Urban agriculture is common across Africa and contributes to the livelihoods of urban dwellers. Some crop systems create suitable mosquito breeding sites and thus might affect malaria transmission. The purpose of this study was to... more
Urban agriculture is common across Africa and contributes to the livelihoods of urban dwellers. Some crop systems create suitable mosquito breeding sites and thus might affect malaria transmission. The purpose of this study was to identify, map, and characterize potential mosquito breeding sites in agricultural land use zones in a medium-sized town of western Côte d'Ivoire and to assess risk factors for productive Anopheles breeding sites. Two surveys were carried out; one toward the end of the rainy season and the second one during the dry season. In all identified potential mosquito breeding sites, two experienced entomologists searched for the presence of Anopheles larvae and pupae with a standardized technique. Totals of 369 and 589 sites were found in the rainy and dry seasons, respectively, mainly in vegetable gardens and irrigated rice fields. Anopheles larvae were present in 50.7% and 42.4% of the sites investigated during the rainy and dry seasons, respectively. Typical Anopheles larval habitats were characterized by the presence of algae, the absence of floating vegetation, and the co-occurrence of Culex larvae. The highest Anopheles larval productivity was observed in rice paddies, agricultural trenches between vegetable patches, and irrigation wells. An indirect link could be established between the occurrence of productive Anopheles breeding sites and agricultural land use through specific man-made habitats, in particular agricultural trenches, irrigation wells, and rice paddies. Our findings have important bearings for the epidemiology and control of urban malaria in sub-Saharan Africa.
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Malaria is still a major public health problem in Côte d'Ivoire. Both treatment and control there are hampered by the spread of resistance to common antimalarial drugs, especially in the south where multidrug-resistant malaria is... more
Malaria is still a major public health problem in Côte d'Ivoire. Both treatment and control there are hampered by the spread of resistance to common antimalarial drugs, especially in the south where multidrug-resistant malaria is highly prevalent. Recent treatment guidelines require in vitro tests and the adaptation of drug policies according to local resistance rates. In addition to performing clinical assays in the field, we sought to establish a national map of drug resistance by using in vitro tests with clinical surveys. These make it possible to detect changes in susceptibility and are expected to prevent the emergence of resistance against the most recently introduced combined therapy. Isolates of Plasmodium falciparum. Isolates of P. falciparum were collected from symptomatic adults and paediatric patients seen at Anonkoua-Kouté Hospital or at the Pasteur Institute of Côte d'Ivoire. Venous blood samples were collected in heparinized vacutainer tubes (Becton Dickinson...
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Multilocus enzyme electrophoresis (MEE) and in vitro antifungal susceptibility testing were used to investigate the Candida albicans strain diversity in twenty nine AIDS patients from Abidjan (Ivory Coast). All patients were monitored for... more
Multilocus enzyme electrophoresis (MEE) and in vitro antifungal susceptibility testing were used to investigate the Candida albicans strain diversity in twenty nine AIDS patients from Abidjan (Ivory Coast). All patients were monitored for a first episode of oropharyngeal candidiasis and were randomly clustered into three groups of therapy: ketoconazole, amphotericin B or nystatin. Oral swabs were collected before every treatment, 14 and 30 days after the initiation of the therapy; a total of 67 isolates were investigated. No resistant or less susceptible isolate to any antifungal agent was found despite the emergence of clinical relapses, mainly for patients treated with nystatin or amphotericin B. The MEE analysis revealed 27 different electrophoretic types (ETs). Genetic distances between ETs were statistically analyzed and represented on a dendrogram. The 27 ETs clustered into three groups; in each group, ETs represented variants of the same strain. A segregation of the C. albica...
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In vivo tests of Plasmodium falciparum chloroquine sensitivity were conducted in October and November, 1988 with 81 children aged 5 to 9 in several districts of Abidjan, Ivory Coast. The WHO standard scheme covering 7 days on basis of 25... more
In vivo tests of Plasmodium falciparum chloroquine sensitivity were conducted in October and November, 1988 with 81 children aged 5 to 9 in several districts of Abidjan, Ivory Coast. The WHO standard scheme covering 7 days on basis of 25 mg per kilo spread over 3 days resulted in a therapeutic failure in 29.6 per cent cases. Nevertheless, a drop in overall parasitemia by over 80 per cent was noted from Day-0 to Day-2 in 70 per cent of visible resistance. Only in vivo tests conducted at a later stage with identification of chloroquine in the blood stream, with together in vitro studies will make it possible to know the actual level of resistance of Plasmodium falciparum strains to chloroquine.
