RESUMELe rotavirus est la première cause de gastroentérites grave chez les enfants de moins de 5 ans. La gravité et la mortalité de la maladie sont majorées dans les pays à revenus faibles d'Asie du sud et d'Afrique subsaharienne. Au Cameroun, la forte prévalence des rotaviroses, associées aux spécificités génotypiques locales du virus, soulignent l'importance de disposer de données épidémiologiques sur le virus. Cette étude visait à contribuer à une meilleure connaissance des principales souches de rotavirus responsables des gastroentérites chez les enfants de moins de 5 ans dans la ville de Yaoundé. Il s'agit d'une étude descriptive transversale d'une durée de 4 mois, dans 8 formations sanitaires de la ville de Yaoundé. Les échantillons de selles d'enfants de moins de 5 ans, hospitalisés pour gastroentérite ont été prélevés. La recherche du rotavirus s'est faite avec le kit ELISA Oxoid ProSpec TTM, et la détermination des génotypes du virus s'est faite par RT -PCR. Cent trente échantillons de selles d'enfants souffrant de gastroentérite ont été collectés. 66,1% de ces échantillons provenaient des hôpitaux FCB/CME, du CHE et de HDE. Le rotavirus a été isolé chez 30% des enfants, dont 40% avait entre 6 et 11 mois. Le CHE (6,9%) et l'HGY (0%) avaient respectivement la prévalence la plus élevée et la plus basse de la ville. Un nombre élevé de combinaisons génotypiques a été isolé, parmi lesquels prédominaient G1P [8] ABSTRACTRotavirus is the leading cause of severe gastroenteritis in children less than 5 years. Severity and mortality of this disease are majored in low-income countries of South -Asia and sub -Saharan Africa. In Cameroon, the high prevalence of rotaviruses associated to local genotypic specificities of virus enhances the importance of epidemiological database on the virus. This study aimed at contributing to a better knowledge of the main rotavirus strains responsible for gastroenteritis in children less than 5 years in Yaoundé. We carried out a descriptive and cross sectional study during 4 months, in 8 health centers in Yaoundé. Stool specimens were collected from children less than 5 years old, hospitalized for gastroenteritis. Rotavirus was detected with ELISA kit Oxoid ProSpecT TM , and genotypes determined by RT -PCR. One hundred and twenty seven stool specimens were collected during the study. FCB/CME, CHE, HDE provided 66.1% of specimens collected. Rotavirus was isolated in 30% of children, and 40% of these children were between 6 to 11 months old. The CHE (6. 9%) and the HGY (0%) had respectively the highest and the lowest prevalence of the town. A large number of genotype has been isolated and G1P[8] (31%) were predominant, followed by G3P [6]
This cross-sectional study, carried out on a cohort of 568 HIV-infected patients followed at the Bertoua Day Hospital, aimed at assessing interventions used in the biomedical management of lipodystrophy and metabolic syndrome related to Antiretroviral therapy through the determination of their prevalence within this hospital. Patients had a minimum age of 18years old, a minimum duration of 2years antiretroviral therapy and all had given their informed consent to participate in the study. The mean duration of treatment for HIV patients with lipodystrophy cases was 68±9.2 months ranged from 24 to 136months and that for patients with metabolic syndrome cases was 46±8.5 months ranged from 24 to 151months (P value = 0.005). Lipodystrophy was observed with all the therapeutic protocols prescribed to HIVinfected patients in our study site. Lipodystrophy cases seen among HIV-infected patients using the d4T in their therapeutic protocol accounted for 41.11%, while those seen among HIV-infected patients using the AZT in their therapeutic protocol accounted for 51.57% (P <0.0001). Among HIV-infected patients using the NVP in their therapeutic protocol, we found 40.41% of lipodystrophy cases versus 28.23% of lipodystrophy cases among HIV-infected patients using the EFV in their therapeutic protocol (P value=0.01). Lipodystrophy cases related to the use of protease inhibitors in the therapeutic protocol accounted for 31.36%. The prevalence of metabolic syndrome cases was greatest among HIV-infected patients using protease inhibitors boosted by the ritonavir in their therapeutic protocol with 72.6% of cases (P value = 0.0003). The prevalence of metabolic syndrome cases determined in this study using the definition of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) was 21.83% and that of lipodystrophy cases was 50.52% with 27.64% for lipoatrophy cases, 20.95% for lipohypertrophy cases and 1.93% for mixed syndrome cases (P value = 0.01). We also found 16.9% for lipodystrophy cases strongly associated with the metabolic syndrome among our HIV infected patients under HAART, with an Odds Ratio of 4.54 which was statistically significant with a confidence interval (CI) between 3.45 and 6.87 to 95% (P value = 0.03). In other words, these HIV infected patients were 4.54 times more likely to have a metabolic syndrome in the presence of lipodystrophy than in its absence.
The biochemical parameters are part of the follow-up care for patients with malaria bout as gravity markers allowing the biologist to inform the doctor about the progressive stage of the malaria bout. Among these markers, we have on the one hand; the ions Sodium, Potassium and Chloride and on the other hand; the blood sugar, the bilirubin and the proteins, which represent the biochemical parameters more used during the biological check-up of the malaria. Indeed a non negligible fraction of deaths occurring during the malaria among patients infected with HIV under HAART is associated to biochemical disorders, from where the interest of this transversal survey carried out at the Regional hospital of Bertoua, aimed at evaluating the variations of biochemical parameters associated to the malaria bouts, due to P. falciparum among these patients. We included in our survey, all HIV positive patients under HAART since at least one year and presenting a malaria bout. We excluded from our survey, all HIV positive patients, unregistered in our study place for the follow-up care for antiretroviral therapy; all HIV positive patients presenting a preexisting hepatic, renal or cardiovascular pathology before the intake of the HAART; and the pregnant women. We analyzed the socio-demographic parameters (Age and Sex), the Biological parameters (parasitic charge, Blood sugar, ions potassium, sodium and chloride, urea, creatinine, bilirubin, protein, HIV serology, rate of hemoglobin and level of CD4) and the therapeutic parameters (therapeutic protocol, length of hospitalization and treatment evolution). During this survey, we noticed that the ionic disorders as the decrease of sodium ion and the increase of the potassium ion and chloride ion in the blood were more frequent during the malaria bouts among our patients infected with HIV under HAART. The blood sugar was also decreased in the blood. The bilirubin and protein were increased in the blood and also present in the urine. The increase of the creatinine and urea had the incidence rates of 100% among these patients. The frequency of these biochemical disorders varied with a meaningful manner according to the gravity stage of illness (simple or serious malaria bout) and was also influenced by the intake of the HAART. Keywords:
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