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BACKGROUND: Primaquine (PQ) is the prototype 8-aminoquinoline drug, a class which targets gametocytes and hypnozoites. The World Health Organization (WHO) recommends adding a single low dose of primaquine to the standard artemisinin-based combination therapy (ACT) in order to block malaria transmission in regions with low malaria transmission. However, the haemolytic toxicity is a major adverse outcome of primaquine in glucose-6-phosphate dehydrogenase (G6PD)-deficient subjects. This study aimed to characterize the pharmacokinetic properties of primaquine and its major metabolites in G6PD-deficient subjects. METHODS: A single low-dose of primaquine (0.4-0.5 mg/kg) was administered in twenty-eight African males. Venous and capillary plasma were sampled up to 24 h after the drug administration. Haemoglobin levels were observed up to 28 days after drug administration. Only PQ, carboxy-primaquine (CPQ), and primaquine carbamoyl-glucuronide (PQCG) were present in plasma samples and measured using liquid chromatography mass spectrometry. Drug and metabolites pharmacokinetic properties were investigated using nonlinear mixed-effects modelling. RESULTS: Population pharmacokinetic properties of PQ, CPQ, and PQCG can be described by one-compartment disposition kinetics with a transit-absorption model. Body weight was implemented as an allometric function on the clearance and volume parameters for all compounds. None of the covariates significantly affected the pharmacokinetic parameters. No significant correlations were detected between the exposures of the measured compounds and the change in haemoglobin or methaemoglobin levels. There was no significant haemoglobin drop in the G6PD-deficient patients after administration of a single low dose of PQ. CONCLUSIONS: A single low-dose of PQ was haematologically safe in this population of G6PD-normal and G6PD-deficient African males without malaria. Trial registration NCT02535767.

Abstract Background In Africa, the relationship between childhood nutritional status and malaria remains complex and difficult to interpret. Understanding it is important in the improvement of malaria control strategies. This study aimed to assess the influence of nutritional status on the occurrence of multiple malaria episodes in children aged 6 to 59 months between 2013 and 2017 living in the village of Dangassa, Mali. Methods A community-based longitudinal study was conducted using cross-sectional surveys (CSSs) at the beginning (June) and end (November) of the malaria transmission season associated with passive case detection (PCD) at the Dangassa Community Health Centre. Children with asymptomatic malaria infection during cross-sectional surveys were selected and their malaria episodes followed by PCD. Malaria indicators in person-months were estimated using an ordinal-logistic model repeated on subjects during follow-up periods. Results The incidence rate (IR) during the period of high transmission (June to October), for 1 episode and for 2 + episodes peaked in 2013 with 65 children (IR = 95.73 per 1000 person-months) and 24 cases (IR = 35.35 per 1000 person-months), respectively. As expected, the risk of multiple episodes occurring during the period of high transmission was 3.23 compared to the period of low transmission after adjusting for other model parameters (95% CI [2.45–4.26], p = 0.000). Children with anaemia were at high risk of having multiple episodes (OR = 1.6, 95% CI [1.12–2.30], p = 0.011). However, the risk of having 2 + episodes for anemic children was higher during the period of low transmission (RR = 1.67, 95% CI [1.15–2.42], p = 0.007) compared to the period of high transmission (RR = 1.58, 95% CI [1.09–2.29], p = 0.016). The trend indicated that anemic and underweight children were significantly associated with multiple malaria episodes during the period of low transmission (p

Abstract Background Primaquine (PQ) is the prototype 8-aminoquinoline drug, a class which targets gametocytes and hypnozoites. The World Health Organization (WHO) recommends adding a single low dose of primaquine to the standard artemisinin-based combination therapy (ACT) in order to block malaria transmission in regions with low malaria transmission. However, the haemolytic toxicity is a major adverse outcome of primaquine in glucose-6-phosphate dehydrogenase (G6PD)-deficient subjects. This study aimed to characterize the pharmacokinetic properties of primaquine and its major metabolites in G6PD-deficient subjects. Methods A single low-dose of primaquine (0.4–0.5 mg/kg) was administered in twenty-eight African males. Venous and capillary plasma were sampled up to 24 h after the drug administration. Haemoglobin levels were observed up to 28 days after drug administration. Only PQ, carboxy-primaquine (CPQ), and primaquine carbamoyl-glucuronide (PQCG) were present in plasma samples and measured using liquid chromatography mass spectrometry. Drug and metabolites’ pharmacokinetic properties were investigated using nonlinear mixed-effects modelling. Results Population pharmacokinetic properties of PQ, CPQ, and PQCG can be described by one-compartment disposition kinetics with a transit-absorption model. Body weight was implemented as an allometric function on the clearance and volume parameters for all compounds. None of the covariates significantly affected the pharmacokinetic parameters. No significant correlations were detected between the exposures of the measured compounds and the change in haemoglobin or methaemoglobin levels. There was no significant haemoglobin drop in the G6PD-deficient patients after administration of a single low dose of PQ. Conclusions A single low-dose of PQ was haematologically safe in this population of G6PD-normal and G6PD-deficient African males without malaria. Trial registration NCT02535767

