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Vector abundance and malaria transmission in rice-growing villages in Mali.

Anophelism without malaria has long been recognized. In large irrigation projects, such as that around Niono, Mali, villages in irrigated areas sometimes have more anopheline vectors of malaria than adjacent nonirrigated villages, but overall malaria prevalence is substantially less. One hypothesized explanation for this is high anopheline densities lead to smaller adults, who do not live so long and hence are less efficient at transmitting the disease. We analyzed serial collections from 18 villages in an irrigated area of Mali, measuring correlations between mosquito densities and survival rates, zoophilic rates, and vectorial capacity over the villages and times. Adult density was inversely related to anthropophily and adult survival and its relationship with vectorial capacity was positive at low mosquito densities, flat at intermediate densities, and negative at high densities. This may partly explain why malaria prevalence is low in irrigated villages with high Anopheles density.

Animals↗

[Implementation of the hypertension network in Mali (RHYTM)].

In view of the rising prevalence of arterial hypertension and its complications throughout sub-Saharan Africa including in rural areas, the Association of the Rural Doctors of Mali asked its NGO partner, Sant6 Sud, for assistance in setting up a medical network dedicated to hypertension. This report describes the implementation of the Mali Hypertension Network (French acronym, RHYTM) that involved three stages, i.e., physician training, development of appropriate protocols and field trials. The physician training stage was carried out over a one-week period and covered all the aspects of hypertension. In the second stage international guidelines were used as a basis for development of appropriate protocols for the rural setting. Field trials were conducted in the villages to verify the feasibility of the protocols and functionality of the network. Treatment of hypertension depends mainly on lifestyle and dietetic measures with emphasis on reducing salt intake. Drug treatment is based primarily on first-intention use of thiazidic diuretics. Management of this chronic pathology runs up against socio-cultural, economic and logistic obstacles. These problems are discussed and possible solutions are proposed. This preliminary experience will provide epidemiologic and clinical data on a sample population including more than 80000 people and explore the possibility of extending the network to other zones in this area of Africa.

Delivery of Health Care↗

Facies leprosa: resorption of maxillary anterior alveolar bone and the anterior nasal spine in patients with lepromatous leprosy in Mali.

Resorption of the anterior nasal spine and alveolar bone in the anterior maxilla was measured in 39 patients with lepromatous leprosy in Mali. Bone resorption occurred in both of these sites, but resorption in one did not predict resorption in the other. These data are interpreted to mean that resorptions of bone anterior (nasal spine) or inferior (alveolar bone) to bacillary populations in the nasal mucosa of patients with lepromatous disease in Mali occur independently.

Adolescent↗

[African histoplasmosis in Mali].

Twenty-four cases of histoplasmosis have been diagnosed since 1945 in native Malians (20 cases) or Europeans living in Mali (4 cases). Seventeen cases have already been published and 7 other cases diagnosed recently in Bamako or Marseille are reported here. Mali is within the African histoplasmosis zone and the Kayes district may be a particularly endemic zone. The disease affected the skin (62 p. 100), lymph nodes (46 p. 100), bones (21 p. 100), gastrointestinal tract (26 p. 100) and lungs (4 p. 100). A rare lesion of the uvula is also reported. Direct fungal and histopathological techniques are the easiest and the most effective diagnostic investigations. All cases were due to Histoplasma duboisii. Amphotericin B was used in over 60 p. 100 of cases for an average period of 3 months. The total recovery rate was 66 p. 100.

Adolescent↗

[Hemoglobin C in a hospital milieu in Bamako (Mali)].

An hospital survey, performed in Bamako (Mali, West Africa) showed 7.5% haemoglobin AC, 0.4% haemoglobin CC, 1.6% haemoglobin SC and 0.2% haemoglobin CA (haemoglobin C-beta+thalassaemia). Haemoglobin C was mostly prevalent among Bobo, Mossi, Senoufo, Minianka and Dogon coming from the Southern border of Mali. Haemoglobin SC and to a lesser extent haemoglobins CC and CA often induce haemolysis and vasoocclusion. Microcytosis is common, even in the absence of anaemia.

