Type 1 Diabetes and Cytomegalovirus Infection: Cytokine and T Lymphocytes Profile in Pointe Noire, Congo

Background: Type 1 Diabetes (T1D) is an autoimmune disease characterized by the destruction of beta cells in the pancreatic islets of Langerhans. This study aimed to investigate the T lymphocyte pathway involved in cytomegalovirus (CMV) infection in T1D patients in the context of. in Pointe Noire Method: We conducted an analytical case-control study over 6 months between June and November 2022. A total of 234 subjects were enrolled, including 68 (T1D +CMV+) cases, 62 (T1D +CMV-) cases, and 104 healthy subjects as the control group (healthy controls). The plasma concentrations of CD4, CD8, CD28, IL2, IL4, and IL10 were measured using ELISA. Linear regression analysis was performed to explore the correlation between T lymphocyte types (CD4, CD8, and CD28) and interleukins. Results: In the case group, the average age was 20.85±0.63 years for (T1D+CMV+) cases, 21.88±4.07 years for (DT1+CMV-) and 31.95±2.13 years for healthy controls. Men were the majority in the study, representing 55.38%, with a male-to-female ratio of 1:2. Plasma concentrations of different types of lymphocytes were higher in the case group compared to the controls CD4 (7,21±0,23 vs 5,71±3,27 vs 2,07±0,14; p<0,0001); CD8 (13,73±0,91 vs 10,01±1,88 vs 1,27±0,14 p <0,0001); CD28 (45.95±2.18 vs 14.39±1.99 vs 7.97±1.96; p<0,0001); IL2 (1048.0±43.47 vs 252.0±10.91 vs 52.91±23.95; p<0,0001); IL4 (474.3±18.45 vs 279.3±169.2 vs 194.9±136.2); IL10 (275.0±134.0 vs 206.0±84.77 vs 44.62±7.22; p <0,0001), and (CD4, CD8, CD28, IL2, IL4, and IL10) showed significant elevation in the case group compared to the controls. The study also revealed a direct correlation between CD4 and CD28. Conclusion: These findings suggest that CMV infection worsens T1D by promoting the increase in CD4, CD8, and CD28 lymphocytes as well as plasma concentrations of interleukins (IL2, IL4, and IL10), and no correlation was observed with CD8

Early Detection of Acute Renal Lesions by Serum Cystatin C in Children at Hospital and University Centre of Brazzaville

 Introduction: Acute Kidney Injury (AKI) is considered one of the main public health problems. The effective management of these alterations is based on the early detection of renal lesions. The objective of this study was to evaluate the contribution of the Cystatin C (CysC) assay in the early diagnosis of acute kidney injury (AKI) in children hospitalized in pediatric intensive care units in Brazzaville. Materials and Methods: Sixty children at high risk of developing AKI were included. Consent form signed was obtained from parents, socio-demographic data, weight and height of children recorded. Creatinine (Cr), CysC and urea were assayed in serum 24 hours after admission. Glomerular filtration clearance was estimated using serum creatinine and CysC. Glomerular filtration rate (GFR) was calculated from CysC and Cr. The diagnostic accuracy was determined by comparing the results of CysC to those of Cr (considered as a reference biomarker). Results: The median age was 5 years (with extremes ranging from 1 month to 17 years). Cr, CysC, urea, and GFR/Cr (mean ± standard deviation [range]) were 0.94±1.17 (0.2–1.4 mg/dl), 0.14 ± 0.062 (0.053-0.095 mg/l), 46.65±47.75 (15.0–45.0 mg/dl), 81.85±31.90 (≥190 ml/min per 1.73 m2 , respectively. The level of CysC in patients with ARL was significantly higher than that of children with normal renal function (p<0.001). CysC detected 71.7% of children with AKI versus 26.7% with Cr. The performance characteristics (area under the curve, sensitivity, specificity) were 0.63, 89.6% and 37.5% for creatinine and 0.76, 92.9% and 54.8% for cystatin respectively. Analysis of the characteristics of the two curves revealed that CysC had a significantly higher diagnostic capacity (p<0.001). Conclusion: Our results show that the performance of serum CysC in detecting AKI early was superior to that of serum Cr in children hospitalized in pediatric intensive care units in Brazzaville

Direct microscopic examination of imprints in patients undergoing cardiac valve replacement

BACKGROUND: Bacteriological analysis of cardiac valves might be indicated in patients with suspected endocarditis. METHODS: We report here a prospective study on fifty-three consecutive patients whose native valves were sent to the bacteriological and pathological laboratories, to investigate the performance of direct microscopic examination of imprints and valve culture. RESULTS: On the basis of a histopathological gold standard to classify the inflammatory valve process, the sensitivity, the specificity, the positive and the negative predictive values of direct microscopic examination of imprints and valve culture were 21%, 100%, 100%, 60%, and 21%, 72%, 38%, 52% respectively. This weak threshold of the direct microscopic examination of imprints could be due to antimicrobial therapy prescribed before cardiac surgery and the fact that the patients came from a tertiary hospital receiving patients with a prolonged history of endocarditis. CONCLUSION: Clinical context and histopathology are indispensable when analyzing the imprints and valve culture

