Sexuality after Childbirth: Analysis of the Experiences of Central African Women in Bangui

Introduction: In many societies, sexuality is still a taboo subject. In the Central African Republic, this topic is rarely discussed outside the context of gynecological consultations and infertility, whereas the sexual life of couples is often disrupted by the arrival of a child, particularly by the ordeal of childbirth. The aim of the study is to analyze the sexual experience of Central African women after childbirth in order to contribute to improving the health of the population, in particular that of mother and child, and to facilitate harmony within the couple. Methodology: Descriptive and analytical cross-sectional study covering the period from July 1 to August 30, 2023, at the maternity ward of the Center University Hospitalier Communautaire. The study concerned only women who had given birth between the second week and the sixth month postpartum. The sampling was exhaustive. Results: A total of 303 women agreed to take part in our study, aged between 15 and 44, more than half of whom had completed secondary school. The eagerness of the women to take part in the study shows that they are ready to express themselves about their sexuality despite certain biases linked to the method of patient selection. Resumption of sexual relations was initiated by the partners within six weeks in the vast majority of cases. Conclusion: Resumption of sexual intercourse was delayed, often at the partner’s initiative. Further studies are needed to understand the cultural, religious and psychological dimensions of postpartum sexuality in the Central African context.

Immunovirological Profile of HIV1 Infection in Children and Adolescents Followed at the Bangui Pediatric University Hospital

History: Pediatric management of HIV infection in children in the Central African Republic began in 2004 with the use of fractionated adult antiretrovirals and Cotrimoxazole. It has evolved over the years with the use of pediatric forms, oral suspensions and dispersible tablets. The transition to Dolutegravir took place in 2020. The active file of our patients will grow from 78 to over 1900 today. Follow-up examinations are carried out to assess adherence to treatment. Objective: To determine the immunovirological profile and factors associated with treatment failure during follow-up of children on ART at the Bangui pediatric university hospital. Patients and Method: This was a cross-sectional, analytical study from May 30 to December 02, 2022. The study sample was drawn from a cohort of HIV-1-infected children followed up at the Bangui pediatric university hospital and on ART for three semesters who met the selection criteria. Results: The prevalence of treatment failure varied from one semester to the next. Thus, the prevalence of therapeutic failure was 20% in the first semester, 10% in the second semester and 7% in the third semester. The prevalence of virological failure was 10.28% in the first half of the year, 6.91% in the second half and 4.98% in the third. Secondly, immunological failure was 0.48% in the first half of the year, 0.32% in the second 0.64% in the third half. Finally, clinical failure was 8.82% in the first half, 4.82% in the second half, 1.92% in the third half. Socio-demographic and clinical factors associated with treatment failure were male gender (p 1000 copies/ml (p Conclusion: The occurrence of treatment failures in children is a major problem, especially in our resource-limited countries, given the challenges facing antiretroviral therapy. It is therefore necessary to carry out a study on resistance genotyping in order to propose correct management protocols, as the future of treatment programs depends on it.

Contribution of CT in the Exploration of Non-Traumatic Pathologies of the Lumbar Spine in Adults in Bangui

Background: In Central African Republic, a study carried out in 2019 highlighted the limits of conventional radiography in the diagnosis of non-traumatic lower back pain in adults. Objective: The objective of this study is to show the value of CT scanning in the exploration of non-traumatic pathologies of the lumbar spine in adults. Patients and Method: Retrospective and descriptive cross-sectional study covering the files of patients aged at least 18 years old, sent for lumbar scanning from March 1 to December 31, 2021 at the medical imaging center. Results: In total, 593 scan examinations were performed including 159 (26.8%) examinations of the lumbar spine. The average age of the patients was 49.84 years. The majority were male (66%). 127 (79.8%) were referred mainly to the neurology and rheumatology departments. Common low back pain (n = 97, 61%) was the main reason for requesting a CT scan. The lumbar scan was performed without contrast product in 88.7% of cases. In total, 148 (93.1%) examinations were pathological and dominated by overall disc overhang (62.2%) and somatic and interapophyseal osteoarthritis (16.9%). The other lesions were spondylodiscitis (7.4%), tumor-like lesions (3.4%) and narrow lumbar canal (1.4%).

