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Background: Chronic carriage of intestinal parasitic infections (IPIs) can induce chronic inflammation and dysbiosis, which are risk factors for non-communicable diseases. The objective of this study was to determine the relationship between IPI carriage and inflammation in a population of volunteers living in Gabon. Methodology and principal findings: A cross-sectional study was conducted from September 2020 to November 2021 in asymptomatic volunteers aged 18 years old and over, residing in different areas of Gabon: Libreville (urban area) and Koula-Moutou and Bitam (rural areas). The detection of IPIs was carried out using four common microscopic techniques. C-reactive protein (CRP), and high-sensitivity C-reactive protein (hsCRP) were measured and levels were compared according to the presence or absence of IPI. Overall, 518 participants were included, 64.5% (n = 334) of whom resided in urban area and 35.5% (n = 184) in rural areas. The median age was 35 years (27; 46). The prevalence of asymptomatic IPIs was 29.9% (n = 155), with a significantly higher frequency in rural areas than in urban area (adjusted OR 6.6 (CI 3.2–13.8), p < 0.01). Protozoa were more frequent than soil-transmitted helminths (STHs) in both areas: 81.6% (n = 40) in urban area and 69.8% (n = 74) in rural areas. STHs were predominant in rural areas (48.1% vs 22.4% in urban area. In case of IPI, the median values of CRP (15 (13–15) mg/L vs 13.0 (11.1–14.9) mg/L) and hsCRP (4.2 (1.4–13.0) mg/L vs 2.2(0.4–6.1) mg/L) were higher (p<0.01). Elevated hsCRP and CRP were significantly more frequent in parasitized individuals (for hsCRP: 22.6%, n = 35; for CRP: 52.9%, n = 82); in particular among STH carriers (for hsCRP: 65.9%, n = 27, for CRP: 36.6%, n = 15) (p < 0.01). Conclusions/Significance: This first study showed that asymptomatic IPIs, particularly STH carriage are associated with high CRP and hsCRP levels. Further larger and longitudinal studies are needed to elucidate the global and specie-specific enteropathogens link with chronic inflammation. Author summary: Repeated or chronic parasitism can maintain local or systemic chronic inflammation, CRP and hsCRP are sensitive biomarkers of subclinical low-grade inflammation. This study assessed the serum levels of CRP and hsCRP in adults with or without intestinal parasite (IPI) carriage according to residence area and parasite species. IPI chronic carriage, especially with pathogenic protozoa and/or STH, was associated with higher levels of CRP and hsCRP. These findings suggest that intestinal parasite carriage contributes to low grade systemic inflammation which is a driver of NCD. The role of chronic carriage of other enteropathogens on chronic inflammation status as well the relationship between IPI and dysbiosis should be further analyzed in endemic countries. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) infection is one of the major public health problems worldwide. In pregnant women, there is a risk of mother-to-child transmission (vertical transmission) of the infection. The contaminated newborn will most often remain a chronic carrier. Gabon is part of the highly endemic area for hepatitis B. This study aims to determine the prevalence of hepatitis B in pregnant women at the Estuaire Regional Hospital of Melen, Libreville, Gabon. Material and methods: The study was carried out at the Laboratory of the Center Hospitalier Régionale Estuaire Melen (CHREM), over a period of 5 years, from January 2018 to December 2022. It was a retrospective and prospective study ranging from January 2018 to December 2022. For the prospective study, the data was collected in the CHREM Laboratory library, by using registers and filing cabinets. For the prospective study, blood samples were taken and analyzed using Abbott Determine® HBsAg kits and the BioMérieux mini Vidas system. The variables studied were age, HBs status, profession, level of study, and residence. The data collected was entered into an Excel file (Microsoft Office 2016) and analyzed using XLSTAT 2016.4.01 and Epi Info™ 7.2.5 software and expressed as means and percentages. Results: A total of 1615 pregnant women seen in the CHREM laboratory department were included in the study. Of which, 315 were diagnosed as HBsAg carriers, representing a prevalence of 8.36%. Depending on the year, the highest prevalence was observed in 2019 with 20 positive cases out of 267 women screened, i.e., 9.38%. Depending on the districts, the highest prevalence was found in the Essassa and Plein Ciel districts with 16.43% and 18.18%, respectively. According to the age groups, the highest prevalence was observed in the age group 26–30 with 10.16% (p = 0.075) out of 492 patients screened. Depending on the profession, the prevalence was higher among female students with 21.97% (p = 0.020). According to marital status, unmarried had the highest prevalence with 8.8% (p = 0.064). And according to nationality, women of Gabonese nationality had a higher prevalence with 9.52%. Conclusion: Antenatal transmission of HBV is high in Libreville. The inaccessibility of antiviral therapy for viral hepatitis B makes the immunization of mothers and children a priority in Gabon. [ABSTRACT FROM AUTHOR]

Background: The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon. Methods: A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization's (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs. Results: Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28–50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level. Conclusion: The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences. [ABSTRACT FROM AUTHOR]

Rift Valley fever (RVF) is a mosquito-borne viral zoonosis caused by the Rift Valley fever virus (RVFV) that can infect domestic and wild animals. Although the RVFV transmission cycle has been well documented across Africa in savanna ecosystems, little is known about its transmission in tropical rainforest settings, particularly in Central Africa. We therefore conducted a survey in northeastern Gabon to assess RVFV circulation among wild and domestic animals. Among 163 wildlife samples tested using RVFV-specific RT-qPCR, four ruminants belonging to subfamily Cephalophinae were detected positive. The phylogenetic analysis revealed that the four RVFV sequences clustered together with a virus isolated in Namibia within the well-structured Egyptian clade. A cross-sectional survey conducted on sheep, goats and dogs living in villages within the same area determined the IgG RVFV-specific antibody prevalence using cELISA. Out of the 306 small ruminants tested (214 goats, 92 sheep), an overall antibody prevalence of 15.4% (95% CI [11.5–19.9]) was observed with a higher rate in goats than in sheep (20.1% versus 3.3%). RVFV-specific antibodies were detected in a single dog out of the 26 tested. Neither age, sex of domestic animals nor season was found to be significant risk factors of RVFV occurrence. Our findings highlight sylvatic circulation of RVFV for the first time in Gabon. These results stress the need to develop adequate surveillance plan measures to better control the public health threat of RVFV. Author summary: Rift Valley fever (RVF) is a mosquito-borne viral zoonosis caused by the Rift Valley fever virus (RVFV) that can affect wild and domestic animals. Although the RVFV transmission cycle has been well documented across Africa in savanna ecosystems, little is known about its transmission in tropical rainforests, especially in Central Africa. We thus conducted a survey in northeastern Gabon to assess RVFV circulation among wild and domestic animals. In this study, we demonstrated for the first time in Gabon the presence of the RVFV in two wildlife species (Peter's duiker Cephalophus callipygus and the blue duiker Philantomba monticola). In addition, we detected RVFV-specific antibodies in small domestic ruminants (sheep and goats) at an overall antibody prevalence of 15.4%, with a much higher seroprevalence rate in goats than sheep (20.1% versus 3.3%). Furthermore, RVFV-specific antibodies were also observed in a single (hunting) dog out of the 26 tested. These results stress the need to develop adequate surveillance plan measures to better control the public health threat of RVFV. [ABSTRACT FROM AUTHOR]

Background: Pyrethroids are the main insecticides used in vector control for malaria. However, their extensive use in the impregnation of long-lasting insecticidal nets (LLINs) and indoor residual spraying has led to the development of resistance, threatening its success as a tool for malaria control. Baseline data prior to large scale distribution of LLINs are important for the implementation of efficient strategies. However, no data on the susceptibility of malaria vectors is available in the Moyen-Ogooué Province in Gabon. The aim of this study was to assess the susceptibility to pyrethroids and organochlorides of malaria vectors from a semi-urban and rural areas of the province and to determine the frequency of insecticide resistance genes. Methods: Larvae were collected from breeding sites in Lambaréné and Zilé and reared to adults. Three to five-day old female Anopheles gambiae sensu lato mosquitoes were used in cone tube assays following the WHO susceptibility tests protocol for adult mosquitoes. A subsample was molecularly identified using the SINE200 protocol and the frequency of Vgsc-1014 F and − 1014 S mutations were determined. Results: Anopheles gambiae sensu stricto (s.s.) was the sole species present in both Lambaréné and Zilé. Mosquito populations from the two areas were resistant to pyrethroids and organochlorides. Resistance was more pronounced for permethrin and DDT with mortality lower than 7% for both insecticides in the two study areas. Mosquitoes were statistically more resistant (P < 0.0001) to deltamethrin in Lambaréné (51%) compared to Zilé (76%). All the mosquitoes tested were heterozygous or homozygous for the knockdown resistance (Kdr) mutations Vgsc-L1014F and Vgsc-L1014S with a higher proportion of Vgsc-L1014F homozygous in Lambaréné (76.7%) compared to Zilé (57.1%). Conclusion: This study provides evidence of widespread resistance to pyrethroids in An. gambiae s.s., the main malaria vector in the Moyen-Ogooué Province. Further investigation of the mechanisms underlining the resistance of An. gambiae s.s. to pyrethroids is needed to implement appropriate insecticide resistance management strategies. [ABSTRACT FROM AUTHOR]

