2024 |
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Journal Articles |
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Kadiatou Koita, Joel D. Bognini, Efundem Agboraw, Mahamadou Dembélé, Seydou Yabré, Biébo Bihoun, Oumou Coulibaly, Hamidou Niangaly, Jean Batiste N’Takpé, Maia Lesosky, Dario Scaramuzzi, Eve Worrall, Jenny Hill, Valérie Briand, Halidou Tinto, Kassoum Kayentao Increasing the uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) through seasonal malaria chemoprevention channel delivery: protocol of a multicenter cluster randomized implementation trial in Mali and Burkina Faso Journal Article In: BMC public health, vol. 24, iss. 1, 2024, ISSN: 1471-2458. Abstract | BibTeX | Tags: Antimalarials* / therapeutic use, Burkina Faso, Chemoprevention, Child, Clinical Trial Protocol, doi:10.1186/s12889-023-17529-z, Drug Combinations, Female, Humans, Joel D Bognini, Kadiatou Koita, Kassoum Kayentao, Malaria* / drug therapy, Malaria* / prevention & control, Mali, MEDLINE, Multicenter Studies as Topic, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic* / prevention & control, PMC10763117, pmid:38166711, Pregnancy, Pregnancy Complications, Preschool, PubMed Abstract, Pyrimethamine / therapeutic use, Randomized Controlled Trials as Topic, Research Support, Seasons, Sulfadoxine / therapeutic use | Links: @article{Koita2024, Background: The uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) remains unacceptably low, with more than two-thirds of pregnant women in sub-Saharan Africa still not accessing the three or more doses recommended by the World Health Organisation (WHO). In contrast, the coverage of Seasonal Malaria Chemoprevention (SMC), a more recent strategy recommended by the WHO for malaria prevention in children under five years living in Sahelian countries with seasonal transmission, including Mali and Burkina-Faso, is high (up to 90%). We hypothesized that IPTp-SP delivery to pregnant women through SMC alongside antenatal care (ANC) will increase IPTp-SP coverage, boost ANC attendance, and increase public health impact. This protocol describes the approach to assess acceptability, feasibility, effectiveness, and cost-effectiveness of the integrated strategy. Methods and analysis: This is a multicentre, cluster-randomized, implementation trial of IPTp-SP delivery through ANC + SMC vs ANC alone in 40 health facilities and their catchment populations (20 clusters per arm). The intervention will consist of monthly administration of IPTp-SP through four monthly rounds of SMC during the malaria transmission season (July to October), for two consecutive years. Effectiveness of the strategy to increase coverage of three or more doses of IPTp-SP (IPTp3 +) will be assessed using household surveys and ANC exit interviews. Statistical analysis of IPT3 + and four or more ANC uptake will use a generalized linear mixed model. Feasibility and acceptability will be assessed through in-depth interviews and focus group discussions with health workers, pregnant women, and women with a child < 12 months. Discussion: This multicentre cluster randomized implementation trial powered to detect a 45% and 22% increase in IPTp-SP3 + uptake in Mali and Burkina-Faso, respectively, will generate evidence on the feasibility, acceptability, effectiveness, and cost-effectiveness of IPTp-SP delivered through the ANC + SMC channel. The intervention is designed to facilitate scalability and translation into policy by leveraging existing resources, while strengthening local capacities in research, health, and community institutions. Findings will inform the local national malaria control policies. Trial registration: Retrospectively registered on August 11th, 2022; registration # PACTR202208844472053. Protocol v4.0 dated September 04, 2023. Trail sponsor: University of Sciences Techniques and Technologies of Bamako (USTTB), Mali. | |||
Serge Ouoba, Moussa Lingani A new tool for assessing hepatitis B treatment eligibility in Africa Journal Article In: The lancet. Gastroenterology & hepatology, vol. 9, iss. 4, pp. 277-278, 2024, ISSN: 2468-1253. Abstract | BibTeX | Tags: Africa / epidemiology, Chronic* / diagnosis, Chronic* / drug therapy, Chronic* / epidemiology, Hepatitis B, Hepatitis B* / diagnosis, Hepatitis B* / drug therapy, Hepatitis B* / epidemiology, Humans, MEDLINE, Moussa Lingani, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, pmid:38367630, PubMed Abstract, Serge Ouoba | Links: @article{Ouoba2024, Commercially available assays for measuring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike (S) or anti-nucleocapsid (N) antibodies differ in units, making results comparisons challenging. This study aimed to develop conversion equations between five quantitative anti-S antibody tests and to assess the agreement over time between three qualitative anti-N antibody tests. Blood samples from 24 216 vaccinated healthcare workers in Hiroshima Prefecture, Japan, were analyzed for anti-S antibodies using five quantitative tests (Abbott, Fujirebio, Ortho, Sysmex, Roche) and for anti-N antibodies using three qualitative tests (Abbott, Sysmex, Roche). Geometric mean regression was performed to establish equations for converting measured values between the five quantitative tests. Fleiss κ statistic was used to assess the agreement between the three qualitative tests. A strong correlation (Pearson's coefficient r > 0.9) was found for each pair of the five quantitative tests measuring anti-S antibodies, enabling the development of equations to convert values between each pair. Using these equations, which are based on the original output unit of each test, values obtained from one test can be transformed to be equivalent to the corresponding values in another test. For the three tests for anti-N antibodies, the agreement was substantial in the total sample (Fleiss' κ, 0.74) and moderate among those with self-reported past coronavirus disease 2019 (COVID-19) infection (Fleiss' κ, 0.39). The agreement decreased with time after infection. Reduced agreement between anti-N antibodies tests over time suggests caution in comparing seroepidemiological studies of COVID-19 exposure based on anti-N antibodies measurement. The findings could help improve antibody measurement systems and inform public health decision-makers. | |||
Correction: What works in engaging communities? Prioritising nutrition interventions in Burkina Faso, Ghana and South Africa Journal Article In: PloS one, vol. 19, iss. 3, 2024, ISSN: 1932-6203. Abstract | BibTeX | Tags: {CollabAuthor(name='PLOS ONE Staff', MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC10939185, Published Erratum, PubMed Abstract | Links: @article{nokey, This article was republished on March 4, 2024, to correct an error in the author list. Aviva Tugendhaft, on behalf of the INPreP study group, was erroneously not included as the last author. The publisher apologizes for this error. Please download this article again to view the correct version. Both the originally published uncorrected article and the republished corrected article are provided here for reference. | |||
Alassane Dicko, Jean Bosco Ouedraogo, Issaka Zongo, Issaka Sagara, Matthew Cairns, Rakiswendé Serge Yerbanga, Djibrilla Issiaka, Charles Zoungrana, Youssoufa Sidibe, Amadou Tapily, Frédéric Nikièma, Frédéric Sompougdou, Koualy Sanogo, Mahamadou Kaya, Hama Yalcouye, Oumar Mohamed Dicko, Modibo Diarra, Kalifa Diarra, Ismaila Thera, Alassane Haro, Abdoul Aziz Sienou, Seydou Traore, Almahamoudou Mahamar, Amagana Dolo, Irene Kuepfer, Paul Snell, Jane Grant, Jayne Webster, Paul Milligan, Cynthia Lee, Christian Ockenhouse, Opokua Ofori-Anyinam, Halidou Tinto, Abdoulaye Djimde, Daniel Chandramohan, Brian Greenwood Seasonal vaccination with RTS,S/AS01E vaccine with or without seasonal malaria chemoprevention in children up to the age of 5 years in Burkina Faso and Mali: a double-blind, randomised, controlled, phase 3 trial Journal Article In: The Lancet Infectious Diseases, vol. 24, iss. 1, pp. 75-86, 2024, ISSN: 14744457. Abstract | BibTeX | Tags: | Links: @article{Dicko2024, Background: Seasonal vaccination with the RTS,S/AS01E vaccine combined with seasonal malaria chemoprevention (SMC) prevented malaria in young children more effectively than either intervention given alone over a 3 year period. The objective of this study was to establish whether the added protection provided by the combination could be sustained for a further 2 years. Methods: This was a double-blind, individually randomised, controlled, non-inferiority and superiority, phase 3 trial done at two sites: the Bougouni district and neighbouring areas in Mali and Houndé district, Burkina Faso. Children who had been enrolled in the initial 3-year trial when aged 5–17 months were initially randomly assigned individually to receive SMC with sulphadoxine-pyrimethamine and amodiaquine plus control vaccines, RTS,S/AS01E plus placebo SMC, or SMC plus RTS,S/AS01E. They continued to receive the same interventions until the age of 5 years. The primary trial endpoint was the incidence of clinical malaria over the 5-year trial period in both the modified intention-to-treat and per-protocol populations. Over the 5-year period, non-inferiority was defined as a 20% increase in clinical malaria in the RTS,S/AS01E-alone group compared with the SMC alone group. Superiority was defined as a 12% difference in the incidence of clinical malaria between the combined and single intervention groups. The study is registered with ClinicalTrials.gov, NCT04319380, and is complete. Findings: In April, 2020, of 6861 children originally recruited, 5098 (94%) of the 5433 children who completed the initial 3-year follow-up were re-enrolled in the extension study. Over 5 years, the incidence of clinical malaria per 1000 person-years at risk was 313 in the SMC alone group, 320 in the RTS,S/AS01E-alone group, and 133 in the combined group. The combination of RTS,S/AS01E and SMC was superior to SMC (protective efficacy 57·7%, 95% CI 53·3 to 61·7) and to RTS,S/AS01E (protective efficacy 59·0%, 54·7 to 62·8) in preventing clinical malaria. RTS,S/AS01E was non-inferior to SMC (hazard ratio 1·03 [95% CI 0·95 to 1·12]). The protective efficacy of the combination versus SMC over the 5-year period of the study was very similar to that seen in the first 3 years with the protective efficacy of the combination versus SMC being 57·7% (53·3 to 61·7) and versus RTS/AS01E-alone being 59·0% (54·7 to 62·8). The comparable figures for the first 3 years of the study were 62·8% (58·4 to 66·8) and 59·6% (54·7 to 64·0%), respectively. Hospital admissions for WHO-defined severe malaria were reduced by 66·8% (95% CI 40·3 to 81·5), for malarial anaemia by 65·9% (34·1 to 82·4), for blood transfusion by 68·1% (32·6 to 84·9), for all-cause deaths by 44·5% (2·8 to 68·3), for deaths excluding external causes or surgery by 41·1% (−9·2 to 68·3), and for deaths from malaria by 66·8% (−2·7 to 89·3) in the combined group compared with the SMC alone group. No safety signals were detected. Interpretation: Substantial protection against malaria was sustained over 5 years by combining seasonal malaria vaccination with seasonal chemoprevention, offering a potential new approach to malaria control in areas with seasonal malaria transmission. Funding: UK Joint Global Health Trials and PATH's Malaria Vaccine Initiative (through a grant from the Bill & Melinda Gates Foundation). Translation: For the French translation of the abstract see Supplementary Materials section. | |||
Moussa Lingani, Assana Cissé, Abdoul Kader Ilboudo, Issaka Yaméogo, Zekiba Tarnagada Patterns of Non-influenza Respiratory Viruses Among Severe Acute Respiratory Infection Cases in Burkina Faso: A Surveillance Study Journal Article In: Influenza and other respiratory viruses, vol. 18, iss. 3, 2024, ISSN: 1750-2659. Abstract | BibTeX | Tags: Assana Cissé, Betacoronavirus, Burkina Faso / epidemiology, doi:10.1111/irv.13271, Enterovirus*, Human* / epidemiology, Humans, Infant, Influenza, MEDLINE, Moussa Lingani, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Orthomyxoviridae* / genetics, Paramyxoviridae Infections* / epidemiology, PMC10949177, pmid:38501305, Pneumonia*, PubMed Abstract, Respiratory Tract Infections* / epidemiology, Viruses*, Zekiba Tarnagada | Links: @article{Lingani2024, Background: Although influenza viruses cause only one-fifth of severe acute respiratory infections (SARI) in Burkina Faso, the other viral causes of SARI remain poorly investigated to inform clinical and preventive decision making. Methods: Between 2016 and 2019, we prospectively enrolled inpatients meeting the World Health Organization (WHO) case definition of SARI in Burkina Faso. Results of viral etiologies among inpatients tested negative for influenza using the Fast Track Diagnostics Respiratory Kits (FTD-33) were reported. Results: Of 1541 specimens tested, at least one respiratory virus was detected in 76.1% of the 1231 specimens negative for influenza virus. Human rhinoviruses (hRVs) were the most detected pathogens (476; 38.7%), followed by human adenoviruses (hAdV) (17.1%, 210/1231), human respiratory syncytial virus (hRSV) (15.4%, 189/1231), enterovirus (EnV) (11.2%, 138/1231), human bocavirus (hBoV) (7.9%, 97/1231), parainfluenza 3 (hPIV3) (6.1%, 75/1231), human metapneumovirus (hMPV) (6.0%,74/1321), parainfluenza 4 (hPIV4) (4.1%, 51/1231), human coronavirus OC43 (hCoV-OC43) (3.4%, 42/1231), human coronavirus HKU1(hCoV-HKU1) (2.7%, 33/1231), human coronavirus NL63 (hCoV-NL63) (2.5%, 31/1231), parainfluenza 1 (hPIV1) (2.0%, 25/1231), parainfluenza 2 (hPIV2) (1.8%, 22/1231), human parechovirus (PeV) (1.1%, 14/1231), and human coronavirus 229E (hCoV-229E) (0.9%, 11/1231). Among SARI cases, infants aged 1–4 years were mostly affected (50.7%; 622/1231), followed by those <1 year of age (35.7%; 438/1231). Most detected pathogens had year-long circulation patterns, with seasonal peaks mainly observed during the cold and dry seasons. Conclusion: Several non-influenza viruses are cause of SARI in Burkina Faso. The integration of the most common pathogens into the routine influenza surveillance system might be beneficial. | |||
Mehreen S. Datoo, Alassane Dicko, Halidou Tinto, Jean Bosco Ouédraogo, Mainga Hamaluba, Ally Olotu, Emma Beaumont, Fernando Ramos Lopez, Hamtandi Magloire Natama, Sophie Weston, Mwajuma Chemba, Yves Daniel Compaore, Djibrilla Issiaka, Diallo Salou, Athanase M. Some, Sharon Omenda, Alison Lawrie, Philip Bejon, Harish Rao, Daniel Chandramohan, Rachel Roberts, Sandesh Bharati, Lisa Stockdale, Sunil Gairola, Brian M. Greenwood, Katie J. Ewer, John Bradley, Prasad S. Kulkarni, Umesh Shaligram, Adrian V. S. Hill, Almahamoudou Mahamar, Koualy Sanogo, Youssoufa Sidibe, Kalifa Diarra, Mamoudou Samassekou, Oumar Attaher, Amadou Tapily, Makonon Diallo, Oumar Mohamed Dicko, Mahamadou Kaya, Seydina Oumar Maguiraga, Yaya Sankare, Hama Yalcouye, Soumaila Diarra, Sidi Mohamed Niambele, Ismaila Thera, Issaka Sagara, Mala Sylla, Amagana Dolo, Nsajigwa Misidai, Sylvester Simando, Hania Msami, Omary Juma, Nicolaus Gutapaka, Rose Paul, Sarah Mswata, Ibrahim Sasamalo, Kasmir Johaness, Mwantumu Sultan, Annastazia Alexander, Isaac Kimaro, Kauye Lwanga, Mwajuma Mtungwe, Kassim Khamis, Lighton Rugarabam, Wilmina Kalinga, Mohammed Mohammed, Janeth Kamange, Jubilate Msangi, Batuli Mwaijande, Ivanny Mtaka, Matilda Mhapa, Tarsis Mlaganile, Thabit Mbaga, Rakiswende Serge Yerbanga, Wendkouni Samtouma, Abdoul Aziz Sienou, Zachari Kabre, Wendinpui Jedida Muriel Ouedraogo, G. Armel Bienvenu Yarbanga, Issaka Zongo, Hamade Savadogo, Joseph Sanon, Judicael Compaore, Idrissa Kere, Ferdinand Lionel Yoni, Tewende Martine Sanre, Seydou Bienvenu Ouattara, Samuel Provstgaard-Morys, Danielle Woods, Robert W. Snow, Nyaguara Amek, Caroline J. Ngetsa, Lynette Isabella Ochola-Oyier, Jennifer Musyoki, Marianne Munene, Noni Mumba, Uche Jane Adetifa, Charles Mwangi Muiruri, Jimmy Shangala Mwawaka, Mwatasa Hussein Mwaganyuma, Martha Njeri Ndichu, Joseph Ochieng Weya, Kelvin Njogu, Jane Grant, Jayne Webster, Anand Lakhkar, N. Félix André Ido, Ousmane Traore, Marc Christian Tahita, Massa Achille Bonko, Toussaint Rouamba, D. Florence Ouedraogo, Rachidatou Soma, Aida Millogo, Edouard Ouedraogo, Faizatou Sorgho, Fabé Konate, Innocent Valea Safety and efficacy of malaria vaccine candidate R21/Matrix-M in African children: a multicentre, double-blind, randomised, phase 3 trial Journal Article In: Lancet (London, England), vol. 403, iss. 10426, pp. 533-544, 2024, ISSN: 1474-547X. Abstract | BibTeX | Tags: {Alassane Dicko, Antibodies, Burkina Faso, Child, Clinical Trial, Double-Blind Method, Female, Humans, Immunization, Infant, Malaria Vaccines* / adverse effects, Malaria* / drug therapy, Male, MEDLINE, Mehreen S Datoo, Multicenter Study, Nanoparticles*, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Phase III, Preschool, PubMed Abstract, Randomized controlled trial, Research Support, Saponins* | Links: @article{Datoo2024, Background: Recently, we found that a new malaria vaccine, R21/Matrix-M, had over 75% efficacy against clinical malaria with seasonal administration in a phase 2b trial in Burkina Faso. Here, we report on safety and efficacy of the vaccine in a phase 3 trial enrolling over 4800 children across four countries followed for up to 18 months at seasonal sites and 12 months at standard sites. Methods: We did a double-blind, randomised, phase 3 trial of the R21/Matrix-M malaria vaccine across five sites in four African countries with differing malaria transmission intensities and seasonality. Children (aged 5–36 months) were enrolled and randomly assigned (2:1) to receive 5 μg R21 plus 50 μg Matrix-M or a control vaccine (licensed rabies vaccine [Abhayrab]). Participants, their families, investigators, laboratory teams, and the local study team were masked to treatment. Vaccines were administered as three doses, 4 weeks apart, with a booster administered 12 months after the third dose. Half of the children were recruited at two sites with seasonal malaria transmission and the remainder at standard sites with perennial malaria transmission using age-based immunisation. The primary objective was protective efficacy of R21/Matrix-M from 14 days after third vaccination to 12 months after completion of the primary series at seasonal and standard sites separately as co-primary endpoints. Vaccine efficacy against multiple malaria episodes and severe malaria, as well as safety and immunogenicity, were also assessed. This trial is registered on ClinicalTrials.gov, NCT04704830, and is ongoing. Findings: From April 26, 2021, to Jan 12, 2022, 5477 children consented to be screened, of whom 1705 were randomly assigned to control vaccine and 3434 to R21/Matrix-M; 4878 participants received the first dose of vaccine. 