Impact of the Ebola virus disease outbreak (2014-2016) on tuberculosis surveillance activities by Guinea's National Tuberculosis Control Program: a time series analysis.

BACKGROUND: Most countries in Subsaharan Africa have well-established National Tuberculosis Control Programs with relatively stable routine performances. However, major epidemiological events may result in significant disruptions. In March 2014, the World Health Organization announced the outbreak of Ebola virus disease in Guinea, a country with a high incidence of TB and HIV. Our study aimed to assess the impact of the Ebola virus disease outbreak on TB notification, treatment, and surveillance, using main indicators. METHODS: This is a retrospective cohort study that compared TB trends using surveillance data from the periods before (2011-2013), during (2014-2016), and after (2017-2018) Ebola virus disease outbreak. A time-series analysis was conducted to investigate the linkages between the decline in TB notification and the Ebola virus disease outbreak through cross-correlation. The lag in the cross-correlation test was evaluated using ANCOVA type II delayed variable dependent model. The surveillance system was assessed using TB surveillance standards and benchmarks and vital registration systems recommended by WHO, compared with those of 2015 during the Ebola virus disease. RESULTS: The rate of reporting of TB declined from 120 cases per 100,000 in 2011 to 100 cases per 100,000 in 2014, at the peak of the Ebola virus disease outbreak. The time-series cross-correlation test of all notified cases of TB and Ebola showed a significant lag of - 0.4 (40%), reflecting a drop in the rate of notification (F-value = 5.7 [95% CI: 0.2-21.3]). The Ebola virus disease had no negative impact on patient treatment outcomes (F-value = 1.3 [95% CI: 0.0-8.8]). Regarding the surveillance system, five out of 13 WHO standards and benchmarks were met following their evaluation in 2019, after the Ebola virus disease outbreak, compared to three in 2015. CONCLUSION: Major epidemics such as the Ebola virus disease outbreak may have a significant impact on well-established TB control programs as shown in the example of Guinea. Sudden disruptions of routine performance may lead programs to improve their surveillance system. The experience acquired in the fight against EVD and the investments made should make it possible to prepare the health system in a coherent manner for the other probable episodes.

Fertility after Endoscopic Surgery for Ectopic Pregnancy Management in Point "G" Teaching Hospital, Bamako-Mali.

Endoscopic surgery of ectopic pregnancy is actually the gold standard for the management of fallopian tubal diseases. A survey was conducted to evaluate fertility in patients who underwent endoscopic management for ectopic pregnancy. A retrospective study was conducted at the department of general and endoscopic surgery of the Point "G" teaching hospital, in Bamako, Mali, from January 1st 2007 to December 31, 2016. Forty-eight (48) patients who underwent endoscopic management of tubal ectopic pregnancy and who have been followed up for fertility were included in this study. Statistical tests used were X2 or Fisher test and their confident interval, p <1 % has been considered as statistically significant. The therapeutic score of Pouly was less than 4 in 25.0% (n = 12). The return to fertility was observed among 48.0% of patients (n = 23). The chance of conception was less than 80.0% after the fourth postoperative year (p=0.001). The outcome of pregnancies has been seventeen full-term pregnancies, three ectopic pregnancies and three miscarriages. The occurrence of pregnancy after endoscopic management indicated for ectopic pregnancy is possible. However, many factors can influence the future conception.

Arsenic uptake and accumulation in rice (Oryza sativa L.) with selenite fertilization and water management.

The accumulation of arsenic (As) in rice grain is a potential threat to human health. Our study investigated the possible mediatory role of selenite fertilization on As uptake and accumulation by rice (Oryza sativa L.) under different water management regimes (aerobic or flooded) in a pot experiment. Soil solutions were also extracted during the growing season to monitor As dynamics. Results showed that As contents in the soil solutions, seedlings, and mature rice were higher under flooded than under aerobic water management. Under aerobic conditions, selenite additions slightly increased As concentrations in soil solutions (in the last two samplings), but decreased As levels in rice plants. Relative to the control, 0.5 mg kg-1 selenite decreased rice grain As by 27.5%. Under flooded conditions, however, selenite additions decreased As in soil solutions, while increased As in rice grain. Tendencies also showed that selenite additions decreased the proportion of As in rice shoots both at the seedling stage and maturity, and were more effective in aerobic soil. Our results demonstrate that the effect of selenite fertilizer on As accumulation by rice is related to water management.

Mechanisms of tumor necrosis factor-alpha-induced leaks in intestine epithelial barrier.

