Le Mali medical最新文献

Introduction: Malaria and malnutrition are among the major causes of morbidity and mortality in children under five in Mali. This study is part of the analysis of the association between both in children under five after a seasonal malaria chemoprevention distribution campaign.

Methods: We carried out a cross-sectional household survey in rural areas after a seasonal malaria chemoprevention distribution campaign to determine the prevalence of malnutrition and parasitaemia in children under five who had passed the season of high transmission of malaria in the health district of Kita. After obtaining written consent, each child was given a physical examination, hemoglobin testing using the Hemocue machine, a thick drop and a thin smear. , A rapid diagnostic test was performed in febrile children. The data was analyzed with ENA 2020 and Stata software version 15.0. Measures of association were made using the chi-square test and a multiple logistic regression model. Odds ratios were used with a 95% confidence interval and a significance level of 0.05.

Results: We selected 308 children aged 6 to 59 months. The prevalence of malaria was 13.6%, it was 15%, 17% and 25% respectively for wasting, underweight and stunting. The susceptibility to malaria increased with age and that of wasting decreased with age. There was no significant relationship between malaria disease and nutritional status.

Conclusion: There is no significant association between malaria and malnutrition in our study.

Objective: The aim of this study was to determine the prevalence of HBsAg carriage in candidates for gendarmerie recruitment.

Methods: This was a prospective cross-sectional study conducted from April 7, 2010 to September 12, 2010 at the Abidjan military hospital. It involved candidates for the national gendarmerie competitive examination who agreed to take part in the study. The parameters studied were socio-demographic characteristics, factors of exposure to the hepatitis B virus and the presence of HBs antigen in the blood. Data were analyzed using EPI INFO software. Proportions were compared using the chi-square test or the chi-square test with Yates correction, or Fischer's exact test when the conditions for applying chi-square were not met. The difference was statistically significant if p ≤ 0.05.

Results: During the study period, we included 891 male candidates, whose average age was 22.5 years (18-26 years). The prevalence carriage of HBsAg in the candidates was 15.6%. The prevalence carriage of HBsAg was highest in candidates aged 18 years (24%), in married candidates (33.3%) and in those who had more than three sexual partners 6 months prior to the survey (19.4%).The prevalence carriage of HBsAg was also higher in candidates who had never used condoms (20.6%), in those who were transfused (27%).

Conclusion: The prevalence of HBsAg carriage is high in candidates for gendarmerie recruitment. A policy of vaccination against HBV must be implemented to reduce HBsAg carriage in the army and in the ivorian population.

Introduction: One of the main goals of routine antenatal care is to identify mal developing fetuses and fetal ultrasound biometry parameters are used for this purpose. The objective of this study was to establish the norms of umbilical cord diameter (UCD) and to investigate its relationship with estimated fetal weight (EFW) and other fetal biometry parameters.

Populations and methods: This was a descriptive and analytical cross-sectional study with prospective data collection conducted in the radiology and medical imaging and gynaecological-obstetrics departments of Sokodé regional hospital. All pregnancies with a single fetus that appeared normal from the 11th week of pregnancy were included. Excel and R-4.2.2 software was used. A significance level of 5% was established for the statistical tests.

Results: A total of 256 pregnant women were recorded. The mean UCD in the 1st, 2nd and 3rd trimester was 4.07±0.99 mm; 9.69±2.65 mm and 15.36±2.08 mm respectively. There was a strong positive linear correlation between UCD and gestational age (r=0.87; p<0.00001) and between UCD and EFW (r=0.80; p<0.00001). The linear relationship between UCD and gestational age (GA) is expressed by the equation: GA= 1.605*UCD+ 6.235. Similarly, the linear relationship between UCD and EFW is expressed by the equation EFW= 207.854*UCD-1382.382. Fetal biometry parameters were strongly correlated with UCD (r≥0.81; p<0.00001).

Conclusion: Ultrasound measurement of umbilical cord diameter is a relatively simple technique to estimate gestational age and assess fetal growth.

Introduction: Smoking, a major preventable cause of morbidity and mortality is a real public health problem in the world.

The objective: was to establish the epidemiological profile of smoking among soldiers at Camp Almamy Samory Touré.

Method: This was a descriptive cross-sectional study lasting 6 months in 2018 at Camp Almamy Samory Touré in Conakry including all serving soldiers, without distinction of age, sex, residence and who accepted freely to participate.

