Prevalence of HIV infection and hepatitis B and factors associated with them among men who had sex with men in Togo in 2017.

Men who have sex with men (MSM) are a population at risk of contracting both HIV and hepatitis B virus (HBV). The objective of this study was to assess the prevalence of these diseases and the factors associated with them among MSM in Togo in 2017. This cross-sectional study took place in eight major cities in Togo from August through September, 2017. MSM aged 18 years and older were recruited with the respondent-driven sampling method. Data on sexual behavior were collected with a standardized questionnaire. Rapid tests were used to screen for HIV and HBV. In all, 678 MSM with a median age of 23 years (interquartile range: 21-26) were recruited, 68.7% of them living in Lomé, the capital of Togo. The prevalence of HIV was 22.0% (95% confidence interval [95% CI] 18.9-25.3) and that of HBV 7.1% (95% CI 5.3-9.3). Seven (1.0%) MSM were co-infected with HIV and HBV. Age, place of residence, living with a male partner, the number of male partners in the 12 months before the study, and history of HIV testing were associated with HIV infection (P<0.05). Age and living in Lomé were associated with HBV infection (P<0.05). The results of this study highlight the importance of focusing response efforts on populations at risk of contracting STIs through routine screening and vaccination.

Prevalence of human papillomavirus, human immunodeficiency virus and other sexually transmitted infections among female sex workers in Togo: a national cross-sectional survey.

OBJECTIVES: Sub-Saharan Africa is a region with high incidence of both human immunodeficiency virus (HIV) and cervical cancer. We conducted the first national study in Togo to assess prevalence of human papillomavirus (HPV), HIV and other sexually transmitted infections (STIs) among female sex workers (FSW). METHODS: A multicentric cross-sectional study was conducted among FSW recruited in hot spots (clubs, streets) in four Togolese cities. HPV and STIs were tested from cervical and anal swabs. HIV and syphilis were screened with rapid tests. RESULTS: In all, 310 FSW were recruited; HIV and cervical high-risk HPV (hrHPV) prevalence were 10.6% (33/310) and 32.9% (102/310), respectively. The most frequent hrHPV types were HPV58 (13.6%, 19/140), HPV35 (12.9%, 18/140), HPV31 (12.1%, 17/140) and HPV16 (10.7%, 15/140). Prevalence of hrHPV and multiple hrHPV infections showed higher rates in HIV-positive than in HIV-negative FSW (48.5% versus 31.0%, p 0.04 and 21.2% versus 9.0%, p 0.03; respectively). Prevalence of hrHPV was higher in cervical than anal swabs (34.1% versus 20.7%, p 0.0004). High-risk HPV anal infections were more frequent among HIV-positive than HIV-negative FSW (51.9% versus 17.3%, p 2 × 10-5). Concomitant anal and cervical hrHPV infections were present in 43.2% (41/95) of hrHPV-positive FSW. Overall prevalence in the cervix of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis were 4.2%, 6.1%, 5.5% and 6.5%, respectively. CONCLUSIONS: This first African study on paired cervical and anal samples showed a high prevalence of genital HPV infections with a rather high rate of concomitant HPV infections but low type concordance. We report an unusual distribution of hrHPV types. These findings highlight the critical need for implementation of a national HPV vaccination strategy.

Resistance profile of children and adolescents infected with HIV-1 in urban areas in Togo.

INTRODUCTION: Children and adolescents are more vulnerable than adults to virologic failure and the emergence of resistance. The objective of our study was to determine the resistance patterns in adolescents on antiretroviral therapy at Sylvanus Olympio University Hospital in Lome, Togo. METHODS: From June 1 to September 30, 2014, we included patients who had been on HAART for more than 12 months in the pediatric ward of Sylvanus Olympio University Hospital. Patients with an HIV viral load ≥ 1000 copies underwent resistance genotyping. RESULTS: Virologic failure was found in 36 of the 198 children and adolescents in the study (18.2%). Half were in WHO stage 3,72.2% were treated with a combination of two NRTIs (nucleoside reverse transcriptase inhibitors) and one NNRTI (non-nucleoside reverse transcriptase inhibitor). The mutations were mostly found in the NNRTI class with 100% mutations for EFV and NVP. The mutations associated with the most frequent NRTIs were M184V, Y181C, and T215Y. CONCLUSION: Our study shows the need to use PIs (boosted protease inhibitors) in most children treated with NNRTI. It is necessary to strengthen the virological monitoring of children on HAART.

