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Xeroderma pigmentosum is related to a defect of the enzymes involved in repairing the oncogenic effects of ultraviolet exposure. The condition is found all over the world, in all ethnicities and races. This rare genodermatosis is often unknown in countries lacking specialist in dermatology. This scarcity and insufficiency of qualified personnel give rise to difficulties in diagnosing this pathology, especially in West Africa where XP is wrongly diagnosed for other pathologies. Objective: To share with colleagues the problem of diagnosis of Xeroderma pigmentosum in countries with insufficient number of dermatologist and poor technical platform. Observation: 21-year-old man, with no pathological history of dermatosis was seeking for medical consultation because of cutaneous dryness and photophobia. Previous visits at several health centers failed to diagnose the condition and no noticeable improvement was seen from given treatment. Verbal questioning found the notion of consanguinity (his father and his mother are cousins, and belong to the same Dogon group). Cutaneous pigmentary disorders were absent at birth but appeared at the age of 12 years. Physical examination highlighted photophobia in addition to specific clinical and paraclinical signs allowed to diagnose Xeroderma pigmentosum varying type. Conclusion: in West Africa, the challenge of diagnosis of Xeroderma pigmentosum is undoubtedly related to a lack of qualified personnel and technical means of diagnosis, which makes its frequency underestimated.Le Xéroderma pigmentosum (XP) est lié à un défaut des enzymes impliquées dans la réparation des effets oncogènes de l'exposition aux ultraviolets. L'affection se rencontre dans le monde entier, dans toutes les ethnies et races. Cette génodermatose rare est souvent méconnue dans les pays en manque de spécialiste en dermatologie. Cette rareté de Xeroderma pigmentosum et l'insuffisance de personnel qualifié engendrent des difficultés diagnostiques de cette pathologie surtout en Afrique Occidentale où le XP est diagnostiqué à tort pour d'autres pathologies.Partager avec les confrères la problématique de diagnostic de Xéroderma pigmentosum dans les pays en insuffisance de dermatologues et de plateau technique.il s'agissait d'un patient de 21 ans, sexe masculin, sans antécédents pathologique de dermatoses, issu d'un mariage consanguin qui a consulté pour sècheresse cutanée et photophobie après un long parcours dans beaucoup des centres de santé de la place sans diagnostic et sans amélioration notable, chez qui l'interrogatoire a retrouvé la notion de consanguinité (son père et sa mère sont des cousins, et provenaient du même clan Dogon),l'absence de troubles pigmentaires cutanées à la naissance et l'apparition des troubles pigmentaires cutanées à l'âge de 16ans. L'examen physique a objectivé la photophobie en plus des signes cliniques et paracliniques specifiques ce qui a permis de retenir le diagnostic de Xéroderma pigmentosum, forme variante.en Afrique Occidentale, la difficulté diagnostique de Xéroderma pigmentosum est sans doute en rapport avec un manque de personnel qualifié et des moyens techniques de diagnostic, ce qui rend sa fréquence sous-estimée.

INTRODUCTION : La DCV de la peau est une pratique courante chez les femmes en Afrique Subsaharienne avec une prévalence de 25 à 71%. Les principaux produits utilisés étaient les dermocorticoïdes d’activité très forte, l'hydroquinone et le mercure. Le CSC est très rare chez les patients atteints de phototype VI de Fitzpatrick. Depuis 2000, le premier cas de carcinome épidermoïde associé à une DCV de la peau a été rapporté par Addo à Accra, au Ghana. Nos objectifs étaient de décrire les cas de CSC survenus chez des femmes noires africaines vivant en Afrique Subsaharienne et d'en déterminer les facteurs associés. MATERIELS ET METHODES : Nous avons mené une étude descriptive multicentrique d'Août 2005 à Octobre 2021 au Mali, en Guinée, en Côte d'Ivoire et au Sénégal. Nous avons inclus tous les patients consultant pour un carcinome épidermoïde cutané associé à un blanchiment de la peau. Les données sociodémographiques, cliniques, paracliniques et thérapeutiques ont été enregistrées. RESULTATS : Au total 37 patientes ont été incluses. L'âge variait de 37 à 77 ans. L'hydroquinone topique et les corticoïdes très puissants ont été les principaux produits utilisés sur l'ensemble du corps, pendant une durée moyenne de 20,3 ans. Aucune maladie cutanée pré-néoplasique n'a été retrouvée chez nos patients. Les aspects cliniques des tumeurs étaient les suivants : ulcéro-bourgeonnant, ulcéré et nodulaire. Le délai moyen de développement avant consultation était de 6,75 mois. Les carcinomes épidermoïdes cutanés étaient localisés le plus souvent sur des lésions lichénoïdes ou des lésions ochronotiques exogènes sur les zones photo-exposées : visage, cou ou haut du dos. Un patient présente deux carcinomes épidermoïdes. Les aspects anatomo-pathologiques du carcinome épidermoïde étaient : la forme infiltrante, la forme invasive et le carcinome in situ. De plus, il existait des stigmates d’infection à HPV a l’histopathologie. L’exposition aux UV, l'immunosuppression et l'inflammation chronique sont certainement les principaux facteurs associés. Le facteur supplémentaire serait le virus HPV qui est oncogène. L'évolution était favorable chez la majorité des patients après résection chirurgicale. Quatre décès sont survenus. CONCLUSION : De 2000 à 2021, 37 cas de carcinomes épidermoïdes cutanés associés à l'utilisation cosmétique de produits de blanchiment ont été rapportés dans quatre pays d'Afrique Subsaharienne. Le mécanisme n'a pas été complètement élucidé et d'autres études sont nécessaires. Ces observations fournissent un argument supplémentaire pour lutter contre cette pratique et inclure le blanchiment de la peau parmi les facteurs de risque connus du carcinome épidermoïde.

