Etiologies des fièvres prolongées inexpliquées au Service de Médecine Interne du CHU de Bouaké (Côte d'Ivoire) / Causes of unexplained prolonged fever in the Bouake CHU Internal Medicine Department (Ivory Coast)

Objectif : déterminer les étiologies des fièvres prolongées inexpliquées au service de médecine interne du CHU de Bouaké. Matériel et méthodes : Il s'agissait d'une étude rétrospective à visée descriptive mené de janvier 2019 à décembre 2020. Nous avons inclus les patients hospitalisés pour fièvre prolongée inexpliquée ou ayant présentés une fièvre prolongée durant l'hospitalisation. Les données anamnestiques, cliniques et paracliniques ont été analysées. Résultats : Nous avons retenus 204 patients sur 1650 patients hospitalisés (12,6%). L'âge moyen des patients était de 32±16,1 ans avec des extrêmes de 16 et 87 ans. Le sexe ratio était de 1,1. La fièvre (32,4%) et AEG (22%) constituaient les motifs d'hospitalisation les plus fréquents. La fièvre était le plus fréquent des symptômes physiques (94,1%) suivi de l'amaigrissement (50%), de la déshydratation (18,1%), de l'hépatomégalie (12,7%) et de l'obnubilation (12%). Les principales étiologies étaient les infections (82,3%), les tumeurs (10,3%), et les maladies inflammatoires (1,5%). Dans 5,9% des cas l'étiologie n'avait pas été retrouvée. Les principales infections étaient le VIH et ses complications (38,1%), la tuberculose (21,4%), et les infections urogénitales (19,9%). Les tumeurs étaient dominées par le cancer primitif du foie (33,4%) et le cancer de la prostate (19,4%). La polyarthrite rhumatoïde, le lupus érythémateux disséminé et la sclérodermie étaient maladies inflammatoires retrouvées. La létalité était de 36%. Conclusion : Les étiologies des fièvres prolongées inexpliquées sont variées. Elles sont dominées dans notre contexte par la tuberculose, l'infection à VIH et ses complications infectieuses.

Pre-exposure prophylaxis among men who have sex with men in Côte d'Ivoire: a quantitative study of acceptability.

This cross sectional study was conducted in 2018 in Côte d'Ivoire to assess PrEP acceptability among men who have sex with men (MSM). Two hundred and one men were asked on their intention to use PrEP if made available. Logistic regression accounting for the sampling design was used to analyze associations between high PrEP acceptability and different independent variables including barriers and facilitators. Participants were mostly young (mean age = 25 years), educated (82% with secondary/postsecondary education) and single (95.5%). On average, 3.4 episodes of anal sex were reported monthly and 37.8% of men did not use a condom at last sex. Most MSM (72.6%) had heard of PrEP before enrollment. Overall, 35.3% reported that they would use PrEP very probably if made available. In multivariate analysis, factors associated with high PrEP acceptability were condom use at last sexual intercourse (Odds ratio (OR) = 2.51; 95%Confidence interval (95%CI) = 1.45-4.33); insertive sex as compared to versatile sex (OR = 2.56; 95%CI = 1.14-5.67); free PrEP delivery (OR = 2.45; 95%CI = 1.07-5.59), concerns about side effects (OR = 0.66; 95%CI = 0.48-0.90), and being preoccupied by the fact that post-PrEP antiretroviral therapy could be inefficient (OR = 0.25; 95%CI = 0.14-0.44). PrEP implementation among MSM in Côte d'Ivoire should be accompanied by awareness raising campaigns explaining its utility.

[Neonatal and child tetanus morbidity and mortality in the University hospitals of Abidjan, Côte d'Ivoire (2001-2010)]. / Morbidité et mortalité du tétanos des nouveau-nés et des enfants dans les Centres hospitaliers universitaires d'Abidjan, Côte d'Ivoire (2001-2010).

