Onychomycosis: experience of the laboratory of parasitology-mycology of CHU-Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar.

INTRODUCTION: onychomycosis is defined as a fungal infection of the nails. They represent the main cause of onychopathy. They constitute a public health problem because of their increased prevalence in the world ranging between 20 to 30%. However, they remain under documented in Madagascar. This study was conducted in order to determine the mycological profile of onychomycosis diagnosed in the Parasitology Mycology laboratory of CHU-JRA. METHODS: a descriptive retrospective study was taken over a 13-year period from June 2005 to December 2018. The data presenting onychomycosis on the mycological outcome register were included in the study. Results showing the presence of fungi on direct examination and / or culture were considered positive. RESULTS: during the study period, a prevalence of 17.75% (180/1014) was observed. The age of our patients ranged from 3 to 76 years. Women were the most affected in 68.34% (n = 123) with a sex ratio of 0.46. Onychomycosis was localized in 64.65% of the fingers (n = 128). Simultaneous involvement of the hands and feet was found in 10% of the cases (n = 18). Candida albicans (C. albicans) was the most isolated in 33.03% (n = 71) of cases, followed by other species of Candida (24.65%, n = 53) and Trichophyton spp (9.3%, n=17). Mixed infections associating dermatophytes, Yeasts and molds were found in 23.33% (n = 42) of the cases. CONCLUSION: this is the first investigation dealing with onychomycosis in Madagascar. These data may be useful for future research and in the development of preventive and educational strategies.

Dermatophyte infection caused by Nannizzia gypsea: A rare case report from Madagascar.

We report a rare case of dermatophyte infection of the glabrous skin (Tinea corporis) caused by Nannizzia gypsea (formerly Microsporum gypseum). A 22-year-old Malagasy female who reported close contact reportedly with cats, presented a single round lesion with a peripheral, active, squamous and pruriginous inflammatory bead. Morphologic species identification was confirmed by sequencing the internal transcribed spacer (ITS) region of the genome. Specific treatment with oral loratadine and topical miconazole cream was effective.

[Seroprevalence of cysticercosis and associated risk factors in a group of patients examined at the Regional Referral Hospital in Antsirabe]. / Séroprévalence de la cysticercose et facteurs de risque associés chez un groupe de patients vus au Centre Hospitalier Régional de Référence d'Antsirabe, Madagascar.

INTRODUCTION: In Madagascar, cysticercosis, a disease caused by Taenia Solium's larval form, is a public health problem. In 2003, the seroprevalence of cysticercosis ranged between 7% and 21% with a higher rate in the central regions of the island. However, epidemiological data on human cysticercosis have been limited over the last dozen years. The objective of our study aimed to determine the seroprevalence of cysticercosis Western blot as well as its associated risk factors in patients from the region of Vakinankaratra with clinical suspicion. METHODS: We conducted a cross-sectional, descriptive study at the Regional Referral Hospital in Antsirabe over a period of 6 months. All the patients included in the study answered a clinic questionnaire collecting their socio-demographic and cultural features as well as their dietary habits and their clinical symptoms. RESULTS: The seroprevalence of cysticercosis in the study population was 14.8% (35/237). These rates did not differ significantly according to sex, age, pork consumption or meat preparation (p > 0.05). However, a significant difference (p < 0.05) was observed among patients with subcutaneous nodules or positive for cysticercosis. CONCLUSION: In our study, the high index of exposure to Taenia solium justifies the strengthening of control and prevention measures already set up in our country.

Current practice about the evaluation of antibody to streptolysin O (ASO) levels by physicians working in Antananarivo, Madagascar.

INTRODUCTION: The diagnosis of post streptococcal diseases is usually confirmed by immunological tests. Only the antistreptolysin O is usually prescribed by physician. This study aimed to describe the current practice of these requests in Antananarivo. METHODS: It was a retrospective and descriptive study conducted at the Para clinic Unit of Immunology at the University Center Hospital of Antananarivo. We analyzed all requests during seven years, from January 2003 to December 2009. We looked at age, gender, and clinical symptoms which led to the request and the result for each request. RESULTS: We retained 4143 requests for antistreptolysin O titration in our study. The mean age of the study participants was 32.9 years with 18.3% of participants being less than 15 years old. The main symptoms leading to the request of this analysis were rheumatologic (41%), followed by neurological (13.9%) and cardiologic symptoms (8.5%) and 19.4% were prescribed for various symptoms. Only 15% of all requests had a value more than 200 U/ml. CONCLUSION: Our study found that in most of requests, ASO titre levels were not significant.

Evaluation of methicillin-resistant Staphylococcus aureus nasal carriage in Malagasy patients.

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of infections. It is well recognized that nasal carriage of S. aureus represents a potent and increasingly prevalent risk factor for subsequent S. aureus infection. However, in Madagascar no data exist concerning this nasal carriage of S. aureus. METHODOLOGY: Nasal swabs from 304 different patients attending the Laboratory of Training and Research in Medical Biology of Madagascar were cultured for methicillin sensitive (MSSA) and MRSA. RESULTS: One hundred and sixteen patients had S. aureus in their noses (38.16 ± 5.46%) of whom 45 (14.80 ± 3.99%) had MRSA.  A risk factor for MSSA nasal carriage included a history of hospitalization when antibiotics were administered (odds ratio [OR] 2.25, 1.09 - 4.64). Among MRSA nasal isolates, high rate of resistance to other antibiotics was observed, particularly for trimethoprim-sulfamethoxazole (68.89%), erythromycin (66.67%) and ofloxacin (53.33%). CONCLUSIONS: Our data showed a high rate of MRSA nasal carriage and a high rate of multidrug resistance. A strategic policy against the spread of multidrug resistant strains is desirable.