[Impact of the COVID-19 pandemic on the activities of the cardiology department of the Ignace Deen National Hospital at the Conakry University Hospital]. / Impact de la pandémie de COVID-19 sur les activités du service de cardiologie de l'hôpital national Ignace Deen du CHU de Conakry.

The new coronavirus pandemic (COVID-19) is the main global health crisis of our time and the greatest threat we have faced in this century. According to the National Health Security Agency (ANSS), which is the national body responsible for managing epidemics and pandemics, 1927 cases of COVID-19 were confirmed, 11 deaths with more than 4000 contact subjects. The objective of this study was to assess the impact of the COVID-19 pandemic on the activities of the cardiology department of the Ignace Deen National Hospital at the Conakry University Hospital. This was a descriptive retrospective study from January 2020 to April 2020, focusing on consultation and hospitalisation activities in the cardiology department of Ignace Deen National Hospital at Conakry University Hospital. The study consisted of assessing the impact of the pandemic on patient use of the service during the first weeks of the pandemic. We recorded the frequency of consultations and hospitalisations from March to April 2020, which we compared to the frequency of consultations and hospitalisations in January and February 2020. During this study from March to April 2020, we identified 130 patients in consultation against 450 patients for the two months preceding the official declaration of the pandemic in Guinea, a drop of 71.1% (320 patients). The same remark was made in hospitalisation with a drop of 75% (35 patients against 140 for the two months preceding the pandemic). At the start of the COVID-19 pandemic in Guinea, it is clear that there has been a rapid and significant drop in the effective use of the cardiology service.

[Brachial Plexus: Dissection At The Laboratory Of Anatomy Of Bamako]. / Plexus Brachial : Dissection Au Laboratoire D'Anatomie De Bamako.

INTRODUCTION: The brachial plexus consists of the ventral twigs of the last four cervical nerves and the first thoracic nerve. It ensures the motor and sensitive innervations of the thoracic limb. AIM: Our goal was to describe the brachial plexus of the cervical region to the middle third of the arm. METHODOLOGY: We conducted a prospective study at the anatomy Laboratory of the Faculty of Medicine and Dentistry in Bamako from September 2016 to October 2017. We dissected the brachial plexus (PB) of 13 fresh adult corpses on both sides. The inclusion criteria were: Fresh adult corpses with cervical regions and brachial without scarring. The injected or scar-carrying corpses were not included in the cervical and brachial regions. RESULTS: Twenty-six brachial plexus of which 18 bp in men and 8 bp in women were dissected. The average age of the subjects was 42 years (extreme: 18 and 70 years). We noted nerve block variations in 3.8%, fascicular in 3.8% and late terminal in 73.1%. The involvement of the anterior branch of the fourth spinal nerve (C4) was found in 46.2%. CONCLUSION: The brachial plexus is the seat of many anatomical variations whose knowledge is indispensable to treat its lesions.

INTRODUCTION: Le plexus brachial est constitué des rameaux ventraux des quatre derniers nerfs cervicaux et du premier nerf thoracique. Il assure l'innervation motrice et sensitive du membre thoracique. BUT: Notre but était de décrire le plexus brachial de la région cervicale au tiers moyen du bras. MÉTHODE: nous avons réalisé une étude prospective au laboratoire d'anatomie de la Faculté de Médecine et d'Odontostomatologie de Bamako de septembre 2016 à octobre 2017. Nous avons disséqué des deux côtés les plexus brachiaux (PB)de 13 cadavres frais d'adultes. Les critères d'inclusion étaient : cadavres frais d'adulte avec les régions cervicale et brachiale sans cicatrice. N'ont pas été inclus les cadavres injectés ou porteurs de cicatrice au niveau des régions cervicale et brachiale. RÉSULTATS: Vingt-six plexus brachiaux dont 18 PB chez les hommes et 8 PB chez les femmes ont été disséqués. L'âge moyen des sujets était de 42 ans (extrême : 18 et 70 ans). Nous avons noté des variations tronculaires dans 3,8%, fasciculaires dans 3,8% et en fin terminales dans 73,1%. La participation du rameau antérieur du quatrième nerf spinal cervical (C4) a été trouvée dans 46,2%. CONCLUSION: Le plexus brachial est le siège de nombreuses variations anatomiques dont la connaissance est indispensable pour traiter ses lésions.

Mechanical clearance of red blood cells by the human spleen: Potential therapeutic applications of a biomimetic RBC filtration method.

