Seck SM, Diakhaté M, Oulfath A
… +3 more, Sow MN, Dieng M, Gueye NN
Med Sante Trop
· 2019 May · PMID 31379339
·
Publisher ↗
INTRODUCTION: The aim of our study was to evaluate the clinical, microbiological, and contributing factors of microbial keratitis in tropical environment. Materiel and methods: We performed a retrospective study of all p...INTRODUCTION: The aim of our study was to evaluate the clinical, microbiological, and contributing factors of microbial keratitis in tropical environment. Materiel and methods: We performed a retrospective study of all patients admitted to the ophthalmology department of Principal Hospital in Dakar for infectious keratitis, over ten years from January 2006 to December 2015. Clinical, microbiological, and contributing factors as well as visual effects were studied. RESULTS: We collected data of 118 patients hospitalized for unilateral infectious keratitis in 10 years, for an average of 12 cases per year. The patients' mean age was 50 years. At least one local risk factor was found in 58.5% of cases. These were mainly ocular trauma (39%), followed by local treatment of glaucoma (16%), and recent eye surgery (14.5%). In 9 cases (8%), the only risk factor for abscess was an isolated general factor. This was diabetes in 7 cases. The clinical aspects described can be grouped according to topography, depth, and severity in pre-perforation state or perforation (45%), anterior chamber Tyndall effect greater than 1 cross, reaching a hypopyon stage (24%), stromal infiltrate larger than 2 mm (18%) and the abscess located within 3 mm of the corneal center (13%). The microbiological examination isolated a germ in 17% of cases, principally Pseudomonas aeruginosa (40%), followed by Staphylococcus aureus (20%). Prognosis was severe with visual acuity of less than 1/10 in 90% of cases and evisceration in 16% of cases. DISCUSSION: The most common risk factor was local ocular trauma by foreign bodies in the cornea. The poor prognostic factors were possible delay in consultation, low initial visual acuity, and low rate of positive microbiological examinations. CONCLUSION: Infectious keratitis is a potentially serious condition that can lead to blindness and eventually to loss of the ocular globe in tropical environments. Local risk factors are largely dominated by ocular trauma. Only early management based on the microbiological results improves the prognosis.
Med Sante Trop
· 2019 May · PMID 31379338
·
Publisher ↗
In 2009, the Franceville International Medical Research Center (CIRMF) celebrated its 30th anniversary, at the same time as the Republic of Gabon celebrated the 50th anniversary of its independence. The CIRMF went into o...In 2009, the Franceville International Medical Research Center (CIRMF) celebrated its 30th anniversary, at the same time as the Republic of Gabon celebrated the 50th anniversary of its independence. The CIRMF went into operation in 1979 when the president of the Republic, M. Omar Bongo Ondimba, decided to establish it in partnership with the Elf-Aquitaine corporation. Three decades later, it was time to assess its work. The day of this 30th anniversary, more than 300 people were working at the Center. To convince the authorities to make a major investment, the Directorate-General of the CIRMF presented the successful results obtained for science, the projects underway and planned, and its international outreach. Mission accomplished: in 2009 a renovation of the CIRMF began. It has worked successfully in the following fields of research: antiretroviral agents, hepatitis viruses, the diversity of plasmodium, emerging viral diseases, and still topics such as neonatal diagnosis of sickle-cell anemia and an exhaustive inventory of the fauna and flora of the tropical forest. The CIRMF has achieved success and can be proud of its 30th anniversary of international biomedical research in the natural environment of Gabon.
