Artemisinin Combination Therapies (ACT) stand as the most potent antimalarial treatments. In response to the emergence of ACT-resistant malaria parasites in Southeast Asia, the World Health Organization (WHO) has recommended continuous monitoring of the effectiveness of ACT and other antimalarials. To address this need, we collected dried blood spots from malaria patients during a 42-days drug efficacy trial evaluating the efficacy of Artesunate plus Amodiaquine (ASAQ), Artemether Plus Lumefantrine (AL) and Dihydroarthemisinine plus Piperaquine (DHAPQ) on simple P. falciparum malaria in 2017. Blood samples were collected on Day 0, prior to the patients' initial ACT dose, and on any days of recurrent parasitemia. Genetic markers such as Merozoite Surface Protein 1 (MSP1) and Merozoite Surface Protein 2 (MSP2) were genotyped to differentiate between recrudescence and re-infestation cases. Furthermore, PCR Single Specific Oligonucleotide Probes combined with-ELISA platform (PCR-SSOP-ELISA) and PCR-RFLP techniques were used to identify Pfcrt 72-76 mutant haplotype and Pfmdr1_86Y allele associated with chloroquine and amodiaquine resistance, respectively. Out of the 320 patients enrolled in the study, only 43 (13.43%) experienced relapses. Upon PCR correction, our analysis revealed that recrudescent infections affected 13 patients, with 8 in the ASAQ group, 5 in the AL group, and none in the DHAPQ group. Notably, no early treatment failures (within the first 3 days of treatment) were observed, and all recurrences occurred between Day 21 and Day 42. The prevalence of the Pfcrt wild-type haplotype CVMNK and Pfmdr N86 allele was 67.03% and 97.70%, respectively. In contrast, the mutant types CVIET and 86Y were found at 32.97% and 2.3%, respectively. The high prevalence of the CVMNK wild haplotype suggests that the parasites remain sensitive to chloroquine, while the low prevalence of the 86Y mutants indicates continued effectiveness of amodiaquine. Furthermore, the low prevalence of strains exhibiting the combination of CVIET and 86Y suggests that the use of multiple antimalarials is valuable for resistance control. Notably, none of the relapse cases carried the 86Y mutation or the combination of 86Y and CVIET.

Visceral leishmaniasis (VL) is an infectious disease caused by protozoa of the genus Leishmania. Sporadic cases are observed in nonendemic areas and often associated with limited foci; therefore, the disease is easily overlooked. In addition, other diseases have similar clinical symptoms, which make it difficult for clinicians to make an accurate diagnosis and to provide effective treatment. We identified visceral leishmaniasis in a 4-year-old child in Pikine, Senegal. The patient was admitted to the Pikine National Teaching Hospital for haemorrhagic, tumoral, and infectious syndromes. At admission, the patient presented with epistaxis and gingivorrhagia, a severe anaemic syndrome poorly tolerated, a systemic inflammatory response syndrome with fever at 39.5°C, a tumoral syndrome with 11 cm of hepatomegaly and 12 cm of type IV splenomegaly, and noninflammatory macropoly adenopathies. A spinal cord puncture was performed, and direct microscopy examination of the sample after GIEMSA staining revealed amastigote forms of Leishmania. The PCR amplification of extracted DNA from the bone marrow aspiration using specific primers for VL (forward and reverse) confirmed that VL was responsible for the infection. A treatment with meglumine antimoniate (Glucantime) was given and it gave a successful outcome with remission of clinical symptoms and favourable evolution with 3 months hindsight. Conclusion. This visceral leishmaniasis case diagnosis in Senegal has shown that, apart from haematological malignancies, this disease must be considered in combination with a tumor syndrome, haemorrhagic syndrome, and infectious syndrome.

