HIV Viral Load Scale-up Among Children and Adolescents: Trends in Viral Load Suppression, Sample Type and Processing in 7 PEPFAR Countries, 2015-2018.

HIV-positive children and adolescents face gaps in viral load (VL) testing. To understand trends in pediatric/adolescent VL testing, 7 countries collected data from Laboratory Information Management Systems. Results showed increasing proportion of VL tests done through dried blood spot (DBS) and decreased sample rejection rates for DBS compared with plasma, supporting use of DBS VL when skilled phlebotomy is unavailable.

[Recurrences of precancerous lesions after conservative treatment: Operational results after a decade in Abidjan]. / Récidives des lésions précancéreuses après traitement conservateur : résultats opérationnels après une décennie à Abidjan.

OBJECTIVES: There remains a significant risk of recurrence of intraepithelial neoplasia regardless of the type of conservative treatment. The aim's work is to assess this rate. METHODS: All women's consenting who had received conservative treatment at the sites identified since for more than 12 months were included in this multicenter cross-sectional study. The outcome measure was a recurrence of precancerous lesions of the cervix during visual inspection with acetic acid performed by a single practitioner to limit interobserver variability. Data collection and analysis were done on the Stata 13 software. We performed an univariate then multivariate analysis with logistic regression. RESULTS: Two hundred and seventy-nine participated in this study with an average age of 37.44 (σ=7.31 years). A total of 52.33% were HIV positive. Moreover, 63.44% were treated by cryotherapy versus 36.66% by loop electrosurgical excision procedure. The overall prevalence of recurrences was 8.96%. Multivariate analysis with logistic regression concluded that the risk of recurrence was 5.72 times (OR=1.69-19.29; P=0.005) higher with cryotherapy and 2.85 times higher (OR=1.04-7.82; P=0.042) in women with HIV. CONCLUSION: The risk of recurrence is proportionally high with cryotherapy and HIV status. This suggests that an adaptation of the strict monitoring protocols to our African context due to the lack of cytocolposcopic logistical resources.

[Acquired caustic vagina stenosis: Surgical outcomes of 21 cases]. / Rétrécissements du vagin d'origine caustique. À propos de 21 plasties.

OBJECTIVE: To document epidemiology, causes, anatomical varieties and surgical management outcomes of caustic acquired vagina stenosis. METHODOLOGY: Retrospective study of 21 patients involved from 1996 to 2012 at the department of obstetrics and gynecology of Yopougon's teaching hospital in Abidjan, Côte d'Ivoire. Vaginal stenosis due to genital malformation, vaginal irradiation of pelvic tumours, repair of bladder and vaginal fistulae or intersexual disorders were excluded. RESULTS: The prevalence was 0.14/1000 admissions, mean age was 32.1 years, mean gravidity was 1.76 and mean parity was 1.1. Vaginal stenosis seat and extent were variable and 100 % had a caustic origin by use of traditional medicine vaginal pessaire. Of the patients, 95.2 % underwent surgical treatment followed by several dilations sessions with glass dilators. Successful surgical outcome allowing coitus was achieved in 47.6 % of cases with 52.4 % failure. CONCLUSION: Acquired caustic vagina stenosis are frequently occurring and are a public health problem related to ignorance. Health education and establishment of expert centers with exchange of experiences in West Africa should be able to improve surgical outcomes.

Comparative effects of developmental thiamine deficiencies and ethanol exposure on the morphometry of the CA3 pyramidal cells.

Maternal alcoholism and thiamine deficiency are frequently considered to be the causal agents of the central nervous system (CNS) damage associated with mental retardation in the offspring. For further understanding of pathological mechanisms underlying CNS damage in both disorders, histological studies were undertaken in developing rats to compare the hippocampus CA3 pyramidal cells measurements and density between three patterns of thiamine deficiency and chronic alcohol exposure. Female rats were given thiamine-deficient diet during different periods of gestation and lactation to obtain pre-, peri-, and postnatal thiamine-deficient pups. Twelve percent ethanol/water drinking fluid was given to mothers throughout gestation and lactation to obtain ethanol-exposed pups. Thiamine was administered during developmental ethanol exposure to assess the extent of interference between ethanol and thiamine metabolism. Nondrug-treated dams were allowed ad lib access to food and water during gestation and lactation to yield control pups. Hippocampus histology was performed in 45-day-old rats, and the CA3 pyramidal cells measurements and density assessed and compared between all treatment groups. It appears that the mean nuclear size of pyramidal cells in the field CA3 was significantly reduced in all the treatments compared to the control. While the mean nuclear size decreased more severely in development ethanol exposure than in the three patterns of thiamine deficiency, no significant difference was noted when pre-, peri-, and postnatal thiamine-deficient rats were compared. However, thiamine administration during developmental ethanol exposure partially restored the mean nuclear size. In contrast, comparisons between ethanol-exposed pups and the three patterns of thiamine-deficient pups, exhibited similar intensity in the deficit of CA3 pyramidal cells. Cell loss generated by ethanol treatment was not suppressed by thiamine administration. Common and separate mechanisms underlying the effects of alcohol intoxication and thiamine deficiency on cell death and cell atrophy were suggested.

[Pharmacologic effects of mansonine on arrhythmias induced in isolated rat heart]. / Effets pharmacologiques de la mansonine sur des arythmies induites au niveau du coeur isolé de rat.

