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Biomedical subjects

P Ranque

Publications and source records attributed to P Ranque.

At least 19 recordsLinked to original sources
PubMed1996

[Update on the dracunculosis eradication program].

Dracunculiasis has been described since antiquity and will be forever associated with the image of the method of extraction consisting of winding a few centimeters of the worm around a stick every day. For nearly ten years a worldwide effort to eradicate this infection has been under way. Achieving this apparently simple goal is hindered by the difficulties in accessing infected areas and by the dire poverty in the regions involved which include the "poorest of the poor". Spectacular results have been accomplished in Pakistan thanks to the concerted efforts of political, financial, and technical officials from a number of national and international organization. While the rate of infestation has decreased by 90% worldwide, the final push to complete eradication is the most difficult and, as in India and Mali, is being oriented towards a strategy involving an integrated approach. Results are slow and gradual but notable and durable progress has been made in terms of village water supply. It is necessary that intervention in these areas be associated with other poverty-fighting programs. Successful eradication without accompanying improvements would be a technical victory but in terms of public health and welfare such a victory would correspond to an unjustifiably missed opportunity.

Dracunculiasis↗
PubMed1992

[Tolerance of ivermectin treatment of rural communities infected by savannah onchocerciasis in Mali].

In an open clinical trial in phase IV, 856 onchocerciasis infected subjects received 150 micrograms/kg of ivermectin in May 1987. While 607 were included as witness. This cohort was revisited 7 and 12 months after. In June 1988, the same treatment was administrated to the previously treated subjects, and the witnesses received their first ivermectin' dose. The clinical tolerance of the treatment appears good and, even improved during the second dose one year after. Among the subjects treated in May 1987, 15.2% of them showed secondary reactions mostly discrete or moderate, precocious and quickly reversible after a second dose. Only 8 of them were incommodated in their daily occupations. A second treatment of these same subjects one year later, caused reactions of feeble intensity 3.7% only. The research of intolerance risk factors, incriminated the high density of microfilaremia. This incite to be careful in mass treatment of hyperendemic area.

Humans↗
PubMed1991

[Current status of the global campaign to eradicate dracunculiasis (guinea worm disease)].

Dracunculiasis is eradicable because it is easy to diagnose, it is only transmitted by drinking water, there is no animal reservoir, and there are three ways to prevent the infection. Global 2000 is assisting guinea worm eradication Programmes in Pakistan, Ghana and Nigeria. The draft criteria for certification of dracunculiasis elimination and the resolutions adopted during the 3rd African Regional Conference on dracunculiasis were described. The progress of Pakistan's guinea worm eradication Programme, which has nearly achieved its goal and the accomplishments of the eradication Programme in Nigeria, which is thought to have the most case of guinea worm in the world were described. Evidence of socio-economic impact of dracunculiasis, vector control, local treatment and case containment were presented during the question and answer period.

Animals↗
PubMed1990

Parasitic diseases and urban development.

The distribution and epidemiology of parasitic diseases in both urban and periurban areas of endemic countries have been changing as development progresses. The following different scenarios involving Chagas disease, lymphatic filariasis, leishmaniasis and schistosomiasis are discussed: (1) infected persons entering nonendemic urban areas without vectors; (2) infected persons entering nonendemic urban areas with vectors; (3) infected persons entering endemic urban areas; (4) non-infected persons entering endemic urban areas; (5) urbanization or domestication of natural zoonotic foci; and (6) vectors entering nonendemic urban areas. Cultural and social habits from the rural areas, such as type of house construction and domestic water usage, are adopted by migrants to urban areas and increase the risk of disease transmission which adversely affects employment in urban populations. As the urban health services must deal with the rise in parasitic diseases, appropriate control strategies for the urban setting must be developed and implemented.

Animals↗
PubMed1988

[Ivermectin and human onchocerciasis. A study of 234 onchocerciasis patients in the Republic of Mali].

