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Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

Open Journal of Obstetrics and Gynecology 2024年第5期14卷 855-867页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam MS Ag Med Elméhdi Elansari kassogue djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohinnon Reference Health Center in Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako district Bamako Mali Reference Health Center in Commune V of the Bamako district Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

关键词： Pregnancy High Blood Pressure Prognosis

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Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second Reference Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 509-519页

作者： Samaké Alou Diarra Lasseny Keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté Moussa Maiga Mariam Mohamed Saydi Ag Med Elmehdi Elansari kassogue djibril Seydou Zana Dao Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Collarete Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (BDH) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several ri

关键词： Advanced Maternal Age Childbirth Risk Mali

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Epidemiological-Clinical Aspects of Uterine Leiomyoma at the Reference Health Center of Commune VI of the Bamako District

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 674-681页

作者： Alou Samaké Lasseny Diarra Mamadou Keita Dramane Haidara Mamadou Haidara Coulibaly Soumana Mamadou Diallo Moussa Konaté Mariam Maiga MS Ag Med Elméhdi Elansari kassogue djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly Moussa Mariko Seydou Colette Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Hangadoumbo Moulaye Touré Hospital in Gao Gao Mali Timbuktu Hospital Tomboctou Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Uterine fibroid is a mixed mesenchymal tumor, developing from smooth muscle cells of the myometrium, separated by connective tissue. The majority of fibroids are asymptomatic and do not require any intervention or other exploratory measures. However, in some cases fibroids are symptomatic, their treatment should aim to improve symptoms and quality of life. Objectives: Describe the epidemiological-clinical aspects of uterine fibroids in the gynecology and obstetrics department of the reference health center of commune VI of the Bamako district. Methodology: This was a retrospective descriptive study carried out over a period of one year. It concerns all patients seen in consultation in the gynecology and obstetrics department of the reference health center of commune VI. Results: during the study period, the uterine fibroid frequency was 1.80%. During this same period, fibroids represented 5.59% of gyneco-obstetric pathologies operated on in the department. The 30 - 45 year old age group was the most represented with a frequency of 75.63%. The average age was 36.87 years ± 6.2 years with extremes of 25 and 63 years. Married women were the most represented 97.48%. The vast majority of our patients 95.8% were not postmenopausal. The multigravidas were the most represented, i.e. 37.50% with a large part of the pauciparous 41.29%. In our patients, 96.64% had a clinical symptom on their fibroid with the main reason for consultation being the sensation of a pelvic mass in 97.48%. We recorded three cases of infertility as associated factors. Ultrasound was performed in all patients. The location of the myxomatous nuclei was subserosal in the majority in 42.86% and with multiple nodules in 84.85% of cases. The main indication for myomectomy was the failure of medical treatment in 86.49% of cases. Surgical treatment was mainly a myomectomy 93.30%, a hysterectomy was indicated in 6.70%. No cases of death were recorded. Conclusion: Uterine fibroid is a gynecologic

关键词： Myomas Surgery Myomectomy

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Bart’s Syndrome: A Neonatal Observation about a Case Report

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Open Journal of Pediatrics 2021年第3期11卷 406-412页

作者： Assetou Cissouma djibril kassogue Mala Sylla Guedioma Dembélé Soumaila Alama Traoré Abdoulaye Kissima-Traoré Dadé Ben Sidi Haidara Mamadou Bernard Coulibaly Madou Traore Mady Niakaté Sikasso Hospital Sikasso Region Mali Timbuktu Hospital Timbuktu Region Mali Bougouni Reference Health Centre Bougouni Mali Mali Hospital Bamako Mali Luxembourg Hospital Bamako Mali

Introduction: Bart’s syndrome is a rare neonatal pathology combining congenital skin aplasia affecting the extremities and congenital epidermolysis bullosa, exceptionally described on black skin. Observation: A 2-day-old male newborn was referred for multiple ulcerations of the limbs observed at birth. The clinical examination found an absence of bilateral and symmetrical skin occupying almost all of the two lower limbs with some flaccid bubbles. The vascular network was clearly visible. The rest of the skin coating was normal. The diagnosis of Bart syndrome in connection with epidermolysis bullosa was evoked clinically and despite pediatric and dermatological management, the evolution was rapidly fatal by severe sepsis. Discussion: Bart syndrome corresponds to a clinical picture of congenital skin aplasia associated with congenital epidermolysis bullosa suspected by areas of fragility and sometimes bubbles. All types of congenital epidermolysis bullosa may be associated with this syndrome. The clinical diagnosis is generally easy but the therapeutic management is difficult and the prognosis reserved. Conclusion: Bart syndrome is a curious congenital association of well-defined skin symptoms, the etiopathogeny of which still remains poorly elucidated, hence the difficulty of establishing an antenatal diagnostic strategy or giving appropriate genetic advice.

