PubMed Health⌕ Search

Biomedical subjects

J L Soares

Publications and source records attributed to J L Soares.

17 recordsLinked to original sources
PubMed2003

[Epidemics of acute respiratory infections in Madagascar in 2002: from alert to confirmation].

UNLABELLED: An epidemiological investigation (Ministry of Health/Institut Pasteur de Madagascar (IPM)) was conducted in July 2002, in two districts of a same province (Fianarantsoa: Fianarantsoa II and Ikongo) considering the high frequency of deaths linked with acute respiratory infection (ARI). Morbidity and mortality data was collected in the Centre de Santé de Base (CSB) which gave the alert (village of Sahafata, district Fianarantsoa II). Analysis of monthly activity reports (MAR) allowed calculation of incidence rates of ARI/pneumonia in Fianarantsoa province. Virological data was based on the analysis of nasopharyngeal samples collected during the investigations. Clinical symptoms and homogeneity of laboratory results are consistent with an origin of these epidemics being related to the circulation of an influenza virus A subtype H3N2. Attack rates were very high. CFR was significantly higher in individuals of less than 1 year and more than 65 years. This data was confirmed by posterior investigations of teams from MoH/WHO. Surprisingly, this large epidemic was due to a known influenza virus that previously circulated in countries of northern hemisphere (the year before) and even in Antananarivo weeks before. Different hypothesis could be proposed to explain such phenomenon: great restriction of exchanges between different geographical zones, nutritional status.... CONCLUSION: The epidemic episodes of acute respiratory infections in Madagascar in July 2002 were due to an influenza virus A subtype H3N2 without any genotypic or phenotypic features. Various factors, could explain the importance of the epidemic and particular high lethality found in some age groups. This epidemic illustrates the relative incapacity for a developing country, to face and manage a flu epidemic caused by a classical influenza virus.

Acute Disease↗
PubMed2003

[Influenza epidemiologic and virologic surveillance in Antananarivo from 1995 to 2002].

The "Institut Pasteur de Madagascar" virology laboratory is the National WHO Centre for Influenza surveillance in Madagascar. On this surveillance collaborate the Ministry of Health with 9 sentinel centres. In the present article, the authors relate the results of influenza surveillance in Antananarivo between 1995 and 2002. Among 6341 patients with nasal and/or pharyngeal swabs, influenza virus were isolated from 427 patients (6.7%): 307 (68.4%) influenza virus A (H3N2), 124 (27.1%) influenza virus B, 8 (4.0%) influenza virus A (H1N1). The virus had been continually spreading all year long. The weak and the strong points of the influenza sentinel surveillance are also discussed in order to ameliorate the collection processes of influenzal and respiratory morbidity data.

Data Collection↗
PubMed2003

[Plague control in Madagascar: evaluation of the efficacy of Kartman baitboxes in urban areas].

A method associating an anticoagulant rodenticide and an insecticide called Kartman bait-box aimed both at fighting reservoir and vectors of plague. It was evaluated in two neighbourhoods of Antananarivo (Madagascar) from October 2002 to May 2003. It involved the local community in the control. The study was carried out in Ambodirano-Ampefiloha refered as treated neighbourhood in which the Kartman bait box were laid out with an anticoagulant rodenticide and an insecticide with a rapid action versus a "pilot neighbourhood", Ankorondrano-Andranomahery in which the boxes were provided with non poisoning bait and non insecticidal white powder. The rodenticide used was Baraki (difethialone 25 ppm) and the insecticide was a powder of Propoxur 3%. The evaluation of effectiveness of this method was based on the four following parameters: (1) the number of dead rats collected daily inside and in the vicinity of the houses, (2) the daily number of baits non consumed in the Kartman bait box, (3) the cheopis index of the rats trapped using the BTS trap, and (4) the flea carrier index of the rats captured monthly with BTS trap. The cheopis index and the flea carrier index of the rats were calculated monthly. The number of rats that died in the treated neighbourhood was of 968 versus 3 in the pilot neighbourhood. The other parameters reached a stable level after 3 months. Between days 120 and 180, the mean number of unconsumed baits was 2.79 in the treated neighbourhood versus 0.14 in the pilot neighbourhood, the flea carriage (percentage of parasitized hosts) was 0% versus 61% in the pilot neighbourhood, and the cheopis index was 0.0 versus 5.0 in the pilot neighbourhood. This study demonstrates that Kartman bait-boxes reached the rat borne and the vectors of plague found in urban area. We propose to use this method extensively both during epidemic and inter-epidemic contexts.

4-Hydroxycoumarins↗
PubMed2003

[Cervical cancers diagnosed at the Pasteur Institute of Madagascar from 1992 to 2002].

