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Search Results: 1 - 10 of 10517 matches for " Alexandre Manirakiza "
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Entomological profile of yellow fever epidemics in the Central African Republic, 2006–2010
Ngoagouni Carine,Kamgang Basile,Manirakiza Alexandre,Nangouma Auguste
Parasites & Vectors , 2012, DOI: 10.1186/1756-3305-5-175
Abstract: Background The causative agent of yellow fever is an arbovirus of the Flaviviridae family transmitted by infected Aedes mosquitoes, particularly in Africa. In the Central African Republic since 2006, cases have been notified in the provinces of Ombella-Mpoko, Ouham-Pende, Basse-Kotto, Haute-Kotto and in Bangui the capital. As the presence of a vector of yellow fever virus (YFV) represents a risk for spread of the disease, we undertook entomological investigations at these sites to identify potential vectors of YFV and their abundance. Findings Between 2006 and 2010, 5066 mosquitoes belonging to six genera and 43 species were identified. The 20 species of the Aedes genus identified included Ae. aegypti, the main vector of YFV in urban settings, and species found in tropical forests, such as Ae. africanus, Ae. simpsoni, Ae. luteocephalus, Ae. vittatus and Ae. opok. These species were not distributed uniformly in the various sites studied. Thus, the predominant Aedes species was Ae. aegypti in Bangui (90.7 %) and Basse-Kotto (42.2 %), Ae. africanus in Ombella-Mpoko (67.4 %) and Haute-Kotto (77.8 %) and Ae. vittatus in Ouham-Pende (62.2 %). Ae. albopictus was also found in Bangui. The distribution of these dominant species differed significantly according to study site (P < 0.0001). None of the pooled homogenates of Aedes mosquitoes analysed by polymerase chain reaction contained the YFV genome. Conclusion The results indicate a wide diversity of vector species for YFV in the Central African Republic. The establishment of surveillance and vector control programs should take into account the ecological specificity of each species.
Availability of Antimalarial Drugs and Evaluation of the Attitude and Practices for the Treatment of Uncomplicated Malaria in Bangui, Central African Republic
Alexandre Manirakiza,Siméon Pierre Njuimo,Alain Le Faou,Denis Malvy,Pascal Millet
Journal of Tropical Medicine , 2010, DOI: 10.1155/2010/510834
Abstract: National malaria management policy is based upon the availability of effective and affordable antimalarial drugs. This study was undertaken to evaluate the quality of the treatment of uncomplicated malaria cases in Bangui, an area with multidrug-resistant parasites, at a time preceding implementation of a new therapeutic policy relying on the artemisinin derivative combined treatment artemether-lumefantrine. A cross-sectional study was carried out in Bangui city to assess availability of antimalarial drugs and the performances of health workers in the management of uncomplicated malaria. Availability of drugs was recorded in all drugs wholesalers ( ), all pharmacies in health facilities ( ), private drugstores ( ), and in 60 non-official drug shops randomly chosen in the city. Despite a limited efficacy at the time of the survey, chloroquine remained widely available in the official and nonofficial markets. Artemisinin derivatives used in monotherapy or in combination were commonly sold. In health care facilities, 93% of the uncomplicated malaria cases were treated in the absence of any laboratory confirmation and the officially recommended treatment, amodiaquine-sulfadoxine/pyrimethamine, was seldom prescribed. Thus, the national guidelines for the treatment of uncomplicated malaria are not followed by health professionals in Bangui. Its use should be implemented while a control of importation of drug has to be reinforced. 