Integrated crop-livestock effects on soil carbon sequestration in Benin, West Africa.

In Benin, adaptation to climate change in the livestock sector has led cattle farmers to develop different livestock practices. Most research has focused on evaluating the effects of these practices on livestock productivity. However, information on the effect of these practices on carbon (C) sequestration in farmland soils is lacking. Soil C sequestration has been identified as a potential strategy to offset greenhouse gas emissions. Thus, the present study aimed at filling this gap. The calculation was one hand based on inventory data obtained from literature sources (excrement production of each cattle category, moisture content of each crop, ratio of crop residue to main product, and C content of the main product and excrement) and on the other hand on activity data (cattle herd size, manure applied, land use area, crop yield, and crop residues management) obtained from surveys carried out among 360 cattle farmers belonging to 3 cattle farming types. The results revealed that whatever the cattle farming type, annual C input from manure was higher (p˂0.05) than C input from crop residues. Annual C sequestration in farmland soil of farms integrating livestock with cereal-legume and forage crops was significantly higher (Type 2: 158.07 ± 1.79 kg C ha-1 year-1) followed by farms integrating livestock with cereal-legume crops (Type 1: 99.51 ± 0.95 kg C ha-1 year-1), which in turn had a higher value than farms practicing pastoral mobility (Type 3: 78.46 ± 0.70 kg C ha-1 year-1). These results highlight the potential for climate change mitigation through these farming practices. This is justified because the quantity of C sequestered in farmland soil of all cattle farming types was significant. Thus, for future research, it is necessary to include soil C sequestration in the calculations of farms' carbon footprint.

Similarities and differences of interstitial lung disease associated with pathogenic variants in SFTPC and ABCA3 in adults.

BACKGROUND AND OBJECTIVE: Variants in surfactant genes SFTPC or ABCA3 are responsible for interstitial lung disease (ILD) in children and adults, with few studies in adults. METHODS: We conducted a multicentre retrospective study of all consecutive adult patients diagnosed with ILD associated with variants in SFTPC or ABCA3 in the French rare pulmonary diseases network, OrphaLung. Variants and chest computed tomography (CT) features were centrally reviewed. RESULTS: We included 36 patients (median age: 34 years, 20 males), 22 in the SFTPC group and 14 in the ABCA3 group. Clinical characteristics were similar between groups. Baseline median FVC was 59% ([52-72]) and DLco was 44% ([35-50]). An unclassifiable pattern of fibrosing ILD was the most frequent on chest CT, found in 85% of patients, however with a distinct phenotype with ground-glass opacities and/or cysts. Nonspecific interstitial pneumonia and usual interstitial pneumonia were the most common histological patterns in the ABCA3 group and in the SFTPC group, respectively. Annually, FVC and DLCO declined by 1.87% and 2.43% in the SFTPC group, respectively, and by 0.72% and 0.95% in the ABCA3 group, respectively (FVC, p = 0.014 and DLCO , p = 0.004 for comparison between groups). Median time to death or lung transplantation was 10 years in the SFTPC group and was not reached at the end of follow-up in the ABCA3 group. CONCLUSION: SFTPC and ABCA3-associated ILD present with a distinct phenotype and prognosis. A radiologic pattern of fibrosing ILD with ground-glass opacities and/or cysts is frequently found in these rare conditions.

Peritonitis by perforation of the gall bladder of typhoid origin in children.

Peritonitis by perforation of the gall bladder of typhic origin is a rare condition. In Côte d'Ivoire, no studies to our knowledge have addressed the vesicular complications of typhoid fever in children. The aim of this work was to describe the epidemic-clinical, therapeutic and evolutionary aspects of the perforation of the gall bladder of typhic origin in subjects under 15 years of age. In 6 years, five children showed a vesicular perforation of typhic origin or 9.4% of peritonites of typhic origin. They were 5 boys with an average age of 07.4 years 5-11 years. The children were from low socioeconomic backgrounds. No history was noted. Clinical examination revealed peritoneal syndrome. X-ray of the abdomen without preparation carried out in all children had objectified a diffuse greyness. Leucocytosis was present in all cases. Treatment in all children initially consisted of resuscitation and antibiotic therapy with the 3rd generation cephalosporin and an imidazole. Surgical exploration revealed gangrene and perforated gallbladder without damage to other organs or the presence of stones. A cholecystectomy was performed. The following procedures were simple in 4 patients. A patient died of sepsis following postoperative peritonitis by biliary fistula. Perforation of the gall bladder of typhic origin is rare in children. It is usually discovered at the stage of peritonitis. The treatment combines antibiotic therapy and cholecystectomy. Systematic screening should reduce the progression to this complication.

