Endoscopie digestive haute à l'hôpital national de Zinder: indications et résultats / Upper digestive endoscopy at Zinder National Hospital: indications and results

Objectif : déterminer les indications et résultats de l'endoscopie digestive haute (EDH) à l'Hôpital National de Zinder. Matériels et méthodes : il s'agit d'une analyse rétrospective des comptes rendus d'EDH, à partir des registres d'endoscopie digestive du 1er Janvier 2020 au 28 Février 2021, portant sur 667 examens, soit une fréquence mensuelle de 48 EDH. . Résultats : l'âge moyen des patients était de 38,98±14,84 (13-80 ans) avec un sex ratio de 1,02. Les épigastralgies représentent 42,8% (n= 363) d'indication d'EDH, la dyspepsie 15,2% (n=129), les douleurs abdominales diffuses 11,9% (n= 101), les vomissements 8,1% (n= 69), la recherche des signes endoscopiques d'hypertension portale 5,1% (n= 43), la dysphagie 4,9% (n=42) et les hémorragies digestives 3,2% (n=27). Selon le segment anatomique concerné, l'estomac comptait pour 55,51% (n=419), l'œsophage 19,6% (n=148) et le duodénum 6,68% (n=50). Les lésions inflammatoires représentent 63,04% (n=475), les ulcères 6,65% (n=50), les tumeurs 3,03% (n=23) et les lésions diverses 27,28% (n=205). La biopsie était réalisée chez 22 patients (3,46%) et 10 comptes rendus histologiques étaient parvenus, repartis en 06 adénocarcinomes gastriques, 02 gastriques chroniques avec métaplasie intestinale, 01 carcinome épidermoÏde de l'œsophage et 01 polype gastrique hyperplasique. Conclusion : Les épigastralgies dominent les indications de l'EDH. La pathologie digestive haute est certes dominée par les lésons inflammatoires, mais les ulcères et les tumeurs sont de plus en plus diagnostiqués. Ces lésions allaient être mieux évaluées si des biopsies systématiques étaient réalisées chez nos patient

Objective: to determine the indications and results of upper digestive endoscopy (EDH) at the Zinder National Hospital. Materials and methods: this is a retrospective analysis of EDH reports, from digestive endoscopy registers from January 1, 2020 to February 28, 2021, covering 667 examinations, or a monthly frequency of 48 EDH. Results: the average age of patients was 38.98±14.84 (13-80 years) with a sex ratio of 1.02. Epigastralgia represents 42.8% (n = 363) of indication of EDH, dyspepsia 15.2% (n = 129), diffuse abdominal pain 11.9% (n = 101), vomiting 8.1% (n = 69), search for endoscopic signs of portal hypertension 5.1% (n = 43), dysphagia 4.9% (n = 42) and digestive hemorrhages 3.2% (n = 27Depending on the anatomical segment concerned, the stomach accounted for 55.51% (n=419), the esophagus 19.6% (n=148) and the duodenum 6.68% (n=50). Inflammatory lesions account for 63.04% (n=475), ulcers 6.65% (n=50), tumours 3.03% (n=23) and miscellaneous lesions 27.28% (n=205). The biopsy was performed in 22 patients (3.46%) and 10 histological reports were obtained, divided into 06 gastric adenocarcinomas, 02 chronic gastric with intestinal metaplasia, 01 epidermoidal carcinoma of the esophagus and 01 hyperplastic gastric polypConclusion: Epigastralgia dominates the indications of HRE. Upper digestive pathology is certainly dominated by inflammatory lesons, but ulcers and tumors are increasingly diagnosed. These lesions would be better evaluated if systematic biopsies were performed in our patients

[Upper Digestive Endoscopy at Zinder National Hospital: Indications and Results]. / Endoscopie Digestive Haute a L'hopital National de Zinder: Indications et Resultats.