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Artemether-lumefantrine is the most widely used artemisinin-based combination therapy for malaria, although treatment failures occur in some regions. We investigated the effect of dosing strategy on efficacy in a pooled analysis from... more
Artemether-lumefantrine is the most widely used artemisinin-based combination therapy for malaria, although treatment failures occur in some regions. We investigated the effect of dosing strategy on efficacy in a pooled analysis from trials done in a wide range of malaria-endemic settings. We searched PubMed for clinical trials that enrolled and treated patients with artemether-lumefantrine and were published from 1960 to December, 2012. We merged individual patient data from these trials by use of standardised methods. The primary endpoint was the PCR-adjusted risk of Plasmodium falciparum recrudescence by day 28. Secondary endpoints consisted of the PCR-adjusted risk of P falciparum recurrence by day 42, PCR-unadjusted risk of P falciparum recurrence by day 42, early parasite clearance, and gametocyte carriage. Risk factors for PCR-adjusted recrudescence were identified using Cox's regression model with frailty shared across the study sites. We included 61 studies done between...
Research Interests: Africa, Global Health, Medical Microbiology, Tropical Medicine, Treatment Outcome, and 16 moreAdolescent, Humans, Child, Female, Asia, Male, Polymerase Chain Reaction, Neglected tropical diseases, Young Adult, Infant, Clinical Sciences, Aged, Middle Aged, Adult, Plasmodium falciparum, and Antimalarials
Strongyloides stercoralis is a neglected soil-transmitted helminth species. In Cote d'Ivoire, as elsewhere, there is a lack of parasitologic and epidemiologic data pertaining to this parasite. The purpose of this study was to evaluate... more
Strongyloides stercoralis is a neglected soil-transmitted helminth species. In Cote d'Ivoire, as elsewhere, there is a lack of parasitologic and epidemiologic data pertaining to this parasite. The purpose of this study was to evaluate the prevalence and impact of sociodemographic factors on anguillulosis among public school children in Abidjan, Cote d'Ivoire. Testing for Strongyloides stercoralis was performed in a random sample of 411 children from 10 public primary schools in Abidjan. Detection methods included direct examination of stool smears, the Baermann test and helminth coproculture study. The overall prevalence of anguillulosis was 2.7% (N=411) (IC95% = 1.34-4.73). The M/F sex-ratio was 1. No correlation was found between prevalence and sex (p = 0.12). Prevalence was higher among children who reported contact with swamps and rivers (respectively 80% and 7.9%) than those who did not report such contact (respectively 1.7% and 1.5%) (p <0.01). Contact with swamps a...
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We comparatively studied the dynamics of malaria transmission in the villages of Zatta (located in close proximity to an irrigated rice perimeter) and Tiémélékro (rural area with traditional agriculture), central Côte d'Ivoire. In the... more
We comparatively studied the dynamics of malaria transmission in the villages of Zatta (located in close proximity to an irrigated rice perimeter) and Tiémélékro (rural area with traditional agriculture), central Côte d'Ivoire. In the former village, the irrigated rice farming had been interrupted in 2003/2004 due to a farmers' conflict over land. In each village, mosquitoes were collected by human landing catches at night in sentinel houses. Anopheles gambiae was the predominant malaria vector, followed by An. funestus. In Zatta, the return to an irrigated rice farming in January 2005 was paralleled by a significant increase of the entomological inoculation rate (EIR) ranging from 38 infective bites per person per year (ib/ply) in 2003 to 295 ib/ply in 2005. In Tiémélékro high EIRs were found in 2003 (342 ib/ply) and 2005 (572 ib/ply). Our findings confirm that changes in irrigated rice agriculture influence malaria transmission dynamics, and call for control measures that ...
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A parasitological survey on intestinal coccidia, Cryptosporidium sp and Isospora belli, has been carried out in paediatric service of an teaching hospital in the district of Abidjan (Côte d'Ivoire). 130 children under 5 years old... more
A parasitological survey on intestinal coccidia, Cryptosporidium sp and Isospora belli, has been carried out in paediatric service of an teaching hospital in the district of Abidjan (Côte d'Ivoire). 130 children under 5 years old suffering from diarrhoea have been enrolled. Direct stools examination method, simplified Ritchie technique and Ziehl Neelsen modified coloration were used for analysis. Moreover, the AIDS serological status of the patients has been determined. The results show that Cryptosporidium sp and Isospora belli were found respectively with a prevalence of 7.7% and 3.9%. Only one case of mixed infestation between theses two parasites has been found. Coccidia were the most recurrent parasites found in diarrhoea after flagellates. Parasitism by coccidia was not related to AIDS serological status of the children. These results point out the necessity to make common coccidian parasitical diagnosis in children under 5 years old suffering from diarrhoea.
