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Biomedical subjects

D Baudon

Publications and source records attributed to D Baudon.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Malaria and febrile pathology of expatriates in Brazzaville in 1993].

Between January 1 and December 31, 1993, malaria was found in 22.6% of unexplained fever cases among expatriates in Brazzaville, i.e. 0.5% of all consulting physicians at the Medico-Social Centre of the Coopération française. There are three possible explanations for the small proportion of paludism infection among expatriates: the low density of anopheles in the city centre, living conditions that restrict possible man-vector contacts and use of chemoprophylaxis. Considering the risks of self-treatment which are not insignificant, the authors on the importance of taking into account these facts when treating cases of fever among European residents in Brazzaville.

Adolescent↗
PubMed1995

[Decision making policies on the utilization of antimalarials in response to a modification of chloroquine efficacity. Applications to Africa].

The strategy for malaria control in Africa is based on the association of malaria case management, selective and lasting vector control and prevention and control of outbreaks. Emergence and wide-spread of Plasmodium falciparum chloroquine resistance enjoins a change of the malaria case management. This change is difficult. It is function of the quality of health services, the epidemiological surveillance of malaria, the monitoring of drug efficacy and acceptability, the drug utilization policy, the time for reaction and adaptation to changes in new drug policy, the different epidemiological patterns. In Africa, alternatives to the loss of chloroquine efficacy are the implementation of public health performances, the control of the circulation of antimalarials, the training of health operators, the education of the beneficiary target populations and to draw up and implement strategies that are relevant, i.e. useful and usable.

Africa↗
PubMed1993

Malaria and travelers--practical aspects.

As international air travel becomes more and more common, we are witnessing an increase in the incidence of imported malaria caused by Plasmodium falciparum, a fatal variety resistant to antimalarial drugs. With the development of drug resistance, travelers can no longer rely on chemoprophylaxis alone for absolute protection against malaria; they need to take a number of complementary measures. The most important among these are steps to prevent mosquito bites (mosquito screens and nets impregnated with insecticide, insecticides and repellents in various formulations; nocturnal air-conditioning) which can be instituted anywhere. Chemoprophylaxis must be adapted in each case with regard to individual characteristics (laboratory and medical status), the drug used (contraindications, side effects) and the travel itinerary (departure date, places to be visited, duration of journey). The back-up treatment prescribed for a traveler before his departure is intended as cover in the event that the chemoprophylaxis used should prove to be ineffective. If people planning trips to malarious regions are to apply preventive measures, they have to be informed, aware and motivated. Information is an integral part of prevention. Objective, scientifically accurate information is provided by specialized centres and official bodies in the form of recommendations subject to regular updating. A recommendation of a nonmedical nature must be given by travel agents and tour operators, by airlines and shipping companies, embassies and consulates, and also by the media at peak periods of travel to the tropics. Information disseminated on this scale will produce the required degree of awareness, and the travelers targeted will then probably consult a doctor for the chemoprophylaxis they need.

Animals↗
PubMed1993

[Effect of 2 vaccination strategies on developments during the epidemic of meningococcal A meningitis in N'Djamena (Chad) in 1988].

From February till May 1988, during an epidemic of group-A meningococcal disease, 4542 cases of meningitis were reported in N'Djamena, the capital of Chad (550,000 inhabitants). A first selective vaccination campaign was carried out between 5 and 14 March; 156,500 vaccine doses (polyvalent: group A and C: Institut Mérieux) were given using jet injectors. The target population for this first campaign consisted of groups such as school-children and the armed forces. As the epidemic continued, a mass vaccination campaign was implemented one month later between 8 and 14 April 1988; this was targeted at the whole population above 1 year of age, not previously immunized, and 266,738 doses of vaccine were injected. One week after the start of the second campaign, the number of reported cases fell sharply and, within four weeks, the epidemic was halted. The vaccination coverage rate, evaluated by a WHO cluster survey method in people above one year of age, was 95.5%. These results show (i) the failure of selective vaccination, restricted to only at-risk groups, to halt the epidemic; (ii) the efficacy of the mass vaccination campaign aimed at the whole population; and (iii) the feasibility in tropical Africa of such a mass campaign which must be carried out in a few days.

