[Postpartum family planning at the district hospital of the commune II of Bamako, Mali]. / Planification familiale du postpartum a l'hopital de district de la commune II de Bamako, Mali.

Postpartum family planning is the prevention of pregnancy during the 12 months following childbirth. OBJECTIVE: To study the use of contraceptive methods in the postpartum period in the obstetrics gynecology department of the district hospital of the commune II of Bamako. MATERIALS AND METHODS: We conducted a descriptive and analytical cross-sectional study with prospective data collection from January 1, 2019 to December 31, 2020. All women who had given birth who had chosen and benefited from a contraceptive method were included. The statistical test used was Fisher's test with a significance level set at 5%. RESULTS: In 2 years, the contraceptive prevalence in the postpartum was 26.1%. More than 2/3 of counseling (61%) was done during prenatal consultations, 8% during the latency phase, 26% in the immediate postpartum and 5% during the postnatal visit. The most chosen methods were implants (47.1%), intrauterine device (29.6%), miro-progestin pills (12.5%), injectable progestogens (8%) and condoms (3.2%). CONCLUSION: Postpartum family planning contributes to increasing contraceptive prevalence.

La planification familiale du postpartum est la prévention des grossesses durant les 12 mois qui suivent l'accouchement. OBJECTIF: Etudier l'utilisation des méthodes contraceptives dans le postpartum dans le service de gynécologie obstétrique de l'hôpital de district de la commune II de Bamako. MATÉRIELS ET MÉTHODES: Nous avons mené une étude transversale descriptive et analytique avec collecte prospective des données du 1er janvier 2019 au 31 décembre 2020. Ont été incluses, toutes les accouchées ayant choisi et bénéficié d'une méthode contraceptive. Le test statistique utilisé a été le test de Fisher avec un seuil de significativité fixé à 5%. RÉSULTATS: En 2 ans, la prévalence contraceptive dans le postpartum était de 26,1%. Plus des 2/3 des counselings (61%) ont été faits lors des consultations prénatales, 8% pendant la phase de latence, 26% dans le postpartum immédiat et 5% lors de la visite postnatale. Les méthodes les plus choisies ont été les implants (47,1%), le dispositif intra-utérin (29,6%), les pilules miro-progestatives (12,5%), les progestatifs injectables (8%) et les préservatifs (3,2%). CONCLUSION: La planification familiale du postpartum contribue à augmenter la prévalence contraceptive.

[Knowledge, attitudes and practices of Bamako media Men' on family planning]. / Connaissances, attitudes et pratiques des Hommes de medias de Bamako sur la planification familiale.

INTRODUCTION: Contraceptive prevalence is low in Mali. The information provided by the media men can help to increase or decrease the use of contraceptive methods. OBJECTIVE: To study the knowledge, attitudes and practices of Bamako media Men on family planning. MATERIAL AND METHODS: We carried out a descriptive cross-sectional study with prospective data collection from June 1 to August 30, 2019. It concerned journalists and presenters of 15 radio and 6 televisions in Bamako. RESULTS: During the 3 months, 615 media Men agreed to participate in this study. These are men and women from 36 to 45 years old in 37.2% of cases, married in 81.3% of cases. The radio with 85.5% was their main source of information on family planning. They all knew at least one contraceptive method. The best-known methods were pills (94.3%), injectables (57%) and implants (49.1%). They were in favor of the practice of family planning in 77.2% of cases, 76.9% had already used a method and 56.7% had already hosted a program on family planning. CONCLUSION: Media men are essential in the transmission of information. The quality of the information provided by these Media men can be influenced by their personal perceptions and attitudes. Their better involvement in the promotion of family planning can help to increase contraceptive prevalence.

INTRODUCTION: La prévalence contraceptive est faible au Mali. Les informations transmises par les Hommes de médias peuvent contribuer à augmenter ou à diminuer l'utilisation des méthodes contraceptives. OBJECTIF: Etudier les connaissances, attitudes et pratiques des Hommes de médias de Bamako sur la planification familiale. MATÉRIEL ET MÉTHODES: Nous avons réalisé une étude transversale descriptive avec collecte prospective des données du 1er juin au 30 août 2019. Elle a concerné les journalistes et les animateurs de 15 radios et 6 télévisions de Bamako. RÉSULTATS: Durant les 3 mois, 615 Hommes de médias de Bamako ont accepté de participer à cette étude. Il s'agissait d'hommes et de femmes âgés de 36 à 45 ans dans 37,2% des cas, mariés dans 81,3% des cas. La radio avec 85,5% était leur principale source d'information sur la planification familiale. Ils connaissaient tous au moins une méthode contraceptive. Les méthodes les plus connues étaient les pilules (94,3%), les injectables (57%) et les implants (49,1%). Ils étaient favorables à la pratique de la planification familiale dans 77,2% des cas, 76,9% avaient déjà utilisé une méthode et 56,7% avaient déjà animé une émission sur la planification familiale. CONCLUSION: Les Hommes de médias sont essentiels dans la transmission de l'information. La qualité de l'information fournie par ces Hommes de médias peut être influencée par leurs perceptions et attitudes personnelles. Leur meilleure implication dans la promotion de la planification familiale peut contribuer à augmenter la prévalence contraceptive.

