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Biomedical subjects

M Kombila

Publications and source records attributed to M Kombila.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Development of chloroquine resistance in Plasmodium falciparum in Gabon between 1984 and 1987-88 (in vivo evaluation in a school environment)].

Unknown in 1980, suspected in 1983 and scarcely present in 1984-85, Plasmodium falciparum resistance to chloroquine as studied in vivo in schoolchildren in Gabon, has strongly developed in 4 years time. In 1987-88, administration of 25 mg/kg of chloroquine leaves one strain out of four with a parasitic load greater than 10/1.000 red blood cells examined by thick drop technique. The present, unfortunately provisional attitude tends to maintain chloroquine at efficient doses for as long as the resistant strains are ethically and practically controllable. The dispersion without strict control of new and for the time being very efficient drugs might rapidly give rise to a polychemoresistance which would leave us without defence.

Animals↗
PubMed1989

[The efficacy and tolerance of ivermectin (Mectizan) prescribed for the patient with multiple filarial infections (Loa loa/Onchocerca and/or M. perstans)].

Administration of ivermectin (Mectizan) in Loa loa filariasis induces a significant decrease of microfilaria load within 3 to 15 days. The excellent tolerability of the drug in patients infested simultaneously by O. volvulus and Loa loa allows to use ivermectin in mass treatments in geographical areas where the same patients can be affected by several filariasis. There is almost no efficacy against Mansonella perstans. A second administration one month after the first one in Loa loa affected patients has not led to a complete disappearance of microfilaria; the tolerability has still been good. Efficacy on Ascaris lumbricoides appears to be excellent; further studies are necessary in the cases of trichuriasis, ancylostomiasis and strongyloidiasis.

Filariasis↗
PubMed1989

[Fungal otitis in Libreville. Study of 83 cases].

83 cases of mycotic otitis of external ear are reported during a period of 27 months from three departments of otorhinolaryngology in Libreville (Gabon, Central Africa) Prevalence is estimated at about 25% among all infectious otitis. The main functional signs are pruritus, otorrhea, pain and hypoacousia. The physical examination shows masse of white, grey, black or creamy caseous debris, invading the external auditory meatus (EAM) which is sometimes inflammatory. Fungal species responsible of otitis are Aspergillus (54%), yeasts (45%) mainly Candida, infrequently Fusarium (1%). A niger (26%), A. flavus (17%), Candida parapilosis (18%), Candida albicans (9%) are predominant species isolated (70%) among all the 21 species of identified fungi from otomycosis in Gabon. Therapy, done by thorough washing of the ear followed by insertion into the EAM of a wick soaked in Econazole or Amphotericin B, is quickly effective.

Administration, Topical↗
PubMed1988

Ivermectin in loiasis and concomitant O. volvulus and M. perstans infections.

Two clinical studies were carried out in Gabon, Africa to evaluate the efficacy, safety, and tolerability of ivermectin in the treatment of patients with Loa loa infection. In the first study, 35 patients received single oral doses of ivermectin, 5-200 mcg/kg body weight. Blood microfilariae levels did not decrease after a single oral 5, 10, 30, or 50 mcg/kg dose of ivermectin, but levels did decrease after doses of 100, 150, and 200 mcg/kg. The most efficacious dose was 200 mcg/kg; mean blood microfilariae levels decreased to 12% of mean pretreatment values by day 15 and remained decreased for 28 days. A second study evaluated the safety and efficacy of ivermectin in patients with multifilarial infections. All 17 patients had concomitant Loa loa and O. volvulus infection. M. perstans affected 5 of the patients. Sixteen patients also had infections due to intestinal nematodes. The patients each received single oral doses of 200 mcg/kg ivermectin. Ten days later, the mean Loa loa blood microfilariae level had decreased to 20% of the mean pretreatment level. O. volvulus dermal microfilariae densities were reduced to 2% of the pretreatment levels. A minimal increase in blood microfilaria levels was observed on day 28. In contrast, dermal microfilariae levels remained near zero for the duration of the study. Intestinal infection due to Ascaris was eradicated in all of the affected patients by day 23; efficacy against Trichuris and hookworm infections, however, was poor. All patients tolerated ivermectin well including those with multiple infections.

