[Evaluation of erythrocyte concentrate prescription in a university hospital center]. / Evaluation de la prescription des concentrés de globules rouges dans un centre hospitalo-universitaire.

This prospective study, based on declaratory data, evaluates the appropriateness of red blood cell transfusion prescriptions in a university hospital. Local recommendations written after data collection and the analysis of prescriptions using a blinded method limited the bias related to the declaratory data. The results show that the rate of unjustified prescriptions is 4.2% (95% CI: 2.2%; 6.2%). This rate is statistically (P = 0.032) lower in the department of surgery (1.3%) than in the department of medicine (5.7%). This rate tends to decrease according to the experience of the prescriber (P = 0.06) and varies significantly according to the hemoglobin levels (P = 0.03). The logistic regression, integrating these three parameters, confirms that only the hemoglobin level is significantly related (P < 0.003) to the appropriateness of RBC transfusions. This study also highlights problems not linked to prescriptions, and the hospital created a quality assurance program as a result.

Evaluation of ibuprofen versus aspirin and paracetamol on efficacy and comfort in children with fever.

OBJECTIVE: We compared efficacy and impact on the comfort of ibuprofen (7.5 mg/kg per dose), aspirin (10 mg/kg/dose) and paracetamol (10 mg/kg per dose) on children with fever aged 6-24 months in an open, randomised study with three parallel groups. METHODS: The main criterion for efficacy was area under the curve (AUC) of percentage temperature reduction. Comfort was assessed on scores depending on general behaviour and degree of relief. General behaviour was assessed on a verbal scale and on a visual analogue scale (VAS) and the degree of relief was assessed in relation to baseline on a verbal scale. RESULTS: The efficacy of ibuprofen was better than that of aspirin or paracetamol. In spite of more adverse events, the comfort scores were significantly in favour of ibuprofen 6 h after the first dose of treatment.

[Serological survey for arbovirus antibodies in the human and simian populations of the South-East of Gabon (author's transl)]. / Enquête sérologique sur l'incidence des arbovirus parmi les populations humaines et simiennes du sud-est de la République Gabonaise.

A serological survey for arbovirus antibodies was carried out in human and simian populations of the South-East of Gabon. 197 human sera (adults), 34 simian sera (collected in the monkey colony of the Centre International de Recherches Médicales de Franceville) and 28 paired sera of mothers and their new-borns (samples collected from the umbilical cord) were tested using haemagglutination inhibition (HI) for all sera and complement fixation test (CF) for some of them. In the human population, 88% showed antibodies against yellow-fever virus as a consequence of vaccination, 20% against Chikungunya virus and 58% against Orungo virus. The high antibody titers for Chikungunya virus detected by HI test with CF antibodies proved a recent activity of this virus. The serological survey of simian population confirms the activity of Chikungunya virus in this area and demonstrates the circulation of one or more Flaviviruses, especially Zika virus. Transmission of maternal antibodies was established for the following arboviruses: Chikungunya, yellow-fever, Uganda S., Zika and Orungo.

Haemorrhagic fever in Gabon. I. Incidence of Lassa, Ebola and Marburg viruses in Haut-Ogooué.

A serological enquiry aimed at determining the incidence of infection with Lassa, Ebola and Marburg viruses was conducted on the human population of the region of Haut-Ogooué (Gabon) and on primates. The results, obtained by the indirect immunofluorescence technique, showed that more than 6% of the human population had had contact with Ebola virus but no antibodies against Marburg or Lassa viruses were found. Most sera reacted to an Ebola antigen from a Zairian strain, but showed little or no reaction to an antigen from a Sudanese strain.

[Erythrocyte phenotypes in Gabon. I. Hemotypologic data]. / Les phénotypes érythrocytaires au Gabon. I. Données hémotypologiques.

Blood group antigens were investigated among 400 gabonese individuals subdivided in 6 ethnic groups. The frequencies were calculated and compared to those reported by MOURANT and al. on geographically close African populations. Our data enter the limits already known for a few antigens of ABO, Lewis, Rhesus, Kell, Duffy, Kidd, MNSs, P and Lutheran systems. In addition, we have observed some rare phenotypes: 12 S--s U--, 1 Lu(a--b--), 2 I negative and 7 Sc: --1.