Background: In Africa, malaria-endemic regions have not been spared from COVID-19 outbreak which emerged in the first quarter of 2020. This pandemic has shown clinical and therapeutic similarities with malaria. This following study sought to determine the impact of COVID-19 on the malaria diagnosis. Method: A review of laboratory registers and an exploitation of the District Health Information Software 2 (DHIS2) to collect information on the diagnosis of malaria by microscopy and by rapid diagnostic test (RDT), but also that of COVID-19 was done from 2017 to 2021 at the Thierno Mouhamadoul Mansour Hospital in Mbour, Senegal. Results: In 2017, 199 Thick drops (TDs) and 1852 RDTs were performed for malaria diagnosis. In 2018, it was 2352 malaria tests with 2138 RDTs and 214 TDs, before reaching a peak of 3943 tests in 2019 including 3742 RDTs and 201 TDs. By 2020, 2263 tests were performed with 2097 malaria RDTs, 158 TDs and 8 COVID RDTs. The latter increased significantly in 2021, reaching 444 COVID RDTs, while TDs and malaria RDT kept decreasing to 147 and 1036 respectively. Positive TDs were higher in 2020 (11.4%) compared to 2017 (3.5%), 2018 (1.4%), 2019 (6.5%) and 2021 (6.8%). For malaria RDTs, a decrease in the number of positive tests was noted between 2017 (4.5%) and 2021 (1.3%). The COVID RDTs were all negative in 2020, 29.5% were positive and 4.1% were undetermined in 2021. Conclusion: COVID-19 has led to changes in efforts to diagnose malaria as well as an increase in malaria prevalence directed towards children under 5 years of age.

Introduction: Although malaria is declining in many countries in Africa, malaria and anaemia remain frequent in children.This study was conducted to assess the relationship between malaria parasitaemia, intestinal worms, and anaemia, in children <6 months living in low transmission area in Senegal.Methods: A survey was carried out in Lamarame in the central part of Senegal.A cross sectional survey was used to select study participant.Children <6 months were enrolled after informed consent.For each child, blood thick and smear tests were performed, haemoglobin concentration was measured with HemoCue, and stool samples were collected and examined using the Ritchie technique.Result: A total of 162 children were recruited.Malaria parasite prevalence was 0.75% (0.7-2.6); anaemia was found in 16. 7% (11.3-23.3),while intestinal parasites and stunting represented 25.4% (18.5-33.4) and 22% (18.6-25.5),respectively.The association was found between intestinal parasites and anaemia OR=1.1 (0.3-3.4).Conclusion: Malaria and anaemia remain closely associated even when malaria is declining.Scaling up antimalarial interventions may contribute to eliminate malaria and reduce the occurrence of anaemia among children.

Introduction: This study aimed to investigate the epidemiology of genital trichomoniasis in Senegal. It sought to determine the prevalence and risk factors associated with this condition in Senegal. Methodology: The study took place at the university hospital of Pikine in the suburbs of Dakar. For each of the women recruited, socio-demographic data, clinical examination data and the results of direct examination of the vaginal sample were collected in a questionnaire designed for this purpose. Results: A total of 312 women with a mean age of 31.13 (±8.41) years were recruited in this study. The majority of these women (59.94%; 95% CI = 54.25 - 65.38), were seen for an infectious diseases assessment. Leucorrhea (58.33%; 95% CI = 52.63 - 63.83) and genital discharge on vaginal touch (99.36%; 95% CI = 97.45 - 99.89) were the predominant signs on clinical examination. The overall prevalence of vaginal trichomoniasis after direct examination of the specimens was 1.28% (95% CI = 0.41 - 3.47). Only the distribution of this prevalence by occupation was statistically significant (p = 0.0004). Conclusion: The low prevalence of genital trichomoniasis in women and the risk factors associated with it found in this study, which took place about ten years ago, should prompt an update of the data to better define the problem in Senegal.

