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Cattle production is an essential livelihood strategy in south-western Burkina Faso. Although having a distinct cultural role and known to be resistant against African animal trypanosomosis, the Lobi taurine cattle breed is endangered due to its low market value. As the first step in preservation efforts, our study aimed to develop a typology of production systems at the farm level. We used a structured questionnaire and focus group discussions for collecting data on household characteristics, socioeconomic activities, livestock, and access to services. The sample comprised 169 households in three communities. The analytical strategy included factor analysis of mixed data and hierarchical clustering. We identified four distinct types of cattle production systems: (1) sedentary Lobi farms, (2) sedentary crossbreed farms, (3) semi-transhumant Fulani zebu farms, and (4) transhumant Fulani zebu farms. Significant factors in developing this typology were the farmers' ethnic group, crop diversity, cattle herd size, cattle herd composition, number of small ruminants, and livestock management strategies. Across all production systems, men were considered being primary decision-makers in cattle production, with women, herders, and children being responsible for specific tasks. All identified production systems are increasingly confronting disease pressure and scarcity of water and land. Future efforts in preservation and breeding will need to respond to these trends in the agroecosystem, integrate risk management measures, and resonate with the specific needs of the different household members involved in cattle rearing.
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Crianza de Animales Domésticos , Cruzamiento , Agricultores , Ganado , Animales , Burkina Faso , Bovinos , Composición Familiar , Granjas , Femenino , Grupos Focales , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
OBJECTIVE: Evaluate the risk brought by the traditional practice in the evolution of the foreign bodies of the aesophagus. CASE REPORT: 30 years old male with migration from the oesophagus of a fish bone in soft tissue of the neck, which could have been favored by the traditional practice. The diagnosis of migration was suspected when a laterocervical mass appeared after a traditional processing. The rigid aesophagoscopy was negative and the scanner allowed to identify the foreign body in an extraluminal location. It was removed by cervicotomy. Postoperative was uneventful.
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Esófago/patología , Cuerpos Extraños/diagnóstico , Migración de Cuerpo Extraño/diagnóstico , Adulto , Esófago/cirugía , Cuerpos Extraños/patología , Cuerpos Extraños/cirugía , Migración de Cuerpo Extraño/patología , Migración de Cuerpo Extraño/cirugía , Humanos , Masculino , Disección del CuelloRESUMEN
INTRODUCTION: Intravitreal injections (IVT) of a drug aim to rapidly obtain effective concentrations greater than those that would be obtained by a periocular or intravenous injection. The objective of the present study is to demonstrate the contribution of IVT in the treatment of pathologies of the posterior segment of the eye. METHODOLOGY: We conducted a 21-month ambidirectional observational study from January 1, 2020, to September 30, 2021. We included by nonprobability sampling all consenting patients admitted for IVT at IOTA Teaching Hospital. RESULTS: During our study, 201 patients were collected out of 30 739 patients seen in consultation. The hospital frequency of IVT was 0.65%. There were 111 women and 90 men. The M/F ratio was 0.82. The number of patients who received IVT antibiotics was 135. Anti-VEGF was injected in 64 patients. Two patients received IVT corticosteroids. Complications frequently encountered were pain at upon injection (94.03%), IOP spike (11.94%) and cataract (7.46%). In our sample, we observed an improvement in visual acuity in 56.21% of cases and a reduction in macular edema in 45.16% of cases. DISCUSSION: The contribution of IVT in the treatment of vitreoretinal diseases is extraordinary. Rigorous observation of aseptic technique and good practices protects against infectious complications. CONCLUSION: IVT has allowed us to effectively treat various diseases of the vitreous and retina. IVT is a simple procedure, but it must be performed with the same aseptic technique as surgical procedures.
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Retinopatía Diabética , Glucocorticoides , Masculino , Humanos , Femenino , Glucocorticoides/uso terapéutico , Triamcinolona Acetonida/efectos adversos , Bevacizumab , Inyecciones Intravítreas , Inhibidores de la Angiogénesis , Factor A de Crecimiento Endotelial Vascular , Retinopatía Diabética/tratamiento farmacológico , Resultado del Tratamiento , Hospitales de EnseñanzaRESUMEN
INTRODUCTION: Dislocations of the knee are serious, involving the functional prognosis and sometimes the vital prognosis of the limb concerned. The aim of our work was to assess the functional results of our care. MATERIALS AND METHODS: This were a prospective study concerning patients with dislocation of the knee, treated and followed in the Department of Orthopedics-Traumatology at the CHU Gabriel TOURE from January 2015 to October 2018. RESULTS: We collected 30 patients with knee dislocation. The male sex predominated (60%) with a sex ratio of 1.5. The average age was 32.56 years. AVP was the main etiology with 83.3%. The mechanism was direct in 86.7%. Standard knee X-ray with front and side views was performed in all patients. Posterolateral dislocation was the most common type of pathology (20%). Associated lesions were observed in 56.6%. The response time was less than 6 hours in 100%. The treatment was orthopedic in 93.3%. Complications were dominated by knee laxity with 43%. At the average follow-up of 18.9 months, the functional results were good in 20%. CONCLUSION: Knee dislocations are the prerogative of the young subject. Accidents due to motorcycles are the main circumstances. Associated lesions are frequent. Orthopedic treatment is still relevant but the evolution is still unpredictable despite the early treatment.
