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The forecasting of high-dimensional, spatiotemporal nonlinear systems has made tremendous progress with the advent of model-free machine learning techniques. However, in real systems it is not always possible to have all the information needed; only partial information is available for learning and forecasting. This can be due to insufficient temporal or spatial samplings, to inaccessible variables, or to noisy training data. Here, we show that it is nevertheless possible to forecast extreme event occurrences in incomplete experimental recordings from a spatiotemporally chaotic microcavity laser using reservoir computing. Selecting regions of maximum transfer entropy, we show that it is possible to get higher forecasting accuracy using nonlocal data vs local data, thus allowing greater warning times of at least twice the time horizon predicted from the nonlinear local Lyapunov exponent.
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Lasers , Aprendizado de Máquina , Previsões , EntropiaRESUMO
BACKGROUND: To sustain the efficacy of malaria vector control, the World Health Organization (WHO) recommends the combination of effective tools. Before designing and implementing additional strategies in any setting, it is critical to monitor or predict when and where transmission occurs. However, to date, very few studies have quantified the behavioural interactions between humans and Anopheles vectors in Africa. Here, we characterized residual transmission in a rural area of Burkina Faso where long lasting insecticidal nets (LLIN) are widely used. METHODS: We analysed data on both human and malaria vectors behaviours from 27 villages to measure hourly human exposure to vector bites in dry and rainy seasons using a mathematical model. We estimated the protective efficacy of LLINs and characterised where (indoors vs. outdoors) and when both LLIN users and non-users were exposed to vector bites. RESULTS: The percentage of the population who declared sleeping under a LLIN the previous night was very high regardless of the season, with an average LLIN use ranging from 92.43 to 99.89%. The use of LLIN provided > 80% protection against exposure to vector bites. The proportion of exposure for LLIN users was 29-57% after 05:00 and 0.05-12% before 20:00. More than 80% of exposure occurred indoors for LLIN users and the estimate reached 90% for children under 5 years old in the dry cold season. CONCLUSIONS: LLINs are predicted to provide considerable protection against exposure to malaria vector bites in the rural area of Diébougou. Nevertheless, LLIN users are still exposed to vector bites which occurred mostly indoors in late morning. Therefore, complementary strategies targeting indoor biting vectors in combination with LLIN are expected to be the most efficient to control residual malaria transmission in this area.
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Anopheles , Mosquiteiros Tratados com Inseticida , Inseticidas , Malária , Animais , Burkina Faso/epidemiologia , Criança , Pré-Escolar , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Controle de Mosquitos , Mosquitos Vetores , Estações do AnoRESUMO
Two-dimensional arrays of coupled waveguides or coupled microcavities allow us to confine and manipulate light. Based on a paradigmatic envelope equation, we show that these devices, subject to a coherent optical injection, support coexistence between a coherent and incoherent emission. In this regime, we show that two-dimensional chimera states can be generated. Depending on initial conditions, the system exhibits a family of two-dimensional chimera states and interaction between them. We characterize these two-dimensional structures by computing their Lyapunov spectrum and Yorke-Kaplan dimension. Finally, we show that two-dimensional chimera states are of spatiotemporal chaotic nature.
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A ring resonator made of a silica-based optical fiber is a paradigmatic system for the generation of dissipative localized structures or dissipative solitons. We analyze the effect of the non-instantaneous nonlinear response of the fused silica or the Raman response on the formation of localized structures. After reducing the generalized Lugiato-Lefever to a simple and generic bistable model with a nonlocal Raman effect, we investigate analytically the formation of moving temporal localized structures. This reduction is valid close to the nascent bistability regime, where the system undergoes a second-order critical point marking the onset of a hysteresis loop. The interaction between fronts allows for the stabilization of temporal localized structures. Without the Raman effect, moving temporal localized structures do not exist, as shown in M. G. Clerc, S. Coulibaly, and M. Tlidi, Phys. Rev. Res. 2, 013024 (2020). The detailed derivation of the speed and the width associated with these structures is presented. We characterize numerically in detail the bifurcation structure and stability associated with the moving temporal localized states. The numerical results of the governing equations are in close agreement with analytical predictions.
