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Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

Background: Children below six months are reported to be less susceptible to clinical malaria. Maternally derived antibodies and foetal haemoglobin are important putative protective factors. We examined antibodies to Plasmodium falciparum merozoite surface protein 3 (MSP3) and glutamate-rich protein (GLURP), in children in their first two years of life in Burkina Faso and their risk of malaria., Methods: A cohort of 140 infants aged between four and six weeks was recruited in a stable transmission area of south-western Burkina Faso and monitored for 24 months by active and passive surveillance. Malaria infections were detected by examining blood smears using light microscopy. Enzyme-linked immunosorbent assay was used to quantify total Immunoglobulin G to Plasmodium falciparum antigens MSP3 and two regions of GLURP (R0 and R2) on blood samples collected at baseline, three, six, nine, 12, 18 and 24 months. Foetal haemoglobin and variant haemoglobin fractions were measured at the baseline visit using high pressure liquid chromatography., Results: A total of 79.6% of children experienced one or more episodes of febrile malaria during monitoring. Antibody titres to MSP3 were prospectively associated with an increased risk of malaria while antibody responses to GLURP (R0 and R2) did not alter the risk. Antibody titres to MSP3 were higher among children in areas of high malaria risk. Foetal haemoglobin was associated with delayed first episode of febrile malaria and haemoglobin CC type was associated with reduced incidence of febrile malaria., Conclusions: We did not find any evidence of association between titres of antibodies to MSP3, GLURP-R0 or GLURP-R2 as measured by enzyme-linked immunosorbent assay and early protection against malaria, although anti-MSP3 antibody titres may reflect increased exposure to malaria and therefore greater risk. Foetal haemoglobin was associated with protection against febrile malaria despite the study limitations and its role is therefore worthy further investigation.

In this study, we have identified the growth factors supporting myeloma self-renewal in eight myeloma cell lines. All cell lines able to form self-colonies displayed constitutive P-AKT and P-ERK1,2 but not P-STAT3 and did not express CD45, suggesting the presence of an insulin-like growth factor 1 (IGF1) loop. We showed that a blocking anti-insulin-like growth factor 1 receptor (IGF1R) monoclonal antibody (mAb) inhibited colony formation in correlation with IGF1R expression and decreased P-AKT. Imatinib or a blocking anti-stem cell factor (SCF) mAb also inhibited colony formation of two cell lines expressing C-KIT and SCF, and decreased P-AKT. Moreover, the PI3K/AKT pathway inhibitor wortmannin inhibited colony formation. Blocking interleukin (IL)6R did not inhibit colony formation in good agreement with a lack of constitutive P-STAT3. We showed that primary cells frequently co-expressed IGF1R/IGF1 but not C-KIT/SCF or IL6R/IL6, suggesting that in vivo autonomous growth could be possible via IGF1R. Despite their similar role in clonogenic growth and shared signaling pathway, IGF1R and C-KIT had opposite prognostic values, suggesting that they were surrogate markers. Indeed, we showed that both C-KIT and IGF1R prognostic values were not independent of MMSET expression. This study highlights the autocrine role of IGF1 in myeloma cells and reinforces the interest in targeting IGF1R in IGFR1(+) CD45(+/-) patients, such as MMSET(+) patients.

Background: Appropriate home management of illness is vital to efforts to control malaria. The strategy of home management relies on caregivers to recognize malaria symptoms, assess severity and promptly seek appropriate care at a health facility if necessary. This paper examines the management of severe febrile illness (presumed malaria) among children under the age of five in rural Koulikoro Region, Mali., Methods: This research examines in-depth case studies of twenty-five households in which a child recently experienced a severe febrile illness, as well as key informant interviews and focus group discussions with community members. These techniques were used to explore the sequence of treatment steps taken during a severe illness episode and the context in which decisions were made pertaining to pursing treatments and sources of care, while incorporating the perspective and input of the mother as well as the larger household., Results: Eighty-one participants were recruited in 25 households meeting inclusion criteria. Children's illness episodes involved multiple treatment steps, with an average of 4.4 treatment steps per episode (range: 2-10). For 76% of children, treatment began in the home, but 80% were treated outside the home as a second recourse. Most families used both traditional and modern treatments, administered either inside the home by family members, or by traditional or modern healers. Participants' stated preference was for modern care, despite high rates of reported treatment failure (52%, n=12), however, traditional treatments were also often deemed appropriate and effective. The most commonly cited barrier to seeking care at health facilities was cost, especially during the rainy season. Financial constraints often led families to use traditional treatments., Conclusions: Households have few options available to them in moments of overlapping health and economic crises. Public health research and policy should focus on the reducing barriers that inhibit poor households from promptly seeking appropriate health care. Enhancing the quality of care provided at community health facilities and supporting mechanisms by which treatment failures are quickly identified and addressed can contribute to reducing subsequent treatment delays and avoid inappropriate recourse to traditional treatments.

