Evaluation of Malaria Microscopy Diagnostic Performance at 40 Public Health Facilities in Abidjan, Côte d'Ivoire in 2020.

PURPOSE: Microscopic diagnosis of Giemsa-stained thick and thin blood films remained the gold standard laboratory method for the diagnosis of malaria. In this context, we felt it was important to conduct this evaluation with 40 public medical biology laboratories (MBLs) in the Abidjan 1 health region that perform blood parasitology tests to improve their implementation process. METHODS: This descriptive and analytical study took place in July 2020 and involved participating laboratories (PLs) from the public sector in Abidjan. A set of 3 blood smear slides of variable parasite densities (PDs) with assigned values (AVs) of parasite densities and assigned Plasmodium species was used. The criterion for establishing the parasite density compliance interval was assigned values of ± 25%, and the performance rates were compared to the 80% recommended by the WHO for the African region. RESULTS: Nearly a quarter (11/40) of the participating laboratories had a compliance rate greater than 80%, including 10 with a performance of 100% for the ability to identify parasites. Regarding identifying plasmodial species, a concordance rate of 100% was obtained for slide 1 for Plasmodium falciparum, while this rate was 20% for slide 2 for Plasmodium ovale. For parasite densities < 200/µl, 87.5% of the participating laboratories (PLs) had a performance rate lower than 80%, while 95% of these PLs had a performance rate higher than 80% for parasitaemia > 2000/µl. CONCLUSIONS: There is a need to strengthen adapted to low parasitaemia, to improve the biological confirmation of malaria in Côte d'Ivoire.

Dermatophytosis and the associated risk factors among primary school children in southern and central Côte d'Ivoire.

BACKGROUND: Dermatophytosis, particularly the subtype tinea capitis, is common among African children; however, the risk factors associated with this condition are poorly understood. OBJECTIVES: This study aimed to determine the factors associated with tinea capitis and the prevalence rate of other dermatophytoses among primary school students in the rural and urban areas of the southern and central Côte d'Ivoire. PATIENTS AND METHODS: The study was carried out in seven towns of Côte d'Ivoire from October 2008 to July 2009, among 17,745 children aged 4-17 years and attending urban and rural primary schools; a complete physical examination of the skin and appendages, including nails and hair, was performed by the physicians. Direct microscopic examination using 30% potassium hydroxide solution and culture on Sabouraud's dextrose agar supplemented with 0.5 g/L chloramphenicol and 0.4 g/L actidione was performed during sampling. RESULTS: For the 17,745 children clinically examined, 2645 exhibited symptoms suggestive of tinea capitis. Positive cultures for dermatophytes were found in 2635 patients, and the overall prevalence rate of tinea capitis was 14.8%. The following factors, age, sex, pets at home, number of bathing daily, sharing of sponges, combs and towels and hair length, were statistically associated with tinea capitis (p < .001). In addition to tinea capitis, other superficial fungal infections were identified among these children. These included tinea corporis (0.9%), tinea unguium (0.6%) and pityriasis versicolor (0.4%). CONCLUSION: Tinea capitis is common among pupils in rural southern and central Côte d'Ivoire, especially in young boys.

Tinea capitis in schoolchildren in southern Ivory Coast.

OBJECTIVES: Fungal infections of the scalp commonly affect the pediatric population. These infections are caused by dermatophytes that are able to invade the keratinized structures of skin, hair, and nails. This study aimed to analyze the epidemiology of fungal scalp infections in southern Ivory Coast during 2008-2009. METHODS: From October 2008 to July 2009, 17,745 children ranging in age from 4-16 years, attending urban and rural primary schools in seven towns in Ivory Coast, were examined clinically for tinea capitis. Hair stumps and scales were collected from children who showed symptoms suggestive of scalp ringworm. Samples were exposed to direct microscopic examination using 30% potassium hydroxide solution and cultivation on Sabouraud's dextrose agar with or without actidione. RESULTS: Of the 17,745 children who were clinically examined, a total of 2645 exhibited symptoms suggestive of scalp ringworm. Positive cultures for fungi were found in 2458, yielding an overall prevalence of tinea capitis of 13.9%. The majority of infections occurred in males (74.0%). The most commonly affected age group involved children ranging from 9-12 years (n = 1335, 54.3%), followed by those in the range of 4-8 years (n = 936, 38.1%). Trichophyton soudanense, Microsporum langeronii, and Trichophyton mentagrophytes were the most prevalent etiologic agents (56.7%, 21.4% and 19.7%, respectively). Other species were occasionally isolated, including Trichophyton violaceum (1.4%) and Trichophyton rubrum (0.8%). CONCLUSIONS: Epidemiological surveys are an essential tool for developing strategies for infection control.