Characterization of socio-land management modes of lowland areas in the Kyon municipality (Burkina Faso)

Context and background The mastery and control of rural areas remain a challenge for both landowners and the Burkinabe State. The major agricultural production basins, particularly areas with high exploitation of lowlands, experience permanent changes in production actors and land management strategies. This leads to the establishment of a multitude of access and exploitation rules aimed at better controlling all production chains. Therefore, what are the set of rules and principles that govern the exploitation of lowland in the study area? What are the changes in the management principles that govern the exploitation of lowland in the study area? What are the explanatory factors for this observed dynamic?Goal and Objectives:The main objective of this study is to analyze the different modes of social and land management of wetland landscapes in Kyon municipality (Burkina Faso).Methodology:The study is based on both quantitative and qualitative research methodologies. A total of 378 producers were surveyed using individual questionnaires. In addition, individual interviews were conducted with landowners and resource persons, as well as group interviews with some solidarity groups of producersResults:The results show an overall diversity and dynamics of management modes of lowland areas in the commune of Kyon. These exploitation sites are now the framework for a proliferation between management rules inspired by social values, and land and environmental management principles. This management mutation is mainly explained by the diversity of production actors in these submerged areas

Characterization of socio-land management modes of lowland areas in the Kyon municipality (Burkina Faso)

Context and background  The mastery and control of rural areas remain a challenge for both landowners and the Burkinabe State. The major agricultural production basins, particularly areas with high exploitation of lowlands, experience permanent changes in production actors and land management strategies. This leads to the establishment of a multitude of access and exploitation rules aimed at better controlling all production chains. Therefore, what are the set of rules and principles that govern the exploitation of lowland in the study area? What are the changes in the management principles that govern the exploitation of lowland in the study area? What are the explanatory factors for this observed dynamic? Goal and Objectives: The main objective of this study is to analyze the different modes of social and land management of wetland landscapes in Kyon municipality (Burkina Faso). Methodology: The study is based on both quantitative and qualitative research methodologies. A total of 378 producers were surveyed using individual questionnaires. In addition, individual interviews were conducted with landowners and resource persons, as well as group interviews with some solidarity groups of producers Results: The results show an overall diversity and dynamics of management modes of lowland areas in the commune of Kyon. These exploitation sites are now the framework for a proliferation between management rules inspired by social values, and land and environmental management principles. This management mutation is mainly explained by the diversity of production actors in these submerged areas

A randomised trial in Mali of the effectiveness of weekly iron supplements given by teachers on the haemoglobin concentrations of schoolchildren

Objective: To assess the effect on the haemoglobin concentrations of schoolchildren of weekly iron tablets administered by teachers. Design: Sixty schools were randomly assigned to two groups: in 30 schools children were given weekly for 10 weeks a tablet providing 65 mg of iron and 0.25 mg of folic acid; in the other 30 schools no iron tablets were given. All children were dewormed and given vitamin A before the study began. The haemoglobin concentration of up to 20 randomly selected children in each school was estimated before and 2 weeks after the end of treatment. Setting: Rural community schools in Kolondieba district of Mali. Subjects: Some 1113 schoolchildren aged 6-19 years with a mean of 11.4 years. Results: The haemoglobin concentration of treated children rose on average by 1.8 g l -1 (P < 0.001) and the prevalence of anaemia fell by 8.2% (P < 0.001); in untreated children the haemoglobin concentration fell by an average of 22.7 g l -1 (P < 0.001) and the prevalence of anaemia rose by 9.4% (P < 0:001). The fall in haemoglobin concentration among untreated girls of 24.0 g l21 was greater than in untreated boys (20.3 g l -1 (P < 0.001). Conclusions: Weekly iron tablets given by teachers prevented a general fall in the haemoglobin concentrations of untreated children, and led to a small but statistically significant rise among treated children (P < 0.001). Young children benefited more than children aged </=12 years, and girls benefited more than boys

Epilepsie du sujet âgé : expérience du service de Neurologie du CHU Gabriel Touré de Bamako, Mali

