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Analysis of Maternal Mortality at the Maradi Maternal and Child Health Center/Niger: About 379 Cases

Open Journal of Obstetrics and Gynecology 2024年第9期14卷 1529-1539页

作者： amadou issa abdou Oumara Maina Lankoandé Salifou Zélika Tamo Kailou Azize Moussa Boukari Soumana Diaouga Hamadou Oumarou Garba Souleymane Hassane Rabiatou Nayama Madi Mother and Child Health Center Dan Dicko Dankoulodo University of Maradi Maradi Niger Faculty of Health Sciences General Reference Hospital Abdou Moumouni University of Niamey Niamey Niger Mother and Child Health Center Andr Salifou University of Zinder Zinder Niger issaka Gazobi Maternity of Niamey Faculty of Health Sciences Abdou Moumouni University of Niamey Niamey Niger

Introduction: Pregnancy, childbirth, and their consequences continue to be the leading cause of death, illness, and disability among women of reproductive age in developing countries. In Niger, maternal deaths account for about 39% of all deaths of women aged 15-49. Our aim was to identify the factors linked to maternal mortality in order to contribute to its reduction. Method: this is a descriptive retrospective study of 379 cases of maternal deaths collected at the Maradi CSME from January 1, 2018, to December 31, ***: Our study’s maternal mortality ratio is 2645.72 per 100,000 live births. The mean age of our patients was 27.46 years, with extremes ranging from 15 to 47 years. The 20-24 age group was the most represented, with 88 cases (23.2%). Housewives were 361 (95.3%), and 334 patients (88.1%) were uneducated. There were 261 of them from rural areas, i.e. 69%. The mean parity in our study was 3.46, with extremes ranging from 0 to 15. Multiparous patients 117 cases (30.9%) represented the most significant proportion. Only 42 patients (11.08%) had performed four or more antenatal consultations. Direct obstetric causes accounted for 56.73% of the causes of maternal death. Anemia was the leading cause of maternal death (31.66%). Nearly half of the patients had died before 24 hours after admission, i.e. 49.86%. Conclusion: Maternal mortality remains a significant challenge for developing countries, given its magnitude and timid decline. The fight to reduce maternal mortality must be the priority of our countries’ health policies.

关键词： Maternal Mortality CSME Maradi Anemia

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Emergency Obstetric Hysterectomy in a Low Resources Country: An Eight-Year Retrospective Cohort Study from a Secondary Care Hospital in Niger

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Open Journal of Obstetrics and Gynecology 2024年第10期14卷 1611-1627页

作者： amadou issa abdou Hamidou Soumana Diaouga Zalika Salifou Lankoandé Souley Ibrahim Lailata Maina Oumara Harouna Salifou Jamila Salamatou Guédé Younsou Ganda Moussa Boukari Oumarou Garba Souleymane Hamissou Souley M. Noury Madi Nayama Department of Obstetrics & Gynecology Mother and Child Health Centre Dan Dicko Dankoulodo University of Maradi Maradi Niger Department of Obstetrics & Gynecology Issaka Gazoby Maternity Hospital Abdou Moumouni University in Niamey Niamey Niger Department of Obstetrics & Gynecology Mother and Child Health Centre Andre Salifou University of Zinder Zinder Niger Department of Obstetrics & Gynecology General Referal Hospital Abdou Moumouni University in Niamey Niamey Niger Department of Anesthesia Referal Hospital in Maradi Maradi Niger

Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the incidence, socio-demographic profile of patients, indications, management and maternal-fetal outcomes of EOH in a maternity hospital with limited resources in Niger. Methodology: This was an eight-year retrospective cohort study involving the analysis of medical records from patients who underwent emergency obstetric hysterectomies between 1 January 2015 and 31 December 2022 at the Mother and Child Health Centre (MCHC) in Maradi, Niger. The epidemiological data, indications, and outcomes of EOH were collated and subjected to analysis using the statistical software package SPSS 21.0. Comparisons were made using the Chi-squared test. A p-value of less than 0.05 was considered statistically significant. Results: During the study period, 239 cases of emergency obstetric hysterectomy were recorded out of 269,710 deliveries, representing a frequency of 0.89%. The mean age of the patients was 32.41 years (range: 17 - 50 years). The patients were identified as married (239 cases, 100%), unemployed (228 cases, 95.4%), and not attending school (215 cases, 90%). The largest number of cases were observed in large multiparous women (i.e., those with more than five children), representing 58.6% of the total number of cases (140 patients). The average parity among this group was 6.15 children. The majority of patients (229 patients, 95.82%) had undergone in utero transfer, with 169 patients (70.71%), originating from peripheral maternity units in the Maradi region. Upon admission, 116 patients (48.53%) exhibited active genital haemorrhage, while 58 patients (24.26%) were in shock. The primary indications for hysterectomy were uterine rupture (153 patients, 64%), uterine atony (77 patients, 32.2%), and placental accreta (six patients, 2.5%). Hysterectomy was performed

