Search

Background & Purpose: In this retrospective study, we aimed at defining the clinical, paraclinical and outcome features of acute neurological syndromes associated with anti-GQ1b antibodies., Results: We identified 166 patients with neurological symptoms appearing in less than 1 month and anti-GQ1b antibodies in serum between 2012 and 2022. Half were female (51%), mean age was 50 years (4-90), and the most frequent clinical features were areflexia (80% of patients), distal upper and lower limbs sensory symptoms (78%), ophthalmoplegia (68%), sensory ataxia (67%), limb muscle weakness (45%) and bulbar weakness (45%). Fifty-three patients (32%) presented with complete (21%) and incomplete (11%) Miller Fisher syndrome (MFS), thirty-six (22%) with Guillain-Barre syndrome (GBS), one (0.6%) with Bickerstaff encephalitis (BE), and seventy-three (44%) with mixed MFS, GBS & BE clinical features. Nerve conduction studies were normal in 46% of cases, showed demyelination in 28%, and axonal loss in 23%. Anti-GT1a antibodies were found in 56% of cases, increased cerebrospinal fluid protein content in 24%, and Campylobacter jejuni infection in 7%. Most patients (83%) were treated with intravenous immunoglobulins, and neurological recovery was complete in 69% of cases at 1 year follow-up. One patient died, and 15% of patients relapsed. Age > 70 years, initial Intensive Care Unit (ICU) admission, and absent anti-GQ1b IgG antibodies were predictors of incomplete recovery at 12 months. No predictors of relapse were identified., Conclusion: This study from Western Europe shows acute anti-GQ1b antibody syndrome presents with a large clinical phenotype, a good outcome in 2/3 of cases, and frequent relapses., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Influenza surveillance in African countries was initially restricted to the identification of circulating strains. In Senegal, the network has recently been enhanced (i) to include epidemiological data from Dakar and other regions and (ii) to extend virological surveillance to other respiratory viruses. Epidemiological data from the sentinel sites is transmitted daily by mobile phone. The data include those for other febrile syndromes similar to influenza-like illnesses (ILI), corresponding to integrated approach. Also, clinical samples are randomly selected and analyzed for influenza and other respiratory viruses. There were 101,640 declared visits to the 11 sentinel sites between week 11-2012 and week 35-2013; 22% of the visits were for fever syndromes and 23% of the cases of fever syndrome were ILI. Influenza viruses were the second most frequent cause of ILI (20%), after adenoviruses (21%) and before rhinoviruses (18%) and enteroviruses (15%). Co-circulation and co-infection were frequent and were responsible for ILI peaks. The first months of implementation of the enhanced surveillance system confirmed that viruses other the influenza make large contributions to influenza-like illnesses. It is therefore important to consider these etiologies in the development of strategies to reduce respiratory infections. More informative tools and research studies are required to assess the burden of respiratory infections in developing countries.

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 microg/dL with a mean of 129.5 microg/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.

Between May and October 2000, the Regional Health Office of Kolda Region in the south of Senegal, West Africa, reported an epidemic of an unknown illness characterized by thoracic pain, dyspnea and edemas of limb and face. The epidemic covered a radius of approximately 40 km (24 miles) between the districts of Kolda and Sedhiou in Kolda Region. Cases were mostly men whose age ranged between 12 and 60 years old. Investigation revealed that they had been exposed to pesticides distributed by the government to groundnut farmers. The signs and symptoms suggested intoxication with carbamates, carbofurans, and possibly thiram, contained in the pesticides distributed with the groundnut seeds. Government distribution created an excessive use of pesticides in the farms, and consequently an overexposure of the subjects who handled the seeders, especially young males but also a small proportion of women who worked in the groundnut fields. Many of these subjects, not accustomed to handle pesticides, came to overestimate the quantity of product to fill the seeder. It should be noted that the policy of distribution of pesticides in Senegal, which presents risk of poisoning, was not systematically accompanied by sufficient information on the danger of the products and of certain precautions that should be taken during their use.

Blood pressure readings of 15756 coloured African schoolchildren aged between 11 and 18 years old were studied. The measurements were casual readings. The study group was not perfectly representative of the school population. However, from the practical point of view, the data may be used in the whole Ivory Coast school population in the 11 to 18 years age range. The distribution of the average readings with respect to age and sex is indicated on Table II. Abnormally high blood pressure was defined as readings greater than the average BP + 2 standard deviations, to the nearest 0,5 cm Hg (to take the practical problems of BP measurement into account). Under these conditions, all boys and girls between 11 and 18 years of age with BP greater than or equal to 150/90 (except boys of 17-18 years of age for whom the limit was 155/95) were considered to be hypertensive. According to these criteria the prevalence of hypertension in coloured African schoolchildren was: -systolic hypertension: 4,86% boys and 4,03% girls; -diastolic hypertension: 4,20% boys and 5,09% girls; -systolic or diastolic hypertension: 6,77% boys and 7,54% girls; -systolic and diastolic hypertension: 2,29% boys and 1,57% girls. In fact, these would be children "at risk" rather than hypertensive. The true number of hypertensive children would only become apparent on follow-up. A comparison with coloured African and white European schoolchildren in the same schools in Abidjan showed that the average BP readings and prevalence of hypertension was higher in the coloured population but the difference was not always statistically significant. The small number of European children made comparison difficult. The data obtained was compared to previously reported series but it was difficult to draw conclusions because of differences in methodology.