Investigation of rodent reservoirs of emerging pathogens in Côte d'Ivoire, West Africa

Background: One of the main health problems in West Africa remains upsurge of emerging pathogens. Ebola virus disease outbreak occurred in 2014 in Liberia, Guinea and Sierra Leone, Monkeypox virus in Nigeria in 2017 and most recently Lassa virus in Nigeria, Togo and Benin in 2018. These pathogens have animal reservoirs as vectors for transmission. Proper investigation of the pathogens in their rodent vectors could help reduce and manage their emergence and spread. Methodology: This study was conducted with an approval from the Côte d'Ivoire Bioethics Community. Small mammal trappings were carried out in 9 sites within three zones namely, peri-urban, peri-rural and protected areas. Liver, lung and kidney tissues from trapped small mammals were sampled in accordance with the recommended conditions of biosafety and bioethics. The organs were transported in liquid nitrogen to the laboratory. Molecular tests were used to detect pathogens. Orthopoxviruses and Monkeypox virus were detected in the organs by PCR using consensus primers targeting the virus surface membrane haemagglutinin (HA) genes, while Leptospira species were detected by PCR using primers targeting the rrs and lfb1 genes. Results: Out of 4930 night-traps, 256 (5.19%) small mammals were trapped including Crocidura, Rattus, Lophuromys, Praomys, Mus and Mastomys. Leptospira species were detected in 6 genera from 7 study sites and the infected small mammals accounted for 13.3%. Leptospira sp was detected mainly in the rodent vector genera Rattus (32.3%), Lophuromys (29.0%), and Praomys (16.1%). Three species of Leptospira were detected and Leptospira interrogans was the most common frequent species (74.2%). Monkeypox virus was not detected from studied small mammals. Conclusion: The initial data from our investigation indicates the presence of Leptospira sp in rodent vectors, Rattus, Lophuromys and Praomys, which are the potential small mammalian reservoirs of this pathogen in Cote d'Ivoire.

Fractures mandibulaires : prise en charge par procédés orthopédiques et prothétiques

Les fractures mandibulaires sont une solution brutale et accidentelle de la continuité complète ou incomplète, avec ou sans déplacement des fragments de la fracture de l'os mandibulaire. Elles ont un retentissement majeur d'ordre fonctionnel et morphologique, avec des complications plus ou moins graves en l'absence de traitement approprié. Il est donc important de faire une prise en charge rapide des patients traumatisés. Méthodes: La prise en charge de ces fractures relève de la chirurgie par mini-plaques d'ostéosynthèse et/ou des procédés orthopédiques et prothétiques. Les auteurs proposent, à travers un cas clinique, la prise en charge des fractures mandibulaires par procédés orthopédiques et prothétiques. Le procédé a consisté à construire et à poser une gouttière bivalve en résine acrylique pour réaliser une contention mandibulaire. Résultats: Le dispositif utilisé a permis de traiter efficacement le patient traumatisé. En outre, les fonctions de l'appareil manducateur et La morphologie des contours du visage ont été restaurées, permettant ainsi une meilleure insertion socio-professionnelle du patient. Discussion: Les procédés orthopédiques et prothétiques sont fréquemment utilisés du fait de leur coût relativement peu élevé par rapport la chirurgie réparatrice. Dans les cas de dents délabrées et d'appuis dentaires insuffisants, le choix de la gouttière bivalve en résine acrylique apparait comme la meilleure option thérapeutique. Conclusion: Dans notre contexte d'exercice caractérisé par des patients aux moyens financiers limités, la prise en charge des fractures mandibulaires par les procédés orthopédiques et prothétiques permet d'obtenir des résultats comparables à la chirurgie réparatrice

Stigmate immunologique de la circulation des Orthopoxvirus chez des sujets nés après l'éradication de la variole en Côte d'ivoire Afrique de l'ouest

