Antibiotic Resistance Profile of Salmonella Strains Isolated at the National Clinical Biology and Public Health Laboratory in Bangui, Central African Republic

In Africa, each year, there are estimated to be more than 91 million cases of salmonellosis and 137,000 cases of death. The problem of antibiotic resistance in Salmonella strains is a threat to public health. The objective of this study is to evaluate the antibiotic resistance profile of Salmonella strains isolated in biological products analyzed at the National Laboratory of Clinical Biology and Public Health (NLCBPH) in Bangui. This is, therefore, a cross-sectional study with a descriptive aim, running from January to December 2022. It focused on the strains of Salmonella isolated and identified in stools, urines, and blood samples. For each strain of Salmonella isolated, an antibiogram was carried out following the recommendations of the French Society of Microbiology (CASFM, 2022). A total of 93 strains of Salmonella have been recorded. The age group 0 - 9 years was 29% and that of >50 years was 11%. The median age of patients was 30 years with a minimum of 1 and a maximum of 78 years. The female gender was more represented at 52.69% than the male gender at 47.31%, i.e. a sex ratio of 0.89 (M/F). Salmonella strains were much more isolated in stools at 62% followed by urines at 29% and blood at 6%. Salmonella arizonae strains were more represented with 52%. Salmonella strains have a resistance rate to Tetracycline of 62.37% followed by Penicillins of 50%. The rate of multi-antibiotic resistance of the Salmonella strains isolated represented 48.38%. Salmonella spp. strains were multi-resistant at 58.69% followed by Salmonella arizonae strains at 47.91%. There is a significant association between the different families of antibiotics and Salmonella strains (p < 0.05). According to the results obtained, Penicillins, Phenicoles, and Cyclins had a high rate of resistance on Salmonella strains. No strain-producing Broad Spectrum Beta-lactamase has been isolated. Salmonella strains represent a zoonotic health danger, constitute a public health problem and remain a current subject. This germ is resistant to the antibiotics used. It is, therefore, essential to emphasize monitoring the resistance of these germs in the Central African Republic (CAR) to improve the health of the population.

Contribution to the Study of Fungal Strains Contaminating Peanut Pastes in Bangui (Central African Republic)

Introduction: Peanut pastes are food products resulting from artisanal or industrial processing, used in cooking in Africa in general and in Central African Republic in particular. These peanut pastes are often contaminated by molds and filamentous fungi involved in the degradation of hygienic and organoleptic or even toxicological quality. This study aims to determine the epidemiological profile of molds contaminating peanut pastes sold on the Central African market. Methodology: This was a cross-sectional study carried out from June to September 2023. Samples of peanut pastes sold on Central African market were taken and analyzed at the National Laboratory of Clinical Biology and Public Health using the conventional microbiology method according to ISO 7954 standards. The data obtained were collected in the ODK 2023.3.1 application and analyzed with the Epi Info 7 software. A multivariate analysis by logistic regression, Ficher’s exact test, and chi2 at the 5% threshold (p Penicillium sp.;11.25% of Mucor sp.;10.63% of Aspergillus terrei;3.13% of Aspergillus niger;1.25% of Aspergillus medullans;28.13% of Aspergillus flavus;2.50% of Aspergillus fumigatus. Peanut pastes stored beyond three days were more contaminated (94.19%). Conclusion: The results of this study made it possible to highlight strains of mold that impact the hygienic and organoleptic quality of peanut pastes sold at the Central African market. Most of the isolated strains were the Aspergillus flavus species which is recognized by its toxigenic effects. This species is much more incriminated in the contamination of foodstuffs with the production of the toxin which causes underlying pulmonary pathologies in humans.

