Entomological drivers of uneven malaria transmission in urban lowland areas in Bouaké, Côte d'Ivoire.

BACKGROUND: The use of urban lowlands for agriculture contributes to the food security of city- dwellers, but promotes malaria transmission. The objective of the study was to characterize the entomological drivers of malaria transmission in two lowlands (N'Gattakro and Odiennekourani) in the city of Bouaké, Côte d'Ivoire. METHODS: The human landing catch technique was used to capture mosquitoes in houses located at the edge of two lowlands in Bouaké from February to December 2019. Cultivated surfaces were calculated monthly in both lowlands for each crop type (rice and market gardening) using images acquired by a drone. The different mosquito species were identified morphologically and by PCR analysis for the Anopheles gambiae complex. Anopheles infection by Plasmodium parasites was assessed by quantitative PCR. Mosquito diversity, biting behaviour and rhythmicity, and malaria transmission were determined in each lowland and compared. RESULTS: Anopheles gambiae sensu lato (s.l.) was predominant in N'Gattakro and Culex quinquefasciatus in Odiennekourani. Four Anopheles species were identified: An. gambiae s.l. and Anopheles funestus s.l. in both lowlands, Anopheles pharoensis in N'Gattakro, and Anopheles ziemanni in Odiennekourani. Within the An. gambiae complex, three species were caught: An. gambiae sensu stricto (s.s.), Anopheles coluzzii, and Anopheles arabiensis for the first time in Côte d'Ivoire (30.1%, 69.9% and 0% in N'Gattakro, and 45.1%, 52.6% and 2.4% in Odiennekourani, respectively). Anopheles gambiae s.l. species exhibited a significant exophagic behaviour in N'Gattakro (77.1% of outdoor bites versus 52.2% in Odiennekourani). In N'Gattakro, 12.6% of captures occurred before bedtime (09.00 pm) and after waking up (05.00 am), 15.1% in Odiennekourani. The mean human biting rate was higher in N'Gattakro than in Odiennekourani (61.6 versus 15.5 bites per person per night). Overall, Anopheles infection rate was 0.68%, with 0.539 and 0.029 infected bites per person per night in N'Gattakro and Odiennekourani, respectively. CONCLUSION: The risk of malaria in urban agricultural lowland areas is uneven. The role of agricultural developments and irrigation patterns in the production of larval habitat should be explored. The exophagic behaviour of Anopheles vectors raises the question of the residual transmission that needs to be assessed to implement appropriate control strategies.

First detection of the malaria vector Anopheles arabiensis in Côte d'Ivoire: urbanization in question.

BACKGROUND: Previous studies have revealed high malaria transmission in Bouaké, Côte d'Ivoire. The sociopolitical crisis in the country and the resulting environmental changes have raised the need to update existing knowledge on mosquito vector species and malaria transmission. METHODS: Adult mosquitoes were caught using the human landing catch (HLC) sampling method in Bouaké. They were collected in six districts representative of the diversity in urban landscapes. Sampling points were selected along the water network crossing the city and monitored from 2020 to 2021 to detect the presence of anopheline larvae. PCR techniques were used to ascertain the species of the Anopheles gambiae complex, Plasmodium falciparum sporozoite infection in a subset of Anopheles vectors, and insecticide resistance mechanisms in Anopheles arabiensis only. RESULTS: A total of 4599 Anopheles mosquitoes were collected and then identified. Anopheles gambiae sensu lato (s.l.) made up the majority of the whole collection (99%) while Anopheles funestus (0.7%), Anopheles ziemanni (0.2%), Anopheles pharoensis (0.2%) represented the remaining proportion of collection. Among the Anopheles gambiae complex, three species were identified namely An. gambiae sensu stricto (45.9%), Anopheles coluzzii (52.2%), and Anopheles arabiensis (1.9%). The first two species had already been collected in Bouaké, however this is the first time that An. arabiensis is reported in Côte d'Ivoire. Anopheles arabiensis was also collected during the larval surveys in a similar proportion (1.1%) in the same areas as the adults. CONCLUSIONS: This study detected the presence of An. arabiensis for the first time in Côte d'Ivoire. This species was found quite far from its usual geographic area and its expansion could be linked to the urbanization process. Although no An. arabiensis was found to be infected by Plasmodium sp., its role in malaria transmission in Bouaké has to be explored, particularly since its exophagic behaviour raises the issue of control measures and the use of insecticide-impregnated nets. The spread of this species in Côte d'Ivoire should be assessed through further research in additional towns in the country.

