Search

Methicillin-resistant Staphylococcus aureus (MRSA) poses a serious therapeutic problem worldwide, and its frequency in most African countries has not been reported. This study was aimed at determining the prevalence and antibiotic susceptibility patterns of MRSA in eight large hospitals (>500 beds) in Africa and Malta, from 1996 to 1997. Susceptibility to methicillin (oxacillin) and to other drugs was determined by E test (AB Biodisk, Solna, Sweden) on a total of 1440 clinical isolates of S. aureus. Methicillin resistance was detected in 213 (15%) of the 1440 isolates tested. The rate of MRSA was relatively high in Nigeria, Kenya, and Cameroon (21-30%), and below 10% in Tunisia, Malta, and Algeria. All MRSA isolates were sensitive to vancomycin, with MICs 60%) of MRSA strains were multiresistant. There is a need to maintain surveillance and control of MRSA infections in Africa.

The purpose of this study regarding isoniazid-epiroprim's association applied to antituberculosis chemotherapy, carried through murine model, initiated into Institut Pasteur of Côte d'Ivoire and worked out at Institut Pasteur of Paris was to evaluate the epiroprim's effect alone and associated with isoniazid on Mycobacterium tuberculosis. Sixteen mouses (lineage C57Bl/6) were inoculated by venous way with 10(5) viable bacillus (strain H37Rv) suspended in 500 microliters sterile physiological aqueous solution and were shared out into 4 sets. Fifteen days later the sets have been submitted or not to a daily treatment by gavage during three weeks (epiroprim, isoniazid, isoniazid plus epiroprim). The mouses were euthanasied, spleen and lung were removed from each animal. The titres of determined bacillus into those organs prove that isoniazid and epiroprim associated seem more efficacious than the isoniazid monotherapy for mouses pulmonary tuberculosis. Bacillus obtained are sensitive to isoniazid.

Objectives: To study mother to child HIV-1 transmission (MTCT) and infant mortality following benzalkonium chloride (BC) disinfection., Methods: A randomised, double blind phase II placebo controlled trial. Women testing positive for HIV-1 infection in prenatal care units in Abidjan, Côte d'Ivoire, and Bobo-Dioulasso, Burkina Faso, from November 1996 to April 1997 were eligible, with their informed consent. Women self administered daily a vaginal suppository of 1% BC (53) or matched placebo (54) from 36 weeks of pregnancy, plus a single dose during labour. The neonate was bathed with 1% BC solution or placebo within 30 minutes after birth. MTCT rate was assessed based on repeated polymerase chain reaction (PCR) and serology results. For the present analysis, children were followed up to 15 months., Results: A total of 107 women were enrolled. Of 103 eligible liveborn children, 23 were HIV infected, 75 uninfected, and five of indeterminate status. MTCT transmission rate was 24.2% overall (95% confidence interval (CI): 14.3% to 30.4%). On an intent to treat basis, the transmission rate did not differ between the two groups (23.5%, CI 13.8 to 38.5, in the BC group and 24.8%, CI 15.0 to 39.6, in the placebo group at 15 months). Similarly, there was no difference in mortality at 15 months (22.9%, CI 13.7 to 36.9, in the BC group and 16.5%, CI 9.0 to 29.4, in the placebo group)., Conclusion: This analysis failed to suggest any benefit of BC disinfection on mother to child HIV transmission or perinatal and infant mortality.

Objective: Buruli ulcer disease (BU), caused by Mycobacterium ulcerans, is endemic in many regions of Africa and causes substantial physical disability. Surgical resection, currently the mainstay of clinical management of BU, is impractical in many endemic areas. Therefore, the study was undertaken to evaluate an antibiotic regimen for medical management of BU., Methods: A randomized, placebo-controlled pilot study of dapsone plus rifampin versus placebo was conducted., Results: Forty-one participants were recruited in a BU-endemic zone of Côte d'Ivoire. Thirty persons completed the 2-month trial: 15 were treated with placebo and 15 with dapsone and rifampin. On blinded evaluation of photographs of the ulcers, clinicians with experience examining BU judged that 82% of ulcers in the treatment group improved compared with 75% in the placebo group (P=0.51). The median change in ulcer size was a decrease of 14.0 cm2 in the treatment group and a decrease of 2.5 cm2 in the placebo group (P=0.02), but initial ulcer sizes were larger in the treatment group (median 26.2 cm2) compared with the placebo group (median 4.8 cm2) (P=0.04)., Conclusions: Results of this study indicate that larger studies of antimycobacterial therapy of BU are warranted and can be successfully undertaken.