3103 participants in the R21/Matrix-M group and 1541 participants in the control group were included in the modified per-protocol analysis (2412 [51·9%] male and 2232 [48·1%] female). R21/Matrix-M vaccine was well tolerated, with injection site pain (301 [18·6%] of 1615 participants) and fever (754 [46·7%] of 1615 participants) as the most frequent adverse events. Number of adverse events of special interest and serious adverse events did not significantly differ between the vaccine groups. There were no treatment-related deaths. 12-month vaccine efficacy was 75% (95% CI 71–79; p<0·0001) at the seasonal sites and 68% (61–74; p<0·0001) at the standard sites for time to first clinical malaria episode. Similarly, vaccine efficacy against multiple clinical malaria episodes was 75% (71–78; p<0·0001) at the seasonal sites and 67% (59–73; p<0·0001) at standard sites. A modest reduction in vaccine efficacy was observed over the first 12 months of follow-up, of similar size at seasonal and standard sites. A rate reduction of 868 (95% CI 762–974) cases per 1000 children-years at seasonal sites and 296 (231–362) at standard sites occurred over 12 months. Vaccine-induced antibodies against the conserved central Asn-Ala-Asn-Pro (NANP) repeat sequence of circumsporozoite protein correlated with vaccine efficacy. Higher NANP-specific antibody titres were observed in the 5–17 month age group compared with 18–36 month age group, and the younger age group had the highest 12-month vaccine efficacy on time to first clinical malaria episode at seasonal (79% [95% CI 73–84]; p<0·001) and standard (75% [65–83]; p<0·001) sites. Interpretation: R21/Matrix-M was well tolerated and offered high efficacy against clinical malaria in African children. This low-cost, high-efficacy vaccine is already licensed by several African countries, and recently received a WHO policy recommendation and prequalification, offering large-scale supply to help reduce the great burden of malaria in sub-Saharan Africa. Funding: The Serum Institute of India, the Wellcome Trust, the UK National Institute for Health Research Oxford Biomedical Research Centre, and Open Philanthropy. | |||
David Twesigomwe, Britt I. Drögemöller, Galen E. B. Wright, Clement Adebamowo, Godfred Agongo, Palwendé R. Boua, Mogomotsi Matshaba, Maria Paximadis, Michèle Ramsay, Gustave Simo, Martin C. Simuunza, Caroline T. Tiemessen, Zané Lombard, Scott Hazelhurst Characterization of CYP2B6 and CYP2A6 Pharmacogenetic Variation in Sub-Saharan African Populations Journal Article In: Clinical pharmacology and therapeutics, vol. 115, iss. 3, pp. 576-594, 2024, ISSN: 1532-6535. Abstract | BibTeX | Tags: Africa South of the Sahara, Alleles, Britt I Drögemöller, Cytochrome P-450 CYP2A6 / genetics, Cytochrome P-450 CYP2B6 / genetics, David Twesigomwe, doi:10.1002/cpt.3124, Gene Frequency, Genotype, Humans, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Nicotine*, NIH, NLM, Non-U.S. Gov't, Pharmacogenetics*, pmid:38049200, PubMed Abstract, Research Support, Scott Hazelhurst | Links: @article{Twesigomwe2024, Genetic variation in CYP2B6 and CYP2A6 is known to impact interindividual response to antiretrovirals, nicotine, and bupropion, among other drugs. However, the full catalogue of clinically relevant pharmacogenetic variants in these genes is yet to be established, especially across African populations. This study therefore aimed to characterize the star allele (haplotype) distribution in CYP2B6 and CYP2A6 across diverse and understudied sub-Saharan African (SSA) populations. We called star alleles from 961 high-depth full genomes using StellarPGx, Aldy, and PyPGx. In addition, we performed CYP2B6 and CYP2A6 star allele frequency comparisons between SSA and other global biogeographical groups represented in the new 1000 Genomes Project high-coverage dataset (n = 2,000). This study presents frequency information for star alleles in CYP2B6 (e.g., *6 and *18; frequency of 21–47% and 2–19%, respectively) and CYP2A6 (e.g., *4, *9, and *17; frequency of 0–6%, 3–10%, and 6–20%, respectively), and predicted phenotypes (for CYP2B6), across various African populations. In addition, 50 potentially novel African-ancestry star alleles were computationally predicted by StellarPGx in CYP2B6 and CYP2A6 combined. For each of these genes, over 4% of the study participants had predicted novel star alleles. Three novel star alleles in CYP2A6 (*54, *55, and *56) and CYP2B6 apiece, and several suballeles were further validated via targeted Single-Molecule Real-Time resequencing. Our findings are important for informing the design of comprehensive pharmacogenetic testing platforms, and are highly relevant for personalized medicine strategies, especially relating to antiretroviral medication and smoking cessation treatment in Africa and the African diaspora. More broadly, this study highlights the importance of sampling diverse African ethnolinguistic groups for accurate characterization of the pharmacogene variation landscape across the continent. | |||
CABU-EICO consortium Evaluating the effect of a behavioural intervention bundle on antibiotic use, quality of care, and household transmission of resistant Enterobacteriaceae in intervention versus control clusters in rural Burkina Faso and DR Congo (CABU-EICO) Journal Article In: Trials, vol. 25, iss. 1, pp. 91, 2024, ISSN: 1745-6215. Abstract | BibTeX | Tags: {Anti-Bacterial Agents* / adverse effects, Burkina Faso / epidemiology, Democratic Republic of the Congo / epidemiology, Enterobacteriaceae*, Humans, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC10821568, PubMed Abstract, Randomized controlled trial, Surveys and Questionnaires | Links: @article{nokey, BACKGROUND: Antimicrobial resistance (AMR) is a rising threat in low-resource settings, largely driven by transmission in the community, outside health facilities. Inappropriate antibiotic use is one of the main modifiable drivers of AMR. Its risk is especially high in poor resource settings, with limited diagnostic and surveillance capacities, and many informal medicine vendors determining community use. We hypothesise that to optimise community antibiotic use, especially Watch antibiotics (recommended only as first-choice for more severe clinical presentations or for causative pathogens likely to be resistant to Access antibiotics), both the supply side (medicine vendors) and the demand side (communities) should be pro-actively involved in any intervention. METHODS: In two existing demographic health surveillance sites (HDSS) in Burkina Faso and in the Democratic Republic of Congo, behavioural intervention bundles were co-created in a participatory approach, aiming to rationalise (Watch) antibiotic use and improve hygiene and sanitation practices. Bundles consisted of interactive interventions, including theatre, posters, discussions, etc. To evaluate impact, 11 of 22 clusters (a HDSS community with at least one (in)formal medicine vendor) were randomly assigned to this intervention, which will run over a year. The effect of the intervention will be evaluated by comparing outcomes before and after in intervention and control villages from a) exit interviews of clients from vendors, b) mystery patients presenting to vendors with a set of predefined symptoms, c) household interviews to assess behavioural changes related to antibiotic use, health literacy and water-sanitation-hygiene indicators. Long-term impact on AMR will be estimated by modelling changes in resistant Enterobacteriaceae carriage from repeated household surveys before, during and after the intervention in both arms. DISCUSSION: Most existing interventions aimed at improving antibiotic use focus on health care use, but in resource-limited settings, community use is highly prevalent. Previous studies targeting only providers failed to show an effect on antibiotic use. Evaluation will be done with before-after epidemiological measurements of actual prescriptions and use. If effective in reducing (Watch) antibiotic use, this would be an empowering methodology for communities, which has significant promise for long-term impact. TRIAL REGISTRATION: ClinicalTrials.gov NCT05378880 . 13 May 2022. | |||
Palpouguini Lompo, Anne Sophie Heroes, Kadija Ouédraogo, Patient Okitale, Abel Wakpo, Jocelyne Kalema, Octavie Lunguya, Halidou Tinto, Dissou Affolabi, Lassana Sangaré, Jan Jacobs Knowledge, awareness, and risk practices related to bacterial contamination of antiseptics, disinfectants, and hand hygiene products among healthcare workers in sub-saharan Africa: a cross-sectional survey in three tertiary care hospitals (Benin, Burkina Faso, and DR Congo) Journal Article In: Antimicrobial resistance and infection control, vol. 13, iss. 1, 2024, ISSN: 2047-2994. Abstract | BibTeX | Tags: Anne-Sophie Heroes, Anti-Infective Agents, bacteria, Benin, Burkina Faso, Chlorine, Cross-Sectional Studies, Democratic Republic of the Congo, Disinfectants*, doi:10.1186/s13756-024-01396-3, Ethanol, Hand Hygiene*, Hospital, Humans, Jan Jacobs, Local*, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Palpouguini Lompo, Personnel, PMC11020199, pmid:38627805, PubMed Abstract, Soaps, Tertiary Care Centers | Links: @article{Lompo2024, Background: Antiseptics, disinfectants, and hand hygiene products can be contaminated with bacteria and cause healthcare-associated infections, which are underreported from low- and middle-income countries. To better understand the user-related risk factors, we conducted a knowledge, awareness, and practice survey among hospital staff in sub-Saharan Africa. Methods: Self-administered questionnaire distributed among healthcare workers in three tertiary care hospitals (Burkina Faso, Benin, Democratic Republic of the Congo). Results: 617 healthcare workers (85.3% (para)medical and 14.7% auxiliary staff) participated. Less than half (45.5%) had been trained in Infection Prevention & Control (IPC), and only 15.7% were trained < 1 year ago. Near two-thirds (64.2%) preferred liquid soap for hand hygiene, versus 33.1% for alcohol-based hand rub (ABHR). Most (58.3%) expressed confidence in the locally available products. Knowledge of product categories, storage conditions and shelf-life was inadequate: eosin was considered as an antiseptic (47.5% of (para)medical staff), the shelf life and storage conditions (non-transparent container) of freshly prepared chlorine 0.5% were known by only 42.6% and 34.8% of participants, respectively. Approximately one-third of participants approved using tap water for preparation of chlorine 0.5% and liquid soap. Most participants (> 80%) disapproved recycling soft-drink bottles as liquid soap containers. Nearly two-thirds (65.0%) declared that bacteria may be resistant to and survive in ABHR, versus 51.0% and 37.4% for povidone iodine and chlorine 0.5%, respectively. Depicted risk practices (n = 4) were ignored by 30 to 40% of participants: they included touching the rim or content of stock containers with compresses or small containers, storing of cotton balls soaked in an antiseptic, and hand-touching the spout of pump dispenser. Filling containers by topping-up was considered good practice by 18.3% of participants. Half (52.1%) of participants acknowledged indefinite reuse of containers. Besides small differences, the findings were similar across the study sites and professional groups. Among IPC-trained staff, proportions recognizing all 4 risk practices were higher compared to non-trained staff (35.9% versus 23.8%, p < 0.0001). Conclusions: The present findings can guide tailored training and IPC implementation at the healthcare facility and national levels, and sensitize stakeholders’ and funders’ interest. | |||
Houreratou Barry, Edouard Lhomme, Mathieu Surénaud, Moumini Nouctara, Cynthia Robinson, Viki Bockstal, Innocent Valea, Serge Somda, Halidou Tinto, Nicolas Meda, Brian Greenwood, Rodolphe Thiébaut, Christine Lacabaratz Helminth exposure and immune response to the two-dose heterologous Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen Journal Article In: PLoS neglected tropical diseases, vol. 18, iss. 4, 2024, ISSN: 1935-2735. Abstract | BibTeX | Tags: Adolescent, Adult, Africa, Aged, Animals, Antibodies, Child, Christine Lacabaratz, Cytokines / immunology, doi:10.1371/journal.pntd.0011500, Ebola Vaccines* / administration & dosage, Ebola Vaccines* / immunology, Ebola* / immunology, Ebola* / prevention & control, Ebolavirus / genetics, Ebolavirus / immunology, Edouard Lhomme, Enzyme-Linked Immunosorbent Assay, Female, Helminth / blood, Helminthiasis / immunology, Helminthiasis / prevention & control, Helminths / genetics, Helminths / immunology, Hemorrhagic Fever, Houreratou Barry, Humans, Immunoglobulin G / blood, Male, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC11037528, pmid:38603720, Preschool, PubMed Abstract, Research Support, Viral* / blood, Young Adult | Links: @article{Barry2024, Background The exposure to parasites may influence the immune response to vaccines in endemic African countries. In this study, we aimed to assess the association between helminth exposure to the most prevalent parasitic infections, schistosomiasis, soil transmitted helminths infection and filariasis, and the Ebola virus glycoprotein (EBOV GP) antibody concentration in response to vaccination with the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen in African and European participants using samples obtained from three international clinical trials. Methods/Principal findings We conducted a study in a subset of participants in the EBL2001, EBL2002 and EBL3001 clinical trials that evaluated the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen against EVD in children, adolescents and adults from the United Kingdom, France, Burkina Faso, Cote d’Ivoire, Kenya, Uganda and Sierra Leone. Immune markers of helminth exposure at baseline were evaluated by ELISA with three commercial kits which detect IgG antibodies against schistosome, filarial and Strongyloides antigens. Luminex technology was used to measure inflammatory and activation markers, and Th1/Th2/Th17 cytokines at baseline. The association between binding IgG antibodies specific to EBOV GP (measured on day 21 post-dose 2 and on Day 365 after the first dose respectively), and helminth exposure at baseline was evaluated using a multivariable linear regression model adjusted for age and study group. Seventy-eight (21.3%) of the 367 participants included in the study had at least one helminth positive ELISA test at baseline, with differences of prevalence between studies and an increased prevalence with age. The most frequently detected antibodies were those to Schistosoma mansoni (10.9%), followed by Acanthocheilonema viteae (9%) and then Strongyloides ratti (7.9%). Among the 41 immunological analytes tested, five were significantly (p < .003) lower in participants with at least one positive helminth ELISA test result: CCL2/MCP1, FGFbasic, IL-7, IL-13 and CCL11/Eotaxin compared to participants with negative helminth ELISA tests. No significant association was found with EBOV-GP specific antibody concentration at 21 days post-dose 2, or at 365 days post-dose 1, adjusted for age group, study, and the presence of any helminth antibodies at baseline. Conclusions/Significance No clear association was found between immune markers of helminth exposure as measured by ELISA and post-vaccination response to the Ebola Ad26.ZEBOV/ MVA-BN-Filo vaccine regimen. Trial registration NCT02416453, NCT02564523, NCT02509494. ClinicalTrials.gov. | |||
