International Study Results

Morphology and multilocus phylogeny of the Spiny-footed Lizard (Acanthodactylus erythrurus) complex reveal two new mountain species from the Moroccan Atlas.

We generated an extensive morphological and multilocus molecular dataset to investigate the taxonomy of Acanthodactylus erythrurus, a widespread species across the Mediterranean and semiarid habitats of the Iberian Peninsula and the Maghreb. Our integrated analyses revealed the existence of at least five basal lineages: (i) an Ibero-Moroccan clade widespread across Morocco and the Iberian Peninsula, from sea-level up to a maximal known altitude of 1,930 m, (ii) an Algero-Tunisian clade, distributed in coastal and inland areas of eastern Algeria and Tunisia, (iii) a Central Algerian clade, formed by two inland populations located in central Algeria (1,000-1,500 m a.s.l.), (iv) a western High Atlas clade including two montane populations from Jbel Siroua and Tizi n’Tichka (at 2,320 m and 2,176 m a.s.l., respectively) and (v) an eastern High Atlas clade, including at least two montane populations from Isli and Tislit (both localities around 2,275 m a.s.l.). An integrated species delimitation approach combining molecular and multivariate morphological analyses demonstrated complete reproductive isolation and hence speciation between the Ibero-Moroccan clade and the eastern High Atlas clade in their contact zone. The divergence between all five clades is broadly similar, supporting the existence of at least five species in the Acanthodactylus erythrurus complex. In the present work we describe the two well-differentiated endemic species from the Moroccan Atlas for which no name is available: Acanthodactylus lacrymae sp. nov. from Isli and Tislit and A. montanus sp. nov. from Jbel Siroua and Tizi n’Tichka. Further work will be needed to fully resolve the taxonomy of this species complex.

Patterns of diagnostic procedures for lung cancer pathology in the Middle East and North Africa.

Accurate pathological diagnosis is the first critical step in the management of lung cancer. This step is important to determine the histological subtype of the cancer and to identify any actionable targets. Our study aimed at evaluating the patterns of procedures used to obtain pathological diagnosis of lung cancer in the Middle East and North Africa (MENA) Region.Data of consecutive patients with the diagnosis of non-small cell lung cancer (NSCLC) were collected from participating centers from different countries in the MENA Region. Methods of obtaining tissue diagnosis and workup were analyzed to determine the practice patterns of obtaining tissue diagnosis of lung cancer.


A total of 566 patients were recruited from 10 centers in 5 countries including Saudi Arabia, United Arab Emirates (UAE), Qatar, Lebanon and Algeria. Majority of patients were males (78.1%) with a median age of 61 years (range, 22-89 years). Obtaining tissue diagnosis was successful in the first attempt in 72.3% of patients, while 16.4% and 6.3% of patients required 2nd and 3rd attempt, respectively. The success in first attempt was as follows: image guided biopsy (91%), surgical biopsy (88%), endobronchial biopsy (79%) and cytology (30%). The success in the second attempt was as follows; surgical biopsy (100%), image guided biopsy (95%), endobronchial biopsy (65%), cytology (25%).

More than quarter of the patients required repeated biopsy in the MENA Region. Image guided biopsy has the highest initial yield. Implementing clear process and multidisciplinary guidelines about the selection of diagnostic procedures is needed.

Racial and Ethnic Disparities in Global Atopic Dermatitis Clinical Trials.

Atopic dermatitis (AD) is a chronic inflammatory dermatosis affecting up to 20% of children and 3% of adults.1 Historically AD was more prevalent in more developed nations. However, recent trends indicate an increasing prevalence in developing regions, including Southeast Asian countries, Mexico, Chile, Kenya, and Algeria.

Occurrence and characterization of surface sediment microplastics and litter from North African coasts of Mediterranean Sea: Preliminary research and first evidence.

The aim of this research work is to investigate the abundance of macroplastics and microplastics from North African coasts of Mediterranean Sea in the Gulf of Annaba (Algeria). The study areas are well known for the high population and high industrial activities that can contribute to the plastic pollution. In this case, microplastics were sampled from the surface sediments at four different stations representing different local activities. The microplastics were extracted by the density separation method from collected samples. Each particle was identified using Fourier transform infrared spectroscopy (ATR-FTIR). Furthermore, beach litters were obtained according to the adopted methodology – guidance on monitoring of marine litter in European seas. The obtained mean concentrations are 182.66 ± 27.32 and 649.33 ± 184.02 kg-1 sediment (DW), respectively. A detailed spatial and quantitative analysis revealed that their distribution was a function of proximity to populated areas and associated with wastewater effluents, industrial installations, degree of shore exposure and complex tidal flow patterns. Five types of microplastics were identified; the most common were fibers (70%), fragments (21%), pellets (5%), films (2%) and foams (2%). Attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) analysis showed that the main polymers detected in the studied microplastics were polyethylene (48%), polypropylene (16%), polyethylene terephthalate (14%), polystyrene (9%), butyl branham (7%), ethylene propylene (3%) and cellulose tri acetate (3%). The obtained results provided a holistic view of the abundance, distribution, and characteristics of microplastics in the Gulf of Annaba.

This study confirmed the presence of microplastics in the Gulf of Annaba, albeit further studies remain necessary for better understanding of sources and fate.

Wide spread of OXA-48-producing Enterobacteriaceae in Algerian hospitals: A four years’ study.