INTRODUCTION: Les luxations du genou sont graves mettant en jeu le pronostic fonctionnel et parfois le pronostic vital du membre concerné. Le but de ce travail était de déterminer les aspects épidémiologiques, cliniques et d'évaluer les résultats du traitement. MATÉRIEL ET MÉTHODES: il s'agissait d'une étude retro prospective concernant les patients présentant une luxation du genou , traités et suivis dans le service d'Orthopédie-Traumatologie au CHU Gabriel TOURE de janvier 2015 à octobre 2018. RÉSULTATS: Nous avons colligé 30 patients présentant une luxation du genou. Le sexe masculin a prédominé (60%) avec un sex-ratio de 1,5. L'âge moyen était de 32,56 ans. Les AVP ont été la principale étiologie avec 83,3%. Le mécanisme était direct dans 86,7%. Les radiographies standards du genou de face et profil ont été réalisées dans 100%. La luxation postéro-latérale a été le type anatomopathologique le plus fréquent (20%). Les lésions associées étaient observées dans 56,6%. Le délai de prise en charge a été de moins de 6 heures dans 100%. Le traitement a été orthopédique dans 93,3%. Les complications étaient dominées par la laxité du genou avec 43%. Au recul moyen de 18,9 mois, les résultats fonctionnels ont été bons dans 20%. CONCLUSION: Les lésions associées sont fréquentes. Le traitement orthopédique reste toujours d'actualité, mais l'évolution est toujours imprévisible malgré la précocité de la prise en charge.
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INTRODUCTION: Acetabularfractures involving the functionalprognosis of the hip. The aim of thisworkwas to determine the epidemiological, clinical, and outcome aspects of treatment. MATERIALS AND METHODS: This wasa retro-prospective study of patients withacetabulum fracture treated and followedfromJanuary 2015 to June 2018. RESULTS: Wecollected 49 patients with an acetabulum fracture. Acetabulum fractures made up 8.3% of all pelvic injuries during the studyperiod. The male sexprevailed (87.8%) with a sex ratio of 7.16. The averageagewas 36.14 years (range: 17 years and 77 years). The circumstances of the trauma were accidents on the public highway (69.4%), accidents atwork (14.3%), accidents in the home (10.2%), accidents in sports (4.1%), assaults (2%). The mechanismwas indirect in 87.8%.Pain with total functional impotence wasobservedin 83.7% and with a vicious attitude of the traumatized limbin 89, 8%. The standard radiographywith the incidences of the pelvis face as well as the ¾ wing and ¾ obturatorwasperformed in all patients. The transverse fracture of the acetabulumwas the mostcommonanatomo-radiological type (61.2%). Shock (34.6%) and hip dislocation (24.4%) were the mostcommonearly complications. Treatment was orthopedicin 95.9%. After an averagefollow-up of 23.24 months, the anatomicalresultsweresatisfactoryin 32.7% and the functionalresults good in 51%. Lameness (91.8%), mechanical pain (30.6%) and osteoarthritis (16.3%) were the main complications in the medium term. CONCLUSION: Fractures of the acetabulum are the preserve of the adult, especially of the male. The complications are dominated by mechanical pain, lameness and early hip osteoarthritis. The anatomicalresultsthat condition the functionalresults are less good with the orthopedictreatment.
INTRODUCTION: Les fractures de l'acétabulum mettent en jeu le pronostic fonctionnel de la hanche et leur traitement est difficile. Le but de ce travail était de déterminer les aspects épidémiologiques, cliniques, et d'évaluer les résultats du traitement. MATÉRIEL ET MÉTHODES: il s'agissait d'une étude retro prospective concernant les patients présentant une fracture de l'acétabulum, traités et suivis de janvier 2015 à juin 2018. RÉSULTATS: Nous avons colligé 49 patients présentant une fracture de l'acétabulum. Les fractures de l'acétabulum ont constitué 8, 3% des traumatismes du bassin pendant la période d'étude. Le sexe masculin a prédominé (87,8%) avec un sex-ratio de 7,16. L'âge moyen était de 36,14 ans (extrêmes : 17 ans et 77 ans). Les circonstances du traumatisme ont été les accidents de la voie publique (69,4%), les accidents de travail (14,3%), les accidents de vie domestique (10,2%), les accidents de sport (4,1%), les agressions (2%). Le mécanisme était indirect dans 87,8%. La douleur avec impotence fonctionnelle totale a été observée dans 83,7%, et avec une attitude vicieuse du membre traumatisé dans 89, 8%. La radiographie standard avec les incidences du bassin de face ainsi que les ¾ alaire et ¾ obturateur était réalisée chez tous patients. La fracture transversale de l'acétabulum a été le type anatomoradiologique le plus fréquent (61, 2%). L'état de choc (34,6%) et la luxation coxo-fémorale (24,4%) ont été les complications précoces les plus observées. Le traitement a été orthopédique dans 95,9%. Après un recul moyen de 23,24 mois, les résultats anatomiques ont été satisfaisants dans 32,7% et les résultats fonctionnelsbons dans 51%. La boiterie (91,8%), la douleur mécanique (30, 6%) et l'arthrose (16, 3%) ont été les principales complications à moyen terme. CONCLUSION: les fractures de l'acétabulum touchent fréquemment l'adulte, surtout de sexe masculin. Les complications sont dominées par les douleurs mécaniques, la boiterie et la coxarthrose précoce. Les résultats anatomiques qui conditionnent les résultats fonctionnels sont moins bons avec le traitement orthopédique.
