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

A 3 years study was decided in 12 villages of the South-West Burkina Faso to compare the chemoprophylaxis and the chemotherapy of febrile cases as potential malaria control strategies. During the first year pretreatment data were collected. During the two following years a programme carried out (I) prophylaxis (10 mg chloroquine/kg body weight) was given weekly to all children under 14 years old in 5 villages, and (II) therapy (10 mg chloroquine/kg body weight) was given in a single dose to all febrile cases in 7 other villages. Chloroquine tablets were distributed by health workers belonging to the community. Both prophylaxis and therapy reduced the gametocyte rate in children (2-9 years) respectively of 63% and 45%. The analysis of the evolution after the first year of the sporozoite rate of anopheline was made difficult by concomitant natural variations of mosquitoes longevity and by mosquitoes displacements. Significant variations of sporozoite rate can be explained by natural variations of mosquitoes longevity. But data from the rice field villages support evidence that reduction of the pool of parasite infective for vectors induced the decrease of Anopheles gambiae s. l. sporozoite rate. Therefore our results reflect a trend more than a strict reduction of malaria transmission.

Seventy-nine French residents in Dar-es-Salaam, Tanzania, on 3 chemoprophylactic regimens, were included in a prospective study for a mean time of 10.8 +/- 3 months. No malaria attack was observed in the group (n = 32) taking chlorproguanil and chloroquine for chemoprophylaxis. Two attacks were reported in the group (n = 29) using chlorproguanil alone and 5 attacks in the group (n = 20) that was not taking antimalarial chemoprophylaxis. The blood concentration of chlorproguanil and chlorcycloguanil, the active metabolite, were measured, 3 hours (II3), 3 days (D3), and 7 days (D7) after the weekly dose. The urine concentration was measured at D7. The prophylaxis failure with chlorproguanil can be explained either by irregular use of the drug, or insufficiently lasting plasma concentration of chlorcyloguanil, or existence of parasite resistance to dihydrofolate reductase inhibitors.

A retrospective investigation permitted us to show presence of HIV infection in Burundi between 1980 and 1981. 658 sera collected in healthy population of Burundi during this period have been tested for HIV1 and HIV2 with ELISA screening and western-blot analysis. Results completed with HIV1 antigen research show 29 patients infected with HIV1 (27 antibodies to HIV1 carriers, and 2 with HIV1 antigen). The epidemiological situation before finding HIV show high prevalence (4.4%) of HIV1 infection. No HIV2 was found. The epidemiology of HIV infection was dominated by high prevalence in urban areas (8.08%) but 2.82% of country people were infected, by frequence in man (5.94%) but 3.08% of women were carriers, and by heterosexual transmission. After this study HIV infection was more frequent and we have observed epidemiological modification (importance of vertical transmission). Frequent antigenic cross-reaction between HIV1 and HIV2 core proteins has been observed. Cross-reaction with other retrovirus is possible.

The cutaneous tuberculosis (CTB) is still frequent in Algeria. From March 81 through December 87, forty-five cases were observed in our service of Dermato-Venereology (CHU Tlemcen), something like 6.4 cases per year. The two sexes are equally represented; 66.6% aged under 40; 66.6% are living in cities and have modest social and economical conditions; 20% were inoculated with BCG; previous CTB (personal 8.8% of family 11.1%) were hardly seen. It took some 44% of the patients less than a year to ask for a diagnosis, after receiving several non specific treatments. The rest took longer to come for consultation and in one case, the disease evaluated for 28 years. One explanation is that sometimes the affection causes very little annoyance. The clinical aspects observed were often evocative: Lupus vulgaris, 28.8%, scrofuloderma, 28.8%, specific adenitis, 13.3%, tuberculosis verrucosa cutis, 13.3%, gum, 13.9%, ulcerous CTB, 2.2%. Tuberculin skin test was positive for 86% of the cases and was taken into consideration when it reaches over 15 mm (46%), and with discomfort (4.4%). The treatment was efficient in the large majority of the cases. However, 29.5% of the patients gave up before the end of the cure. We insist upon the priority of the relationship doctor-patient in the case of a chronicle affection, which is less uneasy for some and shameful for a great many.

Two cases of very high hypereosinophilia (28,160 and 11,232/mm3) observed in congolese patients are presented. Although microfilaraemia was not detectable, loiasis was diagnosed, given the clinical manifestations, epidemiological data, history of sub-conjunctival migration of the adult worm (in one case), spectacular recovery (clinical and biological) after treatment with diethylcarbamazine. This "allergic form" of filariasis is often considered unusual in indigenous subjects.

In permanent malaria transmission area (Gabon), fluorescent malarial antibodies have been studied among a population of mothers new borns and children from 1 to 15 years old. A lack of transplacental transfer of antibodies among african pairs "cord-mother" is noticed and in negative correlation with total mother IgG level. The antibodies rapidly increase from 1-2 years old still 9. Chimioprophylaxis does'nt modified for a long time the development of the FAT malarial antibodies.

The authors report a case of cutaneous Larva migrans attributed to a gnathostomiasis in a Laotian man living in France since 3 years. The diagnosis was suggested on the basis of epidemiological and clinical context (he often ate raw fresh fish in Thailand) and blood eosinophilia. It was confirmed by ELISA method which showed a very high antibody titer to Gnathostoma spinigerum. The patient was treated with cortisone and diethylcarbamazine and he has remained asymptomatic since.

We describe one case of reactive encephalopathy as a complication during treatment of human trypanosomiasis (T.b. gambiense) with melarsoprol (Arsobal, Mel B.). A 37 year white man who had typical T. gambiense sleeping sickness and secondary convulsions, coma and hemiplegia after three days of treatment by melarsoprol. Within 48 hours of intensive care the symptoms and signs released. In the encephalomeningeal period of trypanosomiasis the therapy currently available is the parenteral administration of organic arsenicals as melarsoprol used since the 1940s. This drug remains highly effective but severe untoward reactions occur and the incidence of mortality attributable to melarsoprol is not negligible. Choice and optimal condition of treatment are discussed.

The choleriform diarrhoea may be caused by Vibrio cholerae, but also by other Vibrionaceae exhibiting the cholera-toxin antigenic determinants. The authors report three instances of gastroenteritis in infants, caused by 3 strains of non-O1 Vibrio and they carry out bacteriological study on these strains and their pathogenicity-strength factors.

Eight viral isolates were recovered from Eidolon helvum bats collected in Nigeria and Cameroon in 1971 and from the Central African Republic in 1974. Subsequent studies showed that the agents from the three countries were similar and were strains of a new virus of the Orbivirus genus, family Reoviridae. This new virus was characterized with respect to its sensitivity to lipid solvents and to pH, its relative size and morphology by electron microscopy, its effect on mice experimentally infected by various routes, the histopathology found in infected mice, and its antigenic relationship or lack of a relationship to other known orbiviruses.