Direction de la Lutte contre la Maladie

Ouagadougou, Burkina Faso

Direction de la Lutte contre la Maladie

Ouagadougou, Burkina Faso

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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 | Year: 2015

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.


PubMed | Centers for Disease Control and Prevention, Reseau International Schistosomose, Institute National Of Recherche En Sante Publique, Kenya Medical Research Institute and 7 more.
Type: Journal Article | Journal: The Lancet. Infectious diseases | Year: 2015

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.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 1155818 pixels at 55 km, on the basis of environmental and socioeconomic predictors and to calculate the number of doses of praziquantel needed for prevention of morbidity.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; 185%, 176-195) of the sub-Saharan African population was infected in 2012. Mozambique had the highest prevalence of schistosomiasis in school-aged children (528%, 95% CrI 487-578). 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.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.European Research Council, China Scholarship Council, UBS Optimus Foundation, and Swiss National Science Foundation.


Tartof S.,Centers for Disease Control and Prevention | Cohn A.,Centers for Disease Control and Prevention | Tarbangdo F.,Direction de la Lutte Contre la Maladie | Djingarey M.H.,World Health Organization | And 7 more authors.
PLoS ONE | Year: 2013

Objective:The optimal long-term vaccination strategies to provide population-level protection against serogroup A Neisseria meningitidis (MenA) are unknown. We developed an age-structured mathematical model of MenA transmission, colonization, and disease in the African meningitis belt, and used this model to explore the impact of various vaccination strategies.Methods:The model stratifies the simulated population into groups based on age, infection status, and MenA antibody levels. We defined the model parameters (such as birth and death rates, age-specific incidence rates, and age-specific duration of protection) using published data and maximum likelihood estimation. We assessed the validity of the model by comparing simulated incidence of invasive MenA and prevalence of MenA carriage to observed incidence and carriage data.Results:The model fit well to observed age- and season-specific prevalence of carriage (mean pseudo-R2 0.84) and incidence of invasive disease (mean R2 0.89). The model is able to reproduce the observed dynamics of MenA epidemics in the African meningitis belt, including seasonal increases in incidence, with large epidemics occurring every eight to twelve years. Following a mass vaccination campaign of all persons 1-29 years of age, the most effective modeled vaccination strategy is to conduct mass vaccination campaigns every 5 years for children 1-5 years of age. Less frequent campaigns covering broader age groups would also be effective, although somewhat less so. Introducing conjugate MenA vaccine into the EPI vaccination schedule at 9 months of age results in higher predicted incidence than periodic mass campaigns.Discussion:We have developed the first mathematical model of MenA in Africa to incorporate age structures and progressively waning protection over time. Our model accurately reproduces key features of MenA epidemiology in the African meningitis belt. This model can help policy makers consider vaccine program effectiveness when determining the feasibility and benefits of MenA vaccination strategies.


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 | Year: 2015

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.


Novak R.T.,Centers for Disease Control and Prevention | Kambou J.L.,Direction de la Lutte contre la Maladie | Diomande F.V.K.,Centers for Disease Control and Prevention | Tarbangdo T.F.,Direction de la Lutte contre la Maladie | And 12 more authors.
The Lancet Infectious Diseases | Year: 2012

Background: An affordable, highly immunogenic Neisseria meningitidis serogroup A meningococcal conjugate vaccine (PsA-TT) was licensed for use in sub-Saharan Africa in 2009. In 2010, Burkina Faso became the first country to implement a national prevention campaign, vaccinating 11·4 million people aged 1-29 years. We analysed national surveillance data around PsA-TT introduction to investigate the early effect of the vaccine on meningitis incidence and epidemics. Methods: We examined national population-based meningitis surveillance data from Burkina Faso using two sources, one with cases and deaths aggregated at the district level from 1997 to 2011, and the other enhanced with results of cerebrospinal fluid examination and laboratory testing from 2007 to 2011. We compared mortality rates and incidence of suspected meningitis, probable meningococcal meningitis by age, and serogroup-specific meningococcal disease before and during the first year after PsA-TT implementation. We assessed the risk of meningitis disease and death between years. Findings: During the 14 year period before PsA-TT introduction, Burkina Faso had 148 603 cases of suspected meningitis with 17 965 deaths, and 174 district-level epidemics. After vaccine introduction, there was a 71% decline in risk of meningitis (hazard ratio 0·29, 95% CI 0·28-0·30, p<0·0001) and a 64% decline in risk of fatal meningitis (0·36, 0·33-0·40, p<0·0001). We identified a statistically significant decline in risk of probable meningococcal meningitis across the age group targeted for vaccination (62%, cumulative incidence ratio [CIR] 0·38, 95% CI 0·31-0·45, p<0·0001), and among children aged less than 1 year (54%, 0·46, 0·24-0·86, p=0·02) and people aged 30 years and older (55%, 0·45, 0·22-0·91, p=0·003) who were ineligible for vaccination. No cases of serogroup A meningococcal meningitis occurred among vaccinated individuals, and epidemics were eliminated. The incidence of laboratory-confirmed serogroup A N meningitidis dropped significantly to 0·01 per 100 000 individuals per year, representing a 99·8% reduction in the risk of meningococcal A meningitis (CIR 0·002, 95% CI 0·0004-0·02, p<0·0001). Interpretation: Early evidence suggests the conjugate vaccine has substantially reduced the rate of meningitis in people in the target age group, and in the general population because of high coverage and herd immunity. These data suggest that fully implementing the PsA-TT vaccine could end epidemic meningitis of serogroup A in sub-Saharan Africa. Funding: None. © 2012 Elsevier Ltd.


