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[Superficial mycoses in a wooded region of Gabon: results of fungus isolation].

The authors draw up an inventory of the dermatophytes in Gabon (13 species isolated from 593 people in the wet and hot forest). They show the clear prevalence of Microsporum langeroni, Trichophyton soudanense, Trichophyton rubrum, and Epidermophyton floccosum, Trichophyton violaceum also is fairly often isolated. More infrequently, they find T. mentagrophytes, T. mentagrophytes var. interdigitale, T. gourvili, M. canis, M. audouini, T. yaoundei, M. gypseum.

Adolescent↗

Bed and bed-site reuse by western lowland gorillas (Gorilla g. gorilla) in Moukalaba-Doudou National Park, Gabon.

In this paper we describe bed (nest) and bed-site reuse by western lowland gorillas (Gorilla g. gorilla) in Moukalaba-Doudou National Park, south-eastern Gabon. During an eight-month study 44 bed sites and 506 beds were found. Among these, 38.6% of bed sites and 4.1% of beds were reused. We analyzed the monthly frequency of bed-site reuse in relation to rainfall, fruit abundance, and fruit consumption by the gorillas. The different frequency of bed-site reuse in the rainy and dry seasons was not significant. More bed-site reuse was observed during the fruiting season than during the non-fruiting season. Results from fecal analysis suggested that gorillas ate more fruit in the fruiting season than in the non-fruiting season. The frugivorous diet of western gorillas may possibly cause gorillas to stay in some areas and, consequently, reuse their bed sites. Reuse of bed sites by gorillas suggests their frequent return to an area where preferred fruit is readily available. A higher percentage of arboreal beds may also affect bed-site reuse, because of the shortage of bed material.

Animals↗

Presence of circulating anodic antigen in serum of Schistosoma intercalatum-infected patients from Gabon.

The presence of the schistosome circulating anodic antigen (CAA) in serum of Schistosoma intercalatum-infected patients from Gabon has been investigated using an enzyme-linked immunosorbent assay (ELISA). Blood samples were collected from 10 endemic controls, 29 patients which excreted viable S. intercalatum eggs in rectal mucosa and stool, six persons in which only non-viable eggs were found in rectal biopsy specimens and one person in which besides non-viable eggs a small number of viable eggs was found in the rectal biopsy specimen. CAA, a genus-specific antigen, could be demonstrated in 58.6% of the patients with S. intercalatum eggs in their stools. In comparison to S. mansoni infections, very light infections (0.6 eggs per gram faeces) could be detected by the ELISA. A strong correlation between parasite burden (eggs per gram faeces) and antigen-level (CAA-titer) was found (Spearman's rho = 0.65). Only one positive ELISA-results was found in the group with solely non-viable eggs in rectal tissue. As no false positive results were detected for the negative controls, the present results suggest, in accordance with results earlier obtained for schistosomiasis mansoni, that only in active S. intercalatum infections is antigen demonstrable.

Animals↗

Haemorrhagic fever in Gabon. I. Incidence of Lassa, Ebola and Marburg viruses in Haut-Ogooué.

A serological enquiry aimed at determining the incidence of infection with Lassa, Ebola and Marburg viruses was conducted on the human population of the region of Haut-Ogooué (Gabon) and on primates. The results, obtained by the indirect immunofluorescence technique, showed that more than 6% of the human population had had contact with Ebola virus but no antibodies against Marburg or Lassa viruses were found. Most sera reacted to an Ebola antigen from a Zairian strain, but showed little or no reaction to an antigen from a Sudanese strain.

Adult↗

Filariasis due to Loa loa and Mansonella perstans: distribution in the region of Okondja, Haut-Ogooué Province, Gabon, with parasitological and serological follow-up over one year.

The prevalence of Loa loa and Mansonella perstans filariasis has been determined in 6 rural villages in eastern Gabon. Between 18.9 and 27.2% of people carry L. loa microfilariae with an overall microfilarial rate of 25.1%. The microfilarial rate for M. perstans was more variable, between 33.3 and 62.2% (average 49.1%). No significant difference was seen in the microfilarial rate with age over 15 years for either parasite, but men were infected more frequently than women. Anti-L. loa antibody titres were measured, using a homologous microfilarial antigen in ELISA. Taking the parasitological and immunological evaluations together, only 10% of the sample population appear to be free of these filarial infections. L. loa and M. perstans microfilaraemia and corresponding serology were also investigated twice in 150 people at a one-year interval. 99.1% of the cases who had no circulating L. loa microfilaria in March 1984 still did not show any 12 months later. Similarly, 97.1% of the untreated, microfilaraemic cases still harboured this parasite a year later. The same was not observed for M. perstans, since microfilariae appeared or disappeared in 26.7% of the cases. This suggests different dynamics for the two filarial infections. Variation in individual anti-L. loa antibody titres was low. The possibility of a genetic influence on the expression of loiasis is discussed.