Adult↗
PubMed1988

Filariasis in Gabon: human infections with Microfilaria rodhaini.

In examining skin snips from 1,830 Gabonese 32 were found to have microfilariae indistinguishable from Microfilaria rodhaini. The microfilaria is 300.2 microns long and 2.2 microns wide. Specific clinical signs were not identified, as the same person often was infected by other filaria.

Adult↗
PubMed1988

[Malaria in Gabon. Transplacental passage and dynamics of development of fluorescent antimalarial antibodies with age].

In permanent malaria transmission area (Gabon), fluorescent malarial antibodies have been studied among a population of mothers new borns and children from 1 to 15 years old. A lack of transplacental transfer of antibodies among african pairs "cord-mother" is noticed and in negative correlation with total mother IgG level. The antibodies rapidly increase from 1-2 years old still 9. Chimioprophylaxis does'nt modified for a long time the development of the FAT malarial antibodies.

Adolescent↗
PubMed1987

[Malaria and pregnancy. Comparative study of Central Africa and Western Africa].

The transmission of malaria occurs mainly in and following the rainy season (intermittent transmission) in the Sahelian zone of Africa. On the other hand in rainy Equatorial Africa the transmission of malaria is continuous so that it is stable and can give rise to continuous antigenic stimulation in pregnant women which in turn gives rise to passive early high level immunity in the infant. 150 couples of mother and cord blood and 206 placentae were studied. We found 12.1% of carriers of blood parasites in the blood as compared with 1.6% in the cord bloods (exclusively P. falciparum). Where there were medium quantities of fluorescent antibodies in the mothers 74% could be found in the cord serum. Two methods were used to measure antimalarial antibodies as evidence of infection and also partly protective: the first method was indirect immunofluorescence, and the second was co-electrosyneresis. There was a narrow correlation between the level of precipitant antibodies in the mothers who were infected and in the fetal cord bloods. Anatomo-pathological examination of the placenta showed that 2 out of the 206 had parasites in them, 9 out of the 206 had fibrin deposits around the villi and 6.8% of the placentae showed lesions of malaria. On the other hand, in West Africa there was very little maternal morbidity as evidence by fever and anaemia, or of fetal morbidity. There was no single case of congenital malaria. The levels of the plasma indices in the towns could be explained because of prophylaxis which was both controlled and uncontrolled.

Africa, Central↗
PubMed1987

[Malaria in Gabon. 2. Evaluation of the qualitative and quantitative prevalence of parasites in the total school and preschool population of the country].

The distribution of carriers of hematozoa in the pre-school and school age group in Gabon has been established with the help of systematic enquiry. The plasmodial indexes vary between 11 and 32% in the savanna zones of the south-east, they rise to 64.9% in the forest regions of the north of the country, and in the urban zones (Libreville, Franceville, Lambarene) 6 to 18% of the school children are gametocyte carriers. In Libreville, amongst the febrile children seen in pediatric consultation, the prevalence reached 30%. Boys and girls are equally affected. The most important prevalence is observed in the group of children from 5 to 10 years of age. P. falciparum is found in 96.4% of the cases, P. malariae in 5.3% and P. ovale in 2.4%. The study of the parasitic load revealed that 56% of the positive subjects had less than 10,000 asexual forms/mm3, 44% more than 10,000 hematozoa/mm3. These results are similar to those of the neighbouring countries of equatorial Africa.

Carrier State↗
PubMed1986

[Interaction between Salmonella and Schistosoma intercalatum].

