[Gunshot wounds of low urinary tract in period of security crisis at the Sominé Dolo Hospital of Mopti (Mali): Epidemiological and diagnostic aspects]. / Blessures par arme à feu du bas appareil urinaire en période de crise sécuritaire à l'hôpital Sominé Dolo de Mopti (Mali) : aspects épidémiologiques et diagnostiques.

INTRODUCTION: Firearm injuries to the lower urinary tract are injuries resulting from an energy transfer from a projectile fired by a firearm or a blast from a firearm, to the bladder, prostate, urethra and terminal ureter. Our objective was to describe the epidemiological and diagnostic aspects in the context of a security crisis. PATIENTS AND METHOD: This was a descriptive cross-sectional study of lower urinary tract firearm injuries at Sominé Dolo Hospital in Mopti from January 2017 to December 2021. RESULTS: In five years, 29 traumas of the lower urinary tract have been collected, about 6 cases per year. The mean age of patients was 27.48 years, the sex ratio was 13.5/1. The main circumstances of occurrence were intercommunal violence 51.72 %, war wounds 31.03 %. Injuries were inflicted by rifles in 62.1 % and improvised explosive devices in 37.9 %. The main modes of discovery were acute urine retention, hematuria and penoscrotal wounds respectively in 31.03 %, 20.69 %, 17.24 %. The organs affected were the urethra in 58.62 %, the bladder, 37.93 %, the prostate 3.45 %. Associated non-urological lesions present in 68.96 % (n=20) were dominated by intestinal lesions and pelvic fractures. CONCLUSION: Firearm injuries to the lower urinary tract are rare despite the context of the security crisis. They affect young men, are mostly linked to intercommunal violence, and are dominated by urethral and bladder injuries.

Epidemiology and spatio-temporal distribution of gastrointestinal parasites infection and accuracy of FAMACHA test in sheep in traditional farming systems in Burkina Faso.

Blood and faecal samples from 2086 Sahelian and Djallonke sheep have been collected to assess the epidemiology and spatio-temporal distribution of gastrointestinal parasites. A survey with a questionnaire allowed collecting data on individual animal and farms. Faecal samples were analysed using the McMaster technique, while anaemia was assessed using FAMACHA score test and packed cell volume. The overall prevalence of gastrointestinal parasites was 91%, and strongyles (70.7%), Eimeria sp. (60.4%), Moniezia sp. (5.7%), Stronyloides sp. (0.9%) were identified. There was no significant association between the region and strongyles infection (P ˃ 0.05). Animals sampled during the rainy season (n = 565; P = 82.2%, mean EPG = 154.8 ± 12.02) were mostly and heavily infected than those from the hot dry (n = 518; P = 74.2%; mean EPG = 97.7 ± 17.4) and the cold dry season (n = 392; P = 55.5%; mean EPG = 24.5 ± 19.5) (P ˂ 0.05). Females (n = 1027; P = 72.1%; mean EPG = 77.6 ± 17) were most infected than males (n = 448; P = 67.7%; mean EPG = 61.6 ± 19.5) (P ˂ 0.05). Animals that were treated, at most 3 months before sampling (n = 166; P = 61.5%; mean EPG = 41.7 ± 21.4), were less infected than those, which received this treatment after three months before sampling (n = 199; P = 74.8%; mean EPG = 89.1 ± 15.8) (P ˂ 0.05). Data from blood samples indicate that 6.5% of sheep was anaemic (PCV ≤ 19%), while 59.7% was noted anaemic regarding FAMACHA scores. PCV values varied significantly for FAMACHA scores, and the highest mean value was noted for score 1 (27.6) (P ˂ 0.05). The Cohen's kappa score between FAMACHA and PCV was 0.02. These findings suggest that strongyles infections are significantly associated with season, and heavier infections were noted during rainy season.

Risk factors associated with necrotizing fasciitis of the lower limbs: A multicenter case-control study.

