Situation Epidemio-Clinique De La Dermatose Nodulaire Contagieuse Bovine Dans Le District De Mananjary

La dermatose nodulaire contagieuse représente un problème majeur de la santé des bovins à Madagascar. La présente étude a pour objectif de décrire la situation épidemio-clinique de la dermatose nodulaire contagieuse bovine dans le district de Mananjary. Il s’agit d’une étude descriptive et transversale a été réalisée du mois d’octobre 2015 au mois de février 2016 dans le district de Mananjary. En termes de résultats, la prévalence globale de la dermatose nodulaire contagieuse est de 20,96%. L’étude des facteurs de risque montre que la persistance de ces maladies est significativement liée à la race, au sexe et à l’état d’embonpoint. En conclusion, la dermatose nodulaire des bovins reste encore une menace pour le bétail dans notre pays. Le diagnostic étiologique précis et les traitements efficaces à long terme sont indispensables pour pouvoir les maitriser et les éradiquer.

Situation de la sécurité sanitaire des denrées alimentaires à Madagascar

Résumé— La présente étude sur l’analyse de la situation sanitaire des denrées alimentaires à Madagascar, entre 2016 et la fin du mois de septembre 2020, révèle l’augmentation des cas de TIA, de 398 cas à 908 cas, avec un pic remarquable de 1159 cas en 2019. Cette croissance des cas de TIA dérive de la croissance des TIAC de 1056 cas en 2019, touchant onze régions, après consommation d’aliments à base de sauce mayonnaise et d’autres aliments, contaminés par la salmonella d’une part, et d’autre part, de celle des ICAM de 322 cas en 2020, concernant trois régions, après ingestion de tortues de mer (50,93%), des poissons de mer non définis (38,51%), des requins (8,07%) et des oursins de mer (2,48%), respectivement contaminés par les biotoxines marines provoquant le chélonitoxisme, le ciguatoxisme et le carchatoxisme, et par la palytoxine. La présente étude a également montré que l’insuffisance de la sécurité sanitaire des denrées alimentaires découle des faiblesses et des menaces liées aux facteurs étiologiques, institutionnels, environnementaux, et inhérents aux exploitants alimentaires. Ainsi, des recommandations sont apportées afin de réduire les menaces et faiblesses liées à ces différents facteurs. Par conséquent, elles contribuent fortement à assurer la sécurité alimentaire, améliorer la sécurité nutritionnelle, promouvoir l’agriculture durable, garantir le bien être de tous à tous âges, et atteindre les objectifs de développement durable à l’horizon 2030. Mots-clés—analyses; denrées alimentaires ; gouvernance ; management; sécurité sanitaire. Abstract— This study on the analysis of the food safety situation in Madagascar, between 2016 and the end of September 2020, reveals an increase in foodborne disease cases, from 398 cases to 908 cases, with a remarkable peak of 1159 cases in 2019. This growth in food-borne illnesses cases is derived from the growth in collective food-borne illnesses cases of 1056 cases in 2019, affecting eleven regions, following the consumption of food containing mayonnaise sauce and other food, contaminated with salmonella, on the one hand, and on the other hand, from the growth in intoxications through the consumption of marine animals of 322 cases in 2020, involving three regions, after ingestion of sea turtles (50.93%), undefined sea fish (38.51%), sharks (8.07%) and sea urchins (2.48%), respectively contaminated by marine biotoxins causing chelonitoxism, ciguatoxism and carchatoxism, and by palytoxin. This study also confirmed that the inadequacy of food safety in Madagascar stems from weaknesses and threats related to etiological, institutional, environmental, and farmer-related factors. To this end, recommendations are made, in order to reduce to an acceptable level the threats and weaknesses related to these different factors. As a result, they make an important contribution to ensuring food security, improving nutritional security, promoting sustainable agriculture, ensuring the well-being of all people at all ages, and achieving the Sustainable Development Goals by 2030.