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Coupled nonlinear oscillators can present complex spatiotemporal behaviors. Here, we report the coexistence of coherent and incoherent domains, called chimera states, in an array of identical Duffing oscillators coupled to their nearest neighbors. The chimera states show a significant variation of amplitude in the desynchronized domain. These intriguing states are observed in the bistability region between a homogeneous state and a spatiotemporal chaotic one. These dynamical behaviors are characterized by their Lyapunov spectra and their global phase coherence order parameter. The local coupling between oscillators prevents one domain from invading the other one. Depending on initial conditions, a family of chimera states appear, organized in a snaking-like diagram.
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We investigate the spatio-temporal dynamics of a ring cavity filled with a non-instantaneous Kerr medium and driven by a coherent injected beam. We show the existence of a stable mixed-mode solution that can be either extended or localized in space. The mixed-mode solutions are obtained in a regime where Turing instability (often called modulational instability) interacts with self-pulsing phenomenon (Andronov-Hopf bifurcation). We numerically describe the transition from stationary inhomogeneous solutions to a branch of mixed-mode solutions. We characterize this transition by constructing the bifurcation diagram associated with these solutions. Finally, we show stable localized mixed-mode solutions, which consist of time-periodic oscillations that are localized in space.
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Complex spatiotemporal dynamics have been a subject of recent experimental investigations in optical frequency comb microresonators and in driven fiber cavities with Kerr-type media. We show that this complex behavior has a spatiotemporal chaotic nature. We determine numerically the Lyapunov spectra, allowing us to characterize different dynamical behavior occurring in these simple devices. The Yorke-Kaplan dimension is used as an order parameter to characterize the bifurcation diagram. We identify a wide regime of parameters where the system exhibits a coexistence between the spatiotemporal chaos, the oscillatory localized structure, and the homogeneous steady state. The destabilization of an oscillatory localized state through radiation of counter-propagating fronts between the homogeneous and the spatiotemporal chaotic states is analyzed. To characterize better the spatiotemporal chaos, we estimate the front speed as a function of the pump intensity.
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We consider coupled-waveguide resonators subject to optical injection. The dynamics of this simple device are described by the discrete Lugiato-Lefever equation. We show that chimera-like states can be stabilized, thanks to the discrete nature of the coupled-waveguide resonators. Such chaotic localized structures are unstable in the continuous Lugiato-Lefever model; this is because of dispersive radiation from the tails of localized structures in the form of two counter-propagating fronts between the homogeneous and the complex spatiotemporal state. We characterize the formation of chimera-like states by computing the Lyapunov spectra. We show that localized states have an intermittent spatiotemporal chaotic dynamical nature. These states are generated in a parameter regime characterized by a coexistence between a uniform steady state and a spatiotemporal intermittency state.
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Extreme events such as rogue waves in optics and fluids are often associated with the merging dynamics of coherent structures. We present experimental and numerical results on the physics of extreme event appearance in a spatially extended semiconductor microcavity laser with an intracavity saturable absorber. This system can display deterministic irregular dynamics only, thanks to spatial coupling through diffraction of light. We have identified parameter regions where extreme events are encountered and established the origin of this dynamics in the emergence of deterministic spatiotemporal chaos, through the correspondence between the proportion of extreme events and the dimension of the strange attractor.
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We consider a bistable system consisting of all fiber cavity driven by an external injected continuous wave. We report on front propagation in a high finesse cavity. We study the asymptotic behavior of the front velocity. We show that the front velocity is affected by the distance from the critical point associated with bistability. We provide a scaling low governing its evolution near the up-switching point of the bistable curve. We show also that the velocity of front propagation obeys a generic power law when the front velocity approaches asymptotically its linear growing value.
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OBJECTIVE: to report the epidemiological, clinical, paraclinical and therapeutic characteristics of the first COVID 19 patients in intensive care. PATIENTS AND METHOD: retrospective descriptive and analyticalstudy over 4 months, covering all adult patients tested positive for SARS-Cov-2 and admitted to intensive care. RESULTS: 49 patients, 35 men and 14 women (2% of cases) were admitted to intensive care. The median age was 64 years [26 - 92]. Hypertension (16; 32.6%), and diabetes (11; 22.4%) were the mostcommoncomorbidities. The most common symptoms on admission were cough (38; 80.9%), shortness of breath (35; 74.5%), and fever (33; 70.2%). The median time to onset of symptoms was 11 days. Non-invasive ventilation (NIV) was used in 21 patients (42.9%). Fourteen (28.6%) wereintubated and put onassisted ventilation. The mean hospital stay was 7.77 ± 7.30 days. We recorded 20 (40.8%) deaths. Factors associated with death were high blood pressure, onset of shock, and on mechanical ventilation. CONCLUSION: Covid-19 remains a public healthproblemwith high morbidity and mortality. The morbidity and mortalityfactorsare: comorbidities and the severity of the clinicalpicture.
