Com o objetivo de avaliar a freqüência de infecção por micoplasmas hemotrópicos em gatos com linfoma e seu impacto na ocorrência de anemias nesses animais, foram analisadas amostras sangüíneas de 14 animais com diagnóstico de linfoma, sem qualquer tratamento prévio e 14 amostras de sangue de gatos hígidos, por meio da técnica de PCR-Nested. Utilizaram-se primers que amplificam fragmentos do gene 16S rRNA dos micoplasmas. Eritrograma e bioquímica sérica foram realizados, assim como testes sorológicos imunoenzimáticos (ELISA) para ambos os retrovírus. Anemia foi observada em 28,6% (4/14) dos gatos com linfoma. Em dois a anemia foi classificada como normocítica normocrômica não regenerativa, e em outros dois como macrocitica normocrômica não regenerativa. A freqüência de infecção pelos micoplasmas hemotrópicos felinos nos gatos com linfoma foi de 7,14% (1/14). Após seqüenciamento e posterior prova de identidade no GenBank, o agente foi identificado como M. haemofelis, número de acesso FJ544859. A freqüência de infecção pelos retrovírus foi de 21,42% para o FeLV e 7,14% (3/14) para o FIV. O animal infectado pelo M. haemofelis não apresentou anemia, ainda que apresentasse infecção concomitante pelo FeLV. O grupo controle não apresentou infecção por micoplasmas ou retrovírus. Nas condições em que este estudo foi realizado, concluiu-se que a anemia observada nos gatos com linfoma não foi ocasionada pela infecção por micoplasmas hemotrópicos, mas provavelmente em decorrência das alterações hematológicas promovidas pelo processo neoplásico, associadas ou não à infecção pelo FeLV. Portanto, a infecção pelos micoplasmas não apresentou um impacto direto na ocorrência de anemias em gatos com linfoma. / To evaluate the frequency of infection by hemotropic mycoplasmas in cats with lymphoma and its impact in the development of anaemia in those animals, blood samples from 14 animals diagnosed with Lymphoma and without any previous treatment and 14 blood samples from healthy cats were analyzed by means of the PCR-Nested technique. Primers were utilized and selectively amplified fragments of 16SrRNA gene of mycoplasma. Haematology, serum biochemical profile and FeLV/FIV ELISA were performed in all 28 cats. Anaemia was observed in 28.6% (4/14) of the cats with lymphoma. In two of them, anaemia was classified as normocytic-normochromic nonregenerative and in the other two as macrocytic-normochromic nonregenerative. The frequency of feline haemotropic mycoplasmas infection in cats with lymphoma was 7.14% (1/14). After sequencing and identity proof by the GenBank, the agent was identified as M. haemofelis, access number FJ544859. The frequency of retrovirus infection among all the cats with lymphoma was 21.42% (3/14) for FeLV and 7.14% (1/14) for FIV. The cat infected by M. haemofelis was also infected with FeLV, but was not anaemic. The 14 cats used as control did not exhibited infection by mycoplasmas or retrovirus infections. Under the conditions in which this study was developed, one can conclude that the anaemia observed in cats with lymphoma may not be related to hemotropic microplasmas infection, but to haematologyc alterations promoted by the associated neoplasic process and/or the occurrence or of FeLV infection. Therefore, the infection by the mycoplasmas did not present a direct impact in the occurrence of anaemies in cats with limphoma.

