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Power-Hays A, Tomlinson GA, Tshilolo L, Santos B, Williams TN, Olupot-Olupot P, Smart LR, Aygun B, Lane A, Stuber SE, Latham T, Ware RE. Reducing transfusion utilization for children with sickle cell anemia in sub-Saharan Africa with hydroxyurea: Analysis from the phase I/II REACH trial. Am J Hematol 2024; 99:625-632. [PMID: 38332651 DOI: 10.1002/ajh.27244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 02/10/2024]
Abstract
Children with sickle cell anemia (SCA) in Africa frequently require transfusions for SCA complications. Despite limited blood supplies, strategies to reduce their transfusion needs have not been widely evaluated or implemented. We analyzed transfusion utilization in children with SCA before and during hydroxyurea treatment. REACH (Realizing Effectiveness Across Continents with Hydroxyurea, NCT01966731) is a longitudinal Phase I/II trial of hydroxyurea in children with SCA from Angola, Democratic Republic of Congo, Kenya, and Uganda. After enrollment, children had a two-month pre-treatment screening period followed by 6 months of fixed-dose hydroxyurea (15-20 mg/kg/day), 18 months of dose escalation, and then stable dosing at maximum tolerated dose (MTD). Characteristics associated with transfusions were analyzed with univariate and multivariable models. Transfusion incidence rate ratios (IRR) across treatment periods were calculated. Among 635 enrolled children with 4124 person-years of observation, 258 participants (40.4%) received 545 transfusions. The transfusion rate per 100 person-years was 43.2 before hydroxyurea, 21.7 on fixed-dose, 14.5 during dose escalation, and 10.8 on MTD. During MTD, transfusion incidence was reduced by 75% compared to pre-treatment (IRR 0.25, 95% confidence interval [CI] 0.18-0.35, p < .0001), and by 50% compared to fixed dose (IRR 0.50, 95% CI 0.39-0.63, p < .0001). Hydroxyurea at MTD decreases transfusion utilization in African children with SCA. If widely implemented, universal testing and hydroxyurea treatment at MTD could potentially prevent 21% of all pediatric transfusions administered in sub-Saharan Africa. Increasing hydroxyurea access for SCA should decrease the transfusion burden and increase the overall blood supply.
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Affiliation(s)
- Alexandra Power-Hays
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - George A Tomlinson
- Department of Medicine, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
| | - Leon Tshilolo
- Department of Medicine, Centre Hospitalier Monkole, Kinshasa, Congo
| | - Brígida Santos
- Instituto Hematológico Pediátrico, Hospital Pediátrico David Bernardino, Luanda, Angola
| | | | - Peter Olupot-Olupot
- Mbale Clinical Research Institute, Mbale Regional Referral and Teaching Hospital-Busitema University, Mbale, Uganda
| | - Luke R Smart
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Banu Aygun
- Division of Hematology, Cohen Children's Medical Center of New York, New Hyde Park, New York, USA
| | - Adam Lane
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Susan E Stuber
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Teresa Latham
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Russell E Ware
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
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Diarra YM, Wimba PM, Katchunga PB, Bengehya J, Miganda B, Oyimangirwe M, Tshilolo L, Ahuka SM, Iwaz J, Étard JF, Écochard R, Vanhems P, Rabilloud M. Estimating the number of probable new SARS-CoV-2 infections among tested subjects from the number of confirmed cases. BMC Med Res Methodol 2023; 23:272. [PMID: 37978439 PMCID: PMC10655282 DOI: 10.1186/s12874-023-02077-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 10/20/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES In most African countries, confirmed COVID-19 case counts underestimate the number of new SARS-CoV-2 infection cases. We propose a multiplying factor to approximate the number of biologically probable new infections from the number of confirmed cases. METHODS Each of the first thousand suspect (or alert) cases recorded in South Kivu (DRC) between 29 March and 29 November 2020 underwent a RT-PCR test and an IgM and IgG serology. A latent class model and a Bayesian inference method were used to estimate (i) the incidence proportion of SARS-CoV-2 infection using RT-PCR and IgM test results, (ii) the prevalence using RT-PCR, IgM and IgG test results; and, (iii) the multiplying factor (ratio of the incidence proportion on the proportion of confirmed -RT-PCR+- cases). RESULTS Among 933 alert cases with complete data, 218 (23%) were RT-PCR+; 434 (47%) IgM+; 464 (~ 50%) RT-PCR+, IgM+, or both; and 647 (69%) either IgG + or IgM+. The incidence proportion of SARS-CoV-2 infection was estimated at 58% (95% credibility interval: 51.8-64), its prevalence at 72.83% (65.68-77.89), and the multiplying factor at 2.42 (1.95-3.01). CONCLUSIONS In monitoring the pandemic dynamics, the number of biologically probable cases is also useful. The multiplying factor helps approximating it.
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Affiliation(s)
- Y M Diarra
- Université de Lyon, Lyon, France.
- Université Claude Bernard Lyon 1, Villeurbanne, France.
