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Background In December 2019, the COVID-19 outbreak began in China and quickly spread throughout the world and was reclassified as a pandemic in March 2020. The first case of COVID-19 was declared in Togo on March 5. Two months later, few data were available to describe the circulation of the new coronavirus in the country. Objective This survey aimed to estimate the prevalence of SARS-CoV-2 in high-risk populations in Lomé. Materials and methods From April 23, 2020, to May 8, 2020, we recruited a sample of participants from five sectors: health care, air transport, police, road transport and informal. We collected oropharyngeal swabs for direct detection through real-time reverse transcription polymerase chain reaction (rRT-PCR) and blood for antibody detection by serological tests. The overall prevalence (current and past) of infection was defined by positivity for both tests. Results A total of 955 participants with a median age of 36 (IQR 32–43) were included, and 71.6% (n = 684) were men. Approximately 22.1% (n = 212) were from the air transport sector, 20.5% (n = 196) were from the police sector, and 38.7% (n = 370) were from the health sector. Seven participants (0.7%, 95% CI: 0.3–1.6%) had a positive rRT-PCR test result at the time of recruitment, and nine (0.9%, 95% CI: 0.4–1.8%) were seropositive for IgM or IgG against SARS-CoV-2. We found an overall prevalence of 1.6% (n = 15), 95% CI: 0.9–2.6%. Conclusion The prevalence of SARS-CoV-2 infection among high-risk populations in Lomé was relatively low and could be explained by the various measures taken by the Togolese government. Therefore, we recommend targeted screening.

Introduction:The extent of neuromeningeal cryptococcosis (NMC) has increased since the advent of HIV/AIDS. It has non-specific clinical signs but marked by high mortality.Objective:To analyze the characteristics of the NMC in sub-Saharan Africa.Materials and Methods:We have conducted a literature reviewed on the NMC in sub-Saharan Africa from the publications available on the basis of national and international data with keywords such as “Cryptococcus, Epidemiology, Symptoms, Outcomes and Mortality” and their equivalent in French in July 2011. All publications from 1990 to 2010 with 202 references were analyzed. The following results are the means of different studied variables.Results:We selected in final 43 publications dealing with the NMC which 24 involved 17 countries in Africa. The average age was 36 years old. The average prevalence was 3.41% and the average incidence was 10.48% (range 6.90% to 12%). The most common signs were fever (75%), headaches (62.50%) and impaired consciousness. Meningeal signs were present in 49% of cases. The mean CD4 count was 44.8cells/mm3. The India ink and latex agglutination tests were the most sensitive. The average time before the consultation and the hospital stay was almost identical to 27.71 days. The average death rate was 45.90%. Fluconazole has been the most commonly used molecule.Conclusion:The epidemiological indicators of NMC varied more depending on the region of sub-Saharan Africa. Early and effective taking care of patients to reduce diagnostic delay and heavy mortality remains the challenges.

ObjectivesThe relationship between lopinavir trough plasma concentration at baseline and virological efficacy 3 months after the beginning of the therapy was investigated in an unselected cohort of HIV-1-infected patients MethodsAccording to initial trough lopinavir plasma level, patients were classified into three groups: the subtherapeutic group (o3 mg/L, n 5 18), the therapeutic group (between 3 and 8 mg/L, n 5 50) and the toxic group (48 mg/L, n 5 16). The virological response after 3 months of lopinavir treatment, defined as a viral load o200 HIV-1 RNA copies/mL, was compared amongst these groups. ResultsThe virological response was significantly different (Po0.05) between the subtherapeutic group (22.% of patients with viral loado200 copies/mL) and the other groups (56.0% of patients with a viral loado200 copies/mL in the therapeutic group and 56.2% in the toxic group). ConclusionsA lower virological efficacy should be expected for experienced or naive patients with plasma trough lopinavir concentrationso3 mg/L at the beginning of treatment.

BackgroundInfection with Penicillium marneffei is a common opportunistic infection in Southeast Asia where it is endemic. We report a case of Penicillium marneffei infection with fatal outcome in a Togolese woman infected with Human Immunodeficiency Virus (HIV).Case presentationA 45-years-old patient, infected with Human Immunodeficiency Virus had consulted for ongoing febrile pneumonia since two weeks. Clinical examination revealed fever of 38.5°C, dyspnea, pulmonary syndrome condensation and papulo-nodular of “molluscum contagiosum” like lesions located on the face, arms, neck and trunk. Sputum smear was negative for tuberculosis. The chest radiograph showed reticulonodular opacities in the right upper and middle lobes and two caves in the right hilar region. The CD4 count was 6 cells/mm3 after a year of antiretroviral treatment (Zidovudine-Lamivudine-Efavirenz). She was treated as smear negative pulmonary tuberculosis after a lack of gentamicin and amoxicillin plus clavulanic acid response. Culture of skin samples and sputum had revealed the presence of P. marneffei. A treatment with ketoconazole 600 mg per day was initiated. After two weeks of treatment, there was a decrease in the size and number of papules and nodules, without any new lesions. We noted disappearance of cough and fever. The chest X-ray showed a decrease of pulmonary lesions. There was no reactivation of P. marneffei infection but the patient died from AIDS after two years of follow up.ConclusionWe report a case of P. marneffei infection in a HIV-infected patient in a non-endemic country. Clinicians should think of P. marneffei infection in all HIV-infected patients with “molluscum contagiosum” like lesions.

