[Gunshot wounds of low urinary tract in period of security crisis at the Sominé Dolo Hospital of Mopti (Mali): Epidemiological and diagnostic aspects]. / Blessures par arme à feu du bas appareil urinaire en période de crise sécuritaire à l'hôpital Sominé Dolo de Mopti (Mali) : aspects épidémiologiques et diagnostiques.

INTRODUCTION: Firearm injuries to the lower urinary tract are injuries resulting from an energy transfer from a projectile fired by a firearm or a blast from a firearm, to the bladder, prostate, urethra and terminal ureter. Our objective was to describe the epidemiological and diagnostic aspects in the context of a security crisis. PATIENTS AND METHOD: This was a descriptive cross-sectional study of lower urinary tract firearm injuries at Sominé Dolo Hospital in Mopti from January 2017 to December 2021. RESULTS: In five years, 29 traumas of the lower urinary tract have been collected, about 6 cases per year. The mean age of patients was 27.48 years, the sex ratio was 13.5/1. The main circumstances of occurrence were intercommunal violence 51.72 %, war wounds 31.03 %. Injuries were inflicted by rifles in 62.1 % and improvised explosive devices in 37.9 %. The main modes of discovery were acute urine retention, hematuria and penoscrotal wounds respectively in 31.03 %, 20.69 %, 17.24 %. The organs affected were the urethra in 58.62 %, the bladder, 37.93 %, the prostate 3.45 %. Associated non-urological lesions present in 68.96 % (n=20) were dominated by intestinal lesions and pelvic fractures. CONCLUSION: Firearm injuries to the lower urinary tract are rare despite the context of the security crisis. They affect young men, are mostly linked to intercommunal violence, and are dominated by urethral and bladder injuries.

Connaissances et attitudes face à la prise en charge des maladies parodontales nécrotiques : enquête auprès des chirurgiens-dentistes de Dakar (Sénégal)

Les maladies parodontales nécrotiques nécessitent une prise en charge rapide et efficace pour ne pas compromettre le potentiel de cicatrisation du parodonte. L'objectif de ce travail était d'évaluer les connaissances et attitudes des chirurgiens dentistes de Dakar face aux maladies parodontales nécrotiques. Matériels et méthodes. Il s'agissait d'une enquête transversale descriptive concernant les chirurgiens dentistes de la région de Dakar. L'étude a inclus les chirurgiens dentistes de la région de Dakar inscrits aux tableaux de l'ONCDS de 2015 et ceux du Service de Santé des Armées. Résultats. L'échantillon était constitué de 122 dentistes sur un total de 238 soit un taux de participation de 51,26%. La majorité des praticiens (39,34%) avait une durée d'exercice comprise entre 1 à 5 ans. La formation continue était suivie par 52,45 % des dentistes. La majeure partie (73,77 %) des chirurgiens dentistes ignoraient que les maladies parodontales nécrotiques font partie de la nouvelle classification des maladies parodontales. Concernant le traitement d'urgence de ces pathologies, 91,80 % des praticiens prescrivaient systématiquement des antibiotiques, 67,21 % faisaient une détersion des lésions avec des compresses et 55,74 % pratiquaient un débridement mécanique et irrigation à la polyvidone iodée pendant la phase aigue de la maladie. Conclusion. La prise en charge des maladies parodontales nécrotiques n'est pas toujours conforme aux recommandations scientifiques actuelles. Il convient de faire de la formation continue des chirurgiens dentistes du Sénégal, un impératif éthique et légal

[Influenza sentinel surveillance network improvement in Senegal and results]. / Renforcement du réseau de surveillance sentinelle de la grippe au Sénégal et résultats.