The lack of data on neonatal tetanus and children in university hospitals (UH) in Abidjan for over a decade has motivated the realization of this study. The objective of this study is to evaluate the morbidity and mortality related to neonatal tetanus (NT) and child tetanus (CT) in Abidjan University Hospital from 2001 to 2010. It is a retrospective study, multicenter analysis with records of newborns and children suffering from tetanus in the three UH of Abidjan. The collection and analysis of data were made by the SPHINX 4.5 and EPI.INFO 6.0 software. In ten years, 242 cases of tetanus (53 NT cases and 189 CT cases) were collected with a predominance of cases after the fifth year of life (59.5%). The incidence rate of NT was less than 1 case per 1,000 live births. All mothers of the newborns were inhabiting the city of Abidjan. Their median age was 19 years [16-32] and 64% were teenagers. Gateways were dominated by umbilical wounds (77.3%) in the NTand skin wounds (59%) in CT. The cure rate was 30.2% in the NT and 60% in the CT. Lethality was 60% for NT and 22% for CT with a positive correlation with young age (neonates: p = 4.10-7, age <5 years: p = 0.01), lack of intraspinal injection of tetanus serum (p = 8.10-6), the absence of conventional antibiotic therapy (p = 0.023), the existence of metabolic complications (p = 2.10-5), the score of ≥ 4 Dakar (p = 0.005). Tetanus remains a real morbidly cause among children in Abidjan University Hospital with high lethality. However, the incidence of NT seems consistent with the incidence threshold desired by WHO.

Attitudes and practices of nursing students confronted with blood exposure accidents in Abidjan

"Background: Blood Exposure Accidents (BEAs) are frequent in healthcare settings and may cause such severe consequences as HIV and Hepatitis B and C infections. Objective: to determine the attitudes and practices of nursing students facing BEAs. Materials and Methods: this was a cross-sectional prospective study conducted from August 16 to 23; 2011 at the ""Institut National de Formation des Agents de la Sante d'Abidjan"" (the National Institute in charge of training Health Workers). Data were collected by means of self-administered questionnaires. Results: out of 266 student nurses included in the study; 73.3% were females while 26.7% were males. Their mean age was 29 years [20 years - 37 years]. A previous training was conducted on BEAs for 67.3% of nursing students. Those students who were immunized against hepatitis were 75.2%. Needle recapping was practiced by 43.6% of nursing students. Unclean needles were eliminated in containers by 96.2% of the Background: Blood Exposure Accidents (BEAs) are frequent in healthcare settings and may cause such severe consequences as HIV and Hepatitis B and C infections. Objective: to determine the attitudes and practices of nursing students facing BEAs. Materials and Methods: this was a cross-sectional prospective study conducted from August 16 to 23; 2011 at the ""Institut National de Formation des Agents de la Sante d'Abidjan"" (the National Institute in charge of training Health Workers). Data were collected by means of self-administered questionnaires. Results: out of 266 student nurses included in the study; 73.3% were females while 26.7% were males. Their mean age was 29 years [20 years -37 years]. A previous training was conducted on BEAs for 67.3% of nursing students. Those students who were immunized against hepatitis B were 75.2%. Needle recapping was practiced by 43.6% of nursing students. Unclean needles were eliminated in containers by 96.2% of thestudents and waste containers were within close reach of only 65.4%. Glove wearing was systematic in 77.1% of the students. Before the survey 38% of nursing students had been victim of BEAs at least once. Those BEAs were not reported in 68.3% of the victims.Conclusion: the attitudes and practices of nursing students are inadequate with regards to BEAs. A module on Hospital Hygiene is necessary in view of improving the training of nursing students."

[Clinical, biological, therapeutic and evolving profile of patients with HIV infection hospitalized at Infectious and tropical diseases unit in Abidjan (Ivory Coast)]. / Profil clinicobiologique, thérapeutique et évolutif des patients infectés par le VIH hospitalisés au service des maladies infectieuses et tropicales d'Abidjan (Côte d'Ivoire).

The objective of this study is to describe the clinical, biological, therapeutic and evolving current profile of hospitalized patients with HIV infection in the cohort of the Infectious and Tropical Diseases Unit (ITDU) in the aim to improve their care management. This is a retrospective study, conducted on medical data of hospitalized cases of patients with HIV infection in the ITDU at the teaching hospital of Treichville (Abidjan) from 2006 to 2007. During the two years, 447 patients were included in the study. Their average age was 39 years [18 years-86 years] and sex ratio was 0.69. Of the 447 patients, 35% were unemployed and 67% were new patients who had never undergone antiretroviral therapy (ART). The duration of drug exposure was less than 6 months in 59% of treated patients. The average time to initiate ART was seven weeks. Among naive patients 41.9% were lost to follow up, 35.9% were waiting for treatment and 22.1% waiting for baseline biological test to initiate ART. At the initiation of ART, 79.6% of patients had a CD4 count less than 200/mm(3). The reasons of hospitalization defining AIDS were dominated by tuberculosis (34.2%), cerebral toxoplasmosis (17.9%) and neuromeningeal cryptococcosis (8%). The main reasons of hospitalization in classifying non-AIDS were pyelonephritis (6.5%), bacterial pneumonia (5.4%) and undetermined infectious encephalitis (4.9%). Hospital mortality was 24.4%. The leading causes of death were tuberculosis (22.9%), cerebral toxoplasmosis (20.2%), undetermined infectious encephalitis (18.3%) and cryptococcal meningitis (13.7%). The profile of PLHIV in hospital is characterized by profound immunosuppression due to late diagnosis and high mortality associated with severe opportunistic infections and late initiation of ART.

