Biomedical subjects
Publications and source records attributed to M Le Bras.
Congenital ocular toxoplasmosis with recurrences must be treated by Spiramycin destroys trophozoites when they escape from the true cysts. Fansidar (Pyrimethamine + Sulfadoxine) seems to have less efficacity than Pyrimethamine with Sulfadiazine.
Among nutritional anaemias caused by the lack of erythropoietic nutriments, iron deficiency is the most frequent. In developing countries, it mainly comes from supply deficiencies. It can also be due to multiple and successive pregnancies, to pathological iron loss, to absorption defects. The study of the iron content of the main kinds of nutriments available in Vietnam and of their absorbability allows nutritionists to give useful advice to the population. Other means (use of drugs, foodstuffs enrichment) together with nutritional and health education are essential to fight efficiently against this major nutritional disease.
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The seroprevalence of syphilis was studied in an urban and a semi-rural community in Gabon by a cluster sampling technique. The crude prevalence rate of treponemal infection in the semi-rural population was estimated to be 13.3 +/- 5.0% and in the urban population 19.4 +/- 4.6%. The age-adjusted prevalence rate was significantly higher in the urban than in the semi-rural population. In both areas, it was significantly higher in men than in women. No significant difference was observed according to age. These high rates indicate the need for a control program for sexually transmitted diseases.
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In 1984 and 1985, a non-random survey was conducted among healthy Africans living on the campus of the University of Niamey, Niger. Of 238 asymptomatic subjects, 17.6% carried hepatitis B surface antigen (HBsAg) in their serum, while 50.8% demonstrated protective anti-HBs antibodies. Antibodies to delta virus were detected in 29.3% of HBsAg-positive sera. This suggests that hepatitis B virus (HBV) and hepatitis delta virus (HDV) are common in Niger, and the factors that increase the likelihood of HBV transmission may also enhance the risk of HDV transmission.
Five imported falciparum malaria cases with severe evolution are reported. Treatment associated a blood exchange transfusion and an antimalaria chemotherapy (mefloquine in three patients and quinine in two patients). All patients were successfully cured despite of serious visceral complications occurring in two patients (pulmonary and cerebral oedema). Technical management of treatment is detailed. Exchange transfusion should be considered in falciparum malaria when parasitaemia overcomes 20% and when serious visceral impairment, hemolysis or consumption coagulopathy are occurring.
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We consider an approach to built on a score summarizing some demographic, social, geographic and parasitologic data for purpose of measuring the health impact of schistosomiasis. Operational definitions are given for the social, ecological and medical variables and for the survey design. Twenty villages from the Bam-Kongoussi district were kept for the survey, giving a sample of 11,396 peoples. The process of the survey is described. The overall response rate is 63%. The sensitivity of the survey's results in regard to the non-responses is considered along with the possibility to implement a call back survey.
A death from chloroquinoresistant falciparum malaria contracted by a traveller under chloroquine chemoprophylaxis during a stay in the Cameroon provides the authors with an opportunity to analyze the extension of chloroquinoresistance in Africa. Having appeared there about 10 years ago, it remained for a long time localized in East Africa. In recent years, it has moved West. Today, 17 countries located from the North to the South between Sudan and Mozambique, and from East to West between Kenya and the Cameroon are affected, as are the Malagasy Republic, the Comores and Zanzibar. The strains resistant to chloroquine are still sensitive to amodiaquine. In certain regions which are widespread in the continent, resistance to pyrimethamine has become evident in the last 30 years; resistance to pyrimethamine-sulfadoxine and pyrimethamine-dapsone has appeared in the last 3 years in East Africa. In the light of the complexity of the problem of malaria chemoprophylaxis, the authors emphasize the necessity of resensitizing the public at large with respect to personal protection against biting anopheline mosquitos, especially during the hours of darkness. The medical profession should equally be made aware of these new problems. Three types of chemoprophylaxis in relation to the areas visited are proposed: the first for West Africa; the second for Central Africa, neighbouring regions and the Malagasy Republic and the Comores; the third for the 3 East Africa countries the most affected, which are Kenya, Burundi and Tanzania.
A method is proposed for comparing the number of lost work days for a rural population in a tropical area. It takes into account the pathology of the whole population and not only of the working people. It uses demographic, epidemiologic and clinical data which are generally available. This method allows to assess the usefulness of health programs with regard to the increase of productivity. The example of Mali is presented.
In Niger, two communities, a urban one (Maradi) and a rural one (Tarna), living in a same malarious Soudano-Sahelian climatic area, were compared during wet and dry seasons by different methods (spleen rate, parasite rate, parasite count, level of immunity). During wet and dry season, spleen rates (0.7% and 2.6%) and parasite rates (1% and 1.6%) are considerably lower at Maradi than those observed at Tarna (spleen rates: 38% and 42%; parasites rates: 10% and 22.5%). It is shown that seroconversion occurs later in urban sector (100% between 20 and 29 year age) than in rural sector (100% between 10 and 15 year age). All malarious indicators were negative in a high percentage of Maradi-born children under 9 (79% during wet season and 81% during dry season) against respectively 28% and 31% at Tarna. Better paludometric index in urban community is a favourable sanitary indication. But epidemiological control must be prosecuted since the number of non-immune subjects is increased.
The frequency of reactions to vaccinations against Yellow Fever was determined in a population of 370 travellers in good health. 25% suffered from reactions, most of which were minimal, 5% were local and 22% general of which half were of the post vaccinal viral syndrome type with multiple pains and pyrexia. Strong reactions appeared in only 8 subjects (2%). Age, sex, or number of antigens injected did not cause any significant differences.
Serum samples taken from 370 healthy individuals (aged 15-44) constituting a randomized sample representative of the adult population of the town of Nkongsamba, Cameroon, were tested for Hepatitis B virus surface antigen (HBs); positive samples were then tested for Hepatitis B virus [e] antigen (HBe) and anti-Delta antibody. The mean carrier rate of HBs was 8.4% +/- 2.8%; within HBs carriers, 29% exhibited HBe and 6.5% anti-Delta antibody.
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