Nora Schmit, Hillary M. Topazian, H. Magloire Natama, Duncan Bellamy, Ousmane Traoré, M. Athanase Somé, Toussaint Rouamba, Marc Christian Tahita, Massa Achille Bonko, Aboubakary Sourabié, Hermann Sorgho, Lisa Stockdale, Samuel Provstgaard-Morys, Jeremy Aboagye, Danielle Woods, Katerina Rapi, Mehreen S. Datoo, Fernando Ramos Lopez, Giovanni D. Charles, Kelly McCain, Jean Bosco Ouedraogo, Mainga Hamaluba, Ally Olotu, Alassane Dicko, Halidou Tinto, Adrian V. S. Hill, Katie J. Ewer, Azra C. Ghani, Peter Winskill The public health impact and cost-effectiveness of the R21/Matrix-M malaria vaccine: a mathematical modelling study Journal Article In: The Lancet. Infectious diseases, vol. 24, iss. 5, pp. 465-475, 2024, ISSN: 1474-4457. Abstract | BibTeX | Tags: Antibodies, Burkina Faso / epidemiology, Child, Cost-Benefit Analysis*, Falciparum* / economics, Falciparum* / epidemiology, Falciparum* / prevention & control, Female, Hillary M Topazian, Humans, Infant, Malaria, Malaria Vaccines* / administration & dosage, Malaria Vaccines* / economics, Malaria Vaccines* / immunology, Male, MEDLINE, Models, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Nora Schmit, Peter Winskill, Plasmodium falciparum / immunology, pmid:38342107, Preschool, Protozoan / blood, Protozoan Proteins / immunology, Public Health* / economics, PubMed Abstract, Research Support, Theoretical*, Vaccine Efficacy | Links: @article{Schmit2024, Background: The R21/Matrix-M vaccine has demonstrated high efficacy against Plasmodium falciparum clinical malaria in children in sub-Saharan Africa. Using trial data, we aimed to estimate the public health impact and cost-effectiveness of vaccine introduction across sub-Saharan Africa. Methods: We fitted a semi-mechanistic model of the relationship between anti-circumsporozoite protein antibody titres and vaccine efficacy to data from 3 years of follow-up in the phase 2b trial of R21/Matrix-M in Nanoro, Burkina Faso. We validated the model by comparing predicted vaccine efficacy to that observed over 12–18 months in the phase 3 trial. Integrating this framework within a mathematical transmission model, we estimated the cases, malaria deaths, and disability-adjusted life-years (DALYs) averted and cost-effectiveness over a 15-year time horizon across a range of transmission settings in sub-Saharan Africa. Cost-effectiveness was estimated incorporating the cost of vaccine introduction (dose, consumables, and delivery) relative to existing interventions at baseline. We report estimates at a median of 20% parasite prevalence in children aged 2–10 years (PfPR2–10) and ranges from 3% to 65% PfPR2–10. Findings: Anti-circumsporozoite protein antibody titres were found to satisfy the criteria for a surrogate of protection for vaccine efficacy against clinical malaria. Age-based implementation of a four-dose regimen of R21/Matrix-M vaccine was estimated to avert 181 825 (range 38 815–333 491) clinical cases per 100 000 fully vaccinated children in perennial settings and 202 017 (29 868–405 702) clinical cases per 100 000 fully vaccinated children in seasonal settings. Similar estimates were obtained for seasonal or hybrid implementation. Under an assumed vaccine dose price of US$3, the incremental cost per clinical case averted was $7 (range 4–48) in perennial settings and $6 (3–63) in seasonal settings and the incremental cost per DALY averted was $34 (29–139) in perennial settings and $30 (22–172) in seasonal settings, with lower cost-effectiveness ratios in settings with higher PfPR2–10. Interpretation: Introduction of the R21/Matrix-M malaria vaccine could have a substantial public health benefit across sub-Saharan Africa. Funding: The Wellcome Trust, the Bill & Melinda Gates Foundation, the UK Medical Research Council, the European and Developing Countries Clinical Trials Partnership 2 and 3, the NIHR Oxford Biomedical Research Centre, and the Serum Institute of India, Open Philanthropy. | |||
Peter J. Neyer, Bérenger Kaboré, Christos T. Nakas, Salou Diallo, Halidou Tinto, Annelies Post, Andre J. Ven, Andreas R. Huber, Carlo R. Largiadèr, Angelika Hammerer-Lercher Increased erythroferrone levels in malarial anaemia Journal Article In: British journal of haematology, vol. 204, iss. 5, pp. 2066-2070, 2024, ISSN: 1365-2141. Abstract | BibTeX | Tags: Anemia, Anemia / blood, Anemia / etiology, Angelika Hammerer-Lercher, Animals, Bérenger Kaboré, Biomarkers* / blood, doi:10.1111/bjh.19309, Female, Hepcidins / blood, Humans, Iron / blood, Iron / metabolism, Iron-Deficiency / blood, Malaria* / blood, Malaria* / complications, Male, MEDLINE, Mice, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Peptide Hormones* / blood, Peter J Neyer, pmid:38279554, PubMed Abstract | Links: @article{Neyer2024, We assessed the diagnostic potential of erythroferrone as a biomarker for iron homeostasis comparing iron deficiency cases with anaemia of inflammation and controls. The dysregulation of the hepcidin axis was observed by Latour et al. in a mouse model of malarial anaemia induced by prolonged Plasmodium infection leading to increased erythroferrone concentrations. In line with that, we found significantly higher erythroferrone levels in cases with malaria and anaemia in an African population, compared to asymptomatic controls. Therefore, our findings extend the previous ones of the mouse model, suggesting also a dysregulation of the hepcidin axis in humans, which should be further corroborated in prospective studies and may lay the basis for the development of improved treatment strategies according to ERFE concentrations in such patients. | |||
Jean-Tristan Brandenburg, Wenlong Carl Chen, Palwende Romuald Boua, Melanie Ann Govender, Godfred Agongo, Lisa K Micklesfield, Hermann Sorgho, Stephen Tollman, Gershim Asiki, Felistas Mashinya, Scott Hazelhurst, Andrew P Morris, June Fabian, Michèle Ramsay Genetic Association and Transferability for Urinary Albumin-Creatinine Ratio as a Marker of Kidney Disease in four Sub-Saharan African Populations and non-continental Individuals of African Ancestry Journal Article In: medRxiv : the preprint server for health sciences, 2024. Abstract | BibTeX | Tags: doi:10.1101/2024.01.17.24301398, Jean-Tristan Brandenburg, MEDLINE, Michèle Ramsay, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC10827237, pmid:38293229, Preprint, PubMed Abstract, Wenlong Carl Chen | Links: @article{Brandenburg2024, BACKGROUND Genome-wide association studies (GWAS) have predominantly focused on populations of European and Asian ancestry, limiting our understanding of genetic factors influencing kidney disease in Sub-Saharan African (SSA) populations. This study presents the largest GWAS for urinary albumin-to-creatinine ratio (UACR) in SSA individuals, including 8,970 participants living in different African regions and an additional 9,705 non-resident individuals of African ancestry from the UK Biobank and African American cohorts. METHODS Urine biomarkers and genotype data were obtained from two SSA cohorts (AWI-Gen and ARK), and two non-resident African-ancestry studies (UK Biobank and CKD-Gen Consortium). Association testing and meta-analyses were conducted, with subsequent fine-mapping, conditional analyses, and replication studies. Polygenic scores (PGS) were assessed for transferability across populations. RESULTS Two genome-wide significant (P<5x10-8) UACR-associated loci were identified, one in the BMP6 region on chromosome 6, in the meta-analysis of resident African individuals, and another in the HBB region on chromosome 11 in the meta-analysis of non-resident SSA individuals, as well as the combined meta-analysis of all studies. Replication of previous significant results confirmed associations in known UACR-associated regions, including THB53, GATM, and ARL15. PGS estimated using previous studies from European ancestry, African ancestry, and multi-ancestry cohorts exhibited limited transferability of PGS across populations, with less than 1% of observed variance explained. CONCLUSION This study contributes novel insights into the genetic architecture of kidney disease in SSA populations, emphasizing the need for conducting genetic research in diverse cohorts. The identified loci provide a foundation for future investigations into the genetic susceptibility to chronic kidney disease in underrepresented African populations Additionally, there is a need to develop integrated scores using multi-omics data and risk factors specific to the African context to improve the accuracy of predicting disease outcomes. METHODS Urine biomarkers and genotype data were obtained from two SSA cohorts (AWI-Gen and ARK), and two non-resident African-ancestry studies (UK Biobank and CKD-Gen Consortium). Association testing and meta-analyses were conducted, with subsequent fine-mapping, conditional analyses, and replication studies. Polygenic scores (PGS) were assessed for transferability across populations. RESULTS Two genome-wide significant (P<5x10-8) UACR-associated loci were identified, one in the BMP6 region on chromosome 6, in the meta-analysis of resident African individuals, and another in the HBB region on chromosome 11 in the meta-analysis of non-resident SSA individuals, as well as the combined meta-analysis of all studies. Replication of previous significant results confirmed associations in known UACR-associated regions, including THB53, GATM, and ARL15. PGS estimated using previous studies from European ancestry, African ancestry, and multi-ancestry cohorts exhibited limited transferability of PGS across populations, with less than 1% of observed variance explained. CONCLUSION This study contributes novel insights into the genetic architecture of kidney function in SSA populations, emphasizing the need for conducting genetic research in diverse cohorts. The identified loci provide a foundation for future investigations into the genetic susceptibility to chronic kidney disease in underrepresented African populations. | |||
Bryony Simmons, Elisa Sicuri, Jane Carter, Asrat Hailu, Francois Kiemde, Petra Mens, Davis Mumbengegwi, Bakri Nour, René Paulussen, Henk Schallig, Halidou Tinto, Norbert Dijk, Lesong Conteh Defining a malaria diagnostic pathway from innovation to adoption: Stakeholder perspectives on data and evidence gaps Journal Article In: PLOS global public health, vol. 4, iss. 5, 2024, ISSN: 2767-3375. Abstract | BibTeX | Tags: Bryony Simmons, doi:10.1371/journal.pgph.0002957, Elisa Sicuri, Lesong Conteh, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11098419, pmid:38753739, PubMed Abstract | Links: @article{Simmons2024, Malaria, a major global health concern, requires effective diagnostic tools for patient care, disease control, and elimination. The pathway from concept to the adoption of diagnostic products is complex, involving multiple steps and stakeholders. To map this process, our study introduces a malaria-specific diagnostic pathway, synthesising existing frameworks with expert insights. Comprising six major stages and 31 related activities, the pathway retains the core stages from existing frameworks and integrates essential malaria diagnostic activities, such as WHO prequalification processes, global stakeholder involvement, and broader health systems considerations. To understand the scope and availability of evidence guiding the activities along this pathway, we conducted an online survey with 113 participants from various stages of the malaria diagnostic pathway. The survey assessed perceptions on four critical attributes of evidence: clear requirements, alignment with user needs, accuracy and reliability, and public and free availability. It also explored the types of evidence used and the challenges and potential solutions related to evidence generation and use. Respondents reported using a broad range of formal and informal data sources. Findings indicated differing levels of agreement on the attributes across pathway stages, with notable challenges in the Approvals and Manufacturing stage and consistent concerns regarding the public availability of data/evidence. The study offers valuable insights for optimising evidence generation and utilisation across the malaria diagnostic pathway. It highlights the need for enhanced stakeholder collaboration, improved data availability, and increased funding to support effective evidence generation, sharing, and use. We propose actionable solutions, including the use of public data repositories, progressive data sharing policies, open-access publishing, capacity-building initiatives, stakeholder engagement | |||
Ulugbek Khudayberdievich Mirzaev, Serge Ouoba, Ko Ko, Zayar Phyo, Chanroth Chhoung, Akuffo Golda Ataa, Aya Sugiyama, Tomoyuki Akita, Junko Tanaka Systematic review and meta-analysis of hepatitis E seroprevalence in Southeast Asia: a comprehensive assessment of epidemiological patterns Journal Article In: BMC infectious diseases, vol. 24, iss. 1, 2024, ISSN: 1471-2334. Abstract | BibTeX | Tags: Asia, doi:10.1186/s12879-024-09349-2, Female, Hepatitis Antibodies* / blood, Hepatitis E virus* / immunology, Hepatitis E* / blood, Hepatitis E* / epidemiology, Humans, Immunoglobulin G* / blood, Immunoglobulin M* / blood, Junko Tanaka, Male, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11127338, pmid:38789918, Pregnancy, Prevalence, PubMed Abstract, Risk Factors, Serge Ouoba, Seroepidemiologic Studies, Southeastern / epidemiology, Systematic review, Ulugbek Khudayberdievich Mirzaev | Links: @article{Mirzaev2024, The burden of hepatitis E in Southeast Asia is substantial, influenced by its distinct socio-economic and environmental factors, as well as variations in healthcare systems. The aim of this study was to assess the pooled seroprevalence of hepatitis E across countries within the Southeast Asian region by the UN division. The study analyzed 66 papers across PubMed, Web of Science, and Scopus databases, encompassing data from of 44,850 individuals focusing on anti-HEV seroprevalence. The investigation spanned nine countries, excluding Brunei and East Timor due to lack of data. The pooled prevalence of anti-HEV IgG was determined to be 21.03%, with the highest prevalence observed in Myanmar (33.46%) and the lowest in Malaysia (5.93%). IgM prevalence was highest in Indonesia (12.43%) and lowest in Malaysia (0.91%). The study stratified populations into high-risk (farm workers, chronic patients) and low-risk groups (general population, blood donors, pregnant women, hospital patients). It revealed a higher IgG—28.9%, IgM—4.42% prevalence in the former group, while the latter group exhibited figures of 17.86% and 3.15%, respectively, indicating occupational and health-related vulnerabilities to HEV. A temporal analysis (1987–2023), indicated an upward trend in both IgG and IgM prevalence, suggesting an escalating HEV burden. These findings contribute to a better understanding of HEV seroprevalence in Southeast Asia, shedding light on important public health implications and suggesting directions for further research and intervention strategies. Key points Research Question Investigate the seroprevalence of hepatitis E virus (HEV) in Southeast Asian countries focusing on different patterns, timelines, and population cohorts. Findings Sporadic Transmission of IgG and IgM Prevalence: • Pooled anti-HEV IgG prevalence: 21.03% • Pooled anti-HEV IgM prevalence: 3.49% Seroprevalence among specific groups: High-risk group (farm workers and chronic patients): • anti-HEV IgG: 28.9% • anti-HEV IgM: 4.42% Low-risk group (general population, blood donors, pregnant women, hospital patients): • anti-HEV IgG: 17.86% • anti-HEV IgM: 3.15% Temporal Seroprevalence of HEV: Anti-HEV IgG prevalence increased over decades (1987–1999; 2000–2010; 2011–2023): 12.47%, 18.43%, 29.17% as an anti-HEV IgM prevalence: 1.92%, 2.44%, 5.27% Importance Provides a comprehensive overview of HEV seroprevalence in Southeast Asia. Highlights variation in seroprevalence among different population groups. Reveals increasing trend in HEV seroprevalence over the years. Distinguishes between sporadic and epidemic cases for a better understanding of transmission dynamics. | |||
Golda Ataa Akuffo, Serge Ouoba, Ko Ko, Chanroth Chhoung, Zayar Phyo, Ulugbek Khudayberdievich Mirzaev, Aya Sugiyama, Tomoyuki Akita, Junko Tanaka Assessing the diagnostic accuracy of serological tests for hepatitis delta virus diagnosis: a systematic review and meta-analysis Journal Article In: Scientific reports, vol. 14, iss. 1, 2024, ISSN: 2045-2322. Abstract | BibTeX | Tags: doi:10.1038/s41598-024-69304-8, Golda Ataa Akuffo, Hepatitis Antibodies / blood, Hepatitis D* / blood, Hepatitis D* / diagnosis, Hepatitis D* / immunology, Hepatitis D* / virology, Hepatitis Delta Virus* / immunology, Humans, Immunoglobulin G / blood, Immunoglobulin M / blood, Junko Tanaka, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11316141, pmid:39122751, PubMed Abstract, Sensitivity and Specificity*, Serge Ouoba, Serologic Tests* / methods, Serologic Tests* / standards, Systematic review | Links: @article{Akuffo2024, Hepatitis Delta Virus (HDV), a satellite virus of Hepatitis B virus, exacerbates liver damage in affected individuals. Screening for HDV antibodies in HBsAg positive patients is recommended, but the diagnostic accuracy of serological tests remains uncertain. This review aimed to assess the diagnostic accuracy of serological tests for HDV. We searched PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Scopus etc. for relevant studies. Studies measuring the sensitivity and specificity of serological HDV tests against PCR as a reference standard were included. Pooled sensitivity and specificity for each test method and sero-marker were calculated. The review included six studies with 11 study arms, evaluating ARCHITECT immunoassay, EIA, ELISA, QMAC, RIA, and Western Blot test methods targeting Anti-HDV IgG, Total anti-HDV and Anti-HDV IgM. Sensitivities for Anti-HDV IgG, Total Anti-HDV and Anti-HDV IgM, tests were 97.4%, 51.9%, and 62.0%, respectively, with specificities of 95.3%, 80.0%, and 85.0%. Our findings, with its limited number of studies, suggest that HDV serological tests, particularly those identifying Anti IgG exhibit high accuracy and can serve as effective screening tools for HDV. | |||
