: Severe Tungiasis in Underprivileged Communities: Case Series from Brazil

Tungiasis is caused by infestation with the sand flea (Tunga penetrans). This ectoparasitosis is endemic in economically depressed communities in South American and African countries. Tungiasis is usually considered an entomologic nuisance and does not receive much attention from healthcare professionals. During a study on tungiasis-related disease in an economically depressed area in Fortaleza, northeast Brazil, we identified 16 persons infested with an extremely high number of parasites. These patients had >50 lesions each and showed signs of intense acute and chronic inflammation. Superinfection of the lesions had led to pustule formation, suppuration, and ulceration. Debilitating sequelae, such as loss of nails and difficulty in walking, were constant. In economically depressed urban neighborhoods characterized by a high transmission potential, poor housing conditions, social neglect, and inadequate healthcare behavior, tungiasis may develop into severe disease

Affections Neuroméningées Au Cours Du VIH Dans Le Service Des Maladies Infectieuses Du CHU De Brazzaville : Prévalence Et Facteurs Associés Au Décès

Goal . Neuromeningeal determine the prevalence of disease in PLHIV and identify factors associated with death. Methodology. Retrospective study on descriptive and analytical referred cases hospitalized in the Infectious Diseases department during the period 1 January 2013 to 31 May 2015. Results. One hundred and fifty patients included (10.5% of admissions) with mean age of 41.1 ± 11.8 years (range 19 to 69) women (n = 86, 57.3%), sex ratio of 1,3. were without jobs (n = 68; 45.3%), single (n = 96; 64%), heterosexually infected by HIV-1 (100%). The average time of consultation was 19.2 ± 1.3 days. Fever (n = 99; 66.0%), disorders of consciousness (n = 66; 44.0%) were the main reasons for consultations. Meningeal stiffness (40%), focal signs (n =62; 41,4%) were the main signs consideration. CSF was clear (n = 94; 62.7%), hyperproteinorachique (59.8%), hypoglycorrachique (43.8%). Examining the ink was positive in 39 cases (34.8%) The Gerh was positive in 35 patients .the CT abnormalities were dominated abscess (n = 12; 15.4%).. Thirty four patients were on TDF + FTC + EFV regimen. The average hospital stay was 14.4 ± 9.5 days. Overall mortality was 83.2% mainly due to cerebral herniation (n = 28; 33.3%). Conclusion. The prevalence and lethality of diseases neuromeningeal of HIV are high. The diagnosis delay and TNM influence the prognosis of patients; Hence the importance of early detection of HIV infection for its management to prevent immunosuppression

Controlling Tungiasis in an Impoverished Community: An Intervention Study

Tungiasis is a disease caused by the sand flea Tunga penetrans, a parasite prevalent in many impoverished communities in developing countries. The female sand flea penetrates into the skin of animals and humans where it grows rapidly in size, feeds on the host's blood, produces eggs which are expelled into the environment, and eventually dies in situ. The lesions become frequently superinfected and the infestation is associated with considerable morbidity. Clearly, tungiasis is a neglected disease of neglected populations. We investigated the impact of a package of intervention measures targeted against on-host and off-host stages of T. penetrans in a fishing community in Northeast Brazil. These measures decreased disease occurrence only temporarily, but had a sustained effect on the intensity of the infestation. Since infestation intensity and morbidity are correlated, presumably the intervention also lowered tungiasis-associated morbidity. Control measures similar to the ones used in this study may help to effectively control tungiasis in impoverished communities

Risk Factors for Tungiasis in Nigeria: Identification of Targets for Effective Intervention

Tungiasis is a parasitic skin disease caused by the sand flea Tunga penetrans. After penetration into the skin, the flea grows and reaches the size of a pea. The disease is a neglected public health problem in endemic areas in Latin America, the Caribbean and Africa, and causes considerable morbidity in the affected communities. We performed a study in a rural community in Nigeria to detect factors associated with tungiasis. People were examined for the presence of sand flea lesions, and a questionnaire was applied. Of the 643 individuals examined, 252 (42.5%) had tungiasis. The most important factors independently associated with the disease were: presence of pigs on the compound (adjusted odds ratio [OR] = 17.98), sand or clay floor inside house (OR = 9.33), and having the common resting place outside the house (OR = 7.14). The regular use of closed footwear (OR = 0.34) and the use of insecticides indoors (OR = 0.2) were protective factors. Our data show that tungiasis in this community is determined to an important extent by some variables that may be a target for interventions

