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1.
PLoS One ; 19(4): e0285907, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38578783

RESUMO

BACKGROUND: The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon. METHODS: A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization's (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs. RESULTS: Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28-50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level. CONCLUSION: The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences.


Assuntos
Hipertensão , Síndrome Metabólica , Pré-Hipertensão , Adulto , Masculino , Humanos , Feminino , Adolescente , Idoso , Pessoa de Meia-Idade , Urbanização , Síndrome Metabólica/epidemiologia , Gabão/epidemiologia , Fatores de Risco Cardiometabólico , Prevalência , Estudos Transversais , Hipertensão/epidemiologia , Fatores de Risco , População Rural , População Urbana
2.
Balkan Med J ; 41(2): 139-143, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38259115

RESUMO

Background: Anemia remains a significant public health concern in Gabon, particularly among children, adolescents, and females. Gabon is also home to two major species of filarial worms, Loa and Mansonella spp., which cause microfilaremia. The epidemiological nexus between hemoglobin (Hb) concentrations and microfilaremia in Gabonese first-time blood donors remains unknown. Aims: To understand better the epidemiological relationship between anemia and microfilaremia to improve donor selection and management protocols. Study Design: A retrospective cohort study. Methods: This study was conducted among first-time blood donors in Lambaréné between March 2018 and October 2019. Participants aged 16-65 years old and weighing a minimum of 50 kg were enrolled using standard donor selection criteria. An automatic hematological analyzer was used to quantify Hb concentrations, and microscopy techniques were used to detect the presence of microfilariae. Results: Microfilariae were found in 4.8% (35/723) of the 723 first-time blood donors from Lambaréné. Anemia was classified as mild in 35.5% (257/723) and moderate in 1% (7/723). No significant associations were found between the distribution of microfilariae and variables such as age, sex, socioprofessional classification, marital status, or residence. Blood group O donors had a higher prevalence of microfilariae (6%) than non-O donors (2.7%). However, the observed difference was not statistically significant (AOR =2.3, p = 0.052). Furthermore, microfilariae were associated with increased moderate anemia (3.7% vs. 29%, AOR =15.6, p = 0.003). Conclusion: Our findings highlight microfilaremia as a possible etiological cause of anemia among Gabonese blood donors, emphasizing the need for further research and a potential review of donor management strategies.


Assuntos
Anemia , Loíase , Criança , Animais , Feminino , Adolescente , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Microfilárias , Loíase/epidemiologia , Doadores de Sangue , Gabão/epidemiologia , Prevalência , Estudos Retrospectivos , Anemia/epidemiologia
3.
Antimicrob Resist Infect Control ; 12(1): 47, 2023 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-37173760

RESUMO

BACKGROUND: Urinary tract infections (UTIs) in children are very common. They are often associated with a high risk of sepsis and death. In recent years, antibiotic-resistant uropathogens ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae) are increasingly encountered in UTIs. These bacteria, usually multidrug-resistance (MDR), extensive drug-resistance (XDR), pandrug-resistance (PDR), Extended-spectrum cephalosporin-resistance (ESC), Usual Drug Resistance (UDR), Difficult-to-Treat Resistance (DTR) and Carbapenem-resistance Enterobacteriales (CRE), represent a global threat for the management of paediatric UTIs. The aim of this study was to determine the epidemiology of community origin and antibiotic sensitivity of major ESKAPE uropathogens in paediatric UTIs in South-East Gabon. METHODS: The study involved 508 children aged 0-17 years. Identification of bacterial isolates was carried out using Vitek-2 compact automated system and the antibiogram with the disk diffusion and microdilution methods according to the European Committee on Antimicrobial Susceptibility Testing recommendations. Logistic regression analysis was used to assess the impact of patients' socio-clinical characteristics on uropathogens phenotype in both univariate and multivariate analysis. RESULTS: The prevalence of UTIs was 59%. E. coli (35%) and K. pneumoniae (34%) were the main ESKAPE involved in UTIs followed by Enterococcus spp. (8%) and S. aureus (6%). Among major ESKAPE, DTR-E. coli (p = 0.01), CRE-E. coli (p = 0.02) and XDR-E. coli (p = 0.03), Trimethoprim-sulfamethoxazole-resistant bacteria (p = 0.03) were associated with abdomino-pelvic pain. While MDR-E. coli (p < 0.001), UDR-E. coli (p = 0.02), ESC-E. coli (p < 0.001), MDR- Enterococcus (p = 0.04), UDR- Enterococcus (p = 0.02), bacteria resistant to Ampicillin (p < 0.01), Cefotaxime (p = 0.04), Ciprofloxacin (p < 0.001), Benzylpenicillin (p = 0.03) and Amikacin (p = 0.04) were more frequent among male children. MDR-Enterococcus (p < 0.01), bacteria resistant to Amoxicillin-clavulanic acid (p = 0.03), Cefalotin (p = 0.01), Ampicillin (p = 0.02) and Gentamicin (p = 0.03) were associated with treatment failure. In addition, Trimethoprim-sulfamethoxazole-resistant bacteria (p = 0.03) was associated with recurrent UTIs while those resistant to Ciprofloxacin was associated with pollakiuria (p = 0.01) and urinary burning (p = 0.04). Furthermore, UDR-K. pneumoniae (p = 0.02) was more frequent in neonates and infants. CONCLUSION: This study determined the epidemiology of ESKAPE uropathogens in paediatric UTIs. It found a high prevalence of paediatric UTIs associated with children's socio-clinical characteristics and diverse bacterial antibiotic resistance phenotypes.


