Medecine et sante tropicales最新文献

Since the AIDS pandemic and the demonstration that it originated in the accidental transmission of simian retroviruses to humans, no one can ignore the role of nonhuman primates in carrying pathogens that can cross the species barrier to infect humans. In recent decades, viruses as deadly as those for rabies, Herpes B, Marburg hemorrhagic fever, and Ebola have been transferred from monkeys to humans. Because great apes are genetically our closest relatives, the pathogens that colonize these mammals are probably best adapted to pass into humans should accidental exposure occur. This article attempts to evaluate the risks of infection when apes and humans share the same ecosystem.

The objective of our study was to evaluate the medico-surgical management of Buruli ulcer (BU) in the BU Screening and Treatment Center (CDTUB) of Allada in Benin. This retrospective and descriptive study retrospectively reviewed records of patients seen from 2010 to 2014 at the CDTUB of Allada. It included patients diagnosed with BU according to WHO epidemiological and clinical criteria as well as laboratory results and who were treated according to WHO medical and surgical recommendations. In all, 274 patients were diagnosed and treated, 57.7% of them children younger than 15 years. Ulcerative lesions (189, 69%) and WHO category II lesions (144, 52.5%) predominated. All patients received dual antibiotic therapy and 43.4% (119) underwent surgery as well. Category III lesions and multifocal lesions required more surgery, whereas most category I lesions healed under medical treatment. The overall rate of healing was 92%: 53.3% for patients who received only antibiotic therapy and 38.7% for those who also had surgery. The median healing time was 13 weeks and ranged from 4 to 56 weeks. In the CDTUB of Allada, between 2010 and 2014, most patients were treated with antibiotic therapy alone, but a significant number still received surgery.

To reduce congestion in its capital, Dakar, Senegal decided in 2012 to construct a new city in Diamniadio, in the suburbs. This new urban center, an integral part of the Emerging Senegal Plan (PSE), is a major first step towards the organization of land use planning. The Institute for Health Research, Epidemiologic Surveillance and Training (Iressef) is one of the very first new operational buildings in this new city. Conceived and directed by Professor Souleymane Mboup, Iressef was made possible by the support of the government of Senegal and the GILEAD Foundation. The vision of its sponsors is to make it a hub of excellence for research in the domain of tropical infectious diseases, with expertise and technical equipment and facilities comparable to those in research institutes in developed countries. The existing platforms include, among others, several state-of-the-art laboratories, a health and demographic surveillance system covering a population of 30 000 inhabitants, a clinical trial center, a dynamic community participation program, and a training center. To achieve this vision in the short- and long-terms, Iressef has developed a strategic 5-year plan focusing on two principal objectives, that is: (i) to conduct research programs according to the strictest ethical standards, and (ii) to train an elite group of Senegalese and African scientists, competitive and capable of developing health research in Africa. To attain these objectives, international partners will play an essential role.

Introduction: Niger, located in the meningitis belt, faces recurrent epidemics of magnitudes that vary with the year. The objective of this study was to describe the trends in meningitis and identify the profile of the microbes implicated in meningitis epidemics in Niger.

Methods: We conducted a descriptive study (a secondary analysis) of meningitis data from 2008 through 2015. The study population comprised patients with suspected and confirmed meningitis. We conducted an exhaustive sampling of all suspected and confirmed meningitis cases reported in Niger from 2008 to 2015.

Results: A total of 6167 (40.6 %) confirmed cases of meningitis were identified. Among them, 5,507 (89.3 %) were attributable to Neisseria meningitidis, 593 (9.6 %) to Streptococcus pneumoniae, and 66 (1.1 %) to Haemophilus influenzae respectively. Among the Neisseria meningitidis cases, 2,984 (54.2 %) were caused by serogroup A, 1,333 (24.2 %) by serogroup W, 1,165 (21.1 %) by serogroup C, 23 (0.4 %) by serogroup X, and 2 (0.03 %) by the serogroup B.

Conclusion: This study enabled us to describe meningitis trends and identify the profile of the bacteria implicated in its epidemics in Niger. We observed the emergence of Neisseria meningitidis C and recommend vaccination against this serogroup.

In the Democratic Republic of the Congo, the first recourse in case of suspected malaria in the health system is the private pharmacy sector. This study was therefore designed to assess private provider adherence to national case management guidelines in Kimpese, a rural area of Central Kongo province. A descriptive cross-sectional survey of 103 pharmacies took place in March 2016. The study included 97 pharmacies. The artemether-lumefantrine combination recommended as the first-line treatment for uncomplicated P. falciparum malaria was available in 100% of pharmacies but only 3% stocked quality-assured medicines. The sulfadoxine-pyrimethamine recommended for intermittent preventive treatment of malaria in pregnant women and quinine, which is no longer part of national policy, were widely available (>97.0% of pharmacies). Among providers, fewer than 20% were aware of the national malaria treatment guidelines. The main reasons for non-adherence to national guidelines among private dispensers was the high cost (up to 10 times more expensive than sulfadoxine-pyrimethamine treatment) and adverse effects of artemisinin-based combination therapies. Governmental interventions to improve private sector engagement in implementation of the national guidelines and to prevent the spread of ineffective and non-quality assured antimalarial medicines must be intensified.

Angiomas are vascular abnormalities that affect less than 1% of the world's population. Data on these disorders in Africa are limited. The purpose of our work was to study the epidemiological and clinical aspects of angiomas in the Dermatology-Venerology Department of the University Hospital of Yalgado Ouedraogo in Ouagadougou (Burkina Faso) to contribute to improving knowledge of this group of pathologies in our region. This cross-sectional descriptive, retrospective, and prospective study covers cases from 1998 through 2014. We identified 61 patients with angioma, 67.2% of them younger than 30 months. The sex ratio was 0.56. Vascular tumors (hemangiomas) accounted for 43 cases (70.5%) and vascular malformations 18 (29.5%). Lesions appeared between 0 and 15 days of life in 57.4% of cases. Their size ranged from 1 to 3 cm in 49.2% of cases. They were most frequently located on the head (49.2%). The most frequent clinical forms were cutaneous hemangiomas (tuberous) (36 cases), followed by the nevus flammeus (8 cases), and mixed hemangiomas (7 cases). Only one complex forms was observed: one case of Klippel-Trenaunay syndrome. Superficial vascular abnormalities are rare in our dark skin type context including infantile hemangiomas. The clinical peculiarities of the angiomas observed in this African series in Ouagadougou seem quite similar to the characteristics described in European and American series.