Objectives: To evaluate the overall survival postnephrectomy for renal cancer for patients aged over 80 years, and to identify preoperative prognostic factors that might influence therapeutic strategies., Methods: In a retrospective study in five French departments of urology, 179 patients aged over 80 years with renal cell carcinoma underwent radical nephrectomy between 1990 and 2011. The following data were collected: age, sex, body mass index, Charlson Comorbidity Index, American Society of Anesthesiology class, Eastern Cooperative Oncology Group Performance Status, type of surgery, period of follow-up, survival, death etiology, symptoms, Fuhrman grade and tumor-nodes-metastasis stage., Results: After a 29.6-month follow up, 89 patients (49.7%) died. Death etiologies were: cancer for 46 (52%) patients, immediate or distant perioperative complications for five patients (6%) and three patients (3%) respectively, cardiovascular disease for 16 patients (18%), other cancers for three patients (3%) and unknown for 16 patients (18%). In a multivariate analysis, T-stage, M-stage and Charlson Comorbidity Index were identified as independent prognostic factors. Patients were divided into three groups (good, intermediate and bad prognosis) with significantly different survivals of 91, 36 and 22 months (P < 0.0001), respectively., Conclusions: Preoperative data, including T-stage, M-stage and Charlson Comorbidity Index represent significant independent prognostic factors for survival for patients aged over 80 years. These data might help the clinician in selecting the most suitable candidates for radical nephrectomy among elderly patients with renal cancer., (© 2012 The Japanese Urological Association.)

We investigated the oxidative mechanisms and identified the target protein induced by heat treatment. The study was carried out on M. longissimus thoracis from Galia and Redone pigs. Post mortem metabolic parameters and drip loss were determined. Heat treatment was performed at 100 °C for 10 and 30 min. Physicochemical state of the protein, TBA-RS and Schiff bases were assessed. Protein aggregates were evaluated and the protein target of oxidation studied. Muscles from Galia had higher residual glycogen and drip loss. Heat treatment increased surface hydrophobicity, carbonyl, protein aggregate and Schiff bases and TBA-RS whatever the treatment time. Immunoblotting revealed oxidized myosin, oxidized actin and high molecular weight proteins after 30 min cooking. Oxidation products were significantly correlated with drip loss, suggesting a possible reduced ability of oxidized proteins to retain water. Moreover, residual glycogen was positively correlated with oxidized myosin, suggesting a possible role of glycogen as a glucose donor., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The study aimed to investigate the mechanisms underlying drip loss in meat other than those related to post mortem energy metabolism. The study was carried out on M. longissimus thoracis assessing carcass and meat quality traits plus metabolic parameters and drip loss. Based on the data obtained, three drip loss groups were established: low, medium and high. Heat treatments were performed at 100°C for 30 min. Physicochemical protein modifications were assessed before and after cooking. IMF and L* were higher in the high drip loss group, whereas b* was higher in the medium drip loss group. Residual glycogen, glucose and glycolytic potential were higher in LT muscle from the high drip loss group. Before cooking, protein surface hydrophobicity and carbonyl levels were similar in the three groups. However, after cooking, carbonyl, oxidized actin and oxidized aggregates were higher in the high drip loss group, suggesting that protein oxidation may affect the water holding capacity of meat., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: Dengue viruses (DENV) are endemic in over 100 countries worldwide, and annually 50 to 100 million people are infected by one of the four DENV serotypes, whereas over 2.5 billion people are at risk for infection. West African countries lack the surveillance to determine the true incidence of dengue; hence, this disease is likely significantly underestimated. In Mali, ?14 million people are potentially at risk of acquiring a dengue infection., Methods and Findings: A serosurvey for DENV was conducted on 95 human serum samples obtained from the Institute National de Recherche en Sante Publique in 2006. DENV-specific IgM and IgG enzyme-linked immunosorbent assays were performed on all samples, and a subset was tested using the plaque-reduction neutralization test against the DENV and yellow fever virus (YFV). Samples collected during the acute infection (0-5 days postonset of symptoms) were tested for dengue NS1 antigen and reverse-transcriptase polymerase chain reaction for Flaviviruses, Alphaviruses, and Bunyaviruses RNA. A total of 87 (93%) of samples were positive for anti-DENV IgG antibodies. Of a subset of 13 IgG positive samples, 2 samples neutralized monotypically against DENV-1 and -2, whereas 3 others neutralized broadly against YFV and multiple DENV. Although no polymerase chain reaction positives were found, DENV NS1 was detected in 1 of the 20 acute samples tested., Conclusions: Of the 93 human serum samples tested, the dengue prevalence based on dengue IgG enzyme-linked immunosorbent assay results was 93%. Three DENV specific positive samples and two YFV positives were identified by plaque-reduction neutralization test. Finally, one sample tested positive for dengue NS1, thus suggestive of an acute infection within 14 days of obtaining the sample from the patient. Based on these serological data from this study, YFV and DENV appear to be co-circulating in Mali.

