Molecular and serological pattern of Toxoplasma gondii among rural population in four regions of Gabon

Toxoplasma gondii is an obligatory intracellular parasite that causes a zoonotic disease capable of infecting nearly all warm-blooded hosts, including humans. However, reports on the molecular prevalence of T. gondii in humans are rare in Gabon. The present study aimed to evaluate the serological and molecular prevalence of T. gondii among apparently healthy rural populations in four regions of Gabon. This study included six hundred blood samples from the Interdisciplinary Center for Medical Research (CIRMF) bank, including 300 women and 300 men living in 111 villages. Blood samples were screened using enzyme-linked fluorescent assay (ELFA), while buffy coat samples were analyzed using PCR analyses. Of the 600 samples screened, 548 (91.3%) showed IgG antibodies against T. gondii; 11 (2%) had both IgG and IgM. Among the 548 positive samples, 155 (28%) had higher IgG titers (>300 UI/ml), and 49 of them (31.6%) were detected with T. gondii DNA. The present findings on human toxoplasmosis in Gabon suggest that at an older age, reactivation of old infections seems more frequent than new infections, as indicated by the presence of T. gondii using PCR among elevated IgG subjects without IgM. Further studies should be performed to identify the genotypes of T. gondii that infect humans in Gabon.

Aspects épidémiologiques, diagnostiques et thérapeutiques des traumatismes vertébro-médullaires au Centre Hospitalier Universitaire d'Owendo, Gabon / Spinal cord injury at the Owendo teaching hospital, Gabon. Epidemiology, diagnosis and management

Spinal cord injury constitutes a multidisciplinary therapeutic emergency. It occurs usually in a context of polytrauma. The aim of this study was to describe the management of spinal cord injury admitted to the emergency department of a "trauma center". Methods: This is a prospective observational study carried out at the University Hospital of Owendo, Gabon. Patients admitted to the emergency department of any age for spinal cord injury and having performed a radiological examination were included. Socio-demographic parameters, circumstances and times of onset of trauma, mode of transport, state of consciousness, sensory and motor deficit, American Spinal Injury Association (ASIA) Score, hemodynamic and respiratory status were assessed. Results: During the study period, 850 patients were registered at the emergency department. Among them 112 were admitted for spinal cord injury (3.17%). The average age of the patients was 36 ± 3 years. The male gender accounted for 77% of cases. It concerned in 36% of cases the unemployed. The road accident was incriminated in 61%. Pedestrians were involved in 81% of cases. The clinical evaluation on admission found a sensorimotor deficit in 45 patients (40.17%), there were 11 tetraplegias (10%) and 3 paraplegias (3%). The majority of patients (77.7%) were classified as Fränkel stage A. The lesions were dominated by dislocations of the cervical spine (30.4%). Specialized care was essentially orthopedic in 60.7%. No patient was operated. Conclusion: Spinal cord injuries are "time-dependent" medical and surgical emergencies. A codified organization of pre-hospital care and an efficient "trauma center" are essential factors for the management of this type of traumatic pathology

Traumatismes abdominaux graves aux urgences du «Trauma Center¼ de Libreville: Aspects épidémiologiques, diagnostiques et évolutifs / Severe abdominal trauma in the emergency room of the Trauma Center Libreville: Epidemiological, diagnostic and evolutionary aspects

