La pneumopathie aigue bactérienne communautaire du sujet âge en pneumologie au centre hospitalier et universitaire du point-g, Bamako-mali / Community acute bacterial pneumonitis of the subject age in pulmonology at the Point-g hospital and university center, Bamako- Mali

Introduction : Les pneumopathies aiguës bactériennes (PAB) communautaires sont des infections respiratoires basses aiguës, non suppurées, non tuberculeuses du parenchyme pulmonaire acquises au sein de la communauté. Elles ont une présentation clinique atypique et un mauvais pronostic chez le sujet âgé. Matériels et Méthodes : Il s'agissait d'une étude transversale prospective menée au service de pneumologie du centre hospitalier universitaire (CHU) du Point-G, du 30 Octobre 2018 au 30 Septembre 2019. L'objectif était de déterminer les particularités cliniques, étiologiques, thérapeutiques et évolutives de la PAB chez le sujet âgé. Ont été inclus tout âge ≥ 65 ans, présentant des signes cliniques et radiologiques d'une PAB Résultats : Durant la période d'étude 85 patients répondaient aux critères d'inclusion sur 178 hospitalisés. Le sex-ratio était de 3/1. Environ 2/3 étaient tabagiques et 11% était positif au VIH. La fièvre n'était pas constante enregistrée dans 51,76% des cas. Les signes respiratoires étaient dominés par la toux (96, 47%), la dyspnée (94, 11%) et extra respiratoires par le trouble de la conscience. Le Klebsiellapneumoniae était le germe le plus retrouvé. L'antibiotique le plus utilisé était l'amoxicilline-acide clavulanique. La durée moyenne d'hospitalisation était de 9 jours. La mortalité était de 19%. Conclusion: La PAB chez le sujet âgé est d'une symptomatologie clinique frustre. Elle est grave avec une surmortalité

Introduction: Community-acquired acute bacterial pneumonia (ABP) is an acute, non-suppurative, non-tuberculosis lower respiratory infection of the lung parenchyma acquired within the community. They have an atypical clinical presentation and a poor prognosis in the elderly. Materials and Methods: This was a prospective cross-sectional study conducted in the Pneumology department of the University Hospital Center (CHU) of Point-G, from October 30, 2018, to September 30, 2019. The objective was to determine the clinical, etiological, therapeutic and progression of BAP in the elderly. Were included any age ≥ 65 years, presenting clinical and radiological signs of a PAB. Results During the study period, 85 patients met the inclusion criteria out of 178 hospitalized. The sex ratio was 3/1. About 2/3 were smokers and 11% were HIV positive. Fever was not constant recorded in 51.76% of cases. Respiratory signs were dominated by cough (96.47%), dyspnea (94.11%) and extra respiratory by impaired consciousness. Klebsiella pneumoniae was the most found germ. The most commonly used antibiotic was amoxicillin-clavulanic acid. The average length of hospitalization was 9 days. Mortality was 19%. Conclusion: The PAB in the elderly is of a frustrating clinical symptomatology. It is serious with excess mortality

[Pediatric colonoscopy at the University Hospital of Cocody (Ivory Coast)]. / Coloscopie pédiatrique: expérience du centre hospitalier universitaire de Cocody (Côte d'Ivoire).

No published data are available on pediatric colonoscopy in Ivory Coast (and only one report on pediatric gastroscopy). We conducted a retrospective study of all colonoscopy reports of procedures performed from 1 September, 1991, to December 31, 2010, at the University Hospital of Cocody in Abidjan (Ivory Coast) and examined the epidemiological aspects, conditions of performance, indications, and results of colonoscopy in patients younger than 18 years. Eleven of the total of 1 159 colonoscopies were performed in in this age group (0.94%). The mean age of these 8 girls and 3 boys was 15 years (range: 10 to 17 years). All patients had been referred by a gastroenterologist. Bowel preparation was performed in all with a water enema. Premedication was performed exclusively with midazolam. A pediatric colonoscope was used. The colonoscopy was incomplete in 36% of cases (n=4). Rectal bleeding was the main indication. Results were abnormal in 72% of cases (n=8) and the lesions found were juvenile polyps, ulcerative colitis, sigmoid varices, rectocolitis due to a caustic product, and adenomatous polyps. The results of the examination were normal in 3 children. No complications were reported. In conclusion, although the pediatric colonoscopy practice at the University Hospital of Cocody in Abidjan is extremely small, its therapeutic and diagnostic yields are high, particularly in cases of rectal bleeding. Physicians (general practitioners and pediatricians) managing children should not hesitate to ask for a colonoscopy when appropriate.

