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Background: Attractive targeted sugar baits (ATSBs) have the potential to significantly reduce infective female Anopheles mosquitoes in arid areas, such as in Northern Mali. Malaria is epidemic in the north due to the limited viability of Anopheles species in the desert climate. The goal of this study was to determine of the effect of ATSB on the number of older female An. gambiae and on the number of sporozoite-positive females in villages in northern Mali. Methods: Villages were located in the north of Mali. In this study, 5677 ATSB stations were deployed, two on each home, in ten villages during late July and early August 2019. Ten villages served as controls. After a pre-treatment monitoring period in July, An. gambiae populations were monitored again from August to December using CDC-UV light traps, pyrethrum spray catches (PSC), and human landing catches (HLC). Mosquitoes were dissected to estimate their age, while ELISA detected sporozoite positivity. The monthly entomological inoculation rates (EIRs) were calculated for HLC indoors and outdoors. Data from villages were compared using t-tests, while bait station weighted density versus amount of collected females was checked with a Pearson's correlation. Results: A total of 2703 female An. gambiae were caught from treated villages, 4582 from control villages, a 41.0% difference. Dissection of 1759 females showed that ATSB significantly reduced the number of older females. The proportion of older females in treated villages was 0.93% compared to 9.4% in control villages. ELISA analysis of 7285 females showed that bait stations reduced the number of sporozoite-positive females. The infective females in treated villages was 0.30% compared to 2.73% in the controls. The greater the density of bait stations deployed, the fewer the older, infective females (P < 0.05). EIRs were low in control villages except in months when An. gambiae populations were high. EIRs in ATSB placement villages remained zero. Significant reductions (P < 0.0001) in An. gambiae males were observed. Conclusions: Bait stations reduced all measures of vector populations in this study. In a low-transmission setting, ATSB has the potential to greatly reduce malaria. [ABSTRACT FROM AUTHOR]

Population growth and expanding urbanization have caused persistent shortages and contamination of groundwater resources in Mali, Africa. The increase in groundwater salinity makes it more difficult for residents to obtain drinking water, it is necessary to clarify the causes and control factors of groundwater mineralization in Gao region, northern Mali. Based on the analysis of the hydrochemical composition of groundwater in 24 boreholes, Piper and Schöeller diagrams, principal component analysis (PCA) and hierarchical cluster analysis (HCA) are used to carry out multivariate statistical analysis on the main ions. The results show that the groundwater samples are weakly alkaline, with pH values ranging from 5.83 to 8.40, and the average values of boreholes are 7.50, respectively. The average electrical conductivity (EC) value is 354.4 (µS/cm), and the extreme value is between 124.0 and 1 247 (µS/cm). Water is usually mineralized and presents nine types of water phase. The three principal components explain 84.42% of the total variance for 13 parameters. The factor F1 (58.85%), the factor F2 (16.88%) and the factor F3 (8.69%) present for the majority of the total data set. In addition, multivariate statistical analysis confirmed the genetic relationship among aquifers and identified three main clusters. Clustering related to groundwater mineralization (F1), clustering related to oxide reduction and iron enrichment (F2), and clustering of groundwater pollution caused by nitrate and magnesium (F3). We found that agriculture, weathering activities and dissolution of geological materials promote the mineralization of groundwater. Groundwater quality in the Gao region is becoming less and less potable because of increasing salinity. [ABSTRACT FROM AUTHOR]

Background The effect of clothing colour on the biting rates of different vector mosquito species is not well understood. Studies under tropical field conditions are lacking. This study aimed to determine the influence of clothing colours on mosquito biting rates in rural and suburban settings in West Africa. Methods We performed a simulated field study in a suburban and a rural site in Mali using Mosquito-Magnet traps utilizing CO2 and other attractants, which were covered with black, white, and black/white striped textile sheets covers. These targets operated continuously for 10 consecutive days with bright nights (around full moon) and 10 consecutive days with dark nights (around new moon). Trapped mosquitoes were collected and catch rates counted hourly. Mosquitoes were morphologically identified to the species complex level (Anopheles gambiae s.l. and Culex pipiens s.l.) or species level (Aedes aegypti). A subset of Anopheles specimens were further identified by molecular methods. Results Under bright-night conditions, An. gambiae s.l. was significantly more attracted to black targets than to white and striped targets; during dark nights, no target preference was noted. During bright nights, Cx. pipiens s.l. was significantly more attracted to black and striped targets than to white targets; a similar trend was noted during dark nights (not significant). For day-active Ae. aegypti , striped targets were more attractive than the other targets and black were more attractive than white targets. Conclusions The study firstly demonstrated that under field conditions in Mali, West Africa, mosquito catch rates were influenced by different clothing colours, depending on mosquito species and light conditions. Overall, light colours were least attractive to host-seeking mosquitoes. Using white or other light-coloured clothing can potentially reduce bite exposure and risk of disease transmission in endemic tropical regions. [ABSTRACT FROM AUTHOR]

Measles deaths highlight immunization program gaps. In the Child Health and Mortality Prevention Surveillance study in Mali, we observed a rise in under-5 measles-related deaths in 2022 that corresponded with increased measles cases at the same time and a decline in measles vaccine coverage in Mali in 2020. [ABSTRACT FROM AUTHOR]

Background: The sero‐epidemiological characteristics of SARS‐CoV‐2 infections in Mali are not yet well understood. This study assessed SARS‐CoV‐2 antibody seroprevalence and factors associated with antibody responses in the general population of Bamako, the capital city and epicenter of COVID‐19, to assess the magnitude of the pandemic and contribute to control strategy improvements in Mali. Methods: A cross‐sectional survey was conducted in September 2022 to collect sociodemographic information, clinical characteristics, comorbid factors, and blood samples. ELISA was performed to determine anti‐Spike (anti‐S) and anti‐RBD antibody levels. A total of 3601 participants were enrolled in REDCap. R‐Studio was used for the statistical analysis. The chi‐squared (χ2) test was used to compare the proportions across different groups. Logistic regression models were used to elucidate factors associated with antibody responses. Result: The sex ratio for female‐to‐male was 3.6:1. The most representative groups were the 20–29‐year‐olds (28.9%, n = 1043) and the 30–39‐year‐olds (26.9%, n = 967). The COVID‐19 vaccine coverage among the participants was 35.8%, with vaccines from Covishield AstraZeneca (13.4%), Johnson & Johnson (16.7%), Sinovac (3.9%), and BioNTech Pfizer (1.8%). Overall, S protein and RBD antibody seroprevalences were remarkably high in the study population (98% and 97%, respectively). Factors such as youth (1–9 years old) and male sex were associated with lower SARS‐CoV‐2 antibody responses, whereas COVID‐19 vaccinations were associated with increased antibody responses. Conclusion: This serosurvey demonstrated the high seroprevalence of SARS‐CoV‐2 antibodies and highlighted the factors influencing antibody responses, while clearly underlining an underestimation of the pandemic in Mali. [ABSTRACT FROM AUTHOR]

Sorghum and pearl millet have adapted to the socioecological environment in the dryland of West Africa and have been the staple crops for many years. Engaging key stakeholders and improving the sorghum and pearl millet breeding process is essential to addressing the evolving demands of end-users and environmental conditions. Unlike most trait preference studies focusing on men and women farmers' trait choices, we examined sorghum and pearl millet key value chain actors (VCA), including producers, processors, traders, and consumers. We identified their preferred traits of varieties that need to be mainstreamed into the breeding pipelines. Drawing on the past efforts and experiences of the sorghum and pearl millet breeding programs from the last 30 years, the study was designed to integrate gender equality in sorghum and pearl millet breeding decisions and traits prioritization in West Africa. This process was implemented in phases, leading to the drafting of gender-responsive and client-oriented product profiles. The paper elicited an understanding of how the roles and interests of sorghum and pearl millet VCA influence their varietal choice and adoption decisions. The study found both differences and similarities in the trait preferences of the men and women VCA. Most women, mainly in the production and processing nodes, prefer varieties with specific food and grain quality traits, while men prioritize grain yield and biotic stress resistance traits. Even though both men's and women's varietal choices align with their roles in production and consumption, grain yield was commonly desired across gender, crop, and value chain segments. The findings revealed that the gendered interest of actors in the crops' value chain determines their choice of variety. Gender responsiveness requires identifying and understanding the needs and choices of the sorghum and millet VCA and mainstreaming these into the breeding pipeline. The approach employed in the study elicits the understanding, roles, and interests of the various actors and how these factors influence men's and women's decisions to adopt a crop variety. All major stakeholders should co-develop product profiles for the variety being developed to enable co-ownership, increase adoption, and improve gender equity in agricultural technology development and deployment. [ABSTRACT FROM AUTHOR]

