Labbo R, Doumma A, Mahamadou I
… +5 more, Arzika I, Soumana A, Kadri S, Idi I, Testa J
Med Sante Trop
· 2019 Feb · PMID 31031247
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Its climate and environmental conditions put Niger at particularly high risk of the spread of Aedes mosquitoes, which can transmit arboviruses. In September 2016, the Republic of Niger reported its first outbreak of Rift...Its climate and environmental conditions put Niger at particularly high risk of the spread of Aedes mosquitoes, which can transmit arboviruses. In September 2016, the Republic of Niger reported its first outbreak of Rift Valley Fever (RVF) in the northern region of Tahoua, near the Mali border, particularly in the departments of Tchintabaraden, Tassara, and Abalak. The history of RVF has showed that epidemics and epizootics have a considerable socioeconomic impact in affected countries, such as Niger, whose populations are particularly concerned by livestock farming. Cross-sectional studies were conducted to investigate the abundance of Aedes aegypti and the risk of arbovirus transmission in 54 villages between 2002 and 2017. Sampling took place in 27 villages, with three methods used in each village: (a) capture of aggressive female mosquitoes landing on human adult volunteers from three households, both indoors and outdoors, during two consecutive nights ; (b) insecticide spray collections of resting mosquitoes early in the morning in five selected dwellings, different from those chosen for landing catches, and (c) capture by four Centers for Disease Control (CDC) light traps, both indoors and outdoors, for two nights. The remaining 27 villages were sampled only by insecticide spray collection of resting mosquitoes. The inventory, distribution, and abundance of mosquito species found at the sampled localities were evaluated. The mosquitoes (Culicidae) caught belonged to four genera, namely: Anopheles spp., Aedes spp., Culex spp. and Mansonia spp. Besides these Culicidae, other biting Diptera (Phlebotomes) were found during the capture. À total of 130,424 adult mosquitoes was caught during the study, 2.6% (3,444/130,423) of them Aedes spp. Aedes aegypti accounted for 96.6% of the Aedes spp. captured. Ae. Aegypti was collected in 41.0% (22/54) of the villages and was abundant (accounting for more than 15% of all mosquitoes captured) in 5 localities. The presence, geographical distribution, and abundance of Ae. aegypti near and in human habitations suggest a high risk of arbovirus transmission in Niger. The high abundance of arbovirus vectors encountered in this study should be a source of concern. Our observations highlight the importance of quantifying and monitoring the risk of arbovirus transmission in Niger. These results are of great importance for public health.
Morin F, Debiton-Morin C, Dufour-Gaume F
… +1 more, Annette S
Med Sante Trop
· 2019 Feb · PMID 31031246
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A 40-year-old soldier in Guyana consulted at the end of December for skin lesions that had been developing for several weeks after he was lost overnight in the equatorial forest, near the village of Saul. He was bitten b...A 40-year-old soldier in Guyana consulted at the end of December for skin lesions that had been developing for several weeks after he was lost overnight in the equatorial forest, near the village of Saul. He was bitten by numerous mosquitoes during the night and as he crossed marshy areas. When he arrived at the clinic he had 23 leishmaniasis sites visible.
Mathieu L, Mongo V, Potier L
… +3 more, Bertani A, Niang CD, Rigal S
Med Sante Trop
· 2019 Feb · PMID 31031245
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After presentations of the principles of limb salvage and soft-tissue coverage for Gustilo III open tibia fractures, this third part is dedicated to management of tibial non-unions in low-resource settings. Inter-tibiofi...After presentations of the principles of limb salvage and soft-tissue coverage for Gustilo III open tibia fractures, this third part is dedicated to management of tibial non-unions in low-resource settings. Inter-tibiofibular grafting and the induced membrane technique are preferred because they make it possible to deal with almost all situations. Key technical points of these methods are presented, followed by treatment guidelines based on Catagni's classification and bone defect size.
Dorcelus M, Delaigue S, Bourdeau S
… +3 more, Saint-Louis JN, Cerpa M, Morose W
Med Sante Trop
· 2019 Feb · PMID 31031244
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Leprosy is endemic in Haiti and remains a disease misunderstood by the population. In 2018, the national program to fight tuberculosis and leprosy (PNLTL) produced its first strategic plan against leprosy to implement th...Leprosy is endemic in Haiti and remains a disease misunderstood by the population. In 2018, the national program to fight tuberculosis and leprosy (PNLTL) produced its first strategic plan against leprosy to implement the international strategy of the World Health Organization (WHO). The objective of this study was to describe the epidemiological situation of leprosy in Haiti, to assess its prevalence and morbidity, and to guide the strategies of the national plan. A retrospective study of all cases of leprosy diagnosed in the three centers providing care for this disease in Haiti reviewed the new cases at these centers from January 2013 through December 2017. In all, 232 new patients were recorded, or 49 new cases a year. Multibacillary leprosy was predominant: 86%, compared with the international mean of 60 %. Children accounted for 14 % of the new cases (7.5 % internationally), a finding that is evidence of active community transmission. Of the new cases in 2017, 8 %, including one child, had grade 2 impairments. Nearly all the leprosy cases - 94 % (218/232) - came from the two districts with treatment centers (West and Artibonite). Efforts must continue to implement the international strategy to fight leprosy to ensure a reduction by 2020 in the rate of grade 2 impairments among new cases and the number of new cases among children.
