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Immunovirological Profile of HIV1 Infection in Children and Adolescents Followed at the bangui Pediatric University Hospital

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Open Journal of Pediatrics 2024年第3期14卷 585-597页

作者： Simplice Cyriaque Kango Synthia Ningatoloum Nazita Marie Colette Nganda-Bangue Michaël Dan-Houron Alexandre Manirakiza Jean Chrysostome Gody Department of The Clinique Mé dicale Infantile Raymond Max Siopathis University Children&#8217s Hospital Bangui CAR Faculty of Health Sciences (FACSS) Bangui CAR National Laboratory of Clinical Biology and Public Health Bangui CAR Pasteur Institute Bangui CAR

History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use of pediatric forms, oral suspensions and dispersible tablets. The transition to Dolutegravir took place in 2020. The active file of our patients will grow from 78 to over 1900 today. Follow-up examinations are carried out to assess adherence to treatment. Objective: To determine the immunovirological profile and factors associated with treatment failure during follow-up of children on ART at the bangui pediatric university hospital. Patients and Method: This was a cross-sectional, analytical study from May 30 to December 02, 2022. The study sample was drawn from a cohort of HIV-1-infected children followed up at the bangui pediatric university hospital and on ART for three semesters who met the selection criteria. Results: The prevalence of treatment failure varied from one semester to the next. Thus, the prevalence of therapeutic failure was 20% in the first semester, 10% in the second semester and 7% in the third semester. The prevalence of virological failure was 10.28% in the first half of the year, 6.91% in the second half and 4.98% in the third. Secondly, immunological failure was 0.48% in the first half of the year, 0.32% in the second 0.64% in the third half. Finally, clinical failure was 8.82% in the first half, 4.82% in the second half, 1.92% in the third half. Socio-demographic and clinical factors associated with treatment failure were male gender (p 1000 copies/ml (p Conclusion: The occurrence of treatment failures in children is a major problem, especially in our resource-limited countries, given the challenges facing antiretroviral therapy. It is therefore necessary to carry out a study on resistance genotyping in order to propose correct management protocols, as the future of treatment programs depends on it.

关键词： Profile Immunovirological HIV/AIDS Children bangui

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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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Antibiotic Resistance Profile of Serotypes of Streptococcus pneumoniae Strains in bangui, from 2017 to 2022: Case of Serotype 1

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Open Journal of Medical Microbiology 2024年第2期14卷 131-145页

作者： Zéphirin Dalengat Vogbia Ernest Lango Yaya Marceline Djeintote Stéphanie Judith N’Yetobouko Jean de Dieu Longo Clotaire Donatien Rafaï Christian Diamant Mossoro-Kpindet Gérard Gresenguet Epidemiology and Research Service National Reference Center for Sexually Transmitted Infections and Anti-Retroviral Therapy Ministry of Health Bangui Central African Republic Faculty of Health Sciences Doctoral School of Human and Veterinary Health Sciences University of Bangui Bangui Central African Republic National Laboratory of Clinical Biology and Public Health Bangui Central African Republic National Blood Transfusion Center Bangui Central African Republic Public Department Ministry of Health Bangui Central African Republic

Goals: The aim of this study was to determine the antibiotic resistance profile of serotypes of Streptococcus pneumoniae strains circulating in bangui. Methodology: A prospective and analytical analysis was carried out at the National Laboratory of Clinical Biology and Public Health from 2017 to 2022. The strains came from our study on the contribution to the study of antibiotic sensitivity of Streptococcus pneumoniae strains. The multiplex PCR test was used for its cost-effectiveness in terms of amplifiers which can be purified in order to be sequenced. It also makes it possible to detect several germs as well as their serotypes. For a PCR reaction, several elements are involved in the reaction medium or Master Mix. These are the desoxyribonucleotides (dNTPs), the magnesium ions (MgCl2) and the primers. A set of 14 primers divided into 3 classes were used. Class 1 primers served as an internal control by targeting the cpsA gene. It is a highly conserved gene found in capsular loci characterized to date. The primers of the second class were used to target specific serotypes by specific reactions (out of six possibilities). The group reaction was carried out using the primers of the third class in order to carry out an initial screening of the samples and to classify the pneumococcal isolates. Related serotypes were grouped based on the amplification of common genes. Using the technique of electrophoresis on agarose gel and an ultraviolet radiation device, the migration bands are then visualized and analyzed. The data collected had been entered into Excel 2010 and analyzed with Epi info 7. The exact Fischer chi2 test at the 5% threshold, the relative risk and its 95% confidence interval were used to compare the proportions and determine the associations. Results: 187 antibiotic-resistant strains of Streptococcus pneumoniae were collected. The average frequency of serotypes 1, 9A, 4 and untypeable identified were 43.59%, 18.18%, 18.27% and 39.57% respectively. The frequency of serotype 1 was predominant for the age

