Infection with HIV is one of the deadliest epidemics of our time and its type is widespread in the Central African Republic. It is frequently accompanied by neurological complications. Objective: To contribute to a better understanding of neurocognitive disorders in patients living with HIV (PLHIV) in Bangui, and to identify associated factors using the International HIV Dementia Scale (IHDS) as a screening tool. We conducted a descriptive and analytical crosssectional study from 1 December 2014 to 30 January 2015, in a cohort of patients seen on one of the supported sites in Bangui. A total of 400 patients were received in followup visit during the study period of which 244 met the inclusion criteria. The prevalence of neurocognitive disorders was 25%, 95% CI [19.70 30.92]. The mean age of subjects was 42.77 ± 9.58 with extremes ranging from 24 64 years. The sex ratio (F/M) was 4.5 in. The average score for different tests was 10.93 ± 1.13 with extremes of 7 and 12. The disorder was more about the gestural sequence. Determinants of neu rocognitive disorders in the cohort were older age and lower educational level (p < 0.05). It is useful to conduct further studies to confirm these results by combining a battery of neuropsycho logical tests to recommend this test for all the support sites of PLHIV in the country.
Introduction : La non-divulgation du statut sérologique par une femme enceinte à son entourage, et tout particulièrement au père de l’enfant à naître, peut représenter un obstacle à la prévention de la transmission du VIH de la mère à l’enfant. C’est dans ce contexte que notre étude se propose de déterminer la proportion des femmes n’ayant pas divulgué leur séropositivité au VIH à leur conjoint et les facteurs associés à cette non-divulgation. Patients et méthodes : Il s’agissait d’une étude transversale, descriptive et analytique allant du 1 er février au 30 mai 2017. La population d’étude était constituée de toutes les femmes enceintes ou non enceintes VIH positives, suivies dans l’un des trois principaux services de santé maternelle et infantile de Bangui. Résultats : Au total, 256 femmes ont été recrutées. Parmi elles, 76 femmes n’ont pas divulgué leur séropositivité au VIH à leur conjoint, soit une proportion 29,7 %. Les principaux facteurs associés à la non-divulgation de la séropositivité étaient le jeune âge du conjoint, sa situation professionnelle précaire et les couples qui vivaient séparément. Conclusion : À la lumière des résultats obtenus dans notre étude, des efforts doivent être faits pour impliquer davantage les partenaires dans les programmes de santé sexuelle et reproductive en général et de la prévention de la transmission de la mère à l’enfant en particulier. Également, la population doit être sensibilisée sur les dangers de la stigmatisation et la loi relative à la protection des personnes vivant avec le VIH doit être appliquée.
Like other countries in the world, the Central African Republic is committed to the fight against the elimination of neonatal tetanus (NNT). Despite the efforts made, the number of NNT cases continues to grow. The objective of this work was to describe the epidemiological profile and identify the risk factors for the occurrence of NNT in rural Central African areas in order to improve control strategies in this context. This was a case-control study of newborns with tetanus (case) or not (controls), conducted between 2014 and 2019 at the Gazi Secondary Health Center. A questionnaire collected socio-demographic and clinical data that were entered and analyzed using the Epi info 7 software. Multiple logistic regression used to establish the relationship between the occurrence of tetanus and the characteristics of the mother and the newborn, through the ORs and their 95% CI. A total of 332 newborns were included, including 166 cases of NNT and 166 controls. The average age was 7.8 ±3.6 days. The incidence of NNT was 2.7 and 5.2 cases per 1000 live births in 2014 and 2019 respectively. The main risk factors for NNT were new males (p=0.04), low maternal education (p=0.001), separation from health care (p=0.006), primiparity (p<0.001), low number of antenatal visits (p<0.003) and low tetanus vaccine coverage (p<0.001). According to newborn care practices: home birth (p=0.002), delivery by unskilled personnel (p<0.001), umbilical cord septic section (p<0.001), no cord dressing (p<0.001) and septic dressing (p=0.012) were statistically associated with the occurrence of NNT in our context. In rural Central African Africa, the incidence of neonatal tetanus remains high and the risk factors are multiple. Effective health promotion measures can contribute to the elimination of this disease.
Background The objectives of this study were to determine the association between the vulnerability factors linked to human immunodeficiency virus (HIV) and other sexually transmitted infection among the young women who sell sex (YWSS) group (15–24 years) and adult sex workers, engaged in consensual sex for money (AFSW). Methods A cross-sectional study was conducted among AFSW involved in commercial sex transactions. Prevalence ratios (PR) analysis was carried out using log-binomial regression model. Results The prevalence of HIV-1 was 29.4% among YWSS compared to 19.6% among female sex worker (PR = 1.43 [1.07–1.91]). Consistent condoms use last 3 months were very low at 22.3% and 41.2%, respectively (PR = 0.52 [0.37–0.74]), the low education level among YWSS versus AFSW (PR = 0.55 [0.40–0.76]); YWSS having been a victim of sexual violence in the last 12 months (PR = 2.00 [1.52–2.63]), were also more likely to be HIV positive. Conclusions The YWSS had a high prevalence of HIV, experienced other socioeconomic vulnerabilities and remain a key population for comprehensive HIV programs. To reach all YWSS, programs need to consider many outreach programs and address the shared determinants of HIV risk.
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