Despite a significant reduction in the burden of malaria in children under five years-old, the efficient implementation of seasonal malaria chemoprevention (SMC) at large scale remains a major concern in areas with long malaria transmission. Low coverage rate in the unattainable areas during the rainy season, a shift in the risk of malaria to older children and the rebound in malaria incidence after stopping drug administration are mainly reported in these areas. These gaps represent a major challenge in the efficient implementation of SMC measures. An open randomized study was conducted to assess the effect of a fifth additional round to current regime of SMC in older children living in Dangassa, a rural malaria endemic area. Poisson regression Model was used to estimate the reduction in malaria incidence in the intervention group compared to the control group including age groups (5-9 and 10-14 years) and the use of long-lasting insecticidal nets (LLINs; Yes or No) with a threshold at 5%. Overall, a downward trend in participation rate was observed from August (94.3%) to November (87.2%). In November (round 4), the risk of malaria incidence was similar in both groups (IRR = 0.66, 95%CI [0.35-1.22]). In December (round 5), a decrease of 51% in malaria incidence was observed in intervention group compared to control group adjusted for age groups and the use of LLINs (IRR = 0.49, 95%CI [0.26-0.94]), of which 17% of reduction is attributable to the 5th round in the intervention group. An additional fifth round of SMC resulted in a significant reduction of malaria incidence in the intervention group. The number of SMC rounds could be adapted to the local condition of malaria transmission.

The tomato, a genus of Lycopersicon, is cultivated worldwide for fruit. It is an important gastronomic ingredient and an important source of income for small farmers in Mali. However, its production faces a number of phytosanitary constraints that are still poorly understood. Among phytosanitary problems, bacterial wilt, caused by R. solanacearum, is proving to be the most dangerous and devastating of all tomato crops in Mali. The aim of this study is to contribute to the improvement of tomato production in Mali by identifying tomato varieties tolerant to R. solanacearum and adapted to the growing periods. To achieve this objective, trials under artificial and natural infestation conditions with 12 tomato genotypes during three periods were conducted at the Sotuba research station from December 2018 to December 2019. Analysis of variance revealed no significant difference between the two strains tested. Both strains were more severe, especially in period 2 of the experiment. The Caraïbo variety was the most susceptible to both strains, with an average severity rate of 2.8 (≈3) and the most stress-susceptibility index (0.69). The varieties Carioca and SF-83-61 were the most productive in both experimental conditions. With average yields ≥ 3.5 t/ha under artificial infestation conditions and ≥ 6 t/ha under natural conditions. In contrast, the Roma and Rossol varieties recorded the lowest yields. To minimize R. Solanacearum damage and improve field yields at all cropping periods, the SF-83-61 and Carioca varieties may be recommended for release in areas where R. Solanacearum, responsible for bacterial wilt, causes significant damage in tomato crops after confirmation tests.

Discrete choice models (DCMs) are applied in many fields and in the statistical modelling of consumer behavior. This paper focuses on a form of choice experiment, best–worst scaling in discrete choice experiments (DCEs), and the transition probability of a choice of a consumer over time. The analysis was conducted by using simulated data (choice pairs) based on data from Flynn’s (2007) ‘Quality of Life Experiment’. Most of the traditional approaches assume the choice alternatives are mutually exclusive over time, which is a questionable assumption. We introduced a new copula-based model (CO-CUB) for the transition probability, which can handle the dependent structure of best–worst choices while applying a very practical constraint. We used a conditional logit model to calculate the utility at consecutive time points and spread it to future time points under dynamic programming. We suggest that the CO-CUB transition probability algorithm is a novel way to analyze and predict choices in future time points by expressing human choice behavior. The numerical results inform decision making, help formulate strategy and learning algorithms under dynamic utility in time for best–worst DCEs.

