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Biomedical subjects

P Carnevale

Publications and source records attributed to P Carnevale.

At least 19 recordsLinked to original sources
PubMed1992

A novel sickle cell mutation of yet another origin in Africa: the Cameroon type.

The sickle cell mutation (beta s) arose as at least three independent events in Africa and once in Asia, being termed the Senegal, Benin, Bantu and Indian types respectively. An investigation in Cameroon was carried out to determine whether the atypical sickle genes observed in the neighboring countries are the result of recombination or the presence of a sickle cell mutation of a different genetic origin. It was conducted on 40 homozygous SS patients followed at the Blood Transfusion Center in the capital city of Yaoundé. On 80 beta s chromosomes, 13 exhibited a novel polymorphic pattern that was observed three times in the homozygous state. This chromosome contains an A gamma T gene. The restriction fragment length polymorphism haplotype is different from all the other beta s chromosomes in both the 5' and 3' regions, but has previously been reported in sporadic cases. The (AT)8(T)5 sequence in the -500 region of the beta gene is specific and different from that of the Senegal, Benin, Bantu or Indian beta s genes. All the carriers of this specific chromosome belong to the Eton ethnic group and originate from the Sanaga river valley. This observation strongly argues for yet another independent origin of the sickle cell mutation in Africa, here referred to as the "Cameroon type". The Benin haplotype and a Benin/Bantu recombinant haplotype have been observed in the other studied populations: Ewondo, Bamiléké, Bassa, Yambassa and Boulou.

Anemia, Sickle Cell↗
PubMed1992

Epidemiology of Plasmodium falciparum in a rice field and a savanna area in Burkina Faso. Comparative study on the acquired immunoprotection in native populations.

A longitudinal study, including entomological, parasitological, immunological and clinical data, was carried out in a rice field and a savanna village in Burkina Faso. In this study, the authors followed the evolution of several parasitological parameters in order to compare the level of immunoprotection in children of these two areas. In particular, the percentages of recently 'infected' or 'recovered' children were calculated, during the interval separating two consecutive surveys. In both areas, parasite densities quickly increased in children from 0 to 14 years old, immediately after the beginning of the transmission period. In savanna, during the rainy season (May-October), parasite densities decreased and the proportion of recently 'recovered' children from 0 to 4 years old (becoming parasitologically negative between two consecutive surveys) was very low. On the other hand, parasite densities decreased and the recovery rate was higher in children from 10 to 14 years old before the end of the rainy season, while the transmission was going on. In the rice field area, Plasmodium falciparum densities decreased only at the end of the transmission period (December) and had the same levels as those found in savanna, in spite of a lower inoculation rate. The second peak of transmission seemed neither to increase the proportion of recovered children, nor to boost the immunoprotection of these children.

Adolescent↗
PubMed1992

Anopheles nili as the main vector of human malaria in villages of southern Cameroon.

In villages near Sanaga river, in the forest zone of south Cameroon, Anopheles nili Theobald is the main species of mosquito regularly found biting man inside houses. Its densities are related to the flow level of the river. It is also the main malaria vector in terms of intensity and seasonal duration of transmission. The yearly malaria inoculation rate due to An. nili alone is 104 infective bites/man, varying between 3 infective bites/man in October and 20 in March. Anopheles gambiae Giles is a less important vector in the area but reached its peak in the dry season, when the Sanaga river is at its lowest level. These observations underline the influence of local ecology on malaria transmission and the need for entomological studies in each situation.

Animals↗
PubMed1992

Efficacy of insecticide impregnated bed-nets to control malaria in a rural forested area in southern Cameroon.

Due to current spreading of chemoresistant strains of Plasmodium falciparum malaria control must incorporate vector control programmes. Due to well known constraints house sprayings cannot be performed as before. Personal protection can be developed and a large scale use of insecticide treated bed-nets appeared to be very useful to reduce man-vector contact in Asia, South America and West and East Africa. No trial has been done in forest Central Africa where transmission is permanent. We performed such a trial in the southern part of Cameroon (using deltamethrin, at 25 mg/m2) and obtained similar data to those observed in The Gambia, Burkina Faso and Tanzania with a noteworthy reduction of both transmission and high parasitaemia of P. falciparum (respectively 78% and 75%) meaning a drop of malaria morbidity.

