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Background: Following WHO guidelines, microscopy is the reference for malaria diagnosis in endemic countries. The Parasitology-Mycology laboratory (LPM) is the National Reference Laboratory and is currently undergoing ISO 15189 accreditation. In this perspective, we proceeded to laboratory verification through assessing the performance of the laboratory by confirming the reliability and the accuracy of the results obtained in accordance with the requirements of the ISO 15189 standards. This study aimed to verify the method of microscopic diagnosis of malaria at the LPM, in the Aristide Le Dantec hospital (HALD) in Dakar, Senegal. Methods: This is a validation/verification study conducted from June to August 2020. Twenty (20) microscopic slides of thick/thin smear with known parasite densities (PD) selected from the Cheick Anta Diop University malaria slide bank in Dakar were used for this assessment. Six (6) were used to assess readers' ability to determine PD and fourteen (14) were used for detection and identification of parasites. Four (4) LPM-HALD microscopists read and recorded their results on prepared sheets. Data analysis was done with Microsoft Excel 2010 software. Results: Of these twenty (20) slides read, a 100% agreement was obtained on eight (8) slides. Four (4) out of the six (6) parasite density evaluation slides obtained a concordance of less than 50%. Thirteen (13) out of the fourteen (14) identification slides obtained a concordance greater than 50%. Only one (1) identification slide obtained zero agreement from the readers. On the other hand, for species identification it was noted a score greater than 80% and the PD obtained a score between 0.20 and 0.4. Readers obtained 100% precision, sensitivity, specificity and both negative and positive predictive values. Conclusion: This work demonstrated that the microscopic method of malaria diagnosis used in the LPM/HALD are in accoradance with all the reliability required by ISO 15189.

In the context of increasing incidence of fungal infections worldwide, the availability of antifungal drugs was studied in Senegal, a country with limited resources where diagnosis of invasive fungal infections is not often established by lack of specialists and/or diagnostic tools. After a background on the country's situation with regard to fungal infections and the drug distribution network in Senegal, a compilation of the various available antifungals was presented before concluding with recommendations to prepare for a situation that could allow to treat appropriately invasive mycoses.

Background The diagnosis of malaria cases in regions where the malaria burden has decreased significantly and prevalence is very low is more challenging, in part because of reduced clinical presumption of malaria. The appearance of a cluster of malaria cases with atypical symptoms in Mbounguiel, a village in northern Senegal where malaria transmission is low, in September 2018 exemplifies this scenario. The collaboration between the National Malaria Control Programme (NMCP) at the Senegal Ministry of Health and the Laboratory of Parasitology and Mycology at Cheikh Anta Diop University worked together to evaluate this cluster of malaria cases using molecular and serological tools. Methods Malaria cases were diagnosed primarily by rapid diagnostic test (RDT), and confirmed by photo-induced electron transfer-polymerase chain reaction (PET-PCR). 24 single nucleotide polymorphisms (SNPs) barcoding was used for Plasmodium falciparum genotyping. Unbiased metagenomic sequencing and Luminex-based multi-pathogen antibody and antigen profiling were used to assess exposure to other pathogens. Results Nine patients, of 15 suspected cases, were evaluated, and all nine samples were found to be positive for P. falciparum only. The 24 SNPs molecular barcode showed the predominance of polygenomic infections, with identifiable strains being different from one another. All patients tested positive for the P. falciparum antigens. No other pathogenic infection was detected by either the serological panel or metagenomic sequencing. Conclusions This work, undertaken locally within Senegal as a collaboration between the NMCP and a research laboratory at University of Cheikh Anta Diop (UCAD) revealed that a cluster of malaria cases were caused by different strains of P. falciparum. The public health response in real time demonstrates the value of local molecular and genomics capacity in affected countries for disease control and elimination.

Pityriasis versicolor (PV) is a superficial mycosis caused by yeast of the genus Malassezia. The most common isolated Malassezia species in PV lesions differ among M. furfur, M. globosa and M. sympodialis. We purpose to determine the distribution of Malassezia species in PV patients at the seafarers’ medical service in Dakar, Senegal and to examine whether any association between identified Malassezia species and patients’ profile. From May 2017 to August 2017, first a questionnaire was filled to get informative data before collection of skin scrapings taken from most scaly site using sterile scalpel blade and application of scotch® for direct examination (DE). At the laboratory, DE, culture and identification by MALDI-TOF MS were done. One hundred patients with PV – all men – were included with a mean age of 34 years. Among seafarers, 81% were sailors. Clinical prevalence of PV was highest in aged adults patients with ages of 31 to 60 years (56%). Seafarers with high level of education were less representative with only 2%. The mean duration of the PV was 26.83 months. 20% of subjects suffered lesions in more than one location. The chest was the most affected anatomical site. Furthermore, possible predisposing factors associated with PV were also detected. DE was positive in 95% but culture growth only in 46%. MALDI-TOF MS analysis of the positive cultures could be performed in 84.8% (39/46). Only M. furfur was identified in 100% (39/39). In definitive, M. furfur is the only causative agent of PV in Dakar.

