Evidence of Low-Level Dengue Virus Circulation in the South Region of Cameroon in 2018

Dengue fever is an understudied disease in many parts of Africa and little is known about its prevalence in Cameroon. We tested blood from 629 individuals from the South Region of Cameroon, collected over the course of one year, for flavivirus RNA using conventional broad range PCR. Flavivirus RNA corresponding to dengue virus (DENV) serotype 1 was identified in two individuals who were also diagnosed with malaria. This finding confirms previous reports that indicate the presence of low-level circulation of DENV in Cameroon and supports the concern that dengue fever may be underdiagnosed due to more prevalent diseases that have similar symptomology and insufficient diagnostic capacity.

Unmet Need for Family Planning and Experience of Unintended Pregnancy Among Female Sex Workers in Urban Cameroon: Results From a National Cross-Sectional Study

Female sex workers (FSWs) in Cameroon commonly have unmet need for contraception posing a high risk of unintended pregnancy. Unintended pregnancy leads to a range of outcomes, and due to legal restrictions, FSWs often seek unsafe abortions. Aside from the high burden of HIV, little is known about the broader sexual and reproductive health of FSWs in Cameroon. From December 2015 to October 2016, we recruited FSWs aged ≥18 years through respondent-driven sampling across 5 Cameroonian cities. Cross-sectional data were collected through a behavioral questionnaire. Modified-robust Poisson regression was used to approximate adjusted prevalence ratios (aPR) for TOP and current use of effective nonbarrier contraception. Among 2,255 FSWs (median age 28 years), 57.6% reported history of unintended pregnancy and 40.0% reported prior TOP. In multivariable analysis, TOP history was associated with current nonbarrier contraceptive use (aPR=1.23, 95% confidence interval [CI]=1.07, 1.42); ever using emergency contraception (aPR=1.34, 95% CI=1.17, 1.55); >60 clients in the past month (aPR=1.29, 95% CI= 1.07, 1.54) compared to ≤30; inconsistent condom use with clients (aPR=1.17, 95% CI=1.00, 1.37); ever experiencing physical violence (aPR=1.24, 95% CI=1.09, 1.42); and older age. Most (76.5%) women used male condoms for contraception, but only 33.2% reported consistent condom use with all partners. Overall, 26.4% of women reported currently using a nonbarrier contraceptive method, and 6.2% reported using a long-acting method. Previous TOP (aPR=1.41, 95%CI=1.16, 1.72) and ever using emergency contraception (aPR=2.70, 95% CI=2.23, 3.26) were associated with higher nonbarrier contraceptive use. Recent receipt of HIV information (aPR=0.72, 95% CI=0.59, 0.89) and membership in an FSW community-based organization (aPR=0.73, 95% CI=0.57, 0.92) were associated with lower use nonbarrier contraceptive use. Experience of unintended pregnancies and TOP is common among FSWs in Cameroon. Given the low use of nonbarrier contraceptive methods and inconsistent condom use, FSWs are at risk of repeat unintended pregnancies. Improved integration of client-centered, voluntary family planning within community-led HIV services may better support the sexual and reproductive health and human rights of FSWs consistent with the United Nations Declaration of Human Rights.

Metabiota Risk Report No. 3: Monitoring and risk analytics for the 2019 Novel Coronavirus (COVID-19) Epidemic

Since January 2, 2020, Metabiota has been closely monitoring and analyzing the COVID-19 epidemic. New cases continue to be reported, indicating the epidemic is not yet contained. Metabiota is tracking and analyzing this outbreak in several ways, including through a true-to-source digital surveillance system and a global disease spread model. Metabiota created a near-term forecasting model of disease spread, which incorporates the current known characteristics of the virus. Our forecasting model estimates, for March 3rd, a median… Download full PDF report here 