OBJECTIVE: to determine the indications and results of upper digestive endoscopy (EDH) at the Zinder National Hospital. MATERIALS AND METHODS: this is a retrospective analysis of EDH reports, from digestive endoscopy registers from January 1, 2020 to February 28, 2021, covering 667 examinations, or a monthly frequency of 48 EDH. RESULTS: the average age of patients was 38.98±14.84 (13-80 years) with a sex ratio of 1.02. Epigastralgia represents 42.8% (n = 363) of indication of EDH, dyspepsia 15.2% (n = 129), diffuse abdominal pain 11.9% (n = 101), vomiting 8.1% (n = 69), search for endoscopic signs of portal hypertension 5.1% (n = 43), dysphagia 4.9% (n = 42) and digestive hemorrhages 3.2% (n = 27Depending on the anatomical segment concerned, the stomach accounted for 55.51% (n=419), the esophagus 19.6% (n=148) and the duodenum 6.68% (n=50). Inflammatory lesions account for 63.04% (n=475), ulcers 6.65% (n=50), tumours 3.03% (n=23) and miscellaneous lesions 27.28% (n=205). The biopsy was performed in 22 patients (3.46%) and 10 histological reports were obtained, divided into 06 gastric adenocarcinomas, 02 chronic gastric with intestinal metaplasia, 01 epidermoidal carcinoma of the esophagus and 01 hyperplastic gastric polyp. CONCLUSION: Epigastralgia dominates the indications of HRE. Upper digestive pathology is certainly dominated by inflammatory lesons, but ulcers and tumors are increasingly diagnosed. These lesions would be better evaluated if systematic biopsies were performed in our patients.

OBJECTIF: déterminer les indications et résultats de l'endoscopie digestive haute (EDH) à l'Hôpital National de Zinder. MATÉRIELS ET MÉTHODES: il s'agit d'une analyse rétrospective des comptes rendus d'EDH, à partir des registres d'endoscopie digestive du 1er Janvier 2020 au 28 Février 2021, portant sur 667 examens, soit une fréquence mensuelle de 48 EDH. . RÉSULTATS: l'âge moyen des patients était de 38,98±14,84 (13-80 ans) avec un sex ratio de 1,02. Les épigastralgies représentent 42,8% (n=363) d'indication d'EDH, la dyspepsie 15,2% (n=129), les douleurs abdominales diffuses 11,9% (n=101), les vomissements 8,1% (n= 69), la recherche des signes endoscopiques d'hypertension portale 5,1% (n= 43), la dysphagie 4,9% (n=42) et les hémorragies digestives 3,2% (n=27). Selon le segment anatomique concerné, l'estomac comptait pour 55,51% (n=419), l'œsophage 19,6% (n=148) et le duodénum 6,68% (n=50). Les lésions inflammatoires représentent 63,04% (n=475), les ulcères 6,65% (n=50), les tumeurs 3,03% (n=23) et les lésions diverses 27,28% (n=205). La biopsie était réalisée chez 22 patients (3,46%) et 10 comptes rendus histologiques étaient parvenus, repartis en 06 adénocarcinomes gastriques, 02 gastriques chroniques avec métaplasie intestinale, 01 carcinome épidermoïde de l'œsophage et 01 polype gastrique hyperplasique. CONCLUSION: Les épigastralgies dominent les indications de l'EDH. La pathologie digestive haute est certes dominée par les lésons inflammatoires, mais les ulcères et les tumeurs sont de plus en plus diagnostiqués. Ces lésions allaient être mieux évaluées si des biopsies systématiques étaient réalisées chez nos patients.

Evaluation of the therapeutic efficacy of praziquantel against schistosomes in seven countries with ongoing large-scale deworming programs.

