Causes de décès au service de médecine de l'hôpital régional de Sikasso / Causes of death in the medicine department of the regional hospital of Sikasso

Les causes de décès revêtent une grande importance dans l'évaluation de l'état de santé de la population et de la qualité des soins. Leur étude pourrait orienter les politiques de santé visant à accroître l'espérance de vie. Objectifs : C'était de déterminer les causes de mort ; d'étudier les caractéristiques sociodémographiques des défunts. Matériels et méthodes : Il s'agissait d'une étude rétrospective et descriptive portant sur tous les décès survenus dans le service de Médecine de l'hôpital de Sikasso de Janvier 2018 à Décembre 2020. Résultats : Parmi 265 décès recensés, l'âge moyen était de 45,12±17,5 ans. Le sex-ratio était de 1,59. Il s'agissait en majorité de citadins et 51,64% résidaient à Sikasso ville. La durée moyenne d'hospitalisation était 7,09 ± 6,38 jours. L'insuffisance rénale constituait le 1er motif d'hospitalisation. L'infection à VIH était la 1ère cause de décès (29,8%), suivie de l'insuffisance rénale (24,2%). Le sexe masculin était majoritaire dans toutes les causes de décès hormis l'infection à VIH et l'anémie. Les décès liés à l'insuffisance rénale ont quintuplé de 2018 à 2020. Conclusion : Les décès liés au VIH/SIDA reste en tête malgré leur forte réduction ; ceux liés à l'insuffisance rénale ont quintuplé

The causes of death are of great importance in assessing the health status of the population and care'squality. Their study could guide health policies aimed at increasing life expectancy. Objectives: It was to determine the causes of death; to study the socio-demographic characteristics of deceased. Materials and methods: This was a retrospective and descriptive study of all deaths that occurred in the Medical Department of Sikasso Hospital from January 2018 to December 2020. Results: Among 265 deaths recorded, the mean age was 45.12 ± 17.5 years. The sex ratio was 1.59. They were mostly city dwellers and 51.64% lived in Sikasso city. The mean length of hospitalization was 7.09 ± 6.38 days. Kidney failure was the first reason for hospitalization. HIV infection was the leading cause of death (29.8%), followed by renal failure (24.2%). The male sex was predominant in all causes of death except HIV infection and anemia. Deaths linked to kidney failure have increased fivefold from 2018 to 2020. Conclusion: Deaths related to HIV/AIDS remain in the lead despite their strong reduction; those related to kidney failure have increased fivefold

[Causes Of Death In The Medicine Department Of The Regional Hospital Of Sikasso]. / Causes De Décès Au Service De Médecine De l'Hôpital Régional De Sikasso.

The causes of death are of great importance in assessing the health status of the population and care'squality. Their study could guide health policies aimed at increasing life expectancy. OBJECTIVES: It was to determine the causes of death; to study the socio-demographic characteristics of deceased. MATERIALS AND METHODS: This was a retrospective and descriptive study of all deaths that occurred in the Medical Department of Sikasso Hospital from January 2018 to December 2020. RESULTS: Among 265 deaths recorded, the mean age was 45.12 ± 17.5 years. The sex ratio was 1.59. They were mostly city dwellers and 51.64% lived in Sikasso city. The mean length of hospitalization was 7.09 ± 6.38 days. Kidney failure was the first reason for hospitalization. HIV infection was the leading cause of death (29.8%), followed by renal failure (24.2%). The male sex was predominant in all causes of death except HIV infection and anemia. Deaths linked to kidney failure have increased fivefold from 2018 to 2020. CONCLUSION: Deaths related to HIV/AIDS remain in the lead despite their strong reduction; those related to kidney failure have increased fivefold.

Les causes de décès revêtent une grande importance dans l'évaluation de l'état de santé de la population et de la qualité des soins. Leur étude pourrait orienter les politiques de santé visant à accroître l'espérance de vie. OBJECTIFS: C'était de déterminer les causes de mort ; d'étudier les caractéristiques sociodémographiques des défunts. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude rétrospective et descriptive portant sur tous les décès survenus dans le service de Médecine de l'hôpital de Sikasso de Janvier 2018 à Décembre 2020. RÉSULTATS: Parmi 265 décès recensés, l'âge moyen était de 45,12±17,5 ans. Le sex-ratio était de 1,59. Il s'agissait en majorité de citadins et 51,64% résidaient à Sikasso ville. La durée moyenne d'hospitalisation était 7,09 ± 6,38 jours. L'insuffisance rénale constituait le 1er motif d'hospitalisation. L'infection à VIH était la 1ère cause de décès (29,8%), suivie de l'insuffisance rénale (24,2%). Le sexe masculin était majoritaire dans toutes les causes de décès hormis l'infection à VIH et l'anémie. Les décès liés à l'insuffisance rénale ont quintuplé de 2018 à 2020. CONCLUSION: Les décès liés au VIH/SIDA reste en tête malgré leur forte réduction ; ceux liés à l'insuffisance rénale ont quintuplé.

