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Sans complaisance aucune, Henri Lopès met à nu l'attitude des dictateurs de l'Afrique au lendemain des indépendances. Incapables de conduire leur pays respectifs vers les chemins du développement, ces nouvelles élites au pouvoir se jouent de leurs populations, aidées en cela parfois par un recours à des réalités culturelles rétrogrades. Il est donc question dans cet article de mettre l'accent sur la manière dont l'auteur concrétise la vision d'un Frantz Fanon, Stanislas Adotévi ou d'un Marcin Towa par rapport à la Négritude. En effet, si ce mouvement s'est borné principalement à chanter une Afrique qui aurait été, avant la colonisation, un monde idéal grâce à ses traditions et cultures, les écrits de ces derniers ont remis cette idée entretenue par les chantres de ce mouvement. S'inscrivant dans le sillage de ces auteurs, Henri Lopès montre dans son roman Le pleurer-rire la manière dont ces traditions et cultures ont servi l'entreprise de subjugation des populations par les dictateurs. Ainsi, à travers un extrait dudit roman mettant en scène une séance du conseil des ministres, cet article montre comment les traditions africaines sont souvent manipulées par les dictateurs pour étouffer dans l'œuf toute velléité des populations à prétendre à la démocratie et à la liberté d'expression dont le discours du personnage Bwakamabé Na Sakkadé dit Tonton en témoigne.

During preparedness activities in Senegal to the 2024 Mpox Public Health Emergency of International Concern, a study was conducted to assess the prevalence of Varicella-Zoster virus among patients suspected of having Mpox. Samples, including skin swabs, serum, and nasopharyngeal swabs, were collected from 103 patients who presented with Mpox-like symptoms. Molecular testing via q PCR revealed that 30.1% of patients tested positive for herpesviruses, whereas no Mpox cases were detected. Common symptoms include fever, skin rash, headache, and myalgia, which closely resemble Mpox symptoms, increasing the risk of misdiagnosis. The most affected group was children under 15 years of age (50% of herpesvirus cases), followed by adults over 30 years of age (30.8%). The male/female sex ratio among herpesvirus-positive patients was 2.1, indicating a higher prevalence in males. Phylogenetic analysis of 14 newly characterized Varicella-Zoster virus genomes from metagenomic sequencing revealed that the strains circulating in Senegal were closely related to those from Guinea-Bissau, suggesting possible regional transmission. In addition, viral and bacterial coinfections were identified in Mpox-negative patients, which may have contributed to some skin lesions initially suspected to be Mpox. Our data highlight the importance of differential diagnostic testing to distinguish between Mpox and other infections, such as Chickenpox. The unexpectedly high prevalence of herpesviruses among suspected Mpox cases underscores the need for improved laboratory diagnostics, enhanced epidemiological surveillance, and targeted public health interventions to prevent misdiagnosis and improve patient management.

Chikungunya virus has caused millions of cases worldwide over the last twenty years, with recent outbreaks in Kedougou region in the southeastern Senegal, West Africa. Genomic characterization highlights that an ongoing epidemic in Kedougou in 2023 is not due to an introduction event but caused by the re-emergence of an endemic strain evolving linearly in a sylvatic context.

Rift Valley fever (RVF) is a re-emerging vector-borne zoonosis with a high public health and veterinary impact. In West Africa, many lineages were previously detected, but since 2020, lineage H from South Africa has been the main cause of the outbreaks. In this study, clinical samples collected through national surveillance were screened for RVF virus (RVFV) acute infection by RT-PCR and IgM ELISA tests. Sequencing, genome mapping and in vitro phenotypic characterization in mammal cells were performed on RT-PCR positive samples in comparison with other epidemic lineages (G and C). Four RVFV human cases were detected in Senegal and the sequence analyses revealed that the strains belonged to lineage H. The in vitro kinetics and genome mapping showed different replication efficiency profiles for the tested RVFV lineages and non-conservative mutations, which were more common to lineage G or specific to lineage H. Our findings showed the re-emergence of lineage H in Senegal in 2022, its high viral replication efficiency in vitro and support the findings that genetic diversity affects viral replication. This study gives new insights into the biological properties of lineage H and calls for deeper studies to better assess its potential to cause a future threat in Senegal.

