Men who have sex with men (MSM) and factors associated with not using a condom at last sexual intercourse with a man and with a woman in Senegal

BACKGROUND: Men who have sex with other men (MSM) are a vulnerable population in Africa that has been insufficiently explored. Given the high rate of bisexuality among MSM (73% in the past year), it is important to understand their risk-taking behaviors regarding both men and women. METHODOLOGY/PRINCIPAL FINDINGS: A socio-behavioral survey was carried out in 2007 among 501 MSM recruited using the snowball sampling method. We explore in this article why a condom was not used during last sexual intercourse with a man and with a woman, taking into account the respondent's characteristics, type of relationship and the context of the sexual act. In the survey, 489 men reported that they had had sexual intercourse at least once with another man during the previous year, and 358 with a man and with a woman. The main risk factors for not using a condom at last sexual intercourse with another man were having sex in a public place (aOR = 6.26 [95%CI: 2.71–14.46]), non-participation in an MSM prevention program (aOR = 3.47 [95%CI: 2.12–5.69]), a 19 years old or younger partner (aOR = 2.6 [95%CI: 1.23–4.53]), being 24 years or younger (aOR = 2.07 [95%CI: 1.20–3.58]) or being 35 years or over (aOR = 3.08 [95%CI:1.11–8.53]) and being unemployed (aOR = 0.36 [95%CI: 0.10–1.25]). The last sexual intercourse with the respondent's wife was hardly ever protected (2%). With women, the other factors were a 15 years or younger partner (aOR = 6.45 [95%CI: 2.56–16.28]), being educated (primary: aOR = 0.45 [95%CI: 0.21–0.95], secondary or higher: aOR = 0.26 [95%CI: 0.11–0.62]), being a student (aOR = 2.20 [95%CI: 1.07–4.54]) or unemployed (aOR = 3.72 [95%CI: 1.31–10.61]) and having participated in a MSM prevention program (aOR = 0.57 [95%CI: 0.34–0.93]). CONCLUSION: Having participated in a prevention program specifically targeting MSM constitutes a major prevention factor. However, these programs targeting MSM must address their heterosexual practices and the specific risks involved

Ectopia cordis about a case at Ourossogui regional hospital center

We report in this work, an extremely rare and major case of anterior body wall defects included ectopia cordis define by abnormal location of heart outside of the thorax. This case was diagnosed at the maternity of Ourossogui regional hospital center, in Senegal. Any scan was performed during the pregnancy. Newborn died 10 minutes after birth. Ectopia cordis is related to a possible ventral midline developmental abnormality. It’s associated to other midline abnormalities and is a part of pentalogy of Cantrell. An X-linked genetic abnormality

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

A Rare Cause of Obstructive Chronic Hydrocephalus in an Adult Patient: A Case Report of Fourth Ventricle\'s Foramina Idiopathic Stenosis

Background & Importance: Idiopathic stenosis of the foramina of Magendie and Luschka is a rare cause of obstructive hydrocephalus involving the fourth ventricle. Case Presentation: We reported the case of a 40-year-old woman who developed headaches and vertigo for several months and more recently gait disturbance. The CT scan showed quadri-ventricular hydrocephalus involving mainly the fourth ventricle with dilated lateral recesses. Craniocervical MRI confirmed hydrocephalus and also showed the brainstem and cerebellar tonsil herniation through the foramen magnum with hydromyelia and a hyperintense signal on T2 weighted MRI of cervical spinal cord. Biological analyses were normal. She underwent endoscopic third ventriculostomy (ETV). No complication was observed. The patient became asymptomatic during the weeks following the surgical procedure and remained stable at a mean follow-up interval of 20 months. Postoperative MR images demonstrated regression of the hydrocephalus; complete disappearance of brainstem and cerebellar tonsil herniation, hydromylia and the hyperintense signal on T2 weighted MRI of cervical spinal cord. Conclusion: This case confirms the existence of hydrocephalus caused by idiopathic fourth ventricle outflows obstruction in adult and the efficacy of ETV for this rare indication

Men who have sex with men (MSM) and risk factors associated with last sexual intercourse with a man and a woman in Senegal - ELIHoS Project, ANRS 12139

BackgroundMen who have sex with other men (MSM) are in Africa a vulnerable population which has hitherto been insufficiently explored. Given the high rate of bisexuality among MSM, it is important to understand their risk-taking behaviours regarding both men and women.MethodsA socio-behavioural survey was carried out in 2007 among 501 MSM recruited using the snowball sampling method. We explore in this article why a condom was not used during last sexual intercourse with a man and with a woman, bearing in mind the respondent’s characteristics, type of relationship and the context of the sexual act.Results489 men reported that they had had sexual intercourse at least once with another man during the previous year, and 358 with a man and with a woman. With another man, the main risk factors are sexual intercourse in a public place (adjusted OR = 6.8), and non-participation in an MSM prevention program (adjusted OR = 3.1). The risks, although non-significant at 5%, are higher among younger men (18-19 years) and older men (35 years and over), and among vulnerable people (unemployed). With a woman, sexual intercourse with the respondent’s wife is hardly ever protected (2%). Otherwise, risks are high when the female partner is very young (15 years or younger, adjusted OR = 5.3) and when the man has not participated in an MSM prevention campaign (adjusted OR = 2.3).ConclusionHaving participated in a prevention program specifically targeting MSM constitutes a major prevention factor. However, these programs targeting MSM must address their heterosexual practices and the specific risks involved

Sexual practices at last sexual intercourse.

<p>Sum of columns exceeds 100% (several answers possible).</p

Unprotected anal or vaginal sex at last sexual intercourse with a man and at last sexual intercourse with a woman (bivariate analysis).

<p>Continue in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0013189#pone-0013189-t003" target="_blank">Table 3</a>.</p