PubMed Health⌕ Search

Biomedical subjects

S Ranque

Publications and source records attributed to S Ranque.

At least 19 recordsLinked to original sources
PubMed2005

Treatment of imported malaria in adults: a multicentre study in France.

BACKGROUND: Data about anti-malarial drugs prescription practices in Europe and the safety of imported malaria treatments are scanty. In 1999, a French consensus development conference published guidelines for the prevention and treatment of imported P. falciparum malaria. The impact of these guidelines has not been evaluated. AIM: To investigate the impact of these guidelines on the prescription of anti-malarials, and to evaluate the incidence of acute drug events (ADEs) leading to discontinuation of treatment. DESIGN: Cross-sectional survey. METHODS: Members of the medical staff in 14 French infectious and tropical disease wards completed a standardized form for each patient treated for imported malaria in 2001. A propensity score matching technique was used to estimate the risk of ADEs leading to discontinuation of the regimen. RESULTS: In the 474 patients studied, quinine was the first-line anti-malarial most often prescribed. Only 3% of patients received halofantrine. Mefloquine was associated with a RR of 4.9 (95%CI 3.2-7.4, p < 0.00001) risk of discontinuation of treatment due to ADEs. DISCUSSION: The very limited use of halofantrine indicates that the main practice recommendations of the guidelines have been taken into account. Mefloquine was associated with a substantial risk of discontinuing the treatment because of ADEs. This is a serious limitation for the use of mefloquine in the treatment of out-patients with imported malaria.

Adult↗
PubMed2002

[The treatment of prostatitis].

PURPOSE: Prostatitis are frequently recognized in general practice and often are a diagnosis and therapeutic challenge. We review here the updated knowledge on diagnosis and therapy of prostatitis. CURRENT KNOWLEDGE AND KEY POINTS: Prostatitis are divided into acute bacterial prostatitis (I), chronic bacterial prostatitis (II), chronic prostatitis/ chronic pelvic pain syndrome (III) and asymptomatic inflammatory prostatitis. Chronic prostatitis/ chronic pelvic pain syndrome are divided into : inflammatory (IIIA) and noninflammatory (IIIB). Treatment of prostatitis should follow evidence based guidelines recently published. Acute prostatitis should be treated by ciprofloxacine 500 mg tid or ofloxacine 200 mg bid or cotrimoxazole 960 mg bid for 4 weeks (CIII). When bacteremia occurs third generation cephalosporin with gentamicin should be used (CIII). In chronic bacterial prostatitis ciprofloxacine 500 mg tid or ofloxacine 200 mg bid or norfloxacine 400 mg bid or cotrimoxazole 960 mg bid for 4 weeks may be used (BIII). FUTURE PROSPECTS AND PROJECTS: Molecular techniques should improve the etiological diagnosis of prostatitis and their treatment.

Chronic Disease↗
PubMed2001

[Schistosoma mansoni schistosomiasis].

Schistosomosis are parasitic diseases caused by blood flukes of the Schistosoma genus. The pathology of schistosomosis is mostly brought about by ova trapped in the tissues. In the liver, granuloma around ova eventually trigger periportal fibrosis and portal hypertension. In S. mansoni infection, the infection intensity and the onset of liver fibrosis are under distinct genetic control. Liver fibrosis is the main cause of death in the 20 millions individuals suffering from chronic schistosomosis. However, liver fibrosis is reversible if antischistosomal drugs are administered before the onset of severe hepatic insufficiency.

Cause of Death↗
PubMed2001

Follow-up of Ascaris lumbricoides and Trichuris trichiura infections in children living in a community treated with ivermectin at 3-monthly intervals.

Ivermectin treatment was administered every 3 months over a 1-year period (April 1993-April 1994) to the whole eligible population of a village in South Cameroon where both Ascaris lumbricoides and Trichuris trichiura were hyper-endemic. A parasitological stool examination was performed before each treatment. Thirty children, aged 5-15 years, were not only found egg-positive for A. lumbricoides and/or T. trichiura before the first treatment but were also each treated and examined in each treatment round. Among these children, the intensity of infection with A. lumbricoides decreased significantly following the first treatment but thereafter remained steady. In contrast, the repeated ivermectin treatments had no significant impact on the intensity of the T. trichiura infections or on the prevalence of infection with T. trichiura or A. lumbricoides among the 30 children.

