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3. Incidence and risk factors of neonatal bacterial infections: a community-based cohort from Madagascar (2018–2021)

Author

Devred, Ines, Rambliere, Lison, Herindrainy, Perlinot, Andriamarohasina, Lovarivelo, Harimanana, Aina, Randrianirina, Frederique, Ratsima, Elisoa Hariniaina, Hivernaud, Delphine, Kermorvant-Duchemin, Elsa, Andrianirina, Zafitsara Zo, Abdou, Armya Youssouf, Delarocque-Astagneau, Elisabeth, Guillemot, Didier, Crucitti, Tania, Collard, Jean-Marc, and Huynh, Bich-Tram

Published
2023
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5. Stunted children display ectopic small intestinal colonization by oral bacteria,which cause lipidmalabsorption in experimentalmodels

Author

The Afribiota Investigators, Vonaesch, Pascale, Araújo, João R., Gody, Jean-Chrysostome, Mbecko, Jean-Robert, Sanke, Hugues, Andrianonimiadana, Lova, Naharimanananirina, Tanteliniaina, Ningatoloum, Synthia Nazita, Vondo, Sonia Sandrine, Gondje, Privat Bolmbaye, Rodriguez-Pozo, Andre, Rakotondrainipiana, Maheninasy, Kandou, Kaleb Jephté Estimé, Nestoret, Alison, Kapel, Nathalie, Djorie, Serge Ghislain, Finlay, B. Brett, Parfrey, Laura Wegener, Collard, Jean-Marc, Randremanana, Rindra Vatosoa, and Sansonetti, Philippe J.

Published
2022

8. Factors associated with anaemia among preschool- age children in underprivileged neighbourhoods in Antananarivo, Madagascar

Author

Randrianarisoa, Mirella Malala, Rakotondrainipiana, Maheninasy, Randriamparany, Ravaka, Andriantsalama, Prisca Vega, Randrianarijaona, Anjasoa, Habib, Azimdine, Robinson, Annick, Raharimalala, Lisette, Hunald, Francis Allen, Etienne, Aurélie, Collard, Jean-Marc, Randrianirina, Frédérique, Barouki, Robert, Pontoizeau, Clement, Nestoret, Alison, Kapel, Nathalie, Sansonetti, Philippe, Vonaesch, Pascale, and Randremanana, Rindra Vatosoa

Published
2022
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10. Inappropriate antibiotic prescribing and its determinants among outpatient children in 3 low- and middle-income countries: A multicentric community-based cohort study

Author

Ardillon, Antoine, Ramblière, Lison, Kermorvant-Duchemin, Elsa, Sok, Touch, Zo, Andrianirina Zafitsara, Diouf, Jean-Baptiste, Long, Pring, Lach, Siyin, Sarr, Fatoumata Diene, Borand, Laurence, Cheysson, Felix, Collard, Jean-Marc, Herindrainy, Perlinot, de Lauzanne, Agathe, Vray, Muriel, Delarocque-Astagneau, Elisabeth, Guillemot, Didier, and Huynh, Bich-Tram

Subjects
Drug resistance in microorganisms -- Prevention, Prescription writing -- Methods, Children -- Health aspects, Ambulatory medical care -- Usage, Antibiotics -- Dosage and administration, Biological sciences
Abstract

Background Antibiotic resistance is a global public health issue, particularly in low- and middle-income countries (LMICs), where antibiotics required to treat resistant infections are not affordable. LMICs also bear a disproportionately high burden of bacterial diseases, particularly among children, and resistance jeopardizes progress made in these areas. Although outpatient antibiotic use is a major driver of antibiotic resistance, data on inappropriate antibiotic prescribing in LMICs are scarce at the community level, where the majority of prescribing occurs. Here, we aimed to characterize inappropriate antibiotic prescribing among young outpatient children and to identify its determinants in 3 LMICs. Methods and findings We used data from a prospective, community-based mother-and-child cohort (BIRDY, 2012 to 2018) conducted across urban and rural sites in Madagascar, Senegal, and Cambodia. Children were included at birth and followed-up for 3 to 24 months. Data from all outpatient consultations and antibiotics prescriptions were recorded. We defined inappropriate prescriptions as antibiotics prescribed for a health event determined not to require antibiotic therapy (antibiotic duration, dosage, and formulation were not considered). Antibiotic appropriateness was determined a posteriori using a classification algorithm developed according to international clinical guidelines. We used mixed logistic analyses to investigate risk factors for antibiotic prescription during consultations in which children were determined not to require antibiotics. Among the 2,719 children included in this analysis, there were 11,762 outpatient consultations over the follow-up period, of which 3,448 resulted in antibiotic prescription. Overall, 76.5% of consultations resulting in antibiotic prescription were determined not to require antibiotics, ranging from 71.5% in Madagascar to 83.3% in Cambodia. Among the 10,416 consultations (88.6%) determined not to require antibiotic therapy, 25.3% (n = 2,639) nonetheless resulted in antibiotic prescription. This proportion was much lower in Madagascar (15.6%) than in Cambodia (57.0%) or Senegal (57.2%) (p < 0.001). Among the consultations determined not to require antibiotics, in both Cambodia and Madagascar the diagnoses accounting for the greatest absolute share of inappropriate prescribing were rhinopharyngitis (59.0% of associated consultations in Cambodia, 7.9% in Madagascar) and gastroenteritis without evidence of blood in the stool (61.6% and 24.6%, respectively). In Senegal, uncomplicated bronchiolitis accounted for the greatest number of inappropriate prescriptions (84.4% of associated consultations). Across all inappropriate prescriptions, the most frequently prescribed antibiotic was amoxicillin in Cambodia and Madagascar (42.1% and 29.2%, respectively) and cefixime in Senegal (31.2%). Covariates associated with an increased risk of inappropriate prescription include patient age greater than 3 months (adjusted odds ratios (aOR) with 95% confidence interval (95% CI) ranged across countries from 1.91 [1.63, 2.25] to 5.25 [3.85, 7.15], p < 0.001) and living in rural as opposed to urban settings (aOR ranged across countries from 1.83 [1.57, 2.14] to 4.40 [2.34, 8.28], p < 0.001). Diagnosis with a higher severity score was also associated with an increased risk of inappropriate prescription (aOR = 2.00 [1.75, 2.30] for moderately severe, 3.10 [2.47, 3.91] for most severe, p < 0.001), as was consultation during the rainy season (aOR = 1.32 [1.19, 1.47], p < 0.001). The main limitation of our study is the lack of bacteriological documentation, which may have resulted in some diagnosis misclassification and possible overestimation of inappropriate antibiotic prescription. Conclusion In this study, we observed extensive inappropriate antibiotic prescribing among pediatric outpatients in Madagascar, Senegal, and Cambodia. Despite great intercountry heterogeneity in prescribing practices, we identified common risk factors for inappropriate prescription. This underscores the importance of implementing local programs to optimize antibiotic prescribing at the community level in LMICs., Author(s): Antoine Ardillon 1,2, Lison Ramblière 1,2, Elsa Kermorvant-Duchemin 3, Touch Sok 4, Andrianirina Zafitsara Zo 5, Jean-Baptiste Diouf 6, Pring Long 7, Siyin Lach 7, Fatoumata Diene Sarr 8, [...]

Published
2023
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13. Stunted childhood growth is associated with decompartmentalization of the gastrointestinal tract and overgrowth of oropharyngeal taxa

Author

The Afribiota Investigators, Vonaesch, Pascale, Morien, Evan, Andrianonimiadana, Lova, Sanke, Hugues, Mbecko, Jean-Robert, Huus, Kelsey E., Naharimanananirina, Tanteliniaina, Gondje, Bolmbaye Privat, Nigatoloum, Synthia Nazita, Vondo, Sonia Sandrine, Kandou, Jepthé Estimé Kaleb, Randremanana, Rindra, Rakotondrainipiana, Maheninasy, Mazel, Florent, Djorie, Serge Ghislain, Gody, Jean-Chrysostome, Finlay, B. Brett, Rubbo, Pierre-Alain, Parfrey, Laura Wegener, Collard, Jean-Marc, and Sansonetti, Philippe J.

Published
2018

16. The global distribution and diversity of protein vaccine candidate antigens in the highly virulent Streptococcus pnuemoniae serotype 1

Author

Cornick, Jennifer E., Tastan Bishop, Özlem, Yalcin, Feyruz, Kiran, Anmol M., Kumwenda, Benjamin, Chaguza, Chrispin, Govindpershad, Shanil, Ousmane, Sani, Senghore, Madikay, du Plessis, Mignon, Pluschke, Gerd, Ebruke, Chinelo, McGee, Lesley, Sigaùque, Beutel, Collard, Jean-Marc, Bentley, Stephen D., Kadioglu, Aras, Antonio, Martin, von Gottberg, Anne, French, Neil, Klugman, Keith P., Heyderman, Robert S., Alderson, Mark, and Everett, Dean B.

