Outbreak of poliomyelitis--Cape Verde, 2000.
(17/379)
During August 16-October 17, 2000, 33 cases of acute flaccid paralysis (AFP), including seven (21%) deaths, were reported in Cape Verde, an archipelago of 10 islands west of Senegal and Mauritania. Preliminary laboratory results identified wild type 1 poliovirus among eight cases. The first patient was a child aged 2 years from the capital city of Praia; paralysis onset occurred August 16. The child had received one dose of the recommended three doses of oral poliovirus vaccine (OPV). Twenty-two cases were reported from the island of Santiago, seven from Sal, three from San Vincente, and one from Maio. The ages of the AFP patients ranged from 3 months-38 years; 11 (33%) were aged < 5 years, 15 (46%) were 5-14 years, and seven (21%) were > or = 15 years. No deaths were reported among patients aged < 5 years. Three deaths (case fatality rate [CFR]: 20%) occurred among patients aged 5-14 years and four deaths occurred among patients aged > or = 15 years (CFR: 57%). Of 33 cases with known vaccination status, 13 (39%) were fully vaccinated. (+info)
Etiology of urethral discharge in West Africa: the role of Mycoplasma genitalium and Trichomonas vaginalis.
(18/379)
OBJECTIVE: To determine the etiological role of pathogens other than Neisseria gonorrhoeae and Chlamydia trachomatis in urethral discharge in West African men. METHODS: Urethral swabs were obtained from 659 male patients presenting with urethral discharge in 72 primary health care facilities in seven West African countries, and in 339 controls presenting for complaints unrelated to the genitourinary tract. Polymerase chain reaction analysis was used to detect the presence of N. gonorrhoeae, C. trachomatis, Trichomonas vaginalis, Mycoplasma genitalium, and Ureaplasma urealyticum. FINDINGS: N. gonorrhoeae, T. vaginalis, C. trachomatis, and M. genitalium--but not U. urealyticum--were found more frequently in men with urethral discharge than in asymptomatic controls, being present in 61.9%, 13.8%, 13.4% and 10.0%, respectively, of cases of urethral discharge. Multiple infections were common. Among patients with gonococcal infection, T. vaginalis was as frequent a coinfection as C. trachomatis. M. genitalium, T. vaginalis, and C. trachomatis caused a similar clinical syndrome to that associated with gonococcal infection, but with a less severe urethral discharge. CONCLUSIONS: M. genitalium and T. vaginalis are important etiological agents of urethral discharge in West Africa. The frequent occurrence of multiple infections with any combination of four pathogens strongly supports the syndromic approach. The optimal use of metronidazole in flowcharts for the syndromic management of urethral discharge needs to be explored in therapeutic trials. (+info)
Erroneously low or undetectable plasma human immunodeficiency virus type 1 (HIV-1) ribonucleic acid load, determined by polymerase chain reaction, in West African and American patients with non-B subtype HIV-1 infection.
(19/379)
The polymerase chain reaction (PCR) assay for plasma human immunodeficiency virus type 1 (HIV-1) ribonucleic acid (RNA) inadequately quantitates virus load for some non-B HIV-1 subtypes because of genetic diversity in the gag region targeted by the PCR primers. Unexpectedly low or undetectable plasma HIV-1 RNA findings by PCR were a clue to non-B HIV-1 infections in patients in whom plasma HIV-1 RNA was found to be substantially higher when determined by a branched-chain deoxyribonucleic acid assay. (+info)
Spasmolytic activity of methyl angolensate: a triterpenoid isolated from Entandrophragma angolense.
(20/379)
Entandrophragma angolense is a medicinal plant used in folk medicine against several diseases including peptic ulcer. Methyl angolensate was isolated from E. angolense by recrystallization from methanol. The needle-like crystals were characterized and tested on isolated rabbit jejunum, guinea pig ileum and the rat fundus strip. The compound was also evaluated on the gastrointestinal transit in mice. The results showed that the compound exerted significant concentration dependent inhibition of smooth muscle and reduced the propulsive action of the gastrointestinal tract in mice. The relaxation observed did not attenuate acetylcholine and histamine induced contractions, but was found to inhibit contractions induced by serotonin. It is therefore suggested that methyl angolensate may exert its activity on gastrointestinal smooth muscle via serotonergic mechanisms. (+info)
Occurrence of myxosporean parasites in the gills of two tilapia species from Lake Nokoue (Benin, West Africa): effect of host size and sex, and seasonal patterns of infection.
(21/379)
The gill myxosporean parasites of 2 euryhaline tilapias from Lake Nokoue, Sarotherodon melanotheron melanotheron (Ruppel, 1853) and Tilapia zillii (Gervais, 1852), were investigated from October 1987 to October 1989. A total of 391 S. m. melanotheron and 222 T. zillii were examined. Both of the fish species studied were infected by 3 host-specific myxosporean parasites for which prevalence greatly varied during our investigations. The 2 most common ones were Myxobolus sp. and M. zillii, which were located in the branchial filament. No significant fish sex effect was found for these 6 different myxosporean parasites. As seasonal pattern was clearly demonstrated for M. zillii while a host size effect was found for M. dossoui. However, further investigations of these myxosporean infections are necessary to determine the real effect of these parasites on their host, as host fecundity and survival was not assessed. (+info)
Imported Fasciola hepatica infection in the United States and treatment with triclabendazole.
(22/379)
Infection with Fasciola hepatica, a liver trematode, is not frequently reported in the United States. We describe 2 patients, both originally from Cape Verde, who illustrate the spectrum of clinical presentations of F. hepatica as well as the means of treating infection with this parasite. Patient 1 had extensive disease and underwent multiple diagnostic procedures before the correct diagnosis was reached. Patient 2, who had few symptoms, had fascioliasis diagnosed by a noninvasive evaluation. Both patients were treated with triclabendazole without experiencing significant side effects. Fascioliasis that has been imported to the United States may elude prompt or accurate diagnosis. Obtaining a detailed travel history and recognizing the clinical presentation early in the course of infection may permit timely and noninvasive identification of infection. Triclabendazole is now the recommended drug for treating for fascioliasis because of its efficacy, safety, and ease of use. (+info)
Progress toward poliomyelitis eradication--West and Central Africa, 1999-2000.
(23/379)
In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate poliomyelitis by 2000. Reported polio cases have decreased on all continents. In 2000, poliovirus was isolated from 24 countries, 13 in the African Region of WHO (AFR). This report summarizes the routine polio vaccination coverage, surveillance for acute flaccid paralysis (AFP) during 1999 and 2000, and the synchronization of national immunization days (NIDs) against polio during 2000 and early 2001 in 16 countries in west and central Africa. (+info)
Eliminating onchocerciasis after 14 years of vector control: a proved strategy.
(24/379)
From 1976 through 1989, weekly aerial spraying operations against blackflies were carried out along the rivers of a wide savanna area of West Africa (approximately 700,000 km(2)) where onchocerciasis was hyperendemic. The level of endemicity began to decrease significantly after 4 years of vector control and became very low in 1989. This situation has been maintained without any vector control activity or chemotherapy, and no incidence of any new cases has been detected. An ophthalmological study carried out in 2000 has confirmed these good results, showing only cicatricial ocular lesions in the examined population. These results led to the conclusion that 14 years of vector control may achieve long-term elimination of onchocerciasis, even in the absence of chemotherapy, provided that the treated areas are not subjected to any contamination by exogenous parasites carried in infected humans or flies. (+info)