New-onset diabetic ketoacidosis in a 13-months old african toddler: a case report

Type 1 diabetes mellitus is very rare in infants and toddlers and is usually associated with high mortality when complicated with diabetic ketoacidosis (DKA). Toddlers in DKA are often missed in our typical African setting where there is low index of suspicion. Usually, the classical symptoms are not usually at the forefront and many infants and toddlers who develop DKA are mistreated for infections. The case of a 13-months old toddler with new-onset type 1 diabetes mellitus, complicated with DKA at diagnosis is reported in view of its rarity and elevated mortality even when diagnosed in our African setting. She was subsequently treated with intravenous insulin and was passed over to subcutaneous insulin after the eradication of ketones in urine. She continues follow-up at the out-patient children diabetes clinic at the Bafoussam Regional Hospital.Key words: Diabetic ketoacidosis, children, Africa, diabetes complicatio

Burden of visceral leishmaniasis in villages of eastern gedaref state, Sudan: an exhaustive cross-sectional survey.

Since December 2009, Médecins Sans Frontières has diagnosed and treated patients with visceral leishmaniasis (VL) in Tabarak Allah Hospital, eastern Gedaref State, one of the main endemic foci of VL in Sudan. A survey was conducted to estimate the VL incidence in villages around Tabarak Allah

Determinants of Smallholder Vegetable Farmers Credit Access and Demand in Southwest region, Cameroon

The study analyzed the determinants of smallholder vegetable farmer’s access and demand to credit. Primary data were collected from hundred randomly selected farmers with the aid of structured questionnaires using multi-stage sampling procedures. One common approach used to modeling this situation is the Tobit model. However, the decision taken by farmers to demand credit is preceded by the decision to have “access to credit”. We find that the estimates from the Tobit model captured the demand decision at the level of access. Thus, the double-hurdle model seems appropriate to determine factors influencing credit demand. The study concluded that the spread of lending agencies, membership to farmers’ association and agricultural extension services increase both access to and demand for credit. In addition, small-scale and female farmers should be encouraged to form associations to ensure appropriate information sharing and advantage of non-rationing credit

Renin angiotensin aldosterone system altered in resistant hypertension in Sub-Saharan African diabetes patients without evidence of primary hyperaldosteronism

Background The renin-angiotensin-aldosterone system may be altered in patients with resistant hypertension. This study aimed to evaluate the relation between renin-angiotensin-aldosterone system activity and resistant hypertension in Cameroonian diabetes patients with resistant hypertension. Methods We carried out a case-control study including 19 diabetes patients with resistant hypertension and 19 diabetes patients with controlled hypertension matched to cases according to age, sex and duration of hypertension since diagnosis. After collection of data, fasting blood was collected for measurement of sodium, potassium, chloride, active renin and plasma aldosterone of which the aldosterone-renin ratio was derived to assess the activity of renin-angiotensin-aldosterone system. Then, each participant received 2000 ml infusion of saline solution after which plasma aldosterone was re-assayed. Results Potassium levels were lower among cases compared to controls (mean: (4.10 ± 0.63 mmol/l vs. 4.47 ± 0.58 mmol/l), though nonsignificant (p = 0.065). Active renin, plasma aldosterone both before and after the dynamic test and aldosterone-renin ratio were comparable between cases and controls (all p values > 0.05). Plasma aldosterone significantly decreased after the dynamic test in both groups (p 280 pmol/l. We found a significant negative correlation between potassium ion and plasma aldosterone (ρ = −0.324; p  = 0.047), the other correlations being weak and unsignificant. Conclusion Although this study failed to show an association between RH and primary hyperaldosteronism in our context, there was a hyperactivity of renin-angiotensin-aldosterone system. Moreover, this study confirms the importance of potassium dosage when screening the renin-angiotensin-aldosterone system

Incidence of VL over past year, eastern Gedaref State, Sudan, May-June 2011.

<p>* The size and the colour of the circles are proportionate to VL incidence.</p

Age and sex distribution of VL cases in the past year (725 previously treated cases and 16 new cases) and of the general population, eastern Gedaref State, Sudan, May-June 2011.

*<p>Missing sex in general population: 99 (30 aged 0 to 4 years old, 18 aged 5 to 14 years old, 47 aged 15 and above, 4 with missing age).</p

Flowchart of individuals assessed for fever of at least 2 weeks duration, eastern Gedaref State, Sudan, May-June 2011.

<p>* Positive rK39 test in PKDL suspect, never treated for VL in the past. DAT: Direct Agglutination Test.</p