Rice yellow mottle virus is a suitable amplicon vector for an efficient production of an anti-leishmianiasis vaccine in Nicotiana benthamiana leaves.

BACKGROUND: Since the 2000's, plants have been used as bioreactors for the transient production of molecules of interest such as vaccines. To improve protein yield, "amplicon" vectors based on plant viruses are used. These viral constructs, engineered to carry the gene of interest replicate strongly once introduced into the plant cell, allowing significant accumulation of the protein. Here, we evaluated the suitability of the monocot-infecting RNA virus Rice yellow mottle virus (RYMV) as an amplicon vector. The promastigote surface antigen (PSA) of the protozoan Leishmania was considered as a protein of interest due to its vaccine properties against canine leishmaniasis. RESULTS: Since P1 (ORF1) and CP (ORF3) proteins are not strictly necessary for viral replication, ORF1 was deleted and the PSA gene was substituted to ORF3 in the RYMV-based vector. We evaluated its expression in the best described plant bioreactor system, Nicotiana benthamiana which, unlike rice, allows transient transformation by Agrobacterium. Despite not being its natural host, we demonstrated a low level of RYMV-based vector replication in N. benthamiana leaves. Under optimized ratio, we showed that the P19 silencing suppressor in combination with the missing viral CP ORF significantly enhanced RYMV amplicon replication in N. benthamiana. Under these optimized CP/P19 conditions, we showed that the RYMV amplicon replicated autonomously in the infiltrated N. benthamiana cells, but was unable to move out of the infiltrated zones. Finally, we showed that when the RYMV amplicon was expressed under the optimized conditions we set up, it allowed enhanced PSA protein accumulation in N. benthamiana compared to the PSA coding sequence driven by the 35S promoter without amplicon background. CONCLUSION: This work demonstrates that a non-dicot-infecting virus can be used as an amplicon vector for the efficient production of proteins of interest such as PSA in N. benthamiana leaves.

Epidemiology of glaucoma in Burkina Faso: Determination of the prevalence and circulating glaucomatous phenotypes in Ouagadougou.

PURPOSE: Glaucoma encompasses a particular set of degenerative diseases of the optic nerve which may have predisposing genetic factors. The objective of this study was to determine the prevalence and phenotypes of primary glaucoma encountered in the population. METHODS: This was a cross-sectional study carried out on retrospective data from three healthcare centers in the city of Ouagadougou between 2012 and 2020. Data collection was carried out using patient records. RESULTS: The population receiving diagnostic glaucoma examinations in the 3 healthcare centers during the study period consisted of 13,378 patients, of which 50.55% were female. The general prevalence of patients with primary glaucoma was 4.04% (or 540 patients). Primary open-angle glaucoma (80.37%), congenital glaucoma (15.74%) and primary angle-closure glaucoma (3.89%) were identified in the study population. CONCLUSION: Glaucoma is a public health problem in Burkina Faso. It is often diagnosed in the late stages because of its insidious progression. In a developing country, effort must be also made to equip and increase the number of healthcare centers. In addition, efforts must be made to raise awareness, and to develop and popularize molecular biologic techniques for early detection in order to provide patients with appropriate care.

Dengue Immunological Markers Evolution at Saint Camille Hospital in Ouagadougou (HOSCO) Burkina Faso.

<b>Background and Objective:</b> Dengue is a remerging vector-borne viral disease in Burkina Faso since the outbreak of 2013 and requires special attention from health authorities. This study reports the prevalence of dengue fever serological markers (NS1Ag, IgM and IgG) and infection dynamic from January, 2018 to December, 2020 among patients tested for dengue infection at Saint Camille Hospital of Ouagadougou (HOSCO). <b>Materials and Methods:</b> The study population consisted of 6414 patients aged 0-97 years. Dengue virus infection was detected in serum or plasma using the SD bioline dengue duo rapid detection kit. <b>Results:</b> The prevalence of dengue NS1Ag was 2.25% (45/2003), 18.43% (501/2719) and 2.42% (38/1569) in the study population in 2018, 2019 and 2020, respectively. The age groups over 50 years and 15-20 years were significantly more infected compared to the group 21-30 years respectively in 2019 (p = 0.030) and 2020 (p = 0.035). Patients tested positive for at least one of these markers (NSlAg, IgG and IgM) represented 26.01% (521/2003) and 38.98% (1060/2719). The peak of infection during 2018 and 2019 was observed between October and November. The present study reports a high seroprevalence of acute dengue virus infection. The presence of NS1Ag, IgM and IgG in patients suggests an active circulation of the dengue virus in Ouagadougou. <b>Conclusion:</b> Data shows recurrent outbreaks of dengue infection in our country need strong surveillance and a suitable and affordable diagnostic system to clarify the burden, pinpoint the risk factors and for better case management.

