Nutritional and Obstetric Determinant of Iron Deficiency Anemia among Pregnant Women Attending Antenatal Care Services in Public Health Hospitals in Abidjan (Côte d'Ivoire): A Cross-Sectional Study.

Poorly diversified and micronutrient-deficient dietary intakes during pregnancy remain one of the major causes of nutritional anemia in developing countries. However, data on diet and its relation to anemia in pregnant women in Côte d'Ivoire are scarce. The objective of this study was to determine prevalence and iron deficiency anemia associated factors in pregnant women in Abidjan. A cross-sectional study was conducted among 389 pregnant women attending antenatal care services at public health hospitals in Abidjan. Sociodemographic, obstetrical, and dietary data were collected. Blood samples taken by venipuncture were analyzed for hemoglobin and iron biomarkers. Data were subjected to descriptive statistics and multivariate logistic regression. 47.8% of the pregnant women tested were anemic, 25.8% and 30.4% had iron deficiency and iron deficiency anemia, respectively. Based on AORs, the second and third trimesters of pregnancy (6.04 v 4.18, respectively), multiparity (13.18), skipping meals (3.05), inadequate energy (5.369), protein (2.74), and vitamin C (2.43) intakes and low dietary diversity (8.35) are the independent and significant determinants of iron deficiency anemia. The high prevalence of anemia among pregnant women in Abidjan reveals a real public health problem. Iron deficiency anemia is due to multiparity, gestational age, inadequate intake, low dietary diversity, and skipping meals.

Assessments of serum copper and zinc concentration, and the Cu/Zn ratio determination in patients with multidrug resistant pulmonary tuberculosis (MDR-TB) in Côte d'Ivoire.

BACKGROUND: In Côte d'Ivoire, multidrug-resistant tuberculosis (MDR-TB) is a serious public health problem with a prevalence estimated at 2.5% in 2006. Zinc and copper are essential Trace element needed to strengthen the immune system and also useful in the fight against tuberculosis. The Cu / Zn ratio is a good indicator of oxidative stress. The principal aim of this study was to evaluate the serum concentration of some trace element and determine the Cu / Zn ratio in patients with multidrug resistant pulmonary tuberculosis (MDR-TB) before and after second line treatment of TB. METHODS: Blood samples were obtained from 100 MDR-TB patients after confirmation of their status through the microscopic and molecular diagnosis of resistance to Isoniazid and Rifampicin by GeneXpert. The concentration level of zinc and copper were determined using flame air / acetylene atomic absorption spectrometer (AAS) Type Varian Spectr AA-20 Victoria, Australlia. RESULTS: A significant decrease in zinc levels (P < 0.05) and an increased Cu / Zn ratio (P < 0.05) was observed in MDR-TB patients compared to controls TB free. During treatment a significant reduction in Cu / Zn ratio (P < 0.05) was observed compared to the initial result. CONCLUSIONS: The decrease in serum zinc level and the high Cu / Zn ratio could explain the immune system dysfunction and the high level of oxidative stress in patients with MDR-TB. Therefore the evaluation of the zinc and copper status could represent essential parameters in monitoring of TB second line treatment for better treatment management.

Randomized trial of artesunate-amodiaquine, atovaquone-proguanil, and artesunate-atovaquone-proguanil for the treatment of uncomplicated falciparum malaria in children.

BACKGROUND: Artemisinin-based combination therapies (ACTs) are recommended for the treatment of acute uncomplicated falciparum malaria in many malaria-endemic countries. Despite the emergence of artemisinin resistance, few alternative non-ACTs, including atovaquone-proguanil, are currently available. METHODS: Plasmodium falciparum-infected Cameroonian children ≤5 years old (n = 338) were randomly assigned to artesunate-amodiaquine, atovaquone-proguanil, or artesunate-atovaquone-proguanil treatment groups and followed for 28 days, according to the standard World Health Organization protocol. In vitro response to atovaquone and cytochrome b sequence of clinical isolates were determined. RESULTS: Eight late failures and 16 failures (8 late and 8 early failures) were observed after artesunate-amodiaquine and atovaquone-proguanil therapies, respectively. Most late failures were due to reinfections. Artesunate-atovaquone-proguanil was not associated with any failure. After correction by genotyping, per-protocol analysis showed no difference in the efficacy of 3 drugs. However, the proportion of atovaquone-proguanil-treated patients with positive smears on day 3 was much higher (36.0%; P < .05) than that of the artesunate-amodiaquine (2.9%) and artesunate-atovaquone-proguanil (1.0%) groups. In vitro response and cytochrome b sequence did not indicate atovaquone resistance. CONCLUSIONS: Atovaquone-proguanil was characterized by a slow blood schizontocidal action and resulted in early treatment failure in a few patients. Artesunate-atovaquone-proguanil was a highly effective alternative treatment. CLINICAL TRIALS REGISTRATION: UMIN000003813.

