[Acute Flaccid Paralysis Secondary to Poliomyelitis: 11 Years of Monitoring in Guinea (2005-2015)]. / Paralysies flasques aiguës dues à des poliovirus : bilan de 11 années de surveillance en Guinée (2005-2015).

The sustained worldwide use of the two available types of polio vaccines has significantly reduced the incidence of this disease. Our main objective is to report a 11-year monitoring period for acute flaccid paralysis secondary to poliovirus in Guinea. It was a retrospective descriptive study for all cases of acute flaccid paralysis (AFP) in which poliovirus was isolated by stool examination. During 11 years, 768 cases of AFP, including 8 cases of acute anterior poliomyelitis were collected at a frequency of 1%. The average age was 3.5 years with extremes of 1 year and 6 years, the most represented age group was 0-4 years with 7 cases. Six mothers were housewives doing gold panning as a revenue generating activity. The vaccine virus (serotype 2) was the most isolated with 6 cases.

L'utilisation soutenue à l'échelle mondiale des deux types de vaccins antipoliomyélitiques disponibles a considérablement diminué l'incidence de cette affection. Il s'agit ici d'une étude rétrospective de type descriptive, portant sur tous les cas de paralysie flasque aiguë (PFA) due aux poliovirus en Guinée chez lesquels le poliovirus a été isolé des selles, faisant l'état des lieux de 11 années de surveillance de la PFA. En 11 ans, 768 cas de PFA, dont huit cas de poliomyélite antérieure aiguë ont été enregistrés, soit une fréquence de 1 %. L'âge moyen était de 3,5 ans [1­6 ans]. La tranche d'âge de 0­4 ans était la plus représentée avec 7 cas. La majeure partie (6 cas) des mères des enfants étaient des agricultrices exerçant l'orpaillage. Les souches majoritairement isolées étaient dérivées du vaccin VDPV2.

Ebola virus disease in children in Conakry and Coyah Ebola treatment centers and risk factors associated with death.

OBJECTIVE: To study Ebola virus disease (EVD) in children aged 15 years and below, and to identify risk factors associated with death. PATIENTS AND METHODS: Retrospective, multicenter, descriptive, and analytical study of files of children aged 15 years and below in Ebola treatment centers (ETC) of Donka from March 2014 to May 2015. We included all files of children aged 15 years and below hospitalized for EVD in the two ETCs. RESULTS: A total of 739 patients hospitalized in both ETCs, 146 children aged 15 years and below (20%) were registered during the study period. The mean age of children was 6.73±4.26 years. Most children were aged above five years (65.8%) and the mean time to consultation was 4.34±3.21 days. The main clinical signs were asthenia (78.8%), fever (75.3%), anorexia (53.4%), headache (45.9%), vomiting (41.8%), abdominal pain (29.5%), and diarrhea (28.8%). The case fatality was 48%, including 54.3% in Coyah and 45% in Conakry. Older age (aOR=0.83, 95% CI [0.76-0.95]), fever (aOR=3.28, 95% CI [1.22-8.87]), diarrhea (aOR=2.98, 95% CI [1.19-4.48]), and hemorrhage (aOR=3.13, 95% CI [1.00-10.38]) were independently associated with death due to EVD. CONCLUSION: EVD remains serious especially in children, with high case fatality. Risk factors independently associated with death were young age, diarrhea, hemorrhage, and fever. Particular attention to these risk factors and vaccination will contribute to improving the prognosis of EVD in children.

[Tetanus Observation Over a 12-Month Period in Conakry, Guinea]. / Observation du tétanos sur une période de 12 mois à Conakry, Guinée.

The objective of this study was to determine the factors associated with death in patients hospitalized for tetanus. This study collected prospectively over a twelve (12) month period, the epidemiological, clinical and evolutionary data, and proceeded to an analysis of the factors associated with the death of hospitalized patients. We collected 32 patients with tetanus, or 5% of the total number of hospitalized patients. The average age was 36 ± 14 years. The sex ratio was 15 (30/2). The iatrogenic entrance door was found in 5 (15%) patients. Respiratory complications were the most frequent, ie 9 cases (28%). The most commonly used treatment regimen (28 cases, 88%) was the combination of metronidazole, diazepam, and anti-tetanus serum with an average hospital stay of 23 days. A Dakar prognostic score greater than or equal to 3, the presence of complications and a hospital stay of less than or equal to 7 days were the main factors associated with the death. Tetanus remains common in Guinea with a high lethality rate. Improving immunization coverage is imperative.

