BACKGROUND & AIMS: BACKGROUND:The Onchocercidae is a family of filarial nematodes with several species of medical or veterinary importance. Microfilariae are found in the blood and/or the dermis and are usually diagnosed in humans by microscopy examination of a blood sample or skin biopsy. The main objectives of this study were to evaluate whether filariae DNA can be detected in faecal samples of wild non-human primates (NHPs), whether the detected parasites were closely related to those infecting humans and whether filarial DNA detection in faeces is associated with co-infections with nematodes (Oesophagostumum sp. and Necator sp.) known to cause blood loss while feeding on the host intestinal mucosa. METHODS:A total of 315 faecal samples from 6 species of NHPs from Cameroon and Gabon were analysed. PCRs targeted DNA fragments of cox1 and 12S rDNA genes, to detect the presence of filariae, and the internal transcribed spacer 2 (ITS2), to detect the presence of Oesophagostomum sp. and Necator sp. infections. RESULTS:Among the 315 samples analysed, 121 produced sequences with > 90% homology with Onchocercidae reference sequences. However, 63% of the 12S rDNA and 78% of the cox1 gene sequences were exploitable for phylogenetic analyses and the amplification of the 12S rDNA gene showed less discriminating power than the amplification of the cox1 fragment. Phylogenetic analyses showed that the cox1 sequences obtained from five chimpanzee DNA faecal samples from Gabon and two from Cameroon cluster together with Mansonella perstans with high bootstrap support. Most of the remaining sequences clustered together within the genus Mansonella, but the species could not be resolved. Among the NHP species investigated, a significant association between filarial DNA detection and Oesophagostomum sp. and Necator sp. infection was observed only in gorillas. CONCLUSIONS:To our knowledge, this is the first study reporting DNA from Mansonella spp. in faecal samples. Our results raise questions about the diversity and abundance of these parasites in wildlife, their role as sylvatic reservoirs and their potential for zoonotic transmission. Future studies should focus on detecting variants circulating in both human and NHPs, and improve the molecular information to resolve or support taxonomy classification based on morphological descriptions.

背景与目标： 背景：弓形虫科是丝状线虫科，具有多种医学或兽医学意义。微丝虫病存在于血液和/或真皮中，通常通过血液样本或皮肤活检的显微镜检查在人类中得到诊断。这项研究的主要目的是评估是否可以在野生非人类灵长类动物（NHPs）的粪便样本中检测到丝虫DNA，检测到的寄生虫是否与感染人类的​​寄生虫密切相关，以及粪便中丝状DNA的检测是否与大肠杆菌相关。 -感染线虫（食道线虫（Oesophagostumum sp。）和线虫（Necator sp。））的食物，在进食宿主肠粘膜时会引起失血。
方法：共分析了喀麦隆和加蓬6种NHPs的315份粪便样本。 PCR靶向cox1和12S rDNA基因的DNA片段，以检测丝虫病的存在，以及内部转录间隔区2（ITS2），以检测Oesophagostomum sp的存在。和Necator sp。感染。
结果：在分析的315个样品中，有121条产生的序列与Onchocercidae参考序列具有> 90％的同源性。但是，有63％的12S rDNA和78％的cox1基因序列可用于系统发育分析，并且12S rDNA基因的扩增显示出比cox1片段弱的鉴别力。系统发育分析表明，从加蓬的五只黑猩猩DNA粪便样品和喀麦隆的两个黑猩猩DNA粪便样品中获得的cox1序列与具有高自举支持的曼氏菌一起被发现。其余大多数序列在曼森氏菌属中聚集在一起，但无法解析。在所调查的NHP物种中，丝状DNA检测与食管食管菌sp之间存在显着关联。和Necator sp。仅在大猩猩中观察到感染。
结论：据我们所知，这是第一项报道曼森氏菌属DNA的研究。在粪便样本中。我们的结果提出了有关这些寄生虫在野生生物中的多样性和丰富性，它们作为sylvatic水库的作用以及其人畜共患病传播潜力的问题。未来的研究应侧重于检测人类和NHP中循环的变异体，并改善分子信息以基于形态学描述来解析或支持分类学分类。

BACKGROUND & AIMS: BACKGROUND:In low-income countries (LICs), HIV sentinel surveillance surveys (HIV-SSS) are recommended in between two demographic and health surveys, due to low-cost than the latter. Using the classical unlinked anonymous testing (UAT), HIV-SSS among pregnant women raised certain ethical and financial challenges. We therefore aimed at evaluating how to use prevention of mother-to-child transmission of HIV (PMTCT) routine data as an alternative approach for HIV-SSS in LICs. METHODS:A survey conducted through 2012 among first antenatal-care attendees (ANC1) in the ten regions of Cameroon. HIV testing was performed at PMTCT clinics as-per the national serial algorithm (rapid test), and PMTCT site laboratory (PMTCT-SL) performances were evaluated by comparison with results of the national reference laboratory (NRL), determined as the reference standard. RESULTS:Acceptance rate for HIV testing was 99%, for a total of 6521 ANC1 (49 · 3% aged 15-24) enrolled nationwide. Among 6103 eligible ANC1, sensitivity (using NRL testing as the reference standard) was 81 · 2%, ranging from 58 · 8% (South region) to 100% (West region); thus implying that 18 · 8% HIV-infected ANC1 declared HIV-negative at the PMTCT-SL were positive from NRL-results. Specificity was 99 · 3%, without significant disparity across sites. At population-level, this implies that every year in Cameroon, ~2,500 HIV-infected women are wrongly declared seronegative, while ~1,000 are wrongly declared seropositive. Only 44 · 4% (16/36) of evaluated laboratories reached the quality target of 80%. CONCLUSIONS:The study identified weaknesses in routine PMTCT HIV testing. As Cameroon transitions to using routine PMTCT data for HIV-SSS among pregnant women, there is need in optimizing quality system to ensure robust routine HIV testing for programmatic and surveillance purposes.

