[Epidemiological profile, clinical and therapeutic cutaneous leishmaniasis in the Department of Dermatology at University Hospital in Ouagadougou, Burkina Faso]. / Profil épidémiologique, clinique et thérapeutique de la leishmaniose cutanée dans le Service de Dermatologie du Centre Hospitalier Universitaire de Ouagadougou, Burkina Faso.

It is a retrospective study in the Service of Dermatology at the University Hospital Center Yalgado Ouédraogo of Ouagadougou (C.H.U.-YO). This study aimed to list the leishmaniasis clinical cases reported in the registers of this department from January 1999 to December 2007. In total, 251 leishmaniasis clinical cases have been reported. The hospital prevalence was 1,1%. Women represented 53% versus 47% men. The average age of patients was 22,78 ans +/- 121. The most frequent clinical forms were those often crusted (40.2%), papulo ulcerative (16.7%) and papulonodular (13.9%). Lesions most often sat on the lower limbs (33%) and thoracic limbs (45%). On the therapeutic level, the first line treatment meglumine antimonite (Glucantime) accounted for only 25.9% of prescriptions.

[Case management and diagnosis of severe malaria in adults and the application of national guidelines in Burkina Faso]. / Diagnostic et prise en charge du paludisme grave chez l'adulte : observance des directives nationales au Burkina Faso.

UNLABELLED: The purpose of this study was to assess the application of national guidelines on the diagnosis and treatment of severe malaria in adults in Burkina Faso. We conducted a retrospective study of medical records of the patients admitted for severe malaria in the emergency service of the regional hospital of Fada N'Gourma in the east of Burkina Faso in the year 2008; 165 records were chosen by simple random sampling. We reported all the severe clinical and biological signs of malaria and its treatment. We compared them with the criteria of severe malaria diagnosis and its treatment according to the national guidelines. The mean age of patients was 38 ± 16.2 and male to female ratio was 0.96. The most frequent period of admissions was between July and October. Fever or recent past of fever was reported in 142 cases (86.1%). According to the two criteria for severe malaria (means existing of at least one of the severe signs associated and positive parasitemia with Falciparum plasmodium), we noted that only 74 cases had at least one of the severe signs (44.8%) which were: anemia (51.3%), cardiovascular collapse (7.9%), jaundice (7.3%), dyspnea (6.7%), impairment of consciousness (5.5%), prostration (5.5%), renal failure (4.8%), hypoglycemia (2.4%), hemorrhage (1.8%) and seizures (1.2%). The biological signs were not systematically searched. Parasitological exam was conducted in 91 cases (55.1%). Only 18 were positive (19.8%). In total, only 18 cases (10.9%) met the guidelines' criteria of severe malaria. The other cases were over-diagnosed; note that the investigation was not complete for 74 of these cases (50.3%). Among the 165 cases, the treatment was appropriate in 146 (88.5%) and 19 cases (11.5%) didn't receive treatment for malaria. CONCLUSION: So much we observed an over diagnosis of severe malaria in adults that we can suggest an under diagnosis of the disease due to the lack of biological investigations.

[Trends in incidence of cutaneous leishmaniasis from 1999 to 2005 in Ouagadougou, Burkina]. / Etude de l'évolution de la leishmaniose cutanée de 1999 à 2005 à Ouagadougou, Burkina Faso.

The purpose of this study is to describe trends in the annual incidence of cutaneous leishmaniasis in Ouagadougou, Burkina from 1999 to 2005. Data recorded at city health care centers were reviewed. A total of 7,444 cases of cutaneous leishmaniasis were observed, with an annual mean incidence of 1,063.3 +/- 270.8 cases. The M/F sex ratio was 0.9. Mean patient age was 22.8 +/- 13.5 years. Patients older than 15 years accounted for 72.5% of the population. The predominant age bracket was 16-30 years (51.80%).A decrease in incidence was observed from March to June and in December. Peak incidence occurred in September and October. Over the 7-year study period, the average incidence rate was 0.1% +/- 0.04. Since this rate does not reflect the real prevalence of the disease, a prospective study is needed.

[Onchocerciasis in Burkina Faso: a Re-Emerging Vector-Borne Endemic Disease]. / Onchocercose au Burkina Faso : une endémie à transmission vectorielle en voie de réémergence.

