[Geographic Information Systems and health: application to Antananarivo city]

The general health status of the population in the capital, Antananarivo, is determined by a number of different socio-economical and environmental factors. A study was undertaken in 1998 by which the Geographic Information System (GIS) was implemented in order to describe characteristics in town areas (fokontany) suffering from a high disease burden. It was observed that there was a heterogeneous distribution of health care supporting facilities in comparison to population density in the different areas of the capitol. A risk-score system by use of an image-technique was elaborated. The most important problem encountered in the study was the reduced availability of standardized collected data. The results suggest that GIS constitutes a useful tool in assessment of urban health problems in order to identify fokontany in particular need of additional health care support.

[Epidemiological aspects of acute pelvic pain of gynecologic origin at the maternity of the Befelatanana Hospital Center, Antananarivo]

Acute pelvic pains of pregnancy (APPP) generate a lot of social and professional problems to pregnancy. A retrospective study was carried out in 1996 at the Maternity Hospital of Befelatanana, Antananarivo in order to specify epidemiological feature of APPP suffering pregnancy and to search favourising factors and determinative causes of this disease so that a strategy will be drawn up to reduce its frequency and to organize correct cares. 1,612 APPP were registered for the study period, i.e. an annual incidence of 15.5 per cent. Non periodic APPP were the most frequent clinical forms (99.6 per cent). The average age of pregnancy was 26 years old. Risk factors and determinative causes are infections, hormonal diseases, nulliparity and primiparity, low standard of living. APPP had been associated to hemorrhages (37.4 per cent), circulatory shock (14.5 per cent), and hyperthermia (63.5 per cent). 83 deaths were noted. Deaths are provoked by abortion infectious complications, hemorrhages, hepato-nephric lesions due to abortifacient plants. The authors conclude that prevent measures remain as the best therapy. They are based on Information-Education-Communication program drawn towards sexual education, Reproduction Health and improvement of genital infections cares.

[Leprosy situation in the southeastern region of Madagascar from 1996 to 1998]

Leprosy is endemic in Madagascar. The authors report the results of an epidemiologic study performed between 1996 and 1998 in Farafanguna, localized in the South-Eastern of the country. During this period, 217 new cases have been diagnosed. Of the 130 cases included in the study, 69.23% were children aged lower than 15 years and 76.91% suffered from a multibacillary form. More than 50% of the cases belonged to a large family (6 persons or more) and at least one family case was found in more than 60% of cases. These results enhance the severity of the disease in the country and show the presence of multiple risk factors (promiscuity, family cases and multibacillary forms).

Liquid chromatographic analysis of monosaccharides with phenylisocyanate derivatization

Because of the lack of sensitivity in carbohydrate analysis, HPLC pre-column derivatization techniques which give strongly UV absorbing compounds have been reported. These techniques have the disadvantage of leading to several chromatographic peaks from each reducing sugar. To enhance both the sensitivity and the selectivity of such specific separation problems, a simplex procedure was applied to optimize the phenylisocyanate derivatization of monosaccharides: a major and stable derivative was formed under the optimal conditions established. The method was extended to deoxysugars and methylglycosides. The limit of detection was 0.2-1 ng for all sugars tested.

Simultaneous determination of gluconolactone, galactonolactone and galactitol in urine by reversed-phase liquid chromatography: application to galactosemia

A reversed-phase liquid chromatographic assay was developed for the specific evaluation of metabolic by-products in the urine of galactosemic patients and based on the simultaneous determination of gluconolactone, galactonolactone and galactitol. The procedure involved a lyophilization step and the formation of phenylisocyanate derivatives, followed by injection directly into the chromatograph. Analytical results showed good selectivity, linearity, precision and accuracy. The method enabled the detection of levels as low as 0.05-0.1 ng, and compared favourably with other published techniques for the estimation of aldonic acids in biological fluids.