The object of our study has been to assess Chlamydia trachomatis prevalence among symptomatic women in Abidjan and to identify issues related to the use of cell culture methods in a tropical laboratory. 1522 women with vaginal discharge were enrolled in a cross sectional study. One endocervical swab was taken per woman and inoculated into cycloheximide treated Mac Coy cells. Elementary bodies were detected by direct fluorescent antibody (DFA). The isolate rate of Chlamydia trachomatis by cell culture was estimated to 86%. The prevalence of chlamydial infection among symptomatic women was 10.8%. Culture was influenced by presence of blood or cervical mucus in the sample. 206 samples gave no results because of blood or cervical mucus. During this study repeated contaminations of cells with facultative bacteria were noted and disposing of a sufficient number of cells was not easy.

Thirty Mycobacterium tuberculosis strains (8: INH(R)/INH(R), 12: INH(R)/RIF(S), 10: INH(S)/RIF(S)) were examined against MICs of epiroprim (EPM) and isoniazid (INH) separately or in association. EPM alone proved to be insufficiently active against the various mycobacterial isolates (MIC > or =256 microg/ml). The observed average sensitivity to the association of EPM plus INH was, in contrast, considerably increased, as reflected by reduced MICs and lower percentages of resistant strains. MICs ranged between 16 and 32 microg/ml EPM and 2 and 4 microg/ml INH for INH(R) strains. All INH(S) isolates were inhibited by a concentration of 0.125 microg/ml EPM and 0.06 microg/ml INH. The fractional inhibitory concentration indices indicated an additive activity on INH(R)/RIF(R) strains and a synergistic activity on INH(R)/RIF(S) and INH(S)/RIF(S) strains. The synergistic activity of this drug association needs to be confirmed in an animal model., (Copyright 2001 S. Karger AG, Basel)

The objective of this study was to estimate the interest and the limits of skin exudate microscopy for patients with chronic ulceration with clinically suspected Buruli's ulcer and living in an endemic area in Côte d'Ivoire. Two stained smears, one with Ziehl-Neelsen and the other Dugomier staining, were produced from 140 samples obtained after a swab of skin lesions. The positive smear rate for the acid fast bacilli (AFB) was respectively 16.4% and 12.9% for Dugomier and Ziehl-Neelsen staining. The ulceration with less than one year of evolution have high AFB rates of 15.8% for Ziehl-Neelsen staining and 21.1% for Dugomier's. Microscopic examination of skin exudate in face of ulceration, clinically suspected to be a Buruli's ulcer is not the best tool for biological diagnosis, due to poor technical sensibility. Nevertheless, it remains a good first means of investigation in an endemoepidemic area.

Worldwide spread of antibiotic resistance in Streptococcus pneumoniae is a major problem. However, data from West and North African countries are scarce. To study the level of resistance and compare the situations in different cities, a prospective study was conducted in Abidjan (Ivory Coast), Casablanca (Morocco), Dakar (Senegal), and Tunis (Tunisia), from 1996 to 1997. The resistances to eight antibiotics of 375 isolates were studied by E test, and the results were interpreted using the breakpoints recommended by the National Committee for Clinical Laboratory Standards. Overall, 30.4% of the isolates were nonsusceptible to penicillin G (25.6% were intermediate and 4.8% were resistant). Amoxicillin (96.3% were susceptible) and parenteral third-generation cephalosporins (92.7%) were highly active. Resistance to chloramphenicol was detected in 8.6% of the isolates. High levels of resistance were noted for erythromycin (28%), tetracycline (38.3%), and cotrimoxazole (36.4%). Resistance to rifampin was rare (2.1%). There were significant differences in resistance rates between individual countries. Multiple resistance was more frequent in penicillin-nonsusceptible isolates than in penicillin-susceptible isolates. Recommendations for treatment could be generated from these results in each participating country.

