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1. 18-month effectiveness of short-course antiretroviral regimens combined with alternatives to breastfeeding to prevent HIV mother-to-child transmission.

Author

Valériane Leroy, Didier K Ekouevi, Renaud Becquet, Ida Viho, Laurence Dequae-Merchadou, Besigin Tonwe-Gold, François Rouet, Charlotte Sakarovitch, Appolinaire Horo, Marguerite Timité-Konan, Christine Rouzioux, François Dabis, and ANRS 1201/1202 DITRAME PLUS Study Group

Subjects
Medicine, Science
Abstract

OBJECTIVE: We assessed the 18-month effectiveness of short-course (sc) antiretroviral peripartum regimens combined with alternatives to prolonged breastfeeding to prevent mother-to-child transmission (MTCT) of HIV-1 in Abidjan, Côte d'Ivoire. METHODOLOGY: HIV-1 infected pregnant women received from >/=32-36 weeks of gestation scZidovudine (ZDV)+/-Lamivudine (3TC)+single-dose Nevirapine (sdNVP) at delivery within the ANRS 1201/1202 DITRAME-Plus cohort (2001-2003). Neonates received a sdNVP+7-day ZDV prophylaxis. Two infant-feeding interventions were systematically offered free of charge: formula-feeding or exclusive shortened breastfeeding with early cessation from four months. The reference group was the ANRS 049a DITRAME cohort (1994-2000) exposed to scZDV from 36 weeks, then to prolonged breastfeeding. Pediatric HIV infection was defined by a positive plasma HIV-1 RNA at any age, or if aged >/=18 months, a positive HIV-1 serology. Turnbull estimates of cumulative transmission risks (CTR) and effectiveness (HIV-free survival) were compared by exposure group using a Cox model. FINDINGS: Among 926 live-born children enrolled, 107 (11.6%) were HIV-infected at 18 months. CTRs were 22.3% (95% confidence interval[CI]:16-30%) in the 238 ZDV long-term breastfed reference group, 15.9% (CI:10-27%) in the 169 ZDV+sdNVP shortened breastfed group; 9.4% (CI:6-14%) in the 195 ZDV+sdNVP formula-fed group; 6.8% (CI:4-11%) in the 198 ZDV+3TC+sdNVP shortened breastfed group, and 5.6% (CI:2-10%) in the 126 ZDV+3TC+sdNVP formula-fed group. Each combination had a significantly higher effectiveness than the ZDV long-term breastfed group except for ZDV+sdNVP shortened breastfed children, ranging from 51% (CI:20-70%) for ZDV+sdNVP formula fed children to 63% (CI:40-80%) for ZDV+3TC+NVPsd shortened breastfed children, after adjustment for maternal eligibility for antiretroviral therapy (ART), home delivery and low birth-weight. Substantial MTCT risk reductions are reachable in Africa, even in short-term breastfed children. The two sc antiretroviral combinations associated to any of the two infant feeding interventions, formula-feeding and shortened breastfeeding, reduce significantly MTCT with long-term benefit until age 18 months and without increasing mortality.

Published
2008
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4. Fistules vésico-utérines : à propos de deux cas découverts à l’hystéroscanner

Author

Ahichia Bedji Kouassi, Armel Elogne, Appolinaire Horo, Youssouf Camara, Abdoulaye Toure, and Habib Nouraly

Subjects
Gynecology, medicine.medical_specialty, media_common.quotation_subject, medicine, Surgery, Art, Vesicouterine fistula, media_common
Abstract

Resume Le but de cette etude est de montrer l’interet de l’hysteroscanner dans le diagnostic de fistule vesico-uterine a partir de deux cas decouverts lors d’un bilan d’infertilite. Il s’agit de jeunes patientes, sans symptomatologie urinaire evidente. L’hysteroscanner a ete realise a l’aide d’un scanner 16 barrettes utilisant comme produit de contraste de l’iode dilue au 1/5. L’analyse d’images a ete faite a l’aide des differentes post-reconstructions MPR, MIP, 3D volumique et hysteroscopie virtuelle (CEV). Il nous a permis de fournir des informations precises de la fistule vesico-uterine notamment son siege et son trajet.