Adolescent↗
PubMed2001

Controlled trial of 3-day quinine-clindamycin treatment versus 7-day quinine treatment for adult travelers with uncomplicated falciparum malaria imported from the tropics.

We conducted a randomized, double-blind, placebo-controlled trial to compare a 3-day quinine-clindamycin regimen (group QC) with a 7-day quinine regimen (group Q) for the treatment of uncomplicated Plasmodium falciparum malaria in travelers returning from the tropics. A total of 55 and 53 patients in groups Q and QC were analyzed, respectively. Adverse effects were similar in both groups, although two patients in group Q had severe adverse reactions, leading to the cessation of treatment. The 28-day cure rate for the evaluated patients (per-protocol analysis) was 100% for group QC, whereas it was 96.3% for group Q (P = 0.5). The 28-day cure rate in the intention-to-treat analysis was 96.2% for group QC, whereas it was 94.6% for group Q (P = 1). There were no significant differences between the two regimens with regard to parasite and fever clearance times. Our study shows that the 3-day quinine-clindamycin regimen is well tolerated and compares favorably with a 7-day quinine treatment. This short-term regimen had previously been evaluated only in areas of endemicity. According to our results, the 3-day quinine-clindamycin regimen may be an alternative for the treatment of imported uncomplicated P. falciparum malaria in travelers returning from the tropics.

Adult↗
PubMed1999

Genetic epidemiology of host predisposition microfilaraemia in human loiasis.

Evidence is accumulating from experimental and human studies that genetic factors are involved both in the control of infectious diseases and in the regulation of infection levels and clinical presentation. So far few studies have investigated the role of these genetic factors in human infection by the filarial parasite Loa loa. We present a segregation analysis on 74 nuclear families who live in the tropical rainforest of southern Cameroun and are exposed to homogeneous loiasis transmission. The results indicate that there is a genetic predisposition to be microfilaraemic and that predisposed subjects might be genetically unable to mount an efficient immune response against loiasis antigens. This individual susceptibility could explain at least in part why the prevalence of infection (microfilaraemic individuals) does not usually exceed 30% of the exposed population in hyperendemic regions. Further genetic studies, based on linkage analysis using both familial information and genetic markers, will help to identify the nature of the genetic factors predisposing to microfilaraemia.

Adolescent↗
PubMed1998

[Diagnosis and management of parasitic hypereosinophilia].

ETIOLOGY: Helminth infestation of the digestive tract or organ tissues is a common and curable cause of high eosinophil counts. Parasite infestation should be the number one suspect in patients with hypereosinophilia. DIAGNOSIS: Clinical signs and epidemiology are suggestive. If the patient has travelled to the tropics, one should consider both exotic and cosmopolite parasites. LABORATORY TESTS: The causal agent can sometimes be identified by direct examination of tissue samples, depending on the localization. In practice however identification may be a difficult task when the level of infestation is low or the helminth is in a larval stage. The epidemiological situation, clinical features and results of serology tests must all be considered for diagnosis. ANTIHELMINTH TREATMENT (TEST): Clinical improvement after treatment can be a criteria for positive diagnosis. Normal eosinophil counts followed later by normal serology confirms the diagnosis.

Algorithms↗
PubMed1998

Genetic control of blood infection levels in human malaria: evidence for a complex genetic model.

