PubMed Health⌕ Search

Biomedical subjects

H Dumon

Publications and source records attributed to H Dumon.

At least 19 recordsLinked to original sources
PubMed2005

Colonic fermentation of inulin increases whole-body acetate turnover in dogs.

Metabolism of acetate from colonic fermentation was investigated in dogs. Beagle dogs (n = 9) were fed a control diet for 17 d followed by a 3% inulin-enriched diet (from chicory) for 4 and 21 d. On 3 occasions, the dogs were administered simultaneously infusions of [1-(13)C]acetate i.v. and [1,2-(13)C(2)]acetate intrarectally. Peripheral acetate concentration and turnover did not change over time after consumption of an inulin-enriched diet for 4 d. After 21 d of consuming the inulin-enriched diet, the whole-body acetate turnover increased significantly by 31% from (mean +/- SEM) 15.6 +/- 2.2 to 20.4 +/- 2.9 micromol/(kg . min) without a change in concentration. The rate of colonic acetate production that reached the peripheral circulation was 4.8 +/- 1.8 micromol/(kg . min). However, no [1,2-(13)C(2)]acetate tracer was recovered in the peripheral circulation. The fraction of oxidized tracer was higher in the gut (64 +/- 3%) than in peripheral circulation (46 +/- 3%) in dogs fed an inulin-enriched diet for 21 d. In conclusion, colonic fermentation of inulin occurred and indirectly stimulated whole-body acetate turnover in dogs fed an inulin-enriched diet for 21 d.

Acetates↗
PubMed2004

Echinococcus granulosus strain typing in North Africa: comparison of eight nuclear and mitochondrial DNA fragments.

Recent studies of Echinococcus granulosus molecular strain typing have enabled a better understanding of the transmission cycle of cystic echinococcosis. There have been many publications in this area but there is a need for the evaluation of these tools. We have attempted to respond to this need in our study, which assessed 8 DNA fragments of 40 E. granulosus cysts from North Africa. Parasitological material was collected from 5 types of intermediate hosts, in 5 different countries. The primers chosen to amplify DNA targets were defined either in nuclear DNA, or in mitochondrial DNA. After amplification, PCR products were sequenced. The sequences obtained were aligned and comparisons were made within the group and with GenBank sequences. Whether the target was nuclear or mitochondrial, the same 2 main groups of genotypes were found. The first one, the 'sheep' strain, was found in the human, sheep and cattle samples collected in North Africa. The second one, the 'camel' strain, was found in the camel cysts and cattle and human cysts from Mauritania. These findings further confirm the congruence of the data given by the nuclear and the mitochondrial genome.

Africa, Northern↗
PubMed2004

Insulin resistance and changes in plasma concentration of TNFalpha, IGF1, and NEFA in dogs during weight gain and obesity.

Obesity-induced insulin resistance (IR) is a common problem in humans as well as domestic dogs. It is well-known that this syndrome is associated with many modifications but it is still unclear if the changes are alterations or adaptations. The purpose of this study was to develop obesity-induced IR in dogs, through a long-term overfeeding period, and to explore hormonal and metabolic disturbances associated with the development of this syndrome. Dogs were overfed for 7 months. Body weight increased by 43 +/- 5%, and insulin sensitivity decreased by 44 +/- 5%. Plasma insulin-like growth factor 1 (IGF1), tumour necrosis factor alpha (TNFalpha), and non-esterified fatty acids (NEFA) concentrations progressively increased during the overfeeding period (IGF1: 111 +/- 13 to 266 +/- 32 ng/ml, p < 0.001; TNFalpha: 5 +/- 5 to 134 +/- 41 pg/ml; NEFA: 0.974 +/- 0.094 to 1.590 +/- 0.127 mmol/l, p < 0.05). These metabolic and hormonal impairments are associated with IR, in obese dogs, and could explain, at least in part, the outbreak of this syndrome.

Animals↗
PubMed2004

Wall relative humidity: a simple and reliable index for predicting Stachybotrys chartarum infestation in dwellings.

