Molecular identification of Actinomadura madurae isolated from a patient originally from Algeria; observations from a case report.

BACKGROUND: Mycetoma is a chronic granulomatous subcutaneous infection caused by anaerobic pseudofilamentous bacteria or fungi. It is commonly prevalent in tropical and subtropical countries. Men are more susceptible to the disease due to greater participation in agricultural works. Mycetoma commonly involves lower extremities, wherein untreated cases lead to aggressive therapeutic choices, such as amputation of the affected body organs and consequently lifelong disability. CASE PRESENTATION: In this report, we present the rare case of a 58-year-old man, originally from Algeria with a left foot chronic tumefaction of 5 years. In the initial clinical examination, mycetoma was diagnosed based on tumefaction and the presence of multiple sinuses with the emission of white grains. The latter was observed via direct examination. The histopathological analysis demonstrated an actinomycetoma caused by bacteria, as the etiological agent. Imaging showed a bone involvement with osteolysis at the levels of 2nd to 4th metatarsal diaphysis. The mycological and bacterial cultures were both negative. For an accurate diagnosis, the obtained grains were subjected to molecular analysis, targeting the 16S-rDNA gene. Molecular identification yielded Actinomadura madurae as the causal agent, and 800/160 mg of trimethoprim/sulfamethoxazole was prescribed twice a day for 1 year, as a treatment. CONCLUSION: Considering low information about this disease, especially in non-endemic areas, it is of high importance to enhance the knowledge and awareness of clinicians and healthcare providers, in particular in the countries with immigration issues.

Antimicrobial and antibiofilm activities of phenolic compounds extracted from Populus nigra and Populus alba buds (Algeria)

The interest of this work is the discovery of new antimicrobial agents of plant origin to inhibit the formation of microbial biofilms. The present research was conducted to identify and quantify the phenolic compounds extracted from Populus nigra and Populus alba buds harvested in the area of Tizi-Ouzou (Algeria), and to evaluate their antimicrobial and antibiofilm activity. High performance liquid chromatography (HPLC) was performed to identify the phenolic compounds in the ethyl acetate fraction of P. nigra and the methanolic extracts of P. nigra and P. alba. The antimicrobial activity of the crude extracts and the fractions of these two species was tested against 11 microorganisms, using the disk diffusion method, while the antibiofilm effect of certain extracts was carried out in a 96-well microplate and on a biomaterial (catheter). HPLC analysis revealed the presence of 10 bioactive compounds. The main phenolic compounds identified in the three extracts were p-coumaric acid, ellagic acid, and Kaempferol. This study was able to demonstrate that the extracts of P. nigra and P. alba buds have interesting antimicrobial properties, with diameters ranging from 6.6 to 21.3 mm. In addition, extracts of P. nigra exhibited antibiofilm effects greater than 70%. Our results provide evidence for the antimicrobial and antibiofilm potential of bud extracts from both poplar species. Thus, these results will pave the way for further research on these two plants.

[Griscelli syndrome type 3: A new case]. / Syndrome de Griscelli de type 3 : un nouveau cas.

INTRODUCTION: Griscelli syndrome (GS) is a rare autosomal-recessive genetic disease characterized by hypopigmentation of skin and hair. We report a case of GS type 3 with late diagnosis. OBSERVATION: A 31-year-old female patient had presented depigmentation of the hair and eyebrows as well as diffuse skin hypopigmentation during childhood. Microscopic analysis of a hair shaft revealed irregularly distributed clumps of melanin. DNA sequencing showed a homozygous C103T (R35W) transition in exon 1 of MLPH, confirming Griscelli syndrome type 3. DISCUSSION: Three clinical phenotypes of GS have been described based on the underlying genetic defect. GS type 1 and 2 are associated respectively with a central nervous system dysfunction and an immune defect. GS type 3 is an isolated cutaneous form. Diagnosis is confirmed on microscopic examination of hair shafts. 15 cases of GS type 3 have been reported: 9 in males and 6 in females. Mean age at diagnosis is around 12 years. Nine of the reported patients were of Arab origin, four of Turkish origin, and one of Indian origin. R35W mutation was described in 9 cases and E98X and R35Q mutations were each found in one case. CONCLUSION: GS should be suspected in patients presenting gray silvery hair, particularly when these patients are of Arab or Turkish origin.

