PubMed Health⌕ Search

Biomedical subjects

B Carme

Publications and source records attributed to B Carme.

At least 91 records · Page 5Linked to original sources
PubMed1991

Five cases of encephalitis during treatment of loiasis with diethylcarbamazine.

Five cases of encephalitis following treatment with diethylcarbamazine (DEC) were observed in Congolese patients with Loa loa filariasis. Two cases had a fatal outcome and one resulted in severe sequelae. The notable fact was that this complication occurred in three patients hospitalized before treatment began, with whom particularly strict therapeutic precautions were taken, i.e., initial dose less than 10 mg of DEC, very gradual dose increases, and associated anti-allergic treatment. This type of drug-induced complication may not be that uncommon in highly endemic regions. It occurs primarily, but not exclusively, in subjects presenting with a high microfilarial load. The relationship between the occurrence of encephalitis and the decrease in microfilaremia is evident. The pathophysiological mechanisms are discussed in the light of these observations and the few other comments on this subject published in the literature.

Adolescent↗
PubMed1991

[Clinical presentation of non-pernicious malaria attacks in patients hospitalized in Brazzaville (Congo) in 1989].

The clinical manifestations observed in 102 malaria patients (parasitaemia of over 8,000 Plasmodium falciparum/mm3) hospitalized in 1989 in Brazzaville (Congo) were analyzed after ruling out the cases of pernicious malaria. The clinical picture was fever, stomach upset with headache and musculo-articular pain as in classical cases. In children these manifestations were frequently associated with convulsions. Diarrhoea was not uncommon in young children. Vomiting was frequent in both children and adults. Splenomegaly and hepatomegaly were closely related to age. In these subjects, chemoprophylaxis was rare in children, practically non-existent in those aged over 5 years. However, presumptive treatment and self medication was usual regardless of age.

Adolescent↗
PubMed1991

[Pneumocystis carinii pneumonia in patients with AIDS in the Congo].

Forty-five bronchoalveolar lavages (BAL) were performed in Brazzaville in AIDS patients who did not expectorate acid- and alcohol-resistant bacilli (AARB). All patients presented with respiratory symptoms (cough, dyspnoea or chest pain), and all but 6 of them had abnormal radiography of the chest. Four cases of pneumocystosis were diagnosed (9%); 3 of these patients had interstitial pneumonia and dyspnoea. No AARB was found at microscopic examination of BAL which showed Pneumocyctis carinii; no culture on Löwehstein's medium could be made. The authors consider that the low prevalence of pneumocystosis in Africa, compared with industrial countries, is due to a smaller dissemination of the parasite in Africa rather than to immunodepression which is known to be more pronounced in AIDS patients from industrial countries.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Efficacy of quinine in children hospitalized for malaria attacks in Brazzaville (Congo) in 1989].

The efficacy of quinine prescribed to children from Brazzaville hospitalized for acute malaria (temperature over 38 degrees C, P. falciparum parasitaemia over 10,000/mm3, no other obvious disease; the reason for hospitalisation often being digestive or neurological disorders) was assessed. Quinine was administered by perfusion: 25 mg/kg/day for at least 3 days. Associated treatment (sulfadoxine-pyrimethamine combination in 80% of the cases) was given at day 3. Blood was taken at day 0, and before discharge (usually between days 3 and 5). Thick Blood Smears (TBS) were examined for a volume of blood corresponding to 300 leucocytes. Antimalarials had been taken in 60% of the cases (chloroquine in 67% of the cases, quinine in 10%). Antimalarials were not assayed in the sera. In 68 cases of non pernicious malaria, no obvious cases of resistance were observed. TBF were negative in 49 out of 52 cases at day 3, and 11 out of 12 at day 4 and in five out of five cases at day 5. In 96 cases of pernicious malaria, only one case was suspected of being resistant, with a weakly positive TBS at day 7. 13 children died but all in the first three days without suspicion of resistance. Apyrexia was observed before day 4 in 89% of the cases; only one case of fever at day 7. TBS were negative before day 4 in 97% of the cases. So, at the dosage of 25 mg/kg, quinine was found to be very effective in the Congo in 1989 against both pernicious and non pernicious malaria.

Acute Disease↗
PubMed1991

[Therapeutic trial with ivermectin in loiasis with medium and high microfilaremia].

Treatment with ivermectin at the dosage of 200 microgram/kg in 28 Congolese loiasis patients led to an important decrease of the microfilaremia on day 7, with a reduction of about 90% of the initial parasite load. However, no negativation was observed and, moreover, the parasitemia did not change from day 7 to day 14. Tolerance was quite good, but weak to moderate reactions, linked to the lysis of the microfilariae, were observed in one third of the patients with a microfilaremia greater or equal to 2,500/mm3.

