[Imported malaria in Bordeaux: evaluation of the risk of infection with Plasmodium falciparum as a function of country visited]. / Paludisme d'importation à Bordeaux: évaluation du risque d'infestation par Plasmodium falciparum en fonction de la destination.

This study of imported cases of malaria, which was carried out in Bordeaux (France) in 1987-89, emphasizes the major part played by Plasmodium falciparum, especially in areas lying south of the Sahara in Africa, from where falciparum malaria is mainly imported to other countries. The study of these imported cases is strengthening our understanding of the epidemiology of malaria in relation to the country or area, whether the transmission occurs without interruptions or seasonally. The number of cases of P. falciparum per 1000 travellers (seen for vaccination against yellow fever at Bordeaux) gives an index for evaluating the risk of malaria. This risk changes with the epidemiological profile of falciparum malaria in the three major African ecosystems (rain forest, savannah, and sahelian belts), and is related to the progression of chloroquine resistance in Africa and influenced by the type of chemoprophylaxis proposed to travellers. The use of mefloquine for stays shorter than one month in Central Africa reduced the risk of malaria in 1988 and 1989, compared to 1987. [Editorial note. Recent data indicate some undesirable side-effects of mefloquine, e.g., its use during early pregnancy could lead to congenital defects.] Appropriate chemoprophylaxis and advice to travellers to areas lying south of the Sahara are therefore more and more necessary in order to arrest the increase in the number of imported falciparum malaria cases and reduce the number of serious cases, which are costly in terms of public health.

[Imported malaria at hospitals in Bordeaux (France) in 1987 and 1988. Report of 185 cases]. / Le paludisme d'importation dans les hôpitaux de Bordeaux en 1987-1988. Etude de 185 cas.

100 cases of imported malaria were registered in Hospitals of Bordeaux in 1987 and 85 in 1988. Origin of infestation is Africa in 88 p.c. of the cases mainly from Central Africa (50 p.c.) in 1987 and western Africa (67 p.c.) in 1988. The most frequent species was Plasmodium falciparum 73 p.c. in 1987 and 82 p.c. in 1988. Admitted cases in Bordeaux were mainly French (81 p.c.) with a significant male prevailing and young adults. Mean age was 29 for Europeans and 19 for the others mainly Africans. Infestation risk is in close correlation with the duration of stay in endémic zones. It is maximum for stays between 2 and 11 months. Delay for first symptoms to appear following return from an endemic zone depends of species concerned during the first month, 83 p.c. of malaria fever at Plasmodium falciparum during the second quarter, 50 p.c. of fever at Plasmodium vivax, and after one year or more 40 p.c. at Plasmodium ovale. Only 1/4 of the cases were diagnosed during the first 48 hours. Delay in diagnosing may be prolonged and is in relationship with Plasmodium falciparum chemoresistance and self-medication. 21 strains of Plasmodium falciparum were chloroquinoresistant in vitro: 1 from French Guyana, 9 from Western Africa, and 11 from Central Africa. The strain from Guyana was also less sensible to quinine with a IC 50 = 480 nmol/l.

[A sero-epidemiologic survey of HIV infection in Burundi between 1980 and 1981]. / Enquête séro-épidémiologique sur les infections à HIV au Burundi entre 1980 et 1981.

A retrospective investigation permitted us to show presence of HIV infection in Burundi between 1980 and 1981. 658 sera collected in healthy population of Burundi during this period have been tested for HIV1 and HIV2 with ELISA screening and western-blot analysis. Results completed with HIV1 antigen research show 29 patients infected with HIV1 (27 antibodies to HIV1 carriers, and 2 with HIV1 antigen). The epidemiological situation before finding HIV show high prevalence (4.4%) of HIV1 infection. No HIV2 was found. The epidemiology of HIV infection was dominated by high prevalence in urban areas (8.08%) but 2.82% of country people were infected, by frequence in man (5.94%) but 3.08% of women were carriers, and by heterosexual transmission. After this study HIV infection was more frequent and we have observed epidemiological modification (importance of vertical transmission). Frequent antigenic cross-reaction between HIV1 and HIV2 core proteins has been observed. Cross-reaction with other retrovirus is possible.

