BACKGROUND: Gender imbalance and poor representation of women complicate the anesthesiology workforce crisis in sub-Saharan Africa (SSA). This study was performed to obtain a better understanding of gender disparity among medical graduates and anesthesiologists in SSA. METHODS: Using a quantitative, participatory, insider research study, led by female anesthesiologists as the national coordinators in SSA, we collected data from academic or national health authorities and agencies. National coordinators were nominees of anesthesiology societies that responded to our email invitations. Data gathered from 13 countries included information on medical graduates, anesthesiologists graduating between 1998 and 2021, and number of anesthesiologists licensed to practice in 2018. We compared data between Francophone and Anglophone countries, and between countries in East Africa and West Africa/Central Africa. We calculated anesthesiology workforce densities and compared representation of women among graduating anesthesiologists and medical graduates.Data analysis was performed using linear regression. We used F-tests on regression slopes to assess the trends in representation of women over the years and the differences between the slopes. A value of P < .050 was considered statistically significant. RESULTS: Over a 20-year period, the representation of female medical graduates in SSA increased from 29% (1998) to 41% (2017), whereas representation of female anesthesiologists was inconsistent, with an average of 25%, and lagged behind. Growth and gender disparity patterns were different between West Africa/Central Africa and East Africa. Representation of female anesthesiologists was higher in East Africa (39.4%) than West Africa/Central Africa (19.7%); and the representation of female medical graduates in East Africa (42.5%) was also higher that West Africa/Central Africa (33.1%). CONCLUSIONS: On average, in SSA, female medical graduates (36.9%), female anesthesiologists (24.9%), and female anesthesiology residents projected to graduate between 2018 and 2022 (25.2%) were underrepresented when compared to their male counterparts. Women were underrepresented in SSA, despite evidence that their representation in medicine and anesthesiology in East African countries was rising.
Objectifs. Décrire les aspects cliniques, bactériologiques et évolutifs du sepsis et du choc septique dans le service de réanimation polyvalente du CHUB. Patients et méthodes. Il s'agit d'une étude transversale, monocentrique et descriptive, durant 12 mois, incluant les patients âgés d'au moins 18 ans admis en réanimation polyvalente pour un sepsis ou choc septique. Les variables épidémiologiques, cliniques, bactériologiques et évolutives ont été analysées avec Excel 2019. Résultats. 56 patients ont été retenus (20,7%). Leur âge moyen était de 43,1 ± 17,9 ans (extrêmes de 18 et 84 ans), avec 66,1% des hommes. Le foyer infectieux initial était péritonéal (64,3 %). À l'admission, le nombre médian de défaillances d'organes par patient était de trois (maximum 5). Les défaillances rénale (71,4%), hépatique (69,6%) et hémodynamique (62,5%) étaient les plus représentées. Le taux de réalisation du bilan bactériologique était de 35,7% : hémoculture (10,7%), uroculture (14,3%), porte d'entrée infectieuse (7,1%). La durée d'hospitalisation des patients sortis vivants était de 8,1 ± 6,3 jours (extrêmes de 2 et 31 jours). Le taux de mortalité était de 57,1%. Les décès survenaient au-delà de 24 h d'hospitalisation (75%), chez des patients avec comorbidités (65,6%), porte d'entrée péritonéale (59,4%), et défaillances hémodynamique (81,2%) et rénale (75%). Conclusion. Les prévalences du sepsis et du choc septique dans notre série sont superposables à celles de la littérature. Le taux de réalisation des bilans bactériologiques reste faible. La mortalité du sepsis demeure très élevée.
Introduction. No accurate data on sepsis and septic shock in intensive care unit (ICU) in the Republic of Congo are available. The aim of the study was to describe the course of patients with sepsis and/or septic shock in the polyvalent ICU of the University Teaching Hospital of Brazzaville. Patients and methods. This was a cross-sectional, monocentric and descriptive study, lasting 12 months, including patients aged at least 18 years admitted to ICU for sepsis or septic shock. The clinical presentation, the bacteriological findings and the outcome were analyzed with Excel 2019. Results. 56 patients were selected (20.7%). The average age was 43.1 ± 17.9 years (extremes 18 and 84 years), with 66.1% of men. The initial infection was peritoneal (64.3%). At admission, the median number of organ failures per patient was three (maximum 5). Renal (71.4%), hepatic (69.6%) and hemodynamic (62.5%) failures were the most common. Bacteriological assessment rate was 35.7%: blood culture (10.7%), urine culture (14.3%). The duration of hospitalization of alive patients was 8.1 ± 6.3 days (extremes 2 and 31 days). The mortality rate was 57.1%. Deaths occurred beyond 24 hours of hospitalization (75%), in patients with comorbidities (65.6%), peritonitis (59.4%), hemodynamic (81.2%) and renal (75%) failures. Conclusion. The prevalence of sepsis and septic shock in our study is comparable to other published series. The bacteriological assessments rate is still low. The mortality is very high.
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Shock, Septic , Bacteriology , Sepsis , Emergency Medical Services , Anesthesia Department, Hospital , Signs and Symptoms , Prevalence
