Epidemiology and spatio-temporal distribution of gastrointestinal parasites infection and accuracy of FAMACHA test in sheep in traditional farming systems in Burkina Faso.

Blood and faecal samples from 2086 Sahelian and Djallonke sheep have been collected to assess the epidemiology and spatio-temporal distribution of gastrointestinal parasites. A survey with a questionnaire allowed collecting data on individual animal and farms. Faecal samples were analysed using the McMaster technique, while anaemia was assessed using FAMACHA score test and packed cell volume. The overall prevalence of gastrointestinal parasites was 91%, and strongyles (70.7%), Eimeria sp. (60.4%), Moniezia sp. (5.7%), Stronyloides sp. (0.9%) were identified. There was no significant association between the region and strongyles infection (P ˃ 0.05). Animals sampled during the rainy season (n = 565; P = 82.2%, mean EPG = 154.8 ± 12.02) were mostly and heavily infected than those from the hot dry (n = 518; P = 74.2%; mean EPG = 97.7 ± 17.4) and the cold dry season (n = 392; P = 55.5%; mean EPG = 24.5 ± 19.5) (P ˂ 0.05). Females (n = 1027; P = 72.1%; mean EPG = 77.6 ± 17) were most infected than males (n = 448; P = 67.7%; mean EPG = 61.6 ± 19.5) (P ˂ 0.05). Animals that were treated, at most 3 months before sampling (n = 166; P = 61.5%; mean EPG = 41.7 ± 21.4), were less infected than those, which received this treatment after three months before sampling (n = 199; P = 74.8%; mean EPG = 89.1 ± 15.8) (P ˂ 0.05). Data from blood samples indicate that 6.5% of sheep was anaemic (PCV ≤ 19%), while 59.7% was noted anaemic regarding FAMACHA scores. PCV values varied significantly for FAMACHA scores, and the highest mean value was noted for score 1 (27.6) (P ˂ 0.05). The Cohen's kappa score between FAMACHA and PCV was 0.02. These findings suggest that strongyles infections are significantly associated with season, and heavier infections were noted during rainy season.

[Iron deficiency in adults : to understand what biological evaluation should be carried out]. / Déficit en fer chez l'adulte : comprendre quel bilan biologique réaliser.

Iron is a major mineral in the human body. It participates in various metabolisms, including oxygen transport in hemoglobin. Iron deficiency (ID) is characterized by a deficit in circulating iron. There are two types of ID : 1) absolute ID (AID), in case of decrease in iron reserves and circulating iron, or 2) functional ID (FID), in case of decrease in circulating iron, while reserves are preserved or increased. AID is mainly due to bleeding, usually gastrointestinal, while FID is linked to the inflammatory syndrome. AID is characterized by low serum ferritin and transferrin saturation (TS). Hypochromic microcytic anemia is frequent. FID is characterized by elevated serum ferritin, normal or low TS, and normal sTfR levels. Furthermore, C-reactive protein levels are high, and there is non-regenerative non-macrocytic anemia. New biological tests (serum hepcidin) may be useful in case of doubt. However, they are not yet commonly used.

Le fer, oligoélément capital, participe à divers métabolismes chez l'être humain, dont le transport d'oxygène dans l'hémoglobine. La carence martiale (CM) peut être de deux types : 1) absolue (CMA), en cas de réduction des réserves martiales et du fer circulant, ou 2) fonctionnelle (CMF), avec une réduction du fer circulant et des réserves au contraire préservées ou augmentées. La CMA est principalement secondaire à un saignement, souvent digestif, tandis que la CMF est liée au syndrome inflammatoire. La CMA est attestée par une ferritinémie et un coefficient de saturation de la transferrine (CSTf) abaissés. Une anémie microcytaire hypochrome est fréquente. La CMF se caractérise par une ferritinémie normale ou élevée, un CSTf normal ou abaissé, un taux de récepteurs solubles de la transferrine non élevé, une C-réactive protéine élevée et une possible anémie non macrocytaire arégénérative. De nouveaux biomarqueurs (hepcidine sérique) peuvent être utiles en cas de doute. Cependant, ils ne sont pas encore couramment réalisés.

[Internal Hemorroïd Disease In Digestive Endoscopy Center Of Chu Gabriel Toure Of Bamako]. / La Maladie HemorroïDaire Interne Au Centre D'Endoscopie Digestive Du Chu Gabriel Toure De Bamako.

the goal of this study was to investigate the internal hemorroid disease in our endoscopic center. METHOD: This transversal study went from December 2011 to December 2012. RESULTS: Sixty cases of internal hemorroid desease were enroled with36 men and 24 women and a middle age of 47 ±14.4 years. Clinical signs were frequently: bleeding (66.7%), constipation (58.4%), anal pain (58.3%) and hemorrhoid prolapsed (18.3%). The anal and rectum scopy found only internal hemorrhoid in 78.4% of cases and the grade I was about 81.7% of cases. All patients were beneficied of medical treatement. CONCLUSION: hemorrhoid disease is a frequent pathology in general population mainly around third decade.

