Hepatitis B virus (HBV) and hepatitis delta virus (HDV) occur worldwide and are prevalent in both urban and remote rural communities. In a remote village in Gabon, central Africa, we observed a high ...prevalence of HBsAg carriage and HDV infection, particularly in children and adolescents. The prevalence of HBsAg differed significantly by gender and age, females being more likely than males to carry the HBsAg during the first 10years of life, while the prevalence was higher among males than females aged 11–20years. We also characterised HBV and HDV strains circulating in the village. The principal HBV strains belonged to genotype HBV-E and subgenotype QS-A3. Complete genome analysis revealed for the first time the presence of the HBV-D genotype in Gabon, in the form of an HBV-D/E recombinant. Molecular analysis of HDV strains and their complete genomic characterisation revealed two distinct groups within the dominant HDV clade 8. Molecular analysis of HBV and HDV strains did not reveal vertical transmission within the families studied but rather horizontal, intrafamilial transmission among children aged 0–10years. Our findings indicate that HBV is transmitted in early childhood by body fluids rather than by sexual contact. Health education adapted to the different age groups might therefore help to reduce HBV transmission. Young children should be vaccinated to control HBV infection in areas of extremely high prevalence.
•High prevalence of HBsAg carriage and HDV was found in a remote village in Gabon and the prevalence of HBsAg differed by gender and age.•The main HBV strains belonged to genotype HBV-E and subgenotype QS-A3.•Complete genome analysis revealed for the first time the presence of the HBV-D genotype in Gabon, in the form of an HBV-D/E recombinant.•Complete genomic characterisation of HDV strains revealed two distinct groups within the dominant HDV clade 8.•We observed horizontal, intrafamilial transmission of HBV and HDV among children aged 0–10years.
Clinical forms of chikungunya in Gabon, 2010 Nkoghe, Dieudonné; Kassa, Roland Fabrice; Caron, Mélanie ...
PLoS neglected tropical diseases,
02/2012, Letnik:
6, Številka:
2
Journal Article, Web Resource
Recenzirano
Odprti dostop
Chikungunya virus (CHIKV) has caused multiple outbreaks in tropical and temperate areas worldwide, but the clinical and biological features of this disease are poorly described, particularly in ...Africa. We report a prospective study of clinical and biological features during an outbreak that occurred in Franceville, Gabon in 2010.
We collected, in suspect cases (individuals presenting with at least one of the following symptoms or signs: fever, arthralgias, myalgias, headaches, rash, fatigue, nausea, vomiting, diarrhea, bleeding, or jaundice), blood samples, demographic and clinical characteristics and outcome. Hematological and biochemical tests, blood smears for malaria parasites and quantitative PCR for CHIKV then dengue virus were performed. CHIKV+ patients with concomitant malaria and/or dengue were excluded from the study. From May to July 2010, data on 270 laboratory-confirmed CHIK patients were recorded. Fever and arthralgias were reported by respectively 85% and 90% of patients, while myalgias, rash and hemorrhage were noted in 73%, 42% and 2% of patients. The patients were grouped into 4 clinical categories depending on the existence of fever and/or joint pain. On this basis, mixed forms accounted for 78.5% of cases, arthralgic forms 12.6%, febrile forms 6.7% and unusual forms (without fever and arthralgias) 2.2%. No cases of organ failure or death were reported. Elevated liver enzyme and creatinine levels, anemia and lymphocytopenia were the predominant biological abnormalities, and lymphocytopenia was more severe in patients with high viral loads (p = 0.01).
During CHIK epidemics, some patients may not have classical symptoms. The existence of unusual forms and the absence of severe forms of CHIK call for surveillance to detect any change in pathogenicity.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To evaluate the use of the Foetal Medicine Foundation (FMF) algorithm in routine practice for early pre-eclampsia (PE) screening in Libreville.
We conducted a cohort study on pregnant women within ...their 11-13 + 6 weeks of gestation (WG). We had measured mean blood pressure (MBP), placental growth factor (PlGF), soluble Fms-like tyrosine kinase 1, Uterine Artery Pulsatility Index (UtA-PI) and resistance index (UtA-RI). Statistical analyses were considered significant for P < 0.05.
