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Some J.W.,Institute Of Recherche En Science Of La Sante Direction Regionale Of Louest | Some J.W.,University of California at Davis | Abbeddou S.,University of California at Davis | Jimenez E.Y.,University of New Mexico | And 7 more authors.
BMJ Open | Year: 2015

Objective: Preventive zinc supplementation in the form of tablets or syrup reduces the incidence of diarrhoea and acute lower respiratory tract infections (RTI), but its effect on malaria is inconsistent. When zinc is administered with other micronutrients or foods, its effect is also uncertain. We assessed the effects of different amounts and sources of zinc on the frequency of diarrhoea, malaria, fever and RTI in young children. Design, setting and populations: This communitybased, double-blind, placebo-controlled, clusterrandomised trial of 2435 children 9 months of age was carried out between April 2010 and July 2012 in rural southwestern Burkina Faso. Interventions: Participants were randomly assigned at the concession level to receive daily 1 of 4 interventions for 9 months: (1) 20 g small-quantity lipid-based nutrient supplement (SQ-LNS) without zinc and placebo tablet, (2) 20 g SQ-LNS with 5 mg zinc and placebo tablet, (3) 20 g SQ-LNS with 10 mg zinc and placebo tablet or (4) 20 g SQ-LNS without zinc and 5 mg zinc tablet. Participants were visited weekly in their homes for morbidity surveillance for 9 months, and those with uncomplicated diarrhoea and malaria received treatment from the study field workers in the community. Main outcomes: Incidence and longitudinal prevalence of diarrhoea, malaria, fever, and lower and upper RTI by intervention group. Results: The incidence of diarrhoea, malaria and fever was 1.10 (±1.03 SD), 0.61 (±0.66 SD) and 1.49 (±1.12 SD) episodes per 100 child-days at risk, respectively, and did not differ by intervention group (p=0.589, p=0.856 and p=0.830, respectively). The longitudinal prevalence of acute lower RTI (0.1%; 95% IC 0.10.2%) and of upper RTI (7.8%; 95% IC 7.1-8.4%) did not differ among groups (p=0.234 and p=0.501, respectively). Conclusions: Inclusion of 5 or 10 mg zinc in SQ-LNS and provision of 5 mg zinc dispersible tablet along with SQ-LNS had no impact on the incidence of diarrhoea, malaria and fever or the longitudinal prevalence of RTI compared with SQ-LNS without zinc in this population.


Samb B.,Cheikh Anta Diop University | Samb B.,Institute Pasteur Of Dakar | Dia I.,Institute Pasteur Of Dakar | Konate L.,Cheikh Anta Diop University | And 5 more authors.
Parasites and Vectors | Year: 2012

Background: Anopheles funestus is one of the major malaria vectors in tropical Africa. Because of several cycles of drought events that occurred during the 1970s, this species had disappeared from many parts of sahelian Africa, including the Senegal River basin. However, this zone has been re-colonized during the last decade by An. funestus, following the implementation of two dams on the Senegal River. Previous studies in that area revealed heterogeneity at the biological and chromosomal level among these recent populations. Methods. Here, we studied the genetic structure of the newly established mosquito populations using eleven microsatellite markers in four villages of the Senegal River basin and compared it to another An. funestus population located in the sudanian domain. Results: Our results presume Hardy Weinberg equilibrium in each An. funestus population, suggesting a situation of panmixia. Moreover, no signal from bottleneck or population expansion was detected across populations. The tests of genetic differentiation between sites revealed a slight but significant division into three distinct genetic entities. Genetic distance between populations from the Senegal River basin and sudanian domain was correlated to geographical distance. In contrast, sub-division into the Senegal River basin was not correlated to geographic distance, rather to local adaptation. Conclusions: The high genetic diversity among populations from Senegal River basin coupled with no evidence of bottleneck and with a gene flow with southern population suggests that the re-colonization was likely carried out by a massive and repeated stepping-stone dispersion starting from the neighboring areas where An. funestus endured. © 2012 Samb et al.; licensee BioMed Central Ltd.


