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PubMed1990

[Malaria. Analysis of 149 cases (1981-1987)].

The epidemiological features of the 149 cases of malaria reported to the Institut Municipal de la Salut in Barcelona from 1981 to 1987 are reported. The yearly evolution of the number of cases showed a tendency to increase predominating in the summer months. The incidence rate for 1977 was 1.99/100,000. The districts with the highest rate of involvement were districts I (Ciutat Vella), owing to the immigration, and V (Sarrià-Sant Gervasi), probably owing to overseas visitors. There was a remarkable predominance of males (63.8%), patients aged 20-40 years, and cases of African origin (81.81%); 50.42% of these came from Equatorial Guinea. The most commonly isolated plasmodium was P. falciparum (52.53%), with a progressive increase throughout the years. Only 13.43% of patients had followed a correct chemoprophylaxis. Malaria is still the most important protozoan infection in the world. In the present study its possible reintroduction in Spain is discussed. The malarial endemic used to be very important in this country, and its eradication was not achieved until 1964.

Adolescent↗
PubMedDate not supplied

[The Anti-rabies Service of the National School of Health. 1981-1987].

In the present study, the authors analyze the activities of the Rabies Service of the National Public Health from 1981 to April 1987. During this period, 3,286 animals were evaluated with direct immunofluorescence and culture. Sixteen of them were positive (13 dogs, 2 cats and 1 rat). Thirteen animals came from Ceuta, two from Melilla and one from Equatorial Guinea. The activities of the Service are described and their results are discussed, with emphasis on the need to keep an epidemiological surveillance through the national territory so as to disclose as early as possible the development of new epizootic foci.

Adolescent↗
PubMed1989

[Imported malaria: a clinical and epidemiological description of 49 cases].

Malaria is the most common protozoan infection in the world. In 1964, it was considered eradicated in our country, all the new cases being declared as imported, the present migratory and tourism factors obviously having increased the incidence. We analyzed 49 cases of imported malaria diagnosed at "Hospital de Mar" in Barcelona between 1976 and 1987. 14 patients were emigrants from endemic areas. Africa as the continent (73.4%), and equatorial Guinea as the country (44.8%) being the geographical areas most frequently found as sources of the cases. Only 40% of tourists took chemoprophylaxis measures and only half of them did it correctly. The most usual plasmodium found was the P. Falciparum (21 cases). The conclusion is evident, it is necessary to create a greater awareness in our area, improving the information for travellers to tropical countries applying sanitary controls to immigrants who come from endemic areas.

Africa, Central↗
PubMedDate not supplied

[Epidemiologic surveillance of the acquired immunodeficiency syndrome in 6 states of Central Africa].

Since 1985, OCEAC, the organization for control of widespread endemic disease in Central Africa, has managed an epidemiological surveillance programme concerning HIV infection and AIDS in six countries of the Sub-Region: Cameroon, Tchad, Central African Republic, Congo, Equatorial Guinea and Gabon. This programme consists in evaluating longitudinally incidence rates of infection and clinical cases, and mortality rates. It is based on a selective strategy using a network of sentinels (hospitals and maternity care consultation centers), completed by cross sectional epidemiological studies. Thanks to this programme high risk groups of population, high risk places and high risk activities have been identified. These observations will be used to plan national prevention programmes on AIDS.

AIDS Serodiagnosis↗
PubMedDate not supplied

[Sampling surveys: an objective method of evaluating the prevalence of leprosy in an endemic zone].

The authors submit a simplified sample survey methodology designed to evaluate prevalence rates of leprosy. The system proposed uses a cluster sampling technique. A cluster is a randomly selected group of households. In each household visited by the epidemiological teams all the inhabitants of the target-group are interviewed and examined. Various samples sizes are used (from 6500 to 12,000 peoples) according to the expected prevalence rate of the studied area. All the new cases detected through these surveys are notified to the National Departments in charge of leprosy programmes. Two surveys are already achieved (Equatorial Guinea, Cameroon), a third one in on the way.

Africa, Central↗
PubMed1986

[Evaluation of the clinical, parasitological and immunological indices of malaria in the Bonny's Bay area of Central Africa].

