[Epidemiological and virological aspects Rotavirus diarrhoea in Abidjan, Côte d'Ivoire (1997-2000)]. / Aspects épidémiologiques et virologiques des diarrhées dues aux Rotavirus à Abidjan, Côte d'Ivoire (1997-2000).

Viruses, mainly rotaviruses are aetiological agents in more than 80% of the cases of acute diarrhoea in children. In order to determine the epidemiological characteristics and genotypes of human rotaviruses involved in gastroenteritis in diarrheic children aged from 0 to 5 years old in Abidjan, 642 specimens of stools were collected between 1997 and 2000 in the urban health centres and University Teaching Hospitals in Abidjan. The antigenic detection of rotaviruses carried out by ELISA test was followed by the antigenic (VP6 sub-groups) and molecular characterization: polyacrylamide gel electrophoresis and genetic typing. The general prevalence of Rotavirus diarrhoea was 27.9%. Among the children who were found positive, those whose age ranged from 0 to 11 months old accounted for 45.8% against 41.3% and 12.9% for those whose age ranged from 1 to 2 and 3 to 5 years old respectively proving thus the precocity of rotavirus infection. From an electrophoretypical and antigenic point of view 74.5% of 141 extracts of RNA had a "long" profile and belonged to the VP6 II sub-group against 24.8% of "short" profile belonging to sub-group I. The electrophoretypes with short profile were identified in majority in infants whose age ranged from 0 to 2 years old. Out of the P genotypes identified, the P [8] genotype (59.6%) was predominant followed by the P [6] genotype (26.2%), P [4] (2.8%) and one mosaic genotype P[6,8] which represented 11.4%. These results will need to be completed by the determination of VP7 genotypes in order to provide interesting information on rotaviruses before the introduction of anti-Rotavirus vaccines in the country.

[Results of two-year surveillance of flu in Abidjan, Côte d'Ivoire]. / Bilan de deux années de surveillance de la grippe à Abidjan.

Influenza (flu) is a seasonal viral disease that may have a favorable outcome or be associated with a high morbidity and mortality rate during epidemics. In view of the lack of epidemiological and virological data about flu in Côte d'Ivoire, a surveillance network was set up in Abidjan to monitor the spread of flu and characterize isolated viruses. Over the 24-month period from January 2003 to December 2004, nasal secretions were collected in patients presenting with flu syndrome at various heath care centers in Abidjan. Laboratory identification of viruses was performed by the ELISA technique using anti-A and anti-B monoclonal antibodies (immunocapture) and by isolation on MDCK cells. A fraction of the original samples and isolates was sent for confirmation to the Pasteur Institute in Paris, France and to the National Institute for Communicable Diseases (NICD) in Johannesburg, South Africa. Amongst the 211 samples analyzed, 30 (12.8%) proved positive for flu virus. Twenty-two isolates were positive for influenza virus A including 21 for A (H3N2) type and one for A (H1N1) type. The remaining 8 isolates were positive for influenza virus B. Most of these strains were isolated from patients in two age ranges, i.e. 0 to 5 years (34%) and 15 to 59 years (47%). More than 60% of the strains were isolated in June and October but the study duration was too short to define a flu season. Further surveillance data will allow better determination of flu season and definition of clinical and biological characteristics as a prerequisite for a preventive immunization program.

[Detection of anti-Lassa antibodies in the Western Forest area of the Ivory Coast]. / Detection des anticorps anti-virus de Lassa dans l'ouest forestier de la Côte d'Ivoire.

