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We estimated tuberculosis incidence during the first year on antriretroviral therapy without isoniazid-preventive treatment in 6938 West African HIV-infected adults at 3.33 cases per 100 person-years (95% CI, 2.85–3.80). In multivariate Poisson models, sites in Cote d’Ivoire, male gender, low body mass index, low hemoglobin, low CD4 count, and young age were significantly associated with higher incidence.

Introduction: Despite progress in prevention and treatment, infectious diseases remain a major cause of morbidity and mortality in West Africa. Hospital-level data are limited. This study aimed to assess the burden, clinical spectrum, and outcomes of infectious diseases at a referral hospital in Senegal. Methodology: A retrospective study of all non-coronavirus disease 2019 (COVID-19) infectious disease admissions at the Centre Hospitalier National Universitaire (CHNU) de Fann from January 2021 to December 2022 was conducted. Sociodemographic, clinical, diagnostic, and outcome variables were recorded. Logistic regression identified factors independently associated with in-hospital mortality. Results: A total of 1,098 patients (median age 42, 57.2% male) were included. Tuberculosis (TB; 21.8%), malaria (13%), and community-acquired pneumonia (9.2%) were the leading diagnoses. Human immunodeficiency virus (HIV) infection was present in 28.1% of patients, with 58.4% having opportunistic infections. Overall mortality was 25.0%. Independent predictors of death included HIV-positive status (OR: 2.1; 95% CI: 1.4–3.2), neurological involvement (OR: 1.7; 95% CI: 1.2–2.5), age > 60 years (OR: 1.9; 95% CI: 1.1–3.1), and sepsis (OR: 2.3; 95% CI: 1.5–3.6). Conclusions: Infectious diseases remain a leading cause of hospitalization and death in Senegal. Improving early diagnostics, integrating TB/HIV services, and expanding access to fungal testing are crucial to improve outcomes in resource-limited hospital settings.

The spread of severe acute respiratory syndrome coronavirus 2 began later in Africa than in Asia and Europe. Senegal confirmed its first case of coronavirus disease on March 2, 2020. By March 4, a total of 4 cases had been confirmed, all in patients who traveled from Europe.

Hepatitis B virus (HBV) infection is the first cause of liver cirrhosis and cancer in West Africa. Although the exposure to additional environmental and infectious risk factors may lead to the faster progression of liver disease, few large-scale studies have evaluated the determinants of HBV-related liver fibrosis in the region. We used transient elastography to evaluate the prevalence of liver fibrosis and assessed the association between HBV markers and significant liver fibrosis in a cohort of people living with HBV in Dakar, Senegal. The prevalence of significant liver fibrosis was 12.5% (95% confidence interval [CI] 9.6%–15.9%) among 471 people with HBV mono-infection (pwHBV) and 6.4% (95% CI 2.6%–12.7%) in 110 people with HIV/HBV co-infection (pwHIV/HBV) on tenofovir-containing antiretroviral therapy (p = 0.07). An HBV viral load > 2000 IU/mL was found in 133 (28.3%) pwHBV and 5 (4.7%) pwHIV/HBV, and was associated with significant liver fibrosis (adjusted odds ratio (aOR) 1.95, 95% CI 1.04–3.66). Male participants (aOR 4.32, 95% CI 2.01–8.96) and those with elevated ALT (aOR 4.32, 95% CI 2.01–8.96) were especially at risk of having significant liver fibrosis. Our study shows that people with an HBV viral load above 2000 IU/mL have a two-fold increase in the risk of liver fibrosis and may have to be considered for antiviral therapy, independent of other disease parameters.

