Spreading of SARS-CoV-2 in West Africa and assessment of risk factors.

Although the African continent is, for the moment, less impacted than the rest of the world, it still faces the risk of a spread of COVID-19. In this study, we have conducted a systematic review of the information available in the literature in order to provide an overview of the epidemiological and clinical features of COVID-19 pandemic in West Africa and of the impact of risk factors such as comorbidities, climatic conditions and demography on the pandemic. Burkina Faso is used as a case study to better describe the situation in West Africa. The epidemiological situation of COVID-19 in West Africa is marked by a continuous increase in the numbers of confirmed cases. This geographic area had on 29 July 2020, 131 049 confirmed cases by polymerase chain reaction, 88 305 recoveries and 2102 deaths. Several factors may influence the SARS-CoV-2 circulation in Africa: (i) comorbidities: diabetes mellitus and high blood pressure could lead to an increase in the number of severe cases of SARS-CoV-2; (ii) climatic factors: the high temperatures could be a factor contributing to slow the spread of the virus and (iii) demography: the West Africa population is very young and this could be a factor limiting the occurrence of severe forms of SARS-CoV-2 infection. Although the spread of the SARS-CoV-2 epidemic in West Africa is relatively slow compared to European countries, vigilance must remain. Difficulties in access to diagnostic tests, lack of hospital equipment, but also the large number of people working in the informal sector (such as trading, businesses, transport and restoration) makes it difficult to apply preventive measures, namely physical distancing and containment.

Widening the lens of population-based health research to climate change impacts and adaptation: the climate change and health evaluation and response system (CHEERS).

Background: Climate change significantly impacts health in low-and middle-income countries (LMICs), exacerbating vulnerabilities. Comprehensive data for evidence-based research and decision-making is crucial but scarce. Health and Demographic Surveillance Sites (HDSSs) in Africa and Asia provide a robust infrastructure with longitudinal population cohort data, yet they lack climate-health specific data. Acquiring this information is essential for understanding the burden of climate-sensitive diseases on populations and guiding targeted policies and interventions in LMICs to enhance mitigation and adaptation capacities. Objective: The objective of this research is to develop and implement the Change and Health Evaluation and Response System (CHEERS) as a methodological framework, designed to facilitate the generation and ongoing monitoring of climate change and health-related data within existing Health and Demographic Surveillance Sites (HDSSs) and comparable research infrastructures. Methods: CHEERS uses a multi-tiered approach to assess health and environmental exposures at the individual, household, and community levels, utilizing digital tools such as wearable devices, indoor temperature and humidity measurements, remotely sensed satellite data, and 3D-printed weather stations. The CHEERS framework utilizes a graph database to efficiently manage and analyze diverse data types, leveraging graph algorithms to understand the complex interplay between health and environmental exposures. Results: The Nouna CHEERS site, established in 2022, has yielded significant preliminary findings. By using remotely-sensed data, the site has been able to predict crop yield at a household level in Nouna and explore the relationships between yield, socioeconomic factors, and health outcomes. The feasibility and acceptability of wearable technology have been confirmed in rural Burkina Faso for obtaining individual-level data, despite the presence of technical challenges. The use of wearables to study the impact of extreme weather on health has shown significant effects of heat exposure on sleep and daily activity, highlighting the urgent need for interventions to mitigate adverse health consequences. Conclusion: Implementing the CHEERS in research infrastructures can advance climate change and health research, as large and longitudinal datasets have been scarce for LMICs. This data can inform health priorities, guide resource allocation to address climate change and health exposures, and protect vulnerable communities in LMICs from these exposures.

[Portal cavernoma at child about two observations]. / Cavernome portal chez l'enfant a propos de deux observations.

We report two observations of portal cavernoma diagnosed successively in Bamako and Dakar. The first is a 6-year-old male admitted to the service for ascites and abdominal pain. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The clinical examination noted a moderate skin-mucosal pallor, asthenia. The biological assessment returned to moderate normochrome anemia with impaired pancreatic function while renal and hepatic functions were maintained. The abdominal scan performed after two low-contribution abdominal ultrasounds, objected signs in favor of a portal cavernoma with perisplenic and gastric varicose veins. The second is an 8-year-old male child born from an unborn marriage and from a followed pregnancy with premature delivery. His pathological history includes a notion of prematurity that required a stay in neonatology with umbilical catheterization and repeated abdominal pain. He had an acute abdominal episode in March 2015 justifying a surgical hospitalization for suspicion of appendicitis. At admission the clinical parameters (weight, height, temperature, cranial perimeter and temperature) were within the norms for age. The abdominal ultrasound prescribed for this was suggestive of portal cavernoma, later confirmed by abdominal computed tomography.