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France.
| | - P M Wimba
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Université Officielle de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
- Cliniques Universitaires de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111-CNRS UMR 5308, Lyon, France
| | - P B Katchunga
- Université Officielle de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
- Cliniques Universitaires de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
| | - J Bengehya
- Université Officielle de Mbujimayi (UOM), Mbuji-Mayi, Democratic Republic of the Congo
| | - B Miganda
- Bureau Information Sanitaire, Division provinciale de la Santé Sud-Kivu, Democratic Republic of the Congo, Bukavu, Congo
| | - M Oyimangirwe
- Université Officielle de Bukavu, Democratic Republic of the Congo, Bukavu, Congo
| | - L Tshilolo
- Université Officielle de Mbujimayi (UOM), Mbuji-Mayi, Democratic Republic of the Congo
| | - S M Ahuka
- Department of Virology, National Institute for Biomedical Research (INRB), Democratic Republic of the Congo, Kinshasa, Congo
- Service of Microbiology, Department of Medical Biology, Kinshasa teaching School of Medecine, Faculty of Medecine, University of Kinshasa, Democratic Republic of the Congo, Kinshasa, Congo
| | - J Iwaz
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
| | - J F Étard
- IRD UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
- EpiGreen, Paris, France
| | - R Écochard
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
| | - P Vanhems
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
- Centre International de Recherche en Infectiologie (CIRI), INSERM U1111-CNRS UMR 5308, Lyon, France
- Service d'Hygiène Hospitalière, Infectiovigilance et Prévention, Hospices Civils de Lyon, Épidémiologie, Lyon, France
| | - M Rabilloud
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, CNRS UMR 5558, Villeurbanne, France
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3
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Piel FB, Rees DC, DeBaun MR, Nnodu O, Ranque B, Thompson AA, Ware RE, Abboud MR, Abraham A, Ambrose EE, Andemariam B, Colah R, Colombatti R, Conran N, Costa FF, Cronin RM, de Montalembert M, Elion J, Esrick E, Greenway AL, Idris IM, Issom DZ, Jain D, Jordan LC, Kaplan ZS, King AA, Lloyd-Puryear M, Oppong SA, Sharma A, Sung L, Tshilolo L, Wilkie DJ, Ohene-Frempong K. Defining global strategies to improve outcomes in sickle cell disease: a Lancet Haematology Commission. Lancet Haematol 2023; 10:e633-e686. [PMID: 37451304 DOI: 10.1016/s2352-3026(23)00096-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Frédéric B Piel
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
| | - David C Rees
- Department of Paediatric Haematology, King's College London, King's College Hospital, London, UK
| | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt-Meharry Center of Excellence for Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Obiageli Nnodu
- Department of Haematology and Blood Transfusion, College of Health Sciences and Centre of Excellence for Sickle Cell Disease Research and Training, University of Abuja, Abuja, Nigeria
| | - Brigitte Ranque
- Department of Internal Medicine, Georges Pompidou European Hospital, Assistance Publique-Hopitaux de Paris Centre, University of Paris Cité, Paris, France
| | - Alexis A Thompson
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Russell E Ware
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Miguel R Abboud
- Department of Pediatrics and Adolescent Medicine, and Sickle Cell Program, American University of Beirut, Beirut, Lebanon
| | - Allistair Abraham
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Emmanuela E Ambrose
- Department of Paediatrics and Child Health, Bugando Medical Centre, Mwanza, Tanzania
| | - Biree Andemariam
- New England Sickle Cell Institute, University of Connecticut Health, Connecticut, USA
| | - Roshan Colah
- Department of Haematogenetics, Indian Council of Medical Research National Institute of Immunohaematology, Mumbai, India
| | - Raffaella Colombatti
- Pediatric Oncology Hematology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Nicola Conran
- Department of Clinical Medicine, School of Medical Sciences, Center of Hematology and Hemotherapy (Hemocentro), University of Campinas-UNICAMP, Campinas, Brazil
| | - Fernando F Costa
- Department of Clinical Medicine, School of Medical Sciences, Center of Hematology and Hemotherapy (Hemocentro), University of Campinas-UNICAMP, Campinas, Brazil
| | - Robert M Cronin
- Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Mariane de Montalembert
- Department of Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hopitaux de Paris Centre, Paris, France
| | - Jacques Elion
- Paris Cité University and University of the Antilles, Inserm, BIGR, Paris, France
| | - Erica Esrick
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Anthea L Greenway
- Department Clinical Haematology, Royal Children's Hospital, Parkville and Department Haematology, Monash Health, Clayton, VIC, Australia
| | - Ibrahim M Idris
- Department of Hematology, Aminu Kano Teaching Hospital/Bayero University Kano, Kano, Nigeria
| | - David-Zacharie Issom
- Department of Business Information Systems, School of Management, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | - Dipty Jain
- Department of Paediatrics, Government Medical College, Nagpur, India
| | - Lori C Jordan
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zane S Kaplan
- Department of Clinical Haematology, Monash Health and Monash University, Melbourne, VIC, Australia
| | - Allison A King
- Departments of Pediatrics and Internal Medicine, Divisions of Pediatric Hematology and Oncology and Hematology, Washington University School of Medicine, St Louis, MO, USA
| | - Michele Lloyd-Puryear
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Samuel A Oppong
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Leon Tshilolo
- Institute of Biomedical Research/CEFA Monkole Hospital Centre and Official University of Mbuji-Mayi, Mbuji-Mayi, Democratic Republic of the Congo
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Kwaku Ohene-Frempong
- Division of Hematology, Children's Hospital of Philadelphia, Pennsylvania, USA; Sickle Cell Foundation of Ghana, Kumasi, Ghana
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4
