[Efficacy and tolerance of direct-acting antiviral drugs for the treatment of hepatitis C in Joseph Raseta Befelatanana Teaching Hospital in Antananarivo, Madagascar]. / Efficacité et tolérance des antiviraux à action directe dans le traitement de l'hépatite C au CHU Joseph Raseta Befelatanana d'Antananarivo, Madagascar.

Objective: Our work aimed to assess the efficacy and safety of direct-acting antiviral drugs in the treatment of hepatitis C in Madagascar. Methods: This retrospective clinical study was carried out from March 2018 to February 2020 in the hepato-gastro-enterology department of the University Hospital Center Joseph Raseta de Befelatanana. Results: A total of 35 patients were included, out of which 24 received sofosbuvir/ledipasvir ± ribavirin, 10 sofosbuvir/ribavirin and one sofosbuvir/velpatasvir. Thirty-three patients were naïve to the treatment and 2 patients were initially treated with the sofosbuvir/ledipasvir combination. The sustained virologic response was 94% (33/35) in the general population, 23/25 in cirrhotic patients and 10/10 in non-cirrhotic patients. The sustained virologic response was 22/24 for sofosbuvir/ledipasvir ± ribavirin, 10/10 for sofosbuvir/ribavirin and 1/1 for sofosbuvir/velpatasvir. Adverse effects were observed in 13 patients, mainly asthenia and insomnia. Discussion: The small number of patients with hepatitis C treatments and their limited financial resources are the main limits of this survey. Conclusion: Direct-acting antivirals are effective and characterized by good tolerance in these Malagasy hepatitis C patients.

Description of 48 cases of multiple myeloma seen in the hematology laboratory of the CHU-Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar.

Monoclonal gammopathies are common abnormalities and their incidence increases with age. They are detected in roughly 3 % of people older over 50 years and up to 7 % of those over 70 years. Multiple myeloma (MM) is characterized by the proliferation of plasma cells within the bone marrow and excess secretion of monoclonal immunoglobulins. In Madagascar, late performance of biological examinations such as serum protein electrophoresis overestimates MM rates. We studied 54 patient records between March 2009 and January 2015 in the biology laboratory of the Joseph Ravoahangy Andrianavalona university hospital in Antananarivo (Madagascar). Monoclonal gammopathy was associated with multiple myeloma in most cases (88.9 %). Patients' median age was 64.2 years. Men were slightly more affected than women. It is discovered most frequently due to bone symptoms (83.3 %), and anemia is always present. Monoclonal gammopathy is mostly IgG. The bone marrow study showed medullary plasmacytosis. This disease appears most often in the elderly and has a slight male predominance. Bone marrow cytology is mandatory for diagnosis.