Mbeko Simaleko M, Longo JDD, Camengo Police SM
… +1 more, Piette D
Med Sante Trop
· 2018 Nov · PMID 30799831
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to understand the attitude of men who have sex with men (MSM) towards the use of condoms, to identify potential barriers to their use, environmental factors that facilitate or on the contrary, prevent this use, beliefs a...to understand the attitude of men who have sex with men (MSM) towards the use of condoms, to identify potential barriers to their use, environmental factors that facilitate or on the contrary, prevent this use, beliefs about contracting HIV, and priority needs of MSM for general prevention of sexually transmitted infections (STI). Individual interviews conducted in private with 20 MSM. In general, MSM recognize that condoms protect against STI as well as preventing unwanted pregnancies (although this is not our purpose here). The disadvantages of condom use that they reported included the potential for them to break and their reduction of pleasure. Barriers to their use include the belief that the partner is not HIV-positive, the shame of buying condoms, inability to wear them, and lack of financial resources, as well as social norms and false beliefs. MSM are aware of the positive role of condoms against STIs, including HIV. They perceive the dangerousness of the HIV, but do not feel vulnerable to this disease. They have identified obstacles to condom use, and their lists of perceived needs suggest solutions to them. Implementing these solutions in interventions should improve the frequency of condom use.
Takassi OE, Salou M, Djadou KE
… +5 more, Agbéko F, Agbèrè D, Géraldo R, Dagnra A, Atakouma Y
Med Sante Trop
· 2018 Nov · PMID 30799830
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INTRODUCTION: Children and adolescents are more vulnerable than adults to virologic failure and the emergence of resistance. The objective of our study was to determine the resistance patterns in adolescents on antiretro...INTRODUCTION: Children and adolescents are more vulnerable than adults to virologic failure and the emergence of resistance. The objective of our study was to determine the resistance patterns in adolescents on antiretroviral therapy at Sylvanus Olympio University Hospital in Lome, Togo. METHODS: From June 1 to September 30, 2014, we included patients who had been on HAART for more than 12 months in the pediatric ward of Sylvanus Olympio University Hospital. Patients with an HIV viral load ≥ 1000 copies underwent resistance genotyping. RESULTS: Virologic failure was found in 36 of the 198 children and adolescents in the study (18.2%). Half were in WHO stage 3,72.2% were treated with a combination of two NRTIs (nucleoside reverse transcriptase inhibitors) and one NNRTI (non-nucleoside reverse transcriptase inhibitor). The mutations were mostly found in the NNRTI class with 100% mutations for EFV and NVP. The mutations associated with the most frequent NRTIs were M184V, Y181C, and T215Y. CONCLUSION: Our study shows the need to use PIs (boosted protease inhibitors) in most children treated with NNRTI. It is necessary to strengthen the virological monitoring of children on HAART.
Mabiala Babela JR, Kibangou Lenvo M, Nika ER
… +3 more, Ollandzobo Ikobo LC, Missambou Mandilou SV, Ngoulou BPS
Med Sante Trop
· 2018 Nov · PMID 30799829
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UNLABELLED: Antiretroviral agents (ARVs) are the leading therapeutic weapon against HIV/AIDS infection. When first-line treatment fails, a second-line ARV is needed. OBJECTIVE: To determine the prevalence of HIV-infected...UNLABELLED: Antiretroviral agents (ARVs) are the leading therapeutic weapon against HIV/AIDS infection. When first-line treatment fails, a second-line ARV is needed. OBJECTIVE: To determine the prevalence of HIV-infected children treated with second-line ARVs, to assess their adherence and therapeutic response, and to identify factors of good adherence. MATERIAL AND METHODS: A retrospective multicenter study covering the period from January 2015 to July 2016 in all centers providing care to children with HIV included all children treated with a second-line ARV. RESULTS: A total of 71 children were identified, with a male to female ratio of 1.1 and a mean age of 14.2±3.2 years (range: 5 to 19). Mother-to-child transmission was observed for 97.2 %. In all, 64.8 % of the children had lost at least one parent, 29.6 % both of them. Family socioeconomic status was low for 15.5 % and middle for 74.6 %. Nearly half (46.5 %) were aware of their HIV status, and all received psychological support. The therapeutic regimen used for 54.9 % included ABC + DDI + LPV/r, and the treatment lasted for less than 2 years in 22.5 % and between 2 and 4 years in 38 %. Therapeutic adherence was good in 54.9 %, better in boys (p < 0.01) and in those aged 15 years and younger (p < 0.001). The therapeutic response was good in 89 % at 12 months and 86 % at 4 years, better in those aged 15 years and younger (p < 0.001). CONCLUSION: Despite the small proportion of good therapeutic adherence to second-line ARVs, the rate of good clinical and therapeutic response of 86 % in children and adolescents 4 years after being switched to them is an argument that should encourage prescribers to shift patients to second-line treatment as soon as there is an indication. However, challenges remain in improving the management of children and adolescents treated with a second-line ART.
