Background This last decade’s ongoing conflict in the Central African Republic (CAR) has led to gradual and continuous destruction of health services. With severe gaps in qualified health professionals, community health workers (CHWs) have become essential to ensuring health care access to the affected population. This article aims to evaluate the effectiveness of a 10-y CHW program in the CAR. Methods Routine case management data from CHWs were collected in the Paoua district from January 2012 to December 2017 and analysed. Structured interviews were conducted in the Paoua and Carnot health districts among individuals from three different groups (health service beneficiaries, CHWs and health facility managers). Results From 2012 to 2017, 353 948 people consulted for malaria suspicion with CHWs and 86% were found to be malaria positive after a rapid diagnostic test. Among those diagnosed patients, 98.5% received adequate treatment and nearly 1.5% were referred to health facilities. Also, 94.5% of respondents identified fever as the major malaria symptom. About 70% of the population could identify three malaria signs/symptoms and 84.4% accepted and used CHW services. Interviews with CHWs revealed that 45.8% of them received at least four training sessions per month as part of their capacity building. Conclusions CHWs can be a resourceful solution when other health professional are scarce. This study showed that CHWs are not only able to deliver curative and preventive health services, but they are also well accepted by the served communities.

This is a prospective study conducted as part of a voluntary testing for HBV, HCV and HIV. The aim of the study is to determine the seroprevalence of HBs Ag and anti-HCV antibodies among HIV infected people and a control group of HIV negative people. HIV prevalence among newly diagnosed volunteers is 9.1%. The overall seroprevalence of HBs Ag and anti-HCV antibodies is respectively 13.5% and 2.0%. The seroprevalence of HBs Ag and anti-HCVantibodies in the control group (HIV-negative) is respectively 12.2% and 2%. The seroprevalence of HBs Ag and anti-HCV antibodies among HIV infected people (old and new) is respectively 16.1% and 1%.This study, the first one conducted in Chad, has allowed us to know the seroprevalence of HBs Ag and anti-HCV antibodies among HIV infected people.

Bacterial resistance to antibiotics is a worldwide problem. In Chad, statistical data are scarce. The reason why this study was undertaken from June 2014 to December 2016, to identify the main Enterobacteriaceae responsible for urinary tract infections and their susceptibility to antibiotics. Germs were isolated and identified by standard microbiology methods and tested with antibiotics according to Kirby-Bauer technique. Data collected was analyzed using Excel and Statistical Package for Social Sciences (SPSS) version18.0. Out of the 503 urine samples analyzed, 93 Enterobacteriaceae were isolated (18.5%) of which 60 (64.5%) were Escherichia coli, 23 (24.73%) Klebsiella pneumoniae and 10 (10.75%) were other Enterobacteriaceae. Bacterial resistances to the following were observed: amoxicilline (96.66%-100%), cefoxitine (13.33%-30.4%), cefotaxime (33.3%-56.52%), gentamycine (28.33%-39.13%), and nalidixic acid (31.66%-43.47%), trimethoprim-sulfamethoxazole (65%-95.65%) and fosfomycine (8.33%-13.04%). The present study identified two bacteria associated with urinary tract infections and their resistances to antibiotics commonly used in Chad. It is important to rationalize the use of antibiotics that have good antibacterial activity. Diversified studies in human and veterinary medicine are needed to better control the emergence of new resistance in N'Djamena.

Consumption of street food is growing rapidly in developing countries. Consequently, health problems associated with consumption of street foods exist everywhere and Chad is not an exception, but up to this day, there is limited scientific data on the microbiological quality and safety of foods sold in the street in various regions of the country. The aim of this study is to determine the microbiological quality of some street foods in N'Djamena, Chad: case of sandwiches. A total of 42 samples of sandwiches were collected. These samples were analyzed according to the standard methods of food microbiology. The analysis identified the different germs with respective compliance rates of 14.29% for thermotolerant coliforms, 54.76% for Coagulasepositive staphylococci, 47.62% for Escherichia coli and 19.05% for total mesophilic aerobic flora. The Salmonella compliance rate is 100%. Also yeasts and molds were counted in some samples with an average of 0.80x10 6 CFU/g. There is a significant correlation between MAF and Coagulase-positive staphylococci (p<0.05). The presence of these germs in general and mainly pathogens in sandwiches consumed in N'Djamena, Chad, represent a real public health problem which competent authorities should not neglect.

Dans la perspective de remplacer Immunocomb II Bispot HIV1/2 dans l'algorithme national de dépistage du VIH au Tchad, cinq tests de diagnostics rapides (TDR) étaient sélectionnés et soumis systématiquement à un panel d'échantillons (positif et négatif pour le VIH). Il s'agit de : ABON HIV1/2 O, MP Diagnostics MULTISURE HIV, SD Bioline HIV1/2 3.0, Exacto Pro test HIV et Alere HIV Combo. L'objectif principal de cette étude était de retenir un test rapide efficace et discriminatoire entre le VIH1 et VIH2 comme second test de l'algorithme national, et secondairement revérifier les performances des tests rapides déjà en usage dans notre contexte. Les cinq tests de détection Immunochromatographique étaient réalisés au laboratoire de l'Hôpital Général de Référence Nationale de N'Djamena en respectant les instructions des fabricants. L'étude a porté sur 100 sérums testés négatifs au VIH et 100 sérums des patients positifs au VIH1. Les données de l'évaluation ont été calculées en utilisant le tableau de contingence 2×2 des variables qualitatives nominales. Tous les tests évalués avaient une spécificité de 100%, leur sensibilité a varié de 99 à 100%, leur VPP à 100% et leur VPN de 99 à 100%. Le MULTISURE HIV et SD Bioline HIV1/2 3.0 ont une sensibilité de 99% et une spécificité de 100%. Cependant, des trois tests discriminatoires évalués, seul SD Bioline HIV1/2 3.0, a confirmé 99% de VIH1. Cette étude, a permis d'évaluer les performances des TDR anciens et nouvellement mis sur le marché au Tchad avec des sérums recueillis localement.