ABSTRACT
According to the WHO records of 2013, the incidence of poliomyelitis was reduced by more than 99%, the number of endemic countries decreased from 125 in 1988 to 3 in 2013 and over 10 million cases were prevented from poliomyelitis thanks to the intensive use of Oral polio vaccine (OPV). However, the emergence of circulating vaccine-derived poliovirus strains (cVDPV), causing serious epidemics like the wild poliovirus, is a major challenge on the final straight towards the goal of eradication and OPV cessation. This paper describes the cVDPVoutbreak that occurred in the Democratic Republic of Congo (DRC) from November 2011 to April 2012. All children under 15 years of age with acute flaccid paralysis (AFP) and confirmed presence of cVDPV in the stool samples were included. Thirty (30) children, all from the administrative territories of Bukama and Malemba Nkulu in the Katanga Province (south-east DRC), were reported. The virus responsible was the cVDPV type 2 (0.7% -3.5% divergent from the reference Sabin 2 strain) in 29 children (97%) and the ambiguous vaccine-derived poliovirus strain (0.7% divergent) was confirmed in one case (3%), a boy seventeen months old and already vaccinated four times with OPV. Twentyfive children (83%) were protected by any of the routine EPI vaccines and 3 children (10%) had never received any dose of OPV. In reaction, DRC has conducted five local campaigns over a period of 10 months (from January to October 2012) and the epidemic was stopped after the second round performed in March 2012. As elsewhere in similar conditions, low immunization coverage, poor sanitation conditions and the stop of the use of OPV2 have favoured the emergence of the third cVDPV epidemic in DRC. The implementation of the Strategic Plan for Polio eradication and endgame strategic plan 2013-2018 will prevent the emergence of cVDPV and set up the conditions for a coordinated OPV phase out.
Subject(s)
Disease Outbreaks , Poliomyelitis/epidemiology , Poliomyelitis/prevention & control , Poliovirus Vaccine, Oral/adverse effects , Poliovirus/immunology , Vaccination/adverse effects , Adolescent , Child , Child, Preschool , Democratic Republic of the Congo/epidemiology , Disease Eradication , Disease Outbreaks/statistics & numerical data , Female , Humans , Infant , Infant, Newborn , Male , Poliomyelitis/virology , Seroepidemiologic Studies , Vaccination/statistics & numerical dataABSTRACT
In the Democratic Republic of Congo (DRC), as in many African countries, AIDS and its procession of opportunistic infections are a major cause of morbidity and mortality. In Kinshasa, the estimated prevalence rate of HIV-infected persons is between 4 and 5%, corresponding to more than 200,000 people. Due to the lack of trained laboratory personnel and appropriate diagnostic equipment, no local investigation has been carried out to determine the prevalence of the opportunistic digestive parasitic infection in HIV-infected persons. As a step to obtaining this information that is needed for implementation of an adequate care policy, a preliminary investigation was carried out in Paris, France on 50 stool samples from 50 AIDS-patients hospitalized in 3 reference hospitals in Kinshasa. Eleven patients (22%) had digestive symptoms with a diarrhea syndrome. Further study using specialized techniques demonstrated 2 cases of digestive infection related to opportunistic parasites (4%). The first involved a Cryptosporidium sp. The second represented the first case of Enterocytozoon bieneusi infection reported in the literature from the DRC.
Subject(s)
AIDS-Related Opportunistic Infections/epidemiology , Intestinal Diseases, Parasitic/epidemiology , AIDS-Related Opportunistic Infections/parasitology , Adult , Democratic Republic of the Congo/epidemiology , Diarrhea/parasitology , Female , Humans , Intestinal Diseases, Parasitic/parasitology , Male , Middle Aged , PrevalenceABSTRACT
En Republique Democratique du Congo (RDC); comme dans de nombreux pays africains; le sida et son cortege d'infections opportunistes sont une cause majeure de morbidite et de mortalite. A Kinshasa; on estime entre 4 et 5le taux de prevalence de sujets infectes par le VIH; soit plus de 200 000 personnes (chiffres du Programme National de Lutte contre le Sida; PNLS 2005). A ce jour; faute de personnels formes et de moyens diagnostiques adaptes; aucune enquete n'a encore ete menee sur la prevalence des parasites opportunistes digestifs dans la population des patients infectes par leVIH; prealable indispensable a la mise en place d'une politique de soin adaptee. Une enquete preliminaire a ete realisee a Paris sur 50 echantillons de selles de 50 patients malades du sida; hospitalises dans 3 hopitaux de references de Kinshasa. Onze patients (22) avaient une symptomatologie digestive avec un syndrome diarrheique. La realisation des examens specialises a mis en evidence 2 cas d'infection digestive par des parasitoses opportunistes (4); une a Cryptosporidium sp. et une a Enterocytozoon bieneusi; premier cas decrit dans la litterature en RDC
Subject(s)
Humans , AIDS-Related Opportunistic Infections/epidemiology , Cryptosporidium , Enterocytozoon , Acquired Immunodeficiency Syndrome , HIV , MicrosporidiaABSTRACT
En Republique Democratique du Congo (RDC); comme dans de nombreux pays africains; le sida et son cortege d'infections opportunistes sont une cause majeure de morbidite et de mortalite. A Kinshasa; on estime entre 4 et 5le taux de prevalence de sujets infectes par le VIH; soit plus de 200 000 personnes (chiffres du Programme National de Lutte contre le Sida; PNLS 2005).A ce jour; faute de personnels formes et de moyens diagnostiques adaptes; aucune enquete n'a encore ete menee sur la prevalence des parasites opportunistes digestifs dans la population des patients infectes par leVIH; prealable indispensable a la mise en place d'une politique de soin adaptee. Une enquete preliminaire a ete realisee a Paris sur 50 echantillons de selles de 50 patients malades du sida; hospitalises dans 3 hopitaux de references de Kinshasa. Onze patients (22) avaient une symptomatologie digestive avec un syndrome diarrheique. La realisation des examens specialises a mis en evidence 2 cas d'infection digestive par des parasitoses opportunistes (4); une a Cryptosporidium sp. et une a Enterocytozoon bieneusi; premier cas decrit dans la litterature en RDC
Subject(s)
EnterocytozoonABSTRACT
Le milieu Dobell-Laidlow; mis au point en 1926 par les auteurs dont le nom; s'avere; du fait de sa simplicite; le plus efficace; pour l'isolement; l'entretien de longue duree; des souches d'Entomoeba histolytica; la production de l'antigene utilise dans les tests d'immunofluorescence indirecte pour le diagnostic de l'amibiase tissulaire; et les essais pharmacologiques des plantes medicinales presumees amoebicides. En operant la substitution du serum de cheval qui entre traditionnellement dans sa preparation par du serum de vache; animal plus familier; les auteurs ont facilite significativement la procedure de sa preparation. D'autre part; le succes obtenu dans les essais de culture de Trichomonas vaginilis; d'une part ; et celle de Trichomonas hominis; d'autre part; sur ce meme milieu; vient d'etendre le spectre des protozoaires susceptibles de pousser desus
