Lombard F, Basset D, Cambonie G
… +2 more, Bastien P, Jeziorski E
Med Sante Trop
· 2018 Feb · PMID 29616650
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Angiostrongyliasis, the leading cause worldwide of eosinophilic meningitis, is an emergent disease due to Angiostrongylus cantonensis larvae, transmitted accidentally to humans. Contamination of children usually occurs b...Angiostrongyliasis, the leading cause worldwide of eosinophilic meningitis, is an emergent disease due to Angiostrongylus cantonensis larvae, transmitted accidentally to humans. Contamination of children usually occurs by direct contact with an infected mollusk. Eosinophilic meningoencephalitis is the major clinical feature of this parasitic infection in humans. It is usually benign for adults, but more severe for children. Clinical symptoms usually combine fever, meningitis, and neurological signs (somnolence, moaning, hypotonia, convulsions, and increased intracranial pressure). Presumptive diagnosis of human angiostrongyliasis is based on epidemiologic characteristics, clinical symptoms, medical history, and laboratory findings, in particular, hypereosinophilia in blood and cerebrospinal fluid. Treatment is based on corticosteroids associated with anthelmintics. This work reviews the diagnosis and treatment of this life-threatening (especially in children) parasitic disease and the need for preventive action.
Med Sante Trop
· 2018 Feb · PMID 29616649
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Publisher ↗
Monoclonal gammopathies are common abnormalities and their incidence increases with age. They are detected in roughly 3 % of people older over 50 years and up to 7 % of those over 70 years. Multiple myeloma (MM) is chara...Monoclonal gammopathies are common abnormalities and their incidence increases with age. They are detected in roughly 3 % of people older over 50 years and up to 7 % of those over 70 years. Multiple myeloma (MM) is characterized by the proliferation of plasma cells within the bone marrow and excess secretion of monoclonal immunoglobulins. In Madagascar, late performance of biological examinations such as serum protein electrophoresis overestimates MM rates. We studied 54 patient records between March 2009 and January 2015 in the biology laboratory of the Joseph Ravoahangy Andrianavalona university hospital in Antananarivo (Madagascar). Monoclonal gammopathy was associated with multiple myeloma in most cases (88.9 %). Patients' median age was 64.2 years. Men were slightly more affected than women. It is discovered most frequently due to bone symptoms (83.3 %), and anemia is always present. Monoclonal gammopathy is mostly IgG. The bone marrow study showed medullary plasmacytosis. This disease appears most often in the elderly and has a slight male predominance. Bone marrow cytology is mandatory for diagnosis.
Ngombe LK, Ngatu RN, Nyembo CM
… +5 more, Ilunga BK, Wembonyama SO, Kakoma JBS, Danuser B, Luboya ON
Med Sante Trop
· 2018 Feb · PMID 29616648
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The aim of this study was to determine the prevalence of respiratory complaints in Congolese women selling grain flours in Lubumbashi. The study enrolled 370 women, including 183 cassava, corn and soybean flour selling w...The aim of this study was to determine the prevalence of respiratory complaints in Congolese women selling grain flours in Lubumbashi. The study enrolled 370 women, including 183 cassava, corn and soybean flour selling women (exposed group) and 187 tax collectors in municipal markets (control group) in Lubumbashi, DRC. A standardized respiratory health questionnaire was used, and a lung function test performed with the use of peak flow-meters. The prevalence of respiratory complaints was markedly higher in dust-exposed women than controls. In addition, peak expiratory flow rate (PEFR) was significantly lower in the exposed group than in controls (342.46 ± 65.62 vs. 410.89 ± 70.91, respectively ; P<0.05). After adjustment for age and education level, women involved in cassava, corn and soybean flour selling business were more likely to develop respiratory complaints ad disorders as compared to controls.
