Prevalence of hepatitis B virus serologic markers in pregnant patients in Antananarivo, Madagascar.

BACKGROUND AND OBJECTIVES: Hepatitis B virus (HBV) infection is a major public health problem in Madagascar. Its severity is related to the risk of chronicity, especially in case of neonatal contamination. Our objectives were to investigate the prevalence of HBV infection among pregnant patients at the Befelatanana obstetrics and gynecology teaching hospital department (BOGTH) by detecting HBsAg and to evaluate the risk of HBV mother to child transmission by screening for HBeAg. METHODS: We conducted a 6-month prospective study in the BTHOGD from February 2012 to July 2012. All pregnant patients consulting for antenatal care were screened for HBV serologic markers. RESULTS: The prevalence of HBsAg was 1.9% (20 out 1050 screened patients). The average age was 26.51 years (25-30 years). Most patients tested were unaware of their hepatitis B status and only 0.38% had been vaccinated before pregnancy. Only 1 (5%) of the 20 patients with HBsAg was positive for HBeAg. CONCLUSION: Hepatitis B is very frequent in pregnant patients in Madagascar and it is recommended that all pregnant patients be routinely screened for HBsAg. This screening of maternal infection would allow applying prophylactic measures to neonates to decrease the risk of disease chronicity.

Phenotypic and allelic profile of ABO and Rhésus D blood group system among blood donor in Antananarivo.

This study assessed the phenotypic and allelic profiles of ABO and Rhesus D blood group system among first time blood donors at the National Centre of Blood Supply of Antananarivo. We collected through this retrospective study all data registered during 7 years of practice (from 2003 to 2009). Age and sex were analysed with the result of ABO and RhD screening. They were tested both with Beth Vincent and Simonin tests which were performed in a plate, by using commercial monoclonal antibody (Diaclone(®) et Eryclone(®)), and home-made red cells tests. The Rh D was performed with the same commercial kits. The frequencies of alleles were calculated by using Bernstein method. Data about 45,857 donors were obtained. A male predominance (80.46%) was found and most of our donors were aged <40 (74.92%). 98.90% of the donors were Rh D positive. Phenotypic distribution of each ABO antigen was, respectively, 22.61, 29.66, 6.13 and 41.60% for A, B, AB and O antigen. Allelic frequencies of A, B and O were 0.1559, 0.1987 and 0.6454. These results confirmed the fact that Madagascan population had admixed ethnic origin.

Prevalence and trends of hepatitis C virus among blood donors in Antananarivo, from 2003 to 2009.

PURPOSE OF THE STUDY: Due to anemia and maternal, childhood and infancy diseases, blood transfusion is one of the most important medical cares given in sub-Saharan Africa, including Madagascar. World Health Organization encourages worldwide countries to maximize transfusion security. Until now, there was no data within a large population of blood donors. Therefore, the aim of this study was to assess the prevalence and time trends of hepatitis C virus (HCV) among all first-time blood donors coming into the National Centre of Transfusion Supply in Antananarivo. MATERIAL AND METHODS: This retrospective study was conducted at the National Centre of Transfusion Supply in Antananarivo from 2003 to May 2009. We looked up to all recorded results of systematic screening of blood donor candidates and we took data about all first-time blood donors, including age and gender. Forty-seven thousand five hundred and ten of 47,636 first-time blood donors were retained, the others were excluded due to lack of some data. RESULTS: The mean age of our donors was 33.3 years (35.8 for male, and 32.6 for female; P<<0.05). Eighty percent were male (38,225/47,510). HCV prevalence was 0.65% during the period of study and HCV positive donor candidates were older than HCV negative (mean age: 39.1 vs. 33.2; P<<0.05). It was in fact stable from 2003 to 2007, and then decreased. HCV prevalence was higher in women than in men (0.9 vs. 0.6; P<0.05), and it increased by age (P<0.05). CONCLUSION: Our study found a low prevalence of HCV among blood donors compared to many countries in Africa.