During their lifespan, circulating RBC are frequently checked for their deformability. This mechanical quality control operates essentially in the human spleen. RBC unable to squeeze though narrow splenic slits are retained and cleared from the blood circulation. Under physiological conditions this prevents microvessels from being clogged by senescent, rigid RBC. Retention of poorly deformable RBC is an important determinant of pathogenesis in malaria and may also impact the clinical benefit of transfusion. Modulating the splenic retention of RBC has already been proposed to support therapeutic approaches in these research fields. To this aim, the development of microplates for high throughput filtration of RBC through microsphere layers (microplate-based microsphiltration) has been undertaken. This review focuses on potential therapeutic applications provided by this technology in malaria chemotherapy and transfusion.

[Frequency of glucose-6-phosphate dehydrogenase deficiency (A-376/202) in three Malian ethnic groups]. / Fréquence du déficit en glucose-6-phosphate déshydrogénase (A-376/202) dans trois groupes ethniques vivant en zone d'endémie palustre au Mali.

Erythrocyte G6PD deficiency is the most common worldwide enzymopathy. The aim of this study was to determine erythrocyte G6PD deficiency in 3 ethnic groups of Mali and to investigate whether erythrocyte G6PD deficiency was associated to the observed protection against malaria seen in Fulani ethnic group. The study was conducted in two different areas of Mali: in the Sahel region of Mopti where Fulani and Dogon live as sympatric ethnic groups and in the Sudanese savannah area where lives mostly the Malinke ethnic group. The study was conducted in 2007 in Koro and in 2008 in Naguilabougou. It included a total 90 Dogon, 42 Fulani and 80 Malinke ethnic groups. Malaria was diagnosed using microscopic examination after Giemsa-staining of thick and thin blood smear. G6PD deficiency (A-(376/202)) samples were identified using RFLP (Restriction Fragment Length Polymorphism) assay and analysis of PCR-amplified DNA amplicon. G6PD deficiency (A-(376/202)) rate was 11.1%, 2.4%, and 13.3% in Dogon, Fulani, and Malinke ethnic group respectively. Heterozygous state for G6PD (A-(376/202)) was found in 7.8% in Dogon; 2.4% in Fulani and 9.3% in Malinke ethnic groups while hemizygous state was found at the frequency of 2.2% in Dogon and 4% in Malinke. No homozygous state was found in our study population.We conclude that G6PD deficiency is not differing significantly between the three ethnic groups, Fulani, Dogon and Malinke.

[Risk factors and clinical aspects of myocardial infarction in patients younger than 40 years in the Point G Teaching Hospital]. / Facteurs de risque et aspects cliniques de l'infarctus du myocarde chez les patients de moins de 40 ans au CHU du Point G.

A retrospective and analytical study was conducted, over 9 years, from January 2004 to December 2012. It included 10 inpatients and took place at the cardiology service of the Point G teaching hospital. Its goals were to assess cardiovascular risk factors, the delay between the clinical onset and admission and to describe ECG changes and echocardiographic changes of myocardial infarction in patients under 40 year-old. Young patients accounted for 6.8% of MI admissions with a male predominance of 90%. The disease frequency has increased with age, 40% were within 38-40 year-old range, the risk factors were predominantly smoking 80%, Stress 50%, High Blood Pressure 40% and dyslipidemia 20%. Typical chest pain was the most common recorded symptom. Anterior necrosis was the most common of electrical pattern, 8 out 10 times the ejection fraction was down and segmental kinetic was impaired in 60% of patients on echocardiography. Over 3 quarters of patients were admitted 12 hours after the onset of symptoms and the evolution during hospitalization was good with no fatality.

Notre étude de monocentrique rétrospective et analytique, réalisée de janvier 2004 à décembre 2012 portait sur 10 malades hospitalisés dans le service de cardiologie du CHU du Point G. Elle avait pour objectifs d'évaluer les facteurs de risques cardiovasculaires, le délai entre le début de la symptomatologie clinique et l'admission et de décrire les aspects électriques et écho cardiographiques de l'infarctus du myocarde (IDM) chez les patients de moins de 40 ans. Ces patients représentaient 6,8% des admissions pour IDM et la prédominance était masculine (90 %). La fréquence de l'IDM augmentait avec l'âge, 40 % des patients étaient dans la tranche d'âge [38- 40[. Les facteurs de risque (FDR) étaient dominés par le tabac (80 %), le stress (50%), l'HTA (40%) et la dyslipidémie (20%). La douleur thoracique typique était le maître symptôme. La nécrose antérieure était l'anomalie électrique dominante, huit fois sur dix la fraction d'éjection était diminuée et la cinétique segmentaire était altérée chez 80 % des patients à l'échocardiogramme. Plus des trois quart des malades étaient admis au moins 12 heures après le début des symptômes et l'évolution hospitalière était bonne avec une mortalité nulle.

