[Hepatosplenic sarcoidosis: description of a case at the University hospital center of Brazzaville, Congo]. / Sarcoïdose à localisation hépatosplénique : description d'un cas au Centre hospitalier universitaire de Brazzaville, Congo.

Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The isolated extrapulmonary form is rare. We report the case of hepatosplenic sarcoidosis in a 29-year-old female patient.It is a patient with no notable medical history, who was seen in consultation for repeated epistaxis. Clinical examination noted nodular hepatomegaly associated with signs of portal hypertension and splenomegaly. Sedimentation rate, alkaline phosphatase, serum angiotensin converting enzyme, aminotransferases were high. Histological examination of the spleen and liver biopsy noted granulomatous inflammatory infiltration without cancerous lesion or tonsil stones.This picture is comparable with sarcoidosis, despite the absence of PET scans. The main challenge remains the differential diagnosis with other granulomatoses. Corticosteroid therapy is the first-line treatment, and after splenectomy the patient has achieved clinical and biological stability.

Histomolecular profile of Helicobacter pylori strains circulating in Brazzaville (Congo).

Background and Aim: Helicobacter pylori (Hp) infection is a real public health problem in the Congo. We aimed study the histomolecular profile of Hp strains circulating in Brazzaville, Congo, in order to contribute to the improvement of Hp-infected patients in the country. Methods: This was an analytical-transversal study carried out from January to November 2020 (i.e. a study period of 11 months) in the endoscopy centers of Brazzaville as well as the molecular biology and anatomopathology laboratories of Pointe-Noire and Oyo. It involved 100 symptomatic patients over the age of 18 referred for upper GI endoscopy. These patients underwent gastric biopsies for histopathological analysis according to the Sydney classification and molecular analysis using the real-time polymerase chain reaction (PCR) technique. The frequency of Hp infection was determined using real-time PCR. PCR was also used to identify the Hp strains and assess their tropism in the gastric mucosa. Digestive symptoms, endoscopic lesions, and histopathological lesions associated with HP infection were studied. Results: The incidence of Hp infection was 91%, with a female predominance of 52.75% and an average age of 46.32 years. Endoscopy revealed normal mucosa (56.14%), ulcerated lesions (12.28%), and gastritis (22.81%) in infected patients. Histopathologically, the lesions were chronic atrophic gastritis (91%), with inflammatory activity (16.46%), intestinal metaplasia (16.46%), and adenocarcinoma (3.3%). Cag A strains were present in 85.71% of cases and had no preferential tropism in the gastric mucosa. Strains carrying the Cag A gene were present in severe and serious endoscopic and histopathological lesions. Conclusion: The prevalence of Hp infection is 91% in the Brazzaville population. Cag A strains circulate in high proportions and are implicated in the occurrence of severe lesions of the gastric mucosa.

Prevalence of co-infection with human papillomavirus and Chlamydia trachomatis and risk factors associated with cervical cancer in Congolese women.

The human papillomavirus (HPV) is one of the most frequently diagnosed viruses in developing countries. Chlamydia trachomatis (CT) is an important cofactor in HPV-induced cervical cancer. Cervico-uterine smears were taken for cytology, and a total of 131 samples were analysed. HPV prevalence and CT were detected using specific primers (L1 gene and omp-1 gene). 23 (17.5 %) HPV-only samples were detected, CT-only positives were 10 (7.6 %). And HPV/CT co-infection was 13 (9.9 %). Identified risk factors associated with HPV/CT co-infection were risky sexual behaviour and cytology status. The prevalence of HPV and CT and their co-infection rates being high in our study population, may be an indicator of cervical cancer risk. Consequently, there is an urgent need to raise awareness and take appropriate precautions.

Seroprevalence of SARS-CoV-2 antibodies in Republic of Congo, February 2022.

In resource-limited countries, the lack of widespread screening masks the true situation of COVID-19. We conducted this study to assess SARS-CoV-2 spread by detection of specific antibodies and to determine associated factors. A population-based cross-sectional study was conducted. Subjects were tested for the presence of two antibodies (IgM and IgG) specific to SARS-CoV-2. Data collection was done using a smartphone with the KoboCollect application. Prevalence of antibodies was estimated with 95% confidence intervals. Logistic regression was used to determine factors associated with positive serological test. A total of 9,094 persons were tested in 4,340 households. The mean age was 30.18 ± 18.65 years, 46.5% male. The overall seroprevalence (prevalence, 95% CI) of SARS-CoV-2 antibodies was (48.2% [47.2%-49.2%]). Being vaccinated, having been in contact with a COVID-19 patient, being older than 50 years, living in a union, having secondary education and having tertiary education were factors independently associated with the likelihood of having anti-sars-CoV-2. We estimate in February 2022 that 48% persons had antibodies against the COVID-19 virus, more among those vaccinated. Vaccination intensification in low prevalence departments will reduce the risk of new outbreaks.

