[Evaluation of two methods for haemoglobin measurement in Cameroonian blood donors]. / Evaluation de deux techniques de dosage de l'hémoglobine chez des donneurs de sang camerounais.

In order to identify a rapid feasible and adaptable method of haemoglobin measurement for use in a blood bank, two methods were evaluated against the automated method in 204 blood donors in Yaoundé, Cameroon. Anaemia was defined as Haemoglobin<12 g/dl. Using the World Health Organisation (WHO) haemoglobin colour scale (HCS), the Hemocue method (HemoCue AB, Angelhom, Suède) and the Celly Electronic counter (Hycel Diagnostics, Reims, France), anaemia was found in 27.5, 29.4 and 31.9% of donors respectively (P<0.05). The sensitivity and specificity of the HCS was 75.38 and 94.96% respectively compared to 86.15 and 97.13% respectively in the HemoCue method. Correlation studies between each method compared to automated method showed r=0.70 for the WHO. colour scale method and 0.91 for the Hemocue method. Using the Bland and Altman statistical method, the haemoglobin distribution around the mean was wider in the WHO scale (-2.74;+2.96) than in the Hemocue method (-2.06; +1.38). We conclude that while the two methods can be used to detect anaemia in the blood bank, that the Hemocue method is more sensitive and more specific.

Interactions between human immunodeficiency virus and herpes viruses within the oral mucosa.

There is evidence from clinical case reports and epidemiological studies that human immunodeficiency virus (HIV) can be transmitted through oral sex. Herpes viruses that appear in the oral mucosa might influence the oral replication of HIV. A review of data suggesting that interactions occur between HIV and herpes viruses indicates that such interactions might operate in the oral mucosa. Defining the mechanisms by which herpes viruses interact with HIV in the oral mucosa should permit intervention measures to be targeted more precisely.

[Stress fracture of the femur: a rare complication of sickle cell disease]. / Fracture de stress du fémur dans la drépanocytose: une complication rare.

A 24-year-old patient with homozygous sickle cell disease developed a stress fracture of the femur. Successive x-rays demonstrated defective ossification and a spontaneous unicortical fracture with no notion of trauma or stressful activities (e.g. sports) followed six months later by a bicortical fracture with displacement and periosteal reaction leading to the diagnosis of stress fracture. This type of fracture has not been reported previously in sickle cell disease. The patient was treated with centromedullary nailing. The follow-up was uneventful. Bone healing was achieved at three months. The patient was pain free and could walk without crutches. Stress fracture is a potential diagnosis in homozygous sickle cell disease patients with defective ossification who present spontaneous pain even when plain x-rays do not visualize an overt fracture. Computed tomography or magnetic resonance imaging should be performed when available. Conventional treatment with nailing provides successful cure with good functional outcome.

Serological and virological characterization of HIV-1 group O infection in Cameroon.

OBJECTIVES: To study the presence of HIV-1 group O infection among HIV-infected people in Cameroon and to further characterize the HIV-1 group O infections. DESIGN AND METHODS: During a 2-year survey (1994-1995), all samples tested positive in screening methods in the National Reference and Public Health Laboratory, Centre Pasteur, Yaoundé, Cameroon were identified as HIV-1 group M, HIV-1 group O or HIV-2 by using a serological algorithm. HIV-1 group M and HIV-1 group O were distinguished on the basis of competitive enzyme-linked immunosorbent assay (ELISA) reactivity against gp41 group M recombinant protein. HIV-1 group O infections were confirmed by using group O-specific V3 synthetic peptides. HIV-1 group O strains were isolated by lymphocyte cocultures, proviral DNA was amplified with specific primers, and sequencing was performed on the C2V3 and gag regions. RESULTS: Of the 8,331 screened samples, 3,193 were HIV-reactive, 2,376 (74%) of which were considered to belong to group M. The 817 (26%) that had reacted poorly or not at all against group M gp41 were further characterized: 10 were confirmed as HIV-2 and 82 as HIV-1 group O, the others being indeterminate (n = 285) or negative (n = 440). The frequency of group O relative to group M ranged from 1% in Far North province to 6.3% in the capital. There was no difference in sex, age or frequency of clinical manifestations between group M and group O infections. Group O infection was confirmed in a subset of cases by polymerase chain reaction (n = 14), with perfect concordance. Sequencing and phylogenetic analyses confirmed the high variability inside group O. CONCLUSIONS: Group O and group M epidemiological patterns are known to be similar so the reason for the lower prevalence of group O remains to be found. The wide distribution of group O infection in all Cameroonian provinces underlines the importance of further characterizing the epidemic spread and diffusion of this group.