Nous rapportons deux observations de cavernome portal diagnostiqué successivement à Bamako et à Dakar. Le premier est un enfant de 6 ans de sexe masculin admis dans le service pour ascite et douleurs abdominales. L'examen clinique notait une pâleur cutanéo-muqueuse modérée, une asthénie. Le bilan biologique retrouvait une anémie modérée normochrome normocytaire avec une fonction pancréatique perturbée tandis que les fonctions rénales et hépatiques étaient conservées. Le scanner abdominal réalisé après deux échographies abdominales peu contributives, objectivait des signes en faveur d'un cavernome portal avec varice péri-splénique et gastrique. Le second est un enfant de 8 ans de sexe masculin né d'un mariage non consanguin et issu d'une grossesse suivie avec accouchement prématuré. Il est le 3e enfant de sa fratrie et scolarisé. On retrouve dans ses antécédents pathologiques une notion de prématurité ayant nécessitée un séjour en néonatologie avec cathétérisme ombilical et des douleurs abdominales à répétition. L'enfant a commencé à se plaindre de douleurs abdominales récurrentes vers l'âge de 6 ans. Douleurs de siège péri ombilical sans réveil nocturne dans un contexte de constipation chronique d'allure fonctionnelle. Il a fait un épisode abdominal aigu justifiant une hospitalisation en chirurgie pour suspicion d'appendicite. A l'admission les paramètres cliniques (poids, taille, température, périmètre crânien et température) étaient dans les normes pour l'âge. L'échographie abdominale prescrite à cet effet était évocatrice de cavernome porte, confirmé par la suite par la tomodensitométrie abdominale.

[Ameloblastomas of the jaws: clinical and computed tomography analysis in 15 patients at the university hospital Sourô Sanou in Bobo-Dioulasso]. / Ameloblastomes des machoires : analyse clinique et tomodensitometrique chez 15 patients au centre hospitalier universitaire Souro Sanou de Bobo-Dioulasso.

INTRODUCTION: Ameloblastoma is a locally aggressive and relatively scarce odontogenic benign tumor. Bone swelling is the most common clinical expression. Computed tomography is a considerable diagnostic contribution. This work reports the clinical and computed tomography characteristics of ameloblastomas of the jaws. PATIENTS AND METHODS: a retrospective analysis of the medical records of patients with histologically confirmed ameloblastoma between January 2014 and December 2018 was carried out. RESULTS: The incidence of ameloblastoma was 3 patients per year. Of the 15 patients, there were 7 men (46.7%) and 8 women (53.3%), giving a sex ratio of 0.87. The age of the patients varied between 9 and 56 years with an average age of 33.7 years. All patients had bone swelling. Mandibular localization predominated with a frequency of 86.7%. Heterogeneity, sharpness of contours and setting of the contrast product were the predominant CT characteristics, each observed in more than 4/5 of the patients. CONCLUSION: The development of imaging techniques such as CT has significantly changed the diagnostic approach and the management of ameloblastoma.

INTRODUCTION: l'améloblastome est une tumeur bénigne odontogène localement agressive et relativement rare. La tuméfaction osseuse constitue l'expression clinique la plus fréquente. La tomodensitométrie est d'un apport diagnostique considérable. Ce travail rapporte les caractéristiques cliniques et tomodensitométriques des améloblastomes des mâchoires. PATIENTS ET MÉTHODES: une analyse rétrospective des dossiers médicaux des patients porteurs d'améloblastome histologiquement confirmé entre janvier 2014 et décembre 2018, a été réalisée. RÉSULTATS: L'incidence de l'améloblastome était de 3 patients par an. Des 15 patients, il y avait 7 hommes (46,7%) et 8 femmes (53,3%) soit un sex-ratio de 0,87. L'âge des patients variait entre 9 et 56 ans avec une moyenne d'âge de 33,7 ans. Tous les patients présentaient une tuméfaction osseuse. La localisation mandibulaire prédominait avec une fréquence de 86,7%. L'hétérogénéité, la netteté des contours et la prise du produit de contraste étaient les caractéristiques tomodensitométriques prédominantes observées chacune chez plus de 4/5 des patients. CONCLUSION: Le développement des techniques d'imagerie comme la TDM a largement modifié l'approche diagnostique et la prise en charge de l'améloblastome.

