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Kouriba B, Arama C, Ouologuem DT, Cissoko Y, Diakite M, Beavogui AH, Wele M, Tekete M, Fofana B, Dama S, Maiga H, Kone A, Niangaly A, Diarra I, Daou M, Guindo A, Traore K, Coulibaly D, Kone AK, Dicko A, Clark TG, Doumbo OK, Djimde A. IFNγ, TNFα polymorphisms and IFNγ serum levels are associated with the clearance of drug-resistant P. falciparum in Malian children. Cytokine 2023; 164:156137. [PMID: 36773528 DOI: 10.1016/j.cyto.2023.156137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/11/2023]
Abstract
Host immunity has been suggested to clear drug-resistant parasites in malaria-endemic settings. However, the immunogenetic mechanisms involved in parasite clearance are poorly understood. Characterizing the host's immunity and genes involved in controlling the parasitic infection can inform the development of blood-stage malaria vaccines. This study investigates host regulatory cytokines and immunogenomic factors associated with the clearance of Plasmodium falciparum carrying a chloroquine resistance genotype. Biological samples from participants of previous drug efficacy trials conducted in two Malian localities were retrieved. The P. falciparum chloroquine resistance transporter (Pfcrt) gene was genotyped using parasite DNA. Children carrying parasites with the mutant allele (Pfcrt-76T) were classified based on their ability to clear their parasites. The levels of the different cytokines were measured in serum. The polymorphisms of specific human genes involved in malaria susceptibility were genotyped using human DNA. The prevalence of the Pfcrt-76T was significantly higher in Kolle than in Bandiagara (81.6 % vs 38.6 %, p < 10-6). The prevalence of children who cleared their mutant parasites was significantly higher in Bandiagara than in Kolle (82.2 % vs 67.4 %, p < 0.05). The genotyping of host genes revealed that IFN-γ -874 T and TNF-α -308A alleles were positively associated with parasite clearance. Cytokine profiling revealed that IFN-γ level was positively associated with parasite clearance (p = 0.04). This study highlights the role of host's immunity and immunogenetic factors to clear resistant parasites, suggesting further characterization of these polymorphisms may help to develop novel approaches to antiparasitic treatment strategies.
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Affiliation(s)
- Bourema Kouriba
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali; Centre d'Infectiologie Charles Mérieux-Mali, Mali.
| | - Charles Arama
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Dinkorma T Ouologuem
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Yacouba Cissoko
- Department of Infectious and Tropical Diseases, Point G Teaching Hospital, Bamako, Mali
| | - Mahamadou Diakite
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Abdoul Habib Beavogui
- Maferinyah National Training and Research Center in Rural Health, Forecariah, Guinea
| | - Mamadou Wele
- Institute of Applied Sciences, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Mamadou Tekete
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Bakary Fofana
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Souleymane Dama
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Hamma Maiga
- Institut National de Santé Publique, Bamako, Mali
| | - Aminatou Kone
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Amadou Niangaly
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Issa Diarra
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Modibo Daou
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Ando Guindo
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Karim Traore
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Drissa Coulibaly
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Abdoulaye K Kone
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Alassane Dicko
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Taane G Clark
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK; Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Ogobara K Doumbo
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Abdoulaye Djimde
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali.
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Toure A, Sacko K, Togola R, Diall H, Diakité AA, Traore F, Belco M, Kone A, Guindo A, Maiga M, Dembele A, Konate D, Diakité FL, Doumbia AK, Coulibaly O, Traore I, Cisse EM, Togo P, Konate H, Diallo CO, Dicko FT, Sylla M, Togo B, Traore B, Sidibe T, Diouf S, Fall AL, Sarr M. [Portal cavernoma at child about two observations]. Mali Med 2022; 37:65-70. [PMID: 38196254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
We report two observations of portal cavernoma diagnosed successively in Bamako and Dakar. The first is a 6-year-old male admitted to the service for ascites and abdominal pain. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The clinical examination noted a moderate skin-mucosal pallor, asthenia. The biological assessment returned to moderate normochrome anemia with impaired pancreatic function while renal and hepatic functions were maintained. The abdominal scan performed after two low-contribution abdominal ultrasounds, objected signs in favor of a portal cavernoma with perisplenic and gastric varicose veins. The second is an 8-year-old male child born from an unborn marriage and from a followed pregnancy with premature delivery. His pathological history includes a notion of prematurity that required a stay in neonatology with umbilical catheterization and repeated abdominal pain. He had an acute abdominal episode in March 2015 justifying a surgical hospitalization for suspicion of appendicitis. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The abdominal ultrasound prescribed for this was suggestive of portal cavernoma, later confirmed by abdominal computed tomography.
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Affiliation(s)
- A Toure
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - K Sacko
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - R Togola
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - H Diall
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - A A Diakité
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | | | | | - A Kone
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - A Guindo
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - M Maiga
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - A Dembele
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - D Konate
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - F L Diakité
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - A K Doumbia
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - O Coulibaly
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - I Traore
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - E M Cisse
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - P Togo
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - H Konate
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | | | - F T Dicko
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - M Sylla
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - B Togo
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - B Traore
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - T Sidibe
- Service de Pédiatrie, CHU Gabriel Touré, Bamako, Mali
| | - S Diouf
- Centre hospitalier nationale d'enfant Albert Royer (CHNEAR). Dakar, Sénégal
| | - A L Fall
- Centre hospitalier nationale d'enfant Albert Royer (CHNEAR). Dakar, Sénégal
| | - M Sarr
- Centre hospitalier nationale d'enfant Albert Royer (CHNEAR). Dakar, Sénégal
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Dieng S, Ba E, Sallah K, Guindo A, Piarroux M, Rebaudet S, Sokhna C, Gaudart J. Géo-épidémiologie du paludisme dans la région centre du Sénégal : instabilité spatio-temporelle des zones à haut risque et facteurs associés. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mariko M, Traoré B, Sow DS, Kane B, Bah M, Traoré D, Konaté M, N'Diaye HD, Drago AA, Togo A, Koné A, Konaté M, Minkaïlou M, Ouologuem N, Coulibaly K, Kanté F, Guindo A, Dramé A, Traoré DY, Berté B, Sidibé AT. [Dysthyroidism in children and adolescents at the Mali hospital]. Mali Med 2020; 35:56-61. [PMID: 37978765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Dysthyroidism (hyperthyroidism or hypothyroidism) in children and adolescents is much rarer than in adults. The purpose of our study was to study the epidemiological, clinical, paraclinical, etiological and etiological aspects and to specify the therapeutic and evolutionary modalities of this condition. METHOD This was a five-year descriptive, retrospective and prospective study of children and adolescents under 18 years of age with dysthyroidism. RESULTS We collected 90 children and adolescents with dysthyroidism (hyperthyroidism 77.8% (n=70) and hypothyroidism 22.2% (n=20). For hyperthyroidism (n=70): the average age was 13.07 years and the sex ratio was 0.16. The family history of dysthyroidism was found in 24.3% (n=17). Clinical manifestations were dominated by tachycardia 88.57% (n=62), weight loss 87.14% (n=61), vibrating pulse 87.14% (n=61) and palpitation 81.42% (n=57). Bilateral exophthalmos was present in 70% of patients (n=49) with palpebral retraction in 51.42% (n=56). Goitre was present in 54 patients (77.1%). It was diffuse in 62.9% (n=44) and nodular in 12.9% (n=9). Basedow's disease represented the first etiology with 84.3% (n=59), followed by toxic multinodular goitre12, 9% (n=9). Sixty-eight patients (97.1%) received medical treatment with synthetic antithyroid drugs. Clinical remission was achieved in 64.3% (n=45) and 54.3% of patients were in biological euthyroidism at 6 months follow-up. For hypothyroidism (n=20): the average age was 10.70 years and the sex ratio was 0.53. Six family cases of hypothyroidism and three cases of family goitre were found. The clinical picture was dominated by signs of hypo metabolism at hypersomnia type 95% (n=19) and anorexia 75% (n=15). The skin was dry in 60% (n=12). A staturo-weight delay in 65% (n=13), behavioural disorders in 55% (n=11), weight gain in 40% (n=8) and puberty delay in 10% (n=2). Goitre was nodular in 25% (n=5) with cervical adenopathy present in 15% (n=3). Hashimoto's thyroiditis accounted for 45% (n=9) of etiologies followed by iodine deficiency disorders in 15% (n=3) and iatrogenic causes (2 cases of thyroidectomy). All patients were started on hormone replacement therapy for life. Five patients with large multinodular goiter received total thyroidectomy in addition to medical treatment. Euthyroidism was observed in 55% (n=11) of patients at 6 months follow-up. CONCLUSION Dysthyroidism in children and adolescents exists in our health facilities. Its management is deficient because of the technical and financial platform. Our public health decision-makers must help implement a screening strategy to facilitate faster diagnosis and treatment.
