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Acute Pneumonia Characteristics in Children under Five Years of Age in Bamako, Mali

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Open Journal of Pediatrics 2019年第1期9卷 7-18页

作者： Fatoumata Dicko-Traoré abdoul Karim Doumbia Mariam Sylla Mariatou Traoré Djènèba Konaté Fatoumata Léonie Diakité Karamoko Sacko Belco Maiga Hawa Diall Oumar Coulibaly Pierre Togo Fousseyni Traoré abdoul aziz Diakité Yacouba Toloba Department of Pediatrics CHU Gabriel Touré Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of Pneumology CHU Point G Bamako Mali

Pneumonia is the most common cause of mortality in child under five years of age. The objective of the study was to assess socio-demographic and clinical characteristics of children under 5 hospitalized for pneumonia. Material and method: We conducted a 6 months prospective study from June 1st, 2016 to December 31st, 2016 in the general pediatric service in the Pediatric Department of Gabriel Touré Teaching Hospital in Bamako, the capital city of Mali. Result: We have selected 63 cases of pneumonia according to our definition criteria, i.e. 2.2% of hospitalizations for children aged 1 to 59 months. The average age was 14 months. Infants under 2 years accounted for 82.53%. The sex ratio was 1.2. Seventy eight percent came from an unfavorable socio-economic background. The majority of mothers were uneducated (71.42%). Breastfeeding was exclusive up to 6 months in 50.79% of patients. Vaccination according to the national program was not up to date in 27% of patients. The average consultation time was 18 days. On admission, 81% of the patients had a fever, 93.64% had a tachypnea and 58.73% had crackling rales at pulmonary auscultation. Hypoxemia was present in 58.73%. Severe anemia was present in 79.36%. Radiologically, opacity was found in 42 patients (66.66%). The blood culture was positive in 8.3%. Beta-lactams were first-line prescribed in all patients. The case fatality rate was 9.52%. The factors associated with mortality were age less than 14 months (p = 0.08), adverse socio-economic conditions (p = 0.0003) and the presence of hypoxemia at the entrance (p = 0.01). Conclusion: Pneumonia remains major cause of morbidity and mortality in our context. Emphasis should be put on preventive measures.

关键词： Acute Pneumonia Children Mortality Mali

Ovarian Pregnancy: A Case Report

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1446-1451页

作者： Hadja Maïmouna Barro Daff Brahima Donigolo Aïssatou Mbodji Khalifa Babacar Mansour Fall Youssoupha Touré Moussa Diallo abdoul aziz Diouf Alassane Diouf Cheikh Anta Diop University of Dakar Gynecological and Obstetrical Clinic Public Institution Aristide-Le Dantec Hospital Da-kar Senegal Department of Obstetrics and Gynecology University Hospital of Pikine Thiaroye Pikine Senegal

Background: Ovarian pregnancy is a rare entity of ectopic pregnancy, with a prevalence in the literature estimated between 1/2500 to 1/5000 births. The majority of ovarian pregnancies are diagnosed in the 1st trimester due to the noisy symptomatology. However, in small proportions, they may continue into the 2nd or 3rd trimester, making their diagnosis more difficult. Aim: We report a case of ovarian pregnancy in a 26-year-old patient, discovered intraoperatively as a large unruptured ovarian mass. Case report: A 26-year-old woman referred to the maternity ward for management of fetal death in utero at 31 weeks of amenorrhea associated with overlying placenta previa. Ultrasound performed in the department, was in favor of an abdominal pregnancy stopped at 31 SA with a placenta that seemed to adhere to the posterior wall of the uterus, which was empty. A Laparotomy was performed, on exploration, a large right ovarian mass was found, the site of the pregnancy. A right adnexectomy, after adhesiolysis, was performed. The incision of the operative part revealed a macerated female fetus. The clinical evolution was favorable. Conclusion: We report on a case of unruptured ovarian pregnancy, discovered in the 3rd trimester of pregnancy. The ultrasound diagnosis of an ovarian pregnancy beyond the 2nd trimester remains a challenge, the management remains surgical.

