Acceptability of neonatal sickle cell disease screening among parturient women at the Paul Moukambi Regional Hospital in rural Eastern Gabon, Central Africa

Neonatal screening and the effective management of sickle cell disease (SCD) are now well established in urban areas in some sub-Saharan African countries. The high rate of sickle cell trait in Koula-Moutou, Gabon, prompted an assessment of the psycho-clinical context of the introduction of neonatal screening in this rural area in eastern Gabon. Interviews were conducted with 215 women from February to June 2016 in Maternity and Maternal Child Protection services at the Paul Moukambi Regional Hospital Center in Koula-Moutou. Few childbearing women knew about SCD (24%), very few (6%) knew their hemoglobin status and only 30% of parturient women authorized sampling for neonatal SCD screening. Young mothers aged 16-28 years (p=0.018) and those who were educated (p=0.002) were more likely to authorize neonatal blood screening. There was no association between acceptance of blood sampling and knowledge of SCD or the parturient woman’s hemoglobin status. The barriers to acceptance for SCD neonatal diagnosis are related to the education and culture rather than the knowledge of this disease. Introduction of diagnosis in rural areas requires a team comprising a psychosocial worker and health workers known to the rural population, to remove inhibitions related to blood collection from newborn infants

Hemogram abnormalities in apparently healthy first-time blood donors in Libreville, Gabon.

Background: The objective of this study was to determine complete blood count (CBC) abnormalities in Libreville blood donors to advocate for hemoglobin pre-donation implementation and to take into account CBC results in blood donation qualification. Methods: This retrospective study was conducted with 4573 blood donors in March 2016 and from January to April 2017. CBC was performed using SysmexXP-300TM hematology analyzer (SYSMEX Corporation, Kobe, Japan). Results: Blood donors were predominantly males (83.7%) with an age ranging from 18 to 59 years. The abnormalities of leukocyte, platelet and erythrocyte counts were determined in blood donors. Leukopenia and thrombocytopenia were significantly more common in men than women (29.02% vs 24.4%, p = 0.011 and 16.2% vs 7.5%, p <0.001). Only 1.0% of women and 0.84% of men have leukocytosis, and 0.7% of women and 0.2% of men have thrombocytosis. Anemia was significantly more common in women compared to men (69.4% vs. 45.0%, P <0.001). Normocytic normochromic and normocytic hypochromic anemia were most common among Libreville blood donors with 39.4% and 23.6%; followed by microcytic normochromic (18.7%) and microcytic hypochromic (13.2%) anemia. Normocytic normochromic and normocytic hypochromic anemia were significantly more common in men than in women, whereas microcytic normochromic anemia was more prevalent among women compared to men (34.6% vs. 13.9%, p <0.001). Conclusions: The results of this study clearly show the need to perform a pre-donation hemoglobin test in blood donors and to take into account their hemogram in the blood donation selection process at the Libreville National Blood Transfusion Center. Keywords: Hemogram, Anemia, Blood Donors, Libreville, Gabon

Decrease on malaria clinical cases from 2017 to 2019 in Franceville, Southeast Gabon, Central Africa

Background. In Gabon, malaria remains a major public health problem. All malaria cases with axillary temperature ≥ 37.5°C with a parasites density ≥ 1200/μL are serious cases and must be treated as a medical emergency. Thus, early diagnosis is essential for successful treatment. Because of the impact of malaria on the population, the surveillance of malaria infections in hospitals is urgently needed. The aim of this study was to to assess of clinical cases of malaria in a private health structure in Franceville between 2017 and 2019.Methods. For that, we conducted a retrospective study using data on malaria cases recorded in a private medical analysis laboratory in Franceville, southeast Gabon. Malaria was diagnosed in this laboratory using a Rapid Diagnostic Test and confirmed by microscopic analysis.Results. Analysis of 2518 patient forms revealed an increase in malaria prevalence in Franceville between 2017-2019. The global clinical cases was 26.1% (658/2015). Children under 5 years (44.0%) and patients aged 5-14 years (40.1%) were more affected than patients aged ≥15 years (18.8%, P=0.0001). Malaria infection was also significantly dependent on season and gender. We observed at least three Plasmodium species and the predominant Plasmodium species was P. falciparum 80.0%, followed by P. ovale (19.5%) and P. malariae (17.8%).Conclusion. Our study showed that malaria remains a public health priority for the population of Franceville and that the prevalence of clinical cases of malaria at the laboratory decrease between 2017 and 2019. Our results highlight the need for strategies to control malaria in Franceville, adapted to epidemiological contexts and environmental constraint

