[Sexual behavior, knowledge and attitudes to AIDS and sexually transmitted diseases of students at the University of Benin (Togo)]. / Comportements sexuels, connaissances et attitudes des étudiants de l'Université du Bénin (Togo) face au sida et aux maladies sexuellement transmissibles.

Many studies have shown that in Africa, particularly in Togo, the 20- to 29-year-old age group is the age group most frequently affected by AIDS. This age group accounts for 84% of the students of the University of Benin. We studied students, most of the age group thought to be most at risk, investigating sexual behavior, knowledge and attitudes to AIDS and sexually transmitted diseases (STDs). The level of knowledge about the problems of AIDS and STDs was similar for both sexes and for all ages and levels of education of the students. Students had a reasonable knowledge of AIDS, particularly concerning the transmission of HIV (88.6% of students aware), risk behavior (80.8%), AIDS treatment (57.0%) and more general information about HIV (49.4%). They were poorly informed about the transmission (42.9%) and complications (0.69%) of other STDs. Most students had positive attitudes towards HIV issues, particularly the use of preventive measures (3.41 in 5) and the acceptance of infected individuals (3.98 in 5). However, few had seriously considered that AIDS and STDs might impact on their own sex lives (1. 84 in 5) and some were even fatalistic concerning HIV infection. The students were highly sexually active, having intercourse a mean of 31 times per year. Their sexual behavior depended on age and sex. The 15- to 19-year-olds preferred occasional partners. They had sexual intercourse 1 to 3 times per month and used condoms 10 to 20% of the time. The 20- to 29-year-olds had multiple partners. They had sexual intercourse 3 to 5 times per month and used condoms more than 30% of the time. Students over the age of 30 had many partners in addition to their regular partner. They had sexual intercourse 5 to 10 times per month and used condoms 0 to 20% of the time. Significantly more women than men had high-risk sexual behavior (40. 5% of men claimed to regularly use condoms, versus only 22.7% of the women and 11.9% of the women accepted anal penetration versus only 8. 4% of men). The general assumption is that students, who have a high level of education, should be well informed concerning AIDS and STDs and should therefore have positive attitudes and responsible sexual behavior. This study demonstrates that the assumption bears no resemblance to reality. The students were aware of the way in which HIV is transmitted and of what construes risky behavior, but there was nonetheless a high frequency of high-risk behavior (e.g. multiple sexual partners, anal and oral sex, homosexuality, intravenous drug use). The behavior of the students was not significantly different from that of young people living on the streets of Lomé. There were significant relationships between knowledge and attitudes and between some types of sexual behavior and knowledge. However, there was no correlation between attitudes and behavior. The education of young people should focus on both the prevention of AIDS and STDs and on facing up to these diseases.

Molecular genotyping of HIV-1 in 61 patients with AIDS from Lomé, Togo.

To study the distribution of HIV types and genotypes, in Lomé, Togo, a random population of patients who met the clinical criteria of the Bangui definition of AIDS and were positive with two independent screening assays for antibodies to HIV-1 group M, HIV-2, and HIV-1 group O was selected. HIV RNA from serum samples was reverse-transcribed and amplified with degenerate primers annealing to conserved regions of the HIV-1, HIV-2, and HIV-O gag gene. Amplicons were directly sequenced using an automated sequencer. A 262-271-bp (strain-dependent) fragment of the gag gene from each patient was phylogenetically analyzed and compared to the corresponding gag sequences of published HIV-1 sequences of known African genotypes. Genotype A was found in 48 of 60 patient amplicons (80%), subdivided into two clusters. Ten patients (16.7%) were HIV-1 genotype G; one was genotype D and one genotype H. HIV-1 genotype B was not found. Amplicons from two patients contained sequence ambiguities, requiring cloning and sequencing of the gag insert. One patient (T52) was apparently infected with HIV-1 genotypes A and G; whereas HIV-1 from patient T139 was of genotype A, with 2/10 clones having a three-codon insertion at nucleotide position 1142 of the gag gene. HIV-1 genotype A is dominant in Togo; genotype G is frequent and genotype B has not been found.

[Retinal complications in AIDS patients at the Lomé (Togo) University Hospital]. / Les complications rétiniennes chez des patients atteints de SIDA au CHU de Lomé (Togo).

BACKGROUND: The purpose of this study was to describe retinal complications observed in patients presenting with AIDS at Lome teaching hospital. MATERIAL: All patients who met WHO AIDS clinical case diagnostic in Africa, admitted for various signs in hospital, were followed between December 1996 and May 1997 for ocular examinations. RESULTS: We surveyed 94 patients; 41 (43.6%) had retinal lesions. Retinal complications were cotton whool spots (30 cases), retinal hemorrhages (4 cases), papilloedema (4 cases), cytomegalovirus retinitis (8 cases). Mortality in patients with retinal complications occurred 10 months after the clinical diagnosis of AIDS. CONCLUSION: This study has found a high retinal morbidity contrasting with other studies in Africa. This could be explained by the longer period of follow-up larger than in previous similar studies.

[Risk factors for the development of diarrhea in children of 6-36 months carrying enteropathogenic microbes (apropos of 130 cases observed in Lomé-Togo)]. / Etude des facteurs de risque diarrhéogène chez l'enfant de 6-36 mois porteur de germes entéropathogènes (à propos de 130 cas observés à Lomé-Togo).

Diarrhoea, an important cause of infant morbidity and mortality is a priority problem in developing countries. The diarrhoea is most often of infectious origin. This is an evaluation of the parameters susceptible of influencing the carrying of enteropathogenic agents and the apparition of diarrhoea in children 6-36 months of age living in urban and peri-urban areas in the tropics. The study concerns 130 children divided between well nourished and malnourished. To the parameter "nutritional status" most often used in the different studies one finds in the literature, we chose to add a combination of others regrouped under the categories of "type of feeding" and "environmental factors". In our socio-cultural context, these last two parameters are intimately linked to the mother who lives in symbiosis with her child at least until 36 months of age. At the end of the study we were able to put together the results of research on carriage of a large gamut of enteropathogenic agents (parasites, bacteria, viruses) with our chosen parameters. This allowed us observe all the interactions between these two variables, particularly relating to onset of diarrhoea. We were thus able to conclude that the factors characterizing "Food hygiene and environmental hygiene play the most important role whatever the nutritional status of child".