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PubMed2004

[Newcastle disease in southern Chad: peak epidemic periods and the impact of vaccination].

In spite of its universally acknowledged importance, backyard chicken production is still being hampered by Newcastle disease in some parts of the world. In Chad, the disease has been reported almost everywhere in the country and confirmed in several regions, but there are no control measures in place. A survey was conducted at three sites in south-eastern Chad in July and August 2001, based on face-to-face interviews with 20% of the peasant farmers keeping chickens at these sites. The aim was to collect information on peak epidemic periods and on ways in which the infection spreads. The survey revealed that the peak epidemic periods for Newcastle disease are April, during the mango harvesting and selling period, and December, when trade increases for the seasonal festivities. The survey also showed that peasant farmers attach great importance to chicken farming. The survey was followed by a vaccination trial in November 2001 and February 2002, using the La Sota strain administered ocularly. All of the birds vaccinated during the trial were successfully protected from the disease and both chicken production and the income of the villagers increased. The authors conclude that in order to sustain poultry farming and maximise production in the southern zone, vaccination programmes must be urgently introduced, campaigns to raise awareness of Newcastle disease should be carried out and financial support to pay for vaccines should be provided. Efforts to combat other causes of poultry mortality must also be undertaken.

Animals↗

PubMed2006

The 2001 meningitis epidemic in south Chad.

AIM: Bacterial meningitis is widespread in many areas of tropical countries, has a high mortality rate, and is often devastating. However, epidemiological studies in rural areas are quite rare, especially in Chad. We report data concerning the 2001 meningitis epidemic in the Moyen Chari district, in Southern Chad. METHODS: Five-hundred and ninety-five cases of meningitis were admitted in hospital from January to April 2001. Diagnosis was made on the basis of clinical presentation and/or by cerebrospinal fluid (CSF) specimen analysis. Antimicrobial treatment, time of recovery or death were recorded. Treatments most employed were oily chloramphenicol (CAP) and ampicillin, alone or combined. RESULTS: Two peaks of incidence have been observed: one in children aged below 1 year and the other in 6 year-olds with an overall lethality rate of 8.74%, particularly in children aged below 2 years. Incidence decreased over 13 years of age. Weekly incidence per 1 000 inhabitants, ranged from 0.21 to 1.69. Microbiological data indicated S. pneumoniae as the leading pathogen, but the epidemic nature of the disease suggests that this pathogen was probably overestimated. CONCLUSION: Our data suggest that an incidence of 10 cases per 100 000 appears most useful in predicting an epidemic. CAP was significantly the most effective treatment in terms of lethality, need for second-line treatment, and mean hospital stay, particularly if first administered at a primary health center. In case of lack of response to CAP treatment, the association of ampicillin and gentamicin seems more advisable than ampicillin alone.

Adolescent↗

PubMed1991

[Note on the lessons of rinderpest control in Chad since 1935].

The policy of rinderpest control in Chad has passed through various phases over sufficiently long periods to validate certain concepts such as that of the usefulness of perifocal vaccination of populations which have not been previously vaccinated. After studying the reliability of data regarding livestock, vaccinations and pathology and after having reviewed the various types of vaccine used, it can be concluded that perifocal vaccination, even in conjunction with the systematic vaccination of young, has not enabled rinderpest to be brought under control in Chad. Only systematic livestock vaccination can control and eradicate the disease. A table illustrates the vaccination operations and monitoring systems used.

Animals↗

PubMed1995

[Comparison of the pathogenic effect in mice between stocks of Trypanosoma evansi from Mauritania and from Kenya, Niger, Chad and China].

The pathogenicity to mice of a stock of Trypanosoma evansi from Mauritania has been compared to that of stocks from Kenya, Niger, Chad and China, using doses of 5.10(5), 2.10(6) and 5.10(6) trypanosomes per mouse. The survival of mice inoculated with stocks from Kenya, Niger and China is short, on average 2.1 to 6.5 days. Mice inoculated with stocks from Mauritania and Chad survive longer, 12.5 to 22.7 days, depending on the dose.

