HIV testing among female sex workers and associated factors in Burkina Faso: findings from a respondent-driven sampling survey.

BACKGROUND: In Burkina Faso, only 70% of people living with HIV knew their status in 2018, while the first 95 target of the UNAIDS suggests that by 2025 at least 95% of people living with HIV (PLHIV) know their HIV status. Female sex workers (FSW) are one of the most HIV-vulnerable groups, making it crucial to estimate the rate and associated factors of HIV testing among FSW. METHODS: We conducted a cross-sectional study focused on FSW in five main cities of Burkina Faso (Ouagadougou, Bobo-Dioulasso, Koudougou, Tenkodogo, and Ouahigouya). A respondent-driven sampling (RDS) approach was used to recruit participants. Data were collected through in-person interviews between June and August 2022. The HIV testing rate in the past twelve months was examined by sociodemographic characteristics and risky behaviors. A modified Poisson regression in a generalized estimating equation with an exchangeable correlation structure was used to explore the associated factors of HIV testing. RESULTS: Of 1338 FSW (average age: 27.6 ± 7.25 years) HIV negative, 57.8% (95% CI: 54.2-61.3) reported having been tested for HIV in the last 12 months. Among those who started sex work before the age of 18, 48.0% (95% CI: 39.1-57.1) reported having been tested for HIV in the last 12 months. The HIV testing rate among FSWs within the last 12 months was independently associated with age, education level, and being member of an FSW supportive association. Indeed, FSW aged 25 years and more had a 14% higher rate of being tested for HIV within 12 months compared to those 15 to 24 years old (adjusted prevalence ratio (aPR): 1.14 [95%CI: 1.05-1.24]). The HIV testing rate among those who are not members of an FSW supportive association was 16% lower (aPR: 0.84 [95%CI: 0.72-0.97]) than those who are members of FSW supportive associations. CONCLUSION: The HIV testing rate among FSW is low in Burkina Faso, suggesting an important challenge to reach the first 95% target of UNAIDS among FSW. Innovative diagnostic strategies for the early identification of HIV-infected FSW are essential to achieve the first 95 target by 2025 in Burkina Faso.

Evaluation of ten (10) SARS-CoV-2 rapid serological tests in comparison with WANTAI SARS-CoV-2 ab ELISA in Burkina Faso, West Africa.

BACKGROUND: The aim of this study was to evaluate the performance of ten (10) SARS-CoV-2 serological rapid diagnostic tests in comparison with the WANTAI SARS-CoV-2 Ab ELISA test in a laboratory setting. MATERIALS AND METHODS: Ten (10) SARS-CoV-2 serological rapid diagnostic tests (RDTs) for SARS-CoV-2 IgG/IgM were evaluated with two (2) groups of plasma tested positive for one and negative for the other with the WANTAI SARS-CoV-2 Ab ELISA. The diagnostic performance of the SARS-CoV-2 serological RDTs and their agreement with the reference test were calculated with their 95% confidence intervals. RESULTS: The sensitivity of serological RDTs ranged from 27.39 to 61.67% and the specificity from 93.33 to 100% compared to WANTAI SARS-CoV-2 Ab ELISA test. Of all the tests, two tests (STANDARD Q COVID-19 IgM/IgG Combo SD BIOSENSOR and COVID-19 IgG/IgM Rapid Test (Zhejiang Orient Gene Biotech Co., Ltd)) had a sensitivity greater than 50%. In addition, all ten tests had specificity greater than or equal to 93.33% each. The concordance between RDTs and WANTAI SARS-CoV-2 Ab ELISA test ranged from 0.25 to 0.61. CONCLUSION: The SARS-CoV-2 serological RDTs evaluated show low and variable sensitivities compared to the WANTAI SARS-CoV-2 Ab ELISA test, with however a good specificity. These finding may have implications for the interpretation and comparison of COVID-19 seroprevalence studies depending on the type of test used.

