[Prescription And Delivery's Survey Of Benzodiazepines In The Occurrence Of Addictions At Mbour's District]. / Evaluation De La Prescription Et De La Delivrance Des Benzodiazepines Dans La Survenue Des Addictions Dans Le District Sanitaire De Mbour.

Impact of the prescription and delivery of benzodiazepines in the occurrence of addictions in the district of Mbour. INTRODUCTION: Benzodiazepines (BZD) are widely used nowadays and are at the origin of an addiction. OBJECTIVES: The objective was to evaluate the quality of benzodiazepine prescribing and delivery in the Mbour department of Senegal and subsequently to implement an addictovigilance strategy. Thus, we studied the prescribing habits, the quality of delivery and identified the consumption habits of these drugs. MATERIALS AND METHODS: It was a cross-sectional, prospective study with two questionnaires: addressed to patients and prescribers, conducted in pharmacies, hospitals, districts and Mbour health posts. RESULTS: 44% of BZD prescriptions were prescribed by doctors and especially general practitioner. 31.1% did not comply with the rules of prescription (marketing authorization). As for the dispensing rules, (85.3%) were dispensed without a prescription. The level of consumption was high in the 30-40 age group (43.95%) predominantly female (59%). Insomnia predominated as a reason for prescription (16.4%) on anxiety (11.94%) with (65.5%) dependence. CONCLUSION: The abuses observed in the prescription, the delivery and consumption of BZD, constitutes a real health problem. Half of the consumers become addicted, hence the need for a national addictovigilance program.

INTRODUCTION: Les benzodiazépines (BZD) sont très utilisées de nos jours et sont à l'origine d'une addiction. OBJECTIFS: L'objectif était d'évaluer la qualité de la prescription et de la délivrance des benzodiazépines dans le département de Mbour au Sénégal et ultérieurement mettre en place une stratégie d'addictovigilance. Ainsi, nous avons étudié les habitudes de prescription, la qualité de délivrance et identifié les habitudes de consommation de ces médicaments. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude transversale, prospective avec deux questionnaires : adressé aux patients et prescripteurs, menée dans des pharmacies, hôpital, district et postes de santé de Mbour. RÉSULTATS: 44% des ordonnances de BZD étaient prescrites par des médecins et particulièrement des généralistes. 31,1% ne respectaient pas les règles de prescriptions (hors AMM). Quant aux règles de délivrance, 85,3% étaient délivrées sans ordonnance. Le niveau de consommation était élevé dans la tranche d'âge 30-40 ans (43,95%) avec une prédominance féminine (59%). L'insomnie prédominait comme motif de prescription (16,4%) sur l'anxiété (11,94%) avec (65,5%) de dépendance. CONCLUSION: Les abus observés dans la prescription, la délivrance et la consommation des BZD, constitue un véritable problème de santé. La moitié des consommateurs deviennent addictes, d'où la nécessité de mettre en place un programme d'addictovigilance à l'échelon national.

Th1/Th2 Dichotomy in Obese Women with Gestational Diabetes and Their Macrosomic Babies.

The aim of the study was to assess T cell differentiation and the modulation of inflammatory cytokines in obese and gestational diabetes mellitus (GDM) women and their macrosomic newborns. Hence, immediately after delivery, blood samples were collected through the mother's arm vein and the umbilical cordon vein. Biochemical parameters measured were HbA1C, glucose, insulin, triglyceride (TG), total cholesterol (Tchol), HDL cholesterol (HDLchol), and LDL cholesterol (LDLchol). T lymphocytes were purified from the total blood with Ficoll-Paque. The mRNA expression of inflammatory markers in T cells was determined by RT-qPCR. We observed that diabetic mothers exhibited higher HbA1C, glycemia, insulinemia, TG, Tchol, HDLchol, and LDLchol levels than control mothers. Glycemia was not significantly different between macrosomic and control newborns. However, insulinemia was high in macrosomic babies. TG, Tchol, HDLchol, and LDLchol were not significantly different between macrosomic and control babies. In diabetic mothers, mRNA expression of the Th1 cell subtype was significantly increased. Th1 markers were upregulated in babies born to diabetic women than in control newborns. However, expression of two Th2 markers (GATA3 and IL-4) was not significantly different between control and GDM women and between their respective newborns. Interestingly, IL-10 mRNA expression was decreased in diabetic mothers and their offsprings. The Th1/Th2 cytokine ratio was increased in GDM obese mothers and their macrosomic newborns, suggesting a proinflammatory status in these subjects.

