COVID-19 in children aged 0-15 years seen at Amirou Boubacar Diallo National Hospital in Niamey, Niger, 2020-2021

Background: In 2020, the COVID-19 pandemic affected all age groups. Although COVID-19 is generally benign in children, a diagnostic problem may arise due to clinical similarities with certain pathologies such as malaria, dengue fever and influenza. The objective of this study is to describe the epidemiological profile of COVID 19 in children seen at consultation and to determine the prevalence of influenza, malaria and dengue fever as differential diagnoses. Methodology: We conducted a prospective cohort analytical study from October 1, 2020 to February 28, 2021 in COVID-19 suspected children aged 0 to 15 years admitted to the pediatrics department at the hospital. We used EPI INFO 7.2.4. software for data entry and analysis. Frequencies and proportions were calculated. Results: A total of 570 suspected cases of COVID-19 were enrolled. Of the suspected cases, 53.2% were males and 46.9% were females, with a M/F ratio of 1.13. The median age was 2 years (IQR: 1- 3 years), with age range of 0 to 15 years, and 68,8% in the age range 1 to 5 years. Exposure factors were travel (3.7%), contact with a suspected case of COVID-19 (1.0%), while only 2.6 % (15/570) of suspected cases were confirmed positive for COVID-19. The median age of COVID-19 confirmed children was 2.7 years (IQR 0.33-5). There were more male positive cases, with a M/F ratio of 2. Fever (100%) and cough (53.3%) were the predominant symptoms. The prevalence of malaria, Dengue fever and influenza among suspected COVID-19 cases were 16.8%, 0% and 54.7% respectively, while the respective prevalence in COVID-19 confirmed cases were 66.7%, 0% and 33.3% Conclusion: COVID-19 should be investigated in children presenting with symptoms and signs of malaria, influenza or Dengue fever.

Programmatic Implementation of Contact Investigation in Eight African Countries.

The objective was to implement CI under national tuberculosis programmatic conditions and to advocate for its scaling up. Contact investigation was implemented in 150 Basic Management Units identified across eight countries. The target populations (children <5 years and persons living with HIV (PLHIV)) were evaluated during home and clinic visits using standardized tools, clinical examinations and, according to each country, additional tests. Contacts with active TB received TB treatment and those eligible received TB preventive therapy (TPT). Data were collected each quarter using standardized forms. Meetings were organized with partners to share preliminary results and advocate for scaling up. From October 2020 to December 2021, 9049 home visits were performed. The proportions of children <5 years and PLHIV who were screened and diagnosed with active TB were, respectively, 2.6% and 10.1%. Ninety-three percent of children <5 years and 98% of PLHIV living at home received TPT or TB treatment, respectively. The scale-up for contact investigation partially or at national level in 2022 was effective in six of the eight countries included in the project. These results indicate that CI is feasible under programmatic conditions within the National TB Programs of African countries.

Évaluation de l'hygiène buccodentaire des patients consultant le service d'odontostomatologie du centre de santé de référence de Ouelessebougou au Mali / Assessment of the oral hygiene of the patients consulting the odonto-stomatology service of the reference health center of 0uelessebougou in Mali

INTRODUCTION: La santé bucco-dentaire fait partie intégrante de la santé générale et du bien-être de tous les individus selon l'OMS. L'objectif de cette étude était d'évaluer l'état buccodentaire des patients vus en consultation dans le service d'Odontostomatologie du Centre de Santé de Référence de Ouelessebougou au MALI. MÉTHODOLOGIE: Il s'agissait d'une étude prospective, transversale de type descriptif d' une période de 3 mois allant du 01 Août au 30 octobre 2018.L'étude portait sur tous les patients venus en première consultation dans le service. RÉSULTATS: Dans cette étude, le sexe masculin représentait 52% des cas avec un sex ratio de 1,08 %. La tranche d'âge la plus représentée était celle de 16 à 30 ans avec 53,25 %. La moyenne d'âge était de 30 ans. Parmi les pathologies bucco-dentaires, la carie dentaire était la plus représentée avec 94,14 % suivie des affections parodontales avec 71,82%. Cette étude a montré que 79 % des patients se brossaient les dents. Parmi les 122 patients qui se brossaient, 41,80% se brossaient 1 fois par jour, et 45,80% se brossaient 2 fois par jour. La méthode horizontale traumatisante était la plus présentée avec 78,68 %. Selon cette étude, 91% des patients avaient besoin d'enseignement de l'Hygiène Bucco-dentaire. CONCLUSION: Devant cette situation, une nouvelle orientation de la politique de santé bucco-dentaire basée sur l'odontologie préventive s'impose afin d'améliorer la santé et la qualité de vie des populations

