[Diabetes mellitus and high blood pressure over risk in HIV-infected people followed at Souro Sanou University Hospital Day Hospital, Bobo-Dioulasso 2018]. / Sur-risque de diabète sucré et d'hypertension artérielle chez les personnes infectées par le VIH suivies à l'hôpital de jour du CHU Souro Sanou, Bobo-Dioulasso, Burkina Faso, 2018.

BACKGROUND: Non-communicable diseases (NCDs) represent the leading causes of death worldwide. HIV also increases the risk of developing NCDs including diabetes mellitus and hypertension. METHODS: A cross-sectional study, based on an analysis of the cohort database of the day hospital of the Souro Sanou teaching hospital in Bobo-Dioulasso (Burkina Faso). Diabetes mellitus was defined by the undergoing of anti-diabetic treatment or two successive measurements of fasting blood sugar above 7mmol/l and high blood pressure by the undergoing of antihypertensive treatment or two successive measurements of blood pressure above 140/90mmHg. Comparison of the frequency of diabetes and hypertension in the people living with HIV/AIDS (PLWHA) population on antiretroviral therapy (ART) with that of the general population of Burkina Faso was made by indirect standardization according to age and gender. RESULTS: A total of 4259 patients including 3148 women (73.9%) were included in this study. The median age of the patients was 45 years (IQR: 38-52); the median body mass index (BMI) was 19.6kg/m2 (IQR: 15.4 - 22.7) and 48.3% of patients had a BMI≥25kg/m2. The median CD4 count was 590 cells/mm3 (IQR: 417-785). The median ART duration was 8.2 years (IQR: 4.7-11.2). The majority of patients (82.9%) were on treatment combinations consisting in 2 INTI+1 NNRTI. Prevalence of hypertension was 39.8%; it was statistically higher in men than in women (45.8% versus 37.8%). Prevalence of hypertension was 87.0% higher in the PLWHA population than among same-sex and same-age subjects in the general population. Prevalence of diabetes mellitus was 7.3%. Diabetes mellitus was more common in men than in women (10.1% versus 6.3%; P<10-3). Prevalence of diabetes mellitus was 36.0% higher in the PLWHA population than among same-sex and same-age subjects in the general population. CONCLUSION: Prevalence of diabetes mellitus and hypertension was higher among PLHWA undergoing ART than in the general population. Care for the PLHWA population should more widely include NCD treatment.

[Polyneuropathies in patients treated with HAART in Bobo-Dioulasso hospital, Burkina Faso]. / Les polyneuropathies chez les patients traités par les ARV au CHU de Bobo-Dioulasso, Burkina Faso.

Peripheral neuropathies (PN) represent the most common neurological manifestation in patients with HIV infection. Introduction of highly active antiretroviral therapy (HAART) had a significant impact on the epidemiology of HIV-associated neuropathies even in poor-resources countries. HIV-infected patients were followed up over a 2-years period from January 2002 to December 2003. PN was clinically diagnosed based on abnormalities of ankle reflexes or vibratory perception and if patients described pain, paresthesia or numbness. Electromyography was not performed in this study Among the 133 HIV-infected patients treated with HAART 31 patients (23 females and 8 males) with 38.8 of mean age were followed up for PN. 95.5% among them were HIV1-infected. According to the availability of the antiretroviral therapy, 9 patients were treated with protocol A including lamivudine + stavudine + nevirapine, 12 patients with protocol B including combination of stavudine + lamivudine + efavirenz, and 10 patients with protocol C with other combinations of antiretroviral therapies. Average CD4 cell count was 229.3/microl and 60% of the sample had < 200 CD4 cell counts at the time of diagnosis. PN occurred within 5.6 months from the institution of the HAART and 80% less than 3 months after the beginning of the treatment. Burning feet syndrome was found in 16.1% of the sample. 45.2% of polyneuropathies occurred in late stage of HIV infection (< 200 CD4/microl). The presence of PN was related to decreased CD4 cells counts and neurotoxic antiretroviral therapy Introduction of HAART has modified the course and the prognosis of HIV infection even in poor resources setting. The incidence of toxic neuropathies is increasing with longer patients' life expectancy and represents a major factor in treatment limitation and the neurological side effects of HAART should be well identified by physicians.

