[Sickle cell beta-thalassemia leading to serious ischemic retinopathy: a study of 18 patients in Abidjan]. / Les bêtathalasso-drépanocytoses pourvoyeuses de rétinopathies ischémiques graves. A propos de 18 patients étudiés à Abidjan.

The authors in this study intended to demonstrate that S-beta thalassemia can lead to severe ocular hemorrhagic risks, as is true of the sickle cell form. Both forms are also comparable in terms of the risk of aseptic necrosis of the femoral head. Out of the 18 patients studied, 13 (72.2%) had sickle cell retinopathy. Three of 13 patients had already developed new vessels and risked intravitreous hemorrhage. The authors recommend that more vigilance be mounted for the detection of S-beta thalassemia so as to benefit from rigorous and systematic follow-up and early treatment. Retinal argon laser photocoagulation is only effective if a clear diagnosis is made early.

Evaluation in vivo de l'efficacite de la chloroquine dans le traitement du paludisme a plasmodium falciparum non complique a la PMI de Danane : protocole OMS de 14 jours

Ce travail qui est une etude prospective; s'est deroulee du 25 novembre 1999 au 28 fevrier 2000 a la PMI de Danane. L'objectif a ete d'evaluer les reponses clinique et parasitologique de la chloroquine dans le traitement du paludisme non complique a Danane (Cote d'Ivoire). Deux cents trente huit (238) enfants ages de 6 mois a 59 mois et selectionnes sur la base d'un acces febrile isole ont beneficie d'une goutte epaisse et d'un frottis sanguin. Le protocole OMS de 14 jours (1996) a ete utilise pour cette etude. Soixante cinq enfants repondaient aux criteres d'inclusion. Des controles cliniques et ou parasitologique ont ete effectues au jour 1; au jour 2; au jour 3 au jour 7 et au jour 14. Au terme de l'etude; les resultats suivants ont ete obtenus : 54 patients (83;07 pour cent.) ont presente une reponse clinique satisfaisante; 11 patients (16;93 pour cent) ont evolue essentiellement vers un echec therapeutique tardif; une bonne tolerance de la chloroquine avec un faible taux (9;23 pour cent) d'effet secondaire a titre de prurit; Au vu de ces resultats il ressort que la chloroquine a la dose de 25 mg par kg repartis sur 3 jours reste toujours efficace (sur les plans clinique et parasitologique) dans cette zone; nous conseillons l'utilisation de la chloroquine en traitement de premiere intention de l'acces palustre simple a Danane

Contribution a l'etude de la letalite de la rougeole a Abidjan de 1995 a 1999

C'est une etude retrospective qui avait pour objectif general d'analyser les cas de deces dus a la rougeole dans les centres hospitaliers d'Abidjan a savoir les services pediatriques de CHU de Yopougon et de Treichville; la pediatrie de l'hopital general de Port-Bouet et le Service des Maladies infectieuses et Tropicales (SMIT) de Treichville. A ete considere comme enfant decede de rougeole : tout enfant quelque soit sont age et son sexe; hospitalise dans un contexte en rapport avec la rougeole et dont l'issue fatale a ete rattachee a ce contexte. Au total; sur les 629 enfants hospitalises pour rougeole dans les centres de sante d'Abidjan pendant la periode d'etude; 92 deces ont ete enregistres; soit une letalite hospitaliere 14;6pour cent. Ces 92 deces ont ete analyses avec parfois l'absence de certaines donnees du fait de l'inexistance du dossier ou du manque d'informations dans le dossier. La tendance generale de la mortalite et de la letalite a ete a la baisse ; de 220 hospitaliere en 1995 on est passe a 41 en 199. La letalite hospitaliere est passee de 15;9 pour cent en 1995 a 1;3pour cent en 1999. 89pour cent des deces ont ete enregistres au cours du premier semestre de chaque annee. Les enfants d'age prescolaire etaient majoritaires (36;9pour cent). Les deces sont survenu pour 54;34pour cent pendant les 5 premiers jours d'hospitalisation. Les complication les frequentes etaient representees par les complications respiratoires (94;3pour cent) et metaboliques (32pour cent). Les complications et les deces enregistres sont survenu aussi bien chez les non vaccines que chez les vaccines. Une baisse plus significative de la letalite peut etre observee grace au relevement et au maintien correct du taux de couverture vaccinale contre la rougeole et une education sanitaire des populations

Exacerbation of autoantibody-mediated hemolytic anemia by viral infection.