Does smallpox vaccination modify HIV disease progression among ART-naive people living with HIV in Africa?

We examined the association between a history of smallpox vaccination and immune activation (IA) in a population of antiretroviral therapy-naïve people living with HIV (PLHIV). A cross-sectional study was conducted in Senegal from July 2015 to March 2017. Smallpox vaccination was ascertained by the presence of smallpox vaccine scar and IA by the plasma level of ß-2-microglobulin (ß2m). The association was analysed using logistic regression and linear regression models. The study population comprised 101 PLHIV born before 1980 with a median age of 47 years (interquartile range (IQR) = 42-55); 57·4% were women. Smallpox vaccine scar was present in 65·3% and the median ß2m level was 2·59 mg/l (IQR = 2·06-3·86). After adjustment, the presence of smallpox vaccine scar was not associated with a ß2m level ⩾2·59 mg/l (adjusted odds ratio 0·94; 95% confidence interval 0·32-2·77). This result was confirmed by the linear regression model. Our study does not find any association between the presence of smallpox vaccine scar and the ß2m level and does not support any association between a previous smallpox vaccination and HIV disease progression. In this study, IA is not a significant determinant of the reported non-targeted effect of smallpox vaccination in PLHIV.

[Efficacy of sodium hydroxide at 2.5 %, chlorhexidine gluconate at 0.5 % and calcium hydroxide against Candida albicans]. / Étude de l'efficacité de l'hypochlorite de sodium à 2,5 %, de la chlorhexidine à 0,5 %, et de l'hydroxyde de calcium sur Candida albicans.

INTRODUCTION: Endodontic flora is dominated in the apical part of the channels by strict anaerobic and some facultative anaerobic bacteria but also by Candida yeasts, especially Candida albicans species that are involved in the maintenance and persistence of endodontic infections. Their elimination of the canal system in practice by chemo-mechanical methods of disinfection is not always guaranteed. Thus, this in vitro study was performed to determine the sensitivity of C. albicans with sodium hypochlorite (NaOCl) dosed at 2.5 %, the chlorhexidine digluconate 0.5 % and calcium hydroxide used in inter-session medication. METHODS: The diffusion method was used initially to test the sensitivity of C. albicans strains with the above products. Then a dilution technique has allowed us to determine the minimum inhibitory concentration of these active products on C. albicans. RESULTS: Strains from infected pulp teeth of patients showed a sensitivity of C. albicans to sodium hypochlorite to a minimum inhibitory concentration less than 70µg/mL and 30µg/mL for chlorhexidine. CONCLUSION: This study demonstrated a sensitivity of C. albicans to sodium hypochlorite and chlorhexidine.

Results from the Survey of Antibiotic Resistance (SOAR) 2011-14 in the Democratic Republic of Congo, Ivory Coast, Republic of Senegal and Kenya.

OBJECTIVES: To assess antibiotic susceptibility of community-acquired respiratory tract isolates from Ivory Coast, Kenya, Democratic Republic of Congo (DRC) and Senegal in 2011-14. METHODS: Bacterial isolates were collected and MICs determined using Etest(®) for all antibiotics except erythromycin, for which testing was by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide interpretation, CLSI breakpoints were adjusted for incubation in CO2. RESULTS: Susceptibility to penicillin (using CLSI oral or EUCAST breakpoints) was low among isolates of Streptococcus pneumoniae from the DRC and Kenya (17.4% and 19%, respectively) but higher among isolates from the Ivory Coast (70%) and Senegal (85.7%). Penicillin susceptibility using CLSI iv breakpoints was higher in all countries, but still only 69.6% in the DRC. Macrolide susceptibility (based on CLSI erythromycin disc diffusion breakpoints) was also low in Kenya (∼65%) but 87%-100% elsewhere. Haemophilus influenzae were only collected in the DRC and Senegal, with ß-lactamase prevalence of 39% and 4%, respectively. Furthermore, ß-lactamase-negative ampicillin-resistant (BLNAR) isolates were found in DRC (four isolates, 17%), but only two isolates were found in Senegal (by EUCAST definition). Amoxicillin/clavulanic acid in vitro susceptibility was 73.9% in the DRC and 100% in Senegal based on CLSI breakpoints, but this reduced to 65.2% in the DRC when BLNAR rates were considered. Clarithromycin susceptibility was >95% in both countries. CONCLUSIONS: There was considerable variability in antibiotic susceptibility among the African countries participating in the surveillance programme. Thus, continued surveillance is necessary to track future changes in antibiotic resistance. Use of EUCAST versus CLSI breakpoints showed profound differences for cefaclor and ofloxacin against S. pneumoniae, with EUCAST showing lower susceptibility.

