Inventory of the epidemiological situation of leprosy in Haiti (2013-2017) for the Five-Year Plan: A first stage toward the implementation of the international strategy to combat leprosy, 2016-2020.

Leprosy is endemic in Haiti and remains a disease misunderstood by the population. In 2018, the national program to fight tuberculosis and leprosy (PNLTL) produced its first strategic plan against leprosy to implement the international strategy of the World Health Organization (WHO). The objective of this study was to describe the epidemiological situation of leprosy in Haiti, to assess its prevalence and morbidity, and to guide the strategies of the national plan. A retrospective study of all cases of leprosy diagnosed in the three centers providing care for this disease in Haiti reviewed the new cases at these centers from January 2013 through December 2017. In all, 232 new patients were recorded, or 49 new cases a year. Multibacillary leprosy was predominant: 86%, compared with the international mean of 60 %. Children accounted for 14 % of the new cases (7.5 % internationally), a finding that is evidence of active community transmission. Of the new cases in 2017, 8 %, including one child, had grade 2 impairments. Nearly all the leprosy cases - 94 % (218/232) - came from the two districts with treatment centers (West and Artibonite). Efforts must continue to implement the international strategy to fight leprosy to ensure a reduction by 2020 in the rate of grade 2 impairments among new cases and the number of new cases among children.

On the unusual weak intramolecular C...C interactions in Ru3(CO)12: a case of bond path artifacts introduced by the multipole model?

In a recent publication in this journal, an experimental charge density analysis on the triruthenium cluster Ru(3)(CO)(12) showed unusual C...C bond paths linking the axial carbonyl ligands [Gervasio, G.; Marabello, D.; Bianchi, R.; Forni, A. J. Phys. Chem. A 2010, 114, 9368, hereafter GMBF]. These were also observed in one theoretical DFT calculation, and are associated with very low values of ρ(r(b)) and ∇(2)ρ(r(b)). Our independent experimental charge density analysis on Ru(3)(CO)(12) is entirely consistent with GMBF and confirms the presence of these apparent weak interactions in the multipole model density. However, we conclusively demonstrate that these unusual C...C bond paths between the axial carbonyl ligands are in fact artifacts arising from the Hansen-Coppens multipole model, which is used to analyze the experimental data. Numerous relativistic and nonrelativistic gas-phase DFT calculations, using very extensive basis sets and with corrections for dispersion effects, uniformly fail to reproduce these intramolecular features in the QTAIM topology of the electron density. Moreover, multipole fitting of theoretical static structure factors computed from these quantum electron densities results in the reappearance of the C...C bond paths between the axial carbonyl ligands in the derived molecular graphs. On the other hand, using the experimental structure factors to generate "experimental" X-ray constrained DFT wave functions once again yields molecular graphs which do not show these secondary C...C bond paths. The evidence therefore strongly implicates the multipole model as the source of these spurious features and in turn suggests that great caution should be applied in the interpretation of bond paths where the values of ρ(r(b)) and ∇(2)ρ(r(b)) are very low.

On the calculation of the electrostatic potential, electric field and electric field gradient from the aspherical pseudoatom model.

Accurate, yet simple and efficient, formulae are presented for calculation of the electrostatic potential (ESP), electric field (EF) and electric field gradient (EFG) from the aspherical Hansen-Coppens pseudoatom model of electron density [Hansen & Coppens (1978). Acta Cryst. A34, 909-921]. They are based on the expansion of |r' - r|(-1) in spherical harmonics and the incomplete gamma function for a Slater-type function of the form R(l)(r) = r(n) exp(-alpha ). The formulae are valid for 0 < or = r < or = infinity and are easily extended to higher values of l. Special treatment of integrals is needed only for functions with n = l and n = l + 1 at r = 0. The method is tested using theoretical pseudoatom parameters of the formamide molecule obtained via reciprocal-space fitting of PBE/6-31G** densities and experimental X-ray data of Fe(CO)(5). The ESP, EF and EFG values at the nuclear positions in formamide are in very good agreement with those directly evaluated from density-functional PBE calculations with 6-31G**, aug-cc-pVDZ and aug-cc-pVTZ basis sets. The small observed discrepancies are attributed to the different behavior of Gaussian- and Slater-type functions near the nuclei and to imperfections of the reciprocal-space fit. An EF map is displayed which allows useful visualization of the lattice EF effects in the crystal structure of formamide. Analysis of experimental 100 K X-ray data of Fe(CO)(5) yields the value of the nuclear quadrupole moment Q((57)Fe(m)) = 0.12 x 10(-28) m(2) after taking into account Sternheimer shielding/antishielding effects of the core. This value is in excellent agreement with that reported by Su & Coppens [Acta Cryst. (1996), A52, 748-756] but slightly smaller than the generally accepted value of 0.16 +/- 5% x 10(-28) m(2) obtained from combined theoretical/spectroscopic studies [Dufek, Blaha & Schwarz (1995). Phys. Rev. Lett. 25, 3545-3548].

Mycobacterial heat-shock proteins as carrier molecules.

