Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 -...Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.展开更多
Population growth and expanding urbanization have caused persistent shortages and contamination of groundwater resources in Mali,Africa.The increase in groundwater salinity makes it more difficult for residents to obt...Population growth and expanding urbanization have caused persistent shortages and contamination of groundwater resources in Mali,Africa.The increase in groundwater salinity makes it more difficult for residents to obtain drinking water,it is necessary to clarify the causes and control factors of groundwater mineralization in Gao region,northern Mali.Based on the analysis of the hydrochemical composition of groundwater in 24 boreholes,Piper and Sch?eller diagrams,principal component analysis(PCA)and hierarchical cluster analysis(HCA)are used to carry out multivariate statistical analysis on the main ions.The results show that the groundwater samples are weakly alkaline,with pH values ranging from 5.83 to 8.40,and the average values of boreholes are 7.50,respectively.The average electrical conductivity(EC)value is 354.4(μS/cm),and the extreme value is between 124.0 and 1247(μS/cm).Water is usually mineralized and presents nine types of water phase.The three principal components explain 84.42%of the total variance for 13 parameters.The factor F1(58.85%),the factor F2(16.88%)and the factor F3(8.69%)present for the majority of the total data set.In addition,multivariate statistical analysis confirmed the genetic relationship among aquifers and identified three main clusters.Clustering related to groundwater mineralization(F1),clustering related to oxide reduction and iron enrichment(F2),and clustering of groundwater pollution caused by nitrate and magnesium(F3).We found that agriculture,weathering activities and dissolution of geological materials promote the mineralization of groundwater.Groundwater quality in the Gao region is becoming less and less potable because of increasing salinity.展开更多
Post-Neoproterozoic dolerites from the Kéniéba region (Western Mali) are often associated with kimberlites. The rarity of kimberlite outcrops led to the study of doleritic rocks, spatially associated with th...Post-Neoproterozoic dolerites from the Kéniéba region (Western Mali) are often associated with kimberlites. The rarity of kimberlite outcrops led to the study of doleritic rocks, spatially associated with them. The petrographic and lithogeochemical study showed that the dolerites of the Kéniéba kimberlitic fields are of tholeiitic nature and of the E-MORB (Enriched-Mid Ocean Ridge Basalt) type. This reflects an enrichment over time, compared to the Birimian dolerites of the volcano-sedimentary greenstone belt of Toumodi, in central C?te d’Ivoire. Furthermore, these dolerites are enriched in SiO2, TiO2, Zr and poor in Fe2O3, MgO. These dolerites would have formed in a late to post-orogenic intracontinental context during the breakup of Gondwana. Structurally, Kéniéba dolerites are often associated with kimberlite pipes, fractures and large deep structures identified using aeromagnetic images. Taking into account the fact that kimberlites do not outcrop in the Kéniéba region, the geochemical study coupled with the interpretation of aeromagnetic data proved to be very useful for the search for pipes.展开更多
Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease...Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.展开更多
Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease i...Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.展开更多
Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and techn...Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology Department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: During the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.展开更多
Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive a...Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.展开更多
Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countrie...Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.展开更多
Birth is the transition from fetal life to ectopic life. This transition is usually smooth. Only 10% of newborns will need birth assistance. Successful resuscitation is linked to the skills of the health worker. It is...Birth is the transition from fetal life to ectopic life. This transition is usually smooth. Only 10% of newborns will need birth assistance. Successful resuscitation is linked to the skills of the health worker. It is to assess their skills that this work was undertaken with the objective of evaluating the practice of neonatal resuscitation in the delivery room of the RHC maternity hospital in District V of Bamako. Methodology: This was a descriptive cross-sectional study over a four-month period. We included in the study all live newborns who had a gestational age greater than or equal to 32 weeks and who had an Apgar score at the first minute of less than 7. At each birth, we observe the health agent responsible for the care of the newborn by observing the preparation of resuscitation and compliance with the neonatal resuscitation algorithm. We have excluded all newborns who met our inclusion criteria, were reanimated outside of our collection time and had visible