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INTRODUCTION: at the National Center for Blood Transfusion (NCBT) in Lomé, whole blood is systematically separated into its various labile blood products. This study aims to assess the quality of the red blood cell concentrates (RBCC) produced. METHODS: we conducted a cross-sectional study on 260 RBCCs (204 adult units and 56 paediatric units) from January to March 2018. The bags were weighed to determine the volume of their content. Hemoglobin and hematocrit levels were determined using the Horiba Medical Pentra XLR device. We evaluated the fidelity and precision of the device in order to ensure the accuracy of the measurements of the variables analyzed. Statistical analyses were performed using the R software. RESULTS: adult units assessment showed that 79.90%; 81.86% and 43.13% bags were consistent with respect to the volume and haemoglobin and haematocrit levels. Paediatric units assessment showed that 98.21%; 69.64% and 37.50% bags were consistent with respect to the volume and haemoglobin and haematocrit levels. Simultaneous analysis of the three parameters showed a compliance rate of 42.16% for RBCCs in adults against 35.71% for pediatric RBCCs. CONCLUSION: we recommend to expand the interval between two blood donations and to perform hemoglobin test before blood donation in compliance with the eligibility criteria for giving blood at the National Center for Blood Transfusion in Lomé.
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Donantes de Sangre , Transfusión de Eritrocitos/normas , Eritrocitos , Control de Calidad , Adolescente , Adulto , Estudios Transversales , Femenino , Hematócrito , Hemoglobinas/análisis , Humanos , Masculino , Persona de Mediana Edad , Pediatría , Adulto JovenRESUMEN
OBJECTIVES: The objective of this study was to assess the prevalence of albuminuria in sickle cell disease patients at the Campus University Hospital of Lome. PATIENTS AND METHOD: Albuminuria was assessed by the urinary albumin-to-creatinine ratio (UACR) in sickle cell disease individuals who attended the outpatient consultation in their steady state. RESULTS: The prevalence of albuminuria was 21% (14/67). Albuminuria was more frequent (32% vs 13%, p=0,054) and occurred earlier (6 years vs 21 years) among the 28 SS/Sß0-thalassemia sickle-cell diseases individuals than the 39 SC ones. Albuminuria was associated with high counts of leukocytes (p=0.033) and neutrophils (p=0.008). It was negatively correlated with hemoglobin level (p=0.032) and positively with LDH (p=0.002), SGOT (p=0.002), leukocytes (p=0.003), neutrophils (p< 0.001) and thrombocytes (p=0.010) counts for all sickle cell patients without statistical confirmation for each sickle cell phenotype apart from neutrophils in SS/Sß0-thalassemia. Defining albuminuria as an UACR greater than 20 mg/g had a specificity of 100% and a sensibility and 90% when the UACR was compared to the 24-hours urines albumin quantification. CONCLUSION: The assessment of albuminuria should begin at age 5 years in SS/Sß0-thalassemia sickle-cell anemia patients and from 20 years old in SC patients by the UACR.
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Albuminuria/epidemiología , Anemia de Células Falciformes/epidemiología , Adolescente , Adulto , Albuminuria/orina , Anemia de Células Falciformes/complicaciones , Anemia de Células Falciformes/orina , Niño , Preescolar , Estudios Transversales , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Togo/epidemiología , Adulto JovenRESUMEN
The epidemiological, clinical and biological characteristics of chronic lymphocytic leukemia (CLL) are little studied in Togo. The purpose of this study was to describe these characteristics at the time of diagnosis. We conducted a retrospective and descriptive study of patients diagnosed at the University Hospital Campus from January 1999 to December 2018. Over the past two decades, 87 patients were seen for CLL (20% of patients with hematological malignancies) with an annual prevalence of 4.35 new cases. The average age of patients was 61 +/- 12,48 years (ranging from 17-85 years); 55 women and 32 men (sex ratio M/F 0.58) were enrolled. Clinically, 16 patients (18%) had no tumor syndrome, 33 patients (38%) had lymphadenopathy, 62 patients (71%) splenomegaly and 23 patients (26%) hepatomegaly. Biologically, the mean blood and medullary lymphocyte count was 87188/mm3 (ranging from 7000-481780/mm3) and 75.75% +/- 12,88 (ranging from 44,5-96,5%) respectively; 65 patients (75%) had haemoglobin less than 10g/dl and 20 patients (23%) had platelet count below 100000/mm3. At the time of diagnosis, 67 patients (77%) had Binet stage C, 7 patients (8%) stage B and 13 patients (15%) stage A. The study of biological prognostics factors showed that 66% of cases had ß2-microglobulin level higher than normal and 95% of cases had LDH higher than normal. CLL is a reality in Togo with a predominance of women and an average age of 61 years. Most patients are seen at Binet stage C and their assessment has revealed huge tumor mass with increased LDH and ß2-microglobulin. The current follow-up of these patients will enable us to assess their overall survival.
