Genetic diversity of HPV35 in Chad and the Central African Republic, two landlocked countries of Central Africa: A cross-sectional study.

Human Papillomavirus (HPV)-35 accounts for up 10% of cervical cancers in Sub-Saharan Africa. We herein assessed the genetic diversity of HPV35 in HIV-negative women from Chad (identified as #CHAD) and HIV-infected men having sex with men (MSM) in the Central African Republic (CAR), identified as #CAR. Ten HPV35 DNA from self-collected genital secretions (n = 5) and anal margin samples (n = 5) obtained from women and MSM, respectively, were sequenced using the ABI PRISM® BigDye Sequencing technology. All but one HPV35 strains belonged to the A2 sublineage, and only #CAR5 belonged to A1. HPV35 from #CAR had higher L1 variability compared to #CHAD (mean number of mutations: 16 versus 6). L1 of #CAR5 showed a significant variability (2.29%), suggesting a possible intra-type divergence from HPV35H. Three (BC, DE, and EF) out of the 5 capsid loops domains remained totally conserved, while FG- and HI- loops of #CAR exhibited amino acid variations. #CAR5 also showed the highest LCR variability with a 16bp insertion at binding sites of the YY1. HPV35 from #CHAD exhibited the highest variability in E2 gene (P<0.05). E6 and E7 oncoproteins remained well conserved. There is a relative maintenance of a well conserved HPV35 A2 sublineage within heterosexual women in Chad and MSM with HIV in the Central African Republic.

Séroprévalence de la toxoplasmose chez les femmes en consultation prénatale à l'Hôpital du District de Bossembelé en République Centrafricaine en 2020 / Seroprevalence of toxoplasmosis in women in antenatal clinic at the Bossembelé District Hospital in the Central African Republic in 2020

Contexte et objectif. La toxoplasmose est une anthropozoonose ubiquitaire qui occupe une large place en médecine humaine et vétérinaire. Mais les données y relatives chez la femme enceinte sont paradoxalement fragmentaires. L'objectif de cette étude était de déterminer la séroprévalence de la toxoplasmose chez les femmes enceintes. Méthodes. Il s'agissait d'une étude transversale réalisée, à la maternité de l'Hôpital du District de Bossembelé, entre juin et septembre 2020. La population d'étude était constituée de femmes enceintes se présentant au laboratoire du District pour la sérologie toxoplasmique. Résultats. Au total, les données sérologiques de 50 femmes enceintes ont été analysées. L'âge moyen était de 25 ± 6 ans (extrème 16 et 40 ans). Les femmes au premier geste (n=20 soit 40 %) et les primipares (n= 30 soit 60 %) étaient prépondérantes. La sérologie était positive chez 15 patientes (30 %). Selon les caractéristiques sociodémographiques, la séroprévalence de la toxoplasmose était plus élevée chez les femmes de 20 à 35 ans (35,2 %), les femmes ayant été enceintes trois fois (88,8 %) et les femmes qui habitent le quartier Onoguia (66,66%). Les IgM étaient plus élevées chez les patients de la tranche d'âge de 20 à 35 ans (n=12), les femmes au 3e geste (n=8), les multipares (n=9) et chez celles habitant Bodoukpa (n=6). Les IgG étaient élevées chez les femmes enceintes de 20 à 35 ans (n=13), les femmes au 3e geste (n=7), les primipares (n=14) et celles habitant le quartier Bodoukpa (n=6). Parmi les patientes étudiées, 16 (32 %) étaient immunisées contre la toxoplasmose. Des 50 femmes, 4 avaient connu un avortement spontané durant les grossesses précédentes. Conclusion. Dans la présente étude, la séroprévalence de la toxoplasmose chez la femme enceinte est très fréquente. Une sensibilisation sur les risques de contamination, une surveillance sérologique systématique et des mesures d'hygiène devraient être proposées lors des consultations prénatales

Context and objective. Toxoplamosis is a ubiquitous anthropozoonosis that occupies a large place in human and veterinary medicine. The objective of the present study was to determine the seroprevalence of toxoplasmosis in pregnant women. Methods. This was a cross sectional study involving pregnant women presenting at the laboratory of the Bossembele District Hospital, Central African Republic between June and September 2020 for toxoplasmic serology. Results. A total of 50 pregnant women were examined. The age of patients varied from 16 to 40 years. The average age was 25 ± 6 years. Primigravida (n=20; or 40%) and primiparous women (n=30; or 60%) were more preponderant. Serology was positive in 15 patients (30 %). According to sociodemographic characteristics, the seroprevalence of toxoplasmosis was higher among women aged 20 to 35 (35.2 %), women who had been pregnant three times (88.8 %) and women who lived in the Onoguia neighborhood (66.6 %). IgM was higher in patients aged 20 to 35 years (n=12), in 3rd gravida women (n=8), in multiparous (n=9) and in those living in Bodoukpa (n=6). IgG was high in pregnant women aged 20 to 35 years (n=13), in 3rd gravida women (n=7), in primiparous women (n=14) and in those living in the Bodoukpa neighbourhood (n=6). Of the patients in the study, 16 turned out to be immune to toxoplasmosis. Among 50 women, 4 experienced spontaneous abortions during previous pregnancies. Conclusion. The seroprevalence of toxoplasmosis in the present study is common. Awareness on the risks of contamination, the systematic serological monitoring and the hygiene measures should be raised during antenatal consultations

Usefulness of simultaneous screening for HIV-specific and HCV-specific antibodies and HBsAg by a capillary-based multiplex rapid diagnostic test to strengthen linkage-to-care in sub-Saharan patients attending sexually transmitted infection clinic.

