Décompositions de la bouse de bovin sèche et macrofaune associée en zone sahélienne semi-aride (Matam, Sénégal)

L’étude de la décomposition de la bouse de bovin sèche a été effectuée entre avril 2010 et mai 2011 dans une savane sahélienne à Matam (Sénégal). L’objectif de l’étude était d’identifier la macrofaune impliquée dans la dégradation de la bouse ainsi que l’effet des saisons et de la profondeur d’enfouissement sur l’activité des décomposeurs. L’étude a été effectuée dans trois milieux différents par la pédologie, la végétation et le degré d’anthropisation. Des sacs à bouse de 1 mm, 4 mm et 12 mm de mailles ont été enfouis à des profondeurs de 10, 20, 30 et 40 cm. Au cours de l’année, 4 relevés ont été effectués. Les résultats obtenus montrent que i) l’essentiel de la faune impliquée dans la dégradation de la bouse sèche appartient à l’Ordre des Isoptères, ii) la profondeur n’a pas d’effet sur la dégradation, iii) l’activité de la macrofaune est plus importante juste après la saison des pluies dans les 3 milieux étudiés.© 2013 International Formulae Group. All rights reserved. Mots clés : Enfouissement bouse sèche, macrofaune, perte de masse, sahélien, Matam, Sénégal

External morphology of the hepatic Spiegel lobe

The objective of this study is to determine morphological variations of the Spiegel lobe in the indigenous Senegalese subject. This study  was carried out in the necropsy room of the pathological anatomy department of the Aristide Le Dantec University Hospital Centre in Dakar. It involved 39 livers of indigenous adult Senegalese subjects whose cause of death was neither liver disease nor liver trauma. On each liver collected, rinsed with water, we observed and photographed the external characteristics of Spiegel's lobe including its seat, its shape, the prominence of the caudate process, the presence or not of the papillary process, the presence of antero-posterior or transverse furrow. Spiegel's lobe was present on all livers studied. It sat exclusively at the visceral face in its retro-hilaire portion. The rectangular and ovoid shapes predateed 33.33% and 30.77% of cases, respectively. The papillary process was noticed on 15 lobes of Spiegel out of the 39 studied, or 38.46% of the cases. The caudate process was present in 32 cases or 82% of the cases. We noted the presence of furrows in the Spiegel lobe in 18 subjects or 46% of the cases. On one liver, we noted the simultaneous presence of two furrows on Spiegel's lobe. Of the 39 livers studied, we noticed two cases of Spiegel accessory lobe, representing 5% of the cases. These morphological variations are very useful in the diagnosis and surgery of Spiegel lobe tumors. &nbsp

Interlaminar Fracture Toughness Evaluation in Glass/Epoxy Composites Using Acoustic Emission and Finite Element Methods

© 2014, ASM International. Delamination is one of the most common modes of failure in laminated composites and it leads to the loss of structural strength and stiffness. In this paper, mode I, mode II, and mixed of these pure modes were investigated using mechanical data, Finite Element Method (FEM) and Acoustic Emission (AE) signals. Experimental data were obtained from insitu monitoring of glass/epoxy laminated composites with different lay-ups when subjected to different modes of failure. The main objective was to investigate the behavior of delamination propagation and to evaluate the critical value of the strain energy which is required for onset of the delamination (GC). For the identification of interlaminar fracture toughness of the specimens, four methods were used: (a) ASTM standard methods, (b) FEM analysis, (c) AE method, and (d) sentry function method which is a function of mechanical and AE behaviors of the specimens. The results showed that the GC values obtained by the sentry function method and FEM analysis were in a close agreement with the results of nonlinearity methods which is recommended in the ASTM standards. It was also found that the specimens under different loading conditions and various lay-up have different GC values. These differences are related to different stress components distribution in the specimens which induce various damage mechanisms. Accordingly, stress components distribution obtained from FEM analyses were in agreement with SEM observations of the damaged surfaces of the specimens

Major Reduction in Anti-Malarial Drug Consumption in Senegal after Nation-Wide Introduction of Malaria Rapid Diagnostic Tests

BACKGROUND: While WHO recently recommended universal parasitological confirmation of suspected malaria prior to treatment, debate has continued as to whether wide-scale use of rapid diagnostic tests (RDTs) can achieve this goal. Adherence of health service personnel to RDT results has been poor in some settings, with little impact on anti-malarial drug consumption. The Senegal national malaria control programme introduced universal parasite-based diagnosis using malaria RDTs from late 2007 in all public health facilities. This paper assesses the impact of this programme on anti-malarial drug consumption and disease reporting. METHODS AND FINDINGS: Nationally-collated programme data from 2007 to 2009 including malaria diagnostic outcomes, prescription of artemisinin-based combination therapy (ACT) and consumption of RDTs in public health facilities, were reviewed and compared. Against a marked seasonal variation in all-cause out-patient visits, non-malarial fever and confirmed malaria, parasite-based diagnosis increased nationally from 3.9% of reported malaria-like febrile illness to 86.0% over a 3 year period. The prescription of ACT dropped throughout this period from 72.9% of malaria-like febrile illness to 31.5%, reaching close equivalence to confirmed malaria (29.9% of 584,873 suspect fever cases). An estimated 516,576 courses of inappropriate ACT prescription were averted. CONCLUSIONS: The data indicate high adherence of anti-malarial prescribing practice to RDT results after an initial run-in period. The large reduction in ACT consumption enabled by the move from symptom-based to parasite-based diagnosis demonstrates that effective roll-out and use of malaria RDTs is achievable on a national scale through well planned and structured implementation. While more detailed information on management of parasite-negative cases is required at point of care level to assess overall cost-benefits to the health sector, considerable cost-savings were achieved in ACT procurement. Programmes need to be allowed flexibility in management of these funds to address increases in other programmatic costs that may accrue from improved diagnosis of febrile disease