Background: Haematotoxicity of conventional chemotherapies often results in delays of treatment or reduction of chemotherapy dose. To ameliorate these side-effects, patients are routinely treated with blood transfusions or haematopoietic growth factors such as erythropoietin (EPO) or granulocyte colony-stimulating factor (G-CSF). For the latter ones, pharmaceutical derivatives are available, which differ in absorption kinetics, pharmacokinetic and -dynamic properties. Due to the complex interaction of cytotoxic effects of chemotherapy and the stimulating effects of different growth factor derivatives, optimal treatment is a non-trivial task. In the past, we developed mathematical models of thrombopoiesis, granulopoiesis and erythropoiesis under chemotherapy and growth-factor applications which can be used to perform clinically relevant predictions regarding the feasibility of chemotherapy schedules and cytopenia prophylaxis with haematopoietic growth factors. However, interactions of lineages and growth-factors were ignored so far. Results: To close this gap, we constructed a hybrid model of human granulopoiesis and erythropoiesis under conventional chemotherapy, G-CSF and EPO applications. This was achieved by combining our single lineage models of human erythropoiesis and granulopoiesis with a common stem cell model. G-CSF effects on erythropoiesis were also implemented. Pharmacodynamic models are based on ordinary differential equations describing proliferation and maturation of haematopoietic cells. The system is regulated by feedback loops partly mediated by endogenous and exogenous EPO and G-CSF. Chemotherapy is modelled by depletion of cells. Unknown model parameters were determined by fitting the model predictions to time series data of blood counts and cytokine profiles. Data were extracted from literature or received from cooperating clinical study groups. Our model explains dynamics of mature blood cells and cytokines after growth-factor applications in healthy volunteers. Moreover, we modelled 15 different chemotherapeutic drugs by estimating their bone marrow toxicity. Taking into account different growth-factor schedules, this adds up to 33 different chemotherapy regimens explained by the model. Conclusions: We conclude that we established a comprehensive biomathematical model to explain the dynamics of granulopoiesis and erythropoiesis under combined chemotherapy, G-CSF, and EPO applications. We demonstrate how it can be used to make predictions regarding haematotoxicity of yet untested chemotherapy and growth-factor schedules.:Background; Methods; Results; Model predictions; Discussion; Conclusions

In dieser Studie wurde eine Charakterisierung von Eisenpräparaten entwickelt, die als parenterale und orale Präparate zur Behandlung schwerer Anämie auf Basis von Fe-Kohlenhydrat-Nanopartikeln und Bioverfügbarkeitsstudien in biologischen Proben verwendet werden. Eine vollständige Charakterisierung eines kommerziellen Präparats für die parenterale Behandlung von Anämie (Venofer®) wurde durchgeführt. Solubilisationsstudien des Arzneimittels wurden in Serum und Blut durchgeführt, um die Bioverfügbarkeit von Eisen zu untersuchen. Es wurden Speziationsexperimente von Serumproteinen durchgeführt (UV-vis, ICP-MS), die detailliertere Informationen über das Arzneimittel und sein Verhalten im Körper liefern. Tartrat-modifizierte Eisenoxid-Nanopartikel (FeNPs) und isotopisch angereicherte 57Fe wurden synthetisiert. Nanopartikel wurden weiter in Bezug auf Partikelgröße und -form charakterisiert. Da diese Nanopartikel möglicherweise für die orale Supplementierung bei der Die Labilität dieser FeNPs wurde in saurem Medium bewertet, und das gesamte Fe wurde in nanopartikulärer und löslicher Fraktion quantifiziert. Zur Bestimmung des Nanostrukturverhaltens in zellulären Medien wurde eine Speziationsstrategie für Nanopartikel und ionische Eisenspezies basierend auf einer reversed phase high performance liquid chromatography, gekoppelt an ICP-MS, durchgeführt und erstmals auf Caco-2-Zellen angewendet Proben. Darüber hinaus wurde ein Quantifizierungsansatz durch Anwendung einer Isotopenverdünnungsanalyse mit 57Fe. Die Zytotoxizität wurde untersucht: kolorimetrische Assays wurden in verschiedenen Zelllinien durchgeführt, und die oxidative Schädigung wurde durch Messung der ROS-Produktion bestimmt. Schließlich wurden In-vivo-Modelle zur Bestimmung der Eisenresorption im Dünndarm nach Perfusionsexperimenten an Ratten verwendet. Das Schicksal der FeNPs wurde auch untersucht, indem andere Gewebe wie Leber, Niere, Milz oder Blut nach der intestinalen Aufnahme analysiert wurden. / In this study, a characterization of iron supplements used as parenteral and oral preparations for the treatment of severe anaemia based on Fe-carbohydrate nanoparticles and bioavailability studies in biological samples have been developed. A complete characterization of a commercial preparation for the parenteral