Background Malaria control and elimination strategies are based on levels of transmission that are usually determined by data collected from health facilities. In endemic areas, asymptomatic Plasmodium infection is thought to represent the majority of infections, though they are not diagnosed nor treated. Therefore, there might be an underestimation of the malaria reservoir, resulting in inadequate control strategies. In addition, these untreated asymptomatic Plasmodium infections maintain transmission, making it difficult or impossible to reach malaria elimination goals. Thus, the aim of this study was to determine the prevalence of asymptomatic Plasmodium infections in southeastern Senegal. Methods A cross sectional study was conducted among asymptomatic individuals (N = 122) living in the village of Andiel located in Bandafassi, Kédougou, which consisted of about 200 inhabitants during the malaria transmission season in late October 2019. For each individual without malaria-related symptoms and who consented to participate, a rapid diagnostic test (RDT) was performed in the field. Results were confirmed in the laboratory with photo-induced electron transfer (PET-PCR). Results Malaria prevalence was 70.3% by PET-PCR and 41.8% by RDT. During the same period, the health post of the area reported 49. 1% test positivity rate by RDT. The majority of the infected study population, 92.9%, was infected with a single species and 7.1% had two or three species of Plasmodium. Plasmodium falciparum was predominant and represented 90.2% of the infections, while 6.5% were due to Plasmodium ovale and 3.3% to Plasmodium malariae. 59.4% of children targeted for SMC (zero to ten years old) were infected. Conclusion In southeastern Senegal, where the transmission is the highest, malaria control strategies should address asymptomatic Plasmodium infections at the community level. The results suggest that this area could be eligible for mass drug administration. Moreover, non-falciparum species could be more common and its prevalence should be determined countrywide.

BACKGROUND In developing countries, superficial fungal infections (SFI) are endemic and cause a therapeutic problem because of the duration and cost of treatment. Community living and promiscuity are key factors in the direct or indirect transmission and spread of these diseases. OBJECTIVES The objective was to study the epidemiological aspects of SFI, among koranic school children in two localities in Senegal. PATIENTS/METHODS School koranic students were recruited in Thies and Touba. Diagnosis of fungal diseases was carried out using conventional techniques (microscopic examination and culture). RESULTS Among 210 children, the overall prevalence of SFI was 25.71%, with 27.63% in Touba and 20.68% in Thies. The clinical lesions were epidermophytosis (0.5%), intertrigo (0.9%), palmoplantar keratoderma (KPP) (0.9%), onychomycosis (7.7%) and tinea capitis (TC) (90%). The species responsible for the SFI were Trichophyton soudanense (85.18%), Microsporum audouinii langeronii (9.25%), Trichophyton rubrum (3.70%) and Chrysosporium keratinophilum (1.85%). The prevalence of infection was higher among boys (85.18%). CONCLUSION Superficial fungal infections are prevalent in koranic school children and attention should be given to non-dermatophytic species that could be responsible for SFI.

Mycetoma is a neglected tropical disease which is endemic in Senegal. Although this subcutaneous mycosis is most commonly found on the foot, extrapodal localisations have also been found, including on the leg, knee, thigh, hand, and arm. To our knowledge, no case of blood-spread eumycetoma has been reported in Senegal. Here, we report a case of pulmonary mycetoma secondary to a Madurella mycetomatis knee eumycetoma. The patient was a 41-year-old farmer living in Louga, Senegal, where the Sudano-Sahelian climate is characterised by a short and unstable rainy season and a steppe vegetation. He suffered a trauma to the right more than 20 years previously and had received treatment for more than 10 years with traditional medicine. He consulted at Le Dantec University Hospital in Dakar for treatment of a right knee mycetoma which had been diagnosed more than 10 years ago. He had experienced a chronic cough for more than a year; tuberculosis documentation was negative. Grains collected from the knee and the sputum isolated M. mycetomatis, confirmed by the rRNA gene ITS regions nucleotide sequence analysis. An amputation above the knee was performed, and antibacterial and antifungal therapy was started with amoxicillin-clavulanic acid and terbinafine. The patient died within a month of his discharge from hospital.

