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Screening, Treatment and Control of High Blood Pressure on Five Sites in Mali

World Journal of Cardiovascular Diseases 2024年第5期14卷 322-332页

作者： Mamadou Touré Sagara Ibrahima Youssouf Camara Hamidou Oumar Bâ Ibrahima Sangaré Djénébou Traoré Noumou Sidibé Fousseyni Samassékou Massama Konaté Coumba Thiam Doumbia asmaou maiga Réné-Marie Dakouo Hamidou Camara Sako Mariam Sidibé Samba Adama Sogodogo Boubacar Diarra Boubacar Sonfo Aladji Traoré Mamadou Diakité Ilo Bella Diall Ichaka Menta Departement of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Departement of Cardiology Cardiology University Hospital Sidy Bocar Sall Kati Mali Internal Medecine University Hospital Point G Bamako Mali Departement of Cardiology Cardiology University Hospital &#8220H&#244pital du Mali&#8221 Bamako Mali Departement of Cardiology Cardiology University Hospital Mother-Children Bamako Mali

Introduction: High blood pressure is defined as blood pressure greater than or equal to 140 mm Hg for systolic and or 90 mm Hg for diastolic. It constitutes a major public health problem, the leading chronic disease in the world. The objective was to determine the prevalence, treatment rate and control of hypertension. Methods: This was a cross-sectional and descriptive study which took place over a period of 6 months in a hospital environment and in the general population. Results: Of the 1000 participants, 637 had hypertension, giving a prevalence of 63.70% with a female predominance. Thirty-three percent (33%) were unaware of their high blood pressure. The age group 60 and more was the most represented (44%). A proportion of 33 and 23.20 were overweight and obese participants, respectively. Male subjects were more overweight than female, unlike obesity which was more common among female subjects. Sixty-two percent (62%) of hypertensives were treated, of whom 44% were non-compliant. The excessively high cost and consumption of medications as needed were the main factors in therapeutic non-compliance. Twenty-two percent (22%) of all hypertensive patients and 35% of treated hypertensive patients were controlled. Women were more treated but less observant and less controlled than men. Therapeutic coverage and combination therapy rates were lower in rural areas. Hypertensives who had a high level of education were better treated and controlled than those who had no level. Conclusion: High blood pressure remains a real public health problem in Mali. It is more common in people aged 60 and over and in females. One in three hypertensives were unaware of their hypertension. The majority received antihypertensive treatments, but only a minority of them had their hypertension controlled.

关键词： High Blood Pressure Screening Control Rate Mali

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Screening, Treatment and Control of High Blood Pressure on Five Sites in Mali

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World Journal of Cardiovascular Diseases（心血管病） 2024年第5期 322页

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Prevalence, Pattern and Evolution of Rheumatic Heart Disease: About 120 Cases at Mother-Children University Hospital Luxembourg (MC UHL), Bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第7期8卷 319-327页

作者： Ba Hamidou Oumar maiga asmaou Kéita Doumbia Coumba Thiam maiga Salma Souleimane Sidibé Noumou Sangaré Ibrahima Camara Youssouf Sidibé Salimata Diallo Souleymane Menta Ichaka Diarra Mamadou Bocary CHU Gabriel Touré Bamako Mali CHU Mère Enfant le Luxembourg Bamako Mali CHU Sidy Bocar Sall Kati Mali

Introduction: Acute rheumatic fever (ARF) and its complications including rheumatic heart disease (RHD) remain one of the leading causes of cardiovascular disease worldwide. In our setting with no cardiac surgery, data on RHD are therefore important to point out the need for such structure. In this study, we therefore describe rheumatic disease in terms of prevalence, patients’ characteristics and management of patients. Methods: We performed a retrospective study from May to September 2012, involving children aged 3 to 15 years old and seen at the Mother and Child University Hospital Luxembourg (MC UHL). Included were all children diagnosed with RHD. The diagnosis of rheumatic fever (RF) was defined using the revised Jones criteria from 1992 and RHD defined according to the WHO/NIH joint criteria. Data of interview, clinical examination, complementary and those on evolution were recorded. Results: We found an hospital prevalence of 6.2%. Mean age was 15.33 years ± 6.005 (3 to 36), females representing 54.2% and students 70%. Mitral regurgitation (MR), Mitral Stenosis (MS) and concomitant MR + MS were most found RHD with resp. 43.3%, 15% and 13.3%. Complications occurred in 74.1% before surgery. An operative indication was set in 90% of all cases whereas only 36% underwent surgery. After surgery immediate complications were dominated by anemia (11.6%) and late ones by heart failure in 18.5% of cases. Conclusion: Despite advances in medical diagnostic approach and therapeutical progress which partly explained the relatively high prevalence, the evolution of rheumatic heart disease in our context is unfavorable due to the lack of a surgical management structure. While waiting for a cardiology institute, the focus should be on information and awareness in primary prevention.