Severe Cutaneous Adverse Drug Reactions in Children: Epidemiological, Clinical and Etiological Aspects in Dermatology-Venereology Unit at National and Teaching Hospital of Cotonou.

BACKGROUND: The aim of this study was to describe the epidemiological, clinical and etiological aspects of severe cutaneous adverse drug reactions in children in dermatologyvenereology unit at National and Teaching Hospital of Cotonou. METHODS: A retrospective and descriptive study was carried out for 10 years in dermatology-venereology unit at the National and Teaching Hospital of Cotonou to document the epidemiological, clinical and etiological aspects of severe cutaneous adverse drug reactions in children. It included all children aged from 0 to 18 years with clinical diagnosis of severe cutaneous adverse drug reactions. Drug imputability was based on the criteria of the French pharmacovigilance group. RESULTS: Severe cutaneous adverse drug reactions accounted for 47.3% of paediatric cases (35/74 cases). The mean age was 9.3 years ± 5.2. The sex-ratio was 1.1. Self-medication was noted in 76.5% of children, on the initiative of parents in 66.7% of cases. There were 51.4% cases of Steven Johnson syndrome, 22.8% cases of Lyell syndrome, 8.5% cases of generalized and bullous fixed drug eruption, 2.9% cases of acute generalized exanthematous pustulosis and erythrodermic maculo-papular rash. Drug combinations was noted in 20% of cases. Penicillins (26.5%), paracetamol and sulfonamides (16.3%) were the drugs frequently incriminated. CONCLUSION: Steven Johnson syndrome and Lyell syndrome were the main severe cutaneous adverse drug reactions in children, mostly of school age. Penicillins, paracetamol and sulfonamides were the drugs frequently used and administered most often on self-medication.

INTRODUCTION: L'objectif de cette étude était de décrire les aspects épidémiologiques, cliniques et étiologiques des toxidermies graves chez les enfants en dermatologie à Cotonou. METHODES: Une étude rétrospective et descriptive a été réalisée sur 10 ans dans le service de dermatologie du Centre National Hospitalier et Universitaire de Cotonou pour documenter les aspects épidémiologiques, cliniques et étiologiques des toxidermies graves chez les enfants. Étaient inclus tous les enfants âgés de 0-18 ans chez qui le diagnostic clinique de toxidermie grave a été retenu. L'imputabilité médicamenteuse était basée sur les critères du groupe français de pharmacovigilance. RESULTATS: Les toxidermies graves représentaient 47,3% des cas pédiatriques (35/74 cas). L'âge moyen était de 9,3 ans ± 5,2. La sex-ratio H/F était de 1,1. Une automédication a été notée chez 76,5% des enfants, sur l'initiative des parents dans 66,7% des cas. Il y avait 51,4% de cas de syndrome de Steven Johnson, 22,8% de cas de syndrome de Lyell, 8,5% de cas d'érythème pigmenté fixe bulleux étendu, 2,9% de pustulose exanthématique aigüe généralisée et d'exanthème maculo-papuleux eìrythrodermique. Une polymédication a été notée dans 20% des cas. Les pénicillines (26,5%), le paracétamol et les sulfamides (16,3%) étaient les médicaments fréquemment incriminés. CONCLUSION: Le syndrome de Steven Johnson et le syndrome de Lyell étaient les principales toxidermies graves chez les enfants, majoritairement en âge scolaire. Les pénicillines, le paracétamol et les sulfamides étaient les médicaments fréquemment incriminés et administrés le plus souvent en automédication. Mots clés: Toxidermies graves, syndrome de Steven Johnson, syndrome de Lyell, automédication, sulfamides, enfants, Benin.