Detection of viral RNA by RT-PCR from serum for molecular diagnosis of measles.

Measles continues to be a cause of morbidity and mortality in Côte d'Ivoire although the death rates are weak (2.4%). The monitoring and elimination programme of this disease require a laboratory confirmation testing by diverse methods of diagnosis needing diverse biological products. Serum is usually used for IgM detection. This study has therefore assessed the importance of the measles virus RNA detection from sera of measles suspected cases for confirmation of the case and determination of the genotype. A total of 45 sera tested were split into two groups according to the interval between the rash appearance and the day of blood collection: Group 1 (day 1 to day 3); group (2 day 4 to day 7). Four sera from Group 1 of the 45 (8.9 %) were positive by RT-PCR technique while 10 (22.2%) sera were positive for IgM anti- measles virus by ELISA test. RT-PCR and ELISA showed the same performance in group 1 with a positivity rate of 13.79 %. The B3 genotype was found. This result showed that the viral RNA can be detected in the serum but only from those sera collected the first 3 days after the rash appearance and could be used as palliative in case it is impossible to obtain other biological products.

[Surgical site infections at Bocar Sidy Sall University Hospital Center of Kati]. / Infections du site operatoire en chirurgie generale du Centre Hospitalier Universitaire Bocar Sidy Sall de Kati.

INTRODUCTION: Surgical site infections (SSI) are frequent and dangerous in the surgical ward. They represent an obsession for the surgeon. The objectives were to determine the frequency of ISOs and risk factors, to identify the germs and to study their sensitivity to different antibiotics. MATERIALS AND METHODS: This was a cross-sectional study with prospective data collection, performed at the general surgery department of the Bocar Sidy Sall University Hospital Center (Kati CHU) from January 2015 to December 2018. RESULTS: During this period of study we recorded 55 cases of ISO out of 650 operated patients with a frequency of 8.46%. 450 patients were operated on the cold operating program (69.23%) and 200 patients on emergency (30.77%). The average age was 39, the sex ratio was 2.66. Among the 55 cases of ISO, 60% of these patients were operated in emergency and 40% in the operating program. The most common strains found were Escherichia coli (E. coli) in 38.3% of cases, Staphylococcus aureus in 23.4% and Klebsiella pneumonia in 13.3%. Hemoglobin levels were normal in 70% of cases. 4 of our patients or 7.27% were diabetic. We did not have any cases of obesity. Of the 55 cases of ISO, 66% were of class 3 and 4 of Altemeier, 59% were of ASA score 2 and ASA 3, 55% were of score 2 of NNISS (National Nosocomial Infection Surveillance System), 5.45% were NNISS score 3 or 3 cases and these 3 cases developed ISO. The ISOs were parietal in 49 cases, ie 89%. The recovered germs were 100% sensitive to imipenem. The most informative interventions of the ISOs were peritonitis 25 cases (45.45%), intestinal occlusions 12 cases (21.82%), appendicular abscess 8 cases (14.55%). We had 2 death cases, 3.64%, the average hospital stay was 13 days. CONCLUSION: Escherichia coli was the common germ found in the ISO in general surgery at Kati BSS Hospital. The usual resistance to antibiotics must provoke effective preventive actions.

