The occurrence of Ebola virus (EBOV) in West Africa during 2013–2015 is unprecedented. Early reports suggested that in this outbreak EBOV is mutating twice as fast as previously observed, which ...indicates the potential for changes in transmissibility and virulence and could render current molecular diagnostics and countermeasures ineffective. We have determined additional full-length sequences from two clusters of imported EBOV infections into Mali, and we show that the nucleotide substitution rate (9.6 × 10–4 substitutions per site per year) is consistent with rates observed in Central African outbreaks. In addition, overall variation among all genotypes observed remains low. Thus, our data indicate that EBOV is not undergoing rapid evolution in humans during the current outbreak. This finding has important implications for outbreak response and public health decisions and should alleviate several previously raised concerns.
Abstract Important policy questions during infections disease outbreaks include: i) How effective are particular interventions?; ii) When can resource-intensive interventions be removed? We used ...mathematical modelling to address these questions during the 2017 Ebola outbreak in Likati Health Zone, Democratic Republic of the Congo (DRC). Eight cases occurred before 15 May 2017, when the Ebola Response Team (ERT; co-ordinated by the World Health Organisation and DRC Ministry of Health) was deployed to reduce transmission. We used a branching process model to estimate that, pre-ERT arrival, the reproduction number was $$R=1.49$$ R = 1.49 (95% credible interval $$({{{\mathrm{0.67,2.81}}})$$ ( 0.67, 2.81 ) ). The risk of further cases occurring without the ERT was estimated to be 0.97 (97%). However, no cases materialised, suggesting that the ERT’s measures were effective. We also estimated the risk of withdrawing the ERT in real-time. By the actual ERT withdrawal date (2 July 2017), the risk of future cases without the ERT was only 0.01, indicating that the ERT withdrawal decision was safe. We evaluated the sensitivity of our results to the estimated $$R$$ R value and considered different criteria for determining the ERT withdrawal date. This research provides an extensible modelling framework that can be used to guide decisions about when to relax interventions during future outbreaks.
The described in vitro test system for allergy diagnosis is based on microscope glass slides activated with (3-glycidyloxypropyl)trimethoxysilane. Allergen solutions are immobilized as small droplets ...(∼10 nL) on the activated glass slides with a piezoelectric arrayer. In contrast to other tests for specific IgE, such as Pharmacia CAP FEIA, AlaSTAT, or FAST, only a 25-μL serum sample is needed for the screening of allergen-specific IgE against a multitude of allergens and the test can be performed in less than 1 h. Compared with multiallergen dipstick screening tests (e.g., IgEquick, CMG Immunodot) based on multiallergen-coated nitrocellulose strips, the measurement of the microarray-based system can be performed automatically. The chemiluminescence intensities are detected with a sensitive CCD camera. Allergen extracts and recombinant/purified allergens (24 preparations) have been used on the same modified surface for the screening of allergen-specific IgE. With these disposable microarray slides, it is possible to distinguish between patients with and without elevated levels of allergen-specific IgE. Repeated measurements of serum samples demonstrated a sufficient reproducibility. Detection limits (μg/L) of 0.35 (r Bet v1), 0.16 (PLA2), and 1.9 (Der p1) were achieved.
The 2017 plague outbreak in Madagascar was unprecedented in the African region, resulting in 2417 cases (498 confirmed, 793 probable and 1126 suspected) and 209 deaths by the end of the acute urban ...pneumonic phase of the outbreak. The Health Emergencies Programme of the WHO Regional Office for Africa together with the WHO Country Office and WHO Headquarters assisted the Ministry of Public Health of Madagascar in the rapid implementation of plague prevention and control measures while collecting and analysing quantitative and qualitative data to inform immediate interventions. We document the key findings of the evidence available to date and actions taken as a result. Based on the four goals of operational research - effective dissemination of results, peer-reviewed publication, changes to policy and practice and improvements in programme performance and health - we evaluate the use of evidence to inform response to the outbreak and describe lessons learned for future outbreak responses in the WHO African region. This article may not be reprinted or reused in any way in order to promote any commercial products or services.
This work is about an appropriate cho oiicce of a renewable energy source between a wind turburbine and a solar power plant. The selected renewable energy source sshould supply electricity to a site, ...part of the Universsiity Alioune Diop of Bambey, in Ngoundiane, Thies region. The wwo ork is based on analysis of meteorological parammeters (wind speed, ambient temperature, solar irradiation). Accordrding to this study, the use of solar energy to prododuuce electricity in the site of Ngoundiane is very promising. Focususiing on a standalone photovoltaic system seem to bbe e the solution because solar resource is very abundant in Senegal anndd is easier characterized than wind resources. Moreovveer, photovoltaic technology is very well mastered.
