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Study of Factors Associated with Maternal Deaths at Timbuktu Hospital in Mali

Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1471-1487页

作者： Coulibaly Moussa kassogué Djibril Samaké Alou Sy Ousmane Poda Ghislain Dolo Akoro Sogoba Seydou Cissouma Assetou kassogué abdoulaye Maiga Mariam Mariko Souleymane Ongoiba Oumar Traoré Bassirima Kané Babou Traoré Halima Taoudeni Regional Health Directorate Tombouctou Mali Department of Pediatrics Timbuktu Hospital Timbuktu Mali Department of Pediatrics District Hospital Commune VI Bamako Mali WHO Bamako Mali Department of Pediatrics CHU Point G Bamako Mali Department of Pediatrics Sikasso Hospital Sikasso Mali Department of Pediatrics Nianankoro Fomba Sgou Hospital Segou Mali

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.

关键词： Maternal Mortality Timbuktu Hospital Mali

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Morbidity and Mortality of Newborns in a Context of Limited Resources in Tombouctou, Mali

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Open Journal of Pediatrics 2024年第5期14卷 841-850页

作者： kassogué Djibril Cissouma Assétou kassogué abdoulaye Boré Boubacar Sogoba Robert Diallo Zoumana Maiga Talfi Dolo Akoro Sogoba Seydou Touré Lahaou Maiga Mariam Samaké Alou Mariko Souleymane Ongoiba Oumar Sanogo Oumar Traoré Bassirima Paediatrics Department Timbuktu Hospital Timbuktu Mali Paediatrics Department Sikasso Hospital Sikasso Mali Paediatrics Department Nianankoro Fomba Hospital Sgou Mali Department of Obstetrics and Gynaecology CHU du Point G Bamako Mali Department of Paediatrics Commune VI District Hospital Bamako Mali

Introduction: Worldwide, 2.3 million children died in the first 20 days after birth in 2022, according to the WHO. In Mali, according to the sixth Demographic and Health Survey, the neonatal mortality rate was estimated at 33% live births in 2018. The Timbuktu region had the highest neonatal mortality rate in the country with 44%. The objective of this work was to study the causes of neonatal morbidity and mortality and related factors in the paediatrics department of Timbuktu hospital. Materials and method: This was a descriptive, cross-sectional study conducted from 1 January to 31 December 2023 in the neonatology unit of the paediatrics department of Timbuktu hospital, including all newborns admitted to hospital. Results: Our study took place over 12 months, during which 618 admissions were made to the paediatric ward, including 244 newborns, i.e. 39.48%. The majority of newborns (86.5%) were admitted in the first week of life. The mean age was 3 days, with a sex ratio of 1.1 for males. Weight under 2500 g was 54.1% for an average weight of 2372 g. The main mode of admission was transfer from the hospital maternity unit (62%). The main reasons for admission were acute foetal distress (27.9%) and prematurity (26.2%). The average age of the mothers was 24, with extremes of 15 and 49. The mothers were housewives (87.3%), uneducated and primiparous (59% and 36.5% respectively);only 40.2% had made more than 3 antenatal care visits. Newborns born by vaginal delivery accounted for 80.7% and those born by caesarean section for 19.3%. The risk of infection was present in 52.5% of cases. The three leading causes of hospitalisation were birth asphyxia (40.2%), neonatal infection (32.4%) and prematurity (25%). The mortality rate was 21.7%. The main causes of death were prematurity (39.6%), birth asphyxia (32.1%) and neonatal infection (24.5%). Conclusion: Neonatal morbidity and mortality remain a concern in Timbuktu. Despite the unfavourable security situation, morbidity and

关键词： Morbidity Mortality Newborns Timbuktu

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Para Testicular Pseudotumeurs of Calcified Gait: A Case Report from the Nianankoro Fomba Segou Hospital (Mali)

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Open Journal of Urology 2022年第12期12卷 602-606页

作者： Ibrahim Kone Sory Brehima Samaké abdoulaye kassogué Mahamoudou Keita Tidiani Traoré Thierno Boubacar Bagayogo Adama Bah Alpha Sanogo Damissa Coulibaly abdoulaye Nouhoum Coulibaly Mamadou Togo Aminata Fofana Urology Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali General Surgery Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali Pediatrics Department of Nianankoro Fomba Segou Mali Hospital Ségou Mali Obstetrics and Gynaecology Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali Forensic Medicine Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali Cardiology Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali General Medicine Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali Ophthalmology Department of Nianankoro Fomba Segou Mali Hospital Ségou Mali ENT Department of the Nianankoro Fomba Segou Mali Hospital Ségou Mali