L'érysipèle est une dermohypodermite bactérienne aiguë non nécrosante, affectant le plus souvent les membres inférieurs. Les facteurs favorisant sa survenue sont l'existence d'une porte d'entrée (plaies traumatiques négligées, intertrigo), le lymphœdème, l'obésité et la dépigmentation volontaire. La complication la plus fréquente est la récidive. Les autres complications incluent notamment abcédassions, la fasciite et les bactériémies. Nous rapportons une première observation malienne d'érysipèle chez un nourrisson de 8 mois, de sexe féminin, amené en consultation dans l'unité dermatologique de l'hôpital régional de Gao pour l'installation brutale d'une grosse jambe rouge plus notion de fièvre et de frissons. Le diagnostic a été porté devant une tuméfaction du membre inférieur droit rouge, chaude et douloureuse surmontée de bulles tendues associée à une adénopathie inguinale et une leucocytose à l'hémogramme. Un traitement à base d'antibiotique associé à un pansement et le repos a été instauré. L'évolution a été émaillée par la disparition des lésions en dix jours. Le diagnostic positif est fondé sur la clinique renforcé par la recherche de l'origine streptococcique.

Background The first International Society of Atopic Dermatitis (ISAD) global meeting dedicated to atopic dermatitis (AD) in Sub‐Saharan Africa (SSA) was held in Geneva, Switzerland in April 2019. A total of 30 participants were present at the meeting, including those from 17 SSA countries, representatives of the World Health Organization (WHO), the International Foundation for Dermatology (IFD) (a committee of the International League of Dermatological Societies, ILDS http://www.ilds.org), the Fondation pour la Dermatite Atopique, as well as specialists in telemedicine, artificial intelligence and therapeutic patient education (TPE). Results AD is one of the most prevalent chronic inflammatory skin diseases in SSA. Besides neglected tropical diseases (NTDs) with a dermatological presentation, AD requires closer attention from the WHO and national Departments of Health. Conclusions A roadmap has been defined with top priorities such as access to essential medicines and devices for AD care, in particular emollients, better education of primary healthcare workers for adequate triage (e.g. better educational materials for skin diseases in pigmented skin generally and AD in particular, especially targeted to Africa), involvement of traditional healers and to a certain extent also patient education, bearing in mind the barriers to effective healthcare faced in SSA countries such as travel distances to health facilities, limited resources and the lack of dermatological expertise. In addition, several initiatives concerning AD research in SSA were discussed and should be implemented in close collaboration with the WHO and assessed at follow‐up meetings, in particular, at the next ISAD meeting in Seoul, South Korea and African Society of Dermatology and Venereology (ASDV) meeting in Nairobi, Kenya, both in 2020.

Le zona est une dermatose virale qui peut intéresser n'importe quelle partie du corps. La plus part des personnes atteintes d'un zona ont entre 50 à 70 ans. Toutefois son apparition chez le sujet jeune doit fait rechercher une immunodépression à VIH. Nous rapportons un cas atypique de zona révélant l'infection à VIH chez une patiente de 25 ans présentant une éruption vésiculeuse, douloureuse reposant sur un fond érythémateux localisé sur la plante du pied gauche. Le diagnostic du zona a été évoqué grâce aux éléments cliniques et réconforté par le cytodiagnostic et l'histologie. Cette localisation atypique nous a incités à demander une sérologie à VIH qui est revenue positive.