[Immuno-virologic dissociation in patients infected by HIV-1 under antiretroviral treatment at the Day hospital of Bobo-Dioulasso from 2008 to 2012 (Burkina Faso)]. / Dissociation immuno-virologique chez les patients infectes par le VIH-1 sous traitement antiretroviral a l'hopital de Jour de Bobo-Dioulasso de 2008 a 2012 (Burkina Faso).

OBJECTIVE: describe the sociodemographic, clinical, therapeutic, biological profile and the observance of treatment in cases of immuno-virologic dissociation response (IVDR) in HIV-1 patients at te 12 months of antiretroviral treatment (ARVT). METHODS: This was a historical cohort study with a descriptive and analytical focus from January 2008 to December 2012; covering the IVDR cases at the day hospital of Bobo Dioulasso. We collected the data during medical consultations by means of the ESOPE software and from medical records of the patients. RESULTS: Of 2078 patients on ARVT, 84 or 4% presented one IVDR, among which 56 women (66.7%) and 28 men (33.3%). The average age was 45 years [range: 45-55 years]. At the initiation of ARVT, most patients were in clinical stage 3 or 4 of the WHO classification (57.1%). The body mass index (BMI) average was 20.5kg/m2 [IQR = 18.5 and 23]. The average number of +CD4 T lymphocyte was 42 cells/mm3 [IQR = 12- 63]. During follow-up, the median gain in BMI was 3.2 kg/m2 [IQR = 1.2 to 4.3 kg/m2], the median gain was 76 cells/µl [IQR = 60 - 88]. The viral plasmatic load of the HIV-1 was undetectable with a rate of TCD4+ < 100 cells /µl in 12 months. Factors associated with IVDR were the age between 35 and 45 years (p = 0.0009), the number of +CD4 T cells (+CD4T≤50) at initiation of ARVT (p = 0.00045 ) and the WHO classification clinical stage 3. CONCLUSION: This study demonstrates the problem of IVDR management in Bobo-Dioulasso and reminds of the interest of care follow-up of people living with HIV-1 by viral load and not only by the rate of CD4+ T especially in the decentralized structures of coverage of HIV, where changes of therapeutic mechanisms operate disjointedly.

OBJECTIF: décrire le profil sociodémographique, clinique, thérapeutique, biologique et l'observance du traitement des cas de réponse immuno-virologique dissociée (DIV) chez les patients VIH-1 à 12 mois de traitement antirétroviral (ARV). MÉTHODES: Il s'agissait d'une étude de cohorte historique à visée descriptive et analytique de janvier 2008 à décembre 2012, portant sur les DIV suivis à l'hôpital de jour (HDJ) de Bobo- Dioulasso. Nous avons recueilli les données au cours des consultations médicales à l'aide du logiciel ESOPE et à partir du dossier médical des patients. RÉSULTATS: Sur 2078 patients sous ARV, 84 soit 4% présentaient une dissociation immuno-virologique (DIV), dont 56 femmes (66,7%) et 28 hommes (33,3%). L'âge médian était de 45 ans [EIQ = 45­ 55 ans]. A l'initiation du traitement ARV, la plupart des patients étaient aux stades cliniques 3 ou 4 de l'OMS (57,1%). La médiane de l'IMC était à 20,5kg/m2 [EIQ=18,5 et 23 ans]. La médiane du nombre de lymphocyte TCD4+ était de 42 cellules/mm3 [EIQ= 12­ 63]. Au cours du suivi, le gain médian en indice de masse corporelle était de 3,2 kg/m2 [EIQ=1,2­4,3 kg/m2], le gain médian en TCD4+ était de 76 cellules/µl [EIQ=60 ­ 88]. La charge virale plasmatique du VIH-1 était indétectable chez tous avec un taux de TCD4+ < 100 cellules/µl à 12 mois. Les facteurs associés à la réponse immunovirologique dissociée étaient l'âge compris entre 35 à 45 ans (p = 0,0009), un nombre de lymphocytes T CD4 (CD4≤50) à l'initiation du traitement ARV (p=0,00045) et le stade clinique OMS 3. CONCLUSION: Cette étude prouve la problématique de la gestion de la réponse immuno-virologique dissociée à Bobo-Dioulasso, et rappel tout l'intérêt du suivi des PvVIH par la charge virale et non seulement par le taux de TCD4+ surtout dans les structures déconcentrées de prise en charge du VIH, où des changements de régime thérapeutique s'opèrent à tord.