Adolescent↗
PubMed1992

[Efficacy of radical treatment with halofantrine on the prevention of imported Plasmodium falciparum malaria].

We carried out in 1989 a non randomized comparative study in French army units which had been in Central Africa (Central African Republic and Gabon) for 4 months, in order to compare in 758 men on return from malaria areas the usual strategy of chemoprophylaxis with chloroquine and a radical cure by halofantrine (Halfan). Chloroquine was taken by 278 men (100 mg daily for 6 weeks after their return to France); the other 480 men were given two doses of 1,500 mg halofantrine on the third and on the tenth day after their return to France. In Africa both of the units were on chloroquine prophylaxis (100 mg daily for 4 months). The Plasmodium falciparum attack rates were, during a period of 5 months after the return to France, 0.2% in the halofantrine group (1/480) and 4.7% (13/228) in the chloroquine group (P < 10(-4)). The radical cure by halofantrine was more effective than chloroquine prophylaxis in preventing falciparum malaria on return from malaria areas.

Adult↗
PubMed1992

[Comparative study of 3 bacteriological tests of cerebrospinal meningitis during the epidemiological period].

During an outbreak of group A meningococcal meningitis in Chad in 1988, a comparative study of three bacteriological techniques (direct microscopic examination, latex agglutination, and culture) was conducted with 120 samples of cerebrospinal fluid (CSF) for diagnosis. The results correlated well with cloudy or purulent CSF specimens. Direct microscopic examination was as good a diagnostic indicator as the other tests. The authors recommend using direct microscopic examination, which is easy to perform under field conditions and accurate enough for a rapid diagnosis of cerebrospinal meningitis during an epidemic. However, complete identification of the first cases in the epidemic is important in order to establish control measures as soon as possible.

Bacteriological Techniques↗
PubMed1991

[Malaria in the republic of São Tomé and Principe. Epidemiologic evaluation and chemoresistance of P. falciparum].

The authors report the results of a valuation of paludometric indices during mai 1990 in Democratic São Tomé e Príncipe Republic (RDSTP). These investigations (parasitic index and spleen index) suggest that malaria is mesoendemic in these area. Plasmodium susceptibility to chloroquine at posology of 25 mg/kg per os was evaluated (WHO standard 7 days field test). Among 58 children, ranging from 5 to 11 years old, resistance at level R I was observed in 9% of cases, at level R II in 14%. Among 10 strains of P. falciparum, 9 were chloroquine resistant in vitro. 2 strains were also less sensible to quinine.

Age Factors↗
PubMed1991

[Chemoprophylaxis of Plasmodium falciparum malaria by a combination of 100 mg of chloroquine and 200 mg of proguanil per day in a zone III of chloroquine resistance (Gabon). Study of 431 French soldiers].

Incidence of P. falciparum malaria in french non-immune soldiers serving in Gabon for four months has increased from 21% in 1987 to 37% in 1988. Since 1989, in a first step, the personal protection measures were reinforced. Thereafter, the usual chemoprophylaxis (chloroquine 100 mg daily) was replaced by a daily association of chloroquine 100 mg and proguanil 200 mg. A 85% decrease of malaria incidence was observed in 431 soldiers. The effects of the personal protection strengthening and of the new chemoprophylaxis can be evaluated to be respectively responsible for 50% and 71% decrease. Among the secondary effects, gastric pain was the most frequent, but it was never a cause of chemoprophylaxis stopping. The mouth ulcer frequency was far lower than that elsewhere reported. No significant biological abnormalities could be related to the chloroquine-proguanil association.

Animals↗
PubMed1990

Blood glucose area under the curve. Methodological aspects.

