Esquisse d''une méthode d''estimation du coût économique chiffré des accès palustres: application à une zone rurale au Burkina Faso (Afrique de l''Ouest)

Une méthode d'estimation précise du coût des accès palustres en milieu rural a été développée et a été appliquée dans 3 villages de la région de Bobo-Dioulasso au Burkina Faso. Le coût de l'accès palustre comprend le coût direct (coûts de la consultation, de l'examen microscopique, des médicaments et du transport), et le coût indirect (coût des journées de travail perdues). L'intérêt de la formule tient surtout à la méthode d'estimation du coût indirect qui est le plus difficile à mesurer surtout à l'échelle d'une collectivité. Son estimation utilise les variables suivantes: âge du sujet, degré d'invalidité, durée de la maladie, activité professionnelle, revenu économique, pourcentage de perte économique. Ces variables peuvent être mesurées dans chaque zone et la formule appliquée pour obtenir une estimation plus précise du coût de l'accès palustre. Dans les 3 villages de la région de Bobo-Dioulasso, 3065 consultants ont été enregistrés dans les centres de santé au cours de l'étude. Parmi eux 544 (17,7%) étaient cliniquement diagnostiqués comme paludéens. Mais après l'examen microscopique seuls 353 (11,6%) ont été confirmés parasitologiquement. Ils étaient composés de 73,1%âgés de 0 à 5 ans, 13,9%âgés de 6 à 15 ans, 12,2%âgés de 16 à 50 ans et 0,8%âgés de plus de 50 ans. L'activité professionnelle dominante était l'agriculture puis viennent l'élevage et le commerce. La durée moyenne d'invaliditéétait de 4 jours. Le coût économique moyen de l'accès palustre était de 11,7 $, soit un coût direct moyen de 8 $ et un coût indirect moyen de 3,7 $.     

Electrophysiological and pharmacological study of the inotropic effects of adrenaline,dopamine and tryptamine on frog atrial fibres

In order to investigate the action of the sympathetic amines adrenaline, dopamine and tryptamine, electrophysiological and pharmacological studies were undertaken on frog heart atrial fibres, using a double sucrose gap technique. Electrophysiological measurements, under voltage clamp conditions have shown that adrenaline, dopamine and tryptamine induce a large increase of the slow inward current (I_slow) and tension amplitudes. Dose-response relationships show a direct correlation between the increase in both I_slow and phasic tension, with a half-response dose (K_0·5) of 4 × 10^?7m for adrenaline, 2.5 × 10^?6m for dopamine and 4 × 10^?6m for tryptamine. These effects are inhibited by the β blocker agent propranolol, but a competitive inhibition was only observed in the case of adrenaline. While the typical effect of adrenaline is still present on catecholamine depleted preparations (previously treated with 6-hydroxydopamine), dopamine and tryptamine do not have an effect on those pretreated preparations. Results provide evidence for an adrenaline release mediated type of action of dopamine and tryptamine. Our work also suggests the presence of specific presynaptic dopamine and tryptamine receptors on sympathic nerve terminals in frog atrial fibres.     

Knowledge of an urban population about arterial hypertension: prospective study carried out in Ouagadougou, Burkina Faso

The objective of this prospective survey was to estimate the prevalence of hypertension in the city of Ouagadougou and to evaluate the information level as well as the knowledge of the population regarding hypertension. We carried out a urban community based cross sectional study. Subjects were black African, and aged of 18 years at least. They were considered hypertensive when they were under a treatment for hypertension, or when they had high blood pressure (> or = 140/90 mm Hg) according to the WHO classification in 1999. The study selected 3441 subjects, among them 60.4% of women and 39.6% of men. The average age in the sample was 33.1 +/- 13.3 years; 64.4% of the subjects were 20 to 40 years old. The average systolic blood pressure in the population was of 124 +/- 21 mm Hg, and of 78 +/- 12 mm Hg for the diastolic one. The prevalence of hypertension in our sample was 23%, with 20.4% of unknown hypertensive subjects. Hypertension is highly frequent in urban area in Burkina Faso. As it could be expected, the knowledge of the population regarding hypertension proved inversely proportional to the educational level. Information programs and consciousness-raising campaign as well as detection program should be implemented urgently.     

Socio-cultural and problematic context of AIDS prevention in Africa: some observations drawn from the case of the Mossi society in Burkina Faso

On September 30, 1988, Burkina Faso had only 26 reported cases of AIDS. By March 20, 1992, there were 1263 reported cases. Burkina Faso officials focus on AIDS prevention. Heterosexual transmission of HIV predominates in Africa. There are observable behaviors, practices, and beliefs of the Mossi society in Burkina Faso which expose people to HIV or facilitate its transmission. The Mossi is a hierarchical society with the chief having absolute power. The head of the family has absolute power over the women and children. Polygamy is common. The Mossi describe their past as an earthly paradise with no AIDS. This magnificent past allows a faulty perception of one's risk. The cultural tradition of a widow marrying her husband's younger brother appears to be a risk for HIV transmission. This custom is forced on the widow because in the Mossi society a woman with no husband is nothing. If a man dies of AIDS and has infected some or all of his wives, the younger brother(s) will in turn become infected. On the other hand, a younger brother may be HIV infected and, upon marrying his deceased brother's wife or wives, he infects her or them. Uncircumcised males and females are stigmatized and marginalized in the Mossi society. Nonsterilized instruments are used to perform genital mutilations and are used on several persons. Traditional vaccinations by cutaneous scarification and treatment of sores and cutaneomucous lesions are other possible ways HIV may be transmitted among the Mossi. Preparing the cadaver is done without gloves and, in cases of AIDS, exposes the preparers to open lesions. Serious obstacles to HIV prevention campaigns are erroneous beliefs about the modes of HIV transmission, the acculturated fatalistic attitude among youth that one contracts AIDS whether or not one takes precautions, and the attitude that AIDS comes from elsewhere.     

Expression of CD44 spliced variants with both exons v9 and v10 in primary N(-)M(-) breast carcinomas correlates with metastasis

We analyzed the representation of CD44 isoforms with both exons v9 and v10 among CD44 total amount and also examined correlation between their expression, clinical parameters and survival. We used a semi-quantitative RT-PCR reaction and a panel of 25 normal breast specimens, 10 mammary fibroadenomas, 8 cystic samples and 52 primary breast tumors. CD44 expression level was statistically higher in malignant tumors than in normal breast tissues (p = 0.038) or in fibroadenomas (p = 0.047) and correlated with histological grading, p = 0.047. Ratios CD44 variants with both exons v9 and v10/ total CD44 were similar in normal breast tissues and fibroadenomas but lower in the cystic samples. In primary N(-)M(-) breast tumors, unfavourable outcome and relapse were correlated with low ratios.     

Adaptive reconstruction of phased array MR imagery.

An adaptive implementation of the spatial matched filter and its application to the reconstruction of phased array MR imagery is described. Locally relevant array correlation statistics for the NMR signal and noise processes are derived directly from the set of complex individual coil images, in the form of sample correlation matrices. Eigen-analysis yields an optimal filter vector for the estimated signal and noise array correlation statistics. The technique enables near-optimal reconstruction of multicoil MR imagery without a-priori knowledge of the individual coil field maps or noise correlation structure. Experimental results indicate SNR performance approaching that of the optimal matched filter. Compared to the sum-of-squares technique, the RMS noise level in dark image regions is reduced by as much as the square root of N, where N is the number of coils in the array. The technique is also effective in suppressing localized motion and flow artifacts.