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Evolution of the Etiologies of Purulent Meningitis in Children over a Period of 24 Months in Conflict-Affected Rural Areas of the Central African Republic after the Introduction of 2 New Vaccines in the Expanded Vaccination Program

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Open Journal of Medical Microbiology 2023年第3期13卷 183-194页

作者： Rostand Kombaya Marie Colette Nganda Bangue Irenee Galendji Honorat Nouzoukem Edgar Tchoumateu Brice Olivier Bogning Mejiozem Freddy Samuel Ngbonga Konzapa Voulou henri saint clavaire diemer Christian Diamant Mossoro-Kpindé Pediatric University Hospital Complex Bangui Central African Republic (CAR) Régional University Hospital of Bria Bria Central African Republic (CAR) Régional University Hospital of Bossangoa Bossangoa Central African Republic (CAR) Faculty of Health Sciences The University of Bangui Bangui Central African Republic (CAR) National Laboratory of Clinical Biology and Public Health of Bangui Bangui Central African Republic (CAR)

Background and Objective: Purulent meningitis is a therapeutic emergency and remains a real public health problem in the world, particularly in limited resources countries. The study aimed to describe the epidemiological clinical, etiological and scalable features of purulent meningitis in children in Bria. Methods: A cross-sectional descriptive study was conducted from January 1, 2018 to December 31, 2019 (24 months). It included all suspected cases of purulent meningitis in children aged 0 to 15 years, confirmed by agglutination with Pastorex meningitis. A standard sheet was used to collect the data which was entered and analyzed on Epi Info 7 software. Results: A total of 37 cases of purulent meningitis were confirmed among 90 suspected cases. The female gender predominated (59.5%), with a sex ratio of 0.7. The age group from 0 to 11 months was majority (48.6%). Nearly 2 thirds of children were not vaccinated (64.8%). The most frequent functional signs were fever (83.8%), and convulsion (51.4%). The etiologies were Streptococcus (51.4%), Neisseria meningitidis (35.1%) and Haemophilus influenzae (13.5%). Therapeutic success under 3rd generation cephalosporin treatment was obtained in 86.5% including 8.1% with sequelae;13.5% of death was observed. Streptococcus was the most lethal bacterium at 21.1%. Conclusion: The results of these studies show that pediatric purulent meningitis is still common despite the availability of free vaccination. They require early therapeutic management to limit the occurrence of sequelae and death. Hence, it is important to strengthen prevention strategies.

关键词： Purulent Meningitis Children Epidemiology Etiologies Bria Central African Republic

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Incidence and Management of Occupational Blood Exposure (OBE) among Medical Students at the University of Bangui

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Occupational Diseases and Environmental Medicine 2024年第2期12卷 68-77页

作者： Hermione Dahlia Mossoro-Kpinde Caleb Koyambenguia Yves Kpangba Mangbé saint Calvaire henri diemer Ministè re du Travail de l&#8217Emploi de la Protection Sociale et de la Formation Professionnelle Bangui Central African Republic Dé partement de Sant&#233 Publique &#224 la Facult&#233 des Sciences de la Sant&#233 de l&#8217Universit&#233 de Bangui Bangui Central African Republic Centre Hospitalier Universitaire de l’ Amiti&#233 Sino-Centrafricaine de Bangui Bangui Central African Republic Département de Formation Continue à la Faculté des Sciences de la Santé de l’Université de Bangui Bangui Central African Republic

Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.

关键词： Incidence of Blood Exposure Accidents Medical Student Treatment Bangui

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Epidemiological Profile of Men Who Have Sex with Men: First Data about Male Sex Workers in Central African Republic (CAR)

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Advances in Sexual Medicine 2024年第1期14卷 1-11页

作者： Hermione Dahlia Mossoro-Kpinde Balekouzou Augustin Paola Julienne Demba henri saint Calvaire diemer Direction de la Médecine du Travail Ministère du Travail de l’Emploi de la Protection Sociale et de la Formation Professionnelle Ban-gui République Centrafricaine Comité National de Lutte contre le Sida Bangui République Centrafricaine Faculté des Sciences de la Santé Université de Bangui Bangui République Centrafricaine Département de Santé Publique Faculté des Sciences de la Santé Université de Bangui Bangui République Centrafricaine

Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample.