关键词： Streptococcus pneumonia Serotype Antibiotic Resistance bangui

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Influence of Climate Variability on the Dynamics of Malaria Transmission among Children in bangui, Health Challenges in Central African Republic

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Open Journal of Pediatrics 2022年第3期12卷 461-475页

作者： Bogning Mejiozem Brice Olivier Mbetimangue Péngas Eliezer Edwige Victoire Ngatimo Bogning Kakounguere Evodie Pierrette Maurice Tsalefac Gody Jean Chrysostome Centre Hospitalier Universitaire Pédiatrique de bangui Bangui Central African Republic Université de Dschang Dschang Cameroon Faculté des Sciences de la Santé de l’Université de bangui Bangui Central African Republic

Background: Malaria was the deadliest worldwide vector-borne disease in 2017. The objective of this study was to determine the eco-epidemiology of malaria at the reduced scale of a Health Region in children less than 5 years old. Objectives: To assess the relationship between climate and malaria epidemiology in children less than 5 years old in bangui. Methodology: Health data were collected from the Health Region Nº7 database. Climatic data were collected from the database of the bangui M’poko station and the bangui national meteorological delegation. Demographic data were collected from the United Nations Population Fund and the Central African Institute of Statistics, Economic and Social Studies. Ethical clearance was obtained from the local ethics committee, which allowed us to access the data from each institution. The independent variables were collected in the districts. Several statistical methods were used to analyze confidentially the data. Results: During the survey, for 1160 mm of water in 2004, 317 children died versus 56 for 1516 mm of water in 2013, i.e., a correlation coefficient between rainfall and malaria is 0.51. There was a statistically significant association between rainfall and malaria in bangui as well as a correlation between malaria-related death and the level of humidity, i.e., for 51.99ºC, the number of death increased from 294 cases in 2004 to 216 cases for 49.74ºC in 2013 with a correlation coefficient between humidity and malaria morbidity of 0.46 and the coefficient of determination r2 of 21.31%. Malaria was influenced by humidity. Malaria transmission was higher during the rainy season (May to October) with an incidence of 61.11% (n = 44,193) versus 38.89% (n = 28,125) for the dry season (November to April). The 8th borough of bangui with a very high level of vulnerability recorded the highest incidence of malaria (64,748 cases). Finally, the first borough with 11,502 cases of malaria had a very low level of vulnerability. Conclusion: Climatic trends ha

关键词： Influence Climate Variability Malaria Children bangui

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Survival of Antiretroviral Therapy Patients at the Outpatient Treatment Centre of the Community University Hospital of bangui from 2015 to 2020

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Advances in Infectious Diseases 2023年第3期13卷 389-406页

作者： Sylvain Honore Woromogo Paulette Rose Josephat Mbay Yamotende Jesse Saint Saba Antaon Derguedbé Nebardoum Hermann Ngouakam Pierre Marie Tebeu Inter-State Centre for Higher Education in Public Health of Central Africa Brazzaville Republic of Congo Unit for Research and Intervention in Public Health Department of Public Health Faculty of Health Sciences Bangui Central African Republic Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon

Background: The advent of antiretroviral treatment has considerably increased the life expectancy of people living with HIV in recent years. The Central African Republic, despite challenges related to the socio-political context, is committed to achieving the UNAIDS 90-90-90 targets and to the elimination of AIDS by 2030 advocated by the WHO. Objective: To analyze survival among HIV-positive adult patients on antiretroviral therapy from 2015 to 2020. Methods: This was a history-based cohort study of patients started on ART. The main variable was survival. The Kaplan-Meier method was used to describe the survival curve since inclusion in the cohort and a multivariate Cox model was used to investigate factors associated with mortality on ART. Results: A total of 145 naive patients started ART at the Outpatient Treatment Centre (OTC) in 2015. A female predominance was observed in our study with 78.08% of cases. The analysis of the patients’ fate at the time of point of treatment showed that 58.62% of them were still in active care and 13.10% died. The probability of survival at 5 years was 0.82 and mortality was significantly associated with very advanced disease (WHO stage IV) (p = 0.047) and anemia (p = 0.039). Conclusion: The majority of patients were still in care at the endpoint and mortality was significantly related to advanced disease and anemia. Early management of people living with HIV combined with better quality of care would improve their survival.

