Dramatic declines in seropositivity as determined with crude extracts of Plasmodium falciparum schizonts between 2000 and 2010 in Dielmo and Ndiop, Senegal

BACKGROUND: Programmes of pre-elimination of malaria have been implemented in Senegal since 2010, and the burden of malaria has decreased substantially. These changes in the epidemiology should be monitored with effective tools that allow changes in patterns of transmission to be estimated. In Dielmo and Ndiop, two villages of Senegal with different malaria endemicity, infections have been followed longitudinally for 20 years, during which time there have been several control interventions leading to substantial decreases of transmission. This study aimed to compare malaria antibody responses of the inhabitants of these two villages, between 2000 and 2010, using schizont crude extracts of a local strain of P. falciparum (Pf Sch07/03). METHODS: Sera collected from inhabitants of the two villages (141 from Dielmo and 79 from Ndiop in 2000; 143 from Dielmo and 79 from Ndiop in 2010) were used to assess the prevalence of antibodies against crude schizont extracts of Pf Sch07/03. Three ages groups were defined: [5-9] yrs, [10-14] yrs and [15-19] yrs. Statistical comparisons were performed. Seroprevalence and the magnitude of antibody responses were compared between age groups, villages and periods. RESULTS: Overall seroprevalence to P.fSch07/03 decreased between 2000 and 2010 in both villages: from 94.4% to 44.4% in Dielmo and from 74.4% to 34.6% in Ndiop. The difference between Dielmo and Ndiop was highly significant in 2000 (p0.20). The decrease in seroprevalence was larger in younger (more than 40%) than older (less than 19%) inhabitants. Longitudinal monitoring of the younger group showed that seroprevalence decreased between 2000 and 2010 in Dielmo from 98.7 to 79.3, but not in Ndiop from 67.6 to 66.7. The magnitude of antibody responses in seropositive individuals was significantly higher in 2000 than 2010 for both villages. CONCLUSIONS: Crude extracts of P. falciparum are appropriate tools for evaluating malaria prevalence at different periods, and in both low and high endemic area. Using crude extracts from local strains to assess transmission may allow efficient evaluation of the consequences of control programs on malaria transmission

Uterine ruptures during labor: a study of 26 cases at Nabil Choucair Medical Center, in the suburbs of Dakar

Background: This study aims to clarify the epidemiological profile of patients and describe the diagnostic, therapeutic and prognostic aspects of uterine ruptures at Nabil Choucair Health Center, in the suburbs of Dakar.Methods: This was a retrospective and prospective, descriptive and analytical study conducted over a period of 112 months, from July 31, 2005 and March 31, 2015; it concerned all diagnosed cases with uterine rupture, managed at Nabil Health Center Choucair Dakar. Data were collected from antenatal notebooks, delivery records, surgical reports and anesthetic records. The following parameters were studied: socio-demographic characteristics (frequency, chracteristics of patient), the course of pregnancy, diagnostic, prognostic, and therapeutic aspects. Data analysis was performed using SPSS software (version 11.0).Results: During the study period, we recorded 26 uterine ruptures from a total of 34,097 deliveries, that is a frequency of 8 out of 10,000 births. The epidemiological profile of the patients was that of a 30-year old woman, on average, few previous deliveries with an average parity of 3, who received on average 3 antenatal and evacuated in 50% of cases. Uterine rupture occurred in 17 patients on a new uterus (65, 4%) and in 9 patients on a scarred uterus (34.6%). Two patients (7%) were in hemorrhagic shock. A laparotomy aimed at specifying the place of rupture and making the treatment was performed in all patients. It was 18 uterine segmento-corporeal ruptures (69.2%), 5 segmental ruptures (19.2%) and 2 corporeal ruptures (7.6%). We recorded 9 uterine ruptures with living fetus (38.5%). Twenty-three patients (88.5%) underwent conservative suture against only 3 hemostasis hysterectomy (11.5%). The postoperative courses were uneventful in 57.7% of cases. Eleven patients (42.3%) had anemia and we recorded maternal deaths, which is a maternal mortality of 3.84%.Conclusions: Uterine rupture is a serious complication that is still responsible for significant maternal and fetal mortality. Prevention is based on careful monitoring of pregnancy and delivery

Effects of Ebola epidemic on obstetrical emergencies and outcomes in the region of Kindia, Guinea

