This experience demonstrates that VCT for HIV infection is feasible in Central Africa.

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L'hépatite virale C est un problème majeur de santé publique avec 170 millions de personnes infectées de par le monde. La prévalence mondiale de l'hépatite chronique virale C est estimée à 3 % avec des extrêmes allant de 0,4 % dans certains pays occidentaux à 22 % en Égypte et dans certains pays africains [1]. En Afrique de l'Ouest, plusieurs études multicentriques ont été faites depuis le début des années 1990 et portaient le plus souvent sur la séroprévalence et les diversités génotypiques [2]. Au Bénin, une séroprévalence de 2,3 AE 1,2 % a été trouvée en 1991 [3] chez 349 donneurs de sang, et de 0,7 AE 0,9 % chez 147 femmes enceintes en 1995 ; elle a été établie à 20 % chez des drépanocytaires polytransfusées en 1995 [4].

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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Infection with Helicobacter pylori (H. pylori) is common in developing countries such as Benin. This germ can cause several gastroduodenal diseases such as gastritis, ulcer, adenocarcinoma or gastric MALT lymphoma. This study aimed to determine the prevalence of H. pylori infection and gastric pre-neoplastic histological lesions in patients admitted for upper gastrointestinal endoscopy (UGE) and to identify factors associated with this infection.Methods: This was a cross-sectional descriptive and analytical study, with prospective data collection, conducted from October 2014 to December 2015. We included all patients admitted to Menontin Hospital for UGE in whom a gastric biopsy has been done. H. pylori research was conducted in anatomy-pathology, either in a medical laboratory in Cotonou or at the CERBA laboratory in Paris, France, depending on the patient's choice. The microscopic study was carried out after staining with Haematoxyline-Eosine-Safran (HES) and the search for H. pylori using Giemsa staining.Results: H. pylori was investigated in 137 patients, 67 men (48.9%) and 70 women (51.1%). The mean age was 48.3±14.6years with extremes of 10 and 83years. Some patients had had at least one previous H. pylori eradication treatment (63 cases or 46%). For the general population, the test was positive in 98 cases, i.e. a prevalence of 71.5%. Depending on whether or not patients had been pre-treated for H. pylori, the test was positive in 40 out of 63 (63.5%) pre-treated patients, versus 58 out of 74 (78.4%) patients who were naïve to any eradication treatment (p=0.057). The pre-neoplastic lesions noted were gastric atrophy in 35 patients (including 25 H. pylori positive), intestinal metaplasia in 13 patients (including 10 H. pylori positive) and low grade dysplasia in 14 patients (including 12 H. pylori positive); high grade dysplasia was found in one patient who was H. pylori negative. Only the type of prior eradicant treatment appeared to be associated with H. pylori infection (p=0.182). Conclusion:H. pylori infection is common in our patients admitted for upper gastrointestinal endoscopy. Gastric atrophy was the most common pre-neoplastic lesion.