Endemic goiter in the Man region (Ivory Coast)

An epidemiological study involving 616 subjects carried out in the Man region, C?te-d'Ivoire, showed endemic goitre in 54,4% of the group overall and in 80 % of females. Thyroid function of subjects chosen at random in the goitrous and nongoitrous group (105 G and 71 NG respectively) was identical. Compared with a French control group T4 was significantly lower but T3 and TSH were higher, which represents a high TBG level with low iodine elimination. High levels of TSH are not necessarily associated with low T3 or T4 levels, or with clinical signs of a hypothyroid condition. They are probably the result of a transient reaction. T4-TSH and T3-TSH correlations for NG subjects were (--0,40) but the T3-TSH correlation for the G subjects was significantly lower (--0,23). These differences could be explained by the simultaneous high levels of T3 and TSH more frequently encountered in G subjects and by the fact that serious hypothyroid conditions are more frequent in the NG group (6 out of 9). The percentage of hypothyroid conditions is high in both clinical and biological investigations. No anti-thyroglobulin antibodies were found in any of the hypothyroid cases with goitre. The histograms illustrate the clinical and biological heterogeneity of a homogeneous non-medicalised population.     

Comparative study of four malaria diagnostic techniques used in Ivory Coast

The biological diagnosis of malaria plays an important part in the patients' treatment for malaria. Thus, many techniques have been developed to reach this purpose. We have compared four of them concerning 196 patients from October, 1996 to January, 1997 in Abidjan. Thick blood film has been chosen as the technique for reference. It has come out that the plasmodic index was 18.3%. The Plasmodium falciparum has been the only encountered species. The different sensitivities of the QBC test and of the Parasight F test reached 100% against 83.3% in the case of the thin blood film. The QBC test and the thin blood film had each a specificity of 100% against 88.1% for the Parasight F test. Unlike the QBC test, the thick blood film and the thin blood film have remained the most difficult to be realised. Therefore, the analysis of parameters of credibility (sensitivity, specificity), predictable values and the time involved will allow in a given situation to use the appropriate biological diagnosis technique.     

Rubella in pregnant women in Abidjan (Ivory Coast)

1,143 serums samples collected from pregnant females at first term were tested for the presence of rubella haemagglutination inhibition antibodies. Rubella antibodies were present in 679 (59.4%) of the pregnant females and 464 (40.6%) were seronegative. No statistically significant difference was found in the prevalence of rubella specific antibodies in three age categories considered. 155 positive serum samples for rubella antibodies (IHA) were tested afterward retrospectively for rubella-specific IgM by ELISA technic, and 14 (9.03%) were positive.     

Intestinal helminthiasis on Ancien-Fresco island (Ivory Coast)

An epidemiologic survey has been done in November 1987 on 220 children aged from one to four in the Ancien-Fresco island (C?te-d'Ivoire). The results show that 84.5% of the children whose excreta have been examined have parasites. The Ascaridiasis is the helminthiasis the most frequent.     

Human African trypanosomiasis in Ivory Coast: biological characteristics after treatment. 812 cases treated in the Daloa focus (Ivory Coast)

The treatment and post therapeutic follow up of patients diagnosed with HAT are important for HAT control. A longitudinal survey was implemented in the focus of Daloa (C?te d'Ivoire). A total of 812 patients infected with Trypanosoma brucei gambiense in meningoencephalitic stage and treated with melarsoprol were included, this study pointed out the biological characteristics of patients after treatment. The relapse occurs between 1 and 24 months after treatment. It is essentially neurological, and characterised by the presence in the CSF of antibodies, by the increase of cell count compared with value immediately after treatment, or by the presence of trypanosomes. The cure can be confirmed from 18 months after treatment, and is characterised by the absence of antibodies and trypanosomes in the CSF, by a normal cell count and a normal proteinorachy. Biological scares were recorded on some of the patients after 18 months of follow up, but no relapse occurred among them.     

