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Background: Given HIV elimination by 2030, the World Health Organization and the United Nations' Programme on HIV/AIDS (UNAIDS) have set three programmatic goals that all countries should have achieved before 2025; 95% of people living with HIV should know their status (target-1); 95% of people who know their status should be linked to treatment (target-2); and 95% of people on treatment should achieve viral load suppression (i.e. VL<1000 copies/ml; target-3). Despite considerable global progress over the past decade, many low-middle-income countries are still below the expected targets. This review protocol aims to provide a standardized document for in-depth analysis of the strengths, weaknesses, opportunities and threats (SWOT) towards achieving these programmatic targets in Cameroon., Methods: This systematic review will include randomized and non-randomized trials, cohorts, case-controls, cross-sectional studies, case reports and governmental notices addressing the achievements, the gaps, the challenges and the opportunities towards the 95-95-95 targets in Cameroon. The search will consider studies from 2017 to 2024, retrieved from PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Google Scholar, online African journals, and Cumulative Index to Nursing and Allied Health Literature. We will include studies reporting HIV diagnosis, HIV link to treatment or HIV viral suppression in Cameroon. Results will be stratified according to time, age-group (adults' vs adolescents/children) and geographic locations. Primary outcomes will be "estimates on 95-95-95 programmatic goals at the national level". Secondary outcomes will consist of the SWOT analysis towards achieving these programmatic targets. A random-effects model will be used to calculate pooled prevalence if data permits., Conclusions: This systematic review and meta-analysis protocol will guide global estimation on the achievement of the 95-95-95 targets as well as the stakes and challenges within the Cameroonian setting. Final evidence from the systematic review will allow identification of the gaps and measures to be taken to fasten our move towards the 95-95-95 in Cameroon by 2025., Systematic Review Registration: Systematic review registration: CRD42024502755., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Ngoufack Jagni Semengue et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Key populations (KP) are highly vulnerable to HIV acquisition and account for 70% of new infections worldwide. To optimize HIV prevention among KP, the World Health Organization recommends the combination of emtricitabine plus tenofovir disoproxil fumarate for pre-exposure prophylaxis (PrEP). However, PrEP failure could be attributed to drug resistance mutations (DRMs) but this is unexplored in sub-Saharan Africa (SSA)., Objectives: We aim to conduct a systematic review that will provide evidence on the prevalence of HIV drug resistance (HIVDR) following PrEP failure among KP in SSA., Design: This will be a systematic review and meta-analysis of studies conducted in sub-Saharan Africa., Methods and Analysis: This systematic review will include randomized and non-randomized trials, cohorts, case controls, cross-sectional studies, and case reports evaluating the prevalence of HIVDR following PrEP failure among KP (i.e., gay men and men who have sex with men, female sex workers, transgenders, people who inject drugs, prisoners, and detainees) in SSA. Results will be stratified according to various KP, age groups (adolescents and adults), and geographic locations. Primary outcomes will be "the prevalence of PrEP failure among KP" and "the prevalence of HIVDR after PrEP failure" in SSA. Secondary outcomes would be "the prevalence of DRMs and drug susceptibility" and "the level of adherence to PrEP." A random-effects model will be used to calculate pooled prevalence if data permit and we will explore potential sources of heterogeneity., Discussion: Our findings will provide estimates of HIVDR following PrEP failure among KP in SSA. In addition, determinants of PrEP failure and driving factors of the emergence of DRMs will also be investigated. Evidence will help in selecting effective antiretrovirals for use in PrEP among KP in SSA., Registration: PROSPERO: CRD42023463862., (© The Author(s), 2024.)

Background: WHO recommends the use of COVID-19 antigen rapid diagnostic tests (Ag-RDT) with at least 80 % sensitivity and 97 % specificity. In the era of Omicron variants, we sought to ascertain the performance of the INDICAID™ Ag-RDT compared to real-time PCR (RT-PCR) as the gold standard., Methods: A laboratory-based study was conducted among consenting individuals tested for COVID-19 at the virology laboratory of the Chantal BIYA International Reference Centre, Yaoundé-Cameron. The samples were processed by INDICAID™ Ag-RDT and DaAn Gene real-time PCR according to the manufacturer's instructions, and PCR-results were interpreted as per cycle thresholds (CT). The sensitivity, specificity, positive and negative predictive values (PPV and NVP) of INDICAID™ Ag-RDT were evaluated according to PCR CT-values., Results: A total of 565 nasopharyngeal swabs were collected from participants (median age [IQR]: 40 [31-75]; M/F sex-ratio was 1.2 and 380 were vaccinated). Following PCR, overall COVID-19 positivity was 5.66 %. For CT < 37, INDICAID™ Ag-RDT sensitivity was 21.9 % (95%CI: [8.3-39.9]), specificity 100 % (95%CI: [99.3-100]); PPV 100 % (95%CI: [59.0-100]), NPV 95.5 % (95%CI: [93.4-97.1]) and kappa = 0.34 (95%CI: [0.19-0.35]). For CT < 25, sensitivity was 100 % (95%CI: [47.8-100.0]), specificity 99.6 % (95%CI: [98.7-99.9]); PPV 94.4 % (95%CI: [51.7-100]), NPV 100 % (95%CI: [99.3-100]) and kappa = 0.83 (95%CI: [0.6-1.0]). COVID-19 sequences generated were all Omicron BA.1 subvariants., Conclusion: For patients infected with high viral loads (CT < 25), INDICAID™ Ag-RDT has high intrinsic (sensitivity and specificity) and extrinsic (predictive values) performances for COVID-19 diagnosis. Due to its simplicity and short turnaround time, INDICAID™ Ag-RDT is, therefore a reliable tool to prevent the spread of COVID-19 at community level in the current era of Omicron subvariants., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 The Authors. Published by Elsevier Ltd.)