UNLABELLED: Because the indoor mold Stachybotrys chartarum has been considered as potentially responsible for serious health effects, its identification in dwellings with water damages is of utmost importance. As such dwellings are many, it would be of great value to have a simple and reliable index for predicting its presence. The aim of the study was to compare measurements of wall relative humidity (RH) to mold identification in 458 samples from 100 dwellings. Mold identification was performed by direct microscopic examination of a sample collected on the wall by the gummed paper technique. Mean (+/- s.d.) wall RH (%) was much higher (97.0 +/- 6.1) on the 30 samples where S. chartarum was identified compared with the 291 samples where other molds were identified (41.8 +/- 36.9) and to the 137 samples where no molds were identified (38.9 +/- 34.8). There was no straightforward relationship between wall and room RH. In conclusion, this study clearly demonstrate that the simple measurement of wall RH can be used as a reliable index for discarding and suspecting S. chartarum infestation in dwellings. PRACTICAL IMPLICATIONS: This paper suggests that very high relative humidity (RH) within walls is a strong risk factor for their infestation with the 'toxic mold' Stachybotrys chartarum. Besides, data from the literature demonstrate that other molds are able to produce mycotoxins when RH is very high. Thus, measurement of wall RH, which is easy to perform and very cheap, could be used as a screening tool to select those dwellings where mold identification should be performed and remediation should be promptly carried out.

Air Pollution, Indoor↗
PubMed2003

Cystic echinococcosis in Algeria: cattle act as reservoirs of a sheep strain and may contribute to human contamination.

In Algeria, cystic echinococcosis (CE) is a serious economic and public health problem. The common sheep/dog cycle is usually considered as the major source of human contamination. But to date the main strain of Echinococcus granulosus involved in the human contamination and the role of other hosts are still unknown. This paper reports an original work performed in northern Algeria combining field observations and molecular analysis. In a first step, examination of 6237 carcasses in slaughterhouses showed high infection and fertility rates in cattle and dromedaries. Then, in a second step, we used a molecular biology approach to identify the E. granulosus strain(s) involved. Forty-six samples from various origins were collected. They were analysed using comparison of PCR-amplified DNA sequences with one genomic (BG 1/3) and two mitochondrial (COI and NDI) targets. Results show the presence of a "sheep" strain of E. granulosus in North Algeria circulating between cattle and ovines and infectious to humans, whereas in South Algeria, a "camel" strain and a "sheep" strain were found to circulate in camels and in sheep, respectively. This study also reports an ambiguous genotype which resembled the "sheep" strain genotype (Gl) on the basis of the partial COI gene sequence, whereas on the basis of the partial NDI gene sequence, it was similar either to the "sheep" strain (Gl) or to the "camel" strain (G6). Besides its basic interest, our study confirms the role of other hosts (mainly cattle) in leading to transmission to humans and suggests that control measures should not only target sheep.

Algeria↗
PubMed2003

Influence of age and body size on the digestibility of a dry expanded diet in dogs.

The objectives of the study were (i) to evaluate the effects of age and body size on the apparent digestibility of a dry expanded diet and (ii) to determine whether poor faecal quality could be related to lower nutrient utilization. Four breeds of dogs were used: six Miniature Poodles (MP), six Medium Schnauzers (MS), six Giant Schnauzers (GS) and six Great Danes (GD). Digestive trials were performed at 11, 21, 35 and 60 weeks of age. Faecal moisture and scoring were recorded at the same periods. Digestibility coefficients of all macronutrients increased significantly (p < 0.05) with age in all four breeds. Organic matter digestibility increased from 80.2 +/- 1.5 to 85.5 +/- 1.5% in MP; from 80.2 +/- 0.9 to 86.3 +/- 0.5% in MS; from 79.6 +/- 4.2 to 88.9 +/- 0.5% in GS and from 85.7 +/- 1.5 to 88.4 +/- 0.8% in GD. Crude protein digestibility increased from 74.5 +/- 4.0 to 81.5 +/- 1.9% in MP; from 74.3 +/- 3.9 to 82.6 +/- 0.9% in MS; from 71.8 +/- 6.0 to 85.9 +/- 0.9% in GS and from 80.8 +/- 4.6 to 84.8 +/- 1.3% in GD between 11 and 60 weeks of age, respectively. Mean faecal moisture also increased over the growth, except in GS. Nutrient digestibility was significantly higher in large dogs at all age periods. However, larger dogs showed lower faecal scores and increased faecal moisture. In conclusion, these results show (i) an effect of age and body size on nutrients digestibility and (ii) that the lower faecal quality observed in healthy large breed dogs does not appear related to lower nutrient utilization.

