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Biomedical subjects

M Kone

Publications and source records attributed to M Kone.

At least 19 recordsLinked to original sources

Confirmation of immunogenic consensus sequence HIV-1 T-cell epitopes in Bamako, Mali and Providence, Rhode Island.

The design of epitope-driven vaccines for HIV has been significantly hampered by concerns about conservation of vaccine epitopes across clades of HIV. In previous work, we have described a computer-driven method for a cross-clade HIV vaccine comprised of overlapping, highly conserved helper T-cell epitopes or "immunogenic consensus sequence epitopes" (ICS epitopes). Here, we evaluated and compared the immunogenicity of 20 ICS HIV epitopes in ELISpot assays performed using peripheral blood monocytes (PBMC) from HIV-infected donors in Providence, Rhode Island, USA and in Bamako, Mali, West Africa. Each core 9-mer HIV sequence contained in a given consensus peptide was conserved in at least 105 to as many as 2,250 individual HIV-1 strains. Nineteen of the 20 ICS epitopes (95%) were confirmed in ELISpot assays using PBMC obtained from 13 healthy, HIV-1 infected subjects in Providence, and thirteen of the epitopes (65%) were confirmed in ELISpot assays using PBMC derived from 42 discarded blood units obtained at the Central Blood Bank in Bamako. Twelve of the epitopes were confirmed in ELISpot assays performed both in Providence and Bamako. These data confirm the utility of bioinformatics tools to select and design novel vaccines containing "immunogenic consensus sequence" T-cell epitopes for a globally relevant vaccine against HIV; a similar approach may also be useful for any pathogen that exhibits high variability (influenza, HCV, or variola for example). An HIV vaccine containing these immunogenic consensus sequences is currently under development.

Amino Acid Sequence↗

[Evaluation of the therapeutic efficacy of amodiaquine versus chloroquine in the treatment of uncomplicated malaria in Abie, Côte-d'Ivoire].

The WHO 14-days' test and an in vitro survey were carried out to study the efficacy of amodiaquine versus chloroquine in Abie, a hyperendemic village in the southern forest area of Côte-d'Ivoire. One hundred and nineteen children less than 15 years old suffering from uncomplicated malaria were randomised. Among these, 62 were given amodiaquine treatment and 57 chloroquine treatment. both 4-aminoquinoleines were administered at the same dose of 30 mg/kg spread over three days by 10 mg/kg/day. Before the drug was administered, parasites were taken from some patients of each group and were evaluated in vitro to both drugs. In vivo, the amodiaquine treatment shows 95% of clinical success, 2% of early clinical failures and 3% of late clinical failures. For the chloroquine treatment, the rates are respectively. 79%, 7% and 14%. However, some patients still had a level of parasitaemia for both treatments but were asymptomatic. These parasites were found to be resistant in vitro. The authors recommend that the treatment to be used in Abie must be firstly amodiaquine followed by sulfadoxine-pyrimethamine in cases where there is persistent asymptomatic parasitemia.

Amodiaquine↗

The current status of onchocerciasis in the forest/savanna transition zone of Côte d'Ivoire.

Onchocerca volvulus exists in at least two strains in West Africa, while its black-fly vectors consist of sibling species, dwelling in the savanna and forest/transition zones. In transition and degraded forest zones both parasite strains and different sibling species of the vector can be sympatric. The strain of parasite in infected humans and in vector black-flies was determined in two bioclimes along the Bandama river of Côte d'Ivoire. The upper Bandama is located in the savanna bioclime while the Middle Bandama is located in a degraded forest zone. At both sites, savanna-dwelling sibling species of the Simulium damnosum sensu lato species complex predominated. The severe-strain of O. volvulus was the predominant strain at both sites. However, severe-strain parasites represented a significantly larger proportion of those found in the vector population than in the human population in the degraded forest of the Middle Bandama. These data suggest that in degraded forest areas recently invaded by savanna-dwelling species of S. damnosunz s.l. transmission of the severe-strain of the parasite might be more efficient than transmission of the mild-strain.

Animals↗

[Therapeutic efficiency of chloroquine in the savannah region in the north of Côte d'Ivoire (1997)].

