Profil pharmaco-doppler pénien des patients coronariens souffrant de dysfonction érectile à l’Institut de Cardiologie d’Abidjan : une série de 30 cas

Contexte et objectif. La maladie athéromateuse dont la coronaropathie étant une pathologie diffuse peut être prévenue par le contrôle des facteurs de risqué cardiovasculaire. Le but de cette étude était de décrire les caractéristiques pharmaco doppler pénien des patients coronariens souffrant de dysfonction érectile. Méthodes. Il s’agissait d’une série analytique des cas suivie entre juin 2020 et février 2021. Elle concernait des patients ayant des lésions athéromateuses significatives à la coronographie et souffrant de dysfonction érectile. Nous avons évalué les caractéristiques pharmaco doppler pénien. La qualité d’érection était appréciée par le score de rigidité Erectile Hardness Score (EHS). Résultats. Trente-six patients étaient inclus. L’âge moyen était de 56 ± 8,4 ans. le pic de Vitesse systolique au repos (PSVr) moyen des patients était de 13,7 cm/s ± 5,9. Le pic de vitesse systolique post injection (PSV pi) moyen des patients était de 23,9 cm/s ± 5,4. Les causes étaient principalement artérielles de 75%. La qualité d’érection était appréciée selon le score EHS : E1 (83%), E2 (22%), E3 (5%) et E4 (3%). Conclusion. La dysfunction érectile est associée aux facteurs de risque cardiovasculaire selon plusieurs études. L’echodoppler pénien avait occupé une place importante dans le diagnostic étiologique. Les causes retrouvées étaient principalement artérielles avec une baisse de PSVpi<25 cm/s. English title: Penile pharmaco doppler profile of coronary patients with erectile dysfunction at the Abidjan Cardiology Institute: a series of 30 cases Context and objective. Atheromatous disease, including coronary artery disease, is a diffuse condition that can be prevented by controlling cardiovascular risk factors. The aim of this study was to describe the penile pharmaco doppler characteristics of coronary patients with erectile dysfunction. Methods: This was an analytical series study performed from June 2020 to February 2021. It included patients with significant atheromatous lesions on coronography and erectile dysfunction. We assessed penile pharmaco doppler characteristics. Erectile quality was assessed by the Erectile Hardness Score (EHS). Results. Thirty-six patients were involved. Their mean age was 56 ± 8.4 years. The mean peak resting systolic velocity (PSVr) of the patients was 13.7 cm/s ± 5.9. The mean post-injection peak systolic velocity (piPSV) of the patients was 23.9 cm/s ± 5.4. The causes were mainly arterial at 75 %. Erectile quality was assessed according to the EHS score: E1 (83 %), E2 (22 %), E3 (5 %) and E4 (3 %). Conclusion. Erectile dysfunction is associated with cardiovascular risk factors according to several studies. Penile echodoppler had been an important part of the etiological diagnosis. The causes found were mainly arterial with a drop in PSVpi<25 cm/s. Keywords: Coronary artery disease; peak systolic velocity, telediastolic velocity, EHS scor

Adding tsetse control to medical activities contributes to decreasing transmission of sleeping sickness in the Mandoul focus (Chad)

Background Gambian sleeping sickness or HAT (human African trypanosomiasis) is a neglected tropical disease caused by Trypanosoma brucei gambiense transmitted by riverine species of tsetse. A global programme aims to eliminate the disease as a public health problem by 2020 and stop transmission by 2030. In the South of Chad, the Mandoul area is a persistent focus of Gambian sleeping sickness where around 100 HAT cases were still diagnosed and treated annually until 2013. Pre-2014, control of HAT relied solely on case detection and treatment, which lead to a gradual decrease in the number of cases of HAT due to annual screening of the population. Methods Because of the persistence of transmission and detection of new cases, we assessed whether the addition of vector control to case detection and treatment could further reduce transmission and consequently, reduce annual incidence of HAT in Mandoul. In particular, we investigated the impact of deploying ‘tiny targets’ which attract and kill tsetse. Before tsetse control commenced, a census of the human population was conducted and their settlements mapped. A pre-intervention survey of tsetse distribution and abundance was implemented in November 2013 and 2600 targets were deployed in the riverine habitats of tsetse in early 2014, 2015 and 2016. Impact on tsetse and on the incidence of sleeping sickness was assessed through nine tsetse monitoring surveys and four medical surveys of the human population in 2014 and 2015. Mathematical modelling was used to assess the relative impact of tsetse control on incidence compared to active and passive screening. Findings The census indicated that a population of 38674 inhabitants lived in the vicinity of the Mandoul focus. Within this focus in November 2013, the vector is Glossina fuscipes fuscipes and the mean catch of tsetse from traps was 0.7 flies/trap/day (range, 0-26). The catch of tsetse from 44 sentinel biconical traps declined after target deployment with only five tsetse being caught in nine surveys giving a mean catch of 0.005 tsetse/trap/day. Modelling indicates that 70.4% (95% CI: 51-95%) of the reduction in reported cases between 2013 and 2015 can be attributed to vector control with the rest due to medical intervention. Similarly tiny targets are estimated to have reduced new infections dramatically with 62.8% (95% CI: 59–66%) of the reduction due to tsetse control, and 8.5% (95% 8–9%) to enhanced passive detection. Model predictions anticipate that elimination as a public health problem could be achieved by 2018 in this focus if vector control and screening continue at the present level and, furthermore, there may have been virtually no transmission since 2015. Conclusion This work shows that tiny targets reduced the numbers of tsetse in this focus in Chad, which may have interrupted transmission and the combination of tsetse control to medical detection and treatment has played a major role in reducing in HAT incidence in 2014 and 2015

