Mucocutaneous manifestations in human immunodeficiency virus (HIV)-infected patients in Nouakchott, Mauritania.

BACKGROUND: Mucocutaneous manifestations are one of the first clinical signs in patients infected with human immunodeficiency virus (HIV). To the best of our knowledge, there has been no previous study describing dermatologic manifestations in Mauritanians infected with HIV. The aim of the present study was to determine the profiles of mucocutaneous manifestations in relation to CD4 T cell count in HIV-positive Mauritanian patients. METHODS: A total of 86 adult patients aged > 18 years old attending the Ambulatory Treatment Center of the National Hospital of Nouakchott, Mauritania, with newly diagnosed HIV and who were not under antiretroviral treatment were included in the study in 2015. Dermatologic manifestations were documented before initiating antiretroviral treatment. RESULTS: Most of the included patients were in clinical stage 3 of the World Health Organization classification at initial diagnosis, with the mean CD4 T cell count (± SD) of 514 ± 319 cells/mm3 (range, 2-1328 cells/mm3 ), and 19 of 86 (22.1%) patients had CD4 T cell counts below 200 cells/mm3 . More than half (64%) of newly diagnosed HIV-infected patients had dermatoses, including the following: pruritic papular eruption (44.2%), seborrheic dermatitis (4.7%), Kaposi's sarcoma (3.5%), extensive xerosis cutis (2.3%), drug-induced skin reactions (1.2%), and various infectious dermatoses (dermatophyte infections [16.3%], oral candidiasis [11.6%], herpes zoster [8.1%], and scabies [2.3%]). A low CD4 T cell count (< 200 cells/mm3 ) was significantly correlated (P < 0.05) with the presence of following dermatoses: dermatophytosis, oral candidiasis, Kaposi's sarcoma, seborrheic dermatitis, and extensive xerosis cutis. CONCLUSION: Mucocutaneous lesions occur throughout the course of HIV infection, and dermatologic findings in Mauritanian HIV-positive patients are similar to those of patients in other countries. Early detection of skin disorders in some patients may help establish the diagnosis of HIV and management of HIV-associated diseases, limiting the cost of care in low-resource countries.

Rage furieuse transmise par un chien errant

Nous rapportons une observation d'un cas de rage furieuse survenue suite à la morsure par un chien errant. La discussion porte sur la clinique, sur la démarche à suivre après morsure par un chien et les difficultés de diagnostic de cette affection dans notre contexte. Les auteurs recommandent le traitement prophylactique antirabique en cas de morsure par un chien errant. Ils rappellent également que la rage est transmise par un animal enragé, et ils interpellent les autorités sanitaires sur la nécessité de former le personnel de santé, de rendre accessible les vaccins et les immunoglobulines antirabiques. Aussi le renforcement de la surveillance de cette anthropozoonose nécessite un laboratoire et un plateau technique capable de confirmer les cas humains de rage. Une action en amont basée sur la vaccination des animaux de compagnie, l'abattage des chiens errants et le traitement prophylactique en cas d'exposition, contribuera à réduire de façon significative l'ampleur de cette maladie./p>

2014 Anthrax epidemic in Koubia prefecture, Guinea-Conakry.

Anthrax disease is an anthropozoonosis caused by a Gram-positive bacterium, Bacillus anthracis. Our objective was to describe the epidemiological, clinical and therapeutic features of the 2014 epidemic in Koubia prefecture. This retrospective study examined all of the anthrax cases reported in Fafaya, Koubia Prefecture. In March and April 2014, there were 39 cases of human anthrax reported, for an incidence of 1.135%. The mean age was 20.9 (± 18.3) with a sex ratio of 2.54 (28/11) in favor of men. Seventy-six percent (23/39) were single. More than one half were students (53.8%). The main clinical signs were fever in 71, 8% (n = 28 /), papules 59% (n = 23), vesicles of 59% (n = 23) Digestive and cutaneous signs represented 35.9 % and 64.1% respectively; 35% had ingested contaminated meat and 17.95% were in direct contact with a sick animal. We didn't find any correlation between the mode of infection and onset of signs. The fatality rate was 28.21%. The 2014 epidemic of anthrax disease in the Koubia prefecture was marked by a high incidence and lethality. Clinical manifestations were cutaneaous and digestive. These results may serve further interventions to fight against anthrax disease. They should mainly focus on an awareness of peasants, surveillance and vaccination of cattle. Other studies seem to be necessary.

