Prevalence of sickle cell disease in a northeastern region of the Democratic Republic of Congo: what impact on transfusion policy?

Transfusion therapy may save the lives of patients with sickle cell disease (SCD), but it is also associated with a high risk of transmission of infection. The aims of this study were to determine the prevalence of SCD in a northeastern region of the Democratic Republic of Congo (DRC), and to define ways in which the procedures involved in the security of transfusions should be improved. During a 3-month period in 2006/2007, 520 samples of umbilical cord blood were obtained through neonatal screening in five health centres in Kisangani. The samples were analysed using an isoelectric focusing technique. The estimated prevalence of sickle cell trait and SCD in the population tested was 23.3 and 0.96%, respectively. These numbers will be presented for the attention of the health authorities in DRC with responsibility for SCD and they will be asked to consider improvements in treatment procedures for SCD, such as blood transfusions, as a public health priority.

A randomized clinical trial of two single-dose treatments for paucibacillary leprosy.

We compared 2 single-dose regimens for the treatment of paucibacillary leprosy in a randomized clinical trial in Zaïre. The regimens were: C2 (rifampicin 40 mg/kg and 1200 mg clofazimine once) and C4 (rifampicin 40 mg/kg, clofazimine 100 mg, DDS 100 mg and ethionamide 500 mg once). An analysis of the results of patients enrolled between May 1987 and December 1988, with a maximum follow-up of 4 years, is presented. A total of 622 patients were enrolled and 14 paucibacillary and 1 multibacillary relapses occurred. The overall paucibacillary relapse rate was 2.4 per 100 person years. This relapse rate was higher for older patients as well as for patients with 3 or more lesions. The probability of cure at 3 years is 0.816 for C2 and 0.823 for C4, the difference not being statistically significant. The probability of cure at 3 years with either regimen is higher for patients with 1 or 2 lesions (0.872) than for patients with 3 or more lesions (0.787), and it is higher for patients with a bacterial index of 0 (0.831) than for patients with a bacterial index of 1 (0.699). These results are compared to other studies. We also discuss the potential of single-dose treatment regimens for paucibacillary leprosy.

A longitudinal study of the incidence of leprosy in a hyperendemic area in Zaire, with special reference to PGL-antibody results. The Yalisombo Study Group.

Between 1984 and 1988, yearly surveys for leprosy were done among the 1500 people living in a previous leprosy segregation village in Zaire. In 1984 lepromin tests and phenolic glycolipid (PGL) antibody tests were done in a significant part of the population. The prevalence of the disease at that time was 16.1%, the proportion of multibacillary cases was 11.3% overall and 22% among active cases. Prior to 1984, 23% of paucibacillary cases and 56% of multibacillary cases had presented themselves spontaneously to the Leprosy Service. The exposure to the infection is uniform, but there is a suggestion of family clustering of cases. In spite of a rapidly bactericidal treatment of all known cases in 1984 and thereafter, the annual incidence of 0.34% did not decrease during the 4 years of the study. The PGL antibody test did not contribute to the diagnosis, classification or prognosis of the disease.