Université Alassane Ouattara

Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer that does not express hormonal receptors and Her2. Its prevalence is high and varies from 30 to 41% in the Ivory Coast. For decades, chemotherapy has remained the only systematic treatment choice; however, the current availability of programmed death-ligand 1 (PD-L1) immunohistochemistry provides benefits for immune checkpoint inhibitors. The purpose of the study aimed to determine the prevalence of PD-L1 and its relationship with specific prognostic features for better survival of TNBC patients in the Ivory Coast. A 10-month prospective study included 132 patients diagnosed with TNBC. The paraffin blocks were subjected to PD-L1 immunohistochemistry. The Chi-Square Test was used to evaluate the correlations between PD-L1 status and prognostic parameters. The mean age at diagnosis was 46.6 ± 12.9 years. 62.9% of the study population were premenopausal. The predominant histological type was invasive ductal carcinoma of no special type (95.5%) at the advanced stage of grade II (59.1%) and III (27.3%). There was an abundant inflammatory stroma (67.4%). 20.5% of TNBC patients were PD-L1 positive. PD-L1 status was significantly associated with the breast imaging-reporting and data system (BIRADS) scoring (p = 0.0362) and Nottingham grade (p = 0.0049). However, there was no association between PD-L1 expression and menopausal status (p = 0.1771), sex (p = 0.3030), inflammatory stroma (p = 0.0803), tumor necrosis (p = 0.0571), and histological type (p = 0.2037). 20.5% of TNBC patients expressed PD-L1. This study highlights a significant association between PDL-1 expression and the BIRADS scoring and the Nottingham grade. The present study could help to select patients who would be likely to benefit from anti-PD-L1 immunotherapy for better clinical outcomes in the Ivory Coast.

Translating research evidence into practice has become a priority for academics, funders and public institutions worldwide. However, many research projects still lack strategies and funds for policy-related research translation, innovation, dissemination and uptake activities. This study focuses on research evidence on rabies producedby Centre Suisse de Recherches Scientifiques en Côte d'Ivoire under GAVI's project. It aims to (i) identify the mechanism used by researchers to share evidence with practitioners, policy makers and local communities and to (ii) identify what facilitates research uptake. A qualitative method was used to gather data from the producers (researchers) and users (policy-makers and community) of research from both the human and animal health sectors, and local community leaders, using semistructured interview guide and observation. Fifteen informants were selected using the snowball sampling technique and purposive selection from the GAVI's project team.Theknowledge brokering theory was used to explain the translation of rabies research evidence into practice by understanding what facilitate the research uptake in pratical way. Thematic content analysis was used for the interpretation of data. The main mechanisms mobilized to disseminate results were meeting platforms including workshops, trainings, and sensitizations during the annual WRD and written formats such as policy briefs, reports. The research findings lead to change or to have impact on actual practices, as some of the users associated with the research process hold high-ranking positions in human and animal health and this may facilitateresearch uptake in their sectors. Furthermore, sensitizations of local authorities and communities during the project cycle led to the creation of local intersectoral rabies committees that have had a direct impact on the increase of rabies reporting in the two regions with the highest prevalence of rabies in the country. This paper highlights different strategies used to disseminate research evidence and shows the enabling factors of research evidence uptake at the policy-makers' level and community level. To achieve the 0 rabies target by 2030, science needs to be more closely involved in policy, through dialogue with other stakeholders such as the media. In this way, stakeholders can make better use of health research evidence to co-construct strategies for improving the fight against rabies.

Diabetes is a major public health problem, and dietary fat intake plays a significant role in its incidence and progression. The impact of palm oil consumption on lipid and lipoprotein profiles remains controversial, particularly among diabetic patients. This study aimed to assess the influence of palm oil consumption on serum lipid and lipoprotein profiles in patients with type 2 diabetes (T2D) in Abidjan. A cross-sectional study including diabetic patients categorised according to the frequency and form of palm oil consumption was conducted in which total cholesterol (TC), triglycerides (TG), HDL cholesterol (HDL-c), LDL cholesterol (LDL-c) and the atherogenic index were measured and compared between the different groups. The chi-squared test was used with a significance level of p value <0.05. No statistically significant differences were observed between frequent and occasional patient consumers in terms of total cholesterol (p=0.799), triglycerides (p=0.579), HDL-cholesterol (p=0.840), LDL-cholesterol (p=0.116) and atherogenic index (p=0.588). Similarly, the form of palm oil consumed did not significantly influence lipid and lipoprotein profiles. Palm oil consumption, regardless of frequency or form, does not significantly alter the lipid and lipoprotein profile of type 2 diabetic patients. These findings suggest that palm oil intake, within habitual dietary patterns, may not be a primary determinant of dyslipidemia in this population.

