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1.
Artigo em Inglês | MEDLINE | ID: mdl-34769812

RESUMO

Cholera remains a heavy burden worldwide, especially in Sub-Saharan African countries, which account for the majority of the reported cases on the continent. In this study, a 27-year retrospective analysis of cholera epidemics in Guinea-Bissau was performed in order to highlight major stressors fueling the trigger and dissemination of the disease. Although the role of environmental factors did not always have the same degree of importance for the onset of epidemics, a cholera seasonal pattern was clearly perceived, with most of the reported cases occurring during the wet season. The generated theoretical hypothesis indicated rainfall above climatological average, associated with a lack of WASH (water, sanitation and hygiene) infrastructure, and the occurrence of concomitant epidemics in neighboring countries as the key indicators for optimal conditions for cholera to thrive in Guinea-Bissau. Warmer air temperature, the increase in sea surface temperature, and the decrease in salinity in the coastal areas may also contribute to the emergence and/or aggravation of cholera events. Prediction of the conditions favorable for cholera growth and identification of risk pathways will allow the timely allocation of resources, and support the development of alert tools and mitigation strategies.


Assuntos
Cólera , Epidemias , África Ocidental , Cólera/epidemiologia , Guiné-Bissau/epidemiologia , Humanos , Estudos Retrospectivos
2.
BMJ Glob Health ; 6(8)2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34344667

RESUMO

OBJECTIVE: BCG vaccination is frequently delayed in low-income countries. Restrictive vial-opening policies, where a vial of BCG vaccine is not opened for few children, are a major reason for delay. During delays, children are unprotected against tuberculosis (TB) and deprived of non-specific effects of BCG. We assessed the potential effect and cost-effectiveness of disregarding the restrictive vial-opening policy, on TB and all-cause mortality, in children aged 0-4 years in Guinea-Bissau. METHODS: Using static mathematical models, we estimated the absolute and percentage change in TB and all-cause deaths, in children aged 0-4 years, between the current BCG vaccine restrictive-opening policy scenario, and a non-restrictive policy scenario where all children were vaccinated in the first health-facility contact. Incremental cost-effectiveness was estimated by integration of vaccine and treatment costs. FINDINGS: Disregarding the restrictive BCG vial-opening policy was estimated to reduce TB deaths by 11.0% (95% uncertainty range (UR):0.5%-28.8%), corresponding to 4 (UR:0-15) TB deaths averted per birth cohort in Guinea-Bissau, resulting in incremental cost-effectiveness of US$ 911 per discounted life-year gained (LYG) (UR:145-9142). For all-cause deaths, the estimated reduction was 8.1% (UR: 3.3%-12.7%) corresponding to 392 (UR:158-624) fewer all-cause deaths and an incremental cost-effectiveness of US$ 9 (UR:5-23) per discounted LYG. CONCLUSIONS: Disregarding the restrictive BCG vial-opening policy was associated with reductions in TB deaths and all-cause deaths and low cost-effectiveness ratios. Our results suggest that it would be cost-effective to disregard the restrictive vial-opening policy. Other settings with similar practice are also likely to gain from disregarding this policy.


Assuntos
Vacina BCG , Tuberculose , Criança , Análise Custo-Benefício , Guiné-Bissau/epidemiologia , Humanos , Políticas , Tuberculose/prevenção & controle
3.
Int J Infect Dis ; 109: 123-128, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34224869

RESUMO

OBJECTIVES: Tuberculosis (TB) is associated with a number of non-communicable co-morbidities, which can complicate treatment and impair outcome. The aim of this study was to assess the impact of hypertension on disease severity, treatment outcome and survival in a cohort of patients with TB. METHODS: A retrospective cohort study was conducted in Guinea-Bissau. Patients newly diagnosed with TB between November 2003 and June 2016 were included. Hypertension was defined as blood pressure ≥140/90 mmHg. Disease severity was assessed using the Bandim TBscore. Survival was assessed at the end of treatment and 2 years after treatment initiation. RESULTS: In total, 1544 patients were included in this study. Hypertension was present in 12.8% of patients at inclusion. Patients with hypertension had slightly less severe TB, but were less likely to have a successful treatment outcome and had 64% higher mortality at 2-year follow-up (adjusted hazard ratio 1.64, 95% confidence interval 1.15-2.34). Mortality rates were highest in hypertensive female patients and patients aged ≥ 45 years. CONCLUSION: Patients with high blood pressure at the start of TB treatment had a higher mortality rate at 2-year follow-up. Mortality rates were highest in hypertensive females and patients aged ≥ 45 years.


