Subjects with sickle cell trait (SCT) carry one copy of mutated β-globin gene at position E6V at the origin of the production of sickle hemoglobin (HbS). Indeed, individuals with SCT have both normal ...hemoglobin and HbS, in contrast to patients with sickle cell disease who inherited of two copies of the mutated gene. Although SCT is generally benign/asymptomatic, carriers may develop certain adverse outcomes such as renal complications, venous thromboembolism, exercise-induced rhabdomyolysis … However, little is known about whether similar metabolic pathways are affected in individuals with SCT and whether these metabolic derangements, if present, correlate to clinically relevant parameters. In this study, we performed metabolomics analysis of plasma from individuals with sickle cell trait (
= 34) compared to healthy controls (
= 30). Results indicated a significant increase in basal circulating levels of hemolysis markers, mono- (pyruvate, lactate), di- and tri-carboxylates (including all Krebs cycle intermediates), suggestive of systems-wide mitochondrial dysfunction in individuals with SCT. Elevated levels of kynurenines and indoles were observed in SCT samples, along with increases in the levels of oxidative stress markers (advanced glycation and protein-oxidation end-products, malondialdehyde, oxylipins, eicosanoids). Increases in circulating levels of acyl-carnitines and fatty acids were observed, consistent with increased membrane lipid damage in individuals with sickle cell trait. Finally, correlation analyses to clinical co-variates showed that alterations in the aforementioned pathways strongly correlated with clinical measurements of blood viscosity, renal (glomerular filtration rate, microalbuminuria, uremia) and cardiovascular function (carotid-femoral pulse wave velocity, blood pressure).
Fasting glucose (FG) and glycated hemoglobin A1c (HbA1c) perform sub-optimally in people of African origin, especially in individuals with sickle-cell trait (SCT). The purpose of this study was to ...compare the relationships between HbA1c, FG, and fructosamine in individuals from Senegal with and without SCT. HbA1c, FG, and fructosamine were measured in 203 adults from Senegal (100 control: 45 with type 2 diabetes (T2D); 103 SCT: 51 with T2D). Significant, positive correlations were observed between HbA1c and FG, fructosamine and FG, and fructosamine and HbA1c in both groups. The limits of agreement were inappropriately large in both groups for the Bland-Altman plots of HbA1c and FG (control: -95.97 to 83.97%; SCT: -115.9 to 91.52%), fructosamine and FG (control: -100.6 to 99.89%; SCT: -105.6 to 100.6%), and fructosamine and HbA1c (control: -52.03 to 38.98%; SCT: -88.04 to 71.41%). In both groups, the greatest proportion of subjects were considered above the clinical cut-point for hyperglycemia when fructosamine was used as the criterion (control: 33%; SCT: 44.6%), and the lowest percentage of subjects were classified as over the clinical cut-point when HbA1c was used as the criterion (control: 21%; SCT: 27.7%).Substantial disparities between HbA1c, FG, and fructosamine were observed in both groups, and these differences were exaggerated in the SCT group. Therefore, these three biomarkers should not be considered to be interchangeable measures of glycemic control. These biomarkers should be used thoughtfully, and special care should be taken when using them in individuals with SCT.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In France, screening for cardiovascular risk factors is recommended during annual preventive visits. However, data are lacking on the temporal trend in women's uptake to preventive care services, and ...in cardiovascular and mortality outcomes. The aim of the study was to investigate the participation and mortality of women in annual preventive care services in a major preventive medicine center in France.
We conducted repeated cross-sectional studies including a total of 366,270 individuals who had a first examination at the Centre d'Investigations Préventives et Cliniques, France, between January 1992 and December 2011.
Women's participation was low below 50 years of age, then increases from 50 to 70 years, and is lower for women older than 70 years. The gap in female participation was more pronounced among individuals with high education, low social deprivation, and no depressive symptoms. Compared with the general population, the screened population had significantly lower standardized mortality ratios (SMRs) among both men and women, for all age ranges. Screened women aged 18-49 years showed a lower mortality gain compared with men of the same age; SMRs did not differ significantly by sex for individuals over 50 years.
In this community-based sample, compared with men, women's participation to annual preventive care services was lower, and screened women had a lower mortality gain. Despite the demonstrated benefit of annual check-ups on health, there is a gender gap in adherence to preventive programs and in efficiency of screening programs, especially in the young age range. This gap in cardiovascular disease prevention may result in poorer cardiovascular health in women. Urgent adaptations to overcome this gender gap in preventive screening in France are warranted.
Bamba Gaye is supported by the Fondation Recherche Médicale grant.