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Makani J, Cavazzana M, Gupta K, Nnodu O, Odame I, Tshilolo L, Ware R, Luzzatto L. Blood diseases in Africa: Redressing unjust disparities is an urgent unmet need. Am J Hematol 2022; 97:1505-1506. [PMID: 36216786 DOI: 10.1002/ajh.26754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Julie Makani
- The Sickle Pan-African Research Consortium (SPARCO), Dept of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Marina Cavazzana
- Biotherapy Department and Clinical Investigation Center, Assistance Publique Hôpitaux de Paris, INSERM, Paris, France
| | - Kalpna Gupta
- Hematology/Oncology, Department of Medicine, University of California, Irvine and Southern California Institute for Research and Education, VA Medical Center, Long Beach, California, USA
| | - Obiageli Nnodu
- Centre of Excellence for Sickle Cell Disease Research and Training, University of Abuja, Abuja, Nigeria
- Department of Haematology and Blood Transfusion, College of Health Sciences, University of Abuja, Abuja, Nigeria
| | - Isaac Odame
- Division of Haematology/Oncology, The Hospital for Sick Children and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Leon Tshilolo
- Institut de Recherche Biomédicale CEFA-MONKOLE, Kinshasa, Democratic Republic of the Congo
| | - Russell Ware
- Department of Pediatrics, Division of Hematology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Lucio Luzzatto
- Department of Hematology and Blood Tranfusion, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
- University of Florence, Florence, Italy
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5
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Aquaron R, Lasseaux E, Kelekele J, Bonello-Palot N, Badens C, Arveiler B, Tshilolo L. Co-occurrence of oculocutaneous albinism type 2 and mild sickle cell disease explained by HbS/βthal genotype in an individual from the Democratic Republic of Congo. Eur J Med Genet 2022; 65:104594. [PMID: 35964929 DOI: 10.1016/j.ejmg.2022.104594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/26/2022] [Accepted: 08/07/2022] [Indexed: 11/03/2022]
Abstract
Oculocutaneous albinism type 2 (OCA2) is a pigmentation disorder characterized by hypopigmentation of the skin, hair and eyes and ocular features. Sickle cell disease (SCD) is caused either by homozygosity of the beta globin gene variant c.20A > T/p.Glu6Val giving rise to severe anemia or by combined abnormal hemoglobins (HbS/βthal) leading to mild SCD. We report a 45 years old female patient from the Democratic Republic of Congo affected with these two disorders. She presented with creamy white skin and numerous pigmented patches called dendritic freckles, nystagmus, foveal hypoplasia grade 2, photophobia and very poor visual acuity. Sequencing of the OCA2 gene identified the common exon 7 deletion and a new pathogenic variant c.1444A > C/p.Thr482Pro. She had mild SCD with a total Hb level of 101 g/l. Hbβ sequencing identified variants c.20A > T giving rise to HbS and c.315 + 1 G > A characteristic of β-thalassemia. A heterozygous 3.7 kb deletion of the α globin gene was also found. The combined Hbβ/α globin genotype explains the mild SCD phenotype. Co-occurrence of OCA2 and SCD raises the question whether the patient's phenotype simply results from the addition of the two diseases' phenotypes or whether interaction between the two diseases modulates the phenotype of each other.
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Affiliation(s)
- Robert Aquaron
- Faculté de Médecine, Aix-Marseille Université, 27 Boulevard Jean Moulin, 13385, Marseille, cedex 5, France
| | - Eulalie Lasseaux
- Service de Génétique Médicale, CHU de Bordeaux, Hôpital Pellegrin, 1 place Amelie Raba Léon, 33076, Bordeaux Cedex, France
| | - Joseph Kelekele
- Cliniques Universitaires de Kinshasa, Département d'Ophtalmologie. UNIKIN. Mont Amba, Kinshasa, Democratic Republic of the Congo, The
| | | | - Catherine Badens
- Laboratoire de Génétique Moléculaire, Hôpital d'enfants de la Timone, Marseille, France
| | - Benoit Arveiler
- Service de Génétique Médicale, CHU de Bordeaux, Hôpital Pellegrin, 1 place Amelie Raba Léon, 33076, Bordeaux Cedex, France; Laboratoire Maladies Rares, Génétique et Métabolisme, INSERM U 1211, Université de Bordeaux, France.
| | - Leon Tshilolo
- Centre Hospitalier Monkole, CEFA/ Institut de Recherche Biomédicale, Mont-Ngafula, BP 817, Kinshasa, Democratic Republic of the Congo, The
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6
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Ranque B, Kitenge R, Ndiaye DD, Ba MD, Adjoumani L, Traore H, Coulibaly C, Guindo A, Boidy K, Mbuyi D, Ly ID, Offredo L, Diallo DA, Tolo A, Kafando E, Tshilolo L, Diagne I. Estimating the risk of child mortality attributable to sickle cell anaemia in sub-Saharan Africa: a retrospective, multicentre, case-control study. The Lancet Haematology 2022; 9:e208-e216. [DOI: 10.1016/s2352-3026(22)00004-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 12/13/2022]
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7
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Ranque B, Kitenge R, Coulibaly C, Traore H, Adjoumani L, Ba M, Doucoure D, Diallo D, Kafando E, Tolo A, Tshilolo L, Diagne I. Mortalité infanto-juvénile liée à la drépanocytose en Afrique subsaharienne : étude multinationale en Afrique de l’ouest et du centre. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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Ngasia B, Tshilolo L, Loko G, Vodouhe C, Wamba G, Gonzalez JP. [Realities for a Sickle Cell Disease Control Strategy in the World Health Organization African Region]. Med Trop Sante Int 2021; 1:PSMF-0S04. [PMID: 35685395 PMCID: PMC9128473 DOI: 10.48327/psmf-0s04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Network for the Study of Sickle Cell Disease in Central Africa or REDAC, is a network of African, European and American researchers whose aim is to combat sickle cell disease. Its congresses take place every year in the partner countries with international symposia alternating with workshops. REDAC enables host countries to obtain from local authorities a real involvement in the fight through resolutions in line with national strategies of fight. The Seventh International Symposium of REDAC was held in 2018 in Antananarivo, Madagascar under the auspices of the Malagasy Minister of Health and the Malagasy Senate Authorities. The theme chosen was that of strategies to combat sickle cell disease recommended by the WHO. The presentations focused on neonatal screening, early diagnosis, management of sickle cell disease and new therapies (marrow transplant, gene therapy and treatment with hydroxyurea).