Assuntos
Hipertensão , Tuberculose , Estudos de Coortes , Feminino , Guiné-Bissau/epidemiologia , Humanos , Hipertensão/epidemiologia , Estudos Retrospectivos , Tuberculose/complicações , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia
4.
Environ Pollut ; 288: 117705, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34247000

RESUMO

Marine bivalves are bioindicators of coastal environmental pollution, integrating monitoring programs worldwide. Nonetheless, the choice of particular species as an indicator requires validation, achieved by understanding the differences in element concentrations among and within species. The present study compares the chemical composition of whole body soft tissues of four common bivalve species from the Bijagós Archipelago, a pristine region of West Africa. Significant differences were recorded in the concentrations of various elements among studied species, which likely arise from species-specific uptake and bioaccumulation processes. Overall, there was a segregation between a group including the bloody cockle Senilia senilis and oyster Crassostrea tulipa (with high Cd and Zn concentrations) versus the two other species, Austromacoma nymphalis (with low Cu and high Mn, Se, Hg, Pb concentrations) and Diplodonta spp. (with high values of Cu, Al, Fe, V, Cr, Hg, Pb). C. tulipa was sampled in two different substrates (rock beds and mangrove roots), and the two groups revealed different chemical profiles, with significantly higher concentrations of P, Si, Zn and Cr and lower Cu in specimens fixed in mangrove roots. These results strongly suggest the influence of small-scale environmental variability on the accumulation of particular elements. We found extremely high Cd concentrations in S. senilis (27.1 ± 7.53 µg g-1 DW) and identified C. tulipa as another high Cd-accumulating species (ca. 10 µg g-1 DW). Our results suggest a detoxifying mechanism linked with the presence of Se to reduce the potential toxic effects of Cd in these two species. Cadmium concentrations reported for some bivalve species in this area largely exceed the maximum values proposed by the European Union, emphasizing the need for a regular contamination assessment.


Assuntos
Crassostrea , Mercúrio , Oligoelementos , Poluentes Químicos da Água , Animais , Monitoramento Ambiental , Guiné-Bissau , Oligoelementos/análise , Poluentes Químicos da Água/análise
5.
BMC Genomics ; 22(1): 422, 2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34103015

RESUMO

BACKGROUND: Whole genome re-sequencing provides powerful data for population genomic studies, allowing robust inferences of population structure, gene flow and evolutionary history. For the major malaria vector in Africa, Anopheles gambiae, other genetic aspects such as selection and adaptation are also important. In the present study, we explore population genetic variation from genome-wide sequencing of 765 An. gambiae and An. coluzzii specimens collected from across Africa. We used t-SNE, a recently popularized dimensionality reduction method, to create a 2D-map of An. gambiae and An. coluzzii genes that reflect their population structure similarities. RESULTS: The map allows intuitive navigation among genes distributed throughout the so-called "mainland" and numerous surrounding "island-like" gene clusters. These gene clusters of various sizes correspond predominantly to low recombination genomic regions such as inversions and centromeres, and also to recent selective sweeps. Because this mosquito species complex has been studied extensively, we were able to support our interpretations with previously published findings. Several novel observations and hypotheses are also made, including selective sweeps and a multi-locus selection event in Guinea-Bissau, a known intense hybridization zone between An. gambiae and An. coluzzii. CONCLUSIONS: Our results present a rich dataset that could be utilized in functional investigations aiming to shed light onto An. gambiae s.l genome evolution and eventual speciation. In addition, the methodology presented here can be used to further characterize other species not so well studied as An. gambiae, shortening the time required to progress from field sampling to the identification of genes and genomic regions under unique evolutionary processes.