Angioimmunoblastic T-cell lymphoma (AITL) is a rare hematologic malignancy recognized in the WHO 2016 classification as a clinical and histological entity. It is a very poorly described disease in Africa due to its rarity and diagnostic difficulties, particularly differential diagnosis with tuberculosis. Here, we report a 57-year-old man who presented with fever, weight loss, and lymphadenopathies. The diagnosis of tuberculosis was carried out based on lymph node fine needle aspiration showing the image of tuberculous adenitis and CT images in favor of necrotic lymphadenopathies. The presence of autoantibodies and the failure of tuberculosis treatment led us to perform a biopsy with immunostaining that confirmed pathological features of AITL. The patient was treated by CHOP-based chemotherapy, and complete remission was achieved. This case highlights the difficulty of recognizing AITL and the importance of considering other potential differential diagnoses of tuberculosis in the endemic region.

In 2006, Senegal adopted artemisinin-based combination therapy (ACT) as first-line treatment in the management of uncomplicated malaria. This study aimed to update the status of antimalarial efficacy more than ten years after their first introduction. This was a randomized, three-arm, open-label study to evaluate the efficacy and safety of artemether-lumefantrine (AL), artesunate-amodiaquine (ASAQ) and dihydroartemisinin-piperaquine (DP) in Senegal. Malaria suspected patients were screened, enrolled, treated, and followed for 28 days for AL and ASAQ arms or 42 days for DP arm. Clinical and parasitological responses were assessed following antimalarial treatment. Genotyping (msp1, msp2 and 24 SNP-based barcode) were done to differentiate recrudescence from re-infection; in case of PCR-confirmed treatment failure, Pfk13 propeller and Pfcoronin genes were sequenced. Data was entered and analyzed using the WHO Excel-based application. A total of 496 patients were enrolled. In Diourbel, PCR non-corrected/corrected adequate clinical and parasitological responses (ACPR) was 100.0% in both the AL and ASAQ arms. In Kedougou, PCR corrected ACPR values were 98.8%, 100% and 97.6% in AL, ASAQ and DP arms respectively. No Pfk13 or Pfcoronin mutations associated with artemisinin resistance were found. This study showed that AL, ASAQ and DP remain efficacious and well-tolerated in the treatment of uncomplicated P. falciparum malaria in Senegal.

Background Northern Senegal is a zone of very low malaria transmission, with an annual incidence of Methods A modified snowball sampling survey of nomadic pastoralists was conducted in five districts in northern Senegal during September and October 2014. Demographic information and dried blood spots were collected. Multiplex bead-based assays were used to assess antibody responses to merozoite surface protein (MSP-119) antigen of the four primary Plasmodium species, as well as circumsporozoite protein (CSP) and liver stage antigen (LSA-1) of Plasmodium falciparum. Results In the five study districts, 1472 individuals were enrolled, with a median age of 22 years (range 1 to 80 years). Thirty-two percent of subjects were under 14 years and 57% were male. The overall seroprevalence of P. falciparum MSP-119, CSP and LSA-1 antibodies were 45, 12 and 5%, respectively. Plasmodium falciparum MSP-119 antibody responses increased significantly with age in all study areas, and were significantly higher among males. The highest seroprevalence to P. falciparum antigens was observed in the Kanel district (63%) and the lowest observed in Podor (28%). Low seroprevalence was observed for non-falciparum species in all the study sites: 0.4, 0.7 and 1.8%, respectively, for Plasmodium ovale, Plasmodium vivax and Plasmodium malariae MSP-1. Antibody responses to P. vivax were observed in all study sites except Kanel. Conclusion Prevalence of P. falciparum MSP-119 antibodies and increases by study participant age provided data for low levels of exposure among this transient nomadic population. In addition, antibody responses to P. falciparum short half-life markers (CSP and LSA-1) and non-falciparum species were low. Further investigations are needed to understand the exposure of the Fulani population to P. vivax.

