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Fiogbe AA, Agodokpessi G, Tessier JF, Affolabi D, Zannou DM, Adé G, Anagonou S, Raherison-Semjen C, Marcy O. Prevalence of lung function impairment in cured pulmonary tuberculosis patients in Cotonou, Benin. Int J Tuberc Lung Dis 2020; 23:195-202. [PMID: 30808452 DOI: 10.5588/ijtld.18.0234] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING National teaching hospital for the management of respiratory diseases, Cotonou, Benin. OBJECTIVE 1) To estimate the prevalence of lung function impairment (LFI) and associated factors in patients cured of pulmonary tuberculosis (PTB); and 2) to determine the link between human immunodeficiency virus (HIV) infection and LFI occurrence. DESIGN We performed a cross-sectional study in cured patients with smear-positive TB (PTB+) treated between 2012 and 2015. We recruited two control groups of 70 HIV-infected (HIV+/TB-) and 70 HIV-negative participants without TB (HIV-/TB-). We performed spirometry in all participants to identify LFI (obstructive, restrictive or mixed) and the 6-min walk test (6-MWT) in PTB+ participants. We assessed the factors associated with LFI using logistic regression. RESULTS Of 4711 subjects with PTB, 241 were contacted and 189 were included. The median age was 37 years; 128 (68.0%) were male. Overall, 85 cured PTB+ patients had LFI (45.0%). Extent of initial radiological lesions, time between symptom onset and treatment, and female sex were independently associated with LFI. Fifty-five (29.1%) cured PTB+ patients had an abnormal 6-MWT; those with LFI had a higher risk of poor exercise tolerance (OR 2.23; interquartile range 1.16-4.30). We did not find any association between HIV infection and LFI. CONCLUSION LFI is very common in cured PTB+ patients from Benin and significantly impacts exercise tolerance.
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Affiliation(s)
- A A Fiogbe
- Programme national contre la Tuberculose, Centre national hospitalo-universitaire de Pneumophtisiologie, Cotonou, Benin, International Health, Institut de Santé Publique Epidémiologie Développement (ISPED), Université de Bordeaux, Bordeaux
| | - G Agodokpessi
- Programme national contre la Tuberculose, Centre national hospitalo-universitaire de Pneumophtisiologie, Cotonou, Benin
| | - J F Tessier
- ISPED, Université de Bordeaux, Bordeaux, France
| | - D Affolabi
- Programme national contre la Tuberculose, Centre national hospitalo-universitaire de Pneumophtisiologie, Cotonou, Benin
| | - D M Zannou
- Centre national hospitalo-universitaire, Faculté des Sciences de la Santé, Université d'Abomey Calavi, Cotonou, Benin
| | - G Adé
- Programme national contre la Tuberculose, Centre national hospitalo-universitaire de Pneumophtisiologie, Cotonou, Benin
| | - S Anagonou
- Programme national contre la Tuberculose, Centre national hospitalo-universitaire de Pneumophtisiologie, Cotonou, Benin
| | - C Raherison-Semjen
- Bordeaux Population Health Centre, Centre Institut national de la Santé et de la Recherche médicale Unité 1219, Université de Bordeaux, Bordeaux, France, Service des Maladies respiratoires, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - O Marcy
- Bordeaux Population Health Centre, Centre Institut national de la Santé et de la Recherche médicale Unité 1219, Université de Bordeaux, Bordeaux, France
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Hessou S, Dougnon V, Glele-Ahanhanzo Y, Imorou BCA, Ahoussinou C, Legba B, Zannou DM, Baba-Moussa L. A Behavioral and Serological Survey on HIV Prevalence Among Prisoners in Benin. J Public Health Afr 2017; 8:678. [PMID: 28878871 PMCID: PMC5575451 DOI: 10.4081/jphia.2017.678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 06/10/2017] [Indexed: 11/28/2022] Open
Abstract
Cases of HIV are common in Benin, with infection rates varying according to socioeconomic and cultural factors, and by region. Certain segments of the population, such as prison inmates, sex worker clients and truck drivers are at high risk for HIV/AIDS. The aim of this study is to identify which behavioral and serological indicators contribute to the spread of HIV among prisoners. A total of 496 inmates from prisons located in all major cities in Benin were surveyed. Data was collected through interview sessions carried out using a questionnaire and through blood samples. The results show that most inmates are Beninese (83.5%), and the average age is 33 years (range: 14-80 years). No prisoner reported using a condom the last time they engaged in sexual intercourse. Blood exposure was found in 14.6% of inmates and HIV was detected in 1.4% of cases. Our analysis indicates that the length of detention and gender are factors that influence HIV status. However, age, education, nationality and HIV awareness had no significant effect on HIV prevalence among inmates. The results highlight the need to raise awareness in prisons about HIV. This can be achieved by strengthening communication strategies and by organizing HIV and sexually transmitted diseases information sessions for both prison officers and inmates.