Contribution of Genomic Surveillance in the Detection and Monitoring of SARS-CoV-2 Variants during the 6 Pandemic Waves in the Central African Republic from 2020 to 2023

Objective: The COVID-19 pandemic has highlighted the need to strengthen diagnosis and genomic surveillance capacities. In 2021, Central African managed five waves of COVID-19 by integrating genomic surveillance into their health monitoring system. This study sought to report surveillance data from the National Laboratory of Clinical Biology and Public Health and describe the circulation of SARS-CoV-2 variants. Materials and Methods: This retrospective, descriptive observational study spans three years, from April 2020 to November 2023. It was conducted on a population of consenting volunteers from across the Central African Republic, who were tested using RT-PCR on nasopharyngeal samples. Data with sufficient information were obtained from the National Laboratory of Clinical Biology and Public Health (LNBCSP) databases. Sequencing was largely carried out at the National Institute of Biomedical Research (INRB) in Kinshasa until May 2023, and subsequently at the LNBCSP. Results and Discussion: Out of 97,864 RT-PCR tests performed, 9,764 were positive, resulting in a prevalence of 9.98%. The average age of the patients was 39.97 years ± 13.76, and the male-to-female sex ratio was 2.12. RT-PCR test positivity was significantly associated with age (p = 0.001), sex (p = 0.013) and clinical manifestations. Ten variants circulated during the five recorded waves, with Omicron (B.1.1.529), Delta (B.1.617.2) variants being predominant. Notably, the B.1.620 and B.640 variants were prominent during the second wave. Conclusion: This retrospective study provides key insights into the COVID-19 pandemic in the CAR. It identifies risk factors and details the circulation of various SARS-CoV-2 variants. Enhancing national genomic surveillance capacities would enable the country to better respond to future pandemic challenges.

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.

Prevalence of Gender-Based Violence among Sex Workers in Bangui, Central African Republic (CAR)

Background: Violence against women has become an international public health and human rights issue in recent decades. The violence suffered by sex workers is of little interest for research, yet it constitutes a major health and safety problem. We propose to assess the extent of the phenomenon of gender-based violence (GBV) among sex workers (SWs) in the city of Bangui in the CAR. Methodology: This is a descriptive cross-sectional epidemiological study covering the period from July to October 2021 carried out among SWs in Bangui, the capital of the CAR. Given that the SWs association had only 159 members in Bangui, an exhaustive sampling was retained. Were included in the study, any SW present during the data collection period and having given their written consent. The parameters studied were socio-demographic characteristics: age, sex, residence, level of education, marital status, and characteristics linked to violence: the notion of violence during their professional activity, the type of violence, the declaration and the declaration if necessary, the response and management of this violence. The data collected was analyzed using Epi info version 7 software. Results: Of the 159 SWs that counted the association, 108 had been included. The average age was 27.0 years with extremes of 14 and 46 years. The age groups of 25 to 34 years were the most represented (43.5%). Fifty-six SWs (51.9%) had reached the secondary level. Unemployed SWs were in the majority at 74.1%;Sixty-six (66) SWs in our sample (61.1%) had already been victims of violence during the exercise of their activity Sexual violence was the most represented (28.5%) followed by verbal violence (22.4%). Sixty-eight (62.9%) wanted to stop the professional activity of SWs and 93.1% would accept another income-generating activity in place of sex work. Conclusion: It is necessary to supervise SWs and protect them within the framework of respect for human rights, rather than criminalizing them and the exploiters flouting their human dignity and putting their lives in danger. .

Geochemistry and zircon U–Pb ages of the Paleoproterozoic ultramafic rocks of the Mbi Valley, Boali area, Central African Republic

