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Wild Mandrillus sphinx are carriers of two types of lentivirus.

Mandrillus sphinx, a large primate living in Cameroon and Gabon and belonging to the Papionini tribe, was reported to be infected by a simian immunodeficiency virus (SIV) (SIVmndGB1) as early as 1988. Here, we have identified a second, highly divergent SIVmnd (designated SIVmnd-2). Genomic organization differs between the two viral types; SIVmnd-2 has the additional vpx gene, like other SIVs naturally infecting the Papionini tribe (SIVsm and SIVrcm) and in contrast to the other SIVmnd type (here designated SIVmnd-1), which is more closely related to SIVs infecting l'hoest (Cercopithecus lhoesti lhoesti) and sun-tailed (Cercopithecus lhoesti solatus) monkeys. Importantly, our epidemiological studies indicate a high prevalence of both types of SIVmnd; all 10 sexually mature wild-living monkeys and 3 out of 17 wild-born juveniles tested were infected. The geographic distribution of SIVmnd seems to be distinct for the two types: SIVmnd-1 viruses were exclusively identified in mandrills from central and southern Gabon, whereas SIVmnd-2 viruses were identified in monkeys from northern and western Gabon, as well as in Cameroon. SIVmnd-2 full-length sequence analysis, together with analysis of partial sequences from SIVmnd-1 and SIVmnd-2 from wild-born or wild-living mandrills, shows that the gag and pol regions of SIVmnd-2 are closest to those of SIVrcm, isolated from red-capped mangabeys (Cercocebus torquatus), while the env gene is closest to that of SIVmnd-1. pol and env sequence analyses of SIV from a related Papionini species, the drill (Mandrillus leucophaeus), shows a closer relationship of SIVdrl to SIVmnd-2 than to SIVmnd-1. Epidemiological surveys of human immunodeficiency virus revealed a case in Cameroon of a human infected by a virus serologically related to SIVmnd, raising the possibility that mandrills represent a viral reservoir for humans similar to sooty mangabeys in Western Africa and chimpanzees in Central Africa.

Amino Acid Sequence↗

Prevalence and incidence of multiple sclerosis in Las Palmas, Canary Islands, Spain.

OBJECTIVES: To determine the prevalence and incidence of multiple sclerosis (MS) in the city of Las Palmas (Canary Islands, Spain), geographically belonging to north-western Africa, but with European ancestry. METHODS: This population-based survey was conducted for a period of 5 years (1998-2002) in a Sanitary District of Las Palmas city (28 degrees 20' N), with a population of 82,623 inhabitants. Multiple sources were periodically investigated for case ascertainment. Patients with definite and probable MS were included. RESULTS: Sixty-four patients with MS were identified on prevalence day, December 31, 2002. According to Poser's criteria the crude prevalence rate was 77.5 per 100,000 (95% CI: 59.7-98.9). This rate decreased to 73.8 (95% CI: 56.5-94.8) according to McDonald's criteria. Age-adjusted rates for the world and European standard populations were 61.6 (95% CI: 47.1-78.9) and 70.6 (95% CI: 55-89), respectively. Prevalence was higher for women aged 25-44 years. In 17 patients onset of MS occurred within the study period. Average annual incidence was 4.1 per 100,000 (95% CI: 2.4-6.6). CONCLUSIONS: The prevalence and incidence rates in Las Palmas city are close to those reported from Continental Spain and other countries of southern Europe with similar social and ethnic background. These results highlight the role of racial-ethnic factors in the genesis of MS.

Adolescent↗

Tropical mycoses.

The most common tropical subcutaneous and deep mycoses include chromomycosis, sporotrichosis and mycetoma. All are commonly found in Natal and in other subtropical countries. Although blastomycosis is endemic in North America, only 4 cases have been identified in Natal during the last 25 years, and all presented with atypical clinical features. African histoplasmosis, caused by Histoplasma capsulatum var. duboisii and limited mainly to central and western Africa, has been found in only 1 patient in Natal. Paracoccidioidomycosis, though the most common deep mycosis in Latin America, is limited to that area and there is no experience of this disease in South Africa. Over the past 8 years, itraconazole has been used in clinical trials for all 3 mycoses. The results in sporotrichosis, non-meningeal blastomycosis and paracoccidioidomycosis suggest that for these diseases itraconazole may be the drug of choice. The results in histoplasmosis are encouraging, as are the results in chromomycosis, particularly those cases associated with Cladosporium carrionii. Where Fonsecaea pedrosoi is the causal agent and in mycetomas, however, successful management still remains a therapeutic problem. Enhanced efficacy by combining flucytosine and itraconazole was seen in 3 patients. Even over prolonged periods, itraconazole has an impressive safety profile. In the present series of 41 patients, no side-effects were observed, no adverse reactions occurred, and serum chemistry values remained within normal limits. It appears, therefore, that itraconazole, though not the final answer to management of deep mycoses, is certainly a major improvement on previous drugs.

