[Complications of female genital mutilation: epidemiology and management of cases at Ouahigouya regional teaching hospital, Burkina Faso]. / Complications des mutilations génitales féminines : épidémiologie et prise en charge des cas au Centre hospitalier universitaire (CHU) régional de Ouahigouya, Burkina Faso.

Background: Female genital mutilation is still common in Burkina Faso, despite decades of struggle against its practice. The northern region of this country has one of the highest prevalence of this practice at the national level with 76% of women mutilated. The objective of our study was to describe the health complications of female genital mutilation treated in the referral hospital in this region. Patients and methods: This was a descriptive cross-sectional study with retrospective data collection over a 13-year period, from September 15, 2009 to September 14, 2022. Patients admitted for genital or loco-regional complications related to genital mutilation were included. Mutilated parturients without infibulation, victims of vulvar tears or who had undergone episiotomy were not included. Results: We recorded 204 patients, representing 3,1% of consultants, and an annual frequency of 15.7 cases. The ages of the victims ranged from 15 months to 31 years. The 15-20 age group was the most represented (49.3%). Victims were more likely to come from urban than rural areas. The main reasons for consultation were vulvar stricture, dyspareunia, impossibility of sexual intercourse, and dysuria. These were medium- and long-term complications of the mutilation. These complications were related to infibulation in 81.8% of cases and to type II mutilation in 18.2%. Surgery accounted for 89.9% of treatments, with drug treatments alone accounting for 10.1%. Deinfibulation was the most common surgical procedure. No clitoral reconstruction was performed. The outcome was favourable in all cases. Conclusion: There are many local and regional complications of genital mutilation, but fortunately their treatment has a good anatomical prognosis. However, psychological complications remain to be evaluated and managed in our context. The management of these complications should be an opportunity to raise awareness among the patients' family circles to abandon the practice.

Diagnostic Accuracy of an Indirect Enzyme Linked Immunosorbent Assay (iELISA) for Screening of Babesia bovis in Cattle from West Africa.

The epidemiology of corresponding tick-borne diseases has changed as a result of the recent introduction of Rhipicephalus (Boophilus) microplus to West Africa. The current study aimed to assess the diagnostic performance of an indirect ELISA for the detection of Babesia bovis infection in cattle. In a cross-section study, using a Bayesian Latent Class Model and iELISA diagnostic test for cattle babesiosis due to Babesia bovis, accuracy has been assessed with RT-PCR as an imperfect reference test. A total of 766 cattle were tested. The optimal diagnostic performances were obtained with 5% percentage of positivity. Sensitivity and specificity were, respectively, 0.94 [Cr. I.: 0.85−0.99] and 0.89 [Cr. I.: 0.87−0.92]. Additional diagnostic characteristics revealed that the Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 96.6% [Cr. I.: 92.7−100%] and 82.2% [Cr. I.: 72−93%]. Overall, this test well discriminates an infected status from an uninfected status considering the area under the ROC curve (AUC) which was 0.78 [Cr. I: 0.72−0.85] and a Diagnostic Odds Ratio (DOR) of 127.8 [Cr. I.: 10.43−1562.27]. The AUC was significantly higher than 0.5 (p < 10−5). In consequence, this serologic assay could be suitable in moderate to high prevalence assessments.

[A case of large Mucinous Cystadenoma of the Ovary at the Regional Teaching Hospital of Ouahigouya (Burkina Faso)]. / Un cas de volumineux Cystadénome Mucineux de l'ovaire au Centre Hospitalier Universitaire Régional De Ouahigouya (Burkina Faso).