关键词： Men Who Have Sex with Men Sex Workers Gender-Based Violence Informal Sector Central Africa

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Socio-Demographic and Occupational Aspects of HIV-HBV Co-Infection in Bangui, Central African Republic (CAR): Hospital-Based Cross-Sectional Study

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Advances in Infectious Diseases 2024年第2期14卷 310-321页

作者： Gaspard Tékpa Hermione Dahlia Mossoro-Kpinde Jessy Guylaine Nazilari Gertrude Komoyo saint Calvaire henri Diémer Centre Hospitalier Universitaire de lAmiti Bangui Central African Rpublic (CAR) Dpartement de Mdecine Facult des Sciences de la Sant Universit de Bangui Bangui Central African Republic (CAR) Direction de la Mdecine du Travail Ministre du Travail de lemploi et de la Protection Sociale Bangui Central African Rpublic (CAR) Dpartement de Sant Publique Facult des Sciences de la Sant Universit de Bangui Bangui Central African Rpublic (CAR)

Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.

关键词： People Living with HIV HIV-HBV Co-Infection Occupation Informal Sector

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Prevalence of Gender-Based Violence among Sex Workers in Bangui, Central African Republic (CAR)

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Advances in Sexual Medicine 2024年第2期14卷 13-20页

作者： D. Mossoro-Kpinde Hermione S. C. diemer henri R. Tende Nzengou Richard S. Siki Francis J. D. D. Tekpa Bertrand Ministry of Labor Employment Social Protection and Vocational Training Bangui Central African Republic Department of Public Health Faculty of Health Sciences University of Bangui Bangui Central African Republic Community of the Tree of Life Bangui Central African Republic Traumatology Department The Central African Republic RCA Community Hospital Bangui Central African Republic

Background: Violence against women has become an international public health and human rights issue in recent decades. The violence suffered by sex workers is of little interest for research, yet it constitutes a major health and safety problem. We propose to assess the extent of the phenomenon of gender-based violence (GBV) among sex workers (SWs) in the city of Bangui in the CAR. Methodology: This is a descriptive cross-sectional epidemiological study covering the period from July to October 2021 carried out among SWs in Bangui, the capital of the CAR. Given that the SWs association had only 159 members in Bangui, an exhaustive sampling was retained. Were included in the study, any SW present during the data collection period and having given their written consent. The parameters studied were socio-demographic characteristics: age, sex, residence, level of education, marital status, and characteristics linked to violence: the notion of violence during their professional activity, the type of violence, the declaration and the declaration if necessary, the response and management of this violence. The data collected was analyzed using Epi info version 7 software. Results: Of the 159 SWs that counted the association, 108 had been included. The average age was 27.0 years with extremes of 14 and 46 years. The age groups of 25 to 34 years were the most represented (43.5%). Fifty-six SWs (51.9%) had reached the secondary level. Unemployed SWs were in the majority at 74.1%;Sixty-six (66) SWs in our sample (61.1%) had already been victims of violence during the exercise of their activity Sexual violence was the most represented (28.5%) followed by verbal violence (22.4%). Sixty-eight (62.9%) wanted to stop the professional activity of SWs and 93.1% would accept another income-generating activity in place of sex work. Conclusion: It is necessary to supervise SWs and protect them within the framework of respect for human rights, rather than criminalizing them and the exploit

关键词： Female Sex Workers Gender-Based Violence Central African Republic

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Antibiotic Resistance Profile of Salmonella Strains Isolated at the National Clinical Biology and Public Health Laboratory in Bangui, Central African Republic