Aging↗
PubMed2001

Prenatal diagnosis using polymerase chain reaction on amniotic fluid for congenital toxoplasmosis.

OBJECTIVE: To evaluate sensitivity, specificity, and predictive values of a prenatal amniotic fluid (AF) polymerase chain reaction (PCR) test for diagnosis of congenital toxoplasmosis. METHODS: A multicenter prospective study was done on 271 women with proved primary Toxoplasma infection during pregnancy and who had amniocentesis for prenatal diagnosis by PCR. Live-born infants were eligible for analysis only if a serologic follow-up could assess a definitive infection status. RESULTS: Of the 270 evaluable cases, 75 were congenitally infected, 48 of whom had a positive PCR at prenatal diagnosis. Overall sensitivity of PCR on AF was estimated at 64% (95% confidence interval [CI] 53.1%, 74.9%), negative predictive value of 87.8% (95% CI 83.5%, 92.1%), whereas specificity and positive predictive value were 100% (95% CIs 98%, 100% and 92.3%, 100%, respectively). Among cases with congenital toxoplasmosis, there were no significant differences between those with positive or negative PCR with regard to median gestational age at maternal infection, interval between maternal infection and amniocentesis, or duration of treatment before amniocentesis. However, sensitivity of PCR was found to be significantly higher for maternal infections that occurred between 17 and 21 weeks' gestation (P <.02). CONCLUSION: A negative PCR of AF cannot rule out congenital infection. In this case, continuation of treatment with spiramycin combined with ultrasonographic follow-up and postnatal follow-up are warranted. Our results also suggest presumptive treatment combining pyrimethamine and sulfonamides in case of maternal infection occurring late in pregnancy.

Adult↗
PubMed2001

Leptin, body fat content and energy expenditure in intact and gonadectomized adult cats: a preliminary study.

The present study was conducted to assess the body composition, leptin, and energy expenditure changes following gonadectomy in cats. Twenty-one females (12 intact and nine spayed) and 21 males (11 intact and 10 castrated) were used. Body weight was recorded. Serum plasma leptin was measured by radioimmunoassay and body composition and energy expenditure were assessed after injection of doubly labelled water. These results confirmed the gain in body weight and body fat following neutering and demonstrated a strong linear relationship between body fat and serum level of leptin. Energy expenditure decreased in castrated cats in comparison with intact ones. This study underlined the effect of gonadectomy as a major factor of obesity in cats and showed that the increase in circulating leptin reflected the amount of body fat. The present results provide further evidence that the regimen of gonadectomized cats should be carefully controlled to avoid excessive weight gain.

Adipose Tissue↗
PubMed2001

Effects of dietary protein restriction and amino acids deficiency on protein metabolism in dogs.

Although stable isotope methods have been used to revisit the protein and amino acid requirements of humans in the last two decades, estimates of the minimum protein requirement of the dog have mainly been based on nitrogen balance studies. The aim of this study was: (i) to assess dog protein metabolism using the (13)C-leucine method, and (ii) to test the effects of protein deprivation and amino acid deficiency on protein metabolism. Eight dogs were fed three consecutive diets: (i) a normoprotein regimen [control; 63 g crude protein (CP)/Mcal metabolizable energy (ME)]; (ii) a protein-restricted diet (PR; 32 g CP/Mcal ME); and (iii) a protein-restricted diet that was, in addition, deficient in lysine and tryptophan (D-PR; 31 g CP/Mcal ME). The energy supply was similar for the three diets. The dogs were adapted to each diet for 2 weeks. After a 24 h fasting period, a 3 h infusion of (13)C-bicarbonate was performed, followed by a 3 h continuous infusion of L-[1-(13)C]leucine. Blood and breath samples were collected before and during the last hour of each isotope infusion for determination of plasma (13)C-alpha-ketoisocaproate and breath (13)CO(2) enrichments by mass spectrometry. Rates of protein breakdown, oxidation, and synthesis were calculated from leucine appearance into plasma, oxidation, and non- oxidative disposal, respectively, and expressed in g N/kg body weight (BW)0.75 per day, assuming body protein contains 0.08 g leucine per g protein. Protein breakdown was 3.71 +/- 0.17, 3.29 +/- 0.16 and 2.73 +/- 0.18 (mean +/- SEM) for control, PR, and D-PR, respectively (p < 0.01 D-PR versus control, and p < 0.05 D-PR versus PR). Protein synthesis was 3.08 +/- 0.13, 2.77 +/- 0.13, and 2.15 +/- 0.18 for control, PR and D-PR, respectively (p < 0.001 D-PR versus control, and p < 0.05 D-PR versus PR). Protein oxidation was 0.63 +/- 0.05, 0.53 +/- 0.05 and 0.58 +/- 0.05 for control, PR and D-PR, respectively (p=NS). These data suggest that: (i) the (13)C-leucine method can be used to assess large variations of protein turnover in dogs; (ii) dogs have the capacity to adapt their protein turnover to the level and to the quality of their protein supplies; and (iii) the dog nitrogen requirement for maintenance may be between 0.41 and 0.55 g N/kg BW(0.75) per day.

