Over the past years, Tunisia has experienced important reforms in the field of public health. The Tunisian medical faculties (Universities of Sfax, Tunis el Manar, Sousse and Monastir) play a key role in this endeavor by training public health professionals who can contribute to the modernization of the health system. Funded by the EC through Erasmus+ programme, the CONFIDE project (coordinated by Babes-Bolyai University, having as EU partners the Universities of Southern Denmark and Trnava, and the above mentioned Tunisian universities) has established the Research into Policy training programme by strengthening their capacity to provide public health training. The Research into Policy training programme has been delivered by the Centres for Evidence into Health Policy (C4EHPs) established within the Tunisian partner universities for the needs of CONFIDE. The training programme was implemented in four steps: (1) train the trainer sessions - the European experts trained 18 Tunisian trainers; (2) shadowing sessions - the trainers participated in shadowing sessions in the European partner institutions; (3) training delivery - the CONFIDE trainers, assisted by the European experts, delivered the training to an interdisciplinary group of 25 students and professionals; (4) internships - the students participated in internships in local health institutions. Three modules have been built within the Research into Policy training programme: Public health research, Health promotion policies and Evidence based public health policy. They contributed to increasing the public health knowledge and skills of the professionals trained. The training programme was well received by the Tunisian universities and the material developed so far during the project was adapted to the Tunisian context in the third step of implementation. On the long term, the project is expected to have an impact at the national level and produce updates at curricula level in the Tunisian medical faculties. Research into Policy training programme developed by the EC partners and culturally adapted by the Tunisian partners to the Tunisian public health context. Research into Policy training is a well-received tool for the high quality learning process in the public health field in Tunisian medical faculties.
Abstract Introduction The Centres for Evidence into Health Policy created by the CONFIDE project are multidisciplinary; they are dedicated not only to health professionals but also to researchers, policy makers as well as other social, environmental and economic stakeholders. Good dissemination and awareness among all stakeholders are the basis of the success and sustainability of the project results. The progress Since the start of the project in October 2017 and after developing a dissemination plan, the first and large-scale dissemination action was the creation of a communication platform and a website. Subsequently, we have setup Facebook, Twitter and LinkedIn pages targeting people more involved in the project. These pages are regularly updated (progress of the project, actions carried out). Two press conferences have taken place in order to reach all targeted audiences in Tunisia. Indeed, our press conferences attracted journalists as well as representatives of NGOs, and health decision-makers in the ministry. A poster and a portfolio were designed in order to introduce the project to partner organizations that provide the students` internships and field trainings. The project also includes a policy game as a tool to bring to the same table the policymakers, researchers and other stakeholders in the community that will further contribute to the dissemination of the CONFIDE project results. Due to the dissemination activities of the Tunisian partners, the academic community in Tunisia has been exposed to a different approach and understanding of public health. The dissemination activities of the CONFIDE results have shed a new light on public health in Tunisia. Conclusions A good diffusion of the project, using tools adapted to the various audiences, will make it possible to reach a large and multidisciplinary target public and to associate them with the project. This is a key success factor for the sustainability of the Centres for Evidence into Health Policy.
Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts or non-dermatophyte molds. The aim of our study was to describe the epidemiological features of onychomycoses encountered in the Tunis region. A retrospective study concerned 3458 cases of onychomycosis, confirmed by direct examination and/or a positive culture, was conducted in Parasitology - Mycology Laboratory, Rabta hospital, over a five-year period (2012-2016). Our patients were aged 1 to 85; more than half of the patients were aged over 60 years with a female predominance (67%). Toenail infections were most common, observed in 2702 cases (78%). Direct examination was positive in 3284 cases (95%), culture in 2409 cases (69.6%); these two examinations were positive simultaneously in 2235 cases (64.6%). The causative agents of these onychomycoses were dominated by the genus Candida in fingernails: Candida albicans (55.6%), Candida tropicalis (8.5%) and Candida parapsilosis (8.2%) were the most frequently incriminated species; while in toenail lesions, Trichophyton rubrum was by far the most frequently isolated species (96.8%). Our results join the literature; onychomycosis is a pathology of the adult, mainly candidosic etiology in hands and dermatophytic in feet. (C) 2018 Elsevier Masson SAS. All rights reserved.