Antibiotic Resistance Profile of Serotypes of Streptococcus pneumoniae Strains in Bangui, from 2017 to 2022: Case of Serotype 1

Goals: The aim of this study was to determine the antibiotic resistance profile of serotypes of Streptococcus pneumoniae strains circulating in Bangui. Methodology: A prospective and analytical analysis was carried out at the National Laboratory of Clinical Biology and Public Health from 2017 to 2022. The strains came from our study on the contribution to the study of antibiotic sensitivity of Streptococcus pneumoniae strains. The multiplex PCR test was used for its cost-effectiveness in terms of amplifiers which can be purified in order to be sequenced. It also makes it possible to detect several germs as well as their serotypes. For a PCR reaction, several elements are involved in the reaction medium or Master Mix. These are the desoxyribonucleotides (dNTPs), the magnesium ions (MgCl2) and the primers. A set of 14 primers divided into 3 classes were used. Class 1 primers served as an internal control by targeting the cpsA gene. It is a highly conserved gene found in capsular loci characterized to date. The primers of the second class were used to target specific serotypes by specific reactions (out of six possibilities). The group reaction was carried out using the primers of the third class in order to carry out an initial screening of the samples and to classify the pneumococcal isolates. Related serotypes were grouped based on the amplification of common genes. Using the technique of electrophoresis on agarose gel and an ultraviolet radiation device, the migration bands are then visualized and analyzed. The data collected had been entered into Excel 2010 and analyzed with Epi info 7. The exact Fischer chi2 test at the 5% threshold, the relative risk and its 95% confidence interval were used to compare the proportions and determine the associations. Results: 187 antibiotic-resistant strains of Streptococcus pneumoniae were collected. The average frequency of serotypes 1, 9A, 4 and untypeable identified were 43.59%, 18.18%, 18.27% and 39.57% respectively. The frequency of serotype 1 was predominant for the age group over five years old with 56.88%. The male sex was predominant with 55.08% for serotype 1. Resistance to penicillin and gentamicin for serotype 1 during this study, for the age group under 5 years old, was 77%. For serotypes 19A and 4, tetracycline resistance was predominant with 20% for the age group under 5 years. The resistance to penicillin and gentamicin of non-typeable serotypes was 33% for the age group under 5 years old. For the age group over 5 years old, resistance to erythromycin predominated at 37%. The distribution of serotypes by sex depending on antibiotic resistance was variable. There was a statistically significant association between identified serotypes and antibiotic resistance (p Conclusion: The study determined serotypes 1, serotypes 19A, serotypes 4 and non-typeable serotypes. These results would be due to the quality of vaccination or poor protection of vaccines.

Incidence and Management of Occupational Blood Exposure (OBE) among Medical Students at the University of Bangui

Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.

Contribution of CT Scanning in the Investigation of Cranioencephalic Lesions in Bangui

Introduction: Cranioencephalic exploration has always played a major role in CT scans. In the Central Africa Republic (CAR), the lack of cross-sectional imaging before the year 2020 meant that no study had focused on cranioencephalic lesions. The aim of this study was to contribute to improving the management of cranioencephalic pathologies in CAR. Patients and Method: The study took place at the Bangui National Medical Imaging Centre (CNIMB). It was a retrospective study over a two-year period (March 1, 2021 to February 30, 2023). All patients referred for cranioencephalic CT scans were included, regardless of age or sex. Results: 1745 CT scans were performed, 575 of which were cranioencephalic CT scans. The majority of patients were male (53%). Most lived in the capital Bangui (90.9%). Patients aged 61 and over were the most representative. The distribution of patients by requesting department showed that the reception and emergency department was one of the least requesting departments. The main abnormalities observed were strokes, 82.1% of which were ischaemic strokes and 17.9% haemorrhagic strokes. Strokes were followed by degenerative lesions. Post-traumatic injuries included haemorrhagic contusions (38.3%), subdural haematomas in 20.5% of cases, and extradural haematomas (9.3%). Craniofacial lesions (fractures) were observed in 45.8% of cases. Conclusion: Cranioencephalic scans accounted for 1/3 of CT examinations performed during the study period. It revealed pathologies that could not be detected by conventional means. All in all, CT scans contributed to the diagnosis of cerebral pathologies.

