[Can bilharziasis be considered a health priority in western Africa, justifying control programs of large scope?].
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Africa, Western↗
Biomedical subjects
M Develoux
Publications and source records attributed to M Develoux.
[The prevalence of anti-hepatitis C antibodies in pregnant women and blood donors in Bénin].
In order to precise if the hepatitis C virus (HCV) represents a potentially important infection for public health in Benin, the authors have studied the seroprevalence rate of this virus in august 1991, among two groups of population in Cotonou: 349 donors of blood (including 321 males); mean of ages: 28.7 y.-o., 149 pregnant women (mean of ages: 24.5 y.-o.). They have used an ELISA test (Innotest HCV Innogenetis NV, Antwerpen, Belgium) and retested the positive serums by LIA (Line Immuno Assay, Inno LIA HCV). A serum reacting with at least one peptide has been considered as positive. In the donors of blood and the pregnant women, a prevalence rate of respectively 2.3% (+/- 1.2) and 0.7% (+/- 0.9) has been established. These rates are worthy to be compared to those reported in Niger among the same types of population and with the same serologic tests. They are much inferior to those noted in East Gabon or South Cameroon: respectively 6.5% and 9.8%. This preliminary study has to be enlarged by investigations, which may precise the consequences of HCV presence in Benin for public health in this country.
Adult↗
[Cutaneous rhabdomyosarcoma].
OBJECTIVE: The occurrence of a rare alveolar rhabdomyosarcoma in a 16-year old girl seems worth of a case report. OBSERVATION: A large multinodular tumor developed on the buttocks and the external genitalia; systemic symptoms and metastases of lymph nodes and skin occurred very soon and the disease had a lethal outcome within 16 months. A temporary regression was observed after polychemotherapy with daunorubicine, vincritine and 5-fluoro-uracile. COMMENTS: In children the rhabdomyosarcoma is the most frequent sarcoma of soft tissues; the poor prognosis of the alveolar type is assessed by the case of this 16-year old girl; this tumor may progress as a systemic disease and present as a leukemia with rapid impairment of general health, enlargement of lymph nodes, cutaneous nodules and anemia.
Adolescent↗
[Syringocystadenoma papilliferum. A case located on the knee].
Syringocystadenoma papilliferum is an infrequent hamartoma of the sweat glands, usually of the scalp or temporal area. We observed a syringocystadenoma papilliferum in a young patient from Senegal. The lesion was unique and presented as a round 4 cm plaque with a red smooth surface. The diagnosis was based on the histologic examination. Complete surgical exeresis was performed. Localization on the knee is very unusual.
Adenoma, Sweat Gland↗
[Actinomycotic mycetoma. Apropos of 27 cases in Dakar; medical treatment with cotrimoxazole].
Actinomycotic mycetoma is frequent in Senegal and the treatment has changed greatly over the last decades. We observed 27 cases due to Actinomadura pelletieri (n = 21), Actinomadura madurae (n = 5) and Streptomyces somaliensis (n = 1). The diagnosis was based on clinical and histological arguments. All the patients were treated with cotrimoxazole for several months. The mycetoma was situated on the foot in 15/27 patients. Extrapodal localizations were frequent for red grains due to A. pelletieri (11/21). These mycetomas, the most frequent in Senegal, are extremely severe lesions with rapid local and distance extension. We were able to obtain 8 clinical cures. One death occurred in patient with an abdominal localization and multiorgan invasion. Mid-term outcome could not be determined in the other cases since they were lost to follow-up after initial improvement with cotrimoxazole. As sole treatment, cotrimoxazole should lead to cure in most cases.
Actinomycetales↗
[Prevalence of Enterocytozoon bieneusi spores in the stool of AIDS patients and African children not infected by HIV].
Enterocytozoon bieneusi is a newly described microsporidia in humans thought to be responsible for chronic diarrhoea in acquired immunodeficiency syndrome (AIDS) patients. The epidemiology of this parasite is still unknown; it could be a strictly opportunistic agent or a human enteropathogen. E. bieneusi spores were searched for in stool smears of two populations using a modified chromotrope 2R staining. The first population consisted of 60 patients infected by the human immunodeficiency virus (HIV) and the second of 990 children aged from one month to six years consulting two primary care centers in Niamey, Niger. E. bieneusi spores were found in 4 out of the 60 HIV-positive patients (7%). These 4 patients belonged to a subgroup of 35 patients with < 50 CD4 cells/microliters. Out of 990 children, 8 shed E. bieneusi spores in their stools; the presence of spores was not associated with a particular clinical phenotype (diarrhoea, fever, dehydration, vomiting). Although HIV status could not be evaluated, the HIV prevalence rate among women consulting the same care centers was low (0.5%) and it is therefore unlikely that all eight children were HIV-infected. The results show for the first time that E. bieneusi can infest HIV-negative subjects. Microsporidiosis is frequent in AIDS patients with low CD4 cell counts. Further work is needed to define the prevalence and the possible pathogenic effect of E. bieneusi in immunocompetent subjects.
