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Chantelli Iamblaudiot Razafindrazoto,1 Nitah Harivony Randriamifidy,1 Behoavy Mahafaly Ralaizanaka,2 Jean Tsitamita Andrianoelison,1 Haga Tsilavo Ravelomanantsoa,1 Mialitiana Rakotomaharo,1 Domoina Harivonjy Hasina Laingonirina,1 Sonny Maherison,1 Jolivet Auguste Rakotomalala,3 Anjaramalala Sitraka Rasolonjatovo,1 Andry Lalaina Rinà Rakotozafindrabe,1 Tovo Harimanana Rabenjanahary,1 Soloniaina Hélio Razafimahefa,2 Rado Manitrala Ramanampamonjy1 1Gastroenterology Unit, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar; 2Hepato-Gastroenterology Unit, University Hospital Andrainjato, Fianarantsoa, Madagascar; 3Hepato-Gastroenterology Unit, University Hospital Mahavoky Atsimo, Mahajanga, MadagascarCorrespondence: Chantelli Iamblaudiot Razafindrazoto, Gastroenterology Unit, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, Email iamblaudiotchantelli@yahoo.comBackground: Cirrhosis is a pathology responsible for a significant hospital morbidity and mortality. The objective of this study was to determine the factors associated with hospital mortality in a sample of Malagasy cirrhotics.Patients and Methods: This was a retrospective cohort study from January 2018 to August 2020 conducted in the Hepato-Gastroenterology Unity, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar.Results: One hundred and eight patients were included. The mean age was 51.13± 13.50 years with a sex ratio of 2.37. The etiology of cirrhosis was dominated by alcohol (44.44%), hepatitis B virus (24.07%) and hepatitis C virus (13.89%). Twenty-eight patients (25.93%) had died. Factors associated with in-hospital mortality were hepatic encephalopathy (OR: 14.16; 95% CI: 5.08– 39.4; p: 0.000), renal failure (OR: 8.55; 95% CI: 2.03– 39.9; p: 0.0034), gastrointestinal bleeding (OR: 3.25; 95% CI: 1.32– 7.92; p: 0.0099), hyponatraemia < 130mmol/L (OR: 3.34; 95% CI: 1.04– 10.6; p=0.046), Child-Pugh C classification (OR: 0.19; 95% CI: 0.12– 0.21; p: 0.000), and MELD-Na score > 32 (OR: 27.5; 95% CI: 4.32– 174.8; p: 0.004).Conclusion: The in-hospital mortality rate during acute decompensation of cirrhosis remains high in Madagascar. Hepatic encephalopathy, renal failure, GI bleeding and hyponatraemia are the main clinico-biological factors affecting in-hospital mortality. Early intervention on these modifiable factors is an important step to improve hospital outcomes. The natraemia, MELD score and MELD-Na score should be used in routine practice in Madagascar to identify patients with acute decompensation of cirrhosis at high risk of death.Keywords: risk factors, in-hospital mortality, liver cirrhosis, Madagascar

