Biomedical subjects
Publications and source records attributed to J Doucet.
The authors described a case of generalised and lethal Pentastomiasis by a five years old girl. The most heavy parasitised organs are the lungs and the brain. Considering the age of the child and the uncommon density of the parasites, the authors suggest that the symptoms may follow the casual ingestion of a gravid female worm.
A comparative study of 108 patients with patient amoebiasis and a reference group of 85 free of the disease but living in endemic area. The positivity of the test has been more frequent and has given higher titers in the extra-intestinal forms than in the intestinal ones. The positivity rate in the reference group has been 15 per 100.
The authors report two observations of cysticercosis in two pigs breeders living in the western part of Cameroon. Microscopic observation of several pieces demonstrated the presence of cysticercs larvae of Taenia solium. Treatment by praziquantel (Biltricide) was followed by an increase of antibodies rate, but it was not possible to appreciate the effectiveness of this therapy.
Authors relate the first case of otomyiasis in Ivory Coast due to Chrysomyia bezziana and Sarcophaga sp. They insist on scarcity of such a localisation. Egg-laying and development of larvae in tympanum case was favoured by a preexisting cholesteatoma. Precise entomological diagnosis needs incubation of the larvae in Petri dishes.
S. intercalatum has not yet been observed in Ivory Coast whereas S. mansoni and S. haematobium are frequent. S. mansoni schistosomiasis is distributed in limited foci as a consequence of the vital requirements of Biomphalaria. Its clinical detection is uneasy and stool control is necessary. Kato's technique is recommended. Prevalence has great topographic variations with an average value of 0,7 p. 100. Complications are not frequent, and can be detected only with rather sophisticated techniques available only in hospital. S. haematobium schistosomiasis is much more widespread according to the strong resistence of the mollusc host. Its clinical syndrome is significant and the diagnosis is easily controlled by a microscopic examination of the urine centrifugation deposit. The average prevalence is about 20-25 p. 100. Detection of complication requires hospital equipments.
The authors recapitulate in short the distribution of Paragonimiasis in West Africa. They establish and show keys for determination of adults and eggs of the agents of the disease (Paragonimus uterobilateralis, P. africanus, Poikilorchis congolensis). The first intermediate host is unknown but two species of snails are suspected (Afropomus balanoides, Potadoma sanctipauli). A very abundant crab (Liberonautes latidactylus) seems to be the second intermediate host.
The authors report the first observation, in West Africa, of eosinophilic meningitis in an ivorian child who ingested raw Achatina sp. The presence of a Parastrongylus. sp. in the cerebrospinal fluid was detected.
A survey has been carried out in 2 forest villages, 9 savanna villages and 2 Abidjan suburb districts. A total sample of 860 children aged between 6 and 15, has been examined. Data tabulation indicated a prevalence of the main intestinal nematodes, of S. mansoni and of E. histolytica, with variable respective percentage. Ascaris lumbricoides affected 26 p. 100 of children but is less frequent in the savanna areas than in the forest areas. Trichiuris trichiura affected 1 child out of 4 but infestation rate reached 76 p. 100 in the Abidjan suburb district. Necator americanus is the most frequently detected parasite (67 p. 100) and is more frequent in the forest areas than in the 2 savanna villages. E. histolytica has an uniform and low (5 p. 100) geographical distribution. S. mansoni has such an irregular distribution that no extrapolation is possible from the results obtained to the geographical area considered. Its infestation rates is from 1 p. 100 to 60 p. 100 with important differences inside small geographical zones.
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Pentastomosis is the infection caused by the larvae of a worm resorting to Armillifer genus, the adults living in the lungs of big african snakes. Eggs are released with snakes slime and dejecta and ingested by man and various animals. Larvae are disseminated through lymphatic vessels in peritoneum, liver, spleen, lungs, pleurae, and rarely in kidneys, brain or even eye. Most often the infection is fortuitously detected during a radiologic control or a surgical inspection. The serological prevalence was of 4.2 p. 100 as a whole, somewhat lower than that given by post mortem examinations but higher than the prevalence resulting of radiologic controls. Children under 5 are concerned with a prevalence of 7 p. 100.
Several indirect fluorescents reactions were performed on 46 trypanosomepositive specimens which had been confirmed by parasitologic diagnosis. 38 sera analysed before the commencement of treatment were found to have a G.M.R.T. equal to I:I, 350 and the titer of antibody was, in all cases, greater than I:320. In all cases in the first phase, the titer was I:640 or higher. Four cases were followed beyond the second month and their titers decreased slowly, becoming negative in the fifth month. In 12 cases in the second phase, the cerebrospinal fluid demonstrated fluorescent antibodies although 10 cases in the first phase were negative for these antibodies. Three cerebrospinal fluid were faintly positive and these corresponded to the second phase biologically. In the treatment of individuals (using the analysis of cerebrospinal fluid for antibody) the I.F.A.T. permits the classification of the patient into one of the two phases and enables the clinician to follow the course of therapeutic effectiveness. In mass screening, apparently healthy individuals possessing a serum titer of I:640 or higher are shown to need definitive treatment for trypanosomiasis, while those with titers of I:320 are those who may either be treated with Lomidine or tested regularly for change in serum titer.
We performed a study in 92 diabetic patients (76 Type 1 and 16 Type 2) without retinopathy to determine the relation between diabetic dyschromatopsia and neuropathy, which has been evoked in previous studies. Color vision was explored with Lanthony's desaturated D 15 panel. Peripheral nervous function was explored with an electrophysiological score which has been beforehand validated. Moreover evoked visual potentials were performed in 38 diabetic subjects in order to determine whether dyschromatopsia was related to an impairment of central optic pathways. Fifty-one among the 92 diabetic subjects had a blue-yellow dyschromatopsia. Among the recorded parameters, only peripheral nervous impairment was significantly more frequent in the group with dyschromatopsia than in the group without. Ten among 38 diabetics had impairment of the evoked visual potentials. Frequency of alteration of evoked visual potentials was not different between the group with and the group without dyschromatopsia. Our results confirm the relationship between dyschromatopsia and the alteration of the nervous function in diabetic subjects. In return, lack of significant modification of evoked visual potentials among diabetic patients with dyschromatopsia and the blue-yellow axis of dyschromatopsia are in opposition with a direct neurological origin of dyschromatopsia. We therefore evoke a common process in the beginning of the diabetic dyschromatopsia and of peripheral neuropathy.
In a study of 135 cases, the authors present the dermatologic lesions occasioned by onchocercosis, study and discuss the value of the following three diagnostic procedures: the skin Snip technic, the Mazzotti test, and indirect fluorescent antibody test as used in a region of Africa where onchocercosis is, with dipetalonemosis, the principal filariasis. The skin Snip showed positive in only 11,8% of cases while each of the other technics permitted diagnosis of more than 80% of cases studied. Use of the Mazzotti test in conjunction with indirect fluorescent antibody test proved the origin of dermatologic lesions to be onchocercotic in 100% of the study group while both tests remained negative for subjects in the control group. The authors conclude that, in individual practice the 3 tests should be used conjointly, while, for purposes of mass screening, the determination of fluorescent antibodies must be performed as an adjunct to clinical examination and skin Snip.
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