Changes in patient profiles in the cardiology department of the University Hospital Gabriel Touré (UH-GT) : results of two cross-sectional studies of 2010 and 2022.

BACKGROUND: Little is known about patient profile changes in medical facilities in our country, leading to this study to describe and compare patient profiles in 2010 and 2022. PATIENTS AND METHODS: This was a cross-sectional study with new outpatients aged 15 years and more seen in the cardiology department of the UH-GT. Measurements included height, weight and body mass index (BMI). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Quantitative data are presented as the mean with standard deviation, and categorical one as proportions. Statistical tests were the t test to compare means and chi-test for categorical variables. The level of significance was set to 0.05. RESULTS: The sample consisted of 515 new patients (199 in 2010 and 316 in 2022) with 59.1% female in 2010 and 60.1% in 2022 (p = 0.821). We noticed an increase in hypertension (59.1-71.8%, p = 0.003) and a decrease in tobacco smoking (from 13 to 05.4%, p = 0.002) and stroke (from 05.8 to 02.2%, p = 0.033). Height increased significantly from 1.59 m to 1.66 m, p = 0.002. SBP and DBP showed significant decreases in their means from 155.43 to 144.97 mmHg, p = < 0.001 for SBP and from 95.53 to 89.02 mmHg, p = < 0.001 for DBP. CONCLUSIONS: Cardiovascular risk factors showed different trends with decreasing tobacco smoking, similar to systolic and diastolic blood pressure, albeit with an increase in hypertension prevalence. Other CVrf values increased. Awareness campaigns must be reinforced and maintained to obtain their decrease.

Maladie thromboembolique veineuse chez la femme au service de cardiologie du CHU de Kati / Venous thromboembolic disease in women in the cardiology department of the Kati university hospital

Introduction : La maladie thromboembolique veineuse (MTEV) regroupe : la thrombose veineuse profonde(TVP) et l'embolie pulmonaire(EP).Ce travail a été initié pour identifier les particularités féminines si elles existent. Matériels et Méthode : il s'agissait d'étude rétrospective, descriptive réalisée dans le service de cardiologie du CHU de Kati sur une période allant du 01 janvier 2014 au 31 décembre 2021. Ont été inclues les patientes hospitalisées durant la dite période pour maladie thromboemboliqueveineuse. Les variables étudiées étaient les données sociales démographiques, les facteurs de risque, les paramètres cliniques et paracliniques, les aspects thérapeutiques et évolutifs. Résultats : Au total nous avons enregistré 68 cas de MTEV dont 40 (58,8%) femmes. Il s'agissait 12 (30%) cas de TVP, 25 (62,5%) d'EP et leur association dans 3 (7,5%) cas. La majorité (82,5%) des patientes était des femmes au foyer.Le post partum représentait 10% des cas. La probabilité clinique, selonle score de Wells était élevée chez 93% des TVP, intermédiaire pour les cas d'embolie pulmonaire avec 50%. L'angioscanner révélait que l'embolie pulmonaire était bilatérale dans 80% des cas. L'héparine et l'AVK ont été les plus utilisés. La mortalité était de 7,5%. Conclusion : les femmes sont plus victime des maladies thromboemboliques veineuses que les hommes. Le post partum est une situationparticulière chez la femme. Les récidives ne sont pas rares

Introduction: Venous thromboembolic disease (MTEV) includes: deep venous thrombosis (DVT) and pulmonary embolism (PE).This work was initiated to identify the female particularities if they exist.Materials and Method: This was a retrospective, descriptive study conductedin the cardiology department of the Kati university hospital over a period from January 01, 2014 to December 31, 2021.Patients hospitalized during the period for venousthromboembolic disease were included.The variables studied were demographic social data, risk factors, clinical and para-clinical parameters, therapeutic and evolutionary aspects. Results: In total we recorded 68 cases of MTEV of which 40 (58.8%) women. There were 12 (30%) cases of deep vein thrombosis, 25 (62.5%) cases of pulmonary embolism and their association in 3 (7.5%) cases.The majority (82.5%) of patients were housewives.Thepostpartum accounted for 10% of cases.The clinical probability according to the Wells score was high in 93% of deep vein thrombosis, intermediate for cases of pulmonary embolism with 50%.Angio-CT showed that pulmonary embolism was bilateral in 80% of cases. Heparin and anti-vitamin K were the most commonly used. Mortality was 7.5%. Conclusion: women are more victims of venous thromboembolic diseases than men. Postpartum is a special situation for women. Recurrences are not uncommon

[Epidemiological and clinical aspects of atrial fibrillation at the cardiology department of kati university hospital]. / Aspects epidemiologique et clinique de la fibrillation auriculaire au service de cardiologie du chu de kati.