Lassa fever is an African viral hemorrhagic fever (VHF) known to be endemic in a number of West African countries including Nigeria, Sierra Leone, Liberia and Guinea. Despite having common borders with Liberia and Guinea, Côte d'Ivoire has never reported any cases of Lassa fever. In March 2000, as part of a research project on VHF--mainly yellow fever, Lassa fever and Ebola fever--in Guinea and Cote d'Ivoire, an exploratory survey was conducted to assess knowledge about VHF and immunological status against Lassa virus among forest workers in the Duekoue and Guiglo regions. One hundred and sixty-three male forest workers were interviewed using a questionnaire designed to assess risk factors for VHF exposure and personal medical history over the last 12 months. Detection of IgG antibodies against Lassa virus was performed by immunofluorescence assay with Lassa virus antigens from the Josiah and Las/AV strains. The overall prevalence of IgG antibodies was 26% (42/161). Among the Lassa IgG positive subjects, 38.5% were loggers including 20% that were positive at a serum dilution of 1/40 and 46.7% were national park workers or forest rangers including 69% that were positive at a dilution of 1/40 and more. Forty-one percent of subjects had heard of VHF including 14% who attributed it to animals and 2% who attributed it to plants. Contact with rodents was frequent and more than 50% of subjects had either eaten or skinned rodents. Although the prevalence of anti-Lassa IgG antibodies seemed high in the study population, no conclusion can be about level of exposure to Lassa virus.

Detection des anticorps anti-virus de Lassa dans l'ouest forestier de la Cote d'Ivoire

La fievre de Lassa est une fievre hemorragique virale (FHV) africaine endemique en Afrique de l'Ouest; notamment au Nigeria; en Sierra Leone; au Liberia et en Guinee. La Cote d'ivoire qui part age des frontieres avec le Liberia et la Guinee n'a jamais notifie de cas de fievre de Lassa. Dans le cadre d'un projet de recherche sur les fievres hemorragiques virales principalement la fievre jaune; la fievre de Lassa et la fievre Ebola en Guinee et en Cote d'Ivoire; une enquete a ete realisee en mars 2000 chez des travailleurs forestiers des prefectures de Guiglo et Duekoue; dans le but de determiner le niveau de connaissance sur les fievres hemorra-giques virales et le statut immunitaire vis a vis du virus de Lassa. Cent soixante-trois sujets de sexe masculin professionnels de la foret ont ete interroges a l'aide d'un questionnaire sur les facteurs de risque d'exposition aux FHV et leurs antecedents medicaux des 12 dern i e rs mois. Les anticorps seriques de type IgG anti-virus de Lassa ont ete detectes par technique d'immunofluorescence utilisant les antigenes Lassa des souches Josuah et LAS/AV. La prevalence globale en IgG obtenue etait de 26(42/161). Pa rmi les sujets positifs; 38;5etaient des bucherons dont 20positifs au 1/40; 46;7des agents du parc national ou gardes forestieres dont 69positifs au 1/40 et plus. De plus; 41des sujets avaient entendu parler des FHV; 14ont attribue leur origine a des animaux et 2a des plantes. Les contacts avec les rongeurs etaient frequents et plus de 50des personnes ont deja consomme ou depece des rongeurs. La proportion de sujets porteurs d'anticorps IgG anti-virus de Lassa dans cette population semblait elevee. Cependant cette prevalence ne permet pas de conclure a une exposition particuliere au virus de Lassa

[The spread of the wild Poliovirus in the rural environment, the case of the Adzopé health district, Côte d'Ivoire]. / Circulation de Poliovirus en milieu rural, cas du district sanitaire d'Adzopé, Côte d'Ivoire.

Wild Poliovirus spreading in rural environment in Adzopé, Côte d'Ivoire In order to determine the level of wild Poliovirus spreading among rural children in an endemic poliomyelitis country 469 stools samples, from children aged between three weeks and twelve years old were processed according to WHO procedures for transportation, conservation, isolation and identification of Poliovirus. Intratypic differenciation was performed by an antigenic method using monoclonal antibodies and a genomic RFLP (Restriction Fragment Length Polymorphism). 50 Poliovirus strains (10.7%) were isolated and analyzed: 15 vaccine-like Poliovirus type 1 (30%), 30 vaccine-like Poliovirus type 2 (60%), 4 vaccine-like Poliovirus type 3 (8%) and one wild Poliovirus type 3 (2%). As expected, in the major cases the duration of post-vaccinal viral excretion did not exceed two months. However, in 14% of cases, it varied between 3 and 9 months after the third OPV dose. This long excretion could be due to an inefficient local intestinal immunity or no local immunity at all, in spite of the three OPV doses. These results argue in favor of an increase of the number of OPV doses in such endemic zones. Moreover, OPV strains are well-known to revert to pathogenicity in vaccinees, therefore, the long term excretion of pathogenic OPV derived strains by a certain amount of vaccinees needs to be considered quite seriously.