Connaissances, attitudes et pratiques des tradipraticiens de la sante de la ville d'Abidjan sur le paludisme.

INTRODUCTION : An estimated 300 to 500 million clinical cases of malaria occur each year worldwide, 90% in Africa, mostly among young children. In Cote d'Ivoire, malaria is 46.03% of disease states and 62.44% of hospital admissions. In children under 5 years, it is 42.67% of the reasons for consultation and 59.68% of hospital admissions. In pregnant women, it represents 22.91% of disease states and 36.07% of hospital admissions. In Africa, traditional medicine is the first resort for the vast majority of people, because of its accessibility both geographically, economically and culturally. However, some modern practitioners show an attitude of distrust of traditional medicine and its players, calling them irrational. This work had set out to assess knowledge, attitudes and practices of traditional healers in the uncomplicated and complicated in the context of collaboration between traditional and modern medicine for the optimal management of critical cases. MATERIALS AND METHOD : The study focused on traditional healers practicing in the city of Abidjan. The study was conducted using individual interviews over a period of 30 days. The interviews were conducted in local languages, with the assistance, if necessary, translators. For data collection, we used a questionnaire containing four items: the socio-demographic characteristics of traditional healers, their knowledge on malaria, diagnostic practices and traditional therapies. RESULTS : Of the 60 healers and included in the study, only six were women (10%), a sex-ratio of a woman to 9 men. 66.7% of respondents traditional healers are herbalists and 25% of naturopaths.Only 8.3% were spiritualists. The etiology of malaria most commonly cited by the traditional healers were mosquito bites (16.7%), food (1.7%), solar (1.7%) and fatigue (1.7%) . 25% of traditional healers are associated with mosquitoes, sun and fatigue. Symptomatology most cited were fever (100%), dark urine (86%), the yellow or pale conjunctiva (80%), vomiting (71.7%), nausea (58.3%) and abdominal pain (48.3%). Traditional healers recognized three types of malaria: the white shape, form yellow / red and the black form. Traditional healers malarious patients surveyed were receiving both first (58.3%) than second-line (41.7%). 78.3% of them practiced an interview and physical examination of theirpatients before the diagnosis. In 13.3% of cases they were divinatory consultation. Medications used to treat malaria were herbal in 95% of cases. The main sign of healing was the lack of fever (58.3%). 90%of traditional healers interviewed referring cases of malaria black (severe malaria). This reference is made to modern health facilities (90.2%). 68.3% of respondents practiced traditional healers of malaria prophylaxis among pregnant women and children under 5 years.CONCLUSION : A description of clinical malaria by traditional practitioners in health is not very far from that of modern medicine. Nevertheless, the logics of our respondents are etiological more complex and linked to their cultural context. The management of cases is made from medicinal plants in treatment failure patients are usually referred to modern health facilities. The involvement of traditional healers in the detection and quick reference risk cases can contribute to reducing child mortality due to severe malaria.

[Knowledge, attitude, and practice of traditional healers on the topic of malaria in the city of Abidjan]. / Connaissances, attitudes et pratiques des tradipraticiens de la sante de la ville d'Abidjan sur le paludisme.