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Affiliation(s)
- S Hessou
- National Reference Center for the Research and Management of AIDS, Benin
| | - V Dougnon
- Research Unit, Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Y Glele-Ahanhanzo
- Regional Institute of Public Health, University of Abomey-Calavi, Benin
| | - B C A Imorou
- National Program for the Fight Against AIDS in Benin, Ministry of Health, Benin
| | | | - B Legba
- Research Unit, Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin.,Laboratory of Biology and Molecular Typing in Microbiology, University of Abomey-Calavi, Benin
| | - D M Zannou
- National Reference Center for the Research and Management of AIDS, Benin
| | - L Baba-Moussa
- Laboratory of Biology and Molecular Typing in Microbiology, University of Abomey-Calavi, Benin
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Coffie PA, Patassi A, Doumbia A, Bado G, Messou E, Minga A, Allah-Kouadio E, Zannou DM, Seydi M, Kakou AR, Dabis F, Wandeler G. Changes in viral hepatitis B screening practices over time in West African HIV clinics. Med Mal Infect 2017; 47:394-400. [PMID: 28545675 DOI: 10.1016/j.medmal.2017.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 09/30/2016] [Accepted: 04/18/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND We aimed to describe changes in hepatitis B screening practices over a 3-year period among HIV-infected patients in West Africa. METHODS A medical chart review was conducted in urban HIV treatment centers in Ivory Coast (3 sites), Benin, Burkina Faso, Senegal, and Togo (1 site each). Among patients who started antiretroviral treatment between 2010 and 2012, 100 per year were randomly selected from each clinic. Demographic, clinical, and laboratory data was collected using a standardized questionnaire. We assessed changes in the proportion of patients screened over time and identified predictors of screening in a multivariable logistic regression. RESULTS A total of 2097 patients were included (median age: 37 years, 65.4% of women). Overall, 313 (14.9%) patients had been screened for hepatitis B, with an increase from 10.6% in 2010 to 18.9% in 2012 (P<0.001) and substantial differences across countries. In multivariable analysis, being aged over 45 years (adjusted odds ratio: 1.34 [1.01-1.77]) and having an income-generating activity (adjusted odds ratio: 1.82 [1.09-3.03]) were associated with screening for hepatitis B infection. Overall, 62 HIV-infected patients (19.8%, 95% confidence interval: 15.5-24.7) were HBsAg-positive and 82.3% of them received a tenofovir-containing drug regimen. CONCLUSION Hepatitis B screening among HIV-infected patients was low between 2010 and 2012. The increasing availability of HBsAg rapid tests and tenofovir in first-line antiretroviral regimen should improve the rates of hepatitis B screening.
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Affiliation(s)
- P A Coffie
- Département de dermatologie et d'infectiologie, UFR des sciences médicales, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire; Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, Abidjan, Cote d'Ivoire; Programme PACCI, site ANRS Côte d'Ivoire, Abidjan, Cote d'Ivoire.