This paper investigates the geochemistry of bulk rock and infers the petrogenesis of ultramafic rocks in the Boali Precambrian terrane in Mbi Valley,in the North of the Central African Republic(CAR).The studied rocks comprise coarse primary olivine and orthopyroxene relics(dominant phase),magnesio-hornblende,magnetite,and antigorite.Whole-rock analysis indicates low SiO_(2)(average of 43.14 wt%)and high MgO(19.84–26.98 wt%)contents and their Mg number(Mg#)ranges from 74 to 82.TheydisplayhighNi(526–865 ppm),Cr(1500–3680 ppm)contents.AFM(Na_(2)O-K_(2)O)-FeO-MgO)and ACM(Al_(2)O_(3)-CaO-MgO)ternary diagrams have revealed that the studied samples correspond to arc-related ultramafic cumulates.Chondrite-normalized REE plots display an increasing trend from La to Sm(CeN/SmN:0.74–1.81),weak negative to no Eu(Eu/Eu*=0.72–1.05)and strong negative Ce(Ce/Ce*=0.33–0.98)anomalies.Primitive mantle normalized of multi-element diagrams exhibit LREE enrichment and large ion lithophile elements(LILE)relative to high field strength elements(HFSE),and notable negative anomalies in Nb.This suggests the generation of the parent melt by slab dehydration and wedge melting processes.In addition,incompatible trace element composition and ratios assumed that the source magma had an enhanced mantle source associated with a prominent influence of continental crust.Metasomatism of mantle wedge by plate-dehydrated,LILE-rich fluids and the incorporation of sediments derived from subduction explain the enhancement of the source.Integrated major and trace element compositions jointly with the tectonic reconstruction of this region and LA-ICP-MS U–Pb data on zircon constrain the emplacement age at ca.2099 Ma in a continental margin arc setting involving subduction of an oceanic plate beneath the continental lithosphere,dehydration of the slab and mantle wedge melting.This result intimate that the remnants of Paleoproterozoic oceanic crust or subduction event and subsequent basins closure extended from the Congo craton in Cameroon to CAR and NE Brazil.

High Prevalence of Musculoskeletal Disorders and Self-Medication among Street Vendors in Bangui, Central African Republic (CAR)

Introduction: Musculoskeletal disorders (MSDs) are a set of peri-articular conditions that result mainly in pain and functional discomfort. They represent a major occupational health problem in all areas of activity. The objective of this work was to determine the prevalence of MSDs among street vendors in the city of Bangui in the Central African Republic (CAR). Methods: A cross-sectional study was conducted from September 01 to October 31, 2021 in Bangui, the capital of CAR. The study population consisted of street vendors which were included at the entrance of 4 large markets of Bangui after giving informed consent. The sample size, calculated according to the Schwartz formula, was 384. Sociodemographic data (age, gender, level of education, marital status), professional data (the duration of sale in hours, the distance traveled per day);and health data (the health problems suffered by itinerant sellers and the means of dealing with them) were collected using a pre-established self-questionnaire. This collected data was processed using Microsoft Excel 2013 and Epi-Info version 7 software. Results: Among 384 street vendors included, women represented a quarter (24.9%). The average age was 27 years;the 25-34 age group was the most represented (50%). About two-thirds (64.8%) sold for at least 12 hours and traveled more than 10 km (69.3%) per day. The main health problems reported by street vendors were musculoskeletal disorders (95.8%). Their locations concerned the upper limbs shoulder 65.36% (251), elbow 24.22% (93). Non-ergonomic postures that stress the back and joints all day long, causing pain are risk factors for MSDs. These MSDs were treated by self-medication with non-steroidal anti-inflammatory drugs (22.0%), mainly sold on the street. Conclusion: MSDs dominated the health problems of street vendors. These problems raise the need for recognition and support for these workers to optimize their performance while preserving their health through awareness and good management of MSDs whose chronicity generates a disability.

Humoral Response to Toxoplasma gondii in Pregnant Women in Bangui Central African Republic

Toxoplasmosis is a cosmopolitan antrhropozoonosis widespread in mammals and birds. Normally asymptomatic in the subject health, it can have serious consequences for the fetus in the first trimester of pregnancy in the pregnant woman. It is in this context that we propose to assess the immune response to T. gondii in pregnant women in Bangui. This was a retrospective analytical study that consulted the records of pregnant women received in prenatal consultations at the Bangui Community Hospital Maternity ward from January 2019 to December 2019. Socio-demographic and laboratory data (IgM, IgG response to T. gondii) and results of HIV serology were collected from January to June 2021. Chi2 test was used. A total of 307 pregnant women were analyzed. The average age of the women included was 28 (±6) years. The average parity of the entire sample was 2.18 (±1.93). Toxoplasmosis infectious was 14.65%. Women with a positive IgM response accounted for 17.58% and those with an IgG-positive response for 42.99%. Patients with a positive HIV were 5.86%. Patients aged 20 - 29 had a serological profile suggesting a probable ongoing infection (p = 0.010). The paucipares were more represented with no statistically significant difference (p = 0.23). Pregnant women were not significantly exposed to toxoplasmosis infectious (p = 0.96). Immunized and non-immunized subjects were similarly exposed [OR = 0.97;CI 95% 0.4 = 6 - 2.05]. Toxoplasmosis remains particularly serious during pregnancy. Seroprevalence was significantly higher in the 20 - 24 year age group. Women were similarly exposed depending on whether they were immunized or not. This requires the establishment of a specific prevention program against this disease.

