Relationship South-North in a postcolonial context with Alain Mabanckou ABSTRACT: Starting from t... more Relationship South-North in a postcolonial context with Alain Mabanckou ABSTRACT: Starting from the problematic which tries to raise the question of the relationship between Black and White people, and also the reason that underlies such a relationship, this article attempts to bring elements of answer to a broad questioning from two novels by Alain Mabanckou: Black Bazar (Black Bazaar) and Tais-toi et meurs (Shut up and die). The article analyzes the relationship between Black and White people in a postcolonial context, which manifests itself in a relationship of tension, rejection of the other, but also with intimacy and greed. The Africa/Europe encounter, having been made under dramatic conditions that lowered the Black to the rank of animal, devoid of any faculty of reasoning, some White men continue to see the Black men with the same gaze of inferior human beings. For the analysis, and to clearly define the field of the study, we rely on work in the field of postcolonial studie...
Background A recent trial of 5920 children in Burkina Faso and Mali showed that the combination o... more Background A recent trial of 5920 children in Burkina Faso and Mali showed that the combination of seasonal vaccination with the RTS,S/AS01E malaria vaccine (primary series and two seasonal boosters) and seasonal malaria chemoprevention (four monthly cycles per year) was markedly more effective than either intervention given alone in preventing clinical malaria, severe malaria, and deaths from malaria. Methods In order to help optimise the timing of these two interventions, trial data were reanalysed to estimate the duration of protection against clinical malaria provided by RTS,S/AS01E when deployed seasonally, by comparing the group who received the combination of SMC and RTS,S/AS01E with the group who received SMC alone. The duration of protection from SMC was also estimated comparing the combined intervention group with the group who received RTS,S/AS01E alone. Three methods were used: Piecewise Cox regression, Flexible parametric survival models and Smoothed Schoenfeld residual...
Background Malaria and malnutrition remain major problems in Sahel countries, especially in young... more Background Malaria and malnutrition remain major problems in Sahel countries, especially in young children. The direct effect of malnutrition on malaria remains poorly understood, and may have important implications for malaria control. In this study, nutritional status and the association between malnutrition and subsequent incidence of symptomatic malaria were examined in children in Burkina Faso and Mali who received either azithromycin or placebo, alongside seasonal malaria chemoprevention. Methods Mid-upper arm circumference (MUAC) was measured in all 20,185 children who attended a screening visit prior to the malaria transmission season in 2015. Prior to the 2016 malaria season, weight, height and MUAC were measured among 4149 randomly selected children. Height-for-age, weight-for-age, weight-for-height, and MUAC-for-age were calculated as indicators of nutritional status. Malaria incidence was measured during the following rainy seasons. Multivariable random effects Poisson m...
Cet article propose une réflexion sur le totem et tabou qui sont considérés comme sources du mal ... more Cet article propose une réflexion sur le totem et tabou qui sont considérés comme sources du mal dans l'Etange destin de Wangrin. Après avoir montré les différentes manifestations du tabou dans le roman, l'article propose une typologie de totem comme on le constate dans le récit. Ainsi donc, on parvient à établir une distinction entre le totem individuel et celui du groupe. Pour finir, l'analyse essaye de montrer, contrairement au roman qui justifie l'échec de Wangrin par la transgression du tabou, que l'échec du héros s'explique plutôt par certaines violations de la doxa commune.
La tradition et le sacré peuvent être considérés comme deux thèmes fondamentaux toujours présents... more La tradition et le sacré peuvent être considérés comme deux thèmes fondamentaux toujours présents dans les romans de Seydou Badian. Ces deux éléments peuvent contribuer à la résolution des conflits dans la société, selon les circonstances. La tradition peut contribuer à apaiser la tension sociale grâce à certaines valeurs culturelles. Le sacré peut également intervenir dans le même contexte par le bon usage qu’en font les « connaisseurs ». Cet article tente de montrer l’intervention de la tradition et du sacré dans la résolution de la crise ou du conflit dans les romans de Seydou Badian.
