[Major sickle cell anaemia and hypoacusia: about 112 cases in Yopougon, Côte d'Ivoire]. / Drépanocytose majeure et hypoacousie: à propos de 112 cas relevés à Yopougon, Côte d'Ivoire.

The objective of this study is to evaluate the impact of major sickle cell anaemia on the auditory function of the patients. It was a prospective survey conducted in the university hospital of Yopougon (Republic of Côte d'Ivoire). The auditory function of 112 major sickle cell anaemia patients 5- to 40-five-years-old, was compared with 112 healthy controls. 17% (19/112) of major sickle cell anaemia patients presented hearing loss from 30 dB to 65 dB versus 4% of controls. The average age of deaf patients was 26-years-old (7 years to 40-years-old). The sex-ratio was 0,73. The SC form with 47% (9/19) of deafness was the form the most frequently found followed by form SS, 37% (7/19) and form S beta+ thalassaemia 16% (3/19). The form S beta 0 thalassaemia did not record deafness patients. However the form having shown the highest rate of attack was the form S beta+ thalassaemia with 25% (3/12) followed by form SC 21% (9/43) and form SS 14% (7/51) of deafness. Deafness was generally light 73, 7% of the cases and often bilateral (52.6% of the cases). The audiometric loss affected both extremes of the hearing range, but was more significant in lower tones (58% of cases). Higher tones represented 5% of the cases. It was often sensorineural hearing loss 58% of the cases. Mixed hearing loss represented 42% of the cases.

[Influence of fetal haemoglobin rate (FHb) on the oxidizing stress in homozygote sickle cell patient living in Abidjan, Côte-d'Ivoire]. / Influence du taux d'hémoglobine foetale (HbF) sur le stress oxydant chez le drépanocytaire homozygote vivant a Abidjan, Cote-d'Ivoire.

Sickle cell anemia being involved in oxidizing stress, our objective was to study the influence of the fetal haemoglobin rate (FHb) on the lipoperoxidation markers in homozygote sickle cell patient in tropical African surroundings. The study population was composed of 73 subjects among whom 57 homozygote sickle cell subjects and 16 healthy control cases. These subjects were distributed in 4 groups according to FHb rate: group 1 (FHb rate under 10%), group 2 (FHb rate ranging from 10 and 20%), group 3 (FHb rate above 20%), group 4 (control cases with no sickle cell disease). On the biological level, the markers of plasma lipoperoxidation represented by substances reacting with thiobarbituric acid (TBARS) significantly increased in sickle cell patients comparatively to control cases (p = 10(-6)). A strong positive correlation (r = +0,70, p<0,01) was found between HbS and the TBARS rate. Comparison of biological parameters of homozygote sickle cell patients according to HbF rate shows that TBARS rate is all the more low as the HbF rate is high (p = 0,02). Moreover the number of irreversible and reversible sickle cells is higher in the group 1 which has the highest rate of TBARS. This observation is confirmed by a coefficient of positive correlation between TBARS and reversible sickle cells (r = +0,40, p < 0,01). This study strengthens the role played by HbF on the modulation of physiopathology of homozygote sickle cell anemia by the control, among others, of free radicals.

[Diarrheic diseases in children. Rationalization of fecal test]. / Maladies diarrhéiques de l'enfant. Pour une rationalisation des examens de selles.

The level of diarrheic diseases among children in Burkina Faso is very high. The identification of aetiologic agents of diarrhoea in hospitalized children (0-36 months) is one of the objectives of the study. All children less than 37 months old admitted to the Pediatric Unit of the National Hospital Souro Sanou of Bobo-Dioulasso between January 1990 and March 1991, were investigated by a standardized clinical examination, and in addition, we do an analysis of a rectal swab at admission and a stool to identify aetiologic enteric agents. As a conclusion to the study: an agent was isolated in 56% of the children with diarrhoea, and in 40% of the children without diarrhoea; some germs (such Salmonella, Shigella, Entamoeba) are found in children both with and without diarrhoea; also, the total of these examinations comes to 20 US $ per episode, or 100 US $ per children/year in Burkina Faso where the number of bouts reaches 5 times per year per infant who is less than 5 years old. Stool samples are not beneficial for children with diarrhoea, neither for the diagnosis nor for the treatment. There fore these types of routine exams should not be used in Sub-Saharan Africa.

[HBs antigen carrier state in pregnant women in Bobo Dioulasso (Burkina Faso)]. / Portage de l'antigène HBs chez les femmes enceintes a Bobo-Dioulasso (Burkina Faso).

The aim of this study was to evaluate the prevalence rate and the risk factors for the carriage of hepatitis B markers in pregnant women in Bobo Dioulasso, Burkina Faso. Out of 917 pregnant women recruited during antenatal care, 98 (10.7%) were HBs antigen positive. Among these ones, 18.2% carded HBe antigen, 66.7% antiHBe antibodies and 95.6% antiHBc antibodies. Two risk factors were identified: maternal age of 23 and 28 (RR = 2.33, chi2 =12.21, p = 0.005) and widowage (Fisher test RR = 6.43, p = 0.0016). This high prevalence of HBs antigen calls for systematic screening for hepatitis B during antenatal care along with an immunization policy toward women of reproductive age and newborns.

[Hematologic malignancies in internal medicine, University Hospital of Souro Sanou (Burkina Faso)]. / Place des hemopathies malignes en service de medecine interne du CHU Souro Sanou (Burkina Faso).

INTRODUCTION: Hematologic malignancies (HM) in internal medicine remain undocumented, both epidemiological aspects, diagnosis, therapeutic that evolutionary. An inventory of sites, will document these aspects, to identify highly lethal forms, and thus contribute to improving the management of HM in a hospital in a developing country. MATERIAL AND METHODS: A cross-sectional retrospective study referred to descriptive over two and a half years, from review of patients' medical records allowed an exhaustive census of 58 cases of HM admitted to the Department of Internal Medicine of University Hospital Souro Sanou (UHC SS). RESULTS: The first reason for consultation were abdominal tumor syndrome (63.7%). The average age of patients was 42 ± 19.7 years with extremes ranging from 16 to 87 years. The sex ratio was 1.42: 1. Hematological disturbances were strongly suspected anemia (89.2%), leukocytosis (64.3%) and thrombocytopenia (46.4%). The HM depending on cytology were dominated by lymphomas (48.2%) followed by chronic myeloid leukemia or 15.5%. Chemotherapy was undertaken in 63.7% of cases. Lethality was 23.1%, was significantly higher for acute leukemia 40% (p = 0.0012). HIV serology was positive in 3 patients among the 13 cases tested. CONCLUSION: This study provided a better understanding of HM epidemiology at the UHC SS in the department of internal medicine. It revealed a predominance of lymphomas with difficulties in the initiation of chemotherapy. Improving access to chemotherapy, and technical support enable a reduction in the fatality associated with HM in the department of internal medicine at UHC SS.