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Biomedical subjects

J L Pecarrere

Publications and source records attributed to J L Pecarrere.

At least 19 recordsLinked to original sources
PubMed1997

Schistosoma haematobium induced lesions in the female genital tract in a village in Madagascar.

Female genital schistosomiasis, FGS, was investigated in a gynaecological study as part of an overall community based morbidity survey, including parasitological and ultrasonographical examination, of a Schistosoma haematobium endemic area in Madagascar. Women (103), of childbearing age (15-49 years), were included for a gynaecological examination and visible lesions of vagina and cervix were biopsied in order to determine the origin of the lesion. Furthermore all women were screened for the presence of schistosome ova using PAP smears from the vagina and the endo/exo cervix. In total 15 women showed schistosome ova in the vagina and/or cervix (median age 24 years and range 15-36 years). Of 36 women with cervical abnormalities, 12 eggs were detected by cervical biopsy (33%). In addition, two of the 12 presented vaginal induration, which contained eggs. Six women had eggs in their PAP smears of which three were egg negative by cervical biopsy. The prevalence of positive S. haematobium egg excretion in the urine among the 103 women was 69% and the geometric mean egg count of positive individuals was 51 eggs/10 ml of urine. Five of the 15 women with confirmed FGS had < or = 1 egg/10 ml of urine. Bladder lesions and congestive changes in the kidneys were demonstrated by ultrasonographic examination in 33 and 9% of the 103 women, respectively. None of the 15 women with confirmed FGS had renal congestion. Our study demonstrates that FGS is a common manifestation of the infection with S. haematobium, even in lightly infected individuals.

Adolescent↗
PubMed1996

Treatment of chromomycosis with terbinafine: preliminary results of an open pilot study.

In an open trial, long courses (6-12 months) of terbinafine at a dosage of 500 mg/day were administered orally to 43 patients with a diagnosis of chromomycosis. Sixteen patients (37.2%) had previously relapsed after one or two courses of thiabendazole. A spectacular improvement in the lesions, including disappearance of bacterial superinfections and of associated oedema and elephantiasis, was observed as soon as 2-4 months after the beginning of treatment. The mean number of fungal cells in skin scrapings fell by about 70% in 4 months. Mycological cure, as judged by skin scrapings, was observed in 41.4, 74.1 and 82.5% of patients infected with Fonsecaea pedrosoi after 4, 8 and 12 months of therapy, respectively. For the first time with this disease, total cure was observed even in imidazole-refractory patients or chronic cases (47.2% with a lesion present for longer than 10 years). The efficacy of terbinafine in Cladosporium carrionii-infected patients seemed higher, as indicated by the examination at 4 months.

Antifungal Agents↗
PubMed1996

Forty years of chromoblastomycosis in Madagascar: a review.

Confirmed cases of chromoblastomycosis in Madagascar from 1955 through 1994 were studied retrospectively. The total number of cases reported was 1,343, of which 98.5% were confirmed by histopathology. Only 30.8% of the cases showed a positive cultivation on mycologic media, and Fonsecaea pedrosoi was identified from 61.8% of the fungal strains. Two distinct areas of endemic chromoblastomycosis, each with a characteristic ecosystem and a single species, are identified. Madagascar represents the most important focus of this fungal disease described to date in the world.

Chromoblastomycosis↗
PubMed1996

[Madagascar: esophagogastroduodenoscopy. Descriptive analysis of 12,000 examinations and problems encountered in the tropics].

The experience of the Digestive Endoscopy Center of the Soavinandriana Hospital in Antananarivo provides insight into not only esogastroduodenal disease in Madagascar but also technical problems involved in performing esophago-gastro-duodenoscopy in tropical areas. From September 1990 to March 1995 a total of 12000 esophago-gastro-duodenoscopy procedures were performed without complication. The main finding was duodenal ulcer which observed in 3580 cases (29.8% of patients) followed by peptic esophagitis due to gastroesophageal reflux in 555 cases and gastric ulcer in 460 cases. Esophageal cancer was detected in 16 cases and malignant gastroduodenal tumor in 82 cases including 63 adenocarcinomas and 5 digestive lymphomas. Overall 4156 procedures (34.6%) were normal and 1130 procedures (9.4%) were performed to investigate digestive tract hemorrhage. These findings document the high incidence of duodenal ulcer in Madagascar where treatment of this condition is difficult due to the high cost. This study underlines the problems encountered in operating an endoscopy department in tropical areas especially with regard to desinfection of equipment and training of endoscopists.

