The study results support the use of the short regimen recently recommended by the World Health Organization. Its high level of success even among HIV-positive patients promises substantial improvements in TB control.
Background: Treatment outcomes of the shorter regimen for rifampicin-resistant tuberculosis are not completely established. We report on these outcomes two years after treatment completion among patients enrolled in an observational cohort study in nine African countries. Methods: 1,006 patients treated with the nine-month regimen were followed every six months with sputum cultures up to 24 months after treatment completion. The risk of any unfavourable outcome, of failure and relapse, and of death during and after treatment was analysed according to patient's characteristics and initial drug susceptibility by Cox proportional hazard models. Findings: Respectively 67.8% and 57.2% patients had >=1 culture result six months and 12 months after treatment completion. Fourteen relapses were diagnosed. The probability of relapse-free success was 79.3% (95% confidence interval [CI] 76.6À82.0%) overall, 80.9% (95% CI 78.0À84.0%) among HIV-negative and 72.5% (95% CI 66.5À78.9%) among HIV-infected patients. Initial fluoroquinolone (adjusted hazard ratio [aHR] 6.7 [95% CI 3.4À13.1]) and isoniazid resistance (aHR 9.4 [95% CI 1.3À68.0]) were significantly associated with increased risk of failure/relapse and of any unfavourable outcome. Interpretation: The close to 80% relapse-free success indicates the good outcome of the regimen in low-and middle-income settings. Results confirm the lesser effectiveness of the regimen in patients with initial resistance to fluoroquinolones and support the use of high-dose isoniazid, but do not support exclusion of patients for resistance to drugs other than fluoroquinolones.
The main objectives of this work were to manufacture adobes with good mechanical properties, even in a wet environment, and low thermal conductivity so as to give the population homes that provided better thermal comfort than cement-based constructions. For this purpose, clayey raw material from Burkina Faso, mainly composed of quartz (49 wt.%), kaolinite (28 wt.%), goethite (7 wt.%) and muscovite (9 wt.%) was mixed with up to 12 wt.% of cement to manufacture adobes. Various characterization techniques were implemented to assess the microstructure of these materials: X-ray diffraction, infrared spectrometry, differential scanning calorimetry, scanning electron microscopy and energy dispersive spectrometry. Their physical properties were also investigated (through water absorption, spray test, apparent density, porosity and thermal conductivity) as their mechanical
1. Resistance of some populations of the Simulium damnosum complex to temephos (100-fold at the LC50 level), with degrees of cross-resistance to chlorphoxim (14-fold) and other organophosphate insecticides, follows intensive larvicidal control of S. damnosum s.l. in West African river systems since 1975 by the WHO Onchocerciasis Control Programme. 2. Larvae of at least three sibling species of the S. damnosum complex have become organophosphate-resistant: these are the forest species S. sanctipauli Vajime & Dunbar and the savanna species S. sirbanum V. & D. and S. damnosum Theobald sensu stricto. 3. Organophosphate-resistant S. damnosum s.l. larvae show increased susceptibility to some organochlorine and pyrethroid insecticides, especially to permethrin (up to 11-fold) and OMS 3002 (up to 17-fold), as compared with organophosphate-susceptible populations. 4. This differential susceptibility is reflected by increased pyrethroid efficacy in operational use for river treatments against organophosphate-resistant field populations of S. damnosum s.l. larvae. Treatment of 100 km of the lower Bandama River in 1985 showed that permethrin at the highly selective dosage of 10 min exposure to 0.01 mg/l caused reversion towards organophosphate-susceptibility of the target population of S. sanctipauli. This effect was less pronounced when the Comoe River was treated at the lower dosage of 0.005 mg/l for 10 min. 5. To overcome temephos-resistance, it is proposed that the most rational usage of currently available larvicides would involve the following annual sequence of treatments: Bacillus thuringiensis serotype H-14 when river discharge is below 75 m3/s; chlorphoxim for about eight weekly treatment cycles after river discharge rises; permethrin (or alternative pyrethroid) for up to six treatment cycles--this should eliminate any incipient selection for chlorphoxim-resistance; resume chlorphoxim (or perhaps carbosulfan) treatments until river discharge falls below 75 m3/s permitting resumed use of B.t. H-14.
This study deals with the influence of fonio straw on the physical, thermal and mechanical properties of adobes. The raw materials (soil and fonio straw from Burkina Faso) were characterized from the chemical (ICP-AES), mineralogical (XRD, DSC-TGA, IR), geotechnical (particle size distribution, Atterberg limits, methylene blue value) and microstructural (SEM-EDS) points of view. The physical (thermal conductivity, capillarity water absorption, porosity, erodibility) and mechanical (compressive and flexural strength) properties of the adobes were studied with specific attention paid to their damage and fracture behavior. Because of the biochemical composition of fonio straw (presence of quasicrystalline cellulose and hemicelluloses, which are hydrophilic compounds), its association with the clay matrix increased water absorption and was accompanied by a significant porosity due to the air trapped during mixing. The insulating character of the cellulose and the low density resulting from the high porosity contributed to an appreciable reduction of the thermal conductivity of these adobes. The use of small amounts of fonio straw improved the mechanical properties of the adobes and made them less brittle. This improvement was linked to the good adhesion between fonio straw and the clay matrix, greatly reduced propagation of fissures in the composites and the high tensile strength of fonio straw because of its cellulose content. Thus, fonio-straw-reinforced adobes have interesting properties for use as cheap construction materials in the Sahelian zones and could contribute significantly to the thermal comfort of the inhabitants in this hot climate.
Loa loa filariasis is usually found in the forest areas of Central and West Africa. We report a case that was diagnosed in Ouagadougou (Burkina Faso), a savanna area. The patient lived in Gabon but was visiting his family in Ouagadougou. He complained of fatigue, fever, itchy legs with scratch marks, and intermittent edema of the legs. A blood smear was first examined for malaria parasites, but Loa loa microfilariae were observed. Laboratory tests showed hypereosinophilia (30%). Transient angioedema (Calabar edema) was observed. Loa loa filariasis was diagnosed based on these findings. There were no other laboratory test abnormalities, and ophthalmological examination was normal. The patient received a single dose of ivermectin at 200 µg/kg. After 1 month, the patient's course was favorable and a control blood smear was negative.
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