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Structural abnormalities in erythrocyte membrane are more and more claimed as a determinant factor in the sickle cell disease pathogenesis. This being would have been provided by a new anionic phospholipids distribution and conformation. Phosphatidyl-serine exposing and phosphatidic acid enhancing would induce specific immunoglobulins synthesis. In this study, assessment of antiphospholipid antibodies prevalence was carried out among sickle cell trait patients (n = 35) and homozygous patients (n = 59) as compared to healthy subjects (n = 39). Antiphospholipid antibodies, assayed by ELISA procedure, were significantly higher among the homozygous patients than the sickle cell trait patients ones and highlighted as compared to healthy subjects. Pathologic data were only observed among homozygous patients. These specific antibodies, associated with thrombosis and haemolysis, would have constitute a morbid link and a therapeutic target of this sickness, dominated by homodynamic troubles.

The sickle cell disease pathophysiology is provided by several events including deoxyhemoglobin S polymerization and hemorrheological troubles. Classically, such disorders have been known to concern only the homozygous SS and heterozygous SC profiles. However, troubles are more and more described since early years in the sickle cell trait patients and the pathogenesis factors are unknown. Our study focussed on phospholipids which are the basic and functional constituent elements of erythrocyte plasmic membrane. Assaying the membrane lipids extracted by Folch method and lipid standards (cholesterol, phosphatidic acid, lysophosphatidyl-choline, phosphatidyl-choline, lysophosphatidyl-ethanolamine, phosphatidyl-ethanolamine, sphingomyelin) was carried out by HPLC among 91 sickle cell trait patients as compared to 78 healthy subjects. The main abnormalities observed were an empoverishement in phosphatidyl-choline contrasting with an accumulation of membrane lysophosphatidyl-choline, lysophosphatidyl-ethanolamine, phosphatidic acid and sphingomyelin in sickle cell patients. These results suggest that sickle cell trait harmlessness is not actual. The accumulation of lysophosphatidyl-choline, by its cytolytic biomembrane perturbing properties, predispose therefore the sickled red cell to the haemolysis phenomena and allow to forecast deeper disturbances among homozygous subjects. These morbid disorders attributable to lipid peroxidation would justify an antioxidant treatment during the sickle cell disease.

In Senegal, nephrotic syndrome usually occurs upon malnutrition that confers it its specificity and has brought us to establish the proteinic profile of Senegalese children suffering from it, in the aim to improve its treatment. Twenty children on the average of six years, hospitalized for nephrotic syndrome, were chosen. They were compared to 20 healthy children of the same age group, and 20 other children hospitalized for a non-renal inflammatory syndrome. For each subject were dosed total blood proteins and albumin. The protein electrophoresis has permitted to evaluate the alpha-1, alpha-2, beta and gamma globulins. We have observed predominance of boys with a 2.33 sex ratio. Our patients presenting a nephrotic syndrome were about six years old; no case has been noted before two years. Total proteins and albumin have decreased respectively to 52.10 g/l and 16 g/l. This diminishing is essentially linked to the massive urinary escape of plasmatic proteins and would explain partly the increase of lipids. The alpha-1 globulins were equally lowered but the alpha-2 globulins were increased by 40% of total proteins. Beta globulins have decreased, following the evolution of gamma globulins. In Senegal, The early age of nephrotic syndrome occurrence and the biological perturbations of the proteinic profile, recommend global and quick treatment considering food recovery and nutrition. The correction of these parameters being able to constitute in one hand an element of accessible and reliable supervision, and one the other hand the basis of complete treatment.

Iodine deficiency disorders (IDD) are a major public health problem in Senegal, where strategies of salt iodization were adopted in the southern and eastern regions. The aim of this study led in four districts (Koungheul, Bambey, Mekhe and Kebemer), was to estimate by a questionnaire, the women knowleges, attitudes and practices (KAP) concerning IDD, and to measure children urinary iodine excretion by the Sandell-Kolthoff method to assess a potential deficiency. Six hundred ninety eight households were selected covering 1336 women (age 15 to 49 years) and 400 children (age 6 to 12 years). Sixty three per cent of the women knew the goiter, 89% of them considered that it was a disease and only 0.6% knew the role of iodized salt in the treatment. On the other hand, 20% of the children presented a normal range of urinary iodine excretion superior to 100 microg/l, the deficiency was light (50 to 100 microg/l) in 38% of the children, moderate (25 to 50 microg/l) in 27% and severe (< 25 microg/l) in 15% of them. These results show that other Senegalese regions are concerned by iodine deficiency disorders and need information, education and iodine supplementation programmes, notably for children and young women.

By its frequency, but also by its morbidity and mortality, sickle cell disease is a real problem of public health in Senegal. It is an inherited disease of the red blood cell, characterized by vaso-occlusive manifestations in several organs, and chronic hemolytic anemia. Out of this work carried upon subjects presenting sickle cell trait (AS), we especially studied the membrane phospholipids. The aims of this study was to identify and to measure the major phospholipids of the red blood cell membrane (lecithin, lysolecithin, cephalin, lysocephalin and sphingomyelin). We noted a significant decrease of the lecithine rates, associated with significant accumulation of lysophosphatidyl choline implied in hemolysis disorders. We have also noted a significant increase of sphingomyelin which might be involved in the adhesive phenomena of the sickle cells. These preliminary results, allow to consider eventual new therapeutics, at least to reduce the clinical disorders of this painful disease.

In the investigation of atherosclerosis, cholesterol and its fractions, triglycerides and glucose are more tested than phospholipids. We were interested by this category of lipids in Senegalese suffering from cerebrovascular disease. We did not find differences between healthy and non healthy subjects for the total phospholipids; but the high density lipoprotein phospholipids were significantly lowered in non healthy subjects. This decrease might explain in part, the atherosclerosis strike. Practicians should pay more attention in this lipidic parameter, using the reference values established in Senegalese.