Medecine tropicale et sante internationale最新文献

An experiment was carried out in 1985-87 against schistosomiasis using products neutralizing the intermediate stages of schistosomes. In the laboratory, it had been shown that lauryl betaines, amphoteric substances, used for children's shampoos, quickly immobilized miracidiums and cercariae. Studies in Niger in field conditions with water laden with organic matter gave similar results. This surfactant can be incorporated into ordinary soaps at a dose of 5% without changing their characteristics. Betaine soaps were put on sale in ordinary commercial channels in Niger then in Côte d'Ivoire, in hyperendemic villages for Schistosoma haematobium. Betaines diffused without external intervention into the water used by populations for washing. The soaps were well accepted by these populations. However, after one year, the results in tested villages compared to control ones were unclear on the dynamics of urinary schistosomiasis in terms of prevalence and oviuria. Anti-schistosome treatment seems necessary at the start of the procedure. The use of soap by populations needed to be measured. In conclusion, this promising laboratory action deserves to be evaluated again in the field, in addition to health education and systematic treatment actions.

Zika virus infection, most oft n responsible for a benign arboviral disease or an asymptomatic infection, rarely Guillain-Barré syndrome, can become problematic in pregnant women, due to a risk of fetal malformations, in particular microcephaly linked to its neurotropism. The most recent large-scale epidemic was observed throughout Latin America between 2015 and 2017, causing several hundred thousand cases. Transmission is predominantly vector-borne, but sexual transmission has been described, mainly among travelers, although it undoubtedly accounts for a significant proportion of transmission in epidemic areas. The aim of this review is to describe this sexual transmission, mainly through examples linked to this large-scale epidemic in Latin America, to describe the link with prolonged excretion of infectious viral particles in genital secretions, especially semen but also vaginal secretions, and to highlight possible preventive measures apart from vector transmission, in particular the need for pregnant women or women wishing to become pregnant to avoid visiting countries where circulation of Zika virus is described.

Introduction: Despite the existence of well codified indications, the performance of mutilating surgery in ophthalmology is not an easy decision to take due to the aesthetic and moral damages that patients may suffer. This surgery should be considered as a last resort in the case of a non-functional, painful and unsightly eye or in the presence of an oncological involvement and after all conservative alternatives have been exhausted. This study aims to define the factors making it possible to favor ocular evisceration, which is the least mutilating of the above-mentioned surgeries, by determining the epidemiological and clinical aspects of the patients. In addition, the results of the study will serve as a starting point for epidemiological surveillance and will guide preventive activities and the fight against blindness.

Material & method: We conducted an exhaustive retrospective study of medical records from the archives of the ophthalmology departments of the Dr. Tidjani Damardji University Hospital Center in Tlemcen, the Specialized Hospital Establishment in ophthalmology of Oran Hamou Boutlelis, the Specialized Hospital Establishment in ophthalmology of Oran Front de mer and the University Hospital Center of Bejaia (unit Franz Fanon), in order to specify the epidemiological-clinical profile of patients who have undergone an ocular evisceration in the north of Algeria from January 1, 2008 to December 31, 2014.

Results & discussion: We have identified 136 patients, representing an admission rate of 0,13% in all these services. We noted a slight male predominance with an estimated sex-ratio of 1.4. Evisceration was carried out mainly following an ocular trauma in 39% of cases. The surgical technique performed in all patients is a classic non-conservative evisceration of "four quadrants" or "four squares" under general anesthesia in 55.9% of cases. Post-operative complications were found in 19.8% of patients in our series, the main one being exteriorization of the intra-scleral implant in 9.5% of cases. This rate corresponds to the data in the literature, with figures between 0 and 67%. This complication may be in relation with the experience or even the competence of the surgeon. Accessibility to ocularists and the quality of prosthetic equipment were also studied. All the data collected were compared with data from the international medical literature. Our study carried out in the north of Algeria on ocular eviscerations, allowed us to deduce that this surgery is rarely carried out in ophthalmology. Its main indications are post-traumatic and post-infectious.

