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Sabi I, Olomi W, Nkereuwem E, Togun T, Gomez MP, Sylla M, Diarra B, Sanogo M, Sichone E, Mahiga H, Njeleka F, Ebonyi AO, Egere U, Ntinginya NE, Hoelscher M, Heinrich N, Kampmann B. Diagnosis of paediatric TB using Xpert ® MTB/RIF Ultra on fresh respiratory samples. Int J Tuberc Lung Dis 2022; 26:862-868. [PMID: 35996291 PMCID: PMC9423021 DOI: 10.5588/ijtld.22.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/10/2022] Open
Abstract
OBJECTIVE: To evaluate the diagnostic accuracy of Xpert® MTB/RIF Ultra (Ultra) on fresh respiratory samples for the diagnosis of pulmonary TB (PTB) in children.METHODS: Between July 2017 and December 2019, children with presumed TB were prospectively enrolled at clinical sites in three African countries. Children were assessed using history, physical examination and chest X-ray. Sputum or gastric aspirate samples were analysed using Ultra and culture. The diagnostic accuracy of Ultra was calculated against culture as the reference standard.RESULTS: In total, 547children were included. The median age was 4.7 years, 77 (14.1%) were HIV infected and 77 (14.1%) had bacteriologically confirmed TB. Ultra detected an additional 20 cases in the group of children with negative culture results. The sensitivity of Ultra was 66.3% (95% CI 47-82), and the specificity was 95.4% (95% CI 89-99) when assessed against culture as the reference standard.CONCLUSION: Despite the improved performance of Ultra as compared to Xpert as was previously reported, its sensitivity remains sub-optimal for the detection of TB in children. Ultra detected additional 20 cases which otherwise could not have been detected by culture alone, suggesting that the latter is an imperfect reference standard.
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Affiliation(s)
- I Sabi
- National Institute for Medical Research, Mbeya Medical Research Center, Mbeya, Tanzania, Center for International Health, University Hospital, Ludwig Maximilian University (LMU) Munich, Germany
| | - W Olomi
- National Institute for Medical Research, Mbeya Medical Research Center, Mbeya, Tanzania
| | - E Nkereuwem
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - T Togun
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - M P Gomez
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia
| | - M Sylla
- Paediatrics Department, University Teaching Hospital Gabriel Toure, Bamako, Mali
| | - B Diarra
- University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Sanogo
- University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - E Sichone
- National Institute for Medical Research, Mbeya Medical Research Center, Mbeya, Tanzania
| | - H Mahiga
- National Institute for Medical Research, Mbeya Medical Research Center, Mbeya, Tanzania
| | - F Njeleka
- National Institute for Medical Research, Mbeya Medical Research Center, Mbeya, Tanzania
| | - A O Ebonyi
- Department of Paediatrics, Jos University Teaching Hospital, Jos, Nigeria
| | - U Egere
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - N E Ntinginya
- National Institute for Medical Research, Mbeya Medical Research Center, Mbeya, Tanzania
| | - M Hoelscher
- Center for International Health, University Hospital, Ludwig Maximilian University (LMU) Munich, Germany, German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Germany
| | - N Heinrich
- Center for International Health, University Hospital, Ludwig Maximilian University (LMU) Munich, Germany, German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany, Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Germany
| | - B Kampmann
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Banjul, The Gambia, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Tolofoudie M, Somboro A, Diarra B, Sarro YS, Drame HB, Togo ACG, Sanogo M, Dembele A, Togun T, Nkereuwem E, Baya B, Konate B, Egere U, Traore M, Maiga M, Saliba-Shaw K, Kampmann B, Diallo S, Doumbia S, Sylla M. Isoniazid preventive therapy in child household contacts of adults with active TB in Bamako, Mali. Public Health Action 2021; 11:191-195. [PMID: 34956847 PMCID: PMC8680184 DOI: 10.5588/pha.21.0061] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Isoniazid preventive therapy (IPT) is known to reduce the risk of developing active TB in about 59% in children aged ⩽15 years. We assessed adherence, completion and adverse events among children who were household contacts of a newly diagnosed adult with smear-positive TB in Bamako, Mali. METHODS Children aged <15 years living in the same house with an adult smear-positive index case were enrolled in the study in the Bamako Region after consent was obtained from the parent or legal guardian. Adherence was assessed based on the number of tablets consumed during 6 months. RESULTS A total of 260 children aged <15 years were identified as household contacts of 207 adult patients with smear-positive TB during the study period. Among all child contacts, 130/260 (50.0%) were aged 0-4 years and were eligible for IPT; 128/130 (98.5%) were started on IPT and 83/128 (64.8%) completed with good adherence at the end of the 6 months, and without any significant adverse events. CONCLUSION We successfully implemented IPT with good acceptance, but low completion rate. The Mali National TB Program and partners should expand this strategy to reach more children in Bamako and the whole country and create greater awareness in the population.
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Affiliation(s)
- M Tolofoudie
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A Somboro
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B Diarra
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Y S Sarro
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - H B Drame
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A C G Togo
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Sanogo
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A Dembele
- Department of Paediatrics, University Teaching Hospital of Gabriel Toure, Bamako, Mali
| | - T Togun
- Vaccines and Immunity Theme, Medical Research Council Unit-The Gambia, Banjul, The Gambia
| | - E Nkereuwem
- Vaccines and Immunity Theme, Medical Research Council Unit-The Gambia, Banjul, The Gambia
| | - B Baya
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B Konate
- National Tuberculosis Control Program, Ministry of Health and Public Hygiene, Bamako, Mali
| | - U Egere
- Vaccines and Immunity Theme, Medical Research Council Unit-The Gambia, Banjul, The Gambia
| | - M Traore
- Health Referral Center Five, Ministry of Health and Social Development, Bamako, Mali
| | - M Maiga
- Center for Innovation in Global Health Technology, Northwestern University, Chicago, IL, USA
| | - K Saliba-Shaw
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, MD, USA
| | - B Kampmann
- Vaccines and Immunity Theme, Medical Research Council Unit-The Gambia, Banjul, The Gambia
| | - S Diallo
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - S Doumbia
- University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Sylla
- Department of Paediatrics, University Teaching Hospital of Gabriel Toure, Bamako, Mali
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Niang MN, Sugimoto JD, Diallo A, Diarra B, Ortiz JR, Lewis KDC, Lafond KE, Halloran ME, Widdowson MA, Neuzil KM, Victor JC. Estimates of Inactivated Influenza Vaccine Effectiveness Among Children in Senegal: Results From 2 Consecutive Cluster-Randomized Controlled Trials in 2010 and 2011. Clin Infect Dis 2021; 72:e959-e969. [PMID: 33165566 DOI: 10.1093/cid/ciaa1689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/28/2020] [Accepted: 10/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We report results of years 2 and 3 of consecutive cluster-randomized controlled trials of trivalent inactivated influenza vaccine (IIV3) in Senegal. METHODS We cluster-randomized (1:1) 20 villages to annual vaccination with IIV3 or inactivated poliovirus vaccine (IPV) of age-eligible residents (6 months-10 years). The primary outcome was total vaccine effectiveness against laboratory-confirmed influenza illness (LCI) among age-eligible children (modified intention-to-treat population [mITT]). Secondary outcomes were indirect (herd protection) and population (overall community) vaccine effectiveness. RESULTS We vaccinated 74% of 12 408 age-eligible children in year 2 (June 2010-April 11) and 74% of 11 988 age-eligible children in year 3 (April 2011-December 2011) with study vaccines. Annual cumulative incidence of LCI was 4.7 (year 2) and 4.2 (year 3) per 100 mITT child vaccinees of IPV villages. In year 2, IIV3 matched circulating influenza strains. The total effectiveness was 52.8% (95% confidence interval [CI], 32.3-67.0), and the population effectiveness was 36.0% (95% CI, 10.2-54.4) against LCI caused by any influenza strain. The indirect effectiveness against LCI by A/H3N2 was 56.4% (95% CI, 39.0-68.9). In year 3, 74% of influenza detections were vaccine-mismatched to circulating B/Yamagata and 24% were vaccine-matched to circulating A/H3N2. The year 3 total effectiveness against LCI was -14.5% (95% CI, -81.2-27.6). Vaccine effectiveness varied by type/subtype of influenza in both years. CONCLUSIONS IIV3 was variably effective against influenza illness in Senegalese children, with total and indirect vaccine effectiveness present during the year when all circulating strains matched the IIV3 formulation. CLINICAL TRIALS REGISTRATION NCT00893906.
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Affiliation(s)
| | - Jonathan D Sugimoto
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, Washington, USA.,Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Aldiouma Diallo
- VITROME, Institut de Recherche Pour le Développement, Dakar, Senegal
| | - Bou Diarra
- VITROME, Institut de Recherche Pour le Développement, Dakar, Senegal
| | - Justin R Ortiz
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Kathryn E Lafond
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M Elizabeth Halloran
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Marc-Alain Widdowson
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Institute of Tropical Medicine, Antwerp, Belgium
| | - Kathleen M Neuzil
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Diarra B, Decroo T, Somboro A, Coulibaly G, Tolofoudie M, Kone M, Degoga B, Diallo F, Togo ACG, Sanogo M, Sarro YS, Cisse AB, Kodio O, Baya B, Kone A, Maiga M, Dao S, Maiga II, Murphy RL, Siddiqui S, Toloba Y, Konate B, Diakite M, Doumbia S, Van Deun A, Rigouts L, Diallo S, de Jong BC. Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali. Int J Tuberc Lung Dis 2021; 24:763-769. [PMID: 32912379 DOI: 10.5588/ijtld.19.0698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RR-TB.METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RR-TB.RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7-3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDA-negative at 2M (P = 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%.CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.