Behoavy Mahafaly Ralaizanaka,1 Chantelli Iamblaudiot Razafindrazoto,2 Eloïse Bolot,3 Georges Bors,3 Stéphanie Housson-Wetzel,3 Soloniaina Hélio Razafimahefa,1 Rado Manitrala Ramanampamonjy,2 Pierre Claude3 1Unity of Hepato-Gastroenterology, University Hospital Andrainjato, Fianarantsoa, Madagascar; 2Unity of Gastroenterology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar; 3Unity of Gastroenterology, Emile Müller Hospital of Regional Hospital Group of Mulhouse South Alsace, Mulhouse, FranceCorrespondence: Behoavy Mahafaly Ralaizanaka, Unity of Hepato-Gastroenterology, University Hospital Andrainjato, Fianarantsoa, Madagascar, Tel +261341920148, Email falyralaizanaka@gmail.comIntroduction: Mucormycosis is a rare systemic fungal infection, mainly observed in immunocompromised patients. It is responsible for surface and deep tissue destruction leading to perforations and hemorrhage. Its pathogenesis represented by an angio-invasion is at the origin of a local infarction and a vascular thrombosis. We report a case of gastrointestinal (GI) mucormycosis-induced multiple gastric ulcers, GI bleeding and rectal perforation.Case Presentation: A 75-year-old man, with type II diabetes mellitus, was admitted to the intensive care unit for an acute abdominal pain associated with massive hematochezia. Clinical examination was that of an acute peritonitis and a hemorrhagic shock state. Abdominal and pelvic CT scan with intravenous contrast concluded to a perforation of the anterior wall of the rectum. He underwent immediate laparotomy with temporary colostomy. Several upper GI endoscopies had shown multiple gastric ulcer lesions. Lower GI endoscopy showed a fistulous orifice of the rectum on its anterior surface. Histopathology of the gastric biopsy showed acute and subacute inflammatory changes with filamentous elements suggesting mucormycosis. Histopathology of the rectal biopsy showed a subacute non-specific inflammation. Culture of the secretions from the rectal fistula orifice showed the strain Rhizopus sp. Antifungal susceptibility testing reported sensitivity to liposomal amphotericin B. The diagnosis of GI mucormycosis-induced multiple gastric ulcers, rectal perforation and pulmonary embolism in the patient with type II diabetes mellitus was retained. The outcomes were favorable after 6 weeks of treatment with liposomal amphotericin B associated with temporary colostomy and appropriate diabetes management.Conclusion: GI mucormycosis remains a multidisciplinary diagnostic challenge, less frequent in clinical practice, with a long diagnostic pathway. This opportunistic systemic mycosis can lead to numerous GI complications including perforation, massive GI bleeding and even multiple extra-GI complications. GI mucormycosis has a good prognosis if it is treated early with medical and surgical treatment.Keywords: gastrointestinal bleeding, gastrointestinal mucormycosis, gastrointestinal perforation, gastric ulcer

Jolivet Auguste Rakotomalala,1 Chantelli Iamblaudiot Razafindrazoto,2 Nitah Harivony Randriamifidy,2 Behoavy Mahafaly Ralaizanaka,3 Sonny Maherison,2 Domoina Harivonjy Hasina Laingonirina,2 Mialitiana Rakotomaharo,2 Anjaramalala Sitraka Rasolonjatovo,2 Mamisoa Anicet Rakotovao,4,5 Andry Lalaina Rinà Rakotozafindrabe,2 Tovo Harimanana Rabenjanahary,2 Rija Fanantenantsoa,4,5 Soloniaina Hélio Razafimahefa,3 Rado Manitrala Ramanampamonjy2 1Hepato-Gastroenterology Unit, University Hospital Mahavoky Atsimo, Mahajanga, Madagascar; 2Gastroenterology Unit, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar; 3Hepato-Gastroenterology Unit, University Hospital Andrainjato, Fianarantsoa, Madagascar; 4General Surgery Unit, University Hospital Andrainjato, Fianarantsoa, Madagascar; 5Visceral Surgery Unit, University Hospital Tambohobe, Fianarantsoa, MadagascarCorrespondence: Chantelli Iamblaudiot Razafindrazoto, Gastroenterology Unit, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, Email iamblaudiotchantelli@yahoo.comBackground: Hepatosplenic schistosomiasis (HSS) is one of the most common causes of portal hypertension in developing countries. Variceal bleeding is the most common cause of mortality during HSS. The objective of this study was to evaluate the efficacy of splenectomy associated with endoscopic variceal ligation (EVL) compared with EVL alone in preventing variceal bleeding in patients with HSS.Methods: This was a single-center, retrospective, case–control study. Between January 2015 and December 2019, a total of 59 patients with HSS who had at least one variceal bleeding episode and received EVL with or without splenectomy were identified and stratified. In this case–control design, 22 patients had splenectomy + EVL (case group) and 37 patients had EVL alone (control group). The main endpoints were the rate of variceal rebleeding and the mortality rate between the two groups.Results: The mean age of our patients was 39.92 ± 13.4 (19– 75) years with a sex ratio of 1.8. The recurrence rate of variceal bleeding was significantly lower in the case group (splenectomy + EVL) than in the control group (EVL alone) (4.45% vs 27.2%, p = 0.041). There was no significant difference between the two groups in terms of mortality (4.54 vs 2.7%, p = 1.00).Conclusion: Splenectomy combined with EVL was effective than EVL alone in preventing variceal rebleeding in patients with HSS.Keywords: endoscopic variceal ligation, mortality, variceal bleeding, hepatosplenic schistosomiasis, splenectomy