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Conjunctival tumors are common in tropical areas, where exposure to ultraviolet radiation is high and almost permanent. Malignant tumors are quite rare and the most represented is conjunctival squamous cell carcinoma. We report two cases of invasive squamous cell carcinoma of the conjunctiva received in the ophthalmology department of the Sominé Dolo hospital in Mopti, Mali. The patients were 25 and 51 years old, living in a rural desert area exposed to sunlight and dust. They presented with a mass developed in the area of the palpebral fissure, invading the cornea and preventing palpebral occlusion. The mass was raised, multi-lobulated, well circumscribed, pearly white in color and papillomatous in appearance with dilation of the feeder vessels. A wide surgical excision at 4 - 5 mm from the healthy tissue edges was performed with anatomopathological examination of the specimen, which confirmed a mature and invasive differentiated squamous cell carcinoma of the conjunctiva. The extension workup and HIV serology were negative. The evolution was favorable in the medium term without recurrence.
Les tumeurs conjonctivales sont fréquentes dans les zones tropicales,où l'exposition aux rayons ultraviolets est forte et quasi permanente. Les tumeurs malignes sont assez rares et la plus représentée est le carcinome épidermoïde de la conjonctive.Nous rapportons deux cas de carcinome épidermoïde invasif de la conjonctive reçus dans le service d'ophtalmologie de l'hôpital Sominé Dolo de Mopti au Mali. Il s'agissait de deux patientes de 25 et 51 ans, vivant en zone rurale et désertique exposées aux rayons solaires et à la poussière. Elles présentaient une masse développée dans l'aire de la fente palpébrale, envahissant la cornée et empêchant l'occlusion palpébrale. La masse était en relief, multi lobulée, bien circonscrite, de couleur blanc nacré et d'aspect papillomateux avec une dilatation des vaisseaux nourriciers. Une exérèse chirurgicale large à 4 - 5 mm des berges de tissu sain a été réalisée avec examen anatomopathologique de la pièce qui a confirmé un carcinome épidermoïde différencié mature et invasif de la conjonctive. Le bilan d'extension et la sérologie HIV étaient négatifs. L'évolution était favorable à moyen terme sans récidive.
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<b>Background and Objective:</b> Dengue is a remerging vector-borne viral disease in Burkina Faso since the outbreak of 2013 and requires special attention from health authorities. This study reports the prevalence of dengue fever serological markers (NS1Ag, IgM and IgG) and infection dynamic from January, 2018 to December, 2020 among patients tested for dengue infection at Saint Camille Hospital of Ouagadougou (HOSCO). <b>Materials and Methods:</b> The study population consisted of 6414 patients aged 0-97 years. Dengue virus infection was detected in serum or plasma using the SD bioline dengue duo rapid detection kit. <b>Results:</b> The prevalence of dengue NS1Ag was 2.25% (45/2003), 18.43% (501/2719) and 2.42% (38/1569) in the study population in 2018, 2019 and 2020, respectively. The age groups over 50 years and 15-20 years were significantly more infected compared to the group 21-30 years respectively in 2019 (p = 0.030) and 2020 (p = 0.035). Patients tested positive for at least one of these markers (NSlAg, IgG and IgM) represented 26.01% (521/2003) and 38.98% (1060/2719). The peak of infection during 2018 and 2019 was observed between October and November. The present study reports a high seroprevalence of acute dengue virus infection. The presence of NS1Ag, IgM and IgG in patients suggests an active circulation of the dengue virus in Ouagadougou. <b>Conclusion:</b> Data shows recurrent outbreaks of dengue infection in our country need strong surveillance and a suitable and affordable diagnostic system to clarify the burden, pinpoint the risk factors and for better case management.
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Virus del Dengue , Dengue , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Burkina Faso/epidemiología , Niño , Preescolar , Dengue/diagnóstico , Dengue/epidemiología , Hospitales , Humanos , Lactante , Recién Nacido , Persona de Mediana Edad , Estudios Seroepidemiológicos , Adulto JovenRESUMEN
Most of ingested foreign bodies passthrough the digestive tract spontaneously. The surgical care represents less than 1%. We report two cases of unexpected ingested foreign bodies treated surgically during the year 2019 in order to identify the surgical indications through a literaturereview. There were one woman and one man respectivelyaged 46 and 33. The accidentlyingestedforeign bodies werea denture and a toothbrush. An attempt to endoscopically extract the denture was unsuccessful. Peritonitis appeared as the complication in both cases. A radiography of unprepared abdomen showed the foreign body in the epigastic area, associated with a pneumoperitonitis in one case. Gastrostomy through laparotomy allowed to extract the foreign body without any complication. Surgery should be indicated either in complications or failure of endoscopic means to extractlocked foreign bodies.
La majorité des corps étrangers ingérés passent spontanément le long du tube digestif. Lerecours à la chirurgie représente moins de 1%.Nous rapportons deux cas de corps étrangers insolites ingérés et traités chirurgicalement au cours de l'année 2019afin d'en préciser les indications chirurgicales à travers une revue de la littérature.Il s'agissait d'une femme et d'un homme âgés respectivement de 46 et de 33 ans. Les corps étrangers accidentellement ingérésétaient un dentier et une brosse à dent.Une tentative d'extraction endoscopique du dentier a été pratiquée sans succès.L'évolutionétait marquée par la survenue d'une péritonite dans les deux cas. La radiographie de l'abdomen sans préparation (ASP) montraitle corps étranger dans l'aire épigastrique, associé à un pneumopéritoine dans un cas. Une gastrotomie par laparotomie a permis d'extraire le corps étranger avec des suites simples.La chirurgie doit être indiquée en cas de complications ou d'échec des moyens d'extraction endoscopique de corps étrangers enclavés.