PubMed | Bill and Melinda Gates Foundation, Institute Of Recherche En Science Of La Sante Direction Regionale Of Louest, University of New Mexico and University of California at Davis
Type: Journal Article | Journal: BMJ open | Year: 2015

Preventive zinc supplementation in the form of tablets or syrup reduces the incidence of diarrhoea and acute lower respiratory tract infections (RTI), but its effect on malaria is inconsistent. When zinc is administered with other micronutrients or foods, its effect is also uncertain. We assessed the effects of different amounts and sources of zinc on the frequency of diarrhoea, malaria, fever and RTI in young children.This community-based, double-blind, placebo-controlled, cluster-randomised trial of 2435 children 9months of age was carried out between April 2010 and July 2012 in rural southwestern Burkina Faso.Participants were randomly assigned at the concession level to receive daily 1 of 4 interventions for 9months: (1) 20g small-quantity lipid-based nutrient supplement (SQ-LNS) without zinc and placebo tablet, (2) 20g SQ-LNS with 5mg zinc and placebo tablet, (3) 20g SQ-LNS with 10mg zinc and placebo tablet or (4) 20g SQ-LNS without zinc and 5mg zinc tablet. Participants were visited weekly in their homes for morbidity surveillance for 9months, and those with uncomplicated diarrhoea and malaria received treatment from the study field workers in the community.Incidence and longitudinal prevalence of diarrhoea, malaria, fever, and lower and upper RTI by intervention group.The incidence of diarrhoea, malaria and fever was 1.10 (1.03 SD), 0.61 (0.66 SD) and 1.49 (1.12 SD) episodes per 100 child-days at risk, respectively, and did not differ by intervention group (p=0.589, p=0.856 and p=0.830, respectively). The longitudinal prevalence of acute lower RTI (0.1%; 95% IC 0.1-0.2%) and of upper RTI (7.8%; 95% IC 7.1-8.4%) did not differ among groups (p=0.234 and p=0.501, respectively).Inclusion of 5 or 10mg zinc in SQ-LNS and provision of 5mg zinc dispersible tablet along with SQ-LNS had no impact on the incidence of diarrhoea, malaria and fever or the longitudinal prevalence of RTI compared with SQ-LNS without zinc in this population.NCT00944281.


Tahita M.C.,Institute Of Recherche En Science Of La Sante Direction Regionale Of Louest | Tahita M.C.,Center Muraz | Tahita M.C.,University of Antwerp | Tinto H.,Institute Of Recherche En Science Of La Sante Direction Regionale Of Louest | And 9 more authors.
Malaria Journal | Year: 2013

Background: Malaria in pregnancy is a major public health problem in endemic countries. Though the signs and symptoms of malaria among pregnant women have been already described, clinical presentation may vary according to intensity of transmission and local perceptions. Therefore, determining common signs and symptoms among pregnant women with a malaria infection may be extremely useful to identify those in need of further investigation by rapid diagnostic test or microscopy. Methods. Six hundred pregnant women attending the maternity clinic of Nanoro District Hospital, Burkina Faso were recruited, 200 with suspected clinical malaria and 400 as controls. Cases were matched with controls by gestational age and parity. Signs and symptoms were collected and a blood sample taken for rapid diagnostic test, microscopy and haemoglobin measurement. A multivariate model was used to assess the predictive value of signs and symptoms for malaria infection. Results: The overall prevalence of malaria was 42.6% (256/600) while anaemia was found in 60.8% (365/600) of the women. Nearly half (49%) of the cases and 39.5% of the controls had a malaria infection (p = 0.03). The most common signs and symptoms among the cases were fever (36%,72/200), history of fever (29%,58/200) and headache (52%,104/200). The positive predictive value for fever was 53% (95% CI:41-64), history of fever 58% (95% CI:37-63) and headache 51% (95% CI:41-61). Conclusion: Signs and symptoms suggestive of malaria are frequent among pregnant women living in areas of intense transmission. Common malaria symptoms are not strong predictors of infection. For a better management of malaria in pregnancy, active screening to detect and treat malaria infection early should be performed on all pregnant women attending a health facility. © 2013 Tahita et al.; licensee BioMed Central Ltd.