Epidemiology of Dengue in patients with febrile syndrome at Saint Camille Hospital, Ouagadougou, Burkina Faso from 2020 to 2

: Dengue is still a public health problem in tropical countries. This disease, which had almost disappeared in some areas of the world, has become re-emergent in certain parts of the world including Africa.The aim of this study is to determine the seroprevalence and evolution of Dengue virus (DENV) infection from 2020 to 2021 at the Hospital Saint Camille de Ouagadougou (HOSCO), Burkina Faso. Methodology: This was a descriptive analytical study of patients seen in general practice with febrile syndrome referred for serological diagnosis of Dengue at the HOSCO laboratory over a period of 2 years (January 1, 2020 ­ December 31, 2021). The "Dengue Duo (AgNS1/IgM/IgG)" kit from SD Bioline was used for the rapid diagnosis through the detection of NS1 antigen and IgM/IgG antibodies in plasma. Data were analysed with SPSS version 20.0 software. Association between demographic data and prevalence of DENV infection was determined by Chisquare test and odds ratio (with 95% confidence interval). P value less than 0.05 was considered statistical significance. Results: A total of 2957 patients aged 0-94 years were referred for serological diagnosis of DENV infection at the HOSCO laboratory over the period 2020-2021, comprising 56.3% females and 43.7% males. The overall prevalence of acute DENV infection (NS1Ag positive) was 5.4% (159/2957), with 2.4% (41/1700) in 2020 and 9.4% (118/1257) in 2021 (OR=4.192, 95% CI=2.915-6.028, p<0.0001). The prevalence of acute DENV infection of 7.0% (91/1292) in the males was significantly higher than 4.1% (68/1665) in the females (OR=1.779, 95% CI=1.288-2.458, p=0.0005), and also significantly higher in age groups 20-29 years (7.6%), 10-19 years (6.9%) and 40-49 years (5.8%) than other age groups (X 2=14.928, p=0.0107). The overall prevalence of DENV IgM and IgG antibodies was 3.2% and 37.3% respectively. The prevalence of DENV IgG antibodies was significantly higher in males (44.0%) than females (32.1%) (OR=1.667, 95%CI=1.434-1.938, p<0.0001) and in age groups 30-39 (43.4%), 40-49 (44.0%) and >50 years (49.3%) than other age groups (X2=121.0, p<0.0001), indicating that past exposure to DENV infection is higher among males and older age groups. The peak of DENV infection was between October and November with 84.3% (134/159) of NS1Ag positivity occurring during this period. Conclusion: The present study reports a high prevalence of acute Dengue virus infection in patients from October to November. To eradicate Dengue which has become a tropical silent epidemic, interventions such as vector control, availability of and accessibility to diagnostic tests, and good therapeutic management are of great importance

High prevalence of high-risk human papillomavirus (HPV) infection among sexually active women in Ouagadougou.

Human papillomavirus (HPV) is the leading cause of cervical cancer, which in turn is the leading cause of cancer death in women in Africa. The objective of this study was to determine the prevalence of high-risk HPV infection (HR-HPV) and the distribution of genotypes encountered in the sexually active female population of Ouagadougou. In four level-two health centers, we recruited 234 women who agreed to undergo an endocervical swab. HR-HPV genotypes were identified by real-time PCR. The Chi-square test was used for comparisons, with significance defined by a P-value < 0.05. The prevalence of HR-HPV infection was 52.56%. Fourteen genotypes corresponding to 216 infections were characterized: HPV 59 (42/216), HPV 66 (30/216), HPV 56 (20/216), HPV 45 (20/216), HPV 58 (18/216), HPV 39 (18/216), HPV 51 (16/216), HPV 68 (14/216), HPV 52 (12/216), HPV 18 (12/216), HPV 35 (6/216), HPV 31 (5/216), HPV 16 (3/216), HPV 33 (0/216). HPV infection was statistically associated with age (P = 0.033) and with some specific sexual practices, such as oral sex (P = 0.001). The prevalence of HR-HPV infection among women without lesions in our study is higher than that reported previously in studies conducted in Ouagadougou among women in the general population and those found in the rest of the world. Moreover, HPV16 and 18 were not the genotypes most frequently encountered.