关键词： Retrospective Acute Rheumatic Fever Rheumatic Heart Disease Bamako

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Double Discordance with Pulmonary Stenosis: About a Clinical Case

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World Journal of Cardiovascular Diseases 2020年第12期10卷 825-830页

作者： asmaou keit. maiga Boubacar Sonfo Daffé Sanoussi Fofana Daouda Diallo Souleymane Terra Abdoul Wahab Thiam Coumba Ba Hamidou Touré Mamadou Camara Youssouf Mamadou Bocary Diarra Cardiology Department CHU Mère - Enfant Bamako Mali Cardiology Department of CHU Kati Bamako Mali Cardiology Department CHU Gabriel Touré Bamako Mali

Introduction: Double discordance or corrected transposition of the great vessels is a rare congenital heart disease. It is an atrioventricular and ventriculo-arterial mismatch. It is a complex and unusual form of congenital heart disease. Often asymptomatic, in its isolated form, bradycardia, murmur and cyanosis can be a mode of revelation. Case presentation: We report the case of an 11-year-old child, asymptomatic at birth, after he started to have dyspnea on exertion, recurrent bronchitis, motivating a cardiological consultation. On cardiac physical examination, the heart sounds regular, not rapid at 81 BPM with a grade 3-4/6 systolic murmur at the 4th left EIC (Intercostal space). EKG (electrocardiogram) shows PR interval at 0.20 seconds. Cardiac ultrasound reveals atrioventricular discordance, vascular malposition, anterior aorta, the two vessels placed side by side, minimal pulmonary insufficiency, a small leak at the levels of the mitral and tricuspid valves, dystrophic pulmonary valves with an average gradient of 91 mmHg, max at 158 mmHg. Regular follow-up has been recommended through the performance of a clinical examination and cardiac ultrasound. Conclusion: The double discordance can be asymptomatic, and survival can be long in the isolated forms, but the evolution is not always benign, especially in the associated forms. It depends on the function of the systemic right ventricle and associated abnormalities.

关键词： Double Discordance CHU ME Luxembourg Bamako

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Pediatric Hypertension (HTN) Assessed by Various Methods: A Study among Pediatric Inpatients in University Hospital Gabriel Touré(UH-GT)

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World Journal of Cardiovascular Diseases 2020年第3期10卷 144-154页

作者： Hamidou Oumar Ba Youssouf Camara Ibrahima Sangare maiga Belco Diakite Mamadou A. Dembele Fofana Cheick Hamala Toure Mamadou Hamidou Camara Sogodogo Adama Traore Aladji Sidibe Samba Sidibe Noumou Doumbia Coumba Thiam maiga asmaou Kéita Konate Massama Sonfo Boubacar Menta Ichaka Ilo Bella Diall Togo Boubacar Diarra Mamadou Bocary Service de Cardiologie CHU Gabriel Touré Bamako Mali Service de Cardiologie CHU Kati Bamako Mali Service de Pédiatrie CHU Gabriel Touré Bamako Mali Service de Cardiologie du CHU Point G Bamako Mali Service de Cardiologie CHU Mère-Enfant Bamako Mali Service de Médecine Interne et d’Endocrinologie Hôpital du Mali Bamako Mali

