Five successive waves of SARS-CoV-2 infection in the Central African Republic: a prospective observational study from 2020-2022.

Introduction: the National Laboratory of Clinical Biology and Public Health (NLBPH) in Bangui in the Central African Republic (CAR) carries out the vast majority of molecular screening tests for SARS-CoV-2 infection nationwide. This study aimed to show the contribution of molecular diagnosis and genomic surveillance in monitoring the evolution of longitudinal variations of the SARS-CoV-2 infection epidemic in CAR between 2020 and the end of 2022. Methods: this is an observational study on the variations in the prevalence of detection of SARS-CoV-2 by RT-PCR at the NLCBPH from nasopharyngeal samples taken prospectively over a period of 3 years since the beginning of the COVID-19 epidemic. A subgroup of SARS-CoV-2 positive samples was selected for molecular sequencing performed by Illumina® and MinIon® at the National Institute for Biomedical Research in Kinshasa, Democratic Republic of the Congo. Results: from March 2020 to December 31th, 2022, 88,442 RT-PCR tests were carried out (4/5 of the country) and detected 9,156 cases of SARS-CoV-2 infection in 5 successive waves. The average age of the patients was 39.8 years (extremes ranging from to 92 years). Age(P=0.001), sex(P=0.001) and symptom presentation(P=0.001) were significantly associated with RT-PCR test positivity. Among the different variants identified during successive waves, the Omicron variant predominated during the last two waves. Conclusion: this prospective study over a period of 3 years, marked by 5 successive waves, made it possible to report that age, sex and the presence of clinical symptoms are associated with RT-PCR positivity. Among the different variants identified during successive waves, the Omicron variant predominated during the last two waves.

Diagnostic performances of Exacto® Triplex rapid test for diagnosis of HIV/HCV/HBsAg: a multicenter, cross-sectional, field study in the Central African Republic.

Introduction: the Exacto® Triplex HIV/HCV/HBsAg (Biosynex, Strasbourg, France) consists in lateral flow, immunochromatographic rapid diagnostic test simultaneously detecting human immunodeficiency virus (HIV)-1 and HIV-2 and hepatitis C virus (HCV)- specific antibodies (IgG and IgM) and hepatitis B virus (HBV) surface antigen (HBsAg) in serum, plasma and whole blood. We herein evaluated its diagnostic performances in the Central African Republic (CAR). Methods: cross-sectional study was conducted on prospectively collected panel of 550 sera from adult inpatients living in Bangui, including 200 HIV-positive, 100 HBsAg-positive, 50 HCV-positive, 200 negatives to three viruses according to reference immuno-enzymatic serological tests including Murex HCV (Diasorin, Saluggia, Italy) for HCV, Murex HBsAg (Diasorin) for HBV, Genscreen ULTRA HIV Ag-Ab HIV-1/2 Version 2 (Bio-Rad, Marnes-la-Coquette, France) and Murex HIV 1.2.0 Ag/Ab Combination (Diasorin), the 2 tests associated in the parallel algorithm for the reference strategy for the diagnosis of HIV in CAR. Serum samples were tested blindly in duplicate. The findings are reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: the Exacto® Triplex showed 99.5% (95% CI; 98.5-100.0), 96.0% [90.6-100.0] and 99.0% [97.1-100.0] sensitivities for HIV, HCV and HBsAg, respectively. The specificity, positive and negative predictive values (PPV and NPV) were 100.0% for all three viruses. The Youden's J index and Cohen's κ coefficient were 0.99 for HIV and HBsAg. For HCV, Youden's J and Cohen's κ coefficient were 0.96 and 0.98, respectively. In the epidemiological context of the CAR, the PPV and NPV for all three viral infections were high (≥99.0% to 100%). Conclusion: taken together, our STROBE-compliant study demonstrates that the Exacto® Triplex HIV/HCV/HBsAg showed high sensitivity and specificity for HIV and HBsAg (≥99.0%), and relatively high sensitivity (96.0%) and high specificity (100%) for HCV. These analytical performances are within the limits required by the WHO (i.e. sensitivity ≥99.0% and specificity ≥98.0%) for HIV and HBV. The Exacto® Triplex HIV/HCV/HBsAg is user-friendly at low cost, and appears highly desirable for routine use in the CAR, and likely other Central African countries.