Local religion and political power in the Gabon : case of the rite Ndjobi to Mbede

Entre Sociologie politique et Anthropologie religieuse, cette thèse tente de comprendre l’interaction entre « Religion locale et pouvoir politique» dans la perspective de consolidation du pouvoir en Afrique, plus précisément au Gabon. Elle met l’accent sur la gestion du pouvoir politique en Afrique et analyse les rapports du rite initiatique Ndjobi avec le pouvoir politique dans la communauté Mbede. Ce champ thématique est déconstruit jusqu’à la nation gabonaise à travers l’initiation et l’implication des politiques locaux aux religions locales. Le rite Ndjobi serait une contre-offensive locale visant à réparer l’univers social et à protéger les Mbede. C’est un élément fondamental au maintien de l’ordre à travers le symbolisme de l’Okèlè é Ndjobi qui est l’affirmation par laquelle un initié prend à témoin le sacré et la vérité de la déclaration qu’il profère devant le panier contenant les reliques du Ndjobi. Pour un chef traditionnel, ce rite serait un moyen de compenser une déficience constitutionnelle de son pouvoir politique afin d’entretenir chez ses sujets initiés respect et surtout crainte. Le serment du Ndjobi serait un contrat politique de confiance à un chef de village, à un responsable politique initié à ce rite. A travers cette déconstruction, cette religion locale pourrait être appréhendée comme un support du pouvoir politique gabonais à l’échelle nationale. Les serments se font avec des paroles ; mais en Afrique noire, ces paroles ne sont pas légères. Elles permettent d’agir sur soi, sur les autres et sur le monde concerné comme une contrainte comparable à une épée de Damoclès. Cette contrainte s’exerce d’une manière subtile et imposée avec quelques négociations intra-politiques liées à la « politique du ventre » pour que l’initiation ne s’apparente pas à un acte subi et sorcellaire aux yeux de la population. La sorcellerie comme une sanction du rite Ndjobi est vécue par l’ensemble des Mbede et des initiés politiques, comme une menace permanente d’agression visant leurs corps, leurs biens et leurs familles. En effet, certains chefs traditionnels dit « Nga Mpugu» choisissent la ruse, la fraude, les crimes rituels, la possession matérielle comme moyen politique afin non seulement de contrôler la population, mais aussi de manipuler les envies de pouvoir de leurs adeptes et de leurs proches collaborateurs. En Afrique, « gouverner c’est prévoir » et prévoir, c’est mettre en place un mécanisme permettant d’éviter d’être surpris par l’ennemi qui peut être un proche. Ce serait, en fait, la mise en fonction d’une « Démocratie traditionnelle ». C’est dans ce sens que cette thèse peut s’inscrire dans la perspective de compréhension et d’analyse du politique en Afrique noire à travers les religions locales comme fondement du pouvoir politique malgré l’arrivée actuelle des obédiences religieuses modernes et des parrainagesOn horseback between political Sociology and political Anthropology, this thesis try to understand the interaction enter "local Religion and political Power» with the prospect of consolidation of the power Africa, more exactly in the Gabon. It underlines the management (direction) of the power politics and analyzes the relationship enter the initiation rite Ndjobi and the political power in the community Mbede. This thematic field is deconstructed up to the Gabonese nation through the initiation and the implication of the politics premises within this religion. The rite Ndjobi would be a local counter-offensive to repair the universe social and to protect Mbede. It is a fundamental element in the maintenance of law and order through the symbolism of Okèlè é Ndjobi that is the assertion by which an initiated calls in to witness the sacred and the truth of the statement which he utters in front of the basket containing the relics of Ndjobi. For a traditional leader, this rite would be a way to compensate for a constitutional deficiency of its political power to maintain at its introduced subjects respect and especially been afraid, fault of whom its power could widely be imaginary. The oath of Ndjobi would be a political reliable contract to a village headman, to a politician introduced to this rite. Through this demolition, this local religion appears as a support of the Gabonese political power on a national scale and even money regional. Even if the oaths are made with words; but in Black Africa, these words are not light. They allow to act on one, on the others and on the world concerned as a constraint comparable to a sword of Damocles. The constraint practiced in a way subtle and imposed with some intra-political negotiations bound to the «politics of the stomach " So that the initiation undergone is not similar to an act of the witchcraft in the eyes of the population. The witchcraft as a penalty of the rite Ndjobi is lived by all the Mbede and the political initiated, as a threat perms of aggression aiming their bodies, at their goods and at their families. Indeed, every traditional leader says "Nga Mpuhu" always chooses the guile, the fraud, the ritual crimes, the material ownership as political way to make not only control the population, but also to manipulate the desires for power of her followers and for her close collaborators. In Africa, "you saddle today and ride out tomorrow" and plan, it is to set up a mechanism allowing to avoid being was a surprise by the enemy who, generally, is always a close relation. It would be, in fact, the putting according to a "traditional Democracy ". It is in this direction that this thesis can serve of complementary element with the prospect of understanding and analysis of politics in Black Africa through the religions local as foundation of the political power in spite of the current arrival of the modern religious obedience and the sponsorin