Low prevalence of HIV infection among persons with disabilities in Niger: findings from a household-based cross-sectional study in 2018.

The aim of this work was to report for the first time the prevalence of HIV infection among people with disabilities (PWDs) in Niger. The Washington Group Short questionnaire was used to identify people with disabilities during a household survey. Blood samples for HIV testing were collected using the Dried Blood Sampling (DBS) method. HIV testing was performed according to the Niger national HIV testing guideline. A total of 21,979 persons aged 15-69 years were screened, of them 2237 (10.17%) had disabilities and 949 participants (4.32%) had severe disabilities (level 3 or 4). Finally, 821 participants agreed to participate in the HIV testing. Female persons with disabilities accounted for the majority (52.25%). People with physical impairment were mostly represented (39.27%) followed by those with visual impairment (38.66%). At least one-third had multiple impairs (36.91%). HIV prevalence among person with disabilities was 0.66% (95% CI: 0.33-1.30). There is no difference between HIV prevalence and type of disabilities or socio-demographic characteristics. Hence, there is a need to consider them in the development and implementation of an effective HIV strategy.

Prevalence and factors associated with HIV infection among people with disabilities in Mali.

Previous studies on HIV and disability have reported the vulnerability of people with disabilities (PWDs) to HIV and the need to include them in HIV prevention programs. However, in Mali, data on HIV among this population is scarce. This study aims to estimate HIV prevalence and risk factors among people with disabilities in Mali. We conducted a household-based cross-sectional study in six regions of Mali. The Washington Group (WG) short questionnaire was used to identify PWDs in the household. A total of 1051 PWDs were included in the study. The prevalence of HIV infection among people with disabilities in Mali was 2.38% (25/1051), with a 95% confidence interval (CI) of 1.58%-3.44%. HIV prevalence was higher in women (3.31% [95%CI: 2.14-4.88]) than in men (0.78% [95%CI: 0.22-2.06]). People with visual or intellectual functional limitations were the most affected, with 3.93% (95%CI: 2.22-6.44) and 2.67% (95%CI: 0.56-8.28), respectively. Multivariate analysis shows that age, sex, type of disability and sexual violence are the risk factors for HIV infection among people with disabilities in Mali. These results suggest that HIV strategies should include people with disabilities in order to achieve the target of ending the HIV/AIDS epidemic by 2030 in Mali.

Cervical cancer in the Hauts-Bassins region of Burkina Faso: Results of a screening campaign by visual inspection with acetic acid (VIA screening in Burkina Faso).

This study was conducted to describe the distribution of precancerous and cancerous lesions of the cervix uteri, enumerated during a mass screening in Burkina Faso. We conducted a cross-sectional study involving 577 women aged 18 to 60 years, carried out from November 23 to December 19, 2013, in the city of Bobo-Dioulasso and in the rural commune of Bama. Regarding the screening results, 89 participants (15.4%) were positive for pre-malignant cervical lesions. Chi-square testing and logistic regression analyses were conducted to identify the likelihood of cervical pre-cancer lesion in the women. Participants less than 29 years old were approximately 3 times more likely to have cervical lesions than participants >39 years. Participants who were parous (1-3 deliveries) and multiparous (four or more deliveries) were approximately 4 times more likely to present with cervical lesions than nulliparous women. Access to screening services is low in the Bobo-Dioulasso region. Further research should be conducted to understand the incidence and distribution of cervical precancerous and cancerous lesions in Burkina Faso.

Seroepidemiology of syphilis among men who have sex with men in Burkina Faso, West Africa.