Influenza surveillance in Senegal was initially restricted to the identification of circulating strains. The network has recently been enhanced (i) to include epidemiological data from Dakar and other regions and (ii) to extend virological surveillance to other respiratory viruses. Epidemiological data from the sentinel sites is transmitted daily by mobile phone. The data include those for other febrile syndromes similar to influenza-like illnesses (ILI), corresponding to integrated approach. Also, clinical samples are randomly selected and analyzed for influenza and other respiratory viruses. There were 180,192 declared visits to the 11 sentinel sites between week 11-2012 and week 52-2013; 24% of the visits were for fever syndromes and 25% of the cases of fever syndrome were ILI. Rhinoviruses were the most frequent cause of ILI (19%), before adenoviruses (18%), enteroviruses (18%) and influenza A viruses (13%). Co-circulation and co-infection were frequent and were responsible for ILI peaks. In conclusion, it is clear that the greatest advantage of this system is the ease with which it can be implemented, thanks to the availability of mobile phones and mobile phone networks. We recommend this solution for other African countries, because it performs very well and provides rapid benefits in terms of public health decision-making.

Implementing haemophilia care in Senegal, West Africa.

Despite significant progres on haemophilia care in developed world, this disease remains unknown in many sub-Saharan African countries. The objectives of this article were to report Senegalese experience on the management of haemophilia care through 18 years of follow-up. This cohort study included 140 patients (127 haemophilia A, 13 haemophilia B), followed in Dakar's haemophilia treatment centre from 1995 to 2012. Our study reported a prevalence of 2.3/100,000 male births, accounting for 11.6% of what is expected in Senegal. From the period 1995-2003 to 2004-2012, significant progress was seen including 67.9% increase in new patient's identification, 11.3 years reduction in mean age at diagnosis (from 15.5 to 4.2 years), lower mortality rate (from 15.3% to 6.8%) and age at death evolved from 6.5 to 23.3 years. Of the 50 haemophilia A patients who were tested for inhibitor presence, 10 were positive (eight severe and two moderate) that is prevalence of 20%. All patients were low responders since inhibitor titre was between 1.5 and 3.8 BU. Disabilities were seen in 36.5% of patients above 20 years old who had musculoskeletal sequels and 39% had no scholar or professional activities in our setting. Implementing haemophilia care in sub-Saharan Africa is a great challenge as this disease is not yet counted in national health problems in many countries. Lessons learned from this study show a significant improvement in diagnosis and prognosis parameters. This emphasizes the needs to set up such follow-up initiatives and to enhance medical and lay cooperation for better results.

23 and 39 GHz low phase noise monosection InAs/InP (113)B quantum dots mode-locked lasers.

Here we report for the first time a passive mode-locking of single section Fabry-Perot (FP) lasers based on InAs quantum dots(QDs) grown on (113)B InP substrate. Devices under study are a 1 and 2 mm long laser diodes emitting around 1.58 µm. Self-starting pulses with repetition rates around 23 and 39 GHz and pulse widths down to 1.5 ps are observed after propagation through a suitable length of single-mode fiber for intracavity dispersion compensation. A RF spectral width as low as 20 kHz has been obtained leading to a low timing jitter RMS.

[Predictive factors of chronic complications in adult sickle cell anemia patients in Dakar, Senegal]. / Facteurs prédictifs des complications chroniques de la drépanocytose homozygote chez l'adulte à Dakar (Sénégal).

PURPOSE: Chronic complications of sickle cell disease (SS) usually involve irreversible organ damage. Several genetic factors have been shown to have predicative value for chronic complications but these data are not always available. The purpose of this study was to assess the value of sociodemographic and clinicobiological features in predicting chronic complications. METHODS: This study included a total of 229 adult SS patients who underwent quarterly follow-up examinations for at least 10 years (range, 10 - 16). All sociodemographic and clinicobiological data were recorded. Screening for complications was performed at least once every three years. The risk of developing chronic complications was analyzed in function of patient follow-up data. RESULTS: Mean patient age was 28.6 years (range, 20 - 57) and sex ratio was 1.3. Prevalence of chronic complications was 34.9% (80/229). The most common complication was bone necrosis in 27 cases (11.7%) followed by gallstones in 24 (10.4%). The only sociodemographic factor with predictive value was patient age (p=0.0008). Multivariate analysis identified two clinicobiological factors with predictive value. History of transfusion was associated with a 3-fold higher risk while hemoglobin F level was associated with decreased risk. CONCLUSION: In this study, age and low hemoglobin F level were the only predictive factors of chronic complications in SS patients.