Published
2017
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17. Bacterial genome-wide association study of hyper-virulent pneumococcal serotype 1 identifies genetic variation associated with neurotropism

Author

Chaguza, Chrispin, Yang, Marie, Cornick, Jennifer E., du Plessis, Mignon, Gladstone, Rebecca A., Kwambana-Adams, Brenda A., Lo, Stephanie W., Ebruke, Chinelo, Tonkin-Hill, Gerry, Peno, Chikondi, Senghore, Madikay, Obaro, Stephen K., Ousmane, Sani, Pluschke, Gerd, Collard, Jean-Marc, Sigaùque, Betuel, French, Neil, Klugman, Keith P., Heyderman, Robert S., McGee, Lesley, Antonio, Martin, Breiman, Robert F., von Gottberg, Anne, Everett, Dean B., Kadioglu, Aras, and Bentley, Stephen D.

Published
2020
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18. Severe bacterial neonatal infections in Madagascar, Senegal, and Cambodia: A multicentric community-based cohort study

Author

Huynh, Bich-Tram, Kermorvant-Duchemin, Elsa, Chheang, Rattanak, Randrianirina, Frederique, Seck, Abdoulaye, Hariniaina Ratsima, Elisoa, Andrianirina, Zafitsara Zo, Diouf, Jean-Baptiste, Abdou, Armya Youssouf, Goyet, Sophie, Ngo, Véronique, Lach, Siyin, Pring, Long, Sok, Touch, Padget, Michael, Sarr, Fatoumata Diene, Borand, Laurence, Garin, Benoit, Collard, Jean-Marc, Herindrainy, Perlinot, de Lauzanne, Agathe, Vray, Muriel, Delarocque-Astagneau, Elisabeth, and Guillemot, Didier

Subjects
Infants -- Patient outcomes, Infants (Newborn) -- Diseases, Drug resistance in microorganisms -- Research, Bacterial infections -- Statistics -- Risk factors -- Drug therapy, Pediatric research, Biological sciences
Abstract

Background Severe bacterial infections (SBIs) are a leading cause of neonatal deaths in low- and middle-income countries (LMICs). However, most data came from hospitals, which do not include neonates who did not seek care or were treated outside the hospital. Studies from the community are scarce, and few among those available were conducted with high-quality microbiological techniques. The burden of SBI at the community level is therefore largely unknown. We aimed here to describe the incidence, etiology, risk factors, and antibiotic resistance profiles of community-acquired neonatal SBI in 3 LMICs. Methods and findings The BIRDY study is a prospective multicentric community-based mother and child cohort study and was conducted in both urban and rural areas in Madagascar (2012 to 2018), Cambodia (2014 to 2018), and Senegal (2014 to 2018). All pregnant women within a geographically defined population were identified and enrolled. Their neonates were actively followed from birth to 28 days to document all episodes of SBI. A total of 3,858 pregnant women (2,273 (58.9%) in Madagascar, 814 (21.1%) in Cambodia, and 771 (20.0%) in Senegal) were enrolled in the study, and, of these, 31.2% were primigravidae. Women enrolled in the urban sites represented 39.6% (900/2,273), 45.5% (370/814), and 61.9% (477/771), and those enrolled in the rural sites represented 60.4% (1,373/2,273), 54.5% (444/814), and 38.1% (294/771) of the total in Madagascar, Cambodia, and Senegal, respectively. Among the 3,688 recruited newborns, 49.6% were male and 8.7% were low birth weight (LBW). The incidence of possible severe bacterial infection (pSBI; clinical diagnosis based on WHO guidelines of the Integrated Management of Childhood Illness) was 196.3 [95% confidence interval (CI) 176.5 to 218.2], 110.1 [88.3 to 137.3], and 78.3 [59.5 to 103] per 1,000 live births in Madagascar, Cambodia, and Senegal, respectively. The incidence of pSBI differed between urban and rural sites in all study countries. In Madagascar, we estimated an incidence of 161.0 pSBI per 1,000 live births [133.5 to 194] in the urban site and 219.0 [192.6 to 249.1] pSBI per 1,000 live births in the rural site (p = 0.008). In Cambodia, estimated incidences were 141.1 [105.4 to 189.0] and 85.3 [61.0 to 119.4] pSBI per 1,000 live births in urban and rural sites, respectively (p = 0.025), while in Senegal, we estimated 103.6 [76.0 to 141.2] pSBI and 41.5 [23.0 to 75.0] pSBI per 1,000 live births in urban and rural sites, respectively (p = 0.006). The incidences of culture-confirmed SBI were 15.2 [10.6 to 21.8], 6.5 [2.7 to 15.6], and 10.2 [4.8 to 21.3] per 1,000 live births in Madagascar, Cambodia, and Senegal, respectively, with no difference between urban and rural sites in each country. The great majority of early-onset infections occurred during the first 3 days of life (72.7%). The 3 main pathogens isolated were Klebsiella spp. (11/45, 24.4%), Escherichia coli (10/45, 22.2%), and Staphylococcus spp. (11/45, 24.4%). Among the 13 gram-positive isolates, 5 were resistant to gentamicin, and, among the 29 gram-negative isolates, 13 were resistant to gentamicin, with only 1 E. coli out of 10 sensitive to ampicillin. Almost one-third of the isolates were resistant to both first-line drugs recommended for the management of neonatal sepsis (ampicillin and gentamicin). Overall, 38 deaths occurred among neonates with SBI (possible and culture-confirmed SBI together). LBW and foul-smelling amniotic fluid at delivery were common risk factors for early pSBI in all 3 countries. A main limitation of the study was the lack of samples from a significant proportion of infants with pBSI including 35 neonatal deaths. Without these samples, bacterial infection and resistance profiles could not be confirmed. Conclusions In this study, we observed a high incidence of neonatal SBI, particularly in the first 3 days of life, in the community of 3 LMICs. The current treatment for the management of neonatal infection is hindered by antimicrobial resistance. Our findings suggest that microbiological diagnosis of SBI remains a challenge in these settings and support more research on causes of neonatal death and the implementation of early interventions (e.g., follow-up of at-risk newborns during the first days of life) to decrease the burden of neonatal SBI and associated mortality and help achieve Sustainable Development Goal 3., Author(s): Bich-Tram Huynh 1,2,*, Elsa Kermorvant-Duchemin 3, Rattanak Chheang 4, Frederique Randrianirina 5, Abdoulaye Seck 6, Elisoa Hariniaina Ratsima 5, Zafitsara Zo Andrianirina 7, Jean-Baptiste Diouf 8, Armya Youssouf Abdou [...]

Published
2021
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19. One Health compartment analysis of ESBL-producing Escherichia coli reveals multiple transmission events in a rural area of Madagascar

Author

Gay, Noellie, primary, Rabenandrasana, Mamitina Alain Noah, additional, Panandiniaina, Harielle Prisca, additional, Rakotoninidrina, Marie Florence, additional, Ramahatafandry, Ilo Tsimok’Haja, additional, Enouf, Vincent, additional, Roger, François, additional, Collard, Jean-Marc, additional, Cardinale, Eric, additional, Rieux, Adrien, additional, and Loire, Etienne, additional

Published
2023
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20. Household transmission of Neisseria meningitidis in the African meningitis belt: a longitudinal cohort study

Author

Ali, Oumer, Aseffa, Abraham, Omer, Ahmed Bedru, Lema, Tsehaynesh, Demissie, Tesfaye Moti, Tekletsion, Yenenesh, Worku, Alemayehu, Xabher, Haimanot Guebre, Yamuah, Lawrence, Boukary, Rahamatou Moustapha, Collard, Jean-Marc, Dan Dano, Ibrahim, Habiboulaye, Ibrahim, Issaka, Bassira, Jusot, Jean-François, Ousmane, Sani, Rabe, Issoufa, Dauglaz, Doumagoum Moto, Gami, Jean Pierre, Gamougam, Kadidja, Mbainadji, Lodoum, Naibei, Nathan, Narbé, Maxime, Toralta, Jacques, Berthe, Abdoulaye, Diallo, Kanny, Keita, Mahamadou, Coulibaly, Adama, Onwuchekwa, Uma, Sow, Samba O, Tamboura, Boubou, Traore, Awa, Toure, Aliou, Clark, Tom, Mayer, Leonard, Amodu, Mary, Beida, Omeiza, Gadzama, Galadima, Omotara, Babatunji, Zailani, Sambo, Yahya, Shuaibu, Chandramohan, Daniel, Greenwood, Brian M, Hassan-King, Musa, Manigart, Olivier, Nascimento, Maria, M Stuart, James, Woukeu, Arouna, Basta, Nicole E, Bai, Xilian, Borrow, Ray, Findlow, Helen, Alavo, Serge, Bassene, Hubert, Diallo, Aldiouma, Dieng, Marietou, Doucouré, Souleymane, Gomis, Jules François, Ndiaye, Assane, Sokhna, Cheikh, Trape, Jean François, Bugri, Akalifa, Forgor, Abudulai, Hodgson, Abraham, Osei, Isaac, Quaye, Stephen L, Williams, John, Wontuo, Peter, Irving, Thomas, Trotter, Caroline L, Karachaliou, Andromachi, Bennett, Julia, Hill, Dorothea, Harrison, Odile, Maiden, Martin C, Rebbetts, Lisa, and Watkins, Eleanor

Published
2016
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21. Pharyngeal carriage of Neisseria species in the African meningitis belt

Author

Diallo, Kanny, Trotter, Caroline, Timbine, Youssouf, Tamboura, Boubou, Sow, Samba O., Issaka, Bassira, Dano, Ibrahim D., Collard, Jean-Marc, Dieng, Marietou, Diallo, Aldiouma, Mihret, Adane, Ali, Oumer A., Aseffa, Abraham, Quaye, Stephen L., Bugri, Akalifa, Osei, Isaac, Gamougam, Kadidja, Mbainadji, Lodoum, Daugla, Doumagoum M., Gadzama, Galadima, Sambo, Zailani B., Omotara, Babatunji A., Bennett, Julia S., Rebbetts, Lisa S., Watkins, Eleanor R., Nascimento, Maria, Woukeu, Arouna, Manigart, Olivier, Borrow, Ray, Stuart, James M., Greenwood, Brian M., and Maiden, Martin C.J.