Published
2013

5. Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries

Author

I. Izabelle, F. Ello, H. Ssemuwemba, S. Phiri, J. Olasode, Marie-Sylvie N’Gbeche, S. Kouadio, Jesper Eugen-Olsen, M. Mpoudi-Etame, Cristin Q. Fritz, S. Dapiap, J. Zoungrana, Antoine Jaquet, Aristophane Tanon, Rasmata Ouédraogo, N. T. Loan, E. J. Carter, Obaseki, F. F. Diakité, H. X. Zhao, Kulkanya Chokephaibulkit, Z. J. da Silva, Peter Aaby, Dewi Kumara Wati, David da Silva, L. Ayangma, K. Jjingo, P. Kim, Romanee Chaiwarith, James Ndirangu, Valériane Leroy, L. P. P. Atmikasari, N. Zobo, H. Chenal, Rita Lyamuya, Catherine C. McGowan, Keswadee Lapphra, Wanatpreeya Phongsamart, B. B. Mwebesa, Théodore Niyongabo, D. Katile, B. Ba, Matthias Egger, L. Mofenson, A. Mounkaila-Harouna, Boris Tchounga, M. Moh, Elom Takassi, Haby Signaté Sy, G. Sagbo, F. Kaeser, Eduardo Gotuzzo, Guillaume Bado, C. C. McGowan, S. Karcher, Constantin T. Yiannoutsos, V. H. Bui, Christopher J. Hoffmann, Didier K. Ekouevi, J. Akakpo, I. Azinyue, S. Kiertiburanakul, S. O. Koule, W. Bishai, Mariam Guindo Traoré, C. Williams, Elise Arrivé, A. Tapsoba, S. Bessekon, Patrick A. Coffie, F. Yuliana, A. Gougounon-Houéto, Somnuek Sungkanuparph, Y. Abo, Q. Vo, Praphan Phanuphak, M. B. Kokora, Kouadio Kouakou, Fla Kouéta, M. E. Dainguy, O. Benson, I. Soré, W. Prasitsuebsai, Harry Moultrie, C. Guehi, Beatriz Grinsztejn, T. Q. Du, L. Diecket Ahoussou, Z. Diallo, N. Traoré, Firas Wehbe, C. V. Do, J. Tatwangire, A. Kotosso, F. Soppi, Amabelia Rodrigues, Juan Sierra Madero, P. S. Sow, Rodolphe Thiébaut, I. Y. Malino, Moussa Seydi, Helena Rabie, A. Dienderé, Geoffrey Somi, Emmanuel Bissagnene, Elizabeth A. Bukusi, H. C. Traoré, David A. Cooper, N. M. Manga, P. Osakede, S. Ajayi, J. Paulo, Marguerite Timite-Konan, Andrew Edmonds, B. Diop, A. M. Traoré, W. Hiembo, A. Koïta, M. Faye, A. Azon-Kouanou, Christian Wejse, Claudia P. Cortes, T. Pety, N. Durier, Thira Sirisanthana, Camille Ndondoki, Karl-Günter Technau, J. S. Elvis Diby, G. Alim, M. D'Almeida, A. Komi, J. Bashi, J. M. Tine, D. Hawerlander, R. Ditangco, Akouda Patassi, A. Kalle, F. J. Zhang, Lorna Renner, N. H. Chau, Janet Giddy, G. Clouet, Samwel O. Ayaya, A. Sohn, Lars Østergaard, Sylvie Ouédraogo, Clement Adebamowo, Azar Kariminia, John Ssali, Joseph Drabo, M. Dembelé, Nicola Maxwell, Albert Minga, M. D.N. Amego, Wilai Kotarathititum, Christian Erikstrup, H. A. Traore, Kapella Zacharia Ngonyani, E. Geng, Lukas Fenner, A. Diagne, Marcelo Wolff, A. I. Assi, A. Sackey, A. R. Yao, M. F. Sami, Edmond Addi Aka, H. Adjide, Pagakrong Lumbiganon, Karen Malateste, L. Diero, M. Gansonré, P. N. An, A. H. Sohn, D. Meless, D. Avit-Edi, D. Walker, L. Hardwicke, A. S. Kaya, Véronique