[Evaluation of clinical response by hydroxyurea in 132 patients with major sickle cell anemia]. / Evaluation des effets cliniques de l'hydroxyuree chez 132 patients drepanocytaires homozygotes.

Hydroxyurea is used since close to 10 years in the treatment of major sickle cell anemia. In African sub Sahara, very little study have been dedicated. Yet, this drug represents nowadays, an alternative tot the bone marrow transplantation in the treatment of this illness. This study permits to illustrate the beneficial effects of this drung on 132 patients affected by of major sickle cell anemia. It is about patients whose middle age is of 28 years (range 14 and 54 years), most frequently masculine sex, followed regularly in the service of haematology of CHUB. The treatment consisted to the administration of the hydroxyurea to the posology between 10 and 30 mg/kg per day. The essentially clinical assessment focused on the sickle cell anemia crises and the modifications of hematologic's parameters. The experimentation has been pursued beyond the 18th month among 108 patients. It takes out again of this survey disappearances of the vasculo occlusive crises among 103 patients on 132 (78.03%) during the first 18 months of the survey. Only 10 patients (7.57%) benefited blood transfusion during the period of the survey because of the infectious complications. The hydroxyurea led a meaningful and spontaneous increase of the haemoglobin rate (+2,54 g/dl) of the middle globular volume (+ 16,02 femtolitres) as well as of the rate of haemoglobin foetale on 65 estimated patients. The hydroxyurea didn't bring any objective improvement on the pre-existing dénénératives complications. The treatment has been interrupted precociously among 5 patients for cytopenia. This survey confirms to short and middle term the beneficial effects of the hydroxyurea on the major sickle cell anaemia.

[Seroprevalence of viral hepatitis C in polytransfused patients at Central University Hospital of Brazzaville]. / Séroprévalence de l'hépatite virale C chez les malades polytransfusés au CHU de Brazzaville.

The viral C hepatitis is a disease which is often asymptomatic but with a very high risk of death. A prospective survey on multitransfused patients with a high transfusional risk has been conducted between May 1st and September 30th, 2001 in the medical services of the Hospital of Brazzaville. It deals with 252 samples of blood taken on 132 multitransfused patients and 120 control cases who have never been transfused. The screening of antibodies has been performed with ELISA technique by using 2 sensitive tests: the monolisa anti-HCV plus version 2 (Bio-Rad) and BIOTEC HCV a.b. Only monolisa is registered by AFSSAPS. The survey shows a overall seroprevalence of 13.9%: multitransfused patients: 26 out of 132 (19.7%) and control cases 9 out of 120 (7.5%). The prevalence of anti-HCV antibodies is practically similar in both series. It is low among control cases before 20 years old, but important in this same group when the patients are multitransfused. It is very significant among adult control cases, indicating the probability of other transmission modes in this age bracket. Patients suffering from hemoglobinopathy (sickle cell) and from malignant hemopathy paid an heavy toll to the virus with respectively 16.9% and 22% of prevalence even if the sampling is restricted. This results point out the necessary implementation of a systematic screening of all the main viruses before transfusion.

[Epidemiologic, clinical and hematologic profile of K Woolwich hemoglobinopathies in Ivory Coast]. / Profil épidémiologique, clinique et hématologique de l'hémoglobine K Woolwich en Côte d'Ivoire.

From 1968 to 1992, the hematology laboratory at the University Hospital Center of Abidjan performed 197705 hemoglobin electrophoreses. Isoelectric focusing using the Basset technique allowed identification of hemoglobin K Woolwich. This abnormality of hemoglobin structure (beta 132 (H10) Lys ... Glu) was detected in 130 cases, i.e. 0.065%. It was homozygous in 3 cases, heterozygous in 110 cases, and associated with other hematologic abnormalities in 17 cases. The abnormality was asymptomatic and did not cause any hematological disturbance. Due to autosomal transmission, hemoglobin K Woolwich is a trait of Akan populations (75% of cases) in which it is dominant in the Attie subgroup. Given its ethnic specificity, this abnormality is of anthropological interest.

[Clinical and hematological profile of Lepore Hemoglobin in Ivory Coast]. / Profil clinique et hématologique de l'hémoglobine Lepore en Côte d'Ivoire.

Out of 97320 hemoglobin electrophoreses performed in Abidjan between January 1976 and January 1991, all subjects with hemoglobin Lepore were isolated. This trait was identified by three techniques, i.e., alkaline pH electrophoresis, acid pH electrophoresis, and isoelectric focusing. Seventy-nine cases of hemoglobin Lepore were observed. All were heterozygotes with type HbA-Lepore (n = 54), HbC-Lepore (n = 8) or HbS Lepore (n = 17). Where heterozygosis A and C had clinically silent, heterozygosis Hb-S Lepore resulted in a moderate chronic hemolytic anemia and, in all cases, painful episodes similar to those observed during homozygote sickle-cell disease. However the onset of episodes was later and their occurrence was less frequent. On hemograms, the Lepore trait (HbA Lepore) appeared as a pseudo-polyglobulia with microcytosis; similar features were observed for heterozygosis HbC Lepore. Heterozygosis HbS Lepore caused moderate anemia (mean hemoglobin level: 10.66 g/dl) and microcytosis (MGV = 68.8 fl). The characteristics show that the clinical and hematological behavior of hemoglobin Lepore, a rare hemoglobin, is similar to heterozygous beta-thalassemia.