[Guillain-Barré syndrome in HIV-infected patients at Bobo-Dioulasso Hospital (Burkina Faso)]. / Syndrome de Guillain-Barré chez les patients infectés par le VIH à Bobo-Dioulasso (Burkina Faso).

Neurological manifestations of human immunodeficiency virus (HIV) infection are frequent and several associated peripheral neuropathies have been recognized. Among them, Guillain-Barré syndrome (GBS) may occur either early or during the course of the illness. We present a prospective study of 32 consecutive cases of GBS managed over a 5-Year period at Bobo-Dioulasso Hospital where HIV prevalence reaches 20.1p.cent. Male gender predominated (24/32). GBS occurred during the dry season for 65.7p.cent of the patients. Prior infections were found in 84.4p.cent. The motor deficit was paraplegia or tetraplegia. Clinically, paraplegia was associated with transient urinary sphincteric involvement in 24 HIV-infected patients and 3 HIV negative patients. Facial nerve paralysis was found in 3 patients. Among the 32 patients with GBS, 27 were tested positive for HIV. Two patients were infected by HIV1 and HIV2. Cerebrospinal fluid examination showed albumin-cell dissociation and elevated albumin level in 75p.cent of the samples. Autonomic neuropathies were seen in 9 HIV-infected patients. The CD4 counts were above 200/mm3 in 10 among 18 HIV-infected patients. The clinical presentations were more severe in HIV-positive patients with a longer duration of symptoms. HIV-infected patients walked unaided within 51.1 days of peak paralysis. No fatal event occurred. This study indicates clearly that GBS in young adults is strongly associated with HIV infection and should be considered as an indicator of HIV infection in Black Africans. In the tropical context GBS should lead to HIV screening.

[Peripheral neuropathies revealing HIV infection at the Hospital Center of Bobo-Dioulasso (Burkina Faso)]. / Neuropathies périphériques révélatrices de l'infection par le VIH au Centre hospitalier de Bobo-Dioulasso (Burkina Faso).

Several peripheral neuropathies are associated with human immuno-deficiency virus (HIV) infection. In Africa, certain diseases are of particular importance. In the present work, we report peripheral neurological involvement as revealing signs of HIV infection within the internal medicine unit of a large city over a 2-year period. All adult subjects with a positive HIV serology revealed by a peripheral neuropathy observed in the National Hospital Centre of Bobo-Dioulasso over a two-year period (1 January 1999 and 31 December 2000) were included in the study. 46 cases of peripheral neuropathies revealing HIV infection were screened. Peripheral facial paralysis concerned 25 patients, 15 women and 10 men, in the early stages of HIV infection. The average age was 34 years. For 80% of the patients, he CD4 count was over 200. 5/10 cases of polyneuropathy occurred at the early stage of the HIV infection. Herpes zoster occurred in the early stages in 5/7 cases. 3/4 cases of polyradiculopathy occurred at a later stage with CD4 count under 200. Our study indicates clearly that isolated peripheral facial paralysis, sensitive polyneuropathy, herpes zoster and polyradiculopathy in young adults should lead to HIV testing.

