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Screening, Treatment and Control of High Blood Pressure on Five Sites in Mali

World Journal of Cardiovascular Diseases 2024年第5期14卷 322-332页

作者： Mamadou Touré Sagara Ibrahima Youssouf Camara Hamidou Oumar Bâ Ibrahima Sangaré Djénébou Traoré Noumou Sidibé Fousseyni Samassékou Massama Konaté coumba thiam doumbia Asmaou Maiga Réné-Marie Dakouo Hamidou Camara Sako Mariam Sidibé Samba Adama Sogodogo Boubacar Diarra Boubacar Sonfo Aladji Traoré Mamadou Diakité Ilo Bella Diall Ichaka Menta Departement of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Departement of Cardiology Cardiology University Hospital Sidy Bocar Sall Kati Mali Internal Medecine University Hospital Point G Bamako Mali Departement of Cardiology Cardiology University Hospital &#8220H&#244pital du Mali&#8221 Bamako Mali Departement of Cardiology Cardiology University Hospital Mother-Children Bamako Mali

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.

关键词： High Blood Pressure Screening Control Rate Mali

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ECG and Echocardiographic Findings of Female Hypertension (fHTN) in the Cardiology Department of the University Hospital Gabriel Touré (UH-GT)

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World Journal of Cardiovascular Diseases 2023年第10期13卷 646-656页

作者： Hamidou Oumar Bâ Ibrahima Sangaré Youssouf Camara Kassim Kamaté Tawoufik Tchedre Georges Rosario Christian Millogo Djénébou Traoré Noumou Sidibé Fousseyni Samassékou Massama Konaté coumba thiam doumbia Asmaou Maiga Réné-Marie Dakouo Hamidou Camara Adama Sogodogo Boubacar Diarra Mamadou Touré Boubacar Sonfo Aladji Traoré Mamadou Diakité Ilo Bella Diall Ichaka Menta Cardiology University Hospital Gabriel Touré Bamako Mali Cardiology University Hospital Sidy Bocar Sall Kati Mali Cardiology University Hospital Yalgado Ouédraogo Ouagadougou Burkina-Faso Internal Medecine University Hospital Point G Bamako Mali Cardiology University Hospital “H&ocircpital du Mali” Bamako Mali Cardiology University Hospital Mother-Children Bamako Mali

Introduction: In our setting there is a lack of publications on female hypertension in general population motivating this study to look for electro- and echocardiographic findings of female hypertension. Methods: We performed a cross-sectional study during 6 months in the cardiology department of the UH-GT including 324 female patients aged 18 and more seen in the outpatient unit and by whom the diagnosis of hypertension was set. All patients consented to be study participants after receiving clearly information about the study and that care giving will not be affected by their eventual refusal. Data collection has been done with all needed confidentiality rules. A survey formular was used to collect data in order to record them in an Access database. Analysis was done using IBM SPSS software. Quantitative data are presented as mean with standard deviation and qualitative as proportion. Level of significance for statistic test was set at 5%. Results: During the study time 324 among 524 hypertensive patients visited our outpatient unit giving a prevalence of fHTN of 61.8%. The means for age, body mass index (BMI) in female hypertensive patients were respectively 52 ± 14.461 years and 27.35 ± 06.585 Kg/m2. Main ECG findings were left ventricular hypertrophy (LVH) and sinus tachycardia with respectively 93.6% and 46.4% followed by isolated ventricular extrasystole with 33.7%. Echocardiography findings included LVH, relative wall thickness (RWT) and reduced ejection fraction (EF) in respectively 41.05%, 37.35% and 21.91%. The left ventricular mass (LV) mass and geometry were abnormal in 44.4% and 37.3%. Remodeling as geometry modification (18.2%) and mitral flow Type 2 (90.4%) have been the most abnormal findings. Conclusion: Hypertension induced modifications mainly LVH in ECG and Echocardiography in female patients less than encountered among male hypertensive patients.