le but de ce travail était d'étudier la maladie hémorroïdaire interne. MÉTHODE: Il s'agissait d'une étude transversale déroulée au centre d'endoscopie digestive du CHU Gabriel Touré de Décembre 2011 à décembre 2012. RÉSULTATS: Nous avons colligé 60 cas de maladie hémorroïdaire interne dont 36 hommes et 24 femmes avec un âge moyen de 47 ±14,4 ans. Le tableau clinique était dominé par le saignement (66,7 %), la constipation (58,4 %), la douleur anale (58,3%) et le prolapsus hémorroïdaire (18,3%). L'anorectoscopie réalisée objectivait des hémorroïdes internes isolées dans 78,4% des cas et le stade I de la maladie était observé dans 81,7% des cas. Tous les patients ont bénéficié d'un traitement médical. CONCLUSION: La maladie hémorroïdaire est une pathologie relativement fréquente dans la population générale surtout vers la troisième décade.

[Infection with the Hepatitis B virus in pregnant women in the Gynecology and Obstetrics Department of the Gabriel Touré University Hospital Center]. / L'Infection par le virus de L'Hepatite B chez la femme enceinte dans le service de Gynecologie-Obstetrique du Centre Hospitalo-Universitaire Gabriel Toure.

PURPOSE: The purpose of this study was to study hepatitis B virus infection in pregnant women. METHOD: This was a one-year descriptive cross-sectional study carried out in the Gynecology-Obstetrics Department of the Gabriel Touré University Hospital. RESULT: During this period, 796 pregnant people were seen in antenatal consultations. Ween rolled 500 pregnant women in whom the search for HBs Ag was carried out, a rate of 62.81%. Of these pregnant 85 had HBs Ag a prevalence of 17%. The average age of these women was 26.9±5.6 years. Our patients were paucipare sin 52.9%. Of these, 17.7% had a family history of chronic liver disease and 37.6% had once given birth in a referral health centre. Blood transfusion, polygamous focus and tattooing/scarification were the risk factors associated with HBs Ag carriage. Alarming clinical signs were absent in 95.2% of cases. Hepatic cytolysis and anaemia were foundin 28.8% and 76.3% of cases respectively; viral replication was observed in 13.6% of pregnant women with a high viral loadin 37.2%. Abdominal ultra sound was normal in 90.8% of cases and esophageal varices were present in 6% of women who performed eso-gastroduduedenal fibroscopy. Fibrosis was significant according to an APRI score in 3.4%. CONCLUSION: The prevalence of HBs A in pregnant women followed remains high.

BUT: Le but de cette étude était d'étudier l'infection par le virus de l'hépatite B chez la femme enceinte. METHODE: Il s'agissait d'une étude transversale descriptive sur un an réalisée au service de Gynécologie-Obstétrique du CHU Gabriel Touré. RESULTAT: Durant cette période, 796 gestantes ont été vues en consultation prénatale. Nous avons enrôlé 500 femmes enceintes chez qui la recherche de l'Ag HBs a été effectuée soit un taux de 62,81%. Parmi ces gestantes 85 avaient l'Ag HBs soit une prévalence de 17%.L'âge moyen de ces femmes était de 26,9±5,6 ans. Nos patientes étaient des paucipares dans 52,9%. Parmi elles 17,7% avaient un antécédent familial d'hépatopathie chronique et 37,6% avaient une fois accouché dans un centre de santé de référence. La transfusion sanguine, le foyer polygamique et le tatouage/scarification étaient les facteurs de risque associés au portage de l'Ag HBs. Les signes cliniques alarmants étaient absents chez 95,2% des cas. Une cytolyse hépatique et une anémie étaient retrouvées chez respectivement 28,8% et 76,3% des cas ; une réplication virale était observée chez 13,6% des gestantes avec une charge virale élevée chez 37,2%. L'échographie abdominale était normale dans 90,8% des cas et les varices œsophagiennes étaient présentes chez 6% des femmes ayant réalisé la fibroscopie œsogastroduodénale. La fibrose était significative selon un score APRI chez 3,4%. CONCLUSION: La prévalence de l'AgHBs chez les gestantes suivies reste élevée.

[Epidemiology and prognosis aspects of upper gastrointestinal bleeding of NianankoroFomba hospital in segou]. / Aspects epidemiologiques et pronostiques des hemorragies digestives hautes a l'hôpital Nianankoro Fomba(HNF) de segou.

AIMS: The goal of our work was to clarify the epidemiologicals, clinicals, etiologicals and prognostics of upper gastrointestinal bleeding at Segou Regional Hospital. PATIENTS AND METHODS: This cross-sectional study, which took place from October 1, 2017 to September 31, 2018, involved patients hospitalized for digestive hemorrhage. RESULTS: Upper gastrointestinal bleeding represented 9.7% of all hospitalizations. The mean age of the patients was 50, 94 ± 21, 6 years with a sex ratio of 1.6 in favor of men. Housewives and farmers were represented in 37.7% and 34% of cases. The main modes of disclosure were hematemesis and melena. Evolution was favorable with a mortality of around 34%. CONCLUSION: upper gastrointestinal bleeding is relatively common in our context. High mortality is linked to delayed treatment.