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Antimalarial drug resistance in endemic malaria zones is first detected in vitro; when it reaches a certain threshold, it becomes perceptible and is expressed in therapeutic failure among subjects only slightly or not at all immune. This... more
Antimalarial drug resistance in endemic malaria zones is first detected in vitro; when it reaches a certain threshold, it becomes perceptible and is expressed in therapeutic failure among subjects only slightly or not at all immune. This work conducted in northern Abidjan (Cote d'Ivoire) studied children with uncomplicated malaria, who were followed for 14 days (during the year 2000) in accordance with the WHO protocol for surveillance of antimalarial drug resistance. Concomitantly, the Plasmodium falciparum isolates were cultured in the presence of variable concentrations of chloroquine, pyrimethamine and quinine during in vitro chemosensitivity tests. The RPMI 1640 used as medium for the pyrimethamine did not contain PABA (para-amino benzoic acid) or folic acid. In all, 114 in vitro tests were completed, 33 to chloroquine, 32 to pyrimethamine, and 49 to quinine. Therapeutic efficacy was tested in 65 patients: 33 to chloroquine and 32 to sulfadoxine-pyrimethamine (SP). The resu...
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In order to assess the action scheme of the National Program against Malaria, a study has been conducted in 25 pharmacies in Bouaké an area of high malaria transmission. The kind and quality of malaria treatments suggested by medical... more
In order to assess the action scheme of the National Program against Malaria, a study has been conducted in 25 pharmacies in Bouaké an area of high malaria transmission. The kind and quality of malaria treatments suggested by medical personnel, pharmacy sellers and used in automedication have been studied. The results proved that chloroquine is the molecule most delivered (25.7%) in private pharmacies. The parasitological diagnosis is scarcely requested by medical personnel. As in automedication, posological mistakes are relatively frequent with medical and pharmacy personnel (29.3%). The duration of the treatment is not specified in 14.2% of cases. Training and information actions must be reinforced for a better care of malaria.
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Otomycosis is frequently encountered in tropical and subtropical zones. In Ivory Coast diagnosis of this disease is often based solely on the clinical symptoms. The objectives of this study were to determine the prevalence, predisposing... more
Otomycosis is frequently encountered in tropical and subtropical zones. In Ivory Coast diagnosis of this disease is often based solely on the clinical symptoms. The objectives of this study were to determine the prevalence, predisposing factors, and etiologic agents associated with otomycosis at the Treichville University Hospital Center in Abidjan, Ivory Coast. Mycological examinations were performed on specimens obtained from 115 patients presenting with external otitis at the d'Oto-Rhino-Laryngology Department. Fungi-positive cultures were obtained in 49 patients for an overall otomycosis prevalence of 42.6 (95% Confidence Interval (CI), 34.4-52.2). Univariate analysis showed that the predisposing factors for otomycosis were frequent swimming in natural or artificial pools (Relative Risk (RR) 3.7; CI 1.7-8.1), daily ear cleaning (RR 3.5; CI 1.8-6.8) and excessive use of eardrops containing antibiotics and corticoids (RR = 9.3; IC95% = 4.3-20.1). The most common etiologic agen...
Research Interests: Adolescent, Swimming, Humans, Child, Female, and 10 moreMale, Risk factors, Aged, Prevalence, Middle Aged, Adult, Risk Factors, Swimming Pools, Ear Diseases, and Cote D Ivoire
Study of children treated for uncomplicated malaria in the sub-prefecture of Zouan Hounien in Western Côte d'Ivoire demonstrated that clinical failure rates (WHO 14-day test) were 43% for chloroquine and 6% for... more
Study of children treated for uncomplicated malaria in the sub-prefecture of Zouan Hounien in Western Côte d'Ivoire demonstrated that clinical failure rates (WHO 14-day test) were 43% for chloroquine and 6% for pyrimethamine-sulfadoxine (PS). Two issues raise serious doubts about the use of PS as a replacement for chloroquine. The first is detection of persistent asymptomatic parasitemia at day 7 in children treated with PS. The second is widespread use of one PS component (sulfadoxine) to prevent opportunistic infection in AIDS patients or to treat infection. Further study will be needed to evaluate the therapeutic and parasitological efficacy of amodiaquine in the region.
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A prospective study in the municipality of Attécoubé (Abidjan, Côte d'Ivoire) evaluated the sensitivity of P. falciparum to amodiaquine with a posology of 35 mg/kg over 3 days (1st day: 15 mg/kg; 2nd day: 10 mg/kg; 3rd day: 10 mg/kg)... more
A prospective study in the municipality of Attécoubé (Abidjan, Côte d'Ivoire) evaluated the sensitivity of P. falciparum to amodiaquine with a posology of 35 mg/kg over 3 days (1st day: 15 mg/kg; 2nd day: 10 mg/kg; 3rd day: 10 mg/kg) as well as its tolerance of this dosage. One hundred five WHO in vivo standard tests were performed over 7 days on subjects aged > 15 years from May to December 1995. The subjects were carriers of varying number of trophozoites: between 1000 to 34,000 trophozoites were recorded with a mean of 5193 trophozoites by microliter. We divided the subjects into two groups: group A with 43 patients to whom we administered medication and group B with 62 subjects who took their medication on their own. Clinical and parasitological verifications were made on D0, D2 and D7. Biological verification was conducted for 31 subjects of group A by mean of SGOT and SGPT quantity determination on D0 and D2. This survey revealed that 1.9% of P. falciparum malaria patie...
