clove and Chronic-Disease

Globally one out of four children under 5 years is affected by linear growth delay (stunting). This syndrome has severe long-term sequelae including increased risk of illness and mortality and delayed psychomotor development. Stunting is a syndrome that is linked to poor nutrition and repeated infections. To date, the treatment of stunted children is challenging as the underlying etiology and pathophysiological mechanisms remain elusive. We hypothesize that pediatric environmental enteropathy (PEE), a chronic inflammation of the small intestine, plays a major role in the pathophysiology of stunting, failure of nutritional interventions and diminished response to oral vaccines, potentially via changes in the composition of the pro- and eukaryotic intestinal communities. The main objective of AFRIBIOTA is to describe the intestinal dysbiosis observed in the context of stunting and to link it to PEE. Secondary objectives include the identification of the broader socio-economic environment and biological and environmental risk factors for stunting and PEE as well as the testing of a set of easy-to-use candidate biomarkers for PEE. We also assess host outcomes including mucosal and systemic immunity and psychomotor development. This article describes the rationale and study protocol of the AFRIBIOTA project.. AFRIBIOTA is a case-control study for stunting recruiting children in Bangui, Central African Republic and in Antananarivo, Madagascar. In each country, 460 children aged 2-5 years with no overt signs of gastrointestinal disease are recruited (260 with no growth delay, 100 moderately stunted and 100 severely stunted). We compare the intestinal microbiota composition (gastric and small intestinal aspirates; feces), the mucosal and systemic immune status and the psychomotor development of children with stunting and/or PEE compared to non-stunted controls. We also perform anthropological and epidemiological investigations of the children's broader living conditions and assess risk factors using a standardized questionnaire.. To date, the pathophysiology and risk factors of stunting and PEE have been insufficiently investigated. AFRIBIOTA will add new insights into the pathophysiology underlying stunting and PEE and in doing so will enable implementation of new biomarkers and design of evidence-based treatment strategies for these two syndromes.

Topics: Case-Control Studies; Central African Republic; Child, Preschool; Chronic Disease; Developing Countries; Dysbiosis; Enteritis; Gastrointestinal Microbiome; Growth Disorders; Humans; Madagascar; Nutritional Status; Poverty; Risk Factors; Social Environment

Localised dermatitis, for example unspecific eczema or skinfold pyoderma, is a very common diagnosis in dogs. Typical and impressive complaints are pruritus, erythema, erosion and oozing surface. With respect to the underlying disease dermatological treatment is indicated, usually based on antimicrobial and antipruriginous active substances, it can include transient glucocorticoids. An effective and safe alternative might be a phytotherapeutic topical preparation containing tea tree oil. Tea tree oil exerts both antimicrobial and antipruriginous effects. In an open multicenter study efficacy and safety of a standardized 10% tea tree oil cream applied thinly and twice daily for 4 weeks was tested in 53 dogs with chronic dermatitis, particularly non-specific eczema, allergic dermatitis, interdigital pyoderma, acral lick dermatitis and skinfold pyoderma. Analysis of efficacy assessed by investigating veterinarians showed a good or very good response to treatment for 82% of the dogs, significant at a 5% level (p = 0.05). At the end of the study a strong and significant reduction (p = 0.001) as well as disappearance of major symptoms were observed. Only two adverse events (local reactions) possibly related to tea tree oil occurred during therapy. Consequently the tested study medication (Bogaskin) can be considered an alternative for uncomplicated and localised dermatitis in dogs. Bogaskin might allow reduction of other pharmaceutical products, perhaps even replace standard therapy.

