Médecine tropicale : revue du Corps de santé colonial
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This paper is a description of the clinical features of cerebral malaria in children, based on the author's experience in a study of this disease in Malawi, Africa. The presenting symptoms, physical signs and laboratory features are described, and the course of the illness during treatment is outlined. Cerebral malaria can resemble many other childhood illnesses; accurate diagnosis is essential if correct treatment is to be provided quickly. Even with optimal treatment the mortality is about 20%, and some children are left with neurological sequelae.
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From june 1985 to may 1986, 1.209 consulting patients were examined for filariae in skin and blood. Among patients with microfilariae 17% had associations of filarial infections. ⋯ The frequencies of associations between Dipetalonema perstans and Onchocerca volvulus at one hand, Dipetalonema perstans and Wuchereria bancrofti on the other hand were highly significant. Symptoms of filarial associations were studied and subsequent therapeutic attitude discussed.
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An epidemic of yellow fever raged during the last three months of 1983 in South East of Upper Volta. It spread on about ten thousand square kilometers, in a bushy savanna area, affecting only populations living in contact with forest galleries, belonging especially to the peul ethnical group. The transmission of the virus was effected by sylvatic vectors, essentially Aedes furcifer. ⋯ The epidemic quickly decreased in the sylvatic area, owing to climatic conditions. A mass campaign of vaccinations prevented it from spreading to near urban centres. On this particular case, the thermostability on field of the vaccine 17D provided by the Institute Pasteur of Dakar was proved to be effective.
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The authors report some failures of chemoprophylaxis and curative treatment of Plasmodium falciparum and Plasmodium vivax malaria. These infections were contracted in the area of the cambodian-thaï border by 8 Europeans treated by various regimens and 34 Cambodians treated by quinine. ⋯ Morphological particularities (abnormal pigment, lack of Schüffner dots) were noticed in these Primaquine resistant vivax strains. A possible relation is considered between Primaquine resistance and these morphological particularities.
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In a patient with shock and hyperkalemia , a peritoneal dialysis, started to treat an hyperkalemia , showed the presence of chocolate-like pus in the peritoneal cavity, and confirmed the intraperitoneal rupture of an amoebic liver abscess. Peritoneal dialysis led to the correction of the metabolic disorders and of the shock and restored the diuresis, ensuring favourable conditions to surgical intervention. Surgical drainage of the abscesses and ornidazole treatment led to complete recovery.