[Squamous cell carcinoma associated with use of skin-lightening cream]. / Carcinome épidermoïde associé à une dépigmentation volontaire.

BACKGROUND: Women widely use skin-lightening products for cosmetic purposes in sub-Saharan Africa despite numerous reported cutaneous and systemic complications. The occurrence of epidermoid carcinoma has long been reported, but only three cases have been published so far. We report the first case in Mali. PATIENTS AND METHODS: A 30-year old woman with no noteworthy medical history was seen at our outpatient center for cervical ulceration that had been present for the last 5 years. She had used cosmetic bleaching cream over a period of around ten years. Physical examination revealed extensive ulceration on the left side of her neck. Blood tests for viral hepatitis and human immunodeficiency virus were negative. The pathological examination of the skin biopsy confirmed the diagnosis of squamous cell carcinoma. After failure of the initial excision with early relapse, multiple surgical ablations were performed 3 months later. DISCUSSION: The high prevalence of skin-lightening cosmetic use contrasts with the rarity of epidermoid carcinoma in depigmented skin. However, a large chronic ulcer on uncovered parts of the upper body, particularly the neck, should prompt physicians to consider skin cancer. Appropriate preventive measures include the promotion of educational messages for the general population, the use of sun-protection devices, and routine skin biopsy for all women presenting chronic cervical ulceration after long-term use of skin-lightening products.

Sleep quality assessment in 35 Parkinson's disease patients in the Fann Teaching Hospital, Dakar, Senegal.

INTRODUCTION: Sleep disorders are diverse in Parkinson's disease. We aimed to assess the quality of sleep in patients with Parkinson's disease in an African population. METHODS: In a transversal and prospective study from April to June 2014, all parkinsonian patients followed at the Fann Teaching Hospital Neurology Clinic (Dakar, Senegal) were assessed using the Hoehn and Yahr's scale and filled out the following questionnaires: Parkinson's disease sleep scale (PDSS), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). A PDSS score<82 (or a subscore<5) and a PSQI score>5 indicated poor quality or impaired sleep. An ESS score>10 indicated excessive daytime sleepiness. We used the Pearson coefficient to search for correlation between age, disease stage, disease duration, and the importance of sleep impairment. RESULTS: Hoehn and Yahr staging was 2.42±0.90 in the 35 patients (60% male, mean age 65.7±7.4years, disease duration 32.4±23.4months). The mean total PDSS score was 99.5±24.1 and 74.3% of the patients had an abnormally high PSQI score, indicating high frequency and intensity of sleep disorders. Most frequent disorders were pain or cramps interrupting sleep, night waking to urinate and fatigue or sleepiness on waking. Patients exhibited excessive diurnal sleepiness in 22.9% of the cases; they often had an abnormal PSQI score. Both the total PDSS score and the difficulty to sleep increased with disease stage, but not with age or disease duration. CONCLUSION: We found evidence of major alteration of sleep quality in Senegalese Parkinson patients.

Socio-cultural representation of epilepsy at the teaching hospital of point G, Mali.

Background: Epilepsy is a significant public health concern with psychosocial impacts, including fear, stigma, and misconceptions. These factors contribute to human rights violations and discrimination. The objective of this study was to describe the sociocultural representation of epilepsy in Mali. Materials and methods: This cross-sectional descriptive study was carried out from April 2015 to November 2016 at the University Hospital of Point G. Patients with epilepsy were identified prospectively, and a questionnaire was administered to each patient and their parents. Results: A total of 104 patients were enrolled with an average age of 35 years, ranging from 15 to 89 years. Males were slightly predominant, accounting for 53.85%, resulting in a sex ratio (M/F) of 1.17. In terms of occupation, workers comprised 68.27% of participants. Patients residing in urban areas represented 61.54%, and the most level of education was secondary (40.38%). The majority of patients (57.69%) and their relatives (69.23%) thought that epilepsy was caused by mystical causes. Stigma was reported by 66.35% of our patients. Conclusion: The sociocultural perception of epilepsy hinders evidence-based diagnosis and management in Africa. This study suggests a need to focus on raising awareness to change these misconceptions.

[Progressive myoclonic epilepsy in the department of neurology of the University Teaching hospital Point "G"]. / EPILEPSIES MYOCLONIQUES PROGRESSIVES AU SERVICE DE NEUROLOGIE DU CENTRE HOSPITALIER UNIVERSITAIRE DU POINT "G".

