[Albert Calmette (1863-1933). Description of the BCG vaccine inventor's stay in Gabon]. / Albert Calmette (1863-1933) quand l'inventeur du BCG était au Gabon.

The purpose of this article is to describe Albert Calmette's stay in Gabon from October 1886 to November 1887. During his year in Africa, this illustrious French navy physician who was to invent the BCG vaccine against tuberculosis was keenly interested in malaria and sleeping sickness.

[Covid-19 in Côte d'Ivoire (March 2020 - April 2021) a year under the seal of the Coronavirus]. / La Covid-19 en Côte d'Ivoire (mars 2020 - avril 2021) une année sous le sceau du coronavirus.

After a year of coronavirus epidemic, Côte d'Ivoire is completing a third wave of Covid-19. Although the epidemic has been confined mainly to Greater Abidjan, thanks in particular to the isolation measures imposed on the Ivorian economic capital, the impact of the health crisis has nevertheless been marked. Like other West African countries, Côte d'Ivoire did not experience the epidemic tsunami that some predicted in March 2020, but more than 45 000 cases and nearly 300 deaths have been reported, although these figures underestimate the epidemiological reality. With the advent of vaccination, Côte d'Ivoire hopes to control the epidemic, but the possible circulation of variants, particularly South African variants, and the difficulties in obtaining vaccine doses are challenges that the Ivorian health authorities will have to overcome. The resilience of the population has been significant during this crisis, illustrating the ability of Ivorians to withstand the impact of this crisis.

[The 100-year anniversary of Eugene Jamot's (1879-1937) admittance to the Pharo School]. / Les cent ans de l'entrée d'Eugène Jamot (1879-1937) à l'Ecole du Pharo.

For the 100-year anniversary of Dr. Eugene Jamot's (1879-1937) admittance to the Pharo School (then known as the Training School of the Colonial Army Health Corps), the authors describe the life of a French military physician working in Africa. Eugene Jamot devoted 22 years of his life to fighting sleeping sickness. Using a standardized approach that has become a textbook example, he was highly successful in controlling this dreaded tropical disease. Despite being criticized by some officials of the colonial administration and becoming the target of an obvious smear campaign because of his strong personality and growing fame, Jamot handed down a set of values that are recognized by most physicians working to improve the living conditions of the unfortunately still suffering African population.

[Availability and access to the public healthcare facilities in sub-Saharan Africa: situation in Libreville, Gabon]. / L'offre et l'accès aux soins publics dans les villes d'Afrique subsaharienne: le cas de Libreville au Gabon.

Availability and access to primary healthcare facilities is a subject of great concern in African countries south of the Sahara. Problems remain not only in the range of services but also in equality of access. By definition the public health sector has a responsibility to provide citizens with equal access to care facilities. The purpose of this study was to analyze availability and access to healthcare facilities in Libreville, the capital of Gabon, using health geography tools. These methods allowed measurement of the accessibility of public primary healthcare facilities in Libreville. Specifically the method consisted of quantitative analysis based on maps illustrating patient attraction and buffer zones. Results showed gaps in health care coverage that could lead to unequal access. The main implication of this finding is that the grid of primary healthcare facilities requires revision. A geographical approach to analyze physical geography and requirements in terms of healthcare and healthcare networks would be helpful to assist planning healthcare infrastructure in Libreville.

Pierre Richet (1904-1983), fighting onchocerciasis and totalitarism.

While Eugène Jamot's name is associated with the combat against sleeping sickness, Pierre Richet is permanently linked to the battle against river blindness, which he first reported in 1936 in two neighboring households in Garango (Burkina Faso). Onchocerciasis remained a continuous interest, through his last article "The OCCGE and Onchocerciasis", written in 1983. Nonetheless over the course of these five decades, Richet's trajectory was far from that of a specialist dedicating his life to a single disease. After a decade essentially spent fighting trypanosomiasis, came a decade of war in which the specialist in endemism joined the Free French Army and put his organizational know-how at General Lerclerc's disposal, from Morocco to Indochina, via Germany. On his return to Africa in 1953, he extended the principle of mobile teams to the other major endemic diseases accessible to treatment and to vaccines. Richet organized first the combat against leprosy and launched vaccination programs. In 1955, he returned to the battle against onchocerciasis and deployed the first large-scale insecticide program in Chad. The intermediate term failure of this prototype fermented his scientific, interdisciplinary, and organizational thought, which flourished at Bobo-Dioulasso. At the dawn of the independence of French-speaking African countries, and against the political tides of the time, he obtained in 1960 the creation of a supranational organization, the OCCGE, common to 8 countries of West Africa, and he headed it for a decade. Drawing lessons from the past and in the absence of effective pharmaceutical treatment, Richet the physician played the entomological card with one hand, with technical support from Orstom (IRD); this detailed work enabled the development of a strategy. With the other hand, he played the multilateral card, which led in 1974 to the launching of the extraordinary Onchocerciasis Control Program (OCP). If it is Jamot who awakened Africa, Richet is the person who restored its view but also millions of hectares of cultivable land.

