Influence of Prenatal Surveillance on Maternal and Perinatal Prognosis: A Prospective Study over 6 Months at the Maternity Ward of the Owendo University Hospital (Gabon)

Introduction: The occurrence of pregnancy in women is a risky situation. Prenatal care is necessary, which is not often the case in our context. Aim: To analyze the influence of antenatal surveillance on maternal and perinatal prognosis. Patients and Method: Preliminary longitudinal and analytical survey at the Owendo University Hospital (OHU) over 6 months. It focused on prenatal surveillance. The study population consisted of parturients who gave birth within 24 hours and we studied sociodemographic characteristics, variables related to antenatal contact, those of delivery as well as maternal and newborn outcomes. Results: 2485 deliveries were recorded and 1300 patients were retained according to the inclusion criteria. No prenatal contact (ANC0) was performed in 93 (7.15%), insufficient (ANCI) in 943 patients (72.5%), and sufficient (ANCS) in 264 patients (20.30%). Patients with low school level were significantly found when the NPC was not performed or insufficient and the same was true for the group of patients who were not employed and those who were single (p < 0.005). The caesarean section rate and perinatal mortality are high in this case. Conclusion: The quality of prenatal contact is insufficient in our context. The absence or inadequacy of the latter has a strong negative impact on maternal and perinatal morbidity and mortality.

Intermediate Hip Arthroplasty in Gabon: Blood Loss and Risk Factor for Transfusion

Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip hemiarthroplasty in Gabon. Method: It was a retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion and intraoperative data. The primary outcome was intraoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 97 patients included, the average age was 74.2 years ± 10, male predominance was 73.2%, the average ASA score was 1.9 ± 0.5, and transfusion incidence was 38.1%. The average number of RBCs transfused was 1.2 ± 0.6. Tranexamic acid was used in 11.3% of patients. The average bleeding was 450 ± 453 ml. Preoperative anemia was predictor of transfusion to be significant. Conclusion: The incidence of transfusion is law compared to total hip arthroplasty. The implementation of a patient blood management protocol is difficult given the urgency of bone repair. However, a better use of tranexamic acid could reduce this transfusion incidence.

Multivariate Approach to Characterizing Soil Quality of Gabonese’s Ferralitic Soils

Assessing soil quality is essential for crop management and soil temporal changes. The present study aims to evaluate soil quality in the Ferralitic soils context countrywide. This assessment was done using multivariate soil quality indice (SQI) models, such as additive quality index (AQI), weighted quality indexes (WQIadd and WQIcom) and Nemoro quality index (NQI), applied to two approaches of indicator selection: total data set (TDS) and minimum data set (MDS). Physical and chemical soil indicators were extracted from the ORSTOM’s reports resulting from a sampling campaign in different provinces of Gabon. The TDS approach shows soil quality status according to eleven soil indicators extracted from the analysis of 1,059 samples from arable soil layer (0 - 30 cm depth). The results indicated that 87% of all provinces presented a very low soil quality (Q5) whatever the model. Among soil indicators, exchangeable K+ and Mg2+, bulk density and C/N ratio were retained in MDS, using principal component analysis (PCA). In the MDS approach, 50 to 63% of provinces had low soil quality grades with AQI, WQIadd and NQI, whereas the total was observed with WQIcom. Only 25% of provinces had medium soil quality grades with AQI and NQI models, while 12.5% (NQI) and 25% (AQI) presented high quality grades. Robust statistical analyses confirmed the accuracy and validation (0.80 r P ≤ 0.016) of AQI, WQIadd and NQI into the TDS and MDS approaches. The same sensitivity index value (1.53) was obtained with AQI and WQIadd. However, WQIadd was chosen as the best SQI model, according to its high linear regression value (R2 = 0.82) between TDS and MDS. This study has important implications in decision-making on monitoring, evaluation and sustainable management of Gabonese soils in a pedoclimatic context unfavorable to plant growth.

