Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder that affects approximately 1 in 3,000 births. It is mainly characterized by cutaneous manifestations such as café au lait spots, neurofibromas, and axillary or inguinal freckling. Pulmonary involvement is rare (5-20%) and may include cystic or infiltrative lesions. We here report the case of a 13-year-old boy with no significant past medical history who presented with exertional dyspnea, chest pain, fatigue, and dry cough. Physical examination revealed multiple café au lait spots (>10), axillary freckling, and dorsal scoliosis. Chest X-ray showed a right posterior mediastinal mass. A computer tomography scan confirmed a large mediastinal mass (13 x 15 x 12cm) associated with bilateral pulmonary cystic lesions. Biopsy demonstrated benign neurofibroma, and genetic testing confirmed a mutation in the NF1 gene. Unfortunately, the patient died intraoperatively during an attempted surgical resection.
Biologie cellulaire et moléculaireGénétiqueLicence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p
La maladie dermatophytique, décrite pour la première fois en 1959 par Hadida et Schousboe, est une infection dermatophytique chronique de la peau et des viscères. C'est une maladie rare principalement décrite au Maghreb. Les études immunologiques ont permis de mettre en évidence un déficit de l'immunité cellulaire à transmission autosomale récessive responsable d'un état de tolérance vis-à-vis du dermatophyte. Les premiers signes de cette pathologie surviennent généralement pendant l'enfance. Notre patient présente depuis l'âge de 50 ans une pachyonychie de tous les ongles et des lésions érythémato-squameuses circinées et prurigineuses généralisées à tout le tégument auxquelles se sont progressivement ajoutées une alopécie et une dépilation de toutes les aires pilaires, une kératodermie palmo-plantaire ainsi que des adénopathies axillaires et inguinales bilatérales. Tricophyton violaceum a été isolé sur les ongles. Aucun déficit immunitaire n'a été retrouvé ni atteinte viscérale dans la limite des bilans réalisés. L'évolution est marquée par des améliorations transitoires, la résistance des adénopathies et des atteintes phanériennes ainsi que les multiples rechutes malgré la mise sous griséofulvine. La maladie dermatophytique est une maladie grave mettant en jeu le pronostic vital du fait de l'évolution inexorable vers les atteintes viscérales. L'amélioration du statut immunitaire associée au traitement antifongique pourrait être la meilleure thérapeutique.
Microbiologie (bactériologie, virologie)ImmunologiePharmacologieLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hind Adadi, Hekmat Chaara, Imane Attar, Sofia Jayi, Fatim-Zahra Fdili Alaoui, Moulay Abdelilah Melhouf
La maladie des brides amniotiques (MBA) est un ensemble de malformations congénitales complexes, intéressant principalement les membres, mais aussi la région cranio-faciale et l'axe thoraco-abdominal. Deux théories principales physiopathologiques s'opposent: la rupture précoce de l'amnios (théorie exogène) conduirait à la formation de brides fibreuses, qui seraient elles-mêmes responsables par strangulation des malformations observées; la théorie endogène privilégie une origine vasculaire, les brides n'ayant alors aucun rôle causal. Le pronostic de la maladie dépend de la gravité des malformations. Afin de discuter des difficultés diagnostiques et thérapeutiques de la maladie des brides amniotiques (MBA), nous rapportons deux cas témoignant de malformations létales de cette maladie. L'objectif principal de ce travail est d'aborder l'intérêt du diagnostic anténatal concernant son influence sur la prise en charge thérapeutique de cette embryo-foetopathie.
Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
J. Bonnet, S. Ducroix-Roubertou, S. Rogez, D. Ajzenberg, B. Courtioux, J.-F. Faucher
RésuméL'approche des mécanismes liés aux résultats faussement positifs des tests de diagnostic rapide (TDR) du VIH chez les patients atteints de la trypanosomose humaine africaine (THA) ou maladie du sommeil contribuera à améliorer la précision du dépistage de l'infection par le VIH, dans les zones endémiques pour la THA.Nous présentons le cas d'une patiente du Congo, prise en charge pour une méningoencéphalite opportuniste d'un sida lors de son admission sur la base d'un TDR VIH qui s'est ensuite révélé faussement positif, et dont le diagnostic était celui de maladie du sommeil. Une étude de cohorte rétrospective réalisée ultérieurement chez des patients atteints de THA, montre que la plupart des TDR VIH positifs avant traitement sont des faux positifs et que la moitié d'entre eux ont disparu à la fin du traitement, ce qui suggère une clearance rapide d'anticorps en réaction croisée avec le parasite.Une part importante des TDR VIH faussement positifs disparaît avant la fin du traitement trypanocide. Là où les tests sérologiques Elisa VIH ne sont pas rapidement accessibles, le renouvellement du TDR VIH en fin de traitement de la THA permet d'identifier environ la moitié des TDR VIH faussement positifs.