Assessing abundance and monitoring ecology and population trends are of critical importance for animal species of conservation concern. For sea turtles, annual nest counts represent the most common method of estimating population size. However, to develop a better understanding of population trends, these data need to be complemented by other reproductive parameters, which are lacking for many nesting populations across central Africa.To this end, an intensive capture–mark–recapture programme was conducted spanning 21 years (1997–2018) in the most important nesting sites on the Atlantic coast of central Africa (Gabon and Congo) for leatherback (Dermochelys coriacea) and olive ridley (Lepidochelys olivacea) sea turtles.A total of 18,105 encounters of 14,109 D. coriacea individuals and 2678 encounters of 2427 L. olivacea individuals were recorded. Biological and technical parameters such as clutch frequency, inter‐nesting interval, remigration interval, annual survival rate, somatic growth, size trends, tag loss and number of annual nesting females were estimated through a variety of methods and models.The study detected a decline in body size and low survival probability (not due to tag loss) in both species but no clear decline in estimated annual number of nesting females. High fidelity to nesting sites (<30 km for both species) implies that the current conservation strategy, protecting the main nesting areas, could be effective.We recommend that local conservation managers promote: (i) continued monitoring of the nesting activity of the two species through capture–mark–recapture programmes; (ii) continued nest counts at long‐term monitoring sites, which may also detect possible spatial shifts; and (iii) strengthening of cross‐border cooperation between Gabon and Republic of the Congo given the observed connectivity between nesting sites of the two countries. [ABSTRACT FROM AUTHOR]

Coronaviruses (CoVs, Coronaviridae) are a diverse group of viruses that infect mammals, birds, and fish. Seven CoVs infect humans, among which Severe Acute Respiratory Syndrome CoVs-1 and -2 and Middle East respiratory syndrome CoVs have shown how they can impact global health and the economy. Their spillover from bats-the natural reservoir-to humans has required intermediary hosts. Prevention requires that active surveillance be conducted on animals. Today, there is no data concerning the genetic diversity of CoVs naturally circulating in wild primates. This study aimed to screen wild great apes and mandrills in Gabon for CoVs. A total of 229 faecal samples of great apes and mandrills collected from 2009 to 2012 in forests and national parks were used for the detection of CoVs by nested PCR using primers targeting a conserved region of the RNA-dependent RNA polymerase. While all samples were negative, this lack of detection could be related to sample size, the transient nature of the infection, or because faecal samples are not suitable for detecting CoVs in primates. A longitudinal study should be performed and other non-invasive methods used to collect respiratory samples to better evaluate the circulation of CoVs in these primates. [ABSTRACT FROM AUTHOR]

This prospective, cross-sectional study was conducted from April 3 to July 20, 2023, at the Paul MOUKAMBI Regional Hospital of Koula-Moutou. Blood samples taken from participants were used to diagnose Loa loa filariasis by direct optical microscopy and leucoconcentration. A questionnaire was used to collect data, which were entered into an Excel 2016 spreadsheet and exported to R software version 3.6.1. Univariate analysis, followed by multivariate analysis using logistic regression, yielded crude and adjusted Odds-Ratios. Within a 95% confidence interval, results were considered statistically significant at p ≤ 0.05. A total of 300 participants, with a mean age of 26.7 ± 17.45 years, took part in the study. A prevalence of Loa loa filariasis of 14% (95% CI: [0.10. 0.18]) was reported. After univariate analysis, multivariate logistic regression adjustment of this prevalence according to the different variables indicated that being female (adjusted OR = 56.9, 95% CI: [1.71; 1893,] p =0.024*) was the only significant risk factor for Loa loa filariasis in this study. Systematic epidemiological surveillance is needed to protect elderly women from Loa loa filariasis in Gabon. [ABSTRACT FROM AUTHOR]

Aim: The mosaic of savannas that persists in the forest‐dominant Congo Basin is thought to be palaeoclimatic relics, but past biogeographical processes that have formed and maintained these systems are poorly understood. Here, we explored the post‐Pleistocene biogeography of Gabon's savannas using termites as biological indicators to understand historical and mechanistic factors influencing present‐day termite communities in the country's extant savannas. Location: Gabon, Central Africa. Taxon: Blattodea: Termitoidae. Methods: Using standardised transect methods, we sampled termite communities in four disjunct modern savanna areas of Gabon: the centre (Lopé), the southeast (Batéké) and the south (Mayombe North and South). Termites at Lopé were collected in three habitats (annually burned savannas, savannas with a depressed fire regime and forest). We used DNA barcoding of the COII region to identify termite species and compared abundance, species richness and community composition across areas and habitats. Results: Community composition differed greatly between Lopé and both Batéké and Mayombe savannas with Lopé being exceptionally depauperate and lacking characteristic savanna species. Within Lopé, termite abundance and diversity was highest in forests and lowest in annually burned savannas, with a gradual change in species composition across the forest–savanna gradient associated with fire history. Main Conclusions: The absence of savanna typical species in Lopé savannas challenges current assumptions that these savannas were linked to the south/southeastern savannas during the Pleistocene and suggests a different evolutionary history. Lopé savannas may instead have opened as an isolated grassland and never have been contiguous with neighbouring savannas, or were isolated soon after forest expansion began and have now lost savanna‐typical species. Furthermore, the patterns of termite community composition in fire suppressed savannas support a hypothesis of rapid change driven by fire frequency where either fire suppression or infrequent burning over 23 years has meant savannas have become ecologically much more forest‐like. [ABSTRACT FROM AUTHOR]

Simple Summary: Enteric viruses cause gastroenteritis in humans and animals, but have also been associated with several extraintestinal diseases. These viruses affect a wide range of vertebrate species, including birds and mammals. Frequent and close contact between humans and animals can potentially lead to the emergence of zoonoses. Approximately 60% of zoonotic diseases in humans are spillovers from wildlife. Preventing future outbreaks of emerging zoonotic diseases calls for better description of the viruses that circulate in domestic animals, because they are located at the human/wildlife interface. We therefore screened for the presence of astroviruses, enteroviruses, and caliciviruses—three of the main viral families causing enteric diseases both in humans and animals—in goats, sheep and dogs living in villages in northeastern Gabon. We identified the presence of astroviruses in goats, a calicivirus in a dog, and enteroviruses in all three species. All detected viruses were animal-related, but not those from wildlife. However, we showed that some human-pathogenic enteroviruses infect goats and dogs. Therefore, further studies are required to better understand the role of domestic animals as amplifiers of reverse zoonotic viruses. Astroviruses (AstVs), enteroviruses (EVs), and caliciviruses (CaVs) infect several vertebrate taxa. Transmitted through the fecal–oral route, these enteric viruses are highly resistant and can survive in the environment, thereby increasing their zoonotic potential. Here, we screened for AstVs, EVs, and CaVs to investigate the role of domestic animals in the emergence of zoonoses, because they are situated at the human/wildlife interface, particularly in rural forested areas in Central Africa. Rectal swabs were obtained from 123 goats, 41 sheep, and 76 dogs in 10 villages located in northeastern Gabon. Extracted RNA reverse-transcribed into cDNA was used to detect AstVs, EVs, and CaVs by amplification of the RNA-dependent RNA polymerase (RdRp), or capsid protein (VP1) gene using PCR. A total of 23 samples tested positive, including 17 goats for AstVs, 2 goats, 2 sheep, 1 dog for EVs, and 1 dog for CaVs. Phylogenetic analyses revealed that AstV RdRp sequences clustered with sheep-, goat-, or bovine-related AstVs. In addition, one goat and two sheep VP1 sequences clustered with caprine/ovine-related Evs within the Enterovirus G species, and the CaV was a canine vesivirus. However, human-pathogenic Evs, EV-B80 and EV-C99, were detected in goats and dogs, raising questions on the maintenance of viruses able to infect humans. [ABSTRACT FROM AUTHOR]

Medicinal plants are traditionally used in Gabon to treat several types of illnesses. The study's purpose was to determine the toxic, antibacterial, and anti-inflammatory effects of Antrocaryon klaineanum Pierre extracts and to characterize their phytochemical compounds. Toxicity was evaluated on frog tadpoles (Phrynobatrachus africanus Hallowell). The microorganism susceptibility test was performed by the diffusion method, while minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were evaluated using the microdilution technique. Anti-inflammatory activity was tested through protein denaturation and membrane stabilization methods. Chromatography and molecular network techniques were used to characterize chemical compounds. The lethality test showed that the lethal concentration (LC50) increased from 110.03 ± 1.25 to 15.86 ± 2.21 μg/mL after 24 and 96 hours of exposure. In tadpoles exposed to 7.81 μg/mL extract, the first mortalities (12.5%) were observed on the fifth day of exposure. A relative decrease in mature erythrocytes exposed to plant extracts was observed. The antibacterial activity shows that the Ak F2, Ak F3, and Ak F4 fractions (from the water-ethanol crude extract) gave the greatest antibacterial activities compared to the other extracts. The water, water-acetone, and water-ethanol extracts showed good inhibition of denaturation. The haemolysis test shows that the extracts exhibited good anti-inflammatory activities. Phytochemical characterisation revealed four major compounds, including monogallate epicatechin and hydroxy-ergostadian. The molecular network revealed five main clusters. Our study shows that A. klaineanum Pierre could be a promising natural product for the isolation of molecules with potential biological activities. [ABSTRACT FROM AUTHOR]