OBJECTIVE: The aim of this case-control study was to identify risk factors associated with necrotizing fasciitis (NF) of the lower limbs. PATIENTS AND METHODS: We conducted a prospective case-control study in hospital dermatology departments in 5 sub-Saharan African countries over a 2-year period (April 2017 to July 2019). The cases were patients with NF of the lower limbs and the controls were patients with leg erysipelas. Each case was matched with two controls for age (±5 years) and sex. We analyzed local and general factors. RESULTS: During the study period, 159 cases (73 females, 86 males) were matched with 318 controls. The mean age was 48.5±15.8 years for cases and 46.5±16.2 years for controls (P=0.24). The main local signs of NF were cutaneous necrosis (83.7%), pain (75.5%) and induration (42.1%). Multivariate analysis showed the following to be independent risk factors associated with NF of the lower limbs: obesity (odds ratio [OR]=2.10; 95% confidence interval [CI]: 1.21-3.42), diabetes (OR=3.97; 95% CI: 1.95-6.13), nicotine addiction (OR=5.07; 95% CI: 2.20-11.70), use of non-steroidal anti-inflammatory drugs (NSAIDs) (OR=7.85; 95% CI 4.60-14.21) and voluntary cosmetic depigmentation (OR=2.29; 95% CI: 1.19-3.73). CONCLUSION: Our study documents the role of NSAID use at the onset of symptoms as a risk factor for NF of the lower limbs. However, the originality of our study consists in the identification of voluntary cosmetic depigmentation as a risk factor for NF of the lower limbs in sub-Saharan Africa patients. Our results also identified typical overarching factors such as diabetes, obesity and nicotine addiction. Knowing these factors and taking them into account will enable optimization of management strategies for these conditions.

[Diabetes and frailty in the elderly. A prospective study of an outpatient population supported by general practitioners]. / Diabète et fragilité chez la personne âgée. Etude prospective d'une population ambulatoire prise en charge en Médecine générale.

INTRODUCTION: Elderly people with diabetes represent a large and growing part of the general practitioners patient database, but their state of frailty compared to the non-diabetic population is poorly understood. OBJECTIVE: To study the relationship between diabetes and frailty in people aged 65 and over in primary care. METHOD: Frailty syndrome was assessed by the Fried Scale and compared between populations of diabetic and non-diabetic patients; 268 patients were studied, including 129 diabetic patients. RESULTS: Frailty was found in 27.9 % of older diabetic patients. The observed mean Fried score was 1.76 in people with diabetes versus 1.39 in non-diabetics, with more frail diabetic subjects (p = 0.007). In this study, HbA1c levels showed no significant association to frailty. CONCLUSION: Larger studies in several general practice clinics should be performed on subjects over 65 years of age with or without diabetes.

INTRODUCTION: Les personnes âgées diabétiques représentent une part importante et croissante de la patientèle des médecins généralistes, mais leur état de fragilité par rapport à la population non diabétique est mal connu. Objectif : Etudier les relations entre diabète et fragilité chez la personne âgée de 65 ans et plus en médecine générale. Méthode : La fragilité a été évaluée par l'échelle de Fried et comparée entre les populations de patients diabétiques et non diabétiques; 268 patients ont été inclus dont 129 patients diabétiques. Résultats : La fragilité concernait 27,9 % des diabétiques. Le score de Fried moyen observé était de 1,76 chez les personnes diabétiques versus 1,39 chez les non-diabétiques, avec des sujets diabétiques plus fragiles (p = 0,007). Dans cette étude, le taux d'HbA1c n'est pas significativement associé à la fragilité. CONCLUSION: Des études de plus grande ampleur sur plusieurs sites ambulatoires devraient être réalisées en médecine générale chez les sujets âgés de plus de 65 ans, diabétiques ou non.

Signatures of aestivation and migration in Sahelian malaria mosquito populations.