Men who have sex with men (MSM) have a disproportionate risk of acquiring sexually transmitted infections (STIs), such as syphilis. However, prevalence and determinants of syphilis among this population are less known in West Africa. This study aims to estimate syphilis prevalence among MSM in Burkina Faso. We conducted a cross-sectional biological and behavior survey in the two main cities of Burkina Faso, Ouagadougou and Bobo-Dioulasso. MSM were recruited using Respondent Driven Sampling (RDS) methods. Data were collected from January to April 2013 in Ouagadougou and from May to August 2013 in Bobo-Dioulasso. Out of the 657 MSM screened for syphilis, 6.1% (40/657) tested positive for Treponema pallidum antibodies and 1.1% (7/657) for active syphilis. Population-weighted prevalence of active syphilis was 2.1% (95% CI, 01.1-04.4) in Ouagadougou and 0.0% in Bobo-Dioulasso. Serologic markers of syphilis (anti-Treponema antibodies) were found among 7.4% (95% CI 5.0-10.8) of MSM in Ouagadougou and 5.0% (95% CI 3.1-8.0) in Bobo-Dioulasso. No significant differences were found in syphilis serological markers prevalence by participants' sociodemographic and behavioral characteristics. The prevalence of syphilis among MSM is low and comparable to that of other individuals of reproductive age in Burkina Faso. This low prevalence is very encouraging and suggests implementation of effective public health intervention programs which direct resources and services toward MSM to prevent further spread of syphilis infection and to limit HIV transmission in this group.

Combined testing for herpes simplex virus and Mycobacterium tuberculosis DNA in cerebrospinal fluid of patients with aseptic meningitis in Burkina Faso, West Africa.

BACKGROUND: Little is known about the involvement of herpes simplex virus (HSV) or Mycobacterium tuberculosis (MTB) as potentially curable causes of central nervous system (CNS) infections in sub-Saharan Africa. OBJECTIVE: In this study, we developed a PCR assay dedicated to simultaneous testing of HSV1/HSV2 and MTB in Burkina Faso, a country where HSV is neglected as a cause of CNS infection and where TB prevalence is high. METHODS: A consensus HSV1/HSV2 set of primers and probe were designed and combined to primers and probe targeting the IS6110 repetitive insertion sequence of MTB. Analytical performances of the assay were evaluated on reference materials. Cerebrospinal fluid (CSF) collected from subjects with aseptic meningitis was tested for HSV1/HSV2 and MTB DNA. RESULTS: The UL29 gene was chosen as a highly conserved region targeted by the HSV1/HSV2 nucleic acid test. The lower limits of detection were estimated to be 2.45 copies/µL for HSV1, 1.72 copies/µL for HSV2, and 2.54 IS6110 copies per µL for MTB. The PCR was used in 202 CSF collected from subjects suspected of aseptic meningitis. Five samples (2.46%) tested positive, including two children positive for HSV1 (0.99%) and three adults tested positive for MTB (1.47%). CONCLUSION: Using an in-house real-time PCR assay, we showed that both HSV and MTB are etiologic pathogens contributing to aseptic meningitis in Burkina Faso. This molecular test may have clinical utility for early diagnosis for those treatable CNS infections.

Leptospirosis as Cause of Febrile Icteric Illness, Burkina Faso.

Patients in Burkina Faso who sought medical attention for febrile jaundice were tested for leptospirosis. We confirmed leptospirosis in 27 (3.46%) of 781 patients: 23 (2.94%) tested positive using serologic assays and 4 (0.51%) using LipL32 PCR. We further presumed leptospirosis in 16 (2.82%) IgM-positive specimens.

Hepatitis B and C virus seroprevalence, Burkina Faso: a cross-sectional study.