or diagnosed anomalies or malformations in the prenatal period, and those whose parents refused to give their consent to participate in the study. Data were collected from the survey sheet and analyzed with the Statistical Package for Social Sciences (SPSS) software version 25. Results: We observed a 24.66% frequency of neonatal resuscitation. Pregnancies were too close in 15% (less than one year). Caesarean section delivery represented 34% of the sample. They were at term in 93% of cases. All newborns were well dried (98.5%), with wet linen change only at 49.5%. Apgar was less than 3 in 7.5% of newborns at first. The resuscitation needs were for the absence of a scream in 78.5% of cases and or heart rate Conclusion: The study evaluated neonatal resuscitation practices at a maternity hospital in Bamako, Mali. It found a 24.66% resuscitation rate, with a 95.5% success rate despite technical limitations. Most steps were correctly applied, though some improvements are needed in areas like preventing hypothermia and equipment preparation.展开更多
The care provided in the neonatal period by caregivers in health facilities and by parents in the community is essential for the survival of the newborn. Our work aimed to assess the practice of essential care for new...The care provided in the neonatal period by caregivers in health facilities and by parents in the community is essential for the survival of the newborn. Our work aimed to assess the practice of essential care for newborns at the maternity hospital during the first six hours of life. Methodology: It was a cross-sectional study, which took place over a period of six months and fifteen days (from April 27 to November 12, 2020). We evaluated the practice of immediate care given to newborns over 32 weeks of amenorrhea by the health personnel involved against the recommendations of the World Health Organization (WHO) on essential newborn care (ENC). Results: Our study involved 422 live newborns, which represented 22% of all live births. The sex ratio was 1.2. The gestational age of newborns was 37 to 41Week of Amenorrhea (WA) in 69.2%. The majority of births were performed by doctors specializing in gynecology and obstetrics, or 66.4% of cases. Midwives provided care in 51.7% of cases. Out of 422 newborns, 408 were immediately dried, 96.7% of the time. Less than half (44.1% of newborns) had benefited from the late cord clamping. Eye care was administered to the vast majority of newborns (94.3% of cases). The breastfeeding technique was verified in only 2.8% of cases. Only 1.7% (7 newborns) were monitored during the first six hours of immediate postpartum. In the immediate post-partum period, 18 newborns had problems that required treatment. NNS were correctly administered in 39 newborns (9.2%). Conclusion: Our study shows inadequacies in the practice of essential care for newborns within our maternity. Thus, many newborns can be saved through the practice of essential newborn care (NHS) at different levels of the health pyramid.展开更多
Shallots (Allium cepa ascalonicum L.) are an important crop primarily due to their likely culinary and economic value. However, its production comes with specific challenges. In addition, effective post-harvest manage...Shallots (Allium cepa ascalonicum L.) are an important crop primarily due to their likely culinary and economic value. However, its production comes with specific challenges. In addition, effective post-harvest management is critical to ensure the quality and availability of shallot bulbs for extended periods. This study assessed the yield performance and storability relevant traits of five shallot cultivars (Saboula Jaba, Espagne Jaba, Daou Jaba, Tata Jaba, and N’galamandjan Jaba) under controlled storage conditions. Field experiments were conducted in 2021 to evaluate growth and yield in terms of bulb quantity, size, and weight. Storability traits such as firmness, weight loss, and Total Soluble Solids (TSS) were also measured for each entry. The five ecotypes of shallots were evaluated on-station with a total rainfall of 810 mm in 2021. The results revealed statistically significant variations (p > 0.01) in storability traits and yield among the tested entries. Furthermore, the weight loss of stored bulbs varied, indicating genetic differences among the cultivars that can influence their moisture retention abilities, leading to differences in weight loss rates. Indeed, Daou jaba showed less weight loss and superior firmness. The top highest-ranking entry for yield was shown by N’galamandjan jaba with 40 T/ha, followed by Saboula jaba with 39 T/ha. These highest productivity entries also showed significantly higher bulb quantity and individual bulb size. While there was a significant correlation between weight loss and firmness, a correlation between weight loss and TSS was also observed. The weight loss and firmness of N’galamandjan jaba were significantly correlated (r = 0.52) on the one hand, and on the other hand, the weight loss and visual quality of Espagne Jaba were highly and significantly correlated (r = 0.69). N’galamandjan Jaba and Saboula Jaba can be used to improve the yield and the storability relevant traits and prevent post-harvest losses.展开更多
Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognost...Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognostic aspects of gynaecological hysterectomies. Patients and methods: This was an 18-month retrospective prospective descriptive study with a six-month follow-up period from 1 December 2020 to 31 May 2022 carried out in the gynaecology department of the Segou regional hospital. Results: Fifty-six (56) hysterectomies were performed out of 118 gynaecological surgical procedures (47.45%). The mean age was 47 ± 11.77 years. Large multiparous women were the most common (50%), with an average parity of 4.58. The main indications were uterine fibroids (30.4%), precancerous lesions of the cervix (17.85%) and uterine prolapse (17.85%). The abdominal route was the most commonly used surgical route (82.14%). Hysterectomy was total in 100% of cases and associated with bilateral adnexectomy in 48.2% of cases. The intra- and post-operative prognosis was satisfactory in 94.6% of cases. No deaths were recorded. The average length of stay was 3.28 days, irrespective of the surgical approach. Three cases of dyspareunia were noted among those who had resumed sexual activity.展开更多
Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of co...Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were factors contributing to post-operative complications.展开更多
Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to stu...Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of cases and hematoma: 1.7%). The immediate consequences were simple in 96.6% of cases. No cases of recurrence occurred during the 6 months after the intervention. The average cost of care was estimated at 69,743 FCFA.展开更多
Introduction: Despite progress in universal health coverage, maternal mortality remains a concern for developing countries, including Mali. The problem is not due only to a lack of health services but to a combination...Introduction: Despite progress in universal health coverage, maternal mortality remains a concern for developing countries, including Mali. The problem is not due only to a lack of health services but to a combination of factors that need to be identified to give hope to women of childbearing age. Objective: Determine the factors associated with maternal mortality in the Timbuktu region of Mali. Methodology: Retrospective, descriptive, cross-sectional and analytical study from January 1, 2018 to December 31, 2022 using a questionnaire and an interview guide to determine the factors associated with maternal mortality in the Timbuktu region of Mali. Results: A total of 112 maternal deaths were recorded between 2018 and 2022. The average age of the women who died was 26 years (standard deviation 7.6 years). The 14 – 23-year-old age group is the most affected (43.8%). 66.1% of women came from rural areas. Illiteracy (77.7%), lack of ANC (54.5%), distance of households from health facilities (76%) and insecurity (52.7%) have been identified as factors contributing to maternal mortality. Conclusion: This study reported a high prevalence of maternal mortality rates that may be associated with women’s socioeconomic conditions. Actions must be developed to integrate CPN into an advanced strategy for women living in rural areas in Mali.展开更多
In Mali, few studies have been conducted on the prevalence of cardiovascular risk factors and diseases according to place of residence. The aim of this study was to assess the prevalence of risk factors and cardiovasc...In Mali, few studies have been conducted on the prevalence of cardiovascular risk factors and diseases according to place of residence. The aim of this study was to assess the prevalence of risk factors and cardiovascular diseases according to residents in town of Bougouni and its rural area (southern Mali). Methods: This was a retrospective descriptive study from February 2019 to March 2024. All patients who visited the “CENTRE MEDICAL DE BOUGOUNI” clinic with known or suspected heart disease during the study period were included. Data were collected from medical records. Incomplete or unusable records were excluded. Data were processed using SPS version 22 software. Results: we included 452 patients with an average age of 50 ± 19 years. High blood pression has been found in 42.70% of cases, with higher prevalence in urban areas (47.01%) than in rural areas (41.50%). Diabetes and smoking were found respectively 5.31% and 8.19% in our population. The prevalence of diabetes was higher in urban areas (5.97%) than rural area (5.35%). smoking prevalence was higher in rural areas (8.49%) than urban areas (6.72%). Alcoholism was found in 2.21% of cases with a little difference between rural area (2.24%) and urban area (2.20%). 31.63% of our patients had no cardiovascular factor. Dyspnea was the reason of consultation in 5.75% of cases and atypical precordialgia in 13.72%. Headaches and dizziness in 8.63% of cases and 21.90% of patients presented other non-specific symptoms. Diagnosis of idiopathic dilated cardiomyopathy was found in 23.45% of cases with higher prevalence in rural areas (28.30%) than urban areas (13.43%). Ischaemic heart disease accounted for 9.29% of cases with a higher prevalence in rural areas (10.38%) than in urban areas (6.71%). PPCMs accounted for 5.98% of cases, with a slight increase in urban areas (6.66%) compared with rural areas (5.68%). Rheumatic valvulopathy accounted for 2.21% of cases;2.84% in rural areas and 0.74% in urban areas. Other valvular diseases accounted for 3.76% of cases;4.73% in rural areas and 1.48% in urban areas. Right heart diseases accounted for 3.98% of cases and stroke for 1.77%. Conclusion: The prevalence of cardiovascular risk factors and heart diseases is high in the rural and urban population of the town of Bougouni and its surroundings (Mali). Excepted smoking, the prevalence of other CV risk factors is higher in urban areas, whereas the prevalence of idiopathic dilated cardiomyopathy and ischemic heart disease is higher in rural areas. These data could serve as a basis for developing tailored preventive strategies, depending on the place of residence.展开更多