[Evaluation of the anti-inflammatory activity and phytochemical screening of Annona senegalensis leaves]. / Évaluation de l'activité anti-inflammatoire et screening phytochimique des feuilles de Annona senegalensis.

OBJECTIVE: This study aims to highlight the anti-inflammatory activity of ethanol extract of Annona senegalensis and do its phytochemical screening. METHODS: Rats were divided into three groups. The first group received only saline injection and instillation by intraperitoneal injection on days D0 and D7. This phase was the sensitization of that group. Then, on days D21, D22 and D23, the rats of the same group (Group 1) were injected with saline under anesthesia. The second group (Group 2) was composed of rats had not undergone treatment with the extract of Annona senegalensis. The rats in this batch have been sensitized by intraperitoneal injection (50 µL) of a solution of albumin (50 mg/rat) dissolved in aluminum hydroxide on days 0 and 7. Then during the challenge phase, saline containing 0.9% sodium chloride were injected intraperitoneally on days D21, D22 and D23. The sacrifice took place at D24 or 24 hours after the last challenge to ovalbumin. Similarly, rats of the third group (Group 3) have been sensitized by ovalbumin combined with aluminum hydroxide on days D0 and day D7. Then during the stage of provocation, rats in this batch received at days D21, D22 and D23, conjugated injection of albumin and ethanol extract of Annona senegalensis (injection of 0.4 mL of 7.10(-2) mg/kg body weight). The aqueous extract of Annona senegalensis has been previously prepared in saline. Twenty four hours after the last injection corresponding to D23, the rats were sacrificed under anesthesia. Secondary metabolites have been characterized by physico-chemical properties. RESULTS: Rats in the control (Group 1) gave an average of 24 ± 0.02 mast cells, 7 ± 0.1 macrophages, 9 ± 0.05 eosinophils. In the control group was not revealed the presence of neutrophils. Following the steps of provocation and awareness albumin (Group 2), we observed a significant increase in the number of inflammatory cells compared to control group (p < 0.001). Indeed, mast cells and macrophages have suffered increased respectively to 164 ± 0.01 and 253 ± 0.04. While eosinophils have increased from 9 ± 0.05 to 81 ± 0.01. There were 31 ± 0.02 neutrophils in Group 2. Group 3 treated with Annona senegalensis (7.10(-2) mg/kg) induced a significant decrease in the number of inflammatory cells compared to control group (p < 0.001). Indeed, mast cells decreased from 164 ± 0.01 to 89 ± 0.03. Similarly, the number of macrophages decreased from 253 ± 0.04 to 175 ± 0.06 and neutrophils decreased from 31 ± 0.02 to 10 ± 0.05. Finally, the eosinophils have suffered a decrease (from 81 ± 0.01 to 61 ± 0.08). However, after treatment with the extract, the values of different cell types have always been significantly higher (p < 0.001) compared to those in the control group (except neutrophils). This result indicates that the extract of Annona senegalensis did not completely inhibit the inflammatory effect induced by albumin. The major classes of secondary metabolites, terpenoids, coumarins, flavonoids and tannins were detected in the leaves of the plant. However, they are low in alkaloids and substances quinone. CONCLUSION: The extract induced a significant decrease in the number of inflammatory cells. This effect is likely due to higher concentrations of tannins and phenolic compounds in the extract of plant. Thus this study provides a scientific validation of the use of this plant against asthma and cough in the Ivorian pharmacopoeia. However, its mechanism of action remains to be elucidated.