Necrotizing sarcoid granulomatosis (NSG) is a rare systemic disease that was described by Liebow in 1973. Dyspnea and chest pain may be present, as in our first patient; however, 25% of patients are asymptomatic, as our second patient. The typical radiographic findings are nonspecific: single or multiple lung opacities, with common involvement of the pleura. To the best of our knowledge, fluorodeoxyglucose (FDG) PET has only been reported in one case of NSG, which was atypical as it occurred in an adolescent. We report 2 cases, confirming that the lesions of NSG are FDG positive, showing a typical pattern of multiple bilateral lung nodules (imaged with PET/CT in 1 case). FDG imaging has a potential role when this distribution is observed on CT, to guide the surgical biopsy and show the actual extent of the disease.

Background: Quality of pre-test counseling in empowering women to make informed decisions related to HIV/AIDS is regarded as a key element to ensure effectiveness of PMTCT interventions. This cross-sectional study examined how well HIV testing services with 'Opt in' strategy are being delivered following scaling-up of PMTCT programs in rural peripheral health centers in Burkina Faso., Methods: We observed the process of HIV testing service delivery and evaluate 19 pre- test counseling sessions linked with 16 in-depth interviews with the pregnant women. We also conducted interviews with 6 counselors, district health officer and the PMTCT coordinator. Secondary data on acceptance of HIV testing were collected from each study site., Results: The district authority decentralized the implementation of PMTCT service to the peripheral health facility. No health center has on spot HIV testing facility. The proportion of pregnant women agreed to join pre test counseling was very low (7%-29%). Acceptance of HIV testing after PTC was as high as 100%. There is a substantial gap between the standards set by the National Guidelines and the actual practice of conducting the counseling sessions. Major barriers for health workers were lack of training, disruption of service, work load, difficulties to discuss risk behavior with women and lack of partner involvement. Interviewed women were satisfied with the services and majority wanted to disclose their HIV status., Conclusion: Our findings warrant regular supervision with refresher training and a focus on quality counseling would help health workers to enhance their performance and support them to comply with the program. Encouraging women to engage in a discussion about testing with their partners with male involvement activity in the community could improve couple testing. Strengthening group counseling and reorganizing the strategy including introduction of on site rapid HIV testing could effectively improve coverage.