Burkina Faso, like other countries, reported a focal interruption of onchocerciasis transmission and was thus placed under post-therapeutic surveillance. However, the country seems to be experiencing a resurgence of the disease according to recent surveys at certain sentinel sites and data from various surveys. The aim of our study is to take stock of the evolution of the current epidemiological situation of onchocerciasis in Burkina Faso. For data collection, in addition to the scientific articles, we have used data from different epidemiological and entomological surveys conducted by the National Program for the Control of Neglected Tropical Diseases (PNLMTN) through its onchocerciasis elimination unit in Burkina Faso. Prior to implementation of the Onchocerciasis Control Program in West Africa (OCP), Burkina Faso had onchocerciasis prevalence between 60% and 80%. In 2002, the maximum prevalence dropped to 15%. However, in 2010 and 2011, epidemiological surveys indicated that some villages in the Comoé River basin had prevalence rate ranging from 0.7% to 71%. Thirteen (13) villages had prevalence rates above the tolerable threshold of 5%. Despite the implementation of the community-directed treatment with ivermectin (CDTI) since 2011, recent surveys show a tendency for a recrudescence of the disease in some sites, yet covered by the TIDC. This suggests that the elimination of onchocerciasis requires the integration of new control strategies. Thus, an essential condition for the elimination of onchocerciasis is the analysis of the situation in each focus in order to define the most cost-effective strategy for permanently interrupting the transmission of the parasite. National onchocerciasis elimination committees put in place will play a key role in determining the best strategy.

Le Burkina Faso, comme d'autres pays, avait signalé une interruption focale de la transmission de l'onchocercose et était ainsi placé sous surveillance post-thérapeutique. Cependant, le pays semble connaître une résurgence de la maladie selon les récentes enquêtes au niveau de certains sites sentinelles et les données de diverses enquêtes. Le but de notre étude est de faire le point sur l'évolution de la situation épidémiologique actuelle de l'onchocercose au Burkina Faso. Pour la collecte des données, nous nous sommes servis, en plus des articles scientifiques, des données des différentes enquêtes épidémiologiques et entomologiques menées par le Programme national de lutte contre les maladies tropicales négligées (PNLMTN) au travers de son unité d'élimination de l'onchocercose au Burkina Faso. Avant la mise en oeuvre du Programme de lutte contre l'onchocercose en Afrique de l'Ouest (Onchocerciasis Control Programme in West Africa), le Burkina Faso enregistrait des prévalences de l'onchocercose comprises entre 60 et 80 %. En 2002, la prévalence maximale a chuté à 15 %. Cependant, en 2010 et 2011, des enquêtes épidémiologiques indiquent que certains villages du bassin de la Comoé avaient des prévalences allant de 0,7 à 71 %. Treize villages avaient des prévalences supérieures au seuil tolérable de 5 %.Malgré la mise en place du traitement à l'ivermectine sous directives communautaires (TIDC) depuis 2011, les récentes enquêtes montrent une tendance à la recrudescence de la maladie dans certains sites, pourtant couverts par le TIDC. Cela suggère que l'élimination de l'onchocercose nécessite l'intégration de nouvelles stratégies de lutte. Ainsi, une condition essentielle pour l'élimination de l'onchocercose est l'analyse de la situation dans chaque foyer afin de définir la stratégie la plus rentable pour interrompre de manière permanente la transmission du parasite. Les comités nationaux d'élimination de l'onchocercose mis en place joueront un rôle clé dans la détermination de la meilleure stratégie.

In vitro and in vivo antiplasmodial activity of 'saye', an herbal remedy used in Burkina Faso traditional medicine.

'Saye', a traditional medicine used in Burkina Faso, which consists of extracts of Cochlospermum planchonii (rhizome), Cassia alata (leaf) and Phyllanthus amarus (whole plant), showed a significant effect against Plasmodium falciparum and Plasmodium berghei parasites grown in vivo (IC(50) = 80.11 +/- 3.40 microg/mL; ED(50) = 112.78 +/- 32.32 mg/kg). In vitro the activity was lower.

Anopheles funestus (Diptera: Culicidae) in a humid savannah area of western Burkina Faso: bionomics, insecticide resistance status, and role in malaria transmission.

