Onychomycosis: experience of the laboratory of parasitology-mycology of CHU-Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar

Introduction: onychomycosis is defined as a fungal infection of the nails. They represent the main cause of onychopathy. They constitute a public health problem because of their increased prevalence in the world ranging between 20 to 30%. However, they remain under documented in Madagascar. This study was conducted in order to determine the mycological profile of onychomycosis diagnosed in the Parasitology Mycology laboratory of CHU-JRA. Methods: a descriptive retrospective study was taken over a 13-year period from June 2005 to December 2018. The data presenting onychomycosis on the mycological outcome register were included in the study. Results showing the presence of fungi on direct examination and / or culture were considered positive. Results: during the study period, a prevalence of 17.75% (180/1014) was observed. The age of our patients ranged from 3 to 76 years. Women were the most affected in 68.34% (n = 123) with a sex ratio of 0.46. Onychomycosis was localized in 64.65% of the fingers (n = 128). Simultaneous involvement of the hands and feet was found in 10% of the cases (n = 18). Candida albicans (C. albicans) was the most isolated in 33.03% (n = 71) of cases, followed by other species of Candida (24.65%, n = 53) and Trichophyton spp (9.3%, n=17). Mixed infections associating dermatophytes, Yeasts and molds were found in 23.33% (n = 42) of the cases. Conclusion: this is the first investigation dealing with onychomycosis in Madagascar. These data may be useful for future research and in the development of preventive and educational strategies

Pulmonary candidiasis in immunocompromised patients seen at Befelatanana University Hospital from 2018 to 2019

The Candidiasis occupies an increasingly important place in infectious pulmonary diseases in recent decades. The objectives of this study were to determine the incidence of yeast Candida spp in pulmonary samples, to describe the clinical and socio-demographic characteristics of these pulmonary infections and to propose suggestions to clinicians and biologists who analyze these pulmonary samples. This is a prospective and descriptive study from April 2018 to March 2019 in the laboratory of Joseph Raseta Befelatanana University Hospital. All Candida spp yeast positive pulmonary samples were identified by filamentation testing. The data was entered on the Epi-info 3.5.2 software. For a period of one year, 17 of the 107 pulmonary sampling (15.9%) were positive for yeasts of the genus Candida spp. Of these yeasts, 82.4% are represented by the species Candida albicans. The patients aged 40 and over (8.4%), the men (8.4%), the patients with pneumopathy (10.3%) and the patients hospitalized in the surgical resuscitation department (7.5%) were most affected by Candida albican. Simultaneous bacteriological examination showed a predominance of Acinetobacter bacteria. This study has highlighted the pertinence of mycological examination of any pulmonary sampling in the hospitalized and immunocompromised patients. The use of specific culture media for mycotic pathogens will increase the positivity of the mycological examination. Published by the International journal of Microbiology and Mycology (IJMM

Transfusion practice: Experience of Joseph Ravoahangy Andrianavalona Hospital Analamanga Regional Blood Transfusion Center, Madagascar

Background: Blood transfusion is therapeutic means used in management of many pathologies. Our aim was to describe transfusion practice in Madagascar.Method: A prospective study was performed to describe the indications for blood products issued from the blood bank of Analamanga regional blood transfusion center of University Hospital Joseph Ravoahangy Andrianavalona, Antananarivo.Results: The mean age of the patients was 35.6 years (standard deviation [SD] = 8.2), the male: female ratio was 0.85. The majority of prescriptions came from obstetrics and gynaecology (35.9%); surgery (25.7%) and medicine (22.6%). A total of 17 253 transfused patients received 28 437 blood transfusion with satisfaction rate of 73.6%.Conclusion: As transfusion center, this study informs us about the needs of bloods, the main prescribing departments and indications for transfusion. This data will serve as a basis for study on relevance of blood prescription in Malagasy hospitals. French title: Pratique transfusionnelle : expérience de l'hôpital Joseph Ravoahangy Andrianavalona Centre régional de transfusion sanguine Analamanga, Madagascar Contexte : La transfusion sanguine est un moyen thérapeutique utilisé dans la prise en charge de nombreuses pathologies. Notre objectif était de décrire la pratique transfusionnelle à Madagascar.Méthode : Une étude prospective a été réalisée pour décrire les indications des produits sanguins issus de la banque du sang  d'Analamanga, centre régional de transfusion sanguine du CHU Joseph Ravoahangy Andrianavalona, Antananarivo.Résultats : L'âge moyen des patients était de 35,6 ans (écart-type [SD] = 8,2), le rapport hommes/femmes était de 0,85. La majorité des prescriptions provenaient du service de gynécologie/obstétrique (35,9 %) ; chirurgie (25,7%) et médecine (22,6%). Au total, 17 253 patients transfusés ont reçu 28 437 transfusions sanguines avec un taux de satisfaction de 73,6%.Conclusion : En tant que centre de transfusion, cette étude nous renseigne sur les besoins en sang, les principaux services prescripteurs et les indications de transfusion. Ces données serviront de base à une étude sur la pertinence de la prescription de sang dans les hôpitaux malgaches. &nbsp