Determinants of the psychomotor development delay in children aged 12 to 59 months infected with HIV in Yaounde, Cameroon.

Introduction: children infected with HIV are at increased risk of impaired neurodevelopmental, due to several environmental factors. Methods: we conducted a cross-sectional analytical study on HIV-infected children aged 12 to 59 months, followed up in five hospitals in Yaounde, Cameroon. Sociodemographic, clinical, and biological variables as well as the antecedents were collected. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 25 software. The Denver test was used to assess the psychomotor development of these children. Global psychomotor delay, defined as a global development quotient of less than 70 with an alteration in at least two of the four domains of the test, was retained as the primary endpoint. The significance threshold was set at 5%. Results: one hundred and eighty-one children were included in the study. The sex ratio was 0.6. The age range 48-59 months was the most represented. None of these children had a known chronic pathology other than HIV infection. The proportion of global psychomotor delay was 11.04%, with language (16%) and fine motor skills (16%) being the most affected domains of psychomotor development. The independent factors significantly associated with global psychomotor delay were birth weight below 2500 grams (OR= 17.61 [1.76-181.39], p= 0.022), growth retardation (OR= 17.64 [1.63-190.24], p= 0.018) and elevated viral load (OR= 22.75 [2.78-186.02], p= 0.004). Conclusion: psychomotor delay affects about one out of ten children living with HIV. Its occurrence is linked to various factors that must be taken into account in the development of public health policies in connection with the management of HIV infection in children.

Morphological and functional abnormalities of the orofacial sphere associated with thumb sucking in children aged 3 to 10 years old in Yaounde, Cameroon.

Introduction: thumb sucking is one of the most common oral habits in infants and children. In our context, little is known about the effects of prolonged thumb sucking on the orofacial sphere. Objective: determine the prevalence of thumb sucking and, identify the morphologic and functional abnormalities of the orofacial sphere associated with the duration and frequency of thumb sucking in children aged 3 to 10 years. Methods: a cross-sectional and analytical study was carried out in the pediatric units of the District Hospitals of Biyem-assi and Efoulan from February to June 2020 in children aged 3 to 10 years. Recruitment was consecutive, not probabilistic. After obtaining informed parental consent, a clinical examination was performed and the criteria retained were based on the ANGLE classification of the malocclusions. Socio-demographic, socio-economic, clinical characteristics were collected and morphological and functional abnormalities were observed. Statistical analysis was performed using SPSS software version 23.0. The significance threshold was set at 5%. Results: of the 116 enrolled children; 74 girls (63.79%) and 42 boys (36.21%) with a mean age of 4.80 ± 0.5 years. The highest proportion of thumb sucking was found in firstborn children (n=46, 39.65%), and in those who breastfed for less than 6 months (n=99, 85.62%). The prevalence of thumb sucking was 17.4%. Using the multivariate analysis, class II division 1 canine occlusion [OR=1.52 (1.27-2.68), p=0.03] and decreased overbite [OR=4.5 (2.5-9.3), p=0.001] while class II division 1 canine occlusion [OR=2.59 (1.3-10.1), p=0.009] and increased overjet [OR=1.89 (1.06-6.75), p=0.005] were independent morphologic abnormalities significantly associated with the frequency and the duration of thumb sucking respectively. There was no association between the duration and frequency of thumb sucking and the functional abnormalities. Conclusion: thumb sucking is more common in girls and the likelihood of thumb sucking decreases with age. The prevalence of thumb sucking was 17.4%. The malocclusions observed in our population are class II division 1 canine relationship, decreased overbite and increased overjet.