Conclusion: The prevention of mutilating surgeries requires early diagnosis and appropriate treatment of ophthalmological pathologies and trauma. Losing an eye is always experienced as a tragedy and can be devastating at any age, affecting self-image and self-esteem. Psychological support is therefore

Introduction: Surgical campaigns for thyroid surgery in low-income environments are very efficient, but there is little literature reporting results. These campaigns are complex due to multiple particularities: highly evolved cases, the need for professionals to travel or an obvious socio-cultural barrier influence towards the surgical act. We describe a surgical campaign in Cameroon to treat patients with goiter and issue some medical and sociocultural recommendations in view of our experience for its implementation with guarantees.

Material and methods: An experienced group carried out an 11-day campaign at the Saint Martin de Porres Dominican Hospital, Yaounde, Cameroon. Demographic data, TSH values, surgery and complications after a 12-month follow-up were analyzed.

Results: Thirty-eight patients with goiter were selected for the campaign and 32 patients (mean age, 40-years-old; 30 females) were operated. Bilateral goiter, as assessed with echography, was diagnosed in 13 patients (41%). Ten patients (31%) had a WHO grade II goiter (visible with the neck in a normal position). The surgical procedures were 18 unilateral thyroidectomy with isthmectomie, 13 total thyroidectomy, and 1 totalizing thyroidectomy, due to previous unilateral thyroidectomy (cancer recurrence). A pathological study in 13 patients (40%, extra cost 60 €) showed benign multinodular goiter/thyroid nodule (12 patients) and an extensive papillary carcinoma (one patient). Six months postoperatively, 3 patients had a slight dysphonia and one patient had persistent hypocalcemia. Follow-up was completed in all patients, either face to face (75%, 24 patients) or by phone (25%, 8 patients who failed to have a TSH test because of its cost, 23 €).

Conclusions: Surgical campaigns to treat thyroid pathology can be carried out with guarantees if a series of important steps are followed: active participation of the patient's environment, thyroid ultrasound by the surgical team to decide which technique, intense awareness about monitoring and hormone replacement therapy, and the participation of local personnel for long-term follow-up.

Background and justification: The Republic of Djibouti is located in the Horn of Africa, on the Gulf of Aden and the Bab-el-Mandeb detroit, at the southern entrance to the Red Sea. Prior to its independence in 1977, the Republic of Djibouti was known by two names: "Côte française des Somalis" until 1967, then "Territoire Français de Afars et Issas". As part of our doctoral research on the ecology of mosquitoes in Djibouti, we noted a lack of information on the species encountered, and felt it essential to draw up a list of species before embarking on ecological monitoring. The aim of this work is to survey publications on mosquitoes in Djibouti and to synthesize data from this scientific literature in order to update the national inventory of Culicidae.

Materials and methods: An exhaustive search of electronic bibliographic databases (PubMed, Scopus, HAL Open Archive, Science Direct and Google Scholar) was carried out. Reference lists were filtered to access additional articles in order to obtain more data. Two keywords were used: "Djibouti" and "French Territory of Afars and Issas". A selection of scientific publications on Djibouti mosquitoes and/or diseases transmitted by mosquito vectors was made. Researches were conducted in articles selected. The names of the species listed were checked and validated by referring to the site Mosquito Taxonomic Inventory.

Results: A total of 13 studies, published between 1970 and 2023, were found. Over the years, the composition of the Culicidae fauna has become well known. In part, the movement of people traveling to and from neighboring countries has been linked to the detection of new species and the reappearance of mosquito species in Djibouti. Numerous studies have been carried out over the years, including purely taxonomic studies and others focusing on the incrimination of mosquito vectors and the characterization of the pathogens they transmit. A total of 37 species, belonging to two subfamilies (Anophelinae and Culicinae), of mosquitoes divided between 7 genera (Aedes, Anopheles, Culex, Culiseta, Lutzia, Mimomyia and Uranotaenia) have been mentioned across the country. The number of species per genus is distributed as follows: 5 species of Aedes including 1 subspecies, 14 species of Anopheles including two subspecies, 12 species of Culex including 1 subspecies, 1 species for each of the genera Culiseta and Lutzia and finally 2 species respectively for the genera Mimomiya and Uranotaenia. Five species have been incriminated as vectors of diseases such as malaria, dengue fever, yellow fever, West Nile virus and chikungunya. Others are known for their potential role in pathogen transmission, including Zika and Rift Valley virus.

