Acute febrile illness and influenza disease burden in a rural cohort dedicated to malaria in Senegal, 2012-2013

Background African populations are considered to be particularly vulnerable to fever illnesses, including malaria, and acute respiratory disease, owing to limited resources and overcrowding. However, the overall burden of influenza in this context is poorly defined and incidence data for African countries are scarce. We therefore studied the fever syndrome incidence and more specifically influenza incidence in a cohort of inhabitants of Dielmo and Ndiop in Sokone district, Senegal. Methods Daily febrile-illness data were prospectively obtained from January 2012 to December 2013 from the cohort of the villages of Dielmo and Ndiop, initially dedicated to the study of malaria. Nasopharyngeal swabs were collected from, and malaria diagnosis tests (thick blood smears) carried out on, every febrile individual during clinical visits; reverse transcriptase- polymerase chain reaction was used to identify influenza viruses in the samples. Binomial negative regression analysis was used to study the relationship between the monthly incidence rate and various covariates. Results In Dielmo and Ndiop, the incidence ofmalaria has decreased, but fever syndromes remain frequent. Among the 1036 inhabitants included in the cohort, a total of 1,129 episodes of fever were reported. Influenza was present all year round with peaks in October-December 2012 and August 2013. The fever, ILI and influenza incidence density rates differed significantly between age groups. At both sites, the adjusted incidence relative risks for fever syndromes and ILI were significantly higher in the [6-24 months) than other age groups: 7.3 (95% CI: [5.7-9.3]) and 16.1 (95% CI: [11.1-23.3]) respectively. The adjusted incidence relative risk for influenza was significantly higher for the [0-6 months) than other age groups: 9.9 (95% CI: [2.9-33.6]). At both sites, incidence density rates were lowest among adults > = 50 years. Conclusions In this rural setting in Senegal, influenza was most frequent among the youngest children. Preventive strategies targeting this population should be implemented

The potential for quality assurance systems to save costs and lives:the case of early infant diagnosis of HIV

OBJECTIVES: Scaling up of point-of-care testing (POCT) for early infant diagnosis of HIV (EID) could reduce the large gap in infant testing. However, suboptimal POCT EID could have limited impact and potentially high avoidable costs. This study models the cost-effectiveness of a quality assurance system to address testing performance and screening interruptions, due to, for example, supply stockouts, in Kenya, Senegal, South Africa, Uganda and Zimbabwe, with varying HIV epidemics and different health systems. METHODS: We modelled a quality assurance system-raised EID quality from suboptimal levels: that is, from misdiagnosis rates of 5%, 10% and 20% and EID testing interruptions in months, to uninterrupted optimal performance (98.5% sensitivity, 99.9% specificity). For each country, we estimated the 1-year impact and cost-effectiveness (US$/DALY averted) of improved scenarios in averting missed HIV infections and unneeded HIV treatment costs for false-positive diagnoses. RESULTS: The modelled 1-year costs of a national POCT quality assurance system range from US$ 69 359 in South Africa to US$334 341 in Zimbabwe. At the country level, quality assurance systems could potentially avert between 36 and 711 missed infections (i.e. false negatives) per year and unneeded treatment costs between US$ 5808 and US$ 739 030. CONCLUSIONS: The model estimates adding effective quality assurance systems are cost-saving in four of the five countries within the first year. Starting EQA requires an initial investment but will provide a positive return on investment within five years by averting the costs of misdiagnoses and would be even more efficient if implemented across multiple applications of POCT

Quantitative Analysis of Vasodilatory Action of Quercetin on Intramural Coronary Resistance Arteries of the Rat In Vitro

