Understanding the influence of the COVID-19 pandemic on hospital-based mortality in Burundi: a cross-sectional study comparing two time periods.

This study used hospital records from two time periods to understand the implication of COVID-19 on hospital-based deaths in Burundi. The place of COVID-19 symptoms was sought among deaths that occurred from January to May 2020 (during the pandemic) vs. January to May 2019 (before the pandemic). First, death proportions were tested to seize differences between mortality rates for each month in 2020 vs. 2019. In the second time, we compared mean time-to-death between the two periods using the Kaplan-Meier survival curve. Finally, a logistic regression was fitted to assess the likelihood of dying from COVID-19 symptoms between the two periods. We found statistical evidence of a higher death rate in May 2020 as compared to May 2019. Moreover, death occurred faster in 2020 (mean = 6.7 days, s.d. = 8.9) than in 2019 (mean = 7.8 days, s.d. = 10.9). Unlike in 2019, being a male was significantly associated with a much lower likelihood of dying with one or more COVID-19 symptom(s) in 2020 (odds ratio 0.35, 95% confidence interval 0.14-0.87). This study yielded some evidence for a possible COVID-19-related hospital-based mortality trend for May 2020. However, considering the time-constraint of the study, further similar studies over a longer period of time need to be conducted to trace a clearer picture on COVID-19 implication on hospital-based deaths in Burundi.

Pertinence des indications de l'échographie chez les patients hospitalisés dans les services de pédiatrie et gynéco-obstétrique au CHUK , Burundi

Introduction : L'indication d'un examen d'imagerie médicale est une déscription de la situation clinique d'un patient sur sa demande d'examen.Elle permet de giuder la réalisation et l'interprétation des examens d'imagerie médicale . Objectif : Evaluer la conformité des demandes d'échographies par rapport aux huit éléments de la Haute Autorité de Santé (HAS) Française. Méthodologie : Etude prospective sur 158 cas collectés en deux mois du 05 Janvier au 05 Mars 2019 en provenance des services de gynéco-obstétrique et de pédiatrie. L'évaluation de la conformité de la demande de l'examen s'est basée sur la qualité de la formulation du motif clinique, sa cohérence avec l'examen demandé ainsi que la qualité des renseignements administratifs. Résultats : Notre étude s'est effectuée sur 158 patients dont 102 de la gynéco-obstétrique (64.55%) et 56 de la pédiatrie (35,45%). Les cinq éléments administratifs de conformité ont été fournis à une proportion globale de 89,81% tandis que les trois éléments cliniques de conformité ont été fournis globalement à raison de 54,85%. La non-conformité s'observait de façon sensible sur trois éléments à savoir la finalité de l'examen à 91,13% ; le motif clinique à 37,35% et le service demandeur à 26,59%. Les demandes d'échographies étaient rédigées par les internes à 81,6%. Les résultats pathologiques étaient à 64,45% et le traitement a été ajusté dans les proportions comparables à ceux du résultat pathologique soit 61,39%. Conclusion : Les demandes d'examens d'échographie au CHUK relèvent pas mal d'insuffisances surtout la formulation du motif clinique clair, complet et cohérent avec finalité d'examen. Des efforts continus doivent être faits par les prescripteurs en vue d'une prescription plus conforme des demandes d'imagerie médicale en générale et d'échographies en particulier

Treatment outcomes of pre- and extensively drug-resistant tuberculosis in Johannesburg, South Africa.

BACKGROUND: Extensively drug-resistant tuberculosis (XDR-TB) has a poor treatment success rate and high mortality. Multidrug-resistant TB (MDR-TB) has worse outcomes when there is added resistance to second-line injectable drugs (pre-XDR-TBSLID) or fluoroquinolones (pre-XDR-TBFQ). OBJECTIVES: Treatment outcomes in patients with pre-XDR-TB and XDR-TB in a high HIV prevalence area were compared. METHODS: A retrospective medical record review was conducted of patients with pulmonary pre-XDR-TB and XDR-TB managed from 2008 to 2010 at Sizwe Tropical Disease Hospital, Johannesburg, South Africa. Standardised MDR-TB treatment was instituted and was subsequently individualised when further second-line susceptibility results became available. RESULTS: Of 86 patients studied, 95% were sputum smear-positive at baseline, 73% had sputum culture conversion, and 65% were human immunodeficiency virus (HIV) infected, with a median CD4 count of 201 cells/mm³. Of 53 patients with XDR-TB, 26 with pre-XDR-TBFQ and 7 with pre-XDR-TBSLID, respectively 13%, 12% and 29% were cured, 21%, 23% and 57% had a favourable outcome, and 26%, 23% and 14% died. Clofazimine (P < 0.001) and linezolid (P = 0.044) impacted on favourable outcomes. CONCLUSION: Patients with pre-XDR-TBFQ did not have better outcomes than those with XDR-TB. In countries with standardised regimens for resistant TB, patients with pre-XDR-TBFQ may need to receive XDR-TB treatment.