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Affiliation(s)
- B. Ngasia
- Centre Hospitalier Alliance, et Programme National de Lutte Contre la Drépanocytose (PNLCD), Kinshasa, République Démocratique du Congo
| | - L. Tshilolo
- Centre de Formation et d’Appui sanitaire (CEFA) et Centre Hospitalier Monkole, République Démocratique du Congo
| | - G. Loko
- Centre Hospitalier de la Martinique, Guadeloupe, France
| | - C. Vodouhe
- DORYS, Association de Lutte Contre la Drépanocytose, Strasbourg, France
| | - G. Wamba
- Service Médical, Centre Hospitalier d’Essos, Caisse Nationale de Prévoyance Sociale, Yaoundé, Cameroun
| | - J.-P. Gonzalez
- Center of Excellence for Emerging & Zoonotic Animal Disease, CEEZAD, Kansas State University, Office Park, 1800 Kimball Ave, Suite 130, Manhattan, KS, 66502, USA,*
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9
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Boumbanda Koyo CS, Amanzougaghene N, Davoust B, Tshilolo L, Lekana-Douki JB, Raoult D, Mediannikov O, Fenollar F. Genetic diversity of human head lice and molecular detection of associated bacterial pathogens in Democratic Republic of Congo. Parasit Vectors 2019; 12:290. [PMID: 31174587 PMCID: PMC6555951 DOI: 10.1186/s13071-019-3540-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/29/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Head louse, Pediculus humanus capitis, is an obligatory blood-sucking ectoparasite, distributed worldwide. Phylogenetically, it occurs in five divergent mitochondrial clades (A-E); each exhibiting a particular geographical distribution. Recent studies suggest that, as in the case of body louse, head louse could be a disease vector. We aimed to study the genetic diversity of head lice collected in the Democratic Republic of the Congo (DR Congo) and to screen for louse-borne pathogens in these lice. METHODS A total of 181 head lice were collected from 27 individuals at the Monkole Hospital Center located in Kinshasa. All head lice were genotyped and screened for the presence of louse-borne bacteria using molecular methods. We searched for Bartonella quintana, Borrelia recurrentis, Rickettsia prowazekii, Anaplasma spp., Yersinia pestis, Coxiella burnetii and Acinetobacter spp. RESULTS Among these head lice, 67.4% (122/181) belonged to clade A and 24.3% (44/181) belonged to clade D. Additionally, for the first time in this area, we found clade E in 8.3% (15/181) of tested lice, from two infested individuals. Dual infestation with clades A and D was observed for 44.4% individuals. Thirty-three of the 181 head lice were infected only by different bacterial species of the genus Acinetobacter. Overall, 16 out of 27 individuals were infested (59.3%). Six Acinetobacter species were detected including Acinetobacter baumannii (8.3%), Acinetobacter johnsonii (1.7%), Acinetobacter soli (1.7%), Acinetobacter pittii (1.7%), Acinetobacter guillouiae (1.1%), as well as a new potential species named "Candidatus Acinetobacter pediculi". CONCLUSIONS To our knowledge, this study reports for the first time, the presence of clade E head lice in DR Congo. This study is also the first to report the presence of Acinetobacter species DNAs in human head lice in DR Congo.
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Affiliation(s)
- Celia Scherelle Boumbanda Koyo
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,Unité d'Evolution Epidémiologie et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.,Ecole Doctorale Régionale en Infectiologie Tropicale d'Afrique Centrale, Franceville, Gabon
| | - Nadia Amanzougaghene
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Bernard Davoust
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Leon Tshilolo
- Monkole Mother and Child Hospital, Kinshasa, Democratic Republic of the Congo
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution Epidémiologie et Résistances Parasitaires (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.,Ecole Doctorale Régionale en Infectiologie Tropicale d'Afrique Centrale, Franceville, Gabon.,Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé (USS), Libreville, Gabon
| | - Didier Raoult
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Oleg Mediannikov
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France. .,IHU-Méditerranée Infection, Marseille, France.
| | - Florence Fenollar
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
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Arigliani M, Kitenge R, Castriotta L, Ndjule P, Barbato V, Cogo P, Tshilolo L. Lung function in children with sickle cell disease from Central Africa. Thorax 2019; 74:604-606. [DOI: 10.1136/thoraxjnl-2018-212720] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/05/2019] [Accepted: 02/25/2019] [Indexed: 11/04/2022]
Abstract
Lung function in patients with sickle cell anaemia (SCA) living in sub-Saharan Africa is largely unknown. Anthropometry and spirometry were cross-sectionally evaluated in patients with SCA (HbSS) aged 6–18 years and in schoolchildren from the Democratic Republic of the Congo. The Global Lung Initiative 2012 spirometry reference values were used. A total of 112 patients and 377 controls were included. Twenty-six per cent of patients with SCA had spirometry findings suggestive of a restrictive pattern and 41% had a FEV1 z-score <5th percentile. Wasting, increasing age and female sex were independently associated with increased risk of restrictive spirometry pattern in patients with SCA. Longitudinal studies could clarify the prognostic meaning of these findings.