Background: Progressive Myoclonic Epilepsy (PME) is a heterogeneous group of pathologies associating epileptic seizures and other neurological and non-neurological disorders. Objectives: We aim to characterize patients with symptoms of PME and identify the underlying genetic disorder. Methods: After informed consent, the patients seen in the protocol for hereditary neurological diseases and presenting signs of epilepsy without a secondary cause were clinically evaluated over a three-year period in the Department of Neurology of the CHU Point "G". EEG, brain imaging and laboratory tests were performed to consolidate our diagnosis. DNA was extracted for genetic analysis. Results: 141 families including five families with PME totaling eight cases were enrolled. The predominant symptoms in our patients were myoclonus in 87.5% (N = 8), followed by GTCS and cognitive impairment in 50%, each. A notion of parental consanguinity was found in 60% and autosomal recessive transmission evoked in 80% (N = 5). The EEG was pathological in 62.5% and imaging showed ponto-cerebellar atrophy in 25% (N = 8). The combination of sodium valproate and clonazepam was the main treatment. One case of death was recorded. Conclusion: We report cases of PME in Mali with a possibility of discovering new genes.

Clinical, paraclinical and genetic aspects of autosomal recessive cerebellar ataxias (ARCA) in Mali.

Introduction: Autosomal recessive cerebellar ataxias (ARCA) are a group of rare and heterogynous neurodegenerative diseases mainly characterized by unbalance and walking difficulty and movement incoordination. Objectives: To clinically and paraclinically characterize ARCA in the department of Neurology at the Teaching Hospital of Point G and identify the underlying genetic defect. Patients and method: We have conducted a longitudinal and prospective study from January 2018 to December 2020. Patients with ARCA phenotype seen in the Department of Neurology at the Teaching Hospital of Point "G" were enrolled. Results: We have enrolled 7 families totaling 13 patients after giving an informed verbal and written consent. The sex ratio was 2.2 in favor of males, Kayes region and Fulani ethnic group were respectively the most represented region and ethnic group.Walking difficulty represented the major symptom followed by loss of vibration and joint sense, nystagmus, dysarthria and skeletal deformities. Alpha-foetoprotein level was high in one patient. Genetic testing confirmed Friedreich ataxia in one family and was not conclusive in 4 families. Conclusion: This study showed that ARCA are not uncommon in Mali and genetic testing is crucial to confirm the diagnosis.

Introduction: Les ataxies cérébelleuses autosomiques récessives (ACAR) constituent un groupe de maladies neurodégénératives rares et hétérogènes caractérisées essentiellement par un trouble de l'équilibre et de la marche, et un trouble de la coordination des mouvements. Objectifs: Caractériser les signes cliniques, paracliniques et génétiques des ataxies cérébelleuses autosomiques récessives au Service de Neurologie du CHU du Point "G". Patients et méthodes: Nous avons réalisé une étude de cas enrôlé dans le cadre d'une étude longitudinale et prospective allant de Janvier 2018 à Décembre 2020, portant sur des patients présentant des symptômes d'ACAR et ayant donné leur consentement éclairé. Résultats: Nous avons enrôlé sept familles totalisant 13 patients. Le sexe ratio était de 2,2 en faveur des hommes, la région de Kayes était la plus représentée et l'ethnie peulh était majoritaire. Les troubles de la marche ont représenté les signes majeurs suivis de troubles de la sensibilité profonde, de nystagmus, de dysarthrie, et des déformations ostéoarticulaires. L'alpha-foetoprotéine était élevée chez une patiente. Le test génétique a retrouvé l'ataxie de Friedreich dans une famille et n'a pas été concluant dans quatre autres. Conclusion: Cette étude montre que les ACAR ne sont pas rares au Mali et l'exploration génétique constitue un outil indispensable pour leur diagnostic de certitude.

[Clinical and laboratory features of recessive Limb Girdle Muscular dystrophies in the Department Neurology of University Hospital of Point G]. / Aspects Cliniques et Paracliniques des Myopathies des Ceintures Récessives au Service de Neurologie du CHU Point G.

