Medecine tropicale : revue du Corps de sante colonial最新文献

Introduction: Chronic kidney disease is now regarded as amajor public health concern. This is especially true in developing countries where it accounts for significant morbidity, mortality and decreased life expectancy. The main problem for developing countries is the cost of dialysis. Indeed, the availability of peritoneal dialysis for renal replacement therapy is low in sub-Saharan Africa. Since March 2004 peritoneal dialysis has been available to some patients with end-stage renal disease in Senegal. The purpose of this study was to assess epidemiologic, clinical, technical patterns and outcomes in patients who underwent peritoneal dialysis in the first three years of the program.

Materials and methods: This three-year retropective study identified 26 patients who underwent peritoneal dialysis for end-stage renal disease for a period of at least 15 days. Patients not meeting these criteria were not included. All patients had a Baxter type transfer set. Lactate-bicarbonate solution was used for countinuous ambulatory peritoneal dialysis. In 3 cases, Icodextrin- and amino-acid based-solutions were employed. In automated peritoneal dialysis, the Home Choice machine was used for all patients. Epidemiological, clinical/paraclinical data and outcomes were noted for each patient.

Results: Twenty-six patients were included in the study. Median age was 48 +/- 6 years with a M/F sex ratio of 1.17. Most patients (84%) were literate. Diabetic nephropathy and nephroangiosclerosis were the main causes of end-stage renal disease. The mean Charlson score was 3 (range, 2 to 5). Mean residual diuresis was 435 mL/day. The peritonitis rate was 1 per 20 patient months. Staphylococcus aureus and Pseudomonas aeruginosa were the most common germs. Six patients presented catheter infection: exit-site in 4 and tunnel in 2. Catheter obstruction occurred in three cases. At the end of the study, 6 patients were still in automated peritoneal dialysis and 8 in countinuous ambulatory peritoneal dialysis. Six 6 patients died and 6 were switched to hemodialysis.

Conclusion: Peritoneal dialysis is available as a renal replacement therapy in Senegal. It has allowed end-stage renal disease patients greater autonomy in their working place.

Despite progress in various facts (sanitation, education, access to health care...) that allowed a significant reduction in infectious and parasitic diseases, they persist in some poor geographical areas and populations most in need, especially in young children. An epidemiological transition (increased incidence of cancers, cardiovascular attacks...) clearly tends to replace the old public health problems, rather in urban areas and among the most advantaged social classes. Diseases (re)emerging are also serious concerns for the future: return of resistant malaria, outbreaks of severe clinic forms of dengue, explosion of VHI/TB resistant....

Aim: The aim of this study was to determine the prevalence and types of trachoma in children of central Togo.

Materials and methods: This descriptive cross-sectional investigation was conducted in central Togo in November 2009. At every peripheral health unit (PHU) in 2 villages of the sanitary district, 15 schoolchildren between 6 and 9 years old and 35 children from the community between 1 and 5 years old were examined to detect signs of trachoma using a lamp wipes coupled with binocular magnifying loupes (2.5X). Data were analysed with Excel 2007.

Results: A total of 8200 children were examined at 82 PHU in 164 villages in the sanitary districts. In the 1-5 year age group including 5,740 children, follicular trachomatous inflammation (TF) was observed in 326 cases and intense trachomatous inflammation (TI) in 9 for a prevalence rate of 5.83%. In the 6-9 year age group including 2,460 schoolchildren, TF was observed in 144 and TI in 8 for a prevalence rate of 6.18%. The overall prevalence rate of active trachoma was 5.94 % (n = 487).

Conclusion: This study confirms the persistence of active trachoma in children in central Togo. Trachoma may be public health problem in 2 districts: Blitta and Sotouboua. A population-based survey will be carried our to evaluate trachoma prevalence prior to implementation of the SAFE strategy in this region.

The purpose of this article is to provide a step-by-step description of Georges Moustardier's career. After completing studies at the Ecole Principale du Service de Santé de la Marine et des Colonies in Bordeaux, and at the Ecole d'Application du Service de Santé des Troupes Coloniales in Marseille, he was deployed to Indochina where he served as physician first at the Poulo Condor penitentiary from (1929 to 1930) and then in Cambodia from (1931 to 32). In 1933, he returned to Paris where he followed lectures on Microbiology at the Institut Pasteur, in Paris. He was then assigned to the Institut Pasteur in Madagascar from 1931 to 1932. From 1939 to 1944, he was Head of the General Hospital in Brazzaville, Congo and Director of the Medical School in French Equatorial Africa. He retired from the army in 1946. From 1949 to 1972, he held an academic position as Professor of Bacteriology at the Bordeaux School of Medicine.

