Enhanced degradation of 2,6-dimethylphenol by photocatalytic systems using TiO2 assisted with H2O2 and Fe(III).

In this study, several photocatalytic degradation systems were investigated using 2,6-dimethylphenol (2,6-DMP) as a model compound. Highly reactive species are formed in four systems, Fe(III), TiO2, TiO2/H2O2 and TiO2/Fe(III) where complete degradation of 2,6-DMP was achieved under UV radiation. Photodegradation of the 2,6-DMP has been described by pseudo-first order kinetic model in the presence of TiO2. In UV/TiO2-H2O2 system, the addition of H2O2 in the TiO2 suspension improves the degradation rate of 2,6-DMP from 70% to 100% for a H2O2 concentration of 10-2 M in 3 h. In homogeneous system, HO• and Fe2+ can be generated by the irradiation of Fe(III) solution. The speciation of Fe(III) obtained from Visual MINTEQ soft showed the formation of several species and Fe(OH)2+ were the most predominant and active species in a pH range of 2.5-3.5. At a low concentration of TiO2 (30 mg L-1), an important positive effect due to the iron addition has been shown in TiO2/Fe(III) system, the entrance of metallic ions at different concentrations enhanced the photocatalytic activity of TiO2. A degradation percentage of 90% was achieved in the UV/TiO2-Fe(III) system under optimal conditions against 57% in UV/TiO2 system. Strong synergistic effect was observed in the UV/TiO2-H2O2 binary system. On the basis of literature, a pathway for 2,6-DMP degradation was proposed. The mechanism of degradation of the 2,6-DMP did not involve only HO• radicals, an interaction of Fe(III) in the excited state with 2,6-DMP occurred giving rise to the formation of 2,6-dimethylphenoxyl radical.

Prevalence of extended-spectrum beta-lactamase phenotypes in enterobacteria isolated from blood cultures of patients at admission to the University Hospital of Bamako.

The aim of our study was to determine the frequency of extended-spectrum beta-lactamase (ESBL) phenotypes among the enterobacteria present in blood cultures of patients at admission to two university hospitals of Bamako (Mali). During a period of three months, we isolated enterobacteria from blood cultures from patients upon admission to the Point G and Gabriel Toure University Hospitals. The ESBL-positive enterobacteria were initially identified by API 20E strips and VITEK®2 and then confirmed in France by MALDI-TOF mass spectrometry at the Bichat Hospital bacteriology laboratory. Antibiotic susceptibility was determined by the diffusion method as recommended by EUCAST. The species isolated were K. pneumoniae (14/40, 35.0 %), E. coli (11/40, 27.5 %), and E. cloacae (9/40, 22.5 %); 21/34 (61.8 %) had an ESBL phenotype, including 10/14 (71.4 %) K. pneumoniae, 8/11 (72.7 %) E. coli, and 3/9 (33 3 %), E. cloacae. The ESBL strains of K. pneumoniae, E. coli, and E. cloacae were associated, respectively, with resistance to the following antibiotics: gentamicin (10/10, 100 %; 6/8, 75%; 2/3, 67%), amikacin (2/10, 20 %; 0/8, 0%; 0/3, 0%), ofloxacin (8/10, 80. %; 7/8, 87%; 3/3, 100%), cotrimoxazole (10/10, 100 %; 6/8, 75%; 3/3, 100%). Almost two thirds (61.8%) of the enterobacteria isolated from blood cultures produced extended-spectrum beta-lactamases. They retained regular sensitivity only to carbapenems and amikacin.

Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae isolated from blood cultures in Africa.

Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae have been isolated from many regions of the world. Epidemiological studies are being conducted in Europe, North America, and Asia. No study has however been conducted in Africa to determine the prevalence and distribution of ESBLs on the continent. This literature review aimed at describing the prevalence of ESBL-producing Enterobacteriaceae isolated from blood cultures, as well as the ESBL genes involved at the international level. Our focus was mainly on Africa. We conducted a literature review on PubMed. Articles related to our study field and published between 1996 and 2014 were reviewed and entirely read for most of them, while we only focused on the abstracts of some other articles. Relevant articles to our study were then carefully reviewed and included in the review. The prevalence of ESBL-producing Enterobacteriaceae differs from one country to another. The results of our literature review however indicate that class A ESBLs prevail over the other types. We took into consideration articles focusing on various types of samples to assess the prevalence of ESBL-producing Enterobacteriaceae, but information on isolates from blood cultures is limited. The worldwide prevalence of ESBL-producing Enterobacteriaceae has increased over time. Evidence of ESBL-producing Enterobacteriaceae can be found in all regions of the world. Studies conducted in Africa mainly focused on the Northern and Eastern parts of the continent, while only rare studies were carried out in the rest of the continent.