Moueleu Ngalagou PT, Ngouadjeu Dongho Tsakeu E, Ngo Sack F
… +3 more, Eboumbou Moukoko EC, Konn Jolly Y, Luma H
Med Sante Trop
· 2018 Feb · PMID 29616647
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Data about malignant blood diseases are sparse in Cameroon. Their epidemiology was studied in patients at the General Hospital of Douala (GHD) and the Yaoundé Central Hospital (CHY) from 2004 through 2014. The variables...Data about malignant blood diseases are sparse in Cameroon. Their epidemiology was studied in patients at the General Hospital of Douala (GHD) and the Yaoundé Central Hospital (CHY) from 2004 through 2014. The variables we studied were social and demographic (age, sex, occupation, marital status), clinical (reasons for consultation, clinical signs, year of diagnosis), and biological (blood count, myelogram and blood smear, immunophenotyping, biopsy, and cytogenetics). In all, 4409 files were reviewed and 454 cases identified, documented and confirmed (248 in GHD and 206 in CHY). The prevalence of malignant blood diseases was 10.4%. The patients' mean age was 44.3 ± 19 [range : 1-80] years and the M/F sex ratio 1.4/1. In 32.2% of the cases, the patient consulted because of a tumor. The most frequent malignant blood diseases, in decreasing order, were non-Hodgkin's lymphoma (31.1%), chronic myeloid leukemia (21.4%), chronic lymphoid leukemia (12.6%), multiple myeloma (11.2%), acute lymphoblastic leukemia (7.4%), and acute myeloblastic leukemia (6.4%). Their incidence by age group showed that acute lymphoblastic leukemia was most common among children (20%), and chronic myeloid leukemia among young adults (28.9%). The main hemogram abnormalities were anemia (73.7%), hyperleukocytosis (57.3%), and thrombopenia (39.2%). Various types of malignant blood diseases thus exist in the hospital environment in Cameroon, and their forms are underdiagnosed.
Mouhari-Touré A, Mahamadou G, Kombate K
… +4 more, Akakpo AS, Teclessou JN, Singo A, Pitché P
Med Sante Trop
· 2018 Feb · PMID 29616646
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the aim of this study was to evaluate the mortality and morbidity of HIV-infected children on highly active antiretroviral treatment (HAART) in Togo. this is a retrospective study of HIV-infected children on HAART in the...the aim of this study was to evaluate the mortality and morbidity of HIV-infected children on highly active antiretroviral treatment (HAART) in Togo. this is a retrospective study of HIV-infected children on HAART in the 25 largest centers of HIV/AIDS care in Togo. the study included 1861 children (sex-ratio=0.99). Among them, 35.6 % were in WHO clinical stages 3 or 4 at the beginning of HAART. The most common opportunistic infections were coughing and pneumonia (37.1 %), gastroenteritis (11.3 %), various bacterial infections (10.4 %), and pruritus (10.4 %). The incidence of death was estimated at 4.5 per 100 person-years. Mortality was highest during the first year of antiretroviral therapy. The survival rate at 12 months of ART was 92.6 %. Children who began HAART at WHO clinical stage 4 had a significantly lower survival rate than the others (P<0.0001). The presence of a side effect of HAART (P=0.041), and hospitalization (P<0.001) were significantly associated with death in these children. although the new recommendations for medical care require early initiation of HAART, the improved performance of programs to prevent maternal-infant transmission remains crucial in reducing morbidity and mortality of children on HAART in Togo.
Gnassingbe A, Flahault A, Geissbuhler A
… +2 more, Sprumont D, Awesso A
Med Sante Trop
· 2018 Feb · PMID 29616645
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The extent of medicines sales and consumption in the informal market in Togo raises many ethical and public health issues. In order to report on the situation of public action in the fight against this practice, we condu...The extent of medicines sales and consumption in the informal market in Togo raises many ethical and public health issues. In order to report on the situation of public action in the fight against this practice, we conducted a qualitative survey from 15 to 25 February 2016 in the commune of Lomé and in the Maritime Region among the actors of control system and resource people in the general population. This was supplemented by an analysis of Togo's pharmaceutical and health policy documents and a literature review on the illicit drug market issues relating to public health, political science, the social sciences applied to health. In spite of the existence of national and international tools, household poverty, cultural self-medication, ignorance of the population concerning the health risks of informal market medicines, weak political commitment, weakness regulation and enforcement, corruption, constitute obstacles to the success of actions to combat this practice.