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Hepatomegalia/etiología , Leucemia Linfocítica Crónica de Células B/patología , Linfadenopatía/etiología , Esplenomegalia/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hepatomegalia/epidemiología , Humanos , L-Lactato Deshidrogenasa/metabolismo , Leucemia Linfocítica Crónica de Células B/epidemiología , Linfadenopatía/epidemiología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Esplenomegalia/epidemiología , Togo/epidemiología , Adulto Joven , Microglobulina beta-2/metabolismoRESUMEN
This study aims to describe the different bcr-abl gene transcript variants in order to determine their frequency and to study their influence on CBC diagnostic test. We conducted a cross-sectional study of 34 patients with chronic myeloid leukemia in Togo. The search for fusion transcripts was performed in the laboratory of biological haematology at the Henri Mondor Hospital, Créteil (France). The average age of patients was 42,32±14,87 years ranging between 9 and 65 years. Most patients were male, with a sex- ratio of 1.61 (21 men and 13 women). Molecular examination showed b3-a2 transcript and b2-a2 transcript. Nineteen patients (55.88%) expressed b3-a2 transcript, 13 patients (38.24%) b2-a2 transcript (32.10%) and two patients expressed both b3-a2 and b2-a2 transcripts (5.88%). At diagnosis, mean hemoglobin level, the average number of white blood cells and the average number of platelets in patients expressing b3-a2 transcript were 99,2g/L; 207,63g/l and 451,28g/l respectively. In patients expressing b2-a2 transcript values were 104,6g/l, 114,32g/l and 486,11g/l. In patients with both transcripts, values were 67g/L, 867g/l and 780g/l respectively. CBC parameters are more significantly altered in patients with both transcripts b3-a2 and b2-a2.
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Recuento de Células Sanguíneas , Proteínas de Fusión bcr-abl/genética , Hemoglobinas/metabolismo , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Adolescente , Adulto , Anciano , Niño , Estudios Transversales , Femenino , Humanos , Leucemia Mielógena Crónica BCR-ABL Positiva/sangre , Masculino , Persona de Mediana Edad , Togo , Adulto JovenRESUMEN
BACKGROUND: Togo has conducted annual, integrated, community-based mass drug administration (MDA) for soil-transmitted helminths (STH) and schistosomiasis since 2010. Treatment frequency and target populations are determined by disease prevalence, as measured by baseline surveys in 2007 and 2009, and WHO guidelines. Reported programmatic treatment coverage has averaged over 94%. Togo conducted a cross-sectional survey in 2015 to assess the impact of four to five years of MDA on these diseases. METHODOLOGY/PRINCIPAL FINDINGS: In every sub-district in the country outside the capital, the same schools were visited as at baseline and a sample of fifteen children age 6 to 9 years old was drawn. Each child submitted urine and a stool sample. Urine samples were tested by dipstick for the presence of blood as a proxy measure of Schistosoma haematobium infection. Stool samples were analyzed by the Kato-Katz method for STH and Schistosoma mansoni. At baseline, 17,100 children were enrolled at 1,129 schools in 562 sub-districts; in 2015, 16,890 children were enrolled at the same schools. The overall prevalence of both STH and schistosomiasis declined significantly, from 31.5% to 11.6% for STH and from 23.5% to 5.0% for schistosomiasis (p<0.001 in both instances). Egg counts from both years were available only for hookworm and S. mansoni; intensity of infection decreased significantly for both infections from 2009 to 2015 (p<0.001 for both infections). In areas with high baseline prevalence, rebound of hookworm infection was noted in children who had not received albendazole in the past 6 months. CONCLUSIONS/SIGNIFICANCE: After four to five years of MDA in Togo, the prevalence and intensity of STH and schistosomiasis infection were significantly reduced compared to baseline. Data on STH indicate that stopping MDA in areas with high baseline prevalence may result in significant rebound of infection. Togo's findings may help refine treatment recommendations for these diseases.