The authors report the results of 4 sample surveys carried out in Equatorial Guinea and Cameroon in the Bonny's Bay area, to evaluate the main malarial indexes. In rural and semi-rural areas one notice a high rate of fever attacks and splenomegaly. Parasitaemia is more important in rural areas than in urban areas and is decreasing where the therapeutic pressure is strong and long-lasting. Immunological indexes are high everywhere.

Adolescent↗
PubMed1984

Scytalidium hyalinum infection diagnosed in Spain.

Scytalidium hyalinum infection of the soles and toe webs was diagnosed in a 40-year-old male immigrant to Spain from Equatorial Guinea. Short courses of therapy with oral ketoconazole (Nizoral) 400 mg day-1 and topical clotrimazole (Canesten) failed to improve the condition.

Adult↗
PubMed1996

Expanded programme on immunization (EPI). Immunization schedules in the WHO African region, 1995.

There are 48 countries/areas in this Region (Tables 1-3). No data are available from Reunion and Saint Helena. BCG is given at birth in 46 countries. Diphtheria-pertussis-tetanus (DPT) vaccine is used as a primary series of 3 doses in 46 countries. In 35 countries, DPT is given from 6 weeks of age; in 6 countries at 2 months of age (Angola, Botswana, Burkina Faso, Congo, Gambia and Zambia); and in 5 countries at 3 months of age (Algeria, Mauritius, Seychelles, Swaziland and Zimbabwe). Eight countries give 4 doses of DPT (Benin, Burundi, Congo, Equatorial Guinea, Rwanda, Seychelles, South Africa and Zambia) while 2 countries give 5 doses of DPT (Algeria and Togo). Diphtheria-tetanus (DT) is given in 3 countries: in Botswana at 6 years, in Mauritius at 2 and 5 years and in South Africa at 5 years of age. No Td* is given in any of the countries in this Region. Oral poliovirus vaccine (OPV) is used in a primary series of 3 doses simultaneously with DPT vaccine in all countries. Eighteen countries give OPV at birth. Measles vaccine is given at 9 months of age in 45 countries. Seychelles gives measles vaccine at 15 months of age. None of these countries give a combined measles-mumps-rubella (MMR) vaccine. Rubella vaccine alone is also not given in any of the countries in the Region. Hepatitis B vaccine is used in 7 countries (Botswana, Gabon, Gambia, Nigeria, South Africa, Uganda and Zimbabwe). It is given in 2 doses in 2 countries (Gambia and Nigeria) and at birth in 4 countries (Botswana, Gabon, Gambia and Nigeria). Thirty-one countries are at risk for yellow fever. However, yellow fever vaccine is given only in 10 countries (Central African Republic, Chad, Côte d'Ivoire, Gabon, Gambia, Ghana, Niger, Sao Tome and Principe, Senegal and Togo). Six countries give yellow fever vaccine at 9 months, Chad gives it at 6 months, Gabon and Sao Tome and Principe at 1 year of age and Togo at 10 months. Tetanus toxoid (TT) is used for pregnant women or non-pregnant women of childbearing age. The schedules include 2 to 5 doses. Forty-two countries use a 5-dose schedule. TT is given to schoolchildren in 5 countries (Botswana, Comoros, Guinea, Lesotho and Madagascar).

Africa↗
PubMedDate not supplied

[The development of public health education: the Mauritius experience].

