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Eholie SP, Ekouevi DK, Chazallon C, Charpentier C, Messou E, Diallo Z, Zoungrana J, Minga A, Ngom Gueye NF, Hawerlander D, Dembele F, Colin G, Tchounga B, Karcher S, Le Carrou J, Tchabert-Guié A, Toni TD, Ouédraogo AS, Bado G, Toure Kane C, Seydi M, Poda A, Mensah E, Diallo I, Drabo YJ, Anglaret X, Brun-Vezinet F. Efficacy and safety of three antiretroviral therapy regimens for treatment-naive African adults living with HIV-2 (FIT-2): a pilot, phase 2, non-comparative, open-label, randomised controlled trial. Lancet HIV 2024:S2352-3018(24)00085-7. [PMID: 38740027 DOI: 10.1016/s2352-3018(24)00085-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Due to the low number of individuals with HIV-2, no randomised trials of HIV-2 treatment have ever been done. We hypothesised that a non-comparative study describing the outcomes of several antiretroviral therapy (ART) regimens in parallel groups would improve understanding of how differences between HIV-1 and HIV-2 might lead to different therapeutic approaches. METHODS This pilot, phase 2, non-comparative, open-label, randomised controlled trial was done in Burkina Faso, Côte d'Ivoire, Senegal, and Togo. Adults with HIV-2 who were ART naive with CD4 counts of 200 cells per μL or greater were randomly assigned 1:1:1 to one of three treatment groups. A computer-generated sequentially numbered block randomisation list stratified by country was used for online allocation to the next available treatment group. In all groups, tenofovir disoproxil fumarate (henceforth tenofovir) was dosed at 245 mg once daily with either emtricitabine at 200 mg once daily or lamivudine at 300 mg once daily. The triple nucleoside reverse transcriptase inhibitor (NRTI) group received zidovudine at 250 mg twice daily. The ritonavir-boosted lopinavir group received lopinavir at 400 mg twice daily boosted with ritonavir at 100 mg twice daily. The raltegravir group received raltegravir at 400 mg twice daily. The primary outcome was the rate of treatment success at week 96, defined as an absence of serious morbidity event during follow-up, plasma HIV-2 RNA less than 50 copies per mL at week 96, and a substantial increase in CD4 cells between baseline and week 96. This trial is registered at ClinicalTrials.gov, NCT02150993, and is closed to new participants. FINDINGS Between Jan 26, 2016, and June 29, 2017, 210 participants were randomly assigned to treatment groups. Five participants died during the 96 weeks of follow-up (triple NRTI group, n=2; ritonavir-boosted lopinavir group, n=2; and raltegravir group, n=1), eight had a serious morbidity event (triple NRTI group, n=4; ritonavir-boosted lopinavir group, n=3; and raltegravir group, n=1), 17 had plasma HIV-2 RNA of 50 copies per mL or greater at least once (triple NRTI group, n=11; ritonavir-boosted lopinavir group, n=4; and raltegravir group, n=2), 32 (all in the triple NRTI group) switched to another ART regimen, and 18 permanently discontinued ART (triple NRTI group, n=5; ritonavir-boosted lopinavir group, n=7; and raltegravir group, n=6). The Data Safety Monitoring Board recommended premature termination of the triple NRTI regimen for safety reasons. The overall treatment success rate was 57% (95% CI 47-66) in the ritonavir-boosted lopinavir group and 59% (49-68) in the raltegravir group. INTERPRETATION The raltegravir and ritonavir-boosted lopinavir regimens were efficient and safe in adults with HIV-2. Both regimens could be compared in future phase 3 trials. The results of this pilot study suggest a trend towards better virological and immunological efficacy in the raltegravir-based regimen. FUNDING ANRS MIE.
