The intrinsic host defense system plays an important role in the restriction of retroviral infection. The objective of the study was to determine the role of Trim5α polymorphism in children living in the North region of Cameroon. A case control study was carried out in the health facilities among HIV-1 infected and uninfected children under 15 years, all born from HIV-1 infected mothers. Blood sample was collected to determine HIV status and genotyping conducted by Polymerase Chain Reaction (PCR) followed by Restriction Fragment Length Polymorphism (RFLP). The Chi-squared test was used to assess the Hardy-Weinberg equilibrium. Overall, 25 HIV-1 infected and 88 uninfected children were recruited. We found that the proportion of GG genotype was lower in uninfected children (85.2%) than in infected ones (92.5%). The proportion of GA genotype was higher in uninfected (12.5%) compared to infected children (8.0%). AA genotype was absent among infected children while the proportion in uninfected children was 2.3%. The frequency of Trim5α-136Q allele in uninfected and infected children was 9.0% and 4.0% respectively. The proportion of mutant homozygotes was elevated in uninfected children (14.8%) than in infected ones (8.0%). Moreover, children carrying mutated phenotype were 2 times less likely to be infected compared to those without it. The mutated phenotype of the Trim5α-136Q gene may be protective against HIV-1 acquisition in children. Further investigation in a follow-up cohort considering other polymorphisms in a large population will help in better appreciation of Trim5α role in HIV-1 acquisition and disease progression in children.

BACKGROUND: HIV treatment has significantly improved with the introduction of potent antiretroviral therapy (ART), particularly dolutegravir (DTG)-based regimens. With suboptimal adherence reported in resource-limited settings (RLS), real-word evidence on DTG-effectiveness within ART clinics is limited. This study assessed virological response, drug resistance profiling and HIV-1 diversity among ART recipients at the Yaoundé Central Hospital (YCH), Cameroon. METHODS: A facility-based study was conducted at YCH from March-2023 to February-2025. HIV plasma viral load (PVL) was measured by RT-PCR. Viral suppression (VS) was defined as PVL<1,000copies/mL. Genotypic resistance testing (GRT) was performed for participants with PVL³1,000copies/mL. Drug resistance mutations (DRMs) were interpreted using Stanford HIVdb v9.8 and statistics were performed with significance at p<0.05. RESULTS: Among 6,364 participants enrolled (median-age: 50 [IQR:42–59] years; 71% women), 76% (4,811/6364) were on DTG-based regimens. Median ART-duration was 13 [IQR:9.03–17.4] years, including 3.4 [IQR:3–5] years of DTG-exposure in the DTG-based sub-group. Overall, 93.2% (5,932/6,364) participants achieved VS in 2025; 94% among DTG-based versus 91% among DTG-sparing regimens (OR=1.66; p=0.000002). Interestingly, VS was higher with age ³50years (aOR=1.44; p<0.001), DTG-based ART (aOR=1.65; p<0.0001) and DTG-exposure ³3.4years (aOR=1.29; p=0.044). Between 2021-2025 specifically, VS remained consistently high among participants; with those on DTG-based showing significantly higher and more durable VS compared to those on DTG-sparing therapies (relative risk of failure >1 for DTG-sparing throughout). Furthermore, from those virally unsuppressed in 2025, 9% (39/432) were lost-to-follow-up, 22% (94/432) were transfer-out to other health facilities and 65% (232/432) re-suppressed after enhanced adherence counselling; leaving us with 17 participants eligible for GRT (PVL³1000copies/mL). GRT was successful for 70.5% (12/17) and DRMs detected in 83% (10/12), including major DRMs to protease inhibitors (17%), to nucleoside reverse transcriptase inhibitors (75%) and to non-nucleoside reverse transcriptase inhibitors (83%). CRF02_AG (75%) was the prevailing HIV-1 group M clade, followed by A3, D, and CRF18_cpx (each 8.3%). CONCLUSION: These real-life data reveal viral suppression rates closer to the epidemic control (95%) among DTG-based recipients, especially with older age and DTG-exposure over three years. Considering the broad HIV diversity observed, these findings are essential for modelling the long-term effectiveness of DTG in RLS and beyond. Trial registration: Ethical Clearance Number 2023/022045/CEIRSH/ESS/BC

The risk of HIV transmission during pregnancy remains a concern in Cameroon. Recent estimates suggest a national HIV prevalence of approximately 4.5

