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Epidemiology of co-infections in pregnant women living with human immunodeficiency virus 1 in rural Gabon:a cross-sectional study

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Infectious Diseases of Poverty 2023年第4期12卷 83-92页

作者： Saskia Dede Davi Dearie Glory Okwu Marc Luetgehetmann Frederique Mbang Abba Martin Aepfelbacher Lillian Rene Endamne Ayodele Alabi Rella Zoleko-Manego Ghyslain Mombo-Ngoma Saidou Mahmoudou Marylyn Martina Addo Michael Ramharter Johannes Mischlinger Centre of Tropical Medicine Bernhard-Nocht Institute for Tropical Medicine and I.Department of MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany German Centre for Infection Research Partner Site Hamburg-Lübeck-Borstel-RiemsHamburg-Lübeck-Borstel-RiemsHamburgGermany Centre de Recherches Médicales de Lambaréné LambarénéGabon Saskia Dede DaviDearie Glory OkwuFrederique Mbang AbbaAyodele Center for Diagnostics Institute of Medical MicrobiologyVirology and HygieneUniversity Medical Center Hamburg-Eppendorf(UKE)HamburgGermany Albert-Schweitzer Hospital LambarénéGabon Department of Parasitology Leiden University Medical CenterAlbinusdreefThe Netherlands Department for Clinical Immunology of Infectious Diseases and I.Department of Medicine University Medical Center Hamburg-EppendorfHamburgGermany

Background There is no recent epidemiological data on HIV infection in Gabon,particularly in pregnant women.To close this gap,an HIV-prevalence survey was conducted among Gabonese pregnant women,followed by a cross-sectional case-control study in which the prevalence of various co-infections was compared between HIV-positive and HIV-negative pregnant women.Methods Between 2018 and 2019,data for the HIV-prevalence survey were collected retrospectively in 21 Gabonese antenatal care centres(ANCs).Subsequently,for the prospective co-infection study,all HIV-positive pregnant women were recruited who frequented the ANC in Lambarénéand a comparator sub-sample of HIV-negative pregnant women was recruited;these activities were performed from February 2019 to February 2020.The mean number of coinfections was ascertained and compared between HIV-positive and HIV-negative women.Additionally,the odds for being co-infected with at least one co-infection was evaluated and compared between HIV-positive and HIV-negative women.Results HIV-positivity was 3.9%(646/16,417)among pregnant women.183 pregnant women were recruited in the co-infection study.63%of HIV-positive and 75%of HIV-negative pregnant women had at least one co-infection.There was a trend indicating that HIV-negative women were more often co-infected with sexually transmitted infections(STIs)than HIV-positive women[mean(standard deviation,SD):2.59(1.04)vs 2.16(1.35),respectively;P=0.056];this was not the case for vector-borne infections[mean(SD):0.47(0.72)vs 0.43(0.63),respectively;P=0.59].Conclusions Counterintuitively,the crude odds for concomitant STIs was lower in HIV-positive than in HIV-negative women.The change of magnitude from the crude to adjustedOR is indicative for a differential sexual risk factor profile among HIV-positive and HIV-negative women in this population.This might potentially be explained by the availability of sexual health care counselling for HIV-positive women within the framework of the national HIV control programme,while no such similar

关键词： HIV Cross-sectional study Pregnancy Sexually transmitted infections Gabon

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Challenges Facing the Effective Implementation of the XGest Project in Gabon:A Case Sudy

Challenges Facing the Effective Implementation of the XGest ...

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作者： Gnoundou Alfred Fabrice 浙江师范大学