Discussion - conclusion: The bibliographical research enabled us to summarize the research carried out over more than half a c

Background and rationale: Breastfeeding is considered the best nutrition for infants and plays a significant role in a child's growth and development. In this regard, the World Health Organization (WHO) strongly recommends exclusive breastfeeding for the first 6 months of life, as well as continued breastfeeding when safe and appropriate complementary foods are introduced, up to 2 years of age or beyond. Nonetheless, breastfeeding practices remain sub-optimal in many parts of the world. In this respect, many children have shown not to be breastfed up to 6 months of age or are not breastfed during their first hours of life or are weaned too early. This allows for the use of infant formula, which can be life threatening due to poor hygiene, storage conditions or inappropriate foods. Likewise, breastfeeding rates in the Middle East and North Africa (MENA) region are lower than the global average. In Algeria, the breastfeeding rate up to 6 months of age is among the lowest in the world according to previous Multiple Indicators Cluster Surveys (MICS) reports. In addition, by the end of the sixth month, the percentage of children exclusively breastfed is less than 3% and only 23% of children receive breast milk at 22-23 months. The median duration of breast-feeding is 12 weeks. However, the socio-demographic factors associated with this sub-optimal breastfeeding practice are not explored in these reports, as studies and research conducted in this context using other data are few and mostly conducted in limited geographical areas.

Materials and methods: This stands for a descriptive cross-sectional study of all children who were breastfed in the MICS database, carried out in 2019, 8 709 children, including 4 471 boys and 4 238 girls, registered in the database. To explore factors associated with the duration of breastfeeding, we only included weaned children to minimize bias related to children who were still breastfeeding. This allowed to analyze data from 3 761 children, including 1 930 boys (5.4%) and 1,831 girls (48.6%). Through using a logistic regression model, we could attain the assessment of the role of different socio-demographic, economic and geographical factors in the maintenance of breastfeeding beyond 6 months.

Results: The prevalence of breastfeeding is 81.1%; the rate of exclusive breastfeeding of children aged 0-6 months is 28.7%. The factors associated with breastfeeding beyond six months are area of residence, mother's occupational status and wealth quintile. In fact, rural area appears to be a factor favoring the continuation of breastfeeding beyond six months, compared with urban area (OR = 1.29; CI [1.032-1.369]). Mothers living in the Eastern Highlands geographic region appear to be 1.56 times more likely to maintain breastfeeding for more than six months compared to those living in the Southern region (OR = 1.56; CI [1.123 - 1.677]). Children of non-working mother

Background - rationale: Tsetse flies (Diptera: Glossinidae) are obligate bloodfeeders that occur exclusively in Sub-Saharan Africa, where they are the vectors of trypanosomes causing HAT (human African trypanosomiasis) and AAT (African animal trypanosomiasis). In Chad, tsetse flies occur only in the most southern part of the country because of its favorable bioclimatic conditions. However, despite the importance of HAT and AAT in this country, very little is known about the current tsetse distribution, in particular its northern limit, which is of key importance for the surveillance of these diseases.

Material and methods - results: A total of 217 biconical traps were deployed in 2021 and 2022 from the West to the East around the formerly known northern limit, resulting in 1,024 tsetse caught belonging to three different taxa: Glossina morsitans submorsitans (57%), G. tachinoides (39%) and G. fuscipes fuscipes (4%). In addition to the information gathered on the presence/absence of each tsetse taxon, we show a strong North-South shift of the northen tsetse distribution limit as compared to the previous works from 1966 to 1996, and a growing spatial fragmentation in more and more discrete pockets of tsetse presence.