There is now accumulating evidence for the involvement of genetic factors in the control of immune response against malaria. These arguments come from numerous animal models, from population studies showing associations of red blood cell genetic defects as well as HLA antigens with severe malaria, and from familial studies including a recent segregation analysis, which led to detection of a major gene effect predisposing to high infection levels. The heterogeneity and complexity of this genetic control is one of the main findings of these previous studies, and probably a major cause of the difficulty in developing an effective malaria vaccine. A segregation analysis of blood infection levels is performed here in 44 pedigrees living in the tropical rain forest of southern Cameroon and exposed to high vectorial transmission intensity. The results confirm the existence of complex genetic factors controlling blood infection levels in human malaria but are not consistent with the parent-offspring transmission of a single Mendelian gene. This study also shows the dramatic effect of age on infection levels and its interaction with a putative major gene suggesting that genetic related differences are much more important in children than in adults. Further genetic studies focused on children may help to identify the nature of the genetic factors involved in the expression of human malaria, by means of linkage analyses using both familial information and genetic markers.

Adolescent↗
PubMed1998

[Occurrence of onchocerciasis in subjects coming from non-endemic areas and migrating to a hyperendemic area].

The incidence of Onchocerca volvulus infection was measured from 1992-93 to 1995 in six villages of initially uninfected migrants who settled in 1991 in the Vina Valley (Cameroon), an area of ongoing transmission of onchocerciasis. The mean annual incidence (MAI) exceeded 20% in the three communities located in the first line, and fewer than 15 km from the hyperendemic areas of the Central African Republic. The MAI was lower than 16% in the second line communities. As these populations are particularly at risk of developing ocular complications from onchocerciasis, it is recommended that repeated ivermectin distributions be organized in the migrant villages of the Vina Valley.

Animals↗
PubMed1995

Longitudinal survey of Loa loa filariasis in southern Cameroon: long-term stability and factors influencing individual microfilarial status.

A longitudinal, one-year survey of Loa loa infection was carried out in an endemic area of southern Cameroon. Parasitologic samplings (calibrated thick blood smears) were performed every two months to study the evolution of loiasis infection at both the population and the individual level. The mean number of measurements by subject was 3.8 (range 1-6). At the population level, prevalence of infection and microfilarial load were found to be very stable over time. This observation is consistent with the existence of an important reserve of parasitic material available for vectors and the maintenance of high levels of transmission. At the individual level, both the microfilarial status (microfilaremic/nonmicrofilaremic) and the level of parasitemia showed a remarkable stability over time. Age was the relevant factor that influenced the individual microfilarial status in the whole population. When only microfilaremic individuals were taken into account, age did not influence the level of microfilaremia, suggesting that loiasis could be considered as a noncumulative disease. The stability of individual microfilarial status and the pattern of infection variations observed with age support the view that genetic factors might be involved in host defense mechanisms against loiasis infection.

Adolescent↗
PubMed1995

[Secondary effects of the treatment of hypermicrofilaremic loiasis using ivermectin].

In the last ten years ivermectin appeared an efficient and safe alternative to diethylcarbamazine which is known to induce severe adverse reactions in loiasis, including encephalitis. After these results, large scale ivermectin treatments against onchocerciasis were carried out in Central Africa where loiasis is also endemic; and seven cases of severe reaction were reported in Cameroon since 1991, during these mass ivermectin treatments. In order to study adverse reactions in patients harbouring high load of Loa loa microfilariae (mf), we realized careful hospital based treatment in 112 patients with more than 3,000 mf/ml (ml) blood. Patients received once 200 micrograms ivermectin per kilogram at day 0 (D0). Clinical examination was made daily during the four following days (D1 to D4). Blood and urine samples were analysed before treatment and at D1 and D3. Lumbar puncture was made at D1 for 39 patients with more than 10,000 mf/ml; at D3 for the 49 following patients without consideration for the level of parasitaemia, and at D0 and D3 for ten voluntary patients. For analysis the patients were distributed in 3 groups according to initial parasitaemia: the first group included 50% out of the patients, those whose parasitaemia was fewer than 15,000 mf/ml blood; the second group included 25% patients whose parasitaemia was between 15,000 and 30,000 mf/ml; the third group included the last 25% patients whose parasitaemia was higher than 30,000 mf per ml blood. Adverse reactions were observed in 71% out of the patients. Symptoms described were fever, pruritus, headache, arthralgia. Most symptoms appeared 24 to 36 hours after treatment. Temperature increased significantly in group 3. Microfilaraemia decreased by 85% in the 3 groups during the 4 days following treatment. C-reactive-protein increased dramatically after treatment in all patients (p < 10(-4)). Some patients presented blood in urine in three groups but haematuria reached 35% of patients in group 3. Proteinuria is noted among 33% of all patients but 20% in group 1 and 2 versus 70% in group 3. Loa loa mf were observed in urine of half the patients, but in low amounts (< 10 mf per 50 ml urine). In cerebro-spinal fluid (CSF), some mf appeared at D1 or D3 in people heavily infected with Loa loa, reaching 80% of the patients of group 3. LP made at D0 in ten patients with parasitaemia higher than 30,000 mf/ml blood confirmed that CSF was naturally microfilaria free before treatment. One patient presented severe troubles with fever, asthenia and conscience troubles beginning at D3, reactive coma at D4, renal impairment with transitory anuria; progressive improvement in 2 weeks and complete recovery at D22; he presented 102 mf/ml CSF at D6. The study confirmed that ivermectin treatment is generally well tolerated. Among people with high Loa loa parasitaemia the symptoms after treatment are frequent but mild. However severe cases with conscience troubles are possible, and may occur in about 1% of subjects with more than 3,000 mf/ml blood. Severity of adverse reactions was linked to level of parasitaemia before treatment. The critical parasitaemia level which could lead to expect serious adverse effects seems to be 30,000 ml/ml blood. These informations should induce carefulness to carry out large scale treatments against filariosis in endemic areas of Loa loa.