Hervé Bassinga, Mady Ouedraogo, Kadari Cisse, Parfait Yira, Sibiri Clément Ouedraogo, Abdou Nombré, Wofom Lydie Marie Bernard Bance, Mathias Kuepie, Toussaint Rouamba Prevalence of asymptomatic malaria at the communal level in Burkina Faso: an application of the small area estimation approach Journal Article In: Population health metrics, vol. 22, iss. 1, 2024, ISSN: 1478-7954. Abstract | BibTeX | Tags: Asymptomatic Infections / epidemiology, Burkina Faso / epidemiology, Carrier State / epidemiology, Child, doi:10.1186/s12963-024-00341-1, Female, Hervé Bassinga, Humans, Infant, Mady Ouedraogo, Malaria* / epidemiology, Male, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11330607, pmid:39155384, Preschool, Prevalence, PubMed Abstract, Small-Area Analysis, Toussaint Rouamba | Links: @article{Bassinga2024, Background: In malaria-endemic countries, asymptomatic carriers of plasmodium represent an important reservoir for malaria transmission. Estimating the burden at a fine scale and identifying areas at high risk of asymptomatic carriage are important to guide malaria control strategies. This study aimed to estimate the prevalence of asymptomatic carriage at the communal level in Burkina Faso, the smallest geographical entity from which a local development policy can be driven. Methods: The data used in this study came from several open sources: the 2018 Multiple Indicator Cluster Survey on Malaria and the 2019 general census of the population data and environmental. The analysis involved a total of 5489 children under 5 from the malaria survey and 293,715 children under 5 from the census. The Elbers Langjouw and Langjouw (ELL) approach is used to estimate the prevalence. This approach consists of including data from several sources (mainly census and survey data) in a statistical model to obtain predictive indicators at a sub-geographical level, which are not measured in the population census. The method achieves this by finding correlations between common census variables and survey data. Findings: The findings suggest that the spatial distribution of the prevalence of asymptomatic carriage is very heterogeneous across the communes. It varies from a minimum of 5.1% (95% CI 3.6–6.5) in the commune of Bobo-Dioulasso to a maximum of 41.4% (95% CI 33.5–49.4) in the commune of Djigoué. Of the 341 communes, 208 (61%) had prevalences above the national average of 20.3% (95% CI 18.8–21.2). Contributions: This analysis provided commune-level estimates of the prevalence of asymptomatic carriage of plasmodium in Burkina Faso. The results of this analysis should help to improve planning of malaria control at the communal level in Burkina Faso. | |||
Alseny M’Mah Soumah, Mariame Camara, Justin Windingoudi Kaboré, Ibrahim Sadissou, Hamidou Ilboudo, Christelle Travaillé, Oumou Camara, Magali Tichit, Jacques Kaboré, Salimatou Boiro, Aline Crouzols, Jean Marc Tsagmo Ngoune, David Hardy, Aïssata Camara, Vincent Jamonneau, Annette Macleod, Jean Mathieu Bart, Mamadou Camara, Bruno Bucheton, Brice Rotureau Prevalence of dermal trypanosomes in suspected and confirmed cases of gambiense human African trypanosomiasis in Guinea Journal Article In: PLoS neglected tropical diseases, vol. 18, iss. 8, 2024, ISSN: 1935-2735. Abstract | BibTeX | Tags: Adolescent, Adult, African* / diagnosis, African* / epidemiology, African* / parasitology, Alseny M'mah Soumah, Brice Rotureau, Child, DNA, doi:10.1371/journal.pntd.0012436, Female, Guinea / epidemiology, Humans, Male, Mariame Camara, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Observational Study, PMC11361743, pmid:39159265, Prevalence, Prospective Studies, Protozoan / genetics, PubMed Abstract, Skin* / parasitology, Skin* / pathology, Trypanosoma brucei gambiense* / isolation & purification, Trypanosomiasis, Young Adult | Links: @article{Soumah2024, The skin is an anatomical reservoir for African trypanosomes, yet the prevalence of extravascular parasite carriage in the population at risk of gambiense Human African Trypanosomiasis (gHAT) remains unclear. Here, we conducted a prospective observational cohort study in the HAT foci of Forecariah and Boffa, Republic of Guinea. Of the 18,916 subjects serologically screened for gHAT, 96 were enrolled into our study. At enrolment and follow-up visits, participants underwent a dermatological examination and had blood samples and superficial skin snip biopsies taken for examination by molecular and immuno-histological methods. In seropositive individuals, dermatological symptoms were significantly more frequent as compared to seronegative controls. Trypanosoma brucei DNA was detected in the blood of 67% of confirmed cases (22/33) and 9% of unconfirmed seropositive individuals (3/32). However, parasites were detected in the extravascular dermis of up to 71% of confirmed cases (25/35) and 41% of unconfirmed seropositive individuals (13/32) by PCR and/or immuno-histochemistry. Six to twelve months after treatment, trypanosome detection in the skin dropped to 17% of confirmed cases (5/30), whereas up to 25% of unconfirmed, hence untreated, seropositive individuals (4/16) were still found positive. Dermal trypanosomes were observed in subjects from both transmission foci, however, the occurrence of pruritus and the PCR positivity rates were significantly higher in unconfirmed seropositive individuals in Forecariah. The lower sensitivity of superficial skin snip biopsies appeared critical for detecting trypanosomes in the basal dermis. These results are discussed in the context of the planned elimination of gHAT. | |||
Francois Kiemde, Juvenal Nkeramahame, Ana Belen Ibarz, Sabine Dittrich, Piero Olliaro, Daniel Valia, Toussaint Rouamba, Berenger Kabore, Alima Nadine Kone, Seydou Sawadogo, Antonia Windkouni Bere, Diane Yirgnur Some, Athanase Mwinessobaonfou Some, Adelaide Compaore, Philip Horgan, Stephan Weber, Thomas Keller, Halidou Tinto Impact of a package of point-of-care diagnostic tests, a clinical diagnostic algorithm and adherence training on antibiotic prescriptions for the management of non-severe acute febrile illness in primary health facilities during the COVID-19 pandemic in Burkina Faso Journal Article In: BMC infectious diseases, vol. 24, iss. 1, 2024, ISSN: 1471-2334. Abstract | BibTeX | Tags: Adolescent, Adult, Algorithms*, Anti-Bacterial Agents* / therapeutic use, Burkina Faso, Child, COVID-19* / diagnosis, doi:10.1186/s12879-024-09787-y, Female, Fever* / drug therapy, Francois Kiemde, Halidou Tinto, Humans, Infant, Juvenal Nkeramahame, Male, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11351252, pmid:39192209, Point-of-Care Systems, Point-of-Care Testing, Preschool, Primary Health Care*, PubMed Abstract, Randomized controlled trial, SARS-Cov-2 | Links: @article{Kiemde2024, Objective: To assess the impact of an intervention package on the prescription of antibiotic and subsequently the rate of clinical recovery for non-severe acute febrile illnesses at primary health centers. Methods: Patients over 6 months of age presenting to primary health care centres with fever or history of fever within the past 7 days were randomized to receive either the intervention package constituted of point-of-care tests including COVID-19 antigen tests, a diagnostic algorithm and training and communication packages, or the standard practice. The primary outcomes were antibiotic prescriptions at Day 0 (D0) and the clinical recovery at Day 7 (D7). Secondary outcomes were non-adherence of participants and parents/caregivers to prescriptions, health workers’ non-adherence to the algorithm, and the safety of the intervention. Results: A total of 1098 patients were enrolled. 551 (50.2%) were randomized to receive the intervention versus 547 (49.8%) received standard care. 1054 (96.0%) completed follow-up and all of them recovered at D7 in both arms. The proportion of patients with antibiotic prescriptions at D0 were 33.2% (183/551) in the intervention arm versus 58.1% (318/547) under standard care, risk difference (RD) -24.9 (95% CI -30.6 to -19.2, p < 0.001), corresponding to one more antibiotic saved every four (95% CI: 3 to 5) consultations. This reduction was also statistically significant in children from 6 to 59 months (RD -34.5; 95% CI -41.7 to -27.3; p < 0.001), patients over 18 years (RD -35.9; 95%CI -58.5 to -13.4; p = 0.002), patients with negative malaria test (RD -46.9; 95% CI -53.9 to -39.8; p < 0.001), those with a respiratory diagnosis (RD -48.9; 95% CI -56.9 to -41.0, p < 0.001) and those not vaccinated against COVID-19 (-24.8% 95%CI -30.7 to -18.9, p-value: <0.001). A significant reduction in non-adherence to prescription by patients was reported (RD -7.1; 95% CI -10.9 to -3.3; p < 0.001). Conclusion: The intervention was associated with significant reductions of antibiotic prescriptions and non-adherence, chiefly among patients with non-malaria fever, those with respiratory symptoms and children below 5 years of age. The addition of COVID-19 testing did not have a major impact on antibiotic use at primary health centers. Trial registration: Clinitrial.gov; NCT04081051 registered on 06/09/2019. | |||
Zayar Phyo, Ko Ko, Serge Ouoba, Aya Sugiyama, Ulugbek Khudayberdievich Mirzaev, Golda Ataa Akuffo, Chanroth Chhoung, Tomoyuki Akita, Junko Tanaka Intermediate hepatitis C virus (HCV) endemicity and its genotype distribution in Myanmar: A systematic review and meta-analysis Journal Article In: PloS one, vol. 19, iss. 9, 2024, ISSN: 1932-6203. Abstract | BibTeX | Tags: doi:10.1371/journal.pone.0307872, Endemic Diseases, Genotype*, Hepacivirus* / genetics, Hepacivirus* / isolation & purification, Hepatitis C* / epidemiology, Hepatitis C* / virology, Humans, Junko Tanaka, Ko Ko, MEDLINE, Meta-Analysis, Myanmar / epidemiology, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11412534, pmid:39298388, Prevalence, PubMed Abstract, RNA, Seroepidemiologic Studies, Systematic review, Viral / genetics, Zayar Phyo | Links: @article{Phyo2024, Background Comprehensive details on Hepatitis C virus (HCV) infection in Myanmar are lacking. This study determined the prevalence of HCV antibodies and ribonucleic acid (RNA) and the distribution of HCV genotypes across different populations in Myanmar from 1990 to 2023. Material and methods A systematic search in PubMed, Web of Science, Scopus, and local journals identified studies reporting on HCV antibodies, RNA, and genotypes, excluding clinical research related to liver disease prognosis. Screening and data extraction was done by two authors and study populations were categorized into low-risk, high-risk, liver disease patients, and refugees outside the country. The pooled prevalence was performed by Dersimonian and Laird method using the R program. The publication bias was shown by funnel plot, the Egger test was used to assess the symmetry of the plot, and the heterogeneity was examined by the Cochran Q test and I2 index. Results Out of 135 reports screened for eligibility, 35 reports comprising 51 studies were included in which 33 studies provided data on HCV seroprevalence in 685,403 individuals, 8 studies reported HCV RNA prevalence in 25,018 individuals, and 10 studies examined HCV genotypes in 1,845 individuals. The pooled seroprevalence of HCV among low-risk, high-risk, liver disease patients and refugees were 2.18%, 37.07%, 33.84%, and 2.52% respectively. HCV RNA-positive rates in these groups were 1.40%, 5.25%, 24.96%, and 0.84% respectively. Seroprevalence studies showed publication bias (Egger test | |||
Irene Molina–de Fuente, Marc Christian Tahita, Kabore Bérenger, Thuy Huong Ta Tang, Luz García, Vicenta González, Agustín Benito, Judith M. Hübschen, Halidou Tinto, Pedro Berzosa Malaria diagnosis challenges and pfhrp2 and pfhrp3 gene deletions using pregnant women as sentinel population in Nanoro region, Burkina Faso Journal Article In: Pathogens and global health, vol. 118, iss. 6, 2024, ISSN: 2047-7732. Abstract | BibTeX | Tags: Adolescent, Adult, Antigens, Burkina Faso / epidemiology, Diagnostic Tests, doi:10.1080/20477724.2024.2388489, Falciparum* / diagnosis, Falciparum* / epidemiology, Falciparum* / parasitology, Female, Gene Deletion*, Humans, Irene Molina-de la Fuente, Malaria, Marc Christian Tahita, MEDLINE, Microscopy, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic / diagnosis, Parasitic / epidemiology, Pedro Berzosa, Plasmodium falciparum* / genetics, Plasmodium falciparum* / isolation & purification, PMC11441055, pmid:39140699, Pregnancy, Pregnancy Complications, Protozoan Proteins* / genetics, Protozoan* / genetics, PubMed Abstract, Research Support, Routine* / methods, Sensitivity and Specificity*, Young Adult | Links: @article{nokey, Malaria in pregnancy causes adverse consequences and prompt and accurate diagnosis is essential for case management. In malaria endemic countries, diagnosis is mainly based on rapid diagnostic tests (RDT) and microscopy. However, increasing reports of false negatives caused by low parasitemia and pfhrp2/3 deletions raise concerns about HRP2-based RDT usefulness. This study aimed to assess RDT and microscopy performance and to describe pfhrp2/3 deletions in a cohort of 418 pregnant women in Burkina Faso. Malaria was diagnosed using RDT and microscopy and blood samples were collected during antenatal care visits. Diagnostic results were compared to PCR as gold standard. Pfhrp2 and pfhrp3 deletions were characterized for patients with confirmed P. falciparum infection. RDT had better sensitivity (76%) but lower specificity (83%) than microscopy (sensitivity = 57%; specificity = 98%). Low parasitemia (<150 parasites/µL), especially in multigravidae, was the principal factor causing false negatives by both methods. Moreover, pfhrp2 deletion frequency among overall false negatives by RDT was 21.43%. Higher frequency of deletions was found among all samples, independently of RDT result, for example around 2% of samples had double deletions meaning that the majority of deletions had no effect on RDT testing. Finally, it was found higher pfhrp2 deletion in women with lower uterine height during the first trimester. Wider and National surveillance study of deletions is recommended among pregnant women and in Burkina Faso. | |||
Adélaïde Compaoré, Toussaint Rouamba, Bérenger Kaboré, Jan Jacobs, Koen Peeters Grietens, Salla Sariola Exploring Antibiotic Use in the Community: A Household-Based Survey Using the Drug Bag Method in Rural Burkina Faso Journal Article In: Antibiotics (Basel, Switzerland), vol. 13, iss. 9, 2024, ISSN: 2079-6382. Abstract | BibTeX | Tags: Adélaïde Compaoré, doi:10.3390/antibiotics13090872, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11428394, pmid:39335045, PubMed Abstract, Salla Sariola, Toussaint Rouamba | Links: @article{nokey, In Burkina Faso, there is lack of awareness of antibiotic use at the community level. This study aims to generate information on the commonly used antibiotics along with the reasons for which they have been used in rural Burkina Faso. The drug bag method was employed to collect information from 423 households in the health district of Nanoro. Descriptive analyses were performed using R software version 4.2.1. Of the 33 antibiotics inventoried, amoxicillin tablets and oxytetracycline were the most recognized and used antibiotics. This study indicated that antibiotics were used for a range of health problems in the community, some of which were administered as painkillers. While primary healthcare facilities constituted the primary source of drugs for households (76.8%), informal drug sellers constituted an additional option (61.5%) for community members. This is a significant concern, given that some antibiotics classified as “Watch”—such as norfloxacin—were readily available in these outlets, despite not being included on the country’s Essential Medicines List. This study underscores the necessity of considering the role played by formal providers in the inappropriate use of antibiotics and the importance of understanding the circumstances and logical reasoning underlying communities’ access to and use of antibiotics. | |||