Atrial fibrillation is the most frequent permanent rhythm disorder.Theaim of this work was to determine the epidemiological and clinical aspects of atrial fibrillation cases hospitalized in the cardiology department of the University Hospital of Kati. MATERIALS AND METHODS: We carried out a descriptive retrospective study, from January 2018 to December 2019.Patients of all ages and both sexes with clinical and EKG atrial fibrillation admitted to the department during the study period were included in the study.The variables studiedwere: socio-demographic characteristics, clinical signs, classification of atrial fibrillation, and comorbidities associated. RESULTS: A total of 52 patients were included in the studyof 203 cases hospitalized in the department, with a hospital prevalence of 25.61%, the female sex was predominant 69.23%. The main reason for consultation was heart failure syndrome (46.15%).Arterial hypertension (55.76%) was the mostassociatedcomorbidity. Permanent atrial fibrillation accounted for 63.46% of cases . CONCLUSION: Atrial fibrillation is the most frequent arrhythmia in our environment, preventive measures must be put in place for early detection and better management of comorbiditiesassociatedwith atrial fibrillation.

La fibrillation auriculaire est le trouble du rythme le plus fréquent. Le but de ce travail était de déterminer les aspects épidémiologiques et cliniques de la fibrillation atriale dans le service de cardiologie du CHU de Kati. MATÉRIELS ET MÉTHODES: Il s'agit d'une étude rétrospective descriptive menée de janvier 2018 à décembre 2019. Ont été inclus dans cette étude les patients de tout âge et des deux sexes ayant présenté une fibrillation atriale sur des critères cliniques et électrocardiographiques, admis dans le service pendant la période d'étude. Les variables étudiées étaient : les caractéristiques sociodémographiques, les signes cliniques et électriques, et les comorbidités associées. RÉSULTATS: Au total 52 patients ont été inclus dans l'étude sur 203 cas hospitalisés dans le service soit une prévalence hospitalière de 25,61%, le sexe féminin a été prédominant 69,23%. Le principal motif de consultation était le syndrome d'insuffisance cardiaque (46,15%). L'hypertension artérielle (55,76%) a été la comorbidité la plus associée. La fibrillation atriale permanente représentait 63,46% des cas. CONCLUSION: La fibrillation atriale est l'arythmie la plus fréquente dans notre milieu, des mesures préventives doivent être mise en place pour une détection précoce et une meilleure prise en charge des comorbidités associées.

The Role of Candida Albicans in Routine Clinically Suspected Otomycosis.

BACKGROUND: Candida albicans and non-albicans Candida species are considered as commensal yeasts of many cavities including the external auditory canal (EAC) in healthy individuals. These fungal microorganisms can also act as opportunist pathogens and cause otomycosis. In this study, the patients of clinically suspected otomycosis were specifically investigated mycologically to elucidate the role of Candida albicans and non-albicans Candida species. MATERIAL AND METHODS: A prospective observational study was conducted from July 2016 and June 2017 at the Laboratory of Parasitology and Mycology of the Sourô SANOU University Hospital in Bobo-Dioulasso, Burkina Faso. Identification of Candida isolates was using conventional phenotypic methods. Antifungal susceptibility tests were carried out by disk diffusion method in accordance with CLSI standard document M44-A for yeasts. RESULTS: Out of 160 patients with clinically diagnosed otomycosis, 77(48.1%) were investigated positive for Candida species. Candida albicans (61%) was the most isolated species and non-albicans Candida species accounted for 39% of the isolates, with mainly Candida spp (22.1%), Candida krusei (10.4%), Candida dubliniensis (5.2%) and Candida glabrata (1.3%). Nystatin showed the highest efficacy (95.9%), followed by ketoconazole (90.4%), clotrimazole (83.6%), miconazole (72.6%) and amphotericin B (63.0%). CONCLUSION: Otomycosis due to Candida species should be especially considered, since they have a wide number of potential virulence factors that cause fungal infections. Also, antifungal susceptibility testing should be performed in order to select the appropriate antifungal therapy.

CONTEXTE: Candida albicans et les espèces de Candida non albicans sont considérées comme des levures commensales de nombreuses cavités, y compris le conduit auditif externe (CAE) chez les individus sains. Ces micro-organismes fongiques peuvent également agir comme des agents pathogènes opportunistes et provoquer une otomycose. Dans cette étude, les patients cliniquement suspectés d'otomycose ont été spécifiquement étudiés mycologiquement pour élucider le rôle des espèces de Candida albicans et non albicans Candida. MATÉRIEL ET METHODS: Une étude observationnelle prospective a été menée de juillet 2016 à juin 2017 au Laboratoire de Parasitologie et Mycologie du CHU Sourô SANOU à BoboDioulasso, Burkina Faso. L'identification des isolats de Candida utilisait des méthodes phénotypiques conventionnelles. Des tests de sensibilité aux antifongiques ont été réalisés par la méthode de diffusion sur disque selon le document standard CLSI M44-A pour les levures. RÉSULTATS: Sur 160 patients atteints d'otomycose cliniquement diagnostiquée, 77 (48,1 %) ont été testés positifs pour les espèces de Candida. Candida albicans (61 %) était l'espèce la plus isolée et les espèces non albicans Candida représentaient 39 % des isolats, avec principalement Candida spp (22,1 %), Candida krusei (10,4 %), Candida dubliniensis (5,2 %) et Candida glabrata (1,3%). La nystatine a montré l'efficacité la plus élevée (95,9 %), suivie du kétoconazole (90,4 %), du clotrimazole (83,6 %), du miconazole (72,6 %) et de l'amphotéricine B (63,0 %). CONCLUSION: L'otomycose due aux espèces de Candida doit être particulièrement considérée, car elles ont un grand nombre de facteurs de virulence potentiels qui provoquent des infections fongiques. En outre, des tests de sensibilité aux antifongiques doivent être effectués afin de sélectionner le traitement antifongique approprié. Mots-clés: Candida albicans; Otomycoses; routine; sensibilité antifongique; Burkina Faso.