Factors Associated with Mother-to-Child Transmission of HIV at the Maternity Unit of the Castors Urban Health Center in Bangui

Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1st, 2017 to December 31st, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi2 = 32.61;p < 0.001), late discovery of infection during large or after childbirth (OR = 0.03 [0.007 - 0.10];Khi2 = 55.22;p < 0.001), WHO Clinical Stage 2 and 3 (OR = 0.007 [0.001 - 0.03];Khi2 = 108.73;p < 0.001), CD4 count 200/mm3 (OR = 14.12 [4.03 - 57.20];Khi2 = 21.68;p < 0.001), viral load > 1000 copies/mm3 (OR = 8.85 [2.33 - 43.20];Khi2 = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi2 = 18.47;p < 0.001), premature rupture of membranes (OR = 24.03 [6.97 - 96.01];Khi2 = 40.60;p 2 = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi2 = 97.65;p Conclusion: Taking into account the risk factors for PCTP is essential if we want to achieve the goal of “Zero New Infections in Children by the year 2025”.

Contribution to the Study of Resistance to Anti-Tuberculosis Drugs in the Mycobacterium tuberculosis Complex Isolated at the National Laboratory of Clinical Biology and Public Health in Bangui in the Central African Republic in 2022: Case of Rifampicin

Microscopy-positive and drug-resistant pulmonary tuberculosis (MPT+) is one of the most feared diseases due to the cost of its management and the associated mortality. The GeneXpert, a new molecular test, is in greater demand for the diagnosis of MPT+ resistance cases. The application of GeneXpert to new cases of MPT+ is not effective in the country’s TB screening centres. The objective of this study is to assess the contribution of GeneXpert to the determination of MPT+ resistance cases in Bangui. The study was cross-sectional and covered the period from February to July 2022. The diagnosis of tuberculosis was first performed by microscopy with Ziehl Neelsen hot stain. The GeneXpert was then used to test for resistance in the sputum of all patients with positive microscopy. The collected data was entered into Excel 2013 and analysed with Epi Info 3.3.7. We analysed data from 755 patients, 80 of whom had resistance. The 80 patients ranged in age from 6 to 68 years (mean age = 35 years). The prevalence of resistant TB was 10.60% (80/755). Primary resistance accounted for 73.75% and secondary resistance for 26.25%. The age group 20 - 39 years (57.50%), male (72.50%), 8th district (17.50%), people living in couples (53.75%), farmers (13.75%) were the socio-demographic characteristics most affected by resistance. Treatment failure (13.75%), relapses (13.75%), the notion of contagion (28.75%), a history of smoking (40%) and alcohol (61.25%) were the clinical antecedents reported by the patients. Treatment failure and relapse were the variables associated with the occurrence of resistant PMT+ (p 0.05). A considerable proportion of the overall Mycobacterium tuberculosis resistance to anti-tuberculosis drugs (10.60%) was identified by GeneXpert. Treatment failure and relapse were the factors associated with the risk of resistance.

Survival of Antiretroviral Therapy Patients at the Outpatient Treatment Centre of the Community University Hospital of Bangui from 2015 to 2020

Background: The advent of antiretroviral treatment has considerably increased the life expectancy of people living with HIV in recent years. The Central African Republic, despite challenges related to the socio-political context, is committed to achieving the UNAIDS 90-90-90 targets and to the elimination of AIDS by 2030 advocated by the WHO. Objective: To analyze survival among HIV-positive adult patients on antiretroviral therapy from 2015 to 2020. Methods: This was a history-based cohort study of patients started on ART. The main variable was survival. The Kaplan-Meier method was used to describe the survival curve since inclusion in the cohort and a multivariate Cox model was used to investigate factors associated with mortality on ART. Results: A total of 145 naive patients started ART at the Outpatient Treatment Centre (OTC) in 2015. A female predominance was observed in our study with 78.08% of cases. The analysis of the patients’ fate at the time of point of treatment showed that 58.62% of them were still in active care and 13.10% died. The probability of survival at 5 years was 0.82 and mortality was significantly associated with very advanced disease (WHO stage IV) (p = 0.047) and anemia (p = 0.039). Conclusion: The majority of patients were still in care at the endpoint and mortality was significantly related to advanced disease and anemia. Early management of people living with HIV combined with better quality of care would improve their survival.

Management of Traumatic Foreign Bodies of the Upper Aerodigestive Tract in Children with Limited Diagnostic Resources at the Pediatric University Hospital of Central African Republic of Bangui

Accidental acute upper airway obstruction (UAO) is a common situation in pediatric emergencies. It is a source of morbidity and even mortality, particularly in children under 3 years of age. We report a clinical case of traumatic foreign body injury to the upper aerodigestive tract in a 7-year-old girl following a play accident.

