Surgery in sickle cell anemia

Sickle cell anemia is a hemoglobin disorder with a wide range of clinical manifestations and complications. Medical treatment is the mainstay of management but surgery is indicated in some cases. The authors review the main surgical indications in sickle cell anemia as frequently encountered and review treatment guidelines. Keywords: sickle cell anemia, surgery, indications Clinics in Mother and Child Health Vol. 1(1) 2004: 65-6

Prevalence of HIV, HBV and Chlamydia infections in Cameroonian University context: case of the University of Dschang, in the Western Region

Introduction: In sub-Saharan Africa HIV infection remains largely epidemic, whereas HBV infection is highly endemic (>8%). In Cameroon, HIV prevalence is 4.3%. Concerning HBV and chlamydia infections, their prevalence are both ≥10%. Young adults, including university students, are the population groups mostly affected. Epidemiological data on these infections, among university students could be helpful to implement specific prevention strategies. Methods: A descriptive study was performed in May 2013 among 624 students from the University of Dschang, Cameroon. Participants were screened for HIV, HBV and Chlamydia infections. Data was collected by a standard questionnaire and analyzed by Epi Info. Results: Average age of participants was 23.3 years (σ = 3.2) with female predominance (58.7%). Prevalence of HIV, HBV and Chlamydia infection was 1.1% (7/624), 2.8% (5/176) and 2.0% (2/100) respectively. 83.2% of participants were sexually active. Concerning sexual risk behaviors, participants reported having multi partners (14.8%), using condom occasionally (58.6%) or never (5.0%). 100%, 62.6% and 52.2% reported to be aware on HIV, HBV and Chlamydia infections respectively. In addition, only 5.5% and 21.3% of the participants were aware of their HBV and Chlamydia status respectively, versus 64.4% for HIV. The excessive cost of HBV and Chlamydia tests has been identified as the major barrier to testing (87.6%). Conclusion: Among college Cameroonian students the prevalence of HIV, HBV and Chlamydia infections seems to be relatively low if compared to general population. However, having multiple sexual partners in addition to non-systematic use of condoms during sexual intercourse represents risk behaviors among students. Awareness campaigns and screening facilitation on HBV and chlamydia infections need to be strengthened

Correlation between some environmental variables and abundance of Almophrya mediovacuolata (Ciliophora: Anoplophryidae) endocommensal ciliate of an anecic earthworms (Oligochaeta: Annelida) in Bambui (North-West Cameroon)

This study was devoted to accessing the influence of some soil physico-chemical parameters on the abundance of Almophrya mediovacuolata Ngassam, 1983, astome ciliate of the digestive tract of earthworms (EW) of the species Alma nilotica collected along “Fa’a ntsa” stream in Bambui. The survey primarily involved soil samples collection from the same spots of EW collection and preparation for physico-chemical analysis; evaluation in situ of the volumic density (VD) of worms (number /dm3 soil), their dissection, isolation and counting of ciliates with respect to different portion of EW’s gut (fore, mid and hindgut). Furthermore, correlation analysis between soil physico-chemical parameters and biological responses (EW volumic density and ciliate abundance) were performed. The results reveal that EW abundance was positively and significantly correlated with the following physico-chemical parameters: Cation Exchange Capacity CEC (p <0.01) and Mg2+ (p <0.05). A positive and significant correlation was found between Almophrya mediovacuolata and the pH of KCl in the foregut and midgut (p <0.01) while a negative and significant correlation was found between the abundance of Almophrya mediovacuolata and Ca2+ in the foregut (p <0.05). Almophrya mediovacuolata were found mostly in the foregut. This result shows that each portion of the digestive tract of Alma nilotica can be considered as a set of natural microhabitat in which a number of physico-chemical factors generate ecological niches suitable for the survival of different species of microorganisms among which ciliated protozoa. The fore and midgut was noticed to be the preferential zones of Almophrya mediovacuolata.Keywords: Biotic parameters, ciliated protozoa, microhabitat, soil physico-chemical parameters

La craniectomie decompressive dans la prise en charge des traumatismes craniens graves avec signes radiologiques d’engagement cerebral.

Introduction La craniectomie décompressive peut- elle améliorer le pronostic des patients victimes d’un traumatisme crânien fermé grave avec engagement cérébral ? Objectif Le but de la présente étude était d’évaluer l’efficacité de la craniectomie décompressive dans la prise en charge du traumatisme crânien grave, isolé et fermé avec signes radiologiques d’engagement cérébral. Méthodes Il s’agissait d’une étude réalisée à l’Hôpital Général de Douala pendant 36 mois, de janvier 2007 à décembre 2009, incluant 13 patients victimes d’un traumatisme crânien grave, isolé et fermé, présentant les signes radiologiques d’engagement cérébral. La craniectomie décompressive était indiquée devant l’aggravation ou la persistance du tableau clinique et radiologique malgré le traitement médical conventionnel. Résultats Après deux à dix mois de suivi, l’évolution fut classée selon le score du coma évolutif ; "Glasgow outcome scale (GOS) score ". Dix patients (76, 93 %) ont évolué favorablement GOS (4-5).Un patient (07,69%) est resté végétatif GOS3. Deux décès (15,38%) ont été observé GOS1. Les principales complications étaient : une hydrocéphalie, une hernie cérébrale à travers le foramen de craniectomie, un abcès du cerveau et un état de mal convulsif. Conclusion La craniectomie décompressive est une méthode efficace pouvant améliorer le pronostic des patients victimes de traumatisme crânien grave avec signes radiologiques d’engagement cérébral.Mots clés : craniectomie-décompressive-engagement cérébral-traumatisme crânien

