[Profiles of IgG responses against CSP, GLURP and LSA-3NR2 in urban malaria (Dakar): relations with haemoglobin levels and parasite densities]. / Profils des réponses IgG dirigées contre CSP, GLURP et LSA-3NR2 dans le paludisme urbain à Dakar : influence sur l'hémoglobinémie et les parasitémies circulantes.

Malaria remains a major health problem in sub- Saharan African countries despite substantial decreases in morbidity and mortality due to sustained control programs. Vaccines candidates were mainly tested in rural endemic setting; however increasing proportion of the population is living in urban area. Evaluation of the qualitative or quantitative immune responses to key targets of anti-Plasmodium immunity requires further investigation in urban area. In a cohort of 144 patients with mild malaria living in Dakar, we analyzed IgG responses against target antigens of P. falciparum: CSP, LSA-3NR2 and GLURP by ELISA. A mean age of 15 yrs (4-65 yrs) was found and patients were separated in 59 adults (<15yrs) and 85 children (≤15 yrs). Parasites densities (0,01-15%) did not differ between the two age groups. In contrast, haemoglobin levels appeared lower in children (4.5-16.6 g/dl) (p<0.01). For the immune results, the most recognized antigens were GLURP and CSP compared to LSA-3NR2. Levels of IgG against these antigens were significantly different between the two age groups and they were positively correlated (rho = 0.32; p<0.001). In addition, levels of IgG anti-GLURP were associated with low parasitemia (≤1%) and absence of anemia (≥11g/dl), particularly in adults (p<0.001). In a multiple regression analysis, no significant relationship was found between parasite densities and IgG responses against all the tested antigens. Our study shows the implication of IgG anti-GLURP in humoral immune response against the parasite. The present work contributes to determine IgG levels that can be used as relevant immunologic biomarkers in urban clinical malaria.

Connaissances, attitudes et pratiques des personnes vivant avec le VIH dans un centre de prise en charge au Sénégal

L'objectif de cette étude était d'évaluer les connaissances des Personnes Vivant avec le VIH (PVVIH) sur les modes de transmission, la prévention et le traitement de l'infection à VIH, décrire et d'analyser leurs comportements et pratiques depuis l'annonce de leur séropositivité. Méthodologie : Etude transversale à visée descriptive réalisée du 1er juin au 31 octobre 2012, concernant les patients infectés par le VIH, suivis en ambulatoire au Centre de Recherche Clinique et de Formation de Fann. Résultats : Quarante-sept patients, en majorité des femmes (sex-ratio F/M = 3,2) ont été interrogés. Leur âge médian était de 43 ans [extrêmes : 18 ans-63 ans]. Les infections opportunistes constituaient la principale circonstance de dépistage (75%).Les principales sources d'information sur la maladie étaient les médias (75%). La transmission mère-enfant n'était connue que par 17% des patients. Le préservatif était le moyen de prévention le plus cité (77%). Seuls 4 patients ont cité les centres de dépistage volontaire pour le dépistage de l'infection à VIH. Cinquante-quatre pour cent des cas percevaient leur maladie comme une épreuve divine. Par rapport aux attitudes et pratiques face au VIH, 32 patients étaient favorables au partage du statut sérologique mais seuls 29 avaient informé un tiers qui était le conjoint dans 7 cas. Vingt-huit patients étaient sexuellement actifs et 12 exigeaient le port de préservatif. Conclusion : La prise en charge psycho-sociale et sexuelle au cours du suivi est indispensable afin d'améliorer les connaissances des patients sur l'infection à VIH, leurs attitudes et pratiques

Aspects radiologiques de la tuberculose pulmonaire chez les patients infectés par le VIH hospitalisés au service des maladies infectieuses et tropicales de Fann de Dakar, Sénégal

Objectifs : Déterminer la prévalence de la tuberculose pulmonaire chez les personnes vivant avec le VIH et décrire ses aspects radiologiques. Patients et méthodes : Il s'agit d'une étude rétrospective et descriptive réalisée à partir de dossiers de patients infectés par le VIH/Sida et hospitalisés au service des maladies infectieuses et tropicales pour une tuberculose pulmonaire durant la période allant du 1er janvier 2011 au 31 décembre 2013. Résultats : Durant cette période d'étude, nous avons colligé 124 cas de co-infections tuberculose pulmonaire/VIH sur un total de 571 cas de tuberculose toutes formes confondues soit une prévalence de 21,7%. Le sexe masculin était prédominant avec un sex-ratio de 1,48. La notion de contage tuberculeux était retrouvée dans 8,9% des cas. Les signes cliniques classiques de la tuberculose pulmonaire ont été retrouvés notamment l'altération de l'état général (105 cas), la toux chronique (93 cas) et la fièvre chez (105 cas). L'intradermoréaction à la tuberculine était positive dans 7,3% des cas. Les crachats BAAR étaient réalisés dans 73,3% des cas et positifs dans 18,5% des cas. Le GeneXpert était réalisé chez 62 patients et positif dans 9,7% des cas. La radiographie thoracique était normale chez 35 patients et dans les autres cas les lésions radiologiques étaient dominées par : les infiltrats (20 cas); les miliaires (17 cas), infiltrat + opacités réticulo-nodulaires (15 cas), caverne + infiltrats (14 cas), opacités réticulo-nodulaires (13 cas). Dans la plupart des cas (63,7%), la localisation des lésions était diffuse. Conclusion : Les aspects radiologiques habituels de la tuberculose pulmonaire sont modifiés chez les patients infectés par le VIH avec atteintes parenchymateuses plus étendues