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Health 2024年第2期16卷 160-171页

作者： Marceline Djeintote Ernest Lango-Yaya Zéphirin-Dalengat Vogbia Clotaire Donatien Rafaï Augustin Balekouzou henri saint-Claver Djemer Wilfried Sylvain Nambei Boniface Koffi Gérard Gresenguet National Blood Transfusion Center Bangui Central African Republic Faculty of Health Sciences University of Bangui Bangui Central African Republic National Laboratory of Clinical Biology and Public Health Bangui Central African Republic National Reference Center for Sexually Transmitted Infections and Anti-Retroviral Therapy Bangui Central African Republic National Center for the Fight against AIDS Bangui Central African Republic

In Africa, each year, there are estimated to be more than 91 million cases of salmonellosis and 137,000 cases of death. The problem of antibiotic resistance in Salmonella strains is a threat to public health. The objective of this study is to evaluate the antibiotic resistance profile of Salmonella strains isolated in biological products analyzed at the National Laboratory of Clinical Biology and Public Health (NLCBPH) in Bangui. This is, therefore, a cross-sectional study with a descriptive aim, running from January to December 2022. It focused on the strains of Salmonella isolated and identified in stools, urines, and blood samples. For each strain of Salmonella isolated, an antibiogram was carried out following the recommendations of the French Society of Microbiology (CASFM, 2022). A total of 93 strains of Salmonella have been recorded. The age group 0 - 9 years was 29% and that of >50 years was 11%. The median age of patients was 30 years with a minimum of 1 and a maximum of 78 years. The female gender was more represented at 52.69% than the male gender at 47.31%, i.e. a sex ratio of 0.89 (M/F). Salmonella strains were much more isolated in stools at 62% followed by urines at 29% and blood at 6%. Salmonella arizonae strains were more represented with 52%. Salmonella strains have a resistance rate to Tetracycline of 62.37% followed by Penicillins of 50%. The rate of multi-antibiotic resistance of the Salmonella strains isolated represented 48.38%. Salmonella spp. strains were multi-resistant at 58.69% followed by Salmonella arizonae strains at 47.91%. There is a significant association between the different families of antibiotics and Salmonella strains (p < 0.05). According to the results obtained, Penicillins, Phenicoles, and Cyclins had a high rate of resistance on Salmonella strains. No strain-producing Broad Spectrum Beta-lactamase has been isolated. Salmonella strains represent a zoonotic health danger, constitute a public health problem and remain a curre

关键词： Salmonella Resistance Antibiotics Central African Republic

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High Prevalence of Musculoskeletal Disorders and Self-Medication among Street Vendors in Bangui, Central African Republic (CAR)

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Occupational Diseases and Environmental Medicine 2023年第4期11卷 199-212页

作者： H.D. Mossoro-Kpinde Perrin Ariel Kongbanda Augustin Balekouzou henri saint Calvaire diemer Julienne Anaïs Paola Demba Yabada Chloé Naïgha Liliane Dengue Nzobe Gerard Grésenguet Mor Ndiaye Direction de la Médecine du Travail Ministère du Travail de l’Emploi de la Protection Sociale et de la Formation Professionnelle Bangui Central African Republic Département de Santé Publique Faculté des Sciences de la Santé Université de Bangui Bangui Central African Republic Faculté des Sciences de la Santé Université de Bangui Bangui Central African Republic Comité National de Lutte contre le SIDA Bangui Central African Republic Service de Médecine du Travail et de Médecine Légale Faculté de Médecine de Pharmacie et d’Odontologie Université Cheick Anta Diop Dakar Senegal