Chantelli Iamblaudiot Razafindrazoto,1 Domoina Harivonjy Hasina Laingonirina,1 Behoavy Mahafaly Ralaizanaka,2 Nitah Harivony Randriamifidy,1 Mialitiana Rakotomaharo,1 Antsa Fihobiana Randrianiaina,1 Henintsoa Rakotoniaina,1 Sonny Maherison,1 Jolivet Auguste Rakotomalala,3 Anjaramalala Sitraka Rasolonjatovo,1 Andry Lalaina Rinà Rakotozafindrabe,1 Tovo Harimanana Rabenjanahary,1 Soloniaina Hélio Razafimahefa,2 Rado Manitrala Ramanampamonjy1 1Unity of Gastroenterology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar; 2Unity of Hepato-Gastroenterology, University Hospital Andrainjato, Fianarantsoa, Madagascar; 3Unity Hepato-Gastroenterology, University Hospital Mahavoky Atsimo, Mahajanga, MadagascarCorrespondence: Chantelli Iamblaudiot Razafindrazoto, Unity of Gastroenterology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, Tel +261342315887, Email iamblaudiotchantelli@yahoo.comBackground: SARS-CoV-2 has been described as a respiratory tropic virus since its emergence in December 2019. During the course of the disease, other extra-pulmonary manifestations have been reported in the literature including pancreatic involvement such as acute pancreatitis. This phenomenon linking COVID-19 and acute pancreatitis has been reported by several case reports and cohort studies. No cases had been reported in sub-Saharan Africa and Madagascar. We report one more case Of COVID-19 induced acute pancreatitis in a Malagasy woman patient without risk factors, further consolidating the existing evidence.Case Presentation: A 44-year-old woman was diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and had a favorable course under home isolation and drug treatments. One week later, the patient was admitted to hospital with severe acute abdominal pain. Acute pancreatitis was considered according to the revised Atlanta criteria with the presence of the three criteria. Other etiologies of acute pancreatitis (lithiasis, alcohol, hypercalcemia, hypertriglyceridemia, tumor, trauma, surgery) were excluded. Ultimately, a COVID-19 induced acute pancreatitis was retained. The outcome was favorable under symptomatic medical treatment (fluid resuscitation, bowel rest, management of pain and vomiting, and early oral feeding). The patient was discharged after one week of hospitalization.Conclusion: COVID-19 is a possible etiology of acute pancreatitis. Acute pancreatitis should be routinely ruled out in a patient with COVID-19 infection with acute abdominal pain.Keywords: acute pancreatitis, COVID-19, Madagascar

Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract. They are generally considered as solitary tumors. Here we report the case of a 66-year-old man with familial history of digestive cancers, admitted after a 2-months history of gastrointestinal bleeding. Colonoscopy showed a circumferential ulcerated tumor of the sigmoid which was a well differentiated adenocarcinoma on biopsy. Computerized tomography showed only the lesion of the sigmoid. The patient underwent a left colectomy followed by immediate end-to-end anastomosis. Per-operatively, jejunal mass was discovered and a jejunal segmentectomy was performed. Pathologic examination revealed a colic adenocarcinoma pT2N0M0 associated with a low risk stromal tumor of the jejunum CD117+ and DOG-1+. No adjuvant therapy was given. After 64 months of follow-up, the patient showed no evidence of recurrence. Clinicians should be aware of the coexistence of malignancies and carry careful investigations for accurate diagnosis and better patients' prognosis.

