Apport de l’échographie dans les traumatismes oculaires à Parakou (Bénin)

Introduction: Décrire l’apport de l’échographie réalisée avec un appareil polyvalent dans les traumatismes oculaires. Méthodes: Il s’agit d’une étude prospective descriptive réalisée du 01 février au 01 aout 2010 dans le service d’imagerie médicale du CHD Borgou. Trente deux (32) patients présentant un traumatisme oculaire avec baisse de l’acuité visuelle ont bénéficié d’une échographie oculaire réalisée grâce à un échographe polyvalent. Résultats: L’âge moyen de nos patients était de 29,40 ans (extrêmes 1 et 68 ans). Le sexe ratio (H/F) était de 1,67.Sur 39 yeux traumatisés, l’il droit était atteint dans 22 cas (56,4%), et l’il gauche dans 17 (43,6%) cas. Les contusions ont constitué la variété anatomo-clinique la plus fréquente : 32 cas (82%). Les différentes lésions observées étaient : une hémorragie isolée du vitré 13 cas (33,3%), un décollement rétinien 6 cas (15,4%), un décollement choroïdien 6 cas (15,4%), un décollement postérieur du vitré 5 cas (12,8%), une cataracte 5 cas (12,8%) et une luxation postérieure du cristallin dans 3 cas (7,7%). Conclusion: L’échographie oculaire même réalisée avec un appareil polyvalent permet un bilan lésionnel satisfaisant des traumatismes oculaires.Key words: Traumatisme oculaire, échographie, hémorragie vitréenne, décollement de la rétin

New ecological options for the management of horticultural crop pests in Sudano-Sahelian agroecosystems of west Africa

The agroecological approach to agroecosystem management relies on two pillars: vegetational diversification and soil biological activity enhancement. Although crop pests and their natural enemies may be diversely affected by measures derived from these principles, those generally result in increased agroecosystem resilience visà- vis both aerial and soil pests. Earlier studies by ICRISAT and CIRAD and their partners in West Africa showed the potential of the implementation of these principles for the management of some major pests of both staple food and horticultural crops, and their limitations for others, notably in the water-saving and income-generating systems mixing cereals, legumes, and high-value crops currently promoted in the Sudano-Sahelian zones, such as the drip irrigation-based African Market Garden (AMG) and the water harvesting-based Bio-Reclamation of Degraded Lands (BDL) systems. Pigeon-pea showed potential for trap-cropping tomato fruit worm (TFW) on okra, while Andropogon grass was dismissed for such management of stem-borer on pearl millet, and mixed results were obtained with castor bean and other potential trap crops for panicle-feeding bug management on sorghum. The results presented highlight the potential for mobilizing either aerial or soil-bound biological processes for managing fruit flies (FF), the main pest of grafted jujube tree, and leaf worm, the main pest of the Moringa tree, for sustainable production of these two major crops (in BDL and AMG systems, respectively), without having to rely on synthetic pesticide sprays. Studies on the social acceptability of the proposed management options (e.g., pigeon-pea in okra-based BDL) are also underway. The potential of the Jatropha shrub grown as a live-fence around these systems, either for its top-down effects or via the use of its extracts in an assisted push-pull strategy, is discussed. These studies on targeted pathosystems serve the dual purpose of finding solutions to local problems and contribute more globally to the design of pest resilient agrosystems

New ecological options for the management of horticultural crop pests in Sudano-Sahelian agroecosystems of west Africa

The agroecological approach to agroecosystem management relies on two pillars: vegetational diversification and soil biological activity enhancement. Although crop pests and their natural enemies may be diversely affected by measures derived from these principles, those generally result in increased agroecosystem resilience visà- vis both aerial and soil pests. Earlier studies by ICRISAT and CIRAD and their partners in West Africa showed the potential of the implementation of these principles for the management of some major pests of both staple food and horticultural crops, and their limitations for others, notably in the water-saving and income-generating systems mixing cereals, legumes, and high-value crops currently promoted in the Sudano-Sahelian zones, such as the drip irrigation-based African Market Garden (AMG) and the water harvesting-based Bio-Reclamation of Degraded Lands (BDL) systems. Pigeon-pea showed potential for trap-cropping tomato fruit worm (TFW) on okra, while Andropogon grass was dismissed for such management of stem-borer on pearl millet, and mixed results were obtained with castor bean and other potential trap crops for panicle-feeding bug management on sorghum. The results presented highlight the potential for mobilizing either aerial or soil-bound biological processes for managing fruit flies (FF), the main pest of grafted jujube tree, and leaf worm, the main pest of the Moringa tree, for sustainable production of these two major crops (in BDL and AMG systems, respectively), without having to rely on synthetic pesticide sprays. Studies on the social acceptability of the proposed management options (e.g., pigeon-pea in okra-based BDL) are also underway. The potential of the Jatropha shrub grown as a live-fence around these systems, either for its top-down effects or via the use of its extracts in an assisted push-pull strategy, is discussed. These studies on targeted pathosystems serve the dual purpose of finding solutions to local problems and contribute more globally to the design of pest resilient agrosystems