Introduction: Musculoskeletal disorders (MSDs) are a set of peri-articular conditions that result mainly in pain and functional discomfort. They represent a major occupational health problem in all areas of activity. The objective of this work was to determine the prevalence of MSDs among street vendors in the city of Bangui in the Central African Republic (CAR). Methods: A cross-sectional study was conducted from September 01 to October 31, 2021 in Bangui, the capital of CAR. The study population consisted of street vendors which were included at the entrance of 4 large markets of Bangui after giving informed consent. The sample size, calculated according to the Schwartz formula, was 384. Sociodemographic data (age, gender, level of education, marital status), professional data (the duration of sale in hours, the distance traveled per day);and health data (the health problems suffered by itinerant sellers and the means of dealing with them) were collected using a pre-established self-questionnaire. This collected data was processed using Microsoft Excel 2013 and Epi-Info version 7 software. Results: Among 384 street vendors included, women represented a quarter (24.9%). The average age was 27 years;the 25-34 age group was the most represented (50%). About two-thirds (64.8%) sold for at least 12 hours and traveled more than 10 km (69.3%) per day. The main health problems reported by street vendors were musculoskeletal disorders (95.8%). Their locations concerned the upper limbs shoulder 65.36% (251), elbow 24.22% (93). Non-ergonomic postures that stress the back and joints all day long, causing pain are risk factors for MSDs. These MSDs were treated by self-medication with non-steroidal anti-inflammatory drugs (22.0%), mainly sold on the street. Conclusion: MSDs dominated the health problems of street vendors. These problems raise the need for recognition and support for these workers to optimize their performance while preserving their health through awareness and

关键词： Street Vendors Musculoskeletal Disorders Ergonomy Self-Medication Central African Republic

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Significant Improvement in Tuberculosis Diagnosis by Detection of the Wall Lipoarabinomannan from Mycobacterium tuberculosis in Central African Republic (CAR)

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Open Journal of Medical Microbiology 2022年第3期12卷 71-82页

作者： Christian Diamant Mossoro-Kpinde Honorat Nouzoukem Marcel Mbeko Simaleko Nina Esther Ngoyi Ontsira Hermione Dahlia Mossoro-Kpinde Irenee Galendji henri diemer Gérard Grésenguet University Hospital Center Mother Elisabeth Domitien Bimbo Central African Republic National Laboratory of Clinical Biology and Public Health Bangui Central African Republic Department of Biomedical Sciences Health Sciences Faculty Bangui Central African Republic Public Health Department Health Sciences Faculty Bangui Central African Republic Bacteriology and Virology Laboratory University Hospital Center of Brazzaville Brazzaville Republic of the Congo Faculty of Sciences Marien Ngouabi University Brazzaville Republic of the Congo Regional University Hospital of Bria Bria Central African Republic

Background and Objective: Tuberculosis is one of the leading causes of morbi-mortality, especially in developing countries, due to delayed diagnosis and management. The goal of this study is to assess the contribution of lipoarabinomannan (LAM) in improving tuberculosis (TB) diagnosis in the Central African Republic (C.A.R.). Methods: We conducted a retrospective study at the Regional University Hospital of Bria. The records of patients hospitalized, tested by Determine® TB LAM Ag (Alere, Medical Co, LTD, Chiba, Japan) immunochromatographic test for the detection of LAM in urine, associated or not with acid-fast bacilli (AFB) research by Ziehl-Neelsen stain, were selected from August to October 2020. Results: During this study, 152 files were selected. Among them, there were 50.0% of children aged 14 or less (≤14 years: 33.6% + 16.4%) and 50.0% of adults represented. Patients living in the displaced person camp represented a larger group (65.1%) than those in the other 2 sites. There were seventy-four patients (i.e. 48.7%) who did not benefit from screening for AFB. For the other seventy-eight (i.e. 51.3%), there were 17.1% positive results for the search of AFB. However, among the 152 patients, there was a positive HIV serology in 30.9% of cases (i.e. 47 out of 152) and a positive Determine® TB LAM Ag in 38.2% of cases (i.e. 58 out of 152). It appears that Determine® TB LAM Ag was significantly more able to diagnose tuberculosis than AFB (p 0.003). The 58 patients diagnosed with TB LAM included 20 children who could not provide sputum and HIV-infected patients (p 0.03). Conclusion: The results of this study showed that the microscopy for AFB made it possible to make the diagnosis of tuberculosis in 17.1% of patients against 38.2% for the Alere Determine® TB LAM Ag test. This result highlights the need for routine use of LAM detection to improve the diagnosis of tuberculosis. The conduct of a subsequent stu

