Rate of treatment success and associated factors in the program for drug susceptible tuberculosis in the Forest Region, Republic of Guinea, 2010-2017: a real-world retrospective observational cohort study.

OBJECTIVES To analyze the treatment success rate (TSR = sum of cured or treatment completed) in the tuberculosis (TB) program for drug susceptible TB (DS-TB) of the "Centre Hospitalier Régional Spécialisé" in Macenta, Forest Region, Republic of Guinea. METHODS This cohort study included patients starting treatment for DS-TB between 2010 and 2017. Data collection was part of the documentation for the national TB program. Descriptive analysis was applied to determine TSR in various patient groups. Further, we performed logistic regression to determine factors influencing TSR, in new and relapse cases versus all other previously treated cases. A subgroup analysis for only microbiologically confirmed pulmonary TB was added. RESULTS We included 3,969 patients. TSR increased from 68.3% in 2010 to 80.8% in 2017 (p 100 km) to the clinic and late drug refill. CONCLUSION TSR in the Forest Region of Guinea remains below the WHO goal of 90%. Reaching this target remains a challenge in rural areas with high early mortality and increased risk of loss to follow-up

Rate of treatment success and associated factors in the program for drug susceptible tuberculosis in the Forest Region, Republic of Guinea, 2010-2017: a real-world retrospective observational cohort study

OBJECTIVES To analyze the treatment success rate (TSR = sum of cured or treatment completed) in the tuberculosis (TB) program for drug susceptible TB (DS-TB) of the "Centre Hospitalier Régional Spécialisé" in Macenta, Forest Region, Republic of Guinea. METHODS This cohort study included patients starting treatment for DS-TB between 2010 and 2017. Data collection was part of the documentation for the national TB program. Descriptive analysis was applied to determine TSR in various patient groups. Further, we performed logistic regression to determine factors influencing TSR, in new and relapse cases versus all other previously treated cases. A subgroup analysis for only microbiologically confirmed pulmonary TB was added. RESULTS We included 3,969 patients. TSR increased from 68.3% in 2010 to 80.8% in 2017 (p 100 km) to the clinic and late drug refill. CONCLUSION TSR in the Forest Region of Guinea remains below the WHO goal of 90%. Reaching this target remains a challenge in rural areas with high early mortality and increased risk of loss to follow-up

Characterization and analytical validation of a new antigenic rapid diagnostic test for Ebola virus disease detection

International audienceHemorrhagic fever outbreaks are difficult to diagnose and control in part because of a lack of low-cost and easily accessible diagnostic structures in countries where etiologic agents are present. Furthermore, initial clinical symptoms are common and shared with other endemic diseases such as malaria or typhoid fever. Current molecular diagnostic methods such as polymerase chain reaction require trained personnel and laboratory infrastructure, hindering diagnostics at the point of need, particularly in outbreak settings. Therefore, rapid diagnostic tests such as lateral flow can be broadly deployed and are typically well-suited to rapidly diagnose hemorrhagic fever viruses, such as Ebola virus. Early detection and control of Ebola outbreaks require simple, easy-to-use assays that can detect very low amount of virus in blood. Here, we developed and characterized an immunoassay test based on immunochromatography coupled to silver amplification technology to detect the secreted glycoprotein of EBOV. The glycoprotein is among the first viral proteins to be detected in blood. This strategy aims at identifying infected patients early following onset of symptoms by detecting low amount of sGP protein in blood samples. The limit of detection achieved by this sGP-targeted kit is 2.2 x 104 genome copies/ml in plasma as assayed in a monkey analytical cohort. Clinical performance evaluation showed a specificity of 100% and a sensitivity of 85.7% when evaluated with plasma samples from healthy controls and patients infected with Zaire Ebola virus from Macenta, Guinea. This rapid and accurate diagnostic test could therefore be used in endemic countries for early detection of infected individuals in point of care settings. Moreover, it could also support efficient clinical triage in hospitals or clinical centers and thus reducing transmission rates to prevent and better manage future severe outbreaks