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Lobitz S, Telfer P, Cela E, Allaf B, Angastiniotis M, Backman Johansson C, Badens C, Bento C, Bouva MJ, Canatan D, Charlton M, Coppinger C, Daniel Y, de Montalembert M, Ducoroy P, Dulin E, Fingerhut R, Frömmel C, García-Morin M, Gulbis B, Holtkamp U, Inusa B, James J, Kleanthous M, Klein J, Kunz JB, Langabeer L, Lapouméroulie C, Marcao A, Marín Soria JL, McMahon C, Ohene-Frempong K, Périni JM, Piel FB, Russo G, Sainati L, Schmugge M, Streetly A, Tshilolo L, Turner C, Venturelli D, Vilarinho L, Yahyaoui R, Elion J, Colombatti R. Newborn screening for sickle cell disease in Europe: recommendations from a Pan-European Consensus Conference. Br J Haematol 2018; 183:648-660. [DOI: 10.1111/bjh.15600] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/26/2018] [Indexed: 12/23/2022]
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12
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Arigliani M, Canciani MC, Mottini G, Altomare M, Magnolato A, Loa Clemente SV, Tshilolo L, Cogo P, Quanjer PH. Evaluation of the Global Lung Initiative 2012 Reference Values for Spirometry in African Children. Am J Respir Crit Care Med 2017; 195:229-236. [PMID: 27564235 DOI: 10.1164/rccm.201604-0693oc] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Despite the high burden of respiratory disease, no spirometry reference values for African children are available. OBJECTIVES Investigate whether the Global Lung Initiative (GLI-2012) reference values for spirometry are appropriate for children in sub-Saharan Africa and assess the impact of malnutrition on lung function. METHODS Anthropometry and spirometry were obtained in children aged 6 to 12 years from urban and semiurban schools in three African countries. Spirometry z-scores were derived using the GLI-2012 prediction equations for African Americans. Thinness (body mass index z-score < -2) was a surrogate for malnutrition. Spirometry outcomes were compared with those of African American children from the third National Health and Nutrition Survey. MEASUREMENTS AND MAIN RESULTS Spirometry data were analyzed from 1,082 schoolchildren (51% boys) aged 6.0 to 12.8 years in Angola (n = 306), Democratic Republic of the Congo (n = 377), and Madagascar (n = 399). GLI-2012 provided a good fit with mean (SD) z-scores of -0.11 (0.83) for FEV1, -0.08 (0.86) for FVC, and -0.07 (0.83) for FEV1/FVC. Because of low scatter, the fifth centile corresponded to -1.3 z-scores in boys and -1.5 z-scores in girls. Malnourished African children had a normal FEV1/FVC ratio but significant reductions of ∼0.5 z-scores (∼5%) in FEV1 and FVC compared with African American peers from the third National Health and Nutrition Survey. Children in Angola had the lowest, and those in Madagascar had the highest, zFEV1 and zFVC. CONCLUSIONS The results of this study support the use of GLI-2012 reference values for schoolchildren in sub-Saharan Africa. Malnutrition affects body growth, leading to a proportionately smaller FEV1 and FVC without respiratory impairment, as shown by the normal FEV1/FVC ratio.
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Affiliation(s)
- Michele Arigliani
- 1 Department of Clinical and Experimental Medical Sciences, Unit of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Mario C Canciani
- 1 Department of Clinical and Experimental Medical Sciences, Unit of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Giovanni Mottini
- 2 International Health Cooperation Project, University Campus Bio-Medico, Rome, Italy
| | | | | | | | - Leon Tshilolo
- 6 Service de Pédiatrie, Centre Hospitalier Monkole and Centre de Formation et d'Appui Sanitaire, Kinshasa, Democratic Republic of the Congo; and
| | - Paola Cogo
- 1 Department of Clinical and Experimental Medical Sciences, Unit of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Philip H Quanjer
- 7 Department of Pulmonary Diseases and.,8 Department of Paediatrics-Pulmonary Diseases, Erasmus Medical Centre, Erasmus University, Rotterdam, the Netherlands
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13
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Ngasia B, Kazadi G, Loko G, Sica L, Wamba G, Gonzalez JP, Tshilolo L. [2nd International Symposium on Sickle Cell Disease in Central Africa]. Med Trop (Mars) 2011; 71:535-536. [PMID: 22393614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- B Ngasia
- Département de Pédiatrie, CUK Kinshasa, RDC
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14
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Tshilolo L, Wembonyama S, Summa V, Avvisati G. [Hemogram findings in Congolese children with sickle cell disease in remission]. Med Trop (Mars) 2010; 70:459-463. [PMID: 21520647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Sickle cell disease is associated with a wide range of clinical and laboratory findings depending on genetic modulators and environmental factors. The most severe forms of sickle cell disease occur in patients with the Bantu haplotype. The purpose of this study was to determine the hematological profile of Congolese patients with homozygous sickle cell disease during periods of remission. PATIENTS AND METHODS Hemograms were performed in two series of patients with sickle cell disease in remission, i.e., one including 89 patients with a mean age of 8.7 years and the other including 42 patients with a mean age of 8.9 years. Hemograms were performed using an automated counter and reticulocytes were counted manually on peripheral blood smears. Fetal hemoglobin level (HbF) was measured by chromatography (HPLC). The mean values obtained were compared with those obtained in a sickle-cell-disease-free control group. Some parameters were also compared with those obtained in a group of patients exhibiting complications of sickle cell disease. RESULTS Hemograms in the first series of patients demonstrated the following values: Hb: 7.2 g/dl; Hct 23.1%, red cells: 2.47 tera/L, leukocytes: 14.9 giga/L; VGM: 95.3 fL; CCMH:30.3% L and platelets:345,3 giga/L. Blood count showed 30.4% of polynuclear neutrophils, 33% de lymphocytes, 0.8% of polynuclear basophiles, 14% of monocytes, 7.8% of polynuclear eosinophils and 14% of erythroblasts. Mean HbF level was 7.2% and reticulocytes were at 88%. In the sickle cell disease-free group, the leukocyte rate was almost three fold higher than in the patient group exhibiting sickle cell disease in remission even though rates were higher than during complications. CONCLUSION Hemogram profiles in Congolese patients with sickle cell disease are similar to those reported in the literature for subjects exhibiting the Bantou haplotype. Leukocytosis was associated with esinophilia and monocytosis suggested a topical state and chronic inflammation.
