ABSTRACT
Objective.In the context of the global COVID-19 pandemic, COVID-19 vaccines were made available to different countries. This study aimed to assess travelers' attitudes and practices toward the COVID vaccine and adverse events. Methods. A survey was conducted using a questionnaire from April 1 to June 30, 2021, among travelers who came for their COVID-19 test at the Institut Pasteur of Côte d'Ivoire.Results. A total of 527 travelers agreed to participate in this study, including 336 men and 161 women. Overall, 26% of respondents had already received their COVID-19 vaccine, while 76% of respondents responded they did not want to be vaccinated. The age of those most vaccinated (116) ranged from 25 to 64 years with a small proportion for those over 65 years (0.8%). Travelers (41) to France were the most vaccinated. All vaccinated persons (135) had a high level of education and were either Christian (89 persons), Muslim (45 persons) or animist (1 person). Adverse events related to the COVID vaccination were reported in seven individuals. These included muscle pain, fever and nausea. Conclusion.Negative attitudes towards vaccines are a major public health concern. In view of these results, for awareness raising, vaccination campaign may be focused on youthand people over 65 years of age. Public health messages containing information about vaccine safety should be tailored to address this vaccine hesitancy
Subject(s)
Humans , Vaccines , COVID-19 , Weights and Measures , Dams , Sanitary Control of TravelersABSTRACT
Background: One of the main health problems in West Africa remains upsurge of emerging pathogens. Ebola virus disease outbreak occurred in 2014 in Liberia, Guinea and Sierra Leone, Monkeypox virus in Nigeria in 2017 and most recently Lassa virus in Nigeria, Togo and Benin in 2018. These pathogens have animal reservoirs as vectors for transmission. Proper investigation of the pathogens in their rodent vectors could help reduce and manage their emergence and spread. Methodology: This study was conducted with an approval from the Côte d'Ivoire Bioethics Community. Small mammal trappings were carried out in 9 sites within three zones namely, peri-urban, peri-rural and protected areas. Liver, lung and kidney tissues from trapped small mammals were sampled in accordance with the recommended conditions of biosafety and bioethics. The organs were transported in liquid nitrogen to the laboratory. Molecular tests were used to detect pathogens. Orthopoxviruses and Monkeypox virus were detected in the organs by PCR using consensus primers targeting the virus surface membrane haemagglutinin (HA) genes, while Leptospira species were detected by PCR using primers targeting the rrs and lfb1 genes. Results: Out of 4930 night-traps, 256 (5.19%) small mammals were trapped including Crocidura, Rattus, Lophuromys, Praomys, Mus and Mastomys. Leptospira species were detected in 6 genera from 7 study sites and the infected small mammals accounted for 13.3%. Leptospira sp was detected mainly in the rodent vector genera Rattus (32.3%), Lophuromys (29.0%), and Praomys (16.1%). Three species of Leptospira were detected and Leptospira interrogans was the most common frequent species (74.2%). Monkeypox virus was not detected from studied small mammals. Conclusion: The initial data from our investigation indicates the presence of Leptospira sp in rodent vectors, Rattus, Lophuromys and Praomys, which are the potential small mammalian reservoirs of this pathogen in Cote d'Ivoire.
Subject(s)
Rodent Diseases , Disease Reservoirs , Rodent Control , Ebolavirus , Lassa virus , Orthopoxvirus , Monkeypox virusABSTRACT
La utilización de soporte perioperatorio con sistema de oxigenación a través de membrana extracorpórea (ECMO) es un concepto novedoso en cirugía torácica general. Se presenta el caso de un paciente con trasplante pulmonar derecho por fibrosis pulmonar idiopática (FPI) que requirió la resección de un nódulo pulmonar homolateral con soporte de ECMO veno-venoso (VV). El soporte a través de ECMO VV es una opción viable cuando se prevén dificultades con la ventilación unipulmonar en casos seleccionados.
The use of perioperative support with extracorporeal membrane oxygenation (ECMO) systems is a novel concept in general thoracic surgery We report the case of a male patient with a history of right lung transplant due to idiopathic pulmonary fibrosis (IPF) who required resection of a right pulmonary nodule under veno-venous (VV) ECMO support. The use of VV-ECMO is a feasible option in selected cases when complications are expected to occur with one lung ventilation.
