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1. Self-reactivities to the non-erythroid alpha spectrin correlate with cerebral malaria in Gabonese children.

Author

Vincent Guiyedi, Youri Chanseaud, Constantin Fesel, Georges Snounou, Jean-Claude Rousselle, Pharat Lim, Jean Koko, Abdelkader Namane, Pierre-André Cazenave, Maryvonne Kombila, and Sylviane Pied

Subjects
Medicine, Science
Abstract

BackgroundHypergammaglobulinemia and polyclonal B-cell activation commonly occur in Plasmodium sp. infections. Some of the antibodies produced recognize self-components and are correlated with disease severity in P. falciparum malaria. However, it is not known whether some self-reactive antibodies produced during P. falciparum infection contribute to the events leading to cerebral malaria (CM). We show here a correlation between self-antibody responses to a human brain protein and high levels of circulating TNF alpha (TNFalpha), with the manifestation of CM in Gabonese children.MethodologyTo study the role of self-reactive antibodies associated to the development of P. falciparum cerebral malaria, we used a combination of quantitative immunoblotting and multivariate analysis to analyse correlation between the reactivity of circulating IgG with a human brain protein extract and TNFalpha concentrations in cohorts of uninfected controls (UI) and P. falciparum-infected Gabonese children developing uncomplicated malaria (UM), severe non-cerebral malaria (SNCM), or CM.Results/conclusionThe repertoire of brain antigens recognized by plasma IgGs was more diverse in infected than in UI individuals. Anti-brain reactivity was significantly higher in the CM group than in the UM and SNCM groups. IgG self-reactivity to brain antigens was also correlated with plasma IgG levels and age. We found that 90% of CM patients displayed reactivity to a high-molecular mass band containing the spectrin non-erythroid alpha chain. Reactivity with this band was correlated with high TNFalpha concentrations in CM patients. These results strongly suggest that an antibody response to brain antigens induced by P. falciparum infection may be associated with pathogenic mechanisms in patients developing CM.

Published
2007
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2. Colonisation digestive par des germes nosocomiaux des nouveau-nés hospitalisés au CHU d’Angondjé : aspects épidémiologiques et facteurs de risque

Author

Jean Koko, E. Kuissi Kamgaing, Simon Ategbo, S. Minto’o Rogombé, M. Mengue M’ella, and M. Mymbila

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Nouveau nes, business.industry, 030225 pediatrics, Pediatrics, Perinatology and Child Health, medicine, 030211 gastroenterology & hepatology, business
Abstract

Resume Introduction L’objectif est de rechercher la presence de germes nosocomiaux multiresistants dans la flore digestive des nouveau-nes hospitalises. Methodologie Etude prospective, incluant 51 nouveau-nes ayant une coproculture de la premiere selle et des selles a j15 de vie positive a un germe nosocomial multiresistant. La colonie suspecte devait avoir une concentration > 1010 bacteries/gramme de selles. Resultats L’âge moyen etait de 35,5 ± 4,3 SA. La prematurite etait observee dans 39,21 % de cas. Le poids moyen etait de 2346,17 ± 1022,5 g. La rupture prematuree des membranes etait presente dans 45,09 % des cas. Une antibiotherapie etait administree a l’admission dans 76,90 % des cas. La premiere alimentation etait faite avec un substitut de lait maternel dans 76,50 % des cas. L’analyse des premieres selles montrait la presence de bacteries multiresistantes et de Candida albicans respectivement dans 7,84 % et 11,76 % des cas. A j15 de vie, 70,59 % avaient un portage digestif de germes multiresistants. C. albicans etait le plus frequent (25 %), suivi d’Escherichia coli (22,22 %) dont 3 producteurs de betalactamase a spectre elargi. Une translocation digestive etait observee dans 30,56 % de cas. Le deces survenait chez trois nouveau-nes, du a E. coli K1 BLSE dans un cas et dans deux cas, a C. albicans. La prematurite (p Conclusions La maitrise des facteurs de risque d’infection nosocomiale pour une prise en charge preventive est primordiale.

Published
2017
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3. Cerebral Malaria and Sequelar Epilepsy: First Matched Case-Control Study in Gabon

Author

Marylène Ndong Launay, Yvonne Assengone-Zeh-Nguema, Pierre-Marie Preux, Jean Koko, Michel Druet-Cabanac, Paul-Marie Loembe, Martine Moubeka-Mounguengui, Maryvonne Kombila, Philomène Kouna-Ndouongo, Edouard Engohang, and Edgard Brice Ngoungou

Subjects
Pediatrics, medicine.medical_specialty, business.industry, 030231 tropical medicine, Case-control study, Neurological disorder, Odds ratio, medicine.disease, 3. Good health, Central nervous system disease, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Neurology, Cerebral Malaria, Anesthesia, medicine, Neurology (clinical), Family history, business, 030217 neurology & neurosurgery, Malaria
Abstract

Summary: Purpose: Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas. The purpose of this article was to evaluate the relationship between CM and epilepsy in Gabon. Methods: A matched case–control study was carried out on a sample of subjects aged six months to 25 years and hospitalized between 1990 and 2004 in three hospitals in Libreville, Gabon. Cases were defined as patients suffering from epilepsy and confirmed by a neurologist. Controls were defined as patients without epilepsy. The exposure of interest was CM according to WHO criteria. Results: In total, 296 cases and 296 controls were included. Of these, 36 (26 cases and 10 controls) had a CM history. The adjusted odds ratio (aOR) to develop epilepsy after CM was 3.9 [95% CI: 1.7–8.9], p < 0.001. Additional risk factors were identified: family history of epilepsy: aOR = 6.0 [95% CI: 2.6–14.1], p < 0.0001, and febrile convulsions: aOR = 9.2 [95% CI 4.0–21.1], p < 0.0001. Conclusions: This first case–control study on that issue suggests that epilepsy-related CM is an underrecognized problem. It emphasizes the need for further studies to better evaluate the role of convulsions during CM.

Published
2006
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