Assuntos
Anopheles , Malária , África , Animais , Anopheles/genética , Guiné-Bissau , Ilhas , Malária/genética , Mosquitos Vetores/genética
6.
BMC Public Health ; 21(1): 1164, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-34140010

RESUMO

BACKGROUND: Low birthweight (LBW) is associated with higher mortality and morbidity, but there is limited data on the prevalence of LBW in rural Africa, where many births occur at home. The Bacillus Calmette-Guérin (BCG) vaccine has non-specific effects. Studies suggest that maternal BCG-vaccination may affect the health of the child. METHODS: The present study is nested within a randomised trial in rural Guinea-Bissau: Pregnancies were registered at two-monthly village visits, where information on BCG scar status and other background factors were obtained. Children were enrolled in the trial and weighed at home within 72 h after birth. In this prospective observational study, we assessed factors associated with adverse pregnancy outcomes and birthweight in binomial and linear regression models. RESULTS: Among 1320 women who had their BCG scar status assessed, 848 (64%) had a scar, 472 (36%) had no scar. The risk of adverse pregnancy outcomes (miscarriages, stillbirths, early neonatal deaths) tended to be higher among BCG scar-negative women (13%) than among women with a BCG scar (10%), adjusted prevalence ratio = 1.29 (0.99-1.68). Birthweight was assessed for 628 (50%) of the 1232 live born children. The mean birthweight was 2.89 kg (SD 0.43) and the proportion of LBW children was 17% (104/628). Sex, twinning, region of birth, maternal age, maternal mid-upper arm circumference (MUAC), antenatal consultations, parity and possession of a mobile phone were associated with birthweight, while maternal BCG scar status was not. CONCLUSIONS: This study provides the first birthweight data for home-born children in rural Guinea-Bissau, with a mean birthweight of 2.89 kg (SD 0.43) and a LBW prevalence of 17%. We found a tendency for higher risk of adverse pregnancy outcomes among BCG scar-negative women. Birthweight was similar in children of mothers with and without BCG scar.


Assuntos
Vacina BCG , Resultado da Gravidez , África , Peso ao Nascer , Criança , Feminino , Guiné-Bissau/epidemiologia , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia
7.
BMJ Glob Health ; 6(5)2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33941513

RESUMO

INTRODUCTION: Measles vaccine (MV) may improve health beyond measles protection. To avoid wastage from multi-dose vials, children in Guinea-Bissau are only measles vaccinated when aged 9-11 months and when six or more children are present. We assessed health impacts of providing MV to all measles-unvaccinated children 9-35 months. METHODS: We cluster-randomised 182 village clusters under demographic surveillance in rural Guinea-Bissau to an 'MV-for-all-policy' arm where we offered MV regardless of age and number of children present at our bi-annual village visits, or a 'Restrictive-MV-policy' arm where we followed national policy. Measles-unvaccinated children aged 9-35 months were eligible for enrolment and followed to 5 years of age. In intention-to-treat analyses, we compared mortality using Cox regression analyses with age as underlying timescale. The primary analysis was for children aged 12-35 months at eligibility assessment. Interactions with several background factors were explored. RESULTS: Between 2011 and 2016, we followed 2778 children in the primary analysis. MV coverage by 3 years was 97% among children eligible for enrolment under the MV-for-all-policy, and 48% under the Restrictive-MV-policy. Mortality was 59% lower than anticipated and did not differ by trial arm (MV-for-all-policy: 45/1405: Restrictive-MV-policy: 44/1373; HR: 0.95 (95% CI 0.64 to 1.43)). The effect of MV-for-all changed over time: The HR was 0.53 (95% CI 0.27 to 1.07) during the first 1½ years of enrolment but 1.47 (95% CI 0.87 to 2.50) later (p=0.02, test of interaction). Explorative analyses indicated that the temporal change may be related to interactions with other childhood interventions. CONCLUSION: The MV-for-all-policy increased MV coverage but had no overall effect on overall mortality. TRIAL REGISTRATION NUMBER: NCT01306006.


Assuntos
Vacina contra Sarampo , Sarampo , Criança , Guiné-Bissau/epidemiologia , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle
8.
Infect Dis Poverty ; 10(1): 68, 2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-33975626

RESUMO

BACKGROUND: The Republic of Guinea-Bissau in West Africa has a high HIV/AIDS disease burden and has experienced political instability in the recent past. Our study used qualitative methods to better understand key stakeholders' perceptions of the effects of chronic political instability on the HIV/AIDS response in Guinea-Bissau from 2000 to 2015 and lessons learned for overcoming them. METHODS: Seventeen semi-structured in-depth key informant interviews were conducted in Bissau, Guinea-Bissau in 2018. Interviews were recorded and transcribed verbatim, coded thematically, and analyzed inductively. RESULTS: Four themes emerged: (1) constantly start over; (2) the effects of instability rippling from central level throughout the health pyramid; (3) vulnerable populations becoming more vulnerable; and (4) coping mechanisms. CONCLUSIONS: Stakeholders from government, civil society, and donor organizations have recognized instability's effects as a barrier to mounting an effective local response to HIV/AIDS in Guinea-Bissau. To mitigate the effects of the country's political instability on the health sector, concerted efforts should be made to strengthen the capacities of health officials within the Ministry of Health to shield them from the effects of the country's political instability.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , África Ocidental , Governo , Guiné-Bissau/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Pesquisa Qualitativa
10.
PLoS Negl Trop Dis ; 15(3): e0009232, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33657123