Epidemiological, Clinical, Bacteriological and Evolutionary Profiles of Bacterial Meningitis in Children in Bangui (CAR)

Background: Bacterial meningitis is a major public health problem worldwide due to its severity. It is a vaccine-preventable disease. Methodology: It was a retrospective descriptive study conducted at the Pediatric Teaching Hospital of Bangui from June 2019 to May 2021. Children aged 1 month to 15 years hospitalized for bacterial meningitis were included in the study. Data were entered and analyzed using Stata/IC version 16.1. Results: Of 2490 patients hospitalized during the study period, 122 (4.9%) had bacterial meningitis. The patients were male in 54.92% of cases with a sex ratio of 1.21. The mean age was 35.95 months ± 49.16. Most of the patients (84.42%) came directly from home. The average consultation delay was 3.4 days ± 2.6. The vaccination coverage was 56.55%. The CSF study isolated germs from 24 patients (19.67%), the main ones being S. pneumoniae (75%) and H. influenzae (16.67%). Ceftriaxone was prescribed alone or in combination in all cases as first-line treatment. The average duration of antibiotic therapy was 8.95 days. The mortality rate was 27.87% and 12.30 % of patients had sequelae. Conclusion: Bacterial meningitis is common in Bangui and still poses a public health problem despite the introduction of new vaccines in the EPI. Improving vaccination coverage and raising awareness for early consultation could improve the situation.

High Prevalence of Hepatitis B Virus Infection Compared to Human Immunodeficiency Virus among Blood Donors in Bangui

Introduction: Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) infection is a public health problem worldwide, particularly in sub-Saharan Africa. Objective: to compare the epidemiological, clinical and biological characteristics of chronic HBV and HIV infection in blood donors at the National Center for Blood Transfusion (NCBT) in Bangui. Patients and Methods: This was an 8-month analytical cross-sectional study from August 10, 2011 to April 9, 2012. During this study, we consecutively enrolled consenting blood donors of both sexes in which the search for HBsAg and HIV infection was carried out. Results: During the study period, 850 blood donors were collected. HBsAg was found in 142 donors (16.7%), of whom 55 blood donors (6.5%) were coinfected with HIV. On the other hand, HIV serology was positive in 77 blood donors (9.1%) including 55 co-infected (6.5%) with HBV. In order to better compare the risk factors, we have not included HIV-HBV coinfected patients. Only 795 blood donors were selected for the risk factor study. There were 87 cases of HBsAg positive (10.9%) and 22 cases of HIV positive (2.8%). The average age of HIV and HBV infected patients was 25.7 and 26.2 years, respectively. Twelve blood donors (1.5%) over the age of 20 were HBsAg versus 3 HIV positive blood donors (0.4%). Among blood donors over the age of 20, 75 (9.9%) were HBsAg positive, while 19 (2.4%) were HIV positive. Men were infected with HIV in 20 cases (2.5%), while those infected with HBV were 84 (10.6%). The risk factor found during HIV infection and HBV was unprotected sex with a p of 0.0038 and 0.0017 respectively. Conclusion: The prevalence of HBV infection is higher than that of HIV among blood donors in Bangui. The setting up of a national viral hepatitis control program, which will develop screening, treatment and vaccination actions could make the curve bend.

The Epidemiological, Clinical, Biological and Morphological Characteristics of Primitive Liver Cancers in Bangui