Background A recent trial in Burkina Faso and Mali showed that combining seasonal RTS,S/AS01E mal... more Background A recent trial in Burkina Faso and Mali showed that combining seasonal RTS,S/AS01E malaria vaccination with seasonal malaria chemoprevention (SMC) substantially reduced the incidence of uncomplicated and severe malaria in young children compared to either intervention alone. Given the possible negative effect of malaria on nutrition, the study investigated whether these children also experienced lower prevalence of acute and chronic malnutrition. Methods In Burkina Faso and Mali 5920 children were randomized to receive either SMC alone, RTS,S/AS01E alone, or SMC combined with RTS,S/AS01E for three malaria transmission seasons (2017–2019). After each transmission season, anthropometric measurements were collected from all study children at a cross-sectional survey and used to derive nutritional status indicators, including the binary variables wasted and stunted (weight-for-height and height-for-age z-scores below − 2, respectively). Binary and continuous outcomes between ...
Additional file 4: Table S1. Association of baseline variables with low MUAC-for-age in two cohor... more Additional file 4: Table S1. Association of baseline variables with low MUAC-for-age in two cohorts in Mali. Table S2. Association of baseline variables with stunting, wasting and underweight in 2016 in Mali.
Additional file 3: Table S1. Association of baseline variables with low MUAC-for-age in two cohor... more Additional file 3: Table S1. Association of baseline variables with low MUAC-for-age in two cohorts in Burkina Faso. Table S2. Association of baseline variables with stunting, wasting and underweight in 2016 in Burkina Faso.
Additional file 1: Figure S1. Variation in prevalence of malnutrition (z-score below − 2) for MUA... more Additional file 1: Figure S1. Variation in prevalence of malnutrition (z-score below − 2) for MUAC and MUAC-for-age.
Background A trial in African children showed that combining seasonal vaccination with the RTS,S/... more Background A trial in African children showed that combining seasonal vaccination with the RTS,S/AS01E vaccine with seasonal malaria chemoprevention reduced the incidence of uncomplicated and severe malaria compared with either intervention given alone. Here, we report on the anti-circumsporozoite antibody response to seasonal RTS,S/AS01E vaccination in children in this trial. Methods Sera from a randomly selected subset of children collected before and 1 month after 3 priming doses of RTS,S/AS01E and before and 1 month after 2 seasonal booster doses were tested for anti-circumsporozoite antibodies using enzyme-linked immunosorbent assay. The association between post-vaccination antibody titer and incidence of malaria was explored. Results A strong anti-circumsporozoite antibody response to 3 priming doses of RTS,S/AS01E was seen (geometric mean titer, 368.9 enzyme-linked immunosorbent assay units/mL), but titers fell prior to the first booster dose. A strong antibody response to an...
Introduction Malaria has been the main cause of morbidity and mortality in Mali, with an increase... more Introduction Malaria has been the main cause of morbidity and mortality in Mali, with an increase from 2017 to 2020 (2,884,837 confirmed cases and 1,454 deaths). On the recommendation of the World Health Organization (WHO) and for efficient use of resources, Mali has begun a process of malaria stratification. Method Malaria, entomological and environmental data were collected through the local health information system, the Demographic and Health Survey 2018, research institutions and MALI-METEO services. The WHO stratification based on malaria incidence was used to present a stratified malaria risk map. Environmental factors associated with malaria were identified using a general additive non-linear regression model. The classification and regression tree method was used to improve the stratification. Interventions were proposed according to the incidence stratification and the different environmental, entomological, access to care maps. Results From 2017 to 2019, the median incide...
A tabular dataset that contains measurements of clinical malaria incidence, prevalence of P falci... more A tabular dataset that contains measurements of clinical malaria incidence, prevalence of P falciparum infection, and treatment efficacy. Data was collected as part of the AZ-SMC trial (clinicaltrials.gov NCT02211729) in Houndé District, Burkina Faso and Bougouni District, Mali between 2014 and 2016.