关键词： Emergency Obstetrical Hysterectomy Postpartum Hemorrhage Maternal Mortality Niger

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Primary Non-Hodgkin’s Malignant Lymphoma of the Uterus at the Reference Hospital of Maradi/Niger: A Case Report

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Open Journal of Blood Diseases 2024年第2期14卷 43-46页

作者： Moustapha Elhadji-Chefou Badé Malam-abdou amadou Djibrilla-Almoustapha Maman Brah Moustapha Oumou Kimso Ibrahim Timi Liman Elhadji Ali issa abdou amadou Borges Moreno Yuribet Facult des Sciences de la Sant Universit Dan Dicko Dankoulodo de Maradi Maradi Niger Hopital de Reference de Maradi Maradi Niger Facult des Sciences de la Sant Universit Abdou Moumouni de Niamey Niamey Niger Facult des Sciences de la Sant Universit Andr Salifou de Zinder Zinder Niger

Malignant non-Hodgkins lymphoma (MHNL) of the uterus is uncommon. We report a case diagnosed on the basis of histologic and immunohistochemical studies of a hysterectomy specimen induced by a very painful pelvic mass in a 50-year-old patient with no previous history of the disease. It was classified as Ann Arbor IV Bb after imaging, given the medullary infiltration and signs of clinical and biological evolutivity: the patient had received two courses of chemotherapy, CHOP protocol. She died 23 days after the second treatment due to a hypertensive crisis.

关键词： Malignant Non-Hodgkin’s Lymphoma Uterus Referral Hospital Maradi/Niger

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High-dimensional supervised classification in a context of non-independence of observations to identify the determining SNPs in a phenotype

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Infectious Disease Modelling 2023年第4期8卷 1079-1087页

作者： Aboubacry Gaye abdou Ka Diongue Lionel Nanguep Komen amadou Diallo Seydou Nourou Sylla Maryam Diarra Cheikh Talla Cheikh Loucoubar Laboratory for Studies and Research in Statistics and Development Gaston Berger University of Saint LouisSenegal Epidemiology Clinical Research and Data Science UnitInstitute Pasteur de Dakar220DakarSenegal African Institute for Mathematical Sciences(AIMS) Senegal Information and Communication Technologies for Development Alioune Diop University of BambeySenegal

This work addresses the problem of supervised classification for highly correlated highdimensional data describing non-independent observations to identify SNPs related to a *** use a general penalized linear mixed model with a single random effect that performs simultaneous SNP selection and population structure adjustment in highdimensional prediction ***,the model simultaneously selects variables and estimates their effects,taking into account correlations between *** nucleotide polymorphisms(SNPs)are a type of genetic variation and each SNP represents a difference in a single DNA building block,namely a *** research has shown that SNPs can be used to identify the correct source population of an individual and can act in isolation or simultaneously to impact a *** this regard,the study of the contribution of genetics in infectious disease phenotypes is of great *** this study,we used uncorrelated variables from the construction of blocks of correlated variables done in a previous work to describe the most related observations of the *** model was trained with 90%of the observations and tested with the remaining 10%.The best model obtained with the generalized information criterion(GIC)identified the SNP named rs2493311 located on the first chromosome of the gene called PRDM16((PR/SET domain 16))as the most decisive factor in malaria attacks.

关键词： Non independence of observations Correlated variables High-dimensional supervised classification SNP Phenotype

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Sexual Violence in the Zinder Region, about 441 Cases in Reference Motherhoods

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Surgical Science 2023年第2期14卷 90-96页

作者： Souleymane Oumarou Garba Zélika Salifou Lankoande Maina Oumara Nabara Ibrahim issa abdou amadou Oumarou Habou Madi Nayama Mother and Child Health Centre of Zinder André Salifou University of Zinder Zinder Niger General Referral Hospital of Niamey Abdou Moumouni University of Niamey Niamey Niger Mother and Child Health Centre of Zinder Zinder Niger Mother and Child Health Centre of Maradi Dan Diko University of Maradi Maradi Niger National Hospital of Zinder André Salifou University of Zinder Zinder Niger issaka Gazobi Maternity of Niamey Abdou Moumouni University of Niamey Niamey Niger

