Summary & Key Points
"Bringing together 10 countries (Benin, Burkina Faso, Côte d'Ivoire, Ghana, Guinea, Mali, Nigeria, Senegal, and Togo), IeDEA (International Epidemiology Databases to Evaluate AIDS) or "International Epidemiology Databases to Evaluate AIDS" is an international research consortium established in 2006 by the National Institutes of Health of the United States."
Including 10 countries (Benin, Burkina Faso, Côte d’Ivoire, Ghana, Guinea, Mali, Nigeria, Senegal and Togo) IeDEA (International epidemiology Databases to Evaluate AIDS) or "International Epidemiological Databases to Evaluate AIDS" is an international research consortium created in 2006 by the National Institutes of Health of the United States. Its goal is to provide a rich resource of diverse data on HIV globally.
IeDEA's mission is to collect observational data representing more than 2.2 million people living with HIV or at risk; data provided by clinical centers and research groups in 44 countries. This data is organized into 7 geographic regions and coordinated by centers for Asia-Pacific, the Caribbean, Central and South America, Central, East, Southern, and West Africa, as well as North America.
In West Africa, IeDEA aims to identify individual and structural barriers throughout the continuum of care for people living with HIV (PLHIV), from HIV testing to retention in care and viral suppression; to evaluate the impact of new preventive approaches aimed at reducing AIDS-related morbidity, particularly comorbidities such as tuberculosis and cervical cancer; to determine the burden of non-communicable diseases and assess their interaction with HIV infection in PLHIV.
Indeed, invasive cervical cancer remains one of the most common cancers in West Africa. Unfortunately, women living with HIV are six times more likely to develop cervical cancer compared to seronegative women. Today, thanks to advances in research, several prevention methods exist: HPV vaccination, screening, and treatment of precancerous lesions.
In Côte d'Ivoire, a screening program has been implemented since 2010 and targets both seronegative and seropositive women starting at age 25. This program uses IVA as a screening method and cryotherapy for treatment. To address the disadvantages associated with cryotherapy, Côte d'Ivoire has adopted the WHO recommendation to replace cryotherapy with thermoablation.
Thus, as part of the 2021-2026 cycle, IeDEA is conducting two studies in West Africa: 1) CASCADE, whose main objective is to evaluate the impact of implementing HPV testing and thermoablation on the demand for screening and access to treatment for precancerous lesions of cervical cancer. 2) IPHOTHER. Conducted in Abidjan and Abobo-Dioulasso (Burkina Faso), this study aims to estimate the incidence and persistence of oncogenic HPV infections and precancerous lesions of the cervix according to HIV status at 36 months and associated factors after treatment with thermoablation/RAD.
To report on the progress of the CASCADE and IPHOTHER studies, discuss the plan for valuing these projects, and the next steps, the Steering Committee for Cancer Studies in West Africa met on October 10, 2024, at the headquarters of the National Cancer Control Program (PNLCa) in Abidjan. This meeting was attended by a dozen participants, including the principal investigator, Dr. Antoine JAQUET (from the University of Bordeaux), and the IPHOTHER project coordinator in Burkina Faso via Zoom.
During this meeting, the group dynamics were positive, with active participation from the steering committee members. Various presentations were made, including those by the project manager and social science researchers (qualitative aspect) on the progress and implementation of the different projects. Thanks to relevant exchanges and contributions, several recommendations were made to improve the quality of the results of the CASCADE and IPHOTHER projects.
These include, among others, improving the follow-up of women in the cohort of HIV-seronegative women (SUCCESS cohort) to limit attrition at 12 months post-inclusion, the valorization within a short timeframe of the quantitative data collected on both CASCADE and IPHOTHER (cohort of women living with HIV or AIMACC cohort), and the continuation of qualitative data collection on IPHOTHER for one more month before closure.
In the long term, the results of these studies will provide evidence to guide decision-making aimed at improving the performance of the secondary prevention program as well as better long-term follow-up of women treated with thermoablation.
