Background and Aims: In Ivoirian's school, the management of vaso-occlusive painful crisis in sickle cell disease requires non steroidal anti inflammatory drugs (NSAIDs). Although their effectiveness, these drugs may be accompanied by intolerance reactions. When these occur, no codified alternative therapeutic seems to be used to our knowledge. Authors aimed to evaluate the induction of tolerance to NSAIDs as an effective alternative therapeutic. Methods: 22 patients (15 men and 7 women aged from 12 to 39 years with mean age: 22.41 ± 7.88) suffering from vaso-occlusive painful crisis were enrolled. They were known to have a history of sickle cell disease and at least one episode of adverse reactions following the Ibuprofen or Diclofenac intake. A rapid protocol of oral challenge was used in patients to induce tolerance to NSAIDs. The first day, initial doses (8.82 mg for Ibuprofen and 2.20 mg for Diclofenac) were given and gradually increased at intervals of 1 hour over a total period of 6 hours. On the second and third days, the therapeutic dose has been orally administrated with an interval of 6 hours over a period of 12 hours. Results: Despite of some cases of failure that might be related to the severity of symptoms or possible patho-physiological mechanism, more than 80% of patients have successfully tolerated Diclofenac and Ibuprofen. Conclusion: This experience appears to be the first in our context. It might be used as a solution in the lack of alternative therapeutic in the management of vaso-occlusive painful crisis of sickle cell disease as well as in other diseases such as HIV infection where patients often develop intolerance to none alternative antibiotics.

To conduct a study project on the inactivation of pathogens in whole blood using acridine derivatives in Africa, in order to prevent the transmission of pathogens, it is important to look for possible immunization to acridine in the blood donor population. It is therefore important to undertake an estimate of the prevalence in the sub-Saharan population in order to guide the design of the clinical study that will use the INTERCEPT Red Blood System procedure on whole blood for transfusion. to define the starting point in the evaluation of the immunological safety and transfusion safety of the product treated by this process. The objective of this study is to determine the prevalence of AAA among blood donors in sub-Saharan Africa. We conducted a multicenter prospective descriptive study of 902 blood donors collected in Côte d'Ivoire, Benin and Cameroon over the period from June 2015 to January 2017. Blood samples were collected from voluntary blood donors, of any sex, aged between 18 and 65, having given their consent for the study and having participated in the medical consultation for the donation of blood. The samples were analyzed according to the technique of the RAI gel card of the company BIORAD after centrifugation and incubation using test red cells treated with S-303 and glutathione. In the case of positive RAI results, to confirm the presence of anti-acridine, the donor plasma should be incubated with S-300. S-300 is a degradation product of S-303. The donor serum and S-300 are then incubated with the same red test cells. S-300 binds to the antibody and produces a negative result in the gel map in the presence of anti-acridin antibodies. Of the 903 samples tested both at the Abidjan laboratory in Côte D'Ivoire and at the Frankfurt laboratory, we found 1 positive sample and 8 reactive samples (positive for anti-erythrocyte antibodies). Positive donor plasma was incubated with S-300 which is the degradation product of S-303. The result is always positive, whereas according to the instructions of the reference laboratory of Frankfurt, it should be negative in case of presence of Locustacan. The results on AAA testing among 903 donors in three sub-Saharan countries show the absence of AAA in the sample of subjects included in the study according to the hypothesis emitted from this study. This opens the door to the prospect of conducting a clinical study on the inactivation of pathogens by acridine derivatives.

A part from any incompatible blood transfusion, anti-erythrocyte alloimmunization is observed to pregnant women. It is the result of the passage of red blood cells carrying antigens different from those of the mother during pregnancy and delivery. The Rhesus D system is the most involved; but there are also other systems involved in this alloimmunization. Non-transfusion alloimmunization is an extremely rare event in the order of 1 of 4000 to women in Europe and in most cases concerns the Rhesus D. In sub-Saharan Africa, there are no statistics collected on foeto-maternal alloimmunization. As part of our postgraduate thesis on the sensitization status of red blood cells to acridine, we used the technique of looking for irregular agglutinins. The goal was to find anti-erythrocyte alloimmunization to blood donors in sub-Saharan Africa. We conducted a two-year multicenter prospective and descriptive study of 903 blood donors in Côte d'Ivoire, Benin and Cameroon. The samples were analyzed in the laboratories of the National Blood Transfusion Center of Côte D'Ivoire and Frankfurt according to the technique of the RAI gel card of the BIORAD company after centrifugation and incubation using test red cells treated with S-303. In the case of a positive reaction, identification is made by a panel of red blood cells in the different blood group systems. In our study population, there is a male predominance with a male/female ratio of 7.42. We found a very low prevalence of alloimmunization to non-transfused blood donors (0.9% or 8 cases out of 902). 4 anti-erythrocyte antibodies have been identified (1 Ac anti D and 3 AC anti S); 2 pan-agglutination, 2 unidentified Ac (insufficient serum) and suspicion of anti-glutathione. Anti-erythrocyte alloimmunization to sub-Saharan Africa blood donor is about 0.9% in our series. It remains high compared to European data. This alloimmunization is mainly observed to women with low frequency antigens to black peoples.

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Justification: In the problematic of protection against severe forms of malaria, premunition has often been mentioned as a protective factor acquired in adults at the cost of multiple infections for several years. Exploration of the cellular component of anti-parasite immunity in uncomplicated malaria will provide comparisons of evidence that, despite relative protection, 2 to 3% of adults living in the endemic zone are victims of severe malaria. Main objective: The objective was to evaluate the role of the innate cellular response in susceptibility to uncomplicated malaria in subjects older than 15 years. Patients and Methods: It was a prospective study with descriptive and analytical purpose that took place at Koumassi General Hospital for simple malaria patients and the NBTC for witnesses. All blood samples were analyzed in the Immunology and Hematology Laboratory of CHU de Cocody. It included 50 patients (25 patients with malaria and 25 witnesses) of both sexes, over a 3-month period. The samples carried were processed in the said-laboratory. Results: The average age of our patients was 35 years. The mean of NK cells were 45 cells/mm 3 in patients and 154.64 cells/ mm 3 in witness persons. The risk of not seeing a simple malaria when the number of NK cells is high was 9.03. The PPV was 88.88% and the NPV was 62.6%. The mean parasitemia in patients was 1840 trophozoites/μL. The influence of NK cells on parasitemia was undetermined with a PPV at 1% and a NPV at 39.13%. Conclusion: Susceptibility to simple malaria is a multifactorial phenomenon in which the immune response plays a central role. The evolution towards this clinical state will have to be studied with all the other cellular actors to better appreciate the role of NK cells during its evolution.