Background: Dietary quercetin improves cardiovascular health, relaxes some vascular smooth muscle and has been demonstrated to serve as a substrate for the cyclooxygenase enzyme. Aims: 1. To test quantitatively a potential direct vasodilatory effect on intramural coronary resistance artery segments, in different concentrations. 2. To scale vasorelaxation at different intraluminal pressure loads on such vessels of different size. 3. To test the potential role of prostanoids in vasodilatation induced by quercetin. Methods: Coronary arterioles (70-240 mu m) were prepared from 24 rats and pressurized in PSS, using a pressure microangiometer. Results: The spontaneous tone that developed at 50 mmHg was relaxed by quercetin in the 10(-9) moles/lit concentration (p<0.05), while 10(-5) moles/lit caused full relaxation. Significant relaxation was observed at all pressure levels (10-100 mmHg) at 10(-7) moles/lit concentration of quercetin. The cyclooxygenase blocker indomethacin (10(-5) moles/lit) induced no relaxation but contraction when physiological concentrations of quercetin were present in the tissue bath (p<0.02 with Anova), this contraction being more prominent in smaller vessels and in the higher pressure range (p<0.05, Pearson correlation). A further 2-8% contraction could be elicited by the NO blocker L-NAME (10(-4) moles/lit). Conclusion: These results demonstrate that circulating levels of quercetin (10(-7) moles/lit) exhibit a substantial coronary vasodilatory effect. The extent of it is commeasurable with that of several other physiological mechanisms of coronary blood flow control. At least part of this relaxation is the result of an altered balance toward the production of endogenous vasodilatory prostanoids in the coronary arteriole wall

Relation between Plasmodium falciparum asymptomatic infection and malaria attacks in a cohort of Senegalese children

