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Impact of Therapeutic Education on the Viral Load of HIV Infected Children and Adolescents on Antiretroviral Therapy at the Douala Laquintinie Hospital, Cameroon  [PDF]
Calixte Ida Penda, Anne-Cécile Zoung-Kanyi Bissek, Serge Clotaire Bilong, Loic-Ardin Boupda, Cécile Okala, Francis Atéba Ndongo, Grace Dallé Ngondi, Else C. Moukoko Eboumbou, Louis Richard Njock, Olivier Koki Ndombo
International Journal of Clinical Medicine (IJCM) , 2019, DOI: 10.4236/ijcm.2019.103011
Abstract: Introduction: One of the biggest challenges for HIV-infected adolescents on antiretroviral therapy (ART) is the long-term maintenance of viral suppression, which is the third 90% goal of UNAIDS. Therapeutic Education (TE), process of acquiring abilities and skills that help the patient to live optimally with his illness is one of the strategies that contribute to the achievement of viral suppression through the therapeutic adhesion contract and the follow-up of the patient. The aim of this study was to evaluate the impact of TE on the virologic response of children and adolescents aged 8 - 19 under ART and followed up at the Laquintinie Hospital of Douala (LHD). Method: A cross-sectional study was conducted at the Pediatric Unit of the HIV/AIDS Accredited Treatment Center (ATC) at LHD from February to May 2016. Children and adolescents aged 8 to 19 years on ART, followed in ATC/LHD whose parents had agreed to participate in the study, and who had achieved at least one viral load before and after initiation of TE, were recruited consecutively during routine medical follow-up. Data were collected from patients’ medical records and questionnaires administered to study participants. Results: A total of 198 children and adolescents were included in this study with an average age of 14 years (±3). In this study population, 86.1% of children aged 8 - 10 years had acquired knowledge of the importance of taking medications, 95.4% and 97.3% of adolescents aged 11 - 14 years and 15 - 19 years had knowledge of medication schedules respectively. Among children and adolescents with undetectable viral load prior to initiation of TE, 76.5% maintained an undetectable viral load after initiation of TE. In addition, 72.3% of those whose viral load was detectable before initiation of TE had acquired an undetectable or decreasing viral load after initiation of TE. The only exposure factor significantly associated with maintaining undetectable viral load after initiation of TE was having less than 10 TE sessions (p = 0.02). Conclusion: The virologic response appears to be better in subjects who acquire skills faster through TE and therefore require fewer learning sessions to adapt. In addition, TE effectively contributes to achieving the third 90% goal of UNAIDS.
Hematological Profile and Risk Factors of Anemia in Pregnant Women: A Cross Sectional Descriptive and Analytical Study in Douala Cameroon  [PDF]
Essome Henri, Mve Koh Valere, Esuh Esong Lucas, Penda Ida Calixte, Claudia Melioge Ngalame, Tocki Toutou Grace, Albert Same Ekobo, Carole Else Eboumbou Moukoko
Open Journal of Obstetrics and Gynecology (OJOG) , 2019, DOI: 10.4236/ojog.2019.97094
Abstract: During pregnancy, the hematological system undergoes numerous changes so as to meet up with the demands of the developing fetus and placenta, with major alterations in blood volume and this differs with women from different regions. The aim of this study was therefore to assess the hematological parameters and risk factors for anemia among pregnant women according to different trimesters of pregnancy in Douala, Cameroon. Methods: A cross-sectional study was conducted from February to May 2017, and all pregnant women who attended antenatal visits during our study period and who suited our inclusion criteria were recruited. The study was carried out in the antenatal care Unit of the Douala Laquintinie Hospital (DLH). A pretested questionnaire was used for the necessary data collection. Venous blood was collected from each of these women to perform a Complete Blood Count (CBC) test using an automated hematological analyzer (URIT 3010). Data were analyzed using XLSTAT 2007 and Stata version 11 software. Results: The mean age of the participants was 28 (SD = 5 years). The prevalence of anemia among pregnant women was 22% with a majority (18.4%) of these women being mildly anemic. Mean Hemoglobin values were significantly higher among women in first trimester compared to the third (12.1 ± 0.9 g/dl vs 11.8 ± 1.3 g/dl; p = 0.043). There was also a significant change in mean hematocrit (HCT) values between the first and second trimester (32.8% ± 2.5% vs 31.4% ± 2.9%, p = 0.004) and between the first and third trimester (32.8% ± 2.5% vs 30.8% ± 3.5%, p < 10-4). RBC count value was higher in the first trimester than in the second