Tinto H.,Center Muraz | Tinto H.,Institute Of Recherche En Science Of La Sante Direction Regionale Of Louest | Tinto H.,Clinical Research Unit of Nanoro IRSS CRUN | Bonkian L.N.,Center Muraz | And 18 more authors.
Malaria Journal | Year: 2014

Background: The recent reports on the decreasing susceptibility of Plasmodium falciparum to artemisinin derivatives along the Thailand and Myanmar border are worrying. Indeed it may spread to India and then Africa, repeating the same pattern observed for chloroquine resistance. Therefore, it is essential to start monitoring P. falciparum sensitivity to artemisinin derivatives and its partner drugs in Africa. Efficacy of AL and ASAQ were tested by carrying out an in vivo drug efficacy test, with an ex vivo study against six anti-malarial drugs nested into it. Results of the latter are reported here. Methods. Plasmodium falciparum ex-vivo susceptibility to chloroquine (CQ), quinine (Q), lumefantrine (Lum), monodesethylamodiaquine (MDA), piperaquine (PPQ) and dihydroartemisinin (DHA) was investigated in children (6 months - 15 years) with a parasitaemia of at least ≥4,000/μl. The modified isotopic microtest technique was used. The results of cellular proliferation were analysed using ICEstimator software to determine the 50% inhibitory concentration (IC50) values. Results: DHA was the most potent among the 6 drugs tested, with IC50 values ranging from 0.8 nM to 0.9 nM (Geometric mean IC50 = 0.8 nM; 95% CI [0.8 - 0.9]). High IC50 values ranged between 0.8 nM to 166.1 nM were reported for lumefantrine (Geometric mean IC50 = 25.1 nM; 95% CI [22.4 - 28.2]). MDA and Q IC50s were significantly higher in CQ-resistant than in CQ-sensitive isolates (P = 0.0001). However, the opposite occurred for Lum and DHA (P < 0.001). No difference was observed for PPQ. Conclusion: Artemisinin derivatives are still very efficacious in Burkina Faso and DHA-PPQ seems a valuable alternative ACT. The high lumefantrine IC50 found in this study is worrying as it may indicate a decreasing efficacy of one of the first-line treatments. This should be further investigated and monitored over time with large in vivo and ex vivo studies that will include also plasma drug measurements. © 2014 Tinto et al.; licensee BioMed Central Ltd.


Zeba A.N.,University of Montréal | Zeba A.N.,Institute Of Recherche En Science Of La Sante Direction Regionale Of Louest | Delisle H.F.,University of Montréal | Renier G.,University of Montréal | And 2 more authors.
Public Health Nutrition | Year: 2012

Objective To document the double burden of malnutrition and cardiometabolic risk factors (CMRF) in adults and its occurrence according to different sociodemographic parameters. Design Population-based cross-sectional observational study. We first randomly selected 330 households stratified by tertile of the income levels proxy as low, middle and high income. Setting Northern district of Ouagadougou, the capital city of Burkina Faso. Subjects In each income stratum, 110 individuals aged 25-60 years and who had lived permanently in Ouagadougou for at least 6 months were randomly selected, followed with collection of anthropometric, socio-economic and clinical data, and blood samples. Results The overall obesity/overweight prevalence was 24·2 % and it was twice as high in women as in men (34·1 % v. 15·5 %, P < 0·001). Hypertension, hyperglycaemia and low HDL cholesterol prevalence was 21·9 %, 22·3 % and 30·0 %, respectively, without gender difference. The prevalence of the metabolic syndrome was 10·3 %. Iron depletion and vitamin A deficiency affected 15·7 % and 25·7 % of participants, respectively, with higher rates in women. Coexistence of at least one nutritional deficiency and one CMRF was observed in 23·5 % of participants, and this 'double burden' was significantly higher in women than in men (30·4 % v. 16·1 %, P = 0·008) and in the low income group. Conclusions CMRF are becoming a leading nutritional problem in adults of Ouagadougou, while nutritional deficiencies persist. The double nutritional burden exacerbates health inequities and calls for action addressing both malnutrition and nutrition-related chronic diseases. Copyright © 2012 The Authors.


