Complete Blood Count Parameters, C-Reactive Protein and the Severity of Coronavirus Disease.

BACKGROUND: Coronavirus disease, which initially appeared in Wuhan, China during the month of December 2019, very quickly spread and became a worldwide pandemic. The African continent was not spared. The poor health system and low socioeconomic status in some regions has raised concern on the risk of an epidemic disaster due to the rapid transmission of the virus. This study therefore aims to determine the relationship between the modifications of complete blood count parameters, CRP, and the severity and outcome of SARS-CoV2 infection in the first patients hospitalized at the Centre Hospitalier Universitaire de Libreville (Libreville University Hospital Center) in Gabon. METHODS: This is a prospective study led from April to July 2020 in the COVID infectious department (SICov) of the Centre Hospitalier Universitaire de Libreville (CHUL). RESULTS: In total, 184 patients participated in the study. The median age was 47 (37 - 54) years. Male subjects predominated. The median number of leucocytes was 5.6 (4.4 - 7.45) x 109/L. It was significantly higher in patients with acute respiratory distress syndrome (ARDS) and in intensive care units (ICU) compared to pauci-symptomatic cases (p < 0.01). Factors associated with death were leukocytosis (crude OR 37.1 (8.3 - 98.4) p < 0.01), neutrophilia (OR 20.1 (4.6 - 89.0) p < 0.01), NRL ≥ 9 (OR 13.5 (2.7 - 67.4); p < 0.01) and CRP > 100 mg/L (OR 17.8 (2.0 - 154.0) p = 0.02). CONCLUSIONS: The hematological profile of patients with COVID-19 varies according to the severity of the disease. Leukocytosis, neutrophilia, a NLR above 6 and a CRP higher than 100 mg/L were associated with the severity of the infection and death in Gabonese patients.

Socio-economic status is inversely related to bed net use in Gabon.

BACKGROUND: Insecticide-treated bed nets (ITNs) range among the most effective measures of malaria prophylaxis, yet their implementation level in sub-Saharan Africa is still low. The goal of this study was to investigate the influence of socio-economic factors on the use of bed nets by mothers in Gabon. METHODS: A cross-sectional study was conducted completing pre-tested, interviewer-administered questionnaires exploring socioeconomic proxy measures with 397 mothers or guardians of young children. Respondents were grouped according to their socio-economic situation, using scores. The condition of the bed nets was evaluated during a home visit. RESULTS: Socio-economic factors of wellbeing were negatively associated with bed net use, such as living in a stone house (OR 0.26, 95% CI 0.14-0.48), running water in the house (OR 0.44, 95% CI 0.21-0.92), shower/flush toilet in the house (OR 0.39/0.34, 95% CI 0.21-0.75/0.16-0.73), ownership of a freezer (OR 0.50, 95% CI 0.26-0.96) and belonging to the highest group in the economic score (OR 0.32, 95% CI 0.15-0.67). In contrast, similar factors were positively associated with a good maintenance condition of the bed nets: higher monthly income (OR 5.64, 95% CI 2.41-13.19) and belonging to the highest group in the economic score (OR 2.55, 95% CI 1.19 - 5.45). CONCLUSION: Among the poorest families in Lambaréné the coverage with untreated nets (UTNs) is the highest, but the condition of these UTNs is the worst. To achieve a broad implementation of ITNs in Lambaréné, there is an urgent need for educational programmes as well as need-tailored marketing strategies for ITNs.

High prevalence of asymptomatic Plasmodium falciparum infection in Gabonese adults.

Plasmodium falciparum, the most common malarial parasite in sub-Saharan Africa, accounts for a high number of deaths in children less than five years of age. In malaria-endemic countries with stable transmission, semi-immunity is usually acquired after childhood. For adults, severe malaria is rare. Infected adults have either uncomplicated malaria or asymptomatic parasitemia. During a period of one year, we screened 497 afebrile males to investigate the prevalence of asymptomatic P. falciparum parasitemia in villages near Lambaréné, Gabon by use of three different methods. A total of 52% of the individuals had parasites detected by a subtelomeric variable open reading frame polymerase chain reaction (stevor-PCR), 27% of the rapid diagnostic test results were positive, and 12% of the thick blood smears with low parasitemias had P. falciparum. Most positive cases were only detected by the stevor-PCR. Asymptomatic P. falciparum parasitemia in adults living in a malaria-endemic country is frequent.