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6. Facteurs associés à l'infection au SARS-CoV-2 à Tunis après la deuxième vague épidémique

Author

Cherif, I., primary, Kharroubi, G., additional, Chaabane, S., additional, Yazidi, R., additional, Dellagi, M., additional, Snoussi, M.A., additional, Salem, S., additional, Marzouki, S., additional, Kammoun Rebai, W., additional, Rourou, S., additional, Dellagi, K., additional, Barbouche, M.R., additional, Benabdessalem, C., additional, Ahmed, M. Ben, additional, and Bettaieb, J., additional

Published
2022
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7. Incidence cumulée de l'infection au SARS-CoV-2 à l'Institut Pasteur de Tunis, mars 2021

Author

Kharroubi, G., primary, Cherif, I., additional, Ghawar, W., additional, Dhaouadi, N., additional, Yazidi, R., additional, Chaabane, S., additional, Snoussi, M.A., additional, Salem, S., additional, Hammouda, W. Ben, additional, Hammouda, S. Ben, additional, Gharbi, A., additional, Barbouche, A., additional, Bel Haj Hmida, N., additional, Rourou, S., additional, Dellagi, K., additional, Barbouche, M.R., additional, Benabdessalem, C., additional, Ben Ahmed, M., additional, and Bettaieb, J., additional

Published
2022
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8. Séroprévalence du SARS-CoV-2 parmi la population générale de Tunis, mars-avril 2021

Author

Cherif, I., primary, Kharroubi, G., additional, Chaabane, S., additional, Yazidi, R., additional, Dellagi, M., additional, Snoussi, M.A., additional, Salem, S., additional, Marzouki, S., additional, Kammoun Rebai, W., additional, Rourou, S., additional, Dellagi, K., additional, Barbouche, M.R., additional, Benabdessalem, C., additional, Ben Ahmed, M., additional, and Bettaieb, J., additional

Published
2022
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11. The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

