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(JAMA. 2023;329:716–724)Approximately 40% of childhood deaths occur during the first 28 days following birth. A major cause of these deaths is sepsis. Azithromycin has been introduced as a possible solution to reduce the number of deaths occurring in infants. This study aimed to assess the use of oral azithromycin doses given to mothers during labor to reduce neonatal sepsis following delivery.

Background/Objectives: The iron-binding affinity of vaginal lactoferrin (Lf) reduces iron available to genital pathogens. We describe host reproductive, nutritional, infection and iron biomarker profiles affecting vaginal Lf concentration in young nulliparous and primigravid women in Burkina Faso. Subjects/Methods: Vaginal eluates from women who had participated in a randomized, controlled periconceptional iron supplementation trial were used to measure Lf using a competitive double-sandwich ELISA. For this analysis samples from both trial arms were combined and pregnant and non-pregnant cohorts compared. Following randomization Lf was measured after 18 months (end assessment) for women remaining non-pregnant, and at two antenatal visits for those becoming pregnant. Associations between log Lf levels and demographic, anthropometric, infection and iron biomarker variables were assessed using linear mixed models. Results: Lf samples were available for 712 non-pregnant women at end assessment and for 303 women seen at an antenatal visit. Lf concentrations of pregnant women were comparable to those of non-pregnant, sexually active women. Lf concentration increased with mid-upper-arm circumference, (P?=?0.047), body mass index (P?=?0.018), Trichomonas vaginalis(P?<?0.001) infection, bacterial vaginosis (P?<?0.001), serum C-reactive protein (P?=?0.048) and microbiota community state types III/IV. Adjusted Lf concentration was positively associated with serum hepcidin (P?=?0.047), serum ferritin (P?=?0.018) and total body iron stores (P?=?0.042). There was evidence that some women maintained persistently high or low Lf concentrations from before, and through, pregnancy. Conclusion: Lf concentrations increased with genital infection, higher BMI, MUAC, body iron stores and hepcidin, suggesting nutritional and iron status influence homeostatic mechanisms controlling vaginal Lf responses.

Le paludisme et les infections sexuellement transmissibles (IST) curables sont les infections curables les plus fréquentes, connues pour leur impact grave sur l'issue de grossesse en Afrique subsaharienne. Cette étude vise à fournir les fréquences et les facteurs de risque de ces infections chez la femme enceinte dans le milieu rural du Burkina Faso.

ABSTRACTDeclining malaria transmission and known difficulties with current diagnostic tools for malaria, such as microscopy and rapid diagnostic tests (RDTs) in particular at low parasite densities, still warrant the search for sensitive diagnostic tests. Molecular tests need substantial simplification before implementation in clinical settings in countries where malaria is endemic. Direct blood PCR (db-PCR), circumventing DNA extraction, to detect Plasmodiumwas developed and adapted to be visualized by nucleic acid lateral flow immunoassay (NALFIA). The assay was evaluated in the laboratory against samples from confirmed Sudanese patients (n= 51), returning travelers (n= 214), samples from the Dutch Blood Bank (n= 100), and in the field in Burkina Faso (n= 283) and Thailand (n= 381) on suspected malaria cases and compared to RDT and microscopy. The sensitivity and specificity of db-PCR-NALFIA compared to the initial diagnosis in the laboratory were 94.4% (95% confidence interval [CI] = 0.909 to 0.969) and 97.4% (95% CI = 0.909 to 0.969), respectively. In Burkina Faso, the sensitivity was 94.8% (95% CI = 0.88.7 to 97.9%), and the specificity was 82.4% (95% CI = 75.4 to 87.7%) compared to microscopy and 93.3% (95% CI = 87.4 to 96.7%) and 91.4% (95% CI = 85.2 to 95.3%) compared to RDT. In Thailand, the sensitivity and specificity were 93.4% (CI = 86.4 to 97.1%) and 90.9 (95% CI = 86.7 to 93.9%), respectively, compared to microscopy and 95.6% (95% CI = 88.5 to 98.6%) and 87.1% (95% CI = 82.5 to 90.6) compared to RDT. db-PCR-NALFIA is highly sensitive and specific for easy and rapid detection of Plasmodiumparasites and can be easily used in countries where malaria is endemic. The inability of the device to discriminate Plasmodiumspecies requires further investigation.

Fractionation of an ethanol extract of roots of Cochlospermum tinctorium afforded five compounds:  3-O-E-p-coumaroylalphitolic acid (1), cochloxanthin (2), dihydrocochloxanthin (3), alphitolic acid (4), and 1-hydroxytetradecan-3-one (5). This is the first example of a 1-hydroxyalkan-3-one obtained from plant material after gentle workup. The antiplasmodial activities of the compounds were determined, and the IC50 value of 3-O-E-p-coumaroylalphitolic acid was 2.3 μM.