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Community-Based Diagnosis for the Improvement of Maternal and Child Protection in the ASACOSEKASI Health Area in the Urban Area of Bamako (Mali)

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Open Journal of Obstetrics and Gynecology 2023年第11期13卷 1859-1868页

作者： Fane Seydou Simpara Nouhoum Camara Daouda Sima Mamadou kanté ibrahim Bocoum Amadou Sylla Cheickna Traoré Oumar Soumana Abdoul Razak Dicko Ahmed Diallo Bokary Diallo Sissoko Abdoulaye kanté ibrahim Tegueté ibrahima Traoré Youssouf Department of Obstetrics and Gynecology Gabriel Touré University Hospital Bamako Mali Referral Health Centre of Commune 6 Bamako Mali Kati Reference Health Center Koulikoro Mali University Hospital Center (CHU) of Point G Bamako Mali Referral Health Centre of Commune 5 Bamako Mali District Hospital of Commune 4 Bamako Mali Department of Obstetrics and Gynecology Luxembourg Mother-Child Hospital Bamako Mali

The community diagnosis is an essential approach to the resolution of health problems with the involvement of the communities concerned who become object and subject. Improvingmaternal and child health is a health priority for many developing countries, including Mali. The objective was to study the role of community-based diagnosis in improving maternal and child protection in a vulnerable urban community in a developing country. Methodology: This was a research-action integrating a community diagnosis conducted in March 2023. The involvement of several stakeholders, including social actors including ASACO, membership card holders, district chiefs, neighborhood delegates, local authorities, and health professionals, made it possible to provide curative, preventive and promotional care. The ASACOSEKA Health Area was used as a setting for the study. The methodology was the indicator approach, contact, document review, interview of CSCOM patients, observation of the structure, prioritization of problems, development of an action plan and restitution of the report. Results: The monograph consisted of describing the characteristics of the study setting. Indeed, the ASACOSEKASI area is located on the left bank of the Niger River, with a population of 34,497 inhabitants. The CSCOM presented to describe a medical unit, a maternity unit, a laboratory unit, an ultrasound room and a medication storage room. The main pathologies found were confirmed simple malaria (45.08%), high AKI: 20.43%, confirmed severe malaria: 19.85%, suspected diarrhoea: 3.43%, trauma related to road accidents: 3.36%, pregnancy-related disorders (1%). BCG, Penta3, VAR, and yellow fever vaccination rates were above 100%. It reflects the fact that the doses administered were higher than the target population. This was related to out-of-area vaccination and lost doses. CPN1, CPN4, tetanus vaccination (VAT2) and family planning (FP) consultations all have a proportion above 100%. Maternal care is increased

关键词： Community Diagnosis Reproductive Health Local Solutions ASACOSEKASI Bamako Mali

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Routine Screening for Cervical Cancer

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Open Journal of Obstetrics and Gynecology 2021年第7期11卷 922-928页

作者： Alassane Traoré Aphou Sallé Koné Sima Mamadou Amadou Bocoum Mamadou Bakary Coulibaly Koninba Diabaté Adama Diakité kanté ibrahim Seydou Mariko Idrissa Mama Diarra Service de gynécologie H&ocirc pital du Mali Bamako Mali Service de radiothérapie H&ocirc pital du Mali Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire du Point G Bamako Mali Service de gynécologie-obstétrique Centre hospitalier et universitaire Gabriel Touré Bamako Mali

Objective: To describe the screening for uterine cancer by visual methods. Method: We conducted a prospective and descriptive study over a period of 12 months from January to December 2020. Direct observation of providers and interview of patients were performed for data collection. Results: Out of 3400 patients, 1024 were enrolled for the study, or 30.11%. The average age of the patients was 41 years with the extremes of 17 to 87 years. Women aged 40 to 45 were the most represented with 58.78%, (n = 602). Housewives 85.83% (n = 879), they had a primary education level in 71.09% of cases (n = 728), the vast majority were married 92.28% (n = 945). Multiparous represented 58.78% (n = 602) of the sample, nulliparous 18.26% (n = 187), women living in rural areas 30.17% (n = 309), in urban areas 69.82% (n = 715). The test was positive in 43 patients (4.19%) but squamocylindrical junction was not visible in 17% of cases. The preparation of acetic acid and lugol: good preparation in 100% of cases;