Hepatitis B Infection in HIV-1-Infected Patients Receiving Highly Active Antiretroviral Therapy in Lome; Togo: Prevalence and Molecular Consequences

BACKGROUND:No data are available on HIV/hepatitis B virus (HBV) or hepatitis C virus coinfection in Togo; and patients are not routinely tested for HBV infection.OBJECTIVE:To determine the prevalence of HBV and the risk of HBV drug resistance during antiretroviral treatment in HIV-coinfected patients in Togo.METHOD:This cross-sectional study was carried out in Lome; Togo; from January 2010 to December 2011 among HIV-infected patients who had been on antiretroviral therapy (ART) for at least 6 months.RESULTS:In total; 1 212 patients (74.9% female) living with HIV/AIDS and treated with ART were included in the study. The seroprevalence of hepatitis B surface antigen (HBsAg) was 9.7% (117/1 212; 95% confidence interval (CI) 8.04 - 11.45). Of these 117 HBsAg-positive patients; 16 (13.7%) were hepatitis B e-antigen (HBeAg)-positive; and 115 (98.3%) were on lamivudine. The HBV DNA load was etgt;10 IU/mL in 33/117 patients overall (38%); and in 87.5% of 16 HBeAg-positive patients (petlt;0.0001). In multivariate analysis; factors associated with HBV DNA load etgt;10 IU/mLwere HBeAg positivity (adjusted odds ratio (aOR) 6.4; p=0.001) and a higher level of education (aOR 6.5; p=0.026). The prevalence of HBV resistance to lamivudine was 13.0% (15/115; 95% CI 7.0 - 19.0). The detected resistance mutations were rtL180M (14/15 patients) and rtM204V/I (15/15).CONCLUSION:The seroprevalence of HBV among ART-treated HIV-infected patients in Togo was 9.7%. The prevalence of HBV lamivudine resistance mutations after 2 years of ART was 13.0%. These results suggest that HBV screening before ART initiation can be based on HBsAg testing

Prevalence of multidrug-resistant tuberculosis cases among HIV-positive and HIV-negative patients eligible for retreatment regimen in Togo using GeneXpert MTB/RIF.

Drug-resistant tuberculosis (TB) is emerging as an important health problem in Togo. From sputum of previously treated TB patients, multidrug-resistant (MDR) TB was diagnosed in 24% (10/42) patients via GeneXpert MTB/RIF compared to 25% (6/24) patients via conventional drug susceptibility testing (BACTEC MGIT 960 system). The agreement between these two methods to detect MDR-TB is excellent. However, GeneXpert MTB/RIF offers the advantage of rapidly detecting Mycobacterium tuberculosis complex in sputum samples in instances where the cultures are negative (33%, 14/42) or contaminated (9.5%, 4/42). GeneXpert MTB/RIF permitted us to estimate the prevalence of MDR-TB in previously treated TB patients and to improve TB diagnostics among HIV-positive and -negative patients in Togo, where culturing M. tuberculosis complex from sputum samples is challenging.

Evaluation of 9 rapid diagnostic tests for screening HIV infection, in Lomé, Togo.

PURPOSE: HIV rapid diagnostic tests (RDT) could be greatly contributive for a universal access to HIV diagnosis. However, according to the WHO, these tests need to be assessed before they can be used in routine. METHOD AND RESULTS: We assessed 9 RDT in routine clinical use between 2009 and 2013. The sensitivity and specificity observed for 7 tests were≥99% and≥98%, respectively: FIRST RESPONSE HIV1-2-O PMC Medical, India, GENIE Fast HIV 1-2 and GENIE™ III HIV(1/2) Bio-Rad, France, HIV TRI-DOT+Ag;J. Mitra, INDIA; SD BIOLINE HIV(1/2) 3.0 and SD BIOLINE HIV/SYPHILIS DUO Standard Diagnostic, Korea; and VIKIA HIV(1/2); BioMérieux, France. Two tests had performances inferior to WHO recommendations: INSTI HIV1/2 Biolytical Canada; sensitivity=97.8% and HEXAGON HIV HUMAN GmbH Germany; specificity=94.8%. CONCLUSION: Seven of 9 RDT had excellent performances. Nevertheless, they can be used only after training staff, and taking into account national algorithm for their safe use.

