Rabat, Morocco
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Cuamba N.,National Institute of Health | Kerah-Hinzoumbe C.,Ministere de la sante
Heredity | Year: 2013

Prevention of malaria transmission throughout much of Africa is dependent on bednets that are impregnated with pyrethroid insecticides. Anopheles arabiensis is the major malaria vector in Chad and efforts to control this vector are threatened by the emergence of pyrethroid resistance. WHO bioassays revealed that An. arabiensis from Ndjamena is resistant to pyrethroids and dichlorodiphenyltrichloroethane (DDT) but fully susceptible to carbamates and organophosphates. No 1014F or 1014S kdr alleles were detected in this population. To determine the mechanisms that are responsible for resistance, genetic crosses were established between the Ndja strain and an insecticide susceptible population from Mozambique. Resistance was inherited as an autosomal trait and quantitative trait locus (QTL) mapping identified a single major locus on chromosome 2R, which explained 24.4% of the variance in resistance. This QTL is enriched in P450 genes including 25 cytochrome P450s in total. One of these, Cyp6p4 is 22-fold upregulated in the Ndja strain compared with the susceptible. Piperonyl butoxide (PBO) synergist and biochemical assays further support a role for P450s in conferring pyrethroid resistance in this population. © 2013 Macmillan Publishers Limited All rights reserved.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-FP-SICA | Phase: HEALTH-2009-4.3.1-2 | Award Amount: 6.02M | Year: 2010

Buruli ulcer disease (BUD), caused by Mycobacterium ulcerans, is a neglected bacterial infection of the poor in remote rural areas, mostly affecting children. BUD, the third most common mycobacterial disease in immunocompetent humans after tuberculosis and leprosy, is most endemic in West Africa, but cases have been reported from more than 30 countries. BUD is a mutilating disease leading to severe disability. Treatment with antibiotics is possible but is long-lasting and requires injections, shows treatment failures and drug resistance may occur. A vaccine against M. ulcerans would protect persons at risk in highly endemic areas and could be used as a therapeutic vaccine to shorten duration of treatment and to prevent relapses. The general objective of BuruliVac is to identify and develop novel vaccine candidates suitable for translation into clinical application. This objective will be achieved by a multidisciplinary approach involving among others basic and applied research in immunology, bioinformatics, molecular genetics, tropical medicine, microbiology and clinical bacteriology. As currently no existing vaccine lead candidate is available, the consortium will identify and develop new vaccine candidates of different types, will evaluate them using bioinformatics, applied genomics and proteomics and will subject them to consecutive test systems. For evaluation of vaccine candidates regarding their application in humans, the consortium will also study the immune response and disease immunopathology to define correlates of protection. Essential pre-clinical testing in vitro and in vivo will select a small number of candidates that is amenable to be introduced into clinical studies.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-CSA-Infra | Phase: INFRA-2008-1.1.1 | Award Amount: 10.78M | Year: 2009

Mosquitoes transmit a variety of infectious diseases that cause a tremendous burden to public health. Due to climate changes and to the increase in international trade and tourism the threats posed by mosquitoes are increasingly affecting large parts of Europe, causing understandable concerns among the populations of many Member States. Control methods, mainly based on insecticide usage, are struggling to cope with the challenges posed by the biology and ecology of mosquito vectors. INFRAVEC aims at bridging the gap between the recent advances in transgenic technology and its implementation as a novel powerful approach for vector control. To this aim, a large European Infrastructure will be established, in which the coordination of efforts, expertise and facilities provided by the individual research groups and institutions will bolster and considerably expand the overall research capabilities of the research community. INFRAVEC will operate, through a number of Networking, Joint Research, Transnational and Service activities, towards the objective of considerably strengthening research capability in Europe by sharing knowledge, resources and technology. INFRAVEC will mainly focus on Anopheles gambiae, the major vector of malaria, and Aedes albopictus, a viral disease vector that is rapidly spreading through Europe. Four Infrastructure facilities will be integrated in the project: 1) the Genetically Modified mosquito laboratory of Imperial College London; 2) the Mosquito Mass-rearing facility at the Centro Agricoltura ed Ambiente (with the support of the International Atomic Energy Agency); 3) the Bioinformatics facility at EMBLEBI, UK; and 4) the Mosquito Confined Release facility at ISRIM. INFRAVEC will provide a formidable research capability to external users and facilitate the performance of five research projects aimed at utilizing basic knowledge of mosquito genetics and biology in an unprecedented effort to develop novel opportunities for mosquito control.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-IP-SICA | Phase: HEALTH.2010.2.3.2-4 | Award Amount: 15.40M | Year: 2011