Etude du codon 72 du gene p53 dans la predisposition au cancer du col de l'uterus au Senegal

Introduction: En dehors de l'infection par le Virus du Papillome Humain (HPV); des facteurs genetiques ont ete impliques dans la predisposition au cancer du col de l'uterus. L'allele Arginine du codon 72 du gene suppresseur de tumeur p53 (GC; Arg/Pro); a ete associe a une predisposition au cancer du col de l'uterus chez differentes populations. Notre objectif etait d'etudier l'effet de ce polymorphisme chez une population senegalaise atteinte de cancer du col de l'uterus. Patientes et Methodes: 30 patientes atteintes de cancer du col de l'uterus ont ete recrutees et suivies a l'Institut Curie de l'Hopital Aristide Le Dantec de Dakar et 93 femmes temoins bien portantes sans cancer du col diagnostique. Pour chaque individu; l'ADN a ete extrait a partir de sang total preleve sur tube EDTA. Le genotypage du codon 72 du gene p53 a ete realise par PCR-RFLP. Resultats et Discussion: Il n'a pas ete retrouve une association significative entre l'allele Arginine du codon 72 de p53 et la predisposition au cancer du col de l'uterus (p=0;354) de meme qu'il n'a pas ete retrouve de correlation entre l'allele Arginine et les types de lesions histologiques observees au niveau du col de l'uterus. Malgre l'absence d'association du codon 72 avec la survenue du cancer du col de l'uterus; le gene p53 reste toujours d'actualite dans ce cancer de par son role suppresseur de tumeur

[Evaluation of gingival condition in homozygous children and adolescents with sickle cell anemia in Senegal]. / Evaluation de l'etat gingival chez l'enfant et l'adolescent drepanocytaires homozygotes au Senegal.

Sickle cell anaemia is an inherited disorder of haemoglobin synthesis leading to haemolytic anaemia. It touches more than 50 million people in the world and 10% of the population in Senegal. Only the homozygous form is symptomatic and appears by painful crises of vaso-occlusive type. There is a lack of works carried out or published in Senegal about potential link between periodontal conditions and sickle-cell anaemia. The main objective of this study is to assess the gingival conditions in Senegalese children and adolescents homozygous sickle cell anaemic. Secondary, the gingival state is correlated with oral hygiene and rate of reticulocytes to determine their relationship. Fifty homozygous attending the Albert Royer Paediatric Hospital of Dakar and unscathed of other systemic pathologies, were examined. The patients are old between 3 and 16 years with an average age 9.4 years +/- 3.8. The gingival state is assessed by measurement of the gingival index (GI) and index of sulculary bleeding (SBI). Partial correlation is performed between the two indexes and average of reticulocytes. The gingival index mean is 1.7 +/- 0.6 and 66% of the patients present a severe inflammation, which is more frequent in the age bracket from 3 to 12 years. The SBI mean is 1 +/- 1.1 and 68% of the patients present gingival bleeding, which is moderate to severe in 18%, with a greater frequency in the age bracket from 13 to 16 years. Strong correlation is found between plaque index, GI and SBI. Damage of gingival state seems not to be linked to the high average of reticulocytes controlling for oral hygiene. Children and adolescent homozygous have an inflammatory periodontium associated to poor oral hygiene, which highlights their needs in periodontal treatments. Early tracking and preventive treatment of periodontal diseases during systematic oral visits must be required.

Genetic study of ICAM1 in clinical malaria in Senegal.

Many genes have been implicated in the risk of severe malaria, generally based on candidate gene studies in case/control populations. Among these genes, there has been conflicting reports for the implication of a variant of the intercellular adhesion molecule 1 (ICAM1), ICAM1(Kilifi), in the risk of severe malaria, while in vitro studies provided independent support for a functional role of this variant. In order to explore the possible implication of ICAM1 in the susceptibility/resistance to malaria and to try to understand its clinical relevance in the disease process, we have conducted linkage and association studies of ICAM1 in two Senegalese villages located in regions of endemic malaria. We explored the full genetic variability of ICAM1, and tested it on several clinical malarial traits which are under genetic control, focusing principally on variables related to the parasite density and the number of malarial attacks. Our study provides no evidence for a role of ICAM1 variability on the malarial phenotypes studied.