The World Health Organization (WHO) recommends periodic assessment of the therapeutic efficacy of praziquantel (PZQ) to detect reduced efficacy that may arise from drug resistance in schistosomes. In this multi-country study (2014), we assessed the therapeutic efficacy of a single oral dose of PZQ (40 mg/kg) against Schistosoma mansoni (Brazil, Cameroon, Ethiopia, Mali, Madagascar and Tanzania), S. haematobium (Cameroon, Ethiopia, Mali, Tanzania and Zanzibar) and S. japonicum (the Philippines) infections in school-aged children, across a total of 12 different trials. Each trial was performed according to the standardized methodology for evaluating PZQ efficacy as described by the WHO. Overall, therapeutic efficacy, measured as the reduction in arithmetic mean of schistosome egg counts following drug administration (egg reduction rate; ERR), was high for all three schistosome species (S. mansoni: 93.4% (95%CI: 88.8-96.8); S. haematobium: 97.7% (95%CI: 96.5-98.7) and S. japonicum: 90.0% (95%CI: 68.4-99.3). At the trial level, therapeutic efficacy was satisfactory (point estimate ERR ≥90%) for all three Schistosoma species with the exception of S. mansoni in Cameroon where the ERR was 88.5% (95%CI: 79.0-95.1). Furthermore, we observed that in some trials individual drug response could vary significantly (wide 95%CI) and that few non-responsive individuals could significantly impact ERR point estimates. In conclusion, these results do not suggest any established reduced efficacy of the standard PZQ treatment to any of the three schistosome species within these countries. Nevertheless, the substantial degree of variation in individual responses to treatment in some countries underpins the need for future monitoring. The reported ERR values serve as reference values to compare with outcomes of future PZQ efficacy studies to ensure early detection of reduced efficacies that could occur as drug pressure continues increase. Finally, this study highlights that 95%CI should be considered in WHO guidelines to classify the therapeutic efficacy of PZQ.

Les différences liées au genre dans les accidents vasculaires cérébraux

L'impact dévastateur des accidents vasculaires cérébraux sur la qualité de vie des sujets a motivé à conduire cette étude. Le but est d'identifie lesdifférences entre les genres dans la perspective d'optimiser la prise en charge surtout sur facteurs se révélant péjoratives individuellement pour chaque groupe MéthodesIl s'agit d'une étude prospective analytique d'une durée de neuf (9) mois allant de juillet 2019 à mars 2020 aux urgences médicales de l'Hôpital National de Niamey. Etait éligible, tout patient consentant ayant développé un AVC avec une lésion objectivée au scanner cérébral.Résultats : L'étude avait inclus au total 100 sujets dont 59 ayant présenté un infarctus cérébral et les 41 autres un AVC hémorragique. Le sex-ratio était de 1. Au niveau de l'âge il n'y a pas eu de différence entre les genres (p=0,547). Les non-instruits ont été retrouvés plus chez les femmes (p=0,001). Des pressions artérielles systoliques (p=0,014) et diastoliques p=0,014) et diastoliques (p=0,02) au stade 3 de l'OMS ont concernées plus les hommes que les femmes. Les femmes ont été les plus intéressées par l'infarctus cérébral et inversement les hommes par l'AVC hémorragique (p=0,025). Le genre n'a pas eu de lien statistique avec le décès (p˃0,05).Conclusion : L'étude a seulement objectivé une rela-tion entre le genre, le niveau d'instruction, la pression artérielle et le type d'accident vasculaire

The role of molecular modelling strategies in validating the effects of chrysin on sodium arsenite-induced chromosomal and DNA damage.