[Association between depression and viral load in people on antiretroviral treatment followed at the Yaoundé Central Hospital in Cameroon]. / Association entre dépression et charge virale chez les personnes sous traitement antirétroviral suivies à l´Hôpital Central de Yaoundé au Cameroun.

Introduction: depression may be associated with poor immune and virological response, poor quality of life and high medical costs in people living with HIV. The purpose of this study is to investigate the association between depression and viral load in people living with HIV on antiretroviral treatment followed at the Yaounde Central Hospital. Methods: we conducted a cross-sectional study of people living with HIV who had their viral load results at the Central Hospital of Yaounde over 8 months (November 2019 to July 2020). Before starting the study, informed consent was obtained from each participant. Sociodemographic, clinical, paraclinical and lifestyle data were collected. Depression was assessed using the Hospital Anxiety and Depression scale (HAD). Consecutive and non-probability sampling was used. Statistical analysis was performed using SPSS software version 23.0. A p-value < 0.05 was considered statistically significant. Results: of the 205 participants enrolled, female sex was the most represented (n=153, 74.6%) and the mean age was 46.5 ± 1.8 years. All participants had clinical stage I HIV and most of them had undetectable viral load (n=164, 80.0%). Definite depression was found in 4.8% of cases and people living with HIV with symptoms of definite depression were more likely to have a high viral load (OR = 14.24 [3.61-56.14]; p = <0.001). Conclusion: depression could be a leading cause of high viral load.

Analytical performances of Exacto® HIV self-test in the Central African Republic.

We herein evaluated the analytical performances of the CE-IVD capillary blood Exacto® HIV self-test (Biosynex, Strasbourg, France) in the Central African Republic (CAR). A cross-sectional study was conducted on a representative national panel of 200 sera positive for HIV and 200 negative for HIV, randomly selected thorough the CAR for HIV seroprevalence surveillance survey, according to reference test. The Exacto® HIV self-test showed 99.5% (95% CI: 98.2-99.9) sensitivity and 100.0% (95% CI: 99.0-100.0) specificity. The Youden´s J index and Cohen´s Kappa coefficient were 0.995. At HIV-1 seroprevalence of 3.5% in the general adult population of the CAR, the positive and negative predictive values were 100% (95% CI: 99.0-100) and 99.9% (95% CI: 98.9-100), respectively. The results are within the limits required by the WHO (i.e. sensitivity ≥ 99.0% and specificity ≥ 98.0%), making Exacto® HIV self-test suitable for routine use in the CAR.

Hosting ICASA 2021 in South Africa amidst the global Omicron scare.

The 21st International Conference on HIV/AIDS and STI's in Africa (ICASA) was successfully held from the 6th to 11t h December 2021 in Durban, South Africa. Little did we know at the time of planning that COVID-19 could become such a formidable force in eroding the progress made to bring lifesaving therapies among vulnerable communities in Africa. The conference also highlighted Africa's openness to the world, also shown in the way South Africa shared data on its discovery of the Omicron variant. Arguably the most important of lessons is that integrated HIV/TB services have become a platform on which to provide other services. We also saw how HIV and TB services were used as leverage for COVID-19 services. Much was also discussed about the need to adopt more self-care approaches, as was demonstrated with the increased use of self-testing technologies for HIV, and potentially other health needs. It's clear that Africa needs to increase its capacity to support and enable innovation, particularly in the design and manufacturing of new technologies including diagnostics, vaccines and therapeutics.

Comparative analysis of two molecular tests for the detection of COVID-19 in Cameroon.