RESUMO

Intestinal parasitic infections, caused by helminths and protozoa, are globally distributed and major causes of worldwide morbidity. The gut microbiota may modulate parasite virulence and host response upon infection. The complex interplay between parasites and the gut microbiota is poorly understood, partly due to sampling difficulties in remote areas with high parasite burden. In a large study of children in Guinea-Bissau, we found high prevalence of intestinal parasites. By sequencing of the 16S rRNA genes of fecal samples stored on filter paper from a total of 1,204 children, we demonstrate that the bacterial microbiota is not significantly altered by helminth infections, whereas it is shaped by the presence of both pathogenic and nonpathogenic protozoa, including Entamoeba (E.) spp. and Giardia (G.) lamblia. Within-sample diversity remains largely unaffected, whereas overall community composition is significantly affected by infection with both nonpathogenic E. coli (R2 = 0.0131, P = 0.0001) and Endolimax nana (R2 = 0.00902, P = 0.0001), and by pathogenic E. histolytica (R2 = 0.0164, P = 0.0001) and G. lamblia (R2 = 0.00676, P = 0.0001). Infections with multiple parasite species induces more pronounced shifts in microbiota community than mild ones. A total of 31 bacterial genera across all four major bacterial phyla were differentially abundant in protozoan infection as compared to noninfected individuals, including increased abundance of Prevotella, Campylobacter and two Clostridium clades, and decreased abundance of Collinsella, Lactobacillus, Ruminococcus, Veillonella and one Clostridium clade. In the present study, we demonstrate that the fecal bacterial microbiota is shaped by intestinal parasitic infection, with most pronounced associations for protozoan species. Our results provide insights into the interplay between the microbiota and intestinal parasites, which are valuable to understand infection biology and design further studies aimed at optimizing treatment strategies.


Assuntos
Microbioma Gastrointestinal , Infecções por Protozoários/microbiologia , Infecções por Protozoários/parasitologia , Adolescente , Animais , Bactérias/classificação , Bactérias/genética , Criança , Pré-Escolar , Coinfecção/microbiologia , Coinfecção/parasitologia , Entamoeba/isolamento & purificação , Fezes/microbiologia , Fezes/parasitologia , Feminino , Giardia/isolamento & purificação , Guiné-Bissau , Helmintos/isolamento & purificação , Humanos , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , RNA Ribossômico 16S
11.
Mol Ecol Resour ; 21(5): 1504-1516, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33590707

RESUMO

The two most efficient and most recently radiated Afrotropical vectors of human malaria - Anopheles coluzzii and An. gambiae - are identified by single-locus diagnostic PCR assays based on species-specific markers in a 4 Mb region on chromosome-X centromere. Inherently, these diagnostic assays cannot detect interspecific autosomal admixture shown to be extensive at the westernmost and easternmost extremes of the species range. The main aim of this study was to develop novel, easy-to-implement tools for genotyping An. coluzzii and An. gambiae-specific ancestral informative markers (AIMs) identified from the Anopheles gambiae 1000 genomes (Ag1000G) project. First, we took advantage of this large set of data in order to develop a multilocus approach to genotype 26 AIMs on all chromosome arms valid across the species range. Second, we tested the multilocus assay on samples from Guinea Bissau, The Gambia and Senegal, three countries spanning the westernmost hybridization zone, where conventional species diagnostic is problematic due to the putative presence of a novel "hybrid form". The multilocus assay was able to capture patterns of admixture reflecting those revealed by the whole set of AIMs and provided new original data on interspecific admixture in the region. Third, we developed an easy-to-use, cost-effective PCR approach for genotyping two AIMs on chromosome-3 among those included in the multilocus approach, opening the possibility for advanced identification of species and of admixed specimens during routine large scale entomological surveys, particularly, but not exclusively, at the extremes of the range, where WGS data highlighted unexpected autosomal admixture.