Prurigo is one of the most common dermatological conditions during HIV infection and AIDS. It appears as an immunosuppression marker associated with HIV infection. The study objective was to determine the prevalence of prurigo in people living with the human immunodeficiency virus (PLHIV) in Fousseyni N'Daou Hospital of Kayes, and to describe the socio-demographic aspects of patients and lesions associated with prurigo among PLHIV.It was a descriptive cross-sectional study included all cases of HIV infected patients with prurigo in the Dermatology-Venomology Department of Fousseyni N'DAOU Hospital from January 1, 2015 to August 31, 2015.We collected 121 cases of prurigo. The hospital prevalence was 14.5% among PLHIV with 65% Female and the average age was 34.8 years old (SD: 15-81 years). The elementary lesions associated with prurigo were seropapules (40.2%), vesiculo-crusts (13%), excoriated papules (33.3%), lichenified papules (10.8%), and cicatricial lesions (2.7%). The prurigo was generalized in 68.5% of cases and localized in 31.24%. More than half of our patients had weight loss, fever, diarrhea and oral candidiasis in their medical history. Patients were infected with HIV1 in 60.03% and HIV1+ 2 in 24.3%. More than the half of our patients had a CD4 count inferior to 250 cells/mm3 at the time of prurigo diagnosis.In our study, prurigo remains a common condition in PLHIV, particularly in patients with low CD4 counts. Early detection and rapid antietroviral therapy can reduce the frequency of prurigo in PLHIV.Le prurigo est l'une des affections dermatologiques les plus fréquentes au cours de l'infection à VIH et du sida. Il apparait comme un marqueur de l'immunodépression associée à l'infection VIH. L'objectif était de déterminer la prévalence du prurigo chez les personnes vivant avec le virus de l'immunodéficience humaine (PVVIH) à l'hôpital Fousseyni N'Daou de Kayes (HFDK) et décrire le profil sociodémographique des patients et les lésions associées au prurigo chez les PVVIH à HFDK.Il s'agissait d'une étude transversale descriptive de tous les cas de prurigo chez les PVVIH dans le service de Dermatologie-Vénéréologie de l'hôpital Fousseyni N'DAOU durant la période du 1Nous avons colligé 121 cas de prurigo. La prévalence hospitalière a été de 14,5% chez les PVVIH. Le sexe féminin a représenté 65% des cas. L'âge moyen a été de 34,8 ans (extrêmes :15 – 81 ans). Les lésions élémentaires associées au prurigo ont été les séropapules (40,2%), vésiculo-croutes (13%), papules excoriés (33,3%), papules lichenifiés (10,8%), lésions cicatricielles (2,7%). La forme généralisée a représenté 68,5% et la forme localisée 31,24%. Plus de la moitié de nos patients avait la notion d'amaigrissement, de fièvre, de diarrhée et des candidoses buccales dans leurs antécédents. Le VIH1 a représenté 60,03% et l'association VIH1 et VIH2 a représenté 24,3% des cas. Plus de la moitié de nos patients avait un taux de CD4 inférieure à 250 cellules/mmDans notre étude, le prurigo reste une affection fréquente chez les PVVIH, particulièrement lorsque le taux de CD4 est bas. Un dépistage précoce et le traitement antirétroviral rapide permet de réduire la fréquence du prurigo chez les PVVIH.

Maladie de Kaposi en consultation de dermatologie au CHU Gabriel TOURE : étude de 36 cas.

This study was conducted during the rainy season of 2017 in the agricultural areas at Mouila, with the aim to assess the determination of susceptibility ofCette étude a été menée en 2017 pendant la saison des pluies dans les zones d’exploitations agricoles à Mouila, afin de déterminer le statut de sensibilité des membres du complexe

Pityriasis rosea, described by Gibert in 1860, is a frequent, benign, transient dermatosis, with unknown etiology that affects especially young adults. It is believed to be a consequence of a viral infection, but this argument is not convincing. We report a case of Pityriasis Rosea from Gilbert (PRG) revealing viral hepatitis B. Observation: This was a 47-year-old adult from Diago (commune of Kati), with no known medical and surgical history, who was seen for pink spots scattered throughout the trunk associated with pruritus in which the retained diagnosis was PRG. He have given vaseline with urea 5%, and Mequitazine10mg as treatment. Facing the persistence of this pruritus despite this treatment, a biological investigation was done to look for probable etiology was requested and this led to the diagnosis of an infection with the hepatitis B virus. Conclusion: this observation should lead dermatologists to systematically search for hepatitis B viral infection when facing a PRGs that are very pruriginous and resistant to the usual treatments.Mots clés : Pityriasis rosea, Viral hepatis B

The long-lasting insecticidal nets (LLINs) have been promulgated to compensate the low re-impregnation rate of conventional mosquito nets. Today, the cornerstone of the fight against malaria vectors is based on a large distribution of these LLINs for universal coverage. Despite this promotion, the question of their effective life in operational conditions remains unresolved. Between September and October 2013, a survey was conducted in 11 districts of Senegal where LLINs were sampled and routed to the laboratory for assessing their physical integrity and biological effectiveness. A total of 207 LLINs that were sampled in the 11 districts have been monitored during this study. Our results showed that Olyset® Net and PermaNet® 2.0 are the most represented brands in the districts. These two major brands have a good biological efficiency providing a high rate of knockdown despite their failing physical integrity.Les moustiquaires imprégnées à longue durée d'action (MILDA) ont été promues pour pallier le faible taux de réimprégnation des moustiquaires conventionnelles. Aujourd'hui, la pierre angulaire de la lutte antivectorielle repose sur une forte distribution de ces MILDA pour une couverture universelle. En dépit de cette promotion, la question de leur durée de vie effective en conditions opérationnelles reste toujours posée. Entre septembre et octobre 2013, une enquête a été menée dans 11 districts du Sénégal. Des MILDA y ont été échantillonnées et acheminées au laboratoire pour évaluer leur intégrité physique et leur efficacité biologique. Au total, 207 MILDA ont été collectées dans les 11 districts suivis au cours de cette étude. Nos résultats ont montré que les deux marques majoritairement distribuées présentaient une bonne efficacité biologique, car induisant un taux élevé de

Women widely use skin-lightening products for cosmetic purposes in sub-Saharan Africa despite numerous reported cutaneous and systemic complications. The occurrence of epidermoid carcinoma has long been reported, but only three cases have been published so far. We report the first case in Mali.A 30-year old woman with no noteworthy medical history was seen at our outpatient center for cervical ulceration that had been present for the last 5 years. She had used cosmetic bleaching cream over a period of around ten years. Physical examination revealed extensive ulceration on the left side of her neck. Blood tests for viral hepatitis and human immunodeficiency virus were negative. The pathological examination of the skin biopsy confirmed the diagnosis of squamous cell carcinoma. After failure of the initial excision with early relapse, multiple surgical ablations were performed 3 months later.The high prevalence of skin-lightening cosmetic use contrasts with the rarity of epidermoid carcinoma in depigmented skin. However, a large chronic ulcer on uncovered parts of the upper body, particularly the neck, should prompt physicians to consider skin cancer. Appropriate preventive measures include the promotion of educational messages for the general population, the use of sun-protection devices, and routine skin biopsy for all women presenting chronic cervical ulceration after long-term use of skin-lightening products.

