[The "Health system delay" in tuberculosis patients in Saint-Louis Senegal]. / Évaluation du "health system delay" chez les patients tuberculeux à Saint-Louis du Sénégal.

Sixty patients with positive acid fast bacilli sputum smears between were enrolled consecutively between March and August 2012 in the Saint-Louis (Senegal) health district to determine the Health System Delay in response to tuberculosis. The length of time between the first consultation of a TB patient and the start of treatment was, on average, 8.1 days and is among the shortest in the literature. This promptness reduces the risk of infection related to delayed care. This is one of the focuses of the National Programme of Fight against nosocomial infections in Senegal (PRONALIN), as well as the implementation of environmental procedures and the use of masks and respiratory protection equipment.

[Collection of mollusk intermediate hosts of Schistosoma at two sites in Lampsar (Senegal River valley): quantitative reproducibility]. / Collecte quantitative de mollusques hôtes intermédiaires de Schistosomes dans deux sites sur le Lampsar (Vallée du Fleuve Sénégal).

We studied the number of mollusks collected according to a specific protocol: 2 samplers prospecting in opposite directions for 1 min 30 s at 10 collection points regularly distributed on the site, for a total of 2 times 15 minutes. Because of the good reproducibility of the results of these collections, this method can be used for quantitative studies. A sampling effect was noted.

[Using the capture-mark-recapture method for quantitative assessment of populations of molluscs in two sites in Lampsar (Valley of the Senegal River)]. / Utilisation de la méthode capture-marquage-recapture pour une évaluation quantitative des populations de mollusques dans deux sites à Lampsar (Vallée du Fleuve Sénégal).

The authors have made an estimate of the number of mollusc by the capture-mark-recapture method at two sites in the Valley of the Senegal River. This quantification is necessary to track the effect of the introduction in one of the sites of a native shrimp Machrobrachium vollenhovenii, predator of mollusc. The populations of two study sites were approximately 1,800 and 1,500 individuals with coefficients of variation of about 30%.

[Spatiotemporal distribution of tuberculosis cases in the city of Saint-Louis Senegal from 2008-2011]. / Répartition spatio-temporelle des cas de tuberculose dans la ville de Saint-Louis du Sénégal entre 2008-2011.

BACKGROUND: We studied the incidence of tuberculosis in the health district of Saint-Louis, Senegal over a period of 4years (2008-2011). One thousand three hundred and eighty-six cases were identified, producing an annual standardized incidence ratio of 129 cases per 100,000 inhabitants. RESULTS: Men in the 15-24-year old age group were more likely to be affected, and diagnosis was more common in the second half of the year. Treatment compliance was excellent (96%), and the cure rate of patients with a TB-positive microscopic examination was 95%. The overall treatment failure rate was 1% and the 6-month morality was 2%. Seropositivity, measured in volunteer patients (48%) was 3%. CONCLUSION: A spatial and temporal map of tuberculosis in the city of Saint-Louis, Senegal has been established. A cluster appears to be very likely in Guet Ndar, a particularly dense population zone in a fishing area. There is also a possible secondary cluster at Pikine.

[Intestinal parasite diagnoses in Chad and North Cameroon, 1963-2009]. / Cinquante années de diagnostics coprologiques parasitaires au Tchad et au Nord-Cameroun (1963-2009).

The authors report the results of parasitological analyses of stool samples in N'Djamena (Chad) since 1963 and in Garoua (North Cameroon) since 1990. The number of positive stool examinations has fallen, with a significant decline in helminthiases, although the level of protozoan infections has remained essentially the same.

[Presumptive clinical diagnosis of malaria in children in a hospital in the North Region (Cameroon)]. / Diagnostic clinique présomptif du paludisme chez l'enfant en milieu hospitalier au Nord Cameroun.

The authors studied the correlation between the prescription of antimalarial drugs and the results of a rapid diagnostic test (RDT) and thick smear during dry and rainy seasons in a regional hospital outpatient clinic in North Cameroon. Clinical diagnosis, essentially based on the presence of fever, has a positive predictive value of 2% when compared with laboratory results during the dry season, against 44% during the rainy season. This study confirms the epidemic nature of malaria in the Sahelian zone of the North Region and challenges the currently available hospital statistics. In this epidemiological context, the authors recommend routine laboratory diagnosis of malaria before any treatment, especially during the dry season. This is justified both therapeutically and economically.

[The contribution of biology laboratories to keep immunization recommendations up to date: the example of the Centre Pasteur of Cameroon in the fight against meningococcal meningitis in North-Cameroon]. / Place du laboratoire de biologie médicale dans les recommandations vaccinales: l'exemple du Centre Pasteur du Cameroun dans la lutte contre les méningites a méningocoque au Nord-Cameroun.

