Réseau d'EpidémioSurveillance de la Chimiorésistance aux trypanocides et aux acaricides en Afrique de l'Ouest (RESCAO)

Epidemiological Monitoring Network of Chemoresistance to Trypanocidal and Acaricides Drugs in West Africa (RESCAO). To better coordinate the efforts against trypanocidal and acaricides drugs resistance, the Institute of Tropical Medicine (ITM) of Antwerp and the "Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES)" of Bobo Dioulasso, established in April 2009 an epidemiological surveillance network of chemoresistance to trypanocidal and acaricides drugs in Western Africa, named RESCAO. Its main objective is to contribute to the improvement of the livestock health and of the productivity of agriculture in tropical Africa, through both an efficient strategic control of trypanosomosis and tick born diseases, including a rational use of the available therapeutic drugs. RESCAO is headed by a regional steering committee based at CIRDES. This committee meets on a yearly basis to overview the on-going activities and to identify new strategies for action. Moreover, molecular analyzes performed on samples from seven West African's countries, members of RESCAO, have shown that resistance to diminazeneaceturate was widespread in Trypanosoma congolense with percentages ranging from 67.85 (19/28) for Burkina Faso to 100% (9/9) for Ghana

Les Occlusions Intestinales Par Nœud Ileo-Sigmoïdien : Aspects Diagnostiques, Thérapeutiques Et Pronostiques

Introduction: Ileosigmoid knot (ISK), also known as compound volvulus or double volvulus, is a rare disease and affects mostly male subjects in their fourth decade. Delayed diagnosis often leads to complications with a high incidence of digestive necrosis. Materials and methods: This was a 10-year retrospective, descriptive and analytical study from 1 January 2007 to 31 December 2016, which covered all patients operated emergently for ISK in the surgical and surgical specialty departments at the Niamey National Hospital (NNH). Results: The series involved 8 cases of ISK, representing 0.82% of intestinal obstructions. There were 7 men and 1 woman. The average age of patients was 44.33 years with extremes ranging from 25 to 60 years. The main clinical signs were: abdominal pain (100%), inability to pass gas and stool (100%), vomiting (87.5%) and abdominal meteorism (87.5%). Four patients (50%) had a clear obstructive syndrome and the other 4 patients (50%) had associated signs of peritoneal irritation. Paraclinical diagnosis was difficult because of atypical clinico-radiological signs, but in all cases an abdominal x-ray was performed and showed a double loop of dilated sigmoid shadow in 87.5% of the cases. Laparotomy was the first approach used in all patients and led to a 50% necrosis rate. Hartmann’s colectomy and ideal colectomy were used in identical proportions, with 50% each. Ideal colectomy was characterized by a morbidity rate of 50% and a mortality rate of 25% compared to 0% for Hartmann’s procedure. The overall morbidity was 25% and the overall mortality was 12.5%. The average hospital stay was 65.87 days (range 17 to 128 days). The average time before reestablishment of digestive continuity was 50.37 days (range 31-128 days). Conclusion: Ileosigmoid knot is a rare condition at Niamey national hospital where the diagnostic approach is similar to that of occlusions in general, but remains difficult due to its uncommonness and atypical clinico-radiological signs. Necrosis rates and postoperative complications remain high

Invagination Intestinale Aiguë De L’adulte: Aspects Diagnostiqsues, Thérapeutiques Et Étiologiques

Introduction: Acute intussusception is a rare clinical entity in adults where it accounts for only 1-2% of intestinal obstructions. The authors wanted to report cases of acute intussusception in adult patients, their diagnostic aspects, their management, and their etiologies. Patients and Methods: This study is a retrospective study of the medical files of patients of both sexes. They include adults over 15 years of age, operated between January 2010 and December 2014, who were diagnosed with obstruction due to acute intestinal intussusception. Results: Six cases of adult intestinal intussusception were collected. The average age was 26.5 years. The sex ratio was 1 and there were so many men as women. Five out of six patients were unstable on admission. The diagnosis was made preoperative in two cases out of six, 33.3%. Ultrasound revealed a target sign in two cases. The ileo-ileal form was the most frequent (5 cases out of 6) or 83.3%. Also, there were two cases of intestinal necrosis out of six. Intestinal resection was performed in five cases or 83.33%. The cause of intussusception was found in four cases out of six or 66.7%. Here, a tumor was the cause in half of the cases. Immediate surgical follow-up was uncomplicated in all patients. Conclusion: Acute intestinal intussusception of the adult is a very rare condition. The preoperative diagnosis of acute intussusception of the adult remains delicate. The ileo-ileal form is more frequent than the ileo-colic form in adults. Treatment is always surgical in adults

Cholécystectomies Laparoscopiques Pour Cholécystite Aigue Lithiasique Versus Lithiase Vésiculaire Symptomatique

