Liver abscess of children in Côte-d’Ivoire: retrospective analysis of a series of 30 cases

Objective: The aim of this study was to report the results of liver abscess management in children.Patients and methods: We conducted a retrospective and descriptive study of 30 cases of liver abscesses collected over 9 years (March 2007 to February 2016). The following variables were studied and results were judged on the clinical and ultrasound follow-up: age, sex, hepatodigestive past history, evolution delay, clinical presentation, size, site, and number of collected pouch, HIV serology, bacteriologic exams, and management modalities.Results: Our series was made up of 18 boys and 12 girls with a mean age of 5.4 years. A past history of bloody saddles was noted in five cases. Fontan’s triad combining a painful hepatomegaly with fever was observed in 25 patients. The collection was multiple in seven cases. The right lobe was found to be the most affected in 20 (66.7%) cases. The mean diameter was 11.8 cm with extremes ranging from 4 to 18 cm. The amoebic serology was positive in nine (30%) cases and Staphylococcus aureus was found in four cases. Four patients were subjected to an exclusive medical treatment. An ultrasound-guided evacuating puncture and drainage were carried out, respectively, in five and 17 patients. A laparotomy was carried out in four patients, of which two were after secondary abscess rupture. Mortality was nil. No recurrence was recorded with a mean follow-up of 4.5 years.Conclusion: Liver abscess is not exceptional in the Ivory Coast paediatric hospital environment and constitutes a medicosurgical emergency with a good prognosis whose well-coded management needs to be early.Keywords: children, liver abscess, managemen

Undescended Testis Revealing Triorchidism in a Child: A Case Report

Polyorchidism is a rare genitourinary congenital malformation, which diagnosis is generally fortuitous in children. We report the case of a 7-year-old boy admitted to the pediatric surgery service of Donka University Hospital in Conakry for an empty left scrotum. Initially, the diagnosis of left cryptorchidism had prompted orchidopexy by inguinal approach, whose intraoperative exploration revealed two undescended left testicles. The first, located at the deep ring of the inguinal canal, had normal volume, while the second, located in the inguinal canal, was hypotrophic. The orchiectomy of the latter was performed, associated with a dartos-pouch orchidopexy of the testicle of normal volume. After one year of follow-up, no complications were noted

Building the capacity of West African countries in Aedes surveillance: inaugural meeting of the West African Aedes Surveillance Network (WAASuN)

Arboviral diseases such as dengue, Zika and chikungunya transmitted by Aedes mosquitoes have been reported in 34 African countries. Available data indicate that in recent years there have been dengue and chikungunya outbreaks in the West Africa subregion, in countries including Côte d’Ivoire, Burkina Faso, Gabon, Senegal, and Benin. These viral diseases are causing an increased public health burden, which impedes poverty reduction and sustainable development. Aedes surveillance and control capacity, which are key to reducing the prevalence of arboviral infections, need to be strengthened in West Africa, to provide information essential for the formulation of effective vector control strategies and the prediction of arboviral disease outbreaks. In line with these objectives, the West African Aedes Surveillance Network (WAASuN) was created in 2017 at a meeting held in Sierra Leone comprising African scientists working on Aedes mosquitoes. This manuscript describes the proceedings and discusses key highlights of the meeting

Pregnancy Outcomes after a Mass Vaccination Campaign with an Oral Cholera Vaccine in Guinea: A Retrospective Cohort Study

