Background: The Democratic Republic of the Congo (DRC) faces severe malaria, postpartum haemorrhage, malnutrition and sickle cell disease that require transfusion. The latter poses immunological, infectious, metabolic...Background: The Democratic Republic of the Congo (DRC) faces severe malaria, postpartum haemorrhage, malnutrition and sickle cell disease that require transfusion. The latter poses immunological, infectious, metabolic and hemodynamic risks to recipients. Objective: To present transfusion safety in the DRC through data from the literature. Methods: This review consists of listing the various articles and abstracts published online and presented in scientific conferences having as a subject of interest transfusion safety in the DRC. Results: The review is dominated by articles from eastern DRC and blood mobilization is around 0.5% of the general population. All screening tests are serological with a proven residual risk. The prevalence of HIV, HBV, HCV and syphilis infections is documented at more than 80% and represents respectively 1.9%, 2.96%, 1.89% and 1.21%. The prevalence of other pathogens, the immunological and haemodynamic risk are very poorly documented (12.5% to 25%). The prevalence of Parvovirus B19 infection is 5.3% and that of bacterial contamination at 1.4%, that of malaria infestations between 0.3% and 28.3%, that of trypanosomiasis at 1.3%, that of babebiosis at 0.17% in blood donors. Allo-immunization represents 47.8%, adverse reactions 3.4%, iron deficiency 63.2, iron deficiency anemia 25.9% and anemia 36.5%. Pediatrics is the biggest user of this blood. Conclusion: The prevalence of HIV, HBV, HCV and Syphilis infections is within the range of sub-Saharan African countries. The serological test is systematic and involves the residual risk, it is necessary to introduce the molecular tests. The prevalence of other pathogens (emerging viruses, bacteria and hemoparasites), the immunological and metabolic risk is poorly documented. The search for these pathogens, irregular antibodies and the determination of ferritin in blood donations is not systematic.展开更多
Objective:The aim of this study is to detect in vitro the synergetic activity of colistin in combination with imipenem,amikacin or ciprofloxacin,at sub-inhibitory concentrations,against carbapenems-resistant(CR)Acinet...Objective:The aim of this study is to detect in vitro the synergetic activity of colistin in combination with imipenem,amikacin or ciprofloxacin,at sub-inhibitory concentrations,against carbapenems-resistant(CR)Acinetobacter baumannii and Pseudomonas aeruginosa strains isolated from various wards in Annaba teaching hospital in eastern Algeria.Materials and Methods:The minimal inhibitory concentrations(MIC)were determined by broth macrodilution(BMD).Carbapenemase encoding genes were screened using polymerase chain reaction(PCR).The activity of colistin in combination with second antibiotic was evaluated by the Checkerboard Technique.Results:39 CR P.aeruginosa and 21 CR A.baumanni strains where collected.The MIC values ranging from(0.25 to 4μg/ml)to colistin,≥16μg/ml for imipenem,≥4μg/ml to amikacin and≥8μg/ml ciprofloxacin.The PCR reveals the presence of the genes blaOXA23(n=12),blaOXA24(n=6),blaNDM1(n=3)in A.baumannii and blaVIM2(n=12)in P.aeruginosa.The combination of colistin with imipenem showed synergistic effect on 57.14%and 46.15%of A.baumannii and P.aeruginosa isolates,respectively.For colistin and amikacin,the synergistic effect is detected in 28.6%of A.baumannii and 30.8%of P.aeruginosa.While colistin and ciprofloxacin showed synergy on 14.29%and 15.38%of A.baumannii and P.aeruginosa isolates,respectively.Conclusion:CR A.baumannii and P.aeruginosa remain the most prevalent infection agents in patients from high-risk wards at Annaba Hospital.Colistin associated with imipenem or with amikacin at sub-inhibitory concentrations gives very encouraging results allowing better management of infections caused by this type of bacteria.展开更多
Background: Few data is available in low-burden TB-HIV countries on TB treatment outcomes. We evaluated TB patients (pts) characteristics by HIV status and compared treatment outcomes in relation to HIV status, CD4 co...Background: Few data is available in low-burden TB-HIV countries on TB treatment outcomes. We evaluated TB patients (pts) characteristics by HIV status and compared treatment outcomes in relation to HIV status, CD4 count and antiretroviral therapy (ART). Methods: We performed a retrospective analysis of 447 adult TB pts who registered and initiated treatment in our center from 2014 to 2015. Results: Pts were categorized as HIV-negative (n = 399, 89.3%), HIV-positive on ART (n = 42, 9.4%) and HIV-positive not on ART (n = 6, 1.3%). The proportion of pts with extended TB therapy was higher among HIV-positive pts (p = 0.03). Increased age was associated with higher death rates regarding treatment success (OR 1.08;95% CI 1.01 - 1.17, p = 0.03). Statistically significant higher mortality was found among HIV-positive pts on ART (OR 9.93;95% CI 1.36 - 72.37, p = 0.03) and HIV-positive pts not on ART (OR 397.00;95% CI 44.27 to 3559.91, p ≤ 0.0001) compared to HIV-negative pts. When multivariate analyses were restricted to HIV-positive pts, being not on ART was associated with higher mortality (OR 40.0;95% CI 4.37 - 365.78, p = 0.001). Conclusions: There was significant difference in death rates between HIV-positive and HIV-negative TB pts. HIV-positive pts not on ART had a significantly higher mortality.展开更多
