0541: Management of heart failure: experiences in African patients

AimTo determine clinical characteristics and mode of treatment of patients with heart failure in Yaounde military hospital (YMH).MethodsData of patients with heart failure (HF) followed on a period of 6 months in YMH were used to determine clinical characteristics and mode of treatment.ResultsA total of 72 patients were consecutively studied comprising 45 men (62.5%) and 27 women (37.5%) aged 62.8±16.5 and 61.1±19.4 years, respectively. All the patients presented with NYHA functional class III or IV. Alcohol was the most common etiological factor of HF (66.7%) hypertension was the most common risk factor for HF (37.5%) while only 16.7% of the patients were smokers. Global heart failure was the common presentation (60.9%). Left bundle branch was present in 47% of electrocardiograms while 8.7% of the patients were in atrial fibrillation. Dilated cardiomyopathy was the common lesion (80%). Most patients presented with severe left ventricular (LV) systolic dysfunction (66.6%). Male subjects had worse LV systolic dys-function compare to women without significant difference (56.3% vs 43.8% p=0.8). Diabete was not associated with severe LV dysfunction (78.9% on non diabetic vs 6.3% of diabetic patients). Current recommended pharmacology therapies were used in most of the cases. Diuretics were used in 100% while ACE inhibitors were in 91.3% of cases. 52.4% of patients had beta blockers.ConclusionMost heart failure patients in Cameroon present in the sixth decade with severe heart failure. All the recommended therapies are not available in our country

The effects of ProAlgaZyme novel algae infusion on metabolic syndrome and markers of cardiovascular health

<p>Abstract</p> <p>Background</p> <p>Metabolic Syndrome, or Syndrome X, is characterized by a set of metabolic and lipid imbalances that greatly increases the risk of developing diabetes and cardiovascular disease. The syndrome is highly prevalent in the United States and worldwide, and treatments are in high demand. ProAlgaZyme, a novel and proprietary freshwater algae infusion in purified water, has been the subject of several animal studies and has demonstrated low toxicity even with chronic administration at elevated doses. The infusion has been used historically for the treatment of several inflammatory and immune disorders in humans and is considered well-tolerated. Here, the infusion is evaluated for its effects on the cardiovascular risk factors present in metabolic syndrome in a randomized double-blind placebo-controlled study involving 60 overweight and obese persons, ages 25–60. All participants received four daily oral doses (1 fl oz) of ProAlgaZyme (N = 22) or water placebo (N = 30) for a total of 10 weeks, and were encouraged to maintain their normal levels of physical activity. Blood sampling and anthropometric measurements were taken at the beginning of the study period and after 4, 8 and 10 weeks of treatment. Eight participants did not complete the study.</p> <p>Results</p> <p>ProAlgaZyme brought about statistically significant (p < 0.001) reductions in the following: weight, body fat, total cholesterol, LDL-cholesterol, triglycerides, C-reactive protein and fasting blood glucose levels, accompanied by a significant (p < 0.001) increase in HDL-cholesterol levels over the 10-week study period. The infusion was well-tolerated and no side effects were noted.</p> <p>Conclusion</p> <p>ProAlgaZyme (4 fl oz daily) consumption resulted in significant reductions in weight and blood glucose levels, while significantly improving serum lipid profiles and reducing markers of inflammation, thus improving cardiovascular risk factors in overweight and obese subjects over a course of 10 weeks with an absence of adverse side effects.</p> <p>Trial Registration</p> <p>US ClinicalTrials.gov NCT00489333</p

Spodoptera frugiperda Smith (Lepidoptera: Noctuidae) in Cameroon: case study on its distribution, damage, pesticide use, genetic differentiation and host plants

Open Access JournalMaize farmers in sub-Saharan Africa recently experienced unusual damage in their farms, attributed to the fall armyworm (FAW) Spodoptera frugiperda (J. E. Smith). This pest was first recorded in Africa in 2016, but detailed information on its distribution and damage and farmer's response in invaded areas are largely lacking. In this study, we determined FAW distribution, genetic diversity, host plants, crop damage, and farmers' responses. S. frugiperda was recorded in the 10 regions of Cameroon. Average percentage of infested plants and damage severity (on a scale of 1 to 5) were lowest-20.7 ± 7.4% and 2.1 ± 0.1 respectively-in the Sahelian regions and greatest-69.0 ± 4.3% and 3.1 ± 0.1 respectively-in the Western Highlands. Altitude did not influence FAW incidence and severity and its larvae infrequently co-occurred with maize stemborers on the same plants, suggesting possible direct and/or indirect competition between the two groups of maize pests. In response to this new threat to maize production, farmers have opted for the application of synthetic pesticides. Although our experiments were not designed to determine pesticide efficacy, as parameters such as time since application were not considered, our observations suggest lack of a drastic effect on S. frugiperda infestations on maize. There were two haplotypes of FAW co-occurring in Cameroon corresponding to the rice and corn strains and separated by 1.7% sequence divergence, which does not support the existence of cryptic species. S. frugiperda larvae were also recorded on Sorghum bicolor (L.) Moench (10.6%), Solanum tuberosum L. (2.8%), Ipomoea batatas (L.) Lam. (1.9%), Saccharum officinarum L (0.8%), Phaseolus vulgaris L. (0.4%) and Gossypium hirsutum L. (1.9%). This study show that two strains are present in all agroecological zones in Cameroon, and probably in neighboring countries of central Africa sharing the same agroecologies. Management options should therefore consider the use of specific natural enemies and an informed decision of intervention based on strain capture and damage threshold, to avoid pesticide resistance that may arise from inadequate use of chemicals. Further studies should also be undertaken to assess the response of the two S. frugiperda strains to biopesticides and botanical insecticides