Physico-Chemical Characterization of Some Honeys from the Savannah-Gallery Forest Complex and Primary Forest in Gabon

Honey harvesting throughout beekeeping is a technology recently introduced in Gabon comparing to the other African countries well known in international honey trade. The purpose of this study is to contribute to the knowledge of the quality of multi-flower honeys from the savannah-gallery forest complex and primary forest not well documented in Gabon. Physical and chemical parameters of different honeys were analyzed using the official methods of analysis of the Association of Official Analytical Chemists. The results of physico-chemical analysis show variations in pH (3.4 to 3.9), free acidity (37.12 to 76.65 meq∙kg−1), water content (17.49% to 21.21%), electrical conductivity (0.64 to 1.24 mS∙cm−1), density (1.02 to 1.03) and total sugar content (77% to 82%). These variations were significantly different (p < 0.05) between certain honeys, but independent of the type of ecosystem considered. The pH values confirmed the botanical origin of the five honeys. The physico-chemical parameters of the honeys show significant correlations (p < 0.05). Moisture content is negatively correlated with conductivity (r = −0.628), pH (r = −0.631), density (r = −0.552) and total sugar content (r = −0.890). Conductivity is positively correlated with free acidity (r = 0.688) and total sugar content (r = 0.776), and negatively correlated with water content (r = −0.628). All honeys were in line with Codex Alimentarius standards, except for 3 types of honey (M1, M2 and M4) for free acidity and electrical conductivity, showing possible fermentation of these honeys.

National Soil Organic Carbon Stocks Inventories under Different Mangrove Forest Types in Gabon

Gabonese’s estuary is an important coastal mangrove setting and soil plays a key role in mangrove carbon storage in mangrove forests. However, the spatial variation in soil organic carbon (SOC) storage remain unclear. To address this gap, determining the SOC spatial variation in Gabonese’s estuarine is essential for better understanding the global carbon cycle. The present study compared soil organic carbon between northern and southern sites in different mangrove forest, Rhizophora racemosa and Avicennia germinans. The results showed that the mean SOC stocks at 1 m depth were 256.28 ± 127.29 MgC ha−1. Among the different regions, SOC in northern zone was significantly (p p < 0.001). The deeper layers contained higher SOC stocks (254.62 ± 128.09 MgC ha−1) than upper layers (55.42 ± 25.37 MgC ha−1). The study highlights that low deforestation rate have led to less CO2 (705.3 Mg CO2e ha−1 - 922.62 Mg CO2e ha−1) emissions than most sediment carbon-rich mangroves in the world. These results highlight the influence of soil texture and mangrove forest types on the mangrove SOC stocks. The first national comparison of soil organic carbon stocks between mangroves and upland tropical forests indicated SOC stocks were two times more in mangroves soils (51.21 ± 45.00 MgC ha−1) than primary (20.33 ± 12.7 MgC ha−1), savanna and cropland (21.71 ± 15.10 MgC ha−1). We find that mangroves in this study emit lower dioxide-carbon equivalent emissions. This study highlights the importance of national inventories of soil organic carbon and can be used as a baseline on the role of mangroves in carbon sequestration and climate change mitigation but the variation in SOC stocks indicates the need for further national data.

Noninvasive Respiratory Strategies in Patients with Acute Hypoxemic Respiratory Failure and COVID-19 in Gabon: A Prospective Observational Study

Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High Flow Nasal cannula (HFNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO2/FiO2 ratio ≤ 300, a FR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanical ventilation is a risk factor for death.

Prevalence of Pulmonary Tuberculosis and Associated Factors among Patients Admitted to the Amissa Bongo University Hospital Center in Franceville, Gabon