Assuntos
Escherichia coli , Infecções Urinárias , Masculino , Humanos , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Staphylococcus aureus , Gabão/epidemiologia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Ciprofloxacina , Klebsiella pneumoniae , Enterococcus , Ampicilina/uso terapêutico
4.
J Public Health Afr ; 14(3): 1865, 2023 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-37229438

RESUMO

Background: In Gabon, malaria remains a major public health problem. All malaria cases with axillary temperature ≥ 37.5°C with a parasites density ≥ 1200/µL are serious cases and must be treated as a medical emergency. Thus, early diagnosis is essential for successful treatment. Because of the impact of malaria on the population, the surveillance of malaria infections in hospitals is urgently needed. The aim of this study was to to assess of clinical cases of malaria in a private health structure in Franceville between 2017 and 2019. Methods: For that, we conducted a retrospective study using data on malaria cases recorded in a private medical analysis laboratory in Franceville, southeast Gabon. Malaria was diagnosed in this laboratory using a Rapid Diagnostic Test and confirmed by microscopic analysis. Results: Analysis of 2518 patient forms revealed an increase in malaria prevalence in Franceville between 2017-2019. The global clinical cases was 26.1% (658/2015). Children under 5 years (44.0%) and patients aged 5-14 years (40.1%) were more affected than patients aged ≥15 years (18.8%, P=0.0001). Malaria infection was also significantly dependent on season and gender. We observed at least three Plasmodium species and the predominant Plasmodium species was P. falciparum 80.0%, followed by P. ovale (19.5%) and P. malariae (17.8%). Conclusion: Our study showed that malaria remains a public health priority for the population of Franceville and that the prevalence of clinical cases of malaria at the laboratory decrease between 2017 and 2019. Our results highlight the need for strategies to control malaria in Franceville, adapted to epidemiological contexts and environmental constraint.

5.
Pan Afr Med J ; 42: 194, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36212939

RESUMO

Introduction: in order to promote rapid care of HIV-positive people and to reduce the human immunodeficiency virus (HIV) transmission in Gabon, the national screening algorithm is essentially based on rapid diagnostic tests (RDTs). However, most of these RDTs are not evaluated. Their sensitivities and specificities remain unknown locally. The aim of this study was to determine the diagnostic performance of 3 RDTs used for HIV-1> screening in Gabon. Methods: of the one hundred and sixteen (116) samples tested, 60 plasmas were HIV-1 positive with known genotypes and viral loads; 51 sera were HIV-1 negative while 5 had an undetermined serological status. All the samples were tested by quantitative RT-PCR (Gold standard) and by the following RDTs: Vikia, Alere Combo and Alere Determine. The sensitivities and specificities of the different RDTs were calculated using Epi Info version 6.04dfr. The level of agreement between tests was determined by Cohen´s Kappa test. Results: the three RDTs´ sensitivity according to HIV-1/M subtypes was 100% (95% CI: 92.6-100) while their specificities ranged from 94.6% (95% CI: 84.2-98.6) for the Vikia test to 96.4% (95% CI: 86.6-99.4) for the Alere Combo and Alere Determine tests, respectively. The concordances between the three RDTs were excellent with kappa values ranging from 0.931 (95% CI: 0.864-0.977) to 0.948 (95% CI: 0.890-1.00). Conclusion: the three RDTs showed a maximum sensitivity of 100% and specificities ranging from 94.6% to 96.4%. The specificities obtained with these RDTs are lower than those recommended by the WHO for their inclusion in an HIV-1 screening algorithm.