Author

Tegally, H, San, JE, Cotten, M, Moir, M, Tegomoh, B, Mboowa, G, Martin, DP, Baxter, C, Lambisia, AW, Diallo, A, Amoako, DG, Diagne, MM, Sisay, A, Zekri, A-RN, Gueye, AS, Sangare, AK, Ouedraogo, A-S, Sow, A, Musa, AO, Sesay, AK, Abias, AG, Elzagheid, A, Lagare, A, Kemi, A-S, Abar, AE, Johnson, AA, Fowotade, A, Oluwapelumi, AO, Amuri, AA, Juru, A, Kandeil, A, Mostafa, A, Rebai, A, Sayed, A, Kazeem, A, Balde, A, Christoffels, A, Trotter, AJ, Campbell, A, Keita, AK, Kone, A, Bouzid, A, Souissi, A, Agweyu, A, Naguib, A, Gutierrez, A, Nkeshimana, A, Page, AJ, Yadouleton, A, Vinze, A, Happi, AN, Chouikha, A, Iranzadeh, A, Maharaj, A, Batchi-Bouyou, AL, Ismail, A, Sylverken, AA, Goba, A, Femi, A, Sijuwola, AE, Marycelin, B, Salako, BL, Oderinde, BS, Bolajoko, B, Diarra, B, Herring, BL, Tsofa, B, Lekana-Douki, B, Mvula, B, Njanpop-Lafourcade, B-M, Marondera, BT, Khaireh, BA, Kouriba, B, Adu, B, Pool, B, McInnis, B, Brook, C, Williamson, C, Nduwimana, C, Anscombe, C, Pratt, CB, Scheepers, C, Akoua-Koffi, CG, Agoti, CN, Mapanguy, CM, Loucoubar, C, Onwuamah, CK, Ihekweazu, C, Malaka, CN, Peyrefitte, C, Grace, C, Omoruyi, CE, Rafai, CD, Morang'a, CM, Erameh, C, Lule, DB, Bridges, DJ, Mukadi-Bamuleka, D, Park, D, Rasmussen, DA, Baker, D, Nokes, DJ, Ssemwanga, D, Tshiabuila, D, Amuzu, DSY, Goedhals, D, Grant, DS, Omuoyo, DO, Maruapula, D, Wanjohi, DW, Foster-Nyarko, E, Lusamaki, EK, Simulundu, E, Ong'era, EM, Ngabana, EN, Abworo, EO, Otieno, E, Shumba, E, Barasa, E, Ahmed, EB, Ahmed, EA, Lokilo, E, Mukantwari, E, Philomena, E, Belarbi, E, Simon-Loriere, E, Anoh, EA, Manuel, E, Leendertz, F, Taweh, FM, Wasfi, F, Abdelmoula, F, Takawira, FT, Derrar, F, Ajogbasile, F, Treurnicht, F, Onikepe, F, Ntoumi, F, Muyembe, FM, Ragomzingba, FEZ, Dratibi, FA, Iyanu, F-A, Mbunsu, GK, Thilliez, G, Kay, GL, Akpede, GO, van Zyl, GU, Awandare, GA, Kpeli, GS, Schubert, G, Maphalala, GP, Ranaivoson, HC, Omunakwe, HE, Onywera, H, Abe, H, Karray, H, Nansumba, H, Triki, H, Kadjo, HAA, Elgahzaly, H, Gumbo, H, Mathieu, H, Kavunga-Membo, H, Smeti, I, Olawoye, IB, Adetifa, IMO, Odia, I, Ben Boubaker, IB, Mohammad, IA, Ssewanyana, I, Wurie, I, Konstantinus, IS, Halatoko, JWA, Ayei, J, Sonoo, J, Makangara, J-CC, Tamfum, J-JM, Heraud, J-M, Shaffer, JG, Giandhari, J, Musyoki, J, Nkurunziza, J, Uwanibe, JN, Bhiman, JN, Yasuda, J, Morais, J, Kiconco, J, Sandi, JD, Huddleston, J, Odoom, JK, Morobe, JM, Gyapong, JO, Kayiwa, JT, Okolie, JC, Xavier, JS, Gyamfi, J, Wamala, JF, Bonney, JHK, Nyandwi, J, Everatt, J, Nakaseegu, J, Ngoi, JM, Namulondo, J, Oguzie, JU, Andeko, JC, Lutwama, JJ, Mogga, JJH, O'Grady, J, Siddle, KJ, Victoir, K, Adeyemi, KT, Tumedi, KA, Carvalho, KS, Mohammed, KS, Dellagi, K, Musonda, KG, Duedu, KO, Fki-Berrajah, L, Singh, L, Kepler, LM, Biscornet, L, Martins, LDO, Chabuka, L, Olubayo, L, Ojok, LD, Deng, LL, Ochola-Oyier, L, Tyers, L, Mine, M, Ramuth, M, Mastouri, M, ElHefnawi, M, Mbanne, M, Matsheka, M, Kebabonye, M, Diop, M, Momoh, M, Lima Mendonca, MDL, Venter, M, Paye, MF, Faye, M, Nyaga, MM, Mareka, M, Damaris, M-M, Mburu, MW, Mpina, MG, Owusu, M, Wiley, MR, Tatfeng, MY, Ayekaba, MO, Abouelhoda, M, Beloufa, MA, Seadawy, MG, Khalifa, MK, Matobo, MM, Kane, M, Salou, M, Mbulawa, MB, Mwenda, M, Allam, M, Phan, MVT, Abid, N, Rujeni, N, Abuzaid, N, Ismael, N, Elguindy, N, Top, NM, Dia, N, Mabunda, N, Hsiao, N-Y, Silochi, NB, Francisco, NM, Saasa, N, Bbosa, N, Murunga, N, Gumede, N, Wolter, N, Sitharam, N, Ndodo, N, Ajayi, NA, Tordo, N, Mbhele, N, Razanajatovo, NH, Iguosadolo, N, Mba, N, Kingsley, OC, Sylvanus, O, Femi, O, Adewumi, OM, Testimony, O, Ogunsanya, OA, Fakayode, O, Ogah, OE, Oludayo, O-E, Faye, O, Smith-Lawrence, P, Ondoa, P, Combe, P, Nabisubi, P, Semanda, P, Oluniyi, PE, Arnaldo, P, Quashie, PK, Okokhere, PO, Bejon, P, Dussart, P, Bester, PA, Mbala, PK, Kaleebu, P, Abechi, P, El-Shesheny, R, Joseph, R, Aziz, RK, Essomba, RG, Ayivor-Djanie, R, Njouom, R, Phillips, RO, Gorman, R, Kingsley, RA, Neto Rodrigues, RMDESA, Audu, RA, Carr, RAA, Gargouri, S, Masmoudi, S, Bootsma, S, Sankhe, S, Mohamed, SI, Femi, S, Mhalla, S, Hosch, S, Kassim, SK, Metha, S, Trabelsi, S, Agwa, SH, Mwangi, SW, Doumbia, S, Makiala-Mandanda, S, Aryeetey, S, Ahmed, SS, Ahmed, SM, Elhamoumi, S, Moyo, S, Lutucuta, S, Gaseitsiwe, S, Jalloh, S, Andriamandimby, SF, Oguntope, S, Grayo, S, Lekana-Douki, S, Prosolek, S, Ouangraoua, S, van Wyk, S, Schaffner, SF, Kanyerezi, S, Ahuka-Mundeke, S, Rudder, S, Pillay, S, Nabadda, S, Behillil, S, Budiaki, SL, van der Werf, S, Mashe, T, Mohale, T, Le-Viet, T, Velavan, TP, Schindler, T, Maponga, TG, Bedford, T, Anyaneji, UJ, Chinedu, U, Ramphal, U, George, UE, Enouf, V, Nene, V, Gorova, V, Roshdy, WH, Karim, WA, Ampofo, WK, Preiser, W, Choga, WT, Ahmed, YA, Ramphal, Y, Bediako, Y, Naidoo, Y, Butera, Y, de Laurent, ZR, Ouma, AEO, von Gottberg, A, Githinji, G, Moeti, M, Tomori, O, Sabeti, PC, Sall, AA, Oyola, SO, Tebeje, YK, Tessema, SK, de