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La lutte contre le changement climatique exige une créativité radicale et de nouvelles formes de relations, d’institutions et de pratiques. Reimagining Museums for Climate Action a été lancé le 18 mai 2020, à l’occasion de la Journée internationale des musées 2020, sous la forme d’un concours international d’idées et de design visant à (re)imaginer et à (re)concevoir radicalement l’institution muséale, afin de contribuer à un avenir plus équitable et plus durable à l’ère du changement climatique. Le concours a suscité un intérêt considérable, avec 264 contributions de 48 pays. Huit lauréats ont reçu chacun 2 500 £ pour transformer leurs idées en expositions qui seront présentées au Centre scientifique de Glasgow avant et pendant la COP26. L’exposition présente également un large éventail d’idées parmi les soumissions, visant à fournir au secteur des musées et à la société une source d’innovation et d’inspiration pour atteindre les objectifs de la Convention-cadre sur les changements climatiques et de l’Accord de Paris.

For decades malarial control has been implemented to control the impact of the disease on the health of populations living in endemic zones. The use of artemisinine combination therapy, intermittent preventive treatment for children and pregnant women, vector-control methods such as long-lasting insecticide-impregnated mosquito nets and indoor remanent insecticide spraying has proven to be effective. These practices have lead to such an extensive reduction of the malaria burden in some endemic areas that the objective of eradication that was unimaginable a few years ago is now back to the forefront. Regardless of the method chosen, careful evaluation and surveillance of its effectiveness in man is necessary. Achieving epidemiologic impact is the main goal of malaria control methods. The main measures for evaluation involve parasitological and clinical aspects of human malaria. The purpose of this article is to review methods used for epidemiologic evaluation of malaria burden.

Vector-control measures are a component of integrated malaria control strategies. After evaluation in phase III pilot studies, these measures are currently being deployed in many endemic malaria zones. Their effectiveness must be evaluated under actual conditions of use but it is not ethically acceptable to use unexposed individuals for control groups. In a attempt to overcome this problem, a case-control study was undertaken to evaluate the effectiveness of long-lasting insecticide treated mosquito nets (LLITN) against clinical malaria attacks due to Plasmodium falciparum in an endemic area of southern Benin. During a 4-month period (July to October 2008), 35 clinically documented cases of uncomplicated malaria (fever + parasite density > 3000/microL) were diagnosed in children less than 5 years old from 6 villages in the Tori Bossito medical district. The parents of these children were interviewed at the same time as the parents of 181 children randomly selected from the same 6 villages. A total of 115 of the randomly selected children who had not been feverish during study period were used as controls. The proportion of children having consistently slept under LLITN throughout the study period was 46% in the case group and 78% in the control group (OR=0.32, 95%CI: 0.15-0.71). These data show that the LLITN provided a significant level of protection, i.e., 68% (IC95%: 29%-85%). This case-control study shows that vector control measures can be effectively evaluated after deployment in population. The limitations of this methodology are discussed.

The purpose of this review of the literature is to present factors possibly affecting the spread of malaria in sub-Saharan Africa over the next 20 years. Malaria is a vector-borne disease that depends on environmental and human constraints. The main environmental limitations involve susceptibility of the vector (mosquitoes of the Anopheles genus) and parasite (Plasmodium falciparum) to climate. Malaria is a stable, endemic disease over most of the African continent. Climatic change can only affect a few regions on the fringes of stable zones (e.g. altitude areas or Sahel) where malaria is an unstable, epidemic disease. Higher temperatures could induce a decrease of malaria transmission in regions of the Sahel or an increase in the highlands. The extent of these overall trends will depend on the unpredictable occurrence of major meteorological phenomenon as well as on human activities affecting the environment that could lead to dramatic but limited outbreaks in some locations. The most influential human factors could be runaway demographic growth and urban development. Estimations based on modeling studies indicate that urbanization will lead to a 53.5% drop in exposure to malaria by 2030. However this reduction could be less than expected because of adaptation of Anopheles gambiae and An. arabiensis, the main vectors of malaria in sub-Saharan Africa, to the urban environment as well as increasing vector resistance to insecticides. Another unforeseeable factor that could induce unexpected malaria epidemics is mass migration due to war or famine. Finally immunosuppressive illnesses (e.g. HIV and malnutrition) could alter individual susceptibility to malaria. Social constraints also include human activities that modify land use. In this regard land use (e.g. forest clearance and irrigation) is known to influence the burden of malaria that is itself dependent on local determinants of transmission. Overall the most important social constraint for the population will be access to malarial prevention and implementation action to control this scourge.