A public course has been initiated in 1990 in Mauritius for covering the national growing needs of public health specialists. This training course was organized jointly by the Ministry of Health, the University of Bordeaux II and the French Cooperation. After 3 sessions dedicated specifically to the Mauritian physicians, the course has been re-designed for the needs of the other countries of the region. A feasibility study performed in 1994 in the countries of the Indian ocean region showed that during the past decade, the district level had become the focus point to integrate the health programs. This process has progressively transferred a wider and stronger part of the responsibilities from the central level to the district level and the survey showed that most of the health district managers were physicians that did not have the proper background for carrying such responsibilities. According to these results, a course curriculum was created by the Mauritian Ministry of Health and the University of Bordeaux II and submitted to various organisms supporting health program development in the region. This proposal was strongly supported by several agencies (the french Cooperation, Unicef, WHO, World Bank...) who agreed to sponsor candidates for that training course. The first session was organized in 1995, a second one in 1996. This training course is targeted to the medical doctors who are in charge of the management of health services at the district level. It is divided in two parts: A six-weeks intensive training course performed in Mauritius that include formal teaching and practical exercises in small groups for a total of 210 hours. The curriculum is mainly targeted on the various aspects of management as the management of health information (biostatistics epidemiology and computing), the management of human resources, financial resources and material resources. In addition to these main topics, there is an introduction to pedagogy, communication skills and applied research methodology. Following this six-weeks, training the students come back to work in their country and have 8 months to perform a thesis supervised by a local public health specialist. The subject of the thesis has to be closely related with one of the topic taught and should provide an obvious improvement for the public health situation in the district where this physician is acting. In 1995, 22 candidates attend to the course (13 from Madagascar, 4 from Mauritius, 3 from Comoros, 1 from Angola, 1 from Equatorial Guinea and 1 from Tchad), 19 had successively completed all the modules and got the diploma of public health delivered by the University of Bordeaux II. This diploma has been recognized as an equivalent to a master in public health in Mauritius. The evaluation of the courses-performed by the students, the teachers and the financial agencies gave a very positive results although the workload was considered as too important for a six-weeks training course. The recommendations of the 1995 session were included in the 1996 programs which is still on going for 23 candidates. The 97 session will probably extend the number of students up to 40, divided in 4 subgroups for practical exercises. In parallel to the course, a quarterly bulletin will be created and sent to the present and past candidates of this course in order to support a continuous medical education training program targeted to the district physicians.

Communication↗
PubMed1997

[Schistosoma intercalatum bilharziasis: clinical and epidemiological considerations].

Schistosoma intercalatum bilharziasis continues to raise numerous questions regarding pathogenicity and gravity. The parasite was identified recently and the last fully described outbreak occurred 10 years ago in the city of Bata, Equatorial Guinea. Geographically Schistosoma intercalatum biharziasis is limited to one part of the African continent but has shown a tendency to spread. Hybridization of Schistosoma intercalatum and Schistosoma haematobium has been observed. The main clinical manifestation of Schistosoma intercalatum is rectal bleeding. The endoscopic appearance of lesions is variable and non-specific ranging from granulomas or polyps to ulcerations. Complications include severe rectitis or genital involvement such as salpingitis with secondary sterility. Spontaneous abortion has also been reported. Association with salmonella and klebsiella infection has been confirmed and can lead to life-threatening situations. Few studies have been performed to assess the value of diagnostic tests. The sensitivity of stool smears and urinary sedimentation testing is 81.7% and 56.3% respectively using the two examinations as references for one another. The sensitivity of immunological tests is generally good but varies depending on the reference technique used. Specificity can be affected by cross-reaction with other schistosomas or trematodes and even with nematodes and hematozoons. Treatment with a single dose of Biltricide has proven to be effective. Prevention requires education of the population at risk and use of molluscacides. The control strategy must be adapted in function of the epidemiology of the disease, diagnostic data, cost and effectiveness of screening and treatment.

Abortion, Spontaneous↗
PubMed1998

[7 new cases of HIV-2 infection recognized in Madrid in 1996 and 1997].

The infection with human immunodeficiency virus type-2 (HIV-2) is endemic in Western Africa, where it is responsible for many of AIDS cases. In Spain, 72 cases with HIV-2 until December 1997 had been reported, mainly in African immigrants. Seven of these cases (4 males and 3 females) were identified during 1996 and 1997. Five came from Western Africa and other two were Spanish, one from Alicant and the other from Vigo. Only one out of the seven patients presented clinical manifestations (Pneumocystis carinii pneumonia); the remaining patients were asymptomatic. Viral isolates from six of these patients were genetically characterized: three were subtype A, whereas those from Equatorial Guinea patients corresponded to HIV-2 subtype B.

Adult↗