PURPOSE: The aim of this study was to investigate the signaling mechanisms surrounding changes in tight junction (TJ) and the permeability of human intestinal epithelial cell induced by tumor necrosis factor-alpha (TNF-α). METHODS: To confirm that TNF-α induces epithelial barrier hyperpermeability by disrupting tight junction, Caco-2 cells were exposed to TNF-α, and changes in epithelial permeability (via TER assay), F-actin dynamics (via Rhodamine-phalloidin staining) and tight junction protein expression (via western blot) were monitored. Moreover, to ensure that NF-κB participated in the regulatory mechanisms, Caco-2 cells were transfected with DNMu-IκBα or control plasmids, the above experiments were repeated and the activation effect of TNF-α on NF-κB was detected by luciferase reporter assays. Lastly, we took dominant negative plasmid and knockdown approaches to investigate the potential importance of the NF-κB/myosin light chain kinase (MLCK)/myosin light chain phosphorylation (pMLC) pathways in TNF-a-mediated damage. RESULT: TNF-α could cause NF-κB activation, F-actin rearrangement, tight junction disruption and barrier dysfunction. These effects were alleviated by inhibiting NF-κB. TNF-α induced increase of MLCK transcription and MLC phosphorylation act later than NF-κB activation, which could be suppressed both by inactivating and deleting NF-κB. CONCLUSIONS: TNF-α induces intestinal epithelial cell hyperpermeability by disrupting TJs, in part through MLCK upregulation, in which NF-κB is the positive upstream regulator for MLCK.

Factors determining membership in community-based health insurance in West Africa: a scoping review.

BACKGROUND: In many low-income countries, households bear most of the health care costs. Community-based health insurance (CBHI) schemes have multiplied since the 1990s in West Africa. They have significantly improved their members' access to health care. However, a large proportion of users are reluctant to subscribe to a local CBHI. Identifying the major factors affecting membership will be useful for improving CBHI coverage. The objective of this research is to obtain a general overview of existing evidence on the determinants of CBHI membership in West Africa. METHODS: A review of studies reporting on the factors determining membership in CBHI schemes in West Africa was conducted using guidelines developed by the Joanna Briggs Institute. Several databases were searched (PubMed, ScienceDirect, Global Health database, Embase, EconLit, Cairn.info, BDPS, Cochrane database and Google Scholar) for relevant articles available by August 15, 2022, with no methodological or linguistic restrictions in electronic databases and grey literature. RESULTS: The initial literature search resulted in 1611 studies, and 10 studies were identified by other sources. After eliminating duplicates, we reviewed the titles of the remaining 1275 studies and excluded 1080 irrelevant studies based on title and 124 studies based on abstracts. Of the 71 full texts assessed for eligibility, 32 additional papers were excluded (not relevant, outside West Africa, poorly described results) and finally 39 studies were included in the synthesis. Factors that negatively affect CBHI membership include advanced age, low education, low household income, poor quality of care, lack of trust in providers and remoteness, rules considered too strict or inappropriate, low trust in administrators and inadequate information campaign. CONCLUSIONS: This study shows many lessons to be learned from a variety of countries and initiatives that could make CBHI an effective tool for increasing access to quality health care in order to achieve universal health coverage. Coverage through CBHI schemes could be improved through communication, improved education and targeted financial support.

An experimental study on dynamic morphological changes and expression pattern of GFAP and synapsin i in the hippocampus of MTLE models for immature rats.

OBJECTIVE: To establish an animal model resembling human mesial temporal lobe epilepsy (MTLE); observe the dynamic changes of mossy fiber sprouting (MFS) and neuron loss in the hippocampus; and investigate the expression changes of Glial fibrillary acidic protein (GFAP) and Synapsin I in the hippocampus in immature rats. METHODS: MTLE models of immature rats were induced by lithium-pilocarpine. The surviving animals were continually monitored for 8 weeks. Nissl staining was used to observe the neuron loss and Timm staining was performed to evaluate MFS. Western blot (WB) and immunohistochemical methods were performed to detect the expression of GFAP and Synapsin I. RESULTS: Status epilepticus (SE) was successfully induced in 94.1% of the rats with a high mortality of 68.8%; 75% of the survived rats were observed for spontaneous recurrent seizures (SRS) which resembles the features of human MTLE. Expression levels of glial fibrillary acidic protein and Synapsin I fluctuated in correspondence with the different stages of MTLE development. CONCLUSION: We established an animal model depicting the human MTLE by using immature rats. GFAP and Synapsin I expressions are involved in MTLE development. Neuron loss and mossy fiber sprouting may have a role in epileptogenesis.

Effect of Endogenous Selenium on Arsenic Uptake and Antioxidative Enzymes in As-Exposed Rice Seedlings.

Arsenic (As) and selenium (Se) are two metalloids found in the environment. As it poses a significant threat to human health and plant growth due to its prevalence and toxicity, however Se is a required micronutrient for human health. In this study hydroponic experiments were performed to investigate whether endogenous Se can mitigate As toxicity in rice (Oryza sativa L.). We found that As uptake by rice roots increased by pretreatment with selenateSe(VI) or selenite Se(IV). However, co-application of arsenate As(V) or arsenite As(III) with selenate markedly reduced the uptake of As by roots. Co- or pretreatment with Se with five µM of As(V) or one µM of As(III) significantly decreased shoot As content. Conversely, Se pretreatment before the addition of five µM of As(III) or one µM of As(V) resulted in As accumulation in the shoot compared to As and Se co-application. As translocation to the shoot was lower whereas the transfer factor was higher upon the simultaneous application of Se and As compared to Se pretreatment. Se supplementation with As(III) or pretreatment increased antioxidant enzymes: Superoxide dismutase (SOD), catalase (CAT), and peroxidase (POD) increased in the root and shoot, but decreased glutathione (GSH) and malondialdehyde (MDA) contents in the shoot. Plants under As(V) treatment showed the same trend except that CAT content decreased in the root and shoot, while MDA content increased in the shoot. These results suggest that cultivating rice in the presence of Se can reduce the accumulation of toxic As in seedlings, thus ensuring the safety of this important crop for human consumption.

