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Objectif : Déterminer les aspects histo-épidémiologiques et cliniques du LB de l’enfant Centrafricain.Patients et méthodes : Il s’agissait d’une étude transversale multicentrique avec un mode de regroupement prospectif et rétrospectif réalisée au Centre Hospitalo-Universitaire Pédiatrique de Bangui (CHUPB), dans le service d’Oto-rhino-laryngologie (ORL), et de Stomatologie, et au Laboratoire National de Biologie Clinique et de Santé Publique (LNBCSP) du 1er janvier 2000 au 30 juin 2016. Ont été inclus dans cette étude, les enfants de 0 à 15 ans admis pour suspicion de LB confirmé histologiquement. Un questionnaire a permis de collecter les données qui ont été saisies et analysées à l’aide du logiciel Epi Info 7.Résultats: Durant la période d’étude nous avons collecté 34 cas de LB ce qui représente 28,66% de tous les cancers de l’enfant diagnostiqués pendant la période et 31,49% des lymphomes malins. Le sex-ratio était de 2,03 en faveur des garçons. Les enfants les plus touchés étaient âgés de 5 à 9 ans (50,0%), avec un âge moyen de 6,50 ans. Les patients provenaient de Bangui dans 67,65% de cas et avaient un niveau d’étude primaire dans 64,70%. Les patients étaient immunodéprimé connu à HIV dans 17,64% de cas. Ils étaient suivis au CHUPB et dans le service de Stomatologie respectivement dans 55,88% et 38,24%. La durée moyenne de consultation après apparition des premiers signes était de 6 mois. L’altération de l’état général était retrouvée dans 82,35% de cas. La tumeur était douloureuse dans 52,94% de cas, les deux principales localisations étaient maxillo-faciale (52,94%) et abdominale (17,64%). La tumeur était régulière 64,7% de cas, fixe dans 76,5% et bourgeonnante dans 82,4% de cas.Conclusion: Le lymphome de Burkitt reste préoccupant et mérite d’être connu en vue d’un dépistage précoce, d’autant que les traitements actuels ont permis d’allonger le taux de survie à plus de 90%. D’où l’importance de mener un fort plaidoyer en vue de soutenir des actions de sensibilisation sur les cancers de l’enfant. Objective: To determine the histoepidemiological and clinical aspects of LB in Central African children.Patients and methods: It was a multi-center cross-sectional study with a prospective and retrospective grouping method carried out at the Center Hospitalo-Universitaire Pédiatrique de Bangui (CHUPB), in the department of Otolaryngology (ENT), and Stomatology, and at the National Laboratory of Clinical Biology and Public Health (LNBCSP) from January 1, 2000 to June 30, 2016. Children 0 to 15 years of age admitted for suspected histologically confirmed LB were included in this study. A questionnaire collected the data that was entered and analyzed using the Epi Info 7 software.Results: During the study period we collected 34 cases of LB which represents 28.66% of all childhood cancers diagnosed during the period and 31.49% of malignant lymphomas. The sex ratio was 2.03 in favor of boys. The most affected children were 5 to 9 years old (50.0%), with an average age of 6.50 years. Patients were from Bangui in 67.65% of cases and had a primary education level in 64.70%. The patients were known to be immunocompromised to HIV in 17.64% of cases. They were followed at the CHUPB and in the Stomatology department respectively in 55.88% and 38.24%. The average duration of consultation after appearance of the first signs was 6 months. The deterioration of the general state was found in 82.35% of cases. The tumor was painful in 52.94% of cases, the two main locations were maxillofacial (52.94%) and abdominal (17.64%). The tumor was regular 64.7% of cases, fixed in 76.5% and budding in 82.4% of cases.Conclusion: Burkitt's lymphoma remains a concern and deserves to be known for early detection, especially since current treatments have helped increase survival rates to over 90%. Hence the importance of carrying out strong advocacy in order to support awareness-raising actions on childhood cancers.