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Affiliation(s)
- B Diarra
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali, Unit of Mycobacteriology, Institute of Tropical Medicine Antwerp, Antwerp
| | - T Decroo
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Antwerp, Research Foundation Flanders, Brussels, Belgium
| | - A Somboro
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - G Coulibaly
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Tolofoudie
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Kone
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B Degoga
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - F Diallo
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A C G Togo
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Sanogo
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Y S Sarro
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A B Cisse
- Laboratoire National de Référence des Mycobactéries, Institut National de Recherche en Santé publique, Bamako, Mali
| | - O Kodio
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B Baya
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A Kone
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Maiga
- Global Health, Northwestern University, Chicago, IL, USA
| | - S Dao
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - I I Maiga
- Laboratoire d´analyses Médicales et Hygiène Hospitalière du Centre Hospitalier Universitaire du Point-G, Bamako, Mali
| | - R L Murphy
- Laboratoire National de Référence des Mycobactéries, Institut National de Recherche en Santé publique, Bamako, Mali
| | - S Siddiqui
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Y Toloba
- Service de Pneumo-phtisiologie du Centre Hospitalier Universitaire du Point-G, Bamako
| | - B Konate
- Programme National de Lutte contre la Tuberculose (PNLT), Ministère de la santé et des Affaires Sociales, Bamako, Mali
| | - M Diakite
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - S Doumbia
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - L Rigouts
- Unit of Mycobacteriology, Institute of Tropical Medicine Antwerp, Antwerp, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - S Diallo
- University Clinical Research Centre, SEREFO Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B C de Jong
- Unit of Mycobacteriology, Institute of Tropical Medicine Antwerp, Antwerp
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5
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Coulibaly N, Kone B, Sanogo M, G Togo AC, Diarra B, Sarro YS, Cisse AB, Kodio O, Coulibaly G, Kone M, Baya B, Maiga M, Dabitao D, Belson M, Dao S, Diallo S, Diakite M, Babana AH, Doumbia S. Performance of Mali's biosafety level 3 laboratory in the external quality assessment in preparedness of laboratory accreditation and support to clinical trials. Int J Mycobacteriol 2021; 9:29-33. [PMID: 32474485 PMCID: PMC8075184 DOI: 10.4103/ijmy.ijmy_5_20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: The external quality assessment (EQA) or external quality control is an evaluation conducted by a certified external organization to inquire about the quality of the results provided by a laboratory. The primary role of EQA is to verify the accuracy of laboratory results. This is essential in research because research data should be published in international peer-reviewed journals, and laboratory results must be repeatable. In 2007, the University Clinical Research Center (UCRC’s) biosafety level 3 (BSL-3) laboratory joined the EQA program with the College of American Pathologists in acid-fast staining and culture and identification of mycobacteria as per laboratory accreditation preparedness. Thus, after 11 years of participation, the goal of our study was to evaluate the performance of our laboratory during the different interlaboratory surveys. Methods: We conducted a descriptive retrospective study to evaluate the results of UCRC mycobacteriology laboratory from surveys conducted during 2007 and 2017. Results: Of the 22 evaluations, the laboratory had satisfactory (100% of concordance results) in 18 (81.8%) and good (80% of concordance results) in 4 (18.2%). Overall, the laboratory was above the commended/accepted limits of 75%. Conclusion: So far, UCRC’s BSL-3 performed well during the first 11 years of survey participation, and efforts should be deployed to maintain this high quality in the preparedness for laboratory accreditation and support to clinical trials.
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Affiliation(s)
- N Coulibaly
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B Kone
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Sanogo
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A C G Togo
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B Diarra
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Y S Sarro
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A B Cisse
- National Referral Laboratory of Mycobacteriology, National Institute of Public Health, INSP, Bamako, Mali
| | - O Kodio
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - G Coulibaly
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Kone
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - B Baya
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Maiga
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali; Center for Global Health, Northwestern University, Chicago, IL, USA
| | - D Dabitao
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Belson
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - S Dao
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - S Diallo
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - M Diakite
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - A H Babana
- Microbiology and Biotechnology Research Laboratory, Faculty of Sciences and Techniques, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - S Doumbia
- University Clinical Research Center-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
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6
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Samaké M, Sy S, Coulibaly M, Yattara H, Soumbounou G, Kodio A, Diarra B, Fofana AS, Diallo D, Dolo AM, Maiga D, Coulibaly SB, Coulibaly K, Fongoro S. [Prevalence of the kidney disease at the emergency department of hospital Fousseyni Daou of Kayes]. Mali Med 2021; 36:1-7. [PMID: 37973567] [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 Kidney disease (KD) is defined as a set of functional, morphological and histological kidney abnormalities. It is a truly global public health problem. Its prevalence is estimated to be 50 times that of end-stage renal disease (ESRD). In Kayes, there is no data on the prevalence of kidney disease, hence the interest of this study. OBJECTIVES to determine the prevalence of renal disease, its main causes and the main factors of aggravation of this pathology in the emergency department at hospital Fousseyni DAOU of Kayes. METHODOLOGY Retrospective cross-sectional study carried out from January 1, 2014 to February 1, 2015. We included all hospitalized patients in whom a renal damage marker (elevation of plasma creatinine, urinary sediment abnormality, ultrasound, histology and significant proteinuria) has been found. RESULTS the prevalence of kidney disease was 9.9% (109/1099). Eighty-nine met the inclusion criteria. The study population was composed of 47 women (52.8%) and 42 men (47.2%), with a sex ratio of 0.89 in favor of women. The average age was 40.09 years with a predominance of patients in the age group [40-59]. The main reasons for consultation were hypercreatininaemia (48.3%), edematous syndrome (16.9%), low back pain (10.1%). High blood pressure (55.1%) and lower extremity edema (46.1%) were the medical history frequently found in our study. The kidney disease found was in order of growth: chronic renal failure (51%); acute renal failure (28%); proteinuria (16%), hematuria (3%), morphological abnormality of the kidneys (2%). Tubulointerstitial nephropathy represented 64% of acute renal failure with P = 0.000306. Vascular nephropathy constituted 46.7% of chronic renal failure with P = 0.000251. No cases of glomerular nephropathy were found in patients over 60 years of age.The most common causes were represented by nephrotoxic drugs injuries; infectious; high blood pressure and diabetes. The most observed aggravating factors are herbal medicine, urinary tract infections, renal hypoperfusion and unbalanced hypertension. CONCLUSION kidney disease is not uncommon in the emergency room at Hospital Fousseyni Daou of Kayes. The most common causes are nephrotoxic drugs, hypertension and diabetes.
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Affiliation(s)
- M Samaké
- Unité de Néphrologie de l'hôpital Fousseyni DAOU de Kayes
| | - S Sy
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - M Coulibaly
- Unité de Néphrologie de l'hôpital Mali GAVARDO
| | - H Yattara
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - G Soumbounou
- Service des urgences de l'hôpital Fousseyni DAOU de Kayes
| | - A Kodio
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - B Diarra
- Unité de Néphrologie de l'hôpital Fousseyni DAOU de Kayes
| | - A S Fofana
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - D Diallo
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - A M Dolo
- Unité de Néphrologie de l'hôpital régional de Sikasso
| | - D Maiga
- Unité de Néphrologie de l'hôpital régional de Sikasso
| | - S B Coulibaly
- Service de Néphrologie et d'hémodialyse du CHU du Point G
| | - K Coulibaly
- Unité de Néphrologie de l'hôpital Somino DOLO de Mopti
| | - S Fongoro
- Service de Néphrologie et d'hémodialyse du CHU du Point G
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7
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Somboro A, Tolofoudie M, Berthe G, Diarra B, Sylla M. [Drug-resistant tuberculosis with rifampicin in children co-infected with HIV in Bamako]. Mali Med 2021; 36:74-76. [PMID: 37973569] [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
Drug-resistant tuberculosis, especially in children, is a major public health challenge. We report a case with rifampicin resistance diagnosed in an HIV co-infected in Bamako. The history of the disease suggests possible father-to-child transmission. After confirmation, MDR-TB treatment was initiated. Global improvement and normalization of biological parameters and X-Ray was obtained. The identification of this case highlights the need to improve diagnosticand treatment algorithms for rapid confirmation and better management.
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Affiliation(s)
- A Somboro
- Centre Universitaire de Recherche Clinique (UCRC), USTTB, Bamako, Mali
| | - M Tolofoudie
- Centre Universitaire de Recherche Clinique (UCRC), USTTB, Bamako, Mali
| | - G Berthe
- Service de Pneumophtisiologie du CHU Point-G, Bamako, Mali
| | - B Diarra
- Centre Universitaire de Recherche Clinique (UCRC), USTTB, Bamako, Mali
| | - M Sylla
- Service de Pédiatrie du CHU Gabriel Toure, Bamako, Mali
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8
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Dramé HB, Diallo D, Coulibaly G, Kone M, Diallo F, Diarra HB, Coulibaly A, Camara F, Diakité MT, Dégoga B, Traoré FG, Somboro A, Dolo O, Denou L, Koné K, Coulibaly M, Togo A, Togo J, Somboro AM, Sanogo M, Bane S, Diallo M, Guindo I, Koné A, Tolofoudié M, Sarro Y, Toloba Y, Dao S, Diakité M, Diarra B, Doumbia S. [Contribution of the University Clinical Research Center's laboratoryin the diagnosis of SARS-CoV-2 in Mali]. Mali Med 2021; 36:14-18. [PMID: 37973586] [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 The rapid diagnostic capacities of laboratories in Mali have been an essential element in the response to COVID-19. The University Clinical Research center (UCRC) diagnosed the first cases of Mali COVID-19. OBJECTIVE The objective was to describe the contribution of the UCRC in the diagnosis of Covid-19 and to clinically and epidemiologically characterize the patients tested in the UCRC laboratory. MATERIALS AND METHODS A cross-sectional study was conducted during eight months of intense activity. The samples were sent from the National Institute of Public Health (INSP) to the UCRC. RESULTS The UCRC tested 12,406 contacts and suspected samples and confirmed the diagnosis in 1091 patients, or 9%. The most common symptoms were cough (48.78%), headache (34.14%), fatigue / weakness (34.14%), while (33.33%) of the patients were asymptomatic. The sample positivity rate among new cases decreased from May to September 2020, despite almost 230% of the number of samples tested. CONCLUSION The laboratory played a major role in the response and there may be a low transmission of the virus in the Malian community.
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Affiliation(s)
- H B Dramé
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - D Diallo
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - G Coulibaly
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - M Kone
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - F Diallo
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - H B Diarra
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - A Coulibaly
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - F Camara
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - M T Diakité
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - B Dégoga
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - F G Traoré
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - A Somboro
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - O Dolo
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - L Denou
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - K Koné
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - M Coulibaly
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Acg Togo
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - J Togo
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - A M Somboro
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - M Sanogo
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - S Bane
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - M Diallo
- Département de Laboratoire et de Recherche Biomédicale, Institut National de Santé Publique (INSP), Ministère de la Santé et des Affaires Sociales, Bamako, Mali
| | - I Guindo
- Département de Laboratoire et de Recherche Biomédicale, Institut National de Santé Publique (INSP), Ministère de la Santé et des Affaires Sociales, Bamako, Mali
| | - A Koné
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - M Tolofoudié
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Yds Sarro
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Y Toloba
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - S Dao
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - M Diakité
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - B Diarra
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
| | - S Doumbia
- Centre Universitaire de Recherche Clinique (UCRC), Université des Sciences, des Techniques, et des Technologies de Bamako (USTTB), Bamako, Mali
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Diallo A, Diop OM, Diop D, Niang MN, Sugimoto JD, Ortiz JR, Faye EHA, Diarra B, Goudiaby D, Lewis KDC, Emery SL, Zangeneh SZ, Lafond KE, Sokhna C, Halloran ME, Widdowson MA, Neuzil KM, Victor JC. Effectiveness of Seasonal Influenza Vaccination in Children in Senegal During a Year of Vaccine Mismatch: A Cluster-randomized Trial. Clin Infect Dis 2020; 69:1780-1788. [PMID: 30689757 DOI: 10.1093/cid/ciz066] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 06/28/2018] [Accepted: 01/18/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The population effects of influenza vaccination in children have not been extensively studied, especially in tropical, developing countries. In rural Senegal, we assessed the total (primary objective) and indirect effectiveness of a trivalent inactivated influenza vaccine (IIV3). METHODS In this double-blind, cluster-randomized trial, villages were randomly allocated (1:1) for the high-coverage vaccination of children aged 6 months through 10 years with either the 2008-09 northern hemisphere IIV3 or an inactivated polio vaccine (IPV). Vaccinees were monitored for serious adverse events. All village residents, vaccinated and unvaccinated, were monitored for signs and symptoms of influenza illness using weekly home visits and surveillance in designated clinics. The primary outcome was all laboratory-confirmed symptomatic influenza. RESULTS Between 23 May and 11 July 2009, 20 villages were randomized, and 66.5% of age-eligible children were enrolled (3918 in IIV3 villages and 3848 in IPV villages). Follow-up continued until 28 May 2010. There were 4 unrelated serious adverse events identified. Among vaccinees, the total effectiveness against illness caused by the seasonal influenza virus (presumed to all be drifted A/H3N2, based on antigenic characterization data) circulating at high rates among children was 43.6% (95% confidence interval [CI] 18.6-60.9%). The indirect effectiveness against seasonal A/H3N2 was 15.4% (95% CI -22.0 to 41.3%). The total effectiveness against illness caused by the pandemic influenza virus (A/H1N1pdm09) was -52.1% (95% CI -177.2 to 16.6%). CONCLUSIONS IIV3 provided statistically significant, moderate protection to children in Senegal against circulating, pre-2010 seasonal influenza strains, but not against A/H1N1pdm09, which was not included in the vaccine. No indirect effects were measured. Further study in low-resource populations is warranted. CLINICAL TRIALS REGISTRATION NCT00893906.
