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Open Journal of Blood Diseases 2020年第2期10卷 41-47页

作者： Lydie Ocini Ngolet Vulliez Renucci Nkounkou Blaise Atipo Ibara alexis elira dokekias Department of Medical Hematology University Hospital of Brazzaville Brazzaville The Republic of the Congo Department of Internal Medicine and Gastroenterology Unit University Hospital of Brazzaville Brazzaville The Republic of the Congo

Background: There are no consensual diagnosis criteria to make diagnosis of sickle cell intrahepatic cholestasis and identify its 2 variants. Here we delineate the frequency of the complication in its severe form and describe its clinical features. Methods: We included in the study all the patients with sickle cell disease who were presenting fever, jaundice, pain in the upper right quadrant and filling up the biological criteria of the severe sickle cell intrahepatic cholestasis (serum direct bilirubin ≥ 78.5 mg/dL). Patients with evidence of viral hepatitis or gallstones were not included in the study. Results: Sixty-two patients with an average age of 21.5 years (range 18 and 25 years) meet the inclusion criteria, minimum serum direct bilirubin: 82 versus 528 for the maximum. The liver cytolysis was major and ranged from 310 to 1550 UI/L. Forty-nine patients (83.9%) did not develop any organ failure. The symptoms and biological abnormalities resolved with supportive treatment within 7 days. The global lethality was 16.1% associated with liver failure. Conclusion: Severe sickle cell intrahepatic cholestasis is more frequent than we thought and was mainly represented by borderline clinical feature. Early intervention may reduce the progression to organ failure stage and ultimate death.

关键词： Sickle Cell Disease Serum Direct Bilirubin Borderline Clinical Feature

Evolution of the Outcomes of Children with Acute Leukemia in Congo

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Open Journal of Blood Diseases 2022年第1期12卷 1-9页

作者： Lydie Ocini Ngolet Simo Josué Luokdom alexis Fortuné Bolenga Liboko Firmine Olivia Galiba Atipo Tsiba alexis elira dokekias Department of Medical Hematology Teaching Hospital Brazzaville Congo Pharmacy Department University of Mountains Banganté Cameroon Department of Oncology Teaching Hospital Brazzaville Congo

Background: To lower the mori-mortality related to the aggressiveness of acute leukemia’s chemotherapy regimens, we have implemented in 2017 two low toxicity chemotherapy regimens and new supportive care strategies. The aim of the study is to evaluate our new treatments. Materials and Method: A retrospective study was carried out from January 2014 to May 2021 in the hematology department of the teaching hospital in Brazzaville. The study concerned 47 children diagnosed with acute leukemia. Participants were divided into two groups: acute leukemia diagnosed before 2017 (group 1: 23 children) and after 2017 (group 2: 14 children). They were compared using the chi-square. Results: The median age was 10.0 ± 5.01 years. Features and outcomes of group 2 were better. The median duration of symptoms was shorter: 2.45 ± 2.87 months (p = 0.036). The Karnosky score was higher (p = 0.002) and white blood cell count lower (p = 0.331). Both groups started the treatment with a delay of 6 days. The induction treatment was completed in 69.6% before 2017 versus 93.3% after. The rate of relapse was more important for group 1: 85.7% versus 14.3% (p = 0.01). Conclusion: Trainings of professionals have improved the characteristics outcomes of our patients and should be pursued. Considering the high relapse rate, our protocol will need to be intensified.

关键词： Childhood Acute Leukemia Outcomes

Prevalence of Virological Markers HIV, HBV and HCV in Homozygous Sickle Cell Patients at Brazzaville University Hospital

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Open Journal of Blood Diseases 2021年第4期11卷 140-149页

作者： Laure Flora Josiane Kibangou Rachel Moyen Nanikaly Moyen Innocent Kocko Lydie Ngolet Ettienne Nguimbi alexis elira dokekias National Blood Transfusion Center Brazzaville Congo Laboratory of Cellular and Molecular Biology Faculty of Science and Technology Marien Ngouabi University Brazzaville Congo Laboratory of Virology and Hematology Faculty of Health Sciences Université Marien Ngouabi Brazzaville Congo Clinical Hematology Department University Hospital of Brazzaville Brazzaville Congo National Reference Center for Sickle Cell Disease Brazzaville Congo

