Search

Se presentan los resultados de la excavación y estudio de la necrópolis ibérica de Les Esquarterades (Ulldecona, Tarragona) y la reconstrucción del ritual funerario del período Ibérico Antiguo a partir de los mismos. Este yacimiento se sitúa en una zona donde existen datos relativamente abundantes sobre el mundo funerario, incluyendo varias necrópolis excavadas entre los ríos Ebro y Mijares. Sin embargo, la mayoría de estas investigaciones se realizó entre las décadas de 1960 y 1970, con importantes carencias metodológicas, entre las que destaca la total ausencia de estudios antropológicos. Esta necrópolis se ha estudiado mediante una metodología renovada, con elevado carácter interdisciplinar. Esto ha permitido recuperar información de calidad sobre aspectos hasta ahora poco conocidos para el período y la zona, como la caracterización antropológica de la población enterrada, los ustrina o la identificación de banquetes funerarios o libaciones en el momento de realizar los depósitos funerarios.

Se presentan los resultados históricos derivados de la primera fase de la investigación sobre este importante yacimiento, realizada exclusivamente a partir de métodos no invasivos. Los datos recuperados a partir de la prospección pedestre y geofísica han permitido verificar la condición urbana del asentamiento, atestiguada tanto por sus dimensiones como por su complejidad estructural y la naturaleza de los materiales muebles recuperados, que sugieren actividades económicas especializadas y la coexistencia de distintos sectores sociales. La desaparición del asentamiento en torno a 200 a. C. confirma el profundo impacto de la conquista romana en los patrones de poblamiento del mundo ibérico septentrional.

Geophysical survey methods are broadly used to delimit and characterize archaeological sites, but the archaeological interpretation of geophysical data remains one of the challenges. Indeed, many scenarios can generate a similar geophysical response, and often interpretations can not be validated without access to the subsoil. In large geophysical surveys many anomalies are detected and validation through archaeological trenches can not be afforded. This paper analyses the validity of geoarchaeological core survey to check the archaeological interpretations based on geophysical results. The Roman site located at Auritz/Burguete and Aurizberri/Espinal (Navarre), provides a great case of study as many investigations have been carried out. After the gradiometer survey performed in 2013 a sediment core survey was designed. 132 cores were drilled using a hand-held coring machine and the sediments were analysed in situ. Site delimitation and archaeological interpretations based on magnetic data could be improved or corrected. In this regard, the core survey proved to be an useful methodology as many anomalies could be checked within reasonable time and resources. However, further geophysical investigations trough GPR revealed unexpected remains in areas where no archaeological deposits were identified through coring. Excavations showed poor conservation level in some of those areas, leading to thin archaeological deposits hard to identify at the cores. The sediment core survey, therefore, was proved to be inconclusive to delimit the archaeological site.

Abstract Background In Benin, access to water, sanitation and hygiene (WASH) remains an issue. This study aims to provide an overview of household access to basic WASH services based on nationally representative data. Method Secondary analyses were run using the ‘HOUSEHOLD’ dataset of the fifth Demographic and Health Survey 2017–2018. The dependent variables were household access to individual and combined basic WASH services. The characteristics of the household head and those related to the composition, wealth and environment of the household were independent variables. After a descriptive analysis of all study variables, multivariate logistic regression was performed to identify predictors of outcome variables. Results The study included 14,156 households. Of these, 63.98% (95% CI = 61.63–66.26), 13.28% (95% CI = 12.10–14.57) and 10.11% (95% CI = 9.19–11.11) had access to individual basic water, sanitation and hygiene facilities, respectively. Also, 3% (95% CI = 2.53–3.56) of households had access to combined basic WASH services. Overall, the richest households and few, and those headed by people aged 30 and over, female and with higher levels of education, were the most likely to have access to individual and combined basic WASH services. In addition, disparities based on the department of residence were observed. Conclusion The authors suggest a multifactorial approach that addresses the identified determinants.

