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C Ripert

Publications and source records attributed to C Ripert.

At least 19 recordsLinked to original sources
PubMed2003

[Schistosomiasis due to Schistosoma intercalatum and urbanization in central Africa].

The species name of Schistosoma intercalatum, Fischer 1934 is linked to the shape and the size of his eggs, which are intermediate between those of S. haematobium and S. bovis. S. intercalatum is the instrument of an intestinal form of schistosomiasis looking like the form induced by S. mansoni but characterized by a low location of the lesions, mainly situated at the rectum and sigmoid level. The spreading area of S. intercalatum is bound to Central Africa. The foci are often urban and of a size limited to a town district. Bulinus forskalii is the intermediate host mostly involved in transmitting S. intercalatum lower Guinea strain, which is the strain found in the largest number of foci. B. crystallinus too transmits the parasite in the area of Gamba in Gabon. The Central Basin congolese strain of S. intercalatum is transmitted by Bulinus globosus. The houses where inhabitants are voiding eggs of S. intercalatum are just in front of the river bank or stream which are snails'breeding places. S. intercalatum is expending at the present time because of the development of built-up areas which are characterized by a disorganized town-planning. The disease is due to the high faecal pollution of the environment, causing a contamination of the urban hydrographic network which is the setting of schistosomiasis transmission. Although primely linked to the forest area, S. intercalatum is spreading with deforestation. Coming from the savannah area, S. haematobium is now invading the forest area, entering into competition with S. intercalatum. But since Bulinus acting as intermediate hosts of S. haematobium are more heliophilous than Bulinus transmitting S. intercalatum, urinary schistosomiasis has a tendency to supplant recto-sigmoidal schistosomiasis, especially in foci where hybridization between the two species of schistosomes is occurring.

Africa, Central↗
PubMed2000

[Urinary schistosomiasis].

EPIDEMIOLOGICAL DATA: The most frequently encountered human bilharziasis, urinary Schistosoma haematobium schistosomiasis, is endemic in Africa and western Asia: 51 countries are concerned. Humans are infected by contact with water harboring snails of the genus Bulinus that emit furcocercous cercariae. Older children eliminate large quantities of schistosoma eggs in urine. CLINICALLY: Schistosoma haematobium lives in the adult form in the bladder plexus, emitting eggs into the urine. Hematuria and signs of upper urinary tract dilatation are the most frequent clinical manifestations. There has been no data substantiating a higher incidence of urinary tract infections or urinary stones in S. haematobium infested subjects. Schistosomiasis alone does not appear to play a major role in infertility. Inversely, clinical and pathology studies do persistently demonstrate an epidemiological association between urinary schistosomiasis and bladder cancer.

Adult↗
PubMed2000

[S. mansoni intestinal schistosomiasis].

EPIDEMIOLOGICAL DATA: Caused by Schistosoma mansoni, intestinal bilharziasis is endemic in west central Africa, the Arabic peninsula, the Caribbean Islands and the Atlantic cost of South America. Young adults emit large quantities of eggs in stools. CLINICALLY: The adult stage of Schistosoma mansoni lives in the mesenteric veins draining the colon. Its eggs are deposited in the submucosal veinules then pass into the intestinal lumen. Patients eliminating eggs massively experience abdominal pain and diarrhea with stools containing blood and mucus. Hepatomegalia develops, often with splenomegalia. Signs of portal hypertension, collateral circulation and ascitis are observed in highly endemic areas. Other less typical signs of digestive disorders such as anorexia, vomiting, or nausea, have also been reported.

Africa↗
PubMed2000

[Other forms of schistosomiasis].

SCHISTOSOMA INTERCALATUM: Endemic in central Africa, S. intercalatum is the causal agent of this intestinal bilharziasis, which is similar to Mansoni's disease but with a characteristic lower localization (rectum and sigmoid). The principal clinical signs are digestive disorders: abdominal pain, diarrhea or dysentery, straining, tenesmus, rectal bleeding. The moderately enlarged liver is smooth and hard but not painful, especially observed in adolescents. ORIENTAL BILHARZIASIS: Schistosoma japonicum (found in lakes in China, Thailand, Philippines, Indonesia) and Schistosoma mekongi (Melong valley) are the principal agents. Both lead to major liver fibrosis producing severe portal hypertension and growth retardation in children.

