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      Seroprevalence and risk factors for HIV, HCV, HBV and syphilis among blood donors in Mali

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          Abstract

          Background

          HIV, HBV and HCV remain a global public health concern especially in Africa. Prevalence of these infections is changing and identification of risk factors associated with each infection in Mali is needed to improve medical care.

          Methods

          We conducted a cross-sectional study of all individuals donating blood ( n = 8207) in 2018 to the blood bank at university hospital in Bamako, Mali, to assess prevalence and risks factors associated with HIV, HBV, HCV and syphilis infections.

          Results

          HIV-seroprevalence was 2.16% and significantly increased with age, being married and decreasing education level. In multivariate analysis, after adjustements with age, marital status and geographical setting, only education level was associated with HIV-infection (OR, 1.54 [95% CI, 1.15–2.07], p = 0.016). HBsAg prevalence was 14.78% and significantly increased with to be male gender. In multivariate analysis, adjusting for age, marital status and type of blood donation, education level (OR, 1.17 [95%CI, 1.05–1.31], p = 0.02) and male gender (OR, 1.37 [95%CI, 1.14–1.65], p = 0.005) were associated with HBV-infection. HCV-prevalence was 2.32% and significantly increased with living outside Bamako. In multivariate analysis, adjusting for gender, age and education level, living outside Bamako was associated with HCV-infection (OR, 1.83 [95% CI, 1.41–2.35], p < 0.001). Syphilis seroprevalence was very low (0.04%) with only 3 individuals infected. Contrary to a prior study, blood donation type was not, after adjustments, an independent risk factor for each infection.

          Conclusions

          Overall, HIV and HBV infection was higher in individuals with a lower level of education, HBV infection was higher in men, and HCV infection was higher in people living outside of Bamako. Compared to studies performed in 1999, 2002 and 2007 in the same population, we found that HIV and HCV prevalence have decreased in the last two decades whereas HBV prevalence has remained stable. Our finding will help guide infection prevention and treatment programs in Mali.

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          Most cited references12

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          Immune cells have sex and so should journal articles.

          Males and females have the same immunological cells, proteins, and pathways in place to protect against the development of disease. The kinetics, magnitude, and skewing of the responses mounted against pathogens, allergens, toxins, or self-antigens, however, can differ dramatically between the sexes. Generally, females mount higher innate and adaptive immune responses than males, which can result in faster clearance of pathogens but also contributes to increased susceptibility to inflammatory and autoimmune diseases in females compared with males. Hormonal and genetic factors contribute significantly to sex differences in immune function and disease pathogenesis. In particular, the expression of X-linked genes and microRNA as well as sex steroid hormones signaling through hormone receptors in immune cells can affect responses to immunological stimuli differently in males and females. Despite data illustrating profound differences between the sexes in immune function, sex differences in the pathogenesis of disease are often overlooked in biomedical research. Establishing journal policies that require authors to report the sex of their cells, animals, and subjects will improve our understanding of the pathogenesis of diseases, with the long-term goal of personalizing treatments for immune-mediated diseases differently for males and females in an effort to protect us equally.
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            Programming tools: Adventures with R.

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              HIV epidemic among key populations in west Africa.

              Globally, HIV infection remains a significant issue for key populations such as men who have sex with men (MSM) and female sex workers. A review of recent articles was conducted for west African countries to assess the burden of disease among female sex workers and MSM, access to services and identify barriers to implementation of services for key populations.
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                Author and article information

                Contributors
                aude.jary@aphp.fr
                anne-genevieve.marcelin@aphp.fr
                Journal
                BMC Infect Dis
                BMC Infect. Dis
                BMC Infectious Diseases
                BioMed Central (London )
                1471-2334
                19 December 2019
                19 December 2019
                2019
                : 19
                : 1064
                Affiliations
                [1 ]Department of Virology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), AP-HP, Pitié Salpêtrière Hospital, Paris, France
                [2 ]Département de Biologie Médicale, CHU Gabriel Toure, Bamako, Mali
                [3 ]Department of Virology, IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Bichat Hospital, APHP, Paris, France
                [4 ]Centre National de Transfusion Sanguine, Bamako, Mali
                [5 ]Department of Virology, Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), AP-HP, Saint-Antoine Hospital, Paris, France
                [6 ]ISNI 0000 0001 2299 3507, GRID grid.16753.36, Northwestern University, Institute for Global Health, ; Chicago, IL USA
                [7 ]ISNI 0000 0004 0567 336X, GRID grid.461088.3, Université des Sciences Techniques et des Technologies de Bamako, USTTB, Centre de Recherche et de Formation sur le VIH et la Tuberculose SEREFO, ; Bamako, Mali
                Author information
                http://orcid.org/0000-0002-1952-6729
                Article
                4699
                10.1186/s12879-019-4699-3
                6921458
                31856758
                85abb745-5bc3-4216-aa09-b78e722287bf
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 17 October 2019
                : 11 December 2019
                Funding
                Funded by: Fogarty International Center of the National Institutes of Health
                Award ID: D43TW007995
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Infectious disease & Microbiology
                hiv-prevalence,hbv-prevalence,hcv-prevalence,blood donors,mali
                Infectious disease & Microbiology
                hiv-prevalence, hbv-prevalence, hcv-prevalence, blood donors, mali

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