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In order to assess the parasitic risks related to M'Boune's valley water launching, a study has been carried out from September 16 to November 24, 1998 in 12 villages: four villages surrounding the Guiers lake, four villages surrounding Ferlo already water launched 10 years ago, and four villages within M'Boune not water launched. The prevalence rate of urinary bilharziosis is 0.002% in the frist area, 1.3% in the second one and 13.7% in the third area. In these areas, intestinal parasitosis are prevaling respectively at rates of 38.2%, 36.4% and 21.3%. Although, there is no reason to fear immediately a worsening of the epidemiological situation due to M'Boune's valley revitalisation project, nevertheless, appropriate steps should be taken right now aiming at tackling the extension of conditions related to hydric medium.

Psychiatric manifestations of cerebral malaria have been described for a while. The purpose of this study was conducted to describe this type of clinical manifestations of malaria among inpatients admitted at the psychiatric department in Dakar, Senegal from 1998 to 1999 (2 years) based on personnal observations. During this period. 1 male and 3 females, 13 to 22 years old, presented psychiatric disorders represented by mental confusion, delirium syndrom with zoopsia, visual hallucinations, motor agitation associated to other malarial clinical features: fever, headache, shiver, sweating and belious vomiting. All the patients were smear blood positive to Plasmodium falciparum with a parasiteamia between 2524 to 61500 parasites per ml. No psychiatric history was noted among them. Antimalarial treatment was used associated either with neuroleptic or tranquilliser. All of them recovered after 12 to 31 days of hospitalization (mean lengh of slay = 20 days). Psychotropic treatment was stopped after 15 days and no relapse was observed after 1 year of follow-up. The autors focus on the importance of psychiatric manifestations of cerebral malaria especially in endemic area like Senegal. They also insist on the possiblities of misdiagnosis and though a delay for an early and effective management.

Co-infection of Cryptococcal meningitis and syphilis is rare. We report the first case of coinfection with cryptococcus neoformans and treponema pallidum in Dakar. There was a 41 yearold senegalese man with HIV2 infection despite a CD4 count of 50 /mm3. The patient have had the history of precedent genital ulcerations and trush. Finally he died on eigth day of treatment with Fluconazol and Penicillin G.

Candidiasis are very usual infections of HIV infected patients. By medicine pressure, susceptibility to antifungal drugs decrease in some Candida strains. This study carded out in 1997 at hospital, aimed to identify the yeast species isolated from HIV infected patients with oropharyngeal candidiasis, test their susceptibility to antifungal drugs and a previous antifungal treatment impact. Thus, 60 patients yielded to questionnary were recruited. Isolated yeast colonies from buccal tract after culture on Sabouraud medium with chloramphenicol were identified with the API 20 C AUX (BioMérieux) system by assimilation of different sugars. Susceptibility was evaluated by ATB FUNGUS (BioMérieux) system. 55 from the 60 isolated yeasts were identified and among them C. albicans and C. tropicalis were the main species with 75% and 11,7% respectively rates. In HIV1 infected patients, all specieswere isolated and C. albicans predominated (80,4%) on the other hand, C. albicans and C. tropicalis were the only isolated yeasts from the HIV2 infected patients with 83,3% and 16,6% respectively rates. Susceptibility of C. albicans was 72,2% to nystatine, 58,3% to amphotericin B, 83,3% to flucytosin, 12,8% to miconazole, 8,5% to econazole and 10,6% to ketoconazole. Susceptibility of C. albicans to polyenes was modified by a previous antifungal treatment. This study indicated emergence of saprophytic yeasts of the buccal mucosa and seemed to be more fostered by HIV1 serotype than HIV2. So, C. albicans's susceptibility to polyenes decreased by untimely use of antifungal drugs and by controlling it one could improve the clinic conditions of HIV infected patients.

To assess epidemiological, clinical and therapeutic features of severe malaria among adults in Dakar (Senegal), we carried out a 5-year retrospective study in Infectious Diseases Ward (January 1992-December 1996). Over this period, 222 cases of severe malaria were included according to WHO definition criteria, 120 of them (54%) being adult patients. Monthly distribution of cases showed 2 peaks, on October and November. Most of the patients were males (sex-ratio = 2.1) and lived in urban area (91.7%). The mean age was 28.9 years (range = 16-73 years). Clinically, all of the cases presented with stage II coma. Association existed with convulsion (20%), severe anaemia (29.2%), renal failure (19.2%), hypoglycaemia (17.5%) and jaundice (34%). Patients were treated using quinine intravenously. Case fatality rate reached 26.7%, indicating life-threatening potential of malaria in adults living in urban area.