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Affiliation(s)
- M Mariko
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - B Traoré
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - D S Sow
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - B Kane
- Service de Pédiatrie de l'Hôpital du Mali
| | - M Bah
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - D Traoré
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - M Konaté
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - H D N'Diaye
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - A A Drago
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - A Togo
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - A Koné
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - M Konaté
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - M Minkaïlou
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - N Ouologuem
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - Kbd Coulibaly
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - F Kanté
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - A Guindo
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - Aht Dramé
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - D Y Traoré
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - B Berté
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - A T Sidibé
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
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Mariko M, Traoré B, Sow DS, Coulibaly K, Bah M, Koné A, Traoré D, Drago A, N'Diaye HD, Mariko ML, Minkailou M, Dramé A, Konaté M, Guindo A, Diallo MB, Sidibé AT. [Management of Hyperprolactinemia at the Hôpital du Mali]. Mali Med 2020; 35:26-31. [PMID: 37978778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Hyperprolactinemia, which is a supra-physiological secretion of prolactin, is the most common anterior pituitary disorder encountered in clinical practice. Its incidence and prevalence are poorly defined in Africa and the rest of the world. The objectives were to study the clinical, paraclinical, etiological and therapeutic aspects of hyperprolactinemia at the Mali hospital. METHODOLOGY This was a 5-year cross-sectional study. Data collection was retrospective (July 2011 to October 2015) and prospective (December 2015 to July 2016). RESULTS We collected 37 cases of hyperprolactinemia. The sex ratio was 0.85. The average age was 37.32 years with extremes ranging from 15 to 74 years. The clinical picture was dominated in women by amenorrhea (80%), galactorrhea (70%), headache (55%), hypofertility (50%), visual disorders (25%) and in men by decreased libido (64.7%), gynecomastia (47.1%), headache (47.1%), visual disorders (41.2%) and erection disorders (29.4%). Basal prolactinemia was greater than 100ng/ml in 45.9% of patients. Cerebral CT had objectified: 11 cases of macroadenomas and 5 cases of pituitary microadenomas. The main causes of hyperprolactinemia were: prolactin pituitary adenoma (43.24%); hypothyroidism (5.40%) and estrogen-progestin use in 5.40%. For treatment, 64.9% of patients were placed on cabergoline; 27% on bromocriptine and 8.10% on simple clinical and biological monitoring. CONCLUSION Hyperprolactinemia is a condition that exists in our health care facilities. Clinicians should consider this in the face of galactorrhea amenorrhea or decreased libido. It is also necessary to improve the technical platform for better care.
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Affiliation(s)
- M Mariko
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - B Traoré
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - D S Sow
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - Kbd Coulibaly
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - M Bah
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - A Koné
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - D Traoré
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - Ada Drago
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - H D N'Diaye
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - M L Mariko
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - M Minkailou
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - Aht Dramé
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - M Konaté
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - A Guindo
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - M B Diallo
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
| | - A T Sidibé
- Service de médecine et d'endocrinologie de l'Hôpital du Mali
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Diarra AB, Cisse M, Guitteye H, Togora G, Guindo A. Hemoglobin profile in blood donors at the National blood transfusion center of Bamako. Transfus Clin Biol 2019; 26:352-353. [PMID: 31522978 DOI: 10.1016/j.tracli.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 08/21/2019] [Indexed: 10/26/2022]
Affiliation(s)
- A B Diarra
- Centre National de Transfusion Sanguine, BP E-344, 24, rue Achkhabad quinzambougou, Bamako, Mali.