Adolescent↗
PubMed1996

[Prevalence of toxoplasmosis in Tananarive. Study conducted at the Pasteur Institute of Madagascar (PIM) on a sample of 2354 subjects].

The prevalence of Toxoplasma antibodies was studied in 2,354 individuals in Tananarive, at the Institut Pasteur of Madagascar. The seroprevalence among the malagasy population amounts to 52.1%. At the age of 10 years old, 36.3% of our sample have already acquired toxoplasma antibodies, proving an early infection. No differences have been observed between sexes. The toxoplasmosis prevalence among the female population coming from France, India and Pakistan and living in Tananarive seemed the same than in their home countries, whereas female population coming from China had shown a different seroprevalence compared to their home country.

Adolescent↗
PubMed1995

[Evolution of the Mycobacteria Laboratory of the Pasteur Institute of Madagascar from 1991 to 1994].

In 1991, the Laboratory of Mycobacteria was a small laboratory, part of the Clinical Biology Centre (CBC) of the Institut Pasteur de Madagascar: 656 pathological samples have been analysed for the account of the CBC and the National Control Programme activities. Within 4 years, the number of samples tested increased by more than threefold and the technical ability has evolved in an important way, specially for the identification and the antibiotic sensitivity testing. The scientific equipment have been modernized and the rooms surface increased by fourfold. In 1995, this laboratory was officially designated as the National Reference Laboratory for the culture, the identification and antibiogramme for the account of the National Control programme and for the private clinicians. It also participates to the tuberculosis research programmes of Institut Pasteur de Madagascar. It is associated to the Laboratory of Mycobacteria in the Institut d'Hygiène Sociale of Antananarivo which is the National Reference Laboratory for the bacilloscopy, the teaching and the supervision of the peripheral laboratories.

Academies and Institutes↗
PubMed1995

[Extra-pulmonary tuberculosis in Antananarivo. Principal localizations and biological diagnosis].

We describe the state of extrapulmonary tuberculosis in the capital of Antananarivo, a city of high endemicity for tuberculosis but very low endemicity for HIV infection. The Laboratory of Mycobacteria in the Institut Pasteur of Madagascar had examined from August 94 to April 95, 543 pathological samples issued from 295 patients clinically suspected of extrapulmonary tuberculosis (64% male and 36% female). The diagnosis of tuberculosis was confirmed for 47.7% of the patients (141/295), using either the culture technique or the histopathological method: 93% of them had an unique localization whereas 7% had a double localization. The most frequent form encountered was the pleural localization (77.8%), followed by the lymphadenopathic form (8,4%) and the abdominal form (6.9%). The confirmation rate on biopsies was 67% by histopathological method compared to 55% by the culture. On the fluid samples, the confirmation rate was 20.9% using the culture. The agreement between histology and culture was 70.3%. Of the 138 strains identified, 135 were M. tuberculosis, 1 M. bovis and 2 environmental mycobacteria.

Adolescent↗
PubMed1995

[Pericardial tuberculosis in Madagascar. 23 cases].

