[Liposomal amphotericin B in secondary prophylaxis of visceral leishmaniasis in HIV-infected patients: report of five clinical cases]. / L'amphotéricine B liposomale en prophylaxie secondaire chez les patients VIH+ atteints de leishmaniose viscérale: à propos de cinq cas.

Treatment of visceral leishmaniasis in HIV patients encounters inefficacy and relapse due to drug resistance, toxicity and immunodepression. Our goal was to evaluate treatment of these patients by liposomal amphotericin B (L-AmB). Since 1998, five clinical files were exploitable out of 13 patients. Protocols used bolus doses ranging between 2.9 and 4.1 mg/kg dispatched on 5-24 days, followed by maintenance dose ranging from 2.7 to 3.8 mg/kg every 15 days. Attack treatment involved high bolus dose (cumulated doses ranging from 60 to 86 mg/kg at day 30) and allowed favorable clinical and biological results with healing in four patients. Secondary prophylaxis with L-AmB has been efficacious and well tolerated in three patients. Although literature and study results cannot indicate a standard therapeutic care in these patients, an initial treatment by L-AmB at doses higher than marketing-approved doses with a secondary prophylaxis by L-AmB associated with an antiretroviral treatment seem to be major asset in order to obtain healing. Expanding this study to a multicenter trial should allow to better define the frequency and duration of the secondary prophylaxis and to evaluate the risk of therapeutic escape as well as the life-span increase.

[Amphotericin B into parenteral lipid emulsions. Galenic stability of mixtures. Preliminary results]. / L'amphotéricine B dans des émulsions lipidiques parentérales. Stabilité galénique des mélanges. Résultats préliminaires.

The amphotericin B in glucose solution is the reference's treatment of the major systemic mycoses. Because of its bad tolerance, certain authors put forward others vehicules such as fat emulsions. The aim of our work has been to study the physico-chemical stability of two regeneration's methods; P1: direct regeneration. P2: regeneration of 50mg of Fungizone in 5 ml of glucose serum and laced with 45 ml of Ivelip 20% versus PR: 50 mg of Fungizone in 50 ml of glucose serum. Our results seem to show that the P1 is totally incompatible with a parenteral administration, because 23% of the granulometric population has a diameter superior to 5 microns. The solution P2 seems better even if the pH is different from PR and a light depot comes after reconstitution.

[Evaluation of the level of endemic tuberculosis in a survey of Banqui (Central African Republic)]. / Evaluation du niveau d'endémie tuberculeuse par enquête tuberculinique dans la ville de Bangui (République Centrafricaine).

A cluster sample survey on tuberculosis has been carried out in Bangui in February 1988. The bimodal distribution of the diameters of IDR on children aged between 5 to 9, gives evidence of a circulation of some non typical mycobacteriae and enables to fix the limit of positivity at 14 mm. The prevalence rate of the tuberculotic infection is 7.9 +/- 1.7% in the surveyed children population at school. The annual risk of infection is evaluated at 1.09% that ranks the Centrafrican Republic in the countries with a low prevalence rate.

[Prevalence of pruritus caused by 4-aminoquinoline. Cluster sample survey of the population in a Central African town]. / Prévalence du prurit aux amino-4-quinoléine. Etude par sondage en grappe dans la population d'une ville Centrafricaine.

A survey on prevalence of pruritus caused by amino-4-quinolines has been carried out by mean of a set of questions in the framework of a cluster sample survey with 1512 inhabitants of Bambari (Central African Republic). The results were: a prevalence rate of 7, 6 p.c., mainly due to chloroquine; a variation of the prevalence rate according to age: low with children, frequency is maximum in the age group of 20-30 and then decreasing. no difference between males and females; an increase of frequency related to the education level and the socio-professional category.

[Status of drug resistance of Plasmodium falciparum in the Central African Republic. Results of studies carried out between 1984 and 1986]. / Etat de la chimiorésistance de Plasmodium falciparum en République centrafricaine. Résultats d'enquêtes menées de 1984 à 1986.

Since August 1983, several cases of chloroquine resistant malaria have been observed in caucasian adults living in the Central African Republic (CAR) despite an antimalarial prophylaxis. Between 1984 and 1985, several studies including both in vitro and in vivo tests have been undertaken in cohorts of children to determine antimalaria drug sensitivity of P. falciparum in two towns of the CAR. In Bangui, out of 60 asymptomatic schoolchildren with asexual parasite count per mm3 of blood equal (or more than) 1,000, treated using a single intake of chloroquine at a dose of 10 mg/kg, three had asexual parasites at day 7 after drug administration. Alternatively, out of 57 other children with clinical malaria treated using a total dose of 25 mg/kg of chloroquine daily distributed within a 3 day period, only one exhibited a RII resistance. In vitro tests performed in a limited cohort of 15 school children showed a high sensitivity to chloroquine, amodiaquine, quinine and mefloquine in P. falciparum malaria. In Bouar, a group of 80 preschool children attending pediatric clinic were treated using either a single dose of 10 mg/kg of chloroquine (25 children) or 25 mg/kg of amodiaquine (21 cases) or 25 mg/kg of chloroquine (34 cases) within a three days period. Asymptomatic parasitaemia persisted or reappeared in 6 children all treated with 10 mg/kg of chloroquine. Therapeutic response to amino-4-quinolines in central african children is up to now satisfactory as compared to that observed in surrounding countries. Further surveys including other rural and urban areas are needed to appreciate the evolution of the phenomenon.