A Decade of Partnering to Stop HIV in West Africa: GAIA VF Prevention, Education, Access to Care and Vaccine Trial Site Development in Bamako, Mali

Poster Presentation from AIDS Vaccine 2012 Boston, MA, USA. 9-12 September 201

Knowledge/Attitude/Practices of HPV & Cervical Cancer, Willingness to Participate in Vaccine Trial in Preparation for HIV & HPV Vaccine Trials in Mali

Oral Presentation from AIDS Vaccine 2012 Boston, MA, USA. 9-12 September 201

The feasibility of integrated STI prevalence and behaviour surveys in developing countries

Objectives: To assess the feasibility of conducting a national combined STD prevalence and behaviour survey in Mali among vulnerable populations with the intention of institutionalisation. Methods: From March to June 2000 an integrated STI prevalence and behaviour survey was conducted using cluster sampling among five risk groups in four sites in Mali, west Africa. 2229 individuals in non-traditional settings such as taxi/bus stations, market areas, households, and brothels participated in any one or all components of the study: (1) behavioural questionnaire, (2) urine sample for Neisseria gonorrhoeae (GC)/Chlamydia trachomatis (CT) testing, (3) a fingerstick drop of blood for syphilis, and/or (4) HIV testing. Results: High participation rates of 84%–100% were achieved despite specimen collection and HIV testing. Rates fell only slightly when participants were asked to provide biological samples and participants were more likely to provide urine than blood. Rates among the different groups for HIV and syphilis testing are similar and suggest that refusal was most probably because of a reluctance to give blood rather than because of HIV testing. The cost of the biological component added approximately $30 per participant. Included in the$30 are the costs of training, participant services, laboratory personnel and supplies, STI drugs, and STI testing costs. The total cost of the survey was $154 905. Biomarkers aided in validation of answers to behavioural questions. Consenting individuals received HIV pretest and post-test counselling and referral to a trained health provider for treatment of STI and the provision of services provided the framework for interventions in the groups following the survey. Conclusion: This represents an effective methodology for collecting risk behaviour and STI/HIV prevalence information concurrently and should be considered by countries expanding STI/HIV surveillance as part of UNAIDS second generation HIV surveillance

Genetic subtypes of HIV type 1 and HIV type 2 strains in commercial sex workers from Bamako, Mali

In Africa the highest HIV infection rate has been reported among female commercial sex workers (CSWs) who are at increasing risk of acquiring and transmitting HIV infection. In October 1995, 176 CSWs were studied in Bamako, the capital city of Mali. The ages of the CSWs ranged from 15 to 50 years old (mean, 28.8 years). Only 20.45% of the 176 CSWs were Malian ; the majority were from Nigeria (32.9%) and Ghana (31.8%), and the remaining were from other African countries. Forty-one percent were active for less than 1 year as a commercial sex worker, and the length of prostitution for the remaining women ranged from 1 to 15 years (mean, 2.76). A total of 81 (46.02%) of the 176 CSWs were positive for HIV antibodies ; 63 (35.8%) were HIV-1 positive, 3.9% were HIV-2 posivitive, 11 (6.2%) had antibodies to HIV-1 and HIV-2, and none of them had antibodies to group O viruses. For all HIV antibody-positive samples, PBMCs were separated and genetic subtypes of HIV-1 were determined using the heteroduplex mobility assay (HMA), with ED5-ED12 as outer and ES7-ES8 as inner primers. Among the 66 HIV-1 strains characterized, 53 (80.3%) were subtype A, 2 (3.1%) belonged to subtype C, 1 (1.5%) belonged to subtype D, and 10 (15.1%) were identified as subtype G. Among the 10 subtype G strains, 8 were obtained from women who were very recent CSWs, with an activity of 1 year or less, assuming that there is a high probability that these infections occurred recently. Genetic subtypes of five HIV-2 viruses were determined by sequencing of the env and/or gag genes followed by phylogenetic analysis, and all of them belonged to subtype A. Comparison of HIV-1 and HIV-2 seroprevalence data from our study with previous data from Mali shows a significant rise in HIV-1 prevalence and a significant decrease in HIV-2 prevalence and confirms similar trends observed in neighboring countries... (D'après résumé d'auteur

Prévalence des entérobactéries productrices de bêtalactamases à spectre étendu isolées des hémocultures sur le continent Africain et les gènes impliqués chez les souches BLSE : revue de la littérature

Introduction: Les entérobactéries productrices de bêta-lactamases à spectre étendu ont été trouvées partout dans le monde. Des études de surveillance sont présentes en Europe, en Amérique, et en Asie, mais en Afrique, il n'y a pas eu de recherche récapitulative montrant la prévalence et la répartition de BLSE sur ce continent.But: Cette revue de la littérature a pour but de décrire la prévalence des entérobactéries productrices de bêta-lactamases à spectre étendu (E-BLSE) isolées des hémocultures en Afrique et les gènes BLSE impliqués dans la résistance.Matériel et méthodes: Une recherche de la littérature a été effectuée sur PubMed. Les articles publiés sur le domaine entre 1996 et 2014 ont été examinés et lus en texte intégral dans le but d’observer l’intérêt et la pertinence de la publication. Dans notre contexte, les articles qui étaient pertinents ont été évalués et inclus dans l'étude.Résultats: La prévalence des E-BLSE chez les patients hospitalisés et dans les communautés, varie largement entre les pays et pouvant atteindre souvent jusqu’à 77,8%. Plusieurs types d’échantillons ont été étudiés pour estimer la prévalence des EBLSE, mais le cas particulier des hémocultures reste vraiment limité. Les BLSE (classe  A et D) et AmpC plasmidique (pAmpC) ont régulièrement été trouvées, le gène CTXM- 15 de la classe A est prédominant sur le continent africain.Conclusion: Les entérobactéries productrices de bêta-lactamases à spectre étendu en milieux hospitaliers et communautaires sont courantes en Afrique. La majorité des études se sont réalisées au Nord et à l’Est, laissant presqu’un vide sur les autres parties du continent.Mots-clés: Afrique ; Bêta-lactamases à spectre étendu ; Entérobactérie ; Hémoculture ; PrévalenceEnglish Title: Prevalence of extended spectrum beta lactamases producing enterobacteria isolated from blood cultures on African continent and the involved genes in ESBL strains: literature reviewEnglish AbstractIntroduction: Extended-spectrum beta-lactamases producing Enterobacteria have been found worldwide. Surveillance studies are present in Europe, America, and Asia, but in Africa, there has been no research summary showing prevalence and distribution of extended-spectrum beta-lactamases on this continent.Aim: This literature review aims to describe the prevalence of Extended-spectrum betalactamases producing Enterobacteria (ESBL-E) isolated from blood cultures in Africa and the involved ESBL genes in resistance.Method: A literature search was performed in PubMed. Published articles in the field between 1996 and 2014 were reviewed and read in full text in order to observe the interest and relevance of the publication. In our context, articles that were relevant were assessed and included in the study.Results: Prevalence of ESBL-E in hospitalized patients and in communities varies largely between countries and often can reach up to 77.8%. Several types of samples were studied to estimate prevalence of ESBL-E, but the particular case of blood cultures is really limited. ESBLs (class A and D) and plasmid-encoded AmpC (pAmpC) have regularly been found, CTX-M-15 gene of the class A is predominant in AfricaConclusion: Extended-spectrum beta-lactamases producing Enterobacteria in hospital and communities areas are common around in Africa. Majority of studies were conducted in the North and in the East, leaving almost empty on other parts of the continent.Keywords: Africa; Blood culture; Enterobacteria; Extended spectrum beta-lactamases; Prevalenc