HIV seroprevalence among inmates in Togo.

BACKGROUND: There is no data on HIV seroprevalence among prisoners in Togo. METHODS: A cross-sectional study was conducted among prisoners in Togo from November 2011 to January 2012. The study population was included by selecting the most densely populated prison in each of the six Togo regions, and by including prisoners (at least18years of age and having been in prison for more than 30days) on a voluntary basis. HIV prevalence was estimated with a 95% confidence interval (CI). RESULTS: One thousand three hundred and fourty-two prisoners were included in the study. Their median age was 28years, (IQR 25-33years) and 39 (2.9%) were women. The median time spent in the prison was 10months, interquartile range [4-24months]. HIV testing was accepted by 96.0%. HIV seroprevalence in prisons was 4.3%, 95 CI% [3.2-5.5%]. Few prisoners (2.9%) reported having had sex in prisons. The only factor associated with HIV infection was gender with an HIV seroprevalence of 14.3% for women compared to 4.0% for men (P=0.003). CONCLUSION: The prevention and the management of HIV infection should be a priority in Togolese prisons. This requires implementing healthcare facilities in prisons.

[Becoming new pulmonary tuberculosis patients with sputum smear-positive at the end of second month of anti tubercular treatment in Lome]. / Devenir des nouveaux patients tuberculeux pulmonaires a bacilloscopie positive a la fin du deuxieme mois de traitement antituberculeux a Lome.

AIMS: To determine the frequency of the new smear-positive pulmonary tuberculosis patients at the end of the second month of anti-tuberculosis treatment and to analyze the outcomes of their treatment. PATIENTS AND METHOD: It was a retrospective comparative study from January 2006 to June 2008, based on the analysis of the records and treatment cards from the diagnosis and treatment centers of Lome. New sputum smear-positive tuberculosis patients at the end of the second month (smear positive 2 months) constituted the study population. A comparison group consisted of the new tuberculosis patients with sputum smear-negative at the end of the second month (negative smear 2 months). RESULTS: The proportion of sputum smear-positive at 2 months was 5.34% (163/3050). Cure and failure rates were respectively 69.3% and 17.2% for smear-positive 2 months versus 79.1% and 3.7% for control group. The death rate was similar in both groups (3% and 3.7%). CONCLUSION: The smear positive 2 month's patients have a high risk of failure and must receive special attention during their follow-up to improve the results of treatment.

BUT: Déterminer la fréquence des nouveaux patients tuberculeux pulmonaire à bacilloscopie positive à la fin du 2ème mois de traitement antituberculeux et analyser les résultats de leur traitement. PATIENTS ET MÉTHODE: Il s'agissait d'une étude rétrospective comparative de janvier 2006 à juin 2008, basée sur l'analyse des registres et les cartes de traitement de tuberculose des centres de diagnostic et de traitement de Lomé. Les nouveaux patients tuberculeux à bacilloscopie positive à la fin du deuxième mois (frottis mois 2 positif) constituaient la population de l'étude. Un groupe de comparaison était constitué avec les nouveaux patients tuberculeux à bacilloscopie négatif à la fin du deuxième mois (frottis mois 2 négatif). RÉSULTATS: La proportion des frottis mois 2 positif était de 5,34 % (163/3050). Les taux de guérison et d'échec étaient respectivement de 69,3% et de 17,2% chez les frottis 2 positif contre 79,1% et 3,7 % chez les frottis 2 négatif. Le taux de décès était similaire dans les deux groupes (respectivement 3% et 3,7%). CONCLUSION: Les patients à frottis 2 positif ont un risque élevé d'échec et doivent bénéficier d'une attention particulière au cours de leur suivi afin améliorer les résultats de leur traitement.

