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Epidemiological and Therapeutic Aspects of Proctological Pathologies in Pregnant and Postpartum Women at the Reference Health Center of Commune IV of Bamako District

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Open Journal of Obstetrics and Gynecology 2023年第4期13卷 752-766页

作者： Seydou Mariko Amaguiré Saye Dessé Diarra Sirima Diarra Mariam Tangara Brahima Dembélé Fanta Doumbia Moussa Samaké Abdou Guiré Yéli Dianessi abdoul razakou dicko Amadou Bocoum Youssouf Traoré Adégné Togo Gynecology Department of Mali Bamako Hospital Bamako Mali Department of Gynecology and Obstetrics Reference Health Center of Commune IV Bamako Mali Department of General Surgery Centre de Santé de Référence de la commune IV Bamako Mali Department of Public Health Centre de Santé de Référence de la commune IV Bamako Mali Department of Gynecology and Obstetrics Center Hospitalier Universitaire (CHU) Gabriel TOURE Bamako Bamako Mali

Introduction: Painful proctological conditions that are far less pleasant can mar pregnancy and childbirth. In Mali, few studies have been carried out on proctological pathologies in pregnant women and in the postpartum period. Objective: To determine the frequency and identify the risk factors of anal pathologies during pregnancy and in the postpartum period in the obstetric gynecology department of the Centre de Santé de Référence de la comme IV du District de Bamako. Mali. Methods and Materials: Our observational study, a cross-sectional cohort survey over a period of nine (09) months from January 1, 2020 to September 30, 2020, was conducted in the obstetrics and gynecology department of the Health Center of Reference of Type IV of the District of Bamako. Results: The frequency of anal pathologies during pregnancy and in the post partum period was 24% (36/150). The different anal pathologies found were anal fissures, hemorrhoidal disease, anal incontinence and multiple anal pathologies with respectively 10%;6.67%;5.33%;2%. Chronic constipation (p = 0.003), a newborn weight > 3500 g (p = 0.000) to the occurrence of hemorrhoidal disease. For anal fissures, risk factors were noted such as (weight of the newborn > 3500 g (p = 0.002) and duration of fetal expulsion > 20 minutes (p = 0.000). Finally, a newborn weight > 3500 g (p = 0.000) and a maternal age of up to 30 years (p = 0.001) were associated with the occurrence of anal incontinence. Conclusion: Our study shows that anal pathologies affecting women's intimacy are frequent during pregnancy and in the postpartum period and are part of the many taboos difficult to address in our society.

关键词： Anal Pathologies Delivery Pregnancy

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Quality of Antenatal Care at the Referral Health Center of the Fourth Commune of Bamako District

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Open Journal of Obstetrics and Gynecology 2023年第3期13卷 609-624页

作者： Amaguiré Saye Dessé Diarra Sirima Diarra Brahima Dembele Abdou Guire Souleymane Dembele Yéli Dianessi Moussa Samake Seydou Mariko Seydou Fomba Diakaridia Kone abdoul razakou dicko Pierre Coulibaly Daouda Camara Hamidou Toure Mama Sy Konake Obstetrics and Gynecology Service Commune IV Reference Health Center Bamako Mali Obstetrics and Gynecology Department of Bamako Mali Hospital Bamako Mali Department of Study and Research in Public Health Faculty of Medicine and Odontostomatology USTTB Bamako Mali Reference Health Center of Commune I Bamako Mali Obstetrics and Gynecology Department of the Somine DOLO Hospital Mopti Mali Reference Health Center of Kati Kati Mali

Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.

关键词： Quality Prenatal Consultation Bamako Mali

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Epidemiological and Clinical Profile and Immediate Outcome of Neonates Transferred from the Maternity Unit to the Neonatology Unit of the CSREF in Commune V of Bamako District, Mali

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Open Journal of Pediatrics 2024年第3期14卷 547-557页

作者： Maimouna Kante Ya Traoré Balilé Harber Beydari Mamadou Traoré Issiaka Koné Diéneba Sacko Maimouna Haidara Korotoumou Bamba Assitan Farota abdoulaye Kassogué Mohamed Diarra Dramane Touré abdoul Salam Diarra Leyla Maïga dicko Fatoumata Paediatric Ward CSR&#233f CV Bamako Mali Paediatric Ward of Nianankoro Fomba Hospital S&#233gou Mali Paediatric Ward of Kalaban CoroCSREF Bamako Mali Pediatric Department of the Mopti Reference Health Center Mopti Mali National Centre for Scientific and Technological Research Bamako Mali Paediatrics Department Mohamed VI Perinatal Clinic Bamako Mali Department of Paediatrics Gabriel Tour&#233 University Hospital Bamako Mali