HIV treatment has significantly improved with the introduction of potent antiretroviral therapy (ART), particularly dolutegravir (DTG)-based regimens. With suboptimal adherence reported in resource-limited settings (RLS), real-word evidence on DTG-effectiveness within ART clinics is limited. This study assessed virological response, drug resistance profiling and HIV-1 diversity among ART recipients at the Yaoundé Central Hospital (YCH), Cameroon. A facility-based study was conducted at YCH from May-2023 to February-2025. HIV plasma viral load (PVL) was measured by RT-PCR. Viral suppression (VS) was defined as PVL < 1,000copies/mL. Genotypic resistance testing (GRT) was performed for participants with PVL≥1,000copies/mL. Drug resistance mutations (DRMs) were interpreted using Stanford HIVdb v9.8 and statistics were performed with significance at p < 0.05. Among 6,364 participants enrolled (median-age: 50 [IQR:42–59] years; 71

Men having sex with men (MSM) in Cameroon are disproportionately affected by HIV. We evaluated virological response and HIV drug resistance (HIVDR) at a community-based organization between 2022 and 2023. Enhanced adherence counselling (EAC) sessions were conducted for all and cases with unsuppressed viral load (VL > 1000 copies/ml) underwent genotyping. From 502 treatment-experienced MSM enrolled, 95 (18.9

In countries with high prevalence rates like Cameroon, mother-to-child transmission is responsible for approximately 60

The management of many chronic diseases requires a multidisciplinary and holistic approach. Long Covid is a recent, poorly understood disease with several symptoms. Most recommendations suggest a multidisciplinary approach. While there are a few programs aimed to the management of Long Covid, to our knowledge very few were assessed. The SPACO + study therefore aims to evaluate an innovative program which combines the methods used in therapeutic education and in personalized multifactorial intervention for management of Long Covid. Here, we present the protocol of our study, which aims to evaluate the effectiveness of an educational intervention in terms of changes in quality of life at 6 months in comparison with standard clinical practice in patients suffering from Long Covid. To achieve our objectives, we have planned to carry out a prospective, multicentre, two-arm randomized controlled trial with a convergent parallel mixed methods design. Two countries are involved in this study: France and Cameroon. The study concerns patients aged 18 and over, who have been infected with Covid-19. They must also be diagnosed as having Long Covid in accordance with the WHO definition. The number of subjects required for the study is 400 individuals. Participants will be randomly assigned to either the intervention or control group using a dynamic randomization process to ensure balanced group characteristics. The SPACO + program is an educative intervention with individual follow-up by a nurse dedicated to the program. The SPACO + program offers five workshops, two of which are compulsories. Patients take part in the other workshops according to their needs. The program includes an 8 – 10 weeks intervention period. Each session lasts two hours and includes breaks (pacing). The main outcome measure will be quality of life, evaluated through the SF-36. Primary and secondary outcomes, with few exceptions, are assessed before the intervention (“T0”), at 8 weeks (“T1” corresponding to the end of SPACO + program’s session period) and then 3 months later (“T2”). If the SPACO + program is effective and accepted by professionals and patients, it could be disseminated in other regions to assess its transferability. The medico-economic evaluation will also make it possible to assess the benefits provided. This trial is registered under the number NCT05787366 (March 24, 2023). Protocol Version N°3.0 (May 31, 2024)

Three previously unreported triterpenoid saponins namely pittosposides A-C (1-3), were isolated from the stem bark of Pittosporum viridiflorum, alongside nine known compounds 4-11. The structures were elucidated based on spectroscopic data as well as chemical conversions. The extract, fractions, and some isolated compounds were assessed for their antibacterial activity against sixteen multi-resistant bacterial strains. The extract and fractions exhibited good antibacterial activity on at least one of the tested strains. The EtOAc fraction was the most active against almost all the strains (MIC values, 15.6-500 mu g/mL). 2,6-Dimethoxybenzoquinone (7) was active against almost all the selected bacterial strains with the best activity against E. coli ATCC35218 (MIC = 1.9 mu g/ mL). In addition, the extract, fractions, and compounds 1-4, 7, and 11 were assessed for their cytotoxic activity on the normal Vero cell line. Compounds 1, 2 and 4 were further assessed for their cytotoxic activity on the KB-3-1 cervical carcinoma cell line against which compound 4 displayed moderate cytotoxicity (IC50 = 23.9 mu M). The chemophenetic significance of the isolates was discussed.

