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Biomedical subjects

S Nzingoula

Publications and source records attributed to S Nzingoula.

At least 37 records · Page 2Linked to original sources
PubMed1994

Cerebral malaria in African children: socioeconomic risk factors in Brazzaville, Congo.

Current epidemiologic and clinical research on cerebral malaria is directed towards prognostic criteria and neurologic sequelae. However, the assessment of risk factors related to the environment and the socioeconomic standard of the family is of practical as well as theoretical interest. A prospective survey was carried out in March 1990 in Brazzaville, Congo by interviewing subjects in two groups: 1) 600 households representative of the Brazzaville population and 2) 84 households with a child who had been hospitalized for cerebral malaria between January 1, 1988 and June 30, 1989 (i.e., 9-27 months prior to the interview). The mothers' knowledge and attitudes with regard to the prevention and treatment of malaria in children were assessed, as was the socioeconomic standards of the households. The group in which at least one child had been hospitalized for cerebral malaria had a lower socioeconomic standard than the control group. Other differences in this group included a greater number of offspring and a higher average number of decreased children, less chemoprophylaxis, antimalarials available less often in the household, less early treatment of fever at home, and drugs bought more often at the market. There was no significant difference between the groups with regard to using the correct dosage of chloroquine, ownership of a mosquito net, or the use of insecticides or repellents.

Adult↗
PubMed1993

[Lethal osteogenesis imperfecta in a Congolese newborn infant].

BACKGROUND: Several forms of osteogenesis imperfecta have been described. The perinatally lethal forms (type II of Sillence) have been subclassified into groups A, B and C on the basis of radiological features. This report describes a case of type IIA. CASE REPORT: A female Congolese baby was born at term to healthy, non-consanguineous parents. No ultrasonographic studies were done during the pregnancy. The newborn suffered from acute respiratory distress at birth. Clinical examination showed bone abnormalities: shortened and bowed limbs with crepitation at mobilization, soft calvaria and narrow rib cage. X-rays showed short, broad, bowed long bones with signs of fractures; the ribs were thin and beaded; wormian bones were seen in the skull. The newborn died from respiratory distress at the age of 5 hours. All clinical and X-rays investigations of the parents, the elder brother and cousins were normal. CONCLUSION: This baby seems to have suffered from a lethal form of osteogenesis imperfecta, probably type IIA of Sillence.

Fatal Outcome↗
PubMed1993

[Value of a mass vaccination campaign: measles cases in the hospital milieu in Brazzaville (Congo)].

In November 1986, Congo got up an immunization for measles of nine to 36 months old infants. The aim of this study was to compare the morbidness and the death rate of measles in a 20 months period before and after November 1986. The infants less than nine months old constituted 57.2% of the patients admitted after November 86 opposed to 19, 5% before November 86. The authors stand out for strategies that will let to immunize 97% of the infants.

Child, Preschool↗
PubMed1992

Child morbidity and mortality due to cerebral malaria in Brazzaville, Congo. A retrospective and prospective hospital-based study 1983-1989.

This study was conducted in all four hospitals of Brazzaville, the capital of the Congo in order to assess the trend in malaria morbidity, the frequency of cerebral malaria and the related mortality between 1983 and 1989 in Brazzaville children. For the period 1983 to 1987 the study was retrospective, based on records. For the period 1988 and 1989 a prospective study was carried out in the two main hospitals in which a system for reporting cases of cerebral malaria was set up. This was completed by a retrospective analysis of data similar to that carried for the previous years. The population of Brazzaville children aged between 0 and 14 years and the distribution by district were estimated from the 1984 official census taking the annual demographic growth to be 5%. The results show a marked increase in hospitalizations for malaria, noticeable since 1985, and which now account for about 50% of the overall non-surgical hospitalizations. The number of cases of cerebral malaria and related deaths have probably increased. However, these severe forms of malaria were relatively rare. Indeed, in 1988 and 1989, for the 0-4, 5-9 and 10-14 year age groups, the annual incidence rates of cerebral malaria were estimated at respectively 240, 61 and 13 per 100,000 and the related mortality rates at respectively 58, 5 and 1 per 100,000. No obvious relationship was found between the intensity of malaria transmission, which varied considerably according to the district, and the level of mortality from cerebral malaria.

Adolescent↗
PubMed1992

[Birth weight of full term neonates in Brazzaville (Congo)].

