A. Diouf

Mass lead intoxication from informal used lead-acid battery recycling in dakar, senegal.

Background and objectives Between November 2007 and March 2008, 18 children died from a rapidly progressive central nervous system disease of unexplained origin in a community involved in the recycling of used lead-acid batteries (ULAB) in the suburbs of Dakar, Senegal. We investigated the cause of these deaths. Methods Because autopsies were not possible, the investigation centered on clinical and laboratory assessments performed on 32 siblings of deceased children and 23 mothers and on 18 children and 8 adults living in the same area, complemented by environmental health investigations. Results All 81 individuals investigated were poisoned with lead, some of them severely. The blood lead level of the 50 children tested ranged from 39.8 to 613.9 μg/dL with a mean of 129.5 μg/dL. Seventeen children showed severe neurologic features of toxicity. Homes and soil in surrounding areas were heavily contaminated with lead (indoors, up to 14,000 mg/kg; outdoors, up to 302,000 mg/kg) as a result of informal ULAB recycling. Conclusions Our investigations revealed a mass lead intoxication that occurred through inhalation and ingestion of soil and dust heavily contaminated with lead as a result of informal and unsafe ULAB recycling. Circumstantial evidence suggested that most or all of the 18 deaths were due to encephalopathy resulting from severe lead intoxication. Findings also suggest that most habitants of the contaminated area, estimated at 950, are also likely to be poisoned. This highlights the severe health risks posed by informal ULAB recycling, in particular in developing countries, and emphasizes the need to strengthen national and international efforts to address this global public health problem.

Investigation of Death Cases by Pesticides Poisonning in a Rural Community, Bignona, Senegal

This study gives the report of an epidemiological investigation of twenty nine deaths among fifty cases (global lethality rate was 58%).in a rural community which use widely pesticides and insecticides for agricultural purposed. A case control study with an environmental description has been realized. Serologic tests were performed to eliminate arboviruses aetiology. A qualitative investigation was undertaken, to evaluate the perception, the beliefs, and the population attitudes toward the infection and the inventory of the different pesticides used in the sites of study. In Africa, there are many incidents of domestic or professional poisoning with a fatal ending for which, few data are available, toxicological analysis are still a challenge.

Creation of the African Society of Toxinology

Pendant longtemps en Afrique, les morsures de serpent et les piqures de scorpions resterent une fatalite accablant les populations autochtones, effrayant les etrangers et deconcertant le personnel medical... Jusqu’a tres recemment, l’incidence et la mortalite etaient mal connues, ce qui limitait l’organisation de la prise en charge et la prevision des besoins therapeutiques. A l’epoque coloniale, tres peu d’etudes etaient consacrees aux animaux venimeux, venins et envenimations africains. L’essentiel des travaux concernaient la description d’especes nouvelles, parfois de simples observations cliniques, le plus souvent pour rapporter une evolution remarquable – peu representative mais encourageante – et, plus rarement encore, l’analyse chimique de venins. Au total, quelques articles, moins de cinq par an, rendaient compte de la formidable diversite zoologique, ecologique ou biochimique, et de leurs consequences cliniques et therapeutiques. Le developpement des recherches sur les animaux venimeux et les envenimations commence en Afrique du Nord a partir des annees 50 et en Afrique subsaharienne au debut des annees 70. Au cours de la decennie qui vient de s’ecouler, la recherche en venimologie s’est particulierement developpee en Afrique, notamment en Afrique subsaharienne. Si l’on s’en tient aux publications indexees dans les principales bases bibliographiques imprimees (Bulletin de l’Institut Pasteur, Bulletin signaletique du CNRS, Tropical Diseases Bulletin) ou en ligne (MedLine), le nombre de publications a presque quintuple par rapport aux annees 70 qui virent l’apparition des premieres equipes africaines s’impliquant dans la recherche en venimologie. Il faut cependant souligner que les articles cliniques et epidemiologiques representent plus des deux tiers des travaux publies. Si pendant une trentaine d’annees l’anglais et le francais se partageaient equitablement le nombre de publications, depuis la fin des annees 2000 l’anglais devint nettement majoritaire.

4(e) Conférence internationale sur les envenimations par morsures de serpent et piqûres de scorpion en Afrique : Dakar, 25-29 avril 2011.

The authors present a summary of the proceedings and the recommendations of the Fourth International Conference on Envenomations by Snakebites and Scorpion Stings in Africa, held from 25 to 29 April 2011 in Dakar. After a two-day workshop for Senegalese health personnel on the most relevant aspects of the management of envenomations, about 270 participants met to share their experiences in the field. Nearly a hundred oral and poster presentations were made on the epidemiology of snakebites and scorpion stings in Africa, the composition and action of venoms and the manufacture and use of antivenoms. The last day was devoted to an institutional debate involving experts, representatives of national health authorities and concerned professionals (physicians, pharmacists, nurses and traditional healers) as well as members of the pharmaceutical industry to discuss and elaborate a set of recommendations. It was agreed that it is necessary to improve knowledge of the epidemiological situation by case reporting. Quality control of antivenoms and procedures for their registration at the level of national health authorities should aim at improving the distribution of safe and effective antivenoms in peripheral health centers for the better assessment of victims. It was also recommended that adequate training should be provided for health personnel in all aspects of medical management of envenomations. Equitable distribution of funding and the establishment of a network of African experts were also discussed in the conference.