Most new vector control methods against malaria involve the use of pesticides. Prior to release of these products for general use, their efficacy, persistence, and cross-resistance must be tested on mosquito colonies raised in the laboratory (phase I) then on wild mosquitoes in the field (small-scale), individual dwellings, or experimental huts (phase II). The goal of phase III studies is to evaluate the efficacy and effectiveness of the vector-control product or method against malaria in a population at regular risk for transmission. The main objective of phase III tests is to measure the epidemiologic impact, e.g. on the incidence or prevalence of malaria in humans. This article presents guidelines for carrying out phase III tests of vector-control methods against malaria (e.g. home insecticide spraying or insecticide-impregnated bednet use). It was written by participants in a workgroup formed to define recommendations for the WHOPES (WHO Pesticide Evaluation Scheme).

In a rural area of intense and permanent malaria transmission in Southwest Côte-d'lvoire, traditional midwifes of the Yacouba ethnic group, with also an important function for the children health and care, were interviewed in 2002 about their knowledge of the infantile pathologies. Their nosology is greatly based on symptoms and etiologic explanations of the disorder of secretions. The accumulation of a viscous liquid in different parts of the body, especially in the chest, the throat or the head, explains numerous febrile or afebrile diseases, including malnutrition. Some pathologies, particularly convulsions, are described by analogy with animals behaviour Relations between these entities and the biomedical ones are difficult to establish. The traditional care and treatments result from these concepts. A vomiting child or a child suffering from diarrhoea is subject to devices to evacuate his excess of liquid. Yellow brews are used against jaundice. Furthermore, an important mistrust remains towards medical treatments particularly for all parenteral therapies. Health facilities are only used as a the last resort. Their bad reputation is confirmed by the high rate of mortality of patients coming often too late. To improve malaria care management, health-care workers have to take into consideration these concepts and also prove their abilities to ensure good medical practices.

We evaluated from August to December 1997 the therapeutic effect of chloroquine (CQ) in treatment of mild malaria. Five villages of the savannah area of Côte d'Ivoire were selected for this study In this area and season, the transmission of malaria is of hyper-endemic type. The 14-day protocol of WHO was used and all the patients were treated with CQ 25 mg/kg over three days. 360 febrile children between 6 and 83 months old out of 545 were selected, and 286 were fully followed. At the beginning of the study axillary temperatures and parasitemia showed no difference in the 5 villages. The average therapy failure rate was 11.5% (IC to 95%; 7.8-15.2) with a maximum of 18.5%. The failure rates estimated in the various villages showed a hardly significant difference (p = 0.05). In the North of Côte d'Ivoire, the good efficiency of CQ can be explained by the low drugs pressure related to the behaviour of populations who use traditional phytotherapy in first resort to treat the fevers.

An epidemiological study on malaria was undertaken between July 1995 and July 1996 in two villages (Zaïpobly and Gahably) and their encampments (Kouassikro, Hamanikro and Konankro), in the south-western forest area of Côte d'Ivoire (region of Taï). The parasitological scheme comprised a total of 2023 tests performed on children aged from 0 to 14 years. The species found were Plasmodium falciparum, P. malariae and P. ovale with a proportion of 84%, 14% and 2% respectively. The global parasite prevalence of all Plasmodium species was 85% and malaria was holoendemic. The average parasitic density decreased progressively as the age increased, in contrast to the plasmodic index which did not vary. All the malarial indexes were similar in the villages and their encampments. Only overall fever prevalence was permanent and in all age groups it was higher in the encampments than in the villages. The entomological findings showed that transmission was permanent and intense throughout the year, with a recrudescence during the rainy season. Transmission was attributed to Anopheles gambiae s.l. in 85% of the cases whereas An. funestus played a secondary role. The average sporozoïtic index was 7.6% and varied between 1.1% and 16.7%. The entomological inoculation rate was of 400 infected bites per person-year for An. gambiae s.l. In such conditions of intense transmission, acquisition of premunition starts at a very early age. This assertion is verified by the average parasite density and the frequency of high parasitic densities which were at their maximum between 1 and 4 years of age and decreased thereafter as the age increased. The paludometric and entomologic indexes obtained are the most elevated ever to have been observed in Côte d'Ivoire, as a result of considerable ecological changes linked to the deterioration of the forest environment over the past 30 years. This deterioration has probably been caused by demographic pressure resulting from internal and foreign immigration to the Taï region and more especially by the influx of Liberian refugees.