OBJECTIF: rapporter les caractéristiques épidémiologiques, cliniques, paracliniques et thérapeutiques des premiers patients COVID 19 en réanimation. PATIENTS ET MÉTHODE: étude rétrospective descriptive et analytique sur 4 mois, portant sur l'ensemble des patients adultes testés positif au SARS-Cov-2 et admis en réanimation. RÉSULTATS: 49 patients, 35 hommes et 14 femmes (2% des cas) étaient admis en réanimation. L'âge médian était de 64 ans [26 92]. L'HTA (16 ; 32,6%), et le diabète (11 ; 22,4%) étaient les comorbidités les plus fréquentes. Les symptômes les plus fréquents à l'admission étaient la toux (38 ; 80,9%), l'essoufflement (35 ; 74,5%), et la fièvre (33 ; 70,2%). Le délai médian d'apparition des symptômes était de 11 jours. La ventilation non invasive (VNI) a été utilisée chez 21 patients (42,9%). Quatorze (28,6%) ont été intubés et mise sous ventilation assistée. La durée moyenne d'hospitalisation était de 7,77 ± 7,30 jours. Nous avons enregistré 20 (40,8%) décès. Les facteurs associés au décès étaient l'hypertension artérielle, la survenue d'un état de choc, la mise sous ventilation assistée. CONCLUSION: la Covid-19 reste un problème de santé publique avec une morbi mortalité élevée. Les facteurs de morbi-mortalité sont : les comorbidités et la sévérité du tableau clinique.
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Atrial fibrillation is the most frequent permanent rhythm disorder.Theaim of this work was to determine the epidemiological and clinical aspects of atrial fibrillation cases hospitalized in the cardiology department of the University Hospital of Kati. MATERIALS AND METHODS: We carried out a descriptive retrospective study, from January 2018 to December 2019.Patients of all ages and both sexes with clinical and EKG atrial fibrillation admitted to the department during the study period were included in the study.The variables studiedwere: socio-demographic characteristics, clinical signs, classification of atrial fibrillation, and comorbidities associated. RESULTS: A total of 52 patients were included in the studyof 203 cases hospitalized in the department, with a hospital prevalence of 25.61%, the female sex was predominant 69.23%. The main reason for consultation was heart failure syndrome (46.15%).Arterial hypertension (55.76%) was the mostassociatedcomorbidity. Permanent atrial fibrillation accounted for 63.46% of cases . CONCLUSION: Atrial fibrillation is the most frequent arrhythmia in our environment, preventive measures must be put in place for early detection and better management of comorbiditiesassociatedwith atrial fibrillation.
La fibrillation auriculaire est le trouble du rythme le plus fréquent. Le but de ce travail était de déterminer les aspects épidémiologiques et cliniques de la fibrillation atriale dans le service de cardiologie du CHU de Kati. MATÉRIELS ET MÉTHODES: Il s'agit d'une étude rétrospective descriptive menée de janvier 2018 à décembre 2019. Ont été inclus dans cette étude les patients de tout âge et des deux sexes ayant présenté une fibrillation atriale sur des critères cliniques et électrocardiographiques, admis dans le service pendant la période d'étude. Les variables étudiées étaient : les caractéristiques sociodémographiques, les signes cliniques et électriques, et les comorbidités associées. RÉSULTATS: Au total 52 patients ont été inclus dans l'étude sur 203 cas hospitalisés dans le service soit une prévalence hospitalière de 25,61%, le sexe féminin a été prédominant 69,23%. Le principal motif de consultation était le syndrome d'insuffisance cardiaque (46,15%). L'hypertension artérielle (55,76%) a été la comorbidité la plus associée. La fibrillation atriale permanente représentait 63,46% des cas. CONCLUSION: La fibrillation atriale est l'arythmie la plus fréquente dans notre milieu, des mesures préventives doivent être mise en place pour une détection précoce et une meilleure prise en charge des comorbidités associées.