关键词： Tuberculosis Diagnosis TB-LAM Acid-Fast Bacilli Microscopy HIV/AIDS Central African Republic

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Prevalence of HBsAg and Antibodies to Hepatitis C Virus among Female Sex Workers in Bangui

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Open Journal of Gastroenterology 2020年第6期10卷 144-150页

作者： Serges Magloire Camengo Police Nathalie Philomène Boua-Akélélo Georges Service Eveline Mofini Benoît Elowa Armelo Thibaut Yangba Kalebanga Bernard Bessanguem Marcel Mbeko Simaléko Peggy Guérendo henri diemer Jospeh Roger Molowa Kobendo Department of Hepato-Gastroenterology and Internal Medicine of “Amitié Sino-Centrafraine” University Hospital Center Bangui Central African Republic Department of Internal Medicine “Maman Elisabeth Domitien” University Hospital Center Bimbo Central African Republic National Reference Center for Sexually Transmitted Infections and Antiretroviral Therapy Bangui Central African Republic Department of Public Health Faculty of Health Sciences University of Bangui Bangui Central African Republic Department Venerology Dermatology National University Hospital Center Bangui Central African Republic

Introduction: Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) infection is a public health problem. Sex workers remain a vulnerable group. Objective: To determine the prevalence of HBsAg and hepatitis C virus (HCV) antibody transport among female sex workers (FSW) in Bangui. Patients and Methods: All FSW carriers of HBsAg and/or anti-HCV Antibodies were collected in a 6-month cross-sectional analytical study. The HBsAg research used the Monolisa HBsAg® (BioMérieux®) technique, sandwich ELISA. HCV serology consisted of the search for anti HCV antibodies by monolisa HCV (BioMérieux®), Elisa of the sandwich type. HIV serology used two Elisa tests (Genscreen® and Vironostika®). Data analysis was done using Epi Info 3.5.1 software. The Chi2 test was used for comparison with a signif

关键词： HBsAg Anti HCV Antibodies Female Sex Workers Bangui

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Self-medication of achalasia with cannabis, complicated by a cannabis use disorder

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World Journal of Gastroenterology 2015年第20期21卷 6381-6383页

作者： Amandine Luquiens Nelson Lourenco Amine Benyamina henri-Jean Aubin Hopital Paul Brousse-Addictologie 94804 Villejuif cedex France Service d'hepatogastroenterologie Hopital Saint Louisuniversite Denis Diderot Paris Ⅶ 75010 ParisFrance

Achalasia is a rare esophagus motility disorder. Medical, endoscopic and surgical treatments are available, but all endorse high relapse rates. No data has been published to date reporting a therapeutic effect of cannabis use neither in achalasia nor on its influence on manometric measurements. We report the case of a patient diagnosed with achalasia. He could benefit from a large panel of therapeutic interventions, but none of them was effective over the time. He first used cannabis at age 20 and identified benefits regarding achalasia symptoms. He maintained regular moderate cannabis use for 9 years, with minimal digestive inconvenience. A manometry performed without cannabis premedication was realized at age 26 and still found a cardiospasm. Cannabis use could explain the gap between functional symptoms assessment and manometry measurement. Further investigations are warranted to explore a therapeutic effect of cannabis in achalasia and possible influence on outcome measurements.

关键词： Achalasia Cannabis Treatment Manometry Addiction

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