Subject(s)
Humans , Transplantation , Idiopathic Pulmonary Fibrosis , Lung , Lung/surgery , Thoracic Surgery , Oxygenation , Research ReportABSTRACT
La tuberculosis (TB) constituye un grave problema de salud en el mundo y está relacionada con problemáticas sociales que dificultan su control y erradicación como la pobreza, la marginalidad y el hacinamiento. Aunque la toxicidad hepática por rifampicina es bien conocida, la nefrotoxicidad es una complicación poco frecuente y grave del tratamiento antituberculosis. El deterioro de la función renal, determinado por nefritis tubulointersticial aguda o necrosis tubular aguda o ambos, por lo general aparece en pacientes que reciben tratamiento intermitente; no obstante, algunos autores han informado casos ocurridos durante la terapia continua con rifampicina.Con frecuencia la lesión renal aguda inducida por rifampicina tiene un curso favorable con tratamiento y una recuperación completa de la función renal en un lapso de tres meses. El siguiente reporte describe un paciente en tratamiento por TB Pulmonar, que desarrolló toxicidad renal inducida por rifampicina
Subject(s)
Rifampin , Tuberculosis, Pulmonary , Nephritis, HereditaryABSTRACT
Nowadays, many medicinal plants have proved effective in combating the phenomenon of bacterial multi-resistance against conventional antibiotics. However, the use of these plants, traditionally is done withoutprecise doses. And this inaccuracy of dose is a real problem of traditional medicine. Thus prospecting for empirically administered plant extract requires dosage monitoring to avoid the risk of a fatal therapeutic accident. It is in this context that the study of the toxicity of Terminalia macropterawhich presents itself as an anti-infectious agent, capable of overcoming certain strains of antibiotic-resistant bacteria has been initiated. The objective of this study is to evaluate the toxicity of 70% ethanol extract of T.macroptera in rats and to deduce its safety. With regard to the evaluation of the toxicity, rats were used whose mass varies between 100 and 170 grams. Then, using OECD Guideline 425, (2006), acute toxicity was achieved. Then the 100, 300 and 500 mg / kg bm doses were used in sub-acute toxicity to evaluate biochemical and hematological parameters. The results show an LD50> 5000 mg / kg bm. Therefore, according to the OECD classification, the hydroethanolic extract belongs to category 5, non-toxic substances. Also, the biochemical and hematological results revealed that the extract did not change at any time at P <0.05, biochemical marker levels (UREE, ASAT, ALAT, CK and LDH), reflecting vital organs of the body. So the extract would have no effect on the heart, liver and kidneys. 70% ethanol extract of T. macroptera would be safe for use as a drug and therefore could contribute to the production of Traditionally Enhanced Medicines (MTAs).
ABSTRACT
In Cote d'Ivoire, the prevalence of HIV/AIDS has declined significantly in the last decade as a result ofpublic health actions. An assessment of knowledge, attitudes, perception and behaviours was carriedout to assess the outcome of the strategies for raising awareness and communicating with students about HIV/AIDS. A descriptive cross-sectional study was conducted in 2014 among students enrolled in third year at the university. An anonymous self-questionnaire including a consent form was provided. Mean scores were calculated from the items in the questionnaire to assess the level of knowledge, attitude, perception and behaviours of these students with regard to HIV/AIDS. The chi square test was used to compare the qualitative variables, and the quantitative variables were compared with the test of student. Among 561 students who participated in the study, 41.7, 26.7 and 31.6% were respectively registered in the sectors of human and social sciences (HSS), biosciences and health sciences. The mean age was 25.9 ± 3.4 years with a sex ratio of 1.3. The mean knowledge score of certain modes of transmission was 4.9 ± 0.36 out of 5 while that of condom positive perception was 6.4 ± 2.2 out of 12. This perception score was significantly higher in women than in men (6.1 vs. 6.9, p = 0.0001). The mean acceptance score was 7.3 ± 2.2 out of 10. The results of this work show good knowledge about HIV/AIDS among the students surveyed. However, the positive perception of the condom is far from being integrated in the student environment. This study also showed the persistence of HIV risk behaviour is out of sync with the level of Knowledge. It would be important to review marketing and communication strategies about HIV