Introduction Seasonal malaria chemoprevention (SMC), with sulphadoxine–pyrimethamine plus amodiaq... more Introduction Seasonal malaria chemoprevention (SMC), with sulphadoxine–pyrimethamine plus amodiaquine (SP+AQ) is effective but does not provide complete protection against clinical malaria. The RTS,S/AS01E malaria vaccine provides a high level of protection shortly after vaccination, but this wanes rapidly. Such a vaccine could be an alternative or additive to SMC. This trial aims to determine whether seasonal vaccination with RTS,S/AS01E vaccine could be an alternative to SMC and whether a combination of the two interventions would provide added benefits. Methods and analysis This is an individually randomised, double-blind, placebo-controlled trial. 5920 children aged 5–17 months were enrolled in April 2017 in Mali and Burkina Faso. Children in group 1 received three priming doses of RTS,S/AS01E vaccine before the start of the 2017 malaria transmission season and a booster dose at the beginning of two subsequent transmission seasons. In addition, they received SMC SP+AQ placebo on...
In Mali, since 2007, artemether-lumefantrine has been the first choice against uncomplicated mala... more In Mali, since 2007, artemether-lumefantrine has been the first choice against uncomplicated malaria. Despite its effectiveness, a rapid selection of markers of resistance to partner drugs has been documented. This work evaluated the treatment according to the World Health Organization’s standard 28-day treatment method. The primary endpoint was the clinical and parasitological response corrected by a polymerase chain reaction. It was more than 99.9 percent, the proportion of patients with anemia significantly decrease compared to baseline (p < 0.001), and no serious events were recorded. Plasmodium falciparum remains sensitive to artemether-lumefantrine in Mali.
The drug administration dataset records contacts made with study participants to administer seaso... more The drug administration dataset records contacts made with study participants to administer seasonal malaria chemoprevention plus either azithromycin or placebo.
Background Seasonal malaria chemoprevention (SMC) is now widely deployed in the Sahel, including ... more Background Seasonal malaria chemoprevention (SMC) is now widely deployed in the Sahel, including several countries that are major contributors to the global burden of malaria. Consequently, it is important to understand whether SMC continues to provide a high level of protection and how SMC might be improved. SMC was evaluated using data from a large, householdrandomised trial in Houndé , Burkina Faso and Bougouni, Mali. Methods and findings The parent trial evaluated monthly SMC plus either azithromycin (AZ) or placebo, administered as directly observed therapy 4 times per year between August and November (2014-2016). In July 2014, 19,578 children aged 3-59 months were randomised by household to study group. Children who remained within the age range 3-59 months in August each year, plus children born into study households or who moved into the study area, received study drugs in 2015 and 2016. These analyses focus on the approximately 10,000 children (5,000 per country) under observation each year in the SMC plus placebo group. Despite high coverage and high adherence to SMC, the incidence of hospitalisations or deaths due to malaria and uncomplicated clinical malaria remained high in the study areas (overall incidence rates 12.5 [95% confidence interval (CI): 11.2, 14.1] and 871.1 [95% CI: 852.3, 890.6] cases per 1,000 person-years, respectively) and peaked in July each year, before
BACKGROUND Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions o... more BACKGROUND Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions of Africa. METHODS We conducted an individually randomized, controlled trial to assess whether seasonal vaccination with RTS,S/AS01 E was noninferior to chemoprevention in preventing uncomplicated malaria and whether the two interventions combined were superior to either one alone in preventing uncomplicated malaria and severe malaria-related outcomes. RESULTS We randomly assigned 6861 children 5 to 17 months of age to receive sulfadoxinepyrimethamine and amodiaquine (2287 children [chemoprevention-alone group]), RTS,S/AS01 E (2288 children [vaccine-alone group]), or chemoprevention and RTS,S/ AS01 E (2286 children [combination group]). Of these, 1965, 1988, and 1967 children in the three groups, respectively, received the first dose of the assigned intervention and were followed for 3 years. Febrile seizure developed in 5 children the day after receipt of the vaccine, but the children recovered and had no sequelae. There were 305 events of uncomplicated clinical malaria per 1000 personyears at risk in the chemoprevention-alone group, 278 events per 1000 person-years in the vaccine-alone group, and 113 events per 1000 person-years in the combination group. The hazard ratio for the protective efficacy of RTS,S/AS01 E as compared with chemoprevention was 0.92 (95% confidence interval [CI], 0.84 to 1.01), which excluded the prespecified noninferiority margin of 1.20. The protective efficacy of the combination as compared with chemoprevention alone was 62.8% (95% CI, 58.4 to 66.8) against clinical malaria, 70.5% (95% CI, 41.9 to 85.0) against hospital admission with severe malaria according to the World Health Organization definition, and 72.9% (95% CI, 2.9 to 92.4) against death from malaria. The protective efficacy of the combination as compared with the vaccine alone against these outcomes was 59.6% (95% CI, 54.7 to 64.0), 70.6% (95% CI, 42.3 to 85.0), and 75.3% (95% CI, 12.5 to 93.0), respectively. CONCLUSIONS Administration of RTS,S/AS01 E was noninferior to chemoprevention in preventing uncomplicated malaria. The combination of these interventions resulted in a substantially lower incidence of uncomplicated malaria, severe malaria, and death from malaria than either intervention alone.