Research Interests: Adolescent, Prospective studies, Humans, Female, Male, and 5 moreMiddle Aged, Adult, Antimalarials, Amodiaquine, and Cote D Ivoire
The purpose of this study was to collect ENT signs observed during lymphomas. The study was conducted in the unit of ENT at the CHU of Treichville, during 15 month from december 1995 to march 1997. Ten cas of lymphomas was enrolled with 6... more
The purpose of this study was to collect ENT signs observed during lymphomas. The study was conducted in the unit of ENT at the CHU of Treichville, during 15 month from december 1995 to march 1997. Ten cas of lymphomas was enrolled with 6 Hodgkin's lymphomas, 3 acute leukemia and 1 Hodgkin's lymphoma. The diagnosis was based on biopsy and myelogram. There is a wide spectrum and non specific clinical pictures. Pharynx is the common site particularly on the Waldeyer's ring. The disease is common among young people, low socio-economical status. Female are predominant. Most patients died before specific treatment because of the late diagnosis.
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Hair samples from 2,209 children aged between 4 and 15 years were analyzed in March and April 1997 in an epidemiological study. We found that the prevalence of scalp pediculosis in schools in Abidjan was 18.51%. The girls were more... more
Hair samples from 2,209 children aged between 4 and 15 years were analyzed in March and April 1997 in an epidemiological study. We found that the prevalence of scalp pediculosis in schools in Abidjan was 18.51%. The girls were more frequently infected than the boys (24.88% for girls and 11.85% for boys). The children most frequently affected were those aged 14 to 15 years (24%) or 6 to 7 years (23. 21%). The children least affected were those aged 12 to 13 years (15. 21%) or 10 to 11 years (16.21%). Socioeconomic conditions, particularly the monthly incomes of the parents, cramped conditions and the collective use of washing facilities and bedding affected the prevalence of scalp pediculosis. Measures to deal with scalp pediculosis in schools should take into account socioeconomic and psychological factors, which are as important as the drug treatment for scalp pediculosis.
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Historically the region of Abengourou is a well-known of sleeping sickness in the forest area of Cote d'Ivoire. However data from epidemiologic studies carried out since 1980 show that this area is currently disease-free. This finding... more
Historically the region of Abengourou is a well-known of sleeping sickness in the forest area of Cote d'Ivoire. However data from epidemiologic studies carried out since 1980 show that this area is currently disease-free. This finding warrants study of glossina vectors to clarify the epidemiology of the disease in this area. Entomologic surveys were carried out over a period of one year. Traps were used to capture glossina in ten natural habitats: villages with or without pigs, coffee, cocoa and rice plantations, grazing lands, camping areas, uncultivated farmlands, trails, forest borderlands and wilderness. Findings documented almost total disappearance of zoophilic glossina (Glossina nigrofusca and Glossina pallicera) which accounted for less than 0.5% of glossina captured only during the rainy season. The apparent trap density (ATD) of Glossina palpalis, the main vector of disease, was low overall. However ATD values tended to be higher in villages with pigs (ATD : 2.07 gloss...
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Research Interests: Urban Health, Humans, Child, Hospitalization, Female, and 5 moreMale, Incidence, Adult, Feces, and Cote D Ivoire
We report the results of epidemiological research carried out using a sample of 1,001 children between the ages of 4 and 15 in the city of Abidjan. The aim of the study was to explore the relationship between socioeconomic conditions and... more
We report the results of epidemiological research carried out using a sample of 1,001 children between the ages of 4 and 15 in the city of Abidjan. The aim of the study was to explore the relationship between socioeconomic conditions and the occurrence of intestinal helminthiasis. The variables evaluated in this study were the monthly income of the parents, daily food budget per person, number of people sharing accommodation, availability of running water and electricity, availability of food near schools and regular anti-parasite treatment.
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Feces of 1001 school children aged from 4 to 15 years were examined as an epidemiological investigation. Direct analyses were completed by KATO and RITCHIE methods. The outcome was the global prevalence of intestinal helminthiasis in... more
Feces of 1001 school children aged from 4 to 15 years were examined as an epidemiological investigation. Direct analyses were completed by KATO and RITCHIE methods. The outcome was the global prevalence of intestinal helminthiasis in school age children in the Abidjan area is 36.5%. Male subjects are more infected than females. The most infected group is aged from 12 to 13 years and the less infected from 4 to 5 years. The frequent parasite species are Trichuris trichiura (23.4%), Ascaris lumbricoides (15.5%), Necator americanus (6.3%), Strongyloides stercoralis (1.4%). Hymenolepis nana (1.1%), Schistosoma mansoni (0.8%) and Enterobius vermicularis (0.2%).