The aim of this study was to investigate the presence of carbapenemase-producing Enterobacteriaceae (CPE) in Algerian hospitals and to characterize the molecular types of carbapenemases found.During a four years study lasting between 2012 and 2015, 81 strains of Enterobacteriaceae with reduced susceptibility to carbapenems were collected from different hospitals. Carbapenemase genes were detected by PCR. Multi locus sequence typing was used to study genetic relationships between carbapenemase- producing Klebsiella pneumoniae isolates.Among 56 confirmed CPE, blaOXA-48 was detected in 98.21% of isolates. Two isolates co-expressed NDM, and a single one was only an NDM producer. The strains displayed various susceptibility patterns to antibiotics with variable levels of resistance to carbapenems. Multilocus sequence typing (MLST) revealed the presence of multiple sequence types in circulation.This report highlights the wide distribution of several clones of OXA-48-producing Enterobacteriaceae in Algeria. Urgent action should be taken to avoid epidemic situations.

Virulence and antibiotic resistance profile of avian Escherichia coli strains isolated from colibacillosis lesions in central of Algeria.

Background and Aim
Avian pathogenic Escherichia coli cause extensive mortality in poultry flocks, leading to extensive economic losses. To date, in Algeria, little information has been available on virulence potential and antibiotics resistance of avian E. coli isolates. Therefore, the aim of this study was the characterization of virulence genes and antibiotic resistance profile of Algerian E. coli strains isolated from diseased broilers.
Materials and Methods
In this study, 43 avian E. coli strains isolated from chicken colibacillosis lesions at different years were analyzed to determine their contents in 10 virulence factors by polymerase chain reaction, antimicrobial susceptibility to 22 antibiotics belonging to six different chemical classes and genomic diversity by pulsed-field gel electrophoresis (PFGE).
Mainly E. coli isolates (58.1%) carried two at six virulence genes and the most frequent virulence gene association detected were ompT (protectin), hlyF (hemolysin) with 55.8% (p<0.001), and iroN, sitA (iron acquisition/uptake systems), and iss (protectin) with 41.8% (p<0.001). Some strains were diagnosed as virulent according to their virulence gene profile. Indeed, 23.25% of the isolates harbored iroN, ompT, hlyF, iss, and sitA combination, 14% ompT, hlyF, and frzorf4 (sugar metabolism), and 11,6% iroN, hlyF, ompT, iss, iutA (iron acquisition/uptake systems), and frzorf4. The chicken embryo lethality assay performed on five isolates confirmed the potential virulence of these strains. All isolates submitted to PFGE analysis yielded different genetic profiles, which revealed their diversity. Overall, 97.2% of the isolates were resistant to at least one antibiotic and 53.5% demonstrated multi-antimicrobial resistance to three different antimicrobial classes. The highest resistance levels were against nalidixic acid (83.4%), amoxicillin and ampicillin (83.3%), ticarcillin (80.5%), pipemidic acid (75%), and triméthoprim-sulfamethoxazole (66.6%). For beta-lactam class, the main phenotype observed belonged to broad-spectrum beta-lactamases. However, extended-spectrum beta-lactamase associated with three at six virulence factors was also detected in 13 isolates. Two of them were attested virulent as demonstrated in the embryo lethality test which constitutes a real public threat.
It would be imperative in avian production to discourage misuse while maintaining constant vigilance guidelines and regulations, to limit and rationalize antimicrobial use.

First study on the pyrrolizidine alkaloids of Pardoglossum cheirifolium (L.) E.Barbier & Mathez.: GC-MS analysis of their volatile components in the whole plant.

In this work, the first study on the pyrrolizidine alkaloids content of Pardoglossum cheirifolium (L.) E.Barbier & Mathez. was reported. The studied exemplar was collected in Algeria and the analysis was carried out by means of GC-MS on the crude base extract deriving from the whole plant. Nine compounds were tentatively identified and they all represent new phytochemicals at the species level. Their presence confirms the botanical classification of the plant as a member of the Boraginaceae family. In addition, it points out some interesting chemosystematic relations within the family.

Two novel Rickettsia species of soft ticks in North Africa: ‘Candidatus Rickettsia africaseptentrionalis’ and ‘Candidatus Rickettsia mauretanica’.

Rickettsia are obligate intracellular bacteria often reported from hard ticks but more rarely from soft ticks. In this study, we detected in Northern Africa two putatively novel Rickettsia species in soft tick species of the Ornithodoros erraticus complex: Ornithodoros occidentalis from Morocco, Ornithodoros erraticus from Algeria and Ornithodoros normandi from Tunisia. We characterized these two novel Rickettsia species on the basis of comparative DNA sequence analyses and phylogenetics of four genes (gltA, 16S rRNA, coxA and ompB). These Rickettsia, provisionally named ‘Candidatus Rickettsia africaseptentrionalis’ and ‘Candidatus Rickettsia mauretanica’, differed in nucleotide sequence from those of other Rickettsia species by 0.38-21.43 % depending on the gene examined. Phylogenetics further showed that the two novel Rickettsia species are closely related to each other and represent sister taxa to R. hoogstraalii, R. felis and R. asembonensis within the transitional Rickettsia group. While Ornithodoros host species of ‘Candidatus Rickettsia africaseptentrionalis’ and ‘Candidatus Rickettsia mauretanica’ are among the most common soft ticks to bite humans, their pathogenicity remains to be investigated.

Cardiac arrhythmia services in Africa from 2011 to 2018: the second report from the Pan African Society of Cardiology working group on cardiac arrhythmias and pacing.

