BACKGROUND & AIMS: :Mosquito net ownership is rising in sub-Saharan Africa but will substantially reduce malaria only if nets are used and the most vulnerable household members sleep under them. We used data from 9 large-scale household surveys conducted in 6 African countries from 2000 to 2004 that enumerated all household members and nets owned, analyzing only net-owning households. Across countries, women of reproductive age and children under 5 (without gender bias) were most likely to use the net; least likely were children of age 5-14 and adult males. Nets commonly covered 2-3 people. If a baby net was used, fewer people used the family net. Pregnant women were more likely to use a net in 2004 than in 2000. In several countries, a sizable minority of nets owned were not used. Understanding intra-household net-use patterns helps malaria control programs more effectively direct their efforts to increase their public health impact.

背景与目标： : 在撒哈拉以南非洲，蚊帐的拥有量正在增加，但只有使用蚊帐并且最脆弱的家庭成员睡在蚊帐下，蚊帐的拥有量才会大大减少疟疾。我们使用了在6个非洲国家2000年2004年进行的9次大规模家庭调查的数据，这些数据列举了所有家庭成员和拥有的网，仅分析了拥有网的家庭。在各国，育龄妇女和5岁以下儿童 (无性别偏见) 最有可能使用网络; 5-14岁的儿童和成年男性的可能性最小。蚊帐通常覆盖2-3人。如果使用婴儿网，使用家庭网的人就会减少。孕妇比2000年更有可能使用净2004年。在一些国家，没有使用相当少的蚊帐。了解家庭内部净使用模式有助于疟疾控制计划更有效地指导其努力，以增加其对公共卫生的影响。

BACKGROUND & AIMS: Abstract: Background:Mali is currently in the midst of ongoing conflicts which involve jihadist groups, rebels, and the state. This conflict has primarily centered in the North of the country. Humanitarian actors delivering services in these geographies must navigate the complex environment created by conflict. This study aimed to understand how humanitarian actors make decisions around health service delivery within this context. Methods:The current case-study utilized a mixed methods approach and focused on Mopti, Mali's fifth administrative region and fourth largest in population. Latent content analysis was used to analyze interview transcripts guided by our research objectives and new concepts as they emerged. Indicators of coverage of health interventions in the area of maternal and child health and nutrition were compiled using Mali's National Evaluation Platform and are presented for the conflict and non-conflict regions. Development assistance estimates for Mali by year were obtained from the Developmental Assistance for Health Database compiled by the Institute for Health Metrics and Evaluation. Administrative data was compiled from the annual reports of Mali's Système Local d'Information Sanitaire (SLIS), Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS). Results:Our data suggests that the reaction of the funding mechanisms to the conflict in Mali was a major barrier to timely delivery of health services to populations in need and the nature of the conflict is likely a key modifier of such reaction patterns. Concerns have been raised about the disconnect between the very high administrative capacity of large NGOs that control the work, and the consequent burden it puts on local NGOs. Population displacement and inaccurate estimates of needs made it difficult for organizations to plan program services. Moreover, actors delivering services to populations in need had to navigate an unpredictable context and numerous security threats. Conclusions:Our study highlights the need for a more flexible funding and management mechanism that can better respond to concerns and issues arising at a local level. As the conflict in Mali continues to worsen, there is an urgent need to improve service delivery to conflict-affected populations.

背景与目标：

BACKGROUND & AIMS: :On 16 September 2016, the World Health Organization confirmed a Rift Valley fever (RVF) outbreak in Niger. Epidemiological surveillance was reinforced among the French Armed Forces deployed in Niger and bordering countries: Chad, Mali and Burkina Faso. On 26 October, a probable case of RVF was reported in a service member sampled in Mali 3 weeks earlier. At the time the result was reported, the patient was on vacation on Martinique. An epidemiological investigation was conducted to confirm this case and identify other cases. Finally, the case was not confirmed, but three suspected cases of RVF were confirmed using serological and molecular testing. RVF viral RNA was detectable in whole blood for 57 and 67 days after onset of symptoms for two cases, although it was absent from plasma and serum. At the time of diagnosis, these cases had already returned from Mali to Europe. The infectivity of other arboviruses in whole blood has already been highlighted. That RVF virus has been detected in whole blood that long after the onset of symptoms (67 days) raises the question of its potential prolonged infectivity. Because of exposure to tropical infectious diseases during deployment, military populations could import emerging pathogens to Europe.