treatment of anaemia (Venofer®), has been carried out. Solubilisation studies of the drug have been conducted in serum and blood to evaluate iron bioavailability. Moreover, speciation experiments of serum proteins were conducted using UV-vis and ICP-MS detection, providing more in-depth information about the drug and its behaviour in the body. Tartrate-modified coated-iron oxide nanoparticles (FeNPs) and isotopically enriched 57FeNPs have been synthesized. Nanoparticles were further characterized in terms of particle size and shape. As these nanoparticles are potentially suitable for the oral supplementation in anaemia’s treatment, the lability of these FeNPs in acidic medium was evaluated, and total Fe was quantified in nanoparticulate and soluble fraction. For the determination of nanostructure behaviour in cellular media, a speciation strategy for nanoparticles and ionic species of iron based on a reversed-phase high-performance liquid chromatography coupled to ICP-MS was carried out and applied for the first time to Caco-2 cell samples. Moreover, a quantification approach was also tackled by applying an online post-column isotope dilution analysis with 57Fe as isotopically enriched standard. Cytotoxicity from these tartrate-modified iron oxide nanoparticles was evaluated: colorimetric assays have been conducted in different cell lines and oxidative damage was assessed by measuring ROS production. Finally, in vivo models were used to determine iron absorption in the small intestine after perfusion experiments in rats. The fate of the FeNPs was also studied by analysing other tissues as liver, kidney, spleen, or blood after the intestinal uptake.

Abortion and severe pre-eclampsia/eclampsia remain the major causes of maternal mortality in Zimbabwe. Based on this problem, factors associated with maternal mortality due to abortion and severe pre-eclampsia/eclampsia were investigated to improve pregnancy outcomes. Cases and controls were selected from 4895 abortion and 318 severe preeclampsia/ eclampsia obstetric records to conduct a retrospective case-control study. Significant risk factors identified for reducing maternal mortality due to postabortion complications included the administration of oxytocic drugs and evacuations of the uterus whilst anaemia and sepsis apparently reduced these women's chances of survival. No significant factors could be identified which influenced maternal deaths among women suffering from severe pre-eclampsia/eclampsia. Magnesium sulphate was not routinely administered, as recommended internationally. In both groups, cases apparently received better reported quantitative care than controls. Recommendations based on this research report include improved midwifery education and in-service training, regular audits of patients' records and changed policies for managing these conditions more effectively in Zimbabwe. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)

The expanding aquaculture industry continues to encounter major challenges in the form of highly contagious aquatic viruses. Control and eradication measures targeting the most lethal and economically damaging virus-induced diseases, some of which are notifiable, currently involve ‘stamping out’ policies and surveillance strategies. These approaches to disease control are performed through mass-culling followed by restriction in the movement of fish and fish products, resulting in considerable impacts on trade. Although effective, these expensive, ethically complex measures threaten the sustainability and reputation of the aquatic food sector, and could possibly be reduced by emulating innovative vaccination strategies that have proved pivotal in maintaining the success of the terrestrial livestock industry. DIVA ‘differentiating infected from vaccinated animal’ strategies provide a basis to vaccinate and contain disease outbreaks without compromising ‘disease-free’ status, as antibodies induced specifically to infection can be distinguished from those induced in vaccinated animals. Various approaches were carried out in this study to assess the feasibility of marker/DIVA vaccination for two of the most important disease threats to the global Atlantic salmon and common carp/koi industries, i.e. infectious salmon anaemia (ISA) and koi herpesvirus disease (KHVD), respectively. Antibody responses of Atlantic salmon (Salmo salar L.), following immunisation with an ISA vaccine, administered with foreign immunogenic marker antigens (tetanus toxoid (TT), fluorescein isothiocyanate (FITC) and keyhole limpet hemocyanin (KLH)) were assessed by antigen-specific enzyme linked immunosorbent assay (ELISA). Although antibodies were induced to some markers, these were unreliable and may have been affected by temperature and smoltification. Detectable antibodies to ISAV antigen were also largely inconsistent despite low serum dilutions of 1/20 being employed for serological analysis. The poor antibody responses