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About 86 percent of the estimated 160,000 children newly-infected with the human immunodeficiency virus (HIV) live in sub-Saharan Africa. Despite global efforts to reduce perinatal HIV transmission, this phenomenon continues to be a public health problem in sub-Saharan Africa. This paper discusses challenges associated with perinatal HIV transmission prevention in sub-Saharan Africa and offers strategies for the way forward. These strategies include safe sex education and behavioral change, increased access to integrated antenatal care, training of unskilled traditional birth attendants into formal delivery systems, access to antiretroviral therapy, and investing in virologic testing. Key words: • HIV • Perinatal • Antiretroviral Therapy • Mother to Child HIV Transmission • HIV Prevention • Sub-Saharan Africa Copyright © 2020 Armstrong-Mensah, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

The microbiota of Anopheles mosquitoes influences malaria transmission. Antibiotics ingested during a blood meal impact the mosquito microbiome and malaria transmission, with substantial differences between drugs. Here, we assessed if amoxicillin affects the mosquito microbiota . We collected Anopheles larvae in Burkina Faso, kept them in semi-field conditions and offered a blood meal to adult females. We tested the impact of blood supplementation with two alternative amoxicillin preparations on microbiota composition, determined by high-throughput sequencing in individual gut samples. Our mosquitoes harbored four main genera, Elizabethkingia, Wigglesworthia, Asaia and Serratia . The antibiotic treatment significantly affected overall microbiota composition, with a specific decrease in the relative abundance of Elizabethkingia and Asaia during blood digestion. Besides its interest on the influence of amoxicillin on the mosquito microbiota, our study proposes a thorough approach to report negative-control data of high-throughput sequencing studies on samples with a reduced microbial load.

Summary The microbiota of Anopheles mosquitoes influences malaria transmission. Antibiotics ingested during a blood meal impact the mosquito microbiome and malaria transmission, with substantial differences between drugs. Here, we assessed if amoxicillin affects the gut mosquito microbiota. We collected Anopheles larvae in Burkina Faso, kept them in semi-field conditions, and offered a blood meal to adult females. We tested the impact of blood supplementation with two alternative amoxicillin preparations on microbiota composition, determined by high-throughput sequencing in individual gut samples. Our analysis detected four major genera, Elizabethkingia, Wigglesworthia, Asaia, and Serratia. The antibiotic treatment significantly affected overall microbiota composition, with a specific decrease in the relative abundance of Elizabethkingia and Asaia during blood digestion. Besides its interest on the influence of amoxicillin on the mosquito microbiota, our study proposes a thorough approach to report negative-control data of high-throughput sequencing studies on samples with a reduced microbial load., Graphical abstract, Highlights • We sequenced bacterial 16S in mosquitoes collected as larvae in Burkina Faso • Elizabethkingia, Wigglesworthia, Asaia, and Serratia dominate the gut microbiota • Amoxicillin treatment and potentially gametocyte presence influence the microbiota • We set up methods to consider mock controls after sequencing low-biomass samples, Entomology; Microbiome

Background: The bacterial microbiota which colonize the mosquito midgut play an important role in vector-parasite interactions and consequently can modulate the level of malaria transmission. Their characterization may contribute to new control strategies of malaria transmission. However, these bacteria may also be eliminated in areas of high antibiotics usage. In this study, we identified paratransgenesis bacteria candidate in the gut of adults female Anopheles in Burkina Faso. Methods: The gut of 73 semi-field mosquitoes and 28 laboratory-reared mosquitoes from two villages in Burkina Faso were analyzed by conventional in vitro culture techniques to isolate and identify bacteria of the microbiota. The gene 16S sequencing was used to confirm the presence of bacteria of paratransgenesis interest. Due to the effect of antibiotics on bacteria, we evaluated in vitro their susceptibility to antibiotics generally used for infectious diseases treatment. Results: In total, eleven genera of bacteria were identified: Pantoea, Sphingomonas, Escherichia, Micrococcus, Staphylococcus, Klebsiella, Serratia, Acinetobacter, Pseudomonas, Citrobacter, Asaia. Among these bacteria isolated, Asaia. sp and Pantoea. sp have already been reported as candidates for paratransgenesis. In addition, we observed pathogenic bacteria such as Escherichia coli, Klebsiella pneumonia and Pseudomonas luteola. Investigation of the correlation between the bacterial microbiota and malaria infection status showed that mosquitoes engorged with blood containing Plasmodium falciparum contained a higher bacterial load than non-blood fed mosquitoes. The antibiotic susceptibility test showed that Asaia, Pantoea and Serratia, previously proposed as paratransgenesis candidates, were susceptible to different antibiotics tested in contrast to Escherichia coli, which were resistant. Discussion: Midgut analysis shows that the composition of the bacterial microbiota in wild field mosquitoes exhibits a large variability in contrast to laboratory-reared mosquitoes. The presence of genera already proposed as paratransgenesis candidates in previous studies among bacteria isolated in our study, suggested the possible implementation of this control strategy in Burkina Faso. Nevertheless, our data indicates that an in vivo verification of the stability of these bacteria is needed, as this strategy may be impaired by mass drug administration programs and antibiotic misuse.

Background No safe and highly effective malaria vaccine is available today. The treatment drugs currently in use remain insufficient. Moreover, resistance to these drugs makes malaria control difficult. The development of new therapeutic drugs is required. This abstract is part of a survey from the WANECAM study entitled ‘Randomised trial to assess the effect of repeated treatment of pyronaridine-artesunate (PA), dihydroartemisinin-piperaquine (DHA-PQ) and artemether-lumefantrine (AL) in patients presenting uncomplicated malaria in Bobo-Dioulasso, Burkina Faso’. We present here the analysis of the first episodes on the therapeutic efficiency of PA compared to AL, which is the first-line antimarial used in Burkina Faso. Methods A total of 448 subjects were randomised to receive treatment (224 subjects in each arm). Malaria diagnosis was assessed by microscopy. Subjects were follow-up during 42 days. Treatment response was measured according to standard of care as per WHO guidelines of 2003. The correction of the cases of treatment failure by molecular biology techniques is under analysis. Results On Day 28, the therapeutic failures were 3.35% in the PA group as against 18,10% for the AL group. On Day 42, a significant increase of the treatment failures in every group is observed with a higher rate in the AL group (31.43%), against 17.22% in the PA group. Conclusions This survey shows that less cases of treatment failure occurred in the patients9 group treated with PA compared to the group treated with AL. These findings contributed to evidence base for a change in malaria treatment policy guidelines for uncomplicated malaria in Burkina Faso.