The testing of dried blood spots (DBSs) for human immunodeficiency type 1 (HIV-1) proviral DNA by PCR is a technology that has proven to be particularly valuable in diagnosing exposed infants. We implemented this technology for HIV-1 early infant diagnosis (EID) and HIV-1 RNA viral load determination in infants born of HIV-1-seropositive mothers from remote areas in Cameroon. The samples were collected between December 2007 and September 2010. Fourteen thousand seven hundred and sixty-three (14,763) DBS samples from infants born of HIV-positive mothers in 108 sites nationwide were tested for HIV. Of these, 1452 were positive on first PCR analyses (PCR1), giving an overall infection rate of 12.30%. We received only 475 DBS specimen for a second PCR testing (PCR2); out of these, 145 were positive. The median HIV-1 RNA viral load for 169 infant DBS samples tested was 6.85 log copies/ml, with values ranging from 3.37 to 8 log copies/ml. The determination of the viral load on the same DBS as that used for PCR1 allowed us to bypass the PCR2. The viral load values were high and tend to decrease with age but with a weak slope. The high values of viral load among these infants call for early and effective administration of antiretroviral therapy (ART). The findings from this study indicate that the use of DBS provides a powerful tool for perinatal screening programs, improvement on the testing algorithm, and follow-up during treatment, and thus should be scaled up to the entire nation.
Background: The SARS-CoV-2 and associated corona virus disease COVID-19 have been declared a pandemic having a poor prognosis among individuals with debilitating conditions and those who are immune-compromised. Current evidence is however limited on maternal and fetal transmission and pregnancy outcomes. We aimed to describe the pattern of SARS-CoV-2 infection and outcomes in a group of pregnant women followed up at a tertiary care unit in Cameroon. Methods: This was an observational study conducted over a period of 3 months (April 1 to June 30, 2020) at the Yaounde Central Hospital. All pregnant women who were tested positive for SARS-CoV-2 and who provided a signed written informed consent were included in the study. Results: Out of 83 pregnant women who presented with symptoms suspicious of COVID-19, 25 were tested positive. The median age of these women was 31 (27 -35) years. A total of 76% consulted within 6 days of onset of symptoms and 68% had a gestational age greater than 28 weeks. The most common presenting complaint was fever (88%). All 25 pregnant women who were tested positive for COVID-19 were followed up with 9/25 deliveries registered. There were two intra-uterine fetal deaths and seven live births. All the live birth babies were tested negative on Real Time-Polymerase Chain Reaction (RT-PCR) testing which was performed after birth. Conclusion: Deliverance of live and SARS-CoV-2 negative babies from COVID-19 pregnant women is possible.
Introduction: Improvement of critically ill patients Covid 19 positive placed on glucocorticoids may suggest impairment of the adrenal function. Our objective was to evaluate baseline serum cortisol in covid+ patients.Methods: This was a descriptive and analytical cross-sectional study conducted in a population of patients infected with 2019-nCoV in Cameroon. Patients receiving corticosteroids irrespective of the route of administration within 3 months prior to recruitment and those with any hypothalamic-pituitary-adrenal axis disease were excluded. We reviewed the medical records of patients to collect socio-demographic and clinical data. Patients were then sampled at 8 am for serum cortisol assay by the competitive ELISA method. Statistical analyses were performed using the Student's test to compare means. The significance level was set at p<0.05. Results: We included 80 covid+ patients, predominantly males (45, 56.3%) with a mean age of 43±13 years. The co-morbidities found were hypertension (9, 11.3%), diabetes mellitus (7, 8.8%), cardiovascular disease (8, 10%) and obesity (4, 5%). The most common symptoms were asthenia (44, 55%), fever (36, 45%) and respiratory symptoms (75, 93.7%). The non-severe form was the most common (70, 87.5%). Only 12.5% (10) of patients received oxygen therapy within our study. The mean baseline serum cortisol in the series was 279.55 nmol/l±128.68 (min 96.1332 nmol/l; max 665.0521 nmol/l). Sixty-nine patients (86.3%) had baseline cortisol ≤413.79nmol/l, suggesting an insufficient response to stress. No statistically significant association was found between serum cortisol and disease severity.Conclusion: The absence of a marked rise of cortisol during COVID-19 suggests possible involvement of the hypothalamic-pituitary-adrenal axis in this infection.
Résumé But Décrire les aspects cliniques et thérapeutiques des urgences andrologiques reçues en milieu urbain dans un centre hospitalo-universitaire du Cameroun. Nous avons réalisé une étude prospective sur une période de 36 mois, recrutant toutes les urgences andrologiques reçues à l’hôpital Laquintinie de Douala. Résultats Nous avons recensé 291 patients d’âge moyen de 42,50 ans. La majorité des patients (73,53 %) avait un âge compris entre [0–45] ans. Les affections les plus fréquentes étaient les traumatismes des organes génitaux externes (OGE) (51,50 %) et les infections urogénitales (23,71 %). Le priapisme et la torsion du cordon spermatique (TCS) ont également été retrouvés. Parmi les urgences reçues, 185 ont nécessité des interventions chirurgicales. L’exploration et la suture des plaies des OGE (38,91 %) et la scrototomie exploratrice (21,62 %) étaient les principaux gestes effectués. Conclusion Les traumatismes des OGE sont la principale urgence andrologique en milieu urbain au Cameroun. Des cas d’infections urogénitales, de priapisme et de TCS sont également rencontrés.
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