of salmon to the inactivated ISA vaccine suggested that DIVA vaccination is not feasible for ISA. A similar approach for KHV, utilising green fluorescent protein (GFP) as the marker, similarly failed to induce sufficiently detectable antibody responses in vaccinated carp (Cyprinus carpio L.). However, as high anti-KHV antibody titres were obtained with an inactivated KHV vaccine (≥1/3200), alternative approaches were carried out to assess the feasibility of DIVA vaccination for carp. Investigations of early KHV pathogenesis in vivo and antigen expression kinetics in vitro (0-10 days post infection (dpi)) provided valuable data for the diagnostics necessary for DIVA surveillance strategies. Following viral infection, molecular methods were shown to be the most effective approach for early detection of KHV infected fish prior to sero-conversion, during which time antibodies are not detectable. An experimental immersion challenge with KHV, however, revealed complications in molecular detection during early infection. The KHV DNA was detected in external biopsies of skin and gills, but also internally in gut and peripheral blood leukocytes ≤ 6 hours post infection (hpi), suggesting rapid virus uptake by the host. The gills and gut appeared to be possible portals of entry, supported by detection of DNA in cells by in situ hybridisation (ISH). However, many false negative results using organ biopsies occurred during the first 4 dpi. The gills were the most reliable lethal biopsy for KHV detection by various polymerase chain reaction (PCR) assays, with a PCR targeting a glycoprotein-gene (ORF56) and a real-time PCR assay being the most sensitive of the 7 methods investigated. Importantly, non-lethal mucus samples reduced the number of false negative results obtained by all KHV PCR assays during the earliest infection stages with large levels of viral DNA being detected in mucus (up to 80,000 KHV DNA genomic equivalents 200 μL-1). KHV DNA was consistently detected in the mucus as a consequence of virus being shed from the skin. Determining the expression kinetics of different viral structural proteins can be useful for DIVA serological tests. Analysis of KHV antigen expression in tissues by immunohistochemistry and indirect fluorescent antibody test was inconclusive, therefore 2 novel semi-quantitative immunofluorescence techniques were developed for determining KHV antigen expression kinetics in susceptible cell lines. During the course of KHV infection in vitro, a greater abundance of capsid antigen was produced in infected cells compared to a glycoprotein antigen (ORF56), as determined by detection with antigen-specific monoclonal antibodies (MAbs). The capsid antigen was characterised as a ~100 kDa protein by SDS-PAGE and identified as a product of KHV ORF84 by matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF/TOF MS). This antigen was subsequently detected in the serum of >25% of KHV infected/exposed carp (6/17), as well as in carp vaccinated with a live attenuated vaccine (3/4), but not with an inactivated vaccine (0/7), by Western blot making it a potential DIVA target for an inactivated vaccine. Attempts were made to improve the sensitivity of KHV serological testing by taking advantage of recombinant proteins specific for KHV (CyHV-3), rORF62 and rORF68 and eliminating any interference by cross-reacting antibodies to carp pox (CyHV-1). These proteins successfully reacted with anti-KHV antibodies. The feasibility of DIVA strategies for KHVD was determined using these recombinant antigens to coat ELISA plates. Differential antibody responses were detected from carp sera to an internal virus tegument protein (rORF62) and external region of a transmembrane protein (rORF68). Fish vaccinated with an inactivated vaccine produced significantly lower antibody responses to rORF62 than to rORF68, whereas infected, exposed and live attenuated vaccinated fish recognised both proteins allowing differentiation between vaccinated and infected carp. However, the sensitivity of the assay was limited, possibly by high levels of natural antibodies detected at the relatively low serum dilutions (1/200) used. As the capsid antigen (ORF84) and tegument protein (ORF62) are derived from internal KHV structural proteins, they induce non-neutralising antibodies, which may be useful for DIVA strategies. Such antibodies are longer lasting than neutralising antibodies and often comprise the majority of fish anti-viral antibodies. This was noted in a fish surviving experimental challenge, which had an antibody titre of 1/10,000, but neutralising titre of 1/45. Such antigens may therefore hold potential for developing effective serological diagnostic tests for KHV and provide the potential for DIVA strategies against KHVD. Natural antibodies will, however, continue to present a challenge to the development of sensitive and reliable KHV serological tests, and hence the application of DIVA strategies.