Hémogramme chez les hypertendus vus au laboratoire du CHU-HJRB d’Antananarivo en 2013

Introduction: L’hémogramme est un bilan biologique de routine demandé chez tout patient souffrant d’Hypertension Artérielle (HTA). Cette étude se propose de décrire les résultats d’hémogramme chez les hypertendus et d’identifier les pathologies associées. Méthodes: Il s’agit d’une étude rétrospective type descriptif s’étalant du 01 Décembre 2012 au 31 Décembre 2013 au laboratoire du Centre Hospitalo-Universitaire Hôpital Joseph Raseta Befelatanana (CHU-HJRB) d’Antananarivo. Tous les registres des résultats des hypertendus demandant un hémogramme ont été exploités. Résultats: Parmi les 151 hypertendus, 91 (60,3%) ont présenté des hémogrammes pathologiques. Parmi ces derniers, 64 (70,4%) ont montré un seul type d’anomalie et 27 (29,6 %) des anomalies multiples. Les anémies (33,91%), les hyperleucocytoses (33,04%), les polyglobulies (10,43%) et les leucopénies (9,57%) sont les plus fréquentes. Pour les anomalies multiples, les anémies associées aux hyperleucocytoses sont les plus observées (29,6 %). Les anémies microcytaires (41 %) et les hyperleucocytoses à polynucléaires neutrophiles sont les plus dominantes (47,4 %). Les patients hospitalisés en néphrologie (90%) et en endocrinologie (81,3%) sont les plus concernés (p=0,008). Les hypertendus moins de 20 ans (100%) et les femmes (61,5%) sont les plus affectés (p>0,05). Les crises convulsives (100%), les oedèmes des membres inférieurs (100%) et le diabète (70%) sont les signes et pathologies associés les plus rencontrés (p>0,05). Conclusion: L’hémogramme doit être prescrit chez tout patient hypertendu pour connaître les affections sous-jacentes qui seront traitées simultanément avec l’HTA. Ainsi, le patient hypertendu sera pris en charge convenablement et son espérance de vie sera améliorée.Pan African Medical Journal 2016; 2

Prenatal Consultation Associated with Maternal and Fetal Complications During Delivery in Military Hospital of Soavinandriana Madagascar

Maternal and fetal complications represent a public health problem. The aim of this study is to identify the effects of prenatal consultation (PNC) in pregnant women to the maternal and fetal complications of deliveries in Military hospital of Soavinandriana (CENHOSOA). This is an analytical study using "Historical Cohort" comparing two groups of population, one group have done PNC or "PNC+" and the other group without PNC or "PNC-".The study was conducted in the CENHOSOA over a period of 13 months from 01 May 2012 to May 31, 2013. During the study period, we have include 296 (23.2%) belonged to the group of PNC- and 982 (76.8%) to the PNC+. The proportion of term birth is lower in PNC- than PNC+ (80.4% versus 93.3%,  p<10-6). The cesarean section was high in the PNC- group in comparison with the "PNC+" (32.1% versus 24.1% p<10-2). Group of PNC- have a relative risk RR = 6.64, 95% CI [1.22 – 36.05] of dyspnea. Infections and phlebitis are non significant in the two groups. Concerning fetal complication, PNC- group had RR=1.99, 95% CI [1.13 – 3.52] to have APGAR score<7 and RR=2.65, 95% CI [1.58 – 4.47] of weight <2,000mg. Concerning complications conducting in deaths, mother with PNC- had RR=3.32, 95% CI [0.21 – 52.88] of maternal death and newborns had RR=2.65, 95% CI [0.72 – 9.82] to intrauterine fetal death. In brief, maternal and fetal complications have been more frequent among women who have not had PNC. The state should promote the practice of adequate and well-conducted PNC for the good of the mother and the baby

Quality of Care Received by Children from 1 to 23 Months: Realities in The City of Antananarivo

Children's health depends on the proper care they receive from their mothers. This study aims to describe the quality of care received by children from 1 to 23 months in the city of Antananarivo. This is a cross-sectional and analytical study for a period from December 2016 to April 2017 in the city of Antananarivo which is the capital of Madagascar. The study population was made up of 420 mother-child dyads living in the city of Antananarivo. Regarding the care received by children, 47.6%, 95% Confidence Interval (CI) [42.8–52.4] benefit from quality nutrition care, 92.3%, 95% CI [89.8-94.8], have a social care and 45.5%, 95% CI [40.9–50.5] receive health care. The hygiene of life 66.4%, 95% CI [61.6–70.6] and the body hygiene 35.3%, 95% CI [30.6–39.8] improve as the child grows up. The care received by children was complete for the five types in 7.6%, 95% CI [5.1–10.1].  With regard to the profile of the mother, mothers under the age of 18 (OR=3.25, 95% CI [1.07-9.46]) and those who are single (OR=3.47, 95% CI [1.24-9.35]) offer more acceptable care to their infants. Infant care depends on the socio-economic and demographic profile of the mother. Thus, it is important to strengthen the communication strategy on infant first aid gestures and mothers' education on childcare