Biostatistiques et épidémiologieParasitologie et mycologieImmunologieLicence : https://creativecommons.org/licenses/by/4.0/ Cet article en libre accès est distribué selon les termes de la licence Creative Commons CC BY 4.0 ().
Serge Muleka Ngoie, Philippe Mulenga, Olivier Mukuku, Christian Ngama Kakisingi, Cédrick Milindi Sangwa, Pascal Tshimwang Nawej, Claude Mulumba Mwamba, Dophra Nkulu Ngoy, Faustin Wa Pa Manda Muteta
IntroductionLa maladie rénale chronique constitue un véritable problème mondial de santé publique du fait de l'augmentation de ses principaux facteurs de risque à savoir l'hypertension artérielle et le diabète sucré. Dans nos milieux à faible revenu et spécialement dans notre pays, peu d'études sont connues sur cette pathologie diagnostiquée à un stade très avancée et posant un problème de prise en charge.MéthodesIl s'agit d'une étude descriptive transversale ayant été menée durant la période allant de juillet 2014 à juillet 2015 au service de dialyse de CMDC. Ont été inclus tous les patients avec taux de filtration glomérulaire inférieur à 60ml/min/1,73 m2 ou créatinine élevée au-delà de trois mois durant notre période d'étude L'objectif de cette étude est de décrire les caractéristiques sociodémographiques, les facteurs de risque et les paramètres biologiques de patients reçus pour insuffisance rénale.RésultatsNous avons retenu 60 patients. L'âge moyen était de 51, 38+/-13, 47 ans avec la tranche d'âge la plus touchée comprise entre 50-59 ans. 51, 67% avaient un niveau d'instruction secondaire et 40% un niveau supérieur. Les facteurs de risque d'atteinte rénale étaient l' HTA 66, 64%, le diabète sucré 25%, l'usage des produits nephrotoxiques 35%, l'infection à VIH 11, 67%, l'obésité 10%, la drépanocytose 3, 3%. Le poids de naissance de naissance de nos patients ainsi que l'existence d'une maladie rénale familiale étaient des facteurs méconnus.85% de nos patients avaient un taux d'hémoglobine inférieur à 12g%.ConclusionDe cette observation, il ressort que l'âge de nos patients ne diffère pas de celui observé dans les autres milieux à revenu faible. Le niveau d'instruction de nos patients est plus élevé comparé aux autres études. Il serait mieux de développer des stratégies de dépistage précoce de la maladie rénale pour éviter d'aboutir à l'hémodialyse qui reste un traitement très onéreux.