Assessment on overall efficiency of urban greywater treatment by vermifiltration in hot climate: enhanced pollutants removal.

Vermifiltration technology using Eudrilus Eugeniae could be an alternative low-cost option for the treatment of urban greywater, which is highly polluted with high concentrations of surfactants, sodium and cooking oil. In this study, the effects of these pollutants on performance of a vermifiltration system was tested over a period of 6 to 8 weeks by enriching raw greywater with various concentrations of anionic surfactants (0, 15, 45 and 135 mg/L), sodium (0, 1, 2 and 4 g/L) and refined palm cooking oil (0, 250 and 500 mg/L). The vermifilter system was made of gravel, sand and sawdust layers from the bottom to the top, on which 200 earthworms were added. The greywater used in this study was previously used for dishwashing and laundry by an urban poor household. The greywater quality was compared with the effluent to evaluate the system performance. BOD5, COD, TSS and E. coli removal efficiencies ranged from 93% to 98%, 68% to 93%, 88% to 96% and 1.4-3 ULog, respectively, which are within the range of efficiencies reported in the literature. High proportion of surfactants (95-99%) and oil (84-89%) were removed but sodium was not removed. Instead, an increase in sodium concentrations was observed in the filter over the experimental period. Statistical analysis shows that BOD5, COD, TSS and E. coli removal efficiencies were independent of surfactants, cooking oil and sodium concentrations (p < .05). Thus, short term or accidental exposure of the vermifilter to high concentrations of these three pollutants did not have significant effect on the system performance.

[Management of acquired urethral stricture: our experience in the Division of General Surgery in Sikasso]. / Prise en charge du rétrécissement urétral acquis: expérience du Service de Chirurgie Générale de Sikasso.

Urethral stricture is a disease whose cause and management vary according to the context. This study aims to analyze the epidemiological etiological and therapeutic features of urethral stricture in our department. We conducted a longitudinal cross-sectional study of patients with acquired urethral stricture admitted to our department between March 2014 and February 2016. The average age of our patients was 24.5 years (10 and 81years). The diagnosis was confirmed by retrograde and voiding Urethro-Cystography (UCG). The average stricture length was 2.28cm (0.5-5cm). The therapeutic approaches included: resection with termino-terminal anastomosis; retrograde dilatation etc. Outcome assessment performed 6-15 months after surgery was satisfactory with absence of recidivism, PMR ≤30cc and strong urine flow and weak in the case of recurrence of dysuria or PMR ≥100cc. Urethral stricture accounted for 7.14% of our urologic treatments. Most of our patients were farmers from the rural area. A history of recurrent urethritis was most often reported by our patients and 78,57% of them were married men, among whom 91% were polygamous). The main reason for consultation was dysuria (50% of the study population) and 50.01% of our patients had secondary urinary tract infection, most commonly caused by Escherichia coli. The main cause of urethral stricture was an infection (56.52%). The most affected area was the bulbar urethra (45.60% of cases). UCG was the most used technique (39.13%). Overall outcomes were good (85,65%) and failure rate reached 13.04%; the highest success rate was achieved with resection with anastomosis (94.44% respectively). Urethral stricture is common among young people. Infection is the main cause in our department. Prevention is essential as well as an efficient and effective management of sexually transmitted infections.

[Urogenital fistulas at Sikasso: about 150 cases]. / Fistule urogénitale à Sikasso: à propos de 150 cas.

