Genetic diversity of influenza A(H3N2) viruses in Northern Cameroon during the 2014-2016 influenza seasons

In Cameroon, genome characterization of influenza virus has been performed only in the Southern regions meanwhile genetic diversity of this virus varies with respect to locality. The Northern region characterized by a Sudan tropical climate might have distinct genetic characterization. This study aimed to better understand the genetic diversity of influenza A(H3N2) viruses circulating in Northern Cameroon. Sequences of three gene segments (hemagglutinin (HA), neuraminidase (NA) and matrix (M) genes) were obtained from 16 A(H3N2) virus strains collected during the 2014 to 2016 influenza seasons in Garoua. The HA gene segments were analysed with respect to reference strains while the NA and M gene was analysed for reported genetic markers of resistance to antivirals. Analysis of the HA sequences revealed that majority of the virus strains grouped together with the 2016-2017 vaccine strain (3C.2a-A/Hong Kong/4801/2014) while 3/5 (60%) of the 2015 viral strains grouped together with the 2015-2016 vaccine strain 3C.3a-A/Switzerland/9715293/2013. Within clade 3C.2a, Northern Cameroon sequences mostly grouped in sub-clade A3 (10/16). Analysis of the coding regions of the NA and M genes showed that none had genetic markers of resistance to neuraminidase inhibitors but all strains possessed the S31N substitution of resistance to amantadine. Due to some discrepancies observed in this region with respect to the Southern regions of Cameroon, there is necessity of including all regions within a country in the sentinel surveillance of influenza. These data will enable to track changes in influenza viruses in Cameroon.     

Effects of prolonged oral nutritional support in malnourished cirrhotic patients: results of a pilot study

OBJECTIVES: The aim of this prospective study was to evaluate the acceptance and the effects of nutritional supplementation in malnourished ambulatory patients with liver cirrhosis. METHODS: From June 1999 through June 2000, alcoholic cirrhotic patients with moderate to severe malnutrition as assessed with the Detsky index were included in the study. Patients were instructed to consume, in addition to their regular diet, a commercial solution that provided 500 kcal/day. Physical examination, dietary recalls and laboratory tests were performed at 1, 2 and 3 Month. RESULTS: Twenty-nine patients with a mean age of 52 Years were included. The Child-Pugh grade was A in 6 patients, B in 14 and C in 8. Eighteen patients (62%) completed the 3 Month study protocol. Mean non-alcohol calorie intake increased significantly by 31% at 1 Month and by 48% at 3 Months. At the same time alcohol calorie intake decreased significantly by 68% and 77%, respectively. Subjective improvement in nutritional status was associated with significant improvement of mean Child-Pugh score (P=0.0007) and triceps skinfold thickness (P=0.005). The increase of mid-arm circumference was not significant. CONCLUSION: This study showed that oral supplementation in ambulatory patients with liver cirrhosis is feasible and associated with a significant improvement of nutritional status and biological parameters including the Child-Pugh score. This benefit was associated with a concomitant reduction of alcohol intake.     

Hepatitis C among child transfusion and adult renal dialysis patients in Indonesia

Hepatitis C virus (HCV) prevalence among high-risk pediatric and adult patients was evaluated. The study included 269 adults and 150 children in a case-control research design. Risk factors of HCV exposure in Indonesia were assessed among adult renal dialysis patients and pediatric patients who received multiple blood transfusions. A high prevalence of anti-HCV was found among the adult renal dialysis patients, measured by second-generation electroimmunoassay tests. Family members of dialysis patients, who served as a comparison group for dialysis patients, were found to have a 9.0% seroprevalence. The prevalence of anti-HCV among pediatric patients with hematological disorders was found to be 39.0%. The comparison group seroprevalence (pediatric patients and family members) was 4.3% among sera available for confirmatory testing. Patients with history of hospitalization (odds ratio [OR] = 7.94, 95% confidence interval [CI]: 4.06-15.51, P = 0.0001), blood transfusion (OR = 6.85, 95% CI: 3.95-11.88, P = 0.0001), circumcision (OR = 2.39, 95% CI: 1.43-3.99, P = 0.0001), or marital partner/family member history of jaundice (OR = 3.62, 95% CI: 1.97-6.62, P = 0.0001) were found to have an increased odds of HCV exposure compared with individuals without similar histories.     

Imagerie morphologique et fonctionnelle des tumeurs brunes. À propos d’un cas de localisation maxillo-mandibulaire

Introduction

Brown tumors are uncommon osteolytic lesions directly related to the increased osteoclastic activity due to hyperparathyroidism.

Case report

A 37-year-old woman presented with hypercalcemia related to primary hyperparathyroidism. Multiple and bilateral maxillary osteolytic lesions showing intense fluorodesoxyglucose (FDG) uptake were noted in a positron emission tomography computed tomography (PET-CT). Diagnosis of maxillary brown tumors was discussed and confirmed by both orthopantomogram and magnetic resonance imaging. Left inferior parathyroid adenoma was detected by both cervical ultrasonography and parathyroid scintigraphy, and then surgically treated with consequent improvement of hyperparathyroidism.

Conclusion

Our case emphasizes the necessity of a multidisciplinary diagnostic approach to optimize the interpretation of the available imaging, especially in unusual and unrecognized pathology as brown tumors.     

A successful TB defaulter control in a war zone with high HIV prevalence

War zones in Sub-Saharan Africa represent a challenge for public health projects like TB control programs because planning and communication have been disrupted, doctors and medical workers flied to secure zones. We present a TB control program carried out by an Italian NGO, Italian Association for Solidarity among People (AISPO) in a referral Hospital of North Uganda (Lacor H).