Significant Improvement in Tuberculosis Diagnosis by Detection of the Wall Lipoarabinomannan from Mycobacterium tuberculosis in Central African Republic (CAR)

Background and Objective: Tuberculosis is one of the leading causes of morbi-mortality, especially in developing countries, due to delayed diagnosis and management. The goal of this study is to assess the contribution of lipoarabinomannan (LAM) in improving tuberculosis (TB) diagnosis in the Central African Republic (C.A.R.). Methods: We conducted a retrospective study at the Regional University Hospital of Bria. The records of patients hospitalized, tested by Determine® TB LAM Ag (Alere, Medical Co, LTD, Chiba, Japan) immunochromatographic test for the detection of LAM in urine, associated or not with acid-fast bacilli (AFB) research by Ziehl-Neelsen stain, were selected from August to October 2020. Results: During this study, 152 files were selected. Among them, there were 50.0% of children aged 14 or less (≤14 years: 33.6% + 16.4%) and 50.0% of adults represented. Patients living in the displaced person camp represented a larger group (65.1%) than those in the other 2 sites. There were seventy-four patients (i.e. 48.7%) who did not benefit from screening for AFB. For the other seventy-eight (i.e. 51.3%), there were 17.1% positive results for the search of AFB. However, among the 152 patients, there was a positive HIV serology in 30.9% of cases (i.e. 47 out of 152) and a positive Determine® TB LAM Ag in 38.2% of cases (i.e. 58 out of 152). It appears that Determine® TB LAM Ag was significantly more able to diagnose tuberculosis than AFB (p 0.003). The 58 patients diagnosed with TB LAM included 20 children who could not provide sputum and HIV-infected patients (p 0.03). Conclusion: The results of this study showed that the microscopy for AFB made it possible to make the diagnosis of tuberculosis in 17.1% of patients against 38.2% for the Alere Determine® TB LAM Ag test. This result highlights the need for routine use of LAM detection to improve the diagnosis of tuberculosis. The conduct of a subsequent study combining Xpert MTB/RIF would improve the diagnosis of tuberculosis using all 3 tests.

Epidemiological, Clinical and Anatomopathological Aspects of Cancers in Central African Republic Children

Objectives: To determine the epidemiological, clinical and anatomopathological aspects of childhood cancer in CAR. Patients and Methods: This was a retrospective study carried out from May 2015 to May 2018, at the Center Hospitalier Universitaire Pédiatrique de Bangui (CHUPB). The study population consisted of patients aged under 15 followed in the UHOPB for malignant tumors on clinical, radiological or ultrasound suspicion of malignancy and confirmed or not by histology or biology. A questionnaire was used to collect the data which was analyzed using SPSS11.0 software. Results: During the study period, we collected 107 cases of childhood cancer. The annual hospital incidence was 1.27% in 2016;1.93% in 2017 and 1.50% in 2018 The average monthly frequency of patients followed is 35.66. The intensity of pain assessed in the 99 patients ranged from 02/10 to 09/10 with an average of 5.41/10. The mean duration of the disease was 3.3 months with extremes at 1.2 months and 36 months. A predominance of comorbidity with HIV is 41.66%. Histologically diagnosed malignant tumors are dominated by 30.4% Burkitt’s lymphoma. Conclusion: Data on cancer incidence are scarce in developing countries and for the most part are hospital statistics. In CAR, it will be important to set up a national register for collecting information.