Animals↗
PubMed1992

Transmission factors in malaria epidemiology and control in Africa.

Genetic and environmental components of factors contributing in malaria transmission are reviewed. Particular attention is given to density dependent regulation of vector populations in relation to the survival rate of anophelines. The expectation of vector control activities are different according to the epidemiological characteristics of malaria, mainly its stability. In areas with perennial and high transmission (stable malaria) vector control could reduce malaria related morbidity and mortality, without any effect on the endemicity. However this need further investigations. In areas where the transmission period is very short (unstable malaria), vector control will have an important impact on the disease and on the endemicity. Control projects using indoor spraying with insecticide and impregnated bed nets are discussed.

Africa↗
PubMed1992

Effect of chloroquine chemoprophylaxis during pregnancy on birth weight: results of a randomized trial.

To determine the effect of chloroquine chemoprophylaxis during pregnancy on birth weights, a randomized trial was carried out in 1987 and 1988 in Banfora, Burkina Faso (West Africa). Seven hundred forty-five randomly selected women treated with chloroquine sulfate were compared to with 719 controls who received no treatment. In spite of an unquestionable effect of chloroquine in preventing placental infection (4.1% infected placentas in the treated group versus 19.0% in the controls), the mean difference in birth weights between the two groups (6 g) was not significant. The difference in the proportion of low birth weight (LBW) newborn babies in two groups (16.3% versus 16.4%) was also not significant. However, there was a strong relationship between placental infection and birth weight (the mean birth weight difference between infected and uninfected placentas was 113 g, and the proportion of LBW babies was 26.0% in infected placentas versus 14.8% in uninfected placentas). The small difference in birth weights observed between the two groups may be due to the fact that the prevalence rate of placental infection is low and that prophylaxis is effective only on a portion of the subjects in the treated group. It may also indicate that malaria is only one of several risk factors responsible for LBW. The relatively small increase in birth weight, the expected poor acceptance of mass prophylaxis, and the spreading of chloroquine-resistant Plasmodium strains should be considered before extending malaria chemoprophylaxis to all pregnant women. It might be worth considering to limit prophylaxis to primigravidae.

Adult↗
PubMed1992

[Therapeutic attitudes and malaria in Sanaga Basin (Cameroon)].

In order to evaluate malaria problems such as they are perceived by Sanaga Basin populations in Cameroon, authors appealed to a cluster sample survey on a population sample obtained from a 2 degree population poll in four representative sites. Malaria so defined represents the outstanding endemia by which the most usual therapeutic recourse makes self-medication interfere particularly by amino-4-quinolines. It is convenient to verify the quality of treatment so administered to adapt possibly training objectives of the interested population. In the present context of the chemoresistance extension of plasmodial strains to usual antimalarials, setting up a surveillance system of efficiency is necessary.

Adolescent↗
PubMed1992

[Feasibility of mosquito control using insecticide-impregnated bednets in rural areas of Cameroon].

The feasibility of using impregnated bednets in a malaria control strategy has been evaluated in a rural area of Cameroon. The benefit is well perceived by the population in terms of protection against nuisance but not in terms of prevention of the disease. The correct use of bednets is, however, unsatisfactory. The material should be adapted to the various sleeping accommodations, and efforts for education and information directed towards the potential users should be intensified.

Animals↗
PubMed1992

[Malaria in Yaounde (Cameroon). Cost and antivectorial control at the family level].

In order to evaluate the financial charges of antivector control and disease at family level for "malaria disease" as perceived by Yaounde inhabitants, the authors carried out a transverse survey on a representative sample of populations derived from sampling surveys at different degrees. Malaria, so defined, represents a dominating endemic for which the yearly financial effort consented by each family amounts to 57,000 FCFA which represents medical care and entailed services as well as the purchase of chemicals for antivector control. The development of more efficient therapeutic behaviours and promotion of greater use of remanent insecticide impregnated bed nets comes in first in setting up training programmes aimed at health personnels and populations who are under their responsibility.

Animals↗
PubMed1992

[Urban malaria in Yaounde (Cameroon). 2. Entomologic study in 2 suburban districts].

