Prevalence and risk factors associated with Haemophilus ducreyi cutaneous ulcers in Cameroon.

Epidemics of yaws-like cutaneous ulcers are regularly documented in children in the tropics. They occur mainly in poor and remote communities without access to health facilities. The integration of molecular tools into yaws control efforts has made it possible to describe Haemophilus ducreyi (HD) as a major cause of cutaneous ulcers. The objective of this study was to determine the prevalence of HD as cause of cutaneous ulcers, investigate its presence in asymptomatic individuals and identify associated risk factors. A cross-sectional study was conducted in yaws endemic districts of Cameroon. Participants included people presenting yaws-like ulcers and asymptomatic individuals. Swab samples were collected from each participant and tested for HD and Treponema pallidum (TP) using an established qPCR method. Additionally, demographic, habitat, proximity, and hygiene characteristics were collected using a structured questionnaire. A total of 443 individuals participated in the study, including 271 ulcer cases and 172 asymptomatic contacts. The prevalence of HD in ulcers was 30.3% (Confidence Interval (CI) 95% [24.8-35.7]) and the prevalence of asymptomatic HD carriage was 8.6% (CI95% [4.5-12.9]). TP was also detected in our sample among ulcer cases but in lower proportion (5.2% CI95% [2.5-7.8]) compared to HD. The adjusted logistic regression model showed that women were as much at risk of having HD cutaneous ulcer as men regardless of age. Physical proximity to a confirmed ulcer case was the major factor identified favouring HD transmission. HD ulcers were more likely to be present on Bantu individuals compared to Baka as well as HD colonization. These findings highlight HD as the most common cause of cutaneous ulcers in yaws-endemic communities in Cameroon. The exact implications of detecting HD on intact skin are not yet clear. Further studies are needed to understand the significance of this carriage in the spread dynamics of the disease.

Cancro mole / Chancroid

Aborda o cancro mole, sob os aspectos da epidemiologia, etiologia, manifestaçöes clínicas, diagnóstico laboratorial e diferencial, tratamento e associaçäo com HIV.

Aspectos do cancro mole no Município de Säo Paulo / Aspects of chancroid in Säo Paulo City

Entre 1985 e 1989 foram registrados no Serviço de Dermatologia Sanitária da Faculdade de Saúde Pública da USP 202 pacientes portadores de cancro mole. Mapeou-se os focos geográficos da doença distribuídos pelos 11 Distritos, 48 Subdistritos e 8 ERSA de Säo Paulo. Os subdistritos do Butantä e Santo Amaro concentraram 55 casos e o ERSA-1, 74. A idade concentrou-se entre 20 e 30 anos, com aumento em menores de 20 anos. Os homens participaram numa proporçäo de 7:1 mulher. Houve reduçäo da participaçäo da prostituiçäo no contágio. O período de incubaçäo variou de 1 a 41 dias. A lesäo foi única em 33,7 por cento dos casos masculinos. O tempo da doença reduziu-se e o enfartamento inguinal ocorreu em 49 por cento dos casos. Referiram passado venéreo 123 pacientes e soropositividade para sífilis. Em 1989-1991 foram pesquisados 42 casos de cancro mole para anticorpos anti-VIH-1, resultando 16,6 por cento de sororeatividade. O risco da mulher portadora de um cancro mole apresentar-se infectada parece ser maior do que para o homem. Recomenda-se a implantaçäo imediata da notificaçäo compulsória de todas as Doenças Sexualmente Transmissíveis, bem como a pesquisa rotineira para sífilis e para o VIH-1 nas populaçöes de risco identificadas

VDRL tests in representative communities of Guyanese adults

VDRL tests were carried out on 774 adults aged 35-54 years in two typical African and East Indian communities in Guyana. Results were weakly reactive in 11.2 per cent. at reactive in 6.9 per cent., the reactivity rate being higher in Africans than in East Indians. Reactivity was not due to previous infection with yaws which has been absent from most of Guyana for many years in contrast to some parts of the West Indies. Clinical evidence of syphilis in Guyana is surprisingly infrequent in view of the high reactivity rates. (AU)