Assuntos
HIV-1 , Testes Diagnósticos de Rotina , Gabão , Variação Genética , HIV-1/genética , Humanos , Sensibilidade e Especificidade
6.
Viruses ; 14(4)2022 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-35458403

RESUMO

Immune control of various infectious diseases, particularly viral, was shown to be more efficient for females than males. Response to viral vaccines (HAV, HBV) was higher in females. Data on hepatitis B virus (HBV) markers accumulated over 15 years in blood donors was stratified according to sex, including HBsAg, HBV viral load and levels of anti-HBs in areas where genotypes B and C (China), genotype D (Iran, Lebanon, Tunisia) and genotype E (Ghana, Burkina Faso, Gabon) were prevalent. HBsAg was screened by either ELISA or rapid tests, anti-HBc and anti-HBs by ELISA, HBV DNA load by a standardized method across sites. In Ghanaian children less than 5 years, HBV DNA load was significantly lower in females than in males (p = 0.035). In China, Ghana, Burkina Faso and Gabon blood donors, median HBsAg prevalence was ~5% and 3% in China, ~8.5% and 4.5% in Gabon, ~16% and 11% in Burkina Faso and ~11% and 7% in Ghana for male and female donors, respectively (p < 0.001). In HBsAg+ Ghanaian blood donors, distribution and median viral load were not significantly different between sexes; occult hepatitis B infections (OBI) were significantly more frequent in males. In Chinese blood donor anti-HBc+ and anti-HBs+, anti-HBs levels tended to be higher in males but vaccinated donors' anti-HBs+ only, while anti-HBs levels were females > males. In areas where genotypes B-E are dominant, the prevalence of chronic HBV infection (HBsAg+) seems better controlled before age 16−18 by females infected vertically or horizontally. OBIs appear considerably more frequent in men, suggesting lower efficacy of HBV infection control. Female blood donors appear significantly safer from HBV than males, and their donation should be encouraged.


Assuntos
Hepatite B Crônica , Hepatite B , Adolescente , Doadores de Sangue , Criança , DNA Viral/genética , Feminino , Gana/epidemiologia , Anticorpos Anti-Hepatite B , Antígenos do Núcleo do Vírus da Hepatite B , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B/genética , Hepatite B Crônica/epidemiologia , Humanos , Masculino , Infecção Persistente , Prevalência
7.
Sex Transm Dis ; 49(7): 469-476, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35320152

RESUMO

BACKGROUND: Syphilis continues to be a public health problem, and its diagnosis still has limitations. Molecular diagnosis provides an alternative for rapid and effective management. The objective is to determine the accuracy of tests in the molecular diagnosis of syphilis. METHODS: We searched PubMed and Web of Sciences for articles related to molecular detection of syphilis from January 1, 2009, to December 31, 2019. The bivariate Reitsma model and the hierarchical receiver operating characteristic curve model were used to evaluate the diagnostic performance of molecular tests at a 95% confidence interval. A subgroup meta-analysis was performed to explore sources of heterogeneity. RESULTS: Forty-seven articles were identified for qualitative synthesis, of which 23 met the inclusion criteria for meta-analysis. The pooled sensitivities in conventional polymerase chain reaction (PCR) and real-time PCR were 77.52 (59.50-89.01) and 68.43 (54.96-79.39), respectively. The pooled specificities were 98.00 (90.73-99.59) and 98.84 (97.55-99.46), respectively. Ulcer samples had a better performance (sensitivity of 79.88 [69.00-87.62] and specificity of 98.58 [97.25-99.27]), and the major target genes were the polymerase A gene and tpp47 gene. CONCLUSIONS: Our work showed that conventional PCR was more widely used than real-time PCR in the diagnosis of syphilis, and ulcers were the best specimens. Sample types and target genes are factors that may influence the quality of the different tests. These results could provide evidence for further work in the direction of providing a more efficient diagnostic test.