Oliveira, T, Happi, C, Lessells, R, Nkengasong, J, Wilkinson, E, Tegally, H, San, JE, Cotten, M, Moir, M, Tegomoh, B, Mboowa, G, Martin, DP, Baxter, C, Lambisia, AW, Diallo, A, Amoako, DG, Diagne, MM, Sisay, A, Zekri, A-RN, Gueye, AS, Sangare, AK, Ouedraogo, A-S, Sow, A, Musa, AO, Sesay, AK, Abias, AG, Elzagheid, A, Lagare, A, Kemi, A-S, Abar, AE, Johnson, AA, Fowotade, A, Oluwapelumi, AO, Amuri, AA, Juru, A, Kandeil, A, Mostafa, A, Rebai, A, Sayed, A, Kazeem, A, Balde, A, Christoffels, A, Trotter, AJ, Campbell, A, Keita, AK, Kone, A, Bouzid, A, Souissi, A, Agweyu, A, Naguib, A, Gutierrez, A, Nkeshimana, A, Page, AJ, Yadouleton, A, Vinze, A, Happi, AN, Chouikha, A, Iranzadeh, A, Maharaj, A, Batchi-Bouyou, AL, Ismail, A, Sylverken, AA, Goba, A, Femi, A, Sijuwola, AE, Marycelin, B, Salako, BL, Oderinde, BS, Bolajoko, B, Diarra, B, Herring, BL, Tsofa, B, Lekana-Douki, B, Mvula, B, Njanpop-Lafourcade, B-M, Marondera, BT, Khaireh, BA, Kouriba, B, Adu, B, Pool, B, McInnis, B, Brook, C, Williamson, C, Nduwimana, C, Anscombe, C, Pratt, CB, Scheepers, C, Akoua-Koffi, CG, Agoti, CN, Mapanguy, CM, Loucoubar, C, Onwuamah, CK, Ihekweazu, C, Malaka, CN, Peyrefitte, C, Grace, C, Omoruyi, CE, Rafai, CD, Morang'a, CM, Erameh, C, Lule, DB, Bridges, DJ, Mukadi-Bamuleka, D, Park, D, Rasmussen, DA, Baker, D, Nokes, DJ, Ssemwanga, D, Tshiabuila, D, Amuzu, DSY, Goedhals, D, Grant, DS, Omuoyo, DO, Maruapula, D, Wanjohi, DW, Foster-Nyarko, E, Lusamaki, EK, Simulundu, E, Ong'era, EM, Ngabana, EN, Abworo, EO, Otieno, E, Shumba, E, Barasa, E, Ahmed, EB, Ahmed, EA, Lokilo, E, Mukantwari, E, Philomena, E, Belarbi, E, Simon-Loriere, E, Anoh, EA, Manuel, E, Leendertz, F, Taweh, FM, Wasfi, F, Abdelmoula, F, Takawira, FT, Derrar, F, Ajogbasile, F, Treurnicht, F, Onikepe, F, Ntoumi, F, Muyembe, FM, Ragomzingba, FEZ, Dratibi, FA, Iyanu, F-A, Mbunsu, GK, Thilliez, G, Kay, GL, Akpede, GO, van Zyl, GU, Awandare, GA, Kpeli, GS, Schubert, G, Maphalala, GP, Ranaivoson, HC, Omunakwe, HE, Onywera, H, Abe, H, Karray, H, Nansumba, H, Triki, H, Kadjo, HAA, Elgahzaly, H, Gumbo, H, Mathieu, H, Kavunga-Membo, H, Smeti, I, Olawoye, IB, Adetifa, IMO, Odia, I, Ben Boubaker, IB, Mohammad, IA, Ssewanyana, I, Wurie, I, Konstantinus, IS, Halatoko, JWA, Ayei, J, Sonoo, J, Makangara, J-CC, Tamfum, J-JM, Heraud, J-M, Shaffer, JG, Giandhari, J, Musyoki, J, Nkurunziza, J, Uwanibe, JN, Bhiman, JN, Yasuda, J, Morais, J, Kiconco, J, Sandi, JD, Huddleston, J, Odoom, JK, Morobe, JM, Gyapong, JO, Kayiwa, JT, Okolie, JC, Xavier, JS, Gyamfi, J, Wamala, JF, Bonney, JHK, Nyandwi, J, Everatt, J, Nakaseegu, J, Ngoi, JM, Namulondo, J, Oguzie, JU, Andeko, JC, Lutwama, JJ, Mogga, JJH, O'Grady, J, Siddle, KJ, Victoir, K, Adeyemi, KT, Tumedi, KA, Carvalho, KS, Mohammed, KS, Dellagi, K, Musonda, KG, Duedu, KO, Fki-Berrajah, L, Singh, L, Kepler, LM, Biscornet, L, Martins, LDO, Chabuka, L, Olubayo, L, Ojok, LD, Deng, LL, Ochola-Oyier, L, Tyers, L, Mine, M, Ramuth, M, Mastouri, M, ElHefnawi, M, Mbanne, M, Matsheka, M, Kebabonye, M, Diop, M, Momoh, M, Lima Mendonca, MDL, Venter, M, Paye, MF, Faye, M, Nyaga, MM, Mareka, M, Damaris, M-M, Mburu, MW, Mpina, MG, Owusu, M, Wiley, MR, Tatfeng, MY, Ayekaba, MO, Abouelhoda, M, Beloufa, MA, Seadawy, MG, Khalifa, MK, Matobo, MM, Kane, M, Salou, M, Mbulawa, MB, Mwenda, M, Allam, M, Phan, MVT, Abid, N, Rujeni, N, Abuzaid, N, Ismael, N, Elguindy, N, Top, NM, Dia, N, Mabunda, N, Hsiao, N-Y, Silochi, NB, Francisco, NM, Saasa, N, Bbosa, N, Murunga, N, Gumede, N, Wolter, N, Sitharam, N, Ndodo, N, Ajayi, NA, Tordo, N, Mbhele, N, Razanajatovo, NH, Iguosadolo, N, Mba, N, Kingsley, OC, Sylvanus, O, Femi, O, Adewumi, OM, Testimony, O, Ogunsanya, OA, Fakayode, O, Ogah, OE, Oludayo, O-E, Faye, O, Smith-Lawrence, P, Ondoa, P, Combe, P, Nabisubi, P, Semanda, P, Oluniyi, PE, Arnaldo, P, Quashie, PK, Okokhere, PO, Bejon, P, Dussart, P, Bester, PA, Mbala, PK, Kaleebu, P, Abechi, P, El-Shesheny, R, Joseph, R, Aziz, RK, Essomba, RG, Ayivor-Djanie, R, Njouom, R, Phillips, RO, Gorman, R, Kingsley, RA, Neto Rodrigues, RMDESA, Audu, RA, Carr, RAA, Gargouri, S, Masmoudi, S, Bootsma, S, Sankhe, S, Mohamed, SI, Femi, S, Mhalla, S, Hosch, S, Kassim, SK, Metha, S, Trabelsi, S, Agwa, SH, Mwangi, SW, Doumbia, S, Makiala-Mandanda, S, Aryeetey, S, Ahmed, SS, Ahmed, SM, Elhamoumi, S, Moyo, S, Lutucuta, S, Gaseitsiwe, S, Jalloh, S, Andriamandimby, SF, Oguntope, S, Grayo, S, Lekana-Douki, S, Prosolek, S, Ouangraoua, S, van Wyk, S, Schaffner, SF, Kanyerezi, S, Ahuka-Mundeke, S, Rudder, S, Pillay, S, Nabadda, S, Behillil, S, Budiaki, SL, van der Werf, S, Mashe, T, Mohale, T, Le-Viet, T, Velavan, TP, Schindler, T, Maponga, TG, Bedford, T, Anyaneji, UJ, Chinedu, U, Ramphal, U, George, UE, Enouf, V, Nene, V, Gorova, V, Roshdy, WH, Karim, WA, Ampofo, WK, Preiser, W, Choga, WT, Ahmed, YA, Ramphal, Y, Bediako, Y, Naidoo, Y, Butera, Y, de Laurent, ZR, Ouma, AEO, von Gottberg, A, Githinji, G, Moeti, M, Tomori, O, Sabeti, PC, Sall, AA, Oyola, SO, Tebeje, YK, Tessema, SK, de Oliveira, T, Happi, C, Lessells, R, Nkengasong, J, and Wilkinson, E