1. Background The aim of malaria management policy is to provide therapeutic guidelines to health workers and efficacious and affordable drugs to health facilities for patients to buy. This policy must be based on proper laboratory diagnosis and treatment of malarial episodes. Given the rapid evolution of parasite resistance to chloroquine and sulfadoxine-pyrimethamine (SP), several countries have modified their national policy and adopted the artemisinin derivative combined treatments (ACT’s) as recommended by WHO [1]. Access to drugs is widely available for the urban population through private drugstores and an illicit market [2]. The consequence is an increase of “drugs pressure” on the parasite strains, thus increasing the risk of development of multidrug resistance [3]. Moreover, urban malaria has its own epidemiological characteristics requiring appropriate fighting methods [4]. In Bangui, capital of Central African Republic (CAR), chloroquine is no longer recommended by the National Malaria Control Program (NMCP) because the resistance rate was of 40.9% in 2004 [5], while, in rural areas, this rate has been estimated to be
Seroprevalence of measles and natural rubella antibodies among children in Bangui, Central African Republic
Alexandre Manirakiza, Jean Kipela, Stephen Sosler, Régis Daba, Ionela Gouandjika-Vasilache
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-327
Abstract: Vaccination history and blood samples were collected from 395 children using blotting paper. Samples were analyzed for the presence of measles-specific IgG antibodies using commercial ELISA kits.Measles-specific IgG antibodies were detected in 51.3% of vaccinated children and 27.6% of non-vaccinated children. Maternally derived measles IgG antibodies were present in only 14.8% of infants aged 0-3 months and were absent in all infants aged 4-8 months. The presence of IgG-specific measles antibodies varied among children of vaccination age, from 57.3% for children aged 9 months to 5 years, to 50.6% for children aged 6-9 years and 45.6% for chidren aged 10 years and above. The overall prevalence of rubella-specific IgG was 55.4%, with a high prevalence (87.4%) among children over 10 years of age.The findings suggest that despite efforts to accelerate measles control by giving a second dose of measles vaccine, a large number of children remain susceptible to measles virus. Further research is required to determine the geographic extent of immunity gaps and the factors that influence immunity to measles virus in the Central African Republic.Since 2000, significant progress has been made to reduce the global burden of measles. Nowhere has this achievement been more pronounced than in Africa. Through effective implementation of WHO- and UNICEF-recommended control strategies, the estimated measles-related mortality decreased by 90% in the African Region between 2000 and 2008. In particular, a second dose of measles-containing vaccine (MCV) given during supplemental immunization activities played a vital role in raising population immunity levels, although routine vaccination coverage remains low and health systems weak.In spite of the gains, measles morbidity and mortality continue to be an important public health concern for Africa's impoverished children, who have poorer access to vaccination and curative services. Moreover, the recent resurgence of measles outbreaks, cas
OPV strains circulation in HIV infected infants after National Immunisation Days in Bangui, Central African Republic
Alexandre Manirakiza, Emmanuella Picard, Richard Ngbale, Didier Menard, Ionela Gouandjika-Vasilache
BMC Research Notes , 2010, DOI: 10.1186/1756-0500-3-136
Abstract: Fifty three children were enrolled. Sequential stool samples were collected in between National Immunisation Days rounds and then every month during one year. Children were classified into 2 groups: no immunodepression (n = 38), immunodepression (n = 15) according to CD4+ lymphocytes cells count. Thirteen poliovirus strains were isolated from 11 children: 5 Human immunodeficiency virus positive and 6 Human immunodeficiency virus negative. None of the children excreted poliovirus for more than 4 weeks. The restriction fragment length polymorphism analysis showed that all strains were of Sabin origin including a unique Polio Sabine Vaccine types 2 and 3 (S2/S3) recombinant.From these findings we assume that Human immunodeficiency virus positive children are not a high risk population for long term poliovirus