Crimean-Congo hemorrhagic fever, Mauritania

From February to August 2003, 38 persons were infected with Crimean-Congo hemorrhagic fever (CCHF) virus in Mauritania; 35 of these persons were residents of Nouakchott. The first patient was a young woman who became ill shortly after butchering a goat. She transmitted the infection to 15 persons in the hospital where she was admitted and four members of her family. In Nouakchott, two disease clusters and 11 isolated cases were identified. The case-fatality ratio was 28.6%. Of the patients not infected by the first case-patient, almost half were butchers, which suggests that the primary mode of animal-to-human transmission was direct contact with blood of infected animals. The hospital outbreak alerted health authorities to sporadic cases that occurred in the following weeks, which would have probably gone otherwise unnoticed. Studies must be conducted to determine the potential risk for continued sporadic outbreaks of CCHF in humans and to propose prevention measures.     

Staphylococcus aureus bacteremia in the Dakar Fann University Hospital

OBJECTIVES: The purpose of this report was to describe epidemiological, clinical, and bacteriological findings in cases of Staphylococcus aureus bacteremia at the Infectious Diseases Clinic in Dakar. MATERIALS AND METHODS: This retrospective study was carried out on data recorded between January 1, 1996 and December 31, 2002. The diagnosis of bacteremia was based on isolation of bacteria from blood culture. Bacterial susceptibility was studied with an antibiogram. Resistance to methicillin was assessed with a disk containing 5 microg of oxacillin on Mueller Hinton Agar containing 5% of NaCl. RESULTS: One hundred and thirty cases of S. aureus bacteremia were recorded. The mean age of patients was 31 years. Nosocomial bacteremia occurred in 22% of the cases. HIV infection was noted in 38 patients (29%). The death rate was 24%. Nosocomial and community-acquired strains were resistant to methicillin, respectively, in 72% and 51% of the cases. Bacteremias due to methicillin-resistant S. aureus strain were nosocomial infections in 23% of the cases. Most of the strains (80-100%) were susceptible to fusidic acid, gentamycin, erythromycin, and pefloxacin. All of them were susceptible to vancomycin. CONCLUSION: Such a high rate of MRSA bacteremia, in particular among nosocomial bacteremia, makes it essential to reinforce preventive measures in our hospitals and to provide them with effective drugs against MRSA, such as vancomycin.     

An incomplete form of pachydermoperiostosis. Diagnosis of finger clubbing

INTRODUCTION: The finger clubbing is most of the time associated with cardiovascular and pulmonary diseases. Pachydermoperiostosis also known as osteodermopathic syndrome, an hereditary disorder, is a rare cause of finger clubbing which might be difficult to diagnose in an incomplete form. EXEGESIS: We report a 36 years old black man presenting over many years polyarthralgias, broadening of fingers and clubbing of the fingers and toes extremities. This was mentioned on other family members. The physical examination was otherwise unremarkable. There were no skin thickening, no psoriasis-like and cardio-pulmonary disease features. These following exams were normal; Hemogram, fibrinogen, C reactive protein, rheumato?d factor, serum calcium and phosphorus, thyroid hormones, growth hormone, chest X-ray, gastroduodenoscopy, electrocardiogram. The skeletal X-ray documented a widespread bone formation, a sacro-iliac osteosclerosis and interosseous ossifications betwen tibias and fibulas. CONCLUSION: Pachydermoperiostosis diagnosis was set up on 3 out of the 4 Borochowitz criteria. The absence of pachyderma defines this incomplete form. The osteoarticular manifestations lead mainly to differential diagnosis with the secondary hypertrophic osteoarthropathy and chronic inflammatory rheumatisms. The underlying pathogenic mechanism of this disease remains still unclear.     