Background: Epilepsy is a common condition in the elderly, although it is poorly documented in our context. This work aims at determine the epidemiological and clinical characteristics of epilepsy in elderly people. Patients and Methods: This was a prospective study over a period of one year in the Department of Neurology of Gabriel Toure Teaching Hospital (CHU) in Mali. Were eligible, all subjects aged 50 years or older that had at least two documented seizures, recorded and reported by the patient or his family. For the diagnosis of the seizure, we used validated form of Limoges Institute. Results: During the study period, 1753 patients were admitted to the neurology department of CHU Gabriel Touré, 39 cases of epilepsy in the elderly have been diagnosed, i.e. 2.2% of patients in the department. The average age was 63 years, ranging from 50 to 84 years. Partial seizures were the most represented with 43.6% of cases. Symptomatic epilepsy was found in 82.1% of patients, 18% of patients had no definite etiology. The causes were dominated by vascular epilepsyin 25 cases (64.1%). Treatment was started in all patients with a success after 6 months. Sodium valproate was the most prescribed as first-line therapy 51.3% (20 patients), followed by carbamazepine (41%). Conclusion: This prospective study of epilepsy in the elderly confirms the high prevalence of this  disease in this age group. With the multiple illnesses in the elderly, this condition will require a multidisciplinary management.Introduction : La prévalence élevée de l’épilepsie chez le sujet âgé est bien documentée. L’épilepsie chez la personne âgée reste très peu rapportée dans notre contexte. Ce travail a pour objectif de déterminer les caractéristiques épidémiologiques et cliniques de cette pathologie chez le sujet âgé. Patients et Méthodes : Il s’agissait d’une étude prospective réalisée sur une période d’un an dans le service de Neurologie du Centre Hospitalier Universitaire (CHU) Gabriel Touré au Mali. Ont été éligibles, tous les sujets âgés de 50 ans ou plus qui ont présenté au moins deux crises épileptiques documentées, constatées et rapportées par le patient et /ou son entourage. Pour le diagnostic de la crise, nous avons utilisé le questionnaire validé de L’Institut de Neurologie et Epidémiologie Tropicale de Limoges. Résultats : Durant la période d’étude, 1753 patients ont été admis dans le service de Neurologie du CHU Gabriel Touré ; 39 cas d’épilepsie du sujet âgé ont été diagnostiqués, soit 2,2% des malades dans le service. L’âge moyen était de 63 ans avec des extrêmes de 50 à 84 ans. Les crises partielles étaient les plus représentées, soit 69,2% des cas. Une épilepsie symptomatique a été retrouvée chez 82,1% des patients ; 18% des patients n’avaient pas d’étiologie bien déterminée. Les étiologies étaient dominées par les causes vasculaires, soit 64,1% (25) des cas. Un traitement a été mis en route chez tous nos patients avec un succès après 6 mois. Le Valproate de sodium (VPA) a été la molécule la plus prescrite en première intention soit 51,3% (20) des patients, suivi de la Carbamazépine (41%). Conclusion : Au vu de la poly pathologie, l’épilepsie du sujet âgé nécessite une prise en charge pluridisciplinaire