Animals↗
PubMed1991

Widespread in vitro resistance to chloroquine of Plasmodium falciparum in the Congo, 1987.

The drug sensitivity of 184 Plasmodium falciparum isolates was studied in vitro in three areas of the Congo in January 1987. Results show that parasites resistant to chloroquine but not to quinine or mefloquine were prevalent in the three investigated regions, but the drug response pattern varied widely. In Brazzaville, after the outburst of chloroquine resistance in 1985, prevalence of chloroquine resistant isolates seemed to have stabilized around 60%. The phenomenon more recently reached the North where about 30% isolates could be considered as drug resistant. As in Cameroon, wide variations in the prevalence and the level of resistance were observed within a very limited area emphasizing the role of drug pressure in market places where chloroquine is easily available.

Adolescent↗
PubMed1991

[Comparative efficacy of chloroquine and amodiaquine (25 and 35 mg/kg) in school children infected with P. falciparum (Brazzaville, March 1990)].

The efficacy of 4 therapeutic schedules was compared in March and April 1990 in Brazzaville school children, aged between 6 and 8 years, with parasitaemia of at least 1,000 trophozoites of Plasmodium falciparum per mm3. It was possible to interpret 125 simplified in vivo tests. The results showed that the activity of amodiaquine is still relatively satisfactory. The activity of chloroquine was slightly lower with the schedule of 25 mg/kg but was good at 35 mg/kg. Although these results were obtained in children who were mostly asymptomatic, they show that the use of amino-4-quinolines is still justified, at least in the initial treatment of uncomplicated malaria in semi-immune congolese subjects.

Amodiaquine↗
PubMed1990

Epidemiology of Mansonella perstans filariasis in the forest region of south Congo.

A study of Mansonella perstans filariasis conducted in the Chaillu mountains, Southern Congo, showed that 108 of 134 Pygmies (80.6%) and 79 of 302 Bantus (26.2%) presented with microfilaraemia. The mean microfilarial densities were also significantly higher in the Pygmies (1213 ml-1 of blood) than in the Bantus (136 ml-1). Ninety eight per cent of the Culicoides taken which had bitten man in the daytime were C. grahamii, and 0.8% of these were infected with filarial larvae. Two other species of Culicoides (C. kumbaensis and C. rutshuruensis) might also play a role in the transmission of M. perstans.

Adolescent↗
PubMed1990

Calcifications of the breast probably due to Loa loa.

Five cases of calcification of the breast due to filariasis in Congolese women are reported. The cases were discovered during mammographies carried out for suspect carcinoma (4 cases) and benign tumor (1 case). The geographic origin of the patients, a past history of subconjunctival filarial migration in 2 individuals, the bilateral localization, and, above all, the radiographic appearance and size of the calcifications, suggested that the images were due to Loa loa.

Adult↗
PubMed1990

[Plasmodium falciparum drug resistance in the Congo. Evaluation of surveys carried out from 1985 to 1989].

Surveys on drug sensitivity of Plasmodium falciparum carried out between 1985 and 1989 included 7-day in vitro tests and in vivo tests. 485 in vivo tests were carried out in eight surveys conducted in Brazzaville and in several inland regions. The subjects were congolese children aged between 3 months and 15 years old. They were recruited in hospital, mother-child clinics or at school. The drugs studied were chloroquine, amodiaquine and the sulfadoxine-pyrimethamine combination. 182 strains were tested in vitro in two surveys (December 1985 and January 1987); amino-4-quinolines, quinine and mefloquine were studied. Although resistance to amino-4-quinolines is a recent occurrence, by 1985 it had spread widely in the indigenous population in the Centre and South of the country. Resistance has since increased gradually, especially for chloroquine which undergoes specific surveillance. The situation is less serious in the North, a less densely populated region which is still enclosed. In an in vivo comparative study with chloroquine conducted in Brazzaville in November 1986, amodiaquine was found to be only slightly more effective at a similar dosage. At that time, certain isolated observations already seem to imply that the sulfadoxine-pyrimethamine combination was also affected by resistance. This was not corroborated in an in vivo study carried out in 1989 on 40 children presenting with a malarial attack. Although the sensitivity to quinine may probably be decreased. This drug cannot yet be considered as being truly affected by resistance. The activity of mefloquine, the use of which is still limited, was satisfactory in 1987 in two different regions of the country.

Adolescent↗
PubMed1990

[Toxoplasmosis in the Congo Republic. Seroepidemiological study].

