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The COVID-19 pandemic continues to have devastating consequences on health and economy, even after the approval of safe and effective vaccines. Waning immunity, the emergence of variants of concern, breakthrough infections, and lack of global vaccine access and acceptance perpetuate the epidemic. Here, we demonstrate that a single injection of an adenoassociated virus (AAV)-based COVID-19 vaccine elicits at least 17-month-long neutralizing antibody responses in non-human primates at levels that were previously shown to protect from viral challenge. To improve the scalability of this durable vaccine candidate, we further optimized the vector design for greater potency at a reduced dose in mice and non-human primates. Finally, we show that the platform can be rapidly adapted to other variants of concern to robustly maintain immunogenicity and protect from challenge. In summary, we demonstrate this class of AAV can provide durable immunogenicity, provide protection at dose that is low and scalable, and be adapted readily to novel emerging vaccine antigens thus may provide a potent tool in the ongoing fight against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).
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COVID-19 , Vacinas Virais , Animais , Anticorpos Neutralizantes , Anticorpos Antivirais , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Dependovirus/genética , Humanos , Macaca , Camundongos , Pandemias/prevenção & controle , SARS-CoV-2/genéticaRESUMO
Diarrheal diseases are the second leading cause of child mortality worldwide, occurring in about one in every nine child deaths, and were associated with water, sanitation, and hygiene (WASH) access. In this study, we provided an overview of WASH indicators' evolution from 2000 to 2017 and their impact on the occurrence of diarrhea in children under 5 years old in Senegal. It was a retrospective cross-sectional study, in which we did a secondary analysis of data from the Joint Monitoring Program (JMP) for water supply and sanitation and from the Senegal Demographic and Health Survey 2018. Our results showed that access to safely managed services increased by 18.1 and 19.1%, respectively, for water and sanitation. The prevalence of diarrhea estimated at 18.16% was associated with straining water through a cloth (adjusted odds ratio (AOR) [95% confidence interval (CI)]: 1.21 [1.00-1.45]) and getting water supplies from a source not located in a dwelling (AOR [95% CI]: 1.59 [1.21-2.09]). The prevalence of diarrhea among children under 5 years old was still relatively high in Senegal and was significantly associated with a lack of WASH access. Although the latter continues to increase, additional efforts to make water safer to drink will significantly reduce the occurrence of diarrheal diseases among children under 5 years old in Senegal.
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Higiene , Saneamento , Criança , Humanos , Pré-Escolar , Estudos Transversais , Estudos Retrospectivos , Senegal/epidemiologia , Diarreia/epidemiologiaRESUMO
BACKGROUND: One out of ten deaths of children under five are attributable to indoor air pollution. And Acute Respiratory Illness (ARI) is among the direct causes. OBJECTIVE: This study showed the possibilities of characterizing indoor air pollution in West African Economic and Monetary Union (WAEMU) area and it also made it possible to estimate its impact on the occurrence of ARI in children under five. METHODS: It has been a secondary analysis based on Demographic and Health Surveys (DHSs) from WAEMU countries' data.. "Household level of air pollution" is the created composite variable, from questions on the degradation factors of indoor air quality (domestic combustion processes) which served to characterize indoor air pollution and to measure its impact by a logistic regression. RESULTS: Burkina Faso stands out with a greater number of households with a high level of pollution (63.7%) followed by Benin (43.7%) then Togo (43.0%). The main exposure factor "Household level of air pollution" was associated with ARI symptoms (Togo: prevalence = 51.3%; chi-squared test's p-value < 0.001). Exposure to high level of pollution constitutes a risk (AOR [95 CI]), even though it is not significant ( Ivory Coast: 1.29 [0.72-2.30], Senegal: 1.39 [0.94-2.05] and Togo: 1.15 [0.67-1.95]) and this could be explained by the high infectious etiology of the ARI.
