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The aim of this research was to establish whether hydrothermal conditioning and subsequent thermochemical processing via batch torrefaction or slow pyrolysis may improve the fuel quality of grass residues. A comparison in terms of fuel quality was made of the direct thermochemical processing of the feedstock versus hydrothermal conditioning as a pretreatment prior to thermochemical processing. Hydrothermal conditioning reduced ash content, and particularly nitrogen, potassium and chlorine contents in the biomass. The removal of volatile organic matter associated with thermochemical processes can increase the HHV to levels of volatile bituminous coal. However, slow pyrolysis only increased the HHV of biomass provided a low ash content (<6%) feedstock was used. In conclusion, hydrothermal conditioning can have a highly positive influence on the efficiency of thermochemical processes for upgrading low-value (high-ash) biomass to a higher quality fuel.

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In Togo, chloroquine (CQ) remains the first-line drug for the treatment of uncomplicated, Plasmodium falciparum malaria. In the absence of recent data on the level of parasite resistance to antimalarial drugs, Togo's National Malaria Control Programme (NMCP) decided to assess the current efficacy of CQ in the treatment of uncomplicated, P. falciparum malaria at three sentinel sites in the north of the country. Between the September and November of 2001, the World Health Organization's standard 14-day protocol was used to investigate 153 malarious children aged 6-59 months old (46 from Sokode, 54 from Niamtougou and 53 from Dapaong). Of the subjects from Sokode, Niamtougou and Dapaong, early treatment failure was observed in 0%, 7% and 12%, late treatment failure in 0%, 11% and 17%, and overall parasitological failure in 0%, 45% [with a 95% confidence interval (CI) of 39%-51%] and 62% (CI=54%-70%), respectively. Even within northern Togo, there is clearly considerable geographical variation in the level of resistance to CQ. Before an efficient antimalarial-drug policy can be developed, there is an urgent need to develop and use the national surveillance system further, to collect relevant data on the efficacies of CQ and other antimalarial drugs, such as amodiaquine and sulfadoxine-pyrimethamine.

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The geographical distribution of human infection with Wuchereria bancrofti was investigated in four West African countries (Benin, Burkina Faso, Ghana and Togo), using a commercial immunochromatographic test for filarial antigen. Efforts were made to cover each health-system implementation unit and to ensure no sampling point was >50 km from another, but otherwise the 401 study communities were selected at random. The aim was to enable spatial analysis of the data, to provide a prediction of the overall spatial relationships of the infection. The results, which were subjected to an independent random validation in Burkina Faso and Ghana, revealed that prevalence in the adult population of some communities exceeded 70% and that, over large areas of Burkina Faso, community prevalences were between 30% and 50%. Most of Togo, southern Benin and much of southern Ghana appeared completely free of the infection. Although there were foci on the Ghanaian coast with prevalences of 10%-30%, such high prevalences did not extend into coastal Togo or costal Benin. The prevalence map produced should be useful in prioritizing areas for filariasis control, identifying potential overlap with ivermectin-distribution activities undertaken by onchocerciasis-control programmes, and enabling inter-country and sub-regional planning to be initiated. The results indicate that bancroftian filariasis is more widely distributed in arid areas of Burkina Faso than hitherto recognized and that the prevalences of infection have remained fairly stable for at least 30 years. The campaign to eliminate lymphatic filariasis as a public-health problem in Africa will require significantly more resources (human, financial, and logistic) than previously anticipated.

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AIM OF STUDY: To assess the reliability of endoscopic diagnosis of Candida albicans esophagitis. PATIENTS AND METHODS: A case - control prospective study was carried out from November 1997 to July 1998 at the Campus Teaching Hospital of Lome, in patients with esophagitis macroscopically suggestive of Candida albicans origin at upper digestive endoscopy. Fifteen subjects with normal endoscopy served as controls. Esophageal biopsies for mycologic and pathological examination were performed, as well as HIV serology. RESULTS: During the study period, 26 of the 850 endoscopies performed in our Unit revealed an esophagitis suggestive of Candida albicans origin. Mycology confirmed the presence of filamentous form of Candida albicans in 23 patients and pathology showed non-specific lesions of esophagitis, 20 with intramucous hyphae. HIV serology was positive in 19/23 patients (82.6%) and in 1/15 controls (6.6%). Sensitivity and specificity of upper GI endoscopy for the diagnosis of Candida albicans were 100 and 83.3% respectively; positive and negative predictive values were 88.5 and 100%, respectively. CONCLUSION: Upper digestive endoscopy is a reliable method for the diagnosis of Candida albicans esophagitis. However, mycological confirmation is warranted.

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UNLABELLED: The aim of this work was to differentiate in an endemic area congenital malaria diseases (CMD) from congenital malaria infestations (CMI) or other maternal-fetal infections. METHODS: Four hundred and seventy-five newborn (0-7 d) suspected of infection were prospectively studied. CMD was diagnosed when clinical manifestations were associated with positive thick and thin blood films in a mother and her newborn. The diagnosis of CMI was retained when despite positive parasitemia, no clinical manifestations were observed. RESULTS: Forty newborns (1.7% of the cases of maternal malaria) were diagnosed as CMD and ninety-one (19% of live births) were considered as CMI. The main clinical manifestations were related to cerebral (100%), respiratory (95%) and hemodynamic (90%) systems. Hematologic signs were present in 95% of cases. The level of parasitemia varied from 700 to 3,000 parasites/mL in CMD and from 360 to 870 parasites/mL in CMI. Death occurred in ten cases (25%) of CMD. CONCLUSION: In this malaria-endemic area, neither clinical manifestions nor parasitemia allow one to distinguish CMD from CMI associated with bacterial materno-fetal infections. Studying placental or systemic immunity and antimalaria IgM in the newborn could be of interest to clarify this problem.

