A tooth ablation custom occurring in the Maldives

Not many people would willingly have their teeth drastically filed, ground, chipped away, or even extracted without the use of an anaesthetic. Even fewer would consent to the treatment if the teeth to be involved were the upper incisors and were entirely healthy. The practice of tooth mutilation or ablation has, however, been carried out worldwide since prehistoric times.

Ectodermal dysplasia with blindness in sibs on the island of Rodrigues

A brother and sister from the island of Rodrigues had mental retardation, blindness owing to severe ocular malformations, short stature, dysmorphic facial features, hypotrichosis, and dental abnormalities. It is likely that they have a hitherto unrecognised autosomal recessive ectodermal dysplasia syndrome.

Vicary Lecture, 1989. John Hunter's disciple--Frederic Wood Jones

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Mitochondrial DNA heteroplasmy maintained in natural populations of Drosophila simulans in Réunion

Mitochondrial DNA (mtDNA) variation in Drosophila simulans was studied to determine whether the cytoplasmic state of mtDNA heteroplasmy persists in natural populations in Réunion. For this purpose, 172 isofemale lines, newly collected from two local populations, were examined, among which three types of mtDNA (siII, siIII and siIII') were found, based on the Hpa II restriction pattern. Ten of the lines were heteroplasmic for a combination of siII and siIII, as determined by autoradiography. The same type of heteroplasmy had been noted in one of the two local populations 8 years before (Satta et al. 1988). The present results suggest that the heteroplasmic state occurs recurrently in natural populations of D. simulans in Réunion.

[Impact of the use of larvivorous fish Poecilia reticulata on the transmission of malaria in FIR of Comoros]

Field tests were conducted in the Grande Comore Island, Federal Islamic Republic of Comoros, in order to evaluate the potential of the larvivorous fish Poecilia reticulata for the control of the malaria vector Anopheles gambiae s.s. Due to the high permeability of soil, Anopheles breeding sites in all island occurs only in the man-made water reservoirs. The study was carried out from November 1987 to November 1988 within a framework of a malaria and filariasis control programme, supported by WHO and UNDP in collaboration with the Government of the FIR of Comoros. All larval breeding places of An. gambiae existing in the village of Hantsambou were recorded (59 ablutions basins and 61 cisterns) and provided initially with 3-5 specimens of P. reticulata/m3 in November 1987, after the importation of the larvivorous species from Mayotte Island. The percentage of breeding places positive for An. gambiae decreased from 41% to 6% after one year. Pyrethrum spray catch showed a reduction of indoor resting density from 5.5 to 0.3, while the ma value, number of Anopheles bites/man/night, obtained by night-biting catches, decreased from 6.3 to 1.2. At the same time of the reduction of entomological indices parasite index for P. falciparum and spleen rate drop steadily in 5-9 years school children. The tested vector control method, well accepted by the community, could be implemented in malaria control through primary health care, being the ecological conditions in the entire island very peculiar.

[Antibody levels against circumsporozoitic protein of Plasmodium falciparum and their use as epidemiological indicators of malaria transmission in FIR of Comoros]

Epidemiological survey on prevalence of Plasmodium falciparum anti-circumsporozoite antibodies (Ab-CS) was carried out in 21 villages of Comoros FIR, at the beginning of 1988 rainy season. Evaluation of anopheline indoor resting densities was also carried out at the same time. Frequencies of antibody-positive subjects vary considerably in the different villages, according to the Anopheles gambiae and A. funestus densities per room, which are determined by ecological factors. Ab-CS prevalence varies in the sample population from 5.5% in 3-4 years children to 40% in those of 5 years. Starting from 6-7 years group, prevalence increased steadily reaching a plateau by 30 years of age. The detection of Ab-CS levels in a sample population is a good tool to evaluate malaria transmission levels, especially where the epidemiological situation does not allow a reliable entomological evaluation.