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Poluição do Ar em Ambientes Fechados , Poluição do Ar , Infecções Respiratórias , Criança , Humanos , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etiologia , Fatores de Risco , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Poluição do Ar em Ambientes Fechados/efeitos adversos , Poluição do Ar em Ambientes Fechados/análise , Prevalência , Burkina Faso , CulináriaRESUMO
Marine pollution in West Africa is major threat particularly around coastal megacities. We assess the chemical and ecotoxicological quality of the marine sediments in various submerged sampling sites of Dakar. Analysis revealed that sediments were slightly basic in which fine and coarse sands predominated. High percentages of total organic carbon were found sometime above 6%. Higher levels of heavy metal were reported than in previous studies. Chromium and nickel were above the Probable Effect Concentration. Low trophic level appeared not affected by the overall toxicity, while medium trophic level was more affected. Indeed, the vast majority (91%) of sites studied revealed a net percentage of Magallana gigas embryolarval developmental abnormality over 20%. The assessment of the global toxicity of marine sediments from the Dakar sites Studied (n = 11) seemed, almost, as a whole, to be in a poor ecotoxicological state calling to take measures to improve the sanitary condition of this marine feature.
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Ecotoxicologia , Monitoramento Ambiental , Senegal , África OcidentalRESUMO
AIM: The purpose of this article is to identify, the factors that would explain the adherence and use of MS and make recommendations for actions that would encourage the population to adhere more at the MS in the Ziguinchor region in Senegal. METHOD: The sample was concerned by 392 patients selected by the quota method in the hospitals of the region. The data were processed and analyzed by the sphinx and stata software through the logistic regression method. RESULTS: The factors that would explain the adherence and use of MS in the study area were: perception, the presence of an elderly person in the household, confidence in MS, household size and the pyramid medical institution.
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Hospitais , Idoso , Estudos Transversais , Humanos , Senegal/epidemiologiaRESUMO
AIM: The purpose of this article is to identify, the factors that would explain the adherence and use of MS and make recommendations for actions that would encourage the population to adhere more at the MS in the Ziguinchor region in Senegal. METHOD: The sample was concerned by 392 patients selected by the quota method in the hospitals of the region. The data were processed and analyzed by the sphinx and stata software through the logistic regression method. RESULTS: The factors that would explain the adherence and use of MS in the study area were: perception, the presence of an elderly person in the household, confidence in MS, household size and the pyramid medical institution.
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Seguro de Saúde Baseado na Comunidade , Idoso , Características da Família , Humanos , Seguro Saúde , SenegalRESUMO
The title compound, (C2H10N2)2[(C10H12N2O8)(MoO3)2]·4H2O, which crystallizes in the monoclinic C2/c space group, was obtained by mixing molybdenum oxide, ethyl-enedi-amine and ethyl-enedi-amine-tetra-acetic acid (H4edta) in a 2:4:1 ratio. The complex anion contains two MoO3 units bridged by an edta4- anion. The midpoint of the central C-C bond of the edta4- anion is located on a crystallographic inversion centre. The independent Mo atom is tridentately coordin-ated by a nitro-gen atom and two carboxyl-ate groups of the edta4- ligand, together with the three oxo ligands, producing a distorted octa-hedral coordination environment. In the three-dimensional supra-molecular crystal structure, the dinuclear anions, the organo-ammonium counter-ions and the solvent water mol-ecules are linked by N-Hâ¯Ow, N-Hâ¯Oedta and O-Hâ¯O hydrogen bonds.
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In the title salt, (C8H20N)8[Mo10O34], the [Mo10O34]8- polyanion is located about an inversion centre and can be considered as a ß-type octa-molybdate anion to which two additional MoO4 tetra-hedra are linked via common corners. The [Mo10O34]8- polyanions are packed in rows extending parallel to [001] and are connected to the di-butyl-ammonium counter-cations through N-Hâ¯O hydrogen-bonding inter-actions.