[Epidemiology of Covid-19 and high blood pressure association at Mali'shospital]. / Epidemiologie de l'association Covid-19 et hypertension arterielle a l'hopital du Mali.

INTRODUCTION: High blood pressure is a major cardiovascular risk factor. Patients with cardiovascular risk factors are at risk of developing COVID-19. The objective of this study was to determine epidemiology of Covid-19 infected in patients with high blood pressure. PATIENTS AND METHOD: Descriptive cross-sectional study from April 2020 to June 2020 about patients hospitalized for Covid 19 by PCR diagnosis at the Hopital du Mali Bamako and having high blood pressure. Admission registry and patient charts were used to collect data. RESULTS: We collected 78 out of 484 in patients which mean hospital frequency of 16.11%. The mean age was 55.21 +/- 14.61 years. Sex ratio M / F was 1.36. Patients were followed for high blood pressure in 59% of cases. Medical history was ischemic heart disease in 2.6% and dilated cardiomyopathy in 2.6%. Main functional signs were cough in 41.02% and lost of taste in 11.53%. High blood pressure on admission was grade 2 in 37.2% and grade 3 in 3.8%. Treatments received were calcium channel blockers 41.02%, inhibitors of the reninangiotensinaldosterone system 16.66% and combinations 15.38%. Hospital mortality was 10.3%. There was no statistically significant difference in mortality between known hypertensive patients and de novo hypertensive patients. There was also no statistically significant difference in mortality by grade of hypertension. CONCLUSION: High blood pressure can be associated to Covid 19. Treatment is based on calcium channel blockers and reninangiotensinaldosterone system inhibitors. It has an impact on the prognosis of the disease with significant mortality.

INTRODUCTION: L'hypertension artérielle (HTA) est un facteur de risque cardiovasculaire majeur. Dans la littérature elle est fréquemment retrouvée chez les patients atteints de la COVID-19.L'objectif de cette étude est de décrire l'épidémiologie de cette association chez les patients hospitalisés pour Covid-19. PATIENTS ET MÉTHODE: L'Etude est transversale et descriptive ; elle a été réalisée sur la période du 1erAvril 2020 au 30 Juin 2020. Elle a concerné les patients hospitalisés pour Covid 19 avec un test PCR positif à l'hôpital du Mali de Bamako et ayant une HTA. Les registres d'admission et les dossiers des patients ont servi pour la collecte des données. RÉSULTATS: Nous avons colligé 78 sur 484 patients hospitalisés soit une fréquence de 16,11%. L'âge moyen était de 55,21 +/- 14,61 ans. Le sex ratio H/F était de 1,36.Les patients étaient suivis pour HTA dans 59% des cas. Les antécédents médicaux étaient la cardiopathie ischémique chez 2,6% et la cardiomyopathie dilatée chez 2,6%. Les principaux signes fonctionnels étaient la toux chez 41,02% et l'agueusie chez 11,53%. L'HTA à l'admission était de grade 2 dans 37,2% des cas et de grade 3 dans 3,8% des cas. Les traitements reçus étaient les inhibiteurs calciques 41,02%, les inhibiteurs du système rénine angiotensine aldostérone 16,66% et les associations 15,38%. La mortalité hospitalière était de 10,3%. Il n'y avait pas de différence statistiquement significative concernant la mortalité entre les patients connus hypertendus et les patients hypertendus de novo. Il n'y avait pas non plus de différence statistiquement significative concernant la mortalité selon le grade de l'HTA. CONCLUSION: l'HTA peut être associée au Covid 19. Le traitement est basé sur les inhibiteurs calciques et sur les inhibiteurs du système rénine angiotensine aldostérone. Elle a un impact sur le pronostic de la maladie avec une mortalité importante.

[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.

Prevalence of vulvovaginal candidiasis in pregnancy at three health centers in Burkina Faso.