Adaptation, Physiological↗
PubMed2001

Gastrointestinal transit of solid radiopaque markers in large and giant breed growing dogs.

Observations on food tolerance in dogs have shown that some breeds, especially the giant breeds, have a greater digestive sensitivity. One of the consequences common in these breeds is a higher faecal water content and a poor faecal quality. This could be explained, at least in part, by limited digestive capacity and function in giant breed dogs. In this report, the gastric emptying that represents one parameter of the digestive function was studied in large and giant breed dogs during their growth. Six Great Danes (GD) and six Giant Schnauzers (GS) were fed small radiopaque markers mixed with a test diet at 12, 22 and 36 weeks of age. Abdominal radiographs were made every 30 min for a period of 4 h and then hourly until 12 h. At 12 weeks of age, the gastric emptying pattern was similar in both breeds. However, from 22 weeks of age, the gastric emptying of the GD was significantly more rapid than that of GS. The gastric emptying of small markers tended to slow down in growing dogs, especially in GS. A significant positive correlation between the gastric emptying time of 50% of markers and the body weight was found. These results show that GD have a lower gastric retention time of foods, which could lead to a poor digestion and an altered absorption of nutrients. These could explained why digestive function and sensitivity could be different in dogs from different sizes and breeds.

Age Factors↗
PubMed2001

Protein restriction and dexamethasone as a model of protein hypercatabolism in dogs: effect of glutamine on leucine turnover.

To determine (1) whether protein restriction, combined with glucocorticosteroid treatment, can be used as a hypercatabolic model and (2) if so, whether glutamine attenuates protein wasting in this model, the effects of protein restriction, dexamethasone, and glutamine on leucine metabolism were assessed in dogs. A control group (n = 8) received a maintenance diet; another group (n = 8) received a protein-restricted diet either (1) alone; (2) along with a 7-day corticoid treatment; or (3) along with a 7-day corticoid treatment and a 7-hour intravenous (IV) glutamine infusion. The last day of each regimen, dogs underwent an IV isotope infusion in the fasting state, with a 3-hour NaH(13)CO3 infusion to assess CO2 production, and immediately thereafter, a 3-hour (13)C-leucine infusion to assess leucine appearance rate (Ra), oxidation (Ox), and nonoxidative leucine disposal (NOLD), expressed as micromol x kg(-1) x h(-1). Protein restriction was associated with a 24% decline in leucine Ra (223 +/- 16 v 298 +/- 17; P <.01), an index of whole body proteolysis, and a 29% decline in NOLD (180 +/- 15 v 223 +/- 13; P <.01), an index of whole body protein synthesis. In the protein-restricted group, dexamethasone treatment was associated with a 32% increase in Ra, (295 +/- 28 v 223 +/- 16; P <.05), a 186% increase in Ox (120 +/- 14 v 43 +/- 4; P <.001), with no change in NOLD, when compared with the protein-restricted alone. After protein restriction + dexamethasone, glutamine infusion induced a 40% increase in plasma glutamine (1,090 +/- 70 v 780 +/- 29 micromol x L(-1); P <.01), but failed to alter Ra, Ox, or NOLD. These results suggest that (1) in dogs, protein restriction combined with a 7-day course of dexamethasone results in alterations in leucine kinetics similar to those observed in stress-induced protein wasting in humans, and (2) in that model, a 7-hour IV glutamine infusion in the fasting state does not significantly attenuate protein wasting.

Animals↗
PubMed2001

Immunoblot profile as predictor of toxoplasmic encephalitis in patients infected with human immunodeficiency virus.

