Cryptococcal meningitis associated HIV infection in the Donka national hospital in Conakry (Guinea)

Background Cryptococcal meningitis (CM) is an infection of the brain parenchyma and subarachnoid space by the encapsulated saprophyte yeast organisms such as Cryptococcus neoformans. Over the last twenty years, HIV has created a large and severely immune compromisized population in whom C. neoformans is a dangerous opportunistic infection. In Guinea, the prevalence of CM is unknown. We hypothesized that the occurrence of CM correlates with AIDS/ HIV prevalence.Method This retrospective observational study was carried out at the national Hospital of Conakry (Guinea) between 2001 and 2002. We describe here the epidemiological and clinical and biological characteristics of CM disease in our national hospital.Results Our data show that, 28.6 % of HIV patients with neurological symptoms had Cryptococcus neoformans in their CSF by using Indian ink staining. The median age was 36±3 years and sex ratio (M/F) was 1.8. The major complaints were fever and cephalgia, giddiness while the major complications were altered consciousness and hemiplegia. CSF was clear with low level of glucose and higher level of albumin. The means of lymphocytes in CSF was 8±2/mm3.Conclusion This data therefore becomes relevant in not only focusing of neurological symptoms associated with HIV to be toxoplasmosis but the possibility of C neoformans in these patients; particularly when they present symptoms such as headaches, giddiness and sniff neck etc. This can easily be carried out with Indian ink staining technique

Implementation of the program of measles elimination in the WHO African region

The review is devoted to the analysis of the available literature on the elimination of measles. The review focuses on the current measles epidemic situation in the African Region (AFR) and the implementation of the WHO strategic plan for the elimination of measles in AFR by 2020. Measles in the AFR is characterized by a severe course with a high risk of death due to malnutrition, vitamin A deficiency, concomitant bacterial and viral infections, and malaria. In 2015, 105,256 cases of measles were reported in the WHO African Region, most of them among children under 5 years old, 79% of whom were not vaccinated or had unknown vaccine status. Initially, the strategy for implementing the measles elimination program in AFRs was based on a combination of immunization campaigns for children under 14 years of age (coverage of more than 90%) and routine vaccination of at least 90% of children aged 9–15 months. It was recommended to repeat the campaign of mass immunization of children aged 9 months up to 4 years every 3–5 years. The use of this strategy has reduced the number of measles cases by 83–97% during the first year of additional immunization programs. The recommended age of routine measles vaccination in AFRs is 9 months — a strategy to reduce infant mortality, including that due to complications of measles. In 2016, measles vaccination was introduced into the national immunization schedule in all AFR countries, and 24 countries introduced revaccination. Currently, the measles elimination program in a number of AFR countries is based on two-dose immunization (MCV1 and MCV2). The measles prevention program in a number of AFR countries was disrupted due to the Ebola epidemic. There are some common problems in the realization of the program in AFR countries. All AFR countries are committed to the measles elimination program. The review provides information on strategies and successes in overcoming challenges to achieve the goals set for the WHO African Region in the implementation of the programme of measles elimination