[Prevalence of methicillin-resistant Staphylococcus aureus in community-acquired skin infections in Lomé, Togo]. / Prévalence de Staphylococcus aureus résistant a la méticilline (SARM) au cours des infections cutanées communautaires a Lomé (Togo).

PURPOSE: To determine the prevalence of methicillin-resistant Staphylococcus aureus in community-acquired skin infections in Lomé, Togo. PATIENTS AND METHODS: A prospective study including 90 cases of skin infection observed in dermatological outpatients at the teaching Hospital of Lomé was carried out from 1st June 2003 to 30th May 2005. A bacteriological sample with antibiograms was obtained from all patients. RESULTS: Mean patient age was 21 years (extremes, 6 months to 78 years). The male-to- female ratio was 0.84. Infection was primary in 80% of cases including impetigo in 42.2%, follicular infection in 28.9%, and abscess in 8.9% and secondary in 20% of cases including eczema in 8.9%, mycosis in 3.3%, and other in 7.8%. Staphylococcus aureus strains were isolated in a total of 84 cases (93.3%). Staphylococcus aureus occurred alone in 79 cases (87.8%) or in association with other bacteria in 5. A total of 30 of the 84 Staphylococcus aureus strains (35.7%) isolated were methicillin-resistant. Resistant strains were associated with primary infection in 24 cases and secondary infection in 6. CONCLUSION. Staphylococcus aureus is the most common cause of community-acquired skin infections in Lomé. One third of Staphylococcus aureus strains are methicillin-resistant. These findings should be taken into account in daily practice for prescription of antibiotics to patients presenting these infections.

[Prevalence of HIV-TB co-infection and impact of HIV infection on pulmonary tuberculosis outcome in Togo]. / Prévalence de la co-infection VIH-tuberculose et impact de l'infection VIH sur l'évolution de la tuberculose pulmonaire au Togo.

The aim of this study was to determine the prevalence of HIV infection in tuberculosis patients and its impact on the TB treatment. We enrolled 569 pulmonary TB patients in four diagnosis and treatment centres in Togo. All patients were new TB cases and received the first-line TB drugs: two months of rifampicin-pyrazinamide-isoniazid-ethambutol and six months of isoniazid-ethambutol. HIV testing was done according to the national guidelines, using rapid diagnosis tests. The CD4 lymphocyte counting was performed by Facscalibur (BD, Sciences) for all HIV-positive patients. Of the 569 TB patients enrolled, 135 (23.7%) were HIV positive (TB/HIV+). HIV prevalence was 22.4% (76 of 339) among men and 25.6% (59 of 230) among women without statistical difference. The global rate of treatment success was 82.2%. The rate of treatment success was lower (64.3%) in TB/HIV+ patients than in TB/HIV- patients (87.5%) (p <0.01). The mortality rates were 25.6% and 11.8% in TB/HIV+ patients and TB/HIV- patients, respectively, with a statistically significant difference (p <0.01). We did not found any statistical difference between the rates of treatment success among TB/HIV- (87.5%) patients and TB/HIV+ patients who had TCD4 lymphocyte counts above 200/µl (84.4%). TB program in Togo must take into account HIV infection to improve its performance.

[Pediatric salmonellosis at the Tokoin's teaching hospital, Lomé (Togo)]. / Les salmonelloses chez l'enfant au CHU Tokoin de Lomé (Togo).

