Fractures of the proximal femur in the elderly in a sub-Saharan country

Background: The aim of this study was to describe the epidemiological, radiographic and therapeutic profile of the fractures of the proximal femur in the elderly in a sub-Saharan country.Methods: A retrospective longitudinal study was carried out at the orthopedic trauma department of Idrissa Pouye Hospital in Senegal. Sixty-six patients recruited were aged at least 90 years; and treated for proximal femur fracture between 2008 and 2017.Results: The median age of the patients was 91 years (90-107). Females represented 54.5%. The fracture was located in the right 65.2%. Femoral neck fractures were 53% predominant with 94.3% type IV according to Garden’s classification. Concerning the 31 patients with a pertrochanteric fractures, 61.3% were stable and 38.7% unstable. The time taken for seeking hospital care was an average of 5.8±9.7 days. All patients had a preoperative anesthesic score less than 4 according to the American society of anesthesiologists (ASA). The therapeutic indication was functional in 15.1% of cases, surgical by internal fixation in 39.2% and by arthroplasty in 45.7% of cases. Pertrochanteric fractures were managed by a dynamic hip screw (DHS) in 68.2% and by gamma nail in 18.2%. Femoral neck fractures were managed by Moore's arthroplasty in 93.3% and by bipolar hip prothesis (BHP) in 6.7%.Conclusions: Fractures of the proximal femur represent a growing problem in sub-Saharan Africa. For patients above 90 years, the management remains essentially surgical by internal fixation in pertrochanteric fractures or by arthroplasty in cervical fractures

Soil Fertility Management and Compost Use in Senegal‘s Peanut Basin

The Jó ó r (Dior) soils of Senegal's Peanut Basin are inherently low in organic matter, limiting yields of millet and other crops and threatening the food security of smallholders. Focus groups and interviews were conducted in eight villages to characterise the site-specific fertility management by farmers in the Peanut Basin. Results of the qualitative survey revealed that farmers base management decisions on a series of fertility indicators that include type, colour, and texture of soil, presence of vegetation, and productivity in previous years. In an effort to equalise fertility across the field, farmers amend areas they classify as less fertile with decomposed manure and household waste from the family sëntaare (traditional pile) or with compost from managed piles. On-site measurements of soil in areas of fields amended with compost or sëntaare material revealed significant increases in peanut and millet growth over unamended areas, but little difference between the effects of compost and manure. Similarly, chemical analysis revealed increased effective cation exchange capacity (ECEC) and nutrient concentrations (K, Mg and Al) in soils amended with compost or manure. Similarities in the chemical characteristics of compost and sëntaare material suggest that development workers could emphasise improved pile management rather than promoting more labour-intensive composting

Measuring Morbidity Associated with Urinary Schistosomiasis: Assessing Levels of Excreted Urine Albumin and Urinary Tract Pathologies

Urinary schistosomiasis is a debilitating disease caused by a parasitic worm that dwells in the blood vessels, particularly those surrounding the human bladder wall. Although not directly associated with high patient mortality, this disease is linked to both short-term morbidity, e.g. visible blood in urine (acute), as well as long-term sequelae, e.g. urinary tract pathologies (chronic). Numerous control programmes based upon chemotherapy have been implemented in sub-Saharan Africa in an attempt to reduce the burden of disease inflicted, particularly in children. Although there are rapid tests to assess the prevalence of acute manifestations of disease (i.e. blood in urine), namely urine-reagent strips, monitoring of chronic manifestations (i.e. urinary tract pathologies) is still rather laborious, time-consuming and requires specialised equipment, e.g. portable ultrasonography, as well as highly trained staff. This study has attempted to evaluate associations between albuminuria (albumin in urine, a new application for the HemoCue photometer) and urinary tract pathologies, and consequently assess this new biochemical marker as a potential rapid proxy of chronic disease sequelae typical in children in areas where urinary schistosomiasis is of public health importance

Placental malaria and low birth weight in pregnant women living in a rural area of Burkina Faso following the use of three preventive treatment regimens