PubMed | Centers for Disease Control and Prevention, Institute National Of Recherche En Sante Publique, Reseau International Schistosomiases, Kenya Medical Research Institute and 7 more.
Type: Journal Article | Journal: The Lancet. Infectious diseases | Year: 2014

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.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 womens 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 55 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%).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 165%, 66%, and 44%. 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.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.Swiss National Science Foundation and European Research Council.


Yone E.W.P.,British Petroleum | Kuaban C.,British Petroleum | Simo L.,Direction de la lutte contre la maladie
Revue des Maladies Respiratoires | Year: 2011

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.


Mbopi-Keou F.,University of Yaounde I | Djomassi L.D.,Direction de la Lutte contre la Maladie | Monebenimp F.,University of Yaounde I
Pan African Medical Journal | Year: 2012

Introduction: Etudier les facteurs liés à l'observance au traitement antirétroviral chez les patients adultes suivis à l'Unité de Prise en Charge du VIH/SIDA (UPEC) de l'hôpital de District de Dschang. Méthodes: Dans une étude descriptive transversale conduite à l'hôpital de District de Dschang, l'observance a été évaluée sur la base des déclarations des patients et sur la régularité du renouvellement de leurs ordonnances (observance calculée). Résultats: Parmi les 389 patients répondant à nos critères d'inclusion, 356 ont été interrogés. La durée moyenne du suivi était de 27 mois. La moyenne d'âge était égale à 41 ans et le sexe ratio 2,46 en faveur du sexe féminin. Le statut sérologique était découvert pour 60,56% des patients à l'occasion d'un épisode maladif. Le niveau d'observance déclarée était significativement plus élevé que le niveau global de l'observance calculée (80,2% vs 51,5%, p<10-5). Les deux principales barrières à l'observance étaient l'oubli et le travail. Les patients référés dans cette UPEC étaient moins bien observants (p<10-4). L'observance au traitement antirétroviral était d'autant meilleure quand le taux de CD4 en début de traitement était élevé (p= 0,01) et que la durée du traitement était prolongée (p=0,00). Conclusion: La discordance observée entre les résultats des deux méthodes utilisées pour estimer l'observance, tout en soulévant les contraintes liées à l'évaluation de l'observance thérapeutique, souligne l'importance des méthodes biologiques. Les facteurs individuels se sont avérés être les principales raisons de non-observance. Enfin, un accent devrait être mis sur les consultations d'éducation thérapeutique et le suivi psycho-social des patients sous traitement antirétroviral dans cette UPEC. © François-Xavier Mbopi-Ké;ou et al.


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 | Year: 2011

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.


Tchendjou P.,Center Pasteur du Cameroun | Same-Ekobo C.,Center Hospitalier Essos | Nga A.,Center Hospitalier Essos | Tejiokem M.,Center Pasteur du Cameroun | And 9 more authors.
PLoS ONE | Year: 2010

Background: Multidrug antiretroviral (ARV) regimens including HAART and short-course dual antiretroviral (sc-dARV) regimens were introduced in 2004 to improve Prevention of Mother-to-Child Transmission (PMTCT) in Cameroon. We assessed the effectiveness of these regimens from 6-10 weeks and 12 months of age, respectively. Methodology/Findings: We conducted a retrospective cohort study covering the period from October 2004 to March 2008 in a reference hospital in Cameroon. HIV-positive pregnant women with CD4 ≤350 cells/mm3 received first-line HAART [regimen 1] while the others received ARV prophylaxis including sc-dARV or single dose nevirapine (sd-NVP). Sc-dARV included at least two drugs according to different gestational ages: zidovudine (ZDV) from 28-32 weeks plus sd-NVP [regimen 2], ZDV and lamuvidine (3TC) from 33-36 weeks plus sd-NVP [regimen 3]. When gestational age was >37 weeks, women received sd-NVP during labour [regimen 4]. Infants received sd-NVP plus ZDV and 3TC for 7 days or 30 days. Early diagnosis (6-10 weeks) was done, using b-DNA and subsequently RT-PCR. We determined early MTCT rate and associated risk factors using logistic regression. The 12-month HIV-free survival was assessed using Cox regression. Among 418 mothers, 335 (80%) received multidrug ARV regimens (1, 2, and 3) and MTCT rate with multidrug regimens was 6.6% [95%CI: 4.3-9.6] at 6 weeks, without any significant difference between regimens. Duration of mother's ARV regimen>4 weeks [OR = 4.7, 95%CI: 1.3-17.6], mother's CD4>350 cells/mm3 [OR = 6.4, 95%CI: 1.8-22.5] and low birth weight [OR = 4.0, 95%CI: 1.4-11.3] were associated with early MTCT. By 12 months, mixed feeding [HR = 8.7, 95%CI: 3.6-20.6], prematurity [HR = 2.3, 95%CI: 1.2-4.3] and low birth weight were associated with children's risk of progressing to infection or death. Conclusions: Multidrug ARV regimens for PMTCT are feasible and effective in routine reference hospital. Early initiation of ARV during pregnancy and proper obstetrical care are essential to improve PMTCT. © 2010 Tchendjou et al.

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