Detection of bacterial pathogens in clade E head lice collected from Niger's refugees in Algeria.

BACKGROUND: Head lice, Pediculus humanus capitis, are obligate blood-sucking parasites. Phylogenetically, they occur in five divergent mitochondrial clades (A, D, B, C and E), each having a particular geographical distribution. Recent studies have revealed that head lice, as is the case of body lice, can act as a vector for louse-borne diseases. Here, we aimed to study the genetic diversity of head lice collected from Niger's refugees (migrant population) arriving in Algeria, northern Africa, and to look for louse-borne pathogens. Comparative head lice samples collected from indigenous population of schoolchildren (non-immigrant) were also analyzed to frame the study. RESULTS: In this study, 37 head lice samples were collected from 31 Nigerien refugees, as well as 45 head lice from 27 schoolchildren. The collection was established in three localities of eastern Algiers, north Algeria. Quantitative real-time PCR screening of pathogens bacteria and the genetic characterisation of the head lice satut were performed. Through amplification and sequencing of the cytb gene, results showed that all head lice of Nigerien refugees 37/82 (45.12%) belonged to clade E with the presence of four new haplotypes, while, of the 45 head lice of schoolchildren, 34/82 lice (41.46%) belonged to clade A and 11/82 (13.41%) belonged to clade B. Our study is the first to report the existence of clade E haplogroup in Nigerien head lice. DNA of Coxiella burnetii was detected in 3/37 (8.10%) of the head lice collected from 3 of the 31 (9.67%) migrant population. We also revealed the presence of Acinetobacter DNA in 20/37 (54.05%) of head lice collected from 25/31 (80.64%) of the Nigerien refugees, and in 25/45 (55.55%) head lice collected from 15/27 (55.55%) schoolchildren. All positive Nigerien-head lice for Acinetobacter spp. were identified as A. baumannii, while positive schoolchildren-head lice were identified as A. johnsonii 15/25 (60%), A. variabilis 8/25 (32%) and A. baumannii 2/25 (8%). CONCLUSIONS: Based on these findings from head lice collected on migrant and non-migrant population, our results show, for the first time, that head lice from Niger belong to haplogroup E, and confirm that the clade E had a west African distribution. We also detected, for the first time, the presence of C. burnetii and A. baumannii in these Nigerien head lice. Nevertheless, further studies are needed to determine whether the head lice can transmit these pathogenic bacteria from one person to another.

Clinical variables and ethnicity may influenced by polymorphism of CAT -262C/T and MnSOD 47C/T antioxidant enzymes in Algerian type1 diabetes without complications.

The latest studies in Algeria show that the frequency of type 1 diabetes (T1D) without complications is lower than that with complications and represents a significant burden in terms of cost and treatment. For this reason, we are interested in uncomplicated type1 diabetes and risk factors that are related to polymorphisms of antioxidant enzymes in order to prevent its complications. A total of 260 blood samples of young Algerian adults were examined. The genotypic analysis of Catalase gene (CAT -262C/T, rs1001179) and the superoxide dismutase gene (MnSOD 47C/T, rs4880) was performed by real-time PCR using TaqMan technology. The genotypic distribution of the CAT -262C/T promoter gene's polymorphism showed a significant difference between control and T1D patients for the CC genotype (p = 0.009; OR = 0.30) and for the T allele (p = 0.002; OR = 2.82). In addition, the genotypic distribution of the MnSOD 47C/T gene showed an association with T1D for the CT genotype (p = 0.040; OR = 2.37). Our results revealed that polymorphisms of CAT and MnSOD may be associated with physiopathology causing the onset of T1D. Our data, suggest that the genotypic frequencies of these SNPs appear to be influenced by clinical variables and by the Arab-Berber ethnic origin of the Algerian population.

