Astrovirus Gastroenteritis in Children Younger than 5 Years in Ouagadougou (Burkina Faso): Prevalence and Risks Factors Influencing Severity

Aims:The aim of this study was to investigate the prevalence of astrovirus infections and associated risks factors. Methods:A prospective study was undertaken from May 2009 to March 2010, covering the rainy and dry seasons, at the Saint Camille Medical Center in Ouagadougou, Burkina Faso. A total of 213 non hospitalized children less than 5 years of age with diarrhea were enrolled and examined for astrovirus, others enteropathogens, and clinico-epidemiological aspects.Results:Astroviruses prevalence among the enrolled children was 14.6%. Astrovirus infections were common during the cold dry season from December to February (38.7%), during the rainy season from June to September (54.8%), also during dry season in March (3.2%) and May (3.2%). Children younger than 11 months of age were most affected by astroviruses (16%). Moderate and severe malnutrition influenced more severe symptoms of astrovirus related diarrheas. Conclusion:The present study shows that astroviruses have an important role in pediatric viral-associated diarrhea in Burkina Faso. Diarrhea is more severe in malnourished children

Factors associated with adherence to ARV treatment in people living with HIV/AIDS in a rural area (Koula-Moutou) in East Gabon

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

Trends of blood-borne infectious diseases in a rural blood donation center of southeast Gabon (Koula-Moutou)

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

Comparison of electrochemiluminescence and ELISA methods in the detection of blood borne pathogens in Gabon

Objective:To assess the performances of Cobas 6000 e601 and EVOLIS BioRad in the detection of HIV,HBV and HCV in blood donors in Libreville (Gabon).Methods:A cross-sectional investigation was conducted in July 2017 in a total of 2 000 blood donors recruited at the National Blood transfusion Center,Libreville Gabon.Among them,363 donors were selected to compare the performances of COBAS 6000 e601 (electro-chemiluminescence) and EVOLIS BioRad in detecting HIV,HBV and HCV using Cohen's kappa coefficient.Results:Both methods yielded similar results for the detection of HIV and HBsAg.A very good agreement of 93.39％ and an excellent agreement of 98.90％ were obtained for the detection of HIV and HbsAg,with kappa values of 0.80 and 0.98,respectively.The observed agreement of 91.86％ was found for the detection of HCV,which gave a fair agreement between the two methods with kappa =0.33.Conclusions:The two evaluation methods showed a similar performance in the detection of HIV,HBV.However,given the high rate of intra and inter-genotypes recombination known for HIV and HBV,more robust techniques of detection such as polymerase chain reaction should be used to prevent post-transfusion contaminations.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is associated with asymptomatic malaria in a rural community in Burkina Faso

Objective: To investigate 4 combinations of mutations responsible for glucose-6-phosphate dehydrogenase (G6PD) deficiency in a rural community of Burkina Faso, a malaria endemic country. Methods: Two hundred individuals in a rural community were genotyped for the mutations A376G, G202A, A542T, G680T and T968C using TaqMan single nucleotide polymorphism assays and polymerase chain reaction followed by restriction fragment length polymorphism. Results: The prevalence of the G6PD deficiency was 9.5% in the study population. It was significantly higher in men compared to women (14.3%vs 6.0%, P=0.049). The 202A/376G G6PD A-was the only deficient variant detected. Plasmodium falciparum asymptomatic parasitaemia was significantly higher among the G6PD-non-deficient persons compared to the G6PD-deficient (P Conclusions:This study showed that the G6PD A-variant associated with protection against asymptomatic malaria in Burkina Faso is probably the most common deficient variant.

HIV-Infected Women of Burkina Faso: a Reservoir of Mycoplasma Infection

Introduction: The objective of this work was to assess the prevalence of bacterial vaginosis (BV) and genital mycoplasma colonization in 251 HIV-positive compared to 200 HIV-negative women at the Maternal and Child Health (MCH) service of Saint Camille Medical Center Ouagadougou (Burkina Faso). Methodology: After revealing the cervix with a speculum; we collected swabs of vaginal discharge for the detection of pathogenic bacteria. Results: Among HIV-positive and HIV-negative women; we identified respectively: Mycoplasma hominis (16.7versus 5.5); Ureaplasma urealyticum (16.3versus 0.0); co-infection M. hominis with U. urealyticum (13.14versus 0.0); Candida albicans (21.11versus 41.5); E. coli (9.96versus 4.0); and the presence of abundant vaginal discharge (27.5versus 5.0) respectively. The Nugent's score; utilized for the diagnosis of BV; was significantly higher in HIV-positive women (p 0.001) associated with poor vaginal hygiene practices (p 0.01) and no use of condoms (p 0.01). Enterobacter; Klebsiella pneumonia; Klebsiella oxitocica; Staphylococcus epidermidis and Staphylococcus aureus; Streptococcus agalactiae; Trichomonas vaginalis; and Gardnerella vaginalis were also isolated; but in a low prevalence ranging from 0to 5. Conclusion: These results demonstrate that the HIV-positive women of Burkina Faso are frequently affected by BV and represent a reservoir for mycoplasma infection. Since these germs can lead to sterility and premature delivery; it is important to develop a policy of screening

Towards the complete eradication of mother-to-child HIV/HBV coinfection at Saint Camille Medical Centre in Burkina Faso, Africa

The coinfection of HIV and hepatitis B virus (HBV) and their vertical transmission constitute a public health problem in sub-Saharan countries of Africa. The objectives of this research are: i) identify the pregnant women that are coinfected by HIV and HBV at Saint Camille Medical Centre; ii) use three antiretroviral drugs (zidovudine, nevirapine and lamivudine) to interrupt the vertical transmission of HIV and HBV from infected mothers; and iii) use the PCR technique to diagnose children who are vertically infected by these viruses in order to offer them an early medical assistance. At Saint Camille Medical Centre, 115 pregnant women, aged from 19 to 41 years, were diagnosed as HIV-positive and, among them, 14 coinfected with HBV. They had at least 32 weeks of amenorrhoea and all of them received the HAART, which contained lamivudine. Two to six months after childbirth, the babies underwent PCR diagnosis for HIV and HBV. The results revealed that, among these mothers, 64.4 percent were housewives, 36.5 percent were illiterates, and only 1.7 percent had a university degree. The rate of vertical transmission of HIV and HBV was 0.0 percent (0/115) and 21.4 percent (3/14), respectively. The 3 mothers who transmitted the HBV to their children had all HBsAg, HbeAg, and HBV DNA positive. An antiretroviral therapy that in addition to zidovudine and nevirapine includes lamivudine could, as in the present study, block or reduce the vertical transmission in HIV positive pregnant women who are coinfected with HBV.