Cardiac arrhythmia services are a neglected field of cardiology in Africa. To provide comprehensive contemporary information on the access and use of cardiac arrhythmia services in Africa.Data on human resources, drug availability, cardiac implantable electronic devices (CIED), and ablation procedures were sought from member countries of Pan African Society of Cardiology. Data were received from 23 out of 31 countries. In most countries, healthcare services are primarily supported by household incomes. Vitamin K antagonists (VKAs), digoxin, and amiodarone were available in all countries, while the availability of other drugs varied widely. Non-VKA oral anticoagulants (NOACs) were unequally present in the African markets, while International Normalized Ratio monitoring was challenging. Four countries (18%) did not provide pacemaker implantations while, where available, the implantation and operator rates were 2.79 and 0.772 per million population, respectively. The countries with the highest pacemaker implantation rate/million population in descending order were Tunisia, Mauritius, South Africa, Algeria, and Morocco. Implantable cardioverter-defibrillator and cardiac resynchronization therapy (CRT) were performed in 15 (65%) and 12 (52%) countries, respectively. Reconditioned CIED were used in 5 (22%) countries. Electrophysiology was performed in 8 (35%) countries, but complex ablations only in countries from the Maghreb and South Africa. Marked variation in costs of CIED that severely mismatched the gross domestic product per capita was observed in Africa. From the first report, three countries have started performing simple ablations.The access to arrhythmia treatments varied widely in Africa where hundreds of millions of people remain at risk of dying from heart block. Increased economic and human resources as well as infrastructures are the critical targets for improving arrhythmia services in Africa.

Triterpene saponins from Silene gallica collected in North-Eastern Algeria.

Eleven previously undescribed triterpene saponins, named silenegallisaponin A-K (1-11), were isolated from the aerial parts of Silene gallica L. Their structures were elucidated by analysis of 1D and 2D-NMR spectroscopic data and mass spectrometry (HR-ESI-MS). The saponins comprised caulophyllogenin, echinocystic acid, or quillaic acid substituted at C-3 by a β-d-glucuronic acid or β-d-galactopyranosyl-(1 → 3)-β-d-glucuronopyranoside and at C-28 by a β-d-fucopyranose substituted at C-2 by a β-d-glucose and at C-3 by a β-d-glucose or a β-d-quinovose.

Characterization of ethyl acetate and n-butanol extracts of Cymbopogon schoenanthus and Helianthemum lippii and their effect on the smooth muscle of the rat distal colon.

Cymbopogon schoenanthus (C. schoenanthus) and Helianthemum lippii (H. lippii) are Saharan species found in the South West of Algeria, in the region of Bechar. Both plants are used in traditional medicine to treat gastrointestinal disorders.The aim of our study was to characterize the composition of the ethyl acetate (EtOAc) and n-Butanol (n-BuOH) extracts of C. schoenanthus and H. lippii, and to elucidate and compare their effect on the reactivity of the rat distal colon.The plants were macerated in a hydroalcoholic solution. After concentration, the aqueous solutions of the residues were submitted to liquid-liquid extractions to obtain EtOAc and n-BuOH extracts. The phenolic and flavonoid content of the extracts was determined by high performance liquid chromatography coupled with mass spectrometry with a time of flight analyzer (HPLC-TOF/MS). The effect of the extracts was tested on the rat distal colon, namely on the basal tone and on KCl- and Ach-induced precontracted preparations.HPLC-TOF/MS identified 32 phenols and flavonoids in the extracts. The four extracts relaxed the rat distal colon, the effect being noticed on the basal tone and on the KCl- and Ach-induced precontractions. The EtOAc and the n-BuOH extracts of H. lippii decreased the basal tone of the rat distal colon more markedly than the correspondent extracts of C. schoenanthus. Moreover, the n-BuOH extract of C. schoenanthus decreased the basal tone more markedly than the EtOAc extract of this plant but there was no difference between extracts of H. lippii. The EtOAc extracts of both C. schoenanthus and H. lippii totally reverted both the KCl- and the Ach-induced precontraction of the rat distal colon. However, the n-BuOH extracts of the two plants reverted the Ach-precontracted colon but not the colon that has been precontracted with KCl.Extracts of H. lippii contain a higher level of phenols compared to the extracts of C. schoenanthus. All extracts of C. schoenanthus and H. lippii caused marked relaxation of the isolated rat distal colon, either when applied directly or when tested over KCl- and Ach-induced precontraction. These results give support to the use of C. shoenanthus and H. lippii in traditional medicine, namely for gastrointestinal diseases.

Abundance of Lactobacillus plantarum Strains with Beneficial Attributes in Blackberries (Rubus sp.), Fresh Figs (Ficus carica), and Prickly Pears (Opuntia ficus-indica) Grown and Harvested in Algeria.

