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L’objectif de cette recherche est d’étudier la possibilité de maintenir et/ou de réactiver la vigilance du conducteur automobile à l’aide d’une activité cognitive. Dans un premier temps, nous réalisons une série d’expérimentations en laboratoire. Notre échantillon se compose de 30 étudiants de l’Université Lumière-Lyon 2. Nous proposons aux sujets une tâche de poursuite de trajectoire (tracking) sur un outil expérimental que nous avons mis au point. Cinq types de données sont recueillies : des paramètres physiologiques et comportementaux, la performance à la tâche, des paramètres subjectifs et de personnalité. Dans cet article nous détaillons notre protocole expérimental. The objective of this research is to study the possibility of maintaining and/or reactivating the vigilance of car drivers by cognitive activity. In a first phase, we carried out series of laboratory experiments using 30 students from University Lumière-Lyon 2. We asked subjects to follow a trajectory on an experimental tracking task we developed ourselves. 5 types of data were recorded: physiological and behavioural parameters, performance task, subjective parameters and personalities questionnaires. This article reviews our experimental set-up and protocol.

Créée en 2017 par une petite équipe de médecins de Guyane, la Journée des travaux scientifiques des jeunes médecins de Guyane (Nos internes ont du talent) a pris un nouvel essor en 2021 en devenant la 4e journée des travaux des soignants de Guyane ou JDS Guyane (Fig. 1, 2, 3, 4). En effet la session 2021 a été novatrice à plusieurs égards. Tout d’abord, la journée s’est ouverte à tous les corps de métier dans le domaine de la santé, ainsi des pharmaciens, infirmiers et sages-femmes ont, pour la première fois, contribué à la réalisation et à la réussite de cette journée. Malgré une succession d’annulation et de report du congrès 2020, la journée a été maintenue en 2021 et organisée à la fois en présentiel et en distanciel, permettant la participation de plus de 350 personnes. Cet événement, sans précédent, a permis de proposer le superlatif de 1er e-congrès guyanais., Médecine Tropicale et Santé Internationale - Bulletin, Vol. 1 No 1 (2021): MTSI-Bulletin

Background Multidrug-resistant tuberculosis (MDR-TB) jeopardizes global TB control. The prevalence and predictors of Rifampicin-resistant (RR) TB, a proxy for MDR-TB, and the treatment outcomes with standard and shortened regimens have not been assessed in post-conflict regions, such as the South Kivu province in the eastern Democratic Republic of the Congo (DRC). We aimed to fill this knowledge gap and to inform the DRC National TB Program. Methods of adults and children evaluated for pulmonary TB by sputum smear microscopy and Xpert MTB/RIF (Xpert) from February 2012 to June 2017. Multivariable logistic regression, Kaplan–Meier estimates, and multivariable Cox regression were used to assess independent predictors of RR-TB and treatment failure/death. Results Of 1535 patients Xpert-positive for TB, 11% had RR-TB. Independent predictors of RR-TB were a positive sputum smear (adjusted odds ratio [aOR] 2.42, 95% confidence interval [CI] 1.63–3.59), retreatment of TB (aOR 4.92, 95% CI 2.31–10.45), and one or more prior TB episodes (aOR 1.77 per episode, 95% CI 1.01–3.10). Over 45% of RR-TB patients had no prior TB history or treatment. The median time from Xpert diagnosis to RR-TB treatment initiation was 12 days (interquartile range 3–60.2). Cures were achieved in 30/36 (83%) and 84/114 (74%) of patients on 9- vs 20/24-month MDR-TB regimens, respectively (P = .06). Predictors of treatment failure/death were the absence of directly observed therapy (DOT; adjusted hazard ratio [aHR] 2.77, 95% CI 1.2–6.66) and any serious adverse drug event (aHR 4.28, 95% CI 1.88–9.71). Conclusions Favorable RR-TB cure rates are achievable in this post-conflict setting with a high RR-TB prevalence. An expanded Xpert scale-up; the prompt initiation of shorter, safer, highly effective MDR-TB regimens; and treatment adherence support are critically needed to optimize outcomes., In tuberculosis (TB) patients from post-conflict eastern Democratic Republic of the Congo, 11.1% had rifampicin-resistant TB, of whom 46.5% had no prior TB. Cures were achieved in 83% and 74% of patients on 9- and 20/24-month multidrug-resistant TB regimens, respectively.

Background Rifampicin (RIF) resistance is highly correlated with isoniazid (INH) resistance and used as proxy for multidrug-resistant tuberculosis (MDR-TB). Using MTBDRplus as a comparator, we evaluated the predictive value of Xpert MTB/RIF (Xpert)–detected RIF resistance for MDR-TB in eastern Democratic Republic of the Congo (DRC). Methods We conducted a cross-sectional study involving data from new or retreatment pulmonary adult TB cases evaluated between July 2013 and December 2016. Separate, paired sputa for smear microscopy and MTBDRplus were collected. Xpert testing was performed subject to the availability of Xpert cartridges on sample remnants after microscopy. Results Among 353 patients, 193 (54.7%) were previously treated and 224 (63.5%) were MTBDRplus TB positive. Of the 224, 43 (19.2%) were RIF monoresistant, 11 (4.9%) were INH monoresistant, 53 (23.7%) had MDR-TB, and 117 (52.2%) were RIF and INH susceptible. Overall, among the 96 samples detected by MTBDRplus as RIF resistant, 53 (55.2%) had MDR-TB. Xpert testing was performed in 179 (50.7%) specimens; among these, 163 (91.1%) were TB positive and 73 (44.8%) RIF resistant. Only 45/73 (61.6%) Xpert-identified RIF-resistant isolates had concomitant MTBDRplus-detected INH resistance. Xpert had a sensitivity of 100.0% (95% CI, 92.1–100.0) for detecting RIF resistance but a positive-predictive value of only 61.6% (95% CI, 49.5–72.8) for MDR-TB. The most frequent mutations associated with RIF and INH resistance were S531L and S315T1, respectively. Conclusions In this high-risk MDR-TB study population, Xpert had low positive-predictive value for the presence of MDR-TB. Comprehensive resistance testing for both INH and RIF should be performed in this setting.

Little is known about the respiratory health damage related to household air pollution (HAP) in survivors of pulmonary tuberculosis (PTB). In a population-based cross-sectional study, we determined the prevalence and associated predictors of chronic cough and hemoptysis in 441 randomly selected PTB survivors living in 13 remote health zones with high TB burden in the South Kivu province of the Democratic Republic of Congo (DRC). Trained community and health-care workers administered a validated questionnaire. In a multivariate logistic regression, chronic cough was independently associated with HAP (adjusted odds ratios (aOR) 2.10, 95% CI: 1.10&ndash, 4.00) and PTB treatment &gt, 6 months (aOR 3.80, 95% CI: 1.62&ndash, 8.96). Among women, chronic cough was associated with cooking &ge, 3 h daily (aOR 2.74, 95% CI: 1.25&ndash, 6.07) and with HAP (aOR 3.93, 95% CI: 1.15&ndash, 13.43). Independent predictors of hemoptysis were PTB retreatment (aOR 3.04, 95% CI: 1.04&ndash, 5.09) and ignorance of treatment outcome (aOR 2.24, 95% CI: 1.09&ndash, 4.58) but not HAP (aOR 1.86, 95% CI: 0.61&ndash, 5.62). Exposure to HAP proved a major risk factor for chronic cough in PTB survivors, especially in women. This factor is amenable to intervention.