Adult↗

Rapid aggressive soft-tissue necrosis after beetle bite can be treated by radical necrectomy and vacuum suction-assisted closure.

BACKGROUND: The substance cantharidin, which is produced by a type of beetle, rapidly penetrates the epidermis and can cause severe toxicities such as skin necrosis. Optimal treatment for necrotic beetle bites has not been well defined. Conservative management has been advocated but the hospital stays are long and long-term morbidity may result, especially in multimorbid patients. OBJECTIVE: The value of aggressive surgical management of such necrotizing diseases using newly developed surgical tools is compared to the traditional more conservative approach. RESULTS: We present the case of a multimorbid 60-year-old man with a rapidly progressive necrosis of the medial thigh (measuring 30 X 15 cm), acquired during a stay in Western Africa after being bitten by a beetle of the species Cantharide. The patient was treated with radical surgical debridement and continuous elimination of the wound fluid by permanent computer-controlled negative pressure with a vacuum-assisted wound-closure device. This led to the sudden relief of both local and systemic symptoms and allowed extremely early wound closure. CONCLUSIONS: Comparing literature data with the course of this combined treatment, we strongly suggest an early aggressive management with complete radical excision of necrotic tissue, conditioning of the wound bed by temporary suction-assisted vacuum closure and subsequent skin grafting with continued vacuum application. This treatment leads to immediate relief of pain and enhanced healing of this lesion even in the condition of immunosuppression in the elderly.

Animals↗

HLA-DR associations in black type I diabetics in Nigeria. Further support for models of inheritance.

The distributions of HLA-A, -B, -(Bw4/Bw6), -C, -DR, -(DRw52/DRw53), and -DQ genes in 19 type I diabetics, 37 type II diabetics, and 13 nondiabetics of the Yoruba tribe in southwestern Nigeria were studied. Because no associations between type II diabetes and HLA were detected in the current study and such associations are not known to exist in most ethnoracial groups, type II diabetics plus nondiabetics were used as a group of controls for the group of type I diabetics. Trends toward associations between increased DR3 (53 versus 30% of controls) and decreased DR2 (21 versus 46% of controls) and type I diabetes were found (0.1 greater than P greater than 0.05). The strongest HLA association with type I diabetes in Caucasians is usually with DR4. The percent of DR4-positive type I diabetes (11%) was not significantly greater that that in the controls (4%). Because the strong HLA associations with type I diabetes in American Blacks are the same as in Caucasians (i.e., increased DR3 and DR4 and decreased DR2), the genetic contribution (i.e., the lack of an association with DR4) to susceptibility to type I diabetes in most Nigerian Blacks may be different from that in most Caucasians and American Blacks. Onset of diabetes in most of the type I subjects was after age 20, and type I diabetics were difficult to recruit for the study, in keeping with reports on the rarity of type I diabetes among Blacks in western Africa and reports of DR4, but not DR3, being correlated with an early age of onset in Caucasians.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Human monkeypox in Kasai Oriental, Zaire (1996-1997).

Monkeypox is an orthopoxvirus with enzootic circulation in the rainforests of central and western Africa; the virus can be transmitted to humans and cause a syndrome clinically similar to smallpox (e.g., pustular rash, fever, respiratory symptoms, and in

Journal Article↗

Chlamydia pneumoniae infection in a breeding colony of African clawed frogs (Xenopus tropicalis).

More than 90% of a breeding colony of clawed frogs (Xenopus tropicalis) imported to the United States from western Africa died in an epizootic of chlamydiosis. Chlamydial inclusions were observed by light and electron microscopy in the liver of an infected frog. Chlamydia pneumoniae was isolated in cell cultures from four frogs. A cutaneous infection by a chytridiomycete fungus observed in two frogs could have been a cofactor in the die-off.ous Diseases

Animal Husbandry↗

Ecologic and geographic distribution of filovirus disease.

We used ecologic niche modeling of outbreaks and sporadic cases of filovirus-associated hemorrhagic fever (HF) to provide a large-scale perspective on the geographic and ecologic distributions of Ebola and Marburg viruses. We predicted that filovirus would occur across the Afrotropics: Ebola HF in the humid rain forests of central and western Africa, and Marburg HF in the drier and more open areas of central and eastern Africa. Most of the predicted geographic extent of Ebola HF appear to have been observed; Marburg HF has the potential to occur farther south and east. Ecologic conditions appropriate for Ebola HF are also present in Southeast Asia and the Philippines, where Ebola Reston is hypothesized to be distributed. This first large-scale ecologic analysis provides a framework for a more informed search for taxa that could constitute the natural reservoir for this virus family.