Exploring the heterogeneity of human exposure to malaria vectors in an urban setting, Bouaké, Côte d'Ivoire, using an immuno-epidemiological biomarker.

BACKGROUND: In some African cities, urban malaria is a threat to the health and welfare of city dwellers. To improve the control of the disease, it is critical to identify neighbourhoods where the risk of malaria transmission is the highest. This study aims to evaluate the heterogeneity of malaria transmission risk in one city (Bouaké) in a West African country (Côte d'Ivoire) that presents several levels of urbanization. METHODS: Two cross-sectional studies were conducted in three neighbourhoods (Dar-es-Salam, Kennedy and N'gattakro) in Bouaké during both the rainy and dry seasons. Data on insecticide-treated net (ITN) use and blood samples were collected from children aged between 6 months and 15 years to determine the parasite density and the prevalence of Plasmodium falciparum and the level of IgG against the Anopheles gSG6-P1 salivary peptide, used as the biomarker of Anopheles bite exposure. RESULTS: The specific IgG levels to the gSG6-P1 salivary peptide in the rainy season were significantly higher compared to the dry season in all neighbourhoods studied (all p < 0.001). Interestingly, these specific IgG levels did not differ between neighbourhoods during the rainy season, whereas significant differences in IgG level were observed in the dry season (p = 0.034). ITN use could be a major factor of variation in the specific IgG level. Nevertheless, no difference in specific IgG levels to the gSG6-P1 salivary peptide was observed between children who declared "always" versus "never" sleeping under an ITN in each neighbourhood. In addition, the prevalence of P. falciparum in the whole population and immune responders was significantly different between neighbourhoods in each season (p < 0.0001). CONCLUSION: This study highlights the high risk of malaria exposure in African urban settings and the high heterogeneity of child exposure to the Anopheles vector between neighbourhoods in the same city. The Anopheles gSG6-P1 salivary peptide could be a suitable biomarker to accurately and quantitatively assess the risk of malaria transmission in urban areas.

[Hearing disorders at the candidates of the National Gendarmerie's competition, Ivory Coast].

Objective: Detect the hearing deficiencies of the candi­da­tes of the gendarmerie's competition. Material and method: Pros­pec­tive study realized over 3 years (2008-2010), in the ENT service of the Gendarmerie to Agban (Abidjan). Examination included an otoscopy and a pure tone audiometry. Results: On 23121 candidates, 1245 had a plug of earwax (5.4%). They were aged from 18 to 25 years old (average age: 22.85 years). Eardrum was pathological in 0.5 % of the cases. Prevalence of hearing loss was 1.5%. Hearing loss included sensorineural hearing loss (56.7%), deafness of transmission (29.4%) and mixed deafness (13.9%). Deafness was unilateral in 79.8% and bilateral in 20.2%. Conclusion: Result of audio­gram will be useful for tracking or assessing cases of noise-induced hearing loss attributable to military service.

Bayesian QTL analyses using pedigreed families of an outcrossing species, with application to fruit firmness in apple.