[Value of perineal sonography for diagnosing anterior urethral stenosis]. / Valeur de l'échographie de surface par voie périnéale dans le diagnostic des sténoses de l'urètre antérieur.

OBJECTIVES: To determine the value of perineal sonography in the diagnosis of urethral stenosis and evaluation of surrounding fibrosis. Materials and methods. Fifty-eight healthy subjects underwent urethral sonography. Thirty-two patients with suspected urethral stenosis underwent sonography after retrograde distension of the urethra using normal saline and retrograde urethrogram and voiding cystourethrogram. RESULTS: The mean diameters of the healthy urethra varied from 11 to 15 mm. The mean thickness of normal periurethral tIssue was between 2 and 4mm. Sonography detected 34 stenoses (97.4%). The length of the stenosis was significantly longer at sonography compared to retrograde urethrogram and voiding cystourethrogram. No significant difference was found between both techniques when measuring urethral diameter. In all cases, the thickness of periurethral tIssues was greater at the stenotic level than at a normal level, irrespective of the involved segment. There was no correlation between the thickness of periurethral tIssues and the degree of stenosis. CONCLUSION: Urethral sonography is a method that permits diagnosis of urethral stenosis and evaluation of periurethral fibrosis. It may replace retrograde urethrogram and voiding cystourethrogram in the diagnosis of post infectious stenosis.

[Contribution of radiography and repeat microscopy in the diagnosis of pulmonary tuberculosis in the hospital environment of Bamako]. / Apport de la radiographie et de la bacilloscopie répétée dans le diagnostic de la tuberculose pulmonaire en milieu hospitalier à Bamako.

WHO and IUAT-LD recommend repeated microscopy in order to improve the detection of contagious cases of pulmonary tuberculosis. Our aim was to determine the contributions of radiology and microscopy in the diagnosis of pulmonary tuberculosis. From January 1998 to April 1999 radiography and microscopy were performed for 275 patients who were admitted to the pneumology service. Pulmonary tuberculosis prevalence was higher among women aged 10 to 29 years than among men of the same age (p = 10(-6)). 188 (68.4%) women tested positive, 49 (17.8%) tested positive at the second microscopy and 1 (0.36%) at the the third. The main radiological lesions were nodules + infiltrats (46.2%), nodules + infiltrats + cavity (26.2%) and infiltrats + cavity (6.5%). Repeated microscopy significantly increased the proportion of pulmonary tuberculosis cases detected (from a prevalence 68.4% to 86.5%).

[Epidemiological, clinical and progressive aspects of asthma observed at Bamako, Mali]. / Aspects épidémiologiques, cliniques et évolutifs de l'asthme observés à Bamako, Mali.

We carried out a prospective study of 106 of the 752 asthmatic patients attending the outpatient clinic of Point G Hospital, Bamako, between December 1997 and November 1998. We analyzed data for 61 patients whose lung function was assessed by measurement of peak expiratory flow. The frequency of asthma was 14.9%, suggesting regular progression of the disease. There were slightly more women than men (55.7% women) in the study population and the mean age of the patients was 31 years. Most of the patients (65.5%) were recruited in the dry season (November to May). Based on peak expiratory flow measurements, intermittent asthma was the most frequent type of asthma observed (37.8%), followed by moderate persistent asthma (34.4%), mild persistent asthma (18%) and severe persistent asthma (9.8%). The mean cost per episode of asthma was $36 (US) and the mean cost per patient was $432 (US) per year. In 52.45% of cases, the drugs required were available and the patient had access to them. They were available but not accessible in 26.22% of cases. To improve the management of asthma in countries with limited financial resources, generic drugs should be made available.

[Radiographic and bacteriologic data on pulmonary tuberculosis in Bamako as a function of HIV status]. / Données radiographiques et bactériologiques de la tuberculose pulmonaire à Bamako en fonction du statut VIH.