Virgibacillus doumboii sp. nov., a halophilic bacterium isolated from the stool of a healthy child in Mali.

A moderately halophilic and strictly aerobic bacterium was isolated from a human stool as part of a study on the diagnosis of childhood malnutrition in Mali. Strain Marseille-Q1616T is a Gram-stain-positive, rod-shaped, catalase-positive and oxidase-negative bacterium. It has a genome size of 3.91 Mbp with 39.79% G+C content, which contains 3954 protein-coding genes including genes encoding phosphomycin resistance and Listeria monocytogenes, 16 rRNA genes and 64 tRNA genes. Strain Marseille-Q1616T exhibited a 96.3% 16S rRNA gene sequence similarity and shared an OrthoANI value of 70.64% (the highest observed) with Virgibacillus kekensis, the phylogenetically closest validly published species. Based on phenotypic and phylogenetic evidence and genomic average nucleotide identity values, we suggest the creation of a new species within the Virgibacillus genus, named Virgibacillus doumboii sp. nov., type strain Marseille-Q1616T (= CSURQ1616).

Virgibacillus ihumii sp. nov., a new bacterium isolated from the stool of healthy African children.

During a case-control study on severe acute malnutrition, strain Marseille-Q1233 was isolated. It is a Gram-positive, rod-shaped and halophilic bacillus isolated from a stool sample of Malian child under the age of 5. The fatty acid profile of the strain consisted of C15:0-anteiso and C14:0-iso as major components. Digital DNA-DNA hybridization and average nucleotide identity calculation showed 23.10% and 80.81% similarity respectively between strain Marseille-Q1233 and Virgibacillus siamensis strain Marseille-P2607, the phylogenetically closely related species with standing in nomenclature. On the basis of these results, we report the description of Virgibacillus ihumii sp. nov. strain Marseille-Q1233 as a new bacterial species.

Halobacillus ihumii sp. nov., a new bacterium isolated from stool of healthy children living in Mali.

Strain Marseille-Q1234T is a new species from the genus Halobacillus that was isolated in 2019 from a stool sample in a healthy Malian child <5 years old. Cells are Gram-positive and strictly halophilic bacilli. Strain Marseille-Q1234T exhibits 98.46% 16S rRNA gene sequence similarity to Halobacillus naozhouensis strain JSM 071068T (NR_116505.1), the phylogenetically closely related species with standing in nomenclature. Based on the phenotypic and phylogenetic evidence, OrthoANI values and results of the biochemical tests, the new species is named Halobacillus ihumii sp. nov., for which strain Marseille-Q1234T (= CSURQ1234) is proposed as the type strain.

[Spontaneous triple pregnancy on bicicatricial uterus in the referral health center of commune II of Bamako, Mali]. / Grossesse triple spontanee sur uterus bicicatriciel au centre de sante de reference de la commune II de Bamako, Mali.

The trimellar pregnancy on bicicatricial uterus is a rare situation. It can be associated with many maternal-fetal complications. Given these risks, some teams opt for an embryonic reduction. We report a case of spontaneous trimellar pregnancy on bicicatricial uterus. This was a 38 year-old patient, third pregnancy, second birth, 2 alive with a history of 2 caesareans. The evolution of the pregnancy was marked by a urinary tract infection at 34 weeks of gestation. The caesarean section performed at 36 weeks of gestation allowed the birth of 3 newborns, 2 of which were females in 2000 and 1900 grams, and one male weighing 2400 grams. The postpartum was marked by a rapidly resolved eclampsia crisis.