The Anopheles gambiae complex in the Federal Islamic Republic of Comoros (Indian Ocean): some cytogenetic and biometric data

Samples of adult females of the Anopheles gambiae complex from thirteen localities of three islands of the Comoro Archipelago (Anjouan, Grande Comore and Moheli) were identified by analysis of ovarian polytene chromosomes as An. gambiae s.s. The samples showed only the inversion polymorphism 2La, the mean frequency of the inverted arrangement being 38%. A significantly higher frequency of the inverted arrangement 2La was observed in the localities with a lower annual rainfall. Similarities between the chromosomal polymorphism of the samples from Comoros and that of coastal eastern African countries suggest a probable continental origin of the An. gambiae s.s. populations in the Comoro Archipelago. A biometric analysis was carried out on the palpal index and the number of coeloconic sensilla, two characters partially diagnostic between fresh- and salt-water members of the gambiae complex. The palpal index of the 2La homozygous inverted females of An. gambiae s.s. was found to be significantly higher than the index of standard homozygotes and heterozygotes, suggesting a relation between the inversion and this biometric character. No An. merus was identified, although larvae of An. gambiae s.l. were observed breeding in brackish water.

[Historical epidemiology of malaria in the archipelago of the Mascarenes (Indian Ocean)]

The Mascarenes Islands (Mauritius, Rodrigues and Reunion) have been for the last few centuries a place of rest and convalescence for sailors, soldiers and inhabitants of the other regions of the Indian Ocean affected by "intermittent fevers". In the middle of the nineteenth century a severe and deadly malaria epidemic occurred first in Mauritius and then in Reunion Island. It took a century to bring the disease under control, but this has in no way diminished the risk of its re-introduction. Comparative study of the way the disease appeared and got established in these two islands and not in the adjoining ones (Rodrigues, Chagos, Seychelles) leads us to formulate the hypothesis that massive deforestation for sugar cane cultivation created a favourable environment for the implantation of the malaria vector, the african origin of which is beyond doubt. The evolution of the environment, subjected to natural catastrophe (cyclones) and to human activities (often as a consequence of economic development) has exerted pressure on the vector which in a way gives an answer of the development of the disease over time. This study highlights the importance of epidemiological analysis of the history of major communicable diseases not only in the cognitive context but also in predicting probable public health problem arising from environmental modifications.

Human Salmonella and Shigella infections in Moroni, the capital of Great Comoro Island (1987-1988)

Over a period of two years 98 cultures of Salmonella and 17 cultures of Shigella were isolated at the El Maarouf Hospital, Moroni, capital of the Comoros. Almost half of the isolates were from children under 5 years. Salmonella belonged to a limited range of serotypes, S. typhi dominating in adults and S. enteritidis in children, often with bacteraemia. Antibiotic resistance was virtually absent in Salmonella and without clinical significance in Shigella. The high isolation rate of S. enteritidis and the rarity of antibiotic resistance are commented.

[Alcoholic pancreatitis and pseudocysts. Prospective study of 20 cases in Réunion Island]

In the french indian ocean's island whose name is Reunion, between 1984 and 1986, 20 pancreatic pseudocysts, exclusively encountered in alcoholic patients, were submitted to a prospective study. Most of the lesion were very symptomatic, large and extrapancreatic. Accordingly to Marseille's classification, most of the patients were suffering from acute or chronic relapsing pancreatitis. 18 patients were submitted to a therapeutic procedure. Internal drainage was performed in 9 patients, and external drainage was performed in 5. In addition, pancreatic resection was carried out in 2 patients, and needle aspiration in 2. Comments concern potential specificities of the population which was studied. Special emphasis concern the necessity of preoperative computerized tomographic scanning, the indications of percutaneous external drainage and the long-term survival of patients.

A mycological and bacteriological survey on feed ingredients and mixed poultry feeds in Reunion island

A survey was carried out in Reunion island to obtain data on the occurrence of fungi, aflatoxigenic strains of Aspergillus flavus, aflatoxins, total aerobic bacteria and salmonellae of 150 samples of mixed poultry feeds and raw materials. These were collected at five farms over a 3-month period during the warm rainy season. White corn and Braizlian soybean meal seemed to present a better microbiological quality than yellow corn and US soybean meal. Mixed poultry feeds presented a high total mold count reflecting the mold flora of raw materials. The most frequent and abundant fungi were Aspergillus flavus. A. glaucus group, Fusarium spp., Penicillium spp., A. candidus, Mucor spp., A. restrictus, Scopulariopsis spp., Cladosporium spp. and A. versicolor. Of the 118 A. flavus strains screened, 42 (35.6%) were aflatoxigenic. Yellow corn samples were the most frequently contaminated with aflatoxigenic strains (54.5%), followed by mixed feeds (44%). Of the 66 samples tested, 24 (36%) contained aflatoxins (traces to 22 ng/g). A good correlation seemed to exist between presence of at least one aflatoxigenic strain per sample and presence of aflatoxins.