Topics: Administration, Topical; Animals; Anti-Infective Agents, Local; Chronic Disease; Dermatitis; Dog Diseases; Dogs; Myrtaceae; Phytotherapy; Pruritus; Tea Tree Oil; Treatment Outcome

Schistosomiasis is a major public health problem in Madagascar. The WHO recommends preventive chemotherapy by mass drug administration (MDA) with praziquantel as the primary approach to control Schistosoma mansoni-related morbidity in endemic populations, alongside complementary interventions such as health education. The impact of annual MDA and health education programs was assessed in the hard-to-reach Marolambo district of eastern Madagascar, an area endemic for S. mansoni. Repeated cross-sectional studies undertaken 2015-2019 examined between 300 and 381 school-aged children (aged 5-14 years) annually. The prevalence and infection intensity of S. mansoni were assessed by urine-circulating cathodic antigen (CCA) dipsticks and coproscopy using Kato-Katz (KK) methodologies. After four rounds of annual MDA, a reduction in S. mansoni prevalence was seen in CCA (93.9% in year 1-87.7% in year 5; P = 0.007) and KK (73.9% in year 1-59.4% in year 5; P < 0.0001). The prevalence of heavy-intensity infections roughly halved from 23.7% to 10.1% (P < 0.0001), and the mean intensity of infection fell by 55.0% (480.2-216.3 eggs per gram of feces). A malacological survey found Biomphalaria pfeifferi snail intermediate hosts in multiple water contact sites including rice paddies, streams, and Nosivolo River. Despite reductions in infection prevalence and intensity, schistosomiasis still poses a significant public health challenge in Marolambo district. Twice yearly MDA cycles and/or community-wide MDA are suggested to better reduce infections. Expanding health education, improving standards of water, sanitation and hygiene, and attention on snail-related control will also be important, especially in rice paddy irrigated areas.

Topics: Adolescent; Animals; Anthelmintics; Child; Child, Preschool; Chronic Disease; Female; Humans; Madagascar; Male; Mass Drug Administration; Praziquantel; Prevalence; Schistosoma mansoni; Schistosomiasis mansoni

To our knowledge, there is no data on the epidemiology of patients hospitalized in intensive care unit (ICU) after a stay in Madagascar or other low-income countries. It is possible that such data may improve transfer delays and care quality for these patients.. In a retrospective study, we reviewed the charts of all patients admitted to ICU of the Reunion Island Felix Guyon University Hospital from January 2011 through July 2013. We identified all patients who had stayed in Madagascar during the 6 months prior to ICU admission.. Of 1842 ICU patients, 62 (3.4%) had stayed in Madagascar during the 6 months prior to ICU admission. Patients were 76% male and the median age was 60.5 (48.25-64.75) years; patients were more frequently residents of Madagascar than travellers (56.5%). In most cases, patients were not hospitalized or given antibiotics in Madagascar. The most frequent causes of hospitalization were infections including malaria (21%) and lower respiratory infection (11%). Carriage and infection with multidrug resistant (MDR) bacteria on ICU admission were frequent (37% and 9.7%, respectively). The mortality rate in ICU was 21%, and severity acute physiological Score II was 53.5 (37-68).. Patients admitted to ICU after a stay to Madagascar are mainly elderly patients with chronic illnesses, and often foreign residents. The admission causes are specific of the country like malaria, or specific to the population concerned such as cardiovascular accidents that could be prevented.

Topics: Adult; Aged; Chronic Disease; Female; France; Humans; Intensive Care Units; Length of Stay; Madagascar; Male; Middle Aged; Retrospective Studies; Risk Factors; Travel

The relationship between general disease and bucco-dental disorders has been extensively documented in the literature. This study was undertaken to evaluate the role of dental surgeons in prevention of the diseases other than oral affections. Descriptive and analytical socio-epidemiological surveys of dental patients and surgeons were carried out in two towns in Madagascar. At least once in the year, 40% of the persons reporting pathology had consulted the dental surgeon. Dental surgeons rarely gave patients advice on changing their behavior. Dental surgeons reported asking patients about existing chronic disease and giving advice in only 53.4% of cases. Most surgeons who took into account the risk of chronic disease dealt with 10 or less patients a day, had been practicing for less than 10 years, and/or were practicing in the public sector. These findings indicate that dental surgeons do not take available opportunities to provide advice.

