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This descriptive observational study aims to describe the epidemiological profile of children hospitalized for burns in Guyana, a French district which does not have a burn treatment centre, and direct prevention towards the populations most at risk. Retrospective analysis of 665 hospitalizations was made thanks to the coding of patients aged 0 to 18, hospitalized for burns between January 2010 and December 2022 at Cayenne Hospital Centre. Univariate and multivariate descriptive analyses were carried out on age, sex, municipality of origin, date of burn, duration of hospitalization, mode of burn, location, percentage and depth of burn. A total 416 children with "burn" coding were hospitalized over this period and 358 patients were included. Burns were more common in males (58%) and in children under 6 (75%). A majority of patients were townspeople and lived on the coast (70%). 9.5% of patients were transferred to Trousseau Hospital in Paris for more specialized care. 61% of burns were caused by hot water and 16.5% by flames. Duration of hospitalization was on average 8 days and the burnt skin surface was 9.5%. Children under 2 years old living in Cayenne and its suburbs are the most at risk of burns, but the most serious burns requiring a transfer to Paris are found in children over 3 years old living on the Maroni River and playing with flammable products.

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SUMMARY Tuberculosis (TB) in elephants has the potential to infect humans and is an increasing public health concern. Lao PDR is one of the last countries where elephants are still used for timber extraction and where they live in close contact with their mahouts. There are 500 animals at work in the country, some interacting with wild herds. Although human TB prevalence is known to be high in Laos, studies on elephant TB had yet to be undertaken. From January to July 2012, screening was performed using the ElephantTB Stat-Pak assay on 80 elephants working around the Nam Pouy National Park in Sayaboury Province. This represents more than 18% of the total registered national working elephant population. Here we report that 36% of the elephants were seroreactive to the test. Of these, 31% had contacts with wild individuals, which suggests potential transmission of mycobacteria to the local wild herds. Clinical examination, chest X-rays, sputum microscopy and culture were performed on their 142 mahouts or owners. Despite high TB seroreactivity in elephants, no participant was smear- or culture-positive for Mycobacterium tuberculosis or M. bovis, although atypical mycobacteria were isolated from 4% of participants.

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The purpose of this paper is to highlight the difficulties of applying neuroepidemiological methods in low income countries or developing countries, which are mostly tropical countries, taking advantage of the experience of the Institute of Neuroepidemiology and Tropical Neurology, which was created in Limoges in 1982. These difficulties could be related to several aspects: methodological, logistical, political or economical, linked to ethical issues, even difficulties to publish the studies. However, concept and neuroepidemiological methods should stay the same worldwide, even if their translation into practice could sometimes raise some problems in developing countries. Study protocol should be more detailed. Some specific epidemiological methods could be useful. Collection of data should be standardized. True cooperation at every level is needed for these researches to be valid.

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Introduction. Les accidents vasculaires cerebraux (AVC) sont sources d'invalidites fonctionnelles par fois tres lourdes pour les patients et de contraintes pour leurs entourages. La prise en charge initiale est determinante dans l'amelioration du deficit moteur et partant du pronostic fonctionnel de ces patients. En Mauritanie cette prise en charge initiale se fait a travers differentes filieres de soins.Objectif. Ce travail avait pour objectif de determiner si la filiere initiale de soins en phase aigue avait un impact sur l'amelioration fonctionnelle des patients victimes d'un AVC a Nouakchott. Methodologie. Une etude prospective evaluative portant sur une cohorte de 82 personnes dont 42 au service de Neurologie du CNP; 40 en Medecine Interne et Cardiologie du CHN; s'etait deroulee du 1er mars au 30 novembre 2006. Les patients victimes d'AVC etaient recus aux urgences du CHN avant d'etre orientes en fonction de la periode du mois : en Neurologie (du 1er au 15); en Medecine Interne (du 16 au 23) ou en Cardiologie (du 24 a la fin du mois). Si les malades repondaient a tous les criteres d'inclusion et apres un consentement eclaire; ils etaient evalues sur le plan du deficit et de la capacite fonctionnelle par deux echelles validees : l'Indice de Barthel et la Mesure de l'independance fonctionnelle (MIF). Ces evaluations etaient effectuees a l'inclusion (J0); a J30; J60 et J90. La qualite de vie etait appreciee a J90 par l'echelle de la qualite de vie (EUROQOL). Les patients admis en Neurologie etaient compares a ceux qui etaient hospitalises dans les 2 autres services. Les comparaisons portaient sur les proportions des patients ayant connus une amelioration au cours du suivi et egalement sur les moyennes de l'Indice de Barthel de la MIF recuperes par les patients.Resultats. Soixante Six pour cent (66) des 42 patients inclus en Neurologie ont ete evalues a terme; ce taux est de 30pour la Cardiologie et 10pour la Medecine Interne (p : 0;0005). La comparaison des caracteres socioprofessionnelles; cliniques et radiologiques ne montrait aucune differencestatistiquement signifi-cative entre la Neurologie et les autres Services. Le delai moyen entre l'installation du deficit et le debut de la reeducation etait de 9 jours en Neurologie et 19 jours en Cardiologie; cette difference etait significative (p : 0;0002). La comparaison des proportions de patients ayant recupere aussi bien au niveau du deficit moteur que de l'independance fonctionnelle montrait une difference en faveur des patients qui etaient suivis en Neurologie. La comparaison des moyennes des echelles recuperees ne montrait aucune difference entre les filieres de soins.Conclusion. L'absence de difference entre les differents services au niveau des aspects socioprofessionnels; cliniques et radiologiques temoignait de la qualite de la randomisation. Il y avait plus de patients qui s'ameliorait en Neurologie que dans les 2 autres Services; ceci semblait etre bien correle avec une prise en charge precoce par la kinesitherapie et avec le suivi regulier des patients. Cependant les patients ne recuperaient pas mieux dans une filiere plus que dans une autre