Diverse species of lactic acid bacteria (LAB) are involved in the spontaneous fermentation of lait caillé, a traditional milk product from Burkina Faso. However, there is little information on the identity of the non-LAB occurring in the fermentation. The objective of this study was to provide information on the identity of non-LAB originating from traditional lait caillé and capable of growing abundantly on standard media used for dairy LAB isolation. Man Rogosa Sharp (MRS) and M17 agar plates previously inoculated with traditional lait caillé were used to screen for gram-negative (catalase-positive or -negative) and gram-positive catalase-positive bacteria. Pure colonies were selected, then the penta-GTG oligonucleotide (GTG)5-based rep-PCR fingerprinting followed by cluster analysis and sequencing of the 16S rRNA gene was performed to identify the isolates. These data will provide key information on the presence of bacteria associated with emerging public health risks. In addition, they may provide insights for a broader investigation of non-LAB occurring in the fermentation of unpasteurized milk and for selective media development.

La maladie hémorroïdaire est un état pathologique caractérisé par une dilatation de la veine recto-anale plexus. Une enquête ethnobotanique a révélé l’utilisation des écorces de tronc de Parkia biglobosa (Jacq.) sous forme de pommade ou décoction en lavement anal pour son traitement. L’objectif de cette étude était de caractériser l’extrait afin de formuler des suppositoires. Un screening phytochimique et une caractérisation physico-chimique suivi évaluation de l'activité antioxydante et antiinflammatoire de l’extrait ont été réalisés. Une formulation des suppositoires a été définie à partir d’une stratégie utilisant deux masses à suppositoire (Witerpsol H15 et Suppocire ASX2). Les suppositoires obtenus ont fait l’objet de contrôle qualité et d’évaluation de l’efficacité. L’extrait était de couleur marron avec une texture fine. Son taux d’humidité était à 4,67 et le pH de 7,17. Les suppositoires avaient une forme allongée, une texture et un aspect uniforme avec un temps moyen de ramollissement de 8,36min et un point de fusion moyen de 37,3°C. L’étude phytochimique a permis de mettre en évidence des flavonoïdes. L’évaluation de l’activité antioxydante a donné une concentration inhibitrice (IC50) de 9,35 µg/ml Par ABTS, un pourcentage d’inhibition de 54,34% par LPO et l’activité Antiinflammatoire par l’inhibition de la LOX avec une IC50 de 19,01 µg/ml. Les études réalisées offrent une alternative d’utilisation de l’extrait sous forme de suppositoires pour le traitement de l’inflammation de la maladie hémorroïdaire.

Solid dispersion formation by Hot melt extrusion (HME) is a widely used formulation strategy to improve the solubility and bioavailability of poorly water-soluble drugs. Despite this, they are limited by various factors such as drug-excipient miscibility, poor stability, limited drug loading and extrudability of physical drug-excipient mixtures. In this work, polyethylene glycol 8000 (PEG 8000) was used as a plasticizer for the manufacture of ellagic acid solid dispersions (EASD) with high drug loading. Indeed, EA is a polyphenolic active compound with antimalarial and other promising therapeutic activities. However, its low solubility and low permeability limit its therapeutic use. Solid dispersions formation may overcome this challenge, but its high melting point negatively influences the extrudability of its binary physical mixtures with a high drug loading rate, hence the need to use a plasticizer. Thus, five formulations consisting of EA, Eudragit® EPO and PEG 8000 in the ratio of 15:75:10 (F1), 20:70:10 (F2), 25:65:10 (F3), 15:80:5 (F4) and 20:85:5 (F5) % w/w, respectively, have been extruded, four of which were successful. The extrudates were evaluated by X-ray powder diffraction, FTIR spectroscopy and in vitro dissolution tests. Based on the results of these tests, the F5 formulation was identified as the most promising. Indeed, after 15 min of dissolution test, the dissolution rate of ellagic acid from the formulations was 62.67±3.10%, 58.74±7.23 %, 88.75±3.02% and 83.47±4.40% respectively for formulation F1, F2, F4 and F5. Moreover, the results of the FTIR spectroscopy analyses showed stronger interactions between the different constituents in the F4 and 5 formulations compared to the F1 and 2 formulations. Extruded materials of the F5 formulation, characterized by solid state nuclear magnetic resonance (ssNMR) spectroscopy and subjected to stability studies, showed good physical stability for twelve months under real-time stability study conditions and for six months under accelerated conditions.