Topics: Adult; Attitude of Health Personnel; Chronic Disease; Dentistry, Operative; Female; Humans; Madagascar; Male; Middle Aged; Surveys and Questionnaires

We report a chronic case of pulmonary tuberculosis in a Malagasy citizen from Antsohihy (West of Madagascar), who was infected with a multi-drug resistant Mycobacterium bovis strain. This is the first case reported of the isolation of such a strain in Madagascar.

Topics: Amikacin; Antitubercular Agents; Capreomycin; Chronic Disease; Ciprofloxacin; Cough; DNA, Bacterial; Drug Therapy, Combination; Ethionamide; Humans; Kanamycin; Madagascar; Male; Microbial Sensitivity Tests; Middle Aged; Mutation; Mycobacterium bovis; Ofloxacin; Patient Compliance; Polymorphism, Restriction Fragment Length; Sputum; Treatment Failure; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary

A sample survey with the objective of determining the prevalence of bovine tuberculosis by means of an intradermal tuberculin test was conducted in Madagascar and it was found that the prevalence rate varied from 0-30% by veterinary district. In order to estimate the true prevalence, the validity of the test was investigated by assessing its sensitivity and specificity in two groups of animals from two different regions, which were destined for slaughter. In the first group where the probability of non-infected animals should have been the highest, sensitivity was estimated at 0.52 (n = 21) and specificity at 0.99 (n = 79). In the second group selected on the basis of apparent ill health of the animals in a high-prevalence bovine tuberculosis area, sensitivity was estimated at 0.8 (n = 10) and specificity at 1 (n = 12). The results obtained from both groups of cattle were not combined for statistical purposes because the sensitivity of the skin test seemed to fluctuate in relation to the chronicity of the disease. These fluctuations are discussed. However, since the first group of zebu cattle was more representative of the cattle population across the country as a whole, its results were retained as operational parameters for further screening.

Topics: Animals; Cattle; Chronic Disease; Intradermal Tests; Madagascar; Mycobacterium tuberculosis; Prevalence; Reproducibility of Results; Sensitivity and Specificity; Tuberculin Test; Tuberculosis, Bovine

In this article, the authors summarize studies on hepatitis B virus infection in Madagascar. Estimated prevalence rate for acute or chronic HBs antigen infection is 23% among general population which classify the country in high endemicity area. Vertical and horizontal transmissions for the childhood are high with an estimated prevalence rate for HBs antigen infection of 10 to 35% among children under less than 5-year-old according to areas. This situation indicates that an expanded program of immunization against hepatitis B virus is warranted.

Topics: Acute Disease; Adolescent; Adult; Age Distribution; Child; Child, Preschool; Chronic Disease; Endemic Diseases; Female; Hepatitis B; Humans; Infant; Infectious Disease Transmission, Vertical; Madagascar; Male; Population Surveillance; Prevalence; Public Health; Seroepidemiologic Studies; Sex Distribution; Vaccination

Endonasal dacryorhinocystostomy is a surgical procedure performed to re-establish continuity of the lacrimal duct by partial diversion followed by dilatation. A simultaneous rhinologic and ophthalmologic approach is used. This simple and elegant procedure that results in no residual scarring is indicated for any blockage of the lacrimal duct due to congenital or acquired causes. Except for children under 6 years of age and in patients in poor general condition, contra-indications are uncommon. Operative and postoperative complications are rare. After a review of the relevant anatomy the authors of this report describe the equipment and basic techniques used to perform dacryorhinocystostomy. Endonasal dacryorhinocystostomy was performed in 15 patients presenting chronic (n = 14) or acute (n = 1) dacryocystitis in Madagascar. At six months follow-up the procedure was successful in 14 cases and unsuccessful in one case due a cutaneous fistula. Because it is simple and well-tolerated and results in no residual scarring, endonasal dacryorhinocystostomy is the method of choice for treatment of lacrimal duct obstruction in tropical areas in general and in Black Africa in particular.

Topics: Acute Disease; Adult; Age Factors; Chronic Disease; Contraindications; Dacryocystitis; Dacryocystorhinostomy; Female; Follow-Up Studies; Humans; Madagascar; Male; Nose