Human antibody response to Anopheles saliva for comparing the efficacy of three malaria vector control methods in Balombo, Angola

Human antibody (Ab) response to Anopheles whole saliva, used as biomarker of Anopheles exposure, was investigated over a period of two years (2008–2009), in children between 2 to 9 years old, before and after the introduction of three different malaria vector control methods; deltamethrin treated long lasting impregnated nets (LLIN) and insecticide treated plastic sheeting (ITPS) - Zero Fly®) (ITPS-ZF), deltamethrin impregnated Durable (Wall) Lining (ITPS-DL – Zerovector®) alone, and indoor residual spraying (IRS) with lambdacyhalothrin alone. These different vector control methods resulted in considerable decreases in all three entomological (82.4%), parasitological (54.8%) and immunological criteria analyzed. The highest reductions in the number of Anopheles collected and number of positive blood smears, respectively 82.1% and 58.3%, were found in Capango and Canjala where LLIN and ITPS-ZF were implemented. The immunological data based on the level of anti-saliva IgG Ab in children of all villages dropped significantly from 2008 to 2009, except in Chissequele. These results indicated that these three vector control methods significantly reduced malaria infections amongst the children studied and IRS significantly reduced the human-Anopheles contact. The number of Anopheles, positive blood smears, and the levels of anti-saliva IgG Ab were most reduced when LLIN and ITPS-ZF were used in combination, compared to the use of one vector control method alone, either ITPS-DL or IRS. Therefore, as a combination of two vector control methods is significantly more effective than one control method only, this control strategy should be further developed at a more global scale

In-vivo resistance of Plasmodium falciparum to chloroquine and amodiaquine in South Cameroon and age-related efficacy of the drugs

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Malaria overdiagnosis and subsequent overconsumption of antimalarial drugs in Angola : consequences and effects on human health

Microscopic blood smear examinations done in health centers of Angola demonstrated a large overdiagnosis of malaria cases with an average rate of errors as high as 85%. Overall 83% of patients who received Coartem® had an inappropriate treatment. Overestimated malaria diagnosis was noticed even when specific symptoms were part of the clinical observation, antimalarial treatments being subsequently given. Then, malaria overdiagnosis has three main consequences, (i) the lack of data reliability is of great concern, impeding epidemiological records and evaluation of the actual influence of operations as scheduled by the National Malaria Control Programme; (ii) the large misuse of antimalarial drug can increase the selective pressure for resistant strain and can make a false consideration of drug resistant P. falciparum crisis; and (iii) the need of strengthening national health centers in term of human, with training in microscopy, and equipment resources to improve malaria diagnosis with a large scale use of rapid diagnostic tests associated with thick blood smears, backed up by a “quality control” developed by the national health authorities. Monitoring of malaria cases was done in three Angolan health centers of Alto Liro (Lobito town) and neighbor villages of Cambambi and Asseque (Benguéla Province) to evaluate the real burden of malaria. Carriers of Plasmodium among patients of newly-borne to 14 years old, with or without fever, were analyzed and compared to presumptive malaria cases diagnosed in these health centers. Presumptive malaria cases were diagnosed six times more than the positive thick blood smears done on the same children. In Alto Liro health center, the percentage of diagnosis error reached 98%, while in Cambambi and Asseque it was of 79% and 78% respectively. The percentage of confirmed malaria cases was significantly higher during the dry (20.2%) than the rainy (13.2%) season. These observations in three peripheral health centers confirmed what has already been noticed in other malaria endemic regions, and highlight the need for an accurate evaluation of the Malaria control programme implemented in Angola

Malnutrition protéino-énergétique chez les enfants de moins de 5 ans de la région continentale de la Guinée équatoriale, octobre 1992

Une évaluation de la situation nutritionnelle des enfants de moins de 59 mois a été réalisée sur la partie continentale de la Guinée Equatoriale en 1992 à partir d'un échantillon de 1200 enfants. Si la prévalence de la malnutrition aigüe est moins élevée que dans les pays voisins, l'importance de la malnutrition chronique déjà décrite en 1987 reste un véritable problème de santé publique. Ces éléments soulignent la nécessité de la mise en oeuvre d'un programme adapté de protection nutritionnelle de ces enfants. (Résumé d'auteur

