[External evaluation of the quality of CD4 T cells enumeration in the laboratory of immunology and hematology at the Cocody University Hospital Center]. / Evaluation externe de la qualité de la numération des lymphocytes T-CD4 au laboratoire d'immunologie et hématologie du CHU de Cocody.

INTRODUCTION: The rate of T lymphocytes-CD4 (TLR4) is a crucial parameter for therapeutic decision and follow-up in patients with Human Immunodeficiency Virus (HIV) infection. This must be determined in a reliable and accurate way. The laboratory of immunology and hematology at the Cocody University Hospital Center has participated in the External Quality Assessment program (EQAP) for TLR4 enumeration provided by QASI (Quality Assessment and Standardization for Immunological Measures Relevant to HIV/AIDS) in order to deliver quality results. This study aims to assess laboratory performance in TLR4 enumeration. METHODS: We conducted a retrospective study to evaluate the laboratory performance reports from EQAP. Performance indicators such as SDI (Standard Deviation Index) and CV (coefficient of variation) were evaluated. RESULTS: Program participation rate was 83.33%. Performance indicators were satisfactory. The majority of SDI were included in the confidence interval [-2; +2]. The CV of samples with normal CD4 values were within the standards. Compliance rate of CD4 results was 89.58% and 91.87% for the absolute and the relative performance respectively. The CV of samples with low CD4 rates were beyond the standards (>15%). CONCLUSION: EQAP is an indispensable tool enabling laboratory to monitor the quality of its analyses. However, corrective measures should be strengthened during the follow-up period to sustain and improve the quality of the analyses.

[Malaria serology test: what contribution does it make in an endemic country such as Ivory Coast?] / Sérologie palustre: quel apport dans un pays d'endémie palustre comme la Côte d'Ivoire?

INTRODUCTION: Malaria serology test seems to have attracted very little interest in endemic countries such as Ivory Coast. However, this examination has been regularly performed in the parasitology laboratory at the Training and Research Unit of Medical Sciences in Abidjan. Our study aimed to highlight the contribution of malaria serology test in our endemic country context. METHODS: We conducted a retrospective study of malaria serology test using Falciparum-Spot IF (bioMerieux) kit for the detection of IgG antiplasmodial antibodies. It included all malaria serology tests performed from January 2007 to February 2011 and whose results were available in the registry. RESULTS: In total, 136 patients were selected. The average age of patients was 36,3 years, ranging from 1 to 81 years, and sex ratio was 0,97. Indications for malaria serology test were varied and dominated by splenomegaly (49.3%), cytopenias (14.7%), indeterminate fever (13.2%). Almost all of the patients (98.5%) had antiplasmodial antibodies with high medium titer of 1057,35IU/ml. There was no link between age and Ab titer, which was higher in cytopenias, prolonged fevers and the splenomegaly. CONCLUSION: Malaria serology test seems to have attracted very little interest in routine clinical practice provided in our endemic area because, whatever the reason of the prescription, titers were high.

Sérologie palustre: quel apport dans un pays d'endémie palustre comme la Côte d'Ivoire?

Introduction: la sérologie palustre semble avoir peu d'intérêt dans les pays d'endémie comme la Côte d'Ivoire. Cependant cet examen a été régulièrement réalisé au laboratoire de Parasitologie de l'Unité de Formation et de Recherche Sciences Médicales d'Abidjan. Le but de notre étude était d'apprécier l'apport de la sérologie palustre dans notre contexte de pays endémique.Méthodes: nous avons réalisé une étude rétrospective portant sur la sérologie palustre qui a utilisé le kit Falciparum spot-IF de Biomérieux à la recherche d'anticorps antiplasmodiaux d'isotype IgG. Elle a concerné les sérologies réalisées de janvier 2007 à février 2011 et dont les résultats étaient disponibles dans le registre.Résultats: au total, 136 patients ont été sélectionnés. L'âge moyen était de 36,3 ans avec des extrêmes de 1 an et 81 ans et un sex-ratio de 0,97. Les indications de sérologie palustre étaient variées, dominées par la splénomégalie (49,3%), les cytopénies (14,7%), la fièvre d'origine indéterminée (13,2%). La quasi-totalité des patients (98,5%) avaient des anticorps antiplasmodiaux avec un titre moyen élevé à 1057,35UI/ml. Il n'existait pas de lien entre l'âge et le titre d'Ac qui était plus élevé pour les cytopénies, les fièvres prolongées et la splénomégalie.Conclusion: la sérologie palustre a peu d'intérêt dans notre pratique courante en zone d'endémie car quelque soit le motif de la prescription, les titres étaient élevés

