Technical support study to OUA/IBAR-PARC. Synthesis report

The report is composed of four main chapters: An introduction concerning the zoosanitary situation in sub-Sahara Africa, and an estimation of the economic impact of improvements in animal health. A detailed review of the actors in the livestock sector ant the tools available for intervention in the control of Rinderpest and other major diseases. In a third chapter, technical strateties are proposed for the prospective program. This focuses on disease surveillance and national systems of epidemiological surveillance with support for the laboratories and research (Rinderpest, CBPP). Proposals for geographical strategies of Rinderpest and CBPP control adapted to different geo-epidemiological contexts make up the last chapter of this report. (Résumé d'auteur

Frequency and determinants of ocular trauma in the Kimpese Rural Health Zone, Kongo Central, Democratic Republic of Congo: Fréquence et Déterminants des traumatismes oculaires dans la Zone de santé de Kimpese, Kongo Central, RDC

Context and objective. Ocular trauma is very common and its etiological factors vary by region and age group. This study aims to describe the magnitude and determinants of ocular trauma complications in rural areas.  Methods. We conducted a retrospective study of patients admitted for ocular trauma at Kimpese Hospital between January 2014 and December 2016. Univariate logistic regression was used to assess the determinants of ocular trauma complications. The statistical significance level is p˂ 0.05.  Results. A total of 223 patients were included. The majority of participants were men (69.5%), over 18 years of age (70%), with poor visual acuity (57.8%) and bilateral ocular involvement (51.1%). Plant objects (44.8%) and metal objects (15.2%) were the most common traumatic agents. After treatment, an improvement in visual acuity was observed in 64.3% of patients with previously poor visual acuity (p < 0.001). The delay of care > 7 days [aOR: 2.286 (95% CI: 1.302-4.012), p=0.004] and the poor visual acuity on admission [aOR: 5.906 (95% CI: 3.231-10.796), p< 0.0001] emerged as determinants of the onset of complications. Conclusion. Awareness-raising efforts for early consultation after ocular trauma and integration of eye care at the primary level should be promoted for efficiency in care. Contexte et objectifs. Les traumatismes oculaires sont très fréquents et ses facteurs étiologiques varient selon les régions et les tranches d’âge. Cette étude a pour objectifs de décrire le fardeau et rechercher les déterminants des complications des traumatismes oculaires en milieu rural. Méthodes. Nous avons mené une étude documentaire sur les patients admis à l’hopital de Kimpese pour un traumatisme oculaire entre janvier 2014 et décembre 2016. La régression logistique univariée a été utilisée pour rechercher les déterminants des complications des traumatismes oculaires. Le seuil de signification statistique est p˂0.05. Résultats. La majorité des participants était des hommes (69,5%), de la tranche de plus de 18 ans (70 %), avec une mauvaise acuité visuelle (57,8%) et une atteinte oculaire bilatérale (51,1%). Les objets de nature végétale (44,8%) et les objets métalliques (15,2%) ont constitué les agents traumatiques les plus rencontrés. Après traitement, une amélioration de l’acuité visuelle a été constatée chez 64,3% des patients ayant précédemment une acuité visuelle mauvaise (p< 0,001). Le délai de prise en charge > 7 jours [ORa : 2 ,286 (IC 95% : 1,302-4,012), p= 0,004] et la mauvaise acuité visuelle à l’admission [ORa : 5,906 (IC 95%: 3,231-10,796), p < 0,0001] ont émergé comme déterminants de la survenue des complications. Conclusion. Les efforts de sensibilisation en faveur de la consultation précoce après les traumatismes oculaires et une intégration des soins oculaires au niveau primaire sont à promouvoir pour une efficience dans la prise en charge

