High prevalence of cyclovirus Vietnam (CyCV-VN) in plasma samples from Madagascan healthy blood donors.

Cycloviruses, small ssDNA viruses belonging to the Circoviridae family, have been suggested as possible causes of enteric, respiratory and neurological disorders in human patients. One of these species, cyclovirus-Vietnam (CyCV-VN), initially isolated from cerebrospinal fluid samples of patients with unexplained neurological disorders, has since been reported in serum samples from chronically patients infected with HBV, HCV or HIV, in Italy. On the other hand, CyCV-VN was not detected in serum samples from healthy individuals. Here, we report on a high prevalence of 43.4% (40/92) of CyCV-VN in plasma samples from asymptomatic blood donors from Madagascar. Interestingly, this virus was not detected by metagenomics and PCR in six other African countries, suggesting regional differences in CyCV-VN prevalence across Africa. Phylogenetic analysis based on the complete genomes showed that CyCV-VN sequences isolated from blood were most closely related to sequences previously reported from human stool in Madagascar. Further investigations using larger cohorts are required to determine the global epidemiology, the natural history and the pathological significance, if any, of CyCV-VN infection in humans.

[Transcranial doppler in sickle cell disease (SCD) in Malagasy children]. / Doppler transcranien au cours de la drépanocytose chez l'enfant Malagasy.

INTRODUCTION: Transcranial Doppler is an effective diagnostic tool to detect sickle cell children at risk for stroke. METHODS: We conducted a cross-sectional descriptive study of Malagasy children aged between 24 months and 15 years (group 1: 57 sickle cell diseases, group 2: 43 controls) to assess the cerebral artery velocimetry in the patient population. Transcranial doppler ultrasound with analysis of cerebral blood flow was performed in children of both groups. RESULTS: In subjects with sickle cell disease, the mean velocity (MV) in the middle cerebral artery was 100.9 ± 26.8 cm/s, pulsatility index (PI) was 0.73 ± 0.20, the difference between the right and left middle cerebral artery (MCA) was 19.8 ± 21.5 cm/s, anterior cerebral artery/middle cerebral artery flow velocity ratio (ACA / MCA) was 0.7 ± 0.2. In children without sickle cell disease, MV: 80.6 ± 19.3 cm/s, IP: 0.79 ± 0.14, ACMr: 17 ± 20.1 cm/s, ACA/ACM: 0,8 ± 0,2. The velocity in children with sickle cell disease was higher than in the control group. Velocities were correlated with hemoglobin and age but not with sex and mean corpuscular volume. CONCLUSION: Cerebral Circulation Speeds are higher in children with sickle cell disease and are influenced by hemoglobin levels and age.

Transfusion safety in francophone African countries: an analysis of strategies for the medical selection of blood donors.

BACKGROUND: The goal of selecting a healthy blood donor is to safeguard donors and reduce the risks of infections and immunologic complications for recipients. STUDY DESIGN AND METHODS: To evaluate the blood donor selection process, a survey was conducted in 28 blood transfusion centers located in 15 francophone African countries. Data collected included availability of blood products, risk factors for infection identified among blood donor candidates, the processing of the information collected before blood collection, the review process for the medical history of blood donor candidates, and deferral criteria for donor candidates. RESULTS: During the year 2009, participating transfusion centers identified 366,924 blood donor candidates. A mean of 13% (range, 0%-36%) of the donor candidates were excluded based solely on their medical status. The main risk factors for blood-borne infections were having multiple sex partners, sexual intercourse with occasional partners, and religious scarification. Most transfusion centers collected this information verbally instead of having a written questionnaire. The topics least addressed were the possible complications relating to the donation, religious scarifications, and history of sickle cell anemia and hemorrhage. Only three centers recorded the temperature of the blood donors. The deferral criteria least reported were sickle cell anemia, piercing, scarification, and tattoo. CONCLUSIONS: The medical selection process was not performed systemically and thoroughly enough, given the regional epidemiologic risks. It is essential to identify the risk factors specific to francophone African countries and modify the current medical history questionnaires to develop a more effective and relevant selection process.