Resume Introduction Cette etude avait pour but de comparer les caracteristiques cliniques des acnes de la femme adulte en France et en Afrique sub-saharienne. Malades et methodes Les femmes âgees de 25 ans et plus consultant pour acne dans les services hospitaliers de dermatologie de Creteil, de Dakar et de Bamako ont ete incluses. Les donnees recueillies comportaient un questionnaire de sante, un historique de l’acne, un examen clinique, l’usage de depigmentants. Les caracteristiques des patientes etaient exprimees en effectifs et pourcentages pour les variables qualitatives et en moyennes et ecarts-types ou medianes, premiers et troisiemes quartiles pour les variables quantitatives selon leur distribution. Resultats L’indice de masse corporelle, le tabagisme, l’âge des premieres regles et la prise de contraceptifs n’etaient pas significativement differents entre les groupes. La presence d’une hyperpilosite losangique abdominale etait plus frequente chez les femmes de phototype fonce, sans autres signes d’hyperandrogenie. A Dakar et a Bamako, l’acne etait plus grave qu’a Creteil. Les pigmentations post-inflammatoires, l’atteinte des joues et du front etaient significativement plus frequente sur phototype fonce. L’atteinte du menton etait plus frequente sur peau claire. Aucune femme ne pratiquait la depigmentation volontaire parmi les femmes qui n’etaient pas originaires d’Afrique, alors que cette pratique etait presente chez la moitie des femmes africaines a Creteil et en Afrique. Conclusion Cette etude met en evidence des differences cliniques de l’acne de la femme adulte selon les phototypes et les zones geographiques.

Aim of study. To describe the emergence of dengue 3 virus in Cote d'Ivoire during a yellow fever outbreak which occurred in 2008. Materials and methods. Sera from suspected cases of yellow fever as well as contacts of yellow fever confirmed cases and imported dengue fever cases were tested for immunoglobulin M (IgM) antiyellow fever virus and anti-dengue virus (for IgM antibodies to yellow fever and dengue viruses) and by a specific real time RT-PCR (Bio- Rad) for yellow fever virus and dengue virus viral RNA detection. Results. Of the 511 sera from suspected cases of yellow fever tested, 21 (4.1%) were confirmed positive for yellow fever virus antibody, while 33 (7.6%) of the 432 sera tested were positive for dengue virus antibody. Thirteen viremic subjects, one for yellow fever virus and 12 for dengue 3 virus, were detected by RT-PCR. The majority of the confirmed cases of yellow fever (85%) and dengue 3 fever (93%) were adults, and resided in the city of Abidjan and its regions. Conclusion. These results indicate the existence of transmission foci of these arboviruses diseases in Cote d'Ivoire and the essential contribution of molecular tests for their diagnosis.

Il s’agit d’une etude prospective, descriptive et analytique menee de juillet 2011 a septembre 2011 a l’Hopital national d’enfants Albert Royer de Dakar et dans le district sanitaire de Velingara. Elle portait sur des enfants âges de 0 a 15 ans sans prejuge du statut serologique. Chaque enfant a beneficie d’un prelevement de selle qui a ete examinee par la methode de Ziehl-Neelsen modifiee et d’une recherche d’antigene de Cryptosporidium spp par le kit « Cryptosporidium Antigen Detection Microwell ELISA ». L’objectif de notre etude etait de determiner la prevalence de la cryptosporidiose en milieu rural et en milieu hospitalier et de mesurer les performances du kit ELISA utilise. Sur les 375 examens de selles realises par la methode de Ziehl-Neelsen modifiee, 17 ont revele la presence de Cryptosporidium spp, soit une prevalence de 4,53 %. La prevalence en milieu rural etait de 2 % tandis que la prevalence hospitaliere etait de 7,4 %. Par la methode ELISA, 23 cas positifs ont ete observes, soit une prevalence de 6,13 %. En faisant une correlation de ce test avec la methode de reference qu’est la technique de Ziehl-Neelsen modifiee, nous avions constate que ce test avait une sensibilite de 58,82% et une specificite elevee a 96,37 %. La valeur predictive positive (VPP) etait de 43,4 %, tandis que la valeur predictive negative etait de 98 %. La cryptosporidiose est une cause non negligeable d’infection parasitaire chez les enfants au Senegal; la detection d’antigenes de Cryptosporidium spp peut etre un outil complementaire dans le diagnostic de la cryptosporidiose.