Adult outpatients attending the main sexually transmitted infection clinic of Bangui, Central African Republic, were prospectively subjected to a multiplex rapid diagnostic test for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). In group I (n = 208) of patients already followed for HIV, 6 (2.9%) were unexpectedly negative, thus corresponding to false positive for HIV by the national HIV algorithm; hepatitis B surface antigen and HCV positivities were high (18.7% and 4.3%, respectively). In group II (n = 71) of patients with unknown HIV status, at least 1 chronic viral disease was diagnosed in 26 (36.6%) patients, including 5 (7.1%) HIV, 17 (23.9%) HBV, and 3 (4.2%) HCV infections.

Unusual and unique distribution of anal high-risk human papillomavirus (HR-HPV) among men who have sex with men living in the Central African Republic.

BACKGROUND: High-risk (HR) human papillomavirus (HPV) infection remains a great concern in relation to African men who have sex with men (MSM), especially those infected with HIV. The prevalence of HR-HPV and associated risk factors was estimated in a cross-sectional observational study covering MSM living in Bangui, Central African Republic. METHODS: MSM receiving care at the Centre National de Référence des Infections Sexuellement Transmissibles et de la Thérapie Antirétrovirale, Bangui, were included. HIV serostatus and socio-demographic and behavioral characteristics were collected. HPV DNA was detected and genotyped on anal swabs using Anyplex™ II HPV28 test (Seegene, South Korea), and HSV DNA by in-house real-time PCR. Logistic regression analyses were used to determine risk factors associated with HPV outcomes. RESULTS: 42 MSM (mean age, 23.2 years; range, 14-39) including 69.1% HIV-1-positive and 30.9% HIV-negative were prospectively enrolled. The prevalence of anal HPV was 69.1%, including 82.7% of HR-HPV which were multiple in 52.0%. The most prevalent genotypes were HPV-35, HPV-58, HPV-59 and HPV-31. While, HPV-16 and HPV-18 were present in a minority of samples. Multiple HR-HPV infection was more frequent in HIV-positive MSM (41.4%) with 2.7 genotypes per anal samples than in HIV-negative (7.7%) with 1.5 genotypes per anal samples. HPV types included in the prophylactic Gardasil-9® vaccine were detected in 68.9% of specimens and HPV-58 was the most frequently detected. MSM infected by HPV-16 and HPV-18 were all infected by HIV-1. Few anal swabs (11.9%) contained HSV-2 DNA without relationship with HPV detection. Condomless receptive anal intercourse was the main risk factor to being infected with any type of HPV and condomless insertive anal intercourse was significantly less associated with HPV contamination than receptive anal intercourse (Odd ratio = 0.02). CONCLUSION: MSM in Bangui are at-risk of HIV and HR-HPV anal infections. The unusual distribution of HPV-35 as predominant HPV suggests possible geographic specificities in the molecular epidemiology of HR-HPV in sub-Saharan Africa. Scaling up prevention strategies against HPV infection and related cancers adapted for MSM in Africa should be prioritized. Innovative interventions should be conceived for the MSM population living in Bangui.

Task-shifting of CD4 T cell count monitoring by the touchscreen-based Muse™ Auto CD4/CD4% single-platform system for CD4 T cell numeration: Implication for decentralization in resource-constrained settings.

BACKGROUND: The accuracy of CD4 T cell monitoring by the recently developed flow cytometry-based CD4 T cell counting Muse™ Auto CD4/CD4% Assay analyzer (EMD Millipore Corporation, Merck Life Sciences, KGaA, Darmstadt, Germany) was evaluated in trained lay providers against laboratory technicians. METHODS: After 2 days of training on the Muse™ Auto CD4/CD4% analyzer, EDTA-blood samples from 6 HIV-positive and 4 HIV-negative individuals were used for CD4 T cell counting in triplicate in parallel by 12 trained lay providers as compared to 10 lab technicians. RESULTS: Mean number of CD4 T cells in absolute number was 829 ±â€¯380 cells/µl by lay providers and 794 ±â€¯409 cells/µl by technicians (P > 0.05); and in percentage 36.2 ±â€¯14.8%CD4 by lay providers and 36.1 ±â€¯15.0%CD4 by laboratory technician (P > 0.05). The unweighted linear regression and Passing-Bablok regression analyses on CD4 T cell results expressed in absolute count revealed moderate correlation between CD4 T cell counts obtained by lay providers and lab technicians. The mean absolute bias measured by Bland-Altman analysis between CD4 T cell/µl obtained by lay providers and lab technicians was -3.41 cells/µl. Intra-assay coefficient of variance (CV) of Muse™ Auto CD4/CD4% in absolute number was 10.1% by lay providers and 8.5% by lab technicians (P > 0.05), and in percentage 5.5% by lay providers and 4.4% by lab technicians (P > 0.05). The inter-assay CV of Muse™ Auto CD4/CD4% in absolute number was 13.4% by lay providers and 10.3% by lab technicians (P > 0.05), and in percentage 7.8% by lay providers and 6.9% by lab technicians (P > 0.05). CONCLUSIONS: The study demonstrates the feasibility of CD4 T cell counting using the alternative flow cytometer Muse™ Auto CD4/CD4% analyzer by trained lay providers and therefore the practical possibility of decentralization CD4 T cell counting to health community centers.