Adolescent↗

[Overview of dermatophytes in Mali].

517 isolations of dermatophytes collected in Mali are reported. The various species are described and the main findings are: --Trichophyton species are more common (85.5% isolated from scalp lesions and 77.5% from skin scrapings) than Microsporum species. --Trichophyton verrucosum and Microsporum canis have been found found for the first time in Mali. --Ill-defined clinical forms of scalp lesions caused by either T. schonleinii or T. soudanense occur in the subsaharian areas of the country.

Adult↗

[Estrus synchronization in cattle using chlormadinone acetate ("Bovisynchron" Jenapharm) in the tropics. 1. On the effect of blocking the cycle using chlormadinone acetate and on the introduction of this biotechnical method in the Republic of Mali].

The oestrus synchronization in cattle is being tested as a biotechnical method supporting the implementation of the crossing programme in the Republic of Mali Using the latest results of sexual physiology, the effect is described of Bovisynchron Jenapharm (chlormadinonacetate). Bovisynchron is characterised by a high certainty of synchronization and a good toleration. It leads to a highly fertile oestrus of all animals and to a high rate of conception. An analysis of the situation in the Republic of Mali is used to discuss the advantages of this method.

Animals↗

[Human brucellosis in Mali. Results of a seroepidemiological study].

Prevalence of human brucellosis was evaluated in three contrasted ecoclimatic zones with different peopling of Mali. Rose bengal plate agglutination tests were carried out on capillary blood microsamples taken from 2173 subjects and indirect immunofluorescence tests were performed on 148 blood samples collected on filter paper disks. These seroepidemiological studies demonstrate the presence of the anthropozoonosis in the entire country and the influence of ecoclimatic and demographic factors on human brucellosis distribution in Mali. The high prevalence (24.4%) found in the sahelian region of Gourma shows the necessity of a national control programme. A similar prevalence has been found in other countries of tropical Africa which were formerly considered as almost free of human brucellosis. The findings suggest that seroimmunological tests should be performed systematically to detect brucellosis in immigrants coming to Europe from tropical Africa as well as in Europeans who have been travelling or staying in this region.

Agglutination Tests↗

Are flaviviruses again active in Mali?

Using a hemagglutinating yellow fever antigen, a serologic investigation was done on 1237 blood samples collected between 1979 and 1983 in five regions of Mali. The results showed that the percentage of positive reactions (greater than 1:10) was higher in the sera of mothers than in their new borns (24.8 versus 12.4). In young children (6 months to 3 years old) the percentages of positive sera varied between 4.4 and 9.6. The values were much higher for persons between 15 to 70 years (28.3% to 43.7%). The presence of high antibody titers in sera of adults, the occurrence of seroconversion in young children (less than 1:10 to 1:40) are arguments for supposing that yellow fever virus or other flaviviruses were active in Mali in the period of our investigation.

Adolescent↗

[Therapeutic field trial with praziquantel in a rural population in Mali infected with Schistosoma mansoni (author's transl)].

89 people from 6 to 60 years old living in two villages in the valley of the Oyako near Bamako (Mali) infected with S. mansoni, were treated with a single dose of 40 mg/kg bwt. 2-cyclohexylcarbonyl-1,2,3,6,7,11b-hexahydro-4H-pyrazino [2,1-a]isoquinolin-4-one (praziquantel, EMBAY 8440, Biltricide). Side effects were recorded, a clinical and parasitological examination was effected 5 months later. If the results on efficacy can be confirmed, considering the ease of administration and the good acceptance by the patients praziquantel will be recommended for mass campaigns in Mali, where S. mansoni and especially S. haematobium are rapidly spreading following improvement of the water supply.

Adolescent↗

Influenza and corona-virus antibodies in the newborns and their mothers in Mali (1980).