Ethnobotanical survey of medicinal plants used by nomadic peoples in the Algerian steppe.

ETHNOPHARMACOLOGICAL RELEVANCE: This study is the first ethnobotanical survey focusing on the herbal medicines traditionally used by the nomadic community of the Algerian steppe, identifying new medicinal plants and uses from one of the most characteristic indigenous populations in Algeria. Moreover, the study contributes to the understanding of transmission of medicinal plant knowledge in the Mediterranean basin. AIM OF THE STUDY: This work aims to document the phytotherapeutical knowledge and practice of the nomadic community of the Algerian steppe, and compare it with neighbouring sedentary populations and Mediterranean historical texts. Through this, the study strives to evaluate processes of transmission of knowledge among this population, for whom written sources have been largely unavailable. METHODS: Ethnobotanical surveys were carried out during two years (2015-2017). In total, 73 informants from nomadic populations were interviewed in several steppe regions including areas in the administrative departments of Tiaret, Saida, Naama, Djelfa and M'sila. Structured interviews about medicinal plant knowledge were combined with guided tours with the informants. Prior informed consent was always obtained. The surveys allowed for the collection of sociodemographic data and traditional knowledge about medicinal plants and their uses. Informant Consensus Factor (FIC) was calculated to evaluate agreement among informants. Results were compared to existing literature to evaluate similarities between this nomadic medicinal flora, that of neighbouring communities and historical texts and identify new plant citations and uses. RESULTS: Among Algerian nomadic communities, herbal remedies are used mostly by women and elders, who are often illiterate. We identified 97 taxa of medicinal plants belonging to 42 botanical families, importantly Lamiaceae, Asteraceae and Apiaceae, like in neighbouring communities. The most common plant parts and method of preparation are also shared with neighbouring populations. New uses are described for 25 known medicinal taxa, and nine species with undocumented medicinal uses in recent literature have been reported. However, some of these have been reported in Mediterranean materia medica. In total, 60% of the medicinal plant diversity used by Algerian nomads are well-known plants of the Mediterranean ethnopharmacological heritage. CONCLUSION: This study highlights the importance of traditional medicine for Algerian nomad communities. This indigenous population has specific knowledge about plants from their steppe environment, but also shares a pool of knowledge with sedentary Algerian populations and Mediterranean people as a whole. Our research shows that a common North African and Mediterranean ethnobotanical heritage exists.

Algerian Immigrants to Spain: Study of Attitude to the Donation of Organs for Transplantation.

INTRODUCTION: Many Africans are emigrating to the European Economic Community from countries with little knowledge of transplantation. This population has not yet been studied. OBJECTIVE: Analyze the attitude toward donation among the Algerian population living in Spain. METHODS: We studied the population born in Algeria and residing in Spain, over 15 years old, and stratified by age and sex. Attitude was surveyed using a questionnaire of organ donation for transplantation ("PCID-DTO Ríos"). Support from African immigration associations was needed to advise on the location of potential respondents. The completion was anonymous and self-administered. Verbal consent was obtained to assist in the study. RESULTS: Of the 441 respondents, 27% (n = 119) were in favor of donation after death, 43% (n = 191) were against, and 30% (n = 131) were undecided. The variables associated with the attitude toward the donation were sex (P = .033), having offspring (P = .027), having commented on the subject of organ transplantation at the family level (P < .001), attitude (P < .001), religion (P < .001), and partner's opinion on organ donation and transplantation (P < .001). Only 16% of the respondents have known a transplant recipient or donor, with this subgroup having the most favorable attitude (68% vs 19%, P < .001). CONCLUSIONS: The Algerian population emigrant to Spain has a very unfriendly attitude toward the donation of their own organs.

Acceptability of Mental Health Services for Anxiety and Depression in an Arab Sample.