关键词： Skin Aplasia Congenital Newborn Skin Black

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Clinical and Epidemiological Aspects of Severe Acute Malnourished Children from 6 to 59 Months Hospitalized in a Secondary Hospital in Mali

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Open Journal of Pediatrics 2023年第1期13卷 97-103页

作者： Mariam Maiga Hibrahima Diallo Tati Simaga Mariam Traore Alou Samake Mamadou Diallo Moussa Konate Mamadou Keita Mamadou Traore djibril kassogue Oumou Kone Fatoumata Dicko Hawa G Diall Department of Pediatrics Reference Health Center of Commune VI Bamako MALI Department of Pediatrics CHU Gabriel TOURE Bamako MALI Department of Pediatrics Reference Health Center of Commune V Bamako MALI Timbuktu Regional Hospital Tombouctou MALI National Institute of Public Health Bamako MALI National Institute for Health Science Training Bamako MALI

Introduction: Malnutrition acts on the immune system and thus increases susceptibility to infections. Infections can weaken the body and cause malnutrition, so we speak of a vicious circle between malnutrition and infection. Objective: To study the clinical and epidemiological aspects of severe acute malnutrition in children aged 6 to 59 months. Methodology: This was a prospective and descriptive study extending from July 1, 2018 to June 30, 2019. All severely acute malnourished children aged 6 to 59 months were hospitalized at URENI whose parents or careers accepted their participation in the study. Results: Severe acute malnutrition was diagnosed in 398 of the 671 hospitalized children, i.e. 59.3%. The median age was 15.33 months (2 months - 59 months). The sex ratio was 1.03 (M = 50.8 F = 49.2). Eighty-seven percent of mothers were housewives. Parents were uneducated in 49.3% for mothers and 51.8% for fathers. Marasmus represented 93.5% of cases, children diagnosed with HIV+ represented 6.3% with exclusively HIV1 (100%). Pneumopathy was most frequently associated pathology with 33.4%. The duration of hospitalization was less than 7 days in 67.6% of cases and 93.3% of children had been successfully treated. The mortality rate was 4%. Conclusion: Malnutrition still remains a public health problem affecting mainly children aged 13 to 24 months, mainly from low-income families.

关键词： Severe Acute Malnutrition Children Hospitalized Mali

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Epidemiology and Management of Heart Failure in the Medicine Department of Tombouctou Hospital

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World Journal of Cardiovascular Diseases 2023年第3期13卷 105-113页

作者： Bassirima Traoré Souleymane Mariko Samba Sidibé Karamoko Kantako Mariam Sako Massama Konaté Nouhoum Diallo Abdoul Karim Sacko Kalifa Diallo Youssouf Kassambara djibril kassogue Oumar Ongoiba Oumar Sanogo Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Department of Cardiology Point G University Hospital Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a complex syndrome and very frequently observed and secondary to the outcome of many advanced heart diseases. It is made up of a set of symptoms that reflect the tissue and visceral consequences of heart failure. The objective was to determine the hospital prevalence and to describe the management of heart failure in the medical department of Tombouctou hospital in Mali. Methods: This is a descriptive cross-sectional study with retrospective data collection, carried out over 24 months and involving the analysis of 266 records of patients hospitalized for heart failure. Results: The frequency of heart failure was 17.6% with a female predominance. The average age was 48 years with extremes of 16 and 90 years. Cardiovascular risk factors were dominated by high blood pressure with 38%. Global heart failure was the mode of discovery in 72.2% of cases. The etiologies were dominated by hypertensive dilated cardiomyopathy in 36.8% and peripartum cardiomyopathy in 32% of cases. The majority of our patients benefited from diuretic treatment, i.e. 95.9% frequency;with a favorable evolution in 96.2% of cases. We recorded 10 deaths, i.e. a lethality of 3.7%. We report some difficulties encountered during our security study because Tombouctou is a war zone and the lack of a technical platform for biology such as (BNP or NT-proBNP). Conclusion: Heart failure is a real public health problem. Its prevalence is increasing due to the aging of the population and especially the poor management of arterial hypertension in our context.