Introduction: Neonatal mortality remains a major public health concern. According to the World Health Organisation (WHO), the number of newborns dying each year has fallen from 5 million in 1990 to 2.4 million in 2019. The aim of our study was to describe the main morbid conditions and their lethality in newborns admitted to the paediatric ward of the CSREF in Commune V. Methodology: We conducted a 12-month prospective descriptive and analytical study from August 2020 to July 2021. Results: During the 12 months of the study, out of 2654 neonates admitted to hospital, 216 met our inclusion criteria, i.e. 8%. Newborns admitted in the first few hours of life represented 99.54% of cases. Full-term newborns accounted for 65.74% of the total. Forty-eight percent of newborns had hypothermia on admission. The most common diagnosis was asphyxia in 55.56% of cases, followed by neonatal infection in 27.78% and prematurity in 10.65%. Death was recorded in 22.2% of cases. Asphyxia was the main cause of neonatal death, followed by prematurity in our context. Conclusion: Improving the prognosis of newborn babies will require a thorough understanding of neonatal pathologies and the implementation of a pre- and perinatal prevention policy.

关键词： Newborns Morbidity Mortality

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Evaluation of Antibiotic Prescribing in the Pediatric Department of Gabriel TouréTeaching Hospital, Bamako, Mali

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Open Journal of Pediatrics 2024年第3期14卷 645-656页

作者： Pierre Togo Hawa Konaré Mariam Maïga Karamoko Sacko Djénéba Konaté abdoul Karim Doumbia Adama Dembélé Oumar Coulibaly Aminata Sangaré Mohamed Elmouloud Cissé Fousseyni Traoré Belco Maïga Ibrahim Ahamadou Aminata Doumbia Lala N’Drany Sidibé Amadou Touré Yacouba Aba Coulibaly Kalirou Traoré Tati Simaga Souleymane Sagara Leyla Bagna Maïga Bory Traoré abdoul Aziz Diakité Fatoumata dicko Mariam Sylla Sounkalo Dao Boubacar Togo Paediatric Department Gabriel Tour&#233 Teaching Hospital Bamako Mali Pediatric Department Distric VI Reference Health Center Bamako Mali Infectious Diseases Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to evaluate antibiotic prescribing in the Department of Pediatrics at Gabriel Touré teaching hospital. Methods: This was a prospective descriptive study conducted from September 1 to November 31, 2018, in the Department of Pediatrics at Gabriel Touré teaching hospital. All children aged 0 to 15 years hospitalized for any pathology during the study period and having received at least one antibiotic had been included. Results: We collected 445 children’s records out of 1032 admissions during the study period, representing a hospital frequency of 43.1%. The sex ratio was 1.3%. The 2 - 5 age group accounted for 48.1%. Fever was the reason for consultation in 45.6% of cases. Patients’ general condition was altered in 60% of cases. The fathers were blue-collar workers in 65.4% and the mothers housewives in 85%, and had no education in 42.9% and 64.5% respectively. Hepatomegaly was present in 18.2%, splenomegaly in 9.6% and peripheral adenopathy in 3.1%. The site of infection was pulmonary in 37.6% and ENT in 9.2%. Bacterial infection was assumed on admission in 54% of cases, and meningitis in 57.7%. The discharge diagnosis was malaria in 54.6%, severe acute malnutrition in 18.6% and meningitis in 6.7%. The death rate was 3.8%. Neutrophilic leukocytosis was present in 47.3% of patients. CRP was positive in 85% of patients. Blood cultures taken in 27.6% of patients were positive in 5. CSF analysis in 30% of patients showed elevated leukocytes in 6.5%. No cultures were positive. Antibiotic prescription was justified by infectious hypotheses in 43.1% of patients. β-lactam antibiotics were prescribed in 98.6%. Antibiotic therapy was not adapted to national/international recommendations in 68.3% of cases, and was not justified in 16.3% of cases on D5 of hospitalization. Conclusion: Antibiotic use was justified in more than half of patients, but remained inadequate in almost two-thirds of cases, in line with national and international recommendations.

