Attitudes discriminatoires du professionnel de sante vis-a-vis des personnes vivant avec le virus de l'immunodeficience humaine a Antananarivo

Introduction. L'acces aux soins des personnes vivant avec le VIH (PVVIH) a Madagascar demeure tres faible. Cette situation peut etre aggravee par l'existence des attitudes de discrimination et de stigmatisation de la part de certains personnels de sante. Cette etude se propose d'identifier les facteurs pouvant influer sur les attitudes des professionnels de sante vis-a-vis des PVVIH. Methode. Cette etude retrospective a visee analytique; a ete menee durant le mois d'octobre 2010. Elle a utilise des questionnaires pre-testes pour interviewer les personnels de sante dans les formations sanitaires publiques et privees a Antananarivo. Resultats. Au total; 65;7avec IC95[59;5- 71;1] du personnel de sante au niveau du Service Sanitaire du District d'Antananarivo Renivohitra sont discriminants vis a vis des PVVIH. L'attitude discriminatoire est correlee significativement avec un age eleve (p0;04); le genre feminin (p0;006) et le fait d'appartenir a la categorie des paramedicaux (p0;005). Cette attitude est sous tendue par la peur d'etre infecte par le VIH consequence d'une insuffisance des connaissances des modes de transmission du VIH; de la perception de l'infection a VIH a un groupe particulier. Le role de la formation dans les changements des attitudes depend essentiellement de son contenu. L'ignorance des droits des patients participe significativement a ces attitudes discriminatoires (70;5versus 43;6). Conclusion. Les attitudes discriminatoires sont multifactorielles. Ainsi; c'est le renforcement des connaissances du personnel soignant associe au contact humain effectif avec les personnes vivant avec le virus de l'immunodeficience humaine qui pourrait ameliorer significativement cette attitude dans le respect du droit des patients

[Thyroid cancers in Madagascar]. / Les cancers de la thyroïde à Madagascar.

This is a retrospective study, conducted on thyroid cancer observed for 13 months (from June 1(st) 2004 to June 30(th) 2005). Data were collected from four main surgical pathology laboratories in Antananarivo, Madagascar. Among 6,036 surgical samples, 179 were of thyroid gland, a rate that is near 3% of the total. Among them were found 40 cases of thyroid cancer, which is 0.66% of all screened samples, and 22.32% of all examined thyroid samples. In the studied population was observed a female preponderance (82%) with a mean age of 43.9 years when diagnosis was confirmed. It was evidenced a 50 % of papillary carcinoma and 45% of follicular carcinoma, with a rate of 2.5% respectively for the medullar and anaplastic carcinoma. Metastases were seen in 20%, originated from papillary type for the lymph node involvement and from the follicular type for the bone involvement. In Antananarivo, thyroid cancer is seen mainly in people from the surrounding Highlands, supposed to be sites of endemic goiter related to iodine deficiency. Despite its limits, this study may be used as reference about thyroid cancer in Madagascar. Further studies are required to find out other factors involved in the development of this disease.

[Diagnosis of neurocysticercosis: a case report]. / Diagnostic de la neurocysticercose: à propos d'un cas.

Neurocysticercosis is the most frequent parasitosis of central nervous system in the world. Neurological manifestations are in relation with locations number and topography, inflammatory reactions level and state of development of the parasite. Epilepsy is the main revealing symptom. Among other neurological manifestations, chronic headache, focal neurological signs, ataxia, language and behaviour disorder are the most anecdotal. The authors report a case of neurocysticercosis in a 71-year-old man with dysarthria and memory problems. Suspected by computed tomography, diagnosis was confirmed by immunoserologic assays such as enzyme-linked immunosorbent assay (ELISA) or enzyme-linked immunoelectrotransfer blot assay (EITB). This later emphasized on active form of the cyst. Specific treatment used albendazole as antihelminthic drug. Clinical evolution was good: neuroimaging and immunoserology results were normal respectively 2 and 6 months after the drug therapy.

[Trichobezoars, a little known clinical entity]. / Le trichobézoard, une entité clinique peu courante.

A voluminous trichobezoar was discovered in an 11-year-old girl without major clinical implications. The diagnosis was made by endoscopy and surgery was performed without complications.

Le trichobezoard; une entite clinique peu courante

"Trichobezoar : a case report"" : A voluminous trichobezoar was discovered in an 11-year-old girl without major clinical implications. The diagnosis was made by endoscopy and surgery was performed without complications."