[Anemia in blood donors and criteria of hemoglobin level control at the national blood transfusion center (NBTC) of Lomé, Togo]. / Anemie chez les donneurs de sang et criteres de controle du taux d'hemoglobine au centre national de transfusion sanguine de Lome (Togo).

INTRODUCTION: The aim of this study was to evaluate the prevalence of anemia among blood donors at Lomé national blood transfusion center (NBTC) and to identify criteria for controlling hemoglobin level in blood donation candidates. METHODS: We determined the hemoglobin level using HemoCue® 201+. To identify the hemoglobin level control criteria, the judgment parameters were the proportion of anemic donors based on the number of blood donations in the last 12 months and the staining of the conjunctiva. One parameter is considered "critical" and used as a control criterion when more than 30% of donors meeting this parameter are anemic. RESULTS: A total of 1 291 blood donor candidates, predominantly male (89.70%), were included in this study. The prevalence of anemia was 28.12%. This prevalence was 38.71% among women who made 2 donations and 32.27% among men who made 3 donations and who came for a new donation in the year. Anemia was observed in 59.45% of men and 51.56% of women who had slightly colored conjunctiva. CONCLUSION: The prevalence of anemia was high among blood donors at NBTC Lomé. Hemoglobin control is indicated in blood donation candidates with conjunctiva judged to be slightly colored and / or on their 2nd donation (female) and 3rd blood donation (male) within 12 months.

INTRODUCTION: Cette étude avait pour buts d'évaluer la prévalence de l'anémie parmi les donneurs de sang au centre national de transfusion sanguine (CNTS) de Lomé et d'identifier les critères de contrôle du taux d'hémoglobine chez les candidats au don de sang. MÉTHODES: Nous avons déterminé le taux d'hémoglobine (THb) à l'aide de HemoCue® 201+. Pour identifier les critères de contrôle du THb, les paramètres de jugement étaient la proportion de donneurs anémiés en fonction du nombre de dons de sang dans les douze derniers mois et la coloration des conjonctives. Un paramètre est jugé « critique ¼ et retenu comme critère de contrôle du THb lorsque plus de 30 % des donneurs répondant à ce paramètre sont anémiés. RÉSULTATS: Au total 1291 candidats au don de sang, à prédominance masculine (89,70%), étaient inclus dans cette étude. La prévalence de l'anémie était de 28,12%. Cette prévalence était de 38,71% parmi les femmes qui avaient fait 2 dons et de 32,27% parmi les hommes ayant effectué 3 dons et qui étaient revenus pour un nouveau don de sang en l'espace de 12 mois. L'anémie était observée chez 59,45% des hommes et 51,56% des femmes qui avaient des conjonctives peu colorées. CONCLUSION: La prévalence de l'anémie est élevée parmi les donneurs de sang au CNTS de Lomé. Le contrôle du taux d'hémoglobine est indiqué chez les candidats au don de sang ayant des conjonctives jugées peu colorées et/ou qui sont à leur 2ème don (femme) ou 3ème don de sang (homme) en l'espace de douze mois.

[Hepatitis B virus serologic status among hospital health care staff in Lome]. / Évaluation de la protection vaccinale contre le virus de l'hépatite B chez le personnel soignant hospitalier à Lomé

To assess the hepatitis B virus (HBV) serologic status of hospital health care personnel in Lome. From June 1 to August 31, 2007, 100 workers vaccinated against HBV and 50 unvaccinated workers participated in this comparative cross-sectional study. The data studied were: age, sex, vaccination status, history of accidental exposure to blood, and enzyme-linked immunoassay results for HBs antigen (Ag), total anti-HBc antibodies (Ab), and anti-HBs Ab. Vaccinated subjects had a mean age of 33.2 ± 8.2 years and unvaccinated subjects of 35.2 ± 9.6 years; their respective sex ratios (M:W) were 2:1 and 3:1. Protective levels (>10 IU/L) of anti-HBs Ab were found in 78% (n = 78) of vaccinated subjects compared with 44% (n = 22) of those unvaccinated. HBs Ag was found in 36% (n = 36) of vaccinated and 56% (n = 28) of unvaccinated subjects. Of subjects previously accidentally exposed to blood, 67% (n = 35) had HBs Ag compared with 30% (n = 29) of those subjects without such exposure. This study has proved the high prevalence of HBs Ag carrier status among health care workers in Lome and confirms the importance of vaccination against HBV.