Context Provision of high-quality contraceptive counseling and services is essential to ensure family planning (FP) programs are rights-based and voluntary. Togo's modern contraceptive use has steadily increased with almost a quarter of the method mix attributed to long-acting reversible contraceptives (LARC). The purpose of this study is to assess the quality of LARC provision in Togo. Methods Data for this study were collected in 2016 as part of a larger research study conducted in Lome, Togo to assess the effectiveness of the ongoing FP service delivery model. Quality of FP service was assessed in terms of program capacity and program performance. Program capacity was measured with five individual variables and program performance was measured with the Method Information Index (MII). Descriptive statistics and mixed effects models were used to assess likelihood of LARC uptake. Results Of the 669 clients included in the study, 19.4% received a LARC method. Multivariable results show that LARC uptake is significantly associated with supervisory visit at the facility in the last three months (program capacity indicator) (OR 1.44; 95%CI 1.48-2.39) and is twice as likely for those with a positive MII score, even after controlling for provider and client characteristics (OR 2.1; 95%CI 1.61-2.51). Conclusion This study identified supervisory visits and comprehensive contraceptive counseling as the key quality factors positively associated with uptake of LARC. Continued focus on quality of care and provider-client information exchange is necessary to ensure women's FP needs are met.

Karen Weidert,1 Koffi B Tekou,2 Ndola Prata1 1Bixby Center for Population, Health and Sustainability, School of Public Health, University of California at Berkeley, Berkeley, CA, USA; 2Centre d’Evaluation et de Suivi du Groupe de Recherche et d’Appui en Santé et Education de la Population, Lomé, TogoCorrespondence: Ndola PrataSchool of Public Health, University of California at Berkeley, 6142 Berkeley Way West, Berkeley, CA 94720-6390, USATel +1510643-4284Email ndola@berkeley.eduContext: Provision of high-quality contraceptive counseling and services is essential to ensure family planning (FP) programs are rights-based and voluntary. Togo’s modern contraceptive use has steadily increased with almost a quarter of the method mix attributed to long-acting reversible contraceptives (LARC). The purpose of this study is to assess the quality of LARC provision in Togo.Methods: Data for this study were collected in 2016 as part of a larger research study conducted in Lomé, Togo to assess the effectiveness of the ongoing FP service delivery model. Quality of FP service was assessed in terms of program capacity and program performance. Program capacity was measured with five individual variables and program performance was measured with the Method Information Index (MII). Descriptive statistics and mixed effects models were used to assess likelihood of LARC uptake.Results: Of the 669 clients included in the study, 19.4% received a LARC method. Multivariable results show that LARC uptake is significantly associated with supervisory visit at the facility in the last three months (program capacity indicator) (OR 1.44; 95%CI 1.48– 2.39) and is twice as likely for those with a positive MII score, even after controlling for provider and client characteristics (OR 2.1; 95%CI 1.61– 2.51).Conclusion: This study identified supervisory visits and comprehensive contraceptive counseling as the key quality factors positively associated with uptake of LARC. Continued focus on quality of care and provider–client information exchange is necessary to ensure women’s FP needs are met.Keywords: LARC, Togo, method information index, FP services, quality

Some previously described environmental associations for atopic eczema may be due to reverse causation. We explored the role of reverse causation by comparing individual-and school-level results for multiple atopic eczema risk factors. The International Study of Asthma and Allergies in Childhood (i.e, ISAAC) Phase Three surveyed children in schools (the sampling unit) regarding atopic eczema symptoms and potential risk factors. We assessed the effect of these risk factors on atopic eczema symptoms using mixed-effect logistic regression models, first with individual-level exposure data and second with school-level exposure prevalence. Overall, 546,348 children from 53 countries were included. At ages 6-7 years, the strongest individual-level associations were with current paracetamol use (odds ratio [OR] = 1.45, 95% confidence interval [CI] = 1.37-1.54), which persisted at school-level (OR = 1.55, 95% CI = 1.10-2.21), early-life antibiotics (OR = 1.41, 95% CI = 1.34-1.48), and early-life paracetamol use (OR = 1.28, 95% CI = 1.21-1.36), with the former persisting at the school level, whereas the latter was no longer observed (OR = 1.35, 95% CI = 1.00-1.82 and OR = 0.94, 95% CI = 0.69-1.28, respectively). At ages 13-14 years, the strongest associations at the individual level were with current paracetamol use (OR = 1.57, 95% CI = 1.51-1.63) and open-fire cooking (OR = 1.46, 95% CI = 1.33-1.62); both were stronger at the school level (OR = 2.57, 95% CI = 1.84-3.59 and OR = 2.38, 95% CI = 1.52-3.73, respectively). Association with exposure to heavy traffic (OR = 1.31, 95% CI = 1.27-1.36) also persisted at the school level (OR = 1.40, 95% CI = 1.07-1.82). Most individual-and school-level effects were consistent, tending to exclude reverse causation.