Prevalence and Characteristics of Sleep Apnea in Intensive Care Unit Survivors After SARS-CoV-2 Pneumonia.

Background: Sleep apnea (SA) was reported as possibly exacerbating symptoms of COVID-19, a disease induced by SARS-CoV-2 virus. The same comorbidities are common with both pathologies. This study aimed to estimate the prevalence, characteristics of SA and variation in AHI three months after severe COVID-19 requiring intensive care unit (ICU) admission. Methods: A prospective cohort of patients admitted to ICU for severe COVID-19 underwent an overnight home polygraphy 3 months after onset of symptoms, as part of a comprehensive follow-up program (pulmonary function tests, 6-minute walk tests and chest CT-scan). Patients with an apnea hypopnea index (AHI) ≥5 were considered as having SA. We performed a comparative descriptive analysis of 2 subgroups according to the existence, severity of SA and indication for effective SA treatment: patients with absent or mild SA (AHI <15) vs patients with moderate to severe SA (AHI ≥15). Results: Among 68 patients included, 62 (91%) had known comorbidities (34 hypertension, 21 obesity, 20 dyslipidemia, 16 type 2 diabetes). It has been observed a preexisting SA for 13 patients (19.1%). At 3 months, 62 patients (91%) had SA with 85.5% of obstructive events. Twenty-four patients had no or a mild SA (AHI <15) and 44 had moderate to severe SA (AHI ≥15). Ischemic heart disease exclusively affected the moderate to severe SA group. Except for thoracic CT-scan which revealed less honeycomb lesions, COVID-19 symptoms were more severe in the group with moderate to severe SA, requiring a longer curarization, more prone position sessions and more frequent tracheotomy. Conclusion: SA involved 91% of patients in our population at 3 months of severe COVID-19 and was mainly obstructive type. Although SA might be a risk factor as well as consequences of ICU care in severe COVID-19 infection, our results underline the importance of sleep explorations after an ICU stay for this disease.

Interactive Voice Response Service to Improve High School Students Covid-19 Literacy in Burkina Faso: A Usability Study.

Mobile technology is widely used in healthcare. However, designers and developers in many cases have focused on developing solutions that are often tailored to highly literate people. While the advent of the pandemic has called for people to seek and use Covid-19 related information to adapt their behaviors, it is relatively difficult for low literate to get easily access to health information through digital technologies. In this study, we present a Mobile based Interactive Voice Response service designed particularly for low-literate people which provides validated Covid-19 related health information in local African languages. We conducted a field study, among high school students, through a usability study to assess users' perception. The service received an excellent numerical usability score of 78.75.

Bladder exstrophy: Modern staged repair experience in our institution.

Introduction: Bladder exstrophy is a major malformation in paediatric urology. The treatment results are not still completely satisfactory, and their management is an enormous problem in Sub-Saharan Africa. While outlining our challenges, we report our management experience to improve our results. Subjects and Methods: We retrospectively reviewed the records of patients undergoing surgical repair of classic bladder exstrophy at our department between January 2010 and December 2019 (10 years). Epidemiological, clinical, therapeutic and evolution data were analysed. Results: Twenty-five children with classic bladder exstrophy were treated. Our series included 16 boys and 9 girls with a sex ratio of 1.7. Age ranged from 0 day to 6 years. Twenty-five bladder closures were performed, associated to pelvic osteotomy in 11 cases. Epispadias repair was performed on nine boys. Eight cases of bladder neck reconstruction and three cases of bladder enlargement were performed. We observed six bladder fistulas, four wound dehiscence, of which three partial, two parietal suppurations and six cases of urinary tract infection. Eight children had a continence of 1-2 h. Conclusion: The treatment of bladder exstrophy in our context is still limited because of financial difficulties encountered by the population and the insufficient technical platform in our country.

Oral hygiene practices and their sociodemographic correlates among adults in Burkina Faso: results from the First National Survey.

