Pre-exposure prophylaxis among men who have sex with men in Côte d'Ivoire: a quantitative study of acceptability.

This cross sectional study was conducted in 2018 in Côte d'Ivoire to assess PrEP acceptability among men who have sex with men (MSM). Two hundred and one men were asked on their intention to use PrEP if made available. Logistic regression accounting for the sampling design was used to analyze associations between high PrEP acceptability and different independent variables including barriers and facilitators. Participants were mostly young (mean age = 25 years), educated (82% with secondary/postsecondary education) and single (95.5%). On average, 3.4 episodes of anal sex were reported monthly and 37.8% of men did not use a condom at last sex. Most MSM (72.6%) had heard of PrEP before enrollment. Overall, 35.3% reported that they would use PrEP very probably if made available. In multivariate analysis, factors associated with high PrEP acceptability were condom use at last sexual intercourse (Odds ratio (OR) = 2.51; 95%Confidence interval (95%CI) = 1.45-4.33); insertive sex as compared to versatile sex (OR = 2.56; 95%CI = 1.14-5.67); free PrEP delivery (OR = 2.45; 95%CI = 1.07-5.59), concerns about side effects (OR = 0.66; 95%CI = 0.48-0.90), and being preoccupied by the fact that post-PrEP antiretroviral therapy could be inefficient (OR = 0.25; 95%CI = 0.14-0.44). PrEP implementation among MSM in Côte d'Ivoire should be accompanied by awareness raising campaigns explaining its utility.

Diabetes Mellitus among new tuberculosis patients in Bamako, Mali.

INTRODUCTION: Diabetes Mellitus (DM) increases worldwide, mostly in low- and middle-income countries. In Mali, the prevalence in the adult population is estimated at 1.8%, but tuberculosis (TB) patients are not systematically screened. The goal of our study was to determine the prevalence of DM among newly diagnosed TB patients. METHODS: We conducted a cross sectional study and a pilot prospective cohort study in four health centers in Bamako. All patients underwent fasting capillary-blood glucose (FCBG) test at Day 0, and repeated after one-week of TB treatment. Venous FBG test was performed for discrepancies between the two FCBG results. Thereafter, FCBG was performed for pilot study at month-2 (M2) and M5 of TB treatment. RESULTS: Two hundred and one patients were enrolled in this study. Impaired fasting blood glucose was identified in 17 (8.5%), of whom 11 (5.5%) had DM (VFBG >7 mmol/L). Among patients with DM, seven (63.6%) had successful TB treatment outcome, versus 142 (74.7%) of those without DM (p = 0.64), and (OR: 1.69, 95%CI 0.47-6.02). CONCLUSION: The prevalence of DM among TB patients in Bamako exceeds that of the general population and screening at TB diagnosis suffices to identify those with DM. Systematic screening of both diseases will allow better treatment.

Clinical characteristics of non-tuberculous mycobacterial pulmonary infections in Bamako, Mali.

The global spread of non-tuberculous mycobacteria (NTM) may be due to HIV/AIDS and other environmental factors. The symptoms of NTM and tuberculosis (TB) disease are indistinguishable, but their treatments are different. Lack of research on the epidemiology of NTM infections has led to underestimation of its prevalence within TB endemic countries. This study was designed to determine the prevalence and clinical characteristics of pulmonary NTM in Bamako. A cross-sectional study which include 439 suspected cases of pulmonary TB. From 2006 to 2013 a total of 332 (76%) were confirmed to have sputum culture positive for mycobacteria. The prevalence of NTM infection was 9.3% of our study population and 12.3% of culture positive patients. The seroprevalence of HIV in NTM group was 17.1%. Patients who weighed <55 kg and had TB symptoms other than cough were also significantly more likely to have disease due to NTM as compared to those with TB disease who were significantly more likely to have cough and weigh more than 55 kg (OR 0.05 (CI 0.02-0.13) and OR 0.32 (CI 0.11-0.93) respectively). NTM disease burden in Bamako was substantial and diagnostic algorithms for pulmonary disease in TB endemic countries should consider the impact of NTM.

Performance of microscopic observation drug susceptibility for the rapid diagnosis of tuberculosis and detection of drug resistance in Bamako, Mali.

