C-reactive protein: An easy marker for early differentiation between leptospirosis and dengue fever in endemic area.

In tropical regions, leptospirosis and dengue fever (DF) are infectious diseases of epidemiological importance and have overlapping symptomatic features. The objective of this study was to identify the factors associated to diagnosing leptospirosis that differentiate it to DF at the initial hospital evaluation. A multicenter retrospective study was conducted comparing confirmed leptospirosis to DF cases. Clinical/laboratory findings were compiled at hospital admission on Reunion Island between 2018 and 2019. Multivariable logistic regression was used to identify the predictors of leptospirosis. In total, 98 leptospirosis and 673 DF patients were included with a mean age of 47.8 (±17.1) and 48.9 (±23.3) years, respectively. In the multivariate analyses, the main parameters associated with leptospirosis were: i) increased neutrophil counts, ii) C-reactive protein values, iii) the absence of prolonged partial thromboplastin time, and iv) a decrease of platelets. The most discriminating parameter was C-reactive protein (CRP). With a threshold of 50mg/L, CRP taken alone had a sensitivity of 94% and a specificity of 93.5%. The positive and negative likelihood ratios were 14.5 and 0.06, respectively. In the setting of an early presumptive diagnosis, we found that an increased CRP value (>50 mg/L) could help diagnose leptospirosis and aid the decision process for hospital surveillance and/or a potential antibiotic treatment regimen.

[Why does the Ebola virus epidemic continue to plague the Democratic Republic of the Congo?] / Pourquoi l'épidémie à virus Ebola continue-t-elle à sévir en République démocratique du Congo ?

Why does the ebola virus epidemic continue to plague the democratic republic Of the congo?Ebola virus disease outbreak continues in North Kivu and Ituri provinces in the Democratic Republic of the Congo, despite a marked improvement in management of medical care and prevention of the disease. Since August 2018, the disease has been evolving in a complex epidemic field, forgotten by the international press. In the sensitive geopolitic context with this area of armed conflicts more than 20 years, we describe the socio-cultural and geopolitic parameters that have an impact on the evolution of disease in the eastern of Democratic Republic of the Congo.

Pourquoi l'épidémie à virus ebola continue-t-elle à sévir en république démocratique du congo ?Malgré une avancée certaine dans la prise en charge médicale et préventive de la maladie depuis le second semestre 2019, l'épidémie de la maladie à virus Ebola continue de sévir dans les provinces du Nord-Kivu et de l'Ituri en République démocratique du Congo. Débutée en août 2018, cette maladie évolue sur un terrain épidémique complexe et oublié des médias internationaux. Nous décrivons les paramètres socioculturels et géopolitiques qui impactent l'évolution de l'épidémie de la maladie à virus Ebola dans cette région orientale de la République démocratique du Congo en proie à des menaces armées et à une instabilité politique depuis plus de deux décennies.