Immunity Status of Blood Donors Regarding Toxoplasma gondii Infection in a Low-Income District of Abidjan, Côte d'Ivoire, West Africa.

Background. Toxoplasmosis is a widespread cosmopolitan anthropozoonosis, which affects more than a third of the world population. Except the modes of transmission well known, Toxoplasma gondii can be transmitted during transplantation or blood transfusion. The aim of this study is to determine the prevalence of IgG and IgM Toxoplasma gondii and to estimate the potential risk by blood products. Methods. This is a cross-sectional study on the research for Toxoplasma gondii antibodies (IgG and IgM) blood donors performed by ELISA. Results. An overall seroprevalence of Toxoplasma gondii among blood donors recruited was 67.92% (n = 72). Among these, 68 have Toxoplasma gondii IgG (64.15%), 12 Toxoplasma gondii IgM (11.32%), and 4 (3.77%) both. The risk varies between 8 for 100000 and 172 for 100000 donations. Conclusion. The need to strengthen security measures for people multitransfused, immunocompromised, and pregnant women to reduce the transmission of toxoplasmosis is important.

ABO/Rh Blood Groups and Risk of HIV Infection and Hepatitis B Among Blood Donors of Abidjan, Côte D'ivoire.

Hepatitis B and HIV infection are two viral infections that represent real global public health problems. In order to improve their management, some hypotheses suggest that genetic predispositions like ABO and Rh blood groups would influence the occurrence of these diseases. The aim of the present study was to examine the association between ABO and Rhesus blood groups and the susceptibility to HIV infection and hepatitis B. We conducted a cross-sectional and analytical study in a population of voluntary blood donors in the Blood Transfusion Center of Abidjan. All blood donors who donated blood between January and June 2014 were tested for HBs antigen and anti-HIV antibodies (ELISA tests) and were ABO typed. The total number of examined blood donors during this period was 45,538, of which 0.32% and 8.07% were respectively infected with HIV and hepatitis B virus. O-group donors were more infected than non-O donors. Our study is an outline concerning the search for a link between ABO and Rh blood groups and hepatitis B and HIV infection. Further studies should be conducted to confirm the interaction between these two infections and contribute to the search for new therapeutic approaches.

[Pulmonary events induced by non-steroidal anti-inflammatory drugs in patients with sickle cell disease]. / Manifestations respiratoires induites par les anti-inflammatoires non stéroïdiens chez le drépanocytaire.

Painful sickle cell crises are among the principal manifestations of sickle cell disease. Their treatment routinely requires the use of non-steroidal anti-inflammatory drugs (NSAIDS). These drugs also, however, inhibit the cyclooxygenase cycle in arachidonic acid metabolism, promoting the synthesis of leukotrienes, which have bronchoconstrictive effects. This study took place from March through August, 2007, and included 100 patients of both sexes, aged 2 to 59 years, with any sickle cell phenotype (SS, SC, AS, SFA2, or SAFA2) and treated by NSAIDs in the Immunology and Haematology department of the University Hospital of Cocody. We analysed the characteristics of the respiratory events induced by taking NSAIDs to identify potential risk factors for their occurrence. We found that 5% of these patients presented respiratory symptoms linked to NSAIDs. These appeared within 30 minutes of drug intake for 80%; in 60% of these cases, only corticosteroid and antihistamine treatment resolved these symptoms. The occurrence of respiratory events did not differ by sex; however, younger subjects were more exposed to these respiratory events. All patients with family or individual history of atopy-like hypersensitivity type I events presented these respiratory symptoms when taking NSAIDS for sickle-cell crises.