Background: In Gabon, the epidemiology of tuberculosis has been considerably reshaped by the AIDS virus. It is in this context that the present study was conducted to assess the prevalence of pulmonary tuberculosis and associated factors among patients at the Amissa Bongo Regional Hospital in Franceville, Gabon. Patients and Methods: This prospective, cross-sectional study was conducted in the biomedical analysis laboratory of the Amissa Bongo Regional University Hospital in Franceville from 19 June 2021 to 22 January 2022. After agreeing to take part in the study, participants were asked to fill in a questionnaire to collect their socio-demographic data and habits. Clinical signs were also observed. Sputum and gastric fluid samples were collected and examined using the Xpert MTB/RIF test and BAAR smear microscopy. Data were analysed using R software version 3.6.1. The results of the univariate and multivariate analyses were considered significant for p ≤ 0.05. Results: A total of 309 patients were included in this study, 50.81% (n = 157) men and 49.19% (n = 152) women. Of these, 98 had a positive diagnosis of pulmonary tuberculosis, giving an overall prevalence rate of 31.72%. There were 40 women or 40.82% (95% CI: [0.30 - 0.51]) and 58 men or 59.18% (95% CI: [0.48 - 0.69]). A univariate analysis of the prevalence of tuberculosis according to risk factors and clinical signs indicated a certain association between certain variables. However, an in-depth multivariate logistic regression analysis of this prevalence, according to the risk factors and clinical signs observed in the patients in the study, indicated that the age group 15 and 49 years (Adjusted OR = 47.77;95% CI: [4.4;519.7] p = 0.001*), fever (Adjusted OR = 4.83;95% CI: [1.16, 20.12] p = 0.031*), alcohol consumption (Adjusted OR = 12.2;95% CI: 12.2 [2.5;5.9] p = 0. 002*), smoking (Adjusted OR = 9.83;95% CI: [1.78;54.24] p = 0.037), HIV infection (Adjusted OR = 4.63;95% CI: [1.25;17.1] p = 0.022), cough (Adjusted OR = 4.31;95% CI: [1.21, 15.4] p = 0. 025*), chest pain (Adjusted OR = 103.6;95% CI: [19.4;55.2] p = 0.000), night sweating cough (Adjusted OR = 10.84;95% CI: [3.18;36.98] p = 0.000*) were significant risk factors for pulmonary tuberculosis. Conclusion: The results of the present study showed that the prevalence of pulmonary tuberculosis was greatest among males in Franceville and the surrounding area. The 15 - 49 age group, fever, alcohol consumption, smoking, HIV infection, chest pain, night sweats and cough were significant risk factors for pulmonary tuberculosis. Consequently, screening for tuberculosis in HIV-positive patients, public awareness and community mobilisation should be encouraged.

Frequency of Transfusions and Risk Factor for Bleeding Risk to Guide a Blood-Sparing Program during Hip Arthroplasty in Gabon

Background: Hip arthroplasty is a surgery with a high risk of bleeding. The main objective of this study was to research risk factors for bleeding and transfusion in patients undergoing hip arthroplasty in order to guide a blood-saving program. Method: Retrospective, monocentric, descriptive and analytical study carried out from June 2011 to June 2021 at the Omar Bongo Ondimba army training hospital. The variables studied were demographic characteristics, biological variables, transfusion data, anesthetic and intraoperative data. The primary outcome was intraoperative or postoperative transfusion. A univariate and multivariate analysis was conducted to identify the factors associated with the occurrence of a transfusion. Results: Of the 276 patients included, 179 benefited from Total Hip Prosthesis (THP) and 97 from Intermediate Hip Prosthesis (IHP). Spinal anesthesia was performed in 67.4% of patients. The ASA 2 score predominated (65.9%). The transfusion incidence was 56.9% (157/276). Tranexamic acid was used in 16.3% (45/276) of patients. The average bleeding was 528 ± 405 ml. Preoperative anemia (OR = 0.78, 95% CI [0.66 - 0.91]) and total hip prosthesis (OR = 2.02 95% CI [1.11 - 3.67]) were predictors of bleeding and transfusion to be significant. The average serum hemoglobin predictive of a transfusion was 11.6 ± 1.8. ASA score and operative time were not found as risk factors for bleeding and transfusion. Conclusion: The incidence of transfusion is high. Preoperative anemia remains a major but modifiable risk factor unlike the choice of implant. The implementation of a patient blood management protocol could reduce this transfusion incidence.