Therapeutic efficacy of chloroquine in the uncomplicated malaria due to Plasmodium falciparum in hospital patients in central Ivory Coast (1997-2000)

A study in vivo of Plasmodium falciparum sensitivity to chloroquine was carried out from April 1997 to February 2000 at Yamoussoukro, Kossou and Bouaké in the central region of C?te d'Ivoire. This study was included in the national Plasmodium falciparum-sensitivity program. One hundred and sixteen subjects consulting for suspected malaria were included according to the WHO's standard of 14 days. Chloroquine was administered on a dosage of 25 mg/kg, spread over three days. Among 108 subjects who finished the treatment, 26.9% (29/108) had therapeutic failure to chloroquine (23 precocious therapeutic failure and 6 late therapeutic failure). Chloroquine was more efficacious in Yamoussoukro (87.5% of clinical appropriate response) and Bouaké (82.5%) than in Kossou (61.7%). Parasitic reduction on subjects with therapeutic failure was higher than 85%. The risk of therapeutic failure is not linked to age of patient. Before a revaluation of this situation, chloroquine should always be recommended as a first-line treatment for uncomplicated malaria for the local populations.     

Epidemiology of toxoplasmosis in Ivory Coast

The purpose of this study was to determine the prevalence of toxoplasmosis in samples of healthy populations in Ivory Coast. Various factors have been studied: age, sex, ethnic group, occupation, food, contacts with animals, climate. The samples were obtained in four places which were different by geographical situation and climate: Abidjan (urban site), Bonoua (littoral site), Bin-Houye (forest site), Odienne (predesert site). The samples of sera or blood were deposited on filter-papers and tested by latex agglutination (for IgG) and ISAGA (for IgM). Results were analysed by statistical methods. More than 2,000 samples have been studied, showing a prevalence higher in humid tropical zones (55.6% to 70%) than in predesert zone (37.2%). The first contact of the child with the parasite was more often before reaching 10 years but the risk for women was important until the age of 20. The other studied factors didn't appear to have any effect.     

Antitubercular drug treatment failure and HIV infection in Abidjan (Ivory Coast)

A retrospective study from 1989 to 1993 was carried out on eighty patients out of 106 cases of tuberculosis treatment failure; representing 2.2% of persons with active pulmonary tuberculosis followed at the tuberculosis screening center of Abidjan. The rate of HIV seropositivity was 43.7%. At the beginning of the therapy, 80% of HIV-positive and 89% of HIV-negative had diffuse pulmonary lesions (no significant difference: P > 0.05. At the end of second month therapy, 49% of co-infected and 51% of HIV-negative patients showed bacteriological negative sputum. The treatment administered after reporting failure, led to 63% of recovery among the HIV-positive (22/35) and 62% among the HIV-negative (28/45). On the other hand, the rate of patients out of touch was high in both populations; respectively 29% of HIV infected and 31% of HIV-negative spreading the risk of contamination of neighbourhood by probably resistant bacilli.     

Parasites of fish currently consumed in the Ivory Coast

The authors study parasites of the six most commonly consumed species of fishes in C?te-d'Ivoire. Analysis of gills, alimentary canal and blood of 188 fishes reveal the presence of extremely diverse families of parasites.     

Carriers of Salmonella among the people of four villages in Abidjan area (Ivory Coast) (author's transl)

The authors relate the results of a bacteriological investigation carried out among the people of four villages from Abidjan outskirts (about 1,704 inhabitants). They searched for individuals expelling Salmonellas from their faeces. This investigation, which lasted a year enabled, out of 1,754 cultures to isolate 109 strains belonging to various serotypes, four new ones among them. The isolations frequency increases with the rainy season, and has been especially important in one of the villages. Animals expell Salmonellas from their dejections, in a high percentage of cases.     

A case of mixed otomyiasis in Ivory Coast

Authors relate the first case of otomyiasis in Ivory Coast due to Chrysomyia bezziana and Sarcophaga sp. They insist on scarcity of such a localisation. Egg-laying and development of larvae in tympanum case was favoured by a preexisting cholesteatoma. Precise entomological diagnosis needs incubation of the larvae in Petri dishes.     

Biological health check-up for woodworkers in Ivory Coast: first results (author's transl)

A random sample of 125 woodworkers in Ivory Coast was subjected to a biological health check-up. Being relatively simple this check-up has allowed us however to reveal the following pathological states for subjects not complaining of any illness: 2 anemia, 25 haemoglobinopathies, I monoclonal dysglobulinemia, I massive dysglobulinemia with splenomegaly, 8 massive hypergammaglobulinemia. Otherwise the following frequent values gave been determined according to RICHTERICH's statistical approach: age, height, weight, hematocrite haemoglobinemia, haemoglobin type, proteinemia, lipidemia, cholesterolemia, triglyceridemia, alpha-lipoproteinemia, A. M. G. immunoglobulinemia.     