Pneumocystosis is an opportunist parasitic disease which occurs currently at Europe and United States in HIV infected patients. In Africa, the disease is not current. Pneumocystosis has been detected in the Fann medical universitary center at Dakar from HIV infected patients with acido alcoholo resistant bacilli negative pneumopathy. Analysis of broncho alveolar liquid(BAL) of 29 patients after Giemsa and Blue of Toluidin O staining allowed isolating of two cases of pneumocystosis. A man and a woman were the patients. They were HIV1 positive with at X ray bilateral interstitial syndrome. The CD4 lymphocytes count of the one was lower than 200/mm3 and for the other it was higher than 200/mm3.

In order to determine the prevalence rates of malaria, urinary schistosomiasis and intestinal parasitosis in Saloum's valley, the authors carried out a study which took place from november 16 to november 24, 1996. For malaria, the global parasites index was 22% (146/662). Malaria prevails at a hypoendemic level in N'Diobène and N'Guent-paté villages and at a medium-endemic level in Ribo-Escale and N'Dodj. The infestation index for urinary schistosomiasis was 8.9% (137/154) About intestinal parasite, among 868 persons screened, 124 showed one or several parasites, that is an infestation index of 14.3%. Appropriate steps should be taken to prevent an extension of these conditions along the fossil Saloum's valley.

The authors carried out a parasitologic survey on 367 inhabitants of Malika, a village located in the immediate surroundings of M'Beubeuss disposal, as well as on 433 other residents of Keur Massar, a location 2 km farther, in order to assess parasitic hazards encountered by people neighbouring this disposal. As far as intestinal parasitosis are concerned, the prevalence rate was significantly higher in Malika (61.3%) than in Keur Massar (48.5%) The sex, social and economic status, level of education as well as the time of dwelling in the neighbouring area were identified as the risk factors of intestinal parasitism. Only the last one can be considered as significantly and independently related to a risk of intestinal parasitism. As for malaria, the plasmodial index in Malika was 6% versus 7.6% in Keur Massar (no significant difference). Thus, if it does exist for neighbouring people, an infestation risk by intestinal parasites related to exposure duration, contrarily, it does not exist for malaria. Appropriate steps should be taken to prevent the hazards encountered by inhabitants of surrounding villages.

In order to assess the parasitic risks related to Ferlo's valley water launching, a study has been carried out from september 15 to october 10, 1996 in 12 villages. Four villages surrounding the Guiers lake, four lower within lower Ferlo already water launched 7 years ago, and four villages within upper Ferlo not water launched. Malaria strikes at hypoendemic level in the villages surrounding the Guiers lake (p.i = 6.2%) and at mesoendemic level in the area stretching along lower (P.I = 37.6%) and upper Ferlo (P.I = 34.3%) The prevalence rate of urinary bilharziosis is 0.002% in the first area, 1.3% in the second one and 14.5% in the third area. In these areas, intestinal parasitosis were prevailing respectively at rates of 38.2%, 36.4% and 22.2%. Although, there is no reason to fear immediately a worsening of the epidemiological situation due to Ferlo's valley revitalisation project, nevertheless, appropriate steps should be taken right now aiming at tacking the extension of conditions related to hydric medium.

In order to determine the prevalence of malaria and its epidemiological characteristics, a survey was carried out in 11 villages situated in all the Basin of River Senegal (B.R.S.). 3306 (0-14 years) children are examined. The results show that malaria is hypo-endemic in the B.R.S. with a plasmodic index of 8.6% and a splenic index of 9.9%. But these malariametric indexes change according to the areas visited. Thus, malaria prevails at a hypo-endemic level in Dagana and Podor districts while at a medium if not hyperendemic level in Matam and Bakel districts. The plasmodial index also change according to age reaching a maximum within children from 10 to 14 years. As for the spleen index, it is low among children from 10-14 years. As for the spleen index, it is low among children from 0 to 4 years old, then increases among those aging from 5 to 9 years, before decreasing within children ranging from 10 to 14 years. P.falciparum is the most prevalent species, representing 96% of the cases; it is followed by P.malarioe (3%) and P.ovale (1%). If our results are compared with those obtained before by other authors, we can conclude that the recent hydro-agricultural plannings carried out in the area, have not yet provoked an increase of the cases of malaria. But, in order to avoid this risk, it is necessary to take from now some preventive measures.

From April to November 1994, we carried out a study in Rufisque, an urban area located in Dakar Region. During dry season, 5.32% of febrile outpatients were infected with Plasmodium falciparum with a mean parasitic density evaluated at 12,471 p/microliter. One case of cerebral malaria was noted. During raining season, malaria represented 58.75% of the fevers. Ten presented neurological signs; the mean parasitic density was high, 131,140 p/microliter. Two children died. Good efficiency of quinine was noted but chloroquine treatment failures was present: 50%. Generally malaria is less prevalent in urban areas. But in Rufisque ecological conditions are main factors which permit spreading of the disease. Prior measures of control such correct treatment of cases and good management of environment must be done.