Background/Objectives: Transitions to new vaccines or antigen schedules represent complex system changes requiring coordinated governance, reliable data systems, domestic financing, and multisectoral collaboration. In 2025, African countries were moving toward a switch from separate pentavalent and inactivated poliovirus vaccines to the combined hexavalent vaccine. This project report describes the Hexavalent Vaccine Switch Early Adopters Workshop in Dakar, Senegal, which included ten African countries, and its implications for future vaccine introductions. Methods: We conducted a practice analysis drawing on structured documentation of plenary presentations, country case studies, interactive problem-solving sessions, and national roadmap exercises. A thematic framework aligned to ten process points for the hexa switch guided synthesis. Results: Countries reported shared system vulnerabilities, including coexistence risks of legacy and new vaccine stocks, inconsistent data completeness, under-resourced vaccine safety surveillance, and financing uncertainties. Early adopter countries demonstrated operational feasibility, logistical efficiencies, and opportunities for reducing injection burden. Outputs included a Health System Adaptation Checklist, a Switch Risk Mitigation Catalog, and 12-month national roadmaps. Conclusions: Regional peer-learning mechanisms can accelerate decision-making, improve operational quality, and strengthen accountability for vaccine introductions. Structured cross-country collaborations can transform a product switch into a scalable system-strengthening opportunity.

Our trial of a single-tablet regimen containing elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate in antiretroviral therapy-naive HIV-2-infected individuals for 48 weeks, in a resource-limited setting, demonstrated favorable immunovirologic outcomes and was well tolerated. Abstract Background There is an urgent need for safe and effective antiretroviral therapy (ART) for human immunodeficiency virus type 2 (HIV-2) infection. We undertook the first clinical trial of a single-tablet regimen containing elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate (E/C/F/TDF) to assess its effectiveness in HIV-2-infected individuals in Senegal, West Africa. Methods HIV-2-infected, ART-naive adults with World Health Organization stage 3-4 disease or CD4 count <750 cells/μL were eligible for this 48-week, open-label trial. We analyzed HIV-2 viral loads (VL), CD4 counts, clinical and adverse events, mortality, and loss to follow-up. Results We enrolled 30 subjects who initiated E/C/F/TDF. Twenty-nine subjects completed 48 weeks of follow-up. The majority were female (80%). There were no deaths, no new AIDS-associated clinical events, and 1 loss to follow-up. The median baseline CD4 count was 408 (range, 34-747) cells/μL, which increased by a median 161 (range, 27-547) cells/μL at week 48. Twenty-five subjects had baseline HIV-2 VL of <50 copies/mL of plasma. In those with detectable HIV-2 VL, the median was 41 (range, 10-6135) copies/mL. Using a modified intent-to-treat analysis (US Food and Drug Administration Snapshot method), 28 of 30 (93.3%; 95% confidence interval, 77.9%-99.2%) had viral suppression at 48 weeks. The 1 subject with virologic failure had multidrug-resistant HIV-2 (reverse transcriptase mutation: K65R; integrase mutations: G140S and Q148R) detected at week 48. There were 8 grade 3-4 adverse events; none were deemed study related. Adherence and acceptability were good. Conclusions Our data suggest that E/C/F/TDF, a once-daily, single-tablet-regimen, is safe, effective, and well tolerated. Our findings support the use of integrase inhibitor-based regimens for HIV-2 treatment. Clinical Trials Registration NCT02180438.

This study summarizes 13 years’ experience following people with Human Immunodeficiency Virus Type 2 (HIV-2) receiving antiretroviral therapy (ART) in Senegal. Earlier ART initiation and more modern therapeutic regimens have improved outcomes. However, HIV-2 treatment remains suboptimal, and viral suppression rates remain below 90%.