[Comparative study of 2 commercial tests for the detection of HIV-1 antigens in blood and cerebrospinal fluid using immunoenzymology]. / Etude comparative de deux trousses commerciales pour la recherche de l'antigène HIV I en immunoenzymologie (EIA) dans le sérum et le liquide céphalorachidien.

The authors have carried out, on 150 sera of patients seropositive for the human immunodeficiency virus type I (HIV I) and 11 cerebrospinal fluid of which 5 were patient infected by the HIV I, a comparative study of two commercial tests for the detection of HIV I antigen (Diagnostic Pasteur and Abbott laboratories). A much greater sensitivity was obtained with the specificity being practically identical for the sera with the two tests (100% with Abbott laboratories test, 96.11% with the diagnostic Pasteur test). 4 sera appeared "false negatives" with the Abbott Laboratories test; their optical density was situated between 80 and 100 p. cent of the cut-off level value, whereas that of the "real" negatives was situated between 30 and 60 p. cent of the cut-off level value. 10 of the 11 cerebrospinal fluids appeared false positive with the Diagnostic Pasteur. This seems to be connected with an insufficiency of saturation of protein receptors in the wells. The Diagnostic Pasteur test is not adapted for the detection of HIV I antigen in the body fluids with a weak protein concentration. Contrary to the results obtained with the Encavor test (Abbott laboratories) the analysis in western-blot does not show an inverse prevalence of anti p24 GAG antibodies with regard to antigen HIV I in seropositive patients. On the other hand, the statistical analysis of the positive HIV I sera which are at the same time antigen HIV I positive and antibodies HIV I positive suggests an earlier disappearance of anti p17 GAG antibodies than of anti p24 GAG antibodies.

[Shigella and Salmonella isolated in Burundi from 1980 to 1985]. / Etude des Shigella et Salmonella isolées au Burundi de 1980 à 1985.

Data are presented on 633 strains of Shigella, and 197 strains of Salmonella, isolated in Bujumbura, capital of Burundi, between 1980 and 1985. The epidemiology of shigellosis is dominated by the resurgence of the Shiga bacillus and by its increasing resistance against all available antibacterial drugs. Salmonellosis is caused by a limited range of serotypes, most of them, with the exception of the typhoid bacillus, becoming multiresistant. Bacteriaemia with S. enteritidis is a frequent complication in patients with AIDS.

[Human arbovirus infections in Burundi: results of a seroepidemiologic survey, 1980-1982]. / Arboviroses humaines au Burundi: résultats d'une enquête séroépidémiologique, 1980-1982.

A serological survey on 623 human sera was conducted in Burundi in 1980-1982, in order to evaluate the frequency of arboviral antibodies in the inhabitants of the three main areas: lowlands, central plateau and mountainous ridge. The results show a rather high activity of arboviruses, mainly in the lowlands (34.2% of inhabitants with antibodies). Chikungunya virus seems to be the most active arbovirus; the activity of Flavivirus is moderate; no trace of activity of yellow fever or West Nile viruses was found; Bunyavirus antibodies (particularly against Ilesha virus) were also detected.

[Epidemiological aspects of malaria in 2 villages of the Manyemen forest region (Cameroon, southwest province)]. / Aspects épidémiologiques du paludisme dans deux villages de la région forestière de Manyemen (Cameroun-province du Sud-ouest).

In terms of parasitaemia in blood, the prevalence was 18.7% for Plasmodium falciparum, 10.5% for P. ovale and 1% for P. malariae in the villages of Mungo Ndor and Kokobuma. The plasmodial index of children from 2 to 9 years of age was 38.2% and the spleen index 26.6%, with a mean HACKETT score of 1.56. Malaria is thus meso-endemic in the region. The immunofluorescent test performed with a P. falciparum antigen was positive in 66% of the children in the same age group. Parasites were seen in 15% of new-born children. The malaria infection indices were higher in Mungo Ndor, which is located on the main road in the vicinity of the Manyemen hospital, than in Kokobuma. Morbidity and mortality due to malaria remain major problems in this part of the South-West Province, in spite of improving primary health care facilities and free chloroquine distribution. Anopheles gambiae is the main vector of malaria in the area, and transmission is interrupted only during the short dry season.