[Diagnostic problems of expansive intracranial process in HIV infected patients of the Bobo-Dioulasso Central Hospital (Burkina Faso)]. / Problèmes diagnostiques des processus expansifs intracrâniens chez les patients infectés par le VIH au Centre hospitalier de Bobo-Dioulasso (Burkina Faso).

In HIV infection, cerebral focal lesions are relatively frequent and raise many kinds of diagnostic problems. In tropical practice, neuroradiology is scarcely available and necropsy is still not developed. Therefore, diagnosis of intracerebral masses among patients is not easily performed. We examined a total of 72 patients who presented over a 3-year period. Patients were allocated to presumed diagnostic categories of toxoplasma encephalitis (TE), primary central nervous system lymphoma (PCNSL) or progressive multifocal leukoencephalopathy (PML), based on clinical and therapeutic criteria. In an internal medicine ward, we examined 72 suspected cases of intracerebral masses in a sample of 43 males (60%) and 29 females (40%). The average age was 38 years with extremes ranging from 21 to 72 years. Because of diagnostic problems, the presumption of a TE has been retained in 54 cases (75% of the sample) owing to the efficiency of the treatment of antitoxoplasmic proof. As for the other intracerebral masses, despite insufficient diagnostic means, the assumption of PCNSL was made for 8 cases and PML for 6 cases on the basis of evolutional criteria. In 4 cases, no diagnosis could be retained because of insufficient diagnostic means and treatment failure. Since brain tomodensitometry and brain biopsy are not available, treatment of toxoplasmosis has to be systematically set up whenever there is a presumption of intracerebral masses among patients with HIV infection. It is only in case of failure of this treatment that other hypotheses can be contemplated, especially as they are not entirely reliable.

[Toxoplasma serology in HIV infected patients and suspected cerebral toxoplasmosis at the Central Hospital of Bobo-Dioulasso (Burkina Faso)]. / Sérologie toxoplasmique chez les patients infectés par le VIH et suspects de toxoplasmose cérébrale au Centre hospitalier de Bobo-Dioulasso (Burkina Faso).

A study was conducted in the Internal Medicine unit of Bobo-Dioulasso Hospital. Of the 1828 HIV positive patients admitted in medical wards, 268 presented neurological symptoms. 25.4% had positive Toxoplasma gondii serology. Encephalitis was associated with 12.5% of this latter group and intracranial hypertension with focal neurological defects affected a further 47.5% of them. Presumptive treatment of toxoplasmosis led to significant clinical improvement in 60% of cases. Toxoplasma gondii serology should be part of the standard check-up for every HIV-infected patient, and toxoplasmosis chemoprophylaxis should be given to those with positive toxoplasma serology. Presumptive therapy of toxoplasmosis should be started for all HIV positive patients with focal neurological manifestations in the absence of a cerebral scanner.

[Compared characteristics of peripheral facial paralysis according to HIV status in Bobo-Dioulasso (Burkina Faso)]. / Caractéristiques comparées des paralysies faciales périphériques selon le statut VIH à Bobo-Dioulasso (Burkina Faso).

Facial paralysis is a well-described manifestation of HIV infection. We report 27 cases of peripheral facial paralysis observed at Bobo-Dioulasso Hospital in a prospective study over a period of 9 months: 55 of the cases were HIV positive and 12/15 (80%) were in the 20-39 age group. Nine out of 11 females and 6 out of 16 males were seropositive. 13 of the cases were at stage B of CDC classification and 2 at stage C. ESR was elevated in all the HIV patients. CSF examination revealed lymphocytic pleiocytosis, elevated proteins and a positive HIV serology. CD4 counts were obtained in 8 cases and were under 400/mm3 in 4 cases. The clinical presentation was more severe in HIV seropositives with a longer duration of symptoms. Isolated peripheral facial paralysis associated with an elevated ESR in young adults suggest HIV infection and should lead to HIV counselling and testing.

[New-onset seizures in patients with immunodeficiency virus infection in Bobo-Dioulasso Hospital (Burkina Faso)]. / Crises d'épilepsie d'apparition récente et infection par le VIH au Centre hospitalier de Bobo-Dioulasso (Burkina Faso).

