[Retrospective study of cutaneous leishmaniasis in the district hospital of Am Timan, Chad]. / Étude rétrospective de la leishmaniose cutanée à l'hôpital de district d'Am Timan, Tchad.

Cutaneous leishmaniasis is not included in the statistical yearbook of Health of the Ministry of Public Health. The aim of our study was to describe the epidemiological profile of cases of cutaneous leishmaniasis attended at the District Hospital of Am Timan in order to assess the importance and the prevalence of this neglected disease. This is a retrospective study of cases reported in the records of the Laboratory of the Hospital District of Am Timan between January 2008 and December 2012. It allowed the identification of 680 clinical cases. Direct microscopic diagnosis was positive in 580 cases (85%). The number of cases has been increasing from 2008 to 2010 (2008 = 80 cases, 123 cases in 2009; 2010 = 198 cases) before decreasing during the following year (2011 = 137 cases and in 2012 = 42 cases). The months of strong incidence of the cases were June, July, August and September. The M/F sex-ratio was 1.7.

[Effect of 2 vaccination strategies on developments during the epidemic of meningococcal A meningitis in N'Djamena (Chad) in 1988]. / Effet de deux stratégies de vaccination sur l'évolution de l'épidémie de ménigite à méningocoque A survenue à N'Djamena (Tchad) en 1988.

From February till May 1988, during an epidemic of group-A meningococcal disease, 4542 cases of meningitis were reported in N'Djamena, the capital of Chad (550,000 inhabitants). A first selective vaccination campaign was carried out between 5 and 14 March; 156,500 vaccine doses (polyvalent: group A and C: Institut Mérieux) were given using jet injectors. The target population for this first campaign consisted of groups such as school-children and the armed forces. As the epidemic continued, a mass vaccination campaign was implemented one month later between 8 and 14 April 1988; this was targeted at the whole population above 1 year of age, not previously immunized, and 266,738 doses of vaccine were injected. One week after the start of the second campaign, the number of reported cases fell sharply and, within four weeks, the epidemic was halted. The vaccination coverage rate, evaluated by a WHO cluster survey method in people above one year of age, was 95.5%. These results show (i) the failure of selective vaccination, restricted to only at-risk groups, to halt the epidemic; (ii) the efficacy of the mass vaccination campaign aimed at the whole population; and (iii) the feasibility in tropical Africa of such a mass campaign which must be carried out in a few days.

[Comparative study of 3 bacteriological tests of cerebrospinal meningitis during the epidemiological period]. / Etude comparative de trois examens bactériologiques de la méningite cérébrospinale en période épidémique.

During an outbreak of group A meningococcal meningitis in Chad in 1988, a comparative study of three bacteriological techniques (direct microscopic examination, latex agglutination, and culture) was conducted with 120 samples of cerebrospinal fluid (CSF) for diagnosis. The results correlated well with cloudy or purulent CSF specimens. Direct microscopic examination was as good a diagnostic indicator as the other tests. The authors recommend using direct microscopic examination, which is easy to perform under field conditions and accurate enough for a rapid diagnosis of cerebrospinal meningitis during an epidemic. However, complete identification of the first cases in the epidemic is important in order to establish control measures as soon as possible.

[Reliability of the diagnosis of cerebrospinal meningitis during an epidemic. The epidemic in Chad in 1988]. / Fiabilité du diagnostic de méningite cérébrospinale en période épidémique. A propos de l'épidémie du Tchad en 1988.

The authors analysed the positive predictive value (PPV) of the clinical diagnosis during an epidemic of meningococcal meningitidis in Africa. This PPV was globally 73.3 +/- 11.2%. This PPV was fluctuating according to the standards of the diagnosis. Typical clinical meningitic syndrome without spinal picture: 85.7 +/- 10.3%, Non typical syndrome and macroscopical aspect of cerebrospinal fluid: 62.5 +/- 16.4%.