Background: Superficial candidiasis is a very frequent opportunistic disease caused by yeasts of the genus Candida.Among Candida types, some, such as Candida auris, have developed resistance to several antifungal agents.The objective of this study was to determine the hospital frequency of superficial candidiasis diagnosed at the CHU Fann and to investigate the presence of C. auris among the identified Candida strains.Methods: A cross-sectional study was conducted from February to June 2019.It involved all patients received at the Parasitology-Mycology laboratory of the CHU of Fann for suspected superficial candidiasis.Nails, skin, and vaginal specimens were subjected to direct examination and culture to identify yeasts of the genus Candida.The Candida strains were then tested by molecular biology targeting the specific C. auris ITS2 region.Results: A total of 1196 patients were examined.One thousand two hundred and five specimens (1205) were collected, including 1042 vaginal specimens, 92 nail specimens, and 71 skin specimens.Superficial candidiasis was diagnosed in 408 patients (37%).Women (34.52%) and patients under 30 years of age (39.60%) were the most affected.Yeasts of the genus Candida were found in 411 specimens (349 vaginal swabs, 36 nail fragments, and 26 skin flakes) by routine mycological techniques.The Candida albicans complex (C.albicans, C. dubliniensis, and C. africana) represented 75.91% of the Candida strains isolated.Molecular biology did not identify C. auris.Conclusion: Superficial candidiasis remains very common in hospitals in Senegal.Candida auris was not found in our study.Due to its rapid spread, surveillance is necessary to prevent epidemics in our hospitals.

Introduction: Scalp ringworms or Tinea capitis are ubiquitous superficial fungal infections of the scalp and hair. They represent the most common dermatophytic in the world. They reach almost exclusively pre-pubescent children and mainly school-aged children. The objective of this study was to assess the prevalence of tinea capitis and its associated factors among residents of koranic schools located in the Thiès region of Senegal. Patients and Methods: A cross-sectional study was conducted from February 2019 to March 2020. School children living in Thiès region (Central part of Senegal) were included in this study. Socio-demographic, clinical and biological data were collected standard questionary. Samples collected were examined directly and developed on a medium of Sabouraud-Chloramphenicol and Sabouraud-Chloramphenicol-Actidione. A descriptive analysis was done with the Stata MP. Risk factors were assessed by multivariate survey logistic regression models. Significance level of the different tests was 0.05 two-sided. Results: A total of 110 children were included in this study. The mean age was 9 years and the population was predominantly male (96.4%). The average number of residents in Koranic schools was 112. The prevalence of scalp ringworms was 68.2% [(75/110) (95% CI: 53.6 – 85.5)]. The fungal species found were Trichophyton soudanense (93.4%), Microsporum audouinii (2.7%). Trichophyton mentagrophytes, and Trichophyton violaceum were found with each (1.3%). Parasitism was endothrix-like in 86.7%. Children over 10 years old were more affected (72.9%), OR =2,16, CI (0,48 - 9,69). The rate of positivity was higher in children with small plaques (72.7%). Children with irregular-edged plaques were most affected (76.5%), Prevalence was higher among children who slept at more than 3 per mattress (79.1%), OR=1.82 (95% CI: 1.08 – 3.04). Conclusion: These results showed that Tinea capitis are frequent in children living in community. Trichophyton soudanense is the main fungal specie identified. Better knowledge of the epidemiology of these diseases and improved living conditions for children in Koranic schools could help improve patient management.

Background Intestinal parasitic infections, especially intestinal protozoan parasites remain significant public health problem in Senegal. Several studies have demonstrated the endemicity of the diseases. The study was carried out with the objective of assessing the epidemiolocal profile of intestinal protozoan infection diagnosed among patients attending to Fann University Hospital in Dakar, Senegal.Materials and MethodA retrospective study was conducted from 2016 to 2020. Samples were collected from patients attending to the laboratory for parasitological confirmation. Fresh stool samples were observed using direct examination, formal-ether concentration method and modified Zeilh Nielsen staining method. Descriptive analysis was performed using Stata MP 16 software. The significance level was set at 5%.ResultsAmong 3825 patients selected in the study, 1009 were found with at least one intestinal protozoan parasite representing an overall prevalence of 26.4% (CI 95% (24.7– 28)). Mono-parasitic and di-parasitic infection represent 81.6% and 18.2% respectively while polyparasitism was observed in 26 patients representing 2,6%. Among positive samples, 16 (8.7%) were associated with helminths. Blastocystis sp. (40.8%), Entamoeba Coli (38.2%), Endolimax nana (8.2%) and Giardia intestinalis (8.1%) were mainly observed. Trophozoites Entamoeba histolytica was observed with 2.3%. Frequency of intestinal protozoa was higher in the 15 – 30 age group (28.3%) and in male group (26.9%). The parasite carriage was most important during the wet season comparing the dry season (p = 0.65). Asymptomatic patients (29.5%) were more infected than symptomatic patients (23.5%) (p <10-3). The main clinical symptoms were diarrhea, abdominal pain, dysenteric syndrome, fever, dyspeptic disorders, and vomiting.ConclusionThese results showed that intestinal protozoan infections remain prevalent in Senegal with a high proportion of asymptomatic who constitute an important reservoir of parasites. Effective control strategies such as water supply, hands washing, and mass deworming campaign could reduce the prevalence of these diseases.