关键词： Antibiotic Prescription Hospitalization Child

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Alternative Phenotypic Profile for B-Cell Abnormality in a Case at Zinder National Hospital

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Open Journal of Blood Diseases 2024年第1期14卷 8-16页

作者： Brah Moustapha Maman Amadou Djibrilla-Almoustapha Moustapha Elhadji-Chefou abdoul-Aziz Garba Badé Malam-Abdou Department of Medicine Université André Salifou de Zinder Zinder Niger Department of Medicine H&#244pital National de Zinder Zinder Niger Department of Medicine Université Abdou Moumouni de Niamey Niamey Niger Department of Medicine Université Dan Dicko Dan Koulodo de Maradi Maradi Niger

Introduction: Since it is impossible to establish a diagnosis in the presence of hyperlymphocytosis not secondary to lymphocytic hyperactivation, we considered a B-lymphoid hematopathy with a non-specific phenotypic profile. We report one case of this. Observation: This is a forty-eight (48) year old patient with hyperlymphocytosis at 139,000 elements per cubic millimeter, heterogeneous splenomegaly at 25.6 cm in diameter on abdominal ultrasound without detectable deep or peripheral lymphadenopathy. Peripheral blood cytology shows lymphocyte cell proliferation suggestive of the circulating phase of chronic lymphoproliferative B syndrome. The expression profile of cell membrane markers did not allow for the definition of a specific phenotypic profile. Faced with this immunophenotyping result, we considered a B-lymphoid hemopathy with a non-specific phenotypic profile. After three courses, the MINICHOP treatment was used to achieve partial remission with wasting of more than 80% of the evaluable masses. Conclusion: Despite the contribution of immunophenotyping in the diagnosis of lymphoproliferative syndromes, it is possible to consider the diagnosis of a B-lymphoid hemopathy with a phenotypic non-specific profile of CD45+, monotypic kappa, CD19+, FMC7+, CD22+, CD5−, CD79b−, CD23−, CD43−, CD38−, CD200−.

关键词： Hyperlymphocytosis CLL Immunophenotyping MINICHOP

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Local Criteria Used by Farmers to Evaluate the Agronomic Performance and the Fertilizing Capacity of Cowpea Varieties: Diversity, Variability and Proximal Relation with Agronomic Measurements in Contrasted Sahelian Locations

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Agricultural Sciences 2024年第1期15卷 114-131页

作者： Nouhou Salifou Jangorzo abdoul-Aziz Saïdou Abou-Soufianou Sadda abdoulaye Moussa Mamoudou Hassane Bil-Assanou Issoufou Département des Sciences du Sol et Télédétection Université Dan Dicko Dankoulodo de Maradi Maradi Niger. Unité Mixte de Recherche “Diversité et Adaptation des Plantes” (UMR DAP) Université Dan Dicko Dankoulodo de Maradi Maradi Niger Centre Imaan de Support en Recherche Transdisciplinaire (Imaan Research) Niamey Niger Institut de Recherche pour le Développement Niamey Niger Université Boubacar BA de Tillabéri Tillabéri Niger Département des Sciences et Techniques de Productions Végétales Université Dan Dicko Dankoulodo de Maradi Maradi Niger

When contributing to participatory research, farmers usually appreciate the performance of cowpea varieties using qualitative scores. The score they attribute to each variety are based on local knowledge. The specific criteria they individually use to attribute a score are not well described. The objectives of this work were to: 1) identify and describe exhaustively the local criteria used by farmers to measure the agronomic performance of cowpea;2) assess the variability and statistical structure of these farmer criteria across local contexts;3) and analyze the association between these farmer criteria and the classical agronomic measurement. To achieve these objectives, an augmented block design was implemented across fifteen locations in the regions of Maradi, Dosso and Tillabéri, representing a diversity of local contexts. From a set of 36 cowpea varieties, fifteen varieties were sown per location, including five varieties (controls) common to all locations. In each location, two replicates were sown in randomized Fisher’s blocks. After agronomic measurement and participatory evaluation (scoring of varieties by farmers), a group survey (focus group) was conducted in each location to identify the criteria considered by farmers to found their discretional scoring of varieties during the participatory evaluation. The analysis of the data identified, across locations, thirteen criteria defined by farmers to characterize the agronomic performance of cowpea. Some of these criteria were different according to location. Farmers ranked the three varieties with the best performance for each agronomical trait (Top 3 varieties). A comparison of the farmer ranking with the ranking based on agronomic measurements revealed similarity and complementary between both methods. This study highlighted the importance of considering both local and scientific knowledge in local varietal evaluations.