BACKGROUND: Sociodemographic parameters are the driving determinants of oral hygiene practices. This study aims to describe oral hygiene practices and associated sociodemographic factors in the Burkinabè population using the first nationally representative data. METHODS: This descriptive, cross-sectional study included 4677 adults through multistage cluster sampling performed during the first WHO STEPS survey conducted in 2013 in Burkina Faso. The practices we considered were the frequencies of tooth cleaning, fluoridated toothpaste use and dentist visits within the last six months. Sociodemographic variables and oral hygiene practices were described, and the first variables were used as the explanatory variables for the seconds in the multivariable analyses. RESULTS: Individuals who cleaned teeth at least once a day represented 82.8% and at least twice a day represented 31.4%; 25.6% used fluoridated toothpaste and 2.1% visited a dentist. With the highest odds ratio, only being educated was a favourable factor for each oral hygiene practice. Living in an urban area or being a younger adult were favourable factors for cleaning teeth at least twice a day or the use of a fluoridated paste. Female gender applied more to regular tooth cleaning, as well as to dentist visits. CONCLUSION: Cleaning teeth at least once a day was common among Burkinabè, while cleaning at least twice a day, the use of fluoridated paste or dentist visits were infrequent. Education was the key favourable determinant for healthy oral hygiene practices, and improving oral health literacy interventions through basic health education should be promoted.

Personal Exposure to Fine Particles (PM2.5) in Northwest Africa: Case of the Urban City of Bamako in Mali.

Personal exposure to particulate matter (PM) from anthropogenic activities is a major concern in African countries, including Mali. However, knowledge of particulates is scant. This study was undertaken to characterize personal exposure to PM2.5 microns or less in diameter (PM2.5) in the city of Bamako in Mali. The exposure to PM2.5, through daily activities was observed from September 2020 to February 2021. Participants wore palm-sized optical PM2.5 sensors on their chest during their daily activities. The exposure levels in four different groups of residents were investigated in relation to their daily activities. The variation in PM2.5 concentration was measured during different activities in different microenvironments, and the main sources of exposure were identified. The highest average 10 min concentrations were observed at home and in bedrooms, while the participants were using specific products typically used in Africa, Asia, and South America that included insecticides (IST; 999 µg/m3) and incense (ICS; 145 µg/m3), followed by traffic (216 µg/m3) and cooking (150 µg/m3). The lowest average 10 min concentrations were also observed in the same microenvironment lacking IST or ICS (≤14 µg/m3). With no use of specific products, office workers and students were the least exposed, and drivers and cooks were the most exposed. The concentrations are up to 7.5 and 3 times higher than the World Health Organization's yearly and daily recommended exposure levels, respectively, indicating the need to promptly elaborate and apply effective mitigation strategies to improve air quality and protect public health. This study highlights the importance of indoor air pollution sources related to culture and confirms previous studies on urban outdoor air pollution sources, especially in developing countries. The findings could be applied to cities other than Bamako, as similar practices and lifestyles are common in different cultures.

[Obstetrical brachial plexus palsy (PBOPP): epidemiological, therapeutic and evolutionary features of patients at the Bouaké University Hospital, Ivory Coast]. / Paralysie obstétricale du plexus brachial (POPB): aspects épidémiologiques, thérapeutiques et évolutifs au Centre Hospitalier Universitaire de Bouaké, Côte d'Ivoire.

INTRODUCTION: obstetrical brachial plexus palsy is a relatively rare condition that has not disappeared although important progress has been made in obstetrics. The purpose of this study is to analyze the epidemiological, clinical, therapeutic and evolutionary features of this disorder in our context. METHODS: we conducted a retrospective study of the medical records of newborns with obstetrical brachial plexus palsy treated at the Bouaké University Hospital over a period of two years. Children treated after the age of 3 months weren´t included. The variables studied were the epidemiological, therapeutic and evolutionary features. RESULTS: the study included 60 patients, reflecting a rate of 28.5%. There were 31 (52%) girls. The average age of patients was 8 days (D0 and D35]. Multiparous mothers accounted for 94% of cases. Birth took place in a health center in 97% of cases. All children were born at term, 57 (95%) in cephalic presentation. Delivery was normal in 74% of cases. Average birthweight was 3604g [2150g and 4500g]. Forty seven cases (78%) had C5-C5-C6 palsies . Immobilization elbow off body associated with rehabilitation was performed in 51 children (85%). Rehabilitation was performed immediately in 9 children (15%). Functional recovery of the injured limb was complete in 50 children (83%) after a follow-up period of 6 months. CONCLUSION: obstetrical brachial plexus palsy is a current obstetric disorder. Conservative treatment, that is the only alternative in our context, gives good results.

