Représentativité et réactivité du système de surveillance de la Fièvre Jaune au Togo, 2004-2014: Representativeness and responsiveness of the Yellow Fever surveillance system in Togo, 2004-2014

Introduction: Peu d’informations sont disponibles sur le système de surveillance de la fièvre jaune au Togo. L’objectif est d’évaluer la simplicité, la représentativité et la réactivité de ce système. Méthodes: Une étude transversale descriptive a été menée de 2015 à 2016 à l’Institut Na-tional d’Hygiène (INH) qui est le Laboratoire National de Référence (LNR) pour les maladies à po-tentiel épidémique du Togo. La base de données de 2004-2014 de la fièvre jaune- rougeole -rubéole du LNR et le guide de surveillance intégrée des maladies et riposte, le guide d’évaluation des systèmes de surveillance de Centers for Disease Control and Prevention (CDC) ont été utilisés. Les médianes, intervalles interquartiles et les proportions ont été calculés avec Epi Info 7 et Excel 2003. Résultats: Un cas suspect de fièvre jaune nécessite une confirmation biologique qui se fait à plusieurs niveaux. Le système est représentatif de tous les districts, toutes les années et de toutes les populations du Togo. Un total de 3054 de cas suspects a été notifié dont 32 cas probables et 12 cas confirmés, par-mi lesquels, 8 étaient des hommes. Environs 93,01 % (2833) des cas suspects ont été prélevés dans les 14 jours suivants le début des symp-tômes, 28,39% (866) des échantillons ont été acheminés dans les 72 heures et 77,95% des résultats rendus dans les 7 jours rendant le système peu réactif. Conclusion: Le système de surveillance de la fièvre jaune au Togo est représentatif, complexe et peu réactif. Il s’avère nécessaire de mettre en place un système de convoyage rapide des échantillons. Introduction: Little information is available on yellow fever surveillance system in Togo. The simplicity, representativeness and responsiveness of this system were assessed. Material and Methods: It was a descriptive cross-sectional study conducted from October 2015 to February 2016 at the Institut National d’Hygiène, the National Reference Laboratory (NRL) for epidemic prone diseases of Togo. We used the yellow fever-measles-rubella database, the integrated dis-ease surveillance and response guideline and the Centers for Disease Control and Prevention (CDC) guidelines for surveillance system evaluation. Medians, interquartile intervals and proportions were calculated and presented in tables and figures with Excel 2003 and Epi Info 7. Results: A yellow fever case must be confirmed at several reference levels making yellow fever surveillance complex. This surveillance system is representative of all districts, all years and all populations of Togo. A total of 3054 suspected cases were reported, including 32 probable cases and 12 confirmed cases. Of the confirmed cases, 08 were men. About 93.01% (2833) of the suspected cases samples were taken within 14 days after the symptoms onset, 28,39% (866) of samples were transported within 72 hours and 77, 95% of the results were available within 7 days, making the system unresponsive. Conclusion: The yellow fever surveillance system in Togo is representative, complex, and unresponsive due to the long delay in transporting samples to the NRL. A rapid sample conveying system is recommende

Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo

Background: The only available vaccine that could be potentially beneficial against mycobacterial diseases contains live attenuated bovine tuberculosis bacillus (Mycobacterium bovis) also called Bacillus Calmette-Guerin (BCG). Even though the BCG vaccine is still widely used, results on its effectiveness in preventing mycobacterial diseases are partially contradictory, especially regarding Buruli Ulcer Disease (BUD). The aim of this case-control study is to evaluate the possible protective effect of BCG vaccination on BUD. Methodology: The present study was performed in three different countries and sites where BUD is endemic: in the Democratic Republic of the Congo, Ghana, and Togo from 2010 through 2013. The large study population was comprised of 401 cases with laboratory confirmed BUD and 826 controls, mostly family members or neighbors. Principal Findings: After stratification by the three countries, two sexes and four age groups, no significant correlation was found between the presence of BCG scar and BUD status of individuals. Multivariate analysis has shown that the independent variables country (p = 0.31),sex (p = 0.24),age (p = 0.96),and presence of a BCG scar (p = 0.07) did not significantly influence the development of BUD category I or category II/III. Furthermore, the status of BCG vaccination was also not significantly related to duration of BUD or time to healing of lesions. Conclusions: In our study, we did not observe significant evidence of a protective effect of routine BCG vaccination on the risk of developing either BUD or severe forms of BUD. Since accurate data on BCG strains used in these three countries were not available, no final conclusion can be drawn on the effectiveness of BCG strain in protecting against BUD. As has been suggested for tuberculosis and leprosy, well-designed prospective studies on different existing BCG vaccine strains are needed also for BUD

Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo

Background: The only available vaccine that could be potentially beneficial against mycobacterial diseases contains live attenuated bovine tuberculosis bacillus (Mycobacterium bovis) also called Bacillus Calmette-Guerin (BCG). Even though the BCG vaccine is still widely used, results on its effectiveness in preventing mycobacterial diseases are partially contradictory, especially regarding Buruli Ulcer Disease (BUD). The aim of this case-control study is to evaluate the possible protective effect of BCG vaccination on BUD. Methodology: The present study was performed in three different countries and sites where BUD is endemic: in the Democratic Republic of the Congo, Ghana, and Togo from 2010 through 2013. The large study population was comprised of 401 cases with laboratory confirmed BUD and 826 controls, mostly family members or neighbors. Principal Findings: After stratification by the three countries, two sexes and four age groups, no significant correlation was found between the presence of BCG scar and BUD status of individuals. Multivariate analysis has shown that the independent variables country (p = 0.31),sex (p = 0.24),age (p = 0.96),and presence of a BCG scar (p = 0.07) did not significantly influence the development of BUD category I or category II/III. Furthermore, the status of BCG vaccination was also not significantly related to duration of BUD or time to healing of lesions. Conclusions: In our study, we did not observe significant evidence of a protective effect of routine BCG vaccination on the risk of developing either BUD or severe forms of BUD. Since accurate data on BCG strains used in these three countries were not available, no final conclusion can be drawn on the effectiveness of BCG strain in protecting against BUD. As has been suggested for tuberculosis and leprosy, well-designed prospective studies on different existing BCG vaccine strains are needed also for BUD

