Background: The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon. Methods: A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization’s (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs. Results: Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28–50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level. Conclusion: The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences.

: To implement the appropriate strategies for scale-up interventions to eliminate onchocerciasis without severe adverse events, clinical and biological factors associated with loiasis were analyzed in onchocerciasis-endemic areas. Blood was collected from volunteers after examination by a physician. Detection of microfilariae and measurement of Ov16 IgG4 were performed using direct microscopic examination of blood and onchocerciasis rapid test detection, respectively. Areas with sporadic, hypoendemic, and hyperendemic onchocerciasis endemicity were found. Participants with microfilaremia were considered microfilaremic, and those without microfilaremia were seen as amicrofilaremic. Of the 471 study participants, 40.5% (n = 191) had microfilariae. Among them, Mansonella spp. was the most common (78.2%, n = 147), followed by Loa loa (41.4%, n = 79). The association between the two species represented 18.3% (n = 35). The specific immunoglobulins of Onchocerca volvulus were detected in 24.2% of participants (n = 87/359). Overall prevalence of L. loa was 16.8%. Hypermicrofilaremia was found in 3% (N = 14), and one participant had more than 30,000 microfilaremiae per milliliter. The frequency of L. loa did not vary according to the level of onchocerciasis transmission. Pruritus was the most common clinical sign (60.5%, n = 285) reported, mainly in microfilaremic participants (72.2%, n = 138/191). The prevalence of L. loa microfilaria in the study population was below the threshold at risk for the occurrence of serious side effects due to ivermectin. Clinical manifestations frequently observed could be exacerbated by microfilaremia in areas where onchocerciasis transmission is high.

The objective of this study was to analyze the relationship between the frequency of artemisinin-based combination (ACT) drug resistance molecular markers and clinical forms of P. falciparum malaria and parasitemia. A cross-sectional study was carried out between January and April 2014 at the Operational Clinical Research Unit of Melen in febrile children aged 12 to 240 months with a Plasmodium sp. infection. A total of 3 mL of peripheral blood collected from an EDTA tube was used for leukocyte depletion. DNA mutation detection was performed by next generation sequencing (NGS). A total of 1075 patients were screened for malaria. Among them, 384 had a Plasmodium infection. P. falciparum mono-infection was found in 98.9% of the patients. Pfcrt-326T mutation was found in all isolates, while 37.9% had Pfmdr2-484I mutant allele. The highest median parasite densities were found in patients infected by parasites carrying the CVIET haplotype of the Pfcrt gene. The different genetic profiles found here, and their variations according to clinical and biological signs of severe malaria, are additional arguments for the surveillance of P. falciparum strains.

Background: Patients with acute febrile illness need to be screened for malaria and coronavirus disease 2019 (COVID-19) in malaria-endemic areas to reduce malaria mortality rates and to prevent the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Objectives: To estimate the frequency of children and adolescents with COVID-19 and/or malaria among febrile patients attending for malaria diagnosis Method: This cross-sectional study was conducted in a sentinel site for malaria surveillance during the SARS-CoV-2 pandemic (Omicron variant), from October 2021 to December 2021 in Gabon. All febrile patients were tested for malaria using microscopy. Severe acute respiratory syndrome coronavirus 2 was detected by real time polymerase chain reaction (RT-PCR) and rapid antigen tests developed by Sansure Biotech^®. Results: A total of 135 patients were screened. Their median age was 6 (interquartile range [IQR]: 3–14) years. Malaria was confirmed for 49 (36.3%) patients, 29 (32.5%) children, 13 (59.0%) adolescents and 7 (29.2%) adults. The frequency of COVID-19 cases was 7.4% (n = 10/135), and it was comparable between children (n = 6; 6.7%), adolescents (n = 2; 9.1%) and adults (n = 2; 8.3%) (p = 0.17). Malaria and COVID-19 co-infections were diagnosed in 3 (6.1%) patients from all the age groups. Participants with a co-infection had a higher median temperature, a higher median parasitaemia, and were mostly infected with non-falciparum malaria. Conclusion: COVID-19 cases and cases of malaria/COVID-19 co-infections were found in febrile children and adolescents. SARS-CoV-2 testing should be included in the screening of suspected malaria cases. Contribution: This study highlights the presence of malaria-COVID-19 coinfection among children and adolescents who should also be screened for both diseases, like for adults.

