Profil de l’ionogramme sanguin chez les enfants brûlés du Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle de Ouagadougou (Burkina Faso)

Les brûlures de l’enfant peuvent être à l’origine de troubles ioniques graves, entrainant une morbi-mortalité importante. Ce travail avait pour objectif de décrire les perturbations de l’ionogramme sanguin chez les enfants brûlés, afin de contribuer à l’amélioration des soins. Il s’est agi d’une étude transversale rétrospective allant du 01 janvier 2017 au 30 juin 2019. Ont été inclus les enfants hospitalisés dans le service de chirurgie du CHU pédiatrique Charles de Gaulle pour brûlure et chez lesquels un ionogramme sanguin a été réalisé. L’étude a porté sur 212 enfants, avec un âge moyen de 38,52 mois et un sex ratio de 1,12. La surface corporelle brûlée moyenne était de 26,60% et le délai moyen d’admission de 5,71 heures. La mortalité était de 16,98%. L’ionogramme sanguin à l’entrée a retrouvé une hyponatrémie (27,88%), une hypobicarbonatémie (53,95%), une hypoprotidémie (26,67%) et une hyperchlorémie (53,59%). Au contrôle, ces troubles ioniques étaient toujours présents. S’y sont associées une hypocalcémie (30,43%), une hypomagnésémie (27,27%) et une hyperphosphatémie (28,79%). La natrémie, la bicarbonatémie et la protidémie à l’entrée étaient significativement plus basses chez les patients décédés. Les brûlures de l’enfant sont fréquentes. Leur évolution est marquée par des perturbations de l’ionogramme sanguin et une mortalité élevée.Mots clés : Brûlure, Ionogramme sanguin, Enfants, Burkina Faso.   English title: Blood ionogram profile in burned children at the Charles de Gaulle University Pediatric Hospital of Ouagadougou (Burkina Faso)Burns in children can be the cause of serious ionic disorders, leading to significant morbidity and mortality. The aim of this study was to describe the disturbances in the blood ionogram of burnt children, in order to contribute to the improvement of care. This was a retrospective cross-sectional study from 01 January 2017 to 30 June 2019. Children hospitalised in the surgery department of the Charles de Gaulle Pediatric University Hospital for burns and in whom a blood ionogram was carried out were included. Our study involved 212 children, with an average age of 38.52 months and a sex ratio of 1.12. The average body surface area burned was 26.60% and the average admission time was 5.71 hours. Mortality was 16.98%. The blood ionogram at the entrance showed hyponatremia (27.88%), hypobicarbonatremia (53.95%), hypoprotidemia (26.67%) and hyperchloremia (53.59%). At the control, these ionic disorders were still present. They were associated with hypocalcaemia (30.43%), hypomagnesemia (27.27%) and hyperphosphatemia (28.79%). Natremia, bicarbonateemia and protidemia were significantly lower on admission in patients who died in the course of the evolution. Childhood burns are frequent at the CHUP-CDG; their evolution is marked by disturbances of the blood ionogram and high mortality.Keywords: Burns, Blood Ionogram, Children, Burkina Faso

Lipoprotein (a) profile in HIV-1 infected patients treated with highly active antiretroviral therapy (HAART)

Lipoprotein (a) [Lp(a)] is recognized as an independent factor of arteriosclerosis. The aim of this study was to appreciate the profile of Lipoprotein (a) recognized as an independent factor of arteriosclerosis in the monitoring of HIV-infected patients receiving Nevirapine (NVP) regimens, an antiretroviral known to reduce cardiovascular disease risk. The study population (136 subjects) comprise of 106 HIV-infected subjects, and 30 HIV-negative individuals. The 106 HIV-infected subjects were divided into groups as follows. HAART-untreated (27), HIV-infected subjects that did not receive antiretroviral treatment; HAART-6M (36), HIV-infected subjects on antiretroviral treatment for six months; and HAART-12M (43), HIV-infected subjects on antiretroviral treatment for twelve months. All recruited patients had normal blood lipids values (Total cholesterol < 5.2 mmol/L, Triglycerides < 2 g/L, HDLc > 0.9 mmol/L). The Lp(a) levels were significantly higher in the HIV-infected group compared to the control (p = 0.0036). Within the HIV-infected subjects, Lp(a) level was found to be higher in HAART-treated group compared to HAART naive group (p=0.004). Infected subjects on the antiretroviral treatment for12 months had higher Lp(a) levels than those treated for 6 months (p=0.034). This study shows that adequate management of metabolic abnormalities of HAART-treated HIV-infected patients must include periodic measurement of Lp(a) levels