Published
2016
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22. One Health compartment analysis of ESBL-producing Escherichia coli reveals multiple transmission events in a rural area of Madagascar

Author

Gay, Noellie, Rabenandrasana, Mamitina Alain Noah, Panandiniaina, Harielle Prisca, Rakotoninidrina, Marie Florence, Ramahatafandry, Ilo Tsimok'Haja, Enouf, Vincent, Roger, François, Collard, Jean-Marc, Cardinale, Eric, Rieux, Adrien, Loire, Etienne, Gay, Noellie, Rabenandrasana, Mamitina Alain Noah, Panandiniaina, Harielle Prisca, Rakotoninidrina, Marie Florence, Ramahatafandry, Ilo Tsimok'Haja, Enouf, Vincent, Roger, François, Collard, Jean-Marc, Cardinale, Eric, Rieux, Adrien, and Loire, Etienne

Abstract

Background: ESBL-producing Escherichia coli (ESBL-Ec) is considered a key indicator for antimicrobial resistance (AMR) epidemiological surveillance in animal, human and environment compartments. There is likelihood of ESBL-Ec animal–human transmission but proof of cross-compartment transmission is still unclear. Objectives: To characterize ESBL-Ec genetic similarity in various compartments (humans, animals and environment) from a rural area of Madagascar. Methods: We collected ESBL-Ec isolates prospectively from humans, animals and the environment (water) between April and October 2018. These isolates were subject to WGS and analysed with cutting-edge phylogenomic methods to characterize population genetic structure and infer putative transmission events among compartments. Results: Of the 1454 samples collected, 512 tested positive for ESBL-Ec. We successfully sequenced 510 samples, and a phylogenomic tree based on 179 365 SNPs was produced. Phylogenetic distances between and amongst compartments were indistinguishable, and 104 clusters of recent transmission events between compartments were highlighted. Amongst a large diversity of ESBL-Ec genotypes, no lineage host specificity was observed, indicating the regular occurrence of ESBL-Ec transfer among compartments in rural Madagascar. Conclusions: Our findings stress the importance of using a phylogenomic approach on ESBL-Ec samples in various putative compartments to obtain a clear baseline of AMR transmissions in rural settings, where one wants to identify risk factors associated with transmission or to measure the effect of 'One Health' interventions in low- and middle-income countries.

Published
2023

23. NDP52 mediates an antiviral response to hepatitis B virus infection through Rab9-dependent lysosomal degradation pathway

Author

Cui, Shuzhi, primary, Xia, Tian, additional, Zhao, Jianjin, additional, Ren, Xiaoyu, additional, Wu, Tingtao, additional, Kameni, Mireille, additional, Guo, Xiaoju, additional, He, Li, additional, Guo, Jingao, additional, Duperray-Susini, Aléria, additional, Levillayer, Florence, additional, Collard, Jean-Marc, additional, ZHONG, JIN, additional, Pan, Lifeng, additional, Tangy, Frederic, additional, Vidalain, Pierre-Olivier, additional, Zhou, Dongming, additional, Jiu, Yaming, additional, FAURE, Mathias, additional, and Wei, Yu, additional

Published
2023
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24. Stillbirths and neonatal mortality in LMICs: A community-based mother-infant cohort study

Author

Rambliere, Lison, de Lauzanne, Agathe, Diouf, Jean-Baptiste, Zo, Andrianirina Zafitsara, Landau, Myriam, Herindrainy, Perlinot, Hivernaud, Delphine, Sarr, Fatoumata Diene, Sok, Touch, Vray, Muriel, Collard, Jean-Marc, Borand, Laurence, Delarocque-Astagneau, Elisabeth, Guillemot, Didier, Kermorvant-Duchemin, Elsa, Huynh, Bich-Tram, Study Group, Birdy, Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials (EMAE), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut Pasteur du Cambodge, Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier Roi Baudouin Guédiawaye [Dakar, Senegal], Centre Hospitalier de Soavinandriana (CENHOSOA), Unité d’Épidémiologie et de Recherche clinique [Antananarivo, Madagascar], Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Cité (UPCité), Institut Pasteur de Dakar, Ministry of Health [Phnom Penh], Unité de Bactériologie Expérimentale [Antananarivo, Madagascar] (IPM), Johns Hopkins University School of Medicine [Baltimore], Hôpital Raymond Poincaré [Garches], and The present work was supported by internal resources from Paris-Sud University. The BIRDY 1 & 2 research projects were implemented with the financial support of the Monegasque Cooperation for development, the Total Foundation, and MSDAVENIR.

Subjects
[SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics
Abstract

International audience; BackgroundThe exact timing, causes, and circumstances of stillbirth and neonatal mortality in low- and middle-income countries (LMICs) remain poorly described, especially for antenatal stillbirths and deaths occurring at home. We aimed to provide reliable estimates of the incidence of stillbirth and neonatal death in three LMICs (Madagascar, Cambodia and Senegal) and to identify their main causes and associated risk factors.MethodsThis study is based on data from an international, multicentric, prospective, longitudinal, community-based mother-infant cohort. We included pregnant mothers and prospectively followed up their children in the community. Stillbirths and deaths were systematically reported; information across healthcare settings was collected and verbal autopsies were performed to document the circumstances and timing of death.ResultsAmong the 4436 pregnancies and 4334 live births, the peripartum period and the first day of life were the key periods of mortality. The estimated incidence of stillbirth was 11 per 1000 total births in Cambodia, 15 per 1000 in Madagascar, and 12 per 1000 in Senegal. We estimated neonatal mortality at 18 per 1000 live births in Cambodia, 24 per 1000 in Madagascar, and 23 per 1000 in Senegal. Based on ultrasound biometric data, 16.1% of infants in Madagascar were born prematurely, where 42% of deliveries and 33% of deaths occurred outside healthcare facilities. Risk factors associated with neonatal death were mainly related to delivery or to events that newborns faced during the first week of life.ConclusionsThese findings underscore the immediate need to improve care for and monitoring of children at birth and during early life to decrease infant mortality. Surveillance of stillbirth and neonatal mortality and their causes should be improved to mitigate this burden in LMICs.

Published
2023
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25. Vaccination Coverage and Risk Factors Associated With Incomplete Vaccination Among Children in Cambodia, Madagascar, and Senegal

Author

Verrier, Florian, de Lauzanne, Agathe, Diouf, Jean-Baptiste Niokhhor, Zo, Andrianirina Zafitsara, Ramblière, Lison, Herindrainy, Perlinot, Sarr, Fatoumata Diene, Sok, Touch, Vray, Muriel, Collard, Jean-Marc, Borand, Laurence, Kermorvant-Duchemin, Elsa, Delarocque-Astagneau, Elisabeth, Guillemot, Didier, Huynh, Bich-Tram, Study Group, Bacterial Infections And Antibiotic-Resistant Diseases Among Young Children In Low-Income Countries, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials (EMAE), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Institut Pasteur du Cambodge, Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier Roi Baudouin Guédiawaye [Dakar, Senegal], Centre Hospitalier de Soavinandriana (CENHOSOA), Institut Pasteur de Madagascar, Institut Pasteur de Dakar, Ministry of Health [Phnom Penh], Johns Hopkins University School of Medicine [Baltimore], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Cité (UPCité), Hôpital Raymond Poincaré [Garches], Université Paris-Saclay, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), This work was supported by the Department of International Cooperation of the Principality of Monaco, MSD Avenir, and Total Foundation., and BIRDY Study Group. Members from the Institut Pasteur in Madagascar include Aina Nirina Randriamamonjiarison, Tanjona Antsa Volahasina, Fanjalalaina Rasoanaivo, Feno Manitra Jacob Rakotoarimanana, Tanjona Bodonirina Raheliarivao, and Frédérique Randrianirina. Members from the Institut Pasteur in Cambodia include Thida Chon, Sophie Goyet, Alexandra Kerleguer, Véronique Ngo, Siyin Lach, Pring Long, and Arnaud Tarantola. Members from the Institut Pasteur in Senegal include Marguerite Diatta, Joseph Faye, and Abdoulaye Seck. Members from the Institut Pasteur in Paris include Michael Padget, Armiya Youssouf Abdou, and Benoit Garin.