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Sorghum production system in the semi-arid region of Africa is characterized by low yields which are generally attributed to high rainfall variability, poor soil fertility, and biotic factors. Production constraints must be well understood and quantified to design effective sorghum-system improvements. This study uses the state-of-the-art in silico methods and focuses on characterizing the sorghum production regions in Mali for drought occurrence and its effects on sorghum productivity. For this purpose, we adapted the APSIM-sorghum module to reproduce two cultivated photoperiod-sensitive sorghum types across a latitude of major sorghum production regions in Western Africa. We used the simulation outputs to characterize drought stress scenarios. We identified three main drought scenarios: (i) no-stress; (ii) early pre-flowering drought stress; and (iii) drought stress onset around flowering. The frequency of drought stress scenarios experienced by the two sorghum types across rainfall zones and soil types differed. As expected, the early pre-flowering and flowering drought stress occurred more frequently in isohyets < 600 mm, for the photoperiod-sensitive, late-flowering sorghum type. In isohyets above 600 mm, the frequency of drought stress was very low for both cultivars. We quantified the consequences of these drought scenarios on grain and biomass productivity. The yields of the highly-photoperiod-sensitive sorghum type were quite stable across the higher rainfall zones > 600 mm, but was affected by the drought stress in the lower rainfall zones < 600 mm. Comparatively, the less photoperiod-sensitive cultivar had notable yield gain in the driest regions < 600 mm. The results suggest that, at least for the tested crop types, drought stress might not be the major constraint to sorghum production in isohyets > 600 mm. The findings from this study provide the entry point for further quantitative testing of the Genotype × Environment × Management options required to optimize sorghum production in Mali. [ABSTRACT FROM AUTHOR]

Background Owing to the increased cases of malaria in older children, the World Health Organization has recently recommended extending seasonal malaria chemoprevention (SMC) to children >5 years of age and using other effective drugs for malaria. In this study, we report the safety and efficacy of dihydroartemisinin-piperaquine (DHA-PQ) for SMC in school-aged children in Mali. Method This randomized, controlled trial included 345 participants aged 6–15 years randomized to receive DHA-PQ, sulfadoxine-pyrimethamine plus amodiaquine (SP-AQ), or no chemoprevention (albendazole) at a 1:1:1 ratio. Four rounds of SMC were conducted from September to December 2021. The participants were assessed 7 days after each round for safety and efficacy of the interventions. Results Abdominal pain (11.8% vs 29.2%), headache (11.2% vs 19.2%), and vomiting (5.7% vs 15.2%) were frequently reported in the DHA-PQ and SP-AQ arms. On Day 120 of follow up, the incidence of clinical malaria was 0.01 episodes/person-month in the DHA-PQ and SP-AQ arms and 0.17 episodes/person-month in the control arm (P <.0001). Gametocytes were detected in 37 participants in all arms. Conclusions Children in DHA-PQ arm reported less adverse events compared to the SP-AQ arm. Both drugs were effective against clinical malaria and infection. [ABSTRACT FROM AUTHOR]

Introduction: an effective health information system (HIS) ensures the production, analysis, dissemination and use of reliable and up-to-date information on the determinants of health. However, it can encounter obstacles that hinder its functioning, such as armed conflicts, which limit access and quality of healthcare services. The purpose of our study was to help improve data management for routine health information system in the health district of Timbuktu during a security crisis. Methods: we conducted a descriptive cross-sectional study, among health information management professionals in the Timbuktu Health District from 15 April to 08 September 2023. Data obtained from a survey questionnaire were analyzed using Epi Info version 7.2.2. and processed using Microsoft Word and Excel 2016. Results: a total of 6 health facilities were surveyed. Data collection, analysis and feedback were very poor. Data quality was 100% complete, 92.40% prompt and 68.11% accurate. The major constraints were: low involvement of health workers in the SIS (22.22%), insufficient training on the SISR (29.63%), supervision (47.06%), internet inaccessibility (66.67%), feeling of insecurity (37.04%) and fear (61.76%) in health facilities. Conclusion: our results show low-level processes, poor network coverage, shortage of qualified health information management professionals and increasing insecurity. A broader mixed-methods research would provide a better understanding. [ABSTRACT FROM AUTHOR]

With a view to better documenting care practices influenced by the lifestyle habits of diabetics, research is being carried out to analyse the biopsychosocial aspect of COVID-19 in diabetics in Mali from 2020 to 2023. This crosssectional study describes the biopsychosocial aspect of COVID-19 among diabetics in Mali between March 2020 to December 2023. Findings suggest an association between psychologist consultation and physical exercise, alcohol and cigarette consumption (p <0.05) during the pandemic. As well, we found an increase in diabetic complications and physical exercise, alcohol consumption and cigarette smoking (p <0.05) during the pandemic. Lifestyle habits during COVID-19 have altered the health status of individuals living with diabetes. [ABSTRACT FROM AUTHOR]

Diabetes and hypertension were the most common comorbidities among COVID-19 deaths, at 20.45% and 17.42% respectively in Mali. The aim of this study was to analyze the clinical and biological aspects of COVID-19 and diabetes in Mali from 2020 to 2023. The present study constitutes a comparative cross-sectional analytical study that included 50 patients. Data were collected at home, in the form of individual interviews with patients. Findings indicate before the pandemic, 34% of patients were obese and 54% had uncontrolled diabetes. Arterial hypertension was the only macro-angiopathic complication found in patients, with an increase in frequency during the pandemic whereas respiratory distress was observed in 25% of patients during COVID-19 infection. This means that COVID-19 is as much a risk factor associated with diabetes as diabetes is a factor affecting patients' health. [ABSTRACT FROM AUTHOR]

This study chronicles a 14-year partnership between a Malian rural village and US academics to curb childhood malnutrition. Villagers described agricultural/nutritional traditions while expressing a desire for improved quality of life for the future. Through holistic observation and listening, student/faculty partners developed a trusting relationship, and documented the community's fundamental knowledge-base. Collaborators studied children's dietary intake to predict micronutrient deficiencies. Villagers ultimately chose to participate in the national lunch program and to additionally supplement children's diets with eggs. The Expansive Collaborative Model described in this article, exemplifies a cross-cultural approach which could effectively mitigate malnutrition in remote African villages. [ABSTRACT FROM AUTHOR]

HLA genotyping was performed on 99 type 1 diabetes (T1D) patients and 200 controls from Mali. Next‐generation sequencing of the classical HLA‐A, ‐B, ‐C, ‐DRB1, ‐DRB3, ‐DRB4, ‐DRB5, ‐DQA1, ‐DQB1, ‐DPA1, and ‐DPB1 loci revealed strong T1D association for all loci except HLA‐C and ‐DPA1. Class II association is stronger than class I association, with most observed associations predisposing or protective as expected based on previous studies. For example, HLA‐DRB1*03:01, HLA‐DRB1*09:01, and HLA‐DRB1*04:05 predispose for T1D, whereas HLA‐DRB1*15:03 is protective. HLA‐DPB1*04:02 (OR = 12.73, p = 2.92 × 10−05) and HLA‐B*27:05 (OR = 21.36, p = 3.72 × 10−05) appear highly predisposing, although previous studies involving multiple populations have reported HLA‐DPB1*04:02 as T1D‐protective and HLA‐B*27:05 as neutral. This result may reflect the linkage disequilibrium between alleles on the extended HLA‐A*24:02~HLA‐B*27:05~HLA‐C*02:02~HLA‐DRB1*04:05~HLA‐DRB4*01:03~HLA‐DQB1*02:02~HLA‐DQA1*02:01~HLA‐DPB1*04:02~HLA‐DPA1*01:03 haplotype in this population rather than an effect of either allele itself. Individual amino acid (AA) analyses are consistent with most T1D association attributable to HLA class II rather than class I in this data set. AA‐level analyses reveal previously undescribed differences of the HLA‐C locus from the HLA‐A and HLA‐B loci, with more polymorphic positions, spanning a larger portion of the gene. This may reflect additional mechanisms for HLA‐C to influence T1D risk, for example, through expression differences or through its role as the dominant ligand for killer cell immunoglobulin‐like receptors (KIR). Comparison of these data to those from larger studies and on other populations may facilitate T1D prediction and help elucidate elusive mechanisms of how HLA contributes to T1D risk and autoimmunity. [ABSTRACT FROM AUTHOR]

Summary: Sickle cell disease (SCD) is a life‐threatening disease requiring reliable early diagnosis. We assessed the acceptability and diagnostic performances of two rapid diagnostic tests (RDTs) to identify SCD (HbSS, HbSC, HbS/β‐thalassaemia) or SCD carrier (HbS/HbC) in a pilot SCD newborn screening (NBS) strategy in Mali. All consenting delivering women were offered SCD NBS using cord blood sampling on two RDTs (SickleScan® and HemotypeSC®) compared to the high‐performance liquid chromatography (HPLC) gold standard to detect SCD states. From April 2021 to August 2021, 4333 delivering women were eligible of whom 96.1% were offered NBS: 1.6% refused, 13.8% delivered before consenting and 84.6% consented; 3648 newborns were diagnosed by HPLC; 1.64% had SCD (0.63% HbSS, 0.85% HbSC, 0.16 HbS/β‐plus‐thalassaemia); 21.79% were SCD carrier. To detect accurately SCD, SickleScan® had a sensitivity of 81.67% (95% confidence interval [CI]: 71.88–91.46) and a negative predictive value (NPV) of 99.69% (95% CI: 99.51–99.87); HemotypeSC® had a sensitivity of 78.33% (95% CI: 67.91–88.76) and a NPV of 99.64% (95% CI: 99.44–99.83). To detect SCD carrier: SickleScan® sensitivity was 96.10% (95% CI: 94.75–97.45) and NPV, 98.90% (95% CI: 98.51–99.29); HemotypeSC® sensitivity was 95.22% (95% CI: 93.74–96.70) and NPV, 98.66% (95% CI: 98.24–99.03). Routine SCD NBS was acceptable. Compared with HPLC, both RDTs had reliable diagnostic performances to exclude SCD‐free newborns and to identify SCD carriers to be further confirmed. This strategy could be implemented in large‐scale NBS programmes. [ABSTRACT FROM AUTHOR]

