University of Bangui

Abstract HIV-1 genetic diversity influences disease progression, antiretroviral therapy response, and diagnostic performance. In the Central African Republic (CAR), HIV-1 group M predominates, but detailed data on circulating subtypes and their clinical impact remain limited. This study aimed to characterize HIV-1 subtypes in CAR and assess their association with patients’ immunovirological profiles. A cross-sectional descriptive and analytical study was conducted in 2025 at the National Laboratory of Clinical Biology and Public Health in Bangui. Ninety adult HIV-1–infected patients were included. Viral RNA was extracted from plasma and amplified by RT-PCR targeting the gag p24 region. Subtyping was performed using restriction fragment length polymorphism (RFLP) analysis with HaeIII, MspI, and AluI enzymes. Agarose gel images were optimized using AI (Topaz Gigapixel AI) to enhance band clarity. Clinical and biological data were analyzed using Epi Info software, with univariate analysis and multivariate logistic regression evaluating associations between subtypes and immunovirological parameters. Among the 90 patients (62% women; median age 34 years), the median CD4 count was 312 cells/mm³ and the median viral load was 63,500 copies/mL. Subtype distribution was: CRF02_AG (53.5%), A (17.8%), C (14.4%), and D (14.4%). CRF02_AG showed a tendency toward higher viral load and lower CD4 counts, though these associations were not statistically significant after adjustment. A viral load > 100,000 copies/mL was the only independent predictor of severe immunosuppression (CD4 < 200 cells/mm³; adjusted OR = 3.62; p = 0.019). CRF02_AG predominates among HIV-1–infected patients in CAR, while subtypes A, C, and D co-circulate at lower frequencies. High viral load is the main determinant of severe immunosuppression, regardless of subtype. These findings support continuous molecular surveillance, optimization of treatment strategies, and reinforcement of public health interventions. The combined use of PCR-RFLP and AI-assisted gel imaging offers a reliable and feasible method for subtype monitoring in resource-limited settings.

Semaglutide, a glucagon-like peptide-1 receptor agonist, and resmetirom, a thyroid hormone receptor-β agonist, are approved therapies for noncirrhotic metabolic dysfunction–associated steatohepatitis (MASH) with moderate to advanced fibrosis. Their comparative economic value has not been established. To evaluate the cost-effectiveness of semaglutide and resmetirom compared with standard of care (SOC) in patients with noncirrhotic MASH and F2–F3 fibrosis. A state-transition model simulated disease progression in a hypothetical cohort with F2–F3 fibrosis over 5- and 10-year horizons from a U.S. healthcare payer perspective. Clinical efficacy inputs were derived from phase 3 trials (ESSENCE and MAESTRO-NASH), with costs and utilities obtained from published sources. Scenario analyses incorporated semaglutide’s cardiovascular mortality benefit. Deterministic and probabilistic sensitivity analyses assessed uncertainty. Semaglutide was cost-effective versus SOC at 5 years (ICER, $42,200/QALY) and 10 years (ICER, $44,138/QALY). Resmetirom produced higher ICERs ($95,981/QALY at 5 years; $107,002/QALY at 10 years) but remained below a $150,000/QALY threshold. Inclusion of cardiovascular mortality benefits improved semaglutide’s ICER to $38,324/QALY. Probabilistic analyses showed semaglutide had the highest probability of cost-effectiveness across willingness-to-pay thresholds. Over a 10-year horizon, treatment of 100,000 patients with F2–F3 MASH was projected to prevent 270 cases of decompensated cirrhosis, 10 cases of hepatocellular carcinoma, and 1,040 liver-related deaths with semaglutide, compared with 310 cases of decompensated cirrhosis, 10 cases of hepatocellular carcinoma, and 1,180 liver-related deaths with Resmetirom. Semaglutide demonstrated superior cost-effectiveness compared with SOC and resmetirom, with cardiovascular benefits further strengthening its economic value. Not applicable.

ABSTRACT This study presents the design and evaluation of a hybrid energy harvesting system integrating photovoltaic, thermoelectric generator, and piezoelectric transducers to enhance conversion efficiency and energy reliability in variable environments. A unified power management unit incorporating maximum power point tracking and dynamic source‐switching algorithms enables optimal extraction and regulation of power from each source. The system was modeled and validated using MATLAB/Simulink and hardware prototyping. Experimental results show a 28%–35% increase in overall harvested energy compared with the best‐performing standalone harvester under fluctuating solar irradiance, temperature gradients, and mechanical vibrations. The hybrid configuration demonstrated superior load stability and source redundancy, highlighting its potential for autonomous operation in Internet of Things nodes and off‐grid microelectronic systems.