Ce travail financé par l'ACDI a été réalisé au Laboratoire TRANSNUT de l'Université de Montréal (Canada)en collaboration avec le Laboratoire National de Santé Publique (Burkina Faso) et HKI-Burkina Faso. / L’objectif de l’étude conduite à Ouagadougou était d’évaluer l’état nutritionnel et les habitudes de vie des écoliers ainsi que leurs pratiques alimentaires et certains déterminants, afin d’orienter puis plus tard d’évaluer une intervention nutritionnelle. L’étude a inclus 799 écoliers du cours moyen (âge moyen : 11,7 ± 1,4a) fréquentant 12 écoles privées ou publiques, urbaines ou péri-urbaines. Le poids, la taille, la tension artérielle et l’hémoglobine ont été mesurés et la thyroïde évaluée par palpation. Les lipides sanguins, la glycémie et le rétinol sérique ont été mesurés dans un sous-échantillon (N=208). Un questionnaire complété en classe portait sur la fréquence de consommation d’aliments « santé » (fruits, légumes, viande, poisson, légumineuses) et «superflus » (gâteaux, biscuits, bonbons, glaces, soda), les déterminants du comportement alimentaire ainsi que les pratiques d’hygiène et d’activité physique. Les signes carentiels étaient : une faible rétinolémie, l’anémie, la maigreur, le retard de croissance et le goitre. Les facteurs de risque cardio-métabolique (RCM) consistaient en une tension artérielle élevée, le surpoids/obésité, l’hyperglycémie et la dyslipidémie. Au moins une carence était présente chez 57% des participants. L’anémie (40,4%) et la carence en vitamine A (CVA) (38,7%) étaient fortement prévalentes. Le retard de croissance touchait 8,8% et la maigreur 13,7% des enfants. L’anémie (p=0,001) et la CVA (p<0.001) étaient significativement plus élevées dans les écoles publiques que privées. Aucun cas de goitre n’a été détecté. Le surpoids/obésité était rare (2,3%) . La maigreur et le retard de croissance étaient significativement plus élevés en milieu périurbain. Au moins un facteur de RCM était présent chez 36% des écoliers dont le principal était un taux de cholestérol-HDL-(HDL-C) bas (19,3%), suivi du cholestérol total et du LDL-C élevés (11,6% chacun) et la pression systolique élevée (9,7%). Le sexe féminin était indépendamment et positivement associé aux taux de lipides sanguins dont paradoxalement le HDL-C. L’IMC était indépendamment associé à une tension élevée. On observait que le double fardeau de la malnutrition (DFM) affectait 27,5% des participants. Le score de fréquence de consommation des aliments superflus était plus élevé que celui des aliments santé (p=0,001). Pendant la semaine précédant l’étude, 25 % des enfants n’avaient pas consommé de fruits, 20% pas de viande, 20% pas de légumineuses alors que 18,3% consommaient des glaces tous les jours. Les écoliers du privé consommaient plus fréquemment autant les aliments santé que superflus que ceux des écoles publiques. Les écoliers du milieu urbain avaient un score plus élevé de consommation des aliments superflus que ceux du milieu péri-urbain. La consommation des aliments santé ou superflus était essentiellement expliquée par le contrôle perçu, la disponibilité des produits ainsi que l’influence de la mère pour les aliments santé et l’influence des pairs pour les aliments superflus parmi les explications explorées. Cette étude a montré que les signes de carence nutritionnelle sont répandus et prédominent encore chez les écoliers du milieu urbain, mais aussi que la fréquence des marqueurs de risque cardiométabolique n’est pas négligeable. Des mesures préventives devraient être entreprises pour contrer tant les problèmes de carences que de surcharge. / The aim of this study carried out in Ouagadougou was to assess the nutritional status of schoolchildren and to assess their lifestyle practices as well as their food habits and determinants, for the guidance and evaluation of a nutrition intervention. The cross-sectional survey included 799 schoolchildren in 5th grade (mean age 11.7 ± 1.4y) attending 12 private or public, urban or peri-urban schools. Weight, height, blood pressure and haemoglobin were measured and thyroid palpation was performed. Fasting serum lipids, glycaemia and serum retinol were measured in a sub-sample (N=208). A questionnaire was filled in classroom to assess consumption frequency of ‘healthy’ foods (fruits, vegetables, meat, fish, legumes) and ‘unhealthy’ items (cakes, cookies, candies, ice, soda) and underlying factors as well as hygiene and