A Medico-Socio-Economic Analysis of TeleEKG in Ivory Coast.

Background: TeleEKG is gradually being integrated into the care offered to the most isolated Ivorian populations, however, no medico-socio-economic analysis of its impact has yet been conducted. Introduction: The aim of this study was to assess the medico-socio-economic impact of a teleEKG network in the provision of cardiology care in Ivory Coast. Methods: A retrospective study of the data transmitted by the 10 centers involved in the pilot phase of the teleEKG project from January 2015 to December 2017. Results: The average ratio between the cost to the patient of performing an electrocardiogram (EKG) according to the traditional practice and using a teleEKG was 3.8 ± 1.64. The distance avoided by the 6,045 patients was 1,074,090 km (average 177.7 km/patient). The 6,045 teleEKGs carried out over the period of the study produced a total revenue of 36,270,000 XOF (55,290 EUR) or an average revenue per site of 3,627,000 XOF (5,529 EUR). Dyspnea on exertion (22%), and hypertension (21%) were the main indications for performing the EKG, and left ventricular hypertrophy was the most common electrical anomaly detected (19.8%). Acute coronary syndrome with persistent ST segment elevation was diagnosed in 0.7% of cases (40 cases) and atrial fibrillation in 1.12% of cases (68 cases). Discussion: These results confirm the key role telemedicine can play in the treatment of heart conditions in rural populations and the economic sustainability of such telemedicine networks. Conclusions: teleEKG offers economic accessibility to cardiology care for isolated populations in Ivory Coast.

[Rare pancreatic tumor detected unexpectedly in a child in the Ivory Coast]. / Tumeur pancréatique rare de découverte fortuite chez un enfant en Côte d'Ivoire.

Solid pseudopapillary tumor of the pancreas (SPTP) is rare. It most often affects young women. It was first described by Frantz in 1959, but its pathogenesis remains unclear. This tumor has a good prognosis. Treatment is based on radical surgery. We here report the case of a 11-year old girl with SPTP. Symptomatology was acute, including compression syndrome and epigastralgias. Clinical examination showed a solid mass in the left hypochondrium. Scan showed mixed mass structure of the pancreas tail. Left splenopancreatectomy was performed. The diagnosis was confirmed by histological examination using immunohistochemistry. Long-term follow-up showed no recidivism. The study had a follow-up period of two and a half years. This study and literature review aimed to highlight the role of radiological examination in the diagnosis and underline the importance of radical surgery in the treatment of these tumors with a low degree of malignancy.

Stenting right ventricular outflow in an infant with tetralogy of Fallot and well-developed pulmonary arteries.

A right ventricular outflow tract stent was implanted in a 1-month-old (3.5 kg) baby boy with tetralogy of Fallot and worsening cyanosis to relieve infundibular and pulmonary valve stenosis in the setting of well-developed pulmonary artery branches. This management allowed a symmetric and optimal growth of the pulmonary artery branches, with right and left pulmonary arteries measuring 7-mm (z-score, +1.3 SD) and 7.3-mm (z-score, +1.7 SD), respectively, 3 months after stent implantation. No signs of pulmonary overcirculation developed, and complete surgical repair was performed at the age of 6 months.