[Residual risk of transmission of HIV and HBV, in Senegalese national blood bank from 2003 to 2005]. / Risque résiduel de transmission du VIH et du VHB par transfusion sanguine entre 2003 et 2005 au Centre national de transfusion sanguine de Dakar (Sénégal).

BACKGROUND AND AIM: Using of safety blood products did not stop improving these last years. The use of effective methods as well immunologicals as virologicals ones really reduces risk associated to blood transfusion. However, it persists residual risk (RR) of transfusion transmitted viral diseases. The aim of our study was to detect cases of seroconversion for HIV,and HBV among donors in the Senegalese national blood bank. And then, we estimated the RR of these virus. METHODS: We led a transverse retrospective study from 2003 (January 1st) to 2005 (December 31st). Had been included donors with at least two donations of blood during the period of study. They had to be seronegative for HIV and HBV after the first donation. All donors with only one donation had been excluded. RR was estimated by multiplying incidence rates by the durations of the window periods. RESULTS: During 3 years, we collected 425,503 donations; 388 were positive for HIV and 4240 for HBV. But we noted only two cases of seroconversion for HIV and 23 for HBV. So, RR estimated was 3,5 in 100,000 donation for HIV and 102,45 in 100,000 donations for VHB. CONCLUSION: It emerges from this study that the risk of blood transmitted virus is always high. Introduction of more sensitive tests (as nucleic acid testing) would allow us to deliver more safety products.

[Prevention of transfusion transmitted malaria in endemic area]. / Prévention du paludisme post-transfusionnel en zone d'endémie.

BACKGROUND: Malaria is a real public health problem in Africa; more than 300 million new cases and approximately two million deaths arise every year. In spite of the blood transfusion is a potential way of Plasmodium transmission, there is no consensus for measures to prevent post-transfusion malaria in endemic area. This work aimed at comparing some tools and to discuss various strategies to be implemented. MATERIAL AND METHODS: The study concerned 3001 blood donors recruited in seven blood transfusion centers in Senegal during two periods: dry season (June-July, 2003) and rainy season (October-November, 2003). We evaluated the efficiency of the selection questionnaire for the blood donors to exclude those who are potentially asymptomatic carriers of the Plasmodium. Every donation was screened for pLDH antigen and antibodies against Plasmodium by Elisa technique (DiaMed, Cressier sur Morat, Suisse), morphological tests was also performed, as well as the screening of HIV, HBs Ag, HCV Ab and syphilis. RESULTS: Median age of blood donors was of 27.7 years. Anti-Plasmodium antibodies prevalence was 65.3% and pLDH antigen was of 0.53%, all positivity was confirmed by microscopy. The prevalence of the other infectious markers was 11.7% for HBs Ag; 0.83% for syphilis; 0.49% for HCV Ab and 0.46% for HIV Ab. The risk factors associated with an asymptomatic carrier of Plasmodium were: the rainy season, irregular character of the blood donations, high frequency of malaria attacks in the past, and absence of treatment during the last episode. CONCLUSION: Plasmodium represents the third risk of blood transmitted infectious agents after hepatitis B virus, syphilis, and before HCV and HIV in Senegal. The medical questionnaire is not useful enough for asymptomatic carriers deferral, and we propose to introduce Plasmodium screening. The screening for Plasmodium pLDH by Elisa technique seems to be the best tool in endemic area and the strategy of systematic screening is the most suited in terms of blood transfusion safety.

[Monoclonal gammapathy of undetermined significance and autoimmune disease: description of three cases in Senegal]. / Gammapathies monoclonales de signification indéterminée et maladies auto-immunes: étude de trois observations sénégalaises.

