BACKGROUND & AIMS: :Previous examination revealed a correlation of phytopathogenic data of 'Candidatus Phytoplasma mali' strains and the DNA sequence variability of a type ATP00464 hflB gene fragment. To further investigate such a relationship, all distinct genes previously annotated as hflB in the genome of 'Ca. P. mali' strain AT were fully sequenced and analyzed from a number of representative mild, moderate, and severe strains. The re-annotation indicated that the sequences encode six AAA+ ATPases and six HflB proteases. Each of the nine distinct deduced AAA+ proteins that were examined formed a coherent phylogenetic cluster. However, within these groups, sequences of three ATPases and three proteases from mild and severe strains clustered distantly, according to their virulence. This grouping was supported by an association with virulence-related amino acid substitutions. Another finding was that full-length genes from ATPase AP11 could only be identified in mild and moderate strains. Prediction of the membrane topology indicated that the long ATPase- and protease-carrying C-terminal tails of approximately half of the AAA+ proteins are extracellular, putatively facing the environment of the sieve tubes. Thus, they may be involved in pathogen-host interactions and may compromise phloem function, a major effect of phytoplasma infection. All full-length genes examined appear transcriptionally active and all deduced peptides show the key positions indicative for protein function.

背景与目标： : 先前的检查显示，“假丝酵母菌” 菌株的植物病原学数据与ATP00464型hflB基因片段的DNA序列变异性之间存在相关性。为了进一步研究这种关系，所有先前在 'Ca基因组中注释为hflB的不同基因。对P. mali' 菌株AT进行了完整的测序，并从许多代表性的轻度，中度和重度菌株中进行了分析。重新注释表明该序列编码六个AAA atpase和六个HflB蛋白酶。检查的九种不同的推导AAA蛋白中的每一种都形成了一个相干的系统发育簇。然而，在这些组中，根据其毒力，来自轻度和重度菌株的三种atpase和三种蛋白酶的序列远距聚集。该分组得到了与毒力相关氨基酸取代相关的关联的支持。另一个发现是，ATPase AP11的全长基因只能在轻度和中度菌株中鉴定。膜拓扑的预测表明，大约一半的AAA蛋白的长ATPase和蛋白酶携带的C末端尾巴是细胞外的，假定面对筛管的环境。因此，它们可能参与病原体与宿主的相互作用，并可能损害韧皮部功能，这是植原体感染的主要作用。所检查的所有全长基因均具有转录活性，并且所有推导的肽均显示出指示蛋白质功能的关键位置。

BACKGROUND & AIMS: :Staphylococcus aureus is an important human pathogen, but it appears more commonly in asymptomatic colonization of the nasopharynx than in cases of invasive disease. Evidence concerning the global population structure of S. aureus is limited by the overrepresentation in the multilocus sequence testing database of disease isolates recovered from Western Europe, the Americas, Australia, and Japan. We address this by presenting data from the S. aureus carriage population in Mali, the first detailed characterization of asymptomatic carriage from an African population. These data confirm the pandemic spread of many of the common S. aureus clones in the carriage population. We also note the high frequency (approximately 24%) of a single divergent genotype, sequence type 152 (ST152), which has not previously been recovered from nasal carriage isolates but corresponds to a sporadic Panton-Valentine leukocidin (PVL)-positive, community-acquired methicillin-resistant S. aureus clone noted mostly in Central Europe. We show that 100% of the ST152 isolates recovered from nasal carriage samples in Mali are PVL positive and discuss implications relating to the emergence and spread of this virulent genotype.

背景与目标： : 金黄色葡萄球菌是一种重要的人类病原体，但在无症状的鼻咽定植中比在浸润性疾病中更常见。关于金黄色葡萄球菌全球人口结构的证据受到来自西欧，美洲，澳大利亚和日本的疾病分离株的多位点序列测试数据库中过多代表的限制。我们通过提供马里金黄色葡萄球菌运输人口的数据来解决这个问题，这是非洲人口无症状运输的第一个详细特征。这些数据证实了许多常见的金黄色葡萄球菌克隆在运输人群中的大流行传播。我们还注意到单个不同基因型序列类型152 (ST152) 的高频率 (约24%)，该基因型以前尚未从鼻运输分离株中恢复，但对应于零星的Panton-Valentine leukocidin (PVL) 阳性，社区获得性耐甲氧西林金黄色葡萄球菌克隆主要见于中欧。我们显示从马里的鼻运输样品中回收的100% ST152分离株是PVL阳性，并讨论了与这种强毒基因型的出现和传播有关的含义。

BACKGROUND & AIMS: BACKGROUND:Prompt and effective malaria diagnosis and treatment is a cornerstone of malaria control. Case management guidelines recommend confirmatory testing of suspected malaria cases, then prescription of specific drugs for uncomplicated malaria and for severe malaria. This study aims to describe case management practices for children aged 1-59 months seeking treatment with current or recent fever from public and private, rural and urban health providers in Mali. METHODS:Data were collected at sites in Sikasso Region and Bamako. Health workers recorded key information from the consultation including malaria diagnostic testing and result, their final diagnosis, and all drugs prescribed. Children with signs of severe diseases were ineligible. Consultations were not independently observed. Appropriate case management was defined as both 1) tested for malaria using rapid diagnostic test or microscopy, and 2) receiving artemisinin combination therapy (ACT) and no other antimalarials if test-positive, or receiving no antimalarials if test-negative. RESULTS:Of 1602 participating children, 23.7% were appropriately managed, ranging from 5.3% at public rural facilities to 48.4% at community health worker sites. The most common reason for 'inappropriate' management was lack of malaria diagnostic testing (50.4% of children). Among children with confirmed malaria, 50.8% received a non-ACT antimalarial (commonly artesunate injection or artemether), either alone or in combination with ACT. Of 215 test-negative children, 44.2% received an antimalarial drug, most commonly ACT. Prescription of multiple drugs was common: 21.7% of all children received more than one type of antimalarial, while 51.9% received an antibiotic and antimalarial. Inappropriate case management increased in children with increasing axillary temperatures and those seeking care over weekends. CONCLUSIONS:Multiple limitations in management of febrile children under five were identified, including inconsistent use of confirmatory testing and apparent use of severe malaria drugs for uncomplicated malaria. While we cannot confirm the reasons for these shortcomings, there is a need to address the high use of non-ACT antimalarials in this context; to minimize potential for drug resistance, reduce unnecessary expense, and preserve life-saving treatment for severe malaria cases. These findings highlight the challenge of managing febrile illness in young children in a high transmission setting.

背景与目标：

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：