C rimean-Congo hemorrhagic fever (CCHF) occurs in Europe, Africa, the Middle East, and Asia (1). The virus is transmitted to humans through tick bites or direct contact with blood, secretions, or infected tissue of a viremic animal or person. The incubation period in humans is usually ≈5-6 days and hemorrhaging often occurs on the fourth or fifth day after onset of illness; ≈30% of human case-patients die. In Mauritania, CCHF was first documented in 1983 (2). Although several cases have been reported since, its current distribution is not well known. We report 2 cases of CCHF in 2019 in southern Mauritania. The first patient, a 51-year-old man, a cattle breeder who resided in Tintane, Hodh Elgharbi, was admitted to Kiffa Regional Hospital, Assaba, Mauritania, on June 17, 2019, for hemorrhagic syndrome. The patient began having symptoms, including abdominal pain, bloody diarrhea, and vomiting, 5 days prior. At admission, the patient was in a coma (Glasgow coma scale 8) and had a fever (temperature 41°C), epistaxis, gingivorrhagia, diffuse ecchymosis (Figure 1), pallor, rapid respiratory rate (20 breaths/min), and hypotension (60/40 mm Hg). Laboratory examinations showed severe anemia (3.5 mmol/L); leucocytosis (1.3 × 10 9 cells/L); severe thrombocytopenia (20 × 10 9 /L); prolonged prothrombin time (61%); and elevated urea (35 mmol/L), creatinine (2,298 µmol/L

A prospective study involved a total of 361 HIV-positive patients on antiretroviral therapy (ART) initiated and followed at the CTA from January to December 2019, in order to evaluate the effectiveness of the therapy by monitoring the evolution of TCD4 lymphocytes, plasma viral load. The mean age was 37±12 years. Men were in the majority (62.3%) with a sex ratio (M/F) of 1.65. The first-line (ART) protocol combining 2INTIs + 1INNTI concerned 97.8% of patients. The immunological efficacy of the treatment was evaluated by comparing the initial and final CD4 counts (after 6 months of ART), for the first CD4 count, at the beginning of the treatment, 48.5% of patients had a CD4 count higher than 200 cells/µl against 51.5% who had a count lower than 200 cells/µl. But at the second evaluation six months later, 54.5% had CD4 >200 cells/µl against 45.5% of the patients who had their CD4 rate<200 cells/µl. As for the relationship between the immunological and virological status of the patients, the distribution of HIV patients in our series according to CD4 count and viral load was not significant but allowed us to establish the correlation between these two parameters with a correlation coefficient between -1 and 1. Thus, this correlation coefficient sought after six months of antiretroviral treatment is -0.04. From the analysis of the data, it appears that the antiretroviral drugs are effective in the population studied. The CD4 cell count and viral load changed in the opposite direction during treatment. The use of the correlation coefficient makes it possible to follow the effectiveness of the antiretroviral therapy.

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Goal: The goal of this study is to determine the prevalence of therapeutic failure and the evolution of the biological factors after 6 and 12 months of anti‐retroviral treatment (ART) amongst human immunodefeciency virus (HIV) Patients receiving care through the Ambulatory Treatment Center in Nouakchott. Methods: The study presents a descriptive and retrospective analysis of 479 patients enrolled in ART between January 2015 and January 2019, with focus on treatment failures and related biomarkers. The average age of the patients studied was 37 ± 12.94 years. The majority (52.8%) were males, of whom (52.6%) were married. Results: The average body mass index (BMI) of the patients progressively increased after 6 and 12 months on ART. The average BMI increased from 20.3 ± 5.1 kg/m2, before treatment, to 21.7 ± 5.0 kg/m2 and 22.7 ± 5.4 kg/m2, after 6 and 12 months of treatment, respectively. Of the 479 patients, 97.3% were on 2 NRTIs + NNRTI. During the first 6 months of treatment, the clinical, immunological, and virological therapeutic failures were 0.6%, 34.10%, and 9%, respectively. After 6 and 12 months of ART, the TCD4, Hemoglobin, platelets, glycemia, creatinemia, and transaminase remained normal during the entire monitoring period. Conclusion: study demonstrated effective HIV treatment amongst the study patients. It showed clearance of virus and immune restoration can be attained after 6 and 12 months of ART. The number of patients who received the tests did decrease during the treatment period, which highlights the importance of adherence to patient management protocols, including clinical and biological monitoring.