High SARS-CoV-2 Seroprevalence among Healthcare Workers in Bamako, Mali.

In Mali, a country in West Africa, cumulative confirmed COVID-19 cases and deaths among healthcare workers (HCWs) remain enigmatically low, despite a series of waves, circulation of SARS-CoV-2 variants, the country's weak healthcare system, and a general lack of adherence to public health mitigation measures. The goal of the study was to determine whether exposure is important by assessing the seroprevalence of anti-SARS-CoV-2 IgG antibodies in HCWs. The study was conducted between November 2020 and June 2021. HCWs in the major hospitals where COVID-19 cases were being cared for in the capital city, Bamako, Mali, were recruited. During the study period, vaccinations were not yet available. The ELISA of the IgG against the spike protein was optimized and quantitatively measured. A total of 240 HCWs were enrolled in the study, of which seropositivity was observed in 147 cases (61.8%). A continuous increase in the seropositivity was observed, over time, during the study period, from 50% at the beginning to 70% at the end of the study. HCWs who provided direct care to COVID-19 patients and were potentially highly exposed did not have the highest seropositivity rate. Vulnerable HCWs with comorbidities such as obesity, diabetes, and asthma had even higher seropositivity rates at 77.8%, 75.0%, and 66.7%, respectively. Overall, HCWs had high SARS-CoV-2 seroprevalence, likely reflecting a "herd" immunity level, which could be protective at some degrees. These data suggest that the low number of cases and deaths among HCWs in Mali is not due to a lack of occupational exposure to the virus but rather related to other factors that need to be investigated.

[Cancers associated with HIV: epidemiological, clinical characteristics, and becoming patients in the infectious disease department of Bamako]. / Cancers associes a l'infection a VIH : caracteristiques epidemiologiques, cliniques, et devenir des patients dans le service de maladies infectieuses de Bamako.

INTRODUCTION: The association between HIV and cancer is becoming more and more frequent, given the increased life expectancy of HIV positive patients with triple antiretroviral therapy. This association had not been documented in our service, hence the aim of this work. Our objectives were to describe the epidemiological and clinical characteristics and to determine outcome of patients with both pathologies. METHODS: We conducted a retrospective study based on hospitalization records from the infectious diseases department of Point G University Hospital from 2009 to 2014. All patients aged 15 years and older, HIV positive with a diagnosis of cancer were included with usable medical records. Data entry and analysis were done on Epi Info version 3.5.3. The variables studied were sociodemographic, immunological, virological, clinical and outcome. RESULTS: 51 cancer files were collected on 2525 patients (prevalence of 2%), among them 42 had the combination of cancer and HIV (1.7%). The majority were young adults (mean age 40.5 ± 8.9 years), 88.1% of whom were under 50 years of age and the majority were female (54.8%). HIV-1 was the predominant serotype (90.5%). The average CD4 T cell count was 111±106 cells/µl and 77.4% had less than 200 CD4/µl of blood. The majority (83.8%) were on HAART. Cancers classifying AIDS were predominant (90.5%) including Kaposi's disease (71.4%), non-Hodgkin's lymphoma (NHL) (14.3%) and cervical cancer (4.8%). We recorded 69% of deaths. The case-fatality rates were 66.7% for kaposi's disease and NHL (66.7%) and 50% for cervical cancer, respectively. CONCLUSION: Our study provides an overview of the association between cancer and HIV in the service. Cancers attributable to viral infections are the most numerous. A targeted prevention program and early detection of HIV as part of the test and treat strategy are essential.

INTRODUCTION: L'association VIH et cancer apparaît de plus en plus fréquente, compte tenu de l'augmentation de l'espérance de vie des patients VIH positifs avec la trithérapie antirétrovirale. Cette association n'avait pas été documentée dans notre service, d'où le but de ce travail.Nos objectifs étaient de décrire les caractéristiques épidémio-cliniques et de déterminer le devenir à court terme des patients atteints de cancer au cours du VIH. MÉTHODOLOGIE: Nous avons conduitune étude rétrospective sur les dossiers d'hospitalisation du service des maladies infectieuses du CHU du Point G de 2009 à 2014. Tous les patients âgés de 15 ans et plus, VIH positif chez qui un diagnostic de cancer a été retenu avec dossier médical exploitable ont été inclus. La saisie et l'analyse ont été faites sur Epi Info version 3.5.3.Les variables étudiées étaient sociodémographiques, immunovirologiques, cliniques et évolutives. RÉSULTATS: Au total, 51 dossiers de cancers ont été colligés sur 2525 patients (prévalence de 2%), parmi eux 42 étaient atteints de l'association cancer et VIH (1,7%). Il s'agit en majorité d'adultes jeunes (âge moyen de40,5 ± 8,9 ans)dont 88,1% avaient moins de 50 ans et majoritairement de sexe féminin (54,8%). Le VIH-1 était le sérotype prédominant (90,5%). Le taux moyen de lymphocytes T CD4 est de 111±106 cellules/µl et 77,4% avaient moins de 200 CD4/µl de sang. La majorité (83,8%) était sous trithérapie antirétrovirale. Les cancers classant sida prédominaient (90,5%) dont la maladie de Kaposi (71,4%), le lymphome non hodgkinien (LNH) (14,3%) et cancer du col de l'utérus (4,8%). Nous avons enregistré 69% de décès. Les taux de létalités étaient respectivement de 66,7% pour la maladie de kaposi et le LNH(66,7%) et de 50% pour les cancers du col de l'utérus. CONCLUSION: Notre étude permet de faire un aperçu de l'association cancer et VIH dans le service. Les cancers associés à des infections virales sont les plus fréquentes. Un programme de prévention ciblée et de dépistage précoce du VIH dans le cadre de la stratégie tester et traiter sont indispensables.