Abstract Background Violence against women remains an important issue of inequality in African societies, with several consequences to health, social and economic status. This study aims to identify the factors related to the perception of intimate partner violence in Benin. Methods Data on intimate partner violence was collected by conducting live interviews, and from the Benin Demographic and Health Survey 2012. The dependent variable was acceptance of intimate partner violence. The independent variables were socio-demographic features such as age, level of education, matrimonial status, ethnicity, religion, place of residence and the index of economic well-being. Logistic regressions were performed and odds ratios (OR) with a confidence interval of 95% (CI95%) were estimated. Results Among the 21,574 people who answered the questions relating to violence against women by an intimate partner, the prevalence of acceptance of intimate partner violence was 15.77%. Ethnicity, level of education, administrative department of residence, religion, and socio-economic quintile were factors associated with the respondents’ acceptance of violence against women by an intimate partner. Conclusion Acceptance of intimate partner violence could be a major obstacle to the success of some health programs. There is a need to break the norms that support the vulnerability of women in Beninese society.

Abstract Background The 2016 World Health Organization guidelines recommend all children

Introduction: Knowledge about residual deficiencies and their consequences on daily life activities among stroke patients living at home 1-year after the initial event managed in stroke units is poor. This multi-dimensional study assessed the types of deficiencies, their frequency and the consequences that the specific stroke had upon the daily life of patients.Methods: A cross-sectional survey, assessing, using standardized scales, 1 year post-stroke disabilities, limitations of activities, participation and quality of life, was carried out by telephone interview and by mail in a sample of stroke patients who returned home after having been initially managed in a stroke unit.Results: A total of 161 patients were included (142 able to answer the interview on their own; 19 needing a care-giver). Amongst a sub-group of the patients interviewed, 55.4% (95% Confidence Interval [47.1–63.7]) complained about pain and 60.0% (95% CI [51.4–68.6]) complained of fatigue; about 25% presented neuropsychological or neuropsychiatric disability. Whilst 87.3% (95% CI [81.7–92.9]) were independent for daily life activities, participation in every domains and quality of life scores, mainly in daily activity, pain, and anxiety subscales, were low.Conclusion: Despite a good 1-year post-stroke functional outcome, non-motor disabling symptoms are frequent amongst patients returned home and able to be interviewed, contributing to a low level of participation and a poor quality of life. Rehabilitation strategies focused on participation should be developed to break the vicious circle of social isolation and improve quality of life.

Por los múltiples problemas que presenta la actual terminal de carga aérea del Aeropuerto Juan Santamaría, es imprescindible construir una nueva. La situación económica del país, hace necesario buscar la solución adecuada al costo más bajo posible. Es por ello que se tomó en cuenta, para el diseño que se presenta, la infraestructura actual, los Planes Maestros de desarrollo y sus revisiones. Para realizar las protecciones de carga, se escogió un porcentaje de crecimiento como el mejor método de pronóstico. Aplicando, a partir de los datos reales de 1985, un 5% a las importaciones y un 6% a las exportaciones, se obtiene el total de mercadería a manejar. Una vez calculado el volumen de carga para el año 2010 (último año de diseño), se vio que el sistema de movilización actual es adecuado, se estimó el número de vuelos de carga actual y cualquier incremento en los años próximos. Además, se sugieren pasos y medidas para la puesta en operación de la nueva terminal. Al final se dan una serie de recomendaciones para movilizar adecuadamente la carga actual y cualquier incremento en los años próximos. Además, se sugieren pasos y medidas para la puesta en operación de la nueva terminal.

Chitin is the second most abundant organic compound in nature and represents a rich carbon and nitrogen source that is primarily transformed by bacterial communities. Bacteria capable of gradually hydrolyzing chitin into N-acetylglucosamine monomers can have applications in the transformation of residues from shrimp and other crustaceans. The objective of the present study was to isolate, characterize and identify microorganisms with high chitinolytic activity. These microorganisms were isolated and characterized based on macro- and microscopic morphological traits. Strains were selected on colloidal chitin agar medium primarily based on a hydrolysis halo larger than 2 mm and a growing phase no longer than 6 days. Secondary selection consisted of semi-quantitative evaluation of chitinolytic activity with a drop dilution assay. From the above, ten strains were selected. Then, strain-specific activity was evaluated. The B4 strain showed the highest specific activity, which was 6,677.07 U/mg protein. Molecular identification indicated that the isolated strains belong to the species Stenotrophomonas maltophilia.