Urban malaria is a major public health problem in Africa. In Senegal, the environmental changes seem to favor the persistence of malaria transmission in Dakar suburbs by creating, throughout the year, potential breeding sites of malaria vectors. In such a situation and in a context of a growing threat of insecticide resistance in anopheline vectors, the larval control making use of products from biological origin or growth regulators could represent an additional tool to the current strategies developed against anophelines. In this study conducted in 2012, the efficiency and residual effect of three biological larvicides (VectoBac

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Malaria incidence has markedly declined in the Mbour, Fatick, Niakhar and Bambey districts (central and western Senegal) thanks to a scaling up of effective control measures namely LLINs (Long Lasting Insecticide Treated Net), ACTs (Artesunate Combination Therapy) and promoting care seeking. However malaria cases are now maintained by foci of transmission called hotspots. We evaluate the role of anopheles breeding sites in the identification of malaria hotspots in the health districts of Mbour, Fatick, Niakhar and Bambey. Surveys of breeding sites were made in 6 hotspot villages and 4 non-hotspot villages. A sample was taken in each water point with mosquito larvae by dipping method and the collected specimens were identified to the genus level. Additional parameters as name of the village and breeding sites, type of collection, original water turbidity, presence of vegetation, proximity to dwellings, geographic coordinates, sizes were also collected. Sixty-two water collections were surveyed and monitored between 2013 and 2014. Temporary natural breeding sites were predominant regardless of the epidemiological status of the village. Among the 31 breeding sites located within 500 meters of dwellings in hotspots villages, 70% carried Anopheles larvae during the rainy season while 43% of the 21 breeding sites located at similar distances in non-hotspot villages carried Anopheles larvae during the same period (P = 0.042). At the end of the rainy season, the trend is the same with 27% of positive breeding sites in hotspots and 14% in non-hotspots villages. The breeding sites encountered in hotspots villages are mostly small to medium size and are more productive by Anopheles larvae than those found in non-hotspot area. This study showed that the high frequency of smallest and productive breeding sites around and inside the villages can create conditions of residual transmission.

Acute bacterial cellulitis of the leg (erysipelas) is a common problem involving considerable morbidity in dermatology practice in Africa. Previous studies conducted in Europe and North Africa have highlighted lymphoedema and toe-web intertrigo as independent factors associated with leg erysipelas. The aim of this case-control study was to identify risk factors associated with leg erysipelas in sub-Saharan Africa, within a different socio-economic and culture context.We conducted a prospective case-control study in hospital dermatology departments in 8 sub-Saharan African countries over a 12-month period (October 2013 to September 2014). Each case of acute leg cellulitis was matched with 2 controls for age (±5 years) and sex. We analysed the general and local factors.During the study period, 364 cases (223 female, 141 male) were matched with 728 controls. The mean age was 42.15±15.15 years for patients and 42.11±36 years for controls. Multivariate analysis showed the following to be independent risk factors associated with leg erysipelas in our study: obesity (odds ratio [OR]=2.82 ; 95% confidence interval: 2.11-3.76), lymphoedema (OR=3.87, 95%CI: 2.17-6.89), voluntary cosmetic depigmentation (OR=4.29, 95%CI: 2.35-7.83), neglected traumatic wound (OR=37.2, 95%CI: 24.9-57.72) and toe-web intertrigo (OR=37.86, 95%CI: 22.27-64.5).The results of this study confirms the major role of local risk factors (toe-web intertrigo, lymphoedema) previously identified in other geographical settings. However, the originality of our study consists of the identification of voluntary cosmetic depigmentation as a risk factor for leg erysipelas in sub-Saharan Africa.

The recent decline of malaria transmission in central-western of Senegal after a scaling up of control measures gives an open window for interventions toward malaria elimination. As a consequence, malaria transmission is now occurring as hotspots. The aim of the project is to evaluate whether target control measures combining indoor residual spraying (IRS) with chemoprophylaxis can virtually eliminate malaria in hotspots. Targeted villages located in four (4) health districts (Mbour, Fatick, Niakhar and Bambey) were sprayed in august 2013 with Actellic® 300 CS (Pirimiphosmethyl). Our objective in this study is to evaluate the acceptability of IRS in the population. IRS is a very complex intervention that requires strong adhesion of populations. After its implementation, 370 households have been interviewed. The results of this survey showed good acceptability of IRS using Actellic® 300 CS, with 97.8% of beneficiaries who declared that IRS is good and even excellent for the community. Despite inconveniences that may arise during intervention, including the preparation of structures to be treated, 98% of respondents were not disturbed in their daily activities. 98.6% of responders declared that sprayers were working with professionalism and almost all households (99.7%) are willing to accept IRS next year. The survey revealed a good acceptability of indoor residual spraying in hot spots located in central-western of Senegal; spraying with Actellic® 300 CS did not cause a problem to the targeted populations. Finally, there is great satisfaction in the population due a huge reduction of mosquito nuisances.

Specify epidemioclinical and legal aspects of sexual abuse among minors and evaluate the cost of care in Dakar.This is a retrospective multicenter cross-sectional study on sexual abuse among minors over a period of four years from 1st January 2006 to 31st December 2009. Four maternities were targeted: the Social Hygiene Institute of Medina, health center Roi-Baudouin Guédiawaye, the Pikine hospital and health center Youssou-Mbargane-Diop of Rufisque.During the study period, 252 child victims of sexual abuse were supported at four health facilities on a total of 272 sexual abuses of all ages, a frequency of 92.64%. The epidemiological profile of our patients was a child of 11 years old on average, female (100%) and living in the suburbs of Dakar (68.1%). Children were often abused during working hours (31.7%), outside the family environment and often by someone known to the victim (72.6%). Genito-genital contact was the most common mode of sexual contact (80.9%) with vaginal penetration in 61% of cases. Almost all of the victims (92.1%) came to consult, accompanied by their parents, between the 1st and 4th day after the sexual abuse (70%). The examination usually revealed a hymenal trauma (59.9%) of which nearly half (49%) consisted of old lesions. 56.9% of victims had a post-traumatic stress disorder and 31.1%, mutism. We recorded six (6) pregnancies, 2% of our sample. A case of HIV infection was recorded on a sample taken 72hours after sexual abuse. Control of three months HIV serology was requested in 7.1% of cases and only 20% of children had received antiretroviral prophylaxis. Antibiotic prophylaxis had been performed in 13.7% of cases using doxycycline as drug of choice (75%). Only 29% of our patients had received emergency contraception progestin and psychological care concerned only 22% of children. On the legal aspects, 46% of our patients had filed a complaint. Prosecutions were 38%, 45% of which were convicted and 21% were acquitted. The rate of out-of-court settlement was 35% and the time limit for settlement by the justice was on average 6 months with extremes of one month and 24 months. The average cost of care was estimated at 17,010 CFA francs (26 euros) taking into account the consumables used for clinical examination (sterile gloves, catheter, syringe), analysis and prescription drugs.The sexual abuse of minors is a disturbing reality that raises rightly universal reprobation. In Senegal, this mainly affects children and its magnitude is increasing over the years. Improved support for victims necessarily involves raising public awareness through the media and the development of specialized structures in the management of sexual abuse.