OBJECTIVES: In Mali early detection and treatment of multidrug-resistant tuberculosis (MDR-TB) are still challenging due to the cost, time and/or complexity associated with regular tests. Microscopic Observation Drug Susceptibility (MODS) is a low-cost assay validated by WHO in 2010. It is a liquid-culture-based assay to detect the 'cording' characteristic of Mycobacterium tuberculosis complex and to assess susceptibility to both isoniazid and rifampicin defining multidrug-resistant tuberculosis (MDR-TB). In this study we aimed to evaluate the performance of MODS as diagnostic tool compared with a validated method-Mycobacteria Growth Indicator Tube/Antimicrobial Susceptibility Testing/Streptomycin, Isoniazid, Rifampicin and Ethambutol (MGIT/AST/SIRE). METHODS AND RESULTS: Between January 2010 and October 2015 we included 98 patients with suspected TB in an observational cohort study. The sensitivity and specificity of MODS assay for detecting TB were respectively 94.12% and 85.71% compared with the reference MGIT/7H11 culture, with a Cohen κ coefficient of 0.78 (95% CI 0.517-1.043). The median time to culture positivity for MODS assay and MGIT (plus interquartile range, IQR) was respectively 8 days (IQR 5-11) and 6 days (IQR 5-6). In detecting patients with MDR-TB, the sensitivity and specificity of MODS assay were respectively 100% and 95.92%. The positive predictive value and negative predictive value were, respectively, 66.7% and 100%. The median turnaround times for obtaining MDR-TB results using MODS assay and MGIT/AST/SIRE was respectively 9 days and 35 days. Hence, the MODS assay rapidly identifies MDR-TB in Mali compared with the MGIT/AST/SIRE. CONCLUSION: As an easy, simple, fast and affordable method, the MODS assay could significantly improve the management of TB.

The nucleotide excision repair protein XPC is essential for bulky DNA adducts to promote interleukin-6 expression via the activation of p38-SAPK.

Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants, and many are potent carcinogens. Benzo[a]pyrene (B[a]P), one of the best-studied PAHs, is metabolized ultimately to the genotoxin anti-B[a]P-7,8-dihydrodiol-9,10-epoxide (BPDE). BPDE triggers stress responses linked to gene expression, cell death and survival. So far, the underlying mechanisms that initiate these signal transduction cascades are unknown. Here we show that BPDE-induced DNA damage is recognized by DNA damage sensor proteins to induce activation of the stress-activated protein kinase (SAPK) p38. Surprisingly, the classical DNA damage response, which involves the kinases ATM and ATR, is not involved in p38-SAPK activation by BPDE. Moreover, the induction of p38-SAPK phosphorylation also occurs in the absence of DNA strand breaks. Instead, increased phosphorylation of p38-SAPK requires the nucleotide excision repair (NER) and DNA damage sensor proteins XPC and mHR23B. Interestingly, other genotoxins such as cisplatin (CDDP), hydrogen peroxide and ultraviolet radiation also enhance XPC-dependent p38-SAPK phosphorylation. In contrast, anti-benzo[c]phenanthrene-3,4-dihydrodiol-1,2-epoxide, the DNA adducts of which are not properly recognized by NER, does not trigger p38-SAPK activation. As a downstream consequence, expression and secretion of the pro-inflammatory cytokine interleukin-6 is induced by BPDE and CDDP in vitro and by CDDP in the murine lung, and depends on XPC. In conclusion, we describe a novel pathway in which DNA damage recognition by NER proteins specifically leads to activation of p38-SAPK to promote inflammatory gene expression.

Characterization of indoor dust from Brazil and evaluation of the cytotoxicity in A549 lung cells.