ObjectivesPublic awareness and the dissemination of tailored information to lay populations are essential for highly endemic countries like Senegal to achieve hepatitis B elimination targets by 2030. In Senegal, despite its high prevalence, hepatitis B has not received sufficient attention in health communication campaigns compared with other health issues like HIV. We aimed to explore knowledge and perceptions surrounding hepatitis B virus (HBV), as well as the influence of digital media on the information accessed by individuals living with HBV in Senegal.DesignWe employed a mixed-methods approach combining qualitative semistructured interviews conducted with people living with HBV enrolled in the Senegalese hepatitis B cohort (SEN-B), with a quantitative content analysis of online news coverage focused on HBV within the online media of Senegal.SettingA referral University hospital in Dakar, Senegal.Participants29 individuals aged >18 years presenting with a positive hepatitis B surface antigen (HBsAg) with a median age of 40 years (IQR 27–54), of whom 51.7% were female.Outcomes and analysisQualitative interviews were conducted between December 2019 and October 2021, and we employed purposive sampling to select participants enrolled in SEN-B. Thematic analysis facilitated a systematic synthesis of respondents’ narratives. All data analyses were performed using Atlas.ti (V.22). For content analysis of online media news collected from September 2019 to May 2022, a structured data extraction form was developed to collect relevant information from the selected online news articles. Data on readers’ comments spaces were extracted using an inductive approach and were processed using thematic analyses. The quantitative data issued from content analysis were exported to Stata SE V.17.0 (StataCorp) for statistical analysis.ResultsWe observed a generalised lack of knowledge about HBV among participants, some of whom had never heard of the virus prior to their screening. Incomprehension regarding the disease contributed to feelings of fear and anxiety, leading participants to express various concerns about their personal health status, transmission, cure and treatment(s). The presence of rumours surrounding the disease further underscored the limited awareness of HBV revealing the marginal recognition of HBV as a significant societal concern. In many cases, the absence of effective health communication strategies at the national level resulted in individuals turning to traditional and online media for information, which often intensified their fears and concerns about HBV. An analysis of Senegalese media coverage about HBV included 157 articles published between 2009 and 2022. 55.4% (87/157) of these publications appeared in July, coinciding with World Hepatitis Day, while 65.0% (102/157) focused on general HBV epidemiology and activities led by the National Hepatitis Programme. Online media also served as informal spaces where unaccredited actors within the health sector promoted treatments lacking official verification. Additionally, the reactions’ spaces provided a venue for the exchange of information, though without any guarantee of its accuracy.ConclusionsFacilitating collaboration and engagement between health communication stakeholders and communities is crucial for effectively disseminating structured information and culturally appropriate messages, ultimately contributing to raising awareness of HBV.

Introduction: Despite prevention efforts, malaria remains a public health problem. Methodology: This was a prospective study conducted between October and December 2010 that aimed to describe the therapeutic route of adults presenting with severe malaria prior to being admitted to Fann Teaching Hospital in Dakar, Senegal. Results: A total of 90 patients were included. The majority of them had consulted a public or private health care facility (92%) prior to admission. First consultation occurred on average two days after the onset of the disease. Self-medication (67.4%) and traditional medicine (26.1%) were the main causes of delaying care. Conclusions: Early care and adequate management are needed to reduce malaria mortality.

Background. The efficacy of various antiretroviral (ARV) therapy regimens for human immunodeficiency virus type 2 (HIV-2) infection remains unclear. HIV-2 is intrinsically resistant to the nonnucleoside reverse-transcriptase inhibitors and to enfuvirtide and may also be less susceptible than HIV-1 to some protease inhibitors (PIs). However, the mutations in HIV-2 that confer ARV resistance are not well characterized. Methods. Twenty-three patients were studied as part of an ongoing prospective longitudinal cohort study of ARV therapy for HIV-2 infection in Senegal. Patients were treated with nucleoside reverse-transcriptase inhibitor (NRTI)– and PI (indinavir)–based regimens. HIV-2 pol genes from these patients were genotyped, and the mutations predictive of resistance in HIV-2 were assessed. Correlates of ARV resistance were analyzed. Results. Multiclass drug–resistance mutations (NRTI and PI) were detected in strains in 30% of patients; 52% had evidence of resistance to at least 1 ARV class. The reverse-transcriptase mutations M184V and K65R, which confer high-level resistance to lamivudine and emtricitabine in HIV-2, were found in strains from 43% and 9% of patients, respectively. The Q151M mutation, which confers multinucleoside resistance in HIV-2, emerged in strains from 9% of patients. HIV-1–associated thymidine analogue mutations (M41L, D67N, K70R, L210W, and T215Y/F) were not observed, with the exception of K70R, which was present together with K65R and Q151M in a strain from 1 patient. Eight patients had HIV-2 with PI mutations associated with indinavir resistance, including K7R, I54M, V62A, I82F, L90M, L99F; 4 patients had strains with multiple PI resistance–associated mutations. The duration of ARV therapy was positively associated with the development of drug resistance ( P=.02 ). Nine (82%) of 11 patients with HIV-2 with detectable ARV resistance had undetectable plasma HIV-2 RNA loads (<1.4 log>10 copies/mL), compared with 3 (25%) of 12 patients with HIV-2 with detectable ARV resistance (P=.009). Patients with ARV-resistant virus had higher plasma HIV-2 RNA loads, compared with those with non–ARV-resistant virus (median, 1.7 log>10 copies/mL [range, <1.4 to 2.6 log>10 copies/mL] vs. <1.4 log>10 copies/mL [range, <1.4 to 1.6 log>10 copies/mL]; P=.003 ). Conclusions. HIV-2–infected individuals treated with ARV therapy in Senegal commonly have HIV-2 mutations consistent with multiclass drug resistance. Additional clinical studies are required to improve the efficacy of primary and salvage treatment regimens for treating HIV-2 infection.

