[Acceptability of vaccination against human papillomavirus (HPV) by pediatricians, mothers and young women in Ho Chi Minh City, Vietnam]. / Acceptabilité de la vaccination contre les papillomavirus humains (HPV) par les pédiatres, les mères et les jeunes femmes à Hô Chi Minh Ville, Vietnam.

BACKGROUND: Cervical cancer (CC) is almost always induced by some oncogenic types of human papillomavirus (HPV). In Vietnam, it is the first leading cause of cancer in women, with highest prevalence in Ho Chi Minh City (HCMC). Since 2006, prevention of the CC has been improved by licensure of recombinant vaccines directed against HPV 16 and 18, effective when administered before the age of first sexual intercourse. A national program for routine immunization of pre-adolescent girls in addition to cytological screening of adult women would greatly reduce the impact of CC in Vietnam but vaccines remain expensive and it is unclear how this strategy would be accepted by the target population. The aim of this study was to assess the acceptability of HPV vaccination by pediatricians, mothers with a daughter aged 9-15 years and young women aged 16-26 years in HCMC. METHODS: Between March and June 2010, a cross-sectional survey of knowledge and attitudes was administered to 115 pediatricians in the pediatric hospital, 210 mothers and 400 young women attending the gynecology department of the University Hospital. RESULTS: Pediatricians generally had a good perception of the risk but they still lacked knowledge about HPV vaccination, given by 66% of them. Among mothers, 18% knew the relationship between HPV infection and CC, 43% had heard of HPV vaccination and 40% agreed to vaccinate their daughter. Among young women, 35% knew the risk, 49% knew the vaccine and 38% wanted to be vaccinated. Level of education, amount of income and celibacy were positively related to intention to be vaccinated. The lack of information on HPV vaccination and the high cost of vaccines were the main causes of refusal or indecision. CONCLUSION: Routine HPV vaccination of girls in HCMC will be well accepted by the population if a large campaign of health education is implemented by the government and if the affordability of vaccines is facilitated.

Paragonimiasis and its intermediate hosts in a transmission focus in Lao People's Democratic Republic.

Human cases of paragonimiasis have been reported in Lao People's Democratic Republic from several provinces, however, detailed descriptions of a focus of transmission including parasites species and intermediate hosts are lacking. Field investigations were carried out between February and July 2004 in three neighboring villages of the province of Vientiane. Persons with chronic cough (more than three weeks) were identified during a door-to-door survey and three sputum samples were examined for Paragonimus spp. and tuberculosis on two consecutive days. Potential intermediate snail and crustacean hosts were sampled among the populations' water-contact sites and examined for metacercarial infections or cercarial shedding. Four dogs were infected with metacercaria and the species of the subsequently retrieved adult parasites were identified. 12.7% (15 cases) of all chronic cough patients (0.6% of the total population) suffered from paragonimiasis. Samples of five species of freshwater snails, two species of crabs and one species of prawn were collected from the Nam Sêt River. None of the snails were infected. Metacercariae of P. harinasutai, P. bangkokensis and P. heterotremus were found in Potamon lipkei crabs while an infection with P. westermani was observed in a Chulathelphusa brandti crab. No paragonimid metacercaria was found in the Macrobrachium dienbienphuense prawns Dang and Nguyen 1972. This study demonstrates the importance of Paragonimus spp. as an etiological agent in patients with chronic cough and suggests that similar transmission might be widespread in Lao People's Democratic Republic. We document herein the transmission of several Paragonimus species indicating that paragonimiasis is an active zoonosis in Lao People's Democratic Republic.

[Management of epilepsy in developing countries]. / Prise en charge de l'épilepsie dans les pays en développement.

Epilepsy is a major public health problem in developing countries. In addition to the high prevalence of epilepsy in some regions, there is an acute shortage of trained personnel, clinical equipment, and antiepileptic drugs. As a result of these problems, most patients do not have access to adequate treatment. Despite wake-up calls from the WHO, LICE, and BIE in 2001 using the slogan "Bring epilepsy out of the shadows", few national epilepsy control programs have been implemented in developing countries. Nevertheless reports describing several recent pilot projects have demonstrated that effective screening and management of the disease is feasible through primary health care systems. Phenobarbital should be the first choice for treatment of epilepsy in developing countries.

[Pleuro-pulmonary paragonimiasis]. / La paragonimose pleuropulmonaire.

Paragonimiasis is a food borne zoonosis due to a trematode belonging to the genus Paragonimus. Although present throughout the world, about 90% of the cases occur in Asia where around 20 million people are infected. The parasitic cycle is complex with two different intermediate hosts. Man is infected by ingesting the raw or undercooked flesh of the second host - a freshwater crab or prawn - or possibly of a paratenic mammal host (wild boar), which contains the infective larval stage metacercariae that reaches the lung which is the main target organ. Epidemiological, pathological, and clinical aspects are reviewed. The main symptoms are protracted cough, and recurrent "benign" hemoptysis. Abnormal pleuro-pulmonary imaging features are constant, but protean and non-specific, leading to frequent confusion with tuberculosis. Diagnosis is easily achieved by ova search in the sputum or pleural fluid, or by serology. Evolution is usually considered benign, although not well known. Finally, praziquantel is the effective first choice treatment. Some paradoxical aspects of this disease are underlined such as: underdiagnosis despite a very simple diagnostic procedure, or opposite tendencies according to location, either extinction or re-emergence.