Medecine et sante tropicales最新文献

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One Health, Only the Future Counts. 一个健康，未来才是最重要的。

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-07-01 DOI: 10.1684/mst.2019.0907

J. Boutin

引用次数: 1

Transmissible arthritis in a man from Guinea. 几内亚男子的传染性关节炎。

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-07-01 DOI: 10.1684/mst.2019.0915

K. Condé, M. S. Garba, K. Sylla

We report the case of a 32-year-old man with septic arthritis and Neisseria gonorrhoeae tenosynovitis, diagnosed after joint fluid culture treated with ceftriaxone. It is one of the most frequent causes of purulent septic arthritis in young people in undeveloped countries. Early diagnosis is important to avoid complications.

我们报告了一例32岁的男性感染性关节炎和淋病奈瑟菌性肌腱滑膜炎，在用头孢曲松进行关节液培养后诊断。它是不发达国家年轻人化脓性脓毒性关节炎最常见的原因之一。早期诊断对于避免并发症很重要。

引用次数: 0

Tibia chronic osteomyelitis complicated by fracture in children: relevance of pedicle flaps in low resources setting. 儿童胫骨慢性骨髓炎合并骨折:低资源环境下椎弓根皮瓣的相关性。

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-07-01 DOI: 10.1684/mst.2019.0928

F. Bourbotte-Salmon, A. Bertani, A. Alvernhe, F. Rongiéras, L. Mathieu

The authors report three pediatric cases presenting with tibial osteomyelitis complicated by fracture for which flap coverage was performed in a low-resource setting. Pedicled flap transfers are rarely used for the treatment of chronic osteomyelitis in developing countries. However, these procedures are accessible to any orthopedic surgeon and enable satisfactory treatment of bone infection, reduce the duration of care, and enhance the reliability of bone grafts.

作者报告了三例小儿病例，表现为胫骨骨髓炎合并骨折，皮瓣覆盖在低资源环境下进行。在发展中国家，带蒂皮瓣移植很少用于治疗慢性骨髓炎。然而，这些手术对任何骨科医生来说都是可行的，并且能够令人满意地治疗骨感染，减少护理时间，提高骨移植的可靠性。

引用次数: 0

Organization of funding for community-based HIV testing in Côte d'Ivoire: potentially counterproductive search for efficiency? 在Côte科特迪瓦为社区艾滋病毒检测组织资金:追求效率可能适得其反?

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-07-01 DOI: 10.1684/mst.2019.0926

A. Assoumou, A. Bekelynck, S. Carillon, B. A. Kouadio, H. Ouantchi, M. Doumbia, J. Larmarange, M. Koné

Since the early 2010s, the President's Emergency Plan for AIDS Relief (Pepfar) and the Global Fund to Fight AIDS, Tuberculosis and Malaria have stiffened their result-based management strategies. Disbursement conditions are increasingly demanding for funded NGOs (achievement of quantified objectives, frequent reporting, and monitoring of activities), and their remuneration depends on the results achieved. This article aims to analyze the effects of this strengthening of policies based on New Public Management on local implementation of activities, based on the example of community-based HIV testing. In three health districts of Côte d'Ivoire, in 2015 and 2016, we mapped the actors involved in community-based HIV testing and conducted semi-directive interviews with members of the community-based NGOs (n = 18). The funding of local HIV testing organizations is channeled through intermediary organizations according to a complex pyramid system. This, combined with cumbersome activity reporting and data validation, results in delays in the disbursement of funds and significantly reduces the actual time available to implement activities, i.e., to less than half the time planned for this purpose. This managerialization -of both Pepfar and the Global Fund - produces the counterproductive effects against which it was supposed to fight.