An entomological survey was carried out in three humid savannah sites of western Burkina Faso (Bama, Lena, and Soumousso) to (1) update the taxonomy of the Anopheles funestus Giles group, (2) examine the role of each species in malaria transmission, (3) characterize the insecticide resistance status of this malaria vector, and (4) determine the distribution of An. funestus chromosomal forms in these areas. Polymerase chain reaction identification of the members showed the occurrence of An. leesoni Evans in Lena and An. rivulorum-like in Soumousso in addition to An. funestus s.s. Malaria transmission was ensured mainly by An. funestus s.s. both in Soumousso and Lena and by An. gambiae s.s. Giles in Bama, the rice-growing area. The insecticide resistance status performed only on An. funestus indicated that this mosquito was susceptible to pyrethroids irrespective of the study area, but it was resistant to dieldrin. Furthermore, the occurrence of the two chromosomal forms of An. funestus, namely, Kiribina and Folonzo, seemed to follow ecological setups where Kiribina predominated in the irrigated area and Folonzo was more frequent in classic savannah. This study revealed that the problematic of An. funestus taxonomy was closer to that of An. gambiae requiring more structured studies to understand its genetic ecology.

In vivo antimalarial activities of extracts from Amaranthus spinosus L. and Boerhaavia erecta L. in mice.

Extracts obtained from two Burkinabe folk medicine plants, spiny amaranth (Amaranthus spinosus L., Amaranthaceae) and erect spiderling (Boerhaavia erecta L., Nyctagynaceae) were screened for antimalarial properties with the aim of testing the validity of their traditional uses. The plant extracts showed significant antimalarial activities in the 4-day suppressive antimalarial assay in mice inoculated with red blood cells parasitized with Plasmodium berghei berghei. We obtained values for ED(50) of 789 and 564 mg/kg for Amaranthus spinosus and Boerhaavia erecta extracts, respectively. Moreover the tested vegetal material showed only low toxicity (1,450 and 2,150 mg/kg as LD(50) for Amaranthus spinosus and Boerhaavia erecta, respectively).

[In vivo sensitivity of Plasmodium faciparum to chloroquine and sulfadoxine pyrimethamine in the Bobo Dioulasso region (1998-2001): risk factors associated with treatments failures to the two drugs]. / Sensibilité in vivo de Plasmodium falciparum à la chloroquine et à la sulfadoxine-pyrimethamine dans la région de Bobo Dioulasso (1998-2001): étude des facteurs de risque associés aux échecs thérapeutiques de ces deux médicaments.

The therapeutic efficacy of chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) was determined over a 4 year period (1998-2001) in Bobo Dioulasso, Burkina Faso, with an analysis of the risk factors associated to treatment failures to the 2 drugs. In total, 2008 children (6 months-15 years old) attending in 4 health centres (1 urban and 3 rural) were included in the study. Children were alternatively allocated to either CQ or SP The WHO 14-days in vivo field test was carried out. PCV was measured at day 0 and 14. CQ treatment failure was 24.4% (229/940), most of them being late failures. Between 1998 and 2001 a significant increase in CQ treatment failure (p < 0.001) was observed. SP showed a good efficacy with a total treatment failure of 4.4% (33/749). However; a significant increase of resistance to this drug (p=0.001) was also observed between 1998 and 2001. Among children with anaemia at day 0.85% (23/27) were no more anaemic by day 14 in the SP group, while in the CQ group the proportion was lower; 69% (27/39). However the difference between the two drugs was not significant (p > 0.1). Univariate analysis showed that the site, the age of children, the time of recruitment and the parasitaemia were significantly associated with CQ treatment failure. In the multivariate analysis these 4 variables remain significantly and independently associated with the risk of CQ treatment failure. After adjusting for the effect of the 3 other factors, the risk of treatment failure was reduced by half in rural area compared to urban area as well as in children of 5-15 years of age compared to those under 5. The risk of treatment failure was significantly increased in 2000-2001 (OR = 1.66, p < 0.05) as compared to the 2 previous years (1998-1999). It was also twice higher in children with parasitaemia > or = 16,000/microl than in those having a lower parasitaemia. For SP we have not observed such connexions with the univariate and multivariate analysis.

