Estimation of the burden of flu-association influenza-like illness visits on total clinic visits through the sentinel influenza monitoring system in Senegal during the 2013-2015 influenza seasons.

Knowing the burden of influenza is helpful for policy decisions. Here we estimated the contribution of influenza-like illness (ILI) visits associated with laboratory-confirmed influenza among all clinic visits in a Senegal sentinel network. ILI data from ten sentinel sites were collected from January 2013 to December 2015. ILI was defined as an axillary measured fever of more than 37.5 °C with a cough or a sore throat. Collected nasopharyngeal swabs were tested for influenza viruses by rRT-PCR. Influenza-associated ILI was defined as ILI with laboratory-confirmed influenza. For the influenza disease burden estimation, we used all-case outpatient visits during the study period who sought care at selected sites. Of 4030 ILI outpatients tested, 1022 were influenza positive. The estimated proportional contribution of influenza-associated ILI was, per 100 outpatients, 1.2 (95% CI 1.1-1.3), 0.32 (95% CI 0.28-0.35), 1.11 (95% CI 1.05-1.16) during 2013, 2014, 2015, respectively. The age-specific outpatient visits proportions of influenza-associated ILI were higher among children under 5 years (0.68%, 95% CI: 0.62-0.70). The predominant virus during years 2013 and 2015 was influenza B while A/H3N2 subtype was predominant during 2014. Influenza viruses cause a substantial burden of outpatient visits particularly among children under 5 of age in Senegal and highlight the need of vaccination in risk groups.

[The "Health system delay" in tuberculosis patients in Saint-Louis Senegal]. / Évaluation du "health system delay" chez les patients tuberculeux à Saint-Louis du Sénégal.

Sixty patients with positive acid fast bacilli sputum smears between were enrolled consecutively between March and August 2012 in the Saint-Louis (Senegal) health district to determine the Health System Delay in response to tuberculosis. The length of time between the first consultation of a TB patient and the start of treatment was, on average, 8.1 days and is among the shortest in the literature. This promptness reduces the risk of infection related to delayed care. This is one of the focuses of the National Programme of Fight against nosocomial infections in Senegal (PRONALIN), as well as the implementation of environmental procedures and the use of masks and respiratory protection equipment.

Exploring suppression subtractive hybridization (SSH) for discriminating Lactococcus lactis ssp. cremoris SK11 and ATCC 19257 in mixed culture based on the expression of strain-specific genes.

AIM: An approach based on quantitative reverse transcriptase PCR (RT-qPCR) was developed for monitoring two strains of lactococci in co-culture in milk by measuring the expression of specific genes identified by suppression subtractive hybridization (SSH). METHODS AND RESULTS: SSH was used to identify strain-specific genes of Lactococcus lactis ssp. cremoris SK11 and ATCC 19257. RT-qPCR was then employed to validate gene specificity and compare the expression of selected specific genes (glycosyltransferase and amidase genes for L. lactis ssp. cremoris ATCC 19257 and a hypothetical protein for SK11) identified by SSH. The time profile of changes in gene expression relative to ldh transcription differed between pure and mixed cultures as well as between media. At the stationary phase, gene expression of mixed cultures in GM17 attained the highest proportion of ldh transcription while mixed cultures in milk peaked at the postexponential phase. Strain ratios expressed as RNA proportion appear to favour SK11 in GM17 medium, while ATCC 19257 dominated in milk co-cultures. CONCLUSIONS: This approach was useful to determine the contribution of strain SK11 in relation to strain ATCC 19257 during co-culture in milk compared to rich medium. SIGNIFICANCE AND IMPACT OF THE STUDY: The ability to track the metabolic contribution of each lactococcal strain during fermentation of milk or cheese ripening will extend our understanding of the impact of process parameters on the production performance of strains.

[Description of the first cases of serotype A, sequence type (ST)-11 meningococcal meningitis in Senegal]. / A propos des premiers cas sénegalais de méningite à méningocoques W135 de séquence type (ST)-11.