L'objectif de cette étude est d'analyser les facteurs associés au décès chez les patients hospitalisés pour tétanos. Cette étude a recueilli de façon prospective, sur une période de 12 mois, les données épidémiologiques, cliniques et évolutives, puis procédé à une analyse des facteurs associés au décès des patients hospitalisés. Nous avons colligé 32 patients atteints de tétanos, soit 5 % du total des patients hospitalisés. L'âge moyen était de 36 ± 14 ans. Le sex-ratio était de 15 (30/2). La porte d'entrée iatrogène a été retrouvée chez 5 (15 %) patients. Les complications respiratoires étaient les plus fréquentes, soit 9 cas (28 %). Le schéma de traitement le plus utilisé (28 cas, 88 %) a été l'association de métronidazole, de diazépam et de sérum anti-tétanique avec une durée moyenne d'hospitalisation de 23 jours. Un score pronostique de Dakar supérieur ou égal à 3, la présence de complications et une durée d'hospitalisation inférieure ou égale à 7 jours ont été les principaux facteurs associés au décès. Le tétanos reste fréquent en Guinée avec un taux de létalité élevé. L'amélioration de la couverture vaccinale est impérative.

[Obstetrical vesico-vaginal fistula in Guinea: Data analysis of three sites of treatment at Engender Health ONG]. / Fistules vésico-vaginales obstétricales en Guinée : analyse des données de 3 sites de prise en charge de l'ONG Engender Health.

OBJECTIVE: To analyze the management of obstetric vesico-vaginal fistula in the three sites of Engender Health in Guinea. PATIENTS AND METHODS: It was a retrospective study of descriptive type having helped collect 450 cases of vesico-vaginal fistulas in three support sites engender health between January 2008 and December 2011. The variables studied were epidemiological, clinical and therapeutic reasons and treatment outcomes were evaluated after a decline of at least six months. RESULTS: The mean age of onset of the fistula was 25years, ranging from 12 to 55years and 58.8% (n=265) of patients were aged between 18 and 30years. The mean duration of fistula was 11years, ranging from 1 to 38years. Eighty-two percent (n=416) of patients were housewives and 66.4% (n=299) off school. The complex fistula with 66% (n=297) was the most frequent. The treatment consisted of a fistulorraphie after splitting vesico-vaginal in 93.3% (n=420) of cases. Therapeutic results considered after a mean of 8months have resulted in a cure in 79.3% (n=357) of cases, improvement in 4.2% (n=19) of cases and failure in 16 4% (n=74) of cases. CONCLUSION: Vesico-vaginal fistula is a major cause of maternal morbidity in Guinea. The establishment of a real health policy based on sound medical and social structures contributes to its eradication. LEVEL OF EVIDENCE: 5.

[The profile urological emergencies at the Conakry University Teaching Hospital, Guinea]. / Le profil des urgences urologiques au CHU de Conakry, Guinée.

OBJECTIVE: To stick out the profile urological emergencies at the Conakry University Teaching Hospital, Guinea. PATIENTS AND METHODS: This retrospective study, carried out over a period of 3 years (January 2005-December 2007), included 757 urological emergencies admitted to the urology department of the university hospital of Conakry, Guinea. RESULTS: The mean age of patients was 56 years. These patients had an age equal to or higher than 60 years in 58% of the cases. The sex ratio (M/F) was 16.6. According to the social profession, the farmer (40,6%) and workers (21%) were the dominant patients. The most frequent illness was vesical urinary retention (73.9%), hematuria (9.6%) and genito-urinary system trauma (7%). The most performed procedures were the installation of a urethral catheter (55.25%) and the installation of a suprapubic catheter (24.14%). CONCLUSION: The most frequent urological emergency in our country was vesical urinary retention, the hematuria and genito-urinary system trauma are not rare there.

Les ruptures traumatiques de l'uretre posterieur : analyse de 87 cas au CHU de Conakry