Human papillomavirus genotype distribution by cytological status and associated risk factors in the general population of Congolese women living in urban and rural areas: Implications for cervical cancer prevention.

INTRODUCTION: Cervical cancer related to high risk-human papillomavirus (HR-HPV) is the second female cancer in the Republic of Congo (Congo). We herein evaluated the molecular epidemiology of cervical HPV infection and associated risk factors in Congolese women living in urban (Brazzaville) and rural (Plateaux department) settings. PATIENTS AND METHODS: A population-based, cross-sectional survey was conducted to collect demographic and behavioral data among Congolese women, and to obtain endocervical swab samples for HPV DNA molecular detection (Anyplex II HPV28, Seegene, Seoul, South Korea). RESULTS: A total of 284 women (mean age: 37.8 years; HIV-1-positivity: 18.6%) were included. The prevalence of HPV DNA cervical shedding was 64.4% [HR-HPV: 80.9%, mainly HPV-16 (15.8%), and HPV-35 and HPV-52 (15.3%); multiple HPV infections: 60.6%; 9-valent HPV Gardasil-9® vaccine genotypes: 42.6%]. 91.6% and 100% of low-grade squamous intraepithelial neoplasia (LSIL) and cervical cancer, respectively, showed HR-HPV. HR-HPV prevalence was higher among students (aOR: 7.9) and HIV-infected women (aOR: 3.1) in Brazzaville, and among women aged between 21-30 years (aOR: 7.2) and HIV-infected women (aOR: 5.1) in the Plateaux department. CONCLUSION: Cervical HR-HPV infection is particularly frequent in young or HIV-infected Congolese women. Prophylactic HPV vaccination combined with primary molecular screening of HR-HPV infection in this country should be extended.

The Fight against Poliovirus Is Not Over.

Poliovirus (PV), the virus that causes both acute poliomyelitis and post-polio syndrome, is classified within the Enterovirus C species, and there are three wild PV serotypes: WPV1, WPV2 and WPV3. The launch of the Global Polio Eradication Initiative (GPEI) in 1988 eradicated two of the three serotypes of WPV (WPV2 and WPV3). However, the endemic transmission of WPV1 persists in Afghanistan and Pakistan in 2022. There are cases of paralytic polio due to the loss of viral attenuation in the oral poliovirus vaccine (OPV), known as vaccine-derived poliovirus (VDPV). Between January 2021 and May 2023, a total of 2141 circulating VDPV (cVDPV) cases were reported in 36 countries worldwide. Because of this risk, inactivated poliovirus (IPV) is being used more widely, and attenuated PV2 has been removed from OPV formulations to obtain bivalent OPV (containing only types 1 and 3). In order to avoid the reversion of attenuated OPV strains, the new OPV, which is more stable due to genome-wide modifications, as well as sabin IPV and virus-like particle (VLP) vaccines, is being developed and offers promising solutions for eradicating WP1 and VDPV.

Early detection of acute renal lesions by serum cystatin C in children at hospital and university Centre of Brazzaville

Acute Kidney Injury (AKI) is considered one of the main public health problems. The effective management of these alterations is based on the early detection of renal lesions. The objective of this study was to evaluate the contribution of the Cystatin C (CysC) assay in the early diagnosis of acute kidney injury (AKI) in children hospitalized in pediatric intensive care units in Brazzaville. MATERIALS AND METHODS Sixty children at high risk of developing AKI were included. Consent form signed was obtained from parents, socio-demographic data, weight and height of children recorded. Creatinine (Cr), CysC and urea were assayed in serum 24 hours after admission. Glomerular filtration clearance was estimated using serum creatinine and CysC. Glomerular filtration rate (GFR) was calculated from CysC and Cr. The diagnostic accuracy was determined by comparing the results of CysC to those of Cr (considered as a reference biomarker). RESULTS The median age was 5 years (with extremes ranging from 1 month to 17 years). Cr, CysC, urea, and GFR/Cr (mean ± standard deviation [range]) were 0.94±1.17 (0.2­ 1.4 mg/dl), 0.14 ± 0.062 (0.053-0.095 mg/l), 46.65±47.75 (15.0­45.0 mg/dl), 81.85±31.90 (≥190 ml/min per 1.73 m2 , respectively. The level of CysC in patients with ARL was significantly higher than that of children with normal renal function (p<0.001). Our results show that the performance of serum CysC in detecting AKI early was superior to that of serum Cr in children hospitalized in pediatric intensive care units in Brazzaville