Assuntos
Sífilis , Humanos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Sensibilidade e Especificidade , Sífilis/diagnóstico
8.
Pan Afr Med J ; 38: 299, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34178218

RESUMO

INTRODUCTION: nosocomial diseases are a major public health problem in sub-Saharan Africa particularly in Burkina Faso. The purpose of this study was to determine the biodiversity of the fungal flora identified at the reanimation service of the University Hospital Souro Sanou of Bobo-Dioulasso. METHODS: we conducted a descriptive cross-sectional study from August 2016 to January 2017. The purpose of the study was to investigate the fungal flora in the ambient air and in the reanimation environment. Samples were seeded and incubated for 3-4 days at 37°C in the oven. The identification of colonies of filamentous fungi was macroscopic and microscopic. Blastesis test, chromogenic medium and latex agglutination test were used to identify Candida species. RESULTS: out of 200 samples collected, 176 grew in Sabouraud-Chloramphenicol agar. The overall prevalence of fungal flora was 88% (176/200). Molds were the most common fungal agents found (66.9%). Among the eight types of mold identified, Aspergillus was the most common family (48.9%) while Aspergillus fumigatus was the most detected species (32.9%). CONCLUSION: regular decontamination of fungal niches should be systematic at the reanimation service of the University Hospital Souro Sanou of Bobo-Dioulasso.


Assuntos
Microbiologia do Ar , Microbiologia Ambiental , Fungos/isolamento & purificação , Burkina Faso , Estudos Transversais , Hospitais Universitários , Testes de Fixação do Látex , Prevalência , Ressuscitação
9.
Infect Drug Resist ; 14: 585-594, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33623399

RESUMO

INTRODUCTION: Urinary tract infection is one of the major causes of consultation, microbiologic exploration, intensive use of antibiotics worldwide, and the second leading cause of clinical consultation in community practice. Many bacteria play a role in the urinary tract infections etiology, including Enterobacteriaceae such as Escherichia coli (E. coli) and Klebsiella spp. OBJECTIVE: The study's main objective was to examine the epidemiology of E. coli and Klebsiella pneumoniae (K. pneumoniae) uropathogenic strains resistant to antibiotics in Franceville. METHODOLOGY: The study was carried out between January 2018 and June 2019 in Franceville South-East Gabon. We examined a total of 1086 cytobacteriological urine samples. The identification of E. coli and K. pneumoniae strains was carried out using the Vitek-2 compact automated system and the antibiogram with the disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing recommendations. RESULTS: The prevalence of urinary tract infections was 29.2% (317/1086), of which 25.1% and 4.1% were mono-infections and co-infections, respectively. The prevalence of UTIs with E. coli was 28.7% (91/317) with a predominance of isolation in women. K. pneumoniae was responsible for 16.2% (61/317) of UTIs. E. coli and K. pneumoniae Uropathogenic strains showed resistance to beta-lactams, quinolones and cotrimoxazole, whereas Nitrofurantoin, Amikacin, Imipenem and Ertapenem were the most active antibiotics against E. coli and K. pneumoniae uropathogenic strains. CONCLUSION: This study showed a high prevalence of urinary tract infections with a major implication of E.coli and K. pneumoniae strains. E. coli and K. pneumoniae presented high frequency of resistance to antibiotics, highlighting the need to adapt their use accordingly at the local level.

