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Neonatal Mortality in Rural Area in Senegal

Open Journal of Pediatrics 2022年第2期12卷 325-331页

作者： Aliou Mar Coundoul Amadou Sow Modou Gueye Djibril Boiro Fatou Ndiaye Guilaye Diagne Aminata Mbaye Awa Kane Mohameth Mbodj Khadim Bop Serigne Tawa Ndiaye Papa Souleye Sow Ndeye Fatou Sow Mame Aita Seck Mohamed Fattah Papa moctar Faye Amadou Lamine Fall Ousmane Ndiaye Albert Royer National Hospital Center Dakar Senegal Abass Ndao Hospital Center Dakar Senegal

Most newborn deaths occur in two regions of the world, South Asia and sub-Saharan Africa. In Senegal, much progress has been made over the past two decades with a reduction in overall infant mortality by 38%. However, the decline in neonatal mortality has been slower during the same period. The objective of this study is to assess neonatal mortality, to determine the different causes and to make recommendations for improving care in rural areas. This is a retrospective study with a descriptive and analytical aim carried out in the pediatrics department of the Diourbel regional hospital, 130 km from Dakar, the Senegalese capital, over a 12-month period from January 1 to January 31, December 2018. All newborns hospitalized in the pediatric ward during the study period were included. Overall mortality was 30.6%, newborns between 0 and 7 days accounted for 90.6% of deaths, INBORNs accounted for 62.3% of deaths. Newborns whose mother’s age was between 20 and 35 years of age accounted for 69.3% of deaths. Newborns of first-time mothers accounted for 40.2% of deaths and those of multiparous mothers 31%. Newborns who did not reach term accounted for 58.9% of deaths. Newborns admitted for respiratory distress represented the majority of deaths 45.5% (n = 93) followed by those with low birth weight 32.5 (n = 65) followed by those with neurological manifestations 30.5 (n = 62). Conclusion: Neonatal mortality is very high in the Diourbel region and the main cause is the lack of human resources and a very insufficient technical platform. The fight against this mortality involves improving the technical platform and recruiting sufficient and well-trained staff.

关键词： Mortality Neonatal Rural Area Senegal

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Appendicular Abscess: Epidemio-Clinical and Therapeutic Aspects in the General Surgery Department of the Reference Health Center of Commune III (*** CIII) of the District of Bamako

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Surgical Science 2023年第2期14卷 77-83页

作者： Karembé Boubacar Tounkara Idrissa Diarra Issaka Soumaré Modibo Dianguina Traoré Boureima Sanogo Seydou Diallo moctar Camara Aboubacar Touré Aboubacar Coulibaly Abdoulaye Fall Ibrahim Diakité Mané Diarra Mouminy Diarra Drissa Traoré Abdoulaye Coulibaly Yacaria Kanté Lassana Dembélé Bakary Tientigui Togo Adégné Départment of Surgery CHU Gabriel Touré Bamako Mali

Objectives: The main goal of this study is to determine the hospital frequency of appendicular abscess, to describe the diagnostic and therapeutic aspects and to analyze the postoperative follow-up. Methodology: This was a descriptive and analytical prospective study from January 1, 2020 to June 30, 2021 including patients admitted to our department for appendicular abscess diagnosed pre- and or intraoperatively and confirmed to histology. Results: We collected 30 appendicular abscesses that accounted for 18.75% of emergency interventions. The 16 - 25 age group was the most represented at 53%. The average age was 24 years with extremes of 10 and 58 years. The male sex was mostly represented (60%) with a sex ratio of 1.5. The majority of our patients were students (53.3%). The main clinical signs found were abdominal pain and vomiting (100%). The pain was localized in the Right Iliac Fossa (RIF) in 80% of cases. Fever was present in all our patients with a temperature between 38˚C and 38.5˚C. The physical examination found pain with defense of the right iliac fossa in 93.3% of cases. A painful mass was present in 27 patients (90%). Treatment consisted of appendectomy with abscess drainage in all patients. Postoperative follow-up was simple in 83.3% of cases;we recorded three cases (10%) of parietal suppuration, one case of fistula (3.3%) and one death. Conclusion: Appendicular abscess is a medical-surgical emergency frequent surgery in our context because of the delay in diagnosis. It is a condition with low morbidity and mortality subject to early diagnosis and prompt and appropriate treatment.