trimester (3.7 ± 0.3 × 1012/L vs 3.5 ± 0.4 × 1012/L, p < 10-4) and in the third trimester (3.7 ± 0.3 × 1012/L vs 3.5 ± 0.4 × 1012/L, p = 0.001). After a multivariate analysis, the following categories of women had more odds of developing anemia; women between the age range of 30 - 35 (OR = 2.81, 95%CI: 1.16 - 6.81, p = 0.023), women in the second trimester of pregnancy (OR = 2.20, 95%CI: 0.88 - 5.48, p = 0.024), women with blood group O (OR = 3.57, 95%CI: 1.41 - 16.66, p = 0.012). Conclusion: This study confirms significant variations in hematological parameters. The findings reinforce the need for supplementation and provide additional information on hematological reference values in pregnancy in Cameroon. It also helps us understand that, third trimester, age range 30 - 35, and blood group may be potential risk factors associated with anemia in pregnancy
Low Birth Weight in Perinatally HIV-Exposed Uninfected Infants: Observations in Urban Settings in Cameroon
Casimir Ledoux Sofeu, Josiane Warszawski, Francis Ateba Ndongo, Ida Calixte Penda, Suzie Tetang Ndiang, Georgette Guemkam, Nicaise Makwet, Félicité Owona, Anfumbom Kfutwah, Patrice Tchendjou, Ga?tan Texier, Maurice Tchuente, Albert Faye, Mathurin Cyrille Tejiokem, The ANRS-PEDIACAM study group
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0093554
Abstract: Background The consequences of maternal HIV infection for fetal growth are controversial. Here, we estimated the frequency of small for gestational age and gender (SGAG) among neonates born to HIV-infected or uninfected mothers and assessed the contribution, if any, of maternal HIV to the risk of SGAG. Methods The data used were obtained from the ANRS-Pediacam cohort in Cameroon. Pairs of newborns, one to a HIV-infected mother and the other to an uninfected mother, were identified during the first week of life, and matched on gender and recruitment site from 2007–2010. SGAG was defined in line with international recommendations as a birth weight Z-score adjusted for gestational age at delivery and gender more than two standard deviations below the mean (?2SD). Considering the matched design, logistic regression modeling was adjusted on site and gender to explore the effect of perinatal HIV exposure on SGAG. Results Among the 4104 mother-infant pairs originally enrolled, no data on birth weight and/or gestational age were available for 108; also, 259 were twins and were excluded. Of the remaining 3737 mother-infant pairs, the frequency of SGAG was 5.3% (95%CI: 4.6–6.0), and was significantly higher among HIV-infected infants (22.4% vs. 6.3%; p<.001) and lower among HIV-unexposed uninfected infants (3.5% vs. 6.3%; p<.001) than among HIV-exposed uninfected infants. Similarly, SGAG was significantly more frequent among HIV-infected infants (aOR: 4.1; 2.0–8.1) and less frequent among HIV-unexposed uninfected infants (aOR: 0.5; 0.4–0.8) than among HIV-exposed uninfected infants. Primiparity (aOR: 1.9; 1.3–2.7) and the presence of any disease during pregnancy (aOR: 1.4; 1.0–2.0) were identified as other contributors to SGAG. Conclusion Maternal HIV infection was independently associated with SGAG for HIV-exposed uninfected infants. This provides further evidence of the need for adapted monitoring of pregnancy in HIV-infected women, especially if they are symptomatic, to minimize additional risk factors for SGAG.
Contexte de la réforme du Code de la famille au Sénégal The Context of the Reform of the Family Code of Senegal
Penda Mbow
Droit et Cultures , 2010,
Abstract: Durant les années 1990, un groupe d’intellectuels sénégalais a proposé la promotion d’un Code de statut personnel et l’abrogation du Code de la famille voté en 1973. L’objectif des membres de ce groupe était de subvertir l’orientation politique du Sénégal en utilisant le débat sur le Code de la famille et sur le statut des femmes. On ne peut comprendre ce phénomène sans explorer la relation entre islam et politique sur le long terme, et en particulier la question de la démocratie dans les sociétés musulmanes et dans la pensée politique islamique. Il est aussi important de comprendre les droits et le statut des femmes du point de vue du discours islamique. During the 1990’s, a group of Senegalese intellectuals proposed a new Code of the Status of the Person and the abrogation of the Family Code that had been in effect since 1973. The group’s objective was to change the political direction of Senegal by means of a debate over the Family Code and the status of women. Understanding this situation calls for examination of the relationship between Islam and politics over the longer term – and especially the relationship between the democracy question in Muslim countries and in Muslim political thought. It is also important to understand women’s rights and the status of women as constituted in Islamic discourse.