Close interactions between salmonellae and Schistosoma intercalatum were demonstrated by a study of 118 children conducted at Libreville, Gabon. Bilharziasis, confirmed by rectal biopsy, was present in 76% of children hospitalized for typhoid-like salmonella septicaemia, as against 38% of controls of the same age living in the same district (P less than 0.001). Although the clinical symptoms were typical of typhoid fever, with stupor, myocarditis or leucopenia depending on the cases, the germs responsible in 26 out of 42 cases were salmonella species regarded as minor. Finally, the salmonella infection was clinically prolonged by bilharziasis in 1 out of 3 patients. It would therefore appear that salmonella adheres to the wall of S. intercalatum as to that of other schistosoma species, and that both infections must be treated concomitantly.

Adolescent↗
PubMed1986

[Intestinal parasitic colonization and protein-caloric malnutrition].

Intestinal parasitic infection was determined by fecal examination for parasites with several complementary methods in 380 young Gabonese infants aged 6 to 24 months (190 with normal weights and 190 with malnutrition, matched for age). Trichuris trichiura, Ascaris lombricoides, Giardia intestinalis, Entamoeba histolytica and Strongyloides stercoralis were the most prevalent parasites, without any difference between well-fed infants and patients with malnutrition. The higher prevalence of Strongyloides stercoralis in protein energy malnutrition might be related to a methodologic problem. However, more than 20% of diarrheas in infants with severe malnutrition were dramatically improved by specific treatment of S. stercoralis or Giardia with thiabendazole or metronidazole.

Diarrhea, Infantile↗
PubMed1986

[Malaria in Gabon. I. Study of 500 children with fever in Libreville].

Among 500 febrile children who came for medical examination in the Pediatric Department at the Hôpital Général de Libreville, 29.2% were infected by malaria. P. falciparum was the most common (96.7%), P. malariae and P. ovale were sparsely present. Rarely detected in people consulting for fever, shivering and headache were the two symptoms directly related to paludism. There is a direct correlation between the size of the spleen and the rate of infestation. Screening among babies from 3 to 6 months' old, shows 13% already infected. The top of malaria incidence lies between 2 and 3 years of age (42% were infected).

Age Factors↗
PubMed1985

[Etiology of acute infantile gastroenteritis in Gabon].

Rotaviruses are the main etiology of acute diarrhoeas in gabonese children (11 to 30% according to age). Salmonellae (11.4%), Shigellae (7.1%) and E. histolytica (7.1%), isolated or associated with enterobacteria, E. coli (3%), Giardia and Strongyloides stercoralis (1.4%), Yersinia enterocolitica (1%) and Balantidium coli (0.5%) were also found, without cholera.

Adolescent↗
PubMed1985

[Antiparasitic therapy of children in Equatorial Africa].

Parasitic infections are endemic in children in Africa, making eradication an impossibility. Therapy is directed towards the individual manifesting an imbalance in the host-parasite relationship. Sanitation education is often disappointing, and until effective vaccines are developed, drug therapy remains the only worthwhile intervention. In order for a drug to be used on a mass campaign basis, financial considerations and side effects are of primary importance. Mefloquine has been shown to be a useful second line drug for chloroquine resistant strains of malaria in our Parasitology department. Benzimidazoles in a single dose are useful for intestinal nematode infections. New drugs are now available for schistosomiasis, filariasis, and protozoan infections.

Child↗
PubMed1985

[Indications characteristic for different antiparasitic treatments in endemic zones].

In endemic regions, certain anti-parasitic therapies are automatically prescribed when confronted with apparently benign childhood disorders. The diagnostic differentiation between a simple febrile seizure provoked by Plasmodium falciparum is often impossible, requiring the initial use of intravenous quinine. Helminth or Giardia infestations often aggravate the chronic diarrhea of malnutrition, or are revealed with corticosteroid therapy, necessitating the initiation of an appropriate treatment. In addition, the frequent association of typhoid and schistosomiasis, requires therapy for both in order to prevent relapses.

Child↗