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As a prelude to a national campaign to control schistosomiasis in Togo, mass screening of school children in 22 prefectures was undertaken to determine the extent of endemic schistosomiasis. Children were randomly selected for testing. In each case, stool examinations using by the Kato-Katz method and urine tests (centrifugation of 10 ml) were performed to detect Schistosome eggs. A total of 2511 children were tested. The sex ratio was 1.7 and mean age 10.4 years (range: 5 to 20 years). The incidence of schistosomiasis was 26.7 p. 100. Schistosoma haematobium was the most widespread and active Schistosome species, being endemic in all locations studied. The incidence of Schistosoma haematobium ranged from 0.6 to 72 p. 100 (national mean: 25.5 p. 100). Schistosoma mansoni was prevalent in only 12 prefectures (range 0.6 to 10 p. 100; national average 2.2 p. 100). The rate of infection was highest in the age group between 10 and 20 years and the risk appeared to be significantly higher in males than in females (p < 0.05). This study confirmed the high incidence of schistosomiasis infection in Togo and identified hyperendemic areas in which control measures should be programmed first.

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A prospective study was conducted to determine the etiologies of isolated pruritus among out-patients attending a hospital dermatology clinic in Lome. Two hundred and twenty patients (120 men and 100 women) suffering from isolated pruritus were included in the study. The most frequent etiologies were; digestive parasitosis (n = 50), onchocercosis (n = 45), drug allergy (n = 26), food allergy (n = 10), psychological pruritus (n = 25) and hepatitis (n = 13). The etiology was not determined for 29 cases. This study shows the large contribution of parasites to the pathogenesis of pruritus in tropical Africa.

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Cette etude nous montre que 28 a 33 pour cent de femmes enceintes en ville et en milieu rural ne suivent aucune chimioprophylaxie. Malgre la chloroquino-resistance; 70 a 83 pour cent de souches sont sensibles a la dose de 5 mg/kg de chloroquine. A la lumiere du taux eleve de non observance de la chimiotherapie par les femmes enceintes en ville et en milieu rural; il convient de revoir la strategie d'information et d'education pour la sante

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819 sera and 3 cerebro spinal fluid have been tested for toxoplasmic antibodies. Serum positivity is higher in males than in females (64.86% against 58.70%). Global positivity is 59.26%. Children up to 10 years old have antibodies titre more than 300 UI/ml. These titres decrease as people are growing old.

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The authors compare the seropositivity against Toxoplasma gondii in 618 women from 13 to 55 years old coming from 6 different regions of Togo. The sera were examined for the presence of IgG by ELISA technic. The results show a significant difference with regions (extremes: 62 and 88% seropositive subjects) but religion, ethnic origin and diet do not seem to have any influence.

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Chloroquine, in a single dose of 10 mg of base/kg, was given orally to Togolese children less than 5 years of age as primary therapy for Plasmodium falciparum malaria. A simplified World Health Organization in vivo method was used, as was a sequential analysis procedure for determining if the drug trial was a success or failure. A total of 178 children in 3 regions were treated; 174 (98%) responded successfully, which required a greater than or equal to 75% reduction in parasites by day 2 and elimination of parasites by day 7. All 4 failures had low blood levels of chloroquine and desethylchloroquine at day 7. A single dose of chloroquine for treating malaria can be considered for those areas of Africa where the efficacy of such therapy is documented, and where an antimalarial drug sensitivity monitoring system is operating.

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The authors report an observation of Strongyloidiasis with a localisation of larvae in the sperm. The usual drugs, thiabendazole and albendazole, are not efficacious in this case. The action of strongyloides larvae on the sterility of this patient (his reason for consultation) cannot be proved. Any pathologic or iatrogenic factors cannot explain the failure of the cure.

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The authors note a very high prevalence of schistosomiasis mansoni in the two foci studied in Togo (Lama Kara in the North and Kpalimé in the South-West); however, the prevalence is significantly higher in Lama Kara (79.5%) than in Klonou (54.7%); this was calculated on both coprological and serological basis. The parasite burden is identical in the two foci; but, the GMRT is higher in Lama Kara than in Klonou (31.7 and 8) which might be explained by a different immunogenicity of the two strains. It is noticed schistosomiasis mansoni might be responsible for hepatosplenomegaly found in the two foci, especially in Lama Kara, which might be explained by a higher virulence in this location. The treatment by oltipraz (RP 35972) had a 91.9% success rate in Klonou (similar to our results in Paris). However, in Lama Kara, even though the drug was taken with some food--increasing its biodisponibility--, the treatment was less effective at day 180 (76.5%). The authors wonder whether the difference of oltipraz efficiency between the two foci is based on a difference of biology between the two strains of Schistosoma mansoni in Lama Kara and in Klonou.

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A new membrane filter concentration technique for the detection and quantification of Onchocerca volvulus microfilariae in skin snips was compared for sensitivity and efficiency with a widely used "standard" technique. A field study was carried out in five villages in an onchocerciasis focus north-east of the town of Sokodé, Mô river valley, Togo. Use of the new technique resulted in a substantial rise in the observed prevalence and density of microfilariae.

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