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Among strategies for the development of new antimalarials, a study of plants traditionally used in Africa against malaria has been pursued. Extracts obtained from the plants Azadirachta indica, Cinnamonum camphora, Lippia multiflora,... more
Among strategies for the development of new antimalarials, a study of plants traditionally used in Africa against malaria has been pursued. Extracts obtained from the plants Azadirachta indica, Cinnamonum camphora, Lippia multiflora, Vernonia colorata, Guiera senegalensis, Combretum micranthum, and Ximenia americana, commonly used in Cote d'Ivoire by native healers for the treatment of malaria, were tested on two strains of Plasmodium falciparum: FcB1-Colombia (chloroquine-resistant) and F32-Tanzania (chloroquine-sensitive). Extracts were obtained after infusion and decoction, both techniques being used by most native healers. The antimalarial activities of the extracts were tested first by parasite 3H-hypoxanthine incorporation and second by visual evaluation of the activities of plant extracts on thin blood smears, which also permitted the determination of parasitic stages and parasite alteration. Among the seven plants tested, some had an apparent inhibitory effect on P. falc...
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The authors reviewed the evolution of Plasmodium falciparum chloroquine resistance in greater Abidjan for the year 1990. They used the classical course of treatment consisting of 25 mg per kg of bodyweight distributed on three days.... more
The authors reviewed the evolution of Plasmodium falciparum chloroquine resistance in greater Abidjan for the year 1990. They used the classical course of treatment consisting of 25 mg per kg of bodyweight distributed on three days. Parasitaemia and body temperature controls were carried out on day O, day 2 and day 7. The study, which involved 547 children averaging 38.3 months of age disclosed an early in vivo resistance in the range of 18.20% as against 29.6% in 1988.
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An epidemiologic survey has been done in November 1987 on 220 children aged from one to four in the Ancien-Fresco island (Côte-d'Ivoire). The results show that 84.5% of the children whose excreta have been examined have parasites. The... more
An epidemiologic survey has been done in November 1987 on 220 children aged from one to four in the Ancien-Fresco island (Côte-d'Ivoire). The results show that 84.5% of the children whose excreta have been examined have parasites. The Ascaridiasis is the helminthiasis the most frequent.
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148 adult patients with chronic diarrhoea and suspected to be HIV infected have had stool examinations. 46 are without any enteric parasite. Those detected in the others patients are Sporozoans: I. belli (16.2%) and Cryptosporidium sp.... more
148 adult patients with chronic diarrhoea and suspected to be HIV infected have had stool examinations. 46 are without any enteric parasite. Those detected in the others patients are Sporozoans: I. belli (16.2%) and Cryptosporidium sp. (6.7%) found alone or joint, together or with other parasites. Among those, all Flagellate species are identified, but T. intestinalis (6%) is predominant. Entamoeba coli (8.%) is the most frequent amebic species, however, E. histolytica histolytica have been found twice, once singly, the second associated with I. belli, Schistosoma mansoni and Candida albicans. Necator americanus (14%) and Strongyloides stercoralis (12%) are the predominant worm species. Among the yeasts, C. albicans (35.8%) is the most important species isolated, singly in 13.5% of the patients. In an intertropical and parasitical endemic area where many parasites are not considered uncommon, opportunist agents as I. belli, Cryptosporidium sp. and C. albicans appear in an non-neglig...
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Intestinal helminthiasis affects the health and academic performance of children in developing countries. To highlight a few socio-economic factors that impact the presence and upholding of intestinal helminthiasis, a cohort study was... more
Intestinal helminthiasis affects the health and academic performance of children in developing countries. To highlight a few socio-economic factors that impact the presence and upholding of intestinal helminthiasis, a cohort study was performed from February to June 2001. This study took place in Agboville in Southern Côte d'Ivoire on 363 children, under the age of 15, regularly enrolled in school and selected by two-step clustered sampling. After the survey was completed, their stools were examined using 3 methods: direct exam, Kato's technique, and Graham's anal scotch-test. Infected students received an appropriate anti-helminthic treatment. After performing a test two weeks later, a new sample of 348 parasite-free children was made up and re-examined after three months, through the aforementioned techniques. In this sample, we assumed that students who were infested in the initial exam were "exposed", while those who were not infested in the first place wer...
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A multicentric and prospective survey has been carried out in simple blind from August 1998 to May 2000 at Yopougon and Treichville Teaching Hospitals on 185 patients having undergone an emergency or sheduled surgical intervention for a... more
A multicentric and prospective survey has been carried out in simple blind from August 1998 to May 2000 at Yopougon and Treichville Teaching Hospitals on 185 patients having undergone an emergency or sheduled surgical intervention for a non septic gynaecological affection. Ninety five patients were discharged early just after bowel motion, and ninety others left seven days after the surgical intervention. The authors compared the complications observed in the two modes of discharge and showed that there is no meaningful difference between their respective frequencies. In a more general way it has not been identified particular risk factors of post-operative complications.