The AvecNet consortium will develop practical solutions to the current limitations of vector control strategies in Africa using a combination of translationally-aware, state of the art science and end user analysis to ensure successful development and uptake of the new and improved approaches to malaria control and elimination. Our carefully balanced, multidisciplinary team of European and African experts includes vector biologists, engineers, epidemiologists, social scientists and leaders of large supranational consortia. These partners are all prominent members of global vector control research programs having unique specialization in Africa-centric projects. Together we have developed a proposal focused specifically to address the three major research challenges that confront efforts to interrupt mosquito-mediated transmission of malaria in Africa: 1. The need for practical strategies to prolong the efficacy of existing insecticide-based vector control methods, 2.The need to develop new interventions that target all major malaria vectors, that are simultaneously effective, socially acceptable and sustainable, 3. The impact of the major demographic and environmental changes occurring in Africa on malaria epidemiology and control. These research activities are cross-linked by specific tasks to reinforce our commitment to ensure sustainability, engage all stakeholders and strengthen research capacity in Africa. Overall, the project will add significant value to the international research effort in vector control by taking forward the state of the art and translating this into new or improved control tools that will be trialled within the time frame of this project. The studies planned in this collaborative project will provide scalable solutions, giving the solid platform upon which ongoing and future vector control programmes can be built.


Gomgnimbou M.K.,University Paris - Sud | Refregier G.,University Paris - Sud | Diagbouga S.P.,Ministere de la Sante | Adama S.,Center Muraz | And 3 more authors.
Emerging Infectious Diseases | Year: 2012

Using Ziehl-Neelsen-positive slides collected from tuberculosis diagnostic centers in Burkina Faso, we showed that 20% of 80 spoligotyping-positive DNA samples had a characteristic Mycobacterium africanum-specific genomic signature. This result suggests that M. africanum is still present in Burkina Faso at almost the same prevalence as 15-20 years ago.


Mathieu E.,Centers for Disease Control and Prevention | Dorkenoo A.,Ministere de la Sante | Otogbe F.K.J.,Ministere de la Sante | Budge P.J.,Centers for Disease Control and Prevention | Sodahlon Y.K.,DoNation
American Journal of Tropical Medicine and Hygiene | Year: 2011

One goal of the Global Program to Eliminate Lymphatic Filariasis (GAELF) is interruption of disease transmission through annual mass drug administration (MDA) in areas where LF prevalence is greater than 1%. After MDAs are completed, the World Health Organization (WHO) recommends a period of passive surveillance before final certification of LF elimination is achieved. Guidelines for such a surveillance system have yet to be developed. This paper describes a surveillance system launched in Togo in 2006. The system uses existing laboratories with technicians on call at night who, among other activities, prepare nocturnal thick blood smears for malaria diagnosis that can also be used for LF diagnosis. During its first 2 years (2006-2007), the system provided geographically disperse sampling nationwide, and 1 of 750 people residing in Togo was tested. Over the same period, the system detected two cases of LF, both from areas previously considered non-endemic. This system could be a cost-effective, sustainable model for WHO-mandated passive surveillance after cessation of MDA. Copyright © 2011 by The American Society of Tropical Medicine and Hygiene.


Grant
Agency: European Commission | Branch: FP7 | Program: CP-SICA | Phase: HEALTH-2007-3.5-2 | Award Amount: 3.76M | Year: 2009

Inadequate access to and use of research evidence to inform health policy limits the achievement of universal and equitable access to healthcare, hinders quality improvement and makes it difficult to use healthcare resources wisely. Poorly informed decision-making about health policies and systems is one of the reasons why services fail to reach those most in need, health indicators are off track, and it appears unlikely that many countries in Africa will meet the health MDGs. SURE will support improvements in health policies and systems in low and middle-income countries (LMIC) by improving access to and use of policy-relevant syntheses of research evidence that are contextualized and tailored to meet the needs of decision makers. SURE will develop, pilot and evaluate five strategies designed to strengthen access to and use of reliable and timely research syntheses in policymaking: user friendly formats for research syntheses, clearing houses for syntheses and policy relevant research, mechanisms for responding rapidly to policymakers needs for research evidence, methods for organizing and managing deliberative forums involving policymakers, researchers and others, and methods for involving civil society and the public in policy development. SURE will develop capacity for evidence-informed healthcare policy and undertake a comparative evaluation of initiatives between policymakers and researchers using these and other strategies. SURE will collaborate with the Evidence-Informed Health Policy Network (EVIPNet) and the Regional East African Community Health (REACH) Policy Initiativetwo international efforts to improve the use of research evidence in policy and health systems decisions via partnerships between policymakers, researchers and civil society. SURE will use a range of dissemination strategies. Global dissemination will be coordinated by and capitalise on WHO, with the aim of maximising the projects impact on health policy in Africa and othe


Grant
Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH.2012.2.3.2-4 | Award Amount: 3.94M | Year: 2012