We evaluated from August to December 1997 the therapeutic effect of chloroquine (CQ) in treatment of mild malaria. Five villages of the savannah area of Côte d'Ivoire were selected for this study In this area and season, the transmission of malaria is of hyper-endemic type. The 14-day protocol of WHO was used and all the patients were treated with CQ 25 mg/kg over three days. 360 febrile children between 6 and 83 months old out of 545 were selected, and 286 were fully followed. At the beginning of the study axillary temperatures and parasitemia showed no difference in the 5 villages. The average therapy failure rate was 11.5% (IC to 95%; 7.8-15.2) with a maximum of 18.5%. The failure rates estimated in the various villages showed a hardly significant difference (p = 0.05). In the North of Côte d'Ivoire, the good efficiency of CQ can be explained by the low drugs pressure related to the behaviour of populations who use traditional phytotherapy in first resort to treat the fevers.

Antimalarials↗

[In vivo evaluation of sulfadoxine-pyrimethamine efficacy during uncomplicated falciparum malaria in children of Yopougon (Abidjan, Côte d'Ivoire)].

The malaria, deadly parasite infection in its severe form, is widely spread in tropical zone where it rages in an endemic way. The emergence and the extension of Plasmodium resistance contributed to increase the morbidity and the mortality of this pathology in children under 5 years old. Facing the extend of this phenomenon, a monitoring of the expansion of the chemosensitivity proves to be necessary. The goal of the present study was to assess the sulfadoxine-pyrimethamine (S-P) efficacy according to the in vivo test WHO protocol of 14 days-follow-up. Children are treated to the S-P at the rate of 1/2 tablet per 10 kg of body weight in unique dose, then controls are done days 3, 7 and 14. At the end of this work, 179 on 475 subjects were effectively carriers of asexual parasites. So, the general plasmodic index and Plasmodium falciparum rate infection were respectively 37.7% and 100%. Among the 89 children followed until J14, those aged of 13 to 24 months represented 38% of the population of children suffering from Plasmodium malaria, against 7% of those aged between 49 and 59 months. In terms of therapeutic efficacy, 76.4% of adequate clinical and parasitological response (ACR) have been reached against 23.6% of therapeutic failure (TF).

Antimalarials↗

[Which medication should be used to treat uncomplicated malaria when chloroquine becomes ineffective in Western Côte d'Ivoire?].

Study of children treated for uncomplicated malaria in the sub-prefecture of Zouan Hounien in Western Côte d'Ivoire demonstrated that clinical failure rates (WHO 14-day test) were 43% for chloroquine and 6% for pyrimethamine-sulfadoxine (PS). Two issues raise serious doubts about the use of PS as a replacement for chloroquine. The first is detection of persistent asymptomatic parasitemia at day 7 in children treated with PS. The second is widespread use of one PS component (sulfadoxine) to prevent opportunistic infection in AIDS patients or to treat infection. Further study will be needed to evaluate the therapeutic and parasitological efficacy of amodiaquine in the region.

Antimalarials↗

[Comparative study of four malaria diagnostic techniques used in Ivory Coast].

The biological diagnosis of malaria plays an important part in the patients' treatment for malaria. Thus, many techniques have been developed to reach this purpose. We have compared four of them concerning 196 patients from October, 1996 to January, 1997 in Abidjan. Thick blood film has been chosen as the technique for reference. It has come out that the plasmodic index was 18.3%. The Plasmodium falciparum has been the only encountered species. The different sensitivities of the QBC test and of the Parasight F test reached 100% against 83.3% in the case of the thin blood film. The QBC test and the thin blood film had each a specificity of 100% against 88.1% for the Parasight F test. Unlike the QBC test, the thick blood film and the thin blood film have remained the most difficult to be realised. Therefore, the analysis of parameters of credibility (sensitivity, specificity), predictable values and the time involved will allow in a given situation to use the appropriate biological diagnosis technique.

Adolescent↗

[Clinical trial of amodiaquine in the community of Attécoubé (Abidjan, Côte d'Ivoire)(May-December 1955)].

A prospective study in the municipality of Attécoubé (Abidjan, Côte d'Ivoire) evaluated the sensitivity of P. falciparum to amodiaquine with a posology of 35 mg/kg over 3 days (1st day: 15 mg/kg; 2nd day: 10 mg/kg; 3rd day: 10 mg/kg) as well as its tolerance of this dosage. One hundred five WHO in vivo standard tests were performed over 7 days on subjects aged > 15 years from May to December 1995. The subjects were carriers of varying number of trophozoites: between 1000 to 34,000 trophozoites were recorded with a mean of 5193 trophozoites by microliter. We divided the subjects into two groups: group A with 43 patients to whom we administered medication and group B with 62 subjects who took their medication on their own. Clinical and parasitological verifications were made on D0, D2 and D7. Biological verification was conducted for 31 subjects of group A by mean of SGOT and SGPT quantity determination on D0 and D2. This survey revealed that 1.9% of P. falciparum malaria patients had precocious therapeutic failure to amodiaquine (35 mg/kg over 3 days) in this area. Clinical and biological tolerance was good and there was no difference between the two groups. We suggest that amodiaquine might be used for uncomplicated malaria at first intention in Abidjan.