Abdominal pregnancy is a rare ectopic pregnancy in which the trophoblast implants in the peritoneal cavity. Diagnosis and management are difficult. We report the case of a 21-year-old primigravida, who consulted the h...Abdominal pregnancy is a rare ectopic pregnancy in which the trophoblast implants in the peritoneal cavity. Diagnosis and management are difficult. We report the case of a 21-year-old primigravida, who consulted the hospital in Ségou for an abdominal pregnancy that had stopped at around 16 weeks. We performed a laparotomy and removed a gestational sac included in the left broad ligament containing a still-macerated female foetus weighing 145 g after a second ultrasound following the failure of induction with misoprostol for 48 hours. This case highlights the difficulty of diagnosing abdominal pregnancy in our environment despite the more frequent use of ultrasound.展开更多
Introduction: Radiology and medical imaging examinations bring together the means of acquiring and restoring images of the human body from different physical phenomena such as the absorption of X-rays, nuclear magneti...Introduction: Radiology and medical imaging examinations bring together the means of acquiring and restoring images of the human body from different physical phenomena such as the absorption of X-rays, nuclear magnetic resonance, reflection of ultrasound waves or radioactivity, with which we sometimes associate optical imaging techniques such as endoscopy. The objective of our study was to study the profile of radiological examinations in the radiology and medical imaging department of the “KALALE” medical clinic. Methodology: This was a descriptive, prospective study that took place over a period of six (6) months in the radiology and medical imaging department of the “KALALE” medical clinic and the centers of health of communes III and IV of Bamako in Mali. Data collection was carried out on a survey form. The parameters studied were sociodemographic data, clinical data, radiological data. Results: We recorded 6030 radiology examinations of which 19% of the examination frequency cases came from the “KALALE” medical clinic and 81% of the cases were referrals from the reference health centers of communes III and IV. There were 1500 X-rays or 24.9% of cases including 54% cases of bone X-rays;5% of cases of skull and face X-rays;5% of cases of Intravenous Urography (IVU);4% of cases of Hysterosalpingography (HSG);3% of cases of Retrograde Ureterocystography (UCR) and 1% of cases of X-ray of the Abdomen without preparation (ASP). We found 4530 ultrasounds or 75.1% of cases. Conclusion: Medical imaging has become essential in the study of the human body and now constitutes an essential tool for the detection and treatment of most pathologies, from simple fractures to the most serious tumors.展开更多
In Mali,access to healthcare is a major concern.It has been a national priority since the Alma-Ata Declaration in 1978.Since then,major efforts have been made by the State and its partners to achieve this objective.Th...In Mali,access to healthcare is a major concern.It has been a national priority since the Alma-Ata Declaration in 1978.Since then,major efforts have been made by the State and its partners to achieve this objective.These efforts appear insufficient in the Bougouni health district,wheremore than half the population is still far frombasic health services.Given this situation,it is essential to assess geographical accessibility to healthcare to identify the localities that have been left behind,hence the purpose of this research in the Bougouni District.Three types of data were used:the size of the population,the location of community health centers and the road network.Two consecutive stages summarize the approach used,the improved two-stage floating attraction area method(E2SFCA)was used to measure the spatial dimension of accessibility to health services.It was supplemented by spatial autocorrelation analyses,particularly the local Moran index,to detect clusters of localities with low or high spatial accessibility values.The results reveal strong spatial disparities in access to primary healthcare within and between communes and at the same time call into question the effectiveness of the policy of geographical coverage of the population in terms of basic healthcare.They also highlight the demographic pressure on existing health services and suggest ways of significantly improving geographical access to health services.展开更多
文摘Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.