Results: We investigated 384 soldiers, including 287 smokers, a prevalence of 75% and 97 non-smokers, 25%. The most represented age group was 31-40 years 25.5% with an average age of 38.95 ± 9.36 years. They were all male (100%) and the majority resided in Conakry 96.61%. The level of education was secondary followed by higher and primary respectively: 38.54%; 24.48% and 23.70%. Married people were more numerous 39.58% followed by single people 34.11%. The average age of onset of smoking among our soldiers was 18.86 ± 3.42 years. Leisure places 26.48% were the main place of initiation to tobacco smoking. The 38.46% of the military smoke 11-20 wicks of cigarettes per day. During the study, 55.93% of soldiers wanted to quit smoking now.

Conclusion: The prevalence of smoking among soldiers at Camp Almamy Samory Touré in Conakry remains very high with a young and male predominance. Nearly ¾ of the soldiers surveyed had smoked in the past and places of leisure were the main place of initiation to tobacco smoking. However, more than half of the soldiers now wanted to quit smoking after a good knowledge of the toxic effects of this practice.

Background and objectives: Cesarean section is an increasingly common life-saving procedure in obstetrics. The objectives of this study were to identify the factors associated with the decision to perform a cesarean section in the labor room and to determine the therapeutic and obstetric practices that can increase the probability of giving birth by high way.

Methods: This was a case-control study conducted in the gynecology-obstetrics department of the General Hospital of Bonzola (HGR) in Mbujimayi from May 1, 2020 to April 30, 2021. The target population consisted of all low-risk parturients. The logistic regression model on epi-info 7.2.0 software was used to determine the predictive factors for the indication of caesarean section among parturients.

Results: Indications for cesarean section were dominated by stationary dilatation with 56.2% of cases and ARCF with16.7% of cases; an Apgar≤ 3 and a birth weight ≥ 4000g were retained as essential neonatal characteristics for cesarean section in labor. After multivariate analysis by logistic regression, a Bishop score < 6 with unfavorable cervix,dilatation < 3 cm on admission, and therapy done with oxytocin, artificial rupture of membranes, and G10% during labor were identified as risk factors for cesarean section in labor.

Conclusion: Certain factors predict the risk of cesarean section in parturients at low obstetrical risk. Knowledge of these risk factors may allow practitioners to prevent it or to better prepare patients for this procedure.

Aim: The aim of this work was to describe the deaths by mechanical as phyxiation that occurred in Abidjan in order to contribute to their prevention.

Material and methods: This was a retrospective and descriptive study carried out over a period of 19 years (2002-2020) and relating to deaths by mechanical asphyxia treated by Forensic Medicine.

Results: Deaths by mechanical asphyxiation represented 1.23% (756/60,984), concerned men (85%), from the informal sector (39.7%) or pupils/students (34.1%), single people (75%). These deaths occurred on Wednesdays (16.7%), in the afternoon (47.9%), during the month of June (15.2%), by drowning (72.2%), during swimming (56%). The hanging (15.1%) was discovered at the victim's home (95.6%) and the contexts that occurred were financial problems (26%) and depression (25%). Choking (11.4%) followed landslides (79%). Strangulation (1.3%) was criminal (100%) and occurred in the context of settling scores (60%) and crimes of passion (40%). The circumstances of occurrence of drowning and suffocation were accidental respectively in 71.8% and 82.6% of cases while hanging was suicidal (85%).

Conclusion: Deaths by mechanical asphyxiation although minimal, constitute a social drama. Their prevention requires the implementation of preventive measures against drowning.

Introduction: Musculoskeletal disorders are the most common occupational disease in the world. They constitute a major health problem.

Methods: A cross-sectional study was carried out over a period of three months involving the secretaries of the Yopougon University Hospital. The data were collected using a questionnaire inspired by the National Research and Security Institute (INRS) questionnaire.

Results: The study found an exclusively female population with an average age of 40.6 years ± 8.6, mostly overweight or obese (71%). Almost half of the secretaries had more than ten years of seniority in the post (44.7%) and the absence of an ergonomic chair was noted in 84% of cases. In this population of 38 secretaries, the prevalence of MSDs was 89.5% with pain as the main symptom (89.5%). The preferred locations for MSDs were the dorsolumbar spine (78.9%) and the cervical spine (57.9%). The study showed a predominance of MSDs in the following populations: overweight secretaries (63.1%); more than ten years in the post (39.6%); poor working posture (68.4%); the use of a non-ergonomic seat (81.6%).

