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M Kombila

Publications and source records attributed to M Kombila.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Evaluation of 3 tests applied in the immunological diagnosis of hepatic amebiasis in Gabon].

The diagnosis of hepatic amoebiasis is not always easy. In case of suspicion of hepatic amoebiasis in an endemic area, the patient is immediately treated with a 5-nitroimidazole. Immunological diagnosis is indispensable. After a comparative study of BLA, IHA and IFA reactions, the BLA test has shown to be well adapted to the context of a country with insufficient sanitary infrastructure. The BLA test is easily performed and enables rapid detection of antibodies. The result obtained in about 5 minutes allows to adjust the therapeutic conduct.

Adolescent↗
PubMed1992

[Parasitemia in Plasmodium falciparum malarial attacks in children].

In order to evaluate the predictive value of parasitaemia, this parameter was measured on admission in 69 Gabonese children aged from 3 to 13 years hospitalized for Plasmodium falciparum malarial attacks. Fourteen of these children had cerebral malaria, 5 had isolated convulsions and 50 had uncomplicated attacks. The parasitaemia values measured were compared with those found in asymptomatic children of the same age range carrying trophozoites. There were no significant differences in mean parasitaemia count between the 3 types of malarial attack, and only the asymptomatic carriers had significantly lower counts. However, the wide scattering of individual values within each group indicated that simple measurement of parasitaemia is not discriminative enough to predict the course of malarial attacks in children living in endemic regions. In particular, malarial attacks with very low or very high parasitaemia value are possible, but similar values are found in asymptomatic carriers.

Adolescent↗
PubMed1992

[Malaria and hemoglobin S: interactions in African children].

Among 300 cases of Plasmodium falciparum malaria attacks explored in Gabon, the proportion of homozygous (SS) or heterozygous (AS) sickle-cell patients was 6.2 percent in 206 ordinary attacks and 3.2 percent in 94 cerebral malaria attacks, and 23.2 percent in the general population. On the other hand, asymptomatic carriage, as detected in 98 children by thin blood films in school screening, was as frequent in the SS or AS infantile population as in the general population. These data show that haemoglobin S protects effectively, although not entirely, against severe attacks of P. falciparum malaria. The incidence of anaemia and vaso-obstructive crisis in malaria-infested sickle-cell patients suggests that subclinical carriage of haematozoa may worsen the course of sickle-cell disease, and this must be taken into account when planning treatment.

Adolescent↗
PubMed1992

Efficacy, safety and acceptability of halofantrine in the treatment of acute Plasmodium falciparum malaria in African children (Gabon).

Halofantrine chlorhydrate 2 per cent suspension was given to 50 children (mean age 6.2 years in a dose of 8 mg/kg three times a day as a single day treatment. The children were born and lived in Gabon, where malaria transmission is continuous. They all had acute Plasmodium falciparum malaria. The children were kept in hospital for 5 days, and regularly followed over a 15-day period. The 50 children were cured and efficacy was evaluated as good in 44 cases, and excellent in six cases, as judged by improvement in their clinical signs and parasitaemia. Two criterias were considered in the evaluation of efficacy: clearance of parasitaemia (mean day 4), fever clearance (mean hour 24). There were two cases of persistences of parasites at day 15 with a very low parasitaemia rate. Tolerance to halofantrine was good from a clinical and biological point of view. Acceptability was excellent in all cases. Halofantrine 2 per cent suspension is a good alternative in the treatment of acute Plasmodium falciparum malaria in children, especially with the present situation of multidrug-resistant strains in Central Africa.

Acute Disease↗
PubMed1992

Influence of intestinal parasitism on lactose absorption in well-nourished African children.