OBJECTIVE: To estimate population-wide hepatitis B and C seroprevalence using dried blood spot samples acquired for human immunodeficiency virus (HIV) surveillance as part of the 2010-2011 Demographic and Health Survey in Burkina Faso. METHODS: We used the database acquired during the multistage, clustered, population-based survey, in which 15 377 participants completed questionnaires and provided dried blood spot samples for HIV testing. We extracted sociodemographic and geographic data including age, sex, ethnicity, education, wealth, marital status and region for each participant. We performed hepatitis B and C assays on 14 886 HIV-negative samples between March to October 2015, and calculated weighted percentages of hepatitis seroprevalence for each variable. FINDINGS: We estimated seroprevalence as 9.1% (95% confidence interval, CI: 8.5-9.7) for the hepatitis B surface antigen and 3.6% (95% CI: 3.3-3.8) for hepatitis C virus antibodies, classifying Burkina Faso as highly endemic for hepatitis B and low-intermediate for hepatitis C. The seroprevalence of hepatitis was higher in men than in women, and varied significantly for both with age, education, ethnicity and region. Extremely high HCV-Ab seroprevalence (13.2%; 95% CI: 10.6-15.7) was identified in the Sud-Ouest region, in particular within the youngest age group (15-20 years), indicating an ongoing epidemic. CONCLUSION: Our population-representative hepatitis seroprevalence estimates in Burkina Faso advocate for the inclusion of hepatitis serological tests and risk factor questionnaire items in future surveys, the results of which are crucial for the development of appropriate health policies and infection control programmes.

Estimation of HIV-1 DNA Level Interfering with Reliability of HIV-1 RNA Quantification Performed on Dried Blood Spots Collected from Successfully Treated Patients.

The impact of HIV-1 DNA coamplification during HIV-1 RNA quantification on dried blood spots (DBS) was explored. False-positive HIV RNA detection (22/62, 35%) was associated with high HIV-1 DNA levels. Specificity of HIV-1 RNA assays on DBS should be evaluated following manufacturer protocols on samples with HIV-1 DNA levels of ≥1,000 copies/10(6) peripheral blood mononuclear cells.

Leptospirosis Cases among Outpatients with Non-Malaria Fever Attending Primary Care Clinics during the Rainy Season in Bobo Dioulasso, Burkina Faso.

Leptospirosis is presumably an important cause of non-malarial fever in West Africa. In this study, outpatients consulting in primary care clinics during the rainy season were tested for leptospirosis, and clinical characteristics associated with leptospirosis cases were explored. Patients with fever ≥ 39°C were recruited in nine primary health care centers in Bobo Dioulasso (Burkina Faso). Diagnosis of malaria was ruled out using a rapid diagnostic test (RDT; SD Bioline Malaria®). Leptospirosis cases were defined as patients who tested positive for Leptospira IgM (Leptocheck-WB RDT and Leptospira IgM ELISA assay, Panbio) or DNA in plasma (LipL32 polymerase chain reaction [PCR]). Among 350 patients, 202 tested positive for malaria and were excluded, and 148 met the eligibility criteria and were included. Among these, 26 subjects were considered to be leptospirosis cases: 23 tested positive for Leptospira IgM (15.5%) and three tested positive by PCR (2.2%). Headaches, abdominal symptoms, and myalgia were frequently reported without any difference between leptospirosis cases and negative cases. Cough was more frequently observed among subjects testing positive for leptospirosis (P = 0.02). Water exposure, presence of a skin injury, and walking barefoot were associated with a Leptospira-positive test. All leptospirosis cases recovered without sequelae. A significant portion of outpatients with non-malarial febrile illness during the rainy season in Burkina Faso had epidemiological factors associated with leptospirosis and tested positive for Leptospira. The favorable outcome of leptospirosis cases was reassuring; this could be due in particular to the young age of the patients.

Mass screening of hepatitis B and C in Burkina Faso: seroprevalence update and impact of hepatitis B vaccine.

