Pulmonary and aortic endarteritis revealing a patent ductus arteriosus in an adult.

The ductus arteriosus, an essential fetal structure, normally closes spontaneously soon after birth. Its persistence into late adulthood is considered to be rare; infective endarteritis (IE) complicating a patent ductus arteriosus (PDA) is an even rarer event. The clinical picture of an infected PDA could be subtle, and the diagnosis is frequently delayed. We present the case of a young woman who presented with prolonged fever for whom we made the diagnosis of a PDA complicated by IE, with vegetations in both pulmonary and aortic walls with mycotic aneurysms of the descending aorta. She underwent surgery and the post-operative course was uneventful. To our knowledge, this is the first reported case of a PDA complicated with both pulmonary and aortic endarteritis.

[Gastrointestinal symptoms revealing COVID-19 in Malian breast cancer patient undergoing chemotherapy]. / Troubles digestifs révélateurs de la COVID-19 chez une patiente sous chimiothérapie pour cancer du sein au Mali.

In this review, we report a case of a bone's metastatic breast cancer in Malian patient treated by chemotherapy in whom SRAS-COV-2's diagnosis was made 9days after the onset gastrointestinal symptoms. Patient quickly died before any COVID-19's treatment. According to the poor outcomes of cancer patients with COVID-19, authors emphasize to an intensive attention to such patients in order to find the best therapeutic balance between the two pathologies during this pandemic.

Multiple mechanisms of resistance to pyrethroids in Anopheles gambiae s.l populations in Niger.

INTRODUCTION: We performed a transversal study to map resistance of malaria vectors (Anopheles mosquitoes) to insecticides in Niger within the frame of the National Malaria Control Program funded by the World Health Organization (WHO). METHOD: Larvae of Anopheles gambiae s.l were collected from November to December 2013 in seven locations selected on the basis of different patterns of use of insecticides and environment. WHO susceptibility test tubes were used on females Anopheles to detect resistance to insecticides. Eight insecticides were tested. Percentages of knockdown during exposure time to pyrethroids and DDT and mortality after 24hours of observation for all tested insecticides were calculated. PCR and biochemical tests were carried out to identify the species and mechanisms of resistance (Kdr allele frequencies and activity of detoxification enzymes). RESULTS: In all sites, Anopheles gambiae s.l was susceptible to bendiocarb and malathion but resistant to the five pyrethroids and DDT (24-hour mortality rate was <90%). The Kdr mutation was present in the molecular form M of Anopheles gambiae with an average frequency of 58%. Biochemical tests showed the activity of various enzyme families (esterase, oxidase, and glutathione s-transferase). CONCLUSION: This study showed multiple resistance of Anopheles mosquitoes to insecticides in Niger. A rigorous management of this resistance is imperative to preserve the efficacy of pyrethroids as it is the only class of insecticides used for insecticide-treated nets.

Phase 1 randomized controlled trial to evaluate the safety and immunogenicity of recombinant Pichia pastoris-expressed Plasmodium falciparum apical membrane antigen 1 (PfAMA1-FVO [25-545]) in healthy Malian adults in Bandiagara.

BACKGROUND: The safety and immunogenicity of PfAMA1, adjuvanted with Alhydrogel(®) was assessed in malaria-experienced Malian adults. The malaria vaccine, PfAMA1-FVO [25-545] is a recombinant protein Pichia pastoris-expressed AMA-1 from Plasmodium falciparum FVO clone adsorbed to Alhydrogel(®), the control vaccine was tetanus toxoid produced from formaldehyde detoxified and purified tetanus toxin. METHODS: A double blind randomized controlled phase 1 study enrolled and followed 40 healthy adults aged 18-55 years in Bandiagara, Mali, West Africa, a rural setting with intense seasonal transmission of P. falciparum malaria. Volunteers were randomized to receive either 50 µg of malaria vaccine or the control vaccine. Three doses of vaccine were given on Days 0, 28 and 56, and participants were followed for 1 year. Solicited symptoms were assessed for seven days and unsolicited symptoms for 28 days after each vaccination. Serious adverse events were assessed throughout the study. The titres of anti-AMA-1 antibodies were measured by ELISA and P. falciparum growth inhibition assays were performed. RESULTS: Commonest local solicited adverse events were the injection site pain and swelling more frequent in the PfAMA1 group. No vaccine related serious adverse events were reported. A significant 3.5-fold increase of anti-AMA-1 IgG antibodies was observed in malaria vaccine recipients four weeks after the third immunization compared to the control group. CONCLUSION: The PfAMA1 showed a good safety profile. Most adverse events reported were of mild to moderate intensity. In addition, the vaccine induced a significant though short-lived increase in the anti-AMA1 IgG titres. Registered on www.clinicaltrials.gov with the number NCT00431808.