This first study performed on traditional fruits consumed in North Africa reveals their richness in microorganisms with beneficial attributes like cholesterol lowering capabilities. Blackberries (Rubus sp.), fresh figs (Ficus carica), and prickly pears (Opuntia ficus-indica) are fruits largely and traditionally consumed in Kabylia, a beautiful northern Algerian region. Here, 85 lactic acid bacteria (LAB)-isolates were isolated and identified by MALDI-TOF mass spectrometry. The identified species belong to Lactobacillus and Leuconostoc genera. These 85 LAB-isolates were then assessed for their capabilities to grow under conditions mimicking the gastrointestinal tract, and the resulting data were statistically treated with principal component analysis (PCA). After which, only 26 LAB-isolates were selected and characterized for their genetic relatedness using random amplified polymorphic DNA (RAPD) method. Following the genetic relatedness assessment, only 10 LAB-strains, among which nine Lactobacillus plantarum and one Lactobacillus paracasei were studied for their pathoproperties and some probiotic features. Interestingly, all of these 10 LAB-strains were devoid of adverse effects, but capable to adhere to human epithelial colorectal adenocarcinoma Caco-2 cells. Of note, these 10 LAB-strains exhibited an important in vitro hypocholesteromia effect, in strain-dependent manner. Moreover, the Lactobacillus strains exhibited a high bile salt hydrolase (BSH) activity which was correlated with expression of bsh2, bsh3 and bsh4 genes.

Two decades of experience in a combined adult/pediatric allogeneic hematopoietic stem cell transplantation center in Algiers, Algeria.

Hematopoietic stem cell transplantation (HSCT) has evolved from an experimental to a successful treatment modality reaching worldwide 80.000 HSCT/year. Distribution and trends of HSCT, however, remain heterogeneous. Activities range from none to more than 511/10 million population between countries and regions. Here, we report on a successful autologous and allogeneic HSCT program for adult and pediatric patients started two decades ago in Northern Africa. From 1998 to December 2017, a total of 2828 HSCT was performed of which 2059 were allo-HSCT (1474 adults and 585 children). The activities were analyzed according to indication, donor type, stem cell source, and trends over time. There was a significant difference in indications according to age. Adult patients were transplanted more often for hematological malignancies. In children, the indications were distributed equally between malignant and non-malignant diseases. Overall activities increased substantially in AML and to a lower extent in ALL and CLL despite sharp reduction of activity in CML after 2005. Finally, a higher transplantation rate (33/10 million population) was reached as compared to most regions of the world except Europe and USA/Canada. Overall survival in children with AML was 56.0% at 15 years, in adults 61.3% at 5 years, and in patients with CML 55.5% at 15 years without difference between reduced intensity condition (RIC) and myeloablative conditioning (MAC). Patients with Ph+ ALL had the lowest survival reaching 26.7% at 5 years. Highest survival was observed in patients with aplastic anemia, Fanconi anemia, and thalassemia reaching 77.3%, 73.5%, and 75.7% at 15 years respectively. Long distances and late referral remain a challenge for this large country.

Demographic expansion of an African opportunistic carnivore during the Neolithic revolution.

The diffusion of Neolithic technology together with the Holocene Climatic Optimum fostered the spread of human settlements and pastoral activities in North Africa, resulting in profound and enduring consequences for the dynamics of species, communities and landscapes. Here, we investigate the demographic history of the African wolf (Canis lupaster), a recently recognized canid species, to understand if demographic trends of this generalist and opportunistic carnivore reflect the increase in food availability that emerged after the arrival of the Neolithic economy in North Africa. We screened nuclear and mitochondrial DNA in samples collected throughout Algeria and Tunisia, and implemented coalescent approaches to estimate the variation of effective population sizes from present to ancestral time. We have found consistent evidence supporting the hypothesis that the African wolf population experienced a meaningful expansion concurring with a period of rapid population expansion of domesticates linked to the advent of agricultural practices.

First serological evidence of West Nile virus infection in wild birds in Northern Algeria.

While the epidemiology of Flaviviruses has been extensively studied in most of the Mediterranean basin, little is known about the current situation in Algeria. In order to detect the circulation of West Nile (WNV) and Usutu viruses (USUV) in Kabylia, 165 sera were collected from two wild birds species, namely the long distance migrant Turdus philomelos (song thrush) (n = 92) and the resident Passer domesticus (house sparrow) (n = 73). A total of 154 sera were first analyzed by commercial competition ELISA. WNV and USUV micro-neutralization tests were performed on all c-ELISA positive sera and all samples with poor volume. Overall, 7.8 % (CI95 %: 3.5-11.9) were positive by c-ELISA. Positive results were detected in 12.5 % (CI95 %:5.6-19.4) of song thrushes and 1.5 % (CI95 %: 0.0-4.5) for sparrow. Micro-neutralization tests revealed an overall seroprevalence of 6.7 % for WNV (CI95 %: 2.9-10.3), Neutralizing antibodies were found in 8.7 % (CI95 %: 3.0-14.4) for song thrushes and in 4.1 % (CI95 %: 0.0-8.7) of sparrows. The current study demonstrates significant seroprevalence of WNV antibodies in wild birds in Algeria.

Population dynamics of Macaca sylvanus in Algeria: An 8-year study.

The demography and dynamics of two groups, one living in an evergreen cedar-oak forest (Tigounatine) and the other, in a deciduous oak forest (Akfadou) in Algeria, were studied from 1982 to 1990. Group size fell within the range of other wild groups except for the Tigounatine group when it reached 88 individuals before splitting into three new independent groups. The structure of the studied groups, except one which was temporarily “one male,” was comparable to that of other groups of Barbary macaques. There were 43-50% of immatures on average depending on the group. The sex ratio (M:F) of the sexually mature animals was relatively balanced (1:0.9-1.2). The mean age of primiparous females was 5.5 years in Tigounatine and 5.3 in Akfadou; the rate of reproduction of sexually mature females was 0.56 and 0.63, respectively, while the infant mortality rate was 0.23 and 0.38, respectively. Great interannual variations occurred at both sites. The differences between natality and mortality induced a higher intrinsic mean annual increase for the Tigounatine group (14.6%) than for the Akfadou group (4.8%). The rate of intergroup transfers was not correlated with the increase in group size. Integration of male immigrants did not lead to the departure of resident males. Conversely, fission process promoted a substantial increase in the number of transfers in Tigounatine. The period presenting the greatest risk of infant mortality was the summer dry period, in both habitats. Wide interannual variations occurred in the availability of two staple foods for monkeys: caterpillars and acorns. The cumulative effects of a low acorn supply during the gestation period (autumn) and a low caterpillar supply during the beginning of the following nursing period (spring) led to a temporary increase in infant mortality. © 1993 Wiley-Liss, Inc.