In order to define more accurately human immunodeficiency virus-infected patients at risk of developing toxoplasmic encephalitis (TE), we assessed the prognostic significance of the anti-Toxoplasma gondii immunoglobulin G (IgG) immunoblot profile, in addition to AIDS stage, a CD4(+) cell count <50/mm(3), and an antibody titer > or =150 IU/ml, in patients with CD4 cell counts <200/mm(3) and seropositive for T. gondii. Baseline serum samples from 152 patients included in the placebo arm of the ANRS 005-ACTG 154 trial (pyrimethamine versus placebo) were used. The IgG immunoblot profile was determined using a Toxoplasma lysate and read using the Kodak Digital Science 1D image analysis software. Mean follow-up was 15.1 months, and the 1-year incidence of TE was 15.9%. The cumulative probability of TE varied according to the type and number of anti-T. gondii IgG bands and reached 65% at 12 months for patients with IgG bands of 25 and 22 kDa. In a Cox model adjusted for age, gender, Centers for Disease Control and Prevention (CDC) clinical stage, and CD4 and CD8 cell counts, the incidence of TE was higher when the IgG 22-kDa band (hazard ratio [HR] = 5.4; P < 0.001), the IgG 25-kDa band (HR = 4.7; P < 0.001), or the IgG 69-kDa band (HR = 3.4; P < 0.001) was present and was higher for patients at CDC stage C (HR = 4.9; P < 0.001). T. gondii antibody titer and CD4 cell count were not predictive of TE. Thus, detection of IgG bands of 25, 22, and/or 69 kDa may be helpful for deciding when primary prophylaxis for TE should be started or discontinued, especially in the era of highly active antiretroviral therapy.

AIDS-Related Opportunistic Infections↗
PubMed2001

Strategy for diagnosis of congenital toxoplasmosis: evaluation of methods comparing mothers and newborns and standard methods for postnatal detection of immunoglobulin G, M, and A antibodies.

In a study involving 14 laboratories supported by the European Community Biomed 2 program, we evaluated immunologic methods for the postnatal diagnosis of congenital toxoplasmosis (CT). Among babies born to mothers who seroconverted to positivity for toxoplasmosis during pregnancy, we analyzed 55 babies with CT on the basis of persistent anti-Toxoplasma immunoglobulin G (IgG) at 1 year of life and 50 control babies without anti-Toxoplasma IgG at 1 year of life in the absence of curative treatment with pyrimethamine-sulfonamides. We tested in-house methods such as the enzyme-linked immunofiltration assay (ELIFA) or Immunoblotting (IB) for the detection of IgG or IgM; these methods allowed comparison of the immunologic profiles of the mothers and the infants. We compared ELIFA and IB with a commercial enzyme immunoassay (EIA) or in-house immunosorbent agglutination assay (ISAGA) for the detection of IgM or IgA. The performances of combinations of methods were also assessed. A cumulative sensitivity of 98% during a 1-year follow-up was obtained with the ELIFA plus ISAGA combination. Only one case of CT was missed by the ELIFA plus ISAGA combination, whereas three cases were missed by the IB plus ISAGA combination, even though 48% of patients with CT were treated with pyrimethamine-sulfonamides, which are known to inhibit antibody neosynthesis. A similar performance was obtained with either ELIFA or IB in combination with EIA. The difference in performance between ELIFA plus ISAGA and IB plus ISAGA was not statistically significant (P = 0.31), and we conclude that both combinations of tests can be used for the diagnosis of CT in newborns.

Adult↗
PubMed1999

Protection against lethal toxoplasmosis in mice by an avirulent strain of Toxoplasma gondii: stimulation of IFN-gamma and TNF-alpha response.