INTRODUCTION: Oral health is an integral part of the overall health and well-being of all people according to the WHO. The objective of this study was to evaluate the oral status of patients seen in consultation in the Odonto-stomatology Department of the Ouelessebougou Reference Health Center in MALI. METHODOLOGY: This was a prospective, cross-sectional descriptive study of a 3-month period from August 1st to October 30th, 2018. The study included all the patients who had come for first consultation in the department. RESULTS: In this study, males accounted for 52% of cases with a sex ratio of 1.08%. The most represented age group was 16 to 30 years old with 53.25%. The average age was 30 years old. Among dental pathologies, tooth decay was the most represented with 94.14% followed by periodontal disease with 71.82%. This study showed that 79% of patients brushed their teeth. Of the 122 patients who brushed, 41.80% brushed once a day, and 45.80% brushed twice a day. The traumatic horizontal method was the most presented with 78.68%. According to this study, 91% of patients needed oral hygiene education. CONCLUSION: Given this situation, a new orientation of oral health policy based on preventive dentistry is needed to improve the health and quality of life of populations

Aspects epidemiologique et culturel dutatouage gingival dans le service d'odontologie del'infirmerie hopital de Bamako (ihb) au Mali

Le tatouage gingival est une pratique traditionnelle consistant à une pigmentation artificielle de la gencive rose en noire-grise.L'objectif de cette étude était de déterminer la prévalence et le niveau de perception du tatouage gingival chez les femmes venues en consultation dans le service d'odontologie de l'Infirmerie Hôpital de Bamako (Mali).Méthodologie:Il s'agissait d'une étude transversale, descriptive d'une durée de 3 mois allant du 01 janvier au 31 mars 2018. La collecte des données a été faite sur la base d'une fiche d'enquête élaborée à cet effet en fonction des objectifs de l'étude. Les variables étudiées sont les données épidémiologiques et culturelles. Les données ont été traitées par le logiciel épi-info version 3.5.3.Résultats:Dans cette étude, la prévalence du tatouage gingival était de69,43%.La tranche d'âge la plus représentée était celle de 26-35 ans, suivie de cellede 46­55 ans. La localisation au maxillaire seul représentait 90,16% suivi de la localization maxillaire et mandibulaire dans 06,33%.Les peulhs représentaient 39,58% suiviedes Sarakolés dans 32,55%.Selon cette étude, 65, 11% pensaient que le tatouage gingival est jolie (bon).Conclusion:En plus du côté esthétique créé par le contraste des effets de la couleur grise-noire de la gencive avec le blanc-laiteux des dents, le tatouage gingival est souvent utilisé dans le traitement traditionnel des parodontopathies

Assessing health systems in Guinea for prevention and control of priority zoonotic diseases: A One Health approach.

To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014-2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries responsible for human, animal, and environmental health to identify a list of zoonotic diseases - rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza - as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems "maps" emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.

Hémoglobinurie au cours du paludisme grave de l'enfant: Attention au déficit en G6PD à propos de 5 observations

Le paludisme reste un problème majeur de santé publique en Afrique subsaharienne, notamment au Niger où il sévit sur un mode endémique. Un des éléments de gravité est la survenue d'une hémoglobinurie et/ou une anémie. Nous rapportons 5 observations d'anémie par déficit en glucose-6-phosphatase (G6PD) de diagnostic tardif, car mis dans le compte du paludisme grave. Il s'agissait de cinq enfants d'âge moyen de 8,2 ans. 3 des patients étaient de sexe masculin. Tous les cinq patients étaient admis en urgence, référés pour anémie sévère dans un contexte de fièvre. Le nombre moyen d'hospitalisations antérieures était de 4. Les principaux signes à l'admission étaient la pâleur, les douleurs abdominales et des urines couleur porto. La bandelette urinaire a révélé une hémoglobinurie chez tous les patients et une bilirubinurie dans 4 cas. Une notion d'ictère a été retrouvée chez 2 patients, les 3 autres présentaient un ictère clinique. Le taux d'hémoglobine moyen était de 4,4 g/dl. Le taux des plaquettes et le taux de réticulocytes étaient normaux. La goutte épaisse était positive chez tous les patients. Le profil électrophorétique de l'hémoglobine était hétérozygote AS dans 2 cas et homozygote AA dans 3 cas. L'activité enzymatique de la G6PD, dosée à distance de la crise, était effondrée chez tous les patients. Le déficit en G6PD constituant une cause fréquente d'hémoglobinurie et/ou d'anémie chez l'enfant, le bilan étiologique, surtout devant la récurrence de ces signes, devrait en outre comporter un dosage de l'activité enzymatique de la G6PD

First field efficacy trial of the ChAd63 MVA ME-TRAP vectored malaria vaccine candidate in 5-17 months old infants and children.

