Mycobacterium ulcerans

Objective. The usual preferential site of BU is in the limbs. In our experience, we noticed atypical and often misleading sites which pose serious issues for the diagnosis and often for the treatment. Methods. This is a retrospective study conducted over a period of ten years of BU treatment at the Department of Dermatology of the University Teaching Hospital of Treichville (Abidjan, Côte d’Ivoire). We included in this study all BU cases with atypical site diagnosed clinically and confirmed either by the histology, by smear, or by PCR. Results. Epidemiologically, the age of patients ranged from 3 to 72 years with a median age of 14.2 years. Children aged less than 15 years were affected in almost 80% of case. The clinical table was dominated by ulcerated forms in 82.1% of cases. The unusual topography mostly observed was that of the torso (thorax, back, and abdomen) in 76.8% of cases. Conclusion. BU is an endemic disease in Côte d’Ivoire where it constitutes a serious public health issue. Several years following its first cases, BU still is little known. This dermatosis may present atypical misleading clinical aspects which must be ignored

Parasitological Indices of Malaria Transmission in Children under Fifteen Years in Two Ecoepidemiological Zones in Southwestern Burkina Faso

Twenty years after the latest publications performed on the parasitological indices of malaria transmission in northwest of the second city of Burkina Faso, it was important to update the epidemiological profile of malaria in children under the age of 15 years. The objective of this study was to determine and compare the parasitological parameters of malaria transmission by season, area, and age in the two zones (rice and savanna) in the northwest of Bobo-Dioulasso, Burkina Faso. Overall, the results showed that there was no significant difference in the parasitological indices of malaria transmission within children under fifteen years between the rice site and the savannah site and whatever the season (P>0.05). The profound environmental modifications that occurred in the rice zone would have led to changes in vector behavior and consequently to changes in the epidemiological profile of malaria, contrary to the results obtained since the last publications. An entomological study correlated with this study is therefore necessary for effective decision-making for the malaria control in both areas. Future research must now focus on the impact that these profound environmental modifications of rice area are having on malaria control in Burkina Faso

Case Report Multifocal Buruli Ulcer Associated with Secondary Infection in HIV Positive Patient

Buruli ulcer is a chronic and infectious skin disease, caused by Mycobacterium ulcerans. It leads to large skin ulceration and sometimes bone infection which is responsible for deformities. Here, we report a case of multifocal form of Buruli ulcer associated with secondary infection in a 46-year-old human immunodeficiency virus (HIV) positive woman. The antimycobacterial drugs combined to surgery allowed curing this multifocal case and rose up two relevant issues: the susceptibility of immune reconstitution inflammatory syndrome (IRIS) occurrence and Mycobacterium dissemination. The deep immune depression, the underline biological, and clinical disorders of the patient might contribute to IRIS occurrence and Buruli ulcer dissemination. Future investigations have to be conducted on the mechanism of IRIS on set and on Mycobacterium ulcerans dissemination after ARV drugs initiation and the patient related underline clinical or biological disorders

Surveys of Arboviruses Vectors in Four Cities Stretching Along a Railway Transect of Burkina Faso: Risk Transmission and Insecticide Susceptibility Status of Potential Vectors

Background: A severe outbreak of dengue occurred in Burkina Faso in 2016, with the most cases reported in Ouagadougou, that highlights the necessity to implement vector surveillance system. This study aims to estimate the risk of arboviruses transmission and the insecticide susceptibility status of potential vectors in four sites in Burkina Faso.Methods: From June to September 2016, house-to-house cross sectional entomological surveys were performed in four cities stretching along a southwest-to-northeast railway transect. The household surveys analyzed the presence of Aedes spp. larvae in containers holding water and the World Health Organization (WHO) larval abundance indices were estimated. WHO tube assays was used to evaluate the insecticide susceptibility within Aedes populations from these localities.Results: A total of 31,378 mosquitoes' larvae were collected from 1,330 containers holding water. Aedes spp. was the most abundant (95.19%) followed by Culex spp. (4.75%). Aedes aegypti a key vector of arboviruses (ARBOV) in West Africa was the major Aedes species found (98.60%). The relative larval indices, house index, container and Breteau indexes were high, up to 70, 35, and 10, respectively. Aedes aegypti tended to breed mainly in discarded tires and terracotta jars. Except in Banfora the western city, Ae. aegypti populations were resistant to deltamethrin 0.05% in the other localities with low mortality rate under 20% in Ouagadougou whereas they were fully susceptible to malathion 5% whatever the site. Intermediate resistance was observed in the four sites with mortality rates varying between 78 and 94% with bendiocarb 0.1%.Conclusions: This study provided basic information on entomological indices that can help to monitor the risks of ARBOV epidemics in the main cities along the railway in Burkina Faso. In these cities, all larval indices exceeded the risk level of ARBOV outbreak. Aedes aegypti the main species collected was resistant to deltamethrin 0.05% and bendiocarb 0.1% whereas they were fully susceptible to malathion 5%. The monitoring of insecticide resistance is also important to be integrated to the vector surveillance system in Burkina Faso