Introduction: The aim of this work was to highlight the therapeutic and prognostic difficulties between a laparoscopic cholecystectomy for acute gallstone cholecystitis (CAL) and uncomplicated symptomatic vesicular lithiasis (LVS) as well as the reasons for conversion to laparotomy. Patients and Methods: This was a prospective comparative and analytic study over 18 months. Patients admitted and operated for CAL or LVS in the A Surgery Department of the National Hospital of Niamey (HNN) were included. Results: The study involved 61 patients divided into two groups. Group 1 (30 patients) corresponding to patients operated for CAL, group 2 (31 patients) corresponding to patients operated for LVS. Laparoscopic cholecystectomy accounted for 61% of all cholecystectomies performed and 1.45% of surgical activity during the same period. The average age in group 1 was 43.7 years with extremes of 14 and 61 years. In group 2, the average age was 38.9 years with extremes ranging from 12 to 55 years. Women were predominantly represented with 63.3% and 96.7% respectively for groups 1 and 2. Patients were overweight in 9 cases for group 1 (30% of cases) and 12 cases in group 2 (38%), 7% of cases). Hepatic colic was the main sign of appeal in all patients in both groups. In group 1; 26 out of 30 cases or 86.7% of cases had leukocytosis, whereas in group 2, leukocytosis was normal in 30 cases, ie 96.8% of cases. Accessibility of the vesicle was difficult in 73.3% of cases in group 1 against 22.6% of cases in group 2. The vesicle was distended and necrotic in groups 1 in 76.7% and 10 respectively. % of cases. On the other hand, in 25.8% of cases, the vesicle was distended and without any necrosis in group 2. The rate of conversion to laparotomy was 6.55% (4 cases) and exclusively concerned group 1. Operative follow-up immediate outcomes were simple in 98.34% of cases. The complications involved 2 patients in group 1 (1.66% of the total), including parietal suppuration and biliary leakage. Mean operative time was 68.7 min in group 1 versus 41.6 min in group 2. Mean duration of hospitalization was 4.3 days with extremes between 2 and 10 days in group 1 versus1,7 days with extremes ranging from 1 to 7 days in group 2. Mortality was zero. Conclusion: In recent years, laparoscopic surgery has made remarkable progress in Niger. Laparoscopic cholecystectomy seems to be more difficult to perform with significant morbidity in the case of CAL than LVS. The risk of per and postoperative complications can be estimated from the clinical data (acute cholecystitis or symptomatic vesicular lithiasis) and the surgeon's experience. In a cholecystectomy that lasts more than 2 hours, the cumulative risk of complications is highe

Prise En Charge Des Anévrismes Artériels Dans Un Centre Africain Non Spécialisée

Introduction: Arterial aneurysms affect 7 to 8% of people over 65 in the West and are the 2nd leading cause of death in these countries. In Africa this frequency is poorly evaluated. The objective of this work is to report the management of arterial aneurysms at the National Hospital of Niamey (HNN). Patients and methods: This was a retrospective, descriptive study over a period of eight (8) years from January 2009 to December 2016, performed in the surgical departments of the National Hospital of Niamey. Included in the study were patients of both sexes, hospitalized and / or operated for arterial aneurysm. Not included were patients treated for arterial aneurysm with incomplete records or those concerning the neurosurgical sphere. Results: During the study period, 17,748 patients were hospitalized in the general surgery departments, including 16 patients for arterial aneurysm, or 0.09% of surgical pathologies. There were 13 men (81.25%) and 3 women (18.75%), or a sex ratio of 4.33. The average age was 55.75 years with extremes ranging from 25 years old to 90 years old. The circumstances of discovery of the aneurysms were swelling of the antero-internal aspect of the thigh in 7 cases (43.75%), abdominal mass 6 cases (37.50%), then 2 cases (12.50%) of chest pain and incidental discovery in 1cas (6.25%). The most common risk factor was high blood pressure with 43.75% (7 cases). The aneurysm sat on the femoral artery in 43.75% (n = 7), of which 6 on the deep femoral and 1 on the superficial femoral, on the infrarenal aorta in 31.25% (n = 5), on thoracic aorta 12.50% (n = 2), on the iliac artery 12.50% (n = 2). For the diagnosis the angioscanner is realized in all the patients and in addition Doppler ultrasound in 43, 75% of cases. Twelve (12) patients benefited from curative surgical intervention by prosthetic graft by PTFE in 58.33% of cases and by Dacron in 41.66%. The average stay was 29.75 days and the immediate operative followup was complicated by thrombosis in 12.5% and parietal suppurations in 6.25%. We recorded two (2) deaths, ie 12.5% among non-operated patients. Conclusion: Arterial aneurysms are rare diseases at the HNN. Conventional surgery is the treatment performed in our patients. The postoperative course was simple in most cases

Teaching one health: Animal husbandry in a post-graduate interdisciplinary curriculum

peer reviewe

West African Cattle Farmers’ Perception of Tick-Borne Diseases

Worldwide, cattle production is struggling to face the negative impacts caused by ticks and Rhipicephalus (Boophilus) microplus is one of the most harmful ticks for livestock. Most of the people in West Africa depend on cattle farming and subsistence agriculture. The presence of ticks on cattle is a major problem faced by smallholder farmers who fight for their livelihood. National and regional tick control programs could assist these rural communities in protecting their livelihoods against ticks and tick-borne diseases, but only if they take into account the targeted herders and their perception on cattle management and tick control. This paper aims to provide a better insight in the socio-economic characteristics of Beninese cattle farmers, and their perception on tick burden, as well as to document common tick control strategies. Different tick species and their seasonality are well understood by cattle herders. For tick control, many still use manual tick removal, especially in the north of the country. The high cost of acaricides, the lack of financial means of African farmers, and of the local stockbreeders in particular, limits the use of acaricides in livestock breeding in Benin. While aiming to increase the meat or milk production of their animals, stockbreeders who can afford it sometimes turn to an abusive use of acaricides, which might in time lead to an increase in tick resistance. This study remains one of the rare studies to report extensively on the perceptions of West African cattle herders