学位级别：硕士

This research study aimed at exploring the challenges encountered by teachers that impede the systematic implementation of the XGest project via the XGest application across public secondary education in some selected schools in Libreville Gabon.The study was guided by the following research objectives:to identify:the achievements done so far across Gabonese secondary education since the implementation of XGest project,to determine the main challenges faced by the teachers across the public secondary schools since the implementation of the project and to find out Some policy actions that need to be taken at national,sectorial and local levels in order to solve the challenges encountered by teachers that impede the systematic implementation of the XGest project across public secondary education in GabonThe researcher used qualitative research design,which was estimated appropriate for him to meet the main purpose of this study.The two selected public secondary schools of Libreville were targeted and were mainly the focus of this study.Both convenience and purposeful sampling techniques were used.Three categories of respondents were subjected to questionnaires.They were groups of Ministry of Education Officials and School principals,classroom teachers and parents whose children were schooling in those selected public secondary schools.The total sample of this research was composed of 20 teachers（10 from each school）,10 school principals and ministry of education officials and 10 parents representing a total of 40 participants.Three research instruments were used in collecting data,namely:a Document Analysis Guide,questionnaire guide and interview.Data were transcribed,summarized,categorized and interpreted accordingly.Responses from participants and data which were obtained from diverse documents were compared.Trends and patterns in the responses were established.Narratives,direct quotations,interpretive reports as well as excerpts were written down to depict the situation on ground.Through the data analysis,the fo

关键词： Public Secondary Schools Libreville XGest application XGest project Teachers Gabon

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Prevalence of and risk factors for malaria,filariasis,and intestinal parasites as single infections or co-infections in different settlements of Gabon,Central Africa

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Infectious Diseases of Poverty 2018年第1期7卷 60-76页

作者： Noe Patrick M’bondoukwe Eric Kendjo Denise Patricia Mawili-Mboumba Jeanne Vanessa Koumba Lengongo Christelle Offouga Mbouoronde Dieudonne Nkoghe Fousseyni Toure Marielle Karine Bouyou-AkotetAuthor details Department of Parasitology-Mycology Faculty of MedicineUniversity of Health SciencesP.O.Box 4009LibrevilleGabon International Center for Medical Research of Franceville FrancevilleGabon.

Background:Malaria,filariasis,and intestinal parasitic infections(IPIs)are common and frequently overlap in developing countries.The prevalence and predictors of these infections were investigated in three different settlements(rural,semi-urban,and urban)of Gabon.Methods:During cross-sectional surveys performed from September 2013 to June 2014,451 individuals were interviewed.In addition,blood and stool samples were analysed for the presence of Plasmodium,filarial roundworm,intestinal protozoan,and helminth infections.Results:Intestinal parasitic infections(61.1%),including intestinal protozoa(56.7%)and soil-transmitted helminths(STHs)(22.2%),predominated,whereas Plasmodium falciparum(18.8%),Loa loa(4.7%),and Mansonella perstans(1.1%)were less prevalent.Filariasis and STHs were mainly found in rural settlements,whereas a higher plasmodial infection prevalence rate was observed in the periurban area.The most common IPI was blastocystosis(48.6%),followed by ascaridiasis(13.7%),trichuriasis(11.8%),amoebiasis(9.3%),giardiasis(4.8%),and strongyloidiasis(3.7%).Hookworm was detected in one adult from rural Dienga.Adults had a higher prevalence of Blastocystis hominis and STHs,whereas Giardia duodenalis was more frequently observed among children aged below 5 years(P<0.01).The polyparasitism rate was 41.5%,with 7.0%Plasmodium-IPIs and 1.8%Plasmodium-STH co-infections.The multivariate analysis showed that living in a suburban area,belonging to the age group of 5-15 years,having none or a secondary education,or having an open body water close to home were significant risk factors for malaria(P≤0.01).For STH infections,identified risk factors were drinking untreated water and living in a rural area(P≤0.04).No significant predictors were identified for IPIs and malaria-IPI co-infection.Conclusions:This study reports a high prevalence of IPIs and intestinal protozoa,but a low rate of malaria-IPI co-infections in the study sites.Improvements in the living conditions of the population such as adequate water supply and proper he

关键词： Malaria Filariasis Intestinal parasitic infections Soil-transmitted helminths Co-infection Risk factors Gabon

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Epileptiform seizures revealing neurocysticercosis:report of two clinical cases in Libreville,Gabon

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Asian Pacific Journal of Tropical Medicine 2010年第8期3卷 671-672页

作者： Okome-Nkoumou MML Ondounda M Dzeing-Ella A Mounguengui D Nziengui Madjinou MI Magne C Nzenze JR Departement des maladies infectieuses faculte de medecine de LibrevilleBP 212LibrevilleGabon Service de medecine interne Hopital d'Instruction des Armees Omar Bongo Ondimba(HIAOBO)LibrevilleGabon

Neurocysticercosis(NCC) is recognized as a cause of neurologic disease worldwide.We reported two cases(one co-infected with the HIV) of NCC.Medical treatment led to recovery.NCC should be considered in tropical countr... 详细信息