BUT: Le but de notre travail était de préciser lesaspects épidémiologiques, cliniques, étiologiques et pronostiques de l'hémorragie digestive haute à l'Hôpital Régional de Ségou(HRS). PATIENTS ET MÉTHODES: Cette étude transversalequi s'était déroulée du 1eroctobre 2017 au 31 septembre 2018 a concernéles patients hospitalisés pour hémorragie digestive. RÉSULTATS: Les hémorragies digestives hautes ont représenté 9,7% de l'ensemble des hospitalisations. L'âge moyen des patients était de 50,94 ± 21,6 ans avec un sex ratio de 1,6 en faveur des hommes. Les femmes au foyer et les cultivateurs étaient représentés dans 37,7% et 34% des cas. Les principaux modes de révélation étaient l'hématémèse et le méléna. L'évolution était favorable avec une mortalité de l'ordre de 34%. CONCLUSION: Hémorragie digestive haute est relativement fréquente dans notre contexte. Cependant, la mortalité élevée est liée à un retard de prise en charge.

[Helicobacter pyloriinfection and gastric mucosa in cirrhotic patient]. / Infection a helicobacter pylori et muqueuse gastrique chez le cirrhotique.

The goal of this work was to study helicobacter pylori (HP) infection and gastric mucosa in cirrhotic patient. METHOD: The study was comparative (case-indicator) and transversal from October 2015 to June 2016 in the gastroenterology and hepatology center of CHU Gabriel Touré of Bamako. Hp was identified in pathologic center of CHU du point "G" de Bamako. RESULTS: At the end of the study Hp infection frequency was 73.6% without significative differency with the comparative group (p= 0,200). The mean age was 46,3 ± 20,8 years. The sex ratio was 2,11. The home workers women were more represented (32.1%). Ascites and jaundice were the main signs respectively in 64.3% and 53.6% cases. The upper endoscopy found varices in 89.2% of cases. His worsen histological lesions were mucosal atrophy (17.8%) and intestinal metaplasy (14.2%). CONCLUSION: Helicobacter pylori infection is frequent in cirrhotic patient in our country with sometimes worsen histological lesions.

Le but de ce travail était de déterminer les lésions de la muqueuse gastrique associées à l'infection à Helicobacter pylori chez le cirrhotique. MÉTHODE: Il s'agissait d'une étude comparative (cas-témoins) transversale à recrutement consécutif de patients d'octobre 2015 à juin 2016 dans le service d'Hépato-Gastroentérogie du CHU Gabriel Touré de Bamako. La recherche de l'Helicobacter pylori (Hp) a été faite dans le service d'anatomie pathologique du CHU du Point G. RÉSULTAT: Au terme de cette étude la fréquence de l'infection à Hp chez le cirrhotique a été de 73,6% sans différence statistiquement significative avec la population témoin (p= 0,200). L'âge moyen des patients était de 46,3 ±20,8 ans. Le sex ratio était de 2,11. Les femmes au foyer étaient les plus représentées (32,1%). L'ascite et l'ictère ont dominé le tableau clinique avec respectivement 64,3% et 53,6%. La fibroscopie oeso-gastroduodénale réalisée objectivait les varices œsophagiennes et/ou cardio-tubérositaires dans 89,2%des cas. Les lésions histologiques graves étaient associées à la présence de Hp avec 17,8% d'atrophie de la muqueuse gastrique et 14,2% de métaplasie intestinale. CONCLUSION: L'infection à Hp est aussi fréquente dans notre contexte chez le cirrhotique avec parfois des lésions histologiques sévères.

[Epidemiology of anguillulosis among public school children in Abidjan, Cote d'Ivoire]. / Epidémiologie de l'anguillulose chez les enfants scolarisés à l'école publique à Abidjan (Côte d'Ivoire).

PURPOSE: Strongyloides stercoralis is a neglected soil-transmitted helminth species. In Cote d'Ivoire, as elsewhere, there is a lack of parasitologic and epidemiologic data pertaining to this parasite. The purpose of this study was to evaluate the prevalence and impact of sociodemographic factors on anguillulosis among public school children in Abidjan, Cote d'Ivoire. METHODS: Testing for Strongyloides stercoralis was performed in a random sample of 411 children from 10 public primary schools in Abidjan. Detection methods included direct examination of stool smears, the Baermann test and helminth coproculture study. RESULTS: The overall prevalence of anguillulosis was 2.7% (N=411) (IC95% = 1.34-4.73). The M/F sex-ratio was 1. No correlation was found between prevalence and sex (p = 0.12). Prevalence was higher among children who reported contact with swamps and rivers (respectively 80% and 7.9%) than those who did not report such contact (respectively 1.7% and 1.5%) (p <0.01). CONCLUSION: Contact with swamps and rivers is correlated with an increase in anguillulosis prevalence. Avoiding these areas and proper sanitation could help to reduce the prevalence of anguillulosis in Abidjan.