| | - M Cisse
- Centre National de Transfusion Sanguine, BP E-344, 24, rue Achkhabad quinzambougou, Bamako, Mali
| | - H Guitteye
- Centre National de Transfusion Sanguine, BP E-344, 24, rue Achkhabad quinzambougou, Bamako, Mali
| | - G Togora
- Centre National de Transfusion Sanguine, BP E-344, 24, rue Achkhabad quinzambougou, Bamako, Mali
| | - A Guindo
- Centre de Recherche et de Lutte contre la Drépanocytose, 03 BP 186, Bamako 03 Point G, Mali
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Guindo A, Sagara I, Ouédraogo B, Dicko A, Sallah K, Doumbo O, Gaudart J. Modélisation de l’hétérogénéité spatiale de l’exposition : essais cliniques dans le contexte du paludisme. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.03.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Diallo DA, Guindo A, Touré BA, Sarro YS, Sima M, Tessougué O, Baraika MA, Guindo P, Traoré M, Diallo M, Dorie A. [Targeted newborn screening for sickle-cell anemia: Sickling test (Emmel test) boundaries in the prenatal assessment in West African area]. Rev Epidemiol Sante Publique 2018; 66:181-185. [PMID: 29625861 DOI: 10.1016/j.respe.2018.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 12/11/2017] [Accepted: 02/21/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Newborn screening for sickle cell anemia is necessary in Africa where the disease is more frequent. Hemoglobin electrophoresis is used for screening, but is limited by a high cost and difficult access. Sickling test (Emmel test), which is more affordable and technically more accessible, is often requested for prenatal assessment of pregnant women in West African areas to reserve screening for newborns from mothers in whom the positive sickling test attests the presence of hemoglobin S. This study aims to evaluate the number of undetected sickle cell anemia newborns by a screening policy targeting only newborns from mothers in whom a sickling test would have been positive. METHODS From 2010 to 2012, in Bamako, Mali, West Africa, 2489 newborns were routinely screened for sickle cell anemia at the umbilical cord or heel by isoelectrofocusing and, if necessary, by high-performance liquid chromatography. These newborns were born from 2420 mothers whose hemoglobin was studied by isoelectrofocusing. The data was recorded and processed using Excel software version 14.0.0. We calculated the frequency of the sickle cell gene in mothers and newborns as well as the number of SCA newborns from heterozygous or C homozygous mothers. RESULTS Of the 2489 newborns, 16 had sickle cell anemia (6 SS and 10 SC); 198 had the sickle cell trait; 139 were AC and 1 was CC. Of the 10 newborns with SC profile, 3 were born from mothers not carrying the S gene but the C gene of hemoglobin and in which an Emmel test would have been negative. CONCLUSION Targeted newborn screening, based on the results of sickling test in pregnant women, would misdiagnose more than one of six sickle cell anemia newborns who would not benefit from early care. Cost-effectiveness studies of routine newborn screening for sickle cell anemia should lead to a better screening strategy in contexts where hemoglobin S and other hemoglobin defect genes coexist.
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Affiliation(s)
- D A Diallo
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali.
| | - A Guindo
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - B A Touré
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - Y S Sarro
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - M Sima
- Service de gynécologie et d'obstétrique, CHU du Point G, BP : 333 Bamako, Mali
| | - O Tessougué
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - M A Baraika
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - P Guindo
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - M Traoré
- Centre de santé de référence de la Commune V, Bamako, Mali
| | - M Diallo
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - A Dorie
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
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Dembélé A, Toure B, Sarro Y, Guindo A, Fané B, Offredo L, Kené S, Conaré I, Tessougué O, Traoré Y, Badiaga Y, Sidibé M, Diabaté D, Coulibaly M, Kanta M, Ranque B, Diallo D. Prévalence et facteurs de risque de la rétinopathie drépanocytaire dans un centre de suivi drépanocytaire d’Afrique subsaharienne. Rev Med Interne 2017; 38:572-577. [DOI: 10.1016/j.revmed.2017.01.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/12/2017] [Accepted: 01/23/2017] [Indexed: 11/30/2022]
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Guindo A, Touré BA, Guindo P, Baraika MA, Sarro YS, Fané B, Tessougué O, Dorie A, Traoré K, Diallo DA. Transmission of Plasmodium falciparum by red blood cell transfusions in the management of sickle cell disease patients in Mali. Transfus Med 2016; 26:153-5. [PMID: 27003788 DOI: 10.1111/tme.12294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/11/2016] [Accepted: 02/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
- A Guindo
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - B A Touré
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - P Guindo
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - M A Baraika
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - Y S Sarro
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - B Fané
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - O Tessougué
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - A Dorie
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali.,International Technical Expert of French Cooperation, Bamako, Mali
| | - K Traoré
- National Malaria Control Program, Ministry of Health, Bamako, Mali
| | - D A Diallo
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali.,Service d'hématologie oncologie médicale, CHU du Point G, Bamako, Mali
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11
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Dolo A, Maiga B, Guindo A, Diakité SAS, Diakite M, Tapily A, Traoré M, Sangaré B, Arama C, Daou M, Doumbo O. [Frequency of glucose-6-phosphate dehydrogenase deficiency (A-376/202) in three Malian ethnic groups]. ACTA ACUST UNITED AC 2014; 107:165-70. [PMID: 24952161 DOI: 10.1007/s13149-014-0372-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/29/2014] [Indexed: 11/24/2022]
Abstract
Erythrocyte G6PD deficiency is the most common worldwide enzymopathy. The aim of this study was to determine erythrocyte G6PD deficiency in 3 ethnic groups of Mali and to investigate whether erythrocyte G6PD deficiency was associated to the observed protection against malaria seen in Fulani ethnic group. The study was conducted in two different areas of Mali: in the Sahel region of Mopti where Fulani and Dogon live as sympatric ethnic groups and in the Sudanese savannah area where lives mostly the Malinke ethnic group. The study was conducted in 2007 in Koro and in 2008 in Naguilabougou. It included a total 90 Dogon, 42 Fulani and 80 Malinke ethnic groups. Malaria was diagnosed using microscopic examination after Giemsa-staining of thick and thin blood smear. G6PD deficiency (A-(376/202)) samples were identified using RFLP (Restriction Fragment Length Polymorphism) assay and analysis of PCR-amplified DNA amplicon. G6PD deficiency (A-(376/202)) rate was 11.1%, 2.4%, and 13.3% in Dogon, Fulani, and Malinke ethnic group respectively. Heterozygous state for G6PD (A-(376/202)) was found in 7.8% in Dogon; 2.4% in Fulani and 9.3% in Malinke ethnic groups while hemizygous state was found at the frequency of 2.2% in Dogon and 4% in Malinke. No homozygous state was found in our study population.We conclude that G6PD deficiency is not differing significantly between the three ethnic groups, Fulani, Dogon and Malinke.
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Affiliation(s)
- A Dolo
- Département d'épidémiologie des affections parasitaires, Faculté de médecine, de pharmacie et d'odontostomatologie (DEAP/FMPOS), Malaria Research and Training Center (MRTC), BP 1805, Bamako, Mali,
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12
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Diarra A, Kouriba B, Guindo A, Maiga A, Diabaté D, Douyon I, Diawara S, Touré B, Fonkoro S, Murphy E, Diallo D. Prevalence of HTLV-I virus in blood donors and transfusion in Mali: Implications for blood safety. Transfus Clin Biol 2014; 21:139-42. [DOI: 10.1016/j.tracli.2014.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/14/2014] [Indexed: 11/30/2022]
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13
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Guirou N, Napo A, Bakayoko S, Sylla F, Dougnon A, Sidibé F, Théra PJ, Guindo A, Conaré I, Traore L, Traoré J. [Bilateral persistent fetal vasculature]. J Fr Ophtalmol 2013; 36:803-5. [PMID: 23911068 DOI: 10.1016/j.jfo.2013.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 01/07/2013] [Indexed: 10/26/2022]
Affiliation(s)
- N Guirou
- Centre hospitalier universitaire-institut d'ophtalmologie tropicale d'Afrique (CHU-IOTA) Bamako, boulevard du Peuple, BP 248, Bamako, Mali.
