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Biomedical subjects

L Zekeng

Publications and source records attributed to L Zekeng.

72 records · Page 4Linked to original sources
PubMed1994

Gonorrhea as a risk factor for HIV acquisition.

OBJECTIVE: The role of gonorrhea in facilitating acquisition of HIV infection has only recently been studied. A previous nested case-control analysis in a cohort of female sex workers in Zaïre found a strong association between HIV seroconversion and prior gonorrheal infection. The objective of this study was to replicate the Zaïre study analysis in a cohort of 273 Cameroonian sex workers to determine whether gonorrhea increased the risk of HIV acquisition, and if the crude association between gonorrheal infection and HIV acquisition was weakened when the level of unprotected coitus was more carefully controlled. METHODS: We conducted a nested case-control study of initially HIV-1-negative women (n = 273) followed prospectively (with monthly sexually transmitted disease check-ups and 3-monthly HIV-1 serology). As in Zaïre, cases (seroconverters, n = 17) were compared with controls (women who remained HIV-1-negative, n = 68) for incidence of gonorrhea and sexual exposure during the presumed period of HIV-1 acquisition. RESULTS: The association between gonorrheal infection and subsequent HIV acquisition was stronger in Zaïre than in Cameroon [crude odds ratios (OR), 6.3 versus 2.2]. In both the Zaïre and Cameroon data the crude OR were reduced (6.3 to 4.8, and 2.2 to 1.7, respectively) by controlling for risk factors including a dichotomous variable indicating irregular or no condom use. When this variable was replaced in the Cameroon data with a more precise continuous variable indicating the percentage of unprotected coital acts, the gonorrhea OR was further reduced to 1.4 (95% confidence interval, 0.4-4.9). CONCLUSION: These results suggest that in the Cameroon cohort, gonorrheal infection did not facilitate HIV acquisition, but that having gonorrhea was a marker for unprotected coitus that facilitated HIV acquisition. The data demonstrate how OR can be overestimated when imprecise dichotomous measures of unprotected coitus are used. Future studies should plan for better control of self-reported condom use.

Adult↗
PubMed1994

A new subtype of human immunodeficiency virus type 1 (MVP-5180) from Cameroon.

A new subtype (MVP-5180) of human immunodeficiency virus type 1 (HIV-1) was isolated from a Cameroonian AIDS patient. MVP-5180 was grown in several human T-cell lines and the monocytic U937 line. MVP-5180 DNA could not be amplified by nested primer PCR with conventional env primers and could be only very faintly amplified with gag and pol primers. Most German, Ivoirian, and Malawian anti-HIV-1 sera reacted faintly or moderately with Env proteins in an MVP-5180 immunoblot, whereas some Cameroonian sera reacted strongly. Of HIV-1-infected Cameroonians, 8% were identified by serological methods as infected with MVP-5180; 7% were positive when MVP-5180-specific PCR env primers were used. DNA sequence analysis of MVP-5180 showed that its genetic organization was that of HIV-1, with 65% similarity to HIV-1 and 56% similarity to HIV-2 consensus sequences. The env gene of MVP-5180 had similarities to HIV-1 and HIV-2 of 53 and of 49%, respectively. V3 loop analysis identified a crown of Gly-Pro-Met-Arg by using cloned DNA and Gly-Pro-Leu-Arg by using PCR-amplified DNA, neither of which configuration has been described for other HIV strains. In an analysis of relationships, MVP-5180 occupied a position distant to all other HIV-1 strains, including the chimpanzee simian immunodeficiency virus type 1 SIVcpz and the Uganda virus U455, and closer to the HIV-1/HIV-2 divergence node. MVP-5180, together with another Cameroonian isolate, ANT-70, constitutes a group subtype O of the most divergent HIV-1 isolates yet identified. Characterization of MVP-5180 is important for understanding the natural history of the primate immunodeficiency viruses and for the development of vaccines and diagnostics.

Acquired Immunodeficiency Syndrome↗
PubMed1994

The use of nonoxynol-9 for protection against cervical gonorrhea.