Facteurs liés à l’instabilité des professionnels de soins au poste au Mali

The health human resources crisis in Mali is characterized by the growing instability of health personnel in post. This represents a significant obstacle to the achievement of the objectives of sustainable development and universal health coverage. Training remains a motivating factor for health workers and is a means of improving or maintaining the quality of services. However, it has an influence on the availability of human resources. The objective of this study was to identify the relationship between the instability of healthcare professionals in the post and their participation in in-service training programs leading to a qualification. A cross-sectional, descriptive, mixed-methods study was conducted in various health facilities in Mali. The target population consisted of current healthcare professionals and department managers. Data were collected using questionnaires and semi-structured interviews. In terms of results: 68% of agents completed their training between 2016-2017 compared to 32% in 2013-2015. For the employment structure, most agents surveyed (54%) work in CSRefs. The analysis of the data revealed irregularities and shortcomings in the implementation of continuing education.  These shortcomings are linked to the planning, organization, and management of training. While in-service training leading to a qualification is a motivating factor, it contributes to the instability and inadequacy of the staff in post in Mali.La crise des ressources humaines en santé au Mali est marquée par une instabilité croissante du personnel de santé au poste. Elle constitue un obstacle majeur à l’atteinte des objectifs de développement durable et la couverture santé universelle. La formation continue reste un facteur de motivation du personnel et un moyen d’amélioration ou de maintien de la qualité des services. Mais elle semble à une influence sur la disponibilité des ressource humaines. Le but de l’étude est de mettre en exergue les liens entre l’instabilité des professionnels de soins au poste et les départs en formation continue diplômante. Nous avons mené une étude transversale, descriptive mixte dans différentes structures de santé du Mali. La population cible est composée des professionnels de santé en poste et les responsables de service. La collecte de données a été faite à travers des questionnaires et des entretiens semi structurés. Au niveau des résultats : 68% des agents ont terminé leur formation entre 2016-2017 contre 32% de 2013-2015. Pour la structure d’emplois, la majorité des agents enquêtés (54%) travaillent dans les CSRef. L’analyse des données recueillies met en évidence des irrégularités et insuffisances dans la mise en formation continue.  Ces insuffisances sont liées à la0 planification, organisation et la gestion de la formation. La formation continue diplômante, bien que facteur de motivation, contribue à l’instabilité et insuffisance du personnel au poste au Mali

Facteurs liés à l’instabilité des professionnels de soins au poste au Mali

The health human resources crisis in Mali is characterized by the growing instability of health personnel in post. This represents a significant obstacle to the achievement of the objectives of sustainable development and universal health coverage. Training remains a motivating factor for health workers and is a means of improving or maintaining the quality of services. However, it has an influence on the availability of human resources. The objective of this study was to identify the relationship between the instability of healthcare professionals in the post and their participation in in-service training programs leading to a qualification. A cross-sectional, descriptive, mixed-methods study was conducted in various health facilities in Mali. The target population consisted of current healthcare professionals and department managers. Data were collected using questionnaires and semi-structured interviews. In terms of results: 68% of agents completed their training between 2016-2017 compared to 32% in 2013-2015. For the employment structure, most agents surveyed (54%) work in CSRefs. The analysis of the data revealed irregularities and shortcomings in the implementation of continuing education.  These shortcomings are linked to the planning, organization, and management of training. While in-service training leading to a qualification is a motivating factor, it contributes to the instability and inadequacy of the staff in post in Mali.La crise des ressources humaines en santé au Mali est marquée par une instabilité croissante du personnel de santé au poste. Elle constitue un obstacle majeur à l’atteinte des objectifs de développement durable et la couverture santé universelle. La formation continue reste un facteur de motivation du personnel et un moyen d’amélioration ou de maintien de la qualité des services. Mais elle semble à une influence sur la disponibilité des ressource humaines. Le but de l’étude est de mettre en exergue les liens entre l’instabilité des professionnels de soins au poste et les départs en formation continue diplômante. Nous avons mené une étude transversale, descriptive mixte dans différentes structures de santé du Mali. La population cible est composée des professionnels de santé en poste et les responsables de service. La collecte de données a été faite à travers des questionnaires et des entretiens semi structurés. Au niveau des résultats : 68% des agents ont terminé leur formation entre 2016-2017 contre 32% de 2013-2015. Pour la structure d’emplois, la majorité des agents enquêtés (54%) travaillent dans les CSRef. L’analyse des données recueillies met en évidence des irrégularités et insuffisances dans la mise en formation continue.  Ces insuffisances sont liées à la0 planification, organisation et la gestion de la formation. La formation continue diplômante, bien que facteur de motivation, contribue à l’instabilité et insuffisance du personnel au poste au Mali

Effects of amodiaquine and artesunate on sulphadoxine-pyrimethamine pharmacokinetic parameters in children under five in Mali