There were 30 participants. At the first quarter (T1), 36.7% of them were at high risk of PE according to the FMF algorithm and were consequently prescribed aspirin (100 mg/d). By the end of the observation period, we have found a 13% incidence of PE. MBP was higher in the higher risk PE group than in the lower risk group as early as the T1 (90 ± 6 vs. 81 ± 6 mmHg; P = 0.0007, threshold is >86 mmHg/area under the curve (AUC) = 0.86; P = 0.0012). It was the same for PlGF (58 ± 24 vs. 88 ± 38 pg/ml; P = 0.03; threshold is <71.98 pg/ml/AUC = 0.73; P = 0.03). At the second quarter (20-27 WG), biochemical markers did not change between the two groups. UtA-RI, UtA-PI and notch were unconclusive individually, but they are still very important for FMF algorithm application.
Early detection of PE using the FMF algorithm is possible in routine practice in Gabon. MBP and PlGF levels at T1 seem to be very significant. However, the present study must continue to obtain the larger cohorts that would achieve more conclusive statistical analyses.
Chikungunya (CHIKV) and Dengue (DENV) viruses, both arboviruses, have caused multiple outbreaks worldwide. Their clinical features are poorly described in Africa and there is no comparative study, ...although Chikungunya is considered as a dengue-like disease. We conducted a comparative study of clinical and biological data from CHIKV and DENV positive patients during the 2010 Gabonese outbreak. Patients consulting with general symptoms and having laboratory confirmation for CHIKV or DENV were included. Clinical and biological data were recorded. Statistical analyses were performed using Epi Info. A P value < 0.05 was considered significant. In all, 270 CHIKV+, 53 DENV+ and 20 co-infected patients were included in the study. Headaches, hemorrhage, leukopenia and lymphopenia were significantly (P respectively 0.01, 0.001, 0.02 and 0.001) more frequent in DENV+ patients than in CHIKV+. There was no additive effect of the two viruses. These clinical and hematological disorders are non specific and cannot assist for the differential diagnosis. These diseases are clinically indistinguishable, and need for laboratory confirmation.
Abstract Plasmodium falciparum cells tend to grow in synchronicity during their cyclic intraerythrocytic development in vivo . Both host and parasite factors appear to be involved in this ...synchronization. We examined the link between mixed-allelic-family P. falciparum infection and synchronicity in parasitized red blood cells (PRBC) from symptomatic children. The distribution of rings and trophozoites in each PRBC sample was determined by standard microscopy. P. falciparum was genotyped by using a polymerase chain reaction (PCR) targeting three loci (merozoite surface proteins (MSP) 1 and 2, and 175-kD erythrocyte binding antigen (EBA), allowing us to distinguish parasite clones belonging to a single-allelic family (SAF) and those belonging to a mixed-allelic family (MAF). Parasite development was considered synchronous when peripheral blood contained at least 95% of rings or 95% of trophozoites. Parasite development was synchronous in 22 (21.2%) of the 104 children studied. Twenty (90.9%) of these infections were SAF and two (9.1%) were MAF. Rings and trophozoites predominated in respectively 12 (60%) and 8 (40%) SAF infections. Respectively 17.1% and 82.9% of the 82 asynchronous cases corresponded to SAF and MAF infection. Parasite synchronicity was therefore significantly related to single-allelic-family infection ( p < 2 × 10 − 10 ). Twenty different MSP-1 alleles and thirteen different MSP-2 alleles were identified. Only three isolates from patients with SAF infection comprised a single allele or genotype, the other isolates harboring at least two alleles. The mean number of alleles or clones was respectively 3.0 and 10.0 in SAF and MAF infection. These results reflect the allelic diversity of the MSP loci and show that SAF infection can correspond to multiple parasite clones (or genotypes) but, in general, fewer than in MAF infection ( p ≤ 0.0007). These results confirm the extensive polymorphism of P. falciparum vaccine candidates MSP-1 and -2 in southeastern Gabon and demonstrate that parasite synchronicity in vivo is strongly associated with single-allelic-family infection.
État des lieux du système d’information sanitaire du Gabon Koumamba, Aimé Patrice; Lipenguet, Gaetan Moukoumbi; Mbenga, Raymond Ondzigue ...