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Affiliation(s)
- Serge P Eholie
- Université Félix Houphouët-Boigny, Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Abidjan, Côte d'Ivoire; Centre Hospitalier Universitaire de Treichville Service des Maladies Infectieuses et Tropicales, Abidjan, Côte d'Ivoire; Programme PACCI, Abidjan, Côte d'Ivoire
| | - Didier K Ekouevi
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France; Centre Africain de Recherche en Epidémiologie et en Santé Publique, Lomé, Togo; Université de Lomé, Département Santé Publique, Lomé, Togo
| | - Corine Chazallon
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Charlotte Charpentier
- Service de virologie, Université Paris Cité, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Eugène Messou
- Centre de Prise en Charge et de Formation (CePReF), Abidjan, Côte d'Ivoire
| | - Zelica Diallo
- Université Félix Houphouët-Boigny, Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Abidjan, Côte d'Ivoire; Centre Hospitalier Universitaire de Treichville Service des Maladies Infectieuses et Tropicales, Abidjan, Côte d'Ivoire; Programme PACCI, Abidjan, Côte d'Ivoire
| | - Jacques Zoungrana
- Service des Maladies Infectieuses et Tropicales, CHU Sourô Sanou, Bobo-Dioulasso, Burkina-Faso
| | - Albert Minga
- Centre Médical de Suivi des Donneurs de Sang (CMSDS-CNTSCI), Abidjan, Côte d'Ivoire
| | | | - Denise Hawerlander
- Centre Intégré de Recherches Biocliniques d'Abidjan (CIRBA) Abidjan, Côte d'Ivoire
| | - Fassery Dembele
- Unité de soins ambulatoires et de conseil (USAC), CHU de Treichville, Abidjan, Côte d'Ivoire
| | - Géraldine Colin
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Boris Tchounga
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Sophie Karcher
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Jérome Le Carrou
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | | | - Thomas-d'Aquin Toni
- Programme PACCI, Abidjan, Côte d'Ivoire; CeDReS, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | | | - Guillaume Bado
- Unité de Virologie, CHU Sourô Sanou, Bobo-Dioulasso, Burkina-Faso
| | - Coumba Toure Kane
- Laboratoire de Bacteriologie, Virologie, CHU Le Dantec, Dakar, Sénégal
| | - Moussa Seydi
- Service des Maladies Infectieuses et Tropicales, CHNU Fann, Dakar, Sénégal
| | - Armel Poda
- Service des Maladies Infectieuses et Tropicales, CHU Sourô Sanou, Bobo-Dioulasso, Burkina-Faso
| | - Ephrem Mensah
- ONG espoir Vie Togo, Cente Medico-social, Licia Lomé, Togo
| | - Illah Diallo
- Service de Médecine Interne, CHU Yalgado OUEDRAOGO, Ouagadougou, Burkina Faso
| | | | - Xavier Anglaret
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France.
| | - Françoise Brun-Vezinet
- Service de virologie, Université Paris Cité, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
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Traore M, Nguhiu P, Telly N, Traore S, Toloba Y, Camara F, Keita M, Konaté B, Diallo Y, Diallo Z, Bah N, Dieffaga M, Laokri S, Garcia Baena I. The high costs facing TB-affected households in Mali. Int J Tuberc Lung Dis 2022; 26:1071-1073. [PMID: 36281038 PMCID: PMC9621305 DOI: 10.5588/ijtld.22.0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- M. Traore
- Ministère de la Santé et du Développement Social, Cellule Sectorielle de Lutte contre le VIH/Sida, la Tuberculose et les Hépatites Virales, Bamako, Mali
| | - P. Nguhiu
- World Health Organization, Global TB Programme, Geneva, Switzerland
| | - N. Telly
- Ministère de la Santé et du Développement Social, Cellule Sectorielle de Lutte contre le VIH/Sida, la Tuberculose et les Hépatites Virales, Bamako, Mali
| | - S. Traore
- Ministère de la Santé et du Développement Social, Cellule Sectorielle de Lutte contre le VIH/Sida, la Tuberculose et les Hépatites Virales, Bamako, Mali
| | - Y. Toloba
- Ministère de la Santé et du Développement Social, Centre Hospitalier Universitaire du Point G, Bamako, Mali
| | - F. Camara
- Ministère de la Santé et du Développement Social, Institut Nationale de Santé Publique/Laboratoire Nationale de Référence, Bamako, Mali
| | - M. Keita
- Ministère de la Santé et du Développement Social, Cellule Sectorielle de Lutte contre le VIH/Sida, la Tuberculose et les Hépatites Virales, Bamako, Mali
| | - B. Konaté
- Ministère de la Santé et du Développement Social, Cellule Sectorielle de Lutte contre le VIH/Sida, la Tuberculose et les Hépatites Virales, Bamako, Mali
| | - Y. Diallo