关键词： Heart Failure Epidemiology Etiology Treatment Tombouctou Hospital

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Epidemioclinical Profile and Immediate Outcome of Low Birth Weight at the Reference Health Center in Commune VI of the District of Bamako, Mali

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Open Journal of Pediatrics 2023年第2期13卷 235-243页

作者： Mariam Maiga Oumar Coulibaly Mariam Traore Hibrahima Diallo Korotoumou W. Diallo Bourama Kane Alou Samake Mamadou Diallo Moussa Konate Mamadou Keita Mohamed Saydi Ag Med Elmehdi Elansari Diarra Sidy Moctar Mamadou Traore djibril kassogue Kadiatou Ba Pierre Togo Pediatric Service of the Reference Health Center of the Commune VI Bamako Mali Pediatric Department of CHU Gabriel Touré Bamako Mali Mali Hospital Bamako Mali Pediatric Service of the Reference Health Center of the Commune V Bamako Mali Timbuktu Regional Hospital Bamako Mali Pediatric Service of the Reference Health Center of the Commune II Bamako Mali

Introduction: Low birth weight is responsible for 9.1 million child deaths each year worldwide. It is the leading cause of perinatal and infant mortality. The objective of this work was to determine the epidemio-clinical profile as well as the future of low birth weight at the Reference Health Center of commune VI in the district of Bamako, Mali. Methods: Our study was descriptive and prospective over a year from April 1, 2018 to March 31, 2019. Data were taken from hospital records and newborn referral/evacuation forms. Data processing was performed using Epi Info software version 3.5.4 and Word. Results: The frequency of low birth weight was 34.94%. Multiparity accounted for 47.84%, sex ratio was 0.93, maternal arterial hypertension was present in 41.66%, genitourinary infection was in 58.37% and delivery was by low way in 86.12%. The majority of newborns had a gestational age between 28SA-33SA (56.52%) and a weight between 1501-1999 grams (47.36%). Mortality accounted for 18.66%. Conclusion: Low birth weight is common in our settings with modifiable risk factors. Practitioners must play on them to minimize its importance.

关键词： Low Birth Weight Future Risk Factors Bamako Mali

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Seizures in Children under Five in a Pediatric Ward: Prevalence, Associated Factors and Outcomes

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Open Journal of Pediatrics 2021年第4期11卷 627-635页

作者： Abdoul Karim Doumbia Oumou Koné Guédiouma Dembélé Adama Dembelé Oumar Coulibaly Hawa Gouro Diall Karamoko Sacko Amadou Touré Pierre Togo Abdoul Aziz Diakité Mohamed Elmouloud Cissé Belco Maiga Djeneba Konaté Fatoumata Léonie Diakité Lala N’drainy Sidibe Fousseyni Traoré Adama Bah djibril kassogue Boubacar Togo Madou Traoré Department of Pediatrics at CHU Gabriel Touré Bamako Mali National Institute of Public Health Bamako Mali Mohammed VI Perinatal Clinic Bamako Mali

Introduction: convulsion is a frequent cause of neurological and cognitive sequelae and then of epilepsy. The objective of this work was to describe the socio-demographic, clinical, therapeutic, and evolutionary aspects. Methodology: This was a descriptive retrospective study carried out in the general pediatrics department of CHU-Gabriel Touré. It took place over a period of 02 years from January 2017 to December 2018. We included all children aged 1 to 59 months hospitalized in the ward for convulsion. Results: During the study period, 2653 children aged 2 months to 59 months were hospitalized in the general pediatric ward. We included 288 medical records of children who presented with a seizure on admission. Convulsions represented 11% of pediatric hospitalizations from 1 month to 59 months. The average age was 29 months. Fever was present in 86% of patients. The cerebrospinal fluid (CSF) test was positive in 38 patients. Hypoglycemia was present in 14 patients. Serum calcium was low in 3 patients. The most implicated etiologies were malaria 70%, meningitis 20%, and dehydration 13%. Management consisted of airway clearance, oxygen therapy as needed, and administration of diazepam (54%). Antibiotics were prescribed in 77% of cases and antimalarials in 70%. The average length of hospital stay was 8 days with extremes of 1 and 30 days. The outcome was favorable in 95% of cases. Sequelae were observed in 5% of cases and one case of death was observed. Conclusion: Acute convulsions are one of the most common causes of hospitalization in children under 5 years old. The causes were dominated by infectious diseases (mal

关键词： Convulsions Child Infant Prognosis Sub-Saharan Africa

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Clinico-Pathological Profile of Malignant Abdominal Tumors in Children: Experience of the Pediatric Oncology Unit in Bamako