Attinsounon CA, Agbodande KA, Wanvoegbe A
… +5 more, Alassani CA, Dovonou CA, Akakpo EJ, Azon-Kouanou A, Zannou DM
Med Sante Trop
· 2018 Nov · PMID 30799828
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OBJECTIVES: The aim of this study was to describe the therapeutic situation of patients who had been followed up for antiretroviral therapy for at least 5 years. PATIENTS AND METHODS: A retrospective and descriptive stud...OBJECTIVES: The aim of this study was to describe the therapeutic situation of patients who had been followed up for antiretroviral therapy for at least 5 years. PATIENTS AND METHODS: A retrospective and descriptive study reviewed records of the historical cohort of adults infected with HIV in the national and teaching hospital at Cotonou from January 2, 2002, to March 31, 2013. It included all patients with follow-up for ART for at least five years. Immunological success was defined as a CD4 count above 350 cells/μl at the last test during the study period, and therapeutic success by viral load determined to be undetectable at its last measurement. Data were extracted from the updated ESOPE. STATA 11 software was used for data analysis. RESULTS: In March 2013, 979 patients, accounting for 27.1% of the overall cohort at the site, had been followed up for at least 5 years for ART. Their mean age was 38.1 ± 9.6 years and the sex-ratio (M/F) was 0.7. Analysis showed that 12.3% had been lost to follow-up, 2.3% had died, and 83.6% remained in treatment. The mean CD4 count at treatment initiation was 113.4±90.7 cells/μl, at 5 years 566.6±355.2 cells/μl, and at 10 years, 557.5±311.2 cells/μl. More than half (56.1%) of patients were treated with a first-line ART combination. Immunological success was reported for 63.2% of the patients. Of the 144 patients with a last viral load available, the therapeutic success rate was 76.4%. The probability of survival was 0.95 at 5 years and 0.91 at 10 years. CONCLUSION: Improving the quality and continuity of care can help to ensure short-term survival for PLHIV under a first-line ART treatment in resource-limited countries.
Med Sante Trop
· 2018 Nov · PMID 30799827
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INTRODUCTION: free access to antiretroviral (ARV) treatment has made possible the large-scale management of people living with HIV (PLHIV). Nonetheless, some of them abandon treatment and thus become lost to follow-up. R...INTRODUCTION: free access to antiretroviral (ARV) treatment has made possible the large-scale management of people living with HIV (PLHIV). Nonetheless, some of them abandon treatment and thus become lost to follow-up. Retention is therefore a challenge for treatment programs, especially in resource-limited countries. To improve retention of patients in our active file, we undertook this study, aimed generally at analyzing the follow-up of our patients on ARV. Materials and méthods: This cross-sectional, descriptive, retrospective, and analytical study covered the period from January 2009 to December 2013 at the Treichville sexually transmitted disease (STD) center and reviewed the records of all AIDS patients with ARV treatment aged 16 years and older with complete records. All patients who had not consulted again within 3 months of their last treatment visit were considered lost to follow-up. RESULTS: This study involved 346 patient records. Their average age was 37.5 years, with a sex ratio of 2.17 in favor of women. The overall dropout rate (percentage of patients lost to follow-up) was 19.94% and peaked at 33.33% in 2011. The average age of the patients lost to follow-up was 35.6 years. Patients who transferred to another care center accounted for 14.16% of all patients, deaths for 4.05%, and 61.56% continued care. Only 1 patient stopped treatment. CONCLUSION: The rate of discontinuation of ARV therapy was high in our study. Knowledge of the sociological aspects of those lost to follow-up is necessary to develop strategies for their retention in active treatment.