Data relative to Pneumocystis pneumonia in sub-Saharan Africa are not well known. Weakness of the technical material and use of little sensitive biological tools of diagnosis are among the evoked reasons. The objective of this study is to update the data of the disease at the Fann Teaching Hospital in Dakar and to estimate biological methods used in diagnosis.A descriptive longitudinal study was carried out from January 5th, 2009 to October 31st, 2011 in the parasitology and mycology laboratory of the Fann Teaching Hospital in Dakar. The bronchoalveolar lavages received in the laboratory were examined microscopically for Pneumocystis jirovecii by indirect fluorescent assay or after Giemsa or toluidine blue O staining.One hundred and eighty-three bronchoalveolar lavages withdrawn from 183 patients were received in the laboratory. Sixteen were positive for P. jirovecii at 9% frequency. Four among these patients were HIV positive. Indirect fluorescent assay allowed finding of P. jirovecii among 16 patients while Giemsa staining discovered P. jirovecii only in a single patient. No case was diagnosed by toluidine blue O staining.Pneumocystis pneumonia in Parasitology and Mycology Laboratory of Fann Teaching Hospital at Dakar was mainly diagnosed among HIV patients.

Dans cet article, nous rapportons la place de trois especes de tiques Amblyomma variegatum (Fabricius, 1794), Hyalomma marginatum rufipes (Koch, 1844) et Hyalomma truncatum (Koch, 1844) dans les cycles de maintenance et de transmission du virus de la fievre hemorragique de Crimee-Congo (CCHF) au Senegal. Les imagos de ces especes ont ete infectes par inoculation intra-coelomique. La replication du virus, les transmissions verticale (transovarienne et transtasiale) et horizontale pour les differentes stases ont ete etudiees par les techniques d'isolement sur souriceaux nouveau-nes, d'immunofluorescence indirecte, par la reaction de polymerisation en chaine et par ELISA.Les resultats obtenus ont montre que 15 jours apres l'inoculation, des taux d'infection de 100 % ont ete obtenus avec Hyalomma marginatum rufipes et Hyalomma truncatum . Ce taux passe a 60 % chez Amblyomma variegatum . Les imagos des trois especes infectees ont transmis le virus a leurs hotes ou cours du repas sanguin (100 %). Une transmission transovarienne elevee pour les especes Hyalomma marginatum rufipes et Hyalomma truncatum a ete observee avec respectivement 53 et 50 % de larves positives en immunofluorescence indirecte. Ce taux passe a 12 % chez Amblyomma variegatum . L'infection des tiques ne persiste pas au-dela de la premiere generation chez les trois especes etudiees. Les tiques sont donc des vecteurs-reservoirs temporaires mais pas des reservoirs permanents du virus CCHF.

Conjugal infertility in Senegal is surrounded with accusatory believes most oftenly unfavourable to woman who is generally incriminated and, in somes cases, repudied. This study is an account of a research work carried out on conjugal infertility causes analysis, using post coital and cytospermiologic tests. It aims to help our populations to better appreciate the conjugal infertility by giving them elements for an objective appraisal of this flail, particulary about the mutual responsabilities of the two partners. In a first stage, we run post coital tests with 4636 Negro-African infertile couples living in Senegal, at the Clinical Cytology, Cytogenetics, and Reproductive Biology Laboratory of Aristide Le Dantec Hospital in a period dated from 1983 to 1996. Post coital tests were abnormal for 3838 couples and 3150 of them had anomalies incriminating the husbands. In a second stage, post coital tests were suggested to these 3150 husbands, but only 2842 accepted the post coital test suggestion. The others refused it for sociocultural reasons. It stooks out of this study that: the responsability in the conjugal sterility is mixed and shared by both partners in 43.78% cases, the masculine responsability (38.30%) ruled the feminine one (17.92%) contrary to local believes, almost one husband out of four (23.89%) presented azoospermy, the feminine responsability is ruled by infection factors that represented half of the glair abnormalities (50%). These results contradict the present local mentalities and believes which accuse principally the woman.