Africa↗

Reanalyzing the 1900-1920 sleeping sickness epidemic in Uganda.

Sleeping sickness has long been a major public health problem in Uganda. From 1900 to 1920, more than 250,000 people died in an epidemic that affected the southern part of the country, particularly the Busoga region. The epidemic has traditionally been ascribed to Trypanosoma brucei gambiense, a parasite now confined to central and western Africa. The Busoga region still reports sleeping sickness, although it is caused by T.b. rhodesiense, commonly believed to have spread to Uganda from Zambia in the 1940s. Our analysis of clinical data recorded in the early 1900s shows that the clinical course of sleeping sickness cases during the 1900-1920 epidemic in Uganda was markedly different from T.b. gambiense cases, but similar to T.b. rhodesiense. These findings suggest that T.b. rhodesiense was present in Uganda and contributed to the epidemic. The historic context is reassessed in the light of these data.

Adolescent↗

Human African trypanosomiasis and human immunodeficiency virus co-infection in Western Kenya.

OBJECTIVE: To determine possible interaction between infections of Trypanosoma brucei rhodesiense sleeping sickness and HIV/AIDS in Western Kenya. DESIGN: Random selection and testing for HIV infections of serum samples from HAT patients using an indirect single phase enzyme linked immunosorbent assay (EAI-Immunocomb II, oragenics). SETTING: National Sleeping Sickness Referral Hospital-Alupe. RESULTS: Four (16%) of the HAT serum samples (n = 25) were found to be seropositive for HIV type 1 and 2 infections, while an additional four (16%) were sero-positive to HIV type 2 infections alone. In contrast, the patients from the local STD clinic showed that 52% (n = 53) were seropositive for both HIV type 1 and 2 infections. No patient from the STD clinic was seropositive for HIV type 2 alone. Calculated Yates Chi square value of 17.31 (P > 0.001) indicated a significant increase in HIV type 2 antibodies in T. brucei rhodesiense sleeping sickness patients. RESULTS: Sixteen percent of the HAT serum samples (n = 25) were found to be seropositive for HIV type 1 and 2 infections, while an additional 16% were sero-positive to HIV type 2 infections alone. In contrast, the patients from the local STD clinic showed that 52% (n = 53) were seropositive for both HIV type 1 and 2 infections. No patient from the STD clinic was seropositive for HIV type 2 alone. Calculated Yates Chi square value of 17.31 (P < 0.001) indicated a significant increase in HIV type 2 antibodies in T. brucei rhodesiense sleeping sickness patients. CONCLUSION: T. brucei rhodesiense sleeping sickness is an immuno-suppressive disease whose patients have shown a higher affinity to HIV type 2 infections more common in central and western Africa. Such patients when treated, appear to recover from HAT but later succumb to full-blown AIDS. It is recommended that CD4+ T cell numbers and CD4/CD8 T cell ratios be assessed toinvestigate response to treatment in HIV positive HAT patients.

Age Distribution↗

Salmonellae in the African great cane rat (Thryonomys swinderianus).

Because of its large size, the African great cane rat (Thryonomys swinderianus) is valued for food and has become a popular meat in western Africa. A survey was conducted to determine the occurrence of salmonellae in cane rats. Ten strains of Salmonella sp. were isolated from eight of 25 (32%) cane rats. Salmonella ajiobo was isolated from the spleen and intestines of three cane rats; S. agama was obtained from the spleen, liver and intestines of three animals; and S. poona was isolated from the spleen and liver of two cane rats. The occurrence of salmonellae in T. swinderianus is a potential public health hazard. Humans may become exposed to infection by consumption of inadequately cooked infected cane rat meat, or by eating vegetables, sugar cane and fruits contaminated with excretions of carrier cane rats. Incidents of human salmonellosis attributable to cane rat meat have not yet been reported; however, all three serotypes isolated from the cane rats have also been isolated from stools of patients suffering from gastroenteritis in Nigeria.

Animals↗

Lower hypertension prevalence in first-generation African immigrants compared to US-born African Americans.

Both genetic and environmental factors have been hypothesized to explain the higher prevalence of hypertension in US African Americans compared to populations still residing in western Africa. Studies of first-generation immigrants can help to identify risk factors for increased chronic disease expression in the developed world. Since we could identify no prior studies of hypertension in African immigrants to the United States, we conducted a cross-sectional survey of African-born and US-born African-American health professionals to compare the two groups for the prevalence of hypertension (blood pressure > or = 140/90 mm Hg or use of antihypertensive medication) and risk factors for hypertension (body mass index, lifestyle factors, and psychosocial variables hypothesized to relate to hypertension). Subjects were registered pharmacists and nurses recruited by mail. For the 182 individuals who completed study measurements (95 US-born and 87 African-born), the unadjusted odds ratio for hypertension associated with birthplace was 2.16 (95% CI = 1.12, 3.98). After adjustment for body mass index and age, the OR for birthplace was 1.92 (95% CI = 0.92, 4.00). No lifestyle or psychosocial variables were associated with hypertension prevalence. We conclude that there is a lower prevalence of hypertension in first-generation African immigrants that cannot be readily explained by the environmental effects measured in this study. Larger scale studies with African immigrants could advance understanding of the causes of the increased hypertension prevalence in US-born African Americans.