Aim Investigate the various roles played by nurses in the care of patients afflicted with Long COVID. Background Effectively managing Long Covid requires a multidisciplinary approach - a healthcare pathway that necessitates collaboration among various members of the medical profession to monitor the patient. Among these professions, nursing plays a crucial role. This article compiles information on how nurses are involved in the care of patients afflicted with Long Covid: What roles do they play in enhancing the care of these patients? Are these roles distinct from those they perform in other chronic conditions? Methods We conducted a qualitative study among healthcare professionals in France and enrolled eighteen participants in our study. Semi-structured interviews were conducted with professionals working across various care sectors in France, including private practice, hospitals, schools, and research. A thematic content analysis was performed, and emerging themes were subsequently discussed until the most significant categories were identified. This study was conducted in accordance with the COREQ checklist. Results Nurses play a wide range of roles within their practices, depending on their practice settings. For instance, a nurse practitioner may work in a range of settings such as hospital outpatient clinics, private group practices, inpatient units, or urgent care units. Depending on their work environment, nurses' roles within healthcare pathways may encompass screening and guidance, clinical patient monitoring, providing relational support, patient education, collaborative care and coordination as well as involvement in research. Conclusion The predominant role identified in our study involves coordinating the management of the Long Covid syndrome. The next step would be the implementation of a city-hospital Long Covid healthcare pathway. Implication for the Nursing & Health Policy Perspectives Nursing work is difficult to specify, as it includes numerous recognised and unrecognised aspects. The results of this study highlight a new essential role which is that of coordinating the health pathways of patients suffering from Long Covid.

Background: HIV case finding is an essential component for ending AIDS, but there is limited evidence on the effectiveness of such a strategy in the pediatric population. We sought to determine HIV positivity rates among children according to entry points in Cameroon. Methods: A facility-based survey was conducted from January 2015 to December 2019 among mother–child couples at various entry points of health facilities in six regions of Cameroon. A questionnaire was administered to parents/guardians. Children were tested by polymerase chain reaction (PCR). Positivity rates were compared between entry points. Associations were quantified using the unadjusted positivity ratio (PR) for univariate analyses and the adjusted positivity ratio (aPR) for multiple Poisson regression analyses with 95% confidence intervals (CIs). p-values < 0.05 were considered significant. Results: Overall, 24,097 children were enrolled. Among them, 75.91% were tested through the HIV prevention of mother-to-child transmission (PMTCT) program, followed by outpatient (13.27%) and immunization (6.27%) services. In total, PMTCT, immunization, and outpatient services accounted for 95.39% of children. The overall positivity was 5.71%, with significant differences (p < 0.001) between entry points. Univariate analysis showed that inpatient service (PR = 1.45; 95% CI: [1.08, 1.94]; p = 0.014), infant welfare (PR = 0.43; 95% CI: [0.28, 0.66]; p < 0.001), immunization (PR = 0.56; 95% CI: [0.45, 0.70]; p < 0.001), and PMTCT (PR = 0.41; 95% CI: [0.37, 0.46]; p < 0.001) were associated with HIV transmission. After adjusting for other covariates, only PMTCT was associated with transmission (aPR = 0.66; 95% CI: [0.51, 0.86]; p = 0.002). Conclusions: While PMTCT accounts for most tested children, high HIV positivity rates were found among children presenting at inpatient, nutrition, and outpatient services and HIV care units. Thus, systematic HIV testing should be proposed for all sick children presenting at the hospital who have escaped the PMTCT cascade.

