Assessment of the performance of six in vitro diagnostic kits for qualitative detection of hepatitis B virus surface antigen (HBsAg) in human serum or plasma in Lomé, Togo

Background: Several in vitro diagnostic (IVD) test kits for hepatitis B surface antigen (HBsAg) are commercially available. The question is whether they are performing well for both screening and diagnosis or not? Thus, this study aimed to evaluate the performance of six commercially available HBsAg detection kits in Togo. Methods: This study was conducted at the National Reference Center for HIV/STI testing in Lomé (CNR-VIH/IST), Togo. Reference sera used for the assessment were collected from blood donors and patients with history of hepatitis B viral (HBV) infection between 2008 and 2014, and includes 200 non-reactive HBsAg and 150 reactive HBsAg sera that were confirmed with a reference method which consisted of the combination of an ELISA, a RDT, and a molecular test. Four ELISA kits (EKOlab ELISA-HBsAg; HEPALISA ULTRA; HEPALISA; Murex AgHBs Version 3) and two RDTs kits (ACON AgHBs and OnSite HBsAg Rapid Test-Cassette) were then evaluated using these serum samples. The EPI-INFO software version 7.2 was used to determine the 95% confidence interval and performed statistical analysis. Results: Reference serum samples were collected from the population with 65.0% under 40 years of age and 61.2% males. The sensitivity of the 4 ELISA tests compared to the reference method was 100%. Apart from the HEPALISA test with a specificity of 100.0%, the specificity of the other three ELISA tests (Murex HBsAg version 3, HEPALISA ULTRA and EKOlab ELISA-HBsAg) were 98.4%, 97.3% and 91.8% respectively. For the RDTs, the sensitivity of ACON HBsAg and OnSite HBsAg Rapid Test-Cassette was 70.0% and 95.6% respectively while the specificity was 100.0% for both. Conclusion: The ELISA tests evaluated were more sensitive than the RDTs, and HEPALISA test was the most efficient. Of the two RDTs, the OnSite HBsAg Rapid Test-Cassette was more sensitive. Our findings highlight the need for onsite verification of in vitro diagnostic kits for qualitative detection of hepatitis B surface antigen before their routine use in Togo. Keywords: HBV, HBsAg, Performance, IVD tes

Observance thérapeutique de l’hypertension artérielle et ses facteurs dans le service de cardiologie du CHU Tokoin de Lomé

Introduction: Evaluer l’observance thérapeutique de l’HTA et de déterminer les facteurs de mauvaise observance chez les hypertendus au CHU Tokoin de Lomé Méthodes: Nous avons effectué une étude transversale descriptive sur une durée de 6 mois en consultation externe dans le service de Cardiologie du CHU-Tokoin de Lomé. L’étude a concerné 363 patients hypertendus. L’évaluation de l’observance a été effectuée avec le test d’évaluation de l’observance de Girerd. Résultats: Le revenu mensuel était inférieur à 50.000 FCFA chez 49,86% patients; 85,05% des patients n’avaient aucune assurance maladie. Le coût mensuel du traitement par patient était de 10.560 FCFA soit 37,74% du SMIG au Togo. Quatre-vingt et trois virgule soixante-quinze pour cent (83,75%) de nos patients avaient eu des difficultés à observer correctement leur traitement antihypertenseur. Parmi eux 52,34% étaient mauvais observants et 31,41% avaient de minimes problèmes d’observance. Seuls 16,25% étaient de bons observants. Les facteurs de mauvaises observances étaient: le revenu mensuel faible, l’absence d’assurance maladie, le nombre de comprimés et de prises de comprimés supérieurs à 3, et la tradithérapie. Conclusion: L’observance thérapeutique a été mauvaise dans notre série. Les facteurs de cette mauvaise observance sont multiples et variés mais dominés pour la plupart par la pauvreté et l’absence d’assurance maladie.Pan African Medical Journal 2013; 14:4

Evaluation of Power Losses in a DC-DC Boost Converter

DC-DC converters are dynamic systems consisting of the passive components. These components under the effect of thermal stress in a PV system generate power losses. The knowledge of these power losses is necessary to evaluate the conversion efficiency of the system. Using the polynomial approximation method, the equations for calculating losses in the different components were determined. The system is implemented under the MATLAB / Simulink software. The results show that for a PV application of 240 W supplied to the load, 18% are lost, only 82% are transferred

Morbidité et mortalité hospitalière des maladies cardiovasculaires en milieu tropical : exemple d’un centre hospitalier à Lomé (Togo)

Introduction: Les maladies cardiovasculaires (MCV) occupent une place importante dans la mortalité en Afrique, situation inquiétante tradui sant une transition épidémiologique rapide. La connaissance des  groupes nosologiques les plus mortelles devrait aider à l'élaboration de politiques en matière de  traitement et de prévention. Méthodes: Il's agit d une étude rétrospective du 1er janvier 2006 au 31  décembre 2010, ayant inclus les patients hospitalisés pour une MCV selon la classification Internationale des maladies (CIM-10). Résultats: La fréquentation hospitalière pour maladie MCV a augmenté au fil du temps ; les maladies hypertensives étaient le premier motif d hospitalisation (66.8%). Les autres  pathologies fréquentes étaient la maladie thromboembolique (9.1%), les syndromes coronaires aigus  (SCA) (7.3%),  l'insuffisance cardiaque (5.5%), les cardiomyopathies (5.3%). La majorité des sujets étaient jeunes (âge moyen : 55.1 ans) et il n'y avait pas de corrélation entre la durée d'hospitalisation et l'âge : r = + 0.024, p = 0.09. La mortalité globale était élevée (11%) et les taux de létalité élevés dans le SCA (27.9%), l'embolie pulmonaire (25%) et la péricardite (25%). Conclusion: Les MCV sont  responsables d'une hospitalisation croissante dans nos hôpitaux. L'absence d unité de soins intensifs cardiologiques et des méthodes de revascularisation coronaire, le manque de  personnels qualifiés associés l'inexistence de sécurité sociale expliquent une mortalité élevée dans nos  pays en voie de développement qui sans avoir achevé leur transition démographique entre en pleine  transition épidémiologique.Key words: Maladies cardiovasculaires, morbidité, mortalité, létalité, Afrique tropical