Objective: This survey aims at estimating the prevalence of SARS−CoV−2 in high risk populations in Lom&eacute. Methods: From April 23rd to May 8th 2020, we recruited a sample of participants from five sectors: healthcare, air transport, police, road transport and informal. We collected oropharyngeal swab for direct detection through real time reverse transcription polymerase chain reaction (rRT−PCR), and blood for antibodies detection by serological tests. The overall prevalence (current and past) of infection was defined by positivity for both tests. Results: A total of 955 participants with a median age of 36 (IQR 32−43) were included and 71.6% (n=684) were men. Around 22.1% (n=212) were from the air transport sector, 20.5% (n=196) in the police, and 38.7% (n=370) in the health sector. Seven participants (0.7%, 95% CI: 0.3−1.6%) had a positive rRT-PCR at the time of recruitment and nine (0.9%, 95% CI: 0.4−1.8%) were seropositive for IgM or IgG against SARS-CoV-2. We found an overall prevalence of 1.6% (n=15), 95% CI: 0.9−2.6%. Conclusion: The prevalence of the SARS−CoV−2 infection among high-risk populations in Lom&eacute was relatively low and could be explained by the various measures taken by the Togolese government. Therefore, we recommend targeted screening.

As a follow-up to the first AfroREB (Africa Rabies Expert Bureau) meeting, held in Grand-Bassam (Côte-d'Ivoire) in March 2008, African rabies experts of the Afro-REB network met a second time to complete the evaluation of the rabies situation in Africa and define specific action plans. About forty French speaking rabies specialists from Northern, Western and Central Africa and Madagascar met in Dakar (Senegal), from March 16th to 19th, 2009. With the participation of delegates from Tunisia, who joined the AfroREB network this year, 15 French speaking African countries were represented. Experts from the Institut Pasteur in Paris, the Alliance for Rabies Control, and the Southern and Eastern African Rabies Group (SEARG, a network of rabies experts from 19 English speaking Southern and Eastern African countries) were in attendance, to participate in the discussion and share their experiences. AfroREB members documented 146 known human rabies cases in all represented countries combined for 2008, for a total population of 209.3 million, or an incidence of 0.07 cases per 100,000 people. Even admitting that the experts do not have access to all reported cases, this is far from the WHO estimation of 2 rabies deaths per 100,000 people in urban areas and 3.6 per 100,000 in rural Africa. It was unanimously agreed that the priority is to break the vicious cycle of indifference and lack of information which is the main barrier to human rabies prevention.

Introduction: Dyslipidemia is a significant cardiovascular risk factor in patients living with HIV (PLWHIV). Few data are available in Togo. Objective: The purpose of this study is to assess the prevalence of dyslipidemia and associated factors in PLWHIV on Highly Active Antiretroviral Therapy (HAART). Methods: This is a descriptive and analytical cross-sectional study of patients followed at the Sylvanus Olympio University Hospital's infectious diseases department for six months. The study population consisted of any PLWHIV patient on HAART over 18 years of age who had been regularly monitored and had a serum lipid fraction assay. Results: Two hundred and eighty-four patients were included. 75.4% were women. The median age was 46 years (IQR: 39 -52) and the median CD4 count was 461 cel/U1 (IQR: 330 -607). Eighty-three percent of the patients had suppressed viral load. The median duration of follow-up under antiretroviral treatment antiretroviral treatment was 4.18 years (IQR: 2 -7). The prevalence of dyslipidemia was 72.5%. HDL hypocholesterolemia (HDL-c < 40 mg/dl) was the most represented dyslipidemia in 49.6%. Body mass index, past treated tuberculosis, HAART regimen substitution, abdominal obesity, past smoking and being exposed to Nucleoside reverse transcriptase inhibitors (NRITs) were found to be factors associated to dyslipidemia. Conclusion: Our study revealed a high prevalence of How to cite this paper: Moukaila, A.