INTRODUCTION: Updated data on the seroprevalences of hepatitis B and C viruses (HBV, HCV) are required to enable the adaptation of control strategies. In this study, we aimed to: (i) estimate the seroprevalences of HBsAg carriers and HCV exposure in the general population, and (ii) determine the impact of vaccination on HBV circulation since its introduction in 2006 in the Expanded Program on Immunization (EPI). METHODOLOGY: From October 2020 to October 2022, a mass screening campaign was conducted in 10 cities across Burkina Faso. Individuals of all ages and genders who consented to participate were screened for viral markers (HBsAg, anti-HCV) using rapid diagnostic tests. The proportions of HBsAg carriers and HCV exposure were calculated using Stata, and logistic regression was used to assess the impact of HBV vaccination on HBsAg carriage. RESULTS: A total of 15,650 participants were enrolled in the study. Of these, 51.4% were women and the age range was from 1 to 97 years. All participants were screened for HBsAg and 7,507 were also screened for anti-HCV. Overall, the seroprevalence of HBsAg was 8.8% and 2.6% for anti-HCV. The results indicated that age, gender, and place of residence were associated with HBV infection. CONCLUSIONS: The prevalence of HBV and HCV infections remains high in Burkina Faso. Prevention strategies, including initial mass screening with rapid diagnostic tests and vaccination, need to be intensified.

Leptospirosis seroprevalence and risk factors among slaughterhouse workers in Burkina Faso.

Objectives: The objectives of this study were to determine the seroprevalence and risk factors of leptospirosis among slaughterhouse workers in Burkina Faso. Methods: We performed a cross-sectional survey of slaughterhouse workers from Ouagadougou and Bobo Dioulasso between March and April 2021. Blood was collected by venipuncture and serum samples were tested using enzyme-linked immunosorbent assay and microscopic agglutination test. Questionnaires were used to collect information from these workers on sociodemographic characteristics, work activities, knowledge of zoonosis, and risky behaviors. Results: Of the 172 subjects investigated, 28 (16.28%) were found seropositive for leptospirosis using enzyme-linked immunosorbent assay or microscopic agglutination test. The main Leptospira infecting serogroup were Mini, Autumnalis, Canicola, Copenhageni, L. mayottensis (ND), Icterohaemorrhagiae, Pyrogenes/Tarassovi (cross reaction), Panama, and Ballum. Risk factors according to multivariate analysis, included residence (P = 0.02), working at the bleeding station (P = 0.03), contact with feces and urine (P = 0.04), and the practice of agriculture outside the slaughterhouse (P = 0.05). Conclusion: These findings indicate that a significant proportion of slaughterhouse workers are being exposed to pathogenic Leptospira. Public-health interventions against leptospirosis will need to target this occupational group. Proper personal protective equipment and information about the disease should be disseminated among slaughterhouses.

Herpes simplex virus type 2 (HSV-2) and its association with HIV, HCV, HBV, HTLV-1&2 and syphilis among men who have sex with men in Burkina Faso.

PURPOSE: This study aimed to estimate herpes simplex virus type 2 (HSV-2) seroprevalence and its association with HIV, HBV, HCV, HTLV-1&2 and syphilis among men who have sex with men (MSM) in Ouagadougou, Burkina Faso, West Africa. MATERIALS AND METHODS: We screened MSM sera for HSV-2 antibodies. A total of 329 sera were collected from an HIV and syphilis behavioral and biological cross-sectional survey conducted among MSM in Ouagadougou from January to April 2013. Serum samples were tested using Enzyme Linked Immuno-Sorbent Assay (ELISA) for the detection of IgG antibodies to HSV-2. Also, antibodies to HTLV-1&2, HBsAg and anti-HCV antibodies were screened by ELISA. Laboratory assays were performed according to manufacturers' instructions at the Biomedical Research Laboratory at the "Institut de Recherche en Sciences de la Sante" (IRSS) in Burkina Faso. RESULTS: The seroprevalence of HSV-2 infection among MSM was 14.3%(95% CI: 10.6-18.1), with disparities according to age and occupation. HSV-2 seroprevalence was high among MSM who were seropositive for HIV (40% versus 13.9%), for syphilis (42.9% versus 13.3%), for HCV (32.5% versus 11.7%) and for HTLV-1&2 (38.5% versus 12.9%) compared to people seronegative for these pathogens. Multivariate analysis showed that HIV-positive (ORa â€‹= â€‹5.34, p â€‹= â€‹0.027), anti-HCV-positive (ORa â€‹= â€‹4.44, p â€‹= â€‹0.001), and HTLV-1&2 positive (aOR â€‹= â€‹4.11, p â€‹= â€‹0.046) were associated with HSV-2 infection among MSM. However, no significant statistical association between HSV-2 and syphilis was found. CONCLUSION: HSV-2 seroprevalence among MSM in Burkina Faso is relatively high. Positive associations between sexual transmitted infections including HIV with HSV-2 suggest that HSV-2 infection's prevention should be strengthened through HIV transmission control programs.