10.
Afr J Reprod Health ; 25(3): 72-77, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37585843

RESUMO

Neonatal screening and the effective management of sickle cell disease (SCD) are now well established in urban areas in some sub-Saharan African countries. The high rate of sickle cell trait in Koula-Moutou, Gabon, prompted an assessment of the psycho-clinical context of the introduction of neonatal screening in this rural area in eastern Gabon. Interviews were conducted with 215 women from February to June 2016 in Maternity and Maternal Child Protection services at the Paul Moukambi Regional Hospital Center in Koula-Moutou. Few childbearing women knew about SCD (24%), very few (6%) knew their hemoglobin status and only 30% of parturient women authorized sampling for neonatal SCD screening. Young mothers aged 16-28 years (p=0.018) and those who were educated (p=0.002) were more likely to authorize neonatal blood screening. There was no association between acceptance of blood sampling and knowledge of SCD or the parturient woman's hemoglobin status. The barriers to acceptance for SCD neonatal diagnosis are related to the education and culture rather than the knowledge of this disease. Introduction of diagnosis in rural areas requires a team comprising a psychosocial worker and health workers known to the rural population, to remove inhibitions related to blood collection from newborn infants.

11.
Biomol Concepts ; 10(1): 120-127, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31203256

RESUMO

Breast cancer is the top cause of cancer mortality among women in the world and the second in Africa. The aims of this study were to: i) identify women with breast nodules suspected of having breast cancer ii) sequence the BRCA1 and BRCA2 genes and iii) screen mutations. From 2015 to 2016, 112 women aged from 35 to 44 years, who had come for consultation in the gynecology/obstetrics and the oncology department of the University Hospital Yalgado Ouedraogo, voluntarily agreed to participate to this study. Whole blood was collected from those with mammary nodules. The genomic DNA was extracted using Qiagen kit. FAST KAPA was used for genomic DNA amplification and the purified PCR products were analyzed by direct sequencing using Big Dye v1.1 and ABI 3730 automated sequencer. Nucleotides substitutions were determined. We identified BRCA1 SNPs rs1799966, rs799917, rs16942, rs16941, rs2227945, and BRCA2 SNPs rs169547, rs4986860. These identified variants are found mostly in cases of benign tumors of breast or ovarian cancer with familial history of breast cancer. This study in Burkina-Faso, is the basis for improved and more specific genetic testing, and suggests that additional genes contributing to an increased risk of breast cancer should be analyzed.


Assuntos
Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/genética , Mutação de Sentido Incorreto , Adulto , Neoplasias da Mama/patologia , Burkina Faso , Feminino , Testes Genéticos/normas , Humanos , Glândulas Mamárias Humanas/patologia , Polimorfismo de Nucleotídeo Único
12.
Niger Postgrad Med J ; 26(1): 13-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30860194

RESUMO

BACKGROUND: In Gabon, universal neonatal screening of sickle cell disease is not carried out in rural areas, often leading to late detection of the disease. However, complete blood counts are available in rural areas. MATERIALS AND METHODS: We evaluated the haematological parameters of 45 homozygous steady-state sickle cell anaemia (SCA) patients and compared them with 45 sex- and age-matched Haemoglobin AA controls in Koula-Moutou, a rural area in Eastern Gabon. RESULTS: Homozygous SCA patients had low erythrocyte values (red blood cells: 2.50 × 1012/L, haemoglobin: 7.20 g/dL and haematocrit: 20.70%) and high leucocyte values (white blood cells: 14.40 × 109/L, lymphocytes: 5.24 × 109/L and monocytes: 1.60 × 109/L). Most of the SCA patients had severe anaemia (67%), normochromia (76%), lymphocytosis (73%) and monocytosis (84%). A haemoglobin level of < 8.5 g/dL together with a leucocyte level above 9.5 × 109 cells/L was used as screening test to detect homozygous SCA patients, with sensitivity of 84.4% and specificity of 97.8%. CONCLUSION: The values for erythrocyte and leucocyte cell lines of SCA patients in steady state are clearly different from those of the matched HbA/A controls. This makes it possible to set up a tool to detect SCA based on the haemogram in a rural area that does not possess haemoglobin electrophoresis. This tool could be used by healthcare workers in the absence of universal newborn screening for SCA.