Rotaviruses Are associated with gastroenteritis in human infants and the young of many species. In this study, we analysed the circulating strains of human rotavirus isolated from young children in Abidjan by electrophoresis of the viral RNA genome in agarose gels. Rotavirus strains were identified in 33 children less than two years of age in the Yopougon district of Abidjan, Cote d'lvoire. Viral RNA was extracted from the stools by phenol-chloroform treatment at 56 degrees C, followed by centrifugation at 12 OOOrpm. The electrophoresis was performed in 1.5 % agarose gels stained with 5 % ethidium bromide and Tris-acetate as the running buffer. Ten ul of each sample was loaded onto the gels which were run at lOOv for 30min. In total, 17 of the 33 specimens yielded an RNA electropherotype. Seven different RNA profiles were observed with 14 (82.4% ) long profiles and 3 (17%) short profiles. These RNA profiles represented the group A rotavirus pattern. No mixed infections were seen. There was no correlation between the age and sex of the patient with the RNA electropherotype. Serogroup A rotaviruses were the principle strains circulating in this study. Further characterization of these strains at the subgroup and serotype level will be conducted.

A cross-sectional study was conducted among pregnant women in Côte d'Ivoire to assess the prevalence and the factors associated with mycoplasma colonization. A positive culture was found in 400 of 551 women (73%); Ureaplasma urealyticum was identified in 22%, Mycoplasma hominis in 20% and both microorganisms in 31%. Mycoplasma colonization was not associated with genital symptoms or signs. Young age, low educational level, antimicrobial chemotherapy before consultation and presence of bacterial vaginosis were factors independently associated with M. hominis colonization. Among women colonized with M. hominis, HIV seroprevalence was 21% in women with high amounts of M. hominis (> or = 10(4) colour-changing units per ml) versus 7% in women with lower amounts (P=0.01). U. urealyticum was found more often in unmarried women and when pregnancy was less than 20 weeks. Mycoplasma colonization is frequent among pregnant women in Abidjan, but their pathogenicity requires further study.

New pathogens including Escherichia coli O157:H7 have emerged and spread world-wide as the most important cause of foodborne infections. We established a prospective study in Abidjan from 1996 to 1999 to determine the prevalence of Shiga-toxin producing E. coli (STEC) in our environment. Two O157 strains were found. One (EA47) O157:H7 was isolated from chicken and the other (EH144) O157:HNM from human diarrhoeal stool specimens. Both O157 strains carried stx2, eae, and UidA genes, but not e-hly one. Four other pathogenic E. coli were isolated, including three enteroaggregative E. coli (EAggEC) and one isolate which expresses a cytolethal distending toxin gene (cdtB). This is the first report of Shiga-toxin producing E. coli (STEC) in Côte d'Ivoire. Given its low prevalence (0.8%), E. Coli does not appear to be a public health problem in Côte d'Ivoire.

Objectives: To study the tolerance and acceptability in Africa of a perinatal intervention to prevent vertical HIV transmission using benzalkonium chloride disinfection., Design: A randomized, double blinded phase II trial., Setting: Prenatal care units in Abidjan (Côte d'Ivoire) and Bobo-Dioulasso (Burkina Faso)., Patients: Women accepting testing and counselling who were seropositive for HIV-1 and under 37 weeks of pregnancy were eligible. A total of 108 women (54 in each group) enrolled from November 1996 to April 1997, with their informed consent., Intervention: Women self administered daily a vaginal suppository of 1% benzalkonium chloride or matched placebo from 36 weeks of pregnancy, and a single intrapartum dose. The neonate was bathed with 1% benzalkonium chloride solution or placebo within 30 minutes after birth., Main Outcome Measures: Adverse events were recorded weekly, with a questionnaire and speculum examination in women through delivery, and examination of the neonate through day 30. The incidence of genital signs and symptoms in the women and cutaneous or ophthalmological events in newborns were compared between groups on an intent to treat basis., Results: The median duration of prepartum treatment was 21 days (range 0-87 days). Compliance was 87% for prepartum and 69% for intrapartum treatment, and 88% for the neonatal bath, without differences between the two groups. In women, the most frequent event was leucorrhoea; the incidence of adverse events did not differ between treatment groups. In children, the incidence of dermatitis and conjunctivitis did not differ between the benzalkonium chloride and placebo groups (p = 0.16 and p = 0.29, respectively)., Conclusion: Vaginal disinfection with benzalkonium chloride is a feasible and well tolerated intervention in west Africa. Its efficacy in preventing vertical HIV transmission remains to be demonstrated.