<p>Abstract</p> <p>Background</p> <p>The weekly chemoprophylaxis of malaria during pregnancy with chloroquine (CQ) has become problematic with the increasing resistance of <it>Plasmodium falciparum </it>to this drug. There was a need to test the benefits of new strategies over the classical chemoprophylaxis. This study was conducted to provide data to the National Malarial Control Programme for an evidence-based policy change decision making process. It compares the efficacy of two IPT regimens, using chloroquine (CQ) or sulphadoxine/pyrimethamine (SP), with the classical chemoprophylaxis regimen using CQ in reducing the adverse outcomes of malaria infection, for the mother and the foetus.</p> <p>Methods</p> <p>Pregnant women attending the first antenatal care visit were randomly assigned to one of the three treatment regimens. They were subsequently followed up till delivery. Maternal, placental and cord blood samples were obtained upon delivery to check for <it>P. falciparum </it>infection.</p> <p>Results</p> <p>A total of 648 pregnant women were enrolled in the study. Delivery outcome were available for 423 of them. Peripheral maternal <it>P. falciparum </it>infection at delivery was found in 25.8% of the women. The proportion of women with maternal infection was significantly lower in the IPTp/SP group than in the CQ group (P << 0.000). The prevalence of placental malaria was 18.8% in the CWC/CQ group; 15.9% in the IPTp/CQ group and 10.6% in the IPTp/SP group. The incidence of LBW (weigth < 2,500 g) was significantly higher among infants of mothers in the CWC/CQ group (23.9%) as compared with those of mothers in the IPTp/CQ (15.6%) and IPTp/SP (11.6%) groups (p = 0.02)</p> <p>Conclusion</p> <p>Intermittent preventive treatment with SP has shown clear superiority in reducing adverse outcomes at delivery, as compared with intermittent preventive treatment with CQ and classical chemoprophylaxis with CQ.</p

Transplacental Transmission of Plasmodium falciparum in a Highly Malaria Endemic Area of Burkina Faso

Malaria congenital infection constitutes a major risk in malaria endemic areas. In this study, we report the prevalence of transplacental malaria in Burkina Faso. In labour and delivery units, thick and thin blood films were made from maternal, placental, and umbilical cord blood to determine malaria infection. A total of 1,309 mother/baby pairs were recruited. Eighteen cord blood samples (1.4%) contained malaria parasites (Plasmodium falciparum). Out of the 369 (28.2%) women with peripheral positive parasitemia, 211 (57.2%) had placental malaria and 14 (3.8%) had malaria parasites in their umbilical cord blood. The umbilical cord parasitemia levels were statistically associated with the presence of maternal peripheral parasitemia (OR = 9.24, P ≪ 0.001), placental parasitemia (OR = 10.74, P ≪ 0.001), high-density peripheral parasitemia (OR = 9.62, P ≪ 0.001), and high-density placental parasitemia (OR = 4.91, P = 0.03). In Burkina Faso, the mother-to-child transmission rate of malaria appears to be low

Phylogeography of Rift Valley Fever Virus in Africa Reveals Multiple Introductions in Senegal and Mauritania

Rift Valley Fever (RVF) virus (Family Bunyaviridae) is an arthropod-borne RNA virus that infects primarily domestic ruminants and occasionally humans. RVF epizootics are characterized by numerous abortions and mortality among young animals. In humans, the illness is usually characterized by a mild self-limited febrile illness, which could progress to more serious complications. RVF virus is widespread and endemic in many regions of Africa. In Western Africa, several outbreaks have been reported since 1987 when the first major one occurred at the frontier of Senegal and Mauritania. Aiming to evaluate the spreading and molecular epidemiology in these countries, RVFV isolates from 1944 to 2008 obtained from 18 localities in Senegal and Mauritania and 15 other countries were investigated. Our results suggest that a more intense viral activity possibly took place during the last century compared to the recent past and that at least 5 introductions of RVFV took place in Senegal and Mauritania from distant African regions. Moreover, Barkedji in Senegal was possibly a hub associated with the three distinct entries of RVFV in West Africa