Evaluation of the diagnostic accuracy of a hemoglobin S and C screening test: Sickle Scan

New tools for the rapid diagnosis of hemoglobinosis could encourage the extension of their screening in Africa. Our goal was to assess the analytical performances of a rapid hemoglobin S and C detection test, the Sickle Scan. This was a cross-sectional study carried out in March 2019 at the Yopougon Teaching Hospital. The subjects followed for hemoglobinosis as well as the subjects seeking out an electrophoresis of their hemoglobin were included. We carried out the hemogram, the electrophoresis of hemoglobin at alkaline pH (reference method) coupled with the metabisulfite sickling test (Emmel test) and the rapid detection test to be evaluated. This immunochromatographic test is capable of detecting hemoglobins A, S, and C, and to infer the hemoglobin phenotype from there. The study recruited 191 individuals. The test detected hemoglobins S and C with a sensitivity of 99.4% and 97.7% respectively; a specificity of 93.3% and 99.3%. The positive likelihood ratio for hemoglobins S and C was 15 and 144 respectively. The negative likelihood ratio was 0.01 for hemoglobin S, and 0.02 for hemoglobin C. The intrinsic characteristics obtained make this test an interesting screening tool for hemoglobinosis S and C. Keywords: Diagnostic test, hemoglobinosis, Abidjan, sensitivity, specificity

Caractérisation physico-chimique et bactériologique des eaux usées brutes du réseau d’égout de la ville d’Abidjan

La gestion des eaux résiduaires urbaines pose de nombreux problèmes environnementaux qui deviennent préoccupants pour la santé des populations d’Abidjan. Pour remédier à cela, il est souhaitable de mettre en place des stations d’épurations. Ainsi, notre étude se présente comme une étude préliminaire visant à caractériser sur le plan physico-chimique et bactériologique les effluents du réseau d’égout de la ville d’Abidjan. Pour ce faire, nous avons effectué six campagnes de  prélèvement d’eaux usées durant une  année (Décembre 2013-Novembre 2014) sur huit (8) sites spécifiques du réseau d’égout. Ces échantillons ont fait l’objet  d’analyses physico-chimiques et bactériologiques sur la base des normes Françaises, Canadiennes et celles décrites par Rodier. Les résultats obtenus indiquent qu’à l’exception du phosphore total (PT) dont les concentrations sont comprises entre 4,3±4 et 10,9±6,7mg/l, les autres principaux indicateurs de pollution que sont l’azote total (NTK, 73,3±32 à 118,2±37,6 mg/l), les matières en suspension (MES, 79±23,3 à325,2±270,3 mg/l), la demande biochimique en oxygène en 5 jours (DBO5, 127,3±87,7 à 863,7±262,2 mgO2/l) et la demande chimique en oxygène (DCO, 276,2±195,6 à 975,3±249,4 mgO2/l) sont au-delà des valeurs guidesrecommandées par l’Etat de Côte d’Ivoire à travers le service d’inspection des installations classées (SIIC) en matière de rejet des effluents en milieu récepteur. L’analyse de la flore bactérienne des effluents révèle que les concentrations de coliformes fécaux et les streptocoques fécaux excèdent les valeurs indicatives préconisées par l’OMS.Mots clés : Caractérisation, eaux usées, réseau d’égout, bactériologie, physico-chimie

Evaluation de la qualité des eaux de puits à usage domestique dans les quartiers défavorisés de quatre communes d’Abidjan (Côte d’Ivoire) : Koumassi, Marcory, Port-Bouet et Treichville