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A retrospective review of parasitic intestinal infections reported to the Ministry of Health of Burkina Faso from 1997 to 2007 was conducted. Study focused on the results of 904,733 stool examinations performed for parasite detection in public hospital parasitology laboratories. The overall positivity rate for intestinal parasite infection was 54.7%. Protozoa and helminths were identified in 32.0% and 8.0% of stool examinations respectively. The main parasites checked for were amoebas (29.8%), hookworms (5.7%), tapeworms (1.7%) and Schistosoma mansoni (1.6%). Parasites were detected throughout the country and the proportion of positive samples differed significantly from one region to another. These findings highlight the high frequency of laboratory diagnosis of intestinal parasitic infection and demonstrate the need to improve environmental sanitation and provide health education to the population.
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Enteropatias Parasitárias/epidemiologia , Burkina Faso/epidemiologia , Fezes/parasitologia , Humanos , Estudos RetrospectivosRESUMO
Since September 2002, Côte d'Ivoire has been in the throes of armed conflict that has split the country in two. In the government-controlled area, access to health care services has continued. In the area under the control of the "New Forces", access to health care services decreased dramatically due to departure of qualified health personnel and subsequent shutdown of sanitary facilities. The purpose of this transversal descriptive survey was to measure the impact of this crisis on the health care system in the Séguéla sanitary district that is located in the war zone. Findings showed that 60.7% of sanitary facilities are no longer operational, that 77.7% of qualified personnel have left their workstation, and that 46.2% of sanitary structures have been damaged. A few reference hospitals and sanitary facilitates have been able to remain open thanks to the support of the humanitarian organisations. As a result of declining access to health care services, a recrudescence of measles and IST has been observed and gastritis and traumatology have appeared among the top 10 causes of morbidity. Access to effective health care in the Séguéla sanitary district cannot be envisioned without the return of qualified health care personnel and the renovation of the sanitary facilities.
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Acessibilidade aos Serviços de Saúde , Guerra , Côte d'Ivoire/epidemiologia , Estudos Transversais , Fechamento de Instituições de Saúde/estatística & dados numéricos , Mão de Obra em Saúde , Humanos , Sarampo/epidemiologia , Infecções Respiratórias/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Ferimentos e Lesões/epidemiologiaRESUMO
INTRODUCTION: The objective of this work was to determine the frequency of mental disorders among female inmates of the C.S.D.R.F "Bollé". METHOD: This was a descriptive, cross-cutting, prospective study that took place from August to September 2016 at (C.S.D.R.F) "Bollé" in Bamako. It concerned all female inmates present during the study period. The data were collected from pre-established fact sheets, the administration of the Mental Health Screening Questionnaire (MSQ) and clinical variables according to ICD10 criteria. RESULTS: In total, 85 of inmates, or 74% (N-115) agreed to participate in the study. The 14-24 age group accounted for 61.0%. Singles accounted for 56.5% and 95.3% of female inmates had no previous prison history. Seventy-four percent were in pre-trial detention 12.6% had psychotic disorders. Personality disorders were observed in 11.8%. An inmate was on the committee. Thyme disorders were present in 4.7% of female inmates. Drug abuse was observed in 2.4% of female inmates. CONCLUSION: Detention can trigger, promote or aggravate a mental disorder.
INTRODUCTION: L'objectif de ce travail était de déterminer la fréquence des troubles psychiques chez les détenues du C.S.D.R.F « Bollé ¼. MÉTHODE: Il s'agissait d'une étude descriptive, transversale, prospective qui s'est déroulée d'Août à Septembre 2016 au (C.S.D.R.F) « Bollé ¼ de Bamako. Elle a concerné toutes les détenues présentes pendant la période d'étude. Les données ont été collectées sur des fiches d'enquête préétablies, l'administration du Questionnaire de Dépistage en Santé Mentale (QDSM) et des variables cliniques selon les critères du CIM10. RÉSULTATS: Au total, 85 détenues, soit 74 % (N=115) ont accepté de participer à l'étude. La tranche d'âge de 14-24 ans représentait 61,0%. Les célibataires représentaient 56,5% et 95,3% des détenues étaient sans antécédent carcéral. Soixante quatorze pourcent (74%) étaient en détention provisoire 12,6% présentaient des troubles psychotiques. Les troubles de la personnalité étaient observés chez 11,8%. Une détenue présentait la comitialité. Les troubles thymiques étaient présents chez 4,7% des détenues. L'usage abusif de drogue avait été observé chez 2,4% des détenues. CONCLUSION: La détention peut déclencher, favoriser ou aggraver un trouble psychique.