International Journal of Environmental Research and Public Health, 2021
Context: In Mali, malaria transmission is seasonal, exposing children to high morbidity and morta... more Context: In Mali, malaria transmission is seasonal, exposing children to high morbidity and mortality. A preventative strategy called Seasonal Malaria Chemoprevention (SMC) is being implemented, consisting of the distribution of drugs at monthly intervals for up to 4 months to children between 3 and 59 months of age during the period of the year when malaria is most prevalent. This study aimed to analyze the evolution of the incidence of malaria in the general population of the health districts of Kati, Kadiolo, Sikasso, Yorosso, and Tominian in the context of SMC implementation. Methods: This is a transversal study analyzing the routine malaria data and meteorological data of Nasa Giovanni from 2016 to 2018. General Additive Model (GAM) analysis was performed to investigate the relationship between malaria incidence and meteorological factors. Results: From 2016 to 2018, the evolution of the overall incidence in all the study districts was positively associated with the relative hu...
Introduction: Idiopathic central serous chorioretinopathy (ICSC) is characterized by the buildup ... more Introduction: Idiopathic central serous chorioretinopathy (ICSC) is characterized by the buildup of fluid leading to circumscribed elevation of the retina within the posterior pole. This condition affects young people between the ages of 20-50 years. The disease is seen predominantly in men as compared to women. We report the cases of two (02) patients received in consultation at IOTA-Teaching Hospital between July 2019 and February 2020. Case Presentation: We report two cases of Idiopathic stress central serous chorioretinopathy. The first case is a 37-year-old man that we received in consultation for visual acuity decrease from a sudden installation for 1 hour. The clinical and paraclinical arguments permitted us to retain the diagnosis of Idiopathic stress central serous chorioretinopathy. The patient benefited from laser treatment and the clinical evolution was good. The second case is a 42-year-old man, who consulted for a sudden reduction of visual acuity that had been evolving for 3 weeks. The clinical and paraclinical contexts were in favour of the diagnosis of Idiopathic stress central serous chorioretinopathy. The patient was treated with spironolactone. The clinical evolution was favourable. Conclusion: Our study confirms the existence of central serous chorioretinopathy (CSC) in Black African patients. Studies show the connection between CSC and stress.
International Journal of Environmental Research and Public Health, 2020
Background: Previous controlled studies demonstrated seasonal malaria chemoprevention (SMC) reduc... more Background: Previous controlled studies demonstrated seasonal malaria chemoprevention (SMC) reduces malaria morbidity by >80% in children aged 3–59 months. Here, we assessed malaria morbidity after large-scale SMC implementation during a pilot campaign in the health district of Koutiala, Mali. Methods: Starting in August 2012, children received three rounds of SMC with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ). From July 2013 onward, children received four rounds of SMC. Prevalence of malaria infection, clinical malaria and anemia were assessed during two cross-sectional surveys conducted in August 2012 and June 2014. Investigations involved 20 randomly selected clusters in 2012 against 10 clusters in 2014. Results: Overall, 662 children were included in 2012, and 670 in 2014. Children in 2014 versus those surveyed in 2012 showed reduced proportions of malaria infection (12.4% in 2014 versus 28.7% in 2012 (p = 0.001)), clinical malaria (0.3% versus 4.2%, respectively (p...