This prospective study included patients treated for tuberculosis between January 998 and April 1999 in the pneumology unit of the Point G Hospital in Bamako. The purpose was to analyze chest x-ray and bacteriological findings in HIV+ and HIV- patients. All patients had clinical and radiographic signs suggestive of tuberculosis with one or several sputum samples and HIV serology. Among the 127 patients, 36 were HIV positive (28.3%). There was no sex predominance in the HIV+ patients (p = 0.3). The most common radiographic aspect associated nodules and infiltration irrespective of the immune status (p = 0.014). Characteristic features of the chest x-rays in HIV-positive patients were: frequent military forms and rare cavernous forms (p = 0.007). Sputum tests were positive more often in HIV-negative than HIV-positive patients (p = 0.0003). The diagnosis of tuberculosis was retained in 11.7% of the patients with negative microbiology despite repeated samples. A normal chest x-ray was observed solely in one HIV-negative patient.

[The results of retreatment of pulmonary tuberculosis using a short 6-month protocol 1985-1991 in the pneumo-phthisiology department of the Point G hospital in Bamako]. / Résultats du retraitement de la tuberculose pulmonaire par un régime court de 6 mois de 1985-1991 dans le service de pneumo-phtisiologie de l'hôpital du point G à Bamako.

This study concerns 321 files of smear positive tuberculosis patients admitted in the pneumo-phtysiology service of Pt G Hospital for re-treatment from April 1985 to December 1991. The re-treatment pulmonary tuberculosis with positive spits represent 13.3% of pulmonary tuberculosis cases and 10.1% of the whole tuberculosis diseases. High rate with a ratio of 3 men for a woman was found among men. The same conclusion was reached by SAMAKE (7). Patients age raking from 20 to 49 were the most affected in a proportion of 75.7%. Evolutive relapses were the principal reasons for re-treatment (71.2%) and take place above all among patient treated with the 12 months conventional regime. The conclusion reached corroborates those of STYBLO (8). The regime was 3RHZES3/3R3H3E3. The maximum of negating has been reached during the 3rd month with 93.4% rate. It has been during these 3 last months consolidation phase that the highest drop out has been noticed (17.1%). This is certainly due to the better off felt by patients. At the end of treatment 76.3% of the patients have recovered against 1.5% failure rate and 5.3% drop out. Our treatment regime, though different from those advised by WHO and IUATLD, is an efficient one. However in the new programme of fighting against tuberculosis of Mali, it has been decided to replace our treatment with that of WHO and IUATLD.

[Effect of hygiene measures, water sanitation and oral rehydration therapy on diarrhea in children less than five years old in the south of Ivory Coast]. / Effet de l'observance des mesures d'hygiène, d'approvisionnement en eau et de la thérapie par voie orale sur les diarrhées chez les enfants de moins de 5 ans dans le sud de la Côte d'Ivoire.

The purpose is to assess the impact of compliance with measures of hygiene and water supply and oral rehydration on the diarrhoea with under 5 years of age in four villages of southern Côte d'Ivoire. The method used is to compare morbidity and mortality of children, firstly between two groups of villages without such measures, secondly in two villages before and after implementing them. Initially, an exhaustive survey has determined the incidence rate of diarrhoea, the proportion of deaths resulting from such diarrhoea as well as the mortality rate 1988. Two similar survey were made in 1990 and 1992. The results show a 50% reduction of the incidence rate of diarrhoea and a 85% reduction of the proportion of deaths related to diarrhoea in the villages with intervention. The mortality rate to diarrhoea was likewise reduced by 85%. These results show the importance of the improvement and accessibility to drinkable water and hygiene in the prevention of diarrhoea in areas children.

[Impact of improved sanitary conditions and domestic hygiene on the incidence of ascaridiasis and ancylostomiasis in children two to four years old in the rural zones of Ivory Coast]. / Impact de l'assainissement et de l'hygiène domestique sur l'incidence de l'ascaridiose et de l'ankylostomose chez les enfants de 2 à 4 ans dans les zones rurales de Côte d'Ivoire.

The purpose of this study is to assess the impact of improvement measures for hygiene and water supply, installation of latrines and health education on the incidence of ascaridiasis and ankylostomiasis with 2 to 4 years old children in some villages of southern Côte d'Ivoire. The method used is the comparison of children carrying parasites before and after intervention. Initially in 1988, the stools of all children aged from 2 to 4 were collected and examined in order to look for the presence of parasites in the stools. Two identical inquiries were made in 1990 and 1992. The results show a reduction of the rate of incidence for ascaridiasis by 75% and ankylostomiasis by 82%. They demonstrate the importance of an appropriate evacuation of excreta, of an education of mothers and of domestic hygiene in the process of prevention of children parasitosis.