The Effect of Age on Male Infertility in Gabon

Background: Male age significantly affects semen parameters. However, there is no evidence on the impact of aging on semen quality in men residing in Libreville, Gabon. Objective: To determine the effects of age on semen quality of patients visiting the Reproductive Laboratory at the Academic Hospital Mère Enfant located in Libreville, Gabon. Methods: This descriptive and prospective study was performed between the 1st of October 2021 and 30st of September 2022. This study involved patients who had semen analysis as part of fertility check-up. Semen analysis was performed following the World Health Organization, 2010 guidelines. Semen parameters such as volume, leucocytes count, sperm concentration, sperm motility, norml morphology and vitality were used in the current study. Descriptive statistics were performed. The Chi-square test and the Fisher test were used as statistical tools for the analysis of data. The ROC curve was used to illustrate the data. Results: A total of 148 patients were included in the study. Male infertility prevalence was 77.03%. The average age was 41 years with minimum and maximum of 24 and 61 years respectively. Secondary infertility was predominant (66.9%). Patients displaying asthenozoospermia (22.3%) followed by those displaying oligoasthenozoospermia (OAT) isolated (1.4%) or not (11.6%) were the most frequent semen parameter abnormalities. Men aged more than 45 years were 4.4 times likely to have abnormal semen parameters. Odd = 4.4 (IC 95% = [3.3 - 14.7]). Staphylococcus haemolyticus infection was more prevalent. Conclusion: Male age was found to significantly influence semen quality.

Homozygosity for the CD1E★02 allele is associated with a resistance to Plasmodium falciparum malaria infection in Gabonese school children

Objective:To explore the possible association between polymorphisms in CD1 genes and both asymptomatic and mild Plasmodium falciparum infection.Methods:Two clusters of 85 school children,from the village of Dienga(Gabon) were investigated.The first group was analysed for the prevalence and the multiplicity of asymptomatic Plasmodium falciparum infection,whereas the second group was screened for the frequency of malarial attacks.Results:Our findings showed that homozygosity for the CD1E★02 allele was associated with a low frequency of malarial attacks.Furthermore,a strong association between CD1E★02 homozygotes and the resistance to multiple malarial attacks was identified.The CD1A★01 allele showed a weak association with a small number of malarial attacks.Conclusion:Our results suggest a possible role of CD1E polymorphisms in malaria protection among school children and that CD1e molecules are involved in anti-malarial immunity.

Epileptiform seizures revealing neurocysticercosis:report of two clinical cases in Libreville,Gabon

Neurocysticercosis(NCC) is recognized as a cause of neurologic disease worldwide.We reported two cases(one co-infected with the HIV) of NCC.Medical treatment led to recovery.NCC should be considered in tropical countries as a cause of epilepsy and included in the diagnosis of neurologic infections in HIV patients.

Prevalence and Risk Factors Associated with Tungiasis among School-Aged Children in the City of Port Gentil, Ogooué-Maritime Province, Gabon in Central Africa

Background: Tungiasis is a skin infestation caused by the female sand flea called Tunga penetrans. Associated with a significant morbidity, this ectoparasite is present in all tropical regions, such as Gabon. Unfortunately, in this country, no study has ever been undertaken on this disease. However, in both urban and rural areas of this country, it causes disfigurement and mutilation of the feet or hands in infested persons, and is sometimes responsible for the school dropout of many children. It is in this context that this timely and relevant research was conducted to assess the prevalence and risk factors associated with Tungiasis in school-aged children in the city of Port Gentil, Ogooué-Maritime province, Gabon in Central Africa. Materials and Methods: This prospective and cross-sectional study took place from May 22 to August 18, 2022, in two popular and underprivileged neighborhoods of the city of Port Gentil. It consisted of a physical diagnosis of the participants, and with the help of a questionnaire submitted to their parents/guardians, numerous data were collected. Entered into an Excel 2016 spreadsheet, the data were exported to the R software in its R Commander interface, for two types of analyses. A univariate and a multivariate analysis, using logistic regression, first on socio-demographic characteristics and then on habitual and environmental behavioral characteristics, was performed and the variables in this analysis reported odds ratios and their 95% confidence intervals. The results were statistically significant at p Results: A total of 637 school-aged children with a mean age of 12.73 years and a standard deviation of 5.44, were registered and examined for this study. Among them, Tunga penetrans infestation was found in 242 children, indicating an overall prevalence of 37.99% (95% CI [0.34 - 0.41]). Univariate and multivariate analyses, using logistic regression, first according to socio-demographic characteristics and then according to risk factors indicated that, the age groups of 5 to 9 years (Adjusted Odds Ratio = 9.27;95% CI: [6.66 - 12. 91]) and 10 - 14 years (Adjusted Odds Ratio = 0.16;95% CI: [0.10 - 0.25]), Eshira ethnicity (Adjusted Odds Ratio = 7.46;95% CI: [2.97 - 18.76]), child’s primary education level (Adjusted Odds Ratio = 0.008;95% CI: [0.006 - 0.011]), Father’s/Guardian’s education level (Adjusted Odds Ratio = 0.22;95% CI: [0.13 - 0.35]), homemaker status (Adjusted Odds Ratio = 4.89;95% CI: [3.51 - 6. 79]) and risk factors such as: promiscuity with dogs, cats or other animals around the house (Adjusted Odds Ratio = 38.30;95% CI: [22.13 - 66.26]), wearing shoes a few times (Adjusted Odds Ratio = 0.02;95% CI [0.01 - 0.03]), walking sometimes barefoot, on land or sand (Adjusted Odds Ratio = 0.28;95% CI: [0.18 - 0.42]), having other sources of water consumed than the tap (Adjusted Odds Ratio = 0.25;95% CI: [0.16 - 037]), living in a dwelling with soil or sand (Adjusted Odds Ratio = 6.8;95% CI: [4.58 - 10.09]), having average housing conditions (Adjusted Odds Ratio = 46.8;95% CI [24.29 - 90.16]), and the number of people living in the family that was greater than or equal to 6 (Adjusted Odds Ratio = 0.1;95% CI [0.07 - 0.13]), were significantly associated with the prevalence of Tungiasis. Conclusion: The results of this study will inform control programs and water and sanitation interventions for the Tunga penetrans epidemic in Port Gentil, Gabon.