背景与目标： : 2016年9月16日，世界卫生组织确认尼日尔爆发裂谷发热 (RVF)。在部署在尼日尔和邻国乍得，马里和布基纳法索的法国武装部队中加强了流行病学监测。10月26日，3周前在马里抽样的一名服务人员报告了可能的RVF病例。报告结果时，患者正在马提尼克岛度假。进行了流行病学调查，以确认该病例并确定其他病例。最后，该病例没有得到证实，但使用血清学和分子检测证实了三个疑似病例的RVF。尽管有两例患者在出现症状后57天和67天的全血中可检测到RVF病毒RNA，尽管血浆和血清中没有RVF病毒RNA。在诊断时，这些病例已经从马里返回欧洲。其他虫媒病毒在全血中的传染性已经得到强调。在症状发作后很长时间 (67天) 在全血中检测到RVF病毒，这引发了其潜在的长期传染性的问题。由于在部署过程中暴露于热带传染病，军事人口可以将新兴病原体进口到欧洲。

BACKGROUND & AIMS: :Humanitarian plastic surgery missions are often a substitute, as plastic surgery training missions are essential for the development of plastic surgery in developing countries. This training must be progressive and adapted to the country's needs. Several simple plastic surgery techniques are sufficient to treat a large number of patients: split-skin grafts, full-thickness skin grafts, Z-plasties, latissimus dorsi myocutaneous pedicle flap.

背景与目标： : 人道主义整形外科任务通常可以替代，因为整形外科培训任务对于发展中国家整形外科的发展至关重要。这种培训必须是渐进的，并适应国家的需要。几种简单的整形外科技术足以治疗大量患者: 皮肤裂移植物，全厚皮肤移植物，Z形成形术，背阔肌肌蒂皮瓣。

BACKGROUND & AIMS: :The objective of this study was to use statistically based experimental designs for the optimization of xylanase production from Alternaria mali ND-16. Ten components in the medium were screened for nutritional requirements. Three nutritional components, including NH(4)Cl, urea, and MgSO(4), were identified to significantly affect the xylanase production by using the Plackett-Burman experimental design. These three major components were subsequently optimized using the Doehlert experimental design. By using response surface methodology and canonical analysis, the optimal concentrations for xylanase production were: NH(4)Cl 11.34 g L(-1), urea 1.26 g L(-1), and MgSO(4) 0.98 g L(-1). Under these optimal conditions, the xylanase activity from A. mali ND-16 reached 30.35 U mL(-1). Verification of the optimization showed that xylanase production of 31.26 U mL(-1) was achieved.

背景与目标： : 这项研究的目的是使用基于统计的实验设计来优化马里链格孢ND-16的木聚糖酶生产。筛选了培养基中的10种成分的营养需求。通过使用Plackett-Burman实验设计，鉴定出三种营养成分，包括NH(4)Cl，尿素和MgSO(4)，可显着影响木聚糖酶的产生。随后使用Doehlert实验设计对这三个主要组件进行了优化。通过使用响应面方法和规范分析，木聚糖酶生产的最佳浓度为: NH(4)Cl 11.34g L(-1)，尿素1.26g L(-1) 和MgSO(4) 0.98g L(-1)。在这些最佳条件下，来自A. mali的木聚糖酶活性ND-16达到30.35 U mL(-1)。优化的验证表明，木聚糖酶的产量达到31.26 U mL(-1)。

