[Female urethral diverticulum containing multiple calculi]. / Diverticule de l'urètre féminin contenant de multiples calculs.

Diverticulum of female urethra is rare, often discovered during complications. We report a case of diverticulum of female urethra containing multiple calculi in a multiparous woman of 52 years old. She has consulted for dysuria and a hard painful periurethral mass in the anterior vagina wall. The diagnosis was easily established by physical examination and confirmed by plain radiographs of the lower urinary tract and endovaginal ultrasound. The patient was treated successfully by diverticulectomy.

[Nontyphoidal Salmonella bacteremia cases in AIDS patients in a Dakar University Hospital (Senegal)]. / Etude descriptive des bactériémies àSalmonella non typhi chez les patients infectés par le VIH au CHU de Dakar (Sénégal).

OBJECTIVES: This study had for aim to describe epidemiological, clinical and bacteriological aspects of nontyphoidal Salmonella bacteremia in patients with AIDS in the Dakar University Hospital Infectious Diseases Clinic. METHOD: This study was made on data recorded between 1January1996 and 31December2005. The strains were identified according to biochemical (API 20E, BioMérieux) and antigenic features. Their susceptibility to antibiotic drugs was tested by antibiogram. Screening for strains secreting of an extended-spectrum betalactamase was performed. RESULTS: Sixty-two cases of nontyphoidal Salmonella bacteremia were recorded in AIDS patients as follows: Salmonellaenteritidis bacteremia (32 cases), Salmonellatyphimurium bacteremia (11 cases), and Salmonella spp bacteremia (11 cases). The strains were susceptible to ciprofloxacin, ceftriaxone, aztreonam, amoxicillin plus clavulanic acid in at least 92% of the cases. Only 79% of them were susceptible to cotrimoxazole. The lethality rate was 55%. DISCUSSION: This lethality rate of nontyphoidal Salmonella bacteremia is high in AIDS patients. Therefore, the priority should be put on prevention and, in patients with AIDS, on food hygiene measures, antiretroviral treatment and efficient chemoprophylaxis. This should prove efficient to reduce incidence of nontyphoidal Salmonella bacteremia.

[From genomics to surveillance, prevention and control: new challenges for the African meningitis belt]. / Ceinture africaine de la méningite: de la génomique aux stratégies de surveillance, de lutte et de prévention.

An international conference was held in Niamey, Niger, in November 2005. It aimed at reviewing the current situation in the meningitis belt. This region stretches from Senegal to Ethiopia and is characterized by high levels of seasonal endemicity with large epidemics of meningococcal meningitis occurring cyclically, generally caused by N. meningiditis serogroup A. WHO currently recommends a reactive strategy based on rapid detection of epidemics, intervention with antibiotics to treat cases and mass vaccination with a meningococcal polysaccharide vaccine to halt the outbreak. Epidemiological patterns of the disease in Africa have been changing with the occurrence of outbreaks outside the meningitis belt and with the emergence of serogroup W135, which first caused an epidemic among Hajj pilgrims in 2000 and then a large-scale meningitis outbreak in Burkina Faso in 2002. Consequently enhanced laboratory surveillance and confirmation of the strain responsible for the outbreak are required. New rapid dipstick tests have been developed through a collaboration between Institut Pasteur and CERMES. They are designed for bedside diagnosis and detect meningococcal antigens present in CSF using immunochromatography. The treatment of meningococcal meningitis during epidemics is based on short-course, long-acting oily chloramphenicol. An alternative is the use of ceftriaxone, which is equally effective and can be used in pregnant women and infants. A low-cost, monovalent serogroup A meningococcal conjugate vaccine for large-scale use in Africa is under development. In spite of the emergence of W135 strains in the meningitis belt, N. meningiditis A continues to be the principal strain isolated during the epidemic seasons and elimination of outbreaks of N. meningiditis serogroup A can still be considered as the primary objective of a preventive vaccination strategy.

[RESAOLAB: West African network of laboratories to enhance the quality of clinical biology]. / RESAOLAB : le Réseau d'Afrique de l'Ouest des Laboratoires pour renforcer la qualité de la biologie clinique.

The Fondation Mérieux, in partnership with the Ministries of Health of Burkina Faso, Mali and Senegal, implemented for four years a project to reinforce the laboratory sector in the three participating countries: the RESAOLAB project (West African Network of Biomedical Analysis Laboratories).The objective of RESAOLAB project, in partnership with the WHO Office for West Africa and the West African Health Organization, was to strengthen the systems of biomedical laboratories to improve diagnostic services, access, monitoring and management of infectious diseases. Following the successful results achieved under the RESAOLAB project and due to the demand of the neighbour countries ministries, the RESAOLAB project is now extended to four other countries of the West African region: Benin, Guinea-Conakry, Niger and Togo. The RESAOLAB project has become the RESAOLAB programme, its purpose is to strengthen the quality of the medical biology services thanks to a regional and transversal approach.

Estimating the seroincidence of HIV-1 in the general adult population in Kigali, Rwanda.

OBJECTIVE: To estimate the seroincidence of HIV-1 infection in the general adult population of Kigali, Rwanda. DESIGN: Repeated standardized cross-sectional studies. SETTING: Two urban prenatal clinics. PATIENTS: A total of 4486 consecutive pregnant women consulting in 1989 and 1990. MAIN OUTCOME MEASURES: Prevalence of HIV-1 antibodies. RESULTS: HIV seropositivity increased by 3-5% annually over this period, indicating that it has not reached a plateau in this sentinel population. The percentage infection rates, calculated using two complementary methods, were 26.2-30.7% in 1990. Extrapolating these results to the general population of Kigali, we estimate that 2300-3800 new infections in young women and 3600-6100 new infections in young men occur annually among the total population of 350,000 in Kigali. CONCLUSIONS: A new HIV infection occurred in an adult every 50-90 min, on average, in Kigali during 1989-1990, while every 6-7 h a baby with maternally acquired HIV infection was born. Our HIV surveillance system, which is based on prenatal sentinel posts, is a useful tool for monitoring the progression of the HIV epidemic in Kigali.