INTRODUCTION: Limb-Girdle Muscular dystrophies (LGMD) is a group of inherited diseases characterized by predominantly proximal and limb muscle weakness. These are rare diseases that have not been well studied in sub-saharan Africa. The aim of our was the clinical and paraclinical characterization of patients with recessive LGMD at the Department of Neurology of the Teaching Hospital of Point G. PATIENTS AND METHODS: We conducted a longitudinal prospective study which took place from March 2014 to May 2019. Patients with recessive LGMD phenotype were enrolled. Sociodemographic, clinical and laboratory data were analyzed. RESULTS: We enrolled 46 families (67 patients), i.e. a frequency of 16.7% among the neurodegenerative diseases seen in the service. Among them, 45.6% came from the Sikasso region. Autosomal recessive inheritance pattern was suspected in 67.4% of the families. Symptoms appeared mainly in the first decade of life. Proximal muscle weakness was found in almost all patients. Cardiac examination showed dilated cardiomyopathy in 4.5% of cases. CONCLUSION: Limb-Girdle muscular dystrophy is a disabling disease that is found in Mali. Further study of these cases could elucidate the underlying genetic defects.

[Hypothyroid goiter with tracheal compression in a child in Cote d'Ivoire]. / Goitre hypothyroidien compressif chez une enfant en Côte d'Ivoire.

The purpose of this report is to describe a case involving a primary form of hypothyroid goiter with tracheal compression discovered late in a four-year-old child. Slowing of height and weight gain and mental retardation was irreversible. The child was treated using L-thyroxin. Systematic screening for hypothyroidism during the neonatal period is recommended in developing countries.

Analysis of diagnosis announcements in Abidjan pediatric oncology unit 2 years after introduction of the African Pediatric Cancer Announcement Guideline.

INTRODUCTION: Announcing the diagnosis allows the therapeutic alliance between physicians and patients to be sealed and it prevents abandonment of treatment. To compensate for the deficit in information received by the families, the Franco-African Group of Pediatric Oncology (FAGPO) has published an "African Pediatric Cancer Announcement Guide" for the group's pediatric oncology units. OBJECTIVE: To analyze the announcements made to parents and children 2 years after the provision of this guide. METHODS: Cross-sectional survey conducted from March to July 2016. In total, 69 parents of children followed up in the pediatric oncology unit of Abidjan were interviewed regarding the characteristics of the announcement that was made to them and the information given to the sick child. RESULTS: Of all the accompanying individuals, 91% reported having benefited from the announcement made with empathy, mainly by a physician. In approximately one quarter of the cases the information had been given to a third party. The main barriers to information were: the negative experiences of parents, the medical terminology, and communication problems. The sick child was rarely informed. DISCUSSION: The information given was in accordance, in content and form, with the data from Western and African literature. The lack of information given to the child has a dual explanation: the primacy of the community over the individual advocated by African culture and the non-integration of the rights of children in the current code of ethics. CONCLUSION: The information provided could be improved by practical training of physicians in the technique of breaking bad news to patients and their families and the use of a code of ethics in accordance with the principle of autonomy.

Connaissance et attitude pratique des mères vis-à-vis de la vaccination de routine, étude comparative / Knowledge and practice attitude of mothers regarding routine immunization, comparative study

Introduction : La vaccination de routine est une stratégie clé dans la prévention des maladies évitables par la vaccination. L'objectif de l'étude est d'apprécier les connaissances, attitudes des mères vis-à-vis de la pratique de la vaccination en milieu rural et urbain. Méthodes : Il s'agit d'une étude transversale descriptive comparative qui a eu lieu dans deux aires de santé (urbaine et rurale) sur une période de trois (3) mois d'octobre à décembre 2022. Elle a concerné les mères ou gardiennes d'enfants venus pour la vaccination de routine. Résultats : La moyenne d'âge des femmes était de 28, 76±6,85 ans en milieu urbain et 26,51±7,37 ans en milieu rural. Environ72, 00% et 43,00% des femmes respectivement en milieu urbain et rural avaient donné une bonne définition de la vaccination. 88,00% des femmes en milieu urbain connaissaient au moins une maladie cible du PEV contre 55,00% en milieu rural. Le calendrier vaccinal n'était connu que par 31,00% des femmes en milieu urbain contre 12,00% en milieu rural. La majorité des femmes en milieu urbain (97,00%) et rural (67,00%) trouvaient nécessaire de rattraper un rendez-vous de vaccination manqué les séances prochaines. Elles jugeaient majoritairement d'envoyer les enfants au centre de santé en cas de manifestations post- vaccinale (urbain : 80,00%, rural : 53,00%). Conclusion : Une bonne connaissance et pratique de la vaccination permettrait ainsi de protéger les enfants contre les maladies évitables par la vaccination