KEY MESSAGE: Proof of concept of Bayesian integrated QTL analyses across pedigree-related families from breeding programs of an outbreeding species. Results include QTL confidence intervals, individuals' genotype probabilities and genomic breeding values. Bayesian QTL linkage mapping approaches offer the flexibility to study multiple full sib families with known pedigrees simultaneously. Such a joint analysis increases the probability of detecting these quantitative trait loci (QTL) and provide insight of the magnitude of QTL across different genetic backgrounds. Here, we present an improved Bayesian multi-QTL pedigree-based approach on an outcrossing species using progenies with different (complex) genetic relationships. Different modeling assumptions were studied in the QTL analyses, i.e., the a priori expected number of QTL varied and polygenic effects were considered. The inferences include number of QTL, additive QTL effect sizes and supporting credible intervals, posterior probabilities of QTL genotypes for all individuals in the dataset, and QTL-based as well as genome-wide breeding values. All these features have been implemented in the FlexQTL(™) software. We analyzed fruit firmness in a large apple dataset that comprised 1,347 individuals forming 27 full sib families and their known ancestral pedigrees, with genotypes for 87 SSR markers on 17 chromosomes. We report strong or positive evidence for 14 QTL for fruit firmness on eight chromosomes, validating our approach as several of these QTL were reported previously, though dispersed over a series of studies based on single mapping populations. Interpretation of linked QTL was possible via individuals' QTL genotypes. The correlation between the genomic breeding values and phenotypes was on average 90 %, but varied with the number of detected QTL in a family. The detailed posterior knowledge on QTL of potential parents is critical for the efficiency of marker-assisted breeding.

Surveillance for avian influenza and Newcastle disease in backyard poultry flocks in Côte d'Ivoire, 2007-2009.

Between 2007 and 2009, active surveys were conducted on backyard poultry (chickens, guinea fowls and ducks) in four areas of Côte d'Ivoire, including two areas where avian influenza H5N1 outbreaks occurred in 2006. Each bird underwent clinical examination. In total, 5,578 sera, 4,580 tracheal swabs and 5,120 cloacal swabs were collected, plus tissues from 35 sick chickens. Using the haemagglutination inhibition (HI) test, 277 and 36 serum samples were positive for H5 and H7, respectively; all were negative for H9. All samples were negative by reverse transcription polymerase chain reaction. These results confirm the circulation of H5 and H7 influenza subtypes in backyard poultry in Côte d'Ivoire. Given that the seropositive birds were healthy, the circulating subtypes may be low pathogenicity avian influenza strains. Half (2,680) of the sera collected from chickens were tested by HI for Newcastle disease virus (NDV) antibody: 531 were positive. The seroprevalence of 19.8% confirms the endemic status of NDV, but may underestimate its true prevalence in Côte d'Ivoire.

[Practices and Factors Associated with Recent HIV Testing in the General Population, Côte d'Ivoire: Results of the ANRS Study 12323 DOD-CI]. / Pratiques et facteurs associés au dépistage récent du VIH en population générale, Côte d'Ivoire. Résultats de l'étude ANRS 12323 DOD-CI.

With 2.9% of HIV prevalence in the general population, Côte d'Ivoire is one of the countries most affected by the HIV epidemic in West Africa. In this country, only 63% of people infected with HIV are aware of their status. A cross-sectional phone survey was conducted with a representative sample of 3,867 individuals to describe the practices and factors associated with a recent HIV testing (≤ 1 year) in Côte d'Ivoire. Data relative to the last done HIV test as well as the socio-demographic characteristics, sexual behavior, access to information, perceptions, capacities and autonomy as well as social and geographical environment of the participants were collected. Logistical regression models were used to identify the associated factors with a recent HIV test (≤ 1 year). Lack of information is one of the main barriers to HIV testing (only 60% of individuals know a place to get tested). For men, despite the fact that HIV testing is free of charge, poor economic conditions seem to be a barrier to testing. The social environment, including peer influence, also appears to have an effect on testing among men. For women, testing is associated with their perceptions of HIV exposure. There is a need to rethink the current HIV testing communication in Côte d'Ivoire and to identify economic or social incentives to remove access barriers to HIV testing.