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Affiliation(s)
- Aldiouma Diallo
- UMR VITROME, Institut de Recherche Pour le Développement, Dakar, Senegal
| | | | - Doudou Diop
- UMR VITROME, Institut de Recherche Pour le Développement, Dakar, Senegal
| | | | - Jonathan D Sugimoto
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Justin R Ortiz
- Center for Vaccine Development, University of Maryland, Baltimore
| | | | - Bou Diarra
- UMR VITROME, Institut de Recherche Pour le Développement, Dakar, Senegal
| | | | | | - Shannon L Emery
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sahar Z Zangeneh
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Kathryn E Lafond
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheikh Sokhna
- UMR VITROME, Institut de Recherche Pour le Développement, Dakar, Senegal
| | - M Elizabeth Halloran
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Department of Biostatistics, University of Washington, Seattle
| | - Marc-Alain Widdowson
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Diarra B, Tolofoudie M, Sarro YS, Togo ACG, Bane S, Nientao I, Cisse AB, Kone M, Somboro A, Degoga B, Diallo F, Coulibaly G, Kodio O, Sanogo M, Kone B, Diabate S, Baya B, Kone A, Dabitao D, Maiga M, Belson M, Dao S, Maiga II, Murphy RL, Siddiqui S, Toloba Y, Konate B, Doumbia S, de Jong BC, Diallo S. Diabetes Mellitus among new tuberculosis patients in Bamako, Mali. J Clin Tuberc Other Mycobact Dis 2019; 17:100128. [PMID: 31788570 PMCID: PMC6879999 DOI: 10.1016/j.jctube.2019.100128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Diabetes Mellitus (DM) increases worldwide, mostly in low- and middle-income countries. In Mali, the prevalence in the adult population is estimated at 1.8%, but tuberculosis (TB) patients are not systematically screened. The goal of our study was to determine the prevalence of DM among newly diagnosed TB patients. Methods We conducted a cross sectional study and a pilot prospective cohort study in four health centers in Bamako. All patients underwent fasting capillary-blood glucose (FCBG) test at Day 0, and repeated after one-week of TB treatment. Venous FBG test was performed for discrepancies between the two FCBG results. Thereafter, FCBG was performed for pilot study at month-2 (M2) and M5 of TB treatment. Results Two hundred and one patients were enrolled in this study. Impaired fasting blood glucose was identified in 17 (8.5%), of whom 11 (5.5%) had DM (VFBG >7 mmol/L). Among patients with DM, seven (63.6%) had successful TB treatment outcome, versus 142 (74.7%) of those without DM (p = 0.64), and (OR: 1.69, 95%CI 0.47–6.02). Conclusion The prevalence of DM among TB patients in Bamako exceeds that of the general population and screening at TB diagnosis suffices to identify those with DM. Systematic screening of both diseases will allow better treatment.
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Affiliation(s)
- B Diarra
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.,Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - M Tolofoudie
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y S Sarro
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A C G Togo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Bane
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - I Nientao
- Service de Médecine et d'Endocrinologie de l'hôpital du Mali, Bamako, Mali
| | - A B Cisse
- Laboratoire National de Référence des Mycobactéries (LNR), Institut National de Recherche en Santé publique (INRSP), Bamako, Mali
| | - M Kone
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Somboro
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Degoga
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - F Diallo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - G Coulibaly
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - O Kodio
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M Sanogo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Kone
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Diabate
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Baya
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Kone
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - D Dabitao
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M Maiga
- Global Health, Northwestern University, Chicago, IL, United States
| | - M Belson
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States
| | - S Dao
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - I I Maiga
- Laboratoire d'analyses Médicales et Hygiène Hospitalière du Centre Hospitalier Universitaire du Point-G, Bamako, Mali
| | - R L Murphy
- Global Health, Northwestern University, Chicago, IL, United States
| | - S Siddiqui
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States
| | - Y Toloba
- Service de Pneumo-phtisiologie du Centre Hospitalier Universitaire du Point-G, Bamako, Mali
| | - B Konate
- Programme National de Lutte contre la Tuberculose (PNLT), Ministère de la santé et de l'hygiène publique, Bamako, Mali
| | - S Doumbia
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B C de Jong
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - S Diallo
- University Clinical Research Center (UCRC)-SEREFO-Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
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Diallo A, Victor JC, Feser J, Ortiz JR, Kanesa-Thasan N, Ndiaye M, Diarra B, Cheikh S, Diene D, Ndiaye T, Ndiaye A, Lafond KE, Widdowson MA, Neuzil KM. Immunogenicity and safety of MF59-adjuvanted and full-dose unadjuvanted trivalent inactivated influenza vaccines among vaccine-naïve children in a randomized clinical trial in rural Senegal. Vaccine 2018; 36:6424-6432. [PMID: 30224199 PMCID: PMC6327321 DOI: 10.1016/j.vaccine.2018.08.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Effective, programmatically suitable influenza vaccines are needed for low-resource countries. MATERIALS AND METHODS This phase II, placebo-controlled, randomized safety and immunogenicity trial (NCT01819155) was conducted in Senegal using the 2012-2013 Northern Hemisphere trivalent influenza vaccine (TIV) formulation. Participants were allocated in a 2:2:1 ratio to receive TIV (full-dose for all age groups), adjuvanted TIV (aTIV), or placebo. Participants were stratified into age groups: 6-11, 12-35, and 36-71 months. All participants were vaccine-naïve and received two doses of study vaccine 4 weeks apart. The two independent primary objectives were to estimate the immunogenicity of TIV and of aTIV as the proportion of children with a hemagglutination inhibition (HI) antibody titer of ≥1:40 to each vaccine strain at 28 days post-dose two. Safety was evaluated by solicited local and systemic reactions, unsolicited adverse events, and serious adverse events. RESULTS 296 children received TIV, aTIV, or placebo, and 235 were included in the final analysis. After two doses, children aged 6-11, 12-35, and 36-71 months receiving TIV had HI titers ≥1:40 against A/H1N1 (73.1%, 94.1%, and 97.0%), A/H3N2 (96.2%, 100.0%, and 100.0%), and B (80.8%, 97.1%, and 97.0%), respectively. After two doses, 100% children aged 6-11, 12-35, and 36-71 months receiving aTIV had ≥1:40 titers against A/H1N1, A/H3N2, and B. After a single dose, the aTIV response was comparable to or greater than the TIV response for all vaccine strains. TIV and aTIV reactogenicity were similar, except for mild elevation in temperature (37.5-38.4 °C) which occurred more frequently in aTIV than TIV after each vaccine dose. TIV and aTIV had similarly increased pain/tenderness at the injection site compared to placebo. CONCLUSIONS Both aTIV and full-dose TIV were well-tolerated and immunogenic in children aged 6-71 months. These vaccines may play a role in programmatically suitable strategies to prevent influenza in low-resource settings.
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Affiliation(s)
- Aldiouma Diallo
- UMR Vitrome, Institut de Recherche Pour le Développement, Dakar, Senegal.
| | - John C Victor
- Center for Vaccine Innovation and Access, PATH, Seattle, USA.
| | - Jodi Feser
- Center for Vaccine Innovation and Access, PATH, Seattle, USA.
| | - Justin R Ortiz
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, USA.
| | | | - Moussa Ndiaye
- UMR Vitrome, Institut de Recherche Pour le Développement, Dakar, Senegal
| | - Bou Diarra
- Senegal Ministry of Health and Social Welfare, Dakar, Senegal
| | - Sathie Cheikh
- UMR Vitrome, Institut de Recherche Pour le Développement, Dakar, Senegal
| | - Djibril Diene
- UMR Vitrome, Institut de Recherche Pour le Développement, Dakar, Senegal
| | - Tofene Ndiaye
- UMR Vitrome, Institut de Recherche Pour le Développement, Dakar, Senegal.
| | - Assane Ndiaye
- UMR Vitrome, Institut de Recherche Pour le Développement, Dakar, Senegal
| | - Kathryn E Lafond
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Marc-Alain Widdowson
- Division of Global Health Protection, CDC Kenya, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya; Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Kathleen M Neuzil
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, USA.
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12
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Senghore M, Diarra B, Gehre F, Otu J, Worwui A, Muhammad A, Sanogo M, Baya B, Orsega S, Doumbia S, Diallo S, de Jong B, Pallen M, Antonio M. Evolution of virulent genotypes and an emerging threat of multidrug resistant tuberculosis in Bamako, Mali. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3573] [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: 10/28/2022] Open
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13
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Toloba Y, Ouattara K, Soumaré D, Kanouté T, Berthé G, Baya B, Konaté B, Keita M, Diarra B, Cissé A, Camara FS, Diallo S. [Multidrug-resistant tuberculosis (MDR-TB) in a black African carceral area: Experience of Mali]. Rev Pneumol Clin 2018; 74:22-27. [PMID: 29246463 DOI: 10.1016/j.pneumo.2017.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/04/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Prison constitutes a risk factor for the emergence of multi-drug resistance of tuberculosis (MDR-TB). The aim of this work was to study MDR-TB in a black African carceral center. MATERIAL AND METHODS Prospective study from January to December 2016 at the central house of arrest for men, Bamako. The study population was composed of tuberculous detainee. The suspicion of MDR-TB was done in any tuberculosis case remained positive in the second month of first-line treatment or in contact with an MDR-TB case. RESULT Among 1622 detainee, 21 cases of pulmonary tuberculosis were notified (1.29%), with an annual incidence of 13 cases/1000 detainee, they were 16 cases of SP-PTB (microscopy smear positive tuberculosis) and five cases of microscopy smear negative tuberculosis. The mean age was 28±7 years, extremes of 18 and 46 years. A negative association was found between the notion of smoking and occupation in the occurrence of tuberculosis (OR=0.036, [95% CI: 0.03-0.04], P=0.03. Among the 21 tuberculosis cases notified, one confirmed case of MDR-TB was detected (4.7%). In the first semester of 2016 cohort, we notified a cure rate of 87.5% (7/8 SP-PTB cases), and the confirmed MDR-TB case on treatment (21-month regimen), evolution enameled of pulmonary and hearing sequelae at seven months treatment. CONCLUSION It was the first case of MDR-TB detected in a prison in Mali. Late diagnosis, evolution is enameled of sequelae and side effects.
