Invasive Group B Streptococcal Infection in Infants, Malawi

Incidence and serotype distribution of disease in Malawi are similar to those reported from industrialized countries, but case-fatality rate is high

Neonatal tetanus in Turkey; what has changed in the last decade?

dikici, bunyamin/0000-0001-7572-6525WOS: 000259222800001PubMed: 18713452Background: Neonatal tetanus (NT) is still considered as one of the major causes of neonatal death in many developing countries. The aim of the present study was to assess the characteristics of sixty-seven infants with the diagnosis of neonatal tetanus followed-up in the Pediatric Infectious Diseases Ward of Dicle University Hospital, Diyarbakir, between 1991 and 2006, and to draw attention to factors that may contribute (or may have contributed) to the elimination of the disease in Diyarbakir. Methods: The data of sixty-seven infants whose epidemiological and clinical findings were compatible with neonatal tetanus were reviewed. Patients were stratified into two groups according to whether they survived or not to assess the effect of certain factors in the prognosis. Factors having a contribution to the higher rate of tetanus among newborn infants were discussed. Results: A total of 55 cases of NT had been hospitalized between 1991 and 1996 whereas only 12 patients admitted in the last decade. All of the infants had been delivered at home by untrained traditional birth attendants (TBA), and none of the mothers had been immunized with tetanus toxoid during her pregnancy. Twenty-eight (41.8%) of the infants died during their follow-up. Lower birth weight, younger age at onset of symptoms and at the time admission, the presence of opisthotonus, risus sardonicus and were associated with a higher mortality rate. Conclusion: Although the number of neonatal tetanus cases admitted to our clinic in recent years is lower than in the last decade efforts including appropriate health education of the masses, ensurement of access to antenatal sevices and increasing the rate of tetanus immunization among mothers still should be made in our region to achieve the goal of neonatal tetanus elimination

System-level determinants of immunization coverage disparities among health districts in Burkina Faso: a multiple case study

<p>Abstract</p> <p>Background</p> <p>Despite rapid and tangible progress in vaccine coverage and in premature mortality rates registered in sub-Saharan Africa, inequities to access remain firmly entrenched, large pockets of low vaccination coverage persist, and coverage often varies considerably across regions, districts, and health facilities' areas of responsibility. This paper focuses on system-related factors that can explain disparities in immunization coverage among districts in Burkina Faso.</p> <p>Methods</p> <p>A multiple-case study was conducted of six districts representative of different immunization trends and overall performance. A participative process that involved local experts and key actors led to a focus on key factors that could possibly determine the efficiency and efficacy of district vaccination services: occurrence of disease outbreaks and immunization days, overall district management performance, resources available for vaccination services, and institutional elements. The methodology, geared toward reconstructing the evolution of vaccine services performance from 2000 to 2006, is based on data from documents and from individual and group interviews in each of the six health districts. The process of interpreting results brought together the field personnel and the research team.</p> <p>Results</p> <p>The districts that perform best are those that assemble a set of favourable conditions. However, the leadership of the district medical officer (DMO) appears to be the main conduit and the rallying point for these conditions. Typically, strong leadership that is recognized by the field teams ensures smooth operation of the vaccination services, promotes the emergence of new initiatives and offers some protection against risks related to outbreaks of epidemics or supplementary activities that can hinder routine functioning. The same is true for the ability of nurse managers and their teams to cope with new situations (epidemics, shortages of certain stocks).</p> <p>Conclusion</p> <p>The discourse on factors that determine the performance or breakdown of local health care systems in lower and middle income countries remains largely concentrated on technocratic and financial considerations, targeting institutional reforms, availability of resources, or accessibility of health services. The leadership role of those responsible for the district, and more broadly, of those we label "the human factor", in the performance of local health care systems is mentioned only marginally. This study shows that strong and committed leadership promotes an effective mobilization of teams and creates the conditions for good performance in districts, even when they have only limited access to supports provided by external partners.</p> <p>Abstract in French</p> <p>See the full article online for a translation of this abstract in French.</p

The phosphoprotein pp135 is an essential constituent of the fibrillar components of nucleoli and of coiled bodies.

We examined the distribution of the silver-stainable phosphoprotein, pp135, within Ehrlich tumor and HEp-2 cells by a postembedding Lowicryl immunogold labeling procedure. Identical labeling patterns were obtained in both cell types. During interphase, gold particles were found not only over the dense fibrillar component but were also evident over the fibrillar centers of nucleoli. By contrast, the granular component did not display any significant label. When rRNA synthesis was inhibited by actinomycin D, the same labeling was observed in segregated nucleoli; both fibrillar components were labeled. Aside from the nucleolar labeling, label was also consistently present in coiled bodies. During metaphase, label was visualized in silver-stainable material of the nucleolus organizing regions. It thus appears that, unlike the two major silver-stained proteins, nucleolin/C23 and B23, pp135 remains located in all major silver-stainable structures during the whole cell cycle. This finding strongly suggests that pp135 could be the component responsible for in situ silver staining. On the other hand, the maintenance of pp135 in the fibrillar centers throughout the cell cycle, like RNA polymerase I, upstream binding factor, and DNA topoisomerase I, suggests that pp135 could be a component involved in transcription of the rRNA genes

Isolation of nucleoli from ELT cells: a quick new method that preserves morphological integrity and high transcriptional activity.

We have developed a quick new method for isolating nucleoli which, unlike the methods in current use, preserves the nucleolar ultrastructure. Until now, the isolation process has generally been assumed to empty one of the three major compartments of the nucleolus, the fibrillar center, of its content. We have used the AgNOR staining and in vitro transcription assay to test the degree of structural and functional preservation of the isolated nucleoli. Our results demonstrate the value of our procedure as a reliable tool for biochemical and ultrastructural studies on the nucleolus. Moreover, these proprieties prompt us to investigate the rRNA synthesis, using a nonisotopic approach, within morphologically intact isolated nucleoli. Thus, we show that newly synthesized rRNA transcripts are located not only in the dense fibrillar component, but also indubitably in the fibrillar center