OBJECTIVE:To conduct a comprehensive, systematic review of the profile of HIV-1 reservoirs in children and adolescents with perinatally acquired HIV infection. STUDY DESIGN:Randomized and nonrandomized trials, cohort studies, and cross-sectional studies on HIV reservoirs in pediatric populations, published between 2002 and 2022, were included. Archived-drug resistance mutations (ADRMs) and the size of reservoirs were evaluated. Subgroup analyses were performed to characterize further the data, and the meta-analysis was done through random effect models. RESULTS:Overall, 49 studies from 17 countries worldwide were included, encompassing 2356 perinatally infected participants (48.83% females). There are limited data on the quantitative characterization of viral reservoirs in sub-Saharan Africa, with sensitive methodologies such as droplet digital polymerase chain reaction rarely employed. The overall prevalence of ADRMs was 37.80% (95% CI 13.89-65.17), with 48.79% (95% CI 0-100) in Africa, 42.08% (95% CI 6.68-82.71) in America, 23.88% (95% CI 14.34-34.90) in Asia, and 20.00% (95% CI 10.72-31.17) in Europe, without any difference between infants and adolescents (P = .656). Starting antiretroviral therapy (ART) before 2 months of age limited the levels of HIV-1 DNA (P = .054). Participants with long-suppressed viremia (>5 years) had lower levels of HIV-1 DNA (P = .027). Pre- and post-ART CD4 ≤29% and pre-ART viremia ≥5Log were all found associated with greater levels of HIV-1 DNA (P = .038, P = .047, and P = .041, respectively). CONCLUSIONS:The pooled prevalence of ADRMs is high in perinatally infected pediatric population, with larger proviral reservoir size driven by delayed ART initiation, a shorter period of viral suppression, and immunovirological failures. Thus, strategies for pediatric HIV functional cure should target children and adolescents with very early ART initiation, immunocompetence, and long-term viral suppression.

BackgroundHIV infection and its progression to AIDS depend on several factors including host genetic factors. The immunological mechanisms of host resistance to HIV infection greatly influence the prevalence of HIV in a given region. Worldwide, Cameroon not exempted, the frequency of AIDS-associated genes varies and may influence this prevalence. The North and Far North Regions of Cameroon have had the lowest HIV prevalence in the country for many years despite risky behaviors associated with their customs and habits. In this work, we seek to explore the contribution of host genes to the HIV low prevalence in these regions.MethodologyFive genes variants previously described as HIV AIDS related were studied. These genes are: CCR5Δ32, CCR5promoter59029G, CCR2-64I, SDF1-3ʹA and Trim5α(R136Q). A total of 384 consented participants were included in this study. The HIV serological status was confirmed using national algorithm. Genomic DNA was extracted from the buffy coats and used for genotyping. The results obtained were compiled in Excel 2016, Epi Info 7.1 and snpStats software and Chi two tests allowed us to compare the frequencies of the AIDS related alleles in the North with those in other Regions of Cameroon and to measure the impact of these ARGs on protection against HIV.ResultsThe frequency of protective alleles CCR5Δ32, CCR5promoter59029G, CCR2-64I, SDF1-3ʹA and Trim5α(R136Q) was the allelic frequencies should be expressed as percentages i.e. 0.52%; 37.56%; 36.46%; 25.19% and 69.33%. These allelic frequencies exhibited a significant difference when compared to those obtained in other regions of Cameroon (p < 0.01). Protective alleles were predominant in the Northern region compared to others and were associated with resistance to HIV [(p < 0.0001); OR = 2.02 CI, 95%].ConclusionThe higher frequency of HIV-protective alleles in the northern regions may be a contributing factor to the lower prevalence of HIV. Nevertheless, this should be reinforced by other preventive and surveillance methods to guarantee the sustained low prevalence. HIV can develop resistance through the process of mutation, but the host targets themselves are genetically stable. The study of these host genetic restriction factors is of great value in the design of a practical cure for HIV infection or an effective vaccine.

Introduction Africa is experiencing a gradual demographic shift due to rising life expectancy and increasing urbanisation. In sub-Saharan Africa, elderly individuals typically reside with their children. The rise in life expectancy by almost a decade and the prevalence of precarious living conditions raise concerns about the sustainability of the healthcare system, which has traditionally relied on intergenerational solidarity.Methods The research aims to analyse the evolving role of older adults in Cameroonian society and to examine the potential impact of this change on intergenerational relationships and the health of older adults. A qualitative methodology was employed, using intergenerational focus groups in Cameroon.Results Traditionally, older adults held a central role in knowledge transmission through discourse. However, the modernisation of society is challenging this position.The emergence of new technologies, particularly communication tools, is leading to a questioning of older adults’ experiential knowledge. Societal changes are contributing to a decline in respect for older adults in discourse. Older adults deplore these societal changes and fear for their place in society while young people are questioning the central role of older people in society.Discussion These changes could reduce the sense of usefulness of older people, with negative consequences for their health. Several studies have highlighted the impacts of ageism on the health of older adults in industrialised countries. However, there are little data on the impact of the marginalisation of older adults on their health in industrialising societies. Further research is needed to study the impact on the health of older adults.