BACKGROUND & AIMS: OBJECTIVES:To assess vitamin A supplementation (VAS) coverage of children aged 6-59 months and the factors that favour or limit this coverage during the National Nutrition Weeks in Mali. DESIGN:Cross-sectional study. Interviews about demographic factors and children's adherence to the vitamin A capsule distribution programme were conducted. Professionals' knowledge of vitamin A and various aspects related to the supplementation strategy were assessed. SETTING:Five regions out of the eight regions in the country, in addition to Bamako District. Three rural communes were selected in three regions to represent rural areas. SUBJECTS:Parents or caregivers of children under 5 years of age, health agents who participated in the weeks, and community and administrative leaders. RESULTS:At least 80% of the children received the supplement. More 'traditional' communication channels (town criers, friends and family members) appeared to be more effective in reaching the target groups than modern methods, i.e. radio and television. Mothers' possession of a radio (Pearson chi2 = 5.03; P = 0.025) and fathers' education (Pearson chi2 = 19.02; P < 0.001), possession of a radio (Pearson chi2 = 8.93; P = 0.003) and listening to it (Pearson chi2 = 7.62; P = 0.006) all appeared to be statistically and significantly associated with children's coverage. In multivariate logistic regression analysis, only the study site (urban/rural) (P = 0.004), 'traditional channels' (P = 0.02) and fathers' education (P = 0.04) were significantly associated with children's coverage. Knowledge about VAS was high among community and administrative leaders, and health professionals. The planning and implementation of activities at the district level were found to be good in general. CONCLUSION:National Nutrition Weeks provide a successful example of a periodic VAS strategy with high coverage among children aged 6-59 months in Mali. Campaigns aimed at informing and sensitising populations during the Nutrition Weeks should also target children's fathers.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:Scale-up of prevention of mother-to-child transmission (PMTCT) of HIV programmes in sub-Saharan Africa has stimulated interest to assess whether these programmes can indirectly affect other health priorities. This study assesses whether PMTCT programmes, or components of these programmes, are associated with better obstetrical quality of care and how PMTCT may reinforce existing maternal health programmes. DESIGN:Cross-sectional analysis of data from a cluster-randomized trial called QUARITE. SETTING:Mali and Senegal, West Africa. PARTICIPANTS:Thirty-one referral hospitals and 612 obstetrical patients. INTERVENTION:The exposure of interest was PMTCT measured with a scale containing 10 components describing different prongs of a hospital PMTCT programme. Other variables of interest included: presence of a quality of care improvement programme, hospital resources and patient demographic characteristics. MAIN OUTCOME MEASURE:Obstetrical quality of care measured through a validated chart abstraction tool. RESULTS:Of 45 points, the mean hospital PMTCT score was 26.1 (SD: 6.7). Total PMTCT score was not significantly associated with quality of care, but programme component scores were. After adjustment for known predictors of quality of care, staff training in PMTCT (P = 0.03) and complementary nutritional services (P = 0.03) were significantly associated with better quality obstetrical care. A point increase in scores for either of these components was associated with 40% greater odds of good obstetrical care. CONCLUSIONS:PMTCT training and nutritional components are significantly associated with better quality intrapartum care. Health professionals' training in maternal healthcare and PMTCT could be combined to improve the quality of obstetric care in the region.