Animals↗

PubMed1995

[First- time isolation of the peste des petits ruminants (PPR) virus in Chad and experimental induction of the disease].

In Chad, in 1993-1994, investigation into "peste des petits ruminants" (PPR) outbreaks were carried out in flocks of Sahelian goats. Although in the early 1993 outbreaks the virus had not been isolated yet, a serological prevalence (34%) was observed using ELISA test in 475 sera collected in the infested area. The virus was then isolated for the first time in Chad and typical PPR cases were observed in Sahelian goats, known to be little sensitive to the virus. To experimentally induce the disease, goats were inoculated with suspensions of lymph nodes or lungs, collected from sick animals. Lung suspensions induced the most serious symptoms. Suspensions of lungs and mesenteric lymph nodes were positive by agar-gel immunodiffusion test against PPR anti-serum, while prescapular lymph nodes remained negative. Characterization of the isolated virus, in particular with regard to its genomic identity, should be investigated.

Animals↗

PubMed1994

Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase (L-CHAD) deficiency in a patient with the Bannayan-Riley-Ruvalcaba syndrome.

Bannayan-Riley-Ruvalcaba syndrome (BRRS) is an autosomal dominant condition of macrocephaly in combination with lipomas/hemangiomas, hypotonia, developmental delay, and a lipid myopathy. The etiology of the lipid storage myopathy has been unclear. We describe a black boy with findings of BRRS who also has a defect in long-chain fatty acid oxidation expressed in cultured skin fibroblasts as a deficiency of long-chain-L-3-hydroxyacyl-CoA dehydrogenase (L-CHAD). He also has an abnormal brain MRI and increased size of both lower limbs. We present this child because of his unusual combination of findings, and postulate that L-CHAD deficiency may be the cause of the lipid myopathy in BRRS.

3-Hydroxyacyl CoA Dehydrogenases↗

PubMed2005

Genetic heterogeneity of hepatitis E virus in Darfur, Sudan, and neighboring Chad.

The within-outbreak diversity of hepatitis E virus (HEV) was studied during the outbreak of hepatitis E that occurred in Sudan in 2004. Specimens were collected from internally displaced persons living in a Sudanese refugee camp and two camps implanted in Chad. A comparison of the sequences in the ORF2 region of 23 Sudanese isolates and five HEV samples from the two Chadian camps displayed a high similarity (>99.7%) to strains belonging to Genotype 1. But four isolates collected in one of the Chadian camps were close to Genotype 2. Circulation of divergent strains argues for possible multiple sources of infection.

Chad↗

PubMed2025

Integrated Seroprevalence and Genome-Based Study of SARS-CoV-2 Viral Strains in N'Djamena: Insights Into Chad's COVID-19 Epicenter.

The COVID-19 epidemic has shown regional variations in transmission and outcomes. As a primary hotspot in Chad, N'Djamena is crucial for comprehensive epidemiological investigation. Our study employed two methodologies: seroprevalence data collection and whole-genome sequencing of SARS-CoV-2 strains. This dual approach assessed population exposure and virus genetic diversity. Seroprevalence data indicated broader exposure than confirmed cases suggested, and genome sequencing identified multiple strains, including globally recognized variants of concern. Integrating these data provided insights into transmission dynamics, potential herd immunity thresholds, and the impact of specific variants on disease progression. Our findings underscore the importance of integrated, multidisciplinary research in infectious disease epidemiology and inform targeted public health strategies, including social measures and vaccination, to combat infectious diseases in N'Djamena.

Humans↗

PubMed1979

[Preventive aspects and problems of a rural health project in Chad--the need for health motivation].