[Hypertrophic obstructive cardiomyopathy in child. About two cases]. / Myocardiopathie hypertrophique obstructive du nourrison et de l'enfant. a propos de deux observations.

The authors report two cases of hypertrophic obstructive cardiomyopathy in young girls, age 3 months and 8 years old. The disease manifested itself as a cardiac heart failure in the infant's case and a syncop in the other case. Cardiac echocardiography showed in he first case asymetric hypertrophic cardiomyopathy with ventricular outflow tract obstruction gradient of 100 mmhg, and concentric hypertrophic with 120 mmhg in the second case. Its evolution was fatal in both cases and led to sudden death at home. This disease is severe as no therapeutic treatment can modify its course.

Serological HLA class I alleles in Senegalese blood donors detected HBs Ag positive.

We analysed the HLA class I alleles in 96 blood donors HBs Ag positive compared with 93 healthy control individuals (HBs negative). The most frequent HLA-A, -B, -C alleles found were, A23 (33.6%); A2 (25%); A30 (25%); B8 (31.5%); B7 (16.3%); B58 (11.9%); B35 (11.9%); B49 (11.9%); B53 (10.8%); Cw7 (39.1%); Cw3 (36.9%); Cw4 (36.9%). Significant differences (P<0.001) were found between the blood donors and the controls for the following HLA alleles, A1; A23; B8 and Cw3. The detection of HBe antigen was positive in 26/84 blood donors. It was observed a significant difference (P<0.01; odds ratios (OR)=6.25) between positive and negative HBe antigens blood donors for HLA-A1 allele.

[Association between Class I HLA alleles and HBs antigen carrier status among blood donors in Senegal]. / Association entre allèles HLA de classe I et portage de l'antigene HBs chez des donneurs de sang au Sénégal.

The course of hepatitis B virus (HBV) infection may be influenced by the host immune response. A prospective study was carried out in ninety-eight subjects (mean age = 23 years) HBs antigens carriers of hepatitis B and living in Dakar, Senegal. We analysed the HLA-A, -B, and C antigens distribution compared to that one of a control (HBs negative) healthy senegalese population (n = 96) living in Dielmo village where a longitudinal study was set-up since 1990. The HLA class I typing was performed by microlymphocytotoxicity assays. The most frequent HLA-A, -B, -C antigens found were: locus A: A23 (33.6%), A2 (25%), A30 (25%), locus B: B8 (31%), B7 (16.3%), B58 (11.9%), B35 (11%), B49 (11%), B53 (10.8%) and locus C: Cw7 (39.1%), Cw17 (39.1%), Cw3 (36.9%), Cw4 (36.6%). Significant differences (P < 0.001) were found between the donors and the control group for the following HLA antigens: A1, A23, B8 and Cw3. The detection of HBe antigen was positive in 26/84 blood donors. It was observed a significant difference (p < 0.01) between positive and negative HBe donors for HLA-A1 allele with an odds ratio of 6.25. All the donors carrying the HLA haplotype: A1-B8-Cw7 (11.5%) were positive in HBe antigen. HLA: B8-Cw7 haplotype (detected in 8.5% of positive donors) seems to be likely associated with a liver cancer according to many reports. An adequate follow-up should be set-up for positive HBe subjects carrying a susceptible HLA type.

[HLA-DQ allele typing in a Senegalese population: comparative study of serology and PCR-SSP]. / Typage des allèles HLA-DQ dans une population sénégalaise: étude comparative de la sérologie et de la PCR-SSP.

In this study, we compared the serological standard typing method and the DNA genotyping PCR-SSP for the characterization of HLA-DQ alleles in a senegalese population. For this purpose, 120 individuals leaving in Dielmo were typed using the microlymphocytotoxicity assay and the PCR-SSP DQ low Resolution method. A discordance of 42.5% (51/120) was found between these two methods. Thirty % (36/120) of serological typed persons failed to be typed by PCR-SSP method whereas 1% (1/120) assigned by PCR-SSP failed to be characterized by serology. Advantages and limits of these two typing methods and also the genetic background of our study population were valid arguments to comment our findings. The PCR-SSP, as suggested by several authors, is reliable, accurate and fast for HLA class II alleles characterization. Nevertheless, it needs, to become an alternative HLA typing method, available primers adapted to genetic background of study population.

[Susceptibility to neuro-malaria and HLA-DR alleles in Senegal]. / Susceptibilité au neuropaludisme et allèles HLA-DR au Sénégal.