Despite the significant impact of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) on malaria, 597,000deaths from malaria were still recorded in 2023. Additional measures are clearly needed to complement current tools. We assessed the efficacy of insecticide-treated window screens (a piece of PermaNet 3.0 containing deltamethrin + piperonyl butoxide) versus untreated window screening and eave tube inserts treated withβ-cyfluthrin as household interventions againstAnopheles gambiaesensu lato. Between August and October 2022, five experimental houses in Kolongonouan village, central Côte d'Ivoire, were used under semi-field conditions to evaluate the following interventions: (i) standard control house with small openings in the eaves and no window screens (SCH); (ii) insecticide-treated screening (ITS) of windows with small openings in the eaves (ITS op); (iii) ITS of windows with eaves blocked to prevent mosquito entry via eaves (ITS blq); (iv) insecticide treatment applied to the eaves using In2Care eave tubes, without window screening (ET); and (v) untreated window screening together with insecticide-treated eave tubes (SET). The efficacy of these treatments on the indoor and outdoor density of naturally recruiting Anopheles gambiae mosquitoes was assessed by human landing catches from 6:00pm to 8:00am. The impact of these treatments on mosquito mortality and blood-feeding rates was further assessed using release-recapture experiments, in which large enclosures were built around individual houses and approximately 100 non-blood-fed femaleAn. gambiae were released each night over 15 nights. In addition, for the ITS blq treatment, the importance of physical integrity was assessed by evaluating the effect of damaging the screening with two or four 4cm × 4cm holes in each screened window. Insecticide-treated window screening plus eave blocking (ITS blq) significantly reduced by 31.8% the number of An. gambiae entering houses overnight relative to standard control houses (SCH) (P < 0.001). The use of untreated screening + eave tubes (SET) induced a similar reduction (27.0%, P < 0.001). The house entry reduction magnitude for eave tubes alone (ET) was lower (23.5%), though it remained significant relative to the control (P < 0.001). The impact of the ITS op (insecticide-treated window screening with open eaves) was lower and nonsignificant (18.1%; P = 0.4019). There were no significant differences in house entry rates between ET, ITS blq, and ITS op (P > 0.05). The peak in mosquito abundance within houses occurred between 11:00pm and 3:00am. There were no significant differences between treatments in the numbers of mosquitoes collected outdoors. In the release-recapture experiments, all treatments significantly reduced the blood-feeding rate and increased the mortality of An. gambiae, with again a similar impact for ITS blq and SET. Damaging the ITS with two holes still led to a significant reduction in blood-feeding rate, but protection was lost with four holes. Mortality rate also declined with increasing levels of damage, although it remained significantly higher than that with the untreated window screening. This study demonstrated that the combination (insecticide-treated window screening and blocking of eave access) reduced mosquito entry, increased mortality, and lowered blood-feeding rates of An. gambiae to levels comparable to insecticide-treated eave tubes combined with untreated window screening (SET). A previous cluster randomized controlled trial of SET in this area demonstrated a significant reduction in malaria incidence and prevalence. Insecticide-treated window screens could therefore yield a similar epidemiological impact while potentially being simpler and less expensive to implement. Larger-scale epidemiological trials involving communities are needed to test this assumption and further optimize the approach.