Methylenetetrahydrofolate reductase (MTHFR) plays a major role in the metabolism of folates and homocysteine, which in turn can affect gene expression and ultimately promote the development of breast cancer. Thus, mutations in the MTHFR gene could influence homocysteine, methionine, and S-adenosylmethionine levels and, indirectly, nucleotide levels. Imbalance in methionine and S-adenosylmethionine synthesis affects protein synthesis and methylation. These changes, which affect gene expression, may ultimately promote the development of breast cancer. We therefore hypothesized that such mutations could also play an important role in the occurrence and pathogenesis of breast cancer in a Malian population. In this study, we used the PCR-RFLP technique to identify the different genotypic profiles of the C677T MTHFR polymorphism in 127 breast cancer women and 160 healthy controls. The genotypic distribution of the C677T polymorphism in breast cancer cases was 88.2% for CC, 11.0% for CT, and 0.8% for TT. Healthy controls showed a similar distribution with 90.6% for CC, 8.8% for CT, and 0.6% for TT. We found no statistical association between the C677T polymorphism and breast cancer risk for the codominant models CT and TT p > 0.05 . The same trend was observed when the analysis was extended to other genetic models, including dominant (p  = 0.50), recessive (p  = 0.87), and additive (p  = 0.50) models. The C677T polymorphism of MTHFR gene did not influence the risk of breast cancer in the Malian samples. [ABSTRACT FROM AUTHOR]

This article discusses the determinants of monthly food consumption expenditures of households in Mali, using a quintile approach. The study is based on survey data from the EMOP, 2020 on household expenditures. This survey was conducted in the same year among 6703 households in the eight regions of Mali and the District of Bamako. The application of the simultaneous quintile regression yields results indicating that total household expenditures are positively correlated with monthly household food consumption expenditures in the 25th, 50th, and 75th quintiles and also in all regions and the District of Bamako. An increase of one unit in the number of motorcycles in good condition owned by the household and in the number of internet connections would significantly reduce household food expenditures in all three quintiles in Mali. The inter-regional analysis, by OLS, indicates that with the exception of the regions of Koulikoro, Ségou and Kidal, the effect of the number of motorcycles in the other regions is negatively significant. It is most evident in Bamako (12018.88 FCFA), Kayes (10061.8 FCFA) and Timbuktu (5695.76 FCFA). Compared to the other regions, the effect of the cell phone would reduce the food consumption of households in Timbuktu more (5922.22 FCFA). [ABSTRACT FROM AUTHOR]

A decrease in malaria incidence following implementation of control strategies such as use of artemisinin-based combination therapies, insecticide-impregnated nets, intermittent preventive treatment during pregnancy and seasonal malaria chemoprevention (SMC) has been observed in many parts of Africa. We hypothesized that changes in malaria incidence is accompanied by a change in the predominant clinical phenotypes of severe malaria. To test our hypothesis, we used data from a severe malaria case-control study that lasted from 2014-2019 to describe clinical phenotypes of severe forms experienced by participants enrolled in Bandiagara, Bamako, and Sikasso, in Mali. We also analyzed data from hospital records of inpatient children at a national referral hospital in Bamako. Among 97 cases of severe malaria in the case-control study, there was a predominance of severe malarial anemia (49.1%). The frequency of cerebral malaria was 35.4, and 16.5% of cases had a mixed clinical phenotype (concurrent cerebral malaria and severe anemia). National referral hospital record data in 2013-15 showed 24.3% of cases had severe malarial anemia compared to 51.7% with cerebral malaria. In the years after SMC scale-up, severe malarial anemia cases increased to 30.1%, (P = 0.019), whereas cerebral malaria cases decreased to 45.5% (P = 0.025). In addition, the predominant age group for each severe malaria phenotype was the 0-1-year-olds. The decrease in malaria incidence noted with the implementation of control strategies may be associated with a change in the clinical expressionpatterns of severe malaria, including a potential shift in severe malaria burden to age groups not receiving seasonal malaria chemoprevention. [ABSTRACT FROM AUTHOR]

Introduction: Improving maternal and child health is a worldwide priority. An estimated 8.1 million children under five die each year. Approximately 1,000 women, most of whom live in developing countries, die every day from complications of pregnancy or childbirth. The objective of this work was to assess the availability of mother's and child's medicines at the level of the community health center VI of the Bamako district, Mali. Materials and methods: This were a prospective cross-sectional study which was took place in Bamako in the community health center VI in 12 months over the period from November 2019 to October 2020. We carried out a survey in the 11 community health center VI. Data entry and analysis were performed using SPSS version 21.0 software. Results: In this study, the sex ratio was 2.66. Half of the people surveyed were doctors (50%) who assumed the role of DTC (Technical Director of the Center). As for the profiles of managers, in our sample, accountants were the most represented with a rate of 31.82%. Almost all depot managers have received training in logistics management (86% of cases). 73.00% of Community health centers correctly followed the SDADME (drug supply and distribution master plan). The Community health centers were supplied by other suppliers in the event of a shortage at the PPM (Popular Pharmacy of Mali) with a rate of 86.40%. The total availability rate of medicines for mothers and children was 60%. Breaks were recorded for eight (08) products. The causes mentioned in relation to drug breaks were, among others: non-ordering of drugs, non-availability at the PPM and nonprescription of drugs by providers. Conclusion: This study revealed a good availability of drugs for mother and child. However, we found that some of these drugs were out of stock. These shortages were due either to the nonavailability of the PPM store, or to the non-ordering of these products by the Community health centers. [ABSTRACT FROM AUTHOR]

Introduction: Amoxicillin belongs to the family of ß-lactams and is one of the mostly used in hospitals for the management of bacterial infections especially in Mali. It has a broad spectrum of activity from the group of aminopenicillins or aminobenzylpenicillins (group A penicillins). Microbiological and physico-chemical control has evolved with the development of biotechnology. All bacterial species or germs are affected by the phenomenon of resistance to antibacterials, which often poses real therapeutic problems. Based on previous studies in Mali, amoxicillin is still recommended in pharmacies and university hospitals to treat bacterial infections. It sometimes happens that patients are not satisfied with this amoxicillin-based prescription in our teaching hospitals. The objective of this study was to control the physico-chemical quality of amoxicillin 500 mg in capsule form. Methodology: This is a physico-chemical study of amoxicillin capsules dosed at 500 mg received at the National Health Laboratory in Bamako. We analyzed 10 batches of five (5) boxes (10 platelets/box) of amoxicillin. We used either HPLC, or TLC or Dissolu-test to control the quality of amoxicillin capsules for the presence of the active principle and to ensure fake amoxicillin capsules were not distributed. We used as reference, the standards contained in the pharmacopoeias in use. Results: The results of the physicochemical tests revealed that the samples analyzed complied with the standards of the Pharmacopoeias in use: The weight of our capsules was between 0.5g and 0.6g. All the tested samples were compliant with a disintegration time of 15 minutes at 37°C ±2°C. The peaks of standard amoxicillin and that of the tested samples appeared at substantially equal retention times, i.e. at 3.249 min and 3.248 min. respectively. Conclusion: Our work aimed to assess the quality of antibiotics used in Mali with the analytical means available at the LNS. All the batches of amoxicillin analyzed have not presented any cases of noncompliance so they can be distributed in health structures. This type of study should be extended to the other pharmaceutical forms of amoxicillin in the form of powders to be reconstituted dispensed in health centers in Mali. [ABSTRACT FROM AUTHOR]

This article compares the adoption of intermunicipalities within ten years in Mali, France and the Comoros. Intermunicipalities are transferred from France through original cooperations between diasporas and local authorities. The translocal notion is a relevant way to compare territories with similar institutional frameworks but contrasted practices. A comprehensive approach based on comparative monographs and biographies analyzes how transfer agents operate simultaneously in French and African territories. The article shows new objectives and local agents at work in local-to-local transfers of policies. Opportunistic policy transfers are the result of strategic coalitions between transnational diasporas and local authorities with momentarily converging objectives. [ABSTRACT FROM AUTHOR]

Gundo-So is a community-based programme developed by and for women living with HIV (WLHIV) in Mali through the ARCAD-Santé-PLUS association. It provides support, co-constructed with WLHIV, to develop strategies on whether or not to disclose their status. The aim of the ANRS-12373 research is to evaluate the impact of this programme in the short and medium term. As part of this research, semi-structured interviews were conducted with participants (14). These interviews were analysed thematically. Three themes are presented here: positive feedback from the programme, which enabled them to be listened to and supported them both psychologically and financially. The impact of the programme on the participants' social network is also described, in terms of the links made with peers met during the programme. Finally, a new perspective on issues such as disease management, which improved through the contribution of knowledge, and also through the development of psychosocial resources. The programme enabled participants to acquire psychosocial skills, the ability to effectively self-manage their condition, and strategies on whether or not to disclose their HIV status. Participants' empowerment and social support in relation to the disease were developed through the programme, particularly through the links created with other women living with HIV. [ABSTRACT FROM AUTHOR]