Our study group, which was composed of over 2,500 subjects, aged between 0 and 65 years, came from different regions of Congo. The samples obtained were examined for the presence of IgG and IgM against Toxoplasma gondii. IgG were detected in about 33% of children over 9 years and in about 40% of adults. A study of IgM confirmed the early contact of children with the parasite (11% of positive samples for children between 4 and 9) and that of young women (5 to 7% positivity for subjects between 15 and 30). In spite of local variations, the extremely humid climate did not allow us to detect a difference based on the origin of the samples as furthermore there seems to be an ethnic factor involved. Among the different types of professions in our sample only farmers appear to be less frequently positive. Diet, as well as contact with animals do not seem to have an influence.

Adolescent↗
PubMed1990

[Epidemiological status of onchocerciasis in the Congo].

Analysis of 25 surveys carried out in the Congo between 1978 and 1987 (covering nine of the ten administrative regions), during which 6,215 subjects were examined, showed that onchocerciasis is endemic in the southern part of the country. Two main foci meeting at the southern exit of Brazzaville (Pool region) were identified. One focus in the Djoué basin. The other is the zone along the Congo river stretching from below Brazzaville south west to the Zaire border. Two secondary foci were noted, one in the region of the Bouenza and the other west of the Mayombe mountains. Surveys carried out in the north of the country and in the west did not reveal any onchocerciasis. However, certain areas of primary forest in these regions were found to be endemic for Mansonella streptocerca. Simulium damnosum s.l. in the sole vector of onchocerciasis. In both the Pool foci, and in the Mayombe focus, prevalences assessed from microfilarial and cyst counts were high but the mean microfilarial densities were relatively low. In certain villages over 90% of the population aged over 14 years may present with microfilariae and nearly 70% may present cysts.

Adolescent↗
PubMed1990

Clinical manifestations of loiasis in an endemic area in the Congo.

The functional symptomatology of loiasis was studied in 101 Congolese subjects living in a village in a highly endemic area. 27.7% of them were carriers of Loa loa microfilariae. 5.9% were infected with Mansonella perstans. No subjects were found to have dermal microfilariae. In anamnesis, 51.5% of them reported episodes of Calabar swellings, 69.3% history of eyeworm and 10.9% episodes of subcutaneous migration of worms during the last 12 months. Pruritus and secondary dermal lesions were frequently demonstrated in 64.4% and 56.4% of the individuals respectively. Asymptomatic amicrofilaraemic subjects only accounted for 11.9% of the adult population. The study of the life-time risk of eyeworm, also conducted in the Pygmy and Bantu populations of another village, was shown to be useful in epidemiological evaluations.

Adult↗
PubMed1989

Clinical and biological study of Loa loa filariasis in Congolese.

Clinical and biological evaluations were carried out on 84 Congolese patients with parasitologically confirmed Loa loa filariasis (without concurrent infection with other filariae) and on 98 controls without filariasis. On the patients, 72 presented with microfilaremia; another 12 with negative blood tests were seen towards the end of an episode of subconjunctival migration of the adult worm. The incidence and severity of the clinical signs depended upon the method of recruitment. The 3 most common signs were pruritus and edema (both occurring in successive acute episodes affecting mainly the hands and forearms) and subconjunctival migration of adult filariae. Papulovesicular eruptions were located mainly on the arms. Headaches and arthralgia were noted more frequently than in the controls. No relation was found between the ABO blood groups and loiasis. Eosinophilia (higher in patients with symptoms) and raised serum IgE levels were found in nearly all patients and were strongly marked in approximately 66%. A positive correlation was observed between these 2 parameters. Fluorescent antibody levels (adult filaria Dipetalonema viteae antigen) were comparatively low in patients with microfilaremia.

ABO Blood-Group System↗
PubMed1989

[Malaria attack: a difficult diagnosis in a region of high Plasmodium falciparum endemicity].

The diagnosis of malaria attack in regions for highly endemic P. falciparum is difficult. It is more so since the wide use of antimalarials by the infected populations and the spread of drug resistance. A positive test is not evidence for a malarial attack since in certain schools, in both rural regions and in some districts of big towns, over 3/4 of the children attending school are carriers of Plasmodium. On the other hand, true attacks, even severe forms, can occur without evidence of parasitaemia. The parasitic load is thus an important factor but the following must be taken into consideration: age, level of immunity, the extent of transmission and whether if is continuous or not, self medication and the initial systematic treatments, the possibility of drug resistance, ... The difficulties are illustrated by data collected in the Congo.

Animals↗
PubMed1989

[Loa loa filariasis: cause of severe eosinophilia].

Two cases of very high hypereosinophilia (28,160 and 11,232/mm3) observed in congolese patients are presented. Although microfilaraemia was not detectable, loiasis was diagnosed, given the clinical manifestations, epidemiological data, history of sub-conjunctival migration of the adult worm (in one case), spectacular recovery (clinical and biological) after treatment with diethylcarbamazine. This "allergic form" of filariasis is often considered unusual in indigenous subjects.

Adult↗