INTRODUCTION: COVID-19 equation in Cameroon is yet to be resolved. There is an urgent need for a rapid response strategy to the increasing demand of polymerase chain reaction (PCR) test results for both patients, travelers and competitors to various games. We assessed the diagnostic performance of the AmpliQuick® SARS-CoV-2 against the classic Reverse transcription polymerase chain reaction (RT-PCR). METHODS: a cross-sectional and comparative study was conducted from April 27th to May 29th, 2021 in the city of Douala, Cameroon. The samples consisted of any nasopharyngeal sample received at the Douala Gynaeco-Obstetrics and Pediatric Hospital molecular biology laboratory, regardless of its origin. Sociodemographic parameters (age, profession (footballers, travelers, other), matrimonial status, nationality), comorbidity and known status of COVID-19, were recorded at collection sites. The main collection sites were the Deido Health District and the Douala Gynaeco-Obstetric and Pediatric Hospital. We performed testing using AmpliQuick® SARS-CoV-2 and the classic RT-PCR (Da An Gene Co.Ltd) on each sample during the one month period. Analytical performance parameters were determined. To determine the sensitivity of both methods, the Bayesian latent class model was performed on the median with 95% confidence interval, with p≤0.05 as significant level, as well as Kappa (κ) agreement between tests. An ethical clearance was sought and obtained from the University of Douala Institutional Ethics Committee. RESULTS: a total of 1813 participants were enrolled, with the predominance of male (68.68%) and the age group 31 to 40 years old (31.33%). Most participants were married (53.46%) with only few with known COVID-19 status (5.47%). One thousand eight hundred and ten (1810) tests were performed by AMPLIQUICK® SARS-CoV-2 while only 1107 could be achieved with the classic RT-PCR. Over the study period, it was noted a drastic reduction in the time necessary to render results with the AMPLIQUICK® SARS-CoV-2 from 24 hours to 3 hours. The AMPLIQUICK® SARS-CoV-2 reduced technician hands-on time and its practicability was noticed based on the prefilled and ready-to-use microplates. A prevalence of 1.93% and 1.45% were obtained for AMPLIQUICK® SARS-CoV-2 and the classic RT-PCR respectively. This difference in the prevalence showed that AMPLIQUICK® SARS-CoV-2 (Sensitivity 83.5% [CI=64.6-95.2]) was more accurate than the classic RT-PCR (67.8% [CI=46.6-84.9]). CONCLUSION: it is time for a change of attitude to scale up the COVID-19 testing ability in Cameroon and the AMPLIQUICK® SARS-CoV-2 is an alternative diagnosis strategy which should help resolve the situation of timely and reliable results.

[Evaluation of two COVID-19 antigenic diagnostic tests: BIOSYNEX® COVID-19 Ag BSS and BIOSYNEX® COVID-19 Ag + BSS compared to AmpliQuick® SARS-CoV-2 PCR]. / Evaluation de deux tests de diagnostic antigénique du COVID-19: BIOSYNEX® COVID-19 Ag BSS et BIOSYNEX® COVID-19 Ag+ BSS comparés à la PCR AmpliQuick® SARS-CoV-2.

