H1N1pdm09 infection in the CAR was first described in July 2010. In other African countries, the virus was shown to have been introduced by travellers [12-14], but its source in the CAR has not been elucidated. All four cases detected were indigenous, with no history of travel or contact with a person returning from a country with declared cases. Extensive investigations of contacts of the confirmed cases did not reveal any other cases, sug- gesting low dissemination of H1N1pdm09 in the coun- try. The clinical picture of H1N1pdm09 infection was
recommendations allowing the CentralAfricanRepublic to target these points enumerated by the author of this article, to look forward to thereat Jayakumar, A. Kannan, L&Anbalagan, G. 2014 . The development of an entire country always passes by major theories macroeconomic on a strict application in its generality, proof is that the author has made use of these different theories for the path of a country towards sustainable development. So this article is divided into three major parts that the author could 'first introduce while releasing the keywords of the theme in question. He was also able to identify major macroeconomic theories based on his own arguments submitted to the CentralAfrican government. The author also made a retrospective on the history of the CAR in a process of development while bringing a situation closer to that of South Korea. The average income of a South Korea is ten times higher than that of a CentralAfrican today, while in 1960 the average income of a CentralAfrican was higher than that of a South Korea. So we say, poverty is not inevitable, as long as the macroeconomic rules are respected and the direction of investment in the various activities listed by the author of this article is also respected, the CAR can then move forward.
medical history: date of enrolment and symptom onset, gender, age and clinical symptoms. Nasopharyngeal and oropharyngeal swabs were collected, placed in a tube with a viral transport medium and stored at 2–8 °C in the sentinel site laboratory before delivery to the Na- tional Influenza Reference Laboratory in the same week (Monday to Friday). Workshops were organised every trimester to improve the surveillance system, and site supervision targeted clinical personnel.
DOI: 10.4236/wja.2018.82005 55 World Journal of AIDS 2013-revised World Health Organization (WHO) recommendations , only one viral load per patient was realized to IPB, during April to November 2017. The IPB is a charitable public institute working by agreement with the Govern- ment in the CAR since February 1961. The main activities of the institute are biomedical research, public health support and training. The research is oriented towards public health, providing information to the local health authorities on emerging and neglected diseases such as Buruli ulcer. It also participates in field studies during epidemics (rabies, yellow fever and arboviruses diseases such as dengue) and works with national programs, against poliomyelitis and measles. The institute has a medical analysis laboratory, which provides services for the entire population of the country, including biological monitoring of people liv- ing with HIV (PLWH). Inclusion criteria for this study were followed: antiretro- viral therapy since at least 12 months, consisting in 1st line regimen as recom- mended by 2013-revised WHO recommendations ; availability of simple de- mographic data of patients (age, gender), treatment history (duration), informed consent from patients or tutors. We excluded from this study: HIV-infected pa- tients who were on treatment for less than one year and patients infected with HIV-2. In this study using clinical files and electronic registers, the patient’s identity was not collected in the survey file to ensure ethical clearance.
A number of factors have been identified as potentially pre-hospital determinants associated with stroke mortality. These are high blood pressure and a history of stroke. Note that our finding corroborates the literature data, especially regarding hypertension where the relative risk is 4 for cerebral infarction , while Maïga et al. reported that 61.1% of Malian prescribers cited it as a risk factor . Similarly, some authors    stressed its importance is as the predominant risk factor, whether as main causes of stroke. In our sample during the logistic regression analysis, hypertension was not statistically significantly associated with survival, this could be explained by good management of severe hypertension in stroke patients during hospitalization and that hypertension would not cause mortality.
Data from nationwide serosurveillance for yellow fever between 1 January 2008 and 31 December 2010 were analysed retrospectively. The data are in the Epi Info database (Centers for Diseases Control and Prevention, Atlanta (GA), United States of America), which also contains information on the samples and sociodemo- graphic data on the donors. The patients who gave sam- ples met the WHO standard definition of suspected cases of yellow fever, i.e. any person with acute onset of fever and jaundice appearing within 14 days of onset of the first symptoms . The samples consisted of 1– 5 mL of venous blood drawn into dry tubes and trans- ported in refrigerated sample carriers at 4–8 °C to the national reference laboratory at the Institut Pasteur of Bangui. The transport was ensured by trained focal points at CAR regional health facilities. The data ob- tained for each patient were: age, sex, location, symp- toms (fever and jaundice or any sign of bleeding), history of vaccination against yellow fever, date of onset of symptoms and dates of blood sampling and transport to the laboratory. Serum was separated from each pa- tient’s blood sample within 24 h and tested for yellow fever virus-specific fever IgM by enzyme-linked im- munosorbent assay (ELISA). Positive results with ELISA were confirmed by quantitative polymerase chain reac- tion (qPCR). The remaining serum samples were stored at −20 °C at the Institut Pasteur of Bangui.