Med Sante Trop
· 2019 Feb · PMID 31031238
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The French-speaking Network for Neglected Tropical Diseases (RFMTN), created under the aegis of Aviesan in April, 2016, has among its 5 objectives, those to promote interactions between the French-speaking institutions w...The French-speaking Network for Neglected Tropical Diseases (RFMTN), created under the aegis of Aviesan in April, 2016, has among its 5 objectives, those to promote interactions between the French-speaking institutions who are members, to develop collaborative programs making it possible to respond to requests for proposals and to advocate effectively to political bodies and funders. To mark the milestone of its first two years of existence, it held a plenary conference in Montpellier (France) on October 22 and 23, 2018, at which experts from numerous African, French and international scientific institutions participated very actively. This article presents the essence of the debates.
Med Sante Trop
· 2019 Feb · PMID 31031236
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While Eugène Jamot's name is associated with the combat against sleeping sickness, Pierre Richet is permanently linked to the battle against river blindness, which he first reported in 1936 in two neighboring households...While Eugène Jamot's name is associated with the combat against sleeping sickness, Pierre Richet is permanently linked to the battle against river blindness, which he first reported in 1936 in two neighboring households in Garango (Burkina Faso). Onchocerciasis remained a continuous interest, through his last article "The OCCGE and Onchocerciasis", written in 1983. Nonetheless over the course of these five decades, Richet's trajectory was far from that of a specialist dedicating his life to a single disease. After a decade essentially spent fighting trypanosomiasis, came a decade of war in which the specialist in endemism joined the Free French Army and put his organizational know-how at General Lerclerc's disposal, from Morocco to Indochina, via Germany. On his return to Africa in 1953, he extended the principle of mobile teams to the other major endemic diseases accessible to treatment and to vaccines. Richet organized first the combat against leprosy and launched vaccination programs. In 1955, he returned to the battle against onchocerciasis and deployed the first large-scale insecticide program in Chad. The intermediate term failure of this prototype fermented his scientific, interdisciplinary, and organizational thought, which flourished at Bobo-Dioulasso. At the dawn of the independence of French-speaking African countries, and against the political tides of the time, he obtained in 1960 the creation of a supranational organization, the OCCGE, common to 8 countries of West Africa, and he headed it for a decade. Drawing lessons from the past and in the absence of effective pharmaceutical treatment, Richet the physician played the entomological card with one hand, with technical support from Orstom (IRD); this detailed work enabled the development of a strategy. With the other hand, he played the multilateral card, which led in 1974 to the launching of the extraordinary Onchocerciasis Control Program (OCP). If it is Jamot who awakened Africa, Richet is the person who restored its view but also millions of hectares of cultivable land.
Lakhdar K, Berdai MA, Benlamkadem S
… +2 more, Labib S, Harandou M
Med Sante Trop
· 2019 Feb · PMID 31031235
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Throughout Morocco, cade oil is used in folk medicine for many purposes, in particular for atopic dermatosis. It is also used as a wormer. Cade oil poisoning of newborns and infants thus often has an iatrogenic origin, r...Throughout Morocco, cade oil is used in folk medicine for many purposes, in particular for atopic dermatosis. It is also used as a wormer. Cade oil poisoning of newborns and infants thus often has an iatrogenic origin, resulting especially from the ingestion of a significant amount or from a prolonged and extensive cutaneous application. Thus, this oil, used for therapeutic purposes, is responsible for a non-negligible number of cases of poisoning, some fatal. We report a case of poisoning after cutaneous application of cade oil in a 2-month-old infant. The outcome was fatal. This report calls attention to the real possibility of this event and emphasizes the interest of preventing it by promoting information to families in Morocco.
Med Sante Trop
· 2019 Feb · PMID 31031234
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We report the case of a French soldier deployed in Chad, who developed disabling pollakiuria after starting antimalarial prophylaxis by doxycycline. This rare secondary effect is not mentioned in reference books.We report the case of a French soldier deployed in Chad, who developed disabling pollakiuria after starting antimalarial prophylaxis by doxycycline. This rare secondary effect is not mentioned in reference books.