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The authors report a care management of a patient presenting a severe alloimmunisation treated by spectrophotometry, a very efficient method but difficult of access in developing countries. Beyond the restrictive paraclinical exams which... more
The authors report a care management of a patient presenting a severe alloimmunisation treated by spectrophotometry, a very efficient method but difficult of access in developing countries. Beyond the restrictive paraclinical exams which do not allow an efficient monitoring of this pathology, the lack of alloimmunisation prevention during illegal abortions and the lack of information about patients'medical files are highly responsible for the difficult management of Rhesus- negative patients. However the authors remind that only the scan at best combined with the Doppler, are effective exams helping to avoid the constraints of spectrophotometry. Although quite well-known this pathology induces very severe foetal consequences and may involve the obstetric prognosis of young women. The caesarian section will still remain for a long time the only means to prevent foetus from alloimmunisation complications in developing countries.
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The aim of this survey was to value the contribution of saline infusion sonography (SIS) to endometrial pathologies diagnosis in a context of work where hysterography is the reference exam rather than hysteroscopy. A prospective... more
The aim of this survey was to value the contribution of saline infusion sonography (SIS) to endometrial pathologies diagnosis in a context of work where hysterography is the reference exam rather than hysteroscopy. A prospective comparative cohort survey led at Yopougon's teaching hospital, from July 1st to April 30th 2003. This study concerned 65 patients. The sensitivity, the specificity, and the Kappa test have been calculated from the morbid results. The SIS has been successfully carried out among 63 patients (96,8%). The polyps (23,8%), and the mucous myomas (14%) dominate the endometrial pathologies. The analysis of the results indicated sensitivity and a global specificity respectively of 100% and 76,5%. The dissonant diagnoses have been decided in 82% of the cases in favour of SIS. Besides, SIS permits to save 31.67 Euros/patient. SIS could therefore constitute a tool of choice for the exploration of the uterine cavity in the developing countries.
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Haemorrhage of placenta birth is one of the main reasons of maternal mortality in developing countries. The control of this third stage of delivery remains one of the means to stem the scourge. This survey shows that controlled placenta... more
Haemorrhage of placenta birth is one of the main reasons of maternal mortality in developing countries. The control of this third stage of delivery remains one of the means to stem the scourge. This survey shows that controlled placenta birth is a safe mean to reach this objective: 200 women who had normal vaginal deliveries at the Abobo North hospital were included in the survey. Among them, one hundred women had a controlled placenta birth whereas 100 had a normal one. The analysis of the results showed that: the haemorrhage rates during placenta birth slightly decrease in the group with controlled placenta birth and are clearly lower in the group of patients with risks factors of haemorrhage in 10% of the cases; the delay of placenta birth is twice shorter in the group having a controlled placenta birth than in the group with normal placenta birth; blood loss in the group with controlled placenta birth is three times less important than in the other group. This study speaks in fa...
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The purpose of this study was to assess the value of hand disinfection by rubbing with alcohol in terms of prevention of surgical site infection (SSI) and cost in a tropical setting. This prospective cohort study carried out in the... more
The purpose of this study was to assess the value of hand disinfection by rubbing with alcohol in terms of prevention of surgical site infection (SSI) and cost in a tropical setting. This prospective cohort study carried out in the Gynecology Obstetrics Department of the Yopougon University Teaching Hospital from May to September 2005 was designed to compare two different methods of hand disinfection, i.e., traditional 3-step hand scrubbing using an antiseptic preparation versus handwashing without an antiseptic preparation followed by two applications of an aqueous alcohol solution. The study population included 318 patients who underwent surgery during the study period. The SSI rate was 13.2% in patients operated on after traditional hand scrubbing and 11.5% after handwashing followed by rubbing with alcohol (not significantly different). Hand disinfection by rubbing with alcohol did not increase the risk of SSI and was considered as easier than traditional hand scrubbing by 90% o...
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ABSTRACT Objectives — A study of in vivo Plasmodium falciparum sensitivity to chloroquine was carried out in 102 patients from eight months to 15 years of age, between May and July 1994 in humans (West Ivory Coast).Materials and methods —... more
ABSTRACT Objectives — A study of in vivo Plasmodium falciparum sensitivity to chloroquine was carried out in 102 patients from eight months to 15 years of age, between May and July 1994 in humans (West Ivory Coast).Materials and methods — This study was included in the national P. falciparum-sensitivity supervision program. Chloroquine was administered in accordance with the standard seven day WHO protocol; i.e. administered dose of 25 mg/kg, in split doses, over three days.Results — Of 102 treated patients, 13 apyretic patients (12.75%) harbored RII-RIII type chloroquine-resistant strains with the exception of a patient who became febrile on D7.Conclusion — Considering these results, the authors suggest that the first-line treatment with chloroquine be continued for uncomplicated malaria in humans.
