In Guinea, around 17 new cases of HIV occurred each day and it was responsible for 10 deaths a day in 2022. In addition to this burden, regional disparities have emerged over the years. This study aimed to describe and explain the uneven distribution of HIV infection in Guinea using spatial analysis.

This is a retrospective cross-sectional secondary analysis using data from the 2012 and 2018 Guinea Demographic and Health Survey (DHS).

This study was conducted in Guinea.

We conducted a secondary analysis of data from 300 and 400 enumeration areas, respectively, included in the 2012 and 2018 DHS Program for participants aged 15 to 49 who underwent HIV testing. Spatial analysis methods, including Moran I, interpolation and Kulldorff’s scan statistic, were applied to examine variation and identify high-risk spatial clusters of HIV prevalence rate. The potential relationship between HIV status and socio-demographic, biological, behavioural and socio-environmental explanatory variables was explored using logistic regression at individual level.

In total, 7922 individuals in 2012 and 8539 in 2018 participated in the study. HIV prevalence rate in 2012 and 2018 was 1.9% and 1.5%, respectively. Across Guinea’s 33 prefectures, HIV prevalence rate varied from 0% to 3.9% in 2012 and from 0% to 3.5% in 2018. Spatial analysis identified four significant high-risk spatial clusters in 2012 and one high-risk cluster in 2018. The high-risk clusters in 2012 were in Kissidougou (relative risk (RR)=3.97; p value=0.037), Matam (RR=2.80; p value=0.019), Pita (RR=3.46; p value=0.035) and N’zerekore prefectures (RR=6.08; p value=0.027), the high-risk cluster in 2018 was located in Boffa prefecture (RR=3.95; p value=0.022). Factors significantly and positively associated with HIV infection in 2012 included age class 25–34 (aOR: 2.20; 95% CI 1.40 to 3.47), age class 35–49 (aOR: 2.43; 95% CI 1.51 to 3.92), number of HIV healthcare facilities>30 (aOR: 2.14; 95% CI 1.34 to 3.43). HIV infection was significantly lower in men (aOR: 0.52; 95% CI 0.35 to 0.77). In 2018, in addition to age groups 25–34 years (aOR=1.90; 95% CI 1.18 to 3.04) and 35–49 years (aOR=2.25; 95% CI 1.40 to 3.64), the Soussou ethnicity group (aOR=1.73; 95% CI 1.04 to 2.87) was also positively associated with HIV infection.

This study describes the spatial distribution of HIV prevalence rate and identified high-risk clusters in Guinea. In addition, risk factors associated with HIV status were identified. The information can help prioritise surveillance and response efforts to control HIV in Guinea.

Pain in patients with rheumatoid arthritis (RA) is an unmet clinical need. Targeting joint inflammation with disease-modifying antirheumatic drugs has not resulted in the anticipated reduction in pain for many patients. This can partly be explained by the concept of central sensitisation whereby spinal and supraspinal pathways have a lower threshold of activation, leading to increased perception of pain. Synovial stromal cells, such as fibroblasts, are also thought to play a role through peripheral sensitisation of nerves in the joint. Synovial fibroblasts are known to produce pro-algesic mediators such as interleukin 6 and nerve growth factor at the messenger RNA level. These pro-algesic mediators could activate sensory nerve fibres that send signals from the joint to the spinal cord, thereby driving persistent pain in RA. The purpose of this study is to evaluate which pro-algesic mediators are produced by lining versus sub-lining fibroblasts and whether the level of these mediators correlates with clinical measures of pain in patients with RA.

FiND-Pain RA is a multicentre observational study which will recruit 50 patients with seropositive RA who attend the rheumatology department of Guy’s and St Thomas’ Hospital, London, and the Nuffield Orthopaedic Centre, Oxford. Clinical examination, pain-focused patient-reported outcome measures, ultrasound examination and ultrasound-guided synovial biopsy of the knee will be performed. The levels of known and putative pro-algesic mediators will be measured in fibroblasts from the lining and sub-lining layer of the synovium. The location and spatial morphology of sensory nerve fibres and their proximity to lining and sub-lining fibroblasts will be characterised. The primary outcome will be to determine whether the knee pain scores of participants correlate with the level of leukaemia inhibitory factor, a novel putative pain-mediator expressed in sub-lining fibroblasts. The secondary outcomes will be to determine whether other pro-algesic mediators produced by lining or sub-lining fibroblasts correlate with clinical measures of pain and to assess the location and proximity of sensory nerve fibres to lining versus sub-lining fibroblasts.

The study is a sub-study of the PUMIA (Pain Phenotypes and their Underlying Mechanisms in Inflammatory Arthritis) study, which has been approved by the Bromley Research Ethics Committee (REC: 21/LO/0712). The findings of this study will be disseminated through open-access publications, as well as scientific and clinical conferences.

Cardiovascular disease (CVD) represents a public health burden, with high prevalence and significant morbidity and mortality. Although evidence-based interventions exist, there is a need for more individualised care. The European project Individualised care from early risk of cardiovascular disease to established heart failure (iCARE4CVD) aims to personalise CVD prevention and treatment. Participatory health research, which actively involves patients in the planning, implementation and evaluation of projects, plays a crucial role here. However, patient participation is often unsuccessful due to the lack of a representative patient sample who is involved throughout the project’s duration, has knowledge of the project and can contribute their experience.

Participative Research for Individualised Care in Cardiovascular Diseases is a non-interventional, non-randomised, multicentre mixed-methods study. The aim is to incorporate patients’ insights into several key activities within iCARE4CVD by establishing country-specific patient panels in Belgium, Germany, Ireland and the UK. The primary objective is to identify patients’ preferences, experiences, requirements and needs for better diagnosis, treatment and self-care of CVD. Therefore, 10–12 patients across the CVD spectrum, from early risk to established CVD and heart failure, will be included in each country (40–48 in total). Over 3.5 years, patient panel members are required to complete four tasks: (1) identification of meaningful Patient-Reported Outcome and Experiences Measures, (2) development of a motivational model to increase adherence, (3) feedback on CVD care processes and (4) usability testing of new digital tools developed within iCARE4CVD. These tasks comprise eight activities in the form of paper-based or digital exercises, telephone surveys, written surveys and in-person focus groups. The results will be continuously incorporated into iCARE4CVD.

This study received ethical approval by the Ethics Committee at the Faculty of Medicine of RWTH Aachen University (EK 24-172) and St. Vincent’s University Hospital (RS24-027), Research Ethics Committee. In Geel and Belfast, positive ethics approval is pending. All participants will provide written informed consent prior to enrolment in the study and participation in the first patient panel task. Results will be published in peer-reviewed journals and presented at scientific conferences.

DRKS00034899.

V2.1, 6 June 2024.