Subjects
Infectious Diseases, Oncology, Madagascar, risk factors, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, vaccine coverage, Cambodia, Senegal
Abstract

Background Vaccination reduces mortality from infectious disease, which is the leading cause of death in children under 5 and bears a particularly high burden in low- and middle-income countries. The Global Vaccine Action Plan (2011–2020) has set a target of 90% vaccine coverage for all vaccines included in national immunization programs by 2020. The objectives of this study were to estimate vaccine coverage among children in Madagascar, Cambodia, and Senegal and to identify the risk factors associated with incomplete vaccination. Methods Using data from a community-based prospective cohort that included all newborn of some areas from 2012 to 2018 in these 3 countries, vaccine coverage was estimated for BCG, hepatitis B, oral polio, pentavalent (targeting diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b), and measles vaccines. Risk factor analysis was performed with logistic regression models to identify correlates of incomplete vaccination. Results A total of 3606 children were followed up, and vaccine coverage was below the 90% threshold for most vaccines in all countries. Coverage was higher for vaccines recommended at birth and at 6 weeks, while a decrease in coverage for subsequent doses was observed for vaccines requiring several doses (23–47 points). Low birth weight ( Conclusions Vaccine coverage for common childhood vaccines was lower than World Health Organization recommendations, and multidisciplinary approaches may help to improve vaccine coverage and timeliness.

Published
2023
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26. Public Health Impact After the Introduction of PsA-TT: The First 4 Years

Author

Diomandé, Fabien V. K., Djingarey, Mamoudou H., Daugla, Doumagoum M., Novak, Ryan T., Kristiansen, Paul A., Collard, Jean-Marc, Gamougam, Kadidja, Kandolo, Denis, Mbakuliyemo, Nehemie, Mayer, Leonard, Stuart, James, Clark, Thomas, Tevi-Benissan, Carol, Perea, William A., Preziosi, Marie-Pierre, LaForce, F. Marc, Caugant, Dominique, Messonnier, Nancy, Walker, Oladapo, and Greenwood, Brian

Published
2015

27. Genomic analysis of sewage from 101 countries reveals global landscape of antimicrobial resistance

Author

Munk, Patrick, Brinch, Christian, Møller, Frederik Duus, Petersen, Thomas N., Hendriksen, Rene S., Seyfarth, Anne Mette, Kjeldgaard, Jette S., Svendsen, Christina Aaby, van Bunnik, Bram, Berglund, Fanny, Bego, Artan, Power, Pablo, Rees, Catherine, Lambrinidis, Dionisia, Neilson, Elizabeth Heather Jakobsen, Gibb, Karen, Coventry, Kris, Collignon, Peter, Cassar, Susan, Allerberger, Franz, Begum, Anowara, Hossain, Zenat Zebin, Worrell, Carlon, Vandenberg, Olivier, Pieters, Ilse, Victorien, Dougnon Tamègnon, Gutierrez, Angela Daniela Salazar, Soria, Freddy, Grujić, Vesna Rudić, Mazalica, Nataša, Rahube, Teddie O., Tagliati, Carlos Alberto, Rodrigues, Dalia, Oliveira, Guilherme, de Souza, Larissa Camila Ribeiro, Ivanov, Ivan, Juste, Bonkoungou Isidore, Oumar, Traoré, Sopheak, Thet, Vuthy, Yith, Ngandijo, Antoinette, Nzouankeu, Ariane, Olivier, Ziem A. Abah Jacques, Yost, Christopher K., Kumar, Pratik, Brar, Satinder Kaur, Tabo, Djim-Adjim, Adell, Aiko D., Paredes-Osses, Esteban, Martinez, Maria Cristina, Cuadros-Orellana, Sara, Ke, Changwen, Zheng, Huanying, Baisheng, Li, Lau, Lok Ting, Chung, Teresa, Jiao, Xiaoyang, Yu, Yongjie, JiaYong, Zhao, Morales, Johan F. Bernal, Valencia, Maria Fernanda, Donado-Godoy, Pilar, Coulibaly, Kalpy Julien, Hrenovic, Jasna, Jergović, Matijana, Karpíšková, Renáta, Deogratias, Zozo Nyarukweba, Elsborg, Bodil, Hansen, Lisbeth Truelstrup, Jensen, Pernille Erland, Abouelnaga, Mohamed, Salem, Mohamed Fathy, Koolmeister, Marliin, Legesse, Mengistu, Eguale, Tadesse, Heikinheimo, Annamari, Le Guyader, Soizick, Schaeffer, Julien, Villacis, Jose Eduardo, Sanneh, Bakary, Malania, Lile, Nitsche, Andreas, Brinkmann, Annika, Schubert, Sara, Hesse, Sina, Berendonk, Thomas U., Saba, Courage Kosi Setsoafia, Mohammed, Jibril, Feglo, Patrick Kwame, Banu, Regina Ama, Kotzamanidis, Charalampos, Lytras, Efthymios, Lickes, Sergio A., Kocsis, Bela, Solymosi, Norbert, Thorsteinsdottir, Thorunn R., Hatha, Abdulla Mohamed, Ballal, Mamatha, Bangera, Sohan Rodney, Fani, Fereshteh, Alebouyeh, Masoud, Morris, Dearbhaile, O’Connor, Louise, Cormican, Martin, Moran-Gilad, Jacob, Battisti, Antonio, Diaconu, Elena Lavinia, Corno, Gianluca, Di Cesare, Andrea, Alba, Patricia, Hisatsune, Junzo, Yu, Liansheng, Kuroda, Makoto, Sugai, Motoyuki, Kayama, Shizuo, Shakenova, Zeinegul, Kiiyukia, Ciira, Ng’eno, Eric, Raka, Lul, Jamil, Kazi, Fakhraldeen, Saja Adel, Alaati, Tareq, Bērziņš, Aivars, Avsejenko, Jeļena, Kokina, Kristina, Streikisa, Madara, Bartkevics, Vadims, Matar, Ghassan M., Daoud, Ziad, Pereckienė, Asta, Butrimaite-Ambrozeviciene, Ceslova, Penny, Christian, Bastaraud, Alexandra, Rasolofoarison, Tiavina, Collard, Jean-Marc, Samison, Luc Hervé, Andrianarivelo, Mala Rakoto, Banda, Daniel Lawadi, Amin, Arshana, Rajandas, Heraa, Parimannan, Sivachandran, Spiteri, David, Haber, Malcolm Vella, Santchurn, Sunita J., Vujacic, Aleksandar, Djurovic, Dijana, Bouchrif, Brahim, Karraouan, Bouchra, Vubil, Delfino Carlos, Pal, Pushkar, Schmitt, Heike, van Passel, Mark, Jeunen, Gert-Jan, Gemmell, Neil, Chambers, Stephen T., Mendoza, Fania Perez, Huete-Pιrez, Jorge, Vilchez, Samuel, Ahmed, Akeem Olayiwola, Adisa, Ibrahim Raufu, Odetokun, Ismail Ayoade, Fashae, Kayode, Sørgaard, Anne-Marie, Wester, Astrid Louise, Ryrfors, Pia, Holmstad, Rune, Mohsin, Mashkoor, Hasan, Rumina, Shakoor, Sadia, Gustafson, Natalie Weiler, Schill, Claudia Huber, Rojas, Maria Luz Zamudio, Velasquez, Jorge Echevarria, Magtibay, Bonifacio B., Catangcatang, Kris, Sibulo, Ruby, Yauce, Felipe Campos, Wasyl, Dariusz, Manaia, Celia, Rocha, Jaqueline, Martins, Jose, Álvaro, Pedro, Di Yoong Wen, Doris, Shin, Hanseob, Hur, Hor-Gil, Yoon, Sukhwan, Bosevska, Golubinka, Kochubovski, Mihail, Cojocaru, Radu, Burduniuc, Olga, Hong, Pei-Ying, Perry, Meghan Rose, Gassama, Amy, Radosavljevic, Vladimir, Tay, Moon Y. F., Zuniga-Montanez, Rogelio, Wuertz, Stefan, Gavačová, Dagmar, Pastuchová, Katarína, Truska, Peter, Trkov, Marija, Keddy, Karen, Esterhuyse, Kerneels, Song, Min Joon, Quintela-Baluja, Marcos, Lopez, Mariano Gomez, Cerdà-Cuéllar, Marta, Perera, R.R.D.P., Bandara, N.K.B.K.R.G.W., Premasiri, H.I., Pathirage, Sujatha, Charlemagne, Kareem, Rutgersson, Carolin, Norrgren, Leif, Örn, Stefan, Boss, Renate, Van der Heijden, Tanja, Hong, Yu-Ping, Kumburu, Happiness Houka, Mdegela, Robinson Hammerthon, Hounmanou, Yaovi Mahuton Gildas, Chonsin, Kaknokrat, Suthienkul, Orasa, Thamlikitkul, Visanu, de Roda Husman, Ana Maria, Bidjada, Bawimodom, Njanpop-Lafourcade, Berthe-Marie, Nikiema-Pessinaba, Somtinda Christelle, Levent, Belkis, Kurekci, Cemil, Ejobi, Francis, Kalule, John Bosco, Thomsen, Jens, Obaidi, Ouidiane, Jassim, Laila Mohamed, Moore, Andrew, Leonard, Anne, Graham, David W., Bunce, Joshua T., Zhang, Lihong, Gaze, William H., Lefor, Brett, Capone, Drew, Sozzi, Emanuele, Brown, Joe, Meschke, John Scott, Sobsey, Mark D., Davis, Michael, Beck, Nicola Koren, Sukapanpatharam, Pardi, Truong, Phuong, Lilienthal, Ronald, Kang, Sanghoon, Wittum, Thomas E., Rigamonti, Natalia, Baklayan, Patricia, Van, Chinh Dang, Tran, Doan Minh Nguyen, Do Phuc, Nguyen, Kwenda, Geoffrey, Larsson, D. G. Joakim, Koopmans, Marion, Woolhouse, Mark, Aarestrup, Frank M., Virology, Producció Animal, and Sanitat Animal

Subjects
genomic analysis, sewage, antimicrobial resistance, Multidisciplinary, Sewage, Drug Resistance, Bacterial, Metagenome, General Physics and Astronomy, Drug Resistance, Bacterial/genetics, Genomics, General Chemistry, General Biochemistry, Genetics and Molecular Biology, Anti-Bacterial Agents/pharmacology, Anti-Bacterial Agents
Abstract

Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG-specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention. Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG-specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention.