Seroprevalence du VIH chez les donneurs de sang au Centre National de Transfusion Sanguine d'Antananarivo de 2003 a 2009

Introduction. La securite transfusionnelle est primordiale pour la prevention des infections transmissibles par l'acte transfusionnel; notamment l'infection par les virus des hepatites B et C; et l'infection a VIH. Peu de donnees sont disponibles concernant l'infection au VIH chez les donneurs de sang a Antananarivo. Notre objectif est d'evaluer la seroprevalence de l'infection au VIH pour les premiers dons au Centre National de Transfusion Sanguine d'Antananarivo sur une periode allant de janvier 2003 a mai 2009. Methode. Il s'agit d'une etude retrospective; et nous avons analyse les donnees medicales enregistrees dans le cahier de registre du centre. Le test du VIH a ete realise durant cette periode avec le kit Determine HIV1-2 (Abbott Laboratories; Japan). Resultats. Parmi les 47 635 premiers dons inclus; la seroprevalence du VIH augmentait de facon progressive; allant de 0;08en 2003; a 1;06en 2009. Il n'y a pas eu de difference du genre. Aucun sujet seropositif n'a ete retrouve chez les donneurs ages de plus de 60 ans. Conclusion. Malgre cette tendance a l'augmentation; la seroprevalence du VIH est parmi les plus basses retrouvees en Afrique subsaharienne. Toutefois; il est urgent de reviser le questionnaire pour renforcer la puissance de cette premiere etape. L'amelioration de la technique de depistage est indispensable en ne restant pas seulement sur le test rapide du VIH

[In vitro activity of pristinamycin against Streptococcus pneumoniae]. / Activité in vitro de la pristinamycine sur Streptococcus pneumoniae.

The activity of the pristinamycin was investigated using disk diffusion agar or ATB PNEUMO system and MIC determination using reference liquid medium method (NCCLS) on 749 S. pneumoniae strains isolated in Aquitaine in 1999. We have realized the killing curves against 10 isolates selected from erythromycin-susceptible and resistant S. pneumoniae strains. All the strains tested by ATB PNEUMO system were susceptible to pristinamycin, using disk diffusion agar, 6.8% of strains were intermediate or resistant. However the MIC's of pristinamycin determined by liquid dilution method against these strains were < 1 mg/L. These data suggest that the zone of inhibition around the disk was not correlated with MIC for erythromycin pneumococci and MIC testing must be performed. The results of killing curves showed a very good and rapid bactericidal activity of pristinamycin within two hours for concentration equal to 4 x MIC and four hours for 2 x MIC.

[Estimation of normal hemogram values in Madagascar]. / Estimation des valeurs normales de l'hémogramme à Madagascar.

In Madagascar, as in several african countries, haematological normal values has not been established. To assess the haematological normal values in the laboratory of the Institut Pasteur de Madagascar, blood cell counts among 67 adults healthy malagasy volunteers, living in highlands of Madagascar, was performed. Blood was analysed with a Coulter STKS haematological autoanalyzer. A significant difference was noted between both sexes for the count of red blood cells, leukocytes, platelets, neutrophile polynuclears, eosinophile polynuclears, lymphocytes and for haemoglobin and haematocrit values. Our data were compared to those of different african and caucasian populations.

[Acquired antibiotic resistance in Madagascar: first evaluation]. / Résistances acquises aux antibiotiques à Madagascar: première évaluation.

The purpose of this study was to evaluate the incidence of acquired resistance to antibiotics in Madagascar. Testing was carried out on total of 1267 strains of medically significant bacteria isolated from specimens sent to the Pasteur Institute of Madagascar in Antananarivo between October 1997 and October 1998. Antibiograms were performed using the diffusion technique on gel media with antibiotic disks. Results were read according to the criteria of the Antibiogram Committee of the French Society of Microbiology. Preliminary findings documented a high incidence of resistance to widely available, low-price antibiotics including penicillin G and tetracycline for which 84 p. 100 and 65 p. 100 of Staphylococcus aureus respectively demonstrated resistance; tetracyclin to which 80 p. 100 of streptococcus were resistant; and ampicillin, cotrimoxazole, and phenicoles to which 60 p. 100, 60 p. 100 and 28 p. 100 of Escherichia coli respectively and 77 p. 100, 83 p. 100, and 71 p. 100 of Shigella sp. respectively were resistant. Second-line antibiotics including penicillin M, macrolides, nalidixic acid, and nitrofuranes were still relatively active, thus providing an effective alternative. Newly developed antibiotics such as fluoroquinolones and third-generation cephalosporines were highly effective but a few resistant strains were observed. Although not representative of Madagascar as a whole, the findings of this preliminary study indicate that acquired resistance must be taken into account in designing simplified decision charts for front-line laboratories, that appropriate information must be made available to health care workers, and that further testing is needed to monitor the evolution of antibiotic resistance.