[Hyperthyroidism in children. Experience in internal medicine in Mali]. / Hyperthyroïdie chez l'enfant. Expérience d'un service de médecine interne au Mali.

INTRODUCTION: Thyroid pathology is frequent in Mali, which is an endemic zone for goiter. But this pathology rarely occurs in children. The purpose of our study was to characterize this illness among children in Mali. METHODS: We report on patients aged less than 15-year old who presented with clinical signs and symptoms with hyperthyroidism at the medicine service at Hospital de Point G from January 1999 and December 2005 to determine the characteristics of hyperthyroidism. RESULTS: The frequency was 9.6 per thousand (38/3972), with an average age of 12.5+/-3.34-year. The sex ratio was 3 girls/1 boys. The most common symptoms were tachycardia (n=30, 78.9%), palpitations (n=15, 34.4%). 31 patients (81.5%) presented with exophthalmoses, 93.5% being bilateral. Weight loss was present in 31.5% (n=12). Goiter was present in 37 patients (97.4%). The goiter was diffuse in 27 patients (73%) and nodular in 10 (27.%). The presence of goiter caused signs of compression in the neck in half of the cases: dyspnea and dysphonia were the most common consequences. TSH less than 0.05 microUI/1 was used to confirm the diagnosis. Graves's disease was the most common cause (n=32, 84.2%), followed by toxic adenoma (n=4, 10.5%). Other causes included toxic multinodular goiter and thyroiditis. Etiologies were independent of sex and age: (p=0.95). All patients were started on medical therapy upon diagnosis. 7 patients (18.4%) were lost to follow-up during the 6 months of treatment. Remission was obtained in 26 patients (83.9%), and relapse occurred in 5 patients (16.1%). CONCLUSION: The frequency of hyperthyroidism in children in Mali is a problem in a goiter endemic zone like Mali. Poor general health in children and signs and symptoms of neck compression are markers of progressive disease.

[Transmission of hepatitis B virus from mother to child in Bamako-Mali]. / Transmission du virus B de l'hépatite de la mère a l'enfant a Bamako au Mali.

Results of a study about mother-infant transmission of hepatitis B virus (HBV) confirm the high degree of positivity of HBV markers in Bamako, Republic of Mali. Among 372 sera of mother-newborn pairs, seroprevalence of HBs Ag has been around 11% in mothers. The lack of anti HBc IgM in all sera agree probably with a relative old contamination. Pre-S2 epitope marker has been found in more than 70% of HBs Ag positive mothers and 50% of their children. Large discordance has been noted between the prevalence rate of this marker and the HBe Ag and viral DNA, other markers of HBV replication. Further studies are necessary for the clear understanding of HBV transmission systems in our country.

[Evolution of endemic goiter in Malian women and children after a year of enrichment of drinking water with iodine using diffusers made of silicone]. / Evolution du goitre endémique chez les femmes et les enfants maliens après un an d'enrichissement de l'eau de boisson en iode par des diffuseurs en silicone.

A new method for iodine deficiency disorders prevention is tested during one year in a rural area of Mali. Silicone and sodium iodide made diffusers are set up inside 2 villages' drillings. Their efficiency is compared with a placebo. Supervision criteria are evolution of goiter, rates of iodine in water and ioduria of the population, specially women and children. In the treated villages a decrease of goiters' size of the younger people is observed. Iodine rates in treated drillings water stay during 12 months between 150 and 300 micrograms/l with a minimum intake of 150 micrograms/day/person. The means of ioduria rates from less than 25 micrograms/l before treatment (severe deficiency) increase to more than 100 micrograms/l after six months of treatment (no deficiency).

[Prevalence of pulmonary tuberculosis and HIV infection in the district of Diré in Mali]. / Prévalences de la tuberculose pulmonaire et de l'infection par le VIH dans le cercle de Diré au Mali.

In 1990, a study was made in the district of Diré, North Mali in West Africa, to determine the prevalence of pulmonary tuberculosis and HIV infections in general population. From 1,814 subjects tested, 1.1% (n = 20) have active pulmonary tuberculosis and 0.2% (n = 4) were seropositive with HIV1 or HIV1 + 2. No relation was made between the two diseases.