Institut de Recherche en Sciences de la Santé

Human leukocyte antigen-G (HLA-G) is an immunomodulatory molecule known to play a crucial role in immune tolerance and regulation. In the context of human African trypanosomiasis (HAT), higher soluble HLA-G levels were detected in the plasma of confirmed cases, representing a serological marker of T. b. gambiense infection. As trypanosomes also invade extravascular tissues, especially the skin, this study explored the potential role of HLA-G in the dermal immune response during T. b. gambiense infection. Blood and skin samples from 50 seronegative individuals, 45 seropositive suspects and 36 confirmed HAT cases, collected between 2018 and 2022 in endemic foci of Guinea and Côte d'Ivoire, were analyzed. Plasmatic and dermal levels of HLA-G proteins were quantified by ELISA and immuno-histochemistry, respectively, and compared to the trypanosome detection results in the same samples. The implication of soluble HLA-G plasma level as a biomarker of T. b. gambiense infection was confirmed. In the dermis, HLA-G isoforms were expressed either with a granular distribution or with in diffuse halos. Granular patterns of dermal HLA-G were directly associated with the presence of trypanosomes in the dermis. The presence of diffuse halos was correlated to higher sHLA-G levels in the plasma. In total, this study provides the first evidence of the involvement of HLA-G in the extravascular immune response against parasites, especially in the skin. It shows that HLA-G distribution in the extravascular compartment also represents a biomarker of trypanosome infection.

Implementing shared decision-making (SDM) in maternity care remains challenging in low-income and middle-income countries (LMICs). Decision aids can support SDM, but evidence on their effectiveness in such settings is limited. We assessed the impact of a decision analysis tool (DAT) for pregnant women on mode of birth (MOB) within the QUALIty DECision-making project, a multisite, multicountry pragmatic trial to reduce unnecessary caesarean sections. We conducted a cross-sectional survey among postpartum women considered at low risk for caesarean section in early pregnancy and who delivered in 32 hospitals across Argentina, Burkina Faso, Thailand and Viet Nam. Associations between DAT exposure and selected outcomes were analysed using multilevel, multivariate regression models adjusting for confounders and cluster effects. Of 2368 women included, 249 (11%) had used it outside antenatal care visits, 212 (9%) had heard of but not used it, and 1907 (80%) had never heard of the DAT. Compared with women who had never heard of the DAT, users were more likely to identify at least three risks/benefits of each MOB (adjusted OR (aOR) 1.9; 95% CI 1.3 to 2.8; p=0.001) and to communicate their preferred MOB to providers (aOR 2.3; 95% CI 1.5 to 3.6; p<0.001). DAT users were less likely to prefer caesarean section in late pregnancy (aOR 0.4; 95% CI 0.2 to 0.8; p=0.006) and reported higher birth experience and satisfaction scores (adjusted β=1.9; 95% CI 0.5 to 3.3; p=0.006). The use of the DAT was associated with improved knowledge, communication of birth preferences, lower caesarean preference and greater satisfaction, without adverse outcomes. Findings suggest that decision aids can strengthen SDM and promote respectful, women-centred maternity care in LMICs. ISRCTN67214403.

Abstract Background Adult mosquito survival is a critical factor in malaria transmission because Anopheles vectors must live at least 11–14 days before they can transmit. However, there is no direct method to assess age. Traditional methods of mosquito age-grading rely on indirect proxies of reproductive history derived from dissection and observation of ovarian features (Detinova and Polovodova methods). Both approaches are labour-intensive, time-consuming, and demand specialized expertise; with little known about the extent to which are used in malaria surveillance programmes, and why they may be deprioritised. This study assessed current practices, capacity, and constraints related to mosquito age-grading for malaria vector surveillance in Africa, including knowledge and use of existing dissection-based methods and emerging alternatives such as infrared spectroscopy. Methods We conducted an online survey of 285 stakeholders from across Africa, including researchers, entomologists, and National Malaria Programme (NMP) personnel, to assess the practices, priorities, and barriers to mosquito age-grading. This was complemented with a series of in-depth interviews and focus group discussions to collect insights and perspectives from stakeholders regarding their familiarity and use of age-grading methods. Findings: More than 70% of survey respondents reported that malaria vector surveillance was routinely conducted by their institutions or countries, with the highest priority given to vector density, species identification, human biting rate, and insecticide resistance. Familiarity (awareness as opposed to knowledge) of age-grading methods was highest for the Detinova (55%) and Polovodova (44%), and lower for newer approaches, including infrared-spectroscopy. Only 50% of respondents indicated that they regularly assessed mosquito age (mostly Detinova method); with &gt; 1/3 considering age-grading to be a high-priority in vector surveillance. Reported barriers to conducting mosquito-age-grading included insufficient technical expertise, perceived impracticality of ovary dissections for large-scale surveillance, inadequate tools, and limited funding. Conclusions Despite its critical role in malaria transmission, mosquito survival and age are rarely assessed in African vector surveillance programs. There is need for greater acknowledgment of these measures and their implications for disease transmission and control, and investment in tools, training, and funding to overcome current operational barriers. Integrating more practical and scalable age-assessment methods could enhance targeting of interventions.

