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1. Structured peer-led diabetes self-management and support in a low-income country: The ST2EP randomised controlled trial in Mali

Author

Assa Traoré Sidibé, Stéphane Besançon, Cyril Ferdynus, Xavier Debussche, Hélène Delisle, Laetitia Huiart, Maryvette Balcou-Debussche, CHU Sud Saint Pierre [Ile de la Réunion], Centre d'Investigation Clinique de La Réunion - INSERM (CIC 1410), Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), ONG Santé Diabète, Institut Coopératif Austral de Recherche en Éducation (ICARE), Université de La Réunion (UR), Réseau des universités pour l'éducation à la santé (Réseau UNIRéS), Université Blaise Pascal - Clermont-Ferrand 2 (UBP), CRSN/Faculté de médecine Université de Montréal, Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital Universitaire, This work was supported by the Bridges programme of the International Diabetes Federation. BRIDGES (Bringing Research in Diabetes to Global Environments and Systems) is a programme initiated by the International Diabetes Federation, and supported by an educational grant from Lilly Diabetes, https://www.idf.org/our-activities/epidemiology-research/bridges.html. The NGO Santé Diabète received the funding (https://santediabete.org/en, Director: SB). The funders were not involved in the study design, in the collection, analysis and interpretation of the data, as well as in the writing of the report and in the decision to submit the paper or preparation of the manuscript for publication. The authors were independent from study funders., and Univ, Réunion

Subjects
Male, Psychological intervention, lcsh:Medicine, Social Sciences, Type 2 diabetes, Human learning, Mali, Biochemistry, Vascular Medicine, law.invention, Geographical Locations, 0302 clinical medicine, Endocrinology, Learning and Memory, Diabetes mellitus, Randomized controlled trial, law, Health care, Outcome Assessment, Health Care, Medicine and Health Sciences, Diabetes diagnosis and management, Psychology, 030212 general & internal medicine, lcsh:Science, 2. Zero hunger, Multidisciplinary, Middle Aged, 3. Good health, Health education and awareness, Blood pressure, Female, Research Article, Adult, medicine.medical_specialty, Waist, HbA1c, Patients, Endocrine Disorders, 030209 endocrinology & metabolism, Peer Group, 03 medical and health sciences, Patient Education as Topic, medicine, Learning, Humans, Hemoglobin, Developing Countries, Glycated Hemoglobin, Biology and life sciences, business.industry, Self-Management, lcsh:R, Cognitive Psychology, Proteins, Peer group, medicine.disease, Diagnostic medicine, Health Care, Self Care, Diabetes Mellitus, Type 2, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Metabolic Disorders, People and Places, Africa, Physical therapy, Cognitive Science, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Patient education, Neuroscience
Abstract

Objectives Our objective was to evaluate the effectiveness of peer-led self-management education in improving glycaemic control in patients with type 2 diabetes in a low-income country (Mali). Methods We conducted an open-label randomised controlled trial. A total of 151 adults (76% women, mean age 52.5) with type 2 diabetes (HbA1c≥8%), treated in the diabetes consultation units of two secondary health centres in Bamako, were allocated to peer-led structured patient education (n = 76) or conventional care alone (n = 75). The intervention group received 1 year of culturally tailored structured patient education (3 courses of 4 sessions) delivered in the community by five trained peer educators. Both groups underwent conventional diabetes monitoring and follow-up. Primary outcome was the mean absolute change in HbA1c from baseline to 12 months. Results 177 education sessions were delivered to the intervention group. Patient attrition was 8%. From baseline to 12 months, the decrease in HbA1c levels was 1.05% (SD = 2.0; CI95%: 1.54;-0.56) in the intervention group compared with 0.15% (SD = 1.7; CI95%: -0.56; 0.26) in the control group, p = 0.006. Mean BMI change was -1.65 kg/m2 (SD = 2.5; CI95%: -2.25; -1.06) in the intervention group and +0.05 kg/m2 (SD = 3.2; CI95%: -0.71; 0.81) in the control group, p = 0.0005. Mean waist circumference decreased by 3.34 cm (SD = 9.3; CI95%: -5.56;-1.13) in the intervention group and increased by 2.65 cm (SD = 10.3; CI95%: 0.20; 5.09) in the control group, p = 0.0003. Conclusions Peer-led structured patient education delivered over 1 year to patients with poorly controlled type 2 diabetes in Mali yielded substantial improvements in glycaemic control and anthropometric parameters. This is of importance for the scaling up of efficient interventions in low-resource settings in the future. Trial registration ClinicalTrials.gov NCT01485913

Published
2018

2. Isolation and sequencing of Dashli virus, a novel Sicilian-like virus in sandflies from Iran; genetic and phylogenetic evidence for the creation of one novel species within the Phlebovirus genus in the Phenuiviridae family