Introduction: A benign tumor of middle-aged women, mucinous cystadenoma accounts for about 20% of tumors of the ovary. It can reach very large sizes. Clinical observation: We report the case of a 42-year-old patient received for a voluminous abdomino-pelvic mass. The examination found a soft, rounded, fairly mobile abdomino-pelvic mass going up to the level of the xiphoid appendix with a light skin and collateral venous circulation. Imaging showed a circumscribed fluid formation occupying the abdomino-pelvic cavity of 40.1 x 29 x 25.7 cm developed at the expense of the ovary. A laparotomy brought to light a voluminous cyst at the expense of the left ovary with fluid content cowardly adhering to the abdominal wall and intimately to the left proboscis. The uterus and right adnexa were unremarkable. We performed a left adnexectomy with satisfactory hemostasis taking away the cyst. The adnexectomy piece weighed 13.5 kg. The surgical follow-ups were simple. Anatomo-pathological examination confirmed a mucinous cystadenoma of the ovary. Conclusion: Mucinous cystadenoma of the ovary is a benign tumor which can reach very large volumes. Its treatment is surgical and the follow-ups are usually simple.

Incidences of Rhipicephalus (Boophilus) microplus (Canestrini, 1888) Transmitted Pathogens in Cattle in West Africa.

CONTEXT AND PURPOSE: In a context of recent introduction of Rhipicephalus (Boophilus) microplus tick species in West Africa, the purpose of the authors is to estimate incidence density of cattle babesiosis either caused by Babesia bigemina or Babesia bovis, and cattle anaplasmosis. Incidence density represents how quickly a disease or a condition is occurring amongst a group of individuals at risk. METHODS: The longitudinal and prospective study design took place in south, centre, east, west and north of Côte d'Ivoire. Cattle have been followed for 12 months. At the end of each month, each animal has been RT-PCR tested for new infection by Babesia bovis, Babesia bigemina, and PCR-RFLP tested for new infection by Anaplasma marginale. RESULTS: Findings show for the study area that incidence densities of Babesia bovis, Babesia bigemina and Anaplasma marginale infections in Côte d'Ivoire are, respectively, 15.3 new infections [95% CI 13.1-17.88] per 100 cattle, 32.2 new infections [95% CI 28.5-36.3] per 100 cattle, and 25.9 new infections [95% CI 22.5-29.6] per 100 cattle. CONCLUSION: Finally, there is increasing of infection incidence density following the region distance from the coast or elevation.

Concordance of vaccination status and associated factors with incomplete vaccination: a household survey in the health district of Segou, Mali, 2019.

INTRODUCTION: the region of Segou recorded 36.8% of children were incompletely vaccinated in 2018. In 2019, the district of Segou was one of the districts with the lowest vaccination coverage in the region, with 85.1% coverage for the three doses of the pentavalent vaccine and 85.4% for the measles vaccine. This study was initiated to better understand this low vaccination coverage, in the absence of specific studies on vaccination coverage in the district of Segou. METHODS: a prospective cross-sectional study was conducted from May to August 2020 with 30 clusters. We performed Kappa coefficient, bivariate, and multiple logistic regression analysis. RESULTS: findings showed that 18.46% (101/547) [15.44-21.93] of children were incompletely vaccinated. Mothers correctly reported the vaccination status of their children in 67.30% of cases (Kappa coefficient). Uneducated (OR[IC95%]=2.13[1.30-3.50]), living in rural area (OR[IC95%]=2.07[1.23-3.47]), lack of knowledge of Expanded Program on Immunization (EPI) target diseases (OR[IC95%]=2.37[1.52-3.68]), lack of knowledge of vaccination schedule (OR[IC95%]=3.33[1.90-5.81]) and lack of knowledge of the importance of vaccination (OR[IC95%]=3.6[2.35-6.32]) were associated with incomplete vaccination. In multivariate analysis, uneducated (ORa[IC95%>]=1.68[1.004-2.810]) and lack of knowledge of the importance of vaccination were associated with incomplete vaccination (ORa[IC95%]=3.40[2.049-5.649]). CONCLUSION: findings showed a good concordance of the vaccination status. Living in a rural area, no education, lack of the knowledge of EPI target diseases, lack of the knowledge of vaccination schedule and lack of knowledge of the importance of vaccination were associated with incomplete vaccination.

Distribution of bovine Fasciola gigantica (Cobbold, 1885) in the district des Savanes, northern Côte d'Ivoire.

