Hepatitis C virus prevalence and genetic diversity among pregnant women in Gabon, central Africa
Guy-Roger Ndong-AtomeMaria MakuwaRichard NjouomMichel BrangerFrançoise Brun‐VézinetA. MahéDominique RoussetMirdad Kazanji
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Abstract Background Hepatitis C virus (HCV) infection is a major global public health problem in both developed and developing countries. The prevalence and genetic diversity of HCV in pregnant women in Gabon, central Africa, is not known. We therefore evaluated the prevalence and the circulating genotypes of HCV in a large population cohort of pregnant women. Methods Blood samples (947) were collected from pregnant women in the five main cities of the country. The prevalence was evaluated by two ELISA tests, and the circulating genotypes were characterized by sequencing and phylogenetic analysis. Results Twenty pregnant women (2.1%) were infected with HCV. The seroprevalence differed significantly by region (p = 0.004) and increased significantly with age (p = 0.05), being 1.3% at 14–20 years, 1.1% at 21–25 years, 1.9% at 26–30 years, 4.1% at 31–35 years and 6.0% at > 35 years. Sequencing in the 5'-UTR and NS5B regions showed that the circulating strains belonged to genotypes 4 (4e and 4c). Conclusion We found that the HCV seroprevalence in pregnant women in Gabon is almost as high as that in other African countries and increases with age. Furthermore, only genotype 4 (4e and 4c) was found. More extensive studies aiming to evaluate the prevalence and heterogeneity of HCV genotypes circulating in the general population of the country are needed.Keywords:
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Changes in lipid levels over time after acquiring HCV infection, and how they differ from HCV-uninfected persons are unknown. We used ERCHIVES to identify those with a known HCV seroconversion window and persistently negative controls. We excluded subjects with HIV and hepatitis B and those who received lipid lowering agents. Total Cholesterol (TC), low-density lipoproteins (LDL), high-density lipoproteins (HDL), triglycerides (TG) and non-HDL cholesterol were retrieved at yearly intervals and plotted over time. Among 1,270 HCV+ and 5,070 HCV- subjects, median age [IQR] was 47[37,53] for HCV+ and 52[47,57] for the HCV- group; 69 % were White and 91 % were males in each group. Mean BMI [SD] was 26.94[6.73] in the HCV+ and 28.15 [5.98] in the HCV- group (P < 0.001). Over a 10-year follow-up period among HCV+ persons, TC decreased by (mean (SD) mg/dL) 12.06(36.95), LDL by 9.22(31.44), TG by 13.58(87.01) and non-HDL-C by 12.55(35.14). Among HCV- persons, TC cholesterol decreased by 4.15(31.21), LDL by 4.16(26.51); TG by 4.42(82.34) and non-HDL-C by 5.78(30.17). After HCV acquisition, TC, LDL, TG and non-HDL-C progressively decline over time independent of BMI and liver fibrosis. Consequences of lipid changes and the need and optimal timing of lipid lowering therapy in HCV+ persons require further study.
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(1917). Studies in the Treatment of Malaria. Annals of Tropical Medicine & Parasitology: Vol. 11, No. 2, pp. 173-182.
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"Studies in the Treatment of Malaria." Annals of Tropical Medicine & Parasitology, 13(1), pp. 63–67
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The need to study the outcome of Antiretroviral Therapy (ART) among Human Immunodeficiency Virus (HIV) infected individuals in Ghana, a sub-Saharan African country crucial in the era of the "Treat All" policy. The aim of this study was to analyze selected determinants of immunological and virological response to ART among HIV infected individuals in a tertiary facility in Cape Coast, Ghana. An analytical cross sectional study with a retrospective component was conducted in the Cape Coast Teaching Hospital (CCTH), Central Region. Clients aged 18 years and above attending the HIV Clinics for ART and who were on ART for 6 months or more were recruited. The viral loads, CD4 count and other socio-demographic data were analyzed using STATA version 13 (STATA Corp, Texas USA). Descriptive analysis was done and presented with appropriate measures of central tendencies. In addition, bivariate and multivariate analysis was carried out with p value of 0.05 interpreted as evidence of association between variables. A total of 440 participants were included in this study with a mean age of 45.5 (±11.6) years. The mean CD4 count at baseline, 6 months on ART and currently at study recruitment were 215.1 cells/mm3 (±152.6), 386.6 cells/mm3 (±178.5), and 579.6 cells/mm3 (±203.0) respectively. After 6 months and 12 months on ART, the number who had achieved viral copies < 1000/ml were 149 (47.0%) and 368 (89.6%) respectively. There was strong evidence of an association between having CD4 count < 350 cells/mm3 after 6 months on ART and having a diagnosis of tuberculosis since HIV diagnosis (aOR 8.5, 95% CI 1.1–73.0, p = 0.05) and clients having plasma viral load > 1000 copies/ml after 6 months on ART (aOR 2.0, 95% CI 1.2–3.2, p = 0.01). There was good response to ART among clients, high virological suppression and immunological recovery hence low rates of change to second line ART regimen in this cohort studied. With strict adherence to the national policy on HIV testing, management of positive clients and full implementation of the "Treat All" policy, Ghana could achieve, if nothing at all, the third "90, 90, 90" target by 2020.
