From the ∗Centre de recherche du CHU de Québec—Université Laval

†Département de médecine sociale et préventive, Université Laval, Québec, Canada

‡Dispensaire IST, Centre de santé communal de Cotonou 1, Cotonou, Bénin

§Ecole Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Borgou

¶Programme Santé de Lutte contre le Sida (PSLS), Cotonou, Bénin

∥University of Colorado Anschutz Medical Campus–Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO

∗∗Centre national hospitalier universitaire HMK

††Faculté des sciences de la santé, Université d'Abomey-Calavi, Cotonou, Bénin

‡‡Université Alassane Ouattara, Bouaké, Côte d'Ivoire

§§CHU de Montpellier et INSERM UMR 1058, Montpellier, France

¶¶Institut national de santé publique du Québec, Québec, Canada

Acknowledgments: The authors would like to thank Eric Demers for his continuous support during statistical analysis. They also want to thank all investigators, health professionals, and the team members in Benin who helped collect data. Finally, the authors thank all participants of the study.

This study was funded by the Canadian Institutes of Health Research (grant no. FDN-143218).

Conflict of Interest and Sources of Funding: M.A. declares funding from the Canadian Institutes of Health Research (grant no. FDN-143218) for the conduction of this project and other unrelated grants from the Bill & Melinda Gates Foundation, the Public Health Agency of Canada, and the Ministère de la santé et des services sociaux du Québec. All the other authors declare no competing interests.

Authors Contributions: M.A., N.N., and L.B1. conceived the study. F.A.G., R.K.K., and F.G., helped with the study conception and were responsible for data collection in the field. R.K.K., L.E., L.B2., and P.L.A. performed laboratory procedures and analyzed those data. L.B1., managed the data, and L.M., and L.B1., performed data analysis. L.M. and M.A. drafted the manuscript. L.B1., F.A.G., R.K.K., and S.D. revised the manuscript for important intellectual content. All authors read and approved the final manuscript.

Correspondence: Michel Alary, MD, PhD, Centre de recherche du CHU de Québec–Université Laval, Hôpital du Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, G1S 4L8, Canada. E-mail: [email protected].

Received for publication November 23, 2020, and accepted February 6, 2021.

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