Devenir de l’hématome sous-dural chronique associé à l’alcool : analyse rétrospective d’une série des cas: Outcome of chronic subdural hematoma associated with alcohol: a retrospective case series analysis

Context & objective. Although chronic subduralhaematoma (CSDH) associated with alcoholism isrelatively common in extreme ages (children andelderly subjects), postoperative data are fragmentary. The aim of the present study was todescribe the postoperative outcome of CSDHassociated with chronic alcoholism. Methods.Retrospective study involved a series of cases withCSDH and chronic alcoholics. Parameters ofinterest included sociodemographic data, andpostoperative outcome (immediate, 1 year and 2years). Results. A total of 11 records of chronicalcoholic CSDH patients were collected. Theirmean age was 59 years (all male). The meanduration of the disease was 4 weeks. Threepatients were classified as MARKWALDER I andtwo as MARKWALDER IV. The haematoma wasbilateral in 3 cases. Eight patients were operatedon under local anesthesia. Seven patients had animmediate postoperative complication including 4cases of acute rebleeding. At one-year follow-up,4 cases of recurrence were recorded. At 2-yearfollow-up, 5 cases of post-therapeutic sequelaeand 3 cases of complete recovery were recorded.Conclusion. The management of chronic subduralhaematoma in chronic alcoholics is complex. Therisks of recurrence and postoperative sequelae arenot negligible. Contexte et objectif. Le risque et les conséquences de la grossesse des adolescentes restent peu documentés dans les pays d’Afrique subsaharienne. L’objectif de l’étude était de déterminer le devenir périnatal des nouveau-nés de mères adolescentes. Méthodes. Il s’agissait d’une étude transversale incluant les nouveau-nés des mères adolescentes (âgés de ≤ 18 ans), entre les 1er septembre 2018 et 03 avril 2019, à l’hôpital de Ziguinchor. Etaient exclus, les enfants nés à domicile et les nouveau-nés dont le dossier obstétrico-néonatal était incomplet. Les paramètres d’intérêt englobaient les données épidémiologiques, sociodémographiques, obstétricales et périnatales. Résultats. Au total, il y a eu 170 naissances pour une population de 166 adolescentes dont 162 grossesses mono fœtales et 4 grossesses gémellaires. Les mort-nés étaient au nombre de 7 et les naissances vivantes au nombre de 163. L’âge moyen des adolescentes était de 17 ans [13 – 18], 56% d’entre eux n’avaient pas réalisé les 4 consultations prénatales requises. L’hypertension artérielle, l’éclampsie étaient les pathologies obstétricales les plus représentées (27,1%). Le sex-ratio des nouveau-nés était de 1,2. L’âge gestationnel moyen était de 35,2 semaines d’aménorrhée [32 - 43,5] et le poids de naissance moyen était de 2788 grammes [1300 - 4400]. Quatre-vingt-neuf nouveau-nés étaient hospitalisés, soit un taux de 52,4%. Les principales pathologies néonatales étaient l’asphyxie périnatale (n = 41) ; le petit poids de naissance (n=41) ; l’infection néonatale (n=36). La durée moyenne d’hospitalisation était de 5,5 jours [3 - 16]. Conclusion. Les nouveau-nés de mère adolescente à Ziguinchor présentent des risques de prématurité, d’hypotrophie, d’asphyxie périnatale et d’infection, tandis que leur mère, l’hypertension artérielle

Détermination du Potentiel Pastoral Herbacé dans le Bioclimat Soudanien Nord au Mali : Cas de la Commune Rurale de Dièma