Ouedraogo S, Windsouri M, Sawadogo JT
… +3 more, Zida M, Ouangre E, Traore SS
Med Sante Trop
· 2018 Feb · PMID 29616644
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To describe the etiological, therapeutic, and prognostic aspects of primary biliary peritonitis in Burkina Faso. This retrospective study reviewed records of all patients admitted for primary biliary peritonitis at Tenko...To describe the etiological, therapeutic, and prognostic aspects of primary biliary peritonitis in Burkina Faso. This retrospective study reviewed records of all patients admitted for primary biliary peritonitis at Tenkodogo Regional Hospital (Burkina Faso) from 2010 through 2016. Cases of secondary biliary peritonitis have been excluded. Thirty patients were identified. Their average age was 26.5 years. Fourteen patients were under 12 years of age. The reasons for consultation were dominated by abdominal pain (in all cases) and bile-induced vomiting (in 22 cases). Seven patients had a general condition classified in stage 2 of the World Health Organization classification, 18 in stage 3, and 5 in stage 4. The etiologies of peritonitis were acute typhoidal cholecystitis, which predominated (27 cases), and gallstones (3 cases). The surgical approach was a laparotomy in all cases. Intraoperative observation showed an inflamed and perforated gallbladder in 24 cases; gangrene was noted in 6 cases. Treatment consisted of cholecystectomy and peritoneal lavage, associated with antibiotic therapy. The post-operative period was complicated by septicemia in 12 cases. Fourteen patients died, for a mortality rate of 46.7 %. In rural Burkina Faso, primary biliary peritonitis occurs in young subjects. Its cause is most often acute cholecystitis due to Salmonella typhi. Mortality is very high.
Doudou Halidou M, Arzika A, Manzo ML
… +1 more, Dramaix Wilmet M
Med Sante Trop
· 2018 Feb · PMID 29616642
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To analyze the determinants of the persistence of the cholera epidemic in Tillabery to obtain a durable solution. Case-control study conducted in three health centers in June 2013 in Tillabery. Cholera cases were confirm...To analyze the determinants of the persistence of the cholera epidemic in Tillabery to obtain a durable solution. Case-control study conducted in three health centers in June 2013 in Tillabery. Cholera cases were confirmed by laboratory testing or epidemiologically linked with a confirmed index case. Controls were individuals with no history of diarrhea, of the same sex, from the same village and with an age difference that did not exceed five years. A logistic regression model was used to analyze the appearance of cholera according to the determining factors. The analysis showed significant association between the occurrence of cholera and variables related to behavior. The adjusted OR confirm higher risks of cholera for persons in households with more than five inhabitants (crude OR = 1.55 95 % CI (1.06 to 2.28) and adjusted OR 95 % CI 2.68 (1.79 to 4.56)), or in contact with a person with diarrhea (crude OR = 1.86 95% CI (1.26 to 2.75) and adjusted OR = 1.61 95% CI (1.5 to 2.68)), and who report not washing their hands after defecation (crude OR = 3.44 95% CI (2.20 to 5.41) and adjusted OR = 2.76 95% CI (1.73 to 3.79)). This study concludes that the Tillabery cholera victims are primarily those with hazardous hygienic practices. Niger must define operational recommendations to limit the continuance of cholera in certain river areas, particularly in the Tillabery.
