Leprosy

WHO defined leprosy elimination as reaching a prevalence < 1 case of leprosy per 10,000 inhabitants. Mali eliminated the disease since 2001 but in 2011, it recorded 226 new cases. This has a serious involvement in term of disease spreading. Therefore, we undertook a cross sectional study in Kenieba health district, still above the WHO recommended elimination threshold to better understand the disease epidemiology and its associated potential factors. The study took place from October 2013 to September 2014. All consenting villagers, living in one of the selected villages were included and clinically examined for leprosy signs.

The administration of a drug substance is an essential step in the management of a patient. It aims either to cure the patient, to prevent a given disease or sometimes to help with the diagnosis. Unfortunately, the action of the drug can go beyond the desired effect, and cause skin-mucous accidents. These accidents, also known as drug-induced attacks, can be isolated or associated with systemic manifestations [1]. Drug eruption is a real public health issue because of the high frequency. In Europe, drug eruption is responsible for about 20% of spontaneous reports of drug accidents. They complicate 2% to 3% of hospital treatments and motivate 1% of consultations, 5% of hospitalizations in dermatology [2]. Some African authors were interested in the subject. Reported prevalence in hospital settings ranges from 0.4% to 1.53% [3,4]. In Mali, there are no national figures. Old statistics from the Department of Dermatology show that about thirty cases occur each year, most of which are represented by severe forms. However, the risk of drug eruption is thought to be very high due to increased local use of drugs without medical advice, the illegal proliferation of drug outlets (‘Street Medicine’). And the lack of enforcement of existing regulations. In addition, some authors believe that the advent of antiretrovirals and the use of antiInfectious infections used to treat opportunistic infections have increased the risk of Drug eruption by 4 to 30 times, particularly in subjects infected with the acquired human immunodeficiency virus (HIV) [2]. This same risk can be observed in leprosy patients on combination chimotherapy. Clinically, the diagnosis of drug eruption is not as easy as one might think because of clinical polymorphism. The responsibility of a drug for the onset of a reaction is also not easy to establish, as in most cases several drugs are administered simultaneously before the onset of the rash. Because of illiteracy, patients find it difficult to make a complete list of the molecules consumed. To this must be added the high frequency of counterfeit medicines circulating both on the street and in private pharmacies. Given the scarcity of African studies and due to local specificities, it seemed interesting to us to undertake a study on Drug eruption in the dermatology department of the Dermatology teaching hospital of Bamako whose purpose is to study epidemiological aspects, clinical, etiological and to identify the molecules responsible in these patients.