INTRODUCTION: Les infections du site opératoires (ISO) sont fréquentes et redoutables, au service de chirurgie. Elles représentent une hantise pour le chirurgien. Les objectifs étaient de déterminer la fréquence des ISO et les facteurs de risque, d'identifier les germes et étudier leur sensibilité aux différents antibiotiques. MATÉRIELS ET MÉTHODES: il s'agissait d'une étude transversale avec recueil prospectif des données, réalisée au service de chirurgie générale du Centre Hospitalier Universitaire Bocar Sidy Sall (CHU BSS) de Kati allant de janvier 2015 à décembre 2018. Elle a concerné tous les patients opérés dans le service pendant cette période d'étude. N'ont pas été inclus dans cette étude les cas de biopsie. RÉSULTATS: Au cours de cette période d'étude nous avons enregistré 55 cas d'ISO sur 650 malades opérés soit une fréquence de 8,46%. 450 malades ont été opérés au programme opératoire à froid (69,23%) et 200 malades en urgence (30,77%). L'âge moyen était de 39 ans, le sex-ratio à 2,66. Parmi les 55 cas d'ISO, 60% de ces malades ont été opérés en urgence et 40% au programme opératoire. Les différentes souches les plus retrouvées étaient l'Escherichia coli (E. coli) dans 38,3% des cas, le staphylococcus aureus dans 23,4%, klebsiella pneumonia dans 13,3%. Le taux d'hémoglobine était normal dans 70% des cas. 4 de nos patients soit 7,27% étaient diabétiques. Nous n'avions pas enregistré de cas d'obésité. Parmi les 55 cas des ISO, 66 % étaient de classe 3 et 4 d'Altemeier, 59% étaient de score ASA 2 et ASA 3, 55% étaient de score 2 de NNISS (National Nosocomial Infection Surveillance System), 5,45% étaient de score 3 de NNISS soit 3 cas et ces 3 cas ont développé des ISO. Les ISO étaient pariétales dans 49 cas soit 89%. Les germes retrouvés étaient sensibles à 100% à l'imipénème. Les interventions les plus pourvoyeuses des ISO étaient les péritonites 25 cas (45,45%), les occlusions intestinales 12 cas (21,82%), les abcès appendiculaires 8 cas (14,55%). Nous avions enregistré 2 cas de décès soit 3,64%, la durée moyenne d'hospitalisation a été de 13 jours. CONCLUSION: L'Escherichia coli était le germe fréquemment rencontré dans les ISO en chirurgie générale au CHU BSS de Kati. La résistance aux antibiotiques usuels doit susciter des actions préventives efficaces.

Reduced rate of disease development after HIV-2 infection as compared to HIV-1.

Human immunodeficiency virus type-2 (HIV-2) is a close relative of the prototype acquired immunodeficiency syndrome (AIDS) virus, HIV-1. HIV-2 is biologically similar to HIV-1, but information is lacking concerning clinical outcomes of HIV-2-infected individuals. From 1985 to 1993, a prospective clinical study was conducted in women with HIV-2 and HIV-1 infection to determine and compare rates of disease development. HIV-1-infected women had a 67% probability of AIDS-free survival 5 years after seroconversion in contrast with 100% for HIV-2-infected women. In addition to having significantly less HIV-related disease outcome in HIV-2 enrollees compared to HIV-1 enrollees, the rate of developing abnormal CD4+ lymphocyte counts with HIV-2 infection was also significantly reduced. This natural history study demonstrates that HIV-2 has a reduced virulence compared to HIV-1.

Natural protection against HIV-1 infection provided by HIV-2.

Significant differences have been observed in the rates of transmission and disease development in human immunodeficiency virus (HIV) types 1 and 2. Because many HIV-2-infected people remain asymptomatic for prolonged periods, the hypothesis that HIV-2 might protect against subsequent infection by HIV-1 was considered. During a 9-year period in Dakar, Senegal, the seroincidence of both HIV types was measured in a cohort of commercial sex workers. Despite a higher incidence of other sexually transmitted diseases (STDs), HIV-2-infected women had a lower incidence of HIV-1 than did HIV-seronegative women, with a relative risk of 0.32 (P = 0.008). An understanding of the cross-protective mechanisms involved may be directly relevant to HIV-1 vaccine development.

[Do commercial sex workers who discuss treatment with family and friends adhere to it better?]. / Communiquer avec son entourage sur son traitement aide-t-il les femmes impliquées dans le commerce du sexe à l'observer?