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14
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Diarra AB, Guindo A, Kouriba B, Dorie A, Diabaté DT, Diawara SI, Fané B, Touré BA, Traoré A, Gulbis B, Diallo DA. [Sickle cell anemia and transfusion safety in Bamako, Mali. Seroprevalence of HIV, HBV and HCV infections and alloimmunization belonged to Rh and Kell systems in sickle cell anemia patients]. Transfus Clin Biol 2013; 20:476-81. [PMID: 23916574 DOI: 10.1016/j.tracli.2013.04.111] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 04/26/2013] [Indexed: 11/18/2022]
Abstract
Red cell transfusion is one of the main treatments in sickle cell disease. However there are potential risks of blood transfusions. In order to propose strategies to improve blood safety in sickle cell disease in Mali, we conducted a prospective study of 133 patients with sickle cell anemia recruited at the sickle cell disease research and control center of Bamako, November 2010 to October 2011. The study aimed to determine the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections by serum screening and the frequency of red cell alloimmunization before and after blood transfusion. The diagnosis of sickle cell syndrome was made by HPLC, the detection of markers of viral infection was performed by ELISA, and the diagnosis of alloimmunization was conducted by the Indirect Coombs test. Prevalence of viral infections observed at the time of enrolment of patients in the study was 1%, 3% and 1% respectively for HIV, HBV and HCV. Three cases of seroconversion after blood transfusion were detected, including one for HIV, one for HBV and one another for HCV in sickle cell anemia patients. All these patients had received blood from occasional donors. The red cell alloimmunization was observed in 4.4% of patients. All antibodies belonged to Rh system only. Blood transfusion safety in sickle cell anemia patients in Mali should be improved by the introduction of at least the technique for detecting the viral genome in the panel of screening tests and a policy of transfusions of blood units only from regular blood donors.
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Affiliation(s)
- A B Diarra
- Centre national de transfusion sanguine, BP : E-344, Bamako, Mali.
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15
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Coulibaly D, Rebaudet S, Travassos M, Tolo Y, Laurens M, Kone AK, Traore K, Guindo A, Diarra I, Niangaly A, Daou M, Dembele A, Sissoko M, Kouriba B, Dessay N, Gaudart J, Piarroux R, Thera MA, Plowe CV, Doumbo OK. Spatio-temporal analysis of malaria within a transmission season in Bandiagara, Mali. Malar J 2013; 12:82. [PMID: 23452561 PMCID: PMC3618208 DOI: 10.1186/1475-2875-12-82] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 02/26/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Heterogeneous patterns of malaria transmission are thought to be driven by factors including host genetics, distance to mosquito breeding sites, housing construction, and socio-behavioural characteristics. Evaluation of local transmission epidemiology to characterize malaria risk is essential for planning malaria control and elimination programmes. The use of geographical information systems (GIS) techniques has been a major asset to this approach. To assess time and space distribution of malaria disease in Bandiagara, Mali, within a transmission season, data were used from an ongoing malaria incidence study that enrolled 300 participants aged under six years old". METHODS Children's households were georeferenced using a handheld global position system. Clinical malaria was defined as a positive blood slide for Plasmodium falciparum asexual stages associated with at least one of the following signs: headache, body aches, fever, chills and weakness. Daily rainfall was measured at the local weather station.Landscape features of Bandiagara were obtained from satellite images and field survey. QGIS™ software was used to map malaria cases, affected and non-affected children, and the number of malaria episodes per child in each block of Bandiagara. Clusters of high or low risk were identified under SaTScan(®) software according to a Bernoulli model. RESULTS From June 2009 to May 2010, 296 clinical malaria cases were recorded. Though clearly temporally related to the rains, Plasmodium falciparum occurrence persisted late in the dry season. Two "hot spots" of malaria transmission also found, notably along the Yamé River, characterized by higher than expected numbers of malaria cases, and high numbers of clinical episodes per child. Conversely, the north-eastern sector of the town had fewer cases despite its proximity to a large body of standing water which was mosquito habitat. CONCLUSION These results confirm the existence of a marked spatial heterogeneity of malaria transmission in Bandiagara, providing support for implementation of targeted interventions.
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Affiliation(s)
- Drissa Coulibaly
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | | | - Mark Travassos
- Howard Hughes Medical Institute/Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Youssouf Tolo
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Matthew Laurens
- Howard Hughes Medical Institute/Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Abdoulaye K Kone
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Karim Traore
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Ando Guindo
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Issa Diarra
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Amadou Niangaly
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Modibo Daou
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Ahmadou Dembele
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Mody Sissoko
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Bourema Kouriba
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Nadine Dessay
- Institut de Recherche pour le Développement, Montpellier, France
| | | | | | - Mahamadou A Thera
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
| | - Christopher V Plowe
- Howard Hughes Medical Institute/Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ogobara K Doumbo
- Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Point G, BP 1805, Bamako, Mali
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Diallo DA, Guindo A, Dorie A, Djibo N, Algiman E, Ouane OD, Diakité AA, Traoré FF, Ag Baraika M, Dembélé AK, Tchernia G. [Human parvovirus B19 infection in sickle cell anemia patient in Mali: a case-control study]. Arch Pediatr 2011; 18:962-5. [PMID: 21803552 DOI: 10.1016/j.arcped.2011.06.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Revised: 04/17/2011] [Accepted: 06/26/2011] [Indexed: 11/24/2022]
Abstract
Human parvovirus B19 (HP-19) is the only Parvoviridae known to be pathogenic in human. Studies of HP-19 infection and its associated life-threatening complications in sickle cell anemia patients have been reported in Europe and the US. These results justify the development of HP-B19 prevention and strategies to reduce the incidence of severe and life-threatening complications associated with the infection in patients with sickle cell anemia, particularly in sub-Saharan Africa where the sickle cell anemia burden is high. In light of these considerations, we conducted a case-control study including 163 patients with sickle cell anemia and 163 controls. HP-B19 diagnosis was based on the detection of IgG and IgM antibodies specific for HP-B19 using commercially available enzyme immunoassays. Anti-human parvovirus B19 IgG antibodies were found in 105 of 193 (64.8%) patients vs 79 of 193 controls (48.4%). IgM antibodies were found at a higher frequency in sickle cell anemia patients than in controls. This higher frequency was found to be age-dependent. However, the reticulocyte count showed no significant decrease in Malian patients with sickle cell anemia. Further studies are needed to better characterize the implication of HP-B19 infection in sickle cell anemia mortality and morbidity and to develop preventive strategies and efficient management of the resulting complications.
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Affiliation(s)
- D-A Diallo
- Centre de recherche et de lutte contre la drépanocytose, 03, commune III, BP 186, Bamako 03, Mali.