This study of birth weights of full term neonates completes the preliminary investigations undertaken in Brazzaville in 1985. Mean birth weight was 3,090 +/- 492 g, with higher values in males than in females. Birth weight increased with maternal age up to 30 years, with parity up to 5, and with maternal weight/stature ratio. Nutritional factors seemed to have a major influence on the birth weight of full term babies.

Adolescent↗
PubMed1992

Characteristics associated with HIV-1 infection in pregnant women in Brazzaville, Congo.

Maternal human immunodeficiency virus type 1 (HIV-1) infection in sub-Saharan Africa is a major public health concern because of the high prevalence among women of childbearing age and the poor prognosis for perinatally infected children. Characteristics associated with HIV seroprevalence were studied in a population of 1,833 pregnant women seen in two large mother-child clinics in Brazzaville, Congo. The prevalence of HIV infection was 3.9% (95% confidence interval, 3.0-4.9%) and differed significantly according to the district of residence, marital status, duration of the relationship with the current partner, number of sexual partners in the year prior to pregnancy, number of living and dead children, and history of blood transfusion and/or hospitalization. Logistic regression analysis identified six significant factors independently associated with seropositivity; age, history of blood transfusion and/or hospitalization, district of residence, duration of the relationship, number of living children, and number of decreased children. However, the predictive value of the model was poor: while 80% of the truly positive women were correctly predicted positive by the model, 50% of the truly negative women were misclassified. Among pregnant women attending these clinics it is therefore difficult to identify a subgroup at risk toward which specific actions could be targeted.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Bacillus Calmette-Guérin immunization in infants born to HIV-1-seropositive mothers.

During the prospective follow-up of 64 babies at risk for perinatal HIV-1 infection because their mothers were seropositive, and of 130 control babies whose mothers were seronegative, we studied the occurrence of complications of bacillus Calmette-Guérin (BCG) immunization and its ability to induce cutaneous reactivity to tuberculin. Babies born both to HIV-1-positive and HIV-1-negative mothers received BCG immunization during their first month of life according to the Expanded Programme on Immunization (EPI) recommendations. Local and regional complications of BCG vaccine were looked for at 3, 6 and 9 months after inoculation. A tuberculin skin test was performed at 6 or 9 months of age. Most babies born to HIV-1-positive mothers were later classified as infected or uninfected according to their clinical condition and/or serological status at 18 months of age. The mean duration of the follow-up was 36 months (range 30-40 months). No chronic or deep ulcerations at the site of injection or disseminated forms of BCG infection were observed. The frequency of BCG-related lymphadenitis in the group of HIV-1-infected children (24%) did not differ significantly from the group of uninfected children (19%; Fisher test: P = 0.73). In contrast, the tuberculin skin test responses were positive less often in the group of HIV-1-infected children (33%) than in the uninfected group (83%; Fisher test: P = 0.007). Because BCG vaccine appears to be safe--even when given to perinatally infected babies--continuation of the BCG immunization policies of the EPI is justified, especially in view of the growing incidence of tuberculosis as a complication of HIV infection.

BCG Vaccine↗
PubMed1991

[Clinical presentation of non-pernicious malaria attacks in patients hospitalized in Brazzaville (Congo) in 1989].

The clinical manifestations observed in 102 malaria patients (parasitaemia of over 8,000 Plasmodium falciparum/mm3) hospitalized in 1989 in Brazzaville (Congo) were analyzed after ruling out the cases of pernicious malaria. The clinical picture was fever, stomach upset with headache and musculo-articular pain as in classical cases. In children these manifestations were frequently associated with convulsions. Diarrhoea was not uncommon in young children. Vomiting was frequent in both children and adults. Splenomegaly and hepatomegaly were closely related to age. In these subjects, chemoprophylaxis was rare in children, practically non-existent in those aged over 5 years. However, presumptive treatment and self medication was usual regardless of age.

Adolescent↗
PubMed1991

[Efficacy of quinine in children hospitalized for malaria attacks in Brazzaville (Congo) in 1989].