关键词： Ectopic Pregnancy Ovarian Pregnancy Adnexal Mass

Effect of the Covid-19 Pandemic on Prenatal Consultations for Pathological Pregnancies at the Maternity Unit of Abass Ndao Hospital, Dakar, Senegal

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Open Journal of Epidemiology 2022年第4期12卷 421-430页

作者： abdoul aziz Ndiaye Djiby Sow Nogaye Dieye El Hadji Gueye Boubacar Gueye Alioune Badara Tall Papa Gallo Sow Oumar Sidibe Ousseynou Ka Université Alioune Diop de Bambey Bambey Sénégal Université Cheikh Anta Diop de Dakar Dakar Sénégal Centre Hospitalier Abass NDAO Dakar Sénégal Centre Africain d’Etudes Supérieures en Gestion Dakar Sénégal

Introduction: The COVID-19 pandemic has led to changes in health systems. The objective was to assess the effect of Covid-19 on the frequency of prenatal consultations (PNCs) for pathological pregnancies at the Abass NDAO Hospital Centre. Materials and Methods: This was primarily a retrospective study conducted at the Abass NDAO Hospital maternity ward. The target was the medical records of women followed for a pathological pregnancy at maternity from July 2019 to November 2020. Second, the department’s qualified staffs were asked about their experiences with the Covid-19 pandemic. Data collection was carried out between October 2021 and February 2022. Results: A total of 690 prenatal charts for pathological pregnancy were collected: 375 (54%) before the pandemic compared to 315 during Covid-19 (46%). The average age of women was 28.15 years. The age group 25 and 35 was the most represented (36.81%). Reasons for consultation were dominated by threats of premature delivery (51%), followed by severe pre-eclampsia (14%) and premature membrane rupture (11%), respectively. The frequency of prenatal consultations (PNCs) was inversely related to pandemic dynamics and significant monthly variations were observed. Qualified health personnel were midwives (71.40%) and gynecologists (28.60%). During the pandemic, more than the majority of staff (67%) worked 3 days a week, and 24% of health workers 5 days. The majority of staff (60%) reported experiencing overwork during the pandemic. Non-compliance with consultation days was noted in 38% of health providers. Protective equipment was not provided to 14% of the staff. Staff difficulties during prenatal consultations were fear of occupational exposure (12%) and patient reluctance (88%). Conclusion: The Covid-19 pandemic is having a major impact on prenatal consultations for pathological pregnancies at Abass NDAO Hospital. Effective measures must be taken to avoid the consequences of maternal mortality and the functioning of the s

关键词： Pandemic Covid-19 Pathological Pregnancy

Assessment of Obstetric Evacuations: Received during the Year 2020 at the Touba Ndamatou Public Health Hospital Establishment

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Open Journal of Obstetrics and Gynecology 2022年第6期12卷 528-540页

作者： Babacar Biaye Mouhamadou Wade Daba Diop Abdou Karim Diallo Mor Ndiaye Alioune Diop Awa Ndiaye Mamadou Sene abdoul aziz Diouf Mamour Gueye Université Cheikh Anta Diop Dakar Senegal

