Seizing the big missed opportunity: linking HIV and maternity care services in sub-Saharan Africa

This paper draws on two reviews commissioned by the UK Department for International Development in 2006-2007 that explore progress in linking HIV prevention and maternity services in sub-Saharan Africa. Although pilot and demonstration projects have been successful, progress in scaling up PMTCT has been slow, reaching just 11% of pregnant HIV positive women in much of Africa, less than half the percentage of coverage achieved by antiretroviral treatment programmes for adults in need. Despite ongoing efforts to promote comprehensive approaches, significant policy, financing and institutional barriers, and weak co-ordination and leadership, continue to hamper progress. Maternal health services face human and financial resource shortages which affect their capacity to integrate HIV prevention. Both HIV and maternal health programmes often receive targeted financial and technical assistance that does not take the other into account. However, proposals in 2007 from a number of countries to the Global Fund to Fight AIDS, TB and Malaria incorporate sexual and reproductive health programming that will have an impact on HIV, including certain maternity services. Moreover, Botswana, Kenya and Rwanda have shown that progress can be made where national commitment and increased resources are enabling maternal and newborn care to address HIV.     

Hospitals in sub-Saharan Africa: why we need more of what does not work as it should

This paper analyses the origins of today's crisis in the hospital sector in sub-Saharan Africa. Present trends in availability of hospital services are extrapolated to the future in order to provide a low-end estimate of the need for expansion of first referral level hospitals. This will not be possible without giving due priority to this sector, a commitment to considerable investments and reorientation of resources from tertiary to first referral level hospitals. It is to be feared that if this is not done, the backlog will increase, and, given the time lag before investments translate into operational services, there will be a major shortage of hospital services in sub-Saharan Africa within a decade.     

An outbreak of cholera in a refugee camp in Africa

A total of 541 cases of cholera were observed between May 7 and July 19, 1985 among the 9,929 displaced persons present in a refugee camp in Africa.In spite of malnutrition and other diseases affecting this population, only 12 deaths occurred.Antiepidemic measures consisted of preparation of isolation-wards, treatment of contaminated materials, training of refugees and patient care. Mass prophylaxis, initially considered, was dropped before the end of the epidemic.Corresponding author.     

MECP2 duplication syndrome in a patient from Cameroon

MECP2 duplication syndrome (MDS; OMIM 300260) is an X‐linked neurodevelopmental disorder caused by nonrecurrent duplications of the Xq28 region involving the gene methyl‐CpG‐binding protein 2 (MECP2; OMIM 300005). The core phenotype of affected individuals includes infantile hypotonia, severe intellectual disability, very poor‐to‐absent speech, progressive spasticity, seizures, and recurrent infections. The condition is 100% penetrant in males, with observed variability in phenotypic expression within and between families. Features of MDS in individuals of African descent are not well known. Here, we describe a male patient from Cameroon, with MDS caused by an inherited 610 kb microduplication of Xq28 encompassing the genes MECP2, IRAK1, L1CAM, and SLC6A8. This report supplements the public data on MDS and contributes by highlighting the phenotype of this condition in affected individuals of African descent.     

Some gonad-infecting species of Philometra (Nematoda, Philometridae) from offshore fishes of South Carolina and Georgia, USA, including Philometra charlestonensis sp. nov. from the scamp Mycteroperca phenax

Three gonad-infecting species of Philometra Costa, 1845 were, for the first time, recorded from perciform fishes from estuarine and marine waters in South Carolina and Georgia, USA: Philometra charlestonensis sp. nov. from the scamp Mycteroperca phenax (Jordan et Swain) (Serranidae), P. saltatrix Ramachandran, 1973 from the bluefish Pomatomus saltatrix (Linnaeus) (Pomatomidae), and Philometra sp. from the Atlantic croaker Micropogonias undulatus (Linnaeus) (Sciaenidae). The new species is characterized mainly by males (body length 2.65–3.14 mm) with equally long, needle-like spicules (length 132–141 μm) and the gubernaculum (81–93 μm) bearing dorsal transverse lamella-like structures on its distal portion, the body length of gravid females (168–247 mm), the presence of a well-developed anterior bulbous inflation on the female oesophagus, and by the length of the first-stage larvae (544–597 μm). A key to gonad-infecting species of Philometra parasitizing marine and brackish-water fishes is provided.     