关键词： Agronomic Performance Participatory Research Cowpea Farmers’ Criteria

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Modeling the Spatio-Temporal Dynamics of Local Context for a Contextualized Diffusion of Agroecological Intensification Options in Niger

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International Journal of Geosciences 2024年第3期15卷 270-301页

作者： Nouhou Salifou Jangorzo Maud Loireau Abou-Souﬁanou Sadda Ousmane Sami Mari abdoul-Aziz Saïdou Hassane Bil-Assanou Issoufou Département des Sciences du Sol et Télédétection Université Dan Dicko Dankoulodo de Maradi UMR DAP Maradi Niger Unité mixte de Recherche Diversité et Adaptation des Plantes (UMR DAP) Université Dan Dicko Dankoulodo de Maradi Maradi Niger Institut de Recherche pour le Développement UMR Espace-DEV Université de Perpignan Via Domitia (UPVD) Perpignan France Institut de Recherche pour le Développement Représentation Niamey Niger Centre Imaan de Support en Recherche Transdisciplinaire UMR DAP/UDDM Niamey Niger Département des Sciences et Techniques de Productions Végétales Université Dan Dicko Dankoulodo de Maradi UMR DAP Maradi Niger

Spatio-temporal variability and dynamics in Sahelian agro-pastoral zones make each local situation a special case. These specificities must be considered to guide the dissemination of agricultural options with a view to sustainable development. The territorial scale of municipalities is not sufficient for this necessary contextualization;the scale of the “village terroir” seems to be a better option. This is the hypothesis we put forward in the framework of the Global Collaboration for Resilient Food Systems program (CRFS), i.e. local context is spatially defined by village terroir. The study is based on data collected through participatory mapping and surveys in “village terroirs” in three regions of Niger (Maradi, Dosso and Tillabéri). Then the links between farm managers and their cultivated land, as well as the spatio-temporal dynamics of local context are analyzed. This study provides evidence of the existence and functional usefulness of the village terroir for farmers, their land management and their activities. It demonstrates the usefulness of contextualizing agricultural options at this scale. Their analysis elucidates the links between “terroirs village” and the specific functioning of the agrosocio-ecosystems acting on each of them, thus laying the systemic and geographical foundations for a model of the spatio- temporal dynamics of “village terroirs”. This initial work has opened up new perspectives in modeling and sustainable development.

关键词： Niger Option by Context Local Condition Complex System Multiscale Conceptual Modeling

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The Bronchiolitis in Paediatric Emergencies at the University Teaching Hospital of Gabriel Touré

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Open Journal of Pediatrics 2022年第2期12卷 396-412页

作者： Adama Dembélé abdoul Karim Doumbia Belco Maïga Mohamed Elmouloud Cissé Younoussa Koné Pierre Togo Oumar Coulibaly Karamoko Sacko Djéneba Konaté Hawa Diall Lala Ndrainy Sidibé Koné Oumou Fatoumata Leonie Diakité Fatoumata dicko abdoul Aziz Diakité Mariam Sylla Boubacar Togo Department of Paediatrics University Teaching Hospital of Gabriel Touré Bamako Mali

Introduction: Bronchiolitis is a generally benign condition characterised by acute inflammation, oedema and necrosis of the epithelial cells lining the small airways, and increased mucus production. Symptoms usually begin with rhinitis and cough, which may progress to tachypnoea, wheezing, and rales. The most common etiology is a respiratory syncytial virus (RSV). Bronchiolitis occupies an important place among Acutes Respiratory Infections (ARI) and represented the fifth cause of hospitalisation in the paediatric emergency department of the Gabriel Touré University Hospital in 2008 with a frequency of 10% and a mortality rate of 3.2%. This shows that we are constantly confronted with the management of this pathology. The objective of our study was to study the epidemiological, clinical, and therapeutic aspects of bronchiolitis in the paediatric emergency room of the Gabriel Touré University Hospital. Materials and Method: This was a prospective cross-sectional and descriptive study from April 1, 2018, to March 31, 2020, i.e. 2 years in infants aged 1 to 23 months. Data were collected using an individual survey form by questioning parents and physically examining patients. Results: During the study period, we were able to collect 342 patients meeting our inclusion criteria out of 4207 hospitalized patients, or a frequency of 8.1%. The age range of 1 to 5 months represented 64.9%. The sex ratio was 1.2. The most common reason for consultation was respiratory discomfort (86.8%). Most patients (46%) were hospitalised during the period from September to November. In the majority of cases (74%), patients consulted within five days of the onset of symptoms. The physical examination was mainly dominated by signs of respiratory struggle, fever (51.8%), and sibilants (37%) on auscultation. Complications associated with bronchiolitis were mainly respiratory infections with 57.6% of cases. The main management steps were: nasopharyngeal decontamination (78.9%), oxygen therapy (72.5%), nebulisation with β2 mimetics (69%), and