Justification : Depuis l'éradication du virus de la variole, on note une émergence des autres Orthopoxvirus surtout le Monkeypoxvirus en Afrique centrale. A ce jour aucun cas d'infection humaine à Orthopoxvirus n'a été notifié en Côte d'Ivoire. Cependant, l'activité humaine en milieu rural, la présence des réservoirs potentiels et le climat sont des facteurs favorables à la circulation de ce groupe de virus. Objectif : Mettre en évidence la circulation des Orthopoxvirus en Côte d'Ivoire en situation post éradication de la variole dans la population non vaccinée contre cette maladie. Matériel et méthode : 385 sérums de sujets non vaccinés contre la variole, choisis parmi 1353 sérums collectés lors d'une surveillance nationale de la fièvre jaune, ont été analysés. La méthode ELISA a été utilisée pour rechercher les IgG anti Orthopoxvirus. Résultats : l'âge moyen des patients était de 11 ans et le sex-ratio était de 1,97. Les IgG anti-Orthopoxvirus ont été détectées dans 4,95% des sérums ; seuls 0,78% de ces sérums avaient un titre ≥ 400. La majorité des sérums contenant ces IgG (84,16%) provenaient d'individus habitant la moitié sud de la Côte d'Ivoire. Conclusion : le niveau d'exposition aux Orhopoxvirus reste faible chez les sujets non vaccinés contre la variole. Cependant, vu le nombre croissant de sujets susceptibles à ces virus, il est nécessaire de mettre en place des sites sentinelles de surveillance, particulièrement du Monkeypoxvirus

[Management of a case of unilateral exophthalmos due to an intraorbital lipofibroma at Kara teaching hospital in Togo]. / Prise en charge d'un cas d'exophtalmie unilatérale due à un lipofibrome intra-orbitaire au CHU de Kara au Togo.

In childhood, benign tumors are uncommon causes of exophtalmos. We report a case of intraorbital lipofibroma in an 11-year-old girl who presented with painless, progressive proptosis of the right eye over the preceding 6 months. Ultrasound had shown an extraconal intraorbital mass. Complete excision and pathologic examination were performed, revealing a lipofibroma with no signs of malignancy This case report is notable due to the rarity of the condition.

[Knowledge, attitudes and practices of healthcare providers in Togo regarding prevention of mother-to-child transmission of HIV in 2010]. / Connaissances, attitudes et pratiques des prestataires de soins en matière de prévention de la transmission du VIH de la mère à son enfant en 2010 au Togo.

OBJECTIVE: To evaluate the knowledge, attitudes and practices of health care providers (HCP) in Togo regarding prevention of mother-to-child transmission of HIV (PMTCT). METHOD: A cross-sectional study was conducted in 22 antenatal clinics with PMTCT programs from January 18 to February 6, 2010. Clinic selection was based on attendance and local factors. Data were collected through interviews conducted by 23 trained investigators. RESULTS: A total of 97 HCP were interviewed at the 27 selected clinics. Most, i.e., 76%, had received PMTCT training. In terms of knowledge, interview data revealed the following strengths: 83% of HCP identified transmission from mother to child as the main route of HIV transmission in children < 15 years; 87% asserted that HIV-infected pregnant women do not always transmit HIV to their children; 77% knew that the ELISA test was performed after 18 months: and 96% had a clear notion about feeding infants born to HIV-infected mothers. Knowledge assessment revealed the following weaknesses: 30% of HCP had never heard of polymerase chain reaction; 27% said that confidentiality about HIV status was not always necessary; and 22% were unaware that decontamination of equipment using a chlorine solution kills HIV. In addition, interview data revealed the following positive attitudes and practices: 83% of HCP were willing to continue working in a center with a PMTCT program and 87% referred women pregnant for the HIV serology. On the negative side, however, only 27% of HCP summonsed husbands whose wives tested positive for HIV. CONCLUSION: This investigation shows that the knowledge, attitudes and practices of HCP in Togo regarding PMTCT is fairly good. However, it also revealed several weaknesses that should be addressed by further training.

[Trachoma rapid assessment in the infantile population of Togo]. / Evaluation rapide du trachome infantile au Togo.