背景与目标：

BACKGROUND & AIMS: In Africa the highest HIV infection rate has been reported among female commercial sex workers (CSWs) who are at increasing risk of acquiring and transmitting HIV infection. In October 1995, 176 CSWs were studied in Bamako, the capital city of Mali. The ages of the CSWs ranged from 15 to 50 years old (mean, 28.8 years). Only 20.45% of the 176 CSWs were Malian; the majority were from Nigeria (32.9%) and Ghana (31.8%), and the remaining were from other African countries. Forty-one percent were active for less than 1 year as a commercial sex worker, and the length of prostitution for the remaining women ranged from 1 to 15 years (mean, 2.76). A total of 81 (46.02%) of the 176 CSWs were positive for HIV antibodies; 63 (35.8%) were HIV-1 positive, (3.9%) were HIV-2 positive, 11 (6.2%) had antibodies to HIV-1 and HIV-2, and none of them had antibodies to group O viruses. For all HIV antibody-positive samples, PBMCs were separated and genetic subtypes of HIV-1 were determined using the heteroduplex mobility assay (HMA), with ED5-ED12 as outer and ES7-ES8 as inner primers. Among the 66 HIV-1 strains characterized, 53 (80.3%) were subtype A, 2 (3.1%) belonged to subtype C, 1 (1.5%) belonged to subtype D, and 10 (15.1%) were identified as subtype G. Among the 10 subtype G strains, 8 were obtained from women who were very recent CSWs, with an activity of 1 year or less, assuming that there is a high probability that these infections occurred recently. Genetic subtypes of five HIV-2 viruses were determined by sequencing of the env and/or gag genes followed by phylogenetic analysis, and all of them belonged to subtype A. Comparison of HIV-1 and HIV-2 seroprevalence data from our study with previous data from Mali shows a significant rise in HIV-1 prevalence and a significant decrease in HIV-2 prevalence and confirms similar trends observed in neighboring countries. We have found four different genetic subtypes of HIV-1; however, subtype A is predominant and accounts for 80% of the cases and 15% of the HIV-1 infections were subtype G. It is important to continue the surveillance of subtypes on a systematic basis in order to see to what extent the proportions of the different subtypes will change over time.

The genetic variability of HIV-1 was investigated in a 1995 study of 176 commercial sex workers (CSWs) recruited in different areas in Bamako, Mali. 36 CSWs (20.45%) were born in Mali; 58 (32.9%) were from Nigeria and 56 (31.8%) were from Ghana. They ranged in age from 15-50 years (mean, 28.8 years). 41% of sex workers had been active for less than 12 months; the remaining women had been CSWs for 1-15 years (mean, 2.76 years). Of the 81 CSWs (46.02%) who were HIV-positive, 63 (35.8%) were infected with HIV-1, 7 (3.9%) with HIV-2, and the remaining 11 (6.2%) had antibodies to both HIV-1 and HIV-2. In contrast to other studies conducted among CSWs in Africa, none of these sex workers had antibodies to group O viruses. HIV-1 prevalence increased with age and length of time in prostitution and was higher among women with a history of sexually transmitted diseases. Among the 66 HIV-1 strains characterized, 53 (80.3%) were subtype A, 2 (3.1%) belonged to subtype C, 1 (1.5%) belonged to subtype D, and 10 (15.1%) were identified as subtype G. These results indicate a significant rise in HIV-1 prevalence and significant decreases in HIV-2 and combined HIV-1 and HIV-2 prevalence (10%, 15%, and 13%, respectively, in 1985). Ongoing surveillance of HIV-1 subtypes in Africa is important to identify shifts in the proportions of different subtypes over time. The genetic diversity of HIV has important implications for vaccine development.