Ghariani Fetoui N, Aounallah A, Boussofara L
… +11 more, Ben Kahla M, Mokni S, Marzouk M, Gammoudi R, Saidi W, Boukadida J, Sriha B, Belajouza C, Denguezli M, Ghariani N, Nouira R
Med Sante Trop
· 2019 May · PMID 31379337
·
Publisher ↗
Cutaneous tuberculosis with lymphatic spread is rarely described. We report the case of a woman aged 38, immunocompetent, working in a fruit sorting center, who consulted us for ulceration of the left third finger that h...Cutaneous tuberculosis with lymphatic spread is rarely described. We report the case of a woman aged 38, immunocompetent, working in a fruit sorting center, who consulted us for ulceration of the left third finger that had persisted for four months, following a prick from a prickly pear. Physical examination revealed a nodular, erythematous, and ulcerative lesion of the left third finger, associated with inflammatory subcutaneous nodules arranged in a line along the ipsilateral upper extremity and an ipsilateral axillary lymph node. Laboratory tests and chest X-ray were normal. Pathological examination revealed granulomatous chronic inflammation without necrosis. PCR detected DNA from Mycobacterium tuberculosis. No extracutaneous tuberculosis locations were detected. A tuberculous chancre by direct inoculation was therefore diagnosed. The patient received quadruple therapy (rifampicin + isoniazid + pyrazinamide + ethambutol) for 2 months, followed by a combination therapy based on isoniazid and rifampicin for 6 months. Marked regression of the cutaneous lesions occurred after 1 month of first-line therapy. A tuberculous chancre is a rare form of cutaneous tuberculosis, with possible lymphatic spread, in immunocompromised patients but also in immunocompetent children and young adults.
Med Sante Trop
· 2019 May · PMID 31379336
·
Publisher ↗
The induced membrane technique is a simple and effective method for reconstructing bone defects in limbs. It is suited to low resource settings, if sufficient care is taken in preparing and performing the technique. Key...The induced membrane technique is a simple and effective method for reconstructing bone defects in limbs. It is suited to low resource settings, if sufficient care is taken in preparing and performing the technique. Key points for the success of this procedure are described here. In austere environments, its use is mostly limited by possibilities for treatment of bone infection, but also by access to surgical cement and available bone stock. Alternatives for overcoming these last two obstacles are presented.
Igala M, Nto'o Eyene SA, Ledaga Lentombo LE
… +7 more, Mbiye Cheme SW, Rerambiah L, Ntsame Ngoua S, Pemba LF, Iba Ba J, Bouyou Akotet M, Boguikouma JB
Med Sante Trop
· 2019 May · PMID 31145082
·
Publisher ↗
Loiasis is a chronic cutaneous disease caused by a filarial nematode for whom humans are the only definitive host: Loa loa, an African eyeworm transmitted by Chrysops flies. The parasite is seen on blood smears, in the s...Loiasis is a chronic cutaneous disease caused by a filarial nematode for whom humans are the only definitive host: Loa loa, an African eyeworm transmitted by Chrysops flies. The parasite is seen on blood smears, in the skin, or during its ocular migration, but rarely on a bone marrow smear. We report the case of a 57-year-old Gabonese woman whose bone marrow aspiration during a work-up for T-cell leukemia fortuitously found Loa loa filariae.
Haar A, Garcia AC, Morin J
… +2 more, Morand JJ, Blatteau JE
Med Sante Trop
· 2019 May · PMID 31145079
·
Publisher ↗
We report a case of livedo reticularis of the lower limbs in a 30-year-old woman scuba diver after a diving session. Consideration of the differential diagnoses, the clinical picture, and the course of the symptoms led t...We report a case of livedo reticularis of the lower limbs in a 30-year-old woman scuba diver after a diving session. Consideration of the differential diagnoses, the clinical picture, and the course of the symptoms led to a diagnosis of cutaneous decompression sickness. This accident, which resolved favorably in this scuba diver without any right-to-left shunt, is an alarm signal that calls for her to comply strictly with safety rules before resuming scuba diving, to avoid a more serious accident.