[Surgical tetanus in Abidjan, Cote d'Ivoire]. / Tétanos à porte d'entrée chirurgicale à Abidjan, Côte d'Ivoire.

OBJECTIVE: To describe the epidemiological and clinical features and the outcome of tetanus with a surgical wound (open fracture, burn, incision, curettage, etc) as the portal of entry. METHODS: Cross-sectional analysis of records of patients hospitalized in the department of infectious and tropical diseases in Abidjan for surgical tetanus from 2003 to 2008. RESULTS: During the 6-year study period, 29 cases were identified. They accounted for 11% of all tetanus cases admitted to the hospital: 8% from 2003 through 2006 and 14% in 2007 and 2008. The patients' average age was 36 years (range: 11-72). Most cases (86%) involved recent surgery, in both public (51%) and private (49%) health facilities. All patients had generalized tetanus at admission, and 24 (86%) paroxysms. Moderate forms predominated (69%). The lethality of tetanus in these surgical wound cases was 45%. The characteristics statistically associated with death were: age >44 years, time of hospitalization >4 days, the presence of paroxysms, and a Dakar prognosis score ≥4. CONCLUSION: The severity of surgical tetanus remains a concern for practitioners. Its high prevalence in recent years demonstrates the need to increase surgeons' awareness of tetanus prevention.

[Morbidity and mortality from infectious diseases at the Military Hospital of Abidjan, Côte d'Ivoire]. / Morbimortalité des pathologies infectieuses à l'hôpital militaire d'Abidjan, Côte d'Ivoire.

OBJECTIVES: To determine the proportion of infectious diseases and their lethality at the Abidjan Military Hospital. PATIENTS AND METHODS: This cross-sectional study examined the medical files of patients hospitalized in the internal medicine unit of the hospital during 2004. RESULTS: The study included 668 patients with 855 diseases, 579 of them infectious (67.7%). The prevalence of HIV in this population was 41.3%. The main diseases observed were pneumonia (150 cases; 17.5%), malaria (82 cases; 9.6%), oropharyngeal candidiasis (83 cases; 9.7%), and tuberculosis (54 cases; 6.3%). The immediate causes of death were cerebral toxoplasmosis (27 cases; 39%), pneumopathy (25 cases; 36%), severe malaria (7 cases; 10%), tuberculosis (6 cases; 9%), and bacterial meningitis (5 cases; 7%). The prevalence of HIV infection prevalence among those who died of an infectious disease was 74.3%. CONCLUSION: Infectious diseases are the main pathologies seen in the internal medicine department of the in Abidjan Military Hospital. They were mainly opportunistic infections linked to AIDS. The creation of a laboratory of infectious microbiology and of a medical intensive care unit appears necessary to optimize management of these infectious diseases.

[Prevalence of HBs antigen carriage in a population of national Gendarmerie recruits in Ivory Coast in 2008]. / Prévalence du portage de l'antigène HBs dans une population de recrues de la Gendarmerie nationale de Côte d'Ivoire en 2008.

The purpose of this study was to determine the prevalence of HBsAg carriage in Ivorian gendarmerie recruits in 2008. This prevalence was 15.6%. It was highest in recruits aged 18 years (24%), in those who were married (33.3%) and in those who had had more than three sexual partners in the 6 months before the survey (19.4%). It was also higher in recruits who had never used condoms (20.6%) and in those who had undergone blood transfusions (27%). A policy of vaccination against HBV in the army, in teenagers and adults must be implemented to reduce HBsAg carriage in the army and in the Ivorian population.

[Clinical and developmental aspects of care-related tetanus in the reference service of the teaching hospital of Abidjan]. / Aspects cliniques et évolutifs du tétanos lié aux soins dans le service de référence du CHU d'Abidjan.