OBJECTIVE: The authors had for aim to describe the epidemiological, clinical, and bacteriological aspects and outcome of pediatric Salmonella enterica, Salmonella septicemia, over the last 10 years. PATIENTS AND METHODS: We analyzed the case history of 132 patients hospitalized for Salmonellasepticemia (positive blood culture) between 1995 and 2004. RESULTS: Salmonellosis accounted for 0.36% of all hospitalizations. The mean age of patients was 5.86 plus or minus 4.06 years, significantly higher in patients with S. ser. Typhi (7.14+/-4.04 years) than in patients with other serotypes (4.95+/-3.8 years). The clinical presentation was severe in many children (with dehydration (34.8%) and emaciation (55.3%)), so HIV was suspected and investigated in 51 patients (38.6%). Eight patients were HIV positive. Three serotypes of S. enterica were predominant: S. ser. Typhi, 55 cases (41.7%), S. ser. Enteritidis, 32 cases (24.2%), and S. ser. Typhimurium, 19 cases (14.4%). The bacterial susceptibility to antibiotics was good for ceftriaxone and ciprofloxacin (100%). But 78.8% of the serotypes were resistant to amoxicillin, 75.4% to chloramphenicol, and 69.4% to cotrimoxazole. The mean duration of hospitalization was 13.7 plus or minus 7.4 days (range 4-34 days). Complications occurred in 15.9% of cases, dominated by digestive bleeding (10.6%), and 6.1% of patients died.

[Emergence of multidrug resistant Salmonella strains in Lome (Togo)]. / Emergence des souches de salmonelles multirésistantes aux antibiotiques à Lomé (Togo).

OBJECTIVE: This study had for aim to compare antibiotic resistance of 332 Salmonella enterica strains identified in human samples in the course of infections, in Lome. DESIGN: The strains were collected over two periods: 1998-2002 (N=168) and 2003-2004 (N=164). The antibiotic susceptibility test was performed by disk diffusion assay. RESULTS: The main serotypes identified were 147 Salmonella Typhi (44.3%), 97 Salmonella Typhimurium (29.2%), and 74 Salmonella Enteritidis (22.3%). The proportions of strains resistant to chloramphenicol, cotrimoxazol, and amoxicillin (first line antibiotics) varied respectively from 33, 46, and 57% in 1998-2002 to 73, 79, and 82% in 2003-2004 (P<0.0001). The percentage of resistance to ciprofloxacin or ceftriaxone was inferior to 10%. CONCLUSION: Fluoroquinolones and third generation cephalosporins have become the first line antibiotics for the treatment of Salmonella in Lome (Togo).

[Genital bacterial carriage during the last trimester of pregnancy and early-onset neonatal sepsis]. / Portage génital bactérien au dernier trimestre de la grossesse et infection néonatale précoce.

UNLABELLED: Bacterial infections remain a major cause of morbidity and mortality in newborn infants. OBJECTIVE: To determine the bacterial ecology and pathological status of the genital organs during the last trimester of pregnancy and the germs of the following early-onset neonatal sepsis, in order to evaluate the risk of materno-foetal infections and to find out a drug prophylaxis. METHOD: Vaginal and endocervical samples, usually taken during the first trimester of pregnancy were delayed and taken during the last trimester of pregnancy. A macroscopic examination described the aspect of the vagina, the cervix uteri, leukorrhea and of possible inflammatory lesions or ulcerations. A microscopic examination searched for parasites, epithelial cells, clue cells and leukocytes. The appropriate bacteriological cultures were performed after reading the Gram stain and scoring the vaginal flora. The clinical and cytobacteriological aspects were used to identify the bacterial ecology and the pathological genital states. An exploration was carried out in every newborn suspected of infection. RESULTS: Genital samples were collected from 306 pregnant women. Among them, 118 were at 29-32 weeks of gestation, 104 at 33-36, and 84 at 37-40. The most frequent germs were C. albicans (33,5%), Enterbacteriaceae (20.3%) including E. coli (10.9%), S. aureus (15.4%), Gardnerella (13.6%), and Trichomonas (10.6%), in monomicrobian (79.2%) and polymicrobian carriage (20.8%). Lower genital tract pathological states such as vaginitis (29.4%), bacterial vaginosis (21.5%) or endocervicitis (10.4%), asymptomatic bacterial carriage (23.5%) and normal genital flora (15%) were identified. These pregnancies led to 334 live births with 27 cases of early-onset neonatal sepsis to which endocervicitis (25%) and vaginosis (19,7%) were most often linked. CONCLUSION: Genital samples at the last trimester of pregnancy could evaluate the risk of maternofoetal infections and allow to adapt a drug prophylaxis of Enterobacteriaceae, the most frequent germ of neonatal infections, as it has been done for Streptococcus agalactiae. But larger studies are required to evaluate the risk of maternofoetal infections and to state the drug prophylaxis.