Chrysin (CHR) is a food-based bioactive ingredient whereas, sodium arsenite (SA) is one of the major contaminant in drinking water. When ingested, SA contributes to tissue damage due to bioactivation by S-adenosyl methionine (SAM)-dependent methyltransferase. Hence, the needs to nullify this effect by investigating the potentials of CHR on SA-induced genotoxicity in rats. The experiment was divided into two successive stages (ameliorative and preventive, curative studies) for 1 week. Rats were divided into four groups: distilled water, 10mg/kg SA, 10mg/kg CHR and co-administration. In stage 2, the experimental groups were given either CHR or SA for 1 week, and treated in reversed order for additional week. Lipid peroxidation, protein carbonyl and DNA fragmentation in liver, blood brain and bone marrow cells micronucleus were assayed for using standard protocols. Molecular docking of SAM-dependent methyltransferase in the presence of CHR was conducted. CHR significantly ( p < 0.05) decreased the level of lipid peroxidation, protein carbonyls and DNA fragmentation in blood, liver and brain tissues as against group treated with SA. It also significantly ( p<0.05) reduced the level of micronuclei generated in bone marrow cells. The effects of CHR were shown to be ameliorative, preventive and curative in nature. Furthermore, CHR was able to dock (with binding energy of -24.81 kcal/mol and predicted inhibition kinetic constant (Ki) of 0.959 µM) into the active site of SAM-dependent methyltransferase with strong hydrogen bond and hydrophobic interactions. The study might have unravelled the potentials of CHR against SA-induced chromosomal and DNA damage, which might be due to inhibition of SAM-dependent methyltransferase.

Erratum to: Development of novel multiplex microsatellite polymerase chain reactions to enable high-throughput population genetic studies of Schistosoma haematobium.

Unfortunately, the original version of this article [1], contained a mistake. In Table 1, the primers for Sh6 and Sh9 were included incorrectly. Instead of GGGATGTATGCAGACTTG TTGTTTGGCTGCAGTAAC and GCTGAGCTTGAGATTG CTTCTGTCCCATCGATACC they should have been Sh6 Forward Primer GGTGGATTACGCAATAG, Sh6 Reverse Primer TTTAATCAACCGGGTGTC and Sh9 Forward Primer GGGATGTATGCAGACTTG, Sh9 Reverse Primer TTGTTTGGCTGCAGTAAC respectively. A corrected version of Table 1 is included below

Development of novel multiplex microsatellite polymerase chain reactions to enable high-throughput population genetic studies of Schistosoma haematobium.

BACKGROUND: Human urogenital schistosomiasis caused by Schistosoma haematobium is widely distributed across Africa and is increasingly targeted for control and regional elimination. The development of new high-throughput, cost-effective molecular tools and approaches are needed to monitor and evaluate the impact of control programs on the parasite populations. Microsatellite loci are genetic markers that can be used to investigate how parasite populations change over time and in relation to external influences such as control interventions. FINDINGS: Here, 18 existing S. haematobium microsatellite loci were optimised to enable simultaneous amplification across two novel multiplex microsatellite PCR's, each containing nine loci. Methods were developed for the cost effective and rapid processing and microsatellite analysis of S. haematobium larval stages stored on Whatman-FTA cards and proved robust on miracidia and cercariae collected from Zanzibar and Niger. CONCLUSION: The development of these novel and robust multiplex microsatellite assays, in combination with an improved protocol to elute gDNA from Whatman-FTA fixed schistosome larval stages, enables the high-throughput population genetic analysis of S. haematobium. The molecular resources and protocols described here advance the way researchers can perform multi locus-based population genetic analyses of S. haematobium as part of the evaluation and monitoring of schistosomiasis control programmes.

Lactone-rich fraction from Vernonia blumeoides: antitrypanosomal activity and alleviation of the parasite-induced anemia and organ damage.

