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Biomedical subjects

D Daumerie

Publications and source records attributed to D Daumerie.

At least 19 recordsLinked to original sources
PubMed1994

Activity of two doses of rifampin against Mycobacterium leprae.

In the course of a clinical trial designed to re-examine the bactericidal efficiency of 600-mg doses of rifampin (RMP) against Mycobacterium leprae, two doses of RMP, either 600 mg or 1200 mg, were administered 28 days apart to 29 previously untreated patients with lepromatous or borderline leprosy. Seven, 28, and 35 days after the start of the trial, skin biopsies were performed and immunologically normal mice were inoculated with 5 x 10(3) or 10(4) M. leprae in each hind foot pad. The patients assigned to the two regimens did not differ significantly in terms of sex, age, disease classification, bacterial index, or the concentration of M. leprae in the skin lesion biopsied for the inoculation of mice. The concentrations of organisms in the skin-biopsy specimens did not change significantly over the course of the trial among the patients, whether they were being treated by the first or the second regimen. The M. leprae recovered from specimens obtained from 21 of the patients, before beginning treatment, multiplied in a majority of the mice inoculated. The results of mouse inoculation confirmed the rapid bactericidal effects of RMP against M. leprae: a single dose of RMP rendered the organisms obtained from all but two of the patients incapable of multiplying in mice. No significant difference was demonstrated between the two regimens, nor was an additional effect of the second dose of RMP observed.

Adult↗
PubMed1991

Leprosy in the WHO African region.

The African Region has the second largest prevalence of leprosy among the WHO regions with about 1 per 1,000 population affected. With a very uneven distribution among countries, the region currently has a total of about 480,000 registered cases. The number of new cases detected per year is reported to be about 37,000. A high proportion (25-40%) of the registered cases are estimated to have significant physical disabilities. In spite of the introduction of multidrug therapy (MDT) in the early 1980s, currently only about 20% of the patients are benefiting from this improved treatment. The major problem in the low MDT coverage appears to be operational, against the background of a difficult socioeconomic situation. However, there have been favourable trends towards increased political commitment in several countries in recent years. The operational and technical constraints were discussed at an interregional conference in Brazzaville in 1989 which emphasized the need to make use of the opportunities to reduce disease prevalence through MDT; to coordinate various internal and external resources available for leprosy control; to increase political commitment and develop plans of action to build national capabilities for leprosy control; to integrate leprosy control within general health services; and to promote health education.

Africa↗
PubMed1991

Global review of multidrug therapy (MDT) in leprosy.

Leprosy continues to be an important public health problem in most countries of Asia, Africa and Latin America. While there has been a steady increase in the number of registered leprosy cases from 1966 to 1985, since then there has been a substantial reduction of over 30% in the number of registered cases. This is mainly attributed to the introduction of multidrug therapy (MDT) as recommended by a WHO study group on chemotherapy of leprosy for control programmes in 1981. The coverage for MDT has steadily increased over the last 5 years, reaching a global figure of 55.7% of all registered cases by October 1990. Over 2 million leprosy patients are currently undergoing MDT and, in addition, over 1 million patients have completed MDT since 1985. MDT has been found to be generally well tolerated with a high level of acceptability leading to improved treatment compliance. MDT coverage shows wide variations among WHO regions and among individual countries. The prospects for further reductions in prevalence of registered cases in the next decade are very bright. However, problems such as early case detection, and prevention and management of disabilities after patients have been curred for several years, will continue to pose significant challenges.

Africa↗
PubMed1987

[Kaposi's disease in Western Africa. 11 cases in Mali].

Eleven cases of Kaposi's angiosarcoma (ASK) were observed in Bamako over a 2 year period, representing one third of all malignant cutaneous tumours. There was a clear cut male prevalence. The average age of the patients was 32 years. The commonest sites of involvement were cutaneous, osseous, lymphatic and gastrointestinal. Special features of this series included prurigo preceding skin lesions, a single gastric localisation and involvement of the cavum. Rapid progression was observed in 3 cases, 2 of which had fatal outcomes. Two patients had multifocal disseminated disease at the outset. These cases were similar to ASK in patients with AIDS but our patients were not immunodepressed and LAV serology was negative. The results of chemotherapy were incomplete and transient. This series demonstrates the presence of acute, polyvisceral forms of ASK in Mali which may be classified as intermediary between the classical European or African ASK and the ASK observed in AIDS with positive serology in Central Africa.