© 2008 Le Port et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

PATOGENICIDADE DE ESPÉCIES DE Macrophomina COLETADAS DE PLANTAS DANINHAS EM FEIJÃO-CAUPI

[PT] A podridão de carvão causada por Macrophomina phaseolina é uma das principais doenças do feijão-caupi, causando perdas substanciais para os produtores. Na região semiárida do Brasil, o feijão-caupi é uma das alternativas utilizadas para rotação de culturas durante a entressafra do melão. Isso favorece a multiplicação de Macrophomina, uma vez que ambas as culturas são hospedeiras desse patógeno. O objetivo deste estudo foi verificar a patogenicidade em caupi de Macrophomina phaseolina e M. pseudophaseolina em caupi. Isolados de Macrophomina spp. obtidos das raízes de Trianthema portulacastrum e Boerhavia diffusa, espécies de plantas daninhas prevalentes em áreas de produção de melão no Nordeste brasileiro foram utilizadas neste estudo. O experimento foi realizado em casa de vegetação. Plantas de feijão-caupi 'Paulistinha' foram inoculados com 30 isolados de M. phaseolina, 30 isolados de M. pseudophaseolina e um isolado de referência de M. phaseolina obtido de raízes de feijão-caupi. Todos os isolados de Macrophomina foram patogênicos ao feijão-caupi, não havendo diferenças estatísticas entre as duas espécies de Macrophomina em relação à incidência e severidade da doença. Além disso, 65,2 e 100,0% dos isolados de M. phaseolina, e 56,2 e 92,8% dos isolados de M. pseudophaseolina, obtidos de T. portulacastrum e B. diffusa, respectivamente, foram tão severos ao feijão-caupi quanto o isolado de referência. Esses resultados enfatizam a necessidade de estabelecer práticas de manejo visando o controle de T. portucalastrum e B. diffusa nas áreas de produção de feijão-caupi, pois podem atuar como fontes de inóculo e sobrevivência para Macrophomina spp.[EN] Charcoal rot caused by Macrophomina phaseolina is a major cowpea disease causing substantial losses to growers. In the semi-arid region of Brazil, cowpea is one of the most widely used alternatives for crop rotation during the off-season of melon. This favors Macrophomina multiplication because both crops are hosts of this pathogen. The objective of this study was to verify the pathogenicity of Macrophomina phaseolina and M. pseudophaseolina on cowpea. The Macrophomina spp. isolates used were obtained from the roots of Trianthema portulacastrum and Boerhavia diffusa, weed species prevalent in melon production areas in North-east Brazilian The experiment was carried out in a greenhouse. Cowpea plants cv. Paulistinha' were inoculated with 30 M. phaseolina isolates, 30 M. pseudophaseolina isolates and a reference isolate of H. phaseolina obtained from cowpea roots. All Macrophomina isolates were able to cause disease on cowpea and there were no statistical differences between both Macrophomina species regarding disease incidence and severity. Moreover, 65.2 and 100.0% of the M. phaseolina isolates, and 56.2 and 92.8% of the M. pseudophaseolina isolates, obtained from T. portulacastrum and B. diffusa, respectively, were as severe to cowpea as the M. phaseolina reference isolate from cowpea. These results emphasize the need to establish management practices aiming to control T. portucalastrum and B. diffusa from cowpea production areas, as they can act as potential sources of inoculum and survival for Macrophomina spp.This study was partially financed by the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior -Brazil (CAPES) -Finance Code 001 and by the Conselho Nacional de desenvolvimento Cientifico e Tecnologico (CNPq).Sales Jr., R.; Nogueira, A.; Mitsa Paiva Negreiros, A.; Rodrigues, T.; De Queiroz, M.; Armengol Fortí, J. (2020). PATHOGENICITY OF Macrophomina SPECIES COLLECTED FROM WEEDS IN COWPEA. Revista Caatinga. 33(2):395-401. https://doi.org/10.1590/1983-21252020v33n212rcS395401332Ambrósio, M. M. Q., Dantas, A. C. A., Martínez-Perez, E., Medeiros, A. C., Nunes, G. H. S., & Picó, M. B. (2015). Screening a variable germplasm collection of Cucumis melo L. for seedling resistance to Macrophomina phaseolina. Euphytica, 206(2), 287-300. doi:10.1007/s10681-015-1452-xFreitas, F. C. L., Medeiros, V. F. L. P., Grangeiro, L. C., Silva, M. G. O., Nascimento, P. G. M. L., & Nunes, G. H. (2009). Interferência de plantas daninhas na cultura do feijão-caupi. Planta Daninha, 27(2), 241-247. doi:10.1590/s0100-83582009000200005Gomes-Silva, F., Almeida, C. M. A., Silva, A. G., Leão, M. P. C., Silva, K. P., Oliveira, L. G., … Lima, V. L. M. (2017). Genetic Diversity of Isolates of Macrophomina phaseolina Associated with Cowpea from Brazil Semi-Arid Region. Journal of Agricultural Science, 9(11), 112. doi:10.5539/jas.v9n11p112Gupta, G. K., Sharma, S. K., & Ramteke, R. (2012). Biology, Epidemiology and Management of the Pathogenic Fungus Macrophomina phaseolina (Tassi) Goid with Special Reference to Charcoal Rot of Soybean (Glycine max (L.) Merrill). Journal of Phytopathology, 160(4), 167-180. doi:10.1111/j.1439-0434.2012.01884.xKaur, S., Dhillon, G. S., Brar, S. K., Vallad, G. E., Chand, R., & Chauhan, V. B. (2012). Emerging phytopathogenMacrophomina phaseolina: biology, economic importance and current diagnostic trends. Critical Reviews in Microbiology, 38(2), 136-151. doi:10.3109/1040841x.2011.640977Machado, A. R., Pinho, D. B., Soares, D. J., Gomes, A. A. M., & Pereira, O. L. (2018). Bayesian analyses of five gene regions reveal a new phylogenetic species of Macrophomina associated with charcoal rot on oilseed crops in Brazil. European Journal of Plant Pathology, 153(1), 89-100. doi:10.1007/s10658-018-1545-1Mbaye, N., Mame, P. S., Ndiaga, C., & Ibrahima, N. (2015). Is the recently described Macrophomina pseudophaseolina pathogenically different from Macrophomina phaseolina? African Journal of Microbiology Research, 9(45), 2232-2238. doi:10.5897/ajmr2015.7742Negreiros, A. M. P., Sales Júnior, R., León, M., Melo, N. J., Michereff, S. J., Ambrósio, M. M., … Armengol, J. (2019). Identification and pathogenicity of Macrophomina species collected from weeds in melon fields in Northeastern Brazil. Journal of Phytopathology, 167(6), 326-337. doi:10.1111/jph.12801Negreiros, A. M. P., Júnior, R. S., Rodrigues, A. P. M. S., León, M., & Armengol, J. (2019). Prevalent weeds collected from cucurbit fields in Northeastern Brazil reveal new species diversity in the genusMonosporascus. Annals of Applied Biology, 174(3), 349-363. doi:10.1111/aab.12493Ramos, H. M. M., Bastos, E. A., Andrade Júnior, A. S. de, & Marouelli, W. A. (2012). Estratégias ótimas de irrigação do feijão‑caupi para produção de grãos verdes. Pesquisa Agropecuária Brasileira, 47(4), 576-583. doi:10.1590/s0100-204x2012000400014Reis, E. M., Boaretto, C., & Danelli, A. L. D. (2014). Macrophomina phaseolina: density and longevity of microsclerotia in soybean root tissues and free on the soil, and competitive saprophytic ability. Summa Phytopathologica, 40(2), 128-133. doi:10.1590/0100-5405/1921Rocha, M. de M., Carvalho, K. J. M. de, Freire Filho, F. R., Lopes, Â. C. de A., Gomes, R. L. F., & Sousa, I. da S. (2009). Controle genético do comprimento do pedúnculo em feijão-caupi. Pesquisa Agropecuária Brasileira, 44(3), 270-275. doi:10.1590/s0100-204x2009000300008Sales Junior, R., Oliveira, O. F. de, Medeiros, É. V. de, Guimarães, I. M., Correia, K. C., & Michereff, S. J. (2012). Ervas daninhas como hospedeiras alternativas de patógenos causadores do colapso do meloeiro. Revista Ciência Agronômica, 43(1), 195-198. doi:10.1590/s1806-66902012000100024Sales Júnior, R., Rodrigues, A. P. M. dos S., Negreiros, A. M. P., Ambrósio, M. M. de Q., Barboza, H. da S., & Beltrán, R. (2019). WEEDS AS POTENTIAL HOSTS FOR FUNGAL ROOT PATHOGENS OF WATERMELON. Revista Caatinga, 32(1), 1-6. doi:10.1590/1983-21252019v32n101rcFrancisco, de A. S. e S., & Carlos, A. V. de A. (2016). The Assistat Software Version 7.7 and its use in the analysis of experimental data. African Journal of Agricultural Research, 11(39), 3733-3740. doi:10.5897/ajar2016.11522Silva, M. G. O. da, Freitas, F. C. L. de, Negreiros, M. Z. de, Mesquita, H. C. de, Santana, F. A. O. de, & Lima, M. F. P. de. (2013). Manejo de plantas daninhas na cultura da melancia nos sistemas de plantio direto e convencional. Horticultura Brasileira, 31(3), 494-499. doi:10.1590/s0102-05362013000300025Zhao, L., Cai, J., He, W., & Zhang, Y. (2019). Macrophomina vaccinii sp. nov. causing blueberry stem blight in China. MycoKeys, 55, 1-14. doi:10.3897/mycokeys.55.3501