Subject(s)
Acquired Immunodeficiency Syndrome/psychology , Behavior , Cote d'Ivoire , Cross-Sectional Studies , HIV Infections/epidemiology , Health Knowledge, Attitudes, Practice , StudentsABSTRACT
OBJECTIVES@#To describe the emergence of Neisseria meningitidis (Nm) W135 in Côte d'Ivoire and its characteristics compared to NmA.@*METHODS@#Data on Nm samples isolated at the National Reference Center for meningitis in Côte d'Ivoire between 2007 and 2012 were analyzed. Socio-demographic data and biological information on the samples were extracted from the database. Categorical variables, such as sex and the serotype of the bacteria, were compared using the Fisher exact test, while the distribution of continuous variables, such as age, was compared using the Wilcoxon test.@*RESULTS@#Among the 175 Nm samples, 57 were NmA, 4 were NmB, 13 were NmC, and 99 were NmW135. The geographical distribution of NmA and NmW135 did not show a significant difference according to age or sex. NmW135 was more common than NmA in the northern health districts of Cote d'Ivoire (85.9 vs. 45.5%; p < 0.001). No sample of NmA has been isolated since 2009, while 95% of the type W135 samples were isolated between 2010 and 2012.@*CONCLUSION@#This study highlighted the emergence of NmW135 in Côte d'Ivoire, as well as the simultaneous disappearance of NmA. It is important to improve laboratory-based surveillance of meningitis to assess trends in the circulation of bacteria and to detect the emergence of new serogroups earlier.
ABSTRACT
OBJECTIVES: To describe the emergence of Neisseria meningitidis (Nm) W135 in Côte d'Ivoire and its characteristics compared to NmA. METHODS: Data on Nm samples isolated at the National Reference Center for meningitis in Côte d'Ivoire between 2007 and 2012 were analyzed. Socio-demographic data and biological information on the samples were extracted from the database. Categorical variables, such as sex and the serotype of the bacteria, were compared using the Fisher exact test, while the distribution of continuous variables, such as age, was compared using the Wilcoxon test. RESULTS: Among the 175 Nm samples, 57 were NmA, 4 were NmB, 13 were NmC, and 99 were NmW135. The geographical distribution of NmA and NmW135 did not show a significant difference according to age or sex. NmW135 was more common than NmA in the northern health districts of Cote d'Ivoire (85.9 vs. 45.5%; p < 0.001). No sample of NmA has been isolated since 2009, while 95% of the type W135 samples were isolated between 2010 and 2012. CONCLUSION: This study highlighted the emergence of NmW135 in Côte d'Ivoire, as well as the simultaneous disappearance of NmA. It is important to improve laboratory-based surveillance of meningitis to assess trends in the circulation of bacteria and to detect the emergence of new serogroups earlier.
Subject(s)
Bacteria , Cote d'Ivoire , Meningitis , Meningitis, Bacterial , Neisseria meningitidis , Neisseria , Public Health Surveillance , SerogroupABSTRACT
OBJECTIVES: To describe the emergence of Neisseria meningitidis (Nm) W135 in Côte d'Ivoire and its characteristics compared to NmA.METHODS: Data on Nm samples isolated at the National Reference Center for meningitis in Côte d'Ivoire between 2007 and 2012 were analyzed. Socio-demographic data and biological information on the samples were extracted from the database. Categorical variables, such as sex and the serotype of the bacteria, were compared using the Fisher exact test, while the distribution of continuous variables, such as age, was compared using the Wilcoxon test.RESULTS: Among the 175 Nm samples, 57 were NmA, 4 were NmB, 13 were NmC, and 99 were NmW135. The geographical distribution of NmA and NmW135 did not show a significant difference according to age or sex. NmW135 was more common than NmA in the northern health districts of Cote d'Ivoire (85.9 vs. 45.5%; p < 0.001). No sample of NmA has been isolated since 2009, while 95% of the type W135 samples were isolated between 2010 and 2012.CONCLUSION: This study highlighted the emergence of NmW135 in Côte d'Ivoire, as well as the simultaneous disappearance of NmA. It is important to improve laboratory-based surveillance of meningitis to assess trends in the circulation of bacteria and to detect the emergence of new serogroups earlier.
