From bark to weed: the history of artemisinin.

In the 1970's, in China, some brilliant and courageous scientists carried out a research programme, which lead to the discovery of artemisinin derivatives and new quinoleines that are used today, in combination, as first line treatment of malaria.

[Assessment of a chloroquine-spiramycin combination in the treatment of malaria in an area of moderate resistance]. / Appréciation d'une association chloroquine-spiramycine dans le traitement du paludisme en zone de chloroquinorésistance modérée.

The authors treated two groups of children in Zaire with two different regimens: chloroquine vs chloroquine-spiramycin. Chloroquine alone was successful in 83% of cases and chloroquine-spiramycin in 95% of cases (statistically significant). The tolerance of both regimens was excellent.

[Complement to the epidemiologic study of the focus of Schistosoma mansoni bilharziasis in Kara (northern Togo)]. / Complément a l'étude épidémiologique du foyer de bilharziose a Schistosoma mansoni de Kara (nord Togo).

The present study on the focus of schistosomiasis mansoni of Kara (Northern Togo) complements a report already published in the Bulletin de la Société de Pathologie Exotique in 1988 (9). The following results were obtained through different experiments carried out with snails collected in Kara. According to the season, 3 to 15% of the Biomphalaria pfeifferi studied, were infected. The maximal release of cercariae was observed between 11 am and 1 pm. The survival of cercariae and their ability to infect mice were not superior to 16 hours. Data obtained with the chaetotaxy of miracidia of the Kara strain were compatible with those obtained with african strains by other authors. Moreover, B. pfeifferi from Kara was more susceptible to the Kara strain of Schistosoma mansoni than B. pfeifferi collected in the south of Togo or than B. glabrata from the new world. On the contrary, B. pfeifferi from Kara was susceptible to a strain of S. mansoni from Brazil and was able to produce infectious cercariae. In addition, the search for an animal reservoir was carried out; 3 of the 112 (2.7%) wild rodents captured around the river Kara, were infected. This relatively low number of infected rodents was compatible with the usual findings in Africa where the animal reservoir is considered from human origin and has no importance in the transmission of S. mansoni as it could have in South America and West Indies.

[Drug resistance of Plasmodium falciparum and Plasmodium vivax strains in Cambodia (Cardamone Massif). Morphological characteristics of Plasmodium vivax]. / Chimiorésistance de souches de Plasmodium falciparum et Plasmodium vivax au Cambodge (Massif des Cardamones). Particularités morphologiques de Plasmodium vivax.

The authors report some failures of chemoprophylaxis and curative treatment of Plasmodium falciparum and Plasmodium vivax malaria. These infections were contracted in the area of the cambodian-thaï border by 8 Europeans treated by various regimens and 34 Cambodians treated by quinine. In the latter group, the quinine failure rate in Plasmodium falciparum infections was about 47% (RII or RIII?) and 17,5% in Plasmodium vivax. Total cure of vivax malaria with usual doses of Primaquine among the Europeans, failed in 3 out of the 6 treated patients. Morphological particularities (abnormal pigment, lack of Schüffner dots) were noticed in these Primaquine resistant vivax strains. A possible relation is considered between Primaquine resistance and these morphological particularities.

[Epidemiologic study of 2 foci of Schistosoma mansoni bilharziasis in Togo (Lama Kara and Kpalimé). Comparative efficacy of oltipraz (RP 35972)]. / Etude épidémiologique de deux foyers de bilharziose à Schistosoma mansoni au Togo (Lama Kara et Kpalimé). Efficacite comparée de l'oltipraz (RP 35972).

The authors note a very high prevalence of schistosomiasis mansoni in the two foci studied in Togo (Lama Kara in the North and Kpalimé in the South-West); however, the prevalence is significantly higher in Lama Kara (79.5%) than in Klonou (54.7%); this was calculated on both coprological and serological basis. The parasite burden is identical in the two foci; but, the GMRT is higher in Lama Kara than in Klonou (31.7 and 8) which might be explained by a different immunogenicity of the two strains. It is noticed schistosomiasis mansoni might be responsible for hepatosplenomegaly found in the two foci, especially in Lama Kara, which might be explained by a higher virulence in this location. The treatment by oltipraz (RP 35972) had a 91.9% success rate in Klonou (similar to our results in Paris). However, in Lama Kara, even though the drug was taken with some food--increasing its biodisponibility--, the treatment was less effective at day 180 (76.5%). The authors wonder whether the difference of oltipraz efficiency between the two foci is based on a difference of biology between the two strains of Schistosoma mansoni in Lama Kara and in Klonou.

[An epidemiologic study of a focus of Schistosoma mansoni bilharziasis in Kara (North Togo)]. / Etude épidémiologique du foyer de bilharziose à Schistosoma mansonide Kara (Nord Togo).