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OBJECTIVES: the purpose of this work was to describe the epidemiological, clinical, paraclinical and therapeutic aspect of surgical treatment of chronic osteomyilitis of limbs. PATIENTS METHODS: it was a retrospective study over a period of 12 years, from January 2003 to December 2014. It covered all cases of chronic osteomyelitis osteonecrosis treated our service. RESULTS: The authors report the results of the surgical treatment of a series 56 patients operated on for chronic limb osteomyelitis. The mean age was 20.7 years with extremes of 6 months and 56 years. The tibia and femur were the most affected segments. Staphylococcus aureus was the most frequently found germ, 80% of the cases. We obtained complete healing with total cure in 68% of cases and recurrence of suppuration in 32% of cases. CONCLUSION: Chronic osteomyelitis of limbs is a frequent pathology in Africa. Staphylococcus aureus was the most frequently found germ. Surgery in a time seems a good alternative. The rate of recurrence of the suppuration remains high.
OBJECTIF: Le but de ce travail était de présenter les aspects épidémiologiques, cliniques, bactériologiques, radiologiques et thérapeutiques des ostéomyélites chroniques des membres. MÉTHODES: Nous avons réalisé une étude rétrospective sur une période de 12 ans allant de Janvier 2003 à décembre 2014. Elle a porté sur tous les cas d'ostéomyélites chroniques pris en charge chirurgicalement dans notre service. RÉSULTATS: Nous avons recensé 56 cas d'ostéomyélite chronique des membres. L'âge moyen était de 20 ans avec des extrêmes de 6 mois et 56 ans. Le sex-ratio était de 1,9. Le tibia et le fémur ont été les os les plus atteints. Staphylococcus aureus a été le germe le plus fréquent soit 80% des cas. Nous avons obtenu la cicatrisation parfaite de la plaie dans 68% des cas et la récidive de la suppuration dans 32% des cas. CONCLUSION: L'ostéomyélite chronique des membres est une pathologie fréquente en Afrique. Staphyloccocus aureus demeure le germe le plus fréquent. La chirurgie en un temps nous paraît une bonne alternative. Le taux de récidive de la suppuration reste élevé.
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OBJECTIVE: To assess the reduction in IOP and ocular symptoms in patients newly diagnosed with POAG and treated with latanoprost as monotherapy. PATIENTS AND METHOD: A multicentric, cross-sectional, descriptive study was conducted. We included adults newly diagnosed with POAG. All patients received one drop of preserved latanoprost 0.005% in each eye every night for 12 weeks. Changes in IOP and ophthalmic signs and symptoms were assessed during and at the end of treatment. RESULTS: A total of 524 patients were included, with a participation rate of 93% at 12 weeks. The mean age was 52.79±17.33 years, and the sex ratio M/F was 1.39. At inclusion, the mean IOP was 21.68±9.72mmHg. After 2 weeks of treatment, the mean IOP was 15.49±5.81mmHg, for a reduction of 28.55%. After 12 weeks of treatment, the mean IOP was 13.16±3.54mmHg, for a reduction of 39.30%. The main symptom recorded was a gritty foreign body sensation, the frequency of which was 4.72% at W2 and 2.45% at W12. The main sign was hyperemia (4.33% at W2 and 1.84% at W12). CONCLUSION: Latanoprost given as first-line monotherapy in POAG in blacks considerably reduces IOP. The incidence of side effects remains low; it is higher at the start of treatment.
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Glaucoma de Ángulo Abierto , Hipertensión Ocular , Prostaglandinas F Sintéticas , Adulto , Anciano , Antihipertensivos/efectos adversos , Estudios Transversales , Glaucoma de Ángulo Abierto/tratamiento farmacológico , Humanos , Intención , Presión Intraocular , Latanoprost , Persona de Mediana Edad , Hipertensión Ocular/tratamiento farmacológico , Soluciones Oftálmicas , Prostaglandinas F Sintéticas/efectos adversos , Resultado del TratamientoRESUMEN
INTRODUCTION: The objective of this study was to determine the incidence of the operating site infection, precise the etiologies and identify the risk factors. PATIENTS AND METHOD: This was a prospective study conducted at the department of orthopedics and traumatology at the hospital of Sikasso. The study was conducted from January 2016 to December 2018. The infection criteria were those of CDC from Atlanta. RESULT: This study was conducted on 140 patients including 105 men and 35 women with an average age of 40, 1 years old (3 and 88 years old). We have made 150 interventions including 131 osteosynthesis, 14 arthroplasties and 5 corrective osteotomies. The global incidence of the operating site infection was of 19, 3% with a 13, 4% incidence in surgery class I, 21, 4% in the class II, 26, 5% in the class III and 50% in the class IV. . It was superficial in 18 cases (62, 1%) and deep in 11 cases (37, 9%). The average post-surgery hospitalization duration was 13 days (5 and 70 days in extreme cases). The isolated germs were Staphylococcus aureus in 6 cases (37,5 %), Pseudomonas aeruginosa in 3 cases (18,7 %), Enterobacter cloacae in 3 cases (18,7%), Escherichia Coli in 2 cases (12,5 %,), Klebsiellapneumoniae in 1 case (6,3%) and Proteus mirabilis in 1 case (6,3%). They were 100% sensible to imipramine. 90% of the cases were resisting to ampicillin and penicillin G. CONCLUSION: The incidence of the ISO in our department was high. The risk factors of Operating Sites Infections were: hospitalization duration beyond 2 days, ASA Score over 2 days long, the surgical intervention class and the operation duration higher than 3 hours.
