Bulletin de la Societe de pathologie exotique et de ses filiales最新文献

The use of IgM capture ELISA for surveillance of dengue in Martinique is described. This only pathogenic for human population arbovirus infection, which the transmission is caused by bites of haematophagous diptera like Aedes (Aedes aegypti principally) show an active circulation in Martinique. Clinical evolution was always benign among the adults and the children. To date no case of dengue haemorrhagic fever/dengue shock syndrome (the World Health Organization criteria) was not reported in Martinique.

Before 1949 malaria was highly prevalent in the whole territory of French Guiana. When malaria control based on house-spraying and drug prophylaxis was implemented in 1950 the disease sharply dropped below 20 cases per year. Since 1976 despite vector control malaria is rising again. In 1987, 3,269 cases have been notified giving an incidence of 37.6 per thousand for the whole country population; only four deaths were recorded. All the age groups were concerned but the transmission was restricted to some foci along the Oyapock river (prevalence rate 25%), along the Maroni river (prevalence 2.3%) and in a few places of the coastal area. The main cities remain malaria free. In vivo resistance to chloroquine was observed in 22% of the cases which could be cleared by amodiaquine or quinine.

Four cases of soft chancre have been observed in the service of Dermato-Venereology, CHU Tlemcen. Three were contracted in Morroco and one in Algeria. This affection which no long existed in Algeria, has reappeared through tourism.

The authors report a case-study of 20 subjects affected by visceral Larva migrans (VLM) and ocular Larva migrans (OLM). Of the 20 patients, 11 were male, and 9 female (mean age: 45 years); 7 were children, from 1 to 8 years old. Seventeen patients presented clinical and bio-humoral features which could be correlated with VLM syndrome; alongside cases with clearly suggestive symptomatology, in some patients the infection by Toxocara sp. was found to show few or minor symptoms, or even to be asymptomatic and occasionally it was suspected because of a marked peripheral eosinophilia. In 3 cases the infection was exclusively ocular. So far as immunology is concerned, serological tests confirmed in all 20 cases the clinico-epidemiological and/or bio-humoral suspicion; in particular the ELISA IgG test showed high titres in 16 cases, while the RAST showed significant levels of specific IgE in 17 cases. From the therapeutic point of view, the subjects treated were exclusively those presenting a manifest clinical picture: in 5 patients the first choice drug was thiabendazole, with clinical cure in only 2 cases; diethylcarbamazine resolved the clinico-parasitological picture in 1 case; 1 patient is still under treatment with albendazole.

To describe and evaluate the frequency of neurological and psychiatric manifestations in African patients with AIDS, 93 in patients at the National Hospital Center, Bangui, were chosen according to the WHO clinical definition of AIDS and were confirmed to be HIV-1 positive (92/93) or HIV-2 positive (1/93) by Western blot. Patients were given both neurologic and psychiatric examinations. Cortico-spinal fluid (CSF) analysis was performed in case of neuro-psychiatric signs. 11 patients presented neurologic symptoms: 5 had focal processes associated in 2 cases with deep coma, 4 had cryptococcal meningitidis, 1 demonstrated peripheral facial paralysis, and there was one case of abnormal movement, choréo-athétotic type. 4 patients presented frank psychiatric symptoms (3 dementia syndromes, one of whom was HIV-2 positive, and 1 case of hallucinatory psychosis). CSF analysis was only helpful in the etiologic diagnosis of cryptococcal infection. The mortality rate in these 15 patients was 60% during the 2-month study. In this series, neurologic and/or psychiatric symptoms were detected in 16 (15/93)% of African patients with AIDS.

A sero-epidemiological study was conducted from July to August 1988, in a haitian population living in rural area. Out of 116 serum samples searched for H1V1 antibodies and anti-HTLV1, 5.2% and 4.3% were reactive, respectively. Both positivity H1V1/HTLV1 was observed in one case. HBs Ag carriers were 13%. Analysis of seroreactive people in this population enhances the epidemiological trends of AIDS in Caribbean (rural spreading, heterosexual transmission, sex ratio levelling) which relate to african type AIDS.

Sticks Hemastix, reactive to haematuria have been tested into a focus ivory coast located in a humid savanna area. Into this focus the prevalence rate of urinary schistosomiasis (Schistosoma haematobium) was 27% taken as a whole and 40% for 5 to 19 years old persons. This study has shown that reactive sticks have a good sensitivity and an acceptable specificity compared with filtration. More, a good correlation between intensity of eggs count and the haematuria is observed.

The purpose of this study was to determine the prevalence of toxoplasmosis in samples of healthy populations in Ivory Coast. Various factors have been studied: age, sex, ethnic group, occupation, food, contacts with animals, climate. The samples were obtained in four places which were different by geographical situation and climate: Abidjan (urban site), Bonoua (littoral site), Bin-Houye (forest site), Odienne (predesert site). The samples of sera or blood were deposited on filter-papers and tested by latex agglutination (for IgG) and ISAGA (for IgM). Results were analysed by statistical methods. More than 2,000 samples have been studied, showing a prevalence higher in humid tropical zones (55.6% to 70%) than in predesert zone (37.2%). The first contact of the child with the parasite was more often before reaching 10 years but the risk for women was important until the age of 20. The other studied factors didn't appear to have any effect.

Since a few years, malaria has reappeared in the Central Highland Plateaux of Madagascar. From 1983 to 1987, Plasmodium falciparum resistance to chloroquine remained stable, with a low frequency of R2 therapeutic failures. In 1988, a study was conducted in the village of Manarintsoa, 15 km from Tananarive. Ninety-one WHO in vivo standard tests were performed. In vitro efficacy of amodiaquine and quinine was also studied. In vitro, the efficacy of chloroquine, quinine, and mefloquine was measured against 104, 64, and 23 P. falciparum isolates, respectively, by an isotopic semi-microtest.

The efficacy of praziquantel has been studied in human hydatic disease due to E. granulosus, using parasitological and pharmacological criteria of improvement. This evaluation uses a prospective therapeutic trial in 15 patients with one or several hydatic cysts in different sites. Before surgery, nine of these received daily 75 mg/kg of praziquantel in 2 courses of 10 days each. The other six patients are considered as controls. The protoscolices vitality is determined by direct optic microscopy and by intraperitoneal mouse inoculation. According to the results of optic microscopy, praziquantel sterilizes hydatic cysts: 19 sterilized cysts out of 26 coming from treated patients, and 4 out of 11 in control group. This effect seems to be emphasized in hepatic localization. Nevertheless, according to the results of mouse inoculation, praziquantel does not significantly reduce the pathogenicity of inoculated proscolices and germinal layer: 11 mice out of 39 are healthy in the treated group, and 5 out of 15 in controls. Moreover, the determination with a fluorimetric method has not detected praziquantel in the hydatid liquid issued from treated patients. The drug does not pass through the cyst wall, and so, cannot have a scolicidal activity. Praziquantel cannot be considered as a medical treatment in human hydatidosis.