Jacques Simpore

Self-collected vaginal sampling for the detection of genital human papillomavirus (HPV) using careHPV among Ghanaian women

BackgroundDetection of genital HPV DNA is recommended as an important strategy for modern cervical cancer screening. Challenges include access to services, the reliance on cervical samples taken by clinicians, and patient’s preference regarding provider gender. The objective of this research was to determine the acceptability, feasibility and performance of alternative self-collected vaginal samples for HPV detection among Ghanaian women.MethodsA comparative frequency-matched study was conducted in a systematic (1:5) sample of women attending HIV and outpatient clinics in the Cape Coast Teaching Hospital, Ghana. Participants were instructed on self-collection (SC) of vaginal samples using the careHPV brush and a clinician-collected (CC) cervical sample was obtained using a similar brush. Paired specimens were tested for HPV DNA (14 high-risk types) by careHPV assay (Qiagen) and by HPV genotyping (Anyplex II, Seegene).ResultsOverall, 194 women of mean age 44.1xa0years (SDxa0±xa011.3) were enrolled and 191 paired SC and CC results were analysed. The overall HPV detection concordance was 94.2% (95%CI: 89.9–97.1), Kappa value of 0.88 (pxa0<xa00.0001), showing excellent agreement. This agreement was similar between HIV positive (93.8%) and negative (94.7%) women. Sensitivity and specificity of SC compared to CC were 92.6% (95%CI: 85.3–97.0) and 95.9% (95%CI: 89.8–98.8) respectively. The highest sensitivity was among HIV positive women (95.7%, 95%CI: 88.0–99.1) and highest specificity among HIV negative women (98.6%, 95%CI: 92.4–100). Overall, 76.3% women found SC very easy/easy to obtain, 57.7% preferred SC to CC and 61.9% felt SC would increase their likelihood to access cervical cancer screening.ConclusionsThe feasibility, acceptability and performance of SC using careHPV support the use of this alternative form of HPV screening among Ghanaian women. This could be a potential new affordable strategy to improve uptake of the national cervical cancer screening program.

Molecular Epidemiology of Rotavirus in Children under Five in Africa (2006-2016): A Systematic Review

Group A human rotaviruses (RVA) are the most common causes of severe viral gastroenteritis in infants and young children worldwide. The available vaccines, while effective in Europe and North America have shown a reduced efficacy in Africa. One issue raised is the genetic variability of RVA. The objective of this study was to perform a literature review of molecular epidemiology to determine the prevalence of RVA genotypes circulating in Africa so as to establish a mapping of reliable data on these various genotypes. The search for articles was done from the National Institutes of Health (PUBMED) using three set of keywords. Articles were selected with inclusion criteria such as the date of publication, the age of the children, the sample size and the diagnostic techniques (standardized laboratory techniques). The data were imported into STATA SE version 11 software. Specific prevalence was estimated with Confidence Intervals (CI) of 95%. A total of 326 published studies were initially retrieved, out of which 27 studies were finally selected for the systematic review. The selected studies cover 20 African countries. The most encountered genotypes in Africa during this period were G1 (32.72%), followed by G2 (17.17%), G3 (9.88%), G9 (8.61%) and G12 (7.56%) among the G-types. The most common P-types were P[8] (48.71%) followed by P[6] (22.60%) and P[4] (11.58%) and the G1P[8] combination (22.64%) was the most encountered followed by G2P[4] (8.29%), G9P[8] (6.95%) and G2P[6] (5.00%). North Africa presented the highest prevalence of the P[8] genotype (65.70%). This review provides a comprehensive view of the current circulating rotavirus strains in Africa, which can be important in light of the new rotavirus vaccinations. Indeed, in Africa, the pursuit of national and continental studies for epidemiological surveillance of circulating rotavirus strains is vital for the promotion of future successful vaccines.

Options in human papillomavirus (HPV) detection for cervical cancer screening: comparison between full genotyping and a rapid qualitative HPV-DNA assay in Ghana.