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INTRODUCTION: In francophone West Africa (FWA), contraceptive uptake remains limited, often due to geographic, economic, and social barriers. With technical support from The Challenge Initiative (TCI), municipalities and health systems implemented Family Planning Special Days (FPSDs) to improve family planning (FP) uptake and reduce high unmet need. The FPSD intervention consisted of organizing free FP services on a monthly or quarterly basis over 2 to 5 consecutive days within health facilities or sites close to the population. These events helped to educate, inform, and mobilize the community around FP and improve geographic and financial access to FP services. We describe the process of implementing FPSDs in FWA countries and analyze the results. METHODS: We used several techniques and data sources in our descriptive analysis, including document review of activity reports, analysis of health management information system data, and retrospective data collection on the profile of FPSD users and implementation costs. RESULTS: Between July 2020 and June 2021, municipalities and health systems collaborated to hold 1,046 FPSDs in 452 health facilities in 10 FWA cities. This collaboration was made possible through the establishment of city-level management and coordination units composed of municipal, health system, and TCI focal points. In the 10 FWA cities, 181,792 people were made aware of the FPSDs and 71,669 contraceptive users were served. The overall cost of organizing the FPSDs was about 145382501 Central African CFA francs (US$252839), 35% of which came from the municipalities' local financial contribution. DISCUSSION: Results from our analysis showed that, with appropriate financial support from municipalities, the health system could offer high-quality free FP services. Nonetheless, there are still challenges to the sustainability of conducting FPSDs, including the availability of contraceptive products and continued financing of the strategy during system shocks such as the COVID-19 pandemic.
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Comportamento Contraceptivo , Serviços de Planejamento Familiar , Humanos , Serviços de Planejamento Familiar/organização & administração , Feminino , África Ocidental , Acessibilidade aos Serviços de Saúde , Anticoncepção , Adulto , Adolescente , População Urbana , Adulto Jovem , Áreas de PobrezaRESUMO
INTRODUCTION: In Benin, the unmet need for family planning services is especially high for adolescent girls and youth aged 15-24 years. The Challenge Initiative (TCI) supported the health system to assess and improve the quality of adolescent and youth sexual reproductive health services and enhance contraceptive uptake in 65 service delivery points (SDPs) of the Zou department. PROGRAM DESCRIPTION: Between June 2019 and March 2021, TCI supported the health districts in Zou to train an assessment team to complete 3 cycles of quality assessments (QAs) using a QA checklist adapted to the local context. Based on assessment scores, the SDPs were categorized into poor, moderate, or good to excellent quality. The SDP managers developed remedial action plans after each cycle and for each SDP and followed up with supportive supervision. RESULTS: The first QA cycle showed that 52% of assessed SDPs achieved a good to excellent classification; by the second QA cycle, this reached 74%. However, the quality of adolescent- and youth-friendly health services regressed during the third QA cycle (during COVID-19 pandemic disruptions), when only 40% of SDPs achieved the good to excellent category. Between the first and second QA cycles, contraceptive uptake for adolescents and youth improved in the SDPs that had good or excellent quality of services, compared to the ones that were of lower quality (established significance level of 5% with a P value of .031). CONCLUSION: Further assessments could deepen our understanding of the internal and external factors that can affect service quality. The findings reinforce the importance of investing in quality improvement strategies to maximize the use of sexual and reproductive health services among adolescents and youth. They also underscore the need for a contextual and nuanced approach to ensure enduring results.
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Serviços de Saúde do Adolescente , Melhoria de Qualidade , Humanos , Adolescente , Benin , Melhoria de Qualidade/organização & administração , Feminino , Adulto Jovem , Serviços de Saúde do Adolescente/normas , Serviços de Saúde do Adolescente/organização & administração , Serviços de Saúde Reprodutiva/normas , Serviços de Saúde Reprodutiva/organização & administração , Serviços de Planejamento Familiar/normas , Serviços de Planejamento Familiar/organização & administração , Masculino , COVID-19/epidemiologiaRESUMO
The title SnIV complex, [Sn(C6H5)3Cl(C18H15O4P)], is a formal adduct between triphenyl phosphate (PhO)3P=O and the stannane derivative chlorido-tri-phenyl-tin, SnPh3Cl. The structure refinement reveals that this mol-ecule displays the largest Sn-O bond length for compounds including the X=OâSnPh3Cl fragment (X = P, S, C, or V), 2.6644â (17)â Å. However, an AIM topology analysis based on the wavefunction calculated from the refined X-ray structure shows the presence of a bond critical point (3,-1), lying on the inter-basin surface separating the coordinated phosphate O atom and the Sn atom. This study thus shows that an actual polar covalent bond is formed between (PhO)3P=O and SnPh3Cl moieties.
