[Hydatidosis in children. Current statistical and epidemiological aspects].
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Biomedical subjects
Publications and source records attributed to H Dumon.
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In a 54 year old, algerian male we found a inoperable hydatid disease of the pelvis. A treatment by flubendazole 4 g/day is started on February 1982. The patient presents a neck of the femur fracture, on April 1982; on September 1982 he had a myocardial infarctus and a second one in February 1983. On March 1983 he had a new femur fracture. The biological data show no difference in hypereosinophilia and serological exploration. In this case the result is poor.
It has been studied the continuous growth of a Leishmania infantum canine strain from Marseille. The authors used a modified liquid medium with Panmed : foetal calf serum and calf serum. They used a bench to chemistat at 24 degrees C. With an optimum concentration inoculum they obtained a diphasic growth curve with a first exponential phase from the third to the fifth day, in which the average time of generation is 15 hours and 20 minutes, and a second growth phase from the ninth to the eleventh day. It is a--diauxie growth--(according to the J. Monod Theory). If some medium is added on the third day this first exponential growth phase continues up to the eleventh day.
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Patients hospitalized in an intensive care unit must be considered to be exposed to a "high risk" in terms of candida infection. They often combine several of the factors favouring the development of "candida disease": generally deficient state, multiple antibiotics, iatrogenic or pathological immune depression. While certain patients who are admitted are already suffering from "candida infestation" (endogenous localization), the possibilities of exagenous infection are numerous. This study involved 63 patients spending at least one week in the department, from September 1977 to September 1978. Mycological (pharyngeal swab, urine culture, blood culture) and immunological (hemagglutination, immunoelectrophoresis, immunofluorescence) studies were carried out routinely on admission and then every week. Amongst the 63 patients studied, 12 were admitted with negative serology, which became positive during the first 10 days. 5 already had positive serology at the time of admission. From a mycological standpoint, the pharyngeal swab was frequently positive on admission (17 times out of 63). In 63 patients, the infection was acquired during the course of the hospital stay and, in this case, positive urine cultures were more regularly associated with a positive pharyngeal culture.
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A method of canine lymphocytes isolation and storage in liquid azote with DMSO is described. It was possible to use these lymphocytes in the immunocytoadherence and leucocytes migration inhibition tests in dogs infected with Leishmania donovani. The sensitisation was made with a soluble antigen from promastigotes of L. donovani braid by ultrasounds. The dogs with Leishmaniasis gave positive results. The controls without Leishmaniasis were negative. The tests with conserved lymphocytes were as satisfactory as the same tests with fresh lymphocytes.
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We have carried out a retrospective study on 100 children in hospital in Marseilles, France with a diagnosis of Plasmodium falciparum malaria. On admission, the main clinical features were anaemia (90 cases), fever (83 cases, > 40 degrees C in 22 cases), hepatomegaly (44 cases), vomiting (29 cases), neurological signs (22 cases), thrombocytopenia (13 cases), hyperparasitaemia (6 cases), jaundice (4 cases), shock (1 case) and hypoglycaemia (1 case). Severe malaria, as defined by the World Health Organization Malaria Action Programme, was rare in our study (only 2 cases) and the prognosis was good (no death, no sequela). The search for neurological signs such as impaired consciousness, prostration or convulsions is an effective and simple way to diagnose potentially severe cases. In the presence of these signs, intravenous quinine treatment resulted in a shortened duration of fever (30 h instead of 63 h) and thereby avoided patients becoming worse. In children without neurological signs or persistent vomiting, oral therapy may be used even if there is high fever or hyperparasitaemia, but close surveillance is required. Patients treated with halofantrine or mefloquine had a shorter stay in hospital than those treated with chloroquine (mean = 4 d instead of 5.7 d). The resistance of some strains to chloroquine may explain this difference.
Three different types of education and teaching are offered by the Education and Research Center in Tropical Health and Medicine: To 7th and 8th year students in medicine, given morning and afternoon over a period of 13 weeks, this type of education in tropical health and medicine requests a high degree of participation from the student; it is very well structured in its objectives and program with more than 50% of directed studies and guided training. Evaluation is carried out both in and at the end of sylabuses. To male and female nurses, teaching is given morning and afternoon over a period of 5 weeks. From year to year, the increased number of participants attests the success of such a teaching. To students at the end of their University programmes, whatever they may be. This multidisciplinary education is given over a period of two years, twice a month, late in the afternoon.
The authors report on 9 cases of mediterranean visceral leishmaniasis (Kala-Azar) collected in the south-eastern part of France in 1978. They emphasize the more frequent occurrence of this disease in adults than children. Out of the 40 cases detected in this region between January 1975 and December 1978, 22 affected adults (55 percent) moreover, Kala-Azar appears to occur particularly in adults with decreased general resistance and diagnosis may be difficult because classical clinical features are no complete.
The authors report the main clues of morbidity, infant mortality, fecundity as well as the main endemic affections detected in the nomadic and seminomadic populations in Gourma that they have noticed during a descriptive epidemiological investigation. The worse clues of general morbidity come from children and among the ethnic groups studied from those of the Tamachèques and the Maures. Malaria, brucellosis, treponematosis (bejel) have a high rate of frequency. The few cases of tuberculosis detected incidentally encourage to search for the real effect of this affection. Urinary schistosomiasis is present in Gossi where durable ponds exist. Intestinal helminthiasis, tineas, and hemoglobinopathies seem not to be problems of public health in the area. Pterygiums and conjunctivitis are frequent while trachoma is absent in Gourma.