An annual 20% excess mortality rate is observed in HIV-seropositive patients after treatment for tuberculosis. An affordable secondary prophylaxis against main opportunistic diseases is needed, i.e. against tuberculosis, toxoplasmosis, pneumocystosis and other infections occurring in this target population. This open prospective randomized study assessed morbidity and mortality in 2 cohorts of HIV-seropositive patients having recently recovered from pulmonary tuberculosis: 134 patients assigned to prophylactic treatment with isoniazid (INH, 300 mg once daily) plus sulphadoxine-pyrimethamine (S, 500 mg/P, 25 mg once weekly), and 129 were controls, comparable for sex, age, weight and HIV-serology. Patients were followed-up for up to 2 years: 192 person-years (PY) in the prophylaxis group and 142 PY in the control group. Four patients developed tuberculosis and 20 patients died in the prophylaxis group, compared to 10 and 23 controls, respectively. Sick days were reported by 22 patients in the prophylaxis group and by 77 patients in the control group. This prophylaxis was associated with a moderate decrease of mortality (log rank test: p = 0.1736), a significant decrease of tuberculosis incidence (log rank test: p = 0. 0234), a highly significant reduction of adverse events and sick days, and a prevention of wasting (p = 0.008) and anaemia (p = 0. 045). No death from toxoplasmosis occurred in the prophylaxis group as compared to 2 possible cases among controls; toxoplasmosis IgG levels declined in treated patients, but increased in controls (p = 0.01). There was no adverse drug reaction due to SP (10,006 doses) or to INH. Compliance with SP intake was good, but moderate as with INH intake. We conclude that a secondary prophylaxis with INH+SP represents a cost-effective measure to improve health conditions of HIV-infected adults in Côte d'Ivoire, following a full treatment course against tuberculosis., (Copyright 1999 S. Karger AG, Basel.)

Setting: A national survey of resistance to the antituberculosis drugs used in Côte d'Ivoire was conducted in 1995-1996., Objective: To determine the rate of primary resistance to antituberculosis drugs., Methods: Consecutive new tuberculous patients with positive smear were recruited from tuberculosis centres and rural health centres. Drug susceptibility testing was performed according to the proportion method. Positive cultures were tested against streptomycin, isoniazid, rifampicin, and ethambutol. All resistant strains and 10% of all randomly sampled cultures were sent to an external laboratory for quality control. Human immunodeficiency virus (HIV) tests were performed for consenting patients at the tuberculosis centres., Results: Among the 430 samples, 320 were available for analysis. Primary resistance to antituberculosis drugs was observed for 13.4% of the patients (43/320); multidrug resistance (to at least isoniazid and rifampicin) was observed for 5.3% of the patients; 14.2% of HIV-negative and 16.2% of HIV-positive patients were resistant to at least one antituberculosis drug (P = 0.70)., Conclusion: This study is representative of antituberculosis drug resistance in Côte d'Ivoire. The rate of primary resistance is high and emphasises the need for a sentinel survey of tuberculous resistance. The National Tuberculosis Control Programme needs to make improvements in its management of tuberculosis cases.