Introduction Health facility-based records offer a rich source of information to understand trends and changes in malaria cases over time. This study is aimed at determining the changes in malaria occurrence over the last 28 years, from 1989 to 2016 in Dakar, Senegal. Methods Laboratory suspected and confirmed malaria records from 1989 to 2016 were reviewed from the laboratory registers of the Laboratory of Parasitology and Mycology of Aristide Le Dantec Hospital. Interrupted time series (ITS) analysis was used to estimate the changes by comparing malaria cases post-intervention (2006–2016) with that of the pre-intervention (1989–2005) period. Results A total of 5,876 laboratory confirmed malaria cases were reported out of 29,852 tested cases, with total slide positivity rate (SPR) of 19.7%. Malaria case counts exhibited a fluctuating trend with major peaks occurring in the years 1995 and 2003 with SPR of 42.3% and 42.5%, respectively. Overall, a remarkable decline in the total number of laboratory confirmed malaria cases was observed over the last 28 years. P. falciparum was almost the only reported species, accounting for 99.98% of cases. The highest SPR was observed in the age group of under five years during the pre-intervention period while this shifted to the age group of 6–15 years old for the subsequent years. Two major malaria peak seasons were observed: one in September during the pre-intervention period and the other in November for the post-intervention period. The ITS analysis showed a dramatic decline of 83.6% in SPR following the scale-up of interventions in 2006. Conclusion A remarkable decline in laboratory confirmed malaria cases in Dakar over 28 years was observed. The period of rapid decline in malaria SPR coincided with the scale-up in interventions beginning in 2006 with the introduction of ACTs, followed by the widespread introduction in 2008 of bed nets treated with insecticides. Robust surveillance data should be maintained in the context of malaria elimination efforts.

Resume Introduction L’intertrigo interorteils (IIO) d’origine mycosique est une pathologie frequente essentiellement due a des dermatophytes et a des levures. Fusarium sp. est rarement incrimine dans la genese d’intertrigo. A Dakar, une etude recemment realisee en 2016 sur l’IIO fongique avait montre que les Fusarium etaient plus impliques dans l’etiologie des IIO que les dermatophytes, venant juste apres les levures dominees par les Candida. Suite a cela, nous avons voulu attirer l’attention sur l’incidence croissante des IIO impliquant Fusarium spp. a Dakar (Senegal) et analyser les particularites epidemiologiques et mycologiques de ces IIO a Fusarium spp. Patients et methodes Une etude retrospective incluant tous les patients recus au laboratoire pour suspicion d’IIO entre le 1 er janvier 2014 et le 30 juin 2017 a ete menee. Le diagnostic etait base sur l’examen myologique, comprenant l’examen direct et la culture. L’analyse mycologique a ete consideree comme positive lorsque l’examen direct et la culture etaient positifs apres au moins une repetition. Resultats Vingt-neuf cas d’IIO a Fusarium representant 44,6 % de tous les IIO de la periode d’etude ont ete diagnostiques chez 15 hommes et 14 femmes. L’âge moyen des patients etait de 48,4 ans. Les IIO ont ete diagnostiques chez des patients immunocompetents sauf chez deux diabetiques. La duree moyenne des lesions etait de 6,83 ans. Les especes impliquees appartenaient majoritairement au complexe d’espece Fusarium solani avec 19 cas. Conclusion L’IIO a Fusarium chez un sujet sain necessite une surveillance reguliere car toute diminution ulterieure des defenses immunitaires pourrait entrainer une dissemination hematogene mortelle.

While investigating a signal of adaptive evolution in humans at the gene LARGE, we encountered an intriguing finding by Dr. Stefan Kunz that the gene plays a critical role in Lassa virus binding and entry. This led us to pursue field work to test our hypothesis that natural selection acting on LARGE—detected in the Yoruba population of Nigeria—conferred resistance to Lassa Fever in some West African populations. As we delved further, we conjectured that the “emerging” nature of recently discovered diseases like Lassa fever is related to a newfound capacity for detection, rather than a novel viral presence, and that humans have in fact been exposed to the viruses that cause such diseases for much longer than previously suspected. Dr. Stefan Kunz’s critical efforts not only laid the groundwork for this discovery, but also inspired and catalyzed a series of events that birthed Sentinel, an ambitious and large-scale pandemic prevention effort in West Africa. Sentinel aims to detect and characterize deadly pathogens before they spread across the globe, through implementation of its three fundamental pillars: Detect, Connect, and Empower. More specifically, Sentinel is designed to detect known and novel infections rapidly, connect and share information in real time to identify emerging threats, and empower the public health community to improve pandemic preparedness and response anywhere in the world. We are proud to dedicate this work to Stefan Kunz, and eagerly invite new collaborators, experts, and others to join us in our efforts.

Recently in Senegal, a case of Plasmodium ovale malaria had led to a diagnostic difficulty due to the ignorance of this parasite and the neglect of it. The objective of this study was to actively investigate cases of P. ovale malaria that would be misdiagnosed in the health centre structures of Senegal. The study was conducted in three areas that reflect different epidemiological strata of malaria. Microscopy was performed by microscopy experts on suspected malaria patients. The results were validated by Rougemont real-time PCR. Positive P. ovale cases were genotyped by nested PCR targeting the potra gene. A total of 406 samples were taken. Microscopy of Giemsa stained thick and thin smears recorded 228 cases of Plasmodium falciparum (97%), 3 cases of Plasmodium malariae (1.3%), and 4 cases of P. ovale (1.7%). The cases of P. ovale observed at microscopy were confirmed by real-time PCR. Genotyping of P. ovale revealed 3 cases of P. ovale wallikeri and 1 case of P. ovale curtisi. The prevalence of P. ovale malaria remains low in Senegal. However, malaria microscopists should be trained to recognize non-falciparum species in order to avoid the diagnostic delays and unnecessary investigations. National malaria control program should consider those species for the better management of malaria control in the country. Simplified molecular methods like, loop-mediated isothermal amplification (LAMP) may be useful to better characterize the epidemiology of non-falciparum malaria.