La qualité des eaux de puits à usages domestiques dans les quartiers précaires de quatre communes de la ville d’Abidjan a été étudiée à travers l’analyse des paramètres physico-chimiques et microbiologiques couramment utilisés pour la qualité de l’eau de consommation. Les concentrations en nitrates varient entre 0 et 286 mg/L et celles de l’ammonium entre 3,6 et 39,6 mg/L. Plus de 80% des puits ont des teneurs en nitrates supérieures à la norme de 50 mg/L requise, ce qui traduit que les eaux sont d’une mauvaise qualité pour la boisson, mais subissent l’impact d’une insalubrité urbaine. En plus, la qualité des eaux de puits est variable et dépend d’un certain nombre de facteurs tels que l’emplacement des puits par rapport aux sources de contamination urbaines endogènes. La dégradation de la qualité des eaux est fortement impactée par le défaut d’assainissement des quartiers précaires. L’interprétation des données d’analyse, la corrélation existante entre les eaux de puits et la répartition des eaux de puits en groupes sont réalisées en utilisant l’Analyse en Composante Principale Normée (ACPN). Plusieurs facteurs conditionnent la contamination des eaux de puits par les polluants minéraux tels que NO3 -, NH4 +, SO4 2- et Cl-. Le défaut d’assainissement dans ces quartiers, la mauvaise gestion des déchets urbains, la faible profondeur de la nappe, la nature des sols et la perméabilité de l’aquifère exploité sont les preuves de la vulnérabilité des eaux des puits. En effet, les résultats acquis font ressortir la forte influence de l’activité urbaine sur la qualité de ces eaux qui sont fortement chargées en ions nitrates et ammonium, signe d’une pollution urbaine. © 2010 International Formulae Group. All rights reserved.Mots clés : Pollution, eaux de puits, assainissement, analyse en composante principale normée, sels dissous

Isolation and characterization of acetylated LM-pectins extracted from okra pods

Pectin was isolated by aqueous extraction at pH 6.0 or 2.0 from okra (Abelmoschus esculentus L.) pods. An isolation protocol was designed to extract pectin and to study the influence of the extraction pH on their composition and physicochemical properties. The extracted pectin was assessed using sugar compositional analysis (neutral sugars, galacturonic acid, acetyl and methyl contents). FT-IR and NMR spectroscopy, size exclusion chromatography (SEC) and dilute solution viscometry were also used to determine the macromolecular characteristics of isolated pectin. The extraction protocols resulted in the isolation of pectin of high purity as evidenced by their high total carbohydrate (70.0–81.8%) and low protein (4.3–6.3%) contents. Samples contained between 46 and 56% galacturonic acid, had broad molecular weight distributions, a low degree of methylation (40.0 and 24.6%) and high degree of acetylation (52.2 and 37.6%). Neutral sugar analysis showed that the pectin extracted at pH 6.0 contained more neutral sugars, particularly, galactose (21.7–25.7 mol%), rhamnose (10.1–13.2 mol%) and arabinose (7.1–7.3 mol%) than that extracted at pH 2.0 indicating variations in fine structure. In addition, molecular parameters of the isolated pectins, such as intrinsic viscosity (2.8–4.4 dL g−1), critical concentration (0.15–0.45 dL g−1) and coil overlap parameter (0.66–1.51), showed that extraction conditions resulted in pectin with different chain morphology. The yield and physico-chemical characteristics of the extracted pectin from okra pods were influenced by the extraction conditions

Acceptabilite´ du test VIH propose´ aux nourrissons dans les services pe´ diatriques, en Coˆ te d’Ivoire, Significations pour la couverture du diagnostic pe´diatrique

