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Postpartum Family Planning at the Timbuktu Hospital in Mali

Open Journal of Obstetrics and gynecology 2024年第7期14卷 1074-1082页

作者： Kassogué Djibril Samaké Alou Dolo Akoro Sogoba Seydou Touré Lahaou Cissouma Assetou Kassogué Abdoulaye Maiga Mariam Mariko Souleymane Kantako Karamoko Ongoiba Oumar Sanogo Ooumar Traoré Bassirima Sidibé Idrissa Mandé Kassambara Youssouf Traoré Halima Timbuktu Hospital Bamako Mali Commune VI Bamako District Hospital Bamako Mali chu point g Bamako Bamako Mali Sikasso Hospital Bamako Mali Nianankoro Fomba Sgou Hospital Bamako Mali

Introduction: Postpartum family planning is the prevention of pregnancies during the 12 months following childbirth. Few studies have been devoted to postpartum family planning in Mali. Our work will contribute to reducing unmet need for family planning. Objective: To study the use of contraceptive methods in the postpartum period in the obstetrics and gynecology unit of Timbuktu hospital. Materials and Methods: This was a descriptive and analytical cross-sectional study with prospective collection of data from January 1, 2022 to December 31, 2023. All women who gave birth having chosen and benefited from a contraceptive method were included. The statistical test used was the Fisher test with a significance threshold fixed at 5%. Results: The frequency of contraception in the postpartum period was 17.03%. The average age of clients was 26.14% with extremes of 14 and 45 years. They were paupiparous at 56.4% with an inter-birth interval of less than 12 months at 12.3%. More than half of the counseling (58.5%) was done during postnatal visits. The methods chosen were implants at 48.1%, injectable progestins at 21.3%, intrauterine device at 14.7%, miro-progestin pills at 13.5%, tubal ligation at 1 .4% and condoms at 1%. The regular follow-up rate was 51.1% of cases and 25.6% had no follow-up. Conclusion: The overall rate of postpartum family planning of 17.08% remains low. Improving FP staff skills will reduce unmet needs and contribute to increasing contraceptive prevalence in Timbuktu.

关键词： Family Planning Postpartum Counseling Contraceptive Methods Timbuktu Hospital

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Study of Factors Associated with Maternal Deaths at Timbuktu Hospital in Mali

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Open Journal of Obstetrics and gynecology 2024年第9期14卷 1471-1487页

作者： Coulibaly Moussa Kassogué Djibril Samaké Alou Sy Ousmane Poda ghislain Dolo Akoro Sogoba Seydou Cissouma Assetou Kassogué Abdoulaye Maiga Mariam Mariko Souleymane Ongoiba Oumar Traoré Bassirima Kané Babou Traoré Halima Taoudeni Regional Health Directorate Tombouctou Mali department of Pediatrics Timbuktu Hospital Timbuktu Mali department of Pediatrics District Hospital Commune VI Bamako Mali WHO Bamako Mali department of Pediatrics CHU Point G Bamako Mali department of Pediatrics Sikasso Hospital Sikasso Mali department of Pediatrics Nianankoro Fomba Sgou Hospital Segou Mali

Introduction: Despite progress in universal health coverage, maternal mortality remains a concern for developing countries, including Mali. The problem is not due only to a lack of health services but to a combination of factors that need to be identified to give hope to women of childbearing age. Objective: Determine the factors associated with maternal mortality in the Timbuktu region of Mali. Methodology: Retrospective, descriptive, cross-sectional and analytical study from January 1, 2018 to December 31, 2022 using a questionnaire and an interview guide to determine the factors associated with maternal mortality in the Timbuktu region of Mali. Results: A total of 112 maternal deaths were recorded between 2018 and 2022. The average age of the women who died was 26 years (standard deviation 7.6 years). The 14 – 23-year-old age group is the most affected (43.8%). 66.1% of women came from rural areas. Illiteracy (77.7%), lack of ANC (54.5%), distance of households from health facilities (76%) and insecurity (52.7%) have been identified as factors contributing to maternal mortality. Conclusion: This study reported a high prevalence of maternal mortality rates that may be associated with women’s socioeconomic conditions. Actions must be developed to integrate CPN into an advanced strategy for women living in rural areas in Mali.