In a double blind study Ivermectin has been compared to a placebo in 234 male and female with onchocerciasis who had more than 20 microfilariae per milligram of skin and moderate ocular involvement. Patient was randomized to receive a simple oral dose of Ivermectin 100, 150 and 200 micrograms/kg or placebo. The following was 12 months. The decrease of microfilarodermia since to the 3rd day was from 72.8 to 79.3% of initial rate. At six months it was more than 91% and more than 87% in 12 months. Ocular microfilariae, initially between 12 and 23 stay lower than 2 at 12 months. Punctuated keratitis disappear and did not recidive still 6 months in patients with persistent microfilariae. Ivermectin produce only few side effects. Negative waves have been observed on ECG but without any clinical signs. The Power efficient dose seen to be 100 micrograms/kg.

Clinical Trials as Topic↗
PubMed1988

Forest and savanna onchocerciasis: comparative morphometric histopathology of skin lesions.

A comparative study was made of skin biopsies from onchocerciasis patients living in the forest and in the savanna of West Africa. The lesions and their pathogenesis were similar in the two series of patients. An inflammatory reaction around the extra-lymphatic microfilariae was observed. But the localization of the microfilariae was slightly different: the mean distances between the microfilariae and the border of the basement membrane of the epidermis was approximately 115 microns in the forest and 138 microns in the savanna. Statistical analysis showed that the forest microfilariae were in the superficial parts of the dermis when the densities were low and in deep parts of the dermis when the densities were high. In the savanna, the phenomenon, although less clearly defined was reverse. The two situations were inverted when the density of microfilariae reached approximately 51 microfilariae per calibrated snip, which was seldom the case. Therefore, the most cases, microfilariae appeared to have been more superficial in the forest than the savanna.

Adolescent↗
PubMed1988

Histological examination of onchocercomata after therapy with ivermectin.

During chemotherapy trials in hyperendemic onchocerciasis areas in West Africa 15 adult nodule carriers in Liberia and 24 patients in Mali received single doses of ivermectin (150 or 200 micrograms/kg). Nodules were extirpated two, six and ten months after therapy and examined histologically. No macrofilaricidal effect of ivermectin was observed. Two months after therapy, in 93% of all female worms with intrauterine stretched microfilariae nearly all microfilariae were degenerated. The percentage was lower after ten months but still significantly higher than in untreated control groups. Ivermectin did not cause degeneration of the intrauterine coiled microfilariae. But the percentage of the female worms with coiled microfilariae was significantly lower two and ten months after therapy than that in the placebo or untreated control groups. Correspondingly, the percentage of nodules with intact microfilariae in the nodule tissue was also significantly lower throughout the examination period than that of the untreated control groups. There was not observed any effect on the spermatogenesis and spermatozoa were found frequently in the uteri of female worms. Using the method of histology, the long lasting inhibitory effect of a single dose of ivermectin on the intrauterine production of microfilariae could clearly be demonstrated. This proves the value of histology for the assessment of drug effects on adult O. volvulus.

Animals↗
PubMed1986

[Estimation of the impact of the principal diseases in rural Mali].

The authors assess the health impact of major diseases in the circles of Kita, Bafoulabé and Kenieba (Western Mali) by measuring, for each of them, the number of healthy days of life lost through illness, disability and death. Malaria, birth diseases, infant gastro-enteritis and pneumopathies, measles, malnutrition and hemoglobinopathies account for 58.1% of healthy life lost due to all studied diseases. Parasitic diseases (except malaria), tuberculosis, leprosy are less important than usually said; on the contrary, the impact of hepatic, cardiovascular, and eyes diseases is great. In developing countries assessing the number of healthy days lost by the community due to different diseases is usefull to choose the health priorities and to compare the cost/effectiveness ratio of different health programs.

Adult↗
PubMed1982

[Human brucellosis in Mali. Results of a seroepidemiological study].