Published
2022
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28. Factors Associated with Carriage of Enteropathogenic and Non-Enteropathogenic Viruses: A Reanalysis of Matched Case-Control Data from the AFRIBIOTA Site in Antananarivo, Madagascar.

Author

Razanajatovo, Iony Manitra, Andrianomiadana, Lova, Habib, Azimdine, Randrianarisoa, Mirella Malala, Razafimanjato, Helisoa, Rakotondrainipiana, Maheninasy, Andriantsalama, Prisca, Randriamparany, Ravaka, Andriamandimby, Soa Fy, Vonaesch, Pascale, Sansonetti, Philippe Jean, Lacoste, Vincent, Randremanana, Rindra Vatosoa, Collard, Jean-Marc, and Heraud, Jean-Michel

Subjects
GROWTH of children, ASCARIS lumbricoides, INTESTINAL infections, VIRUS diseases, POLYMERASE chain reaction
Abstract

Environmental Enteric Dysfunction (EED) is an associate driver of stunting in poor settings, and intestinal infections indirectly contribute to the pathophysiology underlying EED. Our work aimed at assessing whether enteric viral carriage is determinant to stunting. A total of 464 healthy and asymptomatic children, aged 2 to 5 years, were recruited, and classified as non-stunted, moderately stunted, or severely stunted. Among the recruited children, 329 stool samples were obtained and screened for enteric and non-enteric viruses by real-time polymerase chain reaction. We statistically tested for the associations between enteric viral and potential risk factors. Approximately 51.7% of the stool samples were positive for at least one virus and 40.7% were positive for non-enteric adenoviruses. No statistical difference was observed between virus prevalence and the growth status of the children. We did not find any statistically significant association between viral infection and most of the socio-demographic risk factors studied, except for having an inadequate food quality score or an over-nourished mother. In addition, being positive for Ascaris lumbricoides was identified as a protective factor against viral infection. In conclusion, we did not find evidence of a direct link between stunting and enteropathogenic viral carriage in our population. [ABSTRACT FROM AUTHOR]

Published
2023
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29. Identifying the etiology and pathophysiology underlying stunting and environmental enteropathy: study protocol of the AFRIBIOTA project

Author

Vonaesch, Pascale, Randremanana, Rindra, Gody, Jean-Chrysostome, Collard, Jean-Marc, Giles-Vernick, Tamara, Doria, Maria, Vigan-Womas, Inès, Rubbo, Pierre-Alain, Etienne, Aurélie, Andriatahirintsoa, Emilson Jean, Kapel, Nathalie, Brown, Eric, Huus, Kelsey E., Duffy, Darragh, Finlay, B.Brett, Hasan, Milena, Hunald, Francis Allen, Robinson, Annick, Manirakiza, Alexandre, Wegener-Parfrey, Laura, Vray, Muriel, Sansonetti, Philippe J., and for the AFRIBIOTA Investigators

Published
2018
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30. Stunted children display ectopic small intestinal colonization by oral bacteria, which cause lipid malabsorption in experimental models

Author

Vonaesch, Pascale, Araújo, João, Gody, Jean-Chrysostome, Mbecko, Jean-Robert, Sanke, Hugues, Andrianonimiadana, Lova, Naharimanananirina, Tanteliniaina, Ningatoloum, Synthia Nazita, Vondo, Sonia Sandrine, Gondje, Privat Bolmbaye, Rodriguez-Pozo, Andre, Rakotondrainipiana, Maheninasy, Kandou, Kaleb Jephté Estimé, Nestoret, Alison, Kapel, Nathalie, Djorie, Serge Ghislain, Finlay, B. Brett, Wegener Parfrey, Laura, Collard, Jean-Marc, Randremanana, Rindra Vatosoa, Sansonetti, Philippe, Collard, Jean-Marc, Pathogénie microbienne moléculaire, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Swiss Tropical and Public Health Institute [Basel], Université de Lausanne = University of Lausanne (UNIL), University of Basel (Unibas), Centre pédiatrique de Bangui, Institut Pasteur de Bangui, Réseau International des Instituts Pasteur (RIIP), Unité de Bactériologie Expérimentale [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHUJRA), Immunologie Translationnelle - Translational Immunology lab, Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), University of British Columbia (UBC), Collège de France (CdF (institution)), This project was funded by the Total Foundation, the Institut Pasteur, Bill and Melinda Gates Foundation Grant OPP1204689, the Fondation Petram, Nutricia Foundation Grant NRF 2016-10, and a donation from the Odyssey Re-Insurance Company. P.V. was supported by Swiss National Science Foundation Early Postdoctoral Fellowship P2EZP3_152159, Advanced Postdoctoral Fellowship P300PA_177876, and Return Grant P3P3PA_17877, a Roux-Cantarini fellowship (2016), a L’Oréal–UNESCO for Women in Science France fellowship (2017), and an Excellence Scholarship from the University of Basel (Forschungsfonds, 2019). Her group is funded through the NCCR Microbiomes, a National Centre of Competence in Research, funded by the Swiss National Science Foundation (grant number 180575). Work in the group of L.W.P. is funded by Human Frontier Science Program Grant RGY0078/2015. P.J.S. is a Howard Hughes Medical Institute Senior Foreign Scholar and CIFAR scholar in the human microbiome consortium., We thank all children and their families who participated in the Afribiota project. Further, we thank the Afribiota Consortium, the participating hospitals in Bangui and Antananarivo, the Institut Pasteur, the Institut Pasteur de Madagascar, the Institut Pasteur de Bangui, and members of the scientific advisory boards for their continuous support, and we thank the Centre de Recherche Translationelle and the Direction Internationale of the Institut Pasteur (especially Paméla Palvadeau, Jane Lynda Deuve, Cécile Artaud, Nathalie Jolly, Sophie Jarrijon, Mamy Ratsialonina, and Jean-François Damaras) for help in setting up and steering the Afribiota project. We also thank J.-M.C., Pierre-Alain Rubbo, Dieu-Merci Welekoi-Yapondo, L.A., Laurence Arowas, and Marie-Noelle Ungeheuer for managing the biobank, the members of the animal facility at the Institut Pasteur for taking care of the mice, the Centre d’Immunolgoie Humaine of the Institut Pasteur, especially Milena Hasan, Tarshana Stephen, and Esma Karkeni, for help with setting up the LUMINEX assays at their platform, Asmaa Tazi for identification of the bacteria by MALDI-TOF spectroscopy, Estelle Martineau at the Platform Spectrometries Capacités at the University of Nantes for quantification of the fermentation products, Kelsey Huus for critical reading of the manuscript, and Munir Winkel for streamlining of the R code., and Liste of Afribiota Inverstigators : Laurence Barbot-Trystram, Hôpital Pitié-Salpêtrière, Paris, France Robert Barouki, Hôpital Necker- Enfants maladies, Paris, France Alexandra Bastaraud, Institut Pasteur de Madagascar, Antananarivo, Madagascar Jean-Marc Collard, Institut Pasteur de Madagascar, Antananarivo, Madagascar Maria Doria, Institut Pasteur, Paris, France Darragh Duffy, Institut Pasteur, Paris, France B. Brett Finlay, University of British Columbia, Vancouver, Canada Serge Ghislain Djorie, Institut Pasteur de Bangui, Bangui, Central African Republic Tamara Giles-Vernick, Institut Pasteur, Paris, France Bolmbaye Privat Gondje, Complexe Pédiatrique de Bangui, Bangui, Central African Republic Jean-Chrysostome Gody, Complexe Pédiatrique de Bangui, Bangui, Central African Republic Milena Hasan, Institut Pasteur, France Francis Allen Hunald, Service de Chirurgie pédiatrique, Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHU-JRA), Antananarivo, Madagascar Nathalie Kapel, Hôpital Pitié-Salpêtrière, Paris, France Jean-Pierre Lombart, Institut Pasteur de Bangui, Bangui, Central African Republic Alexandre Manirakiza, Institut Pasteur de Bangui, Bangui, Central African Republic Synthia Nazita Nigatoloum, Complexe Pédiatrique de Bangui, Bangui, Central African Republic Laura Wegener Parfrey, University of British Columbia, Vancouver, Canada Lisette Raharimalala, Centre de Santé Materno-Infantile, Tsaralalana, Antananarivo, Madagascar Maheninasy Rakotondrainipiana, Institut Pasteur de Madagascar, Antananarivo, Madagascar Rindra Vatosoa Randremanana, Institut Pasteur de Madagascar, Antananarivo, Madagascar Harifetra Mamy Richard Randriamizao, Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona (CHU-JRA), Antananarivo, Madagascar Frédérique Randrianirina, Institut Pasteur de Madagascar, Antananarivo, Madagascar Annick Robinson, Centre Hospitalier Universitaire Mère Enfant de Tsaralalana, Antananarivo, Madagascar Pierre-Alain Rubbo, Institut Pasteur de Bangui, Bangui, République Centrafricaine Philippe Sansonetti, Institut Pasteur, Paris, France Laura Schaeffer, Institut Pasteur, Paris, France Ionela Gouandjika-Vassilache, Institut Pasteur de Bangui, Bangui, République Centrafricaine Pascale Vonaesch, Institut Pasteur, Paris, France Sonia Sandrine Vondo, Complexe Pédiatrique de Bangui, Bangui, Central African Republic Inès Vigan-Womas, Institut Pasteur de Madagascar, Antananarivo, Madagasca

