[Relative frequency of malignant and benign tumors in Arlit, Niger. Analysis of data from anatomopathological examinations over a 15-year period]. / Fréquence relative des tumeurs malignes et bénignes à Arlit (Niger): bilan de 15 ans d'examens anatomo-pathologiques.

The purpose of this study was to determine the frequency and distribution of cancer in the uranium-mining region of Arlit, Niger, based on extensive data from all the anatomopathological examinations performed at local hospitals over a 15-year period. The overall annual incidence, i.e., 26 per 100000, was similar to incidences reported elsewhere in Africa. The rate of examinations leading to diagnosis of malignancy decreased between 1991 and 1997 and, for unexplained reasons, varied from one practitioner to another. There was no evidence of a higher rate of any cancer that might result from possible exposure to radiation during mining operations. The distribution of cancer by organ was unremarkable, i.e., in order of frequency, womb and ovaries in women; skin and prostate in men; thyroid and lymphatic tissue in both genders.

Dengue 1 epidemic in French Polynesia, 1988-1989: surveillance and clinical, epidemiological, virological and serological findings in 1752 documented clinical cases.

An epidemic of dengue 1 occurred in French Polynesia in December 1988 and June 1989. This paper records (i) the trend of the outbreak and its surveillance and (ii) the clinical, epidemiological and virological data obtained from 1752 documented cases. The epidemic reached its peak in February in Tahiti Island, 7 weeks after its recognition. Among 6034 suspect cases reported by sentinel physicians, 60.3% were < 20 years old. The illness was classical dengue. No fatality or case of dengue haemorrhagic fever/dengue with shock syndrome was reported. Of 4792 patients subjected to laboratory testing, 41% were confirmed as positive. The serological attack rate was c. 40%. The estimated number of dengue infections in the Windward Islands was about 20,000. Transmission was associated with Aedes aegypti. Study of documented cases showed a higher confirmation rate in both the civilian population < 15 years old (46.5%) and the susceptible French military population (47.6%) than in older civilians (31.1%, P < 0.05). Furthermore, primary dengue infections were predominant in both of the first 2 groups. The diagnosis was mostly confirmed (i) by virus isolation on day < 5 of illness and (ii) by detection of immunoglobulin (Ig) M on day > or = 5 of illness. The study showed that adequate surveillance of an epidemic requires both clinically and laboratory-based systems.

[Juvenile recto-colonic polyposis. Apropos of a case in Madagascar]. / La polypose recto-colique juvénile. A propose d'une observation à Madagascar.

The authors relate the first case of juvenile polyposis coli noticed in Madagascar. It is a sporadic case developing a serious clinic picture with an accidentally fatal end in a 7 years old Malagasy girl. They recall the principal epidemiological, anatomopathological, clinic and evolutive features which are typical of this polyposis. They wish that the way to medical progress will soon lead to better knowledge of the place of the intestinal polyposis in African countries.

[Rectocolonic polyps in Senegal. Results of 1500 lower endoscopies carried out at the Dakar General Hospital]. / Les polypes recto-coliques au Sénegal. Résultat de 1,500 endoscopies basses effectuées à l'Hôpital Principal de Dakar.

57 polyps were discovered during 1,500 low endoscopies, and 24 of them were adenoma. In the same period of time, 26 proctocolitic adenocarcinomas were found. Adenomatous polyps appear to be 5 times less frequent in Senegal than in industrialized countries and frequency of colitic cancer should be of the same frequency, that is far less negligible. Even if proctocolitic cancer does not set up any Public Health problems one could envisage systematic screening of polyadenoma in every patient aged more than 40. Proctosigmoid being the seat of most adenoma, fibrosigmoidoscopy appears well adapted to this kind of screening because it does not require any preparation, it is easy to perform and well accepted.

[Evaluation of regimens for mass-treatment of onchocerciasis by diethylcarbamazine (author's transl)]. / Evaluation de protocoles de traitement collectig de l'onchocercose par la diethylcarbamazine.

We tested three regimens to find the most effective, best tolerated and most practical therapeutic scheme for the mass treatment of onchocerciasis by diethylcarbamazine. The schemes with a short induction cure followed by a single dose of medication every two months were better than a long and only curative course of medication without maintenance doses. The schemes with induction cure and maintenance doses given every two months were more effective and practical than weekly maintenance doses with or without induction cures tried by other authors. The preferred treatment protocol is the following: an induction cure of ten days with a starter dose of 25 mg the first day, 50 mg the second, 100 mg the third, 200 mg for each of the remaining seven days. This induction procedure is extremely effective and is well maintained by a single dose of 200 mg every two months. After one year, the dermal microfilarial density was found to increase slightly. The study must be continued to determine whether a second course of induction therapy is necessary.

[Epidemiological surveillance of infection by the human immunodeficiency virus (HIV) and of the acquired immunodeficiency syndrome (AIDS) in French Polynesia in 1991]. / Surveillance épidémiologique de l'infection par le virus de l'immunodéficience humaine (VIH) et du syndrome d'immunodéficience acquise (SIDA) en Polynésie Française en 1991.

The authors make out a statement about HIV infection in French Polynesia at the date of 1991 December 31. 96 cases all together of seropositive and AIDS infected people were recorded. These patients are young generally (78 p.c. between 21 and 40 years old) sexually contaminated (72 out of 96) and live in Tahiti island (94 p.c.). Sex-ratio is 2.8 male/1 female. Among them, we noted 55 p.c. of Europeans, 38 p.c. of Polynesians and 7 p.c. of Asiatic people. Epidemiological monitoring of the infection was made easy because of a set of laws and possibilities of detection highly favourable. Progress of the infection is constant, with 20 new cases detected each year with a prevalence of 150 cases of AIDS per 1 million of inhabitants, French Polynesia could be classified as the 5th or 6th region of France as far as the importance of the disease. Clinical, biological and epidemiological taking of charge of patients is detailed as well as the prevention campaign.