In February 1980 blood samples from 91 women and their newborn babies (cord blood) from Mali have been analysed for influenza and corona OC 43 HI antibodies. The titers of influenza HI antibodies were higher in blood samples collected from the mothers at delivery than in their newborns. Considering the GMT values and percentage of persons with protective titers (greater than or equal to 1:40) we may assume that influenza A (H3N2) viruses had been highly active in Mali. Influenza A (H1N1) and B activity may be considered as minor. The prevalence of OC 43 coronaviruses HI antibodies was higher in the cord blood of the newborn babies (95%) than in the blood samples of their mothers (75%).

Antibodies, Viral↗

[Role of iron deficiency in anemia in pregnant women in Mali].

The epidemiological characteristics of iron deficiency anemia after radioimmunoassay of serum and erythrocyte ferritin were evaluated in 209 Malian women at the time of delivery in a maternity unit in Bamako, Mali. The incidence of iron deficiency anemia was high (36.8%). This incidence did not reflect socio-economic status, nor even any particular obstetric history, but was significantly higher in younger mothers (aged under 26). The severity of anemia was such that 2.4% of women would require a blood transfusion post-partum. It looks therefore desirable, in Mali, to screen routinely and to ensure the prevention of iron deficiency in adolescent girls and to include, in the prevention of anemia of pregnant women, routine iron supplements from the beginning of pregnancy.

Adolescent↗

[Epidemiology of trypanosomiasis caused by T. evansi in camels in mali: results of parasitological and clinical survey].

An epidemiological study of trypanosomiasis was conducted in the rearing areas of dromedary camels in Mali. According to the parasitological and clinical surveys performed, the overall infection rates were 9.5% (29/305) in Western Sahel (region I) and 4.5% (28/627) in the areas of Tombouctou and Gao (region II). The proportion of contaminated herds was 55% in region I and 68% in region II and in some herds the infection rate exceeded 50%. The surveys showed a trend for increasing parasitological prevalence with age. While it was almost nonexistent in young camels less than one year old, it increased with age and reached a maximum in 2 to 5-year old camels. The authors showed that the infection has a significantly negative effect on PCV and on the overall status of the animals, confirming the pathogenicity of Trypanosoma evansi in dromedary camels. This trypanosome is almost the only species detected in the dromedary camel in Mali and it does not seem to cause infections in other animals reared in the same environment.

Aging↗

Seasonal variations in energy balance among agriculturalists in central Mali: compromise or adaptation?

OBJECTIVE: This paper considers whether seasonal variations in the energy balance of adult agriculturalists in Central Mali exceed acceptable risk, or whether they represent a short-term adaptive response without functional consequence. DESIGN: Prospective/longitudinal study design. SETTING: Agricultural village in rural Mali. SUBJECTS: From a total population of 166 adults aged > or = 16 years, two cohorts of 63 men and 73 non-pregnant women with complete records were retained for analysis. INTERVENTIONS: Over a 12-month period, monthly anthropometry and biweekly retrospective assessments of morbidity were made on every adult in the sample. Direct measures of household food consumption were collected twice in harvest, dry and rainy seasons respectively. Continuous 15-h observations of time-use and work intensity were conducted on a sub-sample of active adults and used to calculate mean seasonal energy expenditure. RESULTS: Energy balance as measured by body mass index (BMI; kg/m2) declines significantly in the rainy season (P < 0.01), corresponding to a seasonal weight loss of 2-3 kg. A similar seasonal trend in % body fat (P < 0.0001) suggests that most of this loss represents adipose tissue. A rainy season increase in arm muscle area (AMA) implies that there is no seasonal compromise in lean tissue. Among men and women with BMI > 18.5, seasonal fat loss is significantly greater than their leaner counterparts. Considering the likely determinants of variations in energy balance, an increase in the duration and incidence of adult morbidity is observed; however, no significant intercorrelations exist between it and seasonal nutritional indices. Comparing trends in energy expenditure and intake, a disturbance in energy homeostasis is apparent as energy expenditure increases in the rainy season relative to constant household food consumption across seasons. While seasonal variations in energy expenditure are not as dramatic in the female sample, they appear to have less opportunity to recover from so-called 'heavy' levels of expenditure experienced in successive dry and rainy seasons. Periods of 'light' activity in both harvest and dry seasons provide the male sample with a reasonable length of time in which to reconstitute energy stores after the physical demands of the rainy season. CONCLUSIONS: In the year of study, the modest loss of body fat recorded in the rainy season (< 5% body mass) represents a successful physiological response to energy imbalance, and is unlikely to compromise adult productive and reproductive function.