[Floating elbows: anatomo-clinical aspect and review of treatment method]. / Coudes flottants: aspects anatomocliniques et l'analyse du traitement.

INTRODUCTION: Floating elbows are rare pathologies that cause a number of problems to manage. The current treatment tendency is surgical. The orthopedic treatment is a good management option when the technical plateau is limited. METHODS: We performed an 18-month prospective study that included patients with floating elbows. Two treatment methods were used and chosen following predefined indication criteria. The final evaluation was made on average 10 months (minimum 6 and maximum 18 months) according to the functional classification of the mayo clinic. RESULTS: In 18 months, we treated 8 patients with floating elbow, who were all victims of traffic accidents. On an anatomo-clinical level, real floating elbows accounted for 37.5% of all cases, the rest were derived pathologies. Among these derived pathologies, the association of diaphyseal fracture of the humerus with a lesion of one or both forearm bones represented 50% of the cases. Regarding skin condition, open fractures were present in 37.5% of all patients. At the final evaluation we obtained two unsatisfactory results in patient treated surgically. No orthopedic treatment achieved an excellent final result, but they ranged between good and fair. CONCLUSION: This study shows that the orthopedic treatment maintains its position as valid treatment for floating elbows. Nevertheless it is important to master the technique and recognize its limits.

INTRODUCTION: Les coudes flottants sont des pathologies rares qui posent assez de problèmes de prise en charge. La tendance actuelle du traitement est celle de la chirurgie mais le traitement orthopédique est un bon moyen quand on a un plateau technique limité. MATÉRIEL ET MÉTHODE: Nous avons fait une étude prospective de 18 mois qui consistait à faire la prise en charge des patients présentant des coudes flottants. Deux méthodes de traitement ont été utilisées avec des critères d'indication préalablement définis. L'évaluation définitive s'est faite en moyenne en 10 mois avec des extrêmes de 6 et 18 mois et selon la classification fonctionnelle de mayo clinic. RÉSULTATS: En 18 mois, nous avons traité 8 patients présentant des coudes flottants qui étaient tous des victimes d'accidents de circulation. Sur le plan anatomopathologique, les coudes flottants vrais représentaient 37,50% les autres étaient des dérivées. Parmi ces dérivées, l'association de la diaphyse humérale à l'un ou les deux os de l'avant bras représentait 50%. Par rapport à l'état cutané, 37,50% des patients avaient de fractures ouvertes au niveau de l'avant bras. A l'évaluation finale nous avons obtenu 2 mauvais résultats issus du traitement chirurgical, les autres étant des bons et moyens résultats. CONCLUSION: Cette étude montre à suffisance que le traitement orthopédique garde sa place dans le traitement des coudes flottants, mais il faut avoir la maitrise de la technique et connaître ses limites.

[Knowledge and attitudes of medical personnel in blood transfusion in Bamako, Mali]. / Connaissances et attitudes du personnel médical en matière de transfusion sanguine au Mali.

PURPOSE OF THE STUDY: We undertook a study to determine the level of knowledge and practice of medical staff personnel on transfusion medicine in Mali at Bamako and Kati. PATIENTS AND METHODS: The study was conducted from January to April 2010 in the three main teaching hospitals of Bamako and Kati and in the six referral health centers of the district of Bamako. Medical staff knowledge and practice were assessed using a questionnaire. The study population consisted of specialized practitioners (15%), general practitioners (21.4%), nurses (41.6%), and midwives (22%). RESULTS: Overall, 70.9% of the staff did not receive any training in blood transfusion since their graduation. The general knowledge about blood transfusion was insufficient in 53.9% of staff and excellent in 46.1%. Only 42.9% of medical staff has a good basic knowledge of blood products, their indications, and related accidents. CONCLUSION: Our study showed weaknesses in the transfusion system in Bamako, with insufficient knowledge of the medical staff in blood transfusion and little experience.

[Causes, signs and outcome of 30 patients with pulmonary embolus]. / Etilogie, Clinique Et Evolution De L'Embolie Pulmonaire A Propos De 30 Cas.