Pregnant women are very susceptible to malaria infection and Malaria in Pregnancy (MiP) is a major cause of maternal anaemia and low birth weight (LBW) that leads to infant mortality, poor growth and development. In low transmission areas, malaria can become severe, resulting in maternal and foetal death. In sub-Saharan Africa (SSA) MiP is responsible for 814% of LBW, 38% of infant deaths, higher risk of post-partum haemorrhage and >10,000 maternal deaths/year. Prevention like, bed nets and intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp/SP), is cheap and cost-effective, but coverage achieved by these interventions is low. Therefore, we propose Community Health Workers (CHW) to implement scheduled intermittent screening at community level with RDT of pregnant women and if positive treat with anti-malarials (SST). In addition CHWs will encourage pregnant women to attend antenatal clinics (ANC) for other pregnancy-targeted interventions and IPTp/SP, thereby improving its coverage. This approach combines existing IPTp/SP with SST at village level as an extension of Home based management of malaria (HMM). This low cost (based on existing practice) and simple (diagnosis by RDTs) intervention improves maternal and newborn health and capitalise on an already existing intervention (HMM). The aim of this proposal is to determine the added value (as compared to IPTp/SP alone implemented in health facilities) of community SST of pregnant women implemented through the CHW involved in HMM. Objectives are: 1) Identify bottlenecks for implementation by CHW involved in HMM of SST; 2) determine impact of introducing SST in pregnancy on quality of HMM; 3) determine the impact of SST on ANC attendance and IPTp/SP coverage; 4) determine the impact of SST on LBW, anaemia and placenta malaria; 5) estimate cost-effectiveness of SST as compared to IPTp/SP alone and 6) formulate recommendations for possible implementation of the intervention.


Stevens E.R.,United States Peace Corps | Aldridge A.,United States Peace Corps | Degbey Y.,Ministere de la Sante | Pignandi A.,Secretariat Permanent du CCM | And 3 more authors.
Malaria Journal | Year: 2013

Background: Malaria remains a substantial public health problem in Togo. An integrated child health campaign was conducted in Togo in October 2011. This campaign included a component of free distribution of 2,799,800 long-lasting, insecticide-treated nets (LLINs) to households throughout Togo. This distribution marked the first effort in Togo at universal LLIN coverage and was not targeted specifically to children under five years and pregnant women, but to all household members. This study reports the results of the LLIN distribution campaign in terms of bed net possession and utilization. Methods. A representative household survey was implemented during the rainy season nine months after the LLIN distribution component of the campaign. Some 6,015 households selected through two stages of probability proportion to size stratified random sampling were interviewed using a brief questionnaire that included a demographic section with questions on the number of household members and sleeping spaces, and a campaign participation section with questions used to evaluate non-LLIN aspects of the campaign. A net roster listed all nets and their characteristics, and a household roster listed all members and visitors with information about bed net use. The questions addressed different aspects of bed net and LLIN possession and utilization. Crude weighted frequencies, percentages, and t- tests of association were calculated using the Stata 12.0 Survey features. Results: Possession of at least one bed net and/or LLIN increased from 41.3% to 96.7% (P <0.001). Household possession of at least one campaign LLIN was 93.3%. Report LLIN among pregnant women was 77.5% and 79.3% for children under five. For the general population LLIN use was 68.3%. Conclusions: Due to the gap in LLIN possession and use and the significant number of individuals reporting a lack of nets as a reason for non-use, additional national LLIN distribution campaigns with a stronger educational component need to be implemented in order increase the use of available LLINs and to reach and maintain universal coverage of LLINs in Togo. The LLIN distribution campaign focusing on universal coverage of the general population in Togo was more successful at increasing LLIN possession and use of children under five years and pregnant women than other campaigns focusing only on these target groups. © 2013 Stevens et al.; licensee BioMed Central Ltd.


Page A.-L.,Epicentre | Hustache S.,Epicentre | Luquero F.J.,Epicentre | Djibo A.,Ministere de la Sante | And 2 more authors.
BMC Public Health | Year: 2011

Background: Diarrhea remains the second leading cause of death in children under 5 years of age in sub-Saharan Africa. Health care seeking behavior for diarrhea varies by context and has important implications for developing appropriate care strategies and estimating burden of disease. The objective of this study was to determine the proportion of children under five with diarrhea who consulted at a health structure in order to identify the appropriate health care levels to set up surveillance of severe diarrheal diseases. Methods: A cluster survey was done on 35 clusters of 21 children under 5 years of age in each of four districts of the Maradi Region, Niger. Caretakers were asked about diarrhea of the child during the recall period and their health seeking behavior in case of diarrhea. A weighted cluster analysis was conducted to determine the prevalence of diarrhea, as well as the proportion of consultations and types of health structures consulted. Results: In total, the period prevalence of diarrhea and severe diarrhea between April 24 th and May 21 st 2009 were 36.8% (95% CI: 33.7 - 40.0) and 3.4% (95% CI: 2.2-4.6), respectively. Of those reporting an episode of diarrhea during the recall period, 70.4% (95% CI: 66.6-74.1) reported seeking care at a health structure. The main health structures visited were health centers, followed by health posts both for simple or severe diarrhea. Less than 10% of the children were brought to the hospital. The proportion of consultations was not associated with the level of education of the caretaker, but increased with the number of children in the household. Conclusions: The proportion of consultations for diarrhea cases in children under 5 years old was higher than those reported in previous surveys in Niger and elsewhere. Free health care for under 5 years old might have participated in this improvement. In this type of decentralized health systems, the WHO recommended hospital-based surveillance of severe diarrheal diseases would capture only a fraction of severe diarrhea. Lower levels of health structures should be considered to obtain informative data to ensure appropriate care and burden estimates. © 2011 Page et al; licensee BioMed Central Ltd.

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