A cross-sectional descriptive study was conducted from medical data of inpatients with tetanus in the Department of Infectious and Tropical Diseases of the University Hospital of Treichville in Abidjan from January 2003 to December 2007. In five years, 221 cases of tetanus have been hospitalized. The tetanus gateway was found in 188 patients (85%). Tetanus gateway linked to care was found in 22 patients (11.7%). Acts of care in question were intramuscular injections (10 cases) and operative procedures (12 cases). Concerning medical care by intramuscular injection, quinine (four cases), sulfadoxine-pyrimethamine (one case), and long-acting penicillin (one case) were the identified drugs. The operative procedures mainly involved were skin sutures (nine cases), cures of hernia (two cases), and flattening of Fournier's gangrene (one case). The average incubation period was 9.5 days. The invasion lasted for an average of 1.8 days. On admission, tetanus was immediately generalized for all patients with the presence of paroxysms in 20 patients (90.9%). The lethality of tetanus related care was 54.5%. The death rate in the first 48 hours of hospitalization was estimated at 83.3%. The average length of hospital stay was 14.6 days. Health workers should be involved in the prevention of tetanus in improving the quality of care and especially in reducing intramuscular injections. Also, any patient not immunized against tetanus should receive anti-tetanus serum and an update of its tetanus vaccine before any invasive procedures.

[Current aspects of neuromeningeal cryptococcosis in adults infected with HIV in the internal medicine service of the University Hospital of Treichville Abidjan (Cote d'Ivoire)]. / Aspects actuels de la cryptococcose neuroméningée chez des sujets adultes infectés par le VIH dans le service de médecine interne du CHU de Treichville d'Abidjan (Côte d'Ivoire).

OBJECTIVES: To determine the prevalence of neuromeningeal cryptococcosis (NMC) and reporting sociodemographic, clinical, paraclinical aspects and outcome of patients. METHODS: It was a retrospective study concerning 22 HIV positive patients hospitalized between 2006 to and 2009 in the internal medicine service of University Hospital of Treichville for NMC. RESULTS: The prevalence of NMC in patients infected with HIV was 0.6%. The mean age was 35±4.5 years old. The sex-ratio was 0.5. The average time evolution of the symptomatology was 10±2.1 days. The installation of the disease was progressive (86.4%). The main signs were fever (100%) and headache (95.4%). The cerebrospinal fluid was inflammatory aspect (95.4%) with low glucose (91%), hyper lymphocytosis(100%). There were Cryptococcus neoformans in direct exam by China ink (72.7%) and culture on Sabouraud (100%). Treatment was injectable amphoterin B in monotherapy (54.5%) followed by fluconazole per os (45.5%). The mortality was 54.5%. CONCLUSION: This study shows a reduction of NMC prevalence in our service in relation with tritherapy.

[Utility of the viral load measurement after one month of antiretroviral treatment]. / Intérêt de la mesure de la charge virale au premier mois du traitement antirétroviral.

OBJECTIVE: To evaluate the therapeutic utility of the viral load (VL) measurement after one month (M1) of antiretroviral (ARV) treatment. PATIENTS AND METHOD: A retrospective study of HIV patients included in the NADIS database from 1998 to 2006 and followed at Nice University Hospital. We included ARV-naive patients who received ARV (3-drug combination) for at least 3 months and ARV-experienced patients beginning a new ARV after virologic failure. RESULTS: The NADIS database included 1065 patients from 1998 to 2006. We included 262. In all, 234 of them had VL measured at M1 and are considered in this analysis. Their mean age was 44 years, and 174 were men, for a sex ratio of 9.1. ARV-naïve patients accounted for 35% of the sample (n = 81) and previously treated patients 65% (n = 153). All the naive patients had a VL decrease at M1 > 1 log, as did all but 14 of the previously treated patients (9%). This virological result was followed by a medical action 21 times for the naive patients and 97 times for the previously treated patients (p < 0.004). CONCLUSION: The VL measurement at M1 indicates a virological objective that was reached for all the naive patients and 91% of the previously treated patients. Moreover, the medical actions taken at M1 for a new ARV treatment appear to be associated with the patient's treatment history and not the virological results.

[Morbidity and mortality of military personnel at the Abidjan Military Hospital (AMH) in Côte d'Ivoire]. / Morbi-mortalité des militaires à l'hôpital militaire d'Abidjan, Côte d'Ivoire.