文摘Background: The Democratic Republic of the Congo (DRC) faces severe malaria, postpartum haemorrhage, malnutrition and sickle cell disease that require transfusion. The latter poses immunological, infectious, metabolic and hemodynamic risks to recipients. Objective: To present transfusion safety in the DRC through data from the literature. Methods: This review consists of listing the various articles and abstracts published online and presented in scientific conferences having as a subject of interest transfusion safety in the DRC. Results: The review is dominated by articles from eastern DRC and blood mobilization is around 0.5% of the general population. All screening tests are serological with a proven residual risk. The prevalence of HIV, HBV, HCV and syphilis infections is documented at more than 80% and represents respectively 1.9%, 2.96%, 1.89% and 1.21%. The prevalence of other pathogens, the immunological and haemodynamic risk are very poorly documented (12.5% to 25%). The prevalence of Parvovirus B19 infection is 5.3% and that of bacterial contamination at 1.4%, that of malaria infestations between 0.3% and 28.3%, that of trypanosomiasis at 1.3%, that of babebiosis at 0.17% in blood donors. Allo-immunization represents 47.8%, adverse reactions 3.4%, iron deficiency 63.2, iron deficiency anemia 25.9% and anemia 36.5%. Pediatrics is the biggest user of this blood. Conclusion: The prevalence of HIV, HBV, HCV and Syphilis infections is within the range of sub-Saharan African countries. The serological test is systematic and involves the residual risk, it is necessary to introduce the molecular tests. The prevalence of other pathogens (emerging viruses, bacteria and hemoparasites), the immunological and metabolic risk is poorly documented. The search for these pathogens, irregular antibodies and the determination of ferritin in blood donations is not systematic.
文摘Objective:The aim of this study is to detect in vitro the synergetic activity of colistin in combination with imipenem,amikacin or ciprofloxacin,at sub-inhibitory concentrations,against carbapenems-resistant(CR)Acinetobacter baumannii and Pseudomonas aeruginosa strains isolated from various wards in Annaba teaching hospital in eastern Algeria.Materials and Methods:The minimal inhibitory concentrations(MIC)were determined by broth macrodilution(BMD).Carbapenemase encoding genes were screened using polymerase chain reaction(PCR).The activity of colistin in combination with second antibiotic was evaluated by the Checkerboard Technique.Results:39 CR P.aeruginosa and 21 CR A.baumanni strains where collected.The MIC values ranging from(0.25 to 4μg/ml)to colistin,≥16μg/ml for imipenem,≥4μg/ml to amikacin and≥8μg/ml ciprofloxacin.The PCR reveals the presence of the genes blaOXA23(n=12),blaOXA24(n=6),blaNDM1(n=3)in A.baumannii and blaVIM2(n=12)in P.aeruginosa.The combination of colistin with imipenem showed synergistic effect on 57.14%and 46.15%of A.baumannii and P.aeruginosa isolates,respectively.For colistin and amikacin,the synergistic effect is detected in 28.6%of A.baumannii and 30.8%of P.aeruginosa.While colistin and ciprofloxacin showed synergy on 14.29%and 15.38%of A.baumannii and P.aeruginosa isolates,respectively.Conclusion:CR A.baumannii and P.aeruginosa remain the most prevalent infection agents in patients from high-risk wards at Annaba Hospital.Colistin associated with imipenem or with amikacin at sub-inhibitory concentrations gives very encouraging results allowing better management of infections caused by this type of bacteria.
文摘Background: Few data is available in low-burden TB-HIV countries on TB treatment outcomes. We evaluated TB patients (pts) characteristics by HIV status and compared treatment outcomes in relation to HIV status, CD4 count and antiretroviral therapy (ART). Methods: We performed a retrospective analysis of 447 adult TB pts who registered and initiated treatment in our center from 2014 to 2015. Results: Pts were categorized as HIV-negative (n = 399, 89.3%), HIV-positive on ART (n = 42, 9.4%) and HIV-positive not on ART (n = 6, 1.3%). The proportion of pts with extended TB therapy was higher among HIV-positive pts (p = 0.03). Increased age was associated with higher death rates regarding treatment success (OR 1.08;95% CI 1.01 - 1.17, p = 0.03). Statistically significant higher mortality was found among HIV-positive pts on ART (OR 9.93;95% CI 1.36 - 72.37, p = 0.03) and HIV-positive pts not on ART (OR 397.00;95% CI 44.27 to 3559.91, p ≤ 0.0001) compared to HIV-negative pts. When multivariate analyses were restricted to HIV-positive pts, being not on ART was associated with higher mortality (OR 40.0;95% CI 4.37 - 365.78, p = 0.001). Conclusions: There was significant difference in death rates between HIV-positive and HIV-negative TB pts. HIV-positive pts not on ART had a significantly higher mortality.