Feasibility of Early Infant Diagnosis of HIV in Resource-Limited Settings: The ANRS 12140-PEDIACAM Study in Cameroon
Mathurin C. Tejiokem, Albert Faye, Ida C. Penda, Georgette Guemkam, Francis Ateba Ndongo, Gisèle Chewa, Claire Rekacewicz, Dominique Rousset, Anfumbom Kfutwah, Pascal Boisier, Josiane Warszawski, the ARNS 12140-PEDIACAM study group
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0021840
Abstract: Background Early infant diagnosis (EID) of HIV is a key-point for the implementation of early HAART, associated with lower mortality in HIV-infected infants. We evaluated the EID process of HIV according to national recommendations, in urban areas of Cameroon. Methods/Findings The ANRS12140-Pediacam study is a multisite cohort in which infants born to HIV-infected mothers were included before the 8th day of life and followed. Collection of samples for HIV DNA/RNA-PCR was planned at 6 weeks together with routine vaccination. The HIV test result was expected to be available at 10 weeks. A positive or indeterminate test result was confirmed by a second test on a different sample. Systematic HAART was offered to HIV-infected infants identified. The EID process was considered complete if infants were tested and HIV results provided to mothers/family before 7 months of age. During 2007–2009, 1587 mother-infant pairs were included in three referral hospitals; most infants (n = 1423, 89.7%) were tested for HIV, at a median age of 1.5 months (IQR, 1.4–1.6). Among them, 51 (3.6%) were HIV-infected. Overall, 1331 (83.9%) completed the process by returning for the result before 7 months (median age: 2.5 months (IQR, 2.4–3.0)). Incomplete process, that is test not performed, or result of test not provided or provided late to the family, was independently associated with late HIV diagnosis during pregnancy (adjusted odds ratio (aOR) = 1.8, 95%CI: 1.1 to 2.9, p = 0.01), absence of PMTCT prophylaxis (aOR = 2.4, 95%CI: 1.4 to 4.3, p = 0.002), and emergency caesarean section (aOR = 2.5, 95%CI: 1.5 to 4.3, p = 0.001). Conclusions In urban areas of Cameroon, HIV-infected women diagnosed sufficiently early during pregnancy opt to benefit from EID whatever their socio-economic, marital or disclosure status. Reduction of non optimal diagnosis process should focus on women with late HIV diagnosis during pregnancy especially if they did not receive any PMTCT, or if complications occurred at delivery.
HIV-Infected Children Living in Central Africa Have Low Persistence of Antibodies to Vaccines Used in the Expanded Program on Immunization
Mathurin C. Tejiokem, Ionela Gouandjika, Lydie Béniguel, Marie-Claire Endegue Zanga, Gilbert Tene, Jean C. Gody, Elisabeth Njamkepo, Anfumbom Kfutwah, Ida Penda, Catherine Bilong, Dominique Rousset, Régis Pouillot, Frédéric Tangy, Laurence Baril
PLOS ONE , 2007, DOI: 10.1371/journal.pone.0001260
Abstract: Background The Expanded Program on Immunization (EPI) is the most cost-effective measures to control vaccine-preventable diseases. Currently, the EPI schedule is similar for HIV-infected children; the introduction of antiretroviral therapy (ART) should considerably prolong their life expectancy. Methods and Principal Findings To evaluate the persistence of antibodies to the EPI vaccines in HIV-infected and HIV-exposed uninfected children who previously received these vaccines in routine clinical practice, we conducted a cross-sectional study of children, aged 18 to 36 months, born to HIV-infected mothers and living in Central Africa. We tested blood samples for antibodies to the combined diphtheria, tetanus, and whole-cell pertussis (DTwP), the measles and the oral polio (OPV) vaccines. We enrolled 51 HIV-infected children of whom 33 were receiving ART, and 78 HIV-uninfected children born to HIV-infected women. A lower proportion of HIV-infected children than uninfected children had antibodies to the tested antigens with the exception of the OPV types 1 and 2. This difference was substantial for the measles vaccine (20% of the HIV-infected children and 56% of the HIV-exposed uninfected children, p<0.0001). We observed a high risk of low antibody levels for all EPI vaccines, except OPV types 1 and 2, in HIV-infected children with severe immunodeficiency (CD4+ T cells <25%). Conclusions and Significance Children were examined at a time when their antibody concentrations to EPI vaccines would have still not undergone significant decay. However, we showed that the antibody concentrations were lowered in HIV-infected children. Moreover, antibody concentration after a single dose of the measles vaccine was substantially lower than expected, particularly low in HIV-infected children with low CD4+ T cell counts. This study supports the need for a second dose of the measles vaccine and for a booster dose of the DTwP and OPV vaccines to maintain the antibody concentrations in HIV-infected and HIV-exposed uninfected children.