Hydrogen breath tests were performed in Gabon (Central Africa) after a loading dose of lactose in 67 well-nourished African children (50 with intestinal parasites and 17 unparasitized) and in 18 unparasitized young adults. All had normal nutritional status, and none had diarrhea or digestive symptoms. Parasites that were found included Ascaris lumbricoides in 76% of the parasitized children, Trichuris trichiura in 58%, Giardia in 24%, Entamoeba histolytica in 20%, Schistosoma intercalatum in 16%, and Necator Americanus in 14%. A similar proportion of parasitized (64%) or unparasitized (62.8%) subjects were lactose malabsorbers. Giardia infection was associated with a higher, but not significantly different, proportion of lactose intolerance (10 of 12, 83.3%). The presence of infection with A. lumbricoides or T. trichiura did not increase the percentage of lactose malabsorption. These data indicate that a decrease of lactase activity in well-nourished African children is not related to the presence or the importance of Ascaris or other intestinal parasites if the nutritional status is normal.

Animals↗
PubMed1992

[Seroepidemiological study of toxoplasmosis in Libreville, Gabon].

A sero-epidemiological survey of toxoplasmosis has been carried out in 1178 subjects residing in urban and suburban areas of Libreville, Gabon. Two techniques were used: Pastorex toxo of the Institut Pasteur and ISAGA of bioMérieux. The acquisition of antibodies occurs at an early age, from the age of six months on. After the age of 15 years, the age of procreation, the prevalence is 68%. Between the ages of 15 and 19 years, 19% have IgM. The risk for toxoplasmosis acquired during pregnancy is not to be neglected. It decreases between the ages of 20 and 30 years. The most probable source of contamination is the reservoir from the soil. No difference between the sexes was observed.

Adult↗
PubMed1992

[Toxoplasmosis in Gabon. Results of a seroepidemiological investigation].

A toxoplasmosis sero-epidemiological inquiry was effected with 2,324 sera collected from Libreville, Lébamba, Makokou, Lastourville and Woleu-Ntem. All the sera were first screened through Pastorex toxo (Diagnostics Pasteur). Those with more 8 IU/ml and 267 sera with less 8 IU/ml were then assayed by ISAGA (bioMerieux) for IgM. The results of ISAGA must be interpreted with carefulness for natural agglutinins are frequent in this population. The acquisition of immunity is precoce and more of 60% have a serology positive from ten years old. There was no difference between sex.

Adolescent↗
PubMed1992

Microsporum gypseum complex in man and animals.

Twenty-eight strains of the Microsporum gypseum complex isolated from humans and animals were studied. The perfect form was found for 25 of the isolates. Nannizzia incurvata was the species most frequently involved in human pathology, while Nannizzia gypsea was most frequently found on animal lesions. Nannizzia fulva was rarely involved pathologically and Nannizzia corniculata was not isolated during this study. It is surprising to note that this species was not found even though most of our strains (22/28) came from Africa. Reliable methods are not available for differentiating among the anamorphs, which are commonly called M. gypseum, Microsporum fulvum or Microsporum boullardii. The Sabouraud medium conventionally used for medical mycology makes almost no distinction among them. We found that the species could be easily distinguished by colonial and microscopic features when grown on Takashio medium. When strains are atypical, sexual reproduction remains the reference technique but, in most cases, Takashio medium makes it possible to avoid this long drawn-out procedure.

Adolescent↗
PubMed1992

[Decreased intraepithelial lymphocytes in the intestinal mucosa in children with malnutrition and parasitic infections].

In Gabon, 15 children aged 13 to 36 months admitted for malnutrition with chronic diarrhea underwent a small bowel biopsy for detection of parasites in the duodenal contents and histologic evaluation of the intestinal mucosa. In every case, intraepithelial lymphocyte counts (IELC) were under the lower limit of normal for children and adults, regardless of whether or not parasites were found. Partial villous atrophy was a consistent finding. Proportion of lymphocytes among intraepithelial cells was 7.4% in the 6 children with no parasitic infection, 7.9% in the children with giardiasis, and 8.1% in the children with strongyloidiasis. Appropriate treatment of the parasitic infections was quickly followed by resolution of the diarrhea in the nine patients with demonstrable intestinal parasites. These data should be compared with the well documented lymphocyte function anomalies associated with protein-calory malnutrition. The fall in IELC and lack of response to local anigenic stimulations are features of malnutrition.