Seizures are common in advanced stages of immunodeficiency virus (HIV) infection. HIV-infected outpatients and inpatients in the national hospital in Bobo-Dioulasso among whom seizures occurred had been recruited over four years. There were mainly male (30/13) with an average age of 35 years with extremes ranging from 22 to 60 years. New-onset generalised seizures occurred in all cases of cryptococcal meningitis or partial motor secondary generalised in 64% among patients with suspected cerebral toxoplasmosis due to the efficiency of the treatment of the antitoxoplasmic proof. Identified causes such as suspected cerebral toxoplasmosis (65%), suspected tuberculous meningitis (7%) as CSF culture is not available, cryptococcal meningitis (16%) were found in this study. In four cases among 43 patients, no identified causes could be determined. CD4 lymphocytes count which was available in 24 patients was under 200/41 in 74% of the cases. This study indicates clearly that seizures in young adults are strongly associated with focal brain lesions and cerebral toxoplasmosis is becoming an important cause of seizure in tropical area. This should imply a screening of toxoplasmosis with new-onset seizure in young people.

[Cryptococcal meningitis in HIV-infected patients at Bobo-Dioulasso hospital (Burkina Faso)]. / La cryptococcose neuroméningée au cours de l'infection par le VIH au Centre hospitalier de Bobo-Dioulasso (Burkina Faso).

Cryptococcus neoformans is an important fungal pathogen in immunocompromised patients. A retrospective study was conducted to investigate the occurrence of Cryptococcus neoformans infection in patients admitted to Bobo-Dioulasso Hospital over a 3 year-period. During this period, cryptococcal meningo-encephalitis was diagnosed in 36 individuals. The median age of the patients under study was 34.25 years. There was a male preponderance (24 males/12 females) in our report. Typical presentations were persistent headaches (27 cases/36), neck stiffness (16/36), altered consciousness (14/36), fever (12/36) and convulsions (9/36). Oral candidiasis coexisted with cryptococcal meningitis in 7 patients. HIV serology was positive in all patients. At diagnosis, lymphocytes counts were < 1500/mm3 in 66.66% patients. CSF examination with India ink helped to the diagnosis of cryptococcosis in all cases. Cryptococcus neoformans was associated with Streptococcus pneumoniae in 4 patients. 15/36 patients died within 1 to 29 days after admission. High mortality was related to delayed diagnosis. Cryptococcal meningitis highly contributes to mortality in HIV-infected patients in Burkina Faso and it may occur in patients not severely immunocompromised patients. A need exists to improve strategies for clinical management of AIDS patients in poor African countries.

[Neurologic manifestations associated with HIV infections at the Bobo-Dioulasso Hospital Center (Burkina Faso)]. / Manifestations neurologiques associées à l'infection par le VIH au Centre hospitalier de Bobo-Dioulasso (Burkina Faso).

Neurological manifestations of HIV infection are frequent and diverse. Diagnosis is often difficult due to geographical factors. 686 of the 3409 patients admitted to the Internal Medicine ward of Bobo-Dioulasso in 1995-1996 were HIV seropositive. This represents a prevalence of 20.1%. The sociodemographic and clinical characteristics of 101 patients with neurological problems during the study period are reported in this paper. This case series represents 14% of the HIV-positive admissions. The mean age was 35.7 years and 43% of the cases were aged 30 to 40 years. Sex-ratio was 1.6 male for 1 female. Focal deficits were observed in 36 of cases. Peripheral neuropathy (37%), meningitis or meningoencephalitis (20%), fitting (8%) and myelitis (8%) were the other clinical presentations. The etiology of the focal deficits was not ascertained because of the lack of tomodensitometry, specific serology and necropsy. Any neurological manifestation in a HIV seropositive patient should prompt investigations in order to diagnose those infections which can be treated, especially Toxoplasma gondii abscess and Cryptococcus neoformans meningitis.