Oncogenic human papillomavirus in breast cancer: molecular prevalence in a group of Congolese patients.

BACKGROUND: Since the work of Band et al. in 1990 (Proc. Natl. Acad. Sci. USA 87:463-467), several studies have suggested a possible link between the pathogenesis of breast cancer and viral infection. Infection with oncogenic HPV has been one of the viruses implicated in breast cancer cases worldwide. OBJECTIVE: To investigate the presence of HPV DNA in archived paraffin-embedded breast cancer cases at the University Hospital of Brazzaville and to assess the association between viral HPV infections and clinicopathological features. METHODS: A total of 40 formalin-fixed paraffin-embedded (FFPE) biopsies were retrospectively collected and available information was recorded. HPV detection and genotyping were performed by real-time PCR by GeneXpert technology (Cepheid, Sunnyvale, USA). RESULTS: The mean age was 51.1±11.4 years (range 22-75 years; median was 47). Overall, HPV DNA was detected in six (15%) breast carcinoma samples. HPV-16, the most common genotype was identified in 83.7 % of all samples. HPV porting with clinicopathological features showed no significant difference (P>0.05). However, a statistically significant difference was observed between HPV infection and SBR grade (P=0.05). CONCLUSION: Our study described a high prevalence of HPV-HR in breast cancer cases in the Congolese woman. Future type case-control studies are necessary to better describe the potential role of HPV in the occurrence of breast cancer in Congo.

Histoplasmosis in the Republic of Congo dominated by African histoplasmosis, Histoplasma capsulatum var. duboisii.

The Republic of Congo (RoC) is one of the African countries with the most histoplasmosis cases reported. This review summarizes the current status regarding epidemiology, diagnostic tools, and treatment of histoplasmosis in the RoC. A computerized search was performed from online databases Medline, PubMed, HINARI, and Google Scholar to collect literature on histoplasmosis in the RoC. We found 57 cases of histoplasmosis diagnosed between 1954 and 2019, corresponding to an incidence rate of 1-3 cases each year without significant impact of the AIDS epidemic in the country. Of the 57 cases, 54 (94.7%) were cases of Histoplasma capsulatum var. duboisii (Hcd) infection, African histoplasmosis. Three cases (5.3%) of Histoplasma capsulatum var. capsulatum infection were recorded, but all were acquired outside in the RoC. The patients' ages ranged between 13 months to 60 years. An equal number of cases were observed in adults in the third or fourth decades (n = 14; 24.6%) and in children aged ≤15 years. Skin lesions (46.3%), lymph nodes (37%), and bone lesions (26%) were the most frequent clinical presentations. Most diagnoses were based on histopathology and distinctive large yeast forms seen in tissue. Amphotericin B (AmB) was first line therapy in 65% of the cases and itraconazole (25%) for maintenance therapy. The occurrence of African histoplasmosis in apparently normal children raises the possibility that African histoplasmosis is linked to environmental fungal exposure.

Inflammatory biomarkers and prediction of insulin resistance in Congolese adults.

