[Reference values of neonatal erythrocyte and leukocyte count in Bamako, Mali]. / Valeurs de Référence érythrocytaires et leucocytaires chez le Nouveau-né à Bamako, Mali.

Reference values for blood cell count are not established at birth in Mali. This study aimed to determine reference values for erythrocyte and leukocyte at birth in Bamako. Blood was collected from the umbilical cord immediately following its clamping and studied for complete blood cell count in 481 newborns with a birth weight > 2500g, Apgar score ≤ 7 at 5 or 10 minutes, without abnormal hemoglobin mutations and whose mothers were willing in Bamako, Mali. Other than the median and mean values, 2.5 and 97.5 percentiles were calculated. The findings suggest that the normal reference values following a timely clamping of the umbilical cord were (mean ± 1SD and range): RBC = 4,00 ± 0,46.1012/L (3,13 - 4,89), Hb = 14,12 ± 1,49 g/dL (11,20 - 17,00), Hct = 40,27 ± 4,71% (31,62 - 50,18), MCV = 101 ± 5 fl (91 - 112), MCHC = 35,37 ± 2,16 pg/cellule (30,70 - 39,59), MCH = 35,06 ± 0,93 g/dL (33,40 - 36,90), RDW = 17,79 ± 7,33% (15,50 - 20,39), Reticulocytes (109/L) = 133,081 ± 29,95 (66,62 - 200,86), GB (109/L) = 13,24 ± 7,23 (7,20 - 23,70), PMN (109/L) = 7,16 ± 4,70 (3,07 - 14,22), PME (109/L) = 0,28 ± 0,26 (0 - 0,98), PMB(109/L) = 0,05 ± 0,09 (0 - 0,31), Lymphocytes (109/L) = 4,49 ± 2,45 (1,96 - 9,42), Monocytes (109/L) = 1,06 ± 0,73 (0,21 - 2,54), myelocytes = 1.43 ± 1.51%, erythroblasts = 4.52 ± 7.83%. It should be noted that male babies had a lower neutrophil count than female newborns. By taking into account these results when interpreting the blood cell count in Malian newborn infants, costly misdiagnoses should be considerably decreased in a population struggling with low incomes.

Les valeurs de référence de l'hémogramme ne sont pas établies à la naissance au Mali. Cette étude détermine les valeurs de référence érythrocytaires et leucocytaires du nouveau-né à Bamako. Le sang du cordon ombilical a été prélevé après clampage sans délai et étudié pour les paramètres érythrocytaires et leucocytaires chez 481 nouveau-nés à terme avec un poids de naissance > 2500g, un score d'Apgar ≥ 7 à 5 ou 10 minutes, sans mutant de l'hémoglobine et dont les mamans étaient consentantes, à Bamako, Mali. Outre les valeurs médianes et moyennes, les percentiles 2,5 et 97,5 ont été calculés. Les valeurs considérées comme normes de référence locales après un clampage sans délai du cordon ombilical (moyenne ± 1SD et extrêmes) sont : GR = 4,00 ± 0,46.1012/L (3,13 ­ 4,89), Hb = 14,12 ± 1,49 g/dL (11,20 ­ 17,00), Ht = 40,27 ± 4,71% (31,62 ­ 50,18), VGM = 101 ± 5 fl (91 ­ 112), TCMH = 35,37 ± 2,16 pg/cellule (30,70 ­ 39,59), CCMH = 35,06 ± 0,93 g/dL (33,40 ­ 36,90), IDR = 17,79 ± 7,33% (15,50 ­ 20,39), Réticulocytes (109/L) = 133,081 ± 29,95 (66,62 ­ 200,86), GB (109/L) = 13,24 ± 7,23 (7,20 ­ 23,70), PNN (109/L) = 7,16 ± 4,70 (3,07 ­ 14,22), PE (109/L) = 0,28 ± 0,26 (0 ­ 0,98), PB (109/L) = 0,05 ± 0,09 (0 ­ 0,31), Lymphocytes (109/L) = 4,49 ± 2,45 (1,96 ­ 9,42), Monocytes (109/L) = 1,06 ± 0,73 (0,21 ­ 2,54), myélocytes = 1,43 ± 1,51%, érythroblastes = 4,52 ± 7,83%. A noter un taux des polynucléaires neutrophiles plus bas chez le garçon que chez la fille. Ces valeurs diffèrent de celles rapportées pour d'autres populations. La prise en compte de ces résultats dans l'interprétation de l'hémogramme du nouveau-né au Mali, devrait éviter des erreurs de diagnostic et des explorations par excès chez une population à faibles revenues.

[Epidemiological and Clinical features of colorectal cancer at the hematology and oncology ward of Point G in Bamako, Mali, from 2005 to 2011: 113 cases]. / Particularites epidemiologiques et cliniques du cancer colorectal dans le service d'hematologie oncologie medicale du Point G de Bamako au Mali de 2005 a 2011: 113 cas.

