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The purpose of this prospective study conducted from March to December 2000 in the Internal Medicine Department of the Sanou Souro University Hospital in Bobo-Dioulasso, Burkina Faso was to evaluate the epidemiological, clinical, biological and prognostic features of severe malaria in adult patients according to their HIV status. During the study period HIV testing was performed in 37 of the 72 adults with confirmed severe malaria. Findings were positive in 12 cases and negative in 25. The mean age of the 12 seropositive patients with severe malaria was 32.4 +/- 2.8 years and most (50%) had used self-prescribed antimalarial treatment. The most common reasons for seeking medical care were fever, headache and deterioration of general health. The main manifestations of severe malaria were coma (n=4), generalized seizure (n=4) and circulatory collapse (n=4). Six patients (50%) presented two severe manifestations. Mean parasitemia at the time of admission was 4066 parasites/microl for seropositive subjects versus 8563 parasites/microl for seronegative subjects. Outcome of malaria included 4 deaths and 8 recoveries in the seropositive group versus 2 deaths and 23 recoveries in the seronegative group. Comparison with the group of 25 seronegative patients presenting severe malaria demonstrated no significant difference in mean age (p=0.96), self-prescribed antimalarial treatment (p=0.50), parasitemia upon admission (p=0.28), or mortality (p=0.07). However co-infected patients were found to have a higher incidence of anemia (P=0.01) and never presented certain manifestations of severe malaria. Further studies of co-infection by HIV infection and malaria (especially severe malaria) is needed given the high human and economic impact of these two diseases in sub-Saharan Africa.

A retrospective study covering ten years (1987-1996) was conducted to assess the epidemiology, clinical features and management of cancrum oris (noma) in children from Burkina Faso. Fifty nine (59) children were admitted with cancrum oris at the paediatrics and maxillo-facial surgery units of Bobo-Dioulasso, the second town of Burkina Faso. The hospital prevalence of noma is 1.5/1000. 81% of the cases were in the 1 to 5 years age group and 58% were females. Predisposing factors include poverty, lack of immunization, malnutrition, bad oral hygiene, measles and parasitic diseases. The cheek was involved in 31% of the cases. Cure was obtained in 80% of patients after medical and surgical treatment. However, many sequels were observed. Post operative outcome is complicated by the children's growth and often results in retractions, recurrence of ulcers or constriction. Psychological and social problems are associated. Management is difficult in our setting because of the lack of information, cost of the treatment and the absence of well-equipped plastic surgery units.

We report an epidemic of 16 cases of measles during pregnancy. The risk factors for such an association and the materno-fetal outcomes are presented. The mean age of the patients was 20.6 years, with a mean gravidity and parity of 2.1 and 1.1 respectively. The mean clinical features were: conjunctivitis, hyperthermia and cutaneous rash. Nine maternal complications occurred: 6 laryngitis and 3 pneumopathies. All patients were HIV negative. The outcomes of the pregnancy were the following: 2 abortions, 3 stillbirths, 1 preterm delivery and 2 full term births. Eight patients with ongoing pregnancies were lost to follow-up after their discharge from the hospital. We conclude on the need for a systematic prevention in exposed pregnant women by immunotherapy and in children by immunization.