Seroconversion rate, mortality, and clinical manifestations associated with the receipt of a human immunodeficiency virus-infected blood transfusion in Kinshasa, Zaire.

To evaluate the consequences of receiving human immunodeficiency virus type 1 (HIV-1)-seropositive blood, 90 HIV-1-seronegative recipients of HIV-1-seropositive blood (case patients) and 90 HIV-1-seronegative recipients of HIV-1-seronegative blood, matched for age, sex, number of transfusions, diagnosis, and severity of illness (controls), were followed for 12 months after transfusion at Mama Yemo Hospital in Kinshasa, Zaire. Of case patients and controls, 72% were children transfused for anemia caused by malaria. Of the 46 case patients case patients alive 6 months after transfusion and for whom HIV-1 serologic results were obtained, 44 (96%) had seroconverted. Significantly more case patients (47%) than controls (16%) died within 1 year after transfusion (P less than .001). In the first 3 months after transfusion, fatigue, diarrhea, fever, cough, pruritus, pallor, oral candidiasis, polyadenopathy, hepatosplenomegaly, and rhinorrhea were observed more often among seroconverters than controls (P less than .04). Six percent of case patients and no controls had developed clinical AIDS after 12 months of follow-up. These findings underscore the urgent need for appropriate HIV screening facilities in transfusion centers worldwide.

Voluntary blood donor recruitment: a strategy to reduce transmission of HIV-1, hepatitis-B and syphilis in Kinshasa, Zaïre.

We evaluated the use of voluntary blood donor recruitment in Kinshasa, Zaïre, as a means of reducing transmission of HIV-1 and other infectious agents by blood transfusion. Between January 1, 1989, and April 7, 1989, 2,237 blood donors were enrolled in the study at the transfusion centre of the Mama Yemo Hospital. Each donor was tested for antibodies to HIV-1 confirmed by IFA and Western blot, Treponema pallidum, antibodies to hepatitis B virus (HBV) core antigen and screened for the presence of the HBV surface antigen. Test results were related to the data of the blood donors: age, sex, haematocrit, voluntary blood donor, family member donor, paid donor. The serological results of all donors for Anti-HIV-1. Anti-HBc, HBsAg and TPHA were 4.8%, 70.9%, 13.1% and 13.3% respectively. Lower seroprevalence rates were found among voluntary blood donors. However, only TPHA seroprevalence was significantly lower in voluntary blood donors (8.4%, 23/275) compared with paid donors (15.2%, 87/571) (p less than 0.01). A greater proportion of voluntary donors provides a store of blood which allows more extensive screening of blood for HIV-1 and other infectious diseases. Voluntary blood donor recruitment is critical for the provision of safe blood supplies in Kinshasa.

Prevention of transfusion-associated HIV transmission in Kinshasa, Zaire: HIV screening is not enough.

The purpose of this study was to develop a strategy to reduce transfusion-related HIV transmission which went beyond the limits of routine HIV screening of blood donors. Current blood transfusion practices were assessed in 1044 patients for whom staff physicians had requested a transfusion between 5 September and 19 October, 1988. Children under 5 years of age with malaria, and pregnant women with acute anaemia requiring blood transfusion were the two highest risk groups. Many of the transfusions were given without an obvious medical indication; 22.7% (214 out of 955) of the recipients were transfused without prior laboratory tests [haemoglobin (Hb) or haematocrit (Hct)], 7.2% with Hb greater than 6g/100ml or Hct greater than 25% and 16.6% without clinical signs of severe anaemia (pulse less than 100/min without shortness of breath). The data of this study were used to organize a workshop for all the physicians responsible for blood transfusions in Kinshasa and two nearby health zones. A consensus statement on the indications for blood transfusion was developed. Subsequently, transfusion centres adopted this consensus statement instead of previous guidelines.

[Effect of glycolysis inhibitors on the uptake of metronidazole by the protozoa Tritrichomonas foetus and Entamoeba invadens]. / L'action des inhibiteurs de la glycolyse sur l'absorption du métronidazole par les protozoaires Tritrichomonas foetus et Entamoeba invadens.

Uptake of metronidazole by the anaerobic protozoa, Tritichomonas foetus and Entamoeba invadens is dependent on the energy metabolism of these organisms. The inhibitors of glycolysis, iodoacetamide and sodium fluoride, inhibit the uptake. An atmosphere of hydrogen eliminates this inhibition in the hydrogenase-containing T. foetus but not in E. invadens which lacks the enzyme.

Guide pratique de la transfusion

Le guide pratique de la transfusion a ete concu comme un outil dont la destination est triple a savoir informer le personnel medical sur les causes d'anemie au Zaire et leur prevention; aider le personnel medical a poser correctement les indications de la transfusion sanguine de facon a eviter toute transfusion qui ne soit pas indispensable; compte tenu des risques importants de cette therapeutique et; fournir a ce personnel les informations utiles et les instructions pratiques concernant le recrutement des donneurs; les examens a pratiquer sur le sang donne; l'application de la transfusion ainsi que l'information du donneur sur les resultats des examens effectues sur son sang. Il s'adresse donc a toute personne faisant partie du corps medical et paramedical; aussi bien au medecin exercant dans un hopital qu'a l'infirmier travaillant dans un centre de sante en milieu urbain ou rural