关键词： Neurocysticercosis Epilepsy Gabon HIV

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Fever among Children with Sickle-Cell Disease: Findings from the General Pediatric Ward of the Owendo Pediatric Hospital in Libreville, Gabon

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Open Journal of Pediatrics 2014年第4期4卷 262-268页

作者： Jean Koko Daniel Gahouma Simon Ategbo Cathérine Seilhan Armelle Pambou André Moussavou General Pediatrics Service Owendo Peditric Hospital (OPH) Libreville Gabon Laboratory of Medical Biology Owendo Pediatric Hospital (OPH) Libreville Gabon Pediatrics Department Faculty of Medicine Health Sciences University (USS) Libreville Gabon

Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clinical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5°C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Complete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and headache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infections (22.4%). The white blood cell count was >20,000/mm3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels were <5g/dl for 52.2% of the cases involving malaria and 22.6% for those of unknown origin. For four patients, all less than 10 years of age, the disease was fatal. Conclusion: For the majority of fever episode

关键词： Sickle-Cell Disease Fever Malaria Acute Lower Respiratory Infections (ALRI) Gabon

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Frequency of Transfusions and Risk Factor for Bleeding Risk to Guide a Blood-Sparing Program during Hip Arthroplasty in Gabon

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Open Journal of Anesthesiology 2023年第3期13卷 47-57页

作者： Ghislain Edjo Nkilly Raphael Okoue Ondo Arthur Matsanga Pascal Christian Nze Obiang Stéphane Oliveira Léandre Nguiabanda Jean-Marcel Mandji-Lawson Romain Tchoua Department of Anaesthesia and Intensive Care Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon Department of Anaesthesia and Intensive Care Owendo University Hospital (CHUO) Libreville Gabon Department of Anaesthesia and Intensive Care Jeanne Ebori Fondation Libreville Gabon Department of Anaesthesia and Intensive Care Akanda Army Training Hospital Libreville Gabon Orthopedic surgery service Omar Bongo Ondimba Army Training Hospital (HIAOBO) Libreville Gabon

Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip arthroplasty in order to guide a blood-saving program. Method: Retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion data, anesthetic and intraoperative data. The primary outcome was intraoperative or postoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 276 patients included, 179 benefited from Total Hip Prosthesis (THP) and 97 from Intermediate Hip Prosthesis (IHP). Spinal anesthesia was performed in 67.4% of patients. The ASA 2 score predominated (65.9%). The transfusion incidence was 56.9% (157/276). Tranexamic acid was used in 16.3% (45/276) of patients. The average bleeding was 528 ± 405 ml. Preoperative anemia (OR = 0.78, 95% CI [0.66 - 0.91]) and total hip prosthesis (OR = 2.02 95% CI [1.11 - 3.67]) were predictors of bleeding and transfusion to be significant. The average serum hemoglobin predictive of a transfusion was 11.6 ± 1.8. ASA score and operative time were not found as risk factors for bleeding and transfusion. Conclusion: The incidence of transfusion is high. Preoperative anemia remains a major but modifiable risk factor unlike the choice of implant. The implementation of a patient blood management protocol could reduce this transfusion incidence.

关键词： Arthroplasty Hip Gabon Transfusion

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Variation of the Consumption of Mushrooms by Pygmies and Bantus in the North of Gabon

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Advances in Microbiology 2014年第16期4卷 1212-1221页

作者： Hugues Calixte Eyi Ndong Steeve Mounguengui Christiane Attéké Geraldine Obone Ndong Institute of Technological Research Libreville Gabon Institute of Research in Tropical Ecology Libreville Gabon University of Sciences and Technics of Masuku Libreville Gabon

A comparative study of the number of taxa and fungal biomass consumed by the Pygmies and the Bantus of Gabon has been realized in two Gabon north regions (Ogooue-Ivindo and the Woleu-Ntem). This study has allowed not only to establish the list of consumed fungal sorts by those populations, but also to estimate the daily consumed fungal biomasses by each ethnical group. The study has revealed a significant difference between a numbers of taxa and the quantity of mushrooms consumed by various ethnical groups: the Pygmies of the area who live especially by hunting and fishing consumed 96% of the recorded taxa with some high mushrooms quantities (around 3 kg/day/family);the Bantus who live nearby Pygmies also consumed some high mushrooms quantities (around 2 kg/day/family) but a low taxa number (56% of taxa counted by the Fang;69% by the Kota;39% by the Kwele);on the other hand, the Bantus living nearest the Pygmies consumed a high taxa number as much as Pygmies (around 90% of taxa counted) but eat a lower mushrooms quantities than theirs distant congeners Pygmies (around 800 g/day/family).