[Epidemiological aspects of cutaneous mycosis of HIV-infected patients in the National Referral Center of Burkina Faso, West Africa]. / Aspects épidémiologiques des mycoses cutanéo-phanériennes chez les patients infectés par le VIH au Centre national de référence du Burkina Faso, Afrique de l'Ouest.

AIM: Our study aimed to analyze the epidemiological aspects of cutaneous mycosis in people living with human immunodeficiency virus (PLHIV). MATERIALS AND METHODS: This is a descriptive study of 382 patients living with HIV. Following an investigation into the risk factors, mycological samples have been performed. Each sample underwent direct examination and cultivation for the identification of fungal species. The Blastese test is used for the identification of Candida albicans. RESULTS: One hundred and six (106) of the 382 people living with human immunodeficiency virus undergo a mycological collection of which 76 gave a positive result. The overall prevalence of cutaneous mycosis was 19.9 %. It was significantly higher in women and in patients who had a CD4 count ≤500/mm3. C. albicans and Trichophyton rubrum were the most isolated species with 22.4 and 19.8 % of all fungal species isolated, respectively. CONCLUSION: Cutaneous mycoses are common among people living with human immunodeficiency virus and whose CD4 count ≤ 500/mm(3).

[Susceptibility of Culex quinquefasciatus to insecticides in Bobo Dioulasso, Burkina Faso]. / Sensibilité de Culex quinquefasciatus aux insecticides a Bobo Dioulasso, Burkina Faso.

This study conducted from 1999 to 2000 in the suburbs of Bobo Dioulasso a town in the South of Burkina, aimed at investigating the susceptibility of the local population of Culex quinquefasciatus to various insecticides and proposing alternative strategies allowing a better management of insecticide resistance in the field. Eggs of C. quinquefasciatus were first collected in stagnant waste water places. The larvae were reared to early 4rth instar and tested by larval bioassays to determine the LC50/95 and the resistance ratios (RR50 and RR95) as well as their confidence intervals. A susceptible reference Strain "Slab" was used as control. Resistance was found to DDT and pyrethroids, but reduced susceptibility was found for carbamates, organophosphorates, phenyl pyrazole and in a less extend to Bacillus sphaericus. Resistance to pyrethroides is quite alarming since these insecticides are mainly used for bed net impregnation for the Roll Back malaria programme implemented in Africa. The high levels of insecticide resistance in C. quinquefasciatus suggest that alternative strategies have to be implemented to minimize the pressure of selection on resistant genes. The use of bio-larvicides (Bacillus sphaericus) alone or in rotation with different compounds may be a promising strategy for controlling C. quinquefasciatus in Bobo Dioulasso.

[Epidemiological and etiological aspects of superficial fungal infections among prison inmates in Ouagadougou, Burkina Faso]. / Aspects épidémiologiques et étiologiques des mycoses cutanéo-phanériennes chez les détenus de la maison d'arrêt et de correction de Ouagadougou (Burkina Faso).

OBJECTIVE: The fight against fungal infections in prisons is within the overall framework of the fight against these diseases in the general population. To contribute to the fight against these diseases, we conducted this study among inmates of the big prison of Ouagadougou. It aimed to analyze the epidemiological and etiological aspects of superficial fungal infections among prison inmates in Ouagadougou. MATERIALS AND METHODS: It was a matter of an analytical descriptive study (December 2011-April 2012) that examined 212 selected using a stratified sampling detainees. It consisted firstly of a survey on risk factors. Secondly, samples were taken from prisoners with suspicious lesions of superficial mycoses. For each lesion, some fragments were examined directly between slide and coverslip in KOH (10% or 30%). The remaining fragments were cultured on Sabouraud-Chloramphenicol and Sabouraud-Chloramphenicol-Actidione. The media were then incubated at 27°C for 1 month before declaring any negativity. RESULTS: The overall prevalence of superficial fungal infections among prison inmates Ouagadougou was 25.5%. The recent prison inmates (≤24 months) were the most affected (89.8%). Dermatophytes (15.56%) were more isolated than non-dermatophytes (12.26%) Anthropophilic species predominated among dermatophytes: T. mentagrophytes (7.0%), T. rubrum (3.3%), M. langeronii (23%), E. floccosum (1.41%) and T. violaceum (0.94%). M. gypseum (0.47%) was the only land-based species encountered. Non-dermatophytes were Malassezia sp. (11.79%) and Candida sp. (0.47%). Polyparasitism was less represented (7.4% of infected prisoners). Several body sites were mostly infected by one fungal agent. Pityriasis versicolor was the most common fungal infection (37.31%). CONCLUSION: Considering the results, specific control measures are to be taken against the superficial fungal infections in prisons and in the general population.