Background and Objectives: Douching, a common practice, could further increase the risk of genital infections., Goal of This Study: To describe douching practices in pregnant women and to evaluate associations with lower genital tract infections., Study Design: Cross-sectional study in Abidjan, Côte d'Ivoire., Results: Among 552 women included, douching before consultation was reported by 97% and was common practice for 98%. Intravaginal drying agents were used by 10%. Genital warts were less frequent for women who usually douched (p = 0.015). U. urealyticum infection was associated with douching and with the use of intravaginal agents. Diagnosis of genital infections was independent of douching with water or soap, but chlamydial infection was associated with douching with antiseptics, used by 14% of the women (p = 0.036). HIV infection was two times more frequent in women using antiseptics (p = 0.17)., Conclusion: The study confirms the widespread practice of douching in African pregnant women. The harmful effects of antiseptics need to be substantiated.

A transversal survey on 150 pregnant women was carried out at the P.M.I. center in Yopougon, in order to determine the prevalence of genital herpes and to estimate the frequency of asymptomatic excreting of Herpes simplex virus (HSV) in pregnant women. The viral isolation and the direct immuno-fluorescence (IF) assay of the genital secretions were found to have a prevalence of 12.7% Among the women who tested positive (the majority of whom were from modest socio-economic origin and young), 10% had antecedents of genital herpes, 2.7% showed an asymptomatic excretion and 36.8% had an acute episode during their pregnancy including a primary infection in the 20th week. In these women an unexpected recurrence will constitute the major risk for maternal transmission and an emergence of neonatal herpes.

Setting: Respiratory medicine wards of the University Teaching Hospital, Abidjan, Côte d'Ivoire., Objectives: To describe the spectrum of opportunistic infection among human immunodeficiency virus (HIV) infected adults hospitalised in the respiratory medicine unit in Abidjan, and the level of immunosuppression at which these diseases occur., Design: Cross-sectional study., Results: Overall, 75% of patients were HIV-positive: among these patients, the most frequent diagnosis was tuberculosis, in 61%, followed by bacterial pneumonia (15%), Gram-negative septicaemia (particularly non-typhoid Salmonella) (9%) and empyema (5%). Atypical pneumonias appeared to be rare. Most HIV-positive patients had CD4 counts indicative of advanced immunosuppression: 36% had CD4 counts below 100 x 10(6)/l, 19% between 100 and 199 x 10(6)/l, 29% between 200 and 499 x 10(6)/l, and 16% above 500 x 10(6)/l. Overall in-hospital mortality was 27% for HIV-positive patients and 22% for HIV-negative patients (P = 0.5). In a multivariate analysis, the strongest independent risk factors for death were cachexia (odds ratio [OR] 7.4, 95% confidence interval [CI] 2.1-26.3), male sex (OR 4.5, 95% CI 1.2-17.4) and age over 40 (OR 4.1, 95% CI 1.0-17.2)., Conclusions: Tuberculosis and bacterial infections are the major causes of respiratory morbidity in immunosuppressed HIV-infected adults in this population. Efforts to improve the management of HIV-related disease need to focus on prevention and treatment of these infections.

This is a prospective study recruiting 120 patients successively who were admitted to the chest department in hospital for respiratory infections irrespective of their aetiology. The aim of the study was to assess the frequency of nocardiosis in respiratory pathology in the era of AIDS and in an area where tuberculosis is endemic. The HIV serology was carried out on all 120 patients. A systemic search was made for nocardiosis and Koch's bacillus in the sputum and also in the broncho-alveolar lavage liquid obtained by endoscopy. The HIV serology was positive in 74 patients (61.7%). Pulmonary nocardiosis was diagnosed in five patients (4.2%), of whom four patients were HIV positive (80%). Tuberculosis was diagnosed in 58 cases (48.3%) of whom 40 were HIV positive (70%). The association of nocardiosis and tuberculosis was present in only one patient. The radioclinical aspect of nocardiosis in our service was suggestive of tuberculosis. The prevalence of nocardiosis in our series at 4.2% is in agreement with that obtained in autopsy studies in the Ivory Coast. The similarity of the radioclinical appearance between tuberculosis and nocardiosis demands that a search is made for the latter on all HIV positive patients and in negative cases a search for Koch's bacillus and empirical antibiotic therapy ought to have a spectrum of activity that would include nocardia.

