BackgroundEarly infant diagnosis (EID) of HIV is a key-point for the implementation of early HAART, associated with lower mortality in HIV-infected infants. We evaluated the EID process of HIV according to national recommendations, in urban areas of Cameroon.Methods/FindingsThe ANRS12140-Pediacam study is a multisite cohort in which infants born to HIV-infected mothers were included before the 8th day of life and followed. Collection of samples for HIV DNA/RNA-PCR was planned at 6 weeks together with routine vaccination. The HIV test result was expected to be available at 10 weeks. A positive or indeterminate test result was confirmed by a second test on a different sample. Systematic HAART was offered to HIV-infected infants identified. The EID process was considered complete if infants were tested and HIV results provided to mothers/family before 7 months of age. During 2007–2009, 1587 mother-infant pairs were included in three referral hospitals; most infants (n = 1423, 89.7%) were tested for HIV, at a median age of 1.5 months (IQR, 1.4–1.6). Among them, 51 (3.6%) were HIV-infected. Overall, 1331 (83.9%) completed the process by returning for the result before 7 months (median age: 2.5 months (IQR, 2.4–3.0)). Incomplete process, that is test not performed, or result of test not provided or provided late to the family, was independently associated with late HIV diagnosis during pregnancy (adjusted odds ratio (aOR) = 1.8, 95%CI: 1.1 to 2.9, p = 0.01), absence of PMTCT prophylaxis (aOR = 2.4, 95%CI: 1.4 to 4.3, p = 0.002), and emergency caesarean section (aOR = 2.5, 95%CI: 1.5 to 4.3, p = 0.001).ConclusionsIn urban areas of Cameroon, HIV-infected women diagnosed sufficiently early during pregnancy opt to benefit from EID whatever their socio-economic, marital or disclosure status. Reduction of non optimal diagnosis process should focus on women with late HIV diagnosis during pregnancy especially if they did not receive any PMTCT, or if complications occurred at delivery.
/CD8؉ ratio seem to depend on gender. Normal lymphocyte subsets values among children from Cameroon differ from reported values in Caucasian and some African populations. The differences observed could be due to genetic and environmental factors coupled with the methodology used. These values could be used as initial national reference guidelines as more data are assembled.
S ince the recognition of the first cases of at the end of 2019 in Wuhan, China, SARS-CoV-2 has spread rapidly across the globe. By late November 2021, almost 260 million confirmed cases, including at least 5 million deaths, had been reported (1). Cases from Africa represent only 3.4% of those cases worldwide (1,2), but serologic surveys demonstrate that the extent of SARS-CoV-2 spread in Africa is higher (3). After the first pandemic wave, overall seroprevalence in Africa was estimated at ≈22%, ranging from <1% to >70% depending on country and study population (3). The few studies reporting data after the second wave in Africa demonstrated a rapid increase to >50% seroprevalence (4-6). Underestimation of CO-VID-19 cases was most likely caused by weak healthcare infrastructure, low or no access to diagnostic testing, and higher proportions of paucisymptomatic or asymptomatic disease related to younger population or cross-reactive immunity from other coronavirus infections. The overall objective of our study was to evaluate the effect of the second wave of COVID-19 on SARS-COV-2 seroprevalence in the general population of Yaoundé, the capital city of Cameroon. The StudyWe conducted 2 population-based seroprevalence surveys in Yaoundé during January 27-February 6, 2021 (survey 1) and April 24-May 19, 2021 (survey 2). We adapted the study design from the World Health Organization population-based age-stratified seroepidemiologic investigation protocol for COV-ID-19 infection, version 2.0 (7). We randomly selected households in 6 of the 7 health districts in Yaoundé, with a probability of being selected proportional to the population number in each enumeration area (Appendix Figure 1, https://wwwnc.cdc.gov/EID/ article/28/6/21-2580-App1.pdf). In 50% of households, we invited all residents to participate; among the remaining 50%, we invited only residents >40 years of age. We calculated sample size to estimate
BackgroundThe consequences of maternal HIV infection for fetal growth are controversial. Here, we estimated the frequency of small for gestational age and gender (SGAG) among neonates born to HIV-infected or uninfected mothers and assessed the contribution, if any, of maternal HIV to the risk of SGAG.MethodsThe data used were obtained from the ANRS-Pediacam cohort in Cameroon. Pairs of newborns, one to a HIV-infected mother and the other to an uninfected mother, were identified during the first week of life, and matched on gender and recruitment site from 2007–2010. SGAG was defined in line with international recommendations as a birth weight Z-score adjusted for gestational age at delivery and gender more than two standard deviations below the mean (−2SD). Considering the matched design, logistic regression modeling was adjusted on site and gender to explore the effect of perinatal HIV exposure on SGAG.ResultsAmong the 4104 mother-infant pairs originally enrolled, no data on birth weight and/or gestational age were available for 108; also, 259 were twins and were excluded. Of the remaining 3737 mother-infant pairs, the frequency of SGAG was 5.3% (95%CI: 4.6–6.0), and was significantly higher among HIV-infected infants (22.4% vs. 6.3%; p<.001) and lower among HIV-unexposed uninfected infants (3.5% vs. 6.3%; p<.001) than among HIV-exposed uninfected infants. Similarly, SGAG was significantly more frequent among HIV-infected infants (aOR: 4.1; 2.0–8.1) and less frequent among HIV-unexposed uninfected infants (aOR: 0.5; 0.4–0.8) than among HIV-exposed uninfected infants. Primiparity (aOR: 1.9; 1.3–2.7) and the presence of any disease during pregnancy (aOR: 1.4; 1.0–2.0) were identified as other contributors to SGAG.ConclusionMaternal HIV infection was independently associated with SGAG for HIV-exposed uninfected infants. This provides further evidence of the need for adapted monitoring of pregnancy in HIV-infected women, especially if they are symptomatic, to minimize additional risk factors for SGAG.
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