Molecular Epidemiology of Rotavirus in Children under Five in Africa (2006-2016): A Systematic Review.

Group A human rotaviruses (RVA) are the most common causes of severe viral gastroenteritis in infants and young children worldwide. The available vaccines, while effective in Europe and North America have shown a reduced efficacy in Africa. One issue raised is the genetic variability of RVA. The objective of this study was to perform a literature review of molecular epidemiology to determine the prevalence of RVA genotypes circulating in Africa so as to establish a mapping of reliable data on these various genotypes. The search for articles was done from the National Institutes of Health (PUBMED) using three set of keywords. Articles were selected with inclusion criteria such as the date of publication, the age of the children, the sample size and the diagnostic techniques (standardized laboratory techniques). The data were imported into STATA SE version 11 software. Specific prevalence was estimated with Confidence Intervals (CI) of 95%. A total of 326 published studies were initially retrieved, out of which 27 studies were finally selected for the systematic review. The selected studies cover 20 African countries. The most encountered genotypes in Africa during this period were G1 (32.72%), followed by G2 (17.17%), G3 (9.88%), G9 (8.61%) and G12 (7.56%) among the G-types. The most common P-types were P[8] (48.71%) followed by P[6] (22.60%) and P[4] (11.58%) and the G1P[8] combination (22.64%) was the most encountered followed by G2P[4] (8.29%), G9P[8] (6.95%) and G2P[6] (5.00%). North Africa presented the highest prevalence of the P[8] genotype (65.70%). This review provides a comprehensive view of the current circulating rotavirus strains in Africa, which can be important in light of the new rotavirus vaccinations. Indeed, in Africa, the pursuit of national and continental studies for epidemiological surveillance of circulating rotavirus strains is vital for the promotion of future successful vaccines.

Complications aigues métaboliques du diabète sucré dans le Service de Réanimation Polyvalente du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou au Burkina Faso

Objectif : Etudier les complications aiguës métaboliques (CAM) du diabète sucré dans le Service de Réanimation Polyvalente (SRP) du Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU-YO) au Burkina Faso.Patients et méthodes : Etude rétrospective sur une période de cinq ans (1erjanvier 2008 au 31 décembre 2012). La population d'étude était constituée des patients admis dans ledit service pour une CAM du diabète sucré. Résultats :Soixante-six patients ont été retenus pour l'étude.La fréquence d'admission pour des CAM de diabète était de 6,5% avec un âge moyen de 55 ± 17 ans et une prédominance masculine (sex-ratio=1 ,06). Les principaux motifs d'admission étaient lecoma grave (62,1%), détresse respiratoire (81,8%) et déshydratation (15,1%).La mauvaise observance thérapeutique était retrouvée dans 64,5%.L'acidocétose constituait 59,1% des CAM suivie de l'hypoglycémie (27,3%) et du syndrome d'hyperglycémie hyperosmolaire(SHH) (13,6%). L'hyperglycémie moyenne était de 26, 31 mmol/L et l'hypoglycémie moyenne de 1,3 ± 0,7 mmol/L. Une cétonurie (69,1%) et une glycosurie (67,8%) étaient observées. Les complications étaient associées à un âge avancé (p= 0.003).L'infection constituait le principal facteur de décompensation. La durée moyenne de séjour était 5,8 ± 5,6 jours.La mortalité globale (54,55%) était liée à la gravité du coma (p=0,007).Conclusion : Les CAM du diabète sucré sont relativement fréquentes dans le SRP du CHU-YO à Ouagadougou. Le taux de mortalité est élevé. Une prise en charge précoce et adaptée pourrait améliorer le pronostic vital

Prevalence of non-adherence to highly active antiretroviral therapy and its related clinical and therapeutic factors in Ouagadougou (Burkina Faso).