Immunogenicity and Reactogenicity of 13-Valent Pneumococcal Conjugate Vaccine Among Infants, Toddlers, and Children in Western Burkina Faso: Results From a Clinical Trial of Alternative Immunization Schedules.

BACKGROUND: Many African countries have introduced pneumococcal conjugate vaccine (PCV) into their routine immunization program to reduce the burden of morbidity and death that results from Streptococcus pneumoniae infection, yet immunogenicity and reactogenicity data from the region are limited for the 2 available PCV products. METHODS: We conducted a randomized trial of 13-valent PCV (PCV13) in Bobo-Dioulasso, Burkina Faso. Infants received 3 doses of PCV at 6, 10, and 14 weeks of age or at 6 weeks, 14 weeks, and 9 months of age; toddlers received 2 doses 2 months apart or 1 dose beginning at 12 to 15 months of age; and children received 1 dose between 2 and 4 years of age. We measured each participant's serotype-specific serum immunoglobulin G concentration and opsonophagocytic activity before and after vaccination. For each age group, we compared immune responses between study arms and between the standard schedule in our study and the PCV13-licensing trials. RESULTS: In total, 280 infants, 302 toddlers, and 81 children were assigned randomly and underwent vaccination; 268, 235, and 77 of them completed follow-up, respectively. PCV13 resulted in low reactogenicity in all the study arms. The vaccine elicited a strong primary immune response in infants after 2 or more doses and in children aged 1 to 4 years after 1 dose. Infants who received a booster dose exhibited a robust memory response. Immunogenicity was higher than or comparable to that observed in the PCV13-licensing trials for a majority of serotypes in all 3 age groups. CONCLUSIONS: PCV13 has a satisfactory immunogenicity and reactogenicity profile in this population. Our findings will help support decision making by countries regarding their infant and catch-up vaccination schedules.

Hepatitis E Virus Infections among Patients with Acute Febrile Jaundice in Burkina Faso.

Hepatitis E virus infection is a significant public health problem in many parts of the world including Africa. We tested serum samples from 900 patients in Burkina Faso presenting with febrile icterus. They all tested negative for yellow fever, but those from 23/900 (2.6%) patients contained markers of acute HEV infection (anti-HEV IgM and HEV RNA positive). Genotyping indicated that 14 of the strains were HEV genotype 2b. There was an overall HEV IgG seroprevalence of 18.2% (164/900). In a bivariate analysis, the factors linked to HEV exposure were climate and patient age. Older patients and those living in arid regions were more likely to have HEV infection. HEV genotype 2b circulating only in humans can be involved in some acute febrile icterus cases in Burkina Faso. Better access to safe water, sanitation, and improved personal hygiene should improve control of HEV infection in this country.

COVID-19: profil virologique et clinique des patients diagnostiqués dans deux laboratoires à Ouagadougou, Burkina Faso / COVID-19: Virological and clinical profile of patients diagnosed in two laboratories in Ouagadougou, Burkina Faso