Fibrous tumors of para testicular location are extremely rare benign tumors. The diagnosis of benignity, which allows a conservative treatment, will be made intraoperatively in front of the macroscopic aspect with well enucleable nodules and confirmed by the extemporaneous anatomopathological examination. We report a case of multiple calcified paratestinal pseudotumors in a 25-year old patient with no particular history, whose benignity was proven by the histology of the operative parts. Our objective was to discuss, from this observation and a review of the literature, the diagnostic and therapeutic aspects of these tumors.

关键词： Pseudotumor Para Testicular Benign

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Postpartum Family Planning at the Timbuktu Hospital in Mali

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 1074-1082页

作者： kassogué Djibril Samaké Alou Dolo Akoro Sogoba Seydou Touré Lahaou Cissouma Assetou kassogué abdoulaye Maiga Mariam Mariko Souleymane Kantako Karamoko Ongoiba Oumar Sanogo Ooumar Traoré Bassirima Sidibé Idrissa Mandé Kassambara Youssouf Traoré Halima Timbuktu Hospital Bamako Mali Commune VI Bamako District Hospital Bamako Mali CHU Point G Bamako Bamako Mali Sikasso Hospital Bamako Mali Nianankoro Fomba Sgou Hospital Bamako Mali

Introduction: Postpartum family planning is the prevention of pregnancies during the 12 months following childbirth. Few studies have been devoted to postpartum family planning in Mali. Our work will contribute to reducing unmet need for family planning. Objective: To study the use of contraceptive methods in the postpartum period in the obstetrics and gynecology unit of Timbuktu hospital. Materials and Methods: This was a descriptive and analytical cross-sectional study with prospective collection of data from January 1, 2022 to December 31, 2023. All women who gave birth having chosen and benefited from a contraceptive method were included. The statistical test used was the Fisher test with a significance threshold fixed at 5%. Results: The frequency of contraception in the postpartum period was 17.03%. The average age of clients was 26.14% with extremes of 14 and 45 years. They were paupiparous at 56.4% with an inter-birth interval of less than 12 months at 12.3%. More than half of the counseling (58.5%) was done during postnatal visits. The methods chosen were implants at 48.1%, injectable progestins at 21.3%, intrauterine device at 14.7%, miro-progestin pills at 13.5%, tubal ligation at 1 .4% and condoms at 1%. The regular follow-up rate was 51.1% of cases and 25.6% had no follow-up. Conclusion: The overall rate of postpartum family planning of 17.08% remains low. Improving FP staff skills will reduce unmet needs and contribute to increasing contraceptive prevalence in Timbuktu.

关键词： Family Planning Postpartum Counseling Contraceptive Methods Timbuktu Hospital

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Management of Trauma to the External Genitalia at the Nianankoro-Fomba Hospital in Segou Mali

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Open Journal of Urology 2022年第6期12卷 376-382页

作者： Sory Ibrahim Koné abdoulaye kassogué Brehima Samaké Mahamoudou Keita Tidiani Traore abdoulaye Nouhoum Coulibaly Mamadou Adama Togo Thierno Boubacar Bagayoko Adama Bah Aminata Fofana Alpha Sanogo Damissa Coulibaly Sidi Modibo Doucouré Honoré Jean Gabriell Berthé Urology Department The Nianankoro Fomba Hospital Ségou Mali Paediatric Ward The Nianankoro Fomba Hospital Ségou Mali General Surgery Department The Nianankoro Fomba Hospital Ségou Mali Obstetrics and Gynaecology Department The Nianankoro Fomba Hospital Ségou Mali Ophthalmology Department The Nianankoro Fomba Hospital Ségou Mali Forensic Medicine Department The Nianankoro Fomba Hospital Ségou Mali ENT Department The Nianankoro Fomba Hospital Ségou Mali Cardiology Department The Nianankoro Fomba Hospital Ségou Mali Department of General Medicine The Nianankoro Fomba Hospital Ségou Mali Social Security Fund Ségou Mali Department of Urology CHU du Point G Bamako Mali

Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is little exposed, and fairly well protected and its mobility allows it to move with the impact of trauma and thus reduce the vulnating force. Open trauma is rare, as is testicular dislocation, the most common being closed trauma. Testicular trauma is an uncommon accident that affects young people. Trauma is most often caused by road and traffic accidents. Animal bites are rare, as is genital self-mutilation related to a psychiatric disorder. Surgical exploration is the rule except in cases of moderate testicular trauma. Our objective was to report our experience in an emergency context where treatment is poorly codified and to review the literature. We recorded four patients with external genitalia trauma managed in the urology department from April 2013 to March 2022. Our patients were children with open genitalia trauma following a traffic accident, scrotal injuries were encountered in three patients, and additional penile injuries in one patient. All patients were treated surgically. The follow-up was straightforward.

关键词： Trauma Genitalia Open Segou

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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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Hysterectomies for Gynaecological Pathology: 56 Cases at the Segou Regional Hospital in Mali

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1363-1373页

作者： Tidiani Traoré Famakan Kané abdoulaye kassogué Seydou Traoré Seydou Z. Dao Balilé Harber Sory Diallo Kassoun Sidibé Brahima Donigolo Babou Traoré Adama Coulibaly Abdrahamane Diarisso Alima Sidibé Mamadou Sima Augustin Théra Youssouf Traoré Ibrahima Teguété Niani Mounkoro Ministry of Health in Bamako Nianakoro Fomba Hospital Segou Mali Regional Health Department of Segou District Hospital Bla Mali Regional Health Department of Koutiala Reference Health Center Koutiala Mali Regional Health Department of Bamako Reference Health Center Commune II Bamako Mali Ministry of Health in Bamako Fousseyni Daou Hospital Kayes Mali Ministry of Health in Bamako Point G University Hospital Center Bamako Mali Ministry of Health in Bamako Gabriel Toure University Hospital Center Bamako Mali

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.

关键词： Hysterectomy Gynaecological Pathology Mali

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Prevalence, Maternal and Perinatal Prognosis of Breech Delivery Compared to That of the Vertex in 242 Cases for 484 Controls at Ségou Hospital in Malti

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1414-1421页

作者： Tidiani Traoré Famakan Kané abdoulaye kassogué Seydou Traoré Seydou Z. Dao Balilé Harber Sabré Koné Kassoum Sidibé Brahima Donigolo Babou Traoré Adama Coulibaly Abdrhamane Diarisso Alima Sidibé Mamadou Sima Augustin Théra Youssouf Traoré Ibrahima Teguété Niani Mounkoro Ministry of Health in Bamako Nianakoro Fomba Hospital Segou Mali Regional Health Department of Segou District Hospital Bla Mali Regional Health Department of Koutiala Reference Health Center Koutiala Mali Regional Health Department of Bamako Reference Health Center Commune II Bamako Mali Ministry of Health in Bamako Fousseyni Daou Hospital Kayes Mali Ministry of Health in Bamako Point G University Hospital Center Bamako Mali Ministry of Health in Bamako Gabriel Toure University Hospital Center Bamako Mali

Introduction: Breech birth has always been a subject of great interest because of its risks of perinatal morbidity and mortality. Aim: The aim of our study was to compare the maternal and perinatal prognosis of breech delivery with that of vertex delivery. Patients and Method: This was a retrospective case-control analytical study carried out in the obstetrics and gynaecology department of Ségou hospital over a 2-year period from 1 January 2020 to 31 December 2021, involving 242 breech deliveries compared with 484 top deliveries with a live single foetus without foetal malformation of gestational age ≥ 35 SA. The statistical tests used were: chi² (p Results: The frequency of breech delivery was 3.3%, with a predominance of caesarean section for breech presentation (64.88%) compared with 32.85% for vertex (P: 0.00;CI: (0.191 - 0.367). The perinatal prognosis of fetuses with breech presentations was marked by a higher rate of neonatal asphyxia (Apgar score Conclusion: Breech birth is relatively rare in our department. It carries a higher risk of maternal morbidity and neonatal morbidity than breech delivery. However, the vital prognosis for the mother was identical in both groups.

关键词： Delivery Breech Vertex Prognosis Mali

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Postpartum Family Planning at the Timbuktu Hospital in Mali

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2024年第7期 1074页

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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（儿科学期刊） 2024年第3期 547页

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