Solo Traoré, Désiré L. Dahourou, Boyo C. Paré, Yempabou Sagna, Daniel Zemba, Douonibo P. Somé, Nomwindé C. J. Ouédraogo, Kalo R. Millogo, Lassina Séré, Toussaint Rouamba, Hervé Tiéno, Oumar Guira Prevalence of undiagnosed diabetes mellitus and its associated factors in urban Burkina Faso Journal Article In: Journal of public health in Africa, vol. 15, iss. 1, 2024, ISSN: 2038-9922. Abstract | BibTeX | Tags: Désiré L Dahourou, doi:10.4102/jphia.v15i1.497, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Oumar Guira, PMC11447682, pmid:39364302, PubMed Abstract, Solo Traoré | Links: @article{nokey, <p>Background: Community screening could be an effective strategy for identifying people with undiagnosed type 2 diabetes mellitus (T2DM) in low-income countries.Aim: This study aimed to estimate the prevalence of undiagnosed T2DM and its risk factors.Setting: This study was conducted in Ouagadougou, the capital of Burkina Faso.Methods: This was a cross-sectional study, including consenting population (≥ 18 years). Data were collected from 11 November 2020 to 16 November 2020, in five fix sites after a 10-day information campaign on T2DM. The SD CodeFreeTM glucose analyser was used to diagnose T2DM. Multivariable logistic regression was used to identify the associate factors.Results: A total of 1200 (95%) volunteered out of 1330 people were enrolled, which included 667 (52.27%) women. The mean age was 34.16 years (standard deviation: 12.42). Overall, 40.28% were abdominally obese and 31.43% hypertensive. The prevalence of T2DM was 10.74% (95% confidence interval [95% CI]: 9.15; 12.56). In multivariate analysis, being aged or greater than 35 years (adjusted odds ratio [ORa]: 2.30; 95% CI: 1.42; 3.72), having a family history of diabetes (ORa = 1.55; 95% CI: 1.006; 2.40), being overweight (ORa = 1.69; 95% CI: 1.09; 2.62), being obese (ORa = 1.80; 95% CI: 1.08; 3.00), being a known hypertensive (ORa = 2.92 95% CI: 1.64; 5.19) and having high blood pressure on the day of the survey (ORa = 1.86; 95% CI: 1.22; 2.85) increased significantly the probability to present T2DM.Conclusion: Community screening is useful to identify T2DM. A national programme to control diabetes mellitus and its associated risk factors is urgently needed in Burkina Faso.Contribution: This study will enable early detection of diabetes mellitus and its management in order to prevent or delay the onset of complications.</p> | |||
Daniel Valia, Brecht Ingelbeen, Guétawendé Job Wilfried Nassa, Bérenger Kaboré, François Kiemdé, Toussaint Rouamba, Adélaïde Compaoré, Juste Stéphane Kouanda, Annie Robert, Hector Rodriguez-Villalobos, Marianne A B Van Der Sande, Halidou Tinto Antibiotic use by clinical presentation across all healthcare providers in rural Burkina Faso: a healthcare visit exit survey Journal Article In: The Journal of antimicrobial chemotherapy, vol. 79, iss. 10, 2024, ISSN: 1460-2091. Abstract | BibTeX | Tags: Adolescent, Adult, Anti-Bacterial Agents* / therapeutic use, Antimicrobial Stewardship* / statistics & numerical data, Brecht Ingelbeen, Burkina Faso, Daniel Valia, doi:10.1093/jac/dkae252, Drug Utilization / statistics & numerical data, Female, Halidou Tinto, Health Personnel* / statistics & numerical data, Humans, Male, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11441991, pmid:39051704, PubMed Abstract, Rural Population* / statistics & numerical data, Surveys and Questionnaires, Young Adult | Links: @article{Valia2024, DOI: 10.1093/jac/dkae252; Journal of Antimicrobial Chemotherapy, 00, 0, 2024-07-25.; Abstract: Background: To guide antibiotic stewardship interventions, understanding for what indications antibiotics are used is essential. Methods: In rural Burkina Faso, we measured antibiotic dispensing across all healthcare providers. From October 2021 to February 2022, we surveyed patients in Nanoro district, Burkina Faso, following visits to health centres (3), pharmacies (2), informal medicine vendors (5) and inpatients in health centres. We estimated prevalence of antibiotic use and the proportion of Watch group antibiotics by provider type and by clinical presentation, assessing compliance with WHO’s AWaRe Antibiotic Book. We estimated per capita antibiotic use by multiplying prevalence of antibiotic use, mean DDD per adult treatment course, and the rate of healthcare visits per 1000 inhabitants per day, estimated from a prior household survey. Results: Outpatient antibiotic use was more fre | |||
Myriam El Gaaloul, Andre Marie Tchouatieu, Kassoum Kayentao, Brice Campo, Benedicte Buffet, Hanu Ramachandruni, Jean Louis Ndiaye, Timothy N. C. Wells, Celine Audibert, Jane Achan, Cristina Donini, Hellen C. Barsosio, Halidou Tinto Chemoprevention of malaria with long-acting oral and injectable drugs: an updated target product profile Journal Article In: Malaria journal, vol. 23, iss. 1, pp. 315, 2024, ISSN: 1475-2875. Abstract | BibTeX | Tags: Administration, Andre Marie Tchouatieu, Antimalarials* / administration & dosage, Antimalarials* / therapeutic use, Chemoprevention* / methods, doi:10.1186/s12936-024-05128-1, Female, Halidou Tinto, Humans, Injections, Malaria* / prevention & control, MEDLINE, Myriam El Gaaloul, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Oral, PMC11490162, pmid:39425110, Pregnancy, PubMed Abstract, Review | Links: @article{nokey, <p>Malaria is preventable, but the burden of disease remains high with over 249 million cases and 608,000 deaths reported in 2022. Historically, the most important protective interventions have been vector control and chemopreventive medicines with over 50 million children receiving seasonal malaria chemoprevention in the year 2023. Two vaccines are approved and starting to be deployed, bringing additional protection for children up to 36 months. However, the impact of these currently available tools is somewhat limited on various fronts. Vaccines exhibit partial efficacy, are relatively costly, and not accessible in all settings. The challenges encountered with chemoprevention are barriers to acceptability and feasibility, including frequency of dosing, and the lack of options in the first trimester of pregnancy and for women living with HIV. Also, the emergence of resistance against chemopreventive medicines is concerning. To address these limitations, a target product profile (TPP) is proposed as a road map to guide innovation and to boost the quest for novel chemopreventive alternatives. This TPP describes the ideal product attributes, while acknowledging potential trade-offs that may be needed. Critically, it considers the target populations most at risk; primarily infants, children, and pregnant women. Malaria control and elimination requires appropriate chemoprevention, not only in areas of high endemicity and transmission, but also in lower transmission areas where immunity is declining, as well as for travellers from areas where malaria has been eliminated. New medicines should show acceptable safety and tolerability, with high and long protective efficacy. Formulations and costs need to support operational adherence, access, and effectiveness. Next generation long-acting oral and injectable drugs are likely to constitute the backbone of malaria prevention. Therefore, the perspectives of front-line experts in malaria prevention, researchers, and those involved in drug development are captured in the TPP. This inclusive approach aims at concentrating efforts and aligning responses across the community to develop new and transformative medicines.</p> | |||
Ramachandra Sangana, Bernhards Ogutu, Adoke Yeka, Sylvia Kusemererwa, Halidou Tinto, Andre Offianan Toure, Afizi Kibuuka, Moussa Lingani, Carlos Lourenço, Ghyslain Mombo-Ngoma, Videlis Nduba, Tiacoh Landry N'Guessan, Guétawendé Job Wilfried Nassa, Mary Nyantaro, Lucas Otieno Tina, Anup Anvikar, Abhinav Sinha, Grace Kaguthi, Bakary Fofana, Martin Peter Grobusch, Myriam El Gaaloul, Anne Claire Marrast, Rashidkhan Pathan, Havana Chikoto, Katalin Csermak, Celine Risterucci, Guoqin Su, Cornelis Winnips, Jie Zhang, Julia Zack Pharmacokinetics of Ganaplacide and Lumefantrine in Adults, Adolescents, and Children with Plasmodium falciparum Malaria Treated with Ganaplacide Plus Lumefantrine Solid Dispersion Formulation: Analysis of Data from a Multinational Phase 2 Study Journal Article In: Journal of clinical pharmacology, 2024, ISSN: 1552-4604. Abstract | BibTeX | Tags: Bernhards Ogutu, doi:10.1002/jcph.6138, Julia Zack, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, pmid:39344281, PubMed Abstract, Ramachandra Sangana | Links: @article{Sangana2024, The novel antimalarial ganaplacide combined with lumefantrine solid dispersion formulation (LUM-SDF) was effective and well tolerated in the treatment of uncomplicated falciparum malaria in adults, adolescents, and children in a multinational, prospective, randomized, active-controlled Phase II study conducted between August 2017 and June 2021 (EudraCT 2020-003284-25, Clinicaltrials.gov NCT03167242). Pharmacokinetic data from that study are reported here. The trial comprised three parts: a run-in part in 12 adult/adolescent patients treated with a single dose of ganaplacide 200 mg plus LUM-SDF 960 mg assessed potential pharmacokinetic (PK) interactions between ganaplacide and lumefantrine; in Part A, adult/adolescent patients received one of the six ganaplacide-LUM-SDF regimens or artemether-lumefantrine; and in Part B, three dose regimens identified in Part A, and artemether-lumefantrine, were assessed in children aged 2 to <12 years, with body weight ≥10 kg. A rich blood sampling schedule was used for all 12 patients in the PK run-in part and a subset of patients (N = 32) in Part A, with sparse sampling for remaining patients in Parts A (N = 275) and B (N = 159). Drug concentrations were determined by a validated protein precipitation and reverse phase liquid chromatography with tandem mass spectrometry detection method. Parameters including AUCinf, AUClast, AUC0–t, Cmax, and tmax were reported where possible, using non-compartmental analysis. In the PK run-in part, there was no notable increase in ganaplacide or lumefantrine exposure when co-administered. In Parts A and B, ganaplacide exposures increased with dose, but lumefantrine exposure was numerically under dose-proportional. Lumefantrine exposure was higher with ganaplacide-LUM-SDF than with artemether-lumefantrine, although high variability was observed. Ganaplacide and lumefantrine exposures (Cmax and AUC0–24 h) were comparable across age and body weight groups. Drug exposures needed for efficacy were achieved using the dose regimen 400 mg ganaplacide plus lumefantrine 960 mg once daily for 3 days under fasted conditions. | |||
Kié Solange Millogo, Bérenger Kaboré, Paul Sondo, Eulalie W. Compaoré, Amélé Fifi Chantal Kouevi, Sié A. Elisée Kambou, Toussaint Rouamba, Adama Kazienga, Hamidou Ilboudo, Marc Christian Tahita, Ismaila Bouda, Karim Derra, Sanata Bamba, Halidou Tinto Trend of N86Y and Y184F Mutations in Pfmdr1 Gene in Children Under Seasonal Malaria Chemoprevention Coverage in Nanoro, Burkina Faso Journal Article In: Acta parasitologica, 2024, ISSN: 1896-1851. Abstract | BibTeX | Tags: Bérenger Kaboré, doi:10.1007/s11686-024-00923-x, Halidou Tinto, Kié Solange Millogo, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, pmid:39356425, PubMed Abstract | Links: @article{Millogo2024, Background: Seasonal malaria chemoprevention (SMC) is an effective malaria preventive intervention in sub-Sahara Africa. However, as with any other drug-based intervention, the large-scale deployment of this strategy could lead to Amodiaquine plus Sulfadoxine-Pyrimethamine (AQSP) drug pressure on the circulating parasites population with selection for specific alleles that could compromise the impact of the intervention in the near future. This study aimed to assess the distribution of the Pfmdr1 mutation involved in resistance to AQ before and after the annual campaign of SMC in the health district of Nanoro. Methods: Randomly selected dried blood spots collected prior (n = 100) and after (n = 100) the 2021 SMC campaign were used for the detection of mutation in codons 86 and 184 of the Pfmdr1 gene using a nested PCR with restriction fragment length polymorphism approach. Results: No significant change in the prevalence of Pfmdr1 N86Y mutation was observed before and after the SMC campaign (p = 0.28). The mutant allele 86Y was observed at low prevalences, representing only 2.17% and 6.12%, respectively, before and after the SMC campaign. Patients harboring the mutant Pfmdr1 86Y allele exhibited higher parasite densities compared to patients with the wild-type Pfmdr1 N86 allele (p = 0.04). A significant increase in the prevalence of the mutant allele 184 F was observed in the period before and after the SMC campaign (p = 0.03). Conclusion: This selective pressure needs to be closely monitored in order to preserve the efficacy of this intervention for a long-term period in Burkina Faso. | |||
Pauline Getanda, Isatou Jagne, Joel D Bognini, Bully Camara, Bakary Sanyang, Saffiatou Darboe, Ellen Sambou, Momodou Barry, Kady Kassibo, Aminata Cham, Harriet Mendy, Bintou K J Singateh, Ebrahim Ndure, Toussaint Rouamba, Abdoulie Bojang, Christian Bottomley, Benjamin P Howden, Umberto D’Alessandro, Halidou Tinto, Anna Roca, Fatoumata Sillah, Nathalie Beloum, Usman N Nakakana, Madikoi Danso, Joquina C Jones, Shashu Graves, Edrissa Sabally, Siaka Badjie, Sulayman Bah, Omar B Jarra, Abdoulie Suso Impact of Intrapartum Azithromycin on the Carriage and Antibiotic Resistance of Escherichia coli and Klebsiella pneumoniae in Mothers and their Newborns: a sub-study of a Randomized Double-Blind Trial Conducted in The Gambia and Burkina Faso Journal Article In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024, ISSN: 1537-6591. Abstract | BibTeX | Tags: Isatou Jagne, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Pauline Getanda, PubMed Abstract | Links: @article{Getanda2024, BACKGROUND: Limited data exists on effects of intrapartum azithromycin on prevalence of carriage and antibiotic resistance of Enterobacterales. METHODS: We conducted a randomized trial in Gambia and Burkina Faso where women received intrapartum azithromycin (2g) or placebo. We determined impact of treatment on prevalence of carriage and antibiotic resistance of Escherichia coli and Klebsiella pneumoniae by analysing rectal swabs (RS), nasopharyngeal swabs (NPS), breast milk and recto-vaginal swabs (RVS). Bacteria were isolated microbiologically; antibiotic susceptibility was confirmed with an E-test. Prevalence ratios (PR) with 95% confidence intervals (CI's) were used for comparison between arms. RESULTS: In infants, E. coli carriage in RS was lower in the intervention than placebo arm at days 6 (63.0% vs. 75.2%, PR, 0.84; CI, 0.75-0.95) and 28 (52.7% vs. 70.4%, 0.75; 0.64-0.87) post-intervention. Prevalence of azithromycin-resistant E. coli was higher in the azithromycin arm at days 6 (13.4% vs. 3.6%, 3.75; 1.83-7.69) and 28 (16.4% vs. 9.6%, 1.71; 1.05-2.79). For K. pneumoniae, carriage in RS was higher in the intervention than placebo arm at days 6 (49.6% vs. 37.2%, 1.33; 1.08-1.64) and 28 (53.6% vs. 32.9%, 1.63; 1.31-2.03). Prevalence of azithromycin-resistant K. pneumoniae was higher in the azithromycin arm at day 28 (7.3% vs. 2.1%, 3.49; 1.30-9.37). No differences were observed for other sample types. CONCLUSION: Intrapartum azithromycin decreased E. coli carriage but increased both K. pneumoniae carriage and azithromycin resistance in both bacteria. These data need to be considered together with efficacy results to balance the potential short- and long-term impact of the intervention. CLINICAL TRIALS REGISTRATION: www.clinicaltrials.gov: NCT03199547. | |||
Junjie Ding, Richard M. Hoglund, Harry Tagbor, Halidou Tinto, Innocent Valéa, Victor Mwapasa, Linda Kalilani-Phiri, Jean Pierre Van Geertruyden, Michael Nambozi, Modest Mulenga, Sebastian Hachizovu, Raffaella Ravinetto, Umberto D'Alessandro, Joel Tarning Population pharmacokinetics of amodiaquine and piperaquine in African pregnant women with uncomplicated Plasmodium falciparum infections Journal Article In: CPT: pharmacometrics & systems pharmacology, 2024, ISSN: 2163-8306. Abstract | BibTeX | Tags: doi:10.1002/psp4.13211, Joel Tarning, Junjie Ding, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, pmid:39228131, PubMed Abstract, Richard M Hoglund | Links: @article{Ding2024, Artemisinin-based combination therapy (ACT) is the first-line recommended treatment for uncomplicated malaria. Pharmacokinetic (PK) properties in pregnant women are often based on small studies and need to be confirmed and validated in larger pregnant patient populations. This study aimed to evaluate the PK properties of amodiaquine and its active metabolite, desethylamodiaquine, and piperaquine in women in their second and third trimester of pregnancy with uncomplicated P. falciparum infections. Eligible pregnant women received either artesunate-amodiaquine (200/540 mg daily | |||
Dylan G Maghini, Ovokeraye H Oduaran, Jakob Wirbel, Luicer A Ingasia Olubayo, Natalie Smyth, Theophilous Mathema, Carl W Belger, Godfred Agongo, Palwendé R Boua, Solomon SR Choma, F Xavier Gómez-Olivé, Isaac Kisiangani, Given R Mashaba, Lisa Micklesfield, Shukri F Mohamed, Engelbert A Nonterah, Shane Norris, Hermann Sorgho, Stephen Tollman, Floidy Wafawanaka, Furahini Tluway, Michèle Ramsay, Ami S Bhatt, Scott Hazelhurst Expanding the human gut microbiome atlas of Africa Journal Article In: bioRxiv : the preprint server for biology, 2024, ISSN: 2692-8205. Abstract | BibTeX | Tags: doi:10.1101/2024.03.13.584859, Dylan G Maghini, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Ovokeraye H Oduaran, PMC10980044, pmid:38559015, Preprint, PubMed Abstract, Scott Hazelhurst | Links: @article{Maghini2024, Population studies are crucial in understanding the complex interplay between the gut microbiome and geographical, lifestyle, genetic, and environmental factors. However, populations from low- and middle-income countries, which represent ~84% of the world population, have been excluded from large-scale gut microbiome research. Here, we present the AWI-Gen 2 Microbiome Project, a cross-sectional gut microbiome study sampling 1,803 women from Burkina Faso, Ghana, Kenya, and South Africa. By intensively engaging with communities that range from rural and horticultural to urban informal settlements and post-industrial, we capture population diversity that represents a far greater breadth of the world's population. Using shotgun metagenomic sequencing, we find that study site explains substantially more microbial variation than disease status. We identify taxa with strong geographic and lifestyle associations, including loss of Treponema and Cryptobacteroides species and gain of Bifidobacterium species in urban populations. We uncover a wealth of prokaryotic and viral novelty, including 1,005 new bacterial metagenome-assembled genomes, and identify phylogeography signatures in Treponema succinifaciens. Finally, we find a microbiome signature of HIV infection that is defined by several taxa not previously associated with HIV, including Dysosmobacter welbionis and Enterocloster sp. This study represents the largest population-representative survey of gut metagenomes of African individuals to date, and paired with extensive clinical biomarkers, demographic data, and lifestyle information, provides extensive opportunity for microbiome-related discovery and research. | |||