How to manage transfusion systems in developing countries: The Experience of Eastern and Southern Mediterranean countries.

To outline and analyse the national organisation, infrastructure and management of transfusion systems in countries sharing common historical, cultural and economic features and to decipher management trends, in order to potentially benchmark.Little is known regarding transfusion systems in Eastern/southern Mediterranean at a time international organisations are calling for the establishment of a safe and sustainable blood system.Data emanating from eight Arabic-speaking Eastern/Southern Mediterranean countries who responded to five surveys were collected and tabulated.While similarities in terms of supervision by national authorities, authorization of blood centres, quality control and management information system are evident, some significant divergence between these countries do exists. Only Lebanon does not possess a national blood establishment or organisation for blood supply. Blood components are fully government-subsidised in Algeria and Mauritania. Algeria, Morocco and Tunisia have a blood supply that relies mainly on Voluntary non-remunerated donors. Plateletpheresis is performed in all countries except Mauritania while plasmapheresis exists only in Algeria and Egypt. Morocco is the sole country outsourcing its plasma for Plasma derived products.Despite the various challenges facing these countries, lot of progresses have been made so far in the field of transfusion medicine. Yet, nationally coordinated blood programs overviewed by national regulatory authorities and actively supported by local governments are still needed to ensure the optimum level of blood safety.

Towards a prediction of outdoor human thermal comfort adapted for designers of urban spaces: examining UTCI and APCI in the context of Algiers (Algeria).

The aim of this article is to determine the ability of UTCI (universal thermal climate index) to assess summer micrometeorological comfort in the climatic and sociocultural context of Algiers (Algeria). This widely recognised thermo-physiological index is compared with a subjective index, APCI (average perceived comfort index), based on a definition of comfort established beforehand by the studied population. A new procedure was applied based on “micrometeorological walk” in order to collect objective and subjective experimental data simultaneously. From the data collected, both indices were calculated for 12 urban configurations. The correlation between UTCI and the subjective APCI shows that UTCI is able to correctly predict and assess the level of outdoor human thermal comfort felt in the south Mediterranean climate. However, the evaluation scale for heat stress in UTCI is inappropriate in the studied context, unlike that proposed by APCI, which takes sociocultural differences into account, as well as the different perceived environmental and urban aspects that may influence the perception of outdoor thermal comfort. However, this comparison of UTCI and APCI enables us to put forward a contextualised model of the prediction and assessment of perceived outdoor thermal comfort based on an APCI estimate, from which users’ true perception can be assessed, derived exclusively from physical measurements. Designers can therefore evaluate their proposals using digital architectural and urban modelling tools that include calculation of UTCI, by adjusting the heat stress evaluation scale to match the sociocultural context of the project.

Whole-genome sequencing of Listeria monocytogenes serotype 4b isolated from ready-to-eat lentil salad in Algiers, Algeria.

Listeria monocytogenes is a Gram-positive food-borne pathogen causing a serious threat for public health. Here we announce the whole genome sequence (3 011 693 bp) of Listeria monocytogenes serotype 4b, isolated from ready-to-eat lentil salad in Algiers and belonging to sequence type 2, lineage I and clonal complex 2.

Potential use of morphological deformities in Chironomus (Diptera: Chironomidae) as a bioindicator of heavy metals pollution in North-East Algeria.

Human activities have led to profound changes in aquatic environments and degradation at several levels. Preserving the quality of aquatic environments, their good functioning, and the species that are dependent on them has become a crucial element. In order to monitor the overall health of aquatic ecosystems, it is necessary to develop early indicators of environmental quality. In this work, we have tried to evaluate whether the analysis of morphological deformities affecting Chironomidae larvae could tell us about the state of degradation of water courses that are subjected to different discharges. To do this, water, sediment, and larvae of Chironomidae were sampled in dry weather in August-September of 2017 at three sites located in the North-East of Algeria. The heavy metals in the three compartments as well as the deformities affecting the mentum and mandibles of Chironomus were analyzed. The results showed a metal contamination especially in sediments; the highest values were found in Meboujda River and Seybouse River. The three sites have high deformities incidences, more than 33%, which suggests the presence of toxic stress. This study reflected the relationship between heavy metal concentrations in water, sediments, and deformities larval mouthparts (mentum and mandibles) in Chironomus. The use of deformities in Chironomus sp. can serve as an effective tool for bioassessment of freshwater ecosystems.

Cardiometabolic risk prevention strategies: the importance of sharing experiences between Mediterranean countries.