Conclusion: Musculoskeletal disorders are common among secretaries. They are associated with many factors. It is imperative to implement preventive measures to reduce their risk of occurrence.

Objective: to contribute to improving the care of patients hospitalized in the department.

Patients and methods: This was a cross-sectional study from January 1, 2018 to December 31, 2020. We included patients of both sexes hospitalized and who died in the department whose cause of death was known.

Results: During the study period, 1324 patients were hospitalized, of whom 279 died (21.07%). Of the 279 cases of death, 222 were included in the study. The clinical signs were: deterioration in general condition (95%), ascites (61.7%), hepatomegaly (57.6%), jaundice (44.9%). The most frequent diagnoses retained in our patients were: cirrhosis (39.6%), primary liver cancer (30.6%), HIV infection (11.4%), pancreatic cancer '6.8%). Causes of death were in order of frequency: hepatic encephalopathy (22.5%), primary end-stage liver cancer (20.3%), ascites fluid infection (16.2%) , hypovolemic shock (14.9%).

Conclusion: The deceased patients had chronic liver disease with a significant deterioration in general condition. Deaths are due to infectious and metabolic complications. An improvement of the technical platform is essential.

Objective: to determine the indications and results of upper digestive endoscopy (EDH) at the Zinder National Hospital.

Materials and methods: this is a retrospective analysis of EDH reports, from digestive endoscopy registers from January 1, 2020 to February 28, 2021, covering 667 examinations, or a monthly frequency of 48 EDH.

Results: the average age of patients was 38.98±14.84 (13-80 years) with a sex ratio of 1.02. Epigastralgia represents 42.8% (n = 363) of indication of EDH, dyspepsia 15.2% (n = 129), diffuse abdominal pain 11.9% (n = 101), vomiting 8.1% (n = 69), search for endoscopic signs of portal hypertension 5.1% (n = 43), dysphagia 4.9% (n = 42) and digestive hemorrhages 3.2% (n = 27Depending on the anatomical segment concerned, the stomach accounted for 55.51% (n=419), the esophagus 19.6% (n=148) and the duodenum 6.68% (n=50). Inflammatory lesions account for 63.04% (n=475), ulcers 6.65% (n=50), tumours 3.03% (n=23) and miscellaneous lesions 27.28% (n=205). The biopsy was performed in 22 patients (3.46%) and 10 histological reports were obtained, divided into 06 gastric adenocarcinomas, 02 chronic gastric with intestinal metaplasia, 01 epidermoidal carcinoma of the esophagus and 01 hyperplastic gastric polyp.

Conclusion: Epigastralgia dominates the indications of HRE. Upper digestive pathology is certainly dominated by inflammatory lesons, but ulcers and tumors are increasingly diagnosed. These lesions would be better evaluated if systematic biopsies were performed in our patients.

Introduction: Few data exist on the issue of visual impairment (VI) in people living with HIV (PLHIV).

Objective: To identify the causes of visual impairment among people living with HIV (PLHIV) at the University Hospital of Libreville.

Population and methods: This was an observational study of 737 people living with HIV (PLHIV). The parameters studied were age (year), gender, CD4 count, age of infection, use of antiretroviral therapy as well as visual acuity from far and near (CMI-11) and cause of VI.

Results: Out of a population of 737 PLHIV, 75 (101 eyes) had VI, representing a hospital prevalence of 10.2% (n = 75/737). VI was bilateral for 34.7% (n = 26/75) of them. The main aetiology were refractive disorders (47.5%). Uveitis affected 16.8% of the number of eyes, of which 12.9% were of toxoplasmic origin. Other causes were cataracts (11.9%) and cytomegalovirus retinitis (10.9%). Two patients experienced early macular degeneration and two others with macular ischemia. Bilateral macular hemorrhage and occlusion of the central artery of the retina were also observed.

Conclusion: One in 10 PLHIV is visually impaired. In half of the cases, the pathologies that provide this handicap, are opportunistic disease with ocular toxoplasmosis in the foreground. Routine screening may improve visual prognosis.