[Evaluation of the efficacy and safety of three 2-drug combinations for the treatment of uncomplicated Plasmodium falciparum malaria in Senegal: artesunate-amodiaquine, dihydroartemisinin-piperaquine, and artemether-lumefantrine]. / Évaluation de l'efficacité et de la tolérance des combinaisons artésunate-amodiaquine, dihydroartémisinine-pipéraquine et artéméther-luméfantrine pour le traitement du paludisme à Plasmodium falciparum non compliqué au Sénégal.

BACKGROUND: Since 2006, artemisinin-based combination therapies (ACT) have been used to treat uncomplicated Plasmodium falciparum malaria in Senegal, as recommended by WHO. Recently, decreased parasite clearance with artemisinin derivatives has been reported in Cambodia and Thailand. The effectiveness of artemisinin derivatives in Africa must be monitored. This study was conducted to evaluate the efficacy and the tolerability of three ACT widely used in Senegal. METHODS: From October 2010 to February 2011, a descriptive and analytical sequential study was conducted in adults and children to evaluate these three combinations: artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ), and dihydroartemisinin-piperaquine (DHAPQ). The study took place at the health posts of Deggo and Pikine and the health center of Guédiawaye, in the suburbs of Dakar. The primary endpoint was the PCR-corrected adequate clinical and parasitological response (ACPR) at day 28 (D28); the secondary endpoints included ACPR at D42, clearance times for parasites, fever, and gametocytes, and the incidence of adverse events. RESULTS: The study included 393 patients: 139 in the AL group, 130 in the ASAQ group, and 124 in the DHAPQ group. In the intent-to-treat population, PCR-corrected ACPR at day 28 was 92.8% in the AL, 89.2% in the ASAQ, and 91.1% in the DHAPQ (p = 0.58) groups, and in the per-protocol population, 98.4%, 98.3%, and 100% respectively (p = 0.39). At D42, ACPR was 99.2% in the AL, and 99.1% in each of the ASAQ and DHAPQ arms (p = 1). No early therapeutic failure (ETF) was observed. The combinations were well tolerated, with no serious adverse events reported during the follow-up period. CONCLUSION: These combinations are still effective and well-tolerated. Continued monitoring is nonetheless essential to detect early artemisinin resistance in Africa.

Antineoplastic busulfan encapsulated in a metal organic framework nanocarrier: first in vivo results.

Nanoparticles of a mesoporous iron(iii) trimesate MIL-100 nanocarrier encapsulating high amounts of the challenging antineoplastic busulfan were administered to rats and compared with the commercial Busilvex®. Large differences in serum concentration of both busulfan and trimesate revealed the great impact of drug encapsulation both on the drug and on nanoparticle pharmacokinetics during the first 24 h of administration.

Variation in transplacental transfer of tyrosine kinase inhibitors in the human perfused cotyledon model.

