Revue internationale du trachome et de pathologie oculaire tropicale et subtropicale et de sante publique : organe de la Ligue contre le trachome avec la collaboration de l'International Organization against Trachoma et des organisation...最新文献

Authors report the results of a retrospective study of epidemiological, clinical and therapeutical aspects of pterygium carried at the ophthalmological service of the Douala General Hospital. During the period of the study, 167 patients with pterygium were registered, which means a prevalence of 1.10%. The mean age of the patients was 41.76 years with standard deviation of 10.89. The noticed that men were a little bit predominant as compared to women with respectively 54.8% and 45.2% of cases. The pterygium were in the nasal side in 93.66% of cases and bilateral forms represented 31.73% of cases. 67 eyes were operated by excision technic more often associated to conjunctival translation. The relapse rate at 6 months was 7.44%. Authors recommend: 1 degree)-not to operate small and non-evaluative pterygium 2 degrees)-to use a magnifying system and if possible the operatory microscope 3 degrees)-to institute systematically an early, intensive, prolonged but degressive corticotherapy after surgery. 4 degrees)-to prescribe tinted or photochromic glasses to patients.

The authors are publishing the epidemiologic aspects of retinoblastoma in a cameroonian area. The study is prospective and is carried out in the eye clinic of CHU over a period of 7(1/2) years. We include all patients diagnosed and confirmed histologically after enucleations to have retinoblastoma. The frequency of retinoblastoma is 0.83% per 10000 consultations. The sex ratio is 1/6 (two boys and 12 girls) ans the mean age of patients on first consultation (visit) is 38 months (between 3 months and 6 years 7 months). 85.55% of the retinoblastomas are sporadic and the disease is lethal in 78.57% of cases.

This prospective study (January 1993-January 1994) was carried out in two groups of villages of the district of Ouelessebougou (Mali). The objective of the study was to assess the impact of installing water supply boreholes on the incidence of trachoma. A prospective group of 4 villages, where boreholes were sunk at the beginning of the study, was compared to a control group of 4 villages where there are no boreholes. The examination concerned children below the age of 10 years (N = 700) and was carried out using binocular loupes, according to the simplified procedure for trachoma grading proposed by the WHO. Our results show that in the prospective group, the annual rate of incidence of inflammatory trachoma was 8% (cl: 5.8-10.7) while in the control group it was 14% (cl: 9.6-10.9). RR: 0.58 (0.37-0.90). Likewise the rate of spontaneous healing was 12% (Cl: 9.1-14.9) in the prospective group and 5% (cl: 2.4-9) in the control group. Relative Risk was 2.60 (1.36-4.9). These statistically significant results show that the risk of contracting trachoma is reduced by half in the villages where a borehole has been sunk.

Chlamydia Trachomatis (C.T.) most commonly causes cervicitis in women, often without overt symptoms; when untreated, it produces a clinically inapparent but persistent mild infection or an evident salpingitis. Either processes may lead to scarring of the falloppian tubes and fertility problems. A group of 30 women 20-35 years aged has undergone an ophthalmological routine examination; 7 of them presented a chronical follicular conjunctivitis and history of yellow-white cervical discharge, while the remaining 23 had a mild chronical follicular conjunctivitis but not genital symptoms. Each patient has undergone an immunofluorescent test with monoclonal antibody specific for C.T. on the samples collected by genital and conjunctival scraping and cytological evaluation of the above samples with Giemsa staining. 6 out of 7 patients with genital discharge were positive for C.T., one of which even for eye samples too; all eyes samples showed lymphomonocytes and neutrofilic cells in their eye samples. An additional 3 cases negative for C.T. showed this kind of cells in the eye scraping. The preliminary results of this study on mild follicular chronical conjunctivitis suggest that the Ophthalmologist could play an important role in order to make an early diagnosis in genital and eye infection by Chlamydial Trachomatis.

Cysticercosis is due to cysticercus cellulosae and was know since a long time. Human is an intermediate occasional host by ingesting accidentally eggs of tenia. In Madagascar, neurocysticercosis are predominating (55%), occular localisations are not frequent (5%) and concerned particularly vitreous humour and retina. Diagnosis relies on serology: Elisa test, then Western Blot completed with research of circulating antibody and antigen in the acqueous humor by immocapture. Anatomopathologic test permits to confirm the diagnosis. Contribution of tomodensitometry is not conclusive therapeutic is summed up to a specific and symptomatic treatment with surgical extirpation when out means allow it.

An epidemic of A.E.H.C. was broken out everywhere in Madagascar during hot season from September 1990 to May 1991 with an important acuteness in February and March. Clinical symptoms are those of A.E.H.C. to enterovirus with some particularities. Virological study shows cytopathogenic effect of enterovirus and microbiology shows the existence of several bacterial germs particularly staphylococcus epidermidis. The discovery of two cases of streptococcus pneumonia and the absence of chlamydia trachomatis make the originality of our cases. The efficacy of the association antibiotic and steroids is spectacular.

Because of the life-style/environment-related determinants of the disease, trachoma control activities should be multisectorial and multidisciplinary in order to be effective and long lasting. Medical and epidemiological components to be included in the global approach have largely benefited by the existence of the simplified trachoma grading system. In other respects, long-term outcomes of trichiasis surgery are better evaluated and various surgical procedures are available. On the other hand, despite the knowledge that community participation is one of the essentials of trachoma control activities, this element all too often remains neglected. Therefore, realistic and practical community approaches need to be specified which are suited to various socio-cultural settings. Thanks to the support of the Edna McConnell Clark Foundation (USA), the World Health Organization's Programme for the Prevention of Blindness has prepared a set of documents, addressing the different aspects of trachoma control activities.

Hybridization in situ of chlamydia trachomatis allows identification of the bacteria. Moreover exact chlamydia trachomatis localization at tissue level can be demonstrated. It seems to us very important to know for instance in conjunctiva were chlamydia trachomatis are located. We used DNA DIGOXIGENIN labelled plasmidic probe of 503 b.p. Detection of chlamydia trachomatis on paraffin embedded cells becomes possible. Specificity is 100% as plasmidic sequence is not found in other bacteria. Sensitivity seems to be good quality on experimental model. At present time, it is under clinical evaluation. This method could complete PCR for chlamydia detection in case of controversial diagnosis.