ABSTRACT
During the first decades of the 20th century, about 45% of deaths in Cameroon were believed to be due to human African trypanosomiasis. Thanks to the screening and treatment campaigns implemented between 1926-1932, a considerable regression of the disease was achieved and, by the 1950s, only a few well-known and delimited foci remained. Today, human African trypanosomiasis is an extremely rare diagnosis, especially in children. The purpose of this report is to describe two cases of neuromeningeal human African trypanosomiasis that were discovered coincidentally in two children, ages 12 and 2 years. The children were from two villages in the center of Cameroon that is not considered as a known endemic focus. These two cases raise difficult questions about the possibility of latent endemic foci of human African trypanosomiasis and of animal-to-human transmission. The outcome was favorable in the first case and fatal in the second.
Subject(s)
Trypanosomiasis, African/diagnosis , Cameroon , Child , Child, Preschool , Eflornithine/therapeutic use , Fever/parasitology , Humans , Male , Trypanocidal Agents/therapeutic use , Trypanosomiasis, African/drug therapyABSTRACT
Organization of an active screening program for human African trypanosomiasis in an outbreak area is subject to strict guidelines that must take into account the size of the population, the specificity and sensitivity of the diagnostic techniques used, and the cost of screening. Numerous parameters can affect the outcome including accessibility of the outbreak area (road conditions, rainy season); awareness of village populations and of local administrative, traditional, and religious personalities; quality of local health-care facilities and personnel; possibility of referring patients to a health care institution able to provide treatment, etc. For these reasons the cost of screening programs can be high in terms of human, physical, and financial resources. Careful planning and preparation is necessary to ensure worthwhile results. The model described in this article allows screening of 300 to 600 persons a day in areas in which the endemic disease prevalence is higher than 1%. A variant for areas with lower endemicity allows screening of up to 1500 persons a day.
Subject(s)
Mass Screening/organization & administration , Trypanosoma brucei gambiense , Trypanosomiasis, African/diagnosis , Agglutination Tests , Animals , Biopsy, Needle , Cameroon , Decision Trees , Humans , Lymph Nodes/parasitology , Mass Screening/methodsABSTRACT
La situation de la lutte contre la trypanosomiase humaine africaine au Cameroun est tres preoccupante. Les cas observes sont sous-estimes. La couverture des foyers en pieges de lutte est tres faible. La recession economique a ralenti tous les efforts de relance de la lutte malgre la volonte de reduire l'incidence de la maladie dans les foyers. La reprise des activites est conditionnee par consequent par une mobilisation urgente des ressources financieres; humaines et logistiques
Subject(s)
Socioeconomic Factors , Trypanosomiasis , Trypanosomiasis/prevention & controlABSTRACT
Les auteurs ont mene de decembre 1992 a mai 1993 une enquete tranversale sur la lutte antiglossine au Cameroun. De cette etude; il ressort que plusieurs facteurs ont influe negativement sur l'organisation et le fonctionnement des comites locaux de lutte. Il s'agit notamment du processus assez rigide de la decentralisation; de l'absence de supervision des activites et de la demobilisation des populations due a un manque de motivation et de soutien. L'integration au Cameroun des activites de lutte antiglossine dans le programme des soins de sante primaires n'est pas mauvaise en soi. Les comites locaux de lutte encore en activite fonctionnent a 50 pour cent de leur capacite reelle. Il importe de reformuler la strategie en procedant a une decentralisation progressive; l'implantation des activites et leur entretien restant a la charge des communautes. Une mobilisation urgente des ressources humaines; financieres et materielles s'avere necessaire afin de parer au risque de recrudescence des glossines dans tous les foyers
Subject(s)
Trypanosomiasis , Trypanosomiasis/prevention & controlABSTRACT
The present study was designed to assess the health risk of the future hydroelectric dam of Memve'ele with reference to vector-borne diseases. Entomological and malacological surveys were carried out in the project area. The main vectors collected were Anopheles gambiae and An. nili for malaria; Simulium damnosum for onchocerciasis; Glossina palpalis for trypanosomiasis; Chrysops dimidiata and C. silacea for loasis. No snail host of schistosome was reported. The risk of introduction of the diseases they transmit are discussed.
Subject(s)
Disease Vectors , Water , Animals , Anopheles , Arthropods , Cameroon , Humans , Loiasis/transmission , Malaria/transmission , Onchocerciasis/transmission , Risk Factors , Simuliidae , Trypanosomiasis/transmission , Tsetse FliesABSTRACT
Des bio-essais ont permis d'evaluer les reactions immediates et retardees d'anopheles gambiae; souche Yaounde et de culex quinquefasciatus; souche Yaounde et souche Douala. La mise en contact force des moustiques a dure trois minutes. L'impregnation du tulle moustiquaire a ete effectuee avec la deltamethrine ou la permethrine; chacune avec trois concentrations differentes. Des resultats obtenus avec les moustiques testes; il ressort que la deltamethrine est un insecticide sensiblement superieur tant pour l'efficacite que pour la remanence. La deltamethrine est a preferer a la permethrine pour l'impregnation des moustiquaires dans le Sud-Cameroun
