Preventive Exchange Blood Transfusion in Pregnant Women with Sickle Cell Disease: Maternal and Perinatal Prognosis in a Country with Limited Resources, Burkina Faso

Context: In pregnant women with sickle cell disease, the management with exchange transfusion could be useful in improving the prognosis of mother and child by reducing the level of hemoglobin S less than 40%. Objective: To analyze the maternal and perinatal outcome during the program of the exchange transfusion in pregnant women with sickle cell disease. Patients and Methods: We conducted a prospective study over a period of 18 months. Pregnant women with a major form of sickle cell disease were included. A manual blood exchange transfusion was performed monthly. We monitored the occurrence of maternal and perinatal morbidity during the follow-up. Results: A total of 42 pregnant women with sickle cell disease were monitored. The frequency of infectious episodes and vaso-occlusive crisis was significantly reduced, respectively from 47.6% and 83.3% before the beginning of the blood exchanges transfusion to 11.9% and 16.7% during blood exchanges transfusion program. All newborns were alive at birth with an Apgar score higher or equal to 7 at the 5th minute. The rate of admission of the newborns at neonatal intensive care unit was 9.3%. Maternal mortality was estimated at 7.1% and there was no early neonatal mortality. Conclusion: Prophylactic exchange transfusion reduces infections and the reoccurrence of vaso-occlusive crisis, which has an impact on perinatal prognosis.

Prevalence of Hepatitis C Virus Infection and Risk Factors among Pregnant Women in Pointe Noire, Republic of Congo

Background: Hepatitis C virus (HCV) is a public health problem and is highly endemic in Sub-Saharan Africa. This study was carried out to determine the prevalence and potential risk factors of hepatitis C virus in pregnant women. Methods: This was a cross-sectional study involving pregnant women who attended at seven antenatal clinics in Pointe Noire, from June to November 2018. Structured questionnaires were used to obtain participants data. Samples were screened for HCV infection by using 4th ELISA methods and data analysis was done by Epi-info version 7.0 statistical software. Results: A total of 150 pregnant women were included, out of which 11 (7.3%) were positive for HCV. The high proportion of HCV was found in age group 25 - 34 years (45.4%), educated (81.1%), professional (36.4%) and 54.6% were in second trimester gestational stage. Moreover, 54.6% of HCV positive patients had scarification and 45.5% had a history of surgery. There was not a statistically significant association between demographics characteristics, risks factors and HCV seropositivity (p > 0.05). Conclusion: This study showed a high prevalence of HCV infection and confirmed that this infection is a public health problem in pregnant women in Pointe Noire.

Prevalence and Risk Factors for Hepatitis Delta Virus Transmission among HBsAg Positive Blood Donors in Brazzaville, Congo

Background: Hepatitis D virus (HDV) is a defective virus that requires the presence of hepatitis B virus (HBV) for replication. It is a major cause of severe acute and chronic hepatitis B. The objective of this study was to determine the prevalence and risk factors of HDV in blood donors. Methods: This was a descriptive, cross-sectional study involving HBsAg-positive blood donors covering the period from July to December 2020. Testing for HDV RNA was performed by conventional two-step RT-PCR. Data were analysed using SPSS version 22 software. Result: Of 113 HBsAg positive samples included in the study 22 or 19.5% were HDV positive. The prevalence of HDV was higher in the age group 31 - 45 years (45.5%), in male donors (71.4%) and in donors with secondary education (50.0%). Furthermore, 55.4% belonged to the family donor category. A significant statistical difference was observed between HDV infection, tattoos, piercings and multiple sexual partners. Conclusion: This study shows a high prevalence of HDV among blood donors in Brazzaville.

Hematological and Biochemical Profile of Sickle Cell Patients in Critical and Inter-Critical Periods in Brazzaville, Republic of 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 hematological parameters showed significant differences between sickle cell and control subjects.