BackgroundModern cervical cancer screening increasingly relies on the use of molecular techniques detecting high-risk oncogenic human papillomavirus (hr-HPV). A major challenge for developing countries like Ghana has been the unavailability and costs of HPV DNA-based testing. This study compares the performance of careHPV, a semi-rapid and affordable qualitative detection assay for 14xa0hr-HPV genotypes, with HPV genotyping, for the detection of cytological cervical squamous intraepithelial lesions (SIL).MethodsA study comparing between frequency matched HIV-1 seropositive and HIV-seronegative women was conducted in the Cape Coast Teaching Hospital, Ghana. A systematic sampling method was used to select women attending clinics in the hospital. Cervical samples were tested for HPV by careHPV and Anyplex-II HPV28 genotyping assay, and by conventional cytology.ResultsA total of 175 paired results (94 from HIV-1 seropositive and 81 from HIV-seronegative women) were analyzed based on the ability of both tests to detect the 14xa0hr-HPV types included in the careHPV assay. The inter-assay concordance was 94.3% (95%CI: 89.7–97.2%, kappau2009=u20090.88), similar by HIV serostatus. The careHPV assay was equally sensitive among HIV-1 seropositive and seronegative women (97.3% vs. 95.7%, pu2009=u20090.50) and slightly more specific among HIV-seronegative women (85.0% vs. 93.1%, pu2009=u20090.10). careHPV had good sensitivity (87.5%) but low specificity (52.1%) for the detection of low SIL or greater lesions, but its performance was superior to genotyping (87.5 and 38.8%, respectively). Reproducibility of careHPV, tested on 97 samples by the same individual was 82.5% (95%CI: 73.4–89.4%).ConclusionsThe performance characteristics of careHPV compared to genotyping suggest that this simpler and cheaper HPV detection assay could offer a suitable alternative for HPV screening in Ghana.

Sero-prevalence and risk factors for hepatitis E virus infection among pregnant women in the Cape Coast Metropolis, Ghana

Background Hepatitis E virus is an emerging infection in Africa with poor maternal and foetal outcomes. There is scanty data on the sero-prevalence of HEV infection among pregnant women in Ghana. This study highlighted the prevalence and risk factors associated with HEV infection among pregnant women in Cape Coast Metropolis, Central Region of Ghana. Methods A multicenter (3 selected sites) analytical cross sectional study involving 398 pregnant women in the Cape Coast metropolis was conducted. HEV (Anti-HEV IgG and Anti-HEV IgM) ELISA was performed. Sero-positive women had liver chemistries done and data collected on maternal and neonatal outcomes. Data analyses were performed using Stata version 13 software (STATA Corp, Texas USA). Results Mean age was 28.01 (± 5.93) years. HEV sero-prevalence was 12.2% (n = 48) for IgG and 0.2% (n = 1) for IgM with overall of 12.3%. The odds of being HEV sero-positive for women aged 26–35 years was 3.1 (95% CI: 1.1–8.1), p = 0.02 and ≥36 years it was 10.7 (95% CI; 3.4–33.5), p = 0.0001. Living in urban settlement was associated with lowest odds of HEV infection {OR 0.4 (95% CI; 0.2–0.8), p = 0.01}. Factors with no statistical evidence of association include main source of drinking water and history of blood transfusion. The sero-prevalence of HEV IgG increased progressively across trimesters with the highest among women in their third trimester (55.3%). None of the 49 HEV sero-positive women had elevated ALT level. Ten (N = 41) of the neonates born to sero-positive women developed jaundice in the neonatal period. The mean birth weight was 3.1kg (SD 0.4). Conclusion HEV sero-prevalence among pregnant women in the Cape Coast Metropolis is high enough to deserve more attention than it has received so far. It is therefore important to conduct further research on the potential impact on maternal and neonatal mortality and morbidity in Ghana.

