Feasibility and acceptability of rapid HIV screening in a labour ward in Togo

Background: HIV screening in a labour ward is the last opportunity to initiate an antiretroviral prophylaxis among pregnant women living with HIV to prevent mother-to-child HIV transmission. Little is known about the feasibility and acceptability of HIV screening during labour in West Africa. Findings: A cross-sectional survey was conducted in the labour ward at the Tokoin Teaching Hospital in Lomé (Togo) between May and August 2010. Pregnant women admitted for labour were randomly selected to enter the study and were interviewed on the knowledge of their HIV status. Clinical and biological data were collected from the individual maternal health chart. HIV testing or re-testing was systematically proposed to all pregnant women. Among 1530 pregnant women admitted for labour, 508 (32.2%) were included in the study. Information on HIV screening was available in the charts of 359 women (71%). Overall, 467 women accepted HIV testing in the labour ward (92%). The HIV prevalence was 8.8% (95% confidence interval: 6.4 to 11.7%). Among the 41 women diagnosed as living with HIV during labour, 34% had not been tested for HIV during pregnancy and were missed opportunities. Antiretroviral prophylaxis had been initiated antenatally for 24 women living with HIV and 17 in the labour room. Conclusions: This study is the first to show in West Africa that HIV testing in a labour room is feasible and well accepted by pregnant women. HIV screening in labour rooms needs to be routinely implemented to reduce missed opportunities for intervention aimed at HIV care and prevention, especially PMTCT

Staphylococcal Panton-Valentine Leucocidin as a Major Virulence Factor Associated to Furuncles

Panton-Valentine Leucocidin (PVL), one of the β-barrel pore-forming staphylococcal leucotoxins, is known to be associated to furuncles and some severe community pneumonia. However, it is still uncertain how many other virulence factors are also associated to furuncles and what the risk factors of furuncles are in immuno-compromised status of patients, especially the HIV (+) patients. In this paper, we use antigen immunoprecipitation and multiplex PCR approach to determine the presence of 19 toxins, 8 adhesion factors and the PFGE profiles associated to furuncles in three independent patient study groups of S. aureus (SA) isolates collected from the Cayenne General Hospital (French Guiana). The patient groups were made of: 16 isolates from HIV (−) patients, 9 from HIV (+) patients suffering from furuncles, and 30 control isolates from patients with diverse secondary infected dermatitis. Our data reveals that the majority (96%) of SA strains isolated from HIV patient-derived furuncles significantly produced PVL (p<10−7), whereas only 10% of SA strains produced this toxin in secondary infected dermatosis. A high prevalence of LukE-LukD-producing isolates (56 to 78%) was recorded in patient groups. Genes encoding clumping factor B, collagen- and laminin-binding proteins (clfB, cna, lbp, respectively) were markedly frequent (30 to 55%), without being associated to a specific group. Pulse field gel electrophoresis evidenced 24 overall pulsotypes, whereas the 25 PVL-producing isolates were distributed into 15 non clonal fingerprints. These pulsotypes were not specific PVL-producing isolates. PVL appears to be the major virulence factor associated to furuncles in Europe and in South America regardless of the immune status of the HIV patients

Choice-Disability and HIV Infection: A Cross Sectional Study of HIV Status in Botswana, Namibia and Swaziland

Interpersonal power gradients may prevent people implementing HIV prevention decisions. Among 7,464 youth aged 15–29 years in Botswana, Namibia and Swaziland we documented indicators of choice-disability (low education, educational disparity with partner, experience of sexual violence, experience of intimate partner violence (IPV), poverty, partner income disparity, willingness to have sex without a condom despite believing partner at risk of HIV), and risk behaviours like inconsistent use of condoms and multiple partners. In Botswana, Namibia and Swaziland, 22.9, 9.1, and 26.1% women, and 8.3, 2.8, and 9.3% men, were HIV positive. Among both women and men, experience of IPV, IPV interacted with age, and partner income disparity interacted with age were associated with HIV positivity in multivariate analysis. Additional factors were low education (for women) and poverty (for men). Choice disability may be an important driver of the AIDS epidemic. New strategies are needed that favour the choice-disabled

Les aspects epidemiologiques et cliniques de la pelade au Chu Tokoin (Lome)

No Abstract

Evaluation des interventions des pairs-educatrices dans la prevention du VIH/SIDA chez les travailleuses du sexe a Cotonou, Benin