Assuntos
Anopheles , Genoma de Inseto , Animais , Anopheles/classificação , Anopheles/genética , Gâmbia , Genômica , Genótipo , Guiné-Bissau , Malária/transmissão , Mosquitos Vetores/classificação , Mosquitos Vetores/genética , Senegal
12.
Infection ; 49(4): 631-643, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33528814

RESUMO

PURPOSE: To estimate the life expectancy (LE) of HIV-infected patients in the West African country Guinea-Bissau and compare it with the background population. METHODS: Using data from the largest HIV outpatient clinic at the Hospital Nacional Simão Mendes in the capital Bissau, a retrospective observational cohort study was performed. The study included patients attending the clinic between June 2005 and January 2018. A total of 8958 HIV-infected patients were included. In the analysis of the background population, a total of 109,191 people were included. LE incorporating loss to follow-up (LTFU) was estimated via Kaplan-Meier estimators using observational data on adult HIV-infected patients and background population. RESULTS: The LE of 20-year-old HIV-infected patients was 9.8 years (95% CI 8.3-11.5), corresponding to 22.3% (95% CI 18.5-26.7%) of the LE of the background population. (LE for 20-year-olds in the background population was 44.0 years [95% CI 43.0-44.9].) Patients diagnosed with CD4 cell counts below 200 cells/µL had a LE of 5.7 years (95% CI 3.6-8.2). No increase in LE with later calendar period of diagnosis was observed. CONCLUSIONS: LE was shown to be markedly lower among HIV-infected patients compared with the background population. While other settings have shown marked improvements in prognosis of HIV-infected patients in recent years, no improvement in Bissau was observed over time (9.8 years (95% CI 7.6-12.2) and 9.9 years (95% CI 7.6-12.1) for the periods 2005-2010 and 2014-2016, respectively).


Assuntos
Infecções por HIV , Expectativa de Vida , Adulto , Guiné-Bissau/epidemiologia , Infecções por HIV/epidemiologia , Hospitais , Humanos , Estudos Retrospectivos , Adulto Jovem
13.
Trans R Soc Trop Med Hyg ; 115(8): 847-853, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-33444436

RESUMO

BACKGROUND: Trachoma is the leading infectious cause of blindness worldwide and is nearing elimination as a public health problem in Guinea Bissau. It is imperative that elimination is followed by a successful postvalidation surveillance programme. The aim of this study was to determine the acceptability and perceived utility of different diagnostic tests and sample types that could be used for postvalidation trachoma surveillance in the Bijagos Islands, Guinea Bissau. METHODS: Semistructured interviews with community members and stakeholders involved in trachoma elimination were followed by focus group discussions with community members, covering experiences with trachoma and views on trachoma diagnostic methods and sample types. RESULTS: In this setting, all diagnostic tests and sample types used for trachoma surveillance were generally considered acceptable by communities. A preference for laboratory-based testing and finger-prick blood samples was expressed as these results were considered more accurate and applicable to a range of diseases beyond trachoma. CONCLUSIONS: Appropriate community and stakeholder engagement and communication regarding the purpose and processes around diagnostic practice prior to trachoma programme implementation are crucial for long-term successful disease-elimination efforts.


Assuntos
Tracoma , Chlamydia trachomatis , Testes Diagnósticos de Rotina , Erradicação de Doenças , Guiné-Bissau/epidemiologia , Humanos , Ilhas , Tracoma/diagnóstico , Tracoma/epidemiologia
14.
Environ Sci Pollut Res Int ; 28(7): 7636-7651, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33398755

RESUMO

Rapid population growth and poor waste management practice are among the main drivers of plastic pollution in modern times, thus making Africa a hotspot for plastic pollution both now and in the future. This study is a review of plastic pollution reports from the African aquatic environment with regard to causes, current status, toxicological implications and implications for ecosystem services. A total of 59 plastic pollution studies from 1987 to September 2020 were reviewed. They comprised 15 from North Africa (NA) (Algeria, Egypt, Morocco and Tunisia), six from East Africa (EA) (Ethiopia, Kenya, Tanzania and Uganda), 13 from West Africa (WA) (Ghana, Guinea-Bissau, Mauritania and Nigeria), and 25 studies from Southern Africa (SA) (South Africa). This shows that plastic pollution studies in Africa, according to the sub-regions, are in the order: SA > NA > WA > EA. High human population in the basins of African large aquatic systems is identified as the greatest driver enhancing plastic surge in the aquatic environment. The occurrence of plastics was mostly reported in the estuarine/marine environment (42 studies) compared to the freshwater environment (only 17 studies). Plastics have also been reported in the three compartments of the aquatic environment: water column, benthic sediment and animals. Zooplankton, annelids, molluscs, insects, fishes and birds were reported as bioindicators of plastic ingestion in the inland and coastal waters of Africa. Polyethylene, polyethylene terephthalate (polyester) and polypropylene were the common plastic polymers observed in the African aquatic environment. In situ toxicological implications of the ingested plastic polymers were not reported in any of the studies. However, reports from laboratory-controlled experiments showed that these polymers are deleterious to aquatic animal health. More research efforts need to delineate the plastic pollution status of the East, West and North of Africa. Furthermore, such studies are required to identify the plastic polymers and in situ ecotoxicological impacts of plastics on both animal and human health.