excretion. More powerful studies are needed to confirm our findings.Humans are the only host of polioviruses, thus the prospects of global polio eradication look reasonable [1,2]. However the discovery, after years of massive use of oral polio vaccine (OPV), of individuals with immunodeficiencies who were shown to excrete vaccine derived poliovirus (VDPV) for long periods of time led to a reluctance to prolong the vaccination campaign for fear of this end result [3]. Considering the immunodeficiency that prevails in Human immunodeficiency virus (HIV) patients, long term poliovirus excretion would be likely [4,5]. In Africa the OPV is used in mass vaccination campaigns during National Immunization Days (NIDs) notwithstanding HIV status of children. Two recent studies showed that HIV-infected children have low persistence of antibodies to vaccines used in the Expended Program on Immunization (EPI) including OPV [6,7].In Central African Republic (CAR), it have been assessed that the prevalence of HIV infection is 6% in general population [8] thus it would be of interest to study the impact of HIV infection on poliovirus excretion in infants of 0 to 5 years of age rec
Temporal Patterns of Abundance of Aedes aegypti and Aedes albopictus (Diptera: Culicidae) and Mitochondrial DNA Analysis of Ae. albopictus in the Central African Republic
Basile Kamgang,Carine Ngoagouni,Alexandre Manirakiza,Emmanuel Nakouné,Christophe Paupy,Mirdad Kazanji
PLOS Neglected Tropical Diseases , 2013, DOI: 10.1371/journal.pntd.0002590
Abstract: The invasive Asian tiger mosquito Aedes albopictus (Diptera: Culicidae) was first reported in central Africa in 2000, in Cameroon, with the indigenous mosquito species Ae. aegypti (Diptera: Culicidae). Today, this invasive species is present in almost all countries of the region, including the Central African Republic (CAR), where it was first recorded in 2009. As invasive species of mosquitoes can affect the distribution of native species, resulting in new patterns of vectors and concomitant risk for disease, we undertook a comparative study early and late in the wet season in the capital and the main cities of CAR to document infestation and the ecological preferences of the two species. In addition, we determined the probable geographical origin of invasive populations of Ae. albopictus with two mitochondrial DNA genes, COI and ND5. Analysis revealed that Ae. aegypti was more abundant earlier in the wet season and Ae. albopictus in the late wet season. Used tyres were the most heavily colonized productive larval habitats for both species in both seasons. The invasive species Ae. albopictus predominated over the resident species at all sites in which the two species were sympatric. Mitochondrial DNA analysis revealed broad low genetic diversity, confirming recent introduction of Ae. albopictus in CAR. Phylogeographical analysis based on COI polymorphism indicated that the Ae. albopictus haplotype in the CAR population segregated into two lineages, suggesting multiple sources of Ae. albopictus. These data may have important implications for vector control strategies in central Africa.
Les intellectuels burundais face au piège de l’ethnisme
D Manirakiza
African Sociological Review / Revue Africaine de Sociologie , 2011,
Abstract: Le r le habituellement attribué à un intellectuel libre et responsable est d’être un producteur d’idées objectives, et d’accepter de discuter avec la même objectivité les travaux scienti3ques de ses pairs. Si cet idéal-type est di4cile à atteindre dans toutes les sociétés, il l’est davantage dans une société ethniquement polarisée comme le Burundi. Piégés par un ethnisme violent qui a été construit et divulgué par les politiques qui ont géré le pays avant, pendant et après la colonisation, les intellectuels qui se sont prononcés sur les violences répétitives au Burundi ont, à quelques exceptions près, oublié leur identité nationale et se sont plut t présentés comme les défenseurs de leur ethnie. C’est, en partie, ce qui explique le traitement partisan qu’ils ont réservé aux événements cataclysmiques qui ont endeuillé ce pays depuis plus d’un demi-siècle.
