Evolution fatale à moyen terme d'une cirrhose virale C traitée par bithérapie pégylée

La prévalence de l'hépatite C au Congo-Brazzaville est élevée avec prédominance du génotype 4. Nous rapportons un premier cas clinique traité dont la réponse virologique en fin de traitement a été négative du fait que la patiente présentait tous les facteurs prédictifs de mauvaise réponse. L'évolution s'est faite vers les complications classiques mortelles. Les limites d'accès aux explorations et au traitement ont influencé négativement l'évolution. Nous venons de présenter un premier cas d'hépatite C traité à Pointe-Noire avec échec thérapeutique. Ce premier cas de notre expérience nous a permis de vivre la réalité de l'histoire naturelle et des difficultés de la prise en charge de l'hépatite C à Pointe-Noire

[Mycobacterial species repartition: experience of the Antituberculosis Center in Pointe Noire (Republic of Congo)]. / Répartition des espèces de mycobactéries dans une série de tuberculoses pulmonaires au Centre antituberculeux de Pointe Noire (République du Congo).

The aim of the present work was to describe mycobacteria species isolated in the antituberculosis center of Pointe-Noire city in Congo Brazzaville. It was a descriptive transversal study, conducted between September 2008 and April 2009 (7 months). A simple random sample was established from patients who came to the antituberculosis center of Pointe-Noire City (reference center on diagnosis and treatment of tuberculosis). To those patients consulting with symptoms leading to suspect pulmonary tuberculosis, a sputum sampling in three sessions was conducted. Staining techniques to Ziehl-Neelsen and auramine were performed in Pointe-Noire. Culture, molecular hybridization and antibiotic susceptibility testing to first-line antituberculosis drugs (isoniazid, rifampicin, ethambutol, pyrazinamide or streptomycine) using diffusion method on agar were performed in Cerba Pasteur laboratory in France. In 77 patients, 24 sputum (31.20%) were positive to the microscopic examination and 45 (58.44%) to the culture and identification by molecular hybridization. Mycobacteria species complex isolated were M. tuberculosis with 31 cases (68.9%) and M. africanum with 3 cases (6.67%). Non-tuberculous mycobacteria (NMT) were isolated in association or not with M. tuberculosis in 9 cases (20%) and the most common species were M. intracellulare. In M. tuberculosis species, 7 strains (41.20%) were tested sensitive to the first-line antituberculosis drugs, 8 cases (47%) monoresistance and 2 cases multidrug resistance at both isoniazide and rifampicine (12%) (MDR). This study showed the importance of Mycobacteria species complex and non-mycobacteria species in pulmonary tuberculosis. The data on resistance can help medical physicians in the treatment of pulmonary tuberculosis. Another study with a large population is required to confirm these data.

[Coincidental outbreaks of rotavirus and respiratory syncytial virus in Paris: a survey from 1993 to 1998]. / Coïncidence des épidémies de rotavirus et de virus respiratoire syncytial à Paris: une enquête de 1993 à 1998.

PATIENTS AND METHODS: In a pediatric hospital of Paris, from 1993 to 1998, respiratory secretions were positive for respiratory syncytial virus (RSV) in 26.3% of 4,738 children (0-5 years) examined or hospitalized for lower respiratory tract infections. Rotavirus detection was positive in stools of 23.7% of the 8,537 children of the same age with acute diarrhea. RESULTS: The RSV epidemic peak occurred annually in Paris in December and the rotavirus outbreak peaks were observed in December/January. The winter seasonal peaks remained constant for both pathogens and the temporal appearance of these peaks was constant from 1993 to 1998. Fifty to sixty-one percent of rotavirus and 77 to 92% of RSV infections were observed in November, December or January. These simultaneous outbreaks provoked important problems in hospital organization and prevention of nosocomial infections. CONCLUSION: The coincidence of RSV and rotavirus peaks is not found in all countries. The epidemic patterns have to be checked in other parts of France and Europe because this could be important when active immunization programs will be available for these two pathogens.

[Carrier state for HBs antigen and HBc antibody in Brazzaville (congo): sero-epidemiological study in the hospital and non-hospital environment]. / Portage de l'antigène HBs et de l'anticorps HBc à Brazzaville (Congo): étude séro-épidémiologique dans les milieux hospitaliers et non hospitaliers.

In Brazzaville (Congo), the prevalence of chronic carriage of HBs Ag (7.31%) we observed, is similar to the ones previously reported in 1981, 1982 and 1988. The sero-prevalence of anti-HBc is 67.21%. Anti-HBc are considered to be very relevant for the screening of VHB infection. Our study clearly points out that the highest prevalence of HBs Ag was observed among midwives. In all, the frequency distribution of the two serological markers we studied was similar in health workers and general population.

[Seroconversion following immunization with a plasma-derived vaccine against hepatitis B: study of a 3-injection protocol (0, 1, 6 months) in Brazzaville (Congo)]. / Séroconversion après immunisation par un vaccin plasmatique contre le virus de l'hépatite B: étude d'un protocole en 3 injections (0, 1, 6 mois) à Brazzaville (Congo).

The aim was to study the immunogenicity of a plasma-derived vaccine against Hepatitis B Virus administrated in 3 injections at month 0-1-6. Only subjects without HBs Ag and anti-HBc were vaccinated. The seroconversion rates were 79.21% at day 90, 77.50% at day 180 and 87.21% at day 210. At the same dates, the mean geometric titres of anti-HBs (mUI/ml) were respectively 115.01, 100.48 and 772.78. In all subjects, the vaccine was very well tolerated. This 3 injections protocol of vaccination instead of the classical 4 injections protocol significantly reduces the cost of vaccination and may enlarge its application.