Traitement du paludisme de l'enfant en Afrique : les ACT en question

Les Artemisinin-based Combination Therapies (ACT) representent la majorite des alternatives aux antipaludiques de reference et sont sur le point d'etre deployees largement en Afrique. Elles sont particulierement attractives pour traiter les enfants. Les vertus annoncees de ces associations sont multiples : puissance accrue; rapidite d'action; stabilisation de la chimioresistance et reduction de la transmission. L'abondante litterature consacree aux ACT depuis quelques annees permet de faire le point sur ces divers aspects; en insistant sur la question du confort des enfants malades

Seroprevalence des infections a VIH1 a Djoumouna; Congo

Une etude destinee a localiser une zone de forte endemicite pour l'infection a VIH et pour le paludisme en vue des etudes sur les interactions VIH parasitoses a ete menee a Djoumouna; village situe a 25 Km de la sortie de Brazzaville. Les suspects serologiques en ELISA (1 pour cent) ont ete confirmes en Western Blot. Seuls 0;5 pour cent des individus examines avaient des anticorps anti-VIH1. Les raisons pouvant expliquer cette faible prevalencesont discutees

Human babesiosis in Europe

Human babesiosis in Europe came to medical attention in 1957 and until now 19 cases have been reported, most of them due to Babesia divergens. The onset of the disease is characterized by hemoglobinuria, high fever and renal failure ensue rapidly. The patients were generally asplenic and resident in a rural area. Intraerythrocytic pleomorphic parasites (1-3 *m) observed in stained thin blood smears are essential for Genus diagnosis. Parasitemia varyed from 5 to 80% of red blood cells. Massive blood exchange transfusion (2-3 blood volumes) followed by intravenous clindamycine (3-4 times daily) and oral quinine (600 mg base, 3 times daily) were successfully used in the treatment of three recent cases. Splenectomised individuals should be aware for prevention

Mefloquine resistant malaria in cameroon and correlation with resistance quinine

Based on the results of in vitro sensitivity of Plasmodium falciparum to chloroquine, quinine and mefloquine, and evaluation of drug consumption conducted in 1987-1988 in four areas in the noth and south-west of Cameron, two opposite situations were encountered in this country. In northern Cameron where mefloquine resistance is prevalent a close correlation was found between the responses of P. falciparum to mefloquine and to quinine, but not between mefloquine and chloroquine. In the south, where chloroquine resistance is highly prevalent, no correlation was found neither between mefloquine and chloroquine nor mefloquine and quinine, but the responses to quinine and chloroquine appear partly correlated. These lead to formulate the hypothesis of a "southern" type of P. falciparum submitted to a high chloroquine drug pressure inducing a secondary cross resistance, whilst a "northern"type submitted to a relatively high and abortive quinine drug pressure inducing a primary quinine resistance and a secondary cross resistance with mefloquine

Babesia divergens vaccine

A vaccine strategy against Babesia divergens bovine babesiosis was sucessfully developed after perfecting of an efficient in vitro culture. Crude supernatants and purified fractions were able to induce a vaccine protection in gerbils against B. divergens infection. More, supernatants induced an effective vaccine protection in cattle. The role of B. divergens exoantigens of 17, 37, 46, 70 and 90 kDa in the development of the immune response was cleary demonstrated in gerbils, cattle, and man.

Immunological evaluation of cell-mediated and humoral immunity in Thai patients with cerebral and non-cerebral Plasmodium falciparum malaria: I. Cutaneous delayed hypersensitivity, blood leukocytes and in vitro lymphocyte responses.

In Thai patients with acute P. falciparum malaria including cerebral cases, cell mediated immune functions were studied in vivo and in vitro. Initial cutaneous delayed reactions to phytohaemagglutinin and soluble protein antigens were negative in most cerebral malaria patients. No major alteration of the number of circulating T and B cells was observed. In lymphocytes cultures, proliferatives responses to lectins or protein antigens were generally found within normal ranges. This study shows a direct role of P. falciparum on the impairment of cell mediated immunity.

Immunological evaluation of cell-mediated and humoral immunity in Thai patients with cerebral and non cerebral Plasmodium falciparum malaria: II. Evolution of serum levels of immunoglobulins, antimalarial antibodies, complement fractions and alpha interferon.

In Thai patients with Plasmodium falciparum malaria, IgG and IgM values were elevated, whereas IgA levels were within normal ranges. No association of Ig values with parasitaemia was noted. IFA-IgM antibody levels were lower in cerebral malaria (CM) than in the non cerebral malaria (NCM) group. IFA-IgG antibodies were present in all patients. The mean C3 and C4 values were similar among patients from the CM and NCM groups. Interferon like activity was detected in all CM and NCM patients, and no correlation was found with either antimalarial antibodies, complement or parasitaemia.