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L es otomycoses sont des infections fréquemment ren-contrées dans les régions tropicales et subtropicales (1). Elles sont à l'ori gine d'altérations du conduit auditif avec un risque de perfo ration du tympan (2) aux conséquences... more
L es otomycoses sont des infections fréquemment ren-contrées dans les régions tropicales et subtropicales (1). Elles sont à l'ori gine d'altérations du conduit auditif avec un risque de perfo ration du tympan (2) aux conséquences grave s . En Côte d'Ivoire, les otomycoses sont considérées comme courantes par les spécialistes des différents services d'Oto-R h i n o -L a ry n go l ogie (ORL). Cep e n d a n t , très peu de trava u x ont été réalisés sur ces pathologies. L'absence d'une confir-mation biologique entraîne, le plus souvent à tort, la pres-cription de médicaments antifongiques onéreux et non jus-tifiés. Une telle attitude alourdit ainsi le coût de la prise en ch a rge médicale de nos populations re l at ivement pauvres. Pa r ailleurs, la connaissance des facteurs favorisant les otomy-coses en Côte d'Ivo i re pourrait perm e t t re de prévenir la sur-venue de ces affections notamment dans les cas de rechute. Notre étude visait donc, d'une part...
Authors have conducted a re s e a rch of the pre s e n t level of in-vivo sensitivity of local Plasmodium falcipa- rum strains to chloroquine in Abidjan area (Côte d'Ivoire). The re s e a rch was conducted during the second semester... more
Authors have conducted a re s e a rch of the pre s e n t level of in-vivo sensitivity of local Plasmodium falcipa- rum strains to chloroquine in Abidjan area (Côte d'Ivoire). The re s e a rch was conducted during the second semester of 1988 on 140 children aged 2 months to 5 years (average age : 35 months). The WHO thera- peutic scheme (25 mg/kg per os spread over 3 days) was used. The study revealed a 28,9 per cent in-vivo chloroqui- noresistance.
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RÉSUMÉ Les auteurs étudient 74 souches de Candida albicans isolées des prélèvements vaginaux. Le sérotypage de ces souches confirme la prédomi- nance chez les femmes Noires africaines du sérotype B avec 71,62% des cas par rapport au... more
RÉSUMÉ Les auteurs étudient 74 souches de Candida albicans isolées des prélèvements vaginaux. Le sérotypage de ces souches confirme la prédomi- nance chez les femmes Noires africaines du sérotype B avec 71,62% des cas par rapport au sérotype A et au sérotype AB avec respectivement 25,68% et 2,70% des cas. L'étude de leur sensibilité aux antifongiques montre une très forte activité des polyènes. Cette activité s'est révélée insuffisante pour la 5-Fluoro-cytosine et très variable pour les dérivés imidazolés. L'utilisation de ces derniers doit reposer sur les résul- tats de l'antifongigramme. Mots clés : Sérotypage - C. Albicans Antifongigramme. SUMMARY
A coprological study realized with 217 HIV adult subjects has allowed to evaluate the frequency of the cryptosporidiosis during this affection in Abidjan. Cryptosporidium sp. has been found in 8.7% of the subjects. Otherwise 78.9% of the... more
A coprological study realized with 217 HIV adult subjects has allowed to evaluate the frequency of the cryptosporidiosis during this affection in Abidjan. Cryptosporidium sp. has been found in 8.7% of the subjects. Otherwise 78.9% of the patients had a chronic diarrhoea. 89.4% showed an abdominal pain and were dehydrated 94.7% had lost weight and 21% had nausea or vomiting.
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Coprological survey involving 250 ivorian children with diarrhoea was done to evaluate the incidence of cryptosporidiosis. Crypstosporidium sp. was found in 10.4% of subjects. 76.9, 57.7 and 19.2% Cryptosporidium positive children had... more
Coprological survey involving 250 ivorian children with diarrhoea was done to evaluate the incidence of cryptosporidiosis. Crypstosporidium sp. was found in 10.4% of subjects. 76.9, 57.7 and 19.2% Cryptosporidium positive children had profuse diarrhoea, fever and pulmonary symptoms respectively. In Ivory Coast, children diarrhoeas due to cryptosporidiosis are quantitatively important.
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The malaria, deadly parasite infection in its severe form, is widely spread in tropical zone where it rages in an endemic way. The emergence and the extension of Plasmodium resistance contributed to increase the morbidity and the... more
The malaria, deadly parasite infection in its severe form, is widely spread in tropical zone where it rages in an endemic way. The emergence and the extension of Plasmodium resistance contributed to increase the morbidity and the mortality of this pathology in children under 5 years old. Facing the extend of this phenomenon, a monitoring of the expansion of the chemosensitivity proves to be necessary. The goal of the present study was to assess the sulfadoxine-pyrimethamine (S-P) efficacy according to the in vivo test WHO protocol of 14 days-follow-up. Children are treated to the S-P at the rate of 1/2 tablet per 10 kg of body weight in unique dose, then controls are done days 3, 7 and 14. At the end of this work, 179 on 475 subjects were effectively carriers of asexual parasites. So, the general plasmodic index and Plasmodium falciparum rate infection were respectively 37.7% and 100%. Among the 89 children followed until J14, those aged of 13 to 24 months represented 38% of the pop...