Retrospective surveys can be used to monitor mortal- ity in emergencies; however, unless they are repeated periodically, these surveys cannot provide information on changes over time ; furthermore, both household census and previous birth history approaches to mortal- ity estimation require unfeasibly large sample sizes to achieve a precision sufficient to detect changes over rela- tively short periods (e.g., three months or even greater frequency of estimation in highly dynamic emergency scenarios). Community surveillance, while generally more expensive and labor-intensive than surveys, is a recognized approach to generate ongoing health data to capture trends . This method is theoretically less biased than surveys as it is less affected by recall and in- formation biases, and the prospective approach allows for quality to be improved over time [8,9]. Prospective surveillance provides for real-time monitoring and early warning of deteriorations, so as to inform immediate ac- tion by health service providers. Similarly, it allows health providers to detect substantial ameliorations in health conditions that may guide the decision to scale back programs. It may also promote long-term improve- ments in vital events recording, and if data management and analysis are automated, could in some scenarios be handed over to local health agencies with minimal re- searcher input. However, evidence is missing on whether such systems can reliably be implemented in crisis set- tings and particularly in rural, dispersed communities.
One month after the beginning of the 2004 outbreak, 411 patients residing in or around Bangui, aged 1-87 years (average age, 27.9 ± 5.1), were clinically examined by phy- sicians in 11 health care centres, including two national referral hospitals, and completed a questionnaire to pro- vide sociodemographic information, including gender, age and place of residence (district in Bangui). During stan- dard clinical screening, all persons enrolled in the study were also questioned about their history of symptomatic hepatitis. The main criteria for inclusion in the study were gastrointestinal complaints and fever, leading to a clinical diagnosis of malaria with ineffective malaria treatment. Other inclusion criteria were jaundice, anorexia, diarrhoea, nausea or severe asthenia. Individuals should also have had no history of exposure to blood, such as transfusion.
Background: The CentralAfricanRepublic has known long periods of instability. In 2014, following the fall of an interim government installed by the Séléka coalition, a series of violent reprisals occurred. These events were largely directed at the country ’ s Muslim minority and led to a massive displacement of the population. In 2014, we sought to document the retrospective mortality among refugees arriving from the CAR into Chad by conducting a series of surveys.
Today, there is almost unanimous agreement that the fight against malaria depends largely on an early diagnosis through rapid diagnostic tests (RDTs), cases management by artemisinin-based combination therapy (ACT), com- bined with vector control using long-lasting insecticidal bednets (LLINs) and indoor residual spraying (IRS) . Pyrethroids are the only group of insecticides currently approved for treating bednets [7, 8], and several studies have demonstrated the efficacy of both (LLINs) and (IRS) for curbing malaria incidence [9–11]. However, these tools are threatened by the emergence of insecticide resistance. Reduced susceptibility to pyrethroids has been confirmed in mosquitoes in west, central, and east Africa and over 60 countries have reported resistance to at least one insecti- cide and some reported resistance to all insecticide classes (carbamate, organophosphate, pyrethroids and organo- chlorine) [12, 13], which may contribute to malaria re- bound [11, 14]. But in the CAR, no data on the status of malaria vector insecticide resistance are available.
pathogenicity were found depending on isolates origins, but not necessarily on genetic diversity of isolates . Isolates from East Africa have more ability to overcome resistance of Oryza sativa specie such as Gigante, while isolates from West and Central Africa have a high pathogenic diversity. So, it was showed that RYMV strains from west and central Africa have capacity to break down resistance of Oryza sativa and O. glaber- rima species [7, 14, 17]. In addition, regarding the adap- tation of RYMV to host species, the ability to break down resistance was associated to polymorphism in cen- tral domain of the VPg, a viral protein covalently linked to the viral genome. So, the T/E polymorphism at VPg codon 49, significantly associated to resistance break down [16, 17, 18]. In this study, we firstly characterized RYMV isolates from the CentralAfricanRepublic for their pathogenicity using differential rice varieties to the virus. Secondly, we screened rice varieties from the CentralAfricanRepublic for resistance using the charac- terized RYMV isolates.
There are several routes of HBV transmission in sub- Saharan Africa. The highest prevalence is reported in 20 – 40-year-olds, and horizontal transmission in early life, as a consequence of close family contact, is the most common route of infection [8,9]. In the CentralAfricanRepublic (CAR), E is the prevalent genotype among HBV- infected patients, although genotypes A1, D4 and a geno- type E and D recombinant have also been reported .
This study, conducted in seven districts of Bangui allows us to report, for the first time in CAR, the level of sus- ceptibility of the main malaria vector, A. gambiae, to the different families of insecticides conventionally used in vector control. Our study revealed that A. gambiae population from Bangui are resistant to DDT and pyre- throids with a high prevalence of the kdr-w mutation; on the other hand, the kdr-e mutation was not identified in any tested mosquitoes. The presence of kdr mutations have been studied all around Africa . Previously, kdr-w mutation was observed only in West Africa, whereas it now appears to be invading East and Central Africa, with the direct consequence of barrier disappear- ance between kdr-e and kdr-w, allowing significant gene flow among different anopheles populations [26, 27]. Also, a moderate resistance to bendiocarb and a full sus- ceptibility to organophosphates have been observed.
