BackgroundMalaria remains a major public health problem in developing countries. Then in these countries prompt access to effective antimalarial treatment such as Artemisinin based-Combination Therapies (ACT) proves to be an essential tool for controlling the disease. In Senegal, since 2006 a nationwide scaling up program of ACT is being implemented. In this context it has become relevant to monitor ACT efficacy and provide recommendations for the Senegalese national malaria control program.MethodsAn open randomized trial was conducted during two malaria transmission seasons (2011 and 2012) to assess the efficacy and safety of three combinations: dihydro-artemisinin-piperaquine (DHAPQ), artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ). The primary end point of the study was represented by a PCR adjusted adequate clinical and parasitological response (ACPR) at day 28. Secondary end points included: (i) a ACPR at days 35 and 42, (ii) a parasite and fever clearance time, (iii) ACTs safety and tolerability. The 2003 WHO’s protocol for antimalarial drug evaluation was used to assess each outcome.ResultsOverall, 534 patients were randomized selected to receive, either ASAQ (n = 180), AL (n = 178) or DHAPQ (n = 176). The PCR adjusted ACPR at day 28 was 99.41% for the group ASAQ, while that was 100% in the AL and DHAPQ groups (p = 0.37). The therapeutic efficacy was evaluated at 99.37% in the ASAQ arm versus 100% in AL and DHAPQ arm at day 35 (p = 0.37). At day 42, the ACPR was 99.27% in the ASAQ group versus 100% for both AL and DHAPQ groups, (p = 0.36). No serious adverse event was noted during the study period. Also a similar safety profile was noted in the 3 study groups.ConclusionIn the context of scaling up of ACTs in Senegal, ASAQ, AL and DHAPQ are highly effective and safe antimalarial drugs. However, it’s remains important to continue to monitor their efficacy.Trial registrationPACTR 201305000552290.

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The large spectrum of Candida species and their susceptibility to antifungal drugs has made the identification of Candida species and the detection of drug resistance necessary for the management of Candida infection. This study was carried out to determine the distribution of Candida species and to evaluate their susceptibility to antifungal drugs. A prospective observational and descriptive study was conducted from March to June 2016 in the laboratory of Parasitology-Mycology at Fann University Hospital in Dakar. Samples were analyzed by direct microscopy and culture. Identification of Candida species was based on filamentation test, chlamydosporulation formation, auxanogramme (AUXACOLOR TM Bio-Rad) and Candi-Select ® 4 (Bio-Rad,). The susceptibility of Candida species to antifungal drugs was tested using Fungitest ® (Bio-Rad) against 5-fluorocytosine, amphotericin B, miconazole, ketoconazole, itraconazole and fluconazole. A descriptive analysis was performed using Stata MP 14. Among 336 specimens received for mycological examination, 68 (20.2%) were positive for Candida. The most identified Candida species were C. albicans (58.8%), C. glabrata (16.2%), C tropicalis (7.4%), C krusei (7.4%), C. parapsilosis (4.4%), C. dubliniensis (4.4%) and C. kefyr (1.5%). The majority of isolates were susceptible to ketoconazole (94.3%), fluconazole (85.7%), amphotericin B and 5 fluoro-cytosine (88.6%). The susceptibility rates were lower for itraconazole (51.4%) and miconazole (68.6%). One strain of C. albicans was resistant to 5 fluoro-cytosine, one strain of C. glabrata and C. tropicalis were resistant to itraconazole. The results of this study provide useful information regarding the distribution of Candida species and the susceptibility to antifungal drug. Routine identification of Candida species and monitoring of resistance patterns are necessary to manage Candida infection and to control the spread of resistance in clinical isolates of Candida species.

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BackgroundAcute Respiratory Infections (ARI) are common causes of febrile illnesses in many settings in Senegal. These infections are usually managed presumptively due to lack of appropriate diagnostic tools. This situation, can lead to poor management of febrile illness or antibiotic misuse. In addition, there are limited data on the spectrum of pathogens commonly responsible for these ARI. This study was conducted to explore the pathogens community among patients with acute respiratory infection in a rural area in Senegal.MethodsA cross sectional study was conducted from August to December 2015. Children and adult patients attending Keur Socé health post for signs suggestive of acute respiratory infection were enrolled after providing inform consent. Eligible participants were recruited using a consecutive sampling method. Paired nose and throat swabs were collected for pathogen detection. Samples were processed using a multiplex PCR designed to identify 21 pathogens including both virus and bacteria.ResultsTwo hundred and fifty patients participated in the study. Samples positivity rate was evaluated at 95.2% (238/250). Streptococcus pneumoniae was the predominant pathogen (74%) and was present in all months and all age-groups, followed by Staphylococcus aureus (28,8%) and rhinovirus (28,4%). Respiratory syncytial virus (RSV) was detected only among children under 5 years old in August and September while coronavirus was present in all age groups, during the months of October and December.ConclusionThis pilot study revealed a diversity of pathogens over the time and across all age groups, highlighting the need for further exploration. A pathogen community approach including both virus and bacteria at a larger scale becomes crucial for a better understanding of transmission dynamics at population level in order to help shape ARI control strategies.