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Antihelmínticos/administración & dosificación , Antihelmínticos/uso terapéutico , Helmintiasis/tratamiento farmacológico , Esquistosomiasis/tratamiento farmacológico , Suelo/parasitología , Niño , Heces/parasitología , Femenino , Helmintiasis/epidemiología , Humanos , Masculino , Administración Masiva de Medicamentos , Recuento de Huevos de Parásitos , Prevalencia , Administración en Salud Pública , Esquistosomiasis/epidemiología , Togo/epidemiologíaRESUMEN
BACKGROUND: During the last ten years, a resurgence of syphilis has occurred in many countries worldwide, including Togo. Previous studies have shown a wide range of syphilis infection among the female sex workers (FSWs), from 1.5 to 42.1%. In Togo, Key populations, including FSWs, are rarely involved in the sentinel surveillance programs to determine the prevalence of HIV and syphilis. The aim of this study was to determine the prevalence of syphilis among female sex workers (FSWs) and their clients in Togo. METHODS: We conducted a cross-sectional study in December 2011 targeting FSWs and their clients in Togo. Among participant who consented, we collected blood samples for syphilis and HIV testing. RESULTS: In total, 1,836 participants (1,106 FSWs and 730 clients) were included in the survey. Their mean age was 28.6 ± 9 years. The prevalence of syphilis was 2.2% (2.2% among FSWs compare to 2.3% among their clients, p = 0.82). This prevalence was higher among FSWs over 30 years old compare to those less than 30 years old (Odd Ratio (OR) =5.03; 95% CI [1.95-13.49]). Single FSWs were three times less likely to have syphilis than those living in couple or married (OR = 3.11; CI 95% [1.16-8.83]). Brothel based or declared FSWs were 4 times more likely to be infected by syphilis than secret ones (OR = 3.89; CI 95% [1.60-9.54]). Out of the 1,836 participants of the survey, 165 (8.9%) were HIV positive. Having syphilis was associated with HIV infection (OR = 3.41; IC 95% [1.53-7.41]). CONCLUSION: This study showed that: i) the prevalence of syphilis among FSWs and their clients was high; ii) syphilis was significantly associated with HIV infection. It is necessary to increase awareness campaigns and emphasize on condom use among this key population group.
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Vigilancia de Guardia , Trabajadores Sexuales/estadística & datos numéricos , Sífilis/epidemiología , Adolescente , Adulto , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Humanos , Persona de Mediana Edad , Prevalencia , Sexo Seguro/estadística & datos numéricos , Encuestas y Cuestionarios , Togo , Adulto JovenRESUMEN
BACKGROUND: Since 2005, the Togo National Malaria Control Programme has recommended two different formulations of artemisinin-based combination therapy (ACT), artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL), for the treatment of uncomplicated malaria. Regular efficacy monitoring of these two combinations is conducted every 2 or 3 years. This paper reports the latest efficacy assessment results and the investigation of mutations in the k13 propeller domain. METHODS: The study was conducted in 2012-2013 on three sentinel sites of Togo (Lomé, Sokodé and Niamtougou). Children aged 6-59 months, who were symptomatically infected with Plasmodium falciparum, were treated with either AL (Coartem(®), Novartis Pharma, Switzerland) or ASAQ (Co-Arsucam(®), Sanofi Aventis, France). The WHO standard protocol for anti-malarial treatment evaluation was used. The primary end-point was 28-day adequate clinical and parasitological response (ACPR), corrected to exclude reinfection using polymerase-chain reaction (PCR) genotyping. RESULTS: A total of 523 children were included in the study. PCR-corrected ACPR was 96.3-100 % for ASAQ and 97-100 % for AL across the three study sites. Adverse events were negligible: 0-4.8 % across all sites, for both artemisinin-based combinations. Upon investigation of mutations in the k13 propeller domain, only 9 (1.8 %) mutations were reported, three in each site. All mutant parasites were cleared before day 3. All day 3 positive patients were infected with k13 wild type parasites. CONCLUSIONS: The efficacy of AL and ASAQ remains high in Togo, and both drugs are well tolerated. ASAQ and AL would be recommended for the treatment of uncomplicated malaria in Togo.
