Lack of malaria parasite transmission between apes and humans in Gabon.

The International Center for Medical Research (CIRMF) is located in an area highly endemic for malaria in southeastern Gabon, where humans and apes (gorillas and chimpanzees) are living in the same geographic area. The presence of the CIRMF primate center housing apes (59 chimpanzees and nine gorillas in 1994) within the city of Franceville provided an opportunity to investigate the capability of cross-transmission of malaria species from humans to apes. The main vector of human malaria, Anopheles gambiae, was found in the primate center and in a nearby populated area of Franceville. Despite high malaria transmission in humans of both Plasmodium falciparum and P. malariae (mean of 43% cumulative prevalence in schoolchildren), none of the apes were found infected with plasmodia during a six-month investigation. However, low antibody levels against sporozoite and blood stages of both P. falciparum and P. malariae were detected in a few chimpanzees and gorillas. These results demonstrate that only rarely would apes be bitten in the field by mosquitoes infected with human malaria parasites. In the case of infection proven by serology, we did not find any evidence that blood-stage malaria parasites were able to the gametocyte stage. The absence of any established malaria transmission cycle within the primate colony of CIRMF indicates that apes cannot be considered as animal reservoirs for human malaria parasites in this environment.

Reduced Loa loa microfilaria count ten to twelve months after a single dose of ivermectin.

The action of a single dose of ivermectin (200 micrograms/kg) on 71 Gabonese patients with Loa loa microfilariae in the peripheral blood, and living in areas highly endemic for loiasis, has been evaluated. Ten to 12 months after treatment, 43 patients (63%) had no circulating microfilaria and the geometric mean peripheral blood microfilaria count had decreased by 88.6% (P < 0.02). Thus, a single annual dose of ivermectin can markedly reduce loiasis transmission.

Malaria transmission in a region of savanna-forest mosaic, Haut-Ogooué, Gabon.

During the 2 years 1993 to 1995, an entomological survey was carried out in the savanna-forest area of Franceville, Gabon, investigating malaria transmission in one suburban district of Franceville (Akou) and in one rural village (Benguia). The biting rates of the Anopheles vectors were 10 times higher in the rural zone compared to the suburban zone. Anopheles funestus Giles was the predominant species in both zones followed by Anopheles gambiae s.l. Giles. The densities of Anopheles nili Theobald and Anopheles moucheti Evans were very low. In the suburban zone, transmission was maintained throughout the year by An. funestus and An. gambiae s.l., whereas in rural zones the secondary vectors An. nili and An. moucheti were also involved in transmission. Humans in a suburban setting received one infective bite per person every 4 days, whereas in the rural area the infective biting rate was 4 times higher. Considering each vector, the observed entomological inoculation rates (EIRs) were one infective bite per person every 6 and 17 days for An. funestus and An. gambiae s.l., respectively, at Akou. At Benguia, the EIRs were one infective bite per person every 2, 3, 6, and 19 days for the 4 An. funestus, An. gambiae s.l., An. nili, and An. moucheti, respectively. The predominance of An. funestus over An. gambiae s.l. and its high EIR make it the most important malaria vector in this region of Haut-Ogooué.

Clinical evaluation of hand-arm-vibration syndrome in shipyard workers: sensitivity and specificity as compared to Stockholm classification and vibrometry testing.

The hand-arm-vibration syndrome (HAVS) is a complex entity composed of circulatory, sensory, and motor disturbances, as well as associated musculoskeletal components. This study was performed to find a diagnostic testing modality with sufficient sensitivity, specificity, and predictive value to be utilized as a screening test for this disorder in a working population. A full range of testing modalities was utilized in the shipyard medical department. In addition, a clinical diagnosis of vascular and sensorineural disease was established in the workers by a combination of plethysmography, vibrometry, two point discrimination, and monofilament testing in an independent occupational medicine clinic. No one test modality met the requirements for such a definitive diagnostic test. Rather, a range of modalities was required to reach any acceptable level of predictive value, with sufficient degrees of specificity and sensitivity.

Estomatitis eritemato-aftoide de erupción: ¿primoinfección herpética? (trad) / Eruptive erythemato-aphthous stomatitis: herpetic primoinfection?

La estomatitis eritemato-aftoide parece bien debida a una localización del virus herpético a la mucosa bucal, en la ocasión de la erupción dentaria. Se trata de una estomatitis herpética de primoinfección en el niño joven pero puede tratarse de localización mucosa de este virus "de entrada" en el niño mayor