[Labial fusion in the girl about 30 cases: our experience]. / La coalescence des petites levres chez la fille a propos de 30 cas : notre experience.

AIM: To report the epidemiological, diagnostic, therapeutic and evolutionary aspects of the labial fusion in the girl. PATIENTS AND METHODS: This was a descriptive retrospective study of the files collected from patients under the age of 15 over 5 semesters of activity (January 2017 to June 2019) and treated for labial fusion. The anamnestic, clinical, therapeutic and evolutionary data were analyzed. RESULTS: Thirty patients were collected, the average age was 20 months with extremes of 4 months and 8 years. Twenty-five (25) patients were less than 1 year old. There were 28 cases of total labial fusion and 2 cases of partial labial fusion. It was isolated affection in all cases. The patients were all asymptomatic. Surgical detachment was practiced in all the patients and then hormonal treatment was instituted. No recurrence was observed at a mean follow-up of 12 months (1 year). CONCLUSION: This benign condition is most often isolated in our context. Its treatment must combine surgical treatment and hormonal treatment.

BUT: Rapporter les aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs de la coalescence des petites lèvres chez la fillette. PATIENTS ET MÉTHODES: Il s'agissait d'une étude rétrospective descriptive portant sur les dossiers colligés de patientes âgées de moins de 15ans sur 5 semestres d'activités (Janvier 2017 à Juin 2019) traitées pour une coalescence des petites lèvres. Les données anamnestiques, cliniques, thérapeutiques et évolutives ont été analysées. RÉSULTATS: Trente patientes ont été colligées, l'âge moyen était de 20 mois avec des extrêmes de 4 mois et 8ans.Vingtcinq (25) patientes avaient moins de 1 an. Il y avait 28 cas de coalescence totale et 2 cas de coalescences partielles. Il s'agissait d'affection isolée dans tous les cas. Les patientes étaient toutes asymptomatiques. Le décollement chirurgical a été pratiqué chez toutes les patientes puis un traitement hormonal a été institué. Aucune récidive n'a été observée Au recul moyen de 12 mois (1an). CONCLUSION: Cette affection bénigne, est le plus souvent isolée dans notre contexte. Son traitement doit associer un traitement chirurgical et un traitement hormonal.

Effects of Arbuscular Mycorrhizal Fungi Glomus mosseae on the Growth and Medicinal Components of Dysosma versipellis Under Copper Stress.

In order to investigate the effects of arbuscular mycorrhizal fungi (AMF) (Glomus mosseae) inoculations and additions of copper (Cu) ion at gradual concentrations (0, 200, and 400 mg kg-1) on different parameters of Dysosma versipellis such as growth, lipid peroxidation (MDA and MRP), antioxidation enzymatic (SOD, POD and CAT) activities, and active medicinal components. Pot experiments have been conducted. The results showed that additions of Cu could inhibit growth and the activity of antioxidant enzymes, increase the degree of membrane lipid peroxidation, and decrease the podophyllotoxin content of D. versipellis compared with the control. Meanwhile, inoculations with AMF enhanced its antioxidant capacity and reduced the degree of membrane lipid peroxidation in leaves of D. versipellis under Cu stress. Besides, AMF inoculations significantly increased the biomass and content of podophyllotoxin in roots of D. versipellis, while it decreased Cu absorption content in roots. Thus, inoculations with AMF could effectively alleviate the Cu stress and improve the active components content of D. versipellis, which might be important for Cu stress adaptation and the improved productivity and quality of D. versipellis.

Adaptation strategies of cattle farmers in the dry and sub-humid tropical zones of Benin in the context of climate change.

Cattle farming is directly impacted by climate change (CC), as it utilizes resources whose seasonality and productivity are strongly climate-dependent. Farmers respond to the negative influence of CC by implementing different adaptation strategies, where choices are informed by many factors. This study aims at analyzing the adaptation strategies of cattle farmers in the dry tropical zone (DTZ) and sub-humid tropical zone (STZ) of Benin with regard to climate change, as well as the determinants for the choice of these strategies. For that matter, 360 cattle farmers were surveyed. Data collected were related to the demographic and socio-economic characteristics of the cattle farmers, their perception and adaptation to CC. The data collected were subjected to frequency analysis and binary logistic regression. The results showed that livestock farmers were partly aware of climate related with CC, especially the increase of temperature. The most important adaptation strategies mentioned by cattle farmers were mobility, integration of livestock and crop husbandry, provision of concentrate feed, reduction of herd size, diversification of livestock, and forage cropping. Farming experience, cattle herd size, membership in an organization, number of farm assets, level of education, and climate zone were the major variables affecting farmers' adaptation strategies. From this study, we recommend that any program promoting adaption of climate change resilience among farmers, especially cattle farmers, should take the identified factors into account.