- Ministère de la Santé et du Développement Social, Cellule Sectorielle de Lutte contre le VIH/Sida, la Tuberculose et les Hépatites Virales, Bamako, Mali
| | - Z. Diallo
- Ministère de la Santé et du Développement Social, Cellule Sectorielle de Lutte contre le VIH/Sida, la Tuberculose et les Hépatites Virales, Bamako, Mali
| | - N. Bah
- World Health Organization, Bamako, Mali
| | - M. Dieffaga
- Ministère de la Santé et du Développement Social, Direction Nationale du Développement Social, Bamako, Mali
| | - S. Laokri
- World Health Organization, Global TB Programme Technical Assistance, Geneva, Switzerland, Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - I. Garcia Baena
- World Health Organization, Global TB Programme, Geneva, Switzerland
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Bernard C, Font H, Diallo Z, Ahonon R, Tine JM, Abouo FN, Tanon A, Messou E, Seydi M, Dabis F, Dartigues JF, de Rekeneire N. Effects of Age, Level of Education and HIV Status on Cognitive Performance in West African Older Adults: The West Africa IeDEA Cohort Collaboration. AIDS Behav 2021; 25:3316-3326. [PMID: 34050826 DOI: 10.1007/s10461-021-03309-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 12/28/2022]
Abstract
An in-depth understanding of the impact of aging, cognitive reserve, and HIV status on cognitive function is needed in older West African adults. Ninety-nine HIV-negative and 334 HIV-positive adults aged ≥ 50 years were enrolled in three clinics (Senegal and Côte d'Ivoire) participating in the IeDEA West Africa collaboration. All subjects underwent the Free and Cued Selective Reminding Test (FCSRT) and the Isaacs Set Test (IST). Age (both linear and quadratic), education level, and HIV status effects on Z-scores were assessed using multivariate linear regression models. Interactions between HIV status and age or educational level were tested. In the present cohort of older West African adults, the role of age and educational level on episodic memory and verbal fluency was observed without revealing an interaction between HIV status and age effect. As age had quadratic effects, older HIV-positive adults should not be considered as a unique group irrespective of their age. Low-educated HIV-positive patients had the lowest verbal fluency performance compared to others. Further studies are needed to duplicate these results. In clinical settings, screening and adapted programs focusing on improving cognition in those patients are needed.
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Kolou M, Poda A, Diallo Z, Konou E, Dokpomiwa T, Zoungrana J, Salou M, Mba-Tchounga L, Bigot A, Ouedraogo AS, Bouyout-Akoutet M, Ekouevi DK, Eholie SP. Prevalence of human leukocyte antigen HLA-B*57:01 in individuals with HIV in West and Central Africa. BMC Immunol 2021; 22:48. [PMID: 34294032 PMCID: PMC8299582 DOI: 10.1186/s12865-021-00427-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/11/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The presence of the human leukocyte antigen HLA-B*57:01 is associated with the development of a hypersensitivity reaction to abacavir (ABC). Limited data exist on HLA-B*57:01 prevalence in individuals with HIV-1 in Africa. This study aimed to estimate HLA-B*57:01 prevalence in individuals with HIV-1 in West and Central Africa. METHODS A cross-sectional study was conducted in four countries in West and central Africa (Burkina-Faso, Côte d'Ivoire, Gabon, and Togo) from January 2016 to February 2020 to determine the status of HLA-B*57:01 in adults with HIV-1. The presence of HLA-B*57:01 was determined by using Single Specific Primer-Polymerase Chain Reaction (SSP-PCR) in blood samples. Prevalence rates were stratified based on country. RESULTS A total of 4016 (69.8% women) individuals with HIV were enrolled. Their median age was 45, and the interquartile range was 38-52. We included 500 (12.4%) patients in Burkina-Faso, 1453 (36.2%) in Côte d'Ivoire, 951 (23.7%) in Gabon, and 1112 (27.7%) in Togo. The overall HLA-B*57:01 prevalence was 0.1% [95% CI: 0.0-0.2%]. The prevalence of HLA-B*57:01 was similar according to the four countries. Only one case was reported in each country except Togo, with no cases. CONCLUSIONS HLA-B*57:01 prevalence is low in individuals with HIV in West and central Africa, and there is no difference among countries. This study does not confirm the utility of HLA-B*57:01 allele testing for abacavir use in this region.