[Endoscopic And Therapeutic Aspects Of The Colo-Rectal Polyps At The Gabriel Toure Hospital And At The "Promenade Des Angevins" Clinic In Bamako]. / Aspects Endoscopiques Et Therapeutiques Des Polypes Colo-Rectaux Au CHU Gabriel Toure Et A La Clinique « Promenade Des Angevins ¼ De Bamako.

INTRODUCTION: The term polyp refers to any relief formation on the digestive mucosa.The therapeutic endoscopic polypectomy is an effective method to colorectal polyp resection. OBJECTIVE: The maingoal of this work is to study the endoscopic aspects of colo-rectal polyps and to bring our experience on their treatment with endoscopic polypectomy. PATIENTS AND METHOD: Our study was retrospective and descriptive from January 2013 to December 2017 in the endoscopic centers of hepato-gastroenterology department of CHU Gabriel Touré and clinic of "Promenade des angevins". The study concerned in whom polypectomy was performed. RESULTS: A total of 49 patients were included in our study. The main age of our patients was 26.2 2±1.7 years and the sex-ratio was 3.9. The sessile polyps were more frequents with 53.1%. The average size of polyps was 8.7±3.7 mm. The rectum localization was more reported (40.8%). All polyps(100%) were resected in monoblock and we used diathermol cove in 57.1% patients and the cold clamp in 42.9%. Histologically, we had 18 cases of hyperplasia (36.7%), 8 cases of tubulous adenoma (16.3%), 2 cases of tubulo-vilous adenoma (4.1%) and 2 cases of juvenil adenoma (4.1%). One patient was died by perforation five days after the polypectomy. CONCLUSION: The frequency of colorectal polyps is not negligible in our context.Endoscopic colorectal polypectomy is effective therapeutic method for resection of colorectal polyps.

INTRODUCTION: Le terme de polype désigne toute formation en relief sur la muqueuse digestive. La polypectomie endoscopique thérapeutique est la technique de choix pour la résection des polypes colo-rectaux. OBJECTIF: Le but de ce travail est d'étudier les aspects endoscopiquesdes polypes colo-rectaux et d'apporter notre expérience sur leur traitement par la polypectomie endoscopique. PATIENTS ET MÉTHODE: Notre étude descriptive et rétrospective s'est déroulée de janvier 2013 à décembre 2017 à l'unité d'endoscopie du service d'hépato-gastroentérologie du CHU Gabriel Touré et à la clinique promenade des angevins de Bamako.Elle a porté sur les patients adressés pour endoscopie digestive basse.Ont été inclus dans l'étude tous les patients ayant un ou des polypes(nombre < 10) à l'endoscopie et chez qui une polypectomie a pu être réalisée. RÉSULTATS: Au total 49 patients ont été inclus dans notre étude. L'âge moyen de nos patients était de 26,2 ±21,7 ans et lesex-ratio était de 3,9. Les polypes sessiles étaient les plus fréquents soit 53,1%. La taille moyenne des polypesétait de 8,7 ±3,7mm. Le rectum était le siège le plus fréquemment atteint (40,8%). Pour la polypectomie, 100% des polypes ont été reséqués en monobloc et nous avons utilisé l'anse diathermique chez 57,1% des patients et l'anse ou la pince froide chez 42,9%. Sur le plan histologique, nous avons eu 18 cas d'hyperplasie (36,7%), 8 cas d'adénome tubuleux (16,3%), 2 cas d'adénome tubulo-villeux (4,1%) et 2 cas d'adénome juvénile (4,1%). Nous avons enregistré un cas de décès survenu dans un tableau de perforation constatée cinq jours après la polypectomie. CONCLUSION: La fréquence des polypes colorectaux n'est pas négligeable dans notre contexte. La polypectomie endoscopique est un moyen thérapeutique efficace pour le traitement des polypes colo-rectaux.

Pediculosis capitis in Abidjan, Côte d'Ivoire: Epidemiological profile and associated risk factors.

Pediculosis capitis (PC) is a parasitic infestation, common in children's communities caused by Pediculus humanus capitis. Various factors including infestation-related stigma, treatment cost and health risks make this infestation deserves special attention. This study aims to determine epidemiological profile of pediculosis capitis twenty years after the last study in Abidjan, Côte d'Ivoire. An epidemiological cross-sectional survey was carried out from April to June 2018 across 40 public primary schools in the ten districts of Abidjan. Data from schoolchildren and parents and/or guardians were collected using a pretested questionnaire after agreement and signature of the informed consent form. Head lice were identified visually with a magnifying glass, and then collected using fine combs and hairbrushes. The positive diagnosis was made by the detection of living lice in the hair. Of the 4, 805 included participants, 28 (0.58%) were hosting living lice in hair. Analysis of associated factors showed that gender related-status was associated with PC. In this case, girls were more affected than boys (p=0.018). Plateau, Treichville and Port Bouët municipalities were the most affected (p=0.018). The length hair was associated with the occurrence of PC (p<0,001). Schoolchildren from families with low monthly income was most infected by PC (p=0.023). Some parameters such as promiscuity and collective use of washing facilities and bedding, were not found to be associated to head lice infestation. This study shows a drastic decrease of PC prevalence in Abidjan corresponding to 97%. This could be due to the improvement in the quality of life and education of the population of Abidjan. The establishment of hygiene committees and the teaching of basic hygiene practices from the first school years have contributed to these achievements. Maintaining these measures will contribute to the sustainable elimination of CP among children in Abidjan.

