Low levels of zinc in breast milk in Ethiopian mothers were reported in different studies [19–22], although there is no evidence of its association
with clinical manifestations in children. Most of the observed infants presented with signs inhibitor of moderate or severe skin manifestations (14/18) and with ulcerations or erosions (14/18). This is probably due to the delayed access to our center. Beyond the difficult access to health facilities in rural areas of developing countries, some of our patients were previously treated at other health centers/hospitals with systemic or local antibiotics and only referred to us when no improvement was achieved. Children were otherwise in good general health, except one case affected by moderate malnutrition. We observed a preponderance of female infants affected (11 out of 18), although this is not statistically significant given the small number of patients. We could not identify a specific biological or cultural/behavioral reason which could explain the higher number of females affected. Further studies are necessary to understand the causes of the increased incidence of TNZD in this population and to confirm the preponderance of female affected patients. Transient neonatal zinc deficiency is a life threatening disease, often misdiagnosed by rural health workers and general doctors in Northern Ethiopia.
Many of the reported patients were in fact in advanced stage conditions. If not diagnosed and treated properly, TNZD may have severe consequences on the child’s growth. Keeping in mind the presence of the disease in the region is essential to recognize its clinical features and to give the correct treatment, as specific diagnostic tests are often not available in developing countries. Health workers should be made aware of the presence of the disease in order to refer to hospital all those patients who do not respond to first line therapy. Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper.
Mycobacterium
ulcerans (MU) also known as Buruli ulcer (BU) named after the District of Uganda where GSK-3 an epidemic occurred in the 1960s is mycobacteriosis [1]. This disease believed to be mysterious by many parents is characterized by preulcerative lesions leading in the long term to major chronic cutaneous deterioration often associated to definitive disabilities [2]. In Côte d’Ivoire, Buruli ulcer which is the second mycobacteriosis after tuberculosis constitutes an emerging endemic. This is the reason why the government initiated, since 1998, the National Programme of Fight against Mycobacterium Ulcers (PNUM) in Côte d’Ivoire. Its preferential site in 9 out of 10 cases is in lower limbs [3, 4]. However, in our experience, we observed some unusual sites. So the purpose of this study is to contribute to a better understanding of them.