L’élevage contribue environ à 15% du produit intérieur brut de l’ensemble des pays sahéliens de l’Afrique de l’ouest. Au Mali, il est la deuxième activité socioéconomique après l’agriculture. Il est pratiqué de façon extensive avec des mobilités saisonnières des troupeaux à la recherche du disponible fourrager, dans le contexte du changement climatique. Paradoxalement, la production herbacée, dans ces parcours sahéliens, qui équivaut à des milliards de francs, est annuellement consumée par les feux de brousse. C’est dans ce contexte que la présente étude a été initiée pour améliorer la gestion des pâturages naturels dans la commune rurale de Diéma dans la région de Kayes. La méthode de transect a été utilisée dans les parcours naturels suivant les quatre points cardinaux du district de la commune. Les relevés phytoécologiques et des coupes de biomasse herbacée ont été effectués dans les parcelles échantillons. Il a été recensé au total 71 espèces appartenant à 18 familles avec la dominance des Poaceae, Fabaceae et Convolvulaceae. La production de biomasse des parcours est d’environ 3t.ha-1. Une différence significative (P=0,042) a été observée pour la valeur pastorale des parcours et cela en fonction de leur orientation par rapport au District de la Commune.  Pour une meilleure gestion de l’environnement et de production animale, il importe de connaitre les caractéristiques de nos parcours naturels.   Livestock contributes about 15% of the gross domestic product of all the Sahelian countries of West Africa. In Mali, it is the second socioeconomic activity after agriculture. It is practiced extensively with seasonal movements of herds in search of available fodder, in the context of climate change. Paradoxically, the herbaceous production in these Sahelian rangelands, which is equivalent to billions of francs, is consumed annually by bush fires. It is in this context that the present study was initiated to improve the management of natural pastures in the rural commune of Diéma in the Kayes region. The transect method was used in the natural routes following the four cardinal points of the district of the commune. Phytoecological surveys and herbaceous biomass cuts were carried out in the sample plots. 71 species belonging to 18 families have been identified with the dominance of Poaceae, Fabaceae and Convolvulaceae. The biomass production of rangelands is about 3t.ha-1. A significant difference (P=0.042) was observed for the pastoral value of the rangelands and this according to their orientation in relation to the District of the Commune. For better management of the environment and animal production, it is important to know the characteristics of our natural rangelands

Détermination du Potentiel Pastoral Herbacé dans le Bioclimat Soudanien Nord au Mali : Cas de la Commune Rurale de Dièma

L’élevage contribue environ à 15% du produit intérieur brut de l’ensemble des pays sahéliens de l’Afrique de l’ouest. Au Mali, il est la deuxième activité socioéconomique après l’agriculture. Il est pratiqué de façon extensive avec des mobilités saisonnières des troupeaux à la recherche du disponible fourrager, dans le contexte du changement climatique. Paradoxalement, la production herbacée, dans ces parcours sahéliens, qui équivaut à des milliards de francs, est annuellement consumée par les feux de brousse. C’est dans ce contexte que la présente étude a été initiée pour améliorer la gestion des pâturages naturels dans la commune rurale de Diéma dans la région de Kayes. La méthode de transect a été utilisée dans les parcours naturels suivant les quatre points cardinaux du district de la commune. Les relevés phytoécologiques et des coupes de biomasse herbacée ont été effectués dans les parcelles échantillons. Il a été recensé au total 71 espèces appartenant à 18 familles avec la dominance des Poaceae, Fabaceae et Convolvulaceae. La production de biomasse des parcours est d’environ 3t.ha-1. Une différence significative (P=0,042) a été observée pour la valeur pastorale des parcours et cela en fonction de leur orientation par rapport au District de la Commune.  Pour une meilleure gestion de l’environnement et de production animale, il importe de connaitre les caractéristiques de nos parcours naturels.   Livestock contributes about 15% of the gross domestic product of all the Sahelian countries of West Africa. In Mali, it is the second socioeconomic activity after agriculture. It is practiced extensively with seasonal movements of herds in search of available fodder, in the context of climate change. Paradoxically, the herbaceous production in these Sahelian rangelands, which is equivalent to billions of francs, is consumed annually by bush fires. It is in this context that the present study was initiated to improve the management of natural pastures in the rural commune of Diéma in the Kayes region. The transect method was used in the natural routes following the four cardinal points of the district of the commune. Phytoecological surveys and herbaceous biomass cuts were carried out in the sample plots. 71 species belonging to 18 families have been identified with the dominance of Poaceae, Fabaceae and Convolvulaceae. The biomass production of rangelands is about 3t.ha-1. A significant difference (P=0.042) was observed for the pastoral value of the rangelands and this according to their orientation in relation to the District of the Commune. For better management of the environment and animal production, it is important to know the characteristics of our natural rangelands

Détermination du Potentiel Pastoral Herbacé de la Commune Rurale de Dièma dans le Bioclimat Soudanien Nord au Mali