Bacterial diarrheas in developing countries remain a major public health problem. Cholera is endemo-endemic since 1970. Clusters of Shigella infections are commonly observed during the rainy season. Other enteropathogen cause nosocomial infections and foodborne diseases. The HIV epidemic determined the emergence of a new trend of enteric diseases caused by opportunistic bacteria such as Salmonella Enteritidis, S. Typhimurium. The risk factors associated with these infections remains almost unknown. Treatment failure is related to an incre of high level resistance strains.

In order to determine the antipoliomyelitis seroprevalence of children in Abidjan, we checked the presence of antipoliovirus antibodies in 48 children received in the South Abobo's vaccination center for vaccination against measles. According to the vaccination schedule and rules applied in Côte d'Ivoire: 12.5% of the children have received less than three doses or oral polio vaccine (OPV), 87.5% have received the three doses. Antibody titration results indicated that 78.6, 93 and 76.2% of the children have been immunized against Poliovirus type I, type II and type III, respectively; 71.4% of the children showed antibodies against the three poliovirus serotypes and 4.8% had no antipoliovirus antibodies at all. The children which showed an antibodies titer less than 1/8 were considered unprotected: the proportion of unprotected was 21.4, 7 and 23.8% against Poliovirus type I, type II and type III, respectively. Although these results showed that the level of protection against poliomyelitis in Abidjan is acceptable (> 75%), the efforts for vaccination program in Côte d'Ivoire need to be improved in order to eradicate poliomyelitis.

From 313 samples of CSF, urine, sera and pleural liquid, the authors show how appreciable is the contribution in research of soluble antigens by sensibilized latex particles agglutination method in etiologic diagnosis, especially during meningitis, pulmonary and neonatal infections. Soluble antigens were declared positives in 62.26% of cases against S. pneumoniae, 25.4% of cases against H. influenzae, 6.66% of cases against S. agalactiae, 5.71% of cases against N. meningitidis C, with variable percentages from one biological liquid to another. Compared to classical bacteriologic techniques, this method allows the diagnosis of an infection even when decapitated, and could be used in emergency diagnosis.

6,603 women with vaginal discharges were investigated for genital infection with four sexually transmitted diseases. Germs of vaginitis were isolated with prevalence as following: C. albicans 25%, G. vaginalis 17.4%, T. vaginalis 8.2%. Cervicitis with N. gonorrhoeae represented 3.2% of cases.

The authors report the results of a seroepidemiological study of rubella in pregnancy. Rubella antibodies were present in 82% of the pregnant women and 18% were seronegative. Most of seronegative women were less than twenty years old, nulliparous, on first period of gestation and in low socioeconomical conditions.

A study of direct genital swabs achieved in Abidjan, on 116 men and 131 women consulting for urogenital complaints, has revealed that the men show a prevalence of 28.4% Chlamydia trachomatis, and of 18.1% Neisseria gonorrhoeae. Concerning the women the prevalence of the same germs are 13.7% for Chlamydia trachomatis, and 4.6% for Neisseria gonorrhoeae. These results show the importance of Chlamydia trachomatis as a sexually transmitted disease in Abidjan (Côte-d'Ivoire). No differences were observed according to age in the two groups.

To determine the prevalence of group B streptococci to the pregnant woman in Abidjan, we have proceeded an inquiry to a carrier regrouping 150 women examined during a systematic prenatal consultation. The pregnant women did not present any clinical symptoms which can evoke a genital infection. The sampling to the research of group B streptococci have been made to the level of vulva, vagina and cervix. The global frequency of isolation to the pregnant woman is of 19.33% with a frequency of 9.33% to the level of the cervix and the vagina and of 11.33% to the level of the vulva.

About 276 sputums analysed from 1984 to 1989, 61% of them have been positive. Beside the usual germs of the oropharynged flora, 115 bacteria susceptible of being pathogenic have been isolated. The kinds which are frequently found are Klebsiella = 31 (27%), Escherichia coli = 20 (17%), Enterobacter = 19 (17%), Staphylococcus aureus = 17 (15%) and Pseudomonas aeruginosa = 12 (10%).