Introduction: Host gene and protein expression impact susceptibility to clinical malaria, but the balance of immune cell populations, cytokines and genes that contributes to protection, remains incompletely understood. Little is known about the determinants of host susceptibility to clinical malaria at a time when acquired immunity is developing. Methods: We analyzed peripheral blood mononuclear cells (PBMCs) collected from children who differed in susceptibility to clinical malaria, all from a small town in Mali. PBMCs were collected from children aged 4-6 years at the start, peak and end of the malaria season. We characterized the immune cell composition and cytokine secretion for a subset of 20 children per timepoint (10 children with no symptomatic malaria age-matched to 10 children with >2 symptomatic malarial illnesses), and gene expression patterns for six children (three per cohort) per timepoint. Results: We observed differences between the two groups of children in the expression of genes related to cell death and inflammation; in particular, inflammatory genes such as CXCL10 and STAT1 and apoptotic genes such as XAF1 were upregulated in susceptible children before the transmission season began. We also noted higher frequency of HLA-DR+ CD4 T cells in protected children during the peak of the malaria season and comparable levels cytokine secretion after stimulation with malaria schizonts across all three time points. Conclusion: This study highlights the importance of baseline immune signatures in determining disease outcome. Our data suggests that differences in apoptotic and inflammatory gene expression patterns can serve as predictive markers of susceptibility to clinical malaria. [ABSTRACT FROM AUTHOR]

Malaria has been hypothesized as a factor that may have reduced the severity of the COVID-19 pandemic in sub-Saharan Africa. To evaluate the effect of recent malaria on COVID-19 we assessed a subgroup of individuals participating in a longitudinal cohort COVID-19 serosurvey that were also undergoing intensive malaria monitoring as part of antimalarial vaccine trials during the 2020 transmission season in Mali. These communities experienced a high incidence of primarily asymptomatic or mild COVID-19 during 2020 and 2021. In 1314 individuals, 711 were parasitemic during the 2020 malaria transmission season; 442 were symptomatic with clinical malaria and 269 had asymptomatic infection. Presence of parasitemia was not associated with new COVID-19 seroconversion (29.7% (211/711) vs. 30.0% (181/603), p=0.9038) or with rates of reported symptomatic seroconversion during the malaria transmission season. In the subsequent dry season, prior parasitemia was not associated with new COVID-19 seroconversion (30.2% (133/441) vs. 31.2% (108/346), p=0.7499), with symptomatic seroconversion, or with reversion from seropositive to seronegative (prior parasitemia: 36.2% (64/177) vs. no parasitemia: 30.1% (37/119), p = 0.3842). After excluding participants with asymptomatic infection, clinical malaria was also not associated with COVID-19 serostatus or symptomatic seroconversion when compared to participants with no parasitemia during the monitoring period. In communities with intense seasonal malaria and a high incidence of asymptomatic or mild COVID-19, we did not demonstrate a relationship between recent malaria and subsequent response to COVID-19. Lifetime exposure, rather than recent infection, may be responsible for any effect of malaria on COVID-19 severity. [ABSTRACT FROM AUTHOR]

Flood recession farming is an important cropping system for ensuring food security in western Mali. The present study identified sorghum varieties adapted to this farming system. In the first year, numerous varieties were tested in the fields of 12 farmers. The 22 best-performing varieties, based on farmers' scores using a preference index (PI), were further studied the following year. In the third year, the four varieties with the highest PI scores were tested against the local variety, Samé. The best-performing varieties were given the names Yélimané 1, Yélimané 2, Yélimané 3, and Yélimané 4. Across the three years, the best-performing variety, Yélimané 1, showed a 60.2% and 55.3% greater grain and stover yield, respectively, compared to the local Samé variety. The four improved varieties also reached maturity 30 days sooner than the local variety. A survey involving 101 farmers showed that the improved varieties, combined with higher plant density, seed priming and microdosing of mineral fertilizer, reduced the number of food-insecure months by 3.59 months. These varieties combined with improved agronomic practices have the potential to improve food security in flood recession areas in West Africa. [ABSTRACT FROM AUTHOR]

Diabetes is currently a crisis in sub-Saharan West Africa (SSWA) with dramatic implications for public health and national budgets prioritizing infectious diseases. There is limited recent literature about the prevalence, awareness, and risk factors for type 2 diabetes (T2D) in rural parts of SSWA. This study characterized T2D prevalence and risk factors for the rural Malian community of Nièna, which is situated in Mali's second-largest province of Sikasso. Between December 2020 and July 2021, a cross-sectional study of 412 participants was conducted in the Nièna community using clinical questionnaires and rapid diagnostic tests. Among 412 participants, there were 143 (34.7%) and 269 (65.3%) males and females, respectively. The overall prevalence of T2D in Nièna was 7.5% (31/412), and prevalence rates were 8.6% (23/269) and 5.6% (8/143) for females and males, respectively. Age, family history of diabetes, hypertension, waist circumference, and fetal macrosomia were significantly associated with T2D (p = 0.007, p < 0.001, p = 0.003, p = 0.013, and p < 0.001, respectively). Notably, 61.3% (19/31) of T2D subjects were unaware of their diabetic status before the study. Field surveys have considerable utility in driving T2D awareness in rural African settings. [ABSTRACT FROM AUTHOR]

Background: In malaria endemic regions, transmission of Plasmodium falciparum parasites is often seasonal with very low transmission during the dry season and high transmission in the wet season. Parasites survive the dry season within some individuals who experience prolonged carriage of parasites and are thought to 'seed' infection in the next transmission season. Methods: Dry season carriers and their role in the subsequent transmission season are characterized using a combination of mathematical simulations and data analysis of previously described data from a longitudinal study in Mali of individuals aged 3 months–12 years (n = 579). Results: Simulating the life-history of individuals experiencing repeated exposure to infection predicts that dry season carriage is more likely in the oldest, most exposed and most immune individuals. This hypothesis is supported by the data from Mali, which shows that carriers are significantly older, experience a higher biting rate at the beginning of the transmission season and develop clinical malaria later than non-carriers. Further, since the most exposed individuals in a community are most likely to be dry season carriers, this is predicted to enable a more than twofold faster spread of parasites into the mosquito population at the start of the subsequent wet season. Conclusions: Carriage of malaria parasites over the months-long dry season in Mali is most likely in the older, more exposed and more immune children. These children may act as super-spreaders facilitating the fast spread of parasites at the beginning of the next transmission season. [ABSTRACT FROM AUTHOR]

Background: In some settings, sensitive field diagnostic tools may be needed to achieve elimination of falciparum malaria. To this end, rapid diagnostic tests (RDTs) based on the detection of the Plasmodium falciparum protein HRP-2 are being developed with increasingly lower limits of detection. However, it is currently unclear how parasite stages that are unaffected by standard drug treatments may contribute to HRP-2 detectability and potentially confound RDT results even after clearance of blood stage infection. This study assessed the detectability of HRP-2 in periods of post-treatment residual gametocytaemia. Methods: A cohort of 100 P.falciparum infected, gametocyte positive individuals were treated with or without the gametocytocidal drug primaquine (PQ), alongside standard artemisinin-based combination therapy (ACT), in the context of a randomised clinical trial in Ouelessebougou, Mali. A quantitative ELISA was used to measure levels of HRP-2, and compared time to test negativity using a standard and ultra-sensitive RDT (uRDT) between residual gametocyte positive and negative groups. Results: Time to test negativity was longest by uRDT, followed by ELISA and then standard RDT. No significant difference in time to negativity was found between the treatment groups with and without residual gametocytes: uRDT (HR 0.79 [95% CI 0.52–1.21], p = 0.28), RDT (HR 0.77 [95% CI 0.51–1.15], p = 0.20) or ELISA (HR 0.88 [95% CI 0.59–1.32], p = 0.53). Similarly, no difference was observed when adjusting for baseline asexual parasite density. Quantified levels of HRP-2 over time were similar between groups, with differences attributable to asexual parasite densities. Furthermore, no difference in levels of HRP-2 was found between individuals who were or were not infectious to mosquitoes (OR 1.19 [95% CI 0.98–1.46], p = 0.077). Conclusions: Surviving sexual stage parasites after standard ACT treatment do not contribute to the persistence of HRP-2 antigenaemia, and appear to have little impact on RDT results. [ABSTRACT FROM AUTHOR]

Onion is one of the most economically and nutritionally important vegetable crops in West Africa. Onions are very important for consumers due to the antioxidants and compounds they contain that may reduce inflammation, lower triglycerides and reduce cholesterol levels, resulting in lower risks of heart disease and blood clots. However, high-yielding varieties that are accessible to farmers remain scarce. The objective of the present study was to identify adapted onion genotypes for sustainable production in Northern Ghana and Southern Mali. Nine onion lines, including a check variety, were assessed for yield stability using a randomized complete block design. The trials were carried out in "technology parks" under the joint management of farmers and researchers. Onion bulb weight was recorded for each plot after harvest. Separate analyses of variances were performed for each location and season. Analysis of variance of combined locations, seasons and lines was performed to determine the most stable varieties using the line-superiority measure and ecovalence stability coefficients. Results indicated that the lines AVON1310 and AVON1325 were most stable for yield performance over locations and seasons (Wi = 2.20 and 11.60, respectively; Pi = 1.32 and 6.56, respectively). From the genotype main effects and genotype-by-environment interaction biplots, the best performing lines were AVON1310 (33.32 t.h−1), AVON1308 (28.81 t.h−1) and AVON1325 (31.68 t.h−1). The stability of these lines makes them potential candidates for commercial release in West Africa to contribute to sustainably intensifying onion production in the region. [ABSTRACT FROM AUTHOR]