L’élevage contribue à environ 15% du produit intérieur brut de l’ensemble des pays sahéliens de l’Afrique de l’ouest. Au Mali, il est la deuxième activité socioéconomique après l’agriculture. Il est pratiqué de façon extensive avec des mobilités saisonnières des troupeaux à la recherche du disponible fourrager, dans le contexte du changement climatique. Malheureusement, la production herbacée, dans ces parcours sahéliens, qui équivaut à des milliards de francs, est annuellement consumée par les feux de brousse. C’est dans ce contexte que la présente étude a été initiée pour caractériser les pâturages naturels dans la commune rurale de Diéma en vue d’améliorer leur gestion. La méthode de transect a été utilisée dans les parcours naturels suivant les quatre points cardinaux du district de la commune. Les relevés phytoécologiques et des coupes de biomasse herbacée ont été effectués dans les parcelles échantillons. La valeur pastorale des parcours a été calculée. Il a été recensé au total 80 espèces appartenant à 18 familles avec la dominance des Poaceae, des Fabaceae et des Convolvulaceae. La production de biomasse des parcours est d’environ 3tMS.ha-1. Une différence significative (P=0,042) a été observée pour la valeur pastorale avec une moyenne générale de 38,15% entre les orientations. Pour une meilleure gestion de l’environnement et de production animale, il importe de connaitre les caractéristiques de nos parcours naturels.   Livestock contributes about 15% of the gross domestic product of all the Sahelian countries of West Africa. In Mali, it is the second socioeconomic activity after agriculture. It is practiced extensively with seasonal movements of herds in search of available fodder, in the context of climate change. Paradoxically, the herbaceous production in these Sahelian rangelands, whichis equivalent to billions of francs, is consumed annually by bush fires. It is in this context that the present study was initiated to improve the management of natural pastures in the rural commune of Diéma in the Kayes region. The transect method was used in the natural routes following the four cardinal points of the district of the commune. Phytoecological surveys and herbaceous biomass cuts were carried out in the sample plots. 80 species belonging to 18 families have been identified with the dominance of Poaceae, Fabaceae and Convolvulaceae. The biomass production of rangelands is about 3t.ha-1. A significant difference (P=0.042) was observed for the pastoral value of the rangelands and this according to their orientation in relation to the District of the Commune. For better management of the environment and animal production, it is important to know the characteristics of our natural rangelands

Boscia Senegalensis (Pers.) Lam. ex Poir., une Espèce Ligneuse à Fortes Potentialités Ethnobotaniques et Bien Adaptée à la Sécheresse au Sahel : Synthèse Bibliographique

L’exploitation des ressources végétales notamment ligneuses constitue l’une des stratégies paysannes adoptées pour faire face aux déficits alimentaires surtout pour les ménages vulnérables. Cette synthèse bibliographique dresse l’état des lieux de quelques contributions scientifiques et techniques relatives à l’importance socio-économique et environnementale ainsi que quelques caractéristiques écologiques de Boscia senegalensis (Pers.) Lam. ex Poir.. L’exploitation minutieuse de documents scientifiques en ligne notamment des articles scientifiques et des thèses ainsi que les documents fournis par Sahara Sahel Food a servi à la réalisation de cette étude. Il ressort de l’analyse bibliographique que cette ressource revêt une importance capitale pour les communautés sahéliennes. Il s’agit de son importance dans l’alimentation humaine (surtout en période de soudure), son usage dans la pharmacopée traditionnelle, son importance dans le stockage traditionnel du niébé ainsi que son rôle dans l’alimentation du bétail. La grande particularité de l’espèce réside aussi dans sa forte capacité de résilience. En effet, au Sahel cet arbuste polycaule de la famille des Capparaceae occupe souvent des écosystèmes au stade ultime de dégradation. Cependant quelques cas de menaces ont été évoqués sur cette espèce. L’analyse de l’état des lieux des connaissances existantes sur B. senegalensis a permis ainsi de mettre en évidence le besoin urgent d’entreprendre des recherches scientifiques approfondies sur l’état actuel de ses peuplements, ses stratégies de reproduction ainsi que la caractérisation de ses variétés. Ces nouvelles connaissances, une fois acquises contribueront à formuler des recommandations soutenues pour sa valorisation au Niger. The exploitation of woody plant resources is one of the peasant strategies adopted in dealing with food shortages, especially for vulnerable households. This paper focuses on the inventory of some scientific and technical contributions relating to the socio-economic and environmental importance as well as some ecological characteristics of Boscia senegalensis (Pers.) Lam. ex Poir. Detailed study of scientific documents including scientific articles and theses as well as the documents provided by Sahara Sahel Food was used in this study. It, however, emerges based on the bibliographic analysis that this resource is of capital importance for Sahelian communities. This importance can be seen in human nutrition (especially in lean season), traditional pharmacopoeia, traditional cowpea storage as well as its role in livestock feed. The great peculiarity of the species also lies in its strong capacity for resilience. Indeed, in the Sahel this polycaule shrub of the Capparaceae family often occupies ecosystems at the final stage of degradation. However, some cases of threats have been mentioned in this species. The analysis of the current state of knowledge on B. senegalensis has thus made it possible to highlight the urgent need to undertake an in-depth scientific research on the current state of its stands, his reproductive strategies, and the characterization of its varieties. This new knowledge, once acquired, will help in formulating sustained recommendations for its valorization in Niger