The authors relate the results of a bacteriological investigation carried out among the people of four villages from Abidjan outskirts (about 1,704 inhabitants). They searched for individuals expelling Salmonellas from their faeces. This investigation, which lasted a year enabled, out of 1,754 cultures to isolate 109 strains belonging to various serotypes, four new ones among them. The isolations frequency increases with the rainy season, and has been especially important in one of the villages. Animals expell Salmonellas from their dejections, in a high percentage of cases.

The in vitro activity of 4 beta lactam compounds (carbenicillin, ampicillin, cefotaxim, azlocillin), 4 aminoglycosides (gentamicin, dibekacin, netilmicin, amikacin), chloramphénicol and tetracyclin chlorhydrate was studied on 30 strains of Pseudomonas aeruginosa. Amikacin is the most efficient with 97% of sensitive strains, then dibekacin (80%), azlocillin (76%) and carbenicillin (73%). Gentamicin and netilmicin are the less efficient with respectively 43% and 63% resistant strains. Chloramphenicol, ampicillin and cefotaxim have not any activity on these strains. This study reveals that 3% of the strains are polyresistant.

The authors report the epidemiological results of an epidemic about 84 choleriform syndrome in Abidjan (Ivory Coast), June 1985.

A research based on the analysis of 479 coprocultures , allow the isolation of 22 strains of Aeromonas hydrophila. The epidemiological aspects, the contamination processes through water, food... and the enteropathogenic role of these Aeromonas are discussed. These bacteria seen responsible of digestive disturbances from simple gastric discomfort (nausea, light abdominal pain...) to the actual choleriform syndrome. The isolation of 7 strains from the environment (water from lagune , wells; lagune crabs) allow to suspect the role played by the seasonal variations of the lagune salinity in the development of the germ; this allow to drawn the following conclusions: the reduction of the rate of water salinity promotes the multiplication of Aeromonas and increase the risk of human contamination.

The authors report a study about the investigations of N. gonorrhoeae in 1 742 samples from genital. Epidemiological aspects and the prevalence of gonococcal infections are precised: 10% in vulvovaginitis; 73% in acute anterior urethritis.

A retrospective study of 107 neonates with meningitis showed that in 45% of cases the condition occurred during the first 48 hours after birth, probably following a materno-foetal infection. Male neonates accounted for 70% of the cases. In 15% of cases, the mothers previously had a known infectious disease and 55% of cases came from an unfavourable socio-economic environment. Over 50% of the infants had to be resuscitated at birth. The majority of organisms isolated were Gram-negative bacteria or Enterobacteriaceae; the commonest organism was Haemophilus influenzae. The most effective specific treatment (91% favourable results) was intravenous amoxycillin plus intramuscular gentamicin. It is recommended that the newborn infant of parents living in unfavourable socio-economic circumstances should receive careful follow-up during the first week after birth so that the diagnosis of bacterial meningitis can be made at the start of infection. The neonate should receive effective prophylactic antibiotic cover if resuscitated, if the mother has suffered from an infectious disease during pregnancy or if premature rupture of the membranes has occurred.

The authors study parasites of the six most commonly consumed species of fishes in Côte-d'Ivoire. Analysis of gills, alimentary canal and blood of 188 fishes reveal the presence of extremely diverse families of parasites.

Two clinical forms: choleriform syndrome and gastro enteritis came be individualised. The geographical origin of these cases (the coastal region Abidjan) as well as some samples issued aquatic milieu enable to point out some modes of human contamination.

An observation of a case of choleriform syndrome of the Aeromonas hydrophila subspecies anaerogenes biotype II is reported. In a country dealing with a severe comma bacillus under endemo -sporadic from, the case report here could be wrongly diagnosed as cholera.