Deviation inequalities for bifurcating Markov chains on Galton-Watson tree
Siméon Valère Bitseki Penda
Mathematics , 2013,
Abstract: We provide deviation inequalities for properly normalized sums of bifurcating Markov chains on Galton-Watson tree. These processes are extension of bifurcating Markov chains (which was introduced by Guyon to detect cellular aging from cell lineage) in case the index set is a binary Galton-Watson process. As application, we derive deviation inequalities for the least-squares estimator of autoregressive parameters of bifurcating autoregressive processes with missing data. These processes allow, in case of cell division, to take into account the cell's death. The results are obtained under an uniform geometric ergodicity assumption of an embedded Markov chain.
Variation of the Consumption of Mushrooms by Pygmies and Bantus in the North of Gabon  [PDF]
Hugues Calixte Eyi Ndong, Steeve Mounguengui, Christiane Attéké, Geraldine Obone Ndong
Advances in Microbiology (AiM) , 2014, DOI: 10.4236/aim.2014.416131
Abstract: A comparative study of the number of taxa and fungal biomass consumed by the Pygmies and the Bantus of Gabon has been realized in two Gabon north regions (Ogooue-Ivindo and the Woleu-Ntem). This study has allowed not only to establish the list of consumed fungal sorts by those populations, but also to estimate the daily consumed fungal biomasses by each ethnical group. The study has revealed a significant difference between a numbers of taxa and the quantity of mushrooms consumed by various ethnical groups: the Pygmies of the area who live especially by hunting and fishing consumed 96% of the recorded taxa with some high mushrooms quantities (around 3 kg/day/family); the Bantus who live nearby Pygmies also consumed some high mushrooms quantities (around 2 kg/day/family) but a low taxa number (56% of taxa counted by the Fang; 69% by the Kota; 39% by the Kwele); on the other hand, the Bantus living nearest the Pygmies consumed a high taxa number as much as Pygmies (around 90% of taxa counted) but eat a lower mushrooms quantities than theirs distant congeners Pygmies (around 800 g/day/family).
User Experience of ColdZyme Mouth Spray against Common Cold in Competitive Athletes  [PDF]
Ulf Blom, Ida Nelson
Open Journal of Respiratory Diseases (OJRD) , 2018, DOI: 10.4236/ojrd.2018.82002
Abstract:
ColdZyme Mouth Spray (ColdZyme) is intended to reduce the probability of catching a cold and/or can help shorten the duration of a cold, if used at an early stage of the infection, by forming a barrier on the pharyngeal mucous membrane. The user experience of ColdZyme on naturally occurring common cold infections was evaluated in competitive athletes training professionally or on an amateur level. Thirteen athletes completed weekly electronic surveys on occurrence of common colds, cold severity and user experience over the course of 3 months. The 13 participants reported in total 15 cold incidents with an average duration of 7.4 days. The average cold severity was 31.2 on a visual-analogue scale (VAS) ranging from 0 (mildest possible cold) to 100 (worst possible cold). The overall user satisfaction with ColdZyme was high. 81% of the reported colds were experienced to be milder and/or shorter than usual. None of the participants reported “No effect”. Out of the participants who reported absence of a cold in the previous week, 69% reported a positive answer to the question if ColdZyme had prevented them from catching a cold in the previous week. Conclusion: The present study evaluated prevention and alleviation of naturally occurring common cold in athletes, and demonstrated that ColdZyme may be an easy and practical way for competitive athletes to prevent or reduce infections of the common cold virus and corresponding unwanted absence from training and competition. Due to the lack of a comparator group, a placebo effect cannot be excluded.
Deviation inequalities and moderate deviations for estimators of parameters in bifurcating autoregressive models
Hacène Djellout,Valère Bitseki Penda
Mathematics , 2012,
Abstract: The purpose of this paper is to investigate the deviation inequalities and the moderate deviation principle of the least squares estimators of the unknown parameters of general $p$th-order bifurcating autoregressive processes, under suitable assumptions on the driven noise of the process. Our investigation relies on the moderate deviation principle for martingales.
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