关键词： Bronchiolitis Epidemiology Clinic Pediatrics

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Kangaroo Mother Care and Neonatal Outcomes in the Pediatric Department of CHU Gabriel Toure

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Open Journal of Pediatrics 2022年第1期12卷 179-187页

作者： Fousseyni Traoré Hawa G. Diall Karamoko Sacko Belco Maiga Oumar Coulibaly Isabelle Traore Leyla Maiga Lala N. Sidibe Pierre Togo abdoul Karim Doumbia Djeneba Konaté Fatoumata Leonie Diakité Ibrahima Ahamadou Adama Dembélé abdoul Aziz Diakité Fatoumata dicko Traoré Mariam Sylla Boubacar Togo Department of Pediatrics CHU Gabriel Toure Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali

Introduction: In Mali, prematurity is currently the leading cause of neonatal morbidity and mortality at the Gabriel Toure Hospital. Kangaroo Mother” care is an efficient and effective alternative care strategy for preterm and low birth weight babies. This study aimed to evaluate the epidemio-clinical and therapeutic profile of premature/hypotrophic newborns admitted to the “Kangaroo-mother” care unit. Material and method: It was a retrospective study from 01/01/2010 to 31/12/2012. Were included all stable preterm with gestational age between 28 - 37 weeks and hypotrophic newborns with a birth weight 10th percentile for gestational age. Results: One thousand and eighty-four patients (n = 1084) were included. The sex ratio was 1.2 (F = 592;M = 492). The mean birth weight was 1300 g (600 g - 2000 g). The mean gestational age was 32.69 (28 - 37). The mean age of the mothers was 24 years (13 - 45 years). Single pregnancies accounted for 85.1%. Discontinuation of care was 56%. Follow-up to 24 months was effective in 14% of patients. Sixteen percent of the patients died (n = 176). The mothers’ lack of schooling (p = 0.03) and birth weight < 1000 g (p = 0.003) were the major factors in the patients’ mortality. Conclusion: The kangaroo-mother care is an alternative means to improve the survival of preterm and low birth weight babies in Mali.

关键词： Newborns Kangaroo-Mother Care Mali

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Epidemiological Profile of Newborns Who Died during Their Hospitalization in the Neonatology Unit, Mali Hospital

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Open Journal of Pediatrics 2022年第2期12卷 424-432页

作者： Korotoumou Wéllé Diallo Bourama Kané Aboubacar Sangaré Kadidiatou Touré Fatoumata Léonie François Diakité Mamadou Traoré Mohamed Maba Traoré Mamadou Berthé Mariam Maiga abdoul Aziz Diakité Fatoumata dicko Traoré Department of Pediatrics Mali Hospital Bamako Mali Department of Pediatrics Gabriel Touré University Hospital Bamako Mali Reference Health Center of Commune V Bamako Mali Department of Medical Imaging Mali Hospital Bamako Mali National Institute of Public Health Bamako Mali Reference Health Center of Commune VI Bamako Mali

Introduction: Neonatal mortality is a serious problem, particularly in developing countries. Objective: To study the epidemiological and clinical profiles of newborns who died during their hospitalization in the neonatology unit of the hospital in Mali. Methodology: This was a prospective study over a 12-month period (January 1 to December 31, 2020) including all newborns aged 0 - 28 days who died during their hospitalization. Results: A total of 424 neonates were hospitalized in neonatology, 54 died, or 12.73%. Newborns aged 0 - 7 days at admission were the most represented at 79.63% and 94.4% were full-term babies. The male gender was dominant with a ratio of 1.17. The following characteristics were frequently observed in the mothers: not educated (46.3%), poor 75.9%, living in urban areas (68%), housewives 75.4%, and having had less than 4 antenatal care visits (53.7%). For babies, respiratory distress and hyperthermia were the most common reasons for hospitalization (37% and 22.2%, respectively), with 40% being resuscitated at birth. Infection and perinatal anoxia were the most frequent diagnoses, respectively 96.3% and 37%. The death occurred within the first three days of hospitalization in 60% of cases. Conclusion: In order to reduce the mortality rate in our facilities, monitoring of pregnancy and delivery, and correct management of newborns both at birth and in the pediatric wards are important.

关键词： Newborn Death Hospital in Mali

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