HIV and HBV infection in Cameroonian university context: Case of the University of Dschang

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Current practice of epidemiology in Africa: highlights of the 3rd conference of the African epidemiological association and 1st conference of the Cameroon society of epidemiology, Yaoundé, Cameroon, 2014

As the study of disease occurrence and health indicators in human populations, Epidemiology is a dynamic field that evolves with time and geographical context. In order to update African health workers on current epidemiological practices and to draw awareness of early career epidemiologists on concepts and opportunities in the field, the 3rd African Epidemiology Association and the 1st Cameroon Society of Epidemiology Conference was organized in June 2-6, 2014 at the Yaoundé Mont Febe Hotel, in Cameroon. Under the theme«Practice of Epidemiology in Africa: Stakes, Challenges and Perspectives», the conference attracted close to five hundred guest and participants from all continents. The two main programs were the pre-conference course for capacity building of African Early Career epidemiologists, and the conference itself, providing a forum for scientific exchanges on recent epidemiological concepts, encouraging the use of epidemiological methods in studying large disease burden and neglected tropical diseases; and highlighting existing opportunities

Systematic review and meta-analysis of hepatitis C virus infection and HIV viral load: New insights into epidemiologic synergy

INTRODUCTION: Hepatitis C virus (HCV) and HIV infection frequently co-occur due to shared transmission routes. Co-infection is associated with higher HCV viral load (VL), but less is known about the effect of HCV infection on HIV VL and risk of onward transmission. METHODS: We undertook a systematic review comparing 1) HIV VL among ART-naïve, HCV co-infected individuals versus HIV mono-infected individuals and 2) HIV VL among treated versus untreated HCV co-infected individuals. We performed a random-effects meta-analysis and quantified heterogeneity using the I2 statistic. We followed Cochrane Collaboration guidelines in conducting our review and PRISMA guidelines in reporting results. RESULTS AND DISCUSSION: We screened 3925 articles and identified 17 relevant publications. A meta-analysis found no evidence of increased HIV VL associated with HCV co-infection or between HIV VL and HCV treatment with pegylated interferon-alpha-2a/b and ribavirin. CONCLUSIONS: This finding is in contrast to the substantial increases in HIV VL observed with several other systemic infections. It presents opportunities to elucidate the biological pathways that underpin epidemiological synergy in HIV co-infections and may enable prediction of which co-infections are most important to epidemic control

The All-Data-Based Evolutionary Hypothesis of Ciliated Protists with a Revised Classification of the Phylum Ciliophora (Eukaryota, Alveolata)

This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ The file attached is the published version of the article

Alarming rates of virological failure and HIV-1 drug resistance amongst adolescents living with perinatal HIV in both urban and rural settings: evidence from the EDCTP READY-study in Cameroon

Objectives: Adolescents living with perinatal HIV infection (ALPHI) experience persistently high mortality rates, particularly in resource-limited settings. It is therefore clinically important for us to understand the therapeutic response, acquired HIV drug resistance (HIVDR) and associated factors among ALPHI, according to geographical location. Methods: A study was conducted among consenting ALPHI in two urban and two rural health facilities in the Centre Region of Cameroon. World Health Organization (WHO) clinical staging, self-reported adherence, HIVDR early warning indicators (EWIs), immunological status (CD4 count) and plasma viral load (VL) were assessed. For those experiencing virological failure (VF, VL ≥ 1000 copies/mL), HIVDR testing was performed and interpreted using the Stanford HIV Drug Resistance Database v.8.9-1. Results: Of the 270 participants, most were on nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens (61.7% urban vs. 82.2% rural), and about one-third were poorly adherent (30.1% vs. 35.1%). Clinical failure rates (WHO-stage III/IV) in both settings were < 15%. In urban settings, the immunological failure (IF) rate (CD4  < 250 cells/μL) was 15.8%, statistically associated with late adolescence, female gender and poor adherence. The VF rate was 34.2%, statistically associated with poor adherence and NNRTI-based antiretroviral therapy. In the rural context, the IF rate was 26.9% and the VF rate was 52.7%, both statistically associated with advanced clinical stages. HIVDR rate was over 90% in both settings. EWIs were delayed drug pick-up, drug stock-outs and suboptimal viral suppression. Conclusions: Poor adherence, late adolescent age, female gender and advanced clinical staging worsen IF. The VF rate is high and consistent with the presence of HIVDR in both settings, driven by poor adherence, NNRTI-based regimen and advanced clinical staging

Recommendations on data sharing in HIV drug resistance research

• Human immunodeficiency virus (HIV) drug resistance has implications for antiretroviral treatment strategies and for containing the HIV pandemic because the development of HIV drug resistance leads to the requirement for antiretroviral drugs that may be less effective, less well-tolerated, and more expensive than those used in first-line regimens.  • HIV drug resistance studies are designed to determine which HIV mutations are selected by antiretroviral drugs and, in turn, how these mutations affect antiretroviral drug susceptibility and response to future antiretroviral treatment regimens.  • Such studies collectively form a vital knowledge base essential for monitoring global HIV drug resistance trends, interpreting HIV genotypic tests, and updating HIV treatment guidelines.  • Although HIV drug resistance data are collected in many studies, such data are often not publicly shared, prompting the need to recommend best practices to encourage and standardize HIV drug resistance data sharing.  • In contrast to other viruses, sharing HIV sequences from phylogenetic studies of transmission dynamics requires additional precautions as HIV transmission is criminalized in many countries and regions.  • Our recommendations are designed to ensure that the data that contribute to HIV drug resistance knowledge will be available without undue hardship to those publishing HIV drug resistance studies and without risk to people living with HIV