This study aims to analyze the epidemiological, clinical, therapeutic and anatomopathologic features of urogenital fistulas. We conducted a retrospective study of patients with urogenital fistulas admitted to the department of general surgery and gynecology and obstetrics between January 1, 2014 and December 30, 2015, including the first 5 fistula repair campaigns organized by the Fistula Mali project. Urogenital fistulas account for 19.53% of all urologic disorder treated during our daily practice. The median age at first marriage was 16.57 years. The majority of our patients (96.70%) was illiterate and self-employed, coming from rural areas (85.36%). Obstructed labour was the dominant etiology, with 91.50% of stillborn children. The patients were primiparous women (43.33%) and, among them, 53.60% received no prenatal care. The divorce rate associated with the disease was 7.30%. Most patients underwent simple fistulorraphy, of whom 121 underwent lower fistulorraphy, 26 upper fistulorraphy and 3 mixed fistulorraphy. Outcomes were satisfactory in 65.33% patients and poor in 34.66% of patients. Patients with type I and type V obstetric fistulas had the highest healing rate compared to patients with type IV fistulas. Urogenital fistulas are a real public health problem. Treatment is mainly based on surgery and prognosis is compromised by the narrowness of the surgical field, the complexity of the lesions and the condition of the surrounding tissue. The focus must be on the implementation of women's socio economic development programs and on emergency obstetric care access. The research and discussion should continue to facilitate the development of a standard classification.

Fate of filter materials and microbial communities during vermifiltration process.

The fate of filter materials and microbial communities during the vermifiltration process were studied for 5 months while treating the concentrated greywater. Four filters were filled with 10 cm gravel of which a layer of medium size gravel (5 cm thickness, aggregate size 20-40 mm) at the bottom and a layer of coarse gravel (5 cm thickness, aggregate size 10-20 mm) at the top, then filled with 20 cm sand (d60 = 0.2 mm, d10 = 0.118 mm). Finally, Vermifilter 1 (VF1), control unit and Vermifilter 2 (VF2), were filled with 40 cm fine sawdust (0.05-5 mm) but Vermifilter 3 (VF3), was filled with 40 cm cow dung (0.05-5 mm). Three filters were inoculated with 200 individuals of Eudrilus eugeniae except for the control unit which was filled with sawdust. Five sampling ports were installed on the wall of the filters at 10 cm intervals with reference to the surface of the top layer. Three of the filters were supplied with concentrated greywater and VF1 was supplied with drinking water at the hydraulic loading rate of 16 L m-2.d-1 on batch basis, i.e., four times a day at 8:00 a.m., 11:00 a.m., 2:00 p.m. and 5:00 p.m. Weekly, samples from influent and effluent, and monthly, samples of filter materials collected via sampling ports, were collected and analyzed.The removal efficiencies of biological oxygen demand (BOD5), total chemical oxygen demand (tCOD), and dissolved chemical oxygen demand (dCOD) of VF2 and VF3 were 5-7% higher than the control unit, but little differences were observed in terms of total suspended solids (TSS). However, the removal efficiencies of nutrients for the control unit was slightly better than VF2 and VF3. The pH and Moisture content (MC) of filter materials increased along the depth, but percentage of volatile solids to total solids (VS/TS) decreased through time due to the high number of microbial communities and earthworms dominating the top layer compared to the bottom. The performance of VF2-sawdust was slightly better than VF3-cow dung to treat concentrated greywater.

Effect of post-treatment conditions on the inactivation of helminth eggs (Ascaris suum) after the composting process.

Safe and appropriate disposal of human waste is a basic requirement for sanitation and protection of public health. For proper sanitation and nutrient recovery, it is necessary to ensure effective treatment methods to complete pathogen destruction in excreta prior to reuse. Composting toilets convert faeces to a reusable resource such as fertilizer or humus for organic agriculture. A composting toilet for rural Burkina Faso was created by modifying a commercial model available in Japan to improve hygiene and increase food production. The toilet has shown to result in a degraded final product, but its effectiveness for pathogen destruction was unclear due to low temperatures generated from the toilet. This study aimed to sanitize compost withdrawn from the composting toilet for food production by setting post-treatment conditions. The inactivation kinetics of Ascaris suum eggs, selected as an indicator for helminth eggs, was determined during post-treatment at different temperatures (30°C, 40°C, 50°C and 60°C) with varying moisture contents (MC) (50%, 60% and 70%). The treatment of compost in a possible additional post-treatment after the composting process was tried in the laboratory test. Inactivation of A. suum eggs was fast with greater than two log reductions achieved within 2 h for temperature 50°C and 50% MC and greater than three log reductions for temperature 60°C and 50% MC within 3 h. Statistical analysis showed the significant impact of temperature and moisture on the inactivation rates of A. suum eggs. The post-treatment can efficiently increase helminth eggs destruction prior to reuse.

A Theoretical Analysis of the Geography of Schistosomiasis in Burkina Faso Highlights the Roles of Human Mobility and Water Resources Development in Disease Transmission.