In 1985 and 1986, an epidemiological survey was carried out in a focus of Schistosoma mansoni located in Kara (Togo). 412 children, 6 months to 15 years old, were examined. The prevalence of schistosomiasis mansoni, evaluated on parasitological and serological data, was of 51.5%. No parasites were found in children before the age of 4. Beyond, the prevalence increase with age; being more important in girls before 10 years and equivalent for both sexes afterwards. Moreover the number of children with hepatomegaly, was significantly higher (p less than 0.001) in patients with schistosomiasis (9.6%), confirming previous results of 1981. Since this date, the prevalence has decreased from 79.6 to 51.5% just as eggs burden in the stools and mean antibodies titers. The explanation of this phenomenon remains unknown.

[Results of an experiment on chemoprophylaxis of malaria using mefloquine in Cambodia (Cambodia-Thai border region)]. / Bilan d'une expérience de chimioprophylaxie du paludisme par la méfloquine au Cambodge (région frontalière Khmero-Thaïlandaise).

39 members of a medical team working in an area near the Cambodia-Thaï border were given an individual antimalaria chemoprophylaxis by Mefloquine (2 tablets--500 mg--every other week), carried on for 2 months after return. Two falciparum accesses were reported after the return, and in one of them, there was also a failure of the Mefloquine treatment (1,5 g in 16 hours). This access was successfully treated by Naphtyridine. The results proved that Mefloquine is now the best individual chemoprophylaxis in this area of South East Asia where, from 1979 to 1981, the other prophylaxis failed (chloroquine, pyrimethamine + sulphonamide or sulfone, quinine); it was also discovered that some strains of P. falciparum were resistant to Mefloquine.

[Imported malaria: serological diagnostic and prevention of transfusional malaria (author's transl)]. / Le paludisme d'importation: aspects épidémiologiques et cliniques (a propos de 137 cas). Importance de la sérologie dans le diagnostic et la prévention du paludisme transfusionnel.

Some particular aspects, epidemiological, clinical, serological of imported malaria are studied about 137 cases seen in the department of Tropical and Parasitologic Diseases of Cochin Hospital. The interest of studying several antigens, homologous and heterologous, in detection of fluorescent antibodies is discussed. In the case of any infesting Plasmodium species, the use of homologous antigen gives very superior titers. Systematic use of two antigens helps to detect possible antimalaria antibodies in blood donors and prevent transfusion given malaria.

[The peculiar features of Plasmodium vivax on the Cambodian-Thailand frontier (Sokh-Sann region)]. / Notes à propos de caractères particuliers de Plasmodium vivax à la frontière Cambodge-Thailande (région de Sokh-Sann).

The authors report an untypical strain of Plasmodium vivax found in the area of Sokh-Sann (Thaï-Cambodian border). This strain is remarkable by: multiple infections and two chromatin dots occur commonly in the early trophozoite stage; the pigment is coarser and darker in the older stages, and Schüffner dots are seldom found. The incubation period is longer and the symptomatology more severe.

[Treatment of 700 cases of bilharziasis with the new drugs oxamniquine, oltipraz, praziquantel]. / A propos du traitement de 700 cas de bilharziose par les médicaments récents: oxamniquine, oltipraz, praziquantel.

The authors study the results of a treatment of 700 cases of bilharziasis seen in Paris and in two foci in Togo, by oxamniquine, oltipraz or praziquantel. The three drugs are well tolerated; only a few mild side-effects were reported such as discomfort, nausea, headaches (two cases of acrodynia with oltipraz ). The three drugs are very efficacious in the case of schistosomiasis mansoni (85,5% success rate with oxamniquine, 92,9% with praziquantel, from 76,5 to 92% with oltipraz depending on the different strains) at day 180. As far as schistosomiasis haematobium is concerned, oltipraz and praziquantel have a 87,5% success rate with oltipraz and 80% with praziquantel; however, in the case of oltipraz , it is necessary to increase the dose. The action of praziquantel seems to be slower on Schistosoma haematobium than on S. mansoni. By the study of the evolution of antibodies, the fast action of praziquantel was noticed, explaining the peak of serological titers and of eosinophilia as early as day 10 after treatment; in the case of oltipraz , the apparition of this peak is only recorded at the 30th day. The slower effect of oltipraz on worms implicates not to judge its efficacy by too early controls.

[Dirofilariasis in humans. Report of a case with localization in the cheek (author's transl)]. / Dirofilariose humaine. A propos d'un cas à localisation géninne contracté en Corse.

Cutaneous dirofilariasis usually affects animals (dogs and cats) but can occur in human-beings. Occasionally, this cosmopolitan disease is seen in France. Our case-report is the sixteenth registered in France. The patient, a forty-two-year-old man, was infected in Corsica. He presented with a tumor of the right cheek from which a pregnant adult Dirofilaria (Nochtiella) repens was extracted.

[Seroepidemiologic study of toxoplasmosis in the school population of Sousse]. / Etude séroépidémilogique de la toxoplasmose dans la population scolaire de Sousse.

To obtain basic epidemiological data about toxoplasmosis in our area, we undertook a serological investigation of the female school population of Sousse City. 33% of the students in college (mean age: 17.8 years) are seronegatives. Social economic status seems not to be important for the risk of infection. The more important source of contamination may be the soil.