INCOMPATIBILITÉ FŒTO-MATERNELLE ABO DANS TROIS FORMATIONS SANITAIRES DE KINSHASA (RDC) : PROFIL BIOLOGIQUE ET FACTEURS DE MAUVAIS PRONOSTIC

En vue d’apporter notre contribution à l’étude de l’incompatibilité sanguine fœto-maternelle en RDC et précisément à Kinshasa, nous avions choisi trois formations médicales dans lesquelles nous avons eu à prélever 120 échantillons des couples mères nouveau-nés sur lesquelles nous avons effectué les analyses biologiques précises dont : le groupage sanguin, le test de Coombs direct et le taux  d’hémoglobine. A l’issue de notre étude, les résultats suivants ont été obtenus : Chez les nouveau-nés, 57% étaient de sexe masculin contre 43% de sexe féminin ; Les données cliniques ont identifiés un ictère néonatal, les données biologiques un taux d’hémoglobine variant entre 8g /dl et 17 g /dl et le test de Coombs direct  positif à 84% ; le groupe sanguin B est représenté à 55,8% et 44,2% de  groupe sanguin A. l’incompatibilité fœto-maternelle est un problème de santé publique mais dont l’ampleur et les facteurs de risque en RDC ne sont pas évalués. Ainsi, nous retenons le groupe sanguin O de la mère, le groupe sanguin A ou B du nouveau-né, le taux d’Hg bas chez le nouveau-né, le Test de Coombs direct  positif  chez le nouveau-né et l’apparition de l’ictère dès le deuxième jour après la naissance  comme étant  des facteurs de mauvais pronostic qui annoncent une incompatibilité fœto-maternelle ABO. Cette étude montre que les manifestations cliniques d’incompatibilité sanguine fœto-maternelle sont plus fréquentes dans le système ABO et plus sévères chez les nouveau-nés de groupe sanguin B et A.   To contribute to the foeto-maternal blood incompatibility in DRC, mostly in Kinshasa, we have picked up three medical structures in which we got 120 blood specimens from mothers and their newborns. The biological analysis made onthose specimens are blood grouping, direct Coombs test, hemoglobin rate, and mother parity.At the end of the study,57% were male,43% were female, biomedical data show a hemoglobin rate between 8 g/dl and 15 g/dl, and all had neonatal jaundice.The direct Coombs test was positive at 84%,54% of newborns had B blood group, and 44,2 % had A blood group. So, the O group for the mother, the A or B blood group of the father, the low hemoglobin rate in newborns, the positive test of direct Coombs in newborns, and the presence of jaundice from day two of life are considered factors of bad prognostic of an ABO foeto-maternal incompatibility. At the end of the therapeutic following, we consider that the phototherapy treatment is better in emergency for the case of ABO foeto-maternal incompatibility. These studies show that clinical symptoms of ABO foeto-maternal incompatibility are frequent in the ABO system and more severe in newborns of the B and A blood groups. Keywords: Foeto-maternal incompatibility, ABO system, Bad prognostic factors.En vue d’apporter notre contribution à l’étude de l’incompatibilité sanguine fœto-maternelle en RDC et précisément à Kinshasa, nous avions choisi trois formations médicales dans lesquelles nous avons eu à prélever 120 échantillons des couples mères nouveau-nés sur lesquelles nous avons effectué les analyses biologiques précises dont : le groupage sanguin, le test de Coombs direct et le taux  d’hémoglobine.   A l’issue de notre étude, les résultats suivants ont été obtenus : Chez les nouveau-nés, 57% étaient de sexe masculin contre 43% de sexe féminin ; Les données cliniques ont identifiés un ictère néonatal, les données biologiques un taux d’hémoglobine variant entre 8g /dl et 17 g /dl et le test de Coombs direct  positif à 84% ; le groupe sanguin B est représenté à 55,8% et 44,2% de  groupe sanguin A. l’incompatibilité fœto-maternelle est un problème de santé publique mais dont l’ampleur et les facteurs de risque en RDC ne sont pas évalués. Ainsi, nous retenons le groupe sanguin O de la mère, le groupe sanguin A ou B du nouveau-né, le taux d’Hg bas chez le nouveau-né, le Test de Coombs direct  positif  chez le nouveau-né et l’apparition de l’ictère dès le deuxième jour après la naissance  comme étant  des facteurs de mauvais pronostic qui annoncent une incompatibilité fœto-maternelle ABO. Cette étude montre que les manifestations cliniques d’incompatibilité sanguine fœto-maternelle sont plus fréquentes dans le système ABO et plus sévères chez les nouveau-nés de groupe sanguin B et A

Correlation of antifungal susceptibility and sequence types within Cryptococcus neoformans VNI from HIV patients, and ERG11 gene polymorphism.