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INTRODUCTION: Obstructive renal failure or obstructive uropathy is an entity defined by the simultaneous presence of impaired renal function and dilated urinary excretory pathways in medical imaging. It accounts for 2 to 10% of the causes of acute renal failure (ARF). The purpose of this work was to evaluate the prevalence of this condition in our department. METHOD: This was a retrospective study conducted from January 1, 2017 to June 30, 2018 in the said department. The parameters studied were age, sex, etiology, type of renal failure, actions performed, surgical results of the procedure, creatinine level before and after management, and death rate. RESULTS: obstructive renal failure accounted for 7.32% of all hospitalizations during the study period. The sex ratio was 1.86 in favor of men. The average age was 48.99 ± 6.81 years with extremes of 7 and 102 years. The etiologies were dominated by lithiasis (43.4%). Renal failure was acute and chronic in 20.5% and 54.2% of cases, respectively. It was indeterminate in 25.3% of cases. The obstructive character of renal failure has been confirmed in medical imaging. Lithiases accounted for 43.4% of cases. For therapeutic management, our patients received urinary catheterization (38.6%), nephrostomy (34.9%), urological surgery (22.9%) and hemodialysis (22%). The evolution was favorable in 59% of the cases. CONCLUSION: Obstructions of the upper urinary tract are becoming more frequent in our medical practice. They occur mainly in patients with lithiasis. There is a large proportion of kidney failure requiring hemodialysis.
INTRODUCTION: L'insuffisance rénale obstructive ou encore uropathie obstructive est une entité définie par la présencesimultanée d'une altération de la fonction rénale et d'une dilatation des voies excrétrices urinaires à l'imageriemédicale. Elle représente 2 à 10% des causes d'insuffisance rénale aiguë (IRA). L'objectif de ce travail était de déterminer la prévalence de cette affection dans notre service. MÉTHODE: Il s'agissait d'une étude rétrospective réalisée du 1er janvier 2017 au 30 juin 2018 dans le service de néphrologie du CHU du Point G.Ont été inclus, tous les patients hospitalisés dans le service durant la période d'étude et ayant un dossier médical exploitable. Les paramètres étudiés étaient l'âge, le sexe, l'étiologie, le type d'insuffisance rénale, les gestes réalisés, les résultats chirurgicaux de la procédure, le taux de créatinine avant et après la prise en charge et le taux de décès. RÉSULTAT: Durant la période d'étude, 83 patients répondaient aux critères d'inclusion sur les 1133 patients hospitalisés, soit 7, 32%.Le sex-ratio était de 1,86 en faveur des hommes. L'âge moyen était de 48,99±6,81 ans avec des extrêmes de 7 et 102 ans. A l'admission 97,6% des patients avaient une créatininémie augmentée. La créatininémie moyenne était de 1284,087 µmol/l avec des extrêmes de 506 et 2063 µmol/l. La créatininémie moyenne après traitement était de 579,605 µmol/l. L'échographie de l'arbre urinaire réalisée chez tous nos patients a montré une hydronéphrose et une urétérohydronéphrose dans respectivement 61,5% et 38,5% des cas. La tomodensitométrie abdomino-pelvienne réalisée chez 42 patients, montrait une urétérohydronéphrose bilatérale dans 50% des cas. La lithiase urétérale et les séquelles bilharziennes étaient les plus fréquemment retrouvées à la TDM avec 23,53% chacune. L'infection urinaire était présente dans 59,7% des cas et le germe isolé était Escherichia coli dans 32,8% des cas. Les étiologiesétaient dominées par les lithiases (43,4%). L'insuffisance rénale était aiguë et chronique dans respectivement 20,5% et 54,2% des cas. Elle était indéterminée dans 25,3% des cas. La prise en charge thérapeutique comportait le sondage urinaire (38,6%), la néphrostomie percutanée (34,9%), la chirurgie urologique (22,9%) et l'hémodialyse (22%).L'évolution a été favorable dans 59,04% des cas dont 20,48% des cas de guérison complète, 14, 46% des cas d'amélioration et 24,10% des cas ont été transférés. Le taux de mortalité était élevé soit 36,14%. CONCLUSION: les obstructions du haut appareil urinaire sont de plus en plus fréquentes dans notre pratique médicale. Elles sont essentiellement d'origine lithiasique. On compte une importante proportion d'insuffisance rénale nécessitant une prise en charge en hémodialyse.
