L’apport de l’imagerie dans le diagnostic de la tuberculose uro-génitale (TUG): Une analyse de 4 observations et revue de la littérature

La tuberculose uro-génitale (TUG) est une localisation secondaire de la maladie. Son diagnostic est bactériologique, mais la probabilité de mettre en évidence le bacille de Koch (BK) dans les urines est faible. D’où le concours de l’imagerie dans le diagnostic et la mise en route du traitement médical. Nous rapportons 4 observations de patients atteints de TUG, dont les images radiologiques associées aux contextes clinique et épidémiologique ont fait évoquer une tuberculose urinaire et génitale. Dans un cas seulement l’uroculture s’est révélée positive au BK. Chez les trois autres patients où la culture urinaire a été négative, les résultats anatomopathologiques des pièces opératoires ont été en faveur d’une lésion tuberculeuse. D’où l’intérêt de la radiologie dans le diagnostic précoce et la prise en charge de la TUG.Mots clés : Tuberculose uro-génitale, bacille de Koch, imageri

Epidemiological and Pathological Aspects of Cervical Cancer in Ivory Coast

Abstract: Cervical cancer is the most common and the leading cause of women death in developing countries. Purpose: To specify the epidemiological and pathological characteristics of cervical cancers in Ivory Coast. Material and methods: This was a retrospective and descriptive study on the cervical cancers histologically confirmed and identified from the registers for recording laboratory of pathological anatomy of Abidjan teaching hospital. The study period was 24 years (January 1984 to December 2007). The parameters analyzed were: frequency, age, sociodemographic status, macroscopic and histological aspects and the prognosis. Results: The cervical cancer represented 78.78% (2064 cases) of gynecological cancers, 42.71% of woman cancer and 17.41% of all cancers. The average age was 48.36 years ranging from 2 to 88 years and a peak incidence between 45-54 years (29%). Multiparity was observed 57.04% (n = 231) and the low socioeconomic level was predominant (70.41%). Concerning pathological examination, the tumor lesions were predominantly budding (51.52%). Squamous cell carcinomas (92.88%) were the most frequent of histological types with 95.1% (n = 1823) of invasive carcinomas. The average age of patients with squamous cell carcinoma was 49 years with 41.5 years for intraepithelial carcinomas and 46.8 years for invasive carcinomas. At the prognosis, squamous cell carcinomas were diagnosed most often in stage pT2 (57.41%) and with extra-cervical represented 66.4% (n = 519). Conclusion: Cervical cancer is the most common cancer in Ivory Coast taking into account male and female together. Its poor prognosis associated with late diagnosis should encourage the establishment of a cytology screening program

Development of Monitoring and Evaluation Systems in Four National Programs Addressing Mother and Child Health in Cote d’Ivoire: Qualitative Analysis of the Emergence and Formulation Process

Esme Marie Laure Essis,1– 3 Wambi Maurice Evariste Yaméogo,4 Olivier Gbènamblo Sossa,5 Daouda Doukouré,1,2 Rachidatou Compaoré,4,6 Djoukou Olga Denise Kpebo,1,2,7 Marie Laurette Agbré-Yacé,1,2 Joseph Aka,1,7 Issiaka Tiembré,7,8 Blaise Sondo,4 Seni Kouanda4,6 1National Institute of Public Health, Abidjan, Cote d’Ivoire; 2Reproductive Health Research Unit of Cote d’Ivoire, Abidjan, Cote d’Ivoire; 3Doctoral School in Science, Health, and Technology, Saint Thomas Aquinas University, Ouagadougou, Burkina Faso; 4African Institute of Public Health, Saint Thomas Aquinas University, Saaba, Burkina Faso; 5Department of Economics and Management, Thomas Sankara University, Ouagadougou, Burkina Faso; 6Research Institute of Health Sciences, Ouagadougou, Burkina Faso; 7Department of Public Health, Felix Houphouët Boigny University, Abidjan, Cote d’Ivoire; 8National Institute of Public Hygiene, Abidjan, Cote d’IvoireCorrespondence: Esme Marie Laure Essis, National Institute of Public Health, Abidjan, BP V 47, Cote d’Ivoire, Tel +225 07 07 88 72 13, Fax +225 20 22 44 02, Email [email protected]: Monitoring and evaluation were introduced into the management of national health programs to ensure that results were attained, and that donors’ funds were used transparently. This study aims to describe the process of the emergence and formulation of monitoring and evaluation (M&E) systems in national programs addressing maternal and child health in Cote d’Ivoire.Methods: We conducted a multilevel case study combining a qualitative investigation and a literature review. This study took place in the city of Abidjan, where in-depth interviews were conducted with twenty-four (24) former officials who served at the central level of the health system and with six (06) employees from the technical and financial partners’ agencies. A total of 31 interviews were conducted from January 10 to April 20, 2020. Data analysis was conducted according to the Kingdon conceptual framework modified by Lemieux and adapted by Ridde.Results: The introduction of M&E in national health programs was due to the will of the technical and financial partners and the political and technical decision-makers at the central level of the national health system, who were concerned with accountability and convincing results in these programs. However, its formulation through a top-down approach was sketchy and lacked content to guide its implementation and future evaluation in the absence of national expertise in M&E.Conclusion: The emergence of M&E systems in national health programs was originally endogenous and exogenous but strongly recommended by donors. Its formulation in the context of limited national expertise was marked by the absence of standards and guidelines that could codify the development of robust M&E systems.Keywords: monitoring and evaluation, emergence, formulation, health program, Africa, Cote d’Ivoir