Introduction In sub‐Saharan African countries, research on haemophilia is limited. Since 2015, a partnership has been established through the World Federation of Hemophilia (WFH)’s twinning programme between the haemophilia treatment centre (HTC) of the Centre Hospitalier universitaire of Yopougon in Abidjan, Côte d’Ivoire, and the Cliniques universitaires Saint‐Luc of Brussels, Belgium. Aim This study sought to collect accurate, and detailed demographic, clinical, and laboratory data on the whole identified Ivorian haemophilia population. Methods A prospective study was conducted in 2017 in Yopougon’s HTC. Participants were assessed through multidisciplinary workups including interviews, logbook review, pedigree establishment, clinical examination and laboratory testing. Results Data on 81 patients with haemophilia (PWH) (78 severe and moderate) were collected. Postcircumcision bleeding was the most common diagnosis reason (32%). Mouth bleeds and skin wounds accounted for 55.2% of bleeds. Pedigrees revealed 63 deaths in affected relatives among 33 families. Most PWHs (76.5%) were treated on demand, and 21% had never been exposed to clotting factor. Non‐substitutive therapies (tranexamic acid [43%], physiotherapy [11%] and DDAVP [0%]) were underused. Overweight was uncommon. Knees were the most clinically affected joints at the Hemophilia Joint Health Score. Inhibitors were present in 7.8% of previously treated PWHs. Conclusions This study highlights the value of simple, feasible and inexpensive tools to collect data in the Ivorian haemophilia population and provides the basis for developing and implementing locally appropriate strategies to improve screening, diagnosis, preventive care, treatment and education. It demonstrated the WFH twinning programme benefits for haemophilia care in the developing world.
RESUMELa drépanocytose est une maladie génétique qui constitue un problème de santé publique en Côte d'Ivoire. Etant donné les coûts onéreux du traitement, les patients s'orientent vers la médecine traditionnelle avec l'utilisation de plantes, parmi lesquelles Cajanus cajan. L'objectif de ce travail était de réaliser une étude phytochimique et d'évaluer in vitro l'effet antifalcimiant des graines de Cajanus cajan. Cette étude expérimentale s'est effectuée en deux phases : une première consacrée à la caractérisation des graines et l'autre concernait l'étude de l'activité antifalcimiante in vitro de ces graines. L'étude de l'activité antifalcimiante s'est faite sur les prélèvements sanguins de 30 drépanocytaires homozygotes SSFA 2 . Après induction de la falciformation des globules rouges, l'ajout de l'extrait aqueux de la plante a permis d'évaluer l'activité antifalcimiante par la recherche des drépanocytes au microscope optique. Les Characterization and in vitro evaluation of the antisickling effect of the seeds of Cajanus cajan (Fabaceae) on sickle cells in Abidjan -Côte d'Ivoire ABSTRACTSickle cell anemia is a genetic disease that constitutes a public health problem in Côte d'Ivoire. Given the high cost of treatment, patients in Africa turn to traditional medicine with the use of plants, including E. N' DRAMAN-DONOU et al. / Int. J. Biol. Chem. Sci. 9(5): 2300-2308, 2015 2301Cajanus cajan. The objective of this work was to make a phytochemical study and to evaluate in vitro the antisickling effect of seeds of Cajanus cajan. This experimental study was carried out in two phases: the first was devoted to the characterization of the seeds and the other concerned the study of the in vitro antisickling activity of these seeds. The study was done on the blood samples of 30 SSFA 2 homozygote patients with sickle cell anemia. After induction of the sickling of red blood cells, the addition of the aqueous extract of the plant allowed the evaluation of the antisickling activity by the search for sickle cells under an optical microscope. Cajanus cajan seeds contain sterols, polyterpenes, polyphenols, flavonoids, tannins and alkaloids. They are without any acute toxicity. The aqueous extract reduced the rate of sickle cells of about 50% after 30 min of contact. This study made it possible to show that the seeds of Cajanus cajan have antisickling virtues.
BackgroundLittle data is available on awareness of hemophilia carrier condition or associated bleeding risk and management in Sub-Saharan African countries. This study sought to identify hemophilia carriers in Côte d’Ivoire in order to collect data on demographics, bleeding phenotype, and laboratory results. Another purpose was to provide Ivorian hemophilia carriers with counseling on their risk of bleeding and of having children with hemophilia. A 12-month prospective study was conducted involving Ivorian hemophilia carriers recruited trough pedigree analysis pertaining to 81 hemophilia patients followed-up at the Yopougon Hemophilia Treatment Center in Abidjan. They were assessed using in-depth interviews, pedigree analysis, and laboratory testing.ResultsSixty-one subjects comprising 27 obligate and 34 possible carriers were recruited. None had previously been assessed, with 64% unaware of their carrier status despite a familial history of hemophilia in 69%. The most frequently reported bleeding symptom was menorrhagia (31%). Prolonged bleeding was reported after vaginal delivery in 19.6%, post-surgery in 4.9%, and post-dental extraction in 4.9%. Only one carrier was treated with tranexamic acid, with no other hemostatic therapy recorded. The median (range) clotting FVIII was 0.85 IU/mL (0.24–1.90 IU/mL) and FIX 0.60 IU/mL (0.42–1.76 IU/mL) in hemophilia A and B carriers, respectively. HA carriers had a FVIII < 0.5 IU/mL in 12.5%.ConclusionsThis study highlights the need of implementing care for hemophilia carriers in developing countries, and the high value of pedigree analysis for carrier identification, along with the relevance of diagnosis, treatment, and education of carriers, families, and caregivers.
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