背景与目标： 背景：在低收入国家（LICs），建议在两次人口统计和健康调查之间进行HIV前哨监视调查（HIV-SSS），因为这样做的成本较低。使用经典的无关联匿名测试（UAT），孕妇中的HIV-SSS提出了某些道德和财务挑战。因此，我们旨在评估如何使用预防HIV母婴传播（PMTCT）常规数据作为LIC中HIV-SSS的替代方法。
方法：2012年之前对喀麦隆十个地区的第一批产前护理参加者（ANC1）进行了一项调查。按照国家串行算法（快速测试）在PMTCT诊所进行HIV检测，并通过与确定为参考标准的国家参考实验室（NRL）的结果进行比较来评估PMTCT现场实验室（PMTCT-SL）的性能。
结果：全国共纳入6521例ANC1（49·3％，15-24岁），HIV检测合格率为99％。在6103个合格的ANC1中，灵敏度（以NRL测试为参考标准）为81±2％，范围从58±8％（南部地区）到100％（西部地区）；因此，从NRL结果中可以看出，在PMTCT-SL上被HIV感染的18±8％的ANC1呈阴性。特异性为99±3％，各部位之间无显着差异。在人口一级，这意味着在喀麦隆，每年有大约2500名被HIV感染的妇女被错误地宣布为血清阴性，而大约1,000名被错误地宣布为血清阳性。评估实验室中只有44％·4％（16/36）达到了80％的质量目标。
结论：该研究确定了常规PMTCT HIV检测的弱点。随着喀麦隆过渡到使用孕妇的HIV-SSS常规PMTCT数据，有必要优化质量体系，以确保针对程序性和监测目的进行可靠的常规HIV检测。

BACKGROUND & AIMS: :In this study, we analyzed the M. tuberculosis complex (MTBc) population structure among multidrug-resistant TB (MDR-TB) patients in Niger and tested whether the Cameroon family displayed a slower response to MDR-TB treatment. We genotyped baseline clinical isolates that had been collected from pulmonary MDR-TB patients recruited consecutively between 2008 and 2016 in Niger. Spoligotyping was used to analyze the genetic diversity of mycobacterial lineages, and Kaplan Meier's analysis to compare treatment outcomes. A total of 222 MTBc isolates were genotyped; 204 (91,9%) were identified as the Euro-American L4 lineage, with the Ghana family (106, 47,4%) and the Cameroon family (63, 28,4%) being predominant. Patients infected by Cameroon family isolates 61(96,8%) showed faster conversion (log-rank p < 0.01) than those infected with Ghana family isolates (91,5%), and were more likely to experience favorable outcome (adjusted odds ratio [aOR] 4.4; 95%CI 1.1-17.9]; p = 0.015). We found no association between MTBc families and second-line drug resistance profiles (p > 0.05). Our findings show that MDR-TB in Niger is caused by major spoligotypes of the Euro-American L4; with more rapid smear and culture conversion in patients infected with the Cameroon family. These first insights may alert clinicians that slow conversion may be associated with the type of infecting strain.

背景与目标： ：在这项研究中，我们分析了尼日尔耐多药结核病（MDR-TB）患者中的结核分枝杆菌复合群（MTBc）人口结构，并测试了喀麦隆家族对MDR-TB治疗的反应是否较慢。我们对从2008年至2016年在尼日尔连续招募的肺部MDR-TB患者收集的基线临床分离株进行了基因分型。 Spoligotyping用于分析分枝杆菌谱系的遗传多样性，Kaplan Meier的分析用于比较治疗效果。总共对222种MTBc分离株进行了基因分型。欧裔美国人L4血统为204（91,9％），其中加纳（106，47,4％）和喀麦隆（63，28.4％）家族为主要血统。被喀麦隆家族分离株61（96,8％）感染的患者显示出比被加纳家族分离株（91,5％）感染的患者更快的转化（log-rank p <0.01），并且更有可能获得有利的结局（调整后的优势比） [aOR] 4.4； 95％CI 1.1-17.9]； p = 0.015）。我们发现MTBc家族与二线耐药性谱之间无关联（p> 0.05）。我们的研究结果表明，尼日尔的耐多药结核病是由欧美L4的主要嗜血型引起的。感染喀麦隆家庭的患者的涂片和培养转换速度更快。这些最初的见解可能会提醒临床医生，转换缓慢可能与感染株的类型有关。

BACKGROUND & AIMS: :The grading system for ultrasonographic assessment of Schistosoma mansoni morbidity is crucial for evaluation of control programs. This requires prior definition of normal liver organometric ranges in the population from the endemic area. A cross-sectional study was conducted in a S. mansoni endemic area in rural Cameroon. 1002 Participants were screened and 234 of them, free from all common liver-affecting diseases in the area (schistosomiasis, malaria, hepatitis B and C) and with no ultrasonographic signs of liver disease were selected and their liver parameters measured by ultrasonography. All statistics were considered significant for p-values < 0.05. Normal dimensions of livers lobe sizes, portal vein wall thickness and portal vein diameters are reported. The liver organometric data are presented for the entire study population as a whole and separately for males and females as prediction plots, with observed values and fitted regression line with 95% confidence. Reference ranges for liver parameters (size, portal vein thickness and diameter) adjusted for body height established in the current study are novel for Cameroon. The prediction plots generated should improve the accuracy of the assessment of liver morbidity by ultrasonography in the region.

