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

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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Screening in the Birth Room of Parturients with Unknown Human Immunodeficiency Virus (HIV) Serological Status at the Reference Health Center of Commune IV of the District of Bamako

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Open Journal of Obstetrics and Gynecology 2022年第3期12卷 181-192页

作者： Amaguiré Saye Seydou Mariko Nanko Doumbia Dessé Diarra Sirima Diarra Mariam Tangara Brahima Dembélé Niani Mounkoro sounkalo dao Department of Gynecology and Obstetrics of the Reference Health Center of Commune IV Bamako Mali Gynecology Department of Mali Bamako Hospital Bamako Mali Department of Medicine and Endocrinology of Mali Bamako Hospital Bamako Mali Department of Gynecology and Obstetrics at the Center Hospitalier Universitaire (CHU) Gabriel TOURE Faculty of Medicine and Odontostomatology Bamako Mali Department of Infectious Diseases at the University Hospital Center (CHU) Point G Faculty of Medicine and Odontostomatology Bamako Mali

Introduction: In order to prevent the vertical transmission of the Human Immunodeficiency Virus (HIV), it is essential that pregnant women must know their HIV serological status. Objective: To determine the proportion of parturients with unknown Human Immunodeficiency Virus (HIV) status in the delivery room and to identify the associated factors. Methods: We conducted a prospective descriptive study carried out at the Reference Health Center of Commune IV in the district of Bamako from July 1, 2017 to July 1, 2018. The sample size was 267 parturients. The word processing was carried out on World software from the 2016 office suite at the end of the data entry and analysis was carried out on the IBM software, SPSS version 22.0. Results: A total of 267 women were eligible for our study, among which 14 parturients were seropositive, i.e., a proportion of 5.2% of cases. The knowledge of parturients on HIV was 95.5% of cases, but more than half did not know the mode of mother-child transmission. Unschooled parturients were the most represented with 41.2%. Conclusion: In view of the large proportion (5.2%) of HIV-positive parturients in our study, voluntary screening activities in the delivery room remain necessary for the future of children born to HIV-positive mothers.

关键词： HIV Screening Parturients Delivery Room

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Pulmonary and Extra-Pulmonary Tuberculosis: Epidemiological and Diagnostic Aspects at Sominé DOLO Hospital in Mopti

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Journal of Tuberculosis Research 2021年第1期9卷 63-71页

作者： Dramane Samake Modibo Coulibaly Mamadou Sayon Keita Mamoutou Dembele Aboubacar Sidiki Traore Damissa Samuel Coulibaly Oumar Guindo Madou Traore Bakary Sayon Keita sounkalo dao Infectious Diseases and Infectious and Tropical Diseases Research Officer Head of Medicine Sominé DOLO Hospital Mopti Mali Laboratory Department of Medical Biology at Sominé DOLO Hospital Mopti Mali Sectorial Unit to Fight HIV/AIDS Tuberculosis and Viral Hepatitis Bamako Mali Department of Medicine at Sominé DOLO Hospital Mopti Mali Department of Medicine at Nianankoro Fomba Hospital Ségou Mali General Director of Sominé DOLO Hospital Mopti Mali Department of Medicine Sikasso Regional Hospital Sikasso Mali Department of Medicine of the Fousseyni daou Hospital Kayes Mali Head of Infectious Diseases Department at Point G University Hospital Bamako Mali

Despite the efforts made to fight the tuberculosis, Mycobacterium tuberculosis still remains a public health problem, particularly for low-income countries. According to the World Health Organization data, our country, Mali has detected only half of the 10,385 cases of tuberculosis expected for 2014 for a population of 17,309,000 inhabitants. The objective of this present work was to describe the different clinical aspects and the epidemiology of tuberculosis at Hospital Sominé Dolo in Mopti. We performed a retro-prospective and descriptive of tuberculosis cases diagnosed in our department of medicine between May 2016 and August 2018. A total of 96 tuberculosis cases were recorded, i.e. 4.6% and 1.0% for hospitalizations and consultations patterns, respectively. The median of age was 41 with extremes from 5 to 80 years. The age group [31 - 40 years] was the most affected with 20.8%. Men and women were affected in identical proportions, i.e. 50%. Pulmonary locations were the most frequent with 55.2%. Pleural tuberculosis was far the most frequent of the extra-pulmonary forms with 24.0% followed by the peritoneal and bone localization with 6.3%

关键词： Tuberculosis Clinical Aspects Epidemiology Hospital Sominé DOLO Mopti

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Microbiological Assessment and Antimicrobials’ Use in an Infectious Diseases Department in Mali

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Advances in Microbiology 2021年第8期11卷 384-398页

作者： Mikaila Kaboré Issa Konaté Yacouba Cissoko Ibrehima Guindo Bintou Coulibaly Meli Hermine Aboubacar Alassane Oumar Mariam Soumaré Assetou Fofana Abdoulaye Zaré Mohamed Aly Cissé Dramane Sogoba Omar Magassouba Hama Hamidou Issa Fodé Kouyaté sounkalo dao Infectious Diseases Department Point “G” University Teaching Hospital Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Laboratory and Biomedical Research Department National Institute of Public Health Bamako Mali Faculty of Pharmacy University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Laboratory of Biomedical Analysis University Teaching Hospital of Kati Kati Mali Serefo Program University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali

The use of antimicrobials without microbiological proof is frequent and contributes to the emergence of resistance. The aim was to identify the organisms isolated during laboratory examinations and the type of antimicrobials consumed by patients hospitalized to Infectious Diseases’ Clinic. This is a cross-sectional and analytical study, carried out from January 1 to December 31, 2017 in the Infectious Diseases Department of Point “G” Teaching Hospital in Mali. All biological specimens from patients during the study period were analyzed. In total, 322 patients benefited from microbiological test, with a mean age of 40.9 ± 12.2 years (range 15 and 74 years) with a sex ratio of 0.93. Only 5.6% of patients were HIV negative. In all participants, a total of 658 microbiological specimen were taken, 224 (34.0%) identified at least one pathogen including bacteria in more than a half of the cases (58.5%). On the report of bacteriological analysis, the most frequently identified organisms were Mycobacterium tuberculosis (42.2%) mainly in sputum;Escherichia coli (24.2%) and Klebsiella pneumoniae (7.8%) commonly in urine and Gardnerella vaginalis (7.0%) exclusively in vaginal secretions. Candida albicans (5/8) and Cryptococcus neoformans (3/8) were the most common fungi while Plasmodium falciparum (96.4%) represented the parasite frequently found in blood. From a therapeutic standpoint, 1143 antimicrobials were prescribed to 322 admitted patients, i.e. 3.55 anti-infectives per patient. Antibiotics (excluding tuberculosis drugs), antiparasitics and antifungals represented respectively 46.2%;18.8% and 15.1% of anti-infectives. Antibiotic therapy was effective in 274 (85.1%) patients and among them, only 76 (27.7%) cases were based on microbiological evidence. Antibiotics are the most widely used antimicrobials in an infectious disease department. Empiric treatments are common but must be minimized by the search for microbiological evidence.

关键词： Antimicrobial Microbiology Infectious Diseases Mali

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Influence of Age on the Clinical and Prognostic Features of Tetanus in Mali

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International Journal of Clinical Medicine 2021年第3期12卷 77-86页

作者： Mikaï la Kaboré Issa Konaté Yacouba Cissoko Jean Paul Dembélé Mariam Soumaré Assetou Fofana Dramane Sogoba Oumar Magassouba Hermine Méli Abdoulaye Zaré Mohamed Aly Cissé Bintou Coulibaly Hama Hamidou Issa Fodé Kouyaté Japhet Dembélé sounkalo dao Infectious Diseases Department Point “G” University Teaching Hospital Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Serefo Program University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali

Background: The regression of post-vaccination immunity with age exposes elderly subjects to certain infectious diseases, in particular tetanus. The aim was to compare the clinical and prognostic features of tetanus according to the age of patients. Methodology: Analytical study of the files of patients hospitalized for tetanus in the Infectious Diseases Department at Point “G” University Teaching Hospital from 2013 to 2019 with retrospective collection. According to age, three groups of patients were formed: group I (Results: In total, 202 cases of tetanus were recorded or 7.3% of admissions. The mean age was 41.9 ± 15.6 years (range, 6 and 85 years) with a sex ratio of 19.2. According to the age grouping, group II was predominant (79.2%) followed by group III (14.9%) with respective mean ages of 39.2 ± 10.6 and 67.3 ± 6.5 and sex ratio of 39 and 29. Workers (33.3%), farmers (25.8%), traders (19.7%) and drivers (7.1%) represented the most important occupations most at risk. Clinically, bad general condition (p Conclusion: Tetanus is more prevalent in men. Complications and mortality increase with age. It is important to include booster immunization of adults in existing national programs in order to reduce disease-related morbidity and mortality in this age group.

关键词： Tetanus Elderly Clinical Prognosis Mali

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Neuropsychic Disorders Unmasking the Coexistence of Fahr Syndrome and Neuromeningeal Cryptococcosis

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Case Reports in Clinical Medicine 2020年第11期9卷 329-334页

作者： Mikaila Kaboré Issa Konaté Yacouba Cissoko Souleymane P. Coulibaly Jean-Paul Dembélé Assetou Fofana Mariam Soumaré Hermine Méli Dramane Sogoba Oumar Magassouba Adama Sissoko Mohamed Aly Cissé Abdoulaye Zaré Bintou Coulibaly Fodé Kouyaté Moïse Nguemeni sounkalo dao Infectious Diseases Department Point “G” University Teaching Hospital Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali Psychiatry Department Point “G” University Teaching Hospital Bamako Mali Neurology Department Point “G” University Teaching Hospital Bamako Mali Serefo Program University of Sciences Techniques and Technologies of Bamako (USTTB) Bamako Mali

Background: Fahr syndrome associates a set of neuropsychiatric manifestations with bilateral calcifications in the basal ganglia and phosphocalcic disorders. Neuromeningeal cryptococcosis can be present in its manifestations, neuropsychic disorders with or without meningeal signs. The objective was to describe a rare association between Fahr syndrome and neuromeningeal cryptococcosis which can be expressed by the same clinical symptomatology in the context of co-infection with the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV). Presentation: A 37-year-old patient without pathological history, who presented behavioral disorders that led to a fight with those around her and a psychiatric consultation. Then, she was hospitalized in the infectious diseases Department upon discovery of her HIV status and viral hepatitis B. She was logorrheic with behavioral disturbances and subsequently presented with tonic-clonic convulsions. Laboratory tests and imaging have concomitantly discovered Fahr syndrome due to pseudohypoparathyroidism and neuromeningeal cryptococcosis. The correct management of these two pathologies enabled stabilization of the patient’s clinical condition with regular monitoring for HIV-HBV coinfection. Conclusion: Farh syndrome and neuromeningeal cryptococcosis are two different entities but sometimes similar symptoms and risk factors. Treatment of metabolic disorders combined with anticryptococcal therapy improved the prognosis.

关键词： Neuropsychic Disorders Neuromeningeal Cryptococcosis Fahr Syndrome Pseudohypoparathyroidism HIV

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