Simple Security Definitions for and Constructions of 0-RTT Key Exchange

Zero Round-Trip Time (0-RTT) key exchange protocols allow for the transmission of cryptographically protected payload data without requiring the prior exchange of messages of a cryptographic key exchange protocol, while providing perfect forward secrecy. The 0-RTT KE concept was first realized by Google in the QUIC Crypto protocol, and a 0-RTT mode has been intensively discussed for inclusion in TLS 1.3. In 0-RTT KE two keys are generated, typically using a Diffie-Hellman key exchange. The first key is a combination of an ephemeral client share and a long-lived server share. The second key is computed using an ephemeral server share and the same ephemeral client share. In this paper, we propose simple security models, which catch the intuition behind known 0-RTT KE protocols; namely that the first (respectively, second) key should remain indistinguishable from a random value, even if the second (respectively, first) key is revealed. We call this property strong key independence. We also give the first constructions of 0-RTT KE which are provably secure in these models, based on the generic assumption that secure non-interactive key exchange (NIKE) exists

Defining Major Surgery: A Delphi Consensus Among European Surgical Association (ESA) Members

Background: Major surgery is a term frequently used but poorly defined. The aim of the present study was to reach a consensus in the definition of major surgery within a panel of expert surgeons from the European Surgical Association (ESA). Methods: A 3-round Delphi process was performed. All ESA members were invited to participate in the expert panel. In round 1, experts were inquired by open- and closed-ended questions on potential criteria to define major surgery. Results were analyzed and presented back anonymously to the panel within next rounds. Closed-ended questions in round 2 and 3 were either binary or statements to be rated on a Likert scale ranging from 1 (strong disagreement) to 5 (strong agreement). Participants were sent 3 reminders at 2-week intervals for each round. 70% of agreement was considered to indicate consensus. Results: Out of 305 ESA members, 67 (22%) answered all the 3 rounds. Significant comorbidities were the only preoperative factor retained to define major surgery (78%). Vascular clampage or organ ischemia (92%), high intraoperative blood loss (90%), high noradrenalin requirements (77%), long operative time (73%) and perioperative blood transfusion (70%) were procedure-related factors that reached consensus. Regarding postoperative factors, systemic inflammatory response (76%) and the need for intensive or intermediate care (88%) reached consensus. Consequences of major surgery were high morbidity (>30% overall) and mortality (>2%). Conclusion: ESA experts defined major surgery according to extent and complexity of the procedure, its pathophysiological consequences and consecutive clinical outcomes

Acceptability and feasibility of a screen-and-treat programme for hepatitis B virus infection in The Gambia: the Prevention of Liver Fibrosis and Cancer in Africa (PROLIFICA) study.