INTRODUCTION: Pregnant women are more susceptible to vaginal colonization and infection by yeast. The role of Candida colonization in the occurrence of preterm birth is well established. The knowledge of local epidemiology and identification of risk factors for preterm birth is important for the prevention and management strategies. The purpose of the study was to determine the prevalence of Candida sp. in vaginal swabs of pregnant women. METHODS: Pregnant women attending routine antenatal visits in three primary health centres in Bobo-Dioulasso (Burkina Faso) were enrolled into a cross-sectional study carried out from February to April 2015. Vaginal swabs samples were taken from participants after obtaining oral consent. The swabs were inoculated into Sabouraud's glucose agar supplemented with chloramphenicol and incubated at 37°C for 24 to 48hours under aerobic conditions in order to perform fungal culture. The identification of the Candida species was done by culture on HiCrome Candida Differential Agar at 35°C for 48h for production of species-specific colors. RESULTS: A total of 229 pregnant women were included. The prevalence of vulvovaginal candidiasis (VVC) was 22.71%, (95% CI [17.45-28.69]). Candida albicans accounted for 40.39% and non-Candida albicans species for 59.61% of the isolates, with mainly C. glabrata (32.69%), C. tropicalis (15.38%) and C. krusei (11.54%). CONCLUSIONS: This study revealed a high prevalence of non-C. albicans species. The syndromic management guidelines for VVC in Burkina Faso will be revised to include a specific protocol for pregnant women.

In vitro susceptibility of Candida albicans clinical isolates to eight antifungal agents in Ouagadougou (Burkina Faso).

INTRODUCTION: In recent years, the infection Candida albicans infection worldwide has risen, and the incidence of resistance to traditional antifungal therapies is also increasing. The aim of this study was to evaluate in vitro susceptibility of C. albicans clinical isolates to eight antifungal agents in Ouagadougou. MATERIALS AND METHODS: A cross-sectional study was conducted from January 2013 to December 2015 at Yalgado Ouédraogo University Teaching Hospital. Two hundred seven strains have been isolated from 347 symptomatic patients received in different clinical services. Samples were cultured on Sabouraud Dextrose Agar supplemented with Cloramphenicol. Isolates were diagnosed as C. albicans using germ tube test, chlamydospore formation on Corn Meal Agar, and Api-Candida test (Biomérieux). Antifungal susceptibility testing was performed by disk diffusion method and isolates classified as susceptible, susceptible dose-dependent and resistant. RESULTS: Three hundred forty-seven (347) patients are included in this study. Two hundred and six (206) out of 347 collected samples (59.36%) were found positive for C. albicans. The strains were mostly isolated from vulvovaginal (49%) and oral infections (40.3%). The highest resistance rates of azoles were obtained with fluconazole (66.5%), itraconazole (52.3%) and ketoconazole (22.9%) when all clinical isolates were included. The resistance rates of fluconazole, itraconazole and ketoconazole remain highest for vulvovaginal and oral isolates. The rate of resistance to the polyene amphotericin B was 32.0% for all clinical isolates and was 56.4% for vulvovaginal strains. Resistance rate to nystatin was 6.3% for all clinical isolates. Cross-resistance analysis with data of all clinical strains revealed that the incidence of resistance to ketoconazole and itraconazole in fluconazole-resistant isolates was significantly higher than recorded for fluconazole-susceptible isolates. CONCLUSION: In vitro C. albicans antifungal susceptibility test in this study showed relatively high resistance to commonly and widely used azoles (fluconazole, ketoconazole). Most C. albicans clinical isolates were susceptible to nystatin.

[A case of rhinofacial entomophthoromycosis in Soudano-Sahelian tropical climate in Burkina Faso]. / Un cas d'entomophthoromycose rhinofaciale en climat tropical soudano-sahélien au Burkina Faso.

We describe a rhinofacial entomophthoramycosis case in a sexagenarian (65 years old) housewife. She was immunocompetent and resident of Burkina Faso. She consulted both the service of dermatology and the service of stomatology of the Teaching Hospital of Bobo-Dioulasso in February 2016 for a diffuse facial tumefaction evolving over six months. This tumefaction was associated with headaches and a left nasal obstruction. Histological examination of the lesion showed an important and polymorphic inflammatory reaction. Also, a filamentous fungus with wide non-septated hyphae and right-angled fungal branching, consistent with mucormycosis was isolated. Mycological diagnosis based on fungal culture with Sabouraud medium without any antibiotic and cyclohexemide after incubation at 27°C and at 30°C was negative. Furthermore, it was not possible to amplify the DNA extracted from biopsy. Antifungal therapy based on the administration of fluconazole per os at 800mg/day was started allowing clinical improvement. This is the first case of a rhinofacial entomophtharomycosis documented in Bobo-Dioulasso. Rhinofacial entomophthoromycosis is largely unknown, even in tropical regions such as Burkina Faso. This lack of knowledge results in a delay in the diagnosis, and subsequently a bad prognosis. It is therefore urgent to improve knowledge on this disease to guide diagnostic steps, prognosis of outcome, and antifungal therapy.

[Necrotizing cervico-facial cellulitis of dental origin in a developing country]. / Les cellulites cervico-faciales nécrosantes d'origine dentaire dans un pays en voie de développement.