背景与目标： 据报道，在非洲，女性商业性工作者 (csw) 中艾滋病毒感染率最高，她们感染和传播艾滋病毒的风险越来越大。1995年10月，在马里首都巴马科研究了176名csw。Csw的年龄范围为15至50岁 (平均28.8岁)。176的csw中只有20.45% 是马里人; 大多数来自尼日利亚 (32.9%) 和加纳 (31.8%)，其余来自其他非洲国家。40名1% 作为商业性工作者活跃的时间不到1年，其余妇女的卖淫时间为1至15年 (平均2.76年)。176例csw中共有81例 (46.02% 例) HIV抗体呈阳性; 63例 (35.8% 例) HIV-1阳性，(3.9% 例) HIV-2阳性，11例 (6.2% 例) 具有HIV-1和HIV-2抗体，并且它们都没有O组病毒的抗体。对于所有HIV抗体阳性样品，使用异双链迁移率测定 (HMA) 分离pbmc并确定HIV-1的遗传亚型，其中ED5-ED12为外部引物，ES7-ES8为内部引物。在表征的66个HIV-1菌株中，A亚型53个 (80.3%)，C亚型2个 (3.1%)，D亚型1个 (1.5%)，G亚型10个 (15.1%)。在10个亚型G菌株中，有8个是从最近的csw妇女中获得的，活性为1年或更短，假设这些感染最近发生的可能性很高。通过对env和/或gag基因进行测序，然后进行系统发育分析，确定了5种HIV-2病毒的遗传亚型，它们均属于A亚型。我们研究的HIV-1和HIV-2血清阳性率数据与马里以前的数据的比较表明，HIV-1患病率显着上升，HIV-2患病率显着下降，并证实了在邻国观察到的类似趋势。我们发现了四种不同的HIV-1遗传亚型; 然而，A亚型占主导地位，占80% 例，HIV-1感染中有15% 例是G亚型。重要的是要在系统的基础上继续监测亚型，以了解不同亚型的比例将在多大程度上随着时间的推移而变化。
HIV-1的遗传变异性在一项针对不同地区招募的176名商业性工作者 (csw) 的1995研究中进行了调查在巴马科，马里。36名csw (20.45% 名) 出生在马里; 58 (32.9%) 来自尼日利亚，56 (31.8%) 来自加纳。他们的年龄范围为15-50岁 (平均28.8岁)。41% 性工作者的活动时间不到12个月; 其余妇女从事csw工作1-15年 (平均2.76年)。在81名HIV阳性的csw (46.02% 名) 中，有63名 (35.8% 名) 感染了HIV-1，7名 (3.9% 名) 感染了HIV-2，其余11名 (6.2% 名) 具有HIV-1和HIV-2抗体。与在非洲的csw中进行的其他研究相反，这些性工作者都没有O组病毒的抗体。HIV-1患病率随着卖淫的年龄和时间长短而增加，有性传播疾病史的妇女患病率更高。在表征的66个HIV-1菌株中，A亚型53个 (80.3%)，C亚型2个 (3.1%)，D亚型1个 (1.5%)，G亚型10个 (15.1%)。这些结果表明HIV-1患病率显着上升，HIV-2以及HIV-1和HIV-2综合患病率显着下降 (1985年分别为10% 、15% 和13%)。对非洲HIV-1亚型的持续监测对于确定不同亚型比例随时间的变化非常重要。HIV的遗传多样性对疫苗开发具有重要意义。

BACKGROUND & AIMS: :The genus Agrilus comprises diverse exotic and agriculturally important wood-boring insects that have evolved efficient digestive systems. Agrilus mali Matsumara, an invasive insect, is causing extensive mortality to endangered wild apple trees in Tianshan. In this study, we present an in-depth characterization of the gut microbiota of A. mali based on high-throughput sequencing of the 16S rRNA gene and report the presence of lignocellulose-degrading bacteria. Thirty-nine operational taxonomic units (OTUs) were characterized from the larval gut. OTUs represented 6 phyla, 10 classes, 16 orders, 20 families, and 20 genera. The majority of bacterial OTUs belonged to the order Enterobacteriales which was the most abundant taxa in the larval gut. Cultivable bacteria revealed 9 OTUs that all belonged to Gammaproteobacteria. Subsequently, we examined the breakdown of plant cell-wall compounds by bacterial isolates. Among the isolates, the highest efficiency was observed in Pantoea sp., which was able to synthesize four out of the six enzymes (cellulase, cellobiase, β-xylanase, and β-gluconase) responsible for plant-cell wall degradation. One isolate identified as Pseudomonas orientalis exhibited lignin peroxidase activity. Our study provides the first characterization of the gut microbial diversity of A. mali larvae and shows that some cultivable bacteria play a significant role in the digestive tracts of larvae by providing nutritional needs.

