Archives de l'Institut Pasteur de Madagascar最新文献

Excessive and inappropriate use of antibiotics is a world-wide serious problem because it contributes to the development and the spreading of antibiotic resistance. The authors carried out a study for one year by 1998, in order to evaluate antibiotic prescriptions in three childhood diseases: respiratory, digestive and neurological diseases. Patients hospitalized at the unit paediatric of the General hospital of Befelatanana are 0 month to 15 years old. Three antibiotic families were frequently used: cotrimoxazole, penicillins derivatives and aminoglycosides. Results of this study noted that antibiotic precriptions were irrational. Some factors may give explanations to these facts: the insufficiency of biological labs, but also expensive costs of exams. It is desirable that all paediatricians can gather in order to draw up clinical protocols and to assess them by a multicentric survey. Further results may be used as reference for empirical or probabilist antibiotic prescriptions of which efficacy will be checked by an experienced lab.

Using an ELISA method, we quantitated the level of glutathion S-transferase 28 kDa (Sm28GST), specific of Schistosoma mansoni, in the urine of 13 malagasy patients. The presence of Sm28GST antigen has been demonstrated for the first time, in 8 patients (69%). No significant correlation could be found between antigen level and the parasitological burden in the feces. The use of an immunocapture ELISA technic on a larger number of samples will be necessary to assess if this test could be quantitative and reliable enough for the diagnosis or the follow up of patients infected with Schistosoma mansoni.

The immunological status of the brain is generally presented as an "immune privileged" site because of the presence of a strong blood-brain barrier, the lack of lymphatic drainage and, as for the eye, the paucity of professional antigen-presenting cells. This dogma is now challenged by recent studies indicating that there is an active communication with the immune system and that presentation of endogenous (as in autoimmune encephalomyelitis) or exogenous (like in neurocysticercosis or toxoplasmosis) antigens occurs. The local immune (cell-mediated and non-inflammatory humoral) responses seem regulated by active immunosuppressive mechanisms, including apoptosis of alloreactive lymphocytes, in order to limit the destructive effect of inflammatory reactions in this fragile tissue.

The number of acute flaccid paralysis (AFP) cases reported to World Health Organization (WHO) decreased from 1988 (48 cases) to 1996 (8 cases), but the real endemic situation of poliomyelitis is unknown. Cases are under or misreported. Very often, notifications are delayed; virological investigations of the etiology could not be performed as well as the environment studies and the immunization ripostes. In 1996, only one AFP case was confirmed by isolation of wild poliovirus. The immunization coverage in children under one by OPV (3 doses) was 73.0% in 1996 from the statistics of the Public Health Services but only 54.7% from randomized studies. The eradication of poliomyelitis by the year 2000 has engaged Madagascar in the disease prevention by improving the immunization coverage within the Expanded Immunization Programme in association with the Organization of National Immunization Days in October and November 1997. Likewise, the Virological Unit of the Pasteur Institute was recognized as the National WHO Reference Centre for Polio.

At the very first glance, literature research in medical biology seems hard to some scientists. This paper aims to give an overall view of basic principles permitting to exploit correctly all existing equipments of information systems. Several definitions allow to familiarize with the documentary vocabulary.

In addition to the unique physiological and immunological features of the eye, previously presented, some parasitic factors of recent knowledge are induced during ocular cysticercosis. A modulation of the immune response of the host, mediated by larval products (a soluble RNA-peptide, some metacestode surface sphingoglycolipids) seems to occur in vivo. These recent findings lead us to make a critical review of the antigenic profiles obtained by Enzyme-linked immunoelectrotransfer blot assay (EITB) on samples collected from malagasy patients.

We reported a study undertaken in a Sexually Transmitted Disease care unit in Antsiranana amongst two groups of patients: 299 prostitutes and 350 STD patients (204 women and 146 men). The 20-29 years old age group represented 50.3% of the patients. A 12 days average delay between appearance of first symptoms of STD and the visit to the care unit was recorded. The most important clinical signs were cervicovaginal discharge (83%), pelvic pains (67%), and pruritus (53%) in women, urethral discharge and urination pain (64%) in men. Among prostitutes on a routine visit, 22.7% had at least one STD clinical sign. Syphilis serology by TPHA showed a high prevalence among prostitutes (39%) and STD patients (32%). Direct examinations emphazed the major importance of gonorrhoea in more than 70% of STD patients, both men and women, and trichomonasis in women (22%). Chlamydia investigation could not be done. HIV antibodies were recorded in 4 prostitutes (1.3%) and in none of the STD patients. 79.3% of prostitutes and 39.4% of STD patients had at least 2 partners a week and 47.5% of prostitutes used a condom "every time" and only 21.1% STD patients "sometimes" used it. The role of STD care units must be reinforced for information, education and counselling of the population in a non medical context.

The immunological status of the eye, like the one of the brain, is generally considered as an "immune privilege" site because of the presence of a strong blood-ocular barrier, the lack of lymphatic drainage and, last but not the least, the absence of professional antigen-presenting cells. This dogma is now challenged by recent studies indicating that presentation of endogenous (as in autoimmune uveitis) or exogenous (like in ocular cysticercosis) antigens occurs. The local immune response seems regulated by active immunosuppressive mechanisms, in order to limit the destructive effect of inflammatory reactions.