Introduction: It is known for decades that a correlation among child blood pressure and adult pressure exist. There are few publications on Hypertension (HTN) in pediatric area. We therefore conducted this study to estimate the extension of HTN among children and looking for associated factors. Methods: Blood pressure was assessed using the references released by the National institutes of health in the United States, those of the French Society of Pediatric Nephrology and z-score. We used the auscultation method with appropriate cuff adapted to the child’s upper arm. We got for each arm 3 blood pressure measures taken children seated or lying on the back and mean blood pressure was calculated and used for the evaluation of the pressure level. The arm with the higher blood pressure was considered for the study. Socio-demographical and clinical data were collected anonymously on a formulary and then inserted in a Microsoft Access Database. Analysis was done using Statistical Package for the Social Sciences (SPSS) software using appropriate tests. Results: The study involved 154 patients (boys:girls = 56.5:43.5) aged 3 to 16 years. Patients of 11 years and older made 57.1% of the sample. Most patients suffered from severe malaria (35.1%, glomerular and heart diseases with respectively 16.2% and 9.1%. The global proportion of hypertensive patients was 27%, 39% and 5.2% respectively based on references of the French society of nephrology, those of the 4th report of the NHBPEP and standard deviation. Looking for associated factors with hypertension the logistic regression found no predictor for hypertension using pressure cut-offs values based on the French society of nephrology and those of the 4th report of the National High Blood Pressure Education Programm (NHBPEP). Conclusion: Children must be checked for hypertension to avoid organ damage and later cardiovascular complications. Blood pressure assessment should be preferably done on outpatients as the role of the st

关键词： Hypertension Pediatric Bamako

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Management of Hypertension (HTN) in a Cardiology Department in Bamako (Mali): Financial Aspects

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World Journal of Cardiovascular Diseases 2019年第6期9卷 394-403页

作者： Hamidou Oumar Ba Ichaka Menta Ibrahima Sangaré Noumou Sidibé Youssouf Camara Souleymane Coulibaly Hamidou Camara Cheick Hamala Fofana Aladji Traoré Adama Sogodogo Mamadou Touré Kéita asmaou maiga Doumbia Coumba Thiam Adama Daou Kassoum Mamourou Sanogo University Hospital Gabriel Touré Bamako Mali University Hospital Sidy Bocar Sall Kati Mali University Hospital Mother Children Bamako Mali National Center for Disease Fighting Bamako Mali

Background: Studies on financial aspects of High blood pressure management are rare and old without differentiating categories of expenses. On the other hand there is an evolution in health system with the introduction of a medical insurance. Objective: We performed this study to estimate costs related to insurance status. Methodology: The prospective study on patients aged 15 years and older extended from 01 May to 31 August 2016 and was carried out in the cardiology department of the University Hospital Gabriel Touré. Only newly detected or untreated hypertensive patients were included. Sociodemographic data, those on physical examination and financial management (transport, consultation, labor tests and purchase of drugs) were collected. Regarding costs, patients were directly asked about: how much did you spend for transport, consultation, labor tests and drugs? Data analysis was carried out by comparing patients with health insurance (Ins+) and those without it (Ins?). The recorded data were inserted in a MS Access database, preliminarily processed by MS Excel and imported to SPSS version 20 for analysis. Results: Mean total cost of care was 57,018 FCFA [50,139 - 63,897] (around 92 USD). It was 50,072 [42,182 - 57,963] for the Ins? group against 79,670 [66,777 - 92,563] for the Ins+ group with a p value 0.0001. Highest amounts for spending were for cardiovascular medication and labor tests with means of 19,255 FCFA (32 USD) and 18,813 FCFA (30 USD). Mean consultation fee was significantly higher for Ins+ patients: 4064 FCFA with IC (95%) [3210 - 4917] versus 3124 with IC (95%) [2774 - 3474] for Ins? patients and p = 0.018. For ECG, however, mean costs were higher for Ins? patients with 6460 [5944 - 6976] against 5115 [4871 - 5360] for Ins+ patients, p = 0.001. Conclusion: Health insurance has few subscribers compared to patients requiring medical care. It increases the global costs of care while facilitating access to care for those who benefit from it.