HIV/AIDS continues to be a global public health problem. Studies of the incidence and prevalence of HIV and other sexually transmitted infections (STIs) that may contribute to or aggravate its acquisition remain an effective means of prevention. In recent years, terrorist groups have established themselves in the northern regions of Cameroon. This insecurity has led to a large influx of refugees with no information about their HIV and STI status. Given this above mentioned situation, this study aimed to assess the incidence and prevalence of HIV and STI and their associated risk factors in order to adjust strategies to monitor the epidemic. A cohort of 684 consenting participants from the North and Far North were enrolled in the study in 2021 and followed up in 2022 to measure the incidence and prevalence of HIV and to assess some associated risk factors. Each participant was administered a pretested questionnaire to collect sociodemographic variables and risk behaviors. Anti-HIV Ab, HBsAg (Hepatitis B Surface Antigen), TPHA ( Treponema Pallidum Hemagglutination Assay) tests were performed. The data were compiled using EPI Info 7.5.2 for epidemiological analyses. The association between co-infections of HIV, Hepatitis, and syphilis and HIV incidence was evaluated using the Chi-2 test. The HIV incidence and overall prevalence were 1.63% (163/10,000 population) and 3.8%, respectively. The HIV incidence increased from 0.27% in 2017 (DHS) to 1.63% in the North and Far North regions as found in our study. The incidences of syphilis and hepatitis B were 1.03% and 4.56%, respectively. Factors associated with HIV acquisition included religion (Muslims being more infected, P<0.03), unprotected sex with a new partner (P<0.007), having a sex worker as a partner (P<0.0001), and co-infection with syphilis and hepatitis B (P<0.05). The findings also link increased HIV incidence to insecurity and population displacement. In HIV prevention strategies, it is important to consider the security and political stability context as well as HIV-associated infections such as hepatitis B and syphilis. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Cameroon Government, through the Chantal Biya International Reference Centre. The funder play no role in the project ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This work was approved by the hospitals and the National Ethics Committee for Human Health in Cameroon (N°2021/06/85/CE/CNRESH/SP). Recruited participants agreed to participate in the study and signed the informed consent form after reading and understanding it. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable Data collected are fully available and presented in the manuscript.

Background: T- cell are key regulators of the immune system and their role in the initiating and follow –up of patients on antiretroviral therapy (ART) is primordial. In the present work, we compared T-cells and certain biological parameters after 2 months of ART with those obtained after one year and 2 years of ART. Method: In this prospective cohort study, 150 HIV patients on primo ART treatment and consenting were recruited. Five ml of blood were collected at initiation (M0), after 2 months (M2), after 1 year (M12), and after 2 years (M24) of ART. CD4 cells, CD8 cells, and other hematological parameters were measured according to standard operating procedures. Results: The 88 retained participants included 18 (20.6%) men and 70 (79.4%) women, with a mean age of 35.5 years. After 2 months, there was a significant increase in CD4 count, monocytes, and platelets with p-values of 0.001, 0.02, and 0.04, respectively, while hemoglobin and CD8 cells did not significantly change (p-values of 0.06 and 0.82, respectively). After one year and after two years of therapy, the increases in these parameters were not statistically significant compared to the values obtained at M2. Conclusion: CD4 lymphopenia, monopénia and thrombopenia induced by HIV infection are corrected maximally during the first months after the beginning of ART and tend to stabilize over time, while anemia can continue to persist.