Community implementation of human landing and non-human landing collection methods for Wuchereria bancrofti vectors

In the drive towards elimination of lymphatic filariasis, enhanced surveillance of vector mosquitoes requires sound sampling methods which can be easily implemented and accepted by communities. Several tools have been validated as alternatives to human landing catches (HLC) for this purpose, but little is known about their effectiveness compared to HLC in terms of the vector density patterns. This study aimed at assessing the efficiency of four mosquitoes collecting tools (HLC, Center for Diseases Control (CDC) light trap, Double Net trap, Window Exit trap). These four sampling tools were evaluated in three different villages (Bapla, Ouessa and Koudjo) in Burkina Faso, when mosquito collection was managed by local people in each community. The results showed that HLC remained the most effective collection method in terms of vector abundance in all villages, followed by double net traps. Except in Bapla, the double net trap collected more Anopheles than CDC light traps. Across the study, the prevalence of Wuchereria bancrofti infection was estimated to be 0.6% and observed only in Anopheles gambiae sensu stricto. The Double Net trap is the least expensive of all three methods and was well accepted by the community. In conclusion, double net traps can be recommended for communities to use for lymphatic filariasis (LF) vector surveillance program for xeno-monitoring of post transmission assessment survey evaluation. Based on prevalence the mass drug administration (MDA) could be stopped in these villages without risk of resurgence of the disease, according to the current recommendations of World Health Organization (WHO). Set up surveillance and continue to use vector control tools

Antenatal care in practice: an exploratory study in antenatal care clinics in the Kilombero Valley, south-eastern Tanzania

BACKGROUND: The potential of antenatal care for reducing maternal morbidity and improving newborn survival and health is widely acknowledged. Yet there are worrying gaps in knowledge of the quality of antenatal care provided in Tanzania. In particular, determinants of health workers' performance have not yet been fully understood. This paper uses ethnographic methods to document health workers' antenatal care practices with reference to the national Focused Antenatal Care guidelines and identifies factors influencing health workers' performance. Potential implications for improving antenatal care provision in Tanzania are discussed. METHODS: Combining different qualitative techniques, we studied health workers' antenatal care practices in four public antenatal care clinics in the Kilombero Valley, south-eastern Tanzania. A total of 36 antenatal care consultations were observed and compared with the Focused Antenatal Care guidelines. Participant observation, informal discussions and in-depth interviews with the staff helped to identify and explain health workers' practices and contextual factors influencing antenatal care provision. RESULTS: The delivery of antenatal care services to pregnant women at the selected antenatal care clinics varied widely. Some services that are recommended by the Focused Antenatal Care guidelines were given to all women while other services were not delivered at all. Factors influencing health workers' practices were poor implementation of the Focused Antenatal Care guidelines, lack of trained staff and absenteeism, supply shortages and use of working tools that are not consistent with the Focused Antenatal Care guidelines. Health workers react to difficult working conditions by developing informal practices as coping strategies or "street-level bureaucracy". CONCLUSIONS: Efforts to improve antenatal care should address shortages of trained staff through expanding training opportunities, including health worker cadres with little pre-service training. Attention should be paid to the identification of informal practices resulting from individual coping strategies and "street-level bureaucracy" in order to tackle problems before they become part of the organizational culture

The effect of dose on the antimalarial efficacy of artemether-lumefantrine: a systematic review and pooled analysis of individual patient data