Background The long-term benefits of antiretroviral treatment (ART) are associated with metabolic complications, especially lipodystrophy, which has been well described among HIV-infected adults and children on ART in developed settings. Specifically, stavudine, and to a lesser extent zidovudine and protease inhibitors (PI), have been consistently implicated in the development of lipodystrophy. In 2006, following advice from the WHO, Senegal began phasing out stavudine from first-line ART. The objectives of this cross-sectional analysis are to assess and identify risk factors affecting the prevalence of lipodystrophy in Senegalese children and adolescents on long-term ART participating in a cohort study. Methods Lipodystrophy was clinically assessed in two- to 18-year-old children on ART for at least six months and with no concurrent severe acute malnutrition. Risk factors for lipodystrophy were identified using stepwise multivariable logistic regression. Explanatory variables included clinical and personal data, immunovirologic status, and therapeutic history. Results Overall, 254 children were assessed for lipodystrophy. The median age was 10.9 years (IQR: 8.1–14.2) and the median duration on ART was 54 months (32–84). Only 18% had been previously treated with stavudine, with a median treatment duration of 8 months (5–25). Ongoing treatment included 76% of children receiving zidovudine (median duration of 48 months (26–74)) and 27% receiving PI (lopinavir/ritonavir; median duration of 49 months (23–59)). Mild signs of lipodystrophy were observed in 33 children (13%): 28 with lipoatrophy, 4 with lipohypertrophy and one with combined type. Boys were more likely to present with lipoatrophy than girls (aOR: 4.3, 95% CI: 1.6–11.7). Children previously treated with stavudine for ≥1 year had a greater risk for lipoatrophy than those never exposed (3.8, 1.0–14.0), although the association was weak. There was no association between lipodystrophy and age or current or cumulative treatment with lopinavir/ritonavir or zidovudine. Conclusions We report low prevalence of mild lipodystrophy in children and adolescents on long-term ART receiving a stavudine-sparing regimen. These findings are reassuring for clinicians in low-income settings where zidovudine is massively prescribed and lopinavir/ritonavir is the only widely available PI. Trial registration ClinicalTrials.gov identifier: NCT01771562 (registration date: 01/18/2013).

Background Dolutegravir recently became the third integrase strand transfer inhibitor (INSTI) approved for use in HIV-1–infected individuals. In contrast to the extensive dataset for HIV-1, in vitro studies and clinical reports of dolutegravir for HIV-2 are limited. To evaluate the potential role of dolutegravir in HIV-2 treatment, we compared the susceptibilities of wild-type and INSTI-resistant HIV-1 and HIV-2 strains to the drug using single-cycle assays, spreading infections of immortalized T cells, and site-directed mutagenesis. Findings HIV-2 group A, HIV-2 group B, and HIV-1 isolates from INSTI-naïve individuals were comparably sensitive to dolutegravir in the single-cycle assay (mean EC 50 values = 1.9, 2.6, and 1.3 nM, respectively). Integrase substitutions E92Q, Y143C, E92Q + Y143C, and Q148R conferred relatively low levels of resistance to dolutegravir in HIV-2 ROD9 (2- to 6-fold), but Q148K, E92Q + N155H, T97A + N155H and G140S + Q148R resulted in moderate resistance (10- to 46-fold), and the combination of T97A + Y143C in HIV-2 ROD9 conferred high-level resistance (>5000-fold). In contrast, HIV-1 NL4-3 mutants E92Q + N155H, G140S + Q148R, and T97A + Y143C showed 2-fold, 4-fold, and no increase in EC 50 , respectively, relative to the parental strain. The resistance phenotypes for E92Q + N155H, and G140S + Q148R HIV-2 ROD9 were also confirmed in spreading infections of CEM-ss cells. Conclusions Our data support the use of dolutegravir in INSTI-naïve HIV-2 patients but suggest that, relative to HIV-1, a broader array of replacements in HIV-2 integrase may enable cross-resistance between dolutegravir and other INSTI. Clinical studies are needed to evaluate the efficacy of dolutegravir in HIV-2–infected individuals, including patients previously treated with raltegravir or elvitegravir.