[Severe malaria and HIV in adult patients in Bobo-Dioulasso, Burkina Faso]. / Paludisme grave et infection à VIH chez l'adulte a Bobo-Dioulasso, Burkina Faso.

The purpose of this prospective study conducted from March to December 2000 in the Internal Medicine Department of the Sanou Souro University Hospital in Bobo-Dioulasso, Burkina Faso was to evaluate the epidemiological, clinical, biological and prognostic features of severe malaria in adult patients according to their HIV status. During the study period HIV testing was performed in 37 of the 72 adults with confirmed severe malaria. Findings were positive in 12 cases and negative in 25. The mean age of the 12 seropositive patients with severe malaria was 32.4 +/- 2.8 years and most (50%) had used self-prescribed antimalarial treatment. The most common reasons for seeking medical care were fever, headache and deterioration of general health. The main manifestations of severe malaria were coma (n=4), generalized seizure (n=4) and circulatory collapse (n=4). Six patients (50%) presented two severe manifestations. Mean parasitemia at the time of admission was 4066 parasites/microl for seropositive subjects versus 8563 parasites/microl for seronegative subjects. Outcome of malaria included 4 deaths and 8 recoveries in the seropositive group versus 2 deaths and 23 recoveries in the seronegative group. Comparison with the group of 25 seronegative patients presenting severe malaria demonstrated no significant difference in mean age (p=0.96), self-prescribed antimalarial treatment (p=0.50), parasitemia upon admission (p=0.28), or mortality (p=0.07). However co-infected patients were found to have a higher incidence of anemia (P=0.01) and never presented certain manifestations of severe malaria. Further studies of co-infection by HIV infection and malaria (especially severe malaria) is needed given the high human and economic impact of these two diseases in sub-Saharan Africa.

[Metabolic syndrome and cardiovascular risk patients under antiretrovirals in a day hospital at Bobo-Dioulasso (Burkina Faso)]. / Syndrome métabolique et risque cardiovasculaire chez des patients sous antirétroviraux à l'hôpital de jour de Bobo-Dioulasso (Burkina Faso).

Highly active antiretroviral therapy (HAART) has reduced morbidity and mortality of HIV but has led to an increasing metabolic cardiovascular risk. A cross-sectional study was conducted from May to September 2011 in Day Care Hospital for HIV-Patients of Bobo-Dioulasso. We included in this study 400 patients infected by HIVon antiretroviral therapy ≥ 6 months selected by a random draw. Metabolic syndrome was assessed according to the definitions of the IDF and ATP-III. The high risk of cardiovascular disease in 10 years was defined by a Framingham score ≥ 20%. The average age of our patients was 41.4 years [20-76]. 17% received an IP. The average duration of PI exposure was 35.5 months and 50.1 months for NNRTI. The prevalence of diabetes was 1.3% (95% CI: 0.5-3) and that of hypertension of 12.0 % (95% CI: 9.3-16). The prevalence of metabolic syndrome according to IDF was 10% (95% CI: 7.3-13.5) and the metabolic syndrome according to ATP-III 12.3% (95% CI: 9.3-16). The body mass index was higher (BMI 25.2 vs. 22.5 kg/m(2), p <10(-3) with ATPIII and BMI 26.6 vs. 22.4 kg/m(2), p <10(-3) with IDF), and duration exposure to ARVs longer in patients with metabolic syndrome regardless of the definition used (58.6 months vs 27.9 months). High cardiovascular risk was present in 1.8% (95% CI: 0.8 to 3.7) of our patients, all male more than half (n=4/7) of them were smoking. The choice of antiretroviral therapy must take into account its potential long-term toxicity. It should also strengthen supervision.

[Efficacy and tolerability of antiretroviral therapy containing tenofovir disoproxil fumarate-emtricitabine-efavirenz in treatment-naive patients infected with HIV-1 in Bobo Dioulasso (Burkina Faso, 2009-2011)]. / Efficacité et tolérance d'une trithérapie antirétrovirale à base de ténofovir disoproxil-emtricitabine-éfavirenz chez les patients naïfs infectés par le VIH-1 à Bobo Dioulasso (Burkina Faso, 2009-2011).