From February 25th to June 28th of 1999, the authors carried out a prospective and descriptive study of the use of the preventive male condom in schools and universities through an anonymous inquiry questionary dealing with 1065 persons involving 650 boy students, 181 girl students, 128 college boys and 106 college girls. The questionnary involved 5 headings: the socio-demographic characteristics, the use of condoms, the sources of information and supply, the number of partners, and information about the prices. The inquiry essentially let out that: 56.4% of target population used the male condom. Boys used condoms more often than girls. Most of the boys who used condoms were unmarried. Young people used condoms for preventive purpose against STD/AIDS and for contraception in 82.5 cases. The reason more oftenly given by those who didn't like condoms was the reduction of the sexual delight. The mature age and highest level of instruction were factors predicting the use of condoms. About 2/3 of the information sources on condoms were from media. The drugstore was the main source of supply. More than half of the users wished an extension of the Condom commercialization. The problems of acceptability and access to condoms related more of religions and socio-cultural order than geographical and financial.

We report the optical characterization of thin, evaporated organic films used in fabrication of organic light emitting diodes (OLEDs): N,N'-diphenyl-N,N'-bis(3-methyl-phenyl)-l,l'biphenyl-4,4'diamine,or TPD,andtris(8-hydroxy)quinolato aluminum, or Alq3. In particular, we have obtained and analyzed spectroscopic eliipsometry (SE) data using a multi-sample approach, to determine the optical constants for Alq3 and TPD films over the wavelength range 250-850 nm. We show that bi-layer Alq3/TPD films on Si can be analyzed for individual layer thicknesses, even though the refractive index is nearly identical for these films in the visible region. Simulations of in situ monitoring are also presented, which show sub-nm thickness resolution for organic layer growth on a Si monitor wafer. SE has great utility for process control, either by ex situ or in situ thickness measurement.

The identification of one or several hypochromic patches (HP) on the skin is a key stage in the diagnosis of leprosy on dark skin. However, HP are often caused by other disorder than leprosy. A study to determine the prevalence and causes of HP among children was carried out in a rural area of Mali in November 2001. All children under 15 years of age in two villages in an endemic area were screened by two dermatologists. Among the 1729 children seen, HP were identified in 71 patients, with a prevalence of 4.1%. The most common cause of HP was tinea versicolor, which was present in 39.4% of children with HP, followed by pityriasis alba in 31%, naevus achromicus in 24% and vitiligo in 5.6%. No case of leprosy was detected. Our study raises several points with practical consequences for the detection of leprosy cases: the high prevalence of non-leprous HP compared to leprosy, the reliability of the clinical diagnosis of leprosy, and the role of general health care workers in the detection of leprosy cases. Helping those who should be involved in that detection in distinguishing true cases from other hypochromic disorders appears to be a priority.

The purpose of this study was to compare the clinical characteristics of acne in adult women in France and in sub-Saharan Africa.Women aged 25 years and over consulting for acne in hospital dermatology departments in Créteil, Dakar and Bamako were included. The data collected concerned a health questionnaire, previous history of acne, clinical examination and use of skin lighteners. Patient characteristics were expressed as absolute numbers and percentages for qualitative variables and as means and standard deviations or medians, and first and third quartiles, for quantitative variables based on distribution.There was no significant difference between the groups in terms of body mass index, tobacco smoking, age at first period and use of contraceptives. The presence of a lozenge-shaped area of abdominal hyperpilosity was more common in women of dark phototype, with no other signs of hyperandrogenism being seen. Acne was more severe in Dakar and in Bamako than in Créteil. Post-inflammatory pigmentation and involvement of the cheeks and forehead occurred significantly more frequently in patients of dark phototype. Involvement of the chin was more common in light-skinned subjects. While none of the women not of African origin performed voluntary skin lightening, this practice was recorded in half of women of African origin in Créteil and in Africa.This study shows clinical differences in acne in adult women according to phototype and geographical zone.

Afin de combiner efficacement conservation, utilisation durable des ressources et production du savoir, la reserve de biosphere doit necessairement beneficier d’une stratification, d’un zonage integre et d’une gestion cooperative. La methode de zonage est basee sur une caracterisation des ressources vegetales, suivie de la spatialisation des enjeux et du zonage de la reserve de biosphere. Pour etre partage avec les populations locales, le zonage de la reserve de biosphere du Ferlo (RBF) a procede par des reunions d’information et de sensibilisation, des observations sur le terrain, des enquetes et une collecte de donnees biophysiques. L’etude des parametres structuraux de la vegetation a revele que l’aire centrale de la RBF presente une densite d’arbres et un potentiel de regeneration plus eleves. L’analyse du spectre d’abondance a montre que Guiera senegalensis J.F. Gmel est l’espece la plus abondante dans la reserve. L’indice de diversite a revele que la zone tampon et l’aire de transition qui font l’objet de multiples usages et qui subissent l’action de l’homme, presentent une diversite plus grande et un niveau d’organisation du peuplement ligneux plus eleve que l’aire centrale qui est une zone de conservation integrale. Le traitement des images satellitales et la photointerpretation ont permis d’elaborer une carte d’occupation des sols et une carte globale du zonage. Ce zonage participatif a etabli une spatialisation des fonctions de la reserve de biosphere sans pour autant les superposer. Mots cles : Reserve de biosphere, carte d’occupation, zonage, conservation, biodiversite, utilisation du râble.