Discussion - conclusion: This North-South shift of the northern tsetse distribution limit in Chad is the likely consequence of the combined effect of severe draughts that affected the country, and increasing human pressure on land. This update of the tsetse northern limit will be of help to the national programmes in charge of HAT and AAT.

Objective: To observe the evolution in malaria case-fatality rate among children under 5 years of age receiving care at the Bittou district hospital (CMA) after an improvement of the care practices. The management team implemented an emergency plan in 2016 with 5 components: i) health facilities staff sensitization to enable rapid referral of severe malaria cases to CMA; ii) reorganization of CMA paediatric emergencies to make a physician as the mainpoint of contact; iii) ensuring availability of supplies for severe malaria case management, including the availability of blood; iv) daily medical check-ups of hospitalized patients; v) reinforcement of clinical staff skills at all peripheral health facilities. At the same time were introduced i) free care for children under 5 years; ii) municipality involvement to finance ambulance fuel for the referrals of patients; iii) free blood collection in professional schools and soldiers; iv) a free telephone line between the health structures; v) presence of 5 medical doctors at the CMA.

Material and methods: Analysis of data collected from the statistical yearbooks of the Ministry of Health of Burkina Faso from 2014 to 2021.

Results: The malaria case-fatality rate (CFR) in under-five in the Bittou health district (1.39% and 1.52% in 2014 and 2015) was higher than the average for all districts in this region (1.08%). After implementation of the emergency plan, the malaria CFR in Bittou declined to 0% in 2016 and 2017, 0.2% in 2018, 0% in 2019, 0.07% in 2020 and 0.05% in 2021. The same trend was observed at the CMA level with 2.94% and 2.59% in 2014 and 2015, 0% in 2016 and 2017, 0.38% in 2018, 0% in 2019, then 0.17% and 0.47% in 2020 and 2021.

Conclusion: Malaria control remains a challenge in Burkina Faso. However, the improved malaria CFRs observed in Bittou show that effective involvement of health district teams could potentially contribute to substantial reductions in malaria case-fatality risk.

Introduction: Brucellosis in marine mammals (cetacean and pinnipeds) has emerged in a very significant way during the last two decades. Currently Brucella ceti and Brucella pinnipedialis are the two recognized species in marine mammals, but available information is still limited. Several genotypes have been identified, and studies on the relationship between sequence type (ST) and organ pathogenicity or tropism have indicated differences in pathogenesis between B. ceti sequences in cetaceans. The zoonotic potential of this disease is based on the identification of the main sources of introduction and spread of Brucella spp. in the marine environment as well as on the factors of exposure of marine mammals and humans to the bacteria.

Bibliographic review: This article is a bibliographical review on marine mammal brucellosis, including the features, sources and transmission modes of each Brucella species, as well as their potential pathogenicity in animals and humans.

Conclusion: Different genotypes of marine Brucella spp have been isolated from marine mammal species but without any evidence of pathology induced by these bacteria. Associated lesions are variable and include subcutaneous abscesses, meningo-encephalomyelitis, pneumonia, myocarditis, osteoarthritis, orchitis, endometritis, placentitis and abortion. The isolation of marine B. spp from marine mammal respiratory parasites associated to lung injury has raised the intriguing possibility that they may serve as a vector for the transmission of this bacterium.The severity of marine B. spp remains unknown due to the lack of an estimate of the prevalence of this disease in marine mammals. The number of suspected human cases is still very limited. However, by analogy with other germs of the genus Brucella responsible for abortion in ruminants and for a febrile and painful state in human beings, prevention measures are essential. The significant increase in the number of strandings coupled with a high seroprevalence in certain species of marine mammals must be considered for people in direct or indirect contact with these animals. Ongoing epidemiological monitoring combined with extensive post-mortem examinations (necropsy, bacteriology and sequencing) of all species of stranded marine mammals would deepen knowledge on the zoonotic potential of marine Brucella species.