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Enamel hypoplasia in a pliocene hominid from Chad.

Abel is the first Australopithecine known west of the East African Rift Valley. The fossil finds include a perisymphyseal fragment of an adult mandible with well-preserved crowns of the right I2-P4 and the left C-P4. Abel's dentition displays many enamel defects, which are described in detail for each tooth. Pitting affected every tooth, while larger, shallow depressions were observed on the canines alone. From two to four pit bands occurred on the different teeth, each resulting from a separate hypoplastic episode. In modern humans, a large number of causes, both environmental and genetic, have been suggested for such enamel defects. It seems probable that Abel's pathology was systemic. However, the occurrence of a number of bands and the variable intensity of the attacks make it difficult to say whether there was a single, repetitive cause or different etiologies. Possible causes discussed here include recurrent fevers and seasonal nutritional deficiencies.

Animals↗

Weight gain in supervised and take-home feeding programmes in Chad.

The rehabilitative effects of a supplementary feeding programme for Chadian children are reported. Both feeding centre-based and take-home premix strategies for the delivery of an 821 kcal/day porridge supplement were employed. A total of 641 malnourished children no more than 80 per cent median reference weight for height from two nomad reinstallation camps were enrolled in a supervised feeding programme. In a third camp, 133 children were enrolled in a take-home feeding programme. The mean length-of-stay in the programmes was 59 days. A regression model was developed to permit analysis of anthropometric data obtained from follow-up measures varying in number and distribution across time. The model estimates indicate that the supervised group had an average weight gain 60 days after enrollment of 1013 g, while the take-home group had an average 60-day gain of 951 g. The 62 g difference in the two strategies is not significantly greater than zero (P = 0.56).

Chad↗

Urban malaria in the Sahel: prevalence and seasonality of presumptive malaria and parasitaemia at primary care level in Chad.

OBJECTIVE: To assess malaria prevalence rates and seasonal patterns among clinically diagnosed malaria cases at the level of primary care facilities in an urban Sahelian setting. METHOD: Screening all patients consulting two private and two governmental providers on a randomly selected weekday over a period of 9 months. Patients with presumptive malaria underwent a blood test. RESULTS: Of 1658 patients included in the survey, 47% were clinically diagnosed and treated as malaria cases. Malaria was more often diagnosed by private providers. There were no clear seasonal patterns in presumptive malaria. A 30% of clinically diagnosed cases were positive for Plasmodium (all falciparum) by thick film examination. Thus, false positive cases constituted more than 70% of the clinically diagnosed malaria cases. The highest positive prevalence rates were found at the end and shortly after the rainy season (44%-47%) and the lowest during the dry season (2%). CONCLUSIONS: Clinical diagnosis of malaria has a very low positive predicted value in this low endemicity urban setting, and its low specificity leads to inappropriate care for a large proportion of patients. This has a major impact on economic costs for health services and households. In the Sahel, systematic use of microscopy-based diagnosis and/or rapid diagnostic tests should be considered to appropriately manage malaria and non-malaria cases.

Adolescent↗