Rare cutaneous tuberculosis in Sub-Saharan Africa developed on discoid lupus erythematous lesion

Lupus vulgaris is a common presentation of cutaneous tuberculosis (TB), but its ulcerative or vegetating form also called vorax is rare.We report a case of lupus vulgaris in its vorax form, which occurred in a patient with discoid lupus erythematous. A 42-year-old patient monitored for chronic lupus erythematosus consulted again for a facial tumor and fever. Physical examination revealed painful ulcerative and crusted lesions on an old discoid lupus lesion and covered the entire upper lip. Similar lesions were noted on cheeks. Moreover, there were cervical lymphadenopathy, a bilateral pulmonary condensation syndrome, and dysphonia. Cutaneous histopathology had revealed a tuberculoid granuloma without caseating, and nucleic acid amplification tests (GeneXpert®) performed on sputum were positive. Thus, the diagnosis of multifocal TB with skin involvement of vorax type was confirmed. The outcome was favorable following TB treatment. Our observation is distinctive as it is a granulomatosis and ulcerative form of lupus vulgaris, which occurred on a discoid lupus erythematous lesion. This is a rare form of lupus vulgaris. This scarcity can be explained by diagnostic difficulties as there are numerous differential diagnoses and histopathology is not often helpful.

Une tuberculose cutanée rare en Afrique subsaharienne sur une lésion de lupus discoïde@@@Rare cutaneous tuberculosis in Sub-Saharan Africa developed on discoid lupus erythematous lesion

Lupus vulgaris is a common presentation of cutaneous tuberculosis (TB), but its ulcerative or vegetating form also called vorax is rare.We report a case of lupus vulgaris in its vorax form, which occurred in a patient with discoid lupus erythematous. A 42-year-old patient monitored for chronic lupus erythematosus consulted again for a facial tumor and fever. Physical examination revealed painful ulcerative and crusted lesions on an old discoid lupus lesion and covered the entire upper lip. Similar lesions were noted on cheeks. Moreover, there were cervical lymphadenopathy, a bilateral pulmonary condensation syndrome, and dysphonia. Cutaneous histopathology had revealed a tuberculoid granuloma without caseating, and nucleic acid amplification tests (GeneXpert®) performed on sputum were positive. Thus, the diagnosis of multifocal TB with skin involvement of vorax type was confirmed. The outcome was favorable following TB treatment. Our observation is distinctive as it is a granulomatosis and ulcerative form of lupus vulgaris, which occurred on a discoid lupus erythematous lesion. This is a rare form of lupus vulgaris. This scarcity can be explained by diagnostic difficulties as there are numerous differential diagnoses and histopathology is not often helpful.

Une tuberculose cutanée rare en Afrique subsaharienne sur une lésion de lupus discoïde

Lupus vulgaris is a common presentation of cutaneous tuberculosis (TB), but its ulcerative or vegetating form also called vorax is rare.We report a case of lupus vulgaris in its vorax form, which occurred in a patient with discoid lupus erythematous. A 42-year-old patient monitored for chronic lupus erythematosus consulted again for a facial tumor and fever. Physical examination revealed painful ulcerative and crusted lesions on an old discoid lupus lesion and covered the entire upper lip. Similar lesions were noted on cheeks. Moreover, there were cervical lymphadenopathy, a bilateral pulmonary condensation syndrome, and dysphonia. Cutaneous histopathology had revealed a tuberculoid granuloma without caseating, and nucleic acid amplification tests (GeneXpert®) performed on sputum were positive. Thus, the diagnosis of multifocal TB with skin involvement of vorax type was confirmed. The outcome was favorable following TB treatment. Our observation is distinctive as it is a granulomatosis and ulcerative form of lupus vulgaris, which occurred on a discoid lupus erythematous lesion. This is a rare form of lupus vulgaris. This scarcity can be explained by diagnostic difficulties as there are numerous differential diagnoses and histopathology is not often helpful.