[The uteropelvic junction in children: from the clinical problems to the morphogenetic approach]. / La jonction pyélourétérale chez l'enfant: de la problématique clinique à l'approche morphogénique.

The responsibility of the uteropelvic junction (UPJ) syndrome or abnormalities for renal affections and also for high obstructive uropathy is well-known. But, controversies still remain about the anatomic approach of this clinical feature. Our purpose is to elucidate the developmental anatomy of UPJ and eventually to set the steps of the anatomic approach of the UPJ abnormalities. This study also leads to a better understanding of the mechanism of the intrinsic ureteropelvic junction obstructions. A total number of 122 post-mortem specimens with ages ranging from 1 day to 30 months in both sexes underwent formalin treatment for histological investigation. We performed both transverse and longitudinal sections. Hematein-eosin-safran and Masson's trichrome staining were used. Histological examination revealed that myoarchitecture of UPJ set increasingly up. Circular muscle fibers were first to put in. They had an initial arrangement as a ring in neonates and infants. We conclude that circular layer appears first and sooner than others. On the other hand, coincidence in time between ages of our specimens and ages of patients sufferning from UPJ syndrome leads to further investigations to determine the implication of ring-shaped circular layer in intrinsic ureteropelvic junction obstruction.

[Detection and management of the yellow fever epidemic in the Ivory Coast, 2001]. / Detection et gestion de l'epidemie de fievre jaune en Cote d'Ivoire, 2001.

From March to December 2001, an outbreak of yellow fever was observed in Cote d'Ivoire. Sentinel surveillance for hemorrhagic fever allowed detection of the first case in the Duekoue health district in the heavily wooded western part of the country. A weekly reporting system was established. For each suspected case recorded and reported to the Epidemiological Surveillance Department at the National Institute of Public Hygiene, a sample was collected and sent for confirmation at the Pasteur Institute of the Cote d'Ivoire. The outbreak progressed from West to East reaching Abidjan, the economic capital of the country located in the southeast. The epidemic emergency plan consisted of setting up a crisis committee to implement epidemiological, entomological and virological surveillance, mass vaccination campaigns in areas around confirmed cases, and vector control. A total of 280 cases were reported including 32 confirmed cases and 6 deaths. Eleven out of 62 districts were affected with most cases occurring in cities with more than 10000 inhabitants. Over 3.7 million persons were vaccinated for an overall coverage of 92.2% in the areas where campaigns were carried out. As a result of this outbreak, surveillance for potentially epidemic diseases has been reinforced and surveillance of viral transmission is now being considered. A vaccination program for adults has also been established.

[Therapeutic efficacy of chloroquine in the uncomplicated malaria due to Plasmodium falciparum in hospital patients in central Ivory Coast (1997-2000)]. / Efficacité thérapeutique de la chloroquine dans le traitement du paludisme simple dû à Plasmodium falciparum des consultants hospitaliers dans le centre de la Côte d'Ivoire (1997-2000).

A study in vivo of Plasmodium falciparum sensitivity to chloroquine was carried out from April 1997 to February 2000 at Yamoussoukro, Kossou and Bouaké in the central region of Côte d'Ivoire. This study was included in the national Plasmodium falciparum-sensitivity program. One hundred and sixteen subjects consulting for suspected malaria were included according to the WHO's standard of 14 days. Chloroquine was administered on a dosage of 25 mg/kg, spread over three days. Among 108 subjects who finished the treatment, 26.9% (29/108) had therapeutic failure to chloroquine (23 precocious therapeutic failure and 6 late therapeutic failure). Chloroquine was more efficacious in Yamoussoukro (87.5% of clinical appropriate response) and Bouaké (82.5%) than in Kossou (61.7%). Parasitic reduction on subjects with therapeutic failure was higher than 85%. The risk of therapeutic failure is not linked to age of patient. Before a revaluation of this situation, chloroquine should always be recommended as a first-line treatment for uncomplicated malaria for the local populations.