La survenue d'une grossesse triméllaire sur un utérus bicicatriciel est une situation rare. Elle peut être associée à de nombreuses complications materno-fœtales. Compte tenu de ces risques, certaines équipes optent pour une réduction embryonnaire. Nous rapportons un cas de grossesse triméllaire spontanée sur utérus bicicatriciel. Il s'agissait d'une patiente de 38 ans 3è geste, 2è pare avec 2 enfants vivants, ayant un antécédent de 2 césariennes. L'évolution de la grossesse a été marquée par une infection urinaire à 34 SA. La césarienne pratiquée à 36 SA a permit la naissance de 3 nouveaunés dont 2 de sexes féminins de 2000 et 1900g et un de sexe masculin pesant 2400g. Les suites de couches ont été marquées par une crise d'éclampsie rapidement résolue.

[Pregnancy And Delivery In The Large Multiparous In The Reference Health Center Of Commune II Of Bamako, Mali]. / Grossesse Et Accouchement Chez La Grande Multipare Au Centre De Sante De Reference De La Commune II De Bamako, Mali.

AIM: The aim was to compare the maternal-fetal prognosis of pregnancies in large multiparous with that of other parities. MATERIALS AND METHODS: We conducted a case-control study from March 1st, 2014 to February 1st, 2015. It concerned all parturients admitted in our service during the study period. We have chosen 1 case for 2 witnesses. All the large multiparous were included as cases and as witnesses the primiparous, the pauciparous and the multiparous who gave birth just before and after the case. The statistical test was the Chi2 with a significance level at 5%. RESULTS: The frequency of pregnancy in the large multiparous was 4.93%. They were housewives in 84% of cases, unschooled in 74.7% of cases. The maternal-fetal outcome was dominated by uterine rupture in 0.6% of cases, immediate postpartum hemorrhage in 9.8% of cases, vicious presentations in 5.5% of cases and cord prolapse in 6.8% of cases. CONCLUSION: Large multiparity is common in our practice. It is a high-risk pregnancy because of its many maternal-fetal complications.

BUT: Le but était de comparer le pronostic materno-fœtal des grossesses chez les grandes multipares à celui des autres parités. MATÉRIELS ET MÉTHODES: Nous avons réalisé une étude cas-témoins du 1er mars 2014 au 1er février 2015. Elle a concerné toutes les parturientes admises dans le service pendant la période d'étude. Nous avons choisi 1 cas pour 2 témoins. Ont été incluses comme cas toutes les grandes multipares et comme témoins les primipares, les paucipares et les multipares ayant accouchées juste avant et juste après le cas. Le test statistique utilisé a été le Chi2 avec un seuil de significativité fixé à 5%. RÉSULTATS: La fréquence de la grossesse chez la grande multipare était de 4,93%. Il s'agissait de femmes au foyer dans 84% des cas, non scolarisées dans 74,7% des cas. Le pronostic materno-fœtal a été dominé par la rupture utérine dans 0,6% des cas, l'hémorragie de la délivrance dans 9,8% des cas, les présentations vicieuses dans 5,5% des cas et la procidence du cordon dans 6,8% des cas. CONCLUSION: La grande multiparité est fréquente dans notre pratique. C'est une grossesse à haut risque à cause de ses nombreuses complications materno-fœtales.

[Health care-associated infections in teaching hospital Gabriel TOURE]. / Les infections associées aux soins dans le service de chirurgie generale du CHU Gabriel TOURE.

OBJECTIVES: To study health care-associated infections (HCAI) in teaching hospital Gabriel TOURE. METHODOLOGY: This was a prospective study of 6 months (from April to September 2016) which included patients admitted to the General Surgery Department, operated or not, except those who had undergone a necrosectomy. The criteria used for the diagnosis of the infection were those of the CDC of Atlanta. RESULTS: A total of 200 patients were included in the study. Twenty one patients developed IAS that is a frequency of 10.5%. There were 11 men and 10 women with a mean age of 37.7 years with a standard deviation of 17.6 years. Surgical site infection was the most common HCAI (77.3%) followed by urinary tract infection (13.6%) and burn infection (9.1%). The influencing factors were those related to the patients (nutritional status p = 0.004, anemia RR = 3.1 IC p = 0.003 and diabetes), those related to the surgical intervention (the duration of the intervention ≥ 2H, p = 0,0001, the Altemeier class 3 and 4, RR = 4.24, IC p = 0.005, the number of interveners in the blocks ≥7, p = 0.000, the NNISS score 1 and 2 p = 0.0009), invasive procedures (bladder catheter ≥ 4 days p = 0.0000). Escherichia coli was the most isolated microorganism (31.2%) followed by Klebsiella pneumonia and A baumannii (18.7%). The treatment was local (twice-daily dressing with antiseptics), surgical (necrosectomy 16% and re-intervention 10%) and general (adapted to the antibiogram). The consequences of HCAI were an extension of total hospital stay (greater than 7 days) with p = 0.0000, morbidity 3% and mortality 5%. CONCLUSION: HCAI remains a concern in our country and globally. They prolong the hospital stay. The implementation of a prevention, control and surveillance program will improve the quality of care by significantly reducing HCAI.