Blood transfusion is an essential therapeutic tool in the treatment of sickle cell disease. Its indications and modalities vary from one country to another as a function of the clinical severity of the disease and the availability of blood products. This study seeks to evaluate the frequency and modalities of blood transfusions as well as their indications in patients with sickle cell syndrome at the Dakar hematology department from 1995 through 2015. This retrospective study reviewed the records of a cohort of 1078 patients with SS, SC, Sβ0 and Sβ + thalassemia sickle cell syndromes and collected data about the type of blood products, indications, modalities, and acute transfusion complications. The frequency of transfusion was adjusted for age, sex, and sickle cell profile. The patients' mean age was 23 years (2-44 years) and the sex ratio 0.9. SS disease was predominant (87.4 %); 28.5% had transfusions during the study period. Patients older than 20 years received more transfusions (P = 0.047). The frequency of transfusions did not differ significantly by gender (P = 0.12), but did by profile: a higher percentage of patients with SS disease required transfusion (P = 0.043). Acute anemia was the most common indication for transfusion (50.03 %). Acute transfusion complications were rare (5.8 %). This study shows that less than one third of sickle cell anemia patients in Senegal have transfusions, a finding that confirms that our patients have fewer transfusions than patients in other countries in Africa or in the West. This limited use of transfusion therapy may be related to a less severe level of disease among patients in Senegal, but also to the availability of blood products.

To identify the protozoa responsible for intestinal parasitosis diagnosed at Le Dantec University Hospital in Dakar, Senegal. The retrospective study included 2578 patients for whom stool samples were analyzed from 2011 to 2015. The sex ratio was 1.1. Patients' mean age was 28.5 years, with a range of 11 days to 91 years. Direct examination and the Ritchie technique were performed to search for parasites. In total, 317 patients had intestinal protozoa, for a prevalence of 12.3 %. Infections involved one (91%) or two parasites (9%). The most common species found alone were Entamoeba coli (51.5%), E. histolytica/E. dispar (17 %), and Giardia intestinalis (10.5%). The most common associations were E. coli with G. intestinalis (3.6 %) and with E. histolytica (2.4%). These infections affected significantly more outpatients than inpatients (65 %, p = 0.0049) and slightly more women (51.1%, p = 0.22) than men. Adults accounted for 67% of the confirmed intestinal protozoa: 39% aged 31-60 years, 28% aged 15-30, and only 7% older than 60 (p = 0.5). Most of the protozoa isolated were non-pathogenic. However, health education should be promoted in addition to the mass treatment program already begun to limit and even halt the spread of these neglected diseases.

Fungal interdigital tinea pedis (FITP) is the most frequent dermatomycosis in industrial countries. In African tropics, it's a rare motive of consultation and is discovered while complicated. The aims of this article were: to determine the frequency of interdigital tinea pedis among overall mycological analysis in our laboratory; to study epidemiological, clinical and mycological aspects of FITP in outpatients attending the Le Dantec mycology laboratory in Dakar. A total of 62 males (60%) and 42 females (40%), mean age: 43.15 years (range: 11-81 years), were received from January 2011 to December 2015 for suspicion of FITP. Skin specimens were taken from all patients for microscopy and fungal culture. The frequency of ITP represents 5.6% (104/1851) among our overall mycological analysis. FITP was confirmed in 68 patients (SPI=65.38%), mainly located between the 4th and 5th toes and 71 fungal species were isolated (CPI=68.27%). Among patients with confirmed FITP, there were 38 males (56%) and 30 females (44%). The prevalence was highest in patients between 44 and 54 years (26%). Candida albicans, Fusarium solani and Trichophyton interdigitale were shown to be the most common pathogens respectively for yeasts (39%), non-dermatophytic filamentous fungi (NDFF; 21%) and dermatophytes (11%). So FITP isn't a common reason for consultation in Dakar but its simple parasitic index (SPI) is still very high and dermatophytes formerly the main causative agents are being relegated to third place behind yeasts and NDFF.

