ABSTRACT
BACKGROUND: Diagnosis of malaria in pregnancy is problematic due to the low sensitivity of conventional diagnostic tests (rapid diagnostic test and microscopy), which is exacerbated due to low peripheral parasite densities, and lack of clinical symptoms. In this study, six potential biomarkers to support malaria diagnosis in pregnancy were evaluated. METHODS: Blood samples were collected from pregnant women at antenatal clinic visits and at delivery. Microscopy and real-time PCR were performed for malaria diagnosis and biomarker analyses were performed by ELISA (interleukin 10, IL-10; tumor necrosis factor-α, TNF-α; soluble tumor necrosis factor receptor II, sTNF-RII; soluble fms-like tyrosine kinase 1, sFlt-1; leptin and apolipoprotein B, Apo-B). A placental biopsy was collected at delivery to determine placental malaria. RESULTS: IL-10 and sTNF-RII were significantly higher at all time-points in malaria-infected women (p < 0.001). Both markers were also positively associated with parasite density (p < 0.001 and p = 0.003 for IL-10 and sTNF-RII respectively). IL-10 levels at delivery, but not during pregnancy, were negatively associated with birth weight. A prediction model was created using IL-10 and sTNF-RII cut-off points. For primigravidae the model had a sensitivity of 88.9% (95%CI 45.7-98.7%) and specificity of 83.3% (95% CI 57.1-94.9%) for diagnosing malaria during pregnancy. For secundi- and multigravidae the sensitivity (81.8% and 56.5% respectively) was lower, while specificity (100.0% and 94.3% respectively) was relatively high. Sub-microscopic infections were detected in 2 out of 3 secundi- and 5 out of 12 multigravidae. CONCLUSIONS: The combination of biomarkers IL-10 and sTNF-RII have the potential to support malaria diagnosis in pregnancy. Additional markers may be needed to increase sensitivity and specificity, this is of particular importance in populations with sub-microscopic infections or in whom other inflammatory diseases are prevalent.
ABSTRACT
During May and June 1997, we conducted a rapid survey on leprosy prevalence in 30 villages. It was to assess reaching of the leprosy elimination threshold (one case per 10,000 inhabitants) in Burkina Faso. We drew lots for the villages in ten provinces among which five had the highest prevalence rates of leprosy in 1996 and five had the lowest prevalence rates. We added a leprosy elimination monitoring to the survey. This monitoring consisted of visits to the health centers covering the 30 villages. We interviewed and clinically examined 33 cases of leprosy in treatment in those health centers. We found fifty-one patients of leprosy in visited villages. The prevalence rate of leprosy (6.74 per 10,000 inhabitants) was twice higher than the prevalence rate registered in the same villages. We detected 28 new cases of leprosy during the survey. Proportion of hidden cases of leprosy were 54.9%. We estimated geographical coverage of MDT at 75% in the 10 provinces. Eight of the 27 visited health centers (29.6%) did not get sufficient supply. The cure rate has fallen from 93 to 73 per cent between 1992 and 1997. Our results show that leprosy elimination threshold is not reached in Burkina Faso. Leprosy control activities that were declining during the last five years need to be reinforced.
Subject(s)
Communicable Disease Control/organization & administration , Endemic Diseases/prevention & control , Endemic Diseases/statistics & numerical data , Leprosy/epidemiology , Leprosy/prevention & control , Adolescent , Adult , Aged , Burkina Faso/epidemiology , Child , Female , Humans , Male , Middle Aged , Population Surveillance , Prevalence , Program Evaluation , Residence Characteristics , Surveys and QuestionnairesABSTRACT
This study is a contribution to a best knowledge of mycosis in Burkina Faso where the data concerning these diseases are very old. It has been focused on the clinical and mycological features of the dermoskeloton mycosis through the consultations at the two offices of dermatology in the city of Ouagadougou. From April to October, 1990, 216 patients have been taken census of, and they have shown 265 lesions among which 143 mycosis of the skinfolds (54 p. cent), 45 onychomycosis (17 p. cent), 29 palmoplantar mycosis (11 p. cent), 24 mycosis of the glabrous skin (9 p. cent) and 24 mycosis of the scalp (9 p. cent). From these 265 lesions we have isolated 156 strains of dermatophytes and 108 strains of candida. The species which have been seen more frequently are Candida albicans (30 p. cent), Trichophyton rubrum (19 p. cent), Trichophyton soudanense (13 p. cent) and Trichophyton tonsurans (8 p. cent). This study has enabled the identification of some clinical features and some responsible agents of the dermatoskeloton mycosis in Ouagadougou. It will lay the foundation for further specific studies in the country.