Background: Artemether-lumefantrine is the most widely used artemisinin-based combination therapy for malaria, although treatment failures occur in some regions. We investigated the effect of dosing strategy on efficacy in a pooled analysis from trials done in a wide range of malaria-endemic settings. Methods: We searched PubMed for clinical trials that enrolled and treated patients with artemether-lumefantrine and were published from 1960 to December, 2012. We merged individual patient data from these trials by use of standardised methods. The primary endpoint was the PCR-adjusted risk of Plasmodium falciparum recrudescence by day 28. Secondary endpoints consisted of the PCR-adjusted risk of P falciparum recurrence by day 42, PCR-unadjusted risk of P falciparum recurrence by day 42, early parasite clearance, and gametocyte carriage. Risk factors for PCR-adjusted recrudescence were identified using Cox's regression model with frailty shared across the study sites. Findings: We included 61 studies done between January, 1998, and December, 2012, and included 14 327 patients in our analyses. The PCR-adjusted therapeutic efficacy was 97·6% (95% CI 97·4-97·9) at day 28 and 96·0% (95·6-96·5) at day 42. After controlling for age and parasitaemia, patients prescribed a higher dose of artemether had a lower risk of having parasitaemia on day 1 (adjusted odds ratio [OR] 0·92, 95% CI 0·86-0·99 for every 1 mg/kg increase in daily artemether dose; p=0·024), but not on day 2 (p=0·69) or day 3 (0·087). In Asia, children weighing 10-15 kg who received a total lumefantrine dose less than 60 mg/kg had the lowest PCR-adjusted efficacy (91·7%, 95% CI 86·5-96·9). In Africa, the risk of treatment failure was greatest in malnourished children aged 1-3 years (PCR-adjusted efficacy 94·3%, 95% CI 92·3-96·3). A higher artemether dose was associated with a lower gametocyte presence within 14 days of treatment (adjusted OR 0·92, 95% CI 0·85-0·99; p=0·037 for every 1 mg/kg increase in total artemether dose). Interpretation: The recommended dose of artemether-lumefantrine provides reliable efficacy in most patients with uncomplicated malaria. However, therapeutic efficacy was lowest in young children from Asia and young underweight children from Africa; a higher dose regimen should be assessed in these groups. Funding: Bill and Melinda Gates Foundation

Setting a baseline for global urban virome surveillance in sewage

The rapid development of megacities, and their growing connectedness across the world is becoming a distinct driver for emerging disease outbreaks. Early detection of unusual disease emergence and spread should therefore include such cities as part of risk-based surveillance. A catch-all metagenomic sequencing approach of urban sewage could potentially provide an unbiased insight into the dynamics of viral pathogens circulating in a community irrespective of access to care, a potential which already has been proven for the surveillance of poliovirus. Here, we present a detailed characterization of sewage viromes from a snapshot of 81 high density urban areas across the globe, including in-depth assessment of potential biases, as a proof of concept for catch-all viral pathogen surveillance. We show the ability to detect a wide range of viruses and geographical and seasonal differences for specific viral groups. Our findings offer a cross-sectional baseline for further research in viral surveillance from urban sewage samples and place previous studies in a global perspective

Long Distance Dispersal and Connectivity in Amphi-Atlantic Corals at Regional and Basin Scales

Among Atlantic scleractinian corals, species diversity is highest in the Caribbean, but low diversity and high endemism are observed in various peripheral populations in central and eastern Atlantic islands and along the coasts of Brazil and West Africa. The degree of connectivity between these distantly separated populations is of interest because it provides insight into processes at both evolutionary and ecological time scales, such as speciation, recruitment dynamics and the persistence of coral populations. To assess connectivity in broadly distributed coral species of the Atlantic, DNA sequence data from two nuclear markers were obtained for six coral species spanning their distributional ranges. At basin-wide scales, significant differentiation was generally observed among populations in the Caribbean, Brazil and West Africa. Concordance of patterns in connectivity among co-distributed taxa indicates that extrinsic barriers, such as the Amazon freshwater plume or long stretches of open ocean, restrict dispersal of coral larvae from region to region. Within regions, dispersal ability appears to be influenced by aspects of reproduction and life history. Two broadcasting species, Siderastrea siderea and Montastraea cavernosa, were able to maintain gene flow among populations separated by as much as 1,200 km along the coast of Brazil. In contrast, brooding species, such as Favia gravida and Siderastrea radians, had more restricted gene flow along the Brazilian coast