BACKGROUND: Despite the introduction of immunisation for hepatitis B virus (HBV) in the 1990s, HBV-related morbidity and mortality remain high in sub-Saharan Africa. Identification and treatment of asymptomatic people with chronic HBV infection should reduce the disease burden. We therefore assessed the feasibility of a screen-and-treat programme for HBV infection in The Gambia, west Africa, and estimated the proportion of HBV-infected people who had significant liver disease in need of treatment. METHODS: Between Dec 7, 2011, and Jan 24, 2014, individuals living in randomly selected communities in western Gambia were offered hepatitis B surface antigen (HBsAg) screening via a point-of-care test. The test was also offered to potential blood donors attending the central hospital in the capital, Banjul. HBsAg-positive individuals were invited for a comprehensive liver assessment and were offered treatment according to international guidelines. We defined linkage to care as visiting the liver clinic at least once. Eligibility for treatment was judged in accordance with the 2012 European Association for the Study of the Liver guidelines. FINDINGS: HBsAg screening was accepted by 5980 (weighted estimate 68·9%, 95% CI 65·0-72·4) of 8170 adults from 27 rural and 27 urban communities and 5559 (81·4%, 80·4-82·3) of 6832 blood donors. HBsAg was detected in 495 (8·8%, 7·9-9·7) individuals in communities and 721 (13·0%, 12·1-13·9) blood donors. Prevalence was higher in men (239 [10·5%, 8·9-12·1] of 2328 men vs 256 [7·6%, 6·5-8·7] of 3652 women; p=0·004) and middle-aged participants. Linkage to care was high in the communities, with 402 (81·3%) of 495 HBsAg-positive individuals attending the clinic. However, only 300 (41·6%) of 721 HBsAg-positive people screened at the blood bank linked into care. Of those who attended the clinic, 18 (4·4%, 2·5-7·7) patients from the communities and 29 (9·7%, 6·8-13·6) from the blood bank were eligible for treatment. Male sex was strongly associated with treatment eligibility (odds ratio 4·35, 1·50-12·58; p=0·007). INTERPRETATION: HBV infection remains highly prevalent in The Gambia. The high coverage of community-based screening, good linkage into care, and the small proportion of HBsAg carriers who need treatment suggest that large-scale screening and treatment programmes are feasible in sub-Saharan Africa. FUNDING: European Commission (FP7)

Liver Stiffness Measurement and Biochemical Markers in Senegalese Chronic Hepatitis B Patients with Normal ALT and High Viral Load

Despite the high prevalence of chronic hepatitis B (CHB) in Africa, few studies have been performed among African patients. We sought to evaluate liver stiffness measurement by FibroScan® (LSM) and two biochemical scores (FibroTest®, Fibrometer®) to diagnose liver fibrosis in Senegalese CHB patients with HBV plasma DNA load ≥3.2 log(10) IU/mL and normal alanine aminotransferase (ALT) values.LSM and liver fibrosis biochemical markers were performed on 225 consecutive HBV infected Senegalese patients with high viral load. Patients with an LSM range between 7 and 13 kPa underwent liver biopsy (LB). Two experienced liver pathologists performed histological grading using Metavir and Ishak scoring.225 patients were evaluated (84% male) and LB was performed in 69 patients, showing F2 and F3 fibrosis in 17% and 10% respectively. In these patients with a 7-13 kPa range of LSM, accuracy for diagnosis of significant fibrosis according to LB was unsatisfactory for all non-invasive markers with AUROCs below 0.70. For patients with LSM values below 7 kPa, FibroTest® (FT), and Fibrometer® (FM) using the cut-offs recommended by the test promoters suggested a fibrosis in 18% of cases for FT (8% severe fibrosis) and 8% for FM. For patients with LSM values greater than 13 kPa, FT, FM suggested a possible fibrosis in 73% and 70%, respectively.In highly replicative HBV-infected African patients with normal ALT and LSM value below 13 kPa, FibroScan®, FibroTest® or Fibrometer® were unsuitable to predict the histological liver status of fibrosis