背景与目标： ：曼氏血吸虫病发病率的超声评估评分系统对于评估控制程序至关重要。这需要从流行地区开始预先定义正常肝脏器官测量范围。在喀麦隆农村的曼氏葡萄球菌流行地区进行了横断面研究。筛选了1002例参与者，其中234例没有该地区所有常见的影响肝病的疾病（血吸虫病，疟疾，乙型和丙型肝炎），并且没有超声显示肝脏疾病的体征，并通过超声检查测量了他们的肝脏参数。对于p值<0.05，所有统计数据均被视为显着。报告了肝叶大小，门静脉壁厚度和门静脉直径的正常尺寸。整体显示了整个研究人群的肝脏器官测量数据，男性和女性分别作为预测图，具有观察值和具有95％置信度的拟合回归线。在本研究中建立的根据身高调整的肝脏参数（大小，门静脉厚度和直径）的参考范围对于喀麦隆来说是新颖的。生成的预测图应提高该区域通过超声检查评估肝病发病率的准确性。

BACKGROUND & AIMS: OBJECTIVE:To determine the percentage of infected children for whom nevirapine (NVP) was used to prevent peripartum mother-to-child transmission (MTCT) of HIV in Yaoundé, Cameroon. DESIGN:The study was a prospective Public Health Pilot Program covering a 3-year period (January 2000-December 2002). METHODS:Counseled and consenting HIV-1-positive pregnant women were given a single dose of NVP at the onset of labor. Babies were given 2 mg/kg NVP syrup within the first 72 hours of life. NVP-treated children were regularly followed up and examined for HIV-1 infection at 6-8 weeks and 5-6 months through plasma viral load (VL) quantification with the bDNA system. RESULTS:One hundred twenty-three children were diagnosed with perinatal HIV-1 infection at 6-8 weeks and 5-6 months. Thirteen children (10.6% [13/123]; 95% confidence interval, 5.1-16) were infected and presented with high VLs, in general >500,000 copies/mL. Two children had intermediate VLs (between 50 and 3500 copies/mL) at both time points. One hundred seven children (87%) were considered not infected at 6-8 weeks of age. CONCLUSIONS:Our results indicate that the HIV-1 MTCT rate 6-8 weeks after NVP administration was not >13% (16/123), thus demonstrating the effectiveness of NVP for lowering the risk of HIV-1 MTCT in real-life settings.

背景与目标： 目的：确定在喀麦隆雅温得使用奈韦拉平（NVP）预防围产期HIV母婴传播（MTCT）的感染儿童的百分比。
设计：该研究是一项为期三年的前瞻性公共卫生试验计划（2000年1月至2002年12月）。
方法：在接受咨询的自愿同意的HIV-1阳性孕妇在分娩时给予单剂量的NVP。婴儿在出生后的头72小时内应服用2 mg / kg NVP糖浆。对接受NVP治疗的儿童进行定期随访，并通过bDNA系统定量血浆病毒载量（VL）对6-8周和5-6个月的HIV-1感染进行检查。
结果：123名儿童在6-8周和5-6个月被诊断为围产期HIV-1感染。十三名儿童（10.6％[13/123]； 95％置信区间为5.1-16）被感染并呈现出较高的VL，通常> 500,000拷贝/ mL。两个孩子在两个时间点都有中度VLs（介于50和3500拷贝/ mL之间）。认为有67名儿童（87％）在6-8周龄时未感染。
结论：我们的结果表明，NVP给药后6-8周的HIV-1 MTCT发生率未> 13％（16/123），因此证明了NVP在现实环境中降低HIV-1 MTCT风险的有效性。 。

BACKGROUND & AIMS: :The incidence of hearing impairment (HI) is higher in low- and middle-income countries when compared to high-income countries. There is therefore a necessity to estimate the burden of this condition in developing world. The aim of our study was to use a systematic approach to provide summarized data on the prevalence, etiologies, clinical patterns and genetics of HI in Cameroon. We searched PubMed, Scopus, African Journals Online, AFROLIB and African Index Medicus to identify relevant studies on HI in Cameroon, published from inception to 31 October, 2019, with no language restrictions. Reference lists of included studies were also scrutinized, and data were summarized narratively. This study is registered with PROSPERO, number CRD42019142788. We screened 333 records, of which 17 studies were finally included in the review. The prevalence of HI in Cameroon ranges from 0.9% to 3.6% in population-based studies and increases with age. Environmental factors contribute to 52.6% to 62.2% of HI cases, with meningitis, impacted wax and age-related disorder being the most common ones. Hereditary HI comprises 0.8% to 14.8% of all cases. In 32.6% to 37% of HI cases, the origin remains unknown. Non-syndromic hearing impairment (NSHI) is the most frequent clinical entity and accounts for 86.1% to 92.5% of cases of HI of genetic origin. Waardenburg and Usher syndromes account for 50% to 57.14% and 8.9% to 42.9% of genetic syndromic cases, respectively. No pathogenic mutation was described in GJB6 gene, and the prevalence of pathogenic mutations in GJB2 gene ranged from 0% to 0.5%. The prevalence of pathogenic mutations in other known NSHI genes was <10% in Cameroonian probands. Environmental factors are the leading etiology of HI in Cameroon, and mutations in most important HI genes are infrequent in Cameroon. Whole genome sequencing therefore appears as the most effective way to identify variants associated with HI in Cameroon and sub-Saharan Africa in general.