Objective: Limited information is available regarding youth‐onset diabetes in Mali. We investigated demographic, clinical, biochemical, and genetic features in new diabetes cases in children and adolescents. Research Design and Methods: The study was conducted at Hôpital du Mali in Bamako. A total of 132 recently‐diagnosed cases <21 years were enrolled. Demographic characteristics, clinical information, biochemical parameters (blood glucose, HbA1c, C‐peptide, glutamic acid decarboxylase‐65 (GAD‐65) and islet antigen‐2 (IA2) autoantibodies) were assessed. DNA was genotyped for HLA‐DRB1 using high‐resolution genotyping technology. Results: A total of 130 cases were clinically diagnosed as type 1 diabetes (T1D), one with type 2 diabetes (T2D), and one with secondary diabetes. A total of 66 (50.8%) T1D cases were males and 64 (49.2%) females, with a mean age at diagnosis of 13.8 ± 4.4 years (range 0.8–20.7 years) peak onset of 15 years. 58 (44.6%) presented in diabetic ketoacidosis; with 28 (21.5%) IA2 positive, 76 (58.5%) GAD‐65 positive, and 15 (11.5%) positive for both autoantibodies. HLA was also genotyped in 195 controls without diabetes. HLA‐DRB1 genotyping of controls and 98 T1D cases revealed that DRB1*03:01, DRB1*04:05, and DRB1*09:01 alleles were predisposing for T1D (odds ratios [ORs]: 2.82, 14.76, and 3.48, p‐values: 9.68E‐5, 2.26E‐10, and 8.36E‐4, respectively), while DRB1*15:03 was protective (OR = 0.27; p‐value = 1.73E‐3). No significant differences were observed between T1D cases with and without GAD‐65 and IA2 autoantibodies. Interestingly, mean C‐peptide was 3.6 ± 2.7 ng/ml (1.2 ± 0.9 nmol/L) in T1D cases at diagnosis. Conclusions: C‐peptide values were higher than expected in those diagnosed as T1D and autoantibody rates lower than in European populations. It is quite possible that some cases have an atypical form of T1D, ketosis‐prone T2D, or youth‐onset T2D. This study will help guide assessment and individual management of Malian diabetes cases, potentially enabling healthier outcomes. [ABSTRACT FROM AUTHOR]

Moths of Coniesta ignefusalis (Hampson) were collected by automatic light traps on millet field near Bamako in 2018. The light trap data shows three periods of moth flight. The greatest number of moths has been collected in the beginning of September. At the same time, to study the species composition of parasitic hymenopteran, 800 damaged segments of the millet stem were collected, of which a host and its parasitoids were reared in the laboratory for 1.5 month. Eleven species of hymenopteran parasitoids were reared: Tetrastichus atriclavus Waterston, Pediobius furvus Gahan (Eulophidae), Psilochalcis soudenensis (Steffan) (Chalcididae), Eurytoma braconidis (Ferriere) (Eurytomidae), Exoristobia dipterae (Risbec) (Encyrtidae), Pachyneuron sp. (Pteromalidae), Syzeuctus ruberrimus Benoit and S. senegalensis Benoit (Icheumonidae); Stenobracon (Euvipio) unifasciatus (Brullé) and Cheloninae species (Braconidae) and Aphanogmus reticulatus (Fouts) (Ceraphronidae). Three of these species: T. atriclavus (63.3%), S. senegalensis (18.8%) and A. reticulatus (8.0%) make up 90.1% of all specimens reared. Tetrastichus atriclavus is likely the most important hymenopterans regulator of C. ignefusalis. Asynchronous appearance of moths and parasitoids has been found, and is discussed. [ABSTRACT FROM AUTHOR]

Introduction: Almost half of the world's populations do not have access to basic health care. This exclusion mainly affects people living in rural areas, who are nevertheless the most susceptible to diseases. The Medical Assistance Plan allows a marked improvement in access to healthcare by poor patients. It eliminates out of pocket healthcare cost, which normally prevents most of them from accessing health care. Materials and methods: This study was aimed to investigate the accessibility to healthcare for poor patients at the University Hospital Point G. We conducted a 12- month descriptive cross-sectional study from March 2018 to April 2019. Data entry and analysis were performed using SPSS version 21.0. Results: Our study participants we interviewed were aged 30-44 years old in 30.7%, female in 60.7%, and housewives in 46.7%. Our interviewees consulted for consulted for chronic diseases in 79.3%, had no monthly income in 78.7% and obtained the healthcare benefits at no cost to them in 60.7%. The prescriptions costed between 5,000 and 15,000 FCFA in 51.1%, 20252 FCFA on average with a standard deviation of 1340 FCFA. In sum, 59 out of our 150 patients who were eligible for free healthcare had to pay for a contribution either a subsidized cost in 84.7% or a partial purchase in in 15.3%. Conclusion: The main barriers to healthcare were the chronicity of their diseases and the expensiveness of the healthcare due the level of poverty in the country. [ABSTRACT FROM AUTHOR]

Background: A recent trial of 5920 children in Burkina Faso and Mali showed that the combination of seasonal vaccination with the RTS,S/AS01E malaria vaccine (primary series and two seasonal boosters) and seasonal malaria chemoprevention (four monthly cycles per year) was markedly more effective than either intervention given alone in preventing clinical malaria, severe malaria, and deaths from malaria.Methods: In order to help optimise the timing of these two interventions, trial data were reanalysed to estimate the duration of protection against clinical malaria provided by RTS,S/AS01E when deployed seasonally, by comparing the group who received the combination of SMC and RTS,S/AS01E with the group who received SMC alone. The duration of protection from SMC was also estimated comparing the combined intervention group with the group who received RTS,S/AS01E alone. Three methods were used: Piecewise Cox regression, Flexible parametric survival models and Smoothed Schoenfeld residuals from Cox models, stratifying on the study area and using robust standard errors to control for within-child clustering of multiple episodes.Results: The overall protective efficacy from RTS,S/AS01E over 6 months was at least 60% following the primary series and the two seasonal booster doses and remained at a high level over the full malaria transmission season. Beyond 6 months, protective efficacy appeared to wane more rapidly, but the uncertainty around the estimates increases due to the lower number of cases during this period (coinciding with the onset of the dry season). Protection from SMC exceeded 90% in the first 2-3 weeks post-administration after several cycles, but was not 100%, even immediately post-administration. Efficacy begins to decline from approximately day 21 and then declines more sharply after day 28, indicating the importance of preserving the delivery interval for SMC cycles at a maximum of four weeks.Conclusions: The efficacy of both interventions was highest immediately post-administration. Understanding differences between these interventions in their peak efficacy and how rapidly efficacy declines over time will help to optimise the scheduling of SMC, malaria vaccination and the combination in areas of seasonal transmission with differing epidemiology, and using different vaccine delivery systems.Trial Registration: The RTS,S-SMC trial in which these data were collected was registered at clinicaltrials.gov: NCT03143218. [ABSTRACT FROM AUTHOR]

Since the early 2000s, digital soil maps have been successfully used for various applications, including precision agriculture, environmental assessments and land use management. Globally, however, there are large disparities in the availability of soil data on which digital soil mapping (DSM) models can be fitted. Several studies attempted to transfer a DSM model fitted from an area with a well‐developed soil database to map the soil in areas with low sampling density. This usually is a challenging task because two areas have hardly ever the same soil‐forming factors in two different regions of the world. In this study, we aim to determine whether finding homosoils (i.e., locations sharing similar soil‐forming factors) can help transferring soil information by means of a DSM model extrapolation. We hypothesize that within areas in the world considered as homosoils, one can leverage on areas with high sampling density and fit a DSM model, which can then be extrapolated geographically to an area with little or no data. We collected publicly available soil data for clay, silt, sand, organic carbon (OC), pH and total nitrogen (N) within our study area in Mali, West Africa and its homosoils. We fitted a regression tree model between the soil properties and environmental covariates of the homosoils, and applied this model to our study area in Mali. Several calibration and validation strategies were explored. We also compared our approach with existing maps made at a global and a continental scale. We concluded that geographic model extrapolation within homosoils was possible, but that model accuracy dramatically improved when local data were included in the calibration dataset. The maps produced from models fitted with data from homosoils were more accurate than existing products for this study area, for three (silt, sand, pH) out of six soil properties. This study would be relevant to areas with very little or no soil data to carry critical soils and environmental risk assessments at a regional level. Highlights: Soil mapping models were fitted with soil data within the homosoils of Mali.The fitted models were applied to our study area.Model accuracy dramatically improved when including local data.Homosoil maps were more accurate for 3 out of 6 soil properties compared to global and continental maps.New opportunity to map the regional soil pattern of areas with limited soil data coverage. [ABSTRACT FROM AUTHOR]

In sub‐Saharan Africa, the Human Herpesvirus 8 (HHV‐8) is endemic but with disparities between regions and population studied. Although the virus remains mostly latent, there is some evidence that blood transfusion may represents one of the transmission way for this virus. Here, we evaluated HHV‐8 seroprevalence among blood donors in Mali. This cross‐sectional study recruited blood donors from the Blood Transfusion Center at Gabriel Touré Hospital, Bamako. Serum was used for the detection of latent HHV‐8 immunoglobulin G directed against latent associated nuclear antigen 1 by an indirect immunofluorescence assay. Human immunodeficiency virus 1 (HIV‐1), Hepatitis B Virus (HBV), HCV, and Treponema pallidum were also screened. HHV‐8 seroprevalence was 10.4% in Malian blood donors. None of the sociodemographic characteristics were associated with HHV‐8 infection, although there is a tendency of a higher HHV‐8 seroprevalence among participants living in Bamako than those not living there. One individual had coinfection HHV‐8/HBV, another HHV‐8/HCV while another had HCV and T. pallidum. None has been tested positive for HIV infection. This intermediate seroprevalence in Malian blood donors suggests that the risk of HHV‐8 transmission by transfusion should be considered. Further investigations are needed to assess impact of HHV‐8 in polytransfused patients residing in an endemic area for this virus. [ABSTRACT FROM AUTHOR]