Background The risk of HIV transmission during antenatal care (ANC) in Cameroon remains a concern. According to recent studies, the prevalence of HIV in the country is around 4.5%, which increases the likelihood of vertical transmission. Objective To identify the determinants of HIV infection among pregnant women attending antenatal clinics (ANC) in Cameroon and to estimate HIV seroprevalence. Methods A cross-sectional study was conducted among ANC attendees aged ≥15 years from September 2022 to June 2023 in 324 health facilities in 08 regions of Cameroon (Adamaoua, Yaounde, East, Far-North, Douala, North, West, South). Sociodemographic and clinical data were collected using questionnaire. HIV screening was performed according to the national algorithm. Estimates of HIV seroprevalence and identification of its determinants using multivariable logistic regression (95% CI) were performed with Excel and SPSS 22 software. Results Overall, 10674 pregnant women were enrolled, with median [IQR] age 25 years [21– 30]; 40.0% at a secondary educational level; 44.1% married monogamously; 46.3% multiparous; 38.8% in the second quarter of pregnancy and 16.5% reporting at least one abortion. Overall HIV seroprevalence was 2.6% [95%CI: 2.33; 2.93]. Significantly higher prevalence was found with the regions of Adamaoua (aOR 3.78 [95%CI: 1.87-7.67], p<0.001), East (9.38 [5.6-15.67], p<0.001), North (3.07 [1.74-5.42], p<0.001), South (2.93 [1.66-5.16]; p<0.001); lack of education (2.08 [1.06-4.06], p=0.032), primary education (2.44 [1.32-4.50], p=0.004) and secondary education (2.29 [1.28-4.08], p=0.005) were significantly associated with HIV infection, while monogamous marriage (0.33 [0.22-0.51], p<0.001), the absence of abortion (0.59 [0.37-0.98], p=0.036) and large multiparous (0.38 [0.17-0.82]; p=0.015) were protective. Conclusion Despite the overall low-prevalence among pregnant women at national-level, several factors are associated with HIV in ANC, the absence or low-level of education, being elderly (>30 years), singleness, history of abortion and low parity predicted the HIV status during ANC. Thus, public health interventions towards these at-risk target groups will help to reduce new infections among pregnant women, hence contributing to achieve eMTCT in Cameroon. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Elimination of Mother-to-Child Transmission of HIV Project ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was obtained from the National Ethics Committee for Human Health Research (reference number N°2022/08/1478/CE/CNERSH/SP) and an Administrative Research Authorization (reference number N° 631-26-22) was obtained. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data are available

Background and Objective:Socio-demographic factors are important risk factors for HIV infection. Maternal socio-demographic factors associated with HIV transmission from mother to child are not well elucidated to our knowledge. This study aimed to assess the maternal socio-demographic factors associated with HIV vertical transmission.Methods:A matched case-control study was conducted among children under 15 years of age born to HIV-infected mothers; using a structured questionnaire. The study was conducted in four health facilities in the North Region of Cameroon from July 2015 to October 2016. HIV- infected children were the cases, and HIV-uninfected children were the controls. One case was matched to nearly 4 controls according to age and sex. A total of 113 HIV-infected mothers of children under 15 years of age were purposively enrolled in the study. A questionnaire was administered to mothers and socio-demographic characteristics were collected. Blood samples were collected from the mother and her child for the determination or confirmation of HIV status. Univariate and multiple logistic regressions were used to assess associations between socio-demographic variables and HIV transmission from mother to child.Results:A total of 113 HIV-infected mothers and 113 children under 15 years of age were enrolled in this study. The majority of the mothers were between the age ranges of 25 years to 34 years. Of the 113 HIV-infected mothers, 69 (61%) were Muslims, 33 (32.1%) were not educated, 88 (77.8%) were unemployed, 80 (70.9%) were married, out of which 49 (61.6%) were engaged in a monogamous union. Of the 113 children (49.6%) were female, 25 (22.1%) were HIV-infected and 88 (77.9%) were HIV-exposed uninfected. At the univariate level, mothers who achieved a primary level of education were less likely to transmit HIV to infants compared to uneducated mothers [OR=0.28; CI (0.08-0.95); p=0.04]; and widows had a higher likelihood of HIV transmission to infants compared to married mothers [OR=4.65; CI (1.26-17.20); p=0.02]. Using multiple logistic regression, the maternal primary education level [aOR=0.32; CI (0.08-0.90); p=0.03] and widowerhood [aOR=7.05; CI (1.49-33.24); p=0.01] remained highly associated with the likelihood of HIV transmission to infants.Conclusion and Global Health Implications:Uneducated mothers and widows had a higher likelihood of mother-to-child transmission of HIV. Our findings should prompt reinforcement of prevention strategies targeting uneducated women and widows.

