D. S. Karou

Vaginal infections in pregnant women at the Regional Hospital of Sokode (Togo) in 2010 and 2011

OBJECTIVE The aim of this study was to evaluate the prevalence of the major microorganisms causing vaginal infections in pregnant women consulting at the Regional Hospital of Sokodé and to assess their sensitivity to antibiotics. MATERIALS AND METHODS This prospective study took place from June 2010 through August 2011 and included 302 pregnant women from whom a sample was taken by a vaginal swab. Samples were processed for parasitic, bacterial, and fungal agents, by microscopic examination and culture. RESULTS We isolated 273 germs, alone or in association in 221 women. These germs were distributed as follows: Gardnerella vaginalis (55.31%), Candida spp (30.77%), Staphylococcus aureus (5.49%), Enterobacteriaceae (4.40%), Trichomonas vaginalis (3.66%) and Mobiluncus spp (0.37%). No Streptococcus strain was isolated during the study. Over 40% of women had bacterial vaginosis and 23.08% of them were coinfected. The occurrence of coinfection was statistically influenced by the stage of pregnancy (P = 0.05). The susceptibility tests revealed that S. aureus developed a strong resistance to aminopenicillins (66.67%) and cephalosporins (>44.44%), while Enterobacteriaceae was resistant to cephalosporins and quinolones. (16.67%). CONCLUSION This study showed that pregnant women in Sokode are still exposed to vaginal infection, caused mostly by G. vaginalis and Candida species. These results underline the need for at least one vaginal swab culture for each woman during pregnancy.

Molecular detection of Mycobacterium ulcerans in the environment and its relationship with Buruli ulcer occurrence in Zio and Yoto districts of maritime region in Togo

Background Buruli Ulcer (BU) is a neglected tropical skin infection caused by Mycobacterium ulcerans. Residence near aquatic areas has been identified as an important source of transmission of M. ulcerans with increased risk of contracting Buruli ulcer. However, the reservoir and the mode of transmission are not yet well known. The aim of this study was to identify the presence of M. ulcerans in the environment and its relationship with Buruli ulcer occurrence in Zio and Yoto districts of the maritime region in south Togo. Methods A total of 219 environmental samples including soil (n = 119), water (n = 65), biofilms/plants (n = 29) and animals’ feces (n = 6) were collected in 17 villages of Zio and Yoto districts of the maritime region in Togo. DNA of M. ulcerans including IS2404 and IS2606 insertions sequences and mycolactone ketoreductase-B gene (KR-B) was detected using real time PCR amplification (qPCR) technique. In parallel, clinical samples of patients were tested to establish a comparison of the genetic profile of M. ulcerans between the two types of samples. A calibration curve was generated for IS2404 from a synthetic gene of M. ulcerans Transposase pMUM001, the plasmid of virulence. Results In the absence of inhibition of the qPCR, 6/219 (2.7%) samples were tested positive for M. ulcerans DNA containing three sequences (IS2404/IS2606/KR-B). Positive samples of M. ulcerans were consisting of biofilms/plants (3/29; 10.3%), water (1/65; 1.7%) and soil (2/119; 1.5%). Comparative analysis between DNA detected in environmental and clinical samples from BU patients showed the same genetic profile of M. ulcerans in the same environment. All these samples were collected in the environment of Haho and Zio rivers in the maritime region. Conclusion This study confirms the presence of M. ulcerans in the environment of the Zio and Yoto districts of the maritime region of Togo. This may explain partially, the high rates of Buruli ulcer patients in this region. Also, water, plants and soil along the rivers could be possible reservoirs of the bacterium. Therefore, Haho and Zio rivers could be potential sources of infection with M. ulcerans in humans in these districts.

Contribution à la mise en place d’un système d’assurance qualité dans cinq laboratoires de bactériologie médicale au Togo

In Togo, as in many other developing countries, there is a lack of data on quality control and assurance of laboratories. The present study aimed to access for the quality management system in five medical bacteriology laboratories in Togo. The study was conducted from May to August 2006. Data were recorded by an audit on the reliability of results and the technical organization of laboratories. The standard ISO 15189:2003, the Togolese guide of good laboratory practices (GBEA-Togo) and the WHO medical bacteriology standards were used as references. The results of the audit showed a lack of culture media in laboratories, inappropriate choice of culture media, partial identification of some microorganisms, variability of identification procedures, a lack of diagnostic reagents and an inability to identify some potentially pathogenic bacteria. Concerning the technical organization of laboratories, compliance average ranging from 25.8 to 54.8 % was recorded. This indicates a limited organization of such laboratories. The issue of this study showed that laboratories must be equipped, their technical organization should be improved and they must establish a program of equipment maintenance.

Toxicological screening of Daouri, a polyherbal formulation used in children in the Central Region of Togo.

ETHNOPHARMACOLOGICAL RELEVANCE Daouri, a combination of several plants, is an old African Traditional Medicine based on ancestral knowledge transmitted from generation to generation and is used by the Kotokoli Community in Togo. The combination of several plants may potentiate or attenuate the toxicity of individual plants. The present investigation aims to study the composition and potential toxicity of Daouri used in children in the Kotokoli community. MATERIALS AND METHODS Surveys were performed using a semi-structured questionnaire to determine the composition of Daouri. On the basis of these data collected, Standard Daouri was formulated, and its aqueous extract was orally administered at 300, 600 and 1200mg/kg to rats for 28 days. On the 29th day, the rats were sacrificed and their serum were analysed to evaluate hepatic and renal toxicities. RESULTS Four categories of Daouri were collected. The plant combinations used in each Daouri formulation varied according to the pathological conditions, including the age of the children and the availability of each plant. The most plants cited in the four Daouri were Khaya senegalensis (Desv.) A. Juss, Odina acida (A. Rich.) Oliv.,Lophira lanceolata Tiegh, Paullinia pinnata L. and Pteleopsis suberosa Engl. & Diels. Although there was an increase in the alkaline phosphatase concentration, different doses of the aqueous extract of Standard Daouri were not toxic after 28 days of administration. In addition, the concentrations of alanine transaminase, creatinine and urea were not different between the Daouri-treated and control groups. CONCLUSION Daouri is plant combination used in children in the Kotokoli community as a part of African Traditional Medicine. Standard Daouri is not toxic in rats.

Contribution à la mise en place d'un système d'assurance qualité dans cinq laboratoires de bactériologie médicale au Togo Contribution to the establishment of quality assurance in five medical microbiology departments in Togo

In Togo, as in many other developing countries, there is a lack of data on quality control and assurance of laboratories. The present study aimed to access for the quality management system in five medical bacteriology laboratories in Togo. The study was conducted from May to August 2006. Data were recorded by an audit on the reliability of results and the technical organization of laboratories. The standard ISO 15189:2003, the Togolese guide of good laboratory practices (GBEA-Togo) and the WHO medical bacteriology standards were used as references. The results of the audit showed a lack of culture media in laboratories, inappropriate choice of culture media, partial identification of some microorganisms, variability of identification procedures, a lack of diagnostic reagents and an inability to identify some potentially pathogenic bacteria. Concerning the technical organization of laboratories, compliance average ranging from 25.8 to 54.8 % was recorded. This indicates a limited organization of such laboratories. The issue of this study showed that laboratories must be equipped, their technical organization should be improved and they must establish a program of equipment maintenance.