INTRODUCTION: Le but de cette étude était de déterminer l'incidence de l'infection du site opératoire, de préciser les étiologies et d'identifier les facteurs de risque. PATIENTS ET MÉTHODE: Il s'agissait d'une étude prospective réalisée dans le service de chirurgie orthopédique et traumatologique de l'hôpital de Sikasso. L'étude s'est déroulée de Janvier 2016 à décembre 2018. Les critères d'infection ont été ceux du CDC d'Atlanta. RÉSULTATS: Cette étude concernait 140 patients dont 105 hommes et 35 femmes d'âge moyen de 40,1 ans (extrêmes : 3 et 88 ans). Nous avions réalisé 150 interventions dont 131 ostéosynthèses, 14 arthroplasties et 5 ostéotomies de correction. L'incidence globale de l'infection du site opératoire était de 19,3% avec une incidence 13,4% dans la classe de chirurgie I, 21,4% dans la classe II, 26,5% dans la classe III et 50% dans la classe IV. Elle était superficielle dans 18 cas (62,1%) et profonde dans 11 cas (37,9%). La durée moyenne d'hospitalisation post-opératoire était de 13 jours (extrêmes 5 et 70 jours). Les germes isolés étaient le Staphylococcus aureus 6 cas (37,5 %) le Pseudomonas aeruginosa 3 cas (18,7 %), l'Enterobacter cloaca e3 cas (18,7%),l' Escherichia Coli2 cas(12,5 %,), le Klebsiella pneumoniae 1cas (6,3%)et le Protéus mirabilis 1 cas (6,3%). Ils étaient sensibles à l'imipenem dans 100 %. Ils étaient résistants à l'ampicilline, à l'amoxicilline et pénicilline G dans 90% des cas. CONCLUSION: L'incidence des ISO dansnotre service était élevée. Les facteurs de risques des ISO que nous avions identifiés ont été la durée d'hospitalisation supérieure à deux jours, le Score ASA supérieur à 2, la classe de l'intervention chirurgicale et la durée opératoire supérieure à 3 heures.
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In Mali, there were 4508 new cases of tuberculosis in 2003, and 5222 in 2006. Tuberculosis (TB) is thus an important public health problem, decreasing the physical, financial and social capital of individuals, their families and society. Because responses to TB have not yet applied a sufficiently integrated approach that can improve patients' access to quality care, this FORESA project advocates a patient-centered approach. Before any intervention, FORESA thus sought to analyse the situation of TB in Mali and responses to it. The study aims to analyse the discourse about and popular representations of TB (its forms, its signs), the situations in which people are exposed to it or transmit it, and popular practices related to its prevention and the experience of having it. This qualitative, descriptive and analytical study includes a literature review, in-depth interviews with opinion leaders, community health workers and TB patients, focus groups, and the observations of practices. The interviews were recorded, transcribed, and analysed. Subjects provided informed consent to participation. This study showed that: * the terms for TB in local languages (Bambara, Dogon and Fulfuldé) include white cough, big cough, and long cough; * These communities differentiate between 2 main forms of cough (simple and wet); * TB is perceived as a transmissible disease, a disease of contact with a contaminated body or objects; * TB is seen as a serious, contagious, hereditary, shameful disease that may result from the transgression of social norms; * The prevention of TB consists of avoiding people who have the disease or transmitting factors; * Therapeutic remedies, in order, are self-medication, the use of traditional healers, and finally visits to health centres; * The population wants more information about TB and be involved in the fight against it. This study shows the many points of convergence about TB nosology, etiology and therapy between the Mopti population and other groups in Mali (including the Mande, Senoufo and Soso), between the population of Mali and some ethnic groups in Burkina Faso (such as the Dioula, Bobo, Tiéfo Vigué), and between the population of Mali and, Burkina Faso and others in Africa (Gambia, Nigeria, South Africa, etc.). There is also a difference between popular knowledge about TB and biomedical knowledge. The population does not know that TB is transmitted mainly, even exclusively, by nasal droplets or that patients are no longer contagious after two weeks of treatment. The widespread dissemination of this information may have a positive effect, reducing stigmatization and improving access to treatment. Mali must strengthen the skills of all participants in the fight against tuberculosis, to strengthen their framework and to monitor and evaluate their activities.
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Tuberculosis , Antropología , Accesibilidad a los Servicios de Salud , Humanos , Malí , Calidad de la Atención de Salud , Factores Socioeconómicos , Tuberculosis/economía , Tuberculosis/epidemiología , Tuberculosis/terapiaRESUMEN
INTRODUCTION: Visual impairment is a handicap defined as any alteration of visual function responsible for a partial or total limitation of the activities of daily living (OMS, 2004). The objective of this study is to assess quality of life in patients before and after management of low vision. PATIENTS AND METHODS: This was a mono-centric, transverse, analytical study over a period of 6 months. Our study population included all adult patients seen in ophthalmologic consultation and followed in the low vision unit with visual acuity less than 3/10 and greater than or equal to 1/20 in the best eye with best optical correction. The National Eye Institute's quality of life questionnaire, the NEF VFQ 25, was administered to patients on site prior to management and then a month later. RESULTS: Low-vision management improved overall the dimensions of the quality of life questionnaire. Following the end-of-care assessment, the score for ocular pain was lowest (38.20), followed by the overall vision score (44.95) and near vision difficulty score (45.33). DISCUSSION: Our sample population was distinguished by a cultural mix, with diversity of beliefs and lifestyles, and also by the relatively advanced age of the subjects constituting it. This can influence the individual's perception of him- or herself within his or her environment, modifying the patient's estimation of his or her condition and therefore his or her behavior. CONCLUSION: Low-vision rehabilitation can improve the quality of life of visually impaired patients, particularly for near vision, activities of daily living and psychological health.