Background In Senegal, malaria morbidity has sharply decreased over these past years. However, malaria epidemiology remains heterogeneous with persistent transmission in the southeastern part of the country and many cases among older children and adolescents. Little is known about factors associated with clinical malaria among this group. A better understanding of malaria transmission among this newly emerging vulnerable group will guide future interventions targeting this population group. This study aimed to identify factors associated with clinical malaria among adolescents in Senegal. Methods A case–control study was conducted from November to December 2020 in four health posts located in the Saraya district. Cases were defined as adolescents (10–19 years) with an uncomplicated malaria episode with fever (temperature > 37.5°) or a history of fever and positive malaria rapid diagnostic test (RDT). Controls were from the same age group, living in the neighbourhood of the case, presenting a negative RDT. A standardized, pre-tested questionnaire was administered to each study participant followed by a home visit to assess the participant's living conditions. Factors associated with clinical malaria were assessed using stepwise logistic regression analysis. Results In total, 492 individuals were recruited (246 cases and 246 controls). In a multivariate analysis, factors associated with clinical malaria included non-use of long-lasting insecticidal net (LLIN) (aOR = 2.65; 95% CI 1.58–4.45), non-use of other preventive measures (aOR = 2.51; 95% CI 1.53–4.11) and indoor sleeping (aOR = 3.22; 95% CI 1.66–6.23). Protective factors included 15–19 years of age (aOR = 0.38; 95% CI 0.23–0.62), absence of stagnant water around the house (aOR = 0.27; 95% CI 0.16–0.44), having a female as head of household (aOR = 0.47; 95% CI 0.25–0.90), occupation such as apprentice (OR = 0.24; 95% CI 0.11–0.52). Conclusions The study revealed that environmental factors and non-use of malaria preventive measures are the main determinants of malaria transmission among adolescents living in areas with persistent malaria transmission in Senegal. Strategies aimed at improving disease awareness and access to healthcare interventions, such as LLINs, are needed to improve malaria control and prevention among these vulnerable groups.

Background: Intestinal parasitic infections represent a major public health problem worldwide. Pre-school and school children have a high risk of infection. The study aimed to determine the epidemiological aspects of intestinal parasitic infections in preschool and school-aged children in Dakar, Senegal. Methods: A retrospective analysis of laboratory records from preschool and school-aged children referred to the Laboratory of Parasitology at the Fann University Hospital in Dakar, Senegal, was carried out. The analysis of the period from 2016 to 2020. Stool samples were examined for the presence of parasites using direct, formal-ether concentration method and the Modified Ziehl Neelsen staining technique. Descriptive and analytic analysis was performed with Stata MP 16.1 software. Results: The overall prevalence of intestinal parasitic infection was 26.8% (429/1603). Blastocystis sp. (34%), Entamaeba coli (28%), Giardia intestinalis (9.6%), Endolimax nana (4.9%) and Ascaris lumbricoides (3.5%) were the common parasites found. Out of the 429 children positive for intestinal parasites, protozoa parasites represent 93.9%. Single infection and mixed infection represent 83.7% and 16.3%. The most prevalent associations were E. coli + Blastocystis sp. (6.3%), E. coli + E. nana (3.3%), and G. intestinalis + Blastocystis sp. (1.9%). Children between the ages of 5 - 10 years and those over 10 years had the most parasitic infections with 28.1% [aOR = 1.91; 95% CI (1.25 - 2.89)] and 27.4% [aOR = 11.92 (1.07 - 3.07)]. According to the year of sample collection, the prevalence was higher in 2017, 32.6% [aOR = 1.49 (1.11 - 2.01]. The prevalence of intestinal parasitic infection was not significantly related to gender (p = 0.87), season (p = 0.85) and symptomatology (p = 0.19). The main clinical symptoms were dysenteric syndrome, dyspeptic disorders, constipation and abdominal pain. Intestinal parasite carriage in patients with acute diarrhea was 20.4%. In HIV positive with chronic diarrhea, the prevalence was 28.6%. Conclusion: The results showed the frequency of intestinal parasites in preschool and school-aged children with a high proportion of protozoa parasites. Children aged over 5 years were more affected. Preventive measures such as health education, improved socio-economic conditions and environmental sanitation are required for reducing their frequency.

