Using systematic screening to increase integration of reproductive health services delivery in Senegal

This study tested the systematic screening technique to increase the integration of reproductive health services in Senegal. The study took place in four urban health posts in the city of Dakar and three rural health posts in the district of Kebemer. A before and after design tested the hypothesis that the use of the systematic screening tool would result in more services received per client visit. In Dakar, services per visit increased significantly by 20 percent, while in Kebemer, services per visit also increased significantly by 35 percent. The study also examined several techniques to improve provider compliance with the screening technique. The Senegal Ministry of Health has requested assistance in scaling up the strategy to other reproductive health service delivery points at district, regional, and national levels

Genome-scale CRISPR/Cas9 screen determines factors modulating sensitivity to ProTide NUC-1031

A.S. is the recipient of a Medical Research Scotland PhD Studentship awarded to P.A.R. Edinburgh Genomics is partly supported through core grants from Natural Environment Research Council (R8/H10/56), Medical Research Council (MR/K001744/1) and Biotechnological and Biological Research Council (BB/J004243/1). Publication of this article was funded in part by the University of St Andrews Open Access Publishing Fund.Gemcitabine is a fluoropyrimidine analogue that is used as a mainstay of chemotherapy treatment for pancreatic and ovarian cancers, amongst others. Despite its widespread use, gemcitabine achieves responses in less than 10% of patients with metastatic pancreatic cancer and has a very limited impact on overall survival due to intrinsic and acquired resistance. NUC-1031 (Acelarin), a phosphoramidate transformation of gemcitabine, was the first anti-cancer ProTide to enter the clinic. We find it displays important in vitro cytotoxicity differences to gemcitabine, and a genome-wide CRISPR/Cas9 genetic screening approach identified only the pyrimidine metabolism pathway as modifying cancer cell sensitivity to NUC-1031. Low deoxycytidine kinase expression in tumour biopsies from patients treated with gemcitabine, assessed by immunostaining and image analysis, correlates with a poor prognosis, but there is no such correlation in tumour biopsies from a Phase I cohort treated with NUC-1031.Publisher PDFPeer reviewe

Une lesion cutanée persistante non cicatricielle depuis 3 ans: le pyoderma gangrenosum

Le pyoderma gangrenosum (PG) est une dermatose neutrophilique non infectieuse rare souvent méconnue. Il se présente généralement par des ulcérations cutanées inflammatoires, très douloureuses et d'évolution rapide. Il est fréquemment retrouvé dans un contexte de néoplasie, de pathologies inflammatoires digestives, rhumatologiques et/ou hématologiques. Son diagnostic est très souvent tardif après de multiples échecs thérapeutiques. Nous rapportons un cas de pyoderma gangrenosum dont le diagnostic n'a pas été criant. Un patient a été admis dans notre service pour une lésion dermatologique persistante et d'évolution défavorable malgré les débridements et l'administration d'antibiotiques. Il était suivi pour un cancer de la prostate, une hypertension artérielle et un asthme. Du fait des anomalies biologiques observées telles qu'une hyperleucocytose à polynucléaires neutrophiles avec myélémie à myélocytes et métamyélocytes, sans blastose sanguine et une anémie normochrome normocytaire, une leucémie myéloïde chronique a été évoquée chez ce patient. Elle a par la suite été infirmée devant les différents examens complémentaires non concluants. C'est ainsi que le diagnostic de PG a été évoqué et confirmé à l'examen anatomopathologique montrant un aspect histopathologique d'un tissu de granulation concordant avec un pyoderma gangrenosum et une absence de signe histologique de malignité. L'institution d'un traitement à base de corticothérapie a abouti à la guérison

Analysis of pfhrp2 genetic diversity in Senegal and implications for use of rapid diagnostic tests

Background: The Senegalese National Malaria Control Programme has recommended use of rapid diagnostic tests (RDTs) that target the histidine-rich protein 2 (HRP2), specific to Plasmodium falciparum, to diagnose malaria cases. The target antigen has been shown to be polymorphic, which may explain the variability in HRP2-based RDT results reported in field studies. The genetic diversity of the pfhrp2 gene has not been investigated in depth in many African countries. The goal of this study is to determine the extent of polymorphism in pfhrp2 among Senegal, Mali and Uganda parasite populations, and discuss the implications of these findings on the utility of RDTs that are based on HRP2 detection. Methods: Sequencing data from the pfhrp2 locus were used to analyze the genetic diversity of this gene among three populations, with different transmission dynamics and malaria parasite ecologies. Nucleotide diversity (π) and non-synonymous nucleotide diversity (πNS) were studied in the pfhrp2 gene from isolates obtained in Senegal. Amino acid repeat length polymorphisms in the PfHRP2 antigen were characterized and parameters of genetic diversity, such as frequency and correlation between repeats in these populations, were assessed. Results: The diversity survey of the pfhrp2 gene identified 29 SNPs as well as insertion and deletion polymorphisms within a 918 bp region. The Senegal pfhrp2 exhibited a substantial level of diversity [π = 0.00559 and πNS = 0.014111 (πS = 0.0291627)], similar to several polymorphic genes, such as msp1, involved in immune responses, and the gene encoding the SURFIN polymorphic antigen, which are surface exposed parasite proteins. Extensive repeat length polymorphisms in PfHRP2, as well as similar patterns in the number, organization and the type of predicted amino acid repeats were observed among the three populations, characterized by an occurrence of Type 2, Type 4 and Type 7 repeats. Conclusions: These results warrant deeper monitoring of the RDT target antigen diversity and emphasize that development of other essential genes as a target for diagnostic tools is critical

Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal.

