Background Little is known about virological responses to early combined antiretroviral therapy (cART) in HIV-infected infants in limited-resource settings. We estimated the probability of achieving viral suppression within two years of cART initiation, and investigated the factors associated with success.

Objective: Urinary tract infection (UTIs) in child is a serious public health problem especially in developing countries. This study aimed at identifying factors associated with urinary tract infection and determining their diagnosis performances as well as resulting algorithms among Cameroonian under-five. Methods: A descriptive and analytical cross sectional study took place from May 2013 to March 2014 at Pediatrics Department of the Bonassama District hospital in the town of Douala. Urine samples were collected dependent on the age of children and its aptitude to micturate. Ten microliters (10 µL) of urine specimen were cultured at 37°C for 24-48 hours. In addition, sociodemographic, anthropometric, clinic and biological information of each child were documented. Results: The prevalence of UTI was 32.2% (129/400) which was mainly caused by Escherichia coli (41.1%). A total of four risk factors for UTI were found after adjustment for all pertinent characteristics of children. These included female gender (ARR= 0.55; p= 0.0046), presence of fever (ARR = 1.83; p= 0.0426), trouble urine (ARR = 1.36; p= 0.0063) and presence of nitrites in urine (ARR = 1.09; p= 0.0001). Presence of nitrites was the most discriminant parameter based on specificity (98.1%), positive predictive value (95.4%) and negative predictive value (90.1%). The diagnosis performances have gradually improved with the increasing number of parameters. Conclusion: This study reported four factors associated with increased risk for UTI. This also outlined that the presence of nitrites in urine had best diagnosis performances and different predictors-based clinical algorithms could be helpful especially in the identification of UTI-negative children.

Introduction: Malnutrition is characterised by metabolic disturbances identified by measurement of anthropometric and biological parameters. The purpose of this study was to determine the nutritional profile of children living in orphanages and to investigate the factors associated with malnutrition in these institutions.Methods: A cross-sectional study was conducted on subjects aged 0 to 18, living in 13 orphanages in Douala. Sociodemographic data, anthropometric and biological parameters were collected. The diagnosis of malnutrition at the clinical level was based on Z score <-2 for the different index and >2 for Weight-for-Height and Body Mass Index for Age. A blood sample permits the photometric assay of albumin, pre-albumin, and C Reactive Protein. The results were interpreted according to reference values for age.Results: Among the 176 children included, the average age was 10±4 years with a male predominance. The majority of children (51.1%) were placed in orphanages for lack of financial resources, and one or both parents orphaned were 42.1%. The wasting, underweight and stunting rates were 5.6%, 4.7%, and 18.2%, respectively. Hypo-pre-albuminemia and hypo-albuminemia were observed in 42.6% and 34.7% of children respectively. CRP was increased in 5.1% of cases. Stunting and orphanages with one caregiver for more than 5 children were predictive factors for hypoalbuminemia and Hypo-pre-albuminemia. Conclusion:Rates of wasting, stunting and underweight were high. Several children had sub-clinical malnutrition despite normal anthropometric index. These results recall the importance of biology for screening, in order to prevent the occurrence of clinical malnutrition.

Background Achieving the UNAIDS 95% sustained viral suppression (VS) rate requires considerable global efforts, particularly among adolescents living with HIV (ALHIV) who are often associated with high rates of virological failure (VF). In this study, we prospectively assessed the rate of VS, and the factors associated with VF in a cohort of adolescents followed up according to the WHO guidelines in Cameroon. Methods A cross-sectional study was carried out in 2021 among adolescents (aged 10–19 years) receiving ART in the national program in Cameroon. Socio-demographic and clinical data were collected using patients’ medical files and a brief interview with the participant and/or his guardian. Thereafter, a first viral load test (VL1) was performed using the ABBOTT Platform. For adolescents with VL1 > 1000 copies/ml, adherence-enhancing interventions were routinely performed each month for 3 consecutive months, after which a second viral load (VL2) was measured. Adolescents with VL2 > 1000 copies/ml were considered in VF. Results Overall, 280 adolescents were enrolled, of whom 89.3% (250/280) acquired HIV infection via mother-to-child transmission. The median age was 16.0 (IQR: 13.0–18.0) years and the median duration on ART was 9.8 (IQR: 5.1–12.8) years. Females and males were almost equally represented, as 52.1% (146/280) were female, while 47.9% (134/280) were males (p = 0.47). The VS rate was 88.2% (CI: 83.8-91.7%) overall; 89.0% (CI: 82.0-93.1%) and 88.7% (CI: 81.2-93.0%) in females and males, respectively. Being on second or third-line ART, self-declared suboptimal adherence, and a history of past VF were independently associated with VF. Conclusion The high rate of VS we report in this study is welcome in the era of the 95/95/95 UNAIDS goals, and indicates that improving treatment outcomes in this specific and fragile population that represent adolescents in Sub-Saharan Africa is achievable. Trial registration 20/10/2020 NCT04593979 (https://clinicaltrials.gov/ct2/show/NCT04593979).

Background: Viral load (VL) monitoring in the clinical follow-up of HIV patients to detect treatment failure is not routinely offered in Cameroon. The study was designed to characterize virological response on antiretroviral treatment (ART) among adults living with HIV and to identify predictors of virological failure (VF). Methods: Between November 2014 and January 2016, a prospective, population-based cohort study was conducted among HIV-positive adults under first-line treatment and monitored at the Accredited HIV Care Center (AHCC) of Laquintinie Hospital of Douala. Clinical and biological data at the initiation of ART were collected from patients' medical records. HIV VL at 12 and 24 months after the patient started treatment on ART were performed using quantitative real-time PCR protocol with the generic HIV Roche TaqMan assay. Descriptive and logistic regression analysis were performed in Stata SE11 version in data analysis. Results: Overall 150 (45.5%) of 330 adults living with HIV were tested with at least one VL, and of these patients, 51 (34.0%) were tested with two VL during the followed-up. The VF was observed in 13 of 51 (25.5%) patients and among them, 8 (61.5%) switched to second-line ART regimens. Thirty-five (68.6%) of the 51 patients had an undetectable VL at the first VL measurement, and seven (13.7%) patients subsequently developed viral load rebound (VLR) on tritherapy. Using a multivariate analysis, the risk of VF was seven times higher in HIV adults who did not respect the medication hours (OR = 7.38, 95%CI = 1.56-34.90, p = 0.012) and eleven times higher in patients with none or primary school education (OR = 11.38, 95% CI = 2.41-53.76, p = 0.002). Conclusion: Low education level and poor adherence are the main risk factors for VF. Strengthening therapeutic failure prevention strategies and routine VL surveillance would allow early detection of VF and contribute in achieving the third goal of UNAIDS which recommends "90-90-90" targets for People Living with HIV in resourcelimited settings.