Monoclonal gammapathy of undetermined significance (MGUS) has rarely been reported in African literature. The purpose of this article is to describe 3 cases of MGUS observed in women aged 63, 54, and 44 years in Senegal. All three patients had previously documented autoimmune disease, i.e., auto-immune thrombopenia, multiple auto-immune disease (comprising Sjögren's syndrome, polymyositis and vitiligo), and Sjögren's syndrome. Diagnosis of MGUS was made thanks to routine protein electrophoresis that demonstrated a monoclonal peak in the gammaglobulin area in all patients. Serum protein binding showed the IgG lambda subtype in one case and IgG kappa subtype in two cases. Medullogram findings were unremarkable with nondystrophic plasma cell rates ranging from 1 to 4%. Bisphophonate therapy was undertaken along with the recommended treatments for the associated autoimmune diseases, i.e., prednisone, hydroxychloroquine, and methotrexate. Treatment was successful in all three patients with stabilization of the associated diseases and of the monoclonal peak on subsequent electrophoresis. As of this writing, the mean duration of follow-up was 3 years. MGUS that has been uncommon in the African hospital setting should be screened for in all older patients or in patients presenting infection (especially due to virus) or autoimmune disease (as in the three cases presented herein). More systematic use of serum protein electrophoresis should reveal an increased incidence of MGUS. Diagnosis of MGUS requires regular clinical and laboratory surveillance due to the risk for complications of malignant hemopathies, especially multiple myeloma.

Quality of life and depression among HIV-infected patients receiving efavirenz- or protease inhibitor-based therapy in Senegal.

BACKGROUND: Efavirenz has been associated with neuropsychiatric disorders, but little is known about depression and quality of life in sub-Saharan Africa, where nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens are still the first-line treatment recommended by the World Heath Organization (WHO) and are widely prescribed. METHODS: In a cross-sectional study, we evaluated quality of life and depression among Senegalese patients receiving efavirenz- or protease inhibitor (PI)-based regimens. Two hundred consecutive patients who had been taking highly active antiretroviral therapy (HAART) for more than 6 months were asked to complete a questionnaire. RESULTS: According to the Center for Epidemiologic Studies Depression Scale (CES-D), 18% had depression (19% for patients on a PI-based regimen and 17% for patients on efavirenz-based treatment). Fifty-nine per cent of the patients reported no health problems in the past 4 weeks. A quarter of patients had sleep disorders. Moderate or slight adverse events were reported by 28.5% of patients. CONCLUSIONS: Quality of life and depression scores remained good in both study groups. However, quality of life and depression should be monitored in follow-up of HIV-infected patients in sub-Saharan Africa.

[Von Willebrand disease and menorrhagia]. / Maladie de Willebrand et ménorragie.

INTRODUCTION: Known since over than seventy years, von willebrand disaese is the most common herediary bleeding disorder. This condition was first described by Pr. Willebrand in 1926 in a family with (positive) history of excesive bleeding tendency. Von Willebrand desease is characterized by a lifelong tendency toward easy spontaneous mucosal or post operative bleeding. In females, excessive or prolonged menorrhagia could be a sign of von willebrand desease; symptoms that are often misunderstood to be gynecologic rather than hematologic problem. In the present work, we have tried to screen for this anomaly in females with menorrhagia, following a simple anamnestic, clinical and biological protocol. PATIENTS AND METHOD: In a seventeen month study, fifty two procreating females with menorrhagia were recruited in the haematology laboratory of Aristide le Dantec hospital with the cooperation of gynecology and obstetric departements of Aristide Le Dantec, Abass Ndao and grand yoff Hospitals. RESULTS: Eight patients were revealed to be von willebrand positive (prevalence: 15%). The diagnosis was retained on the basis of epidemiological, clinical and biological data. CONCLUSION: These simple and accessible criteria should allow better handling of patients with hemorragic disorders.

[Seroprevalence of hepatitis C virus (HCV) in Senegalease blood donors]. / Seroprevalence du virus de l'hepatite C (VHC) chez les donneurs de sang au Senegal.