Abstract Introduction Although an essential frontline service in the prevention of child morbidity and mortality, there are indications that routine vaccinations have been disrupted during the COVID-19 pandemic. The present study aimed to compare vaccination coverage before COVID-19 in Mali in 2019 and during COVID-19 in 2020. Objective To compare vaccination coverages before COVID-19 in Mali in 2019 and during COVID-19 in 2020. Design Cross-sectional study. Setting and participants We collected routine immunization data from 2019 to 2020 of children under one year in the health district of Commune V in Bamako which includes twelve community health centers (CSCom). Results Considering all vaccines together, coverage in 2019 was higher than in 2020 (88.7% vs. 71,6%) (p

Ce présent article analyse le rôle de la communication participative dans l’insertion socio-économique des femmes déplacées internes (FDI) dans la province du Gourma à partir du dispositif de communication de l’agence CORADE. Une revue documentaire couplée d’une enquête qualitative a été réalisée auprès de 62 personnes à travers un guide d’entretien semi- directif et une fiche d’observation. Les résultats indiquent que les actions de communication participative ont développé d’une part, la résilience des FDI et a facilité d’autre part, l’insertion socio-économique des FDI. Mots clés : crise humanitaire, communication participative, insertion socioéconomique, déplacées internes, résilience.

There has been increasing interest in best–worst discrete choice experiments (BWDCEs) in health economics, transportation research, and other fields over the last few years. BWDCEs have distinct advantages compared to other measurement approaches in discrete choice experiments (DCEs). A systematic study of best–worst (BW) choice pairs can be traced back to the 1990s. Recently, new ideas have been introduced to the subject. Calculating utility helps measure the attractiveness of BW choices. The goal of this paper is twofold. First, we extend the idea of the BW choice pair to include dynamic, time-dependent transition probability and capture utility at each time and for each choice pair. Second, we used the geometry of BW choice pairs to capture the correlations among them and to characterize and clarify the BW choice pairs in the network, where properties can be derived within each class. This paper discusses BWDCEs, the probability transition matrix of choices over time, and the utility function. The proposed network classification for BW choice pairs is laid out. A detailed simulated example is presented, and the results are compared with the classical K-means classification.

The study presents a comparative analysis of climate data under two scenarios: a Gaussian copula marginal regression model for count time series data and a copula-based bivariate count time series model. These models, built after comprehensive simulations, offer adaptable autocorrelation structures considering the daily average temperature and humidity data observed at a regional airport in Mobile, AL.

Résumé : La présente recherche s’inscrit dans la perspective de trouver une solution alternative à l’insécurité dans le Delta Intérieur du Niger et le Seeno au Centre du Mali. Son objectif est d’analyser les propositions de réponses endogènes à cette crise. La démarche méthodologique de type qualitatif, s’est appuyée sur la revue documentaire. Avec un échantillon de cinq cent dix (510) individus répartis entre les deux zones à travers des entretiens individuels et des focus-groupes, les données collectées ont fait l’objet d’une analyse de contenu des discours. Les résultats de l’étude montrent la volonté générale des populations locales à en finir avec le conflit. Il ressort qu’une sortie de crise définitive passe par un changement de paradigme dans le traitement de la question. Pour cela, certains acteurs négligés par l’Etat sont mieux désignés pour faire aboutir la paix dans le Delta Intérieur du Niger et le Seeno. Mots clés : Acteurs locaux, Delta Intérieur du Niger, Insécurité, Propositions, Seeno.