ImmunologieHématologieMaladies infectieuses et tropicalesLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
IntroductionLa maladie thromboembolique veineuse (MTEV) présente par ses deux entités cliniques: thrombose veineuse profonde (TVP) et embolie pulmonaire (EP), est une pathologie fréquente ayant une forte morbi-mortalité. En Algérie, cette pathologie prend de plus en plus de l'ampleur, en l'absence de toute publication révélant sa fréquence et le pouvoir thrombogène des facteurs de risque qui lui sont corrélés. Notre étude a pour objectif de déterminer la fréquence et les facteurs de risque de ce type d'affection dans la région de Sidi Bel Abbes, Algérie.MéthodesIl s'agit d'une étude rétrospective allant du 1er janvier 2006 au 10 juin 2012 ciblant les patients hospitalisés pour TVP et /ou EP au sein du service de cardiologie du CHU de Sidi Bel Abbes.Résultats183 patients atteints de la MTEV dont 112 femmes (61.2%) d’âge moyen 46.4 ± 17.9 et 71 hommes (38.7%) d’âge moyen 51.5 ± 17.7 ont été notés. 146 cas parmi eux (79.7%) présentaient une TVP isolée, alors que 37 autres (20.2%) étaient atteints d'EP, dont 16 cas de TVP associée. Les facteurs de risque les plus fréquents enregistrés en cas de TVP sont surtout: l'immobilité, l'hypertension, la chirurgie, et la contraception orale, tandis que: l'immobilité, la chirurgie, l'hypertension et les fractures sont les facteurs de risques les plus incriminés en cas d'EP. 24.7% des patients présentaient plusieurs facteurs de risque. L'antécédent personnel de la MTEV, était présent dans 12.02% des cas. 97.5% des TVP ont touché les membres inférieurs mais seulement 2.5% des TVP étaient localisés au niveau des membres supérieurs.ConclusionAu terme de notre étude, et en dépit de sa fréquence non alarmante, il serait indispensable d'envisager l'adoption d'une stratégie prophylactique adéquate afin de lutter contre le développement redoutable de ce genre d'affection dans la région de Sidi Bel Abbes.
Médecine interne (cardiologie, endocrinologie, néphrologie…)Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
RÉSUMÉIntroductionDe nouvelles espèces de Borrelia, Rickettsia et Anaplasma ont été récemment détectées chez des tiques en Guyane, et une nouvelle espèce d’Anaplasma a été découverte chez un homme. Des génovariants spécifiques d’Anaplasma et d’Ehrlichia ont également été détectés avec un cycle sylvatique propre en forêt amazonienne guyanaise.Présentation du casNous rapportons le cas d’un patient ayant présenté de la fièvre, des myalgies, une éruption cutanée et des escarres d’inoculation après avoir subi des dizaines de morsures de tiques lors d’une randonnée en forêt amazonienne profonde. Les résultats biologiques retrouvaient une lymphopénie, une polynucléose neutrophile, une cytolyse et une cholestase hépatiques, ainsi qu’une protéine C-réactive à 78 mg/l. Les sérologies VIH, hépatites A, B, C et E, cytomégalovirus, syphilis, fièvre Q étaient négatives. L’antigène NS1, les PCR dengue et leptospirose étaient également négatifs. La biopsie cutanée d’une papule ulcéro-croûteuse de la jambe retrouvait un infiltrat inflammatoire dermique polymorphe avec un bacille Gram-négatif intramacrophagique. Les PCR sanguines pour Anaplasma phagocytophilum, Borrelia, Rickettsia et Babesia étaient négatives. Les sérologies étaient négatives pour Rickettsia conorii et R. typhi, mais positives pour A. phagocytophilum avec des IgM faiblement positives et des IgG positives, confirmées en sérologie de contrôle. Le patient s’est amélioré grâce à un traitement par doxycycline.Discussion et conclusionLes nouvelles espèces d’Anaplasma et d’Ehrlichia détectées en forêt amazonienne guyanaise présentent des caractéristiques différentes des autres espèces de l’hémisphère Nord et sont difficiles à diagnostiquer avec des outils moléculaires non conçus pour détecter des agents pathogènes différents des espèces connues. Même si non prouvée par biologie moléculaire, cette observation peut être une anaplasmose ou une autre infection du groupe des Rickettsiales. Elle rappelle que l’on sait peu du pot
Biologie cellulaire et moléculaireGénétiqueImmunologieLicence : https://creativecommons.org/licenses/by/4.0/ Cet article en libre accès est distribué selon les termes de la licence Creative Commons CC BY 4.0 ().
L’encéphalite à virus West-Nile passe de l’Ancien Monde au « Nouveau ». Elle est désormais endémo épidémique en Europe de l’Est, et présente en Italie (Vénétie, Emilie-Romagne).- Une épidémie inattendue de paludisme s’amplifie en Grèce depuis deux ans, comme dans un lointain passé. Le pays est très fragilisé sur le plan économique, et ceci explique certainement cela...- La tuberculose frappe toujours des personnes mal logées ou sans-abri, particulièrement autour de Paris. Il en est de même de la gale, de l’hépatite A, de la coqueluche… - La rougeole régresse en France (énorme flambée depuis 2008) car les pouvoirs public ont lancé une campagne de revaccination à l’automne 2011, notamment pour les jeunes gens n’ayant eu qu’une seule injection dans leur enfance.