BACKGROUND:The mother-to-child transmission of HIV-1 (MTCT) remains on the major route of HIV-transmission among pediatric populations in Africa. Though a prevention of MTCT (PMTCT) high-priority country, data on the MTCT burdens in Cameroon remains fragmented.OBJECTIVE:We sought to assess the pooled MTCT rate, its risk-factors, and to characterize viral reservoirs of infected-children in Cameroon.METHODS:All relevant observational cohort and cross-sectional studies conducted in Cameroon were searched from PubMed, African Journals Online, Google scholar, ScienceDirect and academic medical education databases. Heterogeneity and publication bias were respectively assessed by the I2 statistic and the Egger/funnel plot test. Meta-analysis was performed using the random effects model. MTCT rate >5% was considered as "high". This review was registered in the Prospero database, CRD42021224497.RESULTS:We included a total of 29 studies and analyzed 46 684 children born from HIV-positive mothers. The overall rate of MTCT was 7.00% (95% CI = 6.07-8.51). According to regions, the highest burden was in Adamaoua-region (17.51% [95% CI:14.21-21.07]) with only one study found. PMTCT option-B+ resulted in about 25% reduction of MTCT (8.97% [95% CI: 8.71-9.24] without option-B+ versus 2.88% [95% CI: 5.03-9.34] with option-B+). Regarding risk-factors, MTCT was significantly associated with the absence of PMTCT-interventions both in children (OR:5.40 [95% CI: 2.58-11.27]) and mothers (OR: 3.59 [95% CI: 2.15-5.99]). Regarding viral reservoirs, a pro-viral DNA mean of 3.34±1.05 log10/mL was observed among 5/57 children and archived HIV drug resistance mutations were identified in pro-viral DNA marker among 21/79 infected-children.CONCLUSION:In spite of the dropdown in MTCT following option-B+ implementation, MTCT remains high in Cameroon, with substantial disparities across regions. Thus, in this era of option-B+, achieving MTCT elimination requires interventions in northern-Cameroon. The variation in pro-viral load in infected-children underlines the relevance of characterizing viral reservoirs for possible infection control in tropical settings.

Background: Initiating early HIV treatment results to sustained viral suppression, reduced viral reservoirs and prompt immune reconstitution that may lead to HIV seronegativity (seroreversion). Seroreversion can be misinterpreted, leading to inappropriate clinical considerations. We thus sought to determine the HIV seroreversion among antiretroviral therapy (ART)-experienced Cameroonians. Method: A laboratory-based cross-sectional study was conducted among ART-experienced individuals with undetectable plasma viral load (less than 40 copies/mL) in 2019 at the Chantal BIYA International Reference Centre in Yaounde-Cameroon. On all blood samples, HIV antibody testing was performed using two rapid diagnostic tests (RDTs), followed by enzyme-linked immunosorbent assay. On non-reactive samples, proviral DNA was tested on on dried blood spots (DBS) specimens. Results: Of the 546 participants on ART (median ART duration : 5 years) and all experiencing a successful ART (VL<40 copies/ml), only 01% (5/546) had shown HIV negative results. Of these five non-reactive cases, only one case (0.18%) was non-reactive to HIV RDTs but reactive to ELISA, and four cases (0.72%) were non-reactive to both RDTs and ELISA. These four samples were also negative for HIV proviral DNA, indicating potential absence of infection or an optimal control of viral replication. Conclusion: Seroreversion of HIV-1 infection is possible but may occur rarely among HIV-infected Cameroonians who are on successful ART. The few cases of HIV negativity on serology and DBS-PCR (proviral DNA) underscores the need for deeper HIV proviral DNA testing (on PBMC) to guide either continuous ART, detect possible functional cure, or events of HIV misdiagnosis in an era of declining prevalence.

The CH2Cl2-MeOH (1:1) extract of roots of Rumex nepalensis (Polygonaceae) displayed significant antibacterial activity against five bacterial strains with MICs (62.5-31.2 mu g.mL(-1)). The EtOAc soluble fraction displayed a significant activity against the same strains with MICs (31.2-3.9 mu g.mL(-1)). The purification of the EtOAc fraction yielded one new phenylisobenzofuranone derivative, berquaertiide (1), along with 19 known compounds (2-20). Their structures were elucidated based on the analysis of their NMR and MS data. All the isolated compounds were assessed for their antibacterial activity. Compound 2 was the most active against all the tested strains (15.7 to 1.9 mu g.mL(-1)), while compounds 3-7 displayed good activities on at least one of the tested strains. In addition, seven analogues (21-27) of compound 2 were prepared and further assessed for their antibacterial activity. Compounds 26 and 27 were most active than 2 against Salmonella enterica and Klebsiella pneumoniae with MIC (125 and 15.6 mu g.mL(-1), respectively).