Yao Layibo

Impact of community-based integrated mass drug administration on schistosomiasis and soil-transmitted helminth prevalence in Togo

Background Togo has conducted annual, integrated, community-based mass drug administration (MDA) for soil-transmitted helminths (STH) and schistosomiasis since 2010. Treatment frequency and target populations are determined by disease prevalence, as measured by baseline surveys in 2007 and 2009, and WHO guidelines. Reported programmatic treatment coverage has averaged over 94%. Togo conducted a cross-sectional survey in 2015 to assess the impact of four to five years of MDA on these diseases. Methodology/Principal findings In every sub-district in the country outside the capital, the same schools were visited as at baseline and a sample of fifteen children age 6 to 9 years old was drawn. Each child submitted urine and a stool sample. Urine samples were tested by dipstick for the presence of blood as a proxy measure of Schistosoma haematobium infection. Stool samples were analyzed by the Kato-Katz method for STH and Schistosoma mansoni. At baseline, 17,100 children were enrolled at 1,129 schools in 562 sub-districts; in 2015, 16,890 children were enrolled at the same schools. The overall prevalence of both STH and schistosomiasis declined significantly, from 31.5% to 11.6% for STH and from 23.5% to 5.0% for schistosomiasis (p<0.001 in both instances). Egg counts from both years were available only for hookworm and S. mansoni; intensity of infection decreased significantly for both infections from 2009 to 2015 (p<0.001 for both infections). In areas with high baseline prevalence, rebound of hookworm infection was noted in children who had not received albendazole in the past 6 months. Conclusions/Significance After four to five years of MDA in Togo, the prevalence and intensity of STH and schistosomiasis infection were significantly reduced compared to baseline. Data on STH indicate that stopping MDA in areas with high baseline prevalence may result in significant rebound of infection. Togo’s findings may help refine treatment recommendations for these diseases.

Performance d'Hemocue Hb 201+ dans le diagnostic de l'anémie de l'enfant dans les structures sanitaires du niveau périphérique au Togo

Contexte L’anémie est un problème de santé publique dans le monde entier, et notamment dans les pays en développement. Elle a des répercussions majeures sur la santé et sur le développement économique et social d’un pays. La prise en charge des patients anémiés étant nécessaire, il faut un diagnostic biologique précis, et donc un dosage du taux d’hémoglobine par des méthodes fiables. Objectif Évaluer les performances diagnostiques du test Hemocue Hb201+®. Méthodes Étude comparative de la mesure du taux d’hémoglobine à partir du photomètre Hemocue Hb 201+® et d’analyseurs d’hématologie chez 213 enfants de 6 à 59 mois souffrant d’un paludisme simple; la détermination du taux d’hémoglobine par les analyseurs est retenue comme méthode de référence pour évaluer Hemocue Hb201+®. Résultats 72.8% des valeurs obtenues par Hemocue Hb201+® étaient à ±1 g/dl de celles de la méthode de référence. Le coefficient de corrélation de Pearson était de 0.80. La prévalence de l’anémie était de 79.3% pour la méthode de référence et de 77.9% pour Hemocue Hb201+®. La sensibilité et la spécificité de l’analyseur Hemocue Hb201+® étaient respectivement de 95.1% et de 65.3%. Conclusion Les résultats de l’étude ont montré que le test Hemocue Hb201+® présentait une bonne sensibilité, une spécificité moyenne et une exactitude moyenne dans le diagnostic de l’anémie et dans le dosage de l’hémoglobine. Son utilisation peut être recommandée dans les structures périphériques afin de faciliter le diagnostic biologique de l’anémie et sa prise en charge dans les populations vivant dans les zones difficiles d’accès.

Syndromes myéloprolifératifs « Philadelphie négatif » et mutation JAK2V617F : étude des 15 premiers cas ayant bénéficié de cette recherche au Togo

The goal of our study is to document the prevalence of change JAK2V617F among patients reached of myeloproliferative syndromes (MPS) in Togo in order to evaluate frequencies. This descriptive study included 15 patients followed with the CHU Campus for a SMP. The research of JAK2 change by PCR was carried out with the APHP Henri Mondor of Creteil (France). During the study period, 15 patients followed for MPS (9 cases of polycythemia Vera, 5 cases of essential thrombocytemia and a case of primitive myelofibrosis) profited from the research of JAK2 change. The Middle age of the patients was respectively of 45±18 years; of 55±6 years for the PV and the essential thrombocytemia. The patient followed for primitive myelofibrosis was 72 years old. Sex-ratio (H/F) was of 2. JAK2 Change was positive in 5 cases out of 9 (55.5%) of the polycythemia Vera, at 3 patients out of 5 (60%) followed for essential thrombocytemia but negative for patient reached of primitive myelofibrosis. In conclusion, JAK2 Change has an interest diagnosis and forecast in the MPS negative Chromosom Philadelphia and can be systematic even in Africa Sub-saharian.