Microbiologie (bactériologie, virologie)Parasitologie et mycologieImmunologieLicence : https://creativecommons.org/licenses/by/4.0/
Cette thèse étudie l’évolution des rapports entre parasitisme, guerre et la pharmacie du XIᵉ siècle au XXIᵉ siècle. À travers une approche croisant histoire de la médecine, parasitologie, pharmacie et médecine militaire, elle met en évidence le rôle des conflits armés dans la production des savoirs relatifs aux maladies parasitaires et dans la structuration progressive des politiques de prévention et de traitement. Des Croisades aux campagnes coloniales, puis aux guerres mondiales, les armées furent confrontées à des environnements favorisant la diffusion de nombreuses parasitoses, parmi lesquelles les helminthiases, le paludisme, ou encore diverses maladies transmises par les arthropodes vecteurs. L’étude montre comment ces contraintes biologiques ont contribué à l’émergence de pratiques sanitaires nouvelles, à la constitution d’une pharmacie militaire organisée et au développement de la parasitologie moderne. L’analyse met également en lumière la place centrale occupée par les pharmaciens dans la prophylaxie, la production thérapeutique, la désinfection et la recherche biomédicale. Enfin, l’intégration des animaux de guerre et des zoonoses permet d’inscrire cette histoire dans une perspective plus large, annonçant les approches contemporaines de santé globale. La pharmacie apparaît ainsi comme un acteur majeur de la construction des savoirs et des dispositifs qui fondent aujourd’hui la santé publique moderne.
Parasitologie et mycologiePharmacologieToxicologieLicence : https://creativecommons.org/licenses/by/4.0/
Jean JANNIN, Jacques CHANDENIER, Jean DELMONT, Alain EPELBOIN, Françoise GAY-ANDRIEU, Pierre GAZIN, Catherine GOUJON, Pierre MARTY, Claire TANTET
PédiatrieLicence : https://creativecommons.org/licenses/by/4.0/ Cet article en libre accès est distribué selon les termes de la licence Creative Commons CC BY 4.0 ().
La malakoplakie est une maladie inflammatoire granulomateuse chronique, qui affecte généralement le tractus génito-urinaire et exceptionnellement la glande mammaire. Il faut savoir évoquer ce diagnostic devant une mastite pseudotumorale. Sa définition est anatomopathologique. Nous rapportons un cas inhabituel de malakoplakie mammaire chez une patiente ayant des antécédents de tuberculose. L'imagerie était en faveur d'une mastite carcinomateuse. L'analyse histologique de la biopsie mammaire révélait une inflammation granulomateuse faite d'histiocytes renfermant des granulations pathognomoniques de Michaelis-Gutmann. La patiente était mise sous traitement médical à base de ciprofloxacine avec bonne évolution clinique et radiologique après un recul d'un mois.
Microbiologie (bactériologie, virologie)Maladies infectieuses et tropicalesLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Caroline Miaffo, Florent Some, Bocar Kouyate, Albrecht Jahn, Olaf Mueller
BackgroundPregnant women are a major risk group for malaria in endemic areas. Only little information exists on the compliance of pregnant women with malaria and anaemia preventive drug regimens in the rural areas of sub-Saharan Africa (SSA). In this study, we collected information on malaria and anaemia prevention behaviour in pregnant women of rural Burkina Faso.MethodsCross-sectional qualitative and quantitative survey among 225 women of eight villages in rural northwestern Burkina Faso. Four of the villages had a health centre offering antenatal care (ANC) services while the other four were more than five kilometers away from a health centre.ResultsOverall ANC coverage (at least one visit) was 71% (95% in health centre villages vs 50% in remote villages). Malaria and anaemia were considered as the biggest problems during pregnancy in this community. ANC using women were quite satisfied with the quality of services, and compliance with malaria and anaemia prevention regimens (chloroquine and iron/folic acid) was high in this population. Knowledge on the benefit of bed nets and good nutrition was less prominent. Distance, lack of money and ignorance were the main reasons for women to not attend ANC services.ConclusionsThere is an urgent need to improve access of rural SSA women to ANC services, either through increasing the number of rural health centres or establishing functioning outreach services. Moreover, alternative malaria and anaemia prevention programmes such as intermittent preventive treatment with effective antimalarials and the distribution of insecticide-treated bed nets need to become implemented on a large scale.