| | - A Patassi
- Service des maladies infectieuses et de pneumologie, CHU Sylvanus-Olympio, Lomé, Togo
| | - A Doumbia
- Département de dermatologie et d'infectiologie, UFR des sciences médicales, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire; Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, Abidjan, Cote d'Ivoire
| | - G Bado
- Service des maladies infectieuses et tropicales, hôpital de Jour, CHU Souro Sanou, Bobo Dioulasso, Burkina-Faso
| | - E Messou
- Département de dermatologie et d'infectiologie, UFR des sciences médicales, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire; Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, Abidjan, Cote d'Ivoire; Centre de prise en charge de recherche et de formation, CePReF-Aconda-VS, Cote d'Ivoire
| | - A Minga
- Centre médical de suivi de donneurs de sang/CNTS/PRIMO-CI, Abidjan, Cote d'Ivoire
| | - E Allah-Kouadio
- Département d'hépato-gastro-entérologie, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire
| | - D M Zannou
- Service de médecine interne, CNHU Hubert-Maga, Cotonou, Benin
| | - M Seydi
- Service des maladies infectieuses et tropicales, CHU de Fann, Dakar, Senegal
| | - A R Kakou
- Département de dermatologie et d'infectiologie, UFR des sciences médicales, université Félix-Houphouët Boigny, Abidjan, Cote d'Ivoire; Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Treichville, Abidjan, Cote d'Ivoire
| | - F Dabis
- ISPED, centre Inserm U1219-Bordeaux Population Health, université de Bordeaux, Bordeaux, France
| | - G Wandeler
- Service des maladies infectieuses et tropicales, CHU de Fann, Dakar, Senegal; Département des maladies infectieuses et institut de médecine sociale et préventive, université de Berne, Berne, Switzerland
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Ogouyèmi-Hounto A, Zannou DM, Ayihounton G, Ahouada C, Azon-Kouanou A, Acakpo J, Sissinto Savi de Tove Y, Kinde Gazard D. [Prevalence and factors associated with cryptococcal antigenemia in HIV-infected patients in Cotonou/Benin]. J Mycol Med 2016; 26:391-397. [PMID: 27641486 DOI: 10.1016/j.mycmed.2016.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 08/09/2016] [Accepted: 08/20/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Determine the prevalence of cryptococcal antigenemia and associated factors in HIV-infected patients in Cotonou in order to introduce systematic screening in national guidelines. PATIENTS AND METHODS This is a cross-sectional, descriptive and analytical study conducted from June to September 2015 in four outpatient treatment centers with adult patients infected with HIV, receiving or not antiretroviral treatment with a number of CD4≤200cell/μL and who have given their informed consent to participate in the study. For each enrolled patient, after signing the informed consent form, it was made a clinical examination and administration of a questionnaire to collect general information, treatment and biological data. Then a blood sample for counting CD4 lymphocytes and the search of cryptococcal antigenemia were done. RESULTS In total, 355 patients were included in the study with a mean age of 40±10.2years. The overall prevalence of cryptococcal antigenemia is 1.7%. All patient with cryptococcal antigenemia have a CD4 count below 100cells/μL with a majority having CD4 count below 50cells/μL. Body mass index<18.5kg/m2, an alteration of the general condition with a CD4 lymphocyte counts<50cells/μL are the main factors associated with the occurrence of cryptococcal antigenemia. CONCLUSION This pilot study showed a low prevalence of cryptococcal antigenemia in the study population, but higher in highly immuno-deficient patients with CD4 counts<50cells/μl. Given the results obtained, the introduction of routine screening among patients infected with HIV could be reserved to those with CD4 counts<50cells/μl.
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Affiliation(s)
- A Ogouyèmi-Hounto
- Laboratoire de parasitologie-mycologie, centre national hospitalier universitaire Koutoukou Maga (CNHU/HKM), 03BP386, Cotonou, Benin.
| | - D M Zannou
- Service de médecine interne, centre national hospitalier universitaire Koutoukou Maga (CNHU/HKM), 03BP386, Cotonou, Benin; Centre de traitement ambulatoire (CTA), Cotonou, Benin
| | - G Ayihounton
- Centre de traitement ambulatoire (CTA), Cotonou, Benin
| | - C Ahouada
- Centre de traitement ambulatoire (CTA), Cotonou, Benin
| | - A Azon-Kouanou
- Service de médecine interne, centre national hospitalier universitaire Koutoukou Maga (CNHU/HKM), 03BP386, Cotonou, Benin; Centre de traitement ambulatoire (CTA), Cotonou, Benin
| | - J Acakpo
- Centre de traitement ambulatoire (CTA), Cotonou, Benin
| | - Y Sissinto Savi de Tove
- Laboratoire de parasitologie-mycologie, centre national hospitalier universitaire Koutoukou Maga (CNHU/HKM), 03BP386, Cotonou, Benin
| | - D Kinde Gazard
- Laboratoire de parasitologie-mycologie, centre national hospitalier universitaire Koutoukou Maga (CNHU/HKM), 03BP386, Cotonou, Benin
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Alary M, Béhanzin L, Guédou FA, Geraldo N, Goma Mastétsé E, Singbo N, Sossa JC, Zannou DM, Giguère K. P18.05 Contribution of biomarkers to the validation of self-reported condom use in a treatment as prevention and a pre-exposure prophylaxis demonstration study among female sex workers. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ibitokou SA, Denoeud-Ndam L, Ezinmegnon S, Ladékpo R, Zannou DM, Massougbodji A, Girard PM, Cot M, Luty AJF, Ndam NT. Insights Into Circulating Cytokine Dynamics During Pregnancy in HIV-Infected Beninese Exposed to Plasmodium falciparum Malaria. Am J Trop Med Hyg 2015; 93:287-92. [PMID: 26101276 DOI: 10.4269/ajtmh.14-0653] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 01/20/2015] [Indexed: 11/07/2022] Open
