[Importance of psychological support for patients with Covid-19 treated at the University Hospital Center (CHU) Hôpital du Mali]. / Importance du soutien psychologique aux patients atteints de Covid-19 pris en charge au Centre Hospitalier Universitaire (CHU) Hopital du Mali.

INTRODUCTION: the disease linked to Covid-19 is a SARS-CoV-2 pneumonia with strong clinical expression and highly lethal which has shaken the world since November 2019, to the detriment of certain determinants of health, in particular the psychosocial aspect. In this work, we are proposed to study the importance of psychological support for patients during the Covid-19 pandemic admitted to the treatment center of the CHU Hôpital du Mali. METHOD: this was a cross-sectional study, a prospective recruitment including 50 patients admitted to hospital from April to May 2020. RESULTS: in the cohort, 30% of patients had a notion of recent travel. Eighty percent (80%) of patients did not follow preventive measures before testing. Sixty percent (60%) of patients were asymptomatic at the time of screening. We found that 80% of the patients had not received any psychological preparation. 78% of the patients did not believe in the existence of the disease. At discharge, 38% of patients were depressed, 10% were in denial of the disease. Regarding the quality of care, 84% of patients were satisfied with the quality. We found that patients who had not received psychological preparation were eight times more likely to have depression, compared to patients who had received it, with a correlation coefficient (r) = 0.810 and a level of significance p < 0.001. OR which excludes 1. CONCLUSION: this study confirms the low importance given to the psychological preparation of patients with Covid-19 in our structure. However, we believe that good psychological preparation could help improve the quality of patient care.

INTRODUCTION: la maladie liée au Covid-19 est une pneumopathie à SARS-CoV-2 à forte expression clinique et fortement létale qui secoue le monde depuis novembre 2019. La prise en charge multidimensionnelle mettait plus l'accent sur les composantes biologique et thérapeutique, au détriment de certains déterminants de la santé notamment l'aspect psychosocial. Dans ce travail, nous nous sommes proposé d'étudier l'importance du soutien psychologique aux patients durant la pandémie Covid-19 admis dans le centre de traitement du CHU Hôpital du Mali. MÉTHODE: il s'agissait d'une étude transversale, a recrutement prospectif incluant 50 patients admis en hospitalisation d'avril à mai 2020. RÉSULTATS: dans la cohorte, 30% des patients avaient une notion de voyage récent. Quatre-vingt pourcent (80%) des patients ne respectaient pas les mesures préventives avant le test. Soixante pour cent (60%) des patients étaient asymptomatiques au moment du dépistage. Nous avons réalisés que, 80% des patients n'avaient reçu aucune préparation psychologique. 78% des patients ne croyaient pas à l'existence de la maladie. A la sortie, 38% des patients étaient déprimés, 10% étaient dans le déni de la maladie. S'agissant de la qualité de la prise en charge, 84% des patients étaient satisfaits de la qualité. Nous avons retrouvé que les malades qui n'avaient pas reçu de préparation psychologique avaient huit fois plus de chance de faire la dépression, par rapport aux malades qui en avaient reçu, avec un coefficient de corrélation (r)= 0,810 et un niveau de signification p<0,001. OR qui exclut 1. CONCLUSION: cette étude confirme la place peu importante accordée à la préparation psychologique des patients atteints de Covid-19 dans notre structure. Cependant nous estimons qu'une bonne préparation psychologique pourrait contribuer à améliorer la qualité de la prise en charge des patients.

Human dietary exposure to chemicals in sub-Saharan Africa: safety assessment through a total diet study.

BACKGROUND: Human dietary exposure to chemicals can result in a wide range of adverse health effects. Some substances might cause non-communicable diseases, including cancer and coronary heart diseases, and could be nephrotoxic. Food is the main human exposure route for many chemicals. We aimed to assess human dietary exposure to a wide range of food chemicals. METHODS: We did a total diet study in Benin, Cameroon, Mali, and Nigeria. We assessed 4020 representative samples of foods, prepared as consumed, which covered more than 90% of the diet of 7291 households from eight study centres. By combining representative dietary surveys of countries with findings for concentrations of 872 chemicals in foods, we characterised human dietary exposure. FINDINGS: Exposure to lead could result in increases in adult blood pressure up to 2·0 mm Hg, whereas children might lose 8·8-13·3 IQ points (95th percentile in Kano, Nigeria). Morbidity factors caused by coexposure to aflatoxin B1 and hepatitis B virus, and sterigmatocystin and fumonisins, suggest several thousands of additional liver cancer cases per year, and a substantial contribution to the burden of chronic malnutrition in childhood. Exposure to 13 polycyclic aromatic hydrocarbons from consumption of smoked fish and edible oils exceeded levels associated with possible carcinogenicity and genotoxicity health concerns in all study centres. Exposure to aluminium, ochratoxin A, and citrinin indicated a public health concern about nephropathies. From 470 pesticides tested across the four countries, only high concentrations of chlorpyrifos in smoked fish (unauthorised practice identified in Mali) could pose a human health risk. INTERPRETATION: Risks characterised by this total diet study underscore specific priorities in terms of food safety management in sub-Saharan Africa. Similar investigations specifically targeting children are crucially needed. FUNDING: Standards and Trade Development Facility.

Levels of persistent organic pollutants (POPs) in foods from the first regional Sub-Saharan Africa Total Diet Study.

