated whether azithromycin, an antibiotic with antimalarial properties, improved malarial parasitemia outcomes in children with severe acute malnutrition compared with amoxicillin, an antibiotic commonly used for severe acute malnutrition that does not have antimalarial properties. Total of 301 children were randomized (1:1) to a single oral dose of azithromycin or a 7-day course of amoxicillin and followed for 8 weeks. We found no significant evidence that children receiving azithromycin had improved parasitemia outcomes relative to amoxicillin. Although azithromycin may have advantages over amoxicillin in terms of dosing and administration for uncomplicated severe acute malnutrition, it may not yield additional benefit for malaria outcomes

Pulse wave velocity is lower in trained than in untrained sickle cell trait carriers

International audienceSickle cell trait (SCT) is a benign condition of sickle cell disease. Nevertheless, previous reports showed that SCT carriers have increased blood viscosity and decreased vascular reactivity compared to non-SCT carrier. The benefit of regular exercise on vascular function has been well documented in the general population but no study focused on the SCT population

Evaluation of the pulse wave velocity in African rheumatoid arthritis subjects

Background: Rheumatoid arthritis is a systemic disease with often fatal vascular events. In addition to traditional cardiovascular risk factors, disease-specific elements contribute to this cardiovascular mortality. The aim of this study was to assess arterial stiffness in rheumatoid arthritis and to determine the factors involved.Methods: We have recruited the black African patients followed in rheumatology and had rheumatoid arthritis diagnosis. Only patients between 18 and 60 years and meeting the American College of Rheumatology criteria were included. All controls were healthy. We evaluated the propagation velocity of the pulse wave finger-toe (PWVft) measured by the pOpmètre®.Results: Present study shows that the PWVft was significantly elevated in over half of patients (55.10%). Besides, the mean patients PWVft was significantly higher than that of the control (respectively 9.40±0.51 and 7.22±0.33 p=0.001). In the patients, no factor was significantly involved in the arterial stiffness, but cons in the control group, the PWVft was significantly correlated with age (p=0.023 and r=0.55).Conclusions: Rheumatoid arthritis patients had higher PWVft compared to controls. Due to the importance of its cardiovascular morbidity and mortality, arthritis requires a regular monitoring element as arterial stiffness, which is currently a major vascular parameter monitoring

Gut Resistome after Antibiotics among Children with Uncomplicated Severe Acute Malnutrition: A Randomized Controlled Trial.

A broad-spectrum antibiotic, typically amoxicillin, is included in many country guidelines as part of the management of uncomplicated severe acute malnutrition (SAM) in children without overt clinical symptoms of infection. Alternative antibiotics may be beneficial for children with SAM without increasing selection for beta-lactam resistance. We conducted a 1:1 randomized controlled trial of single dose azithromycin versus a 7-day course of amoxicillin for SAM. Children 6-59 months of age with uncomplicated SAM (mid-upper arm circumference < 11.5 cm and/or weight-for-height Z-score < -3) were enrolled in Boromo District, Burkina Faso, from June through October 2020. Rectal swabs were collected at baseline and 8 weeks after treatment and processed using DNA-Seq. We compared the resistome at the class level in children randomized to azithromycin compared with amoxicillin. We found no evidence of a difference in the distribution of genetic antibiotic resistance determinants to any antibiotic class 8 weeks after treatment. There was no difference in genetic macrolide resistance determinants (65% azithromycin, 65% placebo, odds ratio, OR, 1.00, 95% confidence interval, CI, 0.43-2.34) or beta-lactam resistance determinants (82% azithromycin, 83% amoxicillin, OR 0.94, 95% CI, 0.33-2.68) at 8 weeks. Although presence of genetic antibiotic resistance determinants to macrolides and beta-lactams was common, we found no evidence of a difference in the gut resistome 8 weeks after treatment. If there are earlier effects of antibiotics on selection for genetic antibiotic resistance determinants, the resistome may normalize by 8 weeks