Une infection est dite associée aux soins (IAS) si elle survient au cours ou au décours d'une prise en charge. L'OBJECTIF ÉTAIT: d'étudier les infections associées aux soins en chirurgie générale du CHU Gabriel Touré. MÉTHODOLOGIE: Il s'agissait d'une étude prospective de 6mois (d'avril à septembre 2016) intéressant les malades hospitalisés dans le service de chirurgie générale opérés ou non, sauf ceux ayant subi une nécrosectomie. Les critères utilisés pour le diagnostic de l'infection ont été ceux du CDC d'Atlanta. RÉSULTATS: Au total 200 malades ont été inclus dans l'étude. Vingt un patients ont développé des IAS soit une fréquence de 10,5%. Il s'agissait de 11 hommes et 10 femmes ayant un âge moyen de 37,7 ans avec un écart type de 17,6 ans. L'infection du site opératoire a été la plus fréquente des IAS (77,3%) suivie par l'infection urinaire (13,6%) et l'infection des brûlures (9,1%). Les facteurs influençant ont été ceux liés aux malades (état nutritionnel p=0,004 ; anémie RR=3,1 IC p=0,003 et diabète), ceux liés à l'intervention chirurgicale (la durée de l'intervention sup ≥2H p=0,0001 ; la classe d'Altemeier 3 et 4 ; RR=4,24 ; IC p=0,005 ; le nombre d'intervenants au blocs ≥7 ; p=0,000 ; le score de NNISS 1et 2 p=0,0009), les actes invasifs (sondage vésical ≥ 4 jours p=0,0000). Escherichia coli a été le germe le plus isolé parmi les micro-organismes (31,2%) suivi de Klebsiella pneumonia et A baumannii (18,7%). Le Traitement a été local (pansement biquotidien avec des antiseptiques), chirurgical (nécrosectomie 16% et ré-intervention 10%) et général (adapté à l'antibiogramme). Les conséquences des IAS ont été le prolongement de la durée totale d'hospitalisation (supérieur à 7 jours) avec p= 0,0000, la morbidité 3% et la mortalité 5%. CONCLUSION: Les IAS demeurent préoccupantes dans notre pays comme à l'échelle mondiale. Elles prolongent le séjour hospitalier. La mise en œuvre d'un programme de prévention, de contrôle et de surveillance permettra d'améliorer la qualité des soins en réduisant considérablement les IAS.

[Evaluation of the care of the severe acute malnutrition in the service of pediatrics of the CHU Gabriel TOURE, Bamako, Mali]. / Evaluation de la prise en charge de la malnutrition aigue severe dans le service de pediatrie du Centre Hospitalier Universitaire (CHU) Gabriel TOURE, Bamako, Mali.

OBJECTIVE: To study the care of children suffering from severe acute malnutrition with complications at the URENI of the pediatrics of the CHU (University Hospital) Gabriel TOURE. PATIENTS AND METHOD: it was a comprehensive cross-sectional study with a retrospective collection of data on children monitored for the treatment of severe acute malnutrition from January 1st till December 31st, 2014. We, also, conducted a qualitative survey of staff and carers of children under treatment during the survey period. RESULTS: 490 patients were admitted directly to URENI. The 12-23 month age group was predominant (46.5%). The sex ratio was 1.09 in favor of the male sex. The success rate of treatment at the URENI was 51.40%. At the URENAS, the dropout rate was 27.50%. At the URENAM, the dropout rate was 72.70%. Almost all the carers interviewed during the individual interviews and focus groups were satisfied with nutritional care. CONCLUSION: The lack of autonomous hospitalization rooms at the URENI and the inadequacies noticed at the level of performance indicators have to motivate the creation of an URENI answering the standards at the level of the pediatrics of the CHU (University Hospital) Gabriel TOURE.