Human T-Lymphotropic virus type 1 and human immunodeficiency virus co-infection in rural Gabon

Introduction Human T-cell lymphotrophic virus type-1 (HTLV-1) and human immunodeficiency virus (HIV-1) co-infection occur in many populations. People living with HIV-1 and infected with HTLV-1 seem more likely to progress rapidly towards AIDS. Both HTLV-1 and HIV-1 are endemic in Gabon (Central Africa). We investigated HTLV-1 and HIV-1 co-infection in the Haut-Ogooué province, and assessed factors that may favor the rapid evolution and progression to AIDS in co-infected patients. Methods Plasma samples from HTLV-1 patients were tested using ELISA, and positive samples were then tested by western blot assay (WB). We used the polymerase chain reaction to detect HTLV-1 Tax/Rex genes using DNA extracted from the buffy coat of ELISA-positives samples. Results We recruited 299 individuals (mean age 46 years) including 90 (30%) men and 209 (70%) women, all of whom are under treatment at the Ambulatory Treatment Centre of the province. Of these, 45 were ELISA HTLV-1/2 seropositive. According to WB criteria, 21 of 45 were confirmed positive: 20 were HTLV-1 (44%), 1 was HTLV-1/2 (2%), 2 were indeterminate (4%) and 22 were seronegative (49%). PCR results showed that 23 individuals were positive for the Tax/Rex region. Considering both serological and molecular assays, the prevalence of HTLV-1 infection was estimated at 7.7%. Being a woman and increasing age were found to be independent risk factors for co-infection. Mean CD4+ cell counts were higher in HTLV-1/HIV-1 co-infected (578.1 (± 340.8) cells/mm3) than in HIV-1 mono-infected (481.0 (± 299.0) cells/mm3) Individuals. Similarly, the mean HIV-1 viral load was Log 3.0 (± 1.6) copies/ml in mono-infected and Log 2.3 (± 0.7) copies/ml in coinfected individuals. Conclusion We described an overall high prevalence of HTLV-1/HIV-1 co-infection in Gabon. Our findings stress the need of strategies to prevent and manage these co-infections

Decline in the seroprevalence of syphilis markers among first-time blood donors in Libreville (Gabon) between 2004 and 2016.

BACKGROUND: Very few studies have been conducted on the seroprevalence of syphilis in Gabon. According to the World Health Organization, the average seroprevalence of syphilis has declined from 5.5 to 1.1% in Central Africa. The aim of this study was to test the hypothesis that syphilis decreased in Gabon between 2004 and 2016 and to identify factors involved in this pattern by testing a large sample of first-time blood donors in the capital Libreville. METHODS: The detection of Treponema pallidum was done using a Rapid Plasma Reagin test (RPR) and confirmed by an ELISA test using the Biorad Syphilis Total Antibody EIA II kit or BioMerieux Trepanostika TP recombinant. Assays were performed by dedicated technicians according to manufacturers' recommendations and following the laboratory standard operating procedures. Test results were manually transferred into the laboratory Excel files and hand-written in the laboratory logbook for syphilis testing. Logistic regression was used to assess the impact of sociodemographic characteristics on syphilis marker seroprevalence in both univariate and multivariable analysis. Odds ratios (OR) and 95% confidence intervals were calculated. RESULTS: The seroprevalence of syphilis markers was 8.4% (95% CI = 7.9-8.9) in 2004 and 2.4% (95% CI = 2.1-2.7) in 2016. The difference was significant [OR = 3.78; 95% CI (3.26-4.38); P < 0.001]. The decrease in syphilis seroprevalence was significant in both women and men and in each age group in univariate analysis. In multivariable analysis, controlling for all sociodemographic factors, the decrease in syphilis seroprevalence from 2004 to 2016 remained significant (OR = 3.29; 95% CI = 2.88-3.88, P < 0.001). The seroprevalence of syphilis decreased significantly in men compared to women and young donors compared to donors aged ≥36 years. CONCLUSIONS: This study shows a significant decline in syphilis seroprevalence in first-time blood donors in Libreville, Gabon. Government actions, including multiple HIV prevention activities, are a likely part of this decline

Polymorphisme génétique humain (loci G6PD, TNF-alpha, CD1, MBL et CCR5) en relation avec la susceptibilité/résistance au paludisme à plasmodium falciparum et à l'infection à HIV-1 en Afrique Centrale (Gabon)