The contribution of aestivating mosquitoes to the persistence of Anopheles gambiae in the Sahel

<p>Abstract</p> <p>Background</p> <p>Persistence of African anophelines throughout the long dry season (4-8 months) when no surface waters are available remains one of the enduring mysteries of medical entomology. Recent studies demonstrated that aestivation (summer diapause) is one mechanism that allows the African malaria mosquito, <it>Anopheles gambiae</it>, to persist in the Sahel. However, migration from distant localities - where reproduction continues year-round - might also be involved.</p> <p>Methods</p> <p>To assess the contribution of aestivating adults to the buildup of populations in the subsequent wet season, two villages subjected to weekly pyrethrum sprays throughout the dry season were compared with two nearby villages, which were only monitored. If aestivating adults are the main source of the subsequent wet-season population, then the subsequent wet-season density in the treated villages will be lower than in the control villages. Moreover, since virtually only M-form <it>An. gambiae </it>are found during the dry season, the reduction should be specific to the M form, whereas no such difference is predicted for S-form <it>An. gambiae </it>or <it>Anopheles arabiensis</it>. On the other hand, if migrants arriving with the first rain are the main source, no differences between treated and control villages are expected across all members of the <it>An. gambiae </it>complex.</p> <p>Results</p> <p>The wet-season density of the M form in treated villages was 30% lower than that in the control (P < 10^-4, permutation test), whereas no significant differences were detected in the S form or <it>An</it>. <it>arabiensis</it>.</p> <p>Conclusions</p> <p>These results support the hypothesis that the M form persist in the arid Sahel primarily by aestivation, whereas the S form and <it>An. arabiensis </it>rely on migration from distant locations. Implications for malaria control are discussed.</p

Maternal and perinatal outcomes in multiple versus singleton pregnancies in Dakar, Senegal: a cross sectional study over 10 years

Background: The birth of twins is a singular event in most societies, and even more when it comes to multiple births. The objective of this study was to investigate maternal and perinatal outcomes in multiple versus singleton pregnancies.Methods: Cross-sectional study carried out at Philippe Maguilen Senghor health center in Dakar, Senegal from January 1, 2011 to June 30, 2019. Data were extracted from this E-perinatal electronic database and then analyzed in statistical package for social science software (SPSS 24, Mac version).Results: A total 42,870 mothers delivered 44,149 newborns including 1250 twins (2.8%) and 29 triplets. The mean maternal age was 27 years. Mothers with multiple pregnancies had 3 times the odds of poor maternal outcome compared to mothers with single pregnancies (OR 2.42, 95% CI; 1.98-2.94, p <0.001, for high blood pressure; OR, 2.66; 95% CI, 2.11-3.32, p= <0.001, for severe pre-eclampsia; and OR, 3.04; 95% CI, 1.64-5.66, p <0.001, for postpartum hemorrhage). Likewise, women with multiple gestations had significantly higher rates of preterm birth (OR 5.62; 95% CI: 4.91-6.41, p <0.001), breech presentations (OR = 11.02; CI = 9.68-12.53, p <0.001) and neonatal deaths (OR = 2.94; CI = 9.6852-12.5328 p= 0.004) as compared to women with singleton gestations. Furthermore, women with multifetal gestations had increased risk for caesarean section (OR 2.14; 95% CI: 1.91-2.41, p <0.001) compared with their singleton counterparts. The risks for episiotomy and perineal injuries were higher for women with singleton gestations as compared to multiple gestation mothers.Conclusions: This study results are in line with previous findings and contradict others. Particular attention should always be paid to multiple pregnancies’ management. However, the pattern of certain complications traditionally correlated with multiple pregnancies is to be confirmed