基金funded by the China's National Natural Science Foundation(No.41440027)。
文摘Population growth and expanding urbanization have caused persistent shortages and contamination of groundwater resources in Mali,Africa.The increase in groundwater salinity makes it more difficult for residents to obtain drinking water,it is necessary to clarify the causes and control factors of groundwater mineralization in Gao region,northern Mali.Based on the analysis of the hydrochemical composition of groundwater in 24 boreholes,Piper and Sch?eller diagrams,principal component analysis(PCA)and hierarchical cluster analysis(HCA)are used to carry out multivariate statistical analysis on the main ions.The results show that the groundwater samples are weakly alkaline,with pH values ranging from 5.83 to 8.40,and the average values of boreholes are 7.50,respectively.The average electrical conductivity(EC)value is 354.4(μS/cm),and the extreme value is between 124.0 and 1247(μS/cm).Water is usually mineralized and presents nine types of water phase.The three principal components explain 84.42%of the total variance for 13 parameters.The factor F1(58.85%),the factor F2(16.88%)and the factor F3(8.69%)present for the majority of the total data set.In addition,multivariate statistical analysis confirmed the genetic relationship among aquifers and identified three main clusters.Clustering related to groundwater mineralization(F1),clustering related to oxide reduction and iron enrichment(F2),and clustering of groundwater pollution caused by nitrate and magnesium(F3).We found that agriculture,weathering activities and dissolution of geological materials promote the mineralization of groundwater.Groundwater quality in the Gao region is becoming less and less potable because of increasing salinity.
文摘Post-Neoproterozoic dolerites from the Kéniéba region (Western Mali) are often associated with kimberlites. The rarity of kimberlite outcrops led to the study of doleritic rocks, spatially associated with them. The petrographic and lithogeochemical study showed that the dolerites of the Kéniéba kimberlitic fields are of tholeiitic nature and of the E-MORB (Enriched-Mid Ocean Ridge Basalt) type. This reflects an enrichment over time, compared to the Birimian dolerites of the volcano-sedimentary greenstone belt of Toumodi, in central C?te d’Ivoire. Furthermore, these dolerites are enriched in SiO2, TiO2, Zr and poor in Fe2O3, MgO. These dolerites would have formed in a late to post-orogenic intracontinental context during the breakup of Gondwana. Structurally, Kéniéba dolerites are often associated with kimberlite pipes, fractures and large deep structures identified using aeromagnetic images. Taking into account the fact that kimberlites do not outcrop in the Kéniéba region, the geochemical study coupled with the interpretation of aeromagnetic data proved to be very useful for the search for pipes.
文摘Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.
文摘Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.
文摘Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology Department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: During the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.
文摘Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.
文摘Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.
