La gigantomastie juvénile: à propos d’un cas à l’institut Joliotcurie de Dakar et revue de la literature

La gigantomastie juvénile ou hypertrophie mammaire virginale est une augmentation pathologique supérieure à 1500 cm3 du volume des deux seins chez l'adolescente. Elle entraine des répercussions psychologiques et physiques importantes. Les traitements médicaux sont décevants laissant la place à la chirurgie qui peut compromettre l'avenir fonctionnel des glandes mammaires. Nous rapportons le cas d'une jeune fille porteuse d'une gigantomastie juvénile. Il s'agissait d'une jeune fille de 15 ans porteuse d'une gigantomastie invalidante dont la prise en charge, essentiellement chirurgicale par une mammoplastie de réduction a été effectuée à l'Institut Joliot Curie de Dakar. La gigantomastie juvénile est rare. Elle est invalidante chez une patiente en pleine croissance avec des répercussions psychologiques et physiques. Le traitement est médical et chirurgical. Les grossesses sont possibles et les récidives ne sont pas rares.Pan African Medical Journal 2015; 2

La gigantomastie gravidique à l’Institut du Cancer de Dakar: à propos de 2 cas

La gigantomastie gravidique est une augmentation exagérée et invalidante de la taille des seins survenant pendant la grossesse chez une patiente aux seins préalablement normaux. Sa physiopathologie est mal cernée. Elle pose localement des problèmes trophiques et rend difficile la grossesse. Le traitement est médical anti hormonal et chirurgical sur la base d'une réduction mammaire. Il est difficile et peut compromettre l'avenir esthétique et fonctionnel de la glande mammaire. Nous rapportons 2 cas de gigantomasties gravidiques suivies et traitées à l'Institut Joliot Curie de Dakar.Pan African Medical Journal 2015; 2

Relationship between Antibody Levels, IgG Binding to Plasmodium falciparum-Infected Erythrocytes, and Disease Outcome in Hospitalized Urban Malaria Patients from Dakar, Sénégal

Background. Management of clinical malaria requires the development of reliable diagnostic methods and efficient biomarkers for follow-up of patients. Protection is partly based on IgG responses to parasite antigens exposed at the surface of infected erythrocytes (iRBCs). These IgG responses appeared low during clinical infection, particularly in severe disease. Methods. We analyzed the IgG binding capacity to the surface of live erythrocytes infected by knob positive FCR3 strain. Sera from 69 cerebral malaria (CM) and 72 mild malaria (MM) cases were analyzed by ELISA for IgG responses to five antigens from iRBC and by flow cytometry for IgG binding as expressed in labeling index ratio (LIR). The relationship between IgG levels, LIR, parasitemia, age, and the clinical outcomes was evaluated. Results. We found a significant decrease of LIR in adult CM fatal cases compared to surviving patients (p=0.019). In MM, LIRs were correlated to IgG anti-iRBC and anti-PfEMP3/5 levels. In CM, no correlation was found between LIR, IgG levels, and parasitemia. Conclusion. The IgG binding assay was able to discriminate outcome of cerebral malaria cases and it deserves further development as a potential functional-associated assay for symptomatic malaria analysis

Asymptomatic Plasmodium vivax infections among Duffy-negative population in Kedougou, Senegal

International audienceBackground: In the southeastern Senegal, the report of Plasmodium vivax infections among febrile patients in Kedougou constitutes a new emerging health problem.Methods: Samples from 48 asymptomatic schoolchildren sampled twice a year over 2 years were used to explore the reservoir of P. vivax parasite infections in this region. Both Duffy genotyping and Plasmodium species diagnostic assays were performed.Results: PCR assays detected Plasmodium genomic DNA in 38.5% (74/192) of samples. Pure P. falciparum and P. vivax infections were identified in 79.7% (59/74) and 20.3% (15/74) of samples, respectively. All schoolchildren were classified as Duffy-negative by genotyping. P. vivax infections were detected in five children: in two children during both years, in one child in 2010 and on May 2011, and only in 2010 for the remaining two children.Conclusions: This unexpectedly high proportion of P. vivax infections in asymptomatic Duffy-negative children highlights to consider vivax malaria as an emerging problem in Senegal

Low genetic diversity and complexity of submicroscopic Plasmodium falciparum infections among febrile patients in low transmission areas in Senegal