Adolescent↗

An epidemiological study of a Schistosoma intercalatum focus in south-east Gabon.

A Schistosoma intercalatum focus in south-east Gabon was studied between July 1989 and July 1990. Among the 356 permanent residents in the village, 354 provided stool specimens and 101 (28.5%) were excreting eggs (geometric mean of egg density = 101.4 eggs/g, with a range of 1-3200). The pattern of prevalence and intensity of infection with age showed the curve usually found in schistosomiasis, i.e. increasing during the first 2 decades of life and then gradually decreasing. The analysis by stepwise logistic regression of factors shown to be important in determining infection in other schistosomiasis clearly demonstrated the significant and independent effects of both age and water contact on infection by S. intercalatum. These similarities with other schistosomal infections could indicate that similar immune mechanisms were operating. Urine from 284 subjects, of whom 90 were egg excreters, was tested for circulating antigen by enzyme-linked immunosorbent assay using a Schistosoma genus-specific monoclonal antibody (Sm 10.27.12). The test was positive for 90 subjects but only 35 of these were egg excreters. Although S. intercalatum is usually considered of low pathogenicity in man, this study showed a relationship between egg excretion and both splenomegaly and lower haemoglobin levels, even after taking into account the confounding presence of Plasmodium falciparum.

Age Factors↗

High level of hepatitis C endemicity in Gabon, equatorial Africa.

To assess the prevalence of hepatitis C virus (HCV) infection, a community-based study was performed in eastern Gabon on 1172 subjects over 5 years of age. The prevalence of antibodies to HCV (anti-HCV) detected using second-generation enzyme-linked immunosorbent assay (ELISA) and confirmed by an immunoblot assay (RIBA 2), was 6.5%. Anti-HCV prevalence increased with age but was related to neither sex nor ethnic group. Among 30 subjects with positive ELISA results, 14 had HCV viraemia as shown by the polymerase chain reaction (11/12 RIBA positive, 2/15 RIBA negative, 1/3 RIBA indeterminate). We conclude that HCV is highly endemic in western equatorial Africa and that a high proportion of the population may be viraemic.

Adolescent↗

Human T-cell leukemia virus type I isolates from Gabon and Ghana: comparative analysis of proviral genomes.

Two isolates of human T-cell leukemia virus type I (HTLV-I) were obtained from lymphocyte cultures of a healthy carrier in Gabon and another in Ghana. Their proviruses were analyzed by Southern blot hybridization and compared with prototypical HTLV-I isolated in Japan and the United States. The provirus genomes of both strains were highly homologous to the prototype HTLV-I along the whole viral genome. The restriction endonuclease sites of the Ghanian isolate were almost identical with those of the prototype HTLV-I, but 10 of 26 sites of the Gabonese isolate were different from those of the prototype. Furthermore, the restriction map of the Gabonese isolate resembled those of a simian T-cell leukemia virus (STLV-I) isolated from a chimpanzee from Sierra Leone and a variant of HTLV-I from Zaire (HTLV-Ib) more closely than those of any other known HTLV-I. These results indicated the existence of some unique strains of HTLV-I transmitted among African people, and the importance of clarifying the origin and transmission of HTLV group viruses.

Biological Evolution↗

Malignant lymphomas in Gabon (equatorial Africa): a morphologic study of 72 cases.

A retrospective morphologic analysis was conducted on 72 malignant lymphomas collected in Gabon, a country of the equatorial area in Africa. Non-Hodgkin's lymphomas (NHLs) were by far the most frequent type of lymphoma, representing 67 cases (93%); only five patients (7%) had Hodgkin's disease. Non-Hodgkin's lymphomas were classified according to two modern systems (Kiel and Working Formulation). The age distribution of NHL patients was bimodal, with the highest peak in the 0 to 14 years age group (these cases were almost exclusively associated with Burkitt's lymphomas), and with the second highest peak in the 55 to 64 years age group. The male to female ratio was 2.5:1, and the overall median age was 44 years. According to the Working Formulation, the NHL cases were composed of one follicular lymphoma (1.5%), 55 diffuse lymphomas (82%), and 11 miscellaneous lymphomas (16.5%). Burkitt's lymphoma was the most frequent NHL (17 cases; 25.4%), followed by diffuse large cell lymphoma (15 cases; 22.4%) and immunoblastic lymphoma (nine cases; 13.4%). Consequently, high-grade NHL formed the largest group (28 cases; 42%), intermediate-grade NHL formed the next largest group (21 cases; 31.3%), and low-grade NHL formed the smallest group (seven cases; 10.4%). These data are compared with series from developed and developing countries, and the observed differences in distribution of the histologic subtypes of malignant lymphoma are discussed.