INTRODUCTION: the COVID-19 pandemic causes biological diagnostic problems that remain relevant in low-income countries in general and in Cameroon in particular. Rapids tests that reliably detect SARS-CoV-2 virus antigen present themselves as an important alternative in several contexts. The objective of our study was to evaluate the diagnostic performance of two rapid diagnostic tests BIOSYNEX® COVID-19 Ag BSS and BIOSYNEX® COVID-19 Ag + BSS, compared to each other and to the AmpliQuick® SARS-CoV-2 PCR test. METHODS: a cross-sectional and comparative study was carried out from April 27 to May 29, 2021 in the city of Douala in Cameroon. The samples consisted of nasopharyngeal swabs received at the molecular biology laboratory of the Douala Gyneco-obstetric and pediatric hospital, whatever their origin. The socio-demographic parameters (age, profession, football players, travelers, others), marital status, nationality), comorbidity and known status of COVID-19, were recorded on the collection sites. The main collection sites were the Deïdo Health District and the Douala Gyneco-Obstetric and Pediatric Hospital. We performed the diagnosis of COVID-19 using the rapid diagnostic test (RDT) BIOSYNEX® COVID-19 Ag BSS and RDT BIOSYNEX® COVID-19 Ag + BSS compared to each other and to the AmpliQuick® SARS-CoV-2 polymerase chain reaction (PCR) test on each sample. Statistical analysis of the data was performed using Microsoft Excel and SPSS version 17 software. To determine the sensitivity of the two RDTs, the Bayesian latent class model was performed on the median with a 95% confidence interval with p<0.05 as the significant level. An ethical clearance was sought and obtained from the University of Douala Institutional Ethics Committee. RESULTS: a total of 1813 participants were included in our study, with a predominance of men (1226, 68.68 %) and the most represented age group was that of 31 to 40 years (568, 31.33 %). Most of the participants were married (888, 53.46%) and only a few had a known COVID-19 status (75, 5.47%). The two rapid tests on our study population show much closed COVID-19 prevalence values, respectively 2.03 for BIOSYNEX® COVID-19 Ag BSS and 2.17 for BIOSYNEX® COVID-19 Ag + BSS. RDT BIOSYNEX® COVID-19 Ag + BSS showed higher sensitivity 94.1% vs. 87.5% for RDT BIOSYNEX® COVID-19 Ag BSS with almost identical specificity 98.9% for RDT BIOSYNEX® COVID-19 Ag + BSS vs. 98.7% for RDT BIOSYNEX® COVID-19 Ag BSS compared to AmpliQuick® SARS-CoV-2. BIOSYNEX® COVID-19 Ag + BSS RDT showed a negative predictive value of 99.9% compared to BIOSYNEX® COVID-19 Ag BSS RDT. There is a 99.9% agreement between the RDT BIOSYNEX® COVID-19 Ag BSS and the RDT BIOSYNEX® COVID-19 Ag + BSS. Conclusion: the RDT BIOSYNEX®COVID-19 Ag + BSS and RDT BIOSYNEX® COVID-19 Ag BSS can be used for the diagnosis of SARS-CoV-2 and can have an important contribution in the context of mass screenings and screening in remote areas.

Cryptococcal antigen carriage among HIV infected children aged 6 months to 15 years at Laquintinie Hospital in Douala.

BACKGROUND: Up to 15% of deaths of people living with HIV is attributable to meningeal cryptococcosis, with nearly 75% occuring in sub-Saharan Africa. Although rare in children, it is a major cause of morbidity and mortality in people living with HIV. A strong association between cryptococcal antigenemia and the development of meningeal cryptococcosis has been shown in adults. Thus, in 2018, the World Health Organization published an updated version of its guidelines for the diagnosis, prevention and management of cryptococcal infection in adults, adolescents and the HIV-infected child. GOAL: To determine the prevalence of cryptococcal antigenemia and to identify its determinants in children infected with HIV. METHODS: An analytical cross-sectional study was carried out at the approved treatment center of Laquintinie hospital in Douala over a period of 4 months. Children were recruited consecutively after informed parental consent. Cryptococcal antigenemia and CD4 assay were performed using a Cryptops® immunochromatographic rapid diagnostic test and flow cytometry, respectively. The data collected included the socio-demographic, clinical and paraclinical variables of the children, as well as their antecedents. Data analysis was performed using Epiinfo software version 3.1 and SPSS 21.0. The significance threshold was set at 5%. RESULTS: A total of 147 children were enrolled. The mean age was 9.8 ± 4.09 years. The majority were on antiretroviral therapy (142, 96.60%). Only 13 (8.80%) were in severe immunosuppression. No child showed signs of meningeal cryptococcosis. The prevalence of cryptococcal antigenemia was 6.12%. Severe immunosuppression [OR: 10.03 (1.52-65.91), p = 0.016] and contact with pigeons [OR: 9.76 (1.14-83.65), p = 0.037] were independent factors significantly associated with the carriage of the cryptococcal antigen. CONCLUSION: We recommend screening for cryptococcal antigenemia and routine treatment with fluconazole of all HIV positive children with cryptococcal antigen whether symptomatic or not.

