Contribution to the Study of the Incidence of Post-Streptococcal Complications in Republic Central African Republic from 2015 to 2018

Introduction: Acute rheumatic fever (AAR) is a non-suppurative complication of late infection by group A. Infections due to streptococci remain a public health problem in the Central African Republic. The present study aims to determine the incidence rate of AAR cases and its complications. Methodology: This was a retrospective and analytical study over a period of 4 years (from January 2015 to December 2018) at the National Laboratory of Clinical Biology and Public Health (LNBCSP) in Bangui. It focused on samples concerning the diagnosis of AAR and patient files seen in consultation in the capital’s reference health establishments. Laboratory registers and patient consultation files were used to collect data. They were entered into Excel 2010 to be analyzed with Epi Info 7. A univariate analysis by logistic regression, Ficher’s exact test, and chi2 at the 5% threshold (p Results: We analyzed 94 cases meeting Jones’s criteria. The ages of the patients ranged from 18 to 85 years (mean age 52 years and mode 45 years). The incidence rate of AAR for the female sex was higher than that of the male sex during the study period (p > 0.05). It went from 166.6 in 2015 to 200 in 2016 and 2018 cases of AAR per 1000 people per year. The average incidence rate was 296.18 cases of AAR per 1000 people per year. The average incidence rate was 223.5 cases of AAR per 1000 people per year for joint damage. Joint damage represented 80.85% (RR = 0.62;Chi2 = 4.88;95% CI [0.39-0.97];p Conclusion: The study allowed data on the impact rate and complications of the AAR in Bangui. Special attention to data management will help produce a complete result on the problem. Joint complications predominated. Sustaining an effective surveillance system and preventing infection would help reduce the risk of AAR occurrence.

Contribution of Automated Antigen Tests, the LumiraDx Ag Test in the Response during the Second Wave of the COVID-19 Pandemic in Bangui

Context and objective: The COVID-19 pandemic has become a major public health problem and has mobilized many innovative means of diagnosis. The Central African Republic is not spared. The emergence of variants and their impact require health monitoring despite the obligation of vaccination. The purpose of this campaign was to determine the circulation of pending second-wave variants. Patients and Methods: A second mass screening campaign took place from 02 to 22 July 2021 in the main land and river entry points of Bangui (Exit North-PK12, Exit South-PK9, Port Beach) and at the LNBCSP. Antigenic and RT-PCR tests carried out on nasopharyngeal samples made it possible to select strains which were finally sequenced. Results: Of 2687 participants included in the study, 53 (1.97%) were positive for SARS-CoV-2. Thirteen (1.53%) were male and 40 (2.18%) female. The analyses carried out on the LumiraDx analyzer were positive for 109 samples against 53 on the RT-PCR. The prevalence was higher in the most tested age groups (30 to 50 years) with two clusters identified. B.1.617.2 (Delta) variants were predominant (57%). Conclusion: SARS-CoV-2 continues to circulate. The acquisition of automated antigenic tests (LumiraDx&#174) with sensitivity and specificity close to those of the reference test (RT-PCR) will allow better mass diagnosis for an optimization of the surveillance of COVID-19 in our countries with limited resources. The predominance of the B.1.617.2 (Delta) variant would suggest a third wave in the Central African Republic.

Mass Screening Using Antigenic and Molecular Diagnostic Tests of COVID-19 in Bangui at the Beginning of the Second Wave in July 2021

Objective: COVID-19 surveillance was established as early as March 2020 in the Central African Republic (CAR), after the WHO statement relating to the identification of several cases outside China. However, given the non-performing molecular biology technical platform in many developing countries in sub-Saharan Africa, the second wave promised to be surprising and formidable. In this context, a mass survey was launched in Bangui to determine the prevalence of COVID-19. Patients and Methods: From March 18 to April 2, 2021, a mass screening campaign took place in tourist places, companies and the main hospital infrastructures. Nasopharyngeal swab samples were collected from participants with and without symptoms of Influenza-like illness (ILI) and stored in VTM tubes. The Ag (COVID-19) and RT-PCR tests were carried out in Bangui at the LNBCSP. The sequencing of RT-PCR SARS-CoV-2 positives was carried out at the INRB. Results: We included 1480 participants of whom 33 (2.23%) were SARS-COV-2 positive, of whom 24 were male and 9 female. This sex difference was statistically significant (p = 0.012) as the sex ratio M/F was 1.09. Sampling sites located in the 1st arrondissement were the most prolific (p = 0.006) and were sequenced. In addition to the analysis of the 33 samples from the predefined sites under study, 17 control sequences from the provinces generated during the same period are added. We detected 2 Variants Of Concern (VOC) including the predominant B.1.620 (43.86%) followed by B.1.1.7 or Alpha (5.10%). Conclusion: The study showed the importance of surveillance and the availability of means of diagnosis of COVID-19. The identified risk factors were sex and sampling site. This study has shown the importance of setting up sentinel sites for COVID-19 surveillance in all regions of the country and the appropriate use of the anti-COVID-19 vaccine.

Contribution to the Study of Antibiotic Sensitivity of Streptococcus pneumoniae Strains in Spinal Cerebral Fluids in Bangui from 2017 to 2022

A prospective and analytical study was carried out from January 2017 to Decem-ber 2022, at the National Laboratory of Clinical Biology and Public Health (LNBCSP) in Bangui. 352 samples of cerebrospinal fluid (CSF) were confirmed out of 2065, coming from the four hospitals in Bangui. This study aimed to evalu-ate the evolution of antibiotic sensitivity to strains of Streptococcus pneumoniae. CSF had been collected from patients who presented with meningeal syndromes. Based on the leukocyte count (White blood cells ≥ 5 mm3), an aliquot was trans-ferred to trans-isolate medium and sent to the LNBCSP for confirmatory testing, culture and determination of antibiotic sensitivity. The antibiotic sensitivity of Streptococcus pneumoniae strains was tested according to the methods recom-mended by the Antibiogram Committee of the French Society of Microbiology. The data collected was entered into Excel 2010 to be analyzed with Epi Info 7.2. Ficher’s exact test, chi2 at the 5% threshold (p < 0.05) was used to compare pro-portions and analyze associations between variables. The average sensitivity rate to β-lactams was 74.43%. The sensitivity rate of Fluoroquinolones was 54.54%. That of levofloxacin was 87%. The average rate of sensitivity to β-lactams for the age group under 5 years old was 79.25%. That of fluoroquinolones was 52.59%. Levofloxacin had 90.37%. The average sensitivity rate to β-lactams for the age group over 5 years old was 76.03%. Fluoroquinolones had 45.16%. Levofloxacin had 69.58%. The average sensitivity rate to β-lactams for males was 76.68%. Fluoroquinolones had 54.26%. That of levofloxacin was 83.40%. The sensitivity rate to β-lactams for females was 74.41%. That of fluoroquinolones was 51.16%. Levofloxacin had 67.44%. Cyclins had 28.68%. The study noted an association between age and sensitivity (p < 0.05;CI [1.05-2.57]). Strains of Streptococcus pneumoniae were always detected in the CSF. The average rate of sensitivity to macrolides was 36.93%;aminoglycosides 28.69%;phenicols 63.35%;sulfona-mides 39.2%. These results could suggest a reduced sensitivity to β lactams. .