The World Health Organization Regional Office for Africa (WHO/AFRO) faces members who encounter annual disease epidemics and natural disasters that necessitate immediate deployment and a trained ...health workforce to respond. The gaps in this regard, further exposed by the COVID-19 pandemic, led to conceptualizing the Strengthening and Utilizing Response Group for Emergencies (SURGE) flagship in 2021. This study aimed to present the experience of the WHO/AFRO in the stepwise roll-out process and the outcome, as well as to elucidate the lessons learned across the pilot countries throughout the first year of implementation. The details of the roll-out process and outcome were obtained through information and data extraction from planning and operational documents, while further anonymized feedback on various thematic areas was received from stakeholders through key informant interviews with 60 core actors using open-ended questionnaires. In total, 15 out of the 47 countries in WHO/AFRO are currently implementing the initiative, with a total of 1,278 trained and validated African Volunteers Health Corps-Strengthening and Utilizing Response Groups for Emergencies (AVoHC-SURGE) members in the first year. The Democratic Republic of Congo (DRC) has the highest number (214) of trained AVoHC-SURGE members. The high level of advocacy, the multi-sectoral-disciplinary approach in the selection process, the adoption of the one-health approach, and the uniqueness of the training methodology are among the best practices applauded by the respondents. At the same time, financial constraints were the most reported challenge, with ongoing strategies to resolve them as required. Six countries, namely Botswana, Mauritania, Niger, Rwanda, Tanzania, and Togo, have started benefiting from their trained AVoHC-SURGE members locally, while responders from Botswana and Rwanda were deployed internationally to curtail the recent outbreaks of cholera in Malawi and Kenya.
This study compared the hemorheological responses of a group of sickle cell trait (SCT) carriers with those of a control (Cont) group in response to 40 min of submaximal exercise (exercise intensity, ...55% aerobic peak power) performed in two conditions: one with water offered ad libitum, i.e., the hydration (Hyd) condition, and one without water, i.e., the dehydration (Dehyd) condition. Blood and plasma viscosities, as well as red blood cell rigidity, were determined at rest, at the end of exercise, and at 2 h recovery with a cone plate viscometer at high shear rate and 37 degrees C. The SCT and Cont groups lost 1 +/- 0.7 and 1.6 +/- 0.6 kg of body weight, respectively, in the Dehyd condition, indicating a significant effect of water deprivation compared with the Hyd condition, in which body weight remained unchanged. Plasma viscosity increased with exercise and returned to baseline during recovery independently of the group and condition. As previously demonstrated, resting blood viscosity was greater in the SCT carriers than in the Cont group. Blood viscosity increased by the end of exercise and returned to baseline at 2 h recovery in the Cont group in both conditions. The blood viscosity of SCT carriers did not change in response to exercise in the Dehyd condition and remained elevated at 2 h recovery. This extended hyperviscosity, in association with other biological changes induced by exercise, could be considered as a risk factor for exercise-related events in SCT carriers, similar to vasoocclusive crises, notably during the recovery. In contrast, the Hyd condition normalized the hyperviscosity and red blood cell rigidity of the SCT carriers, with blood viscosity values reaching the same lower values as those found in the Cont group during the recovery. Adequate hydration of SCT carriers should be strongly promoted to reduce the clinical risk associated with potential hyperviscosity complications.
Abstract
In rapidly urbanising low-income towns and cities, there remains an absence of scientific evidence and regulatory structures to sustain the quality and quantity of groundwater used for ...low-cost water supplies and to reconcile this with continued use of the subsurface for low-cost sanitation. Here, we analyse the relationship between the density of on-site sanitation and shallow groundwater quality in the Thiaroye aquifer of Quaternary sands in Dakar, Senegal. On-site sanitation was mapped using object-oriented classification and visual interpretation of high-resolution, optical satellite images and ground-truthing surveys. Groundwater quality was assessed over a three-year period (2017–2019) from a network of 61 sources comprising boreholes, dug-wells, hand tubewells and piezometers. More than 253,000 on-site sanitation facilities are identified over an area of 520 km2 with densities ranging from 1 to 70 per hectare. A moderate, statistically significant linear relationship (r2 = 0.55, p « 0.01) is found between the density of on-site sanitation facilities and nitrate concentrations in sampled groundwater sources. Groundwater contamination beyond the WHO drinking-water guideline value (50 mg/L) occurs where densities of on-site sanitation facilities exceed 4 (±4) per hectare, a threshold commonly surpassed in peri-urban areas underlain by the Thiaroye aquifer of Dakar.
