Little is known about patient profile changes in medical facilities in our country, leading to this study to describe and compare patient profiles in 2010 and 2022.
This was a cross-sectional study ...with new outpatients aged 15 years and more seen in the cardiology department of the UH-GT. Measurements included height, weight and body mass index (BMI). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Quantitative data are presented as the mean with standard deviation, and categorical one as proportions. Statistical tests were the t test to compare means and chi-test for categorical variables. The level of significance was set to 0.05.
The sample consisted of 515 new patients (199 in 2010 and 316 in 2022) with 59.1% female in 2010 and 60.1% in 2022 (p = 0.821). We noticed an increase in hypertension (59.1-71.8%, p = 0.003) and a decrease in tobacco smoking (from 13 to 05.4%, p = 0.002) and stroke (from 05.8 to 02.2%, p = 0.033). Height increased significantly from 1.59 m to 1.66 m, p = 0.002. SBP and DBP showed significant decreases in their means from 155.43 to 144.97 mmHg, p = < 0.001 for SBP and from 95.53 to 89.02 mmHg, p = < 0.001 for DBP.
Cardiovascular risk factors showed different trends with decreasing tobacco smoking, similar to systolic and diastolic blood pressure, albeit with an increase in hypertension prevalence. Other CVrf values increased. Awareness campaigns must be reinforced and maintained to obtain their decrease.
Many breeding programs have been implemented in developing countries, many of which have been unsuccessful. To better understand the failure of these breeding programs, it is proposed to analyze ...their adequacy with innovations that are actually adopted by smallholders. The proposed methodology takes account of these innovations, the reasons for their adoption and the objectives of livestock keeping. The N’Dama cattle-breeding program in Senegal was used as a case study. Surveys were carried out among 54 farmers: 27 breeders who participated in this program, 17 of whom recently resigned, and 27 breeders who have never participated. Feeding was the most frequently cited area of innovation, followed by infrastructure. Genetics, animal health and reproduction held the third rank. Milk production appeared as an important objective of breeders, although the context remains one of strong multifunctionality. Principal component analysis highlighted three categories of breeders according to the innovations they adopted: institutional, modernizing, and integrating innovators. The groups of institutional and modernizing innovators dominate, gathering each 41% of the farmers. In the first category, breeders have organized themselves in an association and use N’Dama sires, livestock aiming at an insurance objective. In the second category, artificial insemination with exotic breeds and other technical innovations (cowshed, vaccination, urea treatment of straw) are used to improve production of milk and meat. The third group is termed ‘integrating innovators,’ since their innovations aim at integrating livestock and crop production. Gathering 18% of the sampled breeders, this group presents intermediate features between the two previous groups, using animals as draught power and for manure production. These results indicate that a process of intensification is at play and that the genetic improvement through the selection of N’Dama cattle for production criteria does not meet the breeders’ demand. However, the N’Dama’s adaptive traits justify its use as part of the breeding strategy of farmers, either in pure-breeding or in crossbreeding. The study thus tends to show the interactive link between genetic improvement and other innovations. It suggests that the success of a breeding program depends on its adequate positioning within the set of innovations adopted by breeders and proposes a method to inform breeding programs accordingly.
Introduction In 2011, member states of the World Health Organization (WHO) Africa Regional Office (AFRO) resolved to eliminate Measles by 2020. Our study aims to assess The Gambia's progress towards ...the set AFRO measles elimination target and highlight surveillance and immunisation gaps to better inform future measles prevention strategies. Material and methods A retrospective review of measles surveillance data for the period 2011-2019, was extracted from The Gambia case-based measles surveillance database. WHO-UNICEF national coverage estimates were used for estimating national level MCV coverage. Measles post campaign coverage survey coverage estimates were used to estimate national measles campaign coverage. Results One hundred and twenty-five of the 863 reported suspected cases were laboratory confirmed as measles cases. More than half (53.6%) of the confirmed cases have unknown vaccination status, 24% of cases were vaccinated, 52.8% of cases occurred among males, and 72.8% cases were among urban residents. The incidence of measles cases per million population was lowest (0) in 2011-2012 and highest in 2015 and 2016 (31 and 23 respectively). The indicator for surveillance sensitivity was met in all years except in 2016 and 2019. Children aged 5-9 years (Incidence Rate Ratio-IRR = 0.6) and residents of Central River region (IRR = 0.21) had lower measles risk whilst unvaccinated (Adjusted IRR = 5.95) and those with unknown vaccination status (IRR 2.21) had higher measles risk. Vaccine effectiveness was 89.5%. Conclusion The Gambia's quest to attain measles elimination status by 2020 has registered significant success but it is unlikely that all target indicators will be met. Vaccination has been very effective in preventing cases. There is variation in measles risk by health region, and it will be important to take it into account when designing prevention and control strategies. The quality of case investigations should be improved to enhance the quality of surveillance for decision making.