Author

Xavier de Lamballerie, E. Javadian, Cigdem Alkan, Nourina Rahbarian, Bulent Alten, Laurence Bichaud, Nazli Ayhan, Mehdi Badakhshan, Vahideh Moin Vaziri, Rémi N. Charrel, BUISINE, Soline, European Virus Archive goes global - EVAg - - H20202015-04-01 - 2019-03-31 - 653316 - VALID, Biology and control of vector-borne infections in Europe - EDENEXT - - EC:FP7:HEALTH2011-01-01 - 2015-06-30 - 261504 - VALID, Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Department of Parasitology and Mycology [Tehran, Iran] (School of Medicine), Shahid Beheshti University of Medical Sciences [Tehran, Iran], Department of Medical Entomology and Vector Control [Tehran, Iran] (School of Public Health), Tehran University of Medical Sciences-Institute of Public Health Research [Tehran, Iran], Cellular and Molecular Biology Research Center [Tehran, Iran] (SBU), Shahid Beheshti University of Medical Sciences [Tehran] (SBUMS), Hacettepe University = Hacettepe Üniversitesi, Hôpital de la Timone [CHU - APHM] (TIMONE), This work was supported through funds received from EU grant FP7-261504 EDENext and this paper is catalogued by the EDENext Steering Committee (http://www.edenext.eu), the European Virus Archive goes Global (EVAg) project in the European Union's Horizon 2020 research and innovation programme under grant agreement No 653316 (http://global.european- virus-archive.com/). The present article partly was supported by Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. (Grant No: 1573) The work of RNC was done under the frame of EurNegVec (TD1303) COST Action., European Project: 653316,H2020,H2020-INFRAIA-2014-2015,EVAg(2015), European Project: 261504,EC:FP7:HEALTH,FP7-HEALTH-2010-single-stage,EDENEXT(2011), and Shahid Beheshti University-Shahid Beheshti University

Subjects
0301 basic medicine, Male, Phlebovirus, RNA viruses, Fevers, Iran, Disease Vectors, Pathology and Laboratory Medicine, Database and Informatics Methods, Phlebotomus Fever, Bunyaviruses, Medicine and Health Sciences, Sandfly Fever Sicilian Virus, Phylogeny, Data Management, Genetics, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, biology, Phylogenetic tree, lcsh:Public aspects of medicine, Phylogenetic Analysis, Gene Pool, 3. Good health, Phylogenetics, Infectious Diseases, Medical Microbiology, Viral Pathogens, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Viruses, RNA, Viral, Female, Gene pool, Pathogens, Sequence Analysis, Research Article, Computer and Information Sciences, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, Bioinformatics, Genome, Viral, Research and Analysis Methods, Microbiology, Virus, 03 medical and health sciences, Signs and Symptoms, Amino Acid Sequence Analysis, Diagnostic Medicine, Animals, Humans, Evolutionary Systematics, Microbial Pathogens, Taxonomy, Evolutionary Biology, Base Sequence, Population Biology, Sequence Analysis, RNA, Public Health, Environmental and Occupational Health, Organisms, Biology and Life Sciences, lcsh:RA1-1270, biology.organism_classification, Rift Valley fever virus, Sandfly, Insect Vectors, Sand Flies, Species Interactions, 030104 developmental biology, Microbial genetics, Psychodidae, Population Genetics
Abstract

Phlebotomine sandflies are vectors of phleboviruses that cause sandfly fever or meningitis with significant implications for public health. Although several strains of these viruses had been isolated in Iran in the late 1970's, there was no recent data about the present situation at the outset of this study. Entomological investigations performed in 2009 and 2011 in Iran collected 4,770 sandflies from 10 different regions. Based on morphological identification, they were sorted into 315 pools according to species, sex, trapping station and date of capture. A phlebovirus, provisionally named Dashli virus (DASHV), was isolated from one pool of Sergentomyia spp, and subsequently DASHV RNA was detected in a second pool of Phlebotomus papatasi. Genetic and phylogenetic analyses based on complete coding genomic sequences indicated that (i) DASHV is most closely related to the Iranian isolates of Sandfly fever Sicilian virus [SFSV], (ii) there is a common ancestor to DASHV, Sandfly fever Sicilian- (SFS) and SFS-like viruses isolated in Italy, India, Turkey, and Cyprus (lineage I), (iii) DASHV is more distantly related with Corfou and Toros viruses (lineage II) although common ancestry is supported with 100% bootstrap, (iii) lineage I can be subdivided into sublineage Ia including all SFSV, SFCV and SFTV except those isolated in Iran which forms sublineage Ib (DASHV). Accordingly, we suggest to approve Sandfly fever Sicilian virus species consisting of the all aforementioned viruses. Owing that most of these viruses have been identified in human patients with febrile illness, DASHV should be considered as a potential human pathogen in Iran., Author summary Phlebotomine sandflies are vectors of phleboviruses that cause sandfly fever or meningitis with significant implications for public health. Although several strains of these viruses had been isolated in Iran in the late 1970's, there was no recent data about the present situation at the outset of this study. Entomological investigations performed in 2009 and 2011 in Iran collected 4,770 sandflies from 10 different regions. A phlebovirus, provisionally named Dashli virus (DASHV), was isolated / detected in two pools. DASHV strain was isolated in cell culture and complete genome sequence was determined. Sequence analysis indicated that (i) DASHV is most closely related to the Iranian isolates of Sandfly fever Sicilian virus [SFSV], a virus that is known to cause self-resolutive incapacitating febrile illness in humans, (ii) there is a common ancestor to DASHV and all other variants of SFSV isolated in Italy, India, Turkey, and Cyprus (lineage I), (iii) DASHV is more distantly related with Corfou and Toros viruses (lineage II) although common ancestry is supported with 100% bootstrap, (iii) lineage I can be subdivided into sublineage Ia including all SFSV strains, whereas Iranian viruses are most closely related and should be individualized as DASHV (sublineage Ib). Although discovered first in the 1940's, SFSV is still listed as "tentative species" by the International Committee for Taxonomy of Viruses. Based on the results described in this study, we propose to approve Sandfly fever Sicilian virus species. Owing that most of these viruses have been identified in human patients with febrile illness, DASHV should be considered as a potential human pathogen in Iran.

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