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Affiliation(s)
- Y Toloba
- Service de pneumologie, CHU du Point-G, E1631 Bamako, Mali.
| | - K Ouattara
- Service de pneumologie, CHU du Point-G, E1631 Bamako, Mali
| | - D Soumaré
- Service de pneumologie, CHU du Point-G, E1631 Bamako, Mali
| | - T Kanouté
- Service de pneumologie, CHU du Point-G, E1631 Bamako, Mali
| | - G Berthé
- Service de pneumologie, CHU du Point-G, E1631 Bamako, Mali
| | - B Baya
- Service de pneumologie, CHU du Point-G, E1631 Bamako, Mali
| | - B Konaté
- Programme national de lutte contre la tuberculose (PNLT-Mali), Mali
| | - M Keita
- Maison centrale d'arrêt de Bamako (MCA), Bamako, Mali
| | - B Diarra
- Centre de formation et de recherche (SEREFO), Mali
| | - A Cissé
- Institut national de recherche en santé publique (INRSP), Mali
| | - F S Camara
- Institut national de recherche en santé publique (INRSP), Mali
| | - S Diallo
- Service de pneumologie, CHU du Point-G, E1631 Bamako, Mali; Centre de formation et de recherche (SEREFO), Mali
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14
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Kone B, Maiga M, Baya B, Sarro YDS, Coulibaly N, Kone A, Diarra B, Sanogo M, Togo ACG, Goita D, Dembele M, Polis MA, Warfield J, Belson M, Dao S, Orsega S, Murphy RL, Diallo S, Siddiqui S. Establishing Reference Ranges of Hematological Parameters from Malian Healthy Adults. J Blood Lymph 2017; 7:154. [PMID: 29423342 PMCID: PMC5800422 DOI: 10.4172/2165-7831.1000154] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Measurement of immuno-hematological parameters has been historically helpful in the diagnosis and treatment monitoring of many infectious diseases and cancers. However, these parameters have not yet been established in many developing countries where patient care strongly relies on such low-cost tests. This study describes the immuno-hematological parameter ranges for Malian healthy adults. METHODS A cross sectional study was conducted from August 2004 to May 2013. We included 213 healthy volunteers (173 male and 40 female), aged between 18-59 years. Median, 2.5 and 97.5 percentile ranges for each immuno-hematological parameter are presented. RESULTS In our study population, the hematological parameters' ranges were mostly different to the universal established ranges. We found in our population a Median white blood cell (WBC) count of 5200 cells/μL [3237.5-11900], Red Blood Cell (RBC) count of 4.94 10^6 [3.56-6.17], hemoglobin (Hb) of 14.2 g/dL [12.2-17.38], platelet count (Plt) of 275 10^3/μL [145.4-614.4], lymphocytes 2050/μL [1200-3800], neutrophils 2200/μL [1040-6220]; monocytes 200/μL [100-660]; eosinophils 131/μL [0-1026]; CD4 902 cells/μL [444-1669] and CD8 485 cells/μL [0-1272]. We found significant gender differences in RBC, Hb level and MPV. However, RBC and Hb were higher in males median values compared to females (median values) (p<0.001), whereas the Mean platelet volume lower values (MPV) in males than females (P<0.047). The hemoglobin level for some West African countries (Mali, Burkina Faso, Togo, and Nigeria) ranged from 13.5 to 15.1 g/dL for males and 12 to 13 g/dL for females. However in East and Southern Africa, the values were anywhere from 14.1 to 16.1 for males and 11.2 to 14.4 for females. CONCLUSION Our data may help physicians to better define hematological abnormalities in patients. They may also be used to define new "normal hematological values" in Malian population or in the whole West African population.
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Affiliation(s)
- B Kone
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - M Maiga
- University of Sciences, Techniques and Technologies of Bamako, Mali
- Leidos Biomedical Research, Inc., in support to NIAID, Bethesda, Maryland, USA
- Northwestern University, Chicago, Illinois, USA
| | - B Baya
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - YDS Sarro
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - N Coulibaly
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - A Kone
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - B Diarra
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - M Sanogo
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - ACG Togo
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - D Goita
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - M Dembele
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - MA Polis
- National Institute of Allergic and Infectious Diseases (NIAID), Bethesda, Maryland, USA
| | - J Warfield
- Leidos Biomedical Research, Inc., in support to NIAID, Bethesda, Maryland, USA
| | - M Belson
- National Institute of Allergic and Infectious Diseases (NIAID), Bethesda, Maryland, USA
| | - S Dao
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - S Orsega
- National Institute of Allergic and Infectious Diseases (NIAID), Bethesda, Maryland, USA
| | - RL Murphy
- Northwestern University, Chicago, Illinois, USA
| | - S Diallo
- University of Sciences, Techniques and Technologies of Bamako, Mali
| | - S Siddiqui
- National Institute of Allergic and Infectious Diseases (NIAID), Bethesda, Maryland, USA
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15
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Sanogo M, Kone B, Diarra B, Maiga M, Baya B, Somboro AM, Sarro YS, Togo ACG, Dembele BPP, Goita D, Kone A, M'Baye O, Coulibaly N, Diabate S, Traore B, Diallo MH, Coulibaly YI, Saleeb P, Belson M, Orsega S, Siddiqui S, Polis MA, Dao S, Murphy RL, Diallo S. Performance of microscopic observation drug susceptibility for the rapid diagnosis of tuberculosis and detection of drug resistance in Bamako, Mali. Clin Microbiol Infect 2017; 23:408.e1-408.e6. [PMID: 28110049 DOI: 10.1016/j.cmi.2017.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 08/14/2016] [Revised: 11/08/2016] [Accepted: 01/04/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES In Mali early detection and treatment of multidrug-resistant tuberculosis (MDR-TB) are still challenging due to the cost, time and/or complexity associated with regular tests. Microscopic Observation Drug Susceptibility (MODS) is a low-cost assay validated by WHO in 2010. It is a liquid-culture-based assay to detect the 'cording' characteristic of Mycobacterium tuberculosis complex and to assess susceptibility to both isoniazid and rifampicin defining multidrug-resistant tuberculosis (MDR-TB). In this study we aimed to evaluate the performance of MODS as diagnostic tool compared with a validated method-Mycobacteria Growth Indicator Tube/Antimicrobial Susceptibility Testing/Streptomycin, Isoniazid, Rifampicin and Ethambutol (MGIT/AST/SIRE). METHODS AND RESULTS Between January 2010 and October 2015 we included 98 patients with suspected TB in an observational cohort study. The sensitivity and specificity of MODS assay for detecting TB were respectively 94.12% and 85.71% compared with the reference MGIT/7H11 culture, with a Cohen κ coefficient of 0.78 (95% CI 0.517-1.043). The median time to culture positivity for MODS assay and MGIT (plus interquartile range, IQR) was respectively 8 days (IQR 5-11) and 6 days (IQR 5-6). In detecting patients with MDR-TB, the sensitivity and specificity of MODS assay were respectively 100% and 95.92%. The positive predictive value and negative predictive value were, respectively, 66.7% and 100%. The median turnaround times for obtaining MDR-TB results using MODS assay and MGIT/AST/SIRE was respectively 9 days and 35 days. Hence, the MODS assay rapidly identifies MDR-TB in Mali compared with the MGIT/AST/SIRE. CONCLUSION As an easy, simple, fast and affordable method, the MODS assay could significantly improve the management of TB.
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Affiliation(s)
- M Sanogo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Kone
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Diarra
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali; Institute of Tropical Medicine (ITM), Biomedical Department, Antwerp, Belgium.
