Ebola virus circulation in a non-epidemic Guinean rural area: a mixed-method approach to assessing endemicity.

OBJECTIVES: This study aimed to investigate the prevalence of orthoebolavirus antibodies in Madina Oula, a non-epidemic rural area in Guinea, in 2022. METHODS: A cross-sectional study conducted from March 14 to April 3, 2022, involved recording household and socio-demographic characteristics, lifestyle data, and collecting dried blood spots (DBS) from 878 individuals in 235 households. DBS were tested using multiplex serology to detect antibodies to different orthoebolaviruses: Ebola (EBOV), Bundibugyo (BDBV), Sudan (SUDV), Reston (RESTV) and Bombali (BOMV). Seroprevalence was estimated with a 95% confidence interval (CI) and Z-test was performed to compare seropositivity between in children under 15 and those over 15. Household and participant characteristics were analyzed using descriptive statistic, and socio-historical conditions were discussed. RESULTS: Serological analysis conducted in 2022 on 878 participants revealed varying reactivity to orthoebolavirus antigens, notably with GP antigens, particularly glycoprotein SUDV (16%). Twenty-one samples exhibited reactivity with at least two antigens, with a median age of 27 years (interquartile range = 10.00 - 35.00) ranging from 2 to 80 years. There is no significant difference between seropositivity in children under 15 (2.86%) and those over 15 (2.14%). Antibody presence varied per village, with the highest prevalence observed in Ouassou and Dar-es-Salam. CONCLUSION: Serological data in a region unaffected by recent Ebola outbreaks indicate possible orthoebolavirus endemicity, emphasizing the need for preparedness against known or novel orthoebolaviruses with potential cross-reactivity.

Predictors of Death in Rifampicin Resistant Tuberculosis Patients Treated with the Short Course in Conakry, Guinea.

The emergence of rifampicin-resistant tuberculosis (RR-TB) is a major issue for TB control programs due to high risk of treatment failure and death. The objective of this study was to describe survival and to determine predictors of death in RR-TB patients treated with the short regimen (9-11 months) in the Conakry TB treatment centers. Sociodemographic, clinical, and survival data were collected prospectively between 2016 and 2021 on RR-TB patients in the Department of Pneumo-Phtisiology, the Carrière and the Tombolia TB centers. The Kaplan-Meier method was used to estimate the cumulative incidence of death of patients. The Cox regression model was used to identify the predictors independently associated with death. Of 869 patients, 164 (18.9%) patients died during treatment, 126 of them within 120 days of treatment initiation. The factors associated with death during treatment were as follows: patients treated in the Carrière TB center (adjusted hazard ratio [aHR] = 1.65; 95% CI: 1.06-2.59) and in the Department of Pneumo-Phtisiology (aHR = 3.26; 95% CI: 2.10-5.07), patients ≥ 55 years old (aHR = 4.80; 95% CI: 2.81-8.19), patients with no history of first-line TB treatment (aHR = 1.51; 95% CI: 1.05-2.16), and patients living with HIV (aHR = 2.81; 95% CI: 1.94-4.07). The results of this study can help the national TB control program to reconsider its therapeutic strategy to improve patient care in case of RR-TB. Large prospective clinical studies should be conducted to provide evidence of the impact of such factors like previous history of TB treatment and HIV infection on survival of RR-TB patients.

The Past, Present, and Future of Professional Cancer Education in Morocco.

Cancer is the second leading cause of death in Morocco after cardiovascular diseases. Changes associated with societal and economic development, longevity of the population, and lifestyle changes contribute to increasing the burden of cancer in the Morocco. Despite the advances and achievements in cancer care in Morocco, more efforts are needed to better treat, control, and prevent cancer in Morocco. This manuscript illustrates the professional cancer education activities in Morocco over the past 10 years. The manuscript also illustrates the current cancer education and the needed future directions in the field in this middle-income country that is undergoing significant epidemiologic and lifestyle transitions and projections for increasing cancer incidence and mortality in the next few decades.