Over the past decade, ambient air particulate matter (PM) has been clearly associated with adverse health effects. In Brazil, small and poor communities are exposed to indoor dust derived from both natural sources, identified as blowing soil dust, and anthropogenic particles from mining activities. This study investigates the physicochemical and mineralogical composition of indoor PM10 dust samples collected in Minas Gerais, Brazil, and evaluates its cytotoxicity and inflammatory potential. The mean PM10 mass concentration was 206 µg/m(3). The high dust concentration in the interior of the residences is strongly related to blowing soil dust. The chemical and mineralogical compositions were determined by ICP-OES and XRD, and the most prominent minerals were clays, Fe-oxide, quartz, feldspars, Al(hydr)oxides, zeolites, and anatase, containing the transition metals Fe, Cr, V, Ni, Cu, Zn, Ti, and Mn as well as the metalloid As. The indoor dust samples presented a low water solubility of about 6 %. In vitro experiments were carried out with human lung alveolar carcinoma cells (A549) to study the toxicological effects. The influence of the PM10 dust samples on cell viability, intracellular formation of reactive oxygen species (ROS), and release of the pro-inflammatory cytokine IL-8 was analysed. The indoor dust showed little effects on alamarBlue reduction indicating unaltered mitochondrial activity. However, significant cell membrane damage, ROS production, and IL-8 release were detected in dependence of dose and time. This study will support the implementation of mitigation actions in the investigated area in Brazil.

Screening of different metal oxide nanoparticles reveals selective toxicity and inflammatory potential of silica nanoparticles in lung epithelial cells and macrophages.

In cell culture studies, foetal calf serum (FCS) comprising numerous different proteins is added, which might coat the surface of engineered nanomaterials (ENMs) and thus could profoundly alter their biological activities. In this study, a panel of industrially most relevant metal oxide nanoparticles (NPs) was screened for toxic effects in A549 lung epithelial cells and RAW264.7 macrophages in the presence and absence of FCS. In medium without FCS amorphous SiO2-NPs were the most cytotoxic NPs and induced a significant pro-inflammatory response in both cell types. An increased anti-oxidative response after exposure to SiO2-NPs was, however, only observed in RAW264.7 macrophages. Furthermore, pre-coating of SiO2-NPs with FCS proteins or simply bovine serum albumin abrogated responses in A549 lung epithelial cells. Thus, the protein corona bound to the surface of SiO2-NPs suppresses their biological effects, an issue which needs to be more carefully considered for in vitro-in vivo extrapolations.

Criteria for initiating highly active antiretroviral therapy and short-term immune response among HIV-1-infected patients in Côte d'Ivoire.

OBJECTIVES: The aims of this study were to determine the predictors of CD4 count below 200 cells/microL and to propose an algorithm for antiretroviral therapy initiation; and to assess the determinants of immune response to highly active antiretroviral therapy (HAART) in Côte d'Ivoire. METHODS: A total of 615 consecutive patients attending an HIV/AIDS day hospital were enrolled in the study. We constructed a score system based on the results of a multivariate logistic regression analysis of the predictors of CD4 count <200 cells/microL with the intention of proposing an algorithm able to accurately designate patients eligible for HAART. We also identified factors associated with a short-term increase in CD4 count >50 cells/microL after HAART initiation. RESULTS: Total lymphocyte count <1200 cells/microL (P<0.0001), lower haemoglobin levels (P<0.0001), and Centers for Disease Control and Prevention (CDC) clinical stages C (P=0.005) and B (P=0.045), as compared with stage A, were associated with CD4 count <200 cells/microL. Nonetheless, no accurate algorithm for HAART initiation was found. Three hundred and three of the 615 patients were treated. Of these 303 patients, 79.5% showed an increase of >50 cells/microL in CD4 count 6 months after HAART initiation (median increase 128 cells/microL). Adherence >or=95% (P=0.022) and increase in absolute total lymphocyte count during follow-up (P<0.0001) were associated with a short-term positive immune response. CONCLUSIONS: Our results support the effectiveness of generic drug combinations in sub-Saharan Africa. In order to enhance the management of HIV disease in sub-Saharan Africa, efforts should target the development of low-cost CD4 cell count laboratory tests.

Rice irrigation and schistosomiasis in savannah and forest areas of Côte d'Ivoire.

