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Ouagadougou, Burkina Faso

Lai Y.-S.,Swiss Tropical and Public Health Institute | Biedermann P.,Swiss Tropical and Public Health Institute | Ekpo U.F.,Abeokuta Federal University of Agriculture | Garba A.,Reseau International Schistosomose | And 15 more authors.
The Lancet Infectious Diseases

Background: Schistosomiasis affects more than 200 million individuals, mostly in sub-Saharan Africa, but empirical estimates of the disease burden in this region are unavailable. We used geostatistical modelling to produce high-resolution risk estimates of infection with Schistosoma spp and of the number of doses of praziquantel treatment needed to prevent morbidity at different administrative levels in 44 countries. Methods: We did a systematic review to identify surveys including schistosomiasis prevalence data in sub-Saharan Africa via PubMed, ISI Web of Science, and African Journals Online, from inception to May 2, 2014, with no restriction of language, survey date, or study design. We used Bayesian geostatistical meta-analysis and rigorous variable selection to predict infection risk over a grid of 1 155 818 pixels at 5 × 5 km, on the basis of environmental and socioeconomic predictors and to calculate the number of doses of praziquantel needed for prevention of morbidity. Findings: The literature search identified Schistosoma haematobium and Schistosoma mansoni surveys done in, respectively, 9318 and 9140 unique locations. Infection risk decreased from 2000 onwards, yet estimates suggest that 163 million (95% Bayesian credible interval [CrI] 155 million to 172 million; 18·5%, 17·6-19·5) of the sub-Saharan African population was infected in 2012. Mozambique had the highest prevalence of schistosomiasis in school-aged children (52·8%, 95% CrI 48·7-57·8). Low-risk countries (prevalence among school-aged children lower than 10%) included Burundi, Equatorial Guinea, Eritrea, and Rwanda. The numbers of doses of praziquantel needed per year were estimated to be 123 million (95% CrI 121 million to 125 million) for school-aged children and 247 million (239 million to 256 million) for the entire population. Interpretation: Our results will inform policy makers about the number of treatments needed at different levels and will guide the spatial targeting of schistosomiasis control interventions. Funding: European Research Council, China Scholarship Council, UBS Optimus Foundation, and Swiss National Science Foundation. © 2015 Elsevier Ltd. Source

Karagiannis-Voules D.-A.,Swiss Tropical and Public Health Institute | Karagiannis-Voules D.-A.,University of Basel | Biedermann P.,Swiss Tropical and Public Health Institute | Biedermann P.,University of Basel | And 21 more authors.
The Lancet Infectious Diseases

Background: Interest is growing in predictive risk mapping for neglected tropical diseases (NTDs), particularly to scale up preventive chemotherapy, surveillance, and elimination efforts. Soil-transmitted helminths (hookworm, Ascaris lumbricoides, and Trichuris trichiura) are the most widespread NTDs, but broad geographical analyses are scarce. We aimed to predict the spatial and temporal distribution of soil-transmitted helminth infections, including the number of infected people and treatment needs, across sub-Saharan Africa. Methods: We systematically searched PubMed, Web of Knowledge, and African Journal Online from inception to Dec 31, 2013, without language restrictions, to identify georeferenced surveys. We extracted data from household surveys on sources of drinking water, sanitation, and women's level of education. Bayesian geostatistical models were used to align the data in space and estimate risk of with hookworm, A lumbricoides, and T trichiura over a grid of roughly 1 million pixels at a spatial resolution of 5 × 5 km. We calculated anthelmintic treatment needs on the basis of WHO guidelines (treatment of all school-aged children once per year where prevalence in this population is 20-50% or twice per year if prevalence is greater than 50%). Findings: We identified 459 relevant survey reports that referenced 6040 unique locations. We estimate that the prevalence of hookworm, A lumbricoides, and T trichiura among school-aged children from 2000 onwards was 16·5%, 6·6%, and 4·4%. These estimates are between 52% and 74% lower than those in surveys done before 2000, and have become similar to values for the entire communities. We estimated that 126 million doses of anthelmintic treatments are required per year. Interpretation: Patterns of soil-transmitted helminth infection in sub-Saharan Africa have changed and the prevalence of infection has declined substantially in this millennium, probably due to socioeconomic development and large-scale deworming programmes. The global control strategy should be reassessed, with emphasis given also to adults to progress towards local elimination. Funding: Swiss National Science Foundation and European Research Council. © 2015 Elsevier Ltd. Source

Kidd S.,Centers for Disease Control and Prevention | Ouedraogo B.,Direction de la Prevention par les Vaccinations | Kambire C.,World Health Organization | Kambou J.L.,Direction de la Lutte contre la Maladie | And 10 more authors.