关键词： Survival Patients Antiretroviral Treatment bangui

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Epidemiological, Clinical, Bacteriological and Evolutionary Profiles of Bacterial Meningitis in Children in bangui (CAR)

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Open Journal of Pediatrics 2023年第4期13卷 553-561页

作者： Synthia Ningatoloum Nazita Simplice Cyriaque Kango Carine Judith Kiteze Nguinzanémou Rostand Juste Koyangboi Kombaya Iris Vanessa Gaspiet Sonny Brice Olivier Bogning Mejiozem Franck Houndjahoue Jean Chrysostome Gody Centre Hospitalo Universitaire Communautaire de Bangui Bangui République Centrafricaine Faculté des Sciences de la Santé de l’Université de bangui Bangui République Centrafricaine Complexe Hospitalo Universitaire Pédiatrique de Bangui Bangui République Centrafricaine

Background: Bacterial meningitis is a major public health problem worldwide due to its severity. It is a vaccine-preventable disease. Methodology: It was a retrospective descriptive study conducted at the Pediatric Teaching Hospital of bangui from June 2019 to May 2021. Children aged 1 month to 15 years hospitalized for bacterial meningitis were included in the study. Data were entered and analyzed using Stata/IC version 16.1. Results: Of 2490 patients hospitalized during the study period, 122 (4.9%) had bacterial meningitis. The patients were male in 54.92% of cases with a sex ratio of 1.21. The mean age was 35.95 months ± 49.16. Most of the patients (84.42%) came directly from home. The average consultation delay was 3.4 days ± 2.6. The vaccination coverage was 56.55%. The CSF study isolated germs from 24 patients (19.67%), the main ones being S. pneumoniae (75%) and H. influenzae (16.67%). Ceftriaxone was prescribed alone or in combination in all cases as first-line treatment. The average duration of antibiotic therapy was 8.95 days. The mortality rate was 27.87% and 12.30 % of patients had sequelae. Conclusion: Bacterial meningitis is common in bangui and still poses a public health problem despite the introduction of new vaccines in the EPI. Improving vaccination coverage and raising awareness for early consultation could improve the situation.

关键词： Bacterial Meningitis Child bangui

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Factors Associated with Mother-to-Child Transmission of HIV at the Maternity Unit of the Castors Urban Health Center in bangui

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Open Journal of Obstetrics and Gynecology 2023年第5期13卷 950-959页

作者： Thibaut Boris Clavaire Songo-Kette Gbekere Gilles Davy Kossa-Ko-Ouakoua Gertrude Rose De Lima Kogboma Wongo Guerengbo Rodrigue Herman Doyama-Woza Siméon Matoulou-M’bala Wa-Ngogbe Alida Koirokpi Sabrina Ouapou Kelly Mbano-Dede Matike-Ayamboka Josué Eezchiel Sandjima Norbert Richard Ngbale The Maternity Unit of the Centre de Santé Urbain des Castors Bangui Central African Republic Department of Gynecology and Obstetrics Centre Hospitalier Universitaire Communautaire Bangui Central African Republic Department of Public Health Faculty of Health Sciences University of Bangui Bangui Central African Republic Department of Gynecology and Obstetrics Centre Hospitalier Universitaire Maman Elisabeth Domitien Bimbo Central African Republic

Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1st, 2017 to December 31st, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi2 = 32.61;p 2 = 55.22;p 2 = 108.73;p 3 (OR = 14.12 [4.03 - 57.20];Khi2 = 21.68;p 1000 copies/mm3 (OR = 8.85 [2.33 - 43.20];Khi2 = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi2 = 18.47;p 2 = 40.60;p 2 = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi2

关键词： Factors Transmission Mother-Child HIV bangui

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Contribution to the Study of Resistance to Anti-Tuberculosis Drugs in the Mycobacterium tuberculosis Complex Isolated at the National Laboratory of Clinical Biology and Public Health in bangui in the Central African Republic in 2022: Case of Rifampicin

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Journal of Tuberculosis Research 2023年第4期11卷 162-172页

作者： Clotaire Donatien Rafaï Max Namzeka Ernest Lango-Yaya Romaric Oscar Tibet Kada Oscar Senzongo Ndimakamoko Serge Henri Gbazi Le Bon Bondom Christian Maucler Pamatika Boniface Koffi Alain Le Faou Laboratoire National de Biologie Clinique et de Sante Publique Bangui Central African Republic Faculty of Science University of Bangui Bangui Central African Republic Ministry of Health and Population Bangui Central African Republic