背景与目标： ：与高收入国家相比，低收入和中等收入国家的听力障碍（HI）发生率更高。因此，有必要估计发展中国家的这种状况的负担。我们研究的目的是使用一种系统的方法来提供关于喀麦隆HI的患病率，病因，临床模式和遗传学的汇总数据。我们搜索了PubMed，Scopus，Afrolis Online Online，AFROLIB和African Index Medicus，以查找有关喀麦隆HI的相关研究，该研究从成立到2019年10月31日均已发布，没有语言限制。还仔细研究了纳入研究的参考文献清单，并对数据进行了叙述性总结。该研究已在PROSPERO注册，编号为CRD42019142788。我们筛选了333条记录，其中17项研究最终纳入了评价。在基于人群的研究中，喀麦隆的HI患病率从0.9％到3.6％不等，并且随着年龄的增长而增加。在HI病例中，环境因素占52.6％至62.2％，其中最常见的是脑膜炎，受影响的蜡和与年龄相关的疾病。遗传性HI占所有病例的0.8％至14.8％。在32.6％至37％的HI病例中，起源仍然未知。非综合征性听力障碍（NSHI）是最常见的临床实体，占遗传起源的HI病例的86.1％至92.5％。 Waardenburg和Usher综合征分别占遗传综合征病例的50％至57.14％和8.9％至42.9％。 GJB6基因中未发现致病突变，GJB2基因中致病突变的发生率在0％至0.5％之间。在喀麦隆先证者中，其他已知NSHI基因的致病性突变患病率还不到10％。环境因素是喀麦隆HI的主要病因，在喀麦隆，最重要的HI基因突变很少见。因此，在喀麦隆和整个撒哈拉以南非洲地区，全基因组测序似乎是鉴定与HI相关的变异体的最有效方法。

BACKGROUND & AIMS: :Introduction According to the current classification of the Lawson Wilkins Pediatric Endocrine Society (LWPES) and the European Society for Pediatric Endocrinology (ESPE) of Disorders of Sex Development (DSD), etiologies vary around the world. Ethnic or genetic diversity probably explains this variability. We therefore conducted the present study on etiologies of DSDs in a country from central Africa. Methods We carried out an observational retrospective study at the Pediatric Endocrinology Unit of the Mother and Child Centre of the Chantal Biya Foundation in Yaounde, Cameroon from May 2013 to December 2019. All patients diagnosed with a DSD were included, and incomplete files excluded. Results We included 80 patients diagnosed with DSD during the study period. The 46,XX DSD were the most frequent in our study population (n = 41, 51.25%), with congenital adrenal hyperplasia (CAH) as the main diagnosis. The 46,XY DSD accounted for 33.75% and sex chromosome DSD group represented 15% of the study population. Conclusions DSDs are not an exceptional diagnosis in a Sub-Saharan context. 46,XX DSD are the most prevalent diagnosis in our setting. The diagnosis of all these affections is late compared to other centers, justifying advocacy for neonatal screening of DSDs in our context.

背景与目标： ：简介根据劳森·威尔金斯（Lawson Wilkins）儿科内分泌学会（LWPES）和欧洲性发育障碍小儿内分泌学会（ESPE）的当前分类，病因在世界各地有所不同。种族或遗传多样性可能解释了这种可变性。因此，我们在中部非洲一个国家进行了有关DSD病因的本研究。方法我们于2013年5月至2019年12月在喀麦隆雅温得Chantal Biya基金会母婴中心儿科内分泌科进行了观察性回顾性研究。所有诊断为DSD的患者均包括在内，但不完整的文件被排除在外。结果我们纳入了80名在研究期间诊断为DSD的患者。在我们的研究人群中，46，XX DSD是最常见的（n = 41，51.25％），以先天性肾上腺皮质增生（CAH）为主要诊断。 46，XY DSD占33.75％，性染色体DSD组占研究人群的15％。结论在撒哈拉以南地区，DSD并不是一种例外的诊断。 46，XX DSD是我们环境中最常见的诊断。与其他中心相比，所有这些疾病的诊断都晚了，这证明了在我们的背景下倡导新生儿筛查DSD的合理性。

BACKGROUND & AIMS: :Past climate shifts have led to major oscillations in species distributions. Hence historical contingencies and selective processes occurring during such phases may be determinants for understanding the forces that have shaped extant phenotypes. In the plant-ant Petalomyrmex phylax (Formicinae), we observed spatial variation in number of queens in mature colonies, from several queens (high polygyny) in the median part of its distribution to a moderate number of queens (weak polygyny) or even only a single queen (monogyny) in the southwesternmost populations. This variation did not correlate with indicators of variation in current nest site availability and colony turnover, the supposedly determinant selective forces acting on gyny in ants. We show here that the variation in social structure correlates with a historical process corresponding to a progressive colonization of coastal southern Cameroon by the ant. Using microsatellite markers, we observed a clear pattern of isolation by distance except for the southernmost populations. Measures of genetic variability that do not take into account allele size were at equilibrium in all except the southernmost populations, suggesting recent foundation of the latter. Measures of genetic diversity taking into account allele size showed a clinal north-south decrease in variance of allele size. We propose that southern populations have yet to regain allele size variance after bottlenecks associated with the foundation of new populations, and that this variance is regained over time. Hence variation in social structure mirrors an old but still active southward colonization process or metapopulation dynamics, possibly in association with an expansion of the rain forest habitat during the late Holocene. A low number of queens in ant colonies is typically associated with strong dispersal capacity. We therefore suggest that the initial founders of new populations belong to the monogynous to weakly polygynous phenotype, and that queen number progressively increases in older populations.