INTRODUCTION: An estimated 300 to 500 million clinical cases of malaria occur each year worldwide, 90% in Africa, mostly among young children. In Cote d'Ivoire, malaria is 46.03% of disease states and 62.44% of hospital admissions. In children under 5 years, it is 42.67% of the reasons for consultation and 59.68% of hospital admissions. In pregnant women, it represents 22.91% of disease states and 36.07% of hospital admissions. In Africa, traditional medicine is the first resort for the vast majority of people, because of its accessibility both geographically, economically and culturally. However, some modern practitioners show an attitude of distrust of traditional medicine and its players, calling them irrational. This work had set out to assess knowledge, attitudes and practices of traditional healers in the uncomplicated and complicated in the context of collaboration between traditional and modern medicine for the optimal management of critical cases. MATERIALS AND METHOD: The study focused on traditional healers practicing in the city of Abidjan. The study was conducted using individual interviews over a period of 30 days. The interviews were conducted in local languages, with the assistance, if necessary, translators. For data collection, we used a questionnaire containing four items: the socio-demographic characteristics of traditional healers, their knowledge on malaria, diagnostic practices and traditional therapies. RESULTS: Of the 60 healers and included in the study, only six were women (10%), a sex-ratio of a woman to 9 men. 66.7% of respondents traditional healers are herbalists and 25% of naturopaths.Only 8.3% were spiritualists. The etiology of malaria most commonly cited by the traditional healers were mosquito bites (16.7%), food (1.7%), solar (1.7%) and fatigue (1.7%) . 25% of traditional healers are associated with mosquitoes, sun and fatigue. Symptomatology most cited were fever (100%), dark urine (86%), the yellow or pale conjunctiva (80%), vomiting (71.7%), nausea (58.3%) and abdominal pain (48.3%). Traditional healers recognized three types of malaria: the white shape, form yellow / red and the black form. Traditional healers malarious patients surveyed were receiving both first (58.3%) than second-line (41.7%). 78.3% of them practiced an interview and physical examination of theirpatients before the diagnosis. In 13.3% of cases they were divinatory consultation. Medications used to treat malaria were herbal in 95% of cases. The main sign of healing was the lack of fever (58.3%). 90%of traditional healers interviewed referring cases of malaria black (severe malaria). This reference is made to modern health facilities (90.2%). 68.3% of respondents practiced traditional healers of malaria prophylaxis among pregnant women and children under 5 years. CONCLUSION: A description of clinical malaria by traditional practitioners in health is not very far from that of modern medicine. Nevertheless, the logics of our respondents are etiological more complex and linked to their cultural context. The management of cases is made from medicinal plants in treatment failure patients are usually referred to modern health facilities. The involvement of traditional healers in the detection and quick reference risk cases can contribute to reducing child mortality due to severe malaria.

In vitro antioxidant, xanthine oxidase and acetylcholinesterase inhibitory activities of Balanites aegyptiaca (L.) Del. (Balanitaceae).

The present study aimed to test the validity of Balanites aegyptiaca remedies used for the treatment of rheumatisms and mental disorders by examining the antioxidant, xanthine oxidase and acetylcholinesterase inhibitory activities of galls and leaves extracts and fractions. The total phenolics and flavonoids were measured using Folin-Ciocalteu and AlCl3 reagents, respectively. Two methods i.e., FRAP and ABTS were used to estimate the total antioxidant capacity of the plant materials. The FRAP and ABTS antioxidant activities showed that among all extracts and fractions tested, the best antioxidant activities were found with the galls dichloromethane and the leaves ethyl acetate fractions. The antioxidant activities did correlated significantly with the total phenolic and flavonoid contents. The study also showed that B. aegyptiaca galls and leaves fractions exhibited a moderate xanthine oxidase inhibitory activity comparatively to the acetylcholinesterase which was weakly inhibited by the tested extracts and fractions.

Antibacterial activity of Thonningia sanguinea against some multi-drug resistant strains of Salmonella enterica.