Biological Profile of HIV-Positive Patients in Bangui, Central African Republic, in 2017  [PDF]
Yawo Tufa Nyasenu, Alain Farra, Brice Martial Yambiyo, Alexandre Manirakiza, Fernand Didier Padou, Ferdinand Yapou, Pulchérie Pelembi, Rodolphe Mambely-Nzako, Marie-Jo?lle Mandeng, Alain Berlioz-Arthaud, Pierre-Alain Rubbo, Jean-Pierre Lombart
World Journal of AIDS (WJA) , 2018, DOI: 10.4236/wja.2018.81002
Background: The biological profile of HIV-positive patients is essential for diagnosing treatment failure and the prognosis of infection. We determined the virological and immunological profiles and biological anomalies of HIV-positive people on antiretroviral therapy (ART) in Bangui, Central Afri-can Republic. Methods: We conducted an analytical, descriptive study be-tween 4 April and 30 September 2017 of all patients who had received ART for more than 12 months and who attended the Medical Analysis Laboratory of the Institut Pasteur in Bangui for a complete biological work-up, including viral load. A blood sample was taken for quantification of RNA HIV-1, CD4 lymphocytes and blood count in two tubes containing ethylenediamine te-traacetic acid, and another sample was taken in a dry tube for measurement of creatinine and transaminases. Results: The total population comprised 1748 patients, with a mean age of 38.7 years (±14.3; median, 41 years; range, 2 - 79 years); 33.3% of patients were between 40 and 49 years old. Females predo-minated (71.3%), for a sex ratio of 0.4. Immunological failure was observed in 20.2% of patients (CD4 < 200 cells/μL), and 44.5% of patients had a load of RNA HIV-1 ≥ 1000 copies/mL. The main haematological anomalies were anaemia (28.0%), leukopenia (26.7%), neutropenia (42.1%) and lymphopenia (27.2%). Blood creatinine was abnormal in 61.0% of patients, ALAT in 57.0% and ASAT in 66.9%. Conclusion: The abnormalities observed in this study concerned the haematopoietic system, the liver and the kidneys. As other or-gans and systems may be affected, periodic multidisciplinary biological and clinical follow-up is necessary for people living with HIV in order to improve their management.
Relatively Low Prevalence of Peripheral and Placental Plasmodium Infection at Delivery in Bangui, Central African Republic
Alexandre Manirakiza,Eugène Serdouma,Djibrine Djalle,Georges Soula,Remi Laganier,Nestor Madji,Methode Moyen,Alain Le Faou,Jean Delmont
Journal of Tropical Medicine , 2011, DOI: 10.1155/2011/434816
Abstract: Introduction. The aim of this study was to estimate the prevalence of malaria among women giving birth in Bangui. Association between sociodemographic characteristics of those women and malaria, as well as prevention compliance (use of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTsp) and insecticide-treated bed nets (ITNs)), was analyzed. Methods. During September 2009, a survey was conducted on 328 women who gave birth at two main maternities of Bangui. Information was obtained by standardized questionnaire about sociodemographic criteria, IPTsp, other antimalarial treatment, and use of bet nets. Smears prepared from peripheral and placental blood were analysed for malaria parasites. Findings and Discussion. Positive results were found in 2.8% of thick peripheral blood smears and in 4.0% of placental slides. A proportion of 30.5% of the women had received at least two doses of IPTsp during the current pregnancy. Only a proportion of 42.4% of this study population had ITNs. Multigravid women were less likely to use IPTsp and ITNs. However, use of IPTsp was associated with personal income and secondary or university educational status. Hence, although this relatively prevalence was observed, more efforts are needed to implement IPTsp and ITNs, taking into account sociodemographic criteria. 1. Introduction Every year, it is estimated that tens of thousands of pregnant women in malaria-endemic areas are infected with Plasmodium falciparum [1]. Frequently, placental infection occurs, owing to the accumulation of P. falciparum-infected erythrocytes in the intervillous space, despite the absence of parasites in peripheral blood [2]. The complications of malaria during pregnancy are maternal anaemia, preterm delivery, and low birth weight of newborns, which increase perinatal morbidity [1, 3, 4]. The World Health Organization (WHO) recommends intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTsp) during pregnancy, with at least two doses after quickening (18–20 weeks) not more frequently than monthly, use of insecticide-treated bed nets (ITNs) and prompt treatment of clinical malaria [5]. Intermittent preventive treatment consists of delivering a curative treatment dose of an antimalarial at predefined intervals, regardless of the parasitological status of the woman, and the efficacy of this protocol has been demonstrated in a number of malaria-endemic countries [5–8]. Placental Plasmodium screening in the Central African Republic (CAR) in 1990 showed a rate of 37.1% in women who had been given chemoprophylaxis with
