Viral and bacterial factors of mother-to-child transmission of hepatitis B virus

Hepatitis B virus (HBV) infection is the tenth leading cause of death worldwide. Mother-to-child transmission of HBV occurring mainly at delivery remains one of the most common routes of infection in developing countries. One of the main challenges concerning HBV in Africa is to implement a prevention policy aiming at interrupting the cycle of pseudo-vertical transmission of this infection. The aim of this study was to assess the implication of certain bacterial and viral factors in mother-to-child transmission of HBV. This prospective study was conducted on 165 pregnant women carriers of HBV surface antigen (HBsAg) and their 169 newborns who attended care at the Gynecology Department of the University Hospital of Cocody. Serological, molecular, and bacteriological analyses were performed on blood samples and vaginal secretions. Mean viral load (VL) was 4.5 ± 1.3 log₁₀  IU/ml, while mean HBsAg titres were 3.5 ± 0.9 log₁₀  IU/ml. HBV DNA was found in vaginal secretions in 13.3% of mothers and in the blood of 10.3% of the newborns. Six bacterial species were identified in the vaginal discharge of pregnant women during labour before delivery. Staphylococcus aureus and Enterococcus faecalis were the most frequent species found in 23.0% and 13.9% of cases. Mothers positive for vaginal HBV DNA displayed higher plasma HBV DNA loads than negative mothers (6.2 ± 1.6 log₁₀  IU/ml vs. 4.3 ± 1.0 log₁₀  IU/ml, p < .0001). In conclusion, our study showed that presence of HBV DNA in vaginal secretions and the presence of S. aureus could play a role in mother-to-child transmission of HBV. HBV DNA detection in vaginal discharge represents a promising biomarker to identify newborns at risk of perinatal persistent infection.

[Mother-to-child hepatitis B virus markers transmission at a reference hospital in Cote d'Ivoire]

AIMS

To determine the seroprevalence of HBsAg in pregnant women and to determine the incidence of mother-to-child transmission.

PATIENTS AND METHODS

It was a prospective longitudinal study with a descriptive and analytical aim that took place in the maternity ward and in the pediatric department of the CHU of Cocody for 7 months. All newborns whose mothers were HBsAg carriers were included. The parameters studied in pregnant women were socio-demographic data, medical history, risk factors for HBV transmission, mode of delivery, and viral load. Concerning the newborn, the studied parameters were sex, gestational age, birth weight, HBsAg assay.

RESULTS

231 pregnant women were carriers of HBs Ag antigen, an overall frequency of 5.4%. The incidence of mother-to-child transmission was 23.3%. This transmission was statistically related to the high viral load in the mother (p = 0.014). There was a statistical relationship between HBV infection and the occurrence of fetal hypotrophy (p = 0.008).

CONCLUSION

Health Education Program Focused on Preventing Vertical Transmission of HBV Must Accompany Expanded Infant Immunization Coverage.

Prevalence of Newcastle disease virus and infectious bronchitis virus in avian influenza negative birds from live bird markets and backyard and commercial farms in Ivory-Coast

Newcastle disease (ND) and infectious bronchitis (IB) are two major viral diseases affecting the respiratory tracts of birds and whose impact on African poultry is still poorly known. In the present study we aimed at assessing NDV and IBV prevalences in Ivory-Coast by molecular screening of >22,000 avian swabs by nested PCR and by serology testing of close to 2000 avian sera from 2010 through 2012. The NDV and IBV seroprevalences over the study period reached 22% and 72%, respectively. We found 14.7% pooled swabs positive by PCR for NDV and 14.6% for IBV. Both pathogens are therefore endemic in Ivory-Coast. Economic losses associated with NDV and IBV infections still need to be evaluated.

Ambulatory Monitoring of Preterm Infant During Their First Year of Life at the Pediatric Deparment of Cocody Teaching Hospital