Les traumatismes abdominaux représentent environ 15-20 % des lésions observées en traumatologie. L'objectif est de décrire les aspects épidémiologiques, diagnostiques et évolutifs des traumatismes abdominaux graves admis aux urgences du Centre Hospitalier Universitaire d'Owendo (CHUO) au Gabon. Méthodes : Il s'agit d'une étude rétrospective transversale et descriptive. Elle s'est déroulée sur une période de vingt quatre mois de 2020 à 2021 aux urgences du CHUO. Seuls les patients présentant une pathologie abdominale traumatique classée grave ont été inclus. Les variables de l'étude étaient : l'âge, le genre, le mécanisme du traumatisme, la prise en charge pré hospitalière, les signes cliniques, le bilan paraclinique réalisé, le traitement chirurgical et l'évolution. Les données ont été analysées par le logiciel Microsoft Excel© Pro version 2019. Résultats : durant cette période, 4,6% (n=105) des patients présentaient un traumatisme abdominal dont 66,7% (n=70) avaient un traumatisme abdominal grave. L'âge moyen des patients était de 29,8 + 13,8 ans. Dans 70% des cas (n=49), les accidents de la voie publique étaient le principal mécanisme étiologique, puis secondairement les agressions avec 11,4% des cas. En per opératoire, les lésions spléniques représentaient 60% (n=42) des cas. La mortalité brute était de 20% (n=14). Les décès étaient survenus chez 64,2% de patients au cours des quarante-huit premières heures. Conclusion : A Libreville, les accidents de la voie publique représentent le principal pourvoyeur des traumatismes abdominaux graves. Ces urgences restent encore responsables d'une forte mortalité au Gabon

Tétanos de l'enfant au Centre Hospitalier Universitaire Mère­Enfant de Libreville, Gabon / Child tetanus at the Mother and Child University Hospital Center, Libreville, Gabon

L'objectif de cette étude était de déterminer les aspects épidémiologique, clinique, thérapeutique et évolutif du tétanos de l'enfant au service de réanimation du Centre Hospitalier Universitaire Mère-Enfant de Libreville, au Gabon. Méthodes : Etude rétrospective de type descriptif menée du 1er janvier 2019 au 31 décembre 2022. Les dossiers des enfants âgés de 0 à 16 ans, admis en réanimation pour tétanos, ont constitué la base des données. Les variables étudiées étaient épidémiologiques, cliniques, thérapeutiques et évolutives. Résultats : Parmi les 561 enfants hospitalisés en réanimation durant la période, il y'avait 12 cas de tétanos, soit une prévalence de 2,1%. Le sexe ratio était de 2. Les enfants âgés de 10 ans et plus représentaient la moitié de l'effectif (n=6). La porte d'entrée la plus retrouvée était une plaie du pied soit 50%, suivie d'une plaie céphalique dans 25% des cas. Tous les enfants avaient un état vaccinal incorrect, un trismus et des troubles d'alimentation. Le score pronostique de Dakar était à 2 chez six enfants (50%) et de 3 chez les 6 autres. Les molécules les plus utilisées étaient le Midazolam (92%), le Métronidazole (100%), le sérum et vaccin antitétanique (100%). Cinq patients (42%) ont bénéficié d'une ventilation assistée. La durée moyenne de séjour était de 13,6 jours ±9,9 et la létalité de 42%. Conclusion : le tétanos prédomine chez le grand enfant n'ayant pas de couverture vaccinale. Des mesures de sensibilisation des populations sur la vaccination antitétanique sont indispensables pour baisser la létalité.

Aspects épidémio-cliniques des manifestations thrombotiques au cours de la COVID- 19 au sein des hôpitaux militaires de Libreville et d'Akanda, Gabon / Epidemiology and clinical aspects of thrombotic manifestations during COVID-19 at the military hospitals of Libreville and Akanda, Gabon