Simple Summary: Wildlife is an important source of infectious pathogens, including parasites. Intestinal parasites are among the parasites associated with outbreaks of foodborne disease. This article analyses gastrointestinal parasites in fecal and intestine samples from wild animals used as bushmeat in the Zadie Department, Gabon. Identified parasites belonged to Fifteen taxa of gastrointestinal parasites, some of which are pathogenic for the human being. Gastrointestinal parasite detected in fecal samples from wildlife poses risks to humans, animal, and agricultural production due to the possibility of direct contact with feces. Much care should be given when manipulating games, particularly offal. In conclusion, monitoring wildlife parasites should be conducted in the One Health approach, which recognizes the close link between human, animal, plant, and ecosystem health. Wild animals harbor pathogens that can be infectious agents for humans, including parasites. This study aimed to identify gastrointestinal parasites and assess their prevalence and the potential risk for humans associated with consuming these animals. The research was conducted from August to December 2019. Parasitological analyses were carried out on the feces and intestines of 113 wild animals, including antelopes (24), duikers (58), porcupines (18), small monkeys (Cercopithecus) (8), nandinia (2), pangolin (1), genet (1), and a crocodile (1), from the Zadié Department in the province of Ogooué-Ivindo in the northeast of Gabon. The results revealed 15 taxa of gastrointestinal parasites, including nine nematodes: Strongylids (61/113), Strongyloides spp. (21/113), Ascaris spp. (21/113), Trichuris spp. (39/113), Capillaria spp. (9/113), Protostrongylus spp. (5/113), Enterobius spp. (8/113), Toxocara spp. (7/113) and Mammomonogamus spp. (5/113); three species of protozoa, namely Balantidium spp. (12/113), Eimeria spp. (17/113), and Entamoeba spp. (9/113); two species of trematodes, namely Fasciola spp. (18/113) and Paramphistomum spp. (21/113); and cestode species, Taenia spp. (1/113). The prevalence of gastrointestinal parasitism in these animals was 85.84% (97/113). In addition, among these parasitic taxa, some are potential pathogens for humans, such as Ascaris spp., Balantidium spp., Entamoeba spp., and Taenia spp. The consumption of games, particularly offal, infested by these parasites, could threaten human health. [ABSTRACT FROM AUTHOR]

This study aims at establishing specimens pooling approach for the detection of SARS-CoV-2 using the RT-PCR BGI and Sansure-Biotech kits used in Gabon. To validate this approach, 14 positive samples, stored at -20°C for three to five weeks were analyzed individually (as gold standard) and in pools of five, eight and ten in the same plate. We created 14 pools of 5, 8 and 10 samples using 40 μL from each of the selected positive samples mixed with 4, 7 and 9 confirmed negative counterparts in a total volume of 200 μL, 320 μL and 400 μL for the pools of 5, 8 and 10 respectively. Both individual and pooled samples testing was conducted according to the BGI and Sansure-Biotech RT-PCR protocols used at the Professor Daniel Gahouma Laboratory (PDGL). Furthermore, the pooling method was also tested by comparing results of 470 unselected samples tested in 94 pools and individually. Results of our experiment showed that using a BGI single positive sample with cycle threshold (Ct) value of 28.42, confirmed by individual testing, detection occurred in all the pools. On the contrary samples with Ct >31 were not detected in pools of 10 and for these samples (Ct value as high as 37.17) their detection was possible in pool of 8. Regarding the Sansure-Biotech kit, positive samples were detected in all the pool sizes tested, irrespective of their Ct values. The specificity of the pooling method was 100% for the BGI and Sansure-Biotech RT-PCR assays. The present study found an increase in the Ct values with pool size for the BGI and Sansure-Biotech assays. This trend was statistically significant (Pearson's r = 0.978; p = 0,022) using the BGI method where the mean Ct values were 24.04±1.1, 26.74±1.3, 27.91±1.1 and 28.32±1.1 for the individual, pool of 5, 8 and 10 respectively. The testing of the 470 samples showed that one of the 94 pools had a positive test similar to the individual test using the BGI and Sansure-Biotech kits. The saving of time and economizing test reagents by using the pooling method were demonstrated in this study. Ultimately, the pooling method could be used for the diagnosis of SARS-CoV-2 without modifying the accuracy of results in Gabon. We recommend a maximum pool size of 8 for the BGI kit. For the Sansure-Biotech kit, a maximum pool size of 10 can be used without affecting its accuracy compared to the individual testing. [ABSTRACT FROM AUTHOR]

Background The level of blood filariasis parasitaemia as well as the frequency of and the relationship between cotrimoxazole prophylaxis (CTX-P), antiretroviral therapy (ART) intake and CD4 cell count among people living with human immunodeficiency virus (PLHIV) in rural areas of Gabon were being studied. Methods Sociodemographic data and recent biological tests of PLHIV and HIV-negative participants were collected. Loa loa and Mansonella perstans microfilaria were detected by direct microscopy examination and leucoconcentration. Results Overall, 209 HIV-positive and 148 HIV-negative subjects were enrolled. The overall prevalence of microfilaria was comparable between PLHIV (19.9% [n=41/206]) and HIV-negative participants (14.8% [n=22/148]) (p=0.2). The L. loa infection rate was comparable between HIV-positive (9.2%) and HIV-negative participants (6.8%) (p=0.2), while the M. perstans infection rate was 14-fold higher among PLHIV (p<0.01). L. loa parasitaemia was 6-fold lower in PLHIV receiving CTX-P (median 150 mf/mL [interquartile range {IQR} 125–350]) than in patients without (900 [550–2225]) (p<0.01). Among subjects with a CD4 cell count <200 cells/μL, the prevalence of M. perstans was 7-fold higher than that of L. loa (20.6% vs 2.9%). Conclusions This study suggests a similar exposure to L. loa infection of PLHIV and HIV-negative patients while M. perstans is more frequently found in HIV-positive individuals, notably those with a CD4 count <200 cells/μL. [ABSTRACT FROM AUTHOR]

Malaria, blood-borne filarial worms and intestinal parasites are all endemic in Gabon. This geographical co-distribution leads to polyparasitism and, consequently, the possibility of immune-mediated interactions among different parasite species. Intestinal protozoa and helminths could modulate antimalarial immunity, for example, thereby potentially increasing or reducing susceptibility to malaria. The aim of the study was to compare the cytokine levels and cytokine ratios according to parasitic profiles of the population to determine the potential role of co-endemic parasites in the malaria susceptibility of populations. Blood and stool samples were collected during cross-sectional surveys in five provinces of Gabon. Parasitological diagnosis was performed to detect plasmodial parasites, Loa loa, Mansonella perstans, intestinal helminths (STHs) and protozoan parasites. Nested PCR was used to detect submicroscopic plasmodial infection in individuals with negative blood smears. A cytometric bead array was used to quantify interleukin (IL)-6, IL-10 and tumour necrosis factor (TNF)-α in the plasma of subjects with different parasitological profiles. Median IL-6 and IL-10 levels and the median IL-10/TNF-α ratio were all significantly higher among individuals with Plasmodium (P.) falciparum infection than among other participants (p<0.0001). The median TNF-α level and IL-10/IL-6 ratio were higher in subjects with STHs (p = 0.09) and P. falciparum-intestinal protozoa co-infection (p = 0.04), respectively. IL-6 (r = -0.37; P<0.01) and IL-10 (r = -0.37; P<0.01) levels and the IL-10/TNF-α ratio (r = -0.36; P<0.01) correlated negatively with age. Among children under five years old, the IL-10/TNF-α and IL-10/IL-6 ratios were higher in those with intestinal protozoan infections than in uninfected children. The IL-10/TNF-α ratio was also higher in children aged 5–15 years and in adults harbouring blood-borne filariae than in their control counterparts, whereas the IL-10/IL-6 ratio was lower in those aged 5–15 years with filariae and intestinal parasites but higher in adults with intestinal parasitic infections. Asymptomatic malaria is associated with a strong polarization towards a regulatory immune response, presenting high circulating levels of IL-10. P. falciparum/intestinal protozoa co-infections were associated with an enhanced IL-10 response. Immunity against malaria could differ according to age and carriage of other parasites. Helminths and intestinal protozoa can play a role in the high susceptibility to malaria currently observed in some areas of Gabon, but further investigations are necessary. Author summary: The current epidemiological transition of malaria observed in Gabon included, for example, a shift in the at-risk population from children aged less than 5 years old to older children aged 5–15 years. Another consequence was the increasing number of cases of infection among adults. In view of these findings, it is important to explain this phenomenon of epidemiological modification of malaria in Gabon. Intestinal parasites and blood filariasis are endemic in Gabon. These parasites are described to alter the malaria immune response and can be implicated in the susceptibility of individuals to malaria. In Gabon, malaria presents a heterogeneous repartition. Thus, in the present study, we investigated the role of co-endemic parasitosis in the alteration of the malarial immune response by comparing Th1 (IL-6 and TNF-α) and Th2/Treg (IL-10) cytokine production between mono- and co-parasitized individuals in many localities with different epidemiological patterns of malaria. Microscopic analyses and rapid antigenic tests were performed for malaria diagnosis. The nested PCR technique was used to demonstrate the submicroscopic parasitaemia of Plasmodium sp. Then, once groups with different parasitological profiles were constituted, IL-6, IL-10 and TNF-α levels were measured in the plasma of individuals. Th2/Th1 ratios, which can indicate the level of susceptibility of individuals to malaria, were calculated. We observed that there was no interaction between Plasmodium sp. and co-endemic parasites in the present study. However, the high Th2/Th1 cytokine ratio among patients with intestinal protozoa seems to suggest that these intestinal parasites could also play a role in susceptibility to malaria as they do for helminths. [ABSTRACT FROM AUTHOR]

