Evaluation of a Rapid Diagnostic Test Currently Being Used in the Management of Malaria in Patients of the Hia/Chu-Parakou and the Boko Zone Hospital in Northern Benin

Parasitological diagnosis is a fundamental element in the adequate management of the disease. In the last decade, there has been a resurgence of interest in the development of malaria Rapid Diagnostic Test (RDT) kits. This is the case with SD Bioline Malaria Ag Pf, which searches for HRP2 antigen by immunochromatography. The objective of this study is to compare the results of RDT SD Bioline Malaria Ag Pf in use with the results of Thick Gout (TG) in the biological diagnosis of malaria. This was a cross-sectional, descriptive and evaluative study carried out at the Hôpital d’Instruction des Armées-Center Hospitalier et Universitaire de Parakou and at the Boko zone hospital from April 20 to July 30, 2015. Patient identification, we used the non-probabilistic method and the convenience choice technique. The study involved 503 patients. The results of this study showed a good performance of the RDT SD Bioline Malaria Ag Pf. Among the 503 patients, 199 or 39.6% were positive for the RDT against 180 or 35.8% positive for the Thick Gout (TG). Sensitivity, specificity, positive and negative predictive values of the test compared to the thick film were respectively (91.7%, 89.5%, 82.9, 95) and the Kappa coefficient of 0.88 testifies a good match. False positive cases are noted in patients on treatment and even after recovery due to the persistence of the HRP2 antigen in the blood. However, it constitutes an interesting alternative to the management of malaria. At the end of this study, we suggest continuing the use of RDTs in health centers where microscopy is absent and/or reinforcing microscopy, and to strengthen staff training in the management of malaria cases.

Evaluation of Anti-Inflammatory Effects of Naproxen on Pro-Inflammatory Cytokines in COVID-19 Patients

The new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection was declared by the World Health Organization as pandemic in the early 2020. The clinical spectrum of coronavirus disease 2019 (COVID-19) include asymptomatic and symptomatic cases, including dry cough, fatigue, fever, shortness of breath, and gastrointestinal symptoms. However, increased immune inflammatory responses to stimuli can result in the overproduction of pro-inflammatory cytokines, immunopathological complications and death in patients infected with COVID-19. Given the anti-inflammatory effects of Naproxen, this study evaluated the effect of naproxen on IL-1β, TNF-a, IL-6, IFN-γ and TGF-β in COVID-19 patients. According to the results, the serum levels of IFN-γ and TGF-β cytokines significantly decreased in the patients after the treatment with naproxen. In addition, the naproxen treatment was found effective in reducing the serum level of IL-6 and IL-1β in patients with COVID-19, though it did not significantly change the serum level of TNF-a. Overall, the findings demonstrated the effectiveness of naproxen on pro-inflammatory cytokines by regulating their serum levels in COVID-19 patients.

The Role of Inflammatory Factors in the Covid-19 Disease

Late in 2019 a new pandemic was caused by a novel coronavirus which was later named as Covid-19 by WHO. Regarding the unknown behavior of the disease finding some predicting factors was important so it could be possible to curb the mortality and morbidity risk of the disease. Later studies showed the important role of inflammatory factors in the process of the disease. In this retrospective, multicenter study, 1199 adult patients were randomly selected. Patients were divided to three main groups: Severe/Moderate, ICU add/Non- ICU add and Expired/Alive. The clinical data (including heart rate, respiratory rate, systolic blood pressure and diastolic blood pressure) and the laboratory findings (including NLR, PLR, D-dimer, Troponin, and CRP) of their first date of admission were studied from their documents. The mean of each factor was compared within each group and the binary logistic regression was done for each factor. ROC curves were drawn separately based on the results of the binary logistic regression analysis (P-value<0.05). Out of 1199 patients, 908 were in the severe group, 143 were ICU added and 144 were expired. Age and clinical factors were significantly higher (P-value=0.000) in the severe, ICU add, and expired groups. All the inflammatory factors were significantly higher in the severe group (P-value=0.000), were higher among ICU add patients with statistical significance of CRP, NLR, and PLR (P-value = 0.000, 0.000 and 0.001 respectively), and were higher in the expired group with the statistically significant difference in CRP, Troponin, NLR, and PLR (P-value=0.000).

