A possible case of spontaneous Loa loa encephalopathy associated with a glomerulopathy.

It is well known that renal and neurological complications may occur after antifilarial treatment of patients infected with Loa loa. Conversely, spontaneous cases of visceral complications of loiasis have been rarely reported. A 31-year-old Congolese male patient who had not received any antifilarial drug developed oedema of the lower limbs, and then transient swellings of upper limbs. Two months after, he developed troubles of consciousness within several hours. At hospital, the patient was comatose with mild signs of localization. Laboratory tests and an abdominal echography revealed a chronic renal failure due to a glomerulopathy. Three weeks after admission, Loa microfilariae were found in the cerebrospinal fluid, and a calibrated blood smear revealed a Loa microfilaraemia of 74,200 microfilariae per ml. The level of consciousness of the patient improved spontaneously, without any specific treatment, but several days after becoming completely lucid, the patient died suddenly, from an undetermined cause. Unfortunately, no biopsy or autopsy could be performed. The role of Loa loa in the development of the renal and neurological troubles of this patient is questionable. But the fact that such troubles, which are known complications of Loa infection, were found concomitantly in a person harbouring a very high microfilarial load suggests that they might have been caused by the filarial parasite. In areas endemic for loiasis, examinations for a Loa infection should be systematically performed in patients presenting an encephalopathy or a glomerulopathy.

[Prevalence of HIV and HBs antigen in blood donors. Residual risk of contamination in blood recipients in East Kinshasa, Democratic Republic of the Congo]. / Prévalence du VIH et de l'antigène HBs chez les donneurs du sang. Risque résiduel de contamination chez les receveurs de sang à Kinshasa-est, Rèpublique Démocratique du Congo.

Between January and August 1999, a total of 7277 blood donors at various health centers in Kinshasa, Democratic Republic of the Congo were screened for human immunodeficiency virus 1 (HIV1) and hepatitis B surface antigen (HbsAg) using the ELISA technique. Findings showed an incidence of 6.4% for HIV1 antibodies, 9.2% for HbsAg, and 1% for HIV1 and HbsAg. Young females (under 39 years of age) from lower socio-economic classes were the most likely to be infected by HIV1. The risk of HIV transmission by transfusion of contaminated blood was 3%, which is close to the incidence of HIV in the general population. The findings of this study document the need to speed up implementation of blood donor screening in the city of Kinshasa and the rest of the country.