The co-infection of malaria, dengue fever, and COVID-19 is rarely described in Sub-Saharan Africa, yet the overlapping clinical and biological features of these diseases pose a significant diagnostic challenge in endemic areas. We report the case of a 36-year-old woman requiring admission to the intensive care unit in Burkina Faso with acute respiratory distress. She presented with a triple co-infection of Plasmodium falciparum malaria, dengue fever (DEN3 serotype), and COVID-19, complicated by sepsis and multiple organ dysfunction. The patient exhibited severe hypoxemia, hepatic dysfunction (cytolysis and cholestasis), and a SOFA score of 7. Initial diagnosis focused on malaria and dengue, leading to a 10-day delay in the diagnosis of COVID-19. This case underscores the diagnostic complexity of triple co-infection in Sub-Saharan Africa. The diagnosis of COVID-19 was delayed due to the overlapping signs of malaria and dengue fever. Each disease should be assessed systematically in the context of any infectious presentation in this region, especially during the rainy season, as symptoms and biological parameters are not discriminatory. We advocate for the systematic use of multiplex PCR testing to ensure early and accurate diagnosis.
Background: Acute myocarditis is an inflammatory disorder of the myocardium that can lead to severe cardiac dysfunction, arising from a broad spectrum of infectious and noninfec-tious etiologies. Ankylosing spondylitis, which primarily affects the axial skeleton, can involve the heart due to its systemic inflammatory nature, occasionally resulting in severe complications such as myocarditis. Case Presentation: We report an unusual case of acute myocarditis in a 49year-old male with an-kylosing spondylitis presenting with chest pain and systemic inflammatory symptoms. Diagnostic workup using the 2018 Lake Louise Criteria among cardiac MRI confirmed myocarditis in the absence of coronary artery disease or infectious etiology. The patient also demonstrated extra-articular manifestations with pulmonary and ocular involvement, consistent with an active anky-losing spondylitis flare. Management combined beta blockers, physical activity restriction, and re-introduction of anti-TNF alpha therapy, leading to both clinical and biological improvement. Conclusion: Acute myocarditis represents a rare yet severe cardiac manifestation of ankylosing spondylitis, requiring a high clinical suspicion to prevent heart failure and dilated cardiomyopathy.
Rheumatoid arthritis (RA) is commonly treated with Janus kinase inhibitors (JAKis) and anti-tumor necrosis factor-α (anti-TNFα), but the cardiovascular safety profiles of these drugs remain unclear. The aim of this study was to describe the individual case safety reports of major adverse cardiac events (MACE) or stroke and to determine whether there was a difference in the frequency of reporting of cardiovascular events between JAKis and anti-TNFα used in RA. A case/non-case study was conducted using the WHO VigiBase® database. Descriptive analysis was performed, the time to onset (TTO) of MACE was calculated, and the reporting odds ratio (ROR) was used to estimate the frequency of MACE reports associated with JAKis versus anti-TNFα in RA. A total of 18,099 cases of MACE were identified, of which 2543 (14
Abstract Background In Burkina Faso, nearly half of the population is under 15 years old, and one in four adolescents experience depression. This underscores the critical need to enhance mental health literacy among adolescents and youth, empowering them to manage their mental well-being effectively. Comic books offer an engaging approach to health education, yet their effectiveness in addressing mental health remains largely untested. Our study aims to fill this gap by evaluating the effectiveness of comic books in enhancing mental health literacy among adolescents and young adults aged 10–24 years. Methods We will recruit 2,007 participants aged 10–24, stratify them by age, and randomly assign them to three groups (1:1:1): a comic book intervention group (Intervention 1), a text-only flyer group (Intervention 2), and a control group with no intervention. The primary outcome will be mental health literacy and secondary outcomes will include anxiety, depression, and intentions to cope. Discussion We hypothesize that the comic book intervention and flyer intervention will prove more effective in improving mental health literacy than the control group. We further hypothesize that for younger adolescents (10–14), the comic book will be more effective at increasing mental health literacy than the flyer. Conversely, we hypothesize that the flyer will be more effective in increasing mental health literacy for older adolescents (15–24). Our study will provide evidence on novel interventions designed to enhance mental health literacy among adolescents and young adults in low-resource settings. Trial registration This trial has been registered on the German Clinical Trials Register (DRKS), with the registration number DRKS00034242.
Molecular bases of the clinically heterogenous Oculo-Auriculo-Vertebral Spectrum or Craniofacial Microsomia remain largely unknown. Although genetic diagnosis is established in less than 10% of the patients, variants in the FOXI3 gene are the most recurrent genetic cause. We studied a large family with 6 affected individuals on 4 generations showing an autosomal dominant transmission of Oculo-Auriculo-Vertebral Spectrum with incomplete penetrance. The genome sequencing strategy allowed the identification of a new likely pathogenic missense variant located within the Nuclear Localization Signal of FOXI3 and affecting its subcellular localization. Moreover, we described 3 additional rare FOXI3 variants identified in 3 other patients from a cohort of 251 patients with Oculo-Auriculo-Vertebral Spectrum. These variants were classified as Variants of Unknown Significance. In conclusion, this study confirms FOXI3 implication in the Oculo-Auriculo-Vertebral Spectrum and the importance of Nuclear Localization Signal integrity. Genotype-phenotype correlations and putative modifier haplotype are discussed.