[Investigation surrounding a fatal case of yellow fever in Côte d'Ivoire in 1999]. / Investigation autour d'un cas mortel de fièvre jaune en Côte d'Ivoire en 1999.

Côte d'Ivoire is an endemic country for yellow fever, but no case was officially notified in recent years. In July 1999, however, one fatal case was reported. A German citizen was infected in the national park of Comoe, in the north eastern area of the country. In order to evaluate the extent of amaril virus circulation and the risk for local people, a virological, entomological and epidemiological investigation was carried out by the ministry of health, the OCCGE, the Côte d'Ivoire Pasteur Institute (IPCI) and the World Health Organisation in the area where the fatal case had been staying. 18 suspected and 24 confirmed mosquito catchers were identified by interview and a blood specimen was collected from each of them. In addition, 159 batches of mosquitoes from which 94 batches of potential vectors were collected; among the suspected cases, 22% were immunised against yellow fever. Serological and virological analyses were made at IPCI and the Paris Pasteur Institute by ELISA technique and isolation on cells cultures and newborn mice. All the suspicious sera and 87.5% of the catchers were positive for IgG anti-amaril virus. One catcher's serum was positive for IgM anti-amaril virus. 11 suspected sera were positive for IgG anti-dengue virus with 1 positive for IgM. 1 strain of amaril virus and 3 strains of Zika virus were isolated from mosquitoes at IPCI and confirmed by CRORA in Dakar. These results indicated that there is a yellow fever and dengue virus are prevalent among the human and vector populations in the study area. Preventive measures must be adopted to protect human beings at risk for amaril infection.

[Circulation of the poliovirus in endemic zones with children vaccinated by the oral polio vaccine]. / Circulation des poliovirus dans les zones d'endémie chez les enfants vaccinés par le vaccin polio oral.

Strategies aiming to eradicate the poliovirus and poliomyelitis seek primarily to eliminate wild strains associated with the disease, by means of world wide vaccination campaigns using the oral attenuated vaccine (OPV). OPV contains attenuated viral strains which retain their replicating capacity in the digestive tract and thus induce the development of an antiviral local intestinal immunity and limit the circulation of the virus. In such a context, poliomyelitis surveillance laboratories should study above all cases of acute flaccid paralysis (AFP), highlighting the circulation of wild strains, identifying regional reservoirs and guiding vaccination strategies. Alongside circulation, there appear to be important genetic and phenotypic shifts in vaccinating strains, since the OPV is capable of preserving a reservoir of pathogenic stains and thereby impairing vaccination efficacy and the eradication of the virus. Furthermore, non-polio enteroviruses should be considered as a source of emerging pathogenic strains. These questions are being studied by the Pasteur Institute with the objective of determining the effects of OPV campaigns on the circulation of the poliovirus. We have studied the poliovirus vaccine and the circulation of wild strains in urban and peripheral urban areas in African countries known to be endemic for poliomyelitis (Central African Republic, Madagascar, Côte d'Ivoire). The study population consisted of children who had already been vaccinated and new-borns in the course of vaccination. We also evaluated the diffusion of the vaccine strains in their immediate environment. Genetic interchanges were taken into account. For children who received the 3-4 OPV doses, asymptomatic virus excretion was insignificant (0.4-2.4%). The rate of virus excretion in the surrounding environment of children in the course of being vaccinated was relatively low (1.76-5.3%). Our study also detected variant and recombinant strains.

[Seroprevalence of HIV among pregnant women in the ten regions of the Ivory Coast]. / Séroprévalence du VIH chez les femmes enceintes dans dix régions de Côte d'Ivoire.

