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Abstract Background Following WHO guidelines, microscopy is the gold standard for malaria diagnosis in endemic countries. The Parasitology-Mycology laboratory (LPM) is the National Reference Laboratory and is currently undergoing ISO 15189 accreditation. In this context, we assessed the performance of the laboratory by confirming the reliability and the accuracy of results obtained in accordance with the requirements of the ISO 15189 standards. This study aimed to verify the method of microscopic diagnosis of malaria at the LPM, in the Aristide Le Dantec hospital (HALD) in Dakar, Senegal. Methods This is a validation/verification study conducted from June to August 2020. Twenty (20) microscopic slides of thick/thin blood smear with known parasite densities (PD) selected from the Cheick Anta Diop University malaria slide bank in Dakar were used for this assessment. Six (6) were used to assess microscopists’ ability to determine PD and fourteen (14) slides were used for detection (positive vs negative) and identification of parasites. Four (4) LPM-HALD microscopists read and recorded their results on prepared sheets. Data analysis was done with Microsoft Excel 2010 software. Results A minimum threshold of 50% concordance was used for comparison. Of the twenty (20) slides read, 100% concordance was obtained on eight (8) detection (positive vs negative) slides. Four (4) out of the six (6) parasite density evaluation slides obtained a concordance of less than 50%. Thirteen (13) out of the fourteen (14) identification slides obtained a concordance greater than 50%. Only one (1) identification slide obtained zero agreement from the microscopists. For species identification a concordance greater than 80% was noted and the microscopists obtained scores between 0.20 and 0.4 on a scale of 0 to 1 for parasite density reading. The microscopists obtained 100% precision, sensitivity, specificity and both negative and positive predictive values. Conclusion This work demonstrated that the microscopic method of malaria diagnosis used in the LPM/HALD is in accordance with the requirements of WHO and ISO 15189. Further training of microscopists may be needed to maintain competency.

Abstract Background Malaria control is highly dependent on the effectiveness of artemisinin-based combination therapy (ACT), the current frontline malaria curative treatment. Unfortunately, the emergence and spread of parasites resistant to artemisinin (ART) derivatives in Southeast Asia and South America, and more recently in Rwanda and Uganda (East Africa), compromise their long-term use in sub-Saharan Africa, where most malaria deaths occur. Methods Here, ex vivo susceptibility to dihydroartemisinin (DHA) was evaluated from 38 Plasmodium falciparum isolates collected in 2017 in Thiès (Senegal) expressed in the Ring-stage Survival Assay (RSA). Both major and minor variants were explored in the three conserved-encoding domains of the pfkelch13 gene, the main determinant of ART resistance using a targeted-amplicon deep sequencing (TADS) approach. Results All samples tested in the ex vivo RSA were found to be susceptible to DHA (parasite survival rate

Abstract Background The Human Immunodeficiency Virus(HIV) infection prevalence in Cameroon has decreased from $$5.28\%$$ 5.28 % in 2004 to $$2.8\%$$ 2.8 % in 2018. However, this decrease in prevalence does not show disparities especially in terms of spatial or geographical pattern. Efficient control and fight against HIV infection may require targeting hotspot areas. This study aims at presenting a cartography of HIV infection situation in Cameroon using the 2004, 2011 and 2018 Demographic and Health Survey data, and investigating whether there exist spatial patterns of the disease, may help to detect hot-spots. Methods HIV biomarkers data and Global Positioning System (GPS) location data were obtained from the Cameroon 2004, 2011, and 2018 Demographic and Health Survey (DHS) after an approved request from the MEASURES Demographic and Health Survey Program. HIV prevalence was estimated for each sampled area. The Moran’s I (MI) test was used to assess spatial autocorrelation. Spatial interpolation was further performed to estimate the prevalence in all surface points. Hot-spots were identified based on Getis–Ord (Gi*) spatial statistics. Data analyses were done in the R software(version 4.1.2), while Arcgis Pro software tools’ were used for all spatial analyses. Results Generally, spatial autocorrelation of HIV infection in Cameroon was observed across the three time periods of 2004 ( $$MI=0.84$$ M I = 0.84 , $$p-value < 0.001$$ p - v a l u e < 0.001 ), 2011 ( $$MI=0.80$$ M I = 0.80 , $$p-value < 0.001$$ p - v a l u e < 0.001 ) and 2018 ( $$MI=0.87$$ M I = 0.87 , $$p-value < 0.001$$ p - v a l u e < 0.001 ). Subdivisions in which one could find persistent hot-spots for at least two periods including the last period 2018 included: Mbéré, Lom et Djerem, Kadey, Boumba et Ngoko, Haute Sanaga, Nyong et Mfoumou, Nyong et So’o Haut Nyong, Dja et Lobo, Mvila, Vallée du Ntem, Océan, Nyong et Kellé, Sanaga Maritime, Menchum, Dounga Mantung, Boyo, Mezam and Momo. However, Faro et Déo emerged only in 2018 as a subdivision with HIV infection hot-spots. Conclusion Despite the decrease in HIV epidemiology in Cameroon, this study has shown that there are spatial patterns for HIV infection in Cameroon and possible hot-spots have been identified. In its effort to eliminate HIV infection by 2030 in Cameroon, the public health policies may consider these detected HIV hot-spots, while maintaining effective control in other parts of the country.

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p

In Senegal, the needs for care related to sexual and reproductive health and rights (SRHR) among adolescents are significant. This study evaluates the accessibility and use of gender-related SRHR services by adolescents in the municipalities of Kaolack and Gossas. It is based on quantitative and qualitative data from 2,263 adolescents in the 2 sites, 84 in-depth individual interviews, 12 focus groups with adolescents and sexual reproductive Health actors, and 4 interviews with key informants. Quantitative analysis consisted of the interpretation of univariate statistics and bivariate analyses, while qualitative analysis relied on the coding and thematic analysis of verbatim statements. The results show low use of health structures (3% and 0.4% in Gossas and Kaolack respectively). This was attributed to the perceptions that services are not suitable to the needs of adolescents, and also because of socio-cultural constraints in the two sites. Additionally, the distribution of access to reproductive health services by sex shows gaps between boys and girls. We conclude that efforts should be made to tailor the sexual and reproductive health services offered to adolescents to their needs and social circumstances., Competing Interests: The Authors declared no conflict of interest, (African Journal of Reproductive Health © 2024.)

An estimated 650 million girls worldwide are married before their 18th birthday. The phenomenon is recurrent in sub-Saharan Africa with a prevalence of 18% and particularly in Senegal where one in three girls is married before the age of 18, i.e. a prevalence of 31%. Despite the legislative and legal arsenals, the laws on the legal age of marriage are not respected. The general objective of this study is to document the way in which gender norms define and influence the perceptions of adolescents in Gossas and Kaolack on child marriages and to collect possible solutions proposed to prevent/ reduce the practice. We used qualitative data collected in the two study sites. These were individual interviews with adolescents aged 10-19 (n=30) and focus groups (n=8) with the same target. The interviews were conducted in Wolof and transcribed into French then coded using Dedoose software. The results are presented for each age group and each gender then triangulated in order to highlight similarities and divergences according to the different perspectives. The results show that child marriages are rooted in patriarchal social and cultural norms, while reflecting gender inequalities. Thus, adolescents' arguments regarding the causes of child marriage align with those described in the literature on gender norms. Most adolescents cited poverty, tradition, fear of early pregnancy, and concern to preserve the girl's honor as the main factors contributing to the persistence of child marriages., Competing Interests: The Authors declared no conflict of interest, (African Journal of Reproductive Health © 2024.)