关键词： Hypertension Female ECG Echocardiography Mali

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Percutaneous Coronary Intervention in Acute Coronary Syndromes at the Mother-Child University Hospital Luxembourg in Bamako

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World Journal of Cardiovascular Diseases 2024年第4期14卷 288-294页

作者： Mamadou Toure Hamma Sankare Baba I. Diarra Mariam Dagnogo Modibo doumbia Abdoul W. Terra Samba Sidibe coumba A. thiam Boubacar Sonfo Boubacar Diarra Asmaou Keita Ousmane Traore Daouda Fofana Almou A. Diall Mady Sow Massama Konate Hamidou O. Ba Ichaka Menta Cardiology Department CHU-Mother Child Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Faculty of Medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali Department of Cardiac Surgery Center Andre FESTOC Bamako Mali Cardiology Department CHU-Point G Bamako Mali

Introduction: Acute coronary syndromes (ACS) are a diagnostic and therapeutic emergency. Objective: Studying the feasibility, difficulties and results of coronary angioplasty in acute coronary syndromes at the Luxembourg Mother-Child University Hospital in Bamako. Patients and Methods: Cross-sectional, descriptive study with prospective recruitment over 18 months from September 2020 to February 2022. All patients aged at least 18 years old admitted for SCA and having undergone PCI during the study period were included. Result: We collected 249 patients for SCA, of whom 160 underwent angioplasty, either an angioplasty/SCA ratio of 0.64. The average age of the patients was 59.54 ± 11.62 with extremes of 32 and 92 years. The age group of 45 to 65 years was the most representative. The predominance was male, sex ratio of 2.4. The main cardiovascular risk factors were high blood pressure (58.23%) and diabetes (45.78%). Persistent ST-segment elevation on the electrocardiogram was present in 71.48%. The treatment time was more than 12 hours after the first medical contact in 95.5%. The approach was radial in 96.5% of cases. Coronarography was pathological in 91.16% of our patients. The lesions were tri-truncular in 34.13% with the anterior inter ventricular as culprit artery in 72% of cases. The majority of patients (64%) had undergone angioplasty with implantation of an active stent. Angioplasty was performed successfully in 98% and per procedural mortality was 1.87%. Only 6.45% of ACS with ST elevation benefited from primary angioplasty. Conclusion: Percutaneous coronary intervention is performed routinely in our center with satisfactory results. Difficulties exist, related to the diagnostic delay of ACS and the high cost of angioplasty.

关键词： Acute Coronary Syndromes Coronary Angiography Angioplasty Mother-Child University Hospital Luxembourg Bamako Mali

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Hydrological Modelling of the Casamance River in Its Upstream Section (Basin at Kolda Level) to Predict Its Future States as a Function of Different Stresses

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Open Journal of Geology 2024年第2期14卷 143-154页

作者： coumba Ndiaye Saïdou Ndao Laboratory of Water and Environment Sciences and Technologies (LaSTEE) Polytechnic School of Thies (EPT) Thies Senegal UFR Sciences and Technologies (SET) University Iba Der Thiam of Thies (UIDT) Thies Senegal

Flow records for stations in the Casamance basin are incomplete. Several gaps were noted over the 1980-2021 study period, making this study tedious. The aim of this study is to assess the potential impact of climate change on the flow of the Casamance watershed at Kolda. To this end, hydrological series are simulated and then extended using the GR2M rainfall-runoff model, with a monthly time step. Projected climate data are derived from a multi-model ensemble under scenarios SSP2-4.5 (scenario with additional radiative forcing of 4.5 W/m2 by 2099) and SSP5-8.5 (scenario with additional radiative forcing of 8.5 W/m2 by 2099). An analysis of the homogeneity of the rainfall data series from the Kolda station was carried out using KhronoStat software. The Casamance watershed was then delimited using ArcGIS to determine the morphometric parameters of the basin, which will be decisive for the rest of the work. Next, monthly evapotranspiration was calculated using the formula proposed by Oudin et al. This, together with rainfall and runoff, forms the input data for the model. The GR2M model was then calibrated and cross-validated using various simulations to assess its performance and robustness in the Casamance watershed. The version of the model with the calibrated parameters will make it possible to extend Casamance river flows to 2099. This simulation of future flows with GR2M shows a decrease in the flow of the Casamance at Kolda with the two scenarios SSP2-4.5 and SSP5-8.5 during the rainy period, and almost zero flows during the dry season from the period 2040-2059.

