Seroprevalence Of Human Immunodeficiency Virus Infection Among Tuberculosis Patients In The Nylon District Hospital Tuberculosis Treatment Centre

Background: Tuberculosis (TB) incidence in Cameroon is high with 32% of adult TB patients, all forms, co-infected with HIV. The Nylon District Hospital in Douala runs a centre for the diagnosis and treatment of TB since 2001 and a pioneer Human Immunodeficiency Virus (HIV)/Acquired Immune deficiency Syndrome (AIDS) management programme at district level since 2000. Objective: To determine the prevalence of HIV infection in TB patients from 2003 to 2006 and to analyse the pattern of TB/HIV co-infection rate over time. Design: A retrospective study. Setting: Nylon District Hospital, Douala, Cameroon. Results: The prevalence of HIV infection in TB patients was 51.6%. This was greater for patients living out of the Nylon Health District (P= 0.001). Smear positive pulmonary tuberculosis (SPPT) was the most frequent (65%) form of TB diagnosed but extrapulmonary tuberculosis (EPT) and smear negative pulmonary tuberculosis (SNPT) were more frequently associated with HIV co-infection (80% and 68.6% respectively). While men and women presented equally with TB, women (61.4%) were significantly (P< 0.0001) more TB/HIV co-infected than men (42%). The co-infection rate was highest among individuals aged 25-44 years (61.4%) and least among the 0-24 years age group (22.5%). The increase in TB/HIV co-infection rate is monotonic over time with a stronger trend among females aged 25-44 years (P= 0.037) and above 45 years (P= 0.001). Conclusion: The NDH selectively attracted HIV positive patients to adhere to their HIV programme. The creation of HIV / AIDS treatment units in institutions providing TB diagnosis and treatment services will reduce the movement of TB/HIV co-infected patients across provinces and health districts as well as enhancing TB/HIV co-infection diagnosis and notification. East African Medical Journal Vol. 85 (11) 2008: pp. 529-53

Sexual behavior of HIV-positive women in Cameroon

This study aimed at describing the sexual behavior of HIV-positive women in Cameroon. In a cross-sectional study, 282 HIV-infected women were enrolled in 3 HIV-treatment clinics in Cameroon. Of the 282 participants, 257 had been diagnosed with HIV for more than 6 months. Approximately half (46.8%) of these 257 women reported no sex partners in the 6 months before the study; 42.9% had 1 partner; and 1.5% had more than 1 partner. There was a significant decrease in the number of partners, new partners, and an increase in condom use with these partners following HIV diagnosis (P value < .05). However, more than half (55.2%) of the sexually active participants reported inconsistent or no condom use during sexual intercourse. Although HIV-positive women tend to adopt less risky behavior after HIV diagnosis, a substantial proportion of sexually active ones still have risky behaviors. Reinforcing risk reduction programs for these women is imperative

SEROPREVALENCE OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION AMONG TUBERCULOSIS PATIENTS IN THE NYLON DISTRICT HOSPITAL TUBERCULOSIS TREATMENT CENTRE

Background: Tuberculosis (TB) incidence in Cameroon is high with 32% of adult TB patients, all forms, co-infected with HIV. The Nylon District Hospital in Douala runs a centre for the diagnosis and treatment of TB since 2001 and a pioneer Human Immunodefi ciency Virus (HIV)/Acquired Immune defi ciency Syndrome (AIDS) management programme at district level since 2000. Objective: To determine the prevalence of HIV infection in TB patients from 2003 to 2006 and to analyse the pattern of TB/HIV co-infection rate over time. Design: A retrospective study. Setting: Nylon District Hospital, Douala, Cameroon. Results: The prevalence of HIV infection in TB patients was 51.6%. This was greater for patients living out of the Nylon Health District (P= 0.00 I). Smear positive pulmonary tuberculosis (SPPT) was the most frequent (65%) form of TB diagnosed but extrapulmonary tuberculosis (EPT) and smear negative pulmonary tuberculosis (SNPT) were more frequently associated with HIV co-infection (80% and 68.6% respectively). While men and women presented equally with TB, women (61.4%) were signifi cantly (P&lt; 0.0001) more TB/HIV co-infected than men (42%). The co-infection rate was highest among individuals aged 25-44 years (61.4%) and least among the 0-24 years age group (22.5%). The increase in TB/HIV co-infection rate is monotonic over time with a stronger trend among females aged 25-44 years (P= 0.037) and above 45 years (P= 0.001). Conclusion: The NDH selectively attracted HIV positive patients to adhere to their HIV programme. The creation of HIV / AIDS treatment units in institutions providing TB diagnosis and treatment services will reduce the movement of TB/HIV co-infected patients across provinces and health districts as well as enhancing TB/HIV co-infection diagnosis and notifi cation

Présentation atypique d'une duplication intestinale chez un enfant de trois mois

Intestinal duplication is an uncommon congenital anomaly that often is diagnosed during childhood. Ultrasound diagnosis is based on the presence of a characteristic double-walled cystic mass. We report a case of duplication in a three month old child presenting with small bowel obstruction. This case is unusual due to the presence of calcifications that are uncommon in intestinal duplication.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Natural Killer Cells Promote Tissue Injury and Systemic Inflammatory Responses During Fatal Ehrlichia-Induced Toxic Shock-Like Syndrome

Human monocytotropic ehrlichiosis is caused by Ehrlichia chaffeensis, a Gram-negative bacterium lacking lipopolysaccharide. We have shown that fatal murine ehrlichiosis is associated with CD8+T cell-mediated tissue damage, tumor necrosis factor-α, and interleukin (IL)-10 overproduction, and CD4+Th1 hyporesponsiveness. In this study, we examined the relative contributions of natural killer (NK) and NKT cells in Ehrlichia-induced toxic shock. Lethal ehrlichial infection in wild-type mice induced a decline in NKT cell numbers, and late expansion and migration of activated NK cells to the liver, a main infection site that coincided with development of hepatic injury. The spatial and temporal changes in NK and NKT cells in lethally infected mice correlated with higher NK cell cytotoxic activity, higher expression of cytotoxic molecules such as granzyme B, higher production of interferon-γ and tumor necrosis factor-α, increased hepatic infiltration with CD8αCD11c+ dendritic cells and CD8+T cells, decreased splenic CD4+T cells, increased serum concentrations of IL-12p40, IL-18, RANTES, and monocyte chemotactic protein-1, and elevated production of IL-18 by liver mononuclear cells compared with nonlethally infected mice. Depletion of NK cells prevented development of severe liver injury, decreased serum levels of interferon-γ, tumor necrosis factor-α, and IL-10, and enhanced bacterial elimination. These data indicate that NK cells promote immunopathology and defective anti-ehrlichial immunity, possibly via decreasing the protective immune response mediated by interferon-γ producing CD4+Th1 and NKT cells