Prevalence of Iron Deficiency, Anemia, and Associated Factors in a Blood Donor Population in Brazzaville, Congo.

Introduction: Blood donation is not without risk to the donor. It results in a substantial loss of iron and decreased hemoglobin. In our country, no predonation assessment is carried out and the selection of blood donors is only clinical. Objectives: To determine the prevalence of iron deficiency, anemia, and iron deficiency anemia and to identify the factors associated with anemia and iron status in a blood donor population at the National Center for Blood Transfusion (NCBT). Methodology. A prospective study is carried out that consists of 120 blood donors in three NCBT branches in the capital from June to November 2021. The donors were divided into 3 groups: first time donors (FTDs), occasional donors (ODs) who have already made between 1 and 3 previous donations, and regular donors (RDs) with at least 4 previous donations. Iron deficiency was defined by a serum ferritin value of less than 30 ng/mL in men and 20 ng/mL in women. Anemia was defined by Hb levels below 13 g/dL in men and 12 g/dL in women. Iron deficiency anemia was defined by association of anemia and iron deficiency. The chi-square test was used for the comparison of the proportions. The odds ratio with the 95% confidence interval was calculated to assess the association between two variables. The p value of the probability was considered significant for a value < 0.05. Results: Mean serum ferritin and hemoglobin values were lower in RD in both sexes. The prevalence of iron deficiency, anemia, and iron deficiency anemia were 16.66%, 31.66%, and 10.83%, respectively. The factors associated with the three abnormalities were female sex, donor type, including RD, and number of previous donations. Conclusion: Iron deficiency, anemia, and iron deficiency anemia are common among blood donors in Brazzaville. Anemia affects almost a third of blood donors and is not always linked to iron deficiency. Safety of donors should be improved by systematic measurement of ferritinemia and hemoglobin levels before allowing donations for appropriate management in the event of abnormalities.

Associated Factors of Cholelithiasis among Younger Children with Sickle Cell Disease at the National Reference Center for Sickle Cell Disease in Brazzaville, Congo.

Introduction: Chronic hemolysis predisposes sickle cell patients to the development of gallstones. Their frequency increases with age, but they may appear early in young children. In the absence of management, they expose the patient to complications that can hinder the quality of life and sometimes even death. This survey aimed to identify the associated factors of the occurrence of cholelithiasis. Materials and Methods: It was a case-control study carried out between January 2017 and June 2022 at the National Reference Center for Sickle Cell Disease (SCD) "Antoinette Sassou N'guesso" in Brazzaville. It concerned 37 children with cholelithiasis. Sociodemographic (socioeconomic status and diet) and clinical (body mass index, frequency of vasoocclusive crises and hospitalization for vasoocclusive crises, number of blood transfusion, and chronic complications) as well as hematological examination (type of SCD and blood count in the intercritical period) and hydroxyurea treatment were compared with those of 74 children with no clinical and radiographic signs of cholelithiasis. The chi-squared statistical test and the odds ratio were used for the comparison (p < 0.05). Results: The average age was 9.70 ± 1.73 years. The 10-12 age group was the most represented (22 cases or 59.45%), followed by 7- to 9-year-olds (12 cases or 32.43%). Three children (8.10%) were 6 years old. The sex ratio was 0.68 vs. 1.38. Factors associated with cholelithiasis were low socioeconomic status (83.78% vs. 45.95%; IC 95% 1.46-3.89; p ≤ 0.001), a higher number of blood transfusions (5.54 ± 1.22 vs. 2.46 ± 1.13; IC 95% 1.55-6.70; p ≤ 0.001), and irregular systematic monitoring (5.54 ± 1.22 vs. 2.46 ± 1.13; IC 95% 1.55-6.70; p ≤ 0.001). Conclusion: A national strategy to facilitate access to care for patients living with sickle cell disease is imperative. Moreover, emphasis should be placed on the prevention and early management of acute complications of SCD.

[Cervical tumefaction in a child at Brazzaville University Hospital, Republic of the Congo]. / Tuméfaction cervicale chez une enfant au CHU de Brazzaville, République du Congo.

A 8-year-old schoolgirl from West Africa with no previous pathological history was admitted to the haematology department of the Brazzaville University Hospital for the management of cervical adenopathy. The diagnosis of sinus histiocytosis or Destombes-Rosaï-Dorfman disease was retained and the patient was treated with PO corticosteroids (methylprednisolone 32 mg/d then 16 mg/d). Given the rarity and uncertain aetiopathogeny of this syndrome, treatment is poorly codified. It includes corticosteroid therapy, immunomodulators and sometimes chemotherapy, radiotherapy or surgery, indicated in case of clinical manifestations of local organ compression. The disease may regress spontaneously. Its benignity does not justify systematic treatment in the absence of complications.

Neonatal Screening for Sickle Cell Disease in Congo.

INTRODUCTION: Sickle cell disease is an autosomal recessive inherited disorder due to the mutation of a gene coding for the globin beta chain. The aim of this study is to update the epidemiological data on hemoglobinoses, in particular sickle cell disease in newborns in Congo. MATERIALS AND METHODS: This was a descriptive cross-sectional study, conducted from October 1, 2019, to March 31, 2020, throughout the Congolese national territory. It involved all full-term newborns, without distinction of nationality, aged 5 days or less, and whose parents consented to participate in the study. The blood samples, taken at the heel and collected on Whatman blotting paper, were analyzed using the HPLC Variant NBS machine. RESULTS: In 2897 newborns (NN) screened, hemoglobin abnormalities were found in 603 NN (20.81%). The mean age of these newborns was 1 day (extremes 0 and 5 days). The male-to-female ratio was 1.03. Abnormal hemoglobins were mainly Hb S (n = 597 (97.71%)); Hb C (n = 5 (0.82%)); and variants (n = 7 (1.15%)). The national prevalence of major sickle cell (MSC) syndromes and sickle cell trait was 1.35% and 19.43%, respectively. The prevalence ranged from 1.77% to 2.56% for MSS in four departments and from 20.5% to 25.8% for the sickle cell trait in six other departments. CONCLUSION: Data on homozygous sickle cell disease remain consistent with previous studies. However, further studies should clarify the molecular anomalies of the variants observed in our samples.