PARIS-BIUSJ-Thèses (751052125) / SudocPARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

Facteurs influençant la perte de vue et la mortalité chez les personnes vivant avec le VIH suivies au Centre de Traitement Ambulatoire de Koula-Moutou (Gabon) de 2005 à 2015

Introduction: Cette étude avait pour but principal d'évaluer les facteurs biologiques et cliniques associés aux pertes de vue et à la mortalité des patients suivis au Centre de Traitement Ambulatoire VIH/SIDA (CTA) de Koula-Moutou. Méthodes: De 2005 à 2015, 1268 patients ont été suivis au CTA. Le diagnostic sérologique du VIH et le comptage des cellules T CD4 ont été réalisés respectivement par les kits commerciaux Determine, SD Bioline, Immunocombs et par les réactifs FACS Count. Résultats: La majorité des patients suivis était de sexe féminin (66,8%) et recevait un traitement antirétroviral (TAR) de 1ere ligne (63,3%). Les pertes de vue et la mortalité a concerné respectivement 33,5% et 24,6% des patients. La perte de vue était significativement associée à l'absence de prise du TAR (p&lt;0,001) et à un taux de CD4&gt;500 cellules/mm3 à l'inclusion (p&lt;0,001). La mortalité était plus élevée chez les hommes que chez les femmes (p=0,006). Elle était significativement réduite chez les patients en 1ere ligne du TAR (p=0,003) et ceux ayant un taux de CD4&gt;500 cellules/mm3 à l'inclusion (p&lt;0,001). La mortalité des patients très élevée à l'ouverture du CTA en 2005, a connu une réduction significative entre 2013 et 2015, passant de 4,8% à 1,6% (p&lt;0,001). Conclusion: Cette étude décrit l'épidémiologie du VIH dans une zone rurale du Gabon. Elle donne les causes des pertes de vue et de la mortalité des patients suivis dans un des dix (10) CTA du pays.Pan African Medical Journal 2016; 2

Séroprévalence du virus de l’immunodéficience humaine, des virus des hépatites B et C et de Treponema pallidum chez les donneurs de sang dans une zone rurale au sud-est Gabon (Koula-Moutou)

Objectifs: Les agents pathogènes transmissibles par transfusion sanguine constituent un problème de santé publique en Afrique subsaharienne. Le but de cette étude était de déterminer les séroprévalences du virus de l’immunodéficience humaine, des virus des hépatites B et C, et de Treponema pallidum chez les donneurs de sang dans une zone rurale au sud-est du Gabon.Méthodologie et Résultats: La sérologie des agents pathogènes transmissibles par transfusion sanguine a été déterminée par les tests rapides d’orientation diagnostic. Sur un total de 614 donneurs de sang familiaux, 82,2% (506/614) étaient des hommes. La majorité des donneurs appartenait aux tranches d’âges 18-25 ans et 26-35 ans avec respectivement 42,2% et 34,4%. La séroprévalence du virus de l’immunodéficience humaine, des virus des hépatites B et C, et de la syphilis était respectivement de 1,3% ; 3,3% ; 4,9% et 1,6%. La séroprévalence du virus de l’immunodéficience humaine a été plus élevée chez les donneurs de sang âgés de plus de 35 ans.Conclusion: Cette étude présente la première fois à notre connaissance, les séroprévalences des principales infections recherchées chez les donneurs de sang dans une zone rurale au Gabon. Les séroprévalences déterminées dans cette étude sont généralement plus faibles que celles observées dans la population générale. De ce fait, elles pourraient être sous-estimées à cause de l’usage des tests rapides d’orientation diagnostic dans la qualification des dons de sang. Un choix plus judicieux des ces tests rapides et le recrutement de donneurs de sang bénévoles non rémunérés et leur fidélisation pourraient améliorer la sécurité transfusionnelle à Koula-Moutou au sud-est du Gabon.Mots-clés: Donneurs de sang, zone rurale, marqueurs sérologiques, Koula-MoutouEnglish Title: Seroprevalence of Human immunodeficiency virus, Hepatitis B and C viruses, and Treponema pallidum among blood donors in a rural area of south-eastern Gabon (Koula-Moutou)English AbstractObjectives: Blood borne pathogens remain a public health concern in rural areas in sub-Saharan Africa. The aim of this study was to determine seroprevalence of the human immunodeficiency virus, hepatitis B and C viruses and Treponema pallidum among blood donors in a rural area of south-eastern Gabon.Methodology and Results: The serology of blood transmissible infections was determined by rapid diagnostic tests. Of a total of 614 family blood donors, 82.2% (506/614) were male. The majority of donors belonged to the age range 18-25 and 26-35 years with 42.2% and 34.4%, respectively. The seroprevalence of human immunodeficiency virus, hepatitis B and C viruses, and syphilis was 1.3%, 3.3%; 4.9% and 1.6% respectively. The seroprevalence of the human immunodeficiency virus was higher in family blood donors &gt;35 years old.Conclusions and findings: This study presents for the first time to our knowledge, the seroprevalence of the main serological markers sought in blood donors in a rural area of south-eastern Gabon. The seroprevalence determined here are generally lower than those known in the general population. As a result, they may be underestimated due to the use of rapid diagnostic tests in the qualification of blood donations. A more judicious choice of these rapid tests and the recruitment of volunteer non-remunerated blood donors and their steadiness could improve transfusion safety in Koula-Moutou in southeast Gabon.Keywords: Blood donors, rural area, serological markers, Koula-Mouto