Animals↗
PubMed2000

[Schistosomiasis: diagnosis and treatment].

LABORATORY DIAGNOSIS: Eggs from Schistosoma haematobium can be found in large quantities in end-miction urine. Their elimination is favored by forced urination. Large quantities of S. mansoni, S. intercalatum, S. japonicum, and S. mekongi can be found on the surface of stools and in mucus and bloody fecal matter. Eggs from S. haematobium are exceptionally found in stools and may be identified in rectosigmoid biopsy samples. Immunological reactions can also be used to identify the species. THERAPY: Praziquantel, the drug of choice, is active against all schistosomal species. Oxamniquine is only active against S. mansoni and is not used outside Latin America. Molluscicidal agents have provided interesting results. Sanitary measures and education are essential therapeutic tools while waiting for a hypothetical vaccine.

Animals↗
PubMed2000

[Reactive hypereosinophilia in parasitic diseases].

Hypereosinophilia is often linked to the presence of pluricellular parasites in host tissues. Polynuclear eosinophils are sprung from the bone marrow. After multiplying and maturing, they are thrown into the blood flow and from the blood to the tissues where they are found in immediate contact with the parasite. Eosinophils are major components of the parasitic granuloma. Parasitic diseases are a major cause of hypereosinophilia and eosinophilia is mainly due to helminths. Protozoa do not produce hypereosinophilia, except for toxoplasmosis in which a low and discontinuous eosinophilia may be seen. Subsequently, maggots producing myiasis yield to hypereosinophilia too. In helminthiasis, the action of the eosinophil granulocyte is double. In tissues, it destroys the parasite and plays a regulatory role in mastocytes degranulation. Eosinophils which participate in the inflammatory reaction secrete factors which neutralize mediators liberated by mastocytes, histamine mainly, destroyed by histaminase. In a practical point of view, blood hypereosinophilia is a very useful tool for diagnosis. Eosinophilia reach early a high value, this before the parasitic infection becomes detectable by means of resources other than immunological. The eosinophils rates decreases rapidly as an effect of the anthelmintic drug, this confirming the efficacy and specificity of the prescribed treatment.

Diagnosis, Differential↗
PubMed1996

[Epidemiology of certain endemic parasitic diseases in the town of Guadalupe (Republic of Sao Tome and Principe) I. Schistosomiasis intercalatum and intestinal worms].

Schistosomiasis intercalatum in known to exist in Saõ Tomé since 1988, (Corachan et al.). It is transmitted by Bulinus forskalii, (Brown et al., 1989). Stool, blood and urine specimens have been collected from 380 inhabitants of all age groups living in the small town of Guadalupe close to the Agua Traź river and Agua Polino. The prevalence of schistosomiasis by detection of S. intercalatum eggs in a 10 mg stool thick smear (Kato technique) is 25.5%. An excreted Schistosoma polysaccharide antigen, detected by means of a monoclonal antibody (Ripert et al., 1992), is found in 49.1% of the urine samples. Patients voiding S. intercalatum eggs in stools have been treated with praziquantel (40 mg/kg body weight), as recommended by WHO Expert Committee on Schistosomiasis, but it might be wise to also treat persons excreting antigen in urine. The prevalence of intestinal helminthiasis, ascariasis (73.7%), trichuriasis (73.7%) and necatoriasis have been measured.

Adolescent↗
PubMed1991

Failure of falciparum malaria prophylaxis by mefloquine in travelers from West Africa.

Due to the spread of chloroquine-resistant strains of Plasmodium falciparum in French speaking parts of Africa, we have found it necessary to prescribe mefloquine for antimalaria prophylaxis to travelers to this area. Weekly doses of 125 or 250 mg have been recommended for short journeys. In spite of this regimen, 16 documented cases of falciparum malaria in travelers have been recorded in the Bordeaux hospital center since October, 1988. Fifteen of these patients were tourists returning from West African countries, and one was an Ivorian student who had been on vacation to his home country. Nine of these patients were evaluated and found to have high plasma mefloquine levels. This report strongly supports the existence of mefloquine-resistant falciparum malaria in West Africa, especially in Sierra Leone, Burkina Faso, and Cote d'Ivoire.

