Contribution of the community health volunteers in the control of Buruli ulcer in Bénin.

BACKGROUND: Buruli ulcer (BU) is a neglected tropical disease caused by Mycobacterium ulcerans. Usually BU begins as a painless nodule, plaque or edema, ultimately developing into an ulcer. The high number of patients presenting with ulcers in an advanced stage is striking. Such late presentation will complicate treatment and have long-term disabilities as a consequence. The disease is mainly endemic in West Africa. The primary strategy for control of this disease is early detection using community village volunteers. METHODOLOGY/PRINCIPAL FINDINGS: In this retrospective, observational study, information regarding Buruli ulcer patients that reported to one of the four BU centers in Bénin between January 2008 and December 2010 was collected using the WHO/BU01 forms. Information used from these forms included general characteristics of the patient, the results of diagnostic tests, the presence of functional limitations at start of treatment, lesion size, patient delay and the referral system. The role of the different referral systems on the stage of disease at presentation in the hospital was analyzed by a logistic regression analysis. About a quarter of the patients (26.5%) were referred to the hospital by the community health volunteers. In our data set, patients referred to the hospital by community health volunteers appeared to be in an earlier stage of disease than patients referred by other methods, but after adjustment by the regression analysis for the health center, this effect could no longer be seen. The Polymerase Chain Reaction (PCR) for IS2404 positivity rate among patients referred by the community health volunteers was not systematically lower than in patients referred by other systems. CONCLUSIONS/SIGNIFICANCE: This study clarifies the role played by community health volunteers in Bénin, and shows that they play an important role in the control of BU.

[Presence of lead in leaves of Solanum macrocarpon cultivated in Cotonou (Benin): role of poorly composted poultry manure]. / Présence du plomb dans les feuilles de Solanum macrocarpon Linn cultivé à Cotonou (Bénin) : rôle des fientes de poulets mal compostées.

This work assesses the impact of the use of chicken manure and irrigation water on the toxicological quality of Solanum macrocarpon, a highly appreciated vegetable. A control site in Glo-Djigbé, gardeners' sites at Houéyiho, Fidjrossè, and Agongbomey were included in the study. Lead has been sought in the environment of S. macrocarpon culture by Atomic Absorption Spectrophotometry (AAS). Regarding the content of lead in the droppings, the averages in mg/kg varied between 0.696 and 3.618. The soil of Houéyiho (46.320±0.651mg/kg) was more contaminated with lead than that of the other sites. The irrigation water used in the study sites was slightly contaminated with lead with values ranging between 0.038 and 0.017mg/L. Leaves taken from the control site, Glo-Djigbé were contaminated with lead with a value of 0.936±0.070mg/kg compared to those of Agongbomey, Houéyiho and Fidjrossè. The leaves of S. macrocarpon were contaminated with lead at significantly values higher than those imposed by the FAO (0.1mg/kg). Consumption without precautions could expose people to diseases related to the accumulation of this metal.

Health-risk market garden production linked to heavy metals in irrigation water in Benin.

Heavy metals in the Benin market garden products: is irrigation water the first factor in question, and what is the level of health risk linked to the consumption of these vegetables? Such are the essential problems that this survey attempts to solve. Comparison of the level of lead (Pb), cadmium (Cd) and arsenic (As) pollution shows that all the vegetables taken from three market sites are differently contaminated, as well as their irrigation water and the soil. But establishing that water is the first factor responsible for the presence of heavy metals in market garden products is not so obvious. Otherwise, the health risk assessment revealed that the total daily exposure dose (DED) of Cd, namely 8.05µg/kg/day, is high compared to the daily dose defined by the WHO, which is 1µg/kg/day. Also, the ensuing quotient of danger (QD) is 8.05; such a value poses public health risks for the consumer.

Determination of enantiomeric purity of S-amlodipine by chiral LC with emphasis on reversal of enantiomer elution order.

An LC method was developed and prevalidated for the enantiomeric purity determination of S-amlodipine in polar organic solvent chromatography using a chlorine-containing cellulose-based chiral stationary phase (CSP). The concentration of formic acid (FA) (0.01-0.2%) in the mobile phase containing acetonitrile as the main solvent was found to influence the elution order of amlodipine enantiomers as well as the enantioresolution. A reversal of the enantiomer elution order of amlodipine was only observed with chiral stationary phases with both electron-withdrawing (chloro) and electron-donating groups (methyl) on the phenyl moieties of the chiral selector, namely cellulose tris(3-chloro-4-methylphenylcarbamate) and cellulose tris(4-chloro-3-methylphenylcarbamate). The highest enantioresolution (Rs : 4.1) value was obtained at the lowest FA concentration (0.01%) using cellulose tris(4-chloro-3-methylphenylcarbamate) as the chiral selector and the enantiomeric impurity, R-amlodipine, eluted first under these conditions. Therefore, the mobile phase selected for the prevalidation of the method consisted of ACN/0.1% DEA/0.01% FA and the temperature was set at 25°C. The method was prevalidated by means of the strategy based on the total measurement error and the accuracy profile. The method was found to be selective and the limit of quantification was found to be about 0.05% for R-amlodipine, while the limit of detection was close to 0.02%.