Introduction: severe acute malnutrition affects approximately 19 million children under 5 years of age worldwide. In the Democratic Republic of Congo, between July 2024 and June 2025, approximately 1.4 million children aged 6 to 59 months are estimated to suffer from severe acute malnutrition. It represents a major cause of mortality in low-income countries, particularly in this country. This study aims to identify predictors of mortality among children admitted to the intensive therapeutic nutrition units in Kasaï Central. Methods: a retrospective cohort study was conducted among 432 children admitted for severe acute malnutrition (SAM) in six intensive therapeutic nutrition units in Kasaï Central, from January to November 2024. Data were collected via KoboCollect, cleaned in Excel, and analyzed with SPSS. Survival analyses (Kaplan-Meier) and a multivariate Cox model were used to identify predictors of mortality. Results: mortality was 6.3%, and median survival time was 7 days. Weight gain ≥100 g was more common in survivors (51.9%) than in non-survivors (33.3%). Significant predictors included sepsis (HRa = 3.325), hypoglycemia (HRa = 4.324), anemia (HRb = 2.32), and dehydration (HRa = 1.726). Conclusion: early detection of comorbidities and their prompt management are essential to improve the survival of children with SAM. Specific strategies targeting the main complications must be strengthened in the Intensive Therapeutic Nutrition Units of Kasaï Central.
Rising greenhouse gas emissions are intensifying heatwaves, wildfires, extreme rainfall, and sea-level rise, reshaping global health outcomes. However, the full multisystem burden remains insufficiently synthesized. This systematic review quantifies global climate-sensitive health impacts, identifies vulnerable populations, and evaluates adaptation strategies. We searched seven databases and grey literature (2000-2025), including studies linking climate exposures to health outcomes. Dual screening, risk-of-bias assessment (ROBINS-I, ROB 2), meta-analysis, meta-regression, and GRADE certainty grading were applied. Sixty-five studies were included. Non-optimal temperatures were associated with 5.08 million annual deaths (2000-2019). Heat increased all-cause mortality by 3.3% per 1°C above local optimum, while compound heat-ozone events increased cardiovascular mortality by 5.7%. Wildfire smoke contributed to ~339,000 premature deaths annually and a 6% increase in myocardial infarction admissions per 10 µg/m3 PM2.5. Climate-sensitive vectors may expose 1.3 billion people to Aedes-borne diseases by 2050. Heat-related labor losses reached 5.3% of global work hours (~US$671 billion in 2020). Climate-related anxiety/depression prevalence was 24%. Only 27% of World Health Organization (WHO) member States report fully funded health adaptation plans. Early warning systems and deep decarbonization could reduce mortality by up to 42% and avert >160,000 deaths annually. Evidence indicates disproportionate impacts in low-resource settings and multiple interacting pathways across physical and mental health, nutrition, and livelihoods. Climate change is already a major driver of global morbidity, mortality, and economic loss. Urgent mitigation and scaled, equity-focused adaptation are essential to reduce avoidable deaths and health inequities worldwide.
Introduction: mothers of children with autism often experience a low quality of life. A preliminary survey in Pematangsiantar City identified 50 mothers struggling to accept their child's condition, particularly concerning social relationships and environmental interactions. This study aimed to develop and evaluate an integrated behavior model (IBM) based empowerment model to optimize their quality of life. Methods: this explanatory study consisted of two stages. Phase 1 utilized an analytical observational design with a cross-sectional approach, involving 107 mothers selected via systematic random sampling. Data were analyzed using path analysis (AMOS), followed by focus group discussions and expert in-depth interviews to develop the intervention module. Phase 2 employed a quasi-experimental pre-test and post-test control group design involving 30 mothers, equally divided into an intervention group (n = 15) and a control group (n = 15). Phase 2 data were analyzed using paired and independent sample t-tests. Results: in phase 1, the variables influencing intention were personal agency (estimate = 0.327), perceived norms (estimate = 0.254), and attitudes (estimate = 0.115). The variables directly influencing behavior were knowledge (estimate = 0.412), skills (estimate = 0.380), intention (estimate = 0.385), habits (estimate = 0.294) and spirituality (estimate = 0.148). In phase 2, the statistical analysis revealed that the IBM-based empowerment module significantly improved the quality of life in the intervention group compared to the control group (p = 0.005). Conclusion: knowledge and skills demonstrated the greatest influence on behaviors maintaining the quality of life. The implementation of the IBM-based empowerment module effectively optimized the quality of life among mothers of children with autism. The implications of this study highlight that structured enhancements in knowledge, skills, spirituality, and behavioral intentions using module-based media are critical for sustaining maternal well-being.