INTRODUCTION: The number of HIV trials in Africa is increasing, and they target population groups with high HIV incidence, such as sex workers. Little information, however, is available about the adherence to long-term therapy among such marginalized groups with few economic resources and poor social and family support. A project called "Yerelon" ("know herself" in the Dioula language) began in 1998 in Bobo-Dioulasso to improve the health of women involved in commercial sex through STI/HIV prevention and care adapted to them. This study was conducted before introducing long-term treatment to the population, to assess the effect of communication with those around them on the capacity of these vulnerable women to adhere to drug prescriptions. METHODS: The study was based on interviews conducted during the pilot phase of a 3-month trial of vitamins with potential participants. It concerned two groups of women: one group was infected with HIV (N = 22), the other was not (N = 20); all women in both groups were infected by HSV-2, however. For 5 weeks, the two psychologists of the study team in charge of adherence assessment carried out weekly in-depth interviews with the participants. The qualitative data analysis was organised around several themes. The data were related to aspects of communication with family and friends, serologic results, and adherence. RESULTS: According to our definition of communication about treatment, 20 participants communicated with their family and friends; adherence was good for all but three of them. Women who reported that they were married or living with someone (7/42) nearly all spoke about the study treatment (06/07) with him. Of 16 participants living in a family, 10 communicated with them about the treatment. On the other hand, as seems logical, single women who lived alone spoke less often about the treatment with family and friends (04/19). Talking about the treatment did not appear to involve the family or friends in the treatment; no one reminded any participant, whether she lived alone or in a family, to take her medicine. Nor did this discussion seem "helpful" to any of the women. Twenty-two participants hid the study treatment from family and friends; adherence was good for all but two of these. Social management of the treatment was related to HIV serologic status and relationships with family and friends. Concern about gossip about HIV status made it difficult to integrate the treatment into conversation. Those who did not agree to communicate with their family about the treatment did not even take the drug in the sight of the others. Sometimes, refusal to communicate was aimed at avoiding disapproval when the family did not have a favorable perception of prolonged treatment. Hiding the treatment was not an obstacle to good adherence. Adherence was related to perception of the treatment more than to communication about it. CONCLUSION: Adherence was similar in cases with and without communication. It appeared that these marginalized women, without social networks, were able to adhere correctly to a long-term treatment. To minimize the risks of non-adherence, the support system planned must take into account the factors influencing perceptions of the drug. Specific psychological support centered on the relation with the drug appears necessary during treatment initiation and follow up.

High prevalence of high-risk human papillomavirus (HPV) infection among sexually active women in Ouagadougou.

Human papillomavirus (HPV) is the leading cause of cervical cancer, which in turn is the leading cause of cancer death in women in Africa. The objective of this study was to determine the prevalence of high-risk HPV infection (HR-HPV) and the distribution of genotypes encountered in the sexually active female population of Ouagadougou. In four level-two health centers, we recruited 234 women who agreed to undergo an endocervical swab. HR-HPV genotypes were identified by real-time PCR. The Chi-square test was used for comparisons, with significance defined by a P-value < 0.05. The prevalence of HR-HPV infection was 52.56%. Fourteen genotypes corresponding to 216 infections were characterized: HPV 59 (42/216), HPV 66 (30/216), HPV 56 (20/216), HPV 45 (20/216), HPV 58 (18/216), HPV 39 (18/216), HPV 51 (16/216), HPV 68 (14/216), HPV 52 (12/216), HPV 18 (12/216), HPV 35 (6/216), HPV 31 (5/216), HPV 16 (3/216), HPV 33 (0/216). HPV infection was statistically associated with age (P = 0.033) and with some specific sexual practices, such as oral sex (P = 0.001). The prevalence of HR-HPV infection among women without lesions in our study is higher than that reported previously in studies conducted in Ouagadougou among women in the general population and those found in the rest of the world. Moreover, HPV16 and 18 were not the genotypes most frequently encountered.

[The Ileal Neobladder With The Hautmann Technic At The Urology Depatment Of University Hospital Pr. Bocar S. SALL Of Kati]. / Le Remplacement De Vessie Selon La Technique De Hautmann Au Service D'Urologie Du Chu Pr. Bocar S. SALL De Kati.

Radical cystectomy is the standard treatment for bladder tumors infiltrating the bladder muscle, for patients who have tumors without invasion of neighboring organs and without metastasis. After radical cystectomy, the urinary diversion is a challenge for any urologist. Ileal neo bladder is a rare surgery in our country. The ileal neo bladder is recommended in these patients. We report a case of ileal neo bladder in a 42-year-old woman with a bladder tumor. We discuss the clinical, diagnostic and therapeutic aspects.

La cystectomie totale constitue le traitement de référence des tumeurs de vessie infiltrant le muscle vésical, pour les patients qui ont une tumeur sans envahissement des organes voisins et sans métastase. Après la cystectomie, la dérivation des urines est un challenge pour tout urologue. Le remplacement de vessie est un geste rarement réalisé dans notre pays. Un remplacement de vessie par l'intestin est recommandé chez ces patients. Nous rapportons un cas de remplacement de vessie chez une femme de 42 ans ayant une tumeur de vessie. Nous discutons les aspects cliniques, diagnostiques et thérapeutiques.

Occurrence of phlebitis related to peripheral venous catheterization in the emergency services of the Souro Sanou National Teaching Hospital in Burkina Faso.

