Motif de consultation en première ligne : étude rétrospective au centre de santé communautaire et universitaire de Konobougou, Mali

Introduction : La médecine communautaire/famille reste un champ encore mal exploré en matière de recherche scientifique comme le cas du Mali. Objectif de cette étude était de déterminer les motifs de consultation afin de connaitre les types de pathologies rencontrées, les examens réalisés et le devenir des patients dans le centre de santé communautaire et universitaire (CSCOM-U) de Konobougou. Méthodologie : Il s'agissait d'une étude descriptive, rétrospective et déroulée du 1ier janvier au 31 décembre 2018 dans le CSCOM-U de Konobougou/ Mali. Les dossiers des malades ont été tirés au hasard soit tous les dixièmes patients des consultations externes réalisées par deux médecins. Les données ont été collectées sur un questionnaire puis saisies et analysée par SPSS22. Résultats : Le premier motif de consultation était la fièvre avec 25,39% suivi de céphalée 13,69%, algies abdominales 12,95%, troubles digestifs 11,66% et la toux 6,48%. Le paludisme était le plus représenté avec 46,28% suivi des infections respiratoires aigües avec 10,82%, des infections uro-génitales 5,56%, des pathologies gastriques et plaies liées aux accidents 4,77% chacune et en fin des lésions musculosquelettiques 3,1%. Les patients guéris représentaient 90,8% et l'état des patients était amélioré/stabilisé dans 5,6%. Les références/ évacuations représentaient 3,6% et 0,1% de décès. Conclusion : Les motifs de consultations sont divers, variés en première ligne et concernent toutes les spécialités de la médecine d'où l'intérêt d'une bonne démarche diagnostique pour une meilleure prise en charge

Hodgkin lymphoma at the paediatric oncology unit of gabriel touré teaching hospital, bamako, mali: 5-year experience.

Introduction. The aim of this retrospective, unicentric study over 5 years is to describe the epidemiologic, pathologic, clinic and therapeutic aspects of children treated for Hodgkin lymphoma in our paediatric oncology unit. Patients and Methods. From January 2005 to December 2009, all children under 18 years of age, with Hodgkin lymphoma were included in this study. The treatment protocol was the GFAOP (Groupe Franco-Africain d'Oncologie Pédiatrique) Hodgkin lymphoma treatment protocol. Results. During the study period, 217 cancer cases were diagnosed in our centre. Of these cases, 7 were Hodgkin Lymphoma (LH) (0.04%). The mean age was 11.7 years. The sex-ratio was 6/1. 4% (5/7) of patients were stage IIB and 28.6% (2/7) stage IIIB of Ann-Arbor classification. There were 3 cases (42.8%) of sclero-nodular subtype, 2 cases (28.6%) of lymphocyte-rich classical HL subtype, 1 case (14.3%) of mixed cellularity and 1 case (14.3%) of lymphocyte depleted subtype. With a median followup of 37 months, 5 patients (71.4%) are alive, and 2 patients (28.6%) died. Conclusion. Broader multicentric studies are needed for more accurate data on this malignancy.

[Childhood acute lymphoblastic leukemia: 12 cases in Mali]. / Leucémie aiguë lymphoblastique de l'enfant: 12 observations au Mali.

INTRODUCTION: Data about childhood acute lymphoblastic leukemia, the most common childhood malignancy in industrialized countries, are scarce in African publications. The purpose of this prospective, unicentric study were to assess the socio-demographic, clinic and laboratory characteristics of the children treated for lymphoblastic leukemia in our pediatric oncology unit in Gabriel Touré Teaching Hospital in Bamako, Mali. PATIENTS AND METHODS: This study includes all children between 1 and 15 years old treated for cytologically documented acute lymphoblastic leukemia from January 1, 2007 to September 30, 2009. RESULTS: A total of 12 cases including 8 boys and 4 girls (sex ration, 2) were treated during the study period. Mean age was 92 months. Age was less than 4 years old in 2 cases. 5 (41,7%) were between 5 and 9 years in 5 (41.7%) and between 10 to 15 years in five. At the time of presentation, 9 patients (75%) were in a cachectic state; 10 had lymphadenopathies, splenomegaly and hepatomegaly; and 2 had neurological involvement. The delay for definitive diagnosis was 5 months in 4 cases (33,3 %) and less than 5 months in the remaining cases. Initial white blood cell count was more than 50 000/mm3 in 10 cases and less less than 50 000/mm3 in 2 cases. All patients were treated using the LAL GFAOP protocol including LAL1 in 6 cases, LAL2 in 5 and LAL3 in 1. Treatment complications were included 6 undocumented infections in 6 cases, hemorrhage in 2 and severe anemia in 4. Four patients died. At 5 years follow-up, overall survival rate was 66,7%. CONCLUSION: A multicentric study including a greater number of children is needed to increase understanding of the characteristics of childhood acute lymphoblastic leukemia in sub-Saharan Africa.