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17
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Lyke KE, Fernández-Viňa MA, Cao K, Hollenbach J, Coulibaly D, Kone AK, Guindo A, Burdett LA, Hartzman RJ, Wahl AR, Hildebrand WH, Doumbo OK, Plowe CV, Sztein MB. Association of HLA alleles with Plasmodium falciparum severity in Malian children. ACTA ACUST UNITED AC 2011; 77:562-71. [PMID: 21447146 PMCID: PMC3152196 DOI: 10.1111/j.1399-0039.2011.01661.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Pre-erythrocytic immunity to Plasmodium falciparum malaria is likely to be mediated by T-cell recognition of malaria epitopes presented on infected host cells via class I and II major histocompatibility complex (MHC) antigens. To test for associations of human leukocyte antigen (HLA) alleles with disease severity, we performed high-resolution typing of HLA class I and II loci and compared the distributions of alleles of HLA-A, -B, -C and -DRB1 loci in 359 Malian children of Dogon ethnicity with uncomplicated or severe malaria. We observed that alleles A*30:01 and A*33:01 had higher frequency in the group of patients with cerebral disease compared to patients with uncomplicated disease [A*30:01: gf = 0.2031 vs gf = 0.1064, odds ratio (OR) = 3.17, P = 0.004, confidence interval (CI) (1.94-5.19)] and [A*33:01: gf = 0.0781 vs gf = 0.0266, 4.21, P = 0.005, CI (1.89-9.84)], respectively. The A*30:01 and A*33:01 alleles share some sequence motifs and A*30:01 appears to have a unique peptide binding repertoire compared to other A*30 group alleles. Computer algorithms predicted malaria peptides with strong binding affinity for HLA-A*30:01 and HLA-A*33:01 but not to closely related alleles. In conclusion, we identified A*30:01 and A*33:01 as potential susceptibility factors for cerebral malaria, providing further evidence that polymorphism of MHC genes results in altered malaria susceptibility.
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Affiliation(s)
- K E Lyke
- Department of Medicine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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18
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Diaby B, Kroa E, Niaré A, Coulibaly D, Traoré Y, Giani S, Coulibaly A, Niaré B, Guindo A, Keita MT, Sylla AO, Sanogo R, Doumbo OK. [Not Available]. Mali Med 2011; 26:8-12. [PMID: 22949300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION : An estimated 300 to 500 million clinical cases of malaria occur each year worldwide, 90% in Africa, mostly among young children. In Cote d'Ivoire, malaria is 46.03% of disease states and 62.44% of hospital admissions. In children under 5 years, it is 42.67% of the reasons for consultation and 59.68% of hospital admissions. In pregnant women, it represents 22.91% of disease states and 36.07% of hospital admissions. In Africa, traditional medicine is the first resort for the vast majority of people, because of its accessibility both geographically, economically and culturally. However, some modern practitioners show an attitude of distrust of traditional medicine and its players, calling them irrational. This work had set out to assess knowledge, attitudes and practices of traditional healers in the uncomplicated and complicated in the context of collaboration between traditional and modern medicine for the optimal management of critical cases. MATERIALS AND METHOD : The study focused on traditional healers practicing in the city of Abidjan. The study was conducted using individual interviews over a period of 30 days. The interviews were conducted in local languages, with the assistance, if necessary, translators. For data collection, we used a questionnaire containing four items: the socio-demographic characteristics of traditional healers, their knowledge on malaria, diagnostic practices and traditional therapies. RESULTS : Of the 60 healers and included in the study, only six were women (10%), a sex-ratio of a woman to 9 men. 66.7% of respondents traditional healers are herbalists and 25% of naturopaths.Only 8.3% were spiritualists. The etiology of malaria most commonly cited by the traditional healers were mosquito bites (16.7%), food (1.7%), solar (1.7%) and fatigue (1.7%) . 25% of traditional healers are associated with mosquitoes, sun and fatigue. Symptomatology most cited were fever (100%), dark urine (86%), the yellow or pale conjunctiva (80%), vomiting (71.7%), nausea (58.3%) and abdominal pain (48.3%). Traditional healers recognized three types of malaria: the white shape, form yellow / red and the black form. Traditional healers malarious patients surveyed were receiving both first (58.3%) than second-line (41.7%). 78.3% of them practiced an interview and physical examination of theirpatients before the diagnosis. In 13.3% of cases they were divinatory consultation. Medications used to treat malaria were herbal in 95% of cases. The main sign of healing was the lack of fever (58.3%). 90%of traditional healers interviewed referring cases of malaria black (severe malaria). This reference is made to modern health facilities (90.2%). 68.3% of respondents practiced traditional healers of malaria prophylaxis among pregnant women and children under 5 years.CONCLUSION : A description of clinical malaria by traditional practitioners in health is not very far from that of modern medicine. Nevertheless, the logics of our respondents are etiological more complex and linked to their cultural context. The management of cases is made from medicinal plants in treatment failure patients are usually referred to modern health facilities. The involvement of traditional healers in the detection and quick reference risk cases can contribute to reducing child mortality due to severe malaria.
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Affiliation(s)
- B Diaby
- Institut National d’Hygiene Publique, INHP Abidjan, Cote d’Ivoire.
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Diaby B, Kroa E, Niaré A, Coulibaly D, Traoré Y, Giani S, Coulibaly A, Niaré B, Guindo A, Keita MT, Sylla AO, Sanogo R, Doumbo OK. [Knowledge, attitude, and practice of traditional healers on the topic of malaria in the city of Abidjan]. Mali Med 2011; 26:8-12. [PMID: 22977888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION An estimated 300 to 500 million clinical cases of malaria occur each year worldwide, 90% in Africa, mostly among young children. In Cote d'Ivoire, malaria is 46.03% of disease states and 62.44% of hospital admissions. In children under 5 years, it is 42.67% of the reasons for consultation and 59.68% of hospital admissions. In pregnant women, it represents 22.91% of disease states and 36.07% of hospital admissions. In Africa, traditional medicine is the first resort for the vast majority of people, because of its accessibility both geographically, economically and culturally. However, some modern practitioners show an attitude of distrust of traditional medicine and its players, calling them irrational. This work had set out to assess knowledge, attitudes and practices of traditional healers in the uncomplicated and complicated in the context of collaboration between traditional and modern medicine for the optimal management of critical cases. MATERIALS AND METHOD The study focused on traditional healers practicing in the city of Abidjan. The study was conducted using individual interviews over a period of 30 days. The interviews were conducted in local languages, with the assistance, if necessary, translators. For data collection, we used a questionnaire containing four items: the socio-demographic characteristics of traditional healers, their knowledge on malaria, diagnostic practices and traditional therapies. RESULTS Of the 60 healers and included in the study, only six were women (10%), a sex-ratio of a woman to 9 men. 66.7% of respondents traditional healers are herbalists and 25% of naturopaths.Only 8.3% were spiritualists. The etiology of malaria most commonly cited by the traditional healers were mosquito bites (16.7%), food (1.7%), solar (1.7%) and fatigue (1.7%) . 25% of traditional healers are associated with mosquitoes, sun and fatigue. Symptomatology most cited were fever (100%), dark urine (86%), the yellow or pale conjunctiva (80%), vomiting (71.7%), nausea (58.3%) and abdominal pain (48.3%). Traditional healers recognized three types of malaria: the white shape, form yellow / red and the black form. Traditional healers malarious patients surveyed were receiving both first (58.3%) than second-line (41.7%). 78.3% of them practiced an interview and physical examination of theirpatients before the diagnosis. In 13.3% of cases they were divinatory consultation. Medications used to treat malaria were herbal in 95% of cases. The main sign of healing was the lack of fever (58.3%). 90%of traditional healers interviewed referring cases of malaria black (severe malaria). This reference is made to modern health facilities (90.2%). 68.3% of respondents practiced traditional healers of malaria prophylaxis among pregnant women and children under 5 years. CONCLUSION A description of clinical malaria by traditional practitioners in health is not very far from that of modern medicine. Nevertheless, the logics of our respondents are etiological more complex and linked to their cultural context. The management of cases is made from medicinal plants in treatment failure patients are usually referred to modern health facilities. The involvement of traditional healers in the detection and quick reference risk cases can contribute to reducing child mortality due to severe malaria.