Adult↗
PubMedDate not supplied

Imported cutaneous gnathostomiasis: report of five cases.

Gnathostomiasis has rarely been described outside endemic countries. We report on a series of 5 patients (4 females, 1 male, mean age 42.2 years) who returned to France from South-East Asia and presented with cutaneous gnathostomiasis. The cutaneous lesions appeared within a mean period of 62 d (range 10-150 d) after return. They consisted of creeping eruptions in 3 patients (in addition one also had papules, one had nodules and hepatitis, and one had hepatitis; all 3 had profound asthenia) and recurring migratory swellings in 2 patients. The mean eosinophil count was 1546/mm3 (range 398-3245/mm3). Diagnosis was based on positive serological tests in 3 patients and seroconversion in 2 patients, and was confirmed by identification of Gnathostoma hispidum in a biopsy specimen from one of the seropositive patients. Albandazole (1-4 courses) was given as treatment. Recurrences may occur up to 24 months after apparent cure without reinfection. Gnathostomiasis should be considered when patients return from tropical countries and present with migratory swellings or creeping eruption that does not respond to the usual treatment for cutaneous larva migrans. Serological tests may be negative initially and thus need to be repeated to check for seroconversion. Treatment may require multiple courses of albendazole and a prolonged period of follow-up is necessary before cure can be confirmed.

Adult↗
PubMedDate not supplied

Impact of repeated large scale ivermectin treatments on the transmission of Loa loa.

We have studied the impact of large-scale treatment with ivermectin on the transmission of loiasis in a forest village in south Cameroon where loiasis was highly endemic, with a prevalence of 30%. After one year of parasitological and entomological surveillance without treatment, all consenting residents aged > 5 years received ivermectin 200 micrograms/kg every 3 months. For ethical reasons, treatment was interrupted after 2 years, but parasitological and entomological surveillance continued for 18 months after the end of treatment. The prevalence of loiasis was reduced to < 10% and the mean microfilaraemia decreased by 90% in 2 years. The prevalence and average intensity of infection remained stable during the 18 months after treatment ended. Two vector species were identified, Chrysops dimidiata (representing about 90% of the fly population) and C. silacea. The infection rate (all stages) in Chrysops decreased by 75% and the infective rate (percentage of Chrysops harbouring third-stage larvae of Loa loa in the head) decreased by 85% in C. dimidiata and became zero in C. silacea. After the end of treatment, the infection and infective rates increased gradually. Large-scale treatment seemed an efficient method for the control of L. loa transmission provided high drug coverage was achieved. Nevertheless, because of the high risk of adverse effects when using the current microfilaricidal drugs, such a strategy remains unacceptable.

Animals↗