Searching for archaic contribution in Africa

Abstract

Context: Africa’s role in the narrative of human evolution is indisputably emphasised in the emergence of Homo sapiens. However, once humans dispersed beyond Africa, the history of those who stayed remains vastly under-studied, lacking the proper attention the birthplace of both modern and archaic humans deserves. The sequencing of Neanderthal and Denisovan genomes has elucidated evidence of admixture between archaic and modern humans outside of Africa, but has not aided efforts in answering whether archaic admixture happened within Africa.

Objectives: This article reviews the state of research for archaic introgression in African populations and discusses recent insights into this topic.

Methods: Gathering published sources and recently released preprints, this review reports on the different methods developed for detecting archaic introgression. Particularly it discusses how relevant these are when implemented on African populations and what findings these studies have shown so far.

Results: Methods for detecting archaic introgression have been predominantly developed and implemented on non-African populations. Recent preprints present new methods considering African populations. While a number of studies using these methods suggest archaic introgression in Africa, without an African archaic genome to validate these results, such findings remain as putative archaic introgression.

Conclusion: In light of the caveats with implementing current archaic introgression detection methods in Africa, we recommend future studies to concentrate on unravelling the complicated demographic history of Africa through means of ancient DNA where possible and through more focused efforts to sequence modern DNA from more representative populations across the African continent.     

Chromosome abnormalities in chronic lymphocytic leukemia revealed by TPA as a mitogen

Bone marrow and peripheral blood cultures of chronic lymphocytic leukemia patients were mitogenically stimulated with TPA (12-0-tetradecanylphorbol-13-acetate). Clonal cytogenetic abnormalities were detected in frequencies varying from 15% to 100%, in five of the six patients studied. Parallel studies with pokeweek mitogen showed a much lower level of stimulation and only two abnormal clones were detected. The chromosome abnormalities described in this study are similar to those reported in CLL by other authors, particularly with respect to trisomy 12 and deletion 11q. A significant frequency of hypodiploidy and chromosome deletion was also detected in this study, and further studies are underway to determine the significance of these findings.     

Absence of HTLV I from New Zealand

Sera from 1,943 individuals from Auckland, New Zealand, were tested for the presence of serum antibodies to human T cell lymphotropic virus I (HTLV I), mainly with an enzyme-linked immunosorbent assay (ELISA) with cell extracts as target antigen. The individuals tested were blood donors and mostly Caucasian, but included indigenous Maoris and representatives of several groups of Pacific islanders now resident in New Zealand. Also included were 37 patients with various hematological malignancies, including seven with T cell leukemias. Although 1% of samples were positive by ELISA, none of these were confirmed as positives by Western blotting. On the basis of these results we consider that it is unlikely that HTLV I infection occurs in Auckland; however, we cannot exclude the possibility that pockets of virus infection may occur in other parts of New Zealand or the South Pacific.     

HLA class I in three West African ethnic groups: genetic distances from sub-Saharan and Caucasoid populations

Fulani of Burkina Faso (West Africa) are a particularly interesting ethnic group because of their lower susceptibility to Plasmodium falciparum malaria as compared to sympatric populations, Mossi and Rimaibé. Moreover, the occurrence of a Caucasoid component in their genetic make-up has been suggested on the basis of their physical traits and cultural traditions even though this view was not supported by genetic studies. A total of 149 unrelated subjects (53 Mossi, 47 Rimaibé and 49 Fulani) have been typed for 97 HLA class I alleles with the amplification refractory mutation system/polymerase chain reaction (ARMS/PCR) technique. Mossi and Rimaibé data were pooled since none of the 42 statistically testable alleles exhibited a significant heterogeneity. These pooled gene frequencies were found to be very different from those of Fulani: a certain (P<0.001) or a likely (0.001 相似文献   

The neurologic examination in geriatric psychiatry

The need to distinguish functional mental disorders from organic brain dysfunction has become increasingly important with the growing number of elderly patients who present with behavioral disturbances. As part of the evaluation of these patients, the psychiatrist or other physician should perform a basic neurologic examination. The author describes an examination for geriatric patients that includes methods for taking a neurologic history, for clinically measuring psychological functions, for evaluating primitive reflexes, and for interpreting peripheral neurologic responses.