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Affiliation(s)
- B Diaby
- Institut National d’Hygiene Publique, INHP Abidjan, Cote d’Ivoire.
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Thera MA, Sehdev PS, Coulibaly D, Traore K, Garba MN, Cissoko Y, Kone A, Guindo A, Dicko A, Beavogui AH, Djimde AA, Lyke KE, Diallo DA, Doumbo OK, Plowe CV. Impact of trimethoprim-sulfamethoxazole prophylaxis on falciparum malaria infection and disease. J Infect Dis 2005; 192:1823-9. [PMID: 16235184 PMCID: PMC2740817 DOI: 10.1086/498249] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2005] [Accepted: 09/19/2005] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Trimethoprim-sulfamethoxazole (TS) prophylaxis is recommended for persons living with human immunodeficiency virus infection and acquired immunodeficiency syndrome in Africa. TS and the antimalarial combination sulfadoxine-pyrimethamine (SP) share mechanisms of action and resistance patterns, and concerns about the impact of TS resistance on SP efficacy have contributed to reluctance to implement TS prophylaxis in Africa. METHODS To determine whether TS prophylaxis impairs SP efficacy for treatment of uncomplicated falciparum malaria, we conducted a randomized, controlled, open-label study of TS prophylaxis. Two hundred and forty children 5-15 years old were randomized in a 2 : 1 fashion to receive either thrice-weekly TS for 12 weeks or no prophylaxis and were treated with SP for subsequent episodes of malaria. The incidence of malaria, SP efficacy, and the prevalence of parasite mutations that confer antifolate drug resistance were measured. RESULTS TS prophylaxis had a 99.5% protective efficacy against episodes of clinical malaria, with 97% efficacy against infection. Four SP treatment failures occurred in the control group, and none occurred in the TS group. No evidence was seen for selection by TS of antifolate resistance-conferring mutations in parasite dihydrofolate reductase or dihydropteroate synthase during subclinical infections. CONCLUSIONS In this setting of low antifolate resistance, TS was highly effective in preventing falciparum malaria infection and disease and did not appear to select for SP-resistant parasites.
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Affiliation(s)
- Mahamadou A Thera
- Bandiagara Malaria Project, Malaria Research and Training Center, University of Bamako, Mali
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Lyke KE, Dicko A, Kone A, Coulibaly D, Guindo A, Cissoko Y, Traoré K, Plowe CV, Doumbo OK. Incidence of severe Plasmodium falciparum malaria as a primary endpoint for vaccine efficacy trials in Bandiagara, Mali. Vaccine 2004; 22:3169-74. [PMID: 15297070 DOI: 10.1016/j.vaccine.2004.01.054] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2003] [Revised: 12/19/2003] [Accepted: 01/15/2004] [Indexed: 11/18/2022]
Abstract
Potential endpoints for blood stage malaria vaccine efficacy trials include uncomplicated malaria disease, which is hard to differentiate from other febrile illnesses, and mortality, which requires prohibitively large sample sizes. Strictly defined severe malaria predicts malaria-associated mortality where case fatality rates are known. To assess the suitability of severe malaria as a trial endpoint, we conducted a census in 1999 and measured the incidence of severe malaria from 1999 to 2001 in Bandiagara, Mali. The annual incidence of severe malaria in children <6 years of age was 2.3% (n = 2,284) yielding an estimated sample size of 4,580 for a vaccine trial designed to detect 50% efficacy with 80% power at P = 0.05 with 5% loss to follow-up. A trial using severe malaria as an endpoint in this setting would thus require expanding the study population or the length of the trial. This approach may be useful in assessing the suitability of potential sites for malaria vaccine trials.
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Affiliation(s)
- Kirsten E Lyke
- Center for Vaccine Development, University of Maryland School of Medicine, 685 West Baltimore Street, HSF 480, Baltimore, MD, USA.
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Fairhurst RM, Sadou B, Guindo A, Diallo DA, Doumbo OK, Wellems TE. Case report: Life-threatening hypoglycaemia associated with sulfadoxinepyrimethamine,a commonly used antimalarial drug. Trans R Soc Trop Med Hyg 2003; 97:595-6. [PMID: 15307435 DOI: 10.1016/s0035-9203(03)80041-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Due to chloroquine resistance, several African countries have changed their first-line malaria treatment to sulfadoxine-pyrimethamine (SP). In this report, we present a case of hypoglycaemic coma associated with SP, an adverse reaction that is likely to be underreported and expected to occur with greater frequency as the use of SP increases.
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Affiliation(s)
- R M Fairhurst
- Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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Lyke KE, Diallo DA, Dicko A, Kone A, Coulibaly D, Guindo A, Cissoko Y, Sangare L, Coulibaly S, Dakouo B, Taylor TE, Doumbo OK, Plowe CV. Association of intraleukocytic Plasmodium falciparum malaria pigment with disease severity, clinical manifestations, and prognosis in severe malaria. Am J Trop Med Hyg 2003; 69:253-9. [PMID: 14628940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Peripheral parasite density of Plasmodium falciparum is used as an indicator of malaria disease severity, but does not quantify central sequestration, which is important in the pathogenesis of severe disease. Malaria pigment, recognizable within the cytoplasm of phagocytic cells by light microscopy may represent a peripheral marker for parasite biomass. One hundred seventy-two index cases of severe malaria and 172 healthy age-, residence-, and ethnicity-matched controls with uncomplicated malaria in Bandiagara, Mali were analyzed prospectively for presence of malaria pigment. The presence of polymorphonuclear cell (PMN) and monocyte pigment was strongly associated with severe disease compared with uncomplicated malaria. Total PMN pigment burden in children with severe malaria was higher in those with cerebral manifestations and with combined cerebral manifestations and severe anemia (hemoglobin < or = 5 g/dL) but was not associated with hyperparasitemia (> 500,000 asexual forms/mm3). Additionally, pigmented PMNs/mm3 was associated with a fatal outcome in patients with severe malaria. This study validates the presence of malaria pigment in monocytes and neutrophils as a marker for disease severity, and demonstrates that pigmented neutrophils are associated with cerebral malaria and with death in children with severe malaria.