PLoS One

CONCLUSION: This study showed the diversity of circulating HPV genotypes in Togo. Programs of HPV vaccination and early detection of benign or precancerous lesions should be implemented to reduce cancer-related comorbidities

Rasch Analysis of the Upper-Limb Sub-scale of the STREAM Tool in an Acute Stroke Population

Background – Stroke is a leading cause of disability worldwide. The most common impairment resulting from stroke is upper limb weakness. Objectives - To determine the usefulness and psychometric validity of the upper limb sub-scale of the STREAM in an acute stroke population. Methods: Rasch Analysis, including unidimensionality assumption testing, determining model fit, and analysis of: reliability, residual correlations, & differential item functioning. Results - 125 individuals were assessed using the upper limb sub-scale of the Stroke Rehabilitation Assessment of Movement (STREAM) tool. Rasch analysis suggests the STREAM is a unidimensional measure. However, when scored using the originally proposed method (0-2), or using the response pattern (0-5) neither variant fit the Rasch model (p < 0.05). Although, the reliability was good (Person-Separation Index – 0.847 & 0.903 respectively). Correcting for the disordered thresholds, and thereby producing the new scoring pattern, led to substantial improvement in the overall fit (chi-square probability of fit - 22%), however, the reliability was slightly reduced (PSI – 0.806). Conclusions - The study proposes a new scoring method for the upper limb sub-scale of the STREAM outcome measure in the acute stroke population.Stroke Associatio

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

Actualité sur la maladie thromboembolique veineuse au CHU Sylvanus Olympio de Lomé

But de l’étude : Décrire les aspects épidémiologiques et diagnostiques de la maladie thromboembolique veineuse (MTEV) en milieu cardiologique à Lomé.Patients et méthode: Il s’est agit d’une étude rétrospective qui s’était déroulée du 1er janvier 2010 au 30 novembre 2011 dans le service de cardiologie du CHU Sylvanus. Ont été inclus les patients ayant présenté une thrombose veineuse (TV) ou une embolie pulmonaire (EP) documentées.Résultats : L’étude a inclus 69 patients avec un sexe ratio (H/F) = 0,68. La prévalence hospitalière des MTEV était de 3,05%. L’âge moyen était de 49,63 ± 17.78 ans. Les aspects cliniques de la MVTE étaient les TV des membres isolées 51 cas (73 ,91%), les embolies pulmonaires isolées 16 (23,20%) et l’association des deux dans 2 cas (2,89%). La TV au membre inférieur était de 51 cas (96,22%) contre 2 cas (3,78%) au membre supérieur. La répartition de la thrombose aux membres inférieurs (MI) donnait : MI gauche 31 patients (60,78%), MI droit 13 patients (25,49%) et les deux membres 5 patients (9,80%). Les facteurs étiologiques des TV étaient dominés par un alitement prolongé chez 11 patients (20,75%), suivi de cancer dans 9 cas (16,98%). Les EP avaient essentiellement comme facteurs étiologiques : des cardiopathies (50,00%), l’alitement prolongé (11,11), un traumatisme des MI avec plâtre (11,11%) et un  déficit quantitatif en protéine C (11,11%).Conclusion Les maladies thromboemboliques veineuses sont graves et fréquentes au Togo. Leurs facteurs favorisant sont multiples mais sont évitables.Mots clés : Thrombose veineuse, embolie pulmonaire, facteurs étiologiques, Lomé

Performance of the biomerieux DBS puncher and dried blood spots to measure HIV-1 viral load by real-time nuclisenseasyq HIV-1 assay

Introduction: The latest World Health Organization recommendations request viral load (VL) testing, if possible, for monitoring HIV-1 infections. However, the use of plasma is an obstacle to realize this test in sub-Saharan Africa. In this context, the dried blood spot (DBS) is an interesting tool for sample collections. The objective of this study was to assess the performance of, the bioMérieux PUNCHER a new toolfor cutting DBS.Methods: Plasma and DBS samples were obtained from 102 patients, with17 HIV-1 negative patients and 85 HIV-1 infected patients (58% were antiretroviral therapy naïve). DBS were stored at room temperature for 15 days before testing. The PUNCHER’s performance used to cut DBS was evaluated with following criteria: contamination, time of cut and VL measurement. VL was measured in parallel on plasma and DBS samples using NucliSENS EasyQ HIV-1.Results: No contamination was observed with negative samples. Sixty two DBS were cut in one hour. The correlation between plasma and DBS results was strong (R = 0.91; P&lt; 0.001). According to Bland-Altman approach the mean of differences was [-0.59 ± 0.65] log10 copies/ml.Conclusions: PUNCHER is highly efficient at cutting DBS, and the VL results from DBS correlated well with those obtained from plasma. bioMérieux puncher can be used to cut DBS for HIV-1 diagnosis and virological monitoring.Keywords: DBS, bioMérieux puntcher, performance, Viral loa