Subject(s)
Bacteria , Cote d'Ivoire , Meningitis , Meningitis, Bacterial , Neisseria meningitidis , Neisseria , Public Health Surveillance , SerogroupABSTRACT
Objective/background: tuberculosis remains an important cause of mortality worldwide. Previous tuberculosis treatment is a strong determinant of multi-drug resistant tuberculosis. The study objective was to describe the mutations detected of Mycobacterium tuberculosis [MTB] complex clinical strains screened with GeneXpert isolated from previously treated patients in Cote d' Ivoire
Methods: sputum collected and decontaminated by the n-acetyl-L-cysteine method was used to perform Ziehl-Neelsen staining, GeneXpert MTB/ rifampicin, and culture on LowensteinJensen medium. Drug susceptibility testing [DST] for first-line drugs was performed in a Baetee 960 Automated System. After strain identification by antigen MPT64 detection, DNA extraction, and genotyping with MTBDRplus assay was performed and interpreted. The strains muted in rpoB without a specific protein identified and were sequenced
Results: mutant sequences were detected in 60 sputum samples with GeneXpert MTB/ rifampicin of which 55 were confirmed multi-drug resistant MTB strains after DST. The most frequent mutations responsible for rifampin resistance were detected with MTBDR plus assay for 49 [81.7%] clinical strains, while sequencing was required for 11 [18.3%]. H526Qmutation, L533P, and D516V associated respectively with L533P, A532A, and S522L, and were observed for three relapse cases. For these cases, GeneXpert and sequencing results were concordant. Discrepancies between GeneXpert and mycobacteria growth indicator tube-DST for rifampin were observed for three strains, on which D516Y, H526C, and L533P were identified
Conclusion: in the setting of a high prevalence of drug resistance, characterization of the genetic basis of MTB strains resistant to rifampin could be screened first with MTBDR plus
ABSTRACT
During the 6th International Conference on Envenomation by Snakebites and Scorpion Stings in Africa held in Abidjan, from 1 to 5 June 2015, the measures for the management of envenomation were discussed and new recommendations were adopted by the participants. The high incidence and severity of this affliction were confirmed by several studies conducted in African countries. The poor availability of antivenom, particularly because of the cost, was also highlighted. Some experiences have been reported, mainly those regarding the financial support of antivenom in Burkina Faso (more than 90 %) and Togo (up to 60 %) or the mandatory reporting of cases in Cameroon. Key recommendations concerned: improvement of epidemiological information based on case collection; training of health workers in the management of envenomation; policy to promote the use of effective and safe antivenom; and antivenom funding by sharing its costs with stakeholders in order to improve antivenom accessibility for low-income patients.(AU)
Subject(s)
Snake Bites , Antivenins , Policy , Scorpion Stings , Costs and Cost AnalysisABSTRACT
During the 6th International Conference on Envenomation by Snakebites and Scorpion Stings in Africa held in Abidjan, from 1 to 5 June 2015, the measures for the management of envenomation were discussed and new recommendations were adopted by the participants. The high incidence and severity of this affliction were confirmed by several studies conducted in African countries. The poor availability of antivenom, particularly because of the cost, was also highlighted. Some experiences have been reported, mainly those regarding the financial support of antivenom in Burkina Faso (more than 90 %) and Togo (up to 60 %) or the mandatory reporting of cases in Cameroon. Key recommendations concerned: improvement of epidemiological information based on case collection; training of health workers in the management of envenomation; policy to promote the use of effective and safe antivenom; and antivenom funding by sharing its costs with stakeholders in order to improve antivenom accessibility for low-income patients.