Humoral and cell-mediated immunity to MSP3 peptides in adults immunized with MSP3 in malaria endemic area, Burkina Faso.

We performed a single-blind, randomized phase 1 trial of the long synthetic peptide (LSP) of merozoite surface protein-3 (MSP3) in adults living in Burkina Faso. Thirty eligible volunteers were randomized to receive either the MSP3-LSP candidate vaccine or tetanus toxoid vaccine as a control. A dose of each vaccine was administered on days 0, 28 and 112 and the vaccine was formulated with aluminium hydroxide. Humoral immune responses were assessed by ELISA at days 0, 28, 56, 112, 140, 252 and 365 and cell-mediated immune responses by lymphoproliferation assay and by ELISA on days 0, 56 and 140. IgG responses to four peptides of MSP3 were similar in both vaccine groups. Higher IgG concentrations were recorded after the beginning of malaria high transmission season in both vaccine groups. The lymphocyte proliferation and the production of IFN-gamma in response to stimulation with the four overlapping peptides increased following vaccination in the MSP3-LSP vaccine group, but did not change appreciably in the control group. In contrast to natural infection, MSP3-LSP did not boost humoral responses to the four overlapping peptides of MSP3 to any detectable degree in our semi-immune adult. MSP3-LSP may be more immunogenic in young children with little or no acquired immunity.

[About an autochtonous case of neurocysticercosis in Mali]. / A propos d'un cas autochtone de neurocysticercose au Mali (premier cas de la littérature?).

Cysticercosis has been reported in Muslim countries in workers coming from endemic regions for Taenia solium. For the first time in Mali, the authors report a case of autochtonous neurocysticercosis where Muslim religion is predominent. The patient was a woman student with fever, arthralgia, headaches, consciousness troubles followed by partial motor epilepsy. Diagnosis was confirmed by clinic, serology ELISA and Western blotting and cephalic tomodensitometry analysis. The medical treatment was successfully based on combination of albendazole and praziquantel. The origin of contamination remains unknown and further investigations are needed, particularly with veterinary research team and the National League against epilepsy recently founded in Mali.

[Change of antimalarial first-line treatment in Burkina Faso in 2005]. / Les raisons d'un changement de médicaments de première intention pour le traitement du paludisme simple au Burkina Faso en 2005.

Burkina Faso has recently changed the antimalarial drug policy to artesunate/amodiaquine or artemether/lumefantrine as the first-line antimalarial drug and sulfadoxine/pyrimethamine for the intermittent preventive treatment in pregnant woman. Before the implementation of this new strategy we conducted an in vivo efficacy study with chloroquine or sulfadoxine/pyrimethamine for treatment of uncomplicated Plasmodium falciparum malaria in urban area of Burkina from September to December 2003. Chloroquine (25 mg/kg over 3 days) or sulfadoxine/pyrimethamine (25 mg/kg + 0.025 mg/kg single dose) was administered respectively to 137 and 125 children aged from 6 to 59 months old in a randomized, opened study. Follow up extended over 28 days using modified WHO protocol. After adjusting the results by PCR, treatment failures rates were 63.4% (83/131) and 13.8% (17/123) respectively for chloroquine and sulfadoxine/pyrimethamine. These results with other observations have justified the change of malaria therapy policy in Burkina Faso in 2005.

Recurrent vulvo-vaginal candidiasis in Abidjan (Côte d'Ivoire): Aetiology and associated factors.

Recurrent vulvovaginal candidiasis (RVVC) is a major health problem for sexually active women because of its severe effect on their quality of life. A thorough knowledge of their epidemiology leads to their efficient management. Therefore, a cross-sectional study was conducted in 2014 in women with leucorrhoea associated or not with other clinical signs. Recurrence was based on the occurrence of at least four annual episodes of Candida vulvo-vaginitis. An individual interview based on a questionnaire was conducted to identify the socio-demographic parameters that could be associated with the RVVC. Vaginal samples were collected at the obstetrical gynaecology department of the University Hospital of Cocody and at the Pasteur Institute of Côte d'Ivoire. On each sample, a direct examination and culture on Sabouraud-chloramphenicol medium with or without actidione were performed. Yeast identification was performed using chromogenic media (CandiSelect®4 [Bio-Rad]) and the study of sugar assimilation using the Auxacolor® 2 gallery (Bio-Rad). A total of 400 patients were included. The average age was 29.2 years (SD=7.2 years). Of these, 94 had recurrent vulvovaginal candidiasis, with a prevalence of 23.5% (CI95%: 19.49-28.02). Five species of the genus Candida have been identified: Candida albicans (59.6%), Candida glabrata (19.1%), Candida tropicalis (16%), Candida krusei (4.2%) and Candida inconspicua (1.1%). Some factors such as education level, history of sexually transmitted infection, type of underwear used, frequency of personal hygiene and type of product used for these hygiene have been associated with the occurrence of RVVCs. The occurrence of RVVCs is relatively high in our study population. Non-albicansCandida species occupy a significant place in this disease epidemiology. By addressing the factors associated with the occurrence and/or persistence of RVVCs, it will be possible to reduce their incidence in sexually active women.