Adolescent↗

[Profile of intestinal helminthiases in school aged children in the city of Abidjan].

Feces of 1001 school children aged from 4 to 15 years were examined as an epidemiological investigation. Direct analyses were completed by KATO and RITCHIE methods. The outcome was the global prevalence of intestinal helminthiasis in school age children in the Abidjan area is 36.5%. Male subjects are more infected than females. The most infected group is aged from 12 to 13 years and the less infected from 4 to 5 years. The frequent parasite species are Trichuris trichiura (23.4%), Ascaris lumbricoides (15.5%), Necator americanus (6.3%), Strongyloides stercoralis (1.4%). Hymenolepis nana (1.1%), Schistosoma mansoni (0.8%) and Enterobius vermicularis (0.2%).

Adolescent↗

[Redistribution of glossina in a forest area of Ivory Coast?].

Historically the region of Abengourou is a well-known of sleeping sickness in the forest area of Cote d'Ivoire. However data from epidemiologic studies carried out since 1980 show that this area is currently disease-free. This finding warrants study of glossina vectors to clarify the epidemiology of the disease in this area. Entomologic surveys were carried out over a period of one year. Traps were used to capture glossina in ten natural habitats: villages with or without pigs, coffee, cocoa and rice plantations, grazing lands, camping areas, uncultivated farmlands, trails, forest borderlands and wilderness. Findings documented almost total disappearance of zoophilic glossina (Glossina nigrofusca and Glossina pallicera) which accounted for less than 0.5% of glossina captured only during the rainy season. The apparent trap density (ATD) of Glossina palpalis, the main vector of disease, was low overall. However ATD values tended to be higher in villages with pigs (ATD : 2.07 glossina/trap/day) and forest borderlands (ATD : 2.63 glossina/trap/day) than in other habitants where values were always lower than 1 glossina/trap/day. This almost complete disappearance of Glossina palpalis can be attributed mainly to deforestation in most of the areas studied. This accounts for reduced contact with man. The absence of contact between man and anthropophilic glossins could explain that unlike Daloa and Vavoua sleeping sickness has disappeared from the region of Abengourou.

Animals↗

In vitro antimalarial activity of vegetal extracts used in West African traditional medicine.

Among strategies for the development of new antimalarials, a study of plants traditionally used in Africa against malaria has been pursued. Extracts obtained from the plants Azadirachta indica, Cinnamonum camphora, Lippia multiflora, Vernonia colorata, Guiera senegalensis, Combretum micranthum, and Ximenia americana, commonly used in Cote d'Ivoire by native healers for the treatment of malaria, were tested on two strains of Plasmodium falciparum: FcB1-Colombia (chloroquine-resistant) and F32-Tanzania (chloroquine-sensitive). Extracts were obtained after infusion and decoction, both techniques being used by most native healers. The antimalarial activities of the extracts were tested first by parasite 3H-hypoxanthine incorporation and second by visual evaluation of the activities of plant extracts on thin blood smears, which also permitted the determination of parasitic stages and parasite alteration. Among the seven plants tested, some had an apparent inhibitory effect on P. falciparum growth in vitro, while other seemed to be less efficient.

Animals↗

[Cryptosporidiosis and HIV in Abidjan (Ivory Coast)].

A coprological study realized with 217 HIV adult subjects has allowed to evaluate the frequency of the cryptosporidiosis during this affection in Abidjan. Cryptosporidium sp. has been found in 8.7% of the subjects. Otherwise 78.9% of the patients had a chronic diarrhoea. 89.4% showed an abdominal pain and were dehydrated 94.7% had lost weight and 21% had nausea or vomiting.

Acquired Immunodeficiency Syndrome↗

[Cryptosporidiosis in Ivorian children form Yopougon].

Coprological survey involving 250 ivorian children with diarrhoea was done to evaluate the incidence of cryptosporidiosis. Crypstosporidium sp. was found in 10.4% of subjects. 76.9, 57.7 and 19.2% Cryptosporidium positive children had profuse diarrhoea, fever and pulmonary symptoms respectively. In Ivory Coast, children diarrhoeas due to cryptosporidiosis are quantitatively important.