The Role of Sex Work Laws and Stigmas in Increasing HIV Risks Among Sex Workers

Globally HIV incidence is slowing, however HIV epidemics among sex workers are stable or increasing in many settings. While laws governing sex work are considered structural determinants of HIV, individual-level data assessing this relationship are limited. In this study, individual-level data are used to assess the relationships of sex work laws and stigmas in increasing HIV risk among female sex workers, and examine the mechanisms by which stigma affects HIV across diverse legal contexts in countries across sub-Saharan Africa. Interviewer-administered socio-behavioral questionnaires and biological testing were conducted with 7259 female sex workers between 2011–2018 across 10 sub-Saharan African countries. These data suggest that increasingly punitive and non-protective laws are associated with prevalent HIV infection and that stigmas and sex work laws may synergistically increase HIV risks. Taken together, these data highlight the fundamental role of evidence-based and human-rights affirming policies towards sex work as part of an effective HIV response.

Characterizing Cross-Culturally Relevant Metrics of Stigma Among Men Who Have Sex With Men Across Eight Sub-Saharan African Countries and the United States

Overcoming stigma affecting gay, bisexual, and other men who have sex with men (MSM) is a foundational element of an effective response to the human immunodeficiency virus (HIV) pandemic. Quantifying the impact of stigma mitigation interventions necessitates improved measurement of stigma for MSM around the world. In this study, we explored the underlying factor structure and psychometric properties of 13 sexual behavior stigma items among 10,396 MSM across 8 sub-Saharan African countries and the United States using cross-sectional data collected between 2012 and 2016. Exploratory factor analyses were used to examine the number and composition of underlying stigma factors. A 3-factor model was found to be an adequate fit in all countries (root mean square error of approximation = 0.02–0.05; comparative fit index/Tucker-Lewis index = 0.97–1.00/0.94–1.00; standardized root mean square residual = 0.04–0.08), consisting of “stigma from family and friends,” “anticipated health-care stigma,” and “general social stigma,” with internal consistency estimates across countries of α = 0.36–0.80, α = 0.72–0.93, and α = 0.51–0.79, respectively. The 3-factor model of sexual behavior stigma cut across social contexts among MSM in the 9 countries. These findings indicate commonalities in sexual behavior stigma affecting MSM across sub-Saharan Africa and the United States, which can facilitate efforts to track progress on global stigma mitigation interventions.

Analysis of Adenovirus DNA Detected in Rodent Species from the Democratic Republic of the Congo Indicates Potentially Novel Adenovirus Types

Different species of adenoviruses (AdVs) infect humans and animals and are known for their role as pathogens, especially in humans, with animals, primarily rodents, often serving as model systems. However, although we know over 100 types of human AdVs, we know comparatively little about the diversity of animal AdVs. Due to the fact that rodents are the most diverse family of mammals and a standard model system for human disease, we set out to sample African rodents native to the Democratic Republic of the Congo and test them for AdV DNA using a semi-nested consensus PCR. A total of 775 animals were tested, and viral DNA was detected in four of them. The AdV DNA found belongs to three different AdVs, all being closely related to murine adenovirus 2 (MAdV-2). Considering the genetic differences of the amplicon were 9%, 11% and 19% from MAdV-2 and at least 10% from each other, they seem to belong to up to three different novel types within the Murine mastadenovirus B species. This evidence of genetic diversity highlights the opportunities to isolate and study additional AdVs that infect rodents as models for AdV biology and pathology.

First Evidence of a New Simian Adenovirus Clustering with Human Mastadenovirus F Viruses