Décrire les aspects épidémio-cliniques des manifestations thrombotiques au cours de la COVID-19 au sein des hôpitaux militaires de Libreville et Akanda, Gabon. Méthodes : Nous avons mené une étude rétrospective et descriptive multicentrique d'une durée de 7 mois, du 01er septembre 2021 au 31 mars 2022, portant sur les patients admis dans les unités de réanimation des hôpitaux d'instruction des armées de Libreville (HIAOBO) et d'Akanda (HIAA), pour COVID-19 documentée ou suspectée. Résultats : Durant la période d'étude, 167 patients ont été́ admis pour infection à SARS-CoV-2, parmi lesquels, 18 ont présentés des manifestations thromboemboliques (10,8%). La moyenne d'âge était de 54,7±6.4 ans. Il y avait une large prédominance masculine avec un sexe ratio à 2. Nous avons noté́ 9 cas d'embolie pulmonaire (50%), 5 cas d'accidents vasculaires cérébraux ischémiques (28%), 1 cas de thrombose veineuse profonde de membre inferieur (6%), 1 cas de thrombose veineuse cérébrale (6%), 1 cas de thrombose de la veine mésentérique (6%) et 1 cas de thrombose de la veine porte (6%). Les D-dimères étaient élevés chez tous les patients. Les globules blancs étaient élevés (>10000/mm3 ) chez 12 patients (67%). Les plaquettes étaient inférieures à 150000/mm3 pour 6 patients (33%). Tous les patients avaient une pneumonie à SARS-CoV-2 et la moyenne d'atteinte deslésions pulmonaires était estimée à 45%. Neuf patients étaient décédés (50%) au cours de l'hospitalisation. Conclusion : L'infection par le SARS-CoV-2 constitue vraisemblablement une prédisposition à la survenue d'un événement thrombotique. L'incidence des manifestations thrombotiques chez les patients atteints de COVID-19 reste élevée, renforçant ainsi la prescription systématique d'une anticoagulation prophylactique

Epidemiological and clinicopathological profile of endometrial cancer in Gabon

Introduction: L'objectif général de notre travail était d'apporter une description épidémiologique et clinicopathologique du cancer de l'endomètre au Gabon. Patients et méthode: Cette étude descriptive et rétrospective a été réalisée à l'Institut de Cancérologie de Libreville chez les patientes atteintes du cancer de l'endomètre sur une période de 7 années (de janvier 2012 à octobre 2018). Résultats: Cette étude a inclus 32 patientes et les résultats obtenus ontmontré que ce cancer au Gabon est plus fréquent chez la femme multipare, que histologiquement le type 1 est le plus souvent rencontré et que ce cancer est de haut grade de malignité. De ce travail ressort également la difficulté du suivi des patientes. Conclusion: Le cancer de l'endomètre étant un cancer souvent d'emblée de mauvais pronostic, il est d'intérêt de mettre en place une stratégie de prévention et de management adapté.Mots clés: cancer, endomètre, étude clinicopathologique, suivi, Gabon Abstract:Introduction:The general objective of our work was to provide an epidemiological and clinicopathological description of endometrial cancer in Gabon.

Introduction: The general objective of our work was to provide an epidemiological and clinicopathological description of endometrial cancer in Gabon. Epidemiological and clinicopathological profile of... Patients and method: This descriptive and retrospective study was carried out at Cancer Institute of Libreville in patients with endometrial cancer over a period of 7 years (from January 2012 to October 2018) . Results: This study included 32 patients and the results obtained showed that this cancer in Gabon is more frequent in multiparous women, that histologically type 1 is most often encountered and that this cancer is of high grade malignancy. This work also shows the difficulty of following up patients. Conclusion: As endometrial cancer is often a cancer with a poor prognosis , it is interest to put in place an appropriate prevention and management strategy.

Clinical Characteristics and Treatment Outcomes of HIV+ and HIV- Tuberculosis Patients Followed and Treated at the Regional Hospital of Oyem, Northern Gabon: A Two-Year Retrospective Study