We study the geography of schistosomiasis across Burkina Faso by means of a spatially explicit model of water-based disease dynamics. The model quantitatively addresses the geographic stratification of disease burden in a novel framework by explicitly accounting for drivers and controls of the disease, including spatial information on the distributions of population and infrastructure, jointly with a general description of human mobility and climatic/ecological drivers. Spatial patterns of disease are analysed by the extraction and the mapping of suitable eigenvectors of the Jacobian matrix subsuming the stability of the disease-free equilibrium. The relevance of the work lies in the novel mapping of disease burden, a byproduct of the parametrization induced by regional upscaling, by model-guided field validations and in the predictive scenarios allowed by exploiting the range of possible parameters and processes. Human mobility is found to be a primary control at regional scales both for pathogen invasion success and the overall distribution of disease burden. The effects of water resources development highlighted by systematic reviews are accounted for by the average distances of human settlements from water bodies that are habitats for the parasite's intermediate host. Our results confirm the empirical findings about the role of water resources development on disease spread into regions previously nearly disease-free also by inspection of empirical prevalence patterns. We conclude that while the model still needs refinements based on field and epidemiological evidence, the proposed framework provides a powerful tool for large-scale public health planning and schistosomiasis management.

Performance comparison of sand and fine sawdust vermifilters in treating concentrated grey water for urban poor.

A comparative investigation was conducted for 10 months with sand and fine sawdust vermifilters and a control unit to treat concentrated grey water generated from a poor urban household in Ouagadougou, Burkina Faso. Each of the filters was made up of cylindrical DN200-PVC pipes and filled with 10 cm of gravel at the bottom. On top of the gravel layer, filter 1 (fully sand, F1) was completed with 40 cm of sand and 10 cm of fine sawdust, filter 2 (partially sand, F2) with 20 cm of sand and 30 cm of fine sawdust, respectively, and filter 3 (fully sawdust, F3) and 4 (control, F4) with 50 cm of fine sawdust only. Two hundred Eudrilus eugeniae earthworms were inoculated in each of the vermifilters. The vermifiltration system was supplied with grey water four times per day at a hydraulic loading rate of 64 L/m(2)/day on a batch basis. The removal efficiencies of biological oxygen demand, total chemical oxygen demand, and dissolved chemical oxygen demand (dCOD) by the vermifilters were 25-30% higher than the control, but little differences were observed in terms of total suspended solids and coliform removal efficiencies. Though there was no significant difference in the performance of the three vermifilters (p > 0.05), except for dCOD removal efficiency, the lifespan of F2 and F3 was longer than that of F1. Therefore, fine sawdust can substitute sand as a filter medium in vermifilters.

Occurrence, removal and accumulation in sludge of protozoan cysts and helminth eggs in a full-scale anaerobic pond in Burkina Faso.

The present paper investigates the occurrence, removal, and accumulation of protozoan cysts and helminth eggs in a large anaerobic pond treating municipal wastewater of Ouagadougou (Burkina Faso). With a hydraulic retention time of 6.5 days, the anaerobic pond achieved 100% removal of helminth eggs and protozoan cysts most of the time, except during the hot period. The average residual concentrations of helminth eggs and protozoan cysts in the effluent were respectively 0.45 eggs/L (minimum 0 and maximum 3), and 5.4 cysts/L (minimum 0 and maximum 26). Protozoan cysts accumulation in sludge averaged 1,613 cysts/g total solids. Ancylostoma duodenale, Ascaris lumbricoides and Hymenolepis nana were the main helminth species found in the sludge. After 7 years of operation, the sludge in the pond still contained a high level of viable helminth eggs evaluated at 42%.

Electrocoagulation for the treatment of textile wastewaters with Al or Fe electrodes: compared variations of COD levels, turbidity and absorbance.

Electrocoagulation technique has been used for the treatment of two wastewaters issued by textile industry. Treatment was carried out in a discontinuous system provided with aluminium or iron electrodes, and with recirculation of the liquid. The efficiency of the technique was followed depending on the electrode material in terms of water treatment, current efficiency of the dissolution, cell voltage, energy consumption to reach the same COD or turbidity abatement: regardless of the quality of the phase separation in the flocculation section downstream of the electrocoagulation cell, the two metals were found to be of comparable efficiency. Besides COD and absorbance were shown to follow similar, regular variations along the treatment; experimental data could be interpreted by a simple model involving the overall equilibrium between the metal dissolved--in the form of hydroxides--and the polluting substance. Abatement of the waste turbidity was observed to obey another law, with a sharp reduction of turbidity after a preliminary phase, where accumulation of metal hydroxide has no effect on this variable.