Objectif : Rapporter notre experience dans la prise en charge des ruptures traumatiques de l'uretre posterieur. Patients et methodes : Quatre-vingt-sept patients presentant une rupture traumatique de l'uretre posterieur ont ete traites dans le service d'Urologie-Andrologie du CHU de Conakry de janvier 1988 a decembre 2004. Le contexte traumatique a ete un accident de la voie publique dans 68 (78;2) cas et un accident de travail dans 19 (21;8) cas. Seuls 32 (36;8) des patients ont ete recus dans les 72 heures qui ont suivi le traumatisme; les autres ont ete recus au stade de stenose uretrale constituee. Une fracture du bassin a ete notee chez 56 (64;4) patients. La symptomatologie clinique etait dominee par la retention d'urine dans 62 (71;3); l'uretrorragie dans 59 (67;8) et l'hematome perineal dans 23 (26;4) cas. Resultats : Le traitement a consiste en un realignement sur sonde uretrale en urgence; une reparation uretrale en urgence differee entre le 8e et le 10e jour et une uretroplastie tardive selon qu'il s'agissait d'une rupture recente ou ancienne de l'uretre. Les resultats therapeutiques ont ete bons dans 32 (36;8) et moyens dans 39 (44;8) cas. Une dysfonction erectile a ete notee chez 19 (21;8) patientsConclusion : Le traitement des ruptures de l'uretre posterieur demeure controverse; cependant pour nous; l'uretrorraphie termino-terminale en urgence differee reste la methode therapeutique de choix dans notre contexte devant l'impossibilite de pouvoir realiser un realignement endoscopique et en l'absence de lesions associees severes. Devant des lesions associees graves la refection uretrale passe au second plan cedant la priorite aux lesions engageant le pronostic vital

[In vitro evaluation of the sensitivity of Plasmodium falciparum to chloroquine using the deli-microtest in region of Dakar, Senegal]. / Evaluation de la sensibilité in vitro de Plasmodium falciparum à la chloroquine par le DELI-microtest dans la région de Dakar (Senegal).

This study was carried out between 2000 and 2001 in the peri-urban Pikine area located 15 km from Dakar, Senegal. The purpose was to evaluate the in vitro sensitivity of Plasmodium falciparum isolates to chloroquine, which was the recommended first-line drug for uncomplicated malaria treatment in Senegal. Testing was carried out using the double-site enzyme-linked lactate dehydrogenase imnunosorbent (DELI) microtest. The DELI-microtest is an ELISA method using 2 monoclonal antibodies against 2 antigenic sites of the specific P. falciparum lactate dehydrogenase (LDH) enzyme. The level of LDH is proportional to the extent of parasite growth. P. falciparum isolates were cultured in 96-well plates in RPMI 1640 medium supplemented with hypoxanthine and albumax, in the presence of chloroquine sulphate concentrations ranging from 5.6 nM/L to 2870.8 nM/L. Plates were incubated in a candle-jar for 48 hours at 37 degrees C and frozen at -20 degrees C. The DELI-microtest was performed using the supernatant of hemolysed cultures. The amount of pLDH released was evaluated based on optical density. The chloroquine sensitivity of the isolate was estimated based on IC50 with a cut-off of <100 nM/L. Geometric mean IC50 values were 41 nM/L (range: 4.8 nM/L to 1435 nM/L) and 135 nM/L (range: 8.63 nM/L to 2153 nM/L) in 2000 and 2001 respectively. This study demonstrated a dramatic increase in the in vitro resistance of P. falciparum to chloroquine from 30% in 2000 to 59.6% in 2001. These findings suggest that regular surveillance of in vitro drug resistance is important to predict in vivo drug resistance and allow timely changes in public health recommendations.

[Ureterocele in adults. Five case reports]. / Urétérocèle de l'adulte. A propos de cinq cas.

The authors report five cases of ureterocele during six years. Mean age of the patients was 34.2 +/- 11.1 years. There were four female and one male. Pain (N = 3) and dysuria (N = 3) were the most common symptoms at examination. Diagnosis was made by ultrasound (N = 3), IVU (N = 3) or cystoscopy (N = 1). Ureteroceles were bilateral in four cases, unilateral in one case and were always intravesical with single ureter. Two patients presented lithiasis enclosed in the ureterocele. Only four patients had been operated. Surgical treatment was ureterocelectomy with ureteral reimplantation according to Cohen procedure. With mean follow-up of 10.6 +/- 4.7 months results were stable without complications.

[Endoscopic internal urethrotomy in the treatment of male urethral stenosis at the urology service of the CHU Ignace Deen]. / L'urétrotomie interne endoscopique dans le traitement des sténoses de l'urètre masculin au service d'urologie du CHU Ignace Deen.