Fascioliasis, caused by an infection with liver flukes of the genus Fasciola, is an important disease of livestock in most parts of the world. However, little is known about the distribution of fascioliasis in sub-Saharan Africa. We report results of a cross-sectional study conducted in 2014 in the district des Savanes in the northern part of Côte d'Ivoire. We obtained 275 livers from bovine suspected with fascioliasis and 51 unsuspected livers from 24 slaughterhouses. Livers were dissected using a standard operating procedure and all Fasciola gigantica flukes were removed from the tissues of the liver and the biliary ducts. We found F. gigantica in 125 livers from bovines suspected with fascioliasis (45.5%) in 10 departments of the district des Savanes. Among the unsuspected livers, five were positive for F. gigantica (9.8%). The distribution of fascioliasis showed considerable spatial heterogeneity, both at regional (ranging from 18.0% to 52.3%) and departmental level (ranging from 14.3% to 64.0%). Poro region was the most affected (52.3%) with a relatively homogeneous distribution. The departments most affected by fascioliasis were M'Bengué (64.0%), Sinématiali (62.1%) and Ferkessédougou (52.9%). Our study confirms that fascioliasis is an important veterinary disease in the northern part of Côte d'Ivoire, and hence, high-risk areas need to be targeted for prevention and control measures.

Identification of High-Yielding Iron-Biofortified Open-Pollinated Varieties of Pearl Millet in West Africa.

Pearl millet is a predominant food and fodder crop in West Africa. This study was carried out to test the newly developed open-pollinated varieties (OPVs) for field performance and stability for grain yield, grain iron (Fe), and grain zinc (Zn) contents across 10 locations in West Africa (i.e., Niger, Nigeria, Mali, Burkina Faso, Senegal, and Ghana). The test material consisted of 30 OPVs, of which 8 are Fe/Zn biofortified. The experiment was conducted in a randomized complete block design in three replications. ANOVA revealed highly significant variability for grain yield and micronutrient traits. The presence of genotype × environment (G × E) indicated that the expressions of traits are significantly influenced by both genetic and G × E factors, for grain Fe and Zn contents. Days to 50% flowering and plant height showed less G × E, suggesting these traits are largely under genetic control. The genotypes CHAKTI (46 days), ICTP 8203 (46 days), ICMV 177002 (50 days), ICMV 177003 (48 days), and Moro (53 days) had exhibited early flowering across locations leading to early physiological maturity. CHAKTI (1.42 t/ha yield; 62.24 mg/kg of grain Fe, 47.29 mg/kg of grain Zn) and ICMP 177002 (1.19 t/ha yield, 62.62 mg/kg of grain Fe, 46.62 mg/kg of grain Zn) have performed well for grain yield and also for micronutrients, across locations, compared with the check. Additive Main Effect and Multiplicative Interaction (AMMI) ANOVA revealed the highly significant genotypic differences, the mean sum of squares of environment, and its interaction with the genotypes. Based on the AMMI stability value (ASV), the most stable genotype is SOSAT-C88 (ASV = 0.04) for grain yield and resistance to downy mildew; mean grain yield and stability rankings (YSI) revealed that the genotypes CHAKTI, SOSAT-C88, and ICMV IS 99001 were high yielding and expressed stability across regions. The strong correlation (r = 0.98∗∗) of grain Fe and Zn contents that merits Fe-based selection is highly rewarding. CHAKTI outperformed over other genotypes for grain yield (71% higher), especially with early maturing varieties in West Africa, such as GB 8735, LCIC 9702, and Jirani, and for grain Fe (16.11% higher) and Zn (7% higher) contents across locations, and made a candidate of high-iron variety to be promoted for combating the micronutrient malnutrition in West and Central Africa (WCA).

Peoples' attitude toward COVID-19 vaccine, acceptance, and social trust among African and Middle East countries.