The aim of this paper was to examine the acceptability and use of mental health services in an Arab sample. An Internet survey was made available to Arab people worldwide and enquired about the acceptability of traditional face-to-face and internet-delivered mental health services. Five hundred and three participants were recruited via media and Facebook promotions. Of those surveyed, 36% (183/503), 46% (233/503), and 73% (365/503) reported that they would be willing to consult a mental health professional, take prescription medication and try an internet-delivered psychological treatment, respectively. Moderate to high acceptability rates for mental health services were found in this sample of Arab people. High acceptability of internet-delivered treatments among the current Arab sample, provides the opportunity for directing resources to the development of internet-delivered interventions to help reduce the stigma and burden of mental disease in the Arab world.

The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway.

OBJECTIVES: To examine the mental health of unaccompanied refugee minors prospectively during the asylum-seeking process, with a focus on specific stages in the asylum process, such as age assessment, placement in a supportive or non-supportive facility and final decision on the asylum applications. DESIGN: This was a2½ year follow-up study of unaccompanied minors (UM) seeking asylum in Norway. Data were collected within three weeks (n=138) and at 4 months (n=101), 15 months (n=84) and 26 months (n=69) after arrival. SETTING: Initially in an observation and orientation centre for unaccompanied asylum-seeking adolescents, and subsequently wherever the UM were located in other refugee facilities in Norway. PARTICIPANTS: Male UM from Afghanistan, Somalia, Algeria and Iran. MAIN OUTCOME MEASURES: Mental health symptoms assessed by Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire. RESULTS: At the group level, the young asylum seekers reported high levels of psychological distress on arrival and symptom levels that stayed relatively unchanged over time. According to age-assessment procedures, 56% of the population were not recognised as minors. Subsequent placement in a low-support facility was associated with higher levels of psychological distress in the follow-up period. Those who were placed in a reception centre for adults had higher levels of psychological distress symptoms both after 15 months and 26 months compared with the remaining participants who were placed in reception centres for youth. Refusal of asylum was highly associated with higher levels of psychological distress. CONCLUSION: Mental health trajectory of young asylum seekers appears to be negatively affected by low support and refusal of asylum.

Balancing truth-telling: relatives acting as translators for older adult cancer patients of Turkish or northwest African origin in Belgium.

The first generation of Turkish and Northwest African immigrants in Belgium are ageing and at risk for developing cancer. Relatives play an important role and provide both emotional and practical care, including mental support and acting as a contact person and/or a translator for improving access to healthcare, as most patients and their spouses have only a limited command of the language. Although access to professional interpreters has shown to be the best guarantee for qualitative healthcare, oncology health providers working with relatives as interpreters is much more common than professional interpreters. The aim of this study was to provide insight into the process wherein relatives balance truth-telling in translating for an older family member diagnosed with cancer. This was a qualitative research study, with elements of constructivist grounded theory. Twenty-eight loosely structured interviews were conducted. Most relatives consider it their responsibility to contribute to a positive attitude of the patient. Relatives decided to what extent they inform the patient, based on several motives and embedded in their assessment of the patient's emotional strength, understanding and need to be informed. What they decide influences the way they act as a translator and/or a contact person between the patient and health professional(s). Some considered it best to omit medical information while others considered it best to inform the patient fully. The results emphasise the importance for healthcare providers to take into account the complexity and unpredictable character of the process of balancing truth-telling when family members translate for their ill older relative.

[Not Available]. / Diseño de un programa de educación nutricional destinado a mujeres saharauis residentes en los campamentos de Tinduf (Argelia).