In order to evaluate the seroprevalence of major viral markers, a descriptive study was carried out in homozygous sickle cell transfusion patients at the University Hospital of Brazzaville. The profiles were determined in 51 patients, 32 of whom were male and 19 female, with an age range of 17 to 51 years, admitted to the clinical hematology department of the University Hospital and to the National Reference Center for Sickle Cell Disease. The tests were performed on pre- and post-transfusion blood samples. The following reagents were used: GeenscreenTMultraHIVAg-Ab, MonolisaAg-HBs plus, MonolisaHCV Ag-Ab Ultrade Bio-Radot for the detection of HIV, HBV and HCV by fourth generation ELISA tests (serological tests). The results showed that the indications for blood transfusion were: acute crises of anemia due to malaria and in some cases of Vaso-Occlusive Crises (VOC) resistance to analgesic treatment. The prevalence rates of the markers before the new transfusion were respectively: HIV: 0%, HBV: 1.96%, HCV: 3.92%. After transfusion, the final seroprevalence rates of the markers are: HIV: 0%, HBV: 5.88%, HCV: 3.92%. The seroconversion rate for HBV was 3.92%. One case of HBV + HCV co-infection (1.96%). Conclusion: Transfusion safety is achieved through good transfusion practices and the qualification of blood donations. Homozygous sickle cell disease, characterized by frequent anemia attacks, requires a guarantee of efficient transfusion practices in order to limit microbial risks.

关键词： Safety Poly Transfusion Sickle Cell Disease Poly Transfusion Brazzaville

Hematological and Biochemical Profile of Sickle Cell Patients in Critical and Inter-Critical Periods in Brazzaville, Republic of Congo

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Open Journal of Blood Diseases 2021年第2期11卷 57-65页

作者： Edwige Paola Louanga Nanitelamio Serge Oscar Mokono Chaldam Jespère Mbani Olivia Galiba Atipo-Tsiba Fabien Roch Niama Etienne Mokondjimobe Donatien Moukassa Ange Antoine Abena alexis elira dokekias Faculty of Health Sciences Marien NGOUABI University Brazzaville Congo National Center of Blood Transfusion Brazzaville Congo Faculty of Science and Technology Marien NGOUABI University Brazzaville Congo National Reference Center for Sickle Cell Disease Brazzaville Congo

Introduction: Sickle cell disease is a public health problem in the Republic of Congo where the prevalence of sickle cell trait is estimated at 1.25%. The objective of this study is to describe the variations of hematological and biochemical parameters of hemolysis in sickle cell patients in critical and inter-critical periods. Methods: This is a descriptive cross-sectional study including sickle cell patients followed regularly at the National Reference Center for Sickle Cell Disease (CNRDr) from November 2019 to March 2020. A sample of 167 patients (sickle cell subjects in crisis and in steady state as well as control subjects) was randomly selected during the study period. The blood count was performed using a Sysmex-XN 350 automated system and the biochemical parameters were determined using the Cobas e 311 automated system. Statistical analysis was performed with SPSS version 22 software. Results: The study showed that the mean cholesterol level in controls was 4.16 ± 0.77 ul compared with 9.64 ± 4.34 ul in sickle cell crisis subjects. Hb and HCT levels were significantly higher in controls compared with sickle cell subjects in crisis. During crisis, total bilirubin, direct bilirubin, triglycerides, LDH, AST, and CRP were significantly elevated. Hematological parameters such as Hb and HCT were elevated in controls, while the mean WBC value and RET were higher in sickle cell patients in steady state. The mean values of the biochemical parameters were higher in sickle cell patients in steady state. Conclusion: Evaluation of the influence of sickle cell trait on biochemical and hem

关键词： Sickle Cell Disease Hematological Parameters Biochemical Parameters Critical and Inter-Critical Period Brazzaville