Africa↗

[Huntington disease in Burkina Faso].

Four cases of Huntington's disease in two families seen in Burkino Faso, a country in western Africa, are described. All four patients were black Africans aged 43, 42, 38 and 33 years. The clinical presentation was typical with chorea and episodes of psychiatric disorders. Molecular genetics of one family showed abnormal expansion of CAG repeats on IT15 in three patients. Separate mutations are likely to be the origin of Huntington's disease in Burkino Faso.

Adult↗

[Acute intoxication with "sobi-lobi" (Datura). Four cases in Niger].

The datura (Datura stramonium, Datura metel) belongs to a group of plants from the solanacies variety and can be the cause of voluntary intoxication. In Nigher, its flowers and seeds are used for their hallucinogenic properties. Its alcaloïds have an atropine-like effect. We are reporting here the first four cases of voluntary intoxication among teenagers in Niamey (Republic of Niger). The symptoms, which happened to be identical for the four patients, lead us quickly towards the possibility of a collective intoxication. During the questioning, the patients admitted they had smoked the plant's dried flowers, but also they drunk an herbal tea mixed with datura seeds. Symptoms are comparable to that of intoxications caused by atropine. Neurological signs are the main symptoms (agitation, delirium, disorientation, hallucination, mydriasis, retention of urine...). The others noticeable signs are: fever, dry mouth, tachycardia, thirstiness. The evolution was favourable as the patients left the hospital between D2 and D4. Those clinical features are compared to the literature items, which are inexistent in western Africa. The prognosis may be fatal, especially for the child and during massive intoxications meant to be autolystic or toxicomaniac. The recovery when possible leads usually to no sequels however sever the clinical picture is. The consultation of the population enabled us to comprehend that datura is known and consumed for its hallucinogenic proprieties. The therapeutic guidance is described and prevention suggested.

Acute Disease↗

[Analgesic effect of Pilostigma reticulatum (nguiguis)].

Mankind has always given himself means to fight pain by using at first, means offered to him by his environment particularly the plants. African pharmacopoeia is rich of thousand of plants. It changes in term of its ecosystem and its vegetation. Decocted leaves of pilostigma reticulatum (nguiguis in ouolof) are used in western Africa, because of its analgesic properties in case of "borom bop" literally meaning headache associated to odontalgias and mumps. In our study we used lyophilisate obtained from dry leaves of the plant which has been used for experimentation while the decocted dry leaves have been used for clinical application. So, it appeared that leaves of pilostigma reticulatum are almost atoxic when administrated by oral tract (DL50 = 17 g/kg) according to GLEASON classification which recognizes as atoxic every substance having a DL50 higher to 15 g of lyophilisate by kilogram of corporal weight. Elsewhere the study of the peripheric analgesic activity (according to the acetic acid test) has shown a very significant peripheric analgesia since the dose of 750 mg/kg which climbs with it. The clinical survey carried out at the dental community center of Pikine Icotaf based on the usual method of the utilization of the decocted (as mouth rinse) has shown that, this plant procures pain sedation in 97% of the patients having undergone dental avulsion and in 78% of the cases of desmondontal syndromes. This inaugural report must be continued in order to certify the pharmacologic or toxic effects of that plant and define clinical doses from experimental doses we have cleared.

Acetic Acid↗

[Etiologies of ocular and eyelid trauma in Burkina Faso].

PURPOSE: To identify the epidemiological features of ocular traumas in Burkina Faso. METHODS: A retrospective study was conducted in the eye department of the National Hospital of Ouagadougou, from January 1995 to 31 December 1997. All cases of eye trauma during this period were included. RESULTS: The study showed that ocular traumas represented 9.80% of the reasons for consultation in the unit. 73% of the patients were male. The median age was 21. School children and students were the most frequently involved 25.8%) and 58.9% of the patients came from Ouagadougou while 41.1% came from the rural areas. Public thoroughfare accidents (were the main causes of the trauma (25%). Among the traumatic agents, 26% involved vegetal materials. CONCLUSION: Ocular traumas are a major cause of blindness in Western Africa and concern mostly young people. Prevention strategies based on education and information about road safety could reduce the incidence of ocular traumatisms.

Accident Prevention↗

Papua New Guinea.

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Africa, Western↗