Medecine et sante tropicales最新文献

Objective: The aim of this study was to describe the epidemiological, clinical, and therapeutic profile as well as the outcome and to document the causes of pellagra and pellagra-like erythema in a hospital setting in Lomé, Togo.

Methods: This retrospective study examined the records of patients seen for outpatient consultation and/or hospitalization in the three public dermatology departments of Lomé from January 1997 to September 2017.

Results: During the study period, 178 (0.4%) of 47,219 patients seen in these dermatology departments consulted for pellagra or pellagra-like erythema; 159 (89.3%) had pellagra-like erythema. The patients' mean age was 45.8±16 years, and the sex ratio (M/F) 1.8. All patients had at least one site of cutaneous involvement, nearly always erythematous or pigmented lesions in the photo-exposed areas (99.4% of cases). Gastrointestinal and neurological signs were dominated respectively by diarrhea (12.4 % of cases), peripheral neuropathies (8.4% of cases) and insomnia (8.4% of cases). The main causes identified were alcoholism (42.1% of cases) and nutritional deficiency (6.7% of cases). Five of 178 patients were infected with HIV. All patients were treated with nicotinamide and multivitamin supplementation. No deaths were recorded during follow-up.

Conclusion: Our results document the extreme rarity of pellagra-like erythema/pellagra. Its two main causes remain alcoholism and nutritional deficiency. Moreover, its prognosis is good when treated quickly and adequately.

The purpose of this work is to describe pruritus in chronic hemodialysis patients at the G-University Hospital Center.

Method and patients: This a descriptive cross-sectional study included 30 patients receiving chronic hemodialysis.

Results: Among 90 chronic hemodialysis patients, the study selected 30, including 22 men (73.3%) and 8 women (26.7%), with an average age of 46.60 years (range: 24-82 years). All had pruritus: it was localized in 23.3 % (n=7) and diffuse in 76.7% (n=23). It occurred during dialysis sessions for half of them. It could be nocturnal (50%), diurnal (30%) intermittent (10%), or constant (10%). The dermatological signs associated with pruritus were cutaneous hyperpigmentation in 13.3% of cases, contact eczema in 3.3%, and cutaneous xerosis in 53.3%.

Conclusion: Pruritus is still the most common sign of dermatological conditions in chronic hemodialysis. Treatment remains symptomatic.

While Eugène Jamot's name is associated with the combat against sleeping sickness, Pierre Richet is permanently linked to the battle against river blindness, which he first reported in 1936 in two neighboring households in Garango (Burkina Faso). Onchocerciasis remained a continuous interest, through his last article "The OCCGE and Onchocerciasis", written in 1983. Nonetheless over the course of these five decades, Richet's trajectory was far from that of a specialist dedicating his life to a single disease. After a decade essentially spent fighting trypanosomiasis, came a decade of war in which the specialist in endemism joined the Free French Army and put his organizational know-how at General Lerclerc's disposal, from Morocco to Indochina, via Germany. On his return to Africa in 1953, he extended the principle of mobile teams to the other major endemic diseases accessible to treatment and to vaccines. Richet organized first the combat against leprosy and launched vaccination programs. In 1955, he returned to the battle against onchocerciasis and deployed the first large-scale insecticide program in Chad. The intermediate term failure of this prototype fermented his scientific, interdisciplinary, and organizational thought, which flourished at Bobo-Dioulasso. At the dawn of the independence of French-speaking African countries, and against the political tides of the time, he obtained in 1960 the creation of a supranational organization, the OCCGE, common to 8 countries of West Africa, and he headed it for a decade. Drawing lessons from the past and in the absence of effective pharmaceutical treatment, Richet the physician played the entomological card with one hand, with technical support from Orstom (IRD); this detailed work enabled the development of a strategy. With the other hand, he played the multilateral card, which led in 1974 to the launching of the extraordinary Onchocerciasis Control Program (OCP). If it is Jamot who awakened Africa, Richet is the person who restored its view but also millions of hectares of cultivable land.