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Calidad de Vida , Baja Visión/terapia , Actividades Cotidianas/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Personas con Discapacidad/psicología , Personas con Discapacidad/rehabilitación , Personas con Discapacidad/estadística & datos numéricos , Dolor Ocular/terapia , Femenino , Estado de Salud , Hospitales Universitarios , Humanos , Masculino , Malí/epidemiología , Persona de Mediana Edad , Oftalmología/normas , Oftalmología/estadística & datos numéricos , Derivación y Consulta/normas , Derivación y Consulta/estadística & datos numéricos , Encuestas y Cuestionarios , Baja Visión/epidemiología , Baja Visión/fisiopatología , Baja Visión/psicología , Agudeza Visual/fisiología , Adulto JovenRESUMEN
INTRODUCTION: Quality of life is defined by the physical, emotional and social well-being of an individual. Primary Open Angle Glaucoma (POAG) is a blinding optic neuropathy, it can change the quality of life by its chronic and irreversible nature. The objective of this study was to evaluate the quality of life in patients with POAG in urban areas. PATIENTS AND METHODS: this was a quantitative cross-sectional study with a descriptive aim over 3 months. Patients followed for POAG at CHU-IOTA with an age ≥ 18 years were included and submitted to the GlauQOL-17 questionnaire for data collection. RESULTS: We collected 100 glaucomatous patients, the mean age of patients was 52 years with a standard deviation of 14.02. The extreme ages are 18 and 81 years old. There was a male predominance; (54%) with a sex ratio (M / F) of 1.7. The good visual acuities were majority (higher or equal to 3/10). Among our patients, 35% were at the stage of glaucoma starting at OD and 30% at the stage of moderate glaucoma at OG. Our patients had a poor quality of life score (score <50%) in the Anxiety and Driving dimensions. In patients younger than 70 years old, we had a poor anxiety score in all progressive stages of the disease. Scores of self-image dimensions, constraints, and management were greater than 60% in patients over 70 years of age. CONCLUSION: Alteration of some of the domains studied was proportional to evolution of POAG. This degradation can have physical, psychological and social impacts on his patients.
INTRODUCTION: La qualité de vie se définit par le bien-être physique, émotionnel et social d'un individu. Le Glaucome Primitif à Angle Ouvert (GPAO) est une neuropathie optique cécitante, il peut modifier la qualité de vie de par son caractère chronique et irréversible. L'objectif de cette étude était d'évaluer la qualité de vie chez les patients atteints de GPAO en milieu urbain. PATIENTS ET MÉTHODES: il s'agissait d'une étude quantitative transversale à visée descriptive sur 3 mois. Les patients suivis pour GPAO au CHU-IOTA avec un âge ≥ 18 ans ont été inclus et soumis au questionnaire GlauQOL-17 pour la collecte des données. RÉSULTATS: Nous avons colligé 100 patients glaucomateux, la moyenne d'âge des patients était de 52 ans avec un écart type de 14,02. Les extrêmes d'âges sont de 18 et 81 ans. Il y avait une prédominance masculine ; (54%) avec un sex-ratio (M/F) de 1.7. Les acuités visuelles bonnes étaient majoritaires (supérieures ou égales à 3/10).Parmi nos patients 35% étaient au stade de glaucome débutant à OD et 30% au stade de glaucome modéré à OG. Nos patients avaient un mauvais score qualité de vie (score < à 50%) dans les dimensions Anxiété et conduite. Chez les patients de moins de 70 ans nous avons noté un mauvais score d'anxiété dans tous les stades évolutifs de la maladie. Les scores des dimensions image de soi, contraintes, et prise en charge étaient supérieurs à 60% chez les patients de plus de 70 ans. CONCLUSION: L'altération de certains domaines étudiés était proportionnelle à l'évolution du GPAO. Cette dégradation peut avoir des impacts physiques, psychologiques et sociaux sur ses patients.
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INTRODUCTION: Among the 1.4 million blind children in the world, 300,000 live in Africa. The causes of blindness vary from one country to another. The purpose of our study was to report the causes of childhood blindness and visual impairment in children attending the only school for the blind in Mali (National Institute for the Blind in Mali, INAM). MATERIALS AND METHODS: All children attending the INAM were examined. Blindness was defined as visual acuity less than 3/60 (20/400 or 0.05). Visual impairment was moderate when the visual acuity was less than 6/18 (20/70 or 0.30), but greater than or equal to 6/60 (20/200 or 0.1), and severe when visual acuity was less than 6/60 (20/200 or 0.1), but greater than or equal to 3/60 (20/400 or 0.05). RESULTS: The study included a total of 104 children. The average age of our patients was 12 years with a M/F sex-ratio of 1.12. In all, 85.6 % of the children were blind and 14.4 % visually impaired. The main causes of blindness were corneal opacities (26 %), and whole globe lesions and conditions (19.2 %). Ametropia accounted for 60 % of visual impairment. DISCUSSION: According to WHO, corneal and retinal damage are the leading cause of blindness (50.6 %) in children. In our series, corneal diseases were the leading cause, following by damage to the whole globe. CONCLUSION: The results of our study indicate that avoidable and treatable causes of childhood blindness are the leading causes of blindness of children at INAM.
