[Patient satisfaction, an important part of care: case of a surgical department in Niger]. / Satisfaction des patients, element important dans la globalite des soins: cas d'un service des urgences chirurgicales au Niger.

INTRODUCTION: The aim of this study was to assess patient satisfaction in the surgical emergencies department at the National Hospital of Zinder, Niger. MATERIALS AND METHOD: This was a cross-sectional study focusing on patients admitted to the surgical emergency department of the National Hospital of Zinder (NHZ). The study was conducted over a period of 2 month - from July 1st to August 31st, 2015. During a face to face interview, patients were asked a series of questions. RESULTS: Of the 227 patients surveyed, 54.62% (n=124) were satisfied with their experience of the surgical emergencies department. The main factors associated with high satisfaction scores were patient reception (OR: 0.27, 95% CI=0.14 to 0.52; p <0.001), and the management of symptoms (OR: 0.28, 95 % CI=from 0.14 to 0.58; p < 0.001). Dissatisfaction factors were: waiting time before receiving treatment (OR 16.57, 95% CI=8.52 to 32.23; P <0.0001), the environment (OR: 3.89, 95% CI=2.12 to 7.12; p <0.001), accessibility (OR: 5.85, 95% CI=2.54 to 13.46, p < 0.001) and poor staff-patient communication (OR, 13.76; 95% CI 6.54 to 28.98; P <0.0001). CONCLUSION: Despite the shortcomings of the surgical emergencies department of NHZ, a good welcome and prompt patient management have been the key components associated with patient satisfaction.

INTRODUCTION: Le but de cette étude était d'évaluer la satisfaction des patients pris en charge au service des urgences chirurgicales de l'Hôpital National de Zinder, Niger. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude transversale portant sur des patients admis aux urgences chirurgicales de l'hôpital National de Zinder (HNZ). L'enquête a été réalisée sur une période de 2 mois du 1er juillet au 31 août 2015. Un questionnaire adressé aux patients était rempli à travers un entretien direct. RÉSULTATS: Sur les 227 patients retenus, 54,62% (n=124) étaient satisfaits des prestations au service des urgences chirurgicales. Les principaux éléments associés à une bonne satisfaction étaient l'accueil (OR: 0,27; IC95%= 0,14 ­ 0,52; p<0,001) et la prise en charge de la symptomatologie (OR: 0,28; IC95% = 0,14 ­ 0,58; p<0,001). Les facteurs incriminés dans l'insatisfaction étaient: le temps d'attente avant la prise en charge (OR: 16,57; IC95% = 8,52 ­ 32,23; p<0,0001), l'environnement (OR: 3,89; IC95%=2,12 ­ 7,12; p<0,001), l'accessibilité (OR: 5,85; IC95%=2,54 ­ 13,46; p<0,001) et la mauvaise communication soignant-patient (OR: 13,76; IC95% =6,54­28,98; p< 0,0001). CONCLUSION: Malgré les insuffisances du service des urgences chirurgicales de l'HNZ, un bon accueil et une prise en charge rapide, sont les éléments clés associés à la satisfaction du patient.

[Juvenile multiple myeloma. A Nigerian case]. / Myélome multiple juvénile. Un cas nigérien.

One case of juvenile multiple myeloma of the IgG-kappa type, with lytic lesions of the skull, is reported in a 14-year old Nigerian Fulani girl. The outcome was rapidly fatal. This disease is extremely rare: only 2 other documented cases (2 girls aged 13 and 12) have been found in the literature, under the age of 15.

[Anterior urethral duplication in a male child. A case report]. / Duplications sagittales antérieures de l'urètre chez le garçon. A propos d'un cas.

Urethra duplication is a rare anomaly with numerous anatomic variations. These fall into four main groups: epispadiac, hypospadiac, fusiform, and Y-type. We report on one case of sagittal incomplete hypospadiac anterior duplication of the urethra. Surgical repair consisted of incision of the septum between the two urethras and hypospadias repair at the same setting. Follow-up was characterized by the occurrence of some complications.

[Pediatric vesical lithiasis. 70 case reports]. / Lithiase vésicale de l'enfant. A propos de 70 cas.

The study focuses on 70 vesicals lithiasis, with a sample consisting of 60 boys (86%) and ten girls (14%). The age varies from one year to 14 years. The revealing signs are dominated by mictional troubles in 47 cases (67%), macroscopic hematurie in 26 cases (37%), the pyurie in 12 cases (17%) and acute retention of urine in 7 cases (10%). The most frequent germs are the staphylococcus aureus with 28% of cases, the protéus mirabilis with 24% of cases and the Echerichia coli with 24% of the cases. Associated malformations were observed in 9% of the cases. The treatment was essentially surgical (99%). The evolution was simple in 97% of the cases.

The paediatric surgeon and his working conditions in Francophone sub-Saharan Africa.

BACKGROUND: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA) and set the debate at the level of the humanist thinking in medicine. PATIENTS AND METHODS: This was a multicentre study from 1 st May to 30 th October 2008. The African Society of paediatric surgeons' directory was used to identify paediatric surgeons in the Francophone's countries in Sub Saharan Africa. The parameters studied were number of surgeons per country, means of training, working conditions, remunerations, needs for continuous training and the research. RESULTS: A total of 41 paediatric surgeons (68.33%) responded. The average number of paediatric surgeons per country was 5. The means of training included government scholarships among 7 paediatric surgeons (17.07%), scholarship from a non-governmental organisations in 14 (34.15%) and self-sponsorships in 20 (48.78%). The average salary was 450 Euros (€) (range: 120-1 400 Euros). Most of the paediatric surgeons (68.29%) had internet services for continuous update courses and research. Thirty six paediatric surgeons (87.80%) had no subscription to specialised scientific journals. CONCLUSION: The paediatric surgeon in FSSA faces many problems related to his working and living conditions that may have a negative impact on their competences.

[Osteomyelitis in drepanocytosis: epidemiology, diagnosis and treatment. 66 cases, Niamey]. / Les osteomyelites chez les drepanocytaires aspects: epidemiologiques, diagnostiques et therapeutiques. A propos de 66 cas colliges a Niamey.

From January 2001 to June 2003, 66 cases of osteomyelitis in sickle cell disease were collected in the two (2) main hospitals of Niamey (the HNN and the HNL). The sex ratio is 1.27 in favor of the masculine sex. Children payed the heaviest tribute to this. An effect 63.6% patients belong to the group of 0 to 5 years. The consultation is related in 71.21% of cases. This situation would explain itself by the weak level of instruction and income at the more part of families investigated. A door of entrance is identified positively that in 9.09% of cases. The vaso-occlusive crisis is the main factor encouraging and represents 31.57% of antecedents in report with cases of osteomyelitis. Multiple focal localization are observed at 15.15% of patients. Diaphysis are more frequent involved (31.70% of cases).. Staphylococci are the most frequent germs (35.71%) follow salmonellas (14.28%). The medical treatment is used very extensively, notably in the acute osteomyelitis where 100% of patients benefited some with 63.15% of good results.

[Hepatic amebiasis at Niamey Hospital (Nigeria)]. / L'amibiase hépatique à l'hôpital de Niamey (Niger).

The authors report the results of a prospective study on hepatic amebiasis realized in national hospital of Niamey (Republic of Niger). Hepatic amebiasis is uncommon in Niger as in other hot and dry countries of Africa whereas it is common in hot and damp areas of the continent. These results point out the hypothesis of a hepatotropic strain of Entamoeba histolytica uncommon in Sahelia area whereas the amebiasis infestation is frequent.