РАЙОНИРОВАНИЕ АФРИКАНСКОЙ ПРИРОДНО-ОЧАГОВОЙ ПРОВИНЦИИ В ОТНОШЕНИИ ФИЛОВИРУСНЫХ ЛИХОРАДОК

The review presents the following division of the African natural foci province into districts: I. Upper Guinea natural focus region includes the following individual natural foci: I.1. Kazamans; I.2. North Guinea; I.3. Volta; I.4. Adamawa; I.5. Sao Tome. II. Central Africa: II.1. Southern Guinea; II.2. Katanga; II.3. Congo; II.4. Azande; II.5. Ruwenzori. III. South-Eastern Africa: III.1. Mafungabusi; III.2. Drakensberg; III.3. Comoros; III.4. Madagascar; III.5. Seychelles; III.6. Mascarenes. For each natural focus the article describes the characteristic landscapes and species list of fruit-bats (Chiroptera, Megachiroptera) which are natural reservoir for viruses belonging to Filoviridae family, the types of epidemic outbreaks and the intensity of filovirus circulation. Possible explanations of narrowness of filoviruses areal in comparison with fruit-bats areal in Africa are discussed.В обзоре предложено районирование африканской природно-очаговой провинции, в составе которой выделены: I. Верхнегвинейский природно-очаговый район, включающий следующие природные очаги: I.1. Казамaнс; I.2. Северо-Гвинейский; I.3. Вόльта; I.4. Адамaва; I.5. Сан-Томe. II. Центральноафриканский: II.1. Южно-Гвинейский; II.2. Катaнга; II.3. Кόнго; II.4. Азaнде; II.5. Рувензόри. III. Юго-Восточноафриканский: III.1. Мафунгабус́ и; III.2. Дракόновы горы; III.3. Комόры; III.4. Мадагаскaр; III.5. Сейшeлы; III.6. Маскарeны.Для каждого природного очага описаны характерные ландшафты, видовой состав крыланов (Chiroptera, Megachiroptera), представляющих собой природный резервуар для вирусов семейства Filoviridae, а также типы эпидемических вспышек и интенсивность циркуляции филовирусов. Обсуждаются возможные объяснения узости ареала филовирусов по сравнению с ареалом крыланов в Африке

ПРИРОДНЫЙ РЕЗЕРВУАР ФИЛОВИРУСОВ И ТИПЫ СВЯЗАННЫХ С НИМИ ЭПИДЕМИЧЕСКИХ ВСПЫШЕК НА ТЕРРИТОРИИ АФРИКИ

Family Filoviridae includes a set of etiological agents of human hemorrhagic fevers distributed in Africa: Zaire ebolavirus (ZEBOV), Sudan ebolavirus (SUDV), Bundibugyo ebolavirus (BDBV), Taï Forest ebolavirus (TAFV), Marburg marburgvirus (MMARV). Historiography and recent taxonomical structure of Filoviridae family are considered in the review. The discussed data of laboratory and ecological-virological field researches demonstrate the presence of a natural reservoir of filoviruses among fruit-bats (Chiroptera, Megachiroptera) which carry filovirus infection without clinical signs but allocate viruses with urine, saliva, excrements, and sperm, as well as contain viruses in blood and internals. The potential hosts of filoviruses are various mammal species including the higher primacies (Anthropoidea) and the humans (Homo sapiens sapiens). A brief comparison of anatomic and morphologic features of fruit bats and bats (Chiroptera, Microchiroptera) belonging to another suborder of chiropterans is presented. The description of the basic characteristics of the four types of epidemic outbreaks linked with Filoviridae-associated fevers — speleological (from Ancient Greek σπήλαιον — cave), forest, rural, and urban are given; their possible transformation directions are considered as well.Семейство Filoviridae содержит ряд возбудителей геморрагических лихорадок человека, распространенных на территории Африки: эболавирус Заир (Zaire ebolavirus, ZEBOV), эболавирус Судан (Sudan ebolavirus, SUDV), эболавирус Бундибугё (Bundibugyo ebolavirus, BDBV), (Taï Forest ebolavirus, TAFV), марбургвирус Марбург (Marburg marburgvirus, MMARV). В обзоре представлены историография и рецентная таксономическая структура семейства Filoviridae; выполнен этимологический анализ устаревших и современных названий представителей этого семейства; обсуждаются данные лабораторных и полевых эколого-вирусологических исследований, свидетельствующих о том, что резервуаром филовирусов является подотряд Крыланов (Chiroptera, Megachiroptera), которые переносят филовирусную инфекцию инаппарантно, но выделяют вирусы с мочой, слюной, фекалиями и спермой, а также содержат вирусы в крови и внутренних органах. Потенциальными хозяевами филовирусов является широкий спектр видов млекопитающих, включая высших приматов (Anthropoidea) и человека (Homo sapiens sapiens). В работе приводится краткое сравнение анатомических и морфологических особенностей крыланов и летучих мышей (Chiroptera, Microchiroptera), входящих в другой подотряд отряда Рукокрылых. Дано описание основных характеристик четырех типов эпидемических вспышек филовирусных лихорадок — спелеологического (от др.-греч. σπήλαιον — пещера), лесного, деревенского и городского, а также возможные направления трансформации в процессе их развития и масштабирования