The Centre Pasteur of Cameroon, Annex of Garoua, studied since 2007 méningococcus of meningitidis in the North of Cameroon. The serogroup A méningococcus completely seem to have disappeared with the profit from the serogroup W135 méningococcus. Current measurements of answers to an epidemic, based between others on reactive vaccination will have to take into account these new data to remain effective. Trivalent vaccine ACW135, placed at the disposal by WHO, should logically be able to be used in the event of epidemic, under reserve of an identification of the germ by a laboratory. The diffusion of the results of the circulation of serogroup W135 méningococcus supported vaccination by the tetravalent vaccine, but this one remains very expensive and, so held for a negligible minority of the population of North-Cameroon. It is part from now on of the recommendations to the travellers.

[Role of vitamin deficiency in pancytopenia in Djibouti. Findings in a series of 81 consectutive patients]. / Place des étiologies carentielles dans les pancytopénies à Djibouti a propos de 81 patients consécutifs.

The purpose of this study of patients with pancytopenia in Republic of Djibouti was to identify etiologic factors and attempt to define diagnostic and therapeutic strategies adapted to local conditions. Clinical, biological and radiological assessment was performed in 81 patients hospitalized for pancytopenia. There were 56 men and 25 women. Mean hemoglobin, leukocyte and platelet rates were 56,5 +/- 22,7 g/l, 2,1 +/- 0,7.g/l and 56,2 +/- 24,7 g/l respectively. Vitamin deficiency was the most common cause of pancytopenia (49%), followed by hypersplenism (9%), HIV infection (6%) and leishmaniasis (6%). Vitamin-deficient patients had significantly more severe anemia and thrombopenia and significantly higher mean corpuscular volume than patients with pancytopenia related to other causes. Hemoglobin rate lower than 40 g/L and platelet rate lower than 35 G/L showed a positive predictive values of 90% and 100% respectively for a vitamin deficient pancytopenia. Vitamin deficiency is the most frequent etiology of pancytopenia and causes the most severe cytopenia in Djibouti. Rapid vitamin supplementation after minimal etiologic assessment including a myelogram is an effective treatment strategy for this public health problem.

[Blood transfusion in Ethiopia]. / La transfusion sanguine en Ethiopie.

Nearly 30,000 bags of blood are collected per year in Ethiopia for a population of 56 million people. Eighty percent of this volume is obtained from family donors at the ten blood banks run by the National Transfusion Blood Service (NTBS) under the auspices of the International Red Cross. The remaining 20% are collected in hospital laboratories not affiliated with the NTBS but where blood bank procedures are used including the ability to screen for HIV contamination. Transfusion is thus a safe procedure in the major towns of Ethiopia. Screening for hepatitis B is performed only on blood to be administered to children and foreigners.

[Aspects of blood transfusion in Djibouti]. / Aspects de la transfusion sanguine à Djibouti.

Blood transfusion in Djibouti is organized with reference to relevant French regulation and the recommendations of the World Health Organization. The system is basically family donor system operating on the principle of one tested unit of blood for every two untested units donated. Spontaneous donations mainly from the police and army personnel account for only 20% of the 2500 units collected each year. The principle blood products are adult whole blood, adult red cells, and fresh frozen plasma. Products are distributed after viral and microbial testing for infectious disease. Overall the percentage of blood products that are not released due to detection of infectious agents is 17.5%. This rate is well correlated with the incidence of hepatitis B (15.5%), HIV infection (3.4%), hepatitis C (1.5%) and syphilis (0.4%) in Djibouti. The greatest demand for whole blood comes from medical departments where indigent people are treated for anemia due to dietary deficiency. Contamination by HIV present at undetectable levels at the time of testing is a serious problem. Measures should be taken to prevent anemia due to dietary deficiency and develop the use of autologous transfusion.

[History of the public health policy in Chad 1900-1995]. / Historique de la politique de santé publique au Tchad 1900-1995.

Public health policy in Chad began after colonization in 1899 and remained under the control of French Army Medical Corps for a long time. Military doctors shared their time between treating service personnel and indigenous people entitled Medical Assistance and making rounds in their sector. Since independence public health in the country has been based on a two-pronged association including fixed facilities (hospitals and dispensaries) and mobile services such as the Endemic Disease Unit whose most notable success was control of sleeping sickness in the southern part of the country. Over the years Chad has built up a national medical staff comprising 150 physicians. A medical school was opened in N'Djamena in 1990 and paramedical personnel are now trained at the National School for Public Health. War and lack of funds interrupted mobile services and there is presently a recrudescence of sleeping sickness. Since 1990 the World Health Organization has imposed its views and primary care is now available for all. However, it is now too early to judge the efficacity of this program in Chad.

[Prevalence of urinary schistosomiasis in a school environment in N'Djamena (Chad)]. / Prévalence de la bilharziose urinaire en milieu scolaire à N'Djamena (Tchad).

A parasitologic investigation, realised between March and November 1993, among 532 pupils 6-15 years old living in N'Djamena's peripheric quarter and in 5 Chari Baguirmi's villages had showed urogenital schistosomiasis infection prevalence is 11.8%.