The purpose of this retrospective study was to document morbi-mortality in soldiers at the Abidjan Military Hospital (AMH). The medical files of soldiers treated at Abidjan Military Hospital from January 1 to December 31, 2004 were reviewed. During the study period, a total of 155 soldiers were treated for 259 pathologies including 208 infectious diseases (80.5%). The most common diseases were HIV infection (85 cases; 42%), pneumopathy (40 cases; 19%), cerebral toxoplasmosis (22 cases; 10.5%), malaria (18 cases; 9%) and tuberculosis (11 cases; 5%). Direct causes of death were cerebral toxoplasmosis (32%), pneumopathy (28%), tuberculosis (16%) and severe malaria (12%). The prevalence of HIV infection in soldiers who died was 76%. Morbi-mortality in military personnel at the AMH is due mainly to HIV infection and related complications. Specific prevention measures should be implemented for an effective control of this epidemic.

[Efavirenz versus indinavir among HIV-1 naive patients in Abidjan (Ivory Coast)]. / Efavirenz versus indinavir chez les patients naïfs infectés par le VIH-1 à Abidjan (Côte d'Ivoire).

OBJECTIVE: The authors had for aim to compare the therapeutic efficiency and tolerance of 2 NRTI+efavirenz (EFV) versus 2 NRTI+indinavir (IDV) in HIV infected adults in Abidjan. METHODS: A retrospective and multicentric study was made on 327 HIV-1 naive patients, 142 in the EFV group and 185 in the IDV group followed in Abidjan from November 1998 to December 2003. The analysis concerned clinical advents (opportunistic infections) and immunovirological parameters (CD4, viral load). Patients received 2 NRTI such as AZT+3TC or D4T+3TC combined either with EFV or IDV. The principal judgement criterion was therapeutic failure. We assessed the percentage of patients with undetectable viral load and the frequency of grade 3-4 adverse effects after 24 months of follow-up. RESULTS: Clinical improvement of patients' state and regression of opportunistic infections were identical in the two groups. The average gain of CD4 was superior to 177 in EFV versus +219 in IDV (p=0.004). The percentage of patients with undetectable viral load was 66% for EFV versus 59% for IDV (p=0.04). The frequency of adverse effects was more elevated with EFV than IDV, 39% versus 23% (p=0.002) initially, but seemed to decrease later. CONCLUSION: HAART with EFV is at least as efficient as with IDV in terms of reduction of viral load and increased CD4 count and is an excellent low-cost first line treatment.

Morbi-mortalite des militaires a l'hopital militaire d'Abidjan; Cote d'Ivoire

L'objectif etait de preciser la morbi-mortalite des militaires a l'HMA. Il s'agit d'une retrospective realisee sur dossiers des patients hospitalises au service de medecine interne de l'Hopital Militaire d'Abidjan (HMA) du 1er janvier au 31 decembre 2004. Les 155 militaires inclus dans l'etude ont developpe 259 pathologies dont 208 pathologies medicales infectieuses (80;5); 48 medicales non infectieuses (18;5) et 3 pathologies chirurgicales (1). Les principales pathologies observees etaient l'infection a VIH (85 cas ; 42); la pneumopathie (40 cas ; 19); la toxoplasmose cerebrale (22 cas ; 10;5); le paludisme (18 cas ; 9) et la tuberculose (11 cas ; 5). Les causes directes de deces etaient la toxoplasmose cerebrale (32); une pneumopathie (28); la tuberculose (16) et le paludisme grave (12). La prevalence de l'infection a VIH chez les decedes etait de 76. La morbi-mortalite de militaires a l'HMA est essentiellement du fait de l'infection a VIH et ses complications. Des mesures de prevention specifiques devraient etre mises en oeuvre pour un controle efficace de cette epidemie

[Generalized tetanus complicating a traditional medicine applied for snakebite]. / Tétanos généralisé compliquant un traitement traditionnel instauré après une morsure de serpent.

In many of Africa's rural areas, snakebite victims often resort to traditional healers for first line treatment. This may be source of infectious complications. We report a case of generalized tetanus which occured after 15 days in a 13-years old boy who had applied a traditional, plant-based concoction on a snake bite. He presented with trismus, generalized contractures and fever extended musculo-aponevrotic necrosis of the right upper limb, without loss of consciousness. The only accompanying biological sign was an increased leukocyte count (11,200/mm3) with a predominance of neutrophils (84%). Platelets count, creatinin and AST/ALT titers and haemostasis were all normal, as was the radiogram of the right hand. The clinical outcome was favourable after 3 weeks hopital care (antibiotic, muscle relaxants, antitetanus serotherapy and local wounds care). This clinical observation shows that traditional care for snake bite wounds can be an entry point for tetanus. Appropriate treatment of snake bites in a hospital setting is of the utmost importance, in addition to vaccination against tetanus, in order to reduce the incidence of tetanus in African countries.

