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Hepatitis C in Laos： A 7-Year Retrospective Study on 1765 Patients

Virologica Sinica 2018年第4期33卷 295-303页

作者： Phimpha Paboriboune Thomas Vial Philavanh Sitbounlang Stephane Bertani Christian Trepo Paul Deny Francois-Xavier Babin Nicolas Steenkeste Pascal Pineau Eric Deharo Centre d'Infectiologie Lao-Christophe Merieux 3888 Vientiane Laos UMR 152 pharmadev IRD Universite de ToulouseUPS 31062 Toulouse France INSERM U1052 CNRS UMR 5286 Cancer Research Centre of Lyon 69008 Lyon France Universite Paris 13 Sorbonne Paris Cite Hopitaux Universitaires Paris Seine Saint Denis 93000 Bobigny France Fondation Merieux 69002 Lyon France INSERM U993 Institut Pasteur Unite 'Organisation Nucleaire et Oncogenese' 75015 Paris France

Hepatitis C virus （HCV） is a global health concern, notably in Southeast Asia, and in Laos the presentation of the HCV- induced liver disease is poorly known. Our objective was thus to describe a comprehensive HCV infection pattern in order to guide national health policies. A study on a group of 1765 patients formerly diagnosed by rapid test in health centres was conducted at the Centre of Infectiology Lao Christophe Merieux in Vientiane. The demographic information of patients, their infection status （viral load： VL）, liver function （aminotransferases） and treatments were analysed. Results showed that gender distribution of infected people was balanced; with median ages of 53.8 for men and 51.6 years for women （13-86 years）. The majority of patients （72%） were confirmed positive （VL 〉 50 IU/mL） and 28% of them had high VL （〉 61oglo）. About 23% of patients had level of aminotransferases indicative of liver damage （〉 40 IU/mL）; but less than 20% of patients received treatment. Patients rarely received a second sampling or medical imaging. The survey also showed that cycloferon, pegylated interferon and ribavirin were the drugs prescribed preferentially by the medical staff, without following any international recommendations schemes. In conclusion, we recommend that a population screening policy and better management of patients should be urgently implemented in the country, respecting official guidelines. However, the cost of biological analysis and treatment are significant barriers that must be removed. Public health resolutions should be immediately enforced in the perspective of meeting the WHO HCV elimination deadline by 2030.

关键词： Hepatitis C virus (HCV) HCV incidence Antiviral agents Laos

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A diagnostic protocol designed for determining allergic causes in patients with blood eosinophilia

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Military Medical Research 2017年第4期4卷 181-192页

作者： Jean-François Magnaval Guy Laurent Noemie Gaudré Judith Fillaux Antoine Berry Department of Medical Parasitology Faculty of MedicineToulouse University37 aliees Jules-GuesdeToulouseFrance Purpan Center for Pathophysiology INSERM UMR Ulo43CNRS UMR S282Toulouse UniversityToulouseFrance Department of Hematology Toulouse University HospitalsToulouseFrance Cancer Institute Toulouse University and OncopoleToulouseFrance Department of Parasitology and Mycology Toulouse University HospitalsToulouseFrance pharmadev IRD UMR 152Toulouse UniversityToulouseFrance

