Mycobacterium ulcerans

Objective. The usual preferential site of BU is in the limbs. In our experience, we noticed atypical and often misleading sites which pose serious issues for the diagnosis and often for the treatment. Methods. This is a retrospective study conducted over a period of ten years of BU treatment at the Department of Dermatology of the University Teaching Hospital of Treichville (Abidjan, Côte d’Ivoire). We included in this study all BU cases with atypical site diagnosed clinically and confirmed either by the histology, by smear, or by PCR. Results. Epidemiologically, the age of patients ranged from 3 to 72 years with a median age of 14.2 years. Children aged less than 15 years were affected in almost 80% of case. The clinical table was dominated by ulcerated forms in 82.1% of cases. The unusual topography mostly observed was that of the torso (thorax, back, and abdomen) in 76.8% of cases. Conclusion. BU is an endemic disease in Côte d’Ivoire where it constitutes a serious public health issue. Several years following its first cases, BU still is little known. This dermatosis may present atypical misleading clinical aspects which must be ignored

Epidemiological, Clinical, and Paraclinic Aspect of Cutaneous Sarcoidosis in Black Africans

The specific objectives were to identify the epidemiology of cutaneous sarcoidosis and describe the clinical and laboratory aspects of the disease. Materials and Methods. We performed a descriptive cross-sectional study involving 24 referred cases of cutaneous sarcoidosis in 25 years (1990–2014) collected at Venereology Dermatology Department of the University Hospital of Treichville (Abidjan) both in consultation and in hospitalization. Results. The hospital frequency was one case per year. The average age was 42 years, ranging from 9 to 64. The sex ratio was 1. The shortest time interval between the appearance of the skin lesion and consultation of Dermatology Department at CHU Treichville was 3 months. The elementary lesions were represented primarily by a papule (18 cases), placard (3 cases), and nodule (2 cases) and mainly sat on the face and neck in 8 cases (38%). Extra cutaneous lesions were dominated by ganglion and respiratory involvement with 5 cases each followed by musculoskeletal damage in 3 cases. Chest radiography showed abnormality in 13 cases (54%). The pulmonary function test performed in 13 patients found 7 cases (54%) having restrictive ventilatory syndrome and 6 cases (46%) being normal. A tuberculin anergy was found in 11 cases (61%)

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Skin pathology of the elderly patients: Case of black African

Background: Skin diseases of the elderly subjects have clinical signs which are different from those of the young people. The purpose of this study was to determine the skin diseases that led elderly people to consult at the Department of Dermatology at the University Teaching Hospital in Bouaké, Côte d’Ivoire. Methods: That was a descriptive cross-sectional study conducting between January 1, 2015 and December 31, 2015 and including patients 65 years and older who were diagnosed with skin diseases the Department of Dermatology at the University Teaching Hospital in Bouaké, Côte d’Ivoire. Results: During the study period, 109 patients aged 65 years and older (1.8%) were recruited. These patients consulted for 227 diagnoses. The average age of the patients was 71.8 and sex ratio was 0.7. Mycoses were the major reason for consultation (18.7%) followed by pruritus (17.9%), eczema (13.1%), and (9.0%) tumors with 76.5% of benign tumors and (5.1%) disorders of keratinization. Leg ulcers were 2.1%. Mycoses were represented by intertrigo (52.9%) and dermatomycosis of the glabrous skin (25.7%). Kaposi sarcoma and keloid were the most frequent tumors. Conclusion: Our study shows a predominance of mycosis, eczema, and pruritus in the elderly subjects. Mycoses and pruritus could result from the weather and the skin aging, respectively

Fixed pigmented erythema due to cimetidine

Fixed pigmented erythema (EPF) is pathognomonic of drug-induced toxicity. Antisecretory drugs are among the most commonly not responsible drugs. EPF secondary to cimetidine administration has rarely been described. We report an EPF case during a cimetidine-based treatment in Bouake. A 43-year-old patient, HIV negative, consults for an EPF located on both sides of the breasts, on the 5th day of an antiulcer treatment comprising compressed cimetidine and gastric dressing based on phosphatase d ‘aluminum. The diagnosis is made in front of the characteristic aspect of the lesion of EPF and the early reappearance of lesions recurring exactly in the same places, after the reintroduction of cimetidine. The discovery of an EPF imposes a strict etiological approach in search of the responsible drug. During anti-ulcer treatment, the practitioner should bear in mind the potential role of cimetidine

Dépigmentation cutanée cosmétique des femmes noires: résultats d’une enquête CAP à Abidjan (Côte d’Ivoire)

Introduction: la dépigmentation cutanée cosmétique est une pratique largement répandue chez les femmes noires en Afrique. Elle comporte de nombreuses complications bien décrites depuis des décennies. Cependant, les motivations des pratiquantes ne sont pas bien connues. Notre étude avait pour objectif d'appréhender les raisons et les motivations de ces femmes afin de pouvoir mener une action de communication en vue d'un changement de comportement. Méthodes: nous avons mené une étude transversale qui a consisté en une enquête CAP (Connaissances/Attitudes/Pratiques) au centre de Dermatologie du CHU de Treichville d'Abidjan. Les données ont été analysées par les logiciels Epi Info 3.5.1. et 6.04. Résultats: les pratiquantes étaient surtout des femmes urbaines jeunes (20-40 ans), célibataires, lettrées et professionnellement actives. La dépigmentation cutanée et ses conséquences étaient connues des femmes Cependant, elles désiraient être plus belles grâce à un teint plus clair et étaient influencées par les médias et leurs amies proches. Les complications les plus fréquemment observées étaient l'ochronose exogène et les vergetures. Les moyens de communication de proximité étaient les plus souhaités par les utilisatrices pour les aider à changer de comportement. Conclusion: l'élaboration de stratégies de communication de proximité visant un changement de comportement semble nécessaire pour enrayer le phénomène de dépigmentation cosmétique des femmes à Abidjan. The Pan African Medical Journal 2016;2

Squamous Cell Carcinoma in African Children with Xeroderma Pigmentosum: Three Case Reports

Introduction: Xeroderma pigmentosum is a rare autosomal recessive genetic disease. This disease predisposes patients to early-onset skin cancers, particularly squamous cell carcinoma. Here, we report 3 pediatric cases, including 2 deaths. Observation: The subjects included 2 boys and 1 girl with skin type VI. All subjects were from consanguineous marriages, and the average age was 7.6 years. The patients all had ulcerative budding tumor lesions in the cephalic region, and the mean disease duration was 18 months. In all 3 cases, the diagnosis of xeroderma pigmentosum was made before the poikilodermal appearance of sun-exposed areas and photophobia. Neurological-type mental retardation was noted in 1 case. Histology confirmed squamous cell carcinoma in all 3 cases. The evolutions were marked by the death of 2 children (cases 1 and 3). In one case, the outcome was favorable following cancer excision and subsequent chemotherapy with adjuvant radiotherapy. Conclusion: Squamous cell carcinoma is a serious complication related to xeroderma pigmentosum in Sub-Saharan Africa. Prevention is based on the early diagnosis of xeroderma pigmentosum, black skin photoprotection, screening and early treatment of lesions, and genetic counseling

Allergy to Red Meat: A Diagnosis Made by the Patient and Confirmed by an Assay for IgE Antibodies Specific for Alpha-1,3-Galactose

We report the first case of allergy to red meat observed in Ivory Coast. A 49-year-old male presented with pruritus. The diagnosis of allergy to red meat was confirmed by an assay for IgE antibodies specific for alpha-1,3 galactose. Interestingly, the disease was considered a spell to the patient who was suspected of being a sorcerer by the community