Regulation of mtDNA expression is critical for maintaining cellular energy homeostasis and may, in principle, occur at many different levels. The leucine‐rich pentatricopeptide repeat containing ...(LRPPRC) protein regulates mitochondrial mRNA stability and an amino‐acid substitution of this protein causes the French‐Canadian type of Leigh syndrome (LSFC), a neurodegenerative disorder characterized by complex IV deficiency. We have generated conditional Lrpprc knockout mice and show here that the gene is essential for embryonic development. Tissue‐specific disruption of Lrpprc in heart causes mitochondrial cardiomyopathy with drastic reduction in steady‐state levels of most mitochondrial mRNAs. LRPPRC forms an RNA‐dependent protein complex that is necessary for maintaining a pool of non‐translated mRNAs in mammalian mitochondria. Loss of LRPPRC does not only decrease mRNA stability, but also leads to loss of mRNA polyadenylation and the appearance of aberrant mitochondrial translation. The translation pattern without the presence of LRPPRC is misregulated with excessive translation of some transcripts and no translation of others. Our findings point to the existence of an elaborate machinery that regulates mammalian mtDNA expression at the post‐transcriptional level.
LRPPRC regulates mitochondrial mRNA stability and it is implicated in a neurodegenerative disorder. A heart‐specific mouse knockout now reveals that LRPPRC is necessary for mRNA polyadenylation and stability, and for coordinated mitochondrial translation, resulting in respiratory chain defects and cardiomyopathy.
Precise control of mitochondrial DNA gene expression is critical for regulation of oxidative phosphorylation capacity in mammals. The MTERF protein family plays a key role in this process, and its ...members have been implicated in regulation of transcription initiation and site-specific transcription termination. We now demonstrate that a member of this family, MTERF4, directly controls mitochondrial ribosomal biogenesis and translation. MTERF4 forms a stoichiometric complex with the ribosomal RNA methyltransferase NSUN4 and is necessary for recruitment of this factor to the large ribosomal subunit. Loss of MTERF4 leads to defective ribosomal assembly and a drastic reduction in translation. Our results thus show that MTERF4 is an important regulator of translation in mammalian mitochondria.
► Loss of MTERF4 leads to abolished mitochondrial translation ► MTERF4 forms a complex with the rRNA methyltransferase NSUN4 ► MTERF4 targets NSUN4 to the mitochondrial large ribosomal subunit
•This diversity reveals a strong consensus on the need for multi-stakeholder programs.•Divergent views on roles suggest the plurality of potential forms of collaboration with shared ...responsibilities.•Views on the diversity of stakeholders to be involved diverge according to the experts’ profession.
Stakeholders’ involvement is key to breeding programs’ success. The identification of stakeholders, their categories, respective role and weight in the overall process therefore constitutes a crucial aspect of animal breeding. The objective of this paper is to show how the different international experts in breeding perceive the participation of stakeholders and their collaboration in the sustainable management of cattle-breeding programs in developing countries. This study uses the Delphi method to collect experts’ opinions on stakeholders’ involvement in breeding scheme design. In a first round, experts are asked to list all potential stakeholders and to score them on a scale from 1 to 5 according to the perceived importance of roles assigned to them. In a second round, experts were asked to confirm or modify their first notes for each proposal, by taking into account the opinion of the other experts. In the first and second rounds, 17 and 12 experts answered our questionnaires respectively. Two types of analyses were first realized, i.e., a statistical analysis, which evaluated the consensus and the divergence between experts, and a textual analysis, which evaluated the arguments and the roles. Then a factorial correspondence analysis was conducted to propose a typology of stakeholders according to their roles. In the first round, the State representatives, researchers and breeders were frequently mentioned, but the experts variably perceived the importance given to them individually. In the second round, the experts confirmed the need to involve these stakeholders. Between the two rounds, a convergence of views is observed on this implication, despite a persisting divergence on the assigned roles and their relative importance. This diversity of views may have reflected a diversity of origins and professions of responding experts. Development professionals considered the State as the main actor, while researchers considered the breeders and researchers. Expressed through a typological analysis, this divergence of experts’ perception of roles suggests three groups of actors playing main roles. Group 1 corresponds to research, which role is to provide a scientific support for genetic and economic evaluation, as well as technological development. Group 2, composed of State, NGOs and funding institutions, covers roles in financing, subsidizing and capacity building. Group 3, including farmers and their organizations, is responsible of the breeding program management, genetic progress and breed conservation. The proposed typology of actors according to their role may intervene as a basis of discussion, helping in the identification of fruitful agreements beyond the perspective of one sole expert in charge of the designing of a breeding program. It suggests an organization that federates these groups of actors and defines the intervention framework and the activities of the breeding program.
