[Pilot study of antiretroviral therapy in Djibouti]. / Etude pilote de la thérapie antirétrovirale à Djibouti.

A cross-sectional survey was conducted among 112 HIV positive patients who had received antiretroviral therapy for >3 months to assess the efficacy of treatment (viral load <400 copies/mL). The median age at enrolment was 36 years, 90% of patients were at the AIDS stage and median CD4 rate was 118/mm3. Patients received a combined treatment of 2 NRTI +1 NNRTI (51%), 3 NRTI (45%) and 2 NRTI+1 PI (4%). Virological efficacy was seen in 74% of the patients, irrespective of the prescribed protocol and the initial clinical and immunological profile. Mean improvements measured were 20% on the Karnofsky index (KI), 2.1 kg/m2 in body mass index and 82 cells/mm in CD4. The prevalence of side effects was 84%. The predictors for treatment success were quality of care and KI > 70%.

[Herpes Zoster, predictive element of human immunodeficiency virus infection (HIV). Epidemio-clinical study in Cotonou (Benin)]. / Le zona, élément prédictif de l'infection à virus de l'immuno-déficience humaine (VIH). Etude épidémio-clinique à Cotonou (Bénin).

An epidemio-clinical study of Herpes Zoster in 39 healthy patients of Benin has permitted to the authors to evaluate the positive predictive value of Herpes Zoster for HIV infection on West Africa; and to compare it with results of central Africa. The mean age of patients is 34.74 years. The positive predictive value of Herpes Zoster for HIV infection is 41.02%. It is increased by the cranial site of Herpes Zoster.

[A case of Waardenburg-Klein syndrome observed at the Cotonou NUHC]. / Un cas de syndrome de Waardenburg-Klein observé au C.N.H.U. de Cotonou.

Waardenburg-Klein syndrome is an "Oculo-dermato-auditif" dysplasia described in 1947 by Waardenburg and by Klein in 1950. Canthus dystopia and congenital deafness are the main symptoms. Three clinical types have been reported: type I: presents the full symptomatology; type II: without canthus dystopia; type III: presents not only the complete syndrome but also an orthro-osteomyodysplasia of the upper limbs. This clinical case in a small 3.5-year-old boy with congenital deafness, bilateral iris hypochromia and retina albinism without canthus dystopia was classed as type II Waardenburg-Klein syndrome. The patient had a second apparently fortuitous hereditary affection: hemoglobinopathy (Hb AS). But this seems to be fortuitous.

[Reality and importance of transfusion-transmitted malaria in a stable endemic context: Cotonou case in Benin]. / Réalité et importance du paludisme transfusionnel dans un contexte d'endémie stable : cas de Cotonou (Bénin).

Malaria endemic status of our countries supports avoiding malaria screening for the blood qualification. But this attitude makes young children, pregnant women and people without semi-immunity incur a high risk of malaria. The goal of the survey was to value the reality and the importance of transfusion-transmitted malaria and to assess its determining factors. The study included 141 packed-red-cells units transfused to 77 hospitalized recipients, not suffering from malaria and not having been transfused the last two weeks. Every packed-red-cells assigned to a patient was tested for malaria before use. Thick and thin blood film were performed 96hours after transfusion. A clinical follow-up was undertaken as well as in the hospital and at home after release. In all, 13.47% of the transfused packed-red-cells were positive for the thick blood film. Plasmodium research in patients was negative 96hours after transfusion, even in the 19 patients who had received parasitized blood units! The home follow-up had permitted to note that 15.78% of blood recipients had developed clinical malaria. Parasitic density ≥240 parasites/mm(3) seems to be a determining factor. Transfusion-transmitted malaria is a reality we ought to consider. Introduction of malaria screening in donated blood qualification testings simultaneously with a framing of the blood donors appear the lasting solution to hope in the future to limit the waited excessive blood evictions.

[Evaluation of blood grouping in ABO and Rh systems in health facilities in Benin]. / Évaluation du groupage sanguin dans les systèmes ABO et Rh dans les formations sanitaires du Bénin.

STUDY PURPOSE: The goal of this work is to assess the modalities of blood typing achievement in Benin with the view of their improvement. METHODS: On the basis of a questionnaire including the detailed operative process, a prospective investigation has been achieved in public and private health centers laboratories. RESULTS: It came out that the execution of ABO and Rh blood typing took place globally on the fringe of the standards. We note that 72.4% of the private laboratories and 48.9% of the public ones lacked at least one equipment and 51.3% at least one material for blood withdrawal; 38.2% of the laboratories did not respect blood withdrawal standards; 1.32% of the laboratories applied the 4×2 rule. The assessment revealed that respectively 10.8% and 30.7% of the blood centers and non-blood centers achieved the globular test solely; the same 40.5% and 46.2% used reagents of different brands. Anti-A1 and anti-H sera, and A1 and A2 red cells were not available in any laboratory. More than 64% of laboratories have senior technicians and biomedical analysis engineers but only 6.6% of the laboratories were directed by biologists, and 9.2% of the laboratories function with only one technician. CONCLUSION: Instead of some assets, the laboratories assessment noted important non-conformities we ought to raise as a matter of urgency. It is a challenge whose resolution must give blood transfusion centers a reference position relatively to blood grouping when facing blood typing difficulties.

[Proliferative sickle cell retinopathy revealing Glanzmann thrombasthenia]. / Rétinopathie drépanocytaire proliférante révélatrice d'une thrombasthénie de Glanzmann.

Glanzmann thrombasthenia is a rare qualitative platelet abnormality of autosomal recessive transmission caused by absence of GP IIb/IIIa and resulting in disturbance of platelet aggregation and bleeding time extension. We report the case of a 16-year-old female suffering from SC sickle cell disease and presenting with bilateral vitreous hemorrhage revealing Glanzmann thrombasthenia. Despite vitrectomy, the functional prognosis was poor. Indeed, association of a severe hemorrhagic disease and sickle cell retinopathy makes surgical management difficult.

[Pilot study of antiretroviral therapy in Djibouti]

A cross-sectional survey was conducted among 112 HIV positive patients who had received antiretroviral therapy for > 3 months to assess the efficacy of treatment [viral load < 400 copies/mL]. The median age at enrolment was 36 years, 90% of patients were at the AIDS stage and median CD4 rate was 118/mm[3]. Patients received a combined treatment of 2 NRTI +1 NNRTI [51%], 3 NRTI [45%] and 2 NRTI+1 PI [4%]. Virological efficacy was seen in 74% of the patients, irrespective of the prescribed protocol and the initial clinical and immunological profile. Mean improvements measured were 20% on the Karnofsky index [KI], 2.1 kg/m[2] in body mass index and 82 cells/mm[3] in CD4. The prevalence of side effects was 84%. The predictors for treatment success were quality of care and KI > 70%