Prevalence and intensity of infection of Schistosoma haematobium and Schistosoma mansoni were studied in relation to irrigated rice cultivation in Côte d'Ivoire. Urine and stool samples were collected from 4 to 15-year-old children in 24 villages in the savannah zone and 21 villages in the forest zone. Villages were classified according to surrounding inland valleys into three agro-ecosystems: (R2) full or partial water control allowing two rice cycles per year; (R1) no or partial water control allowing one harvest per year and (R0) absence of rice growing. In the savannah zone, S. haematobium prevalence was 4.8%, 2.3% and 0.7% and S. mansoni prevalence was 16.1%, 11.9% and 2.1% in R2, R1 and R0, respectively. In the forest zone, S. haematobium prevalence was 0.9%, 4.4% and 1.7% and S. mansoni prevalence was 61.3%, 46.6% and 17.5% in R2, in R1 and R0, respectively. Prevalences of S. mansoni adjusted for village effects were significantly different between agro-ecosystems in both zones. Significance of differences between agro-ecosystems of S. haematobium infection were strongly influenced by outlying villages. In savannah rice growing villages, negative binomial regression on infection intensity of each species showed significant positive relations to the surface of rice cultivated inland valleys, whereas uncultivated inland valleys showed no significant relation. However, in forest rice growing villages, S. mansoni infection intensity showed significant positive relations to the surface of uncultivated inland valleys, whereas surface water on rice cultivated land showed significant negative relations with infection intensity of each schistosomiasis species.

Formation of reactive oxygen species in rat epithelial cells upon stimulation with fly ash.

Fly ash was used as a model for ambient particulate matter which is under suspicion to cause adverse pulmonary health effects. The fly ash was pre-sized and contained only particles < 20 microm including an ultrafine fraction (< 100 nm) that contributed 31% to the particle number. In our study, we investigated the influence of fly ash on the promotion of early inflammatory reactions like the formation of reactive oxygen species (ROS) in rat lung epithelial cells (RLE-6TN). Furthermore, we determined the formation of nitric oxide (NO). The cells show a clear dose-response relationship concerning the formation of ROS with regard to the mass of particles applied. Lipopolysaccharide (LPS) added as a co-stimulus did not increase the formation of ROS induced by fly ash. Furthermore, in LPS (0.1 microg/ml) and tumour necrosis factor-alpha (TNF-alpha; 1 ng/ml) pre-treated cells no increase in reactive oxygen species comparable to fly ash alone is observable. In presence of the metal chelator, desferrioxamine (DFO), ROS formation can be significantly reduced. Neither fly ash nor LPS induced a significant NO release in RLE-6TN cells.

Tissue free water tritium and organically bound tritium in the rice plant acutely exposed to atmospheric HTO vapor under semi-outdoor conditions.

Potted rice plants were exposed to atmospheric HTO in a box outdoors for 1 h at 9 different times from booting to yellow-ripe stages. It is indicated that the leaf TFWT concentration may reach equilibrium within 1 h in clear weather. The plant TFWT concentration decreased at a rapid rate for the first several hours and at a much slower rate thereafter. The decrease till harvest was by factors of 600-95,000 depending on the plant parts and exposure times. The time course of the ear OBT concentration was characterized by the exposure time. After exposure at the booting to heading stages, the leaf OBT concentration decreased rapidly for the first several hours and then very slowly. The plant OBT concentration was initially about 2 orders of magnitude lower, but at harvest an order of magnitude higher, than the TFWT concentration. The OBT concentration in hulled seeds at harvest varied with exposure times by a factor of 70, being highest in the exposure performed at the earlier stage of rapid grain growth. Also in this exposure, the plant total OBT was greatest due to the seed OBT.

[Ultrasound aspects of abdominal involvement in adults with HIV infections in the Ivory Coast: apropos of 146 cases]. / Aspects échographiques des atteintes abdominales au cours de l'infection à VIH chez l'adulte de Côte d'Ivoire: à propos de 146 cas]

Over a six-month period, 146 grade IV AIDS patients (HIV-1 and HIV-2) systematically underwent abdominal ultrasound examination. All abdominal organs were investigated in the search for lesions. Many lesions were detected. Pathological lesions were most frequent in the nodes (17.2%), hyperechogenic liver tissue (16.5%) and kidneys (13.7%). Lesions in the liver, gall bladder and spleen were less frequent. In most cases, the lesions were not specific to AIDS. However, systemic abdominal ultrasound scans for AIDS patients would be of value because such lesions are present.

Changes in human schistosomiasis levels after the construction of two large hydroelectric dams in central Côte d'Ivoire.