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Affiliation(s)
- Malewe Kolou
- Laboratoire de Biologie Moléculaire et d'Immunologie (BIOLIM), Université de Lomé, Faculté des Sciences de la santé, Lomé, Togo
| | - Armel Poda
- Department of Infectious Diseases, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - Zelica Diallo
- Département de Dermatologie et Maladies Infectieuses, Université Félix Houphouët-Boigny, UFR des Sciences Médicales, Abidjan, Côte d'Ivoire
| | - Esther Konou
- Laboratoire de Biologie Moléculaire et d'Immunologie (BIOLIM), Université de Lomé, Faculté des Sciences de la santé, Lomé, Togo
| | - Tatiana Dokpomiwa
- Department of Pharmacy, Faculty of Health Science, University of Abomey-Calavi, Cotonou, Benin
| | - Jacques Zoungrana
- Department of Infectious Diseases, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso
| | - Mounerou Salou
- Laboratoire de Biologie Moléculaire et d'Immunologie (BIOLIM), Université de Lomé, Faculté des Sciences de la santé, Lomé, Togo
| | - Lionèle Mba-Tchounga
- Programme PACCI, Site de recherche ANRS de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - André Bigot
- Department of Pharmacy, Faculty of Health Science, University of Abomey-Calavi, Cotonou, Benin
| | - Abdoul-Salam Ouedraogo
- Department of Medical Bacteriology and Virology, Université Nazi BONI, CHU Souro Sanou, Bobo-Dioulasso, Burkina Faso
| | - Marielle Bouyout-Akoutet
- Department of Parasitology, Mycology and Tropical Medicine, Université des Sciences de la Santé, Libreville, Gabon
| | - Didier K Ekouevi
- Département de santé Publique, Université de Lomé, Faculté des Sciences de la santé, Lomé, Togo.
- Centre Inserm 1219 & Institut de Santé Publique d'épidémiologie et de développement, Université de Bordeaux, Bordeaux, France.
| | - Serge P Eholie
- Département de Dermatologie et Maladies Infectieuses, Université Félix Houphouët-Boigny, UFR des Sciences Médicales, Abidjan, Côte d'Ivoire
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Aba YT, Moh R, Ello NF, Assi SB, Ano AM, Koffi B, Mossou MC, Diallo Z, Bissagnene E. Prevalence of malaria and clinical profile of febrile HIV infected patients in three HIV clinics in Ivory Coast. Malariaworld J 2017; 8:18. [PMID: 34532241 PMCID: PMC8415048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND To determine the prevalence and clinical profile of malaria among febrile HIV-infected patients followed up in three HIV clinics in Ivory Coast. MATERIALS AND METHODS A cross-sectional multicentre study was conducted between 2009 and 2010 in the Pneumology Department of Cocody Teaching Hospital in Abidjan, Medical Esperance Centre and the Regional Hospital in San-Pedro. Patients of all ages presenting with fever (rectal or axillary temperature >37,5°C) or a medical history of fever within 72 hrs prior to consultation were included. Parasitological diagnostic methods used were microscopy by blood smear (BS) for search malaria parasite and parasite density. Haemoglobin levels were assessed to assess anaemia. RESULTS Over the study period, 530 people living with HIV consulted for fever. The 476 patients included were predominantly female (n=280, 59%), with a median age of 34 (range 3-74 yrs), a mean of 38 ± 8.3 (SD) yrs, infected with HIV-1 (n=409, 86%), on antiretroviral therapy (n=376, 79%), and cotrimoxazole prophylaxis (n=381, 80%). Only 73 (15%) patients were using LLINs. Malaria prevalence was 10% (n=47). Plasmodium falciparum was the only species identified with a mean density of 15 900 trophozoites/μl. Malaria was more common among patients with a CD4 count of <200/mm3 (p<0.001) neither on cotrimoxazole prophylaxis (p<0.001) nor on antiretroviral therapy (ART) (p<0.001). Uncomplicated malaria accounted for 32 (68%) of the cases. The signs of severe malaria (n=15, 32%,) were dominated by severe anaemia (n= 12, 25.5%). CONCLUSION Our study revealed that malaria prevalence appears to be low in HIV clinics for people living with HIV on HAART and cotrimoxazole prophylaxis. Uncomplicated malaria is predominant when consultation is early. Signs of severe malaria were dominated by severe anaemia.