Religion locale et pouvoir politique au Gabon : cas du rite Ndjobi chez les Mbede

On horseback between political Sociology and political Anthropology, this thesis try to understand the interaction enter "local Religion and political Power» with the prospect of consolidation of the power Africa, more exactly in the Gabon. It underlines the management (direction) of the power politics and analyzes the relationship enter the initiation rite Ndjobi and the political power in the community Mbede. This thematic field is deconstructed up to the Gabonese nation through the initiation and the implication of the politics premises within this religion. The rite Ndjobi would be a local counter-offensive to repair the universe social and to protect Mbede. It is a fundamental element in the maintenance of law and order through the symbolism of Okèlè é Ndjobi that is the assertion by which an initiated calls in to witness the sacred and the truth of the statement which he utters in front of the basket containing the relics of Ndjobi. For a traditional leader, this rite would be a way to compensate for a constitutional deficiency of its political power to maintain at its introduced subjects respect and especially been afraid, fault of whom its power could widely be imaginary. The oath of Ndjobi would be a political reliable contract to a village headman, to a politician introduced to this rite. Through this demolition, this local religion appears as a support of the Gabonese political power on a national scale and even money regional. Even if the oaths are made with words; but in Black Africa, these words are not light. They allow to act on one, on the others and on the world concerned as a constraint comparable to a sword of Damocles. The constraint practiced in a way subtle and imposed with some intra-political negotiations bound to the «politics of the stomach " So that the initiation undergone is not similar to an act of the witchcraft in the eyes of the population. The witchcraft as a penalty of the rite Ndjobi is lived by all the Mbede and the political initiated, as a threat perms of aggression aiming their bodies, at their goods and at their families. Indeed, every traditional leader says "Nga Mpuhu" always chooses the guile, the fraud, the ritual crimes, the material ownership as political way to make not only control the population, but also to manipulate the desires for power of her followers and for her close collaborators. In Africa, "you saddle today and ride out tomorrow" and plan, it is to set up a mechanism allowing to avoid being was a surprise by the enemy who, generally, is always a close relation. It would be, in fact, the putting according to a "traditional Democracy ". It is in this direction that this thesis can serve of complementary element with the prospect of understanding and analysis of politics in Black Africa through the religions local as foundation of the political power in spite of the current arrival of the modern religious obedience and the sponsoringEntre Sociologie politique et Anthropologie religieuse, cette thèse tente de comprendre l’interaction entre « Religion locale et pouvoir politique» dans la perspective de consolidation du pouvoir en Afrique, plus précisément au Gabon. Elle met l’accent sur la gestion du pouvoir politique en Afrique et analyse les rapports du rite initiatique Ndjobi avec le pouvoir politique dans la communauté Mbede. Ce champ thématique est déconstruit jusqu’à la nation gabonaise à travers l’initiation et l’implication des politiques locaux aux religions locales. Le rite Ndjobi serait une contre-offensive locale visant à réparer l’univers sociale et à protéger les Mbede. C’est un élément fondamental au maintien de l’ordre à travers le symbolisme de l’Okèlè é Ndjobi qui est l’affirmation par laquelle un initié prend à témoin le sacré et la vérité de la déclaration qu’il profère devant le panier contenant les reliques du Ndjobi. Pour un chef traditionnel, ce rite serait un moyen de compenser une déficience constitutionnelle de son pouvoir politique afin d’entretenir chez ses sujets initiés respect et surtout crainte. Le serment du Ndjobi serait un contrat politique de confiance à un chef de village, à un responsable politique initié à ce rite. A travers cette déconstruction, cette religion locale pourrait être appréhendée comme un support du pouvoir politique gabonais à l’échelle nationale. Les serments se font avec des paroles ; mais en Afrique noire, ces paroles ne sont pas légères. Elles permettent d’agir sur soi, sur les autres et sur le monde concerné comme une contrainte comparable à une épée de Damoclès. Cette contrainte s’exerce d’une manière subtile et imposée avec quelques négociations intra-politiques liées à la « politique du ventre » pour que l’initiation ne s’apparente pas à un acte subi et sorcellaire aux yeux de la population. La sorcellerie comme une sanction du rite Ndjobi est vécue par l’ensemble des Mbede et des initiés politiques, comme une menace permanente d’agression visant leurs corps, leurs biens et leurs familles. En effet, certains chefs traditionnels dit « Nga Mpugu» choisissent la ruse, la fraude, les crimes rituels, la possession matérielle comme moyen politique afin non seulement de contrôler la population, mais aussi de manipuler les envies de pouvoir de leurs adeptes et de leurs proches collaborateurs. En Afrique, « gouverner c’est prévoir » et prévoir, c’est mettre en place un mécanisme permettant d’éviter d’être surpris par l’ennemi qui peut être un proche. Ce serait, en fait, la mise en fonction d’une « Démocratie traditionnelle ». C’est dans ce sens que cette thèse peut s’inscrire dans la perspective de compréhension et d’analyse du politique en Afrique noire à travers les religions locales comme fondement du pouvoir politique malgré l’arrivée actuelle des obédiences religieuses modernes et des parrainage