LARCs after unsafe abortion in Libreville (Gabon): Women accept quickly but the time interval for the insertion is longer than that of injectable contraceptives

Objectives: To determine the percentage of women who accepted a LARC after abortion, specify the interval time for the insertion of the LARC and compare such interval time with that of injectable and oral contraceptives. Patients and Methods: This is a prospective, descriptive and comparative study conducted in Libreville (Gabon), from February 1, 2013 to August 31, 2013. After receiving post-abortion care (PAC), all patients with stable general states were counseled about three types of contraceptive methods: combined oral contraceptive pills, LARCs (Jadelle? implants, Copper IUDs) and injectable Medroxyprogesterone Acetate (DMPA). Results: 231 women received PAC and among them 215 (93%) wanted to use one of the three proposed contraceptive methods. At the end of the study, only 193 women (89.7%) used contraception and 22 others (10.3%) abandoned their intentions. LARCs were used by 31 (16.0%) women. The average period for the insertion of LARCs was 15.4 ± 15.5 days with extremes of 1 to 53 days. This period for the insertion of LARCS was significantly longer than that of other methods (p < 0.001). LARCs were inserted more often after the 2nd day than immediately (same day) with a highly significant difference (p < 0.0001). Conclusion: LARCs could constitute an appropriate approach to reducing unintended pregnancies in Gabon. However, in order to increase their rates of use, it is necessary to improve women awareness.

Fever among Children with Sickle-Cell Disease: Findings from the General Pediatric Ward of the Owendo Pediatric Hospital in Libreville, Gabon

Sickle-cell disease (SCD) represents a substantial public health problem in Gabon. Fever is one of the principal reasons for the hospitalization of children afflicted by major sickle-cell disorder, since it can be a clinical reflection of severe infections that have the potential to become life threatening. Objectives: Identification of the main causes of fever in children with SCD in our clinical setting, with the aim of optimizing treatments. Patients and Methods: This is a retrospective study of all the medical files for children with SCD that were admitted to our ward, over a two year period, due to fever (>38.5°C) lasting more than 24 hours. Only those files that contained at least the following five fundamental medical examinations were retained for further evaluation: Complete Blood Count (CBC), blood smear, blood culture, urine culture and chest X-ray. Out of a total of 118 admissions (103 patients), 87 (73.7%) were due to the incidence of fever. The medical files of 11 patients were deemed to be unusable. Seventy-six episodes of fever were observed among 69 children, of which 42 were male and 27 female (sex ratio of 1.5). Among these, seven (10%) were admitted twice. Results: The age groups that were most affected included 12 - 18 year-olds (30 cases: 43.5%) and 6 - 12 year-olds (26 cases: 37.7%). The most common accompanying symptoms were bone and joint pain (43.4%), asthenia (22.4%), cough (19.7%), vomiting (17%) and headache (15.8%). The specific cause of the fever could not be pinpointed in 29 cases (38.1%). Aside from these cases, the main causes of fever were malaria (30.3%) and bronchopulmonary infections (22.4%). The white blood cell count was >20,000/mm3 in 47% of respiratory infections, 43.5% of the cases involving malaria and 55.2% of cases of fever with unknown cause. Hemoglobin levels were <5g/dl for 52.2% of the cases involving malaria and 22.6% for those of unknown origin. For four patients, all less than 10 years of age, the disease was fatal. Conclusion: For the majority of fever episodes, the underlying cause could not be determined. Nonetheless, malaria was identified as one of the principal identifiable causes of fever among children with SDC in Libreville. Treatment for malaria upon admission, and the promotion of preventative measures, therefore seems to be appropriate for our clinical setting. In light of the large number of unresolved cases, systematic prescription of broad-spectrum antibiotics may also be called for.