Background: Blood eosinophilia is a common laboratory abnormality, and its characterization frequently represents a quandary for primary care physicians. Consequently, in France, specialists and particularly hematologists, often must investigate patients who present with blood eosinophilia that often, but not always, occurs because of allergic causes. Both the Departments of Hematology and Parasitology at Toulouse University Hospitals established a collaboration to rule out allergic causes of eosinophilia, particularly helminthiases, prior to initiating more sophisticated ***: Since 2004, the authors employed the same protocol to investigate eosinophilic outpatients who attended the clinic of Parasitology at Toulouse University Hospitals, and they reported the performance of this diagnostic procedure that was designed to be rapid(no hospitalization required) and only moderately ***: A total of 406 patients who presented with blood eosinophilia greater than 0.5(×10~9, giga cells per litter, G/L) had an allergic etiology in 350(86.2%) cases. Among the remaining 56 subjects, 17 did not undergo a follow-up and 39 were referred to another specialized department, mostly Hematology. However, only 21 patients attended then were subsequently investigated. Non-allergic causes of eosinophilia, including 3 cases of the lymphoid variant of hypereosinophilic syndrome and 2 cases of myeloproliferative disorder, were identified in 14 patients, whereas 7 remained diagnosed as having idiopathic ***: This study underlines the need to investigate patients presenting with even moderate blood eosinophilia. The work-up that was employed appears to be efficient and versatile and may be used by any medical specialist, such as in hematology, infectious disease, or internal medicine departments, who needs to investigate eosinophilic patients and should initially rule out any etiology of allergic eosinophilia.

关键词： Blood eosinophilia Diagnostic protocol Classification Secondary eosinophilias Allergy Helminthiases

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Elevated plasma interleukin-8 as a risk factor for mortality in children presenting with cerebral malaria

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Infectious Diseases of Poverty 2023年第1期12卷 47-61页

作者： Jade Royo Bertin Vianou Manfred Accrombessi Elisée Kinkpé Linda Ayédadjou Ida Dossou-Dagba YéléLadipo Maroufou Jules Alao Gwladys I.Bertin Michel Cot Farid Boumédiène Sandrine Houzé Jean François Faucher Agnès Aubouy 无 UMR152 pharmadev IRDUPSToulouse University35 Chemin Des Maraichers31400 ToulouseFrance Clinical Research Institute of Benin(IRCB) Abomey CalaviBenin Faculty of Infectious and Tropical Diseases Disease Control DepartmentLondon School of Hygiene and Tropical MedicineLondonUK Paediatric Department Calavi HospitalCalaviBenin Paediatric Department Mother and Child University and Hospital Center(CHU-MEL)CotonouBenin UMR261 MERIT IRDParis UniversityParisFrance UMR 1094 EpiMaCT InsermLimoges University HospitalLimoges UniversityLimogesFrance French Malaria Reference Center APHPBichat HospitalParisFrance Parasitology Laboratory APHPBichat-Claude-Bernard HospitalParisFrance Infectious Diseases and Tropical Medicine Department Limoges University HospitalLimogesFrance NeuroCM Group

Background Cerebral malaria(CM)is a neuropathology which remains one of the deadliest forms of malaria among African *** kinetics of the pathophysiological mechanisms leading to neuroinflammation and the death or survival of patients during CM are still poorly *** increasing production of cytokines,chemokines and other actors of the inflammatory and oxidative response by various local actors in response to neuroinflammation plays a major role during CM,participating in both the amplification of the neuroinflammation phenomenon and its *** this study,we aimed to identify risk factors for CM death among specific variables of inflammatory and oxidative responses to improve our understanding of CM *** Children presenting with CM(n=70)due to *** infection were included in southern Benin and divided according to the clinical outcome into 50 children who survived and 20 who *** examination was complemented by fundoscopic examination and extensive blood biochemical analysis associated with molecular diagnosis by multiplex PCR targeting 14 pathogens in the patients'cerebrospinal fluid to rule out *** technology and enzyme immunoassay kits were used to measure 17 plasma and 7 urinary biomarker levels,*** were analysed by univariate analysis using the nonparametric Mann-Whitney U test and Pearson’s Chi2 *** and multivariate analyses were conducted separately for plasma and urinary biomarkers to identify CM mortality risk *** Univariate analysis revealed higher plasma levels of tumour necrosis factor(TNF),interleukin-1beta(IL-1β),IL-10,IL-8,C-X-C motif chemokine ligand 9(CXCL9),granzyme B,and angiopoietin-2 and lower urinary levels of prostanglandine E2 metabolite(PGEM)in children who died compared to those who survived CM(Mann-Whitney U-test,P-values between 0.03 and<0.0001).The multivariate logistic analysis highlighted elevated plasma levels of IL-8 as the m

关键词： Cerebral malaria Children Benin Cytokine Plasma Urine Immunologic marker NeuroCM

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Non-traumatic coma in young children in Benin:are viral and bacterial infections gaining ground on cerebral malaria?