Background . Artemisinin-based Combination Therapies (ACTs) are widely used in the treatment of uncomplicated malaria. Plasmodium falciparum infection is often accompanied by disturbances of hematological and biochemical parameters. The objective of this study was to evaluate the changes in biochemical and hematological parameters during uncomplicated malaria in patients treated with ACTs. Methods . Data from patient with uncomplicated Plasmodium falciparum malaria were pooled from different open-randomized trial evaluating the efficacy of Artesunate-Mefloquine (ASMQ), Artesunate-Amodiaquine (ASAQ), Artemether-Lumefantrine (AL), and Dihydro-artemisinin-Piperaquine (DHAPQ) combinations. Biochemical (transaminases, creatinine, and bilirubin) and hematological (hemoglobin and platelet levels) parameters were performed at baseline (D0) and at day 7 after treatment (D7). Data were analyzed as both continuous and categorical variables with 95% confidence interval. Risks and trends were calculated using multivariate logistic random effect models. Results . A total of 720 patients with completed biological data were included in the analysis (320 in the AL arm, 160 in the ASMQ arm, 120 in the DHAPQ arm, and 88 in the ASAQ arm). The mean age of the patients was 9.43 ± 9.1 years. Male subjects represented 58.47% (sex ratio was 1.4 for males). The mean hemoglobin level at inclusion (D0) was 9.79 g/dl and anemia (Hb < 11 g/dl) was 71.43% (aOR = 1.16 [0.68 − 1.98] p = 0.57). At D7, hemoglobin level was 9.63 g/dl and anemia was significantly more frequent (78.29% [ p = 0.002]). The mean platelet count at day 0 was 154075.5 platelets/mm 3 of blood and 339328.7 platelets/mm 3 at day 7. Thrombocytopenia was about 53.61% and was associated with malaria (aOR = 3.4 [2.18 − 5.3] p < 10 −3 ). 19.58% of patients had abnormal ALT and 40.28% had abnormal AST at D0. 27.22% of patients had normal bilirubin at D0. Renal function was normal in all patients in the study. Normalization of transaminases was noted between D0 and D7. The percentage of subjects with normal bilirubin increased between D0 and D7. Renal function did not vary significantly between D0 and D7. Conclusion . Results from this analysis showed that subjects with high parasitaemia had a greater risk of anemia and thrombocytopenia. Artemisinin combinations were well-tolerated as no major biological disturbances were noted. The effects of ACTs on hematologic and biochemical parameters were not different.

Abstract S6.5 Efforts of improving the management of mycetoma: working towards the 2030 goals, September 22, 2022, 4:45 PM - 6:15 PM Background Mycetoma is a chronic granulomatous inflammatory disease that is caused either by bacteria or fungi. The diagnosis of species is important to guide the therapeutic management of patients particularly for white and yellow grains. However, the identification of the causative agents using mycological and histological techniques is a real problem in our countries. This study aims to identify etiologic agents using molecular techniques in Senegal. Methods A prospective study was carried out to compare mycological and histological techniques with molecular methods in patients attending hospital settings. Biopsy specimens and/or grains obtained from these patients were examined by PCR targeting the ITS (fungal agents) and 16S (actinomycosis agents) genes. Sequencing with the SANGER method allowed us to identify the species. Results Preliminary results were obtained from 30 patients. The grains collected were black (38%), red (4.7%), white (47.6%), and yellow (9.5%). Discriminative PCR ITS vs 16S identified 5 actinomycosis agents including white and yellow grains and 1 fungal agent. The fungal agent was identified after sequencing as Microsporum langeronii. Conclusion The preliminary results of this study show the importance of discriminative PCR to guide the therapeutic choice of clinicians. Its widespread use could improve the detection and management of mycetoma cases in Senegal.

