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[Control of human African trypanosomiasis in Luba in equatorial Guinea:evaluation of three methods].

The object of this study was to (a) reduce the prevalence of sleeping sickness by serological testing, parasitological examination, and treatment of every infected person; (b) determine the maximum acceptable interval between serological surveys; and (c) define the impact of vector control, using monopyramidal non-impregnated traps, on the transmission. For this sero-parasitological survey, the focus in Luba was divided into three zones as follows: Epicentre A (with high prevalence, 27.5%), Epicentre B (with average prevalence, 8.3%), and Peripheral C (with moderate prevalence, 3.0%). Differences in the prevalence rates in the Epicentres and Peripheral zone permitted the use of three different approaches for control and epidemiological follow-up of the disease: (1) Serological examination of the entire population was carried out by the indirect immunofluorescent antibody test (IFAT), with six-month intervals in Epicentres A and B and once a year in the Peripheral zone C. (2) DIAGNOSIS AND TREATMENT: all IFAT seropositives were examined in Luba hospital for parasites, and every parasitologically confirmed patient was treated according to the WHO protocol of 1983. Another serological test (CATT) was applied to cases in which trypanosomes were not present and if this was positive, the CSF was examined. Cases with parasites and abnormal CSF were treated with melarsoprol, and those with a normal CSF received pentamidine. CATT-negative and parasite-negative cases were considered to be false-positives by IFAT and free of the disease. (3) Vector control: 74 monopyramidal traps (18 traps per km2) were set up in Epicentre A. The flies captured were collected once a month and sent to the programme's laboratory where they were identified and counted.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Decline in, and lack of difference between, average birth weights among African and Portuguese babies in Portugal.

BACKGROUND: In preliminary data in Portugal, we found that African babies of migrant mothers were heavier than White Portuguese babies born in Lisbon. We investigate whether this pattern is replicated in the national data, and in addition the trends in birth weight in these groups. METHODS DESIGN AND SETTING: Births registered between 1995 and 2002 classified by reported nationality of mothers. PARTICIPANTS: 849,595 Portuguese births ('Portuguese' nationality, predominantly of European descent) and 22,463 African births ('Angola', 'Cape Verde', or 'Guinea Bissau, Republic of Guinea or Equatorial Guinea' nationality, predominantly of African origin). RESULTS: Among Portuguese births, there was a decline in births to teenaged mothers and an increase to mothers aged >or=35 years, with >9 years of education or in a non-manual class, but among African births there was an increase in births to teenaged mothers and a decline to mothers from advantaged socioeconomic backgrounds. Using the Wilcox-Russell method, overall mean birth weights of term Portuguese (3,303, SD 424 g) and African (3297, SD 441 g) babies were not different but the percentage of small preterm births was higher among African (4.7%) than among Portuguese (2.9%) births. Between 1995 and 2002, mean birth weight of term Portuguese babies declined by 58 g (3,334-3,276 g) and of African babies by 57 g (3,341-3,284 g). The left shift of the birth weight distributions was independent of maternal age, parity, and social factors among Portuguese babies, but among African babies the decrease appeared to be associated with socioeconomic advantage. CONCLUSION: There has been a downward trend in birth weights in Portugal among both Portuguese and African term births, but average birth weights of the two groups were similar.

Adolescent↗

[History of the onset and spread of sleeping sickness in Bipindi (southern Cameroon), from 1896 to today].

The aim of this article is to provide historical background on the onset and spread of sleeping sickness in the Bipindi area of southern Cameroon, from the first suspected cases in 1896 until today. Two recent events have created the need for historical perspective on this topic. In December 1994, an OCEAC mission led by Francis Louis discovered 7 cases in the area between the Lolodorf and Bipindi districts. The epicentre was the village of Bidjouka. Five years later, mass screening of all residents in the Bipindi district revealed a total of 44 cases. Although no previous medical studies are available, historical research indicates that the disease has always present in Bipindi area in a less prevalent and virulent form than in neighboring regions along the Nyong River. Bipindi is located about 140 kilometers northeast of Campo, an area on the border between Cameroon and Equatorial Guinea where sleeping sickness has been a low-grade health problem since the 1880s. Many Cameroonian refugees forced to live in Campo during a war that ended in February 1916 returned with the trypanosome and subsequently contaminated people who stayed in Bipindi. Transmission of sleeping sickness in Bipindi can also be attributed to economic development since the end of the nineteenth century. Numerous plantations have been installed in the area. Migration and trade with the Gulf of Guinea have expanded greatly, especially involving areas on the border between Cameroon and Equatorial Guinea. This study is based on written documentations obtained from the National Archives in Yaoundé (Cameroon) and the "Colegio Claret" Library, in Luba (Republic of Equatorial Guinea) and on firsthand reports from reliable sources in the Bipindi area.

Agriculture↗

Seroepidemiological survey of HTLV-I infection among randomized populations of western central African countries.

Between 1987 and 1988, a survey to determine the distribution of HTLV-I infection was conducted in a representative population of adults, living in southern Chad, Cameroon, and Equatorial Guinea. Populations studied were selected by the cluster sampling technique. Sera were tested for IgG antibodies to HTLV-I by ELISA. ELISA-positive sera were retested by Western blot. The study comprised 2,301 adults, all apparently healthy. Crude prevalence rates range from 0.5 to 11.8%. We found three clearly different areas of HTLV-I seroprevalence rates. An area of low seropositivity in southern Chad and northern Cameroon (0.5-2.0%), an area of moderate seropositivity in the savannah region of Ngaoundere, Cameroon (4.2%) and in Bata, Equatorial Guinea (6.5%), and lastly an area of high seropositivity (8.6-11.8%) in the equatorial forest area of Equatorial Guinea and southern Cameroon. HTLV-I seroprevalence rates increased with age up to 12.6% after 40 years old in the areas of high seropositivity. There was no difference between male and female age-adjusted prevalence rates in all of the areas studied.

Adolescent↗