During the long Sahelian dry season, mosquito vectors of malaria are expected to perish when no larval sites are available; yet, days after the first rains, mosquitoes reappear in large numbers. How these vectors persist over the 3-6-month long dry season has not been resolved, despite extensive research for over a century. Hypotheses for vector persistence include dry-season diapause (aestivation) and long-distance migration (LDM); both are facets of vector biology that have been highly controversial owing to lack of concrete evidence. Here we show that certain species persist by a form of aestivation, while others engage in LDM. Using time-series analyses, the seasonal cycles of Anopheles coluzzii, Anopheles gambiae sensu stricto (s.s.), and Anopheles arabiensis were estimated, and their effects were found to be significant, stable and highly species-specific. Contrary to all expectations, the most complex dynamics occurred during the dry season, when the density of A. coluzzii fluctuated markedly, peaking when migration would seem highly unlikely, whereas A. gambiae s.s. was undetected. The population growth of A. coluzzii followed the first rains closely, consistent with aestivation, whereas the growth phase of both A. gambiae s.s. and A. arabiensis lagged by two months. Such a delay is incompatible with local persistence, but fits LDM. Surviving the long dry season in situ allows A. coluzzii to predominate and form the primary force of malaria transmission. Our results reveal profound ecological divergence between A. coluzzii and A. gambiae s.s., whose standing as distinct species has been challenged, and suggest that climate is one of the selective pressures that led to their speciation. Incorporating vector dormancy and LDM is key to predicting shifts in the range of malaria due to global climate change, and to the elimination of malaria from Africa.

From farmers to livestock keepers: a typology of cattle production systems in south-western Burkina Faso.

Cattle production is an essential livelihood strategy in south-western Burkina Faso. Although having a distinct cultural role and known to be resistant against African animal trypanosomosis, the Lobi taurine cattle breed is endangered due to its low market value. As the first step in preservation efforts, our study aimed to develop a typology of production systems at the farm level. We used a structured questionnaire and focus group discussions for collecting data on household characteristics, socioeconomic activities, livestock, and access to services. The sample comprised 169 households in three communities. The analytical strategy included factor analysis of mixed data and hierarchical clustering. We identified four distinct types of cattle production systems: (1) sedentary Lobi farms, (2) sedentary crossbreed farms, (3) semi-transhumant Fulani zebu farms, and (4) transhumant Fulani zebu farms. Significant factors in developing this typology were the farmers' ethnic group, crop diversity, cattle herd size, cattle herd composition, number of small ruminants, and livestock management strategies. Across all production systems, men were considered being primary decision-makers in cattle production, with women, herders, and children being responsible for specific tasks. All identified production systems are increasingly confronting disease pressure and scarcity of water and land. Future efforts in preservation and breeding will need to respond to these trends in the agroecosystem, integrate risk management measures, and resonate with the specific needs of the different household members involved in cattle rearing.

[Ekbom syndrome or delusional parasitosis: Three cases in Ouagadougou (Burkina Faso)]. / Syndrome d'Ekbom ou parasitose délirante : trois cas à Ouagadougou, Burkina Faso.

INTRODUCTION: Ekbom syndrome is a rare disease characterized by a delusional conviction on the part of the patient of infestation with cutaneous parasites. It is rarely described in an African setting. Herein we report three cases observed in Ouagadougou. PATIENTS AND METHODS: Case 1: a 40-year-old housewife, living alone since her spouse left her, consulted for a feeling of insects under the skin and exulceration progressing over the previous year. A diagnosis was made of Ekbom syndrome in a depressed patient. Case 2: a 45-year-old bachelor, unemployed and with no children, consulted in dermatology for a sensation of continuous movement of insects under his skin, experienced over the previous six years. This sensation, which was worse in hair-covered areas, led to regular hair removal and untimely cleansing in a bid to dislodge them. Case 3: an 80-year-old patient, widowed for 3 years, consulted for a sensation of insects under her skin over the previous 2 years. This sensation was accompanied by intermittent pruritus and she removed the "insects" from her skin, which she brought to us in a sachet, but which in reality corresponded to debris of dead skin. We concluded on Ekbom syndrome in a depressive patient. CONCLUSION: These three cases of delusional parasitism observed in Ouagadougou, Burkina Faso, confirm the main clinical characteristics of Ekbom syndrome and underline the role of emotional and financial isolation, as well as pre-existing psychological difficulties, as potential triggers for this syndrome.