Strong enhancement of the pathogenicity of an antierythrocyte monoclonal antibody was observed after infection of mice with lactate dehydrogenase-elevating virus. While injection of the antierythrocyte antibody alone induced only moderate anemia, concomitant infection with this virus, which is harmless in most normal mice, led to a dramatic drop in the hematocrit and to death of infected animals. In vitro and in vivo analyses showed a dramatic increase in the ability of macrophages from infected mice to phagocytose antibody-coated erythrocytes. These results indicate that viruses can trigger the onset of autoimmune disease by enhancing the pathogenicity of autoantibodies. They may explain how unrelated viruses could be implicated in the etiology of autoantibody-mediated autoimmune diseases.

[Markers of lipid peroxidation, inflammatory proteins and plasma tocopherols in homozygotic and heterozygotic sickle cell anemia]. / Marqueurs de la lipoperoxydation (LPO), protéines inflammatoires et tocophérols plasmatiques dans les drépanocytoses homozygote et hétérozygote.

Lipoperoxidation final products represented by the TBARS (substances reacting with the Thiobarbituric acid), inflammatory reaction proteins and sera tocopherol have been studied in homozygous forms as well as in heterozygous forms of sickle cell diseases. The significant increase of TBARS (P < 0.001) measured by spectrofluorimetry, the considerable decrease of the sera alpha gamma tocopherol, measured by HPLC (P < 0.005) in all sickle cell patients, especially in crisis homozygous form, reinforce our previous study (22, 23, 24). The absence of links between the TBARS and the tocopherols (fig. 1) suggests that other defence mechanisms occur without vitamin E. The collapse of haptoglobinemia in homozygous sickle cell patients associated with the fall of hemoglobinemia indicates a severe tissue and intravascular hemolysis as a consequence of LPO. Furthermore, the simultaneous decrease of cholesterolemia seems to indicate important lipoperoxide activity detected in sickle cell patients.

Involvement of CD4+ cells in the protection of C58 mouse against polioencephalomyelitis induced by lactate dehydrogenase-elevating virus.

Immunosuppression, occurring naturally with aging, or experimentally after cyclophosphamide treatment or irradiation, is required for the development in C58 mice infected with lactate dehydrogenase-elevating virus (LDV) of a severe polioencephalomyelitis that is caused by viral destruction of anterior horn neurons. Here it is shown that depletion of T helper lymphocytes by administration of an anti-CD4 antibody was followed by a progressive paralysis typical of polioencephalomyelitis in C58/J mice inoculated with a neurovirulent strain of LDV. Although it was clear that other cell subsets are also required to assure complete protection of genetically-susceptible mice, our results show that T helper lymphocytes play a major role in the prevention of LDV-induced polioencephalomyelitis. The mechanisms by which these cells confer this protection remain however to be determined.

[Epidemiologic, clinical and hematologic profile of K Woolwich hemoglobinopathies in Ivory Coast]. / Profil épidémiologique, clinique et hématologique de l'hémoglobine K Woolwich en Côte d'Ivoire.

From 1968 to 1992, the hematology laboratory at the University Hospital Center of Abidjan performed 197705 hemoglobin electrophoreses. Isoelectric focusing using the Basset technique allowed identification of hemoglobin K Woolwich. This abnormality of hemoglobin structure (beta 132 (H10) Lys ... Glu) was detected in 130 cases, i.e. 0.065%. It was homozygous in 3 cases, heterozygous in 110 cases, and associated with other hematologic abnormalities in 17 cases. The abnormality was asymptomatic and did not cause any hematological disturbance. Due to autosomal transmission, hemoglobin K Woolwich is a trait of Akan populations (75% of cases) in which it is dominant in the Attie subgroup. Given its ethnic specificity, this abnormality is of anthropological interest.

