[Treatment of childhood cancer in Africa. Action of the Franco-African childhood cancer group]. / Le traitement des cancers de l'enfant en Afrique. Travaux du groupe franco-africain d'oncologie pédiatrique.

The childhood cancer survival rate is currently 75% in industrialized countries. Rates in developing countries are much lower. The Franco-African Childhood Cancer Group (French acronym, GFAOP) was founded in 2000 with aim of reducing this unfavorable situation in Africa. The GFAOP has developed two forms of action. The main form consists of organizing two- to twelve-month training sessions for physicians and nurses in France and Morocco. The other form involves assessing the feasibility of modern treatment protocols for various cancers in Africa. The first feasibility trials were carried out on nephroblastoma and Burkitt's lymphoma in 12 pilot units in North Africa, West Africa, and Madagascar. In the first study from 2001 to 2005 we treated 306 cases of Burkitt's lymphoma using French LMB protocols adapted to the African setting and achieved a survival rate of 61%. A second study started in 2005 using Endoxan alone achieved a highly satisfactory survival rate of 73% for neuroblastoma in all stages except bilateral. Altogether from 2001 to 2007 more than 1000 cases of nephroblastoma and Burkitt's lymphoma were treated in African hospitals by African doctors and nurses. No patients were transferred to Europe. The GFAOP supplied drugs when necessary and took care of most travel expenses. African and French doctors worked together on protocol design, trial management, and data analysis. These promising results show that the latest therapeutic techniques can be used to treat childhood cancer in Africa by adapting the protocol to conditions in developing countries. Sanofi-Aventis Laboratories in association with the International Union against Cancer has launched a major campaign to improve Pediatric Oncology in developing countries. Projects in four GFAOP units are being financed through this campaign. In 2006 the GFAOP began assessment of two new treatment protocols, i.e., one for acute lymphoblastic leukemia and the other for Hodgkin's disease. Two other projects are being planned, i.e., one for treatment of retinoblastoma and the other for treatment of some types of brain tumors.

[Burkitt lymphoma in Cameroon children: descriptive and clinico-anatomical aspects]. / Lymphome de Burkitt chez l'enfant au Cameroun: aspects descriptifs et anatomocliniques.

This retrospective study is armed to indicate the descriptive and pathological aspects of children Burkitt lymphoma in Cameroon. It was performed on a 4 year period between July 1988 and July 1992. Children from 0 to 15-year-old who were hospitalized and who had histologically provern Burkitt lymphoma were included. There were 39 patients, that is 27% of all malignant tumors in children during this period. Twenty-four were boys and 15 were girls; the median age was 90 months (+/-46) (range from 3 to 180 months). All children had Plasmodium falciparum infection. EBV serology was positive in 18 patients out of 25 (72%), 14 (36%) had a good nutritional status, the 25 other patients suffered malnutrition. Tumor localizations were: maxillary in 29 (74%) patients, abdominal in 7 (18%), other in 3 patients. Clinical stages according to Murphy classification were: stage I in 6 (15%) patients, II in 3 (8%), III in 20 (51%) and IV in 10 (26%). It is concluded from this series that clinical aspects and histological pattern in children Burkitt lymphoma in Cameroon are not different from what is observed in other endemic areas.

[Cerebral malaria in children in Yaounde, Cameroon. Clinical, paraclinical and developmental aspects]. / Le neuro-paludisme de l'enfant à Yaoundé, Cameroun. Aspects cliniques, paracliniques et évolutifs.

Cerebral malaria is one of the major and deadly complications of malaria. In Cameroon, recent reports indicate that severe cases of malaria are increasingly more prevalent, particularly in children. The present study aims at describing the clinical presentation and laboratory findings of cerebral malaria in children in Yaounde. All patients admitted in the paediatric ward of Yaounde Central Hospital with malaria, who presented neurological signs and were tested positive for Plasmodium in their peripheral blood were recruited into the study. 36 cases were enrolled in all, making up 2.7% of all admissions. The patients' median age was 4.5 years. 52.8% were on malaria prophylaxis. Convulsions and coma with preceding hyperthermia were present in more than 90% of the patients. Blood parasites level median was 1.3% on admission. One patient had hypoglycaemia on admission and two others had it later on after admission; 16.7% had neurological sequels at discharge and two children died (5.6%). Delay in diagnosis and initiation of treatment with quinine adversely affected the prognosis of cerebral malaria in the study group.

[Diagnosis of maxillo-facial Burkitt's lymphoma by needle puncture and cytologic examination. Experience in Cameroon]. / Diagnostic du lymphome de Burkitt maxillo-facial par ponction à l'aguille et examen cytologique. L'expérience du Cameroun.

The authors report their experience on diagnosis of maxillo-facial Burkitt's lymphoma using needle aspiration and cytology. In all the 21 patients presenting a histological proved Burkitt's lymphoma, the diagnosis was done before with cytology. This method has a 100% sensibility. Thus, cytologic diagnosis of maxillo-facial Burkitt's lymphoma is very reliable. In tropical areas with little revenues and where Burkitt's lymphoma is frequent, needle aspiration and cytology need to be well known and used.