Management of scorpion envenomation at the Faya-Largeau medical post, February-June, 2014.

Scorpion envenomation is common in northern Chad and associated with a high lethality rate. We report the management of 16 cases of scorpion envenomation in 2014 at our Faya-Largeau medical post. Our clinical experience revealed dissociated muscarinic symptoms in patients treated early in contrast to those treated later, who presented cardiogenic shock. In the absence of antivenom, patients with an isolated muscarinic syndrome received small doses of atropine, and their signs and symptoms improved afterwards. Although the use of atropine is controversial, the question here is about using it to treat muscarinic symptoms of scorpion envenomation in the absence of severe hypertension and with no signs of heart failure.

[HIV treatment by ARV in resource-poor francophone countries]. / Le traitement du VIH par les antirétroviraux dans les pays francophones à ressources limitées.

At the last United Nations General Assembly, an ambitious target has been set for HIV treatment: ending AIDS as a public health threat by 2030. This article proposes to review the situation of HIV treatment in francophone limited resources settings and the challenges faced by those countries. It also proposes innovative actions that should be set up urgently to increase ART coverage towards scaling up.

[Epidemics of Ebola haemorrhagic fever in Gabon (1994-2002). Epidemiologic aspects and considerations on control measures]. / Les epidémies de fièvre hémorragique due au virus Ebola au Gabon (1994 - 2002): aspects epidémiologiques et réflexions sur les mesures de contrôle.

Based on the description of the four Ebola haemorrhagic fever epidemics (EHF) occurred in Gabon between 1994 and 2002, the authors are considering the cultural and psycho-sociological aspects accounting for the difficulty to implement control measures. On the whole, the result of these raging epidemics came up to 207 cases and 150 dead (lethality: 72%). Analysing precisely the aspects of the third epidemic and pointing up the possible factors explaining its spreading far beyond its epicentre, the authors bring about the limits of measures not always understood by local populations. The discussion will deal with the possibilities of a better surveillance, a quick management of intervention means including a regional permanent pre-alert and taking into account the issue raised by the possible Ebola virus endemic.

[Fever of unknown origin (FUO) in the camps of Rwandan refugees in the Goma region of in Zaire (September 1994)]. / Les fièvres d'origine indéterminée (FOI) dans les camps de réfugiés rwandais de la région de Goma au Zaïre (septembre 1994).

After the outbreaks of cholera, dysenteriae, meningitidis of which the rwandese refugees have been the victims in August and September 1994 in the camps of the Goma's area (Zaïre), the medical teams were confronted with a great number of fevers of unknown origin. In order to explore the possible etiologies, we have conducted a cases/controls study (n = 96). Clinically, the cases occur more frequently than controls headache (p < 0.001), splenomegaly (p = 0.02) and neutropeny (p < 0.001) Serologically, it has been constated non significantly difference between cases and controls, but prevalence of HIV-1 infections (19 and 6%) and arbovirus (23 and 10%) infections are very high. Arbovirosis could explain, partially or associated with HIV and tuberculosis, the presence of these fevers undeterminated more than malaria or typhus epidemic.

[Chronical of a declared meningococcal meningitis epidemic (Goma, Zaire, August 1994)]. / Chronique d'une épidémie annoncée de méningite à méningocoque (Goma, Zaïre, août 1994).

The authors relate their experience controlling an epidemic of meningitis which broke out in the refugee camps of the Goma region, in northern Zaire, after the dramatic events which had happened in Rwanda in April and June 1994. Out of the 348 cases of purulent meningitis diagnosed by the Bioforce team, meningococcal etiology was confirmed 327 times. The isolated meningococci were all of the serogroup A, serotype A; 4; P 1,9. They were resistant to streptomycin and to sulphamides. The epidemic lasted one month, touched people of all ages and spread progressively to all the camps. The epidemic surveillance set up meant that vaccination was carried out very quickly and the epidemic brought rapidly under control, even if other factors did intervene. All those called upon to intervene in such a context should be made aware of the interest of the basic triad to fight these epidemics: rapid vaccination, treatment of cases with oily chloramphenicol and bio-epidemiological surveillance.

[Epidemiology of infections caused by HIV-1, HIV-2 and HTLV-1 in the republic of Chad]. / Epidémiologie des infections à rétrovirus VIH1-VIH2 et HTLV1 en Republique du Tchad.

From March to July 1989 sero-epidemiological surveys have been carried out in four Chadian towns on representative samples of adults aged 15-44 years in the general population. For the first time, HIV1 virus circulation was shown off with seroprevalence rates varying from 0 to 1.1%. Rates are non-existent for HIV2 and they vary from 0 to 1.6% for HTLV1. These low seroprevalence rates make it difficult to identify special risk factors. There was confirmed a preponderance of heterosexual transmissions of these viruses.

["Doctors and soldiers during the expedition to Egypt" (1798-1799)]. / "Médecins et soldats pendant l'expédition d'Egypte" (1798-1799).