L’epilepsie en milieu scolaire : enquete chez les enseignants de la ville de Kati au Mali et revue de la litterature

Introduction La prévalence de l’épilepsie en Afrique subsaharienne est élevée. Nous avons mené une étude transversale et descriptive dans l’ensemble des écoles primaires de la ville de Kati (200 000 habitants). Les enseignants furent interviewés de manière exhaustive à l’aide de questionnaires portant, d’une part, sur les connaissances, attitudes et pratiques des enseignants en matière d’épilepsie et, d’autre part, sur leurs avis sur les conséquences psychologiques, sociales pour l’enfant épileptique et les incidences sur sa scolarité.Résultats Nous avons interrogé 92 enseignants (60 hommes et 32 femmes). L’âge moyen des enseignants était de 30 ans. La majorité d’entre eux avait une expérience professionnelle de plus de 5 ans. Environ 38% des enseignants attribuaient la maladie à une cause surnaturelle. Plus de 39% des enseignants pensaient que l’épilepsie était contagieuse et 61% pensaient que l’épilepsie était incurable. 79% interdisaient systématiquement la pratique du sport à l’enfant épileptique. Environ 55% pensaient que l’enfant épileptique avait des capacités cognitives inférieures à celles de l’enfant non épileptique et 88% affirmaient que l’enfant épileptique était incapable d’avoir une scolarité normale. 59% trouvaient que l’élève épileptique était victime de stigmatisation et de marginalisation. Devant une crise, 68% renvoyaient l’enfant au domicile.Conclusion Ce travail fait apparaître un besoin de formation des enseignants en matière d’épilepsie. Les données actuelles sur la fréquence de l’épilepsie en milieu scolaire justifient une attention particulière des services de santé et de ceux de l’éducation nationale sur la scolarisation de l’enfant épileptique.Mots clés : Epilepsie, Ecole, Enseignants, Mali, Pratiques

Clustering of under-five mortality in the Navrongo HDSS in the Kassena-Nankana District of northern Ghana

Background: Under-five mortality is a major public health problem and one of the health indicators of health care in sub-Saharan Africa. In order to address inefficient health systems, there is a need to identify the spatial distribution of under-five mortality, especially areas of high mortality clustering. This study aimed to explore spatial and temporal clustering in under-five mortality in the Kassena-Nankana District of the Upper East region. Methods: We used data from the Navrongo Health and Demographic Surveillance System in the Kassena- Nankana District of northern Ghana, which had an average population of 140,000 of which about 18,400 were under five years of age. We analysed under-five mortality in 49 villages during the period 1997&#x2013;2006. We calculated total under-five mortality rates and investigated their geographical distributions. A spatial scan statistic was used to test for clustering of the mortality in both space and time. Results: Under-five mortality has been declining during the period. However, the data show a persistently higher than average clustering of mortality over the period among villages mainly in the north-eastern parts of the district. Conclusion: There is a higher than average under-five mortality clustering in the villages in the north-east of the district and this may suggest a relatively poor health care system despite the many health interventions that took place over time in the district, including the Community Health and Family Planning Project, whose impact may not have been felt in these parts of the district between 1995 and 2004

Role of complement and antibodies in controlling infection with pathogenic simian immunodeficiency virus (SIV) in macaques vaccinated with replication-deficient viral vectors

<p>Abstract</p> <p>Background</p> <p>We investigated the interplay between complement and antibodies upon priming with single-cycle replicating viral vectors (SCIV) encoding SIV antigens combined with Adeno5-SIV or SCIV pseudotyped with murine leukemia virus envelope boosting strategies. The vaccine was applied via spray-immunization to the tonsils of rhesus macaques and compared with systemic regimens.</p> <p>Results</p> <p>Independent of the application regimen or route, viral loads were significantly reduced after challenge with SIVmac239 (p < 0.03) compared to controls. Considerable amounts of neutralizing antibodies were induced in systemic immunized monkeys. Most of the sera harvested during peak viremia exhibited a trend with an inverse correlation between complement C3-deposition on viral particles and plasma viral load within the different vaccination groups. In contrast, the amount of the observed complement-mediated lysis did not correlate with the reduction of SIV titres.</p> <p>Conclusion</p> <p>The heterologous prime-boost strategy with replication-deficient viral vectors administered exclusively via the tonsils did not induce any neutralizing antibodies before challenge. However, after challenge, comparable SIV-specific humoral immune responses were observed in all vaccinated animals. Immunization with single cycle immunodeficiency viruses mounts humoral immune responses comparable to live-attenuated immunodeficiency virus vaccines.</p

High concentration of childhood deaths in the low-lying areas of Chakaria HDSS, Bangladesh: findings from a spatial analysis

Background: Despite significant reduction of childhood mortality in Bangladesh, large spatial variations persist. Identification of lower level spatial units with higher concentrations of deaths can be useful for strengthening services in these areas. This paper reports findings from a spatial analysis of deaths in Chakaria, a rural subdistrict, where a Health and Demographic Surveillance System has been in place since 1999. Chakaria is an INDEPTH member site. Methods: An analysis was done of 339 deaths among nearly 24,500 children under the age of five during 2005&#x2013;2008. One ward, the lowest level of administrative units, was the unit of spatial analysis. Data from 24 wards were analyzed. The Discrete Poisson Probability Model was used to identify the clustering of deaths. Results: Deaths were concentrated within 12 wards located in the low-lying deltaic flood plains of the Chakaria HDSS area. The risk of death in the low-lying areas was statistically, significantly higher, 1.5 times, than the non-low-lying areas (p&#60;0.02). Conclusion: Spatial analysis can be a useful tool for identifying high-risk mortality areas. An understanding of the risk factors prevalent in the low-lying areas can help design effective interventions to reduce mortality in these areas