Senegal is located in the African meningitis belt and meningococcal meniningitis outbreaks are yearly events. Occurrence of an epidemic involving serogroup W135 in 2000 and its spread following the Hajj (pilgrimage to Mecca) exposed the strongly Moslem population of Senegal to the risk of early infection. Indeed the first two cases in Dakar occurred simultaneously with the spread of this epidemic strain. The purpose of this article is to describe clinical, laboratory, and therapeutic findings in these two cases and the results of the ensuing epidemiological survey. The relationship with the pilgrimage and consequences on public health in Senegal are discussed.

[T-cell lymphoma-leukemia caused by HTLV-1 in adults: two lymphomatous forms]. / Leucémie-lymphome à cellules T de l'adulte due au HTLV-1: à propos de deux formes lymphomateuses.

The adult T-cells lymphoma-leukemia is a serious complication by the HTLV-1 infection. It is a rarely described diseases in Africa, in spite of the frequency of the infection by this virus. We report two clinical observations of lymphomatous forms. The first observation concerned a 43 year old Senegalese woman, admitted for a deep alteration of her general status and peripheral polyadenopathies. The adenopathy biopsy set up the diagnosis of pleiomorph T lymphoma with great and medium cells. The HTLV-1 serology was positive. She had benefited of six polychemotherapy cures (cyclophosphamide, farmarubicine, oncovin, prednisone) within which she died in a cachectic presentation. The second observation concerned a 44 year old Senegalese man, admitted for peripheral polyadenopathies, ulcerated lesions of sole of the foot, and deep alteration of the general status. He presented a moderate hypercalcemia by 117 mg/l. The histological examination of a ganglionar biopsy concluded to a diffuse T lymphoma with great cells. The HTLV-1 serology was positive. The cutaneous lesions were due to a phaeohyphomycosis of Exophiala jeanselmei. The symptomatic therapeutic measures had been applied and he died within four weeks in a septicemic clinical manifestation. The adult T-cells lymphoma leukemia due to the HTLV-1 ought to be researched before any lymphomatous and leucemic manifestation by T-cells through a serological research. The prognostic stays very bad.

[Infectious etiology of dysenteric syndromes at the Principal Hospital of Dakar in 1999 and 2000]. / Etiologies infectieuses des syndromes dysentériques à l'Hôpital Principal de Dakar en 1999 et 2000.

Dysenteric syndromes are relatively frequent in tropical areas, due essentially to infectious etiologies, constituted by flimsy pathogenic agents outside and possibilities of laboratory investigations little available. The authors evaluated during two years (1990-2000) the results of 399 parasitological examinations and 419 bacteriological examinations concerning dysenteric syndromes admitted to the laboratory of "Hopital Principal de Dakar". The objective of these examination is to contribute to the management of cases. The patients are divided into two groups: the first group is constituted by children less than two years old hospitalised in the pediatric services, and the second group includes all the other patients. The parasitological studies schow that parasitic etiologies are almost non existent in the first group while in the second group, they are essentially represented by Entamoeba histolytic with 19.5% of prevalence. The bacteriological studies show 42.7% of positivity rate in the first group and 19.5% in the second group with a predominance of E. coli and Shigella dysenteriae. The prevalence or pathogenic agents associations is not neglectable: they represent 8% or positive results with a predominance of amoeba-Shigella association. These results confirm the necessity of a best case management during the preanalytic phase in order to improve the scores of positivity and the particularities of hospitalised children les than two years old, to when the frequency of observed cases is high with bacteriological etiologies essentially (E. coli EPEC+, Nosocomial bacteria).

[Adult T-cell leukemia-lymphoma due to HTLV 1. Two cases of the acute form at the Principal Hospital of Dakar]. / La leucémie-lymphome à cellules T de l'adulte liée au virus HTLV1. Apropos de 2 observations de formes aiguës à l'Hôpital Principal de Dakar.

HTLV1 virus is a retrovirus that has been endemic in Africa. It is the responsible for tropical spastic paraparesis and adult's T Cell leukemia-lymphoma. Few cases of adult T-Cell leukemia-lymphoma have been described in Africa, contrary to Japan and Caribbean. Were are reporting two cases of acute adult T-Cell leukemia-lymphoma which characterised by blood lymphoma signs, tumoral nodes and extranods lesions, hypercalcemia and positive retroviral serology of HTLV1 virus. The prognosis of these acute forms was bad after a six month survey approximately. The treatment is disappointing. Investigations of this affection must be carried out in every patient who presents lymphoma manifestations all the more because they are associated with hypercalcemia.

