The increasing availability of antiretroviral therapy (ART) worldwide is yet to result in decreasing HIV-related mortality among adolescents (10–19 years old) living with HIV (ALHIV) in part because of poor adherence. the poor adherence might itself be due to high level of depression. We assess the prevalence of depressive symptomatology and it's associated with adherence among ALHIV receiving ART care in Brazzaville and Pointe Noire, Republic of Congo (RoC). Adolescents aged 10 to 19 years, on antiretroviral therapy (ART), followed in the two Ambulatory Treatment Centers (ATC) in Brazzaville and Pointe Noire, RoC were included in this cross-sectional study. From April 19 to July 9, 2018, participants were administered face to face interviews using a standardized questionnaire that included the nine-item Patient Health Questionnaire (PHQ-9). Participants who reported failing to take their ART more than twice in the 7 days preceding the interview were classified as non-adherent. Bivariate and multivariable log-binomial models were used to estimate the prevalence ratio (PR) and 95% confidence interval (95%CI) assessing the strength of association between predictors and presence of depressive symptoms (PHQ-9 score ≥9). Overall, 135 adolescents represented 50% of ALHIV in active care at the 2 clinics were interviewed. Of those, 67 (50%) were male, 81 (60%) were 15 to 19 years old, 124 (95%) had been perinatally infected, and 71 (53%) knew their HIV status. Depressive symptoms were present in 52 (39%) participants and 78 (58%) were adherent. In univariate analyses, the prevalence of depressive symptoms was relative higher among participants who were not adherent compared to those who were (73% vs 33%; PR: 2.20 [95%CI: 1.42–3.41]). In multivariate analysis, after adjustment for report of been sexually active, alcohol drinking, age category (10–14 and 15–19), not in school, loss of both parents, the association between depression and adherence was strengthened (PR: 2.06 [95%CI: 1.23–3.45]). The prevalence of depressive symptoms in adolescents living with HIV is high and was strongly associated with poor adherence even after adjustment of potential confounders. Efforts to scale-up access to screening and management of depression among ALHIV in sub-Saharan is needed for them to realize the full of ART.

BackgroundLassa fever is one of the most lethal neglected tropical diseases in West Africa. It is a serious public health problem in this region of Africa where it is endemic in several countries. However, it remains a very little known disease by healthcare workers. The lack of specificity of its clinical manifestations makes its diagnosis difficult even in an epidemic context.Case presentationWe report here a confirmed case of Lassa fever whose diagnosis could not be suspected until 11 days after the symptomatology began. This case was recognized as a suspected case of Lassa fever in the Internal Medicine Department of the Regional and Teaching Hospital of Borgou due to the persistence of the fever and the worsening of the patient’s clinical condition despite triple antibiotic therapy in general and especially due to the appearance of hemorrhages. Confirmation of the presence of Lassa fever virus by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) assay on blood sample was obtained after his death despite late initiation of Ribavirin treatment.ConclusionThis case challenges Benin’s health authorities on the need to facilitate access to diagnosis of viral hemorrhagic fevers and to train caregivers at all levels of the health system for better management of these diseases.

Background in sub-Saharan Africa, the symptoms of covid-19 are similar to those of several pathologies frequently encountered in this region, which can confuse the diagnosis both for the patient and for health structures with limited resources. We studied self-reported time to care-seeking from the onset of covid-19 symptoms. Methods This was a cross-sectional study. Patient’files who attended the medical emergencies Unit of Brazzaville University Hospital, for symptoms suggestive of Covid - 19 between May 2020 and February 2022, were collected. The diagnosis of Covid-19 was confirmed by RT-PCR or antigen test. Delay, between the rise of Covid- 19 symptoms and the attendance at the medical emergencies Unit, was recovered from the history of the disease reported by the patients themselves. When the patient had reported a duration of 'about one week' in the delay we noted '7 days' and 'about 2 weeks' corresponded to '14 days' taking this into account we used the Weibull regression model accelerated failure-time metric to identify potential risk factors which were subsequently presented as a time ratio (TR). Results 102 patients were included, 57 (55.88%) were women, the median age was 64 years (Interquartile Range (IQR): 56 – 71), history of hypertension and diabetes was found respectively in 51 (50%) and 27 (26.47%) patients. 13 (12.75%) were vaccinated against Covid – 19. The median time to care-seeking was 7 days (IIQ: 5 – 7). Being vaccinated (adjusted Time Ratio (aTR): 1.69 (95% CI: 1.09 – 2.6) p=0.02) and having a cough (aTR: 1.74 (95% CI: 1.2 – 2.52) p=0.03) was associated with a longer time to care-seeking. On the other hand, being Hypertensive (aTR: 0.68 (95% CI: 0.51 – 0.9) p= 0.006), asthenic (aTR: 0.46 (95% CI: 0.23 – 0.91) p= 0.03) and having respiratory distress (aTR: 0.48 (95% CI: 0.26 – 0.89) p=0.03) were associated with a faster time to care-seeking. Conclusion the vaccine increases time for care-seeking, especially when it is associated with the classic signs of COVID-19 such as cough. To limit the under-notification of cases in sub-Saharan Africa, Covid 19 testing must be generalized. Disclosures All Authors: No reported disclosures.

Aim: Describe the epidemiological aspects of patients with positive microscopic pulmonary tuberculosis and identify associated factors.

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Objective: Tetanus is present in Congo, the objective of this work is to study the epidemiological, clinical and evolutionary aspects of non-neonatal tetanus cases and to formulate recommendations. Methods: This was a retrospective study conducted among patients admitted to the infectious diseases department of the University Hospital Center of Brazzaville, from January 1st 2018 to December 31st 2020. The data collected were : age, sex, portal of entry, clinical signs, duration of hospitalization, stage of tetanus as well as evolution. Results: A total of 44 cases of non-neonatal tetanus was found among the 2440 patients admited during the study period, with a frequency of 1.8%. A male predominance was observed, the sex ratio M/F was 4.5. The average age was 31.6 ± 2.9 years with extremes of 6 and 78 years. The age group 15-24 years (31.8%) was the most represented. More than half of the patients were single (81.8%) with a secondary level of education level (54.5%), most were students (38.6%). The main portal of entry for tetanus was integumentary in 77.3% of patients. About 70.5% of patients were not vaccinated. Most of them (59.1%) had a moderate form of tetanus, the Dakar score was between 2-3. The mortality rate was 36.4% and was associated with patient age and duration of hospitalization. Conclusion: It is important to promote vaccination against tetanus from adolescence. Systematic verification of their vaccination status and updating them by the administration of the tetanus vaccine and booster doses is necessary. The continuous training of health professionals on the effective management of risky situations or cases of tetanus must be integrated into the strategy for the fight against tetanus.