关键词： Abscess Appendix Surgery

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Kidney Damage during Sharp’s Syndrome: About Two Cases

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Open Journal of Nephrology 2020年第4期10卷 290-297页

作者： Saharé Fongoro Seydou Sy Magara Samaké Hamadoun Yattara moctar Coulibaly Aboubacar Sidiki Fofana Brahima Dégoga Atabième Kodio Eyram Yoan Makafui Amekoudi Djénèba Diallo Djénéba Maiga Aboudou M. Dolo Moustapha Tangara Nouhoum Coulibaly Kalilou Coulibaly Ibrahima Koné Nephrology and Haemodialysis Department of the University Teaching Hospital of Point-G Bamako Mali Faculty of Medicine of Bamako Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital in Kayes Kayes Mali Nephrology Unit of the Mali GAVARDO Hospital Bamako Mali Nephrology Unit of Sikasso Hospital Sikasso Mali Nephrology Unit of Somino DOLO Hospital in Mopti Mopti Mali

Context: The coexistence in the same patient of a mixed connectivitis or Sharp’s syndrome is a rare eventuality. Objective: To underline the presence of this mixed connectivitis in our practice, whose prevalence remains unknown, particularly in Africa and more precisely in Mali. Case Presentations: We report two cases of Sharp’s syndrome in a 48-year-old man and a 40-year-old woman with impaired renal function. The picture achieved associated massive proteinuria, hypoalbuminemia, moderate renal failure and edematous syndrome in men. In women, the picture was associated with accelerated to malignant hypertension and severe renal failure. There were no osteoarticular manifestations and the diagnosis of Sharp’s syndrome was based on the presence of high levels of antibodies to U1RNP. Therapeutic management has been that of predominantly associated connective tissue disease (systemic lupus erythematosus). Conclusion: Mixed connectivitis or Sharp’s syndrome is increasingly recognized as a separate entity thanks to advances in molecular biology. Its prevalence is low in sub-Saharan African countries with renal disease that manifests itself as proteinuria or nephrotic syndrome associated with microscopic hematuria, renal failure, and hypertension. This renal impairment is more likely to occur in severe forms of the disease.

关键词： Sharp Syndrome/Mixed Connectivitis Renal Failure Mali

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Primary Immune Deficiencies (PID): Diagnosis Challenges

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Open Journal of Pediatrics 2021年第3期11卷 388-392页

作者： Indou Deme/ly Awa Kane Mame Sokhna Gueye Ibrahima Diop Mame Tene Ndiaye Abou Ba Idrissa Demba Ba Babacar Niang Aliou Thiongane Yaay Joor Dieng Yaye Fatou Mbodj/Diop Ouafae Achnin Papa moctar Faye Amadou Lamine Fall Ibrahima Diagne Tandakha Ndiaye Dièye Ousmane Ndiaye Albert Royer National Children’s Hospital Center Université Cheikh Anta Diop Dakar Senegal National Blood Transfusion Center Dakar Senegal Health Science Unit Gaston Berger University Saint -Louis Senegal

Background: Primary Immune Deficiencies (PID) are rare, under-determined diseases particularly in sub-Saharan Africa. The diagnosis is often suspected with uncommon clinical signs. Infections are the main diagnostic circumstances in infants. Confirmation is often difficult because some additional examinations are unavailable in many of our countries. Aim: Our aim was to share the challenge of diagnosis and treatment in PID. Case Presentation: It is about two infants, a boy and a girl, with early several infections. Both of them presented a hypo-gammaglobulinemia and to the boy, the immuno-phenotyping lymphocyte showed a decreased level of lymphocytes CD19. We are looking for genetic confirmation but it is not easy. The treatment of these infants requires a substitution for life of immunoglobulin which is unavailable in our countries. Conclusion: PID are suspected with atypical clinical signs. Confirmation genetic diagnosis is difficult in low income countries. To improve the follow up, we need to strengthen clinical-biological collaboration.