Do bednets including piperonyl butoxide offer additional protection against populations of Anopheles gambiae s.l. that are highly resistant to pyrethroids? An experimental hut evaluation in Burkina Fasov.

Malaria control is dependent on the use of longlasting insecticidal nets (LLINs) containing pyrethroids. A new generation of LLINs containing both pyrethroids and the synergist piperonyl butoxide (PBO) has been developed in response to increasing pyrethroid resistance in African malaria vectors, but questions remain about the performance of these nets in areas where levels of pyrethroid resistance are very high. This study was conducted in two settings in southwest Burkina Faso, Vallée du Kou 5 and Tengrela, where Anopheles gambiae s.l. (Diptera: Culicidae) mortality rates in World Health Organization (WHO) discriminating dose assays were < 14% for permethrin and < 33% for deltamethrin. When mosquitoes were pre-exposed to PBO in WHO tube assays, mortality rates increased substantially but full susceptibility was not restored. Molecular characterization revealed high levels of kdr alleles and elevated levels of P450s previously implicated in pyrethroid resistance. In cone bioassays and experimental huts, PBO LLINs outperformed the pyrethroid-only equivalents from the same manufacturers. Blood feeding rates were 1.6-2.2-fold lower and mortality rates were 1.69-1.78-fold greater in huts with PBO LLINs vs. non-PBO LLINs. This study indicates that PBO LLINs provide greater personal and community-level protection than standard LLINs against highly pyrethroid-resistant mosquito populations.

[Results of anastomotic urethroplasty for male urethral stricture disease]. / Résultats de l'urétroplastie anastomotique pour rétrécissement de l'urètre masculin.

OBJECTIVE: To report our experience with anastomotic uretroplasty (AU) due to male urethral stricture disease (USD) and to identify factors affecting the results. PATIENTS AND METHODS: We conducted a retrospective study over a period of 4 years and 6 months (July 2012 to December 2016). Any subsequent use of endoscopic urethrotomy or new urethroplasty was considered a failure. RESULTS: Forty-eight cases were included. The mean age of patients was 53.5±17.3 years (23-87 years). Urinary retention was the reason for consultation in 42 cases (87.5%). The most common localization of USD was the bulbar urethra (n=45). The mean length of USD was 1.23±0.62cm (0.5-3cm) with a median length of 1cm. The etiology was post-infectious in 56.3% of cases. More than half (58.3%) of patients had already undergone at least one urethral manipulation. After an average follow-up of 21.1±12.6 months (1 to 52 months), the overall success rate was 77.1%. In univariate analysis, length, cause and location of the stricture, age of patient, the presenting symptoms of the stricture, previous urethral manipulation and surgeon experience did not significantly impact on the success rate of anastomotic urethroplasty at one and two years follow-up. CONCLUSION: The AU had provided good results in our practice. The infectious origin of the stricture and previous urethral manipulation did not significantly impact the result of this surgical technique. LEVEL OF EVIDENCE: 4.

Correlates of whole-blood polyunsaturated fatty acids among young children with moderate acute malnutrition.