背景与目标： : Agrilus属包括多种外来和农业上重要的枯木昆虫，它们已经进化出有效的消化系统。入侵昆虫Agrilus mali Matsumara正在导致天山濒临灭绝的野生苹果树大量死亡。在这项研究中，我们基于16S rRNA基因的高通量测序，对马里A的肠道菌群进行了深入表征，并报告了降解木质纤维素的细菌的存在。从幼虫肠道中鉴定了39个操作分类单位 (otu)。OTUs代表6个门，10个纲，16个目，20个科和20个属。大多数细菌OTUs属于肠杆菌目，肠杆菌目是幼虫肠道中最丰富的分类单元。可培养的细菌揭示了9个OTUs，全部属于Gammaproteobacteria。随后，我们检查了细菌分离株对植物细胞壁化合物的分解。在分离株中，在Pantoea sp。中观察到最高的效率，它能够合成六种负责植物细胞壁降解的酶 (纤维素酶，纤维二糖酶，β-木聚糖酶和 β-葡糖酶) 中的四种。一种鉴定为东方假单胞菌的分离株表现出木质素过氧化物酶活性。我们的研究首次提供了马里A幼虫肠道微生物多样性的特征，并表明某些可培养的细菌通过提供营养需求在幼虫的消化道中起着重要作用。

BACKGROUND & AIMS: BACKGROUND:The acceptability and efficacy of a new kit with a new formulation of quinine alkaloids designed for the intra-rectal administration in the treatment of non-per os malaria was assessed in the peripheral health care system of Mopti, Mali. METHODS:A single-arm trial was conducted from August 2003 to January 2004. An initial dose of diluted quinine alkaloids (20 mg/kg Quinimax) was administered by the intra-rectal route to children with presumptive non per-os malaria at six peripheral heath care centres. The children were then referred to two referral hospitals where standard inpatient care including intravenous route were routinely provided. A malaria thick smear was done at inclusion and a second malaria thick smear after arrival at the referral facility, where a more complete clinical examination and laboratory testing was done to confirm diagnosis. Confirmed cases of severe malaria or others diseases were treated according to national treatment guidelines. Cases of non per-os malaria received a second dose of intra rectal quinine alkaloids. Primary outcome was acceptability of the intra rectal route by children and their parents as well as the ease to handle the kit by health care workers. RESULTS:The study included 134 children with a median age of 33 months and 53.7% were male. Most of the children (67%) and 92% of parents or guardians readily accepted the intra-rectal route; 84% of health care workers found the kit easy to use. At the peripheral health care centres, 32% of children had a coma score < or = 3 and this was reduced to 10% at the referral hospital, following one dose of intra-rectal quinine alkaloids (IRQA). The mean time to availability of oral route treatment was 1.8 +/- 1.1 days. Overall, 73% of cases were confirmed severe malaria and for those the case fatality rate was 7.2%. CONCLUSION:IRQA was well accepted by children, their parents/guardians and by the health workers at peripheral health facilities in Mopti, Mali. There was also a quick recovery from deep coma and a reduced case fatality rate in severe malaria.

背景与目标：

BACKGROUND & AIMS: :At the end of 10 years' existence, the community health centres of Mali show a way of organisation which meets the public health requirements and demands of financial viability of any health establishment. Their originality lays in several factors: their legal personality, their private status, their financial support of the medical staff, their management by a users association and the public utilities agreement they have signed with the department. In spite of their success which makes their numbers reach 350, they suffer from great deficiencies, which are resulted by the lack of democratic traditions within the associations, a inappropriate transparency of their accounts and an inefficient supervision from the part of the department. The main questions posed by this new experience concern the limits of the concept of community, the importance of citizenship in the development dynamics, the participation of private institutions in the accomplishment of public utilities, the jacobin and authoritarian attitude of the department representatives, the contradictions between multiplication of centres to improve geographic access and the requirements of financial viability.