The objective of this study was to evaluate the effectiveness and the clinical tolerance of a combination containing TDF/FTC/EFV in the treatment of HIV infection. This was a retrospective and descriptive study which included 196 adults infected by HIV-1 and treated by a combination containing TDF/FTC/EFV during 29 months in the daily hospital of Bobo Dioulasso. The median duration of follow-up was 7 months IQR [5-14 month]. The median age was 37 years IQR [31-45].With the initiation of treatment ARV, the median of the index of body mass was of 19 IQR [17-22]. The median of the lymphocytes TCD4 was 201/µl IQR [74-298/µl]. During the follow-up, we reported 25 deaths (12.8%). HIV-1 RNA plasma viral load was undetectable in 91.9% of the patients (124/135) at six months of treatment. The majority of the adverse effects of the treatment were of a neurosensory nature (40.5%). The TDF/FTC/EFV combination showed a good effectiveness in the treatment of the infection with HIV-1 in the first intention just as a good clinical tolerance.

Hepatitis B seroprevalence in HIV-infected patients consulting in a public day care unit in Bobo Dioulasso, Burkina Faso.

OBJECTIVE: The authors had for aim to assess the prevalence of hepatitis B co-infection in a cohort of HIV-infected patients, routinely followed-up at the Day Care Unit of the Bobo Dioulasso Sanou Souro University Hospital, Burkina Faso. PATIENTS AND METHODS: The Elisa technique was used to dose HBs antigen (AgHBs), antibodies anti-HBs and anti-HBc in all the patients followed by the biological laboratory, from October to December 2008. RESULTS: The AgHBs prevalence was 12.7% [CI at 95%: 10.7-15.0%] and men were slightly more likely to be positive for AgHBs than women (16.5% [12.0-21.9%] versus 11.6% [9.4-14.1%]; P=0.047); 83.3% of the patients [80.8-85.6%] were positive for hepatitis B core antibody, and 32.6% [29.7-35.6%] for hepatitis B surface antibody; 29.9% of the patients [27.1-32.8%] had a complete profile of former hepatitis B infection, 41.3% [38.2-44.4%] expressed core antibodies only; 13.8% [11.7-16.0%] had a negative serological test, and 2.3% [1.5-3.4%] presented a vaccinal immunity. CONCLUSION: These results stress the usefulness of screening for hepatitis B in all HIV-infected patients, along with the initial biological tests. This would help adapt HIV treatment to co-infected patients and to build an expanded program of vaccination for non-immune patients.

[Impact of vaccination on admissions for Haemophilus influenzae b meningitis from 2004 to 2008 in Bobo Dioulasso, Burkina Faso]. / Impact de la vaccination sur la méningite à H. influenzae b de 2004 à 2008, à Bobo Dioulasso (Burkina Faso).

OBJECTIVE: Vaccination against Haemophilus influenzae type b was introduced in Burkina Faso on 1st January 2006. This study thus sought to determine the impact of the first 30 months of vaccination on admissions for Hib meningitis in the department of pediatrics at the Sourô-Sanou University Hospital in Bobo Dioulasso. METHODS AND PATIENTS: Retrospective study of children aged zero to 14 years hospitalized from 1st January 2004 to 30th June 2008 for acute bacterial meningitis (laboratory-confirmed). RESULTS: During the study period, 416 children were admitted for acute bacterial meningitis. The bacterium isolated was identified in 386 cases and unidentified in 30 cases. Hib meningitis accounted for 42.3 % of the cases of identified bacterial meningitis before the introduction of the vaccine (2004 to 2005). This rate declined to 11.8 % for the first 30 months of vaccination (p < 0.001). No cases of Hib meningitis have been reported in the first half of 2008. CONCLUSION: Admissions for Hib meningitis in the Department of Pediatrics have practically disappeared two years after the introduction of the Hib vaccine into Burkina Faso's expanded program on immunization.