Santé publique (Vandoeuvre-lès-Nancy, France),
10/2020, Letnik:
32, Številka:
4
Journal Article
Recenzirano
Objectif : Le besoin de disposer d’un système d’information sanitaire efficient et fiable a motivé le Gabon, avec l’appui de la Banque mondiale, pour qu’il financer un projet visant à renforcer son ...système d’information sanitaire. En amont, un audit de ce système s’imposait pour rendre compte de la réalité des dispositifs et des outils existants. Méthode : Les informations ont été recueillies sur deux périodes allant respectivement de mai à septembre 2016 et d’avril à mai 2018 pour la seconde en utilisant des approches qualitative et quantitative. Dans ce cadre, ont été réalisés successivement des ateliers participatifs incluant des acteurs de santé au Gabon, une enquête menée auprès de professionnels de santé, une analyse des documents de référence relatifs à la politique de santé nationale et une analyse des forces, faiblesses, opportunités et menaces du système. Résultats : Au total, 171 professionnels de santé de santé ont participé aux différents ateliers, et 770 autres ont été interrogés parmi 150 structures de soins issues des 10 régions sanitaires du pays. Au terme de ce travail, des problèmes organisationnels et techniques ont été relevés au niveau du système d’information sanitaire du Gabon, notamment l’absence de cadre juridique définissant les rôles et responsabilités des différents acteurs du système, une faible pratique de la gestion des données, un système d’information en silo, plusieurs applications informatiques non interopérables et un taux de complétude faible, à 30 %. Parmi les 770 professionnels de santé enquêtés, 539 (70 %) étaient favorables à la mise en place d’un nouveau système d’information. Comme principaux acquis, nous avons noté l’existence d’un parc informatique et une couverture Internet acceptables, 31,5 % des structures de soins étant connectées via le câble. Conclusion : Ce travail apporte des éclaircissements sur le système d’information sanitaire existant et permet de mieux envisager la mise en œuvre du nouveau système.
As part of a project to identify new compounds active on malarial parasites, we tested the in vitro antiplasmodial activity of nine plants traditionally used to treat malaria symptoms in Haut-Ogooué ...Province, South-East Gabon.
Dichloromethane and methanolic extracts of each plant were tested for their antiplasmodial activity on two chloroquine-resistant strains of Plasmodium falciparum (FCB and W2), based on lactate dehydrogenase activity. Cytotoxicity was assessed with the MTT test on MRC-5 human diploid embryonic lung cells.
The methanolic extract of Staudtia gabonensis and the dichloromethane extract of Adhatoda latibracteata showed high antiplasmodial activity (IC50<1μg/ml) and low cytotoxicity, with selectivity indexes of about 58.25 and 16.43, respectively. The methanolic extract of Monodora myristica and the dichloromethane extract of Afromomum giganteum also showed promising activity (1<IC50<10μg/ml) and low cytotoxicity, with selectivity indexes about 15.70 and 12.48, respectively. Dichloromethane extracts of Monodora myristica and Leonotis Africana showed moderate activity (10<IC50<40μg/ml), with selectivity indexes about 6.07 and 28.89, respectively. Both extracts of Culcasia lancifolia had IC50 values of 10–40μg/ml but high cytotoxicity (selectivity indexes <2.77). The methanolic extract of Dorstenia klaineana had moderate antiplasmodial activity (IC50 around 17μg/ml) but strong cytotoxicity (0.43μg/ml), giving a selectivity index of about 0.03.
Most extracts of nine selected plants traditionally used to treat malaria in Gabon had interesting antiplasmodial activity in vitro. This supports continued investigations of traditional medicines in the search for new antimalarial agents. The compounds responsible for the observed antiplasmodial effects are under investigation.
Etat des lieux du système d’information sanitaire du Gabon Koumamba, Aime Patrice; Moukoumbi Lipenguet, Gaetan; Mbenga, Raymond Ondzigue ...