Birth weight and renal markers in children aged 5-10 years in Cameroon: a cross-sectional study.

BACKGROUND: A relationship exists between birth weight (BW) and glomerular filtration rate (GFR) in postnatal kidney. Willing to fill a gap of knowledge in sub-Saharan Africa, we assessed the effect of BW on blood pressure (BP), proteinuria and GFR among Cameroonians children. METHODS: This was a cross-sectional hospital-based study from January to April 2018 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH). We recruited low BW (LBW) [< 2500 g], normal BW (NBW) [2500-3999 g] and high BW (HBW) [> 4000 g] children, aged 5-10 years, born and followed-up at YGOPH. We collected socio-demographic, clinical (weight, height, BP), laboratory (proteinuria, creatinine), maternal and birth data. The estimated GFR was calculated using the Schwartz equation. RESULTS: We included 80 children (61.2% boys) with 21 (26.2%) LBW, 45 (56.2%) NBW and 14 (15.5%) HBW; the median (interquartile range) age was 7.3 (6.3-8.1) years and 17 (21.2%) were overweight/obese. Two (2.5%) children, all with a NBW (4.4%), had an elevated BP whereas 2 (2.5%) other children, all with a LBW (9.5%), had hypertension (p = 0.233). Seven (8.7%) children had proteinuria with 19, 2.2 and 14.3% having LBW, NBW and HBW, respectively (p = 0.051). Equivalent figures were 18 (22.5%), 14.3, 24.2 and 28.6% for decreased GFR, respectively (p = 0.818). There was a trend towards an inverse relationship between BW and BP, proteinuria and GFR (p > 0.05). CONCLUSION: Proteinuria is more pronounced in childhood with a history of LBW and HBW while LBW children are more prone to develop hypertension. Regular follow-up is needed to implement early nephroprotective measures among children with abnormal BW.

Predictors of AIDS-related death among adult HIV-infected inpatients in Kisangani, the Democratic Republic of Congo.

INTRODUCTION: Human Immunodeficiency Virus (HIV) infection continues to be a major public health concern in sub-Saharan Africa. We aimed to evaluate potential factors associated with AIDS-related death among adult HIV-infected inpatients in Kisangani, the Democratic Republic of the Congo (DRC). METHODS: this is a hospital-based retrospective, observational analysis carried out between 1st January 2019 and 31st March 2020 among inpatients HIV, at 12 facilities integrating the HIV prevention and care packages in Kisangani. Factors associated with AIDS-related death were analyzed using the logistic regression models. RESULTS: a total of 347 HIV-infected inpatients were included. Among those, the rate of AIDS-related death was 25.1% (95% CI: 20.8-29.9). The rates of AIDS-related death were lower among patients with a university education (aOR: 0.03 [95% CI: 0.00-1.0]) and higher among patients in WHO clinical stage 4 (aOR: 15.4 [6.8-27.8]), patients with poor highly active antiretroviral therapy (HAART) observance (aOR: 14.5 [2.3-40.4), and patients suffering from opportunistic infections (aOR: 9.3 [95% CI: 3.4-25.1]), including cryptococcal meningitis (aOR: 27 [95% CI: 6.0-125.7]) and viral infections associated with zona and Kaposi sarcoma (aOR: 4.8 [95% CI: 2.2-10.4]). CONCLUSION: in our retrospective study on a large sample of inpatients hospitalized in Kisangani, classic causes of death were found. The association with the low level of education suggests that the economic level of the patients who die is a determining factor, difficult to correct. The identification of a limited number of other factors will allow a better medical management.

[Determinants of survival of HIV-infected children aged 6 months to 15 years on follow-up in the town of Ebolowa, Cameroon from 2008 to 2018]. / Déterminants de la survie des enfants âgés de 6 mois à 15 ans, infectés par le VIH et suivis dans la ville d'Ebolowa au Cameroun de 2008 à 2018.

