RESUMO
BACKGROUND: Since the early 1970s, cholera outbreaks have been a major public health burden in the Democratic Republic of Congo (DRC). Cholera cases have been reported in a quasi-continuous manner in certain lakeside areas in the Great Lakes Region. As these cholera-endemic health zones constitute a starting point for outbreaks and diffusion towards other at-risk areas, they play a major role in cholera dynamics in the country. Monitoring the spatiotemporal dynamics of cholera hotspots and adjusting interventions accordingly thus reduces the disease burden in an efficient and cost-effective manner. METHODS: A literature review was conducted to describe the spatiotemporal dynamics of cholera in the DRC at the province level from 1973 to 1999. We then identified and classified cholera hotspots at the provincial and health zone levels from 2003 to 2022 and described the spatiotemporal evolution of hotspots. We also applied and compared three different classification methods to ensure that cholera hotspots are identified and classified according to the DRC context. RESULTS: According to all three methods, high-priority hotspots were concentrated in the eastern Great Lakes Region. Overall, hotspots largely remained unchanged over the course of the study period, although slight improvements were observed in some eastern hotspots, while other non-endemic areas in the west experienced an increase in cholera outbreaks. The Global Task Force on Cholera Control (GTFCC) and the Department of Ecology and Infectious Disease Control (DEIDC) methods largely yielded similar results for the high-risk hotspots. However, the medium-priority hotspots identified by the GTFCC method were further sub-classified by the DEIDC method, thereby providing a more detailed ranking for priority targeting. CONCLUSIONS: Overall, the findings of this comprehensive study shed light on the dynamics of cholera hotspots in the DRC from 1973 to 2022. These results may serve as an evidence-based foundation for public health officials and policymakers to improve the implementation of the Multisectoral Cholera Elimination Plan, guiding targeted interventions and resource allocation to mitigate the impact of cholera in vulnerable communities.
Assuntos
Cólera , Humanos , Cólera/epidemiologia , República Democrática do Congo/epidemiologia , Surtos de Doenças , Saúde PúblicaRESUMO
BACKGROUND: The Democratic Republic of the Congo (DRC) implemented the first strategic Multisectoral Cholera Elimination Plan (MCEP) in 2008-2012. Two subsequent MCEPs have since been implemented covering the periods 2013-2017 and 2018-2021. The current study aimed to assess the spatiotemporal dynamics of cholera over the recent 22-year period to determine the impact of the MCEPs on cholera epidemics, establish lessons learned and provide an evidence-based foundation to improve the implementation of the next MCEP (2023-2027). METHODS: In this cross-sectional study, secondary weekly epidemiological cholera data covering the 2000-2021 period was extracted from the DRC Ministry of Health surveillance databases. The data series was divided into four periods: pre-MCEP 2003-2007 (pre-MCEP), first MCEP (MCEP-1), second MCEP (MCEP-2) and third MCEP (MCEP-3). For each period, we assessed the overall cholera profiles and seasonal patterns. We analyzed the spatial dynamics and identified cholera risk clusters at the province level. We also assessed the evolution of cholera sanctuary zones identified during each period. RESULTS: During the 2000-2021 period, the DRC recorded 520,024 suspected cases and 12,561 deaths. The endemic provinces remain the most affected with more than 75% of cases, five of the six endemic provinces were identified as risk clusters during each MCEP period (North Kivu, South Kivu, Tanganyika, Haut-Lomami and Haut-Katanga). Several health zones were identified as cholera sanctuary zones during the study period: 14 health zones during MCEP-1, 14 health zones during MCEP-2 and 29 health zones during MCEP-3. Over the course of the study period, seasonal cholera patterns remained constant, with one peak during the dry season and one peak during the rainy season. CONCLUSION: Despite the implementation of three MCEPs, the cholera context in the DRC remains largely unchanged since the pre-MCEP period. To better orient cholera elimination activities, the method used to classify priority health zones should be optimized by analyzing epidemiological; water, sanitation and hygiene; socio-economic; environmental and health indicators at the local level. Improvements should also be made regarding the implementation of the MCEP, reporting of funded activities and surveillance of cholera cases. Additional studies should aim to identify specific bottlenecks and gaps in the coordination and strategic efforts of cholera elimination interventions at the local, national and international levels.