Background: The objective of this study was to analyse the clinical characteristics of HIV+ and HIV- tuberculosis patients followed and treated at the Oyem Regional Hospital Centre (ORHC). Materials and Methods: During this study conducted between January 2019 and December 2021, data collection was based on the exploitation of medical records and registers of results from the medical analysis laboratory of the regional hospital of Oyem, in which there were personal data (gender and age) of the patients, the status of HIV infection, clinical characteristics (pulmonary or extra pulmonary TB), and finally, the therapeutic outcomes of the patients after anti-tuberculosis and antiretroviral treatment. Binomial test following the Normal distribution was used to find an association between the percentages of extrapulmonary TB and TB+/HIV+ co-infection. Results: In this study, 128 confirmed TB cases were selected. While 54 (42.19%) were co-infected with TB+/HIV+, 74 patients (57.81%) were monoinfected with TB+/HIV+. Among all these patients, 93 (72.66%) were reported to have extra pulmonary TB and 35 (27.34%) had pulmonary TB. A normal binomial test showed that TB+/HIV+ co-infection was significantly associated with extrapulmonary TB (p=0.04). Patients were put on anti-tuberculosis treatment according to the manufacturers' indications. Despite a total of 15 deaths (8.93%) in both mono- and co-infected patients, there was a favourable outcome, with 35 patients (27.34%) declared cured. With 8 deaths, mortality was higher in the co-infected than in the non-HIV infected TB patients who recorded 7 deaths. Conclusion: By indicating a relatively high prevalence of HIV infection in TB patients, this study showed that TB+/HIV+ co-infection was associated with extra pulmonary TB, the severe form of the disease, and increased mortality in patients, hence the need to strengthen joint activities to control this co-infection.

Aspects épidémiologiques et thérapeutiques de la maladie de Kawasaki à Libreville de 2014 à 2021

Introduction.Kawasaki disease (KD) is an acute multi-systemic vasculitis of young children and infants. It is the first cause of acquired cardiac disease in children and remains poorly described in Gabon. We therefore wanted to describe the epidemiological and therapeutic aspects of this disease in two hospitals in Libreville. Patients and methods.We conducted a retrospective, descriptive study from 2014 to 2021 at the Akanda University Hospital and the El Rapha polyclinic in Libreville. All records of patients hospitalised in paediatrics for MK were included. Results.Thirty three cases of MK were retrieved, giving ahospital prevalence of0.6%. The mean age of patients was 20.4 months, the proportion of patients <18 months was 60.6% and the sex ratio was 1.7. The symptoms were observed mainly during the dry season (69.7%). Fever (100%), conjunctivitis (78.8%) and desquamation (72.7%) were the main reasons for consultation. In 24.2% of cases, a traditional medicine was administered. The average time between the onset of symptoms and hospitalization was 11 days. Once hospitalized, the diagnosis of MK was evoked within an average of 3 days. The typical form was observed in 57.6% of cases. In 100% of cases, the hemoglobin level was <12g/dl and the CRP was >15mg/l. Echocardiography was abnormal in 5 patients. Acetylsalicylic acid was the only treatment with a mean time to apyrexia of 3 days after administration. No deaths were recorded. Conclusion:the MK is relatively present in Libreville. It is important to mention it in the event of a fever of more than 5 days.

Malaria and COVID-19 prevalence in a population of febrile children and adolescents living in Libreville

Background: Patients with acute febrile illness need to be screened for malaria and coronavirus disease 2019 (COVID-19) in malaria-endemic areas to reduce malaria mortality rates and to prevent the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Objectives: To estimate the frequency of children and adolescents with COVID-19 and/or malaria among febrile patients attending for malaria diagnosis Method: This cross-sectional study was conducted in a sentinel site for malaria surveillance during the SARS-CoV-2 pandemic (Omicron variant), from October 2021 to December 2021 in Gabon. All febrile patients were tested for malaria using microscopy. Severe acute respiratory syndrome coronavirus 2 was detected by real time polymerase chain reaction (RT-PCR) and rapid antigen tests developed by Sansure Biotech®. Results: A total of 135 patients were screened. Their median age was 6 (interquartile range [IQR]: 3­14) years. Malaria was confirmed for 49 (36.3%) patients, 29 (32.5%) children, 13 (59.0%) adolescents and 7 (29.2%) adults. The frequency of COVID-19 cases was 7.4% (n = 10/135), and it was comparable between children (n = 6; 6.7%), adolescents (n = 2; 9.1%) and adults (n = 2; 8.3%) (p = 0.17). Malaria and COVID-19 co-infections were diagnosed in 3 (6.1%) patients from all the age groups. Participants with a co-infection had a higher median temperature, a higher median parasitaemia, and were mostly infected with non-falciparum malaria. Conclusion: COVID-19 cases and cases of malaria/COVID-19 co-infections were found in febrile children and adolescents. SARS-CoV-2 testing should be included in the screening of suspected malaria cases.