Introduction : Non-adherence to highly active antiretroviral therapy is deleterious in HIV/AIDS programs. This study contributes to the identification of its frequency and of the clinical and therapeutic factors that determine it. Material and methods : This cross-sectional study took place from December 15, 2013, to February 18, 2014, at the Saint Camille health care center and the Pietro Annigoni biomolecular research center in Ouagadougou. It includes adults who had been receiving antiretroviral therapy for at least three months and agreed to participate. The Chi-square test or Fisher's test was used to compare proportions in the univariate analysis. A logistic regression model was applied for the multivariate analysis. P values less than 0.05 were considered significant. RESULTS: The study included 152 patients. Their mean age was 40.7±7.8 years, and the sex-ratio 0.3. The frequency of non-adherence to antiretroviral therapy was 38.2%. In the univariate analysis, laboratory and clinical factors associated with non-adherence were severe immune depression (P=0.03), opportunistic infections (P=0.001), and lack of clinical improvement (P=0.001), while the therapeutic factors associated with it were inadequate knowledge (P=0.001), side effects (P=0.003), and using the treatment secretly (P=0.001). In the multivariate analysis, opportunistic infections (OR=13.51, 95% CI 3.15-58.82, P=0.000), lack of clinical improvement (OR=4.16, 95% CI 1.06-16.32, P=0.04), inadequate knowledge (OR=16.12, 95% CI 1.67-166.66, P=0.01), and secret treatment use (OR=11.36, 95% CI 3.18-40.00, P=0.000) remained associated with non-adherence. CONCLUSION: The study underlines the need to improve strategies for the prescription of this therapy and for reinforcing patients' education and support.

Oncogenic Human Papillomavirus Infection and Genotype Characterization among Women in Orodara, Western Burkina Faso.

BACKGROUND AND OBJECTIVE: Cervical cancer usually occurs several years after persistent infection with oncogenic or high-risk human papillomavirus. The objective of this study was to determine carriage of 14 genotypes of high-risk human papillomavirus among women at Orodara and then characterize the genotypes found in these women. MATERIALS AND METHODS: From June to July 2015, 120 women from the general population were recruited in the health district of Orodara. They voluntarily agreed to participate in the study. Endocervical samples were taken from these women prior to screening for precancerous lesions by visual inspection with acetic acid and lugol's iodine. Identification of high-risk human papillomavirus genotype was done using real-time PCR. RESULTS: High-risk human papillomavirus prevalence was 38.3% and the most common genotypes were HPV 52 (25.4%), HPV 33 (20.6%) and HPV 59 (11.1%). The HPV 66 was also identified with a prevalence of 9.5%. CONCLUSION: The HPV 16 and HPV 18 which are frequently associated with cancer worldwide were not found among the most frequent oncogenic HPV in women in Orodara.

Molecular Epidemiology of High-Risk Human Papillomavirus in High-Grade Cervical Intraepithelial Neoplasia and in Cervical Cancer in Parakou, Republic of Benin.

Human papilloma virus (HPV) infection remains a worldwide concern, especially in Sub-Saharan Africa where cervical cancer is the leading cause of cancer death in women. The aim of the study was to determine the prevalence and genotypic distribution of High-Risk HPV (HR-HPV) involved in Cervical Intraepithelial Neoplasia (CIN) II and III and in cervical cancer in Parakou. Out of a total of 149 samples of cervical tissues archived, fixed and paraffin-embedded, 78 samples with histological diagnosis of CIN-II, CIN-III and cervical cancer went through deparaffinization with xylene, followed by an extraction of HPV DNA and the detection of HR-HPV by real-time multiplex PCR. The average age of the women was 40.05±13.99 years. The samples were positive to at least one HR-HPV genotype in 76.92% (50/65) of cases. The HR-HPV genotypes which are most common in the cervical cancer and in CIN-II and III were, respectively HPV-39 (38 and 37.50%), HPV-18 (35 and 31.30%), HPV-45 (35 and 31.30%), HPV-35 (9 and 25%) and HPV-52 (9 and 12.50%). The HPV-16 was absent. This study helped to detect (in samples archived, fixed and paraffin-embedded tissues) HR-HPV involved in high-grade precancerous lesions and in cervical cancer in Parakou, some of which are not covered by currently available vaccines.

[Epidemiology and characterization of high-risk genotypes of human Papillomavirus in a population of sexually active adolescents in Ouagadougou]. / Épidémiologie et caractérisation des génotypes à haut risque de Papillomavirus humain dans une population d'adolescentes sexuellement actives à Ouagadougou.