Assuntos
Cólera , Humanos , Cólera/epidemiologia , Cólera/prevenção & controle , Estudos Transversais , Bases de Dados Factuais , República Democrática do Congo/epidemiologiaRESUMO
Salmonella enterica is the leading cause of bloodstream infection in children in sub-Saharan Africa, but few data are available from Central-Africa. We documented during the period November 2011 to May 2012 an epidemic increase in invasive Salmonella bloodstream infections in HGR Bwamanda, a referral hospital in Equateur Province, DR Congo. Salmonella spp. represented 90.4 % (103 out of 114) of clinically significant blood culture isolates and comprised Salmonella Typhimurium (54.4 %, 56 out of 103), Salmonella Enteritidis (28.2 %, 29 out of 103) and Salmonella Typhi (17.5 %, 18 out of 103), with Salmonella Enteritidis accounting for most of the increase. Most (82 out of 103, 79.6 %) isolates were obtained from children < 5 years old. Median ages of patients infected with Salmonella Typhimurium and Salmonella Enteritidis were 14 months (14 days to 64 years) and 19 months (3 months to 8 years) respectively. Clinical presentation was non-specific; the in-hospital case fatality rate was 11.1 %. More than two thirds (69.7 %, 53 out of 76) of children < 5 years for whom laboratory data were available had Plasmodium falciparum infection. Most (83/85, 97.6 %) non-typhoid Salmonella isolates as well as 6/18 (33.3 %) Salmonella Typhi isolates were multidrug resistant (i.e. resistant to the first-line oral antibiotics amoxicillin, trimethoprim-sulfamethoxazole and chloramphenicol), one (1.0 %) Salmonella Typhimurium had decreased ciprofloxacin susceptibility owing to a point mutation in the gyrA gene (Gly81Cys). Multilocus variable-number tandem-repeat (MLVA) analysis of the Salmonella Enteritidis isolates revealed closely related patterns comprising three major and four minor profiles, with differences limited to one out of five loci. These data show an epidemic increase in clonally related multidrug-resistant Salmonella bloodstream infection in children in DR Congo.
Assuntos
Bacteriemia/epidemiologia , Infecções por Salmonella/epidemiologia , Salmonella enteritidis/isolamento & purificação , Salmonella typhi/isolamento & purificação , Salmonella typhimurium/isolamento & purificação , Adolescente , Distribuição por Idade , Bacteriemia/microbiologia , Criança , Pré-Escolar , Análise por Conglomerados , República Democrática do Congo/epidemiologia , Farmacorresistência Bacteriana , Feminino , Humanos , Incidência , Lactente , Masculino , Tipagem Molecular , Infecções por Salmonella/microbiologia , Salmonella enteritidis/classificação , Salmonella enteritidis/genética , Análise de SobrevidaRESUMO
While risk factors for konzo are known, determinants of cognitive impairment in konzo-affected children remain unknown. We anchored cognitive performance (KABC-II scores) to serum levels of free-thyroxine (free-T4), thyroid-stimulating hormone (TSH), albumin, and motor proficiency (BOT-2 scores) in 40 children including 21 with konzo (median age: 9 years) and 19 without konzo (median age: 8 years). A multiple regression model was used to determine variables associated with changes in KABC-II scores. Age (ß: -0.818, 95% CI: -1.48, -0.152) (p = 0.018), gender (ß: -5.72; 95% CI: -9.87, -1.57 for females) (p = 0.009), BOT-2 score (ß: 0.390; 95% CI: 0.113, 0.667) (p = 0.008), and free-T4 (ß: 1.88; 95% CI: 0.009, 3.74) (p = 0.049) explained 61.1 % of variation in KABC-II scores. Subclinical hypothyroidism was not associated with poor cognition. A crude association was found between serum albumin and KABC-II scores (ß: 1.26; 95 % CI: 0.136, 2.39) (p = 0.029). On spot urinary thiocyanate reached 688 µmol/l in children without konzo and 1,032 µmol/L in those with konzo. Female gender and low serum albumin are risk factors common to cognitive and proportionally associated motor deficits in children exposed to cassava cyanogens. The two types of deficits may share common mechanisms.
