[Leishmania (Viannia) braziliensis Vianna, 1911 in French Guiana. Clinical, therapeutic and epidemiological considerations in the ninth human diagnosed case]. / Leishmania (Viannia) braziliensis Vianna, 1911 en Guyane française. Considérations cliniques, thérapeutiques et épidémiologiques à propos du neuvième cas humain diagnostiqué.

The authors report the ninth case of cutaneous Leishmaniasis without mucosal involvement due to Leishmania (Viannia) braziliensis (isoenzymatic profile related to zymodeme MON-44) diagnosed in a legionnaire who recently arrived in French Guiana. The skin lesion as a single ulcerated nodule of the dorsum of the left ringfinger was cured after two courses of four intramuscular injections of pentamidine isothionate (total posology of pentamidine-base: 16.6 mg/kg). The transmission occurred during nocturnal trekking in forest and swamps just behind the coastal belt at Degrad Saramaka (7 km South of Kourou). In French Guiana, the good level of medical care and the early treatment of the majority of the cases of Leishmaniasis may explain the rarity of mucosal lesions. Since the clinical aspect of the lesion is not sufficient to prejudge the identity of the causative species, it is necessary to perform cultivation of Leishmania for iso-enzymatic identification. The adaptation of pentamidine doses and long term follow up of patients infected by L. (V.) braziliensis could be defined more precisely.

Abdominal angiostrongyliasis: third case in Guadeloupe - abstract

Angiostrongylus costaricencis causes a clinicopathologic disease, abdominal angiostrongyliasis (AA), first observed in Costa Rica by Morera and Cespedes. AA is mainly observed in children, and is characterized by abdominal pain typically localized to the right lower quadrant. The disease is mostly endemic to Central and South America. However, the disease has begun to appear outside of its endemic area and may simulate Crohn's disease, and is observed in old persons. We report 3 cases of AA, all diagnosed in the Department of Pathology in the CHU in Guadeloupe, FWI, since 1987. The 3 cases are instructive of the disease and the physician needs to be aware of it. It is also a priority to identify intermediate hosts to prevent the disease (AU)

[Digestive histoplasmosis in a patient with AIDS from Guadeloupe]. / Histoplasmose digestive chez un malade Guadeloupéen atteint du SIDA.

The authors report the case of a 45-year-old HIV and HTLV1 antibody positive male patient form French West-Indies who was infected by disseminated histoplasmosis presenting as acute diarrhea. Esophagogastroduodenoscopy revealed gastric mass and colonoscopy patchy erythematous mucosa. The diagnosis was made by histology of bone marrow specimens, upper gastrointestinal tract and colon biopsies, and late skin lesions. Initial therapy with amphotericin B and itraconazole was successful, but maintenance therapy with itraconazole alone did not prevent relapse and a fatal outcome. Disseminated histoplasmosis in AIDS patients may be present as gastrointestinal manifestations and should be kept in mind in non endemic areas such as the French West Indies.

[Natural murine infestation by Angiostrongylus costaricensis Morera and Cespedes, 1971 in Guadeloupe]. / L'infestation murine naturelle par Angiostrongylus costaricensis Morera et Céspedes, 1971 a la Guadeloupe.

In 1992, two cases of abdominal angiostrongylosis were reported in young Guadeloupean children. With a view to determine the natural infestation rate of Guadeloupe rodents (Rattus rattus, R. norvegicus) by Angiostrongylus costaricensis, 656 rats caught in the country have been examined. Both murine species are naturally infested (6.2% in R. rattus and 14.9% in R. norvegicus), which gives a total prevalence of 7.5%. This total prevalence is higher in the tourist area. A complementary investigation proves to be necessary to identify in Guadeloupe the alleged intermediate hosts (slugs, land snails) in which the human illness has its direct origins.

[Presence of abdominal angiostrongylosis in Guadeloupe. Apropos of 2 recent cases]. / Présence de l'angiostrongylose abdominale en Guadeloupe. A propos de deux cas récents.

The authors describe the first two cases of abdominal angiostrongylosis in Guadeloupe, confirmed by a histological analysis. Physicians must be aware of the presence of Angiostrongylus costaricensis in the West Indies in order to provide better care for children presenting with fever, abdominal pain and rectorragiae, along with intense biological markers of inflammation.

[Malaria pattern in French Guyana (author's transl)]. / Physionomie du paludisme en Guyane.

Study of malaria pattern in French Guyana from 121.175 parasitological data collected from 1970 to 1979. -- General incidence is moderate (6,4 p. 1.000) and the mean plasmodial index is 2,7 p. 100. These paludometric data have much increased in 1973 (9,7 p. 1.000 and 5 p. 100) and 1979 (10,8 p. 1.000 and 4 p. 100). This is the consequence of two convergent factors both strengthening vectors activity: a flow of malaria infested immigrants and meteorologic conditions (lengthy drought). Plasmodial species involved are P. falciparum (84 p. 100) and P. vivax (15 p. 100), P. malariae having just a negligible role. However, it must be noted that from 1977, P. vivax, already prevalent in Oyapok, seems to become more frequently rated. -- True autochtonous malaria is localized in border areas; exchanges from both sides of the river are frequent and call for a regional coordination control. A part of these permanently active micro-foci, periodic rises observed are related, in almost all cases, to the arrival of malaria infested migrants. This is specially obvious in Cayenne Island where a sanitary control of migrants from endemic areas should be considered. -- A. (N.) darlingi is in French Guyana the almost sole vector, except for Upper-Oyapok where A. (K.) neivai is responsible for a malaria caused by Bromeliaceae. In exceptional conditions and localized foci A. (N.) braziliensis and less often A. (N.) aquasalis may be effective vectors. -- Anti-vector measures require an increased control at preimaginal stade. This public-health additional option calls for an integrated control: Cayenne Island conditions are assembled to design and evaluate a model.

[Features of malaria in Guyana]. / Physionomie du paludisme en Guyane.

A paludometric study of the 1970-1979 decade in French Guyana, shows a 2.7% plasmodic index, with a mean incidence of 6.4 per 1,000 habitants and a very high prevalence of P. falciparum (84%). Anopheles darlingi, the principal vector, still remains sensitive to DDT after 30 years of insecticide utilisation. The autochthonous malaria occurs permanently in the bordering areas between Guyana and Brasil at the East and between Guyana and Surinam at the West. In the other parts of the country, in the Island of Cayenne particularly, seasonal epidemics appear during the dry months and are due to imported Plasmodium. Sanitary reglementation of immigration and an actualisation of the anti-vectorial programme control are proposed as prophylactic measures.

[Intestinal parasitoses in the child in French Guiana. Evaluation of a 4-year systematical survey in the C.H. of Cayenne]. / Les parasitoses intestinales chez l'enfant en Guyane. Bilan de quatre années d'exploration systématique au C. H. de Cayenne.

A systematic study on intestinal parasites in children of the Cayenne Hospital Center from 1974 to 1977 showed the following: 1(0) With a 26.1 0/0 total infestation index, nematodes are four times more frequently more responsible than protozoa; cestodes are extremely rare (T. saginata 0.8 0/0); trematodes are found only in allochthonous people from the Antilles (S. mansoni). 2(0) Age distribution shows an early nematode infestation. The nematodes infecting children by the oral way have a maximal incidence at the age of 3 to 6 years. Those infecting by the skin way are maximal at 6 to 12 years and keep afterwards a relatively stable incidence. Most carriers of E. dysenteriae cysts are those children who present vegetative forms of histolytica in 4.1 0/0 of the cases.