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Endoscopic Management of Migrated Intra Uterine Device in Sub-Saharan Health Setting Area. Our Experience about Seventeen Cases

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Surgical Science 2018年第1期9卷 17-23页

作者： Traoré Youssouf kanté ibrahim Sima Mamadou Ongoiba ibrahima Coulibaly Ahmadou Dicko Birama Bocoum Amadou Kodio Souma Théra Tiounkani Téguété ibrahima Traoré Mamadou Department of Gynecology and Obstetrics of Gabriel Touré Teaching Hospital Bamako Mali Department of Gynecology and Obstetrics of Point “G” Teaching Hospital Bamako Mali Department of Forensic Medicine of Bamako University Bamako Mali

Intra uterine device migration is a relatively rare event. The migration of the IUD in the surrounded viscera can be managed by endoscopy approach. Objectives: We reported our experience to determine the epidemiologic characteristics of patients that presented migrated IUD, to report clinical aspects and describe the laparoscopic management. Method: We conducted a descriptive and prospective survey from January 1st, 2014 to October 31, 2016. That survey took place in the department of gynecology and obstetrics of Point G Teaching hospital, Bamako, Mali. Population study concerned patients with intra uterine device complications. Statistic tests used have been X2 or Fisher test according their application conditions. P Results: Seventeen patients were included. Mean age of patients is 29 years with extremes of 13 years and 44 years. The main reference incitement of patients were perforation of the uterus and pelvis pain (27.8% for each), misplaced IUD (22.3%). Complications observed were intra uterine device migrated in to the bladder (1 case), in the abdomen (10 cases), in the ovary (2 cases) and in the uterine tuba (1 case). Three perforations were done without migration in to surrounded viscera. We used endoscopic surgery among all of them. But in one case we switched endoscopy method in to laparotomy because of important intra peritoneal bleeding to end the management of the patient. No death occurred and mean duration of the stay of hospitalization was 2 days. Conclusion: IUD migration is a scarce event. All the surrounded viscera can be the site of its migration. The management of that complication is usually done by endoscopy method.

关键词： IUD Migration Bladder Pain Endoscopy Surgery Mali

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Maternal and Perinatal Prognosis of the Cesarean at Chu Point G, Bamako, Mali

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1461-1469页

作者： Coulibaly Ahmadou Seydou Z. Dao Cissouma Assétou Sima Mamadou kanté ibrahim Ousmane Mamadou S. Traoré Koné Konimba Diarra Drissa Sissoko Hamadi Théra Thiounkani Traore Youssouf Obstetric Gynecology Department of the University Hospital Center (CHU) Point G Bamako Mali Obstetric Gynecology Department of the Reference Health Center of Commune II Bamako Mali Pediatric Department of Sikasso Hospital Sikasso Mali Obstetric Gynecology Service of the Reference Health Center of Commune III Bamako Mali Obstetric Gynecology Department of the University Hospital (CHU) Gabriel Touré Bamako Mali

Objective: In light of numerous obstetric evacuations to the Point G University Hospital and taking into account the practice of cesarean section for many years in the service, it seemed necessary to us to make our contribution to the study of cesarean section by putting emphasis on maternal and perinatal prognosis in the Obstetric Gynecology Department of the Point G university hospital. Method and materials: We conducted a retrospective cross-sectional study in the Gynecology and Obstetrics Department of the Point G University Hospital, from January 01, 2018 to December 31, 2018. The Point G University Hospital is a 3rd level center of reference in the field of obstetrics in Mali. There is no neonatal ward. The study included all women who gave birth in the gynecology and obstetrics department during the study period. All prophylactic and emergency Caesarean section records during the period in which management took place in the ward were included. The records of patients who had a prophylactic or emergency cesarean section in other health facilities and non-usable records were not included. Data were collected using a pre-established survey form. The variables analyzed were socio-epidemiological, clinical and prognostic. Data were analyzed using IBM SPSS software version 16.00. The Chi2 test and Fischer’s exact test were used to highlight risk factors. The significance level retained was p

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Bacteriology of Healthcare-Associated Infections in the Gynecology and Obstetrics Department of CHU Gabriel Touré

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Open Journal of Obstetrics and Gynecology 2019年第10期9卷 1336-1346页