背景与目标： ：过去的气候变化导致物种分布出现重大波动。因此，在这些阶段中发生的历史偶然性和选择性过程可能是理解已形成现存表型的力的决定因素。在植物蚂蚁Petalomyrmex phylax（Formicinae）中，我们观察到成熟菌落中皇后数量的空间变化，从分布中位数的几个皇后（高多生）到中等数量的皇后（弱多生）甚至仅最西南人口中的一个女王（单身女）。这种变化与当前巢位可用性和菌落周转率的变化指标无关，所谓的决定因素是对蚂蚁的gyny作用的决定性选择力。我们在这里表明，社会结构的变化与一个历史过程相关，该历史过程对应于蚂蚁在喀麦隆南部沿海地区逐渐殖民。使用微卫星标记，除了最南端的种群外，我们观察到了清晰的距离隔离模式。除最南端的种群外，所有未考虑等位基因大小的遗传变异性指标均处于平衡状态，这表明后者是最近的基础。考虑等位基因大小的遗传多样性测度表明，等位基因大小方差在南北逐渐减少。我们提出，南方人群在与新人群的基础相关的瓶颈之后，尚未恢复等位基因大小的变异，并且随着时间的流逝，这种变异得以重新获得。因此，社会结构的变化反映了一个古老但仍然活跃的南方殖民化过程或种群迁移动态，这可能与全新世晚期雨林栖息地的扩张有关。蚁后蚁后数量少通常与强大的扩散能力有关。因此，我们建议新种群的最初建立者属于单性的到弱多性的表型，并且在较老的种群中女王的数量逐渐增加。

BACKGROUND & AIMS: :The prevalence of antiretroviral therapy (ART) resistance-associated mutations among HIV-1 strains in western Cameroon was evaluated by genotypically analyzing strains isolated from drug-naive individuals. Proviral DNA was extracted from 54 blood samples and amplified by polymerase chain reaction of protease, reverse transcriptase, integrase, and envelope genes. At least 4 clones per sample were analyzed. Of 54 HIV-1 strains, 45 (83.3%) had a concordant subtype or circulating recombinant form (CRF) designation: 40 CRF02_AG, 2 subtype A1, 2 G, and 1 F2. The remaining 9 (16.7%) had a discordant subtype: 6 subtype A1/CRF02_AG, 2 D/CRF02, and 1 G/CRF02. Protease inhibitor-associated primary resistance mutations were found in 4 (7.4%) cases: M46L with full clones in 1 case, and M46I, M46L, and V82A as minor populations in 1 case each. Reverse transcriptase inhibitor-associated primary resistance mutations were found in 5 (9.8%) samples: Y188C in 2 cases, and L100I, M184V, and V75I in 1 case each, although all of these mutations were found as minor populations. This is one of the first reports of the emergence of primary ART resistance mutations among drug-naive, non-B subtype HIV-1-infected individuals in Cameroon. Follow-up studies should be conducted to assess whether these drug-resistant mutants found as minor populations might impact future ART.

背景与目标： ：通过基因型分析从单纯毒品患者中分离出的菌株，评估了喀麦隆西部HIV-1菌株中抗逆转录病毒疗法（ART）耐药相关突变的患病率。从54个血液样本中提取原病毒DNA，并通过蛋白酶，逆转录酶，整合酶和包膜基因的聚合酶链反应进行扩增。每个样品至少分析了4个克隆。在54个HIV-1毒株中，有45个（83.3％）具有一致的亚型或循环重组形式（CRF）名称：40 CRF02_AG，2个亚型A1、2 G和1 F2。其余9个（16.7％）具有不一致的亚型：6个亚型A1 / CRF02_AG，2个D / CRF02和1个G / CRF02。蛋白酶抑制剂相关的原发性耐药突变发生在4个（7.4％）病例中：具有完整克隆的M46L 1例，少数人群M46I，M46L和V82A分别为1例。在5个样本（9.8％）中发现了与逆转录酶抑制剂相关的主要耐药突变：2例患者为Y188C，1例患者为L100I，M184V和V75I，尽管所有这些突变都是次要人群。这是在喀麦隆未接受过药物治疗的非B亚型HIV-1感染者中出现原发性ART抗药性突变的报道之一。应该进行后续研究，以评估这些作为少数人群发现的耐药突变体是否可能影响未来的抗逆转录病毒治疗。

BACKGROUND & AIMS: BACKGROUND:The rapid and unplanned urbanization of African cities is considered to increase the risk of urban malaria transmission. The present study objective was to assess factors influencing the spatio-temporal distribution of Anopheles gambiae s.l. larvae in the city of Yaoundé, Cameroon. METHODS:All water bodies were checked once every 2 months for the presence of mosquito larvae from March 2017 to May 2018 in 32 districts of Yaoundé. Physico-chemical characteristics including the size, depth, turbidity, pH, temperature, conductivity, sulfates, organophosphates, hydrogen peroxide (H2O2), conductivity, iron and calcium were recorded and analyzed according to anopheline larvae presence or absence. High resolution satellite images from landsat sentinel Enhanced Thematic Mapper were used for spatial mapping of both field and environmental variables. Bivariate and multivariate logistic regression models were used to identify variables closely associated with anopheline larvae distribution. RESULTS:A total of 18 696 aquatic habitats were checked and only 2942 sites (15.7%) contained anopheline larvae. A high number of sites with anopheline larvae (≥ 69%) presented late instar larvae (L3, L4 and pupae). Anopheline mosquito larvae were sampled from a variety of breeding sites including puddles (51.6%), tire prints (12.9%), wells (11.7%) and drains (11.3%). Bivariate logistic regression analyses associated anopheline larvae presence with the absence of predators, absence of algae, absence of vegetation and depth of less than 1 m. Conductivity, turbidity, organophosphates, H2O2 and temperature were significantly high in breeding sites with anopheline larvae than in breeding sites without these larvae (P <  0.1). Anopheline species collected included An. coluzzii (91.1%) and An. gambiae s.s. (8.9%). GIS mapping indicated a heterogeneous distribution of anopheline breeding habitats in the city of Yaoundé. Land cover analysis indicated high variability of the city of Yaoundé's landscape. CONCLUSIONS:The data confirms adaptation of An. gambiae s.l. to the urban domain in the city of Yaoundé and calls for urgent actions to improve malaria vector control.