We have previously shown that the priming of mice with live Mycobacterium tuberculosis var. bovis (Bacillus Calmette-Guérin, BCG) and immunization with the repetitive malaria synthetic peptide (NANP)40 conjugated to purified protein derivative (PPD), led to the induction of high and long-lasting titers of anti-peptide IgG antibodies, overcoming the requirement of adjuvants and the genetic restriction of the antibody response to the peptide (Lussow et al., Proc. Natl. Acad. Sci. USA 1990. 87:2960). This initial work led us to the following observations. BCG had to be live for priming to lead to the induction of anti-peptide antibodies. Surprisingly, priming with other living microorganisms which chronically infect the macrophage (e.g. Salmonella typhimurium and Leishmania major) also induced anti-peptide antibodies in mice immunized with PPD-(NANP)40 conjugate. It was, thus, hypothesized that molecules expressed during active infection and also known to be highly conserved between species, namely the heat-shock proteins (hsp), could mediate the T cell sensitization required for the production of anti-peptide antibodies. In fact, when the PPD protion of the conjugate was replaced by a highly purified recombinant protein corresponding to the 65-kDa (GroEL-type) hsp of M. bovis, this resulted in the production of anti-(NANP) IgG antibodies in BCG-primed mice, irrespective of the major histocompatibility complex-controlled responsiveness to the (NANP) sequence itself. Further, similar induction of anti-peptide antibody response was also obtained with a recombinant 70-kDa (DnaK-type) hsp of M. tuberculosis, but not with a small molecular mass (18 kDa) of M. leprae. Finally, an adjuvant-free carrier effect for anti-peptide IgG antibody production in BCG-primed mice, was also exerted by the GroEL hsp of Escherichia coli. This finding that hsp can act as carrier molecules without requiring conventional adjuvants is of potential importance in the development of vaccine strategies.

[A survey of the prevalence of leprosy in 5 countries in central Africa]. / Enquêtes de prévalence de la lèpre dans 5 pays d'Afrique Centrale.

The authors report the results of national surveys conducted in 5 Central Africa states: Cameroon, Congo, Gabon, Equatorial Guinea and RCA. The method used was cluster sampling among random populations. Only adults (greater than 15 years of age) took part in the study. The prevalence rates were between 6 and 14 per thousand. They are markedly higher than the official data.

[Epidemiology of endemic leprosy in the People's Republic of the Congo. Risk factors and markers]. / Epidemiologie de l'éndemie lépreuse en République Populaire du Congo. Facteurs et marqueurs de risques.

A national prevalence survey of leprosy was made in june 1989 in Popular Republic of Congo: authors report results. The prevalence rate is 5.8% +/- 2.6% among people more than 15 years of age, and 10.5% of all forms are multibacillary. All patients are under DDS monotherapy. One overwhelming risk factor is leprosy antecedents in the family history; active case-finding and surveillance of contacts are recommended.

[Endemic leprosy in the People's Republic of Congo. An epidemiological and behavioral analysis]. / L'endémie lépreuse en République Populaire du Congo. Analyse épidémiologique et comportementale.

The authors report the results of a national prevalence survey of leprosy made in 1989 in Popular Republic of Congo. Leprosy is essentially found in rural areas and frequently causes disabilities. The prevalence rate is 5.8 +/- 2.6% among people more than 15 years of age, and 10.5% of all forms are multibacillary. All patients are under DDS monotherapy. One overwhelming risk factor is leprosy cases in the family history; active case-finding and surveillance of contact cases are recommended. Generally, leprosy is poorly understood by the general population; an educational effort is necessary.

[The last offensive of leprosy in the South Pacific Ocean: the epidemic on Rapa (1922-1950)]. / Ultime offensive de la lèpre dans le Pacifique sud: l'épidémie de Rapa (1922-1950).

The observations of leprosy outbreaks are exceptional and always situated in isolated countries. The authors give the example of Rapa, small island in French Polynesia, where an epidemic has occurred from 1922 to 1950. They made the study of the different parameters by retrospective methods and fieldwork. After an 11% incidence rate and an 68% prevalence rate, the outbreak seems today off. Now leprosy is endemosporadic.

Characterization and functional studies of the murine T-lymphocyte response to Mycobacterium leprae antigen.

Mice were immunized with Mycobacterium leprae in incomplete Freund's adjuvant, and sensitized lymphocytes were obtained from draining lymph nodes. The lymphocytes thus obtained proliferated specifically in vitro in the presence of M. leprae antigen, and this response was shown to be both T-cell and macrophage dependent. T-cell blasts generated in vitro in response to M. leprae antigen were grown in the presence of interleukin-2 (IL-2). The proliferative response of these blasts to M. leprae antigen was strictly dependent on the presence of syngeneic spleen cells as antigen-presenting cells. M. leprae-immune F1 blasts responding to the antigen in the context of either parental H-2 haplotype-bearing accessory cell could be obtained by positive selection from an F1 hybrid-responding cell population. By means of flow microfluorometry the T-cell phenotype of the M. leprae-specific T-cell blasts was found to be Thy-1+ and to be composed of Lyt-1+ and Lyt-2+ subpopulations. Functionally, the blasts were shown to transfer delayed-type hypersensitivity locally to non-immunized recipients and to have cytolytic activity. Limiting dilution analysis showed the frequency of M. leprae-responding cells from blasts grown in IL-2 to be approximately 1/333.