[First case of Stevens-Johnson syndrome in a patient treated by Triomune in Abidjan, Côte d'lvoire]. / Premier cas de syndrome de Stevens-Johnson chez un patient traité par association de stavudine, lamivudine et névirapine à Abidjan, Côte d'Ivoire.

The authors report the first case of Stevens-Johnson syndrome which has occurred in a 45 year old patient treated by Triomune containing névirapine. Triomune is used within the context of the African antiretroviral initiative access. It was a mild form whose evolution was favourable when nevirapine was stopped. The prevalence of this affection should increase with the larger use of nevirapine in our countries and the attention of both prescriber and patient must be requested.

[Prevalence of HBs antigen in blood donors in the Bouaké regional centre of blood transfusion in 2001]. / Prévalence de l'antigène HBs chez les donneurs de sang au centre régional de transfusion sanguine de Bouaké (Côte d'lvoire) en 2001.

A prospective cross-sectional study was conducted in the regional center of blood transfusion in Bouaké from December 1, 2001 to February 28, 2002. One thousand two hundred thirty one new blood donors were tested. HBs Antigen detection was made according to ELISA technique (Hepanostika HBs Ag Uni-Form II). HBs Antigen prevalence in blood donors in Bouaké was 12.5%. One hundred fifty four blood donors were tested positive and were divided into 131 males (85%) and 23 females (15%). Their average age was 27, 5 years old (18-65 years). HBs Antigen carriage rate was lower in females and students. They were mainly pupils (62%) and had risk factors of hepatitis B infection (intramuscular injection, multiple sexual partners, unsafe sex). HBs Antigen carriage rate in blood donors is high in Bouaké and justifies the systematic screening of this Antigen in any blood donor to reduce the transfusion risk. On the other hand, it is necessary to modify the blood collection strategy in order to make the most of the donation and to decrease the residual risk.

[Management of accidental exposure to blood in the Treichville teaching hospital, Abidjan (Côte-d'Ivoire)]. / Prise en charge des accidents d'exposition au sang au CHU de Treichville, Abidjan (Côte-d'Ivoire).

OBJECTIVE: The aim of this study was to assess care and preventive measures for accidental exposure to blood (AEB) in Abidjan. METHODS: A retrospective study of all AEB reported in the Infectious and Tropical Diseases Center of the Treichville University Hospital was made between January 2000 and December 2005. Epidemiology, management, clinical and biological post-exposure follow-up were analyzed. RESULTS: One hundred eighty-two AEB were managed over 6 years (151 needlesticks, 14 ocular projections of blood, 12 cuts, and 5 mucocutaneous exposure to blood). 94 men (51.6%) and 68 women (48.4%) were included [sex ratio 1.4] mean age 33.8 years+/-7.4 years. Physicians (29.1%), nurses (19.8%), assistant nurse (12.1%), and medical students (11.4%) were the professional categories which declared most accidents. Among them, only 51.1% was correctly vaccinated against hepatitis B. The average delay of consultation was 26.5 hours (1-240 hours), and 82.9% of victims consulted before the 48th hour. Antiretroviral prophylaxis was prescribed to 151 patients among whom 45% with bitherapy (Zidovudine and Lamivudine), and 55% with HAART including an antiprotease. Only 60 patients had one actual month of treatment. Despite the weak follow-up, no case of HIV seroconversion was reported 6 month after exposure. CONCLUSION: This work underlines once again the high frequency of AEB in Abidjan despite a under reporting, and calls for the implementation of a policy to train health care workers on AEB preventive measures.

[Profound mycoses in AIDS in Abidjan (Côte d'Ivoire)]. / Mycoses profondes au cours du SIDA à Abidjan (Côte d'Ivoire).

During 1995, among 1105 HIV patients explored in our department, 64 presented a deep fungic infection (5.8%). The yeast was searched for in cerebrospinal fluid, blood, urine, and bronchoalveolar aspiration. Isolated germs were Cryptococcus neoformans (95%), Candida tropicalis (1 case), Saccharomyces cerevisiae (1 case) et Aspergillus fumigatus (1 case). Results of treatment with amphotericin B were: recovery (9%), clinical success (11%), out of sight (14%), letality (66%), relapse (23%) and side effects (19%). We emphasized diagnostical and therapeutical difficulties, and bad prognostic of mycoses in patients with AIDS.