The effect of 3 x 10(-13) M Mansonine (MSN) was observed on arrythmias induced on isolated rat heart, perfused with either hypopotassic solution, atropine solution, or MacEwen physiological saline at 18 degrees C. Generally the reversal of induced arrythmias was complete with the hypopotassic solution, and partial with the MacEwen solution at 18 degrees C. On the other hand, when atropine and MSN were combined, their effects induced heart arrest, probably due to an intracellular calcium accumulation. In this case, the heart recovery occurred by preventing the calcium influx, either through EDTA chelation, or blockade of calcium channels. It was concluded that MSN probably acts like most cardiac glycosides, by blocking the Na(+)-K+ ATPase. This may activate a calcium influx, which causes the subsequent positive inotropic effect, as well as a negative chronotropic effect due to an increase of the membrane activation set point.

Spasmogenic effect of the aqueous extract of Tamarindus indica L. (Caesalpiniaceae) on the contractile activity of guinea-pig taenia coli.

The effect of aqueous extract of Tamarindus indica (AETI) was studied on the guinea pig taenia coli, due to its use for treatment of constipation in traditional medicines. AETI, at concentrations ranging from 10(-8) mg/ml to 10(-2) mg/ml, increased the spontaneous contractile activity of guinea pig taenia coli in a dose-dependent manner (EC50 = 4x10(-6) mg/ml). This activity was unaffected by atropine. In high K(+), Ca(2+)-free solution containing EDTA, AETI as well as acetylcholine, used as a control, induced tonic contraction. These results suggest that the plant extract exert a spasmogenic effect that would not involve cholinergic mechanism of action. However, these active principles could mobilize both extra cellular calcium and intracellular calcium from internal stores.

[Toward a new approach in population in Africa: the integration of family planning programs in rural development programs]. / Vers une nouvelle approche d'intervention en matiere de population en Afrique: l'integration des programmes de planning familial dans les programmes de developpement rural.

PIP: The author examines the benefits of integrating family planning into rural development programs in Africa, and the practicalities of so doing. (SUMMARY IN ENG)^ieng

[The integration of family planning programs into rural development programs]. / L'integration des programmes de planning familial dans les programmes de developpement rural.

PIP: Family planning programs in rural Africa have failed to yield the expected results, it is argued, because a minimal degree of modernization or development is required before couples will be motivated to limit their family sizes. This work discusses integration of family planning programs into rural development projects and defines the conditions under which such integration should occur. There is consensus that economic and social development as well as family planning programs lead to fertility decline. The conditions of agricultural production in rural Africa are believed to be factors encouraging high fertility. Women are doubly motivated to high fertility by the desire for daughters to help in daily chores in a context of poorly developed infrastructure, and for many sons in the hope that some will survive to provide support in old age. Voluntary reduction of fertility is risky in this context. Men desire many sons to assist them in their labor intensive agricultural work. Improved productivity will be necessary if higher incomes are to be achieved. Integrating family planning programs into rural development efforts focusing on village infrastructure and improving cultivation techniques should affect both development and fertility. To combat the economic motivation for high fertility, integrated programs should contain elements to improve rural infrastructure and agricultural production, to provide education in new productive techniques, and to promote family planning and maternal-child health care. Mass education on all the elements should be included. Research is needed to define needs and optimal strategies in specific contexts. Pilot projects should be conducted to test strategies before they are implemented on a wide scale.^ieng

[Chronic diarrhea and parasitoses in adults suspected of AIDS in the Ivory Coast]. / Diarrhées chroniques et parasitoses chez des adultes suspectés de SIDA en Côte-d'Ivoire.

148 adult patients with chronic diarrhoea and suspected to be HIV infected have had stool examinations. 46 are without any enteric parasite. Those detected in the others patients are Sporozoans: I. belli (16.2%) and Cryptosporidium sp. (6.7%) found alone or joint, together or with other parasites. Among those, all Flagellate species are identified, but T. intestinalis (6%) is predominant. Entamoeba coli (8.%) is the most frequent amebic species, however, E. histolytica histolytica have been found twice, once singly, the second associated with I. belli, Schistosoma mansoni and Candida albicans. Necator americanus (14%) and Strongyloides stercoralis (12%) are the predominant worm species. Among the yeasts, C. albicans (35.8%) is the most important species isolated, singly in 13.5% of the patients. In an intertropical and parasitical endemic area where many parasites are not considered uncommon, opportunist agents as I. belli, Cryptosporidium sp. and C. albicans appear in an non-negligible frequency in our study.

Detection of p53 alterations in human astrocytomas using frozen tissue sections for the polymerase chain reaction.

The polymorphism of amino acid residue 72 on the human p53 tumor-suppressor gene is a useful marker for detecting intragenic loss of heterozygosity (LOH). We examined the LOH of the p53 gene in human malignant astrocytomas by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis using DNA extracted from frozen tissue sections under histologic examination. Eleven of 16 informative cases (69%) of the malignant astrocytomas were found to have LOH in the p53 gene. Sequential frozen sections were analyzed by immunohistochemistry using anti-p53 antibody PAb1801 to detect overexpression of the p53 protein, which is presumably altered if it is detectable. Ten of the 11 cases that had LOH of the p53 gene overexpressed the p53 protein. Moreover, 4 of the 11 patients with LOH of the p53 gene developed a second neoplasm in addition to an astrocytoma, possibly indicating genetic instability in these patients. These data suggest that alterations of the p53 gene may play an important role in the genesis of malignant astrocytoma. The combination of the PCR-RFLP method and immunohistochemical analysis using frozen tissue sections is a practical diagnostic tool for examination of human malignancies, including astrocytomas. astrocytomas.