The prematurity remains in our developing countries a problem of current events. The deficiency in human resources and the low level of the technical equipment exposes premature babies to a high risk of morbidity and mortality in neonatal period. Those who survive need a closer follow-up after their discharge from hospital. Our objective through this study was to appreciate the quality of following-up premature babies in ambulatory. It was a longitudinal study with descriptive aim which took place from January, 2007 till December, 2008 in the paediatric service of the Teaching Hospital of Cocody. Our population was constituted by 100 premature babies selected in a random way. The premature babies had on average 31,7 weeks of gestationel age. The sex ratio was 0,96. The born weight was between 900 and 2550g. The main causes of prematurity were multiple pregnancies (18 %), malaria (15 %), premature break of membranes (12 %) and éclampsia (10 %). Most of premature babies were hospitalized for a problem of breeding ( 47 %.). The average number of consultation was 6,25. Only 25 children were effectively followed during 12 months with a middleweight of 9112g. The follow-up had been interrupted before 3 months of native age in 31 % of cases and before 3 months of real age in 52 % of cases. The mothers had preferred the feeding in 48 % of cases, but the curves of weight development were superposables whatever the type of food supply. The pathology during the follow-up was dominated by digestive disorders, respiratory infections and anaemia. Forty percent of the premature babies was able to have an haemoglobin test and 8 %, a neuroradiological scraeming. A third of the premature babies (30 %) had been hospitalized again for anaemia (10 %) and respiratory infections (10 %). We recorded 3 deaths. CONCLUSION: The follow-up of premature babies getting out of hospital remains difficult in our context of life. The mothers must be sensitived on the consequences of prematurity and the importance of their follow-up. This follow-up has to be the affair of all, as well parents, health workers that government.

The early detection of peste-des-petits-ruminants (PPR) virus antigens and nucleic acid from experimentally infected goats using RT-PCR and immunocapture ELISA techniques

Goats were infected subcutaneously with different African and Indian isolates of peste-des-petits-ruminants virus. Typical signs of disease were recorded from day 6 post infection for all isolates. Ocular, nasal and mouth samples were tested for the presence of virus antigen or nucleic acid using the immunocapture ELISA (ICE) and the RT-PCR technique. Using ICE, virus antigen was detected at day 4 in ocular and nasal samples of goats infected with Côte-d'Ivoire 89 and in the ocular, nasal and mouth samples with the India, Calcutta strains. By day 5, all samples from both these groups were positive while ocular and nasal samples from groups with Sudan-Sennar and Nigeria 75/1 strains became positive. With the RT-PCR technique virus nucleic acid, presumed to be associated with infectious virus excretion, was detected at day 3 in oral and nasal samples in groups infected with Côte-d'Ivoire 89 and India-Calcutta strains. From day 6-9, all samples from all groups were positive with both techniques. This experiment demonstrated that PPR virus antigens and nucleic acid, presumed to be related to infectious virus, is excreted 2-3days before the appearance of clinical signs whatever the technique used which is of epidemiological importance in controlling the spread of the disease. The ICE being easier to perform in developing countries can be recommended as a useful method to investigate PPR in small ruminants flocks at an early stage to prevent the diffusion of the disease.

The first specific detection of a highly pathogenic avian influenza virus (H5N1) in Ivory Coast

The Virology Laboratory of the Central Laboratory of Animal Diseases in Ivory Coast at Bingerville received samples of wild and domestic avian species between February and December 2006. An RT-PCR technique was used to test for avian influenza (AI) and highly pathogenic AI subtype viruses. Among 2125 samples, 16 were type A positive; of which, 12 were later confirmed to be H5N1. Fifteen of these 16 type A positive samples were inoculated into the chorioallantoic cavity of 11-day-old embryonated hens' eggs for virus isolation. Eight produced virus with hemagglutination titres from 1/64 to 1/512. The 4/16 M-RT-PCR positive samples, which were H5N1 negative, were shown to be H7 subtype negative. The diagnostic efficiency of the laboratory for the surveillance of H5N1 in Ivory Coast was demonstrated. The positive cases of H5N1 were from a sparrowhawk (Accipter nisus); live market poultry and in free-range poultry, where the mortality rate was approximately 20% (2/10) and 96.7% (29/30) respectively. Currently, investigations into intensive poultry farms have proved negative for H5N1. No human cases have been reported this time.

[Anemia in the premature newborn]

Anemia is a common and life threatening pathology among new born babies from premature. It has the potential to delay the child's growth if appropriate care if not taken. In order to improve care to new born babies with anemia, we carried out a retrospective study on a group of 195 records obtained from the neonatology ward and from 46 outpatients in the CHU of Cocody between January 2001 and December 2003. At the end of the study, we made the following reports: Incidence of early anemia is 17.5% and several risk factors are involved such as absence of anemia and malaria prophylaxis during pregnancy. Anemia whether it is secondary or early is often masked. Palor is observed in small proportions among anemic prematures at birth. Thus, cell blood chemistry is important to confirm the diagnosis. Early anemia is generally normochrome normocytaire and secondary one is hypochronic. Care about anemia cases must rely on clinical data as well as bioiogical and epidemiological data. Early iron supplementation (2 to 3 iron element mg/kg/day) could prevent late and secondary anemia in non-anemic prematures at birth.