[Clinical and hematological profile of Lepore Hemoglobin in Ivory Coast]. / Profil clinique et hématologique de l'hémoglobine Lepore en Côte d'Ivoire.

Out of 97320 hemoglobin electrophoreses performed in Abidjan between January 1976 and January 1991, all subjects with hemoglobin Lepore were isolated. This trait was identified by three techniques, i.e., alkaline pH electrophoresis, acid pH electrophoresis, and isoelectric focusing. Seventy-nine cases of hemoglobin Lepore were observed. All were heterozygotes with type HbA-Lepore (n = 54), HbC-Lepore (n = 8) or HbS Lepore (n = 17). Where heterozygosis A and C had clinically silent, heterozygosis Hb-S Lepore resulted in a moderate chronic hemolytic anemia and, in all cases, painful episodes similar to those observed during homozygote sickle-cell disease. However the onset of episodes was later and their occurrence was less frequent. On hemograms, the Lepore trait (HbA Lepore) appeared as a pseudo-polyglobulia with microcytosis; similar features were observed for heterozygosis HbC Lepore. Heterozygosis HbS Lepore caused moderate anemia (mean hemoglobin level: 10.66 g/dl) and microcytosis (MGV = 68.8 fl). The characteristics show that the clinical and hematological behavior of hemoglobin Lepore, a rare hemoglobin, is similar to heterozygous beta-thalassemia.

[Prevalence and genetic profile of alpha-thalassemia in the newborn in Ivory Coast]. / Prévalence et profil génétique de l'alpha-thalassémie chez le nouveau-né en Côte d'Ivoire.

The authors report 525 cases of alpha-thalassemia tracked from samples of cord blood proceeded from 12,709 new-borns. With a frequency of 4.13% alpha-thalassemia was frequently in studied population. The lack of symptomatical shapes (Hemoglobin H disease and hydrops foetalis) agree the present theory about the genetic of Black African alpha-thalassemia.

[Hemoglobin O Arab in Ivory Coast and western Africa]. / L'hémoglobine o Arab en Côte d'Ivoire et en Afrique de l'Ouest.

The authors report 44 cases of hemoglobin O Arab share out in 3 phenotypes (A O Arab, C O Arab and S O Arab). The study of this abnormal hemoglobin has allowed the following conclusions: The Hb O Arab is a rare mutant of hemoglobin. The heterozygote form A O Arab and the association Hb C--Hb O Arab do not present any clinical and hematological manifestations. The associations Hb S--Hb O Arab brings about a serious hemoglobinopathy which has clinical and hematological features like the sickle-cell disease (SSFA2).

Les dysglobulinemies : que faire devant un pic a l'electrophorese des proteines seriques

La decouverte d'un pic etroit et homogene a l'electrophorese des protides suggere la presence d'une immunoglobuline (Ig); monoclonale. Celle-ci; dans la majorite des cas; signe une hemopathie maligne. cette decouverte impose une etude immunochimique serique et urinaire pour affirmer et caracteriser l'Ig monoclonale; la recherche d'une hemopathie maligne de lignee lymphoide et l'analyse des eventuelles consequences pathogenes de cette Ig monoclonale. En fonction des resultats de ce bilan; on decide de traiter l'hemopathie maligne ou de se contenter d'une surveillance reguliere et prolongee

[Prevalence and clinical profile of hemophilia of black Africans in urban areas of the Ivory Coast]. / Prévalence et profil clinique de l'hémophilie du Noir africain en zone urbaine en Côte d'Ivoire.

The authors report 20 haemophilic cases during a screening performed in urban area (Abidjan) in a population of 2.500 male subjects. They estimate the disease prevalence at 0.8%. The only haemophilia form identified is the A form, which does not seem to prevail in a particular ethnic group. No clinical significant particularity has been observed, otherwise.

Increase of the prevalence of hepatitis B virus surface antigen related to immunodeficiency inherent in acquired immune deficiency syndrome (AIDS).