physical activity practices. Deficiencies signs were: low serum retinol, anaemia, thinness, stunting and goitre whereas cardiometabolic risk factors (CRF) signs consisted of elevated blood pressure (BP), overweight/obesity, hyperglycaemia, and dysglyceamia. At least one malnutrition sign was found in 57% pupils. Anaemia (40.4 %) and vitamin A deficiency (VAD) (38.7 %) were highly prevalent. Stunting affected 8.8% of children while thinness affected 13.7 % of them. Anaemia (p = 0.001) and DVA (p < 0.001) were significantly higher in public than private schools. Goitre was not detected. Overweight/obesity was rare (2.3 %). Thinness and stunting were significantly higher in peri-urban compared to urban schools. At least one CRF was found in 36% schoolchildren. The main risk factors were low HDL-cholesterol (HDL-C) (19.3%) followed by high total cholesterol, high LDL-cholesterol (11.6% each) and elevated systolic blood pressure (9.7%). Being a girl was independently associated with increased serum lipids including HDL-C paradoxically. Body Mass Index was independently associated with increased BP. It was found that the double burden of malnutrition (DBM) affected 27.5% children. Consumption scores of unhealthy food were significantly higher than healthy foods’ (p= 0.001). During the week prior to the survey, 25% of children had eaten no fruit, 20% no meat, 20% no legume, while 18.3% ate ice pop every day. Compared to public-school pupils, those from private schools consumed both healthy and unhealthy items more frequently. Urban school children had significantly higher unhealthy food scores compared to peri-urban schools. Children’s healthy and unhealthy food consumption was primarily explained by perceived control and availability for both types of foods, and maternal reinforcement for healthy foods and peers’ reinforcement for consumption of unhealthy items among the investigated explanations. This study showed that malnutrition is widely prevalent in schoolchildren in cities, concurrently with a sizeable prevalence of cardiometabolic risk factors. Preventive measures should be tailored to prevent both dietary inadequacies and excess.

Diss. (sammanfattning) Umeå : Umeå universitet, 2009. / Härtill 4 uppsatser. Även tryckt utgåva.

L’objectif de l’étude conduite à Ouagadougou était d’évaluer l’état nutritionnel et les habitudes de vie des écoliers ainsi que leurs pratiques alimentaires et certains déterminants, afin d’orienter puis plus tard d’évaluer une intervention nutritionnelle. L’étude a inclus 799 écoliers du cours moyen (âge moyen : 11,7 ± 1,4a) fréquentant 12 écoles privées ou publiques, urbaines ou péri-urbaines. Le poids, la taille, la tension artérielle et l’hémoglobine ont été mesurés et la thyroïde évaluée par palpation. Les lipides sanguins, la glycémie et le rétinol sérique ont été mesurés dans un sous-échantillon (N=208). Un questionnaire complété en classe portait sur la fréquence de consommation d’aliments « santé » (fruits, légumes, viande, poisson, légumineuses) et «superflus » (gâteaux, biscuits, bonbons, glaces, soda), les déterminants du comportement alimentaire ainsi que les pratiques d’hygiène et d’activité physique. Les signes carentiels étaient : une faible rétinolémie, l’anémie, la maigreur, le retard de croissance et le goitre. Les facteurs de risque cardio-métabolique (RCM) consistaient en une tension artérielle élevée, le surpoids/obésité, l’hyperglycémie et la dyslipidémie. Au moins une carence était présente chez 57% des participants. L’anémie (40,4%) et la carence en vitamine A (CVA) (38,7%) étaient fortement prévalentes. Le retard de croissance touchait 8,8% et la maigreur 13,7% des enfants. L’anémie (p=0,001) et la CVA (p<0.001) étaient significativement plus élevées dans les écoles publiques que privées. Aucun cas de goitre n’a été détecté. Le surpoids/obésité était rare (2,3%) . La maigreur et le retard de croissance étaient significativement plus élevés en milieu périurbain. Au moins un facteur de RCM était présent chez 36% des écoliers dont le principal était un taux de cholestérol-HDL-(HDL-C) bas (19,3%), suivi du cholestérol total et du LDL-C élevés (11,6% chacun) et la pression systolique élevée (9,7%). Le sexe féminin était indépendamment et positivement associé aux taux de lipides sanguins dont paradoxalement le HDL-C. L’IMC était indépendamment associé à une tension élevée. On observait que le double fardeau de