ABSTRACT
Histoplasmosis is a fungal infection due to Histoplasma capsulatum. The African form of this mycosis, caused by Histoplasma capsulatum var. duboisii, remains rare. We report a case of disseminated African histoplasmosis with skin, lymph nodes, bones and viscera localizations. The 22-year-old patient was HIV-seronegative and was considered immunocompetent. The presence of Histoplasma capsulatum var duboisii in ulcerations and a nodule pus aspiration was confirmed by direct microscopic examination and by culture. The medical treatment was based on fluconazole. Even though a regression of the symptoms was observed, the patient died. In disseminated African histoplasmosis, an early laboratory diagnosis must be carried out for accurate treatment.
Subject(s)
Histoplasma/isolation & purification , Histoplasmosis/microbiology , Burkina Faso , Female , Histoplasmosis/pathology , Humans , Young AdultABSTRACT
BACKGROUND: Burkina Faso achieved the leprosy elimination as a public health problem but this benefit was being lost. So, the National Program for Fighting against Leprosy has defined a strategy to reverse this situation. The aim of this survey was to evaluate the performance of the national program in the execution of this strategy in the region of "Hauts Bassins" (Burkina Faso) from 2005 to 2009. METHOD: The survey was led through the five sanitary districts of the region. It consisted in interview with the mean actors of leprosy control program and the analysis of the data notified on the leprosy cases, in order to estimate the progression of the key indicators of detection and follow-up care for patients having leprosy. RESULTS: During the survey period, 248 cases of leprosy were recorded including 236 new cases and 12 relapses. The prevalence of leprosy was 0.28 per 100 000 inhabitants in 2009. The detection rate decreased from 3.77 per 100 000 in 2005 to 2.75 per 100 000 in 2009. Among the 236 new cases of leprosy, 194 (82.2 %) were multibacillary form (MB). MB patients proportion increased from 69,3 % in 2005 to 91.1 % in 2009. The proportion of children was on average 3.8 %, the one of female cases 38.9 %. Newly diagnosed cases with grade 2 disabilities moved up from 21.4 % in 2005 to 42.2 % in 2009. The completion of cure rate was globally 88.26 %. The losts from follow-up among the patients who started multi-drug therapy were 7.14 %. CONCLUSION: The aim of the leprosy elimination as a public health problem is achieved but some challenges may be taken up, particularly in the organization of leprosy detection by the heath structures.
Subject(s)
Health Promotion/statistics & numerical data , Leprosy/prevention & control , National Health Programs/statistics & numerical data , Adolescent , Adult , Burkina Faso/epidemiology , Child , Clinical Competence , Disease Notification , Female , Health Promotion/economics , Health Promotion/organization & administration , Health Surveys , Humans , Leprostatic Agents/economics , Leprostatic Agents/supply & distribution , Leprostatic Agents/therapeutic use , Leprosy/diagnosis , Leprosy/drug therapy , Leprosy/economics , Leprosy/epidemiology , Leprosy, Multibacillary/diagnosis , Leprosy, Multibacillary/drug therapy , Leprosy, Multibacillary/economics , Leprosy, Multibacillary/epidemiology , Male , Middle Aged , Morbidity/trends , National Health Programs/economics , National Health Programs/organization & administration , Prevalence , Program Evaluation , Recurrence , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Leishmaniasis covers three well-individualized clinical variants, each due to individual species found in different geographic areas. Herein we report the first case of cutaneous leishmaniasis due to Leishmania major involving bone marrow in an AIDS patient in Burkina Faso. CASE REPORT: A 38-year-old HIV-positive man presented with generalized, copper-coloured, painless, infiltrated, itching, papulonodular lesions present over the previous 10 months. Skin biopsy confirmed the diagnosis of diffuse cutaneous leishmaniasis. The bone-marrow smear showed numerous leishmania. The culture was positive and L. major was identified. The patient was being treated with antiretroviral medication and a pentavalent antimonial compound. The disease progression consisted of attacks and remissions separated by an average of three weeks. DISCUSSION: L. major is the Leishmania species identified in Burkina Faso. It is responsible for typical cutaneous leishmaniasis but particular clinical forms have been described in immunodeficient patients, especially with diffuse cutaneous involvement. The spread of L. major infection to bone marrow could represent a public health problem in our country, where the HIV epidemic is still not under control, and particular vigilance is thus called for.
Subject(s)
Bone Marrow/parasitology , HIV Infections/complications , Leishmaniasis, Cutaneous/complications , Adult , Animals , Anti-HIV Agents/therapeutic use , Antiprotozoal Agents/therapeutic use , Burkina Faso , HIV Infections/drug therapy , HIV Infections/parasitology , Humans , Leishmania major/drug effects , Leishmania major/isolation & purification , Leishmaniasis, Cutaneous/drug therapy , Male , Treatment OutcomeSubject(s)
Schistosomiasis/diagnosis , Skin Diseases, Parasitic/diagnosis , Adolescent , Adult , Animals , Burkina Faso , Child , Female , Humans , Male , Middle Aged , Schistosoma/isolation & purification , Urine/parasitologyABSTRACT
Ce document presente les resultats d'une etude sur les hommes qui ont des rapports sexuels avec d'autres hommes (MSM) au Senegal.La sexualite des MSM; leur vulnerabilite aux IST/VIH; le role de la violence et du stigmate ainsi que le manque de services de sante sexuelle et d'information disponible pour couvrir leurs besoins specifiques; y sont decrit