Objective: To describe the epidemiological, clinical, biological and morphological aspects of primary liver cancer (PLC). Patients and Methods: We conducted a 38-month cross-sectional study in the Department of hepatogas-troenterology and Internal Medicine “Amitié Sino-Centrafraine” University Hospital Center in Bangui. Included in the study were all patients with a diagnosis of PLC. The PLC’s diagnostic arguments were the large tumor liver associated or not with the elevation of alpha-fetoprotein, the heteronodular liver hypervascularized on abdominal ultrasound. Data analysis was done using Epi Info 3.5.1 software. Results: We collected 115 cases of CPF among 2410 hospitalized patients (4.7%). There were 86 men and 29 women (sex ratio: 2.9). The average age was 50 years old. The main risk factors were alcohol consumption (72.2%) and chronic hepatitis B infection (67.4%). Frequent clinical signs were pain in the right hypochondrium and/or epigastric (93.86%), large tumor liver under examination (91.3%), weight loss (74.78%). The serum alpha-fetoprotein concentration was ≥ 400 ng/ml in 73% of the cases. The abdominal ultrasound found a heteronodular liver in all patients. The nodules were multiple hyperechoic in 66.1% of the cases. According to the Child-Pugh classification, the patients were classified as B (49.5%) and C (33.9%). The Okuda Classification ranked patients at stage 1 in 16.5% cases, stage 2 in 52.1% cases and stage 3 in 31.3% cases. According to the BCLC classification, 5.2% of patients were in stage A, 12.2% in stage B, 52.2 in stage C and 30.4% in stage D. Death was recorded during hospitalization in 89 cases (77.4%). Conclusion: CPF is a frequent and serious pathology in Bangui. Its diagnosis is often late, preventing curative treatment. The main causes are alcohol consumption and the hepatitis B virus. The population should be educated to reduce the incidence of this disease.

Morbidity, Mortality and the Impact of Climate on the Evolution of Acute Rotavirus Diarrhea in Children under 5 Years Old in Bangui

Background: Rotavirus is the most common pathogen of severe acute diarrhea in children under five years of age worldwide. Objective: The objective of this study was to determine the morbidity and mortality of rotavirus diarrhea while describing the seasonal kinetics of the infection according to climatic parameters in Bangui. Methodology: This was a descriptive and analytical cross-sectional study conducted from January 1, 2011 to December 31, 2020 in the Central African Republic (CHUPB). The health data were recorded and processed with the Access 2019 software, then analyzed with the STATA version 14 software. The climatic trends in the study area and its seasonal variations were highlighted by the monthly rainfall coefficient of Alfred Angot: Cm = 12 Pm/P. Results: Morbidity was 45.99% of cases. The 1 to 12 months old represented 93.81% of cases. The mean age of the children was 6.8 months, the sex ratio was 1.20. The symptomatic triad was diarrhea (100%), vomiting (90.20%) and fever (87.5%). Moderate dehydration was reported in 81.05% of cases. The main genotype combinations found were P[8]G1 in 34.02% (n = 115/338), P[6]G1 in 21.59% (n = 73/338) and P[6]G2 in 16.86% (n = 57/338). Case fatality was 11.45%. The risk of death was influenced by rural origin, severe dehydration, hypovolemic cloc and duration of hospitalization > 5 days. Low rainfall correlated with the highest rates of rotavirus diarrhea. Likewise, high temperature correlated with the highest number of cases of rotavirus diarrhea. Conclusion: Acute rotavirus diarrhea is an important morbidity and mortality issue in children under 5 years old in Bangui.

Influence of Climate Variability on the Dynamics of Malaria Transmission among Children in Bangui, Health Challenges in Central African Republic

Background: Malaria was the deadliest worldwide vector-borne disease in 2017. The objective of this study was to determine the eco-epidemiology of malaria at the reduced scale of a Health Region in children less than 5 years old. Objectives: To assess the relationship between climate and malaria epidemiology in children less than 5 years old in Bangui. Methodology: Health data were collected from the Health Region Nº7 database. Climatic data were collected from the database of the Bangui M’poko station and the Bangui national meteorological delegation. Demographic data were collected from the United Nations Population Fund and the Central African Institute of Statistics, Economic and Social Studies. Ethical clearance was obtained from the local ethics committee, which allowed us to access the data from each institution. The independent variables were collected in the districts. Several statistical methods were used to analyze confidentially the data. Results: During the survey, for 1160 mm of water in 2004, 317 children died versus 56 for 1516 mm of water in 2013, i.e., a correlation coefficient between rainfall and malaria is 0.51. There was a statistically significant association between rainfall and malaria in Bangui as well as a correlation between malaria-related death and the level of humidity, i.e., for 51.99ºC, the number of death increased from 294 cases in 2004 to 216 cases for 49.74ºC in 2013 with a correlation coefficient between humidity and malaria morbidity of 0.46 and the coefficient of determination r2 of 21.31%. Malaria was influenced by humidity. Malaria transmission was higher during the rainy season (May to October) with an incidence of 61.11% (n = 44,193) versus 38.89% (n = 28,125) for the dry season (November to April). The 8th borough of Bangui with a very high level of vulnerability recorded the highest incidence of malaria (64,748 cases). Finally, the first borough with 11,502 cases of malaria had a very low level of vulnerability. Conclusion: Climatic trends have a negative impact on the outcome of malaria in Bangui. The consequences are the number of deaths of children under 5 years old.

