Background Chronic intravascular hemolysis leads to nitric oxide (NO) depletion and pulmonary hypertension in sickle cell disease. To test whether this pathophysiology occurs in malaria, we examined 53 children admitted to hospital with severe malaria (excluding cerebral malaria) and 31 age-matched controls in Mali. Methods Severity of hemolysis was assessed from plasma free hemoglobin (Hb) and arginase-1 levels. NO metabolism was assessed by whole blood nitrite levels and plasma NO consumption. Effects on the cardiovascular system and endothelial function were assessed by using echocardiography to measure peak tricuspid regurgitant jet velocity (TRV) and from plasma levels of N-terminal prohormone brain natriuretic peptide (NT-proBNP) and soluble vascular cell adhesion molecule-1 (sVCAM-1). Results Children with severe malaria had higher plasma Hb and arginase-1 levels, reduced whole blood nitrite levels and increased NO consumption relative to controls. They also had increased pulmonary arterial pressures (p < 0.05) with elevated levels of NT-proBNP and sVCAM-1 (p < 0.001). Conclusions Children with severe malaria have increased pulmonary pressures and myocardial wall stress. These complications are consistent with NO depletion from intravascular hemolysis, and indicate that the pathophysiologic cascade from intravascular hemolysis to NO depletion and its cardiopulmonary effects is activated in children with severe malaria.

Our study demonstrates widespread misconceptions in Mali regarding epilepsy. Our findings argue for more education initiatives focused on the entire population, including traditional healers, to provide knowledge, reduce stigma, and improve quality of life for individuals living with epilepsy.

SummaryBreast milk contains pro-and anti-inflammatory cytokines and chemokines with potential to influence immunological maturation in the child. We have shown previously that country of birth is associated with the cytokine/ chemokine profile of breast milk. In this study we have investigated how these differences in breast milk affect the cellular response of cord blood mononuclear cells (

Knowledge, attitudes and practices(KAP) of mothers/caregivers on infant and young child feeding are key factors for optimal nutritional status, health and growth of the children. A community-based, cross-sectional descriptive study was conducted during January 2017 to assess the knowledge, attitudes and practices on infant and young child feeding (IYCF) of mothers/ caregivers who lived in peri-urban areas of Bobo-Dioulasso, Burkina-Faso.This study was carried out before a nutrition education-based intervention and included 245 mothers/ caregivers that were randomly selected in the peri-urban communities of Bobo-Dioulasso. A semi-structured interviewer-administered questionnaire developed based on Food and Agriculture Organization knowledge, attitudes and practices assessment method was used to collect KAP and socio-economic data. Analyses were performed using SPSS version 20. For this study, authorization was obtained from the regional directorate of health of the Hauts-Bassins region. Verbal consent was obtained after the participants had been informed about the study objectives. Among the 245 study participants, 55.1% were aged less than 30 years. More than 3 out of 4 mothers/caregivers (76.3%) were Muslim and 59.2% of them were illiterate. Almost all mothers/caregivers (98.8%) had adequate knowledge for breastfeeding and 87.9% of them knew about exclusive breast feeding up to 6 months. In addition, 91.8% of mothers/caregivers reported that they gave colostrum at birth. Furthermore, 67.5% of the mothers started breastfeeding within one hour after delivery. Based on mothers/caregivers’ report on complementary foods consumed by 6-59 months children in the previous 24h before the interview, cereals were the most reported consumed food group (89.8%) followed by meat and fish products (28.6%). This study found that mothers/caregivers had adequate knowledge about IYCF in general. However, mothers/caregivers’ practice of complementary feeding was inappropriate. Cereals were the food group consumed by most of children aged 6-59 months raising the needs for interventions, such as cooking demonstrations during postnatal visits in health facilities,to improve complementary feeding in this population.

In Mali, according to DHS III (Demographic and Health Survey) in 2001, the global rate of malnutrition (weight for age <2 sd) among under-five children was 38%. The purpose of this study was to assess the management of malnutrition in children (0-59 months old) by the professionals in the intervention areas of 'Strategy for Accelerated Child Survival and Growth', according to IMCI guidelines. We carried out a cross-sectional survey in three randomly selected health districts (Kolokani, Niono and Koro) and involved 27 health centres, 180 children and 180 mothers. We did direct observation of consultations and interrogated the mothers. The study found that the equipement and tools necessary for nutritional status assessment were available but seldom used in practice. Nutrition training was provided only to the health staff of Kolokani where 78% of the staff were trained in IMCI and 55% in IEC (Information Education and Communication). The indicatory weight-for-age was used to assess nutritional status of 64% children in Kolokani vs. 42% in Koro and 4% in Niono. IMCI classification was used only in Kolokani (57% of children). The management of severe malnbutrition in children was more correct in Kolokani (100%) than in Koro (33%) and Niono (0%). Twenty- eight percent of mothers/caretakers knew the appropiate duration of exclusive breastfeeding, but only 5% knew that vitamin A supplementation should be done every 6 months. Our findings suggest that nutritional status assessment is performed better in the health districts where staffs are training in IMCI. We recommend training the health staff in the other health districts and the intensification of behavioural change communication for mothers.