INTRODUCTION: Necrotizing cellulitis of dental origin is a serious disease and requires prompt and effective management to avoid adverse outcomes. The purpose of this work is to describe the diagnostic and therapeutic difficulties encountered in this condition. METHODS: This was a prospective study in the thoracic surgery department of Mali Hospital from January 2011 to February 2015. We collected consecutively 19 cases of complicating cervico-facial cellulitis of dental origin. The anatomical and clinical aspects, therapeutic modalities and difficulties are described. RESULTS: Dental pain and fever were the predominant symptoms followed by cervical edema. Chest CT-scan was the basis for the diagnosis in all cases. Cervicotomy with debridement was the most performed surgical procedure. Pleural drainage was performed in 6 cases. Three patients (15.8%) died. CONCLUSION: Necrotizing cellulitis of dental origin is a serious disease with high morbidity and mortality. The key radiological examination is the thoracic CT-scan. Early medico-surgical management by emergency care, tailored antibiotic therapy, removal of necrotizing tissues and drainage of collections are required to deliver a good outcome.

Comparative assessment of transmission-blocking vaccine candidates against Plasmodium falciparum.

Malaria transmission-blocking vaccines (TBVs) target the development of Plasmodium parasites within the mosquito, with the aim of preventing malaria transmission from one infected individual to another. Different vaccine platforms, mainly protein-in-adjuvant formulations delivering the leading candidate antigens, have been developed independently and have reported varied transmission-blocking activities (TBA). Here, recombinant chimpanzee adenovirus 63, ChAd63, and modified vaccinia virus Ankara, MVA, expressing AgAPN1, Pfs230-C, Pfs25, and Pfs48/45 were generated. Antibody responses primed individually against all antigens by ChAd63 immunization in BALB/c mice were boosted by the administration of MVA expressing the same antigen. These antibodies exhibited a hierarchy of inhibitory activity against the NF54 laboratory strain of P. falciparum in Anopheles stephensi mosquitoes using the standard membrane feeding assay (SMFA), with anti-Pfs230-C and anti-Pfs25 antibodies giving complete blockade. The observed rank order of inhibition was replicated against P. falciparum African field isolates in A. gambiae in direct membrane feeding assays (DMFA). TBA achieved was IgG concentration dependent. This study provides the first head-to-head comparative analysis of leading antigens using two different parasite sources in two different vector species, and can be used to guide selection of TBVs for future clinical development using the viral-vectored delivery platform.

[Orthostatic low blood pressure in patient suffering from hypertension, in external cardiology consultation]. / L'Hypotension orthostatique chez l'hypertendu en consultation externe de cardiologie.

This work was aimed to describe the epidemiological, clinical, biological and electrical aspects of orthostatic low blood pressure (LBP) within patients with high blood pressure (HBP) in the cardiology department of the Kati University Hospital. This was a prospective cross-sectional study conducted between June 1st, 2012 and May 31st, 2013. It included all the patients with HBP regularly assessed for at least a month, following their treatment and having no other treatments which can induce a orthostatic LBP. RESULTS: With a total of 300 subjects with high blood pressure, 42 subjects presented an orthostatic LBP with or without suggestive clinical demonstrations, among which 16 men and 26 women, with an average age of 55 year. In the HBP population, the orthostatic LBP had a 14% frequency (42/300), the sex ratio was 0.61. Most of the patients were 55 years old or more. The HBP was not controlled in 66.7% of cases. Twelve percent of the patients with orthostatic LBP were diabetics. The number of antihypertensive drug used did not appear to influence the appearance of an orthostatic LBP. Monotherapy was associated with an orthostatic LBP in 47.6% of cases and this monotherapy used the calcic inhibitors in 62% of the cases. Orthostatic low blood pressure is frequent within patient with HBP undergoing treatment. It must be systematically looked for, especially in the uncontrolled HBP, among older subjects, the diabetics, and those with a personal history of neurological disease.

OBJECTIF: Ce travail visait à décrire les aspects épidémiologiques, cliniques, biologiques et électriques de l'hypotension orthostatique chez l'hypertendu dans le service de cardiologie du CHU de Kati. PATIENTS ET MÉTHODES: L'étude était transversale et prospective allant du 1er Juin 2012 au 31 Mai 2013 dans le service de cardiologie du CHU de Kati. Il s'agissait de l'ensemble des patients hypertendus régulièrement suivis depuis un mois et plus, bien observant et n'ayant pas d'autres traitements pouvant favorisés l'hypotension orthostatique. RÉSULTATS: Au total 42 sujets présentant une hypotension orthostatique avec ou sans manifestations cliniques évocatrices ont étés inclus, dont 16 hommes et 26 femmes, en moyenne âgés de 55 ans. Dans la population d'hypertendus, l'hypotension orthostatique avait une fréquence de 14% (42/300), le sex ratio était de 0,61. Les patients âgés de plus de 55 ans étaient plus nombreux. L'hypertension artérielle n'était pas contrôlée dans 66,7%. 11,9% des patients hypotendus orthostatiques étaient diabétiques. Le nombre d'antihypertenseur utilisé ne paraissait pas influencer l'apparition d'une hypotension orthostatique. La monothérapie était associée à une hypotension orthostatique dans 47,6% et cette monothérapie utilisait les inhibiteurs calciques dans 62% des cas. CONCLUSION: L'hypotension orthostatique est fréquente chez les hypertendus traités. Elle doit être recherchée systématiquement, en particulier dans l'HTA non contrôlée, chez les sujets âgés, les diabétiques, et chez ceux ayant un antécédent neurologique.