Several studies have shown that low levels of adiponectin (ADP) and high levels of alpha tumor necrosis factor (NFT) increase the risk or severity of many cardiometabolic diseases associated with insulin resistance. The main objective of this study was to evaluate the association between plasma adipokines and IR measured by HOMA-IR. The secondary objective was to determine the biomarker of the potential inflammation to predict IR in Congolese melanoderm subjects residing in Brazzaville. This cross-sectional study was conducted on 234 apparently healthy participants over the age of 18. Socio-demographic and clinical data were collected. Biological data, including the total ADP and NFT dosage, were measured using the ELISA method. Participants were categorized into two groups according to HOMA-IR ≥ 2.5. Univariate and multivariate logistic regression analyses were conducted to identify risk factors for insulin resistance. An optimized model was obtained after the logistic regression. The analysis of the receptor's operating characteristics (OCR) was performed to determine the optimal threshold value and diagnostic characteristics, as well as the area under the curve (ASC). ADP averages were significantly low (11.49 ± 7.61 ng/mL; P < 0.001) while those of TNF were significantly higher (96.03 ± 44.09 pg/mL) in the HOMA-IR group ≥ 2.5. There was a positive and significant correlation (p < 0.05) between BMI, TT, CRPhs, TNF and HOMA-IR. And a negative and significant correlation was noted between ADP and HOMA-IR (r = - 0.39; P < 0.01). Similarly, a negative and significant correlation (p < 0.01) was noted between BMI, TT, TNF, CRPhs and ADP. The optimal threshold value of the total ADP for predicting IR was 17.52 ng/mL with a sensitivity of 89% [IC 95% (0.83-0.95)], 56% specificity [IC 95% (0.47-0.65)] and a CSA of 0.76 [IC 95% (0.69-0.81)]. After logistic regression, the CSA of the optimized model was 0.84 [IC 95% (0.79-0.89)]. ADP can be used as a highly plausible IR prediction biomarker.

Current burden of serious fungal infections in Republic of Congo.

BACKGROUND: The Republic of Congo (RoC) is characterised by a high prevalence of tuberculosis and HIV/AIDS, which largely drive the epidemiology of serious fungal infections. OBJECTIVE: We aimed to estimate the current burden of serious fungal infections in RoC. MATERIAL AND METHODS: Using local, regional or global data and estimates of population and at-risk population groups, deterministic modelling was employed to estimate national incidence or prevalence of the most serious fungal infections. RESULTS: Our study revealed that about 5.4% of the Congolese population (283 450) suffer from serious fungal infections yearly. The incidence of cryptococcal meningitis, Pneumocystis jirovecii pneumonia and disseminated histoplasmosis in AIDS patients was estimated at 560, 830 and 120 cases per year. Oral and oesophageal candidiasis collectively affects 12 320 HIV-infected patients. Chronic pulmonary aspergillosis, 67% post-tuberculosis, probably has a prevalence of 3420. Fungal asthma (allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation) probably has a prevalence of 3640 and 4800, although some overlap due to disease definition is likely. The estimated prevalence of recurrent vulvovaginal candidiasis and tinea capitis is 85 440 and 178 400 respectively. Mostly related to agricultural activity, fungal keratitis affects an estimated 700 Congolese yearly. CONCLUSION: These data underline the urgent need for an intensified awareness towards Congolese physicians to fungal infections and for increased efforts to improve diagnosis and management of fungal infections in the RoC.

[Epidemiological aspects of obesity in the workplace in Pointe-Noire, Congo-Brazzaville]. / Aspects epidemiologiques de l'obesite en milieu professionnel a Pointe-Noire, Congo-Brazzaville.

OBJECTIVE: To describe the epidemiological aspects of obesity in the workplace. METHODOLOGY: This was a descriptive and cross-sectional study conducted between February and November 2017 in an oil company. The data were collected from the activity reports of its occupational medicine department. RESULTS: Of the 625 subjects in the study, there were 528 (85%) men and 97 (15%) women, for a sex ratio (M/F) of 5.4. The mean age was 38.8±9.3 years. The socio-economic level was very high and the "master's" degrees were the most represented (58.1%). The incidence of obesity was 21.1% (132 workers) with 72.7% of subjects in moderate obesity. There were 104 (78.8%) obese men and 28 (21.2%) obese women. The following were significantly associated with obesity: female sex (p=0.042), meal frequency (p=0.000), snacking (p=0.000), physical inactivity (p=0.000), place of work (p=0.00028) and work stress (p=0.000). Diabetes (p=0.00023) and hypertension (p=0.00117) were significantly associated with obesity. On the other hand, no significant association was found with meal location, addictions (alcohol and tobacco), work rhythm, sedentary work habits and hypercholesterolemia. CONCLUSION: Our study shows the extent of obesity, which is a real health problem, so far little known in the Congolese professional environment. This underlines the need to design a good obesity prevention strategy in this relatively young productive population.