Aspects radiographiques de la tuberculose pulmonaire

162 patients (41 femmes; 121 hommes); hospitalisés pour toux ; et qui étaient tous bacillifères au moment de la réalisation de la radiographie thoracique d'admission; ont été inclus dans cette étude. Aucun de ces patients n'avait bénéficié de traitement antituberculeux avant hospitalisation. Le but de ce travail était de décrire les aspects radiologiques de la tuberculose pulmonaire. Seul le cliché thoracique d'admission à l'hôpital a été retenu pour l'étude qui a consisté à une relecture systématique des radiographies après avoir divise chaque poumon en deux champs séparés par une ligne imaginaire passant par les hiles sur le cliché thoracique de face. Les lésions siégeaient dans les champs supérieurs dans 89 cas (54;94 pour cent); inferieurs dans 21 cas (2;96 pour cent) et au moins deux champs dans 52 cas (32;10 pour cent) [P5 pour cent]. Les anomalies radiologiques étaient de type parenchymateux dans 138 cas (85;19 pour cent); et mixte (parenchymateux et extraparenchymenteux) dans 524 cas. Parmi les anomalies parenchymateuses; nous avons note des nodules dans 75 cas (54;35 pour cent); des foyers alvéolaires dans 13 cas (9;42 pour cent) des cavernes dans 17 cas (12;32 pour cent) et une association de lésions dans 33 cas (23;91 pour cent) [P 1 pour cent]. Les images nodulaires étaient des micros ou macronodules groupées en amas de petit nombre dans 64 cas (85;33 pour cent); et de type miliaire dans 11 cas (14;67 pour cent) [P 1 pour cent]. Les auteurs concluent que la mise en évidence; de lésions nodulaires; groupées en amas de petit nombre surtout dans le champ supérieur des poumons doit emmener les cliniciens à rechercher systématiquement le bacille de Koch dans les crachats; en une d'une prise en charge thérapeutique précoce

[Water supply, excrement disposal and diarrheal diseases in rural zones of Ivory Coast]. / Approvisionnement en eau, evacuation des excreta et maladies diarrhéiques dans les zones rurales de Côte d'Ivoire.

This study was designed to determine the incidence of diarrhea over a 15 day period in children below 4 years living in villages in a rural area of Côte d'Ivoire and to identify possible correlation with water supply and excrement disposal. In this exhaustive cross-sectional household survey, each person caring for a child between the ages of 0 and 4 years was interviewed at home using an open, pretested survey with questions concerning diarrhea, water supply, and excrement disposal. Responses were authenticated by on-site observations made by surveyors. The study population included 1151 care providers and 1260 children between 0 and 4 years of age. Diarrhea had occurred in 27.7% of children within the 15 days prior to questioning, i.e. an annual incidence rate of 3.1 episodes per child after seasonal correction. Age was a risk factor for diarrhea since the incidence of diarrhea was inversely proportional to age. The number of episodes increases up to 6 months, stabilizes at a maximum of 37 to 38% until 36 months, and then gradually decreases to 6% between 53 and 59 months. Diarrhea was more common in children whose care provider was illiterate, the relative risk being 1.22. There was also a correlation between occurrence of diarrhea and age of the care provider since older providers were more likely to be illiterate. Use of a technique to prevent water from splashing out during transport was correlated with diarrhea. Children whose care providers used leaves or plastic covers to prevent splashing during transport had more episodes of diarrhea (30%) than the those whose care providers did not use these techniques (23%). The place where stool pots were emptied was also related to diarrhea. Disposal behavior was strongly correlated with literacy of the care provider, with the site of disposal being relevant only if the provider was illiterate. In view of these findings, we conclude that educating women, teaching child care providers about healthy eating habits in children as young as 5 months, and informing families about proper water storage and excrement disposal would reduce the incidence of diarrheal disease in village children.

[Development of primary resistance of tuberculosis bacilli in Mali between 1980 and 1990]. / Evolution des résistances primaires des bacilles de la tuberculose au Mali entre 1980 et 1990.

The survey of the primary resistances of tuberculosis bacilli to drugs is not only important epidemiologically speaking, but also for its use as a guideline to defining programs, to assessing the quality and the practical development of chemotherapy in a country, to measuring the propensity of the resisting tuberculosis bacilli to infect a given population within some time and to taking the necessary remedial measures. The object of this study has been to compare the rate of initial drugs' resistances of tuberculosis bacilli in Mali between 1980-1982 and 1989-1990. The results, which show a fall in the primary resistances due to drugs and to the combination of antibiotics as well, are being discussed while taking account various factors related to the organization.