关键词： Primary Immune Deficiencies Hypo-Gammaglobulinemia Infants

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Ultrasound Pulse Elastometry: Assessment of One Year’s Practice in the Hepato-Gastroenterology Department of the Saint Camille Hospital in Ouagadougou

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Open Journal of Gastroenterology 2024年第11期14卷 379-385页

作者： Kounpiélimé Sosthène Somda Lawagoulé Joseph Emile Ky Constant Lawrence Coudjo Johnson Stella Line Emmanuella Paré Ben moctar Abdou Djibo Toussaint Vébamba Abraham Ouédraogo Fanta Ousseini Mamadou Sarifou Diallo Sandrine M. O. B. Héma/Soudré Aboubacar Coulibaly Arsène Roger Sombié Department of Gastroenterology Yalgado Ouedraogo University Hospital Ouagadougou Burkina Faso Department of Medicine Joseph KI-ZERBO University Ouagadougou Burkina Faso Department of Gastroenterology Fada NGourma Regional Hospital Fada NGourma Burkina Faso Department of Gastroenterology Donka National Hospital Conakry Guinea Faculty of Health Sciences and Techniques Gamal Abdel Nasser University Conakry Guinea Department of Gastroenterology Tengandogo University Hospital Ouagadougou Burkina Faso

Aims: To review one year of ultrasound impulse elastometry in a hospital in Ouagadougou. Patients and Method: This is a retrospective descriptive study of data from one year’s use of impulse ultrasound elastometry. Ultrasound impulse elastometry was performed using the FibroScan® COMPACT 530. Fibrosis was considered significant when E (hepatic elasticity) ≥ 7.2 kPa (F2 fibrosis). The test was considered valid when the IQR/Median ratio ≤ 30% and there were at least 10 valid measurements. Results: A total of 1911 patients underwent FibroScan®. There were 1079 men, giving a sex ratio of 1.3. The mean age of the patients was 37.9 ± 12.2 years. The indication for FibroScan® was hepatitis B virus infection in 89% of cases. The validation criteria for FibroScan® were met in all patients. The mean value for elasticity was 7.9 kPa and for steatosis 212 dB/m. Fibrosis was non-significant in 75.5% of cases. More than half of our patients (56.7%) didn’t have steatosis, 24.8% had mild steatosis, 12.4% had moderate steatosis and 6.1% had severe steatosis. Conclusion: Ultrasound pulse elastometry plays an important role in monitoring chronic liver disease. It allows non-invasive diagnosis of hepatic fibrosis and steatosis. In our context, however, access to the test is limited by its availability only in large urban centers, and by its cost.

关键词： Pulse Elastometry Hepatic Fibrosis Steatosis Non-Invasive Evaluation of Fibrosis Africa

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Factors Associated with Children’s Death Due to Congenital Heart Disease in Two National Hospitals of Niamey

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International Journal of Clinical Medicine 2024年第11期15卷 502-511页

作者： M’baye Salissou Seck M’baye Samaila Aboubacar Kamaye Moumouni Abdou Siddo Hadjara Garba Moumouni Adehossi Irene Abdoul Djafar Mamoudou Tsague Kengni Hermann Nestor Amadou Douada Issoufou Alzouma Maliki Abdoulaye moctar Mianroh Hybi Langtar Laouan Hamidou Ngo Yon Laurence Carole Guindo Aissata Ndobo Valerine Siddikatou Djibrilla Touré Ali Faculty of Health Sciences Andr Salifou University of Zinder Zinder Niger Faculty of Science of Health Abdou Moumouni University Niamey Niger Faculty of Medicine and Science Pharmaceuticals University of Douala Douala Cameroon General Reference Hospital in Niamey Niamey Niger Pedagogical and Research Unit Mohamed V University Rabat Morocco Faculty of Health Sciences Adam Barka University of Abeche Abeche Chad Faculty of Health Sciences Dan Dicko Dankoulodo University of Maradi Maradi Niger Point G Hospital Center Bamako Mali Faculty of Medicine and Biomedical Sciences of Yaound 1 Yaound Cameroon Faculty of Health Sciences University of Buea Buea Cameroon