[Rare hemoglobins in Togo: a 15-year study at the Lomé University Campus Hospital Center]. / Les hémoglobines rares au Togo : à propos d'une étude réalisée sur quinze ans au CHU Campus de Lomé (Togo).

OBJECTIVES: To identify the rare hemoglobins (Hbs) encountered in Togo and characterize their geographical and ethnic distribution and hematologic expression. MATERIAL AND METHOD: This retrospective descriptive study covers 27,530 hemoglobin electrophoresis tests performed in the department of Hematology of the Lomé Campus teaching hospital from January 1996 through December 2010, the national reference laboratory. The anomalies identified were studied with both alkaline and acid electrophoresis and high performance liquid chromatography (HPLC), all performed in Lome. Any other specialized examinations were conducted mainly at the biochemistry laboratories of either Robert Debre Hospital in Paris or Henri Mondor Hospital in Creteil (France). RESULTS: During the study period, 20 cases of a rare Hb were identified, i.e., 0.07% of all Hb analyses. These rare mutants were: HbK Woolwich (10 cases, 50% of the rare Hbs); HbD Korle-Bu (7 cases, 35%); HbJ Lome, G Philadelphia, and Hb Lepore (1 case each, 5% for each). Eighteen cases were associated with Hb A. Two cases of composite rare Hb were found: HbS/HbK Woolwich and HbC/Hb D Korle-Bu. Carriers of Hb Lepore and of HbC/HbD Korle-Bu had hypochromic and microcytic anemia. HbK Woolwich was found in the Adja-Ewé and Tem-Kabyé ethnic groups, in the Maritime and Kara regions; HbD Korle-Bu, HbJ Lome, and Hb Lepore were also identified among the Adja-Ewé, and HbG Philadelphia in the Akposso ethnic group of the Plateau zone. CONCLUSION: This study although limited to Lome, allowed us to identify the rare Hb forms observed in Togo. Other studies on a national scale will specify their real frequency.

[Situation and perspectives of blood transfusion in Togo]. / Situation actuelle et perspectives de la transfusion sanguine au Togo.

We report the successive stages of the reorganization of the blood transfusion sector in Togo. The starting point was the elaboration of the national policy of blood transfusion, then the adoption of a decree organizing the sector as well the various decree of application, particularly that related to transfusion good practices. The current policy recommends two poles of qualification of the blood ant its components and the creation of six stations of collection and distribution attached to these poles. The reorganization started with the rehabilitation of the National Blood Transfusion Centre (CNTS) in Lomé. If the problem of human resources is alarming, especially the availability of hemobiologists, the rehabilitation allowed the increase of the blood collection passing from 5272 donations in December 2003 to 18 164 in December 2008. However, the requirement of blood products is satisfied in 50% in all the country. In 2003, 24% of the blood products were rejected for positive viral markers against 8.37% in 2008 in relation with the improvement of blood safety. Efforts must be continued to reinforce it in the CNTS and to make a better selection of the donors at the Regional Blood Transfusion Centre (CRTS) de Sokodé. The analysis of the weak points of the sector (human resource insufficiency, shortage of the blood products, blood safety) made it possible to indicate solutions to improve the sector of blood transfusion sector. Future outcome is funded in the blood transfusion safety development project in Togo financed by the Agence française de développement (AFD, French development agency).

[Internal quality control of the blood products in the Lomé National Blood Transfusion Centre]. / Contrôle de qualité interne des produits sanguins labiles préparés au Centre National de Transfusion Sanguine de Lomé.