To evaluate current circulation of RVFV among livestock and humans living in the CentralAfricanRepublic (CAR), blood samples were collected from sheep, cattle, and goats and from people at risk, such as stock breeders and workers in slaughterhouses and livestock markets. The samples were tested for anti-RVFV immunoglobulin M (IgM) and immuno- globulin G (IgG) antibodies. We also sequenced the complete genomes of two local strains, one isolated in 1969 from mosquitoes and one isolated in 1985 from humans living in for- ested areas. The 1271 animals sampled comprised 727 cattle, 325 sheep, and 219 goats at three sites. The overall seroprevalence of anti-RVFV IgM antibodies was 1.9% and that of IgG antibodies was 8.6%. IgM antibodies were found only during the rainy season, but the frequency of IgG antibodies did not differ significantly by season. No evidence of recent RVFV infection was found in 335 people considered at risk; however, 16.7% had evidence of past infection. Comparison of the nucleotide sequences of the strains isolated in the CAR with those isolated in other African countries showed that they belonged to the East/ CentralAfrican cluster.
years the prevalence levels of sleeping sickness declined from 60% in 1919 to 0.2–4.1% in 1930 . Subse- quently, other colonial powers introduced the method of mobile teams for T. b. gambiense sleeping sickness control . Other approaches to the control of African trypano- somiasis were vector control, host reservoir control and game destruction . Vector control was already intro- duced in 1910 and included the use of differently designed traps and bush clearing. Between 1920 and 1940, reservoir host control and game destruction, which was practised mainly in East Africa on the recommenda- tion of Bruce, resulted in a significant reduction, but never in the extermination, of the tsetse fly population . A third drug for treatment of the early stage of T. b. gambi- ense sleeping sickness, pentamidine, was developed by the English chemist Arthur James Ewins (1882–1958) of the pharmaceutical company May and Baker in 1937 . With the discovery of its insecticidal properties in 1939, DDT was used by 1949 in the hope of freeing large parts of endemic areas from tsetse flies [2,20]. Also in 1949, the arsenical melarsoprol, which was developed by the Swiss pathologist, microbiologist and chemist Ernst Friedheim (1899–1989), was introduced for the treatment of late stage human African trypanosomiasis. It was the first and is still the only effective drug for late stage T. b. rhodesiense sleeping sickness. Since the 1950s, several drugs have become available for chemotherapy of animal trypano- somiasis. These include the phenanthridine derivatives homidium bromide (Ethidium ® , Novidium ® ) and isomet-
The CentralAfricanRepublic (CAR), located in tropi- cal Africa, is considered an area of high endemicity for HBV infection with most HBV strains that belong to the West African genotype E . The transmission of this disease is believed to be mainly by sexual, vertical and intrafamilial routes . Previous study on young sexually active adults, examined in a Public health clinic for sexually transmitted disease in CAR, has shown a high prevalence of HBsAg (14%) with a prevalence of anti- HBc antibodies at 89% . In addition, a survey carried out in the pediatric hospital of Bangui revealed a preva- lence of 22.3% in children under 16 years of age with a precocity of the infection (25% of the children were infected before they reached one year) and a high increase of prevalence (48%) among children aged of
Background: Although rubella is generally considered a benign childhood disease, infection of a pregnant woman can cause foetal congenital rubella syndrome, which results in embryo-foetal disease and malformations. The syndrome is still a public health problem in developing countries where the vaccine has not yet been introduced, such as the CentralAfricanRepublic (CAR). The aim of the study reported here was to define the epidemiology of primary rubella infection, in order to determine its effect on morbidity rates in the country.
Background: Despite huge efforts to promote widespread vaccination, measles remains an important cause of morbidity and mortality worldwide, especially in African children. In March 2011, an abnormally high number of cases were reported from the Ouham Prefecture, CentralAfricanRepublic to the national measles case-based surveillance system. In response, reactive vaccination activities were implemented. The aims of this study were to investigate this outbreak and describe the response.
Several limitations have to be addressed. Compliance was measured based on self-administered question- naire, which may have overestimated the rate of correct compliance, as previously shown for anti-viral therapy  or malaria CP . However, the accuracy of self- questionnaires for exploring CP compliance was assessed in previous research in the French armed forces (kappa coefficient = 0.65 between self-report and CP plasma concentration) . While rank distribution was close to those of the French armed forces as a whole, young males were more represented in the field than in the French armed forces in general . Nevertheless, the sample appeared representative of the French service members deployed in CentralAfricanRepublic.