This study evaluated the attitudes and practices of the personnel with respect to the prevention of nosocomial infections in a hospital environment. We carried out a qualitative survey of all categories of personnel between July 1998 and March 1999, at the five regional hospitals in Senegal (Thiés, Kaolack, Saint-Louis, Diourbel, and Louga). Data were collected in two ways: using a questionnaire to evaluate knowledge and by observing the attitudes and practices of the personnel. Hands were rarely washed before and after each procedure and surgical washing was often performed in poor conditions. The decontamination of soiled equipment was ineffective. Reusable instruments were washed directly with bare hands or by individuals wearing used surgical gloves. The equipment used for sterilization was dilapidated and unsuitable and the norms for sterilization were seldom respected. Circulation in the region of the operating theatre was disorganized, if not anarchic. The personnel had a high risk of contamination from blood. Biomedical waste was not decontaminated: it was collected poorly and disposed of directly into the environment. None of the sites visited had a program of waste incineration. In conclusion, at the sites visited, there is a high risk of nosocomial contamination during care and the reuse of equipment, for both the staff and the patients treated.

A study was performed to appreciate the importance of malaria in the low valley of the Senegal River North Bank in Mauritania. The malaria incidence was assessed among patients visiting the regional hospital of Rosso (Trarza region) for a "presumptive malaria", a diagnosis assigned by the clinicians based on fever and other suggestive symptoms of malaria. The malaria prevalence rate was also measured in schoolchildren. A total of 1431 febrile outpatients were sampled for thick and thin blood films, between December 2004 and March 2005, August and November 2005, and April and July 2006. The average malaria prevalence rate was 2.5% (36/1431). It varied from 0.7% (4/576) for the period from December 2004 to March 2005 to 3.8% (18/475) from August to November 2005 and 2.1% (8/380) from April to July 2006. Of the 1040 school children of 6 to 14 years of age, the average malaria parasite prevalence rate was 0.9% (9/1040). It was 0.4% (1/224), 1.7% (7/413) and 0.2% (1/402), Respectively, in February 2004 (cold and dry season), October 2005 (rainy season) and June 2006 (hot and dry season). These very low levels of malaria endemicity and incidence are comparable with those recorded in the same area on the (South) bank of the river in Senegal. In this context of unstable malaria, characterized by the absence or a low level of natural immunity of the population, an effective monitoring is essential for an early detection and a damming up of the malaria epidemic blazes that likely occur.

The impact of intermittent presumptive treatment (IPT) on the immunity of pregnant women in Senegal is still not very well known. We conducted a prospective study at the Roi-Baudouin maternity of Guediawaye in Senegal to assess IgG antibodies production against MSP1, GLURP and DBL5 in pregnant women under IPT. Blood samples were collected from the participating women at inclusion and delivery. Samples were analyzed after centrifugation for the detection of IgG antibodies in sera by Elisa. Informed consent was given by each study participant prior to their inclusion. A total of 101 eligible women aged from 18 to 44 were included in this study. Multigravidae women represented 70.3% of the study population, whereas primigravidae accounted for 29.7%. The IgG level decreased slightly from inclusion to delivery for the women with regard to anti-MSP1 (83.1at inclusion versus 79.5 at delivery, p = 0.52) as well as anti-GLURP-R2 (84.1 at inclusion versus 75.9 at delivery, p = 0.16). After adjustment for number of pregnancies, there was a significant decrease in the production of anti-VAR2CSA between inclusion and delivery (p0.05). By reducing the incidence of malaria during pregnancy, IPT reduced the acquisition of placental parasites antibodies suppressors which could delay the development of protective immunity against malaria. The application of IPT in pregnant women would thus be more appropriate in hypoendemic areas where malaria exposure is lower.

Merkel cell carcinoma (MCC) is a rare tumour with a poor prognosis. Rare cases of paraneoplastic neurological syndrome have been associated with this type of tumour, namely myasthenic syndrome of Lambert-Eaton and encephalomyelitis. We report the first case of severe necrotizing myopathy with anti-Hu antibodies complicating MCC.We describe the case of a 58-year-old woman with Merkel cell carcinoma (MCC) of the forearm complicated by severe necrotizing myopathy associated with the presence of anti-Hu antibodies. This myopathy occurred 3 months after complete remission of MCC. The patient was treated with high-dose corticosteroids combined with two intravenous infusions of immunoglobulins. Her neurological status deteriorated despite this treatment. Pararaneoplastic syndrome (anti-Hu antibodies, necrotizing myopathy) complicating MCC was suspected. There was no visible tumour relapse. After multidisciplinary discussion, it was decided to supplement treatment with chemotherapy (carboplatin and VP-16). The patient died 20 days after the first course of chemotherapy.Severe necrotizing myopathy with anti-Hu antibodies may be added to the list of possible paraneoplastic syndromes associated with Merkel cell carcinoma.

Two cases of Crimean-Congo haemorrhagic fever (CCHF) occurred in two French tourists during their visit in Senegal in November 2004. Febrile and hemorrhagic syndrome with ulorrhagia, petechiae, haematemesis, haematomas associated with biological signs of disseminated intramuscular coagulation were observed. For the first case who had a medical evacuation to France before diagnosis, Crimean-Congo virus infection was revealed by laboratory tests performed by the National Reference Center for Hemorrhagic Fevers (NRCHF, Institut Pasteur, Lyon) and secondly by the Centre de Référence OMS sur la Recherche des Arbovirus et des virus des Fièvres Hémorragiques (CRORA) in the Dakar Pasteur Institute (DPI). The second case diagnosed by the CRORA died after clinical deterioration with liver failure and severe haemorrhages. Healthcare workers and family members who had contact with tissue or blood from patients were followed up after the putative exposure either in France or in Senegal.