For the first time, a multi-centre Total Diet Study was carried out in Benin, Cameroon, Mali and Nigeria. We collected and prepared as consumed 528 typical fatty foods from those areas and pooled these subsamples into 44 composites samples. These core foods were tested for a wide spectrum of POPs, including polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), polychlorinated biphenyls (PCBs), brominated flame-retardants (BFRs), organochlorine compounds (OCs), perfluoro alkyl substances (PFAS) and chlorinated flame retardants (CFRs). The POPs contamination levels were similar or lower than those reported in total diet studies previously conducted worldwide. In most cases, core foods belonging to fish food group presented higher POPs concentrations than the other food groups. Interestingly, we observed a difference in both contamination profile and concentration for smoked fish compared to non-smoked fish. Such finding suggests that the smoking process itself might account for a large proportion of the contamination. Further investigation would require the assessment of combustion materials used to smoke fish as a potential vehicle, which may contribute to the dietary exposure of the studied populations to POPs.

Occurrence of 30 trace elements in foods from a multi-centre Sub-Saharan Africa Total Diet Study: Focus on Al, As, Cd, Hg, and Pb.

This paper reports occurrence data related to 30 trace elements in food composite samples from a multi-regional Sub-Saharan Africa Total Diet Study. Herein, 2700 samples grouped in 225 food composite samples corresponding to 13 food groups: cereals, tubers, legumes, vegetables, fruits, nuts/seeds, meat, eggs, fish, milk/dairy, oil/fats, and beverages from eight locations in four countries, namely Benin (Littoral/Borgou), Cameroon (Duala/North), Mali (Bamako/Sikasso), and Nigeria (Lagos/Kano) were prepared as consumed, pooled, and analysed using a validated method based on inductively coupled plasma-mass spectrometry. The occurrence data for Al, As, Cd, Hg, and Pb as regulated by the Codex Alimentarius are discussed herein. Although the levels of As, Cd, Hg, and Pb were above the limit of quantification, they were below the maximum limits set by the Codex in most samples analysed. A distinct feature was observed for cereals and tubers, as they were mostly contaminated with Al and Pb. A pilot study regarding the impact of using artisanal cookware (made from recycled aluminium) on the contamination of food samples was performed. Relevant contamination with Al and Pb when cooking tomato samples from Cameroon and Nigeria using artisanal aluminium cookware was compared to that when cooked using stainless-steel.

Sub-Saharan Africa total diet study in Benin, Cameroon, Mali and Nigeria: Pesticides occurrence in foods.

In the framework of the first regional Total Diet Study in Sub-Saharan Africa, 3696 foodstuffs, commonly consumed in Benin, Cameroon, Mali and Nigeria were purchased, prepared as consumed and pooled into 308 composite samples. Those core foods were tested for up to 470 pesticides residues by liquid and gas chromatography coupled with tandem mass spectrometry. 39 pesticides were detected with 294 total occurrences, including 47.3% organophosphate pesticides and 35.7% pyrethroids. More specifically, 6 substances represented 75.5% of all 3 organophosphates and 3 pyrethroids: chlorpyrifos (22.4%) cypermethrin (18.0%) dichlorvos (13.6%), lambda cyhalothrin (8.2%), permethrin (7.5%) and profenofos (5.8%). One pesticide or more was detected in 45.8% of samples. Strikingly, several pesticides were quantified in 2 composite samples of smoked fish from Mali: chlorpyrifos (5236-18 084 µg/kg), profenofos (30-182 µg/kg), cypermethrin (22-250 µg/kg), cyfluthrin (16-117 µg/kg), lambda cyhalothrin (9-17 µg/kg) and permethrin (3-6 µg/kg).

Correction: Ingenbleek, L. et al. Regional Sub-Saharan Africa Total Diet Study in Benin, Cameroon, Mali, and Nigeria Reveals the Presence of 164 Mycotoxins and Other Secondary Metabolites in Foods.

The authors wish to make the following corrections to their paper [...].

Regional Sub-Saharan Africa Total Diet Study in Benin, Cameroon, Mali and Nigeria Reveals the Presence of 164 Mycotoxins and Other Secondary Metabolites in Foods.

In the framework of the first multi-centre Sub-Saharan Africa Total Diet Study (SSA-TDS), 2328 commonly consumed foods were purchased, prepared as consumed and pooled into 194 composite samples of cereals, tubers, legumes, vegetables, nuts and seeds, dairy, oils, beverages and miscellaneous. Those core foods were tested for mycotoxins and other fungal, bacterial and plant secondary metabolites by liquid chromatography, coupled with tandem mass spectrometry. The highest aflatoxin concentrations were quantified in peanuts, peanut oil and maize. The mean concentration of the sum of aflatoxins AFB1, AFB2, AFG1 and AFG2 (AFtot) in peanut samples (56.4 µg/kg) exceeded EU (4 µg/kg) and Codex (15 µg/kg) standards. The AFtot concentration (max: 246.0 µg/kg) was associated with seasonal and geographic patterns and comprised, on average, 80% AFB1, the most potent aflatoxin. Although ochratoxin A concentrations rarely exceeded existing Codex standards, it was detected in unregulated foods. One palm oil composite sample contained 98 different metabolites, including 35.4 µg/kg of ochratoxin A. In total, 164 different metabolites were detected, with unspecific metabolites like asperglaucide, cyclo(L-pro-L-val), cyclo (L-pro-L-tyr), flavoglaucin, emodin and tryptophol occurring in more than 50% of composite samples. Aflatoxin B1 (AFB1), fumonisin B1 (FB1), sterigmatocystin (STC), ochratoxin A (OTA), citrinin (CIT) and many other secondary fungal metabolites are frequent co-contaminants in staple foods, such as maize and sorghum. Populations from North Cameroon and from Benin may, therefore, suffer chronic and simultaneous exposure to AFB1, FB1, STC, OTA and CIT, which are prevalent in their diet.