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Abidjan, Ivory Coast

Ndowa F.J.,World Health Organization | Francis J.M.,National Institute for Medical Research | Machiha A.,Ministry of Health and Child Welfare | Faye-Kette H.,Institute Pasteur Of Cote Divoire | Fonkoua M.C.,Center Pasteur du Cameroun
Sexually Transmitted Infections | Year: 2013

Many countries in Africa have weak surveillance systems for data collection of sexually transmitted infections, and hardly any programmes for gonococcal antimicrobial susceptibility assessment. The widespread adoption of the syndromic approach to the diagnosis and management of sexually transmitted infections has also meant that the collection of a genital specimen for laboratory analysis is no longer routinely done when patients present with genital complaints, and clinical staff and laboratory technicians have lost the skill to collect genital specimens and processing them for culture and antimicrobial susceptibility testing. Following reports of gonococcal antimicrobial resistance to quinolones, WHO urged countries to monitor gonococcal antimicrobial resistance in a more systematic and regular manner. Although the response in Africa has been slow to take off, a number of studies have been conducted in a few countries and plans for implementation are in place in others. However, the number of isolates studied has been small in nearly all the countries except one, and the barriers to scaling up gonococcal antimicrobial resistance surveys seem overwhelming. In spite of the studies being few and of small sample sizes, enough information can be discerned to indicate that quinolones can no longer be a medicine of choice for the treatment of gonorrhoea in Africa and the threat of antimicrobial resistance developing in Neisseria gonorrhoeae to thirdgeneration cephalosporins is real and imminent.

Soumahoro M.-K.,University Pierre and Marie Curie | Soumahoro M.-K.,French Institute of Health and Medical Research | Soumahoro M.-K.,Institute Pasteur Of Cote Divoire | Boelle P.-Y.,University Pierre and Marie Curie | And 16 more authors.
PLoS Neglected Tropical Diseases | Year: 2011

Background: This study was conducted to assess the impact of chikungunya on health costs during the epidemic that occurred on La Réunion in 2005-2006. Methodology/Principal Findings: From data collected from health agencies, the additional costs incurred by chikungunya in terms of consultations, drug consumption and absence from work were determined by a comparison with the expected costs outside the epidemic period. The cost of hospitalization was estimated from data provided by the national hospitalization database for short-term care by considering all hospital stays in which the ICD-10 code A92.0 appeared. A cost-of-illness study was conducted from the perspective of the third-party payer. Direct medical costs per outpatient and inpatient case were evaluated. The costs were estimated in Euros at 2006 values. Additional reimbursements for consultations with general practitioners and drugs were estimated as €12.4 million (range: €7.7 million-€17.1 million) and €5 million (€1.9 million-€8.1 million), respectively, while the cost of hospitalization for chikungunya was estimated to be €8.5 million (€5.8 million-€8.7 million). Productivity costs were estimated as €17.4 million (€6 million-€28.9 million). The medical cost of the chikungunya epidemic was estimated as €43.9 million, 60% due to direct medical costs and 40% to indirect costs (€26.5 million and €17.4 million, respectively). The direct medical cost was assessed as €90 for each outpatient and €2,000 for each inpatient. Conclusions/Significance: The medical management of chikungunya during the epidemic on La Réunion Island was associated with an important economic burden. The estimated cost of the reported disease can be used to evaluate the cost/efficacy and cost/benefit ratios for prevention and control programmes of emerging arboviruses. © 2011 Soumahoro et al.

Nelson M.I.,U.S. National Institutes of Health | Njouom R.,National Influenza Center | Viboud C.,U.S. National Institutes of Health | Niang M.N.D.,Institute Pasteur Of Dakar | And 8 more authors.
Journal of Infectious Diseases | Year: 2014

Our understanding of the global ecology of influenza viruses is impeded by historically low levels of viral surveillance in Africa. Increased genetic sequencing of African A/H1N1 pandemic influenza viruses during 2009-2013 revealed multiyear persistence of 2 viral lineages within West Africa, raising questions about the roles of reduced air traffic and the asynchrony of seasonal influenza epidemics among West African countries in the evolution of independent lineages. The potential for novel influenza virus lineages to evolve within Africa warrants intensified influenza surveillance in Africa and other understudied areas. © The Author 2014.

Faye B.,Cheikh Anta Diop University | Offianan A.T.,Institute Pasteur Of Cote Divoire | Ndiaye J.L.,Cheikh Anta Diop University | Tine R.C.,Cheikh Anta Diop University | And 6 more authors.
Tropical Medicine and International Health | Year: 2010

Objective To compare, in a phase IV trial, the efficacy and tolerability of artesunate-amodiaquine (Camoquin plus®) dosed at 300 and 600 mg of amodiaquine per tablet to artemether-lumefantrine (Coartem®) for the treatment of Plasmodium falciparum uncomplicated malaria in Ivory Cost and Senegal. Method Multisite, randomised, open-labelled study in patients over the age of 7 years. The primary endpoint for efficacy was adequate clinical and parasitological response (ACPR) at day 28. The secondary endpoints were fever and parasite clearance and gametocyte carriage in each treatment group. Drug tolerability was assessed comparing adverse events and modification of biological parameters between D0 and D7. Data were analysed on an intention-to-treat and per protocol basis. Results We included 322 patients; 316 patients completed the monitoring to D28 (155 in AS + AQ group and 161 in AL group). In ITT analysis, an ACPR corrected rate of 97.4% was observed in AS + AQ group versus 97% in AL group (P = 0.99). No parasite recrudescence was observed in AS + AQ arm. All patients in both groups had a fever and parasite clearance at D2. Gametocytes had disappeared by D14 in the AL group and by D21 in the AS + AQ group. No serious adverse events were observed. Minor adverse events were significantly more frequent in the AS + AQ arm. Biological parameters between D0 and D7 did not show any significant statistical variations except for anaemia. Conclusion This study demonstrates the efficacy and tolerability of AS + AQ for uncomplicated Plasmodium falciparum malaria treatment in African patients over the age of 7 years. © 2010 Blackwell Publishing Ltd.

Momou K.J.,Nangui Abrogoua University | Akoua-Koffi C.,University of Bouake | Dosso M.,Institute Pasteur Of Cote Divoire
Food and Environmental Virology | Year: 2014

The objective of this study was to compare sensitivities of enterovirus isolation from wastewater in different cell lines as well as to compare the sensitivity and specificity of isolation in cell culture with direct detection by reverse transcription polymerase chain reaction (RT-PCR). Sixty-eight samples of wastewaters were collected between September 2008 and January 2009 in Yopougon, Abidjan. Enteroviruses were concentrated according to World Health Organization recommendations. Viruses were inoculated into various cell lines while direct RT-PCR was performed on water concentrates. The buffalo green monkey kidney cell line was the most sensitive with 58.8 % of viral isolation. This was followed by the rhabdomyosarcoma cell line with sensitivity of 51.6 %, with human epidermoid carcinoma cell line showing sensitivity of 50 % and fibroblastic cells derived from transgenic mice LTK-1 (L20B) cell showing 23.50 % sensitivity. However, a lower specificity of 2.9 % was observed with the L20B cell line. 44.1 % of the samples were positive by direct RT-PCR detection while 51.47 % samples were positive by using RT-PCR on infected cell cultures. No difference in percentage positivity was observed using RT-PCR on infected tissue culture isolates or using RT-PCR directly on wastewater samples. © 2013 Springer Science+Business Media New York.

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