OBJECTIVES: Although condoms are the best defense against sexually transmitted disease, little is known about the effectiveness of female-controlled methods containing nonoxynol-9 as backup protection when condoms are not being used. METHODS: To assess the extent to which nonoxynol-9 protects women against gonorrhea, a cohort of 303 female sex workers (prostitutes) in Yaounde, Cameroon, were asked to use condoms and suppositories containing nonoxynol-9 at every sexual encounter and to record daily sexual activity and use of condoms and suppositories on coital logs that were reviewed monthly. Evidence of gonorrheal infection was based on a positive gonorrhea culture. Stratified analysis and proportional hazards regression were used to estimate rate ratios. RESULTS: Forty-one women enrolled in the study were excluded from the current analysis. The estimated incidence of gonorrhea was 6.2 infections per 100 person-months of observation. Incidence rate ratios estimated from proportional hazards regression models controlling for condom use showed that using nonoxynol-9 during acts not protected by condoms reduced the risk of infection. CONCLUSIONS: Although the protective effect of condoms against sexually transmitted disease is greater than that afforded by nonoxynol-9, using nonoxynol-9 when condoms are not used is a far better strategy in gonorrhea prevention than using no method at all.

Administration, Intravaginal↗
PubMed1994

Serum lipids and atherogenic risk in sickle-cell trait carriers.

This work studies the relationship between a common genetic marker in our population, sickle-cell trait, and atherogenic risk factors. One hundred and twenty-two healthy subjects were studied. Forty-six subjects had normal haemoglobin (HB-AA) while 76 had sickle-cell trait Hb-AS. Mean cholesterol level was higher in subjects with sickle-cell trait (2.82 +/- 0.21 g/I) than in subjects with normal haemoglobin (2.08 +/- 0.40 g/I) used as controls. The difference was statistically significant (p < 0.05). HDL cholesterol levels remained in the normal range in controls (Hb-AA) (0.560 +/- 0.10 g/I) while subjects with Hb-AS had high HDL-c levels (0.618 +/- 0.30 g/I). Mean LDL cholesterol levels in Hb-AS subjects were about 57% higher than those in controls (1.84 +/- 0.10 g/I and 1.17 +/- 0.30 g/I, respectively) (p < 0.05). Apolipoprotein A1 levels of Hb-AS subjects were lower (1.37 +/- 0.10 g) than those of Hb-AA subjects (1.98 +/- 0.15 g/I), (p < 0.05) while apolipoprotein B concentrations of Hb-AS subjects were higher (1.70 +/- 0.27 g/I) than in controls (1.30 +/- 0.10 g/I) (p < 0.05). The atherogenicity index given by the Apo-B/Apo-AI ratio was higher in Hb-AS subjects (1.24) than in those with normal haemoglobin (0.65). We conclude that Hb-AS subjects are at high atherogenic risk if subsequent diet management is not undertaken.

Adolescent↗
PubMed1993

Barrier contraceptive use and HIV infection among high-risk women in Cameroon.

OBJECTIVES: To measure the association between spermicide use and HIV infection, adjusting for condom use, and to measure the association between condom use and HIV infection, adjusting for spermicide use. DESIGN: Prospective study of women using nonoxynol-9 (N-9) spermicides and latex condoms, with up to 12 monthly clinic visits for interviews, examinations and tests, and re-supply. METHODS: A total of 273 HIV-negative women with multiple sexual partners were enrolled, given latex condoms and N-9 vaginal spermicidal suppositories, and advised to use both every time they had sexual intercourse. Participants recorded data on sexual activity on pictorial coital logs. New HIV infections were detected and confirmed by quarterly enzyme-linked immunosorbent assays and Western blots, respectively. RESULTS: Nineteen HIV infections occurred during mean follow-up of 8.1 months (an incidence rate of 10.4 infections per 100 women-years). The adjusted HIV rate ratio (RR) was 0.1 [95% confidence interval (CI), 0.1-0.6] for more consistent compared with less consistent spermicide users; and 1.1 (95% CI, 0.4-2.9) for more consistent compared with less consistent condom users. Among the subgroup of experienced condom users, the RR for more versus less consistent condom use was 0.3. CONCLUSIONS: This is the first epidemiological evidence that N-9 spermicides can reduce the incidence of HIV infection. A more definitive randomized clinical trial is urgently needed.