Assuntos
Plásticos , Poluentes Químicos da Água , Argélia , Animais , Ecossistema , Egito , Monitoramento Ambiental , Etiópia , Gana , Guiné-Bissau , Humanos , Quênia , Marrocos , Nigéria , Tanzânia , Tunísia , Uganda , Poluentes Químicos da Água/análise
15.
Food Chem ; 341(Pt 1): 128229, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33038772

RESUMO

Moringa oleifera is an edible medicinal plant used to fight malnutrition in Africa. In this study, M. oleifera flowers, fruits and seeds from Guinea-Bissau were characterized for their nutritional composition and hydroethanolic and aqueous extracts were prepared to investigate the phenolic profiles and bioactivities. Seeds presented higher levels of proteins (~31 g/100 g dw), fat (~26 g/100 g dw) and flavan-3-ol derivatives, while carbohydrates, proteins, citric acid, and glycosylated flavonoids were abundant in fruits and flowers, these last samples also being rich in α-tocopherol (~18 mg/100 g dw). Some of the identified polyphenols had never been described in M. oleifera. In general, hydroethanolic extracts contained more polyphenols and were more active against lipid peroxidation, NO production, and tumour cells growth. Significant antimicrobial effects against the tested bacteria and fungi strains were displayed by both hydroethanolic and aqueous extracts. The M. oleifera potential to fight malnutrition and health issues was highlighted.


Assuntos
Moringa oleifera/química , Valor Nutritivo , Compostos Fitoquímicos/análise , Flores/química , Frutas/química , Guiné-Bissau , Folhas de Planta/química , Sementes/química
16.
Clin Infect Dis ; 72(10): e596-e603, 2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-32949460

RESUMO

BACKGROUND: Between 2002 and 2014, Guinea-Bissau had 17 national campaigns with oral polio vaccine (OPV) as well as campaigns with vitamin A supplementation (VAS), measles vaccine (MV), and H1N1 influenza vaccine. We examined the impact of these campaigns on child survival. METHODS: We examined the mortality rate between 1 day and 3 years of age of all children in the study area. We used Cox models with age as underlying time to calculate adjusted mortality rate ratios (MRRs) between "after-campaign" mortality and "before-campaign" mortality, adjusted for temporal change in mortality and stratified for season at risk. RESULTS: Mortality was lower after OPV-only campaigns than before, with an MRR for after-campaign vs before-campaign being 0.75 (95% confidence interval [CI], .67-.85). Other campaigns did not have similar effects, the MRR being 1.22 (95% CI, 1.04-1.44) for OPV + VAS campaigns, 1.39 (95% CI, 1.20-1.61) for VAS-only campaigns, 1.32 (95% CI, 1.09-1.60) for MV + VAS campaigns, and 1.13 (95% CI, .86-1.49) for the H1N1 campaign. Thus, all other campaigns differed significantly from the effect of OPV-only campaigns. Effects did not differ for trivalent, bivalent, or monovalent strains of OPV. With each additional campaign of OPV only, the mortality rate declined further (MRR, 0.86 [95% CI, .81-.92] per campaign). With follow-up to 3 years of age, the number needed to treat to save 1 life with the OPV-only campaign was 50 neonates. CONCLUSIONS: OPV campaigns can have a much larger effect on child survival than otherwise assumed. Stopping OPV campaigns in low-income countries as part of the endgame for polio infection may increase child mortality.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Poliomielite , Criança , Mortalidade da Criança , Guiné-Bissau , Humanos , Lactente , Recém-Nascido , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacina Antipólio Oral , Vacinação
17.
Sex Transm Infect ; 97(1): 51-55, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32345631