Subject(s)
Animals , Snake Bites/diagnosis , Snake Bites/epidemiology , Snake Bites/veterinary , Congresses as Topic/organization & administration , Congresses as Topic/trends , Poisoning/veterinaryABSTRACT
Abstract Aim of study. To describe the emergence of dengue 3 virus in Côte d'Ivoire during a yellow fever outbreak which occurred in 2008. Materials and methods. Sera from suspected cases of yellow fever as well as contacts of yellow fever confirmed cases and imported dengue fever cases were tested for immunoglobulin M (IgM) antiyellow fever virus and anti-dengue virus (for IgM antibodies to yellow fever and dengue viruses) and by a specific real time RT-PCR (Bio-Rad) for yellow fever virus and dengue virus viral RNA detection. Results. Of the 511 sera from suspected cases of yellow fever tested, 21 (4.1%) were confirmed positive for yellow fever virus antibody, while 33 (7.6%) of the 432 sera tested were positive for dengue virus antibody. Thirteen viremic subjects, one for yellow fever virus and 12 for dengue 3 virus, were detected by RT-PCR. The majority of the confirmed cases of yellow fever (85%) and dengue 3 fever (93%)were adults, and resided in the city of Abidjan and its regions. Conclusion. These results indicate the existence of transmission foci of these arboviruses diseases in CËote d'Ivoire and the essential contribution of molecular tests for their diagnosis
Subject(s)
Arboviruses , Cote d'Ivoire , Disease Outbreaks , Severe Dengue , Yellow FeverABSTRACT
Background: Viral hemorrhagic fevers are emergent and endemic in Africa and in South America. In Côte d’Ivoire, Yellow fever cases were reported yearly and the distribution of mosquitoes in the country are the main factors for high incidence of Flaviviruses. The poorly reporting of viral hemorrhagic fever cases in some regions, the lack of international interest land and the underestimation of molecular surveillance method contribute to increase the risk for public health. Objectives: To evaluate the performance of molecular diagnostic methods in national surveillanceof two emergent Flaviviruses, Yellow fever virus and Dengue virus in Côte d’Ivoire. Study Design: 63 sera from suspected cases in 2010-2011 of viral hemorrhagic fevers were analyzed to detect viral RNA of Flaviviruses and to compare the results in three different methods. Results and Conclusion: The Flavivirus RT-PCR has showed the high molecular detection by12% and 6% for real time PCR. The methods are specific and high sensitive for the screening of tick and mosquito-borne Flaviviruses in clinical samples. This study confirms the high circulation of Flaviviruses and the introduction of Dengue virus in Côte d’Ivoire. The combination of real time PCR and the Flavivirus RT-PCR contribute to ameliorate the detection panel of molecular detection in Côte d’Ivoire and was a suitable method for the National Laboratory Reference.
ABSTRACT
Background: Buruli ulcer (BU) is neglected skin disease caused by Mycobacterium ulcerans. The lack of early diagnosis and treatment causes severe disability. In Central and in West Africa, BU is endemic and its control is difficult because the most cases occur in rural regions. The molecular particularity of M. ulcerans was the acquisition of the virulence plasmid pMUM001. Genetic analyses have demonstrated the high diversity with variable number tandem repeats (VNTR) and Mycobacterial Interspersed Repetitive Units (MIRU) in M. ulcerans and in mycolactone producing Mycobacteria (MPMs) Objective: The objective of this study was to investigate the molecular diversity by using MIRUVNTR method in clinical samples of BU patients in Côte d’Ivoire. Study Design: 21 clinical samples were collected from BU patients in different sites and were first analyzed in molecular diagnosis of BU using two targets insertion sequence IS2404 and keto reductase-B-domain (KR). In a second step, we have analyzed the strains by PCR typing for four specific and sensitive markers MIRU1, VNTR6, ST-1 and VNTR19. Results and Conclusion: 100% of clinical samples were positive in molecular tests for IS2404 and 95% for KR and confirm M. ulcerans in the samples. By PCR typing, we have found 61.9 % positive for MIRU1 and 52%, 85.7%, and 61.9% for VNTR6, ST-1 and VNTR19 respectively. One of sample was negative for all genotyping markers. Two different genetic profiles were identified by MIRU1 and ST-1 loci by gel-analyzed of the amplified products. The VNTR profile C (3,1,1) corresponding of 3 copies MIRU1, 1 copy VNTR6 and 1 copy ST-1 was detected in 28.5% of samples and confirms the West African genotype in Côte d’Ivoire. Different genetic strains of M. ulcerans were co-circulated in the same endemic region in the country. This study has described first the circulating of different genetic strains of M. ulcerans in Côte d’Ivoire.
