Place de la détermination de l’iode urinaire dans l’exploration du sujet hyperthyroïdien

Urinary iodine is not included in systematic exploration of patients with hyperthyroidism, substituted by hormonal measurements and scintigraphy exploration. Using micro plate colorimetric method, we have explored the interest of urinary iodine in differential diagnosis of some pathologies. We have shown that urinary iodine concentrations are not different between patients with euthyroidism and Basedow’s syndrome. In patients with auto-immune or viral sub acute thyroiditis, urinary iodine is increased to 3 and to 10 in patients with iodine excess. In thyroiditis, urinary iodine is maximal during acute access. The follow-up of urinary iodine concentrations permits to evaluate the thyroid tissue damages and therapeutic efficiency.     

Investigation d’un foyer épidémique de bilharziose urinaire dans l’école primaire du village de Guébo 2, Abidjan,Côte d’Ivoire

We report the results of an outbreak investigation of urinary schistosomiasis in 2012 among school children at Guébo 2. Among the 250 school children, 107 (42.8%) had confirmed urinary schistosomiasis. Age ≥ 10y (OR = 2.6 [1.1 to 6.2]) and self-reported bathing in the river (OR = 14.0 [4.7 to 42.5]) were associated with the presence of S.h. in the adjusted analyses. A massive deworming of the population of Guébo-1&2 was conducted as epidemicresponse.     

Influence du mode de conservation et étude de quelques interférences sur le dosage de l’ostéocalcine par Kryptor-Osteo®

We evaluated the influence of pre-analytic factors on serum osteocalcin (Bone Gla protein) concentration measured by Kryptor-Osteo^®, Brahms, an immunofluorescent assay. Osteocalcin serum level is significantly decreased after a 2 h conservation at room temperature, after a 4 h conservation at 4 °C and by serum hemolysis. Osteocalcin concentration is relatively stable in serum with 1 to 6 freeze–thaw cycles and in turbid samples. Bilirubin does not influence osteocalcin concentration assayed in icteric serum. We advise to transport the sample on ice and to assay osteocalcin quickly after sample (less than 2 h). If not possible, serum should be frozen. Osteocalcin should not be assayed in hemolysed samples.     

évaluation de la disponibilité et l’utilisation du sérum antivenimeux dans le district de Bamako, Mali, Afrique de l’Ouest

The aim of this study is to describe the difficulties related to problems of supply and use of antivenom serum (SAV) in the district of Bamako. A retrospective study over a span of five years (January 1998-December 2002) and an interview with the staff of various facilities were conducted. The study included 2 wholesalers of pharmaceuticals, 20 private pharmacies, and 2 hospital pharmacies as they were involved in antivenom trades. A market-driving ability survey of driving practice was conducted in 37 community health centers (CHCs) and 4 dispensaries because they performed antivenom treatments during the study period. A total of 3,318 doses of antivenom were bought, including 84.4% by the People Pharmacy of Mali (PPM), a public organization, and 15.6% by Laborex, a private company. These were out of stock in 1999. Three kinds of SAV were ordered: the polyvalent IPSER Africa (1,200 vials or 36.2%), FAV Africa (318 vials or 9.6%), and Sii anti-snake venom polyvalent serum (1,800 vials or 54.2%). Orders from PPM involved IPSER Africa (Pasteur Mérieux Serum & Vaccines) and Sii anti-snake venom polyvalent serum (Serum Institute of India), and those from Laborex involved IPSER Africa and FAVAfrica (Aventis Pasteur). Onehalf of private pharmacies (54.3%) had made at least one order of SAV. The PPM lost 50% of 2,000 vials of SAV in 1996 due to the expiration of vials that were bought. Private pharmacies lost 3.6% of stocks due to expiration. Prices varied depending on the type of service and the point of sale. Costs of vials were 19,440-35,000 CFA francs (29.6-53.4 euros) for Sii antivenom and 50,200-63,000 CFA francs (76.5-96.1 euros) for FAV Africa antivenom. In CHCs, 59.5% of prescribers were unaware of the indications and methods of proper administration of the SAV, 32.3% ignored the existence of SAV, and 30.9% were skeptical about its effectiveness in treatment of envenomation by snakebite.