Background: Routine immunization is a key strategy in the prevention of vaccine-preventable diseases. The objective of the study was to assess the knowledge and attitudes of mothers regarding the practice of vaccination in rural and urban areas. Methods: This is a comparative descriptive cross-sectional study that took place in two health areas (urban and rural) over a period of three (3) months from October to December 2022. It involved mothers or guardians of children who came for routine vaccination. Results: The mean age of the women was 28.76±6.85 years in urban areas and 26.51±7.37 years in rural areas. About 72.00% and 43.00% of the women in urban and rural areas, respectively, had given a good definition of vaccination. 88.00% of women in urban areas knew at least one EPI target disease, compared to 55.00% in rural areas. Only 31.00% of women in urban areas knew the vaccination schedule, compared to 12.00% in urban areas. Majority of women in urban (97.00%) and rural (67.00%) areas found it necessary to make up for missed immunization appointments in next sessions. Majority of them considered it necessary to send their children to the health center in the event of postimmunization symptoms (urban: 80.00%, rural: 53.00%). Conclusion: A good knowledge and practice of vaccination would allow to protect children against vaccine preventable diseases

Development of a new automatic on-site detector of pesticides in natural waters by photo induced fluorescence, application to three phenylurea and benzoylurea herbicide.

Prototypes of on-site automatic photo induced fluorescence detectors of pesticide in natural waters are set up and applied for the determination of the benzoyl- and phenylurea pesticides, namely fluometuron, monolinuron and diflubenzuron. As these pesticides present no native fluorescence the set up system use the photo conversion under UV irradiation of these pesticides into highly fluorescent photoproducts. A first system, called AUTOPIF, (evolution the commercial AQUAPOD system) is develop using a detection via a diode array spectrometer. To improve the sensitivity of the method, a second system, called AUTOPIF+, is developed with a more resolute spectrometer and an intensified CCD camera detection. Analytical applications were carried out in aqueous solution and detected on line with the AUTOPIF and AUTOPIF+ system. The calibration curves are linear over one order of magnitude, and the limits of detection are in the µg mL-1 range. The analytical performances of these methods for the determination of the three pesticides are satisfactory in comparison to other classical PIF methods published for the determination of phenylurea pesticides in aqueous solutions. Our results show that the AUTOPIF and AUTOPIF+ methods are versatile, sensible and can be easily applied as an alert system to detect pollutant residues in naturals waters over a threshold value.

[The psychological experience of the mothers whose babies were born deformed in the neonatological ward of the academic hospital center of Treichville (Côte-d'Ivoire)]. / Vécu psychologique des mères de nouveau-nés malformés dans le centre hospitalier et universitaire de Treichville (Côte-d'Ivoire).

OBJECTIVE: When a baby is born deformed, his birth breaks up plans his family has made for his life as well as for the family itself. So, our objective was to describe the experience undergone by the mothers who gave birth to babies with serious deformities. METHOD: A prospective and descriptive study was carried out during 12 months about 35 mothers whose babies were born seriously deformed. The data were collected from newborn's medical file and from a well-conducted interview with volunteered mothers. RESULTS: The incidence of the major deformities was 1.4% and the antenatal diagnosis was carried out on only 6 cases. The announcement of deformities in the 30 cases discovered at birth by the clinical staff brought about a shock among mothers. In fact, 28 mothers were disappointed, while 23 experienced fear and 10 others felt guilty. Six mothers thought in terms of aborting, followed by 25 mothers who without any psychological aid felt lonely. Furthermore, 30 mothers suffered from a lack of communication with nurses and with medical staff concerning deformities. The anxiety of mothers was linked, respectively to fear of their husband (33 cases), to the social environment (35 cases) and to the health care (10 cases). CONCLUSION: Mothers facing congenital deformity experienced painful and violent emotional distress. Therefore, the emphasis must be put on the improvement of the neonatal diagnosis and of relationship between physicians and parents in order to achieve a close support toward mothers.

[Epidemiological and clinical aspects of prurigo in HIV infected patients in Fousseyni N'Daou hospital of Kayes, Mali]. / Aspects Epidemiologiques et Cliniques du Prurigo Chez les Personnes Vivant avec le VIH a L'Hopital Fousseyni N'Daou de Kayes, Mali.