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INTRODUCTION: Mental health is a state of equilibrium and well-being, any alteration of which leads to the appearance of a state of distress and/or mental disorder. OBJECTIVE: The objective of this work was to study familial and environmental factors associated with mental disorders. MATERIALS AND METHODS: A cross-sectional study was conducted in the Psychiatry Department of the Point G University Hospital Center from April 1, 2016 to March 31, 2017 among outpatients with a psychiatric disorder in whom factors associated with psychiatric disorders were studied. RESULTS: We included 288 patients. The median age was 33.0 years. The sex ratio was 1.88 in favor of males. Married patients accounted for 45.5%. First born uterine siblings accounted for 26.7%. Patients born of an inbreeding alliance accounted for 25.7%. Cases with a family history of a psychiatric disorder represented 59.0% and those who spent their childhood with their parents accounted for 64.2%. Cases of psychoactive substance use prior to the onset of the mental disorder accounted for 42.7%. The main psychosocial stress factors that preceded the onset of the mental disorder were grief (46.2%) and family conflict (22.6%). Psychotic disorders accounted for 77.8%. CONCLUSION: Our results show an association of mental disorders with family history of psychiatric disorder among patients followed in psychiatry. Further studies, such as genetic association may prove useful.
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Transtornos Mentais , Transtornos Psicóticos , Adulto , Criança , Estudos Transversais , Hospitais Universitários , Humanos , Masculino , Mali/epidemiologia , Transtornos Mentais/epidemiologiaRESUMO
INTRODUCTION: Kidney disease (KD) is defined as a set of functional, morphological and histological kidney abnormalities. It is a truly global public health problem. Its prevalence is estimated to be 50 times that of end-stage renal disease (ESRD). In Kayes, there is no data on the prevalence of kidney disease, hence the interest of this study. OBJECTIVES: to determine the prevalence of renal disease, its main causes and the main factors of aggravation of this pathology in the emergency department at hospital Fousseyni DAOU of Kayes. METHODOLOGY: Retrospective cross-sectional study carried out from January 1, 2014 to February 1, 2015. We included all hospitalized patients in whom a renal damage marker (elevation of plasma creatinine, urinary sediment abnormality, ultrasound, histology and significant proteinuria) has been found. RESULTS: the prevalence of kidney disease was 9.9% (109/1099). Eighty-nine met the inclusion criteria. The study population was composed of 47 women (52.8%) and 42 men (47.2%), with a sex ratio of 0.89 in favor of women. The average age was 40.09 years with a predominance of patients in the age group [40-59]. The main reasons for consultation were hypercreatininaemia (48.3%), edematous syndrome (16.9%), low back pain (10.1%). High blood pressure (55.1%) and lower extremity edema (46.1%) were the medical history frequently found in our study. The kidney disease found was in order of growth: chronic renal failure (51%); acute renal failure (28%); proteinuria (16%), hematuria (3%), morphological abnormality of the kidneys (2%). Tubulointerstitial nephropathy represented 64% of acute renal failure with P = 0.000306. Vascular nephropathy constituted 46.7% of chronic renal failure with P = 0.000251. No cases of glomerular nephropathy were found in patients over 60 years of age.The most common causes were represented by nephrotoxic drugs injuries; infectious; high blood pressure and diabetes. The most observed aggravating factors are herbal medicine, urinary tract infections, renal hypoperfusion and unbalanced hypertension. CONCLUSION: kidney disease is not uncommon in the emergency room at Hospital Fousseyni Daou of Kayes. The most common causes are nephrotoxic drugs, hypertension and diabetes.