Assuntos
Anemia Falciforme/genética , Hemoglobina A/genética , População Rural/estatística & dados numéricos , Anemia Falciforme/sangue , Anemia Falciforme/epidemiologia , Contagem de Células Sanguíneas , Estudos de Casos e Controles , Feminino , Gabão/epidemiologia , Hemoglobinas , Humanos , Masculino , Fenótipo
13.
Afr J AIDS Res ; 18(1): 51-57, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30880584

RESUMO

The goal of this study was to evaluate the impact of socio-clinical factors on adherence to antiretroviral treatment in people living with HIV/AIDS in Koula-Moutou (a rural area of Gabon). Two adherence assessment methods based on patient declaration and compliance with pharmacy visits were used to determine qualitative and quantitative aspects of adherence to antiretroviral therapy (ART). The quantitative (82.2%) and qualitative (79.5%) adherences to ART declared by patients were higher than those obtained through pharmacy visit assessment methods (15.8% and 45.2%, respectively). Moreover, the declarative and pharmacy visit compliance methods showed fair agreement (quantitative Kappa = 0.317; qualitative Kappa = 0.311). A better quantitative or qualitative declarative adherence was associated with a lower level of education (P = 0.05 and P = 0.025 respectively). This study reported for the first time the factors influencing adherence to ART in a rural area of East Gabon. We recommend further investigations in a large cohort to better assess the impact of socio-clinical factors on ART adherence in a vulnerable group of patients.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Antirretrovirais/uso terapêutico , Escolaridade , Adesão à Medicação/estatística & dados numéricos , Farmácia/estatística & dados numéricos , Adulto , Estudos de Coortes , Feminino , Gabão , HIV-1/efeitos dos fármacos , HIV-1/isolamento & purificação , HIV-2/efeitos dos fármacos , HIV-2/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Inquéritos e Questionários
14.
BMC Public Health ; 19(1): 167, 2019 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-30736765

RESUMO

BACKGROUND: Very few studies have been conducted on the seroprevalence of syphilis in Gabon. According to the World Health Organization, the average seroprevalence of syphilis has declined from 5.5 to 1.1% in Central Africa. The aim of this study was to test the hypothesis that syphilis decreased in Gabon between 2004 and 2016 and to identify factors involved in this pattern by testing a large sample of first-time blood donors in the capital Libreville. METHODS: The detection of Treponema pallidum was done using a Rapid Plasma Reagin test (RPR) and confirmed by an ELISA test using the Biorad Syphilis Total Antibody EIA II kit or BioMerieux Trepanostika TP recombinant. Assays were performed by dedicated technicians according to manufacturers' recommendations and following the laboratory standard operating procedures. Test results were manually transferred into the laboratory Excel files and hand-written in the laboratory logbook for syphilis testing. Logistic regression was used to assess the impact of sociodemographic characteristics on syphilis marker seroprevalence in both univariate and multivariable analysis. Odds ratios (OR) and 95% confidence intervals were calculated. RESULTS: The seroprevalence of syphilis markers was 8.4% (95% CI = 7.9-8.9) in 2004 and 2.4% (95% CI = 2.1-2.7) in 2016. The difference was significant [OR = 3.78; 95% CI (3.26-4.38); P < 0.001]. The decrease in syphilis seroprevalence was significant in both women and men and in each age group in univariate analysis. In multivariable analysis, controlling for all sociodemographic factors, the decrease in syphilis seroprevalence from 2004 to 2016 remained significant (OR = 3.29; 95% CI = 2.88-3.88, P < 0.001). The seroprevalence of syphilis decreased significantly in men compared to women and young donors compared to donors aged ≥36 years. CONCLUSIONS: This study shows a significant decline in syphilis seroprevalence in first-time blood donors in Libreville, Gabon. Government actions, including multiple HIV prevention activities, are a likely part of this decline.