In this study, we examined whether the PTN strain (isolated from an AIDS patient) of Toxoplasma gondii could induce cross-protection in mice against infection with a lethal dose of the PLK strain. Mice were first infected with tachyzoites (5 x 10(5)) of PTN and 5 days later challenged with PLK (1 x 10(5), LD(90)) parasites. None of these mice succumbed to infection until day 21 after infection, whereas 100% of the mice given the same dose of PLK infection alone died between 5 and 11 days after infection. The protection was accompanied by an increased expansion of NK cells and CD4 + T cells. This condition was associated by increased production of IFN-gamma and an augmented number of IFN-gamma-producing cells in the spleen. Further, PTN + PLK-infected mice showed higher production of TNF-alpha and nitrite compared to PLK-infected mice. Mice infected with the PTN strain had an enhanced capacity to activate the immune system early in infection since they produced higher levels of IFN-gamma, TNF-alpha, and NO than PLK-infected mice. Administration of anti-IFN-gamma mAb or anti-asialo GM1 antibody resulted in 100 and 20% mortality, respectively, in PTN-infected mice but no death in PTN + PLK-infected mice. Together, these results suggest that early production of IFN-gamma and NK-cell activity is important in protection against PTN infection, whereas in PTN + PLK infection components of adaptive immunity rapidly developed following elaboration of an effective early innate immune response.

Animals↗
PubMed1999

Specific anti-toxoplasmic IgG antibody immunoblot profiles in patients with AIDS-associated Toxoplasma encephalitis.

Among 186 suspected cases of Toxoplasma encephalitis (TE) in HIV-infected patients, 113 were classified as TE and 73 as non-TE. Serum Toxoplasma gondii (T.g.) antibodies were detected by ELISA in 97% of TE vs 71% of non-TE cases (p < 0.001). In the 164 patients positive for T. g. antibodies, the IgG 27 and 32 bands were more frequently present in TE than in non-TE (p = 0.003, p = 0.002, respectively). Among patients with positive T.g. serology, multivariate analysis showed that the presence of an IgG 32 (OR 3.1) or IgG 27 band (OR 2.7) on Western blot was highly indicative of TE independently of each other. Positive T.g. serology, but not anti-T.g. IgG antibody titres, was predictive. Thus, the positivity of IgG 27 and 32 bands on Western blot analysis provides useful data for improving the diagnosis of presumptive TE in HIV-infected patients with suspected TE and positive Toxoplasma serology.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Treatment of infantile visceral leishmaniasis].

Visceral leishmaniasis is an endemic disease in the Mediterranean Basin. Children are one of the targets of the infection. Treatment usually requires parenteral injections of pentavalent antimony (Glucantime or Pentostam), but the high frequency of adverse events and the occurrence of primary or secondary resistance cases limit the use of these medications. Diamidines (Pentacarinat) or amphotericin B derivatives are alternatives to antimony. Unfortunately, pharmacokinetics and optimal dosage of diamidines are not well-known, and numerous adverse events are described. Liposomal preparations of amphotericin B enhance its efficiency and tolerance, and the duration of treatment may be reduced to 5 days. Moreover, primary resistance to amphotericin B is not described in immunocompetent children. Allopurinol associated with antimony seems no more efficient than antimony alone. Aminosidine is not evaluated.

Amphotericin B↗
PubMed1999

[Imported pediatric malaria in Marseille].

UNLABELLED: Imported malaria is frequently observed in pediatric practices within geographical areas which have a migrant population. MATERIAL AND METHODS: All the pediatric malaria cases of a university children's hospital (Marseilles, southern France) had been studied retrospectively. The period of the study was from January 1987 to December 1997. Inclusion criteria were based on clinical diagnosis criteria established by WHO. RESULTS: Three hundred and fifteen clinical cases were observed. Ninety-nine percent were confirmed by blood smears. Eighty-six percent of the patients came from the archipelago of the Comoro Islands in the Indian Ocean. Twenty percent were not given chemoprophylaxis, and 77% of the patients with chemoprophylaxis were not compliant. Fever (92%), splenomegaly (61%), vomiting and/or diarrhea (50%) were frequently observed. Neurological signs (23%), especially headaches (15%), were noted. The causative species was Plasmodium falciparum in 76%; coinfections with two species were observed in 9%. Halofantrine was commonly used for therapy (64%), but relapses were noted with this drug. No death was observed during the study. DISCUSSION: Imported pediatric malaria is rare in France. Clinical signs may lead to misdiagnosis when splenomegaly is not obvious, or when vomiting and/or diarrhea, cough or otitis occur. Diagnosis relies on blood smears. Curative medications are chloroquine or halofantrine, with special attention to heart troubles. Mefloquine is rarely used in children. Quinine is reserved for serious attacks. Concerning chimioprophylaxy, medical prescriptions should be adapted to the stay abroad, and patient compliance to medications could be improved.

Adolescent↗