Trends of blood-borne infectious diseases in a rural blood donation center of southeast Gabon (Koula-Moutou)

Introduction:&nbsp;blood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis B and C (HBV and HCV) viruses and&nbsp;Treponema pallidum&nbsp;remain a major public health problem in sub-Saharan Africa. The purpose of this study was to assess the frequency and clinical implications of HIV, HBV, HCV and&nbsp;Treponema pallidum&nbsp;markers in blood donors in a rural area of Southeast Gabon (Koula-Moutou) from 2012 to 2017. Methods:&nbsp;hepatitis B surface antigen (HBsAg), anti-HIV, anti-HCV and anti-Treponema pallidum&nbsp;antibodies were screened using rapid diagnostic tests. Results:&nbsp;of a total of 5,706 blood donors, 1,054 (18.5%) were seropositive for at least one infectious marker and 59 (5.6%) had serologic evidence of multiple infections. The overall seroprevalence of HIV, HBsAg, HCV, and syphilis was 3.1%; 5.9%; 6.2% and 3.3%, respectively. HIV, syphilis and HCV distributions were associated with neither the sex nor the age of the donors. Only HBsAg seroprevalence was significantly higher in donors of the age group 26-35 years old compared to donors of the age group 36-45 years (OR = 1.43 (95% CI: 1.01-2.04), P = 0.045). There was a significant increase in the frequencies of HIV and syphilis and a regression of HBsAg and HCV among blood donors. Conclusion:&nbsp;this study presents the epidemiology of the main pathogens detected in blood donors in a rural area in Gabon. We found that the overall distribution of transfusion transmitted infectious diseases were lower than those observed in the general population but could be underestimated due to the use of rapid diagnostic tests (RDTs) in the screening process of the blood donations

Prevalent hepatitis B surface antigen among first-time blood donors in Gabon.

Despite chronic Hepatitis B virus (HBV) infection being the main cause of younger-onset complex liver disease including cirrhosis and hepatocellular carcinoma (HCC) in Africa, very little is known regarding the seroprevalence of HBV in the Gabonese general population. This investigation aimed to provide strong epidemiological data and risk factors associated with HBV infection in first-time blood donors representative of the urban adult population. The screening of HBsAg was carried out using 4th generation ELISA kits. The overall seroprevalence of HBsAg was 7.28%. The frequency of HBsAg was differential and marked by annual variations in blood donors from 2009 to 2016. Seroprevalence was 2-fold higher among males versus females (OR = 1.90 (95% CI: 1.75-2.06), P<0.001). HBsAg seroprevalence was significantly higher in donors of the age group 25-35 years old compared to donors of the age group <18 years (OR = 1.64 (95% CI: 1.03-2.60), P = 0.04). The seroprevalence of HBsAg in family/replacement donors (FRD) was significantly higher than that of voluntary non-remunerated donors (VNRD) (OR = 0.88 (95% CI: 0.83-0.94), P <0.001). The simultaneous comparison of HBsAg seroprevalence with blood donation type, gender and age showed that the higher prevalence in FRD was significant only in males between 18 and 45 years and in females between 25 and 34 years of age. This study confirms the high endemicity of HBV in Gabon while identifying the most infected age groups for both men and women