Adolescent↗
PubMed1992

HIV prevalence in patients with sexually transmitted diseases in Yaounde, (Cameroon) in 1989 and 1990: necessity of an STD control programme.

OBJECTIVE: To monitor HIV seroprevalence among STD clinic attenders as part of a sentinel surveillance programme. DESIGN: Seroepidemiological survey on randomly selected patients. SETTING: "Elig Essono" STD clinic, Yaounde; from February 1989 to December 1990. PATIENTS: 1161 randomly selected patients. MAIN OUTCOME MEASURES: HIV and syphilis seroprevalence. RESULTS: Twenty six of the 1161 patients (2.4%; CI: 95%; 1.5%-3.3%) tested were found to be HIV positive (mostly due to HIV1); 35.4% had antibodies to Treponema pallidum. There was no association between HIV seropositivity and sex, marital status, or educational level. Genital ulcer disease did not correlate with HIV seroprevalence. However, patients with a positive serological test for T pallidum were more likely to have HIV infection (rr = 2.4; 95% CI; from 1.1 to 3.0). Results from 1990 were double those of 1989 (3.3% versus 1.6%, p = 0.02). CONCLUSIONS: Compared with the findings among the same groups in metropolitan areas of various other African countries, the HIV seroprevalence is still low; this could be due to many reasons, such as the recent introduction of the virus in the country, a different spectrum of STDs, the high level of circumcision of males. HIV infection trends should continue to be monitored among risk groups such as STD patients and control programmes implemented to reduce the rapid spread of AIDS in the country.

Adolescent↗
PubMed1992

[Visceral leishmaniasis in Cameroon. Report of various cases and clinical study in the region of Kousseri, far-north of Cameroon].

The far-North province of Cameroon is highly infested with cutaneous leishmaniasis. From October 1987 to January 1988, a prospective study was done in this region (specifically in Kousseri) to diagnose cases of visceral leishmaniasis (VL). Out of 120 patients examined, 46 presenting symptoms related to VL were retained. Diagnosis of VL was confirmed serologically and/or through the presence of leishmanias on bone marrow slides from 9 patients. A retrospective study was also carried out in the pediatric and internal medicine units of the university teaching hospital and the Central Hospital in Yaoundé; 3 pediatric cases of VL were found. No significant difference as regards age and sex of these patients was recorded.

Cameroon↗
PubMed1991

HIV and chlamydia infections among prostitutes in Yaoundé, Cameroon.

Eleven selected prostitute leaders were recruited who subsequently recruited 157 of their peers, bringing the total to 168. Sera was collected and tested for antibodies to HIV-1 and HIV-2 using a commercial enzyme-linked immunoabsorbent assay (ELISA); positive cases were confirmed by Western Blot (Dupont). A direct immunofluorescent method was performed on smears from the endocervical junction. Twelve of 168 (7.1%) of the women tested were found to be HIV-1 positive; none were found positive for HIV-2. Sixty six of 168 (38.3%) were found to be Chlamydia trachomatis (CT) positive; three cases (1.8%) were found to be positive for both HIV-1 and CT. Prostitutes are a high risk group in Yaoundé for HIV and chlamydia infections. The results in this study may not reflect the seriousness of the situation given the selected population used. Similar studies still need to be carried out. Prostitutes need to be educated about AIDS, other STDs and the use of condoms to protect their clients and themselves.

Adolescent↗
PubMed1990

[HIV-1 serology and carrier state for HBs and HBe in blood donors at Yaounde University Hospital Center, Cameroon].