OBJECTIF: Etudier la prise en charge des enfants souffrant de malnutrition aiguë sévère avec complications au niveau de l'URENI de la Pédiatrie du CHU Gabriel TOURE. PATIENTS ET MÉTHODE: Il s'agissait d'une étude transversale exhaustive avec un recueil rétrospectif des données sur les enfants suivis pour le traitement de la malnutrition aiguë sévère du 1er janvier au 31 décembre 2014. Nous avons, aussi, procédé à une enquête qualitative auprès du personnel et des accompagnants des enfants sous traitement pendant la période de l'enquête. RÉSULTATS: Il y avait 490 patients admis directement à l'URENI . La tranche d'âge de 12-23 mois était prédominante (46,5%). Le sex-ratio était de 1,09 en faveur du sexe masculin. Le taux de succès au traitement à l'URENI était de 51,40%. A l'URENAS, le taux d'abandon était de 27,50%. A l'URENAM, le taux d'abandon était de 72,70%. La quasi-totalité des accompagnantes interviewées, en entretien individuel et en focus groupe, étaient satisfaites de la prise en charge nutritionnelle. CONCLUSION: L'absence de salles d'hospitalisation autonome à l'URENI et les insuffisances constatées au niveau des indicateurs de performance doivent motiver la création d'une URENI répondant aux normes au niveau de la pédiatrie du CHU Gabriel TOURE.

Strategies of blood collection in Cote d'Ivoire: impact of mobile collection methods on the production of the National Blood Transfusion Service, 2014-2016.

Blood product suppliers have two options for blood collection: at fixed sites and mobile collection sites. Those preferring voluntary, unpaid donations must move ever closer to the population by organizing mobile collection. The objective of this study was to analyze the impact of mobile collection in the production of the Côte d'Ivoire's CNTS. Our results, based on data from the CNTS from 2014 through 2016 and interviews with 22 managers of blood transfusion centers, confirm the increasing preponderance of this approach. Thus, our results raise the problem of blood safety in a context where the prevalence of transfusion-transmissible infections is higher in mobile collections, where most donors are giving blood for the first time.

Lactimicrobium massiliense gen. nov., sp. nov.; Anaerolactibacter massiliensis gen. nov., sp. nov.; Galactobacillus timonensis gen. nov., sp. nov. and Acidipropionibacterium timonense sp. nov. isolated from breast milk from healthy breastfeeding African women.

Four strains isolated by microbial culturomics from breast milk of healthy mothers from Mali were not identified and characterized by taxono-genomics. This led us to propose the new genera and species Lactimicrobium massiliense, Anaerolactibacter massiliensis and Galactobacillus timonensis containing type strain Marseille-P4301T (CSUR P4301T), Marseille-P4302T (CSUR P4302T) and Marseille-P4641T (CSUR P4641T), respectively. The strain Marseille-P4482 represents a novel species, Acidipropionibacterium timonense, in a previously known genus with type strain being Marseille-P4482T (CSUR P4482T).

[Pregnancy and delivery for women aged 40 years and over at the reference health center of commune II of Bamako district, Mali]. / Grossesses et accouchements chez les femmes de 40 ans et plus au centre de sante de reference de la commune II du district de Bamako, Mali.

GOAL: The aim of this study was to compare the maternal-fetal prognosis of pregnancies at 40 years of age and above with that of pregnancies obtained before 40 years of age in the obstetric gynecology department of the reference health center of commune II of Bamako district. MATERIALS AND METHODS: This was a prospective cohort study that was conducted at the maternity ward of Reference Health Center of Commune II of Bamako district from 1st January to 31 December 2012. Were included in our study as patients exposed, all the pregnant women of 40 years and over and as unexposed patients, pregnant women aged 20-39 who gave birth in our service. Teenage pregnancies were not included in this study. The statistical tests used were Pearson's Khi2 and Fisher's test with a significance level of 5%. RESULTS: The frequency of pregnancy among women aged 40 and over was 1.68%. These were large multiparas unschooled patients in 60% of cases, with hypertension in 6.7% of cases. Pregnancy in her patients was associated with a high rate of caesarean section in 16.7% of cases, term overrun in 6.7% of cases, seat presentation in 6.7% of cases, macrosomia in 6.7% of cases and fetal malformation in 1.7% of cases. CONCLUSION: Slight account of its many maternal-fetal complications, pregnancies in women 40 years and older deserve special attention.

