Évaluation du potentiel prolifératif de six cultivars de bananier (cv. AAB, ABB, et AAA) par macropropagation en République Démocratique du Congo.

Objectifs: L’objectif était celui d’améliorer la technique de macropropagation pour la production du matériel végétal de plantation de bananiers, en comparant les différents cultivars en vue d’identifier le(s) cultivar(s) qui répond(ent) mieux à cette méthode. Méthodologie et résultats : Le test ELISA a été utilisé en vue de cribler les échantillons des plantes, en rapport avec la maladie de Bunchy Top (BBTD). Suivant le dispositif complètement randomisé avec trois répétitions dans les propagateurs, les résultats obtenus ont montré que le nombre total de plantules sevrées par explants le plus élevé a été observé chez les bananiers à cuire Saba et Cardaba respectivement avec 35 et 34 plantules, suivi du plantain Bubi avec 31 plantules. Tandis que, le nombre total de plantules le plus faible a été observé chez le Dessert Gros Michel avec 23 plantules. Conclusion et application des résultats: Au regard des résultats obtenus, tous ces cultivars peuvent être retenus et utilisés dans la technique de macro-propagation en vue d’augmenter la production de matériel de plantation de la culture de bananier en un temps record mais en mettant un accent particulier sur le plantain BUBI pour la ville de Kinshasa et ses environs. Ainsi, le fait que ces matériels biologiques testés soient indemnes de toute contamination virale (BBTV), ils constituent donc le matériel de choix en vue de leur macropropagation, étape préliminaire nécessaire à la mise en place d’un champ expérimental du système agroforestier

Oral fexinidazole for stage 1 or early stage 2 African Trypanosoma brucei gambiense trypanosomiasis: a prospective, multicentre, open-label, cohort study

BACKGROUND: Staging and treatment of human African trypanosomiasis caused by Trypanosoma brucei gambiense (g-HAT) required lumbar puncture to assess cerebrospinal fluid (CSF) and intravenous drugs that cross the blood-brain barrier for late-stage infection. These procedures are inconvenient in rural health systems of disease-endemic countries. A pivotal study established fexinidazole as the first oral monotherapy to be effective against non-severe stage 2 g-HAT. We aimed to assess the safety and efficacy of fexinidazole in early g-HAT. METHODS: In this prospective, multicentre, open-label, single-arm cohort study, patients with stage 1 or early stage 2 g-HAT were recruited from eight treatment centres in the Democratic Republic of the Congo. Primary inclusion criteria included being older than 15 years, being able to ingest at least one complete meal per day (or at least one sachet of Plumpy'Nut®), a Karnofsky score higher than 50, evidence of trypanosomes in the blood or lymph but no evidence of trypanosomes in the CSF, willingness to be admitted to hospital to receive treatment, having a permanent address, and being able to comply with the follow-up visit schedule. Exclusion criteria included severe malnutrition, inability to take medication orally, pregnant or breastfeeding women, any clinically important medical condition that could jeopardise patient safety or participation in the study, severely deteriorated general status, any contraindication to imidazole drugs, HAT treatment in the past 2 years, previous enrolment in the study or previous intake of fexinidazole, abnormalities on electrocardiogram that did not return to normal in pretreatment repeated assessments or were considered clinically important, QT interval corrected using Fridericia's formula of at least 450 ms, and patients not tested for malaria or not having received appropriate treatment for malaria or for soil-transmitted helminthiasis. Patients were classified into stage 1 or early stage 2 g-HAT groups following evidence of trypanosomes in the blood, lymph, and absence in CSF, and using white-blood-cell count in CSF. Patients received 1800 mg fexinidazole once per day on days 1-4 then 1200 mg fexinidazole on days 5-10. Patients were observed for approximately 19 months in total. Study participants were followed up on day 5 and day 8 during treatment, at end of treatment on day 11, at end of hospitalisation on days 11-18, at week 9 for a subset of patients, and after 6 months, 12 months, and 18 months. The primary endpoint was treatment success at 12 months. Safety was assessed through routine monitoring. Analyses were done in the intention-to-treat population. The acceptable success rate was defined as treatment efficacy in more than 80% of patients. This study is completed and registered with ClinicalTrials.gov (NCT02169557). FINDINGS: Patients were enrolled between April 30, 2014, and April 25, 2017. 238 patients were recruited: 195 (82%) patients with stage 1 g-HAT and 43 (18%) with early stage 2 g-HAT. 189 (97%) of 195 patients with stage 1 g-HAT and 41 (95%) of 43 patients with early stage 2 g-HAT were finally included and completed the 10 day treatment period. Three patients with stage 1 g-HAT died after the 10 day treatment period and before the 12 month primary follow-up visit, considered as treatment failure and were withdrawn from the study. Treatment was effective at 12 months for 227 (99%) of 230 patients (95% CI 96·2-99·7): 186 (98%) of 189 patients (95·4-99·7) with stage 1 and 41 (100%) of 41 patients (91·4-100·0) with early stage 2, indicating that the primary study endpoint was met. No new safety issues were observed. The most frequent adverse events were headache and vomiting. In total, 214 (93%) of 230 patients had treatment-emergent adverse events, mainly common-terminology criteria for adverse events grades 1 to 3. None led to treatment discontinuation. INTERPRETATION: Fexinidazole is a valuable first-line treatment option in the early stages of g-HAT. FUNDING: Through the Drugs for Neglected Diseases initiative: the Bill & Melinda Gates Foundation, the Republic and Canton of Geneva (Switzerland), the Dutch Ministry of Foreign Affairs (also known as DGIS; Netherlands), the Norwegian Agency for Development Cooperation (also known as Norad; Norway), the Federal Ministry of Education and Research (also known as BMBF) through KfW (Germany), the Brian Mercer Charitable Trust (UK), and other private foundations and individuals from the HAT campaign

Biological evaluation of coagulation problems in COVID-19 patients hospitalized at the centre hospitalier mère-enfant monkole, kinshasa, Democratic Republic of the Congo

Background: COVID-19 is a viral infection caused by SARS-CoV-2, which enters the body via the ACE2 receptor. This study aims to evaluate the coagulation disorders of COVID-19 patients admitted to Centre Hospitalier Mère-Enfant Monkole, Kinshasa. Methods: This descriptive cross-sectional hospital-based study of patient files was conducted between July 2020 and June 2021 at CHME-Monkole in Kinshasa. The sample size was 130 patients using a random sampling technique after interviewing the respondents. For each respondent, biological and socio-demographic data were collected on a questionnaire. The primary analyses included the determination of PT, APTT, Plasma determination of D-dimers, and platelet count. A descriptive analysis was performed for socio-demographic characteristics, while Pearson correlation was used to determine the associations between socio-demographic characteristics and different biological parameters using SPSS 25.0. For ethical reasons, informed consent from patients was sought, and confidentiality was assured. The authorization was provided by the Ethical Committee of CHME-Monkole (Ethical code: KIN/CHME/04/2020). Results: The findings showed D-dimer levels higher than 500 µg/L in 87.7% of respondents, prolonged APTT (>40 seconds) in 43.1% of respondents, PT (<70%) in 36.9% of respondents, and thrombocytopenia (platelets <150,000) in 26.2% of respondents. A positive correlation was observed between socio-demographic characteristics and D-dimer levels. Conclusion: SARS-CoV-2 infection has a significant impact on coagulation. Thus, determining these biomarkers could predict the risk of disease severity or death in patients with COVID-19