Background: Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) measured the global prevalence of symptoms of asthma in children. We undertook comprehensive analyses addressing risk factors for asthma symptoms in combination, at both the individual and the school level, to explore the potential role of reverse causation due to selective avoidance or confounding by indication. Objective: To explore the role of reverse causation in risk factors of asthma symptoms. Methods: We compared two sets of multilevel logistic regression analyses, using (a) individual level exposure data and (b) school level average exposure (ie prevalence), in two different age groups. In individual level analyses, reverse causation is a possible concern if individual level exposure statuses were changed as a result of asthma symptoms or diagnosis. School level analyses may suffer from ecologic confounding, but reverse causation is less of a concern because individual changes in exposure status as a result of asthma symptoms would only have a small effect on overall school exposure levels. Results: There were 131 924 children aged 6-7 years (2428 schools, 25 countries) with complete exposure, outcome and confounder data. The strongest associations in individual level analyses (fully adjusted) were for current paracetamol use (odds ratio = 2.06; 95% confidence interval 1.97-2.16), early life antibiotic use (1.65; 1.58-1.73) and open fire cooking (1.44; 1.26-1.65). In school level analyses, these risk factors again showed increased risks. There were 238 586 adolescents aged 13-14 years (2072 schools, 42 countries) with complete exposure, outcome and confounder data. The strongest associations in individual level analyses (fully adjusted) were for current paracetamol use (1.80; 1.75-1.86), cooking on an open fire (1.32; 1.22-1.43) and maternal tobacco use (1.23; 1.18-1.27). In school level analyses, these risk factors again showed increased risks. Conclusions & clinical relevance: These analyses strengthen the potentially causal interpretation of previously reported individual level findings, by providing evidence against reverse causation.

Nigeria is a federal republic with 36 states and a federal capital territory. There are 774 local government authorities (LGAs) and 9565 wards across the nation. Based on the last census, held in 2006, the country had a projected population of >170 million in 2014, which makes it the most populous in Africa [1, 2]. After the 1988 World Health Assembly resolution to eradicate polio, the government of Nigeria, with support from the World Health Organization (WHO) and partners, has implemented several rounds of immunization campaigns against polio each year [3]. During 2003–2004, Nigeria experienced loss of public confidence in oral poliovirus vaccine (OPV), which ultimately led to the suspension of the supplemental immunization activities (SIAs). Consequently, poliovirus had a resurgence within Nigeria and spread to 20 previously polio-free countries [4]. Since then, several efforts have been made to improve program performance. At present, Nigeria still remains one of the 3 polio-endemic countries in the world, along with Pakistan and Afghanistan. The May 2015 Independent Monitoring Board report lauded Nigeria's recent progress and recommended that the government “build resilience” to stay polio free through 2017 [5]. In addition to technical and logistic requirements, the success of the polio eradication initiative (PEI) depends on timely provision of adequate financial resources to implement planned activities. The funds required for immunization activities in Nigeria are quite substantial, owing to operational complexity; the nature of the oil-driven economy, which makes the cost of goods and services expensive; and the large size of the population [1, 6]. According to the 2012–2016 financial resource requirements, the basic aspects of polio operations in Nigeria cost an average of $240 million per annum [7, 8]. Despite continued increase in the cost of polio eradication, economic models have proved that the return on PEI investment are justified [9]. The Global Polio Eradication Initiative (GPEI) estimated that incremental net benefits of the GPEI between 1988 and 2035 are approximately $40 billion–$50 billion [10]. Disbursement of funds for field activities and payment of vaccination personnel allowances down to the LGA and ward levels (wards are the lowest administrative unit in Nigeria) are enormous operational challenges in a country the size of Nigeria, because SIAs are the most labor intensive of the eradication strategies [11]. In Nigeria, >360 000 and >180 000 personnel are engaged to support 1 round of national and subnational polio vaccination campaigns, respectively. The subnational rounds are conducted in 11 states, which were categorized as high risk for poliovirus transmission, based on epidemiologic risk analysis. These high-risk states are Bauchi, Borno, Jigawa, Kaduna, Kano, Katsina, Kebbi, Niger, Sokoto, Yobe, and Zamfara. For polio alone, on average 2 national and 7 subnational rounds are conducted every year. Prior to 2004, operational funds to support SIAs in Nigeria were deposited by partners in a central dedicated account managed by the central government agency responsible for disbursement of the funds to the field. This mechanism faced a number of challenges, including underpayment or nonpayment of end beneficiaries, delays in payment and retirement, and inadequacy of documentation. According to a study conducted by the World Bank in 2005, nonpayment of entitlements at the LGA level was an endemic problem in Nigeria [12]. Following an audit's recommendations to address the challenges and inadequacies of the old payment system, major donors requested that a new payment mechanism be set up to continue with their financial contributions. The WHO conducted a risk assessment in 2013 and then established an innovative payment scheme, referred to as a “direct disbursement mechanism” (DDM), in 2014. The objective of the DDM was to resolve the shortcomings of the old disbursement system and meet donors' expectations. Accordingly, the DDM aimed to avail operational funds in time for implementation of field activities, ensure timely payment of eligible vaccination personnel, and ensure transparent and secured payment process to enhance accountability. In this article, we describe the process and activities involved in management of the DDM and how it provided an innovative solution for direct payment of activities and vaccination personnel at the grassroots level for successful implementation of SIAs.

