Sante (Montrouge, France)最新文献

{"title":"[Malaria transmission in lagoon areas in Côte d'Ivoire: the villages of N'gatty and Allaba].","authors":"D Fofana,&nbsp;Ab Koné,&nbsp;Yl Konan,&nbsp;Kl Konan,&nbsp;Jmc Doannio,&nbsp;Ek N'goran","doi":"10.1684/san.2010.0183","DOIUrl":"https://doi.org/10.1684/san.2010.0183","url":null,"abstract":"<p><p>The ecological and climatic variations in tropical areas of Africa make the transmission of malaria very heterogeneous. Several species of mosquitoes of the Anopheles genus transmit the disease. In Côte d'Ivoire, studies in the southern and northern forests have shown the involvement of Anopheles gambiae, An. funestus and An. nili in this transmission. This study was conducted in N'gatty and Allaba, two villages in a lagoon area of southern Côte d'Ivoire, in the district of Dabou. The district is located between 05 degrees 18 N and 04 degrees 27 W, about 40 kilometres from the economic capital of Côte d'Ivoire, and has a surface of 2257.8 km2. Two lagoon villages, N'gatty and Allaba, about a kilometre apart, were selected as sites for this research. The topography of N'gatty is rugged, with two important sides: a banana plantation on the west and the lagoon on the east, covered by aquatic plants (Pistia stratiotes, Acrosticum aureum, nympheacae and Eichhornia crassipes). This aquatic vegetation separates the last plots of the village from the lagoon. Mosquito populations were sampled from December 2007 through September 2008 by nighttime captures on volunteers three consecutive nights each month, inside six living rooms (4 in N'gatty and 2 in Allaba, a smaller village). The mosquitoes were captured when they landed on the volunteer's legs. There were two teams of catchers for each home; the first worked from 18:00 h to 24:00 and the second from 24:00 to 06:00. The ovaries and glands of An. gambiae were dissected. The physiological age of the females was determined by the appearance of the trachea on ovarian dissection. The sporozoites were sought by optic microscopy in cooled glands in a drop of physiological salt solution. During the 10 months of this study, 21 137 mosquitoes were caught in N'gatty and 7163 in Allaba. An. gambiae species accounted for less than 2% of the mosquito fauna in the two villages. Overall, the average bite rate was 203.24 bites per man per night (b/m/n) in N'gatty and 137.75 in Allaba. The average number of An. gambiae bites was 4.04 b/m/n in N'gatty and 2 b/m/n in Allaba. Annually, the average An. gambiae bites totalled 1474.6 bites per man per year (b/m/y) in N'gatty and 730 in Allaba. No An. funestus mosquito was caught in Allaba, and its average number of bites per man per year in N'gatty was only 3.65. No infected glands (n = 420 dissected) were found in N'gatty throughout the investigation. The mean sporozoite rate in Allaba was only 0.285% (n = 104). The mean entomological inoculation rate (EIR) was estimated at 0.017 infecting bites per man and per night (ib/m/n) in N'Gatty and 6.2 in Allaba. This weak entomological inoculation rate leads us to consider continuing the research for infection of An. gambiae by ELISA techniques. In conclusion, malaria transmission by An. gambiae in this area is very low.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"73-9"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29168942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Management of postpartum vaginal haematomas by embolisation: two cases].","authors":"Mehdi Kehila,&nbsp;Sami Mahjoub,&nbsp;Sahbi Kebaili,&nbsp;Hatem Rajhi,&nbsp;Fouzia Zouari","doi":"10.1684/san.2010.0194","DOIUrl":"https://doi.org/10.1684/san.2010.0194","url":null,"abstract":"<p><p>Postpartum vaginal haematomas are a rare complication of delivery. The incidence of large haematomas is estimated at 1/4000 deliveries, and this complication can be life-threatening. We report two such cases. The diagnosis is suggested by shooting perineal pain with urinary tenesmus and vulvovaginal swelling or an unexplained haemorrhagic syndrome in the postpartum period. Rapid management is essential. Embolisation by interventional radiology is preferred to surgery. In the first case, arterial embolisation was performed after bilateral ligation of the hypogastric arteries failed. Arterial embolisation was the first-line treatment for the second patient. It was successful for both women.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"105-7"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29170454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Community organizations and fighting STDs, HIV and AIDS in Montreal: lessons for sub-Saharan Africa].","authors":"Maurice T Agonnoude,&nbsp;C Mesenge","doi":"10.1684/san.2010.0185","DOIUrl":"https://doi.org/10.1684/san.2010.0185","url":null,"abstract":"<p><strong>Unlabelled: </strong>The HIV/AIDS pandemic is one of the most important public health problems in the world. In Benin as elsewhere in Africa, the combination of some sociological and sociocultural factors with socio-economic realities have led this pandemic to progress faster in some farming regions than in urban areas. This survey was performed during a three-month internship researching community-based organizations in Montreal that care for HIV/AIDS patients.