Abstract
Background
High blood pressure (BP) is a major risk factor for several common cardiovascular (CV) disease such as stroke, heart failure or chronic kidney disease. The Sub-Saharan Africa ...(SSA) should face the highest rate of hypertension worldwide with an overall prevalence estimation of 46%. Due to scarce resources and inadequate healthcare provision, SSA have scarce hard data on treatment and control of high BP.
Purpose
To assess the detection and characteristics of hypertension patients admitted in hospitalizations 17 SSA countries
Methods
We conducted a transversal and longitudinal study in CV department of 37 hospitals from 23 cities in 17 SSA countries (10 low income: Niger, Guinea, Benin, Mali, Democratic Republic of the Congo, Tchad, Burkina Faso, Togo, Burundi, Ethiopia and 7 middle income: Cote d'Ivoire, Senegal, Cameroon, Congo, Soudan, Mauritania, Gabon). The February study was designed by a multidisciplinary collaborative team of epidemiologists, pharmacists and cardiologists from Africa and France. This ongoing observatory included all inpatients in February from each year since 2016. Data including socio-demographic and clinical characteristics, causes of admission, clinical, biological, complementary examinations, treatments, length of stay and discharge diagnosis were collected by the investigating physicians. Hypertension and severity of hypertension were defined according to 2018 ESC/ESH guidelines and BP was measured twice using standardized method. All analyses were performed through scripts developed in the R software (4.0.3 (2020-10-10))
Results
The study involved 4360 patients. Hypertension was measured on 1906 (43.7%) patients at admission. Proportion of patients with high BP in hospital increased from 42.2% in 2016 to 52.2% in 2021 (p<0.05) and differed significantly across countries from 77.6% in Niger to 100% in Chad. Among hypertensive patients, men represented 59.6% of patients and mean of age was 59±15.1 years. Overall, 61.4% of patients were from low income countries. The mains causes of admission among hypertensive patients were heart failure (37.8%) and stroke (18.9%). Average of systolic BP was 159±29.3 mmHg and average of diastolic BP was 96.7±16mmHg. Overall, 760 (40.3%), 525 (27.8%) and 602 (31.9%) had grade 1, grade 2 and grade 3 hypertension respectively. History of CV disease was observed in 51.5% of patients. Thus, 70.4% of patients had at least one CV risk factor other than hypertension. Angiotensin converting enzyme inhibitors and diuretics was prescribed in 56.9% and 55.8% of patients respectively. The average amount of antihypertensive drugs prescribed in hospital was 2.09±1.18. Overall, 237 (12.4%), 295 (15.5%), 640 (33.6%) and 734 (38.5%) received respectively no drug, monotherapy, two-drug strategies and three and more drug strategies.
Conclusion
In patients admitted in cardiology departments, hypertension is a huge burden in SSA.
Funding Acknowledgement
Type of funding sources: None.
The 3′ end of the rRNA of the small ribosomal subunit contains two extremely highly conserved dimethylated adenines. This modification and the responsible methyltransferases are present in all three ...domains of life, but its function has remained elusive. We have disrupted the mouse
Tfb1m gene encoding a mitochondrial protein homologous to bacterial dimethyltransferases and demonstrate here that loss of TFB1M is embryonic lethal. Disruption of
Tfb1m in heart leads to complete loss of adenine dimethylation of the rRNA of the small mitochondrial ribosomal subunit, impaired assembly of the mitochondrial ribosome, and abolished mitochondrial translation. In addition, we present biochemical evidence that TFB1M does not activate or repress transcription in the presence of TFB2M. Our results thus show that TFB1M is a nonredundant dimethyltransferase in mammalian mitochondria. In addition, we provide a possible explanation for the universal conservation of adenine dimethylation of rRNA by showing a critical role in ribosome maintenance.
The mtDNA mutator mice have high levels of point mutations and linear deletions of mtDNA causing a progressive respiratory chain dysfunction and a premature aging phenotype. We have now performed ...molecular analyses to determine the mechanism whereby these mtDNA mutations impair respiratory chain function. We report that mitochondrial protein synthesis is unimpaired in mtDNA mutator mice consistent with the observed minor alterations of steady-state levels of mitochondrial transcripts. These findings refute recent claims that circular mtDNA molecules with large deletions are driving the premature aging phenotype. We further show that the stability of several respiratory chain complexes is severely impaired despite normal synthesis of the corresponding mtDNA-encoded subunits. Our findings reveal a mechanism for induction of aging phenotypes by demonstrating a causative role for amino acid substitutions in mtDNA-encoded respiratory chain subunits, which, in turn, leads to decreased stability of the respiratory chain complexes and respiratory chain deficiency.
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