peer reviewed[en] INTRODUCTION: Here we tested the correlation between minimum inhibitory concentrations (MICs) of major antifungal agents and sequence types (STs) within Cryptococcus neoformans VNI isolates, and explored the ERG11 gene of included strains. MATERIALS AND METHODS: We analysed 23 C. neoformans strains categorised into two groups according to the distribution of the ST profile in Kinshasa clinics (Democratic Republic of Congo): major ST [ST93 (n = 15)], and less common STs [ST659 (n = 2), ST5 (n = 2), ST4 (n = 1), ST 53 (n = 1), ST31 (n = 1), and ST69 (n = 1)]. The MICs of the major antifungal agents [amphotericin B (AMB), 5-fluorocytosine (5FC) and fluconazole (FCZ)] were determined following EUCAST guidelines. ERG11 gene sequences were extracted from whole genome sequence of the isolates and compared with the wild-type gene sequence of the C. neoformans VNI. RESULTS: Although major ST isolates appeared to have lower median MICs for AMB and 5FU than less common ST isolates (0.50 vs. 0.75 mg/L for AMB, 2 vs. 4 mg/L for 5FU, respectively), FCZ susceptibility was similar in both groups (4 mg/L) (p-value >0.05). The susceptibility profile of C. neoformans strains separately considered did not significantly affect the patients' clinical outcomes (p-value >0.05). Furthermore, two structural modalities of the ERG11 gene were observed: (1) that of the reference gene, and (2) that containing two exonic silent point substitutions, and one intronic point substitution located in a sequence potentially involved in pre-mRNA splicing (c.337-22C > T); with no association with the MICs of the isolates (p-value >0.05). CONCLUSIONS: The lack of association/correlation found in this study calls for further investigations to better understand the mechanisms of C. neoformans resistance to antifungal agents

Diagnostic performance of several biomarkers for identification of cases of non-communicable diseases among Central Africans

Background: This study determined the diagnostic performance of new biomarkers for a composite diagnosis of non-communicable diseases (NCDs) among Central Africans. Methods:  This case-control study was conducted at LOMO Medical Centre, Kinshasa, DR Congo (DRC) between January – December, 2008. The cases comprised 226 participants with concurrent presence of at least 2 or more of NCDs. Anthropometric parameters and blood pressure were measured while blood samples were assayed for biomarkers. The receiver operating characteristics curve and the logistic regression model were applied.Results: Serum selenium (Se) had specificity and sensitivity of 72.4% and 91.1%, respectively with an area under the curve (AUC) of 0.802; Nitric oxide (NO) (specificity: 72.4%; sensitivity: 93.0%) (AUC = 0.800); Thyroid stimulating hormone (TSH) levels > 6 Mu/L (specificity: 75%; sensitivity: 65%) (AUC = 0.0.727); serum calcium levels of ≥ 110g/L (specificity: 76%; sensitivity: 75%) (AUC = 0.822); and daily salt intake of ≥10 g/day (specificity: 75%; sensitivity: 67%) (AUC = 0.653) in the diagnosis of all NCDs, which were all highly significant (<0.0001).  Conclusion: Serum Se, NO, calcium, TSH and daily salt intake had high diagnostic performance as biomarkers for identification of patients with concurrent NCDs in the study population. Keywords: Non-communicable diseases, diet, new biomarkers, Central Africa

Diagnostic performance of several biomarkers for identification of cases of non-communicable diseases among Central Africans

Background: This study determined the diagnostic performance of new biomarkers for a composite diagnosis of non-communicable diseases (NCDs) among Central Africans. Methods: This case-control study was conducted at LOMO Medical Centre, Kinshasa, DR Congo (DRC) between January \u2013 December, 2008. The cases comprised 226 participants with concurrent presence of at least 2 or more of NCDs. Anthropometric parameters and blood pressure were measured while blood samples were assayed for biomarkers. The receiver operating characteristics curve and the logistic regression model were applied. Results: Serum selenium (Se) had specificity and sensitivity of 72.4% and 91.1%, respectively with an area under the curve (AUC) of 0.802; Nitric oxide (NO) (specificity: 72.4%; sensitivity: 93.0%) (AUC = 0.800); Thyroid stimulating hormone (TSH) levels > 6 Mu/L (specificity: 75%; sensitivity: 65%) (AUC = 0.0.727); serum calcium levels of 65 110g/L (specificity: 76%; sensitivity: 75%) (AUC = 0.822); and daily salt intake of 6510 g/day (specificity: 75%; sensitivity: 67%) (AUC = 0.653) in the diagnosis of all NCDs, which were all highly significant (<0.0001). Conclusion: Serum Se, NO, calcium, TSH and daily salt intake had high diagnostic performance as biomarkers for identification of patients with concurrent NCDs in the study population

Épidémiologie clinique et grande diversité génétique parmi les isolats de Cryptococcus spp. infectant les personnes vivant avec le VIH à Kinshasa, République démocratique du Congo