Background: The African continent is considered to be the largest endemic area of HTLV-1 infection, with at least several million infected individuals. Systematic screening of blood donors can prevent the transmission of HTLV-1 in blood. Gabon is one of the countries with the highest prevalence of HTLV-1 worldwide, and yet the routine testing of blood donors has still not been introduced.Methods: All blood donations collected between April and July 2017 at the Centre National de Transfusion Sanguine of Gabon were studied. Plasma samples were screened by ELISA for the presence of HTLV-1/2 antibodies. Western blot (WB) and polymerase chain reaction (PCR) tests were used for confirmation.Results: In total, 3123 blood donors were tested, including 1740 repeat and 1378 first-time blood donors (FTBDs). Of them, 132 samples tested positive for HTLV-1/2 by ELISA (4.2%). WB and PCR confirmed HTLV-1 infection for 23 individuals. The overall prevalence of HTLV-1 was 0.74% [95% CI 0.47%-1.10%], 1% in FTBD, and 0.5% in repeat donors. Age and sex-adjusted prevalence was five-fold lower in FTBD than in the general adult population of rural areas of Gabon. All detected HTLV-1 strains belonged to the central African HTLV-1b genotype but were highly diverse.Conclusion: We report an overall prevalence of HTLV-1 of 0.74%, one of the highest values reported for blood donors in Africa. Given the high risk of HTLV-1 transmission in blood, it is necessary to conduct cost-effectiveness studies to determine the need and feasibility of implementing screening of HTLV-1 in blood donors in Gabon. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension, associated with certain pathologies, can threaten the maternal and fetal prognosis during pregnancy and even after delivery. Moreover, hypertension may occur before pregnancy and be diagnosed only during prenatal consultation; however, it also seems to be associated with urbanization. Objective: Investigate an association between conventional cardiovascular risk factors and hypertension in pregnant women. Patients and Methods: A cross-sectional, case-control, descriptive, and analytical study was conducted from February to May 2019 at the CHUMEJE and at the biochemistry laboratory of the University of Health Sciences at Libreville (Gabon). After informed consent obtained from woman, systolic and diastolic blood pressures (SBP and DBP) were measured with a sphygmomanometer. Then venipuncture was performed for each fasting woman. Blood glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, creatinine, urea, and uric acid were determined. Means of the qualitative and quantitative variables found among hypertensive patients were compared with those of normotensive patients. A value of P<0.05 was statistically significant. Results: 186 women were included which were 86 hypertensive (cases) and 100 normotensive (controls). Urine dipstick among hypertensive patients identified 93.1% with proteinuria against 0% among normotensive patients. We found 25.6% of hypertensive women with hyperglycemia against 13.0% for controls (p=0.022). Similarly, 54.7% of hypertensive women had hyperuricemia, against 18.0% of controls (p=0.000). Also, hypertriglyceridemia was found among 52.3% of cases versus 29% of controls (p=0.000). Conclusion: It emerges from this study that proteinuria, hyperglycemia, hypertriglyceridemia and hyperuricaemia are cardiometabolic risk factors associated to hypertensive pregnant women in Gabon. These different factors would threaten the vital prognosis of the mother and the pregnancy. Thus, hygieno-dietetic measures should be prescribed and the dosage of these various parameters carried out on a regular basis among hypertensive pregnant women. [ABSTRACT FROM AUTHOR]

Data on the prevalence of antibiotic resistance in Enterobacteriaceae in African wildlife are still relatively limited. The aim of this study was to estimate the prevalence of phenotypic intrinsic and acquired antimicrobial resistance of enterobacteria from several species of terrestrial wild mammals in national parks of Gabon. Colony culture and isolation were done using MacConkey agar. Isolates were identified using the VITEK 2 and MALDI-TOF methods. Antibiotic susceptibility was analysed and interpreted according to the European Committee on Antimicrobial Susceptibility Testing guidelines. The preliminary test for ESBL-producing Enterobacteriaceae was performed by replicating enterobacterial colonies on MacConkey agar supplemented with 2 mg/L cefotaxime (MCA+CTX). Extended-spectrum beta-lactamase (ESBL) production was confirmed with the double-disc synergy test (DDST). The inhibition zone diameters were read with SirScan. Among the 130 bacterial colonies isolated from 125 fecal samples, 90 enterobacterial isolates were identified. Escherichia coli (61%) was the most prevalent, followed by Enterobacter cloacae (8%), Proteus mirabilis (8%), Klebsiella variicola (7%), Klebsiella aerogenes (7%), Klebsiella oxytoca (4%), Citrobacter freundii (3%), Klebsiella pneumoniae (1%) and Serratia marcescens (1%). Acquired resistance was carried by E. coli (11% of all E. coli isolates) and E. cloacae (3% of all E. cloacae) isolates, while intrinsic resistance was detected in all the other resistant isolates (n = 31); K. variicola, K. oxytoca, K. pneumoniae, E. cloacae, K. aerogenes, S. marcescens and P. mirabilis). Our data show that most strains isolated in protected areas in Gabon are wild type isolates and carry intrinsic resistance rather than acquired resistance. [ABSTRACT FROM AUTHOR]

Background: Malaria is one of the leading causes of morbidity and mortality in African countries. It is one of the leading causes of hospital visits and hospitalization in pediatric wards for children under 5 years old. Interestingly however, the economic burden of this disease remains unknown in these endemic countries including Gabon. The purpose of this study is to assess the direct hospital cost for the management of malaria in children under 5 years old at the Libreville University Hospital Centre (CHUL, Centre Hospitalier Universitaire de Libreville) in Gabon. Methods: This research work is a retrospective study using a comprehensive review of medical records of patients seen at the CHUL over a two-year period extending from January 2018 through December 2019. The study focused on children under 5 years old, admitted for malaria in the paediatric ward of the CHUL. The analysis targeted specifically direct hospital costs, which excluded salary and wages of health care workers. The monetary currency used in this study was the CFA francs, as that currency is the one used in Central Africa (as reference, 1 Euro = 656 CFA francs). Results: For the set timeframe, 778 patient records matched the study criteria. Thus, out of 778 admitted patients, 58.4% were male while 41.5% were female. Overall, the average age was 13.2 months (± 13.8 months). The total cost incurred by the hospital for the management of these 778 malaria patients was 94,922,925 CFA francs (144,699.58 €), for an average expense per patient topping at 122,008 CFA francs (185.99 €). The highest expenditure items were hospitalizations (44,200,000 CFA francs, 67,378.1 €), followed by drugs (26,394,425 CFA francs, 40,235.4 €) and biomedical examinations (14,036,000 CFA francs, 21,396.34 €). Conclusion: The financial burden for managing malaria in the paediatric ward seems to be very high, not only for the hospital, but also for families in spite of the government medical insurance coverage in some cases. These findings bring new insights as to the urgency to develop policies that foster preventive initiatives over curative approaches in the management of malaria in children in endemic countries. [ABSTRACT FROM AUTHOR]

In a context where SARS-CoV-2 population-wide testing is implemented, clinical features and antibody response in those infected have never been documented in Africa. Yet, the information provided by analyzing data from population-wide testing is critical to understand the infection dynamics and devise control strategies. We described clinical features and assessed antibody response in people screened for SARS-CoV-2 infection. We analyzed data from a cohort of 3464 people that we molecularly screened for SARS-CoV-2 infection in our routine activity. We recorded people SARS-CoV-2 diagnosis, age, gender, blood types, white blood cells (WBC), symptoms, chronic disease status and time to SARS-CoV-2 RT-PCR conversion from positive to negative. We calculated the age-based distribution of SARS-CoV-2 infection, analyzed the proportion and the spectrum of COVID-19 severity. Furthermore, in a nested sub-study, we screened 83 COVID-19 patients and 319 contact-cases for anti-SARS-CoV-2 antibodies. Males and females accounted for respectively 51% and 49% of people screened. The studied population median and mean age were both 39 years. 592 out of 3464 people (17.2%) were diagnosed with SARS-CoV-2 infection with males and females representing, respectively, 53% and 47%. The median and mean ages of SARS-CoV-2 infected subjects were 37 and 38 years respectively. The lowest rate of infection (8%) was observed in the elderly (aged > 60). The rate of SARS-Cov-2 infection in both young (18–35 years old) and middle-aged adults (36–60 years old) was around 20%. The analysis of SARS-CoV-2 infection age distribution showed that middle-aged adults accounted for 54.7% of SARS-CoV-2 positive persons, followed respectively by young adults (33.7%), children (7.7%) and elderly (3.8%). 68% (N = 402) of SARS-CoV-2 infected persons were asymptomatic, 26.3% (N = 156) had influenza-like symptoms, 2.7% (N = 16) had influenza-like symptoms associated with anosmia and ageusia, 2% (N = 11) had dyspnea and 1% (N = 7) had respiratory failure, which resulted in death. Data also showed that 12% of SARS-CoV-2 infected subjects, had chronic diseases. Hypertension, diabetes, and asthma were the top concurrent chronic diseases representing respectively 58%, 25% and 12% of recorded chronic diseases. Half of SARS-CoV-2 RT-PCR positive patients were cured within 14 days following the initiation of the anti-COVID-19 treatment protocol. 78.3% of COVID-19 patients and 55% of SARS-CoV-2 RT-PCR confirmed negative contact-cases were positive for anti-SARS-CoV-2 antibodies. Patients with severe-to-critical illness have higher leukocytes, higher neutrophils and lower lymphocyte counts contrarily to asymptomatic patients and patients with mild-to-moderate illness. Neutrophilic leukopenia was more prevalent in asymptomatic patients and patients with mild-to-moderate disease for 4 weeks after diagnosis (27.1–42.1%). In Patients with severe-to-critical illness, neutrophilic leukocytosis or neutrophilia (35.6–50%) and lymphocytopenia (20–40%) were more frequent. More than 60% of participants were blood type O. It is also important to note that infection rate was slightly higher among A and B blood types compared with type O. In this African setting, young and middle-aged adults are most likely driving community transmission of COVID-19. The rate of critical disease is relatively low. The high rate of anti-SARS-CoV-2 antibodies observed in SARS-CoV-2 RT-PCR negative contact cases suggests that subclinical infection may have been overlooked in our setting. [ABSTRACT FROM AUTHOR]