A prospective study was carried out in 46 patients suffering from severe malaria. The control group included 220 persons of which the HLA-DR distribution was known. The HLA-DRB1 alleles were typed by PCR-SSP (Sequence Specific Primers). The most frequent HLA-DR alleles found in patients group were: DR52 (82.8%), DR13 (57.1%), DR10 (28.6%), DR53 (25.7%), DR3 (20%), DR18 (20%). A significant difference was observed between patients with severe malaria and control group for the following alleles: DR3, DR10, DR13 (p < 0.001; Chi square with Yates' correction) and their relative risk were respectively 14.67; 6.29; 2.84. HLA-DR3 was considered as the major marker associated to severe malaria.

[Prognostic value of cytokines and HLA markers in patients with cerebral malaria in Senegal]. / Valeurs pronostiques des cytokines et marqueurs HLA chez des patients atteints de neuropaludisme au Sénégal.

41 patients senegalese patients suffering from clinically defined severe malaria were studied in the intensive medical care unit of the Hôpital Principal in Dakar, Senegal. All of these individuals lived in Dakar, an area of low and seasonal Plasmodium falciparum transmission. In this study, we aim to determine in one hand, the cytokine levels of TNF-alpha, TNF-alpha sRI, TNF-alpha sRII, IL-2 sR, IL-6, IL-6 sR, and IL-10 to evaluate their prognostic value in the course of the disease; in the other hand, the influence of the HLA-DR alleles in the susceptibility to get severe malaria. At the day of admission (day 0) and 3 days later, one or two blood samples were collected for each patient to assess different biological parameters. Plasma samples were tested for cytokines cited above by ELISA (Medegenix EASIA kits) and DNA samples for HLA-DR by PCR-SSP genotyping. The concentrations of all the cytokines and/or their receptors were significantly increased at day 0 in the patients who died (TNF-alpha = 455 +/- 480 pg/ml, IL6 = 511 +/- 396 pg/ml) and decreased rapidly in the patients who survived from the disease (TNF-alpha = 354 +/- 629 pg/ml, IL6 = 453 +/- 706 pg/ml). A fatal issue seems likely related to the age of patients (20 +/- 12 years for surviving patients and 31 +/- 16 years for patients who died) and the kinetic of the cytokines. Significant differences were observed (pc < 0.001) between patients with severe malaria and a control group for the following HLA alleles: DR3, DR10 and DR13. The HLA-DR13 allele was found positively and highly associated with severe malaria.

[Identification of HLA-DR alleles for susceptibility to rheumatoid polyarthritis in Senegal]. / Identification des allèles HLA-DR de susceptibilité a la polyarthrite rhumatoïde au Sénégal.

Rheumatoid arthritis is the most frequent inflammatory rheumatism disease. Several studies were aimed to understand its physiopathogenesis in particular the association between some HLA-DR alleles and rheumatoid arthritis. A prospective study was carried out in 34 patients suffering from RA (30 Women and 4 men). The diagnosis was clinically and radiologically made. The control group included 220 persons of which the HLA-DR distribution was known. The HLA-DRB1 alleles were typed by PCR-SSP (Sequence Specific Primers). The most frequent HLA-DR alleles found in patients group were: DR10 (85.3%), DR52 (53%), DR14 (38.2%), DR11 (26.5%), and DR13 (20.3%). A significant difference was observed between RA patients and control group for the following alleles: DR3, DR10, DR18, and DR52 (p < 0.001; Chi square with Yates' correction). HLA-DR3 and DR10 were positively associated with RA. The relative risk was up 30 for DR10.

[Radiological aspects of giant cementoma of the jaws (Pindborg)]. / Les aspects radiologiques du cémentome géant des maxillaires (Pindborg).

In reference to 7 cases of Pindborg's giant cementoma in Senegalese women, the authors describe their radiological aspects. The different aspects of these tumors are emphasized according to their location on the maxilla or the mandible and whether they are anterior or posterior.

[Several cases of giant epulis observed in West Africa]. / Quelques cas d'epulis géantes observés en Afrique de l'Ouest.

The presenting symptomatology in 9 cases of giant epulis seen in West Africa was constantly difficulties in mastication or even speech, and on some occasions tumefaction of the face. A certain number of factors are involved in the development of these benign tumors, and although inflammation represents the primum movens of this affection, other causes, including some specific to the African continent, must be considered with a view to a pathogenic approach.

[Congenital idiopathic gingival hyperplasia observed in a 6-year-old child]. / Une hyperplasie gingivale idiopathique congénitale observée chez un enfant de 6 ans.

Congenital diffuse gingival hyperplasia is a rare entity. A case is presented for the first time in Senegal, the etiology of the affection being undetermined. The various pathogenic hypotheses for this lesion include: diffuse gingival fibroma, congenital, hereditary or idiopathic gingival fibromatosis, familial gingival elephantiasis and idiopathic or hereditary gingival hyperplasia.