背景与目标： : 在10年的存在结束时，马里的社区卫生中心展示了一种组织方式，可以满足公共卫生要求和任何卫生机构的财务可行性要求。他们的独创性有几个因素: 他们的法人资格、他们的私人地位、他们对医务人员的财政支持、他们由用户协会管理以及他们与该部门签署的公共事业协议。尽管他们的成功使他们的人数达到350，但他们仍有很大的缺陷，这是由于协会内部缺乏民主传统，其帐户的不适当透明度以及新闻部的监督效率低下所致。这一新经验提出的主要问题涉及社区概念的局限性，公民身份在发展动态中的重要性，私营机构参与公共事业的完成，部门代表的雅各宾和专制态度，增加中心以改善地理通道与财务可行性要求之间的矛盾。

BACKGROUND & AIMS: BACKGROUND:We assessed a nutritional support intervention in malnourished HIV-infected children in a HIV-care program of the University Hospital Gabriel Touré, Bamako, Mali. METHODS:All HIV-infected children younger than 15 years were diagnosed for malnutrition between 07 and 12, 2014. Malnutrition was defined according to the WHO growth standards with Z-scores. Two types were studied: acute malnutrition (AM) and chronic malnutrition (CM). All participants were enrolled in a 6-month prospective interventional cohort, receiving Ready-To-Use Therapeutic Food, according to type of malnutrition. The nutritional intervention was offered until child growth reached -1.5 SD threshold. Six-month probability to catch up growth (>-2 SD) was assessed for AM using Kaplan-Meier curves and Cox model. RESULTS:Among the 348 children screened, 198 (57%) were malnourished of whom 158 (80%) children were included: 97 (61%) for AM (35 with associated CM) and 61 (39%) with CM. Fifty-nine percent were boys, 97% were on antiretroviral therapy, median age was 9.5 years (Interquartile Range: 6.7-12.3). Among children with AM, 74% catch-up their growth at 6-month; probability to catch-up growth was greater for those without associated CM (adjusted Hazard Ratio = 1.97, CI 95%: 1.13 to 3.44). Anemia decreased significantly from 40% to 12% at the end of intervention (P < 0.001). CONCLUSIONS:This macronutrient intervention showed 6-month benefits for weight gain and reduced anemia among these children mainly on antiretroviral therapy for years and aged greater than 5 years at inclusion. Associated CM slows down AM recovery and needs longer support. Integration of nutritional screening and care in the pediatric HIV-care package is needed to optimize growth and prevent metabolic disorders.

背景与目标：

BACKGROUND & AIMS: :Apple Valsa canker, caused by the fungus Valsa mali, is one of the most destructive diseases of apple trees in East Asia. Feruloyl esterases (ferulic acid esterases, FAEs), which belong to a subclass of carboxylic esterases, can cleave ester bonds that crosslink hydroxycinnamic acids and arabinoxylans or certain pectins in plant cell walls. However, a pathogenic role of FAE has not been demonstrated in plant-pathogenic fungi. In this study, the FAE gene family, including one type A, one type B, three type C and two type D FAE genes, was identified in V. mali. Five of the seven FAE genes had highly elevated transcript levels in V. mali-apple tree bark interactions compared with mycelia grown in axenic culture. Signal peptides of the VmFAEs were confirmed using yeast signal sequence trap assays. To examine whether FAEs are required for the pathogenicity of V. mali, seven single- and six double-gene deletion mutants were generated. Compared with the wild-type, three of the seven FAE single-deletion mutants showed significantly reduced pathogenicity and three of the six FAE double-deletion mutants exhibited greater reductions in pathogenicity, suggesting the joint action of FAEs in the V. mali-apple tree interaction. Most of the FAE mutants that exhibited a significant reduction in pathogenicity had significantly lower FAE activity than the wild-type fungus. These results indicate that secreted FAEs are required for the full pathogenicity of the phytopathogenic fungus V. mali.