Introducción: la población saharaui residente en los campamentos de Tinduf (Argelia) se considera vulnerable desde el punto de vista nutricional.Objetivos: evaluar los hábitos dietéticos de un grupo de mujeres emigrantes saharauis con el fin de obtener datos para diseñar un programa de educación nutricional (EN) destinado a mujeres residentes en los campamentos. Métodos: la información sobre hábitos dietéticos se registró a través de historias dietéticas. Los resultados de ingesta de macro y micronutrientes se compararon con los rangos aceptables de distribución y los requerimientos medios estimados. También se recogieron datos demográficos, socioeconómicos y sobre salud. Análisis estadístico: SPSS vs 22.0. A partir de los datos obtenidos y de la revisión de los programas de salud llevados a cabo en campamentos y de otros programas de EN se diseñó un programa específico. Resultados: la alimentación en campamentos se caracterizó por ser deficitaria en energía y por un bajo consumo de fibra (6,1 [2,8] g/día), de ácidos grasos monoinsaturados (6,9 [2,9]% del valor calórico total) y de la mayoría de los micronutrientes. El aumento en la disponibilidad de alimentos tras emigrar a España incrementó la ingesta calórica, pero la dieta siguió siendo inadecuada. El programa de EN diseñado se basó en la formación de formadoras. En este manuscrito se proporciona información detallada sobre la organización y el material a emplear en esta intervención educativa. Discusión y conclusión: la alimentación de las mujeres saharauis en campamentos y tras emigrar a España fue inadecuada, lo que corrobora que la aculturación puede estar asociada a cambios no saludables. Cabe esperar que el programa de EN diseñado contribuya a mejorar su bienestar nutricional.

[A second case of white lentiginosis]. / Un second cas de lentiginose blanche.

INTRODUCTION: White lentiginosis is characterized by white guttate macules with a typical histological structure: lentiginosis hyperplasia with hypopigmentation. OBSERVATION: A 23-year-old woman, from Algeria, presented with white macules from 5 years ago. Few women in her family had the same trouble. Cutaneous examination revealed diffused white little macules. Histological examination showed a lentiginous hyperplasia of the epidermis, with elongated club-shaped rete ridges and an unusual loss of pigmentation. DISCUSSION: Different diagnosis should be discussed with disseminated leucoderma macules. Nevertheless, the only one which corresponds with our case is the white lentiginosis. To our knowledge, it is the first case described since Grosshans et al. in 1994. Our patient is a descendant of the original case's family. This new case appears to confirm the genetic origin of the disorder and suggests autosomal dominant or X-linked inheritance.

[Ankle and foot ulcerations in a diabetic patient revealing cutaneous leishmaniasis]. / Des ulcérations de cheville et du pied chez un diabétique révélant une leishmaniose cutanée.

INTRODUCTION: Cutaneous leishmaniasis is a parasitic disease that typically manifests as a typical crusted ulcer called the oriental sore. Its localization on the lower limbs can be mistaken for a leg ulcer. CASE REPORT: An 81-year-old male, native of Algeria, with type 2 diabetes, arterial hypertension and arteriopathy developed a chronic ulceration of the right ankle and foot compatible with the diagnosis of infectious diabetic foot. Non-improvement with antibiotics, local treatment and rest, and the absence of any hemodynamic arteriopathy led to skin biopsies. Polymerase chain reaction performed on biopsy samples for parasitological investigations yielded the diagnosis of cutaneous leishmaniasis due to Leishmania major. Complete healing was obtained with topical care alone, the patient having declined an etiological treatment. DISCUSSION: Cutaneous leishmaniasis is one of the rare infectious etiologies of chronic leg ulcers. Several therapeutic options, including abstention, can be proposed.

Nutrition information-seeking behaviour of low-income pregnant Maghrebian women.

PURPOSE: Nutrition information-seeking behaviour was explored among low-income pregnant Maghrebian women living in Montreal. Environmental factors likely to influence nutrition information-seeking behaviour during pregnancy are discussed. METHODS: Data were collected in face-to-face interviews with 14 primigravid pregnant women recruited via the Montreal Diet Dispensary, a nonprofit agency with the mission of promoting health among low-income pregnant women. Data collection was part of a larger project on pregnant women's nutrition decision-making. RESULTS: Environmental factors likely to influence information-seeking behaviour were identified. They were grouped within two major themes: culture and interactions with individuals from the social environment. The culture theme was divided into three minor themes: eating habits, food beliefs, and religious beliefs. The interactions with individuals from the social environment theme was divided into two minor themes: interactions with health care providers and interactions with family members. CONCLUSIONS: Understanding the influence of these environmental factors should help registered dietitians tailor communication strategies to pregnant immigrant women's specific information needs.

The recent multi-ethnic global lung initiative 2012 (GLI2012) reference values don't reflect contemporary adult's North African spirometry.