INTRODUCTION: Hepatitis C virus (HCV) is an important problem of public health in the world according to its transmission mode and its pathogenesis. The risk of blood transmission has led to be the systematic screening of blood donors in the world. In Senegal no study about HCV prevalence on the general population and also has been done. The aim of our study was to determine HCV prevalence in blood donors and the rate of co-infection with hepatitis B (HCV/HBV) or with HIV infection (HCV/HIV). MATERIALS AND METHODS: This study had been done in the National Blood Transfusion Centre (CNTS) in Dakar. Two different techniques has been used for the assessment HCV: 1/ ELISA technique and 2/ Immunoblot RIBA as confirmation test. RESULTS: Our study relates to 1565 blood donors recruited in CNTS during 2002. 369 of them were new blood donors with 365 females and 1200 males. The mean average was 30.5 +/- 9.5 years, ranged from 18 to 59 years. HCV ELISA test were positive in 22 plasma samples and one of them were co-infected with hepatitis B (HCV/HBV). Four out of these 22 samples have been confirmed positive to RIBA test and three of them were not determined. HCV seroprevalence were 1.4% after ELISA and 0.25% after RIBA testing. This seroprevalence were similar in male and in female and higher in new blood donors than in regular blood donors. CONCLUSION: Our results reinforce the necessity to screen hepatitis C virus in all Senegalese blood transfusion centres.

[Relation between lupus-antiphospholipids antibodies and heart disorders]. / Relation lupus-anticorps antiphospholipides et cardiopathie lupique.

BACKGROUND AND AIM: Antiphospholipids antibodies (APL) are autoantibodies found in lupus erythematosus and disorders like. Their frequency varies between 2 and 62% according to the literature. An increased frequency of cardiac disorders in antiphospholipids (APL) positive lupus has been reported. The aim of our study was to evaluate the role of APL as an independent risk factor of cardiac disorders in patients with systemic lupus erythematosus. MATERIAL AND METHOD: A prospective study during 14 months has been designed with the cooperation of dermatologic, internal medicine and cardiology departments of the Aristide Le Dantec hospital of Dakar. Platelets count (Beckmann Coulter analyzer), activated partial thromboplastin time (Diagnostiga stago analyzer) and antiphospholipids antibodies (Elisa) were determined. RESULTS: 37 patients affected by lupus were included in this study with a net feminine prevalence (89%); 8 (14.6%) had APL's significant results and 20 presented an echographic heart abnormality. The analysis of our data did not reveal an increased risk of cardiac diseases among APL positive lupic patients as compared to the negative group (p = 1). CONCLUSION: The presence of APL in patients with systemic lupus does not so seem to be an independant risk factor of heart diseases.

Parodontites et maladies respiratoires au centre hospitalier national universitaire de Fann (Sénégal)

Introduction : Les parodontites sont des pathologies infectieuses associées à différentes maladies générales dont les pathologies respiratoires. L'objectif de ce travail était d'évaluer la distribution des parodontites chez les sujets atteints d'affections respiratoires en milieu hospitalier. Matériels et méthodes : Il s'agissait d'une étude descriptive transversale basée sur un recrutement de patients hospitalisés ou venus en consultation au Service de Pneumologie de l'hôpital Fann. Les patients atteints de tuberculose n'ont pas été inclus. La distribution de l'atteinte parodontale a été évaluée par les mesures des profondeurs de poche (PP) au sondage et la perte d'attache clinique (PAC) à l'aide de la sonde parodontale de Williams. Résultats : Un échantillon de 70 patients dont 25 femmes et 45 hommes a été sélectionné pour cette étude. La moyenne d'âge était de 42 ans ± 4,2.La prévalence des pneumopathies bactériennes était de 54,3%, celle des Broncho Pneumopathies Chroniques Obstructives (BPCO) de 22,9%. Des profondeurs de poche ≥4mm ont été retrouvées chez 50% des sujets et 64,7% ont présenté une perte d'attache clinique ≥2mm.Les profondeurs de poche étaient plus importantes chez les patients atteints de pneumopathie bactérienne et de BPCO. Conclusion : La prévalence élevée des parodontites nécessite une collaboration entre pneumologue et parodontologiste afin de limiter les effets délétères d'une mauvaise condition orale sur la santé générale

[Prevalence and morbidity of G6PD deficiency in sickle cell disease in the homozygote]. / Prevalence et morbidite du deficit en g6pd au cours de la drepanocytose homozygote.