Authors studied 30 cases of pulmonary emboli in BAMAKO in the departments of Cardiology at Point G hospital. The purpose of this work was to determine the pulmonary emboli's frequency, their signs and symptoms and to observe their outcome. Was eligible to study every patient hospitalised for pulmonary emboli confirmed by clinical signs and D- dimere test, with ECG and echocardiogram in most cases. The pulmonary emboli' frequency was 1,7%, with an average age of 51 years ± 16,9. Among causes the most frequent were hypertension (50%), phlebitis (40%), chronic cor pulmonale (30%), and heart failure (40%). Signs were respiratory distress (80%), haemoptysis (43%), syncope (20%), and circulatory collapse (15%). ECG show mostly right ventricular hypertrophy (93,3%) and x ray sometimes a characteristic aspect. Cardiac echography show essentially ventricular and auricular dilatation with a thrombus in 6,7% of the cases. The treatment was by heparin, AVK and analgesic. Mortality in study was 11, 3 %. So pulmonary embolus is always at high risk and sometimes it's diagnostic is difficult.

[Cerebrovascular accidents: risk factors, clinical course and prognosis in the Cardiology "B" Service of the du Point G University Hospital Center, Bamako]. / Accidents vasculaires cerebraux: facteurs de risque, évolution et pronostic dans le service de cardiologie "B" du CHU du Point G, Bamako.

Our study of series, futurology, descriptive and analytical proceeded in the service of Cardiology B of the CHU of the Point G of the 1(er) July at 31 Décember 2007 and related to 57 in-patients. It aimed to release the factors of risks, to evaluate under treatment the evolution and to determine the prognostic elements of the cerebral vascular accidents. All the patients hospitalized in the service of Cardiology G for the period of study for cerebral vascular accident documented by a cerebral TDM was included in the series. The cerebral vascular accidents represented more of the quarter (25,22 %) of the admissions. The sample counted 29 women (50,9 %) and 28 men (49,1 %) with a sex ratio of 1,03 in favour of the women. The average age was 61,17 years ± 13,71 there. Arterial hypertension (59,6 %) was the first factor of risk and in the series the ischaemic AVC constituted approximately three quarters (70,2 %) of the organic types. It was especially male and the rather female hemorrhagic lesion. The hemorrhagic AVC was noted before 30 years and the ischaemic AVC beyond. The complications were with female prevalence and identical lethality in the two sexes. The hospital death rate in the study was considerable (10,5 %). The found prognostic elements did not have statistical significance.

[The use of rhythmic Holter record in the diagnosis of unexplained syncope at the point hospital cardiology division]. / Interet du Holter rythmique dans le diagnostic des syncopes inexpliquees dans le service de cardiologie a du point G.

Authors report the finding of the descriptive study of 36 syncope case following while 1 year (January-December 2006) in cardiology A service at the hospital of point G. The unexplained syncopes have represented 30% of the all syncopes. The female frequency sex was predominant with 58% of cases. The mean age of patients was 43 +/- SD years. The holter rhythmic during 24 hours has been productive for 58% in term of etiology research of syncope dominate essentially by the trouble of rythm at 19%.

[Risk factors for ischemic heart disease: a review of 162 cases in Bamako]. / Cardiopathies ischemiques en cardiologie a Bamako (a propos de 162 cas).

The determination of risk factors a low to prevent or to delay the apparition of certain diseases. Our study put out in Cardiology A of Hôpital du Point G. gold to determine the main risk factors of ischemic heart diseases between 162 patients. It appears that all classical risk factors (HBP, Diabetes, obesity, tobacco use, sedentary, menopause, contraceptives, dyslipidemia) were found among patients. It appears particularly that avoidable risk factors such tobacco use among young men, sedentary and obesity play important role in the beginning. So it is possible to deploy an efficient prevention politic.

[Socio-demographic and prognostic aspects of unfollowed pregnancies of patients admitted in the Department of Gynaecology-Obstetric of Gabriel Toure Hospital]. / Aspects socio-demographiques et pronostic des grossesses non suivies chez les patientes admises dans le Service de Gynecologie-Obstetrique de l'Hopital Gabriel Toure.