UNLABELLED: Ivory Coast, a sub-Saharan African country, has 14 million inhabitants. Two AIDS cases were reported to the WHO in 1985. By December 31st 1996, there were a total of 37,878 AIDS cases in Ivory Coast, 6,727 of which were new cases reported in 1996. Heterosexual transmission is the predominant means of HIV infection in Africa and women of childbearing age account for a substantial proportion of the individuals infected. The aim of this study was to follow the progression of infection in the various regions of the country by comparing data from two time periods: Period I: 1986 to 1989; Period II: 1994 to 1996. LOCATION: Samples were taken in regional maternal and child protection centers. Recruitment method: Women were recruited anonymously, during their antenatal care. BIOLOGICAL ANALYSIS: Period I (1986 to 1989), 2,604 pregnant women. Anti-HIV antibodies were detected with: Abbott HIV-1 EIA Recombinant (Chicago) used initially, for 1,200 sera; Abbott HIV-1/HIV-2 Recombinant (Chicago) used later for the remaining sera. There was no commercially available test for HIV-2 during this first period, so all samples with Rm0.8 (R = optical density/cut-off) were also tested by western blotting. Period II (1994 to 1996), 2,935 pregnant women. All sera were tested with Enzygnost HIV-1-2 and Enzygnost HIV-1-2 Plus, produced by Behring (Germany). All sera testing positive in EIA were also tested by western blotting. RESULTS: The prevalence of HIV infection was 4.23% for Period I and 12.53% for Period II. No region of Ivory Coast was completely free of these 2 viruses after the mid-1980s. Women aged 20 to 29 years of age were the most likely to be infected, for both periods. The highest prevalence of HIV-2 was that for women aged between 20 and 29 years and HIV-2 infection occurred mostly in the South, Southwest and West regions. DISCUSSION: The prevalence of HIV infection is now at least 10% in each region of the country. Abidjan is no longer the city with the highest levels of infection, as shown by the results for Period II. The East and West have the highest levels of HIV infection, and the prevalence of HIV in these areas is significantly higher than that for Abidjan (p = 0.007 for the East and p = 0.009 for the West).

Squamous intraepithelial lesions of the cervix, invasive cervical carcinoma, and immunosuppression induced by human immunodeficiency virus in Africa. Dyscer-CI Group.

BACKGROUND: Squamous intraepithelial lesions (SILs) of the cervix are associated with human immunodeficiency virus (HIV) infection, but multiple risk factors must be considered in this context. The authors performed a cross-sectional study to assess the prevalence of and the factors associated with SILs and invasive cervical carcinoma (ICC). METHODS: In Abidjan, Côte d'Ivoire, women were recruited from three outpatient gynecology clinics and screened for both cervical disease and HIV infection. A CD4 cell count was performed for HIV-infected women. RESULTS: A total of 2198 women were included in the study. The prevalence of HIV infection was 21.7%. Of the 2170 women who underwent a cervical screening, 254 (11.7%) presented with a dysplasia or neoplasia: 7.6% had low grade SILs (LSILs), 3.3% had high grade SILs (HSILs), and 0.8% had ICCs. In multivariate analyses, factors associated with these lesions were as follows: for LSILs, HIV-1 seropositivity, age <24 years, parity >1, consultation for genital infection, and no use of oral contraception in the past; for HSILs, HIV-1 seropositivity, chewing tobacco use, low educational level, and parity >1; and for ICCs, age >33 years, parity >3, and illiteracy. In women infected with HIV-1, the prevalence of LSILs increased with a decrease in CD4 cell count, whereas this relation was not found among patients with HSILs. ICCs were linked to HIV-2 infection, but not to HIV-1 infection, in univariate analysis. CONCLUSIONS: In Africa, the prevalence of SILs is high. The factors associated with precancerous and cancerous lesions are different. Cancers in women infected with HIV-1 often may not reach the invasive stage. These findings could have implications for cervical screening programs in the future.

[Post-vaccination anti-poliomyelitis seroprevalence in an urban setting in Abidjan]. / Séroprévalence antipoliomyélitique post-vaccinale en milieu urbain à Abidjan.

In order to determine the antipoliomyelitis seroprevalence of children in Abidjan, we checked the presence of antipoliovirus antibodies in 48 children received in the South Abobo's vaccination center for vaccination against measles. According to the vaccination schedule and rules applied in Côte d'Ivoire: 12.5% of the children have received less than three doses or oral polio vaccine (OPV), 87.5% have received the three doses. Antibody titration results indicated that 78.6, 93 and 76.2% of the children have been immunized against Poliovirus type I, type II and type III, respectively; 71.4% of the children showed antibodies against the three poliovirus serotypes and 4.8% had no antipoliovirus antibodies at all. The children which showed an antibodies titer less than 1/8 were considered unprotected: the proportion of unprotected was 21.4, 7 and 23.8% against Poliovirus type I, type II and type III, respectively. Although these results showed that the level of protection against poliomyelitis in Abidjan is acceptable (> 75%), the efforts for vaccination program in Côte d'Ivoire need to be improved in order to eradicate poliomyelitis.