Histoplasmosis is a fungal infection caused by a dimorphic fungus, Histoplasma capsulatum. We report a first case of disseminated histoplasmosis in a 34-year-old woman, infected with human immunodeficiency virus (HIV), originating from Ivory Coast and living in Tunisia for 4 years. She was complaining from fever, chronic diarrhoea and pancytopenia. The Histoplasma capsulatum var. capsulatum was identified by direct microscopic examination of the bone marrow. She was treated by Amphotericin B, relayed by itraconazole. Even though a regression of symptoms and normalization of blood cell count (BCC), the patient died in a respiratory distress related to CMV hypoxemic pneumonia.
Despite the changes in their epidemiology, and the improving level of hygiene of the population, tinea capitis is still considered a public health problem in our country, and is the most common type of dermatophytosis in our country. The aim of our study was to evaluate the epidemiological, clinical and mycological features of tinea capitis in children encountered in the Tunis region. A retrospective study concerned 1600 children aged 6 months to 15 years suspected to have tinea capitis was conducted in Parasitology-Mycology laboratory, Rabta hospital, over a 10-years period (2005-2014). Dermatophyte infections were confirmed using scalp scrapings examinated with direct microscopy using potash at 30% and/or culture on Sabouraud medium agar. Tinea capitis diagnosis was confirmed in 947 cases (59.18%). The sex ratio was 2.61 and the average age of 6.28 years with predominance in the age group of 4 to 8 years (52.27%). The most common clinical presentation was ringworm (87.65%). Ringworm large plaque was predominant (65.9%). Direct examination was positive in 884 cases (93.35%). Microsporic tinea was the most frequent (63.25%) followed by trichophytic tinea (29.78%). Positive cultures of dermatophytes were obtained in 912 cases (96.30%). The following dermatophyte species were isolated: Microsporum canis (67%), Trichophyton violaceum (31.68%), Trichophyton mentagrophytes (0.66%), Microsporum audouinii (0.22%), Trichophyton schoenleinii (0.22%) and Microsporum gypseum (0.22%). M. canis is currently the most frequently incriminated species in tinea capitis in Tunisia. This change is related to a change in behavior of our population, in fact the cat; main reservoir of M. canis cohabiting increasingly with Tunisian families.
Objective. - To determine epidemiological, clinical and mycological characteristics of vulvovaginal candidiasis (VVC) in Tunisian population and to evaluate predisposing factors.Patients and methods. - In this retrospective study, 2160 vaginal swabs were performed over 2 years (January 2014 December 2015). It was carried out at the laboratory of Parasitology and Mycology, Rabta Hospital in Tunisia. After swab collecting, direct examination and culture on Sabouraud Chloramphenicol and Sabouraud Chloramphenicol Actidione media were implemented to research yeasts. Then identifying of yeast species was through chlamydosporulation test and auxanogram. For each patient, a questionnaire was filled noting age, medical and surgical history, symptoms and risk factors. Statistical analysis of data was performed on SPSS 16 using Khi(2) test, P < 0.05 was considered significant.Results. - Direct examination was positive showed spore and/or pseudohypha in 24.72%. Candida albicans was isolated most frequently (76.61%) followed by Candida glabrata (17.18%). The maximum frequency of Candida-positive cultures was in 25-34 years old age group. Leucorrhea was the most common symptom (72.25%) followed by vulvar prurits (63.23%), dyspareunia (32.25%) and urinary burning (24.92%). Only pregnancy was correlated positively with WC.Conclusion. - It appears from our study that VVC is relatively common in Tunisia. His diagnosis results from confrontation of anamnestic, clinical and mycological data. The knowledge of risk factors and their correction would be necessary to prevent the occurrence of WC, especially in its recurrent form. (C) 2017 Elsevier Masson SAS. All rights reserved.