BACKGROUND: Severe acute malnutrition (SAM) has been associated with low polyunsaturated fatty acid (PUFA) status. However, investigations regarding PUFA status and correlates in children with moderate acute malnutrition (MAM) from low-income countries are scarce. The aim of this study was to describe whole-blood PUFA levels in children with moderate acute malnutrition (MAM) and to identify correlates of PUFAs. METHODS: We conducted a cross-sectional study using baseline data from a prospective nutritional intervention trial among 1609 children with MAM aged 6-23 months in Burkina Faso,West Africa. Whole-blood PUFAs were measured by gas chromatography and expressed as percent of total whole-blood fatty acids (FA%). Potential correlates of PUFAs including infection, inflammation, hemoglobin, anthropometry (difference between children diagnosed as having MAM based on low mid-upper-arm-circumference (MUAC) only, low MUAC and weight-for-height z-score (WHZ), or low WHZ only) and diet were assessed by linear regression adjusted for age and sex. RESULTS: Children with MAM had low concentrations of whole-blood PUFAs, particularly n-3 PUFAs. Moreover, children diagnosed with MAM based only on low MUAC had 0.32 (95% confidence interval (CI), 0.14; 0.50) and 0.40 (95% CI, 0.16; 0.63) FA% lower arachidonic acid (AA) than those recruited based on both low WHZ as well as low MUAC and those recruited with low WHZ only, respectively. Infection and inflammation were associated with low levels of all long-chain (LC)-PUFAs, while hemoglobin was positively associated with whole-blood LC-PUFAs. CONCLUSION: While PUFA deficiency was not a general problem, overall whole-blood PUFA concentrations, especially of n-3 PUFAs, were low. Infection, inflammation, hemoglobin, anthropometry and diet were correlates of PUFAs concentrations in children with MAM. TRIAL REGISTRATION: The trial is registered at http://www.isrctn.com ( ISRCTN42569496 ).

Audit of provincial IVIG Request Forms and efficacy documentation in four Ontario tertiary care centres.

OBJECTIVE: Retrospective audit of IVIG Request Forms in four Ontario tertiary care centres: to determine the case mix of new IVIG requests, to authenticate information provided, and to determine documentation of clinical efficacy. AIMS: To understand contributors to increases in IVIG utilisation and to determine whether IVIG is being used and monitored appropriately. INTRODUCTION: Intravenous immunoglobulin (IVIG) use in Canada is high compared with other developed countries. We performed a retrospective audit of new IVIG Request Forms across four tertiary care centres in Ontario, one with an active surveillance programme, to determine the case mix, authenticate information provided and assess documentation of efficacy. METHODS: Consecutive adult patients with a first-time IVIG request in 2014 were included. The ordering physician specialty, form completeness, documentation of diagnostic criteria for the medical condition and indication for IVIG use and documentation of efficacy were assessed by form and chart review. RESULTS: Of 178 patients, the most common indications for IVIG were immune thrombocytopenia (24.2%) and secondary immune deficiency (20.2%). The most frequent prescribers were haematologists (37.6%) and neurologists (10.7%). Other conditions not listed on the form represented 24.2% of cases, with most not indicated in current guidelines. A total of 32.6% of cases overall lacked verification of diagnostic criteria and 51.7% lacked verification for IVIG utilisation criteria, with the number of cases meeting criteria based on documentation being higher at the active surveillance site (P = 0.005). A total of 19.1% of cases had a discrepancy between the indication written on the form and the documented clinical diagnosis. A total of 18.7% of clinic notes following IVIG had no mention of efficacy. CONCLUSION: Our audit demonstrates a lack of compliance with IVIG Request Form requirements, a lack of documentation of diagnostic criteria and efficacy, and suggests inappropriate use of IVIG. Current implementation of the form may not be sufficient as a strategy for improving appropriate IVIG use.

Differences in genetic structure assessed using Y-chromosome and mitochondrial DNA markers do not shape the contributions to diversity in African sires.