Background: Elimination of mother-to-child transmission of hepatitis B virus (HBV) requires infant immunoprophylaxis and antiviral prophylaxis for pregnant women with high viral loads. Since real-time polymerase chain reaction (RT-PCR), a gold standard for assessing antiviral eligibility, is neither accessible nor affordable for women living in low-income and middle-income countries (LMICs), rapid diagnostic tests (RDTs) detecting alternative HBV markers may be needed. To inform future development of the target product profile (TPP) for RDTs to identify highly viremic women, we used a discrete choice experiment (DCE) and elicited preference and trade-off of healthcare workers (HCW) in Africa between the following four attributes of fictional RDTs: price, time-to-result, diagnostic sensitivity, and specificity., Methods: Through an online questionnaire survey, we asked participants to indicate their preferred test from a set of two RDTs in seven choice tasks with varying levels of the four attributes. We used mixed multinomial logit models to quantify the utility gain or loss generated by each attribute. We attempted to define minimal and optimal criteria for test attributes that can satisfy ≥ 70% and ≥ 90% of HCWs, respectively, as an alternative to RT-PCR., Results: A total of 555 HCWs from 41 African countries participated. Increases in sensitivity and specificity generated significant utility and increases in cost and time-to-result generated significant disutility. The size of the coefficients for the highest attribute levels relative to the reference levels were in the following order: sensitivity (β = 3.749), cost (β = -2.550), specificity (β = 1.134), and time-to-result (β = -0.284). Doctors cared most about test sensitivity, while public health practitioners cared about cost and midwives about time-to-result. For an RDT with 95% specificity, costing 1 US$, and yielding results in 20 min, the minimally acceptable test sensitivity would be 82.5% and the optimally acceptable sensitivity would be 87.5%., Conclusions: African HCWs would prefer an RDT with the following order of priority: higher sensitivity, lower cost, higher specificity, and shorter time-to-result. The development and optimization of RDTs that can meet the criteria are urgently needed to scale up the prevention of HBV mother-to-child transmission in LMICs., (© 2023. The Author(s).)

Objective: Our work aimed to assess the efficacy and safety of direct-acting antiviral drugs in the treatment of hepatitis C in Madagascar., Methods: This retrospective clinical study was carried out from March 2018 to February 2020 in the hepato-gastro-enterology department of the University Hospital Center Joseph Raseta de Befelatanana., Results: A total of 35 patients were included, out of which 24 received sofosbuvir/ledipasvir ± ribavirin, 10 sofosbuvir/ribavirin and one sofosbuvir/velpatasvir. Thirty-three patients were naïve to the treatment and 2 patients were initially treated with the sofosbuvir/ledipasvir combination. The sustained virologic response was 94% (33/35) in the general population, 23/25 in cirrhotic patients and 10/10 in non-cirrhotic patients. The sustained virologic response was 22/24 for sofosbuvir/ledipasvir ± ribavirin, 10/10 for sofosbuvir/ribavirin and 1/1 for sofosbuvir/velpatasvir. Adverse effects were observed in 13 patients, mainly asthenia and insomnia., Discussion: The small number of patients with hepatitis C treatments and their limited financial resources are the main limits of this survey., Conclusion: Direct-acting antivirals are effective and characterized by good tolerance in these Malagasy hepatitis C patients., Competing Interests: L'auteur déclare ne pas avoir de conflit d'intérêt., (Copyright © 2021 SFMTSI.)

Acute cholangitis secondary to ascariasis is rare and occurs mainly in areas of high endemicity. The clinical presentation is non-specific, sometimes complicated by liver abscess. Abdominal ultrasound plays an important role in diagnosis and therapeutic surveillance. We report the case of a 35-year-old Malagasy woman with an acute cholangitis secondary to ascariasis and complicated by liver abscesses and its course to full recovery under medical treatment.

Pernicious anemia is uncommon in Africa. The purpose of this report is to describe a case of pernicious anemia observed in Madagascar. The revealing manifestation was encephalomyelitis with combined medullar sclerosis that responded favorably to vitamin B12 replacement therapy. Clinical symptoms included paresthesia associated with allodynia of all four extremities and with tetrapyramidal syndrome, medullar ataxia and minor cognitive disturbances ongoing for 5 months. Hemogram testing revealed macrocytic anemia. Serum cobalamin level was low. Anti-intrinsic factor antibody was detected. Spinal cord magnetic resonance imaging showed diffuse high-signal intensity along the posterior spinal cord extending from C1 to C4. Vitamin B12 replacement therapy led to full regression of clinical signs after six weeks. Association of central nervous system involvement with macrocytic anemia suggests vitamin B12 deficiency and pernicious anemia should be suspected. This disease can be considered as a curable form of myelitis in Africa and Madagascar.

