Safety of Chloroquine or Hydroxychloroquine Plus Azithromycin for the Treatment of COVID-19 Patients in Burkina Faso: An Observational Prospective Cohort Study.

INTRODUCTION: Though chloroquine derivatives are used in the treatment of coronavirus disease 2019 (COVID-19) in many countries worldwide, doubts remain about the safety and efficacy of these drugs, especially in African communities where published data are scarce. METHODS: We conducted an observational prospective cohort study from April 24 to September 03, 2020, in Burkina Faso to assess (as primary outcome) the clinical, biological, and cardiac (electrocardiographic) safety of chloroquine or hydroxychloroquine plus azithromycin administered to COVID-19 patients. The main secondary outcomes were all-cause mortality and median time of viral clearance. RESULTS: A total of 153 patients were enrolled and followed for 21 days. Among patients who took at least one dose of chloroquine or hydroxychloroquine (90.1% [138/153]), few clinical adverse events were reported and were mainly rash/pruritus, diarrhea, chest pain, and palpitations. No statistically significant increase in hepatic, renal, and hematological parameters or electrolyte disorders were reported. However, there was a significant increase in the QTc value without exceeding 500ms, especially in those who received chloroquine phosphate. Three adverse events of special interest classified as serious (known from chloroquine derivatives) were recorded namely pruritus, paresthesia, and drowsiness. One case of death occurred. The average onset of SARS-CoV-2 PCR negativity was estimated at 7.0 (95% CI: 5.0-10.0) days. CONCLUSION: Hydroxychloroquine appeared to be well tolerated in treated COVID-19 patients in Burkina Faso. In the absence of a robust methodological approach that could generate a high level of scientific evidence, our results could at least contribute to guide health decisions that should be made based on different sources of scientific evidence including those from our study.

[Description of a new epidemic focus of cutaneous Leishmaniasis major in western Burkina Faso]. / Description d'un nouveau foyer épidémique de leishmaniose cutanée à Leishmania major à l'Ouest du Burkina Faso.

INTRODUCTION: in Burkina Faso, the only epidemic focus of cutaneous leishmaniasis confirmed in the literature by lab tests was in Ouagadougou. We report the epidemiological, clinical and biological results of the assessment of a new epidemic focus in Larama in western Burkina Faso. METHODS: camps were used to receive patients. Sociodemographic and clinical data were collected using a questionnaire. Confirmation was based on microscopy and polymerase chain reaction (PCR). RESULTS: a total of 108 suspected cases have been identified in Larama, reflecting an attack rate of 5.8%. Sex ratio was 1.08. The patients were most often farmers (35.2%) and traders (33.3%). The working population (15-49 years old) accounted for 51.9%. The number of lesions varied between 1 and 5 in 91.7% of the cases. The lesions manifested as raised and infiltrated ulcerative lesions on the limbs (87%) with evolution ranging from 1 to 5 months in 96.3% of the cases. Samples were collected from two patients; microscopy showed leishmanias and PCR confirmed Leishmania major. CONCLUSION: our results confirm the presence of a cutaneous leishmaniasis major outbreak in the western part of the country. Additional surveys are needed to clarify the burden of leishmaniasis in Burkina Faso.

Loa loa filariasis in a tropical savanna area: report of one case in Ouagadougou.

Loa loa filariasis is usually found in the forest areas of Central and West Africa. We report a case that was diagnosed in Ouagadougou (Burkina Faso), a savanna area. The patient lived in Gabon but was visiting his family in Ouagadougou. He complained of fatigue, fever, itchy legs with scratch marks, and intermittent edema of the legs. A blood smear was first examined for malaria parasites, but Loa loa microfilariae were observed. Laboratory tests showed hypereosinophilia (30%). Transient angioedema (Calabar edema) was observed. Loa loa filariasis was diagnosed based on these findings. There were no other laboratory test abnormalities, and ophthalmological examination was normal. The patient received a single dose of ivermectin at 200 µg/kg. After 1 month, the patient's course was favorable and a control blood smear was negative.

Neurofibrome plexiforme orbito-palpebral dans la maladie de recklinghausen: à propos de 8 cas

Introduction : La localisation orbito-palpéral du neurofibrome plexiforme dans la maladie de Von Recklinghausen est rare. Nous en rapportons 8 cas. Patients et Méthode : Il s'agissait d'une étude rétrospective descriptive portant sur les dossiers de patients chez qui un diagnostic clinique et paraclinique de neurofibrome plexiforme palpébro-orbitaire était posé et pris en charge dans les services de Dermatologie-Vénérologie, d'Ophtalmologie et de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de 2005 à 2018. Résultats : Caracté-ristiques épidémiologiques : huit dossiers étaient colligés. Cinq patients étaient de sexe féminin et 3 de sexe masculin. Leur âge moyen était de 15,8 ans. Caractéristiques cliniques : Les atteintes cutanées de la maladie de Von Recklinghausen étaient des taches café au lait, des neurofibromes dermiques, le neurofibrome plexiforme orbito-palpébral unilatéral. L'examenophtalmologique retrouvait une gêne oculaire chez tous les patients, un ptosis, et une exophtalmie chez 2 patients. Un patient présentait un glaucome congénital. Trois patients présen-taient des nodules de Lisch, et un, une périsclérite. Une kérato-uvéite était retrouvée chez deux autres patients. Caractéristiques paracliniques : La tomodensitométrie montrait une atteinte osseuse (sphénoïdal et ou eth-moïdal, et ou du sinus maxillaire) chez tous les patients. L'IRM objectivait la tumeur plexiforme non encapsulé, infiltrant le tissu adipeux intra et extra conal, sans lésion du parenchyme cérébral. L'étude histologique confirmait le diagnostic de névrome plexiforme. Caractéristiques thérapeutiques et évolutives : La prise en charge était multidisciplinaire avec une exérèse chirurgicale à but fonctionnel et esthétique. L'évolution était favorable à court terme chez tous les patients. Une récidive chez un patient a nécessité une reprise chirurgicale qui s'est soldée par une rétraction de la fente palpé-brale, un ptérigion, un symblépharon, une kérato-uvéite et une chéloïde de l'angle extern

[Manicure and pedicure in the city of Ouagadougou (Burkina Faso): practices and risks]. / La manucure et la pédicure dans la ville de Ouagadougou (Burkina Faso): pratiques et risqué.