OBJECTIF GÉNÉRAL: Décrire les aspects épidémiologiques de l'obésité en milieu professionnel. MÉTHODOLOGIE: Il s'est agi d'une étude descriptive et transversale, réalisée entre février et novembre 2017 dans une entreprise pétrolière. Les données ont été recueillies à partir des rapports d'activités de son service de médecine du travail. RÉSULTATS: Sur l'ensemble des 625 sujets de l'étude, il y avait 528 (85%) hommes et 97(15%) femmes, soit un sex-ratio (H/F) de 5,4. L'âge moyen était de 38,8±9,3 ans. Le niveau socio-économique était très élevé et les agents du collège « maitrise ¼ étaient les plus représentés (58,1%). La fréquencede l'obésité était de 21,1% (132 travailleurs) avec 72,7% des sujets enobésité modérée. Il y avait 104 (78,8%) hommes obèses et 28 (21,2%) femmes obèses.Etaient associés significativementà l'obésité: le sexe féminin (p=0,042), la fréquence des repas (p=0,000), le grignotage (p=0,000), l'inactivité physique (p=0,000), le lieu du travail (p=0,00028) et le stress au travail (p=0,000). Le diabète (p=0,00023) et l'HTA (p=0,00117) étaient des affections significativement associées à l'obésité. Par contre, aucune association significative n'avait été retrouvée avec le lieu des repas, les addictions (Alcool et tabac), le rythme de travail, la sédentarité au travail et l'hypercholestéromie. CONCLUSION: Notre étude montre l'ampleur de l'obésité, qui est un réel problème de santé, jusqu'ici mal connu dans le milieu professionnel congolais. Ce constat souligne, la nécessité de concevoir une bonne stratégie de prévention de l'obésité dans cette population productive relativement jeune.

Aqueous extracts of Syzygium brazzavillense can inhibit the infection with coxsackievirus B4 in vitro.

Traditional practitioners commonly use plant crude extracts to treat various diseases in patients with symptoms that can be seen during enterovirus infections. In this study, the antienteroviral activity of medicinal plants from the Republic of Congo has been evaluated in vitro. Through an ethnopharmacological approach, seven plants grouped into six families were identified. Aqueous and organic extracts of various organs from these plants were prepared. The organic extracts at subcytotoxic concentrations did not inhibit the cytopathic effect (CPE) induced by coxsackievirus (CV)B1-5, CVA6, poliovirus type 1, and enterovirus 71. The aqueous extract of Syzygium brazzavillense, but not those of other plants, inhibited the CPE induced by CVB3 and CVB4 at 30 µg/mL (CC50 ; 2800 µg/mL, IC50 ; 0.8 µg/mL) and by CVB2 and poliovirus type 1 at higher concentrations. When aqueous extract of this plant was mixed with CVB4, the replication of the virus was inhibited. In conclusion, aqueous extracts of Syzygium brazzavillense can inhibit the infection with CVB4 and other enteroviruses in vitro. The present ethnopharmacological investigation helped to identify a plant with potential properties useful to combat enterovirus infections.

Effects of Acupuncture on mRNA Levels of Apoptotic Factors in Perihematomal Brain Tissue During the Acute Phase of Cerebral Hemorrhage.

BACKGROUND To explore the time-dependent effects of acupuncture on mRNA levels of the apoptotic factors BCL-2 and BAX in a rat cerebral hemorrhage model, slow injection of autologous blood to the caudate nucleus was used to generate the cerebral hemorrhage model. MATERIAL AND METHODS A sham surgery control group, groups with acupuncture applied 3, 9, 24, and 48 hours after model induction, and time-matched model-only control groups were used. In situ hybridization was used to detect BCL-2 and BAX mRNA expression, and semi-quantitative RT-PCR was used to measure the expression. RESULTS The number of BCL-2 and BAX mRNA-positive cells significantly increased during the acute phase of cerebral hemorrhage. BCL-2 mRNA was significantly upregulated in acupuncture groups compared to other groups, whereas BAX mRNA levels in the acupuncture groups were lower in the other groups, except for the sham surgery group. Additionally, earlier acupuncture intervention was associated with a lower ratio of expression between the two genes. Changes in BCL-2 and BAX mRNA expression were consistent with changes in the number of cells positive for BCL-2 and BAX mRNA; however, the change in the expression ratio was consistent with the change in the number of cells positive for BCL-2 mRNA, but opposite to the change in the number of cells positive for BAX mRNA. CONCLUSIONS Acupuncture ameliorated changes in expression of apoptotic factors in the brain induced by acute cerebral hemorrhage and may thus protect the brain, with greater efficacy when the delay before acupuncture was minimized.