Background West African and Ifakara experimental huts are used to evaluate indoor mosquito control interventions, including spatial repellents and insecticides. The two hut types differ in size and design, so a side-by-side comparison was performed to investigate the performance of indoor interventions in the two hut designs using standard entomological outcomes: relative indoor mosquito density (deterrence), exophily (induced exit), blood-feeding and mortality of mosquitoes. Methods Metofluthrin mosquito coils (0.00625% and 0.0097%) and Olyset® Net vs control nets (untreated, deliberately holed net) were evaluated against pyrethroid-resistant Culex quinquefasciatus in Benin. Four experimental huts were used: two West African hut designs and two Ifakara hut designs. Treatments were rotated among the huts every four nights until each treatment was tested in each hut 52 times. Volunteers rotated between huts nightly. Results The Ifakara huts caught a median of 37 Culex quinquefasciatus/ night, while the West African huts captured a median of 8/ night (rate ratio 3.37, 95% CI: 2.30–4.94, P 4-fold higher mosquito exit relative to the West African huts (odds ratio 4.18, 95% CI: 3.18–5.51, P

The aim was to publish a rare picture of a generalized skin case observed in Central African Republic. A 40-year-old woman comes in for consultation at Dermatology CNHU of Bangui on July 11, 2013 for generalized cutaneous nodules and tumors. The lesions were generalized including the scalp and under the tongue. They were in the form of hard nodules, motionless, variable size and tumors from 2 to 6 cm diameter. Some of which were ulcerated. Histology of a cutaneous nodule showed an image of adenoid cystic carcinoma.

This paper concerns itself with establishing convergence estimates for a linearized scheme for solving numerically the saturation equation. In a previous paper, error estimates were obtained for the same scheme in L2(0, T0;L2(Ω)). In this work, we establish error estimates for the linear scheme in L∞(0, T0;L2(Ω)) and in L2(0, T0;H1(Ω)) (in the discrete norms). Under certain realistic conditions, we show that, if the regularization parameter β and the spatial discretization parameter h are carefully chosen in terms of the time-stepping parameter Δt, the convergence, in these spaces, is at least of order O((Δt)α) for some determined α > 0, function of a parameter μ > 0 defined in the problem. Examples of possible choices of β and h in terms of Δt are given.

The ability of 11 models in simulating the aerosol vertical distribution from regional to global scales, as part of the second phase of the AeroCom model intercomparison initiative (AeroCom II), is assessed and compared to results of the first phase. The evaluation is performed using a global monthly gridded data set of aerosol extinction profiles built for this purpose from the CALIOP (Cloud-Aerosol Lidar with Orthogonal Polarization) Layer Product 3.01. Results over 12 subcontinental regions show that five models improved, whereas three degraded in reproducing the interregional variability in Zα0–6 km, the mean extinction height diagnostic, as computed from the CALIOP aerosol profiles over the 0–6 km altitude range for each studied region and season. While the models' performance remains highly variable, the simulation of the timing of the Zα0–6 km peak season has also improved for all but two models from AeroCom Phase I to Phase II. The biases in Zα0–6 km are smaller in all regions except Central Atlantic, East Asia, and North and South Africa. Most of the models now underestimate Zα0–6 km over land, notably in the dust and biomass burning regions in Asia and Africa. At global scale, the AeroCom II models better reproduce the Zα0–6 km latitudinal variability over ocean than over land. Hypotheses for the performance and evolution of the individual models and for the intermodel diversity are discussed. We also provide an analysis of the CALIOP limitations and uncertainties contributing to the differences between the simulations and observations.