Background: In Mali, cutaneous leishmaniasis (CL) and filariasis are co-endemic. Previous studies in animal models of infection have shown that sand fly saliva enhance infectivity of Leishmania parasites in naïve hosts while saliva-specific adaptive immune responses may protect against cutaneous and visceral leishmaniasis. In contrast, the human immune response to Phlebotomus duboscqi (Pd) saliva, the principal sand fly vector in Mali, was found to be dichotomously polarized with some individuals having a Th1-dominated response and others having a Th2-biased response. We hypothesized that co-infection with filarial parasites may be an underlying factor that modulates the immune response to Pd saliva in endemic regions. Methodology/Principal findings: To understand which cell types may be responsible for polarizing human responses to sand fly saliva, we investigated the effect of salivary glands (SG) of Pd on human monocytes. To this end, elutriated monocytes were cultured in vitro, alone, or with SG, microfilariae antigen (MF ag) of Brugia malayi, or LPS, a positive control. The mRNA expression of genes involved in inflammatory or regulatory responses was then measured as were cytokines and chemokines associated with these responses. Monocytes of individuals who were not exposed to sand fly bites (mainly North American controls) significantly upregulated the production of IL-6 and CCL4; cytokines that enhance leishmania parasite establishment, in response to SG from Pd or other vector species. This selective inflammatory response was lost in individuals that were exposed to sand fly bites which was not changed by co-infection with filarial parasites. Furthermore, infection with filarial parasites resulted in upregulation of CCL22, a type-2 associated chemokine, both at the mRNA levels and by its observed effect on the frequency of recruited monocytes. Conclusions/Significance: Together, our data suggest that SG or recombinant salivary proteins from Pd alter human monocyte function by upregulating selective inflammatory cytokines. Author summary: In Mali, cutaneous leishmaniasis (CL) and filariasis are co-endemic. We hypothesized that co-infection with helminth parasites may modulate the immune response to saliva of the CL vector Phlebotomus duboscqi (Pd). Hence, we investigated the effect of Pd salivary glands (SG) on human monocytes in subjects exposed or unexposed to sand fly bites in the context of a concomitant filaria infection. Monocytes of unexposed individuals selectively upregulated the production of IL-6 and CCL4 in response to SG from Pd or other vector species. In contrast, monocytes of individuals exposed to sand fly bites lost their responsiveness to SG, microfilariae antigen and LPS, irrespective of co-infection with filaria. Nevertheless, infection with filaria significantly upreguled the frequency of CCL22+monocytes, IL-10+mDCs and regulatory T cells. Together, our data suggest that repeated exposure to Pd saliva alters human monocyte function towards a tolerized phenotype while co-infection with filaria favors a Leishmania-promoting Th2/regulatory response. [ABSTRACT FROM AUTHOR]

Background: Application methods of |Attractive Toxic Sugar Baits (ATSB) need to be improved for wide-scale use, and effects on non-target organisms (NTOs) must be assessed. The goals of this study were to determine, at the village level, the effect of different configurations of bait stations to (1) achieve < 25% Anopheles mosquito vector daily feeding rate for both males and females and (2) minimize the effect on non-target organisms. Methods: Dye was added to Attractive Sugar Bait Stations (without toxin) to mark mosquitoes feeding on the baits, and CDC UV light traps were used to monitor for marked mosquitoes. An array of different traps were used to catch dye marked NTOs, indicating feeding on the ASB. Stations were hung on homes (1, 2, or 3 per home to optimize density) at different heights (1.0 m or 1.8 m above the ground). Eight villages were chosen as for the experiments. Results: The use of one ASB station per house did not mark enough mosquitoes. Use of two and three stations per house gave feeding rates above the 25% goal. There was no statistical difference in the percentage of marked mosquitoes between two and three stations, however, the catches using two and three bait stations were both significantly higher than using one. There was no difference in An. gambiae s.l. feeding when stations were hung at 1.0 and 1.8 m. At 1.8 m stations sustained less accidental damage. ASB stations 1.8 m above ground were fed on by three of seven monitored insect orders. The monitored orders were: Hymenoptera, Lepidoptera, Coleoptera, Diptera, Hemiptera, Neuroptera and Orthoptera. Using one or two stations significantly reduced percentage of bait-fed NTOs compared to three stations which had the highest feeding rates. Percentages were as follows: 6.84 ± 2.03% Brachycera followed by wasps (Hymenoptera: Vespidae) 5.32 ± 2.27%, and Rhopalocera 2.22 ± 1.79%. Hanging the optimal number of stations per house for catching mosquitoes (two) at 1.8 m above ground, limited the groups of non-targets to Brachycera, Chironomidae, Noctuoidea, Rhopalocera, parasitic wasps and wasps (Hymenoptera). Feeding at 1.8 m only occurred when stations were damaged. Conclusions: The goal of marking quarter of the total Anopheles population per day was obtained using 2 bait stations at 1.8 m height above the ground. This configuration also had minimal effects on non-target insects. [ABSTRACT FROM AUTHOR]

Background: Attractive targeted sugar baits (ATSBs) are a promising new tool for malaria control as they can target outdoor-feeding mosquito populations, in contrast to current vector control tools which predominantly target indoor-feeding mosquitoes. Methods: It was sought to estimate the potential impact of these new tools on Plasmodium falciparum malaria prevalence in African settings by combining data from a recent entomological field trial of ATSBs undertaken in Mali with mathematical models of malaria transmission. The key parameter determining impact on the mosquito population is the excess mortality due to ATSBs, which is estimated from the observed reduction in mosquito catch numbers. A mathematical model capturing the life cycle of P. falciparum malaria in mosquitoes and humans and incorporating the excess mortality was used to estimate the potential epidemiological effect of ATSBs. Results: The entomological study showed a significant reduction of ~ 57% (95% CI 33–72%) in mosquito catch numbers, and a larger reduction of ~ 89% (95% CI 75–100%) in the entomological inoculation rate due to the fact that, in the presence of ATSBs, most mosquitoes do not live long enough to transmit malaria. The excess mortality due to ATSBs was estimated to be lower (mean 0.09 per mosquito per day, seasonal range 0.07–0.11 per day) than the bait feeding rate obtained from one-day staining tests (mean 0.34 per mosquito per day, seasonal range 0.28–0.38 per day). Conclusions: From epidemiological modelling, it was predicted that ATSBs could result in large reductions (> 30% annually) in prevalence and clinical incidence of malaria, even in regions with an existing high malaria burden. These results suggest that this new tool could provide a promising addition to existing vector control tools and result in significant reductions in malaria burden across a range of malaria-endemic settings. [ABSTRACT FROM AUTHOR]

Background: In Mali, nomadic populations are spread over one third of the territory. Their lifestyle, characterized by constant mobility, excludes them from, or at best places them at the edge of, health delivery services. This study aimed to describe nomadic populations' characteristics, determine their perception on the current health services, and identify issues associated with community-based health interventions. Methods: To develop a better health policy and strategic approaches adapted to nomadic populations, we conducted a cross-sectional study in the region of Timbuktu to describe the difficulties in accessing health services. The study consisted in administering questionnaires to community members in the communes of Ber and Gossi, in the Timbuktu region, to understand their perceptions of health services delivery in their settings. Results: We interviewed 520 individuals, all members of the nomadic communities of the two study communes. Their median age was 38 years old with extremes ranging from 18 to 86 years old. Their main activities were livestock breeding (27%), housekeeping (26.4%), local trading (11%), farming (6%) and artisans (5.5%). The average distance to the local health center was 40.94 km and 23.19 km respectively in Gossi and Ber. In terms of barriers to access to health care, participants complained mainly about the transportation options (79.4%), the quality of provided services (39.2%) and the high cost of available health services (35.7%). Additionally, more than a quarter of our participants stated that they would not allow themselves to be examined by a health care worker of the opposite gender. Conclusion: This study shows that nomadic populations do not have access to community-based health interventions. A number of factors were revealed to be important barriers per these communities' perception including the quality of services, poverty, lifestyle, gender and current health policy strategies in the region. To be successful, future interventions should take these factors into account by adapting policies and methods. [ABSTRACT FROM AUTHOR]

Pesticide markets have grown far faster than regulatory monitoring capacity in West Africa. As a result, fraudulent pesticides (unregistered and counterfeit) have become widely available. This paper focuses on glyphosate, the region's most widely used pesticide. Purchase of 100 glyphosate samples from 50 different retailers across Mali found that 45% were fraudulent. Laboratory testing revealed that fraudulent glyphosate products contained 8-10% less active ingredient than registered products. Together, variable quality and widespread underdosing raise serious risks of accelerating weed resistance. These results suggest a clear need for more aggressive monitoring of pesticide markets, product quality and resulting environmental impacts. For practical purposes, farmers can protect themselves by purchasing only products duly registered by Mali's regulator, the Comité Sahélien des Pesticides (CSP). [ABSTRACT FROM AUTHOR]