Molecular Epidemiology of High-Risk Human Papillomavirus in High-Grade Cervical Intraepithelial Neoplasia and in Cervical Cancer in Parakou, Republic of Benin

Human papilloma virus (HPV) infection remains a worldwide concern, especially in Sub-Saharan Africa where cervical cancer is the leading cause of cancer death in women. The aim of the study was to determine the prevalence and genotypic distribution of High-Risk HPV (HR-HPV) involved in Cervical Intraepithelial Neoplasia (CIN) II and III and in cervical cancer in Parakou. Out of a total of 149 samples of cervical tissues archived, fixed and paraffin-embedded, 78 samples with histological diagnosis of CIN-II, CIN-III and cervical cancer went through deparaffinization with xylene, followed by an extraction of HPV DNA and the detection of HR-HPV by real-time multiplex PCR. The average age of the women was 40.05±13.99 years. The samples were positive to at least one HR-HPV genotype in 76.92% (50/65) of cases. The HR-HPV genotypes which are most common in the cervical cancer and in CIN-II and III were, respectively HPV-39 (38 and 37.50%), HPV-18 (35 and 31.30%), HPV-45 (35 and 31.30%), HPV-35 (9 and 25%) and HPV-52 (9 and 12.50%). The HPV-16 was absent. This study helped to detect (in samples archived, fixed and paraffin-embedded tissues) HR-HPV involved in high-grade precancerous lesions and in cervical cancer in Parakou, some of which are not covered by currently available vaccines.

Oncogenic Human Papillomavirus Infection and Genotype Characterization among Women in Orodara, Western Burkina Faso

BACKGROUND AND OBJECTIVEnCervical cancer usually occurs several years after persistent infection with oncogenic or high-risk human papillomavirus. The objective of this study was to determine carriage of 14 genotypes of high-risk human papillomavirus among women at Orodara and then characterize the genotypes found in these women.nnnMATERIALS AND METHODSnFrom June to July 2015, 120 women from the general population were recruited in the health district of Orodara. They voluntarily agreed to participate in the study. Endocervical samples were taken from these women prior to screening for precancerous lesions by visual inspection with acetic acid and lugols iodine. Identification of high-risk human papillomavirus genotype was done using real-time PCR.nnnRESULTSnHigh-risk human papillomavirus prevalence was 38.3% and the most common genotypes were HPV 52 (25.4%), HPV 33 (20.6%) and HPV 59 (11.1%). The HPV 66 was also identified with a prevalence of 9.5%.nnnCONCLUSIONnThe HPV 16 and HPV 18 which are frequently associated with cancer worldwide were not found among the most frequent oncogenic HPV in women in Orodara.

World hepatitis day in Burkina Faso, 2017: seroprevalence and vaccination against hepatitis B virus to achieve the 2030 elimination goal

BackgroundBurkina Faso is a high endemicity country for HBV infection. However, there are few data on vaccine coverage against HBV. The aim of this study was to contribute to the improvement of HBV vaccine coverage in Ouagadougou through HBV screening.MethodsAwareness campaigns and voluntary hepatitis B screening were organized in the twelve districts of Ouagadougou by the “SOS Hepatitis Burkina” association. A rapid HBsAg detection test (Abon Biopharma Guangzhou, Co., Ltd. Chine) was performed on 2216 individuals, who voluntarily answered a series of questions. Vaccination against hepatitis B was proposed to HBV negative participants.ResultsIn a sample of 2216 participants, aged 1 to 78xa0years (mean age 29.7u2009±u200914.7xa0years); a prevalence of 10.4% (230/2216) of HBsAg was obtained. This prevalence was high in the age groups 31 to 40xa0years (14.5%) and 41 to 50xa0years (15.0%). The prevalence of HBV was higher in the sixth district (14.3%) of Ouagadougou. At the end of the screening, 1202/1986 HBV negative participants were vaccinated, resulting in a vaccination rate of 60.5%. Vaccination coverage ranged from 44.5 to 73.7% all twelve districts.ConclusionsThis study still reports a high prevalence of HBV infection among young people with a peak in the sixth district of Ouagadougou. The study achieved high vaccination coverage in all age groups and districts of Ouagadougou.Trial registrationThe present study has been approved by the Ethics Committee for Health Research of Burkina Faso. CERS201501006 Registered 14 January 2015.