Lipoprotein (a) profile in HIV-1 infected patients treated with highly active antiretroviral therapy (HAART)

Lipoprotein (a) [Lp(a)] is recognized as an independent factor of arteriosclerosis. The aim of this study was to appreciate the profile of Lipoprotein (a) recognized as an independent factor of arteriosclerosis in the monitoring of HIV-infected patients receiving Nevirapine (NVP) regimens, an antiretroviral known to reduce cardiovascular disease risk. The study population (136 subjects) comprise of 106 HIV-infected subjects, and 30 HIV-negative individuals. The 106 HIV-infected subjects were divided into groups as follows. HAART-untreated (27), HIV-infected subjects that did not receive antiretroviral treatment; HAART-6M (36), HIV-infected subjects on antiretroviral treatment for six months; and HAART-12M (43), HIV-infected subjects on antiretroviral treatment for twelve months. All recruited patients had normal blood lipids values (Total cholesterol 0.9 mmol/L). The Lp(a) levels were significantly higher in the HIV-infected group compared to the control (p = 0.0036). Within the HIV-infected subjects, Lp(a) level was found to be higher in HAART-treated group compared to HAART naive group (p=0.004). Infected subjects on the antiretroviral treatment for12 months had higher Lp(a) levels than those treated for 6 months (p=0.034). This study shows that adequate management of metabolic abnormalities of HAART-treated HIV-infected patients must include periodic measurement of Lp(a) levels

Reference Ranges of Cholesterol Sub-Fractions in Random Healthy Adults in Ouagadougou, Burkina Faso

<div><p>In Burkina Faso, the values that serve as clinical chemistry reference ranges are those provided by European manufacturers’ insert sheets based on reference of the Western population. However, studies conducted so far in some African countries reported significant differences in normal laboratory ranges compared with those of the industrialized world. The aim of this study was to determine reference values of cholesterol fractions in apparently normal adults in Burkina Faso that could be used to better assess the risks related to cardiovascular diseases. Study population was 279 healthy subjects aged from 15 to 50 years including 139 men and 140 women recruited at the Regional Center of Blood Transfusion of Ouagadougou, capital city of Burkina Faso (West Africa). Exclusion criteria based on history and clinical examination were used for defining reference individuals. The dual-step precipitation of HDL cholesterol sub-fractions using dextran sulfate was performed according to the procedure described by Hirano. The medians were calculated and reference values were determined at 2.5^th and 97.5^th percentiles. The median and upper ranges for total cholesterol, LDL cholesterol, total HDL cholesterol and HDL2 cholesterol were observed to be higher in women in comparison to men (p <0.05). These reference ranges were similar to those derived from other African countries but lower than those recorded in France and in USA. This underscores the need for such comprehensible establishment of reference values for limited resources countries. Our study provides the first cholesterol sub-fractions (HDL2 and HDL3) reference ranges for interpretation of laboratory results for cardiovascular risk management in Burkina Faso.</p></div

Residual risk of hepatitis B virus transmission through blood donations in Burkina Faso screened with rapid diagnostic tests