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Ceguera/etiología , Adolescente , Avitaminosis/complicaciones , Catarata/congénito , Niño , Preescolar , Enfermedades de la Córnea/complicaciones , Femenino , Humanos , Lactante , Masculino , Malí , Sarampión/complicaciones , Estudios Prospectivos , Errores de Refracción/complicacionesRESUMEN
Esthetic and functional surgeries in the periocular region fall into the domain of oculoplastic, or plastic and reconstructive surgery and otorhinolaryngology. Oculoplasty is the largest surgical spectrum in ophthalmology including eyelids, orbits and the lacrimal system. Our purpose was to study the frequency of eyelid, lacrimal and orbital (oculoplastic) surgery at the CHU IOTA. MATERIAL AND METHODS: Retrospective medical chart review of all the patients who underwent oculoplastic surgery was conducted from October 2015 to September 2016. RESULTS: A total of 233 patients were included with 52% female and 48% male. Patients were 37 years old on average. In total, the surgery was performed on the eyelids in83 cases (35.6%), the orbits in 113 cases (48.5%) and the lachrymal system in 37 cases (15.9%).Eyelid surgery commonly resulted from eye trauma (43,3%), followed by malpositions (30,2%). Mutilating surgery accounted for 92% of the orbital surgery. External dacryocystorhinostomy was the main lacrimal surgery (42%) followed by canalicular lacerations 25%. CONCLUSION: Oculoplasticsurgeryoccupies an important place in the surgical activities of the ophthalmologic University hospital despite a larger volume for cataractsurgery. Our studydoesn't highlight the outcome of the surgery itself but the epidemiology to help decision makers in their eye health policy including the reduction of mutilating surgery and oculoplastic training.
La chirurgie esthétique et fonctionnelle de la région périoculaire est du domaine de l'oculoplastie, ainsi que de la chirurgie plastique et reconstructive et de l'otorhinolaryngologie. L'oculoplastie constitue le plus large éventail chirurgical en ophtalmologie regroupant la paupière, l'orbite et le système lacrymal. OBJECTIF: Etudier la fréquence des procédures chirurgicales orbito-palpébrales et lacrymales (oculoplasties) dans un centre de troisième référence. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude rétrospective des dossiers de patients opérés pour pathologies oculoplastiques d'octobre 2015 à septembre 2016. RÉSULTATS: Au total 233 patients ont été inclus dont 52% de sexe féminin et 48% de sexe masculin avec un âge moyen de 37 ans ; parmi lesquels 83 cas (35,6%) de chirurgie palpébrale, 113 cas (48,5%) de chirurgie orbitaire et 37 cas (15,9%) chirurgie lacrymale.La chirurgie palpébrale était dominée parréparationdesplaies traumatiques (43,3%), suivi des malpositions (30,2%). La chirurgie mutilante constituait 92% de la chirurgie orbitaire. La dacryocystorhinostomie par voie externe était la principale chirurgie lacrymale soit 42%, suivie des lacérations canaliculaires 25%. CONCLUSION: Notre étude ne met pas en exergue le résultat de la chirurgie elle-même, mais l'épidémiologie du traitement chirurgical afin d'aider les décideurs dans leur politique de santé oculaire notamment sur la réduction de la chirurgie mutilante et la formation oculoplastique.
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A baby born at home 14 hours earlier was brought to the neonatology department with bilateral upper palpebral chemosis with purulent secretions and pseudomembranes, with no general signs of infection. The gram staining of a secretion sample shows the presence of Neisseria gonorrhoeae. Intramuscular ceftriaxone treatment was initiated, combined with topical application of rifamycin, dexamethasone, and oxytetracycline. Complete healing without sequelae was obtained after two weeks. This case presents an opportunity to review this preventable pathology and its treatment. The only effective way to prevent it is to raise the awareness of disadvantaged population about the value of antenatal care.
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Oftalmía Neonatal/tratamiento farmacológico , Antibacterianos/uso terapéutico , Ceftriaxona/uso terapéutico , Dexametasona/uso terapéutico , Femenino , Glucocorticoides/uso terapéutico , Humanos , Recién Nacido , Oxitetraciclina/uso terapéutico , Rifamicinas/uso terapéuticoRESUMEN
OBJECTIVES: Trachoma, caused by repeated ocular infections with Chlamydia trachomatis is an important cause of blindness. Mass azithromycin distribution is part of current recommended strategies for controlling trachoma. In order to ascertain an efficient strategy model at an acceptable cost, an intervention study was conducted in Mali between May 2000 and February 2002. METHODS: Three azithromycin administration strategies were evaluated: mass community-based treatment of all residents (strategy I), treatment of all children under 11 years of age and of women between 15 and 50 (strategy II), and treatment targeted to inhabitants of households where at least one child had clinically active trachoma diagnosed (strategy III). In a particular Malian area in which trachoma was known to be mesoendemic, three villages were selected for each of the three strategies. According to the strategy allocation, adults were eventually given a single dose of 1g azithromycin, and children a unique dose of 20 mg/kg. Moreover, cleanliness and washing of children's faces were assessed, and additional questions were addressed about education, environmental and socio-economic conditions for each household at baseline. Ophthalmic examination was performed at baseline and 1, 6 and 12 months after inclusion. The outcome variable was clinically active trachoma frequency 12 months after intervention among children under 11 years of age. A descriptive analysis was performed, and then logistic regression models were built to test the efficiency of the three strategies. RESULTS: Among children under 11 years of age, the active trachoma prevalence fell dramatically in each strategy, from 23.7% to 6.4% in strategy I, from 20.8% to 6.8% in strategy II, and from 20.2% to 8.5% in strategy III. After adjustment on age (adjusted odds ratio [AOR] = 0.81; 95% confidence interval [95% CI]: 0.75-0.87) and on active trachoma occurrence at baseline (AOR = 3.81; [95% CI]: 2.70-5.39), the multiple logistic regression model showed that both strategies I and II gave similar results, while strategy III appeared significantly less effective (AOR = 1.56; [95% CI]: 1.00-2.43). CONCLUSION: In mesoendemic trachoma areas, targeted treatment to all children under 11 years of age and women between 15 and 50 (strategy II) was as effective as indiscriminate mass distribution (strategy I) and more effective than treatment targeted to inhabitants of households where at least one child had active trachoma diagnosed (strategy III). Strategy II could therefore reduce the prevalence and intensity of trachoma infection at a lower cost than mass community-based treatment of all residents (strategy I).