[Monitoring the chemoresistance of Plasmodium falciparum malaria in Yopougon (Abidjan): in vivo study of chloroquine sensitivity and evaluation of pyrimethamine resistance following the analysis of point mutation in the dihydrofolate reductase gene]. / Mise en place d'un système de surveillance de la chimiorésistance de Plasmodium falciparum à Yopougon (Abidjan) : étude in vivo de la sensibilité à la chloroquine et évaluation de la résistance à la pyriméthamine après analyse de la mutation ponctuelle du gène de la dihydrofolate réductase.

A major endemic in Côte d'Ivoire, malaria is the first cause of hospital admissions and mortality in tropical Africa. The decrease of morbidity and mortality depends on early diagnosis and relevant treatment. This situation is hampered by an emerging resistance of P. falciparum to usual drugs such as chloroquine and sulfadoxine-pyrimethamine. In recognition of this problem, we established a monitoring system in the north of Abidjan (Yopougon) in order to better analyse P. falciparum resistance. The molecular basis of P. falciparum resistance to pyrimethamine is associated with point mutations in the dihydrofolate reductase (dhfr) gene. The presence of a wild-type codon 108-ser is defined by the presence of an Alu1 restriction site. A single base change resulting in the change of amino acid from 108-Ser to 108-Asn or 108-Thr results in the appearance of a Bsr1 or a Scrf1 restriction site respectively. In response to these needs, 42 children aged 6 to 59 months were enrolled in the study by using tests of therapeutic efficacy of chloroquine (14-day in vivo test of WHO). Before treatment, infected blood samples were stored at 20 C until P. falciparum DNA extraction. The results of the in vivo sensitivity of chloroquine showed 84.3% of plasmodic rate, 97.7 % of P. falciparum against 2.3% of P. malariae. However, 78.6% of adequate clinical response (ACR) was obtained and 21.4% of early therapeutic failure (ETF). At the end of the study, clearance of parasitemia and fever was obtained but the gametocytic rate was 4.8%. More, RFLP studies of amplified DNA fragment revealed that P. falciparum from 12 children (44.5%) had point mutation in the codon 108 of the dhfr gene. The mutation of these isolates was based on the change of amino-acid from 108-Ser to 108-Asn. Moreover, 51.8% of isolates were of the wild type. In conclusion, our results showed that chloroquine resistance is a reality in Abidjan just like anywhere else in West Africa. However, the number of isolates which had point mutation in the dhfr gene suggested that the future approach must be the study of possible correlation between the in vivo sulfadoxine-pyrimethamine test and point mutations in the dihydrofolate reductase and in the dihydropteroate synthase gene of P. falciparum from Côte d'Ivoire.

[Comparison of the mechanism of cardiotonic action of the fraction 3 of MAI-BAO and digoxin on rat isolated heart]. / Comparison du mecanisme de l'action cardiotonique de la fraction 3 de MAÏ-BAO et de la digoxine sur le coeur isole de rat.

UNLABELLED: MAI-BAO (MB) is a beverage obtained by fermentation of sweet Camellia sinensis tea by the Tea-Mushroom treasure. The action of the chromatographic fraction 3 of MAI-BAO (MB-F3) is cardiotonic. AIMS: To compare the mechanism of cardiotonic activity of MB-F3 and digoxin (Dx) in rats. MATERIALS AND METHODS: MB-F3 obtained by gel chromatography on sephadex G-50 and digoxin are used to infuse the isolated rat heart with the device Langendhorff for the record of cardiac contractions. The biochemical mechanism of cardiac effect of MB-F3 and Dx was determined by measuring phosphorus by the method of Sumner. RESULTS: MB-F3 has a significant positive inotropic effect (P<0.05) as Dx (P <0.01) with respective effective Doses 50% 1mg/ml and 10-6 mg/ml. Furthermore, MB-F3 exerts a competitive inhibition on the ATPase-Na+/K+ less than Dx (P<0.05). CONCLUSION: MB-F3 exerted digitalis-like effect less than digoxin on the rat heart.

