17 research outputs found
Evaluation of heavy metals pollution of Nokoue Lake
Toxic metals (cadmium, lead, copper and arsenic) assessment was carried out in water and sediments samples of Nokoue Lake. Except for water, a group of sediment samples was mineralized before the analysis with atomic absorption spectrophotometer. The second group of sediment samples was processed for texture analysis. The results revealed that for the physico-chemical characteristics, the pH is from 6.5 to 8.5. Four kinds of textures were identified: mud, sand, sandy mud and muddy sand. Heavy metals mean concentrations in water rose from 0.01 to 10.1 mg/L for lead and 5.84 to 8.47 for arsenic. In water, copper showed low concentrations in all sites and the values of cadmium were below the detectable limits. The mean concentrations in the sediments were: Cd (0.56 to 22.07 mg/L); Pb (3.2 to 13.94 mg/L); Cu (11.51 to 54.39 mg/L) and As (ND to 436.81 mg/L). Besides, the pattern of trace elements accumulation according to textures revealed that sandy mud and sand sediments recorded high concentrations of arsenic, mud registered high concentrations of cadmium and the sediment combining sand and mud registered high concentrations of copper. Besides, the correlation between heavy metal concentrations and pH except for arsenic.Key words: Nokoue Lake, pollution, heavy metal, texture
Assessment of groundwater to pollution by the toxic metals in the municipality of Kerou (Benin) in watershed of the Niger
This case study has assessed the vulnerability of boreholes water to pollution by toxic metals in the cotton zone of Kerou, in northern Benin. Toxic metals (lead, copper, cadmium, zinc, nickel and iron) were analyzed by atomic absorption spectrophotometry. The results show high values for lead, nickel and iron, which means that 7 out of 18 boreholes are contaminated. Only the lead level exceeds the standard for the boreholes of Ganbore and Korigourou (0.0613 and 0.098 mg/l against 0.04 mg/l) The level of contamination of Cadmium, zinc and copper is very irregular, but however one must notice that the two aforementioned boreholes are contaminate with the concentration of cadmium above the permitted limit (0.0234 and 0.0244 mg/l against 0.005 mg/l). These findings allow us to say that, apart from the two boreholes of the localities of Ganbore and Korigourou located in cotton farm, most of the boreholes are resistant to pollution. So the responsible factors, of the noticed contamination are defined. It is above all due to the cultivation of cotton in this area. The assays witness of the Mekrou River has revealed high contamination by lead (0.060 mg/l) and the iron (1.4341 mg/l): this result can highlight the ongoing relationship of surface water with groundwater.Keywords: Vulnerability, groundwater, contamination, toxic metals, cotton cultur
Dosage du plomb et du cadmium dans le sperme des sujets consultant pour infertilité masculine dans la ville de Cotonou
La diminution de la concentration des paramètres d’appréciation du sperme a soulevé le problème de la fertilité des hommes. La pollution de l’environnement est incriminée en grande partie dans cette infertilité. Dans la ville de Cotonou (BENIN), nous avons recherché au cours de la présente étude les effets du plomb et du cadmium sur la fertilité masculine. Ces métaux lourds toxiques n’ont aucune utilité pour l’organisme et perturbent le système de reproduction entrainant une infertilité du couple. Dans le cadre de cette étude, nous avons étudié en deux phases le sperme de 27 sujets qui souffrent d’une infertilité masculine dans la ville de Cotonou. La première phase a consisté à faire le bilan de l’infertilité masculine sur le sperme des 27 sujets qui ont fait l’objet de notre étude. Quant à la seconde phase, nous avons dosé par Spectrophotométrie d’Absorption Atomique le plomb et le cadmium dans 10 échantillons de sperme de volume supérieur à 2 g. Les résultats ont montré que 7 des 10 échantillons de sperme ont accumulé le cadmium à des concentrations différentes. Par contre, les teneurs en plomb des échantillons de sperme étaient inférieures à la limite de détection de l’appareil pour le plomb. Mais aucune relation significative n’a pu être démontrée entre les teneurs en cadmium et les anomalies observées. Toutefois, on peut soupçonner que la présence de cadmium dans le sperme, même à un taux infirme, serait responsable des Anomalies observées.Mots clés: Fertilité, Plomb, Cadmium, Spermatozoïde
Global Retinoblastoma Presentation and Analysis by National Income Level
Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- A nd middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs
Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries
BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral
Global Retinoblastoma Presentation and Analysis by National Income Level.
Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs
Global Retinoblastoma Presentation and Analysis by National Income Level
Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved
The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries
DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt
Evolution clinique et biologique de cohortes d’enfants sous traitement antiretroviral au Togo
Introduction: L’infection au VIH est l’une des principales causes de mortalité et de morbidité chez le nourrisson et l’enfant en Afrique subsaharienne. L’objectif de cette étude était de décrire le profil évolutif clinique et biologique des enfants sous traitement antirétroviral (TARV) au Togo.Matériel et méthode: Il s’est agi d’une étude transversale portant sur 870 dossiers du 1er janvier 2001 au 31 décembre 2010 dans 40 sites de prise en charge médicales au Togo. Le traitement des données est fait avec le logiciel Epi-Info 6.04d avec les tests statistiques (test du K²); le seuil de signification du p=<0.05. Les doublons sont traités par le Logiciel ESOPE.Résultats: La fréquence des infections opportunistes diminuait avec l’augmentation du Taux de lymphocytes CD4m. Les infections opportunistes étaient dominées par les affections pulmonaires (38,54 %) ; les affections cutanées (22,84 %) ; les affections buccales (13,15 %) et la diarrhée (11,83 %). La fréquence des infections opportunistes au cours du suivi a progressivement diminuée après chaque année. Les effets secondaires ont essentiellement été retrouvés au cours de la première année de suivi et ont été dominés par la toxicité hépatique (36,36 %) et les toxidermies (25 %).Conclusion: Le traitement antirétroviral a montré son efficacité chez les enfants suivis dans divers sites au Togo. Il s’avère important de poursuivre la prise en charge pédiatrique et de l’étendre à d’autres sites sur toute l’étendue du territoire togolais.Mots clés: Evolution, enfants, VIH, TogoEnglish Title: Clinical and biological evolution of cohorts of children against antiretroviral treatment in TogoEnglish AbstractIntroduction: HIV infection is one of the leading causes of infant and child mortality and morbidity in sub-Saharan Africa. The objective of this study was to describe the clinical and biological evolution of children on HAART in Togo.Material and method: It was a cross-sectional study of 870 cases from 1 January 2001 to 31 December 2010 in 40 medical care sites in Togo. The data processing is done with the Epi-Info 6.04d software with statistical tests; p = significance level of <0.05. Duplicates are processed by the software ESOPE.Results: The frequency of opportunistic infections decreased with increasing CD4m lymphocyte counts. Opportunistic infections were dominated by pulmonary disease (38.54%); Skin disease (22.84%); Mouth disease (13.15%) and diarrhea (11.83%). The frequency of opportunistic infections during follow-up has gradually decreased after each year. Side effects were mostly found in the first year of follow-up and were dominated by hepatic toxicity (36.36%) and toxiderma (25%).Conclusion: Antiretroviral therapy has been shown to be effective in children monitored at various sites in Togo. It is important to continue pediatric care and to extend it to other sites throughout the Togolese territory.Keywords: Evolution, children, HIV, Tog