BACKGROUND: The use of tyrosine kinase inhibitors (TKis) during pregnancy in humans remains rare, and little data are available on their transplacental passage. Erlotinib and gefitinib are the first-line targeted therapy in case of stage IV nonsmall-cell lung cancer with an EGFR-activating mutation. There are no data available regarding the comparative use of these TKis in pregnant patients. We aimed to compare the transplacental transfer of gefitinib, imatinib and erlotinib, using the ex vivo method of human perfused cotyledon, and to determine the placental accumulation of TKis. MATERIALS AND METHODS: Term placentas were perfused after delivery with gefitinib, imatinib and erlotinib at targeted maternal concentrations around the steady-state plasma trough concentration (i.e. 500, 1000 and 1500 ng/ml, respectively). Samples from fetal and maternal circulations were collected in order to monitor TKis concentrations. Main transfer parameters such as fetal transfer rate (FTR), clearance index (CI) and placental uptake were assessed. RESULTS: Mean FTR of gefitinib, imatinib and erlotinib were 16.8%, 10.6% and 31.4%, respectively. Mean CI of gefitinib, imatinib and erlotinib were 0.59, 0.48 and 0.93, respectively. Placental uptake in cotyledon was 0.030% %, 0.010% and 0.003% for gefitinib, imatinib and erlotinib, respectively, corresponding to a mean mass of 27.7 µg for gefitinib, 15.7 µg for imatinib and 6.8 µg for erlotinib. CONCLUSION: The results suggest that TKis cross the placenta at therapeutic level. Particularly, erlotinib crosses the placenta at a higher rate than gefitinib or imatinib. All of them have a very low placental uptake. These data may suggest that gefitinib should be preferred to erlotinib for the treatment of pregnant woman with lung cancer harboring an EGFR-activating mutation, during the second and third trimesters of pregnancy.

[Dehydration and malnutrition as two independent risk factors of death in a Senegalese pediatric hospital]. / Déshydratation et malnutrition : deux facteurs de risque de décès indépendants chez l'enfant sénégalais hospitalisé

UNLABELLED: Inpatient mortality is an indicator of the quality of care. We analyzed the mortality of under 5-year-old hospitalized children in the pediatric ward of Aristide Le Dantec Hospital for updating our data 10 years after our first study. METHODS: We analyzed the data of the children hospitalized between 1 January and 31 December 2012. For each child, we collected anthropometric measurements converted to a z-score related to World Health Organization growth data. Logistic regression-generating models built separately with different anthropometric parameters were used to assess the risk of mortality according to children's characteristics. RESULTS: Data from 393 children were included. The overall mortality rate was 10% (39/393). Using logistic regression, the risk factors associated with death were severe wasting (odds ratio [OR]=8.27; 95% confidence interval [95% CI]) [3.79-18], male gender (OR=2.98; 95% CI [1.25-7.1]), dehydration (OR=5.4; 95% CI [2.54-13.43]) in the model using the weight-for-height z-score; male gender (OR=2.5; 95% CI [1.11-5.63]), dehydration (OR=8.43; 95% CI [3.83-18.5]) in the model using the height-for-age z-score; male gender (OR=2.7; 95% CI [1.19-6.24]), dehydration (OR=7.5; 95% CI [3.39-16.76]), severe deficit in the weight-for-age z-score (OR=2.4; 95% CI [1.11-5.63]) in the model using the weight-for-age z-score; and male gender (OR=2.5; 95% CI [1.11-5.63]) and dehydration (OR=8.43; 94% CI [3.83-18.5]) in the last model with mid-upper arm circumference (MUAC). Dehydration and malnutrition were two independent risk factors of death. The protocols addressing dehydration and malnutrition management should be audited and performed systematically for each child's anthropometric measurements at admission.

Staphylococcus aureus nasal and pharyngeal carriage in Senegal.

Nasal and pharyngeal swabs were collected from 132 patients admitted to the Principal Hospital in Dakar (Senegal), in January and February 2012. The prevalence of Staphylococcus aureus carriage was 56.1% (n = 74): 40.2% for pharyngeal samples and 36.4% for nasal samples. None of the isolates was methicillin-resistant. Carriage was independently associated with being female (p <0.01) and large households (≥15 members) (p 0.04). The luk-PV genes encoding Panton-Valentine leukocidin (PVL) were present in 26.2% of the isolates. These data highlight the importance of the oropharynx as a site of colonization, and the high prevalence of PVL-positive isolates in Senegal as compared with industrialized countries.

Prevalence and characterization of extended-spectrum ß-lactamase-producing clinical Salmonella enterica isolates in Dakar, Senegal, from 1999 to 2009.