Objective: We investigated a large measles outbreak that occurred in 2009 in Burkina Faso in order to describe the epidemic, assess risk factors associated with measles, and estimate measles vaccine effectiveness. Methods: We reviewed national surveillance and measles vaccine coverage data, and conducted a case-control study in three geographic areas. Case-patients were randomly selected from the national case-based measles surveillance database or, when a case-patient could not be traced, were persons in the same community who experienced an illness meeting the WHO measles clinical case definition. Controls were matched to the same age stratum (age 1-14 years or age 15-30 years) and community as case-patients. Risk factors were assessed using conditional logistic regression. Results: Lack of measles vaccination was the main risk factor for measles in all three geographic areas for children aged 1-14 years (adjusted matched odds ratio [aMOR] [95% confidence interval (CI)], 19.4 [2.4-155.9], 5.9 [1.6-21.5], and 6.4 [1.8-23.0] in Bogodogo, Zorgho, and Sahel, respectively) and persons aged 15-30 years (aMOR [95% CI], 3.2 [1.1-9.7], 19.7 [3.3-infinity], 8.0 [1.8-34.8] in Bogodogo, Zorgho, and Sahel, respectively). Among children aged 1-14 years, VE of any measles vaccination prior to 2009 was 94% (95% CI, 45-99%) in Bogodogo, 87% (95% CI, 37-97%) in Zorgho, and 84% (95% CI, 41-96%) in Sahel. Main reasons for not receiving measles vaccination were lack of knowledge about vaccination campaigns or need for measles vaccination and absence during vaccination outreach or campaign activities. Conclusion: These results emphasize the need for improved strategies to reduce missed opportunities for vaccination and achieve high vaccination coverage nationwide in order to prevent large measles outbreaks and to continue progress toward measles mortality reduction. © 2012. Source

Mole S.,Institute Superieur des Technologies Medicales | Onana E.,Ministere de la Sante Publique | Biholong D.,Direction de la Lutte contre la Maladie
Bulletin de la Societe de Pathologie Exotique

The HIV/AIDS infection is in a permanent progress in Cameroon. Through this descriptive and analytical crosssectional study, we aimed to compare the occurrence of the HIV by taking into account the risks factors that are significantly associated with HIV. The investigation was carried out from 1 January till 31 December 2009 in the Blood Bank of the Central Hospital of Yaounde in Cameroon. A structured questionnaire was proposed to collect socio-demographic and risk behavioral information. Venous blood was collected for HIV antibody testing. Generalized estimating equation with logistic regression was used to analyze the risk factors for HIV infection. In all, 5 058 persons were included in this study. Serological examination revealed a total prevalence of 5.4% of HIV infection in the population studied. The family/replacement donors constituted the majority (69.5%) and showed a higher risk of seropositivity of HIV than the benevolent donors in raw analysis; but after adjustment, the family donors had the same risk of seropositivity of HIV than voluntary blood donors (aOR = 1.00). Variables such as homosexual intercourse (aOR = 1.61), to have already made a screening test of HIV (aOR = 1.83), mobility (aOR = 2.24), treatment and records of STI (aOR = 3.81), use of the condom (aOR = 6.63), more than one sexual partner (aOR = 8.40) remained significantly linked to the result of the HIV serology and constituted risk factors that will be emphasized during the selection of the donors. © Société de pathologie exotique et Springer-Verlag France 2011. Source

Yone E.W.P.,British Petroleum | Kuaban C.,British Petroleum | Simo L.,Direction de la Lutte contre la Maladie
Revue des Maladies Respiratoires

Introduction.- L'objectif de cette étude était de déterminer l'impact actuel de l'infection á VIH sur les aspects radiocliniques, biologiques et évolutifs de la tuberculose pleurale á Yaoundé. Méthodes.- Cent quatre vingt seize patients adultes atteints de tuberculose pleurale et hospitalisés dans le service de pneumologie de l'hôpital Jamot de Yaoundé d'octobre 2007 á février 2009 ont été consécutivement inclus de façon prospective dans notre étude. Résultats.- Des 196 patients inclus, 82 (41,8 %) avaient une infection á VIH. La toux, l'expectoration et les signes généraux étaient plus fréquemment observés chez les malades VIH positifs. Chez 47,6 % des patients VIH positifs, une anomalie parenchymateuse non cavitaire était observée contre 29,8 % chez les patients VIH négatifs (p = 0,011). Aucune différence n'a été trouvée quant á l'aspect histologique des fragments de biopsie pleurale entre les malades VIH séropositifs et séronégatifs. Le taux de succès thérapeutique était de 80,7 % dans le groupe VIH négatif et de 72 % dans le groupe VIH positif (p = 0,151). Conclusion.- L'infection á VIH modifie la présentation radioclinique de la tuberculose pleurale, mais ne semble pas avoir d'incidence sur la formation du granulome tuberculoïde pleural ainsi que sur le taux de succès thérapeutique au cours de cette affection. © 2011 SPLF. Source

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