背景与目标： 背景：非洲城市的快速和无计划的城市化被认为增加了城市疟疾传播的风险。本研究的目的是评估影响冈比亚按蚊的时空分布的因素。幼虫在喀麦隆雅温得市。
方法：从2017年3月至2018年5月，在雅温得的32个地区，每2个月对所有水体进行一次蚊子幼虫检查。记录并根据an鱼幼虫的存在与否，记录并分析其理化特性，包括大小，深度，浊度，pH，温度，电导率，硫酸盐，有机磷酸盐，过氧化氢（H2O2），电导率，铁和钙。来自Landats定点增强型专题制图仪的高分辨率卫星图像用于野外和环境变量的空间制图。使用双变量和多元逻辑回归模型来确定与按蚊幼虫分布密切相关的变量。
结果：总共检查了18 696个水生栖息地，只有2942个地点（15.7％）含有按蚊幼虫。大量带有按蚊幼虫的部位（≥69％）呈晚龄幼虫（L3，L4和p）。从各种繁殖地点取样了按蚊蚊幼虫，包括水坑（51.6％），轮胎印迹（12.9％），水井（11.7％）和排水管（11.3％）。双变量逻辑回归分析分析了相关的按蚊幼虫的存在，没有捕食者，没有藻类，没有植被以及深度小于1μm。带有按蚊幼虫的繁殖场所的电导率，浊度，有机磷酸盐，H2O2和温度均显着高于没有这些幼虫的繁殖场所（P <0.1）。收集的按蚊种包括An。 coluzzii（91.1％）和An。冈比亚（8.9％）。 GIS测绘表明雅温得市的按蚊繁殖生境分布不均。土地覆盖分析表明，雅温得市的地貌变化很大。
结论：数据证实了An的适应性。冈比亚有限公司雅温得市的城市范围，并呼吁采取紧急行动以改善对疟疾的控制。

BACKGROUND & AIMS: :Habitat change caused by deforestation can modify the interactions of many biotic and abiotic factors, and in turn influence patterns of diseases in wild birds. Whether deforestation directly or indirectly affects the prevalence of avian haemosporidian parasites through their hosts and/or vectors is still not well understood. We sampled understory bird communities (insectivorous, frugivorous, granivorous and nectarivorous birds) and mosquitoes in three habitats showing a gradient of deforestation (pristine forest, fragmented forest, and young palm oil plantation), to assess the effects of habitat changes on avian haemosporidian (Plasmodium and Haemoproteus) prevalence and its relationship to bird feeding guilds and mosquito abundance. Blood samples of 845 individual birds belonging to 85 species and 27 families were collected in the three habitat types and screened using microscopy and PCR. Plasmodium infections were detected in 136 individuals (16.09%) and varied significantly among habitat types while Haemoproteus infections were detected in 98 individuals (11.60%) and did not vary significantly among habitat types. However, the prevalence of Plasmodium and Haemoproteus in bird feeding groups varied significantly among habitats. Nectarivorous and granivorous birds had the highest Plasmodium and Haemoproteus prevalence, respectively. The abundance of mosquitoes varied significantly among habitat types and the prevalence of Plasmodium significantly and positively correlated with mosquito abundance in fragmented forest. This study highlights the importance of host and mosquito determinants in the transmission dynamics of avian Plasmodium and Haemoproteus infections following habitat changes. Selective logging favored an increase in the prevalence of Plasmodium in insectivores, the prevalence of Haemoproteus in nectarivores and the abundance of female mosquitoes while, the establishment of the palm oil plantation favored an increase in the prevalence of Plasmodium in granivores and Haemoproteus in nectarivores. Species feeding behavior is also an important determinant to consider for a better understanding of patterns of parasite infections in a changing environment.

背景与目标： 森林砍伐引起的生境变化可以改变许多生物和非生物因素的相互作用，进而影响野生鸟类的疾病模式。砍伐森林是通过其宿主和/或媒介直接或间接影响禽血吸虫病寄生虫的流行仍未得到很好的了解。我们在三个森林砍伐呈梯度变化的栖息地（原始森林，零散森林和年轻的棕榈油种植园）中采样了地下鸟类群落（食虫，食肉，食肉和肉食性鸟类）和蚊子，以评估栖息地变化对禽血孢子虫的影响（疟原虫和嗜血杆菌的患病率及其与鸟类饲养协会和蚊子数量的关系。在这三种栖息地类型中收集了来自85个物种和27个科的845只鸟类的血样，并使用显微镜和PCR进行了筛选。在136个个体中检出了疟原虫感染（16.09％），并且在生境类型之间存在显着差异，而在98个个体中检出的血型变形杆菌感染（11.60％）在生境类型之间没有显着差异。但是，鸟类饲喂组中的疟原虫和变形血红蛋白的患病率在栖息地之间存在显着差异。肉食性和肉食性鸟类的疟原虫和血生变形杆菌患病率最高。在不同的生境类型中，蚊子的丰度差异很大，而疟原虫的患病率与零散森林中的蚊虫的丰度显着正相关。这项研究强调了寄主和蚊子决定因素在栖息地变化后禽疟原虫和血红蛋白感染的传播动力学中的重要性。选择性伐木有利于食虫中疟原虫的流行，油桃中嗜血杆菌的流行和雌性蚊子的丰富，而棕榈油种植园的建立则有利于食肉动物中疟原虫的流行和油桃中嗜血菌的流行。物种的进食行为也是要考虑的一个重要决定因素，以便更好地了解不断变化的环境中的寄生虫感染模式。

BACKGROUND & AIMS: :The putative key codon (Lys-76 in sensitive parasites and Thr-76 in resistant parasites) of the novel candidate gene for chloroquine resistance, Plasmodium falciparum chloroquine resistance transporter (pfcrt), was determined by polymerase chain reaction-restriction fragment length polymorphism from 111 Cameroonian isolates and was compared with in vivo and in vitro responses to chloroquine. The key codon was significantly associated (P< .001) with responses in vivo (92% sensitivity and 76% specificity) and in vitro (97% sensitivity and 81% specificity). Some discordant results were due to multiclonal infections. The high, but not perfect, correlation between the pfcrt polymorphism and the phenotype implies that a single point mutation in codon 76 of the pfcrt gene is the major, but possibly not the sole, determinant for chloroquine resistance.