作者： Amadou Bocoum Seydou Fané Youssouf Traoré Siaka Amara Sanogo ibrahim kanté Aminata Kouma Mamadou Sima Abdoulaye Sissoko ibrahima Ongoiba Soumana Oumar Traore ibrahima Tegueté Maténé Sacko Daouda Camara Alassane Traoré Assitan Wane Niani Mounkoro Amadou Dolo Gynecology-Obstetrics Department of CHU G. Touré Bamako Mali Gynecology-Obstetrics Service of CHU of Point G Bamako Mali Gynecology-Obstetrics Department of CHU of Kati Bamako Mali Gynecology-Obstetrics Service of Referral Health Center of Kati Kati Mali Gynecology-Obstetrics Service of Referral Health Center of Commune V Bamako Mali Gynécology-Obstétrics Department of CHU of Mali Bamako Mali.

Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present nor incubation at the beginning of the care. Objective: The purpose of this work was to study the bacteriology of infections associated with obstetric care in the gynecology-obstetrics department of CHU Gabriel Touré. Patients and Methods: This is an epidemiological, descriptive, analytical study conducted in the gynecology-obstetrics department of the CHU Gabriel Touré, from April 11th, 2016 to August 29th, 2016 (5 months). Data collection focused on the clinical and laboratory characteristics of healthcare-associated infections in patients during their hospitalization. Included in the study were any patients hospitalized in the Gynecology and Obstetrics Department who agreed to participate in the study. The criteria used to diagnose the associated infection were those of the Atlanta CDC. Operative wound monitoring was done up to the 30th postoperative day. Results: We have recorded 200 patients, out of whom 138 were operated on and 23 cases of bacterial infection associated with care (11.50%). The average age of the patients was 32.52 years ± 13.36 years against 29.36 years ± 10.28 years for the patients who did not present the infection. Seven point five percent of the evacuated patients had an infection associated with care. The most common types of infection were surgical site infection (60.86%), urinary tract infection (26.08%), endometritis and sepsis with 13.04% each. The isolated organisms were all resistant to Amoxicillin, to Amoxicillin + Clavulanic acid (88.88%) and to Ciprofloxacin (77.77%). The average duration of hospitalization for patients who developed the infection was 14.70 days. The lethality was 1.50%. The average cost of management of patients who developed the surgical site infection was 119,837 FCFA. Conclusion: The bacterial infe

关键词： Bacterial Infection Resistances Gabriel Touré University Hospital Antibiotics Obstetrics

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PRECESION： progressive recovery and restoration planning of interdependent services in enterprise data centers

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Digital Communications and Networks 2018年第1期4卷 39-47页

作者： ibrahim El-Shekeil Amitangshu Pal Krishna kant Computer and Information Sciences Temple University Philaclelphioa. PA 19122 USA

The primary focus of this paper is to design a progressive restoration plan for an enterprise data center environment following a partial or full disruption. Repairing and restoring disrupted components in an enterprise data center requires a significant amount of time and human effort. Following a major disruption, the recovery process involves multiple stages, and during each stage, the partially recovered infrastructures can provide limited services to users at some degraded service level. However, how fast and efficiently an enterprise infrastructure can be recovered de- pends on how the recovery mechanism restores the disrupted components, considering the inter-dependencies between services, along with the limitations of expert human operators. The entire problem turns out to be NP- hard and rather complex, and we devise an efficient meta-heuristic to solve the problem. By considering some real-world examples, we show that the proposed meta-heuristic provides very accurate results, and still runs 600-2800 times faster than the optimal solution obtained from a general purpose mathematical solver [1].

关键词： Progressive restoration planning Enterprise data center Genetic algorithm Integer linear program Multi-layer networks

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Routine Screening for Cervical Cancer

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Open Journal of Obstetrics and Gynecology 2021年第7期

作者： Alassane Traoré AphouSalléKoné Sima Mamadou Amadou Bocoum Mamadou Bakary Coulibaly Koninba Diabaté Adama Diakité kanté ibrahim Seydou Mariko Idrissa Mama Diarra

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Community-Based Diagnosis for the Improvement of Maternal and Child Protection in the ASACOSEKASI Health Area in the Urban Area of Bamako (Mali)

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2023年第11期

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Operating Site Infections at General Surgery Department of Gabriel Toure Training Hospital

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Surgical Science 2015年第2期6卷 59-64页