[Erythrocyte phenotypes in Gabon. II. Estimation of the gene frequencies of the ABO, MNSs, Rh, Lu and Jk systems in 6 ethnic Bantus and a Pygmy group in Gabon (Lower and Upper Ogooué regions)]. / Les phénotypes érythrocytaires au gabon. II. Estimation des fréquences géniques des systèmes ABO, MNSs, Rh, Lu et Jk dans 6 ethnies Bantoues et un groupe Pygmée du Gabon (Ogooué-Lolo et Haut-Ogooué).

There does not seem to be any noticeable difference between the various Bantu groups tests. One can note a higher frequency of the O gene in the High Ogooué (0,77) than in the Ogooué Lolo (0,73). The Powi group shows very few MSU or NSU alleles but because of the small number, no firm conclusions can be drawn. The collection of these Bantu populations is characterised by a high frequency of O, u, and Ro. The tested Pygmies match up with these characteristics and only differ from the Bantus by a very high frequency of u (0,33), especially of the MU haplotype, and by an increased frequency of Ro. The small number does not enable these differences to be considered as statistically valid. It should be noted that the Bawandji group is similar to the Pygmy group as regards ABO and Rhesus, i.e. a marked B and Ro frequency.

[Serum proteins and erythrocyte enzymes. Evaluation of frequencies in 2 populations in the Gabon]. / Protéines sériques et enzymes érythrocytaires. Evaluation des fréquences chez deux populations gabonnaises.

The results of the electrophoretic phenotyping of two serum groups (C'3 and Transferrine) and seven red cell enzymes (PAc, PGM, AK, ADA, 6PGD, sGPT and Est D) in two groups of negroes from Gabon are presented. The frequencies are in the normal range observed for African populations except for acid phosphatase in Southern Africa; Khoisan people have frequencies of the "Negroe allele R" higher than in any other population of the world. In Obamba and Bateke populations frequencies of Pr is 0.013.

Implications of heterophile antigens in immunological infertility in males.

Immunological study was conducted on serum and hydrocel fluids from males belonging to an equatorial African population heavily contaiminated by Filaria and Schistosoma. Anti-spermatozoa antibodies were detected by agglutination in 31 of 64 sera and 24 of 60 fluids, and by cytotoxicity in 19 of 64 sera and 8 of 60 fluids. Antinuclear antibodies were detected in 21 of 64 sera and 8 of 60 fluids. However, the titers of these antibodies were low, as were the frequency and titers of other tissues antibodies. The appearance of antispermatozoa antibodies is also correlated with extensive skin burns and infection by Pseudomonas aeruginosa or severe Candidiasis.

[Toxoplasmosis in Eastern Gabon. Results of a serologic survey]. / La toxoplasmose au Gabon oriental. Résultats d'une enquête sérologique.

1,448 sera taken from individuals of various places of South-Eastern Gabon have been studied by means of indirect immunofluorescence and Fulton direct agglutination associated with 2-mercapto-ethanol test, 52.6% contained antitoxiplasmic antibodies. This study showed that toxoplasmic infection occurs early in both sexes, that it is more frequent in men (57.9%) than in women (45.4%), that the Ogooué-Lolo province is more contaminated (62.6%) than the High Ogooué province (49.6%). It seems that prevalence differences are less dependent upon the telluric elimate than upon other factors, which remain to find.

[A serological survey of arboviruses in Gabon]. / Enquête sérologique pour les arbovirus au gabon.

Serological studies for arbovirus antibodies were carried out on 1.279 human serum specimens collected from adults in south-eastern part of Gabon from June to September 1975 during a multipurpose epidemiological survey. More than 80% of the population surveyed have neutralizing antibodies for yellow fever virus as consequence of mass vaccination campaign. Chikungunya, Zika, Wesselsbron and Koutango virus showed some activity, especially in woodland savannahs.

[Intestinal parasitism in eastern Gabon]. / Le parasitisme intestinal au Gabon oriental.