Abdominal tuberculosis accounts for 3 to 5% of all visceral diseases. Despite the demonstrated effectiveness of anti-tuberculosis treatments, some cases of exacerbation of the initial clinical presentation have been described during the initiation of treatment. However, these reactions also known as \"paradoxical\" have been rarely reported in immunocompetent patients and much less in the case of bowel obstruction. We report a case of intestinal tuberculosis revealed by acute bowel obstruction during paradoxical reaction to anti-tuberculosis treatment. The study included a 26-year old immunocompetent patient with occlusive syndrome after a month of treatment for pleuropulmonary tuberculosis. Abdominal computed tomography (CT) showed small bowel obstruction. Laparotomy objectified intraperitoneal mass with multiple adhesions. Anatomo-pathological examination of the surgical specimen showed intestinal tuberculosis. Patient's outcome was favorable after the continuation of initial antituberculosis treatment.

Introduction Au Sénégal, 85% de la population adulte ont été en contact avec le virus de l'hépatite B et environ 11% sont porteurs chroniques de l'antigène de surface de ce virus (AgHBs). Cette infection est peu documentée dans l'armée sénégalaise. L'objectif de cette étude était d'évaluer la prévalence de l'AgHBs chez des militaires sénégalais envoyés en mission au Darfour (Soudan) et d'identifier les facteurs associés. Méthodes Nous avons mené une étude transversale du 1er juillet 2014 au 31 juillet 2014 chez des militaires sénégalais en mission au Darfour. La recherche de l'AgHBs a été effectuée dans le sérum des participants par la méthode immunochromatographique. La recherche de facteurs associés a été réalisée à l'aide d'une régression logistique multivariée. Résultats Notre étude a porté sur 169 militaires de sexe masculin. L'âge moyen était de 36,6 ans ± 9,5. Des antécédents d'hépatopathie chronique au niveau familial, d'exposition sanguine et d'exposition sexuelle ont été retrouvés respectivement chez 12,4% ; 24,9% et 45,6% de la population d'étude. L'AgHBs a été retrouvé chez 24 participants [14,2% (IC95% = 8,9-19,5)]. Après ajustement sur les facteurs de confusion potentiels, l'âge (OR=0,9 IC95% =0,9-1,0), un niveau d'étude universitaire (OR= 9,5 IC95% =1,3-67,1) et l'exposition sexuelle (OR=3,3; IC95% =1,0-10,3) étaient apparus associés de façon indépendante à l'hépatite B. Conclusion Notre étude retrouve une prévalence élevée de l'AgHBs et souligne la nécessité d'une évaluation plus poussée de l'hépatite B chez cette population.

The novel coronavirus disease 2019 (COVID-19) pandemic has spread from China to the rest of the world. Africa seems less impacted with lower number of cases and deaths than other continents. Senegal recorded its first case on March 2, 2020. We present here data collected from March 2 to October 31, 2020 in Senegal. Socio-demographic, epidemiological, clinical and virological information were collected on suspected cases. To determine factors associated with diagnosed infection, symptomatic disease and death, multivariable binary logistic regression and log binomial models were used. Epidemiological parameters such as the reproduction number and growth rate were estimated. 67,608 suspected cases were tested by the IPD laboratories (13,031 positive and 54,577 negative). All age categories were associated with SARS-CoV-2 infection, but also patients having diabetes or hypertension or other cardiovascular diseases. With diagnosed infection, patients over 65 years and those with hypertension and cardiovascular disease and diabetes were highly associated with death. Patients with co-morbidities were associated with symptomatic disease, but only the under 15 years were not associated with. Among infected, 27.67% were asymptomatic (40.9% when contacts were systematically tested; 12.11% when only symptomatic or high-risk contacts were tested). Less than 15 years-old were mostly asymptomatic (63.2%). Dakar accounted for 81.4% of confirmed cases. The estimated mean serial interval was 5.57 (± 5.14) days. The average reproduction number was estimated at 1.161 (95%CI: 1.159-1.162), the growth rate was 0.031 (95%CI: 0.028-0.034) per day. Our findings indicated that factors associated with symptomatic COVID-19 and death are advanced age (over 65 years-old) and comorbidities such as diabetes and hypertension and cardiovascular disease.