A TYPICAL EXTENSIVE GENITAL ULCER IN FULL BLOWN AIDS WITH SLIM DISEASE

Background: Atypical and exceptional clinical presentation of full blown AIDS may be observed in sub-Saharan Africa. We report herein the case of a Central African 37-year-old male patient presented with full blown AIDS, a typical picture of slim disease with marked cachexia and wasting faces. In addition, the patient was suffering from very extensive genital ulcer with complete loss of substance of the genitalia. Methods: Extensive histological and microbiological analysis of the genital lesion was carried out. Results: HIV-1 serology was positive, the HIV-1 RNA plasma viral load was 5.3 log copies/ml and CD4 T cell count was 1 per μL. Search for Mycobacterium tuberculosis in sputum and urine was negative by direct microscopic examination with Ziehl-Neelsen staining. Testing for syphilis serology was negative. Direct immunofluorescence detection on genital ulcer scraping was negative for Chlamydia trachomatis and Treponema pallidum. Furthermore, the infections with Haemophilus ducreyi and Chlamydia trachomatis were excluded by PCR on genital swabs.Genital PCR was positive for herpes simplex virus (HSV) type 2. Marked improvement was observed within 6 weeks after starting empirical therapy including first-line antiretroviral therapy, cotrimoxazole, doxycycline and valacyclovir, with progressive healing of genital ulcer and negativity of HSV PCR. Conclusion: Taken together, the extensive genital ulcer in this patient is likely the result of a multifactorial process, involving both profound cellular immune depression and complex genital infectious process in which herpetic infection may have participated as a chronic worsening co-factor

Facteurs influençant l’initiation au traitement antirétroviral des personnes vivant avec le VIH dans les Centres de Traitement Agréés de Bamenda et de Bertoua au Cameroun

Introduction: : L'objectif de ce travail était de déterminer les facteurs influençant l'initiation au  traitement antirétroviral des personnes vivant avec le VIH (PVVIH) dans les centres de traitements  agrées (CTA) de Bamenda et de Bertoua au Cameroun. Méthodes: Il s'agissait d'une étude transversale, analytique réalisée de Janvier à Avril 2011, dans les CTA de Bamenda et de Bertoua. Pour cette étude, nous avons obtenu une clairance éthique.Résultats: Nous avons étudiés 460 dossiers de patients séropositifs en phase d'initiation au traitement antirétroviral dans lesCTA de Bamenda et de Bertoua, 53,9% et 46,1% respectivement. L 'âge médian   était de 36 ans. La plupart des séropositifs à Bertoua (41) avaient fait un dépistage volontaire du VIH par rapport à ceux de Bamenda (22) (p= 0.008). Il y 'avait plus de VIH de type 1 et 2 dans le CTA de Bamenda (15) par rapport à Bertoua (3) (p= 0.011). La majorité des patients était classé au stade clinique II à Bamenda (54,0%) tandis qu 'à Bertoua le stade clinique III était prédominant (52,4%) (p=0,000). Le  taux médian de CD4 était de 133 cellules/mm3 dans le CTA de Bamenda et de 175 cellules/mm3 à Bertoua (p=0,008). La Zidovudine était plus prescrit à Bamenda et le Ténofovir à Bertoua (p=0,000). L 'Efavirenz était plus prescrit à Bertoua tandis que la Névirapine l 'était plus à Bamenda (p=0,000). Le Lopinavir/r était plus prescrit à  Bamenda qu 'à Bertoua (p=0,017).Conclusion: Il apparait urgent de standardiser la prise en charge des PVVIH dans les CTA du Cameroun.Key words: VIH, Personnes vivant avec le VIH, Traitement antirétroviral, Bamenda, Bertoua; Centre de traitement agrée, Cameroun

The prevalence, incidence and risk factors of herpes simplex virus type 2 infection among pregnant Zimbabwean women followed up nine months after childbirth

Background Herpes simplex virus type 2 (HSV-2) is the leading cause of genital ulcer disease worldwide. The virus can be transmitted to neonates and there are scarce data regarding incidence of HSV-2 among women in pregnancy and after childbirth. The aim of this study is to measure the incidence and risk factors for HSV-2 infection in women followed for 9 months after childbirth. Methods Pregnant women were consecutively enrolled late in pregnancy and followed at six weeks, four and nine months after childbirth. Stored samples were tested for HSV-2 at baseline and again at nine months after childbirth and HSV-2 seropositive samples at nine months after childbirth (seroconverters) were tested retrospectively to identify the seroconversion point. Results One hundred and seventy-three (50.9%) of the 340 consecutively enrolled pregnant women were HSV-2 seronegative at baseline. HSV-2 incidence rate during the 10 months follow up was 9.7 (95% CI 5.4-14.4)/100 and 18.8 (95% CI 13.9-26.1)/100 person years at risk (PYAR) at four months and nine months after childbirth respectively. Analysis restricted to women reporting sexual activity yielded higher incidence rates. The prevalence of HSV-2 amongst the HIV-1 seropositive was 89.3%. Risk factors associated with HSV-2 seropositivity were having other sexual partners in past 12 months (Prevalence Risk Ratio (PRR) 1.8 (95% CI 1.4-2.4) and presence of Trichomonas vaginalis (PRR 1.7 95% CI 1.4-2.1). Polygamy (Incidence Rate Ratio (IRR) 4.4, 95% CI 1.9-10.6) and young age at sexual debut (IRR 3.6, 95% CI 1.6-8.3) were associated with primary HSV-2 infection during the 10 months follow up. Conclusions Incidence of HSV-2 after childbirth is high and the period between late pregnancy and six weeks after childbirth needs to be targeted for prevention of primary HSV-2 infection to avert possible neonatal infections