Background: The projected UNAIDS goal of ending AIDS by 2030 requires significant global efforts to improve current and future ART strategies. In this study, we assessed viral load (VL) suppression and acquired drug resistance, as well as future efficacy of dolutegravir-based combinations for patients living in semi-rural regions of Gabon.Methods: Eligible study participants were adults receiving ART and recruited between 2018 and 2019 in Franceville, Gabon. VL testing was conducted to assess VL suppression and HIV drug resistance (HIVDR) testing was performed to identify resistance mutations and assess their impact on ongoing and future ART regimens.Results: We recruited 219 participants overall. The median time on ART was 27 months and 216/219 participants were on first-line ART. VL suppression (VL < 1000 copies/mL) was 57.1% (95% CI 50.5-63.8) overall; 59.4% (51.4-67.5) and 52.2% (40.3-64.2) for women and men, respectively. The overall prevalence of HIVDR was 21.9% among the study population and 67.2% among those who failed ART. Presence of both NRTI and NNRTI mutations was found in 84.6% of sequences with drug resistance mutations, and full activity of a dolutegravir-based first-line regimen including tenofovir disoproxil fumarate/lamivudine/dolutegravir was expected only for 5/39 patients with a resistant virus.Conclusions: This study shows a very low rate of VL suppression in a semi-rural context in Africa. Moreover, the high burden of HIVDR has affected both current and newly recommended ART strategies. Better management of ART in resource-limited settings is still a challenging ambition. [ABSTRACT FROM AUTHOR]

Background: Nosocomial infection outbreaks in neonatal services are a serious healthcare concern in both developed and developing countries, but few studies have been conducted in sub-Saharan Africa. Objective: This study explored the etiology of septicemia in neonates and associated patterns of antimicrobial susceptibility in Gabon. Methods: We analyzed cultures from neonates' blood and swabs from medical personnel and equipment located in the neonatology service. Results: Sixty-eight microorganisms were isolated from the medical personnel and equipment; 46 microorganisms were isolated from neonates' blood culture. Klebsiella pneumoniae spp pneumoniae was the most common bacteria found in both (30.6% and 26.9%, respectively). All Klebsiella pneumoniae spp pneumonia isolates were resistant to amoxicillin with clavulanic acid, gentamycin resistance ranged from 93% to 100%, and cephalosporin resistance ranged from 33.3% to 47%. Conclusions:Awareness of the etiology, prevalence, and outcome of nosocomial infection is the first and most important step to appropriate interventions. [ABSTRACT FROM AUTHOR]

Background This cross-sectional study was carried out in different settlements of Gabon to determine the influence of single or multiple parasite carriage on haemoglobin (Hb) levels. Methods Between April 2015 and June 2016, healthy volunteers from urban, peri-urban and rural areas were screened for malaria, blood filariasis and intestinal parasitic infections using microscopic methods. Hb concentration was measured with a Hemocue analyser. The association between parasite carriage and anaemia was assessed. Results Among the 775 volunteers examined, 319 (41.2%) were from rural villages and 76.0% were adults. Filariasis, intestinal parasitic infections, Plasmodium falciparum and polyparasitism were detected in 15.6, 14.6, 9.5 and 6.8% of participants, respectively. Anaemia prevalence was 72.6%, with rates of mild, moderate and severe anaemia being 30.9, 61.1 and 8.0%, respectively. The median Hb level was lowest in the presence of hookworms (7.1 g/dl [interquartile range {IQR} 6.8–7.5]), Schistosoma intercalatum (6.9 g/dl), Trichuris trichiura (10.1 g/dl [IQR 8.9–11.5]) and Plasmodium falciparum (10.0 g/dl [IQR 9.1–11.2]) compared with filariaemia (12.1 g/dl [IQR 10.5–13.2]) (p=0.03). Moderate to severe anaemia predominated among those single-infected with P. falciparum (69.5%) or co-infected with intestinal parasitic infections and P. falciparum (76.2%), while it was found in only 23.2% of individuals with filariasis. All participants with soil-transmitted helminths and more than half with a Blastocystis sp. (68.8%) infection had moderate anaemia. Conclusions The prevalence of anaemia is high. Asymptomatic parasite carriage is associated with anaemia in this surveyed population in Gabon. [ABSTRACT FROM AUTHOR]

Antibiotic resistance occurs in the environment by multiplication and the spread of multidrug-resistant bacteria that would be due to an improper and incorrect use of antibiotics in human and veterinary medicine. The aim of this study was to establish the prevalence of E.coli producing Extended-Spectrum beta-Lactamase (ESBL) antibiotics from rats and gregarious animals in a semirural area of Gabon and to evaluate the origin of a resistance distribution in the environment from animal feces. The bacterial culture was carried out, and the identification of E. coli strains on a specific medium and the antibiotic susceptibility tests allowed establishing the prevalence. Characterization of resistance genes was performed by gene amplification after DNA extraction. On 161 feces collected in rats, 32 strains were isolated, and 11 strains of E. coli produced ESBL with a prevalence of 34.37%. Molecular tests showed that CTX-M genes 214 bp were identified in rats. The presence of CTX-M genes could have a human origin. So, the rats can carry ESBL-producing Enterobacteriaceae which poses a risk to human health and pets in this region of Gabon. [ABSTRACT FROM AUTHOR]

Forest edges that border savanna are dynamic features of tropical landscapes. Although the role of fire in determining edge dynamics has been relatively well explored, the role of mega-herbivores, specifically elephants, has not received as much attention. We investigated the role of forest elephants in shaping forest edges of the forest–savanna mosaic in Lopé National Park, Gabon. Using forty camera traps, we collected 1.2 million images between May 2016 and June 2017. These images were classified by over 10,000 volunteers through an online citizen science platform. These data were combined with a 33-year phenology dataset on elephant-favoured fruiting tree species, and field measurements of elephant browsing preferences and damage. Our results showed a strong relationship between forest elephant density at the forest edge and fruit availability. When fruit availability was high, elephant density at the edge reached values nearly double the highest densities ever reported in any other part of the landscape (7.5 elephants km−2 in this study vs the previous highest estimate of 4 elephants km−2). The highest elephant densities occurred at the end of the dry season, but even outside of this high density period elephant density at the forest edge (2.4 elephants km−2) was more than double what other studies estimate for forest interiors with low human hunting pressure (1 elephant km−2). We found forest elephants to be selective browsers, but their browsing was non-destructive (in contrast to savanna elephants) and had little effect on tree size demography. Elephant paths acted as firebreaks during savanna burning, making them inadvertent protectors of the fire-sensitive forest and contributing to the stabilising feedbacks that allow forest and savanna to coexist in tropical landscapes. [ABSTRACT FROM AUTHOR]

Background: The humid tropical forests of Central Africa influence weather worldwide and play a major role in the global carbon cycle. However, they are also an ecological anomaly, with evergreen forests dominating the western equatorial region despite less than 2,000 mm total annual rainfall. Meteorological data for Central Africa are notoriously sparse and incomplete and there are substantial issues with satellite-derived data because of persistent cloudiness and inability to ground-truth estimates. Long-term climate observations are urgently needed to verify regional climate and vegetation models, shed light on the mechanisms that drive climatic variability and assess the viability of evergreen forests under future climate scenarios. Methods: We have the rare opportunity to analyse a 34 year dataset of rainfall and temperature (and shorter periods of absolute humidity, wind speed, solar radiation and aerosol optical depth) from Lopé National Park, a long-term ecological research site in Gabon, western equatorial Africa. We used (generalized) linear mixed models and spectral analyses to assess seasonal and inter-annual variation, long-term trends and oceanic influences on local weather patterns. Results: Lopé’s weather is characterised by a cool, light-deficient, long dry season. Long-term climatic means have changed significantly over the last 34 years, with warming occurring at a rate of +0.25 °C per decade (minimum daily temperature) and drying at a rate of −75 mm per decade (total annual rainfall). Inter-annual climatic variability at Lopé is highly influenced by global weather patterns. Sea surface temperatures of the Pacific and Atlantic oceans have strong coherence with Lopé temperature and rainfall on multi-annual scales. Conclusions: The Lopé long-term weather record has not previously been made public and is of high value in such a data poor region. Our results support regional analyses of climatic seasonality, long-term warming and the influences of the oceans on temperature and rainfall variability. However, warming has occurred more rapidly than the regional products suggest and while there remains much uncertainty in the wider region, rainfall has declined over the last three decades at Lopé. The association between rainfall and the Atlantic cold tongue at Lopé lends some support for the ‘dry’ models of climate change for the region. In the context of a rapidly warming and drying climate, urgent research is needed into the sensitivity of dry season clouds to ocean temperatures and the viability of humid evergreen forests in this dry region should the clouds disappear. [ABSTRACT FROM AUTHOR]