Biostatistiques et épidémiologieParasitologie et mycologieHématologieLicence : This is an open-access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Moussa Lingani, Serge H. Zango, Innocent Valéa, Massa dit A. Bonko, Sékou O. Samadoulougou, Toussaint Rouamba, Marc C. Tahita, Maïmouna Sanou, Annie Robert, Halidou Tinto, Philippe Donnen, Michèle Dramaix
BackgroundMalaria and sexually transmitted/reproductive tract infections (STI/RTI) are leading and preventable causes of low birthweight in sub-Saharan Africa. Reducing their impact on pregnancy outcomes requires efficient interventions that can be easily integrated into the antenatal care package. The paucity of data on malaria and STI/RTI coinfection, however, limits efforts to control these infections. This study aimed to determine the prevalence and associated factors of malaria and STI/RTI coinfection among pregnant women in rural Burkina Faso. MethodsA cross-sectional survey was conducted among 402 pregnant women attending antenatal clinics at the Yako health district. Sociodemographic and behavioral data were collected, and pregnant women were tested for peripheral malaria by microscopy. Hemoglobin levels were also measured by spectrophotometry and curable bacterial STI/RTI were tested on cervico-vaginal swabs using rapid diagnostic test for chlamydia and syphilis, and Gram staining for bacterial vaginosis. A multivariate logistic regression model was used to assess the association of malaria and STI/RTI coinfection with the characteristics of included pregnant women. ResultsThe prevalence of malaria and at least one STI/RTI coinfection was 12.9% (95% confidence interval, CI: [9.8–16.7]), malaria and bacterial vaginosis coinfection was 12.2% (95% CI: [9.3–15.9]), malaria and chlamydial coinfection was 1.6% (95% CI: [0.6–3.8]). No coinfection was reported for malaria and syphilis. The individual prevalence was 17.2%, 7.2%, 0.6%, 67.7% and 73.3%, respectively, for malaria infection, chlamydia, syphilis, bacterial vaginosis and STI/RTI combination. Only 10% of coinfections were symptomatic, and thus, 90% of women with coinfection would have been missed by the symptoms-based diagnostic approach. In the multivariate analysis, the first pregnancy (aOR = 2.4 [95% CI: 1.2–4.7]) was the only factor significantly associated with malaria and STI/RTI coinfection. Clinica
Biostatistiques et épidémiologieParasitologie et mycologieHématologieLicence : Open Access http://creativecommons.org/licenses/by/4.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original autho
BackgroundMalaria and curable sexually transmitted infections (STI) are the most common curable infections known to have a severe impact on pregnancy outcomes in sub-Saharan Africa. This study aims to assess the marginal and joint prevalence of symptomatic cases of malaria and STI in pregnant women living in rural settings of Burkina Faso and their associated factors, after more than a decade of the introduction of intermittent preventive treatment (IPT-SP).MethodsWe carried out an observational study in two health districts in rural Burkina, namely Nanoro and Yako. Routine data were collected during antenatal and delivery visits for all women who delivered in the year 2016 and 2017. Logistic regression models were used to assess factors associated with infections.ResultsWe collected data from 31639 pregnant women attending health facilities. Malaria, curable STI and their coinfections were diagnosed in 7747 (24.5%; 95%CI: 24.0–25.0%), 1269 (4.0%; 95%CI: 3.8–4.2%) and 388 (1.2%; 95%CI: 1.1–1.4%) women, respectively. In multivariate logistic regression, malaria occurrence was significantly higher in pregnant women < 20 years (Adjusted OR = 2.36; 95% CI: 2.07–2.69) than in women ≥30 years. The prevalence of curable STI was also significantly higher in students (Adjusted OR = 1.93; 95% CI: 1.26–2.95) and compensated workers (Adjusted OR = 1.52; 95% CI: 1.01–2.17) than in uncompensated workers. Women who received no IPT-SP had higher prevalence of malaria (Adjusted OR = 3.33; 95%CI: 3.00–3.70), curable STI (Adjusted OR = 1.96 95%CI: 1.60–2.39) and coinfections (Adjusted OR = 2.11; 95% CI: 1.50–2.95) compared to women who received SP.ConclusionMalaria and curable STI remain highly prevalent in rural settings of Burkina Faso, with young pregnant women and women who received no IPT-SP being the most affected. Prevention must be reinforced to improve maternal and infant health.
Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : Creative Commons Attribution License This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
IntroductionMalaria and malnutrition are major causes of childhood morbidity and mortality. Most of children receiving Seasonal malaria chemoprevention (SMC) are also generally malnourished during SMC delivery period. This study aimed at assessing the risk of malaria infection in malnourished children, compared to children with an adequate nutritional status (ANS) during the delivery period of SMC intervention in the health district of Nanoro, Burkina Faso.MethodsA longitudinal survey of children aged 6–59 months receiving SMC intervention was carried out between 2020 and 2022 in Nanoro, Burkina Faso. WHO online anthro survey tool was used to assess the nutritional status. Included children were stratified into two sub-groups as malnourished from the start of the first SMC round until one month after the last SMC round and those of ANS during that same period. In addition to the monthly home visits, all health care attendance were recorded for all participants. At each visit, socio-anthropometric data were collected. Blood smears were collected for malaria diagnosis by rapid diagnostic test (RDT) and microscopy. The effect of the nutritional status on the occurrence of uncomplicated malaria was assessed using a negative binomial model, with results expressed as incidence risk ratio (IRR).ResultsOut of the 425 children included this study, 260 were malnourished, while 165 children had an ANS. Malaria incidence per 1000 child-month were higher in undernutrition (974.47) than in ANS (214.47). Malnourished children were 1.41 times more likely to have t an episode of clinical malaria than children with ANS (IRR 1.42; 95% CI 1.03–1.94; p = 0.028).ConclusionThere was an increased risk of malaria infection in undernourished children compared to children with an adequate nutritional status suggesting the need of combining SMC intervention with nutrients supplementation to achieve best impact for malaria control in food insecure areas.
Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : Creative Commons Attribution License This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Tubosun A. Olowolafe, Oluwaseyi F. Agosile, Adekemi O. Akinpelu, Nicholas Aderinto, Ojima Z. Wada, David B. Olawade
BackgroundStudies have long documented the presence of malaria and typhoid fever in sub-Saharan Africa (SSA). However, studies on these diseases have primarily concentrated on rural settings, neglecting the potential impact on urban areas. This knowledge gap hinders effective surveillance and intervention strategies. To bridge this gap, this study investigated the prevalence of malaria and typhoid co-infections in an urban environment.MethodsThis study, conducted at Lead City University Hospital in Ibadan, Nigeria (West Africa’s largest metropolis), analysed medical records of over 3195 patients seen between April and June 2023. Descriptive statistics and chi-square tests were used to understand how these co-infections were distributed across different age and gender groups.ResultsThe prevalence of co-infection peaked in May (9.7%), followed by June (8.9%) and April (5.7%). Notably, children aged 6–12 years exhibited the highest co-infection rate (18.5%), while those under five had the lowest (6.3%). Gender analysis indicated a slight difference, with 8.8% of females and 7.1% of males co-infected. Malaria prevalence was highest at the beginning of the rainy season and significantly decreased over time. Conversely, typhoid fever displayed the opposite trend, increasing with the rainy season. Children under five years old were most susceptible to malaria, while typhoid fever predominantly affected adults over 25 years old, with prevalence decreasing significantly with age.ConclusionThis study sheds light on the previously overlooked risk of malaria and typhoid co-infections in urban settings. These findings highlight the need for enhanced surveillance and targeted public health interventions, particularly for vulnerable groups like young children during peak transmission seasons.
Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as
Mady Ouédraogo, David Tiga Kangoye, Sékou Samadoulougou, Toussaint Rouamba, Philippe Donnen, Fati Kirakoya-Samadoulougou
Reducing the 2015 level of malaria mortality by 90% by 2030 is a goal set by the World Health Organization (WHO). In Burkina Faso, several malaria control programs proven to be effective were implemented over the last decade. In parallel, the progressive strengthening of the health surveillance system is generating valuable data, which represents a great opportunity for analyzing the trends in malaria burden and assessing the effect of these control programs. Complementary programs were rolled out at different time points and paces, and the present work aims at investigating both the spatial and temporal pattern of malaria case fatality rate (mCFR) by considering the effect of combining specific and unspecific malaria control programs. To this end, data on severe malaria cases and malaria deaths, aggregated at health district level between January 2013 and December 2018, were extracted from the national health data repository (ENDOS-BF). A Bayesian spatiotemporal zero-inflated Poisson model was fitted to quantify the strength of the association of malaria control programs with monthly mCFR trends at health district level. The model was adjusted for contextual variables. We found that monthly mCFR decreased from 2.0 (95% IC 1.9–2.1%) to 0.9 (95% IC 0.8–1.0%) deaths for 100 severe malaria cases in 2013 and 2018, respectively. Health districts with high mCFR were identified in the northern, northwestern and southwestern parts of the country. The availability of malaria rapid diagnosis tests (IRR: 0.54; CrI: 0.47, 0.62) and treatment (IRR: 0.50; CrI: 0.41, 0.61) were significantly associated with a reduction in the mCFR. The risk of dying from malaria was lower in the period after the free healthcare policy compared with the period before (IRR: 0.47; CrI: 0.38, 0.58). Our findings highlighted locations that are most in need of targeted interventions and the necessity to sustain and strengthen the launched health programs to further reduce the malaria deaths in Burkina F
Parasitologie et mycologieMaladies infectieuses et tropicalesPédiatrieLicence : http://creativecommons.org/licenses/by/4.0/ Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ().
Jennifer B Rosen, Joel G Breman, Charles R Manclark, Bruce D Meade, William E Collins, Hans O Lobel, Pierre Saliou, Jacquelin M Roberts, Pierre Campaoré, Mark A Miller
BackgroundAcute malaria has been associated with a decreased antibody response to tetanus and diphtheria toxoids, meningococcal, salmonella, and Hib vaccines. Interest in giving malaria drug therapy and prevention at the time of childhood immunizations has increased greatly following recent trials of intermittent preventive therapy during infancy (IPTi), stimulating this re-analysis of unpublished data. The effect of malaria chemoprophylaxis on vaccine response was studied following administration of measles vaccines and diphtheria-tetanus-whole cell pertussis (DTP) vaccines.MethodsIn 1975, six villages divided into two groups of children ≤74 months of age from Burkina Faso, were assigned to receive amodiaquine hydrochloride chemoprophylaxis (CH+) every two weeks for seven months or no chemoprophylaxis (CH-). After five months, children in each group received either one dose of measles or two doses of DTP vaccines.ResultsFor recipients of the measles vaccine, the seroconversion rates in CH+ and CH- children, respectively, were 93% and 96% (P > 0.05). The seroresponse rates in CH+ and CH- children respectively, were 73% and 86% for diphtheria (P > 0.05) and 77% and 91% for tetanus toxoid (P > 0.05). In a subset analysis, in which only children who strictly adhered to chemoprophylaxis criteria were included, there were, likewise, no significant differences in seroconversion or seroresponse for measles, diphtheria, or tetanus vaccines (P > 0.05). While analysis for pertussis showed a 43% (CH+) and 67% (CH-) response (P < 0.05), analyses using logistic regression to control for sex, age, chemoprophylaxis, weight-for-height Z-score, and pre-vaccination geometric mean titer (GMT), demonstrated that chemoprophylaxis was not associated with a significantly different conversion rate following DTP and measles vaccines. Seven months of chemoprophylaxis decreased significantly the malaria IFA and ELISA GMTs in the CH+ group.ConclusionMalaria chemoprophylaxis prior to vaccinatio
Parasitologie et mycologieImmunologiePharmacologieLicence : This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