| | - M Maiga
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali; Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., NCI Campus at Frederick, Frederick, MD, USA
| | - B Baya
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A M Somboro
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y S Sarro
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A C G Togo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B P P Dembele
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - D Goita
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Kone
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - O M'Baye
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - N Coulibaly
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Diabate
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Traore
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M H Diallo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y I Coulibaly
- Filariasis Unit of the Malaria Research and Training Centre (MRTC), USTTB, Bamako, Mali
| | - P Saleeb
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - M Belson
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - S Orsega
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - S Siddiqui
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - M A Polis
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - S Dao
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - R L Murphy
- Division of Infectious Diseases, Northwestern University, Chicago, IL, USA
| | - S Diallo
- SEREFO Laboratories of the University Clinical Research Centre, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
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16
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Toloba Y, Cissé A, Soumaré D, Ouattara K, Kanouté T, Koné D, Diarra B, Baya B, Berthé G, Camara F, Konaté B, Diallo S. Apport du GeneXpert dans le diagnostic de la tuberculose et de la résistance à la rifampicine au Mali après 22 mois d’acquisition. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.515] [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: 10/20/2022]
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17
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Diarra B, Goita D, Tounkara S, Sanogo M, Baya B, Togo ACG, Maiga M, Sarro YS, Kone A, Kone B, M'Baye O, Coulibaly N, Kassambara H, Cisse A, Belson M, Polis MA, Otu J, Gehre F, Antonio M, Dao S, Siddiqui S, Murphy RL, de Jong BC, Diallo S. Tuberculosis drug resistance in Bamako, Mali, from 2006 to 2014. BMC Infect Dis 2016; 16:714. [PMID: 27894266 PMCID: PMC5126865 DOI: 10.1186/s12879-016-2060-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 11/22/2016] [Indexed: 12/02/2022] Open
Abstract
Background Although Drug resistance tuberculosis is not a new phenomenon, Mali remains one of the “blank” countries without systematic data. Methods Between 2006 and 2014, we enrolled pulmonary TB patients from local TB diagnostics centers and a university referral hospital in several observational cohort studies. These consecutive patients had first line drug susceptibility testing (DST) performed on their isolates. A subset of MDR was subsequently tested for second line drug resistance. Results A total of 1186 mycobacterial cultures were performed on samples from 522 patients, including 1105 sputa and 81 blood samples, yielding one or more Mycobacterium tuberculosis complex (Mtbc) positive cultures for 343 patients. Phenotypic DST was performed on 337 (98.3%) unique Mtbc isolates, of which 127 (37.7%) were resistant to at least one drug, including 75 (22.3%) with multidrug resistance (MDR). The overall prevalence of MDR-TB was 3.4% among new patients and 66.3% among retreatment patients. Second line DST was available for 38 (50.7%) of MDR patients and seven (18.4%) had resistance to either fluoroquinolones or second-line injectable drugs. Conclusion The drug resistance levels, including MDR, found in this study are relatively high, likely related to the selected referral population. While worrisome, the numbers remained stable over the study period. These findings prompt a nationwide drug resistance survey, as well as continuous surveillance of all retreatment patients, which will provide more accurate results on countrywide drug resistance rates and ensure that MDR patients access appropriate second line treatment. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-2060-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- B Diarra
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali. .,Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
| | - D Goita
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Tounkara
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M Sanogo
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Baya
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A C G Togo
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - M Maiga
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Y S Sarro
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Kone
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - B Kone
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - O M'Baye
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - N Coulibaly
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - H Kassambara
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - A Cisse
- Laboratoire National de Référence des Mycobactéries (LNR), Institut National de Recherche en Santé publique (INRSP), Bamako, Mali
| | - M Belson
- CCRB, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - M A Polis
- CCRB, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - J Otu
- Vaccines and Immunity Theme, Atlantic Boulevard, Medical Research Council (MRC), Fajara, Banjul, The Gambia
| | - F Gehre
- Vaccines and Immunity Theme, Atlantic Boulevard, Medical Research Council (MRC), Fajara, Banjul, The Gambia.,Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - M Antonio
- Vaccines and Immunity Theme, Atlantic Boulevard, Medical Research Council (MRC), Fajara, Banjul, The Gambia.,Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.,Microbiology and Infection Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - S Dao
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - S Siddiqui
- CCRB, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - R L Murphy
- Global Health, Northwestern University, Chicago, IL, USA
| | - B C de Jong
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - S Diallo
- SEREFO Program, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
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18
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Victor JC, Lewis KDC, Diallo A, Niang MN, Diarra B, Dia N, Ortiz JR, Widdowson MA, Feser J, Hoagland R, Emery SL, Lafond KE, Neuzil KM. Efficacy of a Russian-backbone live attenuated influenza vaccine among children in Senegal: a randomised, double-blind, placebo-controlled trial. Lancet Glob Health 2016; 4:e955-e965. [PMID: 27746224 PMCID: PMC5118222 DOI: 10.1016/s2214-109x(16)30201-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/19/2016] [Accepted: 08/01/2016] [Indexed: 12/20/2022]
Abstract
Background Live attenuated influenza vaccines have been shown to significantly reduce influenza in diverse populations of children, but no efficacy studies have been done in resource-poor tropical settings. In Senegal, we assessed the efficacy and safety of a live attenuated influenza vaccine based on Russian-derived master donor viruses and licensed as a single dose. Methods In this double-blind, placebo-controlled, parallel group, single-centre trial done near Niakhar, Senegal, generally healthy children aged 2–5 years were randomly allocated (2:1) to receive a single intranasal dose of masked trivalent live attenuated influenza vaccine or placebo. The allocation sequence was computer-generated by PATH with block sizes of three. The manufacturer provided vaccine and placebo in coded vials to preserve blinding. Participants were monitored through the predictable influenza season in Senegal for adverse events and signs and symptoms of influenza using weekly home visits and surveillance in clinics. The primary outcome was symptomatic laboratory-confirmed influenza caused by any strain and occurring from 15 days post-vaccination to the end of the study. The primary analysis was per protocol. This study is registered with ClinicalTrials.gov, number NCT01854632. Findings Between May 23, and July 1, 2013, 1761 children were randomly assigned, 1174 to receive live attenuated influenza vaccine and 587 to receive placebo. The per-protocol set included 1173 vaccinees and 584 placebo recipients followed up to Dec 20, 2013. Symptomatic influenza was laboratory-confirmed in 210 (18%) of 1173 recipients of live attenuated influenza vaccine and 105 (18%) of placebo recipients, giving a vaccine efficacy of 0·0% (95% CI −26·4 to 20·9). Adverse events were balanced between the study groups. Two girls who had received live attenuated influenza vaccine died, one due to anasarca 12 days postvaccination and one due to malnutrition 70 days postvaccination. Interpretation Live attenuated influenza vaccine was well tolerated in young children in Senegal, but did not provide protection against influenza. Further study in such populations, which might experience extended periods of influenza circulation, is warranted. Funding US Centers for Disease Control and Prevention and Bill & Melinda Gates Foundation.
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Affiliation(s)
| | | | - Aldiouma Diallo
- Mixed Research Unit 198, Institut de Recherche Pour le Développement, Dakar, Senegal
| | - Mbayame N Niang
- Senegal National Influenza Center, Institut Pasteur de Dakar, Dakar, Senegal
| | - Bou Diarra
- Mixed Research Unit 198, Institut de Recherche Pour le Développement, Dakar, Senegal
| | - Ndongo Dia
- Senegal National Influenza Center, Institut Pasteur de Dakar, Dakar, Senegal
| | - Justin R Ortiz
- PATH, Seattle, WA, USA; Departments of Global Health and Medicine, University of Washington, Seattle, WA, USA
| | - Marc-Alain Widdowson
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Shannon L Emery
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathryn E Lafond
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathleen M Neuzil
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
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19
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Idoko OT, Diallo A, Sow SO, Hodgson A, Akinsola A, Diarra B, Haidara FC, Ansah PO, Kampmann B, Bouma E, Preziosi MP, Enwere GC. Community Perspectives Associated With the African PsA-TT (MenAfriVac) Vaccine Trials. Clin Infect Dis 2016; 61 Suppl 5:S416-21. [PMID: 26553669 PMCID: PMC4639498 DOI: 10.1093/cid/civ596] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background. The Meningitis Vaccine Project (MVP) was established to address epidemic meningitis as a public health problem in sub-Saharan Africa and, to that end, worked to develop a group A meningococcal conjugate vaccine, PsA-TT. Methods. Experiences in 4 clinical trial sites are described. Culturally sensitive collaborative strategies were adopted to manage acceptable communication methods, peculiarities with the consent process, participant medical issues, community care, and death. Results. The clinical trials were completed successfully through community acceptance and active community collaboration. The trials also strengthened the capacities in the participating communities, and actively worked to resolve community problems. Conclusions. The understanding and integration of sociocultural realities of communities were major assets in the conduct and acceptance of these trials. MVP succeeded in these sites and provided a sound example for future clinical studies in Africa. Clinical Trials Registration. ISRTCN78147026 (PsA-TT 002); ISRCTN87739946 (PsA-TT 003); ISRCTN82484612 (PsA-TT 004); PACTR ATMR2010030001913177 (PsA-TT 006); and PACTR201110000328305 (PsA-TT 007).
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Affiliation(s)
- Olubukola T Idoko
- Vaccines and Immunity Theme, Medical Research Council Unit, Basse, The Gambia
| | - Aldiouma Diallo
- Institut de Recherche pour le Développement, Niakhar, Senegal
| | - Samba O Sow
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | - Abraham Hodgson
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Adebayo Akinsola
- Vaccines and Immunity Theme, Medical Research Council Unit, Basse, The Gambia
| | - Bou Diarra
- Institut de Recherche pour le Développement, Niakhar, Senegal
| | | | | | - Beate Kampmann
- Vaccines and Immunity Theme, Medical Research Council Unit, Basse, The Gambia
| | - Enricke Bouma
- Meningitis Vaccine Project, PATH, Ferney-Voltaire, France
| | - Marie-Pierre Preziosi
- Meningitis Vaccine Project, PATH, Ferney-Voltaire, France Meningitis Vaccine Project, Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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20
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Diallo A, Sow SO, Idoko OT, Hirve S, Findlow H, Preziosi MP, Elie C, Kulkarni PS, Parulekar V, Diarra B, Cheick Haidara F, Diallo F, Tapia M, Akinsola AK, Adegbola RA, Bavdekar A, Juvekar S, Chaumont J, Martellet L, Marchetti E, LaForce MF, Plikaytis BD, Enwere GC, Tang Y, Borrow R, Carlone G, Viviani S. Antibody Persistence at 1 and 4 Years Following a Single Dose of MenAfriVac or Quadrivalent Polysaccharide Vaccine in Healthy Subjects Aged 2-29 Years. Clin Infect Dis 2016; 61 Suppl 5:S521-30. [PMID: 26553684 PMCID: PMC4639491 DOI: 10.1093/cid/civ518] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Mass vaccination campaigns of the population aged 1-29 years with 1 dose of group A meningococcal (MenA) conjugate vaccine (PsA-TT, MenAfriVac) in African meningitis belt countries has resulted in the near-disappearance of MenA. The vaccine was tested in clinical trials in Africa and in India and found to be safe and highly immunogenic compared with the group A component of the licensed quadrivalent polysaccharide vaccine (PsACWY). Antibody persistence in Africa and in India was investigated. METHODS A total of 900 subjects aged 2-29 years were followed up for 4 years in Senegal, Mali, and The Gambia (study A). A total of 340 subjects aged 2-10 years were followed up for 1 year in India (study B). In study A, subjects were randomized in a 2:1 ratio, and in study B a 1:1 ratio to receive either PsA-TT or PsACWY. Immunogenicity was evaluated by measuring MenA serum bactericidal antibody (SBA) with rabbit complement and by a group A-specific immunoglobulin G (IgG) enzyme-linked immunosorbent assay. RESULTS In both studies, substantial SBA decay was observed at 6 months postvaccination in both vaccine groups, although more marked in the PsACWY group. At 1 year and 4 years (only for study A) postvaccination, SBA titers were relatively sustained in the PsA-TT group, whereas a slight increasing trend, more pronounced among the youngest, was observed in the participants aged <18 years in the PsACWY groups. The SBA titers were significantly higher in the PsA-TT group than in the PsACWY group at any time point, and the majority of subjects in the PsA-TT group had SBA titers ≥128 and group A-specific IgG concentrations ≥2 µg/mL at any point in time in both the African and Indian study populations. CONCLUSIONS Four years after vaccination with a single dose of PsA-TT vaccine in Africa, most subjects are considered protected from MenA disease. CLINICAL TRIALS REGISTRATION PsA-TT-003 (ISRCTN87739946); PsA-TT-003a (ISRCTN46335400).