自2010年代初以来，总统艾滋病紧急救援计划(Pepfar)和全球抗击艾滋病、结核病和疟疾基金加强了以结果为基础的管理战略。资助的非政府组织的支付条件越来越苛刻(实现量化目标、经常报告和监测活动)，其报酬取决于所取得的成果。本文旨在以社区艾滋病毒检测为例，分析以新公共管理为基础的政策加强对地方实施活动的影响。2015年和2016年，在Côte科特迪瓦的三个卫生区，我们绘制了参与社区艾滋病毒检测的行为体的地图，并与社区非政府组织成员进行了半指导性访谈(n = 18)。当地艾滋病毒检测机构的资金是根据复杂的金字塔系统通过中介组织输送的。这种情况，加上繁琐的活动报告和数据验证，导致资金支付的延误，并大大减少了可用于执行活动的实际时间，即不到为此目的计划的一半时间。Pepfar和全球基金的这种管理化产生了本应对抗的反效果。

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引用次数: 2

Neonatal ophthalmia in Mali. 马里新生儿眼炎。

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-07-01 DOI: 10.1684/mst.2019.0930

R. R. Elien Gagnan Yanza-Outou, S. Bakayoko, S. Diallo, A. Sylla, T. Coulibaly, N. Touré, M. Tembely, C. Diabaté, M. A. Dicko, F. Sylla

A newborn 3 hours old newborn presented bilateral eyelid edema with erythema and inflammatory hypertrophy of the palpebral conjunctiva. PCR of the conjunctival swabbing showed the presence of Chlamydia trachomatis DNA. Treatment with erythromycin suspension 125 mg/5 ml was initiated, supplemented by topical application of oxytetracycline ointment 1% and Azyter eye drops.

一个出生3小时的新生儿表现为双眼睑水肿伴眼睑结膜红斑和炎症性肥大。结膜拭子PCR结果显示沙眼衣原体DNA存在。开始使用红霉素混悬液125 mg/ 5ml，外加1%土霉素软膏和Azyter滴眼液。

引用次数: 0

Myeloblasts and atypical bone marrow: Fortuitous discovery of the filiarial nematode loa loa in the bone marrow during a work-up for prolymphocytic T-cell leukemia. 骨髓母细胞和非典型骨髓:在一次前淋巴细胞t细胞白血病的检查中，在骨髓中偶然发现了loa loa线虫。

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-05-01 DOI: 10.1684/mst.2019.0864

M Igala, S A Nto'o Eyene, L E Ledaga Lentombo, S W Mbiye Cheme, L Rerambiah, S Ntsame Ngoua, L F Pemba, J Iba Ba, M Bouyou Akotet, J B Boguikouma

Loiasis is a chronic cutaneous disease caused by a filarial nematode for whom humans are the only definitive host: Loa loa, an African eyeworm transmitted by Chrysops flies. The parasite is seen on blood smears, in the skin, or during its ocular migration, but rarely on a bone marrow smear. We report the case of a 57-year-old Gabonese woman whose bone marrow aspiration during a work-up for T-cell leukemia fortuitously found Loa loa filariae.

路易病是一种由丝状线虫引起的慢性皮肤病，人类是其唯一的最终宿主:Loa Loa，一种由金蝇传播的非洲眼虫。这种寄生虫见于血液涂片、皮肤或眼球迁移过程中，但很少见于骨髓涂片。我们报告一个57岁的加蓬妇女的病例，她的骨髓在一次t细胞白血病的检查中偶然发现了Loa Loa丝状虫。

引用次数: 1

Late-onset spondyloarthritis: a study of 133 patients in Dakar, Senegal. 迟发性脊椎关节炎：对塞内加尔达喀尔133名患者的研究。

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-05-01 DOI: 10.1684/mst.2019.0903

K. Condé, M. Niasse, M. S. Garba, C. Diouf, S. Diallo

Reports of late-onset spondyloarthritis in sub-Saharan Africa are sparse. This series allows us to describe the characteristics of this disease in Senegal. This is a retrospective study conducted in the Rheumatology Department of the Dantec University Hospital (Dakar) where we reviewed records of spondyloarthritis cases. Its diagnosis met the modified ASAS and New York criteria. Late-onset was defined as after the age of 55 years. During the study period, the department managed 133 late-onset patients, or 38% of all spondyloarthritis cases (350). Age ranged from 65 to 74 years, with a mean of 66. HLA B 27 phenotyping was performed in 89 patients; 39 patients were HLA B27 positive (29%). The treatments were based on DMARDs (salazopyrin and methotrexate).