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Introduction: the World Health Organization (WHO) recommends immediate and exclusive breastfeeding in order to reduce malnutrition and neonatal mortality. The purpose of this study was to determine the prevalence of exclusive breastfeeding (EBF) and to identify its associated factors among mothers of children aged 6 to 12 months in Kaolack. Method: we conducted a cross-sectional descriptive and analytical study. The study was conducted from July 8th, 2020 to February 8th, 2021. Multivariate analysis was performed using the logistic regression model. The target population consisted of mothers of children aged 6 to 12 months residing in the city of Kaolack and met during vaccination sessions. Results: a total of 400 women were enrolled in the study. Among them, 51.8% practiced EBF according to the WHO recommendations. The average age of mothers was 27.42 years; 56.3% were housewives and 82.7% have done at least 4 antenatal care (ANC). Logistic regression showed an association between EBF and the following factors: age < 25 years (OR=2.03 CI 95% [1.23-3.36]), receiving advice on EBF during ANCs (OR=2.92 CI 95% [1.70-5.01]), receiving advice on EBF during postnatal care (PNC) (OR=4.33 CI 95% [2.51-7.45]), the permanent presence of mother with her baby (OR=3.97 CI 95% [1.99-7.91]), and a good knowledge of EBF (OR=4.54 CI 95% [1.96-10.51]). Conclusion: these modifiable factors can help improve the practice of EBF in the city of Kaolack.
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Aleitamento Materno , Mães , Humanos , Feminino , Gravidez , Criança , Lactente , Recém-Nascido , Adulto , Senegal , Estudos Transversais , Mortalidade InfantilRESUMO
The aim of this study was to evaluate the effect of the combination of amphotericin B (AmB) and various non-ionic surfactants on the anti-Mucorales activity of AmB, the toxicity of the combination on eukaryotic cells and the modification of AmB aggregation states. Checkerboards were performed on five genera of Mucorales (12 strains) using several combinations of different surfactants and AmB. These data were analyzed by an Emax model. The effect of surfactants on the cytotoxic activity of AmB was then evaluated for red blood cells and two eukaryotic cell lines by absorbance and propidium iodide internalization. Finally, the effect of polyethylene glycol (15)-hydroxystearate (PEG15HS) on the aggregation states of AmB was evaluated by UV-visible spectrometry. PEG15HS increased the efficacy of AmB on four of the five Mucorales genera, and MICs of AmB were decreased up to 68-fold for L. ramosa. PEG15HS was the only surfactant to not increase the cytotoxic activity of AmB. Finally, the analysis of AmB aggregation states showed that the increased efficacy of AmB and the absence of toxicity are related to an increase in monomeric and polyaggregated forms of AmB at the detriment of the dimeric form. In conclusion, PEG15HS increases the in vitro efficacy of AmB against Mucorales at low concentration, without increasing its toxicity; this combination could therefore be evaluated in the treatment of mucormycosis.
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The SARS-CoV-2 pandemic has had a disastrous impact on global health. Although some vaccine candidates have been effective in combating SARS-CoV-2, logistical, economical, and sociological aspects still limit vaccine access globally. Recently, we reported on two room-temperature stable AAV-based COVID-19 vaccines that induced potent and protective immunogenicity following a single injection in murine and primate models. Obesity and old age are associated with increased mortality in COVID-19, as well as reduced immunogenicity and efficacy of vaccines. Here, we investigated the effectiveness of the AAVCOVID vaccine candidates in murine models of obesity and aging. Results demonstrate that obesity did not significantly alter the immunogenicity of either vaccine candidate. In aged mice, vaccine immunogenicity was impaired. These results suggest that AAV-based vaccines may have limitations in older populations and may be equally applicable in obese and non-obese populations.
