[Cutaneous manifestations of arsenicisme in Burkina Faso: epidemiological and clinical features]. / Manifestations cutanees de l'arsenicisme au Burkina Faso: aspects epidemiologiques et cliniques.

The main aetiology of human arsenic toxicity provide from natural geological source. The characteristic skin lesions of arsenic toxicity may be used as an indicator of high exposure. We have registered 45 cases. The age bracket was one to 70 years. We have registered 27 women (60%) and 18 men (40%). The cutaneous manifestations have been dominated by the palmo plantar hyperkeratosis and hyperpigmentations (77,8% each one). The urinary concentrations of arsenic were 13 microg/l to 212 microg/l; they were 69 to 101 microg/l in the drinking water localized in the golden area, however they were normal outside this area. The clinical features were similar with the description of the literature. Intoxication of drinking water is problem of public health and we recommend checking all the other golden areas to find some appropriate solutions.

[W135 meningococcus meningitis: study of 148 cases observed in 2002 and 2003 at the National Teaching Hospital of Ouagadougou, Burkina Faso]. / Méningites à méningocoque du sérogroupe W135: étude de 148 cas observes en 2002 et en 2003 au CHU-YO de Ouagadougou, Burkina Faso.

The purpose of this report is to describe the bacteriological features, clinical signs and therapeutic outcome of 148 cases of W135 meningococcus meningitis observed during meningitis outbreaks in Burkina Faso in 2002 and 2003. Diagnosis was based on microbiological study of cerebrospinal fluid. Cases of meningococcus meningitis were recorded throughout the study period with the peak number of cases occurring around the 14th week. There was a slight male predominance (56.1%) and young patients between one and 15 years accounted for 81.7% of cases. The mean interval between onset of symptoms and hospitalization was 2.6 days and the mean duration of hospitalization was 5.5 days. The most common clinical signs were fever (98.6%), stiff neck (90.5%),Brudzinski's sign (85.1%),Kernig's sign (66.2%), altered consciousness (41.9%), vomiting (36.5%) and headaches (34.5%). In most cases treatment with a singie dose of chiorazuphenicol in oil was curative. Overall mortality was 15.5% idth no correlation with sex or age. Seventeen of the 23 deaths occurred within 24 hours after their admission to the hospital. The other six deaths occurred on the second day after admission inS cases and fifth day in one case. Convulsions, shock and altered consciousness were consistent poor prognostic signs. A correlation was found between mortality and interval for hospitalization with better survival in patients receiving prompt treatment. Study of the susceptibility of 102 samples showed that W135 meningococcus was sensitive to penicillin G, ampicillin,ceftriaxone and chloramphenicol but resistant to sulfamides (cotrimoxazole). Bacterial meningitis is an Important factor of morbidity and mortality worldwide. Our findings indicate that the bacteriological, clinical and epidemiological characteristics of W135 meningococcus is do not differ greatly from those of meningococcus A. Since W135 meningitis is susceptible to antibiotics used to cure meningitis, campaigns to promote early detection and treatment must be continued.

Meningites a meningocoque du serogroupe W135 : etude de 148 cas observes au Burkina-Faso

L'objectif de ce travail etait d'etudier les aspects bacteriologique; clinique et evolutif de la meningite a meningocoque du serogroupe W135 observee au cours des epidemies de meningites qui ont frappe le Burkina Faso en 2002 et en 2003 a trave rs l'etude de 148 cas identifies grace a l'examen bacteri o l ogique du LCR. Les meningites a meningocoque W135 ont ete observ e e s tout au long de l'annee; avec un maximum de cas autour de la 14e semaine. Il ap p a rait une legere predominance masculine (56;1) et les jeunes de un a 15 ans ont ete les plus touches avec 81;7des cas. Le delai moyen d'hospitalisation a ete 2;6 jours et la duree moyenne d'hospita- lisation de 5;5 jours. Les signes cliniques les plus frequents ont ete la fievre (98;6); la raideur de la nuque (90;5); les signes de Brudzinski (85;1); les signes de Kernig (66;2); les tro u bles de la conscience (41;9); les vomissements (36;5) et les cephalees (34;5). Dans la majorite des cas; le traitement curatif a ete fait par administra- tion de chloramphenicol huileux en dose unique. La letalite globale qui a ete de 15;5ne semble influencee ni par le sexe ni par l'age. Sur les 23 cas de deces; 17 sont surve nus dans les 24 heures qui ont suivi l'hospitalisation des patients; cinq le deuxieme jour et un dernier le 5eme jour. Les signes cliniques constamment associes a un mauvais pronostic ont ete les troubles de la conscience; les etats de choc et les convulsions. Il apparait une association letalite/delai d'hospitalisation en effet; plus tot le patient est pris en charge plus ses chances de survie sont importantes. L'etude de la sensibilite de 102 souches a montre la grande sensibilite des meningocoques W135 a la penicilline G; a l'ampicilline; a la ceftriaxone et au ch l o ramphenicol et leur resistance aux sulfamides. En defi n i t ive; le meningocoque W135 semble peu diff e rent du meningocoque A sur les plans cl i n i q u e; epidemiologique et bacteri o l ogique d'ou la necessite de continuer a maintenir des actions de sensibilisation pour une prise en charge rapide des cas