Oxidation of poly(2,2-dimethyltrimethylene sulfide) in solution

Oxidation of poly(2,2-dimethyltrimethylene sulfide) was carried out in chloroform solution at 25°C using trifluoroacetic acid and hydrogen peroxide. Six samples were obtained with weight fractions of sulfoxide comonomer ranging between 0,11 and 0,58, without any content of sulfone groups. When it is attempted to obtain samples with more than 60% of sulfoxide units, sulfone groups are formed. ¹H NMR data show the reaction to take place in a random way. Copolymers exhibit only one glass transition temperature which increases with the number of sulfoxide units, The extrapolated glass transition temperature for the theoretical polysulfoxide corresponds to a value in the range of 261 to 264 K.     

Improving quality of care and use of contraceptives in Senegal

In the 1990s, the government of Senegal implemented a series of policy changes for the provision of family planning services through the public sector. A strategy to provide high quality services through reference centres was adopted. This paper presents findings from a longitudinal survey of 1,320 Senegalese women who had sought family planning services at ten public sector facilities--five reference centres and five health centres. Information was collected on the quality of care they received at the time they adopted family planning. One thousand one hundred and ten of the respondents were followed up sixteen months later to ascertain their contraceptive status. The first principal finding was that attendees at reference centres reported receiving relative better care than those who attended health centres. On average, clients at reference centres received 4.3 out of five units of care, compared to 3.8 units as reported by health centre clients. Second, multivariate analyses indicated that quality of care received at the time of adopting a contraceptive has a significant influence on subsequent contraceptive use. Those who received good care were 1.3 times more likely to be using a method than others.     

Bionomics of Anopheles gambiae Giles,An. arabiensis Patton,An. funestus Giles and An. nili (Theobald) (Diptera: Culicidae) and transmission of Plasmodium falciparum in a Sudano-Guinean zone (Ngari,Senegal)

An entomological study was conducted in a village of Sudano-Guinean savanna in Senegal, during the rainy season from July to November 2001, to investigate the biology and the involvement of each anopheline species in malaria transmission. Mosquitoes were captured when landing on human volunteers and by pyrethrum spray catches. Twelve anopheline species were captured. Four species amounted to 97% of human-bait sampling: Anopheles gambiae molecular form S, An. arabiensis, An. funestus, and An. nili s.s. All An. gambiae and An. nili females were fed on human, whereas the anthropophilic rate was 94.5% for An. funestus and 88.9% for An. arabiensis. Plasmodium falciparum was the only malaria parasite found, and infecting only An. gambiae, An. arabiensis, An. funestus, and An. nili. The circumsporozoite rate was 4.5% for An. gambiae, 1.6% for An. arabiensis, 3.9% for An. funestus, and 2.1% for An. nili. During the period of study, the entomological inoculation rate was estimated to 264 infected bites. An. gambiae, An. arabiensis, An. funestus, and An. nili were responsible respectively of 56, 3, 20, and 21% of malaria transmission. This study shows for the first time the implication of An. nili in malaria transmission in this area and the complexity of the malaria vectorial system that should be taken into account for any malaria control strategy.     

Amplification of the sylvatic cycle of dengue virus type 2, Senegal, 1999-2000: entomologic findings and epidemiologic considerations

After 8 years of silence, dengue virus serotype 2 (DENV-2) reemerged in southeastern Senegal in 1999. Sixty-four DENV-2 strains were isolated in 1999 and 9 strains in 2000 from mosquitoes captured in the forest gallery and surrounding villages. Isolates were obtained from previously described vectors, Aedes furcifer, Ae. taylori, Ae. luteocephalus, and--for the first time in Senegal--from Ae. aegypti and Ae. vittatus. A retrospective analysis of sylvatic DENV-2 outbreaks in Senegal during the last 28 years of entomologic investigations shows that amplifications are periodic, with intervening, silent intervals of 5-8 years. No correlation was found between sylvatic DENV-2 emergence and rainfall amount. For sylvatic DENV-2 vectors, rainfall seems to particularly affect virus amplification that occurs at the end of the rainy season, from October to November. Data obtained from investigation of preimaginal (i.e., nonadult) mosquitoes suggest a secondary transmission cycle involving mosquitoes other than those identified previously as vectors.