[Reverse reaction during BCG therapy followed by antibiochemotherapy].
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Biomedical subjects
Publications and source records attributed to G Baquillon.
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In 1986, vaccinal allergy has been looked for by tuberculin RT 23 intradermal reaction within a random group of 354 Central African Children aged of 3 to 23 months and immunized in the Mother and Child Care Services in Bangui in the framework of the Enlarged Vaccination Program, with the same B.C.G. strain during their postnatal period. Percentage of intradermal reactions equivalent or superior to 6 mm get down with time, of progressive but fast mode from 56.2 p.c. in the age group of 3 to 5 months to 20.2 p.c. in the ones of 12 to 23 months. Nevertheless, the authors recommend B.C.G. immunization in urban milieu during the postnatal period because of the strong vaccinal protection one get, but recommend also a systematic booster injection during the second year of childhood.
In the present review, two staining techniques have been compared to evaluate bacteriological index: the Lapeyssonnie and Causse's technique, used in french speaking Africa, and the one recommended by the O.M.S. scientific panel on chemotherapy of leprosy, Thelep. It appears that the former facilitates the finding of a greater number of bacilli. More efficient, it is also easier and faster than the latter one and, consequently, more adapted to logistic constraints attached to the fight against endemic leprosy in Africa.
The Central African Republic, which once had the highest Hansen disease prevalence rate in the Central African States, had exemplary results in the control carried out on the basis of sulfonic monotherapy since 1958. In 1983, a cluster sample survey in Upper-Sangha seemed to show that the prevalence of the disease was underestimated. It then became necessary to adopt a new national strategy whose objective would be to reduce the prevalence of leprosy in the country by 50% within five years. For this, a "National Programme for the Control of Leprosy in C.A.R." has been developed; in part it foresees the setting up of polychemotherapy for patients. These treatment protocols should insure healing of paucibacillary forms within six months and of multibacillary forms within twenty-four months. The new strategy of screening and decentralized treatment required retraining personnel and combining health education at individual and collective levels. The preliminary results of a national survey for the evaluation of the prevalence of leprosy are presented.
Between 1980 et 1983 all PB patients presenting at the Institut Marchoux, Bamako, took part in a prospective randomized therapeutic trial and were allocated to one of the following regimens: DDS 100 mg 7/7 3 years, RMP 900 mg 1/7 8 doses, RMP 900 mg 7/7 12 doses. At this moment 24, 29 and 22 patients respectively have been followed for periods of 24 to 56 months. With the exception of some irregular drug intake in the DDS patients followed either by relapse or delay in improvement, the efficacity as judged by histopathological examinations did not reveal any difference between the regimens. The study continues.
In Bangui (C.A.R.), a comparative survey about infestation by Plasmodium falciparum was carried out in 250 pregnant women and 250 non-pregnant women. Both groups were matched by age, and none of them had taken any chemoprophylaxis or anti malarial treatment for the month before the survey. Parasitic indices were significantly higher in pregnant women, and higher in primigravidae than multigravidae; the highest malarial indices were noted in the 15/20 age group. On the contrary, no significant differences were found according to the three first months of pregnancy. As a final result of this survey, the authors recommend a regular anti malarial chemoprophylaxis for pregnant women, and particularly for primigravidae, as they all constitute a group at high risk versus malarial infestation and considering the consequential effects on foetus.
Tuberculosis in Central African Republic is an endemic disease. Its prevalence is 3.87 p. 1.000. The relationship between tuberculosis and HIV infection has been observed on 39 out of 72 cases in the National Hospital of Bangui from September 1986 to June 1987. Tuberculosis is often acute and a severe disease with cervical adenopathies. 13 out of 39 patients died. In spite of cutaneous anergy, some cases (7/39) recovered with antituberculosis therapy.
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Taking into account their own experience and very numerous recent publications, the authors proposed an easy protocol towards diagnosed S.T.D., in African woman. Diseases are classified according to symptomatology: clear infection in case of cervico-vaginitis, ulcerations (painful or not), tumural formations, and also during salpingitis or infertility. They particularly emphasize cervico-vaginitis manifestations which represent one visit out of three in Gynecology Departments. For each infection, they recall its symptomatology, diagnosis and efficient treatment. They strongly recommend to keep in mind, in Africa, multi-microbial associations.
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This study of the corneal sensitivity in 57 sahelian black Africans with a biomicroscopically normal cornea demonstrated that most of them (80,8 p. 100) had a normal corneal esthesia. The others (19,2 p. 100) having an hypoesthesia are older than the average age of this group and have a lower sociocultural status.
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M. leprae, extracted from cutaneous biopsies of 4 out of 7 patients treated with DFS during one year at doses of 1000 to 1500 mg/day were injected in mouse foot pads. Bacterial multiplication was observed in each case. The purely bacteriostatic activity of DFS for M. leprae, previously observed in mice, is thus confirmed. The eventual place of DFS in the therapy of leprosy is discussed.