la malnutrition (DFM) affectait 27,5% des participants. Le score de fréquence de consommation des aliments superflus était plus élevé que celui des aliments santé (p=0,001). Pendant la semaine précédant l’étude, 25 % des enfants n’avaient pas consommé de fruits, 20% pas de viande, 20% pas de légumineuses alors que 18,3% consommaient des glaces tous les jours. Les écoliers du privé consommaient plus fréquemment autant les aliments santé que superflus que ceux des écoles publiques. Les écoliers du milieu urbain avaient un score plus élevé de consommation des aliments superflus que ceux du milieu péri-urbain. La consommation des aliments santé ou superflus était essentiellement expliquée par le contrôle perçu, la disponibilité des produits ainsi que l’influence de la mère pour les aliments santé et l’influence des pairs pour les aliments superflus parmi les explications explorées. Cette étude a montré que les signes de carence nutritionnelle sont répandus et prédominent encore chez les écoliers du milieu urbain, mais aussi que la fréquence des marqueurs de risque cardiométabolique n’est pas négligeable. Des mesures préventives devraient être entreprises pour contrer tant les problèmes de carences que de surcharge. / The aim of this study carried out in Ouagadougou was to assess the nutritional status of schoolchildren and to assess their lifestyle practices as well as their food habits and determinants, for the guidance and evaluation of a nutrition intervention. The cross-sectional survey included 799 schoolchildren in 5th grade (mean age 11.7 ± 1.4y) attending 12 private or public, urban or peri-urban schools. Weight, height, blood pressure and haemoglobin were measured and thyroid palpation was performed. Fasting serum lipids, glycaemia and serum retinol were measured in a sub-sample (N=208). A questionnaire was filled in classroom to assess consumption frequency of ‘healthy’ foods (fruits, vegetables, meat, fish, legumes) and ‘unhealthy’ items (cakes, cookies, candies, ice, soda) and underlying factors as well as hygiene and physical activity practices. Deficiencies signs were: low serum retinol, anaemia, thinness, stunting and goitre whereas cardiometabolic risk factors (CRF) signs consisted of elevated blood pressure (BP), overweight/obesity, hyperglycaemia, and dysglyceamia. At least one malnutrition sign was found in 57% pupils. Anaemia (40.4 %) and vitamin A deficiency (VAD) (38.7 %) were highly prevalent. Stunting affected 8.8% of children while thinness affected 13.7 % of them. Anaemia (p = 0.001) and DVA (p < 0.001) were significantly higher in public than private schools. Goitre was not detected. Overweight/obesity was rare (2.3 %). Thinness and stunting were significantly higher in peri-urban compared to urban schools. At least one CRF was found in 36% schoolchildren. The main risk factors were low HDL-cholesterol (HDL-C) (19.3%) followed by high total cholesterol, high LDL-cholesterol (11.6% each) and elevated systolic blood pressure (9.7%). Being a girl was independently associated with increased serum lipids including HDL-C paradoxically. Body Mass Index was independently associated with increased BP. It was found that the double burden of malnutrition (DBM) affected 27.5% children. Consumption scores of unhealthy food were significantly higher than healthy foods’ (p= 0.001). During the week prior to the survey, 25% of children had eaten no fruit, 20% no meat, 20% no legume, while 18.3% ate ice pop every day. Compared to public-school pupils, those from private schools consumed both healthy and unhealthy items more frequently. Urban school children had significantly higher unhealthy food scores compared to peri-urban schools. Children’s healthy and unhealthy food consumption was primarily explained by perceived control and availability for both types of foods, and maternal reinforcement for healthy foods and peers’ reinforcement for consumption of unhealthy items among the investigated explanations. This study showed that malnutrition is widely prevalent in schoolchildren in cities, concurrently with a sizeable prevalence of cardiometabolic risk factors. Preventive measures should be tailored to prevent both dietary inadequacies and excess. / Ce travail financé par l'ACDI a été réalisé au Laboratoire TRANSNUT de l'Université de Montréal (Canada)en collaboration avec le Laboratoire National de Santé Publique (Burkina Faso) et HKI-Burkina Faso.