Background: Niger is one of the countries that have the highest fertility rate in the world, with 7, 6 children per woman. Zinder is the most populated region of Niger with 5 million inhabitants that is 1/5 of Niger population. The demographic impact that has affected Niger the last 10 years: unemployment poverty and drug use, spawned violence of all kinds in Zinder region (physical and sexual violence). Sexual abuse is a major risk for poor psychiatric and physical outcomes. As sexual violence has serious consequences on the life and future of women and the community and it concerns our field of intervention, we initiated this study whose objective was to determine the socio-epidemiological and lesional aspects, the consequences and appropriate solutions of sexual violence in the Zinder. Methodology: This was a retrospective collection study of all cases of alleged sexual violence received over a 12-year period from 1 January 2009 to 30 June 2021 in Zinder’s referral maternity wards. Results: During the study period, 441 cases of sexual violence were collected;an annual average of 36 cases (441/12). The frequency is 1.29% on the 34,186 consultations. The mean age was 12.31 years with age extremes of 3 to 43 years. Students accounted for 25.39%. Street vendors were found in 224 cases or 50.79%. The predominant reason for admission is rape in 64.63%. The defloration was 52.15%. Pregnancy was found in 118 cases or 26.75%. HIV serology was positive in 1 victim. School dropout was 26.75%. Conclusion: The victims of sexual violence were minors, mostly street vendors and school children. The lack of means of repression at the time allowed the expansion of this violence. The consequences of sexual violence were severe. Advocacy has improved the phenomen on of sexual violence in Zinder.

关键词： Sexual Violence Zinder Reference Motherhoods Niger

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Abdominal Pregnancy with Hemorrhagic Placenta: About a Case at the Mother and Child Health Center of Zinder

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Surgical Science 2023年第2期14卷 84-89页

作者： Souleymane Oumarou Garba Maina Oumara Zélika Salifou Lankoande issa abdou amadou Hassane Laoul Nabara Ibrahim H. Adamou Madi Nayama Mother and Child Health Center ANDRE Salifou University of Zinder Zinder Niger Reference General Hospital of Niamey ABDOU Moumouni University of Niamey Niamey Niger Mother and Child Health Center Dan Diko University of Maradi Maradi Niger National Hospital of Zinder ANDRE Salifou University of Zinder Zinder Niger issaka Gazobi Maternity ABDOU Moumouni University of Niamey Niamey Niger

Background: In developing countries maternal mortality and morbidity are most often due to the late to consult, poverty and ignorance. Added to this is, the under-medicalization of the health system. The objective of study is to report a case of late consultation and its consequences and make recommendations to improve: case of abdominal pregnancy with hemorrhagic placenta at the Health and Mother Center (CSME) in Zinder/Niger. Clinical Observation: We describe a case of abdominal pregnancy with hemorrhagic placenta in a 24-year-old woman, without profession, resident in the city of Zinder with a low economic level, consulted for abdomino-pelvic pain. She had a notion of amenorrhea for 5 months without any consultation made. She was pale, feverish and had abdominal pain. Ultrasound revealed a 23-week-old fetus and an empty uterus. The diagnosis was abdominal pregnancy. A laparotomy was performed and a The morbidity was hysterectomy and anemia. The postoperative period course was complicated with anemia. The patient was cured on the 9th day with a good vital prognosis. Conclusion: Abdominal pregnancy occurred in a patient who presented a risk factor. Ultrasound was the key diagnostic test. Surgery was the treatment of choice and the prognosis depends on the earliness of the consultation. Community awareness and early consultation with health services can improve the prognosis of abdominal pregnancy.

关键词： Abdominal Pregnancy Hemorrhagic Placenta CSME Zinder

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Northeastern Tropical Atlantic SST and Sahel Rainfall Variability

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Atmospheric and Climate Sciences 2023年第4期13卷 431-454页

作者： Dahirou Wane abdou Lahat Dieng Coumba Niang amadou T. Gaye Laboratoire de Physique de l’Atmosphère et de l’Océan Siméon Fongang Ecole Supérieure Polytechnique Université Cheikh Anta Diop de Dakar (LPAO-SF/ESP/UCAD) Dakar Senegal

The SST variability during the summer period in the northeastern tropical Atlantic region (NTA) is characterized by an alternation of warming/cooling which represents 87% of the total variability. The aim of this paper is to study the atmospheric responses as well as the precipitation associated with these oceanic conditions. Based on Reynolds’s SST from 1982 to 2019, a normalized Northern Tropical Atlantic index (NTAI) is computed into the region between 15° - 25°W;12° - 16°N and a composite analysis is then performed. It is shown that the NTAI is significantly correlated with the SST’s first principal component mode (PC1) in this region. Moreover, the composite of SST anomalies and atmospheric parameters exhibits a strong local ocean-atmosphere interaction which highly impacts the large-scale atmospheric circulation in West Africa, particularly in the western Sahel. An in-depth analysis shows that the atmospheric response to the warm (cold) SST is a cyclonic (anticyclonic) circulation in the lower layers near the West Africa Coast. This cyclonic (anticyclonic) circulation strengthens/reduces the moisture transport towards the continent in the low levels. In the middle layers of the atmosphere (500 hPa), the warm (cold) composite is associated with a decrease (increase) in the intensity of the African Easterly Jet (AEJ) whereas, in the upper atmosphere (200 hPa), the strengthening (weakening) of the Tropical Easterly Jet (TEJ) is observed. With regard to the composite precipitation field, a positive/negative SST anomaly is associated with significantly enhanced/reduced rainfall in the western Sahelian region. It is found that this relationship (correlation) increases as we are closer to the coasts.