Thrombophlebite des membres dans le service de cardiologie du CHU Gabriel Toure

Objectif: Determiner la frequence des thromboses veineuses profondes des membres superieurs et inferieurs dans le milieu specialise cardiologique. Decrire les signes cliniques et para cliniques. Identifier les facteurs etiologiques. Evaluer l'evolution sous traitement. Materiel et methodes: Il s'agissait d'une etude prospective et longitudinale qui s'est deroulee du 1erjanvier 2007 au 31 mai 2008 dans le service de cardiologie du Centre Hospitalier Universitaire Gabriel Toure de Bamako. Etaient inclus tous les patients qui presentaient une thrombose veineuse profonde des membres confirmee echographiquement. Les donnees ont ete analysees avec le logiciel Epi info 6.04d. Resultats: 22 cas de thrombophlebite confirmee pour un total de 1171 hospitalisations; soit une frequence de 1;88 avec un age de survenue entre 30 et 44ans (40;9) sans aucune preference de sexe (sex ratio=1). Soixante et trois virgule six pour cent n'avaient aucun antecedent cardiovasculaire connu. Les signes cliniques etaient evocateurs dans 90;9. L'alitement prolonge etait present dans 59;09 des cas; associe a l'infection au VIH dans 18;1. L'atteinte du membre inferieur gauche predominait (72;7); un seul cas du membre superieur gauche (4;5). L'atteinte du reseau profond predominait (86;3) avec un siege preferentiellement proximal (72;7). La veine femorale a ete la plus thrombosee (50). Quatre-vingt et six virgule trois pour cent des patients ont recu les Heparines de Bas Poids Moleculaire (HBPM) + Anti Vitamine K (AVK) avec 68;18 de guerison sans sequelle. L'evolution s'est compliquee d'embolie pulmonaire dans 13;6 et de deces dans 4;5. Conclusion: La thrombose veineuse profonde des membres occupe une place importante parmi les pathologies cardiovasculaires en milieu specialise cardiologique a Bamako et l'infection au VIH semble augmenter sa prevalence

[Epidemiology of bacillary pulmonary tuberculosis according to HIV status of patients followed in the department of infectious diseases Conakry (Guinea)]. / Épidémiologie de la tuberculose pulmonaire bacillifère selon le statut VIH des patients suivis dans le service des maladies infectieuses de Conakry (Guinée).

Despite many efforts of prevention and the availability of free treatment, TB/HIV co-infection is still rampant in Guinea. The objective of this study was to describe the epidemiology of smear positive pulmonary tuberculosis according to HIV status among patients hospitalized in the infectious diseases department of Conakry University Hospital. This was a descriptive and analytical retrospective study of patient records admitted for pulmonary tuberculosis from January 2003 to December 2012. During this period, 1953 cases of tuberculosis were collected of which 346 (17.7%) were smear positive. There was a marked male predominance (59.7%). The average age was 38 ± 11 years. The majority of patients originated from the suburbs of Conakry and its surrounding prefectures (76.7%). People without profession were most represented (40.7%). A level of primary education was the most frequently reported (39.7%). Out of 325 patients tested for HIV, the serology was positive in 185 patients (56.9%). A contact with a TB patient was reported in 21.4% of HIV negative patients, and in 6.5% of the HIV-positive group (p = 0.0006). There was no difference between the two groups regarding clinical signs and symptoms. The mean CD4 count was comparable in both groups (p = 0.05). Lethality was higher among co-infected patients (30.4% against 15.56%; p = 0.00037). Strengthening the prevention of TB among PLWHA by the administration of isoniazide seems necessary and warrants further study on this subject in Guinea.

Stress dependent infection cost of the human malaria agent Plasmodium falciparum on its natural vector Anopheles coluzzii.

Unraveling selective forces that shape vector-parasite interactions has critical implications for malaria control. However, it remains unclear whether Plasmodium infection induces a fitness cost to their natural mosquito vectors. Moreover, environmental conditions are known to affect infection outcome and may impact the effect of infection on mosquito fitness. We investigated in the laboratory the effects of exposition to and infection by field isolates of Plasmodium falciparum on fecundity and survival of a major vector in the field, Anopheles coluzzii under different conditions of access to sugar resources after blood feeding. The results evidenced fitness costs induced by exposition and infection. When sugar was available after blood meal, infected and exposed mosquitoes had either reduced or equal to survival to unexposed mosquitoes while fecundity was either increased or decreased depending on the blood donor. Under strong nutritional stress, survival was reduced for exposed and infected mosquitoes in all assays. We therefore provide here evidence of an environmental-dependant reduced survival in mosquitoes exposed to infection in a natural and one of the most important parasite-mosquito species associations for human malaria transmission.