Abdominal Pregnancy: About a Case Observed at the Maternity of the Community University Hospital Center, Bangui, Central African Republic

Abdominal pregnancy is a life threat to both mother and fetus requiring surgery regardless of the age of pregnancy. We report a case of abdominal pregnancy, delivered by laparotomy with a live newborn. This is a 31-year-old woman with 34 weeks and 2 days of amenorrhea whose ultrasound showed an abdominal pregnancy. Laparotomy extracted a newborn female weighing 3000 grams with APGAR at birth rated at 7/10 at one minute. The postoperatives were simple. The patient was discharged on the 14th postoperative day on 20 mg methrotrexate injection once a week for four weeks.

IgG Anti-Body Titers among Patients with Amoebic Liver Abscess in Bangui, Central African Republic

Entamoeba histolytica (Eh) is a protozoan parasite that causes amoebiasis characterized by intestinal damage and amoebic liver development and is an important cause of hospitalization in low-middle income countries. The aims of this study were to determine the prevalence and the titer of IgG anti Eh in ALA (Amoebic Liver Abscess) patients’ in Bangui according sex, age and other risk factors. This was a cross sectional study where data was collected between January 2018 and October 2020. The diagnosis of ALA was suspected based on clinical symptoms of;fever, abdominal pain (usually in the right hypochondrium or epigastrium) and clinical signs of hepatomegaly and/or tender liver with or without jaundice and abdominal ultra-sonography. ALA patients’ IgG antibody titers were measured by Indirect Hemmaglutination Assay and Chi-square test was used. A total of 1249 ALA patients were included, among whom 570 (45.64%) were positive. Of these, 244 (42.08%) had titer 1:160 or less, 223 patients’ (39.13%) had titer ranging from 1:320 to 1:640 and 103 patients (18.07%) had strong titer ranging from 1:1280 to 1:2560. The association between antibody titer results, age and sex was no significant (p = 1.0000). Our findings indicate a high prevalence of ALA and show no significant difference between the sex and age ALA patients.

Rubella Immunity among Pregnant Women in Bangui, Central African Republic

Sero-positivity rates of the rubella virus among pregnant women vary from country to country widely throughout the world. In the Central African Republic, rubella vaccination is not included in the national immunization schedule. Thus, we propose to evaluate the immune status of pregnant women. This was an analytical retrospective study that consulted the records of pregnant women received in prenatal consultations at the Bangui Community Hospital maternity ward from January to December 2020. Socio-demographic and laboratory data (IgM, IgG) were collected from January to June 2021. Chi2 test was used. A total of 289 pregnant women were analyzed. Women with an IgM+ response accounted for 4.15%. Those with an IgG+ were 14.87%. The distribution by age group shows that patients aged 20 - 24 and those aged 25 - 29 had a rubella profile suggesting persistent infection (p = 0.010). The average age of women included was 28 (±6) years. The average parity for the entire sample was 2.18 (1.93). At any age pregnant women were not significantly exposed to rubella infection (p = 0.96), (ORbrut = 1.03;CI95% = [0.32 - 3.34]). Both immunized and non-immunized individuals are similarly exposed [OR = 0.86;95% IC95% = 0.44 - 1.68] with no difference (p = 0.96). Rubella infection remains particularly severe when it occurs during pregnancy. It would be wise to seek immunity in all girls of childbearing age in order to rule out any risk of rubella embryopathy.

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.