Assuntos
Transtornos da Nutrição Infantil/diagnóstico , Cognição/fisiologia , Cianetos/efeitos adversos , Manihot/efeitos adversos , Nitrilas/efeitos adversos , Paraparesia Espástica Tropical/diagnóstico , Criança , Transtornos da Nutrição Infantil/epidemiologia , Transtornos da Nutrição Infantil/etiologia , Cognição/efeitos dos fármacos , Cianetos/administração & dosagem , Feminino , Humanos , Masculino , Nitrilas/administração & dosagem , Paraparesia Espástica Tropical/epidemiologia , Paraparesia Espástica Tropical/etiologia , Desempenho Psicomotor/efeitos dos fármacos , Desempenho Psicomotor/fisiologiaRESUMO
BACKGROUND: The coronavirus pandemic again highlighted the need for robust health care facility infection prevention and control (IPC) programmes. WHO guidelines on the core components (CCs) of IPC programmes provides guidance for facilities, but their implementation can be difficult to achieve in resource-limited settings. We aimed to gather evidence on an initial WHO IPC implementation experience using a mixed methods approach. METHODS: A five-day training on the WHO IPC CCs was conducted at two reference acute health care facilities in the Democratic Republic of Congo and Burkina Faso. This was accompanied by a three-part mixed-methods evaluation consisting of a: (1) baseline and follow-up survey of participants' knowledge, attitudes and practices (KAP), (2) qualitative assessment of plenary discussion transcripts and (3) deployment of the WHO IPC assessment framework (IPCAF) tool. Results were analysed descriptively and with a qualitative inductive thematic approach. RESULTS: Twenty-two and twenty-four participants were trained at each facility, respectively. Baseline and follow-up KAP results suggested increases in knowledge related to the necessity of a dedicated IPC focal person and annual evaluations of IPC training although lack of recognition on the importance of including hospital leadership in IPC training and hand hygiene monitoring recommendations remained. Most participants reported rarely attending IPC meetings or participating in IPC action planning although attitudes shifted towards stronger agreement with the feeling of IPC responsibility and importance of an IPC team. A reocurring theme in plenary discussions was related to limited resources as a barrier to IPC implementation, namely lack of reliable water access. However, participants recognised the importance of IPC improvement efforts such as practical IPC training methods or the use of data to improve quality of care. The facilities' IPCAF scores reflected a 'basic/intermediate' IPC implementation level. CONCLUSIONS: The training and mixed methods evaluation revealed initial IPC implementation experiences that could be used to inform stepwise approaches to facility IPC improvement in resource-limited settings. Implementation strategies should consider both global standards such as the WHO IPC CCs and specific local contexts. The early involvement of all relevant stakeholders and parallel efforts to advocate for sufficient resources and health system infrastructure are critical.