[Human immunodeficiency virus, hepatitis C virus and hepatitis B viruses in patients with sickle-cell disease in Togo]. / Virus de l'immunodéficience humaine et virus des hépatites virales C et B chez les patients drépanocytaires au CHU Campus de Lomé (Togo).

CONTEXT: The clinical features of sickle cell disease (SCD) are vaso-occlusive and/or hemolytic crises which treatment may require blood transfusions. OBJECTIVE: This study aimed to determine the prevalence of HIV, Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV) infections in a population of SCD patients. METHODS: All the samples were analyzed by Elisa technique. We studied 119 sera for HIV using Elisa and a confirmation test in case of positive Elisa. We screened 91 sera for HCV and 119 sera for HBV. RESULTS: The prevalence was 5.04% for HIV, 6.5% for HCV and 20.2% for HBs Ag. Homozygous (SS) patients were more infected than compound heterozygous patients SC, (p < 0.02). 24.6% of the children (0 to 15 years of age) were infected as well as adults (35.5%). The Relative Risk to be contaminated was 7.14 for HIV, 4.29 for HCV and 5.43 for HBV in transfused compared to non transfused SCD patients. CONCLUSIONS: This high infectious risk in SCD patients should lead us to elaborate a better strategy to increase the safety of blood transfusion in Togo.

[Incidence and impact of HIV infection among patients with bacterial pleurisy in Lomé (Togo)]. / Fréquence et impact de l'infection au virus de l'immunodéficience humaine chez les patients souffrant de pleurésies bactériennes à Lomé (Togo).

A prospective study was made in the Tokoin university hospital in Lomé (Togo) to determine the incidence and the impact of HIV among patients with bacterial pleurisy. Two hundred cases of bacterial pleurisy were consecutively included over 17 months. The HIV diagnostic was performed using ELISA (Vironostika HIV Uni-Form II plus O and HIV1 and 2 Bispot Immunocomb II). The 200 cases of pleurisy included 152 (76%) tuberculous pleural effusion and 48 (24%) pleural empyema. Staphylococcus aureus (32%), Streptococcus pneumoniae (14.9%), and Pseudomonas (14.9%) were the main causes of pleural empyema. The HIV incidence was 61% (122/200). The mortality rate ranged from 26.2% in the HIV positive group to 5.1% in HIV negative group (P = 0.0001). The bacterial aspect of pleural empyema was heterogeneous in both groups but Salmonella Enteritidis and Salmonella Typhimurium were identified only among patients with HIV.

[Evaluation of eight diagnostic tests for HIV infection in Lome (Togo)]. / Evaluation de la performance de huit tests de diagnostic de l'infection à VIH à Lome (Togo).

This study to evaluate the performance of eight diagnostic tests for HIV/AIDS infection was conducted at the National Reference Center for HIV/AIDS/STD in Lomé, Togo. The tests were as follows: Enzymum test anti HIV Combi, Enzymum tests anti-HIV1 + 2 + subtype O, Genscreen HIV 1/2, Ice 1.0.2, Vironostika HIV Uni-Form II Plus O, Genie II HIV 1/2, SFD HIV 1/2 PA and DETERMINE HIV 1/2. A total of 238 serum specimens collected consecutively between January and April 1999 were studied. They were from 161 occasional blood donors and 77 patients. New Lav-Blot I and Ii (western blot) were used as reference tests. Test sensitivity ranged from 90 to 100%. Specificity ranged from 96 to 100%. The Enzymum test anti HIV Combi used only on serum samples from blood donors demonstrated a sensitivity and specificity of 100%. Tests based on Elisa (Emzymum Combi, Enzymum HIV 1 + 2 + subtype O, Genscreen, Ice 1.0.2 and Vironostika) allowed acceptable diagnosis of HIV/AIDS as alternatives to western blot. Two of the three rapid assays tested provided acceptable results, i.e., Genie II HIV 1/2 and SFD HIV 1/2. They are suitable for screening to prevent HIV transmission by blood transfusion in areas where Elisa is unfeasible.

