Setting Drug resistance threatens tuberculosis (TB) control, particularly among HIV-infected persons. Objective We surveyed antiretroviral therapy (ART) programs from lower-income countries on prevention and management of drug-resistant TB. Design We used online questionnaires to collect program-level data in 47 ART programs in Southern Africa (14), East Africa (8), West Africa (7), Central Africa (5), Latin America (7) and Asia-Pacific (6 programs) in 2012. Patient-level data were collected on 1,002 adult TB patients seen at 40 of the participating ART programs. Results Phenotypic drug susceptibility testing was available at 36 (77%) ART programs, but only used for 22% of all TB patients. Molecular drug resistance testing was available at 33 (70%) programs and used for 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the whole treatment, 16 (34%) during intensive phase only and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line TB regimens; 18 (38%) reported TB drug shortages. Conclusions Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower income countries. DOT was not always implemented and drug supply was regularly interrupted, which may contribute to the global emergence of drug resistance.

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Introduction: Malaria particularly affects children in sub-Saharan African countries. This study aimed to investigate the factors associated with death in cases of severe childhood malaria to better understand the determinants of death in these children. Patients and Methods: This cohort, descriptive and analytical study was conducted from April 1 to August 15, 2015, at the CNHU-HKM pediatric clinic in Cotonou. Recruitment was exhaustive for all patients under 15 years of age who were admitted for severe malaria, as confirmed by thick smear microscopy. Results: Among the 1774 admitted patients, 449 had severe malaria caused by Plasmodium falciparum (i.e., a hospital frequency of 25.31%).The age group most affected consisted of children younger than 60 months of age (73%); female predominance was noted. The lethality rate of malaria was 13.1% (n = 59). The factors associated with death were coma (p = 0.032), poor convulsive status epilepticus (p = 0.08) and bacterial co-infection by gram negative bacteria (p = 0.021) with respectively correlations coefficient of 0.003, 3.940 and 2.424. Conclusion: Reduction of the malaria mortality rates in Benin hospitals will depend on appropriate management of poor prognostic factors, such as coma, bacterial co-infection and convulsive illness.

Neonatal dermatoses (NND) are frequent, varied and of variable prognosis. The objective of this work was to study the epidemiological and clinical aspects of NND at the NTH-HKM. Methods: This was a cross-sectional descriptive and analytical study from December 1, 2014 to February 28, 2015. All newborns received in the Department of Pediatrics and Medical Genetics and with dermatosis were included. The diagnosis of dermatoses was clinical. Results: During the study period, 355 newborns had at least one NND on a total of 580 newborns received, a prevalence of 61.2%. The sex ratio was 1.54 and the average age was 3.11 days. Transient dermatoses were more frequent (80%), dominated by desquamation + xerosis (33.75%). Congenital melanocytic nevi (40.74%) and malformations and vascular tumors (18.52%) were the most noted pathological neonatal dermatoses. Only age was statistically associated with NND. Conclusion: DNH is common in newborns at the NTH-HKM. They were mostly transitory. Pathological conditions should be treated where appropriate.

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