Molecular characterization of hepatitis B virus among chronic hepatitis B patients from Pointe Noire, Republic of Congo.

BACKGROUND: Chronic Hepatitis B infection is a major health problem in Republic of Congo therefore molecular analysis of HBV strains is important to detect the patients at high risk of disease progression. METHODS: Serum samples were obtained from 111 chronic HBV patients in Pointe Noire. HBsAg, HBeAg and HBeAb were detected. A fragment of the preS1 region of HBV was amplified and sequenced to determine genotypes, subgenotypes and to identify mutations. RESULTS: Of the 111 samples analyzed, 35 patients were asymptomatic carriers (ASC), 24 with a chronic active hepatitis (CAH), 33 with liver cirrhosis (LC) and 19 have a hepatocellular carcinoma (HCC). The mean age were 45 ± 13 year, 88 (79.3 %) were male and 23 (20.7 %) female. The prevalence of HBeAg was 15.3 % and 73 % of subjects were anti-HBe positive. The mean serum level of alanine aminotransferase transaminase (ALT) and aspartate transaminase (AST) was 25.1 ± 9 IU/L and 28.6 ± 10 IU/L respectively. Eighty two samples out of 111 (73.9 %) were genotyped by the analyzing of the S region of HBV, 58 (70.7 %) cases belonged to HBV genotype E and 24 (29.3 %) were genotype A with three subgenotypes; A3 (66.7 %), A4 (20.8 %) and A6 (12.5 %). Prevalence of genotype A was relatively high in CAH (33.3 %) and HCC (31.6 %) patients in comparison with other groups. The most prevalent amino acids substitutions were R38K found in 14 (17.1 %) sequences, following by H44L in 11 (13.4 %), K13E in 8 (9.8 %), N29K in 8 (9.8 %), A35E in 8 (9.8 %), V80I in 7 (8.5 %) and in 6 (7.3 %) sequences for S90T. Different substitutions located in the hepatocyte binding site were higher among patients with LC and HCC (p < 0.05). CONCLUSIONS: This study have shown that HBV genotype E and A were the most frequent strains circulating in Republic of Congo patients. HBV pres1 substitutions found in this study were associated with severe clinical forms of liver diseases. This data have shown the importance of implementing an effective program to fight HBV infection.

Genetic variability in E6 and E7 oncogenes of human papillomavirus Type 16 from Congolese cervical cancer isolates.

BACKGROUND: The molecular epidemiological studies showed that some variants of HPV-16, distributed geographically, would present a higher risk of causing cervical cancer. This study aimed to analyze nucleotide changes of HPV-16 E6 and E7 genomic regions from infected Southwestern Congolese women. METHODS: DNA of twenty HPV-16 isolates was analyzed by amplifying the E6 and E7 genes using type-specific primers PCR and direct sequencing. The sequences obtained were aligned with the HPV-16 GenBank reference sequences. RESULTS: Thirteen (65.0%) out of 20 DNA-samples were successfully amplified. Genetic analysis revealed 18 and 4 nucleotide changes in E6 and E7 genomic regions respectively. The most frequently observed nucleotide variations were the missense C143G, G145T and C335T in E6 (100%), leading to the non-synonymous amino acid variation Q14D and H78Y. E7 genomic region was found to be highly conserved with two most common T789C and T795G (100%) silent variations. All HPV-16 variants identified belonged to the African lineage: 7 (53.8%) belonged to Af-1 lineage and 6 (46.1%) to Af-2 lineage. The missense mutation G622A (D21N) in the E7 region seems to be described for the first time in this study. CONCLUSION: This study reported for the first time the distribution of HPV-16 E6 and E7 genetic variants in infected women from southwest Congo. The findings confirmed almost ascendancy of the African lineage in our study population.

Specific genotypes of human papillomavirus in 125 high-grade squamous lesions and invasive cervical cancer cases from Congolese women.