BACKGROUND: The emergence of strains of S.enterica with multiple drug resistance (MDR) is of great concern worldwide.The extracts of flowers of Thonningia sanguinea are used in traditional medicine in Ivory Coast to treat diarrhoeal diseases including salmonellosis. Previous studies had shown inhibition of the MDR strain Salmonella Enteritidis lysotype 6. OBJECTIVES: The present study focused to investigate the effect of the extract of the flowers of Thonningia sanguinea on some clinical MDR strains of Salmonella namely S. Tyhpi, S. Typhimurium, S. Hadar and a sensitive strain (S. Enteritidis). METHODS: The antimicrobial parameters were determined by double dilution with agar slant method. This method led us to determine MIC, IC50 and MBC. RESULTS: The MDR strain of S.Typhimurium presented the highest MIC (2.5 mg/ml) whereas the other two MDR strains (S. Hadar, S. Typhi) and the sensitive one (S. Enteritidis) had the same MIC (1.25 mg/ml). The four strains presented the same MBC (2.5 mg/ml). The MDR strain of S. Typhi is the most susceptible strain to the aqueous extract of the flowers of Thonningia sanguinea according to The IC50 values. CONCLUSIONS: The aqueous extract of Thonningia sanguinea can provide an alternative therapy for the treatment of salmonellosis, mainly for typhoid fever caused by MDR strains of S Typhi. The extract also inhibits S.Hadar a MDR emerging strain in Ivory Coast.

[Efficiency of ethanol of Thonningia sanguinea against Cryptococcus neoformans]. / Efficacité de l'extrait éthanolique de Thonningia sanguinea sur Cryptococcus neoformans.

Herbal treatment of infectious diseases is a common practice in traditional society. One of the herbs used by African populations against skin and systemic infectious diseases is Thonningia sanguinea (THOS). In the Ivory Coast, Togo, and Ghana, this herb is used to prepare traditional remedies for diarrhoeas, asthma and mycoses. The latter account for a substantial number of the opportunistic infections associated with HIV/AIDS. Some species of eumycetes, such as Cryptococcus neoformans, infect mainly immunocompromised patients but can sometimes infect immunocompetent hosts and they are often fatal. In this study we evaluated the antimicrobial activity of aqueous extracts of T. sanguinea against C. neoformans (and several other microorganisms). We first assessed the fungal growth in vitro on agar medium. We then incubated the cultures for 48 h with various concentrations of THOS to determine the percentage of survival according to the concentration of THOS and the concentration required for 50% inhibition (IC50). The minimum fungicidal concentration (MFC) of the total aqueous extract was 6.25 mg/mL. (THOS was thus most effective against C. neoformans). Accordingly we sought to improve the extract by preparing it with ethanol. This solution yielded an IC50=0.06 mg/mL and an MFC=0.098 mg/mL against C. neoformans.

Antibacterial Activity of Thonningia sanguinea against some Multi-Drug Resistant Strains of Salmonella enterica

Background : The emergence of strains of S.enterica with multiple drug resistance (MDR) is of great concern worldwide.The extracts of flowers of Thonningia sanguinea are used in traditional medicine in Ivory Coast to treat diarrhoeal diseases including salmonellosis. Previous studies had shown inhibition of the MDR strain Salmonella Enteritidis lysotype 6. Objectives: The present study focused to investigate the effect of the extract of the flowers of Thonningia sanguinea on some clinical MDR strains of Salmonella namely S.Tyhpi; S. Typhimurium; S. Hadar and a sensitive strain (S.Enteritidis). Methods : The antimicrobial parameters were determined by double dilution with agar slant method. This method led us to determine MIC; IC 50 and MBC. Results: The MDR strain of S.Typhimurium presented the highest MIC (2.5 mg/ml) whereas the other two MDR strains (S.Hadar; S.Typhi) and the sensitive one (S.Enteritidis) had the same MIC (1.25 mg/ml). The four strains presented the same MBC (2.5 mg/ml). The MDR strain of S.Typhi is the most susceptible strain to the aqueous extract of the flowers of Thonningia sanguinea according to The IC 50 values. Conclusions: The aqueous extract of Thonningia sanguinea can provide an alternative therapy for the treatment of salmonellosis; mainly for typhoid fever caused by MDR strains of S Typhi. The extract also inhibits S.Hadar a MDR emerging strain in Ivory Coast

[Differed autologous blood transfusion in the "G" point hospital in Bamako. Prospective study apropos of 40 cases]. / Transfusion autologue différée à l'hôpital du point "G" à Bamako. Etude prospective portant sur 40 observations.