背景与目标： ：通过聚合酶链反应-限制性片段长度多态性分析，确定了新的候选氯喹抗性候选基因，恶性疟原虫氯喹抗性转运蛋白（pfcrt）的推定关键密码子（敏感寄生虫中的Lys-76和抗性寄生虫中的Thr-76）。并与111种喀麦隆分离物进行了比较，并与体内和体外对氯喹的反应进行了比较。关键密码子与体内（92％敏感性和76％特异性）和体外（97％敏感性和81％特异性）应答显着相关（P <.001）。一些不一致的结果是由于多克隆感染引起的。 pfcrt多态性与表型之间的高度相关但不是完美的相关性意味着pfcrt基因第76位密码子的单点突变是决定氯喹抗性的主要因素，但不是唯一的决定因素。

BACKGROUND & AIMS: :Massive haemoglobinuria is encountered rarely during the course of malaria. It is usually considered a diagnostic criterion for severe malaria, together with anaemia, acute renal failure and jaundice. Haemoglobinuria can also present among expatriates travelling to endemic areas following repeated exposure to quinoline or arylaminoalcohol drugs. A case is described of haemoglobinuria developing in a 38-year-old French expatriate diagnosed concurrently with numerous tropical infections, and treated on presumptive basis with an antimalarial regimen containing artemisinin derivatives. Haemoglobinuria resolved spontaneously within a few days. Although this case does not definitely indicate a causal link between haemoglobinuria and artemisinin derivatives, the risk of such infrequent side-effects should be taken into account in pharmacovigilance monitoring. Moreover, the patient illustrates the multifaceted pathology that can be encountered with tropical infections.

背景与目标： ：在疟疾过程中很少会遇到大规模的血红蛋白尿。通常认为它是严重疟疾，贫血，急性肾衰竭和黄疸的诊断标准。反复接触喹啉或芳基氨基醇类药物后，前往流行地区的外籍人士中也会出现血红蛋白尿。描述了一例血红蛋白尿，该血红蛋白尿症是在38岁的法国外籍人士中发展的，被诊断出与多种热带感染同时发生，并在推定的基础上用含有青蒿素衍生物的抗疟方案进行治疗。血红蛋白尿在几天内自发消退。尽管这种情况并未明确表明血红蛋白尿和青蒿素衍生物之间存在因果关系，但在药物警戒监测中应考虑这种罕见副作用的风险。此外，患者说明了热带感染可能遇到的多方面病理。

BACKGROUND & AIMS: OBJECTIVES:In Cameroon, the integrase (IN) strand transfer inhibitor (INSTI) dolutegravir was recently introduced for the treatment of HIV-1 infection. Since pretreatment HIV-1 drug resistance can jeopardize the success of ART, and considering the high heterogeneity of circulating HIV-1 subtypes in Cameroon, we investigated the prevalence of pretreatment HIV-1 resistance to INSTIs. METHODS:Fingerprick dried blood spot samples were collected from 339 newly diagnosed HIV-1-infected individuals between 2015 and 2016 in four hospitals in Cameroon. Universal primers were designed to amplify the HIV-1 IN region from amino acid 1 to 276. Amplicons were sequenced with Illumina next-generation sequencing and analysed with the Polymorphism Analysis Sequencing (PASeq) platform, using the Stanford HIV Drug Resistance Database to interpret HIV-1 drug resistance mutations (DRMs). RESULTS:The amplification/sequencing success rate was 75.2% with 255/339 sequences obtained. Applying a cut-off of 1%, major DRMs to INSTIs were detected in 13 (5.1%) individuals, but only 1 individual harboured an INSTI DRM (E92G) at a nucleotide frequency ≥15%. However, 140/255 (54.9%) individuals harboured polymorphic accessory INSTI DRMs, mainly at high frequencies. In line with that observation, HIV-1 subtype diversity among individuals was high. CONCLUSIONS:Pretreatment HIV-1 resistance to INSTIs was low in the study sites, which supports the use of INSTIs in Cameroon. Nevertheless, further studies are necessary to assess the impact of polymorphic accessory INSTI DRMs on INSTI-based ART regimens.

背景与目标： 目的：在喀麦隆，最近引入了整合酶（IN）链转移抑制剂（INSTI）多洛格韦用于治疗HIV-1感染。由于预处理HIV-1的耐药性可能会危害ART的成功，并且考虑到喀麦隆循环中HIV-1亚型的高度异质性，我们研究了预处理HIV-1对INSTIs耐药的普遍性。
方法：2015年至2016年之间，在喀麦隆的四家医院中，从339名新诊断的HIV-1感染者中采集了指尖干血斑样本。设计通用引物以扩增HIV-1 IN区（氨基酸1至276）。使用Illumina下一代测序技术对扩增子进行测序，并使用多态性分析测序（PASeq）平台进行分析，并使用斯坦福大学HIV耐药数据库来解释HIV -1耐药性突变（DRM）。
结果：扩增得到255/339个序列，成功率为75.2％。临界值设为1％时，在13名（5.1％）个体中检测到了主要的INRMs DRM，但只有1名个体的核苷酸频率≥15％带有INSTI DRM（E92G）。但是，有140/255（54.9％）个人携带多态附件INSTI DRM，主要是在高频下。与该观察结果一致，个体间HIV-1亚型的多样性很高。
结论：在研究地点，HIV-1对INSTIs的抗药性较低，这支持在喀麦隆使用INSTIs。尽管如此，仍需要进一步的研究来评估多态性辅助INSTI DRM对基于INSTI的ART方案的影响。