[Indications and anomalies of extended electrocardiogram recording (24 hours) at the Gabriel Toure university hospital in Bamako]. / Les indications et anomalies de l'enregistrement de longue duree (24 heures) de l'electrocardiogramme au CHU Gabriel Toure de Bamako.

AIM: To specify indications and main anomalies of the 24 hours electrocardiogram in Bamako. METHODOLOGY: The study was retrospective and conducted from 1st January 2008 to 31st July 2013, on patients whose file comprised a readable recording holter. The Holter recordings were analyzed by the software synetec (syneview 2) of ELA medical. Patients data were analyzed by SPSS 18 and redaction made using Word 2010. RESULTS: 90.2% of the recordings were retained. Mean Age of the sample was of 44,02 ± 16,95 years, the sex-ratio H: F 1,18 with 79.3% of patients coming from the services of cardiology. The indications were: palpitations (32.6%), suspicions of disorder of the rate/rhythm (27.2%), loss of consciousness, cerebral vascular accidents ischemic each one 15.2% and seeks of cause of faintness in (9.8%). An anomaly was found for the indications of disorder of the cardiac rhythm, palpitations, the cerebral vascular accidents ischemic, fainting and the losses of consciousness in resp. 80%, 66.6%, 28.5%, 22.2% and 14.2%. CONCLUSION: The 24 hours electrocardiographic recording is an examination of a great value in looking for cardiac rhythm disorders field of the disorders of the cardiac rhythm. Its provision will have to be effective in the university structures and the evolution towards the forms at longer duration quickly undertaken in Mali.

BUT: Préciser les indications et les principales anomalies du Holter électrocardiographique à Bamako. MÉTHODOLOGIE: L'étude était retrospective allant du 1er janvier 2008 au 31 juillet 2013 et portait sur des patients dont le dossier comportait un enregistrement holter bien lisible. Les enregistrements Holter étaient analysés par le logiciel synetec (syneview 2) de la société ELA médical. Les données des patients ont été analysées par SPSS 18 et saisies sur Word 2010. RÉSULTATS: 90,2% des examens holter effectués ont été retenus. L'âge moyen de l'échantillon était de 44,02 ± 16,95 ans, le sex-ratio H:F 1,18 avec 79,3% de patients provenant des services de cardiologie.Les indications étaient: palpitations ( 32,6%), suspicions de trouble du rythme (27,2 %), perte de connaissance, accidents vasculaires cérébraux ischémiques chacun 15,2% et recherche de cause de malaise dans (9,8%). Une anomalie était retrouvée pour les indications de trouble du rythme cardiaque, les palpitations, les accidents vasculaires cérébraux ischémiques, les malaises et les pertes de connaissance dans resp. 80%, 66,6, 28,5%, 22,2% et 14,2%. CONCLUSION: L'enregistrement Holter électrocardiographique de 24 heures est un examen d'une grande valeur dans le domaine des troubles du rythme cardiaque. Sa mise à disposition devra être effective dans les structures universitaires et l'évolution vers les formes à durée plus longue rapidement entreprise au Mali.

[Risk factors and clinical aspects of myocardial infarction in patients younger than 40 years in the Point G Teaching Hospital]. / Facteurs de risque et aspects cliniques de l'infarctus du myocarde chez les patients de moins de 40 ans au CHU du Point G.

A retrospective and analytical study was conducted, over 9 years, from January 2004 to December 2012. It included 10 inpatients and took place at the cardiology service of the Point G teaching hospital. Its goals were to assess cardiovascular risk factors, the delay between the clinical onset and admission and to describe ECG changes and echocardiographic changes of myocardial infarction in patients under 40 year-old. Young patients accounted for 6.8% of MI admissions with a male predominance of 90%. The disease frequency has increased with age, 40% were within 38-40 year-old range, the risk factors were predominantly smoking 80%, Stress 50%, High Blood Pressure 40% and dyslipidemia 20%. Typical chest pain was the most common recorded symptom. Anterior necrosis was the most common of electrical pattern, 8 out 10 times the ejection fraction was down and segmental kinetic was impaired in 60% of patients on echocardiography. Over 3 quarters of patients were admitted 12 hours after the onset of symptoms and the evolution during hospitalization was good with no fatality.

Notre étude de monocentrique rétrospective et analytique, réalisée de janvier 2004 à décembre 2012 portait sur 10 malades hospitalisés dans le service de cardiologie du CHU du Point G. Elle avait pour objectifs d'évaluer les facteurs de risques cardiovasculaires, le délai entre le début de la symptomatologie clinique et l'admission et de décrire les aspects électriques et écho cardiographiques de l'infarctus du myocarde (IDM) chez les patients de moins de 40 ans. Ces patients représentaient 6,8% des admissions pour IDM et la prédominance était masculine (90 %). La fréquence de l'IDM augmentait avec l'âge, 40 % des patients étaient dans la tranche d'âge [38- 40[. Les facteurs de risque (FDR) étaient dominés par le tabac (80 %), le stress (50%), l'HTA (40%) et la dyslipidémie (20%). La douleur thoracique typique était le maître symptôme. La nécrose antérieure était l'anomalie électrique dominante, huit fois sur dix la fraction d'éjection était diminuée et la cinétique segmentaire était altérée chez 80 % des patients à l'échocardiogramme. Plus des trois quart des malades étaient admis au moins 12 heures après le début des symptômes et l'évolution hospitalière était bonne avec une mortalité nulle.