Background: Temprano ANRS 12136 was a factorial 2 × 2 trial that assessed the benefits of early antiretroviral therapy (ART; ie, in patients who had not reached the CD4 cell count threshold used to recommend starting ART, as per the WHO guidelines that were the standard during the study period) and 6-month isoniazid preventive therapy (IPT) in HIV-infected adults in Côte d'Ivoire. Early ART and IPT were shown to independently reduce the risk of severe morbidity at 30 months. Here, we present the efficacy of IPT in reducing mortality from the long-term follow-up of Temprano. Methods: For Temprano, participants were randomly assigned to four groups (deferred ART, deferred ART plus IPT, early ART, or early ART plus IPT). Participants who completed the trial follow-up were invited to participate in a post-trial phase. The primary post-trial phase endpoint was death, as analysed by the intention-to-treat principle. We used Cox proportional models to compare all-cause mortality between the IPT and no IPT strategies from inclusion in Temprano to the end of the follow-up period. Findings: Between March 18, 2008, and Jan 5, 2015, 2056 patients (mean baseline CD4 count 477 cells per μL) were followed up for 9404 patient-years (Temprano 4757; post-trial phase 4647). The median follow-up time was 4·9 years (IQR 3·3–5·8). 86 deaths were recorded (Temprano 47 deaths; post-trial phase 39 deaths), of which 34 were in patients randomly assigned IPT (6-year probability 4·1%, 95% CI 2·9–5·7) and 52 were in those randomly assigned no IPT (6·9%, 5·1–9·2). The hazard ratio of death in patients who had IPT compared with those who did not have IPT was 0·63 (95% CI, 0·41 to 0·97) after adjusting for the ART strategy (early vs deferred), and 0·61 (0·39–0·94) after adjustment for the ART strategy, baseline CD4 cell count, and other key characteristics. There was no evidence for statistical interaction between IPT and ART (pinteraction=0·77) or between IPT and time (pinteraction=0·94) on mortality. Interpretation: In Côte d'Ivoire, where the incidence of tuberculosis was last reported as 159 per 100 000 people, 6 months of IPT has a durable protective effect in reducing mortality in HIV-infected people, even in people with high CD4 cell counts and who have started ART. Funding: National Research Agency on AIDS and Viral Hepatitis (ANRS).

Introduction The World Health Organization (WHO) 2010 guidelines recommended to treat all HIV‐infected children less than two years of age. We described the inclusion process and its correlates of HIV‐infected children initiated on early antiretroviral therapy (EART) at less than two years of age in Abidjan, Côte d'Ivoire, and Ouagadougou, Burkina Faso. Methods All children with HIV‐1 infection confirmed with a DNA PCR test of a blood sample, aged less than two years, living at a distance less than two hours from the centres and whose parents (or mother if she was the only legal guardian or the legal caregiver if parents were not alive) agreed to participate in the MONOD ANRS 12206 project were included in a cohort to receive EART based on lopinavir/r. We used logistic regression to identify correlates of inclusion. Results Among the 217 children screened and referred to the MONOD centres, 161 (74%) were included and initiated on EART. The main reasons of non‐inclusion were fear of father's refusal (48%), mortality (24%), false‐positive HIV infection test (16%) and other ineligibility reasons (12%). Having previously disclosed the child's and mother's HIV status to the father (adjusted odds ratio (aOR): 3.20; 95% confidence interval (95% CI): 1.55 to 6.69) and being older than 12 months (aOR: 2.05; 95% CI: 1.02 to 4.12) were correlates of EART initiation. At EART initiation, the median age was 13.5 months, 70% had reached WHO Stage 3/4 and 57% had a severe immune deficiency. Conclusions Fear of stigmatization by the father and early competing mortality were the major reasons for missed opportunities of EART initiation. There is an urgent need to involve fathers in the care of their HIV‐exposed children and to promote early infant diagnosis to improve their future access to EART and survival.