</p><p><strong>Objectives: </strong>to analyse the actions taken by community-based organisations to combat this pandemic and point out the strengths and weaknesses of this system; - to draw useful lessons to apply in Africa.</p><p><strong>Method: </strong>more than one hundred organisations play a direct or indirect role in the combat against HIV/AIDS in the city ofMontreal. The choice of organisations to visit was determined by their interest for HIV/AIDS prevention and treatment or for the struggle against social exclusion. After a visit and guided tour of the premises of each organisation, one of its officials was interviewed for 20 to 30 minutes (according to a semi-structured outline, appendix 2. The data were analysed manually.</p><p><strong>Results: </strong>the survey showed that even in high-income countries, the same risk behaviors, equally influenced by poverty, social exclusion andvulnerability, lead to this disease. Further, its chronic nature, related to essentially permanent antiretroviral treatments makes it harder for vulnerable groups to maintain healthy behaviours. The concentration of disease in vulnerable groups gives a false sense of security to most of the population, which does not feel concerned, ignores messages intended to raise awareness, and does not participate in voluntary screening. The organisations and actors involved, with the support of public health facilities, battle this vulnerability while providing information and resources to the target groups to help them protect themselves better. This struggle thus remains too focused on these target groups. Efforts must be made to make the discourse on AIDS legible to broader populations, for the borderlines between these target groups and the rest of the population is very fuzzy. Discussion and lessons: This analysis of the process of fighting HIV/AIDS inMontreal identified some positive experiences that can inspire concrete actions in African setting. One is the experience of the Farha Foundation, an organisation specialized in community fund-raising, which puts its collections at the disposal of other community organisations, and is independent, receiving no funding from local, provincial or federal public authorities. Transposition of this experience to Africa would require contextualisation and would need to mobilize the resources of not only the local community but also the national and international communities. The \"Ruban en route\" organization provides useful awareness programs for the youn","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"116-24"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29170455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Sexual risk factors and HIV seroprevalence among the deaf and hearing-impaired in Yaoundé].","authors":"Adonis Touko,&nbsp;Célestin Pierre Mboua,&nbsp;P Tohmuntain,&nbsp;A Perrot","doi":"10.1684/san.2010.0186","DOIUrl":"https://doi.org/10.1684/san.2010.0186","url":null,"abstract":"<p><p>This quantitative cross-sectional study examines the sexual behaviour of people with hearing impairments in Yaounde, the capital of Cameroon, and measures the prevalence of HIV infection in this group. The study is intended to assess their sexual vulnerability and help to reduce the existing data gaps about HIV serology among people with disabilities in general and the deaf in particular. A snowball sampling procedure was adopted as an appropriate approach to this hard-to-reach population. In all, 118 deaf participants were interviewed in sign language for the behavioural component, and 101 participants provided blood samples for HIV serology testing. Descriptive analyses of behavioural data were performed with Epi info software, and health personnel used rapid and confirmation test reagents to diagnose HIV infection. The results make clear that the hearing-impaired are highly involved in risky sexual practices, as assessed by indicators including: age at first sexual intercourse, multiple sex partners, condom use, and knowledge of STIs and AIDS. Furthermore, HIV prevalence rate for the hearing-impaired in Yaounde was 4%, close to the level in the general population (4.7%). These results point to the need for in-depth behavioral research and serological studies in this domain, to improve our understanding of the determinants of risky sexual behaviours among the hearing-impaired and to help design operational prevention approaches for this target population.