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Affiliation(s)
- L Tshilolo
- Centre de Formation et d'Appui sanitaire (CEFA)/Centre Hospitalier Monkole, Kinshasa, RD Congo.
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15
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Zanardo V, Simbi A, Micaglio M, Cavallin F, Tshilolo L, Trevisanuto D. Laryngeal Mask Airway for neonatal resuscitation in a developing country: evaluation of an educational intervention. Neonatal LMA: an educational intervention in DRC. BMC Health Serv Res 2010; 10:254. [PMID: 20807424 PMCID: PMC2940880 DOI: 10.1186/1472-6963-10-254] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Accepted: 08/31/2010] [Indexed: 12/03/2022] Open
Abstract
Background Studies carried out in developing countries have indicated that training courses in newborn resuscitation are efficacious in teaching local birth attendants how to properly utilize simple resuscitation devices. The aim of this study was to assess the knowledge and expertise gained by physicians and midwifes who participated in a Neonatal Resuscitation Course and workshop organized in a Third World Country on the use of Laryngeal Mask Airway (LMA). Methods A 28-item questionnaire, derived from the standard test contained in the American Heart Association and the American Academy of Pediatrics Neonatal Resuscitation Manual, was administered to 21 physicians and 7 midwifes before and after a course, which included a practical, hands-on workshop focusing on LMA positioning and bag-ventilation in a neonatal manikin. Results The knowledge gained by the physicians was superior to that demonstrated by the midwifes. The physicians, in fact, demonstrated a significant improvement with respect to their pre-course knowledge. Both the physicians and the midwives showed a good level of expertise in manipulating the manipulating the manikin during the practical trial session. The midwifes and physicians almost unanimously manifested a high degree of approval of neonatal resuscitation by LMA, as they defined it a sustainable and cost-effective method requiring minimal expertise. Conclusions Further studies are warranted to test the advantages and limits of the neonatal LMA training courses in developing countries.
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Affiliation(s)
- Vincenzo Zanardo
- Department of Pediatrics, Padua University, 3 Via Giustiniani, Padua 35128, Italy.
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16
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Tshilolo L, Aissi LM, Lukusa D, Kinsiama C, Wembonyama S, Gulbis B, Vertongen F. Neonatal screening for sickle cell anaemia in the Democratic Republic of the Congo: experience from a pioneer project on 31 204 newborns. J Clin Pathol 2008; 62:35-8. [DOI: 10.1136/jcp.2008.058958] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ali-Risasi C, Praet M, Van Renterghem L, Zinga-Ilunga B, Sengeyi D, Lokomba V, Mukamina L, Ndarabu A, Kayembe NN, Tshilolo L, Mukumbi MH. [Human papillomavirus genotype profile in Kinshasa, Democratic Republic of the Congo: implications for vaccination]. Med Trop (Mars) 2008; 68:617-620. [PMID: 19639831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
UNLABELLED Proposed anti-human papillomavirus (HPV) vaccines, i.e., Cervarix (Glaxomith-Kline) and Gardasil (Merck), are designed to prevent infection by two high-risk HPV types, i.e., 16 and 18, for which estimation mainly in Western Europe and North America have demonstrated a prevalence 60 to 70%. OBJECTIVE The purpose of this study was to determine the genotype profile of HPV strains encountered in the women of childbearing age in Kinshasa, Democratic Republic of the Congo and discuss the implications of this profile for anti-HPV vaccination. METHODS Data and specimen collection was carried out at a voluntary HIV screening and treatment facility. Genotyping of HPV was performed in 55 patients presenting dysplastic lesions of the uterine cervix including 47 (85.5%) who were HIV-seropositive. Detection and typing of HPV were performed using the Inno-Lipa technique (Innogenetics Line Probe Assay) from Glaxo-Smith-Kline. RESULTS Tests for HPV were positive in 54 patients (98.2%). A total of 153 HPV strains were isolated. Twenty-three HPV types were identified including 83.0% with high oncogenic activity. In order of frequency the oncogenic types were as follows: 68, 35, 51, 52, 16, 31, 18, 17, 33, 45, 56, 58 and 59. Strain frequency per patient ranged from 1 to 8 (mean +/- standard deviation, 2.8 +/- 2,0). Types 16 and 18 accounted for 11.8% of the isolated strains (18/153) and were observed in 33.3% of patients (18/54). CONCLUSION The findings of this study suggest that the HPV genotype profile in Kinshasa differs from the profile observed in Western Europe and North America. If confirmed by larger-scale studies, this result bodes poorly for the efficacy of anti-HPV vaccines in Kinshasa.
