An outbreak of suspected cutaneous leishmaniasis in Ghana: lessons learnt and preparation for future outbreaks

Human cutaneous leishmaniasis (CL) has previously been reported in West Africa, but more recently, sporadic reports of CL have increased. Leishmania major has been identified from Mauritania, Senegal, Mali, and Burkina Faso. Three zymodemes (MON-26, MON-117, and MON-74, the most frequent) have been found. The geographic range of leishmaniasis is limited by the sand fly vector, its feeding preferences, and its capacity to support internal development of specific species of Leishmania. The risk of acquiring CL has been reported to increase considerably with human activity and epidemics of CL have been associated with deforestation, road construction, wars, or other activities where humans intrude the habitat of the vector. In the Ho Municipality in the Volta Region of Ghana, a localised outbreak of skin ulcers, possibly CL, was noted in 2003 without any such documented activity. This outbreak was consistent with CL as evidenced using various methods including parasite identification, albeit, in a small number of patients with ulcers

Segmental Duplication Implicated in the Genesis of Inversion 2Rj of Anopheles gambiae

The malaria vector Anopheles gambiae maintains high levels of inversion polymorphism that facilitate its exploitation of diverse ecological settings across tropical Africa. Molecular characterization of inversion breakpoints is a first step toward understanding the processes that generate and maintain inversions. Here we focused on inversion 2Rj because of its association with the assortatively mating Bamako chromosomal form of An. gambiae, whose distinctive breeding sites are rock pools beside the Niger River in Mali and Guinea. Sequence and computational analysis of 2Rj revealed the same 14.6 kb insertion between both breakpoints, which occurred near but not within predicted genes. Each insertion consists of 5.3 kb terminal inverted repeat arms separated by a 4 kb spacer. The insertions lack coding capacity, and are comprised of degraded remnants of repetitive sequences including class I and II transposable elements. Because of their large size and patchwork composition, and as no other instances of these insertions were identified in the An. gambiae genome, they do not appear to be transposable elements. The 14.6 kb modules inserted at both 2Rj breakpoint junctions represent low copy repeats (LCRs, also called segmental duplications) that are strongly implicated in the recent (∼0.4Ne generations) origin of 2Rj. The LCRs contribute to further genome instability, as demonstrated by an imprecise excision event at the proximal breakpoint of 2Rj in field isolates

Hydrocolpos et hématocolpos par imperforation hymenale: prise en charge au CHU de Treichville

Les hydro et hématocolpos se définissent comme étant la rétention vaginale soit des secrétions cervicales et vaginales (hydrocolpos), retrouvée chez le nouveau-né et le nourrisson, soit des menstruations (hématocolpos) se constituant à la puberté dès les premières menstruations. L’étiologie principale est l’imperforation hyménale. Pathologie rare et notre but était de présenter les caractéristiques cliniques, paracliniques, thérapeutiques et évolutives ainsi que les difficultés diagnostiques rencontrées, surtout dans les cas d’hydrocolpos. Il s’est agit d’une étude rétrospective et descriptive qui s’est déroulée dans le service de chirurgie pédiatrique du CHU de Treichville sur une période de 10 ans allant de Janvier 2008 à Décembre 2017. Elle concernait toutes les patientes chez qui le diagnostic d’hydro ou hématocolpos avait été posé. Les variables étudiées ont été cliniques, paracliniques, thérapeutiques et évolutives. Nous avons colligé 11 dossiers d’enfant dont 5 cas d’hydrocolpos et 6 cas d’hématocolpos. L’âge moyen était de 12,4 jours dans les cas d’hydrocolpos avec des extrêmes de 0 à 37 jours, et de 13,83 ans dans les cas d’hématocolpos avec des extrêmes de 13 à 14 ans. Le motif de consultation était représenté par la rétention aigue d’urine dans 8 cas (72,7%), la distension abdominale dans 2 cas. La douleur pelvienne cyclique était retrouvée chez toutes les adolescentes, à savoir dans l’hématocolpos, associée à une absence de ménarche dans tous les cas. Le diagnostic de l’imperforation hyménale a été fait tardivement chez 3 patientes. L’échographie a été réalisée dans 100% des cas. Le traitement chirurgical à consisté en une hyménotomie chez toutes les patientes avec laparotomie et une stomie vaginale première dans respectivement 3 et 2 cas. L’évolution était simple dans 9 cas soit 81,8%. Les complications retrouvée étaient un cas de récidive d’hydrocolpos ayant nécessité une reprise d’hyménotomie et une occlusion sur bride. L’imperforation hyménale est une malformation rare et bénigne du tractus génital féminin. Le diagnostic surtout chez le nouveau-né et nourrisson est retardé du fait de la méconnaissance par les praticiens. Devant tout trouble urinaire, il faut y penser et faire systématiquement un examen de la vulve. Mots clés: hydrocolpos, hématocolpos, imperforation hyménale, hyménotomie English Abstract Hydrocolpos and hematocolpos are defined as vaginal retention cervical and vaginal secretions (hydrocolpos), in newborns and infants, or menstrual blood (hematocolpos) unadolescents at puberty. The commonest etilogi is an imperforate hymen. It is a rare pathology and thus aim was be to report on the clinical, paraclinical, therapeutic and evolutionary characteristics as well as the difficulties encountered, especially in case of hydrocolpos. It was a retrospective and descriptive study carried out the pediatric surgery department of the Teaching Hospital of Treichville, over a period of 10 years, from January 2008 to December 2017. It concerned all patients diagnosed with hydro or he matocolpos. Studied variables were clinical, paraclinical, therapeutic and outcom. We recorded 11 cases including 5 cases of hydrocolpos and 6 cases of hematocolpos. The mean age was 12.4 days for hydrocolpos and 13.83 years for hematocolpos ones. The presenting complaint was acute urine retention in 8 cases (72.72%), abdominal distention in 2 cases. Cyclic pelvic pain was found in all adolescents, with in hematocolpos, associated with an absence of menses in all cases. The diagnosis of imperforate hymen was done late in 3 patients. Ultrasound was performed in 100% of cases. Surgical treatment consisted of a hymenotomy in all patients with laparotomy and vaginal opening to the skin in 3 and 2 cases, respectively. The outcom was simple in 9 cases (81.82%). The complications recorded incloded a recurrence of hydrocolpos that required another hymenotomy and intestinal occlusion by adhesions. Imperforate hymen is a rare and benign malformation of the female genital tract. The diagnosis especially in the newborn and infant is delayed because of the ignorance of practitioners. it should be considered in case of any urinary disorder, it and confirmed by examination of the vulva. Keywords: hydrocolpos, hematocolpos, imperforate hymen, hymenotom