RESUMEN
Measles is an infectious disease that continues to be a significant cause of morbidity and mortality among children in Brazzaville. A measles vaccination coverage survey was conducted for children aged 9 to 23 months. A standard EPI cluster sample was applied in two areas: urban and peri-urban. Measles coverage of children after the vaccination campaign according to history ranged from 36.6% in urban to 38.6% in peri-urban areas, compared with 34.5 and 42.8% for routine vaccination in the same areas. The overall rate of measles coverage was 75.4%. The mean age of children was 46 weeks.
Asunto(s)
Vacuna Antisarampión , Sarampión/prevención & control , Congo/epidemiología , Humanos , Lactante , Sarampión/epidemiología , Población Rural , Población UrbanaRESUMEN
A case-control study was carried out in the Congo to define a scoring system based on a number of clinical and epidemiological criteria of African trypanosomiasis due to Trypanosoma brucei gambiense which could be used by peripheral health services to establish a diagnosis. The survey comprised 163 cases and 326 controls. Clinical signs and symptoms were fever, headache, pruritus and skin lesions due to scratching, diarrhoea, oedema, cervical adenopathies, sleep rhythm disturbances, changes in appetite, amenorrhoea or impotence, mental confusion, neurological signs, and other minor clinical disturbances. Other criteria were a history of previous trypanosomiasis and the presence of domestic animals in the home environment. Analysis of the results showed that neither a single criterion nor a group of criteria is pathognomonic for the disease. The selected criteria do not allow discrimination of sleeping sickness patients among suspected individuals who present themselves. A scoring system is therefore of little use at the peripheral level of health services, particularly when considering the additional workload involved. The low diagnostic value of these clinical signs and symptoms and other indicators in African trypanosomiasis stresses the difficulty in developing an early warning tool for an integrated control strategy in primary health care.
Asunto(s)
Trypanosoma brucei gambiense , Tripanosomiasis Africana/diagnóstico , Adolescente , Adulto , Animales , Estudios de Casos y Controles , Niño , Intervalos de Confianza , Congo/epidemiología , Femenino , Humanos , Masculino , Oportunidad Relativa , Valor Predictivo de las Pruebas , Factores de Riesgo , Tripanosomiasis Africana/epidemiologíaRESUMEN
Une enquete cas-temoins a ete realisee au Congo afin de definir une grille de score de presomption de la maladie du sommeil a T.b. gambiense basee sur une selection de criteres cliniques et epidemiologiques de la trypanosomiase; utilisable par les structures sanitaires peripheriques. L'enquete a ete realisee sur 163 cas et 326 temoins. Les signes cliniques et les symptomes retenus sont: fievre; cephalees; prurit et lesions de grattage; diarrhee; odemes; adenopathies cervicales; troubles du sommeil; troubles de l'appetit; troubles sexuels; psychisme; signes neurologiques et autres troubles cliniques mineurs. Les autres criteres retenus sont les antecedents de trypanoso- miase humaine africaine (THA) et /'existence dun cheptel dans la concession. L'analyse des resultats confirme qu'il n'existe pas de critere ou groupe de criteres pathognomo-niques. Aucun des criteres selectionnes n'est suffisamment discriminant pour permettre une selection des trypanosomes parmi des consultants. Une grille de score de presomption semble donc de peu d'utilite au niveau peripherique; ceci est d'autant plus vrai si l'on considere l'augmentation de la charge de travail. Le faible pouvoir discriminant des signes cliniques et des symptomes ainsi que des autres parametres de la trypanosomiase africaine met en evidence la difficulte de mise en place dune strategie d'integration efficiente en temps qu'outil diagnostique precoce