Abstract
We investigated the circulating plasma levels of Th1- (Interleukin-2 [IL-2], tumor necrosis factor-α [TNF-α], interferon-gamma [IFN-γ]) and Th2-type (IL-4, IL-5, IL-10) cytokines in human immunodeficiency virus (HIV)-infected pregnant women living in a malaria-endemic area. We analyzed samples from 200 pregnant women included in the prevention of pregnancy-associated malaria in HIV-infected women: cotrimoxazole prophylaxis versus mefloquine (PACOME) clinical trial who were followed until delivery. Cytokine concentrations were measured by flow cytometry-based multiplex bead array. Significantly elevated levels of IL-10 and lower levels of TNF-α were observed at delivery compared with inclusion (P = 0.005). At inclusion, the presence of circulating IFN-γ, a higher CD4(+) T cell count and having initiated intermittent preventive treatment of malaria with sulfadoxine pyrimethamine (SP-IPTp) were all associated with a lower likelihood of Plasmodium falciparum infection. At delivery, the inverse relationship between the presence of infection and circulating IFN-γ persisted, although there was a positive association between the likelihood of infection and the presence of circulating TNF-α. Initiation of antiretroviral therapy was associated with elevated IL-5 production. Consistent with our own and others' observations in HIV seronegative subjects, this study shows circulating IL-10 to be a marker of infection with P. falciparum during pregnancy even in HIV-infected women, although plasma IFN-γ may be a marker of anti-malarial protection in such women.
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Affiliation(s)
- Samad A Ibitokou
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Lise Denoeud-Ndam
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Sèm Ezinmegnon
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Rodolphe Ladékpo
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Djimon-Marcel Zannou
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Achille Massougbodji
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Pierre-Marie Girard
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Michel Cot
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Adrian J F Luty
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Nicaise Tuikue Ndam
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
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Duvignaud A, Denoeud-Ndam L, Akakpo J, Agossou KV, Afangnihoun A, Komongui DG, Atadokpédé F, Dossou-Gbété L, Girard PM, Zannou DM, Cot M. Incidence of malaria-related fever and morbidity due to Plasmodium falciparum among HIV1-infected pregnant women: a prospective cohort study in South Benin. Malar J 2014; 13:255. [PMID: 24996807 PMCID: PMC4089929 DOI: 10.1186/1475-2875-13-255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 06/30/2014] [Indexed: 11/28/2022] Open
Abstract
Background Malaria and HIV are two major causes of morbidity and mortality among pregnant women in sub-Saharan Africa. Foetal and neonatal outcomes of this co-infection have been extensively studied. However, little is known about maternal morbidity due to clinical malaria in pregnancy, especially malaria-related fever, in the era of generalized access to antiretroviral therapy and anti-malarial preventive strategies. Methods A cohort study was conducted in order to estimate the incidence rate and to determine the factors associated with malaria-related fever, as well as the maternal morbidity attributable to malaria in a high-transmission setting of South Benin among HIV-infected pregnant women. Four-hundred and thirty-two women who participated in a randomized trial testing strategies to prevent malaria in pregnancy were included and followed until delivery, with at least three scheduled visits during pregnancy. Confirmed malaria-related fever was defined as axillary temperature >37.5°C and a concomitant, positive, thick blood smear or rapid diagnostic test for Plasmodium falciparum. Suspected malaria-related fever was defined as an axillary temperature >37.5°C and the concomitant administration of an anti-malarial treatment in the absence of parasitological investigation. Results Incidence rate for confirmed malaria-related fever was of 127.9 per 1,000 person-year (PY) (95% confidence interval (CI): 77.4-211.2). In multivariate analysis, CD4 lymphocytes (Relative Risk (RR) for a 50 cells/mm3 variation = 0.82; CI: 0.71-0.96), antiretroviral treatment started before inclusion (RR = 0.34; CI: 0.12-0.98) and history of symptomatic malaria in early pregnancy (RR = 7.10; CI: 2.35-22.49) were associated with the incidence of confirmed or suspected malaria-related fever. More than a half of participants with parasitaemia were symptomatic, with fever being the most common symptom. The crude fraction of febrile episodes attributable to malaria was estimated at 91%. Conclusions This work highlights that malaria is responsible for a substantial morbidity in HIV-infected pregnant women, with cellular immunodepression as a major determinant, and establishes the possible advantage offered by the early initiation of antiretroviral treatment. Trial registration PACOME Study has been registered under the number NCT00970879.