Couitchere L, N'da G, Aholi JM
… +3 more, N'doumy M, Azagoh R, Oulai S
Med Sante Trop
· 2019 Feb · PMID 31031260
·
Publisher ↗
Cancer is a major cause of morbidity and mortality in children under the age of 15 years worldwide. To contribute to better knowledge of childhood cancers in Africa. To determine the causes of pediatric cancers and compa...Cancer is a major cause of morbidity and mortality in children under the age of 15 years worldwide. To contribute to better knowledge of childhood cancers in Africa. To determine the causes of pediatric cancers and compare them with the results of a previous study and with data available for sub-Saharan Africa. This observational, descriptive study of the data recorded from 2007 to 2015 in the pediatric oncology unit of the University Hospital Center of Treichville in Abidjan analyzes the general and the age- and sex-specific proportions of children under the age of 15 years with neoplasia according to the International Classification of Childhood Cancer, 3rd edition (ICCC.3). This study includes 863 new cases. The sex ratio (M/F) was 1.4, and the mean age 7 years (range: 3 months to 14 years 9 months). The neoplasia rate peaked in the group aged 5-9 years (38.6 %). The most common cancers were: lymphomas (44 %), retinoblastoma (11.7 %), renal tumors (10.1 %), leukemias (6.3 %), and soft tissue sarcomas (5, 9 %). Burkitt lymphoma (85.3 %) and nephroblastoma (90.8 %) were the dominant histological type of lymphoma and renal tumors. This study shows an increase in the annual number of new cases, and an epidemiology close to that reported in other centers in sub-Saharan Africa.
Essayagh T, Essayagh M, El Rhaffouli A
… +1 more, Essayagh S
Med Sante Trop
· 2019 Feb · PMID 31031259
·
Publisher ↗
Hepatitis A virus (HAV) is responsible for 1.5 million cases of infection annually worldwide. This disease occurs in areas where hygiene is precarious and affects mainly developing countries. In Morocco, 222 cases were r...Hepatitis A virus (HAV) is responsible for 1.5 million cases of infection annually worldwide. This disease occurs in areas where hygiene is precarious and affects mainly developing countries. In Morocco, 222 cases were reported in 2015, 34 of them from the city of Meknes. The objective of this study is to describe the trends in HAV incidence in Meknes to improve preventive measures. For this cross-sectional descriptive study, we investigated each case reported to the HAV surveillance system between 2013 and 2016. The following data were collected: socio-demographic information, season of infection, mode of water supply, food consumed, food purchasing environment, and laboratory confirmation of cases (by an ELISA test to detect anti-HAV IgG). Data were analyzed by Epi info version 7.2.0.1, with mapping by QGIS version 2.18.1. In all, 192 cases were reported with a sex ratio (m/f) of 1.3 and an average age of 13 ± 10 years. Incidence fell from 10 per 100 000 inhabitants in 2013 to 1.6 per 100 000 in 2016. Most cases (n = 160, 83%) came from the urban environment, and 63 (32%) occurred in springtime. Two people died. The incidence of HAV in the Meknes area has fallen, but public awareness campaigns by health education in the field of personal hygiene remain necessary. It is also essential to improve implementation of regulations banning food handling by virus carriers. Sanitary control of informal markets must be improved.
Guillard É, Kadio K, Mc Sween-Cadieux E
… +1 more, Ridde V
Med Sante Trop
· 2019 Feb · PMID 31031258
·
Publisher ↗
The most recent international symposium on research on healthcare systems took place in Liverpool in October, 2018. Its theme was the promotion of healthcare systems for all in the era of the Sustainable Development Goal...The most recent international symposium on research on healthcare systems took place in Liverpool in October, 2018. Its theme was the promotion of healthcare systems for all in the era of the Sustainable Development Goals. This biennial event is the occasion to bring together all the players in this domain- researchers, policy-makers, and field workers - to share the newest work. Numerous subjects were raised, some of them mentioned in the article: quality of care in healthcare systems through the necessary improvement in the practices of professionals, the issues of scaling up health interventions, mobilization of knowledge for the development of public policy, and the role of the private sector. Although this field has developed greatly over the past 20 years and has become central in both development aide and international health, it remains relatively little known in the French-speaking world and France is largely absent from it.