The anti-Trypanosoma brucei brucei activity in vitro and in vivo of a lactone-rich fraction of Vernonia blumeoides leaves (VBLF) and its potential in alleviating trypanosome-induced anemia and organ damage were investigated. Gas chromatography-mass spectrometry (GC-MS) analysis of VBLF revealed the presence of a number of lactone-containing compounds. In an in vitro study, VBLF showed concentration-dependent activity and was further used to treat T. brucei brucei-infected rats. The VBLF treatments, especially at 300 mg/kg body weight (BW), significantly (P < 0.05) kept the parasites reduced during the entire experimental period compared with the infected untreated group. At the end of the experiment, the trypanosome-induced anemia and hepatic damage were significantly (P < 0.05) alleviated in all the VBLF treatment groups, but renal damage was only prevented in the 200 and 300 mg/kg BW treatment groups. Furthermore, the trypanosome-induced increase in the relative weights of liver, spleen and kidney were significantly (P < 0.05) alleviated by the 300 mg/kg BW VBLF treatment. It was concluded that orally administered VBLF, especially at 300 mg/kg BW, possessed antitrypanosomal activity and could alleviate parasite-induced anemia and organ damage.

Mapping, monitoring, and surveillance of neglected tropical diseases: towards a policy framework.

As national programmes respond to the new opportunities presented for scaling up preventive chemotherapy programmes for the coadministration of drugs to target lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma, possible synergies between existing disease-specific policies and protocols need to be examined. In this report we compare present policies for mapping, monitoring, and surveillance for these diseases, drawing attention to both the challenges and opportunities for integration. Although full integration of all elements of mapping, monitoring, and surveillance strategies might not be feasible for the diseases targeted through the preventive chemotherapy approach, there are opportunities for integration, and we present examples of integrated strategies. Finally, if advantage is to be taken of scaled up interventions to address neglected tropical diseases, efforts to develop rapid, inexpensive, and easy-to-use methods, whether disease-specific or integrated, should be increased. We present a framework for development of an integrated monitoring and evaluation system that combines both integrated and disease-specific strategies.

Parasitoses intestinales et schistosomoses sur la rive droite du Fleuve Senegal; Republique islamique de Mauritanie

Afin de determiner la prevalence et l'ampleur de l'infection par les parasites intestinaux en general et par les schistosomes en particulier; des echantillons de selles et d'urines de 1259 ecoliers; ages de 6 a 14 ans ont ete examines dans 6 villages situes le long de la rive droite du fleuve Senegal. La technique de filtration des urines; l'examen direct des selles et apres concentration; ainsi que la methode de Kato- Katz ont permis de degager les prevalences moyennes suivantes: S. haematobium 29;9; S. mansoni 7;0; Ascaris lumbricoides 2;4; Trichuris trichiura 0;2; Hymenolepis nana 10;3; Taenia saginata 0;3; Ankylostomes 0;1; Strongyloides stercoralis (anguillules) 0;4; et Enterobius vermicularis (Oxyures) 0;6. Seuls les sites de la basse vallee ont montre la presence de S. mansoni avec une prevalence moyenne de 21;5. Les prospections points d'eau frequentes par les ecoliers de chaque village visite; ont permis de mettre en evidence la presence de 6 especes de mollusques dont 5 sont impliquees dans la transmission de la bilharziose en Mauritanie ; il s'agit de B. Pfeifferi; B. senegalensis; B. globosus; B. umbilicatus; B. truncatus et B. forskalii. En depit de la courte duree de sa realisation; cette enquete illustre bien l'augmentation de la frequence des parasitoses intestinales et l'ampleur de la shistosomose a S. haematobium dans ce coin; suggerant le role des modifications ecologiques par l'instauration des barrages hygrographiques. Des mesures supplementaires devraient accompagner le traitement de masse visant a arreter l'emergence des mollusques; hotes intermediaires de ces parasites. Des mesures multidisciplinaires s'imposent en vue d'investiguer l'homme; les animaux domestiques ou sauvages commensaux de l'homme ainsi que les eaux de surface et de boisson afin d'aboutir a un meilleur controle de la situation

Present and future schistosomiasis control activities with support from the Schistosomiasis Control Initiative in West Africa.

