Population-Based Biochemistry, Immunologic and Hematological Reference Values for Adolescents and Young Adults in a Rural Population in Western Kenya
Identifieur interne : 000364 ( Main/Exploration ); précédent : 000363; suivant : 000365Population-Based Biochemistry, Immunologic and Hematological Reference Values for Adolescents and Young Adults in a Rural Population in Western Kenya
Auteurs : Clement Zeh [Kenya] ; Pauli N. Amornkul [Kenya] ; Seth Inzaule [Kenya] ; Pascale Ondoa [Pays-Bas] ; Boaz Oyaro [Kenya] ; Dufton M. Mwaengo [Kenya] ; Hilde Vandenhoudt [Belgique] ; Anthony Gichangi [Kenya] ; John Williamson [Kenya] ; Timothy Thomas [Kenya] ; Kevin M. Decock [Kenya] ; Clyde Hart [États-Unis] ; John Nkengasong [États-Unis] ; Kayla Laserson [Kenya]Source :
- PLoS ONE [ 1932-6203 ] ; 2011.
Abstract
There is need for locally-derived age-specific clinical laboratory reference ranges of healthy Africans in sub-Saharan Africa. Reference values from North American and European populations are being used for African subjects despite previous studies showing significant differences. Our aim was to establish clinical laboratory reference values for African adolescents and young adults that can be used in clinical trials and for patient management.
A panel of 298, HIV-seronegative individuals aged 13–34 years was randomly selected from participants in two population-based cross-sectional surveys assessing HIV prevalence and other sexually transmitted infections in western Kenya. The adolescent (<18 years)-to-adults (≥18 years) ratio and the male-to-female ratio was 1∶1. Median and 95% reference ranges were calculated for immunohematological and biochemistry values. Compared with U.S-derived reference ranges, we detected lower hemoglobin (HB), hematocrit (HCT), red blood cells (RBC), mean corpuscular volume (MCV), neutrophil, glucose, and blood urea nitrogen values but elevated eosinophil and total bilirubin values. Significant gender variation was observed in hematological parameters in addition to T-bilirubin and creatinine indices in all age groups, AST in the younger and neutrophil, platelet and CD4 indices among the older age group. Age variation was also observed, mainly in hematological parameters among males. Applying U.S. NIH Division of AIDS (DAIDS) toxicity grading to our results, 40% of otherwise healthy study participants were classified as having an abnormal laboratory parameter (grade 1–4) which would exclude them from participating in clinical trials.
Hematological and biochemistry reference values from African population differ from those derived from a North American population, showing the need to develop region-specific reference values. Our data also show variations in hematological indices between adolescent and adult males which should be considered when developing reference ranges. This study provides the first locally-derived clinical laboratory reference ranges for adolescents and young adults in western Kenya.
Url:
DOI: 10.1371/journal.pone.0021040
PubMed: 21713038
PubMed Central: 3119664
Affiliations:
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Mwaengo</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Vandenhoudt, Hilde" sort="Vandenhoudt, Hilde" uniqKey="Vandenhoudt H" first="Hilde" last="Vandenhoudt">Hilde Vandenhoudt</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Institute of Tropical Medicine (ITM), Antwerp, Belgium</addr-line></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine (ITM), Antwerp</wicri:regionArea><wicri:noRegion>Antwerp</wicri:noRegion></affiliation></author><author><name sortKey="Gichangi, Anthony" sort="Gichangi, Anthony" uniqKey="Gichangi A" first="Anthony" last="Gichangi">Anthony Gichangi</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Williamson, John" sort="Williamson, John" uniqKey="Williamson J" first="John" last="Williamson">John Williamson</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Thomas, Timothy" sort="Thomas, Timothy" uniqKey="Thomas T" first="Timothy" last="Thomas">Timothy Thomas</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Decock, Kevin M" sort="Decock, Kevin M" uniqKey="Decock K" first="Kevin M." last="Decock">Kevin M. Decock</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Hart, Clyde" sort="Hart, Clyde" uniqKey="Hart C" first="Clyde" last="Hart">Clyde Hart</name><affiliation wicri:level="2"><nlm:aff id="aff5"><addr-line>Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Nkengasong, John" sort="Nkengasong, John" uniqKey="Nkengasong J" first="John" last="Nkengasong">John Nkengasong</name><affiliation wicri:level="2"><nlm:aff id="aff5"><addr-line>Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Laserson, Kayla" sort="Laserson, Kayla" uniqKey="Laserson K" first="Kayla" last="Laserson">Kayla Laserson</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21713038</idno><idno type="pmc">3119664</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3119664</idno><idno type="RBID">PMC:3119664</idno><idno