OBJECTIVE: This cross-sectional study was to determine the prevalence and characterization of high-risk HPV genotypes circulating among adolescents in Ouagadougou. METHODS: From September to December 2013, 200 adolescents recruited from a youth counseling center have voluntarily accepted a swab of the endocervical canal. The identification of the genotypes of the human Papillomavirus (HPV) was performed by real-time polymerase chain reaction technique. RESULTS: The mean age of adolescents was 18.7±0.7 years and 83/200 adolescents were positive for at least one high-risk genotype HPV a prevalence of 41.5%. Twelve genotypes corresponding to 136 infections were characterized: HPV 52 (22.8%), HPV 59 (14.0%), HPV 39 (13.2%), HPV 35 (10.3%), HPV 51 (10.3%), HPV 56 (8.8%), HPV 16 (5.2%), HPV 18 (5.2%), HPV 58 (4.4%), HPV 31 (3.6%), HPV 45 (1.5%), HPV 33 (0.7%). Multiple infections (2-5 virus) statistically associated with age (p=0.0318) was detected in 42.2% of infected females. If the number of sexual partners was statistically associated with the porting of HPV (OR=2.18; 95% CI=1.17 to 4.09), early sexual intercourse and the recent change of sexual partner were not (p>0,05) CONCLUSION: The prevalence of carriage of HPV in this study is high, as described in young people at the start of sexual activity. Identified genotypes are different from those targeted by prophylactic vaccines currently available. A larger study to map genotypes of high-risk HPV circulating in West Africa is necessary for a suitable vaccine.

[Neurological complications of infective endocarditis in Burkina Faso. Clinical features, management and evolutionary profile]. / Les complications neurologiques des endocardites infectieuses au Burkina Faso. Caractéristiques cliniques, prise en charge et profil évolutif.

INTRODUCTION: Neurological complications are the most frequent extracardiac complications of infective endocarditis (IE). This study aimed to describe the epidemiological, clinical and paraclinical aspects, and outcome of neurological complications of infective endocarditis in three hospitals in the city of Ouagadougou in Burkina Faso. PATIENTS AND METHOD: From 1 January 2009 to 31 December 2012, we included all patients suffering from IE and selected those in whom a neurological complication was objectified. Neurological involvement was sought on clinical examination but especially CT brain (ischemic infarcts, hemorrhages, aneurysms and abscesses). Blood cultures were systematic. Echocardiography was done for vegetations and characteristics. RESULTS: Among 63 cases of IE, neurological complications were found in 14 patients (22.2%). The average age of patients with neurological complications was 37.4 ± 5.8 years. The sex ratio was 1.3 for women. Neurological damage consisted of nine cases of stroke (64.3%), three cases of hemorrhagic stroke (21.4%) and two cases of brain abscess (14.3%). Neurological complications had already occurred before hospitalization in 4 cases. Blood cultures were positive in 8 cases. Germs found were predominantly Staphylococcus aureus (5 cases) and Streptococcus a- viridans (2 cases). All cases of S. aureus were complicated by stroke. At echocardiography, vegetation was found in all cases. It was found on the mitral in 7 cases, the aorta in 3 cases, the mitral and aortic in 2 cases and the mitral and tricuspid in 2 cases also. The EI had occurred on a native valve in 11 cases, prosthesis in 4 cases (2 mitral and 2 aortic). The vegetations average diameter was 11.2 ± 2.1 mm (6.4 and 1 7.7 mm). Vegetations were mobile in 12 cases. The treatment consisted of antibiotics adapted to the antibiogram, neurological and cardiovascular monitoring. The evolution was marked by seven deaths (50%), including 5 deaths related to cerebral complication (71.4% of deaths). CONCLUSION: This study shows that neurological complications during infective endocarditis are frequent, dominated by stroke with a high mortality.

[Epidemiological characteristics and clinical features of black African subject's resistant hypertension]. / Caractéristiques épidémio-cliniques de l'hypertension artérielle résistante du sujet noir africain.