Water management impacts on the solubility of Cd, Pb, As, and Cr and their uptake by rice in two contaminated paddy soils.

Agricultural soil contaminated with heavy metals and the subsequent heavy metals uptake by rice have increasingly been reported in the last few decades. In this study, pot experiments with two contaminated soils (acidic soil from Jiangxi Province and slightly alkaline soil from Hunan Province) were conducted to investigate the effects of water management (flooding and aerobic treatment) on the uptake of cadmium (Cd), lead (Pb), arsenic (As), and chromium (Cr) by rice (Oryza sativa L.). The pore water contents of these heavy metals were determined during the growing season. Flooding the soil decreased Cd, Pb, and Cr in soil pore water, but increased As in the soil solution. Relative to the aerobic treatment, flooding decreased the Cd in the soil solution by 17.3-94.5% and 54.7-88.3% in acidic and slightly alkaline soils, respectively. The total As in the soil solutions increased by 0.2-20.9 and 0.1-15.2 times throughout the growing season in acidic and slightly alkaline soils, respectively. In acidic soil, flooding significantly decreased the Cd contents in iron plaque and rice tissues, significantly increased the Cr content in iron plaque, slightly decreased the Cr uptake by rice, and decreased the Pb content in the aboveground parts of rice, and increased the Pb content in rice roots and iron plaque. Relatively fewer changes were observed in rice grown in slightly alkaline soil. Results suggested that flooding the acidic soil had mixed results on heavy metal bioavailability, and the bioavailability in slightly alkaline soil was not notably impacted by flooding.

Effects of the addition and aging of humic acid-based amendments on the solubility of Cd in soil solution and its accumulation in rice.

Humic substances can reduce mobility and bio-accessibility of Cd in soil and therefore inhibit its uptake by rice, which is a major source of human Cd intake. Yet, the effects of aging humic substances are not fully understood. A rice pot experiment was conducted to evaluate the effects of humic acid-based amendments on the mobility of Cd in soil solution and its uptake by rice when amendments were freshly added or aged for 130 d. The results showed that the aged and the unaged amendments generally decreased Cd concentration in soil solution, but the effect declined with time. Unaged HA-K (humic-potassium) reduced Cd concentration by 88% for the first sampling, but this dropped to 46% for the last sampling, compared to that of the control. All amendments, whether aged or not, reduced the content of Cd in rice seedlings, as well as in mature plants. Aged and unaged woody peat reduced the Cd content in seedlings by 79% and in grains by 70%, respectively. Aging of amendments caused lower pH and higher Cd concentration in the soil solution for all amendments and accordingly, the Cd content in rice seedlings or each part of mature plants in the aged group was higher than that of the unaged group. The applied amendments might reduce the solubility of Cd through the alteration in soil pH, and thus inhibit the uptake of Cd by rice, but the effects diminished with aging.

Cadmium dynamics in soil pore water and uptake by rice: Influences of soil-applied selenite with different water managements.

Cadmium (Cd) in rice grains is a potential threat to human health. This study investigated the effects of selenite fertilisation (0 mg kg-1, 0.5 mg kg-1, and 1.0 mg kg-1) on soil solution Cd dynamics and rice uptake. Rice was grown in two Cd-contaminated soils in Jiangxi and Hunan Provinces under two different sets of conditions: aerobic and flooded. The experiments were conducted in pots. The plants were harvested at the seedling stage and at maturity to determine their Cd levels. Soil solutions were also extracted during the growing season to monitor Cd dynamics. The results showed that in the Jiangxi soil (pH 5.25), Cd concentrations in the soil solutions, seedlings, and mature rice plants were higher under aerobic than under flooded water management conditions. In the Hunan soil (pH 7.26), however, flooding decreased Cd levels in the rice seedlings but not in mature plants. Selenite additions to the Hunan soil decreased Cd concentrations in the soil solutions and in the mature rice plants. These effects were not observed for the solutions or the plants from Jiangxi soil amended with selenite. Relative to the control treatment, 0.5 mg kg-1 selenite decreased the rice grain Cd content by 45.2% and 67.7% under aerobic and flooding conditions, respectively. The results demonstrated that water management regimes affected rice Cd uptake more effectively in Jiangxi than in Hunan soil, whereas selenite addition was more effective in Hunan than in Jiangxi soil. Selenite addition was also more effective at reducing rice grain Cd levels when it was applied under flooding than under aerobic conditions.