Issoufou I, Harmouchi H, Belliraj L
… +10 more, Ammor FZ, Rabiou S, Saeed A, Younssa H, James Didier L, Alio K, Lakranbi M, Rachid S, Ouadnouni Y, Smahi M
Med Sante Trop
· 2019 Feb · PMID 31031257
·
Publisher ↗
Cervicothoracic cellulitis is a very serious, potentially life-threatening infection of the cervical and thoracic soft tissue. It is a genuine medical and surgical emergency with substantial mortality, and its surgical t...Cervicothoracic cellulitis is a very serious, potentially life-threatening infection of the cervical and thoracic soft tissue. It is a genuine medical and surgical emergency with substantial mortality, and its surgical therapy has not yet been standardized. It spreads through the layers of the cervical fascia and can then disseminate to the mediastinum and the pleural cavities, requiring specific management that includes the thoracic surgeon. We present reports of 3 patients with cervicothoracic cellulitis, all complicated by mediastinitis, with pericardial effusion in 1 case and unilateral or bilateral pyothorax in 2 cases. Combining these cases with a review of the literature enables us to describe the management of these complicated cases as seen by a thoracic surgeon.
Rabiou S, Sani R, Lakranbi M
… +2 more, Ouadnouni Y, Smahi M
Med Sante Trop
· 2019 Feb · PMID 31031256
·
Publisher ↗
Posttraumatic diaphragmatic hernias have long been known, but the variety of their clinical expression can lead to diagnostic delay and difficulties in treatment. An intrathoracic hernia of hollow abdominal viscera with...Posttraumatic diaphragmatic hernias have long been known, but the variety of their clinical expression can lead to diagnostic delay and difficulties in treatment. An intrathoracic hernia of hollow abdominal viscera with subsequent necrosis and perforation is an uncommon late complication with poor prognosis. Surgical treatment is mandatory. Laparotomy is an excellent approach, making it possible to achieve therapeutic objectives for the abdomen and thorax with a short operative time and minimal complications in these patients whose hemodynamic status is often precarious. We report 2 cases of posttraumatic left diaphragmatic hernias with intrathoracic necrosis of the digestive tract, treated by laparotomy.
Donamou J, Touré A, Bandiaré MM
… +2 more, Konaté M, Sylla AI
Med Sante Trop
· 2019 Feb · PMID 31031255
·
Publisher ↗
To review the practice of anesthesia in Conakry hospitals This multicenter descriptive study focused on the practice of anesthesia in Conakry hospitals. We selected 9 healthcare facilities: 6 public and 3 private hospita...To review the practice of anesthesia in Conakry hospitals This multicenter descriptive study focused on the practice of anesthesia in Conakry hospitals. We selected 9 healthcare facilities: 6 public and 3 private hospitals. Together, these hospitals had 23 operating theaters, of which 11 (47.8 %) had an anesthesia machine, while 12 (51.9 %) did not have an oxygen supply. Six (26.1 %) had a complete intubation platform. For monitoring, we observed a multiparametric scope in five (21.7 %) of the operating rooms and a pulse oximeter in five. The anesthesia products used most frequently were: ketamine (narcotic), fentanyl (opioid), vecuronium (neuromuscular blocking agent), halothane (volatile anesthetic), and bupivacaine (local anesthetic). These nine facilities have 51 professional anesthesia practitioners: 44 (86.27%) senior technicians in anesthesia-resuscitation, and 7 (13.73 %) physicians specialized in anesthesiology and resuscitation. Over a one-year period (2016), 6303 patients received anesthesia. Gynecology-obstetrical surgery accounted for the highest proportion of patients receiving anesthesia (43.47 %). General anesthesia without intubation was the most common anesthetic technique (67.5 %). Most incidents were intraoperative and cardiovascular (95.6 %). The mortality rate was 0.4 %. Better technical platforms and better training of young practitioners would improve the practice of anesthesia in Guinea.