INTRODUCTION: survival of HIV-infected children is a challenge in developing countries. In Cameroon, HIV-related mortality among children under the age of 15 in 2018 was 20%. Paradoxically, the Southern Cameroon region, despite high seroprevalence among children (4.1%) and low antiretroviral therapy coverage (around 64%), is not among the regions of Cameroon most affected by HIV/AIDS-related pediatric mortality. The purpose of this study was to calculate survival rate and to identify its determinants in HIV-infected children aged 6 months-15 years. METHODS: we conducted a retrospective, prospective cohort study data-collection in three health care facilities specialized in treating HIV-positive children in Ebolowa, South Cameroon from January 2008 to December 2018. The study was conducted in two phases, a retrospective collection phase for the selection of medical records of HIV-positive children that met inclusion criteria in consultation registries and a prospective collection phase in which we collected information from parents about the future of children. Informed parental consent was obtained during this second phase. Socio-demographic, clinical, paramedical, therapeutic data as well as data about the future of children were collected. Mean survival time and factors associated with survival were determined using the Kaplan Meier model. Cox proportional hazards regression allowed for the identification of survival determinants. Evaluation criterion was the death. Significance level was set at 5%. RESULTS: a total of 186 patients were enrolled in the study: the average follow-up period was 18.5 months. Survival rate was 66.7%. The majority of deaths (67%) occurred before the sixth month of follow-up. After multivariate analysis, an age less than 2 years [aHR: 18.6 (6.48-53.59); p=0.001), severe anemia [aHR: 7.69 (1.02-57.9); p=0.04) and the presence of opportunistic infections [aHR: 4.52 (2.51-8.14); p=0.05] were independently and significantly associated with survival. CONCLUSION: in addition to early antiretroviral therapy, good clinical and paraclinical monitoring is needed to improve the survival of HIV-infected children.

Differential influence of race and environment on indeterminate reactivities to non-treponemal and treponemal antigens by immuno-chromatographic dual syphilis rapid test.

INTRODUCTION: Syphilis rapid test results may be influenced by numerous environmental and genetic factors. METHODS: The proportion of false positive syphilis non-treponemal (NT) and treponemal (T) test results using immuno-chromatographic dual syphilis rapid test on serum from Cameroonian blacks (n=103) versus French blacks (n=104) or French caucasians (n=51), all HIV-negative and free of clinical syphilis, was examined. RESULTS: Black individuals in Cameroon had a significantly higher frequency of false positive NT or T tests than black individuals in France. black individuals in France had a higher frequency of indeterminate NT tests as compared to caucasians in France. CONCLUSION: Both racial and environmental factors may affect immuno-chromatographic dual syphilis rapid testing.

Acceptability of HIV self-testing in African students: a cross-sectional survey in the Democratic Republic of Congo.

INTRODUCTION: The empowerment of young people aged 15-24 years is a key component of an effective AIDS response. HIV self-testing (HIVST) is progressively being implemented in the Democratic Republic of Congo (DRC). METHODS: Socio-demographic and behavioural factors associated with acceptability of HIVST were evaluated among university students in Bunia, DRC. A representative cross-sectional study was conducted using a self-administered semi-structured questionnaire. RESULTS: A total of 1,012 students were recruited. Acceptability of unsupervised HIVST was higher in the group of young students as compared with older students and was markedly associated with prior knowledge on HIVST. CONCLUSION: Adapted communication about HIVST appears likely essential to increase the supply and use of HIVST among students in DRC.

African voices and leadership is imperative for the global AIDS response.