Patients must receive high-quality and safe health care. Peripheral venous catheterization (PVC) exposes patients to complications, mostly phlebitis. This study investigated the incidence of phlebitis and its PVC-related risk factors among patients in the medical and surgical emergency departments of the Souro Sanou University Hospital Center (CHUSS) in Bobo Dioulasso, Burkina Faso. This prospective cross-sectional study took place from July 4 to August 3, 2018. The incidence of PVC-related phlebitis was calculated and its risk factors were identified by logistic regression, with SPSS software version 20 (entry option), with significance set at 5%. The 511 patients included in the study had a mean age of 44.7 (95% CI 43.1-46.3) years. The mean duration of PVC was 3.1 days. Of these patients, 149 developed phlebitis, for an incidence of 29.2% (95% CI 25.0%-33.0%). There was no statistically significant difference between the two emergency (medical and surgical) departments. Second-degree phlebitis accounted for slightly more than half the cases (53%). Risk factors associated with the occurrence of PVC-related phlebitis were female gender, catheterization duration more than 3 days, small size of the catheter, and the healthcare worker's failure to use friction in washing with a hydroalcoholic hand solution. Preventive measures are essential.

Noncontiguous finished genome sequences and description of Bacillus massiliglaciei, Bacillus mediterraneensis, Bacillus massilinigeriensis, Bacillus phocaeensis and Bacillus tuaregi, five new species identified by culturomics.

Microbial culturomics, which investigates microbial diversity by combining diversified culture conditions, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rDNA identification, allowed to identify five new species within the Bacillus genus. Bacillus massiliglaciei strain Marseille-P2600T, Bacillus mediterraneensis strain Marseille-P2384T, Bacillus massilinigeriensis strain Marseille-P2366T, Bacillus tuaregi strain Marseille-P2489T and Bacillus phocaeensis strain SIT16T are each the type strain of the corresponding bacterial species. These strains, the genomes of which are described here, are facultative anaerobic Gram-positive bacilli. Here, we describe the main characteristics of each bacterium and present their complete genome sequence and annotation.

[Amputation of a limb secondary to snakebite in a child]. / Amputation de membre secondaire à une morsure de vipère.

Amputation of a limb is a serious consequence of snakebite poisoning. It is caused by the toxicity of the venom and often the use of a tourniquet in some patients, which can lead to limb ischemia. Management of the victim aims to ensure survival and preserve the function of the bitten limb. Antivenom immunotherapy is the only specific treatment for ophidian envenomation. It is indicated in cases of general symptoms and signs related to the bite, but also if local damage could lead to the loss of limb function. The authors report on a case of snakebite that led to amputation at the thigh.

[Contribution of ultrasound in the diagnosis of the complications of intramuscular injection in children]. / Apport de l'echographie dans le diagnostic des complications de l'injection intramusculaire chez l'enfant.

During a prospective study conducted at the rehabilitation Center of the physically handicapped persons and at the mother-child Hospital in Bamako, the authors report 50 cases of neuromuscular complications of the quinine intramuscular injection in the child. The scan revealed muscular calcifications in 37 cases (740%), abscesses, in 7 cases (14%) and muscular inflammations in 6 cases (12%). Xray of the affected limb was not systematic: it has been performed in four children in the case of a subjacent bone involment. It showed calcifications in two cases. If muscular abscess is easily diagnosed by clinical exam it is not the case for calcifications. The scan allows to set up a precise mapping of the muscular lesions, to determine their type and size. It also helps the clinicians in their therapeutic attitude. Medical treatment associated with rehabilitation has been carried out in 40 patients (80%) and surgery in 10 patients (20%).

Microbiological characteristics of community-acquired peritonitis at Souro Sanou Teaching Hospital of Bobo Dioulasso.

The purpose of this study was to describe the microbiological characteristics of community-acquired peritonitis at the Souro Sanou teaching hospital of Bobo Dioulasso, Burkina Faso. This 10-month prospective study, from July 2012 through May 2013 included all cases of community-acquired peritonitis who underwent surgery at our hospital and had a pus sample taken at that time. Bacteriological analyses were performed according to the hospital laboratory's protocol. The study included 72 patients (45 men and 27 women with a sex-ratio of 1.6). Their mean age was 27.3 years (range: 14 months to 67 years). The analysis of 72 samples of pus enabled confirmation of 39 cases and led to the identification of 53 bacterial strains. The most common families were enterobacteriaceae in 58% and Gram-positive cocci in 36%. The most common enterobacteria species was Escherichia coli (47%) followed by Streptococcus species (22%). The microbiological confirmation of peritonitis was most frequent in the 20-30 year-old age group. These bacteria appeared most susceptible to gentamycin, ceftriaxone, and ciprofloxacin, while we observed resistance to amoxicillin and the combination of clavulanic acid-amoxicillin. These findings suggest that the best probabilistic antibiotic treatment for the peritonitis in our context would combine a third-generation cephalosporin with aminoglycosides, with imidazole to cover potential anaerobic bacteria.

