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

In a longitudinal survey conducted in savanna area (Burkina Faso, West Africa) where malarial transmission is seasonal, we studied modifications of T, B lymphocytes, NK cells, and CD4+, CD8+ and activated T subpopulations of 61 patients (31 adults and 30 children, among them 20 showed at least one malarial attack during the survey). Analysis was made by direct immunofluorescence on a cytofluorimeter. Our study did not show any significant differences in lymphocytes subpopulations according to age or presence of malarial attack. None of the lymphocyte markers in the peripheral blood are related to premunition, may be because host/parasite conflict mainly occurs in deep organs.

Two hundred and twenty adult males living in endemic onchocerciasis areas in Ivory Coast, with a mean of 59 to 64 mf/mg of skin microfilariae, having or not ocular lesions, were divided into 4 homogeneous groups and treated by placebo or by a single oral dose of 100, 150 or 200 mcg/kg of ivermectin. Parasitological, clinical, ophthalmological, biological data were gathered before treatment (J less than 1) and at day 4 and 3, 6, 12 months post treatment. The doses of 150 to 200 mcg/kg gave the best results with a reduction of microfilariae of 75 to 79% at day 4 and of 97 to 99% at 3 months. A slight increase appears at six months reaching to 10% of the initial level, at 12 months. These posologies reduce also the number of ocular microfilariae 12 months after treatment. The percentage of patients presenting microfilariae in the cornea varies from 4 to 14% according to the given dose whereas it was initially between 26 and 33%, and in the anterior chamber from 22 to 16% instead of 62 to 67%. In patients who were still positive after treatment the detected number of ocular microfilariae was very small. Side effects starting 12 to 24 hours after treatment are similar to those appearing during the normal evolution of onchocerciasis. They were observed in 36% of subjects receiving a placebo and 56 to 65% of treated subjects. Statistically they are neither correlated with the intensity of parasitism nor to the given posology and disappear spontaneously few days later or after administration of aspirin and/or antihistaminic. Ivermectin given at a single oral dosage of 150 to 200 mcg/kg is a powerful microfilaricidal drug with a rapid and prolonged action and without major side effects.

One hundred and three male and female children of 6 to 14 years old with onchocerciasis, having or not ocular involvement and a mean skin microfilariae level of 36.1 mf/mg, received, in October 1986, a single oral dose of 150 mcg/kg ivermectin and controlled at day 4, 3 months, 6 months and 12 months post treatment. After the last control they were retreated with the same dose. The skin microfilariae count fell down to 94% of the initial level at day 4 and to 99% at 3 months. At 6 months the microfilariae count was 2% of the initial level and 5% at 12 months. The percentage of patients having microfilariae in the anterior chamber of the eye which was 33% before treatment fell down to 6% at 12 months. The percentage of patients having microfilariae in the cornea was 39% before treatment and 18% at 12 months. In the cornea and anterior chamber there was a very reduced number of microfilariae still present. 65% of the children had lesions of keratitis before treatment and 34% two months later. Adverse effects (fever, headache, pruritus, oedemas, myalgias, arthralgias) occurred in 64% of children after the first treatment and 50% after the second. They were of weak or moderate intensity and receded rapidly after administration of aspirin and/or anti-histaminic. The administration of ivermectin is an efficient and well tolerated drug in children above 5 years old.

The filariasis of W. bancrofti with nocturnal periodicity is, together with malaria, the principal endemic disease in the Comoros Islands. Well studied on Mayotte island, which remained a French Territorial Collectivity, its prevalence and distribution are less known in the Grand Comoros, Anjouan and Moheli islands which form the Federal Islamic Republic of the Comoros. The study of the nocturnal microfilariae in the Grand Comoros and Moheli in 1987 is the opportunity to assess the situation of the disease on this archipelago.

Thirty-two patients have been hospitalised in Marseilles since 1979 for recurrent oedema following their return from a tropical region. In spite of strong suspicion, the diagnosis of Loa loa was confirmed only five times. One patient was diagnosed with filariasis due to Mansonella perstans. The diagnosis of loiasis was usually presumptive and there were often wide variations in the laboratory findings. Two patients were thought to have an allergic reaction to diethylcarbamazine. Another patient was felt to have an allergy to streptococcal antigen. One patient who had lived in the Extreme Orient presented with an inflammatory fasciitis. Two patients presented with neurological manifestations: one with eosinophilic meningo-encephalitis, one with a neuropathy of the median nerve. In one case, the oedema was attributed to congenital lymphoedema.

In a study involving 104 children hospitalized with diarrhoea, 9% were infected with oocyst Cryptosporidium spp. add 56% with such yeast-fungus as Candida (C. Candida 38%). The manifestations noted in cryptosporidiosis infected children are acute diarrhea, vomiting and hyperthermia. One subject out of five who were tested for antibody to HIV appeared to be antibody positive. The patients immunity from the disease was not checked. A mycological test must be systematically carried out in case of children diarrheal outbreak.

Twelve children, 2 to 15 years of age, with falciparum malaria (parasitaemia 4,500 to 170,000/mm3) have taken 24 mg/kg body weight of halofantrine hydrochloride (Halfan) per os in three divided doses given within 12 hours. The symptomatology improved after 24 to 48 hours, with no more fever 5 to 90 hours after treatment and with a decrease of splenomegaly in 80% of the cases. The parasitic clearance was obtained after 24 to 60 hours. The haematocrit started raising again in 58% of the cases. Halofantrine hydrochloride is an efficient antimalarial drug in semi-immune patients. It is well tolerated and well accepted, thus representing an alternative for the cure of chloroquine-resistant falciparum malaria.

During and after a Rift Valley fever epidemic in Southern Mauritania, we observed 348 patients infected by RVF virus. 17 of them had encephalitis. These belonged to 2 groups, acute febrile forms with short duration and possibility of death, and sub-acute forms, with a longer duration and with sequelae. They were pure encephalitis, without clinical or biological meningeal signs. We also noticed 5 brutal ocular attacks, running very slowly, with sequelae.

The RFI des Comores is classified by WHO as an area where P. falciparum resistance to chloroquine is rare or low. After reviewing the existing data, the authors are giving the results of an in vivo research in 1988-1989. 1.35 of the tests with 25 mg/kg were positive the 7th day, 3.38% of 207 tests with 20 mg/kg, 10.77% of 232 tests with 10 mg/kg, 21.56% of 51 tests on 5 mg/kg.

During a three-year period (1985-1987), in Reunion Island, 252 cases of leptospirosis were clinically diagnosed in humans, and serologically confirmed. The epidemiological study showed a significant male predominance, presence during all ages of life; no month and no geographical zone are spared but maximal incidences are noted during periods of and in localities with the most important rainfall. Severe forms are frequent but mortality remains low.