Interferon regulatory factor-1 polymorphisms are associated with the control of Plasmodium falciparum infection.

We describe the haplotypic structure of the interferon regulatory factor-1 (IRF-1) locus in two West African ethnic groups, Fulani and Mossi, that differ in their susceptibility and immune response to Plasmodium falciparum malaria. Both populations showed significant associations between IRF-1 polymorphisms and carriage of P. falciparum infection, with different patterns of association that may reflect their different haplotypic architecture. Genetic variation at this locus does not therefore account for the Fulani-specific resistance to malaria while it could contribute to parasite clearance's ability in populations living in endemic areas. We then conducted a case-control study of three haplotype-tagging single nucleotide polymorphisms (htSNPs) in 370 hospitalised malaria patients (160 severe and 210 uncomplicated) and 410 healthy population controls, all from the Mossi ethnic group. All three htSNPs showed correlation with blood infection levels in malaria patients, and the rs10065633 polymorphism was associated with severe disease (P=0.02). These findings provide the first evidence of the involvement in malaria susceptibility of a specific locus within the 5q31 region, previously shown to be linked with P. falciparum infection levels.

Do antibody responses to malaria vaccine candidates influenced by the level of malaria transmission protect from malaria?

OBJECTIVES: To examine whether the humoural response to malaria vaccine candidate antigens, Plasmodium falciparum [circumsporozoite repetitive sequence (NANP)(5) GLURP fragments (R0 and R2) and MSP3] varies with the level of malaria transmission and to determine whether the antibodies (IgG) present at the beginning of the malaria transmission season protect against clinical malaria. METHODS: Cross-sectional surveys were conducted to measure antibody response before, at the peak and at the end of the transmission season in children aged 6 months to 10 years in two villages with different levels of malaria transmission. A cohort study was performed to estimate the incidence of clinical malaria. RESULTS: Antibodies to these antigens showed different seasonal patterns. IgG concentrations to any of the four antigens were higher in the village with high entomological inoculation rate. Multivariate analysis of combined data from the two villages indicated that children who were classified as responders to the selected antigens were at lower risk of clinical malaria than children classified as non-responders [(NANP)(5) (incidence rate ratio (IRR) = 0.65, 95% CI: 0.46-0.92; P = 0.016), R0 (IRR = 0.69, 95% CI: 0.48-0.97; P = 0.032), R2 (IRR = 0.73, 95% CI: 0.50-1.06; P = 0.09), MSP3 (IRR = 0.52, 95% CI: 0.32-0.85; P = 0.009)]. Fitting a model with all four antibody responses showed that MSP3 looked the best malaria vaccine candidate (IRR = 0.63; 95% CI: 0.38-1.05; P = 0.08). CONCLUSION: Antibody levels to the four antigens are affected by the intensity of malaria transmission and associated with protection against clinical malaria. It is worthwhile investing in the development of these antigens as potential malaria vaccine candidates.

[Neuromeningeal cryptococcosis in non-HIV patients to CHU ward of Point G in Bamako (Mali): 3 case report]. / Cryptococcose neuroméningée chez des patients VIH négatif au CHU du Point G de Bamako (Mali): à propos de trois observations cliniques.

We report 3 clinical observations of neuromeningeal cryptococcosis which occurred without any immunodepression related to HIV infection. Our patients were male. They did not present any particular medical history indicating a diagnosis of cryptococcosis. Nevertheless we found a professional exposure to the risk of inhalation of C. neoformans capsules. The diagnosis was based on presence of encapsulated yeast of Cryptococcus in the direct exam by China ink and culture on Sabouraud medium. CD4 lymphocytic count was done in two patients (case 1:899 cells/mm3; case 2:347 cells/mm3). Idiopathic lymphocytopenia was noted in one case. Co-morbidity of 5. pneumoniae meningitis was reported in one patient (case 3). Treatment was based on injectable amphotericin B in monotherapy (case 1), followed by perfusion of fluconazole cure (case 2). Case 3 was treated by perfusion of amphotericin B associated with ceftriaxone (case 2). No secondary prophylactic treatment was administered. Evolution was favorable after follow-up of 5 years (case 1) and of 4 years (case 2). The third patient died during hospitalization.