Facteurs epidemiologiques associes aux anemies severes de l'enfant consultant en urgence a l'Hopital Central de Yaounde (Cameroun)

Dans une etude retrospective couvrant la periode de juillet 1990 a juin 1991; les auteurs etudient chez l'enfant de 1 mois a 15 mois les aspects epidemiologiques des cas d'anemies severes consultant en urgence. Il ressort de cette etude que sur 16.395 enfants qui ont consulte 747 avaient une anemie severe diagnostiquee cliniquement; 78 enfants sont decedes a leur arrivee au service des urgences pediatriques. Il faut dire en definitive que les enfants de moins de 5 ans; de milieu pauvre; etaient les plus affectes

[Neonatal streptococcus group B infection in Yaoundé (Cameroon). Epidemiologic and clinical aspects]. / Infection néonatale à streptocoque du groupe B à Yaoundé (Cameroun). Aspects épidémiologiques et cliniques.

This study was designed to investigate epidemiologic and clinical features of neonatal group B streptococcal infections. Sixty cases seen over a 60-month period were reviewed. Incidence was 0.8% of admissions. Most affected infants were from low-income families (86.7% of mothers were unemployed and 73.5% of homes were without running water). Neonatal infection was delayed in most instances (76.67%). Fetid vaginal discharge (60%) and premature rupture of the membranes (35%) were the main findings upon history taking. Abnormal body temperature regulation (76.7%) was the most prominent clinical manifestation. Respiratory distress developed in 25% of patients. Meningeal involvement occurred in 73.3% of patients. Serotype B III was recovered in 31 of the 34 cases (91%) in which serotype was determined. Mortality rate was 21.7% and permanent sequelae occurred in 8.3% of patients.

[Neonatal septicemia and meningitis caused by gram-negative bacilli in Yaondé: clinical, bacteriological and prognostic aspects]. / Les septicémies et méningites néonatales a bacilles gram négatifs a Yaoundé: aspects cliniques, bactériologiques et pronostiques.

Based on 139 cases collected in 36 months, the authors show that neonatal sepsis and meningitis with Gram negative bacilli represent 62.33% of confirmed neonatal sepsis (223 cases out of 6,784 neonatal hospitalisations). 53.96% of cases are manifest within the first 72 hours of life. 35.25% of these infants are preemies. The principal predisposing factors are: foul-smelling leukorrhea (45.23%), prolonged rupture of membranes (26.62%) and notion of resuscitation (36.69%). The most important clinical signs are: thermal dysregulation (47.48%), tonus disturbances (35.97%) and respiratory distress (25.90%). Sepsis make up 85.61% of cases; the principal germs isolated being: Acinetobacter (21.58%), Pseudomonas (15.83%), Escherichia coli (14.39%), Enterobacter (12.95%), Klebsiella (11.51%). Of the germs isolated, 27.78% were resistant to initial treatment with the association ampicillin gentamicin. Mortality rate was 46.76%.

Le traitement en Afrique des cancers de l'enfant - Travaux du Groupe Franco-Africain d'Oncologie Pediatrique

Les cancers de l'enfant sont actuellement gueris dans 75des cas; dans les pays developpes. Dans les pays en developpement; les resultats sont beaucoup moins bons. Le Groupe Franco-Africain d'Oncologie Pediatrique (GFAOP) s'est constitue en 2000 avec pour objectif de redresser cette situation defavorable enAfrique. Les actions du GFAOP comprennent; d'une part la formation des medecins et des infirmieres avant tout par des stages en France et au Maroc; d'autre part des essais de traitement par des protocoles adaptes des lymphomes de Burkitt et des nephro- blastomes dans douze unites pilotes situees en Afrique du Nord; Afrique de l'Ouest et a Madagascar. Dans une premiere etude 2001-2005; 61des lymphomes de Burkitt ont gueri. Une seconde etude a commence en 2005 avec un traitement a base d'Endoxan seul. Pour les nephroblastomes; le taux de guerison; 73; est tres satisfaisant. Plus de 1000 cas de nephroblastome et de lymphome de Burkitt ont deja ete traites dans ces conditions de 2001 a 2007; tous en Afrique; dans les hopitaux africains; par desmedecins et des infirmieres africains. Ces resultats encourageants permettent de conclure a la faisabilite du traitement des cancers de l'enfant en Afrique; grace a des traitementsmodernes; adaptes de protocoles utilises dans les pays developpes. Le laboratoire Sanofi-Aventis; associe a l'Union Internationale Contre le Cancer; a lance une grande entreprise d'aide a l'Oncologie Pediatrique dans les pays en voie de developpement.Quatre projets d'unites du GFAOP sont ainsi finances. Le GFAOP a lance en 2006 deux nouveaux protocoles : le traitement des leucemies aigues lymphoblastiques et celui de la maladie de Hodgkin. Deux autres projets sont en preparation : le traitement des retinoblastomes et celui de certaines tumeurs cerebrales