[Morbidity and mortality from infectious diseases at the Military Hospital of Abidjan, Côte d'Ivoire]. / Morbimortalité des pathologies infectieuses à l'hôpital militaire d'Abidjan, Côte d'Ivoire.

OBJECTIVES: To determine the proportion of infectious diseases and their lethality at the Abidjan Military Hospital. PATIENTS AND METHODS: This cross-sectional study examined the medical files of patients hospitalized in the internal medicine unit of the hospital during 2004. RESULTS: The study included 668 patients with 855 diseases, 579 of them infectious (67.7%). The prevalence of HIV in this population was 41.3%. The main diseases observed were pneumonia (150 cases; 17.5%), malaria (82 cases; 9.6%), oropharyngeal candidiasis (83 cases; 9.7%), and tuberculosis (54 cases; 6.3%). The immediate causes of death were cerebral toxoplasmosis (27 cases; 39%), pneumopathy (25 cases; 36%), severe malaria (7 cases; 10%), tuberculosis (6 cases; 9%), and bacterial meningitis (5 cases; 7%). The prevalence of HIV infection prevalence among those who died of an infectious disease was 74.3%. CONCLUSION: Infectious diseases are the main pathologies seen in the internal medicine department of the in Abidjan Military Hospital. They were mainly opportunistic infections linked to AIDS. The creation of a laboratory of infectious microbiology and of a medical intensive care unit appears necessary to optimize management of these infectious diseases.

[Prevalence of HBs antigen carriage in a population of national Gendarmerie recruits in Ivory Coast in 2008]. / Prévalence du portage de l'antigène HBs dans une population de recrues de la Gendarmerie nationale de Côte d'Ivoire en 2008.

The purpose of this study was to determine the prevalence of HBsAg carriage in Ivorian gendarmerie recruits in 2008. This prevalence was 15.6%. It was highest in recruits aged 18 years (24%), in those who were married (33.3%) and in those who had had more than three sexual partners in the 6 months before the survey (19.4%). It was also higher in recruits who had never used condoms (20.6%) and in those who had undergone blood transfusions (27%). A policy of vaccination against HBV in the army, in teenagers and adults must be implemented to reduce HBsAg carriage in the army and in the Ivorian population.

[Current aspects of neuromeningeal cryptococcosis in adults infected with HIV in the internal medicine service of the University Hospital of Treichville Abidjan (Cote d'Ivoire)]. / Aspects actuels de la cryptococcose neuroméningée chez des sujets adultes infectés par le VIH dans le service de médecine interne du CHU de Treichville d'Abidjan (Côte d'Ivoire).

OBJECTIVES: To determine the prevalence of neuromeningeal cryptococcosis (NMC) and reporting sociodemographic, clinical, paraclinical aspects and outcome of patients. METHODS: It was a retrospective study concerning 22 HIV positive patients hospitalized between 2006 to and 2009 in the internal medicine service of University Hospital of Treichville for NMC. RESULTS: The prevalence of NMC in patients infected with HIV was 0.6%. The mean age was 35±4.5 years old. The sex-ratio was 0.5. The average time evolution of the symptomatology was 10±2.1 days. The installation of the disease was progressive (86.4%). The main signs were fever (100%) and headache (95.4%). The cerebrospinal fluid was inflammatory aspect (95.4%) with low glucose (91%), hyper lymphocytosis(100%). There were Cryptococcus neoformans in direct exam by China ink (72.7%) and culture on Sabouraud (100%). Treatment was injectable amphoterin B in monotherapy (54.5%) followed by fluconazole per os (45.5%). The mortality was 54.5%. CONCLUSION: This study shows a reduction of NMC prevalence in our service in relation with tritherapy.

[Histoplasma capsulatum histoplasmosis: apropos of 1 case observed in the internal medicine department of the CHU of Treichville (Abidjan)]. / Histoplasmose à Histoplasma capsulatum: à propos d'un cas observé dans le service de médecine interne du CHU de Treichville (Abidjan).

The advent of AIDS has resulted in an increase in diseases which were previously rare. In HIV-infected subjects, histoplasmosis takes a disseminated and particularly severe form, with a fatal outcome in our country, the more so because the clinical presentation resembles tuberculosis and is generally treated as such. The authors report a case of disseminated histoplasmosis in a patient dually-reactive to HIV-1 and HIV-2, in whom the clinical presentation was fever, mediastinal lymphadenopathy and pulmonary infiltrates. The diagnosis of histoplasmosis was made at autopsy.

[Pain during peritoneum pinching, a pathognomonic sign of peritoneal disease. Clinical research. Semiological value]. / La douleur au pincement du péritoine, signe pathognomonique d'affection péritonéale. Recherche clinique. Valeur séméiologique.

Pain induced by pinching the peritoneum betrays a pathology of that membrane. It is absent when the peritoneum is perfectly healthy. Pain is elicited by a special palpation technique. Clinically and statistically, the presence of this pain is pathognomonic, but it does not inform on the aetiology. In the present study the most frequent causes of positive abdominal peritoneal pinching test were peritoneal tuberculosis, followed by portal hypertension with or without liver cirrhosis.

[Stopping persistent hiccups in the adult by endoscopic maneuver]. / Arrêt du hoquet persistant de l'adulte par manoeuvres endoscopiques.

Thirty-four patients with persistent hiccups (median duration 10 days) were treated by gentle endoscopic massage of the region of the cardia. Hiccups stopped in all cases. Its early recurrence in one patient only required a second massage, which was also effective. This simple technique is recommended for the treatment of persistent hiccups.

[Chronic gastritis and Helicobacter pylori infection on the Ivory Coast. A series of 277 symptomatic patients]. / Gastrite chronique et infection à Helicobacter pylori en Côte-d'Ivoire. Etude d'une série de 277 patients symptomatiques.

Only a few reports have established the importance of chronic gastritis and Helicobacter pylori infection in Africa. The aim of this study was to ascertain the prevalence of chronic gastritis and Helicobacter pylori infection in a symptomatic population in Abidjan, Côte-d'Ivoire. The study included 277 consecutive patients referred for gastroscopy. Two hundred nine patients complained of abdominal pain without gastroduodenal ulcer or cancer: 26 had a duodenal ulcer, 23 had a gastric ulcer, and 6 had gastric cancer. The remaining 14 patients underwent gastroscopy for various other reasons. Chronic gastritis was present in 89 percent of cases, of which 96 percent showed signs of activity. There were four cases of lymphocytic gastritis. Patients with antral chronic gastritis were older (39.43 +/- 14.3 years) than those with normal antral mucosa (33.7 +/- 12 years, P less than 0.05). Helicobacter pylori was present in 91.3 percent of cases, representing all patients with active chronic gastritis, and 60 percent of the patients with normal gastric mucosa. Chronic gastritis was present in 86 percent of patients with abdominal pain, in 100 percent of those with duodenal of gastric ulcer, and Helicobacter pylori were observed in 90, 100, and 91 percent of the same patient groups, respectively. This study demonstrates the high prevalence of chronic gastritis and the very high level of Helicobacter pylori infection in Ivorian patients complaining of various gastrointestinal symptoms. The usefulness and feasibility of therapeutic trials still have to be investigated.