[Rabies in children: an often unknown risk among populations at risk]. / La rage chez l'enfant: un risque encore méconnu des populations exposées.

INTRODUCTION: Rabies is a public health problem in many African countries including Burkina Faso. Although animal bites, including dog bites, are relatively common, the persistence of public ignorance about their risk means that children who are bitten may receive no prophylaxis and are thus at serious risk. We report two cases of early childhood rabies in the past 2 years; both children were bitten by infected dogs. The clinical manifestations were those of encephalitis, with agitation and hydrophobia. In the absence of a reference laboratory for human rabies testing, confirmation of this diagnosis was not possible. Neither child received prophylaxis after being bitten. These cases are a reminder that rabies remains a problems today, a disease to which humans and animals of all ages are subject. Access to prevention messages about post-exposure prophylaxis against this disease is essential, for it is always fatal once its symptoms appear. Awareness and education about rabies should be intensified in view of the widespread ignorance of this risk.

[Severe hemorrhagic form of Rift Valley Fever in Mauritania]. / Forme hémorragique grave de la fièvre de la Vallée du Rift en Mauritanie.

We report three severe cases of hemorrhagic form of Rift Valley Fever which have been observed in the Hospital of Aïoun (two cases) and in the regional hospital of Tidjikdja (one case). The disease manifested itself by an infectious syndrome, an early infectious syndrome (on the second day) with onset of hemorrhagic complications and disorder of consciousness ranging from an agitation to deep coma. The biological examinations showed a severe anemia. Multiple organ failures were also observed. Of the three patients treated one died. Therefore, the management of both suspected and confirmed cases must be initiated as soon as possible in order to control organ damages and prevent fatality. There is no specific treatment. The importance of the epidemiological survey must be emphasized to avoid outbreaks and control any epidemic due to this virus.

[The etiological, clinical and prognosis of diarrhea occurs during AIDS in to hospital in Bamako]. / Aspects sémiologique, étiologique et pronostique de la diarrhée au cours du SIDA en milieu hospitalier de Bamako.

UNLABELLED: Its was a descriptive survey achieved in the service of the infectious and tropical illnesses of the teaching hospital of the "Point G" from 31 December 2002 to 30 June 2004 was about the analysis of 76 files. Its goal was to determine the clinical, etiological and prognostic aspects, of the diarrhea during the AIDS. The oral-pharyngeal candidiasis (50%), the deshydratation (60,5%), the fever (67,5%) and the thinning (77,6%) were associated to the diarrhoea frequently. Cholera syndrome was (52.6%), dysenteric syndrome was (36.8%) and the diarrhea syndrome was (10.5%). According to the etiological aspect, the parasites were founded in 51,3 % of cases, bacteria 9,2 % of cases, and fungus 5,3%. Any pathogen hasn't been founded in 34,2% of cases. Cyptosporidium parvum (15,8 %), and Isospora Belli (11,8%) was the most common parasites founded, but some unusual pathogens as: Entamoeba hystolitica, Trichomonas intestinalis , Giardia intestinalis , Shistosoma mansoni , Dicrococelium dendriticum, Trichostrongylus were present . The most common bacteria were Escherichia coli 5,3%. The fungus family was represented by Candida albicans . The lethality rate was 46,1%. CONCLUSION: The etiology of diarrhea occurs during aids is variable and include opportunistic and non opportunistic. The fatality rate remains incised because the delay of care and the poverty of the patients.