Abstract

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century.

Published
2022

24. Recombinant BCG expressing the leishmania surface antigen Gp63 induces protective immunity against Leishmania major infection in BALB/C mice

Author

Abdelhak, S., Louzir, H., Timm, J., Blel, L., Benlasfar, Z., Lagranderie, M., Gheorhiu, M., Dellagi, K., and Gicquel, B.

Subjects
Leishmaniasis -- Care and treatment, BCG vaccines -- Innovations, Cloning -- Analysis, Biological sciences
Abstract

The recombinant bacillus of Calmette and Guerin (BCG) vaccine effectively provides protection against Leishmania major in immunized BALB/c mice. The recombinant vaccine was developed by cloning and expressing the gp63 gene of Leishmania major in BCG under the influence of two microbial expression systems. The capability of recombinant BCG to decrease lesion development does not depend on the mode of vaccination. The experimental set up of the development of the recombinant BCG vaccine is discussed.

Published
1995

30. Biogeography of Leptospira in wild animal communities inhabiting the insular ecosystem of the western Indian Ocean islands and neighboring Africa

Author

Dietrich, Muriel, Gomard, Y., Lagadec, E., Ramazindrazana, B., Le Minter, G., Guernier, V., Benlali, A., Rocamora, G., Markotter, W., Goodman, S.M., Dellagi, K., and Tortosa, P.

Subjects
animal diseases
Abstract

Understanding the processes driving parasite assemblages is particularly important in the context of zoonotic infectious diseases. Leptospirosis is a widespread zoonotic bacterial infection caused by pathogenic species of the genus Leptospira. Despite a wide range of animal hosts, information is still lacking on the factors shaping Leptospira diversity in wild animal communities, especially in regions, such as tropical insular ecosystems, with high host species richness and complex biogeographical patterns. Using a large dataset (34 mammal species) and a multilocus approach at a regional scale, we analyzed the role of both host species diversity and geography in Leptospira genetic diversity in terrestrial small mammals (rodents, tenrecs, and shrews) and bats from 10 different islands/countries in the western Indian Ocean (WIO) and neighboring Africa. At least four Leptospira spp. (L. interrogans, L. borgpetersenii, L. kirschneri, and L. mayottensis) and several yet-unidentified genetic clades contributed to a remarkable regional Leptospira diversity, which was generally related to the local occurrence of the host species rather than the geography. In addition, the genetic structure patterns varied between Leptospira spp., suggesting different evolutionary histories in the region, which might reflect both in situ diversification of native mammals (for L. borgpetersenii) and the more recent introduction of non-native host species (for L. interrogans). Our data also suggested that host shifts occurred between bats and rodents, but further investigations are needed to determine how host ecology may influence these events.

Published
2018

36. Identification of new FANCA mutations in Tunisian patients

Author

Bouchlaka, C., Dellagi, K., and Abdelhak, S.

Subjects
Human genetics -- Research, Gene mutations -- Research, Fanconi's anemia -- Genetic aspects, Genetic disorders -- Research, Chromosome mapping -- Research, Biological sciences
Published
2001

43. Investigation of a leptospirosis outbreak in triathlon participants, Réunion Island, 2013

Author

PAGÈS, F., primary, LARRIEU, S., additional, SIMOES, J., additional, LENABAT, P., additional, KURTKOWIAK, B., additional, GUERNIER, V., additional, LE MINTER, G., additional, LAGADEC, E., additional, GOMARD, Y., additional, MICHAULT, A., additional, JAFFAR-BANDJEE, M. C., additional, DELLAGI, K., additional, PICARDEAU, M., additional, TORTOSA, P., additional, and FILLEUL, L., additional

Published
2015
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47. [Clinical spectrum of cobalamin deficiency in Tunisia]

Author

Maktouf C, Bchir F, Louzir H, Elloumi M, Ben Abid H, Mdhaffer M, Elleuch N, Meddeb B, Chokri MHIRI, Hassen Z, Makni F, Abid M, Cherif O, Rokbani L, Souissi T, Hafsia A, Dellagi K, Institut Pasteur de Tunis, Réseau International des Instituts Pasteur (RIIP), Hedi Chaker Hospital [Sfax], Hôpital Aziza Othmana, Hopital Habib Bourguiba - Habib Bourguiba Hospital [Sfax], Hopital de Razi - Razi Hospital [Tunis], and Hôpital Habib Thameur

Subjects
Adult, Aged, 80 and over, Male, Tunisia, Adolescent, neuro-psychiatric disorder, [SDV]Life Sciences [q-bio], pernicious anaemia, Infant, cobalamin deficiency, Vitamin B 12 Deficiency, Middle Aged, [SCCO]Cognitive science, Child, Preschool, Humans, Female, Prospective Studies, megaloblastic anaemia, Child, Aged
Abstract