The efficacy of quinine prescribed to children from Brazzaville hospitalized for acute malaria (temperature over 38 degrees C, P. falciparum parasitaemia over 10,000/mm3, no other obvious disease; the reason for hospitalisation often being digestive or neurological disorders) was assessed. Quinine was administered by perfusion: 25 mg/kg/day for at least 3 days. Associated treatment (sulfadoxine-pyrimethamine combination in 80% of the cases) was given at day 3. Blood was taken at day 0, and before discharge (usually between days 3 and 5). Thick Blood Smears (TBS) were examined for a volume of blood corresponding to 300 leucocytes. Antimalarials had been taken in 60% of the cases (chloroquine in 67% of the cases, quinine in 10%). Antimalarials were not assayed in the sera. In 68 cases of non pernicious malaria, no obvious cases of resistance were observed. TBF were negative in 49 out of 52 cases at day 3, and 11 out of 12 at day 4 and in five out of five cases at day 5. In 96 cases of pernicious malaria, only one case was suspected of being resistant, with a weakly positive TBS at day 7. 13 children died but all in the first three days without suspicion of resistance. Apyrexia was observed before day 4 in 89% of the cases; only one case of fever at day 7. TBS were negative before day 4 in 97% of the cases. So, at the dosage of 25 mg/kg, quinine was found to be very effective in the Congo in 1989 against both pernicious and non pernicious malaria.

Acute Disease↗
PubMed1989

Mother-child transmission of HIV-1 and infant survival in Brazzaville, Congo.

The aim of this study was to compare the probability of survival of infants born to anti-HIV-1-positive and anti-HIV-1-negative mothers. One thousand, eight hundred and thirty-three pregnant women, recruited sequentially in two mother-child clinics in Brazzaville, were screened for anti-HIV-1 (by enzyme-linked immunosorbent assay with confirmation by Western blot). Each seropositive mother (71 out of 1833, 3.9%) was matched for age, presumed date of delivery and place of residence with two seronegative mothers. Sixty-four babies born to anti-HIV-1-positive mothers and 130 control babies born to anti-HIV-1-negative mothers were followed up for 12-22 months (mean, 18 months). The probabilities of survival were estimated by the Kaplan-Meier method. At birth, the two groups of babies did not differ with regard to rate of stillbirths, gestational age, sex ratio and weight. Among babies born to seropositive mothers, the probability of survival was 0.87 (s.d. 0.04) at 3 months, 0.71 (s.d. 0.06) at 6 months, 0.68 (s.d. 0.06) at 9 months and 0.61 (s.d. 0.06) at 12.5 months. In the controls the probability of survival was 0.98 (s.d. 0.01) at 3 months and 0.97 (s.d. 0.02) at 12 months. The excess of mortality in the babies born to anti-HIV-1-positive mothers is highly significant (P less than 0.001). The deaths occurred more frequently and earlier than in similar cohort studies performed in developed countries.

Age Factors↗
PubMed1987

Malaria and urbanization in central Africa: the example of Brazzaville. Part V: Pernicious attacks and mortality.

The current incidence of pernicious attacks and of mortality due to malaria were studied in Brazzaville. The results of this study, which concerned all the medical units of the town, were analysed in terms of previous studies on the epidemiology of malaria transmission in the various districts of the town. It was estimated that the annual incidence of pernicious attacks in children in Brazzaville is 1.15 per thousand between 0 and 4 years, 0.25 per thousand between 5 and 9 years and 0.05 per thousand between 10 and 14 years. The annual mortality due to malaria was estimated at 0.43 per thousand between 0 and 4 years and 0.08 per thousand between 5 and 9 years. These values are about 30 times lower than those expected from the results of previous studies of the mortality due to malaria in intertropical Africa. Whereas considerable differences in intensity of malaria transmission exist in the different districts of Brazzaville, the incidence of pernicious attacks and the resulting mortality are remarkably unvarying whatever the level of transmission. In particular, similar results were observed for the sector Mfilou-Ngamaba-Ngangouoni, where malaria is holoendemic with over 100 infective bites per person per year and a parasite rate of 80.95% in schoolchildren, and the central sector of Poto-Poto-Ouenze-Moungali, where malaria is hypoendemic with less than one infective bite per person every three years and a parasite rate of less than 4% in schoolchildren. These results are discussed in terms of previous observations in urban and surrounding rural areas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Escherichia coli diarrhea of children and adults at the Brazzaville General Hospital].

The high number of the strains of Escherichia coli (E. coli) isolated from faeces, demonstrated that this bacteria takes the first place in diarrhoea. These isolations had the same frequency all the year long. In infants, the enteropathogenic E. coli (E. P. E. C.) (28.57%) are still frequent contrary to developed countries. The E. coli with hemagglutination phenomenon (colonisation factors) but without toxin detected were also responsible (mortality 6%). The E. coli without toxin and not belonging to E. P. E. C. group were also frequent (71.42%). In adults, only the enteroinvasive E. coli (E. I. E. C.) (16.6%) and the E. coli with hemagglutination but without toxin detected (16.6%) were observed. This situation is due to bad hygienic conditions among the people and the tropical climate.

Adolescent↗