RESUMO

OBJECTIVES: Complications from sexually transmitted infections (STIs) can result in severe morbidity and mortality. To date, no STI population studies have been conducted on the Bijagos Islands, Guinea Bissau. Our objective was to estimate the prevalence of and identify risk factors for Chlamydia trachomatis (Ct), Neisseria gonorrhoea (Ng), Mycoplasma genitalium (Mg), Trichomonas vaginalis (Tv) and Treponema pallidum (Tp) on Bubaque, the most populated island. METHODS: A cross-sectional survey was conducted on the island of Bubaque among people aged 16-49 years. Participants were asked to answer a questionnaire on STI risk factors, to provide urine samples (men and women) and vaginal swabs (women) for PCR testing for Ct, Ng, Mg and Tv, and to provide dry blood spots for Tp particle agglutination assays. Data were analysed to estimate the prevalence of STIs and logistic regression was used to identify risk factors. RESULTS: In total, 14.9% of participants were found to have a curable STI, with the highest prevalence being observed for Tv (5.9%) followed by Ct (3.8%), Ng (3.8%), Mg (1.9%) and Tp (0.8%). Significant risk factors for having any STI included being female, younger age and concurrent partnership. Having had a previous STI that was optimally treated was a protective factor. CONCLUSIONS: This study demonstrates that there is a considerable burden of STI on the Bijagos Islands, stressing the need for diagnostic testing to facilitate early detection and treatment of these pathogens to stop ongoing transmission. Moreover, these results indicate the need to conduct further research into the STI burden on the Bijagos Islands to help inform and develop a national STI control strategy.


Assuntos
Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis , Estudos Transversais , DNA/urina , Feminino , Gonorreia/epidemiologia , Guiné-Bissau/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycoplasma/epidemiologia , Mycoplasma genitalium , Neisseria gonorrhoeae , Prevalência , Fatores de Risco , Sífilis/epidemiologia , Treponema pallidum , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis , Adulto Jovem
18.
J Ethnopharmacol ; 269: 113746, 2021 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-33359184

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: According to ethnobotanical surveys, Cassia sieberiana DC. (1825) is a particularly reputed species in African folk Medicine, namely due to the application of its leaves and roots for the treatment of diseases and symptomatology that appear to be related with an inflammatory background. In contrast with the roots of the plant, the leaves remain to be investigated, which prompted us to further detail mechanisms underlying their anti-inflammatory properties, by using in vitro models of disease. AIM OF THE STUDY: Considering its use in the amelioration and treatment of conditions that frequently underlie an inflammatory response, C. sieberiana leaves extract was prioritized amongst a collection of extracts obtained from plants collected in Guinea-Bissau. As such, this work aims to deliver experimental data on the anti-inflammatory properties of C. sieberiana leaf and to establish possible associations with its chemical composition, thus providing a rationale on its use in folk Medicine. MATERIALS AND METHODS: The chemical profile of an hydroethanol extract obtained from the leaves of the plant was established by HPLC-DAD-ESI/MSn in order to identify bioactives. The extract and its main compound were tested towards a series of inflammatory mediators, both in enzymatic and cell-based models. The capacity to interfere with the eicosanoid-metabolizing enzymes 5-lipoxygenase (5-LOX), cyclooxygenase-1 (COX-1) and -2 (COX-2) was evaluated in cell-free systems, while the effects in interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α) levels produced by THP-1 derived macrophages were assessed through ELISA. RESULTS: HPLC-DAD-ESI/MSn analysis of the extract elucidated a chemical profile qualitatively characterized by a series of anthraquinones, particularly rhein derivatives, and nine flavonols, most of which 3-O-glycosylated. Considering the concentrations of the identified compounds, quercetin was detached as the main component. Effects of the hydroethanol extract obtained from C. sieberiana leaves against key enzymes of the arachidonic acid cascade were recorded, namely a concentration-dependent inhibition against 5-LOX, at concentrations ranging from 16 to 250 µg mL-1 and a selective inhibitory action upon COX-2 (IC50 = 3.58 µg mL-1) in comparison with the isoform COX-1 (IC50 = 9.10 µg mL-1). Impact on inflammatory cytokines was also noted, C. sieberiana leaf extract significantly decreasing IL-6 levels in THP-1 derived macrophages at 250 and 500 µg mL-1. In contrast, TNF-α levels were found to be increased in the same model. Quercetin appears to partially account for the observed effects, namely due to the significant inhibitory effects on the activity of the arachidonic acid metabolizing enzymes COX-2 and 5-LOX. CONCLUSIONS: The anti-inflammatory effects herein reported provide a rationale for the use of C. sieberiana leaves in African folk practices, such as in the treatment of arthritis, rheumatism and body aches. Considering the occurrence of flavonoidic and anthraquinonic constituents, as well as the observed anti-inflammatory properties of quercetin, recorded effects must be related with the presence of several bioactives.