Some of the main difficulties encountered in health work in developing countries depend on the sociocultural conditions. Health animatiod until now) of rural health care. Its implementation requires the training and recycling of existing health personnel as well as of parts of the population. It includes the concept of "barefoot doctor", which corresponds well to the prevailing priority health needs. One should note potential difficulties, however, for example in regard to the way the barefoot doctor is to be remunerated (the author discusses some possibilities). It isn't easy either, in practice, to mobilize the community through health education and to obtain its participation in prevention and health promotion measures. The crucial element is to win its confidence. The author describes his practical experiences in Chad in this respect. Health animation stimulates the responsabilization and the development of a prospective outlook in people, and can thus make an important contribution to their overall development efforts. It is necessary to fight factors which slow down such an evolution, among which certain habits as well as obstacles of an administrative nature.

Chad↗

PubMed2006

The first fossil fungus gardens of Isoptera: oldest evidence of symbiotic termite fungiculture (Miocene, Chad basin).

Higher termites of the subfamily Macrotermitinae (fungus-growing termites) are known to build fungus gardens where a symbiotic fungus (Termitomyces sp.) is cultivated. The fungus grows on a substrate called fungus comb, a structure built with the termites' own faeces. Here we present the first fossil fungus combs ever found in the world. They were extracted from 7-million-year-old continental sandstone (Chad basin). Fossilized fungus combs have an ovoid morphology with a more or less flattened concave base and a characteristic general alveolar aspect. Under lens, they display a typical millimetre-scale pelletal structure. The latter, as well as the general shape and alveolar aspect, are similar to the morphology of fungus combs from extant fungus-growing termites.

Animals↗

PubMed1995

The 1990 meningococcal meningitis epidemic of Sarh (Chad): how useful was an earlier mass vaccination?

A large outbreak of meningococcal meningitis (Serogroup A) occurred in southern Chad in 1990. We describe the epidemic in the town of Sarh, where a mass vaccination against meningococcal meningitis had taken place two years before, in 1988 (estimated coverage: 66%). Early warning that an epidemic was imminent was given at the end of February, following more than 15 recorded cases per 100,000 population on 3 consecutive weeks. This threshold proved to be adequate to predict the outbreak. A total of 721 cases were recorded at Sarh hospital and at a nearby health centre. Direct agglutination tests confirmed that Neisseria meningitis serogroup A was the only causative agent. The overall incidence rate in this population of 80,000 was 0.9%. The highest weekly incidence rate was 186 cases per 100,000 population. The mean age of the patients was 12.6 years and age-specific incidence rates ranged from 0.23% to 1.42%. The male/female sex ratio was 1.36. Overall, the mortality among hospitalized patients was 7.9%. Mortality increased during the epidemic. The major risk factor for dying was the delay until reaching hospital. Only 4 out of 29 interviewed parents said that their child had been vaccinated two years before. Among adult patients this proportion was 12/38 (32%). Because of the small numbers and because of the impossibility to check the vaccination records it was not possible to assess precisely the impact of earlier mass vaccination. However, the previous mass vaccination did not prevent this major epidemic and its impact is likely to have been unimportant.

Adolescent↗

PubMed1996

Female circumcision in southern Chad: origins, meaning, and current practice.

Female circumcision is widely practiced on the African continent; however, published reports describing genital operations on women in non-Islamic, sub-Saharan societies are scarce. This paper examines female circumcision as it is practiced by the Sara, one of Chad's largest ethnic groups. For the Sara, circumcision is an integral part of the female initiation ceremony, the rite of passage marking the transition from childhood to adulthood. Through in-depth interviews and archival research, we trace the origins of female circumcision among this group and examine its role and function in the context of contemporary Sara culture. Urban women's attitudes and practices regarding circumcision are also examined via household surveys. The data indicate that female circumcision has been recently incorporated into the Sara's cultural repertoire, and suggest strategies to reduce its incidence in this setting.

Adolescent↗

PubMed2003

Incidence of canine rabies in N'Djaména, Chad.