Since 2004 the West African countries of Burkina Faso, Mali and Niger have implemented national schistosomiasis and soil-transmitted helminthiasis control programmes with financial and technical support from the Schistosomiasis Control Initiative (SCI). In the first three years of the control programmes, nearly 13.5 million doses of praziquantel and albendazole have been administered against schistosomiasis and soil-transmitted helminthiasis with coverage rates varying between 67.0% and 93.9%. These treatments have resulted in a reduction of the prevalence and intensity of Schistosoma infection in the sentinel cohorts that were set up to monitor and evaluate the national control programmes. The challenges currently faced by these national control programmes are the ability to maintain the reduction in morbidity achieved thus far due to the mass treatment campaigns and ensuring sustainability. For reinforcement of surveillance, the establishment of a geographical information system is suggested in order to contribute towards enhanced sustainability of these programmes. Our new working hypothesis is that targeted control accompanied by periodic mass treatment campaigns (every two to three years) can contribute to maintaining the low levels of morbidity achieved thus far. The implementation of integrated neglected tropical disease control programmes in these countries will provide means to ensure the financial sustainability of control activities for the years to come.

The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002-2008.

Schistosomiasis remains one of the most prevalent parasitic diseases in developing countries. After malaria, schistosomiasis is the most important tropical disease in terms of human morbidity with significant economic and public health consequences. Although schistosomiasis has recently attracted increased focus and funding for control, it has been estimated that less than 20% of the funding needed to control the disease in Africa is currently available. In this article the following issues are discussed: the rationale, development and objectives of the Schistosomiasis Control Initiative (SCI)-supported programmes; the management approaches followed to achieve implementation by each country; mapping, monitoring and evaluation activities with quantifiable impact of control programmes; monitoring for any potential drug resistance; and finally exit strategies within each country. The results have demonstrated that morbidity due to schistosomiasis has been reduced by the control programmes. While challenges remain, the case for the control of schistosomiasis has been strengthened by research by SCI teams and the principle that a national programme using 'preventive chemotherapy' can be successfully implemented in sub-Saharan Africa, whenever the resources are available. SCI and partners are now actively striving to raise further funds to expand the coverage of integrated control of neglected tropical diseases (NTDs) in sub-Saharan Africa.

[Focusing of Schistosoma haematobium transmission in irrigated perimeters of the Niger valley (Niger): importance of malacological factors]. / Focalisation de la transmission de Schistosoma haematobium au sein des périmètres irrigués de la vallée du Niger (Niger): importance des facteurs malacologiques.

BACKGROUND: Currently, the control of urinary schistosomiasis is mostly based on mass treatment. Characterization of Schistosoma haematobium transmission could lead to adding new methods to the control strategy. METHODS: We carried out malacological and cercariometrical surveys in irrigated perimeters of the Niger River valley. A semi-monthly follow-up was performed in three main sites of human-water contact in a village located at the border of the irrigated perimeter. Bulinids were collected during 20 min; after identification based on the shell morphology, their parasites were characterized by isoelectrofocalisation. The cercariometrical technique by differential filtration was used to evaluate the density of cercariae in every site with two 20-litre samples of water collected at various periods of the day (9, 12, 15 and 18 h). RESULTS: In the arm of the river, the cercariometry never showed cercariae whereas only some Bulinus truncatus, all negative, were collected. In the channels, B. truncatus and B. globosus were observed and highest density was found during the dry season. Only B. truncatus was naturally infested. Homozygote BB phenotype (characteristic of S. haematobium) was observed in all positive molluscs. Using cercariometry, more than two third of cercariae were collected at 3:00 PM. CONCLUSION: Transmission of S. haematobium was primarily focused in the irrigating channels during the dry hot season at the beginning of afternoon. These results should lead to improve the output of S. haematobium control methods within irrigated areas.

Bulinus forskalii: a new potential intermediate host for Schistosoma haematobium in Niger.

Malacological monitoring of two irrigated areas in Niger highlighted the natural susceptibility of Bulinus forskalii to infection with Schistosoma haematobium when the parasitic load is high. This first report of S. haematobium infection in B. forskalii, which is an abundant snail in irrigated areas, has been confirmed experimentally.