[Antimicrobial activity of ciprofloxacin and netilmicin compared to various antibiotics in Lome, Togo]. / Activité antimicrobienne de la ciprofloxacine et de la nétilmicine comparée à celle de divers antibiotiques à Lomé, Togo.

We report the antimicrobial activity of ciprofloxacin and netilmicin on 577 strains such as S. aureus, Pseudomonas, E. coli, Salmonella, Proteus, Klebsiella and Enterobacter. Isolation and identification were performed by standard methods. Disk diffusion tests were performed to evalute the susceptibility. The percentage resistance to ciprofloxacin for bacteria was: E. coli = 15%, Enterobacter = 13%, Proteus = 10%, Pseudomonas = 9%, S. aureus and Klebsiella = 4%. The percentage resistance to netilmicin for bacteria was: Pseudomonas = 29%, Proteus = 26%, S. aureus = 21%, Enterobacter = 16%, Klebsiella = 14% and E. coli = 5%. The antimicrobial activity of ciprofloxacin and netilmicin was higher than that of others antibiotics.

[Acute osteomyelitis in the child with sickle cell disease in a tropical zone: value of oral fluoroquinolones]. / Ostéomyélites aiguës de l'enfant drépanocytaire en zone tropicale: intérêt de l'utilisation des fluoroquinolones par voie orale.

AIM: This study was designed to assess the efficacy and the safety of fluoroquinolones in their compassionate use for acute osteomyelitis in children with sickle cell disease in a tropical country. PATIENTS AND METHODS: This study was non comparative, including twelve children (eight SS, three SC and one SEzerothalassemia) treated for acute osteomyelitis with oral ciprofloxacin or ofloxacin because of the following reasons: financial inability to afford conventional parenteral beta-lactams therapy (nine patients), refusal of hospitalization (two patients), and failure of conventional treatment (one patient). RESULTS: The mean age of patients was 9.5 +/- 2.6 years. The long bones were the predominantly site. Salmonella species were present in 75% of cases, followed by other enterobacteriaceae (16.7%), and Staphylococcus aureus (8.3%). Successful outcome occurred in all cases after three to four-weeks of treatment and 45 days of plaster immobilization. Transient bilateral Achilles tendon tendinitis was noted in a five-year-old patient. CONCLUSION: In economically developing countries, oral fluoroquinolones may be a therapeutic alternative for acute osteomyelitis in patients with sickle cell disease particularly in cases of financial hardship or failure with conventional therapy.

[Frequency and susceptibility to antibiotics of Neisseria gonorrhoeae at Lomé]. / Fréquence et sensibilité de Neisseria gonorrhoeae aux antibiotiques à Lomé (Togo)

A cross-sectional study was carried out by the bacteriology laboratory of the Lome-Tokoin University Hospital, to determine the frequency of gonorrhea in patients providing vaginal or urethral samples, and to investigate the susceptibility of N. gonorrhoeae to antibiotics. The samples were treated according to classic bacteriological methods and the disk diffusion tests were used to investigate antibiotic susceptibility. The samples were taken from 420 patients, 246 of whom were male (26.86% ¿NdT: d'où vient ce chiffre??, 58.33% si 420 patients, 61.19% si 402 patients¿) and 156 of whom were female (37.14% ¿NdT: plutôt 38.8% si 402 patients¿) ¿NdT: et le reste?? Il me semble que c'est plutôt 402 patients en total (= 246 + 156). Sinon il y a 18 patients qui ne sont ni male ni femelle?!¿. N. gonorrhoeae was isolated from 88 patients, giving a prevalence of 20.95% ¿NdT: ou 21.89% si 402 patients¿. We isolated strains of the bacterium from 76 men (25.78% ¿NdT: incorrect, 30. 89%¿ and 12 women (7.69%). Ciprofloxacin, ofloxacin and netilmicin were the most effective antibiotics. The cyclins, cotrimoxazole and penicillin were less effective.