Background: To end the COVID-19 pandemic, a large part of the world must be immune to the virus by vaccination. Therefore, this study aimed to gauge intent to be vaccinated against COVID-19 among ordinary people and to identify attitudes towards vaccines and barriers for vaccine acceptance. Methods: The study population comprises 1880 people residing in different countries that answer a prepared questionnaire. The questionnaire topics are demographics, historical issues, participants' attitudes and beliefs regarding vaccines, concerns, and vaccine hesitancy. Results: Attitudes and beliefs relating to vaccines in general, and the COVID-19 vaccine, were ascertained. Overall, 66.81% of the contributors would like to be vaccinated against COVID-19, while %33.19 did not intend to be vaccinated. Reasons for COVID-19 vaccine hesitancy included concern regarding vaccine side effects, fear of getting sick from the uptake of the vaccine, and the absence of accurate vaccine promotion news. Individuals with higher education believe that India (68.6%) produces the best vaccine (P <0.001), while healthcare workers think the Chinese vaccine (44.2%) is the best (P =0.020). Individuals with higher education have not been vaccinated, not be healthcare workers, and females were the most contributors to effective of the vaccine in reducing mortality from COVID-19 disease. Conclusion: Given the degree of hesitancy against COVID-19 vaccination, a multifaceted approach to facilitate vaccine uptake that includes vaccine education, behavioral change strategies, and health promotion, is paramount.

Fighting COVID-19 in the West Africa after experiencing the Ebola epidemic.

Coronavirus disease 2019 (COVID-19) dissemination occurred from December 2019 and quickly spread to all countries. Infected patients with COVID-19 have had a wide range of symptoms, ranging from mild to severe illness. The most mortality was observed in patients with underlying disease and over 45 years. World statistics have shown that the COVID-19 outbreak is most expanded in Middle Eastern, West Asian, European, North, and South American countries, and is least expanded in African countries. Therefore, the aim of the paper was the evaluation of six African countries including Mali, Mauritania, Niger, Guinea, Togo, and Djibouti to find why this disease is least expanded in African countries. Study was conducted by Questioner for countries health organizers to define their different aspect exposure and fight with COVID-19 including epidemiology, clinical aspects of the disease, case definitions, diagnosis laboratory confirmation, and referral of cases by the portal of entry, case management, and disease prevention in these countries. According to this opinion review, due to the low international flights and low domestic travel, the spread, and prevalence of COVID-19 was low and the return of the immigrants of these countries has caused the spread of COVID-19 among these countries. Experience, preparation, and impact of previous infections epidemic such as the Ebola virus epidemic would have beneficial, which have promoted certain reflexes among people that cause low dissemination in these countries.

Genome sequence and genetic diversity analysis of an under-domesticated orphan crop, white fonio (Digitaria exilis).

BACKGROUND: Digitaria exilis, white fonio, is a minor but vital crop of West Africa that is valued for its resilience in hot, dry, and low-fertility environments and for the exceptional quality of its grain for human nutrition. Its success is hindered, however, by a low degree of plant breeding and improvement. FINDINGS: We sequenced the fonio genome with long-read SMRT-cell technology, yielding a ∼761 Mb assembly in 3,329 contigs (N50, 1.73 Mb; L50, 126). The assembly approaches a high level of completion, with a BUSCO score of >99%. The fonio genome was found to be a tetraploid, with most of the genome retained as homoeologous duplications that differ overall by ∼4.3%, neglecting indels. The 2 genomes within fonio were found to have begun their independent divergence ∼3.1 million years ago. The repeat content (>49%) is fairly standard for a grass genome of this size, but the ratio of Gypsy to Copia long terminal repeat retrotransposons (∼6.7) was found to be exceptionally high. Several genes related to future improvement of the crop were identified including shattering, plant height, and grain size. Analysis of fonio population genetics, primarily in Mali, indicated that the crop has extensive genetic diversity that is largely partitioned across a north-south gradient coinciding with the Sahel and Sudan grassland domains. CONCLUSIONS: We provide a high-quality assembly, annotation, and diversity analysis for a vital African crop. The availability of this information should empower future research into further domestication and improvement of fonio.

Evolution of Malaria Incidence in Five Health Districts, in the Context of the Scaling Up of Seasonal Malaria Chemoprevention, 2016 to 2018, in Mali.