Pedicure-manicure represents the aesthetic care of hands, feet and nails. In Burkina Faso, the use of manicure-pedicure products, the techniques used and the level of risk remain unknown. The aim of our study was to evaluate the practice of manicure-pedicure in the city of Ouagadougou. We conducted a descriptive cross-sectional study of all practitioners with at least six months experience in aesthetic care and customers present at the time of the survey from December 2010 to November 2012. We interviewed a total of 313 practitioners and 313 clients. The average age of practitioners was 19 years and of customers was 32.2 years. Fixed location practitioners were mostly women (96.87%) while mobile practitioners were mostly men (68.37%); 64.53% of customers were women. The percentage of practitioners who did not receive professional training was 93.92%. 29.7% of practitioners soaked the instruments in javel water for at least ten minutes; 75.71% knew that the use of certain tools was dangerous and 26.51% had side effects. 40.25% of customers knew that the used equipment may pose some risks and 30.35% were victims of accidents. The manicure and pedicure is done in hair salons by untrained hairdressers to the professional practice. The origin and composition of the products is not known. Not recommended products are used (foot soak shampoo, razor blade and scissors for feet scraping). The use of manicure and/or pedicure is sometimes necessary but that should not obscure the risks to which it exposes customers. Customers education and practitioners training seem necessary to minimize risks.

Stevens-Johnson syndrome and toxic epidermal necrolysis in sub-Saharan Africa: a multicentric study in four countries.

OBJECTIVE: The purpose of this study was to document the clinical profile, etiologies, and outcomes of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in hospitals in four sub-Saharan African countries. PATIENTS AND METHODS: A retrospective study on cases of SJS/TEN treated in dermatology departments and/or intensive care units in four sub-Saharan African countries (Benin, Burkina Faso, Central African Republic, and Togo) from 2000 to 2010. The study focuses on variables such as age, sex, type of SJS/TEN, epidermal detachment of the skin surface, HIV status, drug(s) involved, and outcomes (death and sequelae). RESULTS: This study identified 177 cases of SJS/TEN from 2000 to 2010: 129 with SJS; 37 TEN; and 11 overlapping SJS/TEN. The average age of patients was 32.3 ± 15.4 years, and the sex ratio (M/F) was 0.6. HIV serology was positive in 69 (54.8%) of the 126 patients tested. Antibacterial sulfonamides (38.4%) were the most commonly used drugs followed by nevirapine (19.8%) and tuberculosis drugs (5.6%). We recorded 22 deaths (i.e. six cases of SJS, 15 of TEN, and one of overlapping SJS/TEN). Of the 22 patients who died, 16 were infected with HIV; among them, seven had an opportunistic infection (four cases of cerebral toxoplasmosis and three of pulmonary tuberculosis). Twenty-seven cases of sequelae were noted with a large part of eye complications. CONCLUSION: This study has highlighted: (i) the high proportion of patients infected with HIV among patients who had SJS/TEN in sub-Saharan Africa; (ii) the high frequency of antiretroviral drugs as new SJS/TEN causes in sub-Saharan Africa; and (iii) the impact of HIV infection on morbidity and mortality of these affections.

Diffuse cutaneous leishmaniasis in an HIV-positive patient in western Africa.

A 36-year-old HIV1-positive woman presented with a 6-month history of a progressive papular and nodular eruption of the face and subsequent extensive spread to the rest of the skin. The diagnosis of diffuse cutaneous leishmaniasis was established by direct examination and skin biopsy. This atypical form had a dramatic improvement after a 21-day treatment with meglumine antimoniate. This clinical form may be confused with other endemic diseases in western Africa, especially leprosy.

[Epidemiological features of tumors of the skin and mucosal membranes in the department of dermatology at the Yalgado Ouedraogo National Hospital, Ouagadougou, Burkina Faso]. / Tumeur cutanéo-muqueuses: aspects épidémiologiques dans le service de dermatologie du centre hospitalier national Yalgado Ouedraogo de Ouagadougou, Burkina Faso.

We conducted a retrospective study of the files of all patients seen from 1 January 1992 through 31 December 1996 with tumors of the skin and mucosal membranes at the Yalgado Ouédraogo National Hospital in order to determine the epidemiologic features of this disease. The records revealed 988 patients presented 1024 tumors, which could be classified into 33 categories. Most of the patients (60.6%) were in the age bracket of 20 to 39 years. Nearly all cases (988 or 96.5%) were benign skin tumors, mainly of infectious origin, especially viral (51.7%). We observed a substantial number of sexually transmissible infections, such as condylomata. We also found 36 cases (3.5%) of malignant tumors, including 29 cases of Kaposi sarcoma, five skin carcinoma (13.8%), three spinocellular and two basocellular; we also noted two borderline malignant tumors: a dermatofibrosar-coma protuberans and a nodular hidradenoma. The elevated prevalence of condyloma (151 cases) may explain the predominance of the 20-39 year age group, which is the most sexually active. Our series also confirmed the relative rarity (3.5%) of cutaneous cancers among African blacks. The predominance of Kaposi sarcoma may be explained by the high prevalence of HIV infection in our country.