Subjects
[SDV] Life Sciences [q-bio], stunted child growth, lipid malabsorption, [SDV]Life Sciences [q-bio], environmental enteric dysfunction, low-grade inflammation, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, small intestine, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
Abstract

International audience; Environmental enteric dysfunction (EED) is an inflammatory syndrome postulated to contribute to stunted child growth and to be associated with intestinal dysbiosis and nutrient malabsorption. However, the small intestinal contributions to EED remain poorly understood. This study aimed to assess changes in the proximal and distal intestinal microbiota in the context of stunting and EED and to test for a causal role of these bacterial isolates in the underlying pathophysiology. We performed a cross-sectional study in two African countries recruiting roughly 1,000 children aged 2 to 5 years and assessed the microbiota in the stomach, duodenum, and feces. Upper gastrointestinal samples were obtained from stunted children and stratified according to stunting severity. Fecal samples were collected. We then investigated the role of clinical isolates in EED pathophysiology using tissue culture and animal models. We find that small intestinal bacterial overgrowth (SIBO) is extremely common (>80%) in stunted children. SIBO is frequently characterized by an overgrowth of oral bacteria, leading to increased permeability and inflammation and to replacement of classical small intestinal strains. These duodenal bacterial isolates decrease lipid absorption in both cultured enterocytes and mice, providing a mechanism by which they may exacerbate EED and stunting. Further, we find a specific fecal signature associated with the EED markers fecal calprotectin and alpha-antitrypsin. Our study shows a causal implication of ectopic colonization of oral bacterial isolated from the small intestine in nutrient malabsorption and gut leakiness in vitro. These findings have important therapeutic implications for modulating the microbiota through microbiota-targeted interventions.

Published
2022
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31. Neonatal acquisition of extended-spectrum beta-lactamase-producing Enterobacteriaceae in the community of a low-income country (NeoLIC): protocol for a household cohort study in Moramanga, Madagascar

Author

Harimanana, Aina, primary, Rakotondrasoa, Andriniaina, additional, Rivoarilala, Lalainasoa Odile, additional, Criscuolo, Alexis, additional, Opatowski, Lulla, additional, Rakotomanana, Elliot Fara Nandrasana, additional, Herindrainy, Perlinot, additional, Collard, Jean-Marc, additional, Crucitti, Tania, additional, and Huynh, Bich-Tram, additional

Published
2022
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32. A community survey of antibiotic consumption among children in Madagascar and Senegal: the importance of healthcare access and care quality

Author

Padget, Michael, Tamarelle, Jeanne, Herindrainy, Perlinot, Ndir, Awa, Diene Sarr, Fatoumata, Richard, Vincent, Piola, Patrice, Guillemot, Didier, Delarocque-Astagneau, Elisabeth, Seguy, Maud, Cherblanc, Fanny, Watier, Laurence, Nadimpalli, Maya, Le Fouler, Lenaig, Garin, Benoit, Huynh, Bich-Tram, Collard, Jean-Marc, Raheliarivao, Bodonirina Tanjona, Rakotoarimanana, Feno Manitra Jacob, Randrianirina, Frédérique, Vray, Muriel, Seck, Abdoulaye, Bercion, Raymond, Sow, Amy Gassama, Diouf, Jean Baptiste, Dieye, Pape Samba, Sy, Balla, Ndao, Bouya, Borand, Laurence, Chon, Thida, de Lauzanne, Agathe, Goyet, Sophie, Kerleguer, Alexandra, Lach, Siyin, Ngo, Veronique, Tarantola, Arnaud, Touch, Sok, and Kermorvant-Duchemin, Elsa

Published
2017
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33. Delayed 2009 Pandemic Influenza A Virus Subtype H1N1 Circulation in West Africa, May 2009-April 2010

Author

Nzussouo, Ndahwouh Talla, Michalove, Jennifer, Diop, Ousmane M., Njouom, Richard, de Lourdes Monteiro, Maria, Adje, Herve Kadjo, Manoncourt, Serge, Amankwa, Joseph, Koivogui, Lamine, Sow, Samba, Elkory, Mohamed Brahim, Collard, Jean-Marc, Dalhatu, Ibrahim, Niang, Mbayame Ndiaye, Lafond, Kathryn, Moniz, Filomena, Coulibaly, Daouda, Kronman, Karl C., Oyofo, Buhari A., Ampofo, William, Tamboura, Boubou, Bara, Ahmed Ould, Jusot, Jean-François, Ekanem, Ekanem, Sarr, Fatoumata Diène, Hwang, Inzune, Cornelius, Claire, Coker, Babajide, Lindstrom, Stephen, Davis, Richard, Dueger, Erica, Moen, Ann, and Widdowson, Marc-Alain

Published
2012
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34. Spatiotemporal Circulation of Influenza Viruses in 5 African Countries During 2008–2009: A Collaborative Study of the Institut Pasteur International Network

Author

Heraud, Jean-Michel, Njouom, Richard, Rousset, Dominique, Kadjo, Herve, Caro, Valerie, Ndiaye, Mbayame Niang, Victoir, Kathleen, Collard, Jean-Marc, Orelle, Arnaud, Yekwa, Elsie Laban, Ekaza, Euloge, Razanajatovo, Norosoa Harline, Adamou, Lagare, Biscornet, Leon, Enouf, Vincent, van der Werf, Sylvie, and Diop, Ousmane Madiagne

Published
2012
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36. Excess risk of subsequent infection in hospitalized children from a community cohort study in Cambodia and Madagascar

Author

Rambliere, Lison, primary, Kermorvant-Duchemin, Elsa, additional, de Lauzanne, Agathe, additional, Collard, Jean-Marc, additional, Herindrainy, Perlinot, additional, Vray, Muriel, additional, Garin, Benoit, additional, Zo, Andrianirina Zafitsara, additional, Rasoanaivo, Fanjalalaina, additional, Rakotoarimanana Feno Manitra, Jacob, additional, Raheliarivao, Tanjona Bodonirina, additional, Diouf, Jean-Baptiste Niokhhor, additional, Ngo, Véronique, additional, Lach, Siyin, additional, Long, Pring, additional, Borand, Laurence, additional, Sok, Touch, additional, Abdou, Armiya Youssouf, additional, Padget, Michael, additional, Madec, Yoann, additional, Guillemot, Didier, additional, Delarocque-Astagneau, Elisabeth, additional, and Huynh, Bich-Tram, additional

Published
2022
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37. High prevalence of small intestine bacteria overgrowth and asymptomatic carriage of enteric pathogens in stunted children in Antananarivo, Madagascar