Place de l'infection a chlamydia trachomatis dans les oligoasthenospermies a Abidjan

Dans le but de rechercher la prevalence de l'infection a chlamydia trachomatis dans les oligoasthenospermies a Abidjan; 58 patients africains; de sexe masculin; sans symptomes uretraux et presentant une oligoasthenospermie ont ete analyses. L'age moyen des patients etait de 34;8 ans et 55;17 avaient un antecedent de maladie sexuellement transmissible (uretrite d'etiologie non determinee). La presence de Chlamydia trachomatis a ete recherchee par la coloration de Giemsa et la technique Elisa. A l'examen direct (coloration de Gram); 79;3 pour cent des patients presentaient des signes d'uretrite (polynucleaires neutrophiles superieurs a 5 par champ X 1000). Parmi ceux-ci; 45;65 pour cent avaient des cellules a inclusion et 19 pour cent etaient positifs pour l'antigene chlamydia en Elisa. La severite de l'oligoasthenospermie; semble liee a l'infection a Chlamydia trachomatis et la place de Neisseria gonorrhoeae n'est pas negligeable (26 pour cent)

Interet de la cytologie urinaire dans le diagnostic des cancers vesicaux. [Lettre]

La cytologie urinaire est un examen non invasif; utile dans le diagnostic et dans la surveillance des tumeurs des voies extra-urinaires notamment vesicales. Cette etude retrospective a porte sur 151 prelevements d'urine provenant exclusivement du service d'Urologie du CHU de Cocody et adresses au Laboratoire de Cytologie de la Faculte de Medecine de 1980 a 1990. 20 dossiers (13;2 pour cent) ont ete retenus sur un seul critere: la presence de cellules malignes ou suspectes dans le prelevement urinaire. Au plan epidemiologique; les 20 malades etaient tous des adultes; dont la moyenne d'age etait de 52;8 ans. Le sexe masculin etait predominant (85 pour cent). La symptomatologie dominee par l'hematurie (100 pour cent) etait souvent associee a des lombalgies; une pollakiurie et/ou une dysurie (14 cas sur 20). Des oeufs de bilharzies n'ont pas ete retrouves. Au plan clinique; les diagnostics les plus souvent evoques etaient: les tumeurs vesicales (60 pour cent) et les tumeurs prostatiques avec extension vesicale (20 pour cent). Au plan cytologique; parmi les 20 prelevements retenus; 13 etaient des carcinomes evidents (carcinomes epidermoides vesicaux) et 7 ont paru suspects. L'examen histologique realise dans 7 cas (35 pour cent); a permis de confirmer 5 diagnostics cytologiques (71;42 pour cent) et de deceler 2 faux negatifs (28;57 pour cent). Les correlations cytoclinique: 91 pour cent et cyto-histologique: 71;4 pour cent etaient satisfaisantes pour les cancers vesicaux dans cette etude et ont permis aux auteurs de conclure que l'examen cytologique des urines dans la pathologie tumorale vesicale; demeure un moyen d'investigation fiable et sensible. Il apparait cependant important de sensibiliser les medecins et les auxiliaires de la sante; au bon conditionnement des prelevements afin d'eviter les problemes d'interpretation lies aux alterations cellulaires

[Turner syndrome: mosaic and isochromosome q in a young African woman]. / Syndrome de Turner: mosaïque et isochromosome q chez une jeune Africaine.

The authors describe the first case reported in Ivory Coast of an 18-year-old African girl for a small size and amenorrhea and failure to reach puberty. There was no dysmorphism. The uterus was infantile. X-ray examination of the skeleton revealed early osteoporosis and KOSOWICZ sign. Hormonal evaluation demonstrated hypertrophic hypogonadism. Diagnosis of TURNER's syndrome was confirmed by karyotype obtained by culture of peripheral blood and which was 46,Xi (Xq)/45,X, associating a mosaic and isochromosome q. Hormonal therapy induced menstruation and led to normal breast development. This case report confirms that these syndromes occur in Black Africa where diagnosis remains difficult due to the sophisticated facilities required.