Clinical outcome of skin yaws lesions after treatment with benzathinebenzylpenicillin in a pygmy population in Lobaye, Central African Republic
Alexandre Manirakiza, Susana Boas, Narcisse Beyam, Germain Zadanga, Fran?ois Konamna, Siméon P Njuimo, Rémi Laganier
BMC Research Notes , 2011, DOI: 10.1186/1756-0500-4-543
Abstract: The rate of healing of lesions after 5 months was 95.9%. This relatively satisfactory level of therapeutic response implies that yaws could be controlled in the Central African Republic. Thus, reinforcement of the management of new cases and of contacts is suggested.Yaws is a skin and bone non-venereal treponematosis caused by Treponema pallidum subsp. pertenue. It is not considered a neglected disease, but a forgotten one [1,2]. Most infected people reside in warm, humid tropical areas, in communities with lack of hygiene [3]. The usual means of transmission of yaws is close bodily contact with a patient with infectious lesions [4]. The clinical features are classified in stages [1,5]. During the primary stage, a lesion called the 'mother yaw' occurs as a papule, which develops after 2-4 weeks of incubation at the site of Treponema inoculation and enlarges before it ulcerates. Spontaneous resolution occurs after almost 6 months, and the initial lesion heals. The secondary stage is characterized by widespread smaller skin papules, the 'daughter yaws'. After a variable latency, which can last several years, a late stage develops in 10% of patients, which consists of skin ulceration, gumma formation and destruction of bones and cartilage. Painful palmoplantar hyperkeratosis and keratoderma are also observed during this third stage.Basically, the diagnosis of an infection by Treponema pertenue is based on three criteria,(i) the emergence of the disease in an endemic region, (ii) clinically typical papilloma lesions, and (iii) seroactivity in a treponemal antigen test [6]. The operational definition of a case of yaws is "any person who lives in an endemic area and presents with one or more of the following signs: painless ulcer with scab, papilloma, palmar/plantar hyperkeratosis (thickening)" [2].Clinical diagnosis is reliable with minimal training of health staff. In the field, diagnosis is based mainly on clinical findings and epidemiology. The diagnostic terms sugges
The prevalence of hepatitis B virus markers in a cohort of students in Bangui, Central African Republic
Narcisse P Komas, Souleyman Ba?-Sepou, Alexandre Manirakiza, Josiane Léal, Aubin Béré, Alain Le Faou
BMC Infectious Diseases , 2010, DOI: 10.1186/1471-2334-10-226
Abstract: Dried blood Spots from 801 adolescent high school and young adult university students were prepared by spotting a drop of whole blood (4 spots) from the same fingerprick onto Whatman filter paper. A blood sample aliquot eluted from DBS was then processed with commercial ELISA tests (Abbott Murex, Dartfort, UK) to detect HBsAg antigen, Anti-HBc and Anti-HBs antibodies).The overall prevalence was 42.3% for antibody to hepatitis B core antigen, 15.5% for HBsAg of which 1.3% of HBsAg alone. HBV familial antecedents, sexual activity and socioeconomic conditions were the main risk factors of HBV infection encountered in the adolescents and young adults.These results show for the first time the high prevalence of HBV in apparently healthy young people in Bangui. This high prevalence is age- and sex-independent. Transmission risk factors were a familial antecedent of HBV, no utilisation of condoms and public scholarship. To lower HBV prevalence, an adequate program of active screening and vaccination for adolescents and young adults should be implemented, along with a universal immunization program.Hepatitis B virus (HBV) infection represents a major health problem, with 2 billion people infected worldwide and more than 400 million chronic carriers of HBV. Globally it causes about 1.2 million deaths per year due to various complications including chronic hepatitis, cirrhosis, and liver cancer [1-4]. It is estimated that about one third of the infected individuals have symptoms and/or biological evidence of hepatitis. It is well established that the earlier the contamination, the higher the risk of chronic infection which is as high as 90% in infected infants. Chronic carriers have a high mortality rate due to complications. In Sub-Saharan Africa, the prevalence of HBV surface antigen (HBsAg) is 3 - 20% and markers of past exposure ranging from 60 - 99% [5].The Central African Republic (CAR), located in tropical Africa, is considered an area of high endemicity for HBV infect
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