INTRODUCTION: Prurigo is one of the most common dermatological conditions during HIV infection and AIDS. It appears as an immunosuppression marker associated with HIV infection. The study objective was to determine the prevalence of prurigo in people living with the human immunodeficiency virus (PLHIV) in Fousseyni N'Daou Hospital of Kayes, and to describe the socio-demographic aspects of patients and lesions associated with prurigo among PLHIV. METHODS: It was a descriptive cross-sectional study included all cases of HIV infected patients with prurigo in the Dermatology-Venomology Department of Fousseyni N'DAOU Hospital from January 1, 2015 to August 31, 2015. RESULTS: We collected 121 cases of prurigo. The hospital prevalence was 14.5% among PLHIV with 65% Female and the average age was 34.8 years old (SD: 15-81 years). The elementary lesions associated with prurigo were seropapules (40.2%), vesiculo-crusts (13%), excoriated papules (33.3%), lichenified papules (10.8%), and cicatricial lesions (2.7%). The prurigo was generalized in 68.5% of cases and localized in 31.24%. More than half of our patients had weight loss, fever, diarrhea and oral candidiasis in their medical history. Patients were infected with HIV1 in 60.03% and HIV1+ 2 in 24.3%. More than the half of our patients had a CD4 count inferior to 250 cells/mm3 at the time of prurigo diagnosis. CONCLUSION: In our study, prurigo remains a common condition in PLHIV, particularly in patients with low CD4 counts. Early detection and rapid antietroviral therapy can reduce the frequency of prurigo in PLHIV.

INTRODUCTION: Le prurigo est l'une des affections dermatologiques les plus fréquentes au cours de l'infection à VIH et du sida. Il apparait comme un marqueur de l'immunodépression associée à l'infection VIH. L'objectif était de déterminer la prévalence du prurigo chez les personnes vivant avec le virus de l'immunodéficience humaine (PVVIH) à l'hôpital Fousseyni N'Daou de Kayes (HFDK) et décrire le profil sociodémographique des patients et les lésions associées au prurigo chez les PVVIH à HFDK. PATIENTS ET MÉTHODES: Il s'agissait d'une étude transversale descriptive de tous les cas de prurigo chez les PVVIH dans le service de Dermatologie-Vénéréologie de l'hôpital Fousseyni N'DAOU durant la période du 1er janvier 2015 au 31 août 2015. RÉSULTATS: Nous avons colligé 121 cas de prurigo. La prévalence hospitalière a été de 14,5% chez les PVVIH. Le sexe féminin a représenté 65% des cas. L'âge moyen a été de 34,8 ans (extrêmes :15 ­ 81 ans). Les lésions élémentaires associées au prurigo ont été les séropapules (40,2%), vésiculo-croutes (13%), papules excoriés (33,3%), papules lichenifiés (10,8%), lésions cicatricielles (2,7%). La forme généralisée a représenté 68,5% et la forme localisée 31,24%. Plus de la moitié de nos patients avait la notion d'amaigrissement, de fièvre, de diarrhée et des candidoses buccales dans leurs antécédents. Le VIH1 a représenté 60,03% et l'association VIH1 et VIH2 a représenté 24,3% des cas. Plus de la moitié de nos patients avait un taux de CD4 inférieure à 250 cellules/mm3 au moment du diagnostic du prurigo. CONCLUSION: Dans notre étude, le prurigo reste une affection fréquente chez les PVVIH, particulièrement lorsque le taux de CD4 est bas. Un dépistage précoce et le traitement antirétroviral rapide permet de réduire la fréquence du prurigo chez les PVVIH.

Quality of care in women's, children's, and adolescent health. Methods for assessing evaluation and implementation in West Africa. Experience in the Côte d'Ivoire.

A tool developed by WHO was used to assess the quality of care for mothers, newborns, and children in some healthcare facilities in French-speaking Africa; this study led to the development of recommendations for the implementation of actions intended to resolve the problems observed and to optimize patient management. We report here the experience of the maternity units of the university hospital center of Treichville, in Abidjan, discuss the presentation of the results of the assessment, and make some recommendations as part of an action program. The experience of the monthly review of referred cases is also reported.

[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.

