The surveillance of viral hepatitis B and C in Lao PDR : from routine analysis toward to research of biomarkers by metabolomics methods ; Surveillance des hépatites virales B-C au Laos : de l'analyse de routine à la recherche de biomarqueurs par métabolomique

Abstract

The work presented in this thesis reflects many years of effort to devoted the implementation of quality diagnostics of viral hepatitis in Laos at the Centre d'infectiologie Lao Christophe Mérieux (CILM), of which I am now the scientific director. In the introduction, we wanted to present the socio-economic characteristics of Laos and its health challenges in order to achieve the Millennium Development Goals (MDG), which guide public policies in developing countries. We felt it was important to highlight these points as well as the presentation of the CILM to help the readers to understand the context in which this work was carried out. It is thanks to a bio-bank with more than 7,000 biological samples from patients infected with viral hepatitis B and C viruses, that we were able to ask the key research question of this thesis: What is the evolution of patients infected by viral hepatitis B/C who have been follow the viral load at CILM for the past ten years or so? This question raised a second one concerning the quality of diagnosis in health centres in Vientiane. For example, we were interested in the rapid diagnostic kits for hepatitis B used in Vientiane's health facilities, compared to the standard used in our laboratory. This work, which has resulted in the publication of 2 articles (a third article has been submitted), plays a crucial role for the country, as it provides Laotian public health authorities with a focus for action to combat this scourge. ; Les travaux exposés dans cette thèse sont le reflet d'années d'efforts consacrées à la mise en place de diagnostics de qualités des hépatites virales au Laos au sein du Centre d'infectiologie Lao Christophe Mérieux (CILM), dont je suis aujourd'hui la directrice scientifique. En introduction, nous avons tenu à présenter les caractéristiques socio-économiques du Laos et ses défis sanitaires pour atteindre les Millennium Development Goals, qui guident les politiques publiques de pays en situation de développement. Nous avons jugé important de souligner ces ...