Mea-Assande, G. S. Gottlieb, Denis Padgett, Eric Balestre, Candida Medina, D. Amani, C. Kouakou, C. Shiboski, E Messou, B. G. Kariyare, M. Ballif, W. Wester, J. M. Gonsan, G. Gbadamassi, A. Ba, M. Fomba, Denis Malvy, R. Bantique, S. N. Owiafe, Andrew Kambugu, Festus Igbinoba, M. Y. Maiga, C. Ahomadegbé, A. Berthé, R. D. Gueye, C. C. Bassabi, Djimon Marcel Zannou, Olivia Keiser, Kara Wools-Kaloustian, K. E. Mensah-Zukong, A. Doring, C. Chimbetete, J. Rivenc, V. Andavi, F. Alihonou, S. Datté, S. Pestilli, T. Mengthaisong, Kathryn Anastos, A. D. Mbaye, D. Lameck, Claire Graber, J. Lewis-Kulzer, G. Reubenson, B. Siloué, Marcel Yotebieng, K. T.K. Dung, C. Ahouada, Severin Lenaud, J. Welbeck, D. Dickinsonn, L. Zoungrana, A. Avihingsanon, T. T. Cao, V. K. Nguyen, Morten Sodemann, J. C. Dusingize, B. Okwara, C. Lewden, H. Traoré, Patrick MacPhail, David C Boettiger, G. Oka-Berete, H. K. Truong, F. Houngbé, Robin Wood, Venerandah Nhandu, J. C. Azani, G. Wandeler, K. L. Issouf, K. C. Anzan, Andrea L. Ciaranello, Awachana Jiamsakul, M. T. Ha, K. Brou, M. Maskew, L. Tossa-Bagnan, B. Zerbo, P. Pakpame, Xavier Anglaret, Jean W. Pape, J. B. Essanin, A. Petit, A. Kouakou, E. Rabourdin, Orasri Wittawatmongkol, Daniela Garone, S. El-Hadj Djibril, S. Duda, C. Twizere, K. C. Chan, Annie J. Sasco, N. Sanmeema, N. V. Lam, J. Conrad, Q. T. Du, P. Tharnprisan, Z. Yao, A. Djeha, Siriatou A. Koumakpai, Joachim Gnokoro, I. Hodonou, Sabine Hermans, Timothy R. Sterling, C. Nchot, D. Minta, E. Yunihastuti, T. F. Eboua, T. Cissé, Revathy Nallusamy, Jeffrey S. A. Stringer, Dabis F, F. Bohossou, Brian Eley, E. Traore, R. McKaig, Matthew Law, Manhattan Charurat, G. M. Kouakou, Madeleine Amorissani Folquet, A. Mandalakas, Sophie Desmonde, S. Eholié, J. K. Assouan, Andrew Boulle, Tuti Parwati Merati, A. Koko Lawson-Evi, Eugene Mutimura, C. A. Bosse, M Dosso, Fred Nalugoda, T. T. Pham, T. Udomphanit, H. L. Ha, N. Kancheya, N. Han, J. Sehonou, S. N. Kangah, R. Huebner, A. Gasser, C. Gilbert, Appolinaire Horo, J. C. Kouakou, D. Yé, P. Acquah, A. Héma, Pope Kosalaraksa, Hans Prozesky, J. James, Fatoumata Dicko, P. Cahn, Moussa Doumbia, I. Oliviera-Souto, Morna Cornell, Elenore Judy B. Uy, G. Hounhoui, J. E. Carter, V. A. Yao, Adrien Sawadogo, B. Petersen, S. E. Reid, B. Goka, G. Carriquiry, M. A. Davies, P. Nipathakosol, J. Le Carrou, M. L. Lindegren, H. Dior, P. Cegielski, E. Baramperanye, Mariam Sylla, Anders Fomsgaard, P. Braitstein, S. T. Coulibaly, D. D. Cuong, C. N'Diaye, M. Kone, Dewa Nyoman Wirawan, A. Gitembagara, Niaboula Koné, K. Ruxrungtham, R. Bognounou, Aissatou Touré, A. Ephoévi-gah, Alex Lund Laursen, and Y. Atakouma