[Parasitological and clinical response to amodiaquine versus chloroquine in the treatment of Plasmodium falciparum malaria in children in an endemic area]. / Réponses parasitologique et clinique de l'amodiaquine versus chloroquine dans le traitement de l'accès palustre simple à Plasmodium falciparum chez l'enfant en zone d'endémie.

The therapeutic management of malaria in endemic regions is now hampered not only by the limited number of antimalarial agents, but also by the appearance of chemoresistant plasmodial strains and by the sometimes severe adverse effects related to the use of some of these drugs. Between January and July 1993, 100 patients presenting with symptomatic Plasmodium falciparum malaria were randomised to receive amodiaquine or chloroquine at the dose of 30 mg/kg for 3 days. The objective of this study was to compare the efficacy and safety of these two 4-aminoquinolines in the treatment of uncomplicated malaria. The parasite clearance was 4.87 (+/- 0.33) days in the amodiaquine group and 5.55 (+/- 0.31) days in the chloroquine group. All subjects in both groups were afebrile by D7. Cutaneous adverse effects, such as pruritus, were reported with both amodiaquine (3.2%) and chloroquine (6.8%). Amodiaquine was found to be significantly more effective than chloroquine in terms of parasite clearance on D7. The therapeutic failure rate was 0% for amodiaquine versus 16.3% for chloroquine. At a time when chemoresistance of Plasmodium falciparum, especially chloroquine-resistance, has spread to malarial endemic zones, amodiaquine should be very widely indicated in the treatment of simple malaria due to its excellent efficacy and good safety.

[Thoughts apropos of a case of adenomyoepithelioma of the breast]. / Réflexions à propos d'un cas d'adénomyoépithéliome du sein.

We have observed one case of adenomyoepithelioma of the breast in a 65-years-old woman. Mammography was suspicious of malignancy. Morphological features were characteristic of this tumor. The origin of tumor cells was defined by immunohistochemical study using keratin and actin. The follow-up is not sufficient to predict the prognosis of our case.

[A comparative study of the carriage of enteric viruses in urban and rural populations in the western region of the Ivory Coast]. / Etude comparative du portage des virus entériques dans une population urbaine et rurale de l'ouest de la Côte d'Ivoire.

Stool samples were collected from 300 persons of three classes of age (less than 6, 6-15, greater than 15) coming from urban and rural areas of Ivory Coast and tested for enteric viruses. This study has shown the high frequency of enteric viruses carriage, unrelated to sex or age. Carriage rates were significantly higher in rural areas than in urban areas. Both in urban and rural areas there was no difference of carriage among males and females. Polioviruses are predominant.

[Carrier state of enteric viruses in Ivory Coast pregnant women in good health]. / Portage de virus entérique chez des femmes enceintes ivoiriennes en bonne santé.

The present work emphasize the great diversity of the viral species encountered in pregnant women (Rotavirus, Coronavirus, Adenovirus, Poliovirus, Coxsackievirus). In each of the different regions studied, one or two viral types are usually predominant. In Man (West Ivory Coast) region for instance, Rotaviruses and Coronaviruses were mainly encountered; in Bouaké, Polioviruses and Adenoviruses were predominant whereas in Bondoukou and Odienné respectively Coxsackieviruses and Adenoviruses were predominantly identified. Multiple viral infections were also evidenced: Rotaviruses + Coronaviruses, Rotaviruses + Polioviruses, Coronaviruses + Polioviruses, Polioviruses and Adenoviruses. The greatest number of multiple infections was found in Man (8 cases). Inapparent infections were mainly detected in Man where the prevalence for at least one viral type is very high 91.6%; in Bouaké, prevalence of at least one viral type is around 36%. The least level of prevalence was recorded in Bondoukou (East of Ivory Coast) and Odienné (North-West) respectively 17% and 20%.