The hematological reference values are very important for diagnostic orientation and treatment decision. The aim of this study was to establish hematological reference values for healthy adults in Togo. A total of 2571 voluntary blood donors participated to this study. Only 1349 subjects negative for HIV, HBV, HCV, malaria, and without hemoglobin abnormalities in electrophoresis and hypochromia on blood smear, were definitively retained for the study. Median hemoglobin level was higher in males than females (15.1 g/dL versus 13.0 g/dL, p = 0.000). Median total WBC (4.2×109/L) and absolute neutrophil counts (1.6×109/L) were similar by gender. The median lymphocyte counts in males and females were, respectively, 2.1×109/L and 2.2×109/L (p = 0.11). The median platelet count was lower in males than females (236×109/L versus 247×109/L, p = 0.004). Our median values for RBC parameters differ from those of African countries probably because of our inclusion criteria which eliminate most cases with iron deficiency and/or thalassemia.

BackgroundSickle cell disease (SCD) accounts for 5% of mortality in African children aged < 5 years. Improving the care management and quality of life of patients with SCD requires a reliable diagnosis in resource-limited settings. We assessed the diagnostic accuracy of the rapid Sickle SCAN® point-of-care (POC) test for SCD used in field conditions in two West-African countries.MethodsWe conducted a case-control study in Bamako (Mali) and Lomé (Togo). Known cases of sickle cell disease (HbSS, HbSC), trait (HbAS), HbC heterozygotes (HbAC) and homozygous (HbCC), aged ≥6 months were compared to Controls (HbAA), recruited by convenience. All subjects received both an index rapid POC test and a gold standard (high-performance liquid chromatography in Bamako; capillary electrophoresis in Lomé). Personnel conducting tests were blinded from subjects’ SCD status. Sensitivity and specificity were calculated for each phenotype. Practicality was assessed by local healthcare professionals familiar with national diagnostic methods and their associated constraints.ResultsIn Togo, 209 Cases (45 HbAS, 39 HbAC, 41 HbSS, 44 HbSC and 40 HbCC phenotypes) were compared to 86 Controls (HbAA). 100% sensitivity and specificity were observed for AA Controls and HbCC cases. Estimated sensitivity was 97.7% [95% confidence interval: 88.0–99.9], 97.6% [87.1–99.9%], 95.6% [84.8–99.5%], and 94.9% [82.7–99.4], for HbSC, HbSS, HbAS, and HbAC, respectively. Specificity exceeded 99.2% for all phenotypes. Among 160 cases and 80 controls in Mali, rapid testing was 100% sensitive and specific. Rapid testing was well accepted by local healthcare professionals.ConclusionRapid POC testing is 100% accurate for homozygote healthy people and excellent (Togo) or perfect (Mali) for sickle cell trait and disease patients. In addition to its comparable diagnostic performance, this test is cheaper, easier to implement, and logistically more convenient than the current standard diagnostic methods in use. Its predictive value indicators and diagnostic accuracy in newborns should be further evaluated prior to implementation in large-scale screening programs in resource-limited settings where SCD is prevalent.

Objectives: Determine the frequency of malignancies diagnosed in myelogram seen in hematology services of Campus and Sylvanus Olympio Teaching Hospitals in Lome from 1992 to 2013. Study the epidemiology profile of these diseases. Materials and methods: It was an analytical retrospective study of 469 cases of malignancies diagnosed in 1511 myelograms during 21 years in both teaching hospital of Lome. Results: Blood disorders represent 31.70% of the results of myelogram performed during 21 years in the Teaching Hospital of Lome. Each year, there is an average of 22.3 cases diagnosed hematological malignancies. The most hematological malignancies were Kahler's disease (28.57%), chronic myeloid leukemia (24.52%), chronic lymphocytic leukemia (22.17%), acute lymphoblastic leukemia (12.58%) and acute myeloid leukemia (8.10%). Other (4.05%) were represented by the essential hypereosinophilic syndrome (4 cases), hairy cell leukemia (4 cases), Sezary lymphoma (3 cases), essential thrombocythemia (3 cases), Waldenstrom's disease (2 cases), acute myelomonocytic leukemia (1 case), prolymphocytic leukemia (1 case) and plasma cell leukemia (1 case). By gender, the CLL is most predominant in women against CML in men. Hemopathies were observed at all ages of life. Conclusion: Hematological malignancies are diagnosed in the Teaching Hospital of Campus and Sylvanus Olympio in Lome with a high relatively frequency. This prevalence must be higher if all cases of malignancies diagnosed in Togo were recorded in a national cancer register. This study aims to knowledge of epidemiological aspects of hematological malignancies and improve the care of patients with hematological malignancies by the provision of adequate anti-mitotic drugs.