In Madagascar, the epidemiological data actualized concerning the cancer of the collus of uterus are not available because of the absence of register of cancer. The objective of this study is to achieve a first assessment of the problem, to complete the epidemiological knowledge, to point out the tool of precoce detection of the precancerous lesions, to propose the measures aiming to improve the management of the patients and to contribute to the institution of a register of cancer. This is a retrospective survey on the frequency of the cancer of the cervix observed from 1992 to 2002 about 23,908 withdrawals addressed to the Institut Pasteur de Madagascar for anatomopathological exam and 12,605 cervical smears for cytological exam. In pathological anatomy, 2,621 (63.4%) of 4,136 cases of diagnosed cancer, have been observed in women. 687 cases (26.2%) of them were localized in the collus. The 3/4 of the cancers of the cervix is invasive and the mean age is 48.2 years old at the time of diagnosis. The cytology detects only 74 cases of invasive cancer of which most don't have an histological confirmation. 274 pre-lesions of cervix cancer were diagnosed for this period, the majority lesions are cytological diagnosis. In spite of a non representative recruitment of the general population, and by the number of withdrawals considered, these results may represent indicators of the epidemiological situation and justify the institution of program to detect the precancerous lesions in a national scale.

Academic Medical Centers↗
PubMed2002

Multicenter study of street foods in 13 towns on four continents by the food and environmental hygiene study group of the international network of pasteur and associated institutes.

An international multicenter study of ready-to-eat foods, sandwiches, and ice creams or sorbets sold in the streets and their vendors was carried out to assess the microbiological quality of these foods and to identify characteristics of the vendors possibly associated with pathogens. Thirteen towns in Africa, America, Asia, and Oceania were involved in the study. A single protocol was used in all 13 centers: representative sampling was by random selection of vendors and a sample of foods bought from each of these vendors at a time and date selected at random. Microbiological analyses were carried out using standardized Association Française de Normalisation methods, and the use of a standardized questionnaire to collect data concerning the characteristics of the vendors. Fifteen surveys were carried out, with 3,003 food samples from 1,268 vendors. The proportion of unsatisfactory food samples was between 12.7 and 82.9% for ice creams and sorbets and between 11.3 and 92% for sandwiches. For ice creams and sorbets, the sale of a large number of units (>80 per day) increased the risk of unsatisfactory food by a factor of 2.8 (95% confidence interval [CI]: 1.5 to 5.1), lack of training in food hygiene by 6.6 (95% CI: 1.1 to 50). and by a factor of 2.8 (95% CI: 1.4 to 5.4) for mobile vendors. These risk factors were not identified for sandwiches, this difference may be due to the presence of a cooking step in their preparation. These results show that the poor microbiological quality of these street foods constitutes a potential hazard to public health, that the extent of this hazard varies between the cities studied, and that vendors' health education in food safety is a crucial factor in the prevention of foodborne infections.

Colony Count, Microbial↗
PubMed2001

[Microbiological quality of " ice, ice cream. sorbet" sold on the streets of Phnom Penh; April 1996-April 1997].

A study of the microbiological quality of ice lice creams/sorbets sold on the streets of Phnom Penh city was conducted from April 1996 to April 1997. Socio-demographic and environmental characteristics with two ice/ice creams samples were collected from vendors selected in the city. A total of 105 vendors and 210 ice/ice creams samples were randomly selected for the study period. Ice/ice cream vendors in the streets of Phnom Penh were adults (mean age: 28 years old) with a male predominance (86.5%). Mean educational level of vendors was 5 years with no training in mass catering. Most ice creams and sorbets (81.7%) were made using traditional methods. Microbiological analysis performed in the laboratory of Pasteur Institute of Cambodia indicated the poor bacteriological quality of the samples. The proportions of samples classified unsafe according to microbiological criteria were 83.3% for total bacterial count at 30 degrees C, 70% for total coliforms, 30% for faecal coliforms, 12.2% for Staphylococcus aureus and 1.9% for presence of Salmonella spp. These bacterial results suggest that many other food products sold in the streets may be similarly poor. Safety measures should be undertaken to avoid potential threats. Regulation of the street food sector should be part of a larger strategy for enhanced food safety and environmental quality in the city.

Cambodia↗
PubMed1999

Characterization and observation of animals responsible for rabies post-exposure treatment in Phnom Penh, Cambodia.