Assuntos
Infecção Hospitalar , Humanos , Infecção Hospitalar/prevenção & controle , Controle de Infecções/métodos , Hospitais , Organização Mundial da Saúde , Burkina FasoRESUMO
Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a major public health concern. We previously demonstrated the presence of ESBL-producing Enterobacteriaceae in sachet-packaged water bags sold in Kinshasa, the Democratic Republic of the Congo. In complement to the previous study, we aimed to assess the presence of ESBL-producing Enterobacteriaceae in waste waters in Kinshasa.Enterobacteriaceae isolates recovered from environmental water samples were screened and phenotypically confirmed as ESBL-producers by disk diffusion according to Clinical and Laboratory Standards Institute (CLSI) guidelines (CLSI M100-S21). Final identification to the species level and further antimicrobial susceptibility testing were carried out with MicroScan® NBC42 panels and the identification of bla (ESBL) coding genes was performed by a commercial multiplex ligation polymerase chain reaction (PCR) microarray (Check-Points CT 101, Wageningen, the Netherlands). Overall, 194 non-duplicate Enterobacteriaceae were recovered from several sewer and river sites in nine out of 24 municipalities of Kinshasa. Fourteen isolates (7.4 %) were confirmed as ESBL-producers, the main species being Enterobacter cloacae (46.6 %) and Klebsiella pneumoniae (40.0 %). Associated resistance to both aminoglycoside and fluoroquinolone antibiotics was observed in ten isolates; the remaining isolates showed co-resistance to either fluoroquinolone (n = 3) or to aminoglycoside (n = 1) alone. All but one isolate carried bla (CTX-M) genes belonging to the CTX-M-1 group. ESBL-producing Enterobacteriaceae are increasingly being reported from various sources in the community. The present results suggest that ESBL-producing Enterobacteriaceae are widespread in the environment in the community of Kinshasa. Cities in Central Africa should be added to the map of potentially ESBL-contaminated environments and highlight the need to reinforce safe water supply and public sanitation.
Assuntos
Enterobacteriaceae/enzimologia , Enterobacteriaceae/isolamento & purificação , Águas Residuárias/microbiologia , beta-Lactamases/metabolismo , Antibacterianos/farmacologia , República Democrática do Congo , Farmacorresistência Bacteriana , Humanos , Análise em Microsséries , Testes de Sensibilidade Microbiana , Reação em Cadeia da Polimerase , beta-Lactamases/genéticaRESUMO
In the Democratic Republic of the Congo, the first recourse in case of suspected malaria in the health system is the private pharmacy sector. This study was therefore designed to assess private provider adherence to national case management guidelines in Kimpese, a rural area of Central Kongo province. A descriptive cross-sectional survey of 103 pharmacies took place in March 2016. The study included 97 pharmacies. The artemether-lumefantrine combination recommended as the first-line treatment for uncomplicated P. falciparum malaria was available in 100% of pharmacies but only 3% stocked quality-assured medicines. The sulfadoxine-pyrimethamine recommended for intermittent preventive treatment of malaria in pregnant women and quinine, which is no longer part of national policy, were widely available (>97.0% of pharmacies). Among providers, fewer than 20% were aware of the national malaria treatment guidelines. The main reasons for non-adherence to national guidelines among private dispensers was the high cost (up to 10 times more expensive than sulfadoxine-pyrimethamine treatment) and adverse effects of artemisinin-based combination therapies. Governmental interventions to improve private sector engagement in implementation of the national guidelines and to prevent the spread of ineffective and non-quality assured antimalarial medicines must be intensified.
Assuntos
Antimaláricos/uso terapêutico , Combinação Arteméter e Lumefantrina/uso terapêutico , Fidelidade a Diretrizes/estatística & dados numéricos , Malária/tratamento farmacológico , Assistência Farmacêutica/normas , Farmácias , Setor Privado , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Adulto , Idoso , Administração de Caso , Estudos Transversais , República Democrática do Congo , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde da População Rural , Adulto JovemRESUMO
OBJECTIVE: Artemisinin-based combination therapies have been available since 2005 in the Democratic Republic of the Congo to treat malaria and to overcome the challenge of anti-malarial drug resistance as well as to improve access to effective treatments. The private sector is the primary distribution source for anti-malarial drugs and thus, has a key position among the supply chain actors for a rational and proper use of anti-malarial drugs. We aimed to assess access to nationally recommended anti-malarial drugs in private sector pharmacies of the capital-city of Kinshasa. METHOD: We performed a cross-sectional survey of 404 pharmacies. RESULTS: Anti-malarial drugs were stocked in all surveyed pharmacies. Non-artemisinin-based anti-malarial therapies such as quinine or sulfadoxine-pyrimethamine, were the most frequently stocked drugs (93.8% of pharmacies). Artemisinin-based combination therapies were stocked in 88% of pharmacies. Artemether-lumefantrine combinations were the most frequently dispensed drugs (93% of pharmacies), but less than 3% were quality-assured products. Other non-officially recommended artemisinin-based therapies including oral monotherapies were widely available. CONCLUSION: Artemisinin-based combination therapies were widely available in the private pharmacies of Kinshasa. However, the private sector does not guarantee the use of nationally recommended anti-malarial drugs nor does it give priority to quality-assured anti-malarial drugs. These practices contribute to the risk of emergence and spread of resistance to anti-malarial drugs and to increasing treatment costs.