The counter-referral system is particularly important for care during pregnancy, childbirth and the post-partum period as it facilitates access to emergency obstetric and neonatal care. It allows people to access care that is not likely to be provided at the base and to manage certain complications arising in emergency settings. We therefore looked at the evaluation of obstetric evacuations from the Touba Ndamatou public health. Methodology: This was a retrospective study of descriptive and analytical type extending over a period of 12 months from January 1, 2020 to December 31, 2020 at the public hospital health establishment (PHHE) of Touba Ndamatou. Results: One thousand five hundred and sixty (1560) patients evacuated for obstetrical reasons were collected out of a total admission of 5560, i.e., a frequency of 28%. The average age of the patients was 25.54 years. The mean gestation was 3.24 pregnancies. The average parity was 3.04 deliveries. Almost all of our patients (99%) were married. Slightly more than one in two women (53.6%) had performed at least 2 or 3 Prenatal consultations. 80% of parturients had traveled a distance of less than 20 km. 623 patients came by their own means (54.6%). Evacuation was provided by an ambulance in 509 patients, i.e., 44.6%. Arterial hypertension and its complications were the frequent reason for evacuations with approximately one in four patients (26.2%). Only 3.6% of patients had qualified personnel on board being evacuated. In our series, 13 deaths were recorded, i.e., 1.1% of cases. The distance traveled seemed not to influence the future of the mother (p = 0.51). The non-accompaniment of the patient during the evacuation by a medical staff seemed to influence the prognosis of the mother (p = 0.031). Fetal morbidity was higher among evacuees not accompanied by medical personnel. The state of apparent death was observed in the majority of cases in patients received over a distance of more than 20 km. Conclusion: Evacuation

关键词： Evacuation Pregnancy Senegal

Study of Antenatal Care Completion Determinant Factors in Kedougou Health District (Senegal)

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Open Journal of Obstetrics and Gynecology 2020年第10期10卷 1449-1470页

作者： Babacar Biaye David Ngom Moussa Ndiaye Fode Danfakha Omar Gassama abdoul aziz Diouf Adama Faye Dembo Guirassi Alassane Diouf Jean Charles Moreau Aristide Le Dantec Teaching Hospital Dakar Senegal kedougou Health District Kedougou Senegal Public Health Department Cheikh Anta Diop University Dakar Senegal Reproductive Health Department/Health Ministry Dakar Senegal

Introduction: Maternal mortality is a public health problem of more concern to developing countries. As part of improving the maternofoetal prognosis during pregnancy and childbirth, it is essential to carry out regular follow-ups of pregnant women (FE) through antenatal consultations (ANC). In fact, the World Health Organization (WHO) recommends at least four ANC at regular intervals during pregnancy. In Senegal the completion rate varies greatly depending on the region. In the District of Kédougou it was 41% in 2017 (DHIS2). The national target was not achieved despite the interventions. Thus we studied the determinants of CPN completion in the health district of Kedougou in 2017. Method: The study is of a descriptive and analytical cross-sectional type and concerned a sample of 884 women who gave birth between October 2017 and September 2018. They were chosen by a sample whose distribution in the district was made according to the quota method while respecting the demographic weight of each area of responsibility of the District. Results: The results of our study showed that the average age of women was 24 years with an average number of pregnancies equal to 3. The ANC completion rate at 37% was lower than the administrative data rate which was 41%. The determinants with a statistically most significant link with the completion of ANC are respectively satisfaction with the care and quality of service, the level of information of women regarding PNC, marital status, affordability and distance from the location of t

关键词： Prenatal Consultation Completion Kédougou

Epidemiological and Clinical Aspects of Abnormal Movements in Children from 2 Months to 15 Years in the Pediatric Department of Gabriel Toure University Hospital Centre of Bamako

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Open Journal of Pediatrics 2022年第1期12卷 170-178页

作者： Karamoko Sacko Djeneba Konaté Amadou Touré Belco Maiga Fousseyni Traoré Adama Dembelé Pierre Togo abdoul Karim Doumbia Andoule Guindo Rokia Togola Oumar Coulibaly Diakite Fatoumata Léonie Francois Ibrahima Ahamadou Kalirou Traoré abdoul aziz Diakité Boubacar Togo Gabriel Toure University Hospital Centre Bamako Mali University Hospital Centre Point G Bamako Mali