AIDS-Related Opportunistic Infections↗
Humoral responses against the 85A and 85B antigens of Mycobacterium bovis BCG in patients with leprosy and tuberculosis.
Immunoglobulin G antibodies against the 85A and 85B components of the Mycobacterium bovis BCG antigen 85 complex separated by isoelectric focusing were investigated in serum samples from 129 patients representing the major forms of leprosy, 111 tuberculous patients, and 153 healthy subjects. For both of the antigens, a higher degree of staining was observed for lepromatous leprosy patients and patients with active tuberculosis than for the other groups. Because sera from some healthy subjects recognized the 85A antigen, we suggest that antigen 85B is the most useful component of the antigen 85 complex for the serodiagnosis of the multibacillary forms of leprosy or of the active forms of tuberculosis.
Antibodies, Bacterial↗
Consequences of Schistosoma haematobium infection on the iron status of schoolchildren in Niger.
The relationship between iron status and degree of infection by Schistosoma haematobium was studied in 174 schoolchildren from Niger in an area endemic for urinary schistosomiasis. Iron deficiency was defined by a combination of three reliable indicators: a low serum ferritin level combined with a low transferrin saturation, a high erythrocyte protoporphyrin level, or both. Hematuria and proteinuria were found in 76.4% and 79.9% of the children, respectively, while 95.4% excreted eggs (geometric mean egg count of 31.5 eggs per 10 ml of urine). Anemia was observed in 59.7% of the subjects. The prevalence of iron deficiency was 47.1%. Anemia was associated with iron deficiency in 57.7% of the cases. The hemoglobin level and transferrin saturation decreased significantly when the degree of hematuria increased, while prevalence of anemia and prevalence of iron deficiency increased significantly. The hemoglobin level and the hematocrit were negatively correlated with egg count, while prevalence of anemia increased with increasing egg count. This inverse relationship between degree of infection by S. haematobium and iron status shows a deleterious consequence of urinary schistosomiasis on nutrition and hematopoietic status, which should be considered in the design of nutrition intervention programs.
Anemia, Hypochromic↗
[Seroepidemiological study of visceral leishmaniasis in school children in the Iferouane oasis (Niger)].
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Adolescent↗
[Diversity of malaria in the Sahelo-Saharan region. A review apropos of the status in Niger, West Africa].
The concept of epidemiologic facies of malaria underlines the diversity in the expression of the disease in areas where important ecological variations interfere largely with transmission. Niger is quite a border region between the afrotropical fauna from the south and the Palearctic fauna from the north. The last one filters through the mountains where it maybe represents a relic of ancient paleoclimates. Annual variations of the northern limit of Anopheles arabiensis, in the Sahelo-Saharan region including some oasis, are related to temporary breeding places produced by seasonal rainfall, after estivation during the dry season or after a long migration with the wind. An. gambiae s.s is present in the south and along the Niger river, with An. funestus, even till Zinder. The northern limit of An. nili is the Niger river. The permanent variations of the environment induce great differences in the level of transmission between an intermediate stable situation in the south to an unstable one in the north. Epidemic outbreaks appear some years in vulnerable populations. The implementation of a malaria program supposes to take account of the various eco-epidemiologic situations all over the country. Even if mortality and morbidity became lower, natural precaution in some groups of people must be preserved.
Adolescent↗
Human hydatidosis in Niger.
Thirty-two cases of hydatidosis were collected in two Nigerian hospitals during a 5-year period; 81% of these had extra-hepatic localizations. Human hydatidosis has been considered as exceptional in West Africa but seems to be an underestimated disease in Niger. Studies in slaughtered animals from Niger show a high prevalence of hydatidosis in camels while no infection was found among sheep.
Adolescent↗
[Anti-rubella antibodies in pregnant women in Niamey (Niger)].
A total of 345 serum samples from pregnant Nigerian women were tested for the presence of anti-rubella antibodies. A technique of inhibition of haemagglutination was used and 40 or more was considered as a positive titer. Rubella antibodies were found in 244 (70.7%) of the samples. These results are quite similar to those from other west African surveys.