Therapeutic Route of Patients with Cirrhosis in Bangui

Introduction: Cirrhosis is the final stage in the development of any chronic liver disease. The objective of our study was to determine the therapeutic route of patients with cirrhosis. Patients and Methods: This was a one-year cross-sectional study of consenting patients of both sexes with cirrhosis who were hospitalized for the first time. The study took place from October 1, 2013 to September 30, 2014. The diagnosis of cirrhosis was based on clinical, biological and morphological arguments. Results: In total, 1028 patients were hospitalized, including 202 for cirrhosis (19.6%). One hundred and four patients (10.1%) met our inclusion criteria. These were 70 men (67.3%) and 34 women (32.7%). The sex ratio was 2.05. The average age was 43.74 ± 13.74 years. In 68 cases (65.4%), cirrhosis was considered a supernatural disease and in 36 cases (34.6%) was a natural disease. At the first signs, 88 patients (84.6%) had consulted (traditional healer in 34 cases, pastor in 25 cases, marabout in 16 cases and general practitioner in 13 cases). The pastor prayed to 25 patients (24%). The traditional healer made the patients ingest herbal preparations (n = 18), associated or not with scarification (n = 4) and/or enema (n = 28). The marabout recited Quranic verses written on a board, then washed and ingested in 16 cases (15.4%). The general practitioner prescribed treatment to the 13 patients (12.5%). The various treatments received had led to hepatic encephalopathy (21 cases), digestive hemorrhage (15 cases), abdominal pain (3 cases), jaundice (3 cases), increased abdominal bloating (21 cases). The patients had consulted the specialist within an average of 74 ± 15.3 days. The average time to hospital was 21 days ± 13. Conclusion: Cirrhosis is diagnosed at the complication stage due to inappropriate treatment by pastors, marabouts and the general practitioner. The population must be made aware of the early use of health care facilities.

Neonatal Tetanus at Pediatric Teaching Hospital in Bangui

Background: Despite the Maternal and Neonatal Tetanus (MNT) elimination initiative, neonatal tetanus still persists in some parts of the world. Objectives: To determine hospital prevalence and describe epidemiological, clinical, therapeutic and outcome aspects of neonatal tetanus at the Pediatric Teaching Hospital in Bangui. Methodology: It was the review of hospitalized newborns’ files in the neonatal unit at Pediatric Teaching Hospital in Bangui between January 2016 and December 2019. Newborns discharged with tetanus diagnosis, and whose files were usable were included. The variables studied were: for the newborn: age, sex, birth weight, the reason for transfer, diagnosis, cause and time of death, place and method of delivery;for the mother: age, antenatal care, tetanus vaccine status, parity and geographical provenance. Epi Info 7 software, version 7.1.3.3 was used for data analysis. The chi2 test with the significance level set at p < 0.05 and the odds ratio were used. Résultats: Forty-eight (48) out of 5796 newborns had neonatal tetanus (0.8%). They were newborns to mothers with an average age of 18.8 years of which 68.8% (n = 33) were primipara and 87.5% (n = 42) not vaccinated against tetanus. Childbirth happened at home in 91.7% (n = 44), and the blade was used for sectioning the umbilical cord in 39.6% (n = 19). Newborns were referred from rural area in 47.9% (n = 23). A single antenatal care contact was done in 68.7% (n = 33). Tetanus was classified as severe according to the Dakar prognosis score between 4 and 6 in 89.6% of cases (n = 43). The death occurred in 58.3% (n = 28). Conclusion: The high frequency of neonatal tetanus as well as its severity requires pregnancy follow-up strengthening and childbirth monitoring in order to its elimination. But primary prevention relies on improving individual and general hygiene conditions.