UNLABELLED: The prenatal followed up permit, on the one hand, to track down risk pregnancies, to appreciate the evolution of pregnancy and its repercussion on the maternal state, to finally make the prognosis of the childbirth and on the other hand to identify risk pregnancies and to assure a management outside emergency context. They contribute this fact to the meaningful reduction of the maternal mortality. The non followed up pregnancies are characterized by their important maternal and fetal mortality and morbidity. The aim of our survey was to determine the frequency of the unfollowed pregnancies, to describe the socio demographic profile of the women and to determine the prognosis of these pregnancies. MATERIAL AND METHODS: Our survey had for setting the service of Gynecology and obstetrics of Gabriel Touré hospital. Center of cares, research and formation, this service that is 3rd level in the sanitary pyramid in Mali, receives emergencies from other motherhoods of lower level. Were include in this survey, women who delivered in the service and hadn't done any prenatal consultation. Criterias of non inclusion were next one: women having done at least a prenatal consultation, women having delivered in another sanitary structure, all cases of non assisted childbirths, women whose gestational age is lower to 28 weeks and/or fetal weight lower than 500 grams. Every case has been matched to a witness (consistent woman who has been followed and delivered in the service) according to criterias of age and parity. The statistical tests used to study associations between variables are the chi2 with a significativity doorstep of P = 0.05 and Odd ratio (OR). RESULTS: We recorded 2173 childbirths and 286 non followed pregnancies been 13.16% of frequency. The middle age of our patient was 23 years with extremes of 16 and 44 years, nullipareses represented 25.9% of cases. The domestic helps were more numerous in the group of cases with 4.9% against 0.3% in the witness group (P = 0.0006, OR = 14.6; IC [2.01, 30.05]). The maternal prognosis is marked by 2.1% of death (P = 0.013). Fetal prognosis is bad with 10.9% of child stillborn (P = 0.0007; OR = 3.19) and 21.5% of morbid APGAR. CONCLUSION: The absence of prenatal consultation is associated to a height maternal and fetal mortality and morbidity.

Low prevalence of cervical infections in women with vaginal discharge in west Africa: implications for syndromic management.

OBJECTIVES: To measure prevalence and risk factors for cervical infections among a large sample of women consulting for vaginal discharge in west Africa and to evaluate its syndromic management through a two visit algorithm. METHODS: In 11 health centres in Bénin, Burkina Faso, Ghana, Guinée, and Mali 726 women who presented with a vaginal discharge without abdominal pain and who denied being a sex worker (SW) were enrolled. Cervical samples were tested for the detection of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) with polymerase chain reaction (PCR) assays. All participants were treated with single dose (2 g) metronidazole and clotrimazole cream for 3 days. They were randomised to be told either to come back on day 7 only if there was no improvement in the discharge (group A), or to come back on day 7 regardless of response to treatment (group B). RESULTS: Overall, the prevalence of NG and CT was only 1.9% (14/726) and 3.2% (23/726) respectively. Risk factors previously recommended by the WHO were not associated with the presence of cervical infection, with the exception of the number of sex partners in the past 3 months. When taken together, these risk factors had a positive predictive value of only 6.4% to identify cervical infections. Prevalence of cervical infection was not higher in women who came back on day 7, regardless of the strategy used. Prevalence of NG/CT was lower in Ghana and Bénin (5/280, 1.8%), where comprehensive interventions for SW have been ongoing for years, than in the three other countries (27/446, 6.1%, p = 0.01). CONCLUSIONS: NG and CT infections are uncommon in west African women who consult for vaginal discharge and who are not SW. Syndromic management of vaginal discharge should focus on the proper management of vaginitis. The control of gonococcal and chlamydial infection should be redesigned around interventions focusing on sex workers.

[Workshop of military reconstructive surgery in Conakry May 1999: example of civilian-military cooperation in responding to medical-surgical crisis emergencies]. / L'atelier de chirurgie réparatrice de guerre de Conakry mai 1999: exemple de coopération civilo-militaire dans une réponse aux aspects d'urgence médico-chirurgicale d'une crise.

During the period from 1998 to 1999, civil wars broke out in number of west African countries including Liberia, Sierra Leone, and Guinea Bissau. Due to the situation in surrounding countries, Guinea Conakry was forced to accept nearly 650000 refugees whose presence represented a major risk for the socio-political stability of the country. International organizations and NGOs condemned the atrocities inflicted on civilian populations by the children serving as soldiers in the RUF rebels organizations of Sierra Leone and Liberia. These attacks included murders, gang rapes, abduction of children and young people, and mutilation of extremities of people of all ages ranging from infants to elderly. Treatment of mutilation victims requires the availability of facilities for surgical treatment and prosthetic fitting in Guinea Conakry. The humanitarian action division of the French Foreign Affairs Department and the NGO Handicap International decided to provide specialized training in the management of mutilation injuries to surgical groups in hospitals of Guinea and Sierra Leone. The program consisted in a workshop on reconstructive surgery for war-related injuries to allow optimal prosthetic fitting for reinsertion of mutilation victims into society.