CONTEXT: In Mali, malaria transmission is seasonal, exposing children to high morbidity and mortality. A preventative strategy called Seasonal Malaria Chemoprevention (SMC) is being implemented, consisting of the distribution of drugs at monthly intervals for up to 4 months to children between 3 and 59 months of age during the period of the year when malaria is most prevalent. This study aimed to analyze the evolution of the incidence of malaria in the general population of the health districts of Kati, Kadiolo, Sikasso, Yorosso, and Tominian in the context of SMC implementation. METHODS: This is a transversal study analyzing the routine malaria data and meteorological data of Nasa Giovanni from 2016 to 2018. General Additive Model (GAM) analysis was performed to investigate the relationship between malaria incidence and meteorological factors. RESULTS: From 2016 to 2018, the evolution of the overall incidence in all the study districts was positively associated with the relative humidity, rainfall, and minimum temperature components. The average monthly incidence and the relative humidity varied according to the health district, and the average temperature and rainfall were similar. A decrease in incidence was observed in children under five years old in 2017 and 2018 compared to 2016. CONCLUSION: A decrease in the incidence of malaria was observed after the SMC rounds. SMC should be applied at optimal periods.

[Urocolpos and reflux of urine into the uterus in the aftermath of female genital mutilation at the Regional Teaching Hospital of Ouahigouya, Burkina Faso]. / Urocolpos et reflux d'urine dans l'utérus dans les suites de mutilations génitales féminines au Centre hospitalier universitaire régional de Ouahigouya, Burkina Faso.

Introduction: Urocolpos is rare as is the reflux of urine into the uterus which may be associated with it. Female genital mutilation (FGM) is a rarely described cause. We present two cases, one of which is associated with reflux of urine into the uterus. Clinical cases: Two 7-year-old and 15-month-old girls presented after FGM with pelvic pain, pushing dysuria, and episodes of urine retention. Results: It was the pelvic ultrasound which made it possible to objectify an urocolpos associated in the 7-year-old patient with reflux of urine into the uterine cavity. Bacteriology has isolated Escherichia coli from urine. Deinfibulation and antibiotic therapy restored normal urination. Urocolpos and reflux of urine into the uterus may be due to FGM. Conclusion: There are some signs that suggest urocolpos in the context of FGM, but the ultrasound is important for the diagnosis.

Estimation of dog population and dog bite risk factors in departments of San Pedro and Bouake in Côte d'Ivoire.

Rabies is endemic in Côte d'Ivoire and was identified in January 2017 as a priority zoonosis by all stakeholders in public health. A well-designed integrated national rabies control is essential to attain the objective of zero human deaths from dog rabies by 2030. The current study describes the complementary elements of dog bite risk factors and the dog population estimate that are relevant for planning sustainable interventions. We conducted a transverse survey in 8'004 households in the departments of San Pedro (4'002) and Bouaké (4'002), covering both rural and urban areas. The dog-household ratio was estimated at one dog for three households (0.33) or one dog for 20 people (0.05). The owned canine population on a national level was estimated at 1'400'654 dogs (range 1'276'331 to 1'535'681). The main dog bite risk factors were dog ownership, being male, and living in urban San Pedro Department. The results lay a foundation for public engagement and further steps for mass vaccination of the household dog population to reach vaccination coverage of at least 80%. Stakeholders further recommend raising awareness of dog owners, reinforcing knowledge in school children and young boys, and behavior changes towards domestic animals.

[A 36 weeks heterotopic pregnancy discovered incidentally at the Regional University Hospital of Ouahigouya]. / Une grossesse heterotopique de 36 semaines de decouverte fortuite au centre hospitalier Universitaire Regional de Ouahigouya (Burkina Faso).