International audience; Purpose: the aim of this study was to determine the prevalence of cobalamin (vitamin B12) deficiency in different populations of patients with clinical manifestations associated or secondary to cobalamin or folates deficiency and to analyse the demographic, clinical, paraclinical investigations in cobalamin deficient patients in Tunisia. Methods: it was a prospective (19992001) multicenter study of 604 patients divided into four groups. The first group is composed of 478 consecutive patients with anaemia and/or macrocytosis with megaloblastic haemopoiesis on bone marrow examination without myelodyslasic or malignancy signs. The second group is made up of 34 patients with unexplained neurological symptoms without the presence of anaemia. The third group was composed of 82 invidious with isolated psychiatric disorders and the 10 patients with Hashimoto thyroiditis constituted the last,group. Results: serum cobalamin level was low in 98%, 23%, 14% of cases, respectively, in the first three groups. Only one case of patients with Hashimoto thyroiditis has serum cobalamin deficiency. Pernicious anaemia (Biermer's disease) was established by dual isotope schilling examination in 103 patients among a sample of 120 serum cobalamin deficient patients (86%). The median age at presentation was 45.5 years. Severe chronic atrophic gastritis was diagnosed in 97.5% of patients with Biermer's disease. Serum antibodies against intrinsic factor and gastric parietal cells were detected in (42.5%) and (60.6%) patients, respectively; (25.5%) patients had the both types of antibodies. 23.4% patients were positive for antithyroid antibodies. Anti-nuclear antibodies were detected in 3% patients. Conclusion: an interesting finding of our study was the high frequency of cobalamin deficiency in Tunisia, particularly in relative young patients. Our patients had classic features of florid cobalamin deficiency (severe haematological manifestations and neuro-psychiatric disorders). The main underlying causes of such deficiencies were Biermer's disease. Subtle clinical manifestations should be recognized and investigated even in young patients at risk.; Objectif : déterminer la prévalence des déficits en cobalamines (vitamine B12) chez différentes populations de patients présentant des manifestations cliniques pouvant être associées ou secondaires à un déficit en vitamine B12 ou en folates et analyser les données démographiques, cliniques et paracliniques chez les patients déficitaires en vitamine B12 en Tunisie. Méthodes : il s’agissait d’une étude prospective (1999-2001), multicentrique, incluant 604 patients répartis en quatre groupes : le premier groupe comportait 478 patients consécutifs présentant une hématopoïèse mégaloblastique sans signe de myélodysplasie avec ou sans anémie. Le deuxième groupe était composé de 34 patients présentant un tableau neurologique inexpliqué sans anémie mégaloblastique associée. Le troisième groupe était constitué de 82 individus présentant des manifestations psychiques isolées. Le quatrième groupe comportait dix patients ayant une thyroïdite d’Hashimoto. Résultats : le taux des cobalamines sériques était bas dans 98 %, 23 %, 14 % des cas, respectivement, des trois premiers groupes, alors qu’un seul patient du quatrième groupe était déficitaire en vitamine B12. Le test de Schilling réalisé chez un échantillon de 120 patients déficitaires en cobalamines a montré que 103 patients (86 %) étaient atteints par la maladie de Biermer. Ils avaient une médiane d’âge de 45,5 ans ; 97,5 % d’entre eux avaient une gastrite fundique atrophique sévère. L’Helicobacter pylori a été détecté chez seulement 5 parmi les 43 patients où il a été histologiquement recherché. Le bilan auto-immun chez ces patients montre : anticorps anti-cellules pariétales : 60,6 % ; anticorps anti-facteur intrinsèque : 42,5 % ; concordance entre les 2 anticorps : 48% ; anticorps anti-thyroïdiens : 23,4 % (2 % chez les témoins normaux) ; anticorps anti-nucléaire : 3 %. Conclusion : notre travail souligne la fréquence élevée des déficits en vitamine B12 en Tunisie particulièrement chez les sujets relativement jeunes. Nos patients présentaient un tableau clinique des formes florides des déficits en cobalamines (manifestations hématologiques sévères et troubles neuropsychiatriques). La cause principale sous-jacente de ces déficits était la maladie de Biermer. Les formes cliniques frustes méritent d’être recherchées et explorées même chez les sujets jeunes à risque.

Published
2006
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