A survey of 1,548 stools samples carried out in Gabon showed in the adult population a parasitism ratio of about 100%. Among the protozoa, D. fragilis was found in 0.3% of the cases. In contradiction with the usual observations in tropical Africa, A. lumbricoides and T. trichiura infestation is very high in the villages. The demonstration of S. intercalatum in almost every place of the survey and an important focus at Okondja proves the extension of this bilharziosis.

[Etiological study of low fertility in eastern Gaboon. I. Scheme and first findings (author's transl)]. / Enquête sur l'étiologie de l'hypofécondité au Gabon oriental: I. Protocole et premiers résultats.

The etiological study conducted in 1975 in Haut-Ogooué and Ogooué-Lolo included 1,548 patients male and female. In the 21 investigated areas the patients were asked questions and examined by a medical team which took swabs so that bacterial, parastic, immunological and genetical assays could be carried out. The object of this article is to review the feasibility of such a local inquiry and state the first findings. Abnormalities of the epididymis are more commonly verified in non-fertile men. Microfilaremia is related to the presence of hydroceles and epididymis lesions. It shows more often in men with less than 3 children. The authors do not refer to any of physiopathology to explain these findings which need to be ascertained in further inquiries.

[Etiological study of low fertility in eastern Gaboon. II. Results according to the geographical distribution and the ethnic group (author's transl)]. / Enquête sur l'étiologie de l'hypofécondité au Gabon oriental: II Résultats en fonction du lieu d'habitat et de l'ethnie.

An epidemiological study was conducted in Haut-Ogooué and Ogooué-Lolo, and included 875 men and 673 women. The purpose of this article is to precise the geographical distribution of the factors related to low fertility, and to verify the stability of the etiological relations according to the region, the place of residence and the ethny. Among men, hydroceles and epididym lesions are more frequent in Ogooué-Lolo, in small villages, and in forest areas. Microfilariae Loa-loa and D. perstans has the same distribution. In both regions and what ever the type of residence (town or village), the epididym lesions are more frequent in non fertile men, microfilariae is linked with genital lesions and is more seldom found in men who are the fathers of more than two children. Among women, leukorrheas, pelvic pains, and adnexal masses are related to low fertility, what ever the place of residence is.

[Etiological study of low fertility in eastern Gaboon. III. Filarial endemicity (Loa loa, D. perstans). Prevalence of microfilariae in hydroceles (author's transl)]. / Enquête sur l'étiologie de l'hypofécondité au Gabon oriental: III. Endémie filarienne (Loa loa, D. perstans). Fréquence des microfilaires dans les hydrocéles.

During an inquiry performed in Gaboon the prevalence of hydroceles had led to puncture systematically every vaginal flow. 68 fluids were so collected at the end of the inquiry. Subsequently the statistical analysis of the results in men seems to suggest a correlation between microfilaremia (Loa loa and D. perstans) and the prevalence of hydroceles. Microfilariae were found in 77% according to the following distribution: Loa loa seldom diagnosed in this kind of flow were detected in 10%; D. perstans although never reported so far in hydrocele fluids appeared to be present in 62%. O. volvulus more currently referred to in hydrocele liquids were scarcely traced.

[Toxoplasmosis and chronic myeloid leukemia]. / Toxoplasmose et leucémie myéloïde chronique

A patient suffering from chronic myeloid leukemia and used as a donor of leucocytes was found to have toxoplasmosis associated with a high level of IgG without an elevation of IgM which was maintained for several months. This case raises several points for discussion. Toxoplasmosis is a frequent complication of malignant hematological disease, it is often severe with neurological complications in more than half the patients affected. It is often difficult to diagnose. The parasite is arduous to isolate and serology is problematic to interpretate without reference to previous samples. This suggests it would be wise to measure the titre of anti-toxoplasma antibodies as part of the initial investigations of every malignant hemopathy and to repeat the measurements during the evolution of the disease. Any patient showing a high serological titre, even though it is stable and without IgM should be given systematically a specific treatment for toxoplasmosis, for as in the patient presented in this paper, such a serological picture is compatible with an increasing infection. The frequence of high serological titres seems to be greater among patients suffering from chronic myeloid leukemia than among another people. Then, transfusion of leucocytes of such patients may be the source of parasite transmission; this paper relates one case of post-transfusional toxoplasmosis.