The French-speaking Network for Neglected Tropical Diseases (RFMTN), created under the aegis of Aviesan in April, 2016, has among its 5 objectives, those to promote interactions between the French-speaking institutions who are members, to develop collaborative programs making it possible to respond to requests for proposals and to advocate effectively to political bodies and funders. To mark the milestone of its first two years of existence, it held a plenary conference in Montpellier (France) on October 22 and 23, 2018, at which experts from numerous African, French and international scientific institutions participated very actively. This article presents the essence of the debates.

Hepatitis A virus (HAV) is responsible for 1.5 million cases of infection annually worldwide. This disease occurs in areas where hygiene is precarious and affects mainly developing countries. In Morocco, 222 cases were reported in 2015, 34 of them from the city of Meknes. The objective of this study is to describe the trends in HAV incidence in Meknes to improve preventive measures. For this cross-sectional descriptive study, we investigated each case reported to the HAV surveillance system between 2013 and 2016. The following data were collected: socio-demographic information, season of infection, mode of water supply, food consumed, food purchasing environment, and laboratory confirmation of cases (by an ELISA test to detect anti-HAV IgG). Data were analyzed by Epi info version 7.2.0.1, with mapping by QGIS version 2.18.1. In all, 192 cases were reported with a sex ratio (m/f) of 1.3 and an average age of 13 ± 10 years. Incidence fell from 10 per 100 000 inhabitants in 2013 to 1.6 per 100 000 in 2016. Most cases (n = 160, 83%) came from the urban environment, and 63 (32%) occurred in springtime. Two people died. The incidence of HAV in the Meknes area has fallen, but public awareness campaigns by health education in the field of personal hygiene remain necessary. It is also essential to improve implementation of regulations banning food handling by virus carriers. Sanitary control of informal markets must be improved.

The implementation of mass drug administration (MDA) campaigns of albendazole (400 mg) and ivermectin (150-200 μm/kg) since 2001 has helped to change the epidemiological profile of lymphatic filariasis (LF) in many health districts in Burkina Faso. From 2002 to 2016, 14 rounds of MDA have taken place in the Central East zone, with therapeutic coverage exceeding 65%. The objective of the current study was to evaluate the impact of MDA in the fight against LF at 12 sentinel and spot-check sites. This descriptive cross-sectional study surveyed subjects aged 5 years and older between April and July 2017 at these 12 sites. The blood smear performed on nocturnal samples was used to diagnose Wuchereria bancrofti infection. The study included 4364 subjects. Their mean age was 20.55 years with a standard deviation of 14.22 and a range of 5 to 96 years. The overall prevalence of microfilaremia was 0.62% (27/4364), with rates exceeding 1% at three (3) sites. The average microfilaremia density was 106 μf/mL. The overall prevalence of morbidity was low (0.91%), predominantly lymphedema (0.60%). The MDA strategy has helped to reduce the prevalence of LF significantly in Burkina Faso, but some outbreaks still have microfilarial prevalence greater than 1%. Continuation of the additional 2-year strategy with improved adherence to treatment and vector control would help break LF transmission.

Cancer is a major cause of morbidity and mortality in children under the age of 15 years worldwide. To contribute to better knowledge of childhood cancers in Africa. To determine the causes of pediatric cancers and compare them with the results of a previous study and with data available for sub-Saharan Africa. This observational, descriptive study of the data recorded from 2007 to 2015 in the pediatric oncology unit of the University Hospital Center of Treichville in Abidjan analyzes the general and the age- and sex-specific proportions of children under the age of 15 years with neoplasia according to the International Classification of Childhood Cancer, 3rd edition (ICCC.3). This study includes 863 new cases. The sex ratio (M/F) was 1.4, and the mean age 7 years (range: 3 months to 14 years 9 months). The neoplasia rate peaked in the group aged 5-9 years (38.6 %). The most common cancers were: lymphomas (44 %), retinoblastoma (11.7 %), renal tumors (10.1 %), leukemias (6.3 %), and soft tissue sarcomas (5, 9 %). Burkitt lymphoma (85.3 %) and nephroblastoma (90.8 %) were the dominant histological type of lymphoma and renal tumors. This study shows an increase in the annual number of new cases, and an epidemiology close to that reported in other centers in sub-Saharan Africa.