Santé publique (Vandoeuvre-lès-Nancy, France),
07/2020, Letnik:
32, Številka:
4
Journal Article
Recenzirano
Objective: The need for an efficient and reliable health information system motivated Gabon, with the support of the World Bank, to finance a project to reinforce its health information system. An ...audit of this system was required to report on the reality of the existing system and tools. Methods: Over the course of two periods, May to September 2016 and April to May 2018, information was collected using both qualitative and quantitative approaches. In this framework, were carried out successively: participative workshops including health actors in Gabon, a survey of health care workers, an analysis of reference documents relating to national health policies, and an analysis of the strengths, weaknesses, opportunities, and threats to the system. Results: In total, 171 health care professionals participated in the different workshops, and 770 others were questioned among 150 health care establishments from 10 health care regions of the country. At the end of this research work, organizational and technical problems were noted at the level of the health information system of Gabon, notably the absence of a judicial framework defining the roles and responsibilities of the different actors of the system, weak data management, a stovepipe information system, several non-interoperable IT applications, and weak completeness rate, at 30%. Among the 770 health care professionals surveyed, 539 (70%) were favorable to a new information system. As for the main assets, we noted the existence of computing equipment and acceptable internet coverage, 31.5% of the health care establishments are connected via cable. Conclusion: This research sheds light on the existing health information system and should enable the implementation of a new system.
Objectif : Le besoin de disposer d’un système d’information sanitaire efficient et fiable a motivé le Gabon, avec l’appui de la Banque mondiale, pour qu’il financer un projet visant à renforcer son système d’information sanitaire. En amont, un audit de ce système s’imposait pour rendre compte de la réalité des dispositifs et des outils existants.Méthode : Les informations ont été recueillies sur deux périodes allant respectivement de mai à septembre 2016 et d’avril à mai 2018 pour la seconde en utilisant des approches qualitative et quantitative. Dans ce cadre, ont été réalisés successivement des ateliers participatifs incluant des acteurs de santé au Gabon, une enquête menée auprès de professionnels de santé, une analyse des documents de référence relatifs à la politique de santé nationale et une analyse des forces, faiblesses, opportunités et menaces du système.Résultats : Au total, 171 professionnels de santé de santé ont participé aux différents ateliers, et 770 autres ont été interrogés parmi 150 structures de soins issues des 10 régions sanitaires du pays. Au terme de ce travail, des problèmes organisationnels et techniques ont été relevés au niveau du système d’information sanitaire du Gabon, notamment l’absence de cadre juridique définissant les rôles et responsabilités des différents acteurs du système, une faible pratique de la gestion des données, un système d’information en silo, plusieurs applications informatiques non interopérables et un taux de complétude faible, à 30 %. Parmi les 770 professionnels de santé enquêtés, 539 (70 %) étaient favorables à la mise en place d’un nouveau système d’information. Comme principaux acquis, nous avons noté l’existence d’un parc informatique et une couverture Internet acceptables, 31,5 % des structures de soins étant connectées via le câble.Conclusion : Ce travail apporte des éclaircissements sur le système d’information sanitaire existant et permet de mieux envisager la mise en œuvre du nouveau système.
OBJECTIVEThe need for an efficient and reliable health information system motivated Gabon, with the support of the World Bank, to finance a project to reinforce its health information system. ...An audit of this system was required to report on the reality of the existing system and tools. METHODSOver the course of two periods, May to September 2016 and April to May 2018, information was collected using both qualitative and quantitative approaches. In this framework, were carried out successively: participative workshops including health actors in Gabon, a survey of health care workers, an analysis of reference documents relating to national health policies, and an analysis of the strengths, weaknesses, opportunities, and threats to the system. RESULTSIn total, 171 health care professionals participated in the different workshops, and 770 others were questioned among 150 health care establishments from 10 health care regions of the country. At the end of this research work, organizational and technical problems were noted at the level of the health information system of Gabon, notably the absence of a judicial framework defining the roles and responsibilities of the different actors of the system, weak data management, a stovepipe information system, several non-interoperable IT applications, and weak completeness rate, at 30%. Among the 770 health care professionals surveyed, 539 (70%) were favorable to a new information system. As for the main assets, we noted the existence of computing equipment and acceptable internet coverage, 31.5% of the health care establishments are connected via cable. CONCLUSIONThis research sheds light on the existing health information system and should enable the implementation of a new system.
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