The authors report a series of 157 stenoses of the urethra treated by endoscopic urethrotomy between 1991 and 1997. After a first urethrotomy the success rate is 51.8%, with a decline of one year. Mortality is zero, and the morbidity assessed at 9%. For these authors, the result is better when the urethrotomy concerns an uninfected, one-time, short (less than 2 cm) stenosis, whatever the etiology, located on the proximal urethra. The duration of the postoperatory catheter has been fixed at three days. Poor results (35.20%) have been reported in stretched stenoses located on the distal urethra. These poor results have been treated by another urethrotomy, with 25% good results. The remaining 10.2% have needed sessions of urethral dilatation, even a plasty.

[Bladder diverticulosis at a urologic service of the Ignace Deen de Conakry teaching hospital. Retrospective study of 28 cases]. / Les diverticules de la vessie au service d'urologie du CHU Ignace Deen de Conakry. Etude rétrospective de 28 cas.

From January 1st 1993 to December 31st 1998, 28 cases of bladder diverticula have been collected in Ignace Deen teaching hospital department of urology. The purpose of authors is to study the epidemiological aspects of diverticula of the bladder. They noted that bladder diverticula in 96.40% of cases are male disease, diagnosed by cystography, intravenous urography, ultrasonography or cystoscopy in 86%; and the etiology of bladder diverticula is a prostatic tumor in 68% of cases. A diverticulectomy is done by open surgery, associated to relieving outlet obstruction in 42.90%.

[Antifungal drug susceptibility of Candida causing oropharyngeal candidiasis in HIV infected patients]. / Sensibilité aux antifongiques des souches de Candida responsables de candidose oropharyngée chez des sujets vivant avec le VIH.

Candidiasis are very usual infections of HIV infected patients. By medicine pressure, susceptibility to antifungal drugs decrease in some Candida strains. This study carded out in 1997 at hospital, aimed to identify the yeast species isolated from HIV infected patients with oropharyngeal candidiasis, test their susceptibility to antifungal drugs and a previous antifungal treatment impact. Thus, 60 patients yielded to questionnary were recruited. Isolated yeast colonies from buccal tract after culture on Sabouraud medium with chloramphenicol were identified with the API 20 C AUX (BioMérieux) system by assimilation of different sugars. Susceptibility was evaluated by ATB FUNGUS (BioMérieux) system. 55 from the 60 isolated yeasts were identified and among them C. albicans and C. tropicalis were the main species with 75% and 11,7% respectively rates. In HIV1 infected patients, all specieswere isolated and C. albicans predominated (80,4%) on the other hand, C. albicans and C. tropicalis were the only isolated yeasts from the HIV2 infected patients with 83,3% and 16,6% respectively rates. Susceptibility of C. albicans was 72,2% to nystatine, 58,3% to amphotericin B, 83,3% to flucytosin, 12,8% to miconazole, 8,5% to econazole and 10,6% to ketoconazole. Susceptibility of C. albicans to polyenes was modified by a previous antifungal treatment. This study indicated emergence of saprophytic yeasts of the buccal mucosa and seemed to be more fostered by HIV1 serotype than HIV2. So, C. albicans's susceptibility to polyenes decreased by untimely use of antifungal drugs and by controlling it one could improve the clinic conditions of HIV infected patients.

[Malaria in the central health district of Dakar (Senegal). Entomological, parasitological and clinical data]. / La paludisme dans le district sanitaire centre de Dakar (Sénégal). Données entomologiques, parasitologiques et cliniques.

