[Socio-demographic and economic profile of adult patients with sickle cell disease followed up on a regular basis at the University Hospital Center of Libreville]. / Profil socio-démographique et économique des adultes drépanocytaires régulièrement suivis au Centre Hospitalier Universitaire de Libreville.

Sickle cell disease is a genetic disease transmitted as an autosomal recessive trait. Since September 2016, at the University Hospital Center of Libreville (UHCL) hematology consultation dedicated to adult patients with sickle cell disease was offered. This was the occasion to conduct this study, the purpose of which was to describe the socio-demographic and economic profile of patients followed up on a regular basis. We conducted a retrospective, descriptive and non-comparative study in the Department of Internal Medicine at the UHCL, from September 2016 to June 2019. Patients aged 18 years and older with homozygous sickle cell disease who had been followed up during the study period, were able to answer questions and had undergone at least three haematology consultations were included in the study. A total of 88 patients out of 233 met the inclusion criteria during the study period; women predominated. The sex ratio was 0.5 and the average age of patients was 30.4 ± 7.8 years, 42% had a higher education level, 88.6% had health insurance that allowed 31.8% of them to take care of themselves, in addition to their monthly income. Sickle cell disease was an obstacle in patients daily and professional lives but they got support from family and friends. This study shows that patients with sickle cell disease who attend follow-up visits are integrated into society. Most of them have an education level that allow them to understand their illness and a health insurance which can help them manage their illness.

[Co-infection of malaria and COVID-19 in patients admitted to the COVID Infectious Disease Department of the Libreville University Hospital Center]. / Co-infection paludisme et COVID-19 chez les patients admis au service d'infectiologie COVID du Centre Hospitalier Universitaire de Libreville.

The purpose of this study was to report the cases of co-infection of malaria and COVID-19, after systematic search for plasmodium in patients treated in the COVID Infectious Disease Department (SiCOV) of the Libreville University Hospital (LUH). We conducted a prospective, observational study in the LUH SiCOV from April to July 2020. Patients of both sexes, aged over 18 years, with positive Polymerase Chain Reaction (PCR) test for SARS-CoV-2 with thick blood smear result available, were included. For each patient, demographics (age, gender, weight, height), history and clinical and biological examination results were reported in the Excel file. Of a total of 253 patients who met the inclusion criteria, 8 had malaria associated with positive SARS-CoV-2 PCR. These were women (3) and men (5), with an average age of 36.9 years (25- 53 years). The mode of transmission was unknown in 7/8. All patients were febrile, 6/8 had headaches and 5/8 had respiratory discomfort. Less than half of patients had otolaryngeal (anosmia, ageusia) or digestive (diarrhea) manifestations. One patient with severe form died on day 5 of hospitalization. Clinical similarities between malaria and COVID-19 can lead to confusion in malaria endemic areas. The co-infection of malaria and COVID-19 did not result in severe clinical forms.

Complete Blood Count Parameters, C-Reactive Protein and the Severity of Coronavirus Disease.

BACKGROUND: Coronavirus disease, which initially appeared in Wuhan, China during the month of December 2019, very quickly spread and became a worldwide pandemic. The African continent was not spared. The poor health system and low socioeconomic status in some regions has raised concern on the risk of an epidemic disaster due to the rapid transmission of the virus. This study therefore aims to determine the relationship between the modifications of complete blood count parameters, CRP, and the severity and outcome of SARS-CoV2 infection in the first patients hospitalized at the Centre Hospitalier Universitaire de Libreville (Libreville University Hospital Center) in Gabon. METHODS: This is a prospective study led from April to July 2020 in the COVID infectious department (SICov) of the Centre Hospitalier Universitaire de Libreville (CHUL). RESULTS: In total, 184 patients participated in the study. The median age was 47 (37 - 54) years. Male subjects predominated. The median number of leucocytes was 5.6 (4.4 - 7.45) x 109/L. It was significantly higher in patients with acute respiratory distress syndrome (ARDS) and in intensive care units (ICU) compared to pauci-symptomatic cases (p < 0.01). Factors associated with death were leukocytosis (crude OR 37.1 (8.3 - 98.4) p < 0.01), neutrophilia (OR 20.1 (4.6 - 89.0) p < 0.01), NRL ≥ 9 (OR 13.5 (2.7 - 67.4); p < 0.01) and CRP > 100 mg/L (OR 17.8 (2.0 - 154.0) p = 0.02). CONCLUSIONS: The hematological profile of patients with COVID-19 varies according to the severity of the disease. Leukocytosis, neutrophilia, a NLR above 6 and a CRP higher than 100 mg/L were associated with the severity of the infection and death in Gabonese patients.