BACKGROUND:We aimed to establish an external quality assessment (EQA) programme for the yaws eradication campaign that would meet the needs of reference and district-level laboratories in low- and middle-income countries. METHODOLOGY/PRINCIPAL FINDINGS:We designed proficiency testing items (PTIs) using a plasmid containing gene target sequences for Treponema pallidum (TP) and Haemophilus ducreyi (HD). The storage stability of the plasmids under different environmental conditions was then tested. A proficiency testing panel of seven swabs loaded with different concentrations of plasmids in different combinations, as well as human HEK293 cells to simulate the sample background, was prepared and sent to participating reference (RL) and district (DL) laboratories in Ghana, Côte d'Ivoire and Cameroon followed by three rounds of blinded proficiency testing. We tested quantitative real-time PCR (qPCR) performance of reference laboratories and loop-mediated isothermal amplification (LAMP) performance of district laboratories and retested 20% of human field samples at the London School of Hygiene & Tropical Medicine laboratories to further assess qPCR quality. FINDINGS:PTIs proved to be stable in dry conditions with no significant loss of copy number. Participating laboratories achieved qPCR results with a concordance of 95.0-100.0% (97.7% ± 5.2% (mean±standard deviation ((SD)) with the provider and a concordance of 76.0-100.0% (TP: 90.3 ± 13.7% and HD: 78.5 ± 7.5% (mean±SD)) for LAMP results, with inconsistencies, particularly in the detection of low HD plasmid DNA levels combined with high TP plasmid copies. Retesting of field samples resulted in 100% correct TP and HD sample identification by the African reference laboratories. CONCLUSIONS/SIGNIFICANCE:We have developed a functional plasmid-based EQA programme specifically designed to meet the needs of resource-poor settings in the tropics. The programme is suitable as a blueprint for other disease programmes.
Africa bears a disproportionate burden of epidemic threats, exemplified by COVID-19. Drawing on lessons from the pandemic, we describe how Institut Pasteur de Côte d’Ivoire transitioned from limited capacity to established expertise in genomic surveillance. This institutional strengthening provides a strategic blueprint for enhancing Africa’s resilience against emerging health threats.
Men engaged in transactional sex (METS) represent a neglected key population in sub-Saharan Africa (SSA), yet little is known about their burden of sexually transmitted infections (STIs) and associated factors. This study assessed the prevalence of self-reported STIs (SR-STI) and identified individual, community, and country-level determinants among this group. We analyzed pooled recent nationally representative Demographic and Health Survey (DHS) data from 26 SSA countries. This study included 10,128 men who reported engagement in transactional sex within the past 12 months. Weighted prevalence estimates were calculated, and multilevel logistic regression models were applied to examine individual-, community-, and country-level determinants of SR-STI symptoms, adjusting for survey year. AIC and BIC were used as comparative model selection criteria to identify the best-fitting model among the sequential multilevel models built. The participants’ mean (± SD) age was 29.8 (± 10.2) years. The overall weighted prevalence of SR-STIs among METS was 19.5
In Cote d’Ivoire, there is a disparity between dietary intake and nutritional needs among school-age children. Studies have shown that dietary diversification could offer a solution. A study was therefore conducted to assess the impact of dietary diversification on the anthropometric and vitamin profiles of students in school cafeterias in the Nawa region. This study took place from October 2017 to May 2018 in school cafeterias in 12 localities in the Nawa region. It included 240 school-aged children aged 6 - 12, divided into four groups of 60 students. Four types of meals were offered to the four groups: rice with tomato sauce and fish, sweet potato stew enriched with green soybeans, sweet potato stew enriched with white cowpeas, and sweet potato stew enriched with cowpeas and soybean balls. Anthropometric measurements were based on the standardized method of the World Health Organization and the United Nations Children’s Fund. Concurrently, blood samples were collected before meal consumption (Phase 0), three (3) months later (Phase 1), and six (6) months later (Phase 2). Blood levels of vitamin A were measured using high-performance liquid chromatography (HPLC). In this study, the mean age ranged from 8.62 to 10.25 years, with a significant difference (p < 0.01) between Group 2 (10.25 years) and Group 1 (8.60 years). An increase in the children’s weight, height, and body mass index was observed six months after food consumption. Before the children began eating school meals (phase 0), adequate vitamin A levels were observed. Vitamin A levels decreased in groups 1, 2, and 3 from phase 0 to phase 2. However, they increased in children in group 4 from 0.5 to 0.8 mg/L. In this study, an increase in weight, height, and body mass index was observed among children who consumed the various meals in the study. Furthermore, an improvement in vitamin A status was more pronounced among children who consumed the meal based on sweet potato, soybeans, and cowpeas. This dish could be selected as a suitable option for dietary diversification in school cafeterias.
Background The new antimalarial combination ganaplacide plus lumefantrine-SDF was shown in a previous phase 2 study to be effective and well-tolerated in the treatment of uncomplicated falciparum malaria in adults, adolescents and children ≥ 2 years old. Here we report pharmacokinetic data from a second phase 2 study, which aimed to optimize the dose regimen and food intake with dosing, and to assess efficacy, safety and pharmacokinetics in children aged 6 months to 2 years with acute uncomplicated falciparum malaria. Methods In this randomized, open-label phase 2 study in uncomplicated falciparum malaria, sequential cohorts of patients aged 2 to < 12 years, body weight ≥ 10 kg (Cohort 1, N = 140), and 6 months to < 2 years, body weight ≥ 5 kg (Cohort 2, N = 80) were randomized to a loose combination of ganaplacide 400 mg plus lumefantrine solid dispersion formulation (SDF) 480 mg, administered with a light meal (100–300 calories, 5-10g fat) q.d. for 3 days, or artemether-lumefantrine (b.i.d. 3 days, per prescribing information). Doses were adjusted by body weight range. The ganaplacide plus lumefantrine-SDF treatment regimen was selected based on data from run-in cohorts of patients aged 12 to < 18 years (reported separately). We report pharmacokinetic data from the study. Sparse sampling was used. Drug concentrations were determined by liquid chromatography-mass spectrometry. Pharmacokinetic parameters including AUC 0−24 , C max , and C 168h were determined using non-compartmental analysis. Results Ganaplacide and lumefantrine exposures were within targeted ranges in both cohorts as confirmed by good efficacy and safety. Lumefantrine C 168h was higher in the ganaplacide plus lumefantrine-SDF group than the artemether-lumefantrine group in both cohorts. Drug exposures were comparable to those in patients treated with ganaplacide 400 mg plus lumefantrine-SDF 960 mg (doses adjusted by body weight range) given under fasted conditions in a previous study. Conclusions Ganaplacide 400 mg plus lumefantrine-SDF 480 mg given with a light meal q.d. for 3 days achieved effective drug exposures in patients with uncomplicated falciparum malaria. Trial registration The study is registered with EudraCT (2021-003583-27) and ClinicalTrials.gov (NCT04546633).