About two centuries ago, an uncommon military campaign commanded by General BONAPARTE aged of 29 led the French Army to Egypt. The history did not, up till now, underline the role of the Military Health Service. But it was tremendous, in spite of its poor facilities because its strong subordination to the omnipotent Supply Services Through the description of the conditions of the daily life of soldiers, the author reviews the measures which aimed at the protection of the troops against the usual troubles faced at by an army in the field at the end of the 18th Century: thirst and hunger, long marches with heavy equipment, affective isolation increased by the roughness of battles, diseases among with plague that caused heavy casualties. So, are reviewed in this framework many problems peculiar to that period of time: recruitment, uniforms, food, cantonments, spirits of the troops, personal hygiene as well as collective one; and consequently the measures taken by the French Military officers attached to that expedition to prevent some diseases and epidemics.

[History of human African trypanosomiasis in Moyen-Chari (Chad)]. / Historique de la trypanosomiase humaine africaine dans le Moyen-Chari (Tchad).

The authors give on historical record of the focus of the sleeping disease in Moyen-Chari (South of Chad) from 1914 to 1989. Over such a period, they describe the fighting means used to control this endemic disease.

[Antimalaria campaign in the Middle-east army (1917): the illustrated postcard as a means of information and propaganda by pictures]. / La mission paludéenne de l'Armée d'Orient (1917): La carte postale illustrée, moyen d'information et de propagnande par l'image.

The authors take out from oblivion the series of illustrated post-cards published in 1917 by the French under-secretariat of state for Military Health Service in order to promote the malaria control within the Middle-East French Army. They give some details on how these post-cards were originated, they also illustrate some principles of prevention against malaria made compulsory for the Armed Forces Personnel. The authors also demonstrate how that simple and easy to handle medium, fast vector of sanitary information, was able to support effectively the antimalaria Mission in the Middle-East French Army in its malaria prophylactic action.

[The focus of human African trypanosomiasis in Moissala (Chad): prospective study of 16 villages using the direct card agglutination test (Testryp CATT) and the ion exchange mini-column (mAECT)]. / Le foyer de trypanosomiase humaine africaine de Moissala (Tchad): enquete de prospection dans 16 villages avec utilisation du test d'agglutination directe sur carte (Testryp CATT) et de la minicolonne echangeuse d'ions (mAECT).

The authors report on the results of a case finding survey of human African trypanosomiasis (HAT) within the focus of Moissala (Chad). 2,947 agglutination card-tests (Testryp CATT) have been performed and among them, 19 were confirmed by parasitologic test, either in gland juice or with an ion exchange minicolumn.

[Short-term ciprofloxacin treatment of bacillary dysentery due to Shigella dysenteriae type 1 in Rwandan refugees]. / Traitement court par la ciprofloxacine de la dysenterie bacillaire à Shigella dysenteriae type 1 chez des réfugiés Ruandais.

In 1994, an outbreak of dysentery caused by Shigella dysenteriae type I resistant to all public health antibiotics in vitro occurred among rwandan refugees in Zaïre. The only active antimicrobial agent available was ciprofloxacin. It was administered to hospitalized patients in a conventional 5-day schedule. To ration the supply for the benefit of the greatest number, a randomized blinded study was performed to compare the effectiveness of short-term treatment (1 g of ciprofloxacin in a single daily doses for 2 days) with that of the standard treatment (1 g of ciprofloxacin in two daily doses for 5 days). The study included 57 refugees over the age of 15 years with dysentery. Shigella dysenteriae type I was identified in 26 patients. Except for sex distribution, there was no significant difference in clinical and bacteriologic features of the two populations. Treatment failed in 12 cases, i.e., 7 of 29 patients who received the short-term treatment and 5 of 28 patients who received the standard treatment. Efficacy of ciprofloxacin was not dependent on the mode of treatment, taking into account clinical or bacteriologic criteria. These results indicated that the duration of ciprofloxacin treatment for dysentery caused by Shigella dysenteriae type 1 could be shortened to two days. Short-term treatment has several advantages. One is cost-effectiveness since fluoroquinolones are costly and scarce. Another is to allow treatment of a greater number of patients by improving compliance.

[Epidemiological aspects of human African trypanosomiasis in south Chad]. / Aspects épidémiologiques de la trypanosomiase humaine africaine dans le sud du Tchad.

The authors are recording results of a clinical, parasitological and immunological sample survey about african human trypanosomiasis in the South Chad where old focus has been reexplored. In 1988 the situation ever remains as a problem in some areas (Tapol, Ranga) where high prevalence rates are found again.

[Collective food poisoning in a camp for unaccompanied refugee children in the city of Goma, Zaire, September 1994]. / Toxi-infection alimentaire collective dans une structure d'accueil pour enfants réfugiés non accompagnés de la ville de Goma, Zaïre (septembre 1994).

We report a retrospective study of a group of 440 children following an outbreak of infectious food poisoning in Goma in 1994. The study was part of the epidemiological surveillance in a non-accompanied child refugee reception centre. There were 11 cases (rate 2.5%). We evidence a problem of hygiene in the food preparation chain. Despite the numerous epidemics in the region (cholera, dysentery) this study demonstrated that they were not responsible. Similarly, the findings removed any existing doubts about the quality of the food supplied as part of the international aid.