[Comparative impact of three malaria preventive regimens during pregnancy on maternal anemia due to malaria in Burkina Faso]. / Impact comparatif de trois schémas de prévention du paludisme pendant la grossesse sur l'anémie maternelle, associée à l'infection palustre au Burkina Faso.

OBJECTIVES: The main objective of this study was to compare the efficacy of three regimens of malaria prevention during pregnancy for the reduction of anemia between the first and third antenatal consultations. The first treatment arm was the classical weekly chemoprophylaxis with chloroquine; the other two were the intermittent preventive treatment using either three doses of chloroquine or sulfadoxine-pyrimethamine. DESIGN: We conducted an open, randomized, three-arm study in a rural district of Burkina Faso. A cohort was constituted by 648 pregnant women of any parity. RESULTS: The hemoglobin gain was more significant with the intermittent preventive treatment using sulfadoxine-pyrimethamine compared to the other treatment arms. The hemoglobin increased from 10.3g/dl (at the first antenatal consultation) to 11.4 g/dl (at the third antenatal consultation). In the three arms of treatment, the chemoprophylaxis reduced the prevalence of moderate anemia and severe anemia. The reduction of moderate anemia was more substantial in the sulfadoxine-pyrimethamine arm (65.6 to 36.7%) at second antenatal consultation (p=0.069) and third antenatal consultation (p=0.014). Conversely, in the two chloroquine arms, there was no significant reduction either at second antenatal consultation (p=0.72) or third antenatal consultation (p=0.55). The prevalence of peripheral parasitemia decreased in all treatment groups. However, it was significantly higher in the sulfadoxine-pyrimethamine group (44.3%). CONCLUSIONS: Intermittent preventive treatment with three doses of sulfadoxine-pyrimethamine is a more effective strategy to prevent maternal anemia during pregnancy in Burkina Faso.

[Evaluation of "SD Bioline Malaria Antigen pf® (HRP2)" test in Plasmodium falciparum malaria diagnosis in child at the Yopougon teaching hospital (Côte d'Ivoire)]. / Evaluation du test « SD Bioline Malaria Antigen pf ® (HRP2) ¼ dans le diagnostic du paludisme à Plasmodium falciparum de l'enfant au CHU de Yopougon (Côte d'Ivoire).

Evaluation of "SD Bioline Malaria Antigen Pf ® (HRP2)" test for the confirmation of children's Plasmodium falciparum malaria in a hospital setting. In the present study, a Rapid Diagnostic Test (RDT) for the diagnosis of malaria has been compared to the thick smear in 243 children suspected with malaria in Youpogon's University Hospital pediatrics' consultation and emergency room from the 1st of February to November 11, 2016. Conformity between the two exams was observed in 90.5% of the cases (p=0.01). Factors which statistically influenced the RDT's reliability were children's age, presence of difficulty in breathing (p=0.046) and extreme parasitaemia (too high or too low) (p=0.0096). Diagnostic performances were the following, sensitivity: 92.7%, specificity: 87.1 %, positive predictive value: 87.1%, negative predictive value: 88 %, positive likelihood ratio: 7.2 and negative likelihood ratio: 0.1. Authors insist on the necessity of a permanent access to RDT when a thick smear cannot be done in reference sanitary systems. However, caution is needed concerning RDT's results in children less than 6 months old and those who had low or large parasitaemia.

Dans la présente étude, un test de diagnostic rapide (TDR) du paludisme a été évalué par rapport au Gold standard qu'est la goutte épaisse (GE) chez 243 enfants présumés impaludés en consultation et aux urgences de pédiatrie du CHU de Yopougon du 1er février au 11 novembre 2016. L'objectif était d'étudier les performances du test et de proposer un algorithme d'utilisation des TDR en milieu hospitalier pour une prise en charge précoce des enfants souffrant de paludisme en l'absence de GE disponible. Les deux examens concordaient dans 90,5 % des cas (p = 0,01). Les facteurs qui ont statistiquement influencé la fiabilité du TDR étaient l'âge (taux de discordances d'avec la goutte épaisse plus important chez les moins de 6 mois), la présence de signes de lutte respiratoire à l'examen physique (p = 0,046) et les parasitémies extrêmes (très élevées ou faibles) (p = 0,0096). Le TDR avait une sensibilité de 92,7 %, une spécificité de 87,1 %, une valeur prédictive positive de 87,1 %, une valeur prédictive négative de 88 %, un rapport de vraisemblance positive de 7, 2 et un rapport de vraisemblance négative de 0,1. En raison de ses performances satisfaisantes, le TDR représenterait une aide substantielle rapide en cas de difficulté de réalisation d'une GE aussi bien en milieu hospitalier que dans les centres de premier recours. Son interprétation doit toutefois rester prudente chez les enfants de moins de 6 mois et devant des parasitémies trop faibles ou trop fortes.

[Uper Digestive Tractus Caustic Injuries In Adult Patient In Bamako: Epidemiological, Semiological And Prognostic Aspects]. / Brulures Caustiques Du Tractus Digestif Superieur Chez L'Adulte A Bamako : Aspects Epidemiologiques, Semiologiques Et Pronostiques.