Background: Maternal mortality is still high in Guinea despite a decline from 724 to 550 maternal deaths per 100,000 live births between 2012 and 2018. The proportion of births attended by skilled personnel is estimated at 45%. The objective of this study was to assess the effect of Ebola virus disease (EVD) epidemic on the frequency of absolute maternal indications, as well as the outcomes of these interventions for mother and child in the region of Kindia.Methods: This was a longitudinal study using 20 months of retrospective data collected in the pre-Ebola (March to December 2012 and March to December 2013) and intra-Ebola (March to December 2014 and March to December 2015) periods. The proportions of maternal health indicators in both study periods were compared using a significance level of 0.05.Results: A total of 1747 women were included in this study. The proportion of women who received a major obstetric procedure in Kindia regional hospital was 85% in each pre and post Ebola periods. Ebola, however, contributed to a significant increase in maternal deaths.Conclusions: The Ebola epidemic has contributed to a significant increase in maternal deaths in health facilities. Measures encouraging health workers to manage obstetric emergencies during critical periods would be necessary

Effects of lenten fasting on body composition and biochemical parameters

Background: The catholic lenten fasting is the period of 40 days of fasting that precedes Easter. It is one of religious fasting less documented in the scientific literature. Thus the aim of our study was to evaluate the evolution of anthropometric and body composition and biochemical profile during Catholic lenten fasting.Methods: We conducted a prospective study, which took place during the period between one week before at the end of lenten fasting. Eleven fasters (4 women and 7 men), aged between 18 and 59 years were included in present study. Anthropometric, body composition parameters and biochemical profile were evaluated one week before, at 15th day and at the end of Lenten fasting.Results: Weight, body mass index (BMI) and visceral fat decreased significantly at the end of Lenten fasting. Lipid profile changed significantly during this fasting period. Total cholesterol (TC), low density lipoprotein – cholesterol (LDL-C) and triglycerides decreased significantly with fasting. High density lipoprotein – cholesterol (HDL-C) was remained unchanged during this fasting period while TC/HDL ratio was significantly decreased at the end of Lent.Conclusions: Present study showed that the fasting of Lent seems to have beneficial effects on reducing cardiovascular risk factors. Further studies are required to better understand the physiological mechanisms involved for a therapeutic use

A multiplex assay for the simultaneous detection of antibodies against 15 Plasmodium falciparum and Anopheles gambiae saliva antigens

<p>Abstract</p> <p>Background</p> <p>Assessment exposure and immunity to malaria is an important step in the fight against the disease. Increased malaria infection in non-immune travellers under anti-malarial chemoprophylaxis, as well as the implementation of malaria elimination programmes in endemic countries, raises new issues that pertain to these processes. Notably, monitoring malaria immunity has become more difficult in individuals showing low antibody (Ab) responses or taking medications against the <it>Plasmodium </it><it>falciparum </it>blood stages. Commonly available techniques in malaria seroepidemiology have limited sensitivity, both against pre-erythrocytic, as against blood stages of the parasite. Thus, the aim of this study was to develop a sensitive tool to assess the exposure to malaria or to bites from the vector <it>Anopheles gambiae</it>, despite anti-malarial prophylactic treatment.</p> <p>Methods</p> <p>Ab responses to 13 pre-erythrocytic <it>P. falciparum</it>-specific peptides derived from the proteins Lsa1, Lsa3, Glurp, Salsa, Trap, Starp, CSP and Pf11.1, and to 2 peptides specific for the <it>Anopheles gambiae </it>saliva protein gSG6 were tested. In this study, 253 individuals from three Senegalese areas with different transmission intensities and 124 European travellers exposed to malaria during a short period of time were included.</p> <p>Results</p> <p>The multiplex assay was optimized for most but not all of the antigens. It was rapid, reproducible and required a small volume of serum. Proportions of Ab-positive individuals, Ab levels and the mean number of antigens (Ags) recognized by each individual increased significantly with increases in the level of malaria exposure.</p> <p>Conclusion</p> <p>The multiplex assay developed here provides a useful tool to evaluate immune responses to multiple Ags in large populations, even when only small amounts of serum are available, or Ab titres are low, as in case of travellers. Finally, the relationship of Ab responses with malaria endemicity levels provides a way to monitor exposure in differentially exposed autochthonous individuals from various endemicity areas, as well as in travellers who are not immune, thus indirectly assessing the parasite transmission and malaria risk in the new eradication era.</p