Les hépatites B et C chez les donneurs bénévoles de sang et non rémunérés de l’Est de la République démocratique du Congo

ObjectiveWe aimed to evaluate the global prevalence of hepatitis B and C among voluntary blood donor.MethodsIn the study, 1079 blood donors were included. The investigation was carried out from 1 January till 31 December 2010 in the central Blood Bank of Bukavu in DRC. The median age of sample was 26 years. In total, 72.4% among them were male sex and 54.5% of new blood donors.ResultsThe prevalence of hepatitis B was 4.2% and hepatitis C was found in 3.8% case the coinfection VHB and VHC with 2.2%. VHB was prevalent in blood donor group of less than 30 years (5.0%), new blood donor (5.1%), in medical profession (7.1%) and in the male sex group (5.1%) and was significantly according to the sex (P = 0.01) and the place of residence (P = 0.002). A strong association was showed between the rural medium and hepatitis B OR 3,1 (1.4–6.5) and VHC OR 2.9 (1.3–6.5). After estimation with logistic regression a higher risk of seropositivity of VHB found in blood donor sex male group, married group, blood donor coming from the rural middle and having less than 30 years.ConclusionFor blood safety, a particular attention must be laid in the selection of donor before a blood donation and in donation in reagent.     

Prévention de l’anémie chez les donneurs de sang

The prevention of anemia of blood donor is a main issue for donor safety and self-supplying. This prevention is done in one hand by donor deferral whose haemoglobin level is under defined threshold and in other hand by preventing iron deficiency. Some subgroups of donors are at increased risk for developing iron deficiency and adverse effects of iron deficiency: premenopausal females; donors with haemoglobin values near the minimum for eligibility and frequent donors. Different interventions could be used: lengthening the inter-donational interval and/or decreasing the number of donations per year; donor ferritin testing to evaluate iron store and at least donor iron supplementation.     

Intérêt de la recherche de β2-transferrine dans des prélèvements susceptibles de contenir du LCR

When there is a clinical suspicion of CSF leakage, we can detect the presence of β2-transferrin in fluids from different origins. We used two techniques in the laboratory coupling electrophoresis with immuno-blotting. These two methods are realized on microsamples collected by syringe or on microcollagen sponges. The difference between the two methods concern the nature of the gel electrophoresis: agarose for the first one (zone electrophoresis) which allow separation of β1 and β2 transferrin by the electric charge, and agarose with ampholytes (isoelectrofocusing) allowing separation by isoelectric point of all transferrin isoforms. Whatever the method two controls are used: serum of the patient (negative control) and CSF (positive control).     

Le récepteur de la transferrine : intérêt dans l'exploration du statut martial

Transferrin receptor: contribution in assessment of iron status. Transferrin receptor is a transmembrane glycoprotein expressed by any cell type except erythrocytes. A soluble form of the transferrin receptor is detectable in human sera. Its concentration is proportional to tissue transferrin receptor cells. The primary function of transferrin receptor is to bind diferric transferrin and to internalize it by the process of receptor-mediated endocytosis. The first available tests were immunoenzymatic techniques; nowadays, nephelemetric or turbidimetric methods are developed and are automated on biochemistry or immunochemistry automates. However, due to lack of standardization, results obtained from different tests cannot be compared with respect to both reference and pathological ranges. Soluble transferrin receptor is a promising tool to detect coexisting iron deficiency in patients with anaemia of chronic diseases.     

Contributions du comité directeur de transfusion sanguine du Conseil de l’Europe à la détermination des règles de sélection des donneurs de sang et de composants sanguins et à l’étude des conduites sexuelles ayant un impact sur la sécurité transfusionnelle