This work describes for the first time the incidence risk of passively reported canine rabies, and quantifies reported human exposure in N'Djaména (the capital of Chad). To diagnose rabies, we used a direct immunofluorescent-antibody test (IFAT). From January 2001 to March 2002, we were brought 34 rabies cases in dogs and three cases in cats. Canine cases were geographically clustered. The annual incidence risk of canine rabies was 1.4 (95% CI: 1.2, 1.7) per 1000 unvaccinated dogs. Most of the rabid dogs were owned-although free-roaming and not vaccinated against rabies. Most showed increased aggressiveness and attacked people without being provoked. Eighty-one persons were exposed to rabid dogs and four persons to rabid cats (mostly children<15 years old). Most of the exposed persons were neighbours or family members of the animal owner. Most exposures were transdermal bites, but nearly half of all exposed persons did not apply any first wound care or only applied a traditional treatment. In N'Djaména, humans are often exposed to canine rabies but do not use the full-course post-exposure treatment and wound care is insufficient. Most rabid dogs would be accessible to parenteral vaccination. Pilot vaccination campaigns are needed to determine the success of dog mass vaccination in N'Djaména as a way to prevent animal and human rabies.

Adolescent↗

PubMed2003

Brucellosis and Q-fever seroprevalences of nomadic pastoralists and their livestock in Chad.

As a part of a research-and-action partnership between public health and veterinary medicine, the relationships between the seroprevalences of brucellosis and Q-fever in humans and livestock were evaluated in three nomadic communities of Chad (Fulani cattle breeders, and Arab camel and cattle breeders). Nomad camps were visited between April 1999 and April 2000. A total of 860 human and 1637 animal sera were tested for antibodies against Brucella spp., and 368 human and 613 animal sera for Coxiella burnetii. The same indirect ELISA was used for livestock and human sera, and the test characteristics for its use on human sera were evaluated. Twenty-eight people were seropositive for brucellosis (seroprevalence 3.8%). Brucella seroprevalence was higher in cattle (7%) than other livestock, and brucellosis seropositivity was a significant factor for abortion in cattle (OR=2.8). No correlation was found between human brucellosis serostatus and camp proportions of seropositive animals. Q-fever-seropositive blood samples were taken from 11 Arab camel and 4 Arab cattle breeders (seroprevalence 1%). Being a camel breeder was associated with Q-fever seropositivity in humans (OR=9). Camels had the highest Q-fever seroprevalence (80%) among livestock species. Although there was high-risk human behaviour for the acquisition of brucellosis and Q-fever from livestock through raw-milk consumption (98%) and contact with placentas of livestock (62%), we concluded that seroprevalences in humans were relatively low (likely due to limited active foci in livestock).

Adolescent↗

PubMed2005

Efficacy of chloroquine, sulfadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria among children under five in Bongor and Koumra, Chad.

We report two 28-day in-vivo antimalarial efficacy studies carried out in the urban centres of Bongor and Koumra, southern Chad. We assess chloroquine (CQ), sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) to treat Plasmodium falciparum uncomplicated malaria. Methods and outcome classification complied with latest WHO guidelines. Out of the 301 and 318 children aged 6-59 months included in Bongor and Koumra, respectively, 246 (81.7%) and 257 (80.8%) were eligible for analysis. In Bongor and Koumra, the 28-day PCR-adjusted failure rates for CQ were 23.7% (95% CI 14.7-34.8%) and 32.9% (95% CI 22.1-45.1%), respectively, and those for SP were 16.3% (95% CI 9.4-25.5%) and 4.3% (95% CI 1.2-10.5%). AQ failure rates were 6.4% (95% CI 2.1-14.3%) and 2.2% (95% CI 0.3-7.6%). The current use of CQ in Bongor and Koumra is questionable, and a more efficacious treatment is needed. Considering the reduced efficacy of SP in Bongor, AQ seems to be the best option for the time being. Following WHO recommendations that prioritize the use of artemisinin-based combinations, artesunate plus amodiaquine could be a potential first-line treatment. Nevertheless, the efficacy of this combination should be evaluated and the change carefully prepared, implemented and monitored.

Amodiaquine↗

PubMed2004

Prevalence of Trypanosoma evansi infection and associated risk factors in camels in eastern Chad.