Oncogenic human papillomavirus infection and genotypes characterization among sexually active women in Tenkodogo at Burkina Faso, West Africa

Objective This study was conducted to determine the prevalence and distribution of high-risk human papillomavirus (HR-HPV) genotypes among sexually active women in Tenkodogo, Burkina Faso. Methods Among 131 sexually active women attending the Tenkodogo Urban Medical Center, endocervical samples were collected prior to screening for precancerous lesions. After viral DNA extraction, fourteen HR-HPV genotypes were characterized by real-time multiplex PCR in these cervical samples. Results The mean age was 35.5u202f±u202f9.5 years. Of the 131 women, 45 were infected with at least one HR-HPV genotype. The prevalence of HR-HPV infection among these women was 34.4%. Among the 45 oncogenic HPV-infected women, single HR-HPV genotype was found in 55.6% while 44.4% were infected with more than one HR-HPV genotype. The most frequent genotypes were HPV56 (36.5%), HPV66 (36.5%). Conclusion Tenkodogo women included in this study had a higher prevalence of HPV 56, HPV 66. A larger study with a more representative sample would therefore be needed to determine predominant oncogenic genotypes in the subregion and especially in cancer cases.

Garlic as Alternative Therapy to Treat Uropathogene Bacteria in Women with Urinary Tract Infection in Lomé, Togo

The urinary tract infection (UTI) is the most common bacterial infection, especially in women. The increased incidence of UTIs, at the last decades have paralleled with the growing emergence of antibiotic resistance. The aim is to evaluate aqueous garlic extract (AGE) susceptibility against multidrug-resistant (MDR) bacteria isolated in urine of women. The investigation of antibacterial propriety and time kill effect of AGE was performed by the well method, microdilution method and spectrophotometer assay. Antibiotics susceptibility assay revealed that the nine MDR bacteria had high resistance against Amoxicillin/ clavulanic acid (100%) and Erythromycin (100%), Cefotaxime (83.33%) and Ceftazidime (83.33%). AGE exhibited potent antibacterial activity against the nine MDR bacteria tested. In Gram-negative bacteria, the inhibition diameters ranged from 20 ± 3 to 32 ± 4 mm, with Minimum Inhibitory Concentrations (MICs) ranging from 10% to 12.5% (w/v) and Minimum Bactericidal Concentration (MBCs) was 12.5 % (w/v). Gram-positive bacteria exhibited diameters ranging from 38 ± 2 to 45 ± 1 mm; MIC and MBC values ranged from 05 to 10 % (w/v) and were found more susceptible than Gram-negative bacteria. To conclude, this investigation shown that AGE have high potential antibacterial to use as an alternative to treat women UTIs.

Prevalence, genetic variants and clinical implications of G-6-PD deficiency in Burkina Faso: a systematic review