Purpose: Artesunate–amodiaquine (AS–AQ) and artemether–lumefantrine (AL) have been widely used for the treatment of uncomplicated Plasmodium falciparum malaria since 2005 in Gabon. Since 2011, a rebound of malaria morbidity has been observed in this country, while no survey evaluating ACT efficacy was performed. During the same period, parasite resistance against artemisinin has been reported in Asia. The aim of this study was to assess the efficacy and tolerability of these two drugs in two sentinel sites of Gabon 10 years after their implementation. Methods: Children aged from 12 to 144 months with uncomplicated malaria were recruited at the Regional Hospital of Melen, Libreville and in the Urban Health Center of Franceville between March 2014 and September 2015. The therapeutic efficacy was evaluated according to the WHO 2008 protocol of 28-day follow-up and PCR-uncorrected/corrected treatment outcomes were assessed. Results: One hundred and eighty-five children (98 ASAQ and 89 AL) were followed up until day 28. The PCR-corrected ACPR was 98.9% for AS–AQ and 96.4% for AL. Late therapeutic failure rate was 3.6% and 1.1% for AL and AS–AQ, respectively (p = 0.2). Adverse events and serious adverse events were rarely observed with both treatments. Conclusion: AS–AQ and AL are still efficacious and well-tolerated for the treatment of uncomplicated malaria in Gabonese children. [ABSTRACT FROM AUTHOR]

In many developing countries, mothers' awareness remains a challenge despite the scaling up of antenatal care and programs preventing mother-to-child (MTC) HIV transmission. The present study was done in Libreville, Gabon where all antenatal care (delivery included) is free of charge. Here we assessed the timing of antenatal antiretroviral (ARV) prophylaxis initiation, HIV-exposed infants' age at their first postnatal HIV check visit and investigated the association between mothers' awareness or knowledge on their ARV therapy and infants' HIV infection. We interviewed HIV-positive mothers on their first and subsequent laboratory visits to investigate infants' HIV status and tested infants for HIV RNA and antibody between 2012 and 2014. We established that (1) of 718 HIV-positive mothers, only 6% were fully aware and knew what ARV treatment they were on during pregnancy; (2) half of the women (54%) start their antenatal ARV prophylaxis initiation during the second trimester of pregnancy; (3) 64% of HIV-exposed infants had their first HIV infection screening between birth and three months of age; (4) the overall prevalence of HIV infection in infants born from infected mothers was 8.9%; and (5) infants born from mothers uncertain about taking prophylactic ARV therapy were 13.3 times more likely to be infected by HIV than infants born from mothers certain about taking prophylactic ARV therapy. In conclusion, the study showed that despite free antenatal care, early access and adherence to components of MTC, HIV transmission preventive care remains unsatisfactory. [ABSTRACT FROM AUTHOR]

Background. Studying malaria parasites cross resistance to sulfadoxine-pyrimethamine (SP) and trimethoprim-sulfamethoxazole (cotrimoxazole, CTX) is necessary in areas coendemic for malaria and HIV. Polymorphism and frequency of drug resistance molecular markers, Pfdhfr and Pfdhps genes have been assessed in Plasmodium falciparum isolates from HIV-infected adults, in Gabon. Materiel and Methods. A cross-sectional study was conducted in three HIV care and treatment centers, at Libreville, the capital city of Gabon and at Oyem and Koulamoutou, two rural cities between March 2015 and June 2016. P. falciparum-infected HIV adults were selected. Analysis of Pfdhfr and Pfdhps genes was performed using high resolution melting (HRM) technique. Results. Pfdhps A581G mutation was found in 23.5% (8/34) of the isolates. Triple Pfdhfr mutation (51I-59R-108N) was predominant (29.4%; n=10) while 17.6% (n=6) of the isolates carried a quadruple mutation (Pfdhfr 51I-59R-108N + Pfdhps 437G; Pfdhfr 51I-108N + Pfdhps 437G-Pfdhps581G; Pfdhfr 51I-59R-108N + Pfdhps 581G). Highly resistant genotype was detected in around 10% (n=3) of the isolates. The quintuple mutation (triple Pfdhfr 51I-59R-108N and double Pfdhps437-581) was only found in isolates from two patients who did not use CTX. The most frequent haplotypes were those with a single mutation (NCNIAKA) (36%) and a quadruple mutation (NCIIGKG, NRIIGKA, and NRIIAKG). Mixed unknown genotypes were found at codon 164 in three isolates. Mixed genotypes were more frequent at codons 51 (23.5%; n=8) and 59 (20.5%; n=7) (p<0.01). Conclusion. Pfdhps A581G mutation as well as new combination of quintuple mutations is found for the first time in isolates from HIV-infected patients in Gabon in comparison to a previous study. The detection of these genotypes at a nonnegligible frequency underlines the need of a regular surveillance of antifolates drug resistance. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the phytochemical constituents, antimicrobial and antioxidant activities of the extracts of Distemonanthus benthamianus (D. benthamianus) stem bark and Solanum torvum (S. torvum) fruit which have been used as traditional medicinal herbs in Gabon. Methods: Plant extracts were subjected to a qualitative study (phytochemical screening) and a quantitative (dosing) study of secondary metabolites. Antioxidant activity was tested by 1,1- diphenyl-2-picrylhydrazyl and 2,2'-azino-bis 3-ethylbenzothiazoline-6-sulfonic acid assay. Bacteria and fungi susceptibility tests were performed on Mueller Hinton medium and solid Sabouraud, respectively, using the diffusion method, while minimum inhibitory concentration, minimum fungicidal concentration and minimum bactericidal concentration were evaluated by microdilution method. Results: The total phenol and tannin contents were significantly higher in the water-ethanol extract compared to the other extracts of D. benthamianus and S. torvum. The water-ethanol and water-acetone extracts showed significantly higher antioxidant activity than the aqueous extracts of the two medicinal plants. However, the extracts presented weak antioxidant activities compared to standards (Vitamin C, BHA). The water-acetone and water-ethanol extracts of S. torvum showed the highest antimicrobial activity against Bacillus cereus LMG 13569 BHI, Shigella dysenteriae 5451 CIP, Shigella dysenteriae and Neisseria gonorrhoeae. Conclusions: Our results show that D. benthamianus and S. torvum can be promising sources of natural products with potential antimicrobial and antioxidant activities. [ABSTRACT FROM AUTHOR]

Background: Very few studies have been conducted on the seroprevalence of syphilis in Gabon. According to the World Health Organization, the average seroprevalence of syphilis has declined from 5.5 to 1.1% in Central Africa. The aim of this study was to test the hypothesis that syphilis decreased in Gabon between 2004 and 2016 and to identify factors involved in this pattern by testing a large sample of first-time blood donors in the capital Libreville.Methods: The detection of Treponema pallidum was done using a Rapid Plasma Reagin test (RPR) and confirmed by an ELISA test using the Biorad Syphilis Total Antibody EIA II kit or BioMerieux Trepanostika TP recombinant. Assays were performed by dedicated technicians according to manufacturers' recommendations and following the laboratory standard operating procedures. Test results were manually transferred into the laboratory Excel files and hand-written in the laboratory logbook for syphilis testing. Logistic regression was used to assess the impact of sociodemographic characteristics on syphilis marker seroprevalence in both univariate and multivariable analysis. Odds ratios (OR) and 95% confidence intervals were calculated.Results: The seroprevalence of syphilis markers was 8.4% (95% CI = 7.9-8.9) in 2004 and 2.4% (95% CI = 2.1-2.7) in 2016. The difference was significant [OR = 3.78; 95% CI (3.26-4.38); P < 0.001]. The decrease in syphilis seroprevalence was significant in both women and men and in each age group in univariate analysis. In multivariable analysis, controlling for all sociodemographic factors, the decrease in syphilis seroprevalence from 2004 to 2016 remained significant (OR = 3.29; 95% CI = 2.88-3.88, P < 0.001). The seroprevalence of syphilis decreased significantly in men compared to women and young donors compared to donors aged ≥36 years.Conclusions: This study shows a significant decline in syphilis seroprevalence in first-time blood donors in Libreville, Gabon. Government actions, including multiple HIV prevention activities, are a likely part of this decline. [ABSTRACT FROM AUTHOR]

Measles is a respiratory disease caused by the measles virus (MV) belonging to the Paramyxovirus family and the Morbillivirus genus. Due to a failure in maintaining immunization coverage in some countries, measles is a re-emerging disease in the human population, especially in Africa. The aim of this study was to describe a measles epidemic in Gabon. At first, a syndromic surveillance was set up. Blood samples from febrile patients with maculopapular rash were taken and sent to the measles reference center in Cameroon for laboratory confirmation. Between March and May 2016, 79 clinically suspected cases were reported including 82.3% (n=65) and 17.7% (n=14) in Oyem and Libreville, respectively. In total, 39.2% (n=31) of children were 11 months-old, 34.2% (n=27) were children aged 1 to 4 years, 11.4% (n=9) were older children from 5 to 9 years, 6.3% (n=5) of children were aged 10 to 15 years and 8.9% (n=7) were 15 years and older. 53.3% (16/30) were laboratory confirmed. This measles outbreak reiterates the importance of maintaining a high level of vaccine coverage in Gabon for vaccine-preventable diseases, as well as the usefulness of a near-real-time surveillance system for the detection of infectious diseases. [ABSTRACT FROM AUTHOR]