La progression de l'adénocarcinome prostatique (CaP) vers la résistance à la castration implique des dérèglements moléculaires complexes. Cette étude évalue l'implication de NF-κB et des récepteurs à l'EGF (EGFR, HER3) dans l'agressivité tumorale chez des patients marocains. Une étude rétrospective avec analyse immunohistochimique a été réalisée sur les tissus de 88 patients atteints de CaP. L'expression des sous-unités de NF-κB (p65, p50, RelB), de l'EGFR et de HER3 a été corrélée au statut de résistance à la castration et au score de Gleason (tests du Chi-carré et régression logistique). Une forte localisation nucléaire de NF-κB a été observée dans les cellules cancéreuses résistantes à la castration (p = 0,0005), constituant un marqueur prédictif de progression. Parallèlement, une surexpression de l'EGFR a été identifiée chez les patients hormono-réfractaires (OR = 5,37; p = 0,0010). L'expression nucléaire de HER3 était significativement corrélée à un grade de Gleason élevé (≥ 7) dans les tumeurs résistantes (p = 0,0064). L'activation nucléaire de NF-κB et de HER3, ainsi que la surexpression de l'EGFR, jouent un rôle clé dans l'évolution vers l'échappement hormonal. Ces molécules représentent des cibles thérapeutiques et des biomarqueurs pronostiques prometteurs pour la prise en charge du CaP à haut risque au Maroc.
Introduction: l'usage inapproprié des antibiotiques constitue un facteur d'émergence des résistances antimicrobiennes et représente un problème majeur de santé publique. Pour y faire face, le Burkina Faso a élaboré un guide pratique pour la bonne prescription des antibiotiques. Quatre ans après sa diffusion, aucune évaluation formelle de son application n'a été retrouvée, justifiant l'intérêt de cette étude. Méthodes: une étude transversale a été conduite au département de gynécologie-obstétrique et de médecine de la reproduction du Centre Hospitalier Universitaire Souro Sanou du Burkina Faso du 1er juillet au 31 décembre 2022. Elle a inclus toutes les patientes ayant bénéficié d'une antibiothérapie. L'évaluation de la conformité des prescriptions a été réalisée à l'aide d'une check-list élaborée sur la base du guide national. Résultats: au total, 340 patientes ont été incluses avec un âge médian de 26 ans. Les antibiotiques les plus prescrits étaient les bêta-lactamines (principalement la ceftriaxone, 24,4%) suivis des nitroimidazolés (21,4%). Le taux de conformité globale aux recommandations était de 12,4%. Les principales non-conformités concernaient la durée du traitement (87,7%), la posologie (67,7%), le choix de la molécule (60,3%) et l'indication (45,7%). L'hospitalisation ressortait comme le facteur de risque majeur de non-conformité. Conclusion: le bon usage des antibiotiques demeure un défi majeur particulièrement dans les pays en voie de développement comme le Burkina Faso. Le taux élevé de non-conformité souligne la nécessité d'actions urgentes afin de renforcer la vulgarisation du guide, d'assurer une formation continue des prescripteurs et de mettre en place des audits réguliers.