Purpose: Oxaliplatin displays a frequent dose-limiting neurotoxicity due to its interference with neuron voltage-gated sodium channels through one of its metabolites, oxalate, a calcium chelator. Different clinical approaches failed in neurotoxicity prevention, except calcium-magnesium infusions. We characterized oxalate outcome following oxaliplatin administration and its interference with cations and amino acids. We then looked for genetic predictive factors of oxaliplatin-induced neurotoxicity., Experimental Design: We first tested patients for cations and oxalate levels and did amino acid chromatograms in urine following oxaliplatin infusion. In the second stage, before treatment with FOLFOX regimen, we prospectively looked for variants in genes coding for the enzymes involved (a) in the oxalate metabolism, especially glyoxylate aminotransferase (AGXT), and (b) in the detoxification glutathione cycle, glutathione S-transferase pi, and for genes coding for membrane efflux proteins (ABCC2)., Results: In the first 10 patients, urinary excretions of oxalate and cations increased significantly within hours following oxaliplatin infusion, accompanied by increased excretions of four amino acids (glycine, alanine, serine, and taurine) linked to oxalate metabolism. In a further 135 patients, a minor haplotype of AGXT was found significantly predictive of both acute and chronic neurotoxicity. Neither glutathione S-transferase pi nor ABCC2 single nucleotide polymorphisms we looked for were linked to neurotoxicity., Conclusion: These data confirm the involvement of oxalate in oxaliplatin neurotoxicity and support the future use of AGXT genotyping as a pretherapeutic screening test to predict individual susceptibility to neurotoxicity.

Unlabelled: 5-Fluorouracil (5-FU)-related early toxicity, due to a metabolic deficiency, is rare but is potentially severe and even lethal (0.1%). It is due to dihydropyrimidine dehydrogenase (DPYD) gene polymorphism or some epigenetic factors. The detection of metabolic change could prevent severe toxicity, but until now it has not been carried out in clinical practice., Purpose: To find the simplest and most accurate pretherapeutic test to predict DPD deficiency in patients treated with 5-FU by comparing different approaches., Results: Two hundred and fifty two French Caucasian patients treated by 5-FU infusion were studied. A two-step strategy, combining firstly SNP detection and uracil plasma measurement, followed, in cases where metabolic deficiency was suspected, by dihydrouracil/uracil ratio determination to confirm deficiency and to determine the optimum 5-FU dosage, appeared the best approach, with 83% and 82% sensitivity and specificity, respectively., Conclusion: These data support the future use of this approach, suitable to clinical practice, as screening test to identify DPD deficiency before 5-FU-based therapy.

The authors report 27 cases of cerebral tumours in 22 men and 5 women age 1 to 81. Clinical symptoms were dominated by cranial hypertension (59.3%), focal motor impairment involving cranial nerves (51.9%.) and seizures due to epilepsy (44.4%). The main tumors detected with CT scan include glyoma (.5 cases), craniopharyngioma (3 cases), adenoma (3 cases), medulloblastoma (3 cases), and metastasis (3 cases). The supra tentoriel was predominant (76.9%). Neurosurgery was performed in 6 patients and 21 cases received medical treatment. We fund 13 cases of death. In conclasion, cerebral tumours are very severe pathologies because of the high mortality associated with. CT scan has contributed to diagnose the lesions, show their topography and to determinte the histological nature. Neurosurgery is necessary for the treatment of these lesions.

Purpose: Although single nucleotide polymorphisms (SNP) of the dihydropyrimidine dehydrogenase gene (DPYD) have been reported, which affect enzyme activity and the severity of 5-fluorouracil (5-FU) toxicity, no pretherapeutic detection has thus far been developed. We investigated 22 DPYD gene SNPs, their respective incidence, their link with grade 3 to 4 toxic side effects, and their management in practice: 9 were looked for in 487 patients, whereas 13 others were investigated in 171 patients., Patients and Methods: SNPs were detected before 5-FU-based treatment in WBC using a Pyrosequencing method. Close clinical and biological follow-up was done., Results: Five different SNPs were found in 187 patients (IVS14 + 1G>A, 2846A>T, 1679T>G, 85T>C, -1590T>C). Three hundred patients had no SNP. Forty-four patients had grade 3 to 4 toxic side effects in either the first or second cycle. Sixty percent of patients with either IVS14 + 1G>A or 2846A>T SNPs and the only patient with 1679T>G SNP experienced early grade 3 to 4 toxicity, compared with 0%, 5.5%, and 15% of those with either -1590T>C, 85T>C SNP, or no SNP, respectively. In cases with grade 3 to 4 toxicity, treatment either had to be quickly stopped, or could be safely continued with an individual dose adjustment. Sensitivity, specificity, and positive and negative predictive values of the detection of these three major SNPs as toxicity predictive factors were 0.31, 0.98, and 0.62 and 0.94, respectively., Conclusion: Pretreatment detection of three DPYD SNPs could help to avoid severe toxic side effects. This approach is suitable for clinical practice and should be compared or combined with pharmacologic approaches. In the case of dihydropyrimidine dehydrogenase deficiency, 5-FU administration often can be safely continued with an individual dose adjustment.