Completeness of information in electronic compared with paper-based patients’ records in a maternity setting in Dakar, Senegal

Background: Evaluate the consistency of information in paper-based records when registered in parallel with an electronic medical record.Methods: The study was performed at PMSHC in Dakar Senegal. From the end of year 2016, patients’ files were recorded on both paper-based and electronically. Additionally, previous records were electronically registered. To investigate the completeness of records before and after the electronic recording system has been implemented, information about some maternal and fetal/neonatal characteristics were assessed. When the variable was recorded, the system returned 1, unrecorded variables were coded as 0. We then calculated, for each variable, the unrecorded rate before 2017 and after that date. The study period extended from 2011 to June 2019, a nearly ten-year period. Data were extracted from E-perinatal to MS excel 2019 then SPSS 25 software. Frequencies of unrecorded variables were compared with chi-squared test at a level of significance of 5%.Results: A total of 48,270 unique patients’ records were identified during the eight-year period.  Among the study population, data for patients’ age, address and parity were available most of the time before and after 2017 (0.5% missing data versus 0.3% for age and 2.6% versus 1.3% for home address and from 0.3% to 0.0% for parity). However, phone number, maternal weight, maternal height, last menstrual period and blood group were found to be missing up to 96% before 2017. From 2017, these rates experienced a sudden decrease at a significant level: from 82.4% to 27.8% for phone number, from 96% to 56.3% for maternal weight and from 60.1% to 21.3% for blood group. Regarding newborns’ data, it was found that fetal height, head circumference and chest circumference were missing up to just under 25% before 2017. After that date, their completeness improved and flattened under 5%.Conclusions: Structured and computerized files reduce missing data. There is an urgent need the Ministry of health provides hospitals and health care providers with guidelines that describes the standardized information that should be gathered and shared in health and care records

Efficacy of Artesunate + Sulfamethoxypyrazine/Pyrimethamine versus Praziquantel in the Treatment of Schistosoma haematobium in Children

BACKGROUND:This study was conducted to determine the efficacy of the antimalarial artemisinin-based combination therapy (ACT) artesunate +sulfamethoxypyrazine/pyrimethamine (As+SMP), administered in doses used for malaria, to treat Schistosoma haematobium in school aged children. METHODOLOGY/PRINCIPAL FINDINGS:The study was conducted in Djalakorodji, a peri-urban area of Bamako, Mali, using a double blind setup in which As+SMP was compared with praziquantel (PZQ). Urine samples were examined for Schistosoma haematobium on days -1, 0, 28 and 29. Detection of haematuria, and haematological and biochemical exams were conducted on day 0 and day 28. Clinical exams were performed on days 0, 1, 2, and 28. A total of 800 children were included in the trial. The cure rate obtained without viability testing was 43.9% in the As+SMP group versus 53% in the PZQ group (Chi(2) = 6.44, p = 0.011). Egg reduction rates were 95.6% with PZQ in comparison with 92.8% with As+SMP, p = 0.096. The proportion of participants who experienced adverse events related to the medication was 0.5% (2/400) in As+SMP treated children compared to 2.3% (9/399) in the PZQ group (p = 0.033). Abdominal pain and vomiting were the most frequent adverse events in both treatment arms. All adverse events were categorized as mild. CONCLUSIONS/SIGNIFICANCE:The study demonstrates that PZQ was more effective than As+SMP for treating Schistosoma haematobium. However, the safety and tolerability profile of As+SMP was similar to that seen with PZQ. Our findings suggest that further investigations seem justifiable to determine the dose/efficacy/safety pattern of As+SMP in the treatment of Schistosoma infections. TRIAL REGISTRATION:ClinicalTrials.gov NCT00510159