BackgroundSeasonal malaria chemoprevention (SMC) is a new strategy recommended by WHO in areas of highly seasonal transmission in March 2012. Although randomized controlled trials (RCTs) have shown SMC to be highly effective, evidence and experience from routine implementation of SMC are limited.MethodsA non-randomized pragmatic trial with pre-post design was used, with one intervention district (Kita), where four rounds of SMC with sulfadoxine + amodiaquine (SP + AQ) took place in August–November 2014, and one comparison district (Bafoulabe). The primary aims were to evaluate SMC coverage and reductions in prevalence of malaria and anaemia when SMC is delivered through routine programmes using existing community health workers. Children aged 3–59 months from 15 selected localities per district, sampled with probability proportional to size, were surveyed and blood samples collected for malaria blood smears, haemoglobin (Hb) measurement, and molecular markers of drug resistance in two cross-sectional surveys, one before SMC (July 2014) and one after SMC (December 2014). Difference-in-differences regression models were used to assess and compare changes in malaria and anaemia in the intervention and comparison districts. Adherence and tolerability of SMC were assessed by cross-sectional surveys 4–7 days after each SMC round. Coverage of SMC was assessed in the post-SMC survey.ResultsDuring round 1, 84% of targeted children received at least the first SMC dose, but coverage declined to 67% by round 4. Across the four treatment rounds, 54% of children received four complete SMC courses. Prevalence of parasitaemia was similar in intervention and comparison districts prior to SMC (23.4 vs 29.5%, p = 0.34) as was the prevalence of malaria illness (2.4 vs 1.9%, p = 0.75). After SMC, parasitaemia prevalence fell to 18% in the intervention district and increased to 46% in the comparison district [difference-in-differences (DD) OR = 0.35; 95% CI 0.20–0.60]. Prevalence of malaria illness fell to a greater degree in the intervention district versus the comparison district (DD OR = 0.20; 95% CI 0.04–0.94) and the same for moderate anaemia (Hb < 8 g/dL) (DD OR = 0.26, 95% CI 0.11–0.65). The frequency of the quintuple mutation (dhfr N51I, C59R and S108N + dhps A437G and K540E) remained low (5%) before and after intervention in both districts.ConclusionsRoutine implementation of SMC in Mali substantially reduced malaria and anaemia, with reductions of similar magnitude to those seen in previous RCTs. Improving coverage could further strengthen SMC impact. Trial registration clinical trial registration number NCT02894294

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This study evaluates the levels of total polyphenolic compounds in three Malian medicinal plants and determines their antioxidant potential. Quantitative and qualitative analysis of polyphenolics contained in plants extracts were carried out by RP-C18 RP–HPLC using UV detector. The antioxidant activity was determined by three tests. They are phosphomolybdenum, DPPH (2,2-diphenyl-1 picrylhydrazyl) and ABTS [2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic)] tests. The total phenolic and the total flavonoid contents varied from 200 to 7600 mg 100 g−1 dry weight (dw), expressed as gallic acid equivalents and from 680 to 12 300 mg 100 g−1 dw expressed as catechin equivalents, respectively. The total anthocyanin concentrations expressed as cyanin-3-glycoside equivalent varied from 1670 to 28 388 mg 100 g−1 dw. The antioxidant capacity was measured by determining concentration of a polyphenolic (in mg ml−1) required to quench the free radicals by 50% (IC50) and expressed as vitamin C equivalent antioxidant capacity. The IC50 values were ranked between 2.68 and 8.80 μg ml−1 of a solution of 50% (v/v) methanol in water. The uses of plants are rationalized on the basis of their antioxidant capacity.

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In tropical regions, where most of the developing countries are located, septic tanks and other onsite sanitation systems are the predominant form of storage and pre-treatment of excreta and wastewater, generating septage and other types of sludges. The septage is disposed of untreated, mainly due to lack of affordable treatment options. This study presents lessons that have been learned from the operation of pilotscale constructed wetlands (CWs) for septage treatment since 1997. The experiments have been conducted by using three CW units planted with narrow-leave cattails (Typha augustifolia) and operating in a vertical-flow mode. Based on the experimental results, it can be suggested that the optimum solids loading rate be 250 kg TS/m2 yr and 6-day percolate impoundment. At these operational conditions, the removal efficiencies of CW units treating septage at the range of 80-96% for COD, TS and TKN were achieved. The biosolid accumulated on the CW units to a depth of 80 cm has never been removed during 7 years of operation, but bed permeability remained unimpaired. The biosolid contains viable helminth eggs below critical limit of sludge quality standards for agricultural use. Subject to local conditions, the suggested operational criteria should be reassessed at the full-scale implementation.