作者： Bakary Tientigui Dembélé Alhassane Traoré Adégné Togo Lassana kanté ibrahim Diakité Bourama Diarra Amadou Traoré Madiassa Konaté Boubacar Karembé Yacaria Coulibaly Mamby Keita Souleymane Diallo Souleymane Diallo Gangaly Diallo Faculty of Medicine and Odonto-Stomatology Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Biology and Laboratory CHU Gabriel Touré Bamako Mali

The operating site infections constitute the major postoperative issue in surgery. Our objectives were to determine the hospital frequency, the risk factors, the involved germs as well as the cost generated by the operating site infections. Method: Our three months prospective survey run from September the 1st to November the 30th 2013 has included all department patients being operated on and hospitalized. The criteria have been set by CDC d’Atlanta. Results: 374 files were involved, among them 229 (61.2%) were emergencies and 145 (38.8%) were scheduled. The average age was 41 (extremes 7 and 95 standard deviation 17.46), the sex ratio 1.67. The infective risk according to Altmeier has found 17.5% type 1, 25.1% type 2, 11.2% type 3 and 46.3% type 4;according to NNISS, 96 (25.7) were NNISS 0;94 (51.9%) NNISS 1;80 (21.4%) NNISS 2;and 4 (1.1%) NNISS. In the Altmeier class I have not got antibiotic before infection signs appearances. Our overall rate of operating site infections was 7.9% (29 cases), with 24 (82.8%) emergency cases. According to Altmeier’s class of infective risk, the rate of operating site infections was 1.54% making 1 out of 65 type I patients;4.3% making 4 out of 93 type II patients;11.9% making 5 out of 42 type III patients;10.9% making 19 out of 174 type IV patients. According to NNISS, the infective risk has been assessed and was 2.08% for score 0, we have got 8.25% score 1, and 12.5% for score 2, and 25% for score 3. The bacteriology has been dominated by Escherichia colii(51.7), Proteus mirabilisi(13.8), and Klebsiella pneumoniaei(10.34). The germs have been resistant to the combination Amoxicillin-clavulanic Acid between 50% and 87% of cases. The most active antibiotics on the germs have been Cephalosporin, Polypeptides, and aminoglycosides. The hospital stay has been delayed to 12 days on average by operating site infections, making 2.5 times greater than those uninfected. The infection has increased the cost of management around 600 Euro.

关键词： Infections Operating Sites Bamako

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Diverticular Fistula of the Female Urethra on Lithiasis at the District Health Center (CSREF) in Communeii, Bamako, Mali

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Surgical Science 2019年第3期10卷 83-88页

作者： Tounkara Idrissa Diarra Abdoulaye Traoré Amadou Coulibaly B. Bakary kanté Abdoulaye Dembélé Dabéré Ives Thiam Souleymane Ouattara Kassoum kanté Lassana Konate Madiassa Koné Assitan Ongoiba Oumar Sangaré Modibo Dembélé Bakary Tiètiki Diakité ibrahim Sidibé Yoro Bah Amadou Coulibaly Yakaria Togo Adégné Diallo Gangaly Chirurgie générale du Centre de santé de référence de la commune II de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire de Kati Mali Chirurgie générale Centre Hospitalier Universitaire Gabriel TOURE de Bamako Mali Chirurgie générale du Centre Hospitalier Universitaire du POINT G de Bamako Mali Hopital régional de Gao Mali Hopital régional de Tombouctou Mali

The diverticulum of the female urethra or sub-urethral pouch is in the form of a cul-de-sac lined with mucous membrane through the muscular layer of the urethra. Thus, it is a site of stasis, urinary infection, formation of calculus or even malignant tumor. The diverticula of the urethra or sub-urethral pouches in women have a prevalence of 0.5% to 6% depending on the series. We report the case of a 61-year-old patient operated for a diverticulum on fistulized urethra complicated lithiasis. Our patient had five pregnancies and five births when she consulted for dysuria, urinary burns evolving since a year. The urogenital examination revealed a partially stenotic urethral meatus and a 3-cm large fistulized intravaginal peri-urethral mass allowing urine leak. The mass was painful and hard at palpation. We performed transvaginal diverticulectomy. The follow-up was simple and the probe was removed two weeks after the surgery. An atomo-pathological examination of the resected diverticulum concluded an aspect compatible with lithiasis urethritis.

关键词： Diverticulum Urethral Fistula Lithiasis Bamako

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