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Affiliation(s)
- Yapo T. Aba
- Department of Infectious and Tropical Diseases, University of Alassane Ouattara, Bouaké, Ivory Coast
| | - Raoul Moh
- Department of Infectious and Tropical Diseases, University of Felix Houphouet Boigny, Abidjan, Ivory Coast
| | - Nogbou F. Ello
- Department of Infectious and Tropical Diseases, University of Felix Houphouet Boigny, Abidjan, Ivory Coast
| | - Serge-Brice Assi
- Pierre Richet Institute, Bouaké, Ivory Coast
- National Institute of Public Health, Abidjan, Ivory Coast
| | - Ama M. Ano
- National Institute of Public Health, Abidjan, Ivory Coast
| | - Brigitte Koffi
- Department of Infectious and Tropical Diseases, University of Felix Houphouet Boigny, Abidjan, Ivory Coast
| | - Mélaine C. Mossou
- Department of Infectious and Tropical Diseases, University of Felix Houphouet Boigny, Abidjan, Ivory Coast
| | - Zelica Diallo
- Department of Infectious and Tropical Diseases, University of Felix Houphouet Boigny, Abidjan, Ivory Coast
| | - Emmanuel Bissagnene
- Department of Infectious and Tropical Diseases, University of Felix Houphouet Boigny, Abidjan, Ivory Coast
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Aba Y, Kone D, Diallo Z, Kra O, Botelho-Nevers E, Lucht F, Bissagnene E. Méningites bactériennes et infection par le VIH : analyse d’une série hospitalière dans un CHU de Côte d’Ivoire. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Aba YT, Cissé L, Abalé AK, Diakité I, Koné D, Kadiané J, Diallo Z, Kra O, Oulaï S, Bissagnéné E. [Neonatal and child tetanus morbidity and mortality in the University hospitals of Abidjan, Côte d'Ivoire (2001-2010)]. Bull Soc Pathol Exot 2016; 109:172-179. [PMID: 27177642 DOI: 10.1007/s13149-016-0483-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 02/23/2016] [Indexed: 06/05/2023]
Abstract
The lack of data on neonatal tetanus and children in university hospitals (UH) in Abidjan for over a decade has motivated the realization of this study. The objective of this study is to evaluate the morbidity and mortality related to neonatal tetanus (NT) and child tetanus (CT) in Abidjan University Hospital from 2001 to 2010. It is a retrospective study, multicenter analysis with records of newborns and children suffering from tetanus in the three UH of Abidjan. The collection and analysis of data were made by the SPHINX 4.5 and EPI.INFO 6.0 software. In ten years, 242 cases of tetanus (53 NT cases and 189 CT cases) were collected with a predominance of cases after the fifth year of life (59.5%). The incidence rate of NT was less than 1 case per 1,000 live births. All mothers of the newborns were inhabiting the city of Abidjan. Their median age was 19 years [16-32] and 64% were teenagers. Gateways were dominated by umbilical wounds (77.3%) in the NTand skin wounds (59%) in CT. The cure rate was 30.2% in the NT and 60% in the CT. Lethality was 60% for NT and 22% for CT with a positive correlation with young age (neonates: p = 4.10-7, age <5 years: p = 0.01), lack of intraspinal injection of tetanus serum (p = 8.10-6), the absence of conventional antibiotic therapy (p = 0.023), the existence of metabolic complications (p = 2.10-5), the score of ≥ 4 Dakar (p = 0.005). Tetanus remains a real morbidly cause among children in Abidjan University Hospital with high lethality. However, the incidence of NT seems consistent with the incidence threshold desired by WHO.
