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Cervical Cancer (CC) is a major public health problem in DR Congo; the high incidence of CC is due to the inexistence of effective screening programs based on cytology and/or HPV detection followed by appropriate treatments. This situation highlights the need to implement efficacious and inexpensive treatment methods. This study aims at evaluating the efficacy of a topical antiviral drug named AV2®as a treatment for HPV-associated lesions of the cervix.

ABSTRACTPlasmodium falciparumPfcrt-76 and Pfmdr1-86 gene polymorphisms were determined during a clinical trial in Burkina Faso comparing the efficacies of dihydroartemisinin-piperaquine (DHA-PPQ) and artemether-lumefantrine (AL). Significant selection of Pfcrt-K76 was observed after exposure to AL and DHA-PPQ, as well as selection of Pfmdr1-N86 after AL but not DHA-PPQ treatment, suggesting reverse selection on the Pfcrtgene by PPQ. These results support the rational use of DHA-PPQ in settings where chloroquine (CQ) resistance is high.

Objective: The objective was to determine lipid levels and cardiovascular risk factors in treatment-naïve, human immunodeficiency virus (HIV)-infected rural African people in Limpopo province.Design: This was a case control study.Setting and subjects: The setting was Dikgale Health and Demographic Surveillance System Centre, Limpopo province. Treatment naïve, HIV-infected and HIV-negative people participated in the study.Outcome measures: Demographic, lifestyle and chronic disease data were collected using the World Health Organization stepwise approach to surveillance (STEPS) questionnaire. Biochemical parameters were tested using standard biochemical methods. HIV testing and CD4 counts were performed using the Alere Determine™ HIV 1/2 Ag/Ab kit and The Alere Pima™ Analyser. Insulin resistance, low-density lipoprotein cholesterol (LDL cholesterol), and non-high-density lipoprotein cholesterol (non-HDL cholesterol) levels were calculated.Results: The mean age of participants (years) was 49.7 ± 16.6. More HIV-infected than HIV-uninfected women consumed alcohol (25.4% vs. 11.9%, p-value < 0.05), and the prevalence of abdominal obesity was higher in HIV-uninfected than in HIV-infected women (74.6% vs. 54.8%, p-value < 0.05). Levels of total cholesterol (TC), HDL cholesterol, non-HDL cholesterol, LDL cholesterol and apolipoprotein A1 (ApoA1) were significantly lower in the HIV-infected than in the HIV-uninfected group. The prevalence of low HDL cholesterol was higher in HIV-infected than in HIV-uninfected people (62.4% vs. 41.6%, p-value < 0.01). HIV infection increased the likelihood of low HDL cholesterol by 2.7 times (p-value 0.001). Male gender and alcohol use decreased the likelihood of low HDL cholesterol by 61% (p-value 0.002) and 48% (p-value 0.048), respectively. HIV infection was associated with low HDL cholesterol, ApoA1, LDL cholesterol and TC. Low CD4 count was associated with low body mass index, LDL cholesterol and high diastolic blood pressure.Conclusion: The prevalence of cardiovascular risk factors was equally high in HIV-infected and in HIV-uninfected rural people, except for low HDL and alcohol consumption, which were significantly higher in HIV-infected people, while abdominal obesity was significantly higher in HIV-uninfected people. There is a need to raise awareness of cardiovascular risk factors in rural people in Limpopo province.

The Plasmodium falciparum dihydrofolate reductase (PfDHFR) enzyme is the target of pyrimethamine, a component of the antimalarial pyrimethamine-sulfadoxine. Resistance to this drug is associated primarily with mutations in the Pfdhfr gene. The I164L mutant allele is of particular interest, because strains possessing this mutation are highly resistant to pyrimethamine and to chlorproguanil, a component of chlorproguanil-dapsone. A recent study from Malawi reported this mutation at a prevalence of 4.7% in parasites from human immunodeficiency virus-positive pregnant women by using a real-time PCR method. These observations have huge implications for the use of pyrimethamine-sulfadoxine, chlorproguanil-dapsone, and future antifolate-artemisinin combinations in Africa. It was imperative that this finding be rigorously tested. We identified a number of critical limitations in the original genotyping strategy. Using a refined and validated real-time PCR strategy, we report here that this mutation was absent in 158 isolates from Malawi and 42 isolates from Zambia collected between 2003 and 2005.