Med Sante Trop
· 2018 Feb · PMID 29616641
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Publisher ↗
Bothrops lanceolatus, a member of the Viperidae family and Crotalinae subfamily, is the only snake causing envenomation in Martinique, which is the only place it exists in the world. Any bite by this snake may result in...Bothrops lanceolatus, a member of the Viperidae family and Crotalinae subfamily, is the only snake causing envenomation in Martinique, which is the only place it exists in the world. Any bite by this snake may result in severe thrombotic complications including cerebral, pulmonary, and myocardial infarction and affecting the patient's vital or functional prognosis. The exact composition of the venom as well as the mechanisms of toxicity involved are still debated today. The first specific antivenom immunotherapy (AVI), Bothrofav1, manufactured in 1991, reduced mortality and morbidity significantly. In 2004, however, an increase in the number of cases of Bothrops lanceolatus envenomation-induced ischemic strokes despite early AVI administration, raised questions about its effectiveness and encouraged the development of a second AVI, Bothrofav2, which became available in February 2011. Causes of the failures with the first AVI remain hypothetical, and the effectiveness of the second is under evaluation. This article reviews the published data available on this rare envenomation, present in one of our French overseas departments and discusses its fascinating scientific and medical issues.
Med Sante Trop
· 2018 Feb · PMID 29616640
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Publisher ↗
The author reports the surgical management of a patient with elephantiasis of the leg in the Democratic Republic of Congo. A fasciotomy and lymphangiectomy with skin preservation, combined with compression therapy, resul...The author reports the surgical management of a patient with elephantiasis of the leg in the Democratic Republic of Congo. A fasciotomy and lymphangiectomy with skin preservation, combined with compression therapy, resulted in significant cosmetic, functional, and social improvement. Although challenging in a resource-limited setting, development of surgical management may make it possible to reduce beliefs that elephantiasis is incurable or due to witchcraft and may reduce time to consultation.
Iba Ba J, Nseng Nseng I, Coniquet S
… +1 more, Boguikouma JB
Med Sante Trop
· 2018 Feb · PMID 29616639
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Publisher ↗
Lupus is an autoimmune disease of the connective tissues, relatively frequent in the black population, and with a marked female prevalence. Clinical polymorphisms explain the diverse and varied nature of the clinical for...Lupus is an autoimmune disease of the connective tissues, relatively frequent in the black population, and with a marked female prevalence. Clinical polymorphisms explain the diverse and varied nature of the clinical forms that are sources of diagnostic aberrations. This disease can be associated with various diseases. Here we report an unusual association with AS hemoglobinopathy.
Med Sante Trop
· 2018 Feb · PMID 29616633
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Publisher ↗
After the Ebola outbreak in West Africa (2013-2016), preparedness is on the agenda of health institutions. However, key questions remain about the scope of preparedness and activities related to the socio-cultural dimens...After the Ebola outbreak in West Africa (2013-2016), preparedness is on the agenda of health institutions. However, key questions remain about the scope of preparedness and activities related to the socio-cultural dimension of epidemics. A multidisciplinary short-course Infectious Diseases and Anthropology in West Africa (MIAA) was held at CERFIG, Conakry, in November 2017. Its evaluation provides some answers to key questions, such as who should be trained, and what its objectives, pedagogical contents, and methods should be.
Med Sante Trop
· 2018 Feb · PMID 29616631
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Publisher ↗
In 1995, 20 years after the first known Ebola outbreak, one of us (JPG) wrote an editorial about Ebola Virus Disease that captured the knowledge and attitudes toward viral diseases of that time and discussed the future o...In 1995, 20 years after the first known Ebola outbreak, one of us (JPG) wrote an editorial about Ebola Virus Disease that captured the knowledge and attitudes toward viral diseases of that time and discussed the future of viruses in our world. Now, 21 years later, in the wake of the West African Ebola pandemic of 2013-2016, and after 22 other Ebola outbreaks, we revisit the article to determine if knowledge, attitudes, and practices have changed. We conclude that the necessary infrastructures (surveillance, financial, treatment/preventative health) have improved with each outbreak, and knowledge of the virus (vaccines, therapies, diagnostics) has increased. However, the global reach of the virus has also increased due to expanded means of global transportation. Furthermore, the knowledge of the virus that has increased with each outbreak has not translated into the necessary marginal increase in preparedness; we do not seem to be learning from our mistakes.