Does counseling increase sustained benefit of HAART among prison inmates after release to the community?

The lack of sustained effectiveness of HAART after release to the community of HIV-infected inmates treated in prison was well demonstrated by Springer et al. in a recent article. This disappointing result occurred even though all of the patients scheduled for release were referred for transitional case management services to a community-based organization and were provided with a 2-week supply of medications, a medical appointment with an HIV care provider, emergency housing and food, and assistance with other identified unmet needs

An Outbreak of Q fever in a prison in Italy

We observed an outbreak of Q fever in a prison population. Overall, 65 of the 600 prison inmates developed the disease. The location of the prison cells had no apparent effect on the risk of infection. The outbreak was probably due to exposure to dust contaminated by a passing flock of sheep, which at the time of the outbreak was engaged in lambing. These findings highlight the possible emergence of Q fever in settings and populations not normally thought of as being at risk of exposure to the infection

The Ebola virus disease outbreak in Tonkolili district, Sierra Leone: a retrospective analysis of the Viral Haemorrhagic Fever surveillance system, July 2014–June 2015

In Sierra Leone, the Ebola virus disease (EVD) outbreak occurred with substantial differences between districts with someone even not affected. To monitor the epidemic, a community event-based surveillance system was set up, collecting data into the Viral Haemorrhagic Fever (VHF) database. We analysed the VHF database of Tonkolili district to describe the epi- demiology of the EVD outbreak during July 2014–June 2015 (data availability). Multivariable analysis was used to identify risk factors for EVD, fatal EVD and barriers to healthcare access, by comparing EVD-positive vs. EVD-negative cases. Key-performance indicators for EVD response were also measured. Overall, 454 EVD-positive cases were reported. At multivariable analysis, the odds of EVD was higher among those reporting contacts with an EVD-positive/ suspected case (odds ratio (OR) 2.47; 95% confidence interval (CI) 2.44–2.50; P < 0.01) and those attending funeral (OR 1.02; 95% CI 1.01–1.04; P < 0.01). EVD cases from Kunike chief- dom had a lower odds of death (OR 0.22; 95% CI 0.08–0.44; P < 0.01) and were also more likely to be hospitalised (OR 2.34; 95% CI 1.23–4.57; P < 0.05). Only 25.1% of alerts were gen- erated within 1 day from symptom onset. EVD preparedness and response plans for Tonkolili should include social-mobilisation activities targeting Ebola/knowledge-attitudes-practice dur- ing funeral attendance, to avoid contact with suspected cases and to increase awareness on EVD symptoms, in order to reduce delays between symptom onset to alert generation and consequently improve the outbreak-response promptness

Ebola: when a nightmare becomes reality

Editoria

Vaccine coverage and determinants of incomplete vaccination in children aged 12-23 months in dschang, west region, cameroon: a cross-sectional survey during a polio outbreak

Inadequate immunization coverage with increased risk of vaccine preventable diseases outbreaksremains a problem in Africa. Moreover, different factors contribute to incomplete vaccination status. This study wasperformed in Dschang (West Region, Cameroon), during the polio outbreak occurred in October 2013, in order toestimate the immunization coverage among children aged 12–23 months, to identify determinants for incompletevaccination status and to assess the risk of poliovirus spread in the study population.Methods:A cross-sectional household survey was conducted in November-December 2013, using the WHOtwo-stage sampling design. An interviewer-administered questionnaire was used to obtain information fromconsenting parents of children aged 12–23 months. Vaccination coverage was assessed by vaccination card andparents’recall. Chi-square test and multilevel logistic regression model were used to identify the determinants ofincomplete immunization status. Statistical significance was set atp90 %, and 73.4 % children completedthe recommended vaccinations before 1-year of age. In the final multilevel logistic regression model, factorssignificantly associated with incomplete immunization status were: retention of immunization card (AOR: 7.89;95 % CI: 1.08–57.37), lower mothers’utilization of antenatal care (ANC) services (AOR:1.25; 95 % CI: 1.07–63.75),being the≥3rdborn child in the family (AOR: 425.4; 95 % CI: 9.6–18,808), younger mothers’age (AOR: 49.55;95 % CI: 1.59–1544), parents’negative attitude towards immunization (AOR: 20.2; 95 % CI: 1.46–278.9), and poorerparents’exposure to information on vaccination (AOR: 28.07; 95 % CI: 2.26–348.1). Longer distance from the vaccinationcenters was marginally significant (p=0.05).Conclusion:Vaccination coverage was high; however, 1 out of 7 children was partially vaccinated, and 1 out of 4 didnot complete timely the recommended vaccinations. In order to improve the immunization coverage, it is necessary tostrengthen ANC services, and to improve parents’information and attitude towards immunization, targeting youngerparents and families living far away from vaccination centers, using appropriate communication strategies. Finally, theestimated OPV-3 coverage is reassuring in relation to the ongoing polio outbrea

Molecular evidence of Plasmodium vivax infection in Duffy negative symptomatic individuals from Dschang, West Cameroon

Background: Plasmodium vivax infection is known to be rare in West/Central Africa, the most accepted explanation being the lack of expression of erythroid Duffy antigen in the local human populations. Duffy negativity prevents the parasite to exploit the entry mechanism on the red blood cell surface. However, there are a growing number of reported vivax infections in Duffy-negative individuals. Data on P. vivax circulation in Cameroon are limited. The aim of the study was to evaluate the P. vivax presence, and its association with the Duffy genotype in West Cameroon. Results: Overall, 484 blood samples were collected consecutively from febrile outpatients attending the Dschang’s Hospital (West Cameroon) during a 3-months period. Plasmodium vivax infection was detected by PCR in 5.6% (n = 27/484) of the cases, representing 38.6% (n = 27/70) of all Plasmodium infections detected. All P. vivax infected individuals showed a Duffy-negative genotype, and the frequency of Duffy-positive individuals in the whole tested population was 1.7%. Conclusions: The results of this study confirm the circulation of P. vivax in Cameroon, as well as that the lack of expression of Duffy-antigen does not confer full protection against vivax malaria acquisition