Molecular Characterization of Canine Rabies Virus, Mali, 2006-2013.

We genetically characterized 32 canine rabies viruses isolated in Mali during 2006-2013 and identified 3 subgroups that belonged to the Africa 2 lineage. We also detected subgroup F rabies virus. This information should be useful for development of mass vaccination campaigns for dogs and eventual large-scale control programs in this country.

Alpha 1-acid glycoprotein, hepcidin, C-reactive protein, and serum ferritin are correlated in anemic schoolchildren with Schistosoma haematobium.

BACKGROUND: The World Health Organization and Centers for Disease Control and Prevention recommend the inclusion of indicators of iron status and inflammation in surveys assessing iron deficiency and/or anemia. OBJECTIVE: We examined the associations between serum alpha(1)-acid glycoprotein (AGP), serum C-reactive protein (CRP), and urinary hepcidin and their relations with serum ferritin (SF), serum transferrin receptor (sTfR), and hemoglobin. DESIGN: At enrollment, the measurements were made in randomly selected 7-12-y-old anemic children with documented Schistosoma haematobium infection (n = 224 for AGP, CRP, SF, sTfR, and hemoglobin; n = 61 for urinary hepcidin). RESULTS: The correlation between the conventional markers of inflammation, AGP and CRP, was positive (r = 0.40, P < 0.01), and the correlation between the unambiguous markers of iron nutrition, hemoglobin and s-TfR, was negative (r = -0.36, P < 0.01). None of the correlations (r < 0.08) between the above markers was statistically significant. Urinary hepcidin correlated positively with the 2 measured indicators of inflammation (r > or = 0.42, P < 0.01) but not with the 2 indicators of iron nutrition (r < 0.07). SF correlated positively with the 2 measured inflammation markers (r > or = 0.25, P < 0.01) and the 2 iron-nutrition indicators (r > 0.26, P < 0.01). Urinary hepcidin correlated positively with SF (r = 0.39, P < 0.01). Regression analyses suggested that CRP and AGP were significant predictors of SF (P < 0.001); however, CRP (R(2) = 0.38) explained more of SF's variance than did AGP (R(2) = 0.17). CONCLUSIONS: Correlations between AGP, CRP, urinary hepcidin, and SF were statistically significant. CRP values explained SF's variance better than did the other markers of inflammation studied. We therefore recommend the measurement of both AGP and CRP in population surveys that include an assessment of iron deficiency in developing countries.

A randomized trial of doxycycline for Mansonella perstans infection.

BACKGROUND: Mansonella perstans infection is common in areas of Africa where Wuchereria bancrofti, a causative agent of lymphatic filariasis, is endemic. M. perstans is refractory to standard antifilarial therapies. The recent discovery of bacterial endosymbionts (e.g., wolbachia) in most filarial species, including M. perstans, provides new therapeutic options for reducing microfilaremia. METHODS: In an open-label, randomized trial, we recruited subjects with M. perstans microfilaremia, with or without concomitant W. bancrofti infection, from four villages in Mali and randomly assigned them to receive doxycycline, at a dose of 200 mg daily for 6 weeks (106 subjects), or no treatment (110). At 6 months, subjects who were coinfected with W. bancrofti underwent a second random assignment, to treatment with a single dose of albendazole (400 mg) and ivermectin (150 microg per kilogram of body weight) or no treatment. Subjects were monitored daily during the first 6-week study period for adverse events. M. perstans and W. bancrofti microfilarial levels were assessed at 6, 12, and 36 months. RESULTS: At 12 months, 67 of 69 subjects who had received treatment with doxycycline only (97%) had no detectable M. perstans microfilariae per 60 microl of blood, as compared with 10 of 63 subjects who had received no treatment (16%) (relative risk, 6.18; 95% confidence interval, 3.63 to 11.89; P<0.001). At 36 months, M. perstans microfilaremia remained suppressed in 48 of 64 subjects who had received treatment with doxycycline only (75%), a finding that was consistent with a macrofilaricidal effect of doxycycline. Vomiting was more frequent in the doxycycline-treated group than in the untreated group (17% vs. 4%). CONCLUSIONS: These results are consistent with previous findings that M. perstans harbors the intracellular endosymbiont, wolbachia, and suggest that doxycycline is an effective therapy for M. perstans infection. (ClinicalTrials.gov number, NCT00340691.)

Women's iodine status and its determinants in an iodine-deficient area in the Kayes region, Mali.

OBJECTIVE: To assess iodine status and its determinants in women of childbearing age in a rural area in the Kayes region, Mali, West Africa. DESIGN: Cross-sectional study where women's iodine status was indicated by urinary iodine concentration (UIC) and level of goitre based on palpation. Salt iodine was assessed semi-quantitatively at household level. Individual characteristics were collected using questionnaires. SETTING: Fifteen villages in a rural area in the Kayes region of Mali. SUBJECTS: Women aged 15-45 years (n=423). RESULTS: Median UIC was 2.7 microg dl(-1), and only 6% of the women had adequate iodine status of UIC >10 microg dl(-1). Most women (60%) had visible goitre, and only 9% were classified as without goitre. Only 39% of the households were using salt with any iodine, and level of knowledge about salt iodisation was low. Main determinants of UIC were breast-feeding and level of salt iodisation; currently breast-feeding women had lower UIC, and UIC increased with increasing level of iodine in household salt. Prevalence of goitre was lower in older women with higher body mass index. CONCLUSION: The study indicates severe iodine deficiency in the study area. Urgent action is needed to improve the situation through enforcing salt iodisation legislation and increasing the level of knowledge about the importance of iodised salt in the population.