Resume Introduction Les mycoses superficielles, surtout de la peau, du cuir chevelu et des ongles, sont tres frequentes et ont ete rapportees dans le monde entier. Les champignons les plus frequents agents de ces mycoses sont les dermatophytes, les levures et les moisissures. Cependant, ces agents varient avec le temps et sont fonction de nombreux facteurs notamment geographiques. L’objectif de cette etude etait d’identifier les champignons agents de mycoses superficielles diagnostiquees au CHU Le Dantec de Dakar (Senegal). Materiel et methodes Cette etude a interesse 1851 patients recenses au laboratoire de parasitologie et mycologie de l’hopital Aristide Le Dantec, durant la periode allant de janvier 2011 a decembre 2015. Chacun de ces patients a beneficie d’un examen direct et d’une culture mycologique. Resultats De ces 1851 patients, 633 etaient confirmes porteurs de mycose superficielle, soit une prevalence de 34,2 %. L’âge des patients variait de deux mois a 81 ans avec une moyenne d’âge de 31 ans. Les mycoses superficielles etaient plus retrouvees chez les femmes (70,3 %) que chez les hommes (29,7 %) et un peu plus de trente-neuf pour cent (39,3 %) etaient des adultes âges. Les agents identifies etaient : les dermatophytes (58 %), les levures (36,7 %) et les moisissures (5,3 %). Les especes les plus isolees etaient : Candida albicans (26,9 %), Trichophyton soudanense (24,9 %) et Trichophyton rubrum (13,7 %). Ces differents champignons etaient responsables de differentes atteintes cliniques, certaines isolees et d’autres associees. Parmi les atteintes isolees, celles touchant les cheveux ( tinea capitis ) etaient de loin les plus importantes avec 44,8 %, suivis des atteintes des ongles ( tinea unguium ) (34,5 %). Les associations etaient surtout a type de teigne du cuir chevelu et onychomycose des mains (2,4 %) et d’onychomycose associee a un intertrigo au niveau des pieds (2,7 %). Les agents de tinea capitis etaient exclusivement les dermatophytes dont l’agent predominant etait T . soudanense avec 47,8 %. Par contre, les agents de tinea unguium etaient des levures (79 %), des dermatophytes (18 %) ou des moisissures (3 %) et l’espece la plus retrouvee etait C . albicans (63,9 %). Les dermatophytes, les levures et les moisissures etaient respectivement plus retrouvees chez les enfants et adultes jeunes, chez les adultes âges et les adultes jeunes et chez les adultes âges et les personnes âgees. Conclusion En definitive, ces donnees epidemiologiques devraient permettre une meilleure prise en charge diagnostique et therapeutique des mycoses superficielles dues a ces champignons.

Resume Une patiente senegalaise de 17 ans a presente un onyxis de la main droite sur tous les doigts, excepte le pouce, evoluant depuis environ 10 ans. L’analyse mycologique a l’examen direct a la potasse a 20 % a montre de nombreux filaments myceliens arthrospores. La culture des prelevements a revele Microsporum langeronii dans un premier temps. L’analyse mycologique a ete reprise, avec en plus, un prelevement mycologique du cuir chevelu meme si la patiente ne presentait pas de plaques d’alopecie apparentes sur la tete qui etait, par contre, recouvert de squames abondantes. Le prelevement des cheveux a revele une teigne microsporique a M . langeronii alors que la culture des debris d’ongle avait confirme dans un second temps M . langeronii mais associe aussi a Trichophyton soudanense dans l’onyxis.

The chikungunya virus (CHIKV) is spread by Aedes aegypti and Ae. albopictus mosquitos worldwide, infection can lead to disease including joint pain, fever, and rash, with some convalescent persons experiencing chronic symptoms. Historically, CHIKV transmission has occurred in Africa and Asia, but recent outbreaks have taken place in Europe, Indonesia, and the Americas. From September to October 2014, a survey was undertaken with nomadic pastoralists residing in the northeast departments of Senegal. Blood dried on filter paper (dried blood spots, DBS) were collected from 1465 participants of all ages, and assayed for Immunoglobulin G (IgG) antibodies against CHIKV E1 antigen by a bead-based multiplex assay. The overall seroprevalence of all participants to CHIKV E1 was 2.7%, with no persons under 10 years of age found to be antibody positive. Above 10 years of age, clear increases of seroprevalence and IgG levels were observed with increasing age, 7.6% of participants older than 50 years were found to be positive for anti-CHIKV IgG. Reported net ownership, net usage, and gender were all non-significant explanatory variables of seropositivity. These data show a low-level historical exposure of this pastoralist population to CHIKV, with no evidence of recent CHIKV transmission in the past decade.