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Up to 1899 some one hundred and twenty-two definite species of the Culicidae were described.Since that time many collections of mosquitoes have been examined from all parts of the world.Mr. F. V. Theobald, at the close of last year, as the result of an exhaustive examination of past works and new material, has remodelled the classification of the Culicidae, which he has grouped into some twenty- two genera, and has described some one hundred and thirty-six distinct new species in his Monograph on the Culicidae of the World.To this number must be added some one hundred new species which he has not yet described.As yet only a few of the great number of mosquitoes have been investigatedwith regard to the important point of whether or no they can act as hosts for the malaria parasite.In fact only a few species of Culex have been shown to be incapable of transmitting the disease.When it was considered that not only malaria but other diseases were conveyed by mosquitoes, for example, filaria can develop in two genera, Culex and PanopliteSy and that yellow fever is certainly carried by one genus, Stegomyia, there arose a tendency to look upon all mosquitoes as harmful, and that their judicial destruction, as far as possible, was an object to be aimed at.How far this end can be attained is at present sub j.udice, but we have evidence that certain districts and towns lend themselves readily to this object.Experiments under this head are at present being carried on in West Africa and in Havana.On a smaller scale similar experiments have been carried out in Hong Kong and Statin Island, New York.Major Ross chose Freetown, Sierra Leone, for the scene for an experiment, to see how far mosquitoes can be diminished in a certain area, one of the most difficult places on the West Coast to tackle.He and Dr. Logan Taylor, who was to direct the work there, arrived on July 2, 1901, and at once commenced the campaign against all varieties of mosquitoes.As yet the experiment is not completed, but a great diminution in the numbers of these insects has already been brought about.In Havana the work of exterminating mosquitoes, by the destruction of their breeding places, was commenced soon after the discovery that yellow fever could be transmitted by the bites of the common mosquito, Stegomyia jasciata.Major and Surgeon W. C. Gorgas, in his January report to the Military Governor, states that out of seventeen thousand houses examined during the month by the ' Stegomyia Brigade,' in four hundred and eleven only were mosquito larvae found ; the preceding January, larvae would have been found in all of the houses.Not only have the mos- quitoes diminished, but Havana has been for the last four months, October, November, December, January, entirely free from yellow fever.This result is certainly very encouraging when we compare the prevalence of yellow fever there during the same period of the previous year, when the average number of deaths from this disease was 146-49.II. TOPOGRAPHY AND STATISTICSSt. Mary's Island and Bathurst St. Mary's Island is a long, low-lying island at the mouth of the River Gambia, extending roughly from north-east to south-west along the south bank of the river.It is about four miles long and half-a-mile across at its widest part.The island is only separated from the mainland by a small creek, which, at the north-west corner, is bridged across.One fairly good road runs the length of the island, from the town of Bathurst at the one end to the Creek Bridge.This road runs along the beach, separated from it for the most part by mounds of sand and scrub.On the south side of the road an extensive mangrove swamp occurs, and in places encroaches on to the road.The town of Bathurst is situated at the east corner of St. Mary's Island.It occupies an J-shaped area of land, the long arm of which is almost separated from the island by an encroachment of Oyster Creek at the back of the island and the mangrove swamp.There is only a distance of some two hundred yards between the swamp and the beach, so that this area is for the most part cut off from the island, and is surrounded by a broad expanse of water on all sides, to the north and west by the River Gambia, which is here about four miles across, to the south and west by the creek separating St. Mary's Island from the mainland.In this area the land scarcely reaches the height of four feet above sea-level, the greater part of it being situated below the sea-level.Altogether it is scarcely a square mile in extent.The formation is of light sand and loam on the surface, followed by denser loam which rests upon the water-bearing sand and silt, about eight feet under the sur- face.This area is well though not too thickly wooded ; some very fine trees occur in the town.The town of Bathurst is very well laid out.The chief streets are broad and run parallel and at right angles to one another ; in fact there are very tew narrow streets, even in the strictly native quarters.The chief houses and factories in the principal street, Wellington, face the mouth of the river.These houses are built of stone for the most part, the volcanic iron stone which occurs in great quantity across the river.These houses are very cool and airy, and the rooms are large ; they were probably built by the French.At the back of each house there is generally an enclosed piece of ground used as a garden.Unfortunately, in Bathurst, the houses of the Europeans are not segregated from the natives, many of the traders' and officials' houses, particularly, being sur- rounded by native compounds.
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Background Hepatitis C virus is one of the major causes of parenterally acquired hepatitis. HCV genotypes exhibit different profiles of pathogenicity, infectivity and response to antiviral therapy. The study was taken up to detect HCV seropositivity and common genotype prevalence in a tertiary care hospital. The other objectives of the study were to detect probable risk factors and HIV/HBV co infections.
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"Studies in the Treatment of Malaria." Annals of Tropical Medicine & Parasitology, 13(2), pp. 117–118
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