In this study, we have researched enteroviruses in digestive tract and gills of 106 fishes from farming station, belonging to the five most eaten species in Ivory Coast (Chrisychthys walkeri, Chrisychthys nigrodigitatus, Tilapia nilotica, Tilapia guineensis, Sarotherodon melanotheron). Hepatitis A virus was found in 12 fishes (11.3%), five times in gills, three times in digestive tract and four times in both. The two species apparently the more contaminated, were Chrisychthys nigrodigitatus, Sarotherodon melanotheron with a 4.7% contamination rate for the both.

The authors drawn epidemiological, clinical conclusions, and the geographical data concerning the diarrheas with Aeromonas in Ivory-Coast. The results relate to a study realized from January 1982 to July 1985. Out of the 1,594 excrements 627 germes have been isolated and among which 153 strains of aeromonas if for instance 24.4% of the whole germs. Aeromonas caviae is the most frequent species (50%) compared to 27.3% for Aeromonas sobria, and 22.7% for Aeromonas hydrophila.

The present work emphasize the great diversity of the viral species encountered in pregnant women (Rotavirus, Coronavirus, Adenovirus, Poliovirus, Coxsackievirus). In each of the different regions studied, one or two viral types are usually predominant. In Man (West Ivory Coast) region for instance, Rotaviruses and Coronaviruses were mainly encountered; in Bouaké, Polioviruses and Adenoviruses were predominant whereas in Bondoukou and Odienné respectively Coxsackieviruses and Adenoviruses were predominantly identified. Multiple viral infections were also evidenced: Rotaviruses + Coronaviruses, Rotaviruses + Polioviruses, Coronaviruses + Polioviruses, Polioviruses and Adenoviruses. The greatest number of multiple infections was found in Man (8 cases). Inapparent infections were mainly detected in Man where the prevalence for at least one viral type is very high 91.6%; in Bouaké, prevalence of at least one viral type is around 36%. The least level of prevalence was recorded in Bondoukou (East of Ivory Coast) and Odienné (North-West) respectively 17% and 20%.

Viral water contamination is on the increase all over the world and one is concerned by the dangers to which it exposes health and preoccupied with the search for effective solutions. This study, which was conducted in a year in Côte-d'Ivoire, enabled us to examine the degree of viral pollution from waste water collected from a lagune. It allowed us to follow the distribution of enteroviruses and their fluctuations during the year. 164 waste water samples were tested and 93 enterovirus strains isolated. 67.89% showed polioviruses and 32.11% coxsackieviruses. Seasonal fluctuations of the virus concentration in the lagune water were shown from statistical analysis of the data collected. Concentration was high during the rainy season and definitely lower during the dry season with the rise in water temperature.

210 P. aeruginosa hospital strains isolated at Abidjan from pathological samples or contaminated material were studied by means of serotyping, biotyping, phage-typing and for their resistance to eleven antibiotics. 87% were classified into 14 serogroups: O:1, O:2, O:3, O:4, O:5, O:6, O:8, O:9, O:10, O:11, O:12, O:13, O:15, O:16. No strains were O:7 or O:14. The presence of an ortho-nitrophenyl beta-d-galactopyranoside hydrolase was demonstrated in 42 strains belonging to the serogroup O:11. Sixty-five phage-types were defined but 37% of strains were untypable by phages. The incidence of resistance to each tested antibiotic was as follows: carbenicillin 49%, mezlocillin 44%, ticarcillin 34%, azlocillin 25%, cefamandole 94%, latamoxef 15%, cefotaxime 41%, cefsulodin 32%, tobramycin 35%, amikacin 7%, gentamicin 39%. Thirty-eight strains were multiresistant to carbenicillin, mezlocillin, ticarcillin, azlocillin, and four strains to eleven antibiotics. These results are compared with data of the scientific literature on the epidemiology of hospital Pseudomonas infection.

The bacteriological analysis of 127 fish viscera effected for the research of enteropathogenic germs showed that 8% of them contain Edwardsiella tarda and can be a possible source of human infections.

The treatment of non-complicated or complicated (by a bubo) chancroid with 1 single i.m. injection of 250 mg ceftriaxone gave excellent results. Treatment is simple and economical. This is particularly profitable in countries where chancroid is endemic.