Sangare I.,Institute Of Recherche En Science Of La Sante Direction Regionale Of Louest | Sangare I.,IRD Montpellier | Michalakis Y.,IRD Montpellier | Yameogo B.,Institute Of Recherche En Science Of La Sante Direction Regionale Of Louest | And 5 more authors.
Malaria Journal | Year: 2013

Background: The question whether Plasmodium falciparum infection affects the fitness of mosquito vectors remains open. A hurdle for resolving this question is the lack of appropriate control, non-infected mosquitoes that can be compared to the infected ones. It was shown recently that heating P. falciparum gametocyte-infected blood before feeding by malaria vectors inhibits the infection. Therefore, the same source of gametocyte-infected blood could be divided in two parts, one heated, serving as the control, the other unheated, allowing the comparison of infected and uninfected mosquitoes which fed on exactly the same blood otherwise. However, before using this method for characterizing the cost of infection to mosquitoes, it is necessary to establish whether feeding on previously heated blood affects the survival and fecundity of mosquito females. Methods. Anopheles gambiae M molecular form females were exposed to heated versus non-heated, parasite-free human blood to mimic blood meal on non-infectious versus infectious gametocyte-containing blood. Life history traits of mosquito females fed on blood that was heat-treated or not were then compared. Results: The results reveal that heat treatment of the blood did not affect the survival and fecundity of mosquito females. Consistently, blood heat treatment did not affect the quantity of blood ingested. Conclusions: The study indicates that heat inactivation of gametocyte-infected blood will only inhibit mosquito infection and that this method is suitable for quantifying the fitness cost incurred by mosquitoes upon infection by P. falciparum. © 2013 Sangare et al.; licensee BioMed Central Ltd.


Zeba A.N.,University of Montréal | Zeba A.N.,Institute Of Recherche En Science Of La Sante Direction Regionale Of Louest | Delisle H.F.,University of Montréal | Rossier C.,University of Ouagadougou | Renier G.,University of Montréal
British Journal of Nutrition | Year: 2013

Increasing evidence suggests that high-sensitivity C-reactive protein (hs-CRP) is associated with cardiometabolic risk factors (CMRF) while being also related to micronutrient deficiencies. As part of a project on the double burden of under- and overnutrition in sub-Saharan Africa, we assessed the relationship between hs-CRP and both CMRF and micronutrient deficiencies in a population-based cross-sectional study carried out in the Northern district of Ouagadougou, the capital city of Burkina Faso. We randomly selected 330 households stratified by income tertile. In each income stratum, 110 individuals aged 25-60 years and having lived in Ouagadougou for at least 6 months were randomly selected, and underwent anthropometric measurements and blood sample collection. The prevalence of high hs-CRP was 39·4 %, with no sex difference. Vitamin A-deficient subjects (12·7 %) exhibited significant risk of elevated hs-CRP (OR 2·5; P= 0·015). Serum ferritin was positively correlated with log hs-CRP (r 0·194; P= 0·002). The risk of elevated hs-CRP was significant in subjects with BMI ≥ 25 kg/m 2 (OR 6·9; 95 % CI 3·6, 13·3), abdominal obesity (OR 4·6; 95 % CI 2·2, 7·3) and high body fat (OR 10·2; 95 % CI 5·1, 20·3) (P< 0·001, respectively). Independent predictors of hs-CRP in linear regression models were waist circumference (β = 0·306; P= 0·018) and serum TAG (β = 0·158; P= 0·027). In this sub-Saharan population, hs-CRP was consistently associated with adiposity. Assuming that plasma hs-CRP reflects future risk of cardiovascular events, intervention which reduces CRP, or chronic and acute nutrition conditions associated with it, could be effective in preventing their occurrence particularly in sub-Saharan Africa. Copyright © The Authors 2012.

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