[Chromoblastomycosis in Gabon. Study of 64 cases]. / La chromoblastomycose au Gabon. Etude de 64 cas.

During the last 25 years, 64 cases of chromoblastomycosis were diagnosed in Gabon. They came from the entire territory, where living in rural zones men as well as women were affected. The evolution of the disease has lasted for more than 10 years for the majority of the cases. The preferential location is the lower limb for 78.5% of the patients, with a double localization for one case and an exceptional malignant transformation for another case. Two clinical aspects emerged, despite an apparent polymorphism: extensive patches and warty nodules, spread apart from or adjacent to the others. The histological images were classical and the fumagoid cells, sometimes budding and filamentous, were easily detected during examination of the squama and scabs. Fonsecaea pedrosoï was the only identified species. The 5-fluorocytosine treatment constantly led to an improvement of the lesions. The major problem for these destitute patients is economic, concerning the cost of the therapy.

[Development of chloroquine resistance in Plasmodium falciparum in Gabon between 1984 and 1987-88 (in vivo evaluation in a school environment)]. / Evolution de la résistance de Plasmodium falciparum à la chloroquine au Gabon entre 1984 et 1987-88 (evaluation in vivo en milieu scolaire).

Unknown in 1980, suspected in 1983 and scarcely present in 1984-85, Plasmodium falciparum resistance to chloroquine as studied in vivo in schoolchildren in Gabon, has strongly developed in 4 years time. In 1987-88, administration of 25 mg/kg of chloroquine leaves one strain out of four with a parasitic load greater than 10/1.000 red blood cells examined by thick drop technique. The present, unfortunately provisional attitude tends to maintain chloroquine at efficient doses for as long as the resistant strains are ethically and practically controllable. The dispersion without strict control of new and for the time being very efficient drugs might rapidly give rise to a polychemoresistance which would leave us without defence.

[Malaria in Gabon. 2. Evaluation of the qualitative and quantitative prevalence of parasites in the total school and preschool population of the country]. / Le paludisme au gabon. 2. Evaluation des prévalences parasitaires qualitatives et quantitatives sur l'ensemble du pays en milieu scolaire et préscolaire.

The distribution of carriers of hematozoa in the pre-school and school age group in Gabon has been established with the help of systematic enquiry. The plasmodial indexes vary between 11 and 32% in the savanna zones of the south-east, they rise to 64.9% in the forest regions of the north of the country, and in the urban zones (Libreville, Franceville, Lambarene) 6 to 18% of the school children are gametocyte carriers. In Libreville, amongst the febrile children seen in pediatric consultation, the prevalence reached 30%. Boys and girls are equally affected. The most important prevalence is observed in the group of children from 5 to 10 years of age. P. falciparum is found in 96.4% of the cases, P. malariae in 5.3% and P. ovale in 2.4%. The study of the parasitic load revealed that 56% of the positive subjects had less than 10,000 asexual forms/mm3, 44% more than 10,000 hematozoa/mm3. These results are similar to those of the neighbouring countries of equatorial Africa.

[Toxoplasmosis in pregnant women in Haut Ogooué Province (Gabon)]. / Toxoplasmose chez la femme enceinte dans la province du Haut Ogooué (Gabon).

Anti-toxoplasma antibodies have been studied in 268 pregnant women. Two serological tests have been used: direct agglutination, before and after treatment with 2-mercaptoethanol, and indirect immunofluorescence. Agreement between the tests is over 98%. 60.5% of women have anti-toxoplasma antibodies at first examination. This percentage remains unchanged during pregnancy. Two cases of evolving toxoplasmosis have been observed. The mode of infection in Gabon is discussed.

[An unusual localization of chromoblastomycosis]. / Chromoblastomycose à localisation particulière.

Most African cases of chromoblastomycosis present with lesions on the arms or legs. We report the case of a 48 years old man, a retired professional hunter, living in the Haut-Ogooué province of Gabon. The patient presented with extensive lesions of the upper thorax and left shoulder but none on the limbs. Direct examination of crusts and skin biopsies revealed spherical, septated, pigmented bodies. Fonsecaea pedrosoï was isolated in culture. The patient was treated with ketoconazole (400 mg per day). After 9 months of treatment, improvement was noted but cure had not been achieved.

[Clinical trial of niclofolan (Bay 9015) in the treatment of human opisthorchiasis. Apropos of 51 cases]. / Essais de traitement des opistorchiases humaines par le niclofolan (Bay 9015). A propos de 51 cas.

51 refugees from South east Asia infected with Opisthorchis viverrini or Clonorchis sinensis were included in a therapeutic study with Niclofolan (Bay 9015) at a dose of 1 mg/kg body weight given three times at intervals of 48 hours. Clinical and biological tolerance was carefully controlled and in all cases proved to be very good or excellent particularly in several patients with various haemoglobinopathies or erythrocytal enzymopathies (G-6-PD deficiency). Of the total of 51 cases, 17 were cured. These comprised mainly those with light or moderate infections (less than 10,000 eggs/gram stool). Treatment was, however, not effective in the more severe infections, even when repeated after an interval of 30 days. Between day 30 and 60 after treatment, only a transitory reduction of eggs/gram stool was observed, these values increasing again after day 90. Niclofolan did not reveal to be the ideal treatment of opisthorchiasis. Nevertheless its excellent tolerance should be pointed out which justifies its tentative application in light infections and above all its use in the treatment of paragonimiasis against which it appears to be one of the best drugs available at present.