BackgroundThe number of malaria cases worldwide has increased, with over 241 million cases and 69,000 more deaths in 2020 compared to 2019. Burkina Faso recorded over 11 million malaria cases in 2020, resulting in nearly 4,000 deaths. The overall incidence of malaria in Burkina Faso has been steadily increasing since 2016. This study investigates the spatiotemporal pattern and environmental and meteorological determinants of malaria incidence in Burkina Faso.MethodsWe described the temporal dynamics of malaria cases by detecting the transmission periods and the evolution trend from 2013 to 2018. We detected hotspots using spatial scan statistics. We assessed different environmental zones through a hierarchical clustering and analyzed the environmental and climatic data to identify their association with malaria incidence at the national and at the district’s levels through generalized additive models. We also assessed the time lag between malaria peaks onset and the rainfall at the district level. The environmental and climatic data were synthetized into indicators.ResultsThe study found that malaria incidence had a seasonal pattern, with high transmission occurring during the rainy seasons. We also found an increasing trend in the incidence. The highest-risk districts for malaria incidence were identified, with a significant expansion of high-risk areas from less than half of the districts in 2013–2014 to nearly 90% of the districts in 2017–2018. We identified three classes of health districts based on environmental and climatic data, with the northern, south-western, and western districts forming separate clusters. Additionally, we found that the time lag between malaria peaks onset and the rainfall at the district level varied from 7 weeks to 17 weeks with a median at 10 weeks. Environmental and climatic factors have been found to be associated with the number of cases both at global and districts levels.ConclusionThe study provides important insights into the en
Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : Creative Commons Attribution License This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
BackgroundAnaemia is an increasingly recognized health problem in Africa, particularly in infants and pregnant women. Although malaria is known to be the main risk factor of anaemia in both groups, the consequences of maternal factors, particularly malaria in pregnancy (MiP), on infant haemoglobin (Hb) concentrations during the first months of life are still unclear.MethodsWe followed-up a cohort of 1005 Beninese pregnant women from the beginning of pregnancy until delivery. A subsample composed of the first 400 offspring of these women were selected at birth and followed until the first year of life. Placental histology and blood smear at 1st clinical antenatal visit (ANC), 2nd ANC and delivery were used to assess malaria during pregnancy. Infant Hb concentrations were measured at birth, 6, 9 and 12 months of age. A mixed multi-level model was used to assess the association between MiP and infant Hb variations during the first 12 months of life.ResultsPlacental malaria (difference mean [dm] = - 2.8 g/L, 95% CI [-5.3, -0.3], P = 0.03) and maternal peripheral parasitaemia at delivery (dm = - 4.6 g/L, 95% CI [-7.9, -1.3], P = 0.007) were the main maternal factors significantly associated with infant Hb concentrations during the first year of life. Poor maternal nutritional status and malaria infection during infancy were also significantly associated with a decrease in infant Hb.ConclusionAntimalarial control and nutritional interventions before and during pregnancy should be reinforced to reduce specifically the incidence of infant anaemia, particularly in Sub-Saharan countries.
Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
Claudia Beiersmann, Aboubakary Sanou, Evelyn Wladarsch, Manuela De Allegri, Bocar Kouyaté, Olaf Müller
BackgroundThe literature on health care seeking behaviour in sub-Saharan Africa for children suffering from malaria is quite extensive. This literature, however, is predominately quantitative and, inevitably, fails to explore how the local concepts of illness may affect people's choices. Understanding local concepts of illness and their influence on health care-seeking behaviour can complement existing knowledge and lead to the development of more effective malaria control interventions.MethodsIn a rural area of Burkina Faso, four local concepts of illness resembling the biomedical picture of malaria were described according to symptoms, aetiology, and treatment. Data were collected through eight focus group discussions, 17 semi-structured interviews with key informants, and through the analysis of 100 verbal autopsy questionnaires of children under-five diagnosed with malaria.ResultsSumaya, dusukun yelema, kono, and djoliban were identified as the four main local illness concepts resembling respectively uncomplicated malaria, respiratory distress syndrome, cerebral malaria, and severe anaemia. The local disease categorization was found to affect both treatment and provider choice. While sumaya is usually treated by a mix of traditional and modern methods, dusukun yelema and kono are preferably treated by traditional healers, and djoliban is preferably treated in modern health facilities. Besides the conceptualization of illness, poverty was found to be another important influencing factor of health care-seeking behaviour.ConclusionThe findings complement previous evidence on health care-seeking behaviour, by showing how local concepts of illness strongly influence treatment and choice of provider. Local concepts of illness need to be considered when developing specific malaria control programmes.
Parasitologie et mycologieMaladies infectieuses et tropicalesPédiatrieLicence : This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.