RESUMEN
Given the causative parasite hypothesis for tropical endemic limbo-conjunctivitis (TELC), we conducted an analytical case-control study of all children with tropical endemic limbo-conjunctivitis seen in the ophthalmology department of Laquintinie hospital in Douala during the period from January 2nd to April 30, 2015. RESULTS: We identified 64 cases of tropical endemic limbo-conjunctivitis out of 550 children seen; a hospital prevalence of 11.6%; thirteen cases (eight boys and five girls) did not meet inclusion criteria, and 51 cases were included, 31 boys (60.8%) and 20 girls (39.2%) with a male/female (M/F) sex-ratio of 1.41. For controls, we included 28 males (54.9%) and 23 girls (45.1%) for a M/F sex-ratio of 1.22. The prevalence of tropical endemic limbo-conjunctivitis in boys was 12.1%, and for girls it was 7.1% in the case group. Stage II was the most frequent at 29 cases (56.9%), as well as the mixed form at 31 cases (60.8%). The frequency of intestinal parasites was 14 cases (27.5%) in the group of tropical endemic limbo-conjunctivitis patients and 6 cases (11.8%) in the control group (P=0.08). Entamoeba histolytica in its cystic form was the most intestinal parasite found in both groups, 10 cases for tropical endemic limbo-conjunctivitis (19.6%) and 6 cases in the control groups (11.8%). The mean serum IgE among cases was 81.2 IU/ml, while in the controls it was 15.6 IU/ml (P=0.001) CONCLUSION: There is no relationship between intestinal parasitic infection and the occurrence of tropical endemic limbo-conjunctivitis.
Asunto(s)
Conjuntivitis Alérgica/epidemiología , Enfermedades Endémicas/estadística & datos numéricos , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Clima Tropical , Adolescente , Animales , Camerún/epidemiología , Niño , Preescolar , Conjuntivitis Alérgica/complicaciones , Femenino , Humanos , Lactante , Recién Nacido , Parasitosis Intestinales/complicaciones , Queratoconjuntivitis Infecciosa/epidemiología , Queratoconjuntivitis Infecciosa/parasitología , Masculino , PrevalenciaRESUMEN
BACKGROUND: Since September 2014, zidovudine (ZDV)-based therapy for HIV has been the preferred second-line WHO regimen in Cameroon, but its use is limited by the risk of anaemia at standard dosage. We assessed the safety of a reduced vs. standard dose of ZDV to decrease the risk of anaemia in treatment-naïve, HIV-infected individuals. METHODS: In a prospective, randomized, open-label trial in an HIV clinic in Cameroon, 142 eligible adults (CD4 count < 350 cells/µL) were randomized to receive 24 weeks of a regimen comprising lamivudine plus nevirapine with either a reduced (400 mg) or standard dose (600 mg) of ZDV. The primary endpoint was the proportion of participants with new/worsening anaemia. RESULTS: Median age was 35 years; 58.5% were women; median body mass index was 23.2 kg/m(2) . At baseline, median haemoglobin was 11.6 g/dL, median CD4 cell count was 163 cells/µL, and median plasma HIV-1 RNA load was 5.4 log10 copies/mL. The proportion of participants with new/worsening anaemia was 37.5% (400 mg ZDV) and 32.9% (600 mg ZDV) (P = 0.563). Ten patients with severe anaemia required a switch from ZDV to tenofovir (11.4% in standard-dose arm vs. 2.8% in low-dose arm; P = 0.054). At 24 weeks, there was no significant difference between treatment groups, including median CD4 T-cell count increases. CONCLUSIONS: No significant difference was observed in the overall rate of anaemia between HIV-infected individuals starting a ZDV-based treatment according to a standard- or reduced-dose regimen. Severe anaemia and treatment switches related to study drug, however, were more frequent with 600 mg than 400 mg ZDV.
Asunto(s)
Fármacos Anti-VIH/administración & dosificación , Fármacos Anti-VIH/efectos adversos , Infecciones por VIH/tratamiento farmacológico , Zidovudina/administración & dosificación , Zidovudina/efectos adversos , Adulto , Anemia/inducido químicamente , Anemia/epidemiología , Camerún , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada/métodos , Femenino , Humanos , Lamivudine/administración & dosificación , Lamivudine/uso terapéutico , Masculino , Nevirapina/administración & dosificación , Nevirapina/uso terapéutico , Estudios Prospectivos , Resultado del TratamientoRESUMEN
SETTING: Two southern provinces of Rwanda, Butare and Gikongoro. OBJECTIVES: To identify beliefs and popular perceptions on cough and tuberculosis (TB) in rural Rwanda and determine how they shape health-seeking behaviour. METHODS: Eight focus group discussions, 21 key informant interviews and 12 illness narratives were conducted between May and June 2004. STUDY POPULATION: TB patients, community members, traditional healers and health workers. RESULTS: There is wide use of herbal treatment for chronic cough in Rwanda. Patients seek conventional care when alternative treatment options fail or when severe symptoms such as shortness of breath, bloody sputum and weight loss appear. There are several local illnesses associated with chronic cough, with different alternative treatments. TB symptoms are often mistaken for the acquired immune-deficiency syndrome (AIDS). Identified causes for cough-related illnesses can be classified as biomedical (germs, internal body dysfunction and worms), environmental (seasonal changes and dust), cultural (inheritance), socio-economic (hard work, malnutrition and tobacco), and supernatural (witchcraft). Three health-seeking end points emerge for chronic cough: home care, health facility and the traditional healer. Healers in some areas, however, believe TB due to witchcraft can only be treated traditionally. CONCLUSION: This study unveils beliefs and treatment options for chronic cough in Rwanda, with important implications for TB control that should be addressed.
Asunto(s)
Control de Enfermedades Transmisibles/métodos , Tos/psicología , Necesidades y Demandas de Servicios de Salud , Aceptación de la Atención de Salud/psicología , Población Rural , Tuberculosis/prevención & control , Tuberculosis/psicología , Tos/epidemiología , Grupos Focales , Humanos , Prevalencia , Estudios Retrospectivos , Rwanda/epidemiología , Encuestas y Cuestionarios , Tuberculosis/epidemiologíaRESUMEN
A multi-centre study to determine whether community-directed distributors (CDDs) are capable of carrying out additional healthcare and developmental activities in their communities was carried out in Cameroon, Nigeria, Sudan, Uganda and Togo to ascertain the potential effects of their involvement on the implementation of community-directed treatment with ivermectin (CDTI). Both quantitative and qualitative methods were used to collect data from households, community-directed distributors, community leaders, and health workers. The results showed no major decrease in the CDDs' performance in CDTI: on the contrary, the involvement of CDDs in other health and development activities motivated them to perform their CDTI functions better. However, the results did not show any significant increase in therapeutic coverage of ivermectin distribution. The expansion of the CDDs' experience to include additional healthcare and development related activities would be of interest to onchocerciasis control programmes--it will strengthen CDTI sustainability through greater integration.