Cote d'Ivoire↗

[Primary adenocarcinoma of the fallopian tube. Retrospective study of 16 cases. Prognostic factors].

The authors report the result of a study carried out on 16 cases of tubal adenocarcinoma treated between the years 1975 and 1988. This is a rare gynaecological cancer with a poor prognosis. The mean age of the patients was 57 years, 64.5% of them were menopausal. 25% had had a history of sterility. 29% were nulliparous and 37.5% had previous salpingitis. In 44% of cases the principal clinical signs were a watery discharge and a blood stained discharge. Pelvic pain occurred in 37% of the cases and CT scan showed a pelvic mass in 50% of cases. Hysterosalpingography and ultrasound were two complimentary investigations. The relatively early stage at which first signs of the condition were noted, show the stages of the disease: stage I 68.7%, stage II 25%, stage III 6.2%, stage IV 0%. Surgery above all was the basis of treatment carried out in all cases, and supplemented in 15 out of the 16 cases by added treatment (radiotherapy, chemotherapy of hormone therapy). As far as histology was concerned, well or moderately well differentiated forms were found to predominate (there were 37.5% grade I and 37.5% grade II) against only 26% for grade III. More than half of the tube wall was infiltrated in 50% of cases. The actuarial survival rate after 5 years was 33%. The authors examine the principal factors responsible for the prognosis, the tissue, the early diagnosis and the possibility of removing the tumour completely at the first operation as well as the histological grading and above all the degree of depth of infiltration of the wall of the tube.

Adenocarcinoma↗

[Spontaneous rupture of the membranes before 28 weeks of amenorrhea. Obstetrical and perinatal outcome. Apropos of 28 cases].

The authors studied the outcome of pregnancies after spontaneous rupture of the membranes before 28 weeks of amenorrhoea in a series of 28 women. The mean time of the rupture was at 25 1/2 weeks. The duration of the time of rupture was a mean of 10 days and deliveries occurred between the 19th and the 32nd weeks. In 5 cases with an average term of 22 1/2 weeks the pregnancy was terminated. Caesarean operation was carried out in 4 cases and spontaneous vaginal delivery occurred between the 26th and 30th weeks of amenorrhoea in 19 cases. Chorio-amnionitis was the most common maternal complication (32.1%). Maternal morbidity was high (82%) without important sequelae. Thirty infants were born out of these 28 pregnancies (two sets of twins). 33% of the infants were stillborn, 46.6% died in the neonatal period, all of these from respiratory complications. 20% of the children are still alive, and all of these weighed at least 1,000 grams and were born after 28 weeks. A child that was born at 27 weeks amenorrhoea has serious neurological deficits. Having studied the bibliography on the subject and their own personal experience the authors suggest a routine to carry out in these cases. Although the prognosis is poor, the totality of these factors could encourage obstetrical teams to be conservative so long as they watch very carefully under well defined conditions.

Adolescent↗

[In-vivo evaluation of Plasmodium falciparum sensitivity to chloroquine in Abidjan].

In vivo tests of Plasmodium falciparum chloroquine sensitivity were conducted in October and November, 1988 with 81 children aged 5 to 9 in several districts of Abidjan, Ivory Coast. The WHO standard scheme covering 7 days on basis of 25 mg per kilo spread over 3 days resulted in a therapeutic failure in 29.6 per cent cases. Nevertheless, a drop in overall parasitemia by over 80 per cent was noted from Day-0 to Day-2 in 70 per cent of visible resistance. Only in vivo tests conducted at a later stage with identification of chloroquine in the blood stream, with together in vitro studies will make it possible to know the actual level of resistance of Plasmodium falciparum strains to chloroquine.

Animals↗

[Epithelial cancer of the ovary in adults: prognostic and therapeutic study of 95 cases].

The authors report 95 cases of ovarian carcinoma treated between 1st January 1975 and December 1986 in the department of gynecology and radiotherapy of hospital Bretonneau in Tours. The overall actuarial 5-year survival was 37.5%, for stage I 100%, stage II 51%, stage III 36%, stage IV 5%, grade I 88%, grade II 51%, grade III 18%. The authors stress the prognostic importance of histologic grade and the bad prognosis of small cell ovarian carcinoma with hypercalcemia. The authors propose a therapeutic attitude based on the results and a review of the literature.

Actuarial Analysis↗