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Affiliation(s)
- Aldiouma Diallo
- Institut de Recherche pour le Développement, Niakhar, Sénégal
| | - Samba O Sow
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | | | - Siddhivinayak Hirve
- Shirdi Sai Baba Hospital, Vadu/King Edward Memorial Hospital and Research Centre, Pune, India
| | - Helen Findlow
- Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, United Kingdom
| | - Marie-Pierre Preziosi
- Meningitis Vaccine Project, PATH, Ferney-Voltaire, France Meningitis Vaccine Project, Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Cheryl Elie
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Bou Diarra
- Institut de Recherche pour le Développement, Niakhar, Sénégal
| | | | - Fatoumata Diallo
- Centre pour le Développement des Vaccins, Ministère de la Santé, Bamako, Mali
| | - Milagritos Tapia
- Department of Pediatrics, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | | | | | - Ashish Bavdekar
- Shirdi Sai Baba Hospital, Vadu/King Edward Memorial Hospital and Research Centre, Pune, India
| | - Sanjay Juvekar
- Shirdi Sai Baba Hospital, Vadu/King Edward Memorial Hospital and Research Centre, Pune, India
| | - Julie Chaumont
- Meningitis Vaccine Project, PATH, Ferney-Voltaire, France
| | | | | | | | | | | | - Yuxiao Tang
- Meningitis Vaccine Project, PATH, Seattle, Washington
| | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, United Kingdom
| | - George Carlone
- Centers for Disease Control and Prevention, Atlanta, Georgia
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21
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Martellet L, Sow SO, Diallo A, Hodgson A, Kampmann B, Hirve S, Tapia M, Haidara FC, Ndiaye A, Diarra B, Ansah PO, Akinsola A, Idoko OT, Adegbola RA, Bavdekar A, Juvekar S, Viviani S, Enwere GC, Marchetti E, Chaumont J, Makadi MF, Pallardy F, Kulkarni PS, Preziosi MP, LaForce FM. Ethical Challenges and Lessons Learned During the Clinical Development of a Group A Meningococcal Conjugate Vaccine. Clin Infect Dis 2016; 61 Suppl 5:S422-7. [PMID: 26553670 PMCID: PMC4639500 DOI: 10.1093/cid/civ598] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The group A meningococcal vaccine (PsA-TT) clinical development plan included clinical trials in India and in the West African region between 2005 and 2013. During this period, the Meningitis Vaccine Project (MVP) accumulated substantial experience in the ethical conduct of research to the highest standards. METHODS Because of the public-private nature of the sponsorship of these trials and the extensive international collaboration with partners from a diverse setting of countries, the ethical review process was complex and required strategic, timely, and attentive communication to ensure the smooth review and approval for the clinical studies. Investigators and their site teams fostered strong community relationships prior to, during, and after the studies to ensure the involvement and the ownership of the research by the participating populations. As the clinical work proceeded, investigators and sponsors responded to specific questions of informed consent, pregnancy testing, healthcare, disease prevention, and posttrial access. RESULTS Key factors that led to success included (1) constant dialogue between partners to explore and answer all ethical questions; (2) alertness and preparedness for emerging ethical questions during the research and in the context of evolving international ethics standards; and (3) care to assure that approaches were acceptable in the diverse community contexts. CONCLUSIONS Many of the ethical issues encountered during the PsA-TT clinical development are familiar to groups conducting field trials in different cultural settings. The successful approaches used by the MVP clinical team offer useful examples of how these problems were resolved. CLINICAL TRIALS REGISTRATION ISRCTN17662153 (PsA-TT-001); ISRTCN78147026 (PsA-TT-002); ISRCTN87739946 (PsA-TT-003); ISRCTN46335400 (PsA-TT-003a); ISRCTN82484612 (PsA-TT-004); CTRI/2009/091/000368 (PsA-TT-005); PACTR ATMR2010030001913177 (PsA-TT-006); PACTR201110000328305 (PsA-TT-007).
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Affiliation(s)
| | - Samba O. Sow
- Centre pour le Développement des Vaccins, Bamako, Mali
| | - Aldiouma Diallo
- Institut pour la Recherche et le Développement, Niakhar, Senegal
| | - Abraham Hodgson
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Beate Kampmann
- Vaccines and Immunity Theme, Medical Research Council Unit, Basse, The Gambia
| | - Siddhivinayak Hirve
- Shirdi Sai Baba Hospital, Vadu/King Edward Memorial Hospital Research Centre, Rasta Peth, Pune, India
| | - Milagritos Tapia
- Department of Pediatrics, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore
| | | | - Assane Ndiaye
- Institut pour la Recherche et le Développement, Niakhar, Senegal
| | - Bou Diarra
- Institut pour la Recherche et le Développement, Niakhar, Senegal
| | | | - Adebayo Akinsola
- Vaccines and Immunity Theme, Medical Research Council Unit, Basse, The Gambia
| | - Olubukola T. Idoko
- Vaccines and Immunity Theme, Medical Research Council Unit, Basse, The Gambia
| | | | - Ashish Bavdekar
- Shirdi Sai Baba Hospital, Vadu/King Edward Memorial Hospital Research Centre, Rasta Peth, Pune, India
| | - Sanjay Juvekar
- Shirdi Sai Baba Hospital, Vadu/King Edward Memorial Hospital Research Centre, Rasta Peth, Pune, India
| | | | | | | | - Julie Chaumont
- Meningitis Vaccine Project, PATH, Ferney-Voltaire, France
| | | | - Flore Pallardy
- Meningitis Vaccine Project, PATH, Ferney-Voltaire, France
| | | | - Marie-Pierre Preziosi
- Meningitis Vaccine Project, PATH, Ferney-Voltaire, France
- Meningitis Vaccine Project, Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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22
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Siddiqui S, Sarro Y, Diarra B, Diallo H, Guindo O, Dabitao D, Tall M, Hammond A, Kassambara H, Goita D, Dembele P, Traore B, Hengel R, Nason M, Warfield J, Washington J, Polis M, Diallo S, Dao S, Koita O, Lane HC, Catalfamo M, Tounkara A. Tuberculosis specific responses following therapy for TB: Impact of HIV co-infection. Clin Immunol 2015; 159:1-12. [PMID: 25889622 DOI: 10.1016/j.clim.2015.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 12/08/2014] [Revised: 03/24/2015] [Accepted: 04/01/2015] [Indexed: 02/06/2023]
Abstract
Characterizing perturbations in the immune response to tuberculosis in HIV can develop insights into the pathogenesis of coinfection. HIV+ TB+ and TB monoinfected (TB+) subjects recruited from clinics in Bamako prior to initiation of TB treatment were evaluated at time-points following initiation of therapy. Flow cytometry assessed CD4+/CD8+ T cell subsets and activation markers CD38/HLA-DR. Antigen specific responses to TB proteins were assessed by intracellular cytokine detection and proliferation. HIV+ TB+ subjects had significantly higher markers of immune activation in the CD4+ and CD8+ T cells compared to TB+ subjects. HIV+ TB+ had lower numbers of TB-specific CD4+ T cells at baseline. Plasma IFNγ levels were similar between HIV+ TB+ and TB+ subjects. No differences were observed in in-vitro proliferative capacity to TB antigens between HIV+ TB+ and TB+ subjects. Subjects with HIV+ TB+ coinfection demonstrate in vivo expansion of TB-specific CD4+ T cells. Immunodeficiency associated with CD4+ T cell depletion may be less significant compared to immunosuppression associated with HIV viremia or untreated TB infection.
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Affiliation(s)
- S Siddiqui
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA.
| | - Y Sarro
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - B Diarra
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - H Diallo
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - O Guindo
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - D Dabitao
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - M Tall
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - A Hammond
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - H Kassambara
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - D Goita
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - P Dembele
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - B Traore
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - R Hengel
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - M Nason
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - J Warfield
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - J Washington
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - M Polis
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - S Diallo
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - S Dao
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - O Koita
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - H C Lane
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - M Catalfamo
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
| | - A Tounkara
- Collaborative Clinical Research Branch, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rm 1167, Bldg. 6700B, Rockledge Drive, Bethesda, MD 20892, USA
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Hoenen T, Safronetz D, Groseth A, Wollenberg KR, Koita OA, Diarra B, Fall IS, Haidara FC, Diallo F, Sanogo M, Sarro YS, Kone A, Togo ACG, Traore A, Kodio M, Dosseh A, Rosenke K, de Wit E, Feldmann F, Ebihara H, Munster VJ, Zoon KC, Feldmann H, Sow S. Virology. Mutation rate and genotype variation of Ebola virus from Mali case sequences. Science 2015; 348:117-9. [PMID: 25814067 PMCID: PMC11045032 DOI: 10.1126/science.aaa5646] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [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: 12/24/2014] [Accepted: 02/23/2015] [Indexed: 01/26/2023]
Abstract
The occurrence of Ebola virus (EBOV) in West Africa during 2013-2015 is unprecedented. Early reports suggested that in this outbreak EBOV is mutating twice as fast as previously observed, which indicates the potential for changes in transmissibility and virulence and could render current molecular diagnostics and countermeasures ineffective. We have determined additional full-length sequences from two clusters of imported EBOV infections into Mali, and we show that the nucleotide substitution rate (9.6 × 10(-4) substitutions per site per year) is consistent with rates observed in Central African outbreaks. In addition, overall variation among all genotypes observed remains low. Thus, our data indicate that EBOV is not undergoing rapid evolution in humans during the current outbreak. This finding has important implications for outbreak response and public health decisions and should alleviate several previously raised concerns.
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Affiliation(s)
- T Hoenen
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA
| | - D Safronetz
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA
| | - A Groseth
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA
| | - K R Wollenberg
- Bioinformatics and Computational Biosciences Branch, NIAID, NIH, Bethesda, MD 20892, USA
| | - O A Koita
- Center of Research and Training for HIV and Tuberculosis, University of Science, Technique and Technologies of Bamako, Mali
| | - B Diarra
- Center of Research and Training for HIV and Tuberculosis, University of Science, Technique and Technologies of Bamako, Mali
| | - I S Fall
- World Health Organization Office, Bamako, Mali
| | - F C Haidara
- Centre des Operations d'Urgence, Centre pour le Développement des Vaccins (CVD-Mali), Centre National d'Appui à la lutte contre la Maladie, Ministère de la Sante et de l'Hygiène Publique, Bamako, Mali
| | - F Diallo
- Centre des Operations d'Urgence, Centre pour le Développement des Vaccins (CVD-Mali), Centre National d'Appui à la lutte contre la Maladie, Ministère de la Sante et de l'Hygiène Publique, Bamako, Mali
| | - M Sanogo
- Center of Research and Training for HIV and Tuberculosis, University of Science, Technique and Technologies of Bamako, Mali
| | - Y S Sarro
- Center of Research and Training for HIV and Tuberculosis, University of Science, Technique and Technologies of Bamako, Mali
| | - A Kone
- Center of Research and Training for HIV and Tuberculosis, University of Science, Technique and Technologies of Bamako, Mali
| | - A C G Togo
- Center of Research and Training for HIV and Tuberculosis, University of Science, Technique and Technologies of Bamako, Mali
| | - A Traore
- Centre des Operations d'Urgence, Centre pour le Développement des Vaccins (CVD-Mali), Centre National d'Appui à la lutte contre la Maladie, Ministère de la Sante et de l'Hygiène Publique, Bamako, Mali
| | - M Kodio
- Centre des Operations d'Urgence, Centre pour le Développement des Vaccins (CVD-Mali), Centre National d'Appui à la lutte contre la Maladie, Ministère de la Sante et de l'Hygiène Publique, Bamako, Mali
| | - A Dosseh
- World Health Organization Inter-Country Support Team, Ouagadougou, Burkina Faso
| | - K Rosenke
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA
| | - E de Wit
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA
| | - F Feldmann
- Rocky Mountain Veterinary Branch, Division of Intramural Research, NIAID, NIH, Hamilton, MT 59840, USA
| | - H Ebihara
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA
| | - V J Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA
| | - K C Zoon
- Office of the Scientific Director, NIAID, NIH, Bethesda, MD 20895, USA
| | - H Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA.
| | - S Sow
- Centre des Operations d'Urgence, Centre pour le Développement des Vaccins (CVD-Mali), Centre National d'Appui à la lutte contre la Maladie, Ministère de la Sante et de l'Hygiène Publique, Bamako, Mali.