Avec 2,9 % de sa population infectée par le VIH, la Côte d'Ivoire fait partie des pays d'Afrique de l'Ouest les plus touchés par l'épidémie à VIH. On estime que seules 63 % des personnes infectées par le VIH connaissent leur statut. Une enquête transversale, par téléphone, a été réalisée auprès d'un échantillon représentatif de 3 867 personnes afin de décrire les pratiques et les facteurs associés à la réalisation récente (≤ 1 an) d'un dépistage du VIH en Côte d'Ivoire. Les données collectées concernaient le dernier test réalisé ainsi que les caractéristiques sociodémographiques, comportements sexuels, accès à l'information, perceptions, capacités, autonomies ainsi que l'environnement social et géographique des participants. Des modèles de régression logistique ont été réalisés afin d'identifier les facteurs associés à la réalisation récente d'un test du VIH (≤ 1 an). Le manque d'information est l'un des principaux freins au dépistage (seuls 60 % des individus connaissent un lieu où réaliser un test). Chez les hommes, malgré la gratuité du dépistage, une faible condition économique semble être un frein à la réalisation d'un test. L'environnement social, notamment l'influence des pairs, semble aussi avoir un effet sur le recours au dépistage chez les hommes. Chez les femmes, le dépistage est associé à leurs perceptions d'exposition au VIH. L'offre de dépistage actuelle en Côte d'Ivoire nécessite de repenser la communication autour du test ainsi que d'identifier des incitatifs économiques ou sociaux permettant de lever les freins au dépistage.

[Characteristics of supposedly bacterial community acute pneumonia among HIV-positive patients: prospective preliminary study]. / Pneumonies communautaires d'allure bactérienne chez le sujet infecté par le VIH : étude préliminaire prospective.

INTRODUCTION: Community-acquired pneumonia (CAP) is the second leading cause of hospitalization in the respirology department in Abidjan after tuberculosis. Frequently associated with HIV infection, it has a high mortality rate of about 20% to 30%. The aim of this study is to identify the specificities and severity factors associated with bacterial CAP (BCAP) outcome in HIV-positive patients. METHODS: The authors conducted a prospective and comparative preliminary study on two groups of patients: 29 HIV-positive patients with BCAP and 21 HIV-negative patients with BCAP. All of the patients were hospitalized for BCAP with symptoms of severity according to the usual score of severity. RESULTS: The sociodemographic, clinical and paraclinical characteristics were similar in both groups. Failures and deaths were more frequent in the group with HIV infection. In particular, HIV infected patients with a body mass index under 18.5 and a rate of T CD4 lymphocytes lower than 200/mm(3) presented the least favourable evolution. CONCLUSIONS: A more extensive study should help define the appropriate severity criteria for BCAP associated with HIV infection.

[Removal of an intratracheobronchial foreign body opaque to X-rays in a child within a context of inadequate medical technical equipment]. / Extraction d'un corps étranger intratrachéobronchique radio-opaque chez un enfant dans un contexte de plateau sous-médicalisé.

Intratracheobronchial foreign bodies are common accidents in children. In developed countries, the removal of these intratracheobronchial foreign bodies is performed with flexible or rigid fiberoptic bronchoscopy. Resorting to surgery is rare. In the inadequate medical context described, suitable medical technical equipment doesn't exist. Removal alternatives are necessary in order to avoid sanitary evacuation which is not always within patients' means. In this study, the authors describe the removal of an intratracheobronchial foreign body opaque to X-rays with foreign body forceps. The forceps, passed through the orotracheal intubation probe, were guided by an image intensification system in a traumatology operating theatre.

[Cephalometric characteristics of black African children 3-6 years of age with nasal obstruction]. / Caractéristiques céphalométriques chez l'enfant mélano-africain âgé de 3 à 6 ans avec obstruction du cavum.