Adult↗
PubMed1991

[Hematologic features in imported malaria. Value for the diagnosis of forms with low parasitemia].

Blood cell counts were performed on blood samples from 37 patients with imported malaria using three different blood analyzers (Coulter STKR, Coulter VCS and Technicon H1). Results were controlled by direct microscopic examination. Anemia, leukopenia, thrombocytopenia, or abnormalities of the leukocyte differential count were found in 32, 24, 30 and 92% of patients, respectively. The automatic analyzers gave alert messages for 70 to 75% of specimens, including specimens from ten patients with low parasitemias. These abnormalities should prompt careful analysis of blood smears when drug-resistance is suspected.

Adolescent↗
PubMed1991

[Imported malaria in Bordeaux: evaluation of the risk of infection with Plasmodium falciparum as a function of country visited].

This study of imported cases of malaria, which was carried out in Bordeaux (France) in 1987-89, emphasizes the major part played by Plasmodium falciparum, especially in areas lying south of the Sahara in Africa, from where falciparum malaria is mainly imported to other countries. The study of these imported cases is strengthening our understanding of the epidemiology of malaria in relation to the country or area, whether the transmission occurs without interruptions or seasonally. The number of cases of P. falciparum per 1000 travellers (seen for vaccination against yellow fever at Bordeaux) gives an index for evaluating the risk of malaria. This risk changes with the epidemiological profile of falciparum malaria in the three major African ecosystems (rain forest, savannah, and sahelian belts), and is related to the progression of chloroquine resistance in Africa and influenced by the type of chemoprophylaxis proposed to travellers. The use of mefloquine for stays shorter than one month in Central Africa reduced the risk of malaria in 1988 and 1989, compared to 1987. [Editorial note. Recent data indicate some undesirable side-effects of mefloquine, e.g., its use during early pregnancy could lead to congenital defects.] Appropriate chemoprophylaxis and advice to travellers to areas lying south of the Sahara are therefore more and more necessary in order to arrest the increase in the number of imported falciparum malaria cases and reduce the number of serious cases, which are costly in terms of public health.

Adult↗
PubMed1990

[Imported malaria in Bordeaux in 1989. Epidemiologic, clinical and therapeutic study of 71 cases].

In 1989 there were 71 cases of imported malaria admitted to the hospital in Bordeaux. This is 16.5% and 29% lower than in 1988 and 1987 respectively, thanks to the widespread use in Africa of mefloquine chemoprophylaxis. Sub-Saharan Africa is involved in 95% of cases, mainly West Africa (70% of cases), unlike the situation in 1987, and the first cases of paludism despite mefloquine chemoprophylaxis appeared during the second semester from the seasonal mid-summer recrudescence onwards, in travellers returning from this region. The most frequent species is still Plasmodium falciparum (80% of declared cases). This imported disease especially affects young adults despite regular prophylaxis in 59% of cases. It is therefore important to recommend rigorous protection against anopheles. Male predominance (sex ratio: 5.5) was greater in 1989 than in the previous two years, and French nationals represented 85% of the population. Falciparum malaria presents symptoms in 95% of cases before the end of the month following the patient's return to France, while for P. ovale the time for symptoms to appear is between 39 days and two years after return. Management of patients on their return poses a problem of information, since in 40% of cases diagnosis is made more than a week after the first symptoms. Attacks are mild in most cases (93%); among the serious cases death occurred in a 3-year-old child. Thrombopenia is the most frequent biological sign (22.5% of cases), followed to a lesser degree by anaemia and leukopenia. Mild attacks respond well to classical treatment (halofantrine, mefloquine, quinine, chloroquine), while two cases of more complicated symptoms required exchange transfusion.

Animals↗
PubMed1990

Detection with a monoclonal antibody of a polysaccharide antigen, excreted in the urine, in the schistosomiasis intercalatum focus of Edea (Cameroon).

The detection in the urine specimens of a sample of the inhabitants of Edea of a polysaccharide antigen characteristic for the genus Schistosoma, with monoclonal antibody by means of the inhibition of a passive haemagglutination test, shows that this technique is very sensitive for measuring prevalence of schistosomiasis due to S. intercalatum. In Edea, looking for eggs in stool specimens gives a low prevalence rate of the disease because of the low parasitic load. The prevalence by age, according to the voiding of eggs, is evoluting parallel to the excretion of the antigen.