Study of children treated for uncomplicated malaria in the sub-prefecture of Zouan Hounien in Western Côte d'Ivoire demonstrated that clinical failure rates (WHO 14-day test) were 43% for chloroquine and 6% for pyrimethamine-sulfadoxine (PS). Two issues raise serious doubts about the use of PS as a replacement for chloroquine. The first is detection of persistent asymptomatic parasitemia at day 7 in children treated with PS. The second is widespread use of one PS component (sulfadoxine) to prevent opportunistic infection in AIDS patients or to treat infection. Further study will be needed to evaluate the therapeutic and parasitological efficacy of amodiaquine in the region.

What criteria can be used to diagnose malaria in health centers located in endemic areas? Can an algorithm be developed for management of fever episodes? What parameters should be used to assess the morbidity of malaria for public health surveys or for studies to determine the efficacy insecticide-impregnated bednets, drug prophylaxis protocols, or anti-malarial vaccinations? Finding a useful definition for malaria attack is a perennial problem that becomes more difficult to resolve as the transmission rate and immunity level of the population increases. This review presents the fundamental aspects of diagnosing malaria. The choice of diagnostic technique requires knowledge of physiopathological, epidemiological, and clinical features. There is no single method. It depends on the circumstances, epidemiological context, available facilities, and goals. Diagnosis for treatment is one thing. Diagnosis for evaluation is another. In addition to discussing these concepts, this article provides references from the recent literature and up-to-date information needed to deal with the problem of diagnosing malaria attacks in endemic areas.

The efficacy of permethrin-treated Olyset Net mosquito nets on malaria transmission and morbidity was studied in Kafine, a village located in the savanna region of the Cote d'Ivoire in Africa. After collecting sociodemographic, entomological, and parasitological data, bednets were distributed first in the southern half of the village and then in the whole village. Throughout the study period, mosquito specimens were captured on the skin of inhabitants at four points in the village between 6 PM and 6 AM both inside (but outside bednets) and outside houses. Prior to distribution of bednets, the mean biting rate (MBR) by Anopheles gambiae was 77.4 bites per man per night (b/m/n). The mean parturity rate (MPR) was 40.6 p. 100, the sporozootic index (SI) was 0.99 p. 100, and the mean entomological inoculation rate (MEIR) was 0.7 infectious bites per man per night (b+/m/n). Six months after distribution of bednets in the southern half of the village, MBR was 80.2 b/m/n, MPR was 32 p. 100, SI was 1.8 p. 100, and MEIR was 0.83 b+/m/n. After extending distribution to the whole village, data from November 1996 to July 1997 were as follows: MBR, 67.8 b/m/n; MPR, 20.1 p. 100; SI, 0.65 p. 100; and MEIR, 0.66 p. 100. From August 1977 to July 1998, data were as follows: MBR, 102.6 b/m/n; MPR, 26.2 p. 100; SI, 1.15 p. 100; and MEIR, 0.74 b+/m/n. Comparative analysis of these data showed that use of bednets had no effect on the bite or entomological inoculation rate. This is in agreement with the documented resistance of vectors in the study zone to permethrin. Despite the known stimulation/repulsion effect of permethrin, use of treated bednets had no real impact on transmission. This inefficacy could be related to the high prevalence (80 p. 100) of the Kdr gene (responsible for resistance) in the savanna form of Anopheles gambiae.