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Affiliation(s)
- Y T Aba
- Département de santé publique et Infectiologie, Université Alassane Ouattara de Bouaké, Côte d'Ivoire, France.
| | - L Cissé
- Service de pédiatrie médicale, CHU de Treichville, Côte d'Ivoire, France
| | - A K Abalé
- Service de pédiatrie médicale, CHU de Treichville, Côte d'Ivoire, France
| | - I Diakité
- Service de neurologie médicale, CHU de Yopougon, Côte d'Ivoire, France
| | - D Koné
- Département de santé publique et Infectiologie, Université Alassane Ouattara de Bouaké, Côte d'Ivoire, France
| | - J Kadiané
- Département de santé publique et Infectiologie, Université Alassane Ouattara de Bouaké, Côte d'Ivoire, France
| | - Z Diallo
- Service des maladies infectieuses et tropicales, CHU de Treichville, Côte d'Ivoire, France
| | - O Kra
- Département de santé publique et Infectiologie, Université Alassane Ouattara de Bouaké, Côte d'Ivoire, France
| | - S Oulaï
- Service de pédiatrie médicale, CHU de Treichville, Côte d'Ivoire, France
| | - E Bissagnéné
- Service des maladies infectieuses et tropicales, CHU de Treichville, Côte d'Ivoire, France
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Aba TY, Moh R, Cissé L, Yapo-Kouadio GC, Ello FN, Mossou C, Diallo Z, Kra O, Bissagnené E. Plasmodium falciparum malaria in northern Côte d'Ivoire: prevalence in the general hospital of Tanda sanitary district. Malariaworld J 2016; 7:1. [PMID: 38601357 PMCID: PMC11003207 DOI: 10.5281/zenodo.10784997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Background Until about 2010, the majority of data collected on malaria in Côte d'Ivoire were based on presumptive cases, particularly in the northern part of the country, where parasitological research had rarely been carried out. Recently, WHO recommended restricting treatment to confirmed malaria cases only. Thus, the purpose of this study determine the actual malaria prevalence amongst presumptive cases admitted to one of the general hospitals in the Northern part of the country, where malaria diagnosis is suboptimal. Materials and methods A cr oss-sectional study was conducted in the general medicine, maternity and paediatric wards between January and August 2010. Patients of all ages, suspected of having malaria, were included after giving their informed oral consent. Several parameters were investigated: the presence of Plasmodium using thick blood film, HIV/ Plasmodium co-infection, signs of severity, aspects of malaria treatment and other associated factors. Results Of 379 patients included, with a median age of 4 yrs [range 1 month - 71 yrs], 9% were HIV-positive, 74% were ≤ 15 yrs of age, 60% were urbanised and 23% were using long-lasting insecticide-treated nets. Malaria prevalence was 67.5% and was significantly associated with the rainy season (p < 0.001), age ≤ 5 yrs (p = 0.004) and no cotrimoxazole chemoprophylaxis in HIV-infected patients (p = 0.04). Only P. falciparum was detected, with a mean density of 12,523 trophozoites/μl of blood, but with 12,610 trophozoites/μl of blood in HIV-positive patients and 7,055 trophozoites/μl of blood in HIV-negative patients (p < 0.001). Severe malaria accounted for 77% of cases. Prescribed antimalarial drugs were: IM artemether (56%), quinine (28%), artemether + lumefantrine (10%) and artesunate + amodiaquine (6%). Apyrexia and parasite clearance were observed at day 2-3 post treatment in 87% of patients. Adverse events were reported among 60 patients (17%). The outcome was marked by: a healing rate of 90%, a rate of 5% lost to follow-up and a 7% lethality for severe malaria, significantly associated with the age ≤ 5 yrs (p=0.02), hyperparasitaemia >20% (p=0.004), neurological disorders (p < 0.001) and respiratory distress (p=0.007). Conclusions Malaria prevalence in the general hospital of Tanda remains high, with a predominance of sever e malaria affecting children under the age of 5 yrs.