Seroepidemiology of rubella in the Ivory Coast. Geographic distribution

A total of 3,473 serum samples were collected from healthy subjects in five geographical areas of C?te-d'Ivoire, between July 1985 and August 1986, and were analysed for the presence of rubella haemagglutination inhibition antibodies. Rubella antibodies were present in 1,994 of the samples giving a prevalence of 57.4%. The distribution of this prevalence appeared to be influenced by the climatic conditions and the density of population. The areas of Korhogo and Sinematiali in the north with a hot and dry climate had high prevalences, while the areas of Bouake and Bondoukou in the Centre and Centre-east respectively had low prevalences. The prevalence of rubella antibodies increases with age until it reaches a relatively low level from the age of 15 onward. The analysis of the data by the chi 2 test indicates that there was a statistically significant variation in the prevalence of rubella antibodies between urban and rural communities (p less than 0.001). In the areas of Korhogo and Sinematiali the rubella virus appeared to be best circulate in the rural communities, while the reverse was observed in the areas of Bouake and Bondoukou. In this study, there was not a sex influence in immunity to rubella, because no difference immunity to the virus was observed between males and females. In women of child-bearing age (15 to 44 years) the rubella immunity was relatively low (61.2%).     

Epidemiology of snake bites in the Republic of Ivory Coast

A national survey was carried out in C?te d'Ivoire in 1979 in order to evaluate the incidence, morbidity and mortality of snakebites. This unpublished survey has not been renewed to our knowledge. Although 20 odd years have passed since, the survey is not obsolete and can be usefully presented at this congress. We associated a retrospective survey using health centre registers and a prospective survey performed in 7 health centres between 1972 and 1979. The incidence, estimated prospectively for rural areas, exceeded 200 bites for 100,000 inhabitants. This evaluation could be an underestimation because many victims consulted traditional practitioners. Annual morbidity was higher in forest areas (195 envenomations per 100,000 inhabitants) than in the savannah (130 envenomations per 100,000 inhabitants). Conversely, the case fatality rate was higher in the savannah (3.1%) than in forest areas (2%). More than half of the bites involved men aged 15 to 50 years. The risks were significantly higher for farmers, particularly in industrial plantations, where 27% of the total of number of bites involved 1.5% of the population. At the beginning of the 1980s, envenomations could be estimated at over 13,000 per 8 million inhabitants and the number of deaths 200 per annum.     

Epidemiology of Pseudomonas aeruginosa hospital infection in the Ivory Coast

210 P. aeruginosa hospital strains isolated at Abidjan from pathological samples or contaminated material were studied by means of serotyping, biotyping, phage-typing and for their resistance to eleven antibiotics. 87% were classified into 14 serogroups: O:1, O:2, O:3, O:4, O:5, O:6, O:8, O:9, O:10, O:11, O:12, O:13, O:15, O:16. No strains were O:7 or O:14. The presence of an ortho-nitrophenyl beta-d-galactopyranoside hydrolase was demonstrated in 42 strains belonging to the serogroup O:11. Sixty-five phage-types were defined but 37% of strains were untypable by phages. The incidence of resistance to each tested antibiotic was as follows: carbenicillin 49%, mezlocillin 44%, ticarcillin 34%, azlocillin 25%, cefamandole 94%, latamoxef 15%, cefotaxime 41%, cefsulodin 32%, tobramycin 35%, amikacin 7%, gentamicin 39%. Thirty-eight strains were multiresistant to carbenicillin, mezlocillin, ticarcillin, azlocillin, and four strains to eleven antibiotics. These results are compared with data of the scientific literature on the epidemiology of hospital Pseudomonas infection.     

Surveillance of enteroviruses in the waste water of the Ivory Coast

Viral water contamination is on the increase all over the world and one is concerned by the dangers to which it exposes health and preoccupied with the search for effective solutions. This study, which was conducted in a year in C?te-d'Ivoire, enabled us to examine the degree of viral pollution from waste water collected from a lagune. It allowed us to follow the distribution of enteroviruses and their fluctuations during the year. 164 waste water samples were tested and 93 enterovirus strains isolated. 67.89% showed polioviruses and 32.11% coxsackieviruses. Seasonal fluctuations of the virus concentration in the lagune water were shown from statistical analysis of the data collected. Concentration was high during the rainy season and definitely lower during the dry season with the rise in water temperature.