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BackgroundThe endemicity of hepatitis B virus (HBV) prompted the systematic immunization of newborns in Cameroon since 2005. In the frame of a considerable burden of HIV/HBV co-infection (17.5%), monitoring HBV among children living with HIV (CLHIV) would guide toward HIV/HBV integrated paediatric care. We sought to ascertain the prevalence and determinants of HBV infection in the population of CLHIV and performance of commonly used rapid diagnosis tests (RDTs).MethodsCross-sectional study conducted from February through June 2017 in a subset of CLHIV ≤15 years old at the Essos Hospital Centre, Yaounde, Cameroon. HBV was tested by HBsAg ELISA sandwich in duplicates for each sample, and the mean optical density was calculated. The Determinants of HBV-prevalencewere evaluated, and p < 0.05 was the significance threshold. The performance of two HBV RDTs (Diaspot vs. HBV-5) was evaluated in comparison to ELISA (used as gold standard).ResultsOf the 83 CLHIV enrolled (54.2% female, mean age 8.7 [±3.8] years, 60% vaccinated against HBV, all breastfed), HBV-prevalence was 2.41% (2/83). HBV-positivity was significantly associated with unknown maternal HBV status (2.9% [2/69] vs. 0.0% [0/14], p = 0.0097) and vaginal delivery (2.4% [2/82] vs. 0.0% [0/1], p = 0.0018). Moreover, the most likely to be positive were aged 11 and 15 years, and had experienced neither anti-HBV vaccination nor anti-HBV serum administration, and both had not been treated with any antiseptic solution at birth. Regarding the performance of Diaspot vs. HBV-5 respectively, sensitivity was 100% (2/2) vs. 50% (1/2), while specificity was 100% (45/45) vs. 97.8% (44/45); positive and negative predictive values of Diaspot versus HBV-5 were respectively 100% (2/2) and 100% (45/45) versus 50% (1/2) and 97.8% (44/45).ConclusionHBV-infection in the population of CLHIV appears at a moderate prevalence, suggesting a decreased burden likely due to preventive measures including the wide vaccine coverage. Focusing on mothers with unknown HBV status and promoting safer delivery mode (caesarean section) for HBV-positive motherswould contribute toward pediatric HBV elimination. In context of limited resources, Diaspot test appears more reliable to rollout HBV-infection in the population of CLHIV. As findings are limited to a small sample size, studies on a wider population would be relevant.

Background Intestinal parasitic infections are among the most common communicable diseases worldwide, particularly in developing countries. Human immunodeficiency virus (HIV) causes dysregulation of the immune system through the depletion of CD4+ T lymphocytes which gives rise to opportunistic infections. Methodology A cross-sectional study was conducted from January to October 2018. Stool and blood samples were collected from participants aged 1 to 19. Stool samples were analyzed for intestinal parasites. Blood samples were analyzed for HIV and CD4 + T cell counts. Results Out of 214 children enrolled, 119 (55.6%) were HIV infected and 95 (44.4%) were HIV non-infected. All infected children were on antiretroviral treatment (ART). The prevalence of intestinal parasites was 20.2% in HIV infected and 15.8% in non-infected children. Among the 119 HIV infected children, 33 (27.7%) of them had a CD4+ T cell count less than 500 cells/mm3, and amongst them 5.9% had CD4+ T cell count less than 200 cells/mm3. Among HIV infected children, Cryptosporidium spp. was frequently detected, 7/119 (5.9%), followed by Giardia lamblia 5/119 (4.2%) then Blastocystis hominis 3/119 (2.5%) and Entamoeba coli 3/119 (2.5%). Participants on ART and prophylactic co-trimoxazole for &gt;10 years had little or no parasite infestation. Conclusions Although ART treatment in combination with prophylactic co-trimoxazole reduces the risk of parasitic infection, 20.2% of HIV infected children harbored intestinal parasites including Cryptosporidium spp. Stool analysis may be routinely carried out in order to treat detected cases of opportunistic parasites and such improve more on the life quality of HIV infected children.

Introduction: Blastocystis spp. is a protist found in humans. Although usually the most frequent protozoa found in stool samples of both symptomatic and healthy subjects, its pathogenic or rather opportunistic role is yet to be clearly elucidated. To attempt to fill this gap, a cross-sectional study was conducted to compare the frequency of Blastocystis spp. in HIV positive (HIV+) versus HIV negative (HIV-) individuals in four health facilities of the Center Region of Cameroon. Methodology: Stool samples were collected from 283 HIV positive and 245 HIV negative subjects and analyzed using direct diagnostic tests. Results: A total of 46 (8.7%) individuals were found infected with Blastocystis spp., including 6.7% HIV positive and 11.0% HIV negative. This species was more frequent in urban and semi-urban areas than in rural areas, but evenly distributed among genders and age groups as well as among all sectors of activity. The prevalence of Blastocystis spp. (11.3%) was higher in HIV+ patients with a CD4 count ≥ 500 cells / mm3, but no significant difference was found among HIV clinical stages. Likewise prevalence, the mean number of cysts per gram of stool was similar between HIV positive and HIV negative individuals. People infected with Blastocystis spp. showed diverse clinical signs, but only flatulence was significantly more prevalent. The frequencies of these clinical signs were not related to HIV status. Conclusion: No clear relationship links the infection with Blastocystis spp. to HIV, although its presence was associated with digestive disorder, suggesting that this parasite might not be opportunist.

27In Sub-Saharan Africa, school-age children are the most vulnerable to parasitic 28 infections and are particularly exposed to multi-parasitism and its potential consequences. 29This study aimed at determining the intensity of multi-parasitism in Nyong et Mfoumou 30 Division and identifying its determinants. A cross-sectional study took place from September 31 2017 to July 2018 among pupils of five (05) government schools from the Nyong et 32 Mfoumou Division. Stool samples were collected from each child and examined for 33 protozoan cysts, helminth eggs and larva while blood samples were collected for detection of 34 Plasmodium spp and filarial blood stages. In addition, socio-demographic and school 35 environment related information were documented. In total, 416 schoolchildren were 36 recruited; out of which 309 (74.28%) were infected by at least one parasite species. 13 37 parasite species were found: 03 hemoparasites and 10 intestinal parasites. Plasmodium 38 falciparum was the main hemoparasite (37.26%). Amongst intestinal parasites, Entamoeba 39 coli were the most common among protozoa (29.33%) and Ascaris lumbricoides among 40 helminths (21.39%). The frequency of multi-parasitism was 44.47% and the average species 41 reach was 1.43 ± 0.01 per individual. Four types of multi-parasitism were found (bi-42 parasitism, tri-parasitism, quadri-parasitism and penta-parasitism); the bi-parasitism (26.68%) 43 was the most common. Significantly statistic associations were found between parasite 44 species such as: Entamoeba coli, Entamoeba histolytica/dispar, Ascaris lumbricoides, 45 Trichirus trichiura and Mansonella perstans and can generally be explained by the same 46 means of transmission. We conclude that the intensity of multiparasitism among 47 48 49