[Uro-genital schistosomiasis with S. haematobium and infertility in Niger. Prospective study of 109 cases]. / Bilharziose uro-genitale a S. haematobium et infertilite au Niger. Etude prospective à propos de 109 consultantes.

Schistosomiasis represents the second most endemic diseases following malaria. It is now endemic in 76 countries of the world, and it is estimated that more than 200 million persons are infected. The objective of this work is to help in the improvement of knowledge about Female Genital Schistosomiasis (FSG) effects on the women reproductive. A transversal prospective survey during six months, on women consulting for infertility in the health reproductive center of Niamey. The women included (109 persons) have been asked and consulted in gynecology, cervical smears urine pathology, urine ragent strips test, vesico-renal and gynecologic trans-abdominal ultrasound, hysterosalpingography (HSG) and cervical biopsy on infected patients. The infestation prevalence at S.haematobium was 38,5%. The infected persons have presented more gyneco-obstétrical symptomatology than the non infested ones. The proportion of exocervicite was 31,0% by clinical examination. The cervical biopsy done on 26 bilharziosis patients confirmed the frequence of highs chronic exocervicites (50%) and leucoplasia (11,5%). Echography and HSG noticed that the bilharzios patients can let develop other annexiel pathologies such as: ovary cyst, peri-tuboovary adhesions and wide ovaries. The symptomatology felt by infested women showed the parasitose consequence on women in endemic area. The treatment in o large schaddle by the national program allows to reduce morbidity caused by that infection in Niger.

[Prevalence of the HIV infection and five other sexually-transmitted infections among sex workers in Niamey, Niger]. / Prévalence de l'infection due au VIH et de cinq autres infections sexuellement transmissibles chez les professionnelles du sexe a Niamey, Niger.

We performed a systematic screening of HIV infection and five other sexually transmitted infections on a consecutive sample of 529 female sex workers from Niamey. HIV seroprevalence rate was 30.1%, with HIV-1 profile in 93.1% of the cases. For curable STI, 4.7% of women had treponematosis, 7% gonorrhoea, 16.8% Gardnerella vaginalis, 36.9% Mycoplasma hominis and 68.2% Chlamydia trachomatis infection. The percentage of women with at least one STI was significantly higher in HIV positive's: 95.6% against 87.9%. Only 7.9% of women were free of any infection.

[Behaviour and HIV seroprevalence investigation in sex workers of Dirkou, Niger, 2002]. / Enquête comportementale et de séroprévalence du VIH chez les professionnelles du sexe de Dirkou, Niger, en 2002.

In the framework of the Human Immunodeficiency Virus (HIV) surveillance, seroprevalence and behavioural survey was conducted in 2002 in Dirkou, a place of concentration of female sex workers (FSW) in Niger The global HIV seroprevalence found was 50% (CI at 95%: 40.6-59.36%). The behavioural survey revealed that 98% of FSW had heard about HIV whereas 78.7% know at least one HIV transmission way and 76.9% know at least one HIV prevention means. Only 33.3% declared using condom, what show that sensitisation efforts are needed to induce a behaviour change in FSW and their clients.

[The use of dried blood spots for HIV-antibody testing in Sahel]. / Dépistage du VIH en zone sahélienne a partir de sang séché sur sérobuvard.