Introduction: Blastocystis sp. is a unicellular obligate anaerobic protozoa found in the human intestinal tract. Its role in human health is widely discussed because of the high proportion of asymptomatic carriers. In sub-Saharan Africa, the prevalence of the disease is underestimated. This study was performed to describe the epidemiological, clinical, and parasitological aspects of Blastocystis sp. infection in patients attending to Fann University Hospital. Material and Methods: We carried out a retrospective and descriptive study among patients attending to the laboratory of Parasitology and Mycology of Fann University Hospital from January 2016 to December 2020. All stool samples collected were examined using direct examination, a formal ether concentration method, and a modified Zeilh–Nielsen staining method. A descriptive analysis was performed with Stata MP 16 software. The significance level was set at 5%. Results: Overall, 447 cases of Blastocystis sp. were reported in our study, representing a prevalence rate of 13.7% ((447/3264) (95% CI: 12.5–15.5)). The mean age of the patients was 26 ± 20.7 years. Subjects over 45 years of age were more affected, with a frequency of 14.7%. Blastocystis sp. carriage was more common in males, at 14.6%. The symptomatology was mainly represented by diarrhea, abdominal pain, and dyspeptic disorders. In asymptomatic patients, the frequency of Blastocystis sp. was 33.3%. Mono-infection was found in 78.6% of cases. In total, 96 patients were carriers of at least two parasites (21.5%). Blastocystis sp. was most associated with Entamoeba coli (8.1%) and Endolimax nanus (4.03%). The association with helminths was noted in 5 patients (3 Ascaris lumbricoides, Trichuris trichiura, and Taenia). Conclusion: These results show the frequency of Blastocystis sp. infection with a large proportion of asymptomatic carriers. The presence of the parasite in the stool, associated with digestive disorders or with the association of other intestinal parasites, could justify the initiation of an anti-parasitic treatment.

Malaria is a serious public health burden in Senegal. Accurate diagnosis is essential to avoided unnecessary presumptive treatment. Malaria diagnosis currently relies on identifying malaria parasite using microscopy and detecting soluble parasite antigens by Rapid Diagnostic Tests (RDT). These techniques do not detect low-level, sub-patent malaria infections and are inherently hazardous and invasive. To overcome these obstacles, alternatives diagnostics method were explored. In contrast to blood, saliva presents a reduced biohazard and can be painlessly collected in relatively large quantities by individuals with moderate training. The objective of this study was to use saliva collected in OmnIGEN Kits as an alternative sample for malaria detection. Methods: A total of 77 febril patients tested malaria positive by mRDT were enrolled in this study. From each patient, blood sample was collected for dried blood spot and blood smear; and saliva sample on OMNIGEN kit. Parasite density was determined from smear and Plasmodium falciparum DNA was extracted from both dried blood spot and saliva samples collected from the same patients. Extracted DNA was amplied by qPCR machine. Results: Malaria prevalence using qPCR was 98,7% and 60% respectively with blood and saliva. Compared to blood, saliva showed a sensitivity; specicity; positive predictive value of 60%; 100 %; and 100 %. The concordance between parasites detection from saliva and blood was (p = 0.45). In addition, no difference was found between these two methods and the microscopy counting. Conclusions:Saliva could be a non-invasive alternative method for P. falciparum detection and epidemiological surveillance in country with limited ressources.