Assuntos
Antimaláricos/provisão & distribuição , Artemisininas/provisão & distribuição , Farmácias/estatística & dados numéricos , Antimaláricos/uso terapêutico , Artemisininas/uso terapêutico , Estudos Transversais , República Democrática do Congo , Combinação de Medicamentos , Humanos , Setor PrivadoRESUMO
Molecular epidemiological studies revealed that the epicenter of the HIV pandemic was Kinshasa, the capital city of the Democratic Republic of the Congo (DRC) in Central Africa. All known subtypes and numerous complex recombinant strains co-circulate in the DRC. Moreover, high intra-subtype diversity has been also documented. During two previous surveys on HIV-1 antiretroviral drug resistance in the DRC, we identified two divergent subtype C lineages in the protease and partial reverse transcriptase gene regions. We sequenced eight near full-length genomes and classified them using bootscanning and likelihood-based phylogenetic analyses. Four strains are more closely related to subtype C although within the range of inter sub-subtype distances. However, these strains also have small unclassified fragments and thus were named CRF92_C2U. Another strain is a unique recombinant of CRF92_C2U with an additional small unclassified fragment and a small divergent subtype A fragment. The three remaining strains represent a complex mosaic named CRF93_cpx. CRF93_cpx have two fragments of divergent subtype C sequences, which are not conventional subtype C nor the above described C2, and multiple divergent subtype A-like fragments. We then inferred the time-scaled evolutionary history of subtype C following a Bayesian approach and a partitioned analysis using major genomic regions. CRF92_C2U and CRF93_cpx had the most recent common ancestor with conventional subtype C around 1932 and 1928, respectively. A Bayesian demographic reconstruction corroborated that the subtype C transition to a faster phase of exponential growth occurred during the 1950s. Our analysis showed considerable differences between the newly discovered early-divergent strains and the conventional subtype C and therefore suggested that this virus has been diverging in humans for several decades before the HIV/M diversity boom in the 1950s.
RESUMO
We assessed the relationship between key trace elements and neurocognitive and motor impairments observed in konzo, a motor neuron disease associated with cassava cyanogenic exposure in nutritionally challenged African children. Serum concentrations of iron, copper, zinc, selenium, and neurotoxic lead, mercury, manganese, cadmium, and cobalt were measured in 123 konzo children (mean age 8.53 years) and 87 non-konzo children (mean age 9.07 years) using inductively coupled plasma mass spectrometry (ICPMS). Concentrations of trace elements were compared and related to performance scores on the Kaufman Assessment Battery for Children, 2nd edition (KABC-II) for cognition and Bruininks-Oseretsky Test, 2nd edition (BOT-2) for motor proficiency. Children with konzo had low levels of selenium, copper, and zinc relative to controls. Selenium concentration significantly correlated with serum 8,12-iso-iPF2α-VI isoprostane (Spearman r=0.75, p<0.01) and BOT-2 scores (r=0.31, p=0.00) in children with konzo. Elemental deficiency was not associated with poor cognition. Mean (SD) urinary level of thiocyanate was 388.03 (221.75) µmol/l in non-konzo compared to 518.59 (354.19) µmol/l in konzo children (p<0.01). Motor deficits associated with konzo may possibly be driven by the combined effects of cyanide toxicity and Se deficiency on prooxidant mechanisms. Strategies to prevent konzo may include dietary supplementation with trace elements, preferentially, those with antioxidant and cyanide-scavenging properties.