Candida parapsilosis est une levure saprophyte de la peau, caractérisée par son affinité pour les cathéters, responsable d’un large éventail de manifestations cliniques dont les candidémies, infections de pronostic redoutable. C’est un complexe génétiquement hétérogène comportant trois groupes distincts : Candida parapsilosis (groupe I), Candida orthopsilosis (groupe II) et Candida metapsilosis (groupe III), phénotypiquement identiques. L’objectif de notre travail était l’étude épidémiologique de ce complexe de levures en identifiant les souches correspondantes aux trois groupes par une analyse moléculaire. Notre étude a porté sur 26 souches du complexe C. parapsilosis, préalablement identifiées par les méthodes mycologiques classiques, isolées entre janvier 2011 et juin 2014 dans le laboratoire de parasitologie-mycologie de l’hôpital La Rabta. Parmi les 26 souches, 19 ont été isolées à partir d’hémocultures ; 3 à partir de prélèvements auriculaires ; 2 à partir de prélèvements buccaux et 2 au niveau de cathéters. Trois protocoles d’extraction d’ADN génomique du complexe C. parapsilosis ont été testés : un kit d’extraction (Quick Yeast Genomic DNA Extraction Kit), l’acétate de lithium et l’acétate de potassium. Puis, nous avons mis en place une technique de diagnostic moléculaire par PCR-RFLP. Le gène SADH (716 pb) a été choisi pour la présence au niveau de sa séquence d’un polymorphisme de restriction BanI. L’amplification du gène SADH permet, après digestion par l’enzyme de restriction BanI, d’isoler les trois groupes selon le profil obtenu. Les résultats obtenus au cours de ce travail ont montré que la méthode d’extraction utilisant l’acétate de lithium était la plus efficace en termes de rendement et de profil d’extraction. Le contrôle par électrophorèse de l’amplification du gène codant pour la SADH a confirmé l’identification phénotypique en mettant en évidence la bande de 750 pb spécifique du complexe C. parapsilosis. Enfin, le contrôle par électrophorèse des réactions de digestion enzymatique par BanI des amplifias du gène SADH a montré, pour les 26 souches testées, la présence de 2 bandes de 200 pb et de 550 pb, correspondant à l’espèce C. parapsilosis sensu stricto. Ces résultats doivent impérativement être confirmés par séquençage automatique des produits d’amplification par PCR du gène codant pour la SADH pour chaque souche isolée.
Malgré l’amélioration du niveau d’hygiène de la population tunisienne, les teignes du cuir chevelu constituent encore un motif de consultation fréquent en dermatologie. C’est la principale mycose superficielle de l’enfant nécessitant une prise en charge adaptée. Le but de notre travail était de dégager les caractéristiques épidémiologiques des teignes du cuir chevelu de l’enfant dans la région de Tunis. Il s’agit d’une étude rétrospective ayant porté sur 1600 prélèvements mycologiques du cuir chevelu réalisés au laboratoire de parasitologie-mycologie du CHU la Rabta de Tunis chez des enfants âgés de 6 mois à 15 ans, durant une période de 10 ans (2005–2014). Pour chaque prélèvement de cheveux ont été réalisé de façon systématique un examen direct à la potasse à 30 % et une culture sur milieu Sabouraud. L’identification des dermatophytes isolés a reposé sur des critères macroscopiques et microscopiques des colonies. Le diagnostic mycologique a été considéré positif lorsque l’examen direct et/ou la culture étaient positifs. Parmi nos patients, nous avons colligé 947 cas de teignes (59,18 %). Le sex-ratio était de 2,61 et l’âge moyen de 6,28 ans. L’aspect clinique le plus fréquent était la teigne tondante (87,65 %). L’examen direct était positif dans 884 cas (93,35 %), il avait montré un parasitisme pilaire ectothrix microsporique dans 63,25 % des cas et endothrix trichophytique dans 29,78 % des cas. La culture, positive dans 912 cas (96,30 %), a permis d’isoler les espèces de dermatophytes suivants : Microsporum canis (67 %), Trichophyton violaceum (31,68 %), Trichophyton mentagrophytes (0,66 %), Microsporum audouinii (0,22 %), Trichophyton schoenleinii (0,22 %) et Microsporum gypseum (0,22 %). Nos patients avaient une dermatophytie associée de la peau glabre dans 11 cas. Microsporum canis, inconnu en Tunisie jusqu’en 1950 est actuellement l’espèce la plus fréquemment incriminée dans les teignes du cuir chevelu dans notre pays. Ce changement serait en rapport avec une modification du comportement de notre population ; en effet, le chat, principal réservoir de Microsporum canis cohabite de plus en plus avec les familles tunisiennes.