The relationship between reported fever and Plasmodium falciparum infection in African children

<p>Abstract</p> <p>Background</p> <p>Fever has traditionally served as the entry point for presumptive treatment of malaria in African children. However, recent changes in the epidemiology of malaria across many places in Africa would suggest that the predictive accuracy of a fever history as a marker of disease has changed prompting calls for the change to diagnosis-based treatment strategies.</p> <p>Methods</p> <p>Using data from six national malaria indicator surveys undertaken between 2007 and 2009, the relationship between childhood (6-59 months) reported fever on the day of survey and the likelihood of coincidental <it>Plasmodium falciparum </it>infection recorded using a rapid diagnostic test was evaluated across a range of endemicities characteristic of Africa today.</p> <p>Results</p> <p>Of 16,903 children surveyed, 3% were febrile and infected, 9% were febrile without infection, 12% were infected but were not febrile and 76% were uninfected and not febrile. Children with fever on the day of the survey had a 1.98 times greater chance of being infected with <it>P. falciparum </it>compared to children without a history of fever on the day of the survey after adjusting for age and location (OR 1.98; 95% CI 1.74-2.34). There was a strong linear relationship between the percentage of febrile children with infection and infection prevalence (R²= 0.9147). The prevalence of infection in reported fevers was consistently greater than would be expected solely by chance and this increased with increasing transmission intensity. The data suggest that in areas where community-based infection prevalence in childhood is above 34-37%, 50% or more of fevers are likely to be associated with infection.</p> <p>Conclusion</p> <p>The potential benefits of diagnosis will depend on the prevalence of infection among children who report fever. The study has demonstrated a predictable relationship between parasite prevalence in the community and risks of infection among febrile children suggesting that current maps of parasite prevalence could be used to guide diagnostic strategies in Africa.</p

Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants

BACKGROUND: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. METHODS: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence—defined as fasting plasma glucose of 7·0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs—in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. FINDINGS: We used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4·3% (95% credible interval 2·4–7·0) in 1980 to 9·0% (7·2–11·1) in 2014 in men, and from 5·0% (2·9–7·9) to 7·9% (6·4–9·7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28·5% due to the rise in prevalence, 39·7% due to population growth and ageing, and 31·8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. INTERPRETATION: Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. FUNDING: Wellcome Trust

Success or failure of critical steps in community case management of malaria with rapid diagnostic tests: a systematic review

Background: Malaria still causes high morbidity and mortality around the world, mainly in sub-Saharan Africa. Community case management of malaria (CCMm) by community health workers (CHWs) is one of the strategies to combat the disease by increasing access to malaria treatment. Currently, the World Health Organization recommends to treat only confirmed malaria cases, rather than to give presumptive treatment. Objectives. This systematic review aims to provide a comprehensive overview of the success or failure of critical steps in CCMm with rapid diagnostic tests (RDTs). Methods. The databases of Medline, Embase, the Cochrane Library, the library of the \u27Malaria in Pregnancy\u27 consortium, and Web of Science were used to find studies on CCMm with RDTs in SSA. Studies were selected according to inclusion and exclusion criteria, subsequently risk of bias was assessed and data extracted. Results: 27 articles were included. CHWs were able to correctly perform RDTs, although specificity levels were variable. CHWs showed high adherence to test results, but in some studies a substantial group of RDT negatives received treatment. High risk of bias was found for morbidity and mortality studies, therefore, effects on morbidity and mortality could not be estimated. Uptake and acceptance by the community was high, however negative-tested patients did not always follow up referral advice. Drug or RDT stock-outs and limited information on CHW motivation are bottlenecks for sustainable implementation. RDT-based CCMm was found to be cost effective for the correct treatment of malaria in areas with low to medium malaria prevalence, but study designs were not optimal. Discussion. Trained CHWs can deliver high quality care for malaria using RDTs. However, lower RDT specificity could lead to missed diagnoses of non-malarial causes of fever. Other threats for CCMm are non-adherence to negative test results and low referral completion. Integrated CCM may solve some of these issues. Unfortunately, morbidity and mortality are not adequately investigated. More information is needed about influencing sociocultural aspects, CHW motivation and stock supply. Conclusion: CCMm is generally well executed by CHWs, but there are several barriers for its success. Integrated CCM may overcome some of these barriers