ABSTRACT
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
Control of malaria-related antenatal morbidity and prevention of fetal hypertrophy due to Plasmodium falciparum-induced chorionitis in endemic malaria depends mainly on weekly treatment with chloroquine insofar as that drug is still effective. The purpose of this study was to evaluate the efficacy of chloroquine drug prophylaxis in preventing fetal hypotrophy in the hyper-endemic environment of Kinshasa, Democratic Republic of Congo, where emergence of chloroquine-resistant P. falciparum strains is a current threat. Data concerning the mother, fetus, and placenta were collected from 59 parturients at Saint Marc's Maternity Hospital in Kingasani, which is one of the major health institution in the Democratic Republic of Congo. The confounding effect of parity, age, and placental weight was controlled using general linear model. Our results showed that regular chloroquine treatment did not lower the risk of chorionitis (Odds ratio = 2.0; CI95% = 0.4-11.6; p = 0.226) or its impact on birth weight. Findings after correction showed that mean birth weight was significantly lower (p = 0.011) with (2.724 +/- 89 g; 24 cases) than without (2.992 +/- 80 g; 32 cases) occurrence of chorionitis.
Subject(s)
Antimalarials/pharmacology , Chloroquine/pharmacology , Fetal Growth Retardation/etiology , Fetal Growth Retardation/prevention & control , Malaria, Falciparum/complications , Malaria, Falciparum/prevention & control , Plasmodium falciparum/drug effects , Adolescent , Adult , Age Factors , Animals , Drug Resistance , Embryonic and Fetal Development , Female , Humans , Infant, Newborn , Odds Ratio , Parity , Placenta/physiology , Plasmodium falciparum/pathogenicity , Pregnancy , Risk FactorsABSTRACT
Les auteurs ont effectue des captures des moustiques adultes dans les collectivites peripheriques de la zone de Ndjili (Kinshasa). Les resultats demontrent l'existence d'une cohabitation entre les Culicides et les anophelines. Dans ce dernier groupe; A. gambiae s.l. represente 99;2 pour cent de la population anophelienne. Les collectivites marecageuses et maraicheres abritent plus de moustiques que les autres. Les femelles sont moins nombreuses que les males (31;8 pour cent) mais les sex-ratios les plus importants observes dans les collectivites montrent la dynamique des femelles d'anopheles
Subject(s)
Anopheles , Ecology , Urban HealthABSTRACT
The objective of this study was to determine the relative importance of determinants of fever-episodes in an environment with perennial malaria transmission. In 6 neighbourhoods of Kinshasa with different degrees of urbanization, 120 clusters of children younger than 10 years were selected over a one year period and followed up for 2 weeks each. In the 4,816 children retained for analysis 906 fever episodes were registered, which corresponds to an average incidence rate of 4.9 episodes per child per year. Seven hundred (77.3%) of the fever cases had a positive thick film (IF) but of the 3,289 children with a positive TF only 21.3% presented fever during the observation period. Nevertheless, high parasite densities formed, without neglecting the role of other infectious etiologies, the mayor pathogenic mechanism associated with fever. The risk for a fever episode was, in multivariate analysis, 40 times higher in children with at least one positive TF than in children with a negative TF on both day 1 and day 14, and amongst the ones with a positive TF the risk was 3 times higher in children with a parasitemia above 3,000 trophozoites/microliter blood. The habitat constituted another important independent determinant: the relative risk for fever was 1.48 for non-urbanized neighbourhoods, which probably reflects the low malaria transmission in the urbanized ones, but 2.1 for semi-urbanized against peripheral neighbourhoods, where the parasite index is high. Low socio-economic status, the short dry season and young age formed, in this order, further factors to the take into account.
Subject(s)
Blood/parasitology , Fever/parasitology , Plasmodium/isolation & purification , Animals , Child , Child, Preschool , Cohort Studies , Democratic Republic of the Congo/epidemiology , Humans , Infant , Infant, Newborn , Malaria/epidemiology , Seasons , Urban Population , UrbanizationABSTRACT
Le present travail; dont l'objectif consiste a decrire l'evolution spontanee de la parasitemie au cours d'une infection a Plasmodium falciparum; a ete mene sur une sous-population d'enfants; ages de 0 a 10 ans vivant dans quelques quartiers de la ville de Kinshasa. Pour ce faire; un sous-echantillon de 3.194 enfants; soit 69;7 pour cent de l'effectif total qui a pu etre revu a deux occasions (jour 1 et jour 15); sans notion de medication; ni de manifestation morbide quelconque pouvant susciter la prise des medicaments durant la periode de l'etude; a ete analyse. Cinq profils d'evolution parasitemique ont ete identifies. Ces profils evolutifs decrits ne constituent somme toute qu'une vue fragmentaire des vagues parasitaires qui evoluent. Pour expliquer les faibles valeurs de parasitemies observees contrairement a ce qui est prevu par le modele de croissance geometrique; l'hypothese d'un controle immunologique de la parasitemie dont l'efficacite est variable selon l'environnement; l'age du sujet; le standing familial; la saison et la taille familiale; doit etre acceptee
Subject(s)
Infant , MalariaABSTRACT
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
Subject(s)
Entamoeba histolytica , Trichomonas vaginalisABSTRACT
In accordance with observations reported in the litterature concerning experimental african trypanosomiasis, highly significant correlations were found between any pair of the following parameters: duration of infection, parasitaemia, spleen volume, number of erythrocytes, or between the sharp decrease of the number of erythrocytes and the combines effect of the increase of all other parameters. In subacute T. gambiense infections in mice, it was statistically demonstrated that, in the absence of variation in numbers of erythrocytes, any correlation between the increase of spleen volume and of parasitaemia is repealed. This result suggests the existence of a clear interaction, in the course of the infection, between the development of splenomegaly and the drop of erythrocytaemia. However, it is not clear which one, of the erythrophagocytic activity or the hypertrophy of the spleen is the cause of the other. The influence of splenectomy was studied, assuming that the anaemic syndrome was due to augmentation of the phagocytic activity. However, the suppression on that occasion of the erythrocytic and immunological activities of this important organ, did not produce any improvement in the course of the disease or a prolongation of the survival time of the infected animals. In rodents, the functions of production and of removal of erythrocytes are indeed performed by the same organ, so that no conclusions can be drawn from the splenectomy. We also wondered whether the sequestration and destruction of red cells sensitized by the parasitic antigen could not be extended to immature cells of the erythroblastic line present in the bone marrow (and also in the spleen, in rodents), if, as could be assumed, these cells are coated "in situ" by the soluble antigens actively concentrated by these major effector organs of the reticuloendothelial system.