[Contribution of molecular biology to biotyping in epidemiological surveys of nosocomial infectious outbreaks]. / Apport de la biologie moléculaire et de la biotypie dans l'enquête épidémiologique au cours des épidémies d'infections nosocomiales.

During the period between the end of 1993 and the beginning of 1994 there was a large epidemic rush from severe nosocomial infection essentially in the form of septicemia. Authors implemented a classification of these epidemics and some strains were sent to the Institute Pasteur Paris for a further examination. These strains went under nuclear biology test (study of DNA plasmidic profiles and RNA ribosomal profiles) and passed through an identification by an acheiring biotypic system using 99 sources or carbones--biotype 99. These studies have shown that its about real epidemic, because the same strains were transmitted from one patient to another. This show the precarious condition of our hospital hygiene, involving the necessity of an efficient training of our health staff.

[Broad-spectrum beta-lactamases: profile and perspectives after 3 years of systematic detection at the Main Hospital of Dakar (1 February 1992 to 1 February 1995)]. / Beta lactamases à spectre élargi: bilan et perspectives après trois ans de détection systématique à l'Hôpital Principal de Dakar (1er Février 1992-1er Février 1995).

After having undertaken an estimation upon infections from bacteria generating extended broad spectrum Beta-lactamase at "Hospital Principal" of Dakar between 1992 to 1993 and after having drawn the attention of authorities of the Hospital to the hazard caused by this sort of infections, authors come back in doing a second estimation during the two following years. The results of this estimation show that measures preciously taken, not with standing an certain impact, are clearly unsufficient and have got a limited effect in the future. They suggest practical solutions in the long run, solutions that have already been taken at "Hospital Principal" of Dakar and deserve to be kept on and encouraged.

[Five cases of non-typhoid salmonellosis in patients infected with the human immunodeficiency virus in Senegal]. / A propos de cinq cas de salmonelloses non typhiques au cours de l'infection par le virus de l'immunodéficience humaine au Sénégal.

Among the opportunistic infections observed during infection with human immunodeficiency virus, recurrent non-typhoid salmonella bacteriemia has not been widely documented in Black Africa. This retrospective study identified 5 cases of non-typhoid salmonellosis in a series of 27 seropositive patients, i.e. 18.5%, hospitalized over a two-year period in an internal medicine department in Senegal. All 27 patients presented general or digestive manifestations and were in the stage of full-blown AIDS. The diagnosis was salmonella septicemia in 60% of cases. The incidence of salmonella is higher in immunocompromised patients than in healthy subjects, particularly in Africa. These infections frequently lead to bacteriemia, have a strong tendency to recur, and are highly indicative of immunodeficiency. Salmonellosis which is curable should be suspected in seropositive African patients presenting general and/or digestive manifestations.

[Chlamydia trachomatis in a urogenital practice: 435 specimens collected at a Senegalese hospital]. / Chlamydia trachomatis et sphère uro-génitale: a propos de 435 prélèvement effectués en milieu hospitalier sénégalais.

Between March 1993 and April 1994, tests to detect Chlamydia trachomatis were performed by direct immunofluorescence on genital discharges from 99 men and 336 women at the Medical Biology Laboratory of Principal Hospital in Dakar, Senegal. Chlamadyial infection was demonstrated in 30 men (30.3%) and 31 women (9.2%). Working women who tested positive for Chlamydia trachomatis were significantly older than those who tested negative (p < 0.05). The opposite was true for working men (p < 0.05). The incidence of positive findings was significantly higher in students (20.5%) than in non-students (10.7%) (p < 0.05). From a clinical standpoint urethral discharge was noted in only 24% of infected men whereas vaginal discharge was present in 96% of infected women. For most infected women the motive for consultation was infertility. The findings of this study attest to the prevalence of Chlamydial infection in the population studied and underline the need for further study to determine its role in the etiology of infertility.