Relationship South-North in a postcolonial context with Alain Mabanckou ABSTRACT: Starting from t... more Relationship South-North in a postcolonial context with Alain Mabanckou ABSTRACT: Starting from the problematic which tries to raise the question of the relationship between Black and White people, and also the reason that underlies such a relationship, this article attempts to bring elements of answer to a broad questioning from two novels by Alain Mabanckou: Black Bazar (Black Bazaar) and Tais-toi et meurs (Shut up and die). The article analyzes the relationship between Black and White people in a postcolonial context, which manifests itself in a relationship of tension, rejection of the other, but also with intimacy and greed. The Africa/Europe encounter, having been made under dramatic conditions that lowered the Black to the rank of animal, devoid of any faculty of reasoning, some White men continue to see the Black men with the same gaze of inferior human beings. For the analysis, and to clearly define the field of the study, we rely on work in the field of postcolonial studie...
Background A recent trial of 5920 children in Burkina Faso and Mali showed that the combination o... more Background A recent trial of 5920 children in Burkina Faso and Mali showed that the combination of seasonal vaccination with the RTS,S/AS01E malaria vaccine (primary series and two seasonal boosters) and seasonal malaria chemoprevention (four monthly cycles per year) was markedly more effective than either intervention given alone in preventing clinical malaria, severe malaria, and deaths from malaria. Methods In order to help optimise the timing of these two interventions, trial data were reanalysed to estimate the duration of protection against clinical malaria provided by RTS,S/AS01E when deployed seasonally, by comparing the group who received the combination of SMC and RTS,S/AS01E with the group who received SMC alone. The duration of protection from SMC was also estimated comparing the combined intervention group with the group who received RTS,S/AS01E alone. Three methods were used: Piecewise Cox regression, Flexible parametric survival models and Smoothed Schoenfeld residual...
Background Malaria and malnutrition remain major problems in Sahel countries, especially in young... more Background Malaria and malnutrition remain major problems in Sahel countries, especially in young children. The direct effect of malnutrition on malaria remains poorly understood, and may have important implications for malaria control. In this study, nutritional status and the association between malnutrition and subsequent incidence of symptomatic malaria were examined in children in Burkina Faso and Mali who received either azithromycin or placebo, alongside seasonal malaria chemoprevention. Methods Mid-upper arm circumference (MUAC) was measured in all 20,185 children who attended a screening visit prior to the malaria transmission season in 2015. Prior to the 2016 malaria season, weight, height and MUAC were measured among 4149 randomly selected children. Height-for-age, weight-for-age, weight-for-height, and MUAC-for-age were calculated as indicators of nutritional status. Malaria incidence was measured during the following rainy seasons. Multivariable random effects Poisson m...
Cet article propose une réflexion sur le totem et tabou qui sont considérés comme sources du mal ... more Cet article propose une réflexion sur le totem et tabou qui sont considérés comme sources du mal dans l&#39;Etange destin de Wangrin. Après avoir montré les différentes manifestations du tabou dans le roman, l&#39;article propose une typologie de totem comme on le constate dans le récit. Ainsi donc, on parvient à établir une distinction entre le totem individuel et celui du groupe. Pour finir, l&#39;analyse essaye de montrer, contrairement au roman qui justifie l&#39;échec de Wangrin par la transgression du tabou, que l&#39;échec du héros s&#39;explique plutôt par certaines violations de la doxa commune.
La tradition et le sacré peuvent être considérés comme deux thèmes fondamentaux toujours présents... more La tradition et le sacré peuvent être considérés comme deux thèmes fondamentaux toujours présents dans les romans de Seydou Badian. Ces deux éléments peuvent contribuer à la résolution des conflits dans la société, selon les circonstances. La tradition peut contribuer à apaiser la tension sociale grâce à certaines valeurs culturelles. Le sacré peut également intervenir dans le même contexte par le bon usage qu’en font les « connaisseurs ». Cet article tente de montrer l’intervention de la tradition et du sacré dans la résolution de la crise ou du conflit dans les romans de Seydou Badian.