Subjects
Male, Questionnaires, West African, Pediatrics, Asia Pacific, Antitubercular Agents, HIV Infections, Drug resistance, rifampicin, South Africa, drug resistant tuberculosis, Surveys and Questionnaires, Tuberculosis, Multidrug-Resistant, Central Africa, antiretrovirus agent, Human immunodeficiency virus infected patient, clinical practice, microbial sensitivity test, Infectious Diseases, priority journal, urban population, Female, anti human immunodeficiency virus agent, supply and distribution, medicine.drug, Pulmonary and Respiratory Medicine, Adult, isoniazid, medicine.medical_specialty, Tuberculosis, Asia, phenotype, Anti-HIV Agents, Developing country, MDR-TB, Microbial Sensitivity Tests, purl.org/pe-repo/ocde/ford#3.03.08 [https], preventive medicine, Article, South and Central America, socioeconomics, medicine, Humans, controlled study, human, rural population, drug sensitivity, Developing Countries, Directly Observed Therapy, Preventive healthcare, ART programs, Caribbean, business.industry, questionnaire, Drug resistant tuberculosis, developing country, CD4 lymphocyte count, Central africa, Central America, South America, medicine.disease, major clinical study, Latin America, purl.org/pe-repo/ocde/ford#3.02.07 [https], Africa, world health organization, tuberculostatic agent, business, Rifampicin
Abstract

SETTING: Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons.OBJECTIVE: To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries.DESIGN: We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n = 14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n = 6 programs) in 2012. Patient-level data were collected on 1002 adult TB patients seen at 40 of the participating ART programs.RESULTS: Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the entire course of treatment, 16 (34%) during the intensive phase only, and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line anti-tuberculosis regimens; 18 (38%) reported TB drug shortages.CONCLUSIONS: Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower-income countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance.

Published
2014

6. Acceptability and uptake of a package to prevent mother-to-child transmission using rapid HIV testing in Abidjan, Côte d'Ivoire

Author

Appolinaire Horo, Ida Viho, Didier K. Ekouevi, François Dabis, Christiane Welffens-Ekra, Laurence Bequet, François Rouet, Charlotte Sakarovitch, and Valériane Leroy

Subjects
Adult, Immunology, Population, HIV Infections, Women in development, Acquired immunodeficiency syndrome (AIDS), Pregnancy, Environmental health, Prenatal Diagnosis, medicine, Immunology and Allergy, Humans, Pregnancy Complications, Infectious, Sida, education, reproductive and urinary physiology, education.field_of_study, biology, Transmission (medicine), business.industry, virus diseases, AIDS Serodiagnosis, Patient Acceptance of Health Care, medicine.disease, biology.organism_classification, Infectious Disease Transmission, Vertical, Infectious Diseases, Clinical research, Cote d'Ivoire, Community mobilization, HIV-1, Female, business, Program Evaluation
Abstract

The participation of HIV-1-infected pregnant women in a programme of prevention of mother-to-child transmission (MTCT) of HIV in Abidjan is described. Prenatal counselling with a rapid HIV test was proposed to 14 067 pregnant women and acceptance was 89.4%. The return rate for results was 74.2%. The HIV-1 prevalence was 11.1% and 26.2% of HIV-infected women started the prevention of MTCT programme. To increase the uptake we recommend community mobilization and the strengthening of male involvement. (authors)

Published
2004

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