type="doi">10.1371/journal.pone.0021040</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">000187</idno><idno type="wicri:Area/Pmc/Curation">000187</idno><idno type="wicri:Area/Pmc/Checkpoint">000124</idno><idno type="wicri:Area/Ncbi/Merge">000105</idno><idno type="wicri:Area/Ncbi/Curation">000105</idno><idno type="wicri:Area/Ncbi/Checkpoint">000105</idno><idno type="wicri:Area/Main/Merge">000369</idno><idno type="wicri:Area/Main/Curation">000364</idno><idno type="wicri:Area/Main/Exploration">000364</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Population-Based Biochemistry, Immunologic and Hematological Reference Values for Adolescents and Young Adults in a Rural Population in Western Kenya</title><author><name sortKey="Zeh, Clement" sort="Zeh, Clement" uniqKey="Zeh C" first="Clement" last="Zeh">Clement Zeh</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Amornkul, Pauli N" sort="Amornkul, Pauli N" uniqKey="Amornkul P" first="Pauli N." last="Amornkul">Pauli N. Amornkul</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Inzaule, Seth" sort="Inzaule, Seth" uniqKey="Inzaule S" first="Seth" last="Inzaule">Seth Inzaule</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Centre for Global Health Research, Kenya Medical Research Institute/U.S. CDC Research and Public Health, Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Centre for Global Health Research, Kenya Medical Research Institute/U.S. CDC Research and Public Health, Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Ondoa, Pascale" sort="Ondoa, Pascale" uniqKey="Ondoa P" first="Pascale" last="Ondoa">Pascale Ondoa</name><affiliation wicri:level="3"><nlm:aff id="aff3"><addr-line>Department of Internal Medicine, Center for Infection and Immunity (CINIMA), Center for Poverty-Related Communicable Diseases (CPCD), Academic Medical Center, Amsterdam Institute for Global Health and Development (AIGHD), University of Amsterdam, Amsterdam, The Netherlands</addr-line></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Internal Medicine, Center for Infection and Immunity (CINIMA), Center for Poverty-Related Communicable Diseases (CPCD), Academic Medical Center, Amsterdam Institute for Global Health and Development (AIGHD), University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Oyaro, Boaz" sort="Oyaro, Boaz" uniqKey="Oyaro B" first="Boaz" last="Oyaro">Boaz Oyaro</name><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>Centre for Global Health Research, Kenya Medical Research Institute/U.S. CDC Research and Public Health, Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Centre for Global Health Research, Kenya Medical Research Institute/U.S. CDC Research and Public Health, Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Mwaengo, Dufton M" sort="Mwaengo, Dufton M" uniqKey="Mwaengo D" first="Dufton M." last="Mwaengo">Dufton M. Mwaengo</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Vandenhoudt, Hilde" sort="Vandenhoudt, Hilde" uniqKey="Vandenhoudt H" first="Hilde" last="Vandenhoudt">Hilde Vandenhoudt</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Institute of Tropical Medicine (ITM), Antwerp, Belgium</addr-line></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Institute of Tropical Medicine (ITM), Antwerp</wicri:regionArea><wicri:noRegion>Antwerp</wicri:noRegion></affiliation></author><author><name sortKey="Gichangi, Anthony" sort="Gichangi, Anthony" uniqKey="Gichangi A" first="Anthony" last="Gichangi">Anthony Gichangi</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Williamson, John" sort="Williamson, John" uniqKey="Williamson J" first="John" last="Williamson">John Williamson</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Thomas, Timothy" sort="Thomas, Timothy" uniqKey="Thomas T" first="Timothy" last="Thomas">Timothy Thomas</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Decock, Kevin M" sort="Decock, Kevin M" uniqKey="Decock K" first="Kevin M." last="Decock">Kevin M. Decock</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author><author><name sortKey="Hart, Clyde" sort="Hart, Clyde" uniqKey="Hart C" first="Clyde" last="Hart">Clyde Hart</name><affiliation wicri:level="2"><nlm:aff id="aff5"><addr-line>Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Nkengasong, John" sort="Nkengasong, John" uniqKey="Nkengasong J" first="John" last="Nkengasong">John Nkengasong</name><affiliation wicri:level="2"><nlm:aff id="aff5"><addr-line>Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Global AIDS Program, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Laserson, Kayla" sort="Laserson, Kayla" uniqKey="Laserson K" first="Kayla" last="Laserson">Kayla Laserson</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>U.S. Centers for Disease Control and Prevention (CDC-Kenya), Kisumu</wicri:regionArea><wicri:noRegion>Kisumu</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>There is need for locally-derived age-specific clinical laboratory reference ranges of healthy Africans in sub-Saharan Africa. Reference values from North American and European populations are being used for African subjects despite previous studies showing significant differences. Our aim was to establish clinical laboratory reference values for African adolescents and young adults that can be used in clinical trials and for patient management.