The role of Herpes simplex virus type 2 (HSV-2) as a cofactor in HIV transmission

SIGLEAvailable from British Library Document Supply Centre- DSC:DXN054625 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

ObituaryCelebrating the life of Professor Felix Tietche

Pan African Medical Journal 2016; 2

(A) Medical team with entire village, (B) open-air clinical examination (note Jamot in middle looking on and lone microscope on table in front), and (C) lumbar puncture conducted by medical auxiliaries; rural Cameroon.

<p>(D) Colonel Jamot's statue in front of the Department of Disease Control, Cameroon Ministry of Public Health, Yaounde, Cameroon.</p

Hosting ICASA 2021 in South Africa amidst the global Omicron scare.

The 21 International Conference on HIV/AIDS and STI's in Africa (ICASA) was successfully held from the 6 to 11 December 2021 in Durban, South Africa. Little did we know at the time of planning that COVID-19 could become such a formidable force in eroding the progress made to bring lifesaving therapies among vulnerable communities in Africa. The conference also highlighted Africa's openness to the world, also shown in the way South Africa shared data on its discovery of the Omicron variant. Arguably the most important of lessons is that integrated HIV/TB services have become a platform on which to provide other services. We also saw how HIV and TB services were used as leverage for COVID-19 services. Much was also discussed about the need to adopt more self-care approaches, as was demonstrated with the increased use of self-testing technologies for HIV, and potentially other health needs. It's clear that Africa needs to increase its capacity to support and enable innovation, particularly in the design and manufacturing of new technologies including diagnostics, vaccines and therapeutics

African voices and leadership is imperative for the global AIDS response

CITATION: Mbopi-Keou, F. et al. 2019. African voices and leadership is imperative for the global AIDS response. Pan African Medical Journal, 32. doi:10.11604/pamj.2019.32.87.18452The original publication is available at https://www.panafrican-med-journal.com/This position paper is written in reference to the recent extensive media coverage of the report of the Independent Panel describing Harassment, Including Sexual Harassment, Bullying and Abuse of Power at UNAIDS Secretariat by several newspapers and authoritative journals such as Science and The Lancet. Unfortunately, none of these publications provide any clear evidence to support the accusations and merely repeat what are, in our view, unsubstantiated statements made in the report. Given the critical role that Africans have played in dealing with one of the most severe epidemics that the world has seen and the gravity of these charges, we believe it is essential to reaffirm that African voices and leadership is imperative for the global AIDS response.https://panafrican-med-journal.com/content/article/32/87/full/Publisher’s versio

Pattern of antibiotics resistance and phenotypic characterization of Multidrug resistant bacteria isolates in four hospitals of Littoral region, Cameroon

Objective: To describe the pattern of antibiotics resistance and phenotypic characterization of Multidrug resistant bacteria isolates in four hospitals of Littoral region, Cameroon. Methods: We conducted a descriptive hospital based cross-sectional study from December 2018 to May 2019. A simple random sampling was used to swap 10 selected equipment and 10 materials in the mornings after disinfection but before the start of work in seven units. After inoculation in four agar media consecutively (Eosine Metyleine blue, Cled, Manitol salt agar and blood agar ) and incubated in appropriate conditions, the Kirby-Bauer disk-diffusion method was used for antimicrobial susceptibility test. Results: Among 50.4% (119/236) showed positive bacteria growth, a total of 89 (13 species), predominant bacteria and those more likely to cause nosocomial infections were selected and tested each one to 18 antibiotics. There was high level of resistance to Penicillin (amoxicillin (77.5%) and Oxacillin (76.4%)), followed by 3G Cephalosporine (Ceftazidime (74.2%)) and Monobactam (Aztreonam (70.8%)). Although the least level of resistance was observed in Carbapenem (imipenem (5.6%)). The overall prevalence of MDRB was 62.9% (56/89). MRSA were the mostly detected 57.5 % (30/89), followed by ESBL 10.1% (9/89). Military hospital of Douala and Emergency unit was the MDRBs dominantly contaminated area respectively 39.3% (22/56) and 17.9% (10/56). Conclusion: MDRB occurred to be a current public health problem as well as hospital surfaces are worrying reservoir that can be spread to patient, health professionals and visitors. Keywords: Antibiotic resistance, susceptibility test, multidrug-resistant bacteria, Hospital facilities, Units, Littoral Region-Cameroo