BUT: Le but de cette étude était de comparer le pronostic materno-foetal des grossesses chez les patientes de 40 ans et plus à celui des grossesses conçues avant 40 ans dans le service de gynécologie obstétrique du centre de santé de référence de la commune II de Bamako. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude prospective de Cohorte qui s'est déroulée à la maternité du Centre de Santé de Référence de la Commune II du 1er janvier au 31décembre 2012. Ont été incluses dans notre étude comme patientes exposées toutes les gestantes de 40 ans et plus et comme patientes non exposées les gestantes de 20-39 ans ayant accouchées dans notre service. N'ont pas été retenues dans cette étude, les grossesses chez les adolescentes. Les tests statistiques utilisés ont été le Khi2 de Pearson et le test de Fisher avec un seuil de significativité à 5%. RÉSULTATS: La fréquence de la grossesse chez les femmes de 40 ans et plus était de 1,68%. Il s'agissait de grandes multipares non scolarisées dans 60% des cas, présentant une HTA dans 6,7% des cas. La grossesse chez ces patientes a été associée à un taux élevé de césarienne dans 16,7% des cas, de dépassement de terme dans 6,7% des cas, de présentation du siège dans 6,7% des cas, de macrosomie dans 6,7% des cas et de malformation foetale dans 1,7% des cas. CONCLUSION: Compte ténu de ses nombreuses complications materno-foetales, les grossesses chez les femmes de 40 ans et plus méritent une attention particulière.

[Breast Cancer: Immunohistochemistry And Prognosis At Gabriel Touré Teaching Hospital In Bamako-Mali]. / Cancer Du Sein : Immunohistochimie Et Pronosticau Chu Gabriel Toure De Bamako-Mali.

Breast cancer is the second cancer of women in Mali. Immunohistochemistry is poorly performed in our African countries. OBJECTIVES: To describe the immunohistochemical aspect and determine the prognosis of breast cancer. METHODOLOGY: This is a retrospective descriptive study (March 2006-July 2016) in the General Surgery Department of Gabriel Toure University Hospital in Bamako, Mali. Immunohistochemistry was performed in all patients through a collaboration of our German partners. RESULTS: We collected 98 patients (95 women and 3 men) with an average age of 40.04 ± 13.07 years. Twenty-two patients (22.44%) had a personal history of benign breast disease. In 16 patients (16.33%), we found a family breast cancer. The most common histological types were intra ductal carcinoma with 84 (85.72%) and invasive lobular carcinoma in 9 cases (9.18%). Immunohistochemistry found a predominance of triple negative with forty nine patients (50%) followed by Luminal A subtype with 26 cases (26.23%). According to the TNM classification, 44 patients (44.90%) were received at stage III. The median survival was 60 months in the group of patients who received hormone therapy versus 28 months for the group without hormone therapy (p = 0.007). CONCLUSION: Immunohistochemistry is essential for the adequate management of breast cancer. Its realization has allowed us to improve the prognosis of hormone-dependent cancers.

Le sein est le deuxième siège du cancer chez la femme au Mali. Les examens immunohistochimiques sont peu réalisés dans nos pays africains. OBJECTIFS: Décrire l'aspect immunohistochimique et déterminer le pronostic du cancer du sein. MÉTHODOLOGIE: C'est une étude descriptive à collecte rétrospective (mars 2006-juillet 2016) dans le service de chirurgie générale du CHU Gabriel TOURE de Bamako au Mali. L'examen immunoihistochimique a été réalisé chez tous les malades grâce à la collaboration de nos partenaires allemands. RÉSULTATS: Nous avons colligé 98 malades (95 femmes et 3 hommes) avec un âge moyen de 40,04 ± 13,07 ans. Vingt-deux malades (22,44 %) avaient un antécédent personnel de pathologie bénigne du sein. Chez 16 malades (16,33 %), il y avait une notion familiale de cancer du sein. La prise d'œtroprogestatifs a été évoquée chez 28 femmes (28,57%). Les types histologiques les plus fréquents étaient le carcinome canalaire infiltrant avec 84 (85,72%) et le carcinome lobulaire infiltrant dans 9 cas (9,18%). L'immunohistochimie a permis de trouver une prédominance du triple négatif avec quarante neuf malades (50%) suivi du sous type Luminal A avec 26 cas (26,23%).Selon la classification TNM, 44 patients (44,90 %) ont été reçus au stade III. La médiane de survie a été de 60 mois dans le groupe des patients ayant bénéficié d'une hormonothérapie versus 28 mois pour le groupe sans hormonothérapie (p=0.007). CONCLUSION: l'immunohistochimie est essentielle pour la prise en charge adéquate des cancers du sein. Sa réalisation nous a permis d'améliorer le pronostic des cancers hormono dépendant.

[Knowledge, Attitudes And Practice Of The Pupils Of The High School Famolo Coulibaly Of Kolokani On The HIV And The AIDS (Mali)]. / Connaissances, Attitudes Et Pratiques Des Eleves Du Lycee Famolo Coulibaly De Kolokani Sur Le VIH Et Le Sida (Mali).