Sickle cell disease and G6PD deficiency have similar prevalence of 8 to 10% in Senegalese population. Our objectives were to determine the prevalence of G6PD deficiency in Hb S carriers and normal subjects, and to assess the interaction of G6PD deficiency on clinical severity of sickle cell disease. G6PD activity was measured in 319 sickle cell patients and in 318 subjects without HbS. Clinical severity was compared in male homozygous sickle cell patients (11 with G6PD deficiency and 19 without deficit). In homozygous sickle cell patients, the G6PD status was assessed after correction of reticulocyte count following the micro-centrifugation method of Herz. We found that prevalence of G6PD deficiency was higher in sickle cell disease patients (21.6 %) than in normal subjects (12.3 %) (p = 0.001). No difference was found in the two groups of male sickle cell disease patients concerning number of vaso-occlusive crisis, number of transfusion, frequency of infectious episodes, number of chronic complications, disturbances on patient's activity and total index severity.

[Expression of proliferation marker Ki 67 in chronic lymphocytic leukemia]. / Expression du marqueur de proliferation Ki 67 dans les leucemies lymphoides chroniques.

Chronic lymphocytic leukemia (CLL) is characterized by a clonal expansion of low proliferating mature B and T lymphocytes in the bone marrow and peripheral blood. The nuclear antigen Ki 67 is a protein detected in G1, S, G2 and M phases of the cell cycle, but not in G0, and thus, is a widely accepted proliferation marker of Human tumors. The aim of this study was to evaluate Ki 67 monoclonal antibody in CLL. We studied 48 patients diagnosed as CLL on the presence of clinical signs, over 4.109/l circulating lymphoid cells and immunophenotyping by flow cytometry using CD19, CD5, CD22, CD23, FMC7 and immunoglobulin light chains monoclonal antibodies. Ki 67 immunostaining was determined by Avidin Biotin Complex method. Our results allows to characterize between CLL: one group which proliferation rate (percentage of Ki 67 positive cells) was equal or less than 2%, represented by 14 cases (29,2%) with morphological aspect of typical CLL, one group which proliferation rate was between 3% and 9% represented by 32 cases (66,6%) with morphological aspect of polymorph CLL or prolymphocytic leukemia, and a last group with proliferation rate equal or up to 10% and corresponding to two cases (4,2%) of transformation of CLL to high grade Non Hodgkin lymphoma. There were no correlation between Matutes immunological score and proliferation rate, as this rate was 2.9% in score < 3 and 2.7% in score > 3. This study confirm the Ki 67 usefulness in studying cellular proliferation, and underline that CLL with polymorphic cytology are more proliferate than typical CLL. These data reinforce the notion that CLL is a disease with heterogeneity in clinical behavior, immunophenotype, cytogenetic, molecular aspects, and thus, prognostic.

[Non-Hodgkin's lymphoma in Dakar: study of 107 cases diagnosed between 1986 and 1998]. / Les lymphomes non hodgkiniens à Dakar: étude réalisée sur 107 cas diagnostiqués entre 1986 et 1998.

Non-Hodgkin's Lymphomas (NHL) are the most prevalent malignant hemopathies in Senegal. In this study we have investigated the epidemiological aspects considering the HIV infection pandemic, and evaluated the diagnosis means and evolutive features of this disease in Dakar. Between 1986 and 1998 (13 years), we collected 107 cases of NHL, all histologically confirmed. Average age of patients was 31.4 years (2-85 years) and sex ratio was 21. HIV infection was found in three out of 62 patients tested (4.8%). At moment of diagnosis, 72% of patients were in stage III or IV according to the Ann Arbor Staging System. Large cell lymphomas were predominant (67.2%), followed by small lymphocyte lymphomas (24.2%) and follicular lymphoma with 8.4% of cases. Localization of lymphomas was exclusively nodal (30.8%) or extra nodal (31.7%) or mixed (37.3%). In therapeutical field, 21.5% of patients were treated with only symptomatical means. Chemotherapy was used in 54 patients (78.2% of treated patients), surgery was performed in 6 patients (8.6%), association of radiotherapy and chemotherapy in 5 patients (7.2%) and 4 patients (5.7%) were treated with surgery + chemotherapy. The average survival time was 344 days. Four patients (3.7%) were alive 3 years after diagnosis and only 2 patients (1.8%) after 5 years.