Background: Intestinal Parasitic Infections (IPIs) are considered a serious public health problem and widely distributed worldwide, mainly in urban and rural environments of tropical and subtropical countries. Globally, soil- transmitted helminths and protozoa are the most common intestinal parasites. Decreasing the prevalence of IPIs is one of the main aims of health services in these countries. This study was designed to determine the current status of IPIs in children with vulnerable living conditions by microscopy and PCR. Methodology/main findings: A cross-sectional population-based survey was conducted. One stool sample per participant (n=253) was examined by direct smear, Formal-Ether Concentration (FEC), and real-time PCR. It was found that 17.39% harboured at least one helminth while 12.64% harboured two helminths or more. Among the microscopic techniques, FEC was able to detect the broadest spectrum of parasite species. However, FEC also missed a considerable number of infections, notably S. stercoralis and G. intestinalis. PCR outperformed microscopy in terms of sensitivity and range of parasite species detected. Conclusion: It was shown that intestinal parasites, especially helminths were omnipresent in our population studies. Classical techniques such as FEC are useful for the detection of some intestinal helminth species, but they lack sensitivity for other parasite species. PCR can detect intestinal parasites more accurately but is generally not feasible in resource-poor settings, at least not in peripheral labs. Hence, there is a need for a more field-friendly, sensitive approach for on-the-spot diagnosis of parasitic infections.

Background: In 2017, WHO recognized scabies as a neglected tropical disease. The optimal treatment is not well defined in some communities.Objective: This study aimed to compare ivermectin and benzyl benzoate in the treatment of scabies in Koranic schools (or "daara") in Dakar (region).Methods: This was a prospective randomized trial conducted from January to October 2018 in Senegal. Any resident living in the selected "daara" and diagnosed with scabies was included. The administered treatments were benzyl benzoate (BB) or ivermectin. At the outset, if one case of scabies was diagnosed, all residents received treatment. Ivermectin was given at the dose of 200 mg/kg. The same treatment was repeated on day 7 for each group, the endpoint was at D14, and the data were analyzed with STATA 14.Results: Fifteen "daara" were included. Of the 959 residents, 70 were diagnosed with scabies: prevalence of 7.29%. All patients except one were male; the mean age was 9.98 years (4-17). At D14, in the BB arm, cure rate was 42.85% (n = 15) while in the ivermectin arm, this rate was 5.71% (n = 2) with a significant difference (p = 0.01). On D28, the cure rate was still higher in the BB group 57.14 (n=20) versus ivermectin 21.42 (n = 6) with a significant difference (p = 0.004). On D42, all patients except eight were cured. At D14, we found a link between the cure rate, the number of people in the room (p = 0.01), and the number of showers per week (p = 0.01) but no link with the number of people per "daara" (p = 0.163). At D28, we found a link between the cure rate, the number of people sleeping in the room (p = 0.03), and the number of showers per week (p = 0.01) but not with the number of people per "daara" (p = 0.07).Conclusion: In Koranic schools, the cure rate is higher with benzyl benzoate compared to ivermectin.

BACKGROUND:Trichomonas vaginalis and genital Mycoplasmas are two synergistic pathogens, but in many settings, limited data on the co-infection by Trichomonas and Mycoplasma are available.OBJECTIVE:This study aimed at assessing Mycoplasma prevalence and its association with Trichomonas vaginalis among women with vaginal discharge.MATERIALS AND METHODS:A retrospective analysis of laboratory records (2012 and 2013) from patients referred at the Fann teaching hospital in Dakar Senegal for vaginal discharge was carried out. Detection of genital mycoplasmas was based on the commercial Kit Mycoplasma Duo Bio-Rad™ using endo-cervical swabs. Vaginal swabs were collected and examined using optic microscopy with 40x magnification to detect T. vaginalis.RESULTS:Overall, data from 1257 women were analysed. Prevalence of Mycoplasma hominis represented 57.4%, 95%CI(54.6-60.1), versus 54.9%, 95%CI(52.1-57.5) for Ureaplasma urealyticum. Trichomonas vaginalis infection was observed with a frequency of 3%. Out of the 50 patients with trichomoniasis, 76% of them were co-infected by Mycoplasma hominis and patients with Trichomonas vaginalis had an increased risk of acquiring Mycoplasma infection (adjusted OR:2.5, 95%CI(1.2-5.2);p=0.02)).CONCLUSION:Trichomonas vaginalis and Mycoplasmas are two closely associated pathogens in the urogenital tract of women. This clinically significant symbiotic action may require systematic screening of Mycoplasma among patients with trichomoniasis for optimal management of sexually transmitted infections.