Mission d'appui technique à l'OUA/IBAR-PARC. Rapport de synthèse

Ce rapport comprend 4 chapitres principaux : une introduction sur la situation zoosanitaire en Afrique sub-saharienne, ainsi qu'une estimation de l'impact économique de l'amélioration de la santé animale ; une présentation détaillée des acteurs du secteur élevage et des outils disponibles intervenant tans la lutte contre la peste bovine et les autres pathologies dominantes ; dans un 3ème chapitre, les stratégies techniques sont proposées pour le futur programme. Elles sont axées sur l'épidémiosurveillance et les systèmes nationaux de surveillance épidémiologique avec un appui aux laboratoires et aux recherches (peste bovine, PPCB) ; des propositions de stratégies géographiques de lutte contre la peste bovine et la PPCB, adaptées aux différents contextes géo-épidémiologiques, constituent le dernier chapitre de ce rapport. (Résumé d'auteur

Pattern of non-obstetric infectious recto-vaginal fistula: a case series and literature review in Cameroon, Central Africa

Background: Perineal infection is an uncommon cause of non-obstetrical recto-vaginal fistula (RVF) which is associated with HIV infection. Cameroon (Central Africa) is in the fistula belt but infectious RVFs have not yet been deeply studied in the country. We therefore sought to determine the pattern of non-obstetric infectious RVF in Cameroon.Methods: We carried out a cross-sectional and descriptive review of non-obstetric infectious RVFs managed at the Yaoundé University Teaching Hospital between January 1, 2009 and December 31, 2015. All complete files were included. The following data were retrieved: socio-demographics, characteristics of the RVF, management and outcome.Results: Five non-obstetrical and non-traumatic RVFs of which four were observed in HIV-infected patients were included. All those RVFs occurred spontaneously. The following predisposing factors were identified: perineal warts (one case out of five), perineal suppuration (two cases out of five), hemorrhoids (the HIV-negative patient), spinsterhood (all cases), unemployment (all cases). All HIV-patients were under anti-retroviral therapy (ART) with good immunological and clinical responses for three of them. Three of them underwent previous unsuccessful surgical cure. Management included ART, antibiotics and surgery. Surgical approaches were perineotomy alone or with martius’ flap, procto-perineotomy or trans-vaginal advancement flap. Outcome was satisfactory for all HIV patients (closure of fistula and fecal continence).Conclusions: Local infection is a rare cause of RVF which was associated with HIV in our series. Combined treatment including antibiotics, HAART and surgery gave good results

Impact of Short-Term HAART Initiated during the Chronic Stage or Shortly Post-Exposure on SIV Infection of Male Genital Organs

International audienceBACKGROUND: The male genital tract is suspected to constitute a viral sanctuary as persistent HIV shedding is found in the semen of a subset of HIV-infected men receiving effective antiretroviral therapy (HAART). The origin of this persistent shedding is currently unknown. Phylogenetic studies indicated that HIV in semen from untreated men arises from local sources and/or passive diffusion from the blood. We previously demonstrated in human and macaque low levels and localized infection of several semen-producing organs by HIV/SIV. Using a macaque model, this study investigates the impact of short term HAART (2-4 weeks) initiated either during the asymptomatic chronic stage or 4 h post-intravenous inoculation of SIVmac251 on the infection of male genital organs. METHODOLOGY/PRINCIPAL FINDINGS: Short term HAART during the chronic stage decreased blood viral load. No major impact of HAART was observed on SIV DNA levels in male genital organs using a sensitive nested PCR assay. Using in situ hybridization, SIV RNA+ cells were detected in all male genital tract organs from untreated and treated animals with undetectable blood viral load following HAART. Infected CD68+ myeloid cells and CD3+ T lymphocytes were detected pre- and post-HAART. In contrast, short term HAART initiated 4 h post-SIV exposure led to a drastic decrease of the male genital tissues infection, although it failed to prevent systemic infection. In both cases, HAART tended to decrease the number of CD3+ T cells in the male organs. CONCLUSIONS: Our results indicate that the established infection of male genital organs is not greatly impacted by short term HAART, whereas the same treatment during pre-acute phase of the infection efficiently impairs viral dissemination to the male genital tract. Further investigations are now needed to determine whether infection of male genital organs is responsible for long term persistent HIV shedding in semen despite HAART