A field study in Benin to investigate the role of mosquitoes and other flying insects in the ecology of Mycobacterium ulcerans

Background Buruli ulcer, the third mycobacterial disease after tuberculosis and leprosy, is caused by the environmental mycobacterium M. ulcerans. There is at present no clear understanding of the exact mode(s) of transmission of M. ulcerans. Populations affected by Buruli ulcer are those living close to humid and swampy zones. The disease is associated with the creation or the extension of swampy areas, such as construction of dams or lakes for the development of agriculture. Currently, it is supposed that insects (water bugs and mosquitoes) are host and vector of M. ulcerans. The role of water bugs was clearly demonstrated by several experimental and environmental studies. However, no definitive conclusion can yet be drawn concerning the precise importance of this route of transmission. Concerning the mosquitoes, DNA was detected only in mosquitoes collected in Australia, and their role as host/vector was never studied by experimental approaches. Surprisingly, no specific study was conducted in Africa. In this context, the objective of this study was to investigate the role of mosquitoes (larvae and adults) and other flying insects in ecology of M. ulcerans. This study was conducted in a highly endemic area of Benin. Methodology/Principal Findings Mosquitoes (adults and larvae) were collected over one year, in Buruli ulcer endemic in Benin. In parallel, to monitor the presence of M. ulcerans in environment, aquatic insects were sampled. QPCR was used to detected M. ulcerans DNA. DNA of M. ulcerans was detected in around 8.7% of aquatic insects but never in mosquitoes (larvae or adults) or in other flying insects. Conclusion/Significance This study suggested that the mosquitoes don't play a pivotal role in the ecology and transmission of M. ulcerans in the studied endemic areas. However, the role of mosquitoes cannot be excluded and, we can reasonably suppose that several routes of transmission of M. ulcerans are possible through the world

Health research improves healthcare: now we have the evidence and the chance to help the WHO spread such benefits globally

There has been a dramatic increase in the body of evidence demonstrating the benefits that come from health research. In 2014, the funding bodies for higher education in the UK conducted an assessment of research using an approach termed the Research Excellence Framework (REF). As one element of the REF, universities and medical schools in the UK submitted 1,621 case studies claiming to show the impact of their health and other life sciences research conducted over the last 20 years. The recently published results show many case studies were judged positively as providing examples of the wide range and extensive nature of the benefits from such research, including the development of new treatments and screening programmes that resulted in considerable reductions in mortality and morbidity. Analysis of specific case studies yet again illustrates the international dimension of progress in health research; however, as has also long been argued, not all populations fully share the benefits. In recognition of this, in May 2013 the World Health Assembly requested the World Health Organization (WHO) to establish a Global Observatory on Health Research and Development (R&D) as part of a strategic work-plan to promote innovation, build capacity, improve access, and mobilise resources to address diseases that disproportionately affect the world’s poorest countries. As editors of Health Research Policy and Systems (HARPS), we are delighted that our journal has been invited to help inform the establishment of the WHO Global Observatory through a Call for Papers covering a range of topics relevant to the Observatory, including topics on which HARPS has published articles over the last few months, such as approaches to assessing research results, measuring expenditure data with a focus on R&D, and landscape analyses of platforms for implementing R&D. Topics related to research capacity building may also be considered. The task of establishing a Global Observatory on Health R&D to achieve the specified objectives will not be easy; nevertheless, this Call for Papers is well timed – it comes just at the point where the evidence of the benefits from health research has been considerably strengthened

First delivery of a COVID-19 positive patient in Cameroon

Since its appearance in China in December 2019, COVID-19 which is caused by the SARS-CoV-2 virus has become a real global health problem. Pregnant women are not immune to this novel infection, which makes it difficult for proper management of pregnancy and childbirth. Authors present here the first case of childbirth in Cameroon of a 19-year-old adolescent tested positive for COVID-19

Medical genetics in developing countries in the Asia-Pacific region: challenges and opportunities

