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The main goal of this work was to study the parasitic infections during AIDS diarrhoea. A longitudinal study was carried out from October 2000 to November 2001 in the Hepato-Gastro-Enterology department of Gabriel Toure Hospital and in the Department of Epidemiology and Parasitic infections of Faculty of Medicine, Pharmacy and Odonto-stomatology of Bamako (Mali), concerning HIV positive patients suffering from diarrhoea. Detecting microbes in stools has been done through direct microscopic examination and according to procedures of Henricksen Poblenz Baerman, Kato Katz and the PCR. Among the 70 patients involved, the sex-ratio was 53%, the average age was 35 +/- 8.4 years. Fever weight loss, skin affections and digestive mycosis were often associated. Opportunistic infections have been relatively frequent with Cryptosporidium parvum with 20%, Isospora belli with 8.5% and Microsporidium with 11.5% of cases. Other non-opportunistic microbes were found. Death within the first two weeks seems more important in case of infection by Cryptosporidium parvum. The frequency and the danger of those opportunistic infections require their efficient diagnosis and care management.

A prospective study carried out in Bamako, Mali between July 1998 and January 1999 has assessed the seroprevalence of hepatitis C virus (HCV) in 91 carrier patients of chronic hepatopathy at a cirrhrosis stage (53) or of hepato-cellular carcinoma (38) and to compare with in 92 blood donors as a control population. Only seroprevalence confirmed by a complementary test has been taken into account (RIBA). HCV seroprevalence reached 25% including all hepatopathies, 24% in cirrhrosis and 26% in hepato-cellular carcinomae (HCC) versus 4% in blood donors. Antigen HBs of hepatitis B virus has been found in 55% of patients, versus 25% of the control cases (p = 0.0006). On the whole, the two markers have been notified a little more often in HCC than in cirrhosis and the combination of the two markers has been more frequent during cirrhosis as well. The role of HCV played in cirrhosis and HCC onset in Mali appears to be important.

Ten cases of hepatic amoebiasis are notified in Bamako during 14 months among hospitalized adults. The diagnosis has aimed from clinical signs, specific antibodies seen through hemagglutination and echography. These patients are treated by tinidazole: 2 g/day in unique dose during 3-9 days. The duration of treatment depends on clinical evolution. In any cases the recovery is obtained within subsequent range from 1 to 9 months. This leading is compared with other treatments proposed in the literature. The briefness of treatment, its quick efficacy and the absence of secondary effects have helped to reduce the duration of stay in hospital and its cost. A short recovery by tinidazole is proposed as tentative treatment against hepatic amoebiasis in rural area's medicine.

Etiologies of infectious diarrhoeas in hospitalised adults have been studied during one year; research of cryptosporidium and isospora oocysts is being made with Henriksen-Pohlenz and Kato methods. Diarrhoea is associated with a positive HIV serology in 40% cases. Cryptosporidium spp is found in 38% of cases. In 91% cases of cryptosporidiosis HIV serology is positive. Cryptosporidiosis is the main cause of AIDS diarrhoeas in Mali. 3 cases of isosporiasis are associated with cryptosporidiosis in AIDS patients. Emaciation and dehydration are the main signs of severity. Diarrhoea's profusion, its chronicity and inefficiency of the treatments explain the heavy death rate of cryptosporidiosis among seropositive patients, which reaches 40% during the first two weeks of hospitalisation.