Padaro E, Kueviakoe IMD, Agbétiafa K
… +4 more, Magnang H, Mawussi K, Layibo Y, Vovor A
Med Sante Trop
· 2019 Feb · PMID 31031233
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Publisher ↗
To determine the influence of therapeutic phlebotomy on the reduction of vaso-occlusive crises (VOCs) and of hospital admissions of patients with sickle cell disease and to describe how they experience this practice. Des...To determine the influence of therapeutic phlebotomy on the reduction of vaso-occlusive crises (VOCs) and of hospital admissions of patients with sickle cell disease and to describe how they experience this practice. Descriptive cross-sectional study of 27 patients with sickle cell disease who underwent phlebotomies. We estimated the number of VOCs, hemoglobin levels, and patient response. Among 27 sickle cell patients (24 SC and 3 SS) who underwent phlebotomies, there were 22 men (81.5 %) men and 5 (18.5 %) women, with an average age of 34.6 ±10.9 years (range: 21-56 years). Before the phlebotomies, 23 (85.2 %) had showed signs of hyperviscosity, they had a mean of 5.3 ± 1.02 (range: 3-8) VOCs annually, and their mean hemoglobin level was 14.3 ±1.5g/dl (range: 10.4 g/dl-16.8 g/dl). The mean number of phlebotomies was 4.9±4.11 (range: 1-13). After this treatment, 21 (91.3 %) reported that their signs of hyperviscosity disappeared, and the mean number of VOCs annually decreased to 0.9 ±0.07 (range: 0-2). The mean change in hemoglobin was 1.9 ±0.8 g/dl (range: 0.9-3.2 g/dl). Nine patients (6SC and 3SS), 7 under anti-anemic treatment, initially refused phlebotomy, mainly because they did not understand how it could be useful to reduce the amount of blood in patients with a potentially anemic disease. Phlebotomy has resulted in a decrease in the frequency of VOCs and hospitalizations. It is essential to further popularize it and increase patients' aware of its value in combatting sickle cell disease and thus improve their willingness for and adherence to this treatment.
Coulibaly N, Traoré B, Tounkara AA
… +2 more, Traoré AM, Coulibaly AZS
Med Sante Trop
· 2019 Feb · PMID 31031232
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UNLABELLED: The purpose of this work is to describe pruritus in chronic hemodialysis patients at the G-University Hospital Center. METHOD AND PATIENTS: This a descriptive cross-sectional study included 30 patients receiv...UNLABELLED: The purpose of this work is to describe pruritus in chronic hemodialysis patients at the G-University Hospital Center. METHOD AND PATIENTS: This a descriptive cross-sectional study included 30 patients receiving chronic hemodialysis. RESULTS: Among 90 chronic hemodialysis patients, the study selected 30, including 22 men (73.3%) and 8 women (26.7%), with an average age of 46.60 years (range: 24-82 years). All had pruritus: it was localized in 23.3 % (n=7) and diffuse in 76.7% (n=23). It occurred during dialysis sessions for half of them. It could be nocturnal (50%), diurnal (30%) intermittent (10%), or constant (10%). The dermatological signs associated with pruritus were cutaneous hyperpigmentation in 13.3% of cases, contact eczema in 3.3%, and cutaneous xerosis in 53.3%. CONCLUSION: Pruritus is still the most common sign of dermatological conditions in chronic hemodialysis. Treatment remains symptomatic.
Béranger F, Tregarot M, Aoun O
… +4 more, De Lesquen H, Gagnon N, Meyrat L, Avaro JP
Med Sante Trop
· 2019 May · PMID 31010804
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INTRODUCTION: Use of chronic intermittent hemodialysis is recent in Chad, where it remains underdeveloped. Vascular access is most commonly by catheter. The objective of our study was to demonstrate the feasibility of ar...INTRODUCTION: Use of chronic intermittent hemodialysis is recent in Chad, where it remains underdeveloped. Vascular access is most commonly by catheter. The objective of our study was to demonstrate the feasibility of arteriovenous fistula (AVF) surgery for hemodialysis during deployments as part of the medical civic action program (MEDCAP). METHODS: We prospectively included all patients admitted for AVF creation at Camp Kossei forward surgical unit in N'Djamena (Chad) between December 2016 and February 2017. Surgery was performed by an experienced vascular surgeon. The data collected included age, sex, cause of kidney failure, type of anesthesia, AVF location, and the duration of the intervention and hospitalization. Patients were examined one month after the procedure to evaluate the functionality, morbidity, and mortality of the AVF. RESULTS: We performed 17 AVF in 3 months. Male to female ratio was 3. High blood pressure was the main cause of chronic kidney failure (55%). All interventions were conducted under locoregional anesthesia. Overall, 35% of fistulae were radiocephalic, 41% brachiocephalic, and 24% brachiobasilic. The mean duration of intervention was 58 minutes and that of hospitalization one day. No deaths occurred. Global morbidity, including non-functioning AVF, was 25%. CONCLUSION: Our study showed that AVF surgery is feasible during deployment, especially in Chad, and meets the needs of the local healthcare facilities. It should be developed and taught to local surgeons.