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"109-15"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29177169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The epilepsy treatment gap in six primary care centres in Togo (2007-2009)].","authors":"Kokou Mensah Guinhouya,&nbsp;Adodo Aboki,&nbsp;Damelan Kombaté,&nbsp;Vinyo Kumako,&nbsp;Kossivi Apétsé,&nbsp;Mofou Belo,&nbsp;Agnon Koffi Balogou,&nbsp;Kodjo Eric Grunitzky","doi":"10.1684/san.2010.0193","DOIUrl":"https://doi.org/10.1684/san.2010.0193","url":null,"abstract":"<p><p>Epilepsy, the most common serious neurological condition, is one of the most widespread non-transmissible diseases in the world. In developing countries, about 90% of those with epilepsy do not receive appropriate treatment; this treatment gap, very high compared with other chronic diseases, helps to explain the marginalisation and poor living conditions of these people. Reducing this treatment gap and the burden that epilepsy represents is a difficult task and the obstacles are numerous. The cultural attitudes, the absence of priority for this disease, the weak health infrastructure and the insufficient supply of anti-epileptics are just some of the factors that prevent adequate treatment. The extent of this problem led WHO and the International League against Epilepsy to launch an international campaign in June 1997 to bring epilepsy \"out from the shadows\". We sought to evaluate a strategy of community-based care for epilepsy in the six pilot districts. This strategy consisted in reducing the treatment gap in six local primary care units (PCUs) and then spreading the programme to surrounding PCUs, the entire district and then the entire region. This prospective evaluation study, which took place from May 2008 to July 2009, applied many strategies. WHO/AFRO made available funding of USD 3500 a year. A training meeting was held for PCU staff and community health agents, and numerous meetings from May 2007 through March 2008 aimed to increase awareness and motivation. The National Program for Mental Health (NPMH) ensured the availability of a permanent supply of anti-epileptics. Monitoring with supervision of activities and evaluation were conducted during and at the end of the process by the members of the Lomé Hospital neurology team and the management team of every district. Community-based management of 816 people with epilepsy over a period of 15 months was assessed internally. The planned strategies were conducted. The sex ratio (M/W) was 1.10. Treatment adhesion ranged from 96% to 99%. Mortality was 9%. The treatment gap in the PCUs, which varied from 98% to 94% in May 2008 fell by July 2009, ranging from only 40% to 25%. The \"good practice\" of accepting and treating patients with epilepsy in these areas where traditional culture excludes them from the community demanded the local acceptance of responsibility -- both medical and psychosocial. The reduction in epilepsy attacks and the integration of 2 or 3 patients in a community sufficed to bring other people with epilepsy out from the shadows. These successes show that in developing countries, it is possible to improve the health of different populations when these projects are integrated into primary health care. Positive results, and specifically a treatment gap below 50%, were obtained in all six PCUs. These results, acquired after months of activity, contributed to decrease the stigmatisation of epilepsy. Maintaining this reduction in the treatment gap requires continuation of th","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"93-7"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29164533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Typhoid fever in Lebanon: epidemiological study].","authors":"Soraya Naji-Rammal,&nbsp;Nora Bedrossian","doi":"10.1684/san.2010.0197","DOIUrl":"https://doi.org/10.1684/san.2010.0197","url":null,"abstract":"<p><p>Typhoid fever is a major public health problem, especially in developing countries. From 2000 through 2008, the infectious disease surveillance unit at the Lebanese Ministry of Public Health received 6148 reports of typhoid cases. A case is considered positive for typhoid or paratyphoid fever when fever of at least 38 degrees C persists for three days, and Salmonella enterica serovar Typhi or Paratyphi is isolated from blood, bone marrow, or stool. Statistical analysis was performed with STATA v.10 software. The most cases were recorded in 2003 (n=891), followed by 2007 (n=879), while the fewest were recorded in 2005 (n=461). The distribution of typhoid was not homogeneous between age groups: the age group most affected were those aged 20-39 years, followed by those from 10-19 years; those older than 60 years were least affected. Nor was the geographic distribution, by district (combining Nabatieh and the South together), homogeneous. The most affected individuals were in the North (n=2,192), followed by Bekaa (n=1,651) and Mount Lebanon (n= 1,094). Beirut was the least affected, with 210 cases. The results indicate that typhoid fever remains endemic in Lebanon and that the risk of epidemic episodes is still present.