Heterotopic pregnancy is a rare entity, its development up to term is exceptional. We report a case of heterotopic pregnancy of fortuitous discovery during a caesarean section performed in a 26-year-old female patient received for abdomino-pelvic pain on suspected twin pregnancy of 33 SA. No obstetric ultrasound had been performed before admission. Two ultrasound ultrasounds have objectified an intrauterine twin pregnancy with hydramnios. A caesarean section at 36 weeks indicated for twin pregnancy with hydramnios and severe anemia was performed during which we discovered an intrauterine pregnancy and an abdominal pregnancy with insertion of the placenta at the level of the broad left ligament with adhesion on the left annex, Omentum and small handles. Newborns did not require any special care outside the classical essential care. The first intrauterine had a weight of 2650 g and the second abdominal of 2000 g. The postoperative sequences were simple.

La grossesse hétérotopique est une entité rare, son développement jusqu'à terme est exceptionnel. Nous rapportons un cas de découverte fortuite chez une patiente de 26 ans, reçue pour douleurs abdomino-pelviennes sur grossesse présumée gémellaire de 33 SA. Aucune échographie obstétricale n'avait été réalisée avant son admission. Deux échographies tardives ont objectivé une grossesse gémellaire intra utérine avec hydramnios. Une césarienne à 36 semaines indiquée pour grossesse gémellaire avec hydramnios et anémie sévère a été réalisée au cours de laquelle nous avons découvert une grossesse intra-utérine et une grossesse abdominale avec insertion du placenta au niveau du ligament large gauche avec adhérence sur l'annexe gauche, l'épiploon et les anses grêles.Les nouveaunés étaient bien portant. J1 intra utérin avait un poids de 2650 g et J2 abdominal de 2000g. Les suites ont été simples.

Une grossesse hétérotopique de 36 semaines de découverte fortuite au centre hospitalier universitaire régional de Ouahigouya (Burkina Faso)

Nous rapportons un cas de découverte fortuite chez une patiente de 26 ans, reçue pour douleurs abdomino-pelviennes sur grossesse présumée gémellaire de 33 SA. Aucune échographie obstétricale n'avait été réalisée avant son admission. Deux échographies tardives ont objectivé une grossesse gémellaire intra utérine avec hydramnios. Une césarienne à 36 semaines indiquée pour grossesse gémellaire avec hydramnios et anémie sévère a été réalisée au cours de laquelle nous avons découvert une grossesse intra-utérine et une grossesse abdominale avec insertion du placenta au niveau du ligament large gauche avec adhérence sur l'annexe gauche, l'épiploon et les anses grêles.Les nouveau-nés étaient bien portant. J1 intra utérin avait un poids de 2650 g et J2 abdominal de 2000g. Les suites ont été simples

A full term abdominal pregnancy with an isthmic tubal implantation of the placenta.

BACKGROUND: Abdominal pregnancy is defined as the partial or total insertion of the embryo into the abdominal cavity. It is rare, and can evolve towards the full term if it is not recognized in the early pregnancy. It carries a high risk of maternal-fetal morbidity and mortality. CASE PRESENTATION: We report a case of a 22 year-old gravida IV, para II with an asymptomatic and undiagnosed abdominal pregnancy presumed full term, in a context of health centers under-equipment. She had attended 5 routine antenatal care, but had not performed any ultrasound scan. She had been transferred from a medical center to the Hospital of Ouahigouya (Burkina Faso) for bowel sub-obstruction and intrauterine fetal death, with failure of labor induction. On admission, the hypothesis of uterine rupture or abdominal pregnancy with antepartum fetal demise was considered. A laparotomy was then performed, where an abdominal pregnancy was discovered, and a dead term baby weighing 3300 g delivered. The placenta which was implanted into the ruptured isthmus of the left fallopian tube was removed by salpingectomy. Postoperative follow-up was uneventful. CONCLUSION: This case report exposes the necessity for the practitioner to think about the possibility of abdominal pregnancy in his clinical and sonographic practice, irrespective of the gestational age, mainly in contexts where there is under-equipment of the health centers.

Melioidosis in Africa: Time to Uncover the True Disease Load.