Derivational morphology plays a crucial role in language development, literacy, and learning abilities, yet its integration into speech-language pathology practice remains inconsistent. This study investigates the knowledge and professional practices of French-speaking speech-language pathologists (SLPs) regarding derivational morphology, with a focus on implicit and explicit knowledge, intervention strategies, and barriers to research engagement. A total of 153 SLPs completed an online survey assessing their theoretical knowledge, clinical practices, and self-perceived competence in derivational morphology. Results indicate significant variability in both knowledge and practice. While 86% of respondents report implementing interventions targeting derivational morphology, explicit knowledge remains limited, particularly regarding fundamental concepts such as "base" and "root." Self-assessment scores showed a weak correlation with objective knowledge measures, suggesting overestimation of competence. Intervention descriptions revealed inconsistencies, with frequent confusion between goals, activities, and instructional materials. Additionally, 70% of respondents reported not keeping up with morphology research, citing lack of time, insufficient training, and limited access to resources as major barriers. These findings highlight the need for improved training and standardized resources to bridge the gap between research and practice. Developing specialized training programs, enhancing access to evidence-based materials, and fostering interdisciplinary collaboration are essential steps to support the effective integration of derivational morphology into clinical practice. Future research should examine the impact of structured training on SLPs' knowledge and intervention strategies. https://doi.org/10.23641/asha.31255417.

ABSTRACT Background Severe Plasmodium falciparum malaria is a leading cause of death in sub-Saharan Africa, with most deaths occurring in children younger than five years of age. The RTS,S/AS01 E (RTS,S) malaria vaccine delivered seasonally with Seasonal Malaria Chemoprevention (SMC) led to a two-third reduction in severe malaria and malaria deaths compared with either intervention given alone. The aim of this study was to assess the seasonal distribution and clinical presentation of children admitted in hospital with severe malaria who received RTS,S with or without SMC, and whether seasonal vaccination with RTS,S affected their distribution and clinical presentation. Methods We conducted a secondary ad-hoc analysis of hospital admissions in children aged 5 to 17 months of age when enrolled in the RTS,S + SMC trial in April 2017 in Houndé, Burkina Faso, and Bougouni, Mali, and who were followed until they reached five years of age. Results Three hundred and thirtythirty-seven serious adverse events were reported during the trial with 222 (65.9%) in Burkina Faso and 115 (34.1%) in Mali, and 48.1% (162/337) were due to severe malaria. The mean age of children with severe malaria was 2.9 years; 79.0% (128/162) of the cases occurred in children aged 3 years or less and 21.0% (34/162) in those aged 4 to 5 years. The most common presentation was severe anemia reported in 50% (81/162) of children, followed by repeated convulsions 25.3%, (41/162), prostration 11.1%, (18/162), hyperparasitaemia 8.0%, (13/162) and cerebral malaria 6.2%, (10/162). Severe malaria anemia was a more frequent form of severe malaria in children in the SMC alone arm 62.1%, (36/58) and lower in children in the SMC+ RTS,S arm 37.1%, (13/35), p=0.048. There was no significant difference in frequency of other clinical presentations between the study arms. Most severe malaria cases, 85.8% (139/162) occurred during the transmission season (July to December). Conclusions Severe anaemia was the most common presentation of severe malaria and was most frequent in the SMC alone arm. Children aged 3 years or less were the most affected and almost all the cases occurred between July and December. Trial registration ClinicalTrials.gov , NCT04319380

Although abortion is a frequent event in women’s reproductive life and abortion-related complications have negative consequences for women’s health and wellbeing, little is known about the quality of abortion care. To improve the quality, women’s experience of care and satisfaction, need to be further standardized and studied. This study aims to assess experience and satisfaction with post-abortion care in Africa, and Latin America and the Caribbean (LAC). We performed a secondary analysis from the World Health Organization Multi-Country Survey on Abortion. This analysis uses data from women with abortion-related complications who completed the exit survey in the form of an audio computer-assisted self-interview. Using construct validity, exploratory factor analysis and internal consistency coefficients we developed scales based on 12 items on experience of care and on 5 items on satisfaction. We performed logistic regression analyses to gain a better understanding of which clinical and sociodemographic characteristics were associated with poor experience of care and poor satisfaction. Three thousand one hundred seventy-eight women were included (299 from LAC and 2879 from Africa). Most women (85.1%) had mild or moderate abortion-related complications. The mean total score on experience of care was 2.96 (± 2.43), with a possible score range from 0 to 12. The mean total score regarding satisfaction was 1.05 (± 0.96), with a possible score range from 0 to 5. Women with no education were more likely to have poor experience of care compared to women with primary/secondary education. Women with no running water at home, with no adequacy of household income for personal needs, with no ability to save money and who did not earn their own money were more likely to have poor experience of care and poor satisfaction. Women treated in facilities with better capability to provide postabortion care were less likely to have poor satisfaction. Socioeconomically vulnerable women reported worse experiences and satisfaction with post-abortion care. Facilities with better capabilities improved satisfaction. Utilizing and implementing standardized scales and scores is essential for enhancing post-abortion experience of care improving care quality, and informing effective health policies and practices.

Introduction: The leaves of Leucas martinicensis are used in Burkina Faso to treat many diseases such as fever, bronchitis, insomnia and malaria. But there is a lack of toxicity documentation to inform the users. Therefore, the absence these crucial information’s can cause serious public health problems.Materials and Methods: To fill this gap, we investigated on acute and subacute toxicity study of the hydroalcoholic extract of L. martinicensis following the OECD method. For acute toxicity, the limit dose of 5000 mg/kg body weight was administered. In the subacute toxicity study, four groups of rats were formed, including a control group that received distilled water for 28 days and three other groups that received doses of the hydroalcoholic extract of L. martinicensis of 100, 400, and 700 mg/kg, respectively, for the same period.Results: The LD50 was determined and hematological and biochemical parameters were analyzed. The LD50 was greater than 5000 mg/kg, and there were no significant changes in the rats body weight or the relative weight of their organs (heart, lungs, liver, kidneys, spleen). Urea was the only biochemical parameter that showed a significant increase.Conclusion: The hematological analysis did not show any significant variation. The hydroalcoholic extract of L. martinicensis is practically non-toxic. However, at high doses, the extract has a moderate toxic effect characterized by an increase in uremia.