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Open Journal of Pediatrics 2021年第4期11卷 608-617页

作者： Abdoul Karim Doumbia Adama Dembele Pierre Togo Oumar Coulibaly Arsene Dackono Mohamed Elmouloud Cissé Fousseyni Traoré Hawa Diall Boubacar Togo Abdoul Aziz Diakité Yakaria Coulibaly Cheick Bougadary Traore Lala N’drainy Sidibe Belco Maiga Diakite Fatoumata Léonie Francois Karamoko Sacko Djeneba Konaté Guediouma Dembele Hacimi Poma Adama Bah djibril kassogue Oumar Keita Ibrahim Ahamadou Department of Pediatrics at CHU Gabriel Touré Bamako Mali Pediatric Surgery Department of the Gabriel Touré CHU Bamako Mali Pathological Anatomy and Cytology Department of the “Point G” CHU Bamako Mali

Introduction: the objective was to describe the epidemiological and histological aspects of malignant abdominal tumors in children. Methodology: This was a descriptive, cross-sectional study conducted from January 1, 2017 to December 31, 2018. We included all patients aged 0 to 15 years with histologically confirmed abdominal malignancies. Results: We collected 46 files of malignant tumors of the abdomen (35% of pediatric cancers). The majority of patients were under 5 years old (65%). The sex ratio was 1.7. They were generally from disadvantaged socio-economic backgrounds (67%). The average consultation time was 50 days. The main reasons for consultation were abdominal mass (48%), pain (17%) or distension (9%). The mass was large, hard (89%), immobile (71%) and painful (46%). Malnutrition was found in 80% of patients. The mass was retro-peritoneal in 63% of cases and renal in 54%. It was solid in 94% of cases and heterogeneous in 76% of cases. The assay for tumor markers was not performed. Anemia was present in all patients. Fine needle aspiration was performed in 43%, biopsy in 37% and myelogram in 15% of cases. spinal cord involvement was observed in 28% of Burkitt’s cases. The main cancers diagnosed were nephroblastoma (52%), Burkitt’s lymphoma (26%) and neuroblastoma (13%). Stage 1 and stage 2 were frequent in 20% and 22% of cases, respectively;36% of cases were not staged. The average duration of chemotherapy was 11 weeks. Total resection was performed in 30% of cases. The outcome of the patients was marked by total remission in 65%. Conclusion: Abdominal malignancies are very common in children. The diagnosis of certainty is late in our context.

关键词： Cancer Abdomen Child Sub-Saharan Africa

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Factors Associated with HPV Vaccine Uptake among Girls Aged 9 - 14 in the Langue de Barbarie Area of Saint-Louis, Senegal in 2024

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Journal of Immune Based Therapies, Vaccines and Antimicrobials 2024年第1期13卷 1-15页

作者： Papa djibril Ndoye Lebem Togtoga Abdourahmane Ndong Mamadou Saïdou Bah Khadim Niang Departement of Public Health and Social Medicine UFR of Health Science Gaston Berger University Saint-Louis Senegal ENDA Sant Dakar Senegal

Introduction: The HPV vaccine was included in the Expanded Programme on Immunisation in Senegal in 2018. However, vaccination coverage is still low among targeted girls. The aim of this research was to study the factors associated with vaccine uptake among girls aged 9 - 14 years in the Langue de Barbarie area of Saint-Louis, Senegal. Methodology: This was a descriptive and analytical cross-sectional study. The sample size was calculated using the Schwartz formula and distributed proportionally to the size of the population in the neighborhoods. Data were collected from 2nd to 19th January 2024 from mothers or guardians of girls aged 9 to 14 using anonymous questionnaires configured on tablets with Survey 123 software and analysed using R software. Results: A total of 799 people were interviewed. The average age of the respondents was 35.67 years, with a standard deviation of 7.08 and a range of 17 and 49 years. Reported vaccination coverage was 41.9%. Factors positively correlated with vaccination included: attendance at primary school or daara (OR = 2.50 [CI: 1.43 - 4.48] and OR = 2.05 [CI: 1.09 - 3.94]), information about vaccination (OR = 6.64 [CI: 4.59 - 9.72]), history of cervical cancer screening among mothers or guardians (OR = 6.64 [CI: 4.59 - 9.72]). Conclusion: Identifying the factors associated with HPV vaccination is necessary to assess and improve the vaccination strategy in order to improve vaccination coverage among targeted girls.

关键词： Cervical Cancer Vaccine HPV Girls Risk Senegal

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