In a previous work, stability and consistency results were established for a linearized Euler scheme for the saturation equation. In this paper we continue the mathematical analysis of the scheme, in preparation for its numerical treatment in a future work. We use the regularity results, obtained previously, to establish error estimates in L 2 () for the linear scheme. This work is done with the degenerate nature of the saturation equation in mind, but it is also valid for the non degenerate case like the concentration equation. We show that, if the regularization parameter  and the spatial discretization parameter h are carefully chosen in terms of the time stepping parameter t , the convergence is at least of order O((t)  ) for some determined  >0 . Examples of choices of  and h are given. We also establish a new (at our knowledge) regularity result for the continuous Galerkin formulation of the Saturation Equation and a new regularity result for the linear scheme. 2000 Mathematics Subject Classification. 35Q35, 65M06, 65M15, 65M60. 0)

We give a sufficient condition for uniqueness for the pressure/saturation system. We establish this condition through analytic arguments, and then construct “mobilities” (or mobility-like functions) that satisfy the new condition (when the parameter  is 2). For the constructed “mobilities”, we do graphical experiments that show, empirically, that this condition could be satisfied for other values of 1< < 2  . These empirical experiments indicate that the usual smoothness condition on the fractional flow function (and on the total mobility), for uniqueness and convergence, might not be necessary. This condition is also sufficient for the convergence of a family of perturbed problems to the original pressure/saturation problem.

We consider a system of nonlinear coupled partial differential equations that models immiscible two-phase flow through a porous medium. A primary difficulty with this problem is its degenerate nature. Under reasonable assumptions on the data, and for appropriate boundary and initial conditions, we prove the existence of a weak solution to the problem, in a certain sense, using a compactness argument. This is accomplished by regularizing the problem and proving that the regularized problem has a unique solution which is bounded independently of the regularization parameter. We also establish a priori estimates for uniqueness of a solution.

We consider a standard Galerkin Method applied to both the pressure equation and the saturation equation of a coupled nonlinear system of degenerate advection-diffusion equations modeling a two-phase immiscible flow through porous media. After regularizing the problem and establishing some regularity results, we derive error estimates for a semi-discretized Galerkin Method. A decoupled nonlinear scheme is then proposed for a fully discretized (backward in time) Galerkin Method, and error estimates are derived for that method. We also prove the existence and uniqueness for the nonlinear operator intervening in the backward time discretization.

We study the numerical approximation of the Saturation Equation which arises in the formulation of two phase fluid flow through porous media, idealized as either a convex bounded polyhedral domain or a domain with smooth boundary. This equation is degenerate and the solutions are not guaranteed to be sufficiently smooth for direct numerical approximation. Through regularization, a family of approximate non-degenerate problems is considered along with their numerical approximations. Error estimates are established for appropriately transformed continuous Galerkin approximations, followed by corresponding error estimates for a fully discretized Galerkin method for this class of problems.

Objectif : Chez le cocotier, les transferts de matériels effectués sous forme de cylindres d’albumen contenant l’embryon, compte du poids et du volume de la graine, se heurtent à plusieurs difficultés notamment les problèmes phytosanitaires et les nombreuses contaminations. Ce présent travail vise à déterminer les meilleures conditions de transfert permettant une meilleur régénération des embryons dans les laboratoires d’accueil.Méthodologie et résultats : Pour cela les embryons issus de noix matures (10 à 12 mois) ont été conditionnés sur deux milieux. Un milieu de régénération contenant du sucre (culture direct) et un milieu de maintien en vie ralentie sans sucre (conservation préalable avant la mise en culture). Le taux de germination des embryons extraits de noix matures sur les deux milieux ont été évalués. Les résultats ont montré que les taux de germination des embryons sont similaires après leur transfert sur le milieu de germination pour les deux milieux utilisés. Il varie entre 74 % et 84 % comparativement aux noix entières utilisées comme témoin qui ont un taux de 58 %.Conclusion et application des résultats : Cette étude a montré qu’il est possible d’utiliser directement les embryons zygotiques pour les échanges de matériel chez le cocotier en les maintenant en vie ralentie sur un milieu de culture sans sucre. Le maintien des embryons en vie ralentie et leur transfert sur le milieu dépourvu de sucre n’affecte pas leur régénération ultérieure. Ce mode de transfert permettrait de réduire le taux de contamination élevé lors du transfert de matériel sous forme de cylindres d’albumen. La priorité des pays producteurs de cocotier étant la création de nouvelles collections et l’enrichissement des collections existantes, la disponibilité d’une méthode fiable de transfert de matériel constitue une avancé majeur. L’utilisation du milieu de régénération peut conduire à un épuisement des constituants minéraux et entrainer le mort d’embryons ou des malformations au cours de la croissance.Mots clés: Cocotier, cylindres d'endosperme, embryon, culture in vitro, échange de matériel

Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated mass treatment with ivermectin in 16 sub-Saharan countries (Angola, Burundi, Cameroon, Central African Republic, Chad, Congo, Democratic Republic of Congo, Equatorial Guinea, Ethiopia, Liberia, Malawi, Nigeria, North Sudan, South Sudan, Uganda, and the United Republic of Tanzania) with the aim to control morbidity due to infection with Onchocerca volvulus, a filarial nematode. Recently, we predicted trends in prevalence of infection, visual impairment, blindness, and troublesome itch due to onchocerciasis in APOC countries for the period 1995–2015, based on extensive data on pre-control infection levels, population coverage of ivermectin mass treatment, and the association between infection and morbidity. We also estimated the associated health impact, expressed in disability-adjusted life years (DALYs).

Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated mass treatment with ivermectin in sixteen sub-Saharan countries with the aim to control morbidity due to infection with Onchocerca volvulus, a filarial nematode. The authors predicted trends in prevalence of infection, visual impairment,blindness, and troublesome itch due to onchocerciasis in APOC countries for the period 1995–2015, based on extensive data on pre-control infection levels, population coverage of ivermectin mass treatment, and the association between infection and morbidity . They also estimated the associated health impact, expressed in disability-adjusted life years (DALYs). However, the estimated health impact was based on disability weights from the 2004 update of the Global Burden of Disease (GBD) study, which have been criticized for being based solely on the opinions of health professionals . The published GBD 2010 study addressed the criticism by providing updated disability weights based on household surveys in Bangladesh, Indonesia, Peru, and Tanzania, an open internet survey, and a telephone survey in the United States . As a result of this populationbased approach, the disability weights for visual impairment, blindness, and troublesome itch have changed considerably and should better reflect our ideas and beliefs as a society of what constitutes health.

La plus fréquente au cours du syndrome d’immunodéficience acquise. Le but de ce travail rétrospectif est de décrire les aspects épidémiologiques, cliniques, thérapeutiques et évolutifs de trois cas de maladie de Kaposi révélant une infection par le VIH colligés dans notre formation entre janvier 2002 et décembre 2008. Il s’agissait de deux hommes et une femme d’un âge moyen de 39 ans. Le diagnostic de la maladie de Kaposi a été posé sur l’aspect clinique et histologique des lésions chez les trois patients. Les localisations de la maladie étaient cutanées et ganglionnaires dans tous les cas, muqueuses chez 2 patients (70%), digestive dans un cas et pulmonaire dans un cas. Le taux moyen de CD4 au moment du diagnostic était de 200/mm3. Le traitement était à base de chimiothérapie chez tous nos malades, associée à la trithérapie antirétrovirale. L’évolution était favorable dans 2 cas et fatale chez un patient avec atteinte pulmonaire. Les trois observations rapportées montrent la gravité et le caractère multifocal de cette affection, dont le diagnostic a été porté à un stade avancé de l’infection à VIH. La chimiothérapie antinéoplasique reste très coûteuse et source d’iatrogénie et d’interactions médicamenteuses souvent difficiles à gérer. Un dépistage plus précoce permettrait certainement un diagnostic plus précoce de l’infection à VIH ou du moins celui d’une maladie de Kaposi encore localisée pour laquelle la trithérapie antirétrovirale est généralement suffisante., Maroc Médical, Vol. 31, No 2 (2009)

