An attempt to quantify the role of existing health facilities in controlling vesical schistosomiasis in rural northern Cameroon.

Around the artificial reservoir in the Benue River near Lagdo in Northern Cameroon, Schistosoma haematobium and S. mansoni are prevalent. The primary health care structure has been reinforced in recent years, but no special attention has been paid to schistosomiasis. This setting was considered ideal to estimate the contribution of the existing health facilities in the control of morbidity due to schistosomiasis. The patients locally diagnosed as having vesical schistosomiasis, were subsequently examined with a standardized quantitative filtration method. Furthermore, surveys were carried out in the surrounding villages to estimate the age-specific prevalences of vesical schistosomiasis in the health centre's catchment area. The number of heavily infected people is low in the region (12%), but heavy infections represented 64% of the visitors with vesical schistosomiasis at the health centre. The data suggest that the health centre is efficacious in 'passively' detecting the most heavy infections. It was also possible to identify villages with large numbers of heavily infected people from the health centre's records. Finally, a calculation model is presented to estimate the expected number of visitors to the health centre, based on data from the field survey.

Etude de la reactivite vasculaire au froid: application a l'hypertension arterielle

Nous avons examine 46 sujets dont 22 hypertendus et 24 normotendus; que nous avons soumis au test au froid selon le protocole de Hines et Brown. Dans les deux groupes on a observe une augmentation significative des pressions systolique; diastolique et moyenne; la frequence cardiaque ne s'elevant pas de facon significative. Chez les hypertendus nous avons observe une augmentation de la pression differentielle; ce qui n'est pas le cas chez les normotendus. Les hypertendus reagissent plus vivement que les normotendus et cette difference est marquee par l'augmentation de la pression diastolique. En classant les sujets selon leurs degres de reactivite; 72 pour cent des hypertendus sont repondeurs contre 50 pour cent de normotendus. Ces resultats nous font penser que la reactivite est partie prenante des mecanismes etiologiques ou pathologiques de l'hypertension arterielle; et que cette meme reactivite depend non seulement de l'augmentation serique des substances vaso actives mais aussi de l'etat vasculaire. L'etat vasculaire quant a lui serait mieux exprime par la pente de recuperation

Hemodynamic reactivity factors to cold pressor test in blacks with sustained essential hypertension.

To evaluate factors that might influence arterial pressure response to stress, 29 black African subjects were submitted to a cold pressor test. Eleven of them were normotensive healthy subjects, and 18 were hypertensive patients (WHO stage I to II). Both groups were matched in age (41 +/- 3 years and 42 +/- 3 years, respectively) and body mass index (25 +/- 2.10(-4) kg/cm2). After the cold pressor test, both groups showed a significant increase in arterial pressure, but not in heart rate absolute value. Considering the level of change in each parameter, only systolic and pulse pressure showed significant increases in hypertensive patients (respectively 16 +/- 5 mm Hg v 22 +/- 3 mm Hg, P < .02 and 3 +/- 1 mm Hg v 8 +/- 2 mm Hg, P < .01). An inverse relationship was shown in both study populations: change in systolic arterial pressure was positively and significantly correlated to the change in heart rate (r = +0.63, P < .02), but not to the change in pulse pressure (r = 0.34, P = NS) in normotensive subjects. Inversely, in hypertensive patients there was a positive and significant correlation with the change in pulse pressure (r = +0.52, P < .01), but not with the change in heart rate. We conclude that arterial pressure reactivity to the cold pressor test might be influenced by different mechanisms in normotensives and hypertensives. In the former, the withdrawal of parasympathetic tone might be the main factor, whereas in hypertensives, the cushioning of function of large arteries might be the principal factor.