[Knowledge and practices of hypertension in nursing staff of the Hospital Gabriel Touré and Point G]. / Pratiques et connaissances sur l'hypertension arterielle du personnel soignant des CHU Gabriel Toure et Point G.

OBJECTIVE: This work aimed to study the quality of diagnosis and management of high blood pressure (HBP) by the practitioners of the Gabriel TOURÉ and point G teaching hospitals of Bamako. MATERIALS AND METHODS: It was a descriptive and analytical, cross-sectional study during the study period from 1st March 2009 to 28 February 2010. It included all physicians and paramedics of the teaching hospital of the Point G and Gabriel TOURÉ in Bamako. RESULTS: A total of 283 practitioners (physicians and the paramedics) from both teaching hospitals have accepted our questionnaire, including 133 doctors and 185 paramedics. CHU Gabriel TOURÉ accounted for 55.1%, the majority came from the department of cardiology with 18.4%. Doctors accounted for the largest square with 47.0%. The majority of our practitioners (59%) say it takes at least one session during three medical consultations to diagnose the HBP. Only 29,60% define the HBP from 140/90 mm Hg. With a blood pressure goal of 58, 30% and 57.20% of practitioners claimed to retain 140/90 mm Hg, respectively for the diabetic and the renal-insufficient patients. A considerable number of our practitioners (27.9%) still used in pregnant women the triplet diuretic/IEC/diet without salt. The information of patients on some important aspects of the pathology prior to any therapeutic strategy had been conducted in 63.6. CONCLUSION: The high blood pressure must be a major concern for medical and paramedical staff today.

OBJECTIF: Ce travail visait à étudier la qualité du diagnostic et de la prise en charge de l'hypertension artérielle par les praticiens du CHU Gabriel TOURE et de point G de Bamako. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude transversale descriptive et analytique, pendant la période d'étude du 1er mars 2009 au 28 Février 2010. Elle a concerné l'ensemble des médecins et des paramédicaux des centres hospitalo ­ universitaires du Point G et Gabriel TOURE de Bamako. RÉSULTATS: Au total 283 praticiens (médecins et des paramédicaux) des deux centres hospitalo - universitaires ont accepté notre questionnaire, dont 133 médecins et 185 paramédicaux. Le CHU Gabriel TOURE représentait 55,1%, la majorité provenait du service de cardiologie avec 18,4%. Les médecins ont constitué la plus grande proportion avec 47,0%. La majorité de nos praticiens (59%) affirmaient qu'il faut au moins une séance de prise tensionnelle pendant trois consultations médicales pour diagnostiquer l'HTA. Seulement 29,60% définissent l'HTA à partir de 140/90 mm Hg. Comme objectif tensionnel 58, 30% et 57,20% des praticiens affirmaient retenir 140/90 mm Hg respectivement chez le diabétique et l'insuffisant rénal. Un nombre considérable de nos praticiens (27,9 %) utilisait encore chez la femme enceinte le triplet Diurétique/IEC/Régime sans sel. L'information des patients sur certains aspects importants de la pathologie avant toute stratégie thérapeutique avait été effectuée dans 63,6. CONCLUSION: L'hypertension artérielle doit être une préoccupation majeure pour tout personnel médical et paramédical de nos jours.

[Intestinal parasites in prisoners in Ouagadougou (Burkina Faso)]. / Prévalence du parasitisme intestinal en milieu carcéral à Ouagadougou (Burkina Faso).

OBJECTIVES: to analyze the epidemiologic and clinical aspects of intestinal parasitosis in prisoners at the prison in Ouagadougou (MACO). MATERIALS AND METHODS: cross-sectional study from November 2009 to January 2010, including a survey to determine the risk factors and clinical signs of intestinal parasitosis. It also included laboratory examination of feces samples from 403 prisoners, by direct analysis, the Willis and Ritchie methods, and a scotch test for oxyuris (Enterobios vermicularis). RESULTS: The global prevalence of intestinal parasitosis was 71.5%. There was a link between parasitism and the prison section. Amebae were the most frequent parasites (66.7%), with high prevalence of Entamœba coli (55.6%). They were followed by flagellata (16.6%), mainly Trichomonas intestinalis (9.2%). Helminths were less frequent (7.4%). Most subjects with parasites were symptomatic (diarrhea or constipation) (p = 10(-4)). CONCLUSION: our results highlight the need to improve sanitation at the prison and provide hygiene education for the prison population.