An entomological survey in the Sudanese Guinean environmental transition zone after indoor residual spraying, Chad

Introduction: malaria is a major public health issue in Africa. In Chad in 2019, with 955,243 confirmed cases and 2,955 deaths, malaria is the main cause of consultations. A longitudinal entomological study was conducted in Moïssala Health District. Its objective was to assess the impact of indoor residual spraying with 80% bendiocarb wettable powder on malaria transmission. Methods: two areas were defined for the study: Dembo, located in the sprayed area, Moïssala, in the untreated area. Two sampling methods were used: pyrethrum spray catches and human landing catches. Results: sixteen sessions of human landing catches totalling 32 man-nights were conducted and 160 rooms/site were sprayed. Two anopheles were captured in Dembo and 547 in Moïssala. In Moïssala, An coluzzii, An funestus and An rufipes were captured in the rooms and on human bait. An colluzzii and An funestus were captured in pyrethrum spray catches in Dembo. The anophelian human landing catches density was zero in Dembo while it was 8.38 bites/man/night in outdoor and 10.06 bits/man/night in indoor in Moïssala. Only An coluzzii was found infected in human landing catches and sporozoite index of was 7.46% (10/134) in outdoor and 7.45% (12/161) in indoor in Moïssala. Malaria transmission was estimated at 0.63 infected bites/man/night in outdoor and 0.75 infected bites/man/night in indoor i.e. 229.95 infected bites/man/year in outdoor and 273.75 infected bites/man/year. In pyrethrum spray catches, An coluzzii and An rufipes were the two species found infected in Moïssala with sporozoite indices of 6.70% (23/343) and 20% (2/10) respectively. However, in Dembo, neither of the two captured mosquitoes was found infected. Conclusion: the indoor residual spraying campaign in the eastern zone of Moïssala has led to the collapse of vectors´ density and aggressiveness. However, its evaluation over a short period of time is not sufficient to assess the impact of malaria transmission in this constant and endemic malaria zone

Long-term maintenance of multidrug-resistant Escherichia coli carried by vampire bats and shared with livestock in Peru

Extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-E. coli) have been reported in wildlife worldwide. Whether wildlife is transient hosts of ESBL-E. coli or comprises an independently maintained reservoir is unknown. We investigated this question by longitudinally monitoring ESBL-E. coli in common vampire bats and nearby livestock in Peru. Among 388 bats from five vampire bat colonies collected over three years, ESBL-E. coli were detected at a low prevalence (10% in 2015, 4% in 2017 and 2018) compared to a high prevalence (48%) from 134 livestock sampled in 2017. All ESBL-E. coli were multidrug-resistant, and whole genome sequencing of 33 randomly selected ESBL-E. coli isolates (18 recovered from bats) detected 46 genes conferring resistance to antibiotics including third-generation cephalosporins (e.g., blaCTX-M-55, blaCTX-M-15, blaCTX-M-65, blaCTX-M-3 blaCTX-M-14), aminoglycosides, fluoroquinolones, and colistin (mcr-1). The mcr-1 gene is reported for the first time on a wild bat in Latin America. ESBL-E. coli also carried 31 plasmid replicon types and 16 virulence genes. Twenty-three E. coli sequence types (STs) were detected, including STs involved in clinical infections worldwide (e.g., ST 167, ST 117, ST 10, ST 156 and ST 648). ESBL-E. coli with identical cgMLST (ST 167) were detected in the same bat roost in 2015 and 2017, and several ESBL-E. coli from different bat roosts clustered together in the cgMLST reconstruction, suggesting longterm maintenance of ESBL-E. coli within bats. Most antibiotic resistance and virulence genes were detected in E. coli from both host populations, while ESBL-E. coli ST 744 was found in a bat and a pig from the same locality, suggesting possible cross-species exchanges of genetic material and/or bacteria between bats and livestock. This study suggests that wild mammals can maintain multidrug-resistant bacteria and share them with livestock