Antibodies, Viral↗
[Sheehan's syndrome in sudano-sahelian Africa. 40 observations].
Postpartum hypopituitarism or Sheehan's syndrome is frequent in Sahelian Africa. From February 1983 to July 1988, the authors observed 40 cases at National hospital of Niamey (Republic of Niger). These patients were Black African women living in rural areas, without medical assistance during the last delivery. Two signs were required for the diagnosis: absence of postpartum lactation and prolonged amenorrhoea. A 15 points score was used for identification of each case. Postpartum hypopituitarism is a severe disease in Sahelian Africa: after the pituitary necrosis, 80% children died. 60% of patients had no living child or only one malnourished infant with a poor prognosis. The social future of these sterile African women seemed uncertain. Hormonal treatment (estrogens, thyroxin, cortisone) is justified but expensive. Exceptionally a pregnancy developed after Sheehan's syndrome under treatment with childbirth of a living infant.
Female↗
Cutaneous leishmaniasis in Niger.
This is the first report of cutaneous leishmaniasis in Niger subsequent to the initial finding in 1911 and the report of a second case in 1943. The clinical, histopathological, and epidemiological features of 64 parasitologically confirmed cases are described. Lesions were mostly multiple, situated on exposed areas of skin, but rarely on the face. Two clinical forms were predominant: ulcero-crusted and humid-ulcerous. Nodular lymphangitis was not uncommon. Patients were mostly from rural areas, but urban transmission did occur. The majority of lesions appeared during the June-October rainy season. All features appeared to be similar to those of this disease in other countries in the sahelian endemic zone.
Adolescent↗
Ultrasonographic assessment of urinary tract lesions due to Schistosoma haematobium in Niger after four consecutive years of treatment with praziquantel.
A comparative study on the extent of urinary tract abnormalities detected by ultrasound was conducted in two villages in an irrigated area of Niger where the pretreatment prevalences were 64.3% and 58.8% respectively. Fewer bladder lesions (20% of abnormalities) and fewer renal lesions (6% of abnormalities) were observed after four consecutive years of follow-up and treatment with praziquantel in the study village as compared to the control village where 54% bladder abnormalities and 36% renal abnormalities were observed. This study suggests that morbidity due to Schistosoma haematobium infection can be reduced by annual treatment over several years in a highly endemic area without other associated interventions.
Cohort Studies↗
[Value of echography in the study of periportal fibrosis caused by schistosomiasis in an endemic African zone].
The authors present the results of a survey with ultrasonography conducted to evaluate the prevalence of hepatic fibrosis as a complication of infection by Schistosoma mansoni. Because of the specific images it yields, ultrasonography appears to be highly valuable for the diagnosis of Symmer's fibrosis. It allows the assessment of morbidity from Schistosoma mansoni, which has previously only been performed indirectly by physical examination.
Adolescent↗
High prevalence of giardiasis in an urban population in Niger.
A sample of 2569 persons (1190 m, 1379 f) from Niamey (population 329,000), Niger, showed a giardiasis prevalence of 28.5%. The prevalence was similar between males and females and highest in the age range 3-29 years.
Adolescent↗
24 hour polysomnographic evaluation in a patient with sleeping sickness.
A 24 h polysomnographic recording was performed in a patient with sleeping sickness presenting an atypical neurological syndrome. Trypanosoma gambiense was found in a lymph gland puncture and the CSF, and a serologic immunofluorescence test was positive. The scoring technique of the polygraphic traces had to be adapted because of the presence of a permanent EEG delta wave activity during the NREM sleep stages, and the method used by Schwartz and Escande (1970) was applied. REM sleep and wakefulness presented normal polygraphic characteristics. The patient had 8 sleep episodes throughout the recording period, occurring during the daytime and at night, forming the classical diurnal sleepiness and nocturnal restlessness of sleeping sickness. All but one episode represented 1-3 complete REM-NREM sleep cycles. On all occasions, REM latency was short and 2 SOREM episodes were observed. The nychthemeral organization of the stages of vigilance differed from one state to another. Wakefulness and REM sleep had a circadian rhythmicity, while NREM sleep, total sleep time and deep sleep (corresponding to stages 3 and 4) had an ultradian periodicity. The concordance between the higher pressure for wakefulness and lower pressure for sleep around 20.00 h defined the time of occurrence of a 'forbidden zone' for sleep.
Animals↗