Introduction: Congenital heart disease is a major cause of children’s death. In Niger, despite the frequency of these pathologies, very few studies have been carried out on associated mortality in a paediatric environment. The objective of this work was to look for the risk factors of children with congenital heart disease’s death in Niamey. Patients and Method: It is about a cross-sectional study for descriptive and analytical purposes in children aged from 0 to 15 years. Carriers of congenital heart disease followed from January 2016 to July 2021 in two national hospitals in Niamey. The variable depends and the main ante was the occurrence of deaths (yes or no). The explanatory variables were related to the characteristics of the patients, the type of heart disease and management among others. Chi’s tests2 Pearson’s or Fischer’s exact test were used (P Results: During the period of the research, 514 cases of congenital heart disease were studied, including 132 deaths (25.68%). The average age of patients was 14.64 months [10 days - 15 years]. The sex ratio was 1.08. The most common reason for consultation was respiratory distress that was found in 74.90% of patients. Interventricular communication (IVC) and intear communication (CIA) were the most found type of heart disease with 36.53% and 20.44% of cases respectively. Only 9.54% of patients (n = 48) had received surgical management. The risk factors associated with mortality were pulmonary arterial hypertension (54.17%), pulmonary disease (44.55%) and the presence of anemia (63.16%) [OR > 1;p Conclusion: Congenital heart diseases remain an important cause of death among children in Niger. The pulmonary arterial hypertension and the associated comorbidities such as broncho-pulmonary diseases were the main associated factors. In the meantime, an optimal technical management of these factors will help to reduce this mortality.

关键词： Congenital Heart Disease Associated Factors to Lethality Niger

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Migration of a Progestin Implant into a Pulmonary Artery: Observation of a Case at the Reference Health Center of Commune III of the District of Bamako in Mali

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Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1431-1436页

作者： Hamady Sissoko Souma Kodio Hamidou Albachar Cheickna Sylla Salif Diarra Sidy moctar Diakité Mohamed Traoré Souleymane Traoré Ibrahim Fomba Ouncoumba Diarra Nana Bah Drissa Diarra Mahamoudou Coulibaly Bocary Sidi Koné Hawa Samaké Ahmadou Coulibaly Mamadou Traoré Seydou Z. Dao Sitapha Dembélé Samou Diarra Konimba Koné Alou Samaké Sanogo Siaka Amara Reference Health Centre of Commune III of the District of Bamako Bamako Mali Department of Gynecology and Obstetrics Gabriel Toure University Hospital Center in Bamako Bamako Mali Department of Gynecology and Obstetrics Kalaban Coro Reference Health Centre Bamako Mali Mohamed VI Perinatal Clinic Bamako Mali Reference Health Centre of Commune V of the District of Bamako Bamako Mali Point-G Obstetrics and Gynecology Department of University Hospital Center Bamako Mali Reference Health Centre of Commune II of the District of Bamako Bamako Mali H Department of Gynecology and Obstetrics of the Fousseyni Daou Hospital in Kayes Kayes Mali Reference Health Centre of Commune VI of the District of Bamako Bamako Mali

It was a 36-year-old patient, 5th Pregnancy, 5th Delivery, 4 live children, and I deceased, had a consultation in the department for the removal of implants. Questioning revealed that she had had the implant three years ago without medical follow-up. It was in view of the difficulties in extracting the capsule that the chest X-ray and CT scan carried out concluded that the implant had migrated into a branch of the left pulmonary artery. Therapeutic abstention has been the attitude of cardiovascular surgeons.

关键词： Migration Implant Pulmonary Artery Bamako

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Acute Renal Failure Secondary to Paracetamol Intoxication: A Case Report

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Open Journal of Nephrology 2022年第3期12卷 235-240页

作者： moctar Coulibaly Magara Samaké Konaré Samba Fofana Aboubacar Sidiki Ossil Ampion Marc Batcho Jimmy Mansour Janette Seydou Sy Hamadoun Yattara Atabième Kodio Djénéba Maiga Sah Dit Baba Coulibaly Djénèba Diallo Aboudou M. Dolo Moustapha Tangara Nouhoum Coulibaly Kalilou Coulibaly Ibrahima Koné Saharé Fongoro Nephrology Unit of Mali GAVARDO Hospital in Sebénicoro Bamako Mali Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Nephrology Department of the Soissons Hospital Soissons France Nephrology and Hemodialysis Department of the UHC du Point G Bamako Mali Faculty of Medicine of Bamako Bamako Mali Nephrology Unit of Sikasso Hospital Sikasso Mali Nephrology Unit of Somino DOLO Hospital Mopti Mali

