Le régime coutumier à l’épreuve des juridictions maliennes : quelle protection des droits réels de tenure foncière ?

International audienc

Complications macro-angiopathiques du diabete a l’hopital du Mali de Bamako

Introduction-objectif: Le diabète est un facteur de risque cardiovasculaire (FRCV) majeur, responsable de complications cardiovasculaires dont la  prise en charge est complexe. L’objectif de l’étude est d’évaluer les  complications macro-angiopathiques du diabète.Patients et Méthodes: Etude transversale, descriptive et analytique de 18 mois, concernant les patients diabétiques (type 1 avec 5 ans d’évolution et type 2).Résultats: Nous avons colligé 275 patients diabétiques. L’âge moyen de nos patients était de 59 ans. Le sex ratio était de 0,82. Le diabète était de type 2 chez 93,09% des patients. La durée moyenne d’évolution du diabète était de 6 ans. L’HbA1c était supérieure à 7% chez 51,64% des patients. 77,46% avaient au minimum 2 FRCV associés au diabète. La dyslipidémie était le FRCV le plus fréquent associé au diabète (51,27%). Quatre-vingt-trois (83) patients sur 275 avaient au moins une  macroangiopathie (fréquence hospitalière de 30,18%). L’artériopathie oblitérante des membres inférieurs (AOMI) était présente chez 49 patients, l’accident vasculaire cérébral (AVC) chez 28 patients et la coronaropathie chez 17 patients. Nous avons noté un lien statistiquement significatif entre durée d’évolution du diabète, et deux complications macro-angiopathiques (AOMI p:0,001 et AVC p:0,05). Le mauvais équilibre glycémique et le nombre de FRCV étaient corrélés aux complications macroangiopathiques (AOMI, AVC, coronaropathie) de façon significative avec p<0,05.Conclusion: Le diabète est une maladie métabolique responsable de complications macro-angiopathiques. Sa prise en charge précoce ainsi qu’une correction des autres FRCV permettent d’éviter ou de ralentir ces complications.Mots clés : Diabète, Macro-angiopathies, Hôpital Du Mali.  Macrovascular complications of diabetes at the hôpital du Mali of Bamako Introduction-Aim: Diabete is a major risk cardiovascular factor (FRCV). It is a chronic disease responsible of cardiovascular complications with a complex management. The objective of the study is to evaluate the macrovascular complications of diabetes.Patients and methods: It is a cross-sectional, descriptive and analytical study of 18 months, concerning diabetic patients (type 1 with 5 years of evolution and type 2).Results: We collected 275 diabetics patients. Mean age of our patients was 59 years. Sex ratio was 0.82. Diabetes was type 2 in 93.09%. Mean duration of diabetes was 6 years. HBA1C was greater than 7% in 51.64%. 77.46% had at least 2 cardiovascular risk factors associated with diabetes. Dyslipidemia was the most common cardiovascular risk factors associated with diabetes (51.27%). 83 of 275 patients had at least one macrovascular complication (hospital frequency of 30.18%). Peripheral artery disease (PAD) was present in 49 patients, stroke in 28 patients, and coronary artery disease in 17 patients. We noted a statistically significant link between the duration of diabetes, and two macrovascular complications (PAD p: 0.001 and stroke p: 0.05). The poor glycemic balance and number of  cardiovascular risk factors were correlated with macrovascular complications (AOMI, stroke, coronary artery disease) significantly with p < 0.05.Conclusion: Diabetes is a metabolic disease responsible of macrovascular complications. Early care and correction of other cardiovascular risk factors can prevent or slow these complications.Keywords: Diabetes, Macrovascular complications, Hôpital Du Mal

Sahel, savana, riverine and urban malaria in West Africa: Similar control policies with different outcomes.

The study sites for the West African ICEMR are in three countries (The Gambia, Senegal, Mali) and are located within 750 km of each other. In addition, the National Malaria Control Programmes of these countries have virtually identical policies: (1) Artemisinin Combination Therapies (ACTs) for the treatment of symptomatic Plasmodium falciparum infection, (2) Long-Lasting Insecticide-treated bed Nets (LLINs) to reduce the Entomololgic Inoculation Rate (EIR), and (3) sulfadoxine-pyrimethamine for the Intermittent Preventive Treatment of malaria during pregnancy (IPTp). However, the prevalence of P. falciparum malaria and the status of malaria control vary markedly across the four sites with differences in the duration of the transmission season (from 4-5 to 10-11 months), the intensity of transmission (with EIRs from unmeasurably low to 4-5 per person per month), multiplicity of infection (from a mean of 1.0 to means of 2-5) and the status of malaria control (from areas which have virtually no control to areas that are at the threshold of malaria elimination). The most important priority is the need to obtain comparable data on the population-based prevalence, incidence and transmission of malaria before new candidate interventions or combinations of interventions are introduced for malaria control