BACKGROUND: Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. We conducted the first population-based trachoma prevalence survey in the Casamance region of Senegal to enable the Senegalese National Eye Care Programme (NECP) to plan its trachoma control activities. The World Health Organization (WHO) guidelines state that any individual with trachomatous trichiasis (TT) should be offered surgery, but that surgery should be prioritised where the prevalence is >0.1%, and that districts and communities with a trachomatous inflammation, follicular (TF) prevalence of ≥10% in 1-9 year-olds should receive mass antibiotic treatment annually for a minimum of three years, along with hygiene promotion and environmental improvement, before re-assessing the prevalence to determine whether treatment can be discontinued (when TF prevalence in 1-9 year-olds falls 1% in all districts. CONCLUSION: With a prevalence <5%, TF does not appear to be a significant public health problem in this region. However, TF monitoring and surveillance at sub-district level will be required to ensure that elimination targets are sustained and that TF does not re-emerge as a public health problem. TT surgery remains the priority for trachoma elimination efforts in the region, with an estimated 1819 TT surgeries to conduct

Spectralité et critique de la laideur : l’engagement postcolonial dans la littérature en français de la nouvelle génération d’écrivains africains

This dissertation examines the new generation of Francophone African writers and their negotiation of the theory of “engagement.” Thematically, many of these writers deal with the daunting problems faced by Africa and with issues linked to emigration to France. But they also have to work with French publishing houses and their exigencies as they relate to the international book market. The writers themselves aspire to be integrated in the “World Republic of Letters”. But such concepts as “World Literature in French” or “World Republic of Letters,” while more appealing to the new generation than the old Sartrian theory of “engagement,” do not always accommodate a commitment to specific, regional causes. I argue that because many writers may have divided loyalties and conflicting interests, their works of fiction manifest interesting, subtle ways of understanding and practicing a postcolonial “engagement.” Theories such as “hauntology” and post-realism can be used to account for some of their writings’ main features. To demonstrate this with specific examples, I study individual novels by Simon Njami, Daniel Biyaoula and especially Alain Mabanckou

Spectralite Et Critique De La Laideur: L'engagement Postcolonial Dans La Litterature en Francais De La Nouvelle Generation D'ecrivains Africains

212 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2010.This dissertation examines the new generation of Francophone African writers and their negotiation of the theory of "engagement." Thematically, many of these writers deal with the daunting problems faced by Africa and with issues linked to emigration to France. But they also have to work with French publishing houses and their exigencies as they relate to the international book market. The writers themselves aspire to be integrated in the "World Republic of Letters". But such concepts as "World Literature in French" or "World Republic of Letters," while more appealing to the new generation than the old Sartrian theory of "engagement," do not always accommodate a commitment to specific, regional causes. I argue that because many writers may have divided loyalties and conflicting interests, their works of fiction manifest interesting, subtle ways of understanding and practicing a postcolonial "engagement." Theories such as "hauntology" and post-realism can be used to account for some of their writings' main features. To demonstrate this with specific examples, I study individual novels by Simon Njami, Daniel Biyaoula and especially Alain Mabanckou.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD

Tackling disease education gaps of People with Haemophilia and obligate carriers in Sub-Saharan Africa through the design and implementation of an original Artificial Intelligence (AI) conversational agent

Artificial Intelligence in Medicine (AIM) has the potential to transform physicians’ clinical practice and patients’ health outcomes. The versatility, adaptability, and ability to mimic human behaviours of AI chatbots support their relevance in various chronic diseases for diagnosis, patient disease education, symptoms management or to support physician workflow. Haemophilia is a congenital bleeding disorder, People With Haemophilia (PWH) face may challenges because of the rarity of their condition. In low-resource settings such as sub-Saharan Africa (SSA), haemophilia care management and disease education need to be significantly improved. First, this thesis aimed to understand the challenges, beliefs, behaviors of People with Haemophilia (PWH) in Senegal and to identify the main gaps in haemophilia care. Second, the research focused on the design, development and implementation of an AI chatbot to tackle gaps in disease knowledge. Third, an evaluation of its usability and level of satisfaction of chatbot’s users was also conducted. The published articles describe an original approach with different AI subsets to develop a culturally adapted and multi-lingual (French and Wolof) chatbot for haemophilia. Results are preliminary indicators to support the relevance of implementing an AI chatbot for haemophilia education in Sub-Saharan Africa to potentially improve the Quality of Life ( QoL) of People with Haemophilia.</p