OBJECTIVE: To determine the cephalometric craniofacial characteristic of the child with chronic rhinopharyngeal obstruction. MATERIAL AND METHODS: It is about a comparative cross-sectional study with etiologic aiming including children of the 2 sexes, old from 3 to 6 years. The pathological subjects are represented by those presenting a chronic rhinopharyngeal obstruction due to the presence of hypertrophied tonsils (n = 29) and the "normal" subjects, those without any rhinopharyngeal obstruction (n = 30). Lateral cephalometric radiographs were obtained for each subject. The conventional landmarks were determined with the subject's head in neutral position. The two groups underwent cephalometric measurements. The cephalometric analysis was made starting from conventional landmarks resulting from soft tissues and osseous structures. Various statistical tests (test t of student, test of Kruskal Wallis, test of Mann-Whitney) were used for the exploitation of the cephalometric data. RESULTS: On the skeletal level, the length of the posterior cranial base was shorter at the pathological subjects than at the healthy subjects. Concerning the mandible, the height of the ramus and the length of the mandibular corpus are also weaker at the pathological subjects than at the witnesses. The hyoid bone is further away from the 3rd cervical vertebra and the craniocervical angle is more open at the pathological subjects, representing a modification of the slope of the cervical column. On the level of the rhinopharyngeal space, the average distances from the posterior nasal spine at the posterior edge of the rhinopharyngeal space and between the posterior nasal spine and the posterior base of the base of cranium are respectively of 19,43 +/- 4,78 mm and 37,56 +/- 2,95 mm. These measurements are not significantly different from those described in the literature. CONCLUSION: Our study highlighted skeletal modifications in children presenting a rhinopharyngeal obstruction. Even if they do not justify all the symptoms met, these modifications can represent a readjustment of the pharyngeal corridor aiming at facilitating the flow of airflow.

[Buruli ulcer involving the head: outcomes and therapeutic aspects in 8 cases observed at the University Hospital Center in Abidjan, Cote d'Ivoire]. / Ulcère de Buruli céphalique: huit observations au CHU d'Abidjan, Côte d'Ivoire.

Infection due to Mycobacterium ulcerans or Buruli ulcer usually occurs on the limbs (70%) or trunk (20%). Involvement of the head and neck region is less frequent but can lead to serious sequels. The purpose of this report is to describe 8 patients including 7 children who were treated for Buruli ulcers on the head in the dermatology department of the University Hospital Center in Abidjan, Cote d'Ivoire. Eye lesions and visual impairment were the most frequent sequels.

[Cranio-cervical posture and hyoid-mandibular-pharyngeal equilibrium in the presence of factors related to respiratory dysfunction]. / Posture crânio-cervicale et equilibre hyo-mandibulo- pharyngien en présence de facteurs liés a la dysfonction respiratoire.

AIM: The goal of this study is to know the modifications of the cranio-cervical posture which accompany the functional anomalies by the nasal breathe of black African children. MATERIAL AND METHOD: The study consists of a cephalometric comparison. Sixteen parameters measured on cephalograms of 98 schoolboys from 6 to 15 years were used. The children were divided into two groups according to their usual mode of breathing: 50 mouth-breathing children and 48 nasal breathers. The mode of breathing used three clinical tests: the mirror test, Rosenthal test and nasal reflex. RESULTS: The results show a significant difference of slope the cervical column between the two groups of children (t student). The oral breathers have the rhinopharyngeal airway dimensions more narrowed. The hyoid bone is more distant of the epiglottis and the mandible is more divergent. However, factor analysis of cephalometric variables suggested that craniocervical angulation (C2C4/SN) is independent of the other variables in oral breathers. Its dependence with is clear in nasal breathers. CONCLUSION: The children with predominantly mouth breathing exhibent a cranio-cervical hyperextension which could not closely be associated hyo-mandibulo-pharyngeal equilibrium.

[Retinal detachment surgery: Evaluation of the anatomical success and functional outcomes in a consecutive series of patients operated between 2011 and 2014 at Nantes University Medical Center]. / Chirurgie des décollements de rétine : évaluation du succès anatomique et du devenir fonctionnel sur une série consécutive de patients opérés entre 2011 et 2014 au CHU de Nantes.