AIM: Evaluate the conformity of blood red cells units prepared in the Lomé CNTS with European norms concerning volume, haemoglobin content and haematocrite. Measure the conservation of the haemostatic properties and the rate of haemostasis factors V and VIII in the fresh frozen plasma. Measure the rate of residual cells in the plasma. METHODS: In the year 2006, from March 1st to April 15th, we analysed the quality of 135 units of whole blood, red blood cells (RBC) and plasma from blood donors in the Lomé National Blood Transfusion Centre. The quality control had concerned: the volume of whole blood units; the volume, the haemoglobin content and the haematocrite of red blood cells units; the volume, the prothrombin rate, the cephalin with activator time (TCA), the rate of haemostasis factors V and VIII and the number of residual cells (red cells, leucocytes and platelets) in the plasma. RESULTS: Among the 135 units of whole blood which were controlled, 50.57% were in conformity with the norms concerning the volume. The red blood cells units were in conformity with norms concerning their volume, their haemoglobin content and their haematocrite respectively in 21.48%, 80.75% and 20% of the cases. The volume of 75.56% of the plasma units controlled were conform with the norm. All of the plasma units were conform with the norm concerning the number of residual platelets while the number of residual red blood cells and leucocytes were conform respectively in 80.74% and 60%. The percentage of conformity concerning the prothrombin rate, the TCA, the coagulation factor V and the factor VIII were respectively 66.67; 97.78; 48.89 and 47.4 before freezing, and 54.81; 88.14; 64.44; 84.44 a month after freezing. CONCLUSION: To improve the quality of the new blood products of the Lomé CNTS, some correctives actions must be applied concerning the adequate volume of blood which must be collected from the donors, the position of the blood bags in during the centrifugation and the volume of plasma which must be take out of the bag of red cells.

L'endométriose: une pathologie ignorée dans les centres de formation de base en santé de Lomé

Le travail realise est une evaluation sur les connaissances de l'endometriose dans les centres de formation de base en sante au Togo par une enquete afin de preciser l'ignorance ou la meconnaissance de cette affection au Togo. Une revue de la litterature sur l'endometriose a eu pour objectif de fournir aux praticiens togolais les outils recents de son diagnostic et de sa prise en charge. Resultats L'endometriose est une pathologie frequente dans la population generale. Elle est benigne mais peut induire des consequences lourdes pour les patientes en terme de qualite de vie; de projet parenteral et de traitements medicaux et chirurgicaux iteratifs. Si sa clinique et sa prise en charge sont bien connues dans les pays medicalises; cela n'est pas le cas pour les etudiants en fin de formation dans les centres de sante de base de Lome. En effet la totalite des etudiants enquetes ignore sa clinique et sa prise en charge. Sa clinique repose sur des symptomes varies domines par la dysmenorrhee; les menometrorragies; la dyspareunie; les douleurs abdomino-pelviennnes. Son diagnostic de certitude repose sur la coelioscopie et l'examen anatomopathologique. Son traitement repose sur les oestroprogestatifs qui peuvent etre utilises comme tests therapeutiques dans les pays sous medicalises comme le Togo. L'ignorance ou la meconnaissance de cette affection par le personnel medical et paramedical peut conduire les femmes atteintes vers la medecine traditionnelle et la religion. Conclusion L'endometriose est une affection ignoree dans les centres de formation de base en sante du Togo. Son existence au Togo reste a prouver grace aux tests therapeutiques oestroprogestatifs chez les femmes suspectes et si possible par la coelioscopie et l'anatomopathologie

[Knowledge, attitudes and practices about blood donation. A sociological study among the population of Lomé in Togo]. / Etude des connaissances, attitudes et pratiques en matière de don de sang. Enquête sociologique dans la population de Lomé (Togo).