In November 2009, the Council of Europe's Blood Transfusion Steering Committee created a group of experts to explore the problem of behaviors having an impact on the management of donors of blood and blood components and on blood transfusion safety in Europe. This ad hoc group sought a harmonised interpretation of temporary exclusion (or temporary deferral), as opposed to permanent exclusion (or permanent deferral), in the context of the selection of donors of blood and blood components. It was also given the mandate to assess, on the basis of available data, the possibility of differentiating “at risk” behaviours from behaviours “at high risk” of contamination by serious infectious diseases transmitted by blood, blood components or derived therapeutic products. The primary objective of this work was to ensure the safety of blood, blood components and derived therapeutic products for future recipients by promoting a risk analysis-based approach, given that some countries envisaged amending their provisions for donor selection. However, a risk analysis can only be performed on groups, not individuals, which may give the impression of a discriminatory approach, so it needed to be justified in the context of transfusion safety. A collaborative project, which included an investigation phase, led to the drafting of a technical memorandum that summarised the data collected in ten Council of Europe member states on the selection criteria for blood donors and the epidemiology of infectious diseases (with a focus on human immunodeficiency virus) in the general population and among blood donors. The technical memorandum was published in 2011 on the European Directorate for the Quality of Medicines and Healthcare website dedicated to this project. A draft resolution of the Committee of Ministers of the Council of Europe was then developed by the Council of Europe's Blood Transfusion Steering Committee. This text was circulated among member and observer states of the Council of Europe for review and comments.     

Intérêt de l’étude du gène bêtaglobine dans le dépistage des hémoglobinopathies

As part of hemoglobinopathy’s study in the hospital of Saint-Denis, we search β globin gene mutations to complete standard techniques with the assay “βglobin Strip A^ssay” of Vienna Lab Labordiagnostika, sold by Ingen. This assay allows the detection of 20 frequent β thalassemia mutations, hemoglobin S and C. This assay is executed for β thalassemia and in a number of sickle cell diseases (SS and S-β thalassemia). Mutation was found in 38% of β thalassemia. In sickle cell diseases: SS and S-β+ thalassemia in newborns were confirmed. Nevertheless, considering the origin of our sickle cell disease’s patients, it is essential to complete this assay with African mutations.     

Comparaison de l’efficacité de la chloroquine versus sulfadoxine-pyriméthamine dans la prévention du paludisme chez la femme enceinte dans la région de Toamasina (Madagascar)

Malaria still represents a great cause of death in sub-Saharan African areas, mainly among pregnant women. We conducted this prospective study during two years in a malaria-endemic stable region in the east of Madagascar (Toamasina) with an aim to compare the efficacy of weekly chloroquine (CQ) and the use of intermittent presumptive treatment by sulfadoxine-pyrimethamine (SP). 519 pregnant women were included in this study (CQ = 285; SP = 256). Socio-demographical characteristics of each group were identical. We found more peripheral parasitemia (CQ = 8.07% vs SP = 2.73%; P = 0.0068) and severe malaria in the CQ group (CQ = 1.75% vs SP = 0%; P = 0.0332). Anemia was more frequent in the CQ group (CQ = 4.21% vs SP = 0.35%; P = 0.0038). Placental infestation rate was also higher in the CQ group (CQ = 7.01% vs SP = 0.39%; P = 0.00001). Low birth weight and fetal death were lower in the SP group respectively [(CQ = 4.21% vs SP = 0.78%; P = 0.0121) and (CQ = 1.75%vs SP = 0%; P = 0.0332)].     

Motivation et sociologie des donneurs de sang en Tunisie : réalités et perspectives

In Tunisia, blood donation is voluntary, anonymous and non-remunerated. The aim of the study is to analyze donor motivation and sociology in the regional center of transfusion of Sfax. Between 14 May 2007 and 23 June 2007, a total of 903 Tunisian blood donors filled a questionnaire. Among the donors, 81.8% were men and have a mean age of 34.2 years and the majority of them have an age between 18 and 29 years. The middle social class was majority (77.8%) as well as the liberal profession (65.1%). Primary and secondary education were dominant (79.3%). Among the blood donors, 41.6% were new donors and 28.6% had a history of a single donation, 50.3% were voluntary and 49.7% replacement donors. The reasons motivating the voluntary donation were solidarity (69.9%), religion (21.2%), health benefit (3.6%) and insurance for the family (5.2%). The replacement donors refuse the voluntary donation for not obvious reasons (51%), lack of availability (13.3%), difficulties of accessibility of the sites of collection (7.6%), phobia of the blood and the stings (4.02%) or by refusal of blood donation (1.79%). The information and the raising awareness of the replacement donors could change in a near future their attitudes to become voluntary and regular donors. The implication of donor associations in the organization of the collections and the promotion of the blood donation would be of considerable contribution.