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Affiliation(s)
- C Ali-Risasi
- Département de Biologie Médicale, Service de Biologie Clinique, Cliniques Universitaires de Kinshasa.
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De Montalembert M, Tshilolo L. [Is therapeutic progress in the management of sickle cell disease applicable in sub-Saharan Africa?]. Med Trop (Mars) 2007; 67:612-616. [PMID: 18300525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The life expectancy of patients with sickle cell disease has improved in the United States and Europe thanks to the use of penicillin prophylaxis, appropriate immunizations, neonatal screening, implementation of a quality transfusional policy, hydroxyurea therapy, detection and treatment of cerebral vasculopathy, recognition of situations that can benefit from allogenic marrow transplantation, and improvements in bone marrow transplantation techniques. The cost of almost all these techniques is far beyond the means of health care systems in Africa where they cannot be used. However at least three, i.e., penicillin, vaccines, and hydroxyurea, could be easily accessible in the framework of defined therapeutic strategies. If daily penicillin and pneumococcal vaccine Pneumo 23 are required, it would likely be necessary to select a conjugated vaccine other than Prevenar that does not provide protection against all strains present in Africa. Neonatal screening is still a rare procedure in sub-Saharan countries. Periodic transfusion is steadily improving but exchange transfusion programs aimed in particular at preventing neurological complications are still unfeasible. Indications for hydroxyurea therapy in Africa are more common due to the lack of access to chronic transfusion and must be based on consensus decision. Use of bone marrow transplantation, i.e., the only currently available curative treatment, is still possible only in northern hemisphere countries where it is still restricted to children with severe forms and an HLA-compatible family donor.
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Affiliation(s)
- M De Montalembert
- Service de pédiatrie géndrale, Hôpital Necker-Enfants Malades, Paris, France.
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Wembonyama S, Mpaka S, Tshilolo L. [Medicine and health in the Democratic Republic of Congo: from Independence to the Third Republic]. Med Trop (Mars) 2007; 67:447-457. [PMID: 18225727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The birth and mortality rates in the Democratic Republic of Congo (DRC), a former Belgian colony, are high, i.e., 48.9/1000 and 17/1000 respectively. The DRC also has one of the highest maternal death rates in the world, i.e., 1289/100,000 live births. Health conditions have not improved since independence. Access to drinking water is limited, living conditions are poor, and food availability in households is low. The mean health services utilization rate in the DRC is estimated to be 0.15 visits/inhabitant/year. The incidence of transmissible diseases is rising. This increase is observed even for illnesses that were under control before independence such as sleeping sickness, onchocerciasis, leprosy, and tuberculosis. One the main causes of mortality and morbidity in the population is malaria that is responsible for the deaths of 150,000 to 250,000 children under the age of 5 every year. The HIV prevalence rate is 4.5% with 1.19 million persons with AIDS and 930,000 orphans whose parents died of AIDS. Other potentially epidemic diseases including bubonic plaque and Ebola hemorrhagic fever are serious threats. Non-transmissible diseases are also on the rise including diabetes, systemic arterial hypertension, cancer and neglected diseases such as sickle cell anemia. To meet these challenges, the country's health authorities have established a program called the Strategy for Reinforcement of the Health System (SRHS). One goal of the SRHS is to develop health zones in order to improve access to quality health care for the whole population.
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Affiliation(s)
- S Wembonyama
- Hôpital Général de Référence Provincial Jackson Sendwe
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Tshilolo L, Mungu D, Morillon M. [Osteomyelitis in a Congolese child]. Med Trop (Mars) 2005; 65:134. [PMID: 16038351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- L Tshilolo
- Centre hospitalier de Monkole, Kinshasa, République démocratique du Congo et Service de Biologie, HIA Laveran, Marseille.
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Abstract
OBJECTIVES To determine the prevalence of haemoglobinopathies and the need for neonatal screening for haemoglobinopathies in Brussels. METHODS Between December 1994 and June 1998 23,136 cord blood samples obtained in eight hospital nurseries of Brussels were systematically screened for haemoglobinopathies by isoelectric focusing. RESULTS 45% of the newborns were from regions at risk for haemoglobinopathies. Sickle cell disease was diagnosed for 11 neonates (0.048%) and beta thalassaemia major for one neonate. Three hundred and fifty neonates (1.5%) were carriers for a haemoglobin variant, and Hb Bart's was found in 672 cases (2.9%). These prevalences are similar to those reported elsewhere in northern Europe. CONCLUSIONS These results confirm the value of universal screening for haemoglobinopathies in Brussels.
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Affiliation(s)
- B Gulbis
- Department of Clinical Chemistry, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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Tshilolo L, Kagambega F, Sztern B, Vertongen F, Gulbis B. [Hereditary spherocytosis: one year study of erythrocyte membrane proteins]. Rev Med Brux 1998; 19:417-23. [PMID: 9844481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Hereditary spherocytosis (HS) is a congenital hemolytic anemia which affects one person out of 5000 in Northern Europe. HS is caused by defects of the red cell membrane proteins involving mainly ankyrin or band 3, and less frequently, protein 4.2 or spectrin. The reduction of red cell osmotic resistance and the recognition of spherocytes on the peripheral blood smear are the primary laboratory tests necessary to evocate a diagnosis of hereditary spherocytosis. Analysis of the red cell membrane proteins using polyacrylamide gel electrophoresis is used to quantify individual proteins and to identify the protein defect related to a diagnosis of HS. Samples from 47 patients and 25 controls were studied by electrophoresis of the red cell membrane proteins. Protein deficiencies related to HS were demonstrated for 21 patients. In 4 other cases, abnormalities of membrane proteins unrelated to HS were also demonstrated. Electrophoresis of the red cell membrane proteins allows the identification of the protein deficiency related to HS and thus confirms the diagnosis of HS, but also points to the underlying molecular defect, the inheritance pattern and the clinical aspects of the disease.