PIP: This study aimed to estimate the seroincidence of HIV-1 infection in the general adult population of Kigali, Rwanda, by examining a total of 4486 consecutive pregnant women consulting in 1989 and 1990 at 2 urban prenatal clinics. Via repeated standardized cross-sectional studies the authors aimed to measure prevalence of HIV-1 antibodies. HIV seropositivity increased by 3-5% annually over this sentinel population. The percentage infection rates, calculated using 2 complementary methods, were 26.2-30.7 in 1990. Extrapolating these results to the general population of Kigali, the authors estimate that 2300-3800 new infections in young women and 3600-6100 infections in young men occur annually among the total population of 350,000 in Kigali. A new HIV infection occurred in an adult every 50 through 90 minutes, on average, in Kigali, during 1989 and 1990, while every 6 to 7 hours a baby with maternally acquired HIV infection was born. This HIV surveillance system, which is based on prenatal sentinel posts, is a useful tool for monitoring the progression of the HIV epidemic in Kigali.

[Evaluation of the degree of mitral stenosis : reassessment of the M mode echocardiographic index]. / Appréciation du degré de la sténose mitrale : réévaluation des index échocardiographiques en mode M.

Fifty consecutive patients (32 female and 18 male) with mitral stenosis aged 11 to 60 years underwent cardiac catheterisation and echocardiography to determine the value of M mode in assessing the degree of stenosis. Mitral stenosis was pure in 47 cases; isolated in 31 cases; associated with minimal aortic regurgitation in 11 cases, with mild mitral incompetence in 3 cases and with tricuspid incompetence in 5 cases (all patients underwent aortography and left ventriculography). Mitral valve surface area (MSA) calculated from the Gorlin formula correlated well with the anatomical mitral valve area (r = 0.88) in the 30 operated patients and enabled the patients to be divided into three subgroups : Group I : 36 patients with severe mitral stenosis; MS less than 1.3 cm2 including 29 with very severe stenosis : MS less than 1.0 cm2; Group II : 9 cases of moderate stenosis (1.3 cm2 less than MS less than or equal to 1.8 cm2), and Group III : 8 cases of mild mitral stenosis (MS greater than 1.8 cm2). The indices correlating with haemodynamic MSA were, in decreasing order of significance : EF slope of early diastolic closure of the anterior leaflet (r = 0.74); maximal EE' diastolic separation of the two leaflets (r = 0.57); the ratio of left atrium/aortic root dimensions (r = 0.39) and the Q-mitral closure interval (r = 0.31). The left atrial emptying index, the mitral valve closure index and changes in the rapid phase of left ventricular filling did not correlate with the degree of stenosis. An EF slope of less than 15 mm/sec had a sensitivity of 77% and a specificity of 93% and was a satisfactory method for distinguishing patients in Group I from those in Group II.(ABSTRACT TRUNCATED AT 250 WORDS)

Revisiting Surface-Enhanced Raman Scattering on Realistic Lithographic Gold Nanostripes.

In this article, we investigate the Surface-Enhanced Raman Scattering (SERS) efficiency of methylene blue (MB) molecules deposited on gold nanostripes which, due to their fabrication by electron beam lithography and thermal evaporation, present various degrees of crystallinity and nanoscale surface roughness (NSR). By comparing gold nanostructures with different degrees of roughness and crystallinity, we show that the NSR has a strong effect on the SERS intensity of MB probe molecules. In particular, the NSR features of the lithographic structures significantly enhance the Raman signal of MB molecules, even when the excitation wavelength lies far from the localized surface plasmon resonance (LSPR) of the stripes. These results are in very good agreement with numerical calculations of the SERS gain obtained using the discrete dipole approximation (DDA). The influence of NSR on the optical near-field response of lithographic structures thus appears crucial since they are widely used in the context of nano-optics or/and molecular sensing.

Prevalence of hepatitis B markers among hospital workers in Senegal.

A total of 775 serum samples from men and women working in hospitals in Dakar, Senegal, were tested for serological markers of hepatitis B virus (HBV). HBsAg was detected in 17.8% of the subjects, and 79.2% of the subjects were anti-HBc positive. Among HBsAg carriers 0.04% (5) subjects were HBeAg positive, 0.03% (4) were HBV-DNA positive, and 5.8% (8) were also anti-Delta positive. HBsAg seropositivity was independent of sex and inversely related to age. Duration of service in the hospital was an important predictor of HBsAg seropositivity and the prevalence of seropositive subjects peaked between 2 and 3 years of employment (OR = 1.9; 95% confidence interval [Cl] = 1.1-3.3, when compared to subjects who worked 1 year of less). This peak was critical in the Department of Dentistry, where subjects who worked for 2-3 years experienced a fourfold increase in the risk of HBV infection (OR = 4.0; 95% Cl = 1.8-9.0). Adjusting for age and sex did not modify the results. Within the Department of Dentistry, 15 subjects were HBsAg positive but anti-HBc negative; 12 subjects were retested 1 year later and did not present any markers of past or current HBV infection. These results confirm the increased risk of HBV infection among hospital workers and suggest the presence of HBV variant(s) in Senegal.