背景与目标： : 苹果Valsa溃疡病，由真菌Valsa mali引起，是东亚苹果树最具破坏性的疾病之一。阿魏酸酯酶 (阿魏酸酯酶，FAEs)，属于羧酸酯酶的一个亚类，可以在植物细胞壁中裂解交联羟基肉桂酸和阿拉伯木聚糖或某些果胶的酯键。然而，在植物病原真菌中尚未证明FAE的致病作用。在这项研究中，在马里V中鉴定了FAE基因家族，包括一个a型，一个b型，三个C型和两个D型FAE基因。与在无菌培养中生长的菌丝体相比，七个FAE基因中的五个在马里V-苹果树树皮相互作用中的转录水平高度升高。使用酵母信号序列陷阱测定法确认了vmfae的信号肽。为了检查马里V的致病性是否需要fae，产生了七个单基因和六个双基因缺失突变体。与野生型相比，七个FAE单缺失突变体中的三个显示出明显降低的致病性，而六个FAE双缺失突变体中的三个显示出更大的致病性降低，这表明FAE在V. mali-苹果树中的共同作用相互作用。大多数致病性显着降低的FAE突变体的FAE活性明显低于野生型真菌。这些结果表明，植物病原真菌V. mali的完全致病性需要分泌的fae。

BACKGROUND & AIMS: OBJECTIVES:The under-five mortality rate in Mali is high, with most deaths occurring in the community where there is no reliable vital events registration. The objective of this study was to collect data on community-based vital events registration in the Niono and Baroueli districts of the Segou region, in order to improve the community-based vital events registration system. METHODS:Data collection for this cross-sectional, descriptive, and qualitative study was conducted in May 2010. Participants included health and administrative workers, community members, women's associations, and non-governmental organizations. Data collection methods included individual interviews and focus groups, as well as document review. Data were entered and codified with Modalisa version 5.1. RESULTS:Pregnancy registration was performed exclusively by health workers in health facilities and was not performed before the third month of pregnancy due to concerns about losing the pregnancy (due to sorcery or spells). Birth registration was performed in administrative and health structures and at the community level, but after an interval of about 7 days. Childhood deaths were rarely registered because the community did not understand the importance of this registration, and because of problems accessing the structures in which deaths are registered. Community opinions were favourable to the implementation of an improved system involving relays (community-based volunteers). CONCLUSION:Improvements to vital events registration in this setting should make use of relays by increasing the awareness and involvement of the population.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:In 2010, mass vaccination with a then-new meningococcal A polysaccharide-tetanus toxoid protein conjugate vaccine (PsA-TT, or MenAfriVac) was undertaken in 1- to 29-year-olds in Bamako, Mali. Whether vaccination with PsA-TT effectively boosts tetanus immunity in a population with heterogeneous baseline tetanus immunity is not known. We assessed the impact of PsA-TT on tetanus toxoid (TT) immunity by quantifying age- and sex-specific immunity prior to and 2 years after introduction. METHODS:Using a household-based, age-stratified design, we randomly selected participants for a prevaccination serological survey in 2010 and a postvaccination survey in 2012. TT immunoglobulin G (IgG) antibodies were quantified and geometric mean concentrations (GMCs) pre- and postvaccination among all age groups targeted for vaccination were compared. The probability of TT IgG levels ≥0.1 IU/mL (indicating short-term protection) and ≥1.0 IU/mL (indicating long-term protection) by age and sex was determined using logistic regression models. RESULTS:Analysis of 793 prevaccination and 800 postvaccination sera indicated that while GMCs were low pre-PsA-TT, significantly higher GMCs in all age-sex strata were observed 2 years after PsA-TT introduction. The percentage with short-term immunity increased from 57.1% to 88.4% (31.3-point increase; 95% confidence interval [CI], 26.6-36.0;, P < .0001) and with long-term immunity increased from 20.0% to 58.5% (38.5-point increase; 95% CI, 33.7-43.3; P < .0001) pre- and postvaccination. CONCLUSIONS:Significantly higher TT immunity was observed among vaccine-targeted age groups up to 2 years after Mali's PsA-TT mass vaccination campaign. Our results, combined with evidence from clinical trials, strongly suggest that conjugate vaccines containing TT such as PsA-TT should be considered bivalent vaccines because of their ability to boost tetanus immunity.

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