撒哈拉以南非洲地区迟发性脊椎关节炎的报告很少。这个系列使我们能够描述塞内加尔这种疾病的特点。这是一项在丹特克大学医院（达喀尔）风湿病科进行的回顾性研究，我们在那里回顾了脊椎关节炎病例的记录。其诊断符合改良的ASAS和纽约标准。晚发定义为55岁以后。在研究期间，该部门管理了133名晚发患者，占所有脊椎关节炎病例的38%（350）。年龄在65至74岁之间，平均66岁。对89例患者进行HLAB27分型；HLA-B27阳性39例（29%）。这些治疗是基于DMARD（沙唑吡林和甲氨蝶呤）。

引用次数: 0

Relax from the holiday on the edge of the lagoon : turquoise waters and red legs ! 在泻湖的边缘放松一下:绿松石般的海水和红色的腿!

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-05-01 DOI: 10.1684/mst.2019.0862

A Haar, A C Garcia, J Morin, J J Morand, J E Blatteau

We report a case of livedo reticularis of the lower limbs in a 30-year-old woman scuba diver after a diving session. Consideration of the differential diagnoses, the clinical picture, and the course of the symptoms led to a diagnosis of cutaneous decompression sickness. This accident, which resolved favorably in this scuba diver without any right-to-left shunt, is an alarm signal that calls for her to comply strictly with safety rules before resuming scuba diving, to avoid a more serious accident.

我们报告一个病例网状活的下肢在一个30岁的女性潜水员潜水会议后。考虑到鉴别诊断，临床表现和症状的过程导致诊断为皮肤减压病。这次事故在这位潜水者身上得到了很好的解决，没有发生任何从右到左的分流，这是一个警报信号，要求她在恢复潜水之前严格遵守安全规则，以避免更严重的事故。

引用次数: 0

Severe infectious keratitis in tropical environments: 118 cases collected over 10 years. 热带环境中的严重感染性角膜炎:10年来收集的118例。

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-05-01 DOI: 10.1684/mst.2019.0897

S. Seck, M. Diakhate, A. Oulfath, M. Sow, M. Dieng, N. Guéye

INTRODUCTIONThe aim of our study was to evaluate the clinical, microbiological, and contributing factors of microbial keratitis in tropical environment. Materiel and methods: We performed a retrospective study of all patients admitted to the ophthalmology department of Principal Hospital in Dakar for infectious keratitis, over ten years from January 2006 to December 2015. Clinical, microbiological, and contributing factors as well as visual effects were studied.RESULTSWe collected data of 118 patients hospitalized for unilateral infectious keratitis in 10 years, for an average of 12 cases per year. The patients' mean age was 50 years. At least one local risk factor was found in 58.5% of cases. These were mainly ocular trauma (39%), followed by local treatment of glaucoma (16%), and recent eye surgery (14.5%). In 9 cases (8%), the only risk factor for abscess was an isolated general factor. This was diabetes in 7 cases. The clinical aspects described can be grouped according to topography, depth, and severity in pre-perforation state or perforation (45%), anterior chamber Tyndall effect greater than 1 cross, reaching a hypopyon stage (24%), stromal infiltrate larger than 2 mm (18%) and the abscess located within 3 mm of the corneal center (13%). The microbiological examination isolated a germ in 17% of cases, principally Pseudomonas aeruginosa (40%), followed by Staphylococcus aureus (20%). Prognosis was severe with visual acuity of less than 1/10 in 90% of cases and evisceration in 16% of cases.DISCUSSIONThe most common risk factor was local ocular trauma by foreign bodies in the cornea. The poor prognostic factors were possible delay in consultation, low initial visual acuity, and low rate of positive microbiological examinations.CONCLUSIONInfectious keratitis is a potentially serious condition that can lead to blindness and eventually to loss of the ocular globe in tropical environments. Local risk factors are largely dominated by ocular trauma. Only early management based on the microbiological results improves the prognosis.