Neuromeningeal cryptococcosis (NMC) is a life-threatening opportunistic infection in advanced HIV disease patients (AHDP). It is caused by Cryptococcus spp. complexes and mainly occurs in sub-Saharan Africa. In this study, we performed molecular characterization and antifungal susceptibility profiling of Cryptococcus isolates from AHDP in Kinshasa (DRC). Additionally, we investigated a possible association between NMC severity factors and the Cryptococcus neoformans (Cn) multilocus sequence typing (MLST) profiles. We characterized the isolates using PCR serotyping, MALDI-TOF MS, internal transcribed spacer (ITS) sequencing, and MLST. Susceptibility testing for the major antifungal drugs was performed according to the EUCAST guidelines. Parameters associated with NMC severity, such as hypoglycorrhachia ( 30 cm H2O), and poor therapeutic outcome were compared with the Cn MLST sequences type (ST). Twenty-three out of 29 Cryptococcus isolates were identified as serotype A using PCR serotyping (79.3%; 95% IC: 65.5-93.1), while six (20.7%; 95% IC: 6.9-34.5) were not serotypable. The 29 isolates were identified by ITS sequencing as follows: Cryptococcus neoformans (23/29, 79.3%), Cutaneotrichosporon curvatus (previously called Cryptococcus curvatus) (5/29, 17.2%), and Papiliotrema laurentii (Cryptococcus laurentii) (1/29, 3.5%). Using the ISHAM MLST scheme, all Cn isolates were identified as molecular type VNI. These comprised seven different STs: ST93 (n = 15), ST5 (n = 2), ST53 (n = 1), ST31 (n = 1), ST4 (n = 1), ST69 (n = 1), and one novel ST that has not yet been reported from other parts of the world and was subsequently assigned as ST659 (n = 2). Of the included strains, only Papiliotrema laurentii was resistant to amphoterin B (1/29, 3.5%), 6.8% (2/29) were resistant to 5-flucytosine (the single Papiliotrema laurentii strain and one Cryptococcus neoformans isolate), and 13.8% (4/29) to fluconazole, including two of five (40%) Cutaneotrichosporon curvatus and two of 23 (8.7%) C. neoformans strains. We found a significative association between poor therapeutic outcome and a non-ST93 sequence type of causative strains (these concerned the less common sequence types: ST53, ST31, ST5, ST4, ST659, and ST69) (87.5% versus 40%, p = 0.02). Molecular analysis of Cryptococcus spp. isolates showed a wide species diversity and genetic heterogenicity of Cn within the VNI molecular type. Furthermore, it is worrying that among included strains we found resistances to several of the commonly used antifungals.Cryptococcose chez les personnes vivant avec le VIH à Kinshasa : étude épidémiologique et moléculaire3. Good health and well-bein

Synthèses et propriétés physicochimiques de dérivés de la glycine betaine

audience: researcher, professional, student, popularizationDesign of new surfactants is of considerable interest in order to obtain materials with specific physico-chemical properties for targeted applications. Among them, quaternary ammonium surfactants are widely employed in pharmaceutical and cosmetic industries. Unfortunately, as a consequence of their widespread use and strong resistance to biodegradation, those chemical surfactants may persist in wastewater treatment systems at relatively high concentrations and can cause a disturbance of the ecological equilibrium. In this context, glycine betaine based surfactants are of increasing interest today thanks to their higher biodegradability and low environmental impact. For example, alkylbetaines and alkylamidobetaines are produced on the industrial scale and are used as amphoteric surfactants less irritating compared to sodium dodecylsulfate (SDS) in cosmetics. In this study, new surface-active agents based on glycine betaine and issued from the green chemistry are synthesized. Very simple synthetic methodologies led to different betaine derivatives (esters, thioesters, amides). Their physico-chemical properties are investigated in order to give insights about the key parameters to take into account for the formulation of betaine derived compound preparations for cosmetic or pharmaceutical purposes.Projet Technos

Surveillance moléculaire de la résistance de Plasmodium falciparum aux associations thérapeutiques à base d'artémisinine

Malaria is a major public health problem in the Democratic Republic of Congo. Despite progress achieved over the past decade in the fight against malaria, further efforts have to be done such as in the surveillance and the containment of Plasmodium falciparum resistant strains. We investigated resistance to artemisinin-based combination therapies currently in use in Democratic Republic of Congo by surveying molecular polymorphisms in three genes: pfcrt, pfmdr1 and pfk13 to explore possible emergence of amodiaquine, lumefantrine or artemisinin resistance in Democratic Republic of Congo. This study essentially revealed that resistance to chloroquine is still decreasing while polymorphism related to amodiaquine resistance seems to be not present in Democratic Republic of Congo, that three samples, located in the east of the country, harbor Pfmdr1 amplification and that none of the mutations found in South-East Asia correlated with artemisinine resistance have been found in Democratic Republic of Congo. But new mutations have been identified, especially the M476K, occurred in the same position that the M476I previously identified in the F32-ART strain, strongly resistant to artemisinine. Antimalarial first-line treatments currently in use in Democratic Republic of Congo are not associated with emergence of molecular markers of resistance