We previously investigated malaria in the southern health district of the city of Dakar, which includes the oldest neighborhoods. In this study, we investigated malaria in the central health district, corresponding to the central area of the conurbation. The study was carried out at 12 sites, from March 1996 to February 1997. The sites were selected such that the entire district was covered and included 2 sites in the shanty town and three in an old village that has been absorbed into the city. We carried out prospective monthly entomological analyses with a view to identifying the vectors and the mode of transmission of malaria. We also carried out clinical and parasitological follow up to determine the incidence of parasitemia and of bouts of malaria. Insects were collected overnight from humans and the insects remaining the next morning in 10 bedrooms in the health district were collected. For clinical and parasitological follow up, families were visited at home once per week and their clinical state was assessed. Blood smears were taken to facilitate the detection of bouts of malaria. Body temperature was measured and we checked for the presence of organisms in the blood systematically during the last weekly visit of each month. For a total of 308 collections at night from human volunteers and 1,395 bedroom collections of residual fauna, we obtained 12,879 Culicidae females, 199 (1.5%) of which were anopheles mosquitoes, with Culex quinquefasciatus accounting for 98% of the remaining mosquitoes. As in the southern district, A. arabiensis was the only species of the A. gambiae complex collected. Anopheles mosquitoes accounted for only 0.3 bites per man per night and 0.07 females per room. They were therefore poorly represented in this district and were not detected at all at five sites. They were found in large numbers only during the rainy season, especially in September, when they accounted for 2.25 bites per man per night and 0.3 females per room at 3 sites in an undeveloped zone in which 81.4% of all the anopheles mosquitoes were collected. The parturition frequency of the biting females was 32.6% and that of the females collected in houses was 50.0%. None of the A. arabiensis females dissected (98.5% of those collected) carried Plasmodium sporozoites. The clinical and parasitological follow up concerned 2,583 individuals, aged from 1 month to 80 years, from 285 families resident in Dakar who volunteered for the study; 41.9% of these individuals were less than 15 years old and 92.2% had been living in Dakar for more than 2 years. Thick and thin blood smears taken monthly showed the frequency of the parasite to be 1.0% and that of gametocytes to be 0.1%. P. falciparum was the only parasite detected in the subjects. Plasmodium infections were observed in all age groups, with a frequency of 0.4% (adults over the age of 20 years) to 1.6% (children under two years of age). Parasitized subjects were detected in every month of the study, with a frequency of 0.4% (in January) to 1.9% (in December). The largest number of cases detected in a three-month period (38.8% of all cases) was that for October to December, the three-month period immediately after the rainy season (July to September). Parasite frequency, which was no higher than 1. 2% at 10 sites, was clearly higher at two sites in the shanty town (3.8 and 6.8%), mostly inhabited by immigrants from rural areas. At the end of the study year, satisfactory weekly follow up was considered to have been achieved for 1,067 of the participants. The annual incidence of parasitemia in this cohort was 5.1% and that of malaria was 2.4%. Incidence did not vary significantly with age and was between 1.8% and 7.6% for parasitemia and between 0.8% and 3.5% for malaria. However, significant differences in incidence were observed between areas. Incidence was higher at the two sites in the shanty town, with rates of 12.1% and 36.5% for parasitemia and 6.1% and 15.9% for malaria. (ABSTRACT TR

[Heterogeneity of chloroquine resistant malaria in Senegal]. / Hétérogénéité du paludisme chloroquinorésistant au Sénégal.

In order to evaluate the in vivo efficacy of chloroquine in the treatment of P. falciparum malaria, studies have been carried out in Richard-Toll, Fatick and Tambacounda, 3 areas where dynamics of transmission, population movements, as well as prophylactic and curative practises are different. Failure rates in treatment were 13% in site 1 (Richard-Toll) where medical pressure and population movements are high. In sites 2 and 3 (Fatick and Tambacounda), the failure rate was 3%. Even if medical pressure is lower in the latter site (Tambacounda), the higher transmission could be a factor in the spreading of resistance. A surveillance system and better use of chloroquine must be undertaken.

[Management of severe malaria in children in developing countries. A protocol for economic evaluation]. / Prise en charge du paludisme grave de l'enfant dans un pays en développement. Elaboration d'un protocole d'évaluation médico-économique.

This prospective one-year study was conducted as a preliminary phase to setting up a protocol for economic appraisal of management of severe malaria at Albert Royer Children's Hospital in Dakar, Senegal. Data was routinely collected using a standardized checklist. The four key indicators chosen for this study were nurse workload, adequacy of care (number of patients receiving adequate care), direct cost, and mortality rate. The mean daily care workload was estimated to be 27.2 minutes. This indicator assesses the relationship between supply and demand. Based on 5 criteria, care was considered as adequate in 54.5 p. 100 of patients. This indicator is helpful in judging the effectiveness of the therapeutic modalities used. The direct cost of treating severe malaria was estimated to be 45963 CFA francs. This indicator will be useful in establishing controls to reduce costs. The mortality rate was 12.2 p. 100. Comparison of this rate with previous years suggests little improvement in the outcome of malaria management at the institution. This indicator must be taken into account in the ongoing quality control program. Overall these findings should enable institutional decision-making to improve management of severe malaria based on objective measurable data.

[Pneumocystosis in HIV infected patients presenting with acid-fast bacilli negative pneumopathy at the Central University Hospital at Dakar]. / La pneumocystose chez les sujets infectés par le VIH presentant une pneumopathie à BAAR négative au CHU de Fann à Dakar.