关键词： Casamance Watershed Climate Change GR2M Climate Models

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Acute Coronary Syndrome of Young Subjects at the Luxembourg Mother-Child University Hospital in Bamako

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World Journal of Cardiovascular Diseases 2024年第3期14卷 157-165页

作者： Mamadou Toure Mariam Dagnogo Massama Konate Mariam Sako Daouda Fofana Hamma Sankare Almou A. Diall Modibo doumbia Baba I. Diarr Mady Sow Abdoul Wahhab Terra coumba A. thiam Boubacar Sonfo Boubacar Diarra Asmaou Keita Ousmane Traore Hamidou O. Ba Ichaka Menta Cardiology Department CHU-Mother Child Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Faculty of Medicine University of Sciences Technics and Technologies of Bamako Bamako Mali Center Andre FESTOC Department of Cardiac Surgery of Bamako Mali Bamako Mali

Introduction: Acute coronary syndrome is often the first event of coronary disease of young subjects. Objective: To study sociodemographic, clinical, paraclinical, therapeutic and evolutionary aspects of acute coronary syndrome of young subjects. Patients and Methods: Descriptive cross-sectional study with prospective recruitment from October 01, 2020 to March 31, 2022. Were included all patients admitted for acute coronary syndrome whose age was less or equal to 45 years and who had undergone coronary angiography at the Mother-Child University Hospital on Luxembourg from Bamako. Results: During the study period, we collected 60 patient files out of 198. These 60 patient files met our inclusion criteria. Hospital frequency was 30.30%. Average age of patients was 40.43 ± 3.9 years. Sex ratio M/F was 5.3. Main cardiovascular risk factor was smoking tobacco (23.42%), followed by dyslipidemia (13.92%). Functional signs were dominated by angina 62% followed by dyspnea 25.3%. Persistent ST-segment elevation on electrocardiogram was present in 76.4%. Left ventricular systolic dysfunction was present in 26.5%. Time to first medical contact was more than 12 hours in 62.7% of cases. Radial approach was adopted in 94% of cases. Coronary angiography was pathological in 85% (n = 51) of cases. Lesions were single-vessel disease in 47.1% and culprit artery was anterior interventricular in 51% of cases. Dual anti-platelet aggregation was aspirin and ticagrelor in 91.8% of cases. Angioplasty was performed in all patients who had significant abnormalities at coronary angiography. In-hospital mortality was 3.9%. Conclusion: Acute coronary syndromes exist in young Africans with a male predominance. Main cardiovascular risk factor is smoking tobacco. Coronary lesions are single vessel disease in the majority of case. Most of patients meet medical team after 12 hours. Time to first medical contact is a main challenge in our country.

关键词： Acute Coronary Syndrome Young Subjects Coronary Angiography CHU Luxembourg Bamako

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Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

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World Journal of Cardiovascular Diseases 2024年第2期14卷 77-87页

作者： Youssouf Camara Hamidou Oumar Ba Ibrahima Sangaré Boubacar Sonfo coumba Adiaratou thiam Mahamadou Sékou Diakité Koniba Diarra Karamba Touré Massama Konaté Ichaka Menta Cardiology Department University Hospital Professeur Bocar Sidi Sall Kati Kati Mali Cardiology Department University Hospital Gabriel Touré Bamako Mali Cardiology Department Mali Hospital Bamako Mali

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.

关键词： Stress Test Ischemic Heart Disease Mali

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Epidemiological, Clinical and Coronary Angiography Aspects of Acute Coronary Syndrome in the Cardiology Department of the Hospital Mother-Child “Le Luxembourg”Mali

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World Journal of Cardiovascular Diseases 2024年第4期14卷 228-233页

作者： Sidibé Samba Toure Mamadou Konate Massama Sankaré Hamma Traoré Ousmane Mahamat Guire Sadik Diall Mahan Ameri Dicko Bahaide Daffe Sanoussy Keita Asmaou thiam coumba Adiaratou Diarra Soumaila Menta Ichaka Cardiology Department CHU-M&#232re Enfant Bamako Mali Cardiology Department CHU-Point G Bamako Mali Faculty of Medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Cardiology Department Mali Hospital Bamako Mali

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.