Assuntos
Anti-Inflamatórios/farmacologia , Cassia/química , Inibidores Enzimáticos/farmacologia , Inflamação/tratamento farmacológico , Extratos Vegetais/farmacologia , Antraquinonas/química , Anti-Inflamatórios/química , Ciclo-Oxigenase 1/efeitos dos fármacos , Ciclo-Oxigenase 2/efeitos dos fármacos , Citocinas/antagonistas & inibidores , Eicosanoides/metabolismo , Inibidores Enzimáticos/química , Flavonoides/química , Flavonoides/farmacologia , Guiné-Bissau , Humanos , Inflamação/induzido quimicamente , Lipopolissacarídeos/toxicidade , Medicina Tradicional , Fenóis/química , Extratos Vegetais/química , Folhas de Planta/química , Células THP-1
19.
Philos Trans R Soc Lond B Biol Sci ; 376(1818): 20190807, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33357055

RESUMO

Vector-borne diseases threaten the health of populations around the world. While key interventions continue to provide protection from vectors, there remains a need to develop and test new vector control tools. Cluster-randomized trials, in which the intervention or control is randomly allocated to clusters, are commonly selected for such evaluations, but their design must carefully consider cluster size and cluster separation, as well as the movement of people and vectors, to ensure sufficient statistical power and avoid contamination of results. Island settings present an opportunity to conduct these studies. Here, we explore the benefits and challenges of conducting intervention studies on islands and introduce the Bijagós archipelago of Guinea-Bissau as a potential study site for interventions intended to control vector-borne diseases. This article is part of the theme issue 'Novel control strategies for mosquito-borne diseases'.


Assuntos
Culicidae , Ilhas , Controle de Mosquitos/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Doenças Transmitidas por Vetores/prevenção & controle , Animais , Guiné-Bissau
20.
Mycoses ; 64(1): 4-17, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32969547

RESUMO

Cryptococcosis is a serious and sometimes fatal fungal disease caused by Cryptococcus species. Worldwide, it is estimated to kill over 180 000 annually, with 75% of deaths occurring in sub-Saharan Africa. Though cryptococcal infections are rare in otherwise healthy individuals, there have been reported cases in immunocompetent persons. Most cases occur in individuals who have weakened immune systems, particularly those with advanced HIV/AIDS, thus making West Africa a potential hotspot of the disease. Despite this, there is no recent review article with a focus on published findings on cryptococcosis in Western Africa. Common clinical symptoms include chest pain, dry cough, headache, nausea, confusion, fever, fatigue and stiffness of the neck/neurological impairment. The CNS and the lung remain its preferred target even though rare cases of attack on other parts of the body were reported in this review. Cryptococcal antigen screening and India ink preparation were the most commonly used diagnostic methods. Repeated isolation from environmental samples was observed. Overall, data on the clinical prevalence of Cryptococcus are scarce and variable in the region. The environmental prevalence ranges from 2.3% to 22%. This review covers all published research findings on cryptococcosis in West Africa till date. The epidemiological data will likely be of interest to clinicians within and outside the continent. The nations covered in this review include the following: Benin Republic, Burkina Faso, Cote d'ivoire, Ghana, Guinea, Guinea- Bissau, Mali, Nigeria, Senegal and Sierra Leone. More studies are warranted to fill the observed gaps on the epidemiology of Cryptococcus in the region.


Assuntos
Criptococose/epidemiologia , Cryptococcus , Síndrome de Imunodeficiência Adquirida/epidemiologia , África Ocidental/epidemiologia , Antígenos de Fungos , Benin/epidemiologia , Burkina Faso , Costa do Marfim/epidemiologia , Criptococose/diagnóstico , Criptococose/microbiologia , Gana/epidemiologia , Guiné/epidemiologia , Guiné-Bissau/epidemiologia , Humanos , Mali/epidemiologia , Nigéria/epidemiologia , Prevalência , Senegal/epidemiologia , Serra Leoa/epidemiologia
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