Risk factors of hepatitis B virus surface antigen carriage and serological profile of HBsAg carriers in Lomé Togo, 2016

International audienceIn Togo, the prevalence of Hepatitis B Virus Surface Antigen (HBsAg) among young people aged 15-24 years was estimated at 16.4% in 2010; however, risk factors for HBsAg carriage are poorly documented. We sought to identify risk factors for HBsAg carriage and the serological profile of HBsAg carriers in Lomé (capital city of Togo)

Baseline data of cases^a and controls^b from the Democratic Republic of the Congo (DR Congo), Ghana, and Togo, collected from February 2010 through April 2013.

<p>NA Not applicable. No prevalence was shown if n <5.</p>a<p>Cases were defined as patients affected by Buruli Ulcer Disease (BUD) whose diagnosis was laboratory confirmed by testing with microscopy, polymerase chain reaction (PCR), and culture.</p><p>Any case had a least one positive test result.</p>b<p>Controls were defined as healthy persons having a close relationship with the CA.</p>c<p>AG, age group in years (y).</p>d<p>BCG, Bacillus Calmette-Guérin.</p><p>The only available vaccine against mycobacterial diseases, which contains live attenuated bovine tuberculosis bacillus (<i>Mycobacterium bovis</i>). In our study, the status after BCG vaccination was assessed from all cases and controls of the study population by controlling both sides of the shoulder, if they presented a typical “BCG scar”. Studies that evaluated the presence or absence of BCG scars to determine vaccination status reported that scars develop in most vaccinated persons.</p>e<p>Fisher's exact test was used if at least one cell of contingency table was below 5.</p><p>Baseline data of cases^{<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003457#nt102" target="_blank">a</a>} and controls^{<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003457#nt104" target="_blank">b</a>} from the Democratic Republic of the Congo (DR Congo), Ghana, and Togo, collected from February 2010 through April 2013.</p

BCG^a vaccination and cases^b of BUD category^c I and category^c II/III from the Democratic Republic of the Congo (DR Congo), Ghana, and Togo, collected from February 2010 through April 2013.

<p>NA Not applicable. No prevalence was shown if n <5.</p>a<p>BCG, Bacillus Calmette-Guérin.</p><p>The only available vaccine against mycobacterial diseases, which contains live attenuated bovine tuberculosis bacillus (<i>Mycobacterium bovis</i>). In our study, the status after BCG vaccination was assessed from all cases and controls of the study population by controlling both sides of the shoulders, if they presented a typical “BCG scar” caused by intracutaneous BCG vaccination. Studies that evaluated the presence or absence of BCG scars to determine vaccination status reported that scars develop in most vaccinated persons.</p>b<p>Cases were defined as patients affected by Buruli Ulcer Disease (BUD) whose diagnosis was laboratory confirmed by testing with microscopy, polymerase chain reaction (PCR), and culture.</p><p>Every case had a least one positive test result for BUD.</p>c<p>Categories of BUD.</p><p>According to WHO, the categories of BUD were defined as follows: Category I correspond to single lesions with <5 cm in diameter; Category II correspond to single lesions between 5 and 15 cm in diameter; Category III correspond to single lesions with >15 cm in diameter, multiple lesions, or osteomyelitis.</p>d<p>AG, age group in years (y).</p>e<p>Fisher's exact test was used if at least one cell of contingency table was below 5.</p><p>BCG^{<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003457#nt110" target="_blank">a</a>} vaccination and cases^{<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003457#nt112" target="_blank">b</a>} of BUD category^{<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003457#nt114" target="_blank">c</a>} I and category^{<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003457#nt114" target="_blank">c</a>} II/III from the Democratic Republic of the Congo (DR Congo), Ghana, and Togo, collected from February 2010 through April 2013.</p

Laboratory capacity assessments in 25 African countries at high risk of yellow fever, August-December 2018.

INTRODUCTION: accurate and timely laboratory diagnosis of yellow fever (YF) is critical to the Eliminate Yellow Fever Epidemics (EYE) strategy. Gavi, the Vaccine Alliance recognized the need to support and build capacity in the national and regional laboratories in the Global YF Laboratory Network (GYFLN) as part of this strategy. METHODS: to better understand current capacity, gaps and needs of the GYFLN laboratories in Africa, assessments were carried out in national and regional reference laboratories in the 25 African countries at high risk for YF outbreaks that were eligible for new financial support from Gavi. RESULTS: the assessments found that the GYFLN in Africa has high capacity but 21% of specimens were not tested due to lack of testing kits or reagents and approximately 50% of presumptive YF cases were not confirmed at the regional reference laboratory due to problems with shipping. CONCLUSION: the laboratory assessments helped to document the baseline capacities of these laboratories prior to Gavi funding to support strengthening YF laboratories