Antidiabetic Prescriptions at the University Hospital Center of Libreville (Gabon) Facing the Concept of Therapeutic Inertia: An Andragogical Perspective

Context: Diabetes mellitus is experiencing an alarming progression throughout the world, but more and more drugs are available with the use not always adapted. The aim of this work is to analyze the anti-diabetic prescriptions at the university hospital center of Libreville (Gabon) and confront them with the concept of therapeutic inertia. Patients and Methods: In diabetics coming for their periodic control, we transcripted for 2 months, beyond their characteristics, their glycated hemoglobin rate and the treatment followed. Results: 200 patients have consulted and among them, 160 (80%) had done their A1c analysis. 46% had an A1c ≤ 7% and 54% above with sometimes an unsuitable treatment evoking therapeutic inertia, the factors of which we discuss. Conclusion: Therapeutic inertia is a multifactorial problem, one of the components of which may be the resistance to change of the adult learners who are the practitioners.

Complications of Pregnancy in Patients with Systemic Lupus Erythematosus (Gabon)

Pregnancy and systemic lupus erythematosus in black African women: about 10 cases in Libreville (Gabon). Objectives: Through a study in a population of systemic lupus erythematosus (SLE) pregnant black Gabonese women, we describe the characteristics of these pregnancies to clarify their main complications and to make recommendations to their follow-up in low resource countries. Patients and Methods: This is a longitudinal descriptive study conducted over a period of six years, from 1 January 2008 to October 31, 2013, in Libreville (Gabon). We’ve included, systemic lupus erythematosus women carrying a pregnancy during the period of the study. Results: Seventy-two SLE women were followed and were eligible. Only 8 patients (11%) were pregnant during the follow up period. These 8 SLE patients allowed us to monitor 10 pregnancies. The average parity was 0.88. Eight pregnancies in ten (80%) had complications and most frequent was preeclampsia. Nine pregnancies (90%) resulted in the birth of viable children of which 4 (44.4%) were born by caesarean section and the 5 others (55.6%) were born by natural route. Conclusion: We recommend a monthly prenatal care for these high-risk pregnancies and early detection of preeclampsia.

The Difficulties of Congenital Syphilis Diagnosis about 3 Cases at Libreville, Gabon

First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is not always easy, as it is shown in our three clinical cases. Those three clinical observations demonstrate the difficulties encountered in the diagnosis of congenital syphilis in our country where only the TPHA (Treponema Pallidum Haemaglutination Assay) and VDRL (Venereal Disease Research Laboratory) tests are the only ones to be routinely carried out. Actually, these tests can be negative at the earliest stage of the syphilis or in case of zonal phenomenon. In addition, maternal antibodies could be found in child blood, even if the baby is in good health. At last, the child could have been contaminated belatedly while tests were negative at the third month of pregnancy. Congenital syphilis still exists in our developing countries and, in order to better manage this pathology, a proposition of an efficient algorithm is submitted.