BACKGROUND: Heterologous prime boost immunization with chimpanzee adenovirus 63 (ChAd63) and Modified Vaccinia Virus Ankara (MVA) vectored vaccines is a strategy previously shown to provide substantial protective efficacy against P. falciparum infection in United Kingdom adult Phase IIa sporozoite challenge studies (approximately 20-25% sterile protection with similar numbers showing clear delay in time to patency), and greater point efficacy in a trial in Kenyan adults. METHODOLOGY: We conducted the first Phase IIb clinical trial assessing the safety, immunogenicity and efficacy of ChAd63 MVA ME-TRAP in 700 healthy malaria exposed children aged 5-17 months in a highly endemic malaria transmission area of Burkina Faso. RESULTS: ChAd63 MVA ME-TRAP was shown to be safe and immunogenic but induced only moderate T cell responses (median 326 SFU/106 PBMC (95% CI 290-387)) many fold lower than in previous trials. No significant efficacy was observed against clinical malaria during the follow up period, with efficacy against the primary endpoint estimate by proportional analysis being 13.8% (95%CI -42.4 to 47.9) at sixth month post MVA ME-TRAP and 3.1% (95%CI -15.0 to 18.3; p = 0.72) by Cox regression. CONCLUSIONS: This study has confirmed ChAd63 MVA ME-TRAP is a safe and immunogenic vaccine regimen in children and infants with prior exposure to malaria. But no significant protective efficacy was observed in this very highly malaria-endemic setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT01635647. Pactr.org PACTR201208000404131.

Oral Hygiene: Knowledge and Practices of Students in Three Quranic Schools in Koutiala, Mali

Objective: To evaluate the knowledge, attitudes, and practices on oral hygiene (OH) of students of three Quranic schools of Koutiala, Mali. Material and Methods: It was carried out a descriptive prospective study with 300 students in three Quranic schools in the city of Koutiala, Mali. The data analyzed with the Epi Info 3.5.4 software. Results: The male sex was the most represented with 57.7% and the sex ratio = 0.73. The most represented age group was 8-12 with 52% with an average age of 17 years and minimum and maximum age of was 8 and 26 years. It was observed that 98.3% of students had a notion of knowledge about oral hygiene and this information was given by parents / elders in 60% of cases. They claimed that people who do not brush their teeth properly are the most likely to get tooth decay in 93.3% of cases. Regarding dental caries, 61.3% of students said that caries is transmitted by lack of oral hygiene; 33.3% of students said that using toothbrushes and having good oral hygiene are ways to avoid oral diseases. It was thought in 93.3% of cases that a good oral hygiene prevents oral diseases. The students brushed their teeth every day (98%) and they had a consultation with the dental surgeon in 8.7% of the cases. Conclusion: This study shows that students had knowledge of oral hygiene and preventive measures. Efforts should be made to promote, prevent, screen and manage oral diseases in Quranic schools while involving parents in the processes.

Knowledge, Attitudes and Practices of Doctors and Dental Surgeons in Bamako on the Relationship Between Periodontal Diseases and Chronic Non-Communicable Diseases

Objective: To assess the level of knowledge, attitudes and practices of doctors and dentists in Bamako on the relationship between chronic non-communicable diseases and periodontal diseases. Material and Methods: A cross-sectional study of 420 physicians and dental surgeons was conducted from March to August 2016. Data analysis involved descriptive statistics (frequency distribution). All statistical analyses were performed using the Epi Info 3.5.4 Software. Results: The male sex was the most represented with 58% for a sex ratio of 1.3. The most represented age group was 30-40 years old (48.8%) with an average age of 33 ± 8.2 years. General practitioners were the most represented in 93.6% of cases. Physicians with no knowledge of periodontal disease accounted for 60% of all cases, and all dental surgeons reported knowledge of chronic noncommunicable conditions in 100% of cases. Physicians and dental surgeons rated their knowledge levels of periodontal disease and chronic disease as inadequate in 98% and 90% of cases, respectively. Examination of the oral cavity by the doctors was "sometimes" carried out in 66% of the cases and the non-demand of the clinical signs of the gingival bleeding (64%) and dental migration (80.5%). They did not make recommendations on oral hygiene in 61.7% of cases. Conclusion: This study shows shortcomings among doctors and dentists in Bamako on the relationship between periodontal diseases and chronic non-communicable diseases. Capacity building and multidisciplinary collaboration are needed to support people's health.