The objective of the present study was to evaluate the feasibility of azithromycin prophylaxis with respect to tolerability and compliance during a pertussis outbreak among healthcare workers in a university hospital ward. Compliance with the prophylaxis regimen was 89%; compliance was 75% from intent-to-treat perspective. The rate of adverse events was 33%. Female sex was associated with reporting of adverse events. Nonstudents and healthcare workers who reported adverse events were less compliant with the prophylaxis regimen.

During a prospective study conducted at the rehabilitation Center of the physically handicapped persons and at the mother-child Hospital in Bamako, the authors report 50 cases of neuromuscular complications of the quinine intramuscular injection in the child. The scan revealed muscular calcifications in 37 cases (740%), abscesses, in 7 cases (14%) and muscular inflammations in 6 cases (12%). Xray of the affected limb was not systematic: it has been performed in four children in the case of a subjacent bone involment. It showed calcifications in two cases. If muscular abscess is easily diagnosed by clinical exam it is not the case for calcifications. The scan allows to set up a precise mapping of the muscular lesions, to determine their type and size. It also helps the clinicians in their therapeutic attitude. Medical treatment associated with rehabilitation has been carried out in 40 patients (80%) and surgery in 10 patients (20%).

General circulation models (GCM) are increasingly capable of making relevant predictions of seasonal and long-term climate variability, thus improving prospects of predicting impact on crop yields. This is particularly important for semi-arid West Africa where climate variability and drought threaten food security. Translating GCM outputs into attainable crop yields is difficult because GCM grid boxes are of larger scale than the processes governing yield, involving partitioning of rain among runoff, evaporation, transpiration, drainage and storage at plot scale. This study analyses the bias introduced to crop simulation when climatic data is aggregated spatially or in time, resulting in loss of relevant variation. A detailed case study was conducted using historical weather data for Senegal, applied to the crop model SARRA-H (version for millet). The study was then extended to a 10 degrees N-17 degrees N climatic gradient and a 31 year climate sequence to evaluate yield sensitivity to the variability of solar radiation and rainfall. Finally, a down-scaling model called LGO (Lebel-Guillot-Onibon), generating local rain patterns from grid cell means, was used to restore the variability lost by aggregation. Results indicate that forcing the crop model with spatially aggregated rainfall causes yield overestimations of 10-50% in dry latitudes, but nearly none in humid zones, due to a biased fraction of rainfall available for crop transpiration. Aggregation of solar radiation data caused significant bias in wetter zones where radiation was limiting yield. Where climatic gradients are steep, these two situations can occur within the same GCM grid cell. Disaggregation of grid cell means into a pattern of virtual synoptic stations having high-resolution rainfall distribution removed much of the bias caused by aggregation and gave realistic simulations of yield. It is concluded that coupling of GCM outputs with plot level crop models can cause large systematic errors due to scale incompatibility. These errors can be avoided by transforming GCM outputs, especially rainfall, to simulate the variability found at plot level.

Fibrodysplasia ossificans progressiva (FOP) is an extremely rare hereditary connective tissue disorder characterized by congenital malformation of the great toes and by progressive heterotopic ossification of striated muscles and soft tissues. We report a case of FOP in a Malian boy and review the clinical and radiographic manifestations of this disorder. The body TDM showed ossifications and calcifications in the muscles of the large rhomboid, the erector muscles of the rachis and the trapezius muscles. Radiography of the dorsolumbar rachis showed paravertebral soft tissue calcification adjacent to intact lumbar vertebrae. The diagnosis is based on clinical and radiological findings and demonstration of skeletal malformations. The differential diagnosis of this rare condition from other muscle and joint disease is discussed. There is no effective prevention or treatment. There is a need for a wider knowledge of this condition.