Comparative performance study of three Ebola rapid diagnostic tests in Guinea

Background The 2014/15 Ebola outbreak in West Africa resulted in 11,000 deaths and massive strain on local health systems, and the ongoing outbreak in Democratic Republic of Congo has afflicted more than 3000 people. Accurate, rapid Ebola diagnostics suitable for field deployment would enable prompt identification and effective response to future outbreaks, yet remain largely unavailable. The purpose of this study was to assess the accuracy of three novel rapid diagnostic tests (RDTs): an Ebola, an Ebola-Malaria, and a Fever Panel test that includes Ebola, all from a single manufacturer. Methods We evaluated the three RDTs in 109 Ebola-positive and 96 Ebola-negative stored serum samples collected during the outbreak in Guinea in 2014/15, and tested by real-time polymerase chain reaction (RT-PCR). Sensitivity, specificity, and overall percent agreement were calculated for each RDT using RT-PCR as a reference standard, stratified by Ct value ranges. Results All tests performed with high accuracy on samples with low Ct value (high viral load). The Fever Panel test performed with the highest accuracy, with a sensitivity of 89.9% and specificity of 90.6%. The Ebola and Ebola-Malaria tests performed comparably to each other: sensitivity was 77.1 and 78% respectively, and specificity was 91.7% for the Ebola test and 95.8% for the Ebola-Malaria test. Conclusions This study evaluated the accuracy of three novel rapid diagnostic tests for Ebola. The tests may have significant public health relevance, particularly the Fever Panel test, which detects seven pathogens including Ebola. Given limitations to the study resulting from uncertain sample quality, further evaluation is warranted. All tests performed with highest accuracy on samples with low Ct value (high viral load), and the data presented here suggests that these RDTs may be useful for point-of-care diagnosis of cases in the context of an outbreak. Restrictions to their use in non-severe Ebola cases or for longitudinal monitoring, when viral loads are lower, may be appropriate. Highlighting the challenge in developing and evaluating Ebola RDTs, there were concerns regarding sample integrity and reference testing, and there is a need for additional research to validate these assays

Domestic risk factors for increased rodent abundance in a Lassa fever endemic region of rural Upper Guinea

Lassa fever (LF) is a viral haemorrhagic fever endemic in West Africa and spread primarily by the multimammate rat, Mastomys natalensis. As there is no vaccine, reduction of rodent-human transmission is essential for disease control. As the household is thought to be a key site of transmission, understanding domestic risk factors for M. natalensis abundance is crucial. Rodent captures in conjunction with domestic surveys were carried out in 6 villages in an area of rural Upper Guinea with high LF endemicity. 120 rodent traps were set in rooms along a transect in each village for three nights, and the survey was administered in each household on the transects. This study was able to detect several domestic risk factors for increased rodent abundance in rural Upper Guinea. Regression analysis demonstrated that having > 8 holes (RR = 1.8 [1.0004-3.2, p = 0.048), the presence of rodent burrows (RR = 2.3 [1.6-3.23, p = 0.000003), and being in a multi-room square building (RR = 2.0 [1.3-2.9], p = 0.001) were associated with increased rodent abundance. The most addressable of these may be rodent burrows, as burrow patching is a relatively simple process that may reduce rodent entry. Further study is warranted to explicitly link domestic rodent abundance to LF risk, to better characterize domestic risk factors, and to evaluate how household rodent-proofing interventions could contribute to LF control

Issues of Scientific and Practical Support of Anti-Epidemic Activities in the Course of Ebola Virus Disease Epidemic Response in West Africa

Consideration is given to the experience of cooperation between the Russian Federation and the Republic of Guinea in the matter of Ebola fever response. Outlined are the challenging issues regarding scientific support of preventive activities. Provided is a brief characteristic of Pasteur Institute of Guinea as a unique platform for research activities. Covered are the legal aspects of collaboration and priority areas for the development of common initiatives in the sphere of epidemiological monitoring. Identified are the stages of material reinforcement and medical stuff capacity building, including training of specialists with a view to the establishment of effective system for epidemiological surveillance