A one year entomological survey was carried out to precise the malaria vectors and the malaria transmission in Yaounde, the Cameroon capital (800,000 inhabitants). The study was done in two districts not yet fully urbanized: Nkol Bikok and Nkol Bisson. The latter is located at the periphery and has a pool. Anopheles gambiae was the only human malaria vector. Its agressivity for man depended on the urbanization of the district. Annual man biting rate was 284 in Nkol Bikok and 1,813 in Nkol Bisson. The densities were maximum in May-June and in October-November, corresponding to the end of the short and long rainy seasons. The presence of A. gambiae was permanent except in August-September in Nkol Bikok. In Nkol Bisson the density was higher in the houses near the pool. The yearly inoculation rate (h) was 14 in Nkol Bikok and 30 in Nkol Bisson. The vectorial transmission was observed in may in Nkol Bikok and during four months (June, August, January, February) in Nkol Bisson. These entomological data showed clearly that malaria transmission actually occurred in Yaounde and that the probability to receive at least one infected anopheline bite per year was very near to 1 for inhabitants unprotected against mosquito bites.

Animals↗
PubMed1992

Segregation analysis detects a major gene controlling blood infection levels in human malaria.

The profound influence that the genetic makeup of the host has on resistance to malaria infection has been established in numerous animal studies. This genetic heterogeneity is one of the main causes of the difficulties in developing an effective malaria vaccine. Segregation analysis is the first step in identifying the nature of genetic factors involved in the expression of human complex diseases, as infectious diseases. To assess the role of host genes in human malaria, we performed segregation analysis of blood parasite densities in 42 Cameroonian families by using both the unified mixed model and the class D regressive model of analysis. The results provide clear evidence for the presence of a recessive major gene controlling the degree of infection in human malaria. Parameter estimates show a frequency of .44-.48 for the deleterious allele, indicating that about 21% of the population is predisposed to high levels of infection.

Adolescent↗
PubMed1991

Preliminary report on the use of desferrioxamine in the treatment of Plasmodium falciparum malaria.

The administration of 0.5 g (IM) of desferrioxamine every 12 hr for 3 days with 25 mg/kg (total dose for three days) of chloroquine abated the parasitemia of Plasmodium falciparum infected individuals more rapidly than chloroquine alone. Two patients with in vitro evidence of total or partial resistance to chloroquine also were successfully treated with the combination of drugs, and were free of parasitized red cells by day 7. Further clinical trials and development of desferrioxamine in the treatment of P. falciparum are warranted.

Animals↗
PubMed1991

Nucleotide sequence evidence of the unicentric origin of the beta C mutation in Africa.

The origin of the beta C mutation was studied by characterizing nucleotide sequence polymorphisms on beta C chromosomes of patients from various African countries. In the majority of cases, the beta C mutation was found in linkage disequilibrium with a single chromosomal structure as defined by classical RFLP haplotypes, intergenic nucleotide sequence polymorphisms immediately upstream of the beta-globin gene, and intragenic beta-globin gene polymorphisms (frameworks). In addition, three atypical variant chromosomes carrying the beta C mutation were observed, and are most probably explained either by a meiotic recombination (two cases) or by one nucleotide substitution occurring in an unstable array of tandemly repeated sequences (one case). These data demonstrate the unicentric origin of the beta C mutation in central West Africa, with subsequent mutational modification in a small number of instances. The data also supports gene flow of the beta C chromosome from subsaharan Africa to North Africa.

Africa↗
PubMed1991

Epidemiology of Plasmodium falciparum in a rice field and a savanna area in Burkina Faso: seasonal fluctuations of gametocytaemia and malarial infectivity.