Author

Collard, Jean-Marc, Andrianonimiadana, Lova, Habib, Azimdine, Rakotondrainipiana, Maheninasy, Andriantsalama, Prisca, Randriamparany, Ravaka, Rabenandrasana, M., Weill, François-Xavier, Sauvonnet, Nathalie, Randremanana, Rindra Vatosoa, Guillemot, Vincent, Vonaesch, Pascale, Sansonetti, Philippe, Bidault, Floran, Unité de Bactériologie Expérimentale [Antananarivo, Madagascar] (IPM), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Unité d’Épidémiologie et de Recherche clinique [Antananarivo, Madagascar], Bactéries pathogènes entériques (BPE), Institut Pasteur [Paris] (IP), Pathogénie microbienne moléculaire, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hub Bioinformatique et Biostatistique - Bioinformatics and Biostatistics, This project was funded by the Total and Petram Foundations and by Institut Pasteur. LA, PA and RR wages were supported by the Total Foundation and MR wage by the Petram Foundation. PV was supported by an Early Postdoctoral Fellowship (P2EZP3_152159), an Advanced Postdoctoral Fellowship (P300PA_177876) as well as a Return Grant (P3P3PA_17877) from the Swiss National Science Foundation, a Roux-Cantarini Fellowship (2016), a L'Oréal-UNESCO for Women in Science France Fellowship (2017) and an Excellence Scholarship from the University of Basel (Forschungsfonds, 2019)., We wish to thank all participating families, the AFRIBIOTA Consortium, the participating hospitals in Antananarivo, as well as the Institut Pasteur, the Institut Pasteur de Madagascar, and members of the scientific advisory board for their continuous support, Prof. Jean-Louis Demarquez for training sessions to teach the local health professionals the methods used for duodenal aspirations, Aurélie Etienne for precious help with the clinical procedures and first aspirations performed, the field workers Tseheno Harisoa and Rado Andrianantenaina, as well as all implicated community health workers, for countless hours spent in the field, and the Centre de Recherche Translationelle and the Direction Internationale of the Institut Pasteur, and especially Paméla Palvadeau, Jane Lynda Deuve, Marc Rovatiana Ranarijesy, Kanto Liantsoa Razanakolona, Cécile Artaud, Nathalie Jolly, Sophie Jarrijon, Mamy Ratsialonina, Jean-François Damaras, Marie-Noelle Ungeheuer, and Laurence Arowas for precious help in setting up and steering the AFRIBIOTA project and managing the funds and the biobank. We would like to thank the staff of the 'Plateforme de Microbiologie Mutualisée (P2M)' at Institut Pasteur Paris where the whole genome sequencing was performed, Sophie Lefevre from the Centre National de Référence des Escherichia coli, Shigella et Salmonella in Paris, France for Shigella serotyping, and Claude Parsot and Alexandre Grassart for the interesting discussions on Shigella.

Subjects
Adult, Diarrhea, MESH: Intestine, Small, MESH: Bacterial Infections, MESH: Shigella, MESH: Madagascar, Feces, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, Intestine, Small, Escherichia coli, Madagascar, Prevalence, Humans, Child, MESH: Prevalence, MESH: Humans, Bacteria, MESH: Escherichia coli, digestive, oral, and skin physiology, Public Health, Environmental and Occupational Health, MESH: Feces, MESH: Adult, Bacterial Infections, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, MESH: Bacteria, MESH: Diarrhea, Infectious Diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Shigella, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
Abstract

Environmental Enteric Dysfunction (EED) refers to an incompletely defined syndrome of inflammation, reduced absorptive capacity, and reduced barrier function in the small intestine. It is widespread among children and adults in low- and middle-income countries and is also associated with poor sanitation and certain gut infections possibly resulting in an abnormal gut microbiota, small intestinal bacterial overgrowth (SIBO) and stunting. We investigated bacterial pathogen exposure in stunted and non-stunted children in Antananarivo, Madagascar by collecting fecal samples from 464 children (96 severely stunted, 104 moderately stunted and 264 non-stunted) and the prevalence of SIBO in 109 duodenal aspirates from stunted children (61 from severely stunted and 48 from moderately stunted children). SIBO assessed by both aerobic and anaerobic plating techniques was very high: 85.3% when selecting a threshold of ≥105 CFU/ml of bacteria in the upper intestinal aspirates. Moreover, 58.7% of the children showed more than 106 bacteria/ml in these aspirates. The most prevalent cultivated genera recovered were Streptococcus, Neisseria, Staphylococcus, Rothia, Haemophilus, Pantoea and Branhamella. Feces screening by qPCR showed a high prevalence of bacterial enteropathogens, especially those categorized as being enteroinvasive or causing mucosal disruption, such as Shigella spp., enterotoxigenic Escherichia coli, enteropathogenic E. coli and enteroaggregative E. coli. These pathogens were detected at a similar rate in stunted children and controls, all showing no sign of severe diarrhea the day of inclusion but both living in a highly contaminated environment (slum-dwelling). Interestingly Shigella spp. was the most prevalent enteropathogen found in this study (83.3%) without overrepresentation in stunted children.

Published
2022
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38. Isolation of Novel Vincristine and Vinblastine Producing Streptomyces Species from Catharanthus Roseus Rhizospheric Soil

Author

Ramaroson Luciano, Onja Herivony Andriambeloson, Rabenandrasana Mamitiana Alain Noah, Andrianantenaina Rigobert, Collard Jean-Marc, and Rasolomampianina Rado

Subjects
Vincristine, biology, Botany, medicine, Catharanthus roseus, Isolation (microbiology), biology.organism_classification, Streptomyces species, medicine.drug, Vinblastine
Abstract

Microorganisms could be used as efficient tools to protect high value therapeutic plants against overexploitation and climate change. This work aimed to isolate alkaloids producing endophytic and rhizospheric soil actinomycetes and fungi of Catharanthus roseus. From a total of eleven actinomycetes and eight fungi strains isolated by dilution and plate methods, six telluric actinomycetes were revealed to produce alkaloids according to the precipitation test of their extracts. Revelation by Thin Layer Chromatography method using vinblastine and vincristine standards on the basis of frontal reference values showed that the strain SC8 and the vinblastine, the strain SC7 and the vincristine displayed the same frontal references (0,89 and 0,88, respectively). Whole genome sequencing method showed that both strains belong to the genus Streptomyces with novel species.Moreover, metabolic pathways analysis from their genomes allowed to detect three enzymes involved in the biosynthesis of terpenoid backbone leading to that of terpenoid indole alkaloids.

Published
2021
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39. Rotavirus surveillance in urban and rural areas of Niger, April 2010-March 2012

Author

Page, Anne-Laure, Jusot, Viviane, Mamaty, Abdoul-Aziz, Adamou, Lagare, Kaplon, Jerome, Pothier, Pierre, Djibo, Ali, Manzo, Mahamane L., Toure, Brahima, Langendorf, Celine, Collard, Jean-Marc, and Grais, Rebecca F.

Subjects
Gastroenteritis -- Research -- Risk factors -- Demographic aspects, Viral vaccines -- Usage -- Health aspects, Rotaviruses -- Research -- Demographic aspects -- Prevention, Health
Abstract

As the leading cause of severe gastroenteritis in children, rotavirus is responsible for ≅ 450,000 deaths each year among children Four rotavirus genotypes were historically recognized as predominant: G1P[8], G2P[4], [...]

Published
2014
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40. One Health Genomic Surveillance Reveals Multiple Cross-Reservoirs Transmission Events of Extended-Spectrum β-Lactamase-Producing Escherichia Coli in a Rural Area of Madagascar

Author

Gay, Noellie, primary, Rabenandrasana, Mamitina Alain Noah, additional, Panandiniaina, Harielle Prisca, additional, Rakotoninidrina, Marie Florence, additional, Ramahatafandry, Ilo Tsimok’Haja, additional, Enouf, Vincent, additional, Roger, François, additional, Collard, Jean-Marc, additional, Cardinale, Eric, additional, Rieux, Adrien, additional, and Loire, Etienne, additional

Published
2022
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41. Stunted Child Growth Is Associated With Small Intestinal Colonization by Oral Bacteria Driving Lipid Malabsorption and Inflammation in vitro

Author

Vonaesch, Pascale, primary, Araújo, João R., additional, Gody, Jean-Chrysostome, additional, Mbecko, Jean-Robert, additional, Sanke, Hugues, additional, Andrianonimiadana, Lova, additional, Naharimanananirina, Tanteliniaina, additional, Nigateloum, Cynthia, additional, Vondo, Sonia, additional, Gondje, Privat, additional, Rodriguez-Pozo, Andre, additional, Rakotondrainipiana, Maheninasy, additional, Kandou, Kaleb Jephté Estimé, additional, Nestoret, Alison, additional, Kapel, Nathalie, additional, Djorie, Serge Ghislain, additional, Parfrey, Laura Wegener, additional, Collard, Jean-Marc, additional, Randremanana, Rindra Vatosoa, additional, Sansonetti, Philippe J., additional, and Investigators, Afribiota, additional

Published
2022
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43. Prevalence and Factors Associated with Maternal Group B Streptococcus Colonization in Madagascar and Senegal

Author

Jung, Yu-Jin, primary, Huynh, Bich-Tram, additional, Seck, Abdoulaye, additional, Bercion, Raymond, additional, Sarr, Fatoumata Diene, additional, Herindrainy, Perlinot, additional, Diouf, Jean-Baptiste, additional, Andrianirina, Zafitsara Zo, additional, Firon, Arnaud, additional, Trieu-Cuot, Patrick, additional, Goyet, Sophie, additional, Collard, Jean-Marc, additional, Delarocque-Astagneau, Elisabeth, additional, Guillemot, Didier, additional, Vray, Muriel, additional, and _, _, additional

Published
2021
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44. The eukaryome of African children is influenced by geographic location, gut biogeography, and nutritional status.

