Emergence of G12 and G9 rotavirus genotypes in the Central African Republic, January 2014 to February 2016.

OBJECTIVES: Rotavirus gastroenteritis is a major cause of death among children under 5 years globally. A rotavirus gastroenteritis surveillance program started in October 2011 in the Central African Republic (CAR) with the Surveillance Epidémiologique en Afrique Centrale (SURVAC) project. We present here genotyping results showing the emergence of G9 and G12 genotypes in Central African Republic. RESULTS: Among 222 children hospitalized with acute gastroenteritis who had a stool sample collected at the sentinel site, Complexe Pédiatrique de Bangui (CPB), Bangui, Central African Republic, 100 (45%) were positive for rotavirus between January 2014 and February 2016. During this period the most common rotavirus strains were G1P[8] (37%), G12P[6] (27%) and G9P[8] (18%).

Molecular surveillance of rotavirus infection in Bangui, Central African Republic, October 2011-September 2013.

BACKGROUND: The World Health Organization (WHO) recommends the introduction of rotavirus vaccine in the immunization program of all countries. In the Central African Republic (CAR), sentinel surveillance for rotavirus gastroenteritis was established in 2011 by the Ministry of Health, with the support of the Surveillance en Afrique Centrale Project (SURVAC). The purpose of this study was to assess the burden of rotavirus gastroenteritis and to identify rotavirus strains circulating in CAR before the introduction of rotavirus vaccine planned for this year, 2014. METHODS: One sentinel site and one laboratory at the national level were designated by the CAR Ministry of Health to participate in this surveillance system. Stool samples were collected from children who met the WHO rotavirus gastroenteritis case definition (WHO, 2006). The samples were first screened for group A rotavirus antigen by enzyme immunoassay (EIA), and genotyping assays performed using a multiplex reverse transcriptase PCR (RT-PCR) technique. RESULTS: Between October 2011 and September 2013, 438 stool samples were collected and analyzed for detection of rotavirus antigen; 206 (47%) were positive. Among the 160 (78%) that could be genotyped, G2P[6] was the predominant strain (47%) followed by G1P[8] (25%) and G2P[4] (13%). CONCLUSIONS: Almost half of stool samples obtained from children hospitalized with gastroenteritis were positive for rotavirus. These baseline rotavirus surveillance data will be useful to health authorities considering rotavirus vaccine introduction and for evaluating the efficacy of rotavirus vaccine once it is introduced into the routine immunization system.

Evaluation of rapid HIV testing strategies in under equipped laboratories in the Central African Republic.

Voluntary testing is described as being cornerstone to impact the spread of human immunodeficiency virus (HIV) infection if the person who tests positive is counseled. Therefore, simple, accurate and affordable diagnostic tests are required. The immunoblot test used in developed countries is too expensive for large-scale use in developing countries. Therefore, alternative strategies must be developed. A strategy based on two consecutive rapid tests was tested. This strategy used the Determine HIV-1/2 (Abbott Laboratories, Tokyo, Japan) rapid immunochromatographic test as a screening test and the Uni-Gold HIV test (Trinity Biotech, Dublin, Ireland), SDHO HIV 1/2 test (SDHO laboratories, Saint-Sauveur des Monts, Canada), HIV 1/2 Quick test (Cypress Diagnostics, Langdorp, Belgium) or Retrocheck HIV test (Qualpro Diagnostics, Goa, India) as a confirmatory test. Reference serum samples (HIV-positive and HIV-negative) were first used to evaluate the four confirmatory tests. Secondly, 159 serum samples were used to compare the "consecutive" testing strategy used in our laboratory with the two-test strategy. Thirdly, we tested the feasibility of using this two-test strategy in a under equipped laboratory. The sensitivity and negative predictive value of both test strategies were 100%. The specificity and positive predictive value of the four confirmatory tests were similar (>98%). The strategy used in our laboratory and the two-test strategy always gave identical results, regardless of where this strategy was performed (Institut Pasteur de Bangui or M'baïki hospital). This new strategy appears to be reliable, simple, feasible and rapid in under equipped laboratories. It allows counseling and results to be given on the same day, which should improve post-test counseling.