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Affiliation(s)
- Thomas Y. Aba
- Département de Santé Publique et Infectiologie, Université Alassane Ouattara de Bouaké, Bouaké, Côte d’Ivoire
| | - Raoul Moh
- Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d’Ivoire
| | - Lassina Cissé
- Service de Pédiatrie, CHU de Treichville, Abidjan, Côte d’Ivoire
| | | | - Frederic N. Ello
- Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d’Ivoire
| | - Chrysostome Mossou
- Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d’Ivoire
| | - Zelica Diallo
- Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d’Ivoire
| | - Ouffoue Kra
- Département de Santé Publique et Infectiologie, Université Alassane Ouattara de Bouaké, Bouaké, Côte d’Ivoire
| | - Emmanuel Bissagnené
- Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d’Ivoire
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Eholié SP, Lacombe K, Krain A, Diallo Z, Ouiminga M, Campa P, Bouchaud O, Bissagnene E, Girard PM. Metabolic disorders and cardiovascular risk in treatment-naive HIV-infected patients of sub-saharan origin starting antiretrovirals: impact of westernized lifestyle. AIDS Res Hum Retroviruses 2015; 31:384-92. [PMID: 25707418 DOI: 10.1089/aid.2014.0164] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In a cohort of HIV-infected patients of sub-Saharan origin we describe the incidence of metabolic syndrome, insulin resistance, and lipodystrophy after 3 years of combined antiretroviral therapy, and model the 10-year risk of cardiovascular diseases, while taking into account environmental factors. This is a multinational, prospective cohort study conducted in HIV outpatient clinics from four tertiary care centers set in France and Côte d'Ivoire. The participants were HIV-infected, treatment-naive patients eligible to start antiretroviral treatment and were of sub-Saharan African origin. The main outcome measures were the incidence of metabolic syndrome, insulin resistance, and lipodystrophy, and the assessment of the 10-year risk of cardiovascular diseases using Framingham risk prediction, D.A.D. Cardiovascular Disease Risk, and WHO/ISH prediction charts. Of 245 patients followed for up to 3 years, the incidence of metabolic syndrome, insulin resistance, and lipodystrophy was 5.5, 8.5, and 6.8 per 100 person-years of follow-up (cumulative incidence: 14.4%, 19.2%, and 18.1%, respectively). Living in France as well as female gender and being overweight were risk factors for metabolic disorders as whole and only first generation protease inhibitors were marginally associated with metabolic syndrome. Cardiovascular risk as modeled through the three equations was high in all patients with the synergistic and deleterious effect of living in France compared to Côte d'Ivoire. This cohort study shows how the synergy between HIV, antiretroviral (ARV) exposure, and westernization of life style in a cohort of HIV-infected patients of sub-Saharan origin leads to a progressive increase in the risk of lipodystrophy, as well as metabolic syndrome and insulin resistance, all associated with increased cardiovascular risk.
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Affiliation(s)
- Serge Paul Eholié
- Department of Infectious Diseases and Tropical Medicine, Treichville University Hospital, Abidjan, Côte d'Ivoire
| | - Karine Lacombe
- University of Pierre and Marie Curie, Paris VI, France
- Department of Infectious Diseases and Tropical Medicine, Hospital Saint-Antoine, AP-HP, Paris, France
- Sorbonne Universités, UPMC University Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Alysa Krain
- Department of Infectious Diseases and Tropical Medicine, Hospital Saint-Antoine, AP-HP, Paris, France
| | - Zelica Diallo
- Department of Infectious Diseases and Tropical Medicine, Treichville University Hospital, Abidjan, Côte d'Ivoire
| | - Mariama Ouiminga
- Department of Infectious Diseases and Tropical Medicine, Treichville University Hospital, Abidjan, Côte d'Ivoire
| | - Pauline Campa
- Department of Infectious Diseases and Tropical Medicine, Hospital Saint-Antoine, AP-HP, Paris, France
| | - Olivier Bouchaud
- Department of Infectious Diseases and Tropical Medicine, Hospital Avicenne, AP-HP, Bobigny, France
| | - Emmanuel Bissagnene
- Department of Infectious Diseases and Tropical Medicine, Treichville University Hospital, Abidjan, Côte d'Ivoire
| | - Pierre-Marie Girard
- University of Pierre and Marie Curie, Paris VI, France
- Department of Infectious Diseases and Tropical Medicine, Hospital Saint-Antoine, AP-HP, Paris, France
- Sorbonne Universités, UPMC University Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
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