Biomedical subjects
Publications and source records attributed to J F Molez.
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Cryptococcus neoformans, mainly widespread in Occidental Europe, America and South East of Asia, was rarely described in African pathology. In Central Africa, it was isolated several times in Zaïre. All reported cases concern young people and present no associated pathology. A first fatal case, looking like an acute meningitis, was described in 1959, in a 18 years old Congolese girl. This second case discovered in Brazzaville in a 37 years old young man was a fatal encephalitis after a primary pneumopathy.
During November and December 1992, the authors surveyed the malaria morbidity and the drugs efficiency in an urban area of Dakar region. Malaria represented 13.68% of the fevers in Dakar district and 12.4% in Pikine. The mean parasitic density was evaluated at 5000/mm3. Good efficiency of antimalarial drugs were noted but chloroquine-resistance is present with 24% of prevalence.
The Niayes is geographically characterized by an alternating succession of sand dunes and wet depressions, 20 km wide, which are behind the offshore bars from Saint-Louis to Dakar. Since 1970, the area has been affected by drought. The rainfall which was around 700 mm per year before 1960 has fallen below 500 mm during the last 30 years. In 1991 it was only 350 mm and in 1992, 260 mm. The vegetation has become impoverished in the depressions which are now more and more cultivated for vegetables. Entomological, parasitological and clinical studies on malaria were carried out in 1991 and 1992 in three villages and the results were compared with data gathered from 1967 to 1968 with comparable methods. The main points concerning the evolution of malaria are listed as follows. An. funestus, which was previously the predominant malaria vector, has almost disappeared. An. gambiae has regressed ahead of its sibling species An. arabiensis, a less competent vector. These changes in vector populations have led to lower malaria transmission and consequently a decrease of the endemicity. The children parasitic index, which was between 40 to 80% according to the localities in 1967, fell to 10% or less in 1991 and 1992. Finally, the incidence of clinical cases, calculated on a cohort of 100 children was only 4% in 1992, which is very low for an African endemic country. We conclude that drought and human activities have modified the environment such that malaria endemicity has seriously decreased. However, the risk of epidemic remains with the eventual occurrence of heavy rains. Therefore a surveillance of the area is needed to prevent a future epidemic.
The Sahel region has been suffering from severe drought for the last thirty years, with large deficits and a high degree of variability in the amount of annual rainfall. Agricultural production in the Sahelian zone of the Senegal River valley depends on the flooding of the river. The management of this flooding affects malaria transmission. The area is prone to malaria epidemics because the immunity level of the population is low. We studied epidemiological, meteorological and river level data to identify epidemic risk factors. We propose an epidemiological and managerial system for the early detection of risks and early intervention. This system is based mainly on the water level of the Senegal River and the early detection of unusual increases in the number of cases.