Refugees who attended PRHC clinics were more likely to be evaluated promptly and to complete LTBI treatment. The PRHC clinics serve as a model for communities seeking to improve refugee health care.

The spread of severe acute respiratory syndrome coronavirus 2 began later in Africa than in Asia and Europe. Senegal confirmed its first case of coronavirus disease on March 2, 2020. By March 4, a total of 4 cases had been confirmed, all in patients who traveled from Europe.

Context: Senegal is among the most endemic countries for viral hepatitis B with 11% of chronic HBV carriers. Students in the health sector are among those most at risk. The objectives of this study were to determine the Knowledge, Attitudes and Practices (KAP) of students at a private university in Dakar regarding viral hepatitis B and to identify associated factors. Methodology: A cross-sectional, descriptive, and analytical study has been conducted among students of the St Christopher Iba Mar Diop School from April 1 to 30, 2019. The questionnaire was self-administered. Chi 2 testing and logistic regression were used to identify factors associated with the level of knowledge, as well as attitudes and practices regarding viral hepatitis B. The data was analyzed using SPSS version 22 software. Results: In total, we interviewed 317 students, which corresponds to a participation rate of 60.5%. The main sources of information were predominately training (85.9%) and the media (68.2%). Jaundice (85.9%), hepatomegaly (79.2%) and fever (78.5%) were the main clinical signs known to students. Blood and sexual transmission routes were cited by more than 80% of the respondents. However, 19.4% of students reported that hepatitis B could be transmitted by the fecal-oral route. People with multiple sexual partners (77.5%) and health workers (76.4%) were the most frequently cited at-risk groups. Incarceration as a risk factor was known by only 38.7% of respondents.

As of today, little data is available on COVID-19 in African countries, where the case management relied mainly on a treatment by association between hydroxychloroquine (HCQ) and azithromycin (AZM). This study aimed to understand the main clinical outcomes of COVID-19 hospitalized patients in Senegal from March to October 20202. We described the clinical characteristics of patients and analysed clinical status (alive and discharged versus hospitalized or died) at 15 days after Isolation and Treatment Centres (ITC) admission among adult patients who received HCQ plus AZM and those who did not receive this combination. A total of 926 patients were included in this analysis. Six hundred seventy-four (674) (72.8%) patients received a combination of HCQ and AZM. Results showed that the proportion of patient discharge at D15 was significantly higher for patients receiving HCQ plus AZM (OR: 1.63, IC 95% (1.09–2.43)). Factors associated with a lower proportion of patients discharged alive were: age ≥ 60 years (OR: 0.55, IC 95% (0.36–0.83)), having of at least one pre-existing disorder (OR: 0.61, IC 95% (0.42–0.90)), and a high clinical risk at admission following NEWS score (OR: 0.49, IC 95% (0.28–0.83)). Few side effects were reported including 2 cases of cardiac rhythmic disorders in the HCQ and AZM group versus 13 in without HCQ + AZM. An improvement of clinical status at 15 days was found for patients exposed to HCQ plus AZM combination.

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IntroductionL'objectif de ce travail était d'évaluer les différents facteurs associés à la dissociation immunovirologique malgré un traitement antirétroviral hautement actif et efficace.MéthodesIl s'agissait d'une étude de cohorte historique, descriptive et analytique faite à partir de dossiers de patients infectés par le VIH-1; sous traitement antirétroviral depuis au moins 12 mois, suivis dans la cohorte du CTA de 2001 à 2011 et ayant une charge virale indétectable depuis 6 mois.RésultatsDurant cette période d'étude de 10 ans, la prévalence de la DIV était de 19,3%. Le sexe féminin était prédominant avec un sexe ratio de 1,9. La dissociation immunovirologique a été plus fréquemment rencontrée chez les patients de sexe masculin (29,7% vs 14,1%) avec une différence statistiquement significative (p = 0,00006). L'âge médian était de 44 ans ± 10 ans. Un antécédent de tuberculose a été retrouvé dans environ un tiers des cas (31,4%). La dissociation immunovirologique était significativement plus fréquente chez les patients ayant un antécédent de tuberculose (p = 0,00005). La plupart des patients (68%) était au stade SIDA 3 ou 4 de l'OMS. Les patients ayant une dissociation immunovirologique étaient plus souvent aux stades 3 et 4 de l'OMS (p = 0,0001). La dénutrition a été notée dans plus de la moitié des cas (56,2%) et la dissociation immunovirologique prédominait chez les patients dénutris (p=0,005). Le taux moyen de lymphocytes TCD4+ était de 86,7± 83 cellules / mm3. La dissociation immunovirologique était plus fréquente chez les patients ayant un taux de lymphocytes TCD4 bas à l'initiation avec une différence statistiquement significative (p = 0,00000). En analyse multivariée; Seuls l'âge supérieur ou égal à 43 ans, le taux de CD4 initial < 100 c/mm3 et le sexe masculin étaient significativement associés à cette dissociation immunovirologique.ConclusionLes principaux facteurs associés à la dissociation immunovirologique étant évalués, d'autres études portant sur ce groupe mériteraient d'être envisagées afin de connaitre l'impact de cette réponse immunologique partielle sur la survenue d'infections opportunistes ou bien la mise en place d'une trithérapie spécifique uniquement dans le but d'avoir une restauration immunologique optimale.

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Introduction: Over the past years, efforts have been made to expand access to antiretroviral combinations (cART) in low-income countries. However, major concerns are noted with drug resistance emergence, as treatment failure result and need to introduce a second line treatment, more expensive and difficult to implement. The objective was to study the incidence of switch to second line, reasons for switch and risk factors using a cohort of people living with HIV in an Ambulatory Treatment Center in Dakar. Methodology: This was a cohort study of people living with HIV under cART from January 2004 to December 2013. Naive patients monitored for at least six months, regardless of their profile and regimen with baseline CD4 counts < 350 cells/mm 3 were included in this study. Results: The median age of the 827 patients included was 44 [IQR = 18-78]. The switch to second-line treatment was observed in 72 patients (8.7%) after an average of 38.5 months of follow-up. The overall incidence rate of switch to second line of antiretroviral treatment was 1.59 per 100 persons-years. Most of changes in first-line treatment were motivated by virological failures (n = 60, 83.3%) under treatment with AZT/3TC/NVP (n = 25, 34.7%) or AZT/3TC/EFV21 (29.2%). 9.7% of switch occurred after immunological failure, 1.4% after clinical failure, 4.2% after severe toxicity and 1.4% was not documented. Predictive factors identifying failures at the end of the multivariate analysis were age < 44 years and CD4 counts below 100 cells/mm 3. Conclusions: In total, CTA identified a low incidence rate of treatment failure of the first line of treatment. Associated risk factors were age < 44 years, CD4 counts below 100 cells/mm 3 and high viral load at treatment initiation.