Prevalence of tick-borne pathogens in ticks collected from the wild mountain ungulates mouflon and chamois in 4 regions of France.

Ticks are major vectors of various pathogens of health importance, such as bacteria, viruses and parasites. The problems associated with ticks and vector-borne pathogens are increasing in mountain areas, particularly in connection with global climate change. We collected ticks (n = 2,081) from chamois and mouflon in 4 mountainous areas of France. We identified 6 tick species: Ixodes ricinus, Rhipicephalus bursa, Rh. sanguineus s.l., Haemaphysalis sulcata, H. punctata and Dermacentor marginatus. We observed a strong variation in tick species composition among the study sites, linked in particular to the climate of the sites. We then analysed 791 ticks for DNA of vector-borne pathogens: Babesia/Theileria spp., Borrelia burgdorferi s.l., Anaplasma phagocytophilum, A. marginale, A. ovis, and Rickettsia of the spotted fever group (SFG). Theileria ovis was detected only in Corsica in Rh. bursa. Babesia venatorum (2 sites), Borrelia burgdorferi s.l. (B. afzelii and B. garinii; 2 sites) and Anaplasma phagocytophilum (3 sites) were detected in I. ricinus. Anaplasma ovis was detected at one site in I. ricinus and Rh. sanguineus s.l. SFG Rickettsia were detected at all the study sites: R. monacensis and R. helvetica in I. ricinus at the 3 sites where this tick is present; R. massiliae in Rh. sanguineus s.l. (1 site); and R. hoogstraalii and Candidatus R. barbariae in Rh. bursa in Corsica. These results show that there is a risk of tick-borne diseases for humans and domestic and wild animals frequenting these mountain areas.

Title: Prévalence d'agents pathogènes vectorisés chez des tiques collectées chez des ongulés sauvages (mouflons, chamois) dans 4 zones montagneuses en France. Abstract: Les tiques sont des vecteurs majeurs de différents agents pathogènes d'importance sanitaire, tels que des bactéries, des virus et des parasites. Les problématiques liées aux tiques et aux pathogènes vectorisés augmentent en zones de montagne, en lien notamment avec le réchauffement climatique. Nous avons collecté des tiques (n = 2 081) sur des chamois et des mouflons dans 4 zones montagneuses en France. Six espèces ont été identifiées : Ixodes ricinus, Rhipicephalus bursa, Rh. sanguineus s.l., Haemaphysalis sulcata, H. punctata et Dermacentor marginatus. Nous avons observé une forte variation de la composition en espèces de tiques entre les sites d'étude, en lien notamment avec le climat des sites. Nous avons ensuite recherché les ADN d'agents pathogènes vectorisés sur 791 tiques : Babesia/Theileria spp, Borrelia burgdorferi s.l., Anaplasma phagocytophilum, A. marginale, A. ovis, et de Rickettsia du groupe des fièvres boutonneuses (SFG). Theileria ovis a été détecté uniquement en Corse chez Rh. bursa. Babesia venatorum (2 sites), Borrelia burgdorferi s.l. (B. afzelii and B. garinii; 2 sites) et Anaplasma phagocytophilum (3 sites) ont été détectés chez I. ricinus. Anaplasma ovis a été détecté dans un site chez I. ricinus et Rh. sanguineus s.l.. Les Rickettsia SFG ont été détectées dans tous les sites d'étude : Rickettsia monacensis et R. helvetica chez I. ricinus dans les 3 sites où cette tique est présente; R. massiliae chez Rh. sanguineus s.l. (1 site); et R. hoogstraalii et Candidatus R. barbariae chez Rh. bursa en Corse. Ces résultats montrent un risque de transmission de maladies par les tiques pour les personnes et les animaux domestiques et sauvages fréquentant ces zones de montagne.

Unconventional Cardiovascular Risk Factors and Systematic Coronary Risk Estimation (SCORE) in the Lebanese Rural Population: The Forgotten Factors.

Purpose: To evaluate the correlation between unconventional risk factors and the Systematic Coronary Risk Estimation (SCORE), and estimate the prevalence of conventional and unconventional cardiovascular (CV) risk factors in the rural Lebanese population in order to assess their CV risk. Methods: This is a retrospective descriptive study conducted between November 2017 and June 2019 among the Lebanese rural population. The risk factors were analyzed from the files of the patients who presented for the CV disease screening days organized by a non governmental organization. The CV risk estimation tool is the SCORE. The classification of socio-economic level ranges from zero (low level) to 3 (high level). Results: A total of 433 patients were included. The prevalence of hypertension, diabetes, dyslipidemia, smoking, and metabolic syndrome was 45.1%, 31.2%, 39.2%, 50% and 42.9% respectively. Only 13.6% of hypertensive patients and 6.7% of diabetics were controlled. A total of 0 or 1 point for the classification of socio-economic status was found in 62.6% of cases. A family history of CV diseases was present in 87.3% of participants. The SCORE was correlated with diabetes and metabolic syndrome (p = 0.000), without being correlated to socio-economic status (HR = -0.104; p = 0.059) or to family history (p = 0.834). Conclusion: The socio-economic status and the family history of CV disease must be evaluated in addition to the classical risk calculation of the SCORE to better pinpoint the actual risk of the targeted population. The risk factors are prevalent but poorly controlled, hence the need for a national effort to ensure better care for the rural Lebanese population.

Pharmaceutical brochures in Lebanon: do they meet WHO recommendations?

BACKGROUND: Drug promoting brochures can influence physicians prescription patterns. The validity of the info presented in these brochures is of major importance. World Health Organization (WHO) issued criteria to guarantee validity, equity and ethical presentation of data in medical brochures. This study aims to evaluate the quality and the validity of information presented in the pharmaceutical brochures distributed among family physicians in Lebanon. METHODS: Pharmaceutical brochures were randomly collected at the family medicine center in Hôtel Dieu de France hospital in Beirut - Lebanon. These brochures were evaluated in reference to the WHO ethical criteria for medicinal drug promotion and on guidelines for quality assurance of the graphs, references, texts and illustrations. RESULTS: Among the 60 brochures collected, only 4 fulfilled all the WHO ethical criteria, and 24 presented less than half the required criteria. Information concerning the drug safety are the least mentioned. Only 11.8% of the presented graphs are based on studies of high methodological level. Half of the brochures presented necessary information to identify studies references which are not always retrievable. Texts present mainly brand names instead of generic names and emphasize on information reflecting the drug efficacy. CONCLUSION: The pharmaceutical brochures in this study presented incomplete or invalid information. Prescribing physicians should be aware of the claims found in the brochures distributed by pharmaceutical companies and should be familiar with the principles of the evidence-based medicine to be able to critically appraise the validity of the reference studies and avoid the pitfalls in graphs reading.