A 56 months retrospective study, from October 1990 to May 1995, at the Centre Hospitalier de Soavinandriana in Antananarivo pointed out 29 tuberculous pericarditis among the 97 pericardial effusions discovered by the echocardiography of 5600 patients. The sex-ratio was 0,81 and the mean age 38,6 years old (+/- 14,3). Hospitalization was justified by dyspnea (18 cases), thoracic pain (18 cases), lower limbs edema (6 cases) and ascitis (3 cases). Moreover, electrocardiography showed microvoltage in 18 cases and thoracic radiography showed one heart enlargement. Even if for 15 cases a pleural effusion was associated, only 2 patients had a pulmonary image suggestive of tuberculosis. Tuberculous pericarditis has been proved by the following examinations: pericardium puncture (21 cases), pericardium and pleural biopsy (respectively 11 and 13 cases), ganglionic biopsy and search of alcohol-acid-fast bacilli in sputum: 1 case. Histologic proof has been obtained 8 times out of 9 pericardial biopsies and 6 times out of 7 pleural biopsies. Bacteriological proof has been obtained 11 times by pathological samples cultivation: twice from fresh caseous material taken from the pericardium, once from 13 pleural fluids, 5 times from 6 pericardial biopsies, 3 times from 3 pleural biopsies. The patients have been put under antituberculous treatment associated with prednisone. 20 patients have been declared cured at the end of the treatment, 5 were dead and 4 were lost out of sight. Tuberculous pericarditis has become rare in developed countries but it is still challenging in Madagascar. In spite of the antituberculous treatment associated with corticoids, prognosis is severe (evolution towards pericardial constriction death.

Adult↗
PubMed1995

[Peritoneal tuberculosis in Madagascar, 55 cases at the Soavinandriana Hospital Center in Antananaviro].

This retrospective study conducted in Antananarivo for a 42 months period, from September 1991 to March 1994, allowed to record 55 peritoneal tuberculosis, all of them in malagasy patients. The sex ratio was 0,83 and the mean age 36 years old. Ascites puncture was done each time there was an effusion (44 cases). For all cases. For all cases, the diagnosis based on laparoscopy allowed an investigation of the liver and the peritoneum, and 10 peritoneum biopsies could be done. The tubercular bacillus has been isolated in 2 ascites fluids out of 8 incubations, and in 5 biopsies of peritoneal granulation out of 8. For 8 cases, another tubercular localization has been discovered: 5 pleurisis, 2 evolutive tuberculosis and 1 pericardial effusion. All the patients have been put under antitubercular treatment and have regained health. Peritoneal tuberculosis has become rare in the West but is still a frequent pathology mostly in young women, in Africa and up in Madagascar.

Adolescent↗
PubMed1994

[Entomophthoromycoses in Madagascar (three cases)].

The authors present three new cases of Entomophthoromycosis observed in Madagascar: Two cases of subcutaneous entomophthoromycosis without isolation of germ. An immunofluorescence technique showed the Basidiobolus ranarum to be the real cause. One case of rhinoentomophthoromycosis with isolation of Conidiobolus coronatus (first isolation in Madagascar).

Adult↗
PubMed1994

[History of a hepatic lesion: Schistosoma mansoni bilharziasis].

Schistosomiasis mansoni is a widespread tropical disease affecting about 200 million people in the world (data from the World Health Organization). The adult worms, settled in the mesenteric venous plexus, can survive in the host during 5 to 20 years. They evade the immune response and are not, by themselves, the main cause of the pathological events. Most eggs are swept into the portal circulation and trapped in different systemic organs, including the liver. The continuous egg deposition results in a T cell-mediated granulomatous response that is responsible for the disease syndrome (chronic hepatitis associated with a dense fibrosis and a concurrent portal hypertension). Current immunological and molecular concepts on the modulation of the granuloma, and the associated fibrosis, lead to a better understanding of the pathogenesis of human schistosomiasis. Chemotherapy with praziquantel is presently the main approach of morbidity control, before using in conjunction a human vaccine still in development.

Granuloma↗
PubMed1991

[Evolution of the seroprevalence of HIV-1 and HIV-2 infections in the national hospital of Niamey, Niger].

For 25,368 serologies examined in the biological laboratory of National Hospital of Niamey, Niger, from March 1987 to May 1990, the authors studied seroprevalence HIV1, HIV2 and HIV1 + HIV2 during this periode in the different groups studied: Blood donors, in women patients of child bearing age, pregnant women, prostitutes, prisoners and during systematic visits. It appears there is a tendancy of an increase in HIV1, a decrease in HIV2 and relative stability for the two profiles together.

Blood Donors↗