Vulvo-Vaginal Candidiasis in the Laboratory of Parasitology -Mycology of UHC-JRA Antananarivo Madagascar

Vulvo-vaginal candidiasis is a cosmopolitan infection caused by Candida spp. His diagnosis is mainly clinical, but the mycological examination confirms the species in question. The aim of this study is to determine the prevalence of vulvo-vaginal candidiasis in patients who came to the Parasitology-Mycology Laboratory of the University Hospital Center Joseph Ravoahangy Andrianavalona (UHC- JRA) in Antananarivo -Madagascar for a mycological examination of vaginal specimens.This is a retrospective descriptive study carried out in the Parasitology-Mycology laboratory of the UHC-JRA in Antananarivo from 2005 to 2018. The sociodemographic, clinical and biological information were collected using a register of patients. The specimen were directly inoculated on Sabouraud Dextrose Media and identified by direct examination and filamentation test. We have no result of antifungals susceptibility test because of the lack of discs.During the period of study, 1014 patients were collected. Among them, 132 patients had vulvo-vaginal candidiasis (13.02 %). The age between 21 to 30 years old was the most affected (35.6%) by this infection. The average age was 33.61 years old. Leucorrhoea was found in 33.33% of cases. This last was frequently whitish and most often whitish and scanty. Candida albicans is the prevalent germs in 56.82% and Candida non albicans is encountered in 27.96%.Vulvo-vaginal candidiasis is still a major health problem because of its frequency and its impact on the health of population as premature delivery, abortion, maternofetal infection. The improvement of the technical platform allows to better pose the diagnosis and to identify the different species of Candida spp

Intestinal Giardiasis at UPFR Parasitology-Mycology of CHU-JRA Antananarivo, Madagascar

Introduction: Giardiasis is an intestinal parasitosis extremely widespread in the world but under-diagnosed in Madagascar. It is often asymptomatic. It can be fatal due to intestinal malabsorption syndrome. This study was conducted to determine the epidemiological-clinical aspect of giardiasis in Antananarivo and to determine the relevance of prescribing the KAOP stool examination for its diagnosis.Materials and methods: We report the results of a retrospective study of 2154 KAOP stool examinations performed at the Parasitology-Mycology Laboratory of the CHU-JRA over a 13-year period from June 2005 to June 2018. Results. The positivity rate for intestinal parasitosis was 58.36% or 1257 out of 2154 files examined. We found a prevalence of 1.76% (38/2154) of all claims and a frequency of 3.2% (38/1257) compared to other parasitoses. We found a female predominance with a sex ratio of 0.8.  The average age was 20.46 years, of which 39.47%  (15/38) were under 10 years of age.  Abdominal pain were the main reasons for requesting tests. Only the cystic form of Giardia duodenalis was found, of which 28.95% (11 cases) were isolated and 71.05% (27) were associated with one or more parasites. Conclusion:  Giardiasis is a parasitosis with a harmful effect on children. It is still under-diagnosed in Madagascar. Compliance with the prescription of 3 successive stool examinations allows a diagnosis of certainty

Low seroprevalence of hepatitis E on Reunion island

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Toxoplasmosis among Pregnant Women at the Intergrated Health Center in Mahajanga (Madagascar): A Preliminary Study

Serological screening for toxoplasmosis in pregnant women is not systematic in Madagascar. However, the urban lifestyle and the often precarious lifestyle of the population are a favourable factor in the onset of the disease. The objectives of this study were to determine the seroprevalence of toxoplasmosis in pregnant women who came for an initial prenatal visit at the Integrated Health Center (IHC) Mahabibo, and to determine the socio-demographic factors that can influence the serological status of these patients in order to propose suggestions for improving the management of toxoplasmosis in pregnant women in Madagascar.We conducted a prospective, descriptive and analytical study of pregnant women in first prenatal visit at the IHC Mahabibo from May to July 2018. A questionnaire on risk factors and knowledge of the pathology was conducted to participants. They have benefited a blood sample for free serological screening of toxoplasmosis using the Rapid Lab® EIA technique. A second sample was taken after one month for pregnant women who came to 2nd prenatal visit. The biological study was carried out in the laboratory of the PZaGa Mahajanga University Hospital Center.A total of 96 serologies were performed, including 58 screenings and 38 follow-ups.  The seroprevalence of toxoplasmosis was 36.2%. We found 23.7% seroconversion suggestive of recent infection. The seropositivity of toxoplasmosis was 85.7% among pregnant women who consumed raw vegetables and 71.4% among those who ate undercooked meat (p>0,05).Awareness of the risks of contamination, systematic serological surveillance and hygiene measures should be provided during prenatal visits