Histoplasmosis in the Republic of Congo dominated by African histoplasmosis, Histoplasma capsulatum var. duboisii

International audienceThe Republic of Congo (RoC) is one of the African countries with the most histoplasmosis cases reported. This review summarizes the current status regarding epidemiology, diagnostic tools, and treatment of histoplasmosis in the RoC. A computerized search was performed from online databases Medline, PubMed, HINARI, and Google Scholar to collect literature on histoplasmosis in the RoC. We found 57 cases of histoplasmosis diagnosed between 1954 and 2019, corresponding to an incidence rate of 1–3 cases each year without significant impact of the AIDS epidemic in the country. Of the 57 cases, 54 (94.7%) were cases of Histoplasma capsulatum var. duboisii (Hcd) infection, African histoplasmosis. Three cases (5.3%) of Histoplasma capsulatum var. capsulatum infection were recorded, but all were acquired outside in the RoC. The patients’ ages ranged between 13 months to 60 years. An equal number of cases were observed in adults in the third or fourth decades (n = 14; 24.6%) and in children aged ≤15 years. Skin lesions (46.3%), lymph nodes (37%), and bone lesions (26%) were the most frequent clinical presentations. Most diagnoses were based on histopathology and distinctive large yeast forms seen in tissue. Amphotericin B (AmB) was first line therapy in 65% of the cases and itraconazole (25%) for maintenance therapy. The occurrence of African histoplasmosis in apparently normal children raises the possibility that African histoplasmosis is linked to environmental fungal exposure

Gene expression profiling of <i>p53</i> and <i>c-myc</i> in HTLV-1 positive blood donors in Congo

Objectives. The HTLV-1 infection persists for life, remaining as asymptomatic viral reservoirs in most patients, ensuring the chain of transmission, but around 4% develop adult T-cell leukemia/lymphoma (ATLL). HTLV-1 is an oncogenic retrovirus that transforms CD4+ T lymphocytes and deregulates the lymphoproliferative pathways that contribute to the development of ATLL. To achieve cell transformation, most oncogenic retroviruses use proto-oncogene capture transduction, with proviral integration disrupting the expression of tumor suppressors or proto-oncogenes. The aim. We conducted this study on the prevalence of HTLV-1 infection in blood donors to expand the HTLV-1 database, assess the risk of transmission via blood products, as well as evaluate the risk of persistent infection or development of neoplastic diseases in HTLV-1 carriers. Materials and methods. This is a cross-sectional study of blood donors of all categories. For this study, 265 blood donors were recruited at the Centre National de Transfusion Sanguine in Brazzaville. After testing for HTLV-1 antibodies by ELISA, proviral DNA was extracted from all ELISA-positive samples for detection by nested PCR, followed by RT qPCR using specific primers p53 and c-myc for gene expression. Results. 20/265 were positive for anti-HTLV-1 antibody, 5 donors were positive for proviral DNA. The prevalence of HTLV-1 was 1.8%. All HTLV-1-positive donors were male (1.8%), with a positive correlation (p = 0.05); the 1.1% of positive donors were regular, with the majority aged between 31 and 45 years (1.5%), and concubine donors were the most frequent (1.1%). All samples showed normal expression of the p53 and c-myc genes. Conclusion. The prevalence, though low, remains a serious problem. No abnormal p53 or c-myc gene expression was detected in HTLV-1-positive donors, which could mean that none of the T lymphocytes in these donors had been transformed by HTLV-1

Histomolecular profile of Helicobacter pylori strains circulating in Brazzaville (Congo)

Abstract Background and Aim Helicobacter pylori (Hp) infection is a real public health problem in the Congo. We aimed study the histomolecular profile of Hp strains circulating in Brazzaville, Congo, in order to contribute to the improvement of Hp‐infected patients in the country. Methods This was an analytical‐transversal study carried out from January to November 2020 (i.e. a study period of 11 months) in the endoscopy centers of Brazzaville as well as the molecular biology and anatomopathology laboratories of Pointe‐Noire and Oyo. It involved 100 symptomatic patients over the age of 18 referred for upper GI endoscopy. These patients underwent gastric biopsies for histopathological analysis according to the Sydney classification and molecular analysis using the real‐time polymerase chain reaction (PCR) technique. The frequency of Hp infection was determined using real‐time PCR. PCR was also used to identify the Hp strains and assess their tropism in the gastric mucosa. Digestive symptoms, endoscopic lesions, and histopathological lesions associated with HP infection were studied. Results The incidence of Hp infection was 91%, with a female predominance of 52.75% and an average age of 46.32 years. Endoscopy revealed normal mucosa (56.14%), ulcerated lesions (12.28%), and gastritis (22.81%) in infected patients. Histopathologically, the lesions were chronic atrophic gastritis (91%), with inflammatory activity (16.46%), intestinal metaplasia (16.46%), and adenocarcinoma (3.3%). Cag A strains were present in 85.71% of cases and had no preferential tropism in the gastric mucosa. Strains carrying the Cag A gene were present in severe and serious endoscopic and histopathological lesions. Conclusion The prevalence of Hp infection is 91% in the Brazzaville population. Cag A strains circulate in high proportions and are implicated in the occurrence of severe lesions of the gastric mucosa