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Objective: The prevalence of HIV infection in people aged is of significant importance. We determined the prevalence of HIV infection with patients aged over 50 at the Brazzaville University Hospital and look for its associated factors. Patients and Method: Cases of HIV infection in patients over 50 years admitted to the Infectious Diseases Unit of Brazzaville University Hospital were examined under cross-sectional descriptive and analytical study. This survey concerns the period going from January 1, 2019 to June 30, 2021. Results: There were one hundred and ninety-four patients (8.2% of admissions). Their mean age was 57.40 ± 6.4 years [50-93], they were mostly female (n = 113; 58.2%). The most dominant population was the age group between 50-59 years (n = 136; 70.1%). They were single people (n = 80; 41.2%), without profession (n = 87; 44.8%), with a primary education level (n = 81; 41.8%), hypertensive (n = 27; 13.9%), diabetics (n = 15; 7.7%). HIV infection was discovered during hospitalization (n = 111; 57.2%), for deterioration of the general condition (n = 72; 37.1%), long-term fever (n = 56; 28.9%), chronic cough (n = 40; 20.6%). The patients were at WHO stage 3 (n = 133; 68.6%). The mean CD4 were 188.5 ± 11.7 / mm3 [19-433]. In 172 cases (88.7%), the patients had two sexual partners and did not use a condom (n = 189; 97.4%). The main opportunistic infections were tuberculosis (n = 74; 18.1%) and cerebral toxoplasmosis (n = 48; 24.7%). ART was made with the combination of TDF + FTC + EFV (n = 79; 40.7%). The observation was poor in 33% (n = 64) and unfavourable outcome in 47.4% (n = 92). These were IRIS (n = 5; 2.6%) and death (n = 85; 43.8%), due to anaemic shock (n = 17; 20%), septic shock (n = 8; 9.4%). Marital status (P = 0.04), WHO stage (p = 0.02), and non-compliance treatment (p = 0.0001) could have the link with the death patients. Conclusion: HIV infection in people over 50 years is relatively common at Brazzaville University Hospital, especially among single women. The lethality remains high, unrelated to an opportunistic infection but rather with the notion of non-compliance with treatment and the advanced stage of HIV infection according to the WHO classification. This shows the interest in raising awareness among this population for early detection and the treatment of HIV.

Introduction: Vaginal candidiasis is a fungal disease caused by a yeast type Candida. It affects more than 75% of women during the period of genital activity. Changes in vaginal pH due to various factors lead to the onset of the infection. Objective: Determine the prevalence of vaginal candidiasis in women of childbearing age and look for associated factors or risk for its occurrence. Patients, Materials and Method: We conducted a cross-sectional analytical study from July to October 2019. It concerned all patients aged 15 to 49 years, received at the Parasitology-mycology and parasitic immunology laboratory of the University Hospital of Brazzaville for an analysis of the vaginal sample. For each vaginal sample, a direct examination and culture on Sabouraud Chloramphenicol medium with and without Actidione were performed. A questionnaire was completed specifying age, medical and surgical history, symptoms and risk factors. Statistical analysis was performed by SPSS 20 using Chi-square test and Student's test and multivariate logistic regression was performed. The test was significant when p Ë‚ 0.05. Results: Among 152 samples analyzed, 88 were positive on direct examination (48.7%) and 34 were positive after culture (22.4%). It concerned patients of mean age 32 years (24 years, 40 years), living with one sexual partner (79.4%), never had abortions (64.7%). We found the use of antibiotics (2.9%), corticosteroid therapy (5.9%) and diabetes (6.6%). Among the women included in the study, 32.4% were pregnant. 38.2% of patients used intimate bath and 14.7% used community bath towels; 23.5% wore synthetic underwear; 26.5% of tight clothing and 26.4% had wrong cleaning mode after defecation (p = 0.003). Symptoms associated with vaginal candidiasis were significantly leucorrhoea (38.2%; p = 0.000), burning sensation (22.4%; p = 0.003) and vulvar pruritus (35.5%; p = 0.016). The risk factors associated with the occurrence of vaginal candidiasis were the presence of leucorrhoea and the wrong cleaning mode after defecation associating both front to back / back to front. Patients with leucorrhoea had a 4.21 folds higher risk of vaginal candidiasis, while those with wrong cleaning mode front to-back / back-to-front had a 28.97 folds higher risk. Conclusion: Vaginal candidiasis is common in women of childbearing age with poor hygienic conditions. The associated factors identified are those found in the literature, among which, leucorrhoea and cleaning mode combined from front to back / back to front.

