Prévalence du VIH chez la Femme Enceinte et Transmission Mère-Enfant du VIH à la Maternité de l’Hôpital Général de Douala, Cameroun

Nous rapportons ici une évaluation sommaire de nos activités de prévention transmission mère-enfant du VIH sur 6 ans (2002 à 2007). Il s’agissait d’une étude descriptive et rétrospective effectuée à l’Hôpital Général de Douala. Les enfants inclus étaient âgés d’au moins 18 mois. La technique d’ELISA GENSCREEN 3ème génération pour le VIH a été utilisée. Sur 5261 accouchements effectués pendant cette période, 138 étaient de mères VIH positifs (prévalence : 2,62%). Quatre de nos patientes étaient testées négatives au premier trimestre de gestation. Des 138 bébés, 87 seulement ont pu être testés (63%), dont 4 contaminés (prévalence de transmission : 4,6%). Des 4 enfants contaminés, un seul a reçu la prévention adéquate en grossesse, soit un taux de transmission sous prévention de 1,19%. Une meilleure organisation des stratégies de réduction de la transmission mèreenfant du VIH/SIDA, même dans un environnement à ressources limitées, peut conduire à des résultats similaires à ceux des pays du Nord. A la lumière de cette étude, nous recommandons fortement un deuxième test du VIH au 3ème rimestre de la grossesse afin de réduire davantage le risque de sa transmission périnatale.Mots Clés prévalence du VIH ; femme enceinte ; transmission mère-enfant du VI

Prevalence and risk factors of peripheral artery disease in black Africans with HIV infection: a cross-sectional hospital-based study

Félicité Kamdem,1,2 Yacouba Mapoure,1,2 Ba Hamadou,3 Fanny Souksouna,2 Marie Solange Doualla,1,3 Ahmadou Musa Jingi,3 Caroline Kenmegne,1 Fernando Kemta Lekpa,1,4 Jaff Kweban Fenkeu,1 Gisèle Imandy,5 Jean Pierre Nda Mefo’o,2,5 Henry Luma1,3 1Internal Medicine Service, Douala General Hospital, Douala, Cameroon; 2Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon; 3Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon; 4Faculty of Health Sciences, University of Buea, Buea, Cameroon; 5Chemical Pathology Laboratory, Douala General Hospital, Douala, Cameroon Background: The prevalence of peripheral artery disease (PAD) is not well known among HIV-infected patients in Africa. The aim of this study was to determine the prevalence and associated risk factors of PAD among HIV-infected patients at the Douala General Hospital (DGH).Methods: This was a cross-sectional descriptive and analytic study between November 2015 and April 2016. We recruited patients aged ≥21 years, diagnosed with HIV infection, and who were receiving care at the DGH. We collected sociodemographic data and past medical history of patients. We measured their ankle-brachial index (ABI). We defined PAD as an ABI <0.9. We also measured their fasting blood glucose and lipid profile.Results: We recruited 144 patients for this study. The mean age was 46±9 years, and 72.2% were females. Of which, 89% were on antiretroviral treatment (ARV). Their mean CD4+ T lymphocytes count was 451±306 cells/mm3. Their mean ABI was 1.12±0.17 and 1.07±0.11, respectively, on the left and right legs (P>0.05). The prevalence of PAD was 6.9% (95% CI: 3.4–12.4), and 60% of patients with PAD were symptomatic. After adjusting for age, sex and ARV, ARV treatment was protective (aOR: 0.18, [95% CI: 0.04–0.82], P=0.034), while WHO stages III or IV was associated with PAD (aOR: 11.1, [95% CI: 2.19–55.92], P=0.004).Conclusion: The prevalence of PAD was not as high as expected in this group of patients with high cardiovascular risk infected with HIV. Advanced HIV disease was associated with PAD, while ARV was protective. Keywords: HIV, peripheral artery disease, prevalence, risk factors, Afric