Using adult care visits to diagnose HIV infection in children, Burkina Faso.

Objective: To estimate the feasibility, positivity rate and cost of offering child testing for human immunodeficiency virus (HIV) to mothers living with HIV attending outpatient clinics in Burkina Faso. Methods: We conducted this implementation study in nine outpatient clinics between October 2021 and June 2022. We identified all women ≤ 45 years who were attending these clinics for their routine HIV care and who had at least one living child aged between 18 months and 5 years whose HIV status was not known. We offered these mothers an HIV test for their child at their next outpatient visit. We calculated intervention uptake, HIV positivity rate and costs. Findings: Of 799 eligible children, we tested 663 (83.0%) and identified 16 new HIV infections: 2.5% (95% confidence interval, CI: 1.5-4.1). Compared with HIV-negative children, significantly more HIV-infected children were breastfed beyond 12 months (P-value: 0.003) and they had not been tested before (P-value: 0.003). A significantly greater proportion of mothers of HIV-infected children were unaware of the availability of child testing at 18 months (P-value: < 0.001) and had more recently learnt their HIV status (P-value: 0.01) than mothers of HIV-negative children. The intervention cost 98.1 United States dollars for one child testing HIV-positive. Barriers to implementing this strategy included shortages of HIV tests, increased workload for health-care workers and difficulty accessing children not living with their mothers. Conclusion: Testing HIV-exposed children through their mothers in outpatient clinics is feasible and effective in a low HIV-prevalence setting such as Burkina Faso. Implementation of this strategy to detect undiagnosed HIV-infected children is recommended.

Impact of Carotid atheroma on cardiovascular risk in Mauritanian hypertensive patients.

AIM: To determine the prevalence of carotid atheroma in hypertensive patients and assess the levels of cardiovascular risk. METHODS: This is a prospective study that took place in the outpatient department of the National Cardiology Center of Nouakchott over a period of 6 months (October 2019 to March 2020). Patients with hypertension without complications were included. Patients lost to followup and those whose records were incomplete were excluded from the study. RESULTS: Out of a total of 171 patients, a total of 93 patients (54.38%) was collected, of which 54.8% were women, 55.9% of the patients in the series were over 50 years old.The associated cardiovascular risk factors were dominated by dyslipidemia (27.9%), diabetes (20.4%), smoking (26.8%). hypertension was grade 2 in 47.3% of patients and grade 3 in 52.7% of patients. Left ventricular hypertrophy was noted in 77.4% of patients. Echo-Doppler of the supra-aortic trunks revealed atherosclerotic plaques in 63.4% of patients. CONCLUSION: The prevalence of carotid atheroma in hypertensive patients at high cardiovascular risk level was frequent in our series, it follows from this to recommend early detection for optimal management.