Anopheles gambiae (s.l.) exhibit high intensity pyrethroid resistance throughout Southern and Central Mali (2016-2018): PBO or next generation LLINs may provide greater control.

BACKGROUND: Millions of pyrethroid LLINs have been distributed in Mali during the past 20 years which, along with agricultural use, has increased the selection pressure on malaria vector populations. This study investigated pyrethroid resistance intensity and susceptible status of malaria vectors to alternative insecticides to guide choice of insecticides for LLINs and IRS for effective control of malaria vectors. METHODS: For 3 years between 2016 and 2018, susceptibility testing was conducted annually in 14-16 sites covering southern and central Mali. Anopheles gambiae (s.l.) were collected from larval sites and adult mosquitoes exposed in WHO tube tests to diagnostic doses of bendiocarb (0.1%) and pirimiphos-methyl (0.25%). Resistance intensity tests were conducted using CDC bottle bioassays (2016-2017) and WHO tube tests (2018) at 1×, 2×, 5×, and 10× the diagnostic concentration of permethrin, deltamethrin and alpha-cypermethrin. WHO tube tests were conducted with pre-exposure to the synergist PBO followed by permethrin or deltamethrin. Chlorfenapyr was tested in CDC bottle bioassays at 100 µg active ingredient per bottle and clothianidin at 2% in WHO tube tests. PCR was performed to identify species within the An. gambiae complex. RESULTS: In all sites An. gambiae (s.l.) showed high intensity resistance to permethrin and deltamethrin in CDC bottle bioassay tests in 2016 and 2017. In 2018, the WHO intensity tests resulted in survivors at all sites for permethrin, deltamethrin and alpha-cypermethrin when tested at 10× the diagnostic dose. Across all sites mean mortality was 33.7% with permethrin (0.75%) compared with 71.8% when pre-exposed to PBO (4%), representing a 2.13-fold increase in mortality. A similar trend was recorded for deltamethrin. There was susceptibility to pirimiphos-methyl, chlorfenapyr and clothianidin in all surveyed sites, including current IRS sites in Mopti Region. An. coluzzii was the primary species in 4 of 6 regions. CONCLUSIONS: Widespread high intensity pyrethroid resistance was recorded during 2016-2018 and is likely to compromise the effectiveness of pyrethroid LLINs in Mali. PBO or chlorfenapyr LLINs should provide improved control of An. gambiae (s.l.). Clothianidin and pirimiphos-methyl insecticides are currently being used for IRS as part of a rotation strategy based on susceptibility being confirmed in this study.

Broken needle during spinal anesthesia: an avoidable complication.

The occurrence of a needle breaking is a very rare complication of spinal anesthesia (SA). We report a case of a broken spinal needle occurring in a morbid obese pregnant woman during SA indicated for an emergent cesarean section. Multiple puncture attempts due to difficult identification of lumbar spine, associated with an inadequate use of the introducer, contributed to this complication. The recognition of predictive factors for difficult neuraxial anesthesia, the use of ultrasound in obese patients, and a properly executed technique may have allowed avoiding this complication.

Head Computed Tomography Scan in Isolated Traumatic Brain Injury in a Low-Income Country.

BACKGROUND: Head computed tomography scan (HCTS) is the cornerstone of the management of traumatic brain injury (TBI). The impact of performing a HCTS in TBI has been scarcely investigated in low-income countries (LICs). Furthermore, the cost of a HCTS is a burden for family finances. METHODS: A prospective observational study was conducted in Burkina Faso. All consecutive patients with isolated TBI needing a HCTS were included. Result and impact of HCTS were evaluated. RESULTS: There were 183 patients prescribed a HCTS for an isolated TBI. Mild, moderate, and severe TBIs represented 55%, 31%, and 14% of the cases, respectively. In 72 patients, HCTS was not performed because of economic barrier. Among the 110 HCTSs performed, there were intracranial lesions in 81 (74%) patients. Among the 110 performed HCTS, 34 (31% [22.3%-39.5%]) HCTSs altered the management of TBI, with 16 (15%) cases of surgical indications, and 20 (18%) cases of modification of the medical treatment. In patients without neurologic signs, the rate of alteration of management was 28%. The realization of the HCTSs was associated with the presence of neurologic signs and income level. In-hospital mortality was 11% (n = 21). Among the 162 patients discharged alive from the hospital, 27 (20%) were discharged with a severe disability state (Glasgow Outcome Scale score ≤3). The rate of return to work was 77%. CONCLUSIONS: No modification of guidelines can be advocated from this study. However, given the financial burden on family of performing HCTS, research may identify criteria allowing for avoiding HCTS. Guidelines specific to LICs are needed to get closer to the best interest of patients.