INTRODUCTION: Few studies in sub-Saharan Africa were interested in resistant hypertension. The objectives of this study were to determine the frequency of resistant hypertension in hypertensive black African population, and to describe its clinical and therapeutic features. PATIENTS AND METHODS: From May 1, 2010 to May 31, 2012, we included consecutively hypertensive followed in two hospitals in the city of Ouagadougou, under antihypertensive treatment at optimum dose and observant. Patients whose blood pressure was uncontrolled despite a triple antihypertensive therapy at the optimal dose including a diuretic associated with dietary measures have received ambulatory blood pressure monitoring. Following this examination, patients whose blood pressure was ≥135/85mmHg during the day and/or ≥120/70mmHg at night were considered resistant hypertension. We investigated the cardiovascular risk factors as well as target organ damages. We combined spironolactone 50mg in treatment when absence of contra-indication appreciated the evolution of blood pressure under this treatment. The measurement of plasma renin activity was not performed. Statistical analysis was performed using SPSS Version 17 for Windows. RESULTS: We included 692 patients with 14.6% of resistant hypertension. The average age of patients was 54.8±11.1years in the general population, 56.5±11.8years in the subgroup of non-resistant hypertension and 64.2±5.4years in the subgroup of resistant hypertension. The symptoms were represented by headache (11.9%), dizziness (9.9%) and chest pain (8.9%). Modifiable cardiovascular risk factors were dominated by dyslipidemia, diabetes and obesity/overweight. These risk factors were significantly more frequent in the subgroup of resistant hypertension. The global cardiovascular risk was high in 24.9% of cases in the general population, 22.5% in the subgroup of non-resistant hypertension and 38.6% in the subgroup of resistant hypertension. The target organ damages were significantly more frequent in the same subgroup of resistant hypertension. After addition of spironolactone, 21.8% of resistant hypertensive patients were controlled. CONCLUSION: This study shows that resistant hypertension is common in black Africans. It is mostly subjects of the sixth decade, with limited economic income and living in rural areas. In the absence of contra-indication, spironolactone contributed to decrease the morbidity of this pathology.

[Infective endocarditis in sub-Saharan african children, cross-sectional study about 19 cases in Ouagadougou at Burkina Faso]. / Les endocardites infectieuses chez l'enfant africain subsaharien, étude transversale à propos de 19 cas à Ouagadougou au Burkina Faso.

INTRODUCTION: Infective endocarditis is a transplant of a microorganism on a most often injured endocardium. It is rare in children. This work aimed to determine the frequency of endocarditis of the child, to describe clinical presentation, data from echocardiography, microbiological profile and clinical course. PATIENTS AND METHODS: From May 1 2010 to April 30 2011, we consecutively included children received for infective endocarditis in two medical centers in the city of Ouagadougou: Saint-Camille medical center and teaching hospital Yalgado-Ouedraogo. We investigated the functional and general signs and treatment already received. The physical examination looking for an infectious syndrome, pneumonia, heart failure and entrance doors. Blood cultures, blood count, creatinine, blood chemistry, HIV status, electrocardiogram, chest radiography and cardiac Doppler ultrasound were systematic. The diagnosis of the disease was based on Duke criteria. RESULTS: Nineteen endocarditis in children were reported, that is 1.7% of admissions. The average age was 4.7 ± 2.6 years (extremes: 1 and 14). The sex ratio was 1.7 for girls. The clinical presentation was a common infectious syndrome. Impaired general condition and congestive heart failure were present on admission in six cases, respectively. The front door was dental in nine cases (47.4%), skin in four cases (21%) and ENT in three cases (15.8%). A peripheral vein was implicated in one case. In the two other cases, no front door had been found. HIV serology was positive in four cases. As for the blood cultures, they were positive in 13 cases. The germs found were Streptococcus in 10 cases and staphylococcus in three cases. Echocardiography had revealed vegetations in 18 cases. These vegetations were localized on the mitral in nine cases. Multiple locations were found in four cases. Underlying heart disease was dominated by rheumatic valve disease (68.4%), healthy heart forms were found in two cases. Treatment consisted of antibiotics, antipyretic treatment and that of heart failure as appropriate. The evolution was marked by five deaths (26.3%) in an array of septic shock. Death was more important in congenital heart disease. CONCLUSION: Infective endocarditis of the child is common in our practice. The clinical syndrome is common infectious. Streptococcus and Staphylococcus are the two germs found. The main door is dental. Hence, dental care should be promoted for better prevention of infective endocarditis in our context.

A decade of follow-up and therapeutic drug monitoring in HIV-2 immunocompromised patients at St Camille and General Lamizana Military Medical Centers, Burkina Faso, West Africa.