Background Mycetoma is a pathological process in which fungal or actinomycotic agents of exogenous origin produce grains. In the absence of data on the global burden, it is important to map mycetoma cases, which are useful to implement control strategies. Objective The objective of this study was to map mycetoma cases diagnosed in Senegal over a period of eighteen years. Methodology The cases of mycetoma identified in the laboratory of Mycology at Aristide Le Dantec Hospital were extracted from the notebooks; information on the dates of collection, geographical origin and fungal agent identified was entered in Excel and analysed. Results Three hundred and thirty-seven cases of mycetoma were diagnosed from 1993 to 2016 at Aristide Le Dantec Hospital. Mapping shows that overall, the western zone presented the majority of cases 47% (120), followed, respectively, by the central zone 32% (80), the northern zone 18% (47) and the southern zone 2% (6). However, over the years, this distribution is different with a decrease in cases from the periods 1993-2000 and 2011-2016 of 19% in the western and a progressive increase of cases in northern and central zones of, respectively, 13% and 14%. In the 1990s, the cases were predominant in Dakar, Louga and Diourbel. During 2011-2016, Thies, Diourbel, Fouta and Louga presented more cases. Conclusion The spatial distribution of mycetoma in Senegal changed over the years, most frequent in the west of the country, and during 1993 to 2000, mycetoma is now more common in the north.

Introduction Candida infections are most frequently encountered on the skin and nails. Their proportions vary according to geoclimatic and sociocultural conditions. The objective of this study was to determine the prevalence of skin and/or nail candidiasis diagnosed in the parasitology and mycology laboratory of Le Dantec University Hospital in Dakar, Senegal. Materials and methods This study included 994 patients with suspected skin and/or nail mycosis tested at the parasitology and mycology laboratory during the 8-year study period of 2008-2015. Each patient had both a direct examination and a mycological culture. Results The patients' median age was 34 with an interquartile range of 25 years. Of these 994 patients, 613 had confirmed skins and/or nail fungal infections. In descending order, the fungi isolated and identified from these mycoses were Candida (n= 387, 63.1%), dermatophytes (28.4%), and mold (8.5%). Thus Candida accounted for nearly two thirds of the skin and/or nail mycoses and had a prevalence rate among the patients with suspected skin or nail candidiasis of 38.9%. These skin/nail sites was more common among women (72%) than men (28%), and slightly more than half of them (50,1%) were adults aged 31 to 60 years. The duration of candidiasis exceeded a full year for 76.3%. Onychomycoses were found more frequently (65.24%) than epidermomycoses, and both sites were infected in 5.17%. Candida albicans was the species isolated most frequently, accounting for 80% of Candida specimens. Conclusion Our results reinforce the importance of mycological confirmation of the diagnosis. The mycology laboratory has a crucial role in making the differential diagnosis with other dermatoses of similar clinical appearance and thus in guiding the choice of treatment.

Classically, dermatophytes are identified by phenotypic methods even if these methods, sometimes, remain difficult or uncertain. On the other hand, nucleotide sequence analysis of internal transcribed spacers (ITS) of rDNA has proved to be a useful method for identification of dermatophytes. The objective of this study was to compare the phenotypic method with DNA sequencing of the ITS regions for identification of dermatophyte species isolated in Dakar, Senegal. A collection of thirty-two strains of dermatophytes were isolated from patients suffering from dermatophytosis. Mycological identification revealed Trichophyton soudanense (n = 13), T. interdigitale (n = 10), Microsporum audouinii (n = 5), and one strain for each of the following species: T. rubrum, T. mentagrophytes, and M. canis and one unidentified strain. For comparison, ITS-based PCR and DNA sequencing were applied for identification of the isolated dermatophytes. ITS sequences showed, in BLAST search analysis, 99-100% of similarity. Identification of dermatophyte isolates by conventional methods was confirmed by DNA sequencing of the ITS regions in 84% of cases. Discrepancies concern mostly T. rubrum misidentified as T. interdigitale. PCR sequencing provided an excellent tool for identifying dermatophyte strains that do not present typical morphological characteristics. It was also able to give correct identification of an atypical strain of M. audouinii responsible of mycetoma of the scalp.