Renal damage secondary to paracetamol intoxication is rare, estimated between 1% and 2% of intoxication cases. Its pathophysiology is still debated, the clinical involvement consisting in an acute tubular necrosis with a good prognosis if it is rapidly treated. Renal damage can sometimes occur without prior hepatic damage, and the onset of renal manifestations is generally between the 2nd and 7th day after taking paracetamol. If its management remains exclusively symptomatic, its late onset can sometimes lead to serious metabolic complications. It is therefore important to systematically monitor renal function following paracetamol drug intoxication. We report the case of a 60-year-old male subject hospitalized for the management of voluntary drug intoxication (VDI) with paracetamol complicated by acute hepatocellular failure and acute renal failure. His management required extrarenal purification (hemodialysis) and the evolution was favorable with recovery ad integrumof renal function. Conclusion: Although less known and of unelucidated physiopathology, nephrotoxicity secondary to voluntary drug intoxication with paracetamol is a reality and can lead in extreme cases to the use of extrarenal purification technique (hemodialysis).

关键词： Acute Renal Failure Paracetamol Intoxication Hemodialysis

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异常血常规结果分析在疟疾诊断中的价值

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智慧健康 2021年第34期7卷 25-27页

作者：刘文雄邱明好毛远科莫善颖罗国兰赖军华蒋利君 Dr Chaibou Salaou Ali Chaibou moctar Abdel Salam Boukary Saiba 柳州市工人医院医学检验科广西柳州545005 柳州市工人医院感染科广西柳州545005 贺州市人民医院口腔科广西贺州542899 柳州市工人医院重症监护科广西柳州545005 中国援建尼日尔综合示范医院检验科尼日尔尼亚美

目的利用BC-5300血液细胞分析仪检测的异常结果报告及异常散点图信息进行初步筛查疟原虫感染。方法中国援建尼日尔综合示范医院2020年7月-12月就诊病例300例,根据血常规异常报警的信息分组,对A组150例血常规结果或散点图出现异常的样本... 详细信息

目的利用BC-5300血液细胞分析仪检测的异常结果报告及异常散点图信息进行初步筛查疟原虫感染。方法中国援建尼日尔综合示范医院2020年7月-12月就诊病例300例,根据血常规异常报警的信息分组,对A组150例血常规结果或散点图出现异常的样本和B组150例血常规结果及散点图无异常的样本分别进行涂片、染色,显微镜下查找疟原虫。结果对A、B两组患者血液涂片进行光学显微镜下疟原虫观察,显微镜下观察到疟原虫,结果为阳性;未观察到疟原虫结果为阴性,A组患者中显微镜下找到疟原虫139例,阳性率为92.66%(139/150),B组患者中显微镜下找到疟原虫5例,阳性率为3.33%(5/150),A组患者疟原虫发现率明显更高于B组患者(P<0.05)。结论在疟疾高流行的尼日尔,对BC5300血细胞分析仪的异常结果进行分析联合血涂片染色镜检对疟疾进行快速、及时地筛查与诊断具有一定的价值,准确率高,在援外医疗的具体工作中值得推广。

关键词：异常血常规血涂片疟原虫

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血细胞直方图联合血液涂片分析在疟疾诊断中的应用

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分子诊断与治疗杂志 2023年第9期15卷 1587-1590页

目的探讨BC⁃5300型血液细胞分析仪的血细胞直方图联合血液涂片显微镜下检测疟原虫的方法。为中国援建尼日尔综合示范医院在疟疾的诊断提供参考依据。方法选取450例样本,按血常规白细胞直方图是否异常以及发热情况分为A、B、C三组(发热患... 详细信息

目的探讨BC⁃5300型血液细胞分析仪的血细胞直方图联合血液涂片显微镜下检测疟原虫的方法。为中国援建尼日尔综合示范医院在疟疾的诊断提供参考依据。方法选取450例样本,按血常规白细胞直方图是否异常以及发热情况分为A、B、C三组(发热患者,体温>38℃,且血常规白细胞直方图有异常表达或结果有异常报警信息为A组;非发热患者,体温0.05)。结论应用BC⁃5300型血细胞分析仪联合血液涂片显微镜检测疟原虫的方法能够对疟疾进行简便、快速的诊断,特别在疟疾的高发流行区域更具临床意义,值得在援外医疗工作中应用和推广。

关键词：血细胞直方图血涂片疟原虫

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