Assuntos
Doadores de Sangue/estatística & dados numéricos , Sífilis/epidemiologia , Adolescente , Adulto , Biomarcadores/sangue , Feminino , Gabão/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Sífilis/sangue , Adulto Jovem
15.
J Clin Lab Anal ; 33(3): e22824, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30485543

RESUMO

BACKGROUND: Blood transfusion is a pathway for the transmission of blood-borne pathogens such as human immunodeficiency virus (HIV) and hepatitis B virus (HBV) from donors to recipients in most countries in sub-Saharan Africa, including Gabon. The study aimed to compare the performance of four rapid diagnostic tests (RDTs: Alere DETERMINE, BIOSYNEX Exacto Pro HIV, MEDIFF HIV 1&2, and BIOSYNEX IMMUNOQUICK HBsAg) with results of 4th-generation immunoenzymatic assays COBAS 6000 e601 and EVOLIS BioRad for the detection of HIV and hepatitis B surface antigen (HBsAg) in blood donors in Libreville, Gabon. METHODS: Reactive and nonreactive blood samples for HIV and HBsAg were selected using fourth-generation ELISA COBAS 6000 e601 and EVOLIS BioRad. The sensitivities of RDTs were calculated using Epi Info version 6.04dfr (CDC, Atlanta, USA). RESULTS: Sensitivities for the detection of HIV in blood donors were 90.9% for Alere DETERMINE, 81.8% for BIOSYNEX Exacto Pro HIV, and 81.8% for MEDIFF HIV 1&2 Serum/sang Total Cassette compared with COBAS 6000 e601. The sensitivity of Alere DETERMINE compared to the semi-automated ELISA Bio-Rad for HIV detection was 65.6%. The sensitivity of BIOSYNEX IMMUNOQUICK HBsAg compared to ELISA tests for the detection of HBsAg was 78.0%. The specificity of all RDTs for the detection of HIV and HBsAg was 100%. CONCLUSION: Alere DETERMINE HIV-1/2, MEDIFF HIV 1&2 Serum/sang Total Cassette, BIOSYNEX Exacto Pro HIV, and BIOSYNEX IMMUNOQUICK HBsAg are not recommended for determining whether donors qualify to donate blood because of their low sensitivity for the detection of HIV antibodies and HBsAg in blood donors in Gabon.


Assuntos
Doadores de Sangue , Ensaio de Imunoadsorção Enzimática/métodos , Anticorpos Anti-HIV/sangue , Antígenos de Superfície da Hepatite B/sangue , Estudos Transversais , Gabão , Infecções por HIV/diagnóstico , HIV-1 , Hepatite B/diagnóstico , Humanos , Sensibilidade e Especificidade , Fatores de Tempo , Virologia
16.
PLoS One ; 13(4): e0194285, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29652917

RESUMO

Despite chronic Hepatitis B virus (HBV) infection being the main cause of younger-onset complex liver disease including cirrhosis and hepatocellular carcinoma (HCC) in Africa, very little is known regarding the seroprevalence of HBV in the Gabonese general population. This investigation aimed to provide strong epidemiological data and risk factors associated with HBV infection in first-time blood donors representative of the urban adult population. The screening of HBsAg was carried out using 4th generation ELISA kits. The overall seroprevalence of HBsAg was 7.28%. The frequency of HBsAg was differential and marked by annual variations in blood donors from 2009 to 2016. Seroprevalence was 2-fold higher among males versus females (OR = 1.90 (95% CI: 1.75-2.06), P<0.001). HBsAg seroprevalence was significantly higher in donors of the age group 25-35 years old compared to donors of the age group <18 years (OR = 1.64 (95% CI: 1.03-2.60), P = 0.04). The seroprevalence of HBsAg in family/replacement donors (FRD) was significantly higher than that of voluntary non-remunerated donors (VNRD) (OR = 0.88 (95% CI: 0.83-0.94), P <0.001). The simultaneous comparison of HBsAg seroprevalence with blood donation type, gender and age showed that the higher prevalence in FRD was significant only in males between 18 and 45 years and in females between 25 and 34 years of age. This study confirms the high endemicity of HBV in Gabon while identifying the most infected age groups for both men and women.


Assuntos
Doadores de Sangue , Antígenos de Superfície da Hepatite B/sangue , Hepatite B/sangue , Hepatite B/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Gabão/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Estudos Soroepidemiológicos , Adulto Jovem
17.
J Public Health Afr ; 9(3): 907, 2018 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-30687488

RESUMO

APOBEC3G is a potent inhibitor of HIV-1 replication, and act by deaminating cytidines in uracil on the negative strand of the viral cDNA. In this case-control study, APOBEC3G expression in subjects' naïve to HAART infected by HIV-1 and the effect of APOBEC3G polymorphism on its expression were evaluated. The results show that the HIV-1 infected carriers of the G minor alleles of the variant rs8177832 had a higher expression of APOBEC3G mRNA than the controls carriers of the G minor allele. APOBEC3G polymorphisms could play an important role in the modulation of the HIV-1 dissemination.