For a better understanding of the epidemiology of Plasmodium falciparum in an African savanna area, the authors have: (a) defined the real gametocyte reservoir in the native population; (b) followed the fluctuations of gametocytaemia throughout the transmission period; and (c) measured the infectiousness of malarious individuals to mosquitoes. The transversal surveys, in different villages of this endemic area, have shown that gametocyte carrier rates decreased with age and malaria experience; 10.9% of the whole population were potentially infectious to mosquitoes, and of these 73% were children and only 27% were adults. The longitudinal studies have shown that the P. falciparum gametocyte rate depends on the equilibrium between the gametocyte conversion rates and the density of the asexual forms. When there are large numbers of children who become carriers of the sexual stage of the parasite and at the same time a small number who lose their gametocyte infection, the gametocyte rate increases in the population; and vice versa. The circumstances under which gametocytes are produced are not well-known. Two factors seem to be important: the level of the parasite density and immune mechanisms. The infectiousness of malarious individuals was estimated by the 'mosquito infection probability'. The percentage of mosquitoes infected after feeding on gametocyte carriers (which may partly reflect the infectiousness of a human population to mosquitoes) was multiplied by the percentage of gametocyte carriers in the population. This indicated that, in this endemic area, 4% of biting mosquitoes would become infected; but this theoretical mosquito infection probability is over-estimated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Plasmodium falciparum and P. malariae epidemiology in a West African village.

Transmission of Plasmodium falciparum and P. malariae was studied in a village in Burkina Faso. Consecutive captures of mosquitos were organized twice a month over a year and the species of the mosquitos identified. Also, the prevalences and densities of Plasmodium spp. were determined every 2 months in a sample of children who lived in the village. Anopheles gambiae, A. funestus, and A. nili were the local vectors, but only the first two played a predominant role in both P. falciparum and P. malariae transmission. The parasitological sporozoite index (SI) was 4.48% for A. gambiae and 4.22% for A. funestus. The immunological SIs were higher: 5.82% of A. gambiae were infected with P. falciparum and only 0.16% with P. malariae; the corresponding proportions for A. funestus were 6.45% and 0.41%. Transmission of Plasmodium spp. by A. gambiae was important during the rainy season (July-October) and by A. funestus at the beginning of the dry season (September-November). Each child in the study village could receive about 396 P. falciparum-infected bites per year but only 22 of P. malariae. The P. falciparum parasite indices were maximum during the middle of the rainy season (August), while those for P. malariae reached a peak during the dry season (February).

Adolescent↗
PubMed1991

Influence of deltamethrin treatment of bed nets on malaria transmission in the Kou valley, Burkina Faso.

A 3-year entomological study was carried out on the transmission of malaria in a village of 900 inhabitants in a rice-growing area of Burkina Faso. In the study area inhabitants use bed nets to protect themselves from mosquito bites. In the first year of the study, baseline data were collected; in the second year, the village was divided in two parts and all the bed nets in the southern part were sprayed with deltamethrin (25 mg/m2); and in the third year, all the bed nets in both parts of the village were sprayed. The inoculation rate was estimated by hand collection of mosquitos on human volunteers who were not protected by bed nets. The overall inoculation rate in the first year was 55 infected bites per person and was higher in the southern than in the northern part of the village. During the second year the rate increased to 70 bites per person on average (but was slightly lower than this in the southern part of the village). During the third year, the inoculation rate fell to three infected bites per year, i.e., a reduction of 94% compared with the first year. This reduction arose primarily because of a marked decrease in the sporozoitic index and a lower density of vectors. Thus, use of pyrethroid-impregnated bed nets by all members of the community appears to be a major tool in preventing transmission of malaria.

Animals↗
PubMed1991

[The impact of impregnated mosquito nets on prevalence and morbidity related to malaria in sub-Saharan africa].

Insecticide treated bed nets (permethrin, deltamethrin and lambda cyalothrin) were used for malaria control in The Gambia, Burkina Faso and Tanzania where Anopheles gambiae (and An.funestus in Burkina Faso) is the main vector. Treated mosquito nets are efficient when used on a large scale and not on an individual level. Such a large scale use, acting on longevity and infectivity of vectors, always induced a decrease of malaria transmission by more than 90%. Treated bed nets had no significant effect on the overall parasite rate, showing that malaria transmission was not stopped. But it was usually found that there was a significantly smaller number of children with parasitemia higher than a critical threshold, a sensitive parameter of malaria morbidity. Indeed, in the three situations studied, malaria morbidity (fever + high parasitemia greater than critical level in the concerned area) has generally shown a similar drop of 60%. These data demonstrate that treated bed nets are useful to reduce transmission and morbidity. Advised as a new way for reduction of nuisance, treated bed nets were always welcomed by the populations and this method may be considered as a complementary weapon in public health.

Adolescent↗