A total of 1623 clinical isolates of Salmonella belonging to 229 serotypes were received by the Senegalese Reference Center for Enterobacteria from January 1999 to December 2009. The most common serotypes were Enteritidis (19% of the isolates), Typhi (8%), Typhimurium (7%) and Kentucky (4%). A significant increase in the prevalence of resistance to amoxicillin (0.9% in 1999 to 11.1% in 2009) and nalidixic acid (0.9% in 1999 to 26.7% in 2009) was observed in non-typhoidal Salmonella serotypes. For critically important antibiotics, notably ciprofloxacin and extended-spectrum cephalosporins (ESCs), the rates of resistance were low: 0.3% and 0.5%, respectively. Seven ESC-resistant Salmonella strains and three additional ESC-resistant strains from Senegal (1990) and Mali (2007) were studied to identify the genetic basis of their antibiotic resistance. All ESC-resistant strains produced an extended-spectrum ß-lactamase (ESBL). These were CTX-M-15 (n = 6; 2000-2008), SHV-12 (n = 3; 2000-2001) and SHV-2 (n = 1; 1990). A large IncHI2 ST1 pK29-like plasmid was found in six strains (three producing SHV-12 and three CTX-M-15), whereas IncN and IncF plasmids were found in three strains and one strain, respectively. The association of plasmid-mediated quinolone resistance (PMQR) genes qnrB1 and aac(6')-Ib-cr was found in four ESBL-producing strains, leading to decreased susceptibility and even full resistance to ciprofloxacin (MIC range 0.75-2 mg/L) despite the absence of mutations in the quinolone resistance-determining region (QRDR) of gyrA, gyrB, parC and parE. This association of ESBL and multiple PMQR mechanisms within the same strains is therefore a serious concern as it hampers the use of both ESCs and fluoroquinolones for severe Salmonella infections.

[Relationship between bizygomatic width and the size of maxillary anterior teeth among young Senegalese black people recruited in army]. / Corrélation entre la distance bizygomatique et la largeur des dents antéromaxillaires chez les jeunes sénégalais mélanodermes recrutés dans le service militaire.

INTRODUCTION: Prosthetic teeth size and placement must be in perfect harmony with the bucco-facial structures for a successful and esthetic removable prosthesis. This study aimed to determine among young Senegalese black people facial index estimating maxillary central incisor width and distance between canine points starting from bizygomatic width. PATIENTS AND METHODS: 621 black Senegalese participated to this transversal study. Measurements were made using anthropometric slide caliper and electronic slide caliper. The comparative analysis was carried out by the test t of Student. The correlative analysis used the chi-square test. The risk of error was fixed at 5%. RESULTS: Positive correlations were found between variables. Distance between canine points was significantly (p = 0.000) correlated to bizygomatic width and central incisor width. Using bizygomatic width, the average dividing factors to estimate central incisor width and distance between canine points were respectively 15.13 and 3.75. CONCLUSION: Distance between canine points and central incisor width can be given starting from bizygomatic width, as guide of selecting maxillary anterior prosthetic teeth width.

Analyzing the benefit of optical transmission systems based on Root Raised Cosine PS-QPSK and a flexible channel grid.

We numerically investigate the multi-channel transmission performance of Polarization Switched Quadrature Phase Shift Keying (PS-QPSK) and we compare it to the performance of Polarization-Division-Multiplexed QPSK (PDM-QPSK), using Root Raised Cosine (RRC) spectral shaping, in the context of a flexible channel grid. We point out the impact of the roll-off factor and the potential influence of different dispersion compensation scenarios. Finally, the advantage of PS-QPSK against PDM-QPSK is presented as a function of the system parameters, while we also discuss the benefit of a RRC spectral shaping against a tight filtering at the transmitter side with a 2nd order super-Gaussian-shaped filter.

[Sensitivity to antibiotics and genetic support to resistance of Shigella flexneri strains isolated in Dakar from 2001 to 2010]. / Sensibilité aux antibiotiques et supports génétiques de la résistance des souches de Shigella flexneri isolées à Dakar de 2001 à 2010.

