Profil lipidoprotéinique,isotopique et risque athérogène dans la drépanocytose en Côte d’Ivoire

The principal goal of this study was to assess the possible disturbances of lipids and lipoproteins in sickle cell disease and establish a relationship between painful crisis and atherogenic risks by the atherogenicity index in Ivoirian adults. We analysed serum plasma lipid and lipoprotein profiles of 126 subjects with sickle cell anemia, and 55 “Hb AA” healthy individuals. The lipid and lipoprotein parameters studied were total cholesterol, triglycerids, HDL, LDL, apoproteins A1 and B, electrophoresis of lipoproteins and haemoglobin. In painful crisis, levels of total cholesterol, HDL-cholesterol, LDL-cholesterol, apoproteins A1 (apo A1) in sickle cell anemia patients were shown to be significantly lower and levels of triglycerides higher than that of control group and steady state. The electrophoresis profile showed a significant fall of α lipoproteins while β lipoproteins were significantly high in period of crisis. The atherogenicity index (total cholesterol/HDL ratio) was also significantly high, just as LDL/HDL ratio in period of crisis. The overview of these results might hypothesize a high relatively atherogenic risk during the sickle-cell anemia crisis. A special monitoring of the patients in crisis is also necessary in order to prevent the risk of cardiovascular diseases.     

Performance et vulgarisation de l’écho-Doppler par couplage sus-pubien et endovaginal dans le diagnostic précoce des grossesses extra-utérines en Côte d’Ivoire

ObjectiveThe aim of our study was to describe the epidemiological profile of ectopic pregnancies (EP) in Côte d’Ivoire and to show the utility of ultrasound Doppler in the early diagnosis of EP.Patients and methodOur prospective study had been carried out for 24 months (from February 2006 to January 2008). It concerned 32 cases of ectopic pregnancy discovered at the suprapubic or endovaginal ultrasound scan with or without Doppler use.ResultsThe frequency of ectopic pregnancies was estimated at 1.7%. Patients’ mean age was 26.2 years. The personal history was dominated by abortions (32%) and adnexal infections (20%). Most of the patients were nulliparous (52.5%). Requests for ultrasound scans were motivated for most of them by metrorrhagia. The ectopic pregnancy was diagnosed at the ruptured stage in 65.6% of the cases (21 patients) and at the nonruptured stage in 34.4 % of the cases (11 patients). In six cases of nonruptured stage, we used the Doppler. The elementary lesions found were hematosalpinx in 40.6% of the cases, embryonate ectopic gestational sac (31.3%) and nonembryonate ectopic gestational sac (18.7%). In three cases (9.4%), no elementary lesions were found.Conclusionin Côte d’Ivoire, the ectopic pregnancy concerns a very young nulliparous population with abortion and adnexal history. The use of color signal of Doppler added to the endovaginal ultrasound scan, allows establishing the diagnosis at the early stage.     

Nouvelle stratégie dans le diagnostic,la prévention et le suivi de l’ostéonécrose drépanocytaire en Côte d’Ivoire à partir de la scintigraphie osseuse

Osteonecrosis is the most frequent complications of sickle-cell disease (SCD) whose prevalence in Côte d’Ivoire is 21%. The main of this study was to compare scintigraphy, clinical and radiological observations to assess earlier diagnosis in SCD osteonecrosis. It was a prospective study about 45 SCD patients who presented coxopathy and had radio-labelled diphosphonates bone scintigraphy. The results revealed 49% of lesions whose 48% appeared wiyh homogeneous hyperfixation, 11% homogeneous hypofixation, 5% of hypofixation contourned by hyperfixation. Eighty-one percent of lesions concerned femoral head, 6% femoral condyle and 3% humoral head. Fifty percent of osteonecrosis was not visible in radiology and corresponded to the earlier stade. These invisible radiology aspects were observed in 100% hips without lameness, and in 43% permanent lameness. Scintigraphy (sensitive in 100%) isolated 38% more than conventional radiography. In main to improve SCD osteonecrosis prognostic in Côte d’Ivoire, this preliminary study outline that scintigraphy is fundamental in management.     

Répartition géographique dePapio anubis dans le nord-est et le centre-sud de Côte d’Ivoire

The main purpose of this work was to make a survey of thePapio anubis demography because of the lack of data on Ivory Coast baboons now prevailing in this country. Two outstanding facts came to light: on the one hand, the baboons had vanished from the greater part of the studied regions, either by the destruction of their habitat at the time of rural growth (connected to demographic and agricultural increase) or by excessive hunting; only some restricted territories, sheltering a few troops, still subsisted, scattered along the Nzi River and in sites with little access and thinly populated; on the other hand, observation ofPapio anubis troops was possible only in privileged areas such as National Park. In the Comoé National Park, 14 troops were seen, totaling 257 baboons, of which 173 were adults with a sex-ratio reaching 0.82. The mean size of a troop was 18.4 baboons (size varying between 8 and 32). The youngest individuals, aged under 1 year, were weakly represented (8.9%). This study showed thatPapio anubis of Ivory Coast were closed related to those living in East Africa: differences, when they exited, were linked to geographic circumstances. It also underlined the precariousness of the survival of this primate species in Ivory Coast and the danger of their eradication in the near future.      