Urban development is an increasing threat to the integrity of formerly remote protected areas, in some cases resulting in their downgrading, downsizing or degazetting. One-quarter of previously remote protected areas are now within 17 km of a city and thus face the threat of urbanization. Here we describe a case of avoided downgrading, downsizing and degazetting of a protected area in the Mondah forest of Gabon, north of Libreville. Since its creation in 1934 the Forêt Classée de la Mondah has been downsized regularly, losing 40% of its area over 80 years. During this time the forest surrounding the Forêt Classée was subject to usage for urban and peri-urban needs, including agriculture, sand extraction, collection of medicinal plants, ceremonies, and housing construction. In 2010 the area was threatened with further downsizing. The presence of narrowly endemic plant species in the area was suspected, and mapping and evaluation of these species was proposed in an effort to maintain the protected area boundaries. Botanical field work, including ex situ conservation measures and participant observation in nearby forest communities, was conducted; 24 endemic species, all threatened by urbanization, were evaluated using the criteria for the IUCN Red List of Threatened Species. The borders of the protected area were maintained because of its role in maintaining irreplaceable habitat for threatened species. The area was renamed Raponda Walker Arboretum in 2012. [ABSTRACT FROM PUBLISHER]

In Gabon, sulfadoxine-pyrimethamine (SP) is recommended for intermittent preventive treatment during pregnancy (IPTp-SP) and for uncomplicated malaria treatment through ACTs drug. P. falciparum strains resistant to SP are frequent in areas where this drug is highly used and is associated with the occurrence of mutations on Plasmodium falciparum dihydrofolate reductase (Pfdhfr) and dihydropteroate synthetase (Pfdhps) genes. The aim of the study was to compare the proportion of mutations on Pfdhfr and Pfdhps genes in isolates collected at Oyem in northern Gabon, in 2005 at the time of IPTp-SP introduction and three years later. Point mutations were analyzed by nested PCR-RFLP method. Among 91 isolates, more than 90% carried Pfdhfr 108N and Pfdhfr 59R alleles. Frequencies of Pfdhfr 51I (98%) and Pfdhps 437G (67.7%) mutant alleles were higher in 2008. Mutations at codons 164, 540, and 581 were not detected. The proportion of the triple Pfdhfr mutation and quadruple mutation including A437G was high: 91.9% in 2008 and 64.8% in 2008, respectively. The present study highlights an elevated frequency of Pfdhfr and Pfdhps mutant alleles, although quintuple mutations were not found in north Gabon. These data suggest the need of a continuous monitoring of SP resistance in Gabon. [ABSTRACT FROM AUTHOR]

This study was conducted to assess some important performance characteristics of the optically stimulated luminescence dosimetry system of the national individual monitoring service in Gabon, namely, reader performance tests, dose algorithm, and signal depletion. The reader performance tests demonstrated that the reader photomultiplier tube is performing self-consistently and that there is no abnormality in the counting system. Concerning the dose algorithm, it was shown that the proposed dose algorithm provides a good estimate of the dose compared with the system dose algorithm, which is not known. From the signal depletion study, the depletion rate per reading of 0.4 ± 0.09% (strong stimulation beam) was determined for field dosimeters. Depletion rates per reading of 0.3 ± 0.03% (strong beam) and 0.020 ± 0.001% (weak beam) were also determined for calibration dosimeters. All these values are comparable to those determined in other studies. [ABSTRACT FROM AUTHOR]

Gout is caused by a chronic hyperuricemia whose complications are not currently well evaluated in Africa. The aim of this study was to determine the prevalence and risk factors of hyperuricemia and gout in 85 patients recruited. A total of 26 cases of hyperuricemia, i.e., 30.6% of the study population, with 12 cases of gout and seven cases of gouty access. In this population, hyperuricemia was proportional to age (p-value < 10-4, OR = 2.6), but it was more prevalent in men, 23.5% versus 7.1% for women (p-value = 0.0047). In addition, none of these women showed signs of a gouty affection. Consumption of alcohol (OR = 13) and nucleoprotein-rich foods, obesity (BMI 30 kg/m²; OR = 6), family history of gout (OR = 6.8), as well as diseases such as high blood pressure (associated with taking diuretics; OR = 1.7), renal insufficiency (OR = 4.4) and diabetes (p < 0.049) were the main factors of the diseases associated with gout and hyperuricemia in this population. The biochemical role of these factors may increase and/or decrease the processes of synthesis and/or elimination of uric acid by acting on metabolites involved in the regulation of urate production. [ABSTRACT FROM AUTHOR]

Background Studies showed that chloroquine resistance may revert to sensitivity after its withdrawal mainly detected by a significant decrease of Plasmodium falciparum pfcrt 76T and pfmdr1 86Y alleles. Besides, self-medication is considered as a key factor of antimalarial drug resistance expansion. Thus, pfcrt 76T and pfmdr1 86Y allele frequency and its relationship with antimalarial drug self-medication was analyzed in P. falciparum isolates collected in Gabon. Methods Samples were collected from febrile children screened for P. falciparum infection in 2005 and 2008 at the regional hospital of Oyem. Self-use of antimalarial drugs before the day of consultation was recorded. Polymorphic codons 76 and 86 of pfcrt and pfmdr1 genes were analyzed by PCR-RFLP. Results The frequency of pfcrt 76T mutant allele was greater than 70.0% in 2005 and 2008. Wild type isolates were 1.7-fold more prevalent in 2008. The prevalence of pfmdr1 86Y mutant allele was comparable between 2005 and 2008 (p=0.1); the proportion of wild type allele reached 20.5% in 2008. The frequency of wild type allele pfcrt K76 or pfmdr1 N86 was higher among patients without anti-malarial drug self-medication compared to those who used it. Conclusions An increase of the frequency of P. falciparum wild type allele pfcrt 76K and pfmdr1 86N was observed within a short period after chloroquine withdrawal. The proportion of mutant genotypes is still high, mainly among patients using self-medication with antimalarial drugs. [ABSTRACT FROM AUTHOR]

Through this study, we tried to identify the representations that the teachers and the future Gabonese teachers have regarding some genetic determinism of the phenotype. Our objective was to see if they correspond or gets closer of current paradigm in the scientific community which is the notion of epigenetic. The results obtained by means of the Statistical Analysis Implicative allowed to identify two main representations: one according to which the phenotype would depend only on the genotype and the other for which genotype could not explain the phenotype. [ABSTRACT FROM AUTHOR]

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Abstract: Background: Intrafamilial and sexual transmission of hepatitis C virus (HCV) are still being debated, and little is known about such transmission in central Africa. Objective: To examine the rate of intrafamilial transmission of HCV between patients and their household members. Study design: A cross-sectional study was conducted in Dienga, a remote village in Gabon, involving 195 household members of 14 index cases of HCV infection. After a questionnaire on the risk factors for parenteral exposure, blood samples were obtained and tested for antibody to HCV by an enzyme immunoassay (Monolisa anti-HCV plus version 2). Positive samples were tested for HCV RNA and genotyped by amplification and phylogenetic analysis of a fragment of the NS5B gene. Results: HCV antibody was found in 13/195 (6.7%) household contacts, comprising 5/14 (35.7%) sexual partners and 8/114 (7%) relatives. None of the children of index patients tested positive. HCV RNA was detected in only five household members with HCV antibody. The same genotypes were found in only two of five couples, both couples being sexual partners. Parenteral risk factors were not more likely to be reported by people positive for HCV antibody than by those who were negative. Age over 50 years was the only independent predictor of positivity for HCV antibody. Conclusions: This study indicates, as previously suggested, that the spread of HCV in central Africa is due to a cohort effect, with previous, possibly iatrogenic, transmission rather than intrafamilial or sexual transmission. [Copyright &y& Elsevier]

Background: Hepatitis C virus (HCV) infection is a major global public health problem in both developed and developing countries. The prevalence and genetic diversity of HCV in pregnant women in Gabon, central Africa, is not known. We therefore evaluated the prevalence and the circulating genotypes of HCV in a large population cohort of pregnant women. Methods: Blood samples (947) were collected from pregnant women in the five main cities of the country. The prevalence was evaluated by two ELISA tests, and the circulating genotypes were characterized by sequencing and phylogenetic analysis. Results: Twenty pregnant women (2.1%) were infected with HCV. The seroprevalence differed significantly by region (p = 0.004) and increased significantly with age (p = 0.05), being 1.3% at 14-20 years, 1.1% at 21-25 years, 1.9% at 26-30 years, 4.1% at 31-35 years and 6.0% at > 35 years. Sequencing in the 5'-UTR and NS5B regions showed that the circulating strains belonged to genotypes 4 (4e and 4c). Conclusion: We found that the HCV seroprevalence in pregnant women in Gabon is almost as high as that in other African countries and increases with age. Furthermore, only genotype 4 (4e and 4c) was found. More extensive studies aiming to evaluate the prevalence and heterogeneity of HCV genotypes circulating in the general population of the country are needed. [ABSTRACT FROM AUTHOR]

Purpose: Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas. The purpose of this article was to evaluate the relationship between CM and epilepsy in Gabon. Methods: A matched case–control study was carried out on a sample of subjects aged six months to 25 years and hospitalized between 1990 and 2004 in three hospitals in Libreville, Gabon. Cases were defined as patients suffering from epilepsy and confirmed by a neurologist. Controls were defined as patients without epilepsy. The exposure of interest was CM according to WHO criteria. Results: In total, 296 cases and 296 controls were included. Of these, 36 (26 cases and 10 controls) had a CM history. The adjusted odds ratio (aOR) to develop epilepsy after CM was 3.9 [95% CI: 1.7–8.9], p < 0.001. Additional risk factors were identified: family history of epilepsy: aOR = 6.0 [95% CI: 2.6–14.1], p < 0.0001, and febrile convulsions: aOR = 9.2 [95% CI 4.0–21.1], p < 0.0001. Conclusions: This first case–control study on that issue suggests that epilepsy-related CM is an underrecognized problem. It emphasizes the need for further studies to better evaluate the role of convulsions during CM. [ABSTRACT FROM AUTHOR]