International audience; The chemical composition of 48 leaf oil samples isolated from individual plants of Cleistopholis patens (Benth.) Engl. et Diels harvested in four Ivoirian forests was investigated by GC-FID (determination of retention indices), GC/MS, and 13C-NMR analyses. The main components identified were b-pinene (traces-59.1%), sabinene (traces-54.2%), (E)-b-caryophyllene (0.3-39.3%), linalool (0.1-38.5%), (E)-b-ocimene (0.1-33.2%), germacrene D (0.0-33.1%), a-pinene (0.1-32.3%), and germacrene B (0-21.2%). The 48 oil compositions were submitted to hierarchical clustering and principal components analyses, which allowed the distinction of three groups within the oil samples. The oil composition of the major group (Group I, 33 samples) was dominated by (E)-b-caryophyllene and linalool. The oils of Group II (eight samples) contained mainly b-pinene and a-pinene, while those of Group III (seven samples) were dominated by sabinene, limonene, and b-phellandrene. Moreover, the compositions of the Ivoirian C. patens leaf oils differed from those of Nigerian and Cameroonian origins.

Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015.

Background Onchocerciasis causes a considerable disease burden in Africa, mainly through skin and eye disease. Since 1995, the African Programme for Onchocerciasis Control (APOC) has coordinated annual mass treatment with ivermectin in 16 countries. In this study, we estimate the health impact of APOC and the associated costs from a program perspective up to 2010 and provide expected trends up to 2015. Methods and Findings With data on pre-control prevalence of infection and population coverage of mass treatment, we simulated trends in infection, blindness, visual impairment, and severe itch using the micro-simulation model ONCHOSIM, and estimated disability-adjusted life years (DALYs) lost due to onchocerciasis. We assessed financial costs for APOC, beneficiary governments, and non-governmental development organizations, excluding cost of donated drugs. We estimated that between 1995 and 2010, mass treatment with ivermectin averted 8.2 million DALYs due to onchocerciasis in APOC areas, at a nominal cost of about US$257 million. We expect that APOC will avert another 9.2 million DALYs between 2011 and 2015, at a nominal cost of US$221 million. Conclusions Our simulations suggest that APOC has had a remarkable impact on population health in Africa between 1995 and 2010. This health impact is predicted to double during the subsequent five years of the program, through to 2015. APOC is a highly cost-effective public health program. Given the anticipated elimination of onchocerciasis from some APOC areas, we expect even more health gains and a more favorable cost-effectiveness of mass treatment with ivermectin in the near future., Author Summary In 1995, the World Health Organization launched the African Programme for Onchocerciasis Control (APOC) with the aim to control morbidity due to the parasitic infectious disease onchocerciasis (river blindness). APOC aims to set up sustainable national control programs against onchocerciasis in 16 countries in sub-Saharan Africa, covering over 100 million people who are at risk for infection. The main control strategy is mass treatment with the drug ivermectin, which is donated by the pharmaceutical company Merck. Coordination of the mass treatment programs is made possible by financial contributions from donor and beneficiary countries. We estimated that between 1995 and 2010, APOC has had a huge impact on population health in sub-Saharan Africa, preventing 8.2 million years worth of healthy life from being lost due to disease and mortality, at a cost of about US$257 million. We predicted that this health impact will double during the subsequent five years, at a cost of about US$221 million. This makes APOC one of the most cost-efficient large-scale public health programs in the world. We may expect even greater health gains in the future, given the anticipated extension of the APOC mandate with the aim to eliminate infection where possible.

The CALIOP (Cloud-Aerosol Lidar with Orthogonal Polarization) layer product is used for a multimodel evaluation of the vertical distribution of aerosols. Annual and seasonal aerosol extinction profiles are analyzed over 13 sub-continental regions representative of industrial, dust, and biomass burning pollution, from CALIOP 2007-2009 observations and from AeroCom (Aerosol Comparisons between Observations and Models) 2000 simulations. An extinction mean height diagnostic (Z) is defined to quantitatively assess the models' performance. It is calculated over the 0-6 km and 0-10 km altitude ranges by weighting the altitude of each 100 m altitude layer by its aerosol extinction coefficient. The mean extinction profiles derived from CALIOP layer products provide consistent regional and seasonal specificities and a low inter-annual variability. While the outputs from most models are significantly correlated with the observed Z climatologies, some do better than others, and 2 of the 12 models perform particularly well in all seasons. Over industrial and maritime regions, most models show higher Z than observed by CALIOP, whereas over the African and Chinese dust source regions, Z is underestimated during Northern Hemisphere Spring and Summer. The positive model bias in Z is mainly due to an overestimate of the extinction above 6 km. Potential CALIOP and model limitations, and methodological factors that might contribute to the differences are discussed. Copyright 2012 by the American Geophysical Union.