According to the Global Burden of Disease Study 2017, between 1990 and 2017, Italy experienced a more attenuate reduction in cardiovascular deaths than Western Europe. When considering risk factors, our Country experienced a reduction in the prevalence of hypertension in the last few decades, especially in women. On the other hand, the prevalence of obesity, abdominal obesity and hypercholesterolemia in Italy is on the rise. Likewise, the control of total blood cholesterol is not revealing favorable time changes and sedentary lifestyle remains highly prevalent especially among women. A negative relationship between long-term exposure to the economic crisis and cardiovascular diseases was observed and the association between cardiovascular risk and socioeconomic status is now clearly evident. It is, therefore, necessary to specifically target the efforts towards the weakest sections of the population so that prevention policies can offer their maximum benefit. The study is part of a series of manuscripts promoted by SIMI with the collaboration of the National Internal Medicine Societies of some Mediterranean countries (Tunisia, Algeria, Egypt). The goal was to highlight the health needs related to the growth of metabolic diseases in the area. The observed changes bring the two coasts of the Mediterranean closer together. It is time to work together to build more effective strategies for identifying and reaching population subgroups that have still remained little sensitive to prevention and specially to lifestyles changes.

[Asthma control in adult Algerian patients. Comparison with other North African and Middle-East countries].

Lack of recent data on asthma control in Algeria led to this study whose results were compared with those of the same study conducted in the Middle East and North Africa (MENA).This cross-sectional epidemiological study was performed in adults who had been diagnosed with asthma for at least one year and without exacerbation within the last 4 weeks. Asthma control was assessed using the 2012 Global Initiative for Asthma (GINA) criteria and the Asthma control test (ACT) questionnaire.


We studied 984 patients mainly managed by specialist physicians; 61% female, mean age 45 years, body mass index 27kg/m2, active smokers 2%. Medication was prescribed in 92% with 78% receiving inhaled corticosteroids alone or with add-on therapies. Good adherence was observed in 27%. Asthma control was observed in 34.6% vs. 28.6% in other countries (P < 0.001). Low level of education, absence of medical insurance, lack of physical exercise, and-long duration of the disease were significantly associated with uncontrolled asthma.

Poor control of asthma is still observed in Algeria despite a high level of specialist involvement. Except for adherence, known predictive factors of poor asthma control have been observed. Quality improvement training of health care professionals and patient education are probably the main issues to be addressed.

Epidemiological study of goat’s gastrointestinal nematodes in the North West of Algeria.

An epidemiological study of gastrointestinal nematodes was carried out in naturally infected goats in the North West of Algeria. Coprological analyses were performed for 2 years from January 2014 to December 2015.Examination of 1591 goat samples revealed an overall prevalence of parasite eggs in feces of 96%; the values were very similar in both years at 97% in 2014 and 94.96% in 2015. Five types of nematode eggs were identified: strongyle (95.5%), Nematodirus spp. (19.4%), Marshallagia spp. (3.9%), Trichuris spp. (0.6%), and Skrjabinema spp. (2%).Also, fecal cultures showed the presence of Teladorsagia spp. (56%), Trichostrongylus spp. (20%), Chabertia spp. (10%), Haemonchus spp. (9%), and Oesophagostomum spp. (5%).Season, age, type of grazing, and area affected the epidemiology of gastrointestinal nematodes of goats. The season did not influence the prevalence observed in the 2 years, since no significant differences between the four seasons were observed. On the other hand, egg production was highest in winter and spring. The level of infection decreased with the animal’s age. There were no significant differences between the prevalence in animals on irrigated and non-irrigated pastures, but there were differences in egg excretion. Additionally, no significant difference was observed between the coastal (Oran) and lowland (Mascara) regions in the prevalence or in average egg excretion.

Characterization of New Fengycin Cyclic Lipopeptide Variants Produced by Bacillus amyloliquefaciens (ET) Originating from a Salt Lake of Eastern Algeria.

Fengycin antibiotic displays a strong antifungal activity and inhibits the growth of a wide range of plant pathogens especially filamentous fungi. The main objective of the present study is to characterize fengycin variants produced by B. amyloliquefaciens strain (ET). LC-MS analysis of fengycin extracts has shown several molecular ion peaks corresponding to conventional fengycin homologues (MH + : m/z 1463.9; 1491.9; 1506) and some new ones (MH + : m/z 1433; 1447; 1461; and 1477). Further characterization of these precursor ions was carried out by LC-MS.MS analysis. Reporter fragment ions were observed (named A and B), they correspond to the cleavage of Orn2-Tyr3 (A), Glu1-Orn2 (B), and used for identifying fengycin variants. The reporter fragment couple ions [A/B] at [m/z 966.5/1080.5] and [m/z 994.4 /1108.5] represent fengycin A and B, respectively. The diagnostic ions at ([m/z 980/1094]) may correspond to fengycin C3, D, S or B2. Interestingly, unknown diagnostic product ions at [m/z 951/1065] and [m/z 979/1093] were detected for the first time in this study which prove that they correspond to new fengycin variants, named fengycin X and fengycin Y, respectively. The fengycin X results from a substitution of the glutamine amino acid (Q), at position 8 of the fengycin A peptide part, by an isoleucine (I) or a leucine (L) residue. This mutation should be the same in fengycin Y but compared to fengycin B.

Molecular detection of avian spirochete Borrelia anserina in Argas persicus ticks in Algeria.