This position paper is written in reference to the recent extensive media coverage of the report of the Independent Panel describing Harassment, Including Sexual Harassment, Bullying and Abuse of Power at UNAIDS Secretariat by several newspapers and authoritative journals such as Science and The Lancet. Unfortunately, none of these publications provide any clear evidence to support the accusations and merely repeat what are, in our view, unsubstantiated statements made in the report. Given the critical role that Africans have played in dealing with one of the most severe epidemics that the world has seen and the gravity of these charges, we believe it is essential to reaffirm that African voices and leadership is imperative for the global AIDS response.

[Evaluation of the performances of the "MUSE AUTO CD4/CD4%" flow cytometer vs "GUAVA AUTO CD4/CD4%" flow cytometer for measuring the rate of CD4 lymphocytes in patients infected with HIV in Cameroon]. / Evaluation des performances du cytomètre « MUSE AUTO CD4/CD4% ¼ vs « GUAVA AUTO CD4/CD4% ¼ pour la mesure du taux de lymphocytes CD4 chez des patients infectés par le VIH au Cameroun.

INTRODUCTION: This study aimed to evaluate the performances of the MUSE® flow cytometer compared with the reference GUAVA® flow cytometer. METHODS: We conducted an experimental study on HIV-infected patient samples. Venous blood samples, collected in a K3 EDTA tube, were analyzed within 24-48 hours by MUSE® and GUAVA® cytometers at the International Center for medical diagnosis (Centre International de Diagnostic médical) in Yaoundé. RESULTS: In total, 227 samples were analyzed. There was a strong intraclass correlation (p<0.0001) between MUSE® and GUAVA® cytometers with a correlation coefficient 0.998 (95% CI: 0,998-0,999) for the absolute values and 0,992 (95% CI: 0,989-0,994) for the percentages. A strong positive linear correlation (p=0.0001) was found between MUSE® and GUAVA® cytometers with linear regression slope r2 = 0.98 (95% CI=0,97-0,99) for the absolute values and r2= 0.98 (95% CI= 0.96-1,00) for the percentages. The biases were -4,80 cells/µl (-101.31-91.71) for the absolute values and -0.89% (IC: -6,08-4.3) for the percentages. The percentage of data points outside the limits of agreement was 12/227 (5.29%) and 10/227 (4.41%) respectively for the absolute values and percentages. Cohen's kappa coefficient was 0.92 and the area under the curve was 0,9975 (CI 95%: 0.99-1). CONCLUSION: MUSE®AUTO CD4/CD4% cytometer is a powerful instrument because its results are consistent with those obtained by the reference cytometer. It can enable tracking of patients infected with HIV, in particular in the developing countries.

[Risk factors for multidrug-resistant tuberculosis in the city of Kinshasa in the Democratic Republic of Congo]. / Facteurs de risque de la tuberculose multi-résistante dans la ville de Kinshasa en République Démocratique du Congo.

BACKGROUND: The aim of this study was to determine the risk factors for multidrug-resistant tuberculosis (TB) in the city of Kinshasa in the Democratic Republic of Congo. METHODS: This was a case control study. The cases included all TB patients notified as resistant to rifampicin and isoniazid in Kinshasa from January 2012 to June 2013. The controls included TB patients treated during the same period as the cases and declared cured at the end of treatment. For this study, we obtained ethical clearance. RESULTS: The sample consisted of 213 participants, 132 men (62%) and 81 women (38%). The median age was 31 years (16-73 years). Factors associated with significant (p< 0,05) multidrug-resistant tuberculosis were the non-observance of the hours of taking drugs (0R = 111) (80% cases, 4% controls), the failure of treatment (0R = 20 (76% cases, 13% controls); the concept of multidrug-resistant tuberculosis in the family (0R = 6.4) (28% cases, 6% controls); a lack of knowledge of multidrug-resistant tuberculosis (0R = 3.2) (31% cases, 59% controls); a stay in prison (0R = 7.6) (10% cases, 1% controls) and the interruption of treatment (0R = 6.1) (59% cases, 19% controls). CONCLUSION: The emergence of multidrug-resistant tuberculosis can be avoided by the installation of suitable diagnosis and treatment strategies.