Prevalence of human brucellosis was evaluated in three contrasted ecoclimatic zones with different peopling of Mali. Rose bengal plate agglutination tests were carried out on capillary blood microsamples taken from 2173 subjects and indirect immunofluorescence tests were performed on 148 blood samples collected on filter paper disks. These seroepidemiological studies demonstrate the presence of the anthropozoonosis in the entire country and the influence of ecoclimatic and demographic factors on human brucellosis distribution in Mali. The high prevalence (24.4%) found in the sahelian region of Gourma shows the necessity of a national control programme. A similar prevalence has been found in other countries of tropical Africa which were formerly considered as almost free of human brucellosis. The findings suggest that seroimmunological tests should be performed systematically to detect brucellosis in immigrants coming to Europe from tropical Africa as well as in Europeans who have been travelling or staying in this region.

Agglutination Tests↗
PubMed1981

Associations in filarial infections in man in the savanna zones of Mali and Upper Volta.

In 14 villages located in the West African savanna belt, 1,305 people were examined for microfilariae in blood and skin. The results indicate that the associations between filariae in infected patients are not the result of chance alone. The frequency of associations between Wuchereria bancrofti and Tetrapetalonema perstans was highly significant, whereas Onchocerca volvulus appeared to be associated with W. bancrofti only in the absence of T. perstans.

Burkina Faso↗
PubMed1981

[Therapeutic field trial with praziquantel in a rural population in Mali infected with Schistosoma mansoni (author's transl)].

89 people from 6 to 60 years old living in two villages in the valley of the Oyako near Bamako (Mali) infected with S. mansoni, were treated with a single dose of 40 mg/kg bwt. 2-cyclohexylcarbonyl-1,2,3,6,7,11b-hexahydro-4H-pyrazino [2,1-a]isoquinolin-4-one (praziquantel, EMBAY 8440, Biltricide). Side effects were recorded, a clinical and parasitological examination was effected 5 months later. If the results on efficacy can be confirmed, considering the ease of administration and the good acceptance by the patients praziquantel will be recommended for mass campaigns in Mali, where S. mansoni and especially S. haematobium are rapidly spreading following improvement of the water supply.

Adolescent↗
PubMed1979

[An example of the application of factorial analysis of correspondences to infant mortality and its prevention in a rural area of West Africa].

A retrospective study through questionnaire was made among over 800 women of a Pre-Sahel region of Mali. It confirmed the very high infant and child mortality in this population: over 250% mortality under 1 year of age and over 400% under 6 years of age. The factorial analysis of correspondences proved adequate to determine the main characteristics of the local mortality pattern. In chronological order, the most important causes are obstetrical factors (1st day of life), umbilical tetanus (1 week to 1 month of age), malaria (1 month to 1 year of age), pneumopathies (including pertussis and lung complications of measles), toxicoses and nutritional syndromes (over 1 year of age). Preventive measures at various levels are proposed on the basis of these findings. They belong to three broad groups: -Overall socioeconomic development with effective participation of the rural communities concerned. -Development of an appropriate primary health care structure, with a primary health care team in each village. -Strengthening of the programmes of control of the most important communicable diseases. Such simple and cheap actions should, given a clear political will of the national authorities and a modicum of trust in the future on the part of local leaders, be rapidly implementable even in the most underprivileged countries and bring a significant amount of progress in the rural areas.

Child, Preschool↗
PubMed1976

[Toxoplasmosis in the Republic of Mali. An epidemiologic approach].

1664- sera from children and adults were collected in rural and urban areas of Mali and were tested in Toxoplasmosis serology. Immunofluorescent antibody tests and direct agglutination test have been used for this purpose. 65 per cent of adults from urban area and 56 to 58 per cent of adults from rural area gave positive results. Before the age sixteen, only 33 to 40 percent of children are positive in urban area while 51 to 53 per cent are so in rural area. The study of hundreds of sera collected from various animals allows to explain the different ages of the serological changes. In rural area children have been infected very early after catching birds, reptiles and above all, rodents and eating them not cooked enough. In urban area the infection occurs all along the life and, particularly, in adults, after consuming grilled meat. The recent description of three cases of congenital toxoplasmosis demonstrates the interest of such an epidemiological study.

Adolescent↗