During the period from January to December 1987, 2,191 serum samples were collected from different groups of the population in the Ivory Coast (1,126 healthy people selected from the general population, 416 blood donors, 112 healthy anti-HIV carriers, 173 AIDS patients, and 364 patients suffering from icterigenic hepatitis) and tested for anti-HIV (HIV-1 and HIV-2) antibodies, HBsAg, HBeAg, delta antigen (HDAg), and anti-delta (anti-HD) antibody. Anti-HIV antibodies were found in 30 (2.6%) of the general population. 55 (13.2%) blood donors, and 93 (25.5%) patients suffering from icterigenic hepatitis. HBsAg was observed in 103 (9.1%) of the general population, 45 (10.8%) blood donors, 15 (13.4%) healthy anti-HIV carriers, 59 (34.1%) AIDS patients, and 45 (40%) icterigenous hepatitis patients. The simultaneous presence of anti-HIV and HBsAg was noted in 4 (0.4%) of the general population, 8 (2%) blood donors, 15 (13.4%) healthy anti-HIV carriers, 59 (34.1%) AIDS cases, and 36 (10%) patients suffering from icterigenic hepatitis. A high prevalence of HBeAg and serological markers of infection by the delta agent were noted in the different groups. HDAg was noted only among AIDS patients or those suffering from icterigenic hepatitis, with a higher frequency among anti-HIV carriers. Our conclusion from this study is that healthy anti-HIV carriers are no more likely to be HBsAg carriers than the HIV-seronegative subjects. However, immunodeficiency induced previously by HIV infection is likely to be responsible for the high prevalence of HBsAg among AIDS patients.

Compared prevalence of infections by HIV-1 and HIV-2 during a 2-year period in suburban and rural areas of Ivory Coast.

The testing for human immune deficiency virus type 2 (HIV-2) antibodies of 794 sera collected in July-August 1985 in the four regions of Korhogo, Bondoukou, Man, and Bouaké in Ivory Coast and the collection and testing for HIV-1 and HIV-2 antibodies of 1,126 sera collected in July-August 1987 in the same regions and age groups showed a remarkable stability in the prevalence of infection by these two retroviruses (0.7 and 0.4% in 1985 vs. 0.9 and 0.2% in 1987, respectively, for HIV-1 and HIV-2) in rural areas. In contrast, the increase in prevalence of both HIV-1 (from 1 to 1.9%) and HIV-2 (from 0.8 to 1.3%) from 1985 to 1987 in the urban population was accompanied by a sharp increase during these 2 years of the number of acquired immune deficiency syndromes in regional hospitals.

PIP: The testing for human immune deficiency virus type 2 (HIV-2) antibodies of 794 sera collected in July-August 1985 in the 4 regions of Korhogo, Bondoukou, Man, and Bouake in Ivory Coast and the collection and testing for HIV-1 and HIV-2 antibodies of 1126 sera collected in July-August 1987 in the same regions and age groups showed a remarkable stability in the prevalence of infection by these 2 retroviruses (0.7 and 0.4% in 1985 vs 0.9 and 0.2% in 1987, respectively for HIV-1 and HIV-2) in rural areas. In contrast, the increase in prevalence of both HIV-1 (from 1-1.9%) and HIV-2 (from 0.8-1.3%) from 1985-87 in the urban population was accompanied by a sharp increase during these 2 years in the number of AIDS cases in regional hospitals. (author's modified).

[Epidemiology of infections caused by human immunodeficiency viruses HIV-1 and HIV-2 in the Ivory Coast]. / Epidemiologie des infections par les virus de l'immunodeficience humaine VIH1 et VIH2 en Côte d'Ivoire.