Profil épidémiologique des genoux douloureux au service de rééducation fonctionnelle du Centre Hospitalier Universitaire d'Owendo / Epidemiological profile of painful knees in the functional rehabilitation department of the Owendo University Teaching Hospital

Introduction. Les gonalgies, souvent invalidantes, conduisent à un handicap fonctionnel altérant la qualité de vie des patients. L'objectif du travail était de décrire le profil épidémiologique des patients gonalgiques suivis dans le service de médecine Physique du Centre Hospitalier Universitaire d'Owendo (CHUO). Patients et méthodes. Nous avons mené une étude transversale descriptive, avec recueil rétrospectif de janvier à décembre 2021 dans le service de Médecine Physique et de Réadaption du CHUO. Résultats. Au total, 122 patients ont été retenus. L'âge moyen était de 44,54 ans. Le sexe féminin prédominait à 65,5%, les patients résidaient majoritairement en zone urbaine (90.9%). La population était célibataire à 51,3%, fonctionnaire pour 25,9%, avec une couverture sociale à 95,9%. Seul 50% pratiquait une activité physique régulière. L'HTA constituait l'antécédent médical le plus fréquent (27%). L'indice de masse corporelle moyen était de 27,59. Le délai moyen de prise en charge était de 63 jours (IQR 42,25), la moyenne de séances prescrites était de 15,66 et celles des séances effectuées était de 13,93. L'atteinte était dégénérative à 50% et traumatique à 41% des cas. Le traitement antalgique était initié concomitamment à la kinésithérapie dans 86% des fois, le palier OMS 1 était le plus fréquent (61,7%). Les mesures hygiéno-diététiques et d'économie articulaire ont été appliquées respectivement dans 70,6 et 90,2 % des cas. L'évolution a été favorable dans 80,3% des cas. Conclusion. La gonalgie touche majoritairement les femmes. Son évolution est favorable après un traitement de rééducation bien conduit.

Introduction. Gonalgia is often disabling and may lead to a functional disability altering the quality of life of patients. The aim of this study was to describe the epidemiological profile of gonalgic patients in the Physical Medicine department of the Owendo University Teaching Hospital (CHUO). Patients and methods. We conducted a descriptive cross-sectional study, with retrospective data collection from January to December 2021 in the Physical Medicine and Rehabilitation Department of the CHUO. Results. A total of 122 patients were included. Their average age was 44.54 years. Women represented 65.5% of cases and the patients resided mainly in urban areas (90.9%). The patients were single (51.3%), while 25.9% were civil servants and 95.9% had social security coverage. Only 50% practised regular physical activity. High blood pressure was the most frequent medical history (27%). The average body mass index was 27.59. The median time to treatment was 63 days (IQR 42.25). The average number of sessions prescribed was 15.66 and the average number of sessions performed was 13.93. The etiology was degenerative in 50% of cases and traumatic in 41% of cases. An analgesic treatment was initiated concomitantly with physiotherapy in 86% of cases, with WHO level 1 being the most frequent (61.7%). Hygienic were applied in 70.6% and and dietary measures in 90.2% of cases. The outcome was favorable in 80.3% of cases. Conclusion. Gonalgia mainly affects women. Its evolution is favorable after a well conducted rehabilitation treatment

Profil clinique et évolutif des patients atteints du COVID-19 à Libreville étude rétrospective et mono-centrique / Clinical and evolutionary profile of patients with COVID-19 in Libreville: A Retrospective Cohort study

