Pneumonie varicelleuse du nouveau-né: à propos d’un cas

La varicelle est une maladie contagieuse fréquente chez l’enfant, mais rare chez la femme enceinte. La survenue de varicelle pendant la grossesse peut entrainer des complications périnatales dont la pneumonie varicelleuse du nouveau-né. Cette atteinte pulmonaire est accompagnée d’un taux élevé de décès. Nous rapportons un cas de pneumonie varicelleuse grave chez un nouveau-né qui a été contaminé par le virus de la varicelle par voie transplacentaire. Le tableau clinique associait un syndrome infectieux, une détresse respiratoire sévère avec coma, des râles sous-crépitants diffus aux deux champs pulmonaires, et une éruption cutanée disséminée faite de macules, vésicules, croûtes, évocatrice de la varicelle. La radiographie du thorax montrait un syndrome interstitiel diffus aux deux poumons. Un traitement par l’aciclovir injectable associé à l’oxygénothérapie continue a permis une évolution vers la guérison. La pneumonie varicelleuse du nouveau-né est situation associée à une forte mortalité mais dont le traitement par l’aciclovir injectable peut permettre la guérison. La prophylaxie par administration intraveineuse d’aciclovir ou d’immunoglobulines polyvalentes chez le nouveau-né permet de diminuer la sévérité et la mortalité de la varicelle périnatale.Pan African Medical Journal 2012; 13:2

Sero-epidemiology of human immunodeficiency virus, hepatitis B and C viruses, and syphilis infections among first-time blood donors in Edéa, Cameroon

SummaryBackgroundBlood safety remains an issue of major concern in transfusion medicine in sub-Saharan Africa. Blood-borne agents such as the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Treponema pallidum are among the greatest threats to blood safety for the recipient. This study aimed to determine the seroprevalence and risk factors of HIV, HCV, HBV, and syphilis infections among first-time blood donors at the new hospital-based blood bank in Edéa, Cameroon.MethodsWe carried out a retrospective analysis of blood donor data recorded between December 2011 and May 2012 at the blood bank of the Edéa Regional Hospital. Antibodies to HIV types 1 and 2 were screened with the Determine and ImmunoComb tests. Hepatitis B surface antigen and antibodies to HCV were detected using DIASpot test strips. Syphilis was diagnosed using the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum hemagglutination assay (TPHA).ResultsA total of 543 blood donors were included, among whom 349 (64.3%) were family replacement donors. One hundred and fifteen donors (21.2%) were infected with at least one pathogen. The overall seroprevalence rates of HIV, HBV, HCV, and syphilis were 4.1%, 10.1%, 4.8%, and 5.7%, respectively. We found a total of 26 dual infections. The most common combinations were HBV–HCV and HBV–HIV. There was a significant association between HIV and HBV infections (adjusted odds ratio (aOR) 3.46, 95% CI 1.29–9.39; p=0.014), and between HBV and HCV infections (aOR 2.81, 95% CI 1.02–10.12; p=0.036). Compared to voluntary donors, family replacement donors were significantly more infected by at least one screened pathogen (aOR 1.81, 95% CI 1.14–2.88; p=0.013), and more infected specifically by HIV (aOR 3.66, 95% CI 1.07–12.55; p=0.039) and syphilis (aOR 2.81, 95% CI 1.05–7.46; p=0.039).ConclusionsOur findings indicate that blood safety remains a major problem in Cameroon where hospital-based blood banks and family replacement donors are predominant. There is an urgent need for a national blood transfusion program in Cameroon that will establish a nationally coordinated blood transfusion service based on the principles of voluntary regular non-remunerated blood donation