关键词： Maternal Mortality Timbuktu Hospital Mali

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Skin graft in the Surgery department “B” of the chu du point “g” about 50 Cases

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Surgical Science 2020年第7期11卷 187-193页

作者： Mahamadou Coulibaly Bréhima Bengaly Drissa Ouattara Traoré Drissa Diallo Siaka Souleymane Sanogo Birama Togola Nouhoum Ongoiba Faculty of Medicine University of Science Technique and Technologies of Bamako Bamako Mali department of Surgery Koutiala Hospital Bamako Mali department of Surgery University Hospital Center Point G Bamako Mali

Aim: To analyze the practice of skin grafting in the surgery department “B” of the chu of point “g” in Bamako. Patients and Methods: This was a retrospective and prospective study carried out between 1980 and 2014... 详细信息

g>Aim:g> To analyze the practice of skin grafting in the surgery department “B” of the chu of point “g” in Bamako. g>Patients and Methods:g> This was a retrospective and prospective study carried out between 1980 and 2014, covering all patients who underwent a skin graft and hospitalized. It covered all patients who underwent a skin transplant and were hospitalized in the department during the study period. g>Result:g> There were 50 patients including 25 women and 25 men. The mean age was 25.2 ± 19 years. The average duration of lesion evolution was 1 year. The lesions to be grafted were located in the lower limbs in 60%. The average area of substance loss was 13.2 cm2. The indication for skin graft was asked for loss of substance following scar bridles in 40%, ulcerative-necrotic wounds of infectious or traumatic origin (32%), malignant skin tumor (14%). In pathology, there were 5 cases of malignant melanoma and 2 cases of squamous cell carcinoma. Thin skin grafting was the most used technique (62%). The postoperative follow-ups were simple in 94%. There were 3 cases of graft necrosis. The average length of hospital stay was 28 days. The esthetic result was judged satisfactory in 84% of the cases (n = 42), average in 14% of the cases (n = 7) and unsatisfactory in 2% of the cases (n = 1). The sensitivity was good in 36 patients (72%), average in 12 patients (24%) and poor in 2 patients (4%). g>Conclusion:g> They mainly affect young people. The reduction of accidents on the public highway, good management of burn injuries, wounds and good hygiene of the population will considerably reduce the rate of its affections.

关键词： Skin graft Surgery Postoperative Operations

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Severe acute respiratory syndrome coronavirus-2-related and imputable deaths in children:results from the French pediatric national registry

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World Journal of Pediatrics 2024年第6期20卷 611-620页

作者： Marguerite Lockhart-Bouron Noemie Vanel Michael Levy Anais R.Briant Etienne Javouhey Sophie Breinig Julia Dina Marion Caseris Francois Angoulvant Stephane Leteurtre Morgan Recher David W.Brossier Univ.Lille CHU LilleULR 2694-METRICS:Evaluation Des Technologies de Sante Et Des Pratiques Medicales59000LilleFrance Pediatric Intensive Care Unit CHU de MarseilleMarseilleFrance Pediatric Intensive Care Unit CHU Robert-DebreAssistance Publique Hopitaux de ParisParisFrance UniversitéParis-Cite ParisFrance Biostatistics and Clinical Research Unit CHU de Caen Normandie14000CaenFrance Pediatric Intensive Care Hospices Civils de LyonLyonFrance Neonatal andPediatric IntensiveCare Unit Children's HospitalToulouseFrance Virology department INSERM U1311 DynamicureUniv CAEN NormandieCHU de Caen14000 CaenFrance Medical School Universite Caen Normandie14000 CaenFrance department of Pediatrics CHU Robert-DebréAssistance Publique Hopitaux de ParisParisFrance department Women-Mother-Child Service of PediatricsLausanne University Hospital(CHUV)LausanneSwitzerland Pediatric Intensive Care Unit Réanimation Et Soins Intensifs PéediatriquesCHU de CAENAvenue de La Cote de Nacre14000 CaenFrance chu Sainte Justine Research Center MontréalCanada