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"81-6"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29180234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Homozygous sickle cell disease in Ivory Coast adults].","authors":"Aïssata Tolo-Diebkilé,&nbsp;Kouassi Gustave Koffi,&nbsp;Danho Clotaire Nanho,&nbsp;Duni Sawadogo,&nbsp;Boidy Kouakou,&nbsp;Liliane Siransy-Bogui,&nbsp;Yassongui Mamadou Sékongo,&nbsp;Emeraude N'dhatz,&nbsp;N'dogomon Méité,&nbsp;Roméo Ayémou,&nbsp;Ibrahima Sanogo","doi":"10.1684/san.2010.0184","DOIUrl":"https://doi.org/10.1684/san.2010.0184","url":null,"abstract":"<p><p>Sickle cell disease is a genetic disease characterized by the synthesis of an abnormal haemoglobin called haemoglobin S. It is the most frequent of the hereditary anomalies of haemoglobin and occurs most commonly in individuals of African descent. Various treatments have considerably improved its prognosis, prolonging the survival of patients, especially those with the most severe, homozygous form. The objective of thisstudy is to describe the epidemiologic, clinical, and laboratory characteristics as well as the disease course and available treatments in adults (aged 21 years or older). This retrospective, descriptive, analytic and non-comparative study included 48 adults of both sexes with homozygous sickle cell disease. Their mean age was 26.1 years (range: 21 to 56 years, and sex ratio 1.3. In all, 70.8% had clinical anaemia, 83.3% were subicteric or icteric and 8.3% had hepatomegaly. Spleen size was normal in 41.7% of patients, and atrophic in 37.5%. No case of splenomegaly was noted and 8.3% had been splenectomised. Haemoglobin rates ranged from 4 g/dL to 12.7 g/dL with an average of 9.5 g/dL, haemoglobin S levels from 83 to 93% with an average of 85.3%, and haemoglobin F levels from 3.5 to 17% with an average of 10.6%. The percentage with fewer than three crises (vasooclusive or haemolytic or both) in a year was 68.7%; 27.1% had from three to five crises, and 4.2% more than five. Disease complications included anaemia in 43.7%, infections in 18.8% and ischaemia in 16.7%; 20.8% had no complications. Age at the beginning of treatment was younger than 5 years in 56.25%, from 5 to 10 years in 29.2%, and older than 10 years in 14.6%. Medical follow-up was regular for 68.7% and irregular for 31.2%. Vaccination was up to date in 58.3. Most patients (83.3%) adhered to their maintenance treatment. In all, 41.7% had not had any blood transfusions, 54.2% had had one or two transfusions, and 4.2% three or more. We compared the patients aged 26 years or younger with those older than 26 and studied the influence of age on different disease variables. Age did not affect the frequency of crises (p = 0.368) or of infections (p = 0.116), the rates of haemoglobin (p = 0.221), haemoglobin S (p = 0.44), or haemoglobin F (p = 0.35), or complications (p = 0.56). Nevertheless, we noted that the frequency of crises, infections, and anaemic complications were higher among the younger patients. Early treatment, regular medical follow-up, maintenance treatment and vaccination have all improved the prognosis of homozygous sickle cell disease considerably. These patients have reached adulthood with relatively few chronic complications.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"63-7"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29161743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Exploration of post-menopausal uterine bleeding. Hysteroscopy-histology correlation in 94 cases].","authors":"Sahbi Kebaili,&nbsp;Mohamel Dhouib,&nbsp;Kais Chaabane,&nbsp;Afef Chtioui,&nbsp;Habib Amouri,&nbsp;Belhassen Ben Ayed,&nbsp;Mohamed Guermazi","doi":"10.1684/san.2010.0195","DOIUrl":"https://doi.org/10.1684/san.2010.0195","url":null,"abstract":"<p><strong>Introduction: </strong>Post-menopausal uterine bleeding is the reason for nearly 70% of gynaecological consultations. Because the cause may be a malignant disease, a thorough work-up is necessary to attempt to identify an organic cause.</p><p><strong>Patients and methods: </strong>This retrospective study examined 94 cases of post-menopausal bleeding in which both a hysteroscopic and a histological examination were performed in the gynaecology and obstetrics department of the Hedi Chaker University of Sfax from 1 January 2004 to 28 February 2005. We examined correlations between the hysteroscopy and histology findings as well as the causes determined.</p><p><strong>Results: </strong>By hysteroscopy, we observed atrophic uterine linings in 53 patients (56%), endometrial polyps in 43 patients (45%), endometrial hyperplasia in 23 patients (24%) and myomas in 24 patients (25.5%). This examination suggested malignancy in 12 patients, among 6 of whom endometrial cancer was confirmed histologically. The sensitivity and specificity of hysteroscopy were relatively poor for the diagnosis of endometrial atrophy (about 48.7% and 68.5%), acceptable for endometrial polyps (75% and 86.6%), endometrial hyperplasia (64.7% and 85.5%), and endometrial cancer (60% and 92.7%).</p><p><strong>Conclusion: </strong>Hysteroscopy is the most reliable technique for exploration, offering a direct view of the uterine cavity and allowing direct biopsy. Its sensitivity varies according to the indication and diagnosis and is sometimes very good. However, histology remains the reference examination for diagnosis of the cause of post-menopausal uterine bleeding.