Although, HIV-2 is generally less pathogenic than HIV-1 and its progression towards AIDS occurs less frequently. HIV-2 remains an important cause of disease in West Africa. This study aimed to evaluate HIV-1 and HIV-2 prevalence among pregnant women and to describe the demographic and clinical profile of patients with HIV-2 infection from 2003-2013 at St Camille and General Lamizana Military Medical Centers. A retrospective investigation was conducted using 12,287 medical records from patients screened for HIV. To respond to the lack of data available regarding HIV-2 treatment and also to address the approach to clinical, biological as well as therapeutic monitoring, 62 HIV-2 infected patients' medical records were studied. Seroprevalence of 10.6 and 0.14% were obtained, respectively for HIV-1 and HIV-2 among 12,287 women screened during the study period. From the sixty two (62) HIV-2 patients, the average age was 49.2 years (sex ratio was 0.65). The weight loss and diarrhea were the major clinical manifestations observed, respectively 54.8 and 25.8%. Fungi and herpes zoster (shingles) infections were reported as major opportunistic infections. Also, nearly half of the patients had more than 60 kg, less than 2% were in WHO stage IV and about 2/3 had a CD4 count bellow 250 cells mm(-3). AZT-3TC-IDV/LPV/R was the most prescribed combination. The gain in weight gain the Body Mass Index (BMI) improvement and the non-significant increase of the rate of CD4 between 1st (M1) and 24th month (M24) were observed after treatment with antiviral.

Seroprevalence of latent Toxoplasma gondii infection among HIV-infected pregnant women in Bobo-Dioulasso, Burkina Faso.

The deficit of cellular immunity, as found in HIV infected individuals, may lead to the reactivation of latent Toxoplasma gondii cysts, with as consequence, the occurrence of toxoplasmosis and an eventual vertical transmission of the disease during pregnancy. The present study was designed for determining the occurrence of latent Toxoplasma gondii among HIV-infected pregnant women during the first trimester in Bobo-Dioulasso. Thus, 348 pregnant women aged from 17 to 47 years (average age of 6.64 ± 4.75 yaers) were enrolled. The specific anti-Toxoplasma gondii IgG and IgM antibodies were quantified from whole blood specimens using the high-sensitivity direct agglutination and the enzyme linked fluorescent assays, respectively, the IgG avidity test being used for the dating of the primary infection. The results revealed that the seroprevalence of Toxoplasma gondii latent infection was 34.7%. It was significantly higher in HIV-infected women compared with uninfected ones (68,7%; CI 95%: 43,6%-88,9%) versus (33,1%; CI 95%: 28, 2%-38,3%). In addition, all the occurrences of the high IgG avidity were closely linked with the presence of IgM. These results underlined the need for the clinical follow-up of the maternal HIV diseases including the toxoplasmosis during the pregnancy since; the newborns are still exposed to vertical transmission of Toxoplasma infection in endemic areas like Burkina Faso.

[Vaginal infections in pregnant women at the Regional Hospital of Sokode (Togo) in 2010 and 2011]. / Infections vaginales chez les femmes enceintes au centre hospitalier régional de Sokodé (Togo) entre 2010 et 2011.

OBJECTIVE: The aim of this study was to evaluate the prevalence of the major microorganisms causing vaginal infections in pregnant women consulting at the Regional Hospital of Sokodé and to assess their sensitivity to antibiotics. MATERIALS AND METHODS: This prospective study took place from June 2010 through August 2011 and included 302 pregnant women from whom a sample was taken by a vaginal swab. Samples were processed for parasitic, bacterial, and fungal agents, by microscopic examination and culture. RESULTS: We isolated 273 germs, alone or in association in 221 women. These germs were distributed as follows: Gardnerella vaginalis (55.31%), Candida spp (30.77%), Staphylococcus aureus (5.49%), Enterobacteriaceae (4.40%), Trichomonas vaginalis (3.66%) and Mobiluncus spp (0.37%). No Streptococcus strain was isolated during the study. Over 40% of women had bacterial vaginosis and 23.08% of them were coinfected. The occurrence of coinfection was statistically influenced by the stage of pregnancy (P = 0.05). The susceptibility tests revealed that S. aureus developed a strong resistance to aminopenicillins (66.67%) and cephalosporins (>44.44%), while Enterobacteriaceae was resistant to cephalosporins and quinolones. (16.67%). CONCLUSION: This study showed that pregnant women in Sokode are still exposed to vaginal infection, caused mostly by G. vaginalis and Candida species. These results underline the need for at least one vaginal swab culture for each woman during pregnancy.

[Molecular diagnosis of bacterial meningitis in Burkina Faso]. / Diagnostic moléculaire par PCR en temps réel d'agents bactériens responsables des méningites purulentes au Burkina Faso.