Prevalence of HBsAg and Antibodies to Hepatitis C Virus among Female Sex Workers in Bangui

Introduction: Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) infection is a public health problem. Sex workers remain a vulnerable group. Objective: To determine the prevalence of HBsAg and hepatitis C virus (HCV) antibody transport among female sex workers (FSW) in Bangui. Patients and Methods: All FSW carriers of HBsAg and/or anti-HCV Antibodies were collected in a 6-month cross-sectional analytical study. The HBsAg research used the Monolisa HBsAg® (BioMérieux®) technique, sandwich ELISA. HCV serology consisted of the search for anti HCV antibodies by monolisa HCV (BioMérieux®), Elisa of the sandwich type. HIV serology used two Elisa tests (Genscreen® and Vironostika®). Data analysis was done using Epi Info 3.5.1 software. The Chi2 test was used for comparison with a significance level p < 0.05. Results: Among the 345 FSW enrolled, 41 (11.9%) were carriers of HBsAg and 3 (0.8%) had anti HCV antibodies. The mean age was 21.3 years in HBsAg-positive FSW and 25 years in FSW with anti-HCV antibodies. FSW with HBsAg engaged in informal trade (n = 17), prostitution in bars or on the street (n = 15) and prostitution in the city (n = 9). On the other hand, the 3 FSW carrying anti-HCV antibodies were engaged in prostitution in the city. The 41 FSW HBsAg positive and 304 FSW HBsAg negative had at least 3 sexual partners. Anal penetration during sexual intercourse was acknowledged by 20 FSW carrying HBsAg and 101 FSW HBsAg negative (p = 0.0518). Among the 3 FSW (0.8%) carrying anti-HCV antibodies, 2 were carrying HBsAg. HIV serology was positive in 66FSW (19.13%) including 15 FSW coinfected with HIV/HBV (p = 0.0025). Conclusion: The prevalence of hepatitis B is high among FSW. Awareness and prevention action must be taken in favor of this key population.

Epidemiological Aspects of Stroke in Young People at the Friendship University Hospital Center in Bangui in the Central African Republic

Introduction: Stroke is a major public health problem even more dramatic in young people. Goal of the study: To make our contribution to the knowledge of strokes of the young subject. Methodology: It was a retrospective study conducted over a period of 02 years (January 2017 to December 2018) including the files of patients aged 18 to 49 years hospitalized for any suspected case of stroke in the Department of Neurology of C between Hospitalier A Sino-Central African Friendship University (CHUSCA) from Bangui. Results: During the study, 225 cases of stroke were recorded, including 26 cases in young subjects, representing a hospital frequency of 11.5%. The average age was 42.5 years with extremes ranging from 24 to 49 years. The most represented age group was 45 and 49 with a sex ratio (M/F) of 1.36. The average age for men was 41.93 years compared to 39.27 years for women. Civil servants were in the majority in 50% of the cases. Alcohol was the main FDR (80.8%) followed by hypertension (61.5%) and tobacco (50%). The majority of patients (57.70%) were admitted to neurology after the first 24 hours. Ischemic stroke represented 73.08% compared to 26.92% of AVCH. The lethality was 20.08%. The sequelae were found in 69.20% of cases. Cardiac exploration had found 57.10% of LVH. Conclusion: This study confirms a high frequency of stroke in the young subject. The predominance of modifiable FRCVs requires the implementation of a specific strategy based on awareness, early detection and effective and adequate PEC.

Biological Profile of HIV-Positive Patients in Bangui, Central African Republic, in 2017

Background: The biological profile of HIV-positive patients is essential for diagnosing treatment failure and the prognosis of infection. We determined the virological and immunological profiles and biological anomalies of HIV-positive people on antiretroviral therapy (ART) in Bangui, Central Afri-can Republic. Methods: We conducted an analytical, descriptive study be-tween 4 April and 30 September 2017 of all patients who had received ART for more than 12 months and who attended the Medical Analysis Laboratory of the Institut Pasteur in Bangui for a complete biological work-up, including viral load. A blood sample was taken for quantification of RNA HIV-1, CD4 lymphocytes and blood count in two tubes containing ethylenediamine te-traacetic acid, and another sample was taken in a dry tube for measurement of creatinine and transaminases. Results: The total population comprised 1748 patients, with a mean age of 38.7 years (±14.3;median, 41 years;range, 2 - 79 years);33.3% of patients were between 40 and 49 years old. Females predo-minated (71.3%), for a sex ratio of 0.4. Immunological failure was observed in 20.2% of patients (CD4 Conclusion: The abnormalities observed in this study concerned the haematopoietic system, the liver and the kidneys. As other or-gans and systems may be affected, periodic multidisciplinary biological and clinical follow-up is necessary for people living with HIV in order to improve their management.