Pneumopathies communautaires de l'adulte dans un milieu hospitalier a Douala: epidemiologie et clinique

Les caracteristiques epidemiologiques et cliniques de 43 malades ages de 15 a 81 ans (moyenne = 45) admis consecutivement de mars a juin 1992 pour pneumopathie communautaire dans un hopital de 200 lits a Douala sont rapportees par les auteurs. La pneumopathie communautaire de l'adulte represente 4;6 pour cent des admissions dans cet hopital avec un sex-ratio de 2;3 et un taux eleve de population urbaine (70 pour cent). Les facteurs de risque les plus frequents etaient l'alcoolisme (67;4 pour cent); le tabagisme (44;5 pour cent) et l'infection a VIH (20;9 pour cent). [abstract terminated]

L'experience de filles libres educatrices a Yaounde dans la prevention des MST et du SIDA

Dans le cadre du Programme National de Lutte contre le SIDA au Cameroun; l'utilisation des filles libres educatrices a ete une des strategies adoptees ciblant les groupes a haut risque. Des resultats preliminaires ont ete presentes ailleurs et ont montre son positif impact. Afin d'evaluer cette strategie; une enquete de connaissances; attitudes; croyances et pratiques (ACP) aupres des filles qui pratiquaient la prostitution a Yaounde a ete faite. Cette enquete a eu pour but non seulement de faire le point sur les differentes actions educatrices menees aupres de ce groupe mais aussi de mettre sur pied des methodes d'education plus efficaces

HIV and chlamydia infections among prostitutes in Yaoundé, Cameroon.

Eleven selected prostitute leaders were recruited who subsequently recruited 157 of their peers, bringing the total to 168. Sera was collected and tested for antibodies to HIV-1 and HIV-2 using a commercial enzyme-linked immunoabsorbent assay (ELISA); positive cases were confirmed by Western Blot (Dupont). A direct immunofluorescent method was performed on smears from the endocervical junction. Twelve of 168 (7.1%) of the women tested were found to be HIV-1 positive; none were found positive for HIV-2. Sixty six of 168 (38.3%) were found to be Chlamydia trachomatis (CT) positive; three cases (1.8%) were found to be positive for both HIV-1 and CT. Prostitutes are a high risk group in Yaoundé for HIV and chlamydia infections. The results in this study may not reflect the seriousness of the situation given the selected population used. Similar studies still need to be carried out. Prostitutes need to be educated about AIDS, other STDs and the use of condoms to protect their clients and themselves.

[Biliary calculi in adults in Cameroon. Epidemio-clinical and morphological aspects (apropos of 52 cases seen in Yaounde)]. / La lithiase biliaire de l'adulte Camerounais. Aspects épidémio-cliniques et morphologiques (a propos de 52 cas observés à Yaoundé).

Fifty-two cases of cholelithiasis were retrospectively studied in the Central Hospital of Yaounde over a period of 30 months. Nineteen males and 33 females with an average age of 40 years (range from 15 to 70 years). Forty-six p.c. of these patients had asymptomatic cholelithiasis and most of it consisted in only one gallstone. Etiologic factors found were: sickle-cell anemia, obesity, pregnancy and cirrhosis.