Adolescent↗

Medicinal plants used by the Masango people in Gabon.

Plant species listed are used by the Masango people in two selected villages--Ibagha and Muyanama--in the Ngounie province of Gabon. For each species listed, the family, botanical name, vernacular name, voucher specimen number and medicinal uses are given.

Gabon↗

Extra-pulmonary paragonimiasis with unusual arthritis and cutaneous features among a tourist returning from Gabon.

Paragonimiasis is a helminthic disease that affect accidentally man after consumption of raw or poorly cooked crustacean dishes. The clinical feature is represented mainly by pulmonary signs. Extra-pulmonary manifestations including arthritic and skin attempt remain less frequent. The case is described of a young white French woman who become infected with Paragonimus while travelling to Gabon for a tourist trip. Clinical presentation accounted for extensive recurrent pruritic urticarian subcutaneous induration, permanent assymetrical pauciarthritis associated with joint swelling, and marked eosinophilia. Diagnosis was reached using serological testing showing seroconversion for specific antibodies. The patient was cured with a single oral dose of praziquantel. Even if the condition is rare among tourists to endemic zones, it must be considered when hypereosinophilia occurs in the returning traveller and migrant.

Adult↗

Molecular analysis of DHFR and DHPS genes in P. falciparum clinical isolates from the Haut--Ogooué region in Gabon.

The main objective of this work was to determine the prevalence of mutations in genes coding for the dihydropteroate synthase (DHPS) and the dihydrofolate reductase (DHFR) enzymes which are implicated in resistance of P. falciparum to antifolate (pyrimethamine-sulfadoxine (P/S)). In this study, 117 human blood samples were collected at Franceville located in the region of Haut-Ogooué (South-eastern Gabon). In this area, a relatively low level of sensitivity of Plasmodium falciparum to P/S has been reported with 18.2% of RII and 12.1% of RI resistance. A nested polymerase chain reaction was used to amplify a fragment of the DHFR gene containing codon 108, where a point mutation causing a Serine (wild type) to Asparagine or to a Threonine (resistant types) change occurs in pyrimethamine resistant parasites. Eleven DHFR fragments were sequenced and mutations occurring at codons 51, 59 and 108 were analysed. The DHPS gene was amplified by polymerase chain reaction (PCR) and sequenced directly or after cloning. Variant amino acid residues 436, 437, 540, 581, 613 associated with sulfadoxine resistance were analysed. The analysis of codon 108 of the DHFR gene was undertaken for 81 isolates. More than one DHFR P. falciparum genotype was present in 64% of the samples. We showed that 47% of 141 DHFR gene PCR products had Serine (wild phenotype), and 52% had Asparagine. We found one isolate with the Thr-108 confirmed by sequencing of the PCR product. Triple, double and single DHFR mutant at positions 51, 59 and 108 were found. Only codons 436 and 437 of the 38 analysed sequences of the DHPS gene revealed point mutations. These results have been compared with those reported from different sites in Africa, Asia or South-America.

Adolescent↗

Mosquito distribution and entomological inoculation rates in three malaria-endemic areas in Gabon.

Mosquitoes were collected during 3 separate periods in 3 areas of different malaria transmission rates in the province of Moyen Ogooué, Gabon, within 1 year (July 1996-May 1997). The campus of the Albert Schweitzer Hospital (HAS) and 2 villages, Bellevue and Tchad, were investigated. A total of 19,836 specimens were collected: 13,122 Mansonia, 3944 Anopheles, 2755 Culex and 15 Aedes were captured. The number of mosquitoes was 7896 and 7995 in July to August and from April to May respectively, and dropped to approximately half in November to December. The individual species showed a different distribution pattern in the 3 study areas. In Tchad we found the lowest number of mosquitoes and also the fewest Anopheles, but when we investigated the number of Plasmodium falciparum-infected Anopheles sp. we observed the highest entomological inoculation rate (EIR) there. The EIRs were 23 in HAS, 53 in Bellevue and 61 in Tchad. The method used to determine the number of infected mosquitoes was an enzyme-linked immunosorbent assay (ELISA), confirmed by a polymerase chain reaction-based approach. The ELISA alone revealed too many false-positive mosquitoes.