Introduction: Abnormal or involuntary movements correspond to a disorder in the programming and/or execution of movement. They have two characteristics;they are hardly or not at all controlled by the will and occur in the absence of any paralysis. Objective: To determine the epidemiological, clinical and etiological characteristics of abnormal (involuntary) movements in children aged 2 months to 15 years. Patients and Methods: This was a prospective, descriptive study from January 2016 to December 2018 of children aged 2 months to 15 years seen in neuropediatric consultations for abnormal movements. Results: During the study period 1920 children were seen in neuropediatric consultations and 57 presented with abnormal movements, i.e. a frequency of 2.96%. Children aged between 6 and 60 months were the most affected (54.4%). The sex ratio was 1.53. Movement abnormality was the most common reason for consultation (45.7%), followed by apyretic convulsions (28%), and laxity (5.3%). The onset was progressive in 68.4% of children. The main types of abnormal movements were chorea (31.6%), dystonia (26.3%), myoclonus (17.5%), tremor in 10.5%. The causes were infectious (73.68%). Conclusion: Abnormal movements are rare in paediatric practice. They have multiple causes and their management is urgent in certain situations that can jeopardise the future of children.

关键词： Abnormal Movements Convulsions Children Bamako

Large Basilar Trunk Aneurysm Discovered Incidentally in a Patient with Ischaemic Stroke: Case Report

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World Journal of Cardiovascular Diseases 2023年第11期13卷 811-817页

作者： Wendlassida Martin Nacanabo Yannick Laurent Tchenadoyo Bayala abdoul Nassir Porgo Emilie Agathe Carama Bademain Jean Fabrice Ido Taryètba André Arthur Seghda Wendlassida Léa Francoise Sawadogo Sidy Mahamoud Guebre abdoul-aziz Christian Napon André K. Samadoulougou Cardiology Department Bogodogo University Hospital Ouagadougou Burkina Faso Rheumatology Department Bogodogo University Hospital Ouagadougou Burkina Faso Neurology Department Bogodogo University Hospital Ouagadougou Burkina Faso

Summary: Many anomalies can be observed in the basilar trunk, such as aneurysms. Basilar trunk aneurysms are rare with a low reported prevalence. In this study, we describe a case of ischaemic stroke revealed by a basilar trunk aneurysm associated with venous thromboembolic disease. The patient was 60 years old and had no specific pathological history. She was seen for a sudden onset of right hemiplegia associated with dysarthria that had been present for 12 hours. The physical examination revealed a pyramidal syndrome and an altered general condition. An emergency cerebral computed tomography (CT) scan showed evidence of a cerebrovascular accident associated with a saccular aneurysm. We adopted the diagnosis of a deep left sylvian stroke associated with a superficial right sylvian stroke in the setting of an incidentally discovered basilar trunk aneurysm. On the 9ème day of hospitalisation, the patient experienced sudden onset of respiratory distress in conjunction with a warm, painful swelling of the right leg. TTE revealed signs of pulmonary embolism, with thrombi in the inferior vena cava and right atrium. Pulmonary embolism was highly probable, with a modified Geneva score of 15. We adopted the diagnosis of DVA complicated by pulmonary embolism in the setting of a basilar trunk aneurysm. The patient was transferred to the cardiology department, where she received oxygen therapy and thrombolysis with streptokinase. The immediate outcome 6 hours later was the sudden death of the patient due to the onset of cardiogenic shock.

关键词： Aneurysm Ischemic Stroke Thrombolysis

Support Epidemiology and Prognosis of Premature Rupture of Membranes in Pikine National Hospital Center

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Open Journal of Obstetrics and Gynecology 2019年第11期9卷 1519-1526页

作者： Moussa Diallo abdoul aziz Diouf Hadja Maimouna Barro Daff Natty Seck Aminata Niass Youssou Toure Khalifa Fall Codou Sene Seck Alassane Diouf Departement of Obstetrics and Gynecology Pikine University Hospital Thiaroye Pikine Sénégal Cheikh Anta Diop University of Dakar Gynecological and Obsetric Clinic Public Institution Aristide-Le Dantec Health Center Dakar Senegal