Evolution in fecal bacterial/viral composition in infants of two central African countries (Gabon and Republic of the Congo) during their first month of life.

Few studies have analyzed the gut microbiota of child in unindustrialized countries, but none during the first month of life. Stool samples were collected from healthy newborns in hospitals of Gabon (n = 6) and Republic of the Congo (n = 9) at different time points during the first month of life: meconium, day 2 (D02), day 7 (D07) and day 28 (D28). In addition, one fecal sample was collected from each mother after delivery. Metagenomic sequencing was performed to determine the bacterial communities, and multiplex real-time PCR was used to detect the presence of seven enteric viruses (rotavirus a, adenovirus, norovirus I and II, sapovirus, astrovirus, enterovirus) in these samples. Bacterial diversity was high in the first days of life, and was dominated by the genus Prevotella. Then, it rapidly decreased and remained low up to D28 when the gut flora was composed almost exclusively of strictly anaerobic bacteria. Each infant's fecal bacterial microbiota composition was significantly closer to that of their mother than to that of any other woman in the mothers' group, suggesting an intrauterine, placental or amniotic fluid origin of such bacteria. Moreover, bacterial communities differed according to the delivery mode. Overall, the bacterial microbiota communities displayed a similar diversification and expansion in newborns within and between countries during the first four weeks of life. Moreover, six of the fifteen infants of this study harbored enteric viruses (rotavirus, enterovirus and adenovirus) in fecal samples, but never in the meconium. A maternal source for the viruses detected at D02 and D07 can be excluded because none of them was found also in the child's mother. These findings improve our knowledge on the gut bacterial and viral communities of infants from two Sub-Saharan countries during their first month of life

HIV-1 subtypes and recombinants in the Republic of Congo

To document the actual genetic diversity of HIV-1 strains in the Republic of Congo, 114 HIV-1 positives persons were sampled in 2003 and 2004 after their informed consent. They were attending the teaching hospital, the reference health center in Makelekele, Brazzaville and the regional hospital centers in Pointe-Noire, Gamboma and Ouesso. A total of 104 samples were genetically characterized by direct sequencing of the p24 gag region and 80 were also subtyped in the V3-V5 env region. The genetic subtype distribution of the Congolese strains showed the predominance of subtype A (36.5% and 32.5% in gag and env, respectively) and G (30.8% and 21.25%), whereas subtype D strains represented 12.5% and 15%. Subtypes C, F, H, J, K and the CRFs-01, -02, -05 -06, and also the recently characterized CRF18 were seen at lower rates. Finally, 4.8% (gag) and 6.25% (env) of the strains could not be classified. Moreover, a high intra-subtype diversity was observed in our study. Among 70 strains which have been characterized in the two genomic regions, 14 (20%) appeared to be unique recombinants. These data show a high genetic variability in the Republic of Congo, where all the subtypes have been documented together with certain subsubtypes and several CRFs. (c) 2006 B.V. All rights reserved

Diversity index changes.

<p>Diversity index changes during the first month of life and between mothers and infants. a: Generic richness. b: Shannon diversity index.</p