Qualitative research was carried out in central Mali to inform the development of curricula for an intervention to improve young people's reproductive health. Both the young people and 'societal gatekeepers' (including religious leaders and traditional healers) perceived reproductive health to comprise the social dynamics in which reproductive health decision-making is embedded and not just the biological aspects of sexual relations and fertility. Their definitions of reproductive health reflected social taboos about pre-marital sex, infidelity and illegitimate children, and comprised holistic notions of bodily and spiritual cleanliness. It is argued that the 'Cairo' definition sees many of the social factors identified by respondents as comprising the context or background of reproductive health. The findings presented here indicate that local populations may see them as integral to the concept itself. It is discussed how the 'Cairo' definition of reproductive health needs to be made culturally specific in order to facilitate programme design and implementation.

The sickle cell disease pathophysiology is provided by several events including deoxyhemoglobin S polymerization and hemorrheological troubles. Classically, such disorders have been known to concern only the homozygous SS and heterozygous SC profiles. However, troubles are more and more described since early years in the sickle cell trait patients and the pathogenesis factors are unknown. Our study focussed on phospholipids which are the basic and functional constituent elements of erythrocyte plasmic membrane. Assaying the membrane lipids extracted by Folch method and lipid standards (cholesterol, phosphatidic acid, lysophosphatidyl-choline, phosphatidyl-choline, lysophosphatidyl-ethanolamine, phosphatidyl-ethanolamine, sphingomyelin) was carried out by HPLC among 91 sickle cell trait patients as compared to 78 healthy subjects. The main abnormalities observed were an empoverishement in phosphatidyl-choline contrasting with an accumulation of membrane lysophosphatidyl-choline, lysophosphatidyl-ethanolamine, phosphatidic acid and sphingomyelin in sickle cell patients. These results suggest that sickle cell trait harmlessness is not actual. The accumulation of lysophosphatidyl-choline, by its cytolytic biomembrane perturbing properties, predispose therefore the sickled red cell to the haemolysis phenomena and allow to forecast deeper disturbances among homozygous subjects. These morbid disorders attributable to lipid peroxidation would justify an antioxidant treatment during the sickle cell disease.

Thanks to larviciding and distribution of ivermectine, transmission of onchocerciasis was virtually halted in all countries covered by the WHO Onchocerciasis Control Program (OCP). However as a result of this success vector control has been stopped in most areas covered by the program and a recrudescence of files is an increasing problem. In some rural communities fly biting hinders normal agricultural activity. Since local farmers cannot afford ground larviciding, many rely on topical repellents. For this reason, development of an inexpensive method of individual protection is a major priority. The purpose of this study carried out in the savannah area of the Côte d'Ivoire was to assess the repellent properties of cocoa oil, which is frequently used in some rural areas of the Côte d'Ivoire to prevent fly biting. Results showed that cocoa oil provides excellent protection against Simulium damnosum s.l.

The purpose of this study was to classify the risk for transmission of African human trypanosomiasis (sleeping sickness) according to population and settlement densities in four different areas of Zoukougbeu, Cote d'Ivoire, where the exact location of cases reported since 1990 is known. Epidemiological risk indexes were calculated from entomological data obtained from three surveys and analyzed with respect to presence of patients and occupancy rate in each area. Results indicated that there was a risk of transmission near the village of Bahigbeu II where the population density is between 30 and 40 inhabitants per km2 and settlement density is 4 per km2. There was also a risk in less inhabited areas such as Ouatigbeu where the population density is less than 30 inhabitants per km2 and dwelling density less than 4 per km2. In fact, cases are regularly reported in Ouatigbeu but never in Bahigbeu II. Based on these findings, we conclude that, while land occupancy can be considered as a risk factor for sleeping sickness, other factors such as human mobility must be taken into account to characterize risk areas and predict outbreaks.

A door-to-door survey was conducted in 18 villages in Mali with a total of 5,243 inhabitants classified according to the endemicity of onchocerciasis. Each epileptic was matched with two controls. The survey protocol included the following steps in cases and controls: census taking, socioeconomic data, screening for epilepsy, clinical examination, laboratory testing to detect parasites in stools and urine, and snip-test. The crude prevalence of epilepsy was 13.35 per 1,000 (n = 70). Epidemiological study provided a number of valuable demographic insights concerning age at onset, type of seizure activity during seizure and personal and family medical history. A transverse study showed that the prevalence of epilepsy was not significantly higher (p = 9.09) in zones of high endemicity of onchocerciasis (16.1 per 1000) than in zones of low endemicity (10.8 per 1000). Case-control findings showed evidence of onchocerciasis in 22.4 p. 100 of epileptics and 21.7 p. 100 of controls (odds ratio = 1.02 IC 95 p. 100: 0.4-2.19, not significant). Various risk factors including genetic factors and low socio-economic status could explain the trend toward a higher incidence of epilepsy as well as higher morbidity rates in zones of high endemicity of onchocerciasis.