Animals↗

Reassessment of the resistance of Plasmodium falciparum to chloroquine in Gabon: implications for the validity of tests in vitro vs. in vivo.

Increasing resistance of Plasmodium falciparum to antimalarial drugs presents a major risk factor for people living in endemic areas of tropical Africa. In Lambaréné, Gabon, regular surveillance of chloroquine sensitivity of P. falciparum in vitro has been carried out since 1992 using the WHO standard microtest. Results indicated that from 1994 onwards chloroquine resistance in vitro decreased significantly and that by 2000, about 70% of parasite isolates seemed to be sensitive to chloroquine in vitro. In 2001, we conducted a clinical study to reassess the efficacy of chloroquine in vivo for the treatment of uncomplicated P. falciparum malaria. Twenty-six patients aged 4-15 years were included in this study. Most unexpectedly, the study demonstrated high-grade resistance to chloroquine in vivo (failure rate on day 28 of 100%). As a consequence, tests of parasite susceptibility to chloroquine in vitro were repeated using the same protocol except for the replacement of previously used commercially available predosed WHO culture plates by independently dosed plates. All tested P. falciparum isolates were highly resistant to chloroquine, correlating well with our clinical findings. We concluded that high level resistance of P. falciparum to chloroquine persists in the study area. Neglect or absence of quality controls of essential test material can lead to invalid study results and wrong conclusions and should always be suspected in the case of major fluctuations in the sensitivity patterns of an antimalarial drug in vitro. In addition, our results highlight the supreme value of tests in vivo in providing reliable estimates of the efficacy of an antimalarial in a specific area.

Adolescent↗

Markers of Loa loa infection in permanent residents of a loiasis endemic area of Gabon.

Different markers of infection were analyzed in 56 permanent residents of a Loa loa endemic village in Gabon. The population was divided into those with parasitological evidence of L. loa infection and those with no history of loiasis over the period of observation (c. 5 years). 26.7% of villagers had L. loa microfilariae, 33.9% had an ocular passage of an adult worm, and 17.8% had calabar oedema. Several other clinical symptoms were present in both groups of individuals, but none was considered to be pathognomonic for L. loa infection. Most of the villagers were polyparasitized, with Plasmodium falciparum and gastrointestinal parasites being particularly prevalent. Mansonella perstans was present in 80% of the villagers and was equally distributed between L. loa microfilaraemic and amicrofilaraemic individuals. Eosinophil levels were elevated in the whole population, and were not significantly different between the groups who were infected and non-infected with L. loa. Polyclonal immunoglobulin (Ig) E levels were high in both the Ambinda villagers and in Gambian serum from patients infected with M. perstans alone and there was no significant difference between the levels of L. loa specific IgG in the Ambinda villagers and the Gambian patients. However, the level of L. loa specific IgG4 was elevated in 75.6% of amicrofilaraemic individuals and could discriminate between most individuals infected with L. loa and those infected with M. perstans, suggesting that this is the best determinant of infection status in the absence of L. loa microfilariae.

Adult↗

Molecular analysis of recrudescent parasites in a Plasmodium falciparum drug efficacy trial in Gabon.

Recrudescent Plasmodium falciparum parasites were sampled from 108 children taking part in a drug efficacy trial in Gabon. A finger-prick blood sample was taken from each child before treatment, and a post-treatment sample taken of the recrudescent parasites. Sample deoxyribonucleic acid was amplified by the polymerase chain reaction using primers specific to the P. falciparum antigen genes MSP-1, MSP-2 and GLURP. Seventy-seven children had identical parasites in their pre- and post-treatment samples, indicating genuine recrudescences of resistant parasites. Fourteen children had completely different parasites in their pre- and post-treatment samples, indicating either a fresh infection from a mosquito or growth of a population of parasites not detected in the pre-treatment sample, perhaps due to sequestration. The remaining 17 children had a mixture of pre-treatment and new parasites in their post-treatment samples. This study demonstrated the use of polymorphic markers to confirm whether parasites in patients with clinical recrudescences after drug treatment are genuinely resistant.

Adolescent↗

[Serum proteins and erythrocyte enzymes. Evaluation of frequencies in 2 populations in the Gabon].

The results of the electrophoretic phenotyping of two serum groups (C'3 and Transferrine) and seven red cell enzymes (PAc, PGM, AK, ADA, 6PGD, sGPT and Est D) in two groups of negroes from Gabon are presented. The frequencies are in the normal range observed for African populations except for acid phosphatase in Southern Africa; Khoisan people have frequencies of the "Negroe allele R" higher than in any other population of the world. In Obamba and Bateke populations frequencies of Pr is 0.013.

Adenosine Deaminase↗