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Amodiaquina/uso terapéutico , Antimaláricos/uso terapéutico , Artemisininas/uso terapéutico , Resistencia a Medicamentos , Etanolaminas/uso terapéutico , Fluorenos/uso terapéutico , Malaria Falciparum/tratamiento farmacológico , Plasmodium falciparum/efectos de los fármacos , Proteínas Protozoarias/genética , Combinación Arteméter y Lumefantrina , Preescolar , ADN Protozoario/genética , Combinación de Medicamentos , Femenino , Técnicas de Genotipaje , Humanos , Lactante , Malaria Falciparum/parasitología , Masculino , Mutación , Plasmodium falciparum/genética , Plasmodium falciparum/aislamiento & purificación , Reacción en Cadena de la Polimerasa , Estudios Prospectivos , Togo , Resultado del TratamientoRESUMEN
Performance of HemoCue Hb201+ in the diagnosis of anaemia in children in health facilities at the peripheral level in Togo. BACKGROUND: Anaemia is a global public health problem, especially in developing countries. Anaemia has major repercussions on health status, as well as on the economic and social development of a country. Effective care of anaemic patients requires a reliable and precise diagnostic test that can determine haemoglobin levels. OBJECTIVE: To evaluate the diagnostic performance of the Hemocue test Hb201+®. METHOD: This study compared haemoglobin levels measured using the photometer Hemocue Hb201+® with those measured by analysers of haematology. Children aged 6 to 59 months who suffered from uncomplicated malaria were eligible for inclusion. Haemoglobin levels determined by the analysers were considered the reference for evaluation of the levels measured using Hemocue Hb201+®. RESULTS: 72.8% of the values obtained by Hemocue Hb201® were within ±1g/dl of the reference value. The Pearson correlation coefficient was 0.80. The prevalence of anaemia was 79.3% using the reference method and 77.9% using Hemocue 201+®. The sensitivity and the specificity of Hemocue Hb201+® were 95.1% and 65.3% respectively. CONCLUSION: The study results showed that the Hemocue Hb201 test+® provided good sensitivity, average specificity and average precision, both for the diagnosis of anaemia and for the determination of haemoglobin levels. It may be used in peripheral centres to facilitate the laboratory diagnosis of anaemia and its management in populations that live in areas with difficult accessibility.
RESUMEN
The goal of our study is to document the prevalence of change JAK2V617F among patients reached of myeloproliferative syndromes (MPS) in Togo in order to evaluate frequencies. This descriptive study included 15 patients followed with the CHU Campus for a SMP. The research of JAK2 change by PCR was carried out with the APHP Henri Mondor of Creteil (France). During the study period, 15 patients followed for MPS (9 cases of polycythemia Vera, 5 cases of essential thrombocytemia and a case of primitive myelofibrosis) profited from the research of JAK2 change. The Middle age of the patients was respectively of 45±18 years; of 55±6 years for the PV and the essential thrombocytemia. The patient followed for primitive myelofibrosis was 72 years old. Sex-ratio (H/F) was of 2. JAK2 Change was positive in 5 cases out of 9 (55.5%) of the polycythemia Vera, at 3 patients out of 5 (60%) followed for essential thrombocytemia but negative for patient reached of primitive myelofibrosis. In conclusion, JAK2 Change has an interest diagnosis and forecast in the MPS negative Chromosom Philadelphia and can be systematic even in Africa Sub-saharian.