</p></sec><sec><title>Methods and Findings</title><p>A panel of 298, HIV-seronegative individuals aged 13–34 years was randomly selected from participants in two population-based cross-sectional surveys assessing HIV prevalence and other sexually transmitted infections in western Kenya. The adolescent (<18 years)-to-adults (≥18 years) ratio and the male-to-female ratio was 1∶1. Median and 95% reference ranges were calculated for immunohematological and biochemistry values. Compared with U.S-derived reference ranges, we detected lower hemoglobin (HB), hematocrit (HCT), red blood cells (RBC), mean corpuscular volume (MCV), neutrophil, glucose, and blood urea nitrogen values but elevated eosinophil and total bilirubin values. Significant gender variation was observed in hematological parameters in addition to T-bilirubin and creatinine indices in all age groups, AST in the younger and neutrophil, platelet and CD4 indices among the older age group. Age variation was also observed, mainly in hematological parameters among males. Applying U.S. NIH Division of AIDS (DAIDS) toxicity grading to our results, 40% of otherwise healthy study participants were classified as having an abnormal laboratory parameter (grade 1–4) which would exclude them from participating in clinical trials.</p></sec><sec><title>Conclusion</title><p>Hematological and biochemistry reference values from African population differ from those derived from a North American population, showing the need to develop region-specific reference values. Our data also show variations in hematological indices between adolescent and adult males which should be considered when developing reference ranges. This study provides the first locally-derived clinical laboratory reference ranges for adolescents and young adults in western Kenya.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Esparza, J" uniqKey="Esparza J">J Esparza</name></author><author><name sortKey="Osmanov, S" uniqKey="Osmanov S">S Osmanov</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jaoko, W" uniqKey="Jaoko W">W Jaoko</name></author><author><name sortKey="Nakwagala, Fn" uniqKey="Nakwagala F">FN Nakwagala</name></author><author><name sortKey="Anzala, O" uniqKey="Anzala O">O Anzala</name></author><author><name sortKey="Manyonyi, Go" uniqKey="Manyonyi G">GO Manyonyi</name></author><author><name sortKey="Birungi, J" uniqKey="Birungi J">J Birungi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Unaids" 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(États-Unis)</li><li>Hollande-Septentrionale</li></region><settlement><li>Amsterdam</li></settlement></list><tree><country name="Kenya"><noRegion><name sortKey="Zeh, Clement" sort="Zeh, Clement" uniqKey="Zeh C" first="Clement" last="Zeh">Clement Zeh</name></noRegion><name sortKey="Amornkul, Pauli N" sort="Amornkul, Pauli N" uniqKey="Amornkul P" first="Pauli N." last="Amornkul">Pauli N. Amornkul</name><name sortKey="Decock, Kevin M" sort="Decock, Kevin M" uniqKey="Decock K" first="Kevin M." last="Decock">Kevin M. Decock</name><name sortKey="Gichangi, Anthony" sort="Gichangi, Anthony" uniqKey="Gichangi A" first="Anthony" last="Gichangi">Anthony Gichangi</name><name sortKey="Inzaule, Seth" sort="Inzaule, Seth" uniqKey="Inzaule S" first="Seth" last="Inzaule">Seth Inzaule</name><name sortKey="Laserson, Kayla" sort="Laserson, Kayla" uniqKey="Laserson K" first="Kayla" last="Laserson">Kayla Laserson</name><name sortKey="Mwaengo, Dufton M" sort="Mwaengo, Dufton M" uniqKey="Mwaengo D" first="Dufton M." last="Mwaengo">Dufton M. Mwaengo</name><name sortKey="Oyaro, Boaz" sort="Oyaro, Boaz" uniqKey="Oyaro B" first="Boaz" last="Oyaro">Boaz Oyaro</name><name sortKey="Thomas, Timothy" sort="Thomas, Timothy" uniqKey="Thomas T" first="Timothy" last="Thomas">Timothy Thomas</name><name sortKey="Williamson, John" sort="Williamson, John" uniqKey="Williamson J" first="John" last="Williamson">John Williamson</name></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Ondoa, Pascale" sort="Ondoa, Pascale" uniqKey="Ondoa P" first="Pascale" last="Ondoa">Pascale Ondoa</name></region></country><country name="Belgique"><noRegion><name sortKey="Vandenhoudt, Hilde" sort="Vandenhoudt, Hilde" uniqKey="Vandenhoudt H" first="Hilde" last="Vandenhoudt">Hilde Vandenhoudt</name></noRegion></country><country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Hart, Clyde" sort="Hart, Clyde" uniqKey="Hart C" first="Clyde" last="Hart">Clyde Hart</name></region><name sortKey="Nkengasong, John" sort="Nkengasong, John" uniqKey="Nkengasong J" first="John" last="Nkengasong">John Nkengasong</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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