Pneumocystosis is an opportunist parasitic disease which occurs currently at Europe and United States in HIV infected patients. In Africa, the disease is not current. Pneumocystosis has been detected in the Fann medical universitary center at Dakar from HIV infected patients with acido alcoholo resistant bacilli negative pneumopathy. Analysis of broncho alveolar liquid(BAL) of 29 patients after Giemsa and Blue of Toluidin O staining allowed isolating of two cases of pneumocystosis. A man and a woman were the patients. They were HIV1 positive with at X ray bilateral interstitial syndrome. The CD4 lymphocytes count of the one was lower than 200/mm3 and for the other it was higher than 200/mm3.

[Evaluation of parasitic risks for the population bordering on the Mbeubeuss public waste disposal, Dakar]. / Evaluation des risques parasitaires pour les populations riveraines de la décharge publique de Mbeubeuss (Dakar).

The authors carried out a parasitologic survey on 367 inhabitants of Malika, a village located in the immediate surroundings of M'Beubeuss disposal, as well as on 433 other residents of Keur Massar, a location 2 km farther, in order to assess parasitic hazards encountered by people neighbouring this disposal. As far as intestinal parasitosis are concerned, the prevalence rate was significantly higher in Malika (61.3%) than in Keur Massar (48.5%) The sex, social and economic status, level of education as well as the time of dwelling in the neighbouring area were identified as the risk factors of intestinal parasitism. Only the last one can be considered as significantly and independently related to a risk of intestinal parasitism. As for malaria, the plasmodial index in Malika was 6% versus 7.6% in Keur Massar (no significant difference). Thus, if it does exist for neighbouring people, an infestation risk by intestinal parasites related to exposure duration, contrarily, it does not exist for malaria. Appropriate steps should be taken to prevent the hazards encountered by inhabitants of surrounding villages.

[Endemic parasitoses in the villages surrounding the Saloum fossil valley, Senegal]. / Endémies parasitaires dans les villages riverains de la vallée fossile du Saloum (Sénégal).

In order to determine the prevalence rates of malaria, urinary schistosomiasis and intestinal parasitosis in Saloum's valley, the authors carried out a study which took place from november 16 to november 24, 1996. For malaria, the global parasites index was 22% (146/662). Malaria prevails at a hypoendemic level in N'Diobène and N'Guent-paté villages and at a medium-endemic level in Ribo-Escale and N'Dodj. The infestation index for urinary schistosomiasis was 8.9% (137/154) About intestinal parasite, among 868 persons screened, 124 showed one or several parasites, that is an infestation index of 14.3%. Appropriate steps should be taken to prevent an extension of these conditions along the fossil Saloum's valley.

[Malaria in the southern sanitary district of Dakar (Senegal). 1. Parasitemia and malarial attacks]. / Le paludisme dans le District sanitaire sud de Dakar (Sénégal). 1. Parasitémie et accès paludéens.

A survey of endemic malaria in Dakar was carried out in the southern sanitary district covering the city centre and neighbouring areas. The survey was scheduled from June 1994 to May 1995 in 12 sites distant from each other by 1000 to 1500 meters. Clinical and parasitological data were collected during weekly medical follow-ups at the patients' home with the systematic research of Plasmodium once a month. The study included 2,337 persons aged between 1 month and 88 years and belonging to 284 volunteer resident families. Through monthly parasitological examinations, a parasite rate (P.R.) of 0.3% and a gametocyte rate (G.R.) of 0.005% were recorded. Only Plasmodium falciparum was observed. The P.R. varied according to age: from 0.1% in the children under 2 years to 0.7% in the young adults (15-20 years) who appeared significantly more affected than the other age groups, including that of children from 2 to 9 years, of whom only 0.3% were infected by the parasite. The P.R. varied also according to the site surveyed: from 0% in the city centre to 1.3% at the periphery of the sanitary district and according to the time of year, reaching its height of 0.8%, between October and December, that is just after the rainy season. At the end of the year of survey, 929 among those surveyed were considered to have been satisfactorily followed. Their annual incidence rate was 2.4% for the parasitemia and of 1.5% for the malaria attacks. None of the participants aged under 2 years had the parasite. Among the others, the annual incidence rate varied according to the age--although not significantly--passing from 1.1% to 5.3% for parasitemia and from 0.4% to 3.0% for malaria attacks. Theses rates did not differ significantly according to site; the cases registered varied between 1% and 8% for parasitemia and 1% and 5.8% for malaria attacks. Only 10.6% of febrile subjects suffered from malaria attacks, but this rate seemed to go up between October to December, rising to 26.6% which corresponds to 1 case of malaria attacks for 4 cases of hyperthermia in that period. Weak density of Anopheline population and satisfactory medical surveillance explain the recorded results.