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Denoeud-Ndam L, Zannou DM, Fourcade C, Taron-Brocard C, Porcher R, Atadokpede F, Komongui DG, Dossou-Gbete L, Afangnihoun A, Ndam NT, Girard PM, Cot M. Cotrimoxazole prophylaxis versus mefloquine intermittent preventive treatment to prevent malaria in HIV-infected pregnant women: two randomized controlled trials. J Acquir Immune Defic Syndr 2014; 65:198-206. [PMID: 24220287 DOI: 10.1097/qai.0000000000000058] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Malaria during pregnancy has serious consequences that are worsened by HIV infection. Malaria preventive measures for HIV-infected pregnant women include cotrimoxazole (CTX) prophylaxis given to prevent HIV-related opportunistic infections and also protective against malaria, or intermittent preventive treatment (IPTp) with an antimalarial drug. Here, we present the first study evaluating CTX efficacy versus mefloquine (MQ)-IPTp, alone and in combination, in HIV-infected pregnant women. METHODS We conducted 2 randomized, open-label, noninferiority trials in Benin. In the CTX-mandatory trial, HIV-infected women with CD4 counts of <350 per cubic millimeter received CTX either alone or with MQ-IPTp (N = 292). In the CTX-not-mandatory trial (CD4 count >350/mm), CTX was compared with MQ-IPTp (N = 140). In both the trials, the primary end point was microscopic placental parasitemia. RESULTS At delivery, 1 woman in each CTX-alone treatment group exhibited placental parasitemia, versus no women in the groups receiving MQ. CTX alone demonstrated noninferiority in the CTX-mandatory trial. However, polymerase chain reaction-detected placental parasitemia was markedly reduced in the CTX + MQ group compared with CTX alone (0/105 vs. 5/103, P = 0.03). Because of insufficient recruitment in the CTX-not-mandatory trial, noninferiority could not be conclusively assessed. Dizziness and vomiting of moderate intensity were reported by 34%-37% of women receiving MQ in both the trials, versus 0%-3% in CTX groups (P < 0.0001). No serious adverse events related to these drugs were found. CONCLUSIONS CTX alone provided adequate protection against malaria in HIV-infected pregnant women, although MQ-IPTp showed higher efficacy against placental infection. Although more frequently associated with dizziness and vomiting, MQ-IPTp may be an effective alternative given concerns about parasite resistance to CTX.
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Affiliation(s)
- Lise Denoeud-Ndam
- *UMR 216, Institut de Recherche pour le Développement, Paris, France; †Faculté de Pharmacie, Université Paris Descartes, Paris, France; ‡Centre de Traitement Ambulatoire, Centre National Hospitalier Universitaire Hubert Koutoukou Maga, Cotonou, Benin; §Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Abomey-Calavi, Benin; ‖Inserm U717, Hôpital Saint-Louis, Paris, France; ¶Service de Médecine Interne, Hôpital d'Instructions des Armées, Cotonou, Benin; #Service de gynécologie, Hôpital de la Mère et de l'Enfant Lagune, Cotonou, Benin; **Clinique Louis Pasteur, Porto-Novo, Benin; ††Centre de Traitement Ambulatoire, Hôpital de zone de Suru Léré, Cotonou, Benin; ‡‡Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, APHP, Paris, France; §§Inserm U707, Université Pierre et Marie Curie, Paris, France
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Tounkara FK, Guédou F, Ahoussinou C, Zannou DM, Kpatchavi A, Kintin FD, Avery L, Bédard E, Bitera R, Alary M. P3.110 Relationship Between Violence and HIV Infection Among Female Sex Workers in Benin. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Zannou DM, Azon-Kouanou A, Bashi BJ, Gougounon A, Zinsou R, Adé G, Houngbè F. [Mitochondrial toxicity: a case of palpebral ptosis in a woman infected by HIV and treated with HAART including zidovudine]. Bull Soc Pathol Exot 2009; 102:97-98. [PMID: 19583030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The usual clinical feature of mitochondrial toxicity is proximal myopathy. We present the report case of palpebral ptosis which occurred under zidovudine therapy The symptom remission was obtained by stopping the antiretroviral therapy. This involves an important vigilance from both doctor and patient.
