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Annick Ndoumba-Mintya,1 Yacouba L Diallo,2 Tagny C Tayou,1 Dora N Mbanya1 1Hematology & Transfusion Service, Yaoundé University Teaching Hospital, Yaoundé, Cameroon; 2Service de Médecine - CHU Hôpital du Mali, Bamako, MaliCorrespondence: Dora N Mbanya, Centre Hospitalier et Universitaire, B.P. 8046, Yaoundé, Cameroon, Tel +237 677607037, Email dmbanya1@yahoo.co.ukAbstract: About 75% of persons with hemophilia live in the developing world and do not have access to routine care due to many barriers. There are a lot of challenges associated with hemophilia care in resource-limited settings, ranging from financial to organisational and government commitments. This review discusses some of these challenges and future prospects, while highlighting the important role of the World Federation of Hemophilia in hemophilia patient care. A participative approach involving all stakeholders is key to optimizing care in resource-limited settings.Keywords: hemophilia care, people living with hemophilia, challenges, prospects

Loss of endothelial integrity and vascular leakage are central features of sepsis pathogenesis; however, no effective therapeutic mechanisms for preserving endothelial integrity are available. Here we show that, compared to dermal microvessels, brain microvessels resist infection by Neisseria meningitidis, a bacterial pathogen that causes sepsis and meningitis. By comparing the transcriptional responses to infection in dermal and brain endothelial cells, we identified angiopoietin-like 4 as a key factor produced by the brain endothelium that preserves blood-brain barrier integrity during bacterial sepsis. Conversely, angiopoietin-like 4 is produced at lower levels in the peripheral endothelium. Treatment with recombinant angiopoietin-like 4 reduced vascular leakage, organ failure and death in mouse models of lethal sepsis and N. meningitidis infection. Protection was conferred by a previously uncharacterized domain of angiopoietin-like 4, through binding to the heparan proteoglycan, syndecan-4. These findings reveal a potential strategy to prevent endothelial dysfunction and improve outcomes in patients with sepsis., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Historically, local milk production in Senegal has struggled to keep up with the demands of consumers, so there has been a heavy reliance on imported milk and milk products. More recently, efforts have been made to improve local dairy production by establishing large, organized dairies that collect milk from rural production areas and developing small-scale processing units, such as mini dairies. The local dairy value chain in Senegal consists of (1) informal collection systems where farmers commonly deliver milk directly to dairies; (2) traditional and artisanal processing using simple equipment and techniques; and (3) short local marketing and sale circuits. Most West African dairy sectors are dominated by raw, unpasteurized milk or traditional, spontaneously fermented milk products, such as lait caillé in Senegal, sold through small-scale channels without a cold chain, so the risk of food safety hazards may be increased. Microbiological, chemical, and physical hazards have been found in milk and milk products across West Africa. There is a need to educate milk producers, small-scale processors, and vendors on the importance of refrigerating milk immediately after milking as well as maintaining the cold chain until the milk is heat treated and, subsequently, until the milk is marketed to the consumer. However, without assistance, obtaining the equipment necessary for cold storage and processing of milk can be challenging.

Objective: Chronic myeloid leukemia (CML) is a hematologic malignancy characterized by the presence of the Philadelphia chromosome or its molecular equivalent, the BCR/ABL1 fusion gene. Diagnosis and monitoring of CML are done by detecting this chromosome, the BCR/ABL1 gene, or the BCR/ABL1 transcript. In Mali, genetic tools of diagnosis and follow-up are still lacking, so we did this study with the objectives of developing the FISH technique to diagnose, to follow up, and to characterize the cytogenetic profile of CML patients., Methods: We carried out FISH technique by using the dual color dual fusion probe for BCR/ABL1 on interphase nuclei and metaphases. Slides were scanned with an epifluorescence microscope., Results: A total of 25 patients (16 for diagnostic and 9 for follow-up) were included. We achieved a 92% success rate for obtaining metaphases. The BCR/ABL1 gene fusion signal was present in 22 patients. Among those 22 patients, 16 presented a typical signal pattern and 6 presented atypical signal patterns., Conclusion: We set up the FISH technique in Mali for the diagnosis and the follow-up of CML patients and identified atypical translocation of t(9;22).

Continuity of key water, sanitation, and hygiene (WASH) infrastructure and WASH practices-for example, hand hygiene-are among several critical community preventive and mitigation measures to reduce transmission of infectious diseases, including COVID-19 and other respiratory diseases. WASH guidance for COVID-19 prevention may combine existing WASH standards and new COVID-19 guidance. Many existing WASH tools can also be modified for targeted WASH assessments during the COVID-19 pandemic. We partnered with local organizations to develop and deploy tools to assess WASH conditions and practices and subsequently implement, monitor, and evaluate WASH interventions to mitigate COVID-19 in low- and middle-income countries in Latin America and the Caribbean and Africa, focusing on healthcare, community institution, and household settings and hand hygiene specifically. Employing mixed-methods assessments, we observed gaps in access to hand hygiene materials specifically despite most of those settings having access to improved, often onsite, water supplies. Across countries, adherence to hand hygiene among healthcare providers was about twice as high after patient contact compared to before patient contact. Poor or non-existent management of handwashing stations and alcohol-based hand rub (ABHR) was common, especially in community institutions. Markets and points of entry (internal or external border crossings) represent congregation spaces, critical for COVID-19 mitigation, where globally-recognized WASH standards are needed. Development, evaluation, deployment, and refinement of new and existing standards can help ensure WASH aspects of community mitigation efforts that remain accessible and functional to enable inclusive preventive behaviors., Competing Interests: Competing Interests: The authors have declared that no competing interests exist.