Diarrheal diseases remain a leading cause of death with 14.7 million deaths in 2001 and 26% of global mortality worldwide according to WHO. Shigella species are prevalent in tropical areas; they are present all the year, with epidemic outbreaks in rainy season. Between 2001 and 2010 one hundred ninety (190) strains of Shigella flexneri isolated from National Senegalese Enterobacteriaceae Center located at the Pasteur Institute in Dakar were studied. Susceptibility was performed by antibiogram following the CASFM recommendations. Detection and characterization of integrons and resistance genes was done by PCR using specific primers and sequencing. Antibiotic susceptibility showed high percentage resistance to tetracycline: 95%, cotrimoxazole 60%, ampicillin 55%. Nineteen strains were cephalosporin resistant (10%). Two isolates were resistant to quinolones and one was imipenem resistant. Genes tet, dfr, cat, bla tem1 , bla oxa30 , bla shv , bla CTX-M , blakpc,bla IMP , gyrA, gyrB, parC and parE were detected on isolates. Integrons harbored genes resistance. The class 1 integron predominated followed by class 2 integron. Genes bla oxa30 , aadA1/aadA2 dfrA1, dfrA7 were found on class 1 integron. Class 2 integron showed three different types cassettes. No class 3 integron was detected. Genes dfrA1, dfrA7, sat, and aadA1 were harbouring by integrons. Antibiotic susceptibility showed that Shigella flexneri strains are resistant to the first line drugs used to treat shigellosis in Senegal. Resistance to 3rd generation of cephalosporins and fluoroquinolones emerged and is of great concern. These molecules must be used with caution in the treatment of shigellosis.

[Evaluation of erythrocyte deformability in subjects with sickle cell trait during a soccer game: effect of hydration ad libitum]. / Évaluation de la déformabilité érythrocytaire des sujets porteurs de trait drépanocytaire au cours d'un match de football : effet de l'hydratation ad libitum.

This study compared erythrocyte changes between a group of subjects with sickle cell trait (SCT) and controls (subjects without hemoglobinopathy) during a soccer game in two conditions: with and without hydration. Erythrocyte deformability of subjects was assessed by the coefficient of erythrocyte rigidity (Tk) which was calculated before and after football match. Our results showed a significant increase in erythrocyte rigidity (Tk) in SCT at the end of physical activities without hydration; however when water was provided ad libitum their Tk decreased significantly, reaching values of controls. And adequate hydration is recommended in subjects with sickle cell trait during and after exercise.

[Correlations between colorimetric parameters of teeth, eyes and skin. Perspectives in the choice of tooth shade for complete denture]. / Correlations entre les parametres colorimétriques des dents, des yeux et de la peau. Perspectives dans le choix de la teinte des dents en prothèse adjointe complète.

Rehabilitation with complete denture include among other objectives, improvement of facial and dental esthetics. To these ends, the artificial teeth should mimic as far as possible, healthy and natural dentition. The main objective of this study was to investigate factors associated with tooth color among black African subjects. One hundred and two subjects (72 men and 30 women) were included in this investigation. The colorimetric parameters of their teeth as well as those of the conjunctiva of their eyes and skin were recorded from standardized photographs. Two software, Mesurim and Photoshop were used for that purpose. Univariate and linear regression analysis were run to assess the association between tooth color and the variables age, gender and colorimetric parameters of eyes and skin. It appears from the result of this study that tooth color was positively and significantly associated with age. Stepwise multiple regression analysis further revealed that tooth hue can be best predicted by a combination of skin complexion and brightness and eye lightness.

Clinical relevance of cagA and vacA gene polymorphisms in Helicobacter pylori isolates from Senegalese patients.