[Multiple sites extrapodal actinomycetoma: Favorable outcome to treatment with a combination of cotrimoxazole and NSAI]. / Mycétome actinomycosique extrapodal plurifocal : bonne réponse au traitement par l'association cotrimoxazole et AINS.

Mycetoma is a bacteriological or fungal infectious disease affecting the skin and/or soft tissues, which can be complicated by bone involvement. The most common feature is a tumor of the foot, but extrapodal localizations have been described. We report one case of a 47-year-old man who presented with tumefaction of a leg with multiple skin fistulae. Histopathological examination permitted to confirm the diagnosis of actinomycetoma and TDM showed the degree of bone and soft tissues involvement. Our case was characterized by the very inflammatory aspect of the tumor, its localization to the leg without foot involvement, the modest functional signs compared to the importance of radiological bone involvements, the deep destruction of the fibula while the tibia was apparently intact and the good response to treatment. In spite of its characteristic features, diagnosis of mycetoma is still late in our country, often with bone and/or articular spread. Priority may be given to measures for reduction of mycetoma diagnosis lateness.

Ten-year surveillance of drug-resistant malaria in Burkina Faso (1982-1991).

To understand the evolution of drug-resistant forms of malaria in time and in space, we carried out an analysis of the results of a series of passive and active surveys conducted in Burkina Faso between 1982 and 1991. A total of 607 tests for resistance to chloroquine and mefloquine were carried out in vitro and 3,679 tests for resistance to chloroquine, quinine, and sulfadoxine-pyrimethamine were performed in vivo. The surveys principally involved the two main cities of Burkina Faso, Ouagadougou and Bobo-Dioulasso. However, another 10 locations representing the three different zones of malaria transmission were also studied. The first cases of Plasmodium falciparum resistant to chloroquine in vitro were reported in 1983, but it was only in 1988 that in vivo resistance appeared. The first cases of in vitro resistance to mefloquine were noted in 1987 while chloroquine sensitivity at a high rate (15.8%), which decreased during the following years. The prevalence of resistance to chloroquine increased in parallel to this decrease in sensitivity to an overall peak of 41% in vitro and 16% in vivo in 1990. These rates then decreased to 3% and 6%, respectively, in 1991. This pattern of decreasing resistance was broadly similar in all sites except for the town of Bobo-Dioulasso, where the level of resistance remained stable at approximately 14% from 1988 to 1991. Only two cases of resistance in vivo to sulfadoxine-pyrimethamine were noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Malaria: use of restriction endonuclease digestion and mutation-specific PCR for antifolate resistance isolate detection.

Antifolate resistance isolates of Plasmodium falciparum in the blood of 56 patients was investigated by using PCR technology. DNA was extracted with three different methods from parasite lysate by phenol-chloroform, or from whole blood and from blood collected onto dry filter paper, by chelex-100. The expected 727-bp PCR product was obtained in all samples extracted by chelex-100, while three samples prepared by phenol-chloroform failed to show any amplified product. The crucial point mutation within the dhfr gene leading to pyrimethamine and cycloguanil resistance is localised in an Alul recognition site. Thus, the 727-bp PCR product was submitted to endonuclease digestion. Fifty out of the 56 blood samples analysed yielded the two expected restriction fragments and an undigested 727-bp band. These 50 samples likely represent mixed infection as also confirmed the specific mutation PCR. The six undigested samples amplify a 339-bp fragment using a nested PCR-specific for pyrimethamine resistance mutation. Our results show that, the rapid DNA extraction from blood using chelex-100 and the PCR endonuclease assay can be efficiently used for accurate chemosensitivity analysis in the field.

[Clinical and parasitological aspects of severe malaria in adults in an urban area of Bobo-Dioulasso (Burkina Faso)]. / Aspects cliniques et parasitologiques du paludisme grave de l'adulte en milieu urbain de Bobo-Dioulasso (Burkina Faso).