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Abstract
Aflatoxin contamination in groundnut by Aspergillus section Flavi is a major pre- and post-harvest problem causing kernel-quality loss. Post-harvest aflatoxin contamination is caused initially by infestation of aflatoxigenic strains at the pre-harvest stage, resulting in reduced kernel quality after harvest. Improper handling of pods and storage methods after harvest lead to high moisture and ambient temperatures, directly causing aflatoxin contamination. In this review, we report the extent of post-harvest contamination along the groundnut value chain in the Kolokani, Kayes, and Kita districts of Mali in West Africa. Groundnut kernels and paste samples were collected from retailers in selected markets from December 2010 to June 2011, and aflatoxin B1 (AFB1) content was estimated. Aflatoxin was significantly higher in groundnut paste than in kernels. Kolokani recorded the highest toxin levels in both kernels and groundnut paste compared with the other districts. Overall, AFB1 levels in kernels and paste increased during storage at the market level in the three districts and were above permissible levels (≯20 μg/kg). The effect of weather factors on post-harvest contamination and the reasons for aflatoxin build-up in Mali are discussed. This paper also highlights different management tools for reducing post-harvest aflatoxin contamination, such as post-harvest grain handling, post-harvest machinery, physical separation, storage methods and conditions, disinfestation, detoxification, inactivation, filtration, binding agents, and antifungal compounds. Post-harvest management options and enhanced use of good agricultural practices for mitigating this problem in Mali are also presented.
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Affiliation(s)
- F. Waliyar
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), BP 320, Bamako, Mali
| | - M. Osiru
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), BP 320, Bamako, Mali
| | - B.R. Ntare
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), BP 320, Bamako, Mali
| | | | | | - A. Traore
- International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), BP 320, Bamako, Mali
| | - B. Diarra
- L’Institut d’Economie Rurale (IER), Bamako, Mali
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25
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Traore B, Diarra B, Dembele BPP, Somboro AM, Hammond AS, Siddiqui S, Maiga M, Kone B, Sarro YS, Washington J, Parta M, Coulibaly N, M'baye O, Diallo S, Koita O, Tounkara A, Polis MA. Molecular strain typing of Mycobacterium tuberculosis complex in Bamako, Mali. Int J Tuberc Lung Dis 2012; 16:911-6. [PMID: 22508197 DOI: 10.5588/ijtld.11.0397] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To identify strains of Mycobacterium tuberculosis complex (MTC) circulating in Bamako and to examine the relationship between the strains and their drug susceptibility profiles. METHODS Between 2006 and 2010, we conducted a cross-sectional study using spoligotyping to identify strains of MTC recovered from 126 tuberculosis (TB) patients under treatment in Bamako, Mali. RESULT Three members of the MTC were isolated: M. tuberculosis (71.4%), M. africanum (27.8%) and M. bovis (0.8%). Of these, three strains were found to be the most prevalent: M. tuberculosis T1 (MTB T1; 38.9%), M. africanum F2 (MAF2; 26.2%) and M. tuberculosis Latin American and Mediterranean 10 (MTB LAM 10; 10.3%). MAF2 and MTB LAM 10 strains have a lower risk of multidrug resistance (MDR) than MTB T1 (respectively OR 0.1, 95%CI 0.03-0.4 and OR 0.1, 95%CI 0.01-0.8). Age ≥ 32 years (OR 1.4, 95%CI 0.4-3.9), negative human immunodeficiency virus status (OR 0.4, 95%CI 0.1-2.5) and male sex (OR 4, 95%CI 0.9-16.5) were not associated with MDR. The prevalence of MDR among treatment and retreatment failure patients was respectively 25% and 81.8% compared to new patients (2.9%). CONCLUSION This study indicates a low level of primary drug resistance in Bamako, affirms the importance of using correct drug regimens, and suggests that the MTB T1 strain may be associated with the development of resistance.
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Affiliation(s)
- B Traore
- Project SEREFO-NIAID (Centre de Recherche et de Formation sur VIH/Sida et Tuberculose-Institut National des Maladies Infectieuses et Allergiques)/University of Bamako Research Collaboration on HIV-TB, Bamako, Mali
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26
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Ani AE, Diarra B, Dahle UR, Lekuk C, Yetunde F, Somboro AM, Anatole T, Idoko J. Identification of mycobacteria and other acid fast organisms associated with pulmonary disease. Asian Pacific Journal of Tropical Disease 2011. [DOI: 10.1016/s2222-1808(11)60061-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Tounkara A, Sarro YS, Kristensen S, Dao S, Diallo H, Diarra B, Noumsi TG, Guindo O. Seroprevalence of HIV/HBV coinfection in Malian blood donors. ACTA ACUST UNITED AC 2009; 8:47-51. [PMID: 19182212 DOI: 10.1177/1545109708330118] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES A cross-sectional study was conducted to assess the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and their coinfection among blood donors at the National Blood Transfusion Center in Bamako, Mali, from November 2001 to July 2002. METHODS Enzyme-linked immunosorbent assay techniques with reagents from Bio-Rad (France) were used to test the blood samples. RESULTS 11,592 blood donors were tested for HIV and HBV surface antigens. The prevalence of HIV was 4.5% and the prevalence of HBV was 14.9%. The HIV/HBV coinfection rate was only 1.13% in this population. CONCLUSION The coinfection rate was unexpectedly low in this blood donor population where monoinfection with HIV or HBV prevalence was high.
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Affiliation(s)
- A Tounkara
- Faculté de Médicine, de Pharmacie et d'Odonto-Stomatologie (FMPOS) de l'Université du à Mali Bamako (SER-EFO), Bamako, Mali
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Diallo S, Toloba Y, Nkoumou A, Diarra B, Sissoko B, Mbaye O, Keita B. [Variability of skin test on both tuberculosis and co infected patients with HIV under tuberculosis treatment]. Mali Med 2009; 24:28-30. [PMID: 19666364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
To evaluate the variability of tuberculin skin test (TST), we did a prospective study in the pneumology unit of the teaching hospital at Point G and in the tuberculosis unit of the health district II at Bamako, Mali TST was applied two times to every patient more than 18 years old: at the beginning before the tuberculosis treatment (tst1) and after 2 months (tst2). For all 113 patients followed in both units, 41 were enrolled in this study (36, 2%). The mean age of patients was 37.9 years and 73.2% were male.(sex proportion was 2.72 for male). The different forms of Tuberculosis were: 63.4% of tuberculosis with smear positive(TSP); 7.3% of tuberculosis with smear negative(TSN); and 29,3% of disseminated tuberculosis. 22% of the patients were HIV positive. The tst1 was positive for 58.5% of the patients(11.11% of the HIV positive patients and 78.13% of the HIV negative). The diameter of indurations of the TST increased considerably during the treatment mainly with patients infected by HIV. The TST test can be an indicator of follow op for these patients who had less AFB most of time?
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29
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Diallo S, Diarra B, Diop S, Toloba Y, Berthé F, Sissoko B, Gomez P, M'Baye O, Keita B. [Knowledge of the Bamako general population of tuberculosis]. Mali Med 2009; 24:48-51. [PMID: 19666381] [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: 05/28/2023]
Abstract
The hope of the World Health Organization (WHO) in the fight against tuberculosis rests today on the implementation of the strategy DOTS. The success of this strategy passes obligatorily by an implication of the parents, neighbors in one word of the population living with the patient; this is why we fixed our objective to study knowledge on the tuberculosis of the people of more than 18 years of the district of Bamako. We carried out a cross-sectional study supplemented by focus-groups in 3 districts of Bamako near the general population (socio-medical personnel, old tuberculous, and helping natural) for the period from the 1st of June to July 15, 2004. Our sample was composed of 246 people for the individual questionnaires and of 47 per 8 meetings of focus group: the sex ratio was 2,5 in favour of the men and 60,2% of our subjects had less than 30 years. In the general population of Bamako 24,8% had a good knowledge, 49,0% an average knowledge and 26,2% a bad knowledge. 48,8 % of those which had a good knowledge were the pupils, students and civils servant. So in general the population had a good knowledge on symptomatology (90,2 %), it on the other hand had the knowledge very limited on the etiology (only 10,6% of the subject knew that tuberculosis is caused by a mycobactery) or on the modes of transmission (cigarettes, soap, meat). The population of Bamako has a very passable level of knowledge on tuberculosis. If this level is good with regard to symptomatology, it is very insufficient on the etiology or on the transmission of the disease. To improve this knowledge one needs a sensitizing supported for television and the radio in the dialects and national languages.
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Affiliation(s)
- S Diallo
- Service de pneumologie, Hôpital du point G : BP 333 Bamako Mali
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30
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Diarra B, Venien F, Le Guyader A, Venien J, Cormier M. Oxydation photoinduite et biodegradation de naphtalenes dans l'eau de mer. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/09593338409384282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Konate A, Minta D, Diarra M, Dolo A, Dembele M, Diarra B, Maiga MY, Traore HA, Doumbo O. [Intestinal parasitosis during AIDS diarrhoea]. Bull Soc Pathol Exot 2005; 98:33-5. [PMID: 15915971] [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: 05/02/2023]
Abstract
The main goal of this work was to study the parasitic infections during AIDS diarrhoea. A longitudinal study was carried out from October 2000 to November 2001 in the Hepato-Gastro-Enterology department of Gabriel Toure Hospital and in the Department of Epidemiology and Parasitic infections of Faculty of Medicine, Pharmacy and Odonto-stomatology of Bamako (Mali), concerning HIV positive patients suffering from diarrhoea. Detecting microbes in stools has been done through direct microscopic examination and according to procedures of Henricksen Poblenz Baerman, Kato Katz and the PCR. Among the 70 patients involved, the sex-ratio was 53%, the average age was 35 +/- 8.4 years. Fever weight loss, skin affections and digestive mycosis were often associated. Opportunistic infections have been relatively frequent with Cryptosporidium parvum with 20%, Isospora belli with 8.5% and Microsporidium with 11.5% of cases. Other non-opportunistic microbes were found. Death within the first two weeks seems more important in case of infection by Cryptosporidium parvum. The frequency and the danger of those opportunistic infections require their efficient diagnosis and care management.
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Affiliation(s)
- A Konate
- Service hépato-gastro-entérologie, Hôpital Gabriel Touré, Bamako, Mali
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Diarra B, Coulibaly A, Ehua-Somian F, Soro KG, Souaga KA, Kanga-Miessan JB. [Experience with preperitoneal hernioplasty using Stoppa's procedures in the Ivory Coast]. Ann Chir 2001; 126:325-9. [PMID: 11413812 DOI: 10.1016/s0003-3944(01)00514-4] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The treatment of groin hernias with a high risk of recurrence often provides therapeutic difficulties in Africa for fear of using mesh due to the potential risk of sepsis. The aim of this retrospective study was to emphasize the simplicity and efficacy of Stoppa's technique. PATIENTS AND METHODS From 1994 to 1999, 128 patients with 239 groin hernias underwent hernioplasty with Stoppa's technique. They were all men with a mean age of 54 +/- 8 years. They were classified in stages III and IV (46.8%, n = 60) of Nyhus. One hundred and eleven patients (86.7%) had bilateral hernias and 64 had a factor of recurrence (50%). RESULTS Mean operating time was 150 +/- 42 min (50-240 min). Follow-up ranged from 6 months to 6 years, with a mean time of 26 months. Eighteen patients were lost to follow-up. The mortality rate was 0.8% (n = 1). The morbidity rate was 18.7% (n = 24) with five hematomas (3.9%), 11 seromas (8.6%), one parietal infection (0.8%) and one recurrence (0.8%). CONCLUSION These results suggest that Stoppa's technique is efficient and technically feasible in our conditions and has to be performed more frequently.