A study of antibodies to HIV1 and HIV2 has been performed among selected groups in Ivory Coast from January to December 1987. In total, 2,578 serum samples were examined. A seropositivity to HIV1 and/or HIV2 was observed in 32 (2.4%) of 1.334 healthy subjects of the general population from 5 different areas, 9 (3.6%) of 246 pregnant women, 58 (12.3%) of 471 blood donors, 72 (34.3%) of 210 female prostitutes, 23 (35.3%) of 65 patients with sexual transmitted diseases, 21 (35.6%) patients with chronic renal insufficiency and 98 (50.7%) patients with severe pulmonary tuberculosis. Among the 313 HIV antibodies carriers, the frequency of HIV1 infection (6.7%) was higher than HIV2 infection (2%). However, 3.4% had a double seropositivity HIV1 and HIV2.

Blood transfusions and HIV infections (HIV1, HIV2/LAV2) in Ivory Coast.

Sera from 500 blood donors, 67 multiply-transfused children with sickle-cell anaemia and 320 healthy children who had not been transfused were tested for HIV1 and HIV2 antibodies. Amongst blood donors, 49 (9.8%) exhibited antibodies to retroviruses: 12 (2.4%) to HIV1, 17 (3.4%) to HIV2 and 20 (4%) to both HIV1 and HIV2. Fifteen (22.4%) of the 67 multiply-transfused children had retroviral antibodies: five (7.4%) to HIV1 four (6%) to HIV2 and six (9%) to both HIV1 and HIV2. In contrast, among 320 non-transfused children only two (0.62%) exhibited HIV1 infection. These results suggest that children with sickle-cell anaemia who have been repeatedly transfused, constitute a high risk group for HIV1 and HIV2 infections in Ivory Coast.

[Rubella in pregnant women in Abidjan (Ivory Coast)]. / L'infection rubéolique chez les femmes enceintes à Abidjan (Cote-d'Ivoire).

1,143 serums samples collected from pregnant females at first term were tested for the presence of rubella haemagglutination inhibition antibodies. Rubella antibodies were present in 679 (59.4%) of the pregnant females and 464 (40.6%) were seronegative. No statistically significant difference was found in the prevalence of rubella specific antibodies in three age categories considered. 155 positive serum samples for rubella antibodies (IHA) were tested afterward retrospectively for rubella-specific IgM by ELISA technic, and 14 (9.03%) were positive.

[Vaccination against hepatitis B on the Ivory Coast: study of the anti-HBs response in healthy adult subjects carrying only anti-HBc antibodies before vaccination]. / Vaccination contre l'hépatite B en Côte-d'Ivoire: étude de la réponse anti-HBs chez des sujets adultes sains porteurs uniquement de l'anticorps anti-HBc avant la vaccination.

A total of 103 volunteers, from 18 to 55 years of age, have received the hevac B Pasteur 5 micrograms vaccine subcutane on sly; one injection a month during three months and one booster injection after one year. The study of the anti-HBs reaction of the subjects, with regard to the serological status to the hepatite B virus before inoculation, has shown that only 78.8% of the subjects, who are only positive towards the anti-HBc antibody, will develop an anti-HBs response of primary type with a relatively low value. In contrast, all anti-HBc and/or anti-HBs subjects, who are positive before inoculation, react with relatively high anti-HBs values right after the first injection, of the seronegative subjects before inoculation. 93.3% will develop an anti-HBs seroconversion after the complete inoculation procedure.

[Vaccination of adults against hepatitis B virus in a tropical African environment (Ivory Coast). Study of results according to the serologic status toward the virus]. / Vaccination des adultes contre le virus de l'hépatite B en milieu tropical africain (Côte-d'Ivoire). Etude des resultats selon le statut sérologique vis-à-vis du virus.

A total of 103 volunteers, from 18 to 55 years of age have received subcutaneous injection of the hevac B Pasteur 5 micrograms vaccine: one injection a month during three months and one booster injection after one year. The study of the anti-HBs reaction of the subjects, with regard to the serologicale status to the hepatitis B virus before inoculation, has shown that only 78.8% of the subjects, who are only positive towards the anti-HBc antibody, will develop an anti-HBs response of primary type with a relatively low value. On the contrary, all anti-HBc and/or anti-HBs subjects, who were positive before inoculation, react with relatively high anti-HBs value immediately after the first injection. 93.3% of the seronegative subjects before inoculation will develop an anti-HBs seroconversion after the complete inoculation procedure.