文摘Birth is the transition from fetal life to ectopic life. This transition is usually smooth. Only 10% of newborns will need birth assistance. Successful resuscitation is linked to the skills of the health worker. It is to assess their skills that this work was undertaken with the objective of evaluating the practice of neonatal resuscitation in the delivery room of the RHC maternity hospital in District V of Bamako. Methodology: This was a descriptive cross-sectional study over a four-month period. We included in the study all live newborns who had a gestational age greater than or equal to 32 weeks and who had an Apgar score at the first minute of less than 7. At each birth, we observe the health agent responsible for the care of the newborn by observing the preparation of resuscitation and compliance with the neonatal resuscitation algorithm. We have excluded all newborns who met our inclusion criteria, were reanimated outside of our collection time and had visible or diagnosed anomalies or malformations in the prenatal period, and those whose parents refused to give their consent to participate in the study. Data were collected from the survey sheet and analyzed with the Statistical Package for Social Sciences (SPSS) software version 25. Results: We observed a 24.66% frequency of neonatal resuscitation. Pregnancies were too close in 15% (less than one year). Caesarean section delivery represented 34% of the sample. They were at term in 93% of cases. All newborns were well dried (98.5%), with wet linen change only at 49.5%. Apgar was less than 3 in 7.5% of newborns at first. The resuscitation needs were for the absence of a scream in 78.5% of cases and or heart rate Conclusion: The study evaluated neonatal resuscitation practices at a maternity hospital in Bamako, Mali. It found a 24.66% resuscitation rate, with a 95.5% success rate despite technical limitations. Most steps were correctly applied, though some improvements are needed in areas like preventing hypothermia and equipment preparation.
文摘The care provided in the neonatal period by caregivers in health facilities and by parents in the community is essential for the survival of the newborn. Our work aimed to assess the practice of essential care for newborns at the maternity hospital during the first six hours of life. Methodology: It was a cross-sectional study, which took place over a period of six months and fifteen days (from April 27 to November 12, 2020). We evaluated the practice of immediate care given to newborns over 32 weeks of amenorrhea by the health personnel involved against the recommendations of the World Health Organization (WHO) on essential newborn care (ENC). Results: Our study involved 422 live newborns, which represented 22% of all live births. The sex ratio was 1.2. The gestational age of newborns was 37 to 41Week of Amenorrhea (WA) in 69.2%. The majority of births were performed by doctors specializing in gynecology and obstetrics, or 66.4% of cases. Midwives provided care in 51.7% of cases. Out of 422 newborns, 408 were immediately dried, 96.7% of the time. Less than half (44.1% of newborns) had benefited from the late cord clamping. Eye care was administered to the vast majority of newborns (94.3% of cases). The breastfeeding technique was verified in only 2.8% of cases. Only 1.7% (7 newborns) were monitored during the first six hours of immediate postpartum. In the immediate post-partum period, 18 newborns had problems that required treatment. NNS were correctly administered in 39 newborns (9.2%). Conclusion: Our study shows inadequacies in the practice of essential care for newborns within our maternity. Thus, many newborns can be saved through the practice of essential newborn care (NHS) at different levels of the health pyramid.
文摘Shallots (Allium cepa ascalonicum L.) are an important crop primarily due to their likely culinary and economic value. However, its production comes with specific challenges. In addition, effective post-harvest management is critical to ensure the quality and availability of shallot bulbs for extended periods. This study assessed the yield performance and storability relevant traits of five shallot cultivars (Saboula Jaba, Espagne Jaba, Daou Jaba, Tata Jaba, and N’galamandjan Jaba) under controlled storage conditions. Field experiments were conducted in 2021 to evaluate growth and yield in terms of bulb quantity, size, and weight. Storability traits such as firmness, weight loss, and Total Soluble Solids (TSS) were also measured for each entry. The five ecotypes of shallots were evaluated on-station with a total rainfall of 810 mm in 2021. The results revealed statistically significant variations (p > 0.01) in storability traits and yield among the tested entries. Furthermore, the weight loss of stored bulbs varied, indicating genetic differences among the cultivars that can influence their moisture retention abilities, leading to differences in weight loss rates. Indeed, Daou jaba showed less weight loss and superior firmness. The top highest-ranking entry for yield was shown by N’galamandjan jaba with 40 T/ha, followed by Saboula jaba with 39 T/ha. These highest productivity entries also showed significantly higher bulb quantity and individual bulb size. While there was a significant correlation between weight loss and firmness, a correlation between weight loss and TSS was also observed. The weight loss and firmness of N’galamandjan jaba were significantly correlated (r = 0.52) on the one hand, and on the other hand, the weight loss and visual quality of Espagne Jaba were highly and significantly correlated (r = 0.69). N’galamandjan Jaba and Saboula Jaba can be used to improve the yield and the storability relevant traits and prevent post-harvest losses.