Up to 173 African sires belonging to 11 different subpopulations representative of four cattle groups were analysed for six Y-specific microsatellite loci and a mitochondrial DNA fragment. Differences in Y-chromosome and mtDNA haplotype structuring were assessed. In addition, the effect of such structuring on contributions to total genetic diversity was assessed. Thirty-five Y-chromosome and 71 mtDNA haplotypes were identified. Most Y-chromosomes analysed (73.4%) were of zebu origin (11 haplotypes). Twenty-two Y-haplotypes (44 samples) belonged to the African taurine subfamily Y2a. All mtDNA haplotypes belonged to the "African" taurine T1 haplogroup with 16 samples and nine haplotypes belonging to a recently identified subhaplogroup (T1e). Median-joining networks showed that Y-chromosome phylogenies were highly reticulated with clear separation between zebu and taurine clusters. Mitochondrial haplotypes showed a clear star-like shape with small number of mutations separating haplotypes. Mitochondrial-based FST -statistics computed between cattle groups tended to be statistically non-significant (p > .05). Most FST values computed among groups and subpopulations using Y-chromosome markers were statistically significant. AMOVA confirmed that divergence between cattle groups was only significant for Y-chromosome markers (ΦCT  = 0.209). At the mitochondrial level, African sires resembled an undifferentiated population with individuals explaining 94.3% of the total variance. Whatever the markers considered, the highest contributions to total Nei's gene diversity and allelic richness were found in West African cattle. Genetic structuring had no effect on patterns of contributions to diversity.

Assessing the diversity of preferences of suburban smallholder sheep keepers for breeding rams in Ouagadougou, Burkina Faso.

Urbanisation in developing countries entails deep changes in the livestock sector and the management of animal genetic resources (AnGR). Sheep breeding around Ouagadougou (Burkina Faso) illustrates these changes and the need to coordinate genetic improvement in general and the use of crossbreeding in particular. For this, it is important to understand breeders' choices and improvement strategy, to accompany them within a national plan for AnGR management. In a context of missing market for breeding rams, a stated choice experiment was conducted with 137 farmers, together with a characterisation of herd management practices. This survey analyses farmers' preferences for breeding rams, estimating their willingness to pay (WTP) for different traits (attributes). Their practices were characterised by a high reliance on natural pastures (82% of farmers) and a minority of crossbreeding (23%). The highest WTP was observed for disease resistance. However, the subgroup of farmers practicing crossbreeding showed a tolerance to high susceptibility. A strong preference for the white colour was revealed. Although significant, the influence of sheep body size on decision-making showed a lesser importance, again with a distinct behaviour in the subgroup practicing crossbreeding. These results illustrate the need to take account of the diversity of goals and preferences among smallholder sheep keepers to gain their adhesion to a coordinated genetic improvement framework.

Public health structures attendance during the Ebola outbreak in Guéckédou, Guinea.

The Ebola virus disease (EVD) outbreak in West Africa may affect healthcare attendance. We describe, in the Guinean prefecture of Guéckédou, trends in attendance of public healthcare structures and the main reported diagnoses over the year following the EVD outbreak notification (March 2014). Monthly numbers of visits and main diagnoses such as malaria, schistosomiasis and measles reported by Guéckédou health centres and health posts were described from January 2012 to March 2015. The median number of visits was 15 724/month. From 1 April to 30 September 2014 (EVD outbreak peak), 90 947 visits were reported, representing decreases of 4·8% and 7·4% compared to 2013 and 2012, respectively. Following December 2014 (last EVD notification in Guéckédou), visits increased from 12 540 in January to 16 032 in March 2015. Malaria seasonality was observed in 2014 with 22 519 notifications from 1 April to 31 July. No seasonality was observed for intestinal schistosomiasis (median 485 cases/month); however, a peak was notified in March 2014 (824 cases). Over the study period, all measles cases were notified in 2015 (183 cases). Reduction in healthcare attendance in Guéckédou was modest during the EVD outbreak. Enhanced infectious disease surveillance is a challenge in this context, due to the impact of EVD on traditional prevention programmes.

Microbial diversity and biochemical characteristics of Borassus akeassii wine.