In developing countries where systemic antifungal are often unavailable, treatment of filamentous fungi infection as Fusarium is sometimes very difficult to treat. We report the case of a keratomycosis due to Fusarium oxysporum treated by povidone iodine eye drops and oral fluconazole. The diagnosis of abscess in the cornea was retained after ophthalmological examination for a 28-year-old man with no previous ophthalmological disease, addressed to the Ophthalmological clinic at the University Hospital Le Dantec in Dakar for a left painful red eye with decreased visual acuity lasting for 15 days. The patient did not receive any foreign body into the eye. Samples by corneal scraping were made for microbiological analysis and the patient was hospitalized and treated with a reinforced eye drops based treatment (ceftriaxone+gentamicin). The mycological diagnosis revealed the presence of a mold: F. oxysporum, which motivated the replacement of the initial treatment by eye drops containing iodized povidone solution at 1% because of the amphotericin B unavailability. Due to the threat of visual loss, oral fluconazole was added to the local treatment with eye drops povidone iodine. The outcome was favorable with a healing abscess and visual acuity amounted to 1/200th. Furthermore, we noted sequels such as pannus and pillowcase. The vulgarization of efficient topical antifungal in developing countries would be necessary to optimize fungal infection treatment.

To determine fungal species distribution of interdigital intertrigo among seafarers in Dakar, Senegal, a cross-sectional study was carried out from May to August 2017 among seafarers clinically diagnosed with interdigital intertrigo. A questionnaire was filled to each patient before sampling the affected folds and transporting to Aristide Le Dantec University Hospital where mycological analyses were realized. Species identification by MALDI-TOF MS was performed in Marseille, France. In total, 169 men (21-66 years) were included. Few of them (3%) had a high level of education and the duration of the mycosis exceed 10 years for 88% of patients. Direct microscopic examination (ME) was positive in 34.3%. Among samples with positive ME, 58.6% had positive culture. An overall incidence of 30.2% was found. Patients with confirmed cases aged between 28 and 66 years. Among them, those between 36-50 years were predominant (52.9%). Those with a high level of education were less representative (2%). For 52.1% of patients, the duration of the mycosis was superior to 10 years. Furthermore, 57% of cases were significantly associated with other types of tinea pedis and/or onychomycosis (P=0.03). Culture was positive in 23.7% isolating 43 strains successfully identified at the species level by MALDI-TOF MS for 31 isolates: 20 Candida and 11 dermatophytes. The rest was identified only at the genus level belonged to Fusarium. In definitive, MALDI-TOF MS could be a useful tool for routine and fast identification of dermatophytes, yeasts and NDFF in clinical mycology laboratories.

La leucemie prolymphocytaire T est une hemopathie lymphoide tres rare, de phenotype post thymique et reputee de mauvais pronostic. Elle se caracterise par un syndrome tumoral, des lesions dermatologiques et une lymphocytose importante. Elle doit etre differenciee des autres syndromes lymphoproliferatifs matures a cellules T et meme de la leucemie prolymphocytaire B et ceci ne peut se faire qu’avec une approche multidisciplinaire.

Resume Introduction Les teignes du cuir chevelu (TCC) posent un probleme de sante publique au Senegal. Le but de ce travail a ete d’etudier l’evolution de l’incidence, les aspects mycologiques et epidemiologiques des TCC diagnostiquees a l’hopital Aristide-Le-Dantec de Dakar. Materiel et methodes Nous avons mene une etude retrospective ayant porte sur la totalite des prelevements de cuir chevelu realises au laboratoire de parasitologie-mycologie sur une periode de 6 ans (2008–2013). Resultats Un total de 1640 prelevements du cuir chevelu a ete realise, dont 566 etaient positifs a l’examen direct et a la culture. Nous avons note la diminution du nombre de prelevements et de l’incidence des teignes au cours des 6 annees une variation allant de 147 (46,82 %) a 37 (22,02 %). L’incidence moyenne des teignes au cours des six annees etait de 34,51 %. L’âge des patients variait entre 1 et 83 ans avec une moyenne d’âge de 27,33 ans. La tranche d’âge comprise entre 20 et 29 ans a ete la plus infestee (10,61 %), suivie de celles entre 0 et 9 ans (7,19 %), 10 et 19 ans (6,04 %), et celle entre 30 et 39 ans (5,91 %). La prevalence des teignes etait plus elevee chez les sujets de sexe feminin 469 (82,9 %) que chez le sexe masculin 97 (17,1 %). Les dermatophytes les plus isoles etaient : Trichophyton soudanense dans 318 cas (56,18 %), Trichophyton rubrum dans 104 cas (18,37 %), Microsporum langeronii dans 72 cas (12,72 %), Microsporum canis dans 36 cas (6,36 %), et Trichophyton mentagrophytes dans 26 cas (4,60 %). Conclusion Ces resultats ont montre une diminution de l’incidence annuelle des TCC pendant la periode d’etude et une augmentation nette des teignes trichophytiques. Cette etude a aussi montre que les TCC sont des dermatophyties frequentes au Senegal et touchent surtout les jeunes femmes d’âge compris entre 20 et 29 ans.