From March to December 2000, we carried out a prospective study in the emergency and the internal medicine wards of Bobo-Dioulasso central hospital (Burkina Faso). Among 280 adults with clinical diagnosis of severe malaria, only 60 were confirmed to have severe forms of malaria after the laboratory investigations. Most of these patients (49 cases) were living in the city. The average age was 29.2 years +/- 13.1. At hospital admission, the average temperature was 39.1 degrees C +/- 1 and signs of severe malaria were dominated by impaired consciousness (43 cases), multiple convulsions (6 cases) and severe anaemia (6 cases). Two of these signs were associated in the third of patients. The average parasite density at admission was 11,660 parasites per microliter. 85% of patients hospitalized recovered, 8% died and 7% escaped. The control thick smear at day 3 showed that 23% of patients were still positive. At day 7 none of them was positive. Malaria in adults in urban area is a phenomenon which needs to be assessed and followed in African big towns.

[In vitro susceptibility of 232 isolates of Plasmodium falciparum to antimalarials in Burkina Faso (West Africa)]. / Etude de la sensibilité in vitro de 232 isolats de Plasmodium falciparum aux antipaludéens au Burkina Faso (Afrique de l'Ouest).

Plasmodium falciparum in vitro susceptibility to chloroquine, quinine, mefloquine and halofantrine was investigated in patients living in Bobo-Dioulasso (Burkina Faso, West Africa). Our study was carried out from July to November 1997 at the Malaria Chemoresistance Reference Centre, Centre MurazIOCCGE. Inclusion criteria were: presence of a single infection by R falciparum with a parasite count > or =4000 infected red cells/mm3. The susceptibility to drugs was measured after an incubation period of 48 hours at 37 degrees C, under 5% CO2. (3H) Hypoxanthine was added to the medium to monitor parasite growth. 134 isolates of P. falciparum were tested against chloroquine; 24.6% (33/134) were resistant. We have also documented 11.2% (15/133) of resistant isolates to halofantrine. All the tested isolates were susceptible to quinine (n=135) and mefloquine (n=136). A significant positive correlation was found between the following IC50 values: chloroquine-quinine, quinine-mefloquine and mefloquine-halofantrine. Our study shows no significant increase of the prevalence of chloroquine-resistant strains of P. falciparum in our study area; as well as the persistence of resistance to halofantrine with regard to previous publications in the subject.

[Preliminary study of cutaneous leishmaniasis in the town of Ouagadougou from 1996 to 1998]. / Etude préliminaire de la leishmaniose cutanée dans la ville de Ouagadougou de 1996 à 1998.

Since 1996, there have been reports of cases of cutaneous leishmaniasis in the town of Ouagadougou. The incidence has been on the rise but precise figures are not known. The object of the present study has been, first, to record cases of cutaneous leishmaniasis having occurred in private and public health centres in Ouagadougou from 1996 to 1998 and, second, to determine the progression of the disease in space and time. We wished also to confirm clinical cases in 1998 by parasitological examination, identify different clinical forms of the disease and map out cases in the town. We carried out a retrospective study from 1996 to 1998 and a prospective study in 1998. All cases recorded in this period in visited health centres were included. A total of 1845 cases of cutaneous leishmaniasis was identified, 50.3% of whom concerned women. The age of patients varied between 1 and 79 years for 356 patients, with a mean age of 26.7 years. Cases increased between 1996 and 1998 (1996 = 61 cases, 1997 = 552 cases, 1998 = 1218 cases). The months of highest incidence were August (13%), September (15%) and October (17%). Peripheral districts (28, 30, 29, 16, 15) in south-eastern areas of the town were the worst touched with 87% of cases. On average, patients seek care after 2 months of progression of the disease. The ulcero-crusted form (68.2%) was the most frequent clinical form observed for 327 patients, but almost half of the cases had more than one site of infection, (43.5%). Over half of the patients presented fewer than 10 lesions with an average of 6. The most common locations were on uncovered parts of the body, notably the superior (53%) and inferior limbs (49%). The parasite could be tested for by smear on 52 patients only in 1998 and 53.8% of cases tested were positive. Leishmania major, which is very prevalent in West Africa was identified in one patient. The vectors and main reservoirs of the parasite were not studied. Case management was generally incomplete; the most commonly prescribed drugs were antibiotics (70% of patients), but self-medication was frequent. Our recommendations after this preliminary study are: undertake multidisciplinary studies on cutaneous leishmaniasis in Ouagadougou in order to understand the local aetiology (vectors responsible for transmission, rodent and domestic animals involved in the epidemiological chain, parasite species); identify all other areas in the country where the disease is highly prevalent provide health care staff with a decisional algorithm and protocol therapy carry out and active control programme for cutaneous leishmaniasis in Burkina Faso.