关键词： Coronary Angiography Acute Coronary Syndrome Bamako Mali

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Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology Department of the Mali Hospital

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World Journal of Cardiovascular Diseases 2024年第3期14卷 129-139页

作者： Konaté Massama Mamadou Touré Mariam Sako Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Elhaj Mahamane Maiga coumba Adiaratou thiam Youssouf Camara Hamidou Oumar Ba Asmao Keita Maiga Djenebou Traoré Zoumana Traoré Souleymane Coulibaly Bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Ichaka Menta Faculty of Medicine and Dentistry Bamako USTTB Department of Medicine Hospital of Mali Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali Department of Cardiology CHU Point G Bamako Mali Department of Medicine Hospital of Timbuktu Bamako Mali Department of Cardiology Hospital of Kati Bamako Mali Department of Cardiology CHU Mother and Child Bamako Bamako Mali Department of Internal Medicine CHU Point G Bamako Mali

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.

关键词： Diabetes Echocardiography Mali Hospital

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Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology Department of Kati University Hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 333-342页

作者： Boubacar Sonfo coumba thiam Mariam Sako Massama Konaté Youssouf Camara Mamadou Touré Boubacar Diarra Diakaridja Sacko Samba Sidibé Bassan Diarra Hamidou Camara Asmaou Keita Konimba Diarra Hamidou Oumar Bâ Ibrahima Sangaré Youssouf Guindo Sanoussi Daffe Daouda Fofana Souleymane Coulibaly Ichaka Menta Department of Cardiology University Hospital Bocar Sidy Sall Kati Mali Department of Cardiology University Hospital of Point G Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology University Hospital Mother-Child Luxembourg Bamako Mali Department of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Department of Cardiology Kayes Hospital Kayes Mali

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

关键词： Hypertensive Therapeutic Adherence University Hospital of Kati

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Prevalence, Pattern and Evolution of Rheumatic Heart Disease: About 120 Cases at Mother-Children University Hospital Luxembourg (MC UHL), Bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第7期8卷 319-327页

作者： Ba Hamidou Oumar Maiga Asmaou Kéita doumbia coumba thiam Maiga Salma Souleimane Sidibé Noumou Sangaré Ibrahima Camara Youssouf Sidibé Salimata Diallo Souleymane Menta Ichaka Diarra Mamadou Bocary CHU Gabriel Touré Bamako Mali CHU Mère Enfant le Luxembourg Bamako Mali CHU Sidy Bocar Sall Kati Mali

Introduction: Acute rheumatic fever (ARF) and its complications including rheumatic heart disease (RHD) remain one of the leading causes of cardiovascular disease worldwide. In our setting with no cardiac surgery, data on RHD are therefore important to point out the need for such structure. In this study, we therefore describe rheumatic disease in terms of prevalence, patients’ characteristics and management of patients. Methods: We performed a retrospective study from May to September 2012, involving children aged 3 to 15 years old and seen at the Mother and Child University Hospital Luxembourg (MC UHL). Included were all children diagnosed with RHD. The diagnosis of rheumatic fever (RF) was defined using the revised Jones criteria from 1992 and RHD defined according to the WHO/NIH joint criteria. Data of interview, clinical examination, complementary and those on evolution were recorded. Results: We found an hospital prevalence of 6.2%. Mean age was 15.33 years ± 6.005 (3 to 36), females representing 54.2% and students 70%. Mitral regurgitation (MR), Mitral Stenosis (MS) and concomitant MR + MS were most found RHD with resp. 43.3%, 15% and 13.3%. Complications occurred in 74.1% before surgery. An operative indication was set in 90% of all cases whereas only 36% underwent surgery. After surgery immediate complications were dominated by anemia (11.6%) and late ones by heart failure in 18.5% of cases. Conclusion: Despite advances in medical diagnostic approach and therapeutical progress which partly explained the relatively high prevalence, the evolution of rheumatic heart disease in our context is unfavorable due to the lack of a surgical management structure. While waiting for a cardiology institute, the focus should be on information and awareness in primary prevention.

关键词： Retrospective Acute Rheumatic Fever Rheumatic Heart Disease Bamako

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