[Predictive value of positive and negative results of the Widal and Felix test for typhoid fever in general practice in Niamey]. / Valeurs prédictives positive et négative du test de Widal et Félix dans la fièvre typhoïde en médecine générale à Niamey (Niger).

INTRODUCTION: Typhoid is a common reason for seeking medical care in general practice in the developing countries, Use of the Widal and Felix test is frequent in this setting. The purpose of this study carried out in private general medicine clinics in Niamey, Niger was to determine the incidence of typhoid and the predictive value of positive and negative results of the Widal test. MATERIAL AND METHOD: We used low published values of sensitivity (67.9%) and specificity (93.8%). Estimation of the incidence of typhoid was based on reports made to the national health information system of Niger by 3 private clinics in Niamey. RESULT: A total of 1725 persons attended the clinics between 1/12/07 and 31/01/08, including 311 presenting nonspecific signs suggesting typhoid, i.e., at least fever and headache, and 172 presenting typhoid. The incidence was 9.97% in attendees overall and 55.31% in attendees with nonspecific evocative signs. The positive predictive value of the Widal and Felix test was 53.81% and the negative predictive value was 96.35% in attendees overall and 93.13% and 70.25% respectively in patients with clinical signs. CONCLUSION: Other diagnostic modalities such as PCR, coproculture, and hemoculture can be proposed, but are not available in this setting. The positive predictive value of the Widal test among patients with nonspecific signs suggesting typhoid is high. While not negligible, the negative predictive value in this high-incidence group is relatively low and should indicate monitoring.

[Relative frequency of malignant and benign tumors in Arlit, Niger. Analysis of data from anatomopathological examinations over a 15-year period]. / Fréquence relative des tumeurs malignes et bénignes à Arlit (Niger): bilan de 15 ans d'examens anatomo-pathologiques.

The purpose of this study was to determine the frequency and distribution of cancer in the uranium-mining region of Arlit, Niger, based on extensive data from all the anatomopathological examinations performed at local hospitals over a 15-year period. The overall annual incidence, i.e., 26 per 100000, was similar to incidences reported elsewhere in Africa. The rate of examinations leading to diagnosis of malignancy decreased between 1991 and 1997 and, for unexplained reasons, varied from one practitioner to another. There was no evidence of a higher rate of any cancer that might result from possible exposure to radiation during mining operations. The distribution of cancer by organ was unremarkable, i.e., in order of frequency, womb and ovaries in women; skin and prostate in men; thyroid and lymphatic tissue in both genders.