Med Sante Trop
· 2019 Feb · PMID 31031254
·
Publisher ↗
There is currently a hazardous debate between the rational use of antimalarial drugs based on artemisinin derivatives and the antimalarial efficacy of plant extracts of Artemisia spp. This article recall some fundamental...There is currently a hazardous debate between the rational use of antimalarial drugs based on artemisinin derivatives and the antimalarial efficacy of plant extracts of Artemisia spp. This article recall some fundamental rules guiding progresses in malaria treatment and use of artemisinin, with the aim to provide discussion elements to identify the safest place responding to health situations for drugs and phytotherapy.
Diallo M, Tanoh AC, Mamadou Z
… +1 more, Diallo LL
Med Sante Trop
· 2019 Feb · PMID 31031253
·
Publisher ↗
Polyradiculoneuropathies (PRNs) are inflammatory disorders of the peripheral nervous system. They are diffuse in general, sparing neither the proximal portions of the elements of this system, where they predominate, nor...Polyradiculoneuropathies (PRNs) are inflammatory disorders of the peripheral nervous system. They are diffuse in general, sparing neither the proximal portions of the elements of this system, where they predominate, nor the cranial nerves. To describe the epidemiological and diagnostic profiles, as well as the course, of patients with PRN in the Cocody university hospital center (Abidjan) neurology department over the past six years. This retrospective single-center study describes PRN cases and their course during the 6-year period of 2009-2014 in this neurology department. Among 5319 cases seen in the neurology department over the study period, 58 patients met our criteria, i.e., 1.1%. More patients were men: 55.2% for a sex ratio of 1.23. They included 4 cases of ethanol poisoning, 2 cases of undecompensated diabetes, and one reaction to vaccination for yellow fever (AAV). The electroneuromyographic tracing supported a finding of demyelination in 55.1%, axonal loss in 25.9% and both in 19%. PRN is a relatively common pathology that is often overlooked. Etiological investigation was difficult in our setting. Early management can improve the prognosis of this disorder.
Fortes Déguénonvo L, Lakhe NA, Cisse VMP
… +7 more, Diop Mbaye K, Ka D, Manga NM, Bougar S, Dia Badiane NM, MNdour CT, Soumaré M
Med Sante Trop
· 2019 Feb · PMID 31031252
·
Publisher ↗
To describe the epidemiology, clinical characteristics, and outcomes of infections in postpartum women admitted to the infectious diseases department at Fann Teaching Hospital. This retrospective descriptive study examin...To describe the epidemiology, clinical characteristics, and outcomes of infections in postpartum women admitted to the infectious diseases department at Fann Teaching Hospital. This retrospective descriptive study examined the records of women admitted for infectious diseases within 42 days after childbirth during the five-year period (2007-2011). Data were collected from medical files and analyzed with Sphinx plus V5 software. In all, 54 women were admitted for infections during the postpartum period. Their mean age was 27.4 ± 6.2 years. Fifty women (93%) had had vaginal deliveries. The average interval from delivery to admission was 15.4 ± 11.0 days. Tuberculosis (14 cases), vaginitis (13 cases), and severe malaria (7 cases) were the most frequent infectious diseases. The average duration of hospitalization was 12.1 ± 9.0 days. The mortality rate was 30%, with the main causes of death tuberculosis (25 %) and severe pneumonia of unknown causes (25 %). Tropical diseases remain frequent during the postpartum period, with a high lethality rate, as this study shows. Early diagnosis during pregnancy and better follow-up after delivery should be the best ways of reducing morbidity and mortality from these infections.