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Epilepsy is a major public health problem in developing countries. In addition to the high prevalence of epilepsy in some regions, there is an acute shortage of trained personnel, clinical equipment, and antiepileptic drugs. As a result of these problems, most patients do not have access to adequate treatment. Despite wake-up calls from the WHO, LICE, and BIE in 2001 using the slogan "Bring epilepsy out of the shadows", few national epilepsy control programs have been implemented in developing countries. Nevertheless reports describing several recent pilot projects have demonstrated that effective screening and management of the disease is feasible through primary health care systems. Phenobarbital should be the first choice for treatment of epilepsy in developing countries.

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OBJECTIVE: We sought to determine the number of beds necessary for stroke patients in postacute care units and to measure the relevance of the national guidelines on required number of beds. METHODOLOGY: We conducted an epidemiological follow-up of a cohort, what allowed for evaluating stroke care under real-life conditions. We applied the French guidelines for transfer of patients to postacute care wards. RESULTS: Of the 605 stroke patients hospitalised, 156 with a mean age of 72 years were included. A total of 64 (41%) could return home directly from the acute care wards and 73 (47%) were referred to postacute care wards. Among the latter patients, 31 (43%) were transferred to a physical medicine and rehabilitation (PMR) unit and 42 (57%) to a geriatric unit. The 19 remaining patients died in acute care. Of the 137 surviving patients, 46.7% returned directly home and 53.2% were referred to postacute care wards. Of patients older than 80 years, 74% were transferred to a geriatric unit, whereas 76% of the patients less than 80 years were transferred to a PMR unit. DISCUSSION-CONCLUSION: The national guidelines are based on a rate of discharge of about 24% of stroke patients to postacute care wards. In our study, we found that 47% were transferred to such wards. If the guidelines are applied, 19 beds dedicated to stroke patients would be necessary for postacute stroke care on a national level, or double that (36) on a regional level. Of these 36 beds, 16 to 24 should be PMR beds. The calculation of the number of beds necessary often rests on a simple transposition of the results of the studies and not on an objective evaluation according to the local context. Studies of longitudinal follow-up of cohorts such as this seem essential to evaluate needs and measure the relevance of the national guidelines.

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Epilepsy is, above all tropical, moreover, very african in its frequency and gravity. Data on the prevalence of epilepsy shows it to be two or three times more prevalent in tropical zones than in industrialized countries in non tropical areas, however it is rare to find data on the incidence and prognosis of epilepsy in sub-Saharan Africa. It is difficult to determine the relative contribution of each of the causes of epilepsy. Only a few case-control studies have been carried out in sub-Saharan Africa. Infectious diseases, in particular parasitic diseases such as neurocysticercosis or cerebral malaria, seem to be the cause of the majority of the cases of epilepsy. However it is necessary to do additional epidemiological studies to determine the etiologies of epilepsy more precisely in sub-Saharan Africa.

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