Introduction : L'étude clinique des patients infectés par le SARS-CoV2 est nécessaire pour la mise en œuvre des mesures préventives de lutte contre la COVID-19. L'objectif de l'étude a été de déterminer le profil clinique et évolutif des patients Covid-19 au CHU de Libreville.Méthodes : Il s'agit d'une étude rétrospective à viser analytique menée en secteur d'infectiologie COVID du SICOV du CHU de Libreville sur une période d'activité allant du 15 mars au 30 juin. La régression logistique univariée et multivariée pour explorer les facteurs de risque associés à la mortalité au SICOV a été utilisée. Résultats : Au total 441 patients COVID-19 étaient inclus dans l'étude, parmi lesquels 398 survivants (90,2%) et 43 décédés (9,8%). La population de moins de 65 ans représentait 88,0% de l'effectif. Le sex-ratio était de 1,34. Par rapport aux 398 survivants, les 43 patients décédés étaient significativement plus âgés (âge médian, 59 ans vs 48 ans ; p <0,001). Les lésions pulmonaires avec atteinte critique > 75% étaient plus importantes chez les patients décédés (29,2% vs 3,0% ; p=0,001). Cependant, après ajustement en analyse multivariée, l'âge supérieur à 65 ans était le seul facteur de risque indépendant de décès (p<0,001 ; OR=4,632 IC95% [2,243 ­ 9,565]).Conclusion : L'âge supérieur à 65 ans était le facteur de risque indépendant de décès, nécessitant un renforcement de mesure de contrôle de l'infection dans cette population

Introduction: The study of the prognostic factors of death of patients infected with SARS-CoV2 is necessary for the implementation of preventive measures against COVID-19. Methods: This is a retrospective study conducted in the COVID infectious disease sector of the SICOV of the University Hospital of Libreville over a period of activity from March 15 to June 30. The clinical course of the survivors and the deceased were compared. Univariate and multivariate logistic regression to explore risk factors associated with SICOV deaths were used.Results: A total of 441 COVID-19 patients were included in the study, of which 398 survivors (90.2%) and 43 died (9.8%). The population under 65 represented 88.0% of the workforce. The sex ratio was 1.34. Compared to the 398 survivors, the 43 patients who died were significantly older (median age, 59 years vs 48 years; p <0.001). Lung lesions with critical impairment > 75% were greater in deceased patients (29.2% vs. 3.0%; p = 0.001). On multivariate analysis, age over 65 was the main independent risk factor for death (p <0.001; OR = 4.632 95% CI [2.243 - 9.565]).Conclusion: Age over 65 was the independent risk factor for death, requiring increased infection control measures in this population

Profil épidémio-clinique, fonctionnel et de sensibilisation aux allergènes chez les asthmatiques suivis en consultation en milieu Africain à Libreville, Gabon / Epidemiological-clinical, functional profile and sensitization to allergens in asthmatics followed in consultation in an African environment in Libreville, Gabon

Introduction : La prévalence de l'asthme au niveau national est inconnue. L'objectif était de déterminer la prévalence hospitalière de l'asthme et la sensibilisation aux pneumallergènes standards.Patients et Méthodes : Il s'agit d'une étude transversale, rétrospective qui a consisté en l'analyse descriptive de 164 dossiers de patients asthmatiques reçus pour consultation au CHU de Libreville sur une période d'activité de 36 mois. La mesure du VEMS pré et post-bronchodilatateur ainsi que les prick-tests ont été réalisés. Les extraits standardisés suivants étaient testés : Dermatophagoïdes pteronyssinus et farinae, les phanères (chien et chat), les plantes vertes (Cynodon dactylon) et les moisissures (Alternaria sp). Résultats : Des 2798 patients reçus en consultation de pneumologie, 164 l'étaient pour un asthme soit une fréquence 5,8%. Parmi les 164 patients asthmatiques 59,8%(n=98) étaient des femmes avec un sex-ratio à 0,67. La moyenne d'âge de la population d'étude était de 31±18,1 ans, des extrêmes de 5 et 81 ans. Plus de la moitié des patients résidait en milieu urbain (59,7%), et était sans revenu (50,7%). L'asthme était associé à la rhinite allergique dans 72,6%. Seuls 45 patients avaient réalisé les prick tests parmi lesquels la sensibilisation aux acariens (n=37/45 ; 82,2%) était fréquente et dominée par Dermatophagoïdes pteronyssinus (n=32/37 ; 86,5%). La sensibilisation à Blomia tropicalis était de 73,0% (n=27/37). La sensibilisation aux phanères d'animaux (chiens et chats) était observée chez 9 patients (n=9/45 ; 20,0%). Aucune sensibilisation à l'Alténaria sp n'a été relevée. Le déficit ventilatoire obstructif proximal et distal a été observé dans 45,8% des cas (n=60/131).Conclusion : La prévalence de l'asthme est relativement élevé dans notre contexte d'exercice. Le taux sensibilisation révélé est le témoin d'une forte pression allergénique exercée par l'environnement domestique