Leucémie aigue lymphoblastique néonatale : À propos d'un cas au CHU Hassan II de Fès au Maroc

La leucémie aiguë lymphoblastique (LAL) néonatale est une affection exceptionnelle et est de mauvais pronostic. Nous décrivons l'observation d'un nouveau-né à Jo de vie, atteint d'une LAL de type B, révélée par un syndrome hémorragique et tumoral en service de réanimation néonatale du CHU Hassan II de Fès, dont l'évolution a été marqué après 25 jours de vie par le décès du patient dans un tableau de lyse tumoral, quelques jours après une chimiothérapie d'induction

Safety and efficacy of re-treatments with pyronaridine-artesunate in African patients with malaria: a substudy of the WANECAM randomised trial.

BACKGROUND: Sparse data on the safety of pyronaridine-artesunate after repeated treatment of malaria episodes restrict its clinical use. We therefore compared the safety of pyronaridine-artesunate after treatment of the first episode of malaria versus re-treatment in a substudy analysis. METHODS: This planned substudy analysis of the randomised, open-label West African Network for Clinical Trials of Antimalarial Drugs (WANECAM) phase 3b/4 trial was done at six health facilities in Mali, Burkina Faso, and Guinea in patients (aged ≥6 months and bodyweight ≥5 kg) with uncomplicated microscopically confirmed Plasmodium spp malaria (parasite density <200 000 per µL blood) and fever or history of fever. The primary safety endpoint was incidence of hepatotoxicity: alanine aminotransferase of greater than five times the upper limit of normal (ULN) or Hy's criteria (alanine aminotransferase or aspartate aminotransferase greater than three times the ULN and total bilirubin more than twice the ULN) after treatment of the first episode of malaria and re-treatment (≥28 days after first treatment) with pyronaridine-artesunate. Pyronaridine-artesunate efficacy was compared with artemether-lumefantrine with the adequate clinical and parasitological response (ACPR) in an intention-to-treat analysis. WANECAM is registered with PACTR.org, number PACTR201105000286876. FINDINGS: Following first treatment, 13 (1%) of 996 patients had hepatotoxicity (including one [<1%] possible Hy's law case) versus two (1%) of 311 patients on re-treatment (neither a Hy's law case). No evidence was found that pyronaridine-artesunate re-treatment increased safety risk based on laboratory values, reported adverse event frequencies, or electrocardiograph findings. For all first treatment or re-treatment episodes, pyronaridine-artesunate (n=673) day 28 crude ACPR was 92·7% (95% CI 91·0-94·3) versus 80·4% (77·8-83·0) for artemether-lumefantrine (n=671). After exclusion of patients with PCR-confirmed new infections, ACPR was similar on treatment and re-treatment and greater than 95% at day 28 and greater than 91% at day 42 in both treatment groups. INTERPRETATION: The findings that pyronaridine-artesunate safety and efficacy were similar on first malaria treatment versus re-treatment of subsequent episodes lend support for the wider access to pyronaridine-artesunate as an alternative artemisinin-based combination treatment for malaria in sub-Saharan Africa. FUNDING: European and Developing Countries Clinical Trial Partnership, Medicines for Malaria Venture (Geneva, Switzerland), UK Medical Research Council, Swedish International Development Cooperation Agency, German Ministry for Education and Research, University Claude Bernard (Lyon, France), Malaria Research and Training Centre (Bamako, Mali), Centre National de Recherche et de Formation sur le Paludisme (Burkina Faso), Institut de Recherche en Sciences de la Santé (Bobo-Dioulasso, Burkina Faso), and Centre National de Formation et de Recherche en Santé Rurale (Republic of Guinea).

Anaerobic biodegradation of sumithion an organophosphorus insecticide used in Burkina Faso agriculture by acclimatized indigenous bacteria.

Biodegradation of Sumithion (o,o-dimethyl o-(3-methyl-4-nitrophenyl) phosphorothioate) was tested using microorganisms isolated from mud under controlled conditions. Results showed that after 2 years of acclimatation, the indigenous microorganisms can biodegrade sumithion under anaerobic conditions. This biodegradation lead to methane production. Biodegradation kinetics monitored by high performance liquid chromatography and gas chromatography showed that the acclimated consortium is able to carry out the biodegradation of 20, 50 and 100 mg L(-1) of Sumithion, respectively in 15, 25 and 45 days. The end products of sumithion biodegradation were gases. Such as CO2, N2, CH4 and H2S. Isolation and partial characterization of a strain able to degrade Sumithion were realized. This strain named SY can be easily produced and used for the bioremediation of waters and soils contaminated by Sumithion.