The purpose of this report is to present a series of 111 cases of pulmonary abscess observed over a 4-year period in Madagascar. There were 75 men (67.6%) and 36 women (32.4%) with a mean age of 38 years. Alcohol and tobacco use was found in 32.2% of cases. Thirteen patients (11.7%) used chewing tobacco and all patients were exposed to passive smoking. Eighty-eight patients (79.2%) had a history of bronchopulmonary disorders. Onset was progressive in 63% of cases. The main symptoms were fever (81.9%), pulmonary condensation (74.7%) and pleurisy (9.9%). Coughing was productive in 91.8% cases including 54% of patients having muco-purulent expectorations. In 49 patients (44.1%), chest radiography showed an opacity with a hydroaeric level. The abscess was solitary in 40 cases, multiple in 9, and bilateral in 5. In-hospital antibiotherapy was performed on a presumptive basis: tritherapy in 92 patients (82.9%), bitherapy in 18 (16.2%) and monotherapy in one (0.9%). Other treatment modalities inculuded respiratory kinesitherapy in 57 cases (51.3%), surgical drainage in four (3.6%) and pneumonectomy in one (0.9%). Outcome was favorable in 93 cases (8,7%) but there were 18 deaths (16.2%). This study emphasizes the value of achieving early diagnosis, identifying supporting factors and starting appropriate treatment promptly.

Objective: Gynecologic and mammary cancers occupy a prominent place in female tumor pathology. The purpose of this report is to describe aspects of these cancers in Togo.

Material and methods: This retrospective and descriptive study includes all gynecologic and mammary cancers diagnosed between 1987 and 2006 in the pathology laboratory of Tokoin University Hospital in Lomé, Togo.

Results: During the study period, 882 gynecologic and mammary cancers were diagnosed. Breast cancer accounted for 440 cases (49.88%). The most common gynecologic cancer locations were the cervix in 212 cases (24.03%) and uterine corpus in 108 cases (12.25%). Mean patient age was 48.3 years overall, 48,6 years for breast cancer and 49 years for cervical cancer. In almost all cases, cancer was diagnosed at an invasive stage.

Conclusion: Gynecologic and mammary cancers are common in Togo and most cases are diagnosed at a late stage. An epidemiological monitoring program is needed.

Introduction: To ensure self-sufficiency and lower costs associated with reagent red blood cells, some medical laboratories produce their own test-red blood cells for plasma ABO blood grouping. However, given the vital importance of blood goup testing, it is essential to verify the reliability of these cells. The purpose of this study was to assess the quality of laboratory-made ABO test-red blood cells.

Material and methods: This study comparing house made and commercially available test-red blood cells was carried out at the Medical Biology Training and Research Laboratory in Madagascar. This laboratory is attended by people wishing to obtain their blood group card.

Results: In this population, no discrepancy was found between the red cell and plasma tests. Comparison of test-red blood cells with commercially available reagent red blood cells showed no difference in reactivity in the first four days of conservation. However a decrease in the reactivity of house made cells appeared on the 5th day.

Conclusion: House made red blood cells are costless than commercially available reagent red blood cells mainly due to the simplified method of preparation. However, since laboratory-made cells progressivley lose antigenic reactivity quicly, production must be repeated regularly and good internal quality control is necessary to ensure reliability.

The purpose of this retrospective study was to determine the reasons for consultation in a Dermatology Venereology Department in Cotonou, Benin. A total of 1,070 new patients were included. The main reason for consultation was immunoallergic dermatosis.

Purpose: The purpose of this study carried out among pregnant women in antenatal clinics in Togo was to evaluate knowledge, attitudes and practices related to prevention of mother-to-child transmission of HIV (PMTCT).

Methods: A qualitative cross-sectional study was conducted in 22 antenatal clinics. Data were collected by interviewing all pregnant women examined from January 18th to February 4th, 2010.

Results: A consecutive series of 210 pregnant women was compiled. The women identified sexual relations (93.8%), objects soiled with blood (80.5%) and transmission from mother to child (27.1%) as routes of HIV transmission. A large majority (77.1%) agreed that unprotected sexual relations raised the risk of HIV transmission to the child and most (61%) expressed willingness to use condoms during pregnancy or breastfeeding, A high percentage (68.1%) believed that contamination during pregnancy increased the risk of HIV transmission to the child, and 61% knew that the risk of HIV transmission to the child was higher for mixed breastfeeding than for exclusive breastfeeding. The acceptance rate for HIV testing was 92.4%. The percentage of women who never used condoms (male or female) was 51% and the percentage considering that HIV-positive woman should not have children was 29.5%.

Conclusion: The results of this study indicate that pregnant women in Togo have fairly good knowledge about HIV/AIDS. Attitudes towards PMTCT were generally positive but some behaviors such as condom use still require improvement.