Investigation of the relationship between iron deficiency, iron supplementation and susceptibility to infection, was suggested by the author's initial observations of an association of anaemia with serious bacterial infections in infancy in Papua New Guinea. The bulk of previous longitudinal clinical intervention studies in infancy showed beneficial effects of iron supplementation. However, defects of control and design and recording in these studies and contradictory anecdotal reports left the question unresolved. A prospective, placebo-controlled, randomised, double-blind trial of iron prophylaxis (3ml intramuscular iron dextran = 150mg Fe) to two month old infants was carried out on the North Coast of Papua New Guinea where there is high transmission of malaria. A literature review, pilot studies, protocol, demography, geography and laboratory methods developed are described. Findings indicate that the placebo control group became relatively iron deficient over the first year of life and that the iron dextran group had adequate, although not excessive iron stores and a higher mean haemoglobin; however, the prevalence and effects of malaria recorded in the field were higher in the iron dextran group. Analysis of field and hospital infectious morbidity in the trial indicated a deleterious association with iron dextran for all causes including respiratory infections (the main single reason for admission). Total duration of hospitalisation was significantly increased in the iron dextran group. Analysis of other factors showed (1) a higher admission rate associated with low weight-for-height recorded at the start of the trial; (2) a significant positive correlation between birth haemoglobin and hospital morbidity rates; (3) increased malaria rates in primiparous mothers of the cohort infants who received iron infusion during pregnancy; (4) lower relative risk of malaria associated with iron prophylaxis in individuals with alpha thalassaemia, which was found to be highly prevalent in this region. In conclusion, it is suggested that policies of iron supplementation, total dose iron injection and routine presumptive iron therapy for anaemia which are widely in practice in malaria endemic areas should be closely reviewed.

Anaemia, which is caused by iron deficiency, is a global nutritional disorder of utmost concern. It has been assumed that meat, which contains haem as well as non-haem iron, enhances non-haem iron absorption due to the presence of the “meat factor”. In the experiment reported here, 24 semi-anaemic, 3-week-old piglets were utilised as human nutrition models to assess the effects of dietary lactoferrin, meat and LSF (Low Molecular Weight Sarcoplasmic Fraction) on iron bioavailability during a 4-week feeding period. The parameters that were used as measurements of iron bioavailability were changes in haematological indices, haemoglobin iron repletion efficiency, intestinal morphology and mineral balances. Non-significant (p > 0.05) dietary effects were observed for growth performance and for all the haematological and some histological parameters (small intestine villi height, crypt depth and mucosal thickness). Haemoglobin iron repletion efficiency was highest for the control group and was not significantly different between the other 3 diets. The superiority of the control diet in this respect was not consistent with previous trials and can not be explained. Results suggested that increased retention of calcium, magnesium, phosphorous and manganese tended to inhibit iron absorption. However, the LSF and meat diets significantly (p = 0.003) increased the number of goblet cells/100 µm suggesting that mucin secretion was favoured by these two diets. Additionally, all immunological parameters were significantly (p < 0.05) improved by the LSF diet. As such, the LSF diet can be a potential immunobooster feed ingredient for weanling piglets. Overall, the level of LSF in the LSF diet was insufficient to exert a desirable enhancement of iron bioavailability and betterment of 3 iron status of the semi-anaemic piglets relative to the control group. However, the diet containing LSF was as effective as the meat diet with respect to these characteristics.