With a sample of 40 patients, the authors conducted a prospective case-control study on the feasibility of differed autologous blood transfusion at Point "G" National Hospital in Bamako, Mali. The method has been accepted by all the patients. No clinical nor biological trouble has been reported by the patients themselves. The authors recommend the use of autologous blood transfusion by other hospital units and the development of regulations governing its implementation.

Transfusion autologue différée à l'Hôpital du Point G à Bamako: Etude prospective portant sur 40 observations à l'Hôpital du Point G de Bamako

"Sur un échantillon de 40 patients; les auteurs ont réalisé une étude prospective cas-témoins sur la faisabilité de la transfusion autologue différée à l'Hôpital National du point G de Bamako (Mali). La technique a été acceptée par la totalité des patients. Elle n'a pas entrainé de troubles cliniques ou biologiques pouvant influer sur les suites post-opératoires ; le surcout de la technique a été négligeable et n'a pas été pris en charge par les patients. Les auteurs recommandent une adoption de l'autotransfusion différée par d'autres formations sanitaires ainsi que sa règlementation."

[Influence of dietary calcium/phosphorus ratio on blood calcium, phosphate and magnesium during gestation in the rabbit]. / Influence du rapport calcium/phosphore de la ration sur la calcémie, la phosphatémie et la magnésémie de la lapine en gestation.

Sixteen Thiès strain rabbits were used to study the effect of the calcium/phosphorus ratio on plasma calcium, inorganic phosphorus and magnesium levels during pregnancy. Animals were allocated in 2 groups of 8: one receiving a diet with a Ca/P ratio of 1:0 and the other a diet with Ca/P ratio of 2:1. Water was given ad libitum for all rabbits. Results obtained showed that Ca blood level was significantly higher in rabbits receiving the diet with Ca/P ratio of 2:1 before covering and during the first week of pregnancy. During the last 15 d of pregnancy, Ca blood level decreased significantly in the 2 groups of animals. Plasma inorganic phosphorus and magnesium levels were not significantly different in the 2 groups of rabbits until the 2nd wk of pregnancy. But at the end of pregnancy, while phosphatemia and magnesemia decreased in rabbits fed a high Ca/P ratio, in the other group these parameters remained unchanged.

[In-vivo evaluation of Plasmodium falciparum sensitivity to chloroquine in Abidjan]. / Evaluation in vivo de la sensibilité de Plasmodium falciparum à la chloroquine à Abidjan.

In vivo tests of Plasmodium falciparum chloroquine sensitivity were conducted in October and November, 1988 with 81 children aged 5 to 9 in several districts of Abidjan, Ivory Coast. The WHO standard scheme covering 7 days on basis of 25 mg per kilo spread over 3 days resulted in a therapeutic failure in 29.6 per cent cases. Nevertheless, a drop in overall parasitemia by over 80 per cent was noted from Day-0 to Day-2 in 70 per cent of visible resistance. Only in vivo tests conducted at a later stage with identification of chloroquine in the blood stream, with together in vitro studies will make it possible to know the actual level of resistance of Plasmodium falciparum strains to chloroquine.

[Utilization of modern and traditional health systems in the rural Ivory Coast area]. / Utilisation des systèmes de santé modernes et traditionnels en zone rurale ivoirienne.

The authors carried out a questionnaire survey among the potential users of three rural health centers in Côte d'Ivoire. Between 58 and 90% of heads of family visit their zonal health center, between 18 and 50% also visit more distant centers. The utilization of other modern health structures is rare, but appeal to the herbalist healers is common and varies according to the characteristics of the families. Utilization of the two systems is not exclusive, 51% starting with the biomedical service. Of interrogated heads of family, 24% procure health care for others than members of their own family.