Undertaking a HIV seroepidemiological survey in Sahel is logistically problematic, since countries like Niger or Mali are very large with scattered populations and harsh climatic conditions. Therefore, the replacement of serum samples by whole blood dried on filter papers has been studied for HIV-antibody testing with commercial kits that are commonly used. In Niger, two tests ELISA (Genscreen HIV1/2 version 2, Vironostika HIV Uni-Form II Ag/Ab) and two rapid tests (Determine HIV1/2 et Immunocomb II HIV1&2 Bispot) were used to compare the dried blood spots and serum samples from 43 control individuals. Both ELISAs gave an excellent correlation (r = 0.99 et r = 0.98) between the dried blood spots and serum absorbance values. Using the rapid tests, the HIV status was found 100% concordant with dried blood spots and serum samples. An algorithm using three out of the four mentioned tests was defined then validated on the dried blood spots of 163 control individuals (100% concordant). In conclusion, dried blood spots may accurately and profitably replace serum samples for the serodiagnosis of HIV infection and for mass serosurveys in Sahel.

Immunogenicity, safety, and memory of different schedules of Neisseria meningitidis A/C-diphtheria toxoid conjugate vaccine in infants in Niger.

We studied one to four doses of meningococcal polysaccharides A and C conjugated to diphtheria toxoid (Men D) versus A/C polysaccharide (Men PS) vaccine in 618 infants in Niger. Men PS at 24 months permitted evaluating memory. Two Men D doses (at 3 and 9 months) induced higher serum bactericidal activity (SBA) than other regimens. SBA titers after Men PS at 24 months were higher in those given Men D in infancy versus Men PS. While responses were lower for serogroup C, hyporesponsiveness was not evident. Men D was well-tolerated. A single Men D dose in infancy appeared to induce memory.

[Long-term impact of a mass treatment by praziquantel on morbidity due to Schistosoma haematobium in two hyperendemic villages of Niger]. / Evaluation à long-terme d'un traitement de masse par praziquantel sur la morbidité due à Schistosoma haema- tobium dans deux villages hyper-endémiques du Niger.

Although it is established that the treatment by praziquantel reduces the urinary lesions due to Schistosoma haematobium, the frequency of mass treatment necessary to maintain a low morbidity level remains poorly known. The objective of this work was to study the impact over three years of a single praziquantel mass treatment on schistosomiasis morbidity in two different systems of disease transmission in Niger. The study was performed in 2 villages hyperendemic for schistosomiasis in the South-West of Niger presenting respectively 2 different systems of schistosomiasis transmission: Koutoukalé-Zéno (K Zéno), located close to an irrigated area of the Niger River Valley where the transmission is permanent, and Téguey located along a temporary pond where the transmission is seasonal. After the initial evaluation (1994), we carried out a survey 3 years later (1997) except in K. Zéno where an intermediate evaluation was performed 10 months after the initial survey (1995). Approximately 300 randomised people have been examined as follows: macroscopic examination of urine and reagent sticks for macro- and micro-haematuria, filtration and microscopic examination of urine for Schistosoma eggs, and ultrasound scan of the urinary tract for morbidity. The therapeutic coverage has reached 69.9% in K. Zéno and 78.2% in Téguey. The prevalence of infestation decreased from 74.1% to 56.4 % in K. Zéno (p < 0.001) and from 65.3% to 30.4% in Téguey (p < 0.001) at the end of the 3 years. The prevalence of heavy infestation (eggs > or = 50) went in the same time from 9.9% to 12.8% (p = 0.3) in K. Zéno and from 9.1% to 3.3% in Téguey (p = 0.01). Using ultrasound scan, the prevalence of the bladder lesions reached its previous level in both villages. However the prevalence of hydronephrosis decreased from 21.1% to 3.9% in K. éno (p < 0.001) and from 12.6% to 4.2% in Téguey (p < 0.001). Three years after the single mass treatment, the morbidity did not reach the initial level. The effectiveness of the treatment is better in the pond system where the transmission is seasonal. The lesions of the upper tract decreased more slowly than the bladder lesions, but a long time after the treatment. The re-infestation induced the re-appearance of the bladder lesions sooner than the lesions of the upper tract. The periodicity of the treatment should be variable according to the transmission system. It should occur every 2 years in irrigated areas and could be delayed (3 years) in temporary ponds. The control was beneficial in the pond system and induced a significant reduction of the severe lesions.