Effets d’une assistance technique ciblée pour l’amélioration de la couverture vaccinale au Cameroun,en Côte d’Ivoire et en Mauritanie en 2014

Within the framework of its strategic goal of vaccine coverage (VC) improvement, GAVI, The Vaccine Alliance has entrusted the Agence de médecine préventive (agency for preventive medicine, AMP) with technical assistance services to Cameroon, Cote d’Ivoire (Ivory Coast), and Mauritania. This support was provided to selected priority districts (PDs) with the worst Penta3 coverage performances. In 2014, PDs benefited from technical and management capacities in vaccinology strengthening for district medical officers, supportive supervisions and technical assistance in health logistics, data management and quality. We analyzed the effects of the AMP technical assistance on the improvement of the cumulative Penta3 coverage, which is the key performance indicator of the expanded programme on immunization (EPI) performance. We compared Penta3 coverage between PDs and other non-priority districts (NPDs), Penta3 coverage evolution within each PD, and the distribution of PDs and NPDs according to Penta3 coverage category between January and December 2014. Technical assistance had a positive effect on the EPI performance. Indeed Penta3 coverage progression was higher in PDs than in NPDs throughout the period. Besides, between January and December 2014, the Penta3 VC increased in 70%, 100% and 86% of DPs in Cameroon, Côte d’Ivoire and Mauritania, respectively. Furthermore, the increase in the number of PDs with a Penta3 coverage over 80% was higher in DPs than in NPDs: 20% versus 8% for Cameroon, 58% versus 29% for Côte d’Ivoire and 17% versus 8% for Mauritania. Despite positive and encouraging results, this technical assistance service can be improved and efforts are needed to ensure that all health districts have a VC above 80% for all EPI vaccines. The current challenge is for African countries to mobilize resources for maintaining the knowledge and benefits and scaling such interventions in the public health area.     

‘Ascospore O’, oxidant,host assistance: the pathway to carcinogenesis

Sufficient evidence exists to conclude that a cycle of sequential physiological events is the pathway contributing to the transformation of the mammalian cell to its malignant phase. The cycle of events involves a reticulum or network of cells. These consist either of the reticuloendothelial cells, the squamous, or the epithelial group. A second factor requires the presence, intracellularly, of conidia derived from one of the various groups of the anaerobic micro-organisms known as Ascomycetes. These conidia as a separate entity, totally free of any part of their parental origin, constitute the invasive agent which, however, can or may lie quiescent at the onset. They retain genetically an electronegative viable chemical complex (Oxidant) and also an asexual procreative unit. This Oxidant can alternately accept the negative charged ions (anions) while releasing oxygen.The subsequent ensuing circulation and compatible flow of blood by the host provides the source for the electrolytes as well as the metabolites, enzymes, etc. It is this continued flow of blood that promotes the next stage of the conidia's lifecycle and reactivates their anaerobic respiration, metabolism, and reproduction of new asexual conidia.This is the cycle of physiological events that ultimately contributes to the transformation of an animal (human) cell to its malignant phase. It also accounts for the pathological consequences as clinically present in malignantly ill patients.     

L’information post-don,le quatrième sous-processus de l’hémovigilance

Postdonation information is the knowledge of information about the donor or his donation, occurring after it, which challenges quality or safety of the blood products stemming from this or other donations. Classical hemovigilance sub-processes concerning donors or recipients adverse events do not cover this topic. France is just about to make it official as a fourth sub-process. Less formal management of postdonation information is already set up for more than ten years. French data of the year 2013 are presented, including the regional notification level and the national reporting one. A significant level of heterogeneity is observed as for other hemovigilance sub-processes. It is mainly due to subjective rather than objective differences in risk appreciation. A real consensual work is expected about it in the future.     

L’hydatidose scapulohumérale: à propos d’une nouvelle observation en Tunisie

Osseous hydatidosis is reported in only 0.5-2.5% of the cases. The scapulohumeral localization is extremely rare. A 39-year-old woman, born in a rural area of Tunisia, presented swelling and tenderness of the left shoulder with limited motion 7 days after a minor trauma. Plain radiographs, CT and MRI showed osteolytic scapulohumeral lesions, cortical rupture and multiple cysts in the muscles, which were suggestive of hydatidosis. Indirect haemagglutination test using hydatid antigen was positive (1/280). The patient refused radical surgery and underwent resection of axillary cysts. Albendazole was given in the recommended dose but was stopped immediately due to hepatic toxicity. Scapulohumeral hydatidosis is extremely rare, often invasive and behaves like a locally malignant bone tumour. Its treatment is also difficult.