In order to provide relevant therapeutic answers to human patients exposed to risk of rabies infection who visit the Institut Pasteur du Cambodge for post-exposure treatment and to improve control of rabies in Cambodia, a pilot study was carried out in Phnom Penh Province in November and December 1997 with three objectives: characterization of the population of animals responsible for the exposure to rabies, observation of the animals concerned, and confirmation of the presence of rabies virus in the province. Between 18 November 1997 and 19 December 1997, 409 of the 741 patients treated at the Institut Pasteur du Cambodge because of an exposure to a known rabies vector were included in the study. The animals concerned were: 401 dogs (98%), six monkeys (1.5%) and two cats (0.5%). Three-hundred-and-seventy of the animals (90.5%) were owned, 4 (1%) were unowned but were available for characterization and observation, and 35 (8.6%) had an unknown ownership status and were not available for further study. The exposures occurred on private property in 84% of the cases, and 80 of the 370 owned animals (22%) lived in the same home as had the patient. The 374 animals with known ownership status were examined. Five were already dead and two of these five dogs had presented clinical signs typical of those of rabies. The male:female sex ratio of the dogs was 2.1:1. The 369 live animals were placed under observation for 10 d immediately after exposure of the humans had taken place. At the end of the period none of the animals had developed clinical signs of rabies, three had died of diseases other than rabies, and one was lost. Tests for the rabies nucleocapsid antigen were positive in two cases (the two suspected rabid dogs), confirming the presence of rabies in Phnom Penh Province. Consequently, we recommend measures to improve the control of rabies in Cambodia.

Animals↗
PubMed1996

[Fever of unknown origin (FUO) in the camps of Rwandan refugees in the Goma region of in Zaire (September 1994)].

After the outbreaks of cholera, dysenteriae, meningitidis of which the rwandese refugees have been the victims in August and September 1994 in the camps of the Goma's area (Zaïre), the medical teams were confronted with a great number of fevers of unknown origin. In order to explore the possible etiologies, we have conducted a cases/controls study (n = 96). Clinically, the cases occur more frequently than controls headache (p < 0.001), splenomegaly (p = 0.02) and neutropeny (p < 0.001) Serologically, it has been constated non significantly difference between cases and controls, but prevalence of HIV-1 infections (19 and 6%) and arbovirus (23 and 10%) infections are very high. Arbovirosis could explain, partially or associated with HIV and tuberculosis, the presence of these fevers undeterminated more than malaria or typhus epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1995

[Epidemic of bacillary dysentery in the Rwanda refugee camps of the Goma region (Zaire, North Kivu) in August 1994].

The authors describe the extension of an outbreak of bacillary dysentery among the Rwandese populations seeking refuge in the region of Goma, Zaire in august 1994. Analysis of the epidemiological surveillance data and of the bacteriological laboratory results of the Bioforce, show that this epidemic was probably facilitated by the preceding cholera outbreak. In such circumstances, rapid sterilization of the virus reservoir, by short course treatments, might be beneficial in limiting the extension of the epidemic.

Adolescent↗
PubMed1994

[Short-term ciprofloxacin treatment of bacillary dysentery due to Shigella dysenteriae type 1 in Rwandan refugees].

In 1994, an outbreak of dysentery caused by Shigella dysenteriae type I resistant to all public health antibiotics in vitro occurred among rwandan refugees in Zaïre. The only active antimicrobial agent available was ciprofloxacin. It was administered to hospitalized patients in a conventional 5-day schedule. To ration the supply for the benefit of the greatest number, a randomized blinded study was performed to compare the effectiveness of short-term treatment (1 g of ciprofloxacin in a single daily doses for 2 days) with that of the standard treatment (1 g of ciprofloxacin in two daily doses for 5 days). The study included 57 refugees over the age of 15 years with dysentery. Shigella dysenteriae type I was identified in 26 patients. Except for sex distribution, there was no significant difference in clinical and bacteriologic features of the two populations. Treatment failed in 12 cases, i.e., 7 of 29 patients who received the short-term treatment and 5 of 28 patients who received the standard treatment. Efficacy of ciprofloxacin was not dependent on the mode of treatment, taking into account clinical or bacteriologic criteria. These results indicated that the duration of ciprofloxacin treatment for dysentery caused by Shigella dysenteriae type 1 could be shortened to two days. Short-term treatment has several advantages. One is cost-effectiveness since fluoroquinolones are costly and scarce. Another is to allow treatment of a greater number of patients by improving compliance.

Adult↗
PubMedDate not supplied

[Dysautonomia. An introduction].

Autonomic Nervous System (ANS) dysfunctions may be localized or not, and determine either states of hypo or hyperactivity. This article reviews the structure and function of ANS, methods of evaluation, the main clinical features of its dysfunctions, as well as the most common causes involved and current therapeutic possibilities. Localized dysfunctions and states of hyperactivity are not considered.

Autonomic Nervous System↗
PubMedDate not supplied

[Collective food poisoning in a camp for unaccompanied refugee children in the city of Goma, Zaire, September 1994].

We report a retrospective study of a group of 440 children following an outbreak of infectious food poisoning in Goma in 1994. The study was part of the epidemiological surveillance in a non-accompanied child refugee reception centre. There were 11 cases (rate 2.5%). We evidence a problem of hygiene in the food preparation chain. Despite the numerous epidemics in the region (cholera, dysentery) this study demonstrated that they were not responsible. Similarly, the findings removed any existing doubts about the quality of the food supplied as part of the international aid.

Child, Preschool↗