Background A recent trial in Burkina Faso and Mali showed that combining seasonal RTS,S/AS01E mal... more Background A recent trial in Burkina Faso and Mali showed that combining seasonal RTS,S/AS01E malaria vaccination with seasonal malaria chemoprevention (SMC) substantially reduced the incidence of uncomplicated and severe malaria in young children compared to either intervention alone. Given the possible negative effect of malaria on nutrition, the study investigated whether these children also experienced lower prevalence of acute and chronic malnutrition. Methods In Burkina Faso and Mali 5920 children were randomized to receive either SMC alone, RTS,S/AS01E alone, or SMC combined with RTS,S/AS01E for three malaria transmission seasons (2017–2019). After each transmission season, anthropometric measurements were collected from all study children at a cross-sectional survey and used to derive nutritional status indicators, including the binary variables wasted and stunted (weight-for-height and height-for-age z-scores below − 2, respectively). Binary and continuous outcomes between ...
Additional file 4: Table S1. Association of baseline variables with low MUAC-for-age in two cohor... more Additional file 4: Table S1. Association of baseline variables with low MUAC-for-age in two cohorts in Mali. Table S2. Association of baseline variables with stunting, wasting and underweight in 2016 in Mali.
Additional file 3: Table S1. Association of baseline variables with low MUAC-for-age in two cohor... more Additional file 3: Table S1. Association of baseline variables with low MUAC-for-age in two cohorts in Burkina Faso. Table S2. Association of baseline variables with stunting, wasting and underweight in 2016 in Burkina Faso.
Additional file 1: Figure S1. Variation in prevalence of malnutrition (z-score below − 2) for MUA... more Additional file 1: Figure S1. Variation in prevalence of malnutrition (z-score below − 2) for MUAC and MUAC-for-age.
Background A trial in African children showed that combining seasonal vaccination with the RTS,S/... more Background A trial in African children showed that combining seasonal vaccination with the RTS,S/AS01E vaccine with seasonal malaria chemoprevention reduced the incidence of uncomplicated and severe malaria compared with either intervention given alone. Here, we report on the anti-circumsporozoite antibody response to seasonal RTS,S/AS01E vaccination in children in this trial. Methods Sera from a randomly selected subset of children collected before and 1 month after 3 priming doses of RTS,S/AS01E and before and 1 month after 2 seasonal booster doses were tested for anti-circumsporozoite antibodies using enzyme-linked immunosorbent assay. The association between post-vaccination antibody titer and incidence of malaria was explored. Results A strong anti-circumsporozoite antibody response to 3 priming doses of RTS,S/AS01E was seen (geometric mean titer, 368.9 enzyme-linked immunosorbent assay units/mL), but titers fell prior to the first booster dose. A strong antibody response to an...
Introduction Malaria has been the main cause of morbidity and mortality in Mali, with an increase... more Introduction Malaria has been the main cause of morbidity and mortality in Mali, with an increase from 2017 to 2020 (2,884,837 confirmed cases and 1,454 deaths). On the recommendation of the World Health Organization (WHO) and for efficient use of resources, Mali has begun a process of malaria stratification. Method Malaria, entomological and environmental data were collected through the local health information system, the Demographic and Health Survey 2018, research institutions and MALI-METEO services. The WHO stratification based on malaria incidence was used to present a stratified malaria risk map. Environmental factors associated with malaria were identified using a general additive non-linear regression model. The classification and regression tree method was used to improve the stratification. Interventions were proposed according to the incidence stratification and the different environmental, entomological, access to care maps. Results From 2017 to 2019, the median incide...
A tabular dataset that contains measurements of clinical malaria incidence, prevalence of P falci... more A tabular dataset that contains measurements of clinical malaria incidence, prevalence of P falciparum infection, and treatment efficacy. Data was collected as part of the AZ-SMC trial (clinicaltrials.gov NCT02211729) in Houndé District, Burkina Faso and Bougouni District, Mali between 2014 and 2016.