INTRODUCTION: La maladie rénale (MR) définie comme l'ensemble des anomalies rénales fonctionnelle, morphologique et histologique. Elle est un véritable problème mondial de santé publique. Sa prévalence serait 50 fois celle de l'insuffisance rénale terminale (IRT). A Kayes, il n'existe pas de donnée sur la prévalence de la maladie rénale, d'où l'intérêt de cette étude. OBJECTIFS: déterminer la prévalence de la maladie rénale, ses principales causes et les principaux facteurs d'aggravation de cette pathologie dans le service des urgences de l'hôpital Fousseyni DAOU de Kayes. MÉTHODOLOGIE: Etude transversale rétrospective réalisée du 1er janvier 2014 au 1er février 2015. Etaient inclus, tous les patients hospitalisés chez qui au moins un marqueur d'atteinte rénale (élévation de la créatinine plasmatique, anomalie du sédiment urinaire, anomalie échographique ou histologique et une protéinurie significative) a été retrouvé. Les paramètres analysés étaient socio-épidémiologiques, cliniques et para-cliniques. Nous avons exclu tous les patients dont les dossiers médicaux étaient inexploitables. RÉSULTATS: la prévalence de la maladie rénale était de 9,9% (109/1099). Quatre-vingtneuf répondaient aux critères d'inclusion. La population d'étude était composée de 47 femmes (52,8%) et de 42 hommes (47,2%), avec un sex-ratio de 0,89 en faveur des femmes. La moyenne d'âge était de 40,09 ans avec une prédominance des patients de la tranche d'âge [40-59]. Les principaux motifs de consultation étaient hypercréatininémie (48,3%), syndrome Ådémateux (16,9%), douleur lombaire (10,1%). L'hypertension artérielle (55,1%) et Ådème des membres inférieurs (46,1%) étaient les antécédents pathologiques fréquemment retrouvées dans notre étude. La maladie rénale retrouvée était par ordre de croissance : insuffisance rénale chronique (51%) ; insuffisance rénale aigue (28%) ; protéinurie (16%), hématurie (3%), anomalie morphologique des reins (2%). La néphropathie tubulo-interstitielle représentait 64% des insuffisances rénales aiguës avec P= 0,000306. La néphropathie vasculaire constituait 46,7% des insuffisances rénales chroniques avec P= 0,000251. Aucun cas de néphropathie glomérulaire n'a été retrouvé chez les patients de plus de 60 ans.Les causes les plus fréquentes étaient représentées par les causes toxiques (médicaments néphrotoxiques) ; infectieuses ; l'hypertension artérielle et le diabète. Les facteurs d'aggravations les plus observés sont la phytothérapie, l'infection urinaire, l'hypoperfusion rénale et l'HTA non équilibrée. CONCLUSION: la maladie rénale n'est pas rare aux urgences de l'hôpital Fousseyni Daou de Kayes. Les causes les plus fréquemment rencontrées sont les médicaments néphrotoxiques, l'HTA et le diabète.
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INTRODUCTION: A public health emergency of international concern, COVID-19 is an acute respiratory disease responsible in eight months of approximately 843,158 deaths worldwide, including 29,425 deaths in Africa. The objective was to describe the COVID-19 cases in the health district of Commune III of Bamako. METHODS: This was a descriptive cross-sectional study of COVID-19 surveillance data from March 26 to August 27, 2020. Our variables were extracted from the surveillance database and analyzed on Epi-Info 7.2. Frequencies, rates and proportions were calculated. RESULTS: A positivity rate of 14.86% identified 126 confirmed cases out of an 848 notified suspect. The median age of confirmed cases was 34 years with a minimum of 8 months and a maximum of 93 years. The sex ratio was 2.7 males to females. Civil servants accounted for 32.54% of the positive cases. All the health subdistricts have recorded positive cases. The lethality was 7.94% affecting those over 65 years old. Among asymptomatic people 10.75% were confirmed positive for COVID-19. CONCLUSION: Our study suggests that young males were more likely to be infected with COVID-19. We recommend systematic screening of all contacts and involvement of the community in surveillance.
