Journal: Medecine et sante tropicales
Context. This study was conducted at the National Tuberculosis Center in Burkina Faso from October 2007 through May 2008. Objective. Our objective was to compare the diagnostic performance of three staining methods: Kinyoun, auramine O, and Ziehl-Neelsen. Methods. Ziehl-Neelsen staining served as the reference method to assess the diagnostic performance of Kinyoun and auramine O staining. In all, 616 sputum smears from 233 patients were read with each method to detect acid-fast bacilli. SPSS was used for data analysis. Results. The results of auramine O staining showed positive diagnoses in 15.9% of the samples; sensitivity was 100%, specificity 95.6%, and the positive and negative predictive values 75.7% and 100% respectively. Kinyoun staining produced a positive diagnosis rate of 12%, sensitivity of 96.4%, specificity of 99.5%, and positive and negative predictive values of 96.4% and 99.5%. Conclusion. Our study indicates that auramine O staining had a better sensitivity for detecting acid-fast bacilli than Kinyoun staining. Accordingly, the use of auramine O staining should increase the detection rate for pulmonary tuberculosis in Burkina Faso.
The authors report the results of parasitological analyses of stool samples in N'Djamena (Chad) since 1963 and in Garoua (North Cameroon) since 1990. The number of positive stool examinations has fallen, with a significant decline in helminthiases, although the level of protozoan infections has remained essentially the same.
Colonic ameboma is a rare inflammatory pseudo-tumor of the colon that can mimic cancer development. This case was located in the cecum and appeared malignant from a macroscopic view. Accordingly a right hemicolectomy was performed, followed by an end-to-side ileocolic anastomosis. The pathology study enabled us to correct the diagnosis and affirm its amebic origin.
Plasmodium knowlesi is typically found in macaques and has recently been recognized as the fifth Plasmodium species to cause malaria in humans. Several cases of P. knowlesi malaria have been reported in people in Southeast Asia. Most cases are simple but approximately one in 10 patients develops complications. The morphology of P. knowlesi parasites in human infections closely resembles that of Plasmodium malariae or Plasmodium falciparum, so a molecular method is the optimum diagnostic procedure. The treatment of choice for uncomplicated P. knowlesi malaria is oral chloroquine, whereas severe infection should be treated with intravenous quinine.
The dihydroartemisinin-piperaquine combination is an antimalarial agent newly available in Europe. It is an artemisinin-combined therapy (ACT) that has been used for more than 10 years in malaria-endemic areas and is recommended since 2010 by the WHO as a first-line treatment of uncomplicated Plasmodium falciparum malaria. In Europe, it has recently been authorized for the treatment of uncomplicated P. falciparum malaria in adults, children, and infants aged 6 months or older and weighing at least 5 kg. Its efficacy is similar to the combination of artemether and lumefantrine, and the regimen is easier. The tolerability profile is nearly the same as the other ACTs. Prolongation of the QT interval appears to be greater than with the artemether-lumefantrine combination in the first 48 hours of treatment, although no clinical consequences have been described. This side effect requires the use of electrocardiographic monitoring in some patients. A risk management plan has been set up by the manufacturer.
We evaluated the outcome of treatment of uterine synechiae (or adhesions, also known as Asherman syndrome) by cervical dilatation and sequential estrogen and progestogen administration for three months. This retrospective cohort study examined records of 86 women with infertility or menstrual disorders or both and treated from October 2004 to November 2011 for synechiae diagnosed by hysterosalpingography. The data analyzed included age, presenting complaint, and treatment outcome. During the study period, 86 women were seen for uterine synechiae but only 81 files could be included. The patients' mean age was 25.52 (range: 19-40 years), with 37% in the age group of 25-29 years. Of these 82 women, 71 reported menstrual disorders and 60 infertility. After treatment, 11/60 (18%) became pregnant and 35/71(49%) recovered normal menstrual profiles. The reference treatment for uterine synechiae is hysteroscopy, which yields good results. In poor settings, however, hysteroscopy remains inaccessible, and the old method of cervical dilation and sequential estrogen and progestogen therapy is an acceptable alternative.
In Morocco, leishmaniases are a major public health problem due to their genetic diversity and geographical distribution. Cutaneous leishmaniasis caused by L. tropica is endemic in the center of the country; it has a high risk of transmission, with Phlebotomus sergenti as vector. This study aimed to identify the vectors of Leishmania and the epidemiological trends of cutaneous leishmaniasis in Afourer, Morocco. The entomological study used both adhesive and CDC miniature light trap to capture six different species: P. sergenti (50.21 %), P. papatasi (18.45 %), P. longicuspis (17.17 %), P. perniciosus (12.02 %), S. minuta (1.93 %) and P. chabaudi (0.21 %). The life cycle of sand flies in this area is characterized by a biphasic trend with two activity peaks, in May and November. Hence, the highest transmission levels are likely to occur from early summer to the end of autumn. However, the epidemiological status of leishmaniasis in Afourer between 2009-2013 showed a significant decreasing trend - of 87.7 %.
Silicosis is one of the most prevalent occupational lung diseases and a public health problem throughout the world. Underground miners of copper and cobalt are exposed to the dust of these minerals and thus to the risk of developing silicosis. The objective of this report was to describe a series of silicosis cases in miners exposed to mineral dusts at a mining company operating since the colonial era in Lubumbashi, Katanga province, in the Democratic Republic of the Congo (DRC). This descriptive retrospective study reviewed records at the occupational safety and health department of the mining company mentioned above and included 2500 underground miners who worked there between 1970 and 1995; it collected and analyzed their medical records. Chest radiographs of silicosis patients were classified according to the ILO International Classification of Radiographs of Pneumoconiosis. All miners were males (mean age: 48.5 ±12.5), had low literacy levels, and used no protective device (i.e., mask) against dust. Their mean number of working years in the underground mines was 25.07±7.39 years. Of the 2500 miners, 1.08 % (27/2,500) had developed silicosis. The most common clinical manifestations were dyspnea and cough, and the most prevalent radiologic features large opacities (92.59 %), small opacities (96.27 %), and pleural thickening (25.92 %). The fatality rate was 100 %. This study revealed the absence of safety measures among Congolese underground miners from Lubumbashi, which might have contributed to the development of silicosis in some of them. It is thus necessary to implement occupational safety measures to reduce their risk of silicosis.
Among the 1.4 million blind children in the world, 300,000 live in Africa. The causes of blindness vary from one country to another. The purpose of our study was to report the causes of childhood blindness and visual impairment in children attending the only school for the blind in Mali (National Institute for the Blind in Mali, INAM).
Furuncular myiasis is a cutaneous parasitosis that occurs in tropical regions. It is manifested by lesions with the appearance of pustules, because of the presence of the fly larva in the skin. This misleading appearance can delay diagnosis. The extraction of these Cayor worms can be facilitated by the use of a comedo-extractor.