Atrophy↗
PubMed1991

[Results of a systematic search for Plasmodium in internal medicine in Gabon].

Among 158 adults hospitalized at the University Hospital of Libreville who did not receive any treatment against malaria before blood screening, 20 were carriers of malaria parasites. Plasmodium falciparum was seen in 19 cases with a parasitic density lower than 1,000 trophozoits/mm3 of blood in 18 cases. The most important prevalence was observed into the group of older people. In most cases symptoms related to malaria did not occur during the hospitalization. We conclude that, in such patients, a parasitic density lower than 1,000 trophozoits/mm3 is not sufficient to assess the diagnosis of malaria and does not deserve systematic treatment.

Adolescent↗
PubMed1991

[Role of cryptosporidiosis in infants in Gabon. Results of two prospective studies].

Two epidemiological surveys of cryptosporidiosis in urban and suburban areas of Libreville, Gabon, Equatorial Africa, were conducted in children. On 450 fecal samples on the first study, Cryptosporidium sp. has been seen about 3.11%. For the second survey, on 296 children, aged between 0 and 2 years, with acute diarrhoea, the rate of infestation was 24%. The maxima was observed for infants aged between 6-18 months, in case of malnutrition and during wet seasons.

Acute Disease↗
PubMed1990

Hendersonula toruloidea as an agent of mycotic foot infection in Gabon.

Pathogenic fungi were isolated from 149 of 210 Gabonese patients with clinical signs of tinea pedis. Hendersonula toruloidea was isolated from 51 patients (34.2%), either alone (in 25%) or in association with a dermatophyte species or Candida albicans. Clinical signs of H. toruloidea infection closely resembled those of dermatophyte infection except that hyperkeratinization of the soles was most often associated with infection by H. toruloidea. H. toruloidea mycelium could be readily distinguished from dermatophyte mycelium on direct examination of skin scrapings. All the H. toruloidea isolates closely resembled the Type 1 isolates described by Moore, both microscopically and macroscopically. The importance of establishing a mycological diagnosis of this infection and the therapeutic implications of infection with H. toruloidea are discussed. This fungus was isolated from 34% of our patients from Gabon with clinical tinea pedis.

Adolescent↗
PubMed1990

[Intestinal parasites and lactose malabsorption].

Breath-test was performed for diagnosis of lactose malabsorption in 50 Gabonese children of normal nutritional status, aged 5 to 15 years, with parasites in stools, but without diarrhoea or digestive symptoms. Control group was unparasitized and consisted of 17 children and 18 young adults living in the same area. Parasites discovered by stool examination were Ascaris lumbricoides in 76% of parasitized children, Trichuris trichiura in 58%, Giardia in 24%, Entamoeba histolytica in 20%, Schistosoma intercalatum in 16% and Necator Americanus in 14%. Children were given a 10 g lactose load and adults 20 g. Lactose malabsorption was discovered in 64% of parasitized patients and in 63% of unparasitized. Ten of 12 (83.3%) of Giardia infected children had a lactose malabsorption (no significant difference). These data show that decrease of lactase activity in African children is not related to the presence or to the importance of intestinal parasitism, except for Giardia infestation, if nutritional status is normal.

Adolescent↗
PubMed1989

[Malaria in Gabon. Bioclinical survey of non immune Europeans during short stay and prophylactic attitude].

A group of 300 young European adults visiting Gabon for relatively short periods was surveyed monthly for malaria from a parasitological, clinical, immunological, hematological point of view. The regular increase of fevers due to malaria from 1984 to 1988 and the multiplication of cases of amino-4-quinoline resistance in the plasmodial parasites call for new prophylactic considerations for this group residing in this heavily malaria infested area.

Adult↗