Nugent Score and Vaginal Flora Abnormalities Seen in the Laboratory of University Hospital of Befelatanana

Background: Vaginal flora abnormalities are common in women in their genitally active period. The aims of this study are to describe vaginal flora abnormalities and genital infections discovered from the Nugent score and to describe the associated factors with these abnormalities. Methods: This is a prospective and descriptive study of the microbiological results of the cervico-vaginal smears from the Nugent score and the microbiological culture for a period of six months from July to December 2019. This study was carried out in the laboratory of the University Hospital Joseph Raseta Befelatanana Antananarivo in Madagascar. Results: Among of the 161 cervico-vaginal smears, the score de Nugent associated of the microbiological results showed 52 (32.3%) cases of intermediate vaginal flora, 47(29.2%) cases of bacterial vaginosis, 46 (28.6%) cases of normal vaginal flora, 13 (8.1%) cases of vaginal candidiasis and 3(1.9%) cases of Staphylococcus aureus vaginitis. Concerning the Nugent score values, scores 4 and 7 are the most common. Concerning the associated factors with these vaginal flora abnormalities, women over 40 years (p=0.20; NS), hospitalized (p=0.25; NS) and suffering from leucorrheas (p=0.02) are the most affected by these abnormalities. Conclusion: Associated with the result of microbiological culture, the Nugent score helps biologists to diagnose genital infections from the cervico-vaginal smear.

Cytobacteriological Examination Of Urines And Urinary Tract Infection Seen In The Laboratory Of University Hospital Of Befelatanana

Background: Urinary tract infections are common in the community and the hospitals. The aims of this study are to describe the socio-demographic characteristics, uropathogen frequencies, and antimicrobial resistance rates of all patients with urinary tract infections. Methods: This is a prospective and descriptive study of 362 cytobacteriological urine examinations for a period of six months from July to December 2020. This study was carried out in the laboratory of the University Hospital Joseph Raseta Befelatanana Antananarivo in Madagascar. Results: Among 362 patients, 117 (32.3%) were affected by urinary tract infections. Women (37.1%) were more affected by men (26.3%) (p=0.02). Similarly, patients over 60 years of age (39%)(p=0.04) were the most affected by urinary tract infections. Bacteria were represented by enterobacteria (58.1%), streptococci (8.5%), non-fermenting gram-negative bacilli (3.4%), staphylococci (1.7%) and other microorganisms (28.2%). Concerning the antibiotic resistance, ESBL-producing Enterobacteriacea were more resistant to antibiotics than non-ESBL-producing Enterobacteriaaceae (81.8% versus 60.9% to cotrimoxazole, 72.7% versus 19.6% to ciprofloxacin, 59.1% versus 6.5% to gentamycin and 18.2% versus 10.9% to chloramphenicol). All isolates of non-fermenting gram-negative bacilli were resistant to ticarcillin and gentamycin, 8 (80%) isolates of streptococci to lincomycin and an isolate of staphylococci to penicillin G and tetracycline.   Conclusion: Bacteriological examination of urines and antibiogram were very important to improve the management of patients with urinary tract infections

Burkholderia cepacia: A case report in the laboratory of University Hospital of Befelatanana

Burkholderia cepacia has rarely been reported in Antananarivo. We present a case of a 49-year-old male with chronic kidney disease, hemodialysis-dependent, who was admitted to the hospital because of dyspnoea, deterioration of the general state and fever. His past medical history includes chronic kidney disease, hypertension, diabetes and chronic global heart failure. Burkholderia cepacia was identified in blood culture. The Immuno-compromised state of the patient, the antimicrobial resistance of Burkholderia cepacia and the delay of positivity of blood cultures are discussed. Published by the International journal of Microbiology and Mycology (IJMM

Clinical and genomic features of a Listeria monocytogenes fatal case of meningitis in Madagascar

International audienceListeriosis constitutes a significant public health threat due to its high mortality rate. This study investigates the microbiological and genomic characteristics of Listeria monocytogenes isolates in Madagascar, where listeriosis is a notifiable disease. The analysis focuses on a fatal case of meningeal listeriosis in a 12-year-old child. Genomic analysis revealed a novel cgMLST type (L2-SL8-ST8-CT11697; CC8, serogroup IIa) with typical virulence and antibiotic resistance profiles. These isolates, unique to Madagascar, formed an independent clade in the phylogenetic tree. This study presents the first genomic characterization of Listeria isolates in Madagascar, highlighting the necessity of ongoing genomic surveillance to strengthen listeriosis prevention and control strategies in the region

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