Adaptation, Physiological↗

[Intratypical antigenic differentiation of poliovirus strains circulating in Mali by means of cross-adsorbed sera].

The intratypic antigenic differentiation of poliovirus strains isolated from sick or healthy children in Mali in 1975-1976 was performed. The method is based on the use of cross-adsorbed sera in the neutralization tests in which the virus is titrated by the plaque procedure or by the cytopathic effect. All the examined strains of serologic types I, II, and III were distinguished by the antigenic structure from the vaccine strains and were classified as "wild". Quantitative differences in the antigenic structure of type I strains isolated in different towns of Mali were found.

Adsorption↗

Schistosoma and geohelminth infections in Mali, west Africa.

We report on the prevalence of schistosomiasis and geohelminth infections in Mali, Central West Africa, based on data from the National Schistosomiasis Control Programme of Mali (1982-1991) and from our recent surveys (1992-1993). Combined national figures and regional data are presented from both surveys. Schistosomiasis showed an overall prevalence of 30.1%, with lowest prevalence in Sikasso Region and highest prevalence in Segou Region. Ascaris lumbricoïdes (0.12%) and Trichuris trichiura (0.42%) were comparatively rare, but hookworm infections were more widespread (8.0%). No hookworm infections were detected in the arid northern Region and the highest prevalence (18.7%) was encountered in the humid south of the country. There was a significant positive relationship between the prevalence of hookworm infection and total annual rainfall per region. Overall the prevalence of concurrent infections with schistosomes and hookworms was significantly less than expected, although there were regional differences which were discussed in the light of local variations in climatic and other factors likely to affect transmission.

Adolescent↗

The impact of a family planning multimedia campaign in Bamako, Mali.

An integrated multimedia campaign featuring family planning messages saturated the 900,000-person city of Bamako, Mali, for three months during the spring of 1993. With traditional theater and music, family planning messages were repeatedly broadcast on radio and television that conveyed information about modern contraceptive methods, the need for male sexual responsibility, the health and economic advantages of family planning, the need for communication between spouses, and that Islam, the predominant faith of Mali, does not oppose family planning. A separate sample pretest-post-test quasi-experimental research design was used to evaluate the effects of the campaign and exposure to specific messages on changes in contraceptive knowledge, attitudes, and practice. Results indicate a high level of exposure to and agreement with the messages. A dramatic drop was found in the proportion of men and women who believe that Islam opposes family planning. Logistic regression results indicate that contraceptive knowledge and use and more favorable attitudes toward family planning are positively associated with intensity of exposure to the project interventions, after controlling for relevant variables.

Adolescent↗

Quantification of the rice aroma compound, 2-acetyl-1-pyrroline, in uncooked Khao Dawk Mali 105 brown rice.

Volatile components of uncooked Khao Dawk Mali 105 brown rice were extracted using indirect steam distillation under reduced pressure and controlled temperature in order to prevent cooking. Analysis of the fresh extract by capillary gas chromatography-mass spectrometry revealed that there were >140 volatile constituents. Among these, 70 volatiles were identified, including 2-acetyl-1-pyrroline (2AP), a key aroma compound of cooked rice. Further study concentrated on an improved method for the quantification of 2AP in uncooked brown rice. The method was simplified by utilizing a solvent extraction procedure. Quantitative analysis was performed using a capillary gas chromatographic system employing a flame ionization detector with the aid of a more selective column, CP-Wax 51, for amines. This improved chromatographic system had remarkable detection sensitivity for 2AP in the rice extracts so that 2AP in an extract of only 0.5 g of uncooked Khao Dawk Mali 105 brown rice could be detected.

Capillary Action↗