We read with great interest the article by Danpanichkul and colleagues reporting updated global estimates and projections for gastrointestinal cancer incidence and mortality through 2050 based on data from the GLOBOCAN 2022 database.1 The authors should be congratulated for providing a comprehensive and timely assessment that highlights the magnitude of the future gastrointestinal cancer burden and the pronounced regional and socioeconomic disparities that are expected to emerge. Of particular importance is their finding that Africa is projected to experience the largest relative increases in both incidence and mortality, which accentuates the urgent need for region-specific cancer control strategies. Within this broader gastrointestinal cancer framework, liver cancer warrants special attention in sub-Saharan Africa, where it remains a leading cause of cancer-related death and a major contributor to the region’s gastrointestinal cancer burden. Although the projections presented by Danpanichkul et al.1 appropriately emphasize Africa as a high-growth region, liver cancer trends in sub-Saharan Africa exhibit a distinctive and potentially misleading pattern that merits further discussion. Specifically, declining age-standardized incidence and mortality rates coexist with rapidly rising absolute numbers of cases and deaths: This is a paradox that has important implications for health system planning and policy interpretation.2 Using longitudinal Global Burden of Disease estimates and forward projections through 2050, our analyses of liver cancer in sub-Saharan Africa demonstrate that age-standardized rates are projected to gradually decline over the coming decades. However, these favorable rate trends mask a substantial and sustained increase in the absolute burden of liver cancer. Population growth and demographic aging are the dominant drivers of this divergence and are resulting in a marked expansion in the total number of individuals affected despite improvements in age-adjusted risk. Consequently, liver cancer will continue to exert growing pressure on already constrained health systems across the region, even in the absence of worsening age-specific risks. This dynamic closely aligns with, and further contextualizes, the findings of Danpanichkul et al., who report the steepest proportional increases in gastrointestinal cancer incidence and mortality in Africa overall.1 Liver cancer exemplifies how demographic forces can amplify the cancer burden in low- and middle-income settings, particularly when prevention and early-detection infrastructure remains limited. In sub-Saharan Africa, persistent exposure to viral hepatitis, incomplete coverage of hepatitis B birth-dose vaccination, limited access to antiviral therapy, and rising contributions from metabolic and alcohol-related liver disease collectively sustain a high baseline risk. When coupled with rapid population expansion, these factors translate into accelerating absolute case counts even as age-standardized rates decline. The policy implications of this paradox are substantial. Reliance on age-standardized trends alone may inadvertently convey a sense of progress that is not reflected in real-world service needs. Health systems must prepare for increasing demand for diagnostic, therapeutic, and palliative liver cancer services alongside continued investment in primary prevention. Expanded hepatitis B vaccination, scale-up of hepatitis B and C testing and treatment, integration of metabolic risk management into primary care, and strengthening of cancer surveillance and registry systems are all essential to mitigate the projected rise in absolute burden. Importantly, these interventions must be tailored to regional realities in sub-Saharan Africa, where underdiagnosis and incomplete cancer registration likely result in underestimation of the true burden.3 In conclusion, the work by Danpanichkul and colleagues1 provides a critical global benchmark for understanding future gastrointestinal cancer trends. Complementary, disease-specific analyses from sub-Saharan Africa highlight how liver cancer will continue to expand in absolute terms despite declining age-standardized rates, and they reinforce the urgency of targeted prevention and health system strengthening in the region. Together, these perspectives underline the fact that without sustained and regionally adapted interventions, the projected growth in gastrointestinal cancers, particularly liver cancer in sub-Saharan Africa, will pose a major challenge to global cancer control efforts in the coming decades. The authors declare no conflict of interest.