Assuntos
Cognição , Cobre/sangue , Doença dos Neurônios Motores/sangue , Doença dos Neurônios Motores/fisiopatologia , Selênio/sangue , Zinco/sangue , África , Criança , Pré-Escolar , Cianetos/sangue , Dinoprosta/análogos & derivados , Dinoprosta/sangue , Feminino , Humanos , Masculino , Espectrometria de Massas , Doença dos Neurônios Motores/diagnóstico , Doença dos Neurônios Motores/urina , Testes Neuropsicológicos , Estresse Oxidativo , Tiocianatos/urinaRESUMO
Despite recent declines in HIV incidence, sub-Saharan Africa remains the most heavily affected region in the global HIV/AIDS epidemic. Estimates of HIV prevalence in African military personnel are scarce and inconsistent. We conducted a serosurvey between June and September 2007 among 4043 Armed Forces personnel of the Democratic Republic of Congo (FARDC) stationed in Kinshasa, Democratic Republic of Congo (DRC) to determine the prevalence of HIV and syphilis infections and describe associated risk behaviours. Participants provided blood for HIV and syphilis testing and responded to a demographic and risk factor questionnaire. The prevalence of HIV was 3.8% and the prevalence of syphilis was 11.9%. Women were more likely than men to be HIV positive, (7.5% vs. 3.6% respectively, aOR: 1.66, 95% C.I: 1.21-2.28, p < 0.05). Factors significantly associated with HIV infection included gender and self-reported genital ulcers in the 12 months before date of enrollment. The prevalence of HIV in the military appears to be higher than the general population in DRC (3.8% vs. 1.3%, respectively), with women at increased risk of infection.
Assuntos
Infecções por HIV/epidemiologia , Militares , Sífilis/epidemiologia , Adulto , Estudos Transversais , República Democrática do Congo/epidemiologia , Feminino , Infecções por HIV/sangue , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Sífilis/sangueRESUMO
In 2012, an unprecedented number of four distinct, partially overlapping filovirus-associated viral hemorrhagic fever outbreaks were detected in equatorial Africa. Analysis of complete virus genome sequences confirmed the reemergence of Sudan virus and Marburg virus in Uganda, and the first emergence of Bundibugyo virus in the Democratic Republic of the Congo.
Assuntos
Surtos de Doenças , Infecções por Filoviridae/epidemiologia , Filoviridae/genética , Filoviridae/isolamento & purificação , Genoma Viral , Febres Hemorrágicas Virais/epidemiologia , RNA Viral/genética , República Democrática do Congo/epidemiologia , Filoviridae/classificação , Infecções por Filoviridae/virologia , Febres Hemorrágicas Virais/virologia , Humanos , Dados de Sequência Molecular , Análise de Sequência de DNA , Uganda/epidemiologiaRESUMO
OBJECTIVES: Since measles presents mostly in children, a non-invasive sample collection technique such as oral fluid sampling would be very useful in the early detection of measles RNA and antibodies. The aim of this study was to validate the detection of anti-measles IgM and measles virus RNA in oral fluid and to make a comparison with the gold standard methods of ELISA using serum (Enzygnost(®) anti-Measles IgM) and in-house nested reverse transcriptase polymerase chain reaction (RT-PCR) using nasopharyngeal secretions. METHODS: Three samples each from 73 measles-positive and 44 measles-negative subjects (serum, oral fluid, and nasopharyngeal secretions) were analyzed. RESULTS: The anti-measles IgM ELISA (MicroImmune) on oral fluid was validated against the IgM ELISA (Siemens) for serum and this resulted in a sensitivity of 92% and specificity of 100%. A molecular nested RT-PCR using oral fluid was validated against the standard assay on nasopharyngeal secretions and gave a sensitivity of 100% and specificity of 100%. CONCLUSIONS: The results confirm that both serological and molecular oral fluid assays are suitable for routine use. The use of oral fluid samples for the detection of measles virus may encourage patients, general practitioners, and pediatricians to participate in the Belgian measles surveillance system and other epidemiological studies in the framework of the World Health Organization elimination program.
