Search

76 diarrheic infants (from 15 days to 2 years) had a stool examination for rotavirus (ELISA method) and a stool culture and were classified according to breast feeding or not. This study was performed in a semi-urban region (Haut-Ogooué, Gabon). The preliminary results suggest a protection by breast feeding against rotavirus and enteropathogenic bacteria, rapid elimination of diarrheic agents may be facilitated by human milk.

Plasma testosterone has been studied in 31 full-term male infants born with bilaterally undescended testes (14) or unilaterally undescended testis (17). From 10 to 89 days after birth, the post-natal testosterone rise was significantly lower in the 18 infants who remained cryptorchid at 4 months than in the 13 who underwent spontaneous testicular descensus and in the normal controls. Blunted post-natal Leydig cell secretion in cryptorchids may relate to a primary LH defect and could contribute to the impairment of both testicular descensus and maturation.

Four children aged between 7 and 19 months with severe bronchopneumonia due to adenovirus type 7, proved by virology and/or serology developed severe hyponatraemia. One of them is reported in detail: it was possible to estimate plasma ADH levels and thereby prove the existence of reversible hypersecretion of the hormone. Whilst the syndrome of hyponatraemia with inappropriate secretion of ADH has not yet been reported in association with severe pneumonia in the child, it is known in adults. The limits of the syndrome and its physiopathology are discussed. It may be due either to vagal stimulation as a result of a fall in left aressure, or to central involvement. Therapeutic implications of the problem are emphasized.

Forty-seven Gabonese children with tuberculosis either limited to the lung or associated with other localizations were treated with isoniazid-rifampin (INH + RIF). They had liver tests done during the first 6 months of treatment. In 30 patients (63.8%) there was an increase in aminotransferase levels [over 100 UI/l in 14 (29.2%)]. The main factors increasing the risk of hepatic toxicity was a high dosage of INH and overall malnutrition. In fact, the weights of patients presenting with signs of hepatic toxicity were significantly lower than those in children who had no alterations of liver function. 68% of the severely malnourished (marasmus of kwashiorkor) presented with high ALAT or ASAT levels during treatment. The eventual role of the chronic HBV carrier state is discussed as 2 children presented with a chronic form of hepatitis at the time the treatment was initiated.

Twelve male infants with undescended testes (5 bilaterally, 7 unilaterally) were studied between the ages of 1 week and 11 months. As in older pre-pubertal cryptorchid boys, a significant decrease of the LH response to LH-RH test was found, while basal plasma levels of gonadotrophins and FSH response to LH-RH were normal. Plasma testosterone levels were in the normal range, and Leydig cells responded to stimulation by HCG, the degree of this response being significantly and positively correlated to the LH peak elicited by LH-RH. It may be concluded that some early defect of the pituitary-Leydig cell axis is associated with undescended testis.

Close interactions between salmonellae and Schistosoma intercalatum were demonstrated by a study of 118 children conducted at Libreville, Gabon. Bilharziasis, confirmed by rectal biopsy, was present in 76% of children hospitalized for typhoid-like salmonella septicaemia, as against 38% of controls of the same age living in the same district (P less than 0.001). Although the clinical symptoms were typical of typhoid fever, with stupor, myocarditis or leucopenia depending on the cases, the germs responsible in 26 out of 42 cases were salmonella species regarded as minor. Finally, the salmonella infection was clinically prolonged by bilharziasis in 1 out of 3 patients. It would therefore appear that salmonella adheres to the wall of S. intercalatum as to that of other schistosoma species, and that both infections must be treated concomitantly.

It is usual to consider that the greatest part of the black African population is lactose intolerant. Also, milk lactose malabsorption was studied by a breath hydrogen technique in 87 Gabonese children and 20 Gabonese adults (central Africa). The prevalence of malabsorption was 64.2% in rural schoolchildren, 65% in the urban hospitalized, and 60% in adults. Twelve children and six adults had clinical symptoms after a lactose load. All subjects were Bantus, with no tradition of consuming dairy products. These data must be considered in programs of nutritional support in Africa.

In a series of 50 mother-child pairs from Paris the titers of measles antibodies in cord blood were 1.4 times higher that those measured in the mother's blood, but this ratio was only 0.92 in 116 African mother-child pairs from Libreville (Gabon). Similarly, the ratio of immunoglobulin G levels in cord blood to those of the mother's blood was higher in Paris (1.34) than in Libreville (0.88). This limitation in active transfer of total of specific immunoglobulins is due to their high levels usual in African mothers, and this is not without repercussions on the immune defence mechanisms of African newborns.