Objective: Cirrhotic patients have poorer life expectancy than the general population. The purpose of this study was to identify causes of death in a sample of cirrhotic patients from Madagascar., Methods: A retrospective analytic and descriptive study was conducted on the files of cirrhotic inpatients admitted to the gastroenterology department of the Joseph Raseta Befelatanana University Hospital Center in Antananarivo, Madagascar from January 1, 2003 to June 30, 2007., Results: The files of 117 patients were reviewed. Death occurred in 31 cases for a mortality rate of 26.5%. The main causes of death were disorders of consciousness (51.6%) and hypovolemic shock (25.8%). Jaundice, encephalopathy, and gastrointestinal bleeding were predictive factors for mortality., Conclusion: Cirrhotic patients in this study were hospitalized at a late stage of disease. Further prospective study in a larger sample will be needed to standardize the management protocol in Madagascar.

Introduction: Although they remain a neglected transmissible disease, affecting mainly people in poor countries, the combined forms of schistosomiasis are second only to malaria as a major parasitic disease. Although both urinary and intestinal schistosomiasis are endemic in Madagascar, this study focuses only on the intestinal forms. The symptoms may remain unnoticed or be ignored, for the seriousness of intestinal schistosomiasis is due mainly to its hepatosplenic complications., Objectives: To estimate the etiological fraction of Schistosoma mansoni involved in hepatomegaly (HM), splenomegaly (SM) and hepatosplenomegaly (HSM), with or without signs of portal hypertension (PHT)., Methods: This file-based retrospective study includes patients admitted to the University Hospital of Antananarivo, Madagascar, between January 2005 and July 2008, who presented with HM, SM, HSM and/or PHT. The case was attributed to schistosomiasis if blood serology, tested with ELISA, was positive for this parasite. The statistical analysis used three approaches: a cross-sectional approach, a longitudinal approach (retrospective cohort), and a "case-control" approach., Results: Of 7308 admissions during this period, 269 (4%) were diagnosed with a hepatosplenic complication and were retained. The average age (+/- standard deviation) was 47.8 (+/- 16.4) years. HM accounted for 55.4% of cases, SM 18.9%, HTP 18.6% and HSM 18.6%. Serology was positive for schistosomiasis in 21.6% of cases. The sex ratio (men:women) for these cases was 1.9, and 67.3% of the patients were aged 30 years or older. The main schistosomiasis complications were SM (n=22) and HTP (n=22). The age group most affected depended on the specific complication: for HM, 28.6% of patients were aged between 40 and 49 years; for HSM, 57.1% were aged between 30 and 40 years. The prevalence of SM was lower in subjects between 50 and 59 years of age (4.5%) than the other complications. Patients with positive serology results were significantly younger than those with negative results, or whose serology was not checked (37.8 years vs. 50.5 years, p < 0.001). Stratification according to complication showed that the etiological fraction of schistosomiasis was 76% for patients with SM, 79% for HTP, 58% for HSM and 4.9% for HM. The retrospective cohort and the case-control analyses both showed that a history of dysentery and frequent contact with water were the main factors associated with complicated schistosomiasis. It is important to note that urban and rural residents had the same risk of developing schistosomiasis with complications (OR: 0.9 [0.4; 1.9])., Conclusion: This study showed that schistosomiasis infection is strongly associated with hepatosplenic pathologies. One of the shortcomings of the study is the absence of any analysis of the course and outcome in the study patients. Nevertheless, the course of oesophageal varices, SM or HSM in patients with HTP indicates that schistosomiasis was often fatal.

Helicobacter pylori is a worldwide infection. However very few data are actually available on H. pylori seroprevalence in the Malagasy population. We carried out a transversal study in a sample of persons who met the following criteria: older than 15 years old, presence in the medicine internal unit 2 (University Hospital Center of Antananarivo) during the period of the study whatever the reason. H. pylori infection was identified serologically by using ELISA (G.A.P IgG H. pylori ELISA, Bio-Rad, France). Several factors were evaluated including serological status, demographic information, the reason of the presence in the unit, factors influencing H. pylori infection: socio-economic status, siblings, promiscuity consumption of alcohol, use of tobacco, water source and history of gastroscopy. The presence of clinical symptoms, such as dyspepsia and abdominal pain, was determined. Forty-five men and 45 women were included (mean age: 41.8 +/- 3.4 years). The seroprevalence of H. pylori infection was 82%. H. pylori infection was higher in men than in women (p < 0.02). Promiscuity constituted the principal factor influencing H. pylori infection. The seroprevalence of the H. pylori infection appears to be comparable to the rate encountered in developing countries. Considering this high rate of the H. pylori infection, eradication of H. pylori should be commonly recommended when facing gastrointestinal pathologies potentially induced by H. pylori.