[The control of culicidae in Djibouti town. An experience of 7 years (author's transl)]. / La lutte contre les culicidés dans la ville de Djibouti. Une expérience de 7 années.

The control of culicidae in Djibouti is based first on an antilarval action with suppression of breeding areas and use of Dursban and Abate 5 times a year. Baygon, the use of which is more expensive, is employed for imagicidal control in well delimitated foci.

[Immunization campaign in Ethiopia (author's transl)]. / Campagne médicale en Ethiopie.

In the framework of the smallpox eradication worldwide programme, WHO, the Ethiopian, and the French governments signed a cooperation agreement by which the French Army Medical Service, based in the French Afars and Issas Territory (TFAI), was designated to carry out an immunization campaign in the ethiopian districts along the border with TFAI. With the every-day collaboration of the ethiopian governmental and traditional authorities, 44,000 people were immunized by the medical and paramedical personnel of 5 "ground teams" with heavy equipment and all-track vehicles and 1 "air-team" with helicopteres. In the same time (7 Feb. - 8 March 1974), the teams collected epidemiological informations on five selected tropical diseases: tuberculosis, malaria, bilharziosis, cholera, small-pox; a team from the TFAI Hygiene and Epidemiological Service investigated thoroughly the Kalo area. The ethiopian border districts are under-equiped with medical and hygiene facilities, and the population is used to go to the TFAI dispensaries and hospitals. TFAI being free of malaria, bilharziosis and smallpox, the French Medical Service has to maintain a firm grip on possible spreading. Kalo area might be a favorable reservoir due to the prevailing ecological conditions. Tuberculosis is so widely common that any control in the TFAI would imply a BCG campaign on both sides of the border within an inter-governmental plan of operations.

[Value of liver needle-biopsy in Djibouti (1.1110 specimens) (author's transl)]. / Considérations sur la valeur de la ponction-biopsie du foie à Djibouti. A propos de 1.110 examens.

Liver diseases, specially hepatomegalies and hepatosplenomegalies are very frequent in Republic of Dijibouti. Needle-biopsy of the liver is a good approach of this pathology as demonstrated by controlling 1.110 specimens within a period of 9 years, leading to very different diagnosis.

[Basophilles degranulation test. Its value in an overseas allergologic dispensary (author's transl)]. / Le test de dégranulation des basophiles. Sa place dans une consultation d'allergologie outre-mer.

Specific Ig.E fixed on basophilic leucocytes and mastocytes give way to a release of cytoplasmic granulations when antigen is present. This is the base of a clinical laboratory test easy to perform and consequently of great value in tropical areas. Report of first results in Republic of Djibouti.

[Reaginic allergy to mold in Djibouti]. / A propos de l'allergie réaginique aux moisissures à Djibouti.

16,7 P. 100 OF RESPIRATORY ALLERGIC DISEASES IN Djibouti are caused by years, as demonstrated by the utilization of M. and M2 compounds prepared by Institut Pasteur. The role of air-conditionners appears important. Cultures of dust collected from filters reveale a much greater number of positive yeast cultures than front air.

[The question of endemic malaria in Republic of Djibouti (author's transl)]. / Le problème de l'endémie palustre dans la république de Djibouti.

Since 1973 autochthonous cases of malaria due to P. Falciparum have been reported among local population of French Afars and Issas Territory; 191 cases observed between 1973 and 1976 are recorded. Their monthly distribution and geographical repartition are studied, jointly with the distribution of A. gambiae which has been recently collected in the Territory. This study shows a significant correspondance between the presence of A. gambiae and the malaria cases observed which did not come from neighbouring countries. We may, then, expect the development of small disseminated foci, resulting from the simultaneous introduction of both the parasite and its anopheline vector. This brings about a new epidemiological situation for the Territory.