Advances in genetic and genomic technology changed health-care services rapidly in low and middle income countries (LMICs) in the Asia-Pacific region. While genetic services were initially focused on population-based disease prevention strategies, they have evolved into clinic-based and therapeutics-oriented service. Many LMICs struggled with these noncommunicable diseases and were unprepared for the needs of a clinical genetic service. The emergence of a middle class population, the lack of regulatory oversight, and weak capacity-building in medical genetics expertise and genetic counseling services led to a range of genetic services of variable quality with minimal ethical oversight. Some of the current shortcomings faced include the lack of awareness of cultural values in genetic health care, the variable stages of socioeconomic development and educational background that led to increased demand and abuse of genetics, the role of women in society and the crisis of gender selection, the lack of preventive and care services for genetic and birth defects, the issues of gene ethics in medicine, and the lack of understanding of some religious controversies. These challenges provide opportunities for both developing and developed nations to work together to reduce the inequalities and to ensure a caring, inclusive, ethical, and cost-effective genetic service in the region

Strengthening health systems through networks: the need for measurement and feedback

Cameron D Willis, Barbara L Riley, Allan Best and Pierre Ongolo-Zog

Évaluation de la dose patient en scanographie pédiatrique dans deux hôpitaux universitaires à Yaoundé Cameroun

Les pratiques de radioprotection des patients sont peu documentées en Afrique subsaharienne en raison de l’absence ou de la mise en œuvre approximative des lois et règlements qui y sont relatifs. Ce travail investigue la justification et l’optimisation en scanographie pédiatrique dans deux hôpitaux universitaires de Yaoundé au Cameroun. L’enquête rétrospective portait sur 171 examens chez des enfants de 0 à 15 ans pendant un trimestre. Les données collectées à l’aide d’une fiche adaptée du modèle de l’Institut de radioprotection et de sureté nucléaire d’évaluation dosimétrique en scanographie ont été confrontées aux référentiels de la Société française de radiologie et de la Société francophone d’imagerie pédiatrique et prénatale. La conformité de chaque examen a été analysée et les valeurs d’index de dose scanographique et de produit dose longueur (PDL) ont été comparées aux niveaux de référence diagnostiques (NRD) des référentiels ci-dessus. Si tous les examens étaient justifiés, les protocoles, non affichés, étaient variables selon les équipes et les services. La tension était conforme dans 87,7 % des cas et 15,2 % des PDL étaient supérieurs aux NRD pour les scanners thoraciques et abdominaux en mode spiralé et cérébraux en mode séquentiel. Un affichage des protocoles optimisés est nécessaire pour améliorer les pratiques dans ces services avec une rotation importante de techniciens et résidents de radiologie

Field efficacy of a new deltamethrin long lasting insecticidal net (LifeNet(C)) against wild pyrethroid-resistant Anopheles gambiae in Benin

Background: Malaria vector control is mostly based on Long-Lasting Insecticidal Nets (LLIN). To date, all LLINs fully recommended by the World Health Organization Pesticide Scheme (WHOPES) are made of polyester or polyethylene. In this context, a new LLIN named LifeNet(C), made of polypropylene fiber is developed. According to the manufacturer, LifeNet(C) is made of soft filament, has a greater mechanical strength, a superior insecticide wash resistance with a short insecticide regeneration time, a better flammability profile and a better environmental profile compared to polyester or polyethylene nets. Methods: Through a WHOPES supervised trial, the efficacy of LifeNet(C) was evaluated in Benin in experimental huts against free-flying wild mosquitoes. Results: LifeNet(C) has equal or better performances in terms of wash resistance, exophily, blood feeding inhibition and mortality compared to conventionally treated nets (CTN) treated with deltamethrin at 25 mg/m(2) and washed to just before exhaustion. Conclusions: The efficacy of LifeNet(C) observed in this trial indicates that this net fulfill World Health Organization Pesticide Scheme (WHOPES) requirement for Long Lasting technology in Phase II. Throughout a Phase III trial currently ongoing in Southern Benin, the durability and the acceptability of this long-lasting insecticidal mosquito nets will be assessed under community conditions