AIMS: Epidemiological, clinical and biological characteristics of colorectal cancer vary across continents probably because of different risk factors that are not yet fully listed in countries with limited resources. This study describes the epidemiological and clinical features of colorectal cancer at a University hospital in Bamako, Mali. PATIENTS AND METHODS: A retrospective study that concerned the period from 2005 to 2011 was carried out. It included records of patients with colorectal cancer histologically documented in the service. Were analyzed epidemiological, clinical and biological data stored in files. RESULTS: One hundred-thirteen (113) cases of colorectal cancer were diagnosed representing 15% of all cancers documented over the 7 years. The number of cases increased year by year. The cases of colorectal cancer are not uncommon in young patients (23% under 30 years of age, 60% under 50). The male is significantly more represented in this population of colorectal carriers with a sex ratio M / F = 2. The time between first the symptom and care is long and the diagnosis is made in 85% of cases at a metastatic stage. Localization of the cancer is more frequent in the colon (56%) than in the rectum (44%). Cancer is an adenocarcinoma in 97% of cases. CONCLUSION: These epidemiological and clinical features invite practitioners to reconsider the concept of rarity of colorectal cancer in Africa and vigilance in front of a digestive disorder, even the patient is young, they also emphasize the need to conduct prospective studies to identify specific risk factors and develop appropriate strategies for the prevention and treatment of colorectal cancer in Mali.

BUT: Les caractéristiques épidémiologiques, cliniques et biologiques du cancer colorectal sont variables selon les continents, probablement à cause de facteurs de risque différents et non encore complètement répertoriés dans les pays à faibles moyens. Cette étude décrit les particularités épidémiologiques et cliniques du cancer colorectal dans un service hospitalier de référence spécialisé de Bamako au Mali. PATIENTS ET MÉTHODES: L'étude rétrospective a concerné la période de 2005 à 2011. Elle a inclus les dossiers des patients atteints de cancer colorectal documenté histologiquement. Ont été analysés, les données épidémiologiques, cliniques et biologiques enregistrées dans les dossiers. RÉSULTATS: Cent-treize (113) cas de cancer colorectal ont été colligés et représentaient 15% de l'ensemble des cancers diagnostiqués sur 7 ans. Ces cas étaient en augmentation d'année en année et s'observaient chez une population souvent jeune (23% avant 30 ans, 60% avant 50 ans). Le sexe masculin était significativement plus représenté, soit 2 hommes pour une femme. Le délai entre le premier symptôme et la prise en charge du malade était long avec dans 85% des cas, un diagnostic porté à un stade métastatique. La localisation était plus souvent colique (56%) que rectale (44%). Le cancer était un adénocarcinome dans 97% des cas. CONCLUSION: Ces particularités épidémiologiques et cliniques invitent à reconsidérer le concept de rareté du cancer colorectal en Afrique et à la vigilance de la part des praticiens devant un trouble digestif même chez un sujet jeune, ils soulignent aussi la nécessité de conduire des études prospectives pour identifier des facteurs de risque particuliers et élaborer les stratégies les mieux adaptées pour la prévention et la prise en charge du cancer colorectal au Mali.

High incidence of triple-negative tumors in sub-saharan Africa: a prospective study of breast cancer characteristics and risk factors in Malian women seen in a Bamako university hospital.

OBJECTIVE: Few studies have been conducted on breast cancer in Sub-Saharan Africa and their results have been suspected to be impaired by artefacts. This prospective study was designed to determine tumor and patient characteristics in Mali with control of each methodological step. These data are necessary to define breast cancer treatment guidelines in this country. METHODS: Clinical and tumor characteristics and known risk factors were obtained in a consecutive series of 114 patients. Each technical step for the determination of tumor characteristics [histology, TNM, grade, estrogen (ER) and progesterone receptors (PR), HER2, and Ki67] was controlled. RESULTS: Patients had a mean age of 46 years. Most tumors were invasive ductal carcinomas (94%), T3-T4 (90%) with positive nodes (91%), grade III (78%), and ER (61%) and PR (72%) negative. HER2 was overexpressed in 18% of cases. The triple-negative subgroup represented 46%, displaying a particularly aggressive pattern (90% grade III; 88% Ki67 >20%). CONCLUSION: This study demonstrates the high incidence of aggressive triple-negative tumors in Mali. Apart from a higher prevalence of premenopausal women, no significant difference in risk factors was observed between triple-negative tumors and other tumors. The hormonal therapy systematically prescribed therefore needs to be revised in light of this study.

[The malignant hemopathies in children: epidemiologic aspects in the Haematology and Medical Oncology Ward of Point G Hospital, Bamako, Mali (1996-2003)]. / Les hemopathies malignes de l'enfant: aspects epidemiologiques dans Le Service D'Hematologie Oncologie Medicale de L'Hopital Du Point G, Bamako, Mali (1996-2003).

Data from developed countries place the malignant hemopathies among the most frequent cancers in children. The epidemiologic and prognostic aspects of these diseases are not well known in developing countries notably in Africa sub-Saharan countries because of lack of registry and clinical collaborative studies. Nevertheless, the good progress in the management of paediatric diseases that were a big concerns in former times authorize to think that in future, these countries will be engaged in programs to fit malignant diseases as major health problems in children. A good knowledge of epidemiologic aspects of these diseases must be therefore an important concern. This study describes epidemiologic and prognosis particularities of malignant hemopathies in children diagnosed in a last referral hospital ward, Bamako, Mali (West Africa) during height years. Fifty-nine cases of malignant hemopathies were diagnosed by January 1996 to December 2003 in 19 females and 40 males. Data were analysed retrospectively with SPSS 11.0. These children were aged from 4 to 15 years and the modal class of age was 6-10 years. The mean recruitment of cases per year was 7.37. Lymphomas were more frequent (70%) particularly the Burkitt lymphoma. The Hodgkin's lymphoma was not observed under 5 years of age but represents 24% of cases over this age and was more frequent in male. This study emphasizes the need to put in place strategies for a better understanding of epidemiological aspects of malignant hemopathies in children and for developing policies to improve management and prevention of cases in Mali.