GOALS: 1) analyse the knowledge, attitudes and practices of Lome population about blood donation; 2) identify obstacles to blood donation among the population of Lome; 3) suggest some solutions to improve the performance of the National Blood Transfusion Centre (CNTS). METHODOLOGY: We have conducted a sample survey among the population of Lome from the 6th to 21st October 2003. Three hundred persons filled a questionnaire. RESULTS: In the sample, 183 (61%) were males. Their age ranged from 18 to 67 years with 2/3 of young peoples between 18 and 37 years. Pupils/students were 24,33%, wage-earners, 55% and the unemployed, 17,67%. More than the half of the investigated persons (54,67%) were unmarried and 96, 33% persons were literate. Nearly all the people (96,33%) knew about blood donation in Lome and they have received information mainly from friends, media and sensitization by the CNTS. Sixty-one percent of the investigated knew where blood is donated. All the investigated were unanimous about the vital role of blood. Whatever their religion, they recognized its sacred nature. The majority of the investigated (85%) were willing to donate blood. Only 95 people were donors. The reasons for non-donation were mainly related to the fear of catching diseases (31,71%) especially the HIV (9,76%), the lack of information (25,37%), the religious beliefs (19,51%) and the fear of knowing the result of one's HIV test. 277 people (92,33%) said that blood should be donated without remuneration. CONCLUSION: There is a growing interest in the blood donation among the population of Lome but new strategies must be elaborated to inform the population and motivate blood donors.

Hemoglobins in Togolese newborns: Hb S, Hb C, Hb Bart's, and alpha-globin gene status.

The gene frequency of the most important hemoglobin (Hb) abnormalities is reported in a population of 171 Togolese newborns. Hb phenotypes, hematological parameters, and the more frequently described alpha-gene deletions were analyzed. Structural abnormalities of beta-globin were observed in 35.7% of the children with a gene frequency of 0.105 for beta(S) and 0.091 for beta(C). The frequency of the different alpha-globin genotypes was alpha alpha/ = 0.71, -alpha/ = 0.28, and alpha alpha alpha/ = 0.01. All of the individuals homozygous for the -alpha genotypes, and most of the heterozygous individuals, carried Hb Bart's. Within the alpha alpha/alpha alpha and the -alpha/alpha alpha groups, several individuals with or without Hb Bart's were found; they did not differ from the others by their red blood cell (RBC) parameters but by their levels of fetal hemoglobin (Hb F). The African alpha2 polymorphism marker, characterized by the replacement of G by TCGGCCC at position 7238 (EMBL HSHBA4, 1993) and of T 7174 by G, was found in 21 newborns. The mean value of Hb F was calculated for each genotype, the mean (G)gamma percentage was 69.4 +/- 4.0%, and the gene frequency of the AgammaT marker was 0.10; this marker was linked to the normal beta-globin cluster.

Les plaies penetrantes de l'abdomen au CHU de Lome; a propos de 44 cas

Les auteurs rapportent les resultats d'une etude retrospective de 44 cas de plaies penetrantes de l'abdomen vue en 5 ans (Janvier 1990 a Decembre 1994) dans le service de chirurgie general du CHU Tokoin; dans le but d'en ressortir les problemes diagnostiques et therapeutiques. Les plaies penetrantes ont represente 0;73 pour cent des urgences abdominales chirurgicales durant la meme periode. La plupart des blesses etaient de sexe masculin (90;9 pour cent) et ages de 20 a 40 ans (70;5 pour cent). L'agent causal etait l'arme blanche dans 72;7 pour cent des cas. La lesion intra-abdominale etait cliniquement evidente dans 45;4 pour cent des cas; devant l'existence d'un choc hemorragique; d'un hemoperitoine ou d'une peritonite. Les plaies par armes a feu ont occasionne plus frequemment des lesions abdominales multiviscerales ainsi que des lesions extrathoraciques associees. Compte tenu de l'insuffisance de ressources humaines et materielles dans les services; l'attitude demeure la laparotomie systematique devant toutes les plaies penetrantes abdominales malgre un taux important de laparotomie blanche (40;9 pour cent). La lourde mortalite (15;9 pour cent) pourrait etre reduite par l'amelioration de mesures de reanimation