Because rapidly expanding human populations have devastated gorilla (Gorilla gorilla) and common chimpanzee (Pan troglodytes) habitats in East and West Africa, the relatively intact forests of western equatorial Africa have been viewed as the last stronghold of African apes. Gabon and the Republic of Congo alone are thought to hold roughly 80% of the world's gorillas and most of the common chimpanzees. Here we present survey results conservatively indicating that ape populations in Gabon declined by more than half between 1983 and 2000. The primary cause of the decline in ape numbers during this period was commercial hunting, facilitated by the rapid expansion of mechanized logging. Furthermore, Ebola haemorrhagic fever is currently spreading through ape populations in Gabon and Congo and now rivals hunting as a threat to apes. Gorillas and common chimpanzees should be elevated immediately to 'critically endangered' status. Without aggressive investments in law enforcement, protected area management and Ebola prevention, the next decade will see our closest relatives pushed to the brink of extinction. [ABSTRACT FROM AUTHOR]

This article summarizes the results of archaeological research led from 1995 to 1998 in the fauna reserve of Lope´ (Gabon). The excavated sites were dated from the Upper Pleistocene to the Post-colonial period. It is the longest and the most complete archaeological sequence presently known in Central Africa. These results show evidence of human presence in the reserve for over 40 000 years and that this greatly contributed to the preservation of the ecotone landscape of Lope´. In addition, these results offer the first systematic analysis of the sites and the ceramic artefacts produced and used in the centre of Gabon during the last three millennia. Supported by chronological, linguistic and palaeoenvironmental data, these results allow us to refine the ceramic typology and to prove the antiquity of husbandry, agricultural practices and iron production in this part of Africa. Finally, they allow us to clarify the various phases of settlement in the reserve and to reveal an important historic phenomena in connection with the expansion of the bantu languages and/or the bantu speaking peoples, who populate a third of the African continent. [Copyright &y& Elsevier]

In Gabon, terrestrial mammals of protected areas have been identified as a possible source of antibiotic-resistant bacteria. Some studies on antibiotic resistance in bats have already been carried out. The main goal of our study was to detect extended-spectrum beta-lactamases (ESBLs) that are produced by enterobacteria from bats in the Makokou region in Gabon. Sixty-eight fecal samples were obtained from 68 bats caught in the forests located 1 km from the little town of Makokou. After culture and isolation, 66 Gram-negative bacterial colonies were obtained. The double-disk diffusion test confirmed the presence of ESBLs in six (20.69%) Escherichia coli isolates, four (13.79%) Klebsiella pneumoniae isolates, and one (3.45%) Enterobacter cloacae isolate. The analysis based on the nucleotide sequences of the ESBL resistance genes showed that all cefotaximase-Munichs (CTX-Ms) were CTX-M-15 and that all sulfhydryl variables (SHVs) were SHV-11: 41.67% CTX-M-15-producing E. coli, 16.67% CTX-M-15+SHV-11-producing E. coli, 8.33% CTX-M-15-producing K. pneumoniae, 25% CTX-M-15+SHV-11-producing K. pneumoniae, and 8.33% CTX-M-15-produced E. cloacae. This study shows for the first time the presence of multiresistant ESBL-producing enterobacteria in fruit bats in Makokou. [ABSTRACT FROM AUTHOR]

Unfortunately two errors appeared in this article. [ABSTRACT FROM AUTHOR]

Background: The search for new anti-cancer molecules is one of the main concerns of oncology researchers. Scyphocephalium ochocoa is a plant of Myristicaceae family, used in traditional medicine against inflammatory diseases and several types of cancer. It is well established that free radicals, chronic inflammation and angiogenesis play an important role in initiation, tumor progression and metastasis formation. The aim of this study was to carry out a phytochemical screening, to determine the phenolic compounds content, to investigate the antiangiogenic, anti-inflammatory and antioxidant activities of water, water-ethanol and ethanol extracts of S. ochocoa.Methods: Phytochemical screening and determination of phenolic compounds content were performed using standard methods. Antiangiogenic activity was assessed using chick chorioallantoic membrane (CAM) model and Drabkin test. Anti-inflammatory activity was estimated by protein denaturation and erythrocyte membrane stabilization method. Finally the antioxidant activity was appreciated by DPPH radical inhibition and phosphomolybdenum assay.Results: The results of phytochemical studies show that extracts of bark of S. ochocoa are rich in polyphenols, tannins, flavonoids, proantocyanidins, saponosides, flavonols, flavanonols, sterol and triterpenes. The water extract showed good antiangiogenic activity (IC50 = 1.153 μg/mL). Strong anti-inflammatory activity was observed with all extracts, IC50 ranging from 34.775 ± 2.543 μg/mL to 74.577 ± 3.456 μg/mL for protein denaturation inhibition test and IC50 values ranging from 36.793 ± 0.529 μg/mL at 48.912 ± 0.957 μg/mL for antihemolytic activity. In addition, all extracts showed good antioxidant activity marked by a strong inhibition of the DPPH radical (IC50 ranging from 4.969 ± 0.263 μg/mL to 16.188 ± 0.336 μg/mL and AAI ranging from 3.090 ± 0.065 to 10.080 ± 0.517) and by greater total antioxidant capacity (with contents ranging from 37.654 ± 0.995 to 131.302 ± 1.102 VtCE (mg)/g dry extract).Conclusion: Ultimately, these results could justify the use of S. ochocoa extracts in traditional medicine in the treatment of diseases related to angiogenesis and cancer, inflammatory diseases and diseases due to oxidative stress. A phyto-product with such a pharmacological profile could be a good candidate for the development of anticancer. [ABSTRACT FROM AUTHOR]

Background: Plasmodium falciparum causes severe clinical manifestations by sequestering parasitized red blood cells (PRBC) in the microvasculature of major organs such as the brain. This sequestration results from PRBC adherence to vascular endothelial cells via erythrocyte membrane protein 1, a variant parasite surface antigen. Objective: To determine whether P. falciparum multiple genotype infection (MGI) is associated with stronger PRBC cytoadherence and greater clinical severity. Methods: Nested polymerase chain reaction was used to genotype P. falciparum isolates from symptomatic children and to distinguish between single genotype infection (SGI) and MGI. PRBC cytoadhesion was studied with cultured human lung endothelial cells. Results: Analysis of two highly polymorphic regions of the merozoite surface antigen (MSP)-1 and MSP-2 genes and a dimorphic region of the erythrocyte binding antigen-175 gene showed that 21.4% and 78.6% of the 42 children had SGI and MGI, respectively. It also showed that 37 (89%) of the 42 PRBC samples expressed MSP-1 allelic family K1. Cytoadherence values ranged from 58 to 1811 PRBC/mm2 of human lung endothelial cells monolayer in SGI and from 5 to 5744 PRBC/mm2 in MGI. MGI was not associated with higher cytoadherence values or with more severe malaria. Conclusions: These results suggested that infection of the same individual by multiple clones of P. falciparum does not significantly influence PRBC cytoadherence or disease severity and confirmed the predominance of the MSP-1 K1 genotype in southeastern Gabon. [ABSTRACT FROM AUTHOR]

While the incidence of stroke is increasing in developing countries, resulting in an extremely high economic burden, very few costing studies have been carried out to date. This study aims to measure the direct hospital costs of stroke management in Gabon. The study adopts a retrospective approach, based on a review of patient records in the Neurology and Cardiology Departments of the University Hospital of Libreville (CHUL) between January 2018 and December 2019. It focuses on all patients received for stroke at the CHUL during the study period, regardless of the outcome, analyzing direct hospital costs. Three hundred and thirteen (313) patients were admitted during the period in question, 72.52% in neurology and 27.48% in cardiology. The average age was 58.44 (±13.73 years). Fifty-six percent (56.23%) had health coverage. Ischemic stroke was more common than hemorrhagic stroke, at 79.55% and 20.45%, respectively. The average expenditure per patient was estimated at 619,633 CFA francs (€944.62). From the point of view of social security coverage, the average out-of-pocket expense per patient was 147,140 CFA francs (€224.31), for a reimbursement of 422,883 CFA francs (€644.68). The average direct cost of stroke is very high for both patients and administrations. This argues for the implementation of prevention programs for the disease. The results of this study may be useful for work on the efficiency of such programs. [ABSTRACT FROM AUTHOR]

• SARS-CoV-2 diversity in the Republic of Gabon between February and May 2021 • Emergence of B.1.1.318 SARS-CoV-2 in the Republic of Gabon • High prevalence of the alpha VOC (B.1.1.7) between February and May 2021 • SARS-CoV-2 variants associated with high transmission were detected Variants of concern (VOCs) associated with relatively high transmissibility appear to be rapidly spreading in Gabon. Therefore, it is imperative to understand the distribution of several VOCs in the population, which could have implications for transmissibility and vaccine efficacy. Between February and May 2021, SARS-CoV-2 genomes were sequenced using the Oxford nanopore MinION method and the respective genome diversity was elucidated. Phylogenetic analysis was performed and genomes were classified using pangolin lineages. The results highlighted an increase (46%) in the alpha VOC (B.1.1.7) in the Gabonese population over the study period. In addition, an increase (31%) in the B.1.1.318 lineage, which is associated with high transmission and impaired vaccine efficacy (D614G+E484K+Y144del), was detected. With the second wave ongoing, these findings highlight the need for surveillance of the SARS-CoV-2 genome in the Republic of Gabon and should provide useful guidance to policymakers in selecting an appropriate vaccine for this population. [ABSTRACT FROM AUTHOR]