Conaré I, Sidibé MK, Napo A
… +8 more, Diallo S, Coulibaly B, Guirou N, Bakayoko S, Sylla F, Thera J, Traoré L, Traoré J
Med Sante Trop
· 2018 Nov · PMID 30799834
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Publisher ↗
A baby born at home 14 hours earlier was brought to the neonatology department with bilateral upper palpebral chemosis with purulent secretions and pseudomembranes, with no general signs of infection. The gram staining o...A baby born at home 14 hours earlier was brought to the neonatology department with bilateral upper palpebral chemosis with purulent secretions and pseudomembranes, with no general signs of infection. The gram staining of a secretion sample shows the presence of Neisseria gonorrhoeae. Intramuscular ceftriaxone treatment was initiated, combined with topical application of rifamycin, dexamethasone, and oxytetracycline. Complete healing without sequelae was obtained after two weeks. This case presents an opportunity to review this preventable pathology and its treatment. The only effective way to prevent it is to raise the awareness of disadvantaged population about the value of antenatal care.
Zongo N, Windsouri M, Bambara HA
… +8 more, Some OR, Bambara AT, Ouangré E, Zida M, Bonkoungou G, Sanou A, Dubot C, Dem A
Med Sante Trop
· 2018 Nov · PMID 30799833
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Publisher ↗
Study the epidemiological, diagnostic, and treatment features and outcomes of necrotic breast cancer in women. This observational, longitudinal, and descriptive study covered the period from January, 2011, to the end of...Study the epidemiological, diagnostic, and treatment features and outcomes of necrotic breast cancer in women. This observational, longitudinal, and descriptive study covered the period from January, 2011, to the end of May, 2016 at the Surgery and Gynecology Departments of Yalgado Ouedraogo University Hospital and Schiphra Medical Center. The study included all women with necrotic breast cancers. Survival was calculated by the Kaplan Meier method and survival comparison was possible with the log-rank method. À risk of error of 0.05 was allowed. Necrotic cancer accounted for 9.1% of all breast cancers. The median age of the patients was 46 years old. The median interval before consultation was 12.4 months. The histological type was invasive ductal carcinoma in 90.8% of cases. Surgery was performed in 51 patients (52%). It was a palliative (cleaning) procedure in 92.2% of cases. Chemotherapy was performed in 28 patients. Overall survival was 61.8% at 6 months, 39.5% at 1 year, and 9.2% at 3 years. Median survival was 10 months: 13 months for women with surgery and 6 months for those without it (p<0.001). Necrotic breast cancer is still common in Ouagadougou. Surgery is the mainstay of the treatment. Survival is mediocre. It therefore seems urgent to focus on raising population awareness and organizing screening campaigns.
Diop B, Niang MM, Ba PA
… +4 more, Sy A, MBaye B, Wane Y, Sarre SM
Med Sante Trop
· 2018 Nov · PMID 30799832
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INTRODUCTION: The causes of short bowel syndrome are multiple, but most often in sub-Saharan Africa they result from extensive surgical resection that leaves less than 200 cm. Intestinal failure appears rapidly with a ma...INTRODUCTION: The causes of short bowel syndrome are multiple, but most often in sub-Saharan Africa they result from extensive surgical resection that leaves less than 200 cm. Intestinal failure appears rapidly with a major hydroelectrolytic deficiency and malabsorption. Management requires parenteral nutrition that can be life-long. OBSERVATION: A 53 year-old patient underwent surgery in 1986 for peptic ulcer disease and recovered successfully. He was admitted in July 2015 for acute bowel obstruction of more than 8 hours duration. Intraoperative exploration showed irreversible ischemia in the small bowel, related to tight adhesions. An extensive resection leaving 110 cm of bowel was carried out. Postoperatively, nutritional monitoring and oral supplementation were prescribed and associated with proton pump inhibitors and antidiarrhea drugs. Parenteral feeding was not available. The postoperative period was characterized by temporary stability followed by a significant weight loss, then by two hospitalizations for severe malnutrition and intercurrent infection. Death occurred 7 months after the operation. CONCLUSION: Parenteral nutrition is essential in short bowel syndrome. Availability, especially for a long-term use, is a major problem in our context, and alternatives are rare.