STUDY OBJECTIVES: The aim of this pilot study was to evaluate the use of real-time polymerase chain reaction (RT-PCR) in the diagnosis of bacterial meningitis in Burkina Faso. METHODOLOGY: This retrospective study reviewed the analyses of specimens collected from April 2009 through February 2010. DNA was extracted from cerebrospinal fluid (CSF) from patients with suspected meningitis from different health districts in Burkina Faso and analyzed with RT-PCR. Many patients were also tested with traditional diagnostic methods for meningitis: culture and serology (latex agglutination test). RESULTS: The study included 171 patients hospitalized in 8 health districts. Bacterial DNA for germs causing purulent meningitis was identified in 108/171 patients (63%); corresponding percentages for culture and latex were 60% (56/93) and 77% (66/86), respectively. All three methods found that NmA and Spn were the two main bacteria responsible for purulent meningitis in our cohort: with real time PCR, NmA = 59.3% and Spn = 34.3%), culture (NmA = 78.6% and Spn = 17.8%) or latex (NmA = 77.3% and Spn = 21.2%). Real-time PCR improved the sensitivity and the specificity of the diagnosis of the germs involved in this study and allowed the detection of the serogroups NmY and NmW135, which could not be detected by culture or latex agglutination test. RT-PCR permitted the detection and the characterization of bacteria responsible for purulent meningitis from CSF-contaminated cultures that could not otherwise be detected.

[Prevalence of intestinal parasites at Saint-Camille medical center in Ouagadougou (Burkina Faso), 1991 to 2010]. / Prévalence des parasites intestinaux de 1991 à 2010 au centre médical Saint-Camille de Ouagadougou (Burkina Faso).

BACKGROUND: Intestinal parasitoses continue to be a major public health problem in developing countries. OBJECTIVES: This study sought to evaluate the prevalence of intestinal parasites and their coinfection rates in patients attending the Saint-Camille medical center in Ouagadougou. Methodology. This retrospective study covers the period from 1991 through 2010. RESULTS: In all, 292,148 stool samples were analyzed, and 177,672 contained at least one parasite, for a prevalence rate of 60.82%. Protozoans accounted for 90.53% of the parasites identified (160,838) and helminthes 9.47% (16,834). The most common protozoans were Entamœba histolytica/dispar (39.88%), Trichomonas intestinalis (25.78%) and Giardia intestinalis (24.83%). The helminthes encountered most frequently were Hymenolepis nana (3.99%) and Ancylostoma spp (3.65%). Globally, the prevalence of parasites decreased over the 20-year study period. The prevalence of E. histolytica/dispar decreased while that of Giardia intestinalis became more frequent. The most common parasitic associations were E. histolytica/dispar-G. intestinalis (26.24%) and G. intestinalis-T. intestinalis (20.09%). CONCLUSION: Our results indicate that Burkina Faso is a zone at high prevalence of intestinal parasitosis, even though this prevalence appears to be decreasing. Appropriate strategies should be developed to accelerate the reduction in the incidence of these parasites.

[HIV/AIDS care and international migrations in the rural district of Nanoro, Burkina Faso]. / Prise en charge du VIH/sida et migrations internationales dans le district rural de Nanoro, Burkina Faso.

West African Countries account for almost half of the estimated 20 000 000 international migrants in the continent. In the frame of the scaling up of HAART, our study aims to identify specific features and constraints of access to care for HIV migrant patients returning to Burkina Faso. From January 2007 to August 2011, the Nanoro District Hospital, serving a rural area in the Centre-West of Burkina Faso, followed 437 HIV/AIDS adult patients. Migrants were 139/437 (31.8 %), of whom 108/139 (77.7 %), declared they returned to Burkina Faso to seek care, because the area they migrated to did not offer specific HIV health assistance. At baseline, 113/139 (81,3 %) migrants and 181/298 (60,7 %) residents were in WHO clinical stages III or IV (p< 0.01). For every 100 patients/ year under HAART, 25.5 migrants (91.4 % of whom to foreign countries) and 5.7 Burkina residents were transferred to other centers (p<0.01). 21.8 migrants and 8.5 residents were dead or lost to follow up (p<0.05). For migrant patients, access to HIV screening and care seems to be delayed. The high frequency of migrants under HAART working abroad requires an improved cooperation among the health systems of the African Countries.