OBJECTIVE: To estimate the probability of reaching the criteria for starting highly active antiretroviral therapy (HAART) in a prospective cohort of adult HIV-1 seroconverters in Abidjan, Côte d'Ivoire. METHODS: We recruited participants from HIV-positive donors at the blood bank of Abidjan for whom the delay since the estimated date of seroconversion (midpoint between last negative and first positive HIV-1 test) was < 36 months. Participants were offered early trimethoprim-sulfamethoxazole (cotrimoxazole) prophylaxis, twice-yearly measurement of CD4 count and we made standardized records of morbidity. We used the Kaplan-Meier method to estimate the probability of reaching the criteria for starting HAART according to WHO 2006 guidelines. FINDINGS: 217 adults (77 women (35%)) were followed up during 668 person-years (PY). The most frequent diseases recorded were mild bacterial diseases (6.0 per 100 PY), malaria (3.6/100 PY), herpes zoster (3.4/100 PY), severe bacterial diseases (3.1/100 PY) and tuberculosis (2.1/100 PY). The probability of reaching the WHO 2006 criteria for HAART initiation was estimated at 0.09, 0.16, 0.24, 0.36 and 0.44 at 1, 2, 3, 4 and 5 years, respectively. CONCLUSION: Our data underline the incidence of the early HIV morbidity in an Ivorian adult population and provide support for HIV testing to be made more readily available and for early follow-up of HIV-infected adults in West Africa.

L’Institut de santé publique, d’épidémiologie et développement s’est lancé dans l’enseignement à distance en 2001 afin de répondre initialement à un besoin de formation des professionnels de santé des pays du Sud. Depuis cette date, il a construit un modèle de formation accordant une large place au suivi personnalisé et reposant sur des collaborations étroites avec des enseignants et des institutions à l’international.

Both breastfeeding pattern and duration are associated with postnatal HIV acquisition; their relative contribution has not been reliably quantified.Pooled data from 2 cohorts: in urban West Africa where breastfeeding cessation at 4 months was recommended but exclusive breastfeeding was rare (Ditrame Plus, DP); in rural South Africa where high rates of exclusive breastfeeding were achieved, but with longer duration (Vertical Transmission Study, VTS). 18-months HIV postnatal transmission (PT) was estimated by Kaplan-Meier in infants who were HIV negative, and assumed uninfected, at age >1 month. Censoring with (to assess impact of mode of breastfeeding) and without (to assess effect of breastfeeding duration) breastfeeding cessation considered as a competing event. Of 1195 breastfed infants, not HIV-infected perinatally, 38% DP and 83% VTS children were still breastfed at age 6 months. By age 3 months, 66% of VTS children were exclusively breastfed since birth and 55% of DP infants predominantly breastfed (breastmilk+water-based drinks). 18-month PT risk (95%CI) in VTS was double that in DP: 9% (7-11) and 5% (3-8), respectively (p = 0.03). However, once duration of breastfeeding was allowed for in a competing risk analysis assuming that all children would have been breastfed for 18-month, the estimated PT risk was 16% (8-28) in DP and 14% (10-18) in VTS (p = 0.32). 18-months PT risk was 3.9% (2.3-6.5) among infants breastfed for less than 6 months, and 8.7% (6.8-11.0) among children breastfed for more than 6 months; crude hazard ratio (HR): 2.1 (1.2-3.7), p = 0.02; adjusted HR 1.8 (0.9-3.4), p = 0.06. In individual analyses of PT rates for specific breastfeeding durations, risks among children exclusively breastfed were very similar to those in children predominantly breastfed for the same period. Children exposed to solid foods during the first 2 months of life were 2.9 (1.1-8.0) times more likely to be infected postnatally than children never exposed to solids this early (adjusted competing risk analysis, p = 0.04).Breastfeeding duration is a major determinant of postnatal HIV transmission. The PT risk did not differ between exclusively and predominantly breastfed children; the negative effect of mixed breastfeeding with solids on PT were confirmed.