Med Sante Trop
· 2018 Nov · PMID 30799826
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The results of the fight against tuberculosis in Cameroon remain far from the WHO goals for the eradication of tuberculosis on a global scale, which aim to achieve a global incidence rate of fewer than 100 cases per mill...The results of the fight against tuberculosis in Cameroon remain far from the WHO goals for the eradication of tuberculosis on a global scale, which aim to achieve a global incidence rate of fewer than 100 cases per million inhabitants by 2035. The objective of this study was to describe the social, demographic, and clinical profiles of all patients (n=59) with tuberculosis at the Saint Vincent de Paul Hospital in Dschang, Cameroon, over a one-year period, with an emphasis on their healthcare paths to identify potential factors that may explain delays in their diagnosis and follow-up. Epi Info Version 3.5.3 and Microsoft Excel 2013 software were used to analyze the data. The results of the study showed men accounted for 57.6% of the patients (sex ratio: 1.36). The participants' mean age was 41.87 ± 12 years. The mean duration from onset of first symptoms to the clinical and laboratory diagnosis of TB was 3.26 months. Initially 38.98%, sought care from illicit drug sellers (street sellers), 23.73% from hospital facilities, and 22.03% from traditional medicine practitioners. The influence of illicit drug sellers and traditional practitioners in delaying the diagnosis of these TB infections should be taken into account in national TB control policies in Cameroon.
Diongue K, Baha Z, Seck MC
… +3 more, Ndiaye M, Diallo MA, Ndiaye D
Med Sante Trop
· 2018 Nov · PMID 30799825
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INTRODUCTION: Candida infections are most frequently encountered on the skin and nails. Their proportions vary according to geoclimatic and sociocultural conditions. The objective of this study was to determine the preva...INTRODUCTION: Candida infections are most frequently encountered on the skin and nails. Their proportions vary according to geoclimatic and sociocultural conditions. The objective of this study was to determine the prevalence of skin and/or nail candidiasis diagnosed in the parasitology and mycology laboratory of Le Dantec University Hospital in Dakar, Senegal. MATERIALS AND METHODS: This study included 994 patients with suspected skin and/or nail mycosis tested at the parasitology and mycology laboratory during the 8-year study period of 2008-2015. Each patient had both a direct examination and a mycological culture. RESULTS: The patients' median age was 34 with an interquartile range of 25 years. Of these 994 patients, 613 had confirmed skins and/or nail fungal infections. In descending order, the fungi isolated and identified from these mycoses were Candida (n= 387, 63.1%), dermatophytes (28.4%), and mold (8.5%). Thus Candida accounted for nearly two thirds of the skin and/or nail mycoses and had a prevalence rate among the patients with suspected skin or nail candidiasis of 38.9%. These skin/nail sites was more common among women (72%) than men (28%), and slightly more than half of them (50,1%) were adults aged 31 to 60 years. The duration of candidiasis exceeded a full year for 76.3%. Onychomycoses were found more frequently (65.24%) than epidermomycoses, and both sites were infected in 5.17%. Candida albicans was the species isolated most frequently, accounting for 80% of Candida specimens. CONCLUSION: Our results reinforce the importance of mycological confirmation of the diagnosis. The mycology laboratory has a crucial role in making the differential diagnosis with other dermatoses of similar clinical appearance and thus in guiding the choice of treatment.
Pancha Mbouemboue O, Ngoufack Tsougmo JO, Sakinatou I
… +2 more, Velinga Ndolok AC, Tangyi Tamanji M
Med Sante Trop
· 2018 Nov · PMID 30799824
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UNLABELLED: Diabetes imposes a heavy economic burden on low and middle-income countries. The aim of this work was to study the mean value of fasting blood glucose, as well as of the prevalence, awareness, treatment, and...UNLABELLED: Diabetes imposes a heavy economic burden on low and middle-income countries. The aim of this work was to study the mean value of fasting blood glucose, as well as of the prevalence, awareness, treatment, and control of diabetes in Ngaoundere. METHODOLOGY: This cross-sectional community-based study selected participants according to a three-level cluster sampling method. The variables measured were sociodemographic data, medical history, sleep duration, blood pressure, body mass index, abdominal perimeter, fasting blood glucose, and serum triglyceride and total cholesterol levels. Data were analyzed with SPSS 20.0 software. RESULTS: The study included 948 participants aged 20 to 87 years. Their average fasting blood glucose was 0.85 ± 0.20 g/L. The prevalence of diabetes was 5.59%. It increased with age (p < 0.001), body mass index (p = 0.03), abdominal obesity (p = 0.041), hypertension (p < 0.001), and total cholesterol (p = 0.008). In the multivariate analysis, age greater than or equal to 65 years (p = 0.012) and hypertension (p = 0.001) were independently associated with diabetes. Most patients with diabetes (84.91%) were aware of their disease, but only 13.33% were receiving treatment, and the disease of only 50% of those treated was controlled. CONCLUSION: In Ngaoundere, the prevalence of diabetes is 5.59 %, its control is poor, and its treatment rate is low.