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Affiliation(s)
- B Diarra
- Service de chirurgie digestive, CHU de Yopougon, BP 632 Abidjan 21, Ivory Coast
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Geerts S, Diarra B, Eisler MC, Brandt J, Lemmouchi Y, Kageruka P, De Deken R, Ndao M, Diall O, Schacht E, Berkvens D, Speybroeck N, Holmes PH. Extension of the prophylactic effect of isometamidium against trypanosome infections in cattle using a biodegradable copolymer. Acta Trop 1999; 73:49-58. [PMID: 10379816 DOI: 10.1016/s0001-706x(99)00010-8] [Citation(s) in RCA: 4] [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: 10/18/2022]
Abstract
Two trials were carried out in order to compare the prophylactic effect of a subcutaneously implanted sustained release device (SRD) containing a mixture of a biodegradable copolymer, poly(caprolactone-co-L-lactide), and isometamidium (ISMM) with that obtained after intramuscular injection of the drug. In a first experiment under controlled conditions, two groups of cattle were treated with 0.5 mg/kg isometamidium either as a SRD or intramuscularly (i.m.), and exposed at monthly intervals to Glossina morsitans morsitans infected with Trypanosoma congolense. The average protection period was at least 24 months in the SRD treated against 5.7 months in the i.m. treated group. Using an ISMM enzyme-linked immunosorbent assay, the drug could be detected until 140 days post-treatment in the latter group, whereas in the former group, traces of the drug were detectable until 330 days after treatment. Furthermore, a field trial was carried out at the Madina Diassa ranch in Mali involving three groups of N'Dama cattle, each containing 23 or 24 animals. Two groups were treated with 1 mg/kg ISMM either as a SRD or i.m. and a third group served as untreated control. Twelve months after treatment, the cumulative infection rates were 56.5, 87.8 and 91.6% in the SRD implanted, the i.m. treated and the control groups, respectively. The ISMM concentrations were slightly lower than in the laboratory trial, but the overall pattern of drug disappearance from the sera of the SRD treated cattle was very similar in both trials. Statistical analysis showed that the incidence of trypanosomiasis was significantly lower in the SRD treated than in the i.m. treated group.
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Affiliation(s)
- S Geerts
- Institute of Tropical Medicine, Antwerpen, Belgium.
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Somian FE, Essoh JB, Coulibaly A, Diarra B, Yapo PA, Konan BK, Kanga MJ. [Peritonitis by fish bone. Review of the literature. Pathogenic discussion]. Bull Soc Pathol Exot 1999; 92:18-9. [PMID: 10214513] [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: 02/12/2023]
Abstract
From one case of peritonitis by fish bone, we have reviewed medical literature in order to explain the mechanism of this type of peritonitis perforation, which can be assimilated to peritonitis in three phases.
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Affiliation(s)
- F E Somian
- Service de chirurgie générale et digestive, C.H.U. de Yopougon, Côte d'Ivoire
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Lemmouchi Y, Schacht E, Kageruka P, De Deken R, Diarra B, Diall O, Geerts S. Biodegradable polyesters for controlled release of trypanocidal drugs: in vitro and in vivo studies. Biomaterials 1998; 19:1827-37. [PMID: 9855183 DOI: 10.1016/s0142-9612(98)00074-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.5] [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: 10/18/2022]
Abstract
Copolymers of epsilon-caprolactone and L-lactide P(CL-LLA), epsilon-caprolactone and D,L-lactide P(CL-DLLA) and epsilon-caprolactone and trimethylene carbonate P(CL-TMC) were synthesized. The composition of comonomers and their sequence lengths were determined by means of 1H and 13C NMR measurements. The effect of the comonomer on the thermal properties was investigated by differential scanning calorimetry (DSC) analysis. The in vitro degradation of the rods obtained by melt extrusion of the synthesized copolymers and the commercial homopolymers poly(epsilon-caprolactone) P(CL) and poly(D,L-lactide) P(DLLA) was carried out in phosphate buffer (PB) pH 7.4 at 37 degrees C. The rate of degradation depends on comonomers and polymer composition. The in vitro release of the selected drugs, isometamidium chloride (IMM) and ethidium bromide (EtBr), from such devices was carried out under the same conditions as used for the in vitro degradation. The release experiments show that the release of IMM is faster than for EtBr. During the first stage, for IMM the release is governed by osmotic pressure whereas for EtBr the release is mainly diffusion-controlled. The in vitro release of these drugs is governed by polymer matrix degradation at the later stage of the release process. Comparative in vitro release study from the different polymers showed that the release depends mainly on the physical properties of the polymer. The in vivo experiments carried out in the field on cattle and in the laboratory on rabbits using the classical treatment (intramuscular injection) and the sustained release devices (SRD) subcutaneously implanted, showed that the prophylactic period is significantly enhanced in the case of SRD as compared to intramuscular injection. The comparative efficacy of SRD containing IMM and EtBr evaluated in the case of rabbits showed that, the SRD (IMM) prophylactic period is much longer than for SRD (EtBr).
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Affiliation(s)
- Y Lemmouchi
- Polymer Material Research Group, Institute for Biomedical Technologies, University of Gent, Belgium
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Stoppa R, Diarra B, Verhaeghe P, Henry X. [Problems of reoperation after prosthetic repair of groin hernia]. Chirurgie 1998; 122:369-72; discussion 372-3. [PMID: 9588053] [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: 02/07/2023]
Abstract
The easy performance and the efficiency of these repairs should make the surgeon attentive to some related drawbacks, which can scarcely appear when reoperating on the bladder or the prostate, also on the iliac vessels. The encountered difficulties are related to the scar sclerosis much or less extensive and/or effective, invading the Retzius and/or the Bogros' spaces. The authors report their intraoperative and anatomical findings. They propose the following solutions: (1) when the cleavage of the Retzius' space is impossible (for bladder or prostate surgery): a subperiosteal retropubic cleavage, either isolated or combined with a transperitoneal approach. (2) When the cleavage of the Bogros' space is impossible (for a surgery on the iliac vessels): a transperitoneal approach; but the prevention of the perivascular sclerosis after the use of large prostheses relies on the easy preservation of the funicular sheath, able to protect the iliac vessels, providing no slit has been done on the mesh prosthesis.
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Diarra B, Diall O, Geerts S, Kageruka P, Lemmouchi Y, Schacht E, Eisler MC, Holmes P. Field evaluation of the prophylactic effect of an isometamidium sustained-release device against trypanosomiasis in cattle. Antimicrob Agents Chemother 1998; 42:1012-4. [PMID: 9593118 PMCID: PMC105735 DOI: 10.1128/aac.42.5.1012] [Citation(s) in RCA: 6] [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: 02/07/2023] Open
Abstract
In order to compare the prophylactic effect provided by a poly(D,L-lactide) sustained-release device (SRD) containing isometamidium (ISMM) with that provided by the classical intramuscular injection of the drug, a field trial was carried out at the Madina Diassa Ranch in Mali. One- to 3-year-old N'Dama cattle were randomly divided into three groups. The first group (n = 42) was treated with ISMM at a dose of 1 mg/kg of body weight, the second group (n = 44) received the same dose of the drug via an SRD, which was subcutaneously implanted in the shoulder region, and the third group (n = 36) was kept as an untreated control group. All animals were treated with diminazene aceturate (7 mg/kg of body weight) 2 weeks before the start of the experiment and were tested monthly by the buffy coat technique for a period of 8 months. Glossina morsitans submorsitans was the most important tsetse species, with apparent densities (number of catches/trap/day) varying between 11.9 and 38.7 over the experimental period. Eight months after treatment the cumulative infection rates were 27.7, 58.5, and 77.4% in the group with the SRD implant, the group receiving the intramuscular injection, and the control group, respectively. Statistical analysis showed that the incidence of trypanosomiasis was significantly lower (P = 0.006) in the group which received ISMM via the SRD than in the one which was treated with ISMM intramuscularly.
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Affiliation(s)
- B Diarra
- Laboratoire Central Vétérinaire, Bamako, Mali
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Stoppa R, Diarra B, Verhaeghe P, Henry X. Some problems encountered at re-operation following repair of groin hernias with pre-peritoneal prostheses. Hernia 1998. [DOI: 10.1007/bf01207772] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Diarra B, Stoppa R, Verhaeghe P, Mertl P. About prolongations of the urogenital fascia into the pelvis: An anatomic study and general remarks on the interparietal-peritoneal fasciae. Hernia 1997. [DOI: 10.1007/bf01234757] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Geerts S, Kageruka P, De Deken R, Brandt JR, Kazadi JM, Diarra B, Eisler MC, Lemmouchi Y, Schacht E, Holmes PH. Prophylactic effects of isometamidium- and ethidium-sustained release devices against Trypanosoma congolense in cattle. Acta Trop 1997; 65:23-31. [PMID: 9140511 DOI: 10.1016/s0001-706x(97)00649-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 02/04/2023]
Abstract
Two successive experiments were carried out in which three cows were treated by intramuscular injection of either 0.5 mg/kg isometamidium or 1 mg/kg ethidium and compared with another group of three cows which received a subcutaneously implanted sustained release device (SRD) containing the same dose of drug. The prophylactic effect of both drug formulations was evaluated by exposing the animals at monthly intervals to Glossina morsitans morsitans infected with Trypanosoma congolense. The average protection period using the isometamidium- and the ethidium-SRD was extended by a factor of 3.2 and 2.8, respectively in comparison with the intramuscular injection of the drugs. In the analysis of isometamidium concentrations in the serum of the animals using a competitive drug-ELISA the drugs remained present for much longer periods in the sera of the implanted animals than in those of the intramuscularly treated cattle. The animals were still protected, however, a long time after the disappearance of detectable drug levels in the serum. No difference in drug sensitivity could be observed, when breakthrough isolates were compared from animals which received the ethidium-SRD and those treated intramuscularly, although a slight loss sensitivity occurred in the breakthrough isolates as compared to the parent trypanosome population.
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Affiliation(s)
- S Geerts
- Institute of Tropical Medicine, Antwerpen, Belgium.
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Silaev AB, Diarra B, Trifonova ZP, Katrukha GS. Structure of the aglycone of the glycopeptide antibiotic ristomycin A. Chem Nat Compd 1979. [DOI: 10.1007/bf00565969] [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: 11/25/2022]
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42
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Katrukha GS, Diarra B, Silaev AB, Trifonova ZP, Rozynov BV. [New amino acid from the antibiotic, ristomycin A]. Antibiotiki 1979; 24:179-81. [PMID: 220905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A new amino acid E was isolated from a mixture of the products of the reductive hydrolysis of ristomycin A 57% HJ in the presence of red phosphorus. Its characterization was performed. The new amino acid was formed as a result of reductive dehydration of the respective beta-oxyamino acid present in the native antibiotic and being completely destroyed during general acid or alkaline hydrolysis.
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Katurkha GS, Terent'ev PB, Diarra B, Gershtein ES. The structure of the diamino dicarboxylic amino acids from the glycopeptide antibiotic ristomycin A. Chem Nat Compd 1978. [DOI: 10.1007/bf00565901] [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: 11/29/2022]
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