OBJECTIVE: Evaluate the anatomical and functional outcomes of retinal detachment (RD) surgery from January 2011 to November 2014. MATERIALS AND METHODS: We conducted a retrospective study of 182 eyes of 175 patients with a minimum follow-up of 6 months, operated for RD at Nantes University Medical Center. It consists of 56 simple RDs and 126 complex RDs treated in first intention by Scleral Buckling (SB), vitrectomy or combined surgery. The analysis is based on anatomic reattachment at the end of a follow-up of at least 6 months after the first surgery and the progression of the best corrected visual acuity (BCVA). RESULTS: One hundred and seventy-two vitrectomies, 15 SB and 5 combined surgeries (vitrectomy+SB) were performed. The overall anatomical success rate after a single operation was 131 eyes (72 %). It increased to 163 eyes (90 %) at the end of the follow-up. Depending on the type of RD, anatomic success at 6 months after surgery was achieved for 47 simple RDs (84 %) and 84 complex RDs (67 %). At the end of the follow-up, after one or more operations, these rates increased to 53 simple RDs (95 %) and 110 complex RDs (87 %). For all RDs with an anatomically successful result, we observed a visual improvement≥2 lines in 45 % of cases and a postoperative BCVA≥5/10 in 40 % of cases. CONCLUSION: This study confirms the evolution toward vitrectomy surgery for retinal detachment. It finds anatomical and functional results consistent with the literature, with a percentage of approximately 5 % of RDs still not reattached in spite of several operations.

Comparative cephalometric study of three different ethnic groups of black Africa with normal occlusion.

INTRODUCTION: The aim of this study was to investigate if there are differences or not between African ethnic groups in order to determine any ethnic and regional differences in the facial morphology. MATERIAL: Lateral cephalograms of 53 young Ivorians, 50 young Senegalese and 62 young Chadians, obtained under the same conditions in each country, were measured. Ten skeletal, eleven dento-skeletal and twelve soft tissue variables were investigated. RESULTS: The comparison of all these parameters (test t student) showed multiple differences between these groups. But, those from Senegal presented with a high degree of protrusion of the upper lip and incisors. Moreover they were strongly hyperdivergent compared to those from Côte d'Ivoire and Chad. The latter showed the least convex soft tissue profile. CONCLUSIONS: There were certain differences in dental, skeletal and soft-tissue facial morphology between the three African populations compared. This study provided a better knowledge of facial morphology in this area of Africa and consequently a better adaptation of the treatment planning of cases requiring orthodontics and orthognathic surgery.

[Amputation of a limb secondary to snakebite in a child]. / Amputation de membre secondaire à une morsure de vipère.

Amputation of a limb is a serious consequence of snakebite poisoning. It is caused by the toxicity of the venom and often the use of a tourniquet in some patients, which can lead to limb ischemia. Management of the victim aims to ensure survival and preserve the function of the bitten limb. Antivenom immunotherapy is the only specific treatment for ophidian envenomation. It is indicated in cases of general symptoms and signs related to the bite, but also if local damage could lead to the loss of limb function. The authors report on a case of snakebite that led to amputation at the thigh.

[Three-dimensional imaging of root axes in patients from X-ray computed tomography slices]. / Visualisation tridimensionnelle des axes radiculaires des dents chez les patients explorés en coupes TDM.

The authors propose to materialize the corono-radicular axes of the teeth starting from their centre of gravity. This last is calculated with the data of the matrix of inertia resulting from the segmentation from tomodensitometric cuts (TDM). The sample is composed of 37 subjects (16 women and 21 men) old from 15 to 65 years, pertaining to a orthomorphic population. The helicoid acquisition of the data is carried out by an apparatus CT Twin Flash (Elscint Haïfa, Israel) on the subjects in decubitus dorsal under 120 kV with 100 mAs. The software C2000 allows the building of the maxillo-facial frame 8 points which becomes the absolute reference mark of the study. The same software allows by thresholding the selection of the teeth on the native cuts. The calculation of their axis of inertia makes it possible to materialize their barycentre. It becomes thus possible to visualize the position and the orientation of each tooth inside the maxillo-facial frame and the intra-reports/ratios and inter-arcades. The observations which result from this introduce interrogations as for the relevance of certain dogmas occlusodontic.