Adult↗
PubMedDate not supplied

[Chemosensibility of Plasmodium falciparum in Africa south of the Sahara: evaluation of two and a half years' research at the Tropical Medicine Institute of the Health Service of the French Armed Forces].

From March 1987 to June 1989, 194 isolates of Plasmodium falciparum were studied in vitro by the isotopic semi-microtest. 86.1% were resistant to chloroquine; 9.5% had a decrease of sensibility to quinine and 3.3% a decrease of sensibility to mefloquine. There was a positive correlation between I.C. 50 of the antimalarial drugs compared by pairs.

Adolescent↗
PubMedDate not supplied

[Epidemiological value of graphic representation of the Tukey test].

The method of Tukey shows a graphic view of a distribution of data around its median. This graphic representation is simple, easy, pertinent and computer-compatible. It optimizes the description of distribution of data (normal or free distribution). Usable with small size samples, the Tukey test is not very powerful, but robust, and authorizes a comparison of two or more medians with a risk of 5%.

Data Interpretation, Statistical↗
PubMedDate not supplied

[Principle findings connected with the problems of implementing the multi-drug therapy for leprosy in West Africa].

The Implementation of Multidrug Therapy (MDT) in the states of West Africa oblige to analyse new restraints, in order to modify the existing health structures. The planning of Hansen's programs based on MDT needs to consider the technical and logistic parameters. Solutions are proposed for health workers training course, flow chart, drug supply system and supervision system. The advocated method uses at the existing resources, and aims at the integration into general health services, reinforced by specialized teams.

Africa, Western↗
PubMedDate not supplied

[Evaluation of endemic leprosy in an urban zone--sampling survey at the household level: results at Bamako, Republic of Mali].

A sample survey on households was conducted in Bamako (capital of the Republic of Mali) in order to estimate epidemiological and logistical indexes relating to Hansen's disease. With a prevalence rate reaching 7.37 +/- 1.83 per thousand, a detection rate reaching 0.91 +/- 0.49 per thousand the city is a high level endemic area. All observed parameters (age, sex, racial, hygiene status, geographic distribution) seem to have no influence on disease aspect. The majority of the patients (80%) are treated by monotherapy with Dapsone, generally for excessive duration. The sociocultural impact of the Hansen's disease is very important, the physical and sensorial handicaps are frequent (34%). The survey's results could be used in order to elaborate a strategy for leprosy control based on multi-drug therapy in urban areas.

Family↗
PubMedDate not supplied

[Necrotic course of erythema nodosum leprosum].

During 2 years, 25 lepromatous patients were hospitalised in the Hansen complications room of Institut Marchoux. Between these patients, 9 developed a Necrotic Erythema Nodosum Leprosum. A review of the observed clinic effects is established and 3 types of signs are isolated and discussed: necrotic extension after big nodes on chest and arms, a punch crater complicating small nodes, and a sclerous xylodermia on arms and legs. The course of this complication is estimated about six months average, with pauses and relapses with general and subjectives symptoms. The final course shows side effects: anemia, denutrition, functional disabilities of joint movements and cutaneous straps. In the group of 9 patients, 3 died. We did not find relations between the necrotic phenomenon and therapy or occurred diseases. The best drug to stop the necrotic processus is thalidomide 400 mg daily and decrease 100 mg when the signs fall near normality. One or two mg/kg each day coricosteroides were tested: the effect is unconstant, the duration of action is shorter. Side effects occur rapidly and patient will become corticosteroïd dependent. The importance of bath with disinfectants is high. We did not observed surinfection.

Adult↗
PubMedDate not supplied

[Integration of leprosy polychemotherapy into general health services].

The actual control of leprosy must conciliate difficulties of multidrug therapy (MDT) application and integration of general health services. The getting up of multidrug therapy needs a logistic with clinical and bacteriological track off, patient categorisation, supervision of treatment, follow up of the drug compliance and control of the disease evolution. The management of such system must be perfectly mastered in order to avoid the uncontroled circulation of rifampicine. Solutions are proposed in order to increase specialized teams efficiency and integration of non specialized officers incumbent tasks.

Drug Therapy, Combination↗