Onychomycosis is a fungal nails infection often caused by yeasts, dermatophytes and molds. It is an important public health concern due to its high prevalence, the problem of diagnostics, and the poor response to treatments. The objective of this study was to evaluate the epidemiological and microbiological profile of onychomycosis diagnosed at the Laboratory of Parasitology-Mycology of the National University Hospital of Fann in Dakar, Senegal, from 2012 to 2016. A retrospective and descriptive study was performed from January 2012 to December 2016 in a patient attending the laboratory of Parasitology-Mycology at the Fann teaching hospital. Socio-demographic, clinical and biological data were collected from the bench registers. Samples from the lesions were tested using direct microscopy and cultured on a Sabouraud-Chloramphenicol and Sabouraud-Chloramphenicol-Actidione medium. A descriptive analysis was done using Stata IC 12 software. The significance level of different tests was set at 5% two-side. A total of 469 patients were included in this study. The mean age of the study population was 33.2 ± 15.2 years, and the sex ratio was 0.52. The prevalence of onychomycosis was 48.4% (227/469). The main clinical presentations were disto-lateral subungual onychomycosis (37.9%) and onyxis (46.5%). Identified fungal species were Candida albicans (42.7%), Candida spp (39.5%), Trichophyton soudanense (10.1%), Fusarium spp (5.3%), and Candida tropicalis (2.6%). Candida albicans was more frequent in subjects over 15 years of age (43.6%) and women (45%). However, Trichophyton soudanense was higher in patients under 15 years old (17.4%) as well as in male subjects (18.8%). In conclusion, onychomycosis is a common cause of consultation in health facilities. Candida albicans and Trichophyton Soudanense are the main fungal species causing onychomycosis. A better understanding of the epidemiology of onychomycosis as well as the spectrum of the pathogen could contribute to improve the management of the infection.

The large spectrum of Candida species and their susceptibility to antifungal drugs has made the identification of Candida species and the detection of drug resistance necessary for the management of Candida infection. This study was carried out to determine the distribution of Candida species and to evaluate their susceptibility to antifungal drugs. A prospective observational and descriptive study was conducted from March to June 2016 in the laboratory of Parasitology-Mycology at Fann University Hospital in Dakar. Samples were analyzed by direct microscopy and culture. Identification of Candida species was based on filamentation test, chlamydosporulation formation, auxanogramme (AUXACOLORTM Bio-Rad) and Candi-Select® 4 (Bio-Rad,). The susceptibility of Candida species to antifungal drugs was tested using Fungitest® (Bio-Rad) against 5-fluorocytosine, amphotericin B, miconazole, ketoconazole, itraconazole and fluconazole. A descriptive analysis was performed using Stata MP 14. Among 336 specimens received for mycological examination, 68 (20.2%) were positive for Candida. The most identified Candida species were C. albicans (58.8%), C. glabrata (16.2%), C tropicalis (7.4%), C krusei (7.4%), C. parapsilosis (4.4%), C. dubliniensis (4.4%) and C. kefyr (1.5%). The majority of isolates were susceptible to ketoconazole (94.3%), fluconazole (85.7%), amphotericin B and 5 fluoro-cytosine (88.6%). The susceptibility rates were lower for itraconazole (51.4%) and miconazole (68.6%). One strain of C. albicans was resistant to 5 fluoro-cytosine, one strain of C. glabrata and C. tropicalis were resistant to itraconazole. The results of this study provide useful information regarding the distribution of Candida species and the susceptibility to antifungal drug. Routine identification of Candida species and monitoring of resistance patterns are necessary to manage Candida infection and to control the spread of resistance in clinical isolates of Candida species.