BACKGROUND:Malaria has been eliminated in Tunisia since 1979, but the country remains, like all other countries harboring the vector, exposed to the potential risk of resurgence.OBJECTIVES:Describe the clinical and epidemiological investigation of 4 cases of autochthonous malaria in July 2013 and report the main actions of regional and national response.METHODS:Retrospective descriptive survey of the 4 clinical observations as well as the study of the regional report data of basic health care for the region of Tunis in 2013.RESULTS:Febrile table concomitant for 4 Tunisian male patients, aged from 21 to 27 years old ; fortuitous discovery of Plasmodium falciparum when checking thrombocytopenia of patient 1 ; diagnosis in cascade of other cases following the epidemiological investigation and field consultation with clinicians ; 3 simple forms and a neuromalaria of favorable evolution ; negative entomological survey for anopheles ; elimination of imported malaria and blood-borne ; airport malaria highly probable. The response included the establishment of a regional and national monitoring unit, an information program aimed at health professionals concerned and public opinion, the involvement of health and entomology teams for the detection and census of potential larval habitats and the implementation of local mosquito eradication measures.CONCLUSION:The clinical vigilance and competent biologist's eye is necessary to prevent the resurgence of this disease. The epidemiological surveillance system should be maintained and kept as well as the food safety standards monitoring at the borders.
Les mycoses profondes restent encore une pathologie peu connue du fait de leur rareté dans la pratique médicale quotidienne en zone d’endémie subsaharienne. L’histoplasmose africaine Histoplasma capsulatum variété duboisii (H. capsulatum duboisii) est la plus décrite au Mali, à travers des études parcellaires chez des sujets adultes, depuis la description du premier cas par Catanei et Kervran (1945) au Soudan. Notre observation porte sur une histoplasmose africaine disséminée d’un jeune enfant de 6 ans, masculin, rural. Les localisations étaient cutanéo-muqueuses, ganglionnaires, urinaire et osseuse. L’évolution a été émaillée d’un épisode d’aggravation de la symptomatologie malgré une amélioration clinique initiale par le kétoconazole. Après guérison des ulcérations cutanéo-muqueuses, on a noté une limitation de mouvement des deux poignets. Les lésions osseuses séquellaires radiographiques étaient faites d’image lacunaire de l’extrémité inferieure du radius droit et du cubitus droit et une fragmentation de l’épiphyse cubitale du même bras. Sur le 5e doigt droit existaient des lacunes des métatarses et des phalanges. Une lacune et un aspect soufflé de la 2e phalange du 3e doigt gauche étaient notés. La forme disséminée de l’histoplasmose africaine peut survenir sur terrain VIH négatif. Le pronostic dépend de la précocité du diagnostic et l’administration d’un traitement adapté et bien conduit.Endemic deep fungal infections are still under recognised diseases in daily medical practice because of their rarity in sub-Saharan area. The African histoplasmosis Histoplasma capsulatum var. duboisii (H. capsulatum duboisii) is the most frequent variety described in Mali through limited studies in adult patients, since the first case described by Catanei and Kervran (1945). Our case report is a disseminated histoplasmosis in a young 6-year-old african child. He was male and rural. The infectious localisations were mucosae, skin, lymphnodes, urinary tract and bones. Evolution has been marred by an episode of worsening of symptoms despite initial clinical improvement with ketoconazole. After healing of mucocutaneous lesions, we noticed a limitation of ampliation of both wrists. The radiographic bone lesions were lysis of the right lower end of the right radius and cubitus and fragmentation of cubital epiphysis of the same arm. Lacunes were present on the fifth right finger in metatarsus and phalanx; lacune and blowing aspect of the second phalanx of the left third finger was noted. The disseminated form of African histoplasmosis may occur in HIV-negative subject. The prognosis depends on early diagnosis and administration of appropriate and well-conducted therapy.