PIP: Serological surveillance of HIV infection in accordance with World Health Organization guidelines has taken place in French Polynesia since 1985. 20,000 tests are conducted annually in a population not exceeding 200,000. 30% of tests are among blood donors. An average of 20 new cases of HIV infection are diagnosed each year. A total of 96 cases of HIV infection or AIDS were reported to the public health authorities between 1985 and December 31, 1990. 78% of the 96 persons were aged 21-40 years. The sex ratio was 2.8 men per woman. 55% were in Europeans (53 cases among 24,000 European residents), and 7% were in Asians (7 cases among 10,000 Asians). 94% of the patients were inhabitants of Tahiti. 44 of the 96 patients were male homosexuals or bisexuals, 18 were heterosexuals with multiple partners, 13 received transfusions before 1985, 10 were sex partners of seropositive persons, 9 were former addicts, 1 was the infant of an infected mother, and 1 had no known risk factor. ELISA tests were conducted in 6 different laboratories in the island of Tahiti, with confirmation by Western blot at the laboratory of the Louis Mallarde Territorial Medical Research Institute. Contacts are traced and tested, and seropositive individuals are followed regularly, with consultations at 6 month intervals for seropositive persons. Of the 46 patients present in the territory as of December 1990, 36 were at stage 1, 2 at stage 2, 5 at stage 3, and 3 at stage 4 according to the World Health Organization guidelines. 20 of the other 50 had died and 30 left the territory.

Immunotypes of Chlamydia trachomatis isolated from genital tract specimens in Tahiti.

The distribution of Chlamydia trachomatis immunotypes (serovars) in Tahiti was studied by immunotyping of local isolates using monoclonal antibodies in the micro-immunofluorescence test. From 115 isolates obtained from the genital tracts of patients attending a sexually transmitted diseases clinic and other gynecological consultations, eight immunotypes were identified: E (51.3%), F (16.5%), G (13%), H (5.2%), J (6.9%), D (3.5%), K (1.7%) and I (0.9%). In addition, an isolate with mixed immunotypes, EJ (0.9%), was observed. This distribution was compared with those in different geographical areas.

Demographic reductions and genetic bottlenecks in humans: minisatellite allele distributions in Oceania.

Polynesians have lower heterozygosities at minisatellite VNTR (Variable Number of Tandem Repeat) loci than have Melanesians; this has been taken as evidence of population-size bottlenecks during the colonisation of Polynesia. We have analysed the allelic distribution of several minisatellite loci in the population of Rapa, a Polynesian island that is known to have undergone a demographic reduction of approximately 95% since first contact with European explores 200 years ago, leaving a surviving population of 120. We found that the minisatellite diversity of this population does not differ significantly from that of other Polynesian populations, and appears consistent with the neutral expectation of diversity assuming the infinite alleles model. This suggests that the demographic crisis that Rapa underwent did not perturb the allele distribution to the extent that the tests used here could detect. Thus we cannot say that a demographic change of this magnitude constitutes a genetic bottleneck detectable at these loci. The reduced diversity seen in Polynesia must therefore be explained either by more severe bottlenecks as might be expected during colonisation, or else by other causes.

Alpha-thalassaemia and globin gene rearrangements in French Polynesia.

The prevalence of alpha-thalassaemia and various globin gene rearrangements was determined in 1992 individuals living on 11 islands in French Polynesia. The gene frequencies for alpha(+)-thalassaemia (almost exclusively the -alpha 3.7III deletion form) range from 5.3% to 19.2%. Haematological indices on 177 heterozygotes and 27 homozygotes for the -alpha 3.7III variant showed considerable overlap with indices of normal individuals; although there was a broad correlation of average indices with alpha-globin genotype, individual values were a poor indication of genotype. A non-deletion form of alpha(+)-thalassaemia (alpha alpha Th), triplicated alpha genes (alpha alpha alpha) and single zeta gene (-zeta) chromosomes were present at low frequencies (< 1%), whereas triplicated gamma gene (gamma gamma gamma) and triplicated zeta (zeta zeta zeta) arrangements were more common (1.1-16.3%). alpha 0-thalassaemia, probably introduced from Southeast Asia in the early part of this century, was observed in a number of individuals of Chinese and Chinese/Polynesian ancestry. Because of the high frequency of alpha(+)-Thalassaemia on some islands, it therefore seems likely that haemoglobin H disease (resulting from the interaction between alpha 0 and alpha(+)-thalassaemia) must occur in parts of French Polynesia.

Seroepidemiological survey of HTLV-I infection in French Polynesia, Cook Islands and Fiji.

Different population groups of French Polynesia, Cook Islands and Fiji were screened for Human T-Lymphotropic Virus type I (HTLV-I) antibodies. Among 1487 individuals sampled in French Polynesia, twelve were considered Western Blot (WB) indeterminate and one was considered WB-positive for HTLV-I infection. This positive subject originated from France and was a blood donor. Out of 196 Polynesians of the Cook Islands, one was WB-indeterminate. Among populations sampled in Fiji, one of 222 Melanesians was found WB-indeterminate and one of 211 Indians was WB-indeterminate.