AIM: The aim of this study was to determine the prevalence and types of trachoma in children of central Togo. MATERIALS AND METHODS: This descriptive cross-sectional investigation was conducted in central Togo in November 2009. At every peripheral health unit (PHU) in 2 villages of the sanitary district, 15 schoolchildren between 6 and 9 years old and 35 children from the community between 1 and 5 years old were examined to detect signs of trachoma using a lamp wipes coupled with binocular magnifying loupes (2.5X). Data were analysed with Excel 2007. RESULTS: A total of 8200 children were examined at 82 PHU in 164 villages in the sanitary districts. In the 1-5 year age group including 5,740 children, follicular trachomatous inflammation (TF) was observed in 326 cases and intense trachomatous inflammation (TI) in 9 for a prevalence rate of 5.83%. In the 6-9 year age group including 2,460 schoolchildren, TF was observed in 144 and TI in 8 for a prevalence rate of 6.18%. The overall prevalence rate of active trachoma was 5.94 % (n = 487). CONCLUSION: This study confirms the persistence of active trachoma in children in central Togo. Trachoma may be public health problem in 2 districts: Blitta and Sotouboua. A population-based survey will be carried our to evaluate trachoma prevalence prior to implementation of the SAFE strategy in this region.

Aplasia cutis congenita associated with Goltz syndrome in a male neonate.

Here we report the association of giant aplasia cutis congenita in a newborn black male with Goltz syndrome. The cutis aplasia defect is extensive and circonscript at the vertex. The cerebral structures are visible through the lesions. In addition, the patient has a low birth weight, syndactyly, adactyly, cutaneous atrophy, and areas of hyperpigmentation on the legs and hypoplastic maxillary. We think that these signs are probably due to mosaic mutations in PORCN. We reviewed 18 cases of Goltz syndrome in 18 male neonates but none has aplasia cutis congenita. Such a combination of severe aplasia cutis congenita was not reported previously in Goltz syndrome.

[Is the mother a risk factor for transmission of Helicobacter pylori infection in children between the ages of 6 months and 5 years in Côte d'Ivoire?]. / La mère est-elle un facteur de risque de transmission de l'infection a Helicobacter pylori a l'enfant de 6 mois a 5 ans en Côte d'Ivoire?

OBJECTIVES: The goals of this study were to determine the prevalence of H. pylori antibodies in children, to establish the relationship between child and mother serostatus, and to identify potential risk factors for contamination. MATERIAL AND METHODS: A cross-sectional study was conducted over a 3-month period. All children between 6 months and 5 years of age examined in the Pediatrics Department of the University Hospital Center in Yopougon, Côte d'Ivoire were included after obtaining informed consent from their mothers. Testing for H. pylori antibodies using Pylorix (Acon) was performed in both children and mothers. Based on test results, children were divided into two groups, i.e. case group with H. pylori antibodies and control group without H. pylori antibodies. Case and control groups were compared according to the H. pylori status of their mother and several potential lifestyle and environmental factors. RESULTS: A total of 101 children and 101 mothers were included. The prevalence of H. pylori antibodies was 40.6% in mothers and 24.8% in children. The mean age of children (53% male) was 22.8 +/- 15.6 months (median, 18 months). The mean age of the mothers was 29.6 +/- 5.5 years (range, 19 to 46 years; median, 29 years). Most mothers, i.e., 78.2%, lived in two-parent households but 19% lived in single-parent settings (community or shacks). The number of persons living in the same house ranged from 2 to 20 people (mean, 7.2 +/- 3.8; median, 6 people). Mean monthly household income was 226,188 +/- 161,425 FCFA (range: 30,000 - 750,000 FCFA). In the case group, 80% of children had mothers infected with H. pylori. In the control group, 73.7% of children had non-infected mothers (OR = 11.2, p < 0.001). Median income was less than 150 000 FCA in 76% of families with seropositive children in comparison to 46.1% of families with seronegative children (p = 0.009). CONCLUSION: This study confirms the early occurrence of H. pylori infection in children. Findings also showed that poor socio-economic condition was a risk factor for infection but the greatest risk factor was living with a mother infected with H. pylori.