Adolescent↗
PubMed1990

Evaluation of the treatment of intestinal helminthiases with albendazole in Djohong (North Cameroon).

246 inhabitants of Djohong, a township located in North-east Cameroon, presented with single or mixed nematode infections. They were treated by 400 mg albendazole in a single dose. The results were evaluated either with the Kato thick-smear technique and the Ritchie technique on stools and/or the Graham test: albendazole has proved to be 100% efficacious in pinworm and roundworm treatment, 63% to 84% in hookworm treatment (difference due to the type of technique used). Albendazole showed a mean efficacy in whipworm treatment (about 50% cure rate). In case of residual worm infection, the egg count is reduced from 80% to 90% which is of the utmost importance. The relative treatment failures occurring with large worm load. This systematic treatment of a whole population considerably reduces the spread of nematode eggs over the soil (18-fold for Nector americanus, 10-fold for Trichuris trichiura). This broad spectrum anthelmintic is strongly recommended in mass treatments for its efficacy and excellent tolerance, as its ovicide action reduces the probability of fecal pollution of the environment by treated patients who have residual parasites.

Adolescent↗
PubMed1989

Effect of a mass treatment with praziquantel on the excretion in urine of a polysaccharide antigen used for diagnosis of schistosomiasis due to S. mansoni in Cameroon.

The detection in urine, with a monoclonal antibody, of an excreted polysaccharide antigen characteristic of the genus Schistosoma, allows evaluation of the effect of praziquantel used for mass treatment, in a focus of S. mansoni infection. Inhibition of the passive haemagglutination test, which was used for detecting the polysaccharide antigen in urine, is more sensitive for measuring prevalence than the determination of eggs in stools by means of direct examination and the formalin-ether concentration technique. Nine months after anthelminthic treatment, the percentage of inhabitants excreting antigen in urine diminished markedly, while the circulating antibody levels remained high. The test for detecting the antigen in urine seems to be the most efficient way to monitor the effect of mass treatment in intestinal schistosomiasis.

Age Factors↗
PubMed1989

[In vivo sensitivity of Plasmodium falciparum to amodiaquine in the town of Edea (Cameroon)].

In the town of Edea, where falciparum malaria is hyperendemic, an in vivo study of amodiaquine sensitivity of the local strain of the parasite is performed in school children 6 to 12 years of age: 184 children with parasites in their blood and no chloroquine in their urine are given amodiaquine orally. In 96 children having taken 35 mg per kg body weight of amodiaquine base, none is any longer harboring parasites in his blood as soon as the second day following the end of the 3 days treatment (15 mg/kg body weight the first day, 12 mg/kg the second day and 8 mg/kg the third day). The 73 children having taken 27 mg/kg body weight of amodiaquine base are cleared of their parasites at the rate of 93% on the seventh day of the experiment. The 15 children having only taken 15 mg/kg body weight of amodiaquine base are cleared of their parasites at the rate of 54%. At the utilized doses, amodiaquine is generally well tolerated. Conjunctival hyperhaemia has only been observed as a secondary effect in 9 children among the 184 children treated but this side symptom disappeared soon after the end of the treatment. Aminotransferases blood levels are not modified in the course of the amodiaquine treatment.

Amodiaquine↗
PubMed1989

[Halofantrine in the treatment of malaria. Clinical trial in a semi-rural zone of Cameroon].

Twelve children, 2 to 15 years of age, with falciparum malaria (parasitaemia 4,500 to 170,000/mm3) have taken 24 mg/kg body weight of halofantrine hydrochloride (Halfan) per os in three divided doses given within 12 hours. The symptomatology improved after 24 to 48 hours, with no more fever 5 to 90 hours after treatment and with a decrease of splenomegaly in 80% of the cases. The parasitic clearance was obtained after 24 to 60 hours. The haematocrit started raising again in 58% of the cases. Halofantrine hydrochloride is an efficient antimalarial drug in semi-immune patients. It is well tolerated and well accepted, thus representing an alternative for the cure of chloroquine-resistant falciparum malaria.

Adolescent↗