Introduction: The national prevalence of asthma is unknown. The objective was to determine the hospital prevalence of asthma and sensitization to standard airborne allergens. Patients and Methods: This is a cross-sectional, retrospective study which consisted of the descriptive analysis of 164 records of asthmatic patients received for consultation at the University Hospital of Libreville over a period of activity of 36 months. Measurement of pre- and post-bronchodilator FEV1 as well as prick-tests were performed. The following standardized extracts were tested: Dermatophagoides pteronyssinus and farinae, skin appendages (dog and cat), green plants (Cynodon dactylon) and molds (Alternaria sp).Results: Of the 2798 patients seen in a pulmonology consultation, 164 were for asthma, i.e. a frequency of 5.8%. Among the 164 asthmatic patients 59.8% (n=98) were women with a sex ratio of 0.67. The average age of the study population was 31 ± 18.1 years, extremes of 5 and 81 years. More than half of the patients lived in urban areas (59.7%), and had no income (50.7%). Asthma was associated with allergic rhinitis in 72.6%. Only 45 patients had performed prick tests,among which sensitization to house dust mites (n=37/45; 82.2%) was frequent and dominated by Dermatophagoides pteronyssinus (n=32/37; 86.5%). Sensitization to Blomia tropicalis was 73.0% (n=27/37). Sensitization to animal dander (dogs and cats) was observed in 9 patients (n=9/45; 20.0%). No sensitization to Altenaria sp was noted. Proximal and distal obstructive ventilatory deficit was observed in 46.5% of cases (n=60/130).Conclusion: The prevalence of asthma is relatively high in our exercise context. The sensitization rate revealed is the witness of a strong allergenic pressure exerted by the domestic environment.

Comparative performance of four malaria rapid diagnostic tests, Vikia Malaria Pf/Pan, Meriline-Meriscreen Pf/Pv/Pan, Right Sign Malaria Pf/Pan, and Right Sign Malaria Pf, among febrile patients in Gabon

Abstract INTRODUCTION: Rapid diagnostic tests (RDTs) are selected based on their performances. Here, we compared the diagnostic performance of different malaria RDTs. METHODS: Febrile patients were tested for malaria using Vikia Malaria Pf/Pan, Meriline-Meriscreen Pf/Pv/Pan, Right Sign Malaria Pf/Pan, and Right Sign Malaria Pf RDTs at Melen Regional Hospital in Gabon. RESULTS: In total, 120 of 274 tested children (43.8%) had malaria. The sensitivity was > 95% for all RDTs, while the specificity was > 85% for two tests. One test generated invalid tests (8%). CONCLUSIONS: Based on their performances, all tests except one may be recommended for malaria diagnosis.

Homozygosity for the CD1E*02 allele is associated with a resistance to Plasmodium falciparum malaria infection in Gabonese school children

OBJECTIVE@#To explore the possible association between polymorphisms in CD1 genes and both asymptomatic and mild Plasmodium falciparum infection.@*METHODS@#Two clusters of 85 school children, from the village of Dienga (Gabon) were investigated. The first group was analysed for the prevalence and the multiplicity of asymptomatic P. falciparum infection, whereas the second group was screened for the frequency of malarial attacks.@*RESULTS@#Our findings showed that homozygosity for the CD1E*02 allele was associated with a low frequency of malarial attacks. Furthermore, a strong association between CD1E*02 homozygotes and the resistance to multiple malarial attacks was identified. The CD1A*01 allele showed a weak association with a small number of malarial attacks.@*CONCLUSION@#Our results suggest a possible role of CD1E polymorphisms in malaria protection among school children and that CD1e molecules are involved in anti-malarial immunity.