Immunocontraception par la prévention de l’interaction gamétique

The paper summarize the main data relevant to the obtention of contraceptive vaccines based on spermatozoa as well as zona pellucida antigens. The development of novel forms of contraception is one way in which this global population problems can be tackled. The sperm as well as the oocyte antigens are studied as possible contraceptive vaccine candidates are the subject of this review.     

Apport de l’échographie dans le bilan d’une infécondité masculine

Recent technical progress in ultrasound, particularly with respect to high-frequency linear probes and transrectal probes, now enables a very detailed morphological approach to the scrotal, prostate and surrounding structures, such as the seminal vesicles, the vas deferens and the ejaculatory ducts. For almost 20 years, in close collaboration with Male Sterility Center of Toulouse, we have carried out such examinations as part of infertility testing procedures, and we set out below the results of our experience. After a short anatomical reminder, we shall begin with an echographical study of the scrotum, followed by the prostate and its adjoining structures, pursuant to a transrectal examination. In the course of these two examinations, we shall consider the various pathologies that we have encountered, which have tended to be secretory with respect to the scrotum, and excretory in the prostate area, in order to determine the usefulness and importance of echographical examinations in male infertility.     

Determinants of bushmeat supply sources in rural areas of Côte d’Ivoire

The bushmeat trade provides an income to hunters, transporters, and vendors living in the vicinity of protected areas but remains a challenge to wildlife conservation objectives. The key factors driving the source, choice and use of bushmeat vary among actors in the commercial bushmeat value chain, and insights into these determinants are required to facilitate the development of conservation strategies. Therefore, we aimed to identify the socioeconomic factors that explain the source of supply and quantities of bushmeat available in households and local restaurants. We carried out a survey with 144 rural household heads and 24 restaurant owners in 20 villages in the Western part of Taï National Park in Côte d’Ivoire. We found that bushmeat quantity and species diversity were low in households, originating mainly from subsistence hunting. However, both the amount of bushmeat and the variety of species were high in restaurants and primarily supplied by commercial hunters. Furthermore, the quantity of bushmeat was lower in households with other protein sources and in restaurants in villages that had been the target of more conservation awareness campaigns. We highlight the importance of understanding the determinants of bushmeat supply to regulate the bushmeat trade by applying relevant conservation interventions.     

Alcide d’Orbigny,un précurseur dans l’étude de la faune du Danien du bassin de Paris

One of the major contributions of Alcide d’Orbigny to palaeontology is his work on the Danian of the Paris Basin. The Danian material includes well-preserved external imprints of Invertebrates. By making casting of these imprints, Alcide d’Orbigny inaugurated an original technique, which enabled him to describe more than 40 species. The question of the age of the Danian localities has long been debated since that time. It was settled once and for all in the seventies by micropalaeontologists.     

Enjeux,défis,opportunités et stratégie durable d’implantation de l’imagerie hybride TEMP/TDM dans un pays à ressources médicales limitées,la Côte d’Ivoire

From HO Anger's analogic gamma camera to digital camera, developed countries are at the time of hybrid cameras SPECT/CT and PET/CT. Sub-Saharan black Africa in the image of Côte d’Ivoire, a country with limited medical resources shows an important delay in the evolution of the health system in general and particularly in medical imaging equipment. The purpose of this paper was to approach the issues, challenges and sustainable strategy for the implementation of hybrid imaging SPECT/CT in a developing country where the rate of morbidity and mortality remains high due to infectious but also cancer diseases because of the inadequacy of the health technical platform. To address these challenges, Côte d’Ivoire like many countries in sub-Saharan Africa with limited medical resources must design, test and develop clinical strategies adapted to developing countries. Health authorities of this country must develop a policy for sustainable financing of medical imaging, including the training of the adequate health personnel according to a model of corporate leadership. In this perspective, Côte d’Ivoire must have a SPECT/CT instead of a simple gamma camera. This would allow to optimize its diagnostic health system in oncology, bone and joint disease and in many other medical disciplines. And especially since the SPECT/CT is a high-performance device that has largely demonstrated its diagnostic efficiency and that can be used as SPECT alone or as isolated CT. In addition, this country should take over digital imaging in the context of cooperation with some countries of Africa and Europe ahead in the field of modern medical imaging, seeking assistance from international organizations (IAEA, RAD-AID, WHO,…). Finally this country should implement methods of assessment, types of performance indicators to guide planning for future projects of its system.     

