Search

Post-malaria neurological syndrome is a rare complication of malaria. Typically, it occurs in case of severe malaria. Here we report a case in a Malagasy patient presenting a non-severe Plasmodium falciparum malaria complicated by post-malaria neurological syndrome. The management of such a syndrome is radically different from non-severe malaria. No specific treatment is needed.

This is a retrospective study, conducted on thyroid cancer observed for 13 months (from June 1(st) 2004 to June 30(th) 2005). Data were collected from four main surgical pathology laboratories in Antananarivo, Madagascar. Among 6,036 surgical samples, 179 were of thyroid gland, a rate that is near 3% of the total. Among them were found 40 cases of thyroid cancer, which is 0.66% of all screened samples, and 22.32% of all examined thyroid samples. In the studied population was observed a female preponderance (82%) with a mean age of 43.9 years when diagnosis was confirmed. It was evidenced a 50 % of papillary carcinoma and 45% of follicular carcinoma, with a rate of 2.5% respectively for the medullar and anaplastic carcinoma. Metastases were seen in 20%, originated from papillary type for the lymph node involvement and from the follicular type for the bone involvement. In Antananarivo, thyroid cancer is seen mainly in people from the surrounding Highlands, supposed to be sites of endemic goiter related to iodine deficiency. Despite its limits, this study may be used as reference about thyroid cancer in Madagascar. Further studies are required to find out other factors involved in the development of this disease.

African histoplasmosis is a rare but not an exceptional condition and recently discovered in Madagascar. We report the fifth Malagasy case involving skin and nodes in an immunocompetent patient. Management of African histoplasmosis encountered many problems because of the availability of amphotericin B and cost of the biochemical tests in order to prevent major side effects in case of failure of oral antimycotic drug.

Few data are available about severe malaria in Madagascar. Our aims were to describe epidemiological, clinical and therapeutic aspects of severe malaria in patients in Antananarivo. We conducted a retrospective study from 1 March 2006 to 31 March 2008 at the infectious disease department. We recorded 61 cases of severe malaria among 1,803 in patients. Sex ratio was 2 and average age was 35.3 years old. Three pregnant women were recorded among women (15.8%). Self-medication was registered in 23%. Among 35 patients who received first medical care, no one had parasitological examination. The treatment was inadequate for all patients (n = 19). Conscience impairment (65.6%), jaundice (24.6%), seizure (18%) and prostration (14.8%) were the major severe signs. Diagnosis was made 6.54 days after the onset of the disease. Mortality rate was 11.5%. Self-medication, inappropriate primary care and delayed diagnosis represented risk factors for severe malaria in our cohort.