Proble`me: Le de´pistage VIH chez les enfants a rarement e´te´ au centre des pre´occupations des chercheurs. Quand le de´pistage pe´diatrique a retenu l’attention, cela a e´te´ pour e´clairer seulement sur les performances diagnostiques en ignorant meˆme que le test pe´diatrique comme bien d’autres peut s’accepter ou se refuser. Cet article met au coeur de son analyse les raisons qui peuvent expliquer qu’on accepte ou qu’on refuse de faire de´pister son enfant.Objectif: Etudier chez les parents, les me`res, les facteurs explicatifs de l’acceptabilite´ du test VIH des  nourrissons de moins de six mois.Me´thodes: Entretien semi-directif a` passages re´pe´te´s avec les parents de nourrissons de moins de six mois dans les formations sanitaires pour la pese´e/vaccination et les consultations pe´diatriques avec proposition syste´matique d’un test VIH pour leur nourrisson.Re´sultats: Nous retenons que la re´alisation effective du test pe´diatrique du VIH chez le nourrisson repose sur trois e´le´ments. Primo, le personnel de sante´ par son discours (qui de´note de ses connaissances et  perceptions meˆme sur l’infection) oriente´ vers les me`res influence leur acceptation ou non du test. Secundo, la me`re qui par ses connaissances et perceptions meˆme sur le VIH, dont le statut particulier, l’impression de bien-eˆtre chez elle et son enfant influence toute re´alisation du test pe´diatrique VIH. Tertio, l’environnement conjugal de la me`re, particulie`rement caracte´rise´ par les rapports au sein du couple, sur la facilite´ de parler du test VIH et sa re´alisation chez les deux parents ou chez la me`re seulement sont autant de facteurs qui influencent la re´alisation effective du de´pistage du VIH chez l’enfant. Le principe pre´ventif du VIH, et le de´sir de faire tester l’enfant ne suffisent pas a` eux seuls pour aboutir a` sa re´alisation effective, selon certaines me`res confronte´es au refus du conjoint. A l’oppose´, les autres me`res refusant la re´alisation du test  pe´diatrique disent s’y opposer ; bien entendu, meˆme dans le cas ou` le conjoint l’accepterait.Discussion: Les me`res sont les principales mises en cause et craignent les re´primandes et la stigmatisation. Le pe`re, le conjoint peut eˆtre un obstacle, quand il s’oppose au test VIH du nourrisson, ou devenir le facilitateur de sa re´alisation s’il est convaincu. Le positionnement du pe`re demeure donc essentiel dans la question de l’acceptabilite´ du VIH pe´diatrique. Les me`res en ont conscience et pre´sagent des difficulte´s a` faire  de´pister ou non les enfants sans avis pre´alable du conjoint a` la fois pe`re, et chef de famille.Conclusion: La question du de´pistage pe´diatrique du VIH, au terme de notre analyse, met en face trois e´le´ments qui exigent une gestion globale pour assurer une couverture effective. Ces trois e´le´ments n’existeraient pas sans s’influencer, donc ils sont constamment en interaction et empeˆchent ou favorisent la re´alisation ou non du test pe´diatrique. Aussi, dans une intention d’aboutir a` une couverture effective du de´pistage VIH des nourrissons, faut-il tenir compte d’une gestion harmonieuse de ces trois e´le´ments: La premie`re, la me`re seule (avec ses connaissances, ses perceptions), son environnement conjugal (de  proposition du test inte´grant 1- l’e´poux et / ou pe`re de l’enfant avec ses perceptions et connaissances sur l’infection 2- la facilite´ de parler du test et sa re´alisation chez les deux ou un des parents, la me`re) et les connaissances, attitudes et pratiques du personnel de l’e´tablissement sanitaire sur l’infection du VIH.Recommandations: Nos recommandations proposent une rede´finition de l’approche du VIH/sida vers des familles expose´es au VIH et une inte´gration plus accentue´e du pe`re facilitant leur propre acceptation du test VIH et celle de leur enfant.Mots cle´s: Acceptabilite´, Test VIH, Enfants, Nourrissons Problem: HIV testing in children had rarely been a central concern for researchers. When pediatric tracking retained the attention, it was more to inform on the diagnosis tools performances rather than the fact the pediatric test can be accepted or refused. This article highlights the parent’s reasons which explain why pediatric HIV test is accepted or refused.Objective: To study among parents, the explanatory factors of the acceptability of pediatric HIV testing among infant less than six months.Methods: Semi-structured interview with repeated passages in the parents of infants less than six months attending in health care facilities for the pediatric weighing/vaccination and consultations.Results: We highlight that the parent’s acceptance of the pediatric HIV screening is based on three elements.Firstly, the health care workers by his speech (which indicates its own knowledge and perceptions on the infection) directed towards mothers’ influences their acceptance or not of the HIV test. Secondly, the mother who by her knowledge and perceptions on HIV, whose particular status, give an impression of her own wellbeing for her and her child influences any acceptance of the pediatric HIV test. Thirdly, the marital environment of the mother, particularly characterized by the ease of communication within the couple, to speak about the HIV test and its realization for the parents or the mother only are many factors which influence the effective realization of the pediatric HIV testing. The preventive principle of HIV transmission and the desire to realize the test in the  newborn are not enough alone to lead to its effective realization, according to certain mothers confronted with the father’s refusal. On the other hand, the other mothers refusing the realization of the pediatric test told to be opposed to it; of course, even if their partner would accept it.Discussion: The mothers are the principal facing the pediatric HIV question and fear the reprimands and stigma. The father, the partner could be an obstacle, when he is opposed to the infant HIV testing, or also the facilitator with his realization if he is convinced. The father position thus remains essential face to the question of pediatric HIV testing acceptability. The mothers are aware of this and predict the difficulties of achieving their infant to be tested without the preliminary opinion of their partner at the same time father, and head of the family.Conclusion: The issue of pediatric HIV testing, at the end of our analysis, highlights three elements which require a comprehensive management to improve the coverage of pediatric HIV test. These three elements would not exist without being influenced; therefore they are constantly in interaction and prevent or support the realization or not pediatric test. Also, with the aim to improve the pediatric HIV test coverage, it is necessary to take into account the harmonious management of these elements. Firstly, the mother alone (with her knowledge, and perceptions), its marital environment (with the proposal of the HIV test integrating (1) the partner and/or father with his perceptions and knowledge on HIV infection and (2) facility of speaking about the test and its realization at both or one about the parents, the mother) and of the knowledge, attitudes and practices about the infection of health care workers of the sanitary institution.Recommendations: Our recommendations proposed taking into account a redefinition of the HIV/AIDS approach towards the families exposed to HIV and a more accentuated integration of the father facilitating their own HIV test acceptation and that of his child.Keywords: acceptability, HIV testing, children, infantsArticle in French