Abstract Background and Aims hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) represent the major transfusion–transmissible pathogens worldwide. The risk of transmission is relatively high in African countries, mainly due to unreliable screening methods of blood donations. In Burkina Faso, predonation screening using rapid diagnostic tests (RDTs) is widespread, raising the major question of the transfusion safety in the country. The objective of this study was to assess the risk of transmission of HBV, HCV, and HIV through blood transfusion in the context of the use of RDTs for screening of the blood donations. Methods In this cross‐sectional study, a total of 417 serum samples obtained from blood donors tested negative for HBsAg, anti‐HCV, and anti‐HIV using RDTs were retested for the same markers using chemiluminescent immunologic assays. Total antibodies to HBV core (anti‐HBc) were tested on randomly selected samples. HBV‐DNA and HCV‐RNA viral loads (VLs) were quantified on HBsAg and anti‐HCV positive samples, respectively. To assess possible occult hepatitis B infection (OBI), HBV‐DNA‐VL was quantified on 313 randomly selected HBsAg‐negative samples. Results HBsAg and anti‐HCV were found respectively in 6 (6/417; 1.4%) and 11 (11/417; 2.6%) samples. No samples were reactive for anti‐HIV. Total anti‐HBc were detected in 217 out of the 319 randomly selected samples (217/319; 68.02%). HBV‐DNA was detected in four (4/313; 1.27%) samples, including two (2/6; 33.33%) of the six HBsAg positive samples and two (2/313; 0.6%) of the HBsAg‐negative samples, suggesting two cases of occult HBV infection. All anti‐HCV antibody‐positive samples were HCV‐RNA negative. Conclusion This study shows that RDTs are not sufficiently sensitive for the screening of blood donations. Our results highlight the urgent need to think about the extension of sensitive immunological tests in all blood transfusion centers and also the implementation of nucleic acid amplification techniques

Seroprevalence of human immunodefi ciency virus, hepatitis B and C viruses and syphilis among blood donors in Koudougou (Burkina Faso) in 2009

Background. The high prevalence of numerous transfusion-transmitted infectious diseases such as human immunodefi ciency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis in sub-Saharan Africa affects the safety of blood for recipients. This study was undertaken with the aim of determining the seroprevalence of HIV, HCV, HBV, syphilis and socio-demographic risk factors associated with blood donation in a new regional blood transfusion centre in Burkina Faso. Material and methods. Sera samples were screened for hepatitis B surface antigen (HBsAg), antibodies to HCV, HIV types 1 and 2 and to Treponema pallidum using enzymelinked immunosorbent assays and Rapid Plasma Reagin test (RPR) respectively. All the reactive samples for HIV, HBsAg, and HCV were confi rmed using a second enzyme-linked immunosorbent assays. Antibodies to Treponema pallidum were confi rmed with a Treponema pallidum haemagglutination test (TPHA). Results. From the total of 4,520 blood donors in 2009, 1,348 (29.82%) were infected with at least one pathogen and 149 (3.30%) had serological evidence of multiple infections. The overall seroprevalence rate of HIV, HBV, HCV and syphilis was 2.21%, 14.96%, 8.69% and 3.96%, respectively. Among blood donors with multiples infections, the most common dual or triple combinations were HBsAg-HCV (1.39%), HBsAg-syphilis (0.66%) and HBsAg-HCV-syphilis (0.11%). The highest prevalences of HBsAg and HIV were found among blood donors from rural areas and in the age groups of 20-29 years and &gt;40 years old, respectively. Conclusion. HBV and HCV remain the greatest threats to blood safety in Burkina Faso. Strict selection and retention of voluntary, non-remunerated low-risk blood donors are recommended to improve blood safety in the regional blood transfusion centre of Koudougou

SCREENING OF HEPATITIS G AND EPSTEIN-BARR VIRUSES AMONG VOLUNTARY NON REMUNERATED BLOOD DONORS (VNRBD) IN BURKINA FASO, WEST AFRICA

In most sub-Saharan countries screening of blood-transmitted infections includes mainly HIV, HBV, HCV and syphilis. Many viruses such as Hepatitis G (HGV) and Epstein-Barr virus (EBV) which also carry a risk of transmission by blood transfusion raise the question of the extent of screening for these pathogens. This work aims to evaluate the prevalence of HGV and EBV in first-time blood donors in Ouagadougou. The prevalence of HGV and EBV in 551 blood donors was 7.4% and 5.4% respectively. HGV prevalence was significantly higher in blood donors with hepatitis B antigens and positive for HCV compared to donors negative for HCV and no hepatitis B antigens (respectively p<0.001 and p=0.004). EBV prevalence was higher among blood donors of < 20 years age group. This study shows significant results with regard to the prevalence of HGV and EBV prevalence in blood donors in Burkina Faso and emphasizes the need for a general screening