BackgroundIt is now well-known that some antimalarials such as primaquine may induce severe hemolytic anemia in people with G-6-PD deficiency. Antimalarial drug prescriptions must, therefore take into account the patient’s G-6-PD status in malaria endemic areas such as Burkina Faso, where the prevalence of this genetic abnormality is relatively high. Although great clinical heterogeneity is observed depending on the molecular nature of the deficiency and the residual enzyme activity in the red blood cell, there is very poor data on the prevalence of G-6-PD deficiency and the distribution of involved genetic variants in Burkina Faso. In this systematic review, we present a synthesis of the various studies carried out on the G-6-PD deficiency in Burkina Faso in order to determine its prevalence, probable distribution of the genetic variants involved and their clinical implications for a national systematic screening policy among the groups most vulnerable to malaria.MethodsA systematic review was carried out to analyze available published data on the prevalence, phenotypes and mutations responsible for G-6-PD deficiency in Burkina Faso. The key words used were “G-6-PD deficiency AND Burkina Faso” or “Déficit en G-6-PD AND Burkina Faso” in French. To identify the relevant articles, two independent reviewers reviewed the titles, abstracts and the full text of the selected papers.ResultsAn average prevalence of 16.6% (183/1100; CI 95%: 0.145–0.190) and 6.5% (69/1066; CI 95%: 0.051–0.081) of G-6-PD deficiency was found respectively in men and women in this systematic review. Although the predominance (99.8% of G-6-PD deficient cases) of 202A/376G G-6-PD A- variant, the Santamaria and Betica Selma variants were identified in Burkina Faso. Independently of the method used, the enzymatic deficiency was significantly higher in males (2.5–20.5%) compared to females (3.3–12.3%).ConclusionThis systematic review suggests that despite the ubiquity of the 202A/376G G-6-PD A- variant in Burkina Faso, it will be necessary to consider the Santamaria and Betica Selma variants although their frequencies remain to be specified. A systematic screening of the G-6-PD deficiency is also needed to prevent the occurrence of iatrogenic hemolytic accidents.RésuméContexteIl est. actuellement bien connu que certains antipaludiques comme la primaquine, peuvent induire des crises d’anémie hémolytique graves chez les personnes présentant un déficit en G-6-PD. Les prescriptions de médicaments antipaludiques doivent donc tenir compte du statut G-6-PD du patient dans les zones d’endémie du paludisme comme le Burkina Faso où la prévalence de cette anomalie génétique est. relativement élevée. En dépit d’une grande hétérogénéité clinique observée selon la nature moléculaire du déficit et l’activité résiduelle de l’enzyme dans le globule rouge, il existe très peu de données sur la prévalence du déficit en G-6-PD et la distribution des variants génétiques en cause au Burkina Faso. Dans cette revue de la littérature nous présenterons la synthèse des différents travaux réalisés sur le déficit en G-6-PD au Burkina Faso afin de déterminer sa prévalence, la distribution probable des variants génétiques en cause et leurs implications cliniques en vue d’une politique nationale de dépistage systématique au sein des groupes les plus vulnérables au paludisme.MéthodesUne revue systématique a été réalisée pour analyser les données publiées disponibles sur la prévalence, les phénotypes et les mutations du déficit en G-6-PD au Burkina Faso Les mots clés utilisés étaient « G6PD deficiency AND Burkina Faso » en anglais ou « Déficit en G6PD AND Burkina Faso en français ». Pour identifier les articles pertinents, deux examinateurs indépendants ont examiné les titres, les résumés et le texte intégral des articles retenus.RésultatsUne prévalence moyenne de 16,6% (183/1100; IC 95%: 0,145–0,190) et 6,5% (69/1066; IC 95%: 0,051–0,081) du déficit en G-6-PD a été observée respectivement chez les hommes et les femmes dans cette revue systématique. Malgré la prédominance (99,8% des cas de déficients en G-6-PD) du variant G-6-PD A- 202A/376G, les variants Santamaria et Betica Selma ont été identifiées au Burkina Faso.Indépendamment de la méthode utilisée, la prévalence du déficit enzymatique était significativement plus élevée chez les hommes (2,5–20,5%) comparativement aux femmes (3,3–12,3%).ConclusionCette revue systématique suggère qu’en dépit de l’ubiquité du variant G-6-PD A- 202A/376G au Burkina Faso, il est. nécessaire de prendre en compte les variants Santamaria et Betica Selma, bien que leurs fréquences restent à préciser. Un dépistage systématique de la déficience en G-6-PD est. également nécessaire pour prévenir la survenue d’accidents hémolytiques iatrogènes notamment chez les populations les plus vulnérables au paludisme.