To specify the influence of methods used in estimating area under the curve (AUC) and the meaning of total and incremental AUC, 75 glycemic responses to a mixed meal were studied in 75 diabetic patients, 39 with insulin-dependent diabetes mellitus and 36 with non-insulin-dependent diabetes mellitus. AUC was integrated with five computerized methods: polynomial interpolation of third and fourth degree, trapezoidal rule, Simpson's integration, and cubic interpolatory splines. Although these methods gave significantly different results (P less than 0.001), a strong correlation was found between estimations of AUC with different methods (r greater than 0.99, P less than 0.001). In addition, variation between methods was less than or equal to 2%, whereas the coefficient of variation between subjects was 38%. Total AUC was strongly correlated with basal blood glucose value (r = 0.90, P less than 0.001), whereas incremental and positive AUC were not (r = 0.12 and 0.07, respectively, NS). Incremental and positive AUC were strongly correlated with glycemic rise (r = 0.89 and 0.93, respectively, P less than 0.001), whereas total AUC was only slightly so (r = 0.31, P less than 0.01). Incremental and positive AUC gave slightly but significantly different information on glucose response. These results suggest that variations related to the method used in estimating AUC are not clinically relevant and that a simple method such as trapezoidal rule can be used. Total AUC is a descriptive factor related to basal blood glucose value, whereas incremental and positive AUC more accurately describe glycemic response to foods.

Analysis of Variance↗
PubMed1990

[Reliability of the diagnosis of cerebrospinal meningitis during an epidemic. The epidemic in Chad in 1988].

The authors analysed the positive predictive value (PPV) of the clinical diagnosis during an epidemic of meningococcal meningitidis in Africa. This PPV was globally 73.3 +/- 11.2%. This PPV was fluctuating according to the standards of the diagnosis. Typical clinical meningitic syndrome without spinal picture: 85.7 +/- 10.3%, Non typical syndrome and macroscopical aspect of cerebrospinal fluid: 62.5 +/- 16.4%.

Chad↗
PubMed1989

[The effect of 2 chloroquine-based drug strategies (prevention and therapy of febrile cases] on malaria transmission].

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.

Adolescent↗
PubMed1989

[Current quantitative approach to the splenic index in malaria: the median hypertrophied spleen].

The mean Hackett score is a commonly used index in malaria surveys. It is, however not suitable for comparing the distribution of hypertrophied spleens among small population samples, owing to the validity conditions of statistical tests. The authors suggest to use another index, the median Hackett score, which can be compared to the Tukey test. This test gives a graphical representation of hypertrophied spleen distribution, allowing for rapid and easy comparison. The lack of power of this test is compensated by its robustness (a consequence of its broad limits of validity), its graphical simplicity and its easy interpretation.

Child↗
PubMed1988

[Diagnostic difficulties and current clinical aspects of Plasmodium falciparum malaria upon returning from a chemoresistance area].

The incidence and clinical aspects of malaria in patients returning from chemoresistance areas were evaluated by means of two studies. The first one was a prospective study of 145 subjects back from a 4 months' stay in Gabon and who had complied with an appropriate chemoprophylaxis regimen. Twelve of these subjects were found to have particulate P. falciparum antigens on the 3rd day following their return. Spontaneous negativation of parasitaemia was observed in 10 cases, whereas 2 subjects were about to develop a malarial attack. Forty-five days after the return home, 5 new cases of malarial attack and 3 cases of anaemia had occurred, although none of these 8 patients had haematozoa on the 3rd day. In the second study 31 patients admitted to hospital in 1987 were reviewed. The following clinical syndromes were detected: malarial attacks with high parasitaemia in 6 cases, malarial attacks with low or undetectable parasitaemia in 5 cases, anaemia, thrombocytopenia or pancytopenia in 5 cases, and febrile alteration of the general condition in 3 cases. Two aspects of malaria were identified: "malaria infection" with a latent and asymptomatic parasitic infestation likely to disappear spontaneously or to turn into "malaria disease". The latter has protean manifestations, but bouts of fever with low parasitaemia and blood disorders are predominant.

Adult↗