INTRODUCTION: Urgence de santé publique de portée internationale, la COVID-19 est une maladie respiratoire aiguë responsable en huit mois d'environ 843 158 décès dans le monde dont 29 425 décès en Afrique. L'objectif était de décrire les cas de la COVID-19 en Commune III de Bamako. MÉTHODES: Il s'agissait d'une étude transversale descriptive des données de surveillance de la COVID-19 du 26 Mars au 27 Août 2020. Nos variables ont été extraites de la base de données de surveillance et analysées sur Epi-Info 7.2. Les fréquences, taux et proportions ont été calculés. RÉSULTATS: Un taux de positivité de 14,86% a permis d'identifier 126 cas confirmés sur un 848 suspect notifié. L'âge médian des cas confirmés était de 34 ans avec un minimum de 8 mois et un maximum de 93 ans. Le sex-ratio était de 2,7 en faveur des hommes. Les fonctionnaires représentaient 32,54% des positifs. Toutes les aires de santé ont enregistré des cas confirmés. La létalité était de 7,94% affectant les plus de 65 ans. Parmi les personnes asymptomatiques 10,75% ont été confirmés positives à la COVID-19. CONCLUSION: Notre étude suggère que les jeunes de sexe masculin étaient plus susceptibles d'être infectés par la COVID-19. Nous recommandons le dépistage systématique de tous les contacts et une implication de la communauté dans la surveillance.
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INTRODUCTION: High blood pressure is a major cardiovascular risk factor. Patients with cardiovascular risk factors are at risk of developing COVID-19. The objective of this study was to determine epidemiology of Covid-19 infected in patients with high blood pressure. PATIENTS AND METHOD: Descriptive cross-sectional study from April 2020 to June 2020 about patients hospitalized for Covid 19 by PCR diagnosis at the Hopital du Mali Bamako and having high blood pressure. Admission registry and patient charts were used to collect data. RESULTS: We collected 78 out of 484 in patients which mean hospital frequency of 16.11%. The mean age was 55.21 +/- 14.61 years. Sex ratio M / F was 1.36. Patients were followed for high blood pressure in 59% of cases. Medical history was ischemic heart disease in 2.6% and dilated cardiomyopathy in 2.6%. Main functional signs were cough in 41.02% and lost of taste in 11.53%. High blood pressure on admission was grade 2 in 37.2% and grade 3 in 3.8%. Treatments received were calcium channel blockers 41.02%, inhibitors of the reninangiotensinaldosterone system 16.66% and combinations 15.38%. Hospital mortality was 10.3%. There was no statistically significant difference in mortality between known hypertensive patients and de novo hypertensive patients. There was also no statistically significant difference in mortality by grade of hypertension. CONCLUSION: High blood pressure can be associated to Covid 19. Treatment is based on calcium channel blockers and reninangiotensinaldosterone system inhibitors. It has an impact on the prognosis of the disease with significant mortality.
INTRODUCTION: L'hypertension artérielle (HTA) est un facteur de risque cardiovasculaire majeur. Dans la littérature elle est fréquemment retrouvée chez les patients atteints de la COVID-19.L'objectif de cette étude est de décrire l'épidémiologie de cette association chez les patients hospitalisés pour Covid-19. PATIENTS ET MÉTHODE: L'Etude est transversale et descriptive ; elle a été réalisée sur la période du 1erAvril 2020 au 30 Juin 2020. Elle a concerné les patients hospitalisés pour Covid 19 avec un test PCR positif à l'hôpital du Mali de Bamako et ayant une HTA. Les registres d'admission et les dossiers des patients ont servi pour la collecte des données. RÉSULTATS: Nous avons colligé 78 sur 484 patients hospitalisés soit une fréquence de 16,11%. L'âge moyen était de 55,21 +/- 14,61 ans. Le sex ratio H/F était de 1,36.Les patients étaient suivis pour HTA dans 59% des cas. Les antécédents médicaux étaient la cardiopathie ischémique chez 2,6% et la cardiomyopathie dilatée chez 2,6%. Les principaux signes fonctionnels étaient la toux chez 41,02% et l'agueusie chez 11,53%. L'HTA à l'admission était de grade 2 dans 37,2% des cas et de grade 3 dans 3,8% des cas. Les traitements reçus étaient les inhibiteurs calciques 41,02%, les inhibiteurs du système rénine angiotensine aldostérone 16,66% et les associations 15,38%. La mortalité hospitalière était de 10,3%. Il n'y avait pas de différence statistiquement significative concernant la mortalité entre les patients connus hypertendus et les patients hypertendus de novo. Il n'y avait pas non plus de différence statistiquement significative concernant la mortalité selon le grade de l'HTA. CONCLUSION: l'HTA peut être associée au Covid 19. Le traitement est basé sur les inhibiteurs calciques et sur les inhibiteurs du système rénine angiotensine aldostérone. Elle a un impact sur le pronostic de la maladie avec une mortalité importante.