Oncogenic Human Papillomavirus Infection and Genotype Characterization among Women in Orodara, Western Burkina Faso.

BACKGROUND AND OBJECTIVE: Cervical cancer usually occurs several years after persistent infection with oncogenic or high-risk human papillomavirus. The objective of this study was to determine carriage of 14 genotypes of high-risk human papillomavirus among women at Orodara and then characterize the genotypes found in these women. MATERIALS AND METHODS: From June to July 2015, 120 women from the general population were recruited in the health district of Orodara. They voluntarily agreed to participate in the study. Endocervical samples were taken from these women prior to screening for precancerous lesions by visual inspection with acetic acid and lugol's iodine. Identification of high-risk human papillomavirus genotype was done using real-time PCR. RESULTS: High-risk human papillomavirus prevalence was 38.3% and the most common genotypes were HPV 52 (25.4%), HPV 33 (20.6%) and HPV 59 (11.1%). The HPV 66 was also identified with a prevalence of 9.5%. CONCLUSION: The HPV 16 and HPV 18 which are frequently associated with cancer worldwide were not found among the most frequent oncogenic HPV in women in Orodara.

[Value of computer tomography in the managment of brain injuries]. / Apport de la tomodensitométrie dans la prise en charge des traumatismes cranio-encéphauques: expérience de L'Hopital de Bamako.

The purpose of this prospective study conducted from January 2001 to December 2001 was to ascertain the value of computer tomography for evaluation of brain injuries. Computer tomography was performed using a Toshiba X VID system with contiguous 5 mm axial sections through the posterior fossa and 10 mm contiguous axial sections through the subtentorial region without contrast injection. A total of 107 patients with brain injuries were enrolled over the one-year study period. These patients accounted for 0.8% of all admissions to surgical emergency unit of Gabriel Toure Hospital in Bamako, Mali. The predominant age group for brain injuries was the 20- to 29-year-old group (35 cases). The male-to-female sex ratio was 5:1. Vehicular accident was the most frequent cause of brain injury (76 cases). Trauma was severe in 48 patients with a Glasgow score less than 8. Coma occurred immediately after injury in 90 cases. Ventricular hemorrhage led to coma in 100% of cases whereas brain hemorrhage and hematoma led to coma in 93.3% and 83.3% of cases respectively. Treatment was medical in 99 cases and neurosurgical in 8. The mortality rate was 34% and the morbidity rate (permanent sequels) was 36%. Computer tomography is a valuable tool for therapeutic decision-making in medico-surgical emergencies involving brain injuries.

[Epidemiological aspects of stroke in CT-scan department of the Point-G Hospital in Bamako, Mali]. / Aspects epidémiologiques des accidents vasculaires cérébraux dans le service de tomodensitométrie a L'Hopital du Point G.

The purpose of this prospective study conducted between January 2000 and December 2001 was to identify tomodensitometric aspects of stroke. The relationship between lesion type (hemorrhagic, ischemic, and transient ischemic) and prognosis was assessed. Axial sections were made through the posterior fossa (5 mm at 5mm intervals) and subtentorial region (10 mm at 10 mm intervals). The Virchow plan was used as the reference for sections. The chi square test was used to evaluate the correlation between lesion type and prognosis. A total of 159 stroke patients with a mean age of 44.5 years were enrolled during the study period. There were 90 men (56.6%) and 69 women (43.3%). In 118 patients (74.2%), CT scans showed cerebral abnormalities including ischemic lesions in 71 (44.6%) and hemorrhagic lesions in 47 (29.6%). Overall mortality was 45.7% (54/118). Hemorrhagic lesions were fatal in 51.1% (24/47) of cases and ischemic lesions in 35.2% (25/71). Transitory ischemic accidents were fatal in 0.12% of cases (5/41). This study demonstrates that CT scan is an important tool for stroke management by identifying the type and location of lesions.