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COVID-19 , Vacinas , Idoso , Envelhecimento , Animais , Anticorpos Neutralizantes , Anticorpos Antivirais , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Modelos Animais de Doenças , Humanos , Camundongos , Obesidade , SARS-CoV-2 , Glicoproteína da Espícula de CoronavírusRESUMO
In this paper heavy metal pollution has been investigated by comparing total concentrations and speciation of heavy metals (Cr, Cu, Mn, Zn, Pb and Sr) in soils from four agricultural fields (S1, S2, S3, S4) located in the direct vicinity of the largest landfill in Senegal. The sequential test allowed discriminating between various fractions of heavy metals, namely the acid-extractable fraction, the fraction bound to Fe oxides, the fraction bound to organic matter and the residual fraction. It was proven that the most important fractions of metals (Cr, Cu, Pb, Mn, Sr and Zn) are bound to the residual fraction, more than 50% for most sites, and thus they may be relatively hardly liberated into the environment. The results also showed that the metal pollution in S3 and S4 were more severe than in other sampling sites, especially for Mn and Zn. In addition, the exchangeable fraction, which is the most available, represents from 10 to 47% of the total concentration for Sr, Mn and Zn, indicating that a non-negligible part of these elements may be easily released. Matrix correlation between soil characteristics and the elemental concentrations was tested to study and to detect a possible trend of metal mobilization from organic matter or oxides to agricultural soils. Vegetable grown from the four sampling sites were analyzed, Cr, Zn and Pb concentrations were high in many studied foodstuffs, (up to 54 mg/kg; 45.8 mg/kg and 3.4 mg/kg for Mn, Zn and Pb respectively) and higher than the threshold values of FAO/WHO. Calculation of hazard indexes suggested no potential health risks associated with consuming the vegetables with the exception of cassava and cassava leaves.
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Metais Pesados , Poluentes do Solo , Monitoramento Ambiental , Chumbo , Metais Pesados/análise , Óxidos , Solo , Poluentes do Solo/análise , VerdurasRESUMO
INTRODUCTION: In Senegal, the main causes of death are the pneumonia, the diarrhea and the malaria. The malnutrition is an underlying factor in more than a third of the deaths, because it returns the more vulnerable children to the serious illnesses. The general objective of this research is to study the availability and the price of medicine in the therapeutic care of the children of less than 5 years old in the region of Dakar in Senegal. METHODOLOGY: Our study is of transverse, descriptive concerned the public sanitary, the wholesalers, the private pharmacies, The population of study concerns the old children at least of 5ans. The methods used were the interviews by means of questionnaire. RESULTS: The group of antibiotics, acid anti, antidotes, vitamins, diuretics, antiemetic's, and psychotropic were not available. As regards generic medicines, relatively low availability of 30,4 %, 23,8 % and 16,7 % is respectively observed in the public, private and denominational sectors. The availability of generic medicines in Dakar was from 81 % in the public sector and from 113 % in the private sector. CONCLUSION: The findings make it imperative for all other relevant medicine drugs in order to reduce the mortality rate.
INTRODUCTION: Au Sénégal, les principales causes de mortalitéchez les enfants de moins de 5ans sont la pneumonie, la diarrhée et le paludisme. La malnutrition est un facteur sous-jacent dans plus d'un tiers des décès, car elle rend les enfants plus vulnérables aux maladies graves. MÉTHODE: Notre étude est de type transversal, descriptif et a porté sur les formations sanitaires publiques les grossistes, les pharmacies privées, L'objectif général de cette recherche est d'étudier la disponibilité et le prix des médicaments dans la prise en charge thérapeutique des enfants âgés de moins de 5 ans dans la région de Dakar au Sénégal. La méthode utilisée était des questionnaires et entrevues. RÉSULTATS: Le groupe des antibiotiques, des anti acides, des antidotes, des vitamines, des diurétiques, des antiémétiques et des psychotropes n'étaient pas disponibles. Concernant les médicaments génériques, des disponibilités relativement faibles de 30,4 %, 23,8% et 16,7% sont respectivement observées dans les secteurs public, privé et confessionnel. La disponibilité des médicaments génériques à Dakar était de 81% dans le secteur public et de 113% dans le secteur privé. CONCLUSION: Les résultats prouvent l'impérieuse nécessité de rendre disponibles les médicaments pédiatriques si nous voulons réduire la mortalité des enfants de moins de 5ans.