Microscopy-positive and drug-resistant pulmonary tuberculosis (MPT+) is one of the most feared diseases due to the cost of its management and the associated mortality. The GeneXpert, a new molecular test, is in greater demand for the diagnosis of MPT+ resistance cases. The application of GeneXpert to new cases of MPT+ is not effective in the country’s TB screening centres. The objective of this study is to assess the contribution of GeneXpert to the determination of MPT+ resistance cases in bangui. The study was cross-sectional and covered the period from February to July 2022. The diagnosis of tuberculosis was first performed by microscopy with Ziehl Neelsen hot stain. The GeneXpert was then used to test for resistance in the sputum of all patients with positive microscopy. The collected data was entered into Excel 2013 and analysed with Epi Info 3.3.7. We analysed data from 755 patients, 80 of whom had resistance. The 80 patients ranged in age from 6 to 68 years (mean age = 35 years). The prevalence of resistant TB was 10.60% (80/755). Primary resistance accounted for 73.75% and secondary resistance for 26.25%. The age group 20 - 39 years (57.50%), male (72.50%), 8th district (17.50%), people living in couples (53.75%), farmers (13.75%) were the socio-demographic characteristics most affected by resistance. Treatment failure (13.75%), relapses (13.75%), the notion of contagion (28.75%), a history of smoking (40%) and alcohol (61.25%) were the clinical antecedents reported by the patients. Treatment failure and relapse were the variables associated with the occurrence of resistant PMT+ (p 0.05). A considerable proportion of the overall Mycobacterium tuberculosis resistance to anti-tuberculosis drugs (10.60%) was identified by GeneXpert. Treatment failure and relapse were the factors associated with the risk of resistance.

关键词： GeneXpert Resistance Mycobacterium tuberculosis bangui

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Management of Traumatic Foreign Bodies of the Upper Aerodigestive Tract in Children with Limited Diagnostic Resources at the Pediatric University Hospital of Central African Republic of bangui

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Open Journal of Pediatrics 2023年第4期13卷 523-528页

作者： Daniel Sylvère Ouaïmon Jean Rufen Malendoma Carine Judith Kiteze Nguinzanemou Ebenezer Same Valère Ndoma Ngatchoukpo Centre Hospitalier Universitaire Pédiatrique de bangui (CHUPB) Bangui Central African Republic Faculty of Health Sciences Bangui University Bangui Central African Republic Centre National Hospitalier-Universitaire de bangui (CNHUB) Bangui Central African Republic

Accidental acute upper airway obstruction (UAO) is a common situation in pediatric emergencies. It is a source of morbidity and even mortality, particularly in children under 3 years of age. We report a clinical case ... 详细信息

关键词： Foreign Bodies Trauma Child bangui

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Morbidity, Mortality and the Impact of Climate on the Evolution of Acute Rotavirus Diarrhea in Children under 5 Years Old in bangui

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Open Journal of Pediatrics 2022年第4期12卷 607-632页

作者： Olivier Brice Bogning Mejiozem Sylvère Tenehombi-Koyangbo Lonela Gouandjika Vodie Pierrette Kakouguere Emmanuel Nakoune Gody Jean Chrysostome Centre Hospitalier Universitaire Pédiatrique de bangui Bangui Central African Republic Institut Pasteur de bangui Bangui Central African Republic Faculté des Sciences de la Santé Université de Bangui Bangui Central African Republic

Background: Rotavirus is the most common pathogen of severe acute diarrhea in children under five years of age worldwide. Objective: The objective of this study was to determine the morbidity and mortality of rotavirus diarrhea while describing the seasonal kinetics of the infection according to climatic parameters in bangui. Methodology: This was a descriptive and analytical cross-sectional study conducted from January 1, 2011 to December 31, 2020 in the Central African Republic (CHUPB). The health data were recorded and processed with the Access 2019 software, then analyzed with the STATA version 14 software. The climatic trends in the study area and its seasonal variations were highlighted by the monthly rainfall coefficient of Alfred Angot: Cm = 12 Pm/P. Results: Morbidity was 45.99% of cases. The 1 to 12 months old represented 93.81% of cases. The mean age of the children was 6.8 months, the sex ratio was 1.20. The symptomatic triad was diarrhea (100%), vomiting (90.20%) and fever (87.5%). Moderate dehydration was reported in 81.05% of cases. The main genotype combinations found were P[8]G1 in 34.02% (n = 115/338), P[6]G1 in 21.59% (n = 73/338) and P[6]G2 in 16.86% (n = 57/338). Case fatality was 11.45%. The risk of death was influenced by rural origin, severe dehydration, hypovolemic cloc and duration of hospitalization > 5 days. Low rainfall correlated with the highest rates of rotavirus diarrhea. Likewise, high temperature correlated with the highest number of cases of rotavirus diarrhea. Conclusion: Acute rotavirus diarrhea is an important morbidity and mortality issue in children under 5 years old in bangui.

关键词： Diarrhea Rotavirus Children Climate bangui

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