[Prevention of post-transfusional malaria in France: a descriptive survey]. / Prévention du paludisme post-transfusionnel en France: enquête descriptive.

Due to an expansion in international travel, an increasing number of blood donors are at risk of exposure to malaria. Preventions of transfusional malaria is required by law in France. Acting as National Reference Center for Malarial Immunology we noticed that this regulation was not being respected by all blood banks. We conducted a questionnaire study concerning 181 blood banks to evaluate under which circumstances serological tests were requested, the policy employed in case of seropositivity, the cost of screening, and wishes concerning modification of the law. The response rate was 46.9%. We noticed a great variability in attitude: only 21% of blood banks followed the regulation; 63% added extra criteria to the law; 16% did not follow the regulation. Indirect immunofluorescence was the main method used by 91.5% of blood banks. However the specificity threshold fluctuated. The fate of the blood unit in case of seropositivity was variable (discard of blood bags, plasma fractionation, blood used). Centers who answered to questionnaire performed 2,513,687 blood donations during the survey. A serology was carried out in 2.6% of donations, and was positive in 9.4% of cases i.e. 0.24% of donations. The average cost of screening was 35 FF. The profit loss due to discard of positive blood was estimated at 1.7 million FF. for the duration of the survey and the blood banks studied. 99% of centers answering the questionnaire expressed desire for standardisation of screening method.

[Economic benefit of using antibiotics prophylactically in cesarean sections with little risk of infection]. / Bénéfice économique de l'antibioprophylaxie dans les césariennes dépourvues de haut risque infectieux.

A randomised double trial was carried out in 266 women who had Caesarean without any high risk of infection in order to study the efficacy of prophylactic antibiotics given during the operation. One group received 1 gram of cefotetan when the cord was being clamped and the other had an injection of placebo under the self-same conditions. Apart from studying the clinical efficacy, evaluation of the economics of the treatment was carried out using, as parameters, the length of stay in hospital and the cost of the antibiotics which were prescribed after the operation. The following results were obtained: 75% of the Caesarean operations carried out in the Maternity Units of the University Regional Hospital Centre were without high risk of infection. Prophylactic antibiotics are proficient because they reduce post Caesarean morbidity due to: endometritis, superficial and deep abscesses and septicaemia. 12.5% in the group who had antibiotics developed infections as against 26% in the placebo group. Post Caesarean infections which required antibiotics cost on an average for each Caesarean 16 francs in the groups who received antibiotics as against 52 francs in the groups that received the placebo. Even including the cost of the antibiotics given prophylactically the costs of antibiotics (prophylactic and curative) was higher in the antibiotic group than in the placebo group. The length of hospital stay was significantly reduced in the group that received prophylactic antibiotics.