Detecting and responding to acute public health threats is one of the World Health Organization's (WHO) most important activities. Therefore, WHO established a unique approach for the global ...detection and verification of events of potential international public health concern and adopted an all-hazards approach as part of the International Health Regulations (2005), moving beyond a focus on infectious diseases only. Here, we analysed 20-year trends of acute public health events globally.
We extracted data on acute public health events reported between 2002 and 2021 from the Event Management System (EMS). EMS is an internal WHO web-based platform used for tracking health threats globally. We examined the designation, source and hazard of events by WHO Region and over time by calculating descriptive statistics and trends using R.
Between 2002 and 2021, 7572 events were recorded globally in EMS, ranging from 231 to 576 per year. Of these, 5466 (76%) were designated as substantiated, deemed true acute public health events, and only a small proportion (379, 5%) were unverifiable or had no designation. During the 20-year period, substantiated events were greatest in the WHO African Region (1684 events, 31%) and the WHO Region of the Americas (1312 events, 24%) and, similarly, by year, the burden was highest in those WHO regions. Globally, over time, two-thirds (3536, 65%) of substantiated events were initially reported by WHO and infectious diseases (4298, 79%) were the predominant cause of public health events. However, other causes, including animal origin or zoonoses were also important and disaster related events were on the rise in recent years, particularly in some WHO Regions.
WHO has a robust system for global disease detection but health threats are continuously evolving. The impact of climate change and zoonoses is becoming more pronounced, emphasizing the importance of a One Health approach for disease detection.
Liver abscess is a serious infection that can cause life-threatening complications.
To describe the epidemiology, diagnosis, and progression of liver abscess at the Dakar National Albert-Royer ...Children's Hospital.
A retrospective study was conducted from over a period of 5 years (1st January 2010 to 31st December 2014). All children aged 0-15 years hospitalized for liver abscess with ultrasound confirmation were included. We collected demographic data (age, gender, socioeconomic status, origin), clinical data (general and hepatic symptoms), diagnostic data (ultrasound, bacteriology) and progression (death, complications, sequelae). The data were analyzed with Epi-info (P<0.05 was considered significant).
We collected 26 cases of liver abscesses, representing a hospital prevalence of 100 cases per 100,000 admissions. Males predominated (sex ratio: 1.36). The children's average age was 7.2 years. Most of the children came from urban areas of Dakar. Low socioeconomic status and precarious lifestyle were the contributing factors. Anemia (69.2%), malnutrition (42.3%), and abdominal trauma (15.3%) were the main causes found. The Fontan triad characteristic of the liver abscess was found in 57.7% of cases. At ultrasound, a single abscess was found in 21 cases. The abscess was located in the right lobe in 18 cases, the left lobe in three cases, and in both lobes in three cases. Segment VI (four cases) was the most frequently involved. Bacteriologically, the abscess was pyogenic in 17 cases and an amoebic abscess in nine cases. The main pyogenic sources found were Klebsiella pneumoniae in two cases, Pseudomonas aeruginosa in one case, Streptococcus pneumoniae in one case, and Staphylococcus aureus in one case. The average duration of antibiotic treatment was 14.5 days. Liver drainage was carried out in 24 cases. The outcome was favorable in all children.
The prevalence of liver abscesses at the Albert-Royer Children's Hospital is relatively high, compared to the literature data. Percutaneous drainage combined with antibiotics remains the treatment of choice. The prognosis is favorable.
Umbilical hernia is a frequent pathology of the anterior abdominal wall in children. The hernia ring closes usually before 4 years, but a strangulation can occur. It is an exceptional complication ...according to the literature data. Since this complication is rare, we undertook a retrospective study of these strangulations in a 5-year period from January 1997 to December 2001 at Aristide Le Dantec hospital. We collected 41 cases that underwent emergency surgery operations for strangulated umbilical hernias, which represent about 15% of umbilical hernias operated during the same period. The age range was 8 months to 10 years and the average age was 14 months. All the children were examined within 24 h after the onset of the disease and the surgery was immediately performed. In five cases the bowel was necrosed and perforated and we performed a resection followed immediately by an anastomosis. In the follow up, two children presented wound infections and a hernia recurred in one child. There was no mortality. This study conducts us to question western reports which recommend conservative therapy for umbilical hernia in children.
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