[Comparative diagnosis of bacterial pneumonia and pulmonary tuberculosis in HIV positive patients]. / Diagnostic comparé des pneumopathies bactériennes et de la tuberculose pulmonaire chez les patients VIH.

INTRODUCTION: Immunodepression induced by the human immunodeficiency virus (HIV) modifies the clinical, radiological and microbiological manifestations of pulmonary tuberculosis; leading to similarities between pulmonary tuberculosis and acute community-acquired bacterial pneumonia. A consequence is the high proportion of discordant pre- and post-mortem diagnoses of pneumonia. The aim of our study was to contribute to the improvement in the diagnosis of acute bacterial pneumonia in HIV positive patients in areas where tuberculosis is endemic. METHODS: This retrospective study in HIV positive patients has compared 94 cases of positive smear cases pulmonary tuberculosis and 78 cases of acute community-acquired bacterial pneumonia. RESULTS: Using logistic regression, the following features were positively associated with bacterial pneumonia: the sudden onset of signs (OR=8.48 [CI 95% 2.50-28.74]), a delay in the evolution of symptoms of less than 15 days (OR=3.70 [CI 95% 1.11-12.35]), chest pain (OR=2.81 [CI 95% 1.10-7.18]), radiological alveolar shadowing (OR=12.98 [CI 95% 4.66-36.12) and high leukocytosis (OR=3.52 [CI 95% 1.19-10.44]). These five variables allowed us to establish a diagnostic score for bacterial pneumonia ranging from 0 to 5. The area under the ROC curve was 0.886 [CI 95% 0.84-0.94, P<0.001]). Its specificity was >96.8% for a score of greater than or equal to 4. CONCLUSION: The diagnostic score for acute community-acquired pneumonia may improve the management of bacterial pneumonia in areas where tuberculosis is endemic.

[Clinical, paraclinic and evolutive profile of HIV infected subject compared with that of non-HIV infected subject in pneumology hospitalization at Abidjan]. / Profil clinique, paraclinique et évolutif du sujet infecté par le VIH comparé à celui du sujet non infecté par le VIH en milieu pneumologique hospitalier à Abidjan.

INTRODUCTION: The HIV infection is a problem of public health in Côte d'Ivoire. Voluntary screening is encouraged for the premature management of HIV infected patients before the stage of serious opportunist affections. Antiretroviral therapy became free. The purpose of this study was to describe the characteristics of HIV infected subject infected in hospitalization of pneumology. METHODOLOGY: Our retrospective and analytic study concerned the activity period from January 2001 to December 2012 of pneumology department of Cocody university hospital. RESULTS: On 1141 recorded files, the prevalence of HIV infection was 48.20%. The multi-varied analysis showed the following results. Male patients were less HIV infected (OR=0.490 [0.363-0.661]) as the old patients of more than 64 years (OR=0.150 [0.080-0.280]). In case of HIV infection, infectious pathology, severe anemia and renal insufficiency were dominating respectively with OR=1.763 (1.212-2.564), OR=3.167 (2.125-4.720) and OR=2.054 (1.335-3.161). A stronger mortality was associated with HIV infection (OR=1.920 [1.312-2.809]). CONCLUSION: HIV infection always remains frequented in pneumology hospitalization in Abidjan with late discovery, source of complications and abnormally high death rate.

[Treatment of class I malocclusion with severe dento-maxillary dysharmony in the permanent dentition of young black African patients]. / Traitement de la malocclusion de classe i avec dysharmonie dento-maxillaire severe chez le jeune patient Africain melanoderme en denture permanente.

Class I malocclusion with severe dental crowding can constitute a serious psychosocial and functional damage among young patients; from where orthodontic importance of the treatment. In the present study the authors present the treatment of two clinical cases whose initial problems are similar. They are two cases of class I malocclusion but whose certain diagnosed clinical factors have constrained in a case to control to the maximum anchoring on the level of the molars and in the other to control the dental axes. The final results are satisfactory because of the restoration of a physiological occlusion. Concomitantly we obtain a clear improvement of the smile.