Objectif: Le but de cette étude est d'évaluer l'efficacité des interventions des pairs-éducatrices sur la connaissance de l’infection à VIH/SIDA chez les femmes travailleuses du sexe à Cotonou.Méthode: Il s'est agi d'une étude transversale descriptive à visée évaluative réalisée en octobre 2014. La méthode probabiliste a été utilisée pour le choix des Travailleuses du Sexe (TS). Les informations concernant la connaissance des TS sur le VIH/SIDA ont été recueillies à l'aide de questionnaires structurés.Résultats: Selon l’échantillonnage 11 sites de prostitution ont été parcourus dont six (54,5%) disposaient d'une Pair-éducatrice (PE). Pour cette enquête 102 TS ont accepté à y participer après consentement. La connaissance des voies de transmission et des méthodes de prévention du VIH/SIDA était plus élevée chez les TS ayant une PE sur leur site que chez les TS n'ayant pas de PE sur leur site (p respectivement égal à 0,04 et 0,05). L'utilisation du préservatif avec les boy-friends lors des relations sexuelle non tarifiée était faible dans les deux populations de TS (p = 0,09), comparativement aux clientsConclusion: Cette étude nous a permis de conclure à l'efficacité des interventions des PE sur l'amélioration des connaissances sur le VIH/SIDA chez les TS. Cependant, ces résultats méritent d’être confirmés par une étude sur le plan national avec des échantillons plus grand.Mots-clés: Evaluation, pairs-éducatrices, travailleuses du sexe, VIHEnglish Title: Evaluation of the interventions of peer educators in the prevention of HIV/AIDS among sex-workers in Cotonou, BeninEnglish AbstractObjective: The aim of this study was to evaluate the effectiveness of interventions for peer educators in the prevention of HIV / AIDS infection among female sex workers (FSW) in Cotonou. Method: This is a cross-sectional study aimed at evaluative analyses carried out in October 2014. The sampling probabilistic method was used for the selection of SC. Information regarding the knowledge of FSW on HIV / AIDS were collected using structured questionnaires.Results: According to the sampling method, , 11 sex workers sites were visited and out of them six (54.5%) had pair educator (PE). For the study, 102 female sex workers (FSWs) were recruited after obtaining their informed consent to participate in the study. Knowledge of methods of transmission and methods of prevention of HIV / AIDS was higher in FSWs with peer-educators on their site than in FSWs with no PE on their site (0.04 and 0.05, p-values respectively). Condom use with boy-friends at non-paying sex was low in both populations TS (p = 0.09).Conclusion: This study allows us to conclude the effectiveness of peer-edicator interventions on improving knowledge about HIV / AIDS among FSW. However, these results need to be confirmed by a study on the national level with samples greater.Keywords: evaluation, Peer-educators, Sex-workers, HI

Causes medicales d’hospitalisation des personnes agees de 65 ans et plus au Chu Tokoin de Lome.

Vascular diseases, diabetes, cancer and dementia increase with age in according to WHO. This retrospective study from 1999 to 2003, had the aim to look for medical hospitalization causes of old persons in Lom&eacute;-Tokoin university hospital by comparing patients of 40 to 64 years (group A) and 65 years and over (group B). 8419 patients was hospitalized (A=32.41%; B=9.66%). We notified among other diseases, stroke (A=9.08% B=17.32%), diabetes (A=3.37% B=8.23%), hypertension (A=3.4% B=6.87%), heart insufficiency (A=0.40% B=3.56%). Dementia was not notified.Les affections cerebro-cardiovasculaires, le diabete, le cancer et la demence augmentent avec l'age selon lfOMS.But : Faire lfinventaire des causes medicales dfhospitalisation des personnes agees (. 65 ans) et comparer ces causes a celles des adultes de 40 a 64 ans.Methodologie : Il s'agit d'une etude retrospective allant de 1999 a 2003 menee a partir des dossiers des archives des services de Medecine du CHU Tokoin de Lome. Nous avions inclus dans cette etude tous les dossiers des patients ages de 40 ans et plus ; nous avions compare, avec le khi carre, les principales causes medicales dfhospitalisation des patients de 40 a 64 ans (groupe A) et celles des patients de 65 ans et plus (groupe B).Resultats : Au total, 8419 patients etaient hospitalises dont 2729 du groupe A (A=32,41%) et 814 du groupe B (B=9,66%). Les deux groupes avaient presente les memes maladies et symptomes, mais certains de ceux-ci etaient significativement dominants dans le groupe B. Il sfagit des AVC (A=9% ; B=17,3% ; p&lt;0,001), du diabete (A=3,3% ; B=8,2% ; p&lt;0,001), de lfHTA (A=3,4% ; B=6,9% ; p&lt;0,001), de lfinsuffisance cardiaque (A=0,4% ; B=3,5% ; p&lt;0,001), du neuropaludisme (A=0,5% ; B=1,3% ; p&lt;0,02)et des metastases osseuses (A=0,2% ; B=1,1% ; p&lt;0,001).Conclusion : Notre etude retrouve, conformement a la litterature, les memes affections chez les personnes agees et les adultes sauf les demences. Dfou lfimportance dfune unite de geriatrie a Lome