ABSTRACT
The spread of severe acute respiratory syndrome coronavirus 2 began later in Africa than in Asia and Europe. Senegal confirmed its first case of coronavirus disease on March 2, 2020. By March 4, a total of 4 cases had been confirmed, all in patients who traveled from Europe.
Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Disease Outbreaks/statistics & numerical data , Disease Transmission, Infectious/statistics & numerical data , Pneumonia, Viral/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , Child, Preschool , Coronavirus Infections/transmission , Coronavirus Infections/virology , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2 , Senegal/epidemiology , Young AdultABSTRACT
BACKGROUND: Cervical cancer is a major public health problem for women in sub-Saharan Africa. Availability of a human papillomavirus (HPV) vaccine could have an important public health impact. METHODS: In this phase IIIb, double-blind, randomized, placebo-controlled, multicenter trial (NCT00481767), healthy African girls and young women seronegative for human immunodeficiency virus (HIV) were stratified by age (10-14 or 15-25 years) and randomized (2:1) to receive either HPV-16/18 AS04-adjuvanted vaccine (n = 450) or placebo (n = 226) at 0, 1, and 6 months. The primary objective was to evaluate HPV-16/18 antibody responses at month 7. Seropositivity rates and corresponding geometric mean titers (GMTs) were measured by enzyme-linked immunosorbent assay. RESULTS: In the according-to-protocol analysis at month 7, 100% of initially seronegative participants in the vaccine group were seropositive for both anti-HPV-16 and anti-HPV-18 antibodies (n = 130 and n = 128 for 10-14-year-olds, respectively; n = 190 and n = 212 for 15-25-year-olds). GMTs for HPV-16 and HPV-18 were higher in 10-14-year-olds (18 423 [95% confidence interval, 16 185-20 970] and 6487 [5590-7529] enzyme-linked immunosorbent assay units (EU)/mL, respectively) than in 15-25-year-olds (10 683 [9567-11 930] and 3743 [3400-4120] EU/mL, respectively). Seropositivity was maintained at month 12. No participant withdrew owing to adverse events. No vaccine-related serious adverse events were reported. CONCLUSIONS: The HPV-16/18 AS04-adjuvanted vaccine was highly immunogenic and had a clinically acceptable safety profile when administered to healthy HIV-seronegative African girls and young women.
Subject(s)
Adjuvants, Immunologic/administration & dosage , Aluminum Hydroxide/administration & dosage , Human papillomavirus 16/immunology , Human papillomavirus 18/immunology , Lipid A/analogs & derivatives , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/administration & dosage , Adjuvants, Immunologic/adverse effects , Adolescent , Adult , Africa South of the Sahara , Aluminum Hydroxide/adverse effects , Antibodies, Viral/blood , Child , Double-Blind Method , Drug-Related Side Effects and Adverse Reactions/epidemiology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Lipid A/administration & dosage , Lipid A/adverse effects , Papillomavirus Infections/complications , Papillomavirus Infections/virology , Papillomavirus Vaccines/adverse effects , Placebos/administration & dosage , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/virology , Young AdultABSTRACT
As of today, little data is available on COVID-19 in African countries, where the case management relied mainly on a treatment by association between hydroxychloroquine (HCQ) and azithromycin (AZM). This study aimed to understand the main clinical outcomes of COVID-19 hospitalized patients in Senegal from March to October 20202. We described the clinical characteristics of patients and analysed clinical status (alive and discharged versus hospitalized or died) at 15 days after Isolation and Treatment Centres (ITC) admission among adult patients who received HCQ plus AZM and those who did not receive this combination. A total of 926 patients were included in this analysis. Six hundred seventy-four (674) (72.8%) patients received a combination of HCQ and AZM. Results showed that the proportion of patient discharge at D15 was significantly higher for patients receiving HCQ plus AZM (OR: 1.63, IC 95% (1.09-2.43)). Factors associated with a lower proportion of patients discharged alive were: age ≥ 60 years (OR: 0.55, IC 95% (0.36-0.83)), having of at least one pre-existing disorder (OR: 0.61, IC 95% (0.42-0.90)), and a high clinical risk at admission following NEWS score (OR: 0.49, IC 95% (0.28-0.83)). Few side effects were reported including 2 cases of cardiac rhythmic disorders in the HCQ and AZM group versus 13 in without HCQ + AZM. An improvement of clinical status at 15 days was found for patients exposed to HCQ plus AZM combination.
ABSTRACT
INTRODUCTION: To investigate the clinical characteristics of COVID-19 in pregnancy in Senegal. METHODS: This was a cross-sectional and descriptive study of all cases of COVID-19 including nine pregnant women who were admitted in COVID-19 treatment centers in Senegal from March 2 to May 15, 2020. SARS-COV-2 infection was confirmed by PCR. Patients' characteristics, clinical features, treatment and outcome were obtained with a customized data collection form. RESULTS: The frequency of the association COVID-19 and pregnancy was 0.5%. The age range of the patients was 18-42 years with an average 28 years, and the range of gestational weeks at admission was 7 weeks to 32 weeks. None of the patients had underlying diseases. All the patients presented with a headache and only four of them had fever. Other symptoms were also observed: two patients had a cough, two had rhinorrhea, and two patients reported poor appetite. The median time to recovery was 13.6 days, corresponding to the number of days in hospital. None of the nine pregnant women developed severe COVID-19 pneumonia or died. CONCLUSION: Pregnant women appear to have the same contamination predispositions and clinical features of SARS-COV-2 infection as the general population. This study shows no evidence that pregnant women are more susceptible to infection with coronavirus.
Subject(s)
COVID-19 Nucleic Acid Testing , COVID-19/physiopathology , Hospitalization/statistics & numerical data , Pregnancy Complications, Infectious/virology , Adolescent , Adult , COVID-19/diagnosis , COVID-19/epidemiology , Cross-Sectional Studies , Female , Headache/epidemiology , Headache/virology , Humans , Length of Stay , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Senegal , Severity of Illness Index , Young AdultABSTRACT
Late diagnosis of HIV infection can be fatal because it favors the appearance of opportunistic infections whose management requires the use of several molecules which can cause drug interactions. We report the case of a 45-year old female patient under heroin substitution treatment, using methadone and with HIV1 under antiretroviral treatment. This patient had nonspecific pulmonary appearance associated with dry nagging cough and progressive dyspnea evolving in a feverish context. Moreover, clinical examination showed left lower limb lymphedema with painless angiomatous nodules evolving over three years associated with plaques, angiomatous nodules occurred more recently at the level of the anterior face of the thorax. Sputum GeneXpert test allowed isolation of Mycobacterium tuberculosis. The diagnosis of pulmonary tuberculosis associated with Kaposi's sarcoma and immunosuppression caused by HIV was retained.