文摘Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognostic aspects of gynaecological hysterectomies. Patients and methods: This was an 18-month retrospective prospective descriptive study with a six-month follow-up period from 1 December 2020 to 31 May 2022 carried out in the gynaecology department of the Segou regional hospital. Results: Fifty-six (56) hysterectomies were performed out of 118 gynaecological surgical procedures (47.45%). The mean age was 47 ± 11.77 years. Large multiparous women were the most common (50%), with an average parity of 4.58. The main indications were uterine fibroids (30.4%), precancerous lesions of the cervix (17.85%) and uterine prolapse (17.85%). The abdominal route was the most commonly used surgical route (82.14%). Hysterectomy was total in 100% of cases and associated with bilateral adnexectomy in 48.2% of cases. The intra- and post-operative prognosis was satisfactory in 94.6% of cases. No deaths were recorded. The average length of stay was 3.28 days, irrespective of the surgical approach. Three cases of dyspareunia were noted among those who had resumed sexual activity.
文摘Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were factors contributing to post-operative complications.
文摘Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the Reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of cases and hematoma: 1.7%). The immediate consequences were simple in 96.6% of cases. No cases of recurrence occurred during the 6 months after the intervention. The average cost of care was estimated at 69,743 FCFA.
文摘Introduction: Despite progress in universal health coverage, maternal mortality remains a concern for developing countries, including Mali. The problem is not due only to a lack of health services but to a combination of factors that need to be identified to give hope to women of childbearing age. Objective: Determine the factors associated with maternal mortality in the Timbuktu region of Mali. Methodology: Retrospective, descriptive, cross-sectional and analytical study from January 1, 2018 to December 31, 2022 using a questionnaire and an interview guide to determine the factors associated with maternal mortality in the Timbuktu region of Mali. Results: A total of 112 maternal deaths were recorded between 2018 and 2022. The average age of the women who died was 26 years (standard deviation 7.6 years). The 14 – 23-year-old age group is the most affected (43.8%). 66.1% of women came from rural areas. Illiteracy (77.7%), lack of ANC (54.5%), distance of households from health facilities (76%) and insecurity (52.7%) have been identified as factors contributing to maternal mortality. Conclusion: This study reported a high prevalence of maternal mortality rates that may be associated with women’s socioeconomic conditions. Actions must be developed to integrate CPN into an advanced strategy for women living in rural areas in Mali.
文摘In Mali, few studies have been conducted on the prevalence of cardiovascular risk factors and diseases according to place of residence. The aim of this study was to assess the prevalence of risk factors and cardiovascular diseases according to residents in town of Bougouni and its rural area (southern Mali). Methods: This was a retrospective descriptive study from February 2019 to March 2024. All patients who visited the “CENTRE MEDICAL DE BOUGOUNI” clinic with known or suspected heart disease during the study period were included. Data were collected from medical records. Incomplete or unusable records were excluded. Data were processed using SPS version 22 software. Results: we included 452 patients with an average age of 50 ± 19 years. High blood pression has been found in 42.70% of cases, with higher prevalence in urban areas (47.01%) than in rural areas (41.50%). Diabetes and smoking were found respectively 5.31% and 8.19% in our population. The prevalence of diabetes was higher in urban areas (5.97%) than rural area (5.35%). smoking prevalence was higher in rural areas (8.49%) than urban areas (6.72%). Alcoholism was found in 2.21% of cases with a little difference between rural area (2.24%) and urban area (2.20%). 31.63% of our patients had no cardiovascular factor. Dyspnea was the reason of consultation in 5.75% of cases and atypical precordialgia in 13.72%. Headaches and dizziness in 8.63% of cases and 21.90% of patients presented other non-specific symptoms. Diagnosis of idiopathic dilated cardiomyopathy was found in 23.45% of cases with higher prevalence in rural areas (28.30%) than urban areas (13.43%). Ischaemic heart disease accounted for 9.29% of cases with a higher prevalence in rural areas (10.38%) than in urban areas (6.71%). PPCMs accounted for 5.98% of cases, with a slight increase in urban areas (6.66%) compared with rural areas (5.68%). Rheumatic valvulopathy accounted for 2.21% of cases;2.84% in rural areas and 0.74% in urban areas. Other valvular diseases accounted for 3.76% of cases;4.73% in rural areas and 1.48% in urban areas. Right heart diseases accounted for 3.98% of cases and stroke for 1.77%. Conclusion: The prevalence of cardiovascular risk factors and heart diseases is high in the rural and urban population of the town of Bougouni and its surroundings (Mali). Excepted smoking, the prevalence of other CV risk factors is higher in urban areas, whereas the prevalence of idiopathic dilated cardiomyopathy and ischemic heart disease is higher in rural areas. These data could serve as a basis for developing tailored preventive strategies, depending on the place of residence.