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MESH Headings
- Adolescent
- Animals
- Biomarkers
- Case-Control Studies
- Child
- Child, Preschool
- Humans
- Infant
- Malaria, Cerebral/blood
- Malaria, Cerebral/epidemiology
- Malaria, Cerebral/mortality
- Malaria, Cerebral/parasitology
- Malaria, Cerebral/pathology
- Malaria, Falciparum/blood
- Malaria, Falciparum/epidemiology
- Malaria, Falciparum/mortality
- Malaria, Falciparum/parasitology
- Malaria, Falciparum/pathology
- Mali/epidemiology
- Neutrophils/physiology
- Pigments, Biological
- Plasmodium falciparum/pathogenicity
- Plasmodium falciparum/physiology
- Prognosis
- Prospective Studies
- Severity of Illness Index
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Affiliation(s)
- Kirsten E Lyke
- Malaria Section, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
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Schémann JF, Banou A, Malvy D, Guindo A, Traore L, Momo G. National immunisation days and vitamin A distribution in Mali: has the vitamin A status of pre-school children improved? Public Health Nutr 2003; 6:233-44. [PMID: 12740072 DOI: 10.1079/phn2002432] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The impact on vitamin A status of the distribution of vitamin A during national immunisation days (NIDs) has not been well established despite strong promotion by international agencies and donors. Using a pre-post design, the change in prevalence of vitamin A deficiency was examined in pre-school children in Mali. DESIGN Two cross-sectional surveys were conducted in Mopti region, the first in March 1997 before this strategy was adopted and the second in March 1999, four-and-a-half months after a mass distribution of vitamin A during NIDs. SUBJECTS AND SETTING We compared the vitamin A status of children aged 12 to 66 months targeted in 1999 by NIDs with the status of children in the same age group in 1997. Infectious events of the previous two weeks were concurrently recorded. Within the 1999 sample, the status of recipient and non-recipient children was also compared. RESULTS In 1997, the prevalence of xerophthalmia (defined by the presence of night blindness and/or Bitot spots) was 6.9% (95% confidence interval (CI) 5.1-9.2) and the modified retinol dose response (MRDR) test proved abnormal in 77.8% of 12-66-month-old children (95% CI 68.27-85.17). In 1999 this picture had improved significantly, both for xerophthalmia prevalence, 3.3% (95% CI 2.1-5.2), and abnormal MRDR test response, 63.1% (95% CI 54.25-71.23). The infectious morbidity rates between 1997 and 1999 tended to decrease. No significant improvement was found among children older than those targeted by NIDs. In 1999, children who received vitamin A had a lower risk for xerophthalmia (3.0% for recipients vs. 8.7% for non-recipients) and experienced fewer infectious events. CONCLUSIONS The clinical and biological vitamin A status of pre-school children improved between 1997 and 1999. Mass distribution of vitamin A appears to reduce the occurrence of xerophthalmia and would seem to be associated with a decrease in other related illnesses. Vitamin A supplementation during NIDs should be given a high priority when vitamin A deficiency remains a public health problem.
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Affiliation(s)
- J F Schémann
- Institute of African Tropical Ophthalmology (IOTA), BP 248 Bamako, Mali.
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25
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Maiga MY, Dembele MY, Traoré HA, Kouyate M, Traoré AK, Maiga II, Bougoudogo F, Doumbo O, Guindo A. [Gastrointestinal manifestations of AIDS in adults in Mali]. Bull Soc Pathol Exot 2002; 95:253-6. [PMID: 12596372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Our main objective consists in evaluating the frequency of digestive signs and digestive opportunistic infections in AIDS patients with diarrhea. The prospective study occurred from January 1997 to July 1998 in Bamako hospitals. The patients underwent a clinical examination, blood and stools tests, and sometimes upper digestive endoscopy. Among 434 cases of AIDS, 426 patients (98%) had at least one digestive sign. The main digestive signs were diarrhea (80.1%), abdominal pains (62.2%), vomiting (47.2%) and dysphagea (36.6%). Isospora belli and Cryptosporidium parvum have been pointed up in respectively 9% and 16.3% of examined specimen. Echerichia coli was found in 8.6% of stool cultures and in 2.9% in the case of Salmonella Arizonae. Twenty cases of Kaposi's sarcoma were diagnosed and mycosis was found in 71.9% of patients. In conclusion, digestive change is a constant phenomenon in AIDS patients. Patients survival could be improved by early management, improvement of diagnosis and provisioning of medicines.
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Affiliation(s)
- M Y Maiga
- Service d'hépato-gastro-entérologie, Hôpital Gabriel Touré, BP 2931 Bamako, Mali
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Abstract
OBJECTIVES A representative sample of 1510 preschool children living in the Bandiagra circle (Mopti Region, Mali) was examined between March and April 1997 to determine the level of vitamin A deficiency. METHODS Using a randomized two level cluster sampling, 20 clusters of 75 children aged six months to six years were selected for evaluating xerophthalmia (XN night blindness and/or X1B Bitot spot). Concurrently stature and weight were determined. A semiquantitative seven-day dietary questionnaire was applied to the mothers of 484 infants to assess consumption of vitamin A rich foodstuffs. The prevalence of biochemical deficiency was attested using the Modified Relative Dose Response test (MRDR) on a sub-sample of 192. RESULTS Of the studied children, 4.3% (95% Confidence interval [CI]: 3.2-5.3) reported night blindness and 2% (95% CI: 1.3-2.7) had Bitot spots. Prevalence of xerophthalmia attested by at least one of these signs was 5.4% (95% CI: 4.2-6.5). The prevalence reached 10.5% at three years of age. The MRDR test proved abnormal in 77.1% of the subjects (95% CI: 70.3-82.7). Serum retinol was lower than 0.35 micro mol/L in 43.8% (95.6% CI: 36.9-51.3) and less than 0.70 micro mol/L in 92.7% of the children (95% CI: 87.8-95.8). Weekly consumption of vitamin A rich food was rare: 75.8% had not eaten any animal vitamin A rich food, and 22.1% had consumed less than seven times a vitamin A rich food of either vegetable or animal origin. CONCLUSIONS These data define vitamin A deficiency as a severe public health problem in the Bandiagara area of Mali.