The first case is about a man of 60 years old suffering of hypereosinophilic syndrome (HES) developed since 1998. He presented chronic cough, insomnia, and negative parasitical test. We observed hypereosinophilia and fibroblastic hyperplasia at the bone marrow biopsy. Initially, hydroxyurea and α-interferon treatment failed. We proposed to him imatinib mesylate in May 2003. The FIP1L1-PDGFRA gene was detected. The second case is about a man of 34 years old seen in March 2002. First investigation concluded to CML. Progressively, eosinophil cells increased, and complications occurred as oedema syndrome, dyspnoea, and parietal chronic endocarditic fibrosis associated with pericarditis. In addition, a bowel obstruction happened and was cured by surgery. Bcr-abl fusion was negative, and FIP1L1-PDGFRA gene was detected after and imatinib mesylate was given. Actually, endocarditic fibrosis decreased. The two patients are in haematological and cytogenetic remission. We concluded that clonal HES is present in Africa, and imatinib mesylate is effective.

Décrire les différents types de transcrits de fusion moléculaire bcr-abl afin d'évaluer leur fréquence et étudier leurs influences sur les paramètres de l'hémogramme au diagnostic. Il s'agit d'une étude prospective de 34 patients porteurs d'une leucémie myéloïde chronique au Togo. La recherche des transcrits de fusion a été réalisée au laboratoire d'hématologie biologique de l'hôpital Henri Mondor à Créteil (France). L'âge moyen des patients était de 42,32±14,87 ans avec des extrêmes de 9 et 65ans. On notait une prédominance masculine avec un sex- ratio de 1,61 (21 hommes et 13 femmes). L'étude moléculaire révélait deux types de transcrits b3-a2 et b2-a2. Dix-neuf patients (55,88%) avaient le transcrit b3-a2, 13 (38,24%) le transcrit b2-a2 (32,10 %) et deux patients possédaient les deux types de transcrits b3-a2 et b2-a2 (5,88%). Au diagnostic, le taux d'hémoglobine moyen, le nombre moyen de globules blancs, le chiffre moyen des plaquettes chez les patients porteurs du transcrit b3-a2 étaient respectivement de 99,2g/l ; 207,63G/l et 451,28G/l. Pour les patients porteurs du transcrit b2-a2 les valeurs sont 104,6g/l, 114,32G/l et 486,11G/l. Les patients ayant les deux types de transcrit de fusion avaient respectivement 67g/l, 867G/l et 780G/l. Les paramètres de l'hémogramme sont significativement plus perturbés chez les patients porteurs des deux types de transcrits b3-a2 et b2-a2.

The aim of this study was the determination of hemoglobin (Hb) variants and ABO blood groups in a school population aged 6 to 9 years in the township of Agbandé-Yaka in North Togo. A cross-sectional study was carried out on 570 children of four primary schools at Agbande-Yaka, between March and July 2010. Hemoglobin characterization was done by alkaline buffer electrophoresis and the blood types ABO-Rhesus (Rh) D by immuno-hematological methods. A Hb variant was detected in 37.0% of the schoolchildren. Among them, the AS trait accounted for 11.9% and the AC trait for 20.2%. Homozygous Hb S (HBB: c.20A>T) was not found but Hb C (HBB: c.19G>A) appeared at a frequency of 3.3%, while compound heterozygotes carrying Hb SC were seen at a frequency of 1.6%. The O, B and A blood groups accounted for 49.0, 26.8 and 21.9%, respectively. The Hb anomalies reached a high prevalence in this school population. These results are remarkable by the absence of homozygous Hb S individuals compared to homozygous Hb C individuals, which were as numerous as expected. The frequencies of the ABO blood groups are similar to what has been found in other West African populations.

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