This prospective survey determined the prevalence and intensity of infections due to geohelminths and the associated risk factors in five onchocerciasis-endemic communities in Gabon between January and February 2020. Onchocerciasis endemicity was confirmed by Ov16 IgG testing. STHs were detected using the Kato–Katz techniques. Prevalence and parasite density were analyzed according to age, sex, and onchocerciasis endemicity. STHs were found in 64.8% of participants and were more common in hypoendemic (80.9%) and hyperendemic (63.9%) onchocerciasis communities (p < 0.01). Ascaris lumbricoides (65.5%), Trichuris trichiura (57.1%), and hookworms (17.3%) were prevalent in areas hypoendemic for onchocerciasis (p = 0.04). Male participants were more often infected by hookworms. Adults were more frequently infected by STHs (75.9%) than elders, who were the least infected (39.3%) (p < 0.01). Participants living in sporadic onchocerciasis areas frequently but not significantly harbored a moderate ascariasis load (6960.0 (1068.0–9492.0) eggs per gram) (p = 0.4). The highest parasite density was observed among participants aged 20–45 years (15,336.0 (3888.0–35,028.0)). A low T. trichiuria prevalence was found in all communities. STHs are highly prevalent in hypoendemic and hyperendemic areas and adults. An integrated combined approach of STH and onchocerciasis elimination through efficacious mass drug administration targeting all age groups should be considered.

Le retard de délai d'entrée aux soins est un obstacle à la mise en route immédiate du traitement antirétroviral (TARV) dès le diagnostic, tel que recommandé par l’Organisation mondiale de la santé. Cette étude a pour but de déterminer et de comparer les délais d'entrée aux soins et les facteurs associés chez des personnes vivant avec le VIH (PvVIH) vues dans deux centres de traitement ambulatoires de Libreville entre 2012 et 2020. Étude rétrospective réalisée à partir des dossiers colligés de PvVIH, de janvier 2012 à mars 2020, au sein des deux plus grands Centres de traitement ambulatoire (CTA) de Libreville, celui du Centre hospitalier universitaire de Libreville (CHUL) et celui de l'hôpital de Nkembo. L'entrée aux soins était définie comme précoce lorsque le délai entre le diagnostic de l'infection à VIH et la première consultation au CTA était de moins de 28 jours. Elle était tardive lorsque ce délai était de plus de trois mois. Pour l'analyse, les patients ont été répartis entre deux périodes : 2012-2015 quand le démarrage du traitement était lié au taux de CD4, et 2016-2020, période au cours de laquelle le Test and Treat a été adopté au Gabon. Au total, 979 patients ont été nouvellement pris en charge dans les deux CTA et les dossiers de 672 personnes ont pu être exploités. Dans 48,3 % des cas, le diagnostic d'infection à VIH était réalisé à un stade tardif (OMS 3 ou 4). Le délai médian d'entrée aux soins était de 1,2 [IQ : 0-3] mois après le diagnostic de l'infection à VIH. Entre 2016 et 2020, 47 % entraient aux soins dans un délai de moins de 28 jours alors que cette proportion était de 35,7 % en 2012-2015 (p < 0,01). Le pourcentage de PvVIH ayant eu une entrée aux soins tardive était comparable entre les deux périodes (14,4 % vs 15,9 % en 2012-2015; p = 0,62). Les facteurs associés à un délai tardif étaient le stade OMS 3, la non-réalisation du dosage des CD4, la profession et la grossesse (p<0,05). Le délai d'entrée aux soins est encore long à l'ère du Test and Treat à Libreville. Une meilleure connaissance des facteurs associés et une approche décentralisée et intégrée de la prise en charge de l'infection à VIH permettraient d'atteindre le 2^e pilier des « 95-95-95 » à Libreville.