BackgroundApproximately 70% of Sub-Saharan African countries have experienced armed conflicts with significant battle-related fatalities in the past two decades. Niger has witnessed a substantial rise in conflict-affected populations in recent years. In response, international cooperation has aimed to support health transformation in Niger’s conflict zones and other conflict-affected areas in Sub-Saharan Africa. This study seeks to review the available evidence on health interventions facilitated by international cooperation in conflict zones, with a focus on Niger.MethodsWe conducted a systematic literature review (SLR) adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted from 2000 to 4 September 2022 using MeSH terms and keywords to identify relevant studies and reports in Sub-Saharan Africa and specifically in Niger. Databases such as PubMed (Medline), Google Scholar, Google, and gray literature were utilized. The findings were presented both narratively and through tables and a conceptual framework.ResultsOverall, 24 records (10 studies and 14 reports) that highlighted the significant role of international cooperation in promoting health transformation in conflict zones across Sub-Saharan Africa, including Niger, were identified. Major multilateral donors identified were the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), United Nations Fund for Population Activities (UNFPA), World Bank, United States Agency for International Development (USAID), European Union, European Commission Humanitarian Aid (ECHO), Global Fund, and Global Alliance for Vaccines and Immunization (GAVI). Most supports targeted maternal, newborn, child, adolescent, and youth health, nutrition, and psycho-social services. Furthermore, interventions were in the form of public health initiatives, mobile clinic implementation, data management, human resource capacity building, health information systems, health logistics, and research funding in conflict zones.ConclusionThis literature review underscores the significant engagement of international cooperation in strengthening and transforming health services in conflict-affected areas across Sub-Saharan Africa, with a particular focus on Niger. However, to optimize the effectiveness of healthcare activities from short- and long-term perspectives, international partners and the Ministry of Public Health need to re-evaluate and reshape their approach to health intervention in conflict zones.

ABSTRACT: The thyroid gland is susceptible to chemical exposure such as organophosphate insecticides (OPIs). With the ubiquitous nature of these products, humans are simultaneously exposed to a multitude of chemicals. This study aimed to evaluate the association between an individual and a mixture of OPI metabolites and changes in serum thyroid hormone (TH) concentrations. The analyzed data were 1,434 participants from the United States National Health and Nutrition Examination Surveys (NHANES) cycle 2007‐2008. Generalized linear model (GLM) regression, weighted quantile sum (WQS), and adaptive least absolute shrinkage and selection operator (adaptive LASSO) regression were used to investigate the associations between urinary OPI metabolites and altered serum THs. In GLM, all of the five urinary OPI metabolites were inversely associated with free triiodothyronine (FT3) among the male subjects; meanwhile, higher thyroglobulin (Tg) was related to dimethylphosphate (DMP). Moreover, in WQS models, the metabolite mixture induced FT3 down-regulation (β = ‐0.209 (95% CI: ‐0.310, ‐0.114)), and caused an increased Tg concentration (β = 0.120 (95% CI: 0.024, 0.212)), however, any significant association was observed among female participants. Consistently, the weighted index and LASSO coefficient demonstrated dimethylthiophosphate (DMTP) as the strongest metabolite in the FT3 model (mean weight= 3.449e-01 and β =‐0.022, respectively), and dimethylphosphate (DMP) represented the highest association in the Tg model (mean weight= 9.873e-01 and β =‐0.020, respectively). Further research is required to confirm our results and investigate the clinical impacts of these disruptions.

Résumé : Parler de l’impact de la décentralisation sur la participation de la femme au développement local revient à questionner son rôle ainsi que celui des organisations féminines dans la gouvernance des collectivités locales. L’objectif principal est de contribuer à l’amélioration de la participation des femmes et leur contribution dans le développement local. La méthodologie a combiné les conclusions de méta-analyse d’études et d’enquêtes qualitatives (20 entretiens individuels et 7 focus groupes) qui a permis de recueillir d’importantes informations et données sur les aspects théoriques et pratiques des expériences dans trois régions du Burkina Faso (le Nord, le Centre Ouest et l’Est), particulièrement dans six communes urbaines et trois communes rurales. Les résultats soulignent l’existence d’une faible représentativité des femmes dans les instances locales de décision ainsi que leur faible participation aux processus, liés aux obstacles d’ordre socioculturel, humain, financier et stratégique. En somme, les femmes devraient saisir les enjeux de la décentralisation et s’organiser en fonction des opportunités existantes, car l’impact de leur participation au développement local peut modifier les relations hommes-femmes vers une transformation sociale équitable. Mots-clés : décentralisation, développement local, participation, genre, femme.