关键词： Hypertension New Patients Untreated Patients Costs Cardiology Bamako

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Assessment of Common Dental Indices and Need for Periodontal Treatment in the Cardiology Outpatients Unit at the University Hospital Gabriel Touré(UH-GT) in Bamako

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World Journal of Cardiovascular Diseases 2020年第3期10卷 131-143页

作者： Hamidou Oumar Ba Ibrahima Sangaré Youssouf Camara Sidibé Noumou Daou Ousmane maiga asmaou Kéita Touré Mamadou Coulibaly Souleymane Sidibé Samba Konaté Massama Doumbia Coumba Thiam Sonfo Boubacar Diakité Mamadou Menta Ichaka Ilo Bella Diall Ahmed Ba Boubacar Ba Sanogo Kassoum Mamourou Service de Cardiologie CHU Gabriel Touré Bamako Mali Service de Cardiologie CHU Kati Bamako Mali CHU Odontostomatologie Bamako Mali Service de Cardiologie CHU Mère-Enfant Bamako Mali Service de Cardiologie du CHU Point G Bamako Mali Service de Médecine Interne et d’Endocrinologie Hôpital du Mali Bamako Mali

Introduction: Little is known through the literature about dental status of patients seen in cardiology department, motivating this study which aims to assess most dental indices of outpatients and the need for periodontal treatment. Methodology: It was a cross-sectional study from November 2016 to April 2017 in the cardiology outpatient unit of the University Hospital Gabriel Touré (UH-GT) in Bamako. Included were all patients with minimum 24 teeth and willing to be involved in the study. History, cardiovascular parameters and dental examination by a resident in Odontostomatology were performed for each patient. Data were analyzed using SPSS 18, quantitative as means and standard deviation (SD) and categorical as proportions. Khi-2 Test, analysis of variance were applied with a significance level set at 0.05. All patients give their verbal consent after being informed about the procedures in the study. Results: Our sample involved 100 patients (66% female, mean age of 54.12 ± 16.150 and patients ≥ 60 years most represented with 50% for male and 37.9 for female patients. Tooth brush use was practiced by 100% and 98.5% respectively for male and female patients and twice daily brushing by 97.1% of male and 97% of female patients. Brushing duration was less than 3 minutes for 35.3% and 31.8% of respectively male and female patients. Plaque index and calculus index were in the male group with respectively 0.79 and 1.06 for male and 0.63 and 0.79 for female (p = 0.047 and 0.020). Mean Decayed Missed and Filled Teeth (DFMT) index showed a significantly increase from 0.22 in the age group under 30 to 0.68 for that other 60 years. Only 2.9% and 9.1% of respectively male and female patients had community paradontal index for treatment needs (CPITN) classe 0. The need for treatment was TN1 meaning instruction to an oral cavity hygiene, similar for both sex (55.9 and 57.6 respectively for male and female patients) and highest in the age-group 30 - 44 increased to 70%. The need

关键词： Dental Indices Cardiology Outpatients Bamako

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ECG and Echocardiographic Findings of Female Hypertension (fHTN) in the Cardiology Department of the University Hospital Gabriel Touré (UH-GT)

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World Journal of Cardiovascular Diseases 2023年第10期13卷 646-656页

作者： Hamidou Oumar Bâ Ibrahima Sangaré Youssouf Camara Kassim Kamaté Tawoufik Tchedre Georges Rosario Christian Millogo Djénébou Traoré Noumou Sidibé Fousseyni Samassékou Massama Konaté Coumba Thiam Doumbia asmaou maiga Réné-Marie Dakouo Hamidou Camara Adama Sogodogo Boubacar Diarra Mamadou Touré Boubacar Sonfo Aladji Traoré Mamadou Diakité Ilo Bella Diall Ichaka Menta Cardiology University Hospital Gabriel Touré Bamako Mali Cardiology University Hospital Sidy Bocar Sall Kati Mali Cardiology University Hospital Yalgado Ouédraogo Ouagadougou Burkina-Faso Internal Medecine University Hospital Point G Bamako Mali Cardiology University Hospital “H&ocircpital du Mali” Bamako Mali Cardiology University Hospital Mother-Children Bamako Mali