Background Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)is responsible for an important mortality rate *** aimed to evaluate the actual imputability of SARS-CoV-2 on the mortality rate associated with SARS-CoV-2-related illnesses in the pediatric intensive care unit(PICU).Secondary objectives were to identify risk factors for *** This national multicenter comparative study comprised all patients under 18 years old with positive SARS-CoV-2 polymerase chain reactions(PCRs)[acute corona virus disease 2019(COVID-19)or incidental SARS-CoV-2 infection]and/or pediatric inflammatory multisystem syndrome(PIMS)recorded in the French PICU registry(PICURe)between September 1,2021,and August 31,*** patients were classified and compared according to their living status at the end of their PICU *** patients were evaluated by four experts in the field of pediatric infectiology and/or pediatric intensive *** imputability of SARS-CoV-2 as the cause of death was classified into four categories:certain,very probable,possible,or unlikely,and was defined by any of the first three *** There were 948 patients included of which 43 died(4.5%).From this,26 deaths(67%)could be attributed to SARS-CoV-2 infection,with an overall mortality rate of 2.8%.The imputability of death to SARS-CoV-2 was considered certain in only one case(O.1%).Deceased patients suffered more often from comorbidities,especially heart disease,neurological disorders,hematological disease,cancer,and *** of the deceased patients were admitted for pediatric inflam-matory multisystem syndrome(PIMS).Mortality risk factors were male gender,cardiac comorbidities,cancer,and acute respiratorydistress *** SARS-CoV-2 mortality in the French pediatric population was *** though the imputability of SARS-Cov-2 on mortality was considered in almost two-thirds of cases,this imputability was considered certain in only one case.

关键词： Death Pediatric intensive care unit SARS-CoV-2

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Digestive Surgical Emergencies at the “Mother Child”Hospital Center Luxembourg in Mali

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Surgical Science 2024年第5期15卷 299-310页

作者： Cheickna Tounkara Amara Coulibaly Yaya Ongoiba Aboubakrine Sylla Abdoul Karim Simaga Bréhima B. Coulibaly Aminata Dabo Souleymane Dembele Samake Hamidou Sidiki Keita Sékou Bréhima Koumare Soumaïla Keita Bakary Tientigui Dembele Zimogo Zié Sanogo Djibril Sangare department of general Surgery and Anesthesia-Resuscitation of the “ Mother Child&#8221 Hospital Center Luxembourg Bamako Mali Social Health Service of the Armed Forces of Mali Bamako Mali department of general Surgery “ A&#8221 and Cardiovascular of Point G University Hospital Bamako Mali department of general Surgery of chu gabriel TOURE Bamako Mali

Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.

关键词： Emergency Digestive Surgery Post-Operative Complication

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Nephroblastoma in Adults about a Clinical Case

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Surgical Science 2024年第2期15卷 81-88页

作者： Tounkara Cheickna Coulibaly Amara Malle Oumar Amadou Bréhima Bolo Coulibaly Bagoyoko Kaloga Daye Samake Hamidou Berthe Honoré Jean-Baptiste gabriel Diakite Mamadou Lamine department of general Surgery Hospital Center “Mother Child” Luxembourg Bamako Mali Directorate of Army Health Services Kati Mali department of Urology and Andrology Point G University Hospital Bamako Mali