The construction of large dams has been shown to increase the prevalence and intensity of human schistosomiasis. However, until now no study had been carried out to assess the impact of such a project in Côte d'Ivoire. For Kossou and Taabo, two large dams which became operational in the 1970s, baseline data are available on schistosomiasis prevalence in the surrounding area before dam construction, so that the changes in schistosomiasis levels can be assessed. We re-evaluated the prevalence of Schistosoma haematobium and S. mansoni in November 1992, by analysing 548 urine and 255 stool samples, respectively, from schoolchildren from five villages around each lake. A marked increase in the overall prevalence of S. haematobium was observed, from 14% to 53% around Lake Kossou and from 0 to 73% around Lake Taabo. Baseline data for S. mansoni are only available for Lake Taabo, where a prevalence of 3% was found in 1979 and where the prevalence in 1992 was still low at 2%. The construction of these two large dams therefore led to little change in S. mansoni prevalence but to a significant increase in that of S. haematobium.

Organically bound tritium.

Tritium released into the environment may be incorporated into organic matter. Organically bound tritium in that case will show retention times in organisms that are considerably longer than those of tritiated water which has significant consequences on dose estimates. This article reviews the most important processes of organically bound tritium production and transport through food networks. Metabolic reactions in plant and animal organisms with tritiated water as a reaction partner are of great importance in this respect. The most important production process, in quantitative terms, is photosynthesis in green plants. The translocation of organically bound tritium from the leaves to edible parts of crop plants should be considered in models of organically bound tritium behavior. Organically bound tritium enters the human body on several pathways, either from the primary producers (vegetable food) or at a higher tropic level (animal food). Animal experiments have shown that the dose due to ingestion of organically bound tritium can be up to twice as high as a comparable intake of tritiated water in gaseous or liquid form. In the environment, organically bound tritium in plants and animals is often found to have higher specific tritium concentrations than tissue water. This is not due to some tritium enrichment effects but to the fact that no equilibrium conditions are reached under natural conditions.

Structure of the major oligosaccharides in the fusion glycoprotein of Newcastle disease virus.

The fusion glycoprotein (F0) was isolated from Newcastle disease virus (NDV) particles metabolically labelled with [2-3H]mannose; it was successively digested with protease and with endo-beta-N-acetylglucosaminidase from Streptomyces griseus. In this manner, the majority of the oligosaccharides in NDV F0 could be liberated. After reduction with NaBH4, they were separated by high-performance liquid chromatography, and were subjected to structural analysis. Using micromethylation/capillary gas chromatography/mass fragmentography, alpha-mannosidase digestion, and acetolysis, it was found that the enzymatically released NDV F0 oligosaccharides are common oligomannosidic glycoprotein glycans of size classes (Man)8GlcNAc, Man)7GlcNAc, (Man)6GlcNAc, (Man)9GlcNAc, and (Man)5GlcNAc (in order of prevalence). The major structural isomers present in the NDV F0 (Man)8GlcNAc to (Man)5GlcNAc fractions were shown to lack mannose residues D2, D1D2 or D2D3, D1D2D3, and CD1D2D3, respectively, of (Man)9GlcNAc.

Separation and sugar component analysis of the oligosaccharides in the surface glycoproteins of Newcastle disease virus.

The precursor glycoproteins HN0 and F0 in the surface spikes of Newcastle Disease Virus strain Ulster as produced by MDBK cells, were found to contain 10.4 and 11.9 weight per cent, respectively, of the sugars typical for N-glycosidically linked glycoprotein glycans. A molar ratio of D-mannose:D-galactose: L-fucose:N-acetyl-D-glucosamine approaching 1.0:1.1:0.5:1.0 was found for HN0, and of 1.0:0.7:0.3:0.6 for F0. By a sequence of degradation (with pronase, with endo-beta-N-acetylglucosaminidase H [endo H], and by hydrazinolysis) and separation procedures (Concanavalin A-affinity and Biogel P-4 chromatography), the radiolabelled carbohydrate moieties of NDV HN0 and F0 (as oligosaccharitols) were separated into (at least) ten and eight fractions, respectively. Separate in vivo labelling with tritiated derivatives of the four sugars showed that both glycoproteins contain oligosaccharides of the oligomannosidic ("high mannose"), of the N-acetyllactosaminic ("complex"), as well as of the "mixed" type. The majority of the oligosaccharides in F0, but not of those in HN0, was found to be endo H-sensitive.