Scott Hazelhurst, Palwendé Boua, Ananyo Choudhury, Siyanda Madala, Dhriti Sengupta, Furahini Tluway, Michèle Ramsay Computation of Socio-Economic Status in the AWI-Gen Project Journal Article In: medRxiv : the preprint server for health sciences, 2024. Abstract | BibTeX | Tags: doi:10.1101/2024.08.22.24312411, MEDLINE, Michèle Ramsay, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Palwendé Boua, PMC11370514, pmid:39228720, Preprint, PubMed Abstract, Scott Hazelhurst | Links: @article{Hazelhurst2024, Socio-economic status of participants in many public health, epidemiological, and genome-wide association studies is an important trait of interest. It is often used in these studies as a measure of direct interest or as a covariate. The Africa Wits INDEPTH Partnership for Genomic and Environmental Research (AWI-Gen) explores genomic and environmental factors in non-communicable diseases, particularly cardio-metabolic disease. In Phase I of AWI-Gen, approximately 12,000 participants were recruited at six sites in four African countries. Participants were asked questions about asset ownership. This technical note describes how AWI-Gen computed socio-economic status from the asset register. | |||
Marc Christian Tahita, Quique Bassat Post-discharge malaria chemoprevention in children with severe anaemia: a robust strategy to save lives Journal Article In: The Lancet. Global health, vol. 12, iss. 1, pp. e2-e3, 2024, ISSN: 2214-109X. BibTeX | Tags: Aftercare, Anemia* / epidemiology, Anemia* / prevention & control, Antimalarials* / therapeutic use, Chemoprevention, Child, Humans, Infant, Malaria* / drug therapy, Malaria* / prevention & control, Marc Christian Tahita, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Patient Discharge, pmid:38097287, PubMed Abstract, Quique Bassat | Links: @article{Tahita2024, | |||
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Blahima Konate, Rachel Medah, Isidore Traore, Samiratou Ouedraogo, Nongodo Firmin Kabore, Ariane Kamga Mamguem, Oumar Billa, Dramane Kania, Hermann Badolo, Esperance Ouedraogo, Nathalie Rekeneire, Armel Poda, Arnaud Eric Diendere, Boukary Ouedraogo, Halidou Tinto, Tienhan Sandrine Dabakuyo-Yonli A Qualitative Study of the Experience of COVID-19 Patients in Burkina Faso Journal Article In: The American journal of tropical medicine and hygiene, vol. 110, iss. 1, pp. 170-178, 2023, ISSN: 1476-1645. Abstract | BibTeX | Tags: Blahima Konaté, Burkina Faso / epidemiology, COVID-19*, Cross-Sectional Studies, doi:10.4269/ajtmh.22-0351, Humans, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Patients, PMC10793024, pmid:38109766, PubMed Abstract, Qualitative research, Rachel Médah, Tienhan Sandrine Dabakuyo-Yonli | Links: @article{Konate2023, In Burkina Faso, the health system is characterized by systemic insufficient and antiquated health-care infrastructures. Consequently, few health-care establishments have the required resources to diagnose and manage patients with COVID-19, and fewer still have intensive care facilities for severely ill patients with COVID. Furthermore, there is a widespread scarcity of qualified health-care staff. The aim of this study was to explore the experiences of patients with COVID-19 who recovered after being cared for in Bobo Dioulasso and Ouagadougou. Using individual semistructured interviews, we performed a cross-sectional qualitative, descriptive study from June 12 to 30, 2020 with the aid of 13 well-educated patients who had survived COVID-19. The results reveal that prior to hospital admission, the main reason that prompted patients to seek care was onset of symptoms of COVID-19, regardless of whether they had been in contact with suspected or confirmed cases. Transmission was mainly believed to have occurred in the community, in the hospital, and during travel. Patient management was punctuated by frequent self-medication with medicinal plants or pharmaceutical drugs. The participants reported a negative perception of hospitalization or home-based management, with several forms of stigmatization, but a positive perception influenced by the satisfactory quality of management in health-care centers. This report of patient experiences could be helpful in improving the management of COVID-19 in Burkina Faso, both in the health-care setting and in home-based care. | |||
Zakaria Garba, Isidore O. J. Bonkoungou, Nadège O. Millogo, H. Magloire Natama, Pingdwendé A. P. Vokouma, Massa A. Bonko, Ibrahima Karama, Lagmêyesgo A. W. Tiendrebeogo, Kaisa Haukka, Halidou Tinto, Lassana Sangaré, Nicolas Barro Wastewater from healthcare centers in Burkina Faso is a source of ESBL, AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae Journal Article In: BMC microbiology, vol. 23, iss. 1, 2023, ISSN: 1471-2180. Abstract | BibTeX | Tags: Animals, Anti-Bacterial Agents / pharmacology, bacteria, Bacterial Proteins, beta-Lactamases, Burkina Faso, Carbapenem-Resistant Enterobacteriaceae*, doi:10.1186/s12866-023-03108-0, Escherichia coli, Escherichia coli Infections* / microbiology, Humans, Isidore O J Bonkoungou, Klebsiella pneumoniae, MEDLINE, Microbial Sensitivity Tests, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Nicolas Barro, NIH, NLM, Non-U.S. Gov't, PMC10655474, pmid:37978428, PubMed Abstract, Research Support, Wastewater, Zakaria Garba | Links: @article{Garba2023, Background: Extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae have spread into the environment worldwide posing a potential public health threat. However, the prevalence data for low- and middle-income countries are still scarce. The aim of this study was to evaluate the presence of ESBL, AmpC-β-lactamase and carbapenemase-producing and multidrug-resistant E. coli and K. pneumoniae in wastewaters from healthcare centers in Burkina Faso. Results: Eighty-four (84) wastewater samples were collected from five healthcare centers and plated on selective ESBL ChromAgar. E. coli and Klebsiella pneumoniae isolates were identified using API20E. ESBL-producing bacteria were detected in 97.6% of the samples and their average concentration per hospital ranged from 1.10 × 105 to 5.23 × 106 CFU/mL. Out of 170 putative ESBL-producing isolates (64% of them were E. coli) and 51 putative AmpC-β-lactamase-producing isolates, 95% and 45% were confirmed, respectively. Carbapenemase production was detected in 10 isolates, of which 6 were NDM producers, 3 were OXA-48 producers and 1 was NDM and OXA-48 producer. All isolates were multidrug resistant and, moreover, all of them were resistant to all tested β-lactams. Resistance to ESBL inhibitors was also common, up to 66% in E. coli and 62% in K. pneumoniae. Amikacin, fosfomycin and nitrofurantoin were the antibiotics to which the least resistance was detected. Conclusions: This study showed that wastewater from healthcare centers constitutes a reservoir of multidrug-resistant bacteria in Burkina Faso, including carbapenemase producers. Untreated healthcare wastewater entering the environment exposes people and animals to infections caused by these multi-resistant bacteria, which are difficult to treat, especially in the resource-poor settings. | |||
Hamtandi Magloire Natama, Gemma Moncunill, Marta Vidal, Toussaint Rouamba, Ruth Aguilar, Rebeca Santano, Eduard Rovira-Vallbona, Alfons Jiménez, M. Athanase Somé, Hermann Sorgho, Innocent Valéa, Maminata Coulibaly-Traoré, Ross L. Coppel, David Cavanagh, Chetan E. Chitnis, James G. Beeson, Evelina Angov, Sheetij Dutta, Benoit Gamain, Luis Izquierdo, Petra F. Mens, Henk D. F. H. Schallig, Halidou Tinto, Anna Rosanas-Urgell, Carlota Dobaño Associations between prenatal malaria exposure, maternal antibodies at birth, and malaria susceptibility during the first year of life in Burkina Faso Journal Article In: Infection and immunity, vol. 91, iss. 10, pp. 290, 2023, ISSN: 1098-5522. Abstract | BibTeX | Tags: Antibodies, Antigens, Burkina Faso / epidemiology, Carlota Dobaño, Child, Cohort Studies, doi:10.1128/iai.00268-23, Falciparum*, Female, Gemma Moncunill, Hamtandi Magloire Natama, Humans, Immunoglobulin G, Infant, Malaria, Malaria* / epidemiology, Maternal Exposure, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Newborn, NIH, NLM, placenta, Plasmodium falciparum, PMC10580994, pmid:37754682, Pregnancy, Preschool, Protozoan, PubMed Abstract | Links: @article{Natama2023, In this study, we investigated how different categories of prenatal malaria exposure (PME) influence levels of maternal antibodies in cord blood samples and the subsequent risk of malaria in early childhood in a birth cohort study (N = 661) nested within the COSMIC clinical trial (NCT01941264) in Burkina Faso. Plasmodium falciparum infections during pregnancy and infants’ clinical malaria episodes detected during the first year of life were recorded. The levels of maternal IgG and IgG1-4 to 15 P. falciparum antigens were measured in cord blood by quantitative suspension array technology. Results showed a significant variation in the magnitude of maternal antibody levels in cord blood, depending on the PME category, with past placental malaria (PM) more frequently associated with significant increases of IgG and/or subclass levels across three groups of antigens defined as pre-erythrocytic, erythrocytic, and markers of PM, as compared to those from the cord of non-exposed control infants. High levels of antibodies to certain erythrocytic antigens (i.e., IgG to EBA140 and EBA175, IgG1 to EBA175 and MSP142, and IgG3 to EBA140 and MSP5) were independent predictors of protection from clinical malaria during the first year of life. By contrast, high levels of IgG, IgG1, and IgG2 to the VAR2CSA DBL1-2 and IgG4 to DBL3-4 were significantly associated with an increased risk of clinical malaria. These findings indicate that PME categories have different effects on the levels of maternal-derived antibodies to malaria antigens in children at birth, and this might drive heterogeneity to clinical malaria susceptibility in early childhood. | |||
Anna Roca, Bully Camara, Joel D. Bognini, Usman N. Nakakana, Athasana M. Somé, Nathalie Beloum, Toussaint Rouamba, Fatoumata Sillah, Madikoi Danso, Joquina C. Jones, Shashu Graves, Isatou Jagne, Pauline Getanda, Saffiatou Darboe, Marc C. Tahita, Ebrahim Ndure, Hien S. Franck, Sawadogo Y. Edmond, Bai L. Dondeh, Wilfried G. J. Nassa, Zakaria Garba, Abdoulie Bojang, Yusupha Njie, Christian Bottomley, Halidou Tinto, Umberto D'Alessandro Effect of Intrapartum Azithromycin vs Placebo on Neonatal Sepsis and Death: A Randomized Clinical Trial Journal Article In: JAMA, vol. 329, iss. 9, 2023, ISSN: 15383598. Abstract | BibTeX | Tags: | Links: @article{Roca2023, Importance: Neonatal sepsis is a leading cause of neonatal mortality. New interventions are needed to decrease neonatal sepsis and mortality in regions with highest burden. Objective: To evaluate the efficacy of intrapartum azithromycin to reduce neonatal sepsis or mortality, as well as neonatal and maternal infections. Design, Setting, and Participants: This double-blind, placebo-controlled, randomized clinical trial enrolled and followed up birthing parents and their infants at 10 health facilities in The Gambia and Burkina Faso, West Africa, between October 2017 and May 2021. Interventions: Participants were assigned at random to receive oral azithromycin (2 g) or placebo (ratio 1:1) during labor. Main Outcomes and Measures: The primary outcome was a composite of neonatal sepsis or mortality, with the former defined based on microbiologic or clinical criteria. Secondary outcomes were neonatal infections (skin, umbilical, eye and ear infections), malaria, and fever; postpartum infections (puerperal sepsis, mastitis), fever, and malaria; and use of antibiotics during 4-week follow-up. Results: The trial randomized 11983 persons in labor (median age, 29.9 years). Overall, 225 newborns (1.9% of 11783 live births) met the primary end point. The incidence of neonatal mortality or sepsis was similar in the azithromycin and placebo groups (2.0% [115/5889] vs 1.9% [110/5894]; risk difference [RD], 0.09 [95% CI, -0.39 to 0.57]), as was the incidence of neonatal mortality (0.8% vs 0.8%; RD, 0.04 [95% CI, -0.27 to 0.35]) and neonatal sepsis (1.3% vs 1.3%; RD, 0.02 [95% CI, -0.38 to 0.43]). Newborns in the azithromycin group compared with the placebo group had lower incidence of skin infections (0.8% vs 1.7%; RD, -0.90 [95% CI, -1.30 to -0.49]) and need for antibiotics (6.2% vs 7.8%; RD, -1.58 [95% CI, -2.49 to -0.67]). Postpartum parents in the azithromycin group had lower incidence of mastitis (0.3% vs 0.5%; RD, -0.24 [95% CI, -0.47 to -0.01]) and puerperal fever (0.1% vs 0.3%; RD, -0.19 [95% CI, -0.36 to -0.01]). Conclusions and Relevance: Azithromycin administered orally during labor did not reduce neonatal sepsis or mortality. These results do not support routine introduction of oral intrapartum azithromycin for this purpose. | |||
Melina A. Markkanen, Kaisa Haukka, Katariina M. M. Pärnänen, Victorien Tamegnon Dougnon, Isidore Juste O. Bonkoungou, Zakaria Garba, Halidou Tinto, Anniina Sarekoski, Antti Karkman, Anu Kantele, Marko P. J. Virta Metagenomic Analysis of the Abundance and Composition of Antibiotic Resistance Genes in Hospital Wastewater in Benin, Burkina Faso, and Finland Journal Article In: mSphere, vol. 8, iss. 1, 2023, ISSN: 23795042. Abstract | BibTeX | Tags: | Links: @article{Markkanen2023, The global emergence and increased spread of antibiotic resistance threaten the effectiveness of antibiotics and, thus, the health of the entire population. Therefore, understanding the resistomes in different geographical locations is crucial in the global fight against the antibiotic resistance crisis. Antibiotic resistance is a global threat to human health, with the most severe effect in low- and middle-income countries. We explored the presence of antibiotic resistance genes (ARGs) in the hospital wastewater (HWW) of nine hospitals in Benin and Burkina Faso, two low-income countries in West Africa, with shotgun metagenomic sequencing. For comparison, we also studied six hospitals in Finland. The highest sum of the relative abundance of ARGs in the 68 HWW samples was detected in Benin and the lowest in Finland. HWW resistomes and mobilomes in Benin and Burkina Faso resembled each other more than those in Finland. Many carbapenemase genes were detected at various abundances, especially in HWW from Burkina Faso and Finland. The bla GES genes, the most widespread carbapenemase gene in the Beninese HWW, were also found in water intended for hand washing and in a puddle at a hospital yard in Benin. mcr genes were detected in the HWW of all three countries, with mcr-5 being the most common mcr gene. These and other mcr genes were observed in very high relative abundances, even in treated wastewater in Burkina Faso and a street gutter in Benin. The results highlight the importance of wastewater treatment, with particular attention to HWW. IMPORTANCE The global emergence and increased spread of antibiotic resistance threaten the effectiveness of antibiotics and, thus, the health of the entire population. Therefore, understanding the resistomes in different geographical locations is crucial in the global fight against the antibiotic resistance crisis. However, this information is scarce in many low- and middle-income countries (LMICs), such as those in West Africa. In this study, we describe the resistomes of hospital wastewater in Benin and Burkina Faso and, as a comparison, Finland. Our results help to understand the hitherto unrevealed resistance in Beninese and Burkinabe hospitals. Furthermore, the results emphasize the importance of wastewater management infrastructure design to minimize exposure events between humans, HWW, and the environment, preventing the circulation of resistant bacteria and ARGs between humans (hospitals and community) and the environment. | |||