Nephroblastoma is the most common malignant renal tumor in children and is related to an abnormal proliferation of cells resembling those of the embryonic kidney (metanephroma), hence the terminology;embryonal tumor. These are tumors that remain and remain unstudied in Mali because they are common in adults in our context. Its annual incidence is estimated at approximately 1/10,000 births. Nephroblastoma is a rare or even exceptional tumor in adults. The clinical manifestation was a large swelling of the right hypochondrium;abdominal pain for a year;unquantified fever, hypertension, initial hematuria associated with burning during urination and anemia. The main clinical manifestation remained fever and abdominal pain. This renal tumor posed a diagnostic problem which was previously labeled as a mesenteric tumor in our general surgery department. The diagnosis was made by imaging: CT and magnetic resonance imaging. The treatment is multidisciplinary and combines chemotherapy, surgery with or without radiotherapy. The prognosis is poor due to late diagnosis and less effectiveness of chemotherapy compared to the child. Survival did not exceed a year and a half because the renal tumor in our patient was surgically overcome. We report a case of nephroblastoma in an 86-year-old patient with unfavorable histology (hematogenous metastases), operated on in the general surgery department and whose postoperative course was simple and who was referred to oncology for treatment.

关键词： Nephroblastoma Malignant Kidney Tumor Treatment Adult Mali

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Liposarcoma Retro-Peritoneal in the general Surgery department of the Hospital of the District of the Commune IV

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Surgical Science 2024年第7期15卷 430-437页

作者： Moussa Samaké Souleymane Bingué Dembelé Yely Dianessy Abdou guiré Dorcas Laurel Sodjiné Yede Youssouf Boiré Mahamane Dicko Mantia Sara Nouhoum Sanogo Amaguiré Saye Sirama Diarra Brahima Dembele Thierno Nadio Ibrahima Maiga Modibo Diarra Siaka Konaté Birama Cheick Traoré Boubacar Diassana Bathio Traoré Amadou Maiga Boubacar Yoro Sidibé Adégné Togo general Surgery department of Bamako District IV Hospital Bamako Mali Anesthesia and Resuscitation Service of the Hospital of the District of the Commune IV of Bamako Bamako Mali anatomopathology department of the chu of point g Bamako Mali Obstetric gynecology department of the Bamako District IV Hospital Bamako Mali department of Ophthalmology of the Hospital of the District of the Commune IV of Bamako Bamako Mali Imaging Service of the Bamako District IV Hospital Bamako Mali Internal Medicine department of the District Hospital of Commune IV of Bamako Bamako Mali general Surgery department Kolondjeba Referral Health Centre Sikasso Mali gynecology and Obstetrics department of the San Reference Health Center Segou Mali general Surgery department of Sikasso Hospital Sikasso Mali general Surgery department of the gabriel Tour University Hospital Bamako Mali

Retroperitoneal soft tissue sarcomas in the retroperitoneal/intra-abdominal regions represent 10% - 15% of all cases of soft tissue sarcoma. Liposarcomas, which are the most common histological type, account for 20% - 45% of retroperitoneal/intra-abdominal sarcoma cases, and 20% of liposarcomas cases are primary retroperitoneal liposarcomas. Surgical resection in case of malignancy remains the treatment of choice for liposarcomas, according to the guidelines of most major international companies. Our goal was to improve the management of retroperitoneal liposarcoma. This was a 65-year-old patient, with no medical or surgical history, who was referred to us for abdominal swelling, in whom clinical and paraclinical examination found retroperitoneal liposarcoma stage IV, and the surgical treatment consisted in making a tumor reduction. Conclusion: Retro-peritoneal liposarcoma is an undervalued malignant tumor, and the diagnosis is often late.