Akakpo AS, Saka B, Teclessou JN
… +5 more, Mouhari-Toure A, Moise Elegbede Y, Kombate K, Tchangai-Walla K, Pitche P
Med Sante Trop
· 2019 Feb · PMID 31031251
·
Publisher ↗
OBJECTIVE: The aim of this study was to describe the epidemiological, clinical, and therapeutic profile as well as the outcome and to document the causes of pellagra and pellagra-like erythema in a hospital setting in Lo...OBJECTIVE: The aim of this study was to describe the epidemiological, clinical, and therapeutic profile as well as the outcome and to document the causes of pellagra and pellagra-like erythema in a hospital setting in Lomé, Togo. METHODS: This retrospective study examined the records of patients seen for outpatient consultation and/or hospitalization in the three public dermatology departments of Lomé from January 1997 to September 2017. RESULTS: During the study period, 178 (0.4%) of 47,219 patients seen in these dermatology departments consulted for pellagra or pellagra-like erythema; 159 (89.3%) had pellagra-like erythema. The patients' mean age was 45.8±16 years, and the sex ratio (M/F) 1.8. All patients had at least one site of cutaneous involvement, nearly always erythematous or pigmented lesions in the photo-exposed areas (99.4% of cases). Gastrointestinal and neurological signs were dominated respectively by diarrhea (12.4 % of cases), peripheral neuropathies (8.4% of cases) and insomnia (8.4% of cases). The main causes identified were alcoholism (42.1% of cases) and nutritional deficiency (6.7% of cases). Five of 178 patients were infected with HIV. All patients were treated with nicotinamide and multivitamin supplementation. No deaths were recorded during follow-up. CONCLUSION: Our results document the extreme rarity of pellagra-like erythema/pellagra. Its two main causes remain alcoholism and nutritional deficiency. Moreover, its prognosis is good when treated quickly and adequately.
Bakhoum S, Ndione RA, Haggerty CJE
… +5 more, Wolfe C, Sow S, Ba CT, Riveau G, Rohr Jason R
Med Sante Trop
· 2019 Feb · PMID 31031250
·
Publisher ↗
The objective of this work was to identify possible correlations between physicochemical parameters (water temperature, water flow velocity, electrical conductivity, dissolved oxygen, salinity, pH, nitrates, and phosphat...The objective of this work was to identify possible correlations between physicochemical parameters (water temperature, water flow velocity, electrical conductivity, dissolved oxygen, salinity, pH, nitrates, and phosphates) and the spatial distribution in the Senegal River delta of snail species that are intermediate hosts of human schistosomes. Eight water points (ME1 to ME4, NE1 and NE2, TA1 and TA2) were selected in the villages of Menguègne Boye, Ndellé Boye, and Thilla for biweekly monitoring of these snails and the physicochemical parameters of the water. The results show that the spatial distribution of the snail populations is related to pH, dissolved oxygen (mg/l), conductivity, temperature (̊C), and water flow velocity (m/s).
Kima A, Guiguemde KT, Meda ZC
… +4 more, Bougma R, Serme M, Bougouma C, Drabo F
Med Sante Trop
· 2019 Feb · PMID 31031248
·
Publisher ↗
The implementation of mass drug administration (MDA) campaigns of albendazole (400 mg) and ivermectin (150-200 μm/kg) since 2001 has helped to change the epidemiological profile of lymphatic filariasis (LF) in many healt...The implementation of mass drug administration (MDA) campaigns of albendazole (400 mg) and ivermectin (150-200 μm/kg) since 2001 has helped to change the epidemiological profile of lymphatic filariasis (LF) in many health districts in Burkina Faso. From 2002 to 2016, 14 rounds of MDA have taken place in the Central East zone, with therapeutic coverage exceeding 65%. The objective of the current study was to evaluate the impact of MDA in the fight against LF at 12 sentinel and spot-check sites. This descriptive cross-sectional study surveyed subjects aged 5 years and older between April and July 2017 at these 12 sites. The blood smear performed on nocturnal samples was used to diagnose Wuchereria bancrofti infection. The study included 4364 subjects. Their mean age was 20.55 years with a standard deviation of 14.22 and a range of 5 to 96 years. The overall prevalence of microfilaremia was 0.62% (27/4364), with rates exceeding 1% at three (3) sites. The average microfilaremia density was 106 μf/mL. The overall prevalence of morbidity was low (0.91%), predominantly lymphedema (0.60%). The MDA strategy has helped to reduce the prevalence of LF significantly in Burkina Faso, but some outbreaks still have microfilarial prevalence greater than 1%. Continuation of the additional 2-year strategy with improved adherence to treatment and vector control would help break LF transmission.