本研究的目的是评估热带环境下细菌性角膜炎的临床、微生物学和影响因素。材料和方法:我们对2006年1月至2015年12月期间在达喀尔主要医院眼科收治的感染性角膜炎患者进行了回顾性研究。研究了临床、微生物和影响因素以及视觉效果。结果我们收集了10年内118例单侧感染性角膜炎住院患者的资料，平均每年12例。患者平均年龄50岁。58.5%的病例至少存在一种局部危险因素。主要是眼部外伤(39%)，其次是局部青光眼治疗(16%)和近期眼部手术(14.5%)。9例(8%)脓肿的唯一危险因素是孤立的一般因素。7例为糖尿病。所描述的临床方面可以根据地形、深度和穿孔前状态或穿孔的严重程度(45%)、前房Tyndall效应大于1十字、达到低水平(24%)、基质浸润大于2mm(18%)和脓肿位于角膜中心3mm内(13%)进行分组。微生物学检查在17%的病例中分离出一种细菌，主要是铜绿假单胞菌(40%)，其次是金黄色葡萄球菌(20%)。预后严重，90%的病例视力低于1/10,16%的病例内脏切除。最常见的危险因素是角膜异物引起的局部眼外伤。预后不良的因素可能是就诊延误、初始视力低、微生物学检查阳性率低。结论传染性角膜炎是热带环境中一种潜在的严重疾病，可导致失明并最终导致眼球丧失。局部危险因素主要是眼外伤。只有根据微生物学结果进行早期治疗才能改善预后。

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引用次数: 1

Arteriovenous fistulae for access to hemodialysis in Chad : feasibility study of a medical civic action program by a French army surgical unit. 乍得获得血液透析的动静脉瘘:法国陆军外科部队医疗公民行动方案的可行性研究。

Q4 Medicine

Medecine et sante tropicales

Pub Date : 2019-05-01 DOI: 10.1684/mst.2018.0858

F Béranger, M Tregarot, O Aoun, H De Lesquen, N Gagnon, L Meyrat, J P Avaro

Introduction: Use of chronic intermittent hemodialysis is recent in Chad, where it remains underdeveloped. Vascular access is most commonly by catheter. The objective of our study was to demonstrate the feasibility of arteriovenous fistula (AVF) surgery for hemodialysis during deployments as part of the medical civic action program (MEDCAP).

Methods: We prospectively included all patients admitted for AVF creation at Camp Kossei forward surgical unit in N'Djamena (Chad) between December 2016 and February 2017. Surgery was performed by an experienced vascular surgeon. The data collected included age, sex, cause of kidney failure, type of anesthesia, AVF location, and the duration of the intervention and hospitalization. Patients were examined one month after the procedure to evaluate the functionality, morbidity, and mortality of the AVF.

Results: We performed 17 AVF in 3 months. Male to female ratio was 3. High blood pressure was the main cause of chronic kidney failure (55%). All interventions were conducted under locoregional anesthesia. Overall, 35% of fistulae were radiocephalic, 41% brachiocephalic, and 24% brachiobasilic. The mean duration of intervention was 58 minutes and that of hospitalization one day. No deaths occurred. Global morbidity, including non-functioning AVF, was 25%.

Conclusion: Our study showed that AVF surgery is feasible during deployment, especially in Chad, and meets the needs of the local healthcare facilities. It should be developed and taught to local surgeons.

简介:乍得最近才开始使用慢性间歇血液透析，但仍不发达。血管通道最常通过导管。我们研究的目的是为了证明作为医疗公民行动计划(MEDCAP)的一部分，在部署期间进行血液透析动静脉瘘(AVF)手术的可行性。方法:我们前瞻性地纳入了2016年12月至2017年2月期间在乍得恩贾梅纳(N’djamena)的科塞营前沿外科收治的所有AVF形成患者。手术是由一位经验丰富的血管外科医生进行的。收集的数据包括年龄、性别、肾功能衰竭原因、麻醉类型、AVF位置、干预和住院时间。术后1个月对患者进行检查，评估AVF的功能、发病率和死亡率。结果:3个月内行17例AVF。男女比例为3。高血压是慢性肾衰竭的主要原因(55%)。所有干预均在局部麻醉下进行。总体而言，35%的瘘管为放射性头端，41%为头臂端，24%为肱基底端。干预时间平均为58分钟，住院时间平均为1天。没有人员死亡。包括无功能AVF在内的全球发病率为25%。结论:我们的研究表明，AVF手术在部署期间是可行的，特别是在乍得，满足当地医疗机构的需求。应该发展并教给当地的外科医生。

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引用次数: 0

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