Melioidosis is an often fatal infectious disease with a protean clinical spectrum, caused by the environmental bacterial pathogen Burkholderia pseudomallei. Although the disease has been reported from some African countries in the past, the present epidemiology of melioidosis in Africa is almost entirely unknown. Therefore, the common view that melioidosis is rare in Africa is not evidence-based. A recent study concludes that large parts of Africa are environmentally suitable for B. pseudomallei. Twenty-four African countries and three countries in the Middle East were predicted to be endemic, but no cases of melioidosis have been reported yet. In this study, we summarize the present fragmentary knowledge on human and animal melioidosis and environmental B. pseudomallei in Africa and the Middle East. We propose that systematic serological studies in man and animals together with environmental investigations on potential B. pseudomallei habitats are needed to identify risk areas for melioidosis. This information can subsequently be used to target raising clinical awareness and the implementation of simple laboratory algorithms for the isolation of B. pseudomallei from clinical specimens. B. pseudomallei was most likely transferred from Asia to the Americas via Africa, which is shown by phylogenetic analyses. More data on the virulence and genomic characteristics of African B. pseudomallei isolates will contribute to a better understanding of the global evolution of the pathogen and will also help to assess potential differences in disease prevalence and outcome.

Exploring the Diversity of Field Strains of Brucella abortus Biovar 3 Isolated in West Africa.

Brucellosis is one of the most widespread bacterial zoonotic diseases in the world, affecting both humans and domestic and wild animals. Identification and biotyping of field strains of Brucella are of key importance for a better knowledge of the epidemiology of brucellosis, for identifying appropriate antigens, for managing disease outbreaks and for setting up efficient preventive and control programmes. Such data are required both at national and regional level to assess potential threats for public health. Highly discriminative genotyping methods such as the multiple locus variable number of tandem repeats analysis (MLVA) allow the comparison and assessment of genetic relatedness between field strains of Brucella within the same geographical area. In this study, MLVA biotyping data retrieved from the literature using a systematic review were compared using a clustering analysis and the Hunter-Gaston diversity index (HGDI). Thus, the analysis of the 42 MLVA genotyping results found in the literature on West Africa [i.e., from Ivory Coast (1), Niger (1), Nigeria (34), The Gambia (3), and Togo (3)] did not allow a complete assessment of the actual diversity among field strains of Brucella. However, it provided some preliminary indications on the co-existence of 25 distinct genotypes of Brucella abortus biovar 3 in this region with 19 genotypes from Nigeria, three from Togo and one from Ivory Coast, The Gambia, and Niger. The strong and urgent need for more sustainable molecular data on prevailing strains of Brucella in this sub-region of Africa and also on all susceptible species including humans is therefore highlighted. This remains a necessary stage to allow a comprehensive understanding of the relatedness between field strains of Brucella and the epidemiology of brucellosis within West Africa countries.

Dental students' HIV/AIDS-related knowledge, attitudes, and intentions: impact of the U.S. Health Resources and Services Administration's community-based dental partnership program.

Access to oral health care for vulnerable populations is one of the concerns addressed by the U.S. Health Resources and Services Administration HIV/AIDS Bureau's Community-Based Dental Partnership Program (CBDPP). The program introduces dental students and residents at several dental schools to care for vulnerable patients through didactic and clinical work in community-based dental settings. This study of the dental students and residents in this program answered three questions: 1) What are their HIV knowledge, attitudes, and behaviors? 2) How has participation in the CBDPP impacted their knowledge, attitudes, and behaviors? 3) Has the intervention affected their work placement decisions and attitudes after graduation, particularly with respect to treating people living with HIV and other underserved populations? A total of 305 first- through fourth-year dental students and first- and second-year residents at five dental schools across the United States completed surveys before and after a community-based rotation and following graduation. Response rates at each of the five schools ranged from 82.4 to 100 percent. The results showed an increase in the participants' knowledge and positive attitudes regarding treatment for patients with HIV and other vulnerable populations post-rotation compared to pre-rotation. Results after graduation found that most respondents were practicing in private settings or in academic institutions as residents but were willing to treat a diverse patient population. These findings support the role of training programs, such as the CBDPP, for expanding the dental workforce to treating vulnerable populations including people living with HIV/AIDS.