BACKGROUND: Knowledge on HPV prevalence and genotype distribution in HSIL and ICC is highly essential for the introduction of an effective vaccination program and appropriate epidemiological monitoring of viral ecology before and after vaccination in Congo. This study aimed to determine the specific-HPV genotypes in HSIL and ICC among women in southwestern Congo. METHODS: 125 archival paraffin-embedded biopsy collected between 2008 and 2012 and histologically diagnosed were investigated. DNA extraction was performed using the phenol/chloroform method. HPV search was performed by nested-PCR using MY09/MY11 and GP5+/GP6+ consensus primers followed by direct sequencing. RESULTS: The mean age of participants was 44.3 ± 8.2 years. Overall, HPV prevalence was 89.6% (112/125) with all high-risk genotypes. HPV-DNA was detected in 81.5% (53/65) of HSIL and 98.3% (59/60) of ICC. HPV 16 the most common genotype was detected in 47.1% (25/53) of HSIL and 52.5% (31/59) of ICC. Other types identified were: HPV 33 (22.6%), HPV 18 (15%), HPV 31 (11.3%) and HPV 69 (3.7%) in HSIL, and HPV 33 (28.8%), HPV 18 (11.8%), HPV 31 (5%) and HPV 35 (1.7%) in ICC. Knowing that the ADC accounted for 6.7% (4/60) of ICC cases, HPV 18 was identified in 25% (1/4) of these cases against 75% (3/4) for HPV 16. CONCLUSION: Our study showed that HPV 16, 33, 18 and 31 were the four most common genotypes in women with HSIL and ICC. These findings indicate that current vaccines against HPV could help to reduce the burden of cervical cancer in Congo.

Higher levels of hepatitis C virus RNA found in blood donors co-infected with HIV as compared to HCV mono-infected donors.

INTRODUCTION: Hepatitis C virus (HCV) infection and human immunodeficiency virus (HIV) infections are public health problems in sub-Saharan countries such as the Republic of Congo. HIV infection could impact the characteristics of HCV infection in co-infected people. We investigated HCV-HIV co-infection among blood donors in Congo. METHODOLOGY: Ninety-nine HIV-positive and/or HCV-seropositive blood donors were selected during screening and subsequently tested for aminotransferases and HCV RNA. RESULTS: A total of 29 donors were found positive for HCV RNA (HCV-infected individuals), including 19/60 (31.66%) HIV donors (co-infected) and 10/39 (25.64%) non-HIV donors (mono-infected). Most of the co-infected donors (17/19) displayed a high viral load (> 5 log). The median HCV RNA level was at least 2 logs higher in co-infected people. The levels of alanine aminotransferase (ALT) were also slightly higher in co-infected donors than in HCV mono-infected donors. CONCLUSION: This study reports HCV-HIV co-infection among blood donors in Congo and shows that HCV viral load is higher in HIV donors.

Detection of hepatitis B virus infection markers in dried plasma spots among patients in Congo-Brazzaville.

The detection of hepatitis B virus (HBV) infection markers by using dried plasma spots from 32 patients living in Congo has been assessed. Considering frozen plasma samples as gold standard, the sensitivity and specificity of HBV serologic markers detection in dried plasma eluted from filter paper were 100%. The sensitivity and the specificity of HBV DNA detection reached 96% and 100%, respectively, with plasma samples dried on filter paper compared to standard samples. Dried plasma samples can represent an alternative to conventional sampling for HBV detection and management of the infection in developing countries.

[Clinical and outcome characteristics of inflammatory breast cancers in Brazzaville]. / Caractéristiques cliniques et évolutives des cancers du sein inflammatoires à Brazzaville.

T4 breast cancers are a heterogeneous group. We conducted this study to analyze the differences between inflammatory and non-inflammatory T4 breast cancers. In a cross-sectional descriptive study over a period ranging from 2007 to 2010, we collected patients with T4 breast cancer. These patients were divided into two groups: a group of inflammatory breast cancer (IBC) and a group of breast cancer T4 non inflammatory (NIBC). We compared the epidemiological, clinical and outcome characteristics of the two groups. We identified 129 patients with T4 stage out of 343 patients with a diagnosis of breast cancer. Fifty-two IBC and 77 NIBC patients were observed. We did not found any epidemiological difference between the two groups. The two entities differed in tumor size (greater in the IBC group) and skin ulceration (less frequently found in the NIBC group). The only independent prognostic factor for failure of first line chemotherapy was, for both groups, non-compliance treatment intervals. The median overall survival in our study was 9 months in the IBC versus 13 months in the NIBC (p = 0.01, Log-rank test) patients. By multivariate analysis, IBC was the only independent prognostic factor negatively influencing the survival. IBC is a frequent entity in Brazzaville, Congo and displays a poor-prognosis.