The efficacy of permethrin-treated Olyset Net mosquito nets in preventing transmission and morbidity of malaria was studied in Kafine, a village in the rice-growing region of the Cote d'Ivoire. Entomological data demonstrated that permethrin-treated mosquito nets failed to reduce transmission of malaria. Laboratory tests showed that Anopheles gambiae s.s. in Kafine were resistant to permethrin and other pyrethroids. Study included a cohort of 163 children under five years of age who did or did not use mosquito nets. The number of patients seeking treatment for malaria attacks with fever was recorded weekly. No difference was found between the user and non-user groups with regard to the percentage of children exhibiting Plasmodium flaciparum trophozoites or gametocytes or to the mean parasite load. However the rate of high density parasitemia and malaria attacks was twice as high in the non-user group. This difference between users and non-users of mosquito nets cannot be explained only as the result of a physical barrier against bites. In areas where mosquitoes are resistant to pyrethroids, tests conducted in experimental huts have shown that impregnated mosquito nets reduce host/vector contact. However further study will be need to evaluate the overall impact of impregnated nets on malaria in the areas where mosquitoes are resistant to insecticides.

We present here data from the Ivory Coast on the susceptibility of Plasmodium falciparum to chloroquine, obtained since the first chloroquine-resistant strains were discovered in 1987. Susceptibility was assessed using the WHO 7-day field test. Almost all the tests were carried out in the capital, Adidjan, and in the southern forest zone. The frequency of chloroquine resistance was below 30% in most cases, the actual frequency differing between regions. The frequency of R3 chloroquine-resistant P. falciparum was very low. Such resistant parasites were found only on an oil-palm plantation and in the south west of the country, probably due to the free medical care available at both locations. In general, access to health care is limited. Fevers attributed to malaria are generally treated at home using plants or incomplete courses of chloroquine. Our data suggest that R3 chloroquine-resistant P. falciparum strains are selected by repeated high doses of chloroquine, rather than by low doses. Thus, symptomatic treatment of uncomplicated malaria and treatment at home with the "correct" medication may be more effective than systematic medication, for limiting the level of chloroquine resistance in the parasite. Pyrethroid-resistant Anopheles gambiae s.l. is present in West Africa and this may reduce the short-term effectiveness of impregnated mosquito nets. In the absence of R3 chloroquine-resistant P. falciparum, self-medication at home may be a practical and realistic way to treat malaria. However, more knowledge about the effectiveness of anti-malaria drugs, their use in various social, cultural and economic environments and the geographical distribution of insecticide-resistant vectors is required before effective strategies can be designed. However, it would certainly be of value to consistently check the quality of anti-malaria drugs and to try to improve the effectiveness of self-medication at home.

Opportunistic parasitic infections are diagnosed more and more often in African patients with AIDS. Cryptosporidiosis is the most frequent with a prevalence between 7 and 31%. The prevalence of Isospora belli is between 5 and 19% and that of strongyloidiasis between 2 and 5%, depending on the authors. These parasitic infections are probably one of the frequent causes of chronic diarrhea in Africa. The prevalence of toxoplasmosis and pneumocystosis are not well known. (Between 5 and 17% for toxoplasmosis and 29% for pneumocystosis). The diagnostic technics used are those currently known. Toxoplasmosis and pneumocystosis seen in these patients have the same presentations as those in developed countries.

The authors report an epizootic form of toxoplasmosis observed among the crowned pigeons (Goura cristata Pallas and Goura victoria Frazer). The evolution of toxoplasma from pigeons is described and the epizootiological analysis of two epizootic forms of toxoplasmosis encountered in Antwerp Zoo are compared.

Referring to the sociological structure of the family in the Bateke ethnic group which most of the inhabitants of Kwamouth (Bandundu region, Zaïre) are descendants, the author defines the concept to family contamination in trypanosomiasis induced by Trypanosoma brucei gambiense. The calculated incidence in the selected population according to the different types of family and vicinity contamination was found to be at least five times higher than the incidence obtained for the global population. To explain this considerable difference, the author suggests the mechanical transmission of the trypanosoma, but feels that cyclic transmission plays a significant role, as the life in close community is characteristic for the inhabitants of this area.

Ornithosis-psittacosis is a widely distributed disease in birds throughout the world. A serological study by the complement-fixation test and a few isolation of Chlamyqia were performed on feral pigeon population of Antwerpen city. The incidence of positive cases in Antwerpen averages 58.51 %. For each serum, a serological index (S. I.) was calculated with regard to the intensity of immunological response in different dilutions: S. I. seems to suggest an endemic status of the disease in Antwerpen. Evolution in time of the prevalence and the serological response shows the presence of two peaks: the first one in spring and the last one in summer. This might be explained by some factors influencing the transmission of the infection: between them, one must emphasize the pigeons habits and the ectoparasites.