[Imported malaria in Moselle: 75 cases in three years].

Purpose: Imported malaria frequency is increasing in France. Moselle, a north-east French county, with high concentration of servicemen going in endemic areas, follows the same trend.

Methods: Clinical, epidemiological aspects and treatment of all malaria attacks diagnosed over 3 years (from 1st january 1996 to 31st january 1999) were studied.

[Djibouti, history of 2 epidemics of cholera: 1993-1994].

When two cholera epidemics broke out in Djibouti, respectively in 1993 and 1994, Bioforce was obliged to intervene. The first time, three goals were pursued: setting up a rehydration centre in a tent, organizing epidemiological surveillance and training local personnel in treatment and diagnosis techniques. The next year, the epidemic followed serious flooding.

Activity of two doses of rifampin against Mycobacterium leprae.

In the course of a clinical trial designed to re-examine the bactericidal efficiency of 600-mg doses of rifampin (RMP) against Mycobacterium leprae, two doses of RMP, either 600 mg or 1200 mg, were administered 28 days apart to 29 previously untreated patients with lepromatous or borderline leprosy. Seven, 28, and 35 days after the start of the trial, skin biopsies were performed and immunologically normal mice were inoculated with 5 x 10(3) or 10(4) M. leprae in each hind foot pad.

Short-term trial of clofazimine in previously untreated lepromatous leprosy.

Forty-five previously untreated lepromatous leprosy patients were allocated randomly to three groups and treated, respectively, with Regimen A, standard dosage of clofazimine (CLO) in multidrug therapy (MDT) regimen; Regimen B, CLO 600 mg once every 4 weeks; and Regimen C, CLO 1200 mg once every 4 weeks. The duration of the trial was 24 weeks. By the end of the trial, although a few patients in each group did not improve at all clinically, the majority of patients showed clinical amelioration but the responses were slow.

Evaluation of five treatment regimens, using either dapsone monotherapy or several doses of rifampicin in the treatment of paucibacillary leprosy.

The objective of the present study was to define short-course treatment regimens for PB leprosy and to compare them with the 'classical' dapsone treatment and the WHO-PB regimen. Five treatment regimens were studied and evaluated by the histologic evolution. The regimens were: (1) dapsone 100 mg daily, non-supervised for 3 years; (2) RMP 900 mg supervised, once weekly, 8 doses; (3) idem 12 doses; (4) RMP 600 mg, once monthly, supervised, 6 doses and during this treatment dapsone 100 mg daily unsupervised; (5) RMP 600 mg together with dapsone 100 mg daily, supervised for 6 days.

The incubation time of relapses after treatment of multibacillary leprosy with rifampicin containing regimens.

In order to determine the duration of follow-up needed to evaluate the efficacy of short-course bactericidal regimens for multibacillary leprosy, information is needed on the incubation time of relapses after stopping treatment. Several groups of patients, who had been on rifampicin-containing regimens, were followed up for periods ranging from 4 to 10 years. Two groups of relapses were observed: early relapses occurring within 3.

[Evaluation of endemic leprosy in an urban zone--sampling survey at the household level: results at Bamako, Republic of Mali].

A sample survey on households was conducted in Bamako (capital of the Republic of Mali) in order to estimate epidemiological and logistical indexes relating to Hansen's disease. With a prevalence rate reaching 7.37 +/- 1.

[Suspicion of paucibacillary leprosy resistant to dapsone: importance of follow-up].

Behind the story of one paucibacillary patient treated by dapsone monotherapy, the authors discussed on the possibility of relapse. But the therapy course, observed by DDS/Urine examination shows a default of the patient. The problems of follow up and attendance of the patient are discussed.

[Histological progression of paucibacillary leprosy during treatment with various therapeutic regimens].

Histopathological examination of skin biopsies from PB patients during the first 12-18 months of treatment did not reveal any significant difference in the time necessary for disappearance of the lesions. The regimens studied were: DDS 100 mg 7/7, RMP 600 mg 1/30 6x, RMP 600 mg 6/6 6x, RMP 900 mg 1/7 8x and 12x, RMP 1500 mg 1x and 1 year of DDS, RMP 4 mg/K 1x.

[Inadequate treatment in multibacillary leprosy and incubation times for relapses].

Among a population of over 500 PB patients treated with different regimens, 6 multibacillary relapses were detected: 5 in patients erroneously classified as PB but in reality MB with a low bacterial load, one patient was PB at the start. Treatment regimens had been: 10 weekly doses of RMP either 600 mg (1 case) or 900 mg (1 case) two successive doses of RMP 1500 mg (1 case) a single dose of RMP 40 mg/K (3 cases). Four MB patients with proven DDS-R relapsed after a single dose of RMP either 20 mg/K (1 case) or 40 mg/K (3 cases).

[Principle findings connected with the problems of implementing the multi-drug therapy for leprosy in West Africa].

The Implementation of Multidrug Therapy (MDT) in the states of West Africa oblige to analyse new restraints, in order to modify the existing health structures. The planning of Hansen's programs based on MDT needs to consider the technical and logistic parameters. Solutions are proposed for health workers training course, flow chart, drug supply system and supervision system.

[Comparison of 3 therapeutic regimens in paucibacillary leprosy. Preliminary note].

Between 1980 et 1983 all PB patients presenting at the Institut Marchoux, Bamako, took part in a prospective randomized therapeutic trial and were allocated to one of the following regimens: DDS 100 mg 7/7 3 years, RMP 900 mg 1/7 8 doses, RMP 900 mg 7/7 12 doses. At this moment 24, 29 and 22 patients respectively have been followed for periods of 24 to 56 months. With the exception of some irregular drug intake in the DDS patients followed either by relapse or delay in improvement, the efficacity as judged by histopathological examinations did not reveal any difference between the regimens.

[Efficacy of combined treatments comprising 6 months' administration of rifampicin in multibacillary leprosy].

Ten patients infected with mouse proven DDS-resistant bacilli were treated with the following combined regimen: RMP 600 2/7 6 months, ETH 500 7/7 6 months and DDS 100 7/7 12 months. Follow up was for 27-54 months, without relapses. Added to patients from previous study (Int.

[Compulsory commitment of psychiatric patients from the viewpoint of physicians and judges--exemplified by the use of the psychiatric law of North Rhine and Westphalia].

For several years now a working team of judges and physicians has been tackling the questions involved in the compulsory hospitalisation of mentally diseased patients. In the course of this teamwork the deficiencies and drawbacks of hospitalisation legislation have become glaringly evident. The problems of hospitalisation by law and under the legislation practised by Guardianship Courts, are compared by juxtaposition.

[Necrotic course of erythema nodosum leprosum].

During 2 years, 25 lepromatous patients were hospitalised in the Hansen complications room of Institut Marchoux. Between these patients, 9 developed a Necrotic Erythema Nodosum Leprosum. A review of the observed clinic effects is established and 3 types of signs are isolated and discussed: necrotic extension after big nodes on chest and arms, a punch crater complicating small nodes, and a sclerous xylodermia on arms and legs.

[Integration of leprosy polychemotherapy into general health services].

The actual control of leprosy must conciliate difficulties of multidrug therapy (MDT) application and integration of general health services. The getting up of multidrug therapy needs a logistic with clinical and bacteriological track off, patient categorisation, supervision of treatment, follow up of the drug compliance and control of the disease evolution. The management of such system must be perfectly mastered in order to avoid the uncontroled circulation of rifampicine.