Portopulmonary hypertension is characterized by a chronic liver disease associated with a mean pulmonary artery pressure >25 mmHg at rest, an increased pulmonary vascular resistance and a capillary pulmonary pressure <15 mmHg with portal hypertension. Schistosomiasis may be an aetiology of this syndrome, however, few cases have been reported. We describe the first cases of portopulmonary hypertension with schistosomiasis in Malagasy patients. There were 2 men aged of 18 and 20 from hyperendemic area of schistosomiasis in Madagascar Both had a history of repeated water contact. They presented a dyspnea associated with ascites and oedema. Clinical examination showed portal and pulmonary hypertension with right ventricular heart failure. Cardiac examination revealed a systolic murmur and splint of the second heart pulmonary Pulmonary hypertension was confirmed by cardiac ultrasonogaphy Serology of bilharzias was positive. Parasitological examination showed eggs of S. mansoni. The treatment based on salt-free diet, spironolactone and praziquantel led to a better evolution of symptoms (case 1). Symptoms of right heart failure remained for the second patient even though improvement was noted. In tropical countries, schistosomiasis may be one of the cause of portopulmonary hypertension and may appear in early age. Its treatment remains difficult as the drugs recommended are not affordable.

Portal vein thrombosis (PVT) seems rare among HIV infected patients. Even though, the report of such cases is of great interest because it may help to determine the factors of occurrence. We describe cases of PVT in 4 HIV-infected men, aged 32 - 64. Two of them were co-infected with hepatitis C virus (HCV). The four patients had a history of disseminated mycobacterial infection (one case of tuberculosis, 3 cases of mycobacterium avium complex infection) with abdominal lymphadenitis. Despite HAART, their immunodeficiency was profound (CD4: 65 to 216/mm(3)). At the time of diagnosis, two patients were treated with protease-inhibitor containing regimen: indinavir (one case), ritonavir-saquinavir (one case). PVT was revealed by haematemesis (one case), abdominal pain (ome case), anasarca (2 cases). In three patients, the diagnosis of PVT was confirmed by imagery (echo-doppler or angio- RMI), and for the last patient, PVT was found during the transjugular intrahepatic portosystemic shunt setup. A low level of C protein was diagnosed in one case. Cirrhosis was not found in HIV-HCV co-infected patients. Two patients died early after diagnosis, one patient died 3 years after the onset of symptoms. Various factors may cause the development of a PVT in HIV infected patient. Serious immunodeficiency, opportunistic infections such as tuberculosis and mycobacterium avium complex related infection with abdominal lymphadenitis can further the development of PVT. Protease-inhibitor might have facilitated the process. Due to the severe prognosis of advanced cases, early evocation of diagnosis is needed.

A voluminous trichobezoar was discovered in an 11-year-old girl without major clinical implications. The diagnosis was made by endoscopy and surgery was performed without complications.

Neurocysticercosis is the most frequent parasitosis of central nervous system in the world. Neurological manifestations are in relation with locations number and topography, inflammatory reactions level and state of development of the parasite. Epilepsy is the main revealing symptom. Among other neurological manifestations, chronic headache, focal neurological signs, ataxia, language and behaviour disorder are the most anecdotal. The authors report a case of neurocysticercosis in a 71-year-old man with dysarthria and memory problems. Suspected by computed tomography, diagnosis was confirmed by immunoserologic assays such as enzyme-linked immunosorbent assay (ELISA) or enzyme-linked immunoelectrotransfer blot assay (EITB). This later emphasized on active form of the cyst. Specific treatment used albendazole as antihelminthic drug. Clinical evolution was good: neuroimaging and immunoserology results were normal respectively 2 and 6 months after the drug therapy.

In 1958, a large study on the distribution of Bancroft filariasis was set up in Madagascar. In order to update these data, the authors have studied in the same areas the parasitological and clinical prevalence of Bancroft filariasis. Here are the preliminary results of this study, concerning 1862 people, aged 10 years and more. The mean prevalence rate of microfilaria-carriers was of 22.9%, and the average parasitic density was of 3.6 parasits/20 microliters of blood. The prevalence rate of chronic clinical symptoms was of 14.7% for men (elephantiasis, hydroceles, chyluria) and of 2% for women (elephantiasis). These were usually mild symptoms, which very little impact on way of life.