Makoto Saito, Rose McGready, Halidou Tinto, Toussaint Rouamba, Dominic Mosha, Stephen Rulisa, Simon Kariuki, Meghna Desai, Christine Manyando, Eric M. Njunju, Esperanca Sevene, Anifa Vala, Orvalho Augusto, Christine Clerk, Edwin Were, Sigilbert Mrema, William Kisinza, Josaphat Byamugisha, Mike Kagawa, Jan Singlovic, Mackensie Yore, Anna Maria Eijk, Ushma Mehta, Andy Stergachis, Jenny Hill, Kasia Stepniewska, Melba Gomes, Philippe J. Guérin, Francois Nosten, Feiko O. Kuile, Stephanie Dellicour Pregnancy outcomes after first-trimester treatment with artemisinin derivatives versus non-artemisinin antimalarials: a systematic review and individual patient data meta-analysis Journal Article In: The Lancet, vol. 401, iss. 10371, 2023, ISSN: 1474547X. Abstract | BibTeX | Tags: | Links: @article{Saito2023, Background: Malaria in the first trimester of pregnancy is associated with adverse pregnancy outcomes. Artemisinin-based combination therapies (ACTs) are a highly effective, first-line treatment for uncomplicated Plasmodium falciparum malaria, except in the first trimester of pregnancy, when quinine with clindamycin is recommended due to concerns about the potential embryotoxicity of artemisinins. We compared adverse pregnancy outcomes after artemisinin-based treatment (ABT) versus non-ABTs in the first trimester of pregnancy. Methods: For this systematic review and individual patient data (IPD) meta-analysis, we searched MEDLINE, Embase, and the Malaria in Pregnancy Library for prospective cohort studies published between Nov 1, 2015, and Dec 21, 2021, containing data on outcomes of pregnancies exposed to ABT and non-ABT in the first trimester. The results of this search were added to those of a previous systematic review that included publications published up until November, 2015. We included pregnancies enrolled before the pregnancy outcome was known. We excluded pregnancies with missing estimated gestational age or exposure information, multiple gestation pregnancies, and if the fetus was confirmed to be unviable before antimalarial treatment. The primary endpoint was adverse pregnancy outcome, defined as a composite of either miscarriage, stillbirth, or major congenital anomalies. A one-stage IPD meta-analysis was done by use of shared-frailty Cox models. This study is registered with PROSPERO, number CRD42015032371. Findings: We identified seven eligible studies that included 12 cohorts. All 12 cohorts contributed IPD, including 34 178 pregnancies, 737 with confirmed first-trimester exposure to ABTs and 1076 with confirmed first-trimester exposure to non-ABTs. Adverse pregnancy outcomes occurred in 42 (5·7%) of 736 ABT-exposed pregnancies compared with 96 (8·9%) of 1074 non-ABT-exposed pregnancies in the first trimester (adjusted hazard ratio [aHR] 0·71, 95% CI 0·49–1·03). Similar results were seen for the individual components of miscarriage (aHR=0·74, 0·47–1·17), stillbirth (aHR=0·71, 0·32–1·57), and major congenital anomalies (aHR=0·60, 0·13–2·87). The risk of adverse pregnancy outcomes was lower with artemether–lumefantrine than with oral quinine in the first trimester of pregnancy (25 [4·8%] of 524 vs 84 [9·2%] of 915; aHR 0·58, 0·36–0·92). Interpretation: We found no evidence of embryotoxicity or teratogenicity based on the risk of miscarriage, stillbirth, or major congenital anomalies associated with ABT during the first trimester of pregnancy. Given that treatment with artemether–lumefantrine was associated with fewer adverse pregnancy outcomes than quinine, and because of the known superior tolerability and antimalarial effectiveness of ACTs, artemether–lumefantrine should be considered the preferred treatment for uncomplicated P falciparum malaria in the first trimester. If artemether–lumefantrine is unavailable, other ACTs (except artesunate–sulfadoxine–pyrimethamine) should be preferred to quinine. Continued active pharmacovigilance is warranted. Funding: Medicines for Malaria Venture, WHO, and the Worldwide Antimalarial Resistance Network funded by the Bill & Melinda Gates Foundation. | |||
Sidsel Nag, Gunhild Larsen, Judit Szarvas, Laura Elmlund Kohl Birkedahl, Gábor Máté Gulyás, Wojchiech Jakub Ciok, Timmie Mikkel Lagermann, Silva Tafaj, Susan Bradbury, Peter Collignon, Denise Daley, Victorien Dougnon, Kafayath Fabiyi, Boubacar Coulibaly, René Dembélé, Georgette Nikiema, Natama Magloire, Isidore Juste Ouindgueta, Zenat Zebin Hossain, Anowara Begum, Deyan Donchev, Mathew Diggle, Lee Ann Turnbull, Simon Lévesque, Livia Berlinger, Kirstine Kobberoe Sogaard, Paula Diaz Guevara, Carolina Duarte Valderrama, Panagiota Maikanti, Jana Amlerova, Pavel Drevinek, Jan Tkadlec, Milica Dilas, Achim Kaasch, Henrik Torkil Westh, Mohamed Azzedine Bachtarzi, Wahiba Amhis, Carolina Elisabeth Satán Salazar, JoséEduardo E. Villacis, Mária Angeles Dominguez Lúzon, Dámaris Berbel Palau, Claire Duployez, Maxime Paluche, Solomon Asante-Sefa, Mie Moller, Margaret Ip, Ivana Mareković, Agnes Pál-Sonnevend, Clementiza Elvezia Cocuzza, Asta Dambrauskiene, Alexandre Macanze, Anelsio Cossa, Inácio Mandomando, Philip Nwajiobi-Princewill, Iruka N. Okeke, Aderemi O. Kehinde, Ini Adebiyi, Ifeoluwa Akintayo, Oluwafemi Popoola, Anthony Onipede, Anita Blomfeldt, Nora Elisabeth Nyquist, Kiri Bocker, James Ussher, Amjad Ali, Nimat Ullah, Habibullah Khan, Natalie Weiler Gustafson, Ikhlas Jarrar, Arif Al-Hamad, Viravarn Luvira, Wantana Paveenkittiporn, Irmak Baran, James C. L. Mwansa, Linda Sikakwa, Kaunda Yamba, Rene Sjogren Hendriksen, Frank Moller Aarestrup Whole genomes from bacteria collected at diagnostic units around the world 2020 Journal Article In: Scientific data, vol. 10, iss. 1, 2023, ISSN: 2052-4463. Abstract | BibTeX | Tags: Bacteria* / genetics, Bacterial*, Computational Biology, Databases, Dataset, doi:10.1038/s41597-023-02502-7, Factual, Frank Moller Aarestrup, Genome, Gunhild Larsen, MEDLINE, Metadata, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC10505216, pmid:37717051, PubMed Abstract, Sidsel Nag | Links: @article{Nag2023, The Two Weeks in the World research project has resulted in a dataset of 3087 clinically relevant bacterial genomes with pertaining metadata, collected from 59 diagnostic units in 35 countries around the world during 2020. A relational database is available with metadata and summary data from selected bioinformatic analysis, such as species prediction and identification of acquired resistance genes. | |||
Piero Olliaro, Juvenal Nkeramahame, Philip Horgan, Halidou Tinto, François Kiemde, Rita Baiden, Alexander Adjei, James Kapisi, Heidi Hopkins, Olawale Salami, Catrin E. Moore, Sabine Dittrich, Stephan Weber, Stefano Ongarello Synthesis and Meta-analysis of 3 Randomized Trials Conducted in Burkina Faso, Ghana, and Uganda Comparing the Effects of Point-of-Care Tests and Diagnostic Algorithms Versus Routine Care on Antibiotic Prescriptions and Clinical Outcomes in Ambulatory Patients <18 Years of Age With Acute Febrile Illness Journal Article In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 77, iss. Suppl 2, pp. S199-S205, 2023, ISSN: 1537-6591. BibTeX | Tags: {Algorithms, Anti-Bacterial Agents* / therapeutic use, Author(firstnames='Adélaïde', Author(firstnames='Alexander', Author(firstnames='Asadu', Author(firstnames='Daniel', Author(firstnames='David', Author(firstnames='Deborah', Author(firstnames='Elizeus', Author(firstnames='François', Author(firstnames='Freddy Eric', Author(firstnames='Halidou', Author(firstnames='Heidi', Author(firstnames='James', Author(firstnames='Rita', Author(firstnames='Vida', Burkina Faso, CollabAuthor(name='ADIP study group', Diagnostic Tests, Ghana, Humans, Juvenal Nkeramahame, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Piero Olliaro, PMC10368413, Point-of-Care Testing*, Prescriptions, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support | Links: @article{Olliaro2023, | |||
Francois Kiemde, Daniel Valia, Berenger Kabore, Toussaint Rouamba, Alima Nadine Kone, Seydou Sawadogo, Adelaide Compaore, Olawale Salami, Philip Horgan, Catrin E. Moore, Sabine Dittrich, Juvenal Nkeramahame, Piero Olliaro, Halidou Tinto A Randomized Trial to Assess the Impact of a Package of Diagnostic Tools and Diagnostic Algorithm on Antibiotic Prescriptions for the Management of Febrile Illnesses Among Children and Adolescents in Primary Health Facilities in Burkina Faso Journal Article In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 77, iss. Suppl 2, pp. S134-S144, 2023, ISSN: 1537-6591. Abstract | BibTeX | Tags: Adolescent, Algorithms, Anti-Bacterial Agents* / therapeutic use, Burkina Faso, Child, Daniel Valia, doi:10.1093/cid/ciad331, Francois Kiemde, Halidou Tinto, Health Facilities, Humans, Infant, Malaria* / drug therapy, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10368409, pmid:37490742, Preschool, Prescriptions, PubMed Abstract, Randomized controlled trial, Research Support | Links: @article{Kiemde2023, Background: Low- and middle-income countries face significant challenges in differentiating bacterial from viral causes of febrile illnesses, leading to inappropriate use of antibiotics. This trial aimed to evaluate the impact of an intervention package comprising diagnostic tests, a diagnostic algorithm, and a training-and-communication package on antibiotic prescriptions and clinical outcomes. Methods: Patients aged 6 months to 18 years with fever or history of fever within the past 7 days with no focus, or a suspected respiratory tract infection, arriving at 2 health facilities were randomized to either the intervention package or standard practice. The primary outcomes were the proportions of patients who recovered at day 7 (D7) and patients prescribed antibiotics at day 0. Results: Of 1718 patients randomized, 1681 (97.8%; intervention: 844; control: 837) completed follow-up: 99.5% recovered at D7 in the intervention arm versus 100% in standard practice (P =. 135). Antibiotics were prescribed to 40.6% of patients in the intervention group versus 57.5% in the control arm (risk ratio: 29.3%; 95% CI: 21.8-36.0%; risk difference [RD]: -16.8%; 95% CI: -21.7% to -12.0%; P <. 001), which translates to 1 additional antibiotic prescription saved every 6 (95% CI: 5-8) consultations. This reduction was significant regardless of test results for malaria, but was greater in patients without malaria (RD: -46.0%; -54.7% to -37.4%; P <. 001), those with a respiratory diagnosis (RD: -38.2%; -43.8% to -32.6%; P <. 001), and in children 6-59 months old (RD: -20.4%; -26.0% to -14.9%; P <. 001). Except for the period July-September, the reduction was consistent across the other quarters (P <. 001). Conclusions: The implementation of the package can reduce inappropriate antibiotic prescription without compromising clinical outcomes. Clinical Trials Registration: clinicaltrials.gov; NCT04081051. | |||
Adelaïde Compaore, Deborah Ekusai-Sebatta, David Kaawa-Mafigiri, Vida Kukula, Selase Odopey, James Kapisi, Heidi Hopkins, François Kiemde, Halidou Tinto, Rita Baiden, Piero Olliaro, Juvenal Nkeramahame, Sabine Dittrich, Philip Horgan Viewpoint: Antimicrobial Resistance Diagnostics Use Accelerator: Qualitative Research on Adherence to Prescriptions Journal Article In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 77, iss. Suppl 2, pp. S206-S210, 2023, ISSN: 1537-6591. Abstract | BibTeX | Tags: {Adélaïde Compaoré, Anti-Bacterial Agents* / therapeutic use, Author(firstnames='Adélaïde', Author(firstnames='Alexander', Author(firstnames='Asadu', Author(firstnames='Daniel', Author(firstnames='David', Author(firstnames='Deborah', Author(firstnames='Elizeus', Author(firstnames='François', Author(firstnames='Freddy Eric', Author(firstnames='Halidou', Author(firstnames='Heidi', Author(firstnames='James', Author(firstnames='Rita', Author(firstnames='Vida', Bacterial*, Clinical Trial, CollabAuthor(name='ADIP study group', Communication, Deborah Ekusai-Sebatta, Drug Resistance, Humans, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10368411, Prescriptions, PubMed Abstract, Qualitative research, Research Support | Links: @article{Compaore2023, In this Viewpoint, the authors explore the determinants of patients' prescription adherence behaviors as part of FIND's Advancing Access to Diagnostic Innovation essential for Universal Health Coverage and AMR Prevention (ADIP) trials (ClinicalTrials.gov identifier: NCT04081051). Research findings from Burkina Faso, Ghana, and Uganda show that basic knowledge and understanding of prescription instructions are essential for adherence and can be improved through better communication. However, there are a range of other factors that influence adherence, some of which can be influenced through tailored communication messages from healthcare workers. These messages may contribute to changes in adherence behavior but may require other reinforcing interventions to be effective. Finally, there are some drivers of nonadherence centered around costs and time pressure that require other forms of intervention. | |||
Palpouguini Lompo, Anne Sophie Heroes, Esenam Agbobli, Adama Kazienga, Marjan Peeters, Halidou Tinto, Katrien Lagrou, Lassana Sangaré, Dissou Affolabi, Jan Jacobs Growth of Gram-Negative Bacteria in Antiseptics, Disinfectants and Hand Hygiene Products in Two Tertiary Care Hospitals in West Africa—A Cross-Sectional Survey Journal Article In: Pathogens, vol. 12, iss. 7, pp. 917, 2023, ISSN: 20760817. Abstract | BibTeX | Tags: antiseptics, bacteria, cross-sectional, disinfectants, Gram-negative, hand hygiene, healthcare-associated infections, low-and middle-income countries, resistance, West Africa | Links: @article{Lompo2023, Antiseptics, disinfectants, and hand hygiene products can act as reservoirs of Gram-negative bacteria causing healthcare-associated infections. This problem is rarely documented in low- and middle-income countries, particularly in sub-Saharan Africa. In a cross-sectional survey, we assessed the bacterial contamination of antiseptics, disinfectants, and hand hygiene products in two university hospitals in Burkina Faso and Benin. During ward visits and staff interviews, in-use products were cultured for the presence of Gram-negative bacteria. The growth of Gram-negative bacteria was absent or rare in alcohol-based products, povidone iodine, and Dakin solution. Contamination was highest (73.9% (51/69)) for liquid soap products (versus antiseptic/disinfectants (4.5%, 7/157) (p < 0.0001)), mostly used in high-risk areas and associated with high total bacterial counts (>10,000 colony-forming units/mL). Contaminating flora (105 isolates) included Enterobacterales and the Vibrio non-cholerae/Aeromonas group (17.1%) and non-fermentative Gram-negative rods (82.8%). Multidrug resistance was present among 9/16 Enterobacterales (Klebsiella and Enterobacter spp.) and 3/12 Acinetobacter spp., including carbapenem resistance (Acinetobacter baumannii: NDM, Pseudomonas stutzeri: VIM). The risk factors for contamination included the type of product (cleaning grade and in-house prepared liquid soap), use of recycled disposable containers and soft drink bottles, absence of labeling, topping-up of containers, dilution with tap water (pharmacy and ward), and poor-quality management (procurement, stock management, expiry dates, and period after opening). | |||
Selidji T. Agnandji, Mario Recker, Benjamin Mordmüller, Stephan Glöckner, Akim A. Adegnika, Bertrand Lell, Lucas Otieno, Walter Otieno, Seth Owusu-Agyei, Kwaku P. Asante, Tsiri Agbenyega, Daniel Ansong, Eusebio Macete, Pedro Aide, Hermann Sorgho, Halidou Tinto, Neema Mturi, John P. A. Lusingu, Samwel Gesase, Irving Hoffman, Nahya Salim Masoud, Charles R. Newton, Kalifa Bojang, Gérard Krause, Peter Gottfried Kremsner Prostration and the prognosis of death in African children with severe malaria Journal Article In: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, vol. 134, pp. 240-247, 2023, ISSN: 1878-3511. Abstract | BibTeX | Tags: Anemia*, Child, Clinical Trial, Coma, doi:10.1016/j.ijid.2023.06.022, Falciparum* / drug therapy, Humans, Infant, Malaria, Malaria* / complications, Malaria* / diagnosis, Mario Recker, MEDLINE, Multicenter Study, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Peter Gottfried Kremsner, Phase III, pmid:37414210, Prognosis, PubMed Abstract, Randomized controlled trial, Selidji T Agnandji | Links: @article{Agnandji2023, Objectives: Malaria is still one of the main reasons for hospitalization in children living in sub-Saharan Africa. Rapid risk stratification at admission is essential for optimal medical care and improved prognosis. Whereas coma, deep breathing, and, to a lesser degree, severe anemia are established predictors of malaria-related death, the value of assessing prostration for risk stratification is less certain. Methods: Here we used a retrospective multi-center analysis comprising over 33,000 hospitalized children from four large studies, including two observational studies from the Severe Malaria in African Children network, a randomized controlled treatment study, and the phase-3-clinical RTS,S-malaria vaccine trial, to evaluate known risk factors of mortality and with a specific emphasis on the role of prostration. Results: Despite comparable age profiles of the participants, we found significant inter- and intra-study variation in the incidence of fatal malaria as well as in the derived risk ratios associated with the four risk factors: coma, deep breathing, anemia, and prostration. Despite pronounced variations, prostration was significantly associated with an increased risk of mortality (P <0.001) and its consideration resulted in improved predictive performance, both in a multivariate model and a univariate model based on the Lambaréné Organ Dysfunction Score. Conclusion: Prostration is an important clinical criterion to determine severe pediatric malaria with possible fatal outcomes. | |||