The presence of antiphospholipid antibodies (APL) has been investigated in 68 African women presenting obstetrical complications versus a control group of 22 pregnant healthy women. Patients inclusion criterias were recurrent foetal loss,... more
The presence of antiphospholipid antibodies (APL) has been investigated in 68 African women presenting obstetrical complications versus a control group of 22 pregnant healthy women. Patients inclusion criterias were recurrent foetal loss, pre eclampsia, retroplacental haematoma and chronic foetal suffering. Eight of patients (11.8%) had a positive APL diagnosis, versus 0% in controls, using the combination of diluted thromboplastin test and Staclot LA These results argue for the systematic APL screening in African women with obstetrical complications, and could further improve the management of patients at risk.
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The biological diagnosis of malaria plays an important part in the patients' treatment for malaria. Thus, many techniques have been developed to reach this purpose. We have compared four of them concerning 196 patients from October,... more
The biological diagnosis of malaria plays an important part in the patients' treatment for malaria. Thus, many techniques have been developed to reach this purpose. We have compared four of them concerning 196 patients from October, 1996 to January, 1997 in Abidjan. Thick blood film has been chosen as the technique for reference. It has come out that the plasmodic index was 18.3%. The Plasmodium falciparum has been the only encountered species. The different sensitivities of the QBC test and of the Parasight F test reached 100% against 83.3% in the case of the thin blood film. The QBC test and the thin blood film had each a specificity of 100% against 88.1% for the Parasight F test. Unlike the QBC test, the thick blood film and the thin blood film have remained the most difficult to be realised. Therefore, the analysis of parameters of credibility (sensitivity, specificity), predictable values and the time involved will allow in a given situation to use the appropriate biologica...
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A comparative study of the in vivo sensitivity of Plasmodium falciparum to amodiaquine versus chloroquine has been made among children in Agou (south Côte d'Ivoire). In case of resistance to these drugs, the association of... more
A comparative study of the in vivo sensitivity of Plasmodium falciparum to amodiaquine versus chloroquine has been made among children in Agou (south Côte d'Ivoire). In case of resistance to these drugs, the association of sulfadoxine-pyrimethamine was administered and followed by a J14 checking. We have noticed: (1) 8.47% of amodiaquine resistance versus 36.96% of chloroquine resistance (all these resistances are from type II), (2) a good clinical efficiency of the 4 amino quinolines. Only 1.69% of the subjects having resistant stocks to amodiaquine have gone feverish down to J7 whereas 10.47% of subjects have clinically resisted to chloroquine, (3) a good tolerance of drugs and an excellent clinical and parasitological efficiency of the second intention treatment. These data are in favour of using first the 4 amino quinolines (particularly the amodiaquine) in the treatment of simple bout of malaria to Plasmodium falciparum in this region. In case of resistance to these drugs, ...
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A survey has been carried out in south-west of Côte d'Ivoire in order to study chloroquine resistance in treatment of malaria according to 14 days protocol of WHO (World Health Organisation) (1996) for evaluation of antimalarial drugs... more
A survey has been carried out in south-west of Côte d'Ivoire in order to study chloroquine resistance in treatment of malaria according to 14 days protocol of WHO (World Health Organisation) (1996) for evaluation of antimalarial drugs activity; 63 children, aged from 6 months to 15 years and suffering from noncomplicated malaria due to Plasmodium falciparum, received by oral way 25 mg/kg of chloroquine over three days (10-10-5). During the survey, they were subjected to a clinic and parasitologic (thick and thin blood film) follow up. We obtained, for 51 children (81%), a satisfactory clinical answer, for 8 children (13%) an early therapeutic failure and for the other 4 (6%) a late therapeutic failure. Moreover, we obtained 40% of failure in children of less than 24 months old, 25% between 24 months and 59 months and 7% beyond 6 years old.
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The WHO 14-days' test and an in vitro survey were carried out to study the efficacy of amodiaquine versus chloroquine in Abie, a hyperendemic village in the southern forest area of Côte-d'Ivoire. One hundred and nineteen children... more
The WHO 14-days' test and an in vitro survey were carried out to study the efficacy of amodiaquine versus chloroquine in Abie, a hyperendemic village in the southern forest area of Côte-d'Ivoire. One hundred and nineteen children less than 15 years old suffering from uncomplicated malaria were randomised. Among these, 62 were given amodiaquine treatment and 57 chloroquine treatment. both 4-aminoquinoleines were administered at the same dose of 30 mg/kg spread over three days by 10 mg/kg/day. Before the drug was administered, parasites were taken from some patients of each group and were evaluated in vitro to both drugs. In vivo, the amodiaquine treatment shows 95% of clinical success, 2% of early clinical failures and 3% of late clinical failures. For the chloroquine treatment, the rates are respectively. 79%, 7% and 14%. However, some patients still had a level of parasitaemia for both treatments but were asymptomatic. These parasites were found to be resistant in vitro. Th...