Pectin at the oil-water interface: Relationship of molecular composition and structure to functionality

The present review examines how macromolecular structure and functional groups of pectin affect its functionality with particular focus on its interfacial activity. We venture into a description of the particularly complex pectin structure and describe the major building blocks and their properties. In the following section, the role of each structural parameter is discussed with particular attention to protein, degree of acetylation and methylation, molecular weight, and branching. Finally, we discuss how modification of the extraction conditions could be tailored to obtain pectin with the desired emulsification properties. It is proposed that pectin with protein content in the range of 3%, with degree of acetylation greater than 10%, molecular weight between 100 and 200 x103 g mol-1 and enriched in RG-I segments is more likely to perform well as an emulsifier. To tailor such a structure, an aqueous extraction protocol with low pH values (between 2.5-3.5) with a strong monoprotic acid (e.g., HCl) and one-step solvent precipitation should be selected. The proposed set of extraction conditions could be used as a first step towards rational design of pectin with desirable interfacial functionality

Diagnosis of Human Visceral Pentastomiasis

Visceral pentastomiasis in humans is caused by the larval stages (nymphs) of the arthropod-related tongue worms Linguatula serrata, Armillifer armillatus, A. moniliformis, A. grandis, and Porocephalus crotali. The majority of cases has been reported from Africa, Malaysia, and the Middle East, where visceral pentastomiasis may be an incidental finding in autopsies, and less often from China and Latin America. In Europe and North America, the disease is only rarely encountered in immigrants and long-term travelers, and the parasitic lesions may be confused with malignancies, leading to a delay in the correct diagnosis. Since clinical symptoms are variable and serological tests are not readily available, the diagnosis often relies on histopathological examinations. This laboratory symposium focuses on the diagnosis of this unusual parasitic disease and presents its risk factors and epidemiology

Thermal crop water stress index base line temperatures for sugarbeet in arid western U.S.

Sugarbeet is a deep-rooted crop in unrestricted soil profiles that can readily utilize stored soil water to reduce seasonal irrigation requirements. Utilization of soil water below 0.6 m is not commonly considered for irrigation scheduling due to the labor and expense of soil water monitoring at deeper depths and uncertainty in effective rooting depth and soil water holding capacity. Thermal-based crop water stress index (CWSI) irrigation scheduling for sugarbeet has the potential to overcome soil water monitoring limitations and facilitate utilization of stored soil water. The traditional canopy temperature based CWSI for monitoring plant water status has not been widely used for irrigated crops partly because of the need to know well-watered and non-transpiring canopy temperatures under identical environmental conditions. In this study, canopy temperature of irrigated sugarbeet under full irrigation (FIT) and 25%FIT in 2014, 2015, 2017 and 2018 in southcentral Idaho and FIT and 60%FIT in 2018 in northwestern Wyoming USA was monitored from full cover through harvest along with meteorological conditions and soil water content. Data driven models, multiple linear regression (MLR) and neural network (NN), were used to predict well-watered canopy temperature based on 15-min average values for solar radiation, air temperature, relative humidity, and wind speed collected within 2 hours of solar noon (13:00 – 16:00 MDT). The NN model had significantly less (p 0.6 m) soil water monitoring

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030