Aim
The sickle cell trait (SCT) is the heterozygous and benign form of the homozygous SC disease (SCD). Although SCT exhibits hemorheological disturbances and increased oxidative stress, its exact ...role in the development of cardiovascular disease in SCT remains to be determined. The present study sought to determine the arterial stiffness, an independent marker of subclinical atherosclerosis, between SCT and trained SCD.
Materials and methods
Twelve SCT (43±11yrs, 6 males) were compared to 14 trained younger SCD (29±9yrs, 2 males) and 26 controls with normal hemoglobin (36±11rs, 13 males). Aortic (AoStiff-Physioflow) and peripheral arterial stiffness (pOpmetre-Axelife-France) assessed by foot-to-toe pulse wave velocity (ft-PWV), blood pressure (BP) and Framingham-Laurier cardiovascular risk score (CVR in %) were measured in each group.
Results
SCT exhibited stiffer arteries (Aostiff: 5.8±0.71 m/s, ft-PWV: 10.9±6.2 m/s) than controls (Aostiff = 4.8±0.5 m/s, ft-PWV: 7.7±2.6 m/s) and SCD (Aostiff = 4.9±0.6 m/s, p = 0.001, ft-PWV: 6.1±0.9 m/s p = 0.003). SCT were older (p = 0.001) than controls and SCD. The systolic and mean AP were lower in SCD than controls and SCT. In the whole group, the CVR score was the major contributor to PerStiff (r
2
= 0.402, p<0.0001) while AoStiff was mainly associated to the hemoglobin abnormalities (r
2
= 0.291, p<0.0001).
Conclusion
Both central and peripheral arterial stiffness are increased in SCT compared to SCD. Our data suggest that hemoglobin abnormalities and CVR play a differential role in the observed changes.
Abstract only Background: Patients with renal failure have a higher risk or cardiovascular events. However, the prevalence of renal failure in Sub Saharan Africa communities remain poorly documented. ...Methods: Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam et and Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency subjects aged between 18 and 80 years. However, the present study focused on adult populations below 40 years of age. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure and anthropometric measurements were performed in addition to blood tests including plasma creatinine. Renal failure was defined as a GFR < 60 ml/min/1.73 m 2 using the MDRD method adapted to the African population. Continuous data were reported as mean ± standard deviation (SD). Comparisons used the χ2 test for categorical variables and Student’s t test for continuous variables. Multiple logistic regression was used to identify factors associated with CFI, after considering potential confounders. Covariates with significant association (P<0.05) in univariate analysis were included in the multivariate logistic model. Results: Among the 2440 subjects in this study the mean age was 44 ± 15.99, 692 (28%) were male. Among the 1080 participants who were aged less than 40 years old (mean: 31 ± 7.54), 296 (27.4%) were male. Body mass index higher than 25 was present in 32% of the studied population with a significant increase in women (38% vs 15%, p<0,001). The prevalence of hypertension was 28%. The prevalence of renal failure was 3.1% (95%CI: 2.1-4.3%) with a mean glomerular filtration rate of 55 ± 23.58. None of the participants with renal failure had diabetes. Conclusion: This community-based cross-sectional study showed a low prevalence of renal failure in younger participants in Northern Senegal. Further investigations are needed to assess chronic kidney failure and its determinants.
Abstract only Background: Diabetes is a major cardiovascular disease (CVD) risk factor. There has been a epidemiological shift and chronic CVD is increasing in Sub-Saharan Africa, however, the extent ...is unknown. Methods: Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam etand Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency, we included subjects aged between 18 and 80 years old. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure and anthropometric measurements were measured in addition to blood tests including fasting plasma glucose. Diabetes was defined as fasting plasma glucose >= 1.26 g/L. Continuous data were reported as mean ± standard deviation (SD). Comparisons used the chi-squared test for categorical variables and Student’s t test for continuous variables. Multivariable adjusted logistic regression was used to identify factors associated with diabetes. Covariates with significant association (P<0.05) in univariate analysis were included in the model. Results: Among the 2440 subjects in this study (mean age: 44 years old, SD: 15.99), 692 (28%) were male. Nearly half of the sample never attended school (48%, 95%CI: 46-50%). Body mass index (BMI) higher than 25 was present in 43% of the sample (95%CI: 29-35%), with a significant increase in women (51% vs 22%, p<0,001).. The prevalence of diabetes was 5.9% (95%CI: 5-6,9%). Among them, 93% had at least two cardiovascular diseases (95% CI: 87-96%), 71% had dyslipidemia (95%CI: 63-78%) and 67% had a BMI over 25 (95%CI: 58-74%). Conclusion: This community-based study revealed a low prevalence of diabetes. However, the prevalence of additional CVD risk factors in this population was high. Preventive measures should be implemented to avoid increasing rates of diabetes in Sub-Saharan Africa.
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