Introduction: In our setting there is a lack of publications on female hypertension in general population motivating this study to look for electro- and echocardiographic findings of female hypertension. Methods: We performed a cross-sectional study during 6 months in the cardiology department of the UH-GT including 324 female patients aged 18 and more seen in the outpatient unit and by whom the diagnosis of hypertension was set. All patients consented to be study participants after receiving clearly information about the study and that care giving will not be affected by their eventual refusal. Data collection has been done with all needed confidentiality rules. A survey formular was used to collect data in order to record them in an Access database. Analysis was done using IBM SPSS software. Quantitative data are presented as mean with standard deviation and qualitative as proportion. Level of significance for statistic test was set at 5%. Results: During the study time 324 among 524 hypertensive patients visited our outpatient unit giving a prevalence of fHTN of 61.8%. The means for age, body mass index (BMI) in female hypertensive patients were respectively 52 ± 14.461 years and 27.35 ± 06.585 Kg/m2. Main ECG findings were left ventricular hypertrophy (LVH) and sinus tachycardia with respectively 93.6% and 46.4% followed by isolated ventricular extrasystole with 33.7%. Echocardiography findings included LVH, relative wall thickness (RWT) and reduced ejection fraction (EF) in respectively 41.05%, 37.35% and 21.91%. The left ventricular mass (LV) mass and geometry were abnormal in 44.4% and 37.3%. Remodeling as geometry modification (18.2%) and mitral flow Type 2 (90.4%) have been the most abnormal findings. Conclusion: Hypertension induced modifications mainly LVH in ECG and Echocardiography in female patients less than encountered among male hypertensive patients.

关键词： Hypertension Female ECG Echocardiography Mali

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Pulmonary Embolism: Epidemiological, Clinical, Therapeutic and Evolution Aspects in the Medicine Department of Hospital of Mali Bamako

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World Journal of Cardiovascular Diseases 2021年第4期11卷 242-248页

作者： Massama Konaté Mariam Sako Boubacar Sonfo Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Coumba Adjaratou Thiam Djenebou Traoré Hamidou Oumar Ba asmaou keit. maiga Ibrahima Sangare Mamadou Toure Souleymane Coulibaly Nouhoum Diallo Bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Youssouf Camara Yacouba Lazare Diallo Nanko Doumbia Mahamadoun Coulibaly Ichaka Menta Faculty of Medicine and Dentistry (FMOS) of the University of Sciences Technique and Technology of Bamako (USTTB) Bamako Mali Medicine Department Hospital of Mali Bamako Mali Cardiology department CHU Point G Bamako Mali Cardiology Department Hospital of Kati Kati Mali Medicine Department Hospital of Tombouctou Tombouctou Mali Internal Medicine Department CHU Point G Bamako Mali Cardiology Department CHU Gabriel Toure Bamako Mali Cardiology Department CHU Mère Enfant Bamako Mali

Background: Pulmonary embolism (PE) is a severe form of venous thromboembolic disease. In Africa, prevalence of PE in hospitalized medical patients varies among studies. Objective: Aim of this work was to study the epidemiological, clinical, therapeutic and evolution aspects of PE in the medicine department of Mali’s Hospital Bamako-Mali. Methodology: This was a retrospective cross-sectional study carried out from January 01, 2017 to December 31, 2020 in the medicine department of Mali’s hospital Bamako, including all inpatients admitted for PE during the study period. Results: Of 1814 hospitalized patients, 54 patients had pulmonary embolism. Hospital frequency of pulmonary embolism was 2.97%. Predominance was female and sex-ratio M/F was 0.38. Mean age in our series was 54.24 ±1.19 years. Predisposing factors to pulmonary embolism were dominated by obesity 37%, high blood pressure 35.2% and history of cardiovascular disease 20.4%. Dominant signs were dyspnoea and chest pain in 83.3% and 70.4% of cases respectively. Probability of pulmonary embolism was high in 40.7% according to Wells score. Patients with right heart failure were 22.2%. EKG showed sinus tachycardia70.4% and S1Q3 aspect 7.4%. Heart right chambers were dilated at transthoracic echography 42.6%. Obstruction was bilateral at chest angio CT for 51.9% and proximal for 42.6%. Deep venous thrombosis was associated at EP in 16.6%. Treatment was low weight molecular heparin followed by vitamin K antagonist or direct oral anticoagulant. One patient was successfully treated by thrombolysis. Hospital mortality was 16.7%. Conclusion: PE is a serious disease probably underdiagnosed. It is responsible of important mortality.

关键词： Pulmonary Embolism Epidemiology Mali’s Hospital

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Double Discordance with Pulmonary Stenosis: About a Clinical Case

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World Journal of Cardiovascular Diseases（心血管病） 2020年第12期

作者： asmaou keit. maiga Boubacar Sonfo Daffé Sanoussi Fofana Daouda Diallo Souleymane Terra Abdoul Wahab Thiam Coumba Ba Hamidou Touré Mamadou Camara Youssouf Mamadou Bocary Diarra

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