Hystérectomie obstétricale d’urgence : aspects cliniques et thérapeutiques à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé

Le but de ce travail était d’étudier les aspects cliniques et thérapeutiques de l’hystérectomie obstétricale d’urgence (HOU) à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé (HGOPY). Nous avons mené une étude transversale avec collecte rétrospective des données sur une période de 10 ans, du 1er Janvier 2008 au 31 Décembre 2017. Ont été inclus toutes les patientes ayant bénéficié d’une HOU à la maternité de l’HGOPY. Les informations ont été recueillies à partir des dossiers des patientes et des registres du bloc opératoire et de la salle d’accouchement. Les logiciels SPSS version 20.0 et Epi info 3.5.4 ont été utilisés pour analyser les données. Sur les 27274 accouchements sur la période d’étude, 75 HOU ont été pratiquées, soit une prévalence de 0,3%. La moyenne d’âge des  patientes était de 31,6±5,6 ans. Les principales indications d’HOU étaient : l’atonie utérine (50,7%), la rupture utérine (48,0%). L’HOU intervenait leplus souvent après une césarienne (64,0 %) exclusivement sous anesthésie générale et était plus souvent subtotale (86,7%). Les complications post opératoires incluaient l’anémie (100%) et lasuppuration pariétale (16,0% ; 12/75). Le taux de létalité était respectivement de 18,7% (14/75) et 58,7% (44/75) pour la mère et le foetus. L’HOU était pratiquée chez les femmes jeunes pour des indications d’hémorragie. Améliorer la qualité des soins obstétricaux pourrait diminuer sa fréquence de même que sa morbidité et sa mortalité.Mots-clés : hystérectomie d’urgence, grossesse, circonstances de survenue et pronostic.The aim of this study was to describe the clinical and therapeutic aspects of peripartum hysterectomy at the Yaoundé Gyneco-Obstetric- and Pediatric Hospital. We carried out a cross-sectional study with retrospective data collection over a period of 10 years, from January 2008 to 31 December  2017. Medical records reporting cases of peripartum hysterectomy were used. Data were collected from medical records, operating and delivery room registers. Data analysis was done using the softwares SPSS version 20.0 and Epi info 3.5.4. During our study period, 27274 deliveries occurred with 75peripartal hysterectomies, a prevalence of 0.28%. The mean age of parturients was 31.58±5.58 years. The main indications for peripartal hysterectomies were: uterine atony (50.7%) and uterine rupture (48.0%). Most cases were cesarean hysterectomies (64.0%). General endotrachealanesthesia was used exclusively, and a subtotal hysterectomy was performed in 86.7% of cases. Post-operative complications included anemia (100%) and abdominal wall suppuration (16.0% ; 12/75). Maternal and fetal mortalities were 18.7% (14/75) and 58.7% (44/75), respectively. Peripartal hysterectomy was indicated for hemorrhage in young women. Improvement in obstetrical care could diminish both the prevalence of peripartal hysterectomies, and its associated morbidity and mortality.Key words: peripartal hysterectomy, post-partum hemorrhage, uterine rupture, uterine atony, maternal mortality, fetal death

Malnutrition protéino-énergétique chez les enfants de moins de 5 ans du département de la Méfou au Cameroun, février-mars 1993

Dans le cadre d'un projet de renforcement des activités de soins de santé primaires du département de la Méfou, situé dans la province du Centre au Cameroun, une enquête anthropométrique a été réalisée du 4 février au 26 mars 1993. L'échantillon de 1303 enfants âgés de 0 à 59 mois, a été obtenu par un sondage en grappes à deux degrés. 24,5% des enfants (I.C. 95% : 21,5%-27,5%) présentaient une malnutrition chronique (Taille pour l'âge < moins 2 écarts-type de la moyenne de la population de référence N.C.H.S./O.M.S.), 12,9% (I.C. 95% : 10,7%-15,2%) une insuffisance pondérale (poids pour l'âge < moins 2 écarts-type) et 2,1% (I.C. 95% : 1,4 %-2,8 %) une malnutrition aiguë (poids pour l'âge < moins 2 écarts-type et/ou présence d'oedèmes des pieds). (Résumé d'auteur