A cross-sectional study was conducted to estimate the prevalence of Trypanosoma evansi infection (Surra) in herds of camels from the eastern area of Chad. The risk factors associated with disease were also identified. From August 1997 to April 1998, a random sample of 2831 camels from 136 herds was selected. Blood samples were collected and examined for the presence of T. evansi using an antibody (card agglutination test-CATT/T. evansi) and a parasite detection test (buffy-coat technique-BCT). Standardized questionnaires with information about the host and management practices were collected and evaluated for their association with seroprevalence (model 1) and parasitological prevalence (model 2) as indications of host sensitivity. In both models, risk factors were selected using ordinary logistic regression (OLR) and herd effect was evaluated using a generalized estimating equations (GEE) model. The apparent prevalence was 5.3% using BCT and 30.5% with CATT. Real prevalence was estimated at 16.9% +/- 1.4 (alpha = 5%). Overall, 27.9% (BCT) and 94.9% (CATT) of the herds had a least one-positive animal. Real herd prevalence was estimated at 42.6 +/- 8.3% (alpha = 5%). Camels of the large transhumants had the highest prevalence (estimated to 30.3% +/- 2.5; 62.9 +/- 12.0 in herds). Risk factors associated with seroprevalence were age, ethnic group, length of seasonal migration and longitude of pasture area in the dry season. Risk factors associated with BCT prevalence were age, length of seasonal migration, longitude of pasture area in the dry season, latitude of pasture area in the rainy season and season of sampling.

Agglutination Tests↗

PubMed2002

Networks of nomads: negotiating access to health resources among pastoralist women in Chad.

Health resources among pastoralist groups are strongly gendered. While certain types of health resources fall within the female domain (home-based treatment, caring and supportive roles, and knowledge surrounding particular reproductive conditions) access to most outside health practitioners, treatments and knowledge is controlled largely by men. For pastoralist women, this means that actions taken during illness episodes depend largely on the nature and quality of social support systems available, and on their ability to mobilise them effectively. These support systems include husband and other affines, male kin, and networks of female kin and friends. Factors such as position within domestic and wider social units, as well as life cycle, affect women's ability to access and mobilise these different support systems for their health needs. However, seasonal mobility interacts with gender and social support systems in complex ways that profoundly influence women's access to health resources. Most literature on nomadic peoples and health focuses on the physical barriers posed by spatial mobility to accessing health resources. However, it is suggested here that, for pastoralist women in Chad, the spatial fluidity of social networks might be a more important consideration. At certain times of the year women enjoy relatively easy access to a large range of extended kin and other social contacts, while at other times, when people are very dispersed, options become much more limited, often resulting in illness treatment being delayed. Mobility should not, though, be seen purely as a constraint. It can also be an opportunity, increasing the potential geographical and social resource base with regard to health for women.

Agriculture↗

PubMed2004

[Factors explaining quality of primary health care in Logone Occidental (Chad)].

The extent of the deficit in human and financial resources associated with alarming health indicators in the developing countries has prompted us to undertake an evaluation of the quality of the primary health care provided in our country. The study was designed to identify the determinants of the quality of primary care delivered in the health centers of Western Logone in Chad by comparing systematic data collected from public and private health structures and an adapted questionnaire. Data were collected from 24 healthcare centers providing care for 395699 people, 73.1% of the population of the district of Logone Occidental. The average costs born by patients receiving care delivered by the different centers was not statistically different between the centers financed by public funds and those with denominational support: 944 Fcfa versus 1315 Fcfa. Variable statistically correlated with quality of care were: number of qualified healthcare workers in the center, training level of the center's manager, average patient-born cost of consultation, average healthcare expenditure per capita in the recruitment area (p<0.01). Considering the importance of the medical district in the organization of healthcare systems in the countries of Sub-Saharan Africa, quality assessment must become a continuous, supervised activity enabling proper description of the processes involved and propositions for local solutions designed to improve the quality of care.

Adult↗