Introduction: Toxoplasmosis is a disease caused by an obligate intracellular coccidia Toxoplasma gondii, which is transmitted by cats. In pregnant women, it is a concern because of the severe complications to the foetus. The objective of this study is to determine the toxoplasma serologic profile in pregnant women at the Brazzaville University Centre Hospital (CHUB). Materials and Methods: This is a cross-sectional study from September 2015 to March 2016 (6 months) which includes sera from pregnant women received at the Parasitology Mycology laboratory of the CHUB for Toxoplasma serology. Immunoglobulins G and M searches were done by immuno-analysis (Biomerieux, Mini-Vidas technology). The data was analysed by the IBM SPSS version 20 software. The comparisons of proportion is done by the khi 2 test. The level of significance of statistical data were fixed at 5%. Results: The mean age of pregnant women included in our study was 27, 8+/- 6,84 with the extremes ages of 15 and 44 years. Toxoplasma seroprevalence in this study is 47,2% (68/144). The types of immunoglobulins (Ig) retrieved were IgG alone in 45,1% of cases (65/144), IgG associated to IgM in 2,8% of cases (4/144). Serological profiles were: no immunity (52,1%) immunised (41%), recent infection (1,4%) active infection (2,8%) equivocal result (2,8%). Conclusion: Toxoplasmosis is a zoonosis which represents a real public health issue in our environment, even when the level of immunised pregnant women seems high.

Objective: To determine the prevalence of tetanus in women of childbearing age and to find out associated factors. Patients and Methods: Prospective study for descriptive and analytical purposes of tetanus cases in women of reproductive age registered in the Infectious Diseases Department at the Brazzaville University Hospital between January 1st, 2018 and July 31st, 2019. Results: Fifty-one cases of patients were collected (4.02% of admissions) with mean age 24.22 ± 10.38 (15-49 years), female students (n=31, 60.78%), single (n=43, 84.3%), low socio-economic status (n=33, 65.35%) and immunodepressed with HIV type 1 (n=10, 19.60%), (n=43, 84.31%). Patients lived in city (n=43, 84.31%). Immunization status was doubtful and absent respectively in 20 cases (39.21%). Patients had an average delay of 94.56 ± 45.38 hours (48-336) for trismus (n=41, 80.4%), other contractures (n=8, 15.7%), and paroxysms (2, 3.9%). Tetanus was generalized at admission (n=49, 96.1%), without complication (n=46, 90.2%). The entryway was integumentary (n=35, 68.6%), intramuscular (n=10, 19.6). The antitetanus serum was administered to all patients (100%) but suboccipital serum in only three patients (5.9%). In thirty patients (58.8%), the trimming of the entryway has not been realized. The Dakar score was ranked 3 in 25 patients (49.0%) and the mean duration of hospitalization was 10.55 ± 6.22 days (range 1-30). The evolution was favorable for thirty four patients (66.7%). The IM (p=0.000) and integumentary (p=0.003) and the Dakar 3 (p=0.000) gateways had a connection to the occurrence of death. Conclusion: The situation of tetanus in women of childbearing age is worrying at the University Hospital of Brazzaville with a high prevalence despite the existence of a vaccine. It is therefore important to prevent this disease by systematizing tetanus vaccination within this target population group.

Background: Anti-retroviral drugs reduce morbidity and mortality due to HIV and prevent transmission from mother to child. But compliance on anti-retroviral treatment is an essential element for the success of therapeutic goals.Objective: To assess the level of compliance of anti-retroviral treatment in pregnant and lactating HIV women and identify factors of non-compliance in Brazzaville.Design: An analytical and transversal study conducted in three specialised centres from March to June 2014.Setting: Three support centres for HIV patients in Brazzaville, Republic of Congo.Subjects: It had interested pregnant and lactating HIV women and having given consent. The variables studied were: socio-demographic, related to treatment and linked to the health system. Five statistic tests were used: Yates’ chi², Fisher, Student, Kruskal-Wallis and Bartlett.Results: One hundred and thirty patients were included, the mean age was 32 years, 92.3% had good education level, and 72.3% lived as couple. The adherence to antiretroviral treatment within seven days before the survey was 77.7%. Factors significantly influencing non-adherence were: ignorance of HIV status by the partner (RR = 2.10 (1.12 - 3.92)), traditional treatment (RR = 1.77 (0.92 - 3.41), forgetfulness to take drugs (RR = 5.10 (2.07 - 12.55), and discomfort with side effects (RR = 2.12 (1.13 - 3.95).Conclusion: Several factors influence the non-adherence of anti-retroviral treatment. Improving compliance with treatment requires multi-sectoral participation.