Création de la Société africaine de venimologie

Pendant longtemps en Afrique, les morsures de serpent et les piqures de scorpions resterent une fatalite accablant les populations autochtones, effrayant les etrangers et deconcertant le personnel medical... Jusqu’a tres recemment, l’incidence et la mortalite etaient mal connues, ce qui limitait l’organisation de la prise en charge et la prevision des besoins therapeutiques. A l’epoque coloniale, tres peu d’etudes etaient consacrees aux animaux venimeux, venins et envenimations africains. L’essentiel des travaux concernaient la description d’especes nouvelles, parfois de simples observations cliniques, le plus souvent pour rapporter une evolution remarquable – peu representative mais encourageante – et, plus rarement encore, l’analyse chimique de venins. Au total, quelques articles, moins de cinq par an, rendaient compte de la formidable diversite zoologique, ecologique ou biochimique, et de leurs consequences cliniques et therapeutiques. Le developpement des recherches sur les animaux venimeux et les envenimations commence en Afrique du Nord a partir des annees 50 et en Afrique subsaharienne au debut des annees 70. Au cours de la decennie qui vient de s’ecouler, la recherche en venimologie s’est particulierement developpee en Afrique, notamment en Afrique subsaharienne. Si l’on s’en tient aux publications indexees dans les principales bases bibliographiques imprimees (Bulletin de l’Institut Pasteur, Bulletin signaletique du CNRS, Tropical Diseases Bulletin) ou en ligne (MedLine), le nombre de publications a presque quintuple par rapport aux annees 70 qui virent l’apparition des premieres equipes africaines s’impliquant dans la recherche en venimologie. Il faut cependant souligner que les articles cliniques et epidemiologiques representent plus des deux tiers des travaux publies. Si pendant une trentaine d’annees l’anglais et le francais se partageaient equitablement le nombre de publications, depuis la fin des annees 2000 l’anglais devint nettement majoritaire.

Création de la Société africaine de venimologie@@@Creation of the african society of toxinology

Pendant longtemps en Afrique, les morsures de serpent et les piqures de scorpions resterent une fatalite accablant les populations autochtones, effrayant les etrangers et deconcertant le personnel medical... Jusqu’a tres recemment, l’incidence et la mortalite etaient mal connues, ce qui limitait l’organisation de la prise en charge et la prevision des besoins therapeutiques. A l’epoque coloniale, tres peu d’etudes etaient consacrees aux animaux venimeux, venins et envenimations africains. L’essentiel des travaux concernaient la description d’especes nouvelles, parfois de simples observations cliniques, le plus souvent pour rapporter une evolution remarquable – peu representative mais encourageante – et, plus rarement encore, l’analyse chimique de venins. Au total, quelques articles, moins de cinq par an, rendaient compte de la formidable diversite zoologique, ecologique ou biochimique, et de leurs consequences cliniques et therapeutiques. Le developpement des recherches sur les animaux venimeux et les envenimations commence en Afrique du Nord a partir des annees 50 et en Afrique subsaharienne au debut des annees 70. Au cours de la decennie qui vient de s’ecouler, la recherche en venimologie s’est particulierement developpee en Afrique, notamment en Afrique subsaharienne. Si l’on s’en tient aux publications indexees dans les principales bases bibliographiques imprimees (Bulletin de l’Institut Pasteur, Bulletin signaletique du CNRS, Tropical Diseases Bulletin) ou en ligne (MedLine), le nombre de publications a presque quintuple par rapport aux annees 70 qui virent l’apparition des premieres equipes africaines s’impliquant dans la recherche en venimologie. Il faut cependant souligner que les articles cliniques et epidemiologiques representent plus des deux tiers des travaux publies. Si pendant une trentaine d’annees l’anglais et le francais se partageaient equitablement le nombre de publications, depuis la fin des annees 2000 l’anglais devint nettement majoritaire.

4e Conférence internationale sur les envenimations par morsures de serpent et piqûres de scorpion en Afrique : Dakar, 25–29 avril 2011@@@Report of the 4th International Conference on Envenomations by Snakebites and Scorpion Stings in Africa, Dakar, April 25–29, 2011

The authors present a summary of the proceedings and the recommendations of the Fourth International Conference on Envenomations by Snakebites and Scorpion Stings in Africa, held from 25 to 29 April 2011 in Dakar. After a two-day workshop for Senegalese health personnel on the most relevant aspects of the management of envenomations, about 270 participants met to share their experiences in the field. Nearly a hundred oral and poster presentations were made on the epidemiology of snakebites and scorpion stings in Africa, the composition and action of venoms and the manufacture and use of antivenoms. The last day was devoted to an institutional debate involving experts, representatives of national health authorities and concerned professionals (physicians, pharmacists, nurses and traditional healers) as well as members of the pharmaceutical industry to discuss and elaborate a set of recommendations. It was agreed that it is necessary to improve knowledge of the epidemiological situation by case reporting. Quality control of antivenoms and procedures for their registration at the level of national health authorities should aim at improving the distribution of safe and effective antivenoms in peripheral health centers for the better assessment of victims. It was also recommended that adequate training should be provided for health personnel in all aspects of medical management of envenomations. Equitable distribution of funding and the establishment of a network of African experts were also discussed in the conference.