Seroprevalence of human parvovirus B19 infection in Sao Tomé and Principe, Malawi and Mascarene Islands

The prevalence of antibodies to human parvovirus B19 (anti-B19 IgG) in sera (n = 577) from Sao Tomé and Principe, Malawi and Mascarene Islands (Mauritius and Rodriguez Islands) was determined by antibody capture ELISA. The B19 prevalence was 51.5% on Sao Tomé and Principe, 58.4% in Malawi, and 55.0% on the Mauritius mainland and 2.2% on Rodriguez Island, indicating that B19 virus is highly prevalent not only in Europe, Japan and the Americas but also in the African region. Rodriguez Islands has a very low B19 prevalence.

[A survey of filariasis in the Comoro Islands, in Great Comoro and Mohéli]

The filariasis of W. bancrofti with nocturnal periodicity is, together with malaria, the principal endemic disease in the Comoros Islands. Well studied on Mayotte island, which remained a French Territorial Collectivity, its prevalence and distribution are less known in the Grand Comoros, Anjouan and Moheli islands which form the Federal Islamic Republic of the Comoros. The study of the nocturnal microfilariae in the Grand Comoros and Moheli in 1987 is the opportunity to assess the situation of the disease on this archipelago.

[Clinical aspects and prognostic factors of icterohemorrhagic leptospirosis in adults. Apropos of 249 cases in La Reunion]

Human leptospirosis of the classical and severe icterohemorrhagic type, usually due to the L. icterohaemorrhagiae serogroup, is frequent in La Réunion. In a retrospective study conducted between 1980 and 1984 in 249 adult patients, the mortality rate was 13 p. 100. Our data and those found in the literature indicate that the main cause of death is pneumopathy, followed by profuse haemorrhages, arrhythmias and cardiovascular collapse. Acute renal failure is common and often severe; it facilitates gastrointestinal bleeding and is of poor prognosis, particularly in patients with prolonged anuria, a possible cause of lethal hyperkalaemia. Other factors of unfavourable outcome have been demonstrated statistically; they include disturbances of consciousness, hypoprothrombinaemia, epigastric muscle rigidity, hyperleukocytosis, thrombocytopenia, high aspartate aminotransferase levels and chronic alcoholism. At the moment, pulmonary, cardiac and haemorrhagic complications concur with renal failure to darken the prognosis of these severe forms of leptospirosis.

Autosomal dominant antecubital pterygium: syndromic status substantiated

An autosomal dominant (AD) antecubital pterygium syndrome has been documented on the Indian Ocean Island of Rodrigues, and 11 affected family members in five generations have been studied over four decades. The consistent features include a fleshy web extending across the anterior aspect of the cubital fossa, absence of the long head of the triceps, limitation of full elbow extension and missing skin creases over the terminal inter-phalangeal joints of the fingers. On the basis of our observations, we consider that this condition warrants acceptance as an autonomous AD entity.

[Diagnosis of cerebral cysticercosis on Réunion Island by an immuno-enzymological method (ELISA): comparison with x-ray computed tomography]

An immunoenzymologic (Elisa) serodiagnosis of cysticercosis is evaluated in 75 encephalic cysticercosis patients whose diagnosis of the disease and its progression in assessed by tomodensitometry. A Taenia solium antigen is used. Only IgG are investigated. The sensibility of serodiagnosis is 85% and specificity 87% when there is a progression of the disease; no difference is noticed in the patients without any progression of the disease and in control normal subjects. This serodiagnosis of cysticercosis appears of value for the evaluation of the activity of the disease.

[Short-term clinical and histological evaluation of combination drug therapy of leprosy in Mayotte]

Leprosy in Mayotte affects 480 persons in a population of 80,000 inhabitants. 229 patients have been treated every day by association of Rifampicin, Clofazimine and Isoniazide. This study make a clinical, histological and bacteriological valuation after treatment, during a period of 3 years. With paucibacillary patients, whom received 1 year of mean treatment and after 2 years under observation, histology for short-dated can stay positive and active. With multibacillary patients, whom received 26 months of mean treatment and most of the time after 1 year under observation, the all of morphological index is negative, sometime bacteriology is positive, less often than histology. For middle- and long-dated, histology should allow a good valuation for disease evolution, specially for interpolar leprosy patients.