UNLABELLED: Palm wine produced traditionally and consumed by many people in the South-West of Burkina Faso is subject to alteration. In this study, we carried out a follow-up of two palm wines' fermentation during the 10 days in which palm wines are classically produced and consumed. We monitored biochemical characteristics of fermenting wines as well as followed the microflora kinetics using culture-dependent and culture-independent methods. The analysis of the acid content and the bacterial population revealed the correlation between the development of Lactic acid bacteria, acetic acid, and total acidity. Ribosomal intergenic spacer analysis and sequencing results revealed different yeast and bacterial populations for the two palm wines. Although Saccharomyces cerevisiae remained the sole yeast species in one fermentation, it was quickly replaced by Clavispora lusitaniae in the second fermentation, which had never been described until now in palm wine. When considering bacteria, the species Corynebacterium sp., Lactobacillus casei, Lactobacillus paracasei and Leuconostoc sp. were detected in both palm wines. But we also detected Acetobacter pasteurianus, Bacillus cereus and Bacillus thuringiensis in the second fermentation. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results highlight the evolution of palm wine during the 10 days separating palm tapping and consumption of the fermented wine. The fermentation step is performed within few hours and completed after 24 h. The next days, its acidity increases progressively with the production of lactic and acetic acids by bacteria. The high production of acetic acid is very likely one of the main cause of palm wine degradation during this period. This indicates that the solution to palm wine preservation might be protection against oxygen, as well as the limit of bacterial growth through the use of preservatives.

Lack of haplotype structuring for two candidate genes for trypanotolerance in cattle.

Bovine trypanotolerance is a heritable trait associated to the ability of the individuals to control parasitaemia and anaemia. The INHBA (BTA4) and TICAM1 (BTA7) genes are strong candidates for trypanotolerance-related traits. The coding sequence of both genes (3951 bp in total) were analysed in a panel including 79 Asian, African and European cattle (Bos taurus and B. indicus) to identify naturally occurring polymorphisms on both genes. In general, the genetic diversity was low. Nineteen of the 33 mutations identified were found just one time. Seventeen different haplotypes were defined for the TICAM1 gene, and 9 and 12 were defined for the exon 1 and the exon 2 of the INHBA gene, respectively. There was no clear separation between cattle groups. The most frequent haplotypes identified in West African taurine samples were also identified in other cattle groups including Asian zebu and European cattle. Phylogenetic trees and principal component analysis confirmed that divergence among the cattle groups analysed was poor, particularly for the INHBA sequences. The European cattle subset had the lowest values of haplotype diversity for both the exon1 (monomorphic) and the exon2 (0.077 ± 0.066) of the INHBA gene. Neutrality tests, in general, did not suggest that the analysed genes were under positive selection. The assessed scenario would be consistent with the identification of recent mutations in evolutionary terms.

[Ichthyosis and social stigma in Burkina Faso]. / Ichtyose et stigmatisation sociale au Burkina Faso.

BACKGROUND: Through the story of two families presenting ichthyosis, we report the support and social integration difficulties inherent in these genetic diseases. PATIENTS AND METHODS: Family No. 1: a 38-year-old shepherd and his wife of 25 years both had lamellar ichthyosis that had been present continually since childhood. They had had 2 stillborn infants as well as a live newborn that were all presenting lamellar ichthyosis. Family No. 2: a 45-year-old housewife was seen at our consultation with her 3 youngest children aged 8 years, 6 years and 18 months. According to the mother, at birth, all 3 children were covered with a membrane resembling plastic that crackled during movement, and they had red eyes. Examination of the 3 children revealed a clinical picture of lamellar ichthyosis with ectropion, malformed ears and brachydactyly. Although they presented delayed growth and weight development, psychomotor development was normal. There was no consanguinity between the parents. DISCUSSION: In both families, the visible nature of the dermatosis resulted in discrimination and ostracism. The precarious living conditions of the parents and the high cost of treatment in an African setting resulted in degradation of quality of life with exacerbation of the difficulties of social integration, resulting in a lack of schooling and a bleak future for these children.

[Ecthyma gangrenosum of the eyelid after chickenpox]. / Ecthyma gangreneux de la paupière compliquant une varicelle.