Introduction Seasonal malaria chemoprevention (SMC), with sulphadoxine–pyrimethamine plus amodiaq... more Introduction Seasonal malaria chemoprevention (SMC), with sulphadoxine–pyrimethamine plus amodiaquine (SP+AQ) is effective but does not provide complete protection against clinical malaria. The RTS,S/AS01E malaria vaccine provides a high level of protection shortly after vaccination, but this wanes rapidly. Such a vaccine could be an alternative or additive to SMC. This trial aims to determine whether seasonal vaccination with RTS,S/AS01E vaccine could be an alternative to SMC and whether a combination of the two interventions would provide added benefits. Methods and analysis This is an individually randomised, double-blind, placebo-controlled trial. 5920 children aged 5–17 months were enrolled in April 2017 in Mali and Burkina Faso. Children in group 1 received three priming doses of RTS,S/AS01E vaccine before the start of the 2017 malaria transmission season and a booster dose at the beginning of two subsequent transmission seasons. In addition, they received SMC SP+AQ placebo on...
In Mali, since 2007, artemether-lumefantrine has been the first choice against uncomplicated mala... more In Mali, since 2007, artemether-lumefantrine has been the first choice against uncomplicated malaria. Despite its effectiveness, a rapid selection of markers of resistance to partner drugs has been documented. This work evaluated the treatment according to the World Health Organization’s standard 28-day treatment method. The primary endpoint was the clinical and parasitological response corrected by a polymerase chain reaction. It was more than 99.9 percent, the proportion of patients with anemia significantly decrease compared to baseline (p < 0.001), and no serious events were recorded. Plasmodium falciparum remains sensitive to artemether-lumefantrine in Mali.
The drug administration dataset records contacts made with study participants to administer seaso... more The drug administration dataset records contacts made with study participants to administer seasonal malaria chemoprevention plus either azithromycin or placebo.
Background Seasonal malaria chemoprevention (SMC) is now widely deployed in the Sahel, including ... more Background Seasonal malaria chemoprevention (SMC) is now widely deployed in the Sahel, including several countries that are major contributors to the global burden of malaria. Consequently, it is important to understand whether SMC continues to provide a high level of protection and how SMC might be improved. SMC was evaluated using data from a large, householdrandomised trial in Houndé , Burkina Faso and Bougouni, Mali. Methods and findings The parent trial evaluated monthly SMC plus either azithromycin (AZ) or placebo, administered as directly observed therapy 4 times per year between August and November (2014-2016). In July 2014, 19,578 children aged 3-59 months were randomised by household to study group. Children who remained within the age range 3-59 months in August each year, plus children born into study households or who moved into the study area, received study drugs in 2015 and 2016. These analyses focus on the approximately 10,000 children (5,000 per country) under observation each year in the SMC plus placebo group. Despite high coverage and high adherence to SMC, the incidence of hospitalisations or deaths due to malaria and uncomplicated clinical malaria remained high in the study areas (overall incidence rates 12.5 [95% confidence interval (CI): 11.2, 14.1] and 871.1 [95% CI: 852.3, 890.6] cases per 1,000 person-years, respectively) and peaked in July each year, before
BACKGROUND Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions o... more BACKGROUND Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions of Africa. METHODS We conducted an individually randomized, controlled trial to assess whether seasonal vaccination with RTS,S/AS01 E was noninferior to chemoprevention in preventing uncomplicated malaria and whether the two interventions combined were superior to either one alone in preventing uncomplicated malaria and severe malaria-related outcomes. RESULTS We randomly assigned 6861 children 5 to 17 months of age to receive sulfadoxinepyrimethamine and amodiaquine (2287 children [chemoprevention-alone group]), RTS,S/AS01 E (2288 children [vaccine-alone group]), or chemoprevention and RTS,S/ AS01 E (2286 children [combination group]). Of these, 1965, 1988, and 1967 children in the three groups, respectively, received the first dose of the assigned intervention and were followed for 3 years. Febrile seizure developed in 5 children the day after receipt of the vaccine, but the children recovered and had no sequelae. There were 305 events of uncomplicated clinical malaria per 1000 personyears at risk in the chemoprevention-alone group, 278 events per 1000 person-years in the vaccine-alone group, and 113 events per 1000 person-years in the combination group. The hazard ratio for the protective efficacy of RTS,S/AS01 E as compared with chemoprevention was 0.92 (95% confidence interval [CI], 0.84 to 1.01), which excluded the prespecified noninferiority margin of 1.20. The protective efficacy of the combination as compared with chemoprevention alone was 62.8% (95% CI, 58.4 to 66.8) against clinical malaria, 70.5% (95% CI, 41.9 to 85.0) against hospital admission with severe malaria according to the World Health Organization definition, and 72.9% (95% CI, 2.9 to 92.4) against death from malaria. The protective efficacy of the combination as compared with the vaccine alone against these outcomes was 59.6% (95% CI, 54.7 to 64.0), 70.6% (95% CI, 42.3 to 85.0), and 75.3% (95% CI, 12.5 to 93.0), respectively. CONCLUSIONS Administration of RTS,S/AS01 E was noninferior to chemoprevention in preventing uncomplicated malaria. The combination of these interventions resulted in a substantially lower incidence of uncomplicated malaria, severe malaria, and death from malaria than either intervention alone.