Risk Factors of Influenza-Associated Necrotizing Encephalopathy in Children

Objective: A case-control study of Influenza-Associated Necrotizing Encephalopathy (IANE) in children was conducted to explore the risk factors for the diagnosis of IANE, and to provide a predictive reference for the diagnosis of IANE. Methods: The children with IANE who received treatment in our hospital from January 2016 to December 2020 were selected as the study group, and the children with Influenza-Associated Encephalopathy (IAE) group who received treatment in the same period were selected as the control group. The blood biochemical, coagulation function and cerebrospinal fluid test results of the two groups were analyzed by univariate analysis. Receiver Operating Characteristic Curve (ROC) analysis was used to determine the optimal threshold point of each index for the indicators with statistically significant differences in univariate analysis results, and multivariate Logistic stepwise regression analysis was performed according to the optimal threshold points. Results: In the IANE group, there were 32 children, including 20 males and 12 females, aged 58 (23, 97) months. There were 40 children in IAE group, including 26 males and 14 females, aged 58 (23, 97) months. Univariate results showed that serum Lactate Dehydrogenase (LDH), Cerebrospinal Fluid Lactate Dehydrogenase (CSF LDH) and Cerebrospinal Fluid Protein (CSF Pro) in the IANE group were significantly higher than those in the IAE group, and the difference between the two groups was statistically significant (P <0.001). The optimal threshold points of blood LDH, CSF LDH and CSF Pro by ROC curve analysis were 535U/L, 67U/L and 0.49g/L, respectively. Further Multivariate Logistic stepwise regression analysis showed that LDH >535U/L (OR=31.264, 95% CI: 5.892-165.878, P <0.001) and CSF PRO >0.49g/L (OR=7.695, 95% CI: 1.052-56.305, P=0.044) were independent risk factors for IANE. Conclusion: For children with influenza whose neurological symptoms appear rapidly and persist in the early stages of the disease, blood LDH >535U/L and CSF PRO >0.49g/L are independent risk factors for IANE.

Characteristics and Mortality Risk Factors of Influenza-Associated Encephalopathy/Encephalitis in Children in a Tertiary Pediatric Hospital in China, 2016-2019

Objective: Seasonal influenza associated neurological complications had high mortality and morbidity rates in children. In this study, we aimed to investigate the clinical characteristics and mortality risk factors in children with influenza-associated encephalopathy. Methods: Retrospectively analyze the clinical data, laboratory tests, and imaging examinations of 68 children diagnosed with influenza-associated encephalopathy from January 2016 to December 2019 at Guangzhou Women and Children’s Medical Center, and the cases were divided into survival and non-survival groups by disease outcome and analyzed between two groups Results: Among the 68 children with influenza-associated encephalopathy, 40 were male, and 28 were female, aged from 3 months to 13 years, of which 66.18% (45/68) were under 5 years old. Pathogenetic tests showed that influenza virus type A accounted for 63.24% (43/68), and influenza virus type B accounted for 36.76% (25/68). Typical brain MRI changes in childhood influenza-associated encephalopathy were bilateral symmetrical lesions of the thalamus, basal ganglia, brainstem, and cerebellum. 68 patients had a mortality rate of 20.59% (14/68), with a significantly higher proportion of fever peak >39°C, Acute Disturbance Of Consciousness (ADOC), and cardiac arrest in the non-survival group than in the survival group (P<0.05). Laboratory tests showed significantly higher Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), Creatinine Kinase (CK), and Lactate Dehydrogenase (LDH), Lactate, C-Reactive Protein (CRP), and CSF protein levels in the non-survival group compared with the survivor (P<0.05), and among them, elevated ALT, AST, LDH, and CSF protein were independent high-risk factors for death from influenzaassociated encephalopathy. Conclusions: Children under 5 years of age with influenza are prone to combine neurological complications and have a higher mortality rate. Significant elevations in ALT, AST, LDH, and CSF proteins predict death from influenzaassociated encephalopathy in children.

A Data Analysis of D-Dimer & Interleukin-6 (IL-6) Test for Covid Patient

Various biomarkers, especially inflammatory markers like C-reactive protein (CRP), ferritin, fibrinogen, D-dimer and Interleukin 6 (IL-6) are associated with Covid-19 progression. Thrombosis prophylaxis with low molecular weight heparin has shown beneficial results in preventing coagulopathy a reducing risk of mortality due to thrombotic events. The COVID-19 patients highlighting the role of D-dimer, and Interleukin-6 (IL-6). During plasma coagulation soluble fibrin is generated by the influence of thrombin on fibrinogen. The soluble fibrin is crosslinked to the vessel walls by factor XIIIa. When splitting this cross linked fibrin, characteristic products called D-dimers are released. Increased D-dimer concentrations are found in thrombotic diseases and microthrombotic events (e.g. in case of disseminated intravascular coagulation, DIC). D-dimer determination is mainly used to exclude deep vein thrombosis of the leg and pulmonary embolism. D-Dimer levels rise during pregnancy and high levels are associated with complications. D-dimer is a fibrin degradation product that is often used to measure and assess clot formation. Amid the COVID-19 pandemic, elevated D-dimer levels have been associated with disease severity and mortality trends. Interleukin-6 (IL-6) is a pro-inflammatory cytokine secreted by T cells and macrophages to stimulate immune response to trauma, especially burns or other tissue damage leading to inflammation. IL-6 is also secreted by macrophages in response to specific microbial molecules, referred to as Pathogen Associated Molecular Patterns (PAMPs), which trigger the innate immune response and initiate inflammatory cytokine production. IL-6 is one of the most important mediators of fever and of the acute phase response. IL-6 is also called a “myokine”, a cytokine produced from muscle that increases in response to muscle contraction. Additionally, osteoblasts secrete IL-6 to stimulate osteoclast formation. The detection and control of pro-inflammatory response is crucial in the early stages of viral infection. COVID-19 is an emerging viral disease of global concern and optimal treatment has yet to be determined. Unknown response of treatment of COVID-19 is important during patient monitoring. IL-6 is one of the key cytokines after activated macrophages. Here we will present a laboratory data analysis of COVID-19 patients in different age group highlighting the role of positivity D-dimer and interleukin-6 (IL-6).

