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

24 cases cutaneous schistosomiasis are presented. Among these cases, 6 patients have localization of perineum and 18 patients have local blotch pigmented papules. These frequent and typical lesions allow an early diagnostic of this disease and particularly in the child.

With regard to an acute disease, Rift Valley fever, we tried to establish a prognostic score to help physicians to set prognosis and to choose a health management suitable in their context. Using clinical and biological data collected during the 1987 RVF epidemic in Southern Mauritania, we established a prognosis score card. Data analysis allows to prognosticate forms of possible severe evolution as an association of four syndromes: fever over 39 degrees, hemorrhagic syndrome, icterus and neurological signs. Using 12 clinical symptoms and 3 biological signs, it is possible to prognosticate cases with fatal evolution.

Human infestation by retrolentivirus which are incriminated in human disease called AIDS turns to be a "serious endemic". Once adequate medicine and vaccine discovered, it could perhaps be jugulated or eradicated in ethno-ecosystems combining a high socioeconomic level and a heavy attendance of efficient biomedicine. These criteria fit in neither with Quarter, nor with Third World, nor with worlds which do not think or live Health, Illness, Death, Misfortune in the same terms than those inspired by biomedical philosophies. Native logic apprehends AIDS as any form of sequence of misfortune, without taking care of its physiopathologic and epidemiologic specificity.

Administration of ivermectin (Mectizan) in Loa loa filariasis induces a significant decrease of microfilaria load within 3 to 15 days. The excellent tolerability of the drug in patients infested simultaneously by O. volvulus and Loa loa allows to use ivermectin in mass treatments in geographical areas where the same patients can be affected by several filariasis. There is almost no efficacy against Mansonella perstans. A second administration one month after the first one in Loa loa affected patients has not led to a complete disappearance of microfilaria; the tolerability has still been good. Efficacy on Ascaris lumbricoides appears to be excellent; further studies are necessary in the cases of trichuriasis, ancylostomiasis and strongyloidiasis.

In this work a total of 82 strains of Salmonella typhi were isolated from Egyptian patients diagnosed as quiry enteric fever. These cases were from Ismalia, Suez and port Said Areas. The strains fell in 16 phage types. Phage types N, 40, E1, and degraded Vi were the commonest phage type in Ismailia, while phage types degraded Vi and C1 were the commonest in Port Said. Phage types Di-N, degraded Vi, A and C1 were the commonest in Suez. Chemotyping of Salmonella typhi showed that the majority of the strains belonged to chemotype I (82%), and the rest belonged to chemotype II (18%). Colicin production was negative and all the strains were susceptible to the currently used antibiotics.

Patients were composed of 85 adults and 19 children; 70 were European, 23 Comorian; malaria was contracted by 9 patients in French Guyana, 60 in Africa, 23 in Comoro Islands; prophylaxis was correct for 45 patients (nearly all of the cases with chloroquine) when the first symptoms occurred. Every case of malaria appeared during the month following their return from an endemic area. Fever was often moderate or intermittent, altered by prophylaxis and previous treatments. Some patients had a clinical profile of "visceral evolutive malaria" and 3 a cerebral malaria. The most frequent biologic alteration was thrombopenia (40 times under 100,000/microliters). No relation between parasites density and clinical profile has been identified. The sensitivity of the strains for antimalarial drugs has been studied 35 times: 28 strains were chloroquine resistant, 3 have a decreased sensitivity for quinine. Most of the resistant strains came from Central Africa. Two patients died.

The amazonian region of Ecuador is the site of a powerful migratory influx for colonizing new lands. 1/3 of the settlers come from the coastal part of the country and 2/3 from the andean part (Sierra). To cope with their new situation, people carry out cash crop cultivations and adopt stereotyped food consumption patterns. Though they do not suffer from any important food shortages, the dietary quality of foods is poor and nutritional deficiencies are observed. Prevalence rate of parasitic infestation is high and infectious diseases are common. About 10% of the children are moderately undernourished and more than 50% denote growth retardation. The extent of growth retardations varies according to the geographical origin of families. Children from the coast having a faster growth than their andean counterparts. The differences could be explained by the fact that coastal families, coming from an area with ecological and climatic characteristics closed to those encountered in Amazonia, are less out of their element than the Sierra's. It seems that fortune of settlers improve with time, however the evolution of the colonization process and its consequences on the health status of populations is almost unknown. The magnitude of this phenomenon, the number of countries involved and people concerned emphasize the need for more substantial research on the scope.

Within the framework of the preparation (acceptability and feasibility) of an integrated malaria control including insecticide impregnated bednets notably, a Knowledge Attitude Practice survey (home cluster sample) was carried through in March, 1988 in Yaoundé City to identify the current major mosquito behaviour control methods: insecticide sprays, mosquito coils and bednets and the motivations in the use of these control methods. The cost of vector control and cares for diseases attributed to mosquitoes have been evaluated. The survey shows that insecticide impregnated bednets represent an accessible and suitable control method subject to regular supply with reasonable prices and implementation of demonstration stations for the impregnation.

56 patients carriers of Plasmodium falciparum were observed throughout 1987: 47 males and 9 females of a mean age of 32. The following clinical aspects were observed: Falciparum malaria: 35 cases, malaria with a low parasitaemia (less than 1,000 HPM): 5 cases, tropical splenomegaly syndrome: 3 cases, isolated bi- or tricytopenia: 10 cases, cerebral malaria: 1 case, asymptomatic carriers: 2 cases. Statistically speaking, no significant correlation was observed between parasitaemia and the following clinical and biological symptoms: fever, splenomegaly, Hb level, platelet count. However, we noted a level of parasitaemia higher in the acute forms of malaria (Falciparum malaria and cerebral malaria) than in the non typical forms (chronic visceral malaria, haematological disorders). All asymptomatic carriers, who represent "malaria infection", presented a low parasitaemia (less than 1,000 HPM).

Q fever is seldom reported in West Africa. The case of a man returning from Guinea Bissau who presented an acute lobar pneumonia with fever, headache, hematuria and hepatitis was confirmed by high titers of antibody in Phase II indirect immuno-fluorescence which appeared on the twelfth day of fever. Treatment with erythromycin was continued by doxycyclin, and complete resolution of all signs was promptly obtained. Coxiella Burnetii might thus be responsible of cases of unexplained fever with respiratory or hepatic manifestations in West Africa.