关键词： SST-Rain Sahel Rainfall Senegal Rainfall Ocean-Atmosphere Interaction

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Urological Complications of Female Genital Mutilation: A Case Report of 15 Patients

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Open Journal of Urology 2024年第9期14卷 499-506页

作者： Mamadou Tidiani Coulibaly issa amadou Maimouna Traore Falaye Sissoko Dramane Cisse Urological Surgeon at the Urology Department of CHU Gabriel Tour Bamako Mali

Objective background: This was a retrospective study of the clinical and therapeutic aspects of urological complications of female genital mutilation in the urology department of Bamako’s Gabriel Touré University Hospital. Methods: Our study took place from 2002 to 2017 in the urology department of the Gabriel Touré University Hospital in Bamako and concerned cases of complications of female genital mutilation. Our study included all girls or women presenting with urinary disorders related to complications of genital mutilation and received in urological consultation and surgical management. Results: The average age of our patients was 2.5 years, with extremes ranging from 3 months to 35 years. The oldest patient had presented with dystocia during both deliveries. Acute urine retention (n = 7) was the most frequent reason for consultation. Other signs included urinary incontinence, pollakiuria and burning. Physical examination revealed clitoridectomy and abrasion of the labia minora in 13 patients. Type III of the WHO classification of female genital mutilation was the most frequent and corresponded to infibulation.

关键词： Acute Retention of Urine Clitoridectomy Female Genital Mutilation

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Duplication of the Urethra in Boys: A Case Report

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Open Journal of Urology 2024年第6期14卷 353-358页

作者： Mamadou Tidiani Coulibaly Falaye Sissoko Moumine Diarra Adama Toutou Diallo issa amadou amadou Berthé Sory Koné CHU Gabriel Tour Urology Department Bamako University of Science Technology and Engineering Bamako Mali Lafiabougou Reference Health Center Bamako University of Science Technology and Engineering Bamako Mali CHU Gabriel Tour Pediatric Surgery Bamako University of Science Technology and Engineering Bamako Mali Korofina Reference Health Center Bamako University of Science Technology and Engineering Bamako Mali Segou Regional Hospital Bamako University of Science Technology and Engineering Bamako Mali

Supernumerary urethra in boys is a very rare anatomical entity. Sagittal urethral duplications are classified into four groups: epispadias, hypospadias, fusiform and Y-shaped urethra. The most widely used classification is that of Effmann and Lebowitz, which describes 6 types, one of the rarest being the ‘Y’ subtype IIA2, which corresponds to a duplicated urethral path from the vesical neck to an ectopic perineal or anal outlet. We report here the case of a 4-year-old child presenting with subtype IIA2 with a perineal orifice and no other urinary disorders.

关键词： Duplicity Ureter Malformation

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Contribution of Geophysical Prospecting (1D) to Characterize a Precambrian Basement Aquifers Agadez Region (North, Niger)

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International Journal of Geosciences 2023年第11期14卷 1177-1191页

作者： Illias Alhassane abdou Babaye Maman Sani issa Malan S. Souleymane Department of Geology Faculty of Science and Techniques Agadez University Agadez Niger Department of Geology UMR SERMUG Faculty of Science and Techniques Dan Dicko Dankoulodo University Maradi Niger Department of Geology and Environment Faculty of Sciences and Techniques Zinder University Zinder Niger

In the A?r massif, and more particularly in the Iférouane area, the basement is flush. Thus, the essential of water resources is contained in the discontinuous aquifers of basement. Indeed, the weathered and cracked basement is an excellent reservoir of groundwater. The objective of this study is to determine the areas favorable to establishment of productive drilling in the village of Ebourkoum. A methodological approach based on the combination of remote sensing and geophysics methods was implemented. The fracturing map developed highlighted three main accidents of directions N0° - N10°, N30° - N50° and N130° - N140° in the said locality. The geophysical investigation mainly electrical prospecting has allowed to locate structures with high hydraulic potential below alluvium and alterites. Subsequently, drilling will be carried out in the areas retained.

关键词： Fractured Aquifers Electrical Prospecting Basement Remote Sensing Aïr Massif Niger

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