关键词： Pygmies Bantus Mushrooms Gabon

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The Difficulties of Congenital Syphilis Diagnosis about 3 Cases at Libreville, Gabon

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Open Journal of Pediatrics 2014年第2期4卷 121-128页

作者： C. M. Essomo Megnier-Mbo S. Mayi Y. Vierin A. Ndjoyi Biguino J. Koko A. Moussavou Département de Pédiatrie Faculté de Médecine Libreville Gabon Departement Mère Enfant HIAOBO Libreville Gabon Laboratoire de Microbiologie Faculté de Médecine Libreville Gabon Service de Réanimation Néonatale et Néonatologie HIAOBO Libreville Gabon

First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is not always easy, as it is shown in our three clinical cases. Those three clinical observations demonstrate the difficulties encountered in the diagnosis of congenital syphilis in our country where only the TPHA (Treponema Pallidum Haemaglutination Assay) and VDRL (Venereal Disease Research Laboratory) tests are the only ones to be routinely carried out. Actually, these tests can be negative at the earliest stage of the syphilis or in case of zonal phenomenon. In addition, maternal antibodies could be found in child blood, even if the baby is in good health. At last, the child could have been contaminated belatedly while tests were negative at the third month of pregnancy. Congenital syphilis still exists in our developing countries and, in order to better manage this pathology, a proposition of an efficient algorithm is submitted.

关键词： Congenital Syphilis Diagnosis Difficulties Libreville Gabon

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Complications of Pregnancy in Patients with Systemic Lupus Erythematosus (Gabon)

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Open Journal of Obstetrics and Gynecology 2015年第8期5卷 443-447页

作者： Sosthène Mayi-Tsonga Landry Missounga Josaphat Ibaba Jean Ronald Edoa Jean Baptiste Moussavou Kombila Obstetrics Department Libreville’s Military Hospital Libreville Gabon Department of Internal Medicine Libreville’s Hospital University Libreville Gabon

Pregnancy and systemic lupus erythematosus in black African women: about 10 cases in Libreville (Gabon). Objectives: Through a study in a population of systemic lupus erythematosus (SLE) pregnant black Gabonese women, we describe the characteristics of these pregnancies to clarify their main complications and to make recommendations to their follow-up in low resource countries. Patients and Methods: This is a longitudinal descriptive study conducted over a period of six years, from 1 January 2008 to October 31, 2013, in Libreville (Gabon). We’ve included, systemic lupus erythematosus women carrying a pregnancy during the period of the study. Results: Seventy-two SLE women were followed and were eligible. Only 8 patients (11%) were pregnant during the follow up period. These 8 SLE patients allowed us to monitor 10 pregnancies. The average parity was 0.88. Eight pregnancies in ten (80%) had complications and most frequent was preeclampsia. Nine pregnancies (90%) resulted in the birth of viable children of which 4 (44.4%) were born by caesarean section and the 5 others (55.6%) were born by natural route. Conclusion: We recommend a monthly prenatal care for these high-risk pregnancies and early detection of preeclampsia.

关键词： Systemic Lupus Erythematosus Pregnancy Preeclampsia Gabon

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LARCs after unsafe abortion in Libreville (Gabon): Women accept quickly but the time interval for the insertion is longer than that of injectable contraceptives

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Open Journal of Obstetrics and Gynecology 2014年第1期4卷 23-27页

作者： Sosthène Mayi-Tsonga Jacques Bang Ntamack Boniface Sima-Ole Pamphile Assoumou Obiang Ulysse Minkobame Doris Ngouafo Department of Obstetrics and Gynecology of University Hospital of Libreville Gabon Africa Faculty of Health Sciences of Libreville Gabon Africa

Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.

关键词： Unsafe Abortion Contraception LARC Period for the Insertion of LARCs Gabon

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