Homozygosity for the CD1E*02 allele is associated with a resistance to Plasmodium falciparum malaria infection in Gabonese school children

Objective To explore the possible association between polymorphisms in CD1 genes and both asymptomatic and mild Plasmodium falciparum infection. Methods Two clusters of 85 school children, from the village of Dienga (Gabon) were investigated. The first group was analysed for the prevalence and the multiplicity of asymptomatic P. falciparum infection, whereas the second group was screened for the frequency of malarial attacks. Results Our findings showed that homozygosity for the CD1E*02 allele was associated with a low frequency of malarial attacks. Furthermore, a strong association between CD1E*02 homozygotes and the resistance to multiple malarial attacks was identified. The CD1A*01 allele showed a weak association with a small number of malarial attacks. Conclusion Our results suggest a possible role of CD1E polymorphisms in malaria protection among school children and that CD1e molecules are involved in anti-malarial immunity.

Allelic Diversity of MSP1 Gene in Plasmodium falciparum from Rural and Urban Areas of Gabon

The present study determined and compared the genetic diversity of Plasmodium falciparum strains infecting children living in 2 areas from Gabon with different malaria endemicity. Blood samples were collected from febrile children from 2008 to 2009 in 2 health centres from rural (Oyem) and urban (Owendo) areas. Genetic diversity was determined in P. falciparum isolates by analyzing the merozoite surface protein-1 (msp1) gene polymorphism using nested-PCR. Overall, 168 children with mild falciparum malaria were included. K1, Ro33, and Mad20 alleles were found in 110 (65.5%), 94 (55.9%), and 35 (20.8%) isolates, respectively, without difference according to the site (P>0.05). Allelic families' frequencies were comparable between children less than 5 years old from the 2 sites; while among the older children the proportions of Ro33 and Mad20 alleles were 1.7 to 2.0 fold higher at Oyem. Thirty-three different alleles were detected, 16 (48.5%) were common to both sites, and 10 out of the 17 specific alleles were found at Oyem. Furthermore, multiple infection carriers were frequent at Oyem (57.7% vs 42.2% at Owendo; P=0.04) where the complexity of infection was of 1.88 (+/-0.95) higher compared to that found at Owendo (1.55+/-0.75). Extended genetic diversity of P. falciparum strains infecting Gabonese symptomatic children and high multiplicity of infections were observed in rural area. Alleles common to the 2 sites were frequent; the site-specific alleles predominated in the rural area. Such distribution of the alleles should be taken into accounts when designing MSP1 or MSP2 malaria vaccine.

Phlebotomus (Legeromyia) multihamatus subg. nov., sp. nov. from Gabon (Diptera: Psychodidae)

During a research project aimed at the study of the Culicinae fauna of Gabon and carried out in the National Park of La Lopé, we captured an unknown sandfly male specimen (genus Phlebotomus) by CDC miniature light trap belonging to a new species for Science. Furthermore, the originality of his genitalia does not allow us to include this species in one of the existing subgenus, thus in this paper we propose the creation of a new subgenus, as Phlebotomus (Legeromyia) multihamatus sp. nov., subg. nov. described from the National Park of La Lopé, through one male captured with CDC miniature light trap. A new species and a new subgenus of sandfly is characterised by a short style with three spines, a paramere wearing a basal hook as well as a basal pouch and the absence of basal lobe on the coxite. The originality of the genitalia of the male gives way to discussion about potential primary homologies between P. multihamatus sp. nov. and Phlebotomus (Abonnencius) fortunatarum, Phlebotomus (Anaphlebotomus) stantoni and Phlebotomus (Euphlebotomus) argentipes, which should be verified for future studies. The discovery of this new species in Gabon must encourage the study of sandflies in this country.