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 2","pages":"99-104"},"PeriodicalIF":0.0,"publicationDate":"2010-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29169640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Epidemiological and clinical characteristics of intestinal microsporidiosis].","authors":"Sonia Anane,&nbsp;H Attouchi,&nbsp;E Kaouech,&nbsp;S Belhadj,&nbsp;T Ben Chaabane,&nbsp;N Ben Abdallah,&nbsp;T Ben Othman,&nbsp;A Samoud,&nbsp;M Ben Hriz,&nbsp;K Kallel,&nbsp;E Chaker","doi":"10.1684/san.2010.0188","DOIUrl":"https://doi.org/10.1684/san.2010.0188","url":null,"abstract":"<p><strong>Introduction: </strong>Intestinal microsporidiosis is an opportunistic parasitological infection affecting mainly immunocompromised patients, particularly those infected with HIV.</p><p><strong>Purpose: </strong>The purpose of this study was to analyse the epidemiological and clinical characteristics of intestinal microsporidiosis and the treatments available for it.</p><p><strong>Material and methods: </strong>This retrospective study examined records collected over a 13-year period (from January 1995 through December 2007). It included 572 immunocompromised patients (279 HIV-infected patients and 293 without HIV infection) with symptoms suggesting intestinal microsporidiosis. All were tested systematically for microsporidia spores by modified (Weber's) Trichrome staining.</p><p><strong>Results: </strong>Fourteen patients (10 men, 4 women) were diagnosed with intestinal microsporidiosis, for a prevalence of 2.4% overall, 3.6% in HIV-infected patients and 1.4% in those without HIV infection. Intestinal microsporidiosis affected 10 HIV-infected patients, 70% of whom had a CD4 count <100 cells/mm3. Their mean age was 30+/-15 years (range: 15 months to 48 years). The average age of HIV-infected patients (36 years) was significantly higher than of those without HIV infection (15 years). Thirteen patients had symptoms, most frequently diarrhea (11 cases), sometimes associated with dehydration (5 cases). Eight patients (57%) received only symptomatic treatment, and 4 (28.6%) received albendazole. No treatment was recommended in 2 cases (14.3%). Clinical course was marked by improvement in 6 cases, death in 5, and persistence of asymptomatic carriage in one. Two patients were lost to follow-up.</p><p><strong>Conclusion: </strong>Intestinal microsporidiosis is a parasitological disease that mainly affects AIDS patients with CD4 counts <100 cells/mm3. Its diagnosis requires special techniques. Its symptomatology is dominated by chronic diarrhea that can cause dehydration. Effective treatment requires identification of the species.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 1","pages":"21-9"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29001184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Health care utilization in Nouakchott (Mauritania): spatial inequalities or social sluggishness?].","authors":"Ibrahima Sy,&nbsp;Moussa Keita,&nbsp;Moustapha Ould Taleb,&nbsp;Baidy Lo,&nbsp;Marcel Tanner,&nbsp;Guéladio Cisse","doi":"10.1684/san.2010.0187","DOIUrl":"https://doi.org/10.1684/san.2010.0187","url":null,"abstract":"<p><p>In African cities where environmental, social and economic problems facilitate the development of urban pathology, inadequate or ineffective health facilities raise the question of access to quality care, especially for slum dwellers. The city of Nouakchott marked by a multifaceted urban crisis is an illustration of this troubling situation. To analyse the spatial organisation and functioning of the healthcare system by assessing the use of health services, we studied this utilisation in August 2004 in three areas of the city by a cross-sectional survey of 836 households. The results show that therapeutic itineraries are as diverse as health care provision is varied. About 50.8 % of those seeking health care reported using modern services (public health clinics, private clinics, private doctors or nurses) for the most common diseases (acute respiratory infection and diarrhea) in their community, but this rate varied significantly by disease, social category and neighborhood. Thus, this mediocre level of utilisation of public health clinics is due to the poor quality of care provided. Moreover, healthcare services are often used only in case of severe or worsening illness, with signs (e.g., cough and persistent fever, or weight loss) seen to suggest more serious diseases, such as tuberculosis, meningitis or severe malaria. Geographic accessibility of health services was relatively good (70 %). It was the economic, socio-cultural, organizational and functional factors that appeared to determine the choice to use modern health care. The slackening of socio-cultural and organizational constraints and adaptation to economic ones should help to improve health policies and foster a functioning healthcare system.</p>","PeriodicalId":79375,"journal":{"name":"Sante (Montrouge, France)","volume":"20 1","pages":"51-8"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1684/san.2010.0187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28981826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}