International Journal of Environmental Research and Public Health, 2021
Context: In Mali, malaria transmission is seasonal, exposing children to high morbidity and morta... more Context: In Mali, malaria transmission is seasonal, exposing children to high morbidity and mortality. A preventative strategy called Seasonal Malaria Chemoprevention (SMC) is being implemented, consisting of the distribution of drugs at monthly intervals for up to 4 months to children between 3 and 59 months of age during the period of the year when malaria is most prevalent. This study aimed to analyze the evolution of the incidence of malaria in the general population of the health districts of Kati, Kadiolo, Sikasso, Yorosso, and Tominian in the context of SMC implementation. Methods: This is a transversal study analyzing the routine malaria data and meteorological data of Nasa Giovanni from 2016 to 2018. General Additive Model (GAM) analysis was performed to investigate the relationship between malaria incidence and meteorological factors. Results: From 2016 to 2018, the evolution of the overall incidence in all the study districts was positively associated with the relative hu...
Introduction: Idiopathic central serous chorioretinopathy (ICSC) is characterized by the buildup ... more Introduction: Idiopathic central serous chorioretinopathy (ICSC) is characterized by the buildup of fluid leading to circumscribed elevation of the retina within the posterior pole. This condition affects young people between the ages of 20-50 years. The disease is seen predominantly in men as compared to women. We report the cases of two (02) patients received in consultation at IOTA-Teaching Hospital between July 2019 and February 2020. Case Presentation: We report two cases of Idiopathic stress central serous chorioretinopathy. The first case is a 37-year-old man that we received in consultation for visual acuity decrease from a sudden installation for 1 hour. The clinical and paraclinical arguments permitted us to retain the diagnosis of Idiopathic stress central serous chorioretinopathy. The patient benefited from laser treatment and the clinical evolution was good. The second case is a 42-year-old man, who consulted for a sudden reduction of visual acuity that had been evolving for 3 weeks. The clinical and paraclinical contexts were in favour of the diagnosis of Idiopathic stress central serous chorioretinopathy. The patient was treated with spironolactone. The clinical evolution was favourable. Conclusion: Our study confirms the existence of central serous chorioretinopathy (CSC) in Black African patients. Studies show the connection between CSC and stress.
International Journal of Environmental Research and Public Health, 2020
Background: Previous controlled studies demonstrated seasonal malaria chemoprevention (SMC) reduc... more Background: Previous controlled studies demonstrated seasonal malaria chemoprevention (SMC) reduces malaria morbidity by >80% in children aged 3–59 months. Here, we assessed malaria morbidity after large-scale SMC implementation during a pilot campaign in the health district of Koutiala, Mali. Methods: Starting in August 2012, children received three rounds of SMC with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ). From July 2013 onward, children received four rounds of SMC. Prevalence of malaria infection, clinical malaria and anemia were assessed during two cross-sectional surveys conducted in August 2012 and June 2014. Investigations involved 20 randomly selected clusters in 2012 against 10 clusters in 2014. Results: Overall, 662 children were included in 2012, and 670 in 2014. Children in 2014 versus those surveyed in 2012 showed reduced proportions of malaria infection (12.4% in 2014 versus 28.7% in 2012 (p = 0.001)), clinical malaria (0.3% versus 4.2%, respectively (p...
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