Background: Conjunctival cancers are masses raised or flat, located in or directly under the conjunctival mucous membrane covering the anterior sclera, tarsus and conjunctival dead-end. These tumours usually occur in the elderly or in cases of HIV/AIDS.Objective: To list the different types of conjunctival cancer in cases of HIV/AIDS at the University Hospital of Brazzaville.Design: It was a descriptive and transversal study, conducted between January 2008 and December 2012.Setting: The University Hospital of Brazzaville.Subjects: HIV patients under anti-retroviral treatment or not seen for conjunctival cancer histologically proven were selected.Results: Twenty-eight patients (28) were selected including a woman at 30 weeks of gestation. Two types of cancers were diagnosed, Carcinoma in situ (28.57%) and Squamous Cell Carcinoma (71.43%), no secondary tumour. There were anti-retroviral treatment failure in 89.29% of the cases.Conclusion: Squamous Cell Carcinoma was the most common conjunctival cancer. Better compliance of anti-retroviral treatment can reduce the prevalence of these tumours.

Background: Laparoscopy in the treatment of ovarian cysts is new in most African countries. In 2009 we performed the first ovarian cysts operations by laparoscopy at the University Hospital of Brazzaville (UHB).Objective: To show the contribution of laparoscopic surgery in the management of ovarian cysts.Design: Retrospective comparative study.Setting: Obstetrics and Gynaecology Department of the UHB, from 1st August 2009 to 31st August 2012.Subjects: All patients operated on at the UHB for suspected ovarian cyst.Results: Laparoscopic surgery for ovarian cyst represented 30.3% of operated cases. The average age of patients was 32.2 years versus 33 years in laparoscopy to laparotomy. The average rate was similar in both groups (1.78 ± 1.57 vs. 2.17 ± 1.8; p> 0.05). The most surgery was the intraperitoneal cystectomy in both groups, with no significant difference.The mean duration of surgery was reduced by laparoscopy (45.7 ± 17 min vs. 30 ± 7 min, p

Objective: To assess the level of knowledge of this tumour by midwives in two hospitals (Talangaï and Makélékélé) in Brazzaville.Design : An analytical cross-sectional study.Setting : Two maternity units (government hospitals) in the outskirts of BrazzavilleSubjects: One hundred midwives who responded to a questionnaire in the form of multiple-choice question (MCQ). These midwives were randomly selected based on their availability to respond to questions. Each midwife was seen once and had 30 minutes to answer three questions, define the retinoblastoma and recognise its two main early clinical signs (leucocoria, strabismus).Results: Forty percent were able to define the retinoblastoma. For 60% leucocoria was the only sign suspect of retinoblastoma, for 80% strabismus was the only sign of retinoblastoma, only 10% had associated leucocoria and strabismus as two early signs of this cancer. Twelve percent had a score equal to 3/3, eight (8%) had a score equal to 2/3, and 80% had a score of less than or equal to 1/3.Conclusion: midwives in Brazzaville poorly understand the retinoblastoma. Training programmes should be tailored to effectively fight against mortality of this pathology.

Guillain-Barre’s syndrome (GBS) or inflammatory/post-infectious acute polyradiculoneuropathy is due to demyelination of nerves, causing a progressive paresis or paralysis. It usually begins in the legs and sometimes goes up to the respiratory muscles and cranial nerves. The exact mechanism of GBS occurrance is still unclear. An autoimmune disease is the assumption with the largest consensus to date. Autoantibodies related to a viral or bacterial infection in the days or weeks before the onset of symptoms damage the myelin sheaths of nerve fibers. These infections can range from a simple cold with sore throat to gastrointestinal disorders. In very rare cases, it is also recognised that the use of some drugs (streptokinase, Captopril ...) can cause GBS. The gestation is a relative immunological rest period in which autoimmune pathologies have, in their majority, a true clinical lull related to the acceptance of the embryo and the foetus by the woman's body. The onset of the GBS in the period is exceptional. We report a case of paralysis of the nerve VI accompanied by dysphonia and tetraparesis due to GBS in a pregnant of 24 year old with 14 weeks of gestation.