Agricultural activity occurs within many medium size towns in developing countries. Rural influences and urbanization, which may be well or poorly managed, combine to create new health problems. A geographical approach is useful for evaluating the ability of the health care system to deal efficiently with these problems. Such an approach should take into account the urban environment and human population, health care and spatial differentiation factors. Relevant health indicators were selected to analyze the geographical patterns of health risk and of the health care system. These factors were analyzed according to area, at various levels. Field studies were carried out and aerial photographs and the various available maps were also studied. Results were compared to determine whether the health care system was appropriate for the health needs of the town. Urinary schistosomiasis is a useful example for assessing the value of the suggested methodology. The risk of transmission of this disease is high so its early detection is vital. The ability of the health care system to detect infection was assessed.

Mass treatment programs using ivermectin are now beginning in forest areas and simuli will soon be feeding on individuals with low microfilarial loads (probably < 10). Most previous reports have involved higher mean loads (range: 14-6950. The purpose of this study was to ascertain the impact of low microfilarial loads on the number of infecting larvae present at the end of a parasite cycle in the Simulium soubrense-Simulium sanctipauli group and on availability for transmission to man by inoculation. Tests were carried out on five subjects from a forest area of southwest Ivory Coast who were infected with onchocerciasis and presented mean microfilarial loads of 1, 5, 10, 20, and 100. Findings showed a direct correlation between microfilarial load (1, 5, 20, and 100) and intake of microfilaria per dissected female. Similarly there was a correlation between microfilarial loads (1, 5, 10, 20, and 100), quantity of infected females, and number of infecting larvae per infected female. Parasite output was variable but decreased as microfilarial load increased. This study suggests that the experimental vectorial capacity of simuli is similar in subjects presenting onchocerciasis with high and low microfilarial loads.

Since 1974 grassy plain areas of the western Africa have been protected by the Onchocerciasis Control Programme, but wooded endemic areas are also of concerned to countries in the region. Numerous studies have been performed to study endemic features of onchocerciasis in wooded areas. A parasitologic/entomologic survey was conducted between April and October 1990 in 5 villages in wooded areas located in Cote d'Ivoire. The parasitologic survey consisted of blood-free skin snips taken from both iliac crests of all subjects one year or over. Microfilarial counts performed after soaking biopsy material in distilled water for 30 minutes allowed characterization of the disease in the area. Overall microfilariae were found in 60.51% of the population indicating that onchocerciasis was highly endemic. The level of endemicity varied from one village to another. Prevalence was same in the two sexes and increased with age. Microfilarial density was the same in men and women up to the age of 9 years. After that time the density was at least twofold higher in men than in women at the same age. Although onchocerciasis is highly endemic in the area, blindness is uncommon.

Sera of 14 bacteriological confirmed pulmonary tuberculosis and 16 non-tuberculotic or healthy controls were sampled in Ignace Deen University Hospital in Conakry, Quinea. Samples were examined for IgG and IgM antibodies by means of enzyme-linked immunosorbent assay (ELISA) using sonicated M. bovis BCG and M. avium antigens and were tested for antibodies to HIV-1/HIV-2 as well. Median of IgG antibody titres to M. bovis BCG antigen was 1:445 and differed significantly from that of the control group (1:149). The median of IgM antibody titres was 1:79.1 and did not differ statistically from that of control group (1:69.3) as well as the antibody titres against M. avium antigen in the IgG and IgM classes for both analyzed serum groups. Seven of tested TB patients sera were positive for antibodies against HIV-1. The median of IgG antibody titres against M. bovis BCG antigen was 1:442 not differing significantly from values of remaining TB patients as well as the IgM antibody titre (1:109).

