[show abstract][hide abstract] ABSTRACT: Chikungunya virus (CHIKV) has caused multiple outbreaks in tropical and temperate areas worldwide, but the clinical and biological features of this disease are poorly described, particularly in Africa. We report a prospective study of clinical and biological features during an outbreak that occurred in Franceville, Gabon in 2010.
We collected, in suspect cases (individuals presenting with at least one of the following symptoms or signs: fever, arthralgias, myalgias, headaches, rash, fatigue, nausea, vomiting, diarrhea, bleeding, or jaundice), blood samples, demographic and clinical characteristics and outcome. Hematological and biochemical tests, blood smears for malaria parasites and quantitative PCR for CHIKV then dengue virus were performed. CHIKV+ patients with concomitant malaria and/or dengue were excluded from the study. From May to July 2010, data on 270 laboratory-confirmed CHIK patients were recorded. Fever and arthralgias were reported by respectively 85% and 90% of patients, while myalgias, rash and hemorrhage were noted in 73%, 42% and 2% of patients. The patients were grouped into 4 clinical categories depending on the existence of fever and/or joint pain. On this basis, mixed forms accounted for 78.5% of cases, arthralgic forms 12.6%, febrile forms 6.7% and unusual forms (without fever and arthralgias) 2.2%. No cases of organ failure or death were reported. Elevated liver enzyme and creatinine levels, anemia and lymphocytopenia were the predominant biological abnormalities, and lymphocytopenia was more severe in patients with high viral loads (p = 0.01).
During CHIK epidemics, some patients may not have classical symptoms. The existence of unusual forms and the absence of severe forms of CHIK call for surveillance to detect any change in pathogenicity.
[show abstract][hide abstract] ABSTRACT: Chikungunya (CHIKV) and Dengue (DENV) viruses, both arboviruses, have caused multiple outbreaks worldwide. Their clinical features are poorly described in Africa and there is no comparative study, although Chikungunya is considered as a dengue-like disease. We conducted a comparative study of clinical and biological data from CHIKV and DENV positive patients during the 2010 Gabonese outbreak. Patients consulting with general symptoms and having laboratory confirmation for CHIKV or DENV were included. Clinical and biological data were recorded. Statistical analyses were performed using Epi Info. A P value < 0.05 was considered significant. In all, 270 CHIKV+, 53 DENV+ and 20 co-infected patients were included in the study. Headaches, hemorrhage, leukopenia and lymphopenia were significantly (P respectively 0.01, 0.001, 0.02 and 0.001) more frequent in DENV+ patients than in CHIKV+. There was no additive effect of the two viruses.These clinical and hematological disorders are non specific and cannot assist for the differential diagnosis. These diseases are clinically indistinguishable, and need for laboratory confirmation.
[show abstract][hide abstract] ABSTRACT: As part of a project to identify new compounds active on malarial parasites, we tested the in vitro antiplasmodial activity of nine plants traditionally used to treat malaria symptoms in Haut-Ogooué Province, South-East Gabon.
Dichloromethane and methanolic extracts of each plant were tested for their antiplasmodial activity on two chloroquine-resistant strains of Plasmodium falciparum (FCB and W2), based on lactate dehydrogenase activity. Cytotoxicity was assessed with the MTT test on MRC-5 human diploid embryonic lung cells.
The methanolic extract of Staudtia gabonensis and the dichloromethane extract of Adhatoda latibracteata showed high antiplasmodial activity (IC₅₀<1 μg/ml) and low cytotoxicity, with selectivity indexes of about 58.25 and 16.43, respectively. The methanolic extract of Monodora myristica and the dichloromethane extract of Afromomum giganteum also showed promising activity (1<IC₅₀<10 μg/ml) and low cytotoxicity, with selectivity indexes about 15.70 and 12.48, respectively. Dichloromethane extracts of Monodora myristica and Leonotis Africana showed moderate activity (10<IC₅₀<40 μg/ml), with selectivity indexes about 6.07 and 28.89, respectively. Both extracts of Culcasia lancifolia had IC₅₀ values of 10-40 μg/ml but high cytotoxicity (selectivity indexes <2.77). The methanolic extract of Dorstenia klaineana had moderate antiplasmodial activity (IC₅₀ around 17 μg/ml) but strong cytotoxicity (0.43 μg/ml), giving a selectivity index of about 0.03.
Most extracts of nine selected plants traditionally used to treat malaria in Gabon had interesting antiplasmodial activity in vitro. This supports continued investigations of traditional medicines in the search for new antimalarial agents. The compounds responsible for the observed antiplasmodial effects are under investigation.
Journal of ethnopharmacology 02/2011; 133(3):1103-8. · 2.32 Impact Factor
[show abstract][hide abstract] ABSTRACT: The serological prevalence of Toxoplasma gondii was studied among 839 pregnant women in two hospitals from Franceville (Gabon), between May 2007 and December 2007. Specific T gondii IgG and IgM were measured by Enzyme Linked Fluorescent Assay (ELFA). Datation of the infection was carried out by avidity test. Fifty-six percent of women in this study were immunised compare to the 71% who were found as immunised in a previous study carried out fifteen years ago. 2.6% were found to be IgM positive. However, from the avidity test it was found that these infections occurred before pregnancy contact with cats and age increase this prevalence. The lack of information for pregnant women, the lack of continuous training for health personnel and lack of awareness about interpretation of laboratory diagnostic tests like avidity test in these hospitals reduce the level of counselling for women about T gondii.
Bulletin de la Société de pathologie exotique 02/2010; 103(1):41-43.
[show abstract][hide abstract] ABSTRACT: Tuberculosis is an important public health problem in Gabon, and the DOTS strategy recommended by the World Health Organisation has not been successfully applied. In 2006, 45% of patients abandoned treatment during the first phase. A pilot cross-sectional study was thus conducted from September 1 to November 30, 2006, at the Nkembo Tuberculosis Centre in Libreville, Gabon. Thirty patients with positive microscopy results who returned after having interrupted treatment completed a standardised questionnaire. They were mainly young men: their mean age was 33 years old and the male/female ratio was 2.7. Reasons for having abandoned treatment were a lack of money to pay for it (43%) and an impression that they had been cured (23%). The motivations for resuming treatment were the return of symptoms (73%). The risk of drug resistance requires that the Gabonese government play a greater role in the fight against tuberculosis.