BACKGROUND: The applicability of the recent multi-ethnic reference equations derived by the ERS Global Lung Initiative (ERS/GLI) in interpreting spirometry data in North African adult subjects has not been studied. OBJECTIVE: To ascertain how well the recent ERS/GLI reference equations fit contemporary adult Tunisian spirometric data. POPULATION AND METHODS: Spirometric data were recorded from 1192 consecutive spirometry procedures in adults aged 18-60 years. Reference values and lower limits of normality (LLN) were calculated using the local and the ERS/GLI reference equations. Applied definitions: large airway obstructive ventilatory defect (LAOVD): FEV1/FVC < LLN. Tendency to a restrictive ventilatory defect (TRVD): FEV1 and FVC < LLN and FEV1/FVC ≥ LLN. The spirometric profile, according to the two reference equations, was determined. Z-scores for spirometry from North African healthy subjects (n = 489) were calculated. If the average Z-score deviated by <± 0.5 from the overall mean, the ERS/GLI reference equations would be considered as reflective of contemporary Tunisian spirometry. RESULTS: Using Tunisian reference equations, 71.31%, 6.71% and 19.04% of spirometry records were interpreted as normal, and as having, LAOVD and TRVD, respectively. Using the ERS/GLI reference equations, these figures were respectively, 85.82%, 4.19% and 8.39%. The mean ± SD Z-scores for the contemporary healthy North African subject's data were -0.55 ± 0.87 for FEV1, -0.62 ± 0.86 for FVC and 0.10 ± 0.73 for FEV1/FVC. CONCLUSION: The present study don't recommend the use of the recent ERS/GLI reference equations to interpret spirometry in North African adult population.

Inadequate prenatal care and maternal country of birth: a retrospective study of southeast Spain.

OBJECTIVE: To quantify the association between the maternal country of birth and inadequacy in the use of prenatal care, and to identify factors that might explain this association. STUDY DESIGN: A retrospective case series was carried out in a public hospital in southern Spain, including 6873 women who delivered between 2005 and 2007. The maternal country of birth was categorised into four regional groups: Spain, Maghreb (north-west Africa), Eastern Europe and Others (non-Spain), while the use of prenatal care was quantified according to a modified Kotelchuck index: APNCU-1M and APNCU 2M. The effect of country of birth on inadequate prenatal care was analysed using a multiple logistic regression model designed to accommodate factors such as age, parity, previous miscarriages, and pre-gestational and gestational risks. Likelihood ratio tests were performed to assess any interactions. RESULTS: A significant association was found between maternal country of birth and inadequate prenatal care regardless of the index used. Under APNCU 1-M the strength of association was strongest for Eastern European origin (odds ratio (OR) 6.17, 95% confidence interval (CI) 5.2-7.32), followed by the Maghreb (OR: 5.58, 95% CI: 4.69-6.64). These associations remained virtually unchanged after adjusting for potential confounders. Interactions were observed between age and parity, with the highest risk of inadequacy seen among the Eastern European childbearing women over 34 years of age having 1-2 previous children (OR: 7.63, 95% CI: 3.65-15.92). CONCLUSION: Prenatal health care initiatives would benefit from the study of a larger number of variables to address the differences between different groups of women. We recommend the widespread use of standardised indices for the study of prenatal care utilisation.

[Sickle cell disease and invasive osteoarticular Salmonella infections]. / Drépanocytose et salmonelloses invasives ostéo-articulaires.

Non-typhi Salmonella are responsible for severe invasive infections in children with sickle cell disease, with osteoarticular locations that can affect short- and long-term outcomes. We describe the cases of 2 children with sickle cell disease who presented paucisymptomatic Salmonella osteoarticular infections on returning from North Africa. Progression was favorable in both cases after appropriate systemic antibiotic therapy, although one Salmonella was multidrug-resistant. Invasive salmonellosis remains rare in France, but, because of its severity, it should be suspected in any patient with sickle cell disease presenting fever, especially in the context of recent trips in Africa countries. Early clinical diagnosis is essential to start appropriate empirical treatment without waiting for bacteriological results.