Contexte/objectif : La maladie à coronavirus (COVID-19) est une maladie émergente, dont l'agentpathogène est le virus du syndrome respiratoire aigu sévère dû au coronavirus 2 (SRAS-CoV-2). L'objectif de cette étudeétait de décrire le profil virologique et clinique des patients diagnostiqués dans deux laboratoires. Matériels et méthodes : Il s'est agi d'uneétude descriptive avec collecte rétrospective de données des patients atteints de COVID-19, qui a couvert la période du 04 avril au 31 décembre 2020. Le test de khi deux et le test exact de Fisher sont les tests statistiques utilisées. Résultats : Au total, 28 872 échantillons ont été testés dans les deux laboratoires. L'étude arévélé 1965 cas positifs soit 6, 80% (63 % hommes et 37,05 % femmes). La tranche d'âge de 20 à 50 ans représentait 68,68 %. La province de la capitale a enregistré autant le plus grand nombre d'échantillons (26277 soit91,00%) que le plus grand nombre des cas positifs (91,15%). Les manifestations cliniques étaient dominées par la toux 68,42%, la fatigue générale (43,86%), les céphalées (43,86%), l'écoulement nasal (40,93%), la fi èvre (39,18%). Les comorbidités les plus fréquentes étaient l'hypertension artérielle (HTA) et le diabète. Conclusion: Cette étude a montré unepopulation jeune testée. La capitale (Ouagadougou) a enregistré le plus grand nombre de demandeurs de tests et de cas positifs. La toux était la principale manifestation clinique. Les patients avec comorbidités dont l'HTA et le diabète ont été les plus nombreux a effectué le test

Background/Purpose. Coronavirus disease (COVID-19) is an emerging disease, whose pathogen is the severe acute respiratory syndrome virus due to coronavirus 2 (SARS-CoV-2). The objective of this study was to describe the virological and clinical profile of patients diagnosed in two laboratories. Methods. This was a descriptive study with retrospective data collection of patients with COVID-19, which covered the period from 04 April to 31 December 2020. Chisquare test and Fisher's exact test were used as statistical tests. Results. A total of 28,872 samples were tested in the two laboratories. The study revealed 1965 positive cases or 6, 80% (63% male and 37.05% female). The age group 20-50 years represented 68.68%. The capital province recorded both the largest number of samples (26277 or 91.00%) and the largest number of positive cases (91.15%). Clinical manifestations were dominated by cough 68.42%, general fatigue (43.86%), headache (43.86%), nasal discharge (40.93%), fever (39.18%). The most frequent comorbidities were arterial hypertension (AH) and diabetes. Conclusion. This study showed a young population tested. The capital (Ouagadougou) recorded the highest number of testers and positive cases. Cough was the main clinical manifestation. Patients with comorbidities including hypertension and diabetes were the most numerous to be tested

[Advantages and drawbacks of expectoration decontamination methods for tuberculosis and anti-tuberculosis drug resistance diagnosis]. / Avantages et limites des méthodes de décontamination des expectorations pour le diagnostic de la tuberculose et des résistances aux antituberculeux.

In the actual context of increasing tuberculosis and anti-tuberculosis drug resistance, the laboratory diagnosis of Mycobacterial infections remain the primordial objective of control and surveillance of human tuberculosis. The diagnosis and following of tuberculosis in resource limited settings are done by microscopy Ziehl-Neelsen method which is poor sensitive (20-53%) and have poor specificity because it's can't distinguish tuberculosis mycobacterium and atypical tuberculoid mycobacterium. Mycobacterium culture on solid media is the gold standard method for tuberculosis and anti-tuberculosis drug resistance diagnosis. Here, the challenge is that expectorations using for culture contain mycobacterium and others contaminating bacteria responsible of culture contamination. Many different methods of homogenization and decontamination of sputum specimens for culturing exist and each laboratory had to do a choice of the better method to optimize isolating of mycobacterium. This review is a summary of homogenization and decontamination methods described in literature and used by certain laboratories for diagnosis of TB by culture. However, it's essential for each laboratory to conduct evaluation of the different methods and do the choice of the appropriate one by taking into account factors such as the feasibility and cost effectively. Nine methods of decontaminations are described in this review taking account of their advantages, drawbacks and their feasibility in resource limited settings.