[Prevalence of antiphospholipid antibodies in patients with sickle cell disease]. / Prévalence des anticorps antiphospholipides au cours de la drépanocytose homozygote.

Structural abnormalities in erythrocyte membrane are more and more claimed as a determinant factor in the sickle cell disease pathogenesis. This being would have been provided by a new anionic phospholipids distribution and conformation. Phosphatidyl-serine exposing and phosphatidic acid enhancing would induce specific immunoglobulins synthesis. In this study, assessment of antiphospholipid antibodies prevalence was carried out among sickle cell trait patients (n = 35) and homozygous patients (n = 59) as compared to healthy subjects (n = 39). Antiphospholipid antibodies, assayed by ELISA procedure, were significantly higher among the homozygous patients than the sickle cell trait patients ones and highlighted as compared to healthy subjects. Pathologic data were only observed among homozygous patients. These specific antibodies, associated with thrombosis and haemolysis, would have constitute a morbid link and a therapeutic target of this sickness, dominated by homodynamic troubles.

[Maternal anaemia: effect on the newborn]. / Anémie par carence en fer maternelle: retentissement sur le nouveau-né.

Pregnancy increases considerably iron needs in mother and her foetus. The purpose of our study is to measure the effect of maternal anaemia on the foetus and the effect of iron supplementation on the maternal and foetal reserves. Therefore, we conducted a three-month cross sectional study at the gynaecological and obstetrics clinics of Aristide Le Dantec Hospital. Ninety-five women aged 16 to 43 years old and having an haemoglobin rate < 11 g/dl were recruited. Most of them were primipares. Among them 69 had a low ferritinemia (< 50 ng/ml), 36, a ferritinemia collapsed (< 30 ng/ml) and 13 virtually non-existent reserves (< 12 ng/ml). All newborns were born in terms with an apgar score >/= in 93 of them. Among them 24 had anemia (rate of haemoglobin < 14 g/dl) and 54.7% a low ferritinemia. There is no relationship between the maternal and foetal rates of haemoglobin; 74% of newborn had a normal rate of haemoglobin. Among 36 women with low ferritinemia only two gave birth to a newborn without iron reserves. In our study, among 68 women who received iron regularly, 41 had normal reserves and 43 gave birth to a newborn with high ferritinemia. There is significant difference between the women having received iron during their pregnancy and those not supplemented as regards the effect on newborn (p = 0.00001). The prevention of iron deficiency and anaemia can be done by the iron systematic and premat supplementation.

[Bone marrow aspiration in diagnosis of hemopathies in Dakar, Senegal]. / Intérêt du myélogramme dans le diagnostic des hémopathies au CHU de Dakar: a propos de 1000 ponctions réalisées de 1991 a 1999.

The cytological study of bone marrow aspirate, is a useful technique in diagnosis and epidemiological surveillance of hemopathies. Between January 1991 and February 1999, we realized 1000 bone marrow puncture in Dakar hospitals, this study aims to analyze the frequency of diagnosed hemopathies, and to appreciate justification of prescription. Mean age was 31.6 (1 to 88 years). Bone marrow puncture was safe because no incident was observed. Interpretation was possible in 937 cases while the 33 authors was diluted by blood. Bone marrow was normal in 550 cases (57.3%) whereas abnormality was detected in 417 cases (42.7%). The more frequent pathology were quantitative or qualitative defect of bone marrow production with respectively 25.8% and 20.1%, followed by chronic myeloid leukemia (16%), lymphoproliferative disorders (16%), acute leukemias (13.9%), bone marrow metastasis (5.9%), and storage diseases (1.9%). The best justification of the prescription was obtained when done on the basis of hemogram abnormalities or signs in hematopoietic organs with a pathology found in 90% of cases. Prescription on the basis of non hematological signs or to search for metastasis when primitive tumor was not identified were less efficient with respectively 20% and 42% of normal bone marrow. These results emphasize the interest of bone marrow aspiration in epidemiological surveillance of hemopathies, and the advantage to respect the rights indications, in consideration of pain and intolerability of the puncture by patients.