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Affiliation(s)
- L Tshilolo
- Laboratoire de Chimie Clinique, Hôpital Erasme
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Gulbis B, Kagambega F, Tshilolo L, Vertongen F. Globin chains analysis: improved resolution by electrophoresis in urea-acetic acid-Triton X-100. Ann Clin Biochem 1998; 35 ( Pt 3):415-7. [PMID: 9635108 DOI: 10.1177/000456329803500311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To improve the resolution and rapidity of globin chains separation, we have modified the basic technique of globin chain electrophoresis in urea-acetic acid-Triton X-100. Haemolysates from anticoagulated cord or adult blood samples were submitted to urea-acetic acid-Triton X-100 polyacrylamide gel electrophoresis using a 15% polyacrylamide gel cast in a mini slab cell which allows a rapid analysis of globin chains samples. After staining proteins with Coomassie brilliant blue R-250, the relative amounts of globin chains were determined by scanning. This new procedure has allowed us to obtain a better separation of the normal and abnormal globin chains than described previously. All the normal globin chains, i.e. A gamma, G gamma, delta, beta and alpha, are well separated by this modified technique. Semi-quantification of the G gamma/A gamma ratio has been performed. This simple and rapid method is also suitable for the global identification of the globin chain involved in the most common abnormal haemoglobin variants, except beta-S.
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Affiliation(s)
- B Gulbis
- Department of Clinical Chemistry, Hôpital Erasme, Brussels, Belgium
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Gulbis B, Tshilolo L, Wajcman H, Riou J, Galactéros F, Promé D, Kister J, Papassotiriou I, Van Laethem Y, Vertongen F. Structural and functional studies of hemoglobin Moabit (alpha 86(F7) Leu-->Arg. Hematol Cell Ther 1997; 39:137-8. [PMID: 9262990 DOI: 10.1007/s00282-997-0137-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
An abnormal hemoglobin fraction was detected on high performance liquid chromatography profile performed for the measurement of glycated hemoglobin in a 55-year-old caucasian patient. The structural and functional studies were performed by standard techniques. Separation of hemoglobins by alkaline electrophoresis and by IEF revealed a slightly more rapid fraction than does Hb S. By acid electrophoresis, no abnormal Hb fraction could be observed. Separation of globin chains by electrophoresis demonstrated an alpha-chain variant and by chromatography, a fraction which eluted between beta and gamma globin chains. Tryptic digests and amino acid analysis have demonstrated a previously described substitution of Leu-->Arg alpha 86(F7).
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Affiliation(s)
- B Gulbis
- Department of Clinical Chemistry, Hôpital Erasme, Bruxelles, Belgique
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Tshilolo L, Gulbis B, Barlow P, Damis E, Denis-Song R, Ferster A, Haumont D, Vanderpas JB, Pardou A, Schwers J, Vokaer A, Vertongen F. [Neonatal screening for hemoglobinopathies in the Brussels region]. Rev Med Brux 1997; 18:70-3. [PMID: 9221465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We realised this study in order to determine the frequency of abnormal haemoglobins and to appreciate the need for a neonatal screening for haemoglobinopathies in Brussels. Over a two year-period, 9575 cord blood samples were systematically screened. The study disclosed following results : 40% of newborns were from regions at risk for haemoglobinopathies and abnormal haemoglobins were present in 2.5% of the neonates tested. This frequency is similar to those reported elsewhere in North Europe. The most frequent abnormal haemoglobins were the Hb S, Bart's, C, D and E. Three cases of severe forms of sickle cell anaemia were identified. The frequency of abnormal haemoglobins and Hb S traits combined to the high rate of mixed marriages (16%) justifies the need for a universal screening for haemoglobinopathies in Brussels.
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Abstract
BACKGROUND This work concerns 591 sickle cell disease patients followed by the same paediatrics team in south Zaire. POPULATION Two series of homozygous sickle cell patients were studied: 1) 251 in-patients hospitalized in Kolwezi during the period 1988-1989, and 2) 340 out-patients examined in Lubumbashi during the period 1990-1992. RESULTS In the first series, a high proportion of children aged 3-5 years (30.7%) and 6-12 years (54%) was observed in comparison with a control group of patients hospitalized for anemia at the same time. The symptoms of the disease occurred during the first year of life in 80% of the children: hand-foot syndrome and/or anemia. Tooth decay was observed as soon as the age of 3 years with a high frequency (62%) as compared with the control group. Epistaxis, sometimes very important, was observed in 39.5% and 52% of the cases in children respectively aged 6-12 years and up to 13. A splenomegaly was noted during a longer period than in the control group, suggesting associated causing factors different from malaria, perhaps alpha thalassemia. The high frequency of viral contaminations due to transfusion is illustrated by the seropositivity prevalences of HIV (11.5%), HBV (10%) and in the children in Lubumbashi. CONCLUSION The main interest of these series of children is to point out the clinical specificities of a cohort genetically homogenous, offering the opportunity of defining basis of inter-individual variability of sickle cell disease.
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Affiliation(s)
- L Tshilolo
- Service de pédiatrie, hôpital Gécamines, Kolwesi, Zaïre
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