In vitro anti-proliferation/cytotoxic activity of epingaione and its derivatives on the human SH-SY5Y neuroblastoma and TE-671 sarcoma cells.

Epingaione (4-Methyl-1-(5-methyl-2, 3,4,5-tetrahydro-[2,3']bifuranyl-5-yl)-pentan-2-one) was isolated as one of the major lipophilic secondary metabolites from the leaves and stems of Bontia daphnoides L. The compound gave 79.24% and 50.83% anti-proliferation/cytotoxic activity on the human SH-SY5Y neuroblastoma and TE-671 sarcoma cells in vitro at 50 pg/mL, respectively. Epingaione was transformed into eleven derivatives under laboratory conditions using ethanol, some gave greater anti-proliferation/cytotoxic activity on the cancer cell lines tested. One of the derivatives (compound 2) with enhanced cytotoxic activity was elucidated as 5'-Ethoxy-5-methyl-5-(4-methyl-2-oxo-pentyl)-2,3,4,5-tetrahydro-5'H-[2,3']bifuranyl-2'-one. Both epingaione and compound 2 caused an accumulation of arrested or dead SH-SY5Y neuroblastoma in the m-phase of the cell cycle as revealed by the m-phase specific marker KE 67.

In vitro anti-proliferation/cytotoxic activity of sixty natural products on the human SH-SY5Y neuroblastoma cells with specific reference to dibenzyl trisulphide.

Sixty natural products belonging to the following structural classes: artemisinins, coumarins, flavonoids, tannins, tetrahydroberberine alkaloids, tetracyclic triterpenes, tetranortriterpenoids and polysulphides were screened against the human SH-SY5Y neuroblastoma cell line revealing differences in their effects on cell morphology and in anti-proliferation/cytotoxic activity. Based on the data obtained, dibenzyl trisulphide is the most effective anti-proliferative/cytotoxic compound. In addition, we hereby propose the human SH-SY5Y cell line as a sensitive and uncomplicated in vitro test system for detecting compounds with potential anti-proliferation/cytotoxic activity.

In vitro anti-proliferation/cytotoxic activity of sixty natural products on the human SH-SY5Y neuroblastoma cells with specific reference to dibenzyl trisulphide

Sixty natural products belonging to the following structural classes: artemisinins, coumarins, flavonoids, tannins, tetrahydroberberine alkaloids, tetracyclic triterpenes, tetranortriterpenoids and polysulphides were screened against the human SH-SY5Y neuroblastoma cell line revealing differences in their effects on cell morphology and in anti-proliferation/cytotoxic activity. Based on the data obtained, dibenzyl trisulphide is the most effective anti-proliferative/cytotoxic compound. In addition, we hereby propose the human SH-SY5Y cell line as a sensitive and uncomplicated in vitro test system for detecting compounds with potential anti-proliferation/cytotoxic activity

Knowledge about AIDS in a Central African town.

PIP: In July 1986, at the request of the Ministry of Health in Rwanda, the Rwandan Red Cross initiated a 2-year Acquired Immune Deficiency Syndrome (AIDS) education program, funded by the Norwegian Red Cross. The short daily radio spots and six 1-hour programs were produced and broadcast for 6 months on Rwandan national radio. This campaign had a major impact on the level of knowledge of AIDS among urban adults. Post-broadcast research showed an increased understanding of the HIV modes of transmission among those with higher levels of education. At least 25% of these adults reported a change in their sexual behavior in the past year. Sexual abstinence was the most common preventive measure adopted by this group. To develop an effective information strategy, the Red Cross conducted a survey in Kigali. The great majority of the 1192 men and women surveyed (98%) knew that AIDS is a disease, and 76% knew that it is caused by a microbe. 73% learned about AIDS by listening to the radio; 14% learned of it from friends and smaller percentages from newspapers, health workers, and from others. Following the radio program and assessment of the survey data, a 30-page information booklet was prepared using a question and answer format. During this ongoing 2-year public education campaign, the Rwandan Red Cross intends to distribute 25,000 booklets to opinion leaders throughout the country. 3000 copies of a more scientific document were prepared for paramedical personnel. Leaflets also will be produced targeting identified high risk groups such as prostitutes, chauffeurs, soldiers, and students. The Rwandan Red Cross will be a primary distributor of the booklets.^ieng