Delisle L, Besancon S, Beran D
… +38 more, Aronica E, Balcou-Debussche M, Balde N, Batal M, Bernasconi J, Burgalat B, Chabre O, Chancel P, Comte E, Coulon A, Debeaufort C, Debussche X, De Kerdanet M, Delfraissy JF, Drabo J, Du-Boullay H, Duriez G, Fleury C, Fontbonne A, Genay Diliautas S, Giron C, Giros E, Hacquin D, Mary C, Micheletti P, Mohadji F, Olejas S, Paquet C, Quick I, Raymond G, Salignon P, Shojaei T, Sidibe AT, Touraine P, Toure O, Wackernie S, Waterlot C, Weil O
Med Sante Trop
· 2018 Nov · PMID 30799821
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Med Sante Trop
· 2018 Nov · PMID 30799820
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The WHO global coordination mechanism on noncommunicable diseases (GCM/NCD) was created in 2014 by the World Health Assembly to provide a platform for exchange and coordination between the 194 Member States, the United N...The WHO global coordination mechanism on noncommunicable diseases (GCM/NCD) was created in 2014 by the World Health Assembly to provide a platform for exchange and coordination between the 194 Member States, the United Nations organizations and to date, more than 200 non-State actors to federate actions around a collaborative program aimed at meeting the NCD-related targets of the Sustainable Development Goals and to reduce the premature mortality attributable to these diseases. This mechanism has five functions: advocating and raising awareness, disseminating knowledge and information, encouraging innovation and identifying barriers, advancing multisectoral action, advocating for mobilization of resources.
Besançon S, Sidibe AT, Beran D
… +1 more, Fleury-Perkins C
Med Sante Trop
· 2018 Nov · PMID 30799819
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Several years ago, infectious diseases such as tuberculosis, HIV/AIDS, and malaria were the principal health menace on an international scale. But, today, noncommunicable diseases (NCD), such as diabetes and cardiovascul...Several years ago, infectious diseases such as tuberculosis, HIV/AIDS, and malaria were the principal health menace on an international scale. But, today, noncommunicable diseases (NCD), such as diabetes and cardiovascular diseases, are a health emergency in both high- and low-income countries. The NGO Santé Diabète (Diabetes Health) has now been developing actions for diabetes prevention and management in Africa for 15 years. The strategies they have developed combine advocacy, support for the Ministry of Health for the implementation of plans to fight NCDs, staff training, and the establishment of a structure for prevention and management. In Mali, these activities, begun a decade ago, now manage 15,000 patients with diabetes.
Med Sante Trop
· 2018 Nov · PMID 30799818
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Late diagnosis and lack of access to insulin contribute most to the mortality of people with type 1 diabetes. The presence of this chronic noncommunicable disease is not bound by borders or even continents. Without treat...Late diagnosis and lack of access to insulin contribute most to the mortality of people with type 1 diabetes. The presence of this chronic noncommunicable disease is not bound by borders or even continents. Without treatment, it is fatal, while with treatment and good control, it is possible to prevent acute complications (hyperglycemia and hypoglycemia) and to reduce severe late complications (cardiovascular and cerebrovascular, kidney failure and blindness). Access to equipment and supplies for diagnosis and to essential drugs for hospitals and later families at an affordable price is critical to mortality and morbidity in Africa. Intensive training of professionals in the field and in hospitals to recognize and treat this disease is necessary. These factors, together with intensive education of patients and their families, can reduce the mortality and morbidity of diabetes. Adequate management of diabetes, an important noncommunicable disease, will contribute to meeting the Sustainable Developments Goals and reducing infant mortality.