[Spontaneous hematoma of right angle of the transverse mesocolon: exceptional complication of anticoagulant therapy with vitamin K]. / Hématome spontané du méso de l'angle colique droit et du colon transverse compliquant un traitement par anti vitamine K: à propos d'un cas et revue de la littérature.

Spontaneous hematoma of transverse mesocolon is a rare complication of anticoagulant treatment with vitamin K. We report the case of spontaneous hematoma of right angle of the transverse mesocolon associated with a hemoperitoneum in a 32-year-old patient treated by fluindione for pulmonary embolism. The diagnosis must be made urgently. The abdominal ultrasound and the scanning confirm the diagnosis. It is important to note that surgery is indicated only in the case of complications such as the risk of rupture of the hematoma.

Trauma related to falls from trees treated in a specialized trauma centre in Burkina-Faso-one hundred and six cases treated in one year.

PURPOSE: Falls from trees related traumas are rarely reported in literature. They are public health problems in developing countries where their frequency is still important. The aim of the study is to describe falls from trees related trauma patterns and to present preventative measures. METHODS: An annual ongoing prospective study was held in our trauma emergency department (ED) about all the patients who sustained an injury after a recent fall from tree. A questionnaire related to the patient and to the trauma was established. The data were encoded and analysed by a statistical software. RESULTS: One hundred six patients who sustained a fall from tree trauma, out of a total of 139, were studied. Most patients were under 15 years old (76.4 %); they were injured in fruits season (33 %) after a fall from a fruit tree (mango trees, Shea trees, Néré, etc.) and were received late (86 %). Injuries were polymorphic from traumatic brain injuries (51.8 %) and spine injuries (13.2 %) to thoraco-abdominal (21.6 %) and limbs injuries (46.2 %). Three housewives were pregnant at the time of the trauma with secondary abortions. Patients were managed medically (33.9 %), surgically (19.8 %) or by casting (34.9 %) with good outcome in 59 cases. Twelve patients refused medical care and two died. CONCLUSION: Education programs must focus on picking fruits and leaves in order to make them safe and prevent injuries related to these traditional or professional activities.

Amniotic band syndrom at Bobo Dioulasso university teaching hospital (Burkina-Faso): about two cases.

Amniotic band syndrome is a rare congenital disorder. The authors report the first cases documented at Souro Sanou University Hospital in Bobo-Dioulasso (CHUSS) in 2 male new borns. The malformations found at birth, were worn only on limbs and were in the form of skin furrow necking with a major lymphedema downstream. In both cases, the constriction furrow at member pelvic was associated with a club foot and a pseudosyndactyly in one case. Surgical treatment consisted of a section of the constrictor ring and a Z-plasty. The functional outcome was satisfactory with the acquisition of a plantar support for both children. Through these two observations, epidemiological, diagnostic, and particularities of the management of this condition are discussed in the Burkina-Faso.

Video-laryngoscopy introduction in a Sub-Saharan national teaching hospital: luxury or necessity?

Tracheal intubation using Macintosh blade is the technique of choice for the liberation of airways. It can turn out to be difficult, causing severe complications which can entail the prognosis for survival or the adjournment of the surgical operation. The video-laryngoscope allows a better display of the larynx and a good exposure of the glottis and then making tracheal intubation simpler compared with a conventional laryngoscope. It is little spread in sub-Saharan Africa and more particularly in Burkina Faso because of its high cost. We report our first experiences of use of the video-laryngoscope through two cases of difficult tracheal intubation which had required the adjournment of the interventions. It results that the video-laryngoscope makes tracheal intubation easier even in it's the first use because of the good glottal display which it gives and because its allows apprenticeship easy. Therefore, it is not a luxury to have it in our therapeutic arsenal.