关键词： Retroperitoneal Liposarcoma Diagnostic Delay

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Evaluation of Antibiotic Prescribing in the Pediatric department of gabriel TouréTeaching Hospital, Bamako, Mali

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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 recommend

关键词： Antibiotic Prescription Hospitalization Child

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Preclinical and clinical evidence of the association of colibactinproducing Escherichia coli with anxiety and depression in colon cancer

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World Journal of gastroenterology 2024年第21期30卷 2817-2826页

作者： Fabien Rondepierre Maëva Meynier Johan gagniere Vincent Deneuvy Anissa Deneuvy gwenaelle Roche Elodie Baudu Bruno Pereira Richard Bonnet Nicolas Barnich Frédéric Antonio Carvalho Denis Pezet Mathilde Bonnet Isabelle Jalenques Service de Psychiatrie de l’Adulte A et Psychologie Médicale CHU Clermont-FerrandClermont-Ferrand 63000France M2iSH UMR 1071INSERMUniversity of Clermont AuvergneINRAE USC 1382Clermont-Ferrand 63001France NeuroDol UMR 1107INSERMUniversity of Clermont AuvergneClermont-Ferrand 63001France department of Digestive Surgery CHU de Clermont-FerrandClermont-Ferrand 63001France Biostatistics Unit Department of Clinical Research and InnovationCHU Clermont-FerrandClermont-Ferrand 63000France department of Bacteriology CHU de Clermont-FerrandClermont-Ferrand 63001France UniversitéClermont Auvergne INPCNRSClermont Auvergne Institut PascalClermont-Ferrand 63000France

BACKgROUND The association between the intestinal microbiota and psychiatric disorders is becoming increasingly *** gut microbiota contributes to colorectal carcinogenesis(CRC),as demonstrated with colibactin-producing Escherichia coli(CoPEC).AIM To evaluate the association between CoPEC prevalence and anxiety-and depressive-like behaviors with both preclinical and clinical *** Patients followed after a CRC surgery and for whom the prevalence of CoPEC has been investigated underwent a psychiatric *** were compared according to the CoPEC *** parallel C57BL6/J wild type mice and mice with a CRC susceptibility were chronically infected with a CoPEC *** behavior was assessed using the Elevated Plus Maze test,the Forced Swimming Test and the Behavior recognition system PhenoTyper®.RESULTS In a limited cohort,all patients with CoPEC colonization presented with psychiatric disorders several years before cancer diagnosis,whereas only one patient(17%)without CoPEC *** result was confirmed in C57BL6/J wildtype mice and in a CRC susceptibility mouse model(adenomatous polyposis colimultiple intestinal neoplasia/+).Mice exhibited a significant increase in anxiety-and depressive-like behaviors after chronic infection with a CoPEC *** This finding provides the first evidence that CoPEC infection can induce microbiota-gut-brain axis disturbances in addition to its procarcinogenic properties.

关键词： Colorectal cancer Colibactin Escherichia coli Colibactin-producing Escherichia coli Inflammation Anxiety Depression Behavior

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Chronic Hepatitis B Virus Infection: Biological Parameters in Patients Treated with Tenofovir Disoproxil Fumarate

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Open Journal of gastroenterology 2024年第4期14卷 145-151页

作者： Sanra Déborah Sanogo Moussa Y. Dicko Lamine N’Diaye Ousmane Diarra Drissa Katilé Abdoulaye Maiga Ouatou Mallé Sabine Drabo Makan S. Tounkara Hourouma Sow Kadiatou Doumbia Anselme Konaté Moussa T. Diarra Hepato-gastroenterology department Centre Hospitalier Universitaire Du Point G Bamako Mali Hepato-gastroenterology department Gabriel Toure University Hospital Bamako Mali Hepato-gastroenterology Unit Csref Commune V Bamako Mali

Chronic hepatitis B causes a liver disease characterized by inflammation of the liver parenchyma. The aim of this study was to investigate the evolution of biological parameters in patients treated with Tenofovir for chronic B infection at the Commune V referral health center in Bamako. We obtained a prevalence of 14.15%. The most represented age group was 31 - 40 years, with 36.8%. The sex ratio was 1.44 in favour of men. Viral load was undetectable after 18 months of treatment in 25 patients (42.37%). Tenofovir, the 1st-line drug in Mali, is effective on the biological parameters monitored in patients.

关键词： Viral Hepatitis B Tenofovir Biological Parameters

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