Les mycoses superficielles, surtout de la peau, du cuir chevelu et des ongles, sont très fréquentes et ont été rapportées dans le monde entier. Les champignons les plus fréquents agents de ces mycoses sont les dermatophytes, les levures et les moisissures. Cependant, ces agents varient avec le temps et sont fonction de nombreux facteurs notamment géographiques. L’objectif de cette étude était d’identifier les champignons agents de mycoses superficielles diagnostiquées au CHU Le Dantec de Dakar (Sénégal).Cette étude a intéressé 1851 patients recensés au laboratoire de parasitologie et mycologie de l’hôpital Aristide Le Dantec, durant la période allant de janvier 2011 à décembre 2015. Chacun de ces patients a bénéficié d’un examen direct et d’une culture mycologique.De ces 1851 patients, 633 étaient confirmés porteurs de mycose superficielle, soit une prévalence de 34,2 %. L’âge des patients variait de deux mois à 81 ans avec une moyenne d’âge de 31 ans. Les mycoses superficielles étaient plus retrouvées chez les femmes (70,3 %) que chez les hommes (29,7 %) et un peu plus de trente-neuf pour cent (39,3 %) étaient des adultes âgés. Les agents identifiés étaient : les dermatophytes (58 %), les levures (36,7 %) et les moisissures (5,3 %). Les espèces les plus isolées étaient : Candida albicans (26,9 %), Trichophyton soudanense (24,9 %) et Trichophyton rubrum (13,7 %). Ces différents champignons étaient responsables de différentes atteintes cliniques, certaines isolées et d’autres associées. Parmi les atteintes isolées, celles touchant les cheveux (tinea capitis) étaient de loin les plus importantes avec 44,8 %, suivis des atteintes des ongles (tinea unguium) (34,5 %). Les associations étaient surtout à type de teigne du cuir chevelu et onychomycose des mains (2,4 %) et d’onychomycose associée à un intertrigo au niveau des pieds (2,7 %). Les agents de tinea capitis étaient exclusivement les dermatophytes dont l’agent prédominant était T. soudanense avec 47,8 %. Par contre, les agents de tinea unguium étaient des levures (79 %), des dermatophytes (18 %) ou des moisissures (3 %) et l’espèce la plus retrouvée était C. albicans (63,9 %). Les dermatophytes, les levures et les moisissures étaient respectivement plus retrouvées chez les enfants et adultes jeunes, chez les adultes âgés et les adultes jeunes et chez les adultes âgés et les personnes âgées.En définitive, ces données épidémiologiques devraient permettre une meilleure prise en charge diagnostique et thérapeutique des mycoses superficielles dues à ces champignons.Superficial fungal infections, particularly of the skin, scalp and nails are very common and have been reported worldwide. The most common causative agents of these mycoses are dermatophytes, yeasts and molds. However, these agents vary with time and depend on many factors including the geography. The objective of this study was to identify the causative agents of superficial mycoses diagnosed at the Le Dantec University Hospital in Dakar (Senegal).The study concerned 1851 outpatients received in the parasitological and mycological laboratory of Le Dantec hospital during the period from January 2011 to December 2015. Every patient benefited from direct examination and mycological culture.Among the 1851 patients, 633 were confirmed with superficial mycoses and the prevalence was 34.2 %. The age of patients ranged from two months to 81 years with a mean age of 31 years. Superficial mycoses were found more in women (70.3 %) than men (29.7 %) and a little more than thirty-nine percent (39.3 %) were adults. The causative agents identified were: dermatophytes (58 %), yeast (36.7 %) and non-dermatophytic filamentous fungi (NDFF, 5.3 %). The most isolated species were: Candida albicans (26.9 %), Trichophyton soudanense (24.9 %) and T. rubrum (13.7 %). These fungi were responsible for different clinical aspects, isolated and other associated. Among the isolated clinical aspects, those affecting hair (tinea capitis) were by far the largest with 44.8 %, followed by tinea unguium (34.5 %). Associations were especially type of tinea capitis and tinea manuum (2.4 %) and toenails onychomycosis associated with interdigital tinea pedis (2.7 %). Tinea capitis agents were exclusively dermatophytes and the predominant agent was T. soudanense with 47,8 %. Tinea unguium agents were yeast (79 %), dermatophytes (18 %) or NDFF (3 %) and the most found species was C. albicans (63.9 %). Dermatophytes, yeasts and molds were respectively found more in children and young adults, older adults and young adults and older adults and the elderly.In definitive, these epidemiological data should enable better diagnostic and therapeutic management of superficial mycoses.