Optimisation du protocole d’acquisition de la TEP à la fluorocholine dans la détection des lésions parathyroïdiennes

18F-Fluorocholine (FCH) PET/CT shows very promising potential for detection of hyperfunctioning parathyroid tumors. However, the optimal time to perform imaging after FCH administration has not yet been determined and protocols are highly variable. The aim of this study was to qualitatively and quantitatively compare 5, 10, 15, 20 and 60 min post-injection acquisition times in patients with primary hyperparathyroidism and equivocal traditional imaging. Thirty-one patients were included. Two observers retrospectively analyzed the five protocols. Any focal increase in FCH uptake was localized and graded on a discrete gradation scale between 1 and 5 to assess the likelihood of hyperfunctioning parathyroid tumors. Gold standard was histopathological findings for the 11 operated patients. Regarding quantitative analysis, ratio of SUVmax of parathyroid foci on SUVmean of thyroid background (as signal-to-noise ratio) were compared between protocols. After injection of 2.5 MBq/kg, FCH PET performed 60 min post-injection (2 min) had the best sensitivity and specificity by lesion (92% and 100% respectively and the best signal-to-noise ratio (median of 2). We suggest performing PET scan 60 min after injection, associated with early acquisition so as not to miss a wash-out hyperfunctioning parathyroid tumors.     

Rôle de l’échographie dans le diagnostic des kystes ovariens et des masses annexielles,en dehors de la grossesse et de la stimulation ovarienne

This article contains the semiological bases used to characterize ovarian lesions in imaging, especially ultrasound.     

Histoire d’un itinéraire épidémiologique entre le Burkina Faso et la C?te d’Ivoire : le cas des foyers de maladie du sommeil de Koudougou

In the first half of the XXth century, while Upper-Volta (now Burkina Faso) was suffering a terrible epidemic of sleeping sickness, the French colonial administration encouraged the movement of people from Upper-Volta to Ivory Coast to meet their demands for labour. This led to the establishment of Mossi villages, such as those of Koudougou, in the Ivorian forest with populations originating from areas of Upper-Volta that were not only densely populated but also severely affected by sleeping sickness. Since 2000, most cases of sleeping sickness in the Koudougou district of Burkina Faso have been in people originally from Ivory Coast. Who are they? Where did they settle in Burkina Faso? Where do they come from in Ivory Coast? After having retraced the epidemiological history of Koudougou villages in Burkina Faso and Ivory Coast, the history of ten cases of sleeping sickness detected passively at Koudougou hospital since 2000 were analysed. All cases originated from the forest area of Ivory Coast. Understanding the spread of sleeping sickness between Burkina Faso and Ivory Coast will assist in the identification of areas of disease risk.     

Mapping malaria risk among children in Côte d’Ivoire using Bayesian geo-statistical models

ABSTRACT: BACKGROUND: In Cote d'Ivoire, an estimated 767,000 disability-adjusted life years are due to malaria, placing the country at position number 14 with regard to the global burden of malaria. Risk maps are important to guide control interventions, and hence, the aim of this study was to predict the geographical distribution of malaria infection risk in children aged <16 years in Cote d'Ivoire at high spatial resolution. METHODS: Using different data sources, a systematic review was carried out to compile and georeference survey data on Plasmodium spp. infection prevalence in Cote d'Ivoire, focusing on children aged <16 years. The period from 1988 to 2007 was covered. A suite of Bayesian geo-statistical logistic regression models was fitted to analyse malaria risk. Non-spatial models with and without exchangeable random effect parameters were compared to stationary and non-stationary spatial models. Non-stationarity was modelled assuming that the underlying spatial process is a mixture of separate stationary processes in each ecological zone. The best fitting model based on the deviance information criterion was used to predict Plasmodium spp. infection risk for entire Cote d'Ivoire, including uncertainty. RESULTS: Overall, 235 data points at 170 unique survey locations with malaria prevalence data for individuals aged <16 years were extracted. Most data points (n = 182, 77.4%) were collected between 2000 and 2007. A Bayesian non-stationary regression model showed the best fit with annualized rainfall and maximum land surface temperature identified as significant environmental covariates. This model was used to predict malaria infection risk at nonsampled locations. High-risk areas were mainly found in the north-central and western area, while relatively low-risk areas were located in the north at the country border, in the northeast, in the south-east around Abidjan, and in the central-west between two high prevalence areas. CONCLUSION: The malaria risk map at high spatial resolution gives an important overview of the geographical distribution of the disease in Cote d'Ivoire. It is a useful tool for the national malaria control programme and can be utilized for spatial targeting of control interventions and rational resource allocation.