Peter J. Neyer, Bérenger Kaboré, Christos T. Nakas, Britta Hartmann, Annelies Post, Salou Diallo, Halidou Tinto, Angelika Hammerer-Lercher, Carlo R. Largiadèr, Andre J. Ven, Andreas R. Huber Exploring the host factors affecting asymptomatic Plasmodium falciparum infection: insights from a rural Burkina Faso study Journal Article In: Malaria journal, vol. 22, iss. 1, 2023, ISSN: 1475-2875. Abstract | BibTeX | Tags: Adolescent, Andreas R Huber, Asymptomatic Infections / epidemiology, Bérenger Kaboré, Burkina Faso / epidemiology, Child, doi:10.1186/s12936-023-04686-0, Falciparum* / epidemiology, hemoglobin, Hepcidins*, Humans, Malaria, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Peter J Neyer, Plasmodium falciparum / genetics, PMC10474782, pmid:37658365, PubMed Abstract, Sickle | Links: @article{Neyer2023, Background: Asymptomatic Plasmodium falciparum parasitaemia forms a reservoir for the transmission of malaria disease in West Africa. Certain haemoglobin variants are known to protect against severe malaria infection. However, data on the potential roles of haemoglobin variants and nongenetic factors in asymptomatic malaria infection is scarce and controversial. Therefore, this study investigated the associations of iron homeostasis, inflammation, nutrition, and haemoglobin mutations with parasitaemia in an asymptomatic cohort from a P. falciparum-endemic region during the high transmission season. Methods: A sub-study population of 688 asymptomatic individuals (predominantly children and adolescents under 15 years | |||
Palwende Romuald Boua, Toussaint Rouamba, Estelle Bambara, Saidou Kaboré, Ella W. R. Compaore, Boureima Ouedraogo, Halidou Tinto, Marie Louise Newell, Kate Ward, Hermann Sorgho Undernutrition in children aged 0-59 months by region and over time: secondary analysis of the Burkina Faso 2012-2018 National Nutrition Surveys Journal Article In: BMJ open, vol. 13, iss. 9, 2023, ISSN: 2044-6055. Abstract | BibTeX | Tags: {Author(firstnames='Adélaïde', Author(firstnames='Aminata', Author(firstnames='Caroline', Author(firstnames='Cornelius', Author(firstnames='Daniella', Author(firstnames='Doreen', Author(firstnames='Edith', Author(firstnames='Engelbert', Author(firstnames='Esmond W', Author(firstnames='James', Author(firstnames='Josephine', Author(firstnames='Kadija', Author(firstnames='Karim', Author(firstnames='Keith', Author(firstnames='Marie-Louise', Author(firstnames='Mark', Author(firstnames='Mary', Author(firstnames='Maxwell', Author(firstnames='Michael', Author(firstnames='Paul', Author(firstnames='Paula', Author(firstnames='Polly', Author(firstnames='Samuel', Author(firstnames='Sarah', Author(firstnames='Shane A', Author(firstnames='Stephanie', Author(firstnames='Winfred', Burkina Faso / epidemiology, Cachexia, Child, CollabAuthor(name='INPreP Study Group', Growth Disorders / epidemiology, Humans, Malnutrition* / epidemiology, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Nutrition Surveys, Palwende Romuald Boua, PMC10496659, Preschool, PubMed Abstract, Research Support, Thinness* / epidemiology, Toussaint Rouamba | Links: @article{Boua2023, The global burden of undernutrition remains high, responsible for significant under-five mortality in resource-limited settings. Numerous sustainable development goals (SDGs) are linked to nutrition, and nationally representative nutrition surveillance is a key activity to track progress towards SDGs and guide efficient programmes. Objectives The aim of this study is to look at spatial and temporal trends in undernutrition in children under 5 years age in Burkina Faso. Setting We used data from annual National Nutrition Surveys using Standardised Monitoring and Assessment of Relief and Transitions methodology (anthropometry, morbidity) over 7 years (2012-2018) in Burkina Faso. Participants Children of under 5 years from households selected through systemic sampling at countrywide level. Main outcome measures Prevalence of stunting (height-for-age z-score, <-2), underweight (weight-for-age z-score, <-2) and wasting (weight-for-height z-score, <-2) at regional and national. We used general linear mixed models, adjusted by age, survey year, sex, presence of fever and/or diarrhoea, and poverty index to quantify the risk of undernutrition over time and by region of residence. Results Between 2012 and 2018, decreases were observed overall in the prevalence of growth retardation (stunting) decreased from 33.0% (95% CI 32.3 to 33.8) in 2012 to 26.7% (95% CI 26.2 to 27.3) in 2018. Underweight reduced from 24.4% (95% CI 23.7 to 25.1) to 18.7% (95% CI 18.2 to 19.2) for the same period and wasting decreased from 10.8% (95% CI 10.3 to 11.3) in 2012 to 8.4% (95% CI 8.1 to 8.8) in 2018. However, there was substantial variation across the country, with increased risk of undernutrition in the regions of Sahel, East and Cascades primarily. High-risk regions were characterised by a lower poverty index and limited access to healthcare services. Conclusions Our findings could inform national policymakers in refining and optimising resource allocation based on the identification of high-risk areas. | |||
Jessica Amegee Quach, Innocent Valea, Imelda Bates, Justin Pulford Factors affecting African postdoctoral researcher capacity development within 'learn-by-doing' international research partnerships: findings from the 'Partnership for Increasing the Impact of Vector Control (PIIVeC)' Journal Article In: BMJ global health, vol. 8, iss. 9, 2023, ISSN: 2059-7908. Abstract | BibTeX | Tags: doi:10.1136/bmjgh-2023-012626, Focus Groups, Health Personnel*, Humans, Innocent Valea, Jessica Amegee Quach, Justin Pulford, Leadership, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Physicians*, PMC10496693, pmid:37678937, PubMed Abstract, Qualitative research, Research Support | Links: @article{nokey, Introduction The Partnership to Increase the Impact of Vector Control sought to develop the research and leadership capacity of 10 African postdoctoral vectorborne disease scientists via a € learn-by-doing' approach. We identified factors that either supported or hindered their development and, drawing on this information, determined key lessons for future programmes with similar objectives. Methods A longitudinal qualitative study encompassing focus group discussions and semistructured interviews conducted with the cohort of African postdoctoral fellows, programme leadership, supervisory and research support staff (N=28). Data analysis was informed by a general inductive approach. Results Numerous supportive and hindering factors were identified. Supportive factors were primarily structural or attitudinal in nature, whereas hindering factors were primarily operational or contextual. None of the supporting or hindering factors were specific to vectorborne disease research. Four key lessons for future programme implementation emerged, including: the value in exposing postdoctoral fellows to a diverse work-mix and training-mix to improve understanding of the broad skillset needed for scientific career advancement; recognising and managing the potentially competing interests of different partnership members to ensure everyone benefits from participation; ensuring equity of opportunity and rewarding engagement; and ensuring flexibility in support provision. Conclusion Our study highlights numerous factors that may be readily incorporated into early career researcher capacity strengthening initiatives based on a learn-by-doing approach. Many of these factors are supported by a growing weight of evidence and would be appropriate to research capacity strengthening programmes both within and outside of a vectorborne disease context. | |||
Bernhards Ogutu, Adoke Yeka, Sylvia Kusemererwa, Ricardo Thompson, Halidou Tinto, Andre Offianan Toure, Chirapong Uthaisin, Amar Verma, Afizi Kibuuka, Moussa Lingani, Carlos Lourenço, Ghyslain Mombo-Ngoma, Videlis Nduba, Tiacoh Landry N'Guessan, Guétawendé Job Wilfried Nassa, Mary Nyantaro, Lucas Otieno Tina, Piyoosh K. Singh, Myriam El Gaaloul, Anne Claire Marrast, Havana Chikoto, Katalin Csermak, Ivan Demin, Dheeraj Mehta, Rashidkhan Pathan, Celine Risterucci, Guoqin Su, Cornelis Winnips, Grace Kaguthi, Bakary Fofana, Martin Peter Grobusch Ganaplacide (KAF156) plus lumefantrine solid dispersion formulation combination for uncomplicated Plasmodium falciparum malaria: an open-label, multicentre, parallel-group, randomised, controlled, phase 2 trial Journal Article In: The Lancet. Infectious diseases, vol. 23, iss. 9, pp. 1051-1061, 2023, ISSN: 1474-4457. Abstract | BibTeX | Tags: Adoke Yeka, Adolescent, Adult, Antimalarials*, Artemether / pharmacology, Artemether / therapeutic use, Artemisinins*, Bernhards Ogutu, Child, Clinical Trial, doi:10.1016/S1473-3099(23)00209-8, Drug Combinations, Ethanolamines / pharmacology, Ethanolamines / therapeutic use, Falciparum* / drug therapy, Falciparum* / parasitology, Fluorenes / pharmacology, Fluorenes / therapeutic use, Humans, Lumefantrine / pharmacology, Lumefantrine / therapeutic use, Malaria, Malaria* / drug therapy, Martin Peter Grobusch, MEDLINE, Multicenter Study, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Phase II, Plasmodium falciparum, pmid:37327809, PubMed Abstract, Randomized controlled trial, Research Support, Treatment Outcome | Links: @article{Ogutu2023, Background: Emergence of drug resistance demands novel antimalarial drugs with new mechanisms of action. We aimed to identify effective and well tolerated doses of ganaplacide plus lumefantrine solid dispersion formulation (SDF) in patients with uncomplicated Plasmodium falciparum malaria. Methods: This open-label, multicentre, parallel-group, randomised, controlled, phase 2 trial was conducted at 13 research clinics and general hospitals in ten African and Asian countries. Patients had microscopically-confirmed uncomplicated P falciparum malaria (>1000 and <150 000 parasites per μL). Part A identified the optimal dose regimens in adults and adolescents (aged ≥12 years) and in part B, the selected doses were assessed in children (≥2 years and <12 years). In part A, patients were randomly assigned to one of seven groups (once a day ganaplacide 400 mg plus lumefantrine-SDF 960 mg for 1, 2, or 3 days; ganaplacide 800 mg plus lumefantrine-SDF 960 mg as a single dose; once a day ganaplacide 200 mg plus lumefantrine-SDF 480 mg for 3 days; once a day ganaplacide 400 mg plus lumefantrine-SDF 480 mg for 3 days; or twice a day artemether plus lumefantrine for 3 days [control]), with stratification by country (2:2:2:2:2:2:1) using randomisation blocks of 13. In part B, patients were randomly assigned to one of four groups (once a day ganaplacide 400 mg plus lumefantrine-SDF 960 mg for 1, 2, or 3 days, or twice a day artemether plus lumefantrine for 3 days) with stratification by country and age (2 to <6 years and 6 to <12 years; 2:2:2:1) using randomisation blocks of seven. The primary efficacy endpoint was PCR-corrected adequate clinical and parasitological response at day 29, analysed in the per protocol set. The null hypothesis was that the response was 80% or lower, rejected when the lower limit of two-sided 95% CI was higher than 80%. This study is registered with EudraCT (2020–003284–25) and ClinicalTrials.gov (NCT03167242). Findings: Between Aug 2, 2017, and May 17, 2021, 1220 patients were screened and of those, 12 were included in the run-in cohort, 337 in part A, and 175 in part B. In part A, 337 adult or adolescent patients were randomly assigned, 326 completed the study, and 305 were included in the per protocol set. The lower limit of the 95% CI for PCR-corrected adequate clinical and parasitological response on day 29 was more than 80% for all treatment regimens in part A (46 of 50 patients [92%, 95% CI 81–98] with 1 day, 47 of 48 [98%, 89–100] with 2 days, and 42 of 43 [98%, 88–100] with 3 days of ganaplacide 400 mg plus lumefantrine-SDF 960 mg; 45 of 48 [94%, 83–99] with ganaplacide 800 mg plus lumefantrine-SDF 960 mg for 1 day; 47 of 47 [100%, 93–100] with ganaplacide 200 mg plus lumefantrine-SDF 480 mg for 3 days; 44 of 44 [100%, 92–100] with ganaplacide 400 mg plus lumefantrine-SDF 480 mg for 3 days; and 25 of 25 [100%, 86–100] with artemether plus lumefantrine). In part B, 351 children were screened, 175 randomly assigned (ganaplacide 400 mg plus lumefantrine-SDF 960 mg once a day for 1, 2, or 3 days), and 171 completed the study. Only the 3-day regimen met the prespecified primary endpoint in paediatric patients (38 of 40 patients [95%, 95% CI 83–99] vs 21 of 22 [96%, 77–100] with artemether plus lumefantrine). The most common adverse events were headache (in seven [14%] of 51 to 15 [28%] of 54 in the ganaplacide plus lumefantrine-SDF groups and five [19%] of 27 in the artemether plus lumefantrine group) in part A, and malaria (in 12 [27%] of 45 to 23 [44%] of 52 in the ganaplacide plus lumefantrine-SDF groups and 12 [50%] of 24 in the artemether plus lumefantrine group) in part B. No patients died during the study. Interpretation: Ganaplacide plus lumefantrine-SDF was effective and well tolerated in patients, especially adults and adolescents, with uncomplicated P falciparum malaria. Ganaplacide 400 mg plus lumefantrine-SDF 960 mg once daily for 3 days was identified as the optimal treatment regimen for adults, adolescents, and children. This combination is being evaluated further in a phase 2 trial (NCT04546633). Funding: Novartis and Medicines for Malaria Venture. | |||
Surina Singh, Ananyo Choudhury, Scott Hazelhurst, Nigel Crowther, Palwende Boua, Hermann Sorgho, Godfred Agongo, Engelbert Nonterah, Lisa Micklesfield, Shane Norris, Isaac Kisiangani, Shukri Mohamed, Francesc Gomez-Olive, Stephen Tollman, Solomon Choma, Jean-Tristan Brandenburg, Michele Ramsay Genome-wide Association Study Meta-analysis of Blood Pressure Traits and Hypertension in Sub-Saharan African Populations: An AWI-Gen Study Journal Article In: Research square, 2023, ISSN: 2693-5015. Abstract | BibTeX | Tags: Ananyo Choudhury, doi:10.21203/rs.3.rs-2532794/v1, MEDLINE, Michèle Ramsay, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC9949264, pmid:36824767, Preprint, PubMed Abstract, Surina Singh | Links: @article{Singh2023, Most hypertension-related genome-wide association studies (GWAS) focus on non-African populations, despite hypertension (a major risk factor for cardiovascular disease) being highly prevalent in Africa. The AWI-Gen study GWAS meta-analysis for blood pressure-related traits (systolic and diastolic blood pressure, pulse pressure, mean-arterial pressure and hypertension) from three sub-Saharan African geographic regions (N=10,775), identified two genome-wide significant signals (p<5E-08): systolic blood pressure near P2RY1 (rs77846204; intergenic variant | |||
Isidore W. Yerbanga, Seydou Nakanabo Diallo, Toussaint Rouamba, Agustin Resendiz-Sharpe, Katrien Lagrou, Olivier Denis, Hector Rodriguez-Villalobos, Isabel Montesinos, Sanata Bamba Performances of disk diffusion method for determining triazole susceptibility of Aspergillus species: Systematic review Journal Article In: Journal de mycologie medicale, vol. 33, iss. 4, 2023, ISSN: 1773-0449. Abstract | BibTeX | Tags: Agar, Antifungal Agents* / pharmacology, Aspergillus, doi:10.1016/j.mycmed.2023.101413, Isidore W Yerbanga, Itraconazole* / pharmacology, MEDLINE, Microbial Sensitivity Tests, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, pmid:37603962, PubMed Abstract, Reproducibility of Results, Review, Sanata Bamba, Seydou Nakanabo Diallo, Systematic review, Triazoles / pharmacology, Voriconazole / pharmacology | Links: @article{Yerbanga2023, The therapeutic management of invasive aspergillosis should be guided by antifungal susceptibility testing (AFST). The disk diffusion (DD) method due to its simplicity and low cost could be an appropriate alternative to the reference methods (CLSI, EUCAST) which are not suitable for AFST in routine clinical microbiology laboratories, particularly in resource-constrained settings. This review summarizes the available data on the performance of the DD method in determining triazole susceptibility profile of Aspergillus species. The published articles on the performance of DD method for determining triazole susceptibility of Aspergillus spp. were systematically searched on major medical databases and Google Scholar. We identified 2725 articles of which 13 met the inclusion criteria. The overall average agreement value obtained between DD and CLSI broth microdilution (CLSI-BMD) methods for the itraconazole 10 µg disk (70.75%) was low especially when the medium used was not Mueller-Hinton (MH) agar. In contrast average agreement for the voriconazole 1 µg disk and the posaconazole 5 µg disk were > 94% regardless of media used. The correlation coefficient values between the DD and CLSI-BMD methods on MH agar were acceptable (≥ 0.71) for the itraconazole 10 µg disk and posaconazole 5 µg disk and good (≥ 0.80) for the voriconazole 1 and 10 µg disk. The reproducibility of the DD method regardless to the medium used was ≥ 82%. This systematic review shows that the disk diffusion method could be a real alternative for triazole antifungals susceptibility testing of Aspergillus spp. |
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