International audienceWe examined rates of N 2 fixation from the surface to 2000 m depth in the Eastern Tropical South Pacific (ETSP) during El Niñ o (2010) and La Niñ a (2011). Replicated vertical profiles performed under oxygen-free conditions show that N 2 fixation takes place both in euphotic and aphotic waters, with rates reaching 155 to 509 mmol N m 22 d 21 in 2010 and 24614 to 118687 mmol N m 22 d 21 in 2011. In the aphotic layers, volumetric N 2 fixation rates were relatively low (,1.00 nmol N L 21 d 21), but when integrated over the whole aphotic layer, they accounted for 87-90% of total rates (euphotic+aphotic) for the two cruises. Phylogenetic studies performed in microcosms experiments confirm the presence of diazotrophs in the deep waters of the Oxygen Minimum Zone (OMZ), which were comprised of non-cyanobacterial diazotrophs affiliated with nifH clusters 1K (predominantly comprised of a-proteobacteria), 1G (predominantly comprised of c-proteobacteria), and 3 (sulfate reducing genera of the d-proteobacteria and Clostridium spp., Vibrio spp.). Organic and inorganic nutrient addition bioassays revealed that amino acids significantly stimulated N 2 fixation in the core of the OMZ at all stations tested and as did simple carbohydrates at stations located nearest the coast of Peru/Chile. The episodic supply of these substrates from upper layers are hypothesized to explain the observed variability of N 2 fixation in the ETSP

Resistance profile of bacteria isolated from the environment of high-risk departments in Ziguinchor hospitals

Background: The environment of our hospital facilities is colonised by various microorganisms. These microorganisms in general and bacteria in particular are often responsible for nosocomial infections. The occurrence of these infections is linked firstly to the lack of asepsis, secondly to the nature of the colonising bacteria and thirdly to the immune status of the patients. The objective of this study was to evaluate the composition of the bacterial flora and to determine the antibiotic resistance profile of these bacteria. Methods : We proceeded to swab the surface of the work areas (table, bench, trolley, hospital bed, door wrist, gurney, incubator, respirator, etc.).  The swabs were then soaked in a culture broth (Thioglycolate Broth or BT) for 18 to 24 hours before being plated on selective media for identification ; Chapman agar, EMB agar (Eosin Methylen Blue), GSN agar (Blood Agar + nalidixic acid), Sabouraud agar. Results: The isolated bacteria consisted mainly of multidrug-resistant bacteria (MDR). Thus, extended-spectrum beta-lactamase-secreting bacteria represented 5.5% (8 strains) of the isolated bacteria were distributed as follows: Enterobacter spp (25%, n=4) Klebsiella pneumoniae (12.5%, n=2) and Escherichia coli (12.5%, n=2). Among the other BMR, we found Acinetobacter spp (25%, n=4), Pseudomonas aeruginosa (6.25%, n=1) and methicillin-resistant Staphylococcus aureus (18.75%, n=3). Conclusion: Nosocomial infections are nowadays one of the main causes of prolonged hospital stay. The isolated bacteria of medical interest were mainly multidrug resistant bacteria. It is therefore imperative to respect the rules of hygiene during care and to evaluate the composition of the bacterial flora of the services in order to set up a strategic plan to fight against these infections

Fine-scale Spatiotemporal Mapping of Asymptomatic and Clinical Plasmodium falciparum Infections: Epidemiological Evidence for Targeted Malaria Elimination Interventions

International audienceAbstract Background A detailed understanding of the contribution of the asymptomatic Plasmodium reservoir to the occurrence of clinical malaria at individual and community levels is needed to guide effective elimination interventions. This study investigated the relationship between asymptomatic Plasmodium falciparum carriage and subsequent clinical malaria episodes in the Dielmo and Ndiop villages in Senegal. Methods The study used a total of 2792 venous and capillary blood samples obtained from asymptomatic individuals and clinical malaria datasets collected from 2013 to 2016. Mapping, spatial clustering of infections, and risk analysis were performed using georeferenced households. Results High incidences of clinical malaria episodes were observed to occur predominantly in households of asymptomatic P falciparum carriers. A statistically significant association was found between asymptomatic carriage in a household and subsequent episode of clinical malaria occurring in that household for each individual year (P values were 0.0017, 6 × 10–5, 0.005, and 0.008 for the years 2013, 2014, 2015, and 2016 respectively) and the combined years (P = 8.5 × 10–8), which was not found at the individual level. In both villages, no significant patterns of spatial clustering of P falciparum clinical cases were found, but there was a higher risk of clinical episodes <25 m from asymptomatic individuals in Ndiop attributable to clustering within households. Conclusion The findings provide strong epidemiological evidence linking the asymptomatic P falciparum reservoir to clinical malaria episodes at household scale in Dielmo and Ndiop villagers. This argues for a likely success of a mass testing and treatment intervention to move towards the elimination of malaria in the villages of Dielmo and Ndiop

Correction to: Fine-scale Spatiotemporal Mapping of Asymptomatic and Clinical Plasmodium falciparum Infections: Epidemiological Evidence for Targeted Malaria Elimination Interventions

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