Vitamin A Status in the Mother-Child Couple at the University Teaching Hospital of Angondje in Gabon

Introduction: Vitamin A deficiency is responsible for severe disorders, and sometimes irreversible consequences in children. We aimed to evaluate the Vitamin A status of newborns in Gabon. Method: prospective study from August to December 2017 at the maternity of the University Teaching Hospital of Angondje (Gabon). We included at random mother-child pairs. A nutritional inquiry on Vitamin A was ran in the selected parturient. We performed the measurement of serum retinol booth in mother and child according to standardized and strict criteria, in Gabon and in France. World Health Organization defines Vitamin A deficiency by serum retinol .7 μmol/L. Results: We included 75 mother-child couples. The mean age of the mothers was 25.7 ± 7 years, 89.3% of neonates were an age gestational ≥ 36 weeks, and 10.7% were premature. Mango was the most commonly used source of Vitamin A and 27% of women consumed more than 3 times a week. The mean serum retinol of the mothers was 0.87 μmol/L ± 0.35 extremes [0.22 μmol/L - 1.79 μmol/L], the mean serum retinol of the newborns was 0.92 μmol/L ± 0.30 extremes [0.24 μmol/l - 1.84 μmol/L].Vitamin A deficiency was observed in 23.3% (n = 25;CI 95% [22.1% - 25.8%]) of mothers and 20% (n = 15;CI 95% [18.2% - 22%]) newborns. There was a weak correlation between the serum retinol of mothers and serum retinol of newborns (r = 0, 17). Conclusion: The prevalence of Vitamin A deficiency is quite important in neonates of our investigation, and justifies a systematic supplementation.

Variation of the Consumption of Mushrooms by Pygmies and Bantus in the North of Gabon

A comparative study of the number of taxa and fungal biomass consumed by the Pygmies and the Bantus of Gabon has been realized in two Gabon north regions (Ogooue-Ivindo and the Woleu-Ntem). This study has allowed not only to establish the list of consumed fungal sorts by those populations, but also to estimate the daily consumed fungal biomasses by each ethnical group. The study has revealed a significant difference between a numbers of taxa and the quantity of mushrooms consumed by various ethnical groups: the Pygmies of the area who live especially by hunting and fishing consumed 96% of the recorded taxa with some high mushrooms quantities (around 3 kg/day/family);the Bantus who live nearby Pygmies also consumed some high mushrooms quantities (around 2 kg/day/family) but a low taxa number (56% of taxa counted by the Fang;69% by the Kota;39% by the Kwele);on the other hand, the Bantus living nearest the Pygmies consumed a high taxa number as much as Pygmies (around 90% of taxa counted) but eat a lower mushrooms quantities than theirs distant congeners Pygmies (around 800 g/day/family).

Phenotipic Prevalence of Antibiotic Resistance in Gabon

Background: The increasing phenomenon of bacterial resistance to antibiotics is a real public health problem. The main causes are poor management of hygiene and water quality, but also the use of antibiotics without precaution. The objective of this study was to isolate and determine the antibiotic resistance profile of the different bacteria found in the main hospitals and bacteriology laboratories in Gabon. Methods: 6034 samples were taken from hospitals in seven main cities of Gabon, and analyzed according to the usual techniques. The pathogenic strains were identified by Matrix-Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry. Antimicrobial susceptibility testing was performed by the agar disc diffusion method, according to the Antibiogram Committee of the French Society for Microbiology guidelines. Results: 974 pathogenic bacterial strains were found, including 890/974 (91.4%) Gram-negative bacilli. The systematic antimicrobial susceptibility testings identified 160/974 (16.4%) multi-resistant strains. Escherichia coli was the most represented species. 12.5% - 25% of Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Citrobacter sedlakii strains were resistant to amoxicillin + clavulanic acid, third and fourth generation cephalosporins. Aminoglycoside resistance rates of 8.5% - 19% were also noted. 4.5% to 25% of the bacteria found were resistant to quinolones and cotrimoxazole. Resistance rates to carbapenems ranged from 1% to 10.5%. 16% of Staphylococcus aureus were methicillin-resistant (MRSA). Rates of extended spectrum beta-lactamase-producing enterobacteriaceae (ESBL-PE) ranged from 2.5% to 25%. Conclusion: This study showed an increasing evolution of bacterial resistance to antibiotics that are spreading throughout Gabon. This constitutes a threat to the health of Gabonese population.