Introduction: Antimicrobial resistance remains a concern for the World Health Organization, a problem affecting both veterinary health and the agri-food system, with serious risks to consumers due to the global emergence of antibiotic-resistant strains. This global threat is increasingly poorly controlled in certain sectors, and despite the "One Health" approach, few developed countries have conducted studies on antibiotic resistance in bacterial strains isolated from food and veterinary products. The overall objective of this study was to investigate, using isolates obtained from samples of peanut paste sold in the city of Bangui, the genes conferring resistance to beta-lactams and quinolones. Methodology: A total of 320 samples of peanut paste sold in the eight main markets of Bangui were collected and analyzed. Fifty-one strains of Enterbacteria of medical interest were isolated and identified, and the antibiotic susceptibility of these strains was tested by the disk diffusion method on Muller-Hinton agar. From these strains, resistance genes to beta-lactams (TEM, CTX-M1, and CTX-M2) and quinolones (qnrB and SHV) were investigated using conventional PCR genotyping analysis, including thermal extraction of genetic material and detection by agarose gel electrophoresis. Results: The results of this study reveal the presence of pathogens in different proportions. Citrobacter freundii 5.7%; Citrobacter koserii 4.6%; Enterobacter cloacae 10.3%; Enterobacter koserii 1.1%; Enterobacter sakazakii 4.6% Escherichia coli 29.9%; Flaviomonas Horzitiabita 4.6%; Flaviomonas luteola 1.1% Klebsiella arizonnae 1.1%; Klebsiella ornithinolytica 4.6%; Klebsiella oxytoca 3.4%Klebsiella ozaenae1.1%; Klebsiella pneumoniae 3.4%; Klebsiella spp 10.3%; Proteus mirabilis 8.0%; Pseudomonas aeruginosa 4.6%; Serratia liquefaciens 1.1%. the proportion of beta-lactam resistance genes was 69% for the TEM gene.27.6% for CTXM1, and absent for the CTXM2 gene. The observed quinolone genotypic resistance genes were qnrb at 18% and SHV at 21.5%. Conclusion: Phenotypic and genomic research on antibiotic resistance in peanut paste samples sold in the city of Bangui revealed the presence of resistance genes to beta-lactams and quinolones. The detection of these resistance genes in a food sample poses a serious problem for consumer health and therapeutic management in human medicine.

This paper summarizes the test setup and results of a GEM46 motor destruct performed at AFRL, Edwards AFB. The purpose of the test was to determine if a shorter-than-standard LSC was capable of rendering a Graphite-epoxy solid rocket motor non-propulsive and provide data for computational and empirical models for solid rocket motor safety.

Based on a comprehensive analysis of remote sensing data and geological information, the role of neotectonics in shaping the modern topography of the Central African Republic (CAR) is assessed. Using lineament analysis, a fault tectonics map is interpreted and compiled, which is compared with the region’s geological structure. It is established that the lineament field fragmentarily reflects inherited basement faults and is largely associated with manifestations of recent (neotectonic) activity. The analysis has revealed a clear spatial relationship between the CAR’s main ore regions and zones of neotectonic uplifts and faults, indicating the leading role of modern tectonic movements in controlling the distribution of mineral deposits. The obtained results can be used to refine the structural tectonic schemes of the region and develop criteria for predicting new mineral deposits.

Abstract Emerging evidence suggests that ectopic colonization of oral bacteria in the lower digestive tract may exacerbate gastrointestinal disorders. Nevertheless, it remains unclear whether bacteria of oral origin are continuously translocating from the oral cavity to the lower gastrointestinal tract or are locally adapted and persist in their respective niches. We investigated strain translocation dynamics in 44 healthy and stunted children from Bangui, Central African Republic. Using cross-sectional shotgun metagenomic sequencing of saliva, gastric, duodenal and fecal samples, and isolation and whole genome sequencing of 87 Streptococcus salivarius isolates, we showed translocation of members of the genera Streptococcus , Veillonella , Rothia and Haemophilus . Fecal isolates were more closely related to oral isolates from the same individuals than those from other individuals. Additionally, saliva showed higher S. salivarius nucleotide diversity compared to other compartments, suggesting a source-sink dynamic in which S. salivarius populations are continuously seeded from the oral cavity without durably establishing in the lower gastrointestinal tract. Last, we showed that overrepresentation of oral bacteria in the duodenum of stunted children is due to increased biomass, while in the colon it is linked to depletion of overall biomass, including in butyrate-producing strains. Our study quantifies mechanisms of oral-to-gut translocation and enrichment of oral taxa, providing key insights into microbiota disruption in stunted children.

To investigate the role of epidemic predictors in the mpox outbreak in Africa. This was a retrospective analysis of national-level mpox surveillance data from 20 mpox-affected African countries from January through December 2024. Predictors included viral clades, gross domestic product (GDP) per capita, and population density. A negative binomial regression model estimated the incidence rates ratio (IRR) [95% confidence interval] for mpox incidence and mortality. Random forest models assessed the influence of each predictor in the epidemic dynamic. Clade II was associated with lower mpox incidence (IRR = 0.15 [0.02-0.97]) and mortality (IRR = 0.09 [0.01-1.72]) compared to Clade I. GDP per capita was associated with a 95% reduction in cases count per US $1000 (IRR = 0.05 [0.38-0.74]). Population density was not significantly associated with mpox incidence or mortality. Random forest analysis confirmed GDP per capita as the strongest predictor of mpox burden. The 2024 mpox epidemic highlights how countries with low GDP per capita and Clade I face greater outbreak burdens. Strengthening health systems and addressing poverty as a key social determinant of health through a multisectoral approach are essential to ensure equitable outbreak prevention, control, and long-term resilience.