Development and Testing of the Method for the Detection of Lassa virus RNA, Based on real-Time Polymerase Chain reaction with reverse Transcription

Abstract. Objective of the study was the development of a method for the detection and quantitative analysis (realtime RT-PCR) to identify genetic markers of Lassa virus - LASV-Fl. Materials and methods. We utilized all the available in the GenBank database (https://www.ncbi.nlm.nih.gov/genbank/) Lassa virus sequences that have been aligned to identify conservative sites applying the BioEdit 7.2.5 software package (IbisBiosciences, USA). To test the developed PCR kit, the control panel of Lassa virus RNA and pseudo-viral particles, 27 viral strains belonging to different fami­lies, as well as 37 serum samples from patients with feverish diseases selected in medical institutions of the Republic of Guinea in 2016-2018 and 55 samples of organ suspensions from multi-spiked mice were used. Results and discussion. The analytical sensitivity of the method varied from 103 copies/ml to 105 copies/ml and had 96.4 % diagnostic sensitivity, while the analytical and diagnostic specificity was 100 %. It is shown that the developed technique can be successfully introduced into practice for the detection of Lassa virus in the Republic of Guinea, using various types of material from small mammals, including whole blood and organ suspensions of M. natalensis, as well as samples of human blood sera collected 3-7 days after the onset of the disease. It is also suggested that this method can be used for strains of Lassa virus, common not only in Guinea but also in other endemic areas, but this fact must be confirmed in further studies

Analysis of Ebola virus Zaire 2014 isolates

Analysis of 5 Ebola virus Zaire 2014 isolates passaged in cell cultures or in mice, demonstrated presence of unique mutations in the genome RNA in some cases. All identified nucleotide substitutions are singular, stochastically located, synonymous or fall within non-coding regions. Variability level of nucleotide sequences is equal to 0.005-0.01 %, suggesting extremely high genetic stability of Ebola virus Zaire, the causative agent of the outbreak. Confirmed is suppression of non-synonymous mutations accumulation in ebolavirus variants in the course of time. Detected are alterations in glycosilation sites and mucin-like domain of ebolavirus glycoprotein

New data on the level of immune stratum against Q fever agent in population of the of Republic of Guinea

which is bacteria of the species Coxiella burnetii. One of the factors showing the possibility of pathogen circulation in a certain territory is assessed by the presence of an immune stratum in the inhabitants of the region. In the 1980s, the study of the immune structure of the population of the Republic of Guinea in relation to coxiellosis has begun. The present study, carried out in 2015—2019, has been aimed to obtain new information about the immune stratum of the population of the Republic of Guinea against the causative agent of Q fever and to compare it with previous studies. Specific IgG antibodies in the blood of the Guinea residents were detected by using enzyme-linked immunosorbent assay (ELISA) with a set of reagents manufactured at the St. Petersburg Pasteur Institute (St. Petersburg, Russian Federation). The serum samples were tested in at 1:100 dilution. Antibodies against C. burnetii were detected in 124/2346 (5.3% [CI 4.5-6.3]) samples. This study confirms the previously obtained data on the circulation of the causative agent of coxiellosis in all landscape and geographical zones of the Republic of Guinea. The natural and climatic conditions of the region, the variety of ixodic tick species currently inhabiting this territory being a reservoir and vector of infection, as well as a large amount of livestock are the factors for active circulation of the Q fever pathogen and the emergence of related disease outbreaks. The data obtained necessitate continuing further studies on distribution of C. burnetii in the territory of the Republic of Guinea. Taking into consideration the epidemiological significance of Q fever, a pressing task is to study a proportion of this infectious disease in the overall structure of diseases registered in the territory of the Republic of Guinea. It is also necessary to conduct regular epizootological monitoring in order to clarify the types of carriers and vectors of C. burnetii in different landscape and geographical zones of the Republic of Guinea as well as to assess the immune stratum against the pathogen in large and small cattle being the main sources of infection for humans. The data obtained will allow us to determine presence of a natural focus of this infection as well as its borders and develop a set of preventive (anti-epidemic) measures