[Factors in quitting antituberculous treatment in Bamako (Mali)]. / Les facteurs d'abandon du traitement antituberculeux à Bamako (Mali).

This is a descriptive study of 33 cases with recurrent tuberculosis in patients who abandoned their treatment, admitted between March and October 1991 in the Pulmonary Tuberculosis Service of the Hospital Point G. The aim of the study was to identify the reasons for stopping treatment and to propose corrective measures. One third of the patients registered in the study were agricultural workers. Sixteen per cent of those who stopped treatment did so in the first four months of treatment. The duration and the nature of the therapeutic regime had no influence on the attendance of the patients: 42% received a standard regime for twelve months and 45% a short regime for eight months. We thought that the poor motivation of the health personnel to counsel the patients correctly was the principal factor in influencing their attendance. Sixty seven per cent did not know the nature of their disease. The distance factor between home and the place of treatment was another important point which should be improved. Concrete proposals were made to improve the supervision and follow up of tuberculous patients.

Evolution des resistances initiales des bacilles de la tuberculose au Mali entre 1980 et 1990

La surveillance des resistances des bacilles de la tuberculose aux drogues antibacillaires est importante sur le plan de la surveillance epidemiologique; et doit surtout servir comme guide pour la definition des programmes; pour apprecier la qualite et l'extension pratique de la chimiotherapie dans un pays; pour mesurer les tendances des bacilles resistants a se developper au sein d'une population donnee; et enfin pour prendre des mesures correctives necessaires. L'objet de cette etude etait de comparer l'etat des resistances initiales des bacilles de la tuberculose au Mali en 1980-1982 et 1989-1990. Les resultats qui montrent une baisse des resistances initiales entre ces deux periodes; aussi bien par drogue que par combinaison de drogues; sont discutes en rapport avec l'impact positif de differents facteurs organisationnels

[Purulent pleurisy in a specialized hospital environment in Bamako]. / Les pleurésies purulentes en milieu hospitalier spécialisé à Bamako.

We report the results of a retrospective study of 108 cases of pleural empyema collected in the Pneumo-Phthisiology Department of the National Hospital of "Point G" from September 1984 to August 1990. The sex-ratio is 3/1 in favour of males with a mean age of 35.5 years. The pleural empyema represent 2.2% of all patients admitted in the Hospital and 20.2% of liquid effusions of the Pleura observed during the study period. The causal common germ has been placed in a proeminent position in 18 cases (16.7%) including 14 cases of gram-positive germs. Tuberculous aetiology has been proven in 16 cases (27.6%) against 67 cases of bacterial pleuresies (62%). The initial treatment has consisted in an empirical antibiotherapy of a large spectrum associated with repeated washing punctions. A short-term antituberculous chemotherapy (8 months, 2RHZS(6TH)) has been administrated each time the tuberculous aetiology has been proven or strongly presumed. The therapeutic results have been favourable in 85 cases (78.7%) and unfavourable in 23 cases (21%) including 10 deaths (9.2%).

Cancer in Mali, 1987-1988.

Results from the population cancer registry in Bamako, Mali, for the years 1987 and 1988, are presented. The age-standardized incidence for all cancers is high compared with rates reported elsewhere in West Africa (119.6 per 10(5) in males and 88.3 per 10(5) in females), but the leading cancers in each sex are the same (liver cancer in males, cervix cancer in females). The incidence of stomach cancer is the highest recorded in Africa, while rates for lung cancer, although low, exceed those in earlier series from registries in the region.

[African histoplasmosis in Mali]. / L'histoplasmose africaine au Mali.

Twenty-four cases of histoplasmosis have been diagnosed since 1945 in native Malians (20 cases) or Europeans living in Mali (4 cases). Seventeen cases have already been published and 7 other cases diagnosed recently in Bamako or Marseille are reported here. Mali is within the African histoplasmosis zone and the Kayes district may be a particularly endemic zone. The disease affected the skin (62 p. 100), lymph nodes (46 p. 100), bones (21 p. 100), gastrointestinal tract (26 p. 100) and lungs (4 p. 100). A rare lesion of the uvula is also reported. Direct fungal and histopathological techniques are the easiest and the most effective diagnostic investigations. All cases were due to Histoplasma duboisii. Amphotericin B was used in over 60 p. 100 of cases for an average period of 3 months. The total recovery rate was 66 p. 100.