18.
Pan Afr Med J ; 31: 81, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-31007828

RESUMO

INTRODUCTION: Blood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis B and C (HBV and HCV) viruses and Treponema pallidum remain a major public health problem in sub-Saharan Africa. The purpose of this study was to assess the frequency and clinical implications of HIV, HBV, HCV and Treponema pallidum markers in blood donors in a rural area of Southeast Gabon (Koula-Moutou) from 2012 to 2017. METHODS: Hepatitis B surface antigen (HBsAg), anti-HIV, anti-HCV and anti-Treponema pallidum antibodies were screened using rapid diagnostic tests (RDTs). RESULTS: Of a total of 5,706 blood donors, 1,054 (18.5%) were seropositive for at least one infectious marker and 59 (5.6%) had serologic evidence of multiple infections. The overall seroprevalence of HIV, HBsAg, HCV, and syphilis was 3.1%; 5.9%; 6.2% and 3.3%, respectively. HIV, syphilis and HCV distributions were associated with neither the sex nor the age of the donors. Only HBsAg seroprevalence was significantly higher in donors of the age group 26-35 years old compared to donors of the age group 36-45 years (OR = 1.43 (95% CI: 1.01-2.04), P = 0.045). There was a significant increase in the frequencies of HIV and syphilis and a regression of HBsAg and HCV among blood donors. CONCLUSION: This study presents the epidemiology of the main pathogens detected in blood donors in a rural area in Gabon. We found that the overall distribution of transfusion transmitted infectious diseases were lower than those observed in the general population but could be underestimated due to the use of RDTs in the screening process of the blood donations.


Assuntos
Doadores de Sangue , Patógenos Transmitidos pelo Sangue/isolamento & purificação , Programas de Rastreamento/métodos , População Rural , Adolescente , Adulto , Feminino , Gabão/epidemiologia , HIV/isolamento & purificação , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Hepacivirus/isolamento & purificação , Hepatite B/sangue , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/isolamento & purificação , Hepatite C/sangue , Hepatite C/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Sífilis/sangue , Sífilis/epidemiologia , Treponema pallidum/isolamento & purificação , Adulto Jovem
20.
Artigo em Inglês | AIM (África) | ID: biblio-1268543

RESUMO

Introduction: blood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis B and C (HBV and HCV) viruses and Treponema pallidum remain a major public health problem in sub-Saharan Africa. The purpose of this study was to assess the frequency and clinical implications of HIV, HBV, HCV and Treponema pallidum markers in blood donors in a rural area of Southeast Gabon (Koula-Moutou) from 2012 to 2017.Methods: hepatitis B surface antigen (HBsAg), anti-HIV, anti-HCV and anti-Treponema pallidum antibodies were screened using rapid diagnostic tests. Results: of a total of 5,706 blood donors, 1,054 (18.5%) were seropositive for at least one infectious marker and 59 (5.6%) had serologic evidence of multiple infections. The overall seroprevalence of HIV, HBsAg, HCV, and syphilis was 3.1%; 5.9%; 6.2% and 3.3%, respectively. HIV, syphilis and HCV distributions were associated with neither the sex nor the age of the donors. Only HBsAg seroprevalence was significantly higher in donors of the age group 26-35 years old compared to donors of the age group 36-45 years (OR = 1.43 (95% CI: 1.01-2.04), P = 0.045). There was a significant increase in the frequencies of HIV and syphilis and a regression of HBsAg and HCV among blood donors.Conclusion: this study presents the epidemiology of the main pathogens detected in blood donors in a rural area in Gabon. We found that the overall distribution of transfusion transmitted infectious diseases were lower than those observed in the general population but could be underestimated due to the use of rapid diagnostic tests (RDTs) in the screening process of the blood donations


Assuntos
Patógenos Transmitidos pelo Sangue , Doenças Transmissíveis , Infecções por HIV , Hepatite B
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