The main objective of this longitudinal and prospecting study from February 2013 to January 2014 was to analyze uper digestive tractus caustic injuries in adult patients at the service of gastroenterology of CHU Gabriel Touré Bamako-Mali. PATIENTS AND MÉTHOD: We include patients (age more than 16 years) hospitalized for digestive caustic injuries. RESULTS: During the period a hospital frequency was 2.1% (20/970). The mean age was about 33.1 ± 9 years. Over toxic substances was discovered in 45 % of patients. The caustic ingestion was intentional in 18 patients. Psychoaffective disorders were the main reason of caustic consumption. At the entry haematemesis was the main sign. The endoscopic lesions were in majority at stage IIIb of the Zargar et al classification. A case of inhalation pneumonia, a case of digestive perforation and 6 cases of digestive obstruction were the main complications of the caustics injuries. Early death was found in 3 patients. CONCLUSION: Upper digestive tractus caustic injuries are more and more met in our context. Preventive measures are necessary to prevent these serious lesions.

Le but principal de ce travail longitudinal, prospectif s'étendant de Février 2013 à Janvier 2014 était d'étudier les brûlures caustiques du tractus digestif supérieur dans le service d'hépatogastroentérologie du CHU Gabriel Touré de Bamako-Mali. PATIENTS ET MÉTHODES: Cette étude a porté sur tous les patients âgés de 16 ans ou plus hospitalisés pour ingestion de produit caustique prouvée. RÉSULTATS: Pendant la période d'étude une fréquence hospitalière de 2,1% a été retrouvée. La moyenne d'âge était de 33,05± 9,012 ans avec un sex ratio de 9. La prise de toxique a été retrouvée chez 45% des patients. L'ingestion était volontaire chez 18 malades. Un choc psychoaffectif était le principal motif de l'ingestion. A l'admission les signes étaient dominés par l'hématémèse. Les lésions endoscopiques étaient majoritairement au stade IIIb de la classification de ZARGAR. Un cas de pneumopathie d'inhalation, un cas de perforation digestive et 6 cas de sténoses ont compliqué les brûlures caustiques. Il y a eu 3 décès précoces. CONCLUSION: Les brûlures caustiques du tractus digestif supérieur sont de plus en plus rencontrées dans notre contexte. Des mesures préventives s'imposent pour espérer diminuer sa prévalence.

[Hepatic Amoebic Abscess: Clinical Aspects And Prognosis At CHU De Gabriel Touré De Bamako]. / L'Abces Amibiens Du Foie : Aspects Cliniques Et Evolutifs Au CHU Gabriel Toure De Bamako.

The main goal of this study was to analyze hepatic amoebiasis abscess at the service of gastroenterology of CHU Gabriel Touré, Bamako- Mali. MATERIAL AND METHOD: It was longitudinal and prospective study from January 2013 to February 2014 and concerned patients having hepatic abscess diagnosed by echography and amoebic serology or chocolate pus finding. RESULT: During the study the frequency of disease was 2.4% (24/970). The sex-ratio was 2 with a mean age of 36.8±10.9 years. Smoking was observed in 58.8% of cases. Abdominal pain, fever and hepatomegaly were found respectively in 87.5%, 83.3% and 79.3% of patients. The abscess was mainly located in right lobe. HIV serology was performed among 18 patients and was negative in all cases. The medical treatment by the metronidazol was systematically proposed and was associated to abscess tap in 42.2% of patients. A total recovery was observed in 23 patients and 1 patient was died by abscess rupture in the peritoneum. CONCLUSION: An early management cans evord complication.

Le but principal de ce travail était de décrire les aspects cliniques et évolutifs des abcès amibiens du foie dans le service d'hépato-gastroentérologie du CHU Gabriel Touré, Bamako-Mali. MATÉRIEL ET MÉTHODE: Cette étude longitudinale prospective étalée sur une période de 14 mois de janvier 2013 en février 2014 a porté sur les patients ayant un abcès du foie retenu sur la présence d'un abcès à l'échographie associée à une sérologie amibienne positive et/ou une ponction de l'abcès ramenant un pus chocolat. RÉSULTAT: Pendant la période d'étude une fréquence hospitalière de 2,4% a été retrouvée. Le sex ratio était de 2 avec un âge moyen de 36,8 ± 10,9 ans et des extrêmes de 20 et 62 ans. La prise de toxique (tabac et alcool) a été observée dans 58,8% des cas. La douleur abdominale, la fièvre et l'hépatomégalie ont été retrouvées respectivement chez 87,5%, 83,3% et 79,3% des patients. L'abcès le plus souvent unique était localisé sur le lobe droit à l'échographie. La sérologie VIH réalisée chez 18 patients était négative dans tous les cas. Le traitement médical par le métronidazole était systématiquement proposé associé à une ponction évacuatrice chez 54,2% des patients. L'évolution était favorable chez 23 patients et 1 décès par rupture de l'abcès dans le péritoine. CONCLUSION: La prise en charge précoce permet d'éviter les complications.