Premature rupture of membranes (PROM) complicates 3% of preterm pregnancies and occurs in 60% to 80% of term pregnancies. However, its management remains largely controversial. The objective of this study was to establish the epidemiological profile, to study the management and the prognosis of Premature rupture of membranes (PROM) in our practice. Patients and methods: It was a prospective, descriptive and analytical study from May 1st 2016 to January 31st 2017 at the Pikine National Hospital Center. The target population consisted of all patients received at the hospital with premature rupture of membranes and who had given birth in the structure. The variables studied were: marital status, mode and reason for admission;risk factors;antecedents;prenatal care;the clinical and paraclinical examinations;support and immediate maternal and fetal neonatal complications. Results and comments: The mean maternal age was 27.34 years and the majority of women were aged between 18 and 39 years (94.4%). Fifty-one point three percent of patients were primiparous, large multiparous represented only 2.5%. The majority of patients (385 patients or 66.9%) had consulted in the first 12 hours following the onset of fluid flow. For 20.1% of them this flow was associated with uterine contractions. Hidden risk factors were dominated by the twin pregnancy. The blood count showed that 38.8% of patients had leukocytosis and CRP was positive in 18.3% of patients. An ampicillin-based antibiotics was established in 42.6% of cases, corticosteroid therapy in 5.2% and 1% in tocolysis. An expectation was adopted in 65.7% of cases, induction of labor in 7.3% and a cesarean section immediately in 27% of cases. In total, 65.7% of patients had vaginal delivery and 34.3% cesarean. The perinatal mortality rate was 3.6% or 22 newborns on 610. Two cases of endometritis were observed and one case of immediate postpartum hemorrhage. No maternal deaths were recorded. Conclusion: These results show that the

关键词： Premature Rupture of Membranes Childbirth Stillbirth Chorioamnionitis

Assessment Postpartum Glucose Status among Women with Gestational Diabetes: Experience of a Sub-Saharan African Endocrinology Department

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Journal of Diabetes Mellitus 2020年第3期10卷 124-131页

作者： Ngoné Diaba Diack Aminata Mbaye Nafy Ndiaye Yakham Mohamed Leye abdoul aziz Diouf Mamadou Ba Khadidja Samb Papemomar Guisse abdoulaye Leye Alassane Diouf Endocrinology-Diabetology Department Teaching Hospital of Pikine Dakar Senegal Obstetrics and Gynécology Department Teaching Hospital of Pikine Dakar Senegal

Background: Women with gestational diabetes mellitus (GDM) have a significantly increased risk for developing type 2 diabetes after delivery. The purpose of this study was to determine the postpartum glycemic status among women with GDM in an Endocrinology-Diabetology department in Sub-Saharan Area. Methods: It was a prospective cohort study conducted between January 1, 2013, and July 31, 2018 (over period of 5 years and 7 months) at Pikine National Hospital, Dakar, Senegal. Postpartum glucose status was evaluated at least 6 weeks post-partum among women with history of GDM according to IADPSG criteria. The glycemic status after delivery was pointed referring to 2006 WHO criteria. Results: Overall 53 patients were included in this study. Fasting plasma glucose was performed as a screening test in 94% of the cases. A type 2 diabetes after GDM as diagnosed in 6 patients, accounting for a prevalence of 11.32%. An Impaired Fasting Glucose (IFG) was revealed in 5 patients (9.43%). The patients underwent a screening test in the first year after delivery in 54.70% of the cases, over a half of whom during the post-partum period range from the 6th to the 12th week. Insulin usage during pregnancy was statistically correlated with the occurrence of postpartum diabetes. Conclusion: Diabetes prevention and early diagnosis require a glycemic status monitoring among women with history of GDM.

关键词： Gestational Diabetes Mellitus Postpartum Glucose Status Type 2 Diabetes Africa IADPSG