Author

Vonaesch, Pascale, Billy, Vincent, Mann, Allison E, Morien, Evan, Habib, Azimdine, Collard, Jean-Marc, Dédé, Michel, Kapel, Nathalie, Sansonetti, Philippe J, Parfrey, Laura Wegener, and Investigators, for the Afribiota

Abstract

Eukaryotes have historically been studied as parasites, but recent evidence suggests they may be indicators of a healthy gut ecosystem. Here, we describe the eukaryome along the gastrointestinal tract of children aged 2–5 years and test for associations with clinical factors such as anaemia, intestinal inflammation, chronic undernutrition, and age. Children were enrolled from December 2016 to May 2018 in Bangui, Central African Republic and Antananarivo, Madagascar. We analyzed a total of 1104 samples representing 212 gastric, 187 duodenal, and 705 fecal samples using a metabarcoding approach targeting the full ITS2 region for fungi, and the V4 hypervariable region of the 18S rRNA gene for the overall eukaryome. Roughly, half of all fecal samples showed microeukaryotic reads. We find high intersubject variability, only a handful of taxa that are likely residents of the gastrointestinal tract, and frequent co-occurrence of eukaryotes within an individual. We also find that the eukaryome differs between the stomach, duodenum, and feces and is strongly influenced by country of origin. Our data show trends towards higher levels of Fusarium equiseti , a mycotoxin producing fungus, and lower levels of the protist Blastocystis in stunted children compared to nonstunted controls. Overall, the eukaryome is poorly correlated with clinical variables. Our study is of one of the largest cohorts analyzing the human intestinal eukaryome to date and the first to compare the eukaryome across different compartments of the gastrointestinal tract. Our results highlight the importance of studying populations across the world to uncover common features of the eukaryome in health. [ABSTRACT FROM AUTHOR]

Published
2023
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47. Stunted children display ectopic small intestinal colonization by oral bacteria,which cause lipidmalabsorption in experimentalmodels.

Author

Vonaesch, Pascale, Araújo, João R., Gody, Jean-Chrysostome, Mbecko, Jean-Robert, Sanke, Hugues, Andrianonimiadana, Lova, Naharimanananirina, Tanteliniaina, Ningatoloum, Synthia Nazita, Vondo, Sonia Sandrine, Gondje, Privat Bolmbaye, Rodriguez-Pozo, Andre, Rakotondrainipiana, Maheninasy, Estimè Kandou, Kaleb Jephtè, Nestoret, Alison, Kapel, Nathalie, Djorie, Serge Ghislain, Finlay, B. Brett, Parfrey, Laura Wegener, Collard, Jean-Marc, and Randremanana, Rindra Vatosoa

Subjects
SMALL intestinal bacterial overgrowth, INTESTINES, SMALL intestine, STUNTED growth, GUT microbiome
Abstract

Environmental enteric dysfunction (EED) is an inflammatory syndrome postulated to contribute to stunted child growth and to be associated with intestinal dysbiosis and nutrient malabsorption. However, the small intestinal contributions to EED remain poorly understood. This study aimed to assess changes in the proximal and distal intestinal microbiota in the context of stunting and EED and to test for a causal role of these bacterial isolates in the underlying pathophysiology. We performed a cross-sectional study in two African countries recruiting roughly 1,000 children aged 2 to 5 years and assessed the microbiota in the stomach, duodenum, and feces. Upper gastrointestinal samples were obtained from stunted children and stratified according to stunting severity. Fecal samples were collected. We then investigated the role of clinical isolates in EED pathophysiology using tissue culture and animal models. We find that small intestinal bacterial overgrowth (SIBO) is extremely common (>80%) in stunted children. SIBO is frequently characterized by an overgrowth of oral bacteria, leading to increased permeability and inflammation and to replacement of classical small intestinal strains. These duodenal bacterial isolates decrease lipid absorption in both cultured enterocytes and mice, providing a mechanism by which they may exacerbate EED and stunting. Further, we find a specific fecal signature associated with the EED markers fecal calprotectin and alpha-antitrypsin. Our study shows a causal implication of ectopic colonization of oral bacterial isolated from the small intestine in nutrient malabsorption and gut leakiness in vitro. These findings have important therapeutic implications for modulating the microbiota through microbiota-targeted interventions. [ABSTRACT FROM AUTHOR]

Published
2022
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48. Prevalence and factors associated with faecal carriage of extended-spectrum β-lactamase-producing Enterobacterales among peripartum women in the community in Cambodia.

Author

Lauzanne, Agathe de, Sreng, Navin, Foucaud, Elsa, Sok, Touch, Chon, Thida, Yem, Chhaily, Hak, Veasna, Heng, Sothada, Soda, Meng, Gouali, Malika, Nadimpalli, Maya, Inghammar, Malin, Rabenandrasana, Mamitina Alain Noah, Collard, Jean Marc, Vray, Muriel, Hello, Simon Le, Kerleguer, Alexandra, Piola, Patrice, Delarocque-Astagneau, Elisabeth, and Guillemot, Didier

Abstract

Background: In Southeast-Asia, where many conditions associated with dissemination of ESBL-producing Enterobacterales (ESBL-E) in the community are met, data from the community are scarce but show high ESBL-E carriage prevalence. Maternal ESBL-E colonization is considered a risk factor for neonatal colonization, which is the first step towards developing neonatal sepsis. Despite this, ESBL-E carriage prevalence and its risk factors during pregnancy or postpartum remain undefined in Southeast-Asia.Objectives: To estimate the prevalence of ESBL-E faecal colonization among peripartum women in the community of an urban and a rural area in Cambodia, to investigate ESBL-E genomic characteristics and to identify associated risk factors.Methods: Epidemiological data and faecal samples from 423 peripartum women were collected in an urban and rural areas in Cambodia (2015-16). Bacterial cultures, antibiotic susceptibility tests and ESBL gene sequencing were performed. Risk factor analysis was conducted using logistic regression.Results: The prevalence of ESBL-E faecal carriage was 79.2% (95% CI 75.0%-82.8%) among which Escherichia coli (n = 315/335, 94.0%) were most frequent. All isolates were multidrug resistant. Among 318 ESBL-E, the genes most frequently detected were blaCTX-M-15 (41.5%), blaCTX-M-55 (24.8%), and blaCTX-M-27 (15.1%). Low income, undernutrition, multiparity, regular consumption of pork, dried meat, and raw vegetables, were associated with ESBL-E faecal carriage.Conclusions: The high prevalence of ESBL-E carriage observed among peripartum women in Southeast-Asia and the identified associated factors underline the urgent need for public health measures to address antimicrobial resistance, including a 'One Health' approach. [ABSTRACT FROM AUTHOR]

Published
2022
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49. Characterization of Klebsiella pneumoniae isolated from patients suspected of pulmonary or bubonic plague during the Madagascar epidemic in 2017

Author

Rakotondra, Andriniaina, primary, Andrianonimiadana, Lova, additional, Rahajandraibe, Soloandry, additional, Razafimahatratra, Solohery, additional, Andrianaivoarimanana, Voahangy, additional, Rahelinirina, Soanandrasana, additional, Crucitti, Tania, additional, Brisse, Sylvain, additional, Jeannoda, Victor, additional, Rajerison, Minoarisoa, additional, and Collard, Jean-Marc, additional

Published
2021
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50. Putative Biomarkers of Environmental Enteric Disease Fail to Correlate in a Cross-Sectional Study in Two Study Sites in Sub-Saharan Africa.

Author

Vonaesch, Pascale, Winkel, Munir, Kapel, Nathalie, Nestoret, Alison, Barbot-Trystram, Laurence, Pontoizeau, Clément, Barouki, Robert, Rakotondrainipiana, Maheninasy, Kandou, Kaleb, Andriamanantena, Zo, Andrianonimiadana, Lova, Habib, Azimdine, Rodriguez-Pozo, Andre, Hasan, Milena, Vigan-Womas, Inès, Collard, Jean-Marc, Gody, Jean-Chrysostome, Djorie, Serge, Sansonetti, Philippe J., and Randremanana, Rindra Vatosoa

Abstract

Environmental enteric dysfunction (EED) is an elusive, inflammatory syndrome of the small intestine thought to be associated with enterocyte loss and gut leakiness and lead to stunted child growth. To date, the gold standard for diagnosis is small intestine biopsy followed by histology. Several putative biomarkers for EED have been proposed and are widely used in the field. Here, we assessed in a cross-sectional study of children aged 2–5 years for a large set of biomarkers including markers of protein exudation (duodenal and fecal alpha-1-antitrypsin (AAT)), inflammation (duodenal and fecal calprotectin, duodenal, fecal and blood immunoglobulins, blood cytokines, C-reactive protein (CRP)), gut permeability (endocab, lactulose-mannitol ratio), enterocyte mass (citrulline) and general nutritional status (branched-chain amino acids (BCAA), insulin-like growth factor) in a group of 804 children in two Sub-Saharan countries. We correlated these markers with each other and with anemia in stunted and non-stunted children. AAT and calprotectin, CRP and citrulline and citrulline and BCAA correlated with each other. Furthermore, BCAA, citrulline, ferritin, fecal calprotectin and CRP levels were correlated with hemoglobin levels. Our results show that while several of the biomarkers are associated with anemia, there is little correlation between the different biomarkers. Better biomarkers and a better definition of EED are thus urgently needed. [ABSTRACT FROM AUTHOR]

Published
2022
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