[Tuberculosis and human immunodeficiency virus infection in the Central African Republic]. / Tuberculose et infection par le virus de l'immunodéficience humaine en République Centrafricaine.

In order to determine the proportion of tuberculosis (TB) patients in Bangui (Central African Republic) infected with human immunodeficiency virus (HIV), we collected prospectively serum samples from all new TB patients seen at the University Hospital in Bangui during a three-month period (nov. 87-Jan. 88). 220 serum samples were tested for antibodies to HIV, by an Elisa assay and confirmed by Western-Blot. The general HIV seropositivity rate among TB patients was 27.7% (31.2% in adults (N = 183), and 10.8% in children (N = 37)). Within the adult population, there was non association between HIV infection and sex or previous history of TB. Seropositivity was more common in patients with extrapulmonary TB, especially lymphadenitis, and in patients with mediastinal adenopathy, or extensive pulmonary involvement without cavitation. Seropositivity was also strongly associated with negative tuberculin skin tests, chronic diarrhoea, generalized lymphadenopathy, and thrush. It is concluded that HIV infection is responsible for the increasing incidence of tuberculosis in Central African Republic, and that investigations for TB should be carried out in every symptomatic African patient infected with HIV.

[Clinical aspects of AIDS in the Central African Republic]. / Aspects cliniques du SIDA en République Centrafricaine.

AIDS is known in Central African Republic since 1983: 64 recognized cases have been registered. AIDS is of endemic aspect presenting the main following signs: lost of weight (100%), degeneration of the health status (80%), lymphadenopathy (46%), pneumopathy (44%), diarrhea (40%), candidiasis (21%), Kaposi's disease (16%), purpura (8%), pruritus (8%), Cutaneous anergy to tuberculin or to the 7 antigens (Merieux test) is constant. LAV serology was positive in 61 cases. The number of helper T. cells is less than 400/mm3, and OKT4/OKT8 ratio is less than 0.50. The concerned population is heterosexual with a sexual hyperactivity.

[Heart and schistosomiasis (author's transl)]. / Coeur et bilharziose.

The review is based on three studies previously reported and involving the clinical, epidemiological and hemodynamic aspects of this problem. Schistosomasis may give frequently (21.6 p. 100) an arterial pulmonary hyperpressure related to the development of granulomas and arteriolitis. A myocarditis may be suspected but is rarely proved. Anemia and specific treatment are also responsible for myocardial deficiency. The parasitic changes of the urinary tract may give a systemic hypertension. Some very rare cases of acute pulmonary heart insufficiency have been reported and the responsibility of schistosomiasis in constrictive fibrous endomyocarditis is still questionned.