[Ocular hypertension after intra-capsular cataract extraction]. / Hypertonie oculaire après extraction intra-capsulaire de la cataracte.

During 20 months, 593 intracapsular cataract extractions have been studied, the authors founded 10 cases of ocular hypertension representing 1.68%. These eyes did not present any ocular pathology before and the intraocular pressure was normal before the operation. Among the 10 cases, 4 developed pupillary block. In 7 cases, the intraocular pressure was normalized within one month by local and general low pressure treatment, while 3 cases developed persistent ocular hypertension. The authors preconise to have a low pressure by premedication before surgery and to survey every day the intraocular pressure after intracapsular cataract extraction to prevent irreversible modifications of the optic nerve.

[Pupillary blockage after intracapsular cataract extraction in the adult apropos of 4 cases]. / Le blocage pupillaire apres extraction intra capsulaire de la cataracte chez l'adulte à propos de 4 cas.

Intra capsular extraction is the most employed surgical technics for the treatment of senile cataract in developing countries. Nevertheless complications are usual, among them the pupillary block. The authors notified in 365 intra capsular cataract extractions, executed during 8 months, 4 cases of pupillary block occurred after operation without incident. The 3 cases had favorable evolution after an average of 4 days with medical treatment. 1 case had unfavorable evolution to aphakic glaucoma in spite of medical and surgical treatment. They point out in the necessity of strict post operative supervision and early treatment.

Evolution des resistances aux antibiotiques: comparaison des principaux germes isoles de pus en 1989 et 1992 a l'Hopital Principal de Dakar

Le controle de l'apparition et de l'extension des resistances des germes aux antibiotiques est un imperatif pour les laboratoires de bacteriologie hospitaliers. Afin d'etablir les bases de donnees utiles et d'initier une surveillance; le Laboratoire de Biologie de l'Hopital Principal de Dakar a compare les niveaux de resistance des principaux germes isoles de pus d'hospitalises en 1989 et 1992. Les auteurs montrent un accroissement des resistances aux molecules utilisees depuis longtemps et expriment leurs craintes vis-a-vis de l'utilisation inadequate d'antibiotiques recemment introduits

[A trial of polychemotherapy of leprosy in the Dakar region. Initial observations on the acceptability of the protocols used]. / Présentation d'un essai de polychimiothérapie de la lèpre dans la région de Dakar. Premières observations sur l'acceptabilité des protocoles utilisés.

Since 1982, in Dakar, a controlled essay tests the suitability of several short protocols of multidrug therapy (MDT), some of them being close to those advised by the WHO, others showing a starter stage of a two month daily MDT. In three years, 198 paucibacillary and 123 multibacillary patients have been treated. The short duration of these treatments leads to an important decrease in the load of the Department. The total rate of those who have not attended for the treatment is of 15.2% whereas it was of 52% with DDS monotherapy for a similar treatment duration. Those who gave up don't seem to live in Dakar. To judge by the diligence of the patients, the compliance seems excellent even for the protocols requiring a daily dose of ethionamide: 95% of paucibacillary, 76% of multibacillary patients have maximal attendance. The authors think that any MDT program: must be preceded by a retraining of staffs; must give a priority to the health education of the patients; must involve a home patient search for system.

[HLA and leprosy in Dakar: distribution of histocompatibility antigens in leprous patients and their relationship to ENL reactions]. / HLA et lèpre à Dakar: répartition des antigènes d'histocompatibilité chez le lépromateux et relation avec les réactions ENL.

50 lepromatous patients among whom 34 shared repeating ENL reactions and a reference group of 150 blood donors were typed for HLA antigens. In the comparison of the lepromatous group to the reference group, the HLA-B 8 was the only antigen which turned out to be significantly increased within the lepromatous patients. Some changes reported by other authors have also been pointed out (decrease in HLA-A2 and HLA-A3, increase in HLA-AW 23 within the lepromatous patients) but those are not significant in this study. In the lepromatous group itself, not any significant change has been pointed out between the patients sharing ENL and those who did not show any. Nevertheless a non-significant increase in HLA-BW 35 in the patients with ENL is to be pointed out.