The molecular epidemiology of Helicobacter pylori in Africa is poorly documented. From January 2007 to December 2008, we investigated 187 patients with gastric symptoms in one of the main tertiary hospitals in Dakar, Senegal. One hundred and seventeen patients were culture-positive for H. pylori. Polymorphisms in vacA and cagA status were investigated by PCR; the 3'-region of cagA was sequenced, and EPIYA motifs were identified. Bacterial heterogeneity within individuals was extensively assessed by using an approach based on vacA and cagA heterogeneity. Fourteen per cent of H. pylori-positive patients displayed evidence of mixed infection, which may affect disease outcome. Patients with multiple vacA alleles were excluded from subsequent analyses. Among the final study population of 105 patients, 29 had gastritis only, 61 had ulcerated lesions, and 15 had suspicion of neoplasia based on endoscopic findings. All cases of suspected neoplasia were histologically confirmed as gastric cancer (GC). The cagA gene was present in 73.3% of isolates. CagA proteins contained zero (3.7%), one (93.9%) or two (2.4%) EPIYA-C segments, and all were western CagA. Most of the isolates possessed presumed high-vacuolization isotypes (s1i1m1 (57.1%) or s1i1m2 (21.9%)). Despite the small number of cases, GC was associated with cagA (p 0.03), two EPIYA-C segments in the C-terminal region of CagA (p 0.03), and the s1 vacA allele (p 0.002). Multiple EPIYA-C segments were less frequent than reported in other countries, possibly contributing to the low incidence of GC in Senegal.

[Helicobacter pylori and gastroduodenal lesions in Dakar, Senegal]. / Helicobacter pylori et pathologie gastroduodenale a Dakar (Sénégal).

INTRODUCTION: The bacteriological characteristics of Helicobacter pylori (HP) vary in function of time and place. The aim of this study was to update histological and bacteriological feature of HP infection in patients presenting gastroduodenal lesions in Dakar, Senegal. PATIENTS AND METHOD: This prospective study included patients with gastroduodenal lesions managed over a 6-month period in a digestive endoscopy center in Dakar. In all cases gastric biopsy was performed to obtain specimens for histological diagnosis according Sydney modified classification and HP culture with antibiogram. RESULTS: A total of 158 patients were included. Mean patient age was 48.7 years and the sex-ratio was 1.2. Endoscopic lesions were ulcer in 88 cases, gastritis in 54 cases and tumors in 16. Histological examination demonstrated chronic gastritis in 100% of cases, inflammatory activity in 79.1%, metaplasia in 78.5%, gastric atrophy in 41.1%, adenocarcinoma in 7.6%, dysplasia in 5.7%, and MALT lymphoma in 2.5% with presence of HP in 72.8% of cases. Cultures were positive for HP in 65.8% of cases. Antibiograms indicated that HP was sensitive to amoxicilline in 100% of cases, clarithromycine in 96.6%, ciprofloxacine in 84.1%, and métronidazole in 29.5%. CONCLUSION: Chronic gastritis is a constant feature of gastroduodenal lesions in Dakar. Histology combined with culture showed HP infection in 78.5% of cases. The antibiotic sensitivity of HP in Dakar has changed over the past decade.

[Gastroduodenal peptic ulcer: descriptive study]. / Etude descriptive de la maladie ulcéreuse gastro-duodénale non compliquée.

Our goals were to describe the epidemiological, clinical and endoscopic aspects of gastrointestinal ulcer and to determine the frequency of H. pylori, we included 140 gastrointestinal peptic ulcers from January 1999 to June 2000. Diagnosis of ulcerous disease delt with the presence of an ulcer discovered during a high digestive endoscopy. Gastro-duodenal ulcers bleeding or with stenosis have been excluded as well as patients who were under anticoagulant treatment or antibiotics or under pump of protons inhibitors during the previous month. Data were collected from a unique questionnaire specifying the sociodemographic characteristic, the history of the ulcerous disease, the antecedents, the style of life, and the endoscopic findings. Five biopsies were done using sterile grips and a fast urease test and the direct exam of the smear. The prevalence of gastro-duodenal ulcers in our population of survey was 6.2%. One hundred twenty eight duodenal ulcers (91.4%), and 12 gastric ulcers (8.6%) were found. The average of age was of 37.1 years +/- 15.3. The sex ratio was 2.9. The gastro-duodenal disease had begun for more than 5 years at 40.8%. No difference in the characters of the pain and signs has been found between duodenal and gastric localization of the ulcer. Hp was associated in 91.4% (91.4% when duodenal ulcers, 88.9% when gastric ulcers and all gastric and duodenal ulcers). We conclude that gastrointestinal ulcers occupies an important place in our gastroenterological practice and the infection rate with H. pylori infection is so high during gastro-duodenal ulcers in our country that the eradication of Hp could be proposed in any case of gastro-duodenal ulcer diagnosed by endoscopy.