BackgroundLong-lasting insecticidal nets (LLINs) are essential for malaria control, but their effectiveness is threatened by increasing resistance of Anopheles to pyrethroids. In 2021, Côte d’Ivoire distributed both standard and new-generation LLINs during its mass distribution campaign. This study assessed the physical integrity and residual efficacy of these nets 3 y after their distribution.MethodsA cross-sectional survey was conducted in 10 health districts chosen for ecological diversity. A total of 570 LLINs were withdrawn from randomly selected households and evaluated through WHO cone bioassays using both the susceptible Anopheles gambiae strain, Kisumu, and a local pyrethroid-resistant strain from Tiassalé. Multivariate analysis was performed to explore factors influencing mosquito mortality.ResultsLLIN coverage remained high (2.49 nets per household; 86.6% usage). However, 58.25% of LLINs had at least one hole, especially among standard LLINs in the North. While full efficacy was retained against the Kisumu strain, mortality dropped to 50% against the resistant strain. New-generation LLINs were more effective in the North, whereas standard LLINs were more effective in the South.ConclusionThese findings underscore the importance of adapting LLIN distribution strategies to local resistance profiles and maintaining regular monitoring to ensure sustained protection and guide vector control policies.

La guerra civil, como fenómeno social, impactó profundamente en todas las capas de la sociedad española, con la pérdida de bienes materiales y vidas humanas. Frente a este desastre, los escritores comprometidos, como Juan Goytisolo, utilizaron su pluma para realizar una crítica alegórica mediante personajes adolescentes, resaltando la función socioética de la literatura. Este trabajo pretende analizar la representación literaria de la guerra civil dentro de este marco a través de Duelo en el paraíso, explorando cómo la mirada literaria articuló y articula una reflexión crítica sobre la contienda y sus repercusiones.

BackgroundAcute Febrile Disease of Unknown Cause (AFDUC) remains a major diagnostic and clinical challenge in sub-Saharan Africa (SSA), where malaria dominates while other aetiologies are under-recognised. The African Network for Improved Diagnostics, Epidemiology and Management of common Infectious Agents aimed to enhance understanding of the epidemiology of AFDUC in SSA through clinical and laboratory-based surveillance.MethodsA multicentre prospective sentinel surveillance case-control study was conducted across urban and rural sites in Côte d’Ivoire (CI), Burkina Faso (BF) and South Africa (SA). We enrolled 6100 AFDUC cases and 1455 healthy controls between 2018 and 2022 across all study sites. Standardised clinical, laboratory and follow-up data were collected. Diagnostics included biomolecular multiplex PCR, serology and blood culture. Associations between pathogens and AFDUC were assessed using adjusted odds ratios.ResultsPlasmodium falciparum remained the leading pathogen in BF and CI, and EBV was the most frequent viral detection (up to 23% in SA). HBV prevalence matched WHO estimates, while DENV and CHIKV IgM seropositivity reached 20–22% in BF and CI, with marked regional and rural-urban differences. Blood cultures had low positivity (5.4%), with Staphylococcus aureus and Salmonella spp predominating. Mortality was highest in BF (22%), particularly in adults ≥45 years, and largely attributed to unresolved febrile illness. Across sites, HIV infection, comorbidities and neurological symptoms were linked to poor outcomes. Mortality patterns mirrored health system disparities, with lowest physician density and health spending in BF. Despite broad testing, no pathogen was detected in 65% of cases.ConclusionsOur results highlight the need for improved diagnostics of common and zoonotic pathogens in SSA and provide insights into febrile disease aetiologies. Strengthened laboratory surveillance, improved case management and targeted vector control are critical to reduce the burden of febrile illness.

Résumé D’un point de vue général, la gestion des anthroponymes n’est pas une chose aisée lorsqu’on s’en tient à la complexité de leurs compositions et surtout de la portée des messages qu’ils véhiculent. En mangoro et en baoulé, l’énonciation s’incruste incidemment dans les anthroponymes à telle enseigne qu’il est difficile de s’en passer, si l’on projette de disséquer la quintessence de leur portée pragmatico-énonciative. L’objectif de cette étude est de voir que l’approche esquissée à travers les anthroponymes mangoro-baoulé ne peut avoir d’assise solide sans cette théorie. Pour être en phase avec un certain nombre d’exigences du domaine, nous avons eu recours tout d’abord aux notions préliminaires sur les anthroponymes. Ensuite, les études sur les antonomases lexicalisées seront l’objet d’analyse. Enfin, apparaissent les antonomases vues en contexte discursif.