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Appendicitis is the first etiology for abdominal surgical emergency. Ascariasis is the most common helminth infection in tropical countries where it is endemic. The ability of intestinal helminths to wander through the digestive system means that it can end up in the appendix lumen and lead to appendicitis by luminal obstruction. However, this presentation is still rarely described in the literature. In fact, most of the diagnoses of roundworm associated with appendicitis are made retrospectively by the discovery of its eggs on the pathological examination of an appendectomy specimen. We report the case of a 7-year-old patient living in a tropical area who consulted for acute right lower quadrant pain. The ultrasound suspected the diagnosis of appendicitis and also revealed multiple intestinal worms including one in contact with the inflamed appendix. Surgical exploration confirmed appendicitis associated with roundworm partly in the appendicular lumen through a perforation.
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Gene therapy is emerging as a modality in 21st-century medicine. Adeno-associated viral (AAV) gene transfer is a leading technology to achieve efficient and durable expression of a therapeutic transgene. However, the structural complexity of the capsid has constrained efforts to engineer the particle toward improved clinical safety and efficacy. Here, we generate a curated library of barcoded AAVs with mutations across a variety of functionally relevant motifs. We then screen this library in vitro and in vivo in mice and nonhuman primates, enabling a broad, multiparametric assessment of every vector within the library. Among the results, we note a single residue that modulates liver transduction across all interrogated models while preserving transduction in heart and skeletal muscles. Moreover, we find that this mutation can be grafted into AAV9 and leads to profound liver detargeting while retaining muscle transduction-a finding potentially relevant to preventing hepatoxicities seen in clinical studies.
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Capsídeo , Vetores Genéticos , Animais , Camundongos , Capsídeo/metabolismo , Vetores Genéticos/genética , Dependovirus/genética , Proteínas do Capsídeo/genética , Fígado/metabolismoRESUMO
Introduction: atrial fibrillation (AF) is the most common cardiac rhythm disorder. Its prevalence is underestimated in Africa, hence the initiation of the Atrial Fibrillation Registry In Countries of Africa (AFRICA). The aim of our study was to describe, within the framework of the AFRICA registry, the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of atrial fibrillation (AF) in Africa, particularly in Senegal. Methods: we performed a cross-sectional, retrospective, multicentric study conducted from January 1st to December 31st 2017, in three referral cardiology wards in Senegal. Results: one hundred and sixty-eight patients, with a mean age of 63 years, were selected, representing a hospital prevalence of 5.99%. There was a predominance of women with sex-ratio of 0.69. High blood pressure was the most frequent risk factor (24.4%). Heart failure was the most frequent circumstance of discovery (59.52%). AF was persistent in 52.24% and valvular AF accounted for 31% and was more frequent in young people (p= 0.005). Left ventricular systolic function was impaired in 55.7%, the left atrium was dilated in 70.83%. The strategy to reduce heart rate was the most used. Patients with CHA2DS2VASC ≥ 2 received anticoagulation with LMWH and oral relay maid mostly of VKA. The complications were dominated by heart failure (66.6%) and ischemic stroke cerebral (28%). Conclusion: atrial fibrillation (AF) is the most frequent cardiac rhythm disorder. It is a major public health concern.
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Fibrilação Atrial , Cardiologia , Insuficiência Cardíaca , Humanos , Feminino , Adolescente , Pessoa de Meia-Idade , Masculino , Fibrilação Atrial/epidemiologia , Senegal/epidemiologia , Estudos Transversais , Heparina de Baixo Peso Molecular , Estudos RetrospectivosRESUMO
In the title compound, (C(12)H(24)N)[Sn(CH(3))(3)(C(6)H(6)O(3)P)(2)], the SnMe(3) residues are axially coordinated by two monodentate [PhPO(3)H](-) anions, leading to a trigonal-bipyramidal geometry for the Sn(IV) atom. The two [SnMe(3)(PhPO(3)H)(2)](-) anions in the unit cell are associated into infinite chains along the a axis by O-Hâ¯O hydrogen bonds involving the hy-droxy group of the hydrogen phenyl-phospho-nate ion. The chains inter-act with one another via O-Hâ¯O hydrogen bonds along the c axis. These networks of anions assemble with the dicyclo-hexyl-ammonium ion through N-Hâ¯O hydrogen bonds, forming a three-dimensional network.