ABSTRACT
Background: Africa and Asia remain the continent most affected by viral hepatitis B with more than1 million deaths per year. These deaths are due to complications such as cirrhosis and hepatocellular carcinoma. Several studies have shown that the rate of progression of hepatitis B to cirrhosis and liver cancer is related to the virus genotypes. Previous analyses of hepatitis B virus genome have revealed 10 genotypes (A-J) with distinct geographical distribution worldwide. Some studies have shown that the genotype E is predominant in West Africa. In Côte d'Ivoire, few data exist on the genotypes circulating. The presence of genotypes A, B, C and E has been proven but not their involvement in the development of liver complications. Aim of Study: To determine the hepatitis B virus genotypes circulating in asymptomatic and symptomatic carriers and to establish correlation between genotypes and clinical outcome in Côte d’Ivoire. Place and Duration of Study: Patients were recruited in different hospitals in Côte d’Ivoire and study was conducted in the National Reference Center for Viral Hepatitis of the Institute Pasteur from April 2010 to February 2013. Methodology: The study examined samples from 754 subjects using serological and molecular techniques. PCR and multiplex-nested PCR, using type-specific primers, were carried out to determine genotypes of hepatitis B virus in the study samples. Results: Hundred thirty nine were HBsAg-positive. Out of the 139, 49% were asymptomatic and 51% were symptomatic. Among the HBsAg-positive, the average age was 41years with 38.85% having HBV DNA in their blood samples. Sixty-four point eight percent of the latter were typeable with 97.1% as genotype E and 2.9% as genotype B. Conclusion: This study revealed a predominance of genotype E of HBV and revealed that genotype E was associated (P=0.03) with clinical Outcome.
Subject(s)
Asymptomatic Diseases , Enzyme-Linked Immunosorbent Assay/methods , Cote d'Ivoire/epidemiology , Gene Expression Profiling/methods , Genotype , Hepatitis B/genetics , Hepatitis B/transmission , Hepatitis B virus/genetics , Hepatitis B virus/pathogenicity , Host-Pathogen Interactions , Polymerase Chain Reaction/methodsABSTRACT
Background: Recent studies have shown that wastewater is contaminated by salmonella sp., pathogenic antibiotics-resisting bacteria. Using wastewater in periurban agriculture in Abidjan is likely to be the source of food-borne diseases such as salmonellosis. However, what we know about these resistant salmonella spp. in wastewater is limited in the country. Aims: This study aims to establish the susceptibility profile of Salmonella spp., isolated from wastewater to antibiotics and to antimetabolite commonly used by medical practitioners. Study Design: Spatio-temporal variation was taken into account. Place and Duration of Study: The study took place from August 2008 to January 2009 at the main campus of the university of Cocody in Abidjan. Methodology: Sampling was done on a weekly basis. Wastewater samples were collected at four different sewers in the campus area. Salmonella sp was isolated by a standard method of laboratory. The resistance of these isolated species to antibiotics was determined according to the disk diffusion method of Kirby-Baeur. The serotypes of salmonella were identified with the Kauffman-White table Results: Five serotypes of eleven strains, which consist of 4 Hato, 3 Farmsen, 2 Derby, 1 Essen and 1 Ovonmouth, were isolated and tested in order to determine their resistance to antibiotics. Amongst the various classes of antibiotics, high resistance was found to sulfonamid (100%), followed by cefotaxime (46.67%) and tetracycline (9.1%). Ampicillin, amoxicillin and clavulanic acid, gentamicin, kanamycin, amikacin, ciprofloxacine, nalidixic acid and chloramphenicol had a high potentiality: their efficacity in the elimination of the Salmonella sp was proved at a level of 100%. Although the majority of strains tested (85.94%) were eliminated by the antibiotics, the serotypes Derby, Hato and Farmsen showed resistance. Conclusion: The Wastewater in the area of the main campus of the University of Cocody contains the antibiotic-resisting strains of salmonella sp. In spite of the fact that the efficacity of some antibiotics in the elimination of Salmonella sp. is proved, the resistance of these strains to third generation of cephalosporin and sulfamid is worrisome. Further studies should be carried out to determine the effects of this antibiotic-resisting salmonella species on humain health.