The study of malarial seroprevalence in Dakar has interested 598 women among whom 377 pregnant and 221 non pregnant, between 15 to 45 years old and happens during the dry season, period of which malaria transmission is practically stopped in the locality. Among the tested serums by indirect immunofluorescence with Plasmodium falciparum asexual blood forms as antigen, 24.4% contained antimalarial antibodies. The serological index does'nt vary significantly according to the months during the dry season, the women age and their previous pregnancy number. On the contrary, the women who live in Dakar since less than 2 years, have e higher seropositivity rate of 33.7% than those who are there since more than 2 years, 20.0%. It is likewise for the women practicing chemoprophylaxy with chloroquine of whom 16.5% have antibodies against 26.0% among those who don't practice it. The seropositivity rate doesn't vary significantly according as the women are pregnant (24.7% of positive) or not pregnant (24.0% of positive). The weakness of the serological rate in the examined women, can be explained by the situation of Dakar in a weak malarial hypoendemic area. II shows that the major examined subjects have lost or have never had contact with Plasmodium what predispose them to make severe and complicated malarial attacks.

The authors carried out an epidemiological survey from october 12 to december 4, 1995, at Medina's mother and Child care centre (MCC) in Dakar in order to assess chemoprophylaxis among pregnant women in Dakar. The midwife/pregnant women ratio is 0.08 The mentioned diagnosis criteria were relevant regards to the references established for most of the answers because since the latter base malaria diagnosis on the following signs: fever, chills, headaches and vomiting. 64.6% of them assume compliance to antimalarial chemoporphylaxis. Education level seems to be the main determining factor in this trend. Although chloroquine is the most widely used drug, nevertheless 11.9% of pregnant women assuming compliance use it at inappropriate posology. Besides, pyrimethamine is used by 12.3% of them. 34% of pregnant women do show chloroquine in urine. The plasmodial index is 1.4%. Only 8.1% of these women are supplied by health centres where shortages are noted.

The comparison of the prevalence of malaria in pregnant and non pregnant women living in Dakar has interested 1819 women among whom 950 pregnant and 869 non pregnant. For all the examined women, the global plasmoidic index was 2.6% and the gametocytic index 0.1%. Plasmodium falciparum was the only observed species. According to the obtained results, pregnant women, with a plasmoidic index of 4.5% are more often parasited than the non pregnant women, only affected in a proportion of 0.5% Whatever the age, the number of previous pregnancy, the place of residence, the duration of the stay in Dakar may be, the pregnant women are always more often parasited than the non pregnant women and the registered differences are statistically significant. That situation could come from a greater receptivity of the pregnant women what is admitted by some authors. But a more important proportion of natives from rural area was observed among the pregnant women, from where a difference in the exposure to the risk of impaludation between the two groups that could explain the registered results. The global plasmoidic index of 2.6% obtained in the examined women, reflects well the present situation of the malaria endemy in Dakar, a weak hypo-endemic area.

72 patients with AIDS, having diarrhoea and admitted in the Unit of Infectious diseases, Fann Hospital from 1989 to 1991 were investigated for Cryptosporidium sp. and Isospora belli isolation by the modified Ziehl-Neelsen technique, after stolls' concentration by Ritchie technique. The prevalence were 13.9% for Cryptosporidium sp, and 15.3% for I. belli. In two patients (2.8%), these 2 coccidiae were associated. Cryptosporidium sp. and I. belli were the single parasites found respectively in 6 (8.3% and 7 (9.7%) of the patients. In the other faecal samples with a positive result for Cryptosporidium sp. or I. belli, they were associated with A. lumbricoides, G. intestialis, E. histolytica or S. stecoralis. According to these results, Cryptosporidium sp. and I. belli were more frequently observed in AIDS patients from Dakar than those from Zaĭre, Congo and Côte d'Ivoire.

From November 1991 to March 1992 authors have carried out a study on the place of cryptosporidiosis among the intestinal diseases in children from a Dakar Pediatric Hospital. Different technics have been used to identify the parasites in the stool: direct examination, followed by Ritchie and Zielh Nielsen modified by Henricksen and Poblenz. The results show that 32% of the children were carriers parasites. Helminths represent 53.2% of the parasites with predominance of Ascaris lumbricoides. Giardia intestinalis is the more representative parasite among the Protozoa which constitute 46.8% of the parasites. 13 cases of parasites associations have been founded. The cryptosporidies have been founded in 3 stools, and constitute 4.6% of the whole parasites. The cryptosporidiosis take a little place among the intestinal diseases in Dakar's children.