Med Sante Trop
· 2018 Nov · PMID 30799817
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For some 40 years now, in France, the progressive recognition of the knowledge and experience of patients has been accompanied by an institutionalization of their participation and a diversification of the spaces in whic...For some 40 years now, in France, the progressive recognition of the knowledge and experience of patients has been accompanied by an institutionalization of their participation and a diversification of the spaces in which they act. In this contribution, we offer an analytic look at the different forms of patient participation in the health world, in France and abroad. This non exhaustive overview underlines the need to pay particular attention to the conditions required if the shared experiences of care providers and patients are to serve as an occasion to optimize and revitalize the approach to medical care.
Med Sante Trop
· 2018 Nov · PMID 30799816
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Access to drugs is a key element in the treatment of diabetes. Access remains an issue because of their price, availability, and especially affordability. Two elements included in the sustainable development goals - univ...Access to drugs is a key element in the treatment of diabetes. Access remains an issue because of their price, availability, and especially affordability. Two elements included in the sustainable development goals - universal health coverage and partnerships - offer an opportunity to improve access.
Med Sante Trop
· 2018 Nov · PMID 30799815
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Chronic noncommunicable diseases are increasingly frequent in low- and medium-income countries, but problems of malnutrition, such as growth restriction in children or micronutrient deficiencies in both children and adul...Chronic noncommunicable diseases are increasingly frequent in low- and medium-income countries, but problems of malnutrition, such as growth restriction in children or micronutrient deficiencies in both children and adults, persist in these same countries. This double burden of malnutrition and the emergence of chronic diseases such as type 2 diabetes strain healthcare systems and constitute a sometimes unbearable load for the countries concerned, for the government, but also for the individuals affected and their families. This double burden is often associated with the nutrition transition or the progression away from the local traditional diet towards a Westernized diet frequently high in fat, salt, and sugar, with low nutritional density. This transition is attributed to worldwide changes in dietary systems expressed by an increased availability of foodstuffs marketed across the planet, such as vegetable oils, sugars, and refined flours, but also the multiplication of points of sale of food that has been processed, even ultraprocessed. The efforts to battle this scourge must take into account the complexity of the phenomenon and the many factors associated with it. A systemic approach that considers the global forces governing the food systems must be promoted. Actions concerning nutrition must therefore emphasize simultaneously the problems of undernutrition and of overnutrition. WHO labels these interventions "double duty actions."
Med Sante Trop
· 2018 Nov · PMID 30799814
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Although different in nature, HIV/AIDS and the noncommunicable diseases have many issues in common: the importance of rapid screening, the high cost of treatment, patients' treatment adherence, and the challenge of integ...Although different in nature, HIV/AIDS and the noncommunicable diseases have many issues in common: the importance of rapid screening, the high cost of treatment, patients' treatment adherence, and the challenge of integrating services in basic health facilities, especially in the South. Several lessons can be drawn today from the fight against AIDS (about community involvement, the organization of research, free treatment, and the mobilization of funding) that can nourish strategic thinking for the fight against noncommunicable diseases.
Zouirech M, Rhajaoui M, Faraj C
… +6 more, El Guamri Y, Amahmid O, El Hachimi MY, Bouhout S, El Kharrim K, Belghyti D
Med Sante Trop
· 2018 Nov · PMID 30728115
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In Morocco, leishmaniases are a major public health problem due to their genetic diversity and geographical distribution. Cutaneous leishmaniasis caused by L. tropica is endemic in the center of the country; it has a hig...In Morocco, leishmaniases are a major public health problem due to their genetic diversity and geographical distribution. Cutaneous leishmaniasis caused by L. tropica is endemic in the center of the country; it has a high risk of transmission, with Phlebotomus sergenti as vector. This study aimed to identify the vectors of Leishmania and the epidemiological trends of cutaneous leishmaniasis in Afourer, Morocco. The entomological study used both adhesive and CDC miniature light trap to capture six different species: P. sergenti (50.21 %), P. papatasi (18.45 %), P. longicuspis (17.17 %), P. perniciosus (12.02 %), S. minuta (1.93 %) and P. chabaudi (0.21 %). The life cycle of sand flies in this area is characterized by a biphasic trend with two activity peaks, in May and November. Hence, the highest transmission levels are likely to occur from early summer to the end of autumn. However, the epidemiological status of leishmaniasis in Afourer between 2009-2013 showed a significant decreasing trend - of 87.7 %.