The strain FPO4 was isolated from the rhizoplane of rice plant root and identified as a fluorescent Pseudomonas aeruginosa on the basis of 16S rDNA sequences and BLAST analysis. The extracellular metabolites produced by this strain were purified by silica gel column chromatography and isolated four pure compounds. Based on the spectral data the four compounds were identified as phenazin-1-ol, phenazine-1-carboxylic acid (PCA), 2-heptyl-3-hydroxyl-4(1H)-quinolone (PQS), and phenazine-1-carboxamide (PCN), respectively. Phenazin-1-ol and PCA were active against all the eight fungi tested. The highest activity of 4 μg/mL by PCA was recorded against Trichophyton rubrum, a human pathogen responsible for causing athlete's foot, jock itch, ringworm and fingernail fungus infections, followed by Candida albicans and Candida tropicalis. The activity of phenazin-1-ol, PCA against Candida spp. was found to be better than the standard antifungal agent amphotericin B. Furthermore, the present study reports the antimicrobial activity of the purified phenazines on major human pathogen, T. rubrum for the first time.La souche FPO4 a été isolée à partir de rhizome de racine de riz et identifiée en tant que Pseudomonas aeruginosa fluorescent sur la base des séquences d’ADNr 16S et de l’analyse BLAST. Les métabolites extracellulaires produits par cette souche ont été purifiés par chromatographie sur colonne de gel de silice et quatre composés purs ont été isolés. Sur la base des données spectrales les quatre composés ont été identifiés comme phénazine-1-ol, l’acide phénazine-1-carboxylique (APC), le 2-heptyl-3-hydroxy-4 (1H)-quinolone (PQS) et phénazine-1-carboxamide (PCN), respectivement. La phénazine-1-ol et l’APC étaient actifs contre tous les huit champignons testés. L’activité la plus forte de 4 μg/mL pour l’APC a été enregistré contre Trichophyton rubrum, un agent pathogène humain responsable de pied d’athlète, d’intertrigo inguinal, d’herpès circiné et d’infections fongiques des ongles, suivi par Candida albicans et Candida tropicalis. L’activité de la phénazine-1-ol, et APC contre Candida spp. a été jugée meilleure que celle de l’agent antifongique amphotéricine B. En outre, la présente étude rapporte l’activité antimicrobienne des phénazines purifiés sur un pathogène humain majeur, T. rubrum pour la première fois.
Over a period of ten years, a series of 694 Leishmania strains from Tunisian leishmaniasis foci were isolated and identified by isoenzymatic analysis. Strains were obtained from human cutaneous and visceral leishmaniasis in immunocompetent subjects, visceral leishmaniasis in imunocompromised individuals and from dogs with visceral leishmaniasis. Two classically dermotropic species, Leishmania (L.) major and Leishmania killicki were found. L. major with the single zymodeme MON-25 was the most isolated in cutaneous leishmaniasis foci of the Centre and South of Tunisia with a recent northern extension. L. killicki zymodeme MON-8 was sporadically found both in its classical microfocus of Tataouine in southeastern Tunisia as well as in some new foci in Southwestern, Central and Northern Tunisia. Leishmania infantum with its three zymodemes MON-1, MON-24 and MON-80 was isolated from both visceral and cutaneous human cases. The majority of L. infantum strains were found in the Northern part of the country; however, some strains were reported for the first time in the Southern part. L. infantum MON-1 was the only zymodeme isolated from canine leishmaniasis.
La leishmaniose cutanée (LC) est une maladie parasitaire qui constitue un problème de santé publique aussi bien dans le monde qu’en Tunisie. Son diagnostic repose sur des techniques de routine, examen direct (ED) et culture, qui, en raison de plusieurs facteurs, manquent de sensibilité. La biologie moléculaire, plus rapide et plus sensible, a montré son apport dans le diagnostic de la LC. Le but de notre travail était de démontrer, d’une part, l’apport de la Polymerase Chain Reaction (PCR) dans le diagnostic de la LC (en comparant les résultats obtenus par cette technique de biologie moléculaire à ceux trouvés à l’ED) et, d’autre part, de comparer deux paires d’amorces ciblant le gène leishmanien codant pour la sous-unité 18s ribosomale : la paire R221/R332 (PCR1) et la paire Lei70L/Lei70R (PCR2). Notre travail a été réalisé sur 299 échantillons. Cent quatre-vingt-huit prélèvements étaient positifs par l’ED et/ou la PCR et 111 étaient négatifs. Deux prélèvements seulement étaient positifs uniquement par l’ED contre 74 qui étaient positifs uniquement en PCR (PCR1 et/ou PCR2). Parmi ces 74 prélèvements, 64 étaient positifs par la PCR2 seule contre deux prélèvements qui étaient positifs par la PCR1 seule. Les huit prélèvements restants étaient positifs à la fois par la PCR1 et la PCR2. La PCR (notamment la PCR2) montre un pourcentage de positivité plus important que l’ED : 98,93 % pour la PCR contre 60,6 % pour l’ED.