INTRODUCTION: The epidemic of the AIDS is global. No country or territory is saved. Mali takes into account the preventive education in the AIDS in the sectorial programs of the Ministry of Education and the courses of study. OBJECTIVE: to estimate the level of the Knowledge, Attitudes and Practice of the pupils regarding prevention of the HIV and the AIDS. METHODS: it was about an exhaustive, quantitative and transverse survey led to the high school of Kolokani. The survey concerned 515 pupils questioned from 2 till 7 March 2007. RESULTS: At the level of the knowledge the mode of transmission the most quoted by the pupils was the sexual intercourse with multiple partners (78.46 % for the boys and 71.22 % for the girls). Compared with the behavior, 62.89% of sexually active pupils used the condom in their last high-risk sexual intercourse. Only 25.05% of students reported having conducted a voluntary screening test. Attitudes of discrimination exist because 18.06 % of pupils have a feeling of fear towards the People Living with the HIV. CONCLUSION: These results show that there is a risk of transmission of the HIV and the AIDS in schools. This has to motivate the intensification of the activities of raising sensitization and prevention to improve the indicators of prevention of this pandemic.

INTRODUCTION: L'épidémie du SIDA est globale. Aucun pays ou territoire n'est épargné. Le Mali prend en compte l'éducation préventive au SIDA dans les programmes sectoriels du Ministère chargé de l'éducation et des programmes scolaires. OBJECTIF: Evaluer le niveau des Connaissances, Attitudes et Pratiques des élèves en matière de prévention du VIH et du SIDA. MÉTHODES: Il s'agissait d'une étude exhaustive, quantitative et transversale menée au lycée de Kolokani. L'enquête a porté sur 515 élèves interrogés du 2 au 7 Mars 2007. RÉSULTATS: Au niveau des connaissances le mode de transmission le plus cité par les élèves était le rapport sexuel avec les partenaires multiples (78,46% pour garçons et 71,22% pour les filles). Par rapport aux comportements 62,89% des élèves sexuellement actifs ont utilisé le préservatif lors de leur dernier rapport sexuel à haut risque. Seulement 25,05% des élèves ont déclaré avoir effectué un test de dépistage volontaire. Les attitudes de discrimination existent car 18,06% des élèves ont un sentiment de peur envers les Personnes Vivant avec le VIH. CONCLUSION: Ces résultats montrent qu'il y a un risque de transmission du VIH et du SIDA en milieu scolaire. Ceci doit motiver l'intensification des activités de sensibilisation et de prévention pour améliorer les indicateurs de prévention de cette pandémie.

'Lactomassilus timonensis,' a new anaerobic bacterial species isolated from the milk of a healthy African mother.

We here report the main characteristics of a new anaerobic bacterial genus and species 'Lactomassilus timonensis,' strain Marseille-P4641T (CSUR = P4641), isolated by microbial culturomics from the milk of a 35-year-old healthy lactating mother from Mali.

[Epidemiology of schistosomiasis in the periurban area of Sotuba, 10 years mass treatment began in Mali]. / Épidémiologie des schistosomoses dans le village périurbain de Sotuba, dix années après la mise à échelle du traitement de masse au Mali.

OBJECTIVE: The objective of this work was to describe the epidemiology of schistosomiasis 10 years after mass administration of praziquantel began in Sotuba, Mali. METHODOLOGY/RESULTS: This observational cross-sectional survey in Sotuba, a periurban village in the Bamako district, took place from July to September 2010 and collected stool and urine samples from residents at least one year old. Kato-Katz (for stool) and urine filtration techniques were used to detect Schistosoma mansoni and S. hæmatobium eggs, respectively. Overall, 335 urine samples and 300 stool samples were examined. The prevalence rate was 5.4% (18/335) for S. hæmatobium and 8.7% (26/300) for S. mansoni. Excretion of these eggs was most frequent in the 6-15 year-old group: 4.8% (16/335) for S. hæmatobium and 7.7% (23/300) for S. mansoni. Snails of the Biomphalaria pfeifferi and Bulinus truncatus species were the intermediate hosts, captured in the fields at water contact points. The principal clinical symptoms reported by participants were abdominal pain 27.2% (61/169) and headaches 23.2% (52/169). CONCLUSION: Despite the implementation of mass drug administration in Mali a decade ago, our results show that schistosomiasis transmission continues in Sotuba. Assessment of the risk factors for this persistent transmission is strongly needed.

