Cancer de la prostate au Centre Hospitalier Universitaire Aristidie Le Dantec de Dakar : aspects épidemiologiques sur les cinq dernières années: Prostate cancer in Aristide Le Dantec hospital of Dakar: epidemiological aspects over the last five years

Context and objective. Prostate cancer represents a major public health issue, but data from sub-Saharan Africa are scarce. This study aimed to describe the epidemiological aspects of prostate cancer during the last five years in Aristide Le Decantec hospital of Dakar. Methods. it’s a retrospective and descriptive study involving 5 last years including all patients with histologically confirmed prostate cancer. The studied parameters were: prevalence, incidence, age, clinical stage, lethality and death rate. Results. Two hundred and thirty-three patients were enrolled. The prevalence of prostate cancer during the study period was 0.8%. Depending on the stage, metastatic cancer was the most common form with 45.9% of cases. The new cases were 199 with an average of 39.8 per year. The total incidence of prostate cancer over the study period was 0.7%. The mean age of the patients at the diagnosis time was 68.6 ± 9.2 years. The lethality was 0.5%. The global death rate was 0.9 ‰. The specific death rate was 0.9‰. The annual mortality rate was higher in 2017 (36.4%) compared to other years. Depending on the stage, the death rate was higher in metastatic stages patients. Conclusion. The incidence of prostate cancer is increasing in our medical center. Metastatic forms remain more common with higher death rate. Early detection campaigns for prostate cancer should be considered. Contexte et objectif. Le cancer de la prostate représente un enjeu majeur de santé publique et mais il reste très peu documenté en Afrique subsaharienne. L’objectif de cette étude était d’évaluer les aspects épidémiologiques du cancer de la prostate sur les 5 dernières années dans notre centre. Méthodes. Il s’agissait d’une étude documentaire et descriptive sur 5 ans ayant colligé les dossiers de tous les patients avec cancer de la prostate histologiquement confirmé. Les paramètres étudiés étaient : la prévalence, l’incidence, l’âge, le stade clinique, la létalité et la mortalité. Résultats. Deux cent trente-trois patients ont été retenus. La prévalence du cancer de la prostate durant la période étudiée était de 0,8%. En fonction du stade, le stade de cancer métastatique était prépondérant (45,9%). Les nouveaux cas étaient de 199, soit une moyenne de 39,8 nouveaux cas par an. L’incidence totale du cancer de la prostate sur la période étudiée était de 0,7%. L’âge moyen des patients au moment du diagnostic était de 68,6 ± 9,2 ans. Le taux létalité était de 0,5%. La mortalité globale était de 0,9‰. Le taux de mortalité annuelle était plus important en 2017 (36,4%) en comparaison aux autres années étudiées. En fonction du stade, le taux de mortalité était plus important pour les stades métastatiques. Conclusion. L’incidence du cancer de la prostate est en augmentation dans notre centre. Les formes métastatiques restent prédominantes assombrissant le pronostic vital. Des campagnes de dépistage précoce du cancer de la prostate sont à envisager

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Evaluation of Senegal’s prevention of mother to child transmission of HIV (PMTCT) program data for HIV surveillance

Abstract Background With the expansion of Prevention of Mother to Child Transmission (PMTCT) services in Senegal, there is growing interest in using PMTCT program data in lieu of conducting unlinked anonymous testing (UAT)-based ANC Sentinel Surveillance. For this reason, an evaluation was conducted in 2011–2012 to identify the gaps that need to be addressed while transitioning to using PMTCT program data for surveillance. Methods We conducted analyses to assess HIV prevalence rates and agreements between Sentinel Surveillance and PMTCT HIV test results. Also, a data quality assessment of the PMTCT program registers and data was conducted during the Sentinel Surveillance period (December 2011 to March 2012) and 3 months prior. Finally, we also assessed selection bias, which was the percentage difference from the HIV prevalence among all women enrolled in the antenatal clinic and the HIV prevalence among women who accepted PMTCT HIV testing. Results The median site HIV prevalence using routine PMTCT HIV testing data was 1.1% (IQR: 1.0) while the median site prevalence from the UAT HIV Sentinel Surveillance data was at 1.0% (IQR: 1.6). The Positive per cent agreement (PPA) of the PMTCT HIV test results compared to those of the Sentinel Surveillance was 85.1% (95% CI 77.2–90.7%), and the percent-negative agreement (PNA) was 99.9% (95% CI 99.8–99.9%). The overall HIV prevalence according to UAT was the same as that found for women accepting a PMTCT HIV test and those who refused, with percent bias at 0.00%. For several key PMTCT variables, including “HIV test offered” (85.2%), “HIV test acceptance” (78.0%), or “HIV test done” (58.8%), the proportion of records in registers with combined complete and valid data was below the WHO benchmark of 90%. Conclusions The PPA of 85.1 was below the WHO benchmarks of 96.6%, while the combined data validity and completeness rates was below the WHO benchmark of 90% for many key PMTCT variables. These results suggested that Senegal will need to reinforce the quality of onsite HIV testing and improve program data collection practices in preparation for using PMTCT data for surveillance purposes