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.

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Introduction: The impact of aromatic plants used in cooking on health is indisputable. This study aims to evaluate the in vitro cytotoxicity of Artemia salina, acute and the 28 days subchronic toxicity of X. aethiopica dried fruit used like spice in Togo by oral administration of the extract to female Wistar rats. Results: The A. salina assay showed that the hydroalcoholic extract of X. aethiopica presented any toxicity. The LC50 values of X. aethiopica on brine shrimp were 0.64 ± 0.13 mg/mL.  The acute toxicity study revealed neither behavioral disturbances nor death in rats. The lethal dose (DL50) of this extract is greater than 5000 mg/kg body weight. The results of subchronic toxicity showed no significant change in body and organs weight gain in rats at test doses throughout the treatment period. No changes in haematological parameters were observed apart from a significant increase in platelet number at doses of 500 and 1000 mg/kg. Biochemical parameters such as Urea, Creatinine, Triglycerides, Total cholesterol, Serum glutamic pyruvic transaminase (SGPT), C-reactive protein (CRP) and glycemia were not significantly changed. Serum glutamic oxaloacetic transaminase (SGOT) and Alkaline phosphatase (ALP) activities increased at doses of 500/1000 mg/kg and 1000 mg/kg respectively. Creatine Phosphokinase (CPK) activity decrease at the dose of 500 and 1000 mg/kg. Blood electrolytes showed no significant change. The histological sections showed no organ damage. Conclusions: Aqueous extract of X. aethiopica did not lead to any adverse effects in rats after acute and subchronic treatment at 500 and 1000 mg/kg doses.  Keywords: Xylopia aethiopica, Cytotoxicity, Toxicity, Wistar rats.

Objectives: The present study was conducted to describe and analyze antibiotic demands via prescription and non-prescription media received in private pharmacies in Lomé. Methods: A cross-sectional study was conducted in 26 private pharmacies in Lomé (Togo) from August to October 2013. The study was based on a survey conducted with a standardized questionnaire to collect data representing the daily activity of the pharmacies. Data on prescription documents, non-prescription media, patients' and prescribers' identification, and antibiotics requested were collected and analyzed. Key findings: During the study period, 596 antibiotic prescriptions were collected. Various prescription and non-prescription media permitted available antibiotic access in private pharmacies. Seventy-nine percent (79%) of the received orders contained one antibiotic. All categories of health care professionals were found among antibiotic prescribers. Prescribers were not identifiable in 40.2% of all prescription tools received for antibiotics demand. Forty-four percent (44%) of antibiotic orders were supported by a prescription. The study found that many people ordering antibiotic (61%) were not the direct users. Some elements of prescription compliance were mentioned at the rate of 82%, 44.7% and 59% (date, prescribers' identity and qualification), 3/4 of the prescription material (patients' identity and sex), more than 87% (accuracy of the dosage), 79.7% (oral route of administration) and less than 1/3 (duration of treatment). The results also indicated that Beta-lactams (41%), quinolones (17%), and 5-nitroimidazoles (15%) were the most prescribed classes of antibiotics. Conclusions: The study revealed that more than half of the antibiotics orders, received in pharmacies were non-compliant. This calls for an awareness of healthcare workers and populations on the rational use of antibiotics.

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