Phenotypic Profile of Rh and Kell Blood Group Systems among Blood Donors in Cote d'Ivoire, West Africa.

Few countries in sub-Saharan Africa make systematic searches for antigens C, c, E, and e of the Rh and Kell system antigens in the donor and recipient, thereby exposing transfused patients. Purpose and Objectives. In this paper, we propose to determine the red cell Rh and Kell blood groups among blood donors from traditional techniques to improve medical care of transfused patients. This study will allow us to assess the frequency of blood group antigens in these systems. Study Design and Methods. We carried out a study on the red cell typing in the blood donor population of the National Blood Transfusion Center in Abidjan. This study was performed on 651 blood donors. Results. For the Rh system, the antigen frequencies of D, c, e, C, and E are, respectively, 92.93%, 99.85%, 99.85%, 21.97%, and 13.82%. K antigen is found in 0.77% of donors. Discussion and Conclusion. Although the frequencies of the most immunogenic antigens are lower than in the white race, lack of preventive measures makes the immunological risk high in Africa. Furthermore, Africa is full of specificities that are important to note for a better care of our patients.

Dating the fungus-growing termites' mutualism shows a mixture between ancient codiversification and recent symbiont dispersal across divergent hosts.

The mutualistic symbiosis between fungus-growing termites and Termitomyces fungi originated in Africa and shows a moderate degree of interaction specificity. Here we estimate the age of the mutualism and test the hypothesis that the major splits have occurred simultaneously in the host and in the symbiont. We present a scenario where fungus-growing termites originated in the African rainforest just before the expansion of the savanna, about 31 Ma (19-49 Ma). Whereas rough age correspondence is observed for the four main clades of host and symbiont, the analysis reveals several recent events of host switching followed by dispersal of the symbiont throughout large areas and throughout different host genera. The most spectacular of these is a group of closely related fungi (the maximum age of which is estimated to be 2.4 Ma), shared between the divergent genera Microtermes, Ancistrotermes, Acanthotermes and Synacanthotermes (which diverged at least 16.7 Ma), and found throughout the African continent and on Madagascar. The lack of geographical differentiation of fungal symbionts shows that continuous exchange has occurred between regions and across host species.

[Coverage rate and satisfaction of populations after mass treatment with praziquantel and albendazole in Mali]. / Taux de couverture et satisfaction des populations apres traitement de masse au praziquantel et a l'albendazole au Mali.

In Mali, schistosomiasis always remains a major public health problem. In 2005, mass treatment campaigns with praziquantel and albendazole have been organized in all endemic regions. The present study aimed to assess the impact of these mass treatment campaigns and the recipient's satisfaction in two endemic areas (Mopti and Ségou). It was a cross-sectional study with one passage from February to March 2006. The study carried out on political authorities (n=142), teachers and school administers (n=70), health workers (n=46), community distributors (n=33), community members (n=2170) and pupils (n=2480). We used Lot Quality Assurance Sample (LQAS) to determine treatment coverage and recipient's satisfaction. Two types of lots were considered, villages and schools. Questionnaires were used for investigation. In Ségou, the treatment rates varied from 100% at school level and in community in Bla district to 97.2% in the community of Ségou town. In Mopti, a treatment rate of 100% was observed in Bankass and Douentza both at school and in the community. The proportion of happiest individuals (to feel well) after the mass treatment campaign was 72.3% among pupils and 76.6% in the community. The results of this study suggest that the high treatment coverage rates observed during these campaigns should be sustained by a yearly chemotherapy strategy preceded by a community's health education programmes.

[Blackwater fever in children during cerebral malaria: 3 case reports in Bamako]. / La fièvre bilieuse hémoglobinurique chez l'enfant: à propos de 3 observations à Bamako.

BACKGROUND: Blackwater fever is a rare but serious form of malaria in children. Diagnosis relies on clinical symptoms and on the color of the urines. OBJECTIVES: To describe blackwater fever in children, a disease whose prevalence seems to be increasing. METHOD: We report 3 cases of blackwater fever observed in our institution. RESULTS: In 2 cases, acute renal insufficiency with oligoanuria was observed. In all the 3 cases, treatment with quinine was stopped and replaced by injectable artemether. Evolution was dependent on renal function, and included in 1 patient neurological sequels consisting in aphasia. CONCLUSION: Blackwater fever is a severe affection whose diagnosis should be evoked using the color of urine. Evolution is usually favorable in the pediatric population, when adequate care can be provided.