Are the SARS-CoV-2 Variants Greater Threats? - An In Silico Analysis of the Spike Protein

March 2020 marked the beginning of a global pandemic caused by SARSCoV- 2. With the development, production and distribution of several vaccines there are hopes to an end in sight. However, with the emergence of several mutated viral strains concerns are mounting as to the effectiveness of the current treatments and preventative measures against the new strains. Herein we analyzed and compared the interaction of the SARS-CoV-2 Spike (S) protein and its variants with human Angiotensin Converting Enzyme (ACE-2) and the binding affinities of several possible S-protein inhibitors with these variants via in silico molecular docking studies. The binding affinities of all the variants to ACE- 2 are less than that of SARS-CoV-2, indicating they are less potent than SARSCoV- 2. The inhibitors, however, showed decreased binding affinity to most of the mutant S-proteins than SARS-CoV-2, indicating it is more difficult to treat COVID using the therapeutic approach targeting the S-protein.

Electrochemical Biosensors for COVID-19

Today COVID-19 pandemic caused by the SARS-CoV-2 virus is the most challenging health issue due to the fast transmission rate and its impact on different aspects of human life. Although RT-PCR is the primary method to detect SARS-CoV-2, other reliable methods are being developed to detect this pathogen. Biosensors can provide fast, reliable, and point-of-care diagnostic. Among them, electrochemical biosensors attract considerable interest. In this mini-review, I will summarize few electrochemical biosensors which have been developed to detect the SARS-CoV-2 virus.

Improved Piglet Performance and Reduced Mortality and Antimicrobial use Following Oral Vaccination with a Live Non-Pathogenic Escherichia coli F4/F18 Vaccine Against Post-Weaning Diarrhoea

Background: Post-Weaning Diarrhoea (PWD) in pigs is a worldwide economically important disease, which is frequently controlled using antimicrobials. However, emergence of antimicrobial resistance in E. coli strains and new EU regulations urge the need for alternative control measures, such as adapted feeding strategies or immunization. Oral vaccination of suckling piglets using a live non-pathogenic E. coli F4/F18 vaccine was performed in 10 farrow-to-finish sow farms to prevent against post-weaning diarrhoea due to F4-Enterotoxigenic E. coli (ETEC) or F18-ETEC. The vaccination strategy was compared to the standard therapeutic approach in each farm, meanwhile collecting data on Average Daily Weight Gain (ADWG), Feed Conversion Rate (FCR), mortality rate and treatment incidence with antimicrobial drugs (TI100) during the post-weaning period. Results: Vaccine-treated groups demonstrated a significant improvement in FCR, mortality rate and TI100 as compared to the Control group. The ADWG only marginally and non-significantly improved in the Vaccine-treated group. Conclusions: In conclusion, the present study demonstrated the efficacy of an oral live non-pathogenic E. coli F4/F18 vaccine (Coliprotec® F4/F8; Elanco Animal Health) for active immunization of piglets against PWD due to F4-ETEC and F18-ETEC under field conditions. For several economically important performance parameters, such as FCR, mortality rate and TI100, E. coli vaccination performed significantly better as compared to the standard therapeutic approach. Therefore, vaccination against PWD due to F4-ETEC or F18-ETEC using an oral live non-pathogenic E. coli F4/F18 vaccinated may be considered a good alternative to consolidate post-weaning piglet performance results while meeting the new European requirements concerning prudent use of antimicrobials in intensive pig production.

In Search of the Vaccine Against Chagas Disease: A Tedious Road of More Than 100 Years

Chagas disease is a neglected and widely distributed parasitic disease in America, caused by Trypanosoma cruzi parasites. Currently, there are 6 to 7 million infected people and between 60 to 80 million people remain at risk of infection in endemic areas. Normally the infection does not manifest itself in the acute phase or it does so in a mild and nonspecific way, but several years later infected people suffer from heart or digestive system problems with varying degrees of disability and even death. In the acute stage of the infection, there are treatments with antiparasitic drugs that are effective and that are why it is very important to treat children who are born infected. During the chronic phase, on the other hand, the effectiveness of the treatment has been much debated by experts, and recent multicenter studies carried out throughout Latin America showed that, although drugs eliminate the parasite, they are not effective in preventing the development of the illness. Therefore, it is an urgent need to have new strategies to control the infection and the development of the disease, therefore, the objective of achieving a vaccine that not only prevents primary infection (when the parasite comes into contact with the body) but also controls the progression of the disease in infected people and reverses the damage associated with the infection by that obtaining a vaccine is imperative. This work aims to highlight the efforts, progress and show the different approaches in the development of the vaccine against ChD.