BACKGROUND & AIMS: BACKGROUND:The spread of HIV in sub-Saharan Africa is believed to be driven by unsafe sex, and identification of modifiable risk factors of the latter is needed for comprehensive HIV prevention programming in the region. Some previous studies suggest an association between alcohol abuse and unsafe sexual behaviour, such as multiple concurrent sexual partnerships and inconsistent condom use in sex with non-spousal non-cohabiting partners. However, most of these studies were conducted in developed countries and the few studies in Africa were conducted among well-defined social groups such as men attending beer halls or sexually transmitted infection clinics. We therefore examined the association between alcohol and extramarital sex (a sign of multiple concurrent sexual partnerships) among men in a population-based survey in Cameroon; a low-income country in sub-Saharan Africa with a high rate of alcohol abuse and a generalised HIV epidemic. METHODS:We analyzed data from 2678 formally married or cohabiting men aged 15 to 59 years, who participated in the 2004 Cameroon Demographic and Health Survey, using a multivariate regression model. RESULTS:A quarter of the men (25.8%) declared having taken alcohol before their last sexual intercourse and 21% indicated that the last sex was with a woman other than their wife or cohabiting partner. After controlling for possible confounding by other socio-demographic characteristics, alcohol use was significantly associated with having extramarital sex: adjusted odds ratio (OR) 1.70, 95% confidence intervals (CI) 1.40 to 2.05. Older age (30-44 years: OR 3.06, 95%CI 2.16-4.27 and 45-59 years: OR 4.10, 95%CI 2.16-4.27), higher education (OR 1.25, 95%CI 1.10-1.45), and wealth (OR 1.71, 95%CI 1.50-1.98) were also significantly associated with higher odds of having extramarital sex. The men were more likely to have used a condom in their last sex if it was extramarital (OR 10.50, 95%CI 8.10-13.66). Older age at first sex (16-19 years: OR 0.81, 95%CI 0.72-0.90 and > 19 years: OR 0.74, 95% CI 0.65-0.87) and being the head of a household (OR 0.17, 95%CI 0.14-0.22) significantly decreased the odds of having sex outside of marriage. Religion and place of residence (whether urban or rural) were not significantly associated with extramarital sex. CONCLUSION:Alcohol use is associated with having multiple concurrent non-spousal sexual partnerships among married men in Cameroon. We cannot infer a causal relationship between alcohol abuse and unsafe sex from this cross-sectional study, as both alcohol use and unsafe sexual behaviour may have a common set of causal personal and social factors. However, given the consistency with results of studies in other settings and the biologic plausibility of the link between alcohol intake and unsafe sex, our findings underscore the need for integrating alcohol abuse and HIV prevention efforts in Cameroon and other African countries with similar social profiles.

背景与目标： 背景：艾滋病毒在撒哈拉以南非洲的传播被认为是由不安全的性行为所驱动，因此，对该地区进行全面的艾滋病毒预防规划需要确定后者的可改变的危险因素。先前的一些研究表明，酗酒与不安全的性行为之间存在关联，例如，多个并发性伴侣关系以及与非配偶非同居伴侣发生性行为时使用避孕套不一致。但是，这些研究大多数是在发达国家进行的，而非洲的少数研究是在明确定义的社会群体中进行的，例如参加啤酒馆或性传播感染门诊的男人。因此，我们在喀麦隆进行了一项以人口为基础的调查，研究了男性饮酒与婚外性行为之间的关联（多种并发性伴侣关系的迹象）。撒哈拉以南非洲的一个低收入国家，酗酒率很高，艾滋病毒泛滥。
方法：我们使用多元回归模型分析了参加2004年喀麦隆人口与健康调查的2678名15至59岁正式结婚或同居男性的数据。
结果：四分之一的男性（25.8％）宣布在他们最后一次性交之前已饮酒，而21％的男性表示最后一次性交是与妻子或同居伴侣以外的女性进行的。在控制了其他社会人口统计学特征可能造成的混淆之后，饮酒与婚外性别显着相关：调整后的优势比（OR）为1.70，95％置信区间（CI）为1.40至2.05。年龄较大（30-44岁：OR 3.06，95％CI 2.16-4.27和45-59岁：OR 4.10，95％CI 2.16-4.27），高等教育（OR 1.25，95％CI 1.10-1.45）和财富（OR 1.71，95％CI 1.50-1.98）也与婚外性发生几率高有关。如果婚外恋，男性更可能在最后一次性交中使用安全套（OR 10.50，95％CI 8.10-13.66）。初婚年龄较大（16-19岁：OR 0.81，95％CI 0.72-0.90，> 19岁：OR 0.74，95％CI 0.65-0.87）并且是一家之主（OR 0.17，95％CI 0.14 -0.22）大大降低了婚外发生性行为的几率。宗教和居住地点（无论是城市还是农村）与婚外性别没有显着相关。
结论：在喀麦隆已婚男子中，酗酒与多个同时存在的非配偶性伴侣有关。我们不能从这项横断面研究中推断出酗酒与不安全性行为之间的因果关系，因为饮酒和不安全性行为都可能具有共同的因果性个人和社会因素。但是，鉴于与其他环境下的研究结果保持一致，并且饮酒与不安全性行为之间的联系具有生物学上的合理性，我们的发现强调了在喀麦隆和其他具有相似社会背景的非洲国家中，必须整合酗酒和艾滋病毒预防工作。