Argasid ticks are one of the most important poultry ectoparasites. They affect poultry directly through blood meal and indirectly through the transmission of pathogens essentially Borrelia anserina, agent of avian borreliosis, one of the most widespread poultry diseases in the world, and is of great economic importance. This study was conducted between April 2014 and March 2015 in the region of Ksar El Boukhari, Algeria, in order to investigate the presence of soft ticks in laying hen farms and to detect B. anserina bacteria using molecular tools. DNA was extracted and screened for the presence of Borrelia spp. DNA by real-time polymerase chain reaction (qPCR). Borrelia spp. screening was performed using primers and probe targeting the 16S rRNA gene. A total of 83 traditional laying hen farms were visited, of which 39 (46.98 %) were found infested with A. persicus tick. Molecular analysis revealed that 2/34 (5.88 %) of ticks were infected by B. anserina. None of the ticks tested were positive for Rickettsia spp., and Coxiella burnetii. These results constitute the first report in Algeria of A. persicus harboring B. anserina.

Cultural adaptation of internet interventions for refugees: Results from a user experience study in Germany.

The estimated number of refugees worldwide resulting from persecution, conflict, violence, or human rights violations reached 25.4 million in 2017. An increased prevalence of mental disorders combined with language and socio-cultural barriers pose a challenge for healthcare systems. Internet-based interventions can help to meet this challenge. For the effective use of such interventions in refugees, cultural adaptations are necessary. The variety of their cultural backgrounds thereby is particularly challenging.
We conducted this explorative qualitative study in order to identify elements of Internet-based interventions that need cultural adaptation to be suitable for refugees. Six refugees from Syria, Iran, Eritrea, Algeria, and Iraq, and six healthcare providers (two social workers, two psychologists, one physiotherapist, one physician) working with refugees went through an intervention for individuals with sleeping problems (eSano Sleep-e). Possible threats to user experience were identified using the Think Aloud method and semi-structured interviews. Statements were analysed based on the grounded theory method.
Results indicate the necessity to adapt the intervention to the specifics of refugees including aspects related to the flight (i.e., past and current stressors) and non-western characteristics (i.e., habits, disease and treatment concepts). Elements of adaptation should include pictures, role models, language, psychoeducational elements, structure of modules, and format of presentation.Cultural adaptation can be used to facilitate the identification with an intervention, which seems crucial to increase the acceptance among refugees. In spite of their diverse cultural backgrounds, it appears feasible to create interventions that allow identification by refugees from different home countries.

Cancers in the Central Maghreb: epidemiology from 1990 to 2017 and trends in 2040.

To describe the epidemiology of cancers in terms of global burden of disease, incidence, prevalence and typology in the three Central Maghreb countries from 1990 to 2017, as well as their trends from 2017 to 2040.This is a descriptive and predictive study of the epidemiology of cancers in the Central Maghreb (Tunisia, Algeria and Morocco) from 1990 to 2040. The epidemiological data: incidence, prevalence, specific mortality rate and Disability Adjusted Life Years were collected via the Global Burden of Disease Database created by the Institute of Heath Metrics and Evaluation. These parameters were expressed in terms per 100,000 inhabitants.In 2017 and for the three Central Maghreb countries, cancers represented the second leading cause of death, with an overall specific mortality rate of 69/100,000 and an overall incidence rate of 116/100,000 inhabitants. The Disability Adjusted Life Years rate varied from 1516/100,000 in Algeria to 1992/100,000 in Morocco. In the three Central Maghreb countries and during the year 2017, lung cancer was the first cancer in terms of mortality, regardless of age and sex, followed by colorectal cancer in Tunisia and breast cancer in Algeria and Morocco. These three cancers will remain in 2040 the most important in terms of mortality rate with lung cancer topping the list in Tunisia and Morocco with respective mortality rates of 30 and 16/100,000.Cancers are currently, and in the next two decades, an important component of the GlobalBurden of Disease in Central Maghreb countries. The typology is dominated by lung, breast and colorectal cancers. The establishment of a Maghreb cancer registry would be a fundamental component of the Maghreb cancer plan.

Frequency and susceptibility pattern of uropathogenic Enterobacteriaceae isolated from patients in Algiers, Algeria.

The frequency of Enterobacteriaceae involved in urinary tract infections (UTI) has increased significantly since the early 1990s, particularly in at-risk facilities such as resuscitation, surgery, urology and nephrology. The objective of this study was to evaluate the antimicrobial susceptibility of Enterobacteriaceae causing urinary tract infections (UTIs)at the University Hospital Centre of Benimessous in Algiers.The study was designed as a retrospective study (between January 1st 2010 and December 31st 2012) and a prospective study (between January 1standApril 30th 2013) on 13,611 urine samples. Antimicrobial resistance phenotyping was conducted on the bacterial isolates using disk-diffusion method.On 13,611 urine samples analysed, 1,790 (13.15%) fulfilled the criteria for urinary tract infection. Enterobacteriaceae were identified in 1,561 analysed samples (87%). Escherichia coli was the dominant uropathogen (66,15%) in both hospitalized and non-hospitalized patients. The other main detected Enterobacteriaceae members were Klebsiella pneumoniae (11,96%) and Proteus mirabilis (5,42%). Analysis of results showed also that women were more prone to UTI than men with sex ratio of 3.76(W/M). The susceptibilities of isolated Enterobacteriaceae to antibiotics revealed that they had acquired resistance to several classes, particularly toward β-lactams. Resistance frequencies were relatively high to ampicillin and sulfomethoxasole, while being very low to aminoglycosides and furans. Results obtained revealed also that 7% of isolates where resistant to third generation cephalosporins by production of extended spectrum β-lactamases (ESBL).The continuous monitoring of antibiotic resistance of uropathogenic Escherichia coli is crucial to guide the clinician to choose the best empiric treatment.