[Prevalence of 4 agents of sexually transmitted diseases in leukorrhea in Abidjan (Ivory Coast)]. / Prévalence de quatre agents des maladies transmises sexuellement au cours des leucorrhées à Abidjan (Côte-D'Ivoire).

6,603 women with vaginal discharges were investigated for genital infection with four sexually transmitted diseases. Germs of vaginitis were isolated with prevalence as following: C. albicans 25%, G. vaginalis 17.4%, T. vaginalis 8.2%. Cervicitis with N. gonorrhoeae represented 3.2% of cases.

[The contribution of latex tests for the diagnosis of bacterial infections in Abidjan]. / Apport des tests au latex pour le diagnostic des infections bactériennes a Abidjan.

From 313 samples of CSF, urine, sera and pleural liquid, the authors show how appreciable is the contribution in research of soluble antigens by sensibilized latex particles agglutination method in etiologic diagnosis, especially during meningitis, pulmonary and neonatal infections. Soluble antigens were declared positives in 62.26% of cases against S. pneumoniae, 25.4% of cases against H. influenzae, 6.66% of cases against S. agalactiae, 5.71% of cases against N. meningitidis C, with variable percentages from one biological liquid to another. Compared to classical bacteriologic techniques, this method allows the diagnosis of an infection even when decapitated, and could be used in emergency diagnosis.

[3 cases of vulvar epidermal cysts after female genital mutilation]. / Trois cas de kystes épidermiques de la vulve après mutilations génitales féminines.

We report three cases of tumors of the vulva following an excision during childhood, in patients aged 22 to 25. The achieved surgical removal gave correct aesthetic and functional results. Histological examination of these tumors revealed epidermal cyst containing keratin. Because of clinical, psychological and social impact of female excision, steps should be taken against such traditional practices.

[Bacterial pneumopathies of the newborn: diagnostic and therapeutic aspects]. / Pneumopathies bactériennes du nouveau-né: aspects diagnostiques et thérapeutiques.

OBJECTIVES: To describe the diagnosis and therapeutic management of bacterial pneumopathies in a neonatology unit located in a tropical area. METHODS: Transverse and prospective survey over an 18-month period. The diagnosis was based on the comparison of anamnestic features with clinical, biological and radiological features. A research was made in order to determine the causal agent in the blood, in cerebrospinal fluid, in urines, in pleural liquid and skin lesions. A treatment by two antibiotics was administered through parenteral route. RESULTS: Risk factors were found in 61 selected patients. Polypnea was associated with signs of respiratory distress in 53 patients. Blood abnormalities were present in 47, 5% of the cases. All the patients showed a positive C reactive protein and abnormal X-rays. The diagnosis was confirmed bacteriologically in 32, 8% of the cases. The association of a third-generation cephalosporin with an aminoside was prescribed in 44 cases. The initial antibiotic therapy was not relevant in 19, 7% of the cases. The lethality rate was 24, 6%. The scarcity of bacteriological confirmation led us to consider the combination of radiological abnormalities with respiratory distress as significant symptoms of bacterial pneumopathy. Biological and anamnestic features were considered as extra elements. CONCLUSION: The severity of clinical features, the nature of germs and their sensitivity to antibiotics in our local environment led us to recommend a large prescription of third-generation cephalosporins combined to aminoglycosides.

[Pulmonary complications of human immunodeficiency virus infection in sub-Saharan Africa]. / Complications pulmonaires de l'infection par le virus de l'immunodéficience humaine en Afrique sub-saharienne.

Based on a selection of articles published in the literature and reports from international AIDS conferences, we present the main pulmonary complications of HIV-infection observed in sub-Saharan Africa. The different clinical studies demonstrate the predominance of infectious complications, mainly tuberculosis (29 to 44%) and bacterial pneumonia (21 to 35%). The frequency of Pneumocystis carinii pneumonia remains low (5 to 19%). Other complications (mycobacterial infection, cytomegalovirus, toxoplasmosis, cryptococcus, aspergillosis, interstitial lymphoid pneumonia, Kaposi sarcoma) are less frequent. The autopsy studies report similar results and mention the predominance of tuberculosis and pneumonia due to common germs as well as the low frequency of pneumocystosis. This analysis of work conducted in sub-Saharan Africa clearly indicate that tuberculosis remains the leading cause of morbidity and mortality in HIV-infected patients.