Background: Spatial repellents have been widely used for the prevention of mosquito bites but their efficacy in reducing mosquito-borne diseases has never been evaluated in Africa. Additionally, spatial repellents have the potential of being critical tools in the prevention of mosquito-borne diseases in contexts where typical vectors control efforts such as insecticide-treated nets (ITNs) and indoor residual spray (IRS) are inaccessible or underutilized such as among displaced populations or in emergency relief settings. To address this knowledge gap, Kolondieba District, Sikasso Region, Mali was selected as a site to estimate the impact of the Mosquito Shield™, a spatial repellent that incorporates transfluthrin on a plastic sheet, on malaria-related outcomes. Over the past decade, the Region of Sikasso, Health districts of Kadiolo, Yorosso, and Kolondieba have remained among the most afflicted, characterized by an annual parasite incidence of more than 116 cases per 1000 population [1] and a Plasmodium falciparum prevalence rate of 29.7% [2].Methods: Cluster-randomized, placebo-controlled, double-blinded clinical trial, whereby children ≥ 6 months to < 10 years old will be enrolled and followed to determine the time to malaria infection with monthly blood samples for microscopic diagnosis. A total of 1920 subjects (HHs) will be enrolled in 60 clusters (30 spatial repellent, 30 placebo). Malaria incidence will be estimated and compared to demonstrate and quantify the protective efficacy (PE) of a spatial repellent, in reducing malaria infection. Monthly mosquito collections using CDC light traps will be conducted to determine if there are entomological correlates of spatial repellent efficacy that may be useful for the evaluation of new spatial repellents. Quarterly human landing catches (HLC) will assess the behavioral effects of the intervention.Discussion: Findings will serve as an efficacy trial of spatial repellent products for sub-Saharan Africa. Findings will be submitted to the World Health Organization Vector Control Advisory Group (WHO VCAG) for assessment of whether spatial repellents have "public health value." Entomological outcomes will also be measured as proxies of malaria transmission to help develop guidelines for the evaluation of future spatial repellent products.Trial Registration: ClinicalTrials.gov NCT04795648 . Registered on March 12, 2021. [ABSTRACT FROM AUTHOR]

Background: The aim of this field trial was to evaluate the efficacy of attractive toxic sugar baits (ATSB) in Mali, where sustained malaria transmission occurs despite the use of long-lasting insecticidal nets (LLINs). ATSB bait stations were deployed in seven of 14 similar study villages, where LLINs were already in widespread use. The combined use of ATSB and LLINs was tested to see if it would substantially reduce parasite transmission by Anopheles gambiae sensu lato beyond use of LLINs alone. Methods: A 2-day field experiment was conducted to determine the number of mosquitoes feeding on natural sugar versus those feeding on bait stations containing attractive sugar bait without toxin (ASB)—but with food dye. This was done each month in seven random villages from April to December 2016. In the following year, in seven treatment villages from May to December 2017, two ATSB bait stations containing the insecticide dinotefuran were placed on the outer walls of each building. Vector population density was evaluated monthly by CDC UV light traps, malaise traps, pyrethrum spray (PSCs) and human landing catches (HLCs). Female samples of the catch were tested for age by examination of the ovarioles in dissected ovaries and identification of Plasmodium falciparum sporozoite infection by ELISA. Entomological inoculation rates (EIR) were calculated, and reductions between treated and untreated villages were determined. Results: In the 2-day experiment with ASB each month, there was a lower number of male and female mosquitoes feeding on the natural sugar sources than on the ASB. ATSB deployment reduced CDC-UV trap female catches in September, when catches were highest, were by 57.4% compared to catches in control sites. Similarly, malaise trap catches showed a 44.3% reduction of females in August and PSC catches of females were reduced by 48.7% in September. Reductions of females in HLCs were lower by 19.8% indoors and 26.3% outdoors in September. The high reduction seen in the rainy season was similar for males and reductions in population density for both males and females were > 70% during the dry season. Reductions of females with ≥ 3 gonotrophic cycles were recorded every month amounting to 97.1% in October and 100.0% in December. Reductions in monthly EIRs ranged from 77.76 to 100.00% indoors and 84.95% to 100.00% outdoors. The number of sporozoite infected females from traps was reduced by 97.83% at treated villages compared to controls. Conclusions: Attractive toxic sugar baits used against Anopheles mosquitoes in Mali drastically reduced the density of mosquitoes, the number of older females, the number of sporozoite infected females and the EIR demonstrating how ATSB significantly reduces malaria parasite transmission. [ABSTRACT FROM AUTHOR]

Background: A recent trial in Burkina Faso and Mali showed that combining seasonal RTS,S/AS01E malaria vaccination with seasonal malaria chemoprevention (SMC) substantially reduced the incidence of uncomplicated and severe malaria in young children compared to either intervention alone. Given the possible negative effect of malaria on nutrition, the study investigated whether these children also experienced lower prevalence of acute and chronic malnutrition. Methods: In Burkina Faso and Mali 5920 children were randomized to receive either SMC alone, RTS,S/AS01E alone, or SMC combined with RTS,S/AS01E for three malaria transmission seasons (2017–2019). After each transmission season, anthropometric measurements were collected from all study children at a cross-sectional survey and used to derive nutritional status indicators, including the binary variables wasted and stunted (weight-for-height and height-for-age z-scores below − 2, respectively). Binary and continuous outcomes between treatment groups were compared by Poisson and linear regression. Results: In 2017, compared to SMC alone, the combined intervention reduced the prevalence of wasting by approximately 12% [prevalence ratio (PR) = 0.88 (95% CI 0.75, 1.03)], and approximately 21% in 2018 [PR = 0.79 (95% CI 0.62, 1.01)]. Point estimates were similar for comparisons with RTS,S/AS01E, but there was stronger evidence of a difference. There was at least a 30% reduction in the point estimates for the prevalence of severe wasting in the combined group compared to the other two groups in 2017 and 2018. There was no difference in the prevalence of moderate or severe wasting between the groups in 2019. The prevalence of stunting, low-MUAC-for-age or being underweight did not differ between groups for any of the three years. The prevalence of severe stunting was higher in the combined group compared to both other groups in 2018, and compared to RTS,S/AS01E alone in 2017; this observation does not have an obvious explanation and may be a chance finding. Overall, malnutrition was very common in this cohort, but declined over the study as the children became older. Conclusions: Despite a high burden of malnutrition and malaria in the study populations, and a major reduction in the incidence of malaria in children receiving both interventions, this had only a modest impact on nutritional status. Therefore, other interventions are needed to reduce the high burden of malnutrition in these areas. Trial registration: https://www.clinicaltrials.gov/ct2/show/NCT03143218, registered 8th May 2017. [ABSTRACT FROM AUTHOR]

Background: In 2012, seasonal malaria chemoprevention (SMC) was recommended as policy for malaria control by the World Health Organization (WHO) in areas of highly seasonal malaria transmission across the Sahel sub-region in Africa along with monitoring of drug resistance. We assessed the long-term impact of SMC on Plasmodium falciparum resistance to sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) over a 3-year period of SMC implementation in the health district of Ouelessebougou, Mali. Methods: In 8 randomly selected sub-districts of Ouelessebougou, Mali, children aged 0–5 years were randomly selected during cross-sectional surveys at baseline (August 2014) and 1, 2 and 3 years post-SMC, at the beginning and end of the malaria transmission season. Blood smears and blood spots on filter paper were obtained and frequencies of mutation in P. falciparum genes related to resistance to SP and AQ (Pfdhfr, Pfdhps, Pfmdr1, and Pfcrt) were assessed by PCR amplification on individual samples and PCR amplification followed by deep sequencing on pooled (by site and year) samples. Results: At each survey, approximately 50–100 individual samples were analysed by PCR amplification and a total of 1,164 samples were analysed by deep sequencing with an average read depth of 18,018–36,918 after pooling by site and year. Most molecular markers of resistance did not increase in frequency over the period of study (2014–2016). After 3 years of SMC, the frequencies of Pfdhps 540E, Pfdhps 437G and Pfcrt K76T remained similar compared to baseline (4.0 vs 1.4%, p = 0.41; 74.5 vs 64.6%, p = 0.22; 71.3 vs 67.4%, p = 0.69). Nearly all samples tested carried Pfdhfr 59R, and this proportion remained similar 3 years after SMC implementation (98.8 vs 100%, p = 1). The frequency of Pfmdr1 N86Y increased significantly over time from 5.6% at baseline to 18.6% after 3 years of SMC (p = 0.016). Results of pooled analysis using deep sequencing were consistent with those by individual analysis with standard PCR, but also indicated for the first time the presence of mutations at the Pfdhps A581G allele at a frequency of 11.7% after 2 years of SMC, as well as the Pfdhps I431V allele at frequencies of 1.6–9.3% following 1 and 2 years of SMC, respectively. Conclusion: Two and 3 years of SMC implementation were associated with increased frequency of the Pfmdr1 N86Y mutation but not Pfdhps 540E, Pfdhps 437G and Pfcrt K76T. The first-time detection of the Pfdhps haplotype bearing the I431V and A581G mutations in Mali, even at low frequency, warrants further long-term surveillance. [ABSTRACT FROM AUTHOR]