[Vaccination against malaria: initial trial with an ant-sporozoite vaccine, (NANP)3-TT (RO 40-2361) in Africa (Bobo-Dioulasso, Burkina Faso)]. / Vaccination contre le paludisme: premier essai avec un vaccin antisporozoïte, le (NANP)3-TT (RO 40-2361) en Afrique (Bobo-Dioulasso, Burkina Faso).

The vaccine (NANP)3-TT is a synthetic peptide of the circumsporozoite protein (CS) of Plasmodium falciparum coupled to tetanus toxoid (TT) as protein carrier and adsorbed to aluminium hydroxide as adjuvant. The objectives of the study were to assess the immunogenicity and the protective efficacy of the vaccine in an area where malaria is endemic. The study was conducted in a zone of irrigated rice cultivation known as the Vallée du Kou to the North of Bobo-Dioulasso. Malaria transmission is permanent in the Vallée with maxima in July and November. The study was conducted from June to December 1988. It was a controlled randomised, double blind, prospective vaccine trial. A total of 123 infants from 3 to 5 months of age were randomly assigned to three groups. Group I (controls) received three doses of TT alone, group II received two doses of TT and one of (NANP)3-TT and group III received three doses of (NANP)3-TT. These vaccines were administered simultaneously with the Enlarged Program of Immunisation (EPI) vaccines. The clinical parasitological and immunological status of the children was then monitored over a period of five months. No systemic reactions to the vaccine were observed in the infants either immediately after administration or during the follow-up. Minor local tumefactions were observed in only 3% of the children. The vaccine was found to be immunogenic with a peak IgG response at day 75, when 56% (group II) and 60% (group III) showed antibody titres of at least four times that seen at day 0. The response, however, was a short duration; by day 150 the average antibody titres were not significantly different between the three groups. The incidence and the level of parasiaemia and the incidence of clinical malaria were also not significantly different for each of the three groups during the period of the study. The association of (NANP)3 with tetanus toxoid was not shown to be immunologically inhibitive. The results, despite not showing a protective effect for the vaccine (NANP)3-TT, have shown its immunogenicity and therefore suggest that further development of this vaccine may be worthwhile.

[Preliminary epidemiological study of dracunculosis in the southwest of Burkina Faso]. / Etude épidémiologique préliminaire de la dracunculose au sud-ouest du Burkina Faso.

An epidemiologic survey was carried out before the setting up of an applied research project on dracunculiasis control through three strategies. The data were collected by house-to-house visits and from family cards. The overall incidence rate was 10.3 per cent + 0.9 with variations from 1.7 to 35 per cent according to the villages. The incidence rates were significantly higher in the 5-14 and 15-59 years age groups. On the opposite, there was no significant difference between the rates according to sex. The disease presented a family feature and cases were concentrated in 35 per cent of families. The proportion of polyparasitism was important more than half of patients had two or more worms. The measurement of the same indicators at the end of project will allow the assessment of the project results.

[Filarial multiparasitism in the savannah zone in Burkina Faso]. / Etude du polyparasitisme filarien en zone de savane au Burkina Faso.

From june 1985 to may 1986, 1.209 consulting patients were examined for filariae in skin and blood. Among patients with microfilariae 17% had associations of filarial infections. The multiple infections rate seemed more important in man than woman and increased with age. The results showed that associations were not due to chance only. The frequencies of associations between Dipetalonema perstans and Onchocerca volvulus at one hand, Dipetalonema perstans and Wuchereria bancrofti on the other hand were highly significant. Symptoms of filarial associations were studied and subsequent therapeutic attitude discussed.