Assuntos
Sarampo/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Nasofaringe/metabolismo , Adolescente , Adulto , Anticorpos Antivirais/sangue , Líquidos Corporais/virologia , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina M/sangue , Lactente , Masculino , Sarampo/imunologia , Vírus do Sarampo/imunologia , Vírus do Sarampo/isolamento & purificação , Pessoa de Meia-Idade , Nasofaringe/virologia , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Saliva/virologia , Sensibilidade e Especificidade , Soro/virologia , Adulto JovemRESUMO
Reported here are two outbreaks of acute hemorrhagic conjunctivitis that occurred in the Democratic Republic of the Congo and in Morocco in the summers of 2003 and 2004, respectively, with a large impact on public health. Virus was isolated from the conjunctival swabs of 30 Congolese and 20 Moroccan patients. Enterovirus-specific cytopathic effect was observed in all samples. None of the strains could be typed using a conventional neutralization assay with the Melnick intersecting pools; however, by sequencing the VP1 region, the viruses could be identified as coxsackie A24 variants. Phylogenetic analysis of the 3C protease region revealed that these strains were closely related to each other as well as to genotype III isolates detected in Korea in 2002, thus proving their worldwide spread. This is the first report of an epidemic of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant in Africa since 1987 and the first ever from Morocco.
Assuntos
Conjuntivite Hemorrágica Aguda/virologia , Infecções por Coxsackievirus/virologia , Surtos de Doenças , Enterovirus Humano C/genética , Animais , Linhagem Celular , Conjuntivite Hemorrágica Aguda/epidemiologia , Infecções por Coxsackievirus/epidemiologia , República Democrática do Congo/epidemiologia , Enterovirus Humano C/isolamento & purificação , Genótipo , Humanos , Dados de Sequência Molecular , Marrocos/epidemiologia , Filogenia , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodosRESUMO
Intraperitoneally administered chlorite-oxidized oxyamylose (COAM) provided protection of mice against intranasal infection with several influenza virus strains. Treated animals invariably showed a reduced consolidation of the lungs and, in the case of infection with lethal strains of virus, also a delay in mortality. With a small dose of influenza A/PR8 virus, an increase in final survival rate could be observed. The effect of COAM on influenza virus infection lasted for at least 4 to 8 days. Inhibition of lung consolidation was not paralleled by a decrease in virus multiplication in the lung. The significance of this finding in relation to the mechanism of the antiviral action of COAM is discussed.
Assuntos
Antivirais/uso terapêutico , Infecções por Orthomyxoviridae/prevenção & controle , Orthomyxoviridae/efeitos dos fármacos , Polissacarídeos , Animais , Ácidos Carboxílicos/uso terapêutico , Cloro , Modelos Animais de Doenças , Feminino , Hemaglutininas Virais/análise , Injeções Intraperitoneais , Pulmão/microbiologia , Pulmão/patologia , Camundongos , Orthomyxoviridae/crescimento & desenvolvimento , Orthomyxoviridae/isolamento & purificação , Infecções por Orthomyxoviridae/microbiologia , Infecções por Orthomyxoviridae/mortalidade , Infecções por Orthomyxoviridae/patologia , Oxirredução , Especificidade da Espécie , Fatores de Tempo , Replicação Viral/efeitos dos fármacosRESUMO
The present study was undertaken to examine possible correlations between long-term protection of mice treated with polycarboxylates and infected with vaccinia virus, and the presence of subdetectable amounts of interferon in the tissues, as determined by tissue or organ resistance to replication of viruses. After a single dose of polycarboxylate, splenic resistance to virus replication could be detected. It persisted for 7 to 14 days, but no attempt was made to prove that it was due to subdetectable amounts of interferon. Whole-animal protection lasted longer than splenic resistance. Moreover, when different polycarboxylates and different virus strains were used, patterns of early protection were not correlated with those of splenic resistance. These data, as others presented earlier, suggest that, in addition to interferon, other antiviral mechanisms are stimulated by polycarboxylates.
