Epidémiologie des cancers digestifs en milieu hospitalier à Bamako

Les cancers digestifs sont de plus en plus constatés dans nos régions, probablement du fait de la disponibilité plus importante des moyens diagnostiques. Le but principal de notre travail était d’étudier l’épidémiologie de ces affections dans les services d’hépato-gastro-entérologie et de chirurgie générale du CHU Gabriel Touré. Il s’agissait d’une étude transversale portant sur les patients hospitalisés de février à juin 2007 puis de février à juin 2008. Nous avons retrouvé 115 cancers digestifs sur 1 547 patients hospitalisés, soit une fréquence de 7,4 %. Le sex ratio était de 1,5 en faveur des hommes et l’âge moyen des patients était de 56,6 ± 2,4 ans. Les cancers de l’estomac et le CHC étaient plus fréquents avec respectivement : 59,1 % et 19,1 % des cas. Les femmes au foyer et les cultivateurs (couches socio-économiques défavorisées) étaient plus fréquemment atteints, avec respectivement 34,8 % et 33 % des cas. La salaison, la fumaison, la consommation de tabac, de tô (pâte cuite de céréale) avec potasse ont été les facteurs de risque les plus retrouvés dans respectivement 74,8 %, 80,9 %, 33,9 % et 99,1 % des cas. Les cancers digestifs constituent un véritable problème de santé publique.Digestive cancers are increasingly found in our regions, probably due to the greater availability of diagnosis facilities. The main goal of our work was to study the epidemiological aspects of these diseases in the hepatology and gastro intestinal tract unit and in the general surgery unit in the University hospital Gabriel Touré. It was a cross-sectional study about in-patient from February to June 2007 and from February to June 2008. We found 115 gastro-intestinal tract cancers among 1 547 in-patients (7.4%). The sex-ratio was 1.5 for men and the patient’s mean age was 56.6 ± 2.4 years. Gastric cancers and hepatocellular carcinoma were more frequent with 59.1% and 19.1% of the cases. Housewives and farmers (low incomes group) were more frequently affected with respectively 34.8% and 33% of the cases. Salt intake, smoking, chewing tobacco, tô (cereal dough with potash) consumption were the strongest risk factor found respectively in 74.8%, 80.9%, and 99.1% of the cases. Digestive cancer is thus a major public health concern

Active Trachoma among Children in Mali: Clustering and Environmental Risk Factors

Active trachoma is not uniformly distributed in endemic areas, and local environmental factors influencing its prevalence are not yet adequately understood. Determining whether clustering is a consistent phenomenon may help predict likely modes of transmission and help to determine the appropriate level at which to target control interventions. In this work, we estimated the magnitude of clustering at different levels and investigated the influence of socio-economic factors and environmental features on active trachoma prevalence among children in Mali (1996–1997 nationwide survey). Clustering revealed significant results at the child, caretaker, household, and village levels. Moreover, beyond some well-established individual risk factors (age between 3 and 5, dirty face, and flies on the face), we found that temperature, sunshine fraction, and presence of rainy days were negatively associated with active trachoma prevalence. This study clearly indicates the importance of directing control efforts both at children with active trachoma as well as those with close contact, and at communities. These results support facial cleanliness and environmental improvements as population-health initiatives to combat blinding trachoma