ABSTRACTThe Plasmodium falciparumdihydrofolate reductase (PfDHFR) enzyme is the target of pyrimethamine, a component of the antimalarial pyrimethamine-sulfadoxine. Resistance to this drug is associated primarily with mutations in the Pfdhfrgene. The I164L mutant allele is of particular interest, because strains possessing this mutation are highly resistant to pyrimethamine and to chlorproguanil, a component of chlorproguanil-dapsone. A recent study from Malawi reported this mutation at a prevalence of 4.7% in parasites from human immunodeficiency virus-positive pregnant women by using a real-time PCR method. These observations have huge implications for the use of pyrimethamine-sulfadoxine, chlorproguanil-dapsone, and future antifolate-artemisinin combinations in Africa. It was imperative that this finding be rigorously tested. We identified a number of critical limitations in the original genotyping strategy. Using a refined and validated real-time PCR strategy, we report here that this mutation was absent in 158 isolates from Malawi and 42 isolates from Zambia collected between 2003 and 2005.

Introduction:Family planning (FP) is a key element in the conduct of research and is essential in managing family sizes. Although fishing communities (FCs) are targeted populations for HIV prevention research, their FP practices are poorly understood. We explored barriers and facilitators of FP use in FCs of Lake Victoria in Uganda. Methods:We employed a mixed-methods approach comprising a cross-sectional survey, in-depth interviews, and focus group discussions in 2 FCs. Multivariable logistic regression was used to analyze quantitative data and a thematic approach to generate themes from the qualitative data. Results:Up to 1410 individuals participated in the survey and 47 in the qualitative study. Just over a third (35.6%) used FP. The most commonly used methods were condoms, pills, and injectables. In Kigungu community, participants whose religion was Anglican and Muslim were more likely to use FP than Catholics (adjusted odds ratio [aOR] 1.45; 95% CI 1.05-1.99 and aOR 1.45; 95% CI 1.05-2.07, respectively). Participants were more likely to use FP if they had satisfactory FP knowledge compared to those with no satisfactory FP knowledge (aOR 1.79; 95% CI 1.23-2.61), or if they were married compared to their single counterparts (aOR 1.84; 95% CI 1.32-2.57). In both communities, participants were more likely to use FP if they had 2 or more sexual partners in the past 12 months than those with less than 2 sexual partners (aOR 1.41 95% CI 1.07-1.87 and aOR 2.60; 95% CI 1.36-4.97). Excessive bleeding and delayed fecundity; fertility desire; gender preferences of children; method stock outs and lack of FP trained personnel constituted barriers to FP use. There were also cultural influences in favor of large families. Conclusion:FP use in FCs is suboptimal. Barriers of FP use were mainly biomedical, religious, social, and cultural, which underscores a need for FP education and strengthening of FP service provision in FCs.

In high transmission settings, up to 70% of school-aged children harbour malaria parasites without showing any clinical symptoms. Thus, epidemiologically, school aged children act as a substantial reservoir for malaria transmission. Asymptomatic Plasmodiuminfections induce inflammation leading to iron deficiency anaemia. Consequently, anaemia retards child growth, predisposes children to other diseases and reduces cognitive potential that could lead to poor academic performance. School aged children become increasingly more vulnerable as compared to those aged less than five years due to delayed acquisition of protective immunity. None of the existing Intermittent Preventive Treatment (IPT) strategies is targeting school-aged children. Here, we describe the study protocol of a clinical trial conducted in north-eastern Tanzania to expand the IPT by assessing the effectiveness and safety of two antimalarial drugs, Dihydroartemisinin-Piperaquine (DP) and Artesunate-Amodiaquine (ASAQ) in preventing malaria related morbidities in school-aged children (IPTsc) living in a high endemic area.

Non-surgical topical therapies have been assessed in the treatment of precancerous lesions of the cervix. Their use can offer logistical and feasibility advantages in low-resource settings. Antiviral AV2®is a mixture of natural essential oils (eugenol, carvone, nerolidol, geraniol) in olive oil, and has a broad spectrum anti-viral activity. In a phase II randomized controlled trial (RCT), AV2®proved effective in reducing the size of cervical lesions associated with human papillomavirus (HPV). The purpose of the present study was to further evaluate the efficacy of AV2 over placebo in the topical treatment of HPV-associated cervical lesions.