<div><p>Introduction</p><p>Since 2010, WHO has recommended oral cholera vaccines as an additional strategy for cholera control. During a cholera episode, pregnant women are at high risk of complications, and the risk of fetal death has been reported to be 2–36%. Due to a lack of safety data, pregnant women have been excluded from most cholera vaccination campaigns. In 2012, reactive campaigns using the bivalent killed whole-cell oral cholera vaccine (BivWC), included all people living in the targeted areas aged ≥1 year regardless of pregnancy status, were implemented in Guinea. We aimed to determine whether there was a difference in pregnancy outcomes between vaccinated and non-vaccinated pregnant women.</p><p>Methods and Findings</p><p>From 11 November to 4 December 2013, we conducted a retrospective cohort study in Boffa prefecture among women who were pregnant in 2012 during or after the vaccination campaign. The primary outcome was pregnancy loss, as reported by the mother, and fetal malformations, after clinical examination. Primary exposure was the intake of the BivWC vaccine (Shanchol) during pregnancy, as determined by a vaccination card or oral history. We compared the risk of pregnancy loss between vaccinated and non-vaccinated women through binomial regression analysis. A total of 2,494 pregnancies were included in the analysis. The crude incidence of pregnancy loss was 3.7% (95%CI 2.7–4.8) for fetuses exposed to BivWC vaccine and 2.6% (0.7–4.5) for non-exposed fetuses. The incidence of malformation was 0.6% (0.1–1.0) and 1.2% (0.0–2.5) in BivWC-exposed and non-exposed fetuses, respectively. In both crude and adjusted analyses, fetal exposure to BivWC was not significantly associated with pregnancy loss (adjusted risk ratio (aRR = 1.09 [95%CI: 0.5–2.25], p = 0.818) or malformations (aRR = 0.50 [95%CI: 0.13–1.91], p = 0.314).</p><p>Conclusions</p><p>In this large retrospective cohort study, we found no association between fetal exposure to BivWC and risk of pregnancy loss or malformation. Despite the weaknesses of a retrospective design, we can conclude that if a risk exists, it is very low. Additional prospective studies are warranted to add to the evidence base on OCV use during pregnancy. Pregnant women are particularly vulnerable during cholera episodes and should be included in vaccination campaigns when the risk of cholera is high, such as during outbreaks.</p></div

Timeline of the cholera vaccination campaign and field surveys in Boffa prefecture, Guinea, 2012 and 2013.

<p>Timeline of the cholera vaccination campaign and field surveys in Boffa prefecture, Guinea, 2012 and 2013.</p

Enrollment of study participants for the primary analysis and the bias-indicator analysis, Boffa prefecture, Guinea, 2013.

<p>Enrollment of study participants for the primary analysis and the bias-indicator analysis, Boffa prefecture, Guinea, 2013.</p

Longitudinal antibody and T cell responses in Ebola virus disease survivors and contacts: an observational cohort study.

BackgroundThe 2013-16 Ebola virus disease epidemic in west Africa caused international alarm due to its rapid and extensive spread resulting in a significant death toll and social unrest within the affected region. The large number of cases provided an opportunity to study the long-term kinetics of Zaire ebolavirus-specific immune response of survivors in addition to known contacts of those infected with the virus.MethodsIn this observational cohort study, we worked with leaders of Ebola virus disease survivor associations in two regions of Guinea, Guéckédou and Coyah, to recruit survivors of Ebola virus disease, contacts from households of individuals known to have had Ebola virus disease, and individuals who were not knowingly associated with infected individuals or had not had Ebola virus disease symptoms to serve as negative controls. We did Zaire ebolavirus glycoprotein-specific T cell analysis on peripheral blood mononuclear cells (PBMCs) on location in Guinea and transported plasma and PBMCs back to Europe for antibody quantification by ELISA, functional neutralising antibody analysis using live Zaire ebolavirus, and T cell phenotype studies. We report on the longitudinal cellular and humoral response among Ebola virus disease survivors and highlight potentially paucisymptomatic infection.FindingsWe recruited 117 survivors of Ebola virus disease, 66 contacts, and 23 negative controls. The mean neutralising antibody titre among the Ebola virus disease survivors 3-14 months after infection was 1/174 (95% CI 1/136-1/223). Individual results varied greatly from 1/10 to more than 1/1000 but were on average ten times greater than that induced after 1 month by single dose Ebola virus vaccines. Following reactivation with glycoprotein peptide, the mean T cell responses among 116 Ebola virus disease survivors as measured by ELISpot was 305 spot-forming units (95% CI 257-353). The dominant CD8+ polyfunctional T cell phenotype, as measured among 53 Ebola virus disease survivors, was interferon γ+, tumour necrosis factor+, interleukin-2-, and the mean response was 0·046% of total CD8+ T cells (95% CI 0·021-0·071). Additionally, both neutralising antibody and T cell responses were detected in six (9%) of 66 Ebola virus disease contacts. We also noted that four (3%) of 117 individuals with Ebola virus disease infections did not have circulating Ebola virus-specific antibodies 3 months after infection.InterpretationThe continuous high titre of neutralising antibodies and increased T cell response might support the concept of long-term protective immunity in survivors. The existence of antibody and T cell responses in contacts of individuals with Ebola virus disease adds further evidence to the existence of sub-clinical Ebola virus infection.FundingUS Food & Drug Administration, Horizon 2020 EU EVIDENT, Wellcome, UK Department for International Development.TranslationFor the French translation of the abstract see Supplementary Materials section