5,980 blood donors were screened for HIV1 antibodies and Hepatitis B Virus surface antigen (HBs Ag), using the ELISA technique, in the University Teaching Hospital of Yaounde, Cameroon, between January 1988 and May 1989. All HBs Ag positive samples were also screened for HBe Ag. The seroprevalence of HIV1 antibodies was 0.43%; 11.72% of blood donors were found to be HBs Ag positive and, among these, 16.26% were also HBe Ag positive.

Adolescent↗
PubMedDate not supplied

A short term projection of HIV infection and AIDS cases in Cameroon.

By September 1991 Cameroon had reported 650 cases of the acquired immune deficiency syndrome (AIDS). The results from the sentinnel surveillance system showed a seroprevalence of human immunodeficiency virus (HIV)1 of 1.3% among pregnant women, 2.5% in people attending sexually transmitted disease clinics and 3.5% in tuberculosis patients in 1990. The estimated number of persons infected with HIV varies between 10,000 and 30,000. The World Health Organization projection model was used to make a short-term projection of HIV infection and AIDS cases; it indicated that the number of persons infected with HIV will double by the year 1995, with an estimated 8500 AIDS cases. Even in a low prevalence country such as Cameroon, the impact of the HIV epidemic is important and will result in a burden for the health care system.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Childhood leukemia is still a deadly disease in Yaounde, Cameroon: a report of 14 cases.

In the Pediatric Unit of the University Teaching Hospital Center of Yaounde, 58 of 2,900 (2%) hospitalized children aged 0 to 15 years who had a malignancy were studied. Fourteen (24.1%) had acute leukemia based on morphologic and cytochemical studies. Acute lymphoblastic leukemia was encountered in 11 of these patients (78.6%). The male to female ratio was 1.3 to 1. Nine of the 11 children (64.3%) were 5 years of age or younger. Eleven (78.6%) died of disease progression and its complications.

Adolescent↗
PubMedDate not supplied

Diagnostic challenges for rapid human immunodeficiency virus assays. Performance using HIV-1 group O, HIV-1 group M, and HIV-2 samples.

OBJECTIVE: We sought to determine the ability of seven rapid assays for human immunodeficiency virus (HIV) to detect antibodies in a panel of sera from individuals infected with different types and groups of HIV. STUDY DESIGN/METHODS: Sixty-eight well-characterized samples, including HIV-1 group O (24), several HIV-1 group M clades (21), HIV-1/2 (10), HIV-2 (10), and samples with indeterminate results (3), were tested by the following rapid HIV assays: HIV-Spot, HIVCHEK System 3, A/Q Rapid HIV, Genie II HIV-1/HIV-2, Quix HIV-1-2-O, ImmunoComb II HIV-1+2 BiSpot, and the Serodia HIV-1+2. RESULTS: All tests successfully detected the HIV-1 group M clades and the HIV-1/2-positive samples. Of the HIV-2 stand-alone samples, four tests missed the same sample, and three tests missed another sample. Of the HIV-1 group O samples, four samples were missed by at least one test, and another sample was missed by three tests. The sensitivity of the seven rapid assays in detecting each group of sera was between 83% and 100%, with only one test having a sensitivity of 100% for all groups of sera. Three samples proved to be problematic because they were misclassified by more than one assay. CONCLUSIONS: The performance of rapid HIV assays is variable when testing sera from individuals infected with HIV-1 group O and HIV-2.

Evaluation Studies as Topic↗
PubMedDate not supplied

[Short term projections of infection by the human immunodeficiency (HIV) and the acquired immunodeficiency syndrome (AIDS) in Cameroon].

As of December 1991, Cameroon has reported 827 cases of AIDS. The results from the Sentinel Surveillance System show a seroprevalence of 1.3% HIV1 among pregnant women, 2.5% in people attending STD clinic and 3.5% in tuberculosis patients. The World Health Organization projection model was used to make a short term projection of HIV infection and AIDS cases. Results show that the number estimated of HIV infected populations varies between 24 to 45,000 people by the year 1995. Results show also an estimated 8,500 cumulative AIDS cases. Even in a low prevalence country as Cameroon the impact of the HIV epidemic is important and will result in a burden for the health care system.

Acquired Immunodeficiency Syndrome↗