Evolution of the Etiologies of Purulent Meningitis in Children over a Period of 24 Months in Conflict-Affected Rural Areas of the Central African Republic after the Introduction of 2 New Vaccines in the Expanded Vaccination Program

Background and Objective: Purulent meningitis is a therapeutic emergency and remains a real public health problem in the world, particularly in limited resources countries. The study aimed to describe the epidemiological clinical, etiological and scalable features of purulent meningitis in children in Bria. Methods: A cross-sectional descriptive study was conducted from January 1, 2018 to December 31, 2019 (24 months). It included all suspected cases of purulent meningitis in children aged 0 to 15 years, confirmed by agglutination with Pastorex meningitis. A standard sheet was used to collect the data which was entered and analyzed on Epi Info 7 software. Results: A total of 37 cases of purulent meningitis were confirmed among 90 suspected cases. The female gender predominated (59.5%), with a sex ratio of 0.7. The age group from 0 to 11 months was majority (48.6%). Nearly 2 thirds of children were not vaccinated (64.8%). The most frequent functional signs were fever (83.8%), and convulsion (51.4%). The etiologies were Streptococcus (51.4%), Neisseria meningitidis (35.1%) and Haemophilus influenzae (13.5%). Therapeutic success under 3rd generation cephalosporin treatment was obtained in 86.5% including 8.1% with sequelae;13.5% of death was observed. Streptococcus was the most lethal bacterium at 21.1%. Conclusion: The results of these studies show that pediatric purulent meningitis is still common despite the availability of free vaccination. They require early therapeutic management to limit the occurrence of sequelae and death. Hence, it is important to strengthen prevention strategies.

Evaluation of the Third 90 of the 90-90-90 Cascade for the Period 2019-2020 in the Central African Republic

Introduction In Central-African Republic, according to UNAIDS in 2019, out of approximately 100,000 people living with HIV, 70% (72,000) knew their HIV status and 47,000 (46%) were on ARV therapy;however, there is a paucity of data on viral load suppression in people on ARV therapy. The objective of this study was to assess the third 90 of the UNAIDS strategy for the years 2019 and 2020 in the CAR. Methods We analyzed the available viral load data extracted from the data base of the medical analysis laboratory (SYSLAM) of the Institut Pasteur of Bangui for the years 2019 and 2020. The viral loads were determined based on plasma collected in an EDTA tube with Cepheid’s GeneXpert® 16-module controllers. Viral load data were extracted from SYSLAM, converted to Excel format, and analyzed with STATA version 14 software. The significance threshold for the statistical tests was set at 5%. Results This study included 22,895 patients, of who 72% were female. The average age was 40.82 years, and the majority of the patients (80%) came from the city of Bangui. Regarding the virological parameters associated with this study, 66% of the patients had significant viral load suppression according to the WHO recommendations and 34% were in virological failure. Patients over 50 years of age (71.85%) and age group 40 - 49 years (69.25%) recorded significant levels of viral load suppression. On the other hand, 63.45% of patients under 18 years of age had virological failure. All of these results were statistically significant (p < 0.005). Conclusion There should be a concerted effort, to make viral load accessible and available to all patients receiving ARV treatment in the CAR and the management of HIV/AIDS infection of children and adolescents should be given special attention.

Detection and Serological Characterization of Rice Yellow Mottle Virus in Central African Republic

Serological and biological detection of Rice Yellow Mottle Virus (RYMV) in leaf samples belonging from cultivated rice species and wild grasses revealed 201 positive detections. All these isolates occurred exclusively on cultivated rice species (Oryza sativa L. and O. glaberrima Steud). A relationship was found between cultural practices and presence of RYMV in fields (X2 = 108.83, df = 1, P

Determinants of Neurocognitive Impairment in HIV in a Cohort of Patients on Antiretroviral Therapy Followed in Bangui (Central African Republic)

Infection with HIV is one of the deadliest epidemics of our time and its type is widespread in the Central African Republic. It is frequently accompanied by neurological complications. Objective: To contribute to a better understanding of neurocognitive disorders in patients living with HIV (PLHIV) in Bangui, and to identify associated factors using the International HIV Dementia Scale (IHDS) as a screening tool. We conducted a descriptive and analytical cross-sectional study from 1 December 2014 to 30 January 2015, in a cohort of patients seen on one of the supported sites in Bangui. A total of 400 patients were received in follow-up visit during the study period of which 244 met the inclusion criteria. The prevalence of neurocognitive disorders was 25%, 95% CI [19.70 - 30.92]. The mean age of subjects was 42.77 ± 9.58 with extremes ranging from 24 - 64 years. The sex ratio (F/M) was 4.5 in. The average score for different tests was 10.93 ± 1.13 with extremes of 7 and 12. The disorder was more about the gestural sequence. Determinants of neurocognitive disorders in the cohort were older age and lower educational level (p < 0.05). It is useful to conduct further studies to confirm these results by combining a battery of neuropsychological tests to recommend this test for all the support sites of PLHIV in the country.