<p>Abstract</p> <p>Background</p> <p>Sulphadoxine-pyrimethamine, in combination with artesunate or amodiaquine, is recommended for the treatment of uncomplicated malaria and is being evaluated for intermittent preventive treatment. Yet, limited data is available on pharmacokinetic interactions between these drugs.</p> <p>Methods</p> <p>In a randomized controlled trial, children aged 6-59 months with uncomplicated <it>falciparum </it>malaria, received either one dose of sulphadoxine-pyrimethamine alone (SP), one dose of SP plus three daily doses of amodiaquine (SP+AQ) or one dose of SP plus 3 daily doses of artesunate (SP+AS). Exactly 100 μl of capillary blood was collected onto filter paper before drug administration at day 0 and at days 1, 3, 7, 14, 21 and 28 after drug administration for analysis of sulphadoxine and pyrimethamine pharmacokinetic parameters.</p> <p>Results</p> <p>Fourty, 38 and 31 patients in the SP, SP+AQ and SP+AS arms, respectively were included in this study. The concentrations on day 7 (that are associated with therapeutic efficacy) were similar between the SP, SP+AQ and SP+AS treatment arms for sulphadoxine (median [IQR] 35.25 [27.38-41.70], 34.95 [28.60-40.85] and 33.40 [24.63-44.05] μg/mL) and for pyrimethamine (56.75 [46.40-92.95], 58.75 [43.60-98.60] and 59.60 [42.45-86.63] ng/mL). There were statistically significant differences between the pyrimethamine volumes of distribution (4.65 [3.93-6.40], 4.00 [3.03-5.43] and 5.60 [4.40-7.20] L/kg; <it>p = 0.001</it>) and thus elimination half-life (3.26 [2.74 -3.82], 2.78 [2.24-3.65] and 4.02 [3.05-4.85] days; <it>p < 0.001</it>). This study confirmed the lower SP concentrations previously reported for young children when compared with adult malaria patients.</p> <p>Conclusion</p> <p>Despite slight differences in pyrimethamine volumes of distribution and elimination half-life, these data show similar exposure to SP over the critical initial seven days of treatment and support the current use of SP in combination with either AQ or AS for uncomplicated <it>falciparum </it>malaria treatment in young Malian children.</p

La cryptococcose neuro-méningée au Mali

Cryptococcal meningitis is the most common fatal central nervous system infection in AIDS patients in Sub-Saharan Africa. The purpose of this prospective study conducted from March 2003 to February 2004 in the internal medicine and infectious diseases departments of the Point G University Hospital Center was to investigate the clinical, prognostic and epidemiological profile of Cryptococcus neoformans infection in patients hospitalized for brain and meningeale infection (BMI). Diagnosis of neuromeningeal cryptococcosis (NMC) was based on positive identification of Cryptococcus by direct exam of the cebrospinal fluid (CSF) after India ink staining and/or culture on Sabouraud medium without actidione. During the study period, a total of 569 patients were hospitalized including 235 (41.3%) with HIV infection. Overall C. neoformans was identified in 14 patients. Median patient age was 39 ± 8 years. There was a male preponderance with a sex ratio of 1.8 (9 men/5 women). Patients with BMI were HIV positive in 85.7% of cases (n=12) and HIV-negative in 14.3% (n=2). The overall and HIV-specific prevalence of BMI was 2.5% and 5.1% respectively. The CD4 lymphocyte count was between 1 and 49 cells/mm3 in 64.3% of cases. The main clinical symptoms were cephalea in 85.7% of cases, altered consciousness in 50% and nausea/vomiting in 35.7%. Neurological manifestations (hemiparesis and cranial nerve deficit) were noted in 14.3%. HIV infection is the main purveyor of NMC in Mali. The actual incidence of cryptococcosis is unclear due to the poor sensitivity of diagnostic techniques. This study highlights diagnostic difficulties related to clinical polymorphism and poor technical facilities. Agglutination testing of blood and CSF is recommended, but mortality remains