BACKGROUND: Ecthyma gangrenosum is an acute ulcer necrotic skin infection frequently caused by Pseudomonas aeruginosa. It is characterised by necrotic ulcerations circumscribed by an inflammatory halo. Lesions are normally found in the anal, genital and axillary regions. Ecthyma gangrenosum is most commonly seen in immunodepressed patients (cytotoxic chemotherapy, HIV infection, neutropenia or functional neutrophil deficiency, agammaglobulinemia). It is a rarely described complication in chicken pox. PATIENTS AND METHODS: Herein we report the case of a girl aged 2 ½ years presenting in our dermatology department with ecthyma gangrenosum on the right upper eyelid secondary to varicella. The disease course was marked by fibrous scarring of the inner canthus with ptosis of the right upper eyelid. The retractile scarring caused disability. DISCUSSION: There have been previous reports of the contribution of non-steroidal anti- inflammatory drugs (NSAIDs) to the appearance of necrotic cutaneous super infections during the course of chickenpox. The occurrence of such complications on an eyelid may be harmful not only for the function of the eye but it can also cause extensive aesthetic impairment. Subsequent aesthetic and functional impairment may be improved by corrective surgery.

First analysis of 10-year trends in national factor concentrates usage in haemophilia: data from CHARMS, the Canadian Hemophilia Assessment and Resource Management System.

The Canadian Hemophilia Assessment and Resource Management System (CHARMS) tracks factor concentrates (FC) from the sole suppliers, Canadian Blood Services (CBS) and Hema-Quebec (HQ), to hospitals and to patients' homes. Patients FC infusion data are entered into CHARMS at Canadian Hemophilia Treatment Centres (HTCs) then exported to the national database (CentrePoint). From 2000 to 2009, 2260 registered haemophilia A or B patients received FVIII (1,009,097,765 IU) and FIX (272,406,859 IU). Over 91% of FVIII and over 84% of FIX was infused at home. Utilization of FVIII progressively increased; this was accounted for by an increase in the number of patients treated (r = 0.97; P < 0.001), there being a linear relationship between the increase in utilization and the increase in number of patients treated (P < 0.001). There was also a correlation with the annual amount used per patient (r = 0.95; P < 0.001). Utilization of FIX did not increase over time. The highest proportional utilization of both FVIII and FIX was for prophylaxis, and this proportion progressively increased being, in year 10 (2009), 77% and 66% for FVIII and FIX respectively. The proportion used for bleeding remained steady; in year 10 that proportion was 14% for FVIII and 26% for FIX, the use per patient for bleeding decreasing. The HTC-based CHARMS tracking system is essential, in Canada, for analysing indications for infusion, for predicting utilization and planning for future needs.

Assessing introgression of Sahelian zebu genes into native Bos taurus breeds in Burkina Faso.

A total of 350 samples were analyzed to estimate zebu gene proportions into two different taurine cattle breeds of Burkina Faso (Lobi and N'Dama) using 38 microsatellites and various statistical methodologies. West African and East African zebu samples were sequentially used as reference parental populations. Furthermore, N'Dama cattle from Congo, the composite South African Bonsmara cattle breed and a pool of European cattle were used successively as second parental populations. Independently of the methodology applied: (a) the use of West African zebu samples gave higher admixture coefficients than the East African zebu; (b) the higher zebu proportions were estimated when the European cattle was used as parental population 2; and (c) the use of the N'Dama population from Congo as parental population 2 gave the more consistent zebu proportion estimates for both the Lobi and the N'Dama breeds. In any case, the zebu admixture proportions estimated were not negligible and were always higher in the N'Dama cattle than in the Lobi cattle of Burkina Faso. This suggested that the introgression of Sahelian zebu genes into the taurine cattle of Southern West Africa can follow a complex pattern that can depend on local agro-ecological features. The current research pointed out that the estimation of admixture coefficients is highly dependent on both the assumptions underlying the methodologies applied and the selection of parental populations. Our analyses suggest that either too high or nil genetic identity between the parental and the expectedly derived populations must be avoided.