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Challenges of Rheumatoid Arthritis Management in Sub-Saharan Africa in the 21st Century

Open Journal of Rheumatology and Autoimmune Diseases 2023年第1期13卷 17-40页

作者： malewe kolou Department of Fundamental and Biological Sciences Faculty of Health Sciences (FSS) University of Lome Lome Togo

In recent decades, several advances have been made in the management of rheumatoid arthritis (RA) both in the diagnostic field and in the therapeutic field. Unfortunately, RA remains poorly studied in black Africa. Epidemiological data are rare and controversial. The estimated prevalence of RA in Africa is about 0% - 2.54%. Risk factors associated with RA must be studied by taking into account special features of black Africa such as the low tobacco consumption in certain regions, the tropical climate and the high frequency of endemic parasitic and viral infections. The initially supposed mildness of RA in black Africa is increasingly challenged. The diagnosis is often made too late because of the scarcity of rheumatologists and ignorance. Diagnostic tools are limited to the clinical data, the erythrocyte sedimentation rate and radiographs as the other tools are poorly available. In addition, there are misconceptions in African communities, responsible for loss of sight during follow-up and treatment discontinuations. This is exacerbated by the shortage of disease-modifying anti-rheumatic drugs (DMARDs) and the inability to afford them. Furthermore, biological agents are very difficult to access. Further studies are essential to better understand the characteristics of RA in black Africa. Thus, collaborations between African and Western research teams seem very important. In order to make available the DMARDs especially biological agents, pharmaceutical companies can contribute through research partnerships. Moreover, governments should provide a better place for chronic inflammatory diseases in the programs against non-communicable diseases. Finally, training must also be promoted to increase the number of specialists and the level of knowledge of other health workers.

关键词： Rheumatoid Arthritis Black Africa Rheumatoid Factor Anti-Cyclic Citrullinated Peptide Antibodies

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CD4 T-Lymphocytes Count in HIV-<i>Toxoplasma gondii</i>Co-Infected Pregnant Women Undergoing a Prevention of Mother-to-Child Transmission Program

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Journal of Biosciences and Medicines 2018年第4期6卷 76-84页

作者： Gnatoulma Katawa malewe kolou Liza Koboyo Nadjir Essoham Ataba Gatigbene Bomboma Simplice Damintoti Karou Ecole Superieure des Techniques Biologiques et Alimentaires (ESTBA-UL) Universite de Lome Lomé Togo Laboratoire de Biologie Moleculaire et d’Immunologie (BIOLIM) Universite de Lome Lomé Togo

Toxoplasma gondii (T. gondii) is a parasite responsible of toxoplasmosis, a disease often asymptomatic but with serious consequences in pregnant women and immunocompromised subjects. Objective: This study aimed to investigate the impact of T. gondii infection on CD4+ T lymphocytes count in HIV-infected pregnant women. Methods: This was a cross-sectional study of pregnant women co-infected by HIV and T. gondii. The study was conducted from January to July 2016 at the Prevention of Mother-to-Child Transmission of HIV (PMTCT) sites in the Health District of Lacs in Togo. Diagnosis of HIV was performed by immuno-chromatographic methods with Determine TM HIV-1/2 and immuno-filtration with Tri-Dot HIV-1 and 2 kits. Presence of anti-toxoplasmic IgG and IgM antibodies was established via enzyme immunoassay using ELISA-BIOREX®kit. Flow cytometry was used to count CD4+ T lymphocytes. Results: Our study found that of the 4599 pregnant women, 111 (2.41%) were HIV-positive. Among them, 109 (98.20%) were infected by HIV-1 and 2 (1.98%) by HIV-2. Antibodies against T. gondii were detected in 5.36% (IgM), 25% (IgG) and 3.57% (both IgM and IgG) of HIV 56 infected women. There was no significant difference between CD4 cell count in HIV (+)/T. gondii IgM (-)/IgG (-) infected pregnant women (378.8 ± 222.8 cell//μl) compared to HIV (+)/T. gondii/IgM (+) (457.3 ± 183.3 cell//μl), HIV (+)/T. gondii IgG (+) (419.4 ± 287.3 cell//μl) and HIV (+)/T. gondii IgM/IgG (+) (480.5 ± 252.4 cell/μl). Conclusion: This study showed that intracellular parasite T. gondii did not alter CD4+ T lymphocytes count in HIV/T. gondii co-infected pregnant women.

关键词： HIV Toxoplasma gondii Co-Infection CD4+ T Lymphocytes Count

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Challenges of Rheumatoid Arthritis Management in Sub-Saharan Africa in the 21st Century

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Open Journal of Rheumatology and Autoimmune Diseases（风湿病与自身免疫疾病期刊） 2023年第1期

作者： malewe kolou

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Trends in HIV-2 Seroprevalence at the National Reference Center of HIV from 2005 to 2014 in Lome, Togo

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World Journal of AIDS 2017年第4期7卷 239-246页

作者： Amivi Amenyah- Ehlan Mounerou Salou malewe kolou Komlan Ali- Edje Tufa Nyasenu Sika Dossim Alassane Ouro- Medeli Mensah Douffan Anoumou Dagnra Mireille Prince- David Laboratoire de Biologie Moleculaire et d’immunologie de la Faculte des Sciences de la Sante de l’Universite de Lome (BIOLIM/FSS-UL) Lome Togo Centre National de Reference Pour les Tests VIH et les IST (CNR-VIH) Lome Togo

Background: In Togo, the HIV/AIDS epidemic is characterized by the circulation of the 2 subtypes of HIV. Thus, patients infected with HIV-2 are diagnosed and monitored in the care centers. Objective: To document the trend of HIV-2 prevalence over a decade of activities of the National Reference Center for HIV tests and screening (CNR-VIH). Methods: A cross sectional study was carried out from the screening data archived from January 2005 to December 2014 at the CNR-VIH, a laboratory located in the Sylvanus Olympio University Hospital (CHU SO) Lome. The sampling consisted of adults and children outpatients or those who were hospitalized in CHU SO, subjects presenting for voluntary testing, pregnant women and patients or samples referred for HIV confirmation. All samples were tested for HIV-1 and HIV-2 infections by combining ELISA and rapid diagnostic tests. Result: During the decade, 34,077 subjects were screened for HIV infection. The overall prevalence of HIV infection was 20.70% (7055/34077). In 10 years, the prevalence of HIV infection in CNR-VIH decreased significantly from 35.40% CI95% [34.50% - 36.20%] in 2005 to 14.20% CI95% [13.60% - 14.70%] in 2014 (p = 0.03). The prevalence of HIV-1, HIV-2 and dual HIV1&HIV-2 was respectively 20.40%, 0.23% and 0.07%, with annual prevalence of HIV-2 between 0.07% and 0.39%. The differences between the HIV-2 prevalence over the decade were not statistically significant (p > 0.15). A 4-year-old child from mother-to-child HIV-2 transmission was diagnosed. Sixty-five percent of adult patients were over 40 years of age with an average age of 43.5 ± 11.3 years. Conclusion: Data from the National Reference Center for HIV Tests in Togo over the last ten years confirm the existence of a weak epidemic of HIV- 2 infection with a tendency towards stability.

关键词： HIV-2 Seroprevalence Togo

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