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Infectious Diseases of Poverty 2022年第2期11卷 1-10页

作者： Josselin Brisset Karl Angendu Baki Laurence Watier Elisee Kinkpe Justine Bailly Linda Ayedadjou Maroufou Jules Alao Ida Dossou-Dagba Gwladys I.Bertin Michel Cot Farid Boumediene Daniel Ajzenberg Agnes Aubouy Sandrine Houze Jean-Francois Faucher NeuroCM Group Infectious Diseases and Tropical Medicine Department Limoges University Hospital2 Avenue Martin Luther King87000 LimogesFrance Inserm UMR 1094 IRD U270EpiMaCT-Epidemiology of chronic diseases in tropical zoneInstitute of Epidemiology and Tropical NeurologyOmegaHealthUniv.LimogesCHU LimogesLimogesFrance Center for Research in Epidemiology and Population Health(CESP) INSERM U1018Paris-Saclay UniversityUVSQMontigny-Le-BretonneuxFrance Epidemiology and Modeling of Bacterial Evasion to Antibacterials Unit(EMEA) Institut Pasteur25-28Rue du Dr.Roux75724 Paris Cedex 15France Paediatric Department Calavi HospitalCalaviBenin UMR261 MERIT IRDUniversite de Paris75006 ParisFrance French Malaria Reference Center Hopital BichatAPHPParisFrance Paediatric Department Mother and Child University and Hospital Center(CHU-MEL)CotonouBenin Clinical Research Institute of Benin(IRCB) Abomey CalaviBenin UMR152 pharmadev Universite de ToulouseIRDUPSToulouseFrance Parasitology Laboratory Hopital Bichat-Claude-BernardAPHPParisFrance. 不详

Background:While malaria morbidity and mortality have declined since 2000,viral central nervous system infections appear to be an important,underestimated cause of coma in malaria-endemic Eastern *** aimed to describe the etiology of non-traumatic comas in young children in Benin,as well as their management and early outcomes,and to identify factors associated with ***:From March to November 2018,we enrolled all HIV-negative children aged between 2 and 6 years,with a Blantyre Coma Score≤2,in this prospective observational *** were screened for malaria severity signs and assessed using a systematic diagnostic protocol,including blood cultures,malaria diagnostics,and cerebrospinal fluid analysis using multiplex *** determine factors associated with death,univariate and multivariate analyses were ***:From 3244 admissions,84 children were included:malaria was diagnosed in 78,eight of whom had a viral or bacterial *** children had a non-malarial infection or no identified *** mortality rate was 29.8%(25/84),with 20 children dying in the first 24 ***-infected children appeared to have a poorer *** the 76 children who consulted a healthcare professional before admission,only 5 were prescribed adequate antimalarial oral *** of early death were jaundice or increased bilirubin[odd ratio(OR)=8.6;95% confidential interval(CI):2.03-36.1]and lactate>5 mmol/L(OR=5.1;95%CI:1.49-17.30).Antibiotic use before admission(OR=0.1;95%CI:0.02-0.85)and vaccination against yellow fever(OR=0.2,95%CI:0.05-0.79)protected against ***:Infections were found in all children who died,and cerebral malaria was by far the most common cause of non-traumatic *** opportunities to receive early effective antimalarial treatment were *** central nervous system infections must be considered in their *** factors that proved to be protective against early death were unexpected.

关键词： Non-traumatic coma Cerebral malaria Co-infection Central nervous system infection West Africa

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