[Complications of illegal induced abortions at Bamako (Mali) between December 1997 and November 1998]. / Complications des avortements provoqués illgaux à Bamako (Mali) de décembre 1997 à novembre 1998.

We carried out a descriptive retrospective study over a period of one year, in the Gynecology and Obstetrics Referrals Department of Gabriel-Touré Hospital at Bamako. We analyzed 1,081 files of patients presenting at the department with complications of spontaneous or induced abortion. We identified and studied 189 cases of illegal induced abortions. The patients were young (mean age 21.8 years), of a low socioeconomic level and most (71.4%) had no living child. The gestational age of the fetus was less than 12 weeks for 19.5% of the women and between 13 and 16 weeks for 47.6%. The abortions were carried out by traditional practitioners (3.7%), general practitioners (9%), trainee nurses (10.5%) and state nurses and midwives (57.1%). In more than half the cases (71.4%), the abortion took place at the home of the practitioner. Several methods of abortion were used (e.g. curettage, uterine probes). In 44.4% of the cases, the woman refused to comment on the reasons for the abortion. The other women cited mostly academic reasons (20.63% of cases) and fear of their parents (13.22%). The main reasons for consultation were bleeding (51.3%), hyperthermia (35.4%), pain (9. 52%) and neurological problems (3.1%). Three types of complication were identified: bleeding (47%), infectious complication (33.3%) and drug poisoning (4.2%). The rate of maternal mortality was 10% and the management of the patients required surgical (from curettage to hysterectomy) and medical treatment, with a mean stay in hospital of 10 days.

[Premature delivery: epidemiology, etiologic factors, prevention strategies]. / Accouchement prématuré: épidémiologie-facteurs étiologiques-stratégies de prévention.

Early delivery is not rare, it is an important cause of perinatal mortality. In this study its rate, was 4.95%. The early and late ages of procreation were particularly interested (7.95%) and 3.90%. The first and last parities were more exposed (7.75%-5.31%). The woman occupation was as an important risk-factor. The incidences increased in the poor and rich women groups (7.34%-3.84%) the early labor risk was reduced when the women had efficient prenatal care; when the women had delivered early, the early labor risk increased. So when the women had delivered a stillborn. The early labor risk factor was more important. Finally the authors founded 83.33% of maternal causes could be controlled by efficient prenatal care. Even this rate was so important in the foetal group causes.

PIP: An important cause of perinatal mortality, premature delivery involves the expulsion of the fetus during weeks 28-37 of gestation. Such deliveries are seen rather often, but its frequency varies by country and in the same country from one time period to the next. Results are presented from a study on the frequency and epidemiology of premature deliveries at Ignace Deen Hospital in Conakry between May 1994 and June 1995. This prospective study was conducted using hospital documents. Of 2057 births, 102 were premature, for a frequency of 4.95%. Adolescents, women aged 35 years and older, primiparous women, and grand multiparas ran the greatest risks of bearing a premature child. The risk of premature delivery was 3.8 times greater in the group of housewives than in the group of salaried women, and 2.45 times more than among students. The highest incidences of premature delivery were among poor and wealthy women, at the respective levels of 7.54% and 3.84%. The absence of prenatal care was an important risk factor, with the risk of premature delivery decreasing as the degree of prenatal follow-up increased. Having already had a premature birth and a stillbirth multiplied by 7.86 and 12.58, respectively, the risk of premature delivery. 83.33% of maternal factors involved in premature delivery could have been controlled using effective prenatal care.

[Role of iron deficiency in anemia in pregnant women in Mali]. / Place de la carence martiale dans l'anémie de la femme enceinte au Mali.

The epidemiological characteristics of iron deficiency anemia after radioimmunoassay of serum and erythrocyte ferritin were evaluated in 209 Malian women at the time of delivery in a maternity unit in Bamako, Mali. The incidence of iron deficiency anemia was high (36.8%). This incidence did not reflect socio-economic status, nor even any particular obstetric history, but was significantly higher in younger mothers (aged under 26). The severity of anemia was such that 2.4% of women would require a blood transfusion post-partum. It looks therefore desirable, in Mali, to screen routinely and to ensure the prevention of iron deficiency in adolescent girls and to include, in the prevention of anemia of pregnant women, routine iron supplements from the beginning of pregnancy.