Musculoskeletal conditions in children attending two Togolese hospitals.

OBJECTIVE: A retrospective study was conducted in order to point out the different kinds of musculoskeletal conditions observed in children attending two Togolese hospitals. RESULTS: A total of 434 (242 females, 192 males) of the 29 620 children examined (1.5%) were suffering from these conditions. Probable joint and bone infections (187 patients, 43%), limb deformities (106 patients, 24%), osteochondrosis (60 patients, 14%) and vaso-occlusive crisis due to haemoglobinopathies (29 patients, 7%) were the main conditions observed. Osteomyelitis observed in 128 patients affected the humerus (25 patients), radius (10 patients), femur (68 patients), tibia (15 patients), fibula (five patients), and both tibia and fibula (five patients). Probably, infectious arthritis seen in 30 patients affected mainly the hip (11 patients) and the knee (13 patients). In the spine, infection affected the midthoracic and upper lumbar areas. Underdevelopment, sickle cell anaemia and sickle cell haemoglobin C disease were the main risk factors in determining susceptibility to infections. Vaso-occlusive crises were due to sickle cell anaemia (11 patients) and sickle cell haemoglobin C disease (18 patients). Osteochondrosis seen in 60 patients free from haemoglobinopathy involved the spine (Scheuermann's disease, 38 patients) and the hip (Legg-Calvé-Perthes disease, 22 patients). Limb deformities were observed in the knee (varus and valgus deformities in 64 patients) and the foot (talipes varus equin in 40 patients). CONCLUSION: This study's findings, which require further confirmation, suggest some conclusions. Scheuermann's disease can explain in part the degenerative disc conditions observed in African adults. Valgus and varus deformities play an important role in the development of knee osteoarthritis in Black Africa. An African child with joint or bone pain should be investigated for sickle cell anaemia. In the future, improved lifestyle and better health care will be essential to reduce bone and joint infections, and allow refined diagnosis of connective tissue diseases now probably underestimated in African children.

Mycobacterium ulcerans infection (Buruli ulcer): first reported patients in Togo.

Mycobacterium ulcerans infection (Buruli ulcer) is the third most common mycobacterial infection of immunocompetent humans, and is an emerging disease in West Africa. We describe the first two reported patients with Buruli ulcer in Togo, establishing a geographical continuum of the disease in all countries bordering the Gulf of Guinea. The aetiological agent was identified by molecular biological analysis of biopsy material. We speculate that changing environmental factors related to human habitation may influence rates of incidence of Buruli ulcer.

HIV 1 and HIV 2 prevalence of seropositivity in a population of West Africa.

In the month of August 1986, tests for anti-HIV 1 and anti-HIV 2 antibodies were performed in people coming to the hospital of Tanguietà (North Benin) (401 subjects) and in people working in the same hospital (23 subjects). The study revealed an anti-HIV 1 antibody prevalence of 0.4% (2/424) and an anti-HIV 2 prevalence of 0.2% (1/419). Seropositivity for both antibodies (anti-HIV 1 and anti-HIV 2) was found in one case; the other case was positive only for anti-HIV 1. The changing composition of the population due to frequent migratory displacements lead us to expect some possible alterations of the registered data in the future.

PIP: In August 1986, researchers tested 424 and 419 blood serum samples from patients, hospital workers, and blood donors at a hospital in Tanguieta, Benin for HIV 1 and HIV 2 antibodies respectively. Not so long ago, this region was completely isolated, but improved roads now allow free movement of people into and out of the region. The main economic activities include sheep farming and agriculture. The HIV 1 enzyme immunoassay (EIA) test 1st detected 23 seropositive sample, but only 4 tested positive (.94%) on the repeat EIA test. These 4 individuals included asymptomatic men between 30-50 years old. The distances they lived from the hospital ranged from several kilometer-600 km, 3 of whom lived in Benin and the 4th in Burkina Faso. 1 man visited the capital frequently. Further, the Western Blot and a test checking for the presence of antibodies against core and envelope proteins of HIV 1 confirmed 2 samples positive (.47%). The researchers considered these 2 as true positives, but they considered the other 2 samples which only tested positive, but they considered the other 2 samples which only tested positive under the Western Blot test as negative. The HIV 2 EIA test 1st detected 57 seropositive samples, but only 29 tested positive (6.9%) on the repeat test. The age of these individuals (19 men and 10 women) ranged from 19-54 years. The Lav-Blot test clearly confirmed only 1 positive case (.24%) and 2 negative cases. The remaining samples generated antibody bands against HIV 2 core proteins only. The researchers considered these 26 samples as indeterminate. The same person that tested positive for HIV 2 also tested positive for HIV 1. This 50 year old man belonged to a primitive ethnic group that hunts monkeys. Overall prevalence for both HIV 1 and HIV 2 stood at 1%.

Band delta hepatitis virus infection in a population of West Africa

Em 424 amostras de soros examinadas, a prevalência da infecçäo pelo vírus da hepatite B foi de 89,6% com 15,6% de positividade para o HBsAg. Algumas das amostras pertenciam a uma populaçäo aferente e outras a pessoas trabalhando em hospital rural situado na Africa Ocidental (República Popular de Benin). Vinte e sete por cento dos indivíduos soro-positivos evidenciaram replicaçäo do vírus como demonstrado pela presença do HBcAg. Nos indivíduos HBcAb positivos, os anticorpos anti-delta foram positivos em uma freqüência de 19,7%. A presença de HBsAg em 15% das mulheres gestantes eleva a importância da transmissäo de HBV, da mäe para o filho, nesta regiäo. Os resultados apresentados podem ser comparados com aqueles obtidos em outra áreas da Africa, com condiçöes sócio-econômicas semelhantes

B and delta hepatitis virus infection in a population of west Africa.

Among the 424 serum samples examined, the prevalence of hepatitis virus infection turned out to be 89.6%, with 15.6% of HBsAg positivity. Some of the samples belonged to an afferent population and some other to workers of a West Africa rural hospital (Pop. Rep. of Benin). 27.3% of the positive subjects presented active replication of the virus, shown by the presence of HBcAg. Among the HBcAb positive subjects the anti-delta antibodies showed a positivity frequency of 19.7%. HBsAg presence in 15% of pregnant women suggested the importance of HBV mother-foetal transmission in the district. The examined results can be compared with those obtained in other African areas, with similar socio-economic conditions.