Prevalence of mastitis in dairy goat farms in Eastern Algeria.

This study aimed to investigate mastitis in dairy goat farms through the California mastitis test (CMT) and bacteriological examinations.A total of 845 goats belonging to 18 farms from four regions (Tébessa, Guelma, Souk Ahras, and Skikda) were examined.


Clinical examination of the mammary glands showed that 30/845 (3.55%) goats had clinical mastitis and 32 goats had half-teat inflammation. CMT subclinical mastitis (SCM) was detected in 815 goats that were presumed to be healthy. CMT showed 46 (5.64%) CMT-positive goats as well as 47 (2.88%) positive half-udders with a score of ≥2. A total of 79 bacteria were isolated and identified from the 79 bacterial positive samples. Bacteriological analyses showed that Gram-positive staphylococci were largely responsible for clinical and SCM. Coagulase-negative staphylococci, with an isolation frequency of 56.96%, were the most prevalent bacteria from all isolated organisms. The second most prevalent organism was Staphylococcus aureus at 40.50% and streptococci (2.53%) had the smallest percentage of isolation.

It is suggested that due to the prevalence of mastitis in this species, farmers should be aware of the problem to plan preventive and control measures to reduce dairy goat losses due to this disease.

In Vitro Cytotoxicity of Parasporins from Native Algerian Bacillus thuringiensis Strains Against Laryngeal and Alveolar Cancers.

Parasporins (PS), a class of non-insecticidal and non-hemolytic crystal proteins of Bacillus thuringiensis (Bt), are being explored as promising anti-cancer agents due to their specific toxicity to cancer cells. This work is considered as a first initiative aiming at investigating Algerian soil Bt isolates’ activity and cytotoxic potential against cancer cells. A total of 48 Bacillus spp. were isolated from different sites in Algeria. Phenotypic and biochemical tests, 16S rDNA molecular identification, and microscopic observation of crystal have confirmed the identification of Bt for ten strains. A screening for non-hemolytic crystalline proteins was performed. Extraction, purification, and activation of non-hemolytic proteins by chromatographic analysis yielded several polypeptides of different molecular weights. A purified PS1, with pro-protein of 81 kDa and several peptides with different molecular weights (18-58 kDa) after activation by trypsin, has been identified from the strain BDzG. The NH2-terminal sequence deciphered in BLAST analysis showed homology to a Bt PS1 protein. Moreover, the screening of parasporin-1 (PS1) gene has also been performed. Cytocidal activity against human epithelial type 2 (HEp2) cells, considered to originate from a human laryngeal carcinoma, was observed with an IC50 equal to 2.33 μg/ml, while moderate cytotoxicity against adenocarcinomic human alveolar basal epithelial (A549) cells has been shown with IC50 equal to 18.54 μg/ml. No cytotoxicity against normal cells was noted. Fluorescence microscopy revealed a condensed or fragmented chromatin indicating the apoptotic death of HEp2 cells. Thus, Bt PS-producer isolated from Algerian soil might have a potential to join the arsenal of natural anti-cancer drugs with high therapeutic potential.

Characterization of VIM-4 Producing Clinical Pseudomonas aeruginosa Isolates from Western Algeria: Sequence Type and Class 1 Integron Description.

Objectives:Pseudomonas aeruginosa occupies a central position in nosocomial infections and remains a significant cause of morbidity and mortality. The aim of this study was to characterize carbapenem resistance mechanisms in P. aeruginosa isolates from clinical specimens collected at the University Hospital of Oran, western Algeria. Materials and Methods: The identification of 214 nonduplicated P. aeruginosa isolates (collected from January to December 2016) was confirmed using matrix-assisted laser desorption/ionization-time of flight mass spectrometry. Thirteen antibiotics were tested using the disc diffusion method. Carbapenemase-encoding genes were detected with the GeneXpert system and multiplex polymerase chain reaction (PCR). Clonal relatedness was determined using multilocus sequence typing (MLST) and the seven housekeeping genes were further used for phylogenetic analysis of imipenem-resistant P. aeruginosa using concatenated gene fragments. The flanking regions of the blaVIM-4 gene were analyzed by whole-genome sequencing. Results: Eleven isolates (5.39%) were resistant to carbapenems. PCR amplification and sequencing showed that six of these isolates (2.94%) harbored the blaVIM-4 gene that was carried on a novel class 1 integron. MLST analysis assigned the tested isolates to seven different sequence types (STs), of which two were new (ST3349 and ST3350) and five were previously described (ST244, ST499, ST709, ST809, and ST1239). Conclusion: In this study, we reported P. aeruginosa isolates producing VIM-4 in an Algerian hospital. The blaVIM-4 is harbored in class 1 integron with a new arrangement of genes cassettes.

[Epidemiology of Cutaneous Leishmaniasis in Algeria through Molecular Characterization].

Three distinct noso-epidemiological cutaneous leishmaniasis (LC) entities coexist in Algeria: the so-called sporadic form of the North (LCN), the zoonotic form (LCZ) and the chronic form (LCC). The precise identification of the parasitic species involved in each of the forms makes it possible to specify the geographical distribution of each of the forms raised, to distinguish their clinical aspects, to guide the therapeutic behaviors and to adapt the control programs. Ninety-seven (97) human strains from Gentaur.