文摘Abdominal pregnancy is a rare ectopic pregnancy in which the trophoblast implants in the peritoneal cavity. Diagnosis and management are difficult. We report the case of a 21-year-old primigravida, who consulted the hospital in Ségou for an abdominal pregnancy that had stopped at around 16 weeks. We performed a laparotomy and removed a gestational sac included in the left broad ligament containing a still-macerated female foetus weighing 145 g after a second ultrasound following the failure of induction with misoprostol for 48 hours. This case highlights the difficulty of diagnosing abdominal pregnancy in our environment despite the more frequent use of ultrasound.
文摘Introduction: Radiology and medical imaging examinations bring together the means of acquiring and restoring images of the human body from different physical phenomena such as the absorption of X-rays, nuclear magnetic resonance, reflection of ultrasound waves or radioactivity, with which we sometimes associate optical imaging techniques such as endoscopy. The objective of our study was to study the profile of radiological examinations in the radiology and medical imaging department of the “KALALE” medical clinic. Methodology: This was a descriptive, prospective study that took place over a period of six (6) months in the radiology and medical imaging department of the “KALALE” medical clinic and the centers of health of communes III and IV of Bamako in Mali. Data collection was carried out on a survey form. The parameters studied were sociodemographic data, clinical data, radiological data. Results: We recorded 6030 radiology examinations of which 19% of the examination frequency cases came from the “KALALE” medical clinic and 81% of the cases were referrals from the reference health centers of communes III and IV. There were 1500 X-rays or 24.9% of cases including 54% cases of bone X-rays;5% of cases of skull and face X-rays;5% of cases of Intravenous Urography (IVU);4% of cases of Hysterosalpingography (HSG);3% of cases of Retrograde Ureterocystography (UCR) and 1% of cases of X-ray of the Abdomen without preparation (ASP). We found 4530 ultrasounds or 75.1% of cases. Conclusion: Medical imaging has become essential in the study of the human body and now constitutes an essential tool for the detection and treatment of most pathologies, from simple fractures to the most serious tumors.
文摘In Mali,access to healthcare is a major concern.It has been a national priority since the Alma-Ata Declaration in 1978.Since then,major efforts have been made by the State and its partners to achieve this objective.These efforts appear insufficient in the Bougouni health district,wheremore than half the population is still far frombasic health services.Given this situation,it is essential to assess geographical accessibility to healthcare to identify the localities that have been left behind,hence the purpose of this research in the Bougouni District.Three types of data were used:the size of the population,the location of community health centers and the road network.Two consecutive stages summarize the approach used,the improved two-stage floating attraction area method(E2SFCA)was used to measure the spatial dimension of accessibility to health services.It was supplemented by spatial autocorrelation analyses,particularly the local Moran index,to detect clusters of localities with low or high spatial accessibility values.The results reveal strong spatial disparities in access to primary healthcare within and between communes and at the same time call into question the effectiveness of the policy of geographical coverage of the population in terms of basic healthcare.They also highlight the demographic pressure on existing health services and suggest ways of significantly improving geographical access to health services.