"Soninke and Poular migration from the valley of the Senegal River [has] historical pre-colonial roots. The colonial and post-colonial economies have confirmed and reinforced the migratory models of both ethnic groups. The data of [a] 1982 survey highlight similarities and differences in the demographic indicators of [these] migrations, which can be explained in relation to their respective pasts." (SUMMARY IN ENG AND SPA), (excerpt)

Dracunculiasis prevention should be simple: in a population at risk, everyone may be protected by the filtration of drinking water. The research described in this paper allowed the authors to follow the acceptance of new information by villagers in nine localities in Mali. Two strategies were studied: safe water supply (bore-hole or cement lined wells) plus health education on the one hand, and health education alone (based on filtration) on the other. Safe water supply is undoubtedly an effective strategy whereas the success of the health education intervention is uncertain. This experience showed that health education as the only means of control failed due to a lack of social cohesion or of coordinated group-action. Also, when dracunculiasis control is not a population's priority goal, the constraints on systematic filtration are too great and a tendency to discontinue the filtration process occurs. On the other hand, when dracunculiasis is considered to be a serious problem by the population, new information about systematic filtration is better assimilated and leads to behavioural changes. In order that the goal of eradicating dracunculiasis by 1995 should not be an utopic dream, it is necessary to prioritize the allocation of clean rural water supply projects only to those endemic villages where the conditions that allow for health education to be successful are met.

An investigation on the effects of hand burns has been undertaken about 32 children admitted in the plastic surgery outpatients Department. Accident occurs among the lower class population and heat is the major factor pointed out. The most frequent effects are hand palmar contracture. The surgical treatment completed with the functional re-education has given very good results in 79% cases. However the cheloid contractures are the most difficult to cure. Indeed the authors insist or the prevention and the creation of a center of burned patients and a plastic surgery Service to take care of patients whose life prognostic is optimistic.

The use of a highly sensitive and inexpensive method for determination of residues of bromophos (an organophosphate pesticide) in peanut crops, by fluorogenic labelling and thin-layer chromatography (TLC) is described. The bromophos is hydrolysed and the product 4-bromo-2,5-dichlorophenol (BDCP) dansylated with dansyl chloride. The fluorescent dansylated BDCP is separated by TLC and detected fluorimetrically. Linear fluorimetric analytical curves are obtained for bromophos weights ranging between 0.5 and 50 ng. The minimum detectable quantity is estimated to be 0.5 ng. The method can be used to recover as little as 400 ng of bromophos residue from 25 g of peanut seeds.

The utility of zero-order and first- and second-derivative ultraviolet (UV) spectrophotometry for the identification of benfluralin, trifluralin, isopropalin and oryzalin is discussed. These four herbicides were determined by zero-order and first-derivative UV spectrophotometry, with linear calibration graphs established between 50 and 100 concentration units and limits of detection ranging from 1 to 7 micrograms ml-1. The application of these techniques to the residue analysis of fortified soils and niebe and peanut leaves is described. Trifluralin residues were found to be 6.7, 8 and 1.7 micrograms ml-1 in samples of fortified soils, niebe leaves and peanut leaves, respectively. Isopropalin residues were found to range from 62 to 154 micrograms ml-1 in samples of fortified niebe leaves.

Six hundred and ninety two cattle, slaughtered in various abattoirs in Mali between August 1983 and November 1984 were examined for evidence of Fasciola gigantica and Dicrocoelium hospes infections. A great variation in geographic prevalence was observed. Sufficient knowledge was acquired to demonstrate both the importance of fascioliasis in some areas and also the high prevalence of D. hospes in other areas. We suggest that the difference in prevalence from one geographic area to another is influenced by local climatic conditions, presence or absence of rivers and lakes, and differences in livestock management practices by various ethnic groups.

This review summarises epidemiological and clinical data of HIV infection who was recognized in Mali since 1985. The most important rate of seropositivity for HIV is observed in the prostitutes group (40%). The estimated seroprevalence for adult population is between 1% and 5%. 46 cases for AIDS are reported in both sexes. The mean age is 35 years. Main signs are weight loss (91%), fever (80%), diarrhea (70%) and lymphadenopathy (50%). Three among the five cases of Kaposi's sarcoma are aggressive. 19.5% of AIDS have antibodies to HIV1, 41.3% to HIV2 and 39.1% to HIV1 and HIV2. Death rate is more than 50%. These data are compared with other countries of Africa.