Many countries have adopted integrated community case management (iCCM) to reduce mortality among children under five years from common childhood illnesses. The 2016–2020 Malian Red Cross iCCM program trained 441 Community Health Workers (CHWs) to treat malaria, pneumonia, diarrhea, and malnutrition for children under five years of age in six districts. Implementation strength and quality of care (QoC) were assessed through the program's supervision function, using the Malian Ministry of Health's system. This paper compares methods and results of program supervision data and an independent evaluation to assess the effectiveness of program implementation and supervision and inform program improvement. It also presents the benefits and limitations of each method. An independent QoC evaluation was conducted using tools developed by the Real Accountability: Data Analysis for Results (RADAR) project, hereafter referred to as the RADAR evaluation. RADAR evaluation data collected in July and August 2018 were compared with program supervision data collected mostly between May and December 2018. The RADAR evaluation provided detailed findings on correct assessment, classification, and treatment per illness, medication type, and dosage. Program supervision combined the findings for all illnesses, medication type, and dosage due to limitations in the data collection process. Six indicators were comparable between both methods. Findings were similar for temperature and mid-upper arm circumference measurements but diverged between program supervision and the RADAR evaluation, respectively, on correct classification for all illnesses (87.1% vs. 65.3%), correct treatment for all illnesses (69.5% vs. 39.8%), correct respiratory rate counting (88.5% vs. 54.7%), and administering the first dose by CHW (75.4% vs. 65.0%). Findings from the RADAR evaluation guided improvements in program supervision. A robust program supervision system can serve as a credible method to assess QoC. However, a rigorous independent QoC evaluation provides a valuable benchmark to gauge the effectiveness of the supervisory process. [ABSTRACT FROM AUTHOR]

Background: For almost a decade now, Mali has been facing a security crisis that led to the displacement of thousands of people within the country. Since March 2020, a health crisis linked to the COVID-19 pandemic also surfaced. To overcome this health crisis, the government implemented some physical distancing measures but their adoption proved difficult, particularly among internally displaced people (IDPs). The objective of this study is to identify the challenges relating to the implementation and adoption of physical distancing measures and to determine the main mitigation measures taken by IDPs to adjust to these new policies. Methods: An exploratory qualitative research was conducted in Bamako and Ségou, two of the ten regions of Mali. The study counted 68 participants including 50 IDPs, seven administrative and health authorities, and 11 humanitarian actors. Sampling was guided by the principle of saturation and diversification, and data was collected through semi-structured individual interviews (n = 36) and focus groups (n = eight). Analysis was based on thematic content analysis through NVivo software. Results: The main challenges identified concerning the implementation and adoption of physical distancing measures include the proximity in which IDPs live, their beliefs and values, the lack of toilets and safe water on sites, IDPs habits and economic situation, humanitarian actors' lack of financial resources and authority, and social pressure from religious leaders. Implemented mitigation measures include the building of new shelters or their compartmentalization, the creation of income-generating activities and food banks, psychosocial support, promoting awareness of IDPs, and nightly police patrols and surveillance to discourage IDPs from going out. Finally, a call for action is suggested for the actors involved in IDPs support and management. Conclusions: The study demonstrates the difficulty for IDPs to follow most of the physical distancing measures and informs about the risk of disease spreading among IDPs with its potential consequences. It also shows the inability of mitigation measures to control the outbreak and suggests actions to be considered. [ABSTRACT FROM AUTHOR]

γδ T cells and malaria immunity: Repeated infections with Plasmodium falciparum can induce protective immunity against malaria, but mechanisms mediating protection are not completely understood. von Borstel et al. observed that repeated P. falciparum infection altered the ratios of human γδ T cells in children and adults with naturally occurring infections in Mali and found enrichment and maintenance of cytotoxic Vδ1effector T cells compared with naïve controls who had innate-like Vδ2+ γδ T cells as a dominant subset. U.S. adults subjected to sequential controlled human malaria infections (CHMI) initially expanded Vδ2+ γδ T cells, but repeated infection promoted clonal selection, differentiation, and expansion of cytotoxic Vδ1effector T cells. These Vδ1+ γδ T cells from U.S. and Malian individuals reacted to P. falciparum parasites in vitro, suggesting a role for this subset in malaria immunity. Repeated Plasmodium falciparum infections drive the development of clinical immunity to malaria in humans; however, the immunological mechanisms that underpin this response are only partially understood. We investigated the impact of repeated P. falciparum infections on human γδ T cells in the context of natural infection in Malian children and adults, as well as serial controlled human malaria infection (CHMI) of U.S. adults, some of whom became clinically immune to malaria. In contrast to the predominant Vδ2+ T cell population in malaria-naïve Australian individuals, clonally expanded cytotoxic Vδ1effector T cells were enriched in the γδ T cell compartment of Malian subjects. Malaria-naïve U.S. adults exposed to four sequential CHMIs defined the precise impact of P. falciparum on the γδ T cell repertoire. Specifically, innate-like Vδ2+ T cells exhibited an initial robust polyclonal response to P. falciparum infection that was not sustained with repeated infections, whereas Vδ1+ T cells increased in frequency with repeated infections. Moreover, repeated P. falciparum infection drove waves of clonal selection in the Vδ1+ T cell receptor repertoire that coincided with the differentiation of Vδ1naïve T cells into cytotoxic Vδ1effector T cells. Vδ1+ T cells of malaria-exposed Malian and U.S. individuals were licensed for reactivity to P. falciparum parasites in vitro. Together, our study indicates that repeated P. falciparum infection drives the clonal expansion of an adaptive γδ T cell repertoire and establishes a role for Vδ1+ T cells in the human immune response to malaria. [ABSTRACT FROM AUTHOR]

Sorghum [Sorghum bicolor (L.) Moench], a staple food crop in Mali, has low yields for several reasons including that many farmers do not have the financial resources to purchase state‐of‐the‐art genetics and fertilizers and information is not available on how to optimize yields for heirloom variety. To improve their economic and environmental sustainability, Mali farmers need to understand how to invest their limited resources. In many situations this involves the use of open‐pollinated varieties that have a range of tillering capabilities. This study determined the best population density and nitrogen (N) fertilization combinations for eight locally available sorghum varieties. The research was conducted in 2018 and 2019 and the experimental design was split‐split‐plot randomized block, the treatments were two plant densities (26,600 and 53,300 plants ha–1), three N levels (0 kg ha–1, 89 kg ha–1, and 178 kg ha–1), and eight varieties that had a range of tillering characteristics. Each treatment was replicated three times and six of the varieties were open pollinated. Results showed that each variety had a different yield response to plant density and N rate. For example, the tall guinea (hybrids FADDA and PABLO) and the short durra‐caudatum A12‐79 cultivar produced higher yields when planted at 53,300 plants ha–1 and fertilized with 178 kg N ha–1 N2D2 treatment. For the short guinea‐caudatum improved varieties C2_007‐03 and C2_075‐15 and caudatum GRINKAN and SOUMBA varieties the optimum seeding rate was 53,300 plants ha–1 that were fertilized with 89 kg N ha–1 (N1D2). For the tall local guinea TIEBILE variety the highest yields were observed when it was seeded at a rate of 26,600 plants ha–1 and fertilized with 89 kg N ha–1. Grain yield increase was associated with yield components and growth traits for eight varieties studied. Panicle numbers per square meter and chlorophyll index were associated with grain yield in guinea hybrid. Grain number per panicle and 1,000 grain weight were involved in increasing grain yield in caudatum varieties. Nitrogen rate and planting density combination in terms of grain yield varied with different sorghum [Sorghum bicolor (L.) Moench] varieties studied. Knowledge of optimum combinations will help producers decide which option to promote to booster sorghum production in Mali. Core Ideas: Hybrid and durra varieties produced better yield under high N rate and plant density.Caudatum varieties produced better grain yield with N and plant density moderate use.Local guinea variety produced better grain yield with moderate use of N and low plant density.Panicle number and SPAD value were traits explaining grain yield increase of hybrid varieties.Grain number and grain weight were traits explaining grain yield increase of caudatum varieties. [ABSTRACT FROM AUTHOR]

Background In malaria-endemic areas, pregnant women and especially first-time mothers are more susceptible to Plasmodium falciparum. Malaria diagnosis is often missed during pregnancy, because many women with placental malaria remain asymptomatic or have submicroscopic parasitemia, masking the association between malaria and pregnancy outcomes. Severe maternal anemia and low birthweight deliveries are well-established sequelae, but few studies have confirmed the relationship between malaria infection and severe outcomes like perinatal mortality in high transmission zones. Methods Pregnant women of any gestational age enrolled at antenatal clinic into a longitudinal cohort study in Ouelessebougou, Mali, an area of high seasonal malaria transmission. Follow-up visits included scheduled and unscheduled visits throughout pregnancy. Blood smear microscopy and polymerase chain reaction (PCR) analysis were employed to detect both microscopic and submicroscopic infections, respectively. Intermittent preventative treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) was documented and prompt treatment regardless of symptoms given upon malaria diagnosis. Results Of the 1850 women followed through delivery, 72.6% of women received 2 or more IPTp-SP doses, 67.2% of women experienced at least 1 infection between enrollment up to and including delivery. Malaria infection increased the risks of stillbirth (adjusted hazard ratio [aHR] 3.87, 95% confidence interval [CI]: 1.18–12.71) and preterm delivery (aHR 2.41, 95% CI: 1.35–4.29) in primigravidae, and early neonatal death (death within 7 days) in secundigravidae and multigravidae (aHR 6.30, 95% CI: 1.41–28.15). Conclusions Malaria treatment after diagnosis, alongside IPTp-SP, is insufficient to prevent malaria-related stillbirth, early neonatal death and preterm delivery (PTD). Although IPTp-SP was beneficial in Mali during the study period, new tools are needed to improve pregnancy outcomes. Clinical Trials Registration NCT01168271. [ABSTRACT FROM AUTHOR]