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Agarwal A, Guindo A, Cissoko Y, Taylor JG, Coulibaly D, Koné A, Kayentao K, Djimde A, Plowe CV, Doumbo O, Wellems TE, Diallo D. Hemoglobin C associated with protection from severe malaria in the Dogon of Mali, a West African population with a low prevalence of hemoglobin S. Blood 2000; 96:2358-63. [PMID: 11001883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
The malaria hypothesis proposes a survival advantage for individuals with hemoglobin variants in areas of endemic Plasmodium falciparum malaria. Hemoglobin C (HbC) is a possible example in West Africa, where this hemoglobin has a centric distribution with high frequencies among certain populations including the Dogon ethnic group. To test whether HbC is associated with protection from malaria, we performed a case-control study in the Dogon of Bandiagara, Mali. HbC was present in 68 of 391 (17.4%) of uncomplicated malaria control cases, whereas it was detected in only 3 of 67 cases (4.5%) of severe malaria (odds ratio [OR], 0.22; P =. 01). Further, HbC was present in only 1 of 34 cases (2.9%) with cerebral manifestations, the most common presentation of severe malaria in this population (OR, 0.14; P =.03). Episodes of uncomplicated malaria and parasitemias (4800-205 050/microL) were identified in cases of homozygous HbC (HbCC), which indicates that P falciparum parasites are able to efficiently replicate within HbCC erythrocytes in vivo. These findings suggest that HbC does not protect against infection or uncomplicated malaria but can protect against severe malaria in the Dogon population of Bandiagara, Mali. The data also suggest that the protective effect associated with HbC may be greater than that of HbS in this population.
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Affiliation(s)
- A Agarwal
- National Institute of Allergy and Infectious Diseases and the National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Moulds JM, Kassambara L, Middleton JJ, Baby M, Sagara I, Guindo A, Coulibaly S, Yalcouye D, Diallo DA, Miller L, Doumbo O. Identification of complement receptor one (CR1) polymorphisms in west Africa. Genes Immun 2000; 1:325-9. [PMID: 11196694 DOI: 10.1038/sj.gene.6363676] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Complement receptor one (CR1) is a ligand for the rosetting of Plasmodium falciparum infected red cells with uninfected cells. Since CR1 exhibits three known polymorphisms, we studied European-Americans (n = 112) and African-Americans (n = 330) and Malians (n = 158) to determine if genetic differences existed in an area endemic for malaria that could offer a survival advantage. The frequencies of Knops blood group phenotypes McC(b+) and Sl(a-) were greatly increased in Africans vs Europeans. Although the frequency of McC(b+) was similar between Africans from the USA or Mali, the Sl(a-) phenotype was significantly higher in Mali (39% vs 65%, respectively). There was an increased frequency of the largest size (250 kD) of CR1 in Mali, but this did not differ significantly from the USA (P = 0.09). Both cohorts of Africans had higher expression of red cell CR1 than European-Americans but this showed little difference between the USA and Mali groups. Thus, the most important CR1 polymorphism relevant to rosetting of malaria infected cells appears to be the Knops blood group.
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Affiliation(s)
- J M Moulds
- University of Texas-Houston Medical School, Houston, TX, USA.
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Diallo G, Ongoiba N, Maiga MY, Dembele M, Baye H, Traoré AH, Traoré AK, Guindo A, Koumaré AK. [Biliary tract lithiasis in Mali]. Ann Chir 1998; 52:667. [PMID: 9805808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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30
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Traore HA, Maiga MY, Diallo A, Dembele M, Sidibe AT, Diallo D, Ayanga Mouko C, Pichard E, Guindo A, Diallo A. Présentation clinique et étiologie des granulomatoses abdominales en médecine interne de l'hôpital national du point ≪ G ≫ à Bamako, Mali. Rev Med Interne 1997. [DOI: 10.1016/s0248-8663(97)80376-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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31
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Traore HA, Maiga MY, Sogodogo S, Dembele M, Sidibe TA, Diallo D, Diallo AN, Guindo A, Pichard E, Doumbo O. [Importance of hepatic bilharziasis in liver pathologies in the internal medicine department of the National Hospital of Point "G", Bamako-Mali]. Dakar Med 1996; Spec No:26-8. [PMID: 14520983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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Sacko HB, Ag Mohamed A, Maiga MY, Kalle A, Doumbia SY, Guindo A. [ORL manifestations observed in AIDS. Apropos of 65 cases]. Bull Soc Pathol Exot 1995; 88:234-5. [PMID: 8646013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We realized a clinical study in 65 patients with acquired immunodeficiency syndrome, aged from 3 to 62 years old (mean, 34 years) (34 males and 31 females) interned or showed in consultations at the hospital Gabriel Touré in Bamako, Mali (departments of ENT diseases and of internal medicine), in order to analyse and to state precisely different otorhinolaryngologic manifestations in AIDS. Oropharyngeal candidiasis was the most prevalent otorhinolaryngologic manifestation (57 %). Other less common lesions were suppurative otitis media (29 %), atrophic pharyngitis (18,5 %), sinusitis (11 %), Kaposi's sarcoma (5 %) localized above all on the palate: they are however a frequent sign of infection by HIV. The manifestations merit a particular attention by otorhinolaryngologist because, although they have few influence on the general evolution of the disease, they appear as additional manifestations of infectious risks in AIDS patients.
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Affiliation(s)
- H B Sacko
- Service ORL, Hôpital Gabriel Touré Bamako, Mali
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33
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Pichard E, Guindo A, Grossetete G, Fofana Y, Maiga YI, Koumare B, Traore S, Maiga M, Brun-Vezinet F, Rosenheim M. [Human immunodeficiency virus (HIV) infection in Mali]. Med Trop (Mars) 1988; 48:345-9. [PMID: 3221782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This review summarises epidemiological and clinical data of HIV infection who was recognized in Mali since 1985. The most important rate of seropositivity for HIV is observed in the prostitutes group (40%). The estimated seroprevalence for adult population is between 1% and 5%. 46 cases for AIDS are reported in both sexes. The mean age is 35 years. Main signs are weight loss (91%), fever (80%), diarrhea (70%) and lymphadenopathy (50%). Three among the five cases of Kaposi's sarcoma are aggressive. 19.5% of AIDS have antibodies to HIV1, 41.3% to HIV2 and 39.1% to HIV1 and HIV2. Death rate is more than 50%. These data are compared with other countries of Africa.
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Affiliation(s)
- E Pichard
- Médecine Interne C.D. Hôpital National du Point G, Bamako, Mali
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Affres H, Christoforov B, Reigneau O, Guindo A, Cremer G. [A case of LAV II-virus AIDS in Mali]. Presse Med 1986; 15:2211-2. [PMID: 3027687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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35
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Couturier D, Rozé C, Rosemond A, Guindo A, Lequerler Y, Debray C. [Achalasia of the esophagus: confrontation of clinical, radiological, and manometric findings (author's transl)]. Gastroenterol Clin Biol 1977; 1:151-7. [PMID: 873111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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