Viral Acute Respiratory Infections in Central African Republic Children: Epidemiological and Clinical Aspects

Background: Acute respiratory infections (ARI) are recognized as an important cause of morbidity, mortality, and hospitalization among children in developing countries. Objectives: To identify the respiratory viruses circulating in Central African children before the SARS-COV2 pandemic and to assess the clinical manifestations. Methodology: This is a cross-sectional, descriptive, multicenter study, run from March 1, 2019, to March 31, 2020. Children aged 28 days to 15 year-old, with respiratory symptoms ≤10 days had been included. Nasopharyngeal swabs were taken and sent to the Institute Pasteur in Bangui (WHO National Referral Center for influenza). Virus research was done by cell and molecular culture techniques. Data were recorded and processed with Access 2019 software, then analyzed with STATA version 14 software. Chi-square test and ANOVA test were used to compare proportions at the p 0.05 threshold. Results: Out of 659 children included during the study period, viruses were identified in 231 children, for an overall positivity rate of 35.05% (231/659). Rhinoviruses (RV) and influenza viruses were found in 66.23% and 16.88% respectively. Virus-virus co-infections were found in 10 (10/231) children (4.32%). Children under 5 years of age were more represented (78.60%). The main reasons for consultation were: fever (96.20%), cough (95.45%), runny nose (78.5%), and breathing difficulty (30.50%). ILI (Influenza-Like Illness) was found in 71.02% versus 28.98% of SARI (Severe Acute Respiratory Infection). There was a statistically significant association between age 5 years and severity of acute respiratory infection (p = 0.001). The outcome was known for the 122 children at the CHUPB site with a mortality rate of 17.21% (n = 21). Conclusion: Viral ARI is common in children in Central African Republic. Care givers should think about it in order to reduce the inappropriate prescription of antibiotics.

Interruption of Yaws in Central African Republic: What Dose of Azithromycin and How Many Cycles of Mass Treatment?

Introduction: The WHO recommends mass administration of azithromycin 30 mg/kg to eradicate yaws and 20 mg/kg to eliminate trachoma. We evaluated the effectiveness of azithromycin at 20 and 30 mg/Kg, and the number of cycles of mass administration on the treatment and interruption of yaws transmission in the Mbaïki health district in the Central African Republic. Methods: Following a yaws prevalence survey, azithromycin was administered as a mass treatment in four yaws endemic communities in the Mbaïki health district. Azithromycin 30 mg/kg was administered in one cycle in Kenengué and three cycles spaced three months apart in Bambou. In Kapou and Bangui-Bouchia, azithromycin was administered at a dose of 20 mg/kg in one cycle and three cycles, respectively, spaced three months apart. Before the mass treatment round, confirmed yaw cases were selected and followed for seven months. The primary endpoint was serological cure seven months after the first treatment cycle. Secondary endpoints were clinical cure at four weeks after the first treatment cycle and serological cure at four months after the first treatment cycle. A non-inferiority margin (∆) of 10% was used. Results: A total of 92 participants aged 1 to 90 years, including 52 men, were included in the study. The frequently encountered skin lesions were ulcers (65.22%) and were localized to the lower limbs (59.78%). Clinical cure was not obtained in Bangui-Bouchia and Kapou (∆ = 17.1% and 30.8%). Serological cure at four and seven months was not obtained in Kapou (∆ equal to 17.9% and 13.8% respectively). Conclusion: This study confirms the effectiveness of azithromycin 30 mg/kg in a single dose for the treatment of yaws. However, the study suggests that for yaws eradication programs, two to three cycles of mass administration of azithromycin at 20 or 30 mg/kg spaced three months apart, with therapeutic coverage greater than 90% are essential.