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Affiliation(s)
- D M Zannou
- Service de médecine interne, Centre national hospitalier universitaire H.K.-Maga, Cotonou, Bénin.
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11
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Zannou DM, Houngbè F, Acapko J, Adé G, Gougounou A, Akondé A. [Undesirable effect of antiretroviral drugs in patients infected with HIV at Cotonou Benin]. Mali Med 2007; 22:37-43. [PMID: 19617114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Evaluate the tolerance of highly active antiretroviral therapy (HAART) on PLWHA treated in Cotonou to improve the quality of their follow up. METHODS Retrospective study among PLWHA aged > or = 15 years, treated by HAART during the period February 2002 - January 2004 and who respond to one or more consultation of follow up. Adverse effects (AE) revealed by patients or noticed by the physician are analyzed. RESULTS The study on 130 PLWHA, revealed 62,3% receiving HAART with nonnucleoside reverse transcription inhibitor and 37,7% with protease inhibitor. 75,4% presented one or more AE. Those AE were severe for 4,6% (6 patients). The frequency of AE was significantly different by drugs used. The most common events were neurosensorial (64,6%), digestive (34,6%) and dermatologic (14,6%). 2/3 of PLWHA presented AE within the first fifteen days of treatment. The patients were compliant. Only one patient stopped voluntary the treatment. CONCLUSION The frequency and the type of AE occurred predispose patients to the non observance. Their follow up must therefore include education and surveillance guided by the profile of AE identified.
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Affiliation(s)
- D M Zannou
- Clinique Universitaire de Médecine Interne, Centre National Hospitalier et Universitaire-HKM, Cotonou, Bénin.
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12
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Zannou DM, Kindé-Gazard D, Vigan J, Adè G, Sèhonou JJ, Atadokpèdé F, Azondékon A, Gbèdo C, Anagonou SY, Houngbé F. [Clinical and immunological profile of HIV infected patients in Cotonou, Benin]. Med Mal Infect 2006; 34:225-8. [PMID: 16235600 DOI: 10.1016/j.medmal.2004.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study had for aim to identify the clinical status and the level of immuno-deficiency of HIV-infected patients on their first visit. METHODS One hundred and thirty-six HIV+ patients were prospectively evaluated from November 1, 2001 to May 31, 2002. RESULTS One hundred and thirty-four were infected with HIV1 and two with HIV2. The mean age on the first consultation was 37 +/- 2 years. The m/w sex ratio was 0.9. 46.3% were stage C. The main clinical symptoms were: weight loss (88%), fever (80%), cough (71%), diarrhea (51%). BMI was normal in 70% and KI > or =80% in 57% of the cases but immuno-deficiency was severe with CD4 cells count <200 per mm3 in 69%. The main diseases were digestive candidiasis (53%), pneumonia (18%), tuberculosis (12%), non-determined pneumonia (29%), prurigo (20%), zona (16%), cryptosporidiosis (4%), cerebral toxoplasmosis (3%), and Kaposi's sarcoma (1%).
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Affiliation(s)
- D M Zannou
- Service de médecine interne, CNHU H.K.-Maga, 01 BP 386 Cotonou, Bénin.
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Amoussou-Guenou KD, Zannou DM, Ade G, Djrolo F, Avimadje M, Bigot A, Koffi-Tessio A, Houngbe F. [Morbidity of diabetic foot in Internal Medicine CNHU HKM, Cotonou]. Mali Med 2006; 21:4-7. [PMID: 19437837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The diabetes and its complications appear increasingly frequent in our medical practice. We fixed ourselves for objectives to determine the frequency of the foot diabetic in Internal Medicine at Cotonou, to count the factors etiopathogenic responsible for the lesions and to describe the clinical aspects of the lesions. We carried out a retrospective study on the 420 diabetics hospitalized of January 1, 1995 to December 31, 1999. The frequency of the foot diabetic was 16.66%, the average age of the patients 60 years and the sex ratio 2.04. The diabetes of the type 2 was most frequent (71.4%). The traumatisms were the supporting factors most often found (32.86%). The lesions were in majority (38.57%) at the stage V of the classification of Wagner. On the therapeutic level, the amputations were frequent (20%) especially the amputations of legs. The installation of medical team of education for the assumption of responsibility of the diabetes and the prevention of the complications appears essential.
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