Epidemiological, Clinical, and Paraclinic Aspect of Cutaneous Sarcoidosis in Black Africans

The specific objectives were to identify the epidemiology of cutaneous sarcoidosis and describe the clinical and laboratory aspects of the disease. Materials and Methods. We performed a descriptive cross-sectional study involving 24 referred cases of cutaneous sarcoidosis in 25 years (1990–2014) collected at Venereology Dermatology Department of the University Hospital of Treichville (Abidjan) both in consultation and in hospitalization. Results. The hospital frequency was one case per year. The average age was 42 years, ranging from 9 to 64. The sex ratio was 1. The shortest time interval between the appearance of the skin lesion and consultation of Dermatology Department at CHU Treichville was 3 months. The elementary lesions were represented primarily by a papule (18 cases), placard (3 cases), and nodule (2 cases) and mainly sat on the face and neck in 8 cases (38%). Extra cutaneous lesions were dominated by ganglion and respiratory involvement with 5 cases each followed by musculoskeletal damage in 3 cases. Chest radiography showed abnormality in 13 cases (54%). The pulmonary function test performed in 13 patients found 7 cases (54%) having restrictive ventilatory syndrome and 6 cases (46%) being normal. A tuberculin anergy was found in 11 cases (61%)

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Aspects épidémio-cliniques du paludisme chez les enfants d’âge scolaire au Centre de Référence de la Commune IV du district de Bamako

Nous avons effectué du 2 février 2009 au 1 février 2010 une étude rétrospective sur les aspects épidémiocliniques du paludisme chez les enfants de 5 à 12 ans, au Centre de Santé de Référence de la commune IV du district de Bamako. L’enquête a porté sur 836 sujets dont 302 cas de paludisme diagnostiqué. Les variables cliniques aussi bien que parasitologiques ont été évaluées chez chaque enfant. La goutte épaisse ou le test de diagnostique rapide a été réalisé pour diagnostiquer le paludisme. Nos résultats ont montré que la fièvre intermittente représentait le motif de consultation le plus fréquent, soit 51% des cas. La majorité de nos patients, soit 77,2% ont fait le paludisme simple contre 22,8% de cas de paludisme grave. La goutte épaisse était positive dans 156 cas sur 461 (33,8%) et le test rapide 146 cas de positif sur 375 (38,9%). Le taux de guérison était de 97,7% des cas dont 74,8% (226/302) avec les Combinaisons Thérapeutiques à base d'Artémisinine (CTA). Notre travail a montré que les enfants d’âge scolaire, n’étant pas pris en charge gratuitement par le Programme National de Lutte contre le Paludisme constituent un groupe à risque aussi élevé et méritent une attention particulière tout autant que ceux de moins de cinq ans

Model-based assessment of Chikungunya and O’nyong-nyong virus circulation in Mali in a serological cross-reactivity context

International audienceSerological surveys are essential to quantify immunity in a population but serological cross-reactivity often impairs estimates of the seroprevalence. Here, we show that modeling helps addressing this key challenge by considering the important cross-reactivity between Chikungunya (CHIKV) and O’nyong-nyong virus (ONNV) as a case study. We develop a statistical model to assess the epidemiology of these viruses in Mali. We additionally calibrate the model with paired virus neutralization titers in the French West Indies, a region with known CHIKV circulation but no ONNV. In Mali, the model estimate of ONNV and CHIKV prevalence is 30% and 13%, respectively, versus 27% and 2% in non-adjusted estimates. While a CHIKV infection induces an ONNV response in 80% of cases, an ONNV infection leads to a cross-reactive CHIKV response in only 22% of cases. Our study shows the importance of conducting serological assays on multiple cross-reactive pathogens to estimate levels of virus circulation

Author Correction: Model-based assessment of Chikungunya and O’nyong-nyong virus circulation in Mali in a serological cross-reactivity context

International audienc