Assuntos
Ácidos Carboxílicos/farmacologia , Imunidade Celular/efeitos dos fármacos , Indutores de Interferon/farmacologia , Vaccinia virus/imunologia , Vacínia/imunologia , Animais , Linhagem Celular , Células Cultivadas , Embrião de Galinha , Feminino , Fibroblastos , Técnica de Placa Hemolítica , Injeções Intraperitoneais , Rim , Mengovirus/imunologia , Camundongos/embriologia , Camundongos Endogâmicos , Polímeros/farmacologia , Coelhos , Baço/imunologia , Baço/microbiologia , Fatores de Tempo , Replicação Viral/efeitos dos fármacosAssuntos
Vacina contra Brucelose/administração & dosagem , Brucella abortus/imunologia , Brucelose/imunologia , Imunidade , Mengovirus/patogenicidade , Animais , Encéfalo/microbiologia , Feminino , Temperatura Alta , Injeções Intraperitoneais , Injeções Intravenosas , Interferons/biossíntese , Mengovirus/isolamento & purificação , Camundongos , Camundongos Endogâmicos , Fagocitose , Poliovirus/isolamento & purificação , Baço/microbiologia , Replicação ViralAssuntos
Ácidos/farmacologia , Antivirais/farmacologia , Interferons/biossíntese , Animais , Anticorpos/análise , Encéfalo/microbiologia , Ácidos Carboxílicos/administração & dosagem , Ácidos Carboxílicos/farmacologia , Injeções Intraperitoneais , Interferons/farmacologia , Camundongos , Polímeros/farmacologia , Fatores de Tempo , Viroses/imunologia , Viroses/microbiologia , Viroses/mortalidade , Vírus/efeitos dos fármacos , Vírus/isolamento & purificaçãoRESUMO
"Objectif : Determiner la frequence; le profil et l'evolution de la resistance primaire aux antituberculeux parmi des sujets seropositifs et seronegatifs pour le VIH traites dans deux centres de Kinshasa. Methodes : Les expectorations des sujets eligibles ont ete ensemencees sur milieu de Lowenstein Jensen et la sensibilite des souches aux antituberculeux usuels testee selon la technique des proportions de Canetti et al. (7). La resistance globale a un ou plusieurs antituberculeux etait de 42et la comparaison des donnees entre sujets VIH+ et VIH- a ete effectuee a l'aide du test de Chi-carre ou du test exact de Fisher selon le cas. Resultats : Sur 161 souches isolees de Mycobacterium tuberculosis; 68 (42) se sont revelees resistantes a au moins un de quatre antituberculeux testes. La monoresistance a ete plus marquee pour la streptomycine (30;4) et l'Isoniazide (19;9). La frequence la plus faible a ete observee pour la rifampicine (5). Le profil de la resistance globale n'a pas montre de difference significative entre sujets VIH+ et VIH- (45""vs 40; p=0;505) tandis que la resistance isolee est apparue plus marquee pour les sujets VIH+ pour tous les antituberculeux testes hormis l'ethambutol La multiresistance (MDR-TB) a ete observee pour 8 souches (5). Conclusion : Le taux de resistance primaire a au moins un antituberculeux et la presence de la multiresistance justifient l'extension de la surveillance au reste du pays en vue de definir les strategies adequates de riposte. L'impact du VIH sur la resistance merite d'etre etudie dans des series plus grandes."