ABSTRACT
Tuberculosis is explicitly recognized as a major global public health problem. In Cote d'Ivoire, relapse cases represent 66.5% of patients eligible for retreatment according to the National Tuberculosis Control Program. This study objective was to detect multidrug-resistance tuberculosis among relapse cases. Patients were recruited in tuberculosis centers in routine. A standardized questioning was administrated. Two sputum samples were collected and transported at Institut Pasteur. Sputum samples were decontaminated by NALC method. The DNA extraction was realized with 500 microl of decontaminated sputum sample with smear-positive. MTBDRplus assay version 2.0 was performed according to the manufacturer's instruction. An internal quality control program with positive and negative controls was implemented for interpretation of results. In total 146 relapse cases with smear positive were studied. Out of selected patients, 130 had received the 2RHZE/4RH regimen and 16, the 2RHZES/1RHZE/5HRE. In group of relapse cases previously treated with 2RHZE/4RH regimen, 40 [31.3%, IC95%: [0.23; 0.39]] had punctual mutations at codon 526 in rpoB gene. Although, in patients under treated with 2RHZES/1RHZE/5HRE, a mutation in rpoB gene was identified in 12 of 16 sputum samples. Thirteen mutations conferring a resistance to Isoniazid were observed of which 9 in katG gene and 4 in katG and promoter region of inhA gene. The comparison [Chi-square with Yates correction] of resistance rates to Rifampin estimated showed a statistically significant difference. Use of a rapid method to detect drug-resistance in recurrent TB cases has permitted to identify patients eligible for first-line drugs or not.
Subject(s)
Humans , Recurrence , Molecular Diagnostic Techniques , TuberculosisABSTRACT
Detection of circulating influenza strains is a key public health concern especially in limited-resource settings where diagnosis capabilities remain a challenge. As part of multi-site surveillance in Cote d'Ivoire during the 2009 influenza A(H1N1) pandemic; we had the opportunity to test respiratory specimens collected from patients with acute respiratory illness (ARI). We analyzed and compared the percentage of specimens testing positive using three laboratory methods (rtRT-PCR; ELISA; viral culture). From January to October 2009; 1;356 respiratory specimens were collected from patients with acute respiratory illness and shipped at the WHO NIC (Institut Pasteur) Cote d'Ivoire; and 453 (33) tested positive for influenza by one or more laboratory methods. The proportion of positive influenza tests did not differ by the sex or age of the patient or presenting symptoms; but did differ depending on the timing and site of specimen collection. Of the 453 positive specimens; 424 (93.6) were detected by PCR; 199 (43.9) by ELISA and 40 (8.8) by viral culture. While seasonal influenza A(H1N1) virus strains were prominent; only four 2009 pandemic influenza A(H1N1) cases were detected. Use of molecular biology method (rtRT-PCR) increased sensitivity and diagnosis capabilities. Among all three methods used; rRT-PCR was the most sensitive and rapid method. More capacity building is still required for viral culture. Need to collect denominator data in order to have an accurate estimate of the burden of influenza. There was delayed introduction of pandemic influenza A(H1N1)2009 in Cote d'Ivoire
Subject(s)
Cote d'Ivoire , Diagnostic Techniques and Procedures , Evaluation Study , Immunologic Tests , Influenza, Human/diagnosis , Poverty AreasABSTRACT
Background: This study aim was to investigate an outbreak of human cases of unexplained influenza-like illness and fatal acute respiratory infection (ARI); with simultaneous poultry illness and high mortality raising concerns of possible influenza A (H5N1); virus in Cote d'Ivoire in February and March 2007. Materials and Methods: To investigate the outbreak; we conducted active surveillance in the community and reviewed health registries. Persons meeting the case definition were asked to provide nasopharyngeal specimens. On the basis of clinical and epidemiological information; specimens were tested using conventional RT-PCR for the M gene of the influenza viruses and hemagglutinin H5 of avian influenza A (H5N1); virus; negative samples were tested for other respiratory viruses. Specimens from healthy animals were also collected. Results: Between October 2006; and February 2007; 104 suspected cases of Acute Respiratory Disease that included; 31 deaths recorded. We collected and tested 73 nasopharyngeal specimens; of which; 2; were positive for human Coronavirus OC43 and 1 for influenza C virus. No pathogens were identified in animal specimens. Conclusions: The investigation quickly ruled out influenza A (H5N1); virus as the cause and found laboratory-confirmed cases of influenza C virus and human Coronavirus OC 43 for the first time in both Cote d'Ivoire and in a Sub-Saharan African country. However we were not able to show that these viruses caused the outbreak. Monitoring of influenza viruses must be a priority but other respiratory viruses and non-viral causes may be of interest too