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Antibacterianos/administración & dosificación , Azitromicina/administración & dosificación , Chlamydia trachomatis/crecimiento & desarrollo , Tracoma/tratamiento farmacológico , Adolescente , Adulto , Animales , Ceguera/prevención & control , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Malí , Persona de Mediana Edad , Población Rural , Tracoma/microbiología , Tracoma/prevención & control , Resultado del TratamientoRESUMEN
INTRODUCTION: Treatment of cataract blindness is surgical to restore vision. The aim of this work was to compare the PKA to the classic EEC in the surgical treatment of adult cataract in terms of anatomical and functional results in our institute. MATERIALS AND METHODS: This was a cross-sectional study of 333 operated eyes of cataract of the adult and followed for one month. The postoperative functional data and the causes of poor results were specified. RESULT: A total of 172 men (51.7%) and 161 women (48.3%) underwent cataract surgery. The mean age was 64.2 years. 61.26% of patients had visual acuity (≥3 / 10) in EEC compared with 65.28% in PKA. (21%) for EEC, and (15%) for PKA had poor visual acuity (<1/10). The proportion of patients with good results increases with the best correction to 77.3% for EEC and 91.5% for PKA. The poor results close to those of the WHO in both techniques (6.7%). EEC and (5.3%) PKA. The poor results were mainly related to pre-existing pathologies (6.6%) and astigmatism related to surgery (7.1%). CONCLUSION: In order to achieve the objectives of "Vision 2020", within the framework of the fight against blindness, it is imperative to facilitate the popularization of the PKA throughout the African subregion.
INTRODUCTION: Le traitement de la cécité par cataracte est chirurgical permettant ainsi de restaurer la vision. Le but de ce travail était de comparer la phacomanuelle sans suture (PKA) à l'extraction extra capsulaire (EEC) classique dans le traitement chirurgical de la cataracte de l'adulte en terme de résultats anatomiques et fonctionnels dans notre institut. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude transversale sur 333 yeux opérés de cataracte de l'adulte et suivis pendant un mois. Les données fonctionnelles postopératoires et les causes de mauvais résultats ont été précisées. RÉSULTATS: Au total 172 hommes (51,7%) et 161 femmes (48,3%) ont subi une chirurgie de la cataracte. L'âge moyen était de 64,2 ans. L'acuité visuelle était bonne (≥3/10) chez (61,26 %) de nos patients en EEC contre (65,28%) en PKA. En EEC, (21%) et (15%) pour la PKA avaient une mauvaise acuité visuelle (<1/10). La proportion des patients avec de bons résultats augmente avec la meilleure correction à (77,3%) pour EEC et (91,5%) pour la PKA. Les mauvais résultats avoisinent ceux de l'OMS dans les deux techniques (6,7%) EEC et (5,3%) PKA. Les mauvais résultats étaient principalement liés aux pathologies préexistantes (6,6%) et astigmatismes liés à la chirurgie (7,1%). CONCLUSION: Pour atteindre les objectifs de la « vision 2020 ¼, dans le cadre de la lutte contre la cécité, il est impératif de faciliter la vulgarisation de la PKA dans toute la sous-région africaine.
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INTRODUCTION: In recent years, the infection Candida albicans infection worldwide has risen, and the incidence of resistance to traditional antifungal therapies is also increasing. The aim of this study was to evaluate in vitro susceptibility of C. albicans clinical isolates to eight antifungal agents in Ouagadougou. MATERIALS AND METHODS: A cross-sectional study was conducted from January 2013 to December 2015 at Yalgado Ouédraogo University Teaching Hospital. Two hundred seven strains have been isolated from 347 symptomatic patients received in different clinical services. Samples were cultured on Sabouraud Dextrose Agar supplemented with Cloramphenicol. Isolates were diagnosed as C. albicans using germ tube test, chlamydospore formation on Corn Meal Agar, and Api-Candida test (Biomérieux). Antifungal susceptibility testing was performed by disk diffusion method and isolates classified as susceptible, susceptible dose-dependent and resistant. RESULTS: Three hundred forty-seven (347) patients are included in this study. Two hundred and six (206) out of 347 collected samples (59.36%) were found positive for C. albicans. The strains were mostly isolated from vulvovaginal (49%) and oral infections (40.3%). The highest resistance rates of azoles were obtained with fluconazole (66.5%), itraconazole (52.3%) and ketoconazole (22.9%) when all clinical isolates were included. The resistance rates of fluconazole, itraconazole and ketoconazole remain highest for vulvovaginal and oral isolates. The rate of resistance to the polyene amphotericin B was 32.0% for all clinical isolates and was 56.4% for vulvovaginal strains. Resistance rate to nystatin was 6.3% for all clinical isolates. Cross-resistance analysis with data of all clinical strains revealed that the incidence of resistance to ketoconazole and itraconazole in fluconazole-resistant isolates was significantly higher than recorded for fluconazole-susceptible isolates. CONCLUSION: In vitro C. albicans antifungal susceptibility test in this study showed relatively high resistance to commonly and widely used azoles (fluconazole, ketoconazole). Most C. albicans clinical isolates were susceptible to nystatin.