Adenoviruses play an important role as human pathogens, though most infections are believed to be asymptomatic. The over 100 human adenovirus types are classified into seven species (A-G), some of which include simian adenoviruses. Recent findings have highlighted that simian adenoviruses have a zoonotic potential and that some human adenoviruses are likely the result of relatively recent spillover events. In order to evaluate the risks associated with primates hunted and sold as bushmeat, multiple samples from 24 freshly killed monkeys were collected in the Republic of the Congo and tested for adenovirus DNA by PCRs targeting the conserved DNA polymerase and hexon genes. The DNA of a novel simian adenovirus was detected in a moustached monkey (Cercopithecus cephus) by the DNA polymerase PCR, but not by the hexon PCR. The 275 nucleotide amplicon was most closely related to members of the Human mastadenovirus F species (93% HAdV-40 and 89% HAdV-41 amino acid identity), rather than to other known simian adenoviruses. The phylogenetic clustering with Human mastadenovirus F sequences suggests a common ancestor, more recent than the last common ancestor of humans and moustached monkeys. The findings increase concerns about the zoonotic potential of simian adenoviruses and highlight the need for more research and surveillance on the issue.

Knowledge and Beliefs About Ebola Virus in a Conflict-Affected Area: Early Evidence from the North Kivu Outbreak

The current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) – the country’s 10th – is centered in North Kivu, a region affected by long-running armed conflict. As of September 15 2019, 3129 cases have been reported as well as 2096 deaths, giving an estimated case fatality ratio of approximately 67% [1]. North Kivu presents a particularly challenging context for outbreak control. Conflict and population displacement are well-known to facilitate disease transmission and inhibit humanitarian response efforts [2]. Estimates suggest that approximately 319,000 people were displaced from North Kivu and Ituri by vio-lence during January - February 2018 [3], and although displacement data are not systematically available, conflict-induced forced migration has continued. Ongoing insecurity across the outbreak area threatens the ability of health workers to investigate cases, trace contacts, deliver care, and administer vaccines.

Complete Genome Sequence of a Virulent African Swine Fever Virus From a Domestic Pig in Ukraine

Here, we report the complete genome sequence of an African swine fever (ASF) virus (ASFV/Kyiv/2016/131) isolated from the spleen of a domestic pig in Ukraine with a lethal case of African swine fever. Using only long-read Nanopore sequences, we assembled a full-length genome of 191,911 base pairs in a single contig.

Molecular characteristics of group B Streptococcus isolates from infants in southern mainland China

Invasive group BStreptococcus(GBS) disease in Chinese infants has gradually gained attention inrecent years, but the molecular epidemiology of the pathogen is still not well known. This multicenter study retrospectively investigated distribution of capsular serotypes, sequence types(STs), and hypervirulent GBS adhesin gene (hvgA) in clinical GBS isolates that caused invasive disease in infants aged< 3 months of age in southern mainland China between January 2013 and June 2016. Genes for antibioticresistance to tetracycline, erythromycin, and clindamycin were also examined. From a total of 93 GBS isolates taken from 34 early-onset disease (EOD, 0–6 days after birth) and 59 late-onset disease (LOD, 7–89 days after birth) cases, four serotypes were identified: serotypes III (79.6%), Ib (12.9%), Ia(4.3%), and V (3.2%). Serotype III accounted for 73.5% of EOD and 83.1% of LOD and was responsible for 75.5% ofcases involving meningitis. Fifteen STs were found, with the majority being ST17 (61.3%), ST12 (7.5%), ST19 (7.5%),and others (23.7%). 96.8% of STs belonged to only five clonal complexes (CCs): CC17 (64.5%), CC10 (12.9%), CC19(9.7%), CC23 (6.5%), and CC1 (3.2%). ThehvgAgene was detected in 66.7% of GBS isolates and 95% of CC17isolates, all of which were serotype III except one serotype Ib/CC17 isolate. A large proportion of GBS isolates werefound to be resistant to tetracycline (93.5%), clindamycin (65.5%), and erythromycin (60.2%). Genes oftetO(74.7%)andtetM(46.0%) were found in tetracycline resistant isolates,linB(24.6%) in clindamycin resistant isolates, andermB(87.5%) andmefA(3.6%) in erythromycin resistant isolates. Our results reveal higher prevalence of serotype III, ST17, CC17,hvgAexpressing, and antibioticresistant GBS isolates than previously reported in southern mainland China.This study provides guidance for appropriate measures of prevention and control to be taken in the future.