[Reversible immunosuppression, liver and kidney markers, calcium and phosphorus in the healthy rabbit]. / Immunosuppression reversible, marqueurs du foie, des reins et metabolisme phosphocalcique chez le lapin sain.

AIM: The aim of this study was to determine one or several doses of Methylprednisolone ( MP) who leads a long time of immunosuppression without disrupting phosphor and calcium, liver and kidney markers at the healthy rabbit. MATERIAL AND METHODS: This study was made to fifteen rabbit. Five (5) batches were constituted according to Nacl and Methylpredmisolone administered dose by body weight. Control batch ( Nacl 0,9%); batch I (2,5mg / kg MP); batch II ( 5mg / kg MP); batch III ( 10mg / kg MP) and batch IV ( 15 mg / kg MP). Biochemical parameters were measured by chemical and enzymatic methods. RESULTS: The results of this study showed an immunosuppression during seven days with 10 and 15 mg / kg of MP doses (P < 0.05). The biochemical disturbances were only observed with 15 mg / kg dose where calcium was lowered to day 15 and TGO increased to day 3 according to day 0 (P < 0.05). CONCLUSION: This study showed that the doses which lead a long time of immunosuppression ( 7 days) are 10 and 15 mg / kg of MP, then the dose which does not disrupt the biochemical parameters is 10 mg / kg of MP.

[Effect of the minor and moderate malnutrition on immunity, inflammatory and nutritional proteins at Côte d'Ivoire child]. / Effet des Malnutritions Mineure et Moderee sur les Proteines Immunitaires, Inflammatoires et Nutritionnelles Chez L'Enfant en Cote D'Ivoire.

This study was realiszed in Côte d'Ivoire at the children from 5 to 15 years old. The purpose of this study was to determine the alteration of immunity, inflammatory and nutritional proteins at 142 children (30 minor and 12 moderated malnutrition). The nutritional state or the state of malnutrition was to appreciate by Weight/height ratio which is the most usued by far. Immunity, inflammatory and nutritional proteins were measured by radical immunodiffusion according to Mancini. The results of this study showed that the Albumin was lowered (p<0.01) during the moderate and minor malnutrition in comparison to the children.On the other hand, it was observed an increased of CRP in both forms of malnutrition (p<0.05).Also, the index prognostic nutritional and inflammatory who, allows to appreciate simultaneously the inflammatory and nutritional state (PINI) was increased in the malnutrition moderated with regard to the minor malnutrition and to the children (p<0.05).Besides, immunity proteins remain unchanged in both forms of malnutrition in comparison to the healthy children (p<0.05). Finally, this study shows that the moderate and malnutrition are associated with an inflammatory process and of protein consumption notably the Albumin .These observations suggest that determination of the nutritional status requires the use of the clinical method coupled with the biological examinations.

Influence of Mitragyna ciliata (MYTA) on the microsomal activity of ATPase Na+/K+ dependent extract on a rabbit heart.

Mitragyna ciliata (MYTA) (Rubiaceae) inhibits plasmodia activity. MYTA induces a cardiotonicity of the digitalic type on rat's isolated heart. In this work we studied the effect of MYTA on microsomal Na(+)/K(+) dependant ATPase (Na(+), K(+) ATPase) extracted from the heart of a rabbit since digitalics inhibit Na(+), K(+) ATPase. Our results revealed that the Na(